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      HLX11, a Proposed Pertuzumab Biosimilar: Pharmacokinetics, Immunogenicity, and Safety Profiles Compared to Three Reference Biologic Products (US-, EU-, and CN-Approved Pertuzumab) Administered to Healthy Male Subjects

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          Abstract

          Background

          Pertuzumab is a humanized monoclonal antibody for the treatment of breast cancer. HLX11 is a biosimilar of pertuzumab developed by Shanghai Henlius Biotech, Inc. We conducted a bioequivalence study for HLX11 and pertuzumab (United States [US]-, European Union [EU]-, and China [CN]-approved products).

          Objectives

          This study compared the biosimilarity in pharmacokinetics (PK), safety, and immunogenicity between HLX11 and reference pertuzumab (approved in the US, the EU, and CN) in healthy Chinese male participants after a single infusion and further characterized the PK profile of HLX11.

          Methods

          Eligible individuals were randomized 1:1:1:1 to receive a single dose of 420 mg HLX11, US-, EU-, or CN-pertuzumab via intravenous infusion over 60 min. The primary endpoints were maximum serum drug concentration ( C max), area under the serum concentration–time curve (AUC) from time 0 to time of the last quantifiable concentration (AUC 0– t ), and AUC from time 0 to infinity (AUC 0–∞). PK bioequivalence was established if the 90% confidence intervals (CIs) of the geometric mean ratios of the primary endpoints were between 80.0 and 125.0%. Secondary endpoints included other PK parameters, safety, and immunogenicity.

          Results

          A total of 160 participants were enrolled and randomly assigned to each group ( n = 40 per group). The 90% CIs of the geometric mean ratios of the primary endpoints were all within the prespecified equivalence margins (HLX11 vs. pertuzumab [US-, EU-, CN-approved products]: C max 97.03–115.06%, 91.39–109.80%, 94.53–110.65%; AUC 0– t 87.65–99.68%, 87.07–100.79%, 86.29–101.09%; AUC 0–∞ 87.66–99.90%, 87.54–101.05%, 89.23–103.20%). The incidence of adverse drug reactions was comparable across the four groups. The presence of anti-drug antibodies or neutralizing antibodies had no obvious effect on PK.

          Conclusion

          The PK, safety, and immunogenicity of HLX11 were highly similar to those of reference pertuzumab (US-, EU-, CN-approved products). The established bioequivalence supports further clinical trials of HLX11 in cancer treatment.

          Trial Registration

          This study was registered with ClinicalTrials.gov (NCT04411550) and Chinadrugtrials.org.cn (CTR20200618).

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s40259-022-00534-w.

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          Most cited references22

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          Breast cancer

          Breast cancer is still the most common cancer worldwide. But the way breast cancer is viewed has changed drastically since its molecular hallmarks were extensively characterised, now including immunohistochemical markers (eg, ER, PR, HER2 [ERBB2], and proliferation marker protein Ki-67 [MKI67]), genomic markers (eg, BRCA1, BRCA2, and PIK3CA), and immunomarkers (eg, tumour-infiltrating lymphocytes and PD-L1). New biomarker combinations are the basis for increasingly complex diagnostic algorithms. Neoadjuvant combination therapy, often including targeted agents, is a standard of care (especially in HER2-positive and triple-negative breast cancer), and the basis for de-escalation of surgery in the breast and axilla and for risk-adapted post-neoadjuvant strategies. Radiotherapy remains an important cornerstone of breast cancer therapy, but de-escalation schemes have become the standard of care. ER-positive tumours are treated with 5-10 years of endocrine therapy and chemotherapy, based on an individual risk assessment. For metastatic breast cancer, standard therapy options include targeted approaches such as CDK4 and CDK6 inhibitors, PI3K inhibitors, PARP inhibitors, and anti-PD-L1 immunotherapy, depending on tumour type and molecular profile. This range of treatment options reflects the complexity of breast cancer therapy today.
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            Durvalumab with olaparib and paclitaxel for high-risk HER2-negative stage II/III breast cancer: Results from the adaptively randomized I-SPY2 trial

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              Global challenges and policy solutions in breast cancer control

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                Author and article information

                Contributors
                fflahykdx@163.com
                huwei@ahmu.edu.cn
                Journal
                BioDrugs
                BioDrugs
                Biodrugs
                Springer International Publishing (Cham )
                1173-8804
                1179-190X
                20 May 2022
                20 May 2022
                2022
                : 36
                : 3
                : 393-409
                Affiliations
                [1 ]GRID grid.452696.a, ISNI 0000 0004 7533 3408, Department of Clinical Pharmacology, , The Second Hospital of Anhui Medical University, ; Hefei, Anhui People’s Republic of China
                [2 ]Anhui Provincial Institute of Translational Medicine, Hefei, Anhui People’s Republic of China
                [3 ]GRID grid.452696.a, ISNI 0000 0004 7533 3408, Department of Oncology, , The Second Hospital of Anhui Medical University, ; Hefei, Anhui People’s Republic of China
                [4 ]Shanghai Henlius Biotech, Inc., Shanghai, People’s Republic of China
                Author information
                http://orcid.org/0000-0002-3106-3798
                Article
                534
                10.1007/s40259-022-00534-w
                9148872
                35594017
                2647c1bc-0969-4eb7-8e2e-3d3dc3dd8601
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 13 April 2022
                Categories
                Original Research Article
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                © Springer Nature Switzerland AG 2022

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