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Prediction of non-linear pharmacokinetics in humans of an antibody-drug conjugate (ADC) when evaluation of higher doses in animals is limited by tolerability: Case study with an anti-CD33 ADC

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Pages 738-750 | Received 18 Jan 2018, Accepted 09 Apr 2018, Published online: 18 May 2018

Figures & data

Figure 1. CD33 expression levels in monkey and human cells measured by flow cytometry. Data corresponding to human and monkey cells are shown in full and half-full circles, respectively. Horizontal bars show mean measured values.

Figure 1. CD33 expression levels in monkey and human cells measured by flow cytometry. Data corresponding to human and monkey cells are shown in full and half-full circles, respectively. Horizontal bars show mean measured values.

Table 1. Binding affinities of anti-CD33 mAb to human and cynomolgus monkey CD33 positive cells.

Figure 2. Characterization of anti-CD33 mAb binding to stable 293 HEK cells overexpressing recombinant human (red) and cynomolgus monkey (black) CD33. Incubations performed on ice for 30 min followed by detection with a goat-anti-human IgG-PE secondary reagent. Approximate EC50 for human and monkey are 0.60 µg/ml and 0.35 µg/ml, respectively.

Figure 2. Characterization of anti-CD33 mAb binding to stable 293 HEK cells overexpressing recombinant human (red) and cynomolgus monkey (black) CD33. Incubations performed on ice for 30 min followed by detection with a goat-anti-human IgG-PE secondary reagent. Approximate EC50 for human and monkey are 0.60 µg/ml and 0.35 µg/ml, respectively.

Table 2. Mean and standard deviation (SD) non-compartmental plasma PK parameters following administration of a 0.5 and 15 mg/kg IV bolus of anti-CD33 mAb to cynomolgus monkeys.

Figure 3. (a) Anti-CD33 mAb serum concentration following administration of a 0.5 mg/kg (in green) and 15 mg/kg (in blue) IV bolus of anti-CD33 mAb to cynomolgus monkeys. Symbols and bars represent mean and standard deviation, n = 3 unless indicated otherwise; missing values were below of the LLOQ of the assay (7.8 ng/mL). Solid lines correspond model fitted serum TAB curve using both PK and RO data sets. (b) Receptor availability/occupancy in granulocytes and monocytes following administration of a 0.5 mg/kg (in green) and 15 mg/kg (in blue) IV bolus of anti-CD33 mAb to cynomolgus monkeys. Symbols and bars represent mean and standard deviation (n = 3). Solid lines correspond fitted RO curve using both PK and RO data sets.

Figure 3. (a) Anti-CD33 mAb serum concentration following administration of a 0.5 mg/kg (in green) and 15 mg/kg (in blue) IV bolus of anti-CD33 mAb to cynomolgus monkeys. Symbols and bars represent mean and standard deviation, n = 3 unless indicated otherwise; missing values were below of the LLOQ of the assay (7.8 ng/mL). Solid lines correspond model fitted serum TAB curve using both PK and RO data sets. (b) Receptor availability/occupancy in granulocytes and monocytes following administration of a 0.5 mg/kg (in green) and 15 mg/kg (in blue) IV bolus of anti-CD33 mAb to cynomolgus monkeys. Symbols and bars represent mean and standard deviation (n = 3). Solid lines correspond fitted RO curve using both PK and RO data sets.

Figure 4. (a) Predicted and measured concentrations of TAB after administration of 0.1 mg/kg (n = 4), 0.2 mg/kg (n = 4), 0.4 mg/kg (n = 1) and 1 mg/kg (n = 1) of anti-CD33 ADC in toxicology study in cynomolgus monkey (LLOQ = 1 µg/mL). (b) Corresponding model predicted receptor availability/occupancy for the same study.

Figure 4. (a) Predicted and measured concentrations of TAB after administration of 0.1 mg/kg (n = 4), 0.2 mg/kg (n = 4), 0.4 mg/kg (n = 1) and 1 mg/kg (n = 1) of anti-CD33 ADC in toxicology study in cynomolgus monkey (LLOQ = 1 µg/mL). (b) Corresponding model predicted receptor availability/occupancy for the same study.

Table 3. Model parameters for the presented PK-RO model. The model was fitted to cynomolgus monkey data using both PK and RO data sets. Scaled-up parameters used for prediction for humans are also shown.

Table 4. Predicted human AUC0-t using the estimated parameters as well as the 5th and 95th percentile of the simulated distribution for doses of 0.25, 2.4 and 21 µg/kg. The maximum concentration (Cmax) and the predicted values of RO at Cmax are also reported.

Figure 5. (a) Predicted levels of receptor availability using the PK-RO model for lintuzumab for a range of Vmax values. Symbols and error bars correspond to the standard deviations as reported in Ref. Citation54. (b) Comparison of predicted clearance values a function of dose when the target capacity in humans is 1-fold (solid line), 3-fold (dashed line) and 10-fold (dotted line) the observed value of Vmax in cynomolgus monkey; symbols represent clinical data using AVE9633Citation 59 and GO.Citation 57 , Citation 58

Figure 5. (a) Predicted levels of receptor availability using the PK-RO model for lintuzumab for a range of Vmax values. Symbols and error bars correspond to the standard deviations as reported in Ref. Citation54. (b) Comparison of predicted clearance values a function of dose when the target capacity in humans is 1-fold (solid line), 3-fold (dashed line) and 10-fold (dotted line) the observed value of Vmax in cynomolgus monkey; symbols represent clinical data using AVE9633Citation 59 and GO.Citation 57 , Citation 58

Figure 6. Model scheme used to describe PK-RO relationship in cynomolgus monkey and humans. The model consists of two compartments: central and peripheral. Drug concentrations are noted by C1 and C2 in the central and peripheral compartment, respectively. From the central compartment there are two main elimination mechanisms: non-specific (accounted by a CL term) and target mediated (represented by Vmax and KM). Receptor occupancy is related to concentrations by the Michaelis-Menten constant, KM.

Figure 6. Model scheme used to describe PK-RO relationship in cynomolgus monkey and humans. The model consists of two compartments: central and peripheral. Drug concentrations are noted by C1 and C2 in the central and peripheral compartment, respectively. From the central compartment there are two main elimination mechanisms: non-specific (accounted by a CL term) and target mediated (represented by Vmax and KM). Receptor occupancy is related to concentrations by the Michaelis-Menten constant, KM.
Supplemental material

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