据报道,在服用 Veoza 的女性中,肝酶丙氨酸氨基转移酶 (ALT) 和/或天冬氨酸氨基转移酶 (AST) 严重升高(>正常上限的 10 倍),同时胆红素和/或碱性磷酸酶 (ALP) 也升高。在某些情况下,肝功能测试 (LFT) 升高与提示肝损伤的体征或症状有关,例如疲劳、瘙痒、黄疸、尿液呈深色、食欲不振或腹痛。
在没有治疗的患者中,客观反应率(“ ORR”)为62.1%,疾病控制率(“ DCR”)为92.0%,中位反应持续时间为12.5个月,如一个独立审查委员会评估。中值无进展生存期(“ PFS”)为13.7个月,中间生存期(“ OS”)未达到20.8个月的中位随访。在先前治疗的患者中,ORR为39.2%,DCR为92.4%,中位数为11.1个月,如独立审查委员会的评估。中位PFS为11.0个月,中位OS不成熟,中位随访时间为12.5个月。反应发生在未接受治疗和先前治疗的患者中的早期(应答1.4-1.6个月)。安全性是可以忍受的,没有观察到新的安全信号。The most common drug-related treatment-emergent adverse events of Grade 3 or above (5% or more of patients) were abnormal hepatic function (16.9%), increased alanine aminotransferase (14.5%), increased aspartate aminotransferase (12.0%), peripheral oedema (6.0%) and increased gamma-glutamyltransferase (6.0%).
1L一线2L二线ADA抗药物抗体吸收,分布,新陈代谢,消除AE不良事件ALT ALT丙氨酸氨基转移酶Aspartate aspartate氨基转移酶API API API活性药物活性药物ATC ATC解剖学化学化学分类系统AUCAUD AUCMATION AUCMATIITS AUCMATIITS AUCMATIITS AUCMATION AUCMATION AUCMATIITS AUCMATIITS AUCMATINE AUCMATION AUC AUCMATION AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AR A A AR缩减为4 curve for the 24-hour dosing interval CI Confidence interval C max Maximum observed plasma/serum concentration of drug CYP Cytochrome P450 DDI Drug-drug interaction DOR Duration of response ECOG Eastern Cooperative Oncology Group EMA European Medicines Agency ERA Environmental risk assessment FDA Food and Drug Administration (USA) GLP Good Laboratory Practice HPLC High-performance liquid chromatography IC/EC 50 Half-maximal抑制/有效集中IC国际协调IG IG免疫球蛋白Inn国际非专有名称ITT意向性对处理的LOQ LOQ列表MAH营销授权持有人最大最小最小最小最小最小MRHD最低MRHD最大最大剂量MTD最大耐受剂量N/A不适用NCCN国有综合癌症网络无适用的稳定性(a)nocessigent and consection no nocessightion nocessightion nocessigent of Arvestion Providest of ARSEVER IDEVER(A)生存效果(A) pharmacokinetics PD Pharmacodynamics PFS Progression-free survival PIP Paediatric Investigation Plan (EMA) PK Pharmacokinetics PopPK Population pharmacokinetics PSP Pediatric study plan (US FDA) RMP Risk management plan SAE Serious adverse event SwissPAR Swiss Public Assessment Report TEAE Treatment-emergent adverse event TPA Federal Act of 15 December 2000 on Medicinal Products and Medical Devices (SR 812.21)2018年9月21日的TPO条例(SR 812.212.21)
1L一线2L二线ADA抗药物抗体吸收,分布,新陈代谢,消除AE不良事件ALT ALT丙氨酸氨基转移酶Aspartate aspartate氨基转移酶API API API活性药物活性药物ATC ATC解剖学化学化学分类系统AUCAUD AUCMATION AUCMATIITS AUCMATIITS AUCMATIITS AUCMATION AUCMATION AUCMATIITS AUCMATIITS AUCMATINE AUCMATION AUC AUCMATION AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AR A A AR缩减为4 curve for the 24-hour dosing interval CI Confidence interval C max Maximum observed plasma/serum concentration of drug CYP Cytochrome P450 DDI Drug-drug interaction DOR Duration of response ECOG Eastern Cooperative Oncology Group EMA European Medicines Agency ERA Environmental risk assessment FDA Food and Drug Administration (USA) GLP Good Laboratory Practice HPLC High-performance liquid chromatography IC/EC 50 Half-maximal inhibitory/effective concentration ICH International Council for Harmonisation Ig Immunoglobulin INN International non-proprietary name ITT Intention-to-treat LoQ List of Questions MAH Marketing Authorisation Holder Max Maximum Min Minimum MRHD Maximum recommended human dose MTD Maximum tolerated dose N/A Not applicable NCCN National Comprehensive Cancer Network NO(A)EL No observed (adverse) effect level ORR Objective response rate OS Overall survival PBPK Physiology-based pharmacokinetics PD Pharmacodynamics PFS Progression-free survival PIP Paediatric Investigation Plan (EMA) PK Pharmacokinetics PopPK Population pharmacokinetics PSP Pediatric study plan (US FDA) RMP Risk management plan SAE Serious adverse event SwissPAR Swiss Public Assessment Report TEAE Treatment-emergent adverse event TPA Federal Act of 15 December 2000 on Medicinal Products and Medical Devices (SR 812.21)2018年9月21日的TPO条例(SR 812.212.21)
1L一线2L二线ADA抗药物抗体吸收,分布,新陈代谢,消除AE不良事件ALT ALT丙氨酸氨基转移酶Aspartate aspartate氨基转移酶API API API活性药物活性药物ATC ATC解剖学化学化学分类系统AUCAUD AUCMATION AUCMATIITS AUCMATIITS AUCMATIITS AUCMATION AUCMATION AUCMATIITS AUCMATIITS AUCMATINE AUCMATION AUC AUCMATION AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AUC AR AR A A AR缩减为4 curve for the 24-hour dosing interval CI Confidence interval C max Maximum observed plasma/serum concentration of drug CYP Cytochrome P450 DDI Drug-drug interaction DOR Duration of response ECOG Eastern Cooperative Oncology Group EMA European Medicines Agency ERA Environmental risk assessment FDA Food and Drug Administration (USA) GLP Good Laboratory Practice HPLC High-performance liquid chromatography IC/EC 50 Half-maximal抑制/有效集中IC国际协调IG IG免疫球蛋白Inn国际非专有名称ITT意向性对处理的LOQ LOQ列表MAH营销授权持有人最大最小最小最小最小最小MRHD最低MRHD最大最大剂量MTD最大耐受剂量N/A不适用NCCN国有综合癌症网络无适用的稳定性(a)nocessigent and consection no nocessightion nocessightion nocessigent of Arvestion Providest of ARSEVER IDEVER(A)生存效果(A) pharmacokinetics PD Pharmacodynamics PFS Progression-free survival PIP Paediatric Investigation Plan (EMA) PK Pharmacokinetics PopPK Population pharmacokinetics PSP Pediatric study plan (US FDA) RMP Risk management plan SAE Serious adverse event SwissPAR Swiss Public Assessment Report TEAE Treatment-emergent adverse event TPA Federal Act of 15 December 2000 on Medicinal Products and Medical Devices (SR 812.21)2018年9月21日的TPO条例(SR 812.212.21)
Pyrexia 5 (5.1) 95 (96.9) Hypoproteinemia 2 (2.0) 81 (82.7) Occult blood positive 0 75 (76.5) Hypoalbuminemia 0 73 (74.5) Alanine aminotransferase increased 9 (9.2) 67 (68.4) Activated partial thromboplastin time prolonged 0 64 (65.3) Bilirubin conjugated increased 22 (22.4) 62 (63.3) Aspartate aminotransferase increased 8 (8.2) 61 (62.2) Hyponatremia 5 (5.1) 61 (62.2) Sinus tachycardia 2 (2.0) 54 (55.1) Hypokalemia 12 (12.2) 52 (53.1) Hypotension 1 (1.0) 49 (50.0) Prothrombin time prolonged 0 48(49.0) Blood bilirubin increased 14 (14.3) 47 (48.0) Blood glucose increased 0 45 (45.9) Proteinuria 0 44 (44.9) Weight decreased 4 (4.1) 43 (43.9) Lipase increased 5 (5.1) 33 (33.7) Temperature intolerance 0 32 (32.7) Hypophagia 0 31 (31.6)皮疹3(3.1)29(29.6)水肿周围0 25(25.5)血纤维蛋白原降低4(4.1)25(25.5)
1个单向方差分析; 2 Kruskal-Wallis测试;平均值 - 算术平均值; SD - 标准偏差; Q1-Q3 - 四分之一; BMI - 体重指数,WBC - 白细胞;中性粒细胞; RBC-红细胞; HBG - 血红蛋白; HCT - 血细胞比容; MCV - 平均肺泡体积; MCH - 平均白细胞血红蛋白; MCHC - 平均红细胞血红蛋白浓度; RDW - 红细胞分布宽度; PLT - 血小板计数; Alt - 丙氨酸转氨酶; AST - 天冬氨酸转氨酶; bil - 胆红素;创造 - 肌酐;
缩写:AST,天冬氨酸转氨酶;AUROC,受试者工作特征曲线下面积;BMI,身体质量指数;CK-18,细胞角蛋白-18;FAST,Fibroscan-AST;FIB-4,纤维化-4指数;GBM,梯度增强机;HOMA,稳态模型评估;MASH,代谢功能障碍相关脂肪性肝炎;MAST,MRI-AST;MEFIB,MRE 联合 FIB-4;MRE,磁共振弹性成像;MRI,磁共振成像;NASH,非酒精性脂肪性肝炎;VCTE,振动控制瞬时弹性成像。
AAV adeno-associated virus AAV5 adeno-associated virus serotype 5 AAVRh74var adeno-associated virus serotype Rh74var ABR annualized bleeding rate AE adverse event ALT alanine aminotransferase AST aspartate aminotransferase BEQVEZ fidanacogene elaparvovec BLA biologics license application BMI body mass index CAG chicken beta ‐ actin CDRH Center for Devices and Radiological Health CI confidence interval CMC chemistry, manufacturing, and controls CSA chromogenic assay EEP efficacy evaluation period FIX clotting factor IX FIX:C circulating levels of FIX LTFU long-term follow-up nAb neutralizing antibody NI non-inferiority OSA one-stage assay PI package insert PMC postmarketing commitment PMR售后需求Pro患者报告的结果REMS风险评估和缓解策略RP常规预防SAE SAE严重不良事件SD标准偏差teae teae exter-everermergerement Extress Eversem forverse Everse uln USPI USPI USPI USPI美国处方信息VG矢量基因组的上限
K-Ras 是人类癌症中最常见的突变致癌基因,但直到最近,直接针对 K-Ras 突变体的小分子靶向治疗大多未取得成功。在 Switch-II 下发现具有共价半胱氨酸交联分子的变构口袋,这为开发靶向疗法提供了可能,这种疗法可以选择性地与 K-Ras(G12C) 突变中反应性极强的获得性半胱氨酸结合,而不会影响野生型蛋白质。Sotorasib 和 adagrasib 是两种先进的 Switch-II Pocket 抑制剂,已获得 FDA 批准用于治疗 K-Ras(G12C) 驱动的非小细胞肺癌。然而,最常见的 K-Ras 突变 G12D(尤其常见于胰腺导管腺癌)由于体细胞天冬氨酸残基的亲核性较差,因此共价药物无法靶向该突变。这里我们介绍了一组基于马来酸内酯的亲电试剂,它们利用环张力将 K-Ras(G12D) 与突变天冬氨酸交联,形成稳定的共价复合物。通过 X 射线晶体学的结构洞察和对亲电试剂攻击的立体电子要求的利用,开发出了一种取代的马来酸内酯,它能抵抗水性缓冲液的攻击,但能与 GDP 和 GTP 状态下的 K-Ras 的天冬氨酸-12 迅速交联。信号传导能力强的 GTP 状态靶向可以有效抑制下游信号传导和携带 K-Ras(G12D) 突变的癌细胞的增殖,以及小鼠细胞系衍生异种移植瘤的肿瘤生长。我们的研究结果表明,共价抑制剂的设计合理,可以靶向 K-Ras(G12D) 中非催化羧酸侧链,而这种侧链一直受到传统药物发现工作的阻碍。