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Phase I Evaluation of CDP791, a PEGylated Di-Fab' Conjugate that Binds Vascular Endothelial Growth Factor Receptor 2

Authors' Affiliations: ¹ Cancer Research UK and University of Manchester Department of Medical Oncology, Christie Hospital, Withington, ² Imaging Science and Biomedical Engineering, Stopford Building, University of Manchester, Oxford Road, and ³ Department of Radiology, Christie Hospital, Withington, Manchester, United Kingdom; and ⁴ UCB Celltech, Bath Road, Slough, United Kingdom

Requests for reprints: Gordon Jayson, Cancer Research UK and University of Manchester Department of Medical Oncology, Christie Hospital, Withington, Manchester M20 4BX, United Kingdom. Phone: 44-161-446-3606; Fax: 44-161-446-8565; E-mail: Gordon.Jayson{at}christie.nhs.uk.

Purpose: Specific blocking of vascular endothelial growth factor receptor 2 (VEGFR-2) is a novel therapeutic approach. Here, we report the first phase I clinical trial evaluation of CDP791, a PEGylated di-Fab' conjugate that binds VEGFR-2.

Experimental Design: Cohorts of patients received CDP791 at doses between 0.3 and 30 mg/kg every 3 weeks for the initial two doses.

Results: The compound was well tolerated with no dose-limiting toxicity. Dose-related hypertension was observed in patients receiving CDP791 10 mg/kg or more and several patients on the higher doses developed infusion-related cutaneous hemangiomata arising 28 to 106 days after the first drug administration and resolving 3 weeks after cessation. Biopsy and histologic evaluation showed that CDP791-bound VEGFR-2 is non-phosphorylated, suggesting that the drug is biologically active. Concentrations of CDP791 considered biologically relevant were sustained for 3 weeks when doses of 10 mg/kg or more were administered. Although no reductions in vascular permeability were recorded using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), there was a significant dose level–related reduction in tumor growth. While challenging the recent dogma that active VEGF inhibitors should modulate DCE-MRI measurements of vascular permeability, this highlights the potential of serial three-dimensional tumor measurements to detect tumor growth arrest. Twelve patients received drug for more than two treatments, although no partial or complete responses were seen.

Conclusion: The data show that CDP791 is biologically active and well tolerated, achieving appropriate plasma concentrations when administered at 10 mg/kg or more every 3 weeks.

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