Abstract

PurposeBevacizumab is a recombinant humanized monoclonal antibody that inhibits vascular endothelial growth factor-specific angiogenesis in some cancers. MYL-1402O is a proposed bevacizumab biosimilar.MethodsThe primary objective of this single-center, randomized, double-blind, three-arm, parallel-group, phase 1 study in healthy male volunteers was to evaluate bioequivalence of MYL-1402O to EU and US-reference bevacizumab, and EU-reference bevacizumab to US-reference bevacizumab. The primary pharmacokinetic parameter was area under the serum concentration–time curve from 0 extrapolated to infinity (AUC0–∞). Pharmacokinetic parameters were analyzed using general linear models of analysis of variance. Secondary endpoints included safety and tolerability.ResultsOf 111 enrolled subjects, 110 were included in the pharmacokinetic analysis (MYL-1402O, n = 37; EU-reference bevacizumab, n = 36; US-reference bevacizumab, n = 37). Bioequivalence was demonstrated between MYL-1402O and EU-reference bevacizumab, MYL-1402O and US-reference bevacizumab, and between EU- and US-reference bevacizumab where least squares mean ratios of AUC0–∞ were close to 1, and 90% CIs were within the equivalence range (0.80–1.25). Secondary pharmacokinetic parameters (AUC from 0 to time of last quantifiable concentration [AUC0–t], peak serum concentration [Cmax], time to Cmax, elimination rate constant, and elimination half-life) were also comparable, with 90% CIs for ratios of AUC0–t and Cmax within 80–125%. Treatment-emergent adverse events were similar across all three treatment groups and were consistent with clinical data for bevacizumab.ConclusionMYL-1402O was well tolerated and demonstrated pharmacokinetic and safety profiles similar to EU-reference bevacizumab and US-reference bevacizumab in healthy male volunteers. No new significant safety issues emerged (ClinicalTrials.gov, NCT02469987; ClinicalTrialsRegister.eu EudraCT, 2014-005621-12; June 12, 2015).

Highlights

  • The growth of blood vessels, a process known as angiogenesis, is essential for organ growth and repair (Carmeliet 2009; Folkman 2002)

  • Vascular endothelial growth factor-mediated angiogenesis is involved in invasive tumor growth and metastasis in cancers including nonsquamous non-small cell lung cancer (Han et al 2001), colorectal cancer (André et al 2000), breast cancer (Kurebayashi et al 1999), cervical cancer (Hashimoto et al 2001), and ovarian cancer (Nishida et al 2004)

  • In the United States and Europe, bevacizumab is approved in combination for the treatment of metastatic colorectal cancer; metastatic or recurrent nonsquamous non-small cell lung cancer; metastatic or recurrent cervical cancer; recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer; and metastatic renal cell cancer (Avastin 2019; Roche Pharma AG 2020)

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Summary

Introduction

The growth of blood vessels, a process known as angiogenesis, is essential for organ growth and repair (Carmeliet 2009; Folkman 2002). Vascular endothelial growth factor (VEGF) is a small signaling molecule that stimulates angiogenesis (Carmeliet 2009). Vascular endothelial growth factor-mediated angiogenesis is involved in invasive tumor growth and metastasis in cancers including nonsquamous non-small cell lung cancer (Han et al 2001), colorectal cancer (André et al 2000), breast cancer (Kurebayashi et al 1999), cervical cancer (Hashimoto et al 2001), and ovarian cancer (Nishida et al 2004). In the United States and Europe, bevacizumab is approved in combination for the treatment of metastatic colorectal cancer; metastatic or recurrent nonsquamous non-small cell lung cancer; metastatic or recurrent cervical cancer; recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer; and metastatic renal cell cancer (Avastin 2019; Roche Pharma AG 2020). A metaanalysis performed on data from 38 clinical trials in bevacizumab-treated patients with solid tumors demonstrated a significant overall survival benefit compared with the control group (hazard ratio [HR] 0.92; 95% CI 0.88–0.95; P < 0.0001) in addition to a significant improvement in overall survival in colorectal cancer, cervical/uterine cancer, non-small cell lung cancer, and renal cancer (Roviello et al 2017)

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