Estimation of dose requirements for sustained in vivo activity of a therapeutic human anti-CD20 antibody

Br J Haematol. 2008 Feb;140(3):303-12. doi: 10.1111/j.1365-2141.2007.06916.x. Epub 2007 Nov 27.

Abstract

We evaluated the dose requirements for sustained in vivo activity of ofatumumab, a human anti-CD20 antibody under development for the treatment of B cell-mediated diseases. In a mouse xenograft model, a single dose, resulting in an initial plasma antibody concentration of 5 microg/ml, which was expected to result in full target saturation, effectively inhibited human B-cell tumour development. Tumour growth resumed when plasma concentrations dropped below levels that are expected to result in half-maximal saturation. Notably, tumour load significantly impacted antibody pharmacokinetics. In monkeys, initial depletion of circulating and tissue residing B cells required relatively high-dose levels. Re-population of B-cell compartments, however, only became detectable when ofatumumab levels dropped below 10 microg/ml. We conclude that, once saturation of CD20 throughout the body has been reached by high initial dosing, plasma concentrations that maintain target saturation on circulating cells (5-10 microg/ml) are probably sufficient for sustained biological activity. These observations may provide a rationale for establishing dosing schedules for maintenance immunotherapy following initial depletion of CD20 positive (tumour) cells.

MeSH terms

  • Animals
  • Antibodies / blood
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / blood
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antibody-Dependent Cell Cytotoxicity
  • Antigens, CD20 / immunology*
  • B-Lymphocytes / immunology*
  • Cell Line, Tumor
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Immunotherapy / methods*
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy
  • Lymphoma, B-Cell / therapy
  • Macaca fascicularis
  • Mice
  • Mice, SCID
  • Xenograft Model Antitumor Assays

Substances

  • Antibodies
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antigens, CD20
  • ofatumumab