1. Low Bioavailability and High Immunogenicity of a New Brand of E. coli l-Asparaginase with Active Host Contaminating Proteins
- Author
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Silvia Regina Brandalise, Natacha Azussa Migita, José Andrés Yunes, Priscila Pini Zenatti, Fabio C. Gozzo, Rosângela Aparecida Mendes-Silva, Nathalia Moreno Cury, and Pedro O. de Campos-Lima
- Subjects
0301 basic medicine ,Drug ,Proteomics ,Asparaginase ,Bioavailability ,media_common.quotation_subject ,Lymphoblastic Leukemia ,Biological Availability ,lcsh:Medicine ,General Biochemistry, Genetics and Molecular Biology ,beta-Lactamases ,L asparaginase ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Malate Dehydrogenase ,Escherichia coli ,Medicine ,Animals ,Humans ,Protein Isoforms ,Amino Acid Sequence ,Child ,Host contaminant proteins ,media_common ,National health ,Mice, Inbred BALB C ,lcsh:R5-920 ,Mass spectrometry ,business.industry ,Immunogenicity ,lcsh:R ,Reproducibility of Results ,General Medicine ,Biotechnology ,Anti-Bacterial Agents ,l-Asparaginase ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Christian ministry ,business ,lcsh:Medicine (General) ,Research Paper - Abstract
The drug l-asparaginase is a cornerstone in the treatment of acute lymphoblastic leukemia (ALL). The native E. colil-asparaginase used in Brazil until recently has been manufactured by Medac/Kyowa. Then a decision was taken by the Ministry of Health in 2017 to supply the National Health System with a cheaper alternative l-asparaginase manufactured by Beijing SL Pharmaceutical, called Leuginase®. As opposed to Medac, the asparaginase that has been in use in Brazil under the trade name of Aginasa®, it was not possible to find a single entry with the terms Leuginase in the Pubmed repository. The apparent lack of clinical studies and the scarcity of safety information provided to the hospitals by the drug distributor created a debate among Brazilian pediatric oncologists about issues of safety and efficacy that culminated eventually in a court decision to halt the distribution of the new drug all over the country. Boldrini Children's Center, a non-profit pediatric oncohematology hospital, has conducted its own evaluation of Leuginase®. Mass spectrometry analyses found at least 12 different contaminating host-cell proteins (HCP) in Leuginase®. The presence of two HCP (beta-lactamase and malate dehydrogenase) was confirmed by orthogonal methodologies. The relative number of HCP peptides ranged from 19 to 37% of the total peptides identified by mass spectrometry. In vivo studies in mice injected with Leuginase® revealed a 3 times lower plasma bioavailability and the development of higher antibody titres against l-asparaginase in comparison to Aginasa®-injected animals. The decision to buy a new drug based on its price alone is not safe. Developing countries are especially vulnerable to cheaper alternatives that lack solid quality assurance., Highlights • l-asparaginase is one of the first biologicals to be used and an essential drug for the treatment of acute lymphoblastic leukemia (ALL). • Current access to technology has facilitated the worldwide production of l-asparaginase and other biosimilars at lower prices. • Different quality control standards among countries pose a serious challenge to warrant quality, safety and efficacy of biosimilars. l-asparaginase is a cornerstone drug in the treatment of acute lymphoblastic leukemia (ALL). A cheaper l-asparaginase biosimilar was introduced in the Brazilian market in 2017. This report describes the bioanalytical evaluation of such biosimilar, which revealed the presence of at least 12 different contaminating host-cell proteins (HCP), that accounted for 19 to 37% of the peptides identified by three independent mass spectrometry analyses. The second most abundant HCP alone was confirmed by an orthogonal method to represent 2.4% of the total protein mass. Studies carried out in mice showed lower plasma bioavailability and higher anti-asparaginase antibodies titres for the biosimilar in comparison to the well-known Medac l-asparaginase previously used in the Country.
- Published
- 2018