A QSP Model for Predicting Clinical Responses to Monotherapy, Combination and Sequential Therapy Following CTLA-4, PD-1, and PD-L1 Checkpoint Blockade

被引:62
|
作者
Milberg, Oleg [1 ]
Gong, Chang [1 ]
Jafarnejad, Mohammad [1 ]
Bartelink, Imke H. [2 ,5 ]
Wang, Bing [2 ]
Vicini, Paolo [3 ]
Narwal, Rajesh [4 ]
Roskos, Lorin [4 ]
Popel, Aleksander S. [1 ,6 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Biomed Engn, Baltimore, MD 21205 USA
[2] MedImmune, Clin Pharmacol Pharmacometr & DMPK CPD, San Francisco, CA USA
[3] MedImmune, Clin Pharmacol Pharmacometr & DMPK, Cambridge, England
[4] MedImmune, Gaithersburg, MD USA
[5] Vrije Univ Amsterdam, Amsterdam UMC, Dept Clin Pharmacol & Pharm, Amsterdam, Netherlands
[6] Johns Hopkins Univ, Sch Med, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD USA
关键词
T-CELL-ACTIVATION; DENDRITIC CELLS; CANCER-IMMUNOTHERAPY; IMMUNE-RESPONSE; REGULATORY T; LYMPH-NODES; IPILIMUMAB; SAFETY; CHEMOTHERAPY; EXPRESSION;
D O I
10.1038/s41598-019-47802-4
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Over the past decade, several immunotherapies have been approved for the treatment of melanoma. The most prominent of these are the immune checkpoint inhibitors, which are antibodies that block the inhibitory effects on the immune system by checkpoint receptors, such as CTLA-4, PD-1 and PD-L1. Preclinically, blocking these receptors has led to increased activation and proliferation of effector cells following stimulation and antigen recognition, and subsequently, more effective elimination of cancer cells. Translation from preclinical to clinical outcomes in solid tumors has shown the existence of a wide diversity of individual patient responses, linked to several patient-specific parameters. We developed a quantitative systems pharmacology (QSP) model that looks at the mentioned checkpoint blockade therapies administered as mono-, combo- and sequential therapies, to show how different combinations of specific patient parameters defined within physiological ranges distinguish different types of virtual patient responders to these therapies for melanoma. Further validation by fitting and subsequent simulations of virtual clinical trials mimicking actual patient trials demonstrated that the model can capture a wide variety of tumor dynamics that are observed in the clinic and can predict median clinical responses. Our aim here is to present a QSP model for combination immunotherapy specific to melanoma.
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页数:17
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