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Phase I Clinical Trial of the Chimeric Monoclonal Antibody (c30.6) in Patients with Metastatic Colorectal Cancer¹

Cooperative Research Centre for Biopharmaceutical Research Ltd., Darlinghurst 2010, New South Wales [R. L. W., D. P., A. M. S., P. A-S., N. K., R. M., P. P., G. M. S.]; Departments of Medical Oncology [R. L. W., M. R., D. D.], Nuclear Medicine [K. P., J. S.], Colorectal Surgery [A. M.], and Radiology [G. B-W.], St. Vincent’s Hospital, Darlinghurst 2010, New South Wales; Schools of Biotechnology [N. K., P. P., P. G., G. M. S.] and Pathology [R. L. W., N. J. H.], University of New South Wales, Sydney 2052, New South Wales; and Department of Nuclear Medicine [M. F.], Royal Prince Alfred Hospital, Sydney 2050, New South Wales, Australia

The murine antibody 30.6 recognizes an antigen that is expressed on a high proportion of colorectal carcinomas and their metastases. We report the results of single-dose escalation studies of the chimeric 30.6 (c30.6) monoclonal antibody in metastatic colorectal cancer, to evaluate its safety, pharmacokinetics, and biodistribution.

Recombinant c30.6 (IgG1) antibody was secreted from Chinese hamster ovary cells and purified by a multistep chromatography process. Seventeen patients with metastatic colorectal cancer were enrolled in this dose escalation study. The first four patients were treated with 3 mg of ¹²³I-labeled c30.6, whereas the next 13 received a single dose of unlabeled antibody (maximum dose, 50 mg/m²).

The most frequent side effect was a novel syndrome of severe burning and erythema of the face, chest, neck, ears, palms, soles, and genitalia. The frequency of this syndrome was markedly reduced in those patients premedicated with high doses of histamine receptor 1 and histamine receptor 2 blockers. Other side effects were mild and predictable. Biodistribution studies showed a rapid and intensive hepatic uptake. At the 50 mg/m² level the half-life and maximum serum concentration were 81 ± 15 h and 7.9 µg/ml, respectively. One patient developed a low-level human anti-c30.6 response. Tumor response was assessed by computed tomography, positron emission tomography scanning, and serial carcinoembryonic antigen measurements. There were no partial responses, although positron emission tomography scanning demonstrated some reduction in tumor activity in three individuals.

The chimerized c30.6 antibody is not immunogenic in humans and appears worthy of further study. It does, however, produce a unique profile of side effects that can be well controlled with premedication.