Abstract B129: A bispecific antibody inhibits FGFR3 dimerization and is highly effective in FGFR3-driven tumor models

Abstract

Abstract Background: The receptor tyrosine kinase (RTK) FGFR3 is frequently mutated in bladder cancer (~15-20% in muscle invasive bladder cancer, MIBC) and is a validated therapeutic target. Oncogenic alterations in FGFR3 include point mutations in the extracellular domain (S249C, R248C, G372C, Y375C) and gene fusions that place an oligomerization domain from a fusion partner at the FGFR3 C-terminus (e.g., FGFR3-TACC3). Although pan-FGFR tyrosine kinase inhibitors (TKI) have demonstrated clinical efficacy, toxicity and acquired resistance limit the benefit of these agents. While antibody-based therapy can offer superior selectivity compared to TKIs, conventional ligand-blocking antibodies are usually ineffective inhibitors of constitutively active RTKs. Further, the existence of multiple oncogenic variants of FGFR3 presents an additional challenge for antibody-mediated blockade. Results: We generated a tetravalent bispecific FGFR3xFGFR3 antibody that potently inhibits both FGFR3 point mutants and fusions with better efficacy than the conventional antibodies that we produced and a clinical-stage comparator antibody. Mechanistically, our bispecific antibody binds FGFR3 through two different epitopes located in immunoglobulin-like domains D1 and D2/3 respectively. It potently blocks the dimerization of FGFR3 S249C, the most common oncogenic variant, inhibiting receptor phosphorylation and downstream signaling. Additionally, our bispecific antibody inhibits the function of FGFR3 gatekeeper mutations (V557M/L) that are resistant to TKIs. In FGFR3-driven tumor models, our antibody is highly effective, providing efficacy similar to that of the FDA-approved TKI erdafitinib. Conclusion: We have characterized the properties of a tetravalent bispecific FGFR3xFGFR3 antibody that shows strong anti-tumor activity in models driven by FGFR3 S249C as well as by FGFR3-TACC3 fusion, outperforming a conventional antibody that was previously in clinical development. The activity of the bispecific antibody is superior to the mixture of the two parental antibodies and results from strong inhibition of FGFR3 dimerization. Our bispecific antibody provides a novel approach to achieve selective and potent inhibition of multiple oncogenic variants of FGFR3 in bladder cancer, including FGFR3 variants that are resistant to FGFR TKIs. Citation Format: Yan Yang, Naga Suhasini Avvaru, Zaoli Jiang, Nina Liu, Michael Rosconi, Bojie Zhang, Yinyin Li, Erica Ullman, John Chia-Yang Lin, Yang Shen, Christopher Daly. A bispecific antibody inhibits FGFR3 dimerization and is highly effective in FGFR3-driven tumor models [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr B129.