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Annals of Oncology Advance Access originally published online on April 29, 2007
Annals of Oncology 2007 18(7):1216-1223; doi:10.1093/annonc/mdm114
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© 2007 European Society for Medical Oncology

hematologic malignancies

A phase I/II study of galiximab (an anti-CD80 monoclonal antibody) in combination with rituximab for relapsed or refractory, follicular lymphoma

JP Leonard1,*,{dagger}, JW Friedberg2,{dagger}, A Younes3, D Fisher4, LI Gordon5, J Moore6, M Czuczman7, T Miller8, P Stiff9, BD Cheson10, A Forero-Torres11, N Chieffo12, B McKinney13, D Finucane14 and A Molina12

1 Division of Hematology/Oncology, Weill Medical College of Cornell University and NewYork-Presbyterian Hospital, New York, NY
2 Lymphoma Clinical Research, James P. Wilmot Cancer Center, University of Rochester, Rochester, NY
3 Division of Cancer Medicine Department of Lymphoma and Myeloma, M.D. Anderson Cancer Center, Houston, TX
4 Department of Hematologic Malignancies, Dana Farber Cancer Institute, Boston, MA
5 Division of Hematology/Oncology, Northwestern University, Chicago, IL
6 Division of Hematology—Oncology, Duke University, Durham, NC
7 Departments of Hematologic Oncology and Bone Marrow Transplantation, Roswell Park Cancer Institute, Buffalo, NY
8 Section of Hematology/Oncology, University of Arizona, Tucson, AZ
9 Division of Hematology/Oncology, Loyola University Medical Center, Chicago, IL
10 Department of Hematology, Georgetown University Hospital, Washington, DC
11 Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL
12 Department of Hematology/Oncology - Medical Research
13 Department of Biostatistics
14 Department of Medical Writing, Biogen Idec Inc., San Diego, CA, USA

* Correspondence to: Dr J. P. Leonard, Weill Medical College of Cornell University and NewYork-Presbyterian Hospital, Starr Building, Room 340, 520 East 70th Street, New York, NY 10021 USA. Tel: +1 212-746-2932; Fax: +1 212-746-3844; E-mail: jpleonar{at}med.cornell.edu

Background: Galiximab is a monoclonal antibody that targets CD80, a costimulatory molecule constitutively expressed on follicular and other lymphomas. Modest single-agent clinical activity and tolerability were demonstrated in a phase I study in relapsed or refractory, follicular non-Hodgkin's lymphoma (NHL). A phase I/II study was conducted to evaluate galiximab in combination with a standard course of rituximab. Safety, pharmacokinetics, and efficacy were evaluated.

Patients and methods: Patients with follicular NHL who had relapsed or failed primary therapy were enrolled. Rituximab-refractory patients (no response or a response with time to progression <6 months) were excluded. Patients received 4 weekly i.v. infusions of galiximab (125, 250, 375, or 500 mg/m2) and rituximab (375 mg/m2). International Workshop Response Criteria (IWRC) were used to evaluate response.

Results: Seventy-three patients received treatment. All had received at least one prior lymphoma therapy; 40% were rituximab naive. Infusions were delivered in an outpatient setting and were well tolerated. The most common study-related adverse events (AE) were lymphopenia, leukopenia, neutropenia, fatigue, and chills. The overall response rate at the recommended phase II dose of galiximab (500 mg/m2) was 66%: 19% complete response, 14% unconfirmed complete response, and 33% partial response. The median progression free survival was 12.1 months. Combination therapy did not appear to alter pharmacokinetics.

Conclusion: These results indicate that galiximab can be safely combined with a standard course of rituximab. This doublet biologic approach offers the potential to avoid or delay chemotherapy or to integrate with other lymphoma therapies. A phase III, randomized study evaluating clinical benefit of rituximab versus the combination has been initiated.

Key words: galiximab, lymphoma, monoclonal antibody, rituximab, CD80


{dagger} These authors contributed equally to this work and share first authorship.

Received for publication November 7, 2006. Revision received February 21, 2007. Accepted for publication February 22, 2007.


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