Dosage and administration for preventing cardiotoxicity in treatment with ERBB2-targeted immunoliposomes comprising anthracycline chemotherapeutic agents
Methods for determining dosage of HER2-targeted anthracycline-containing immunoliposomes are disclosed, as are methods of treating cancer patients with HER2-positive tumors using dosages so determined. Upon administration, the dosages share the low cardiotoxicity profile of standard dosages of non-immunoliposomal (untargeted), anthracycline-containing liposomes.
1. A method of treating a human cancer patient by administration of anthracycline-comprising anti-HER2 immunoliposomes, the method comprising determining a first dosage, such a dosage indicating a dose magnitude and frequency of dosing, for a patient diagnosed with a cancer characterized by expression of HER2 receptor, the first dosage being for a liposomal anthracycline chemotherapeutic agent that does not comprise an immunoliposome and is doxorubicin HCl liposome injection, which dosage is determined to provide to the patient a safe and effective amount of the liposomal anthracycline chemotherapeutic agent, and administering anthracycline-comprising anti-HER2 immunoliposomes, a plurality of which immunoliposomes is each bearing a plurality of anti-HER2 antibody molecules on its surface and each containing the anthracycline chemotherapeutic agent,
wherein the anthracycline-comprising anti-HER2 immunoliposomes:
a) are formulated in sterile 10 mM/L histidine-HCl (pH 6.5) and 10% sucrose and comprise a lipid membrane comprised of phosphatidylcholine, cholesterol, and a polyethyleneglycol-derivatized phosphatidylethanolamine in the amount of approximately one PEG molecule for 200 phospholipid molecules, of which approximately one PEG chain for each 1780 phospholipid molecules bears at its end an F5 single-chain FIT antibody fragment that binds to HER2, so that, on average, 45 copies of F5-scFv (anti-HER2) are comprised per liposome, the membrane encapsulating an aqueous space which contains 130-170 g doxorubicin/mol phospholipid, and
b) are administered to the patient at the first dosage.
2. The method of claim 1 , wherein the HER2-targeted immunoliposomes are MM-302.
3. The method of claim 1 , wherein the cancer is breast cancer, Kaposi's sarcoma, ovarian cancer, or multiple myeloma.
4. The method of claim 1 , wherein the first dosage is 50 mg/m.sup.2, 40 mg/m.sup.2, 30 mg/m.sup.2, 20 mg/m.sup.2, or 10 mg/m.sup.2 every two weeks or every three weeks or every four weeks.
5. The method of claim 1 , wherein the cancer characterized by expression of HER2 receptor is further characterized as being HER2.sup.2+, HER2.sup.3+, or HER2 FISH positive.
6. The method of claim 1 , wherein the cancer characterized by expression of ErbB2 receptor further characterized as expressing an average of at least 200,000 cell surface ErbB2 receptors per cell.
7. The method of claim 1 , wherein the administration of the immunoliposomes at the first dosage is effective to treat the cancer.
8. The method of claim 1 , wherein the administration of the immunoliposomes at the first dosage does not result in increased cardiotoxicity as compared to administration at the first dosage of the liposomal anthracycline chemotherapeutic agent that does not comprise an immunoliposome.
9. The method of claim 1 , wherein the administration of the immunoliposomes to the patient at the first dosage results in a peak concentration of the immunoliposome in the patient's bloodstream and wherein treating human cardiomyocytes in vitro by culturing in medium comprising the immunoliposomes at about the peak concentration does not reduce, or reduces by no more than 5%, heregulin-stimulated increase of pERK or pAKT in the cultured cardiomyocytes as compared to in control human cardiomyocytes cultured in medium free of the immunoliposomes.
10. The method of claim 9 , wherein the immunoliposome concentration in the patient's bloodstream is measured as a serum immunoliposome concentration.