复宏汉霖-B(02696.HK):HLX02与原研曲妥珠单抗在HER2阳性转移性乳腺癌患者上的疗效、安全性和药代动力学相当
格隆汇 9 月 17日丨复宏汉霖-B(02696.HK)宣布,今日,公司自主开发的HLX02注射用曲妥珠单抗(中国境内商品名:汉曲优;欧盟商品名:Zercepac®)("HLX02")的最新临床研究数据以电子海报形式于2020年欧洲肿瘤内科学会("ESMO")大会线上平台发布,该等临床研究数据亦将于近期召开的2020年第十二届欧洲乳腺癌大会("EBCC")上发表。
一项比较曲妥珠单抗生物类似药候选药HLX02与曲妥珠单抗在转移性乳腺癌中的疗效、安全性及药代动力学特性的全球3期临床试验
(A) 试验设计
在多中心、随机、双盲、平行对照的 3 期 临 床 试 验( 临 床 试 验 号 :NCT03084237;欧洲临床试验号:2016-000206-10)HLX02-BC01中,未经系统治疗的HER2阳性复发或转移性乳腺癌患者按1:1随机分为两组,分别接受每三周一次,最长一年的HLX02或欧盟市售曲妥珠单抗联合多西他赛治疗。本试验主要疗效终点为8个治疗周期后即24周的总缓解率(ORRwk24)。群体药代动力学(PopPK)数据(HLX02组:356例;原研曲妥珠单抗组:398例;血清样本5,882份)来源於HLX02-BC01试验和HLX02-HV01(临床试验号:NCT02581748)试验,采用非线性混合效应模型(NONMEM?)中考虑到交互作用的一级拟合方法(FOCEI)进行建立。为评估药代动力学(PK)与药效学(PD)的相关性,重要协变量(如人口统计、病理生理╱疾病状况等)被纳入模型分析。基於筛选后的协变量,我们进行了1000次模拟检验。
(B) 试验结果
1) 有效性
a) 主要终点
本试验入组了649例病患(HLX02,N=324;EU-TZB,N=325)。在意向性分析集中,HLX02组的ORRwk24为71.3%,原研组为71.4%,组间差异为-0.1%(95%置信区间:-7.0%,6.9%)。在符合方案集中,HLX02组的ORRwk24为74.2%,原研组为73.2%,组间差异为1%(95%置信区间:-6.0%,7.9%)。ORRwk24组间差异在预设等效区间内(±13.5%)。此外,亚组(亚洲vs.非亚洲,中国vs.非中国)分析显示,HLX02组与原研组ORRwk24在不同人群中无统计学差异(p>0.05),验证了HLX02与原研曲妥珠单抗的疗效相似性。
b) 次要终点
两治疗组的次要疗效终点如临床获益率(CBR)、疾病控制率(DCR)、缓解持续时间(DoR)、无进展生存期(PFS)、总生存期(OS)等,均无统计学差异(p>0.05)。
2) 安全性
HLX02和原研曲妥珠单抗安全性(包括药物相关的心脏疾病的发生率)相似。
3) 群体药代动力学
此PopPK模型为具有一级消除速率的二室模型。结果显示,HLX02与不同来源曲妥珠单抗的稳态暴露量没有显着差异(AUCss和Cmax,ss差别均小於等於13%)。协变量(例如体重)对於HLX02与不同来源曲妥珠单抗的药代动力学暴露量的影响也具有相似性。
(C) 结论
3期临床试验及PopPK模型结果显示,HLX02与原研曲妥珠单抗在HER2阳性转移性乳腺癌患者上的疗效、安全性和药代动力学相当。HLX02作为首个获批的中国制造的曲妥珠单抗生物类似药,将为全球患者提供替代治疗的选择。
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