anti-EGFR Antibody-drug Conjugate Research Articles

Anti-EGFR Antibody-Drug Conjugate Carrying an Inhibitor Targeting CDK Restricts Triple-Negative Breast Cancer Growth.

Anti-EGFR antibodies show limited response in breast cancer, partly due to activation of compensatory pathways. Furthermore, despite the clinical success of cyclin-dependent kinase (CDK) 4/6 inhibitors in hormone receptor-positive tumors, aggressive triple-negative breast cancers (TNBC) are largely resistant due to CDK2/cyclin E expression, whereas free CDK2 inhibitors display normal tissue toxicity, limiting their therapeutic application. A cetuximab-based antibody drug conjugate (ADC) carrying a CDK inhibitor selected based on oncogene dysregulation, alongside patient subgroup stratification, may provide EGFR-targeted delivery. Expressions of G1/S-phase cell cycle regulators were evaluated alongside EGFR in breast cancer. We conjugated cetuximab with CDK inhibitor SNS-032, for specific delivery to EGFR-expressing cells. We assessed ADC internalization and its antitumor functions in vitro and in orthotopically grown basal-like/TNBC xenografts. Transcriptomic (6,173 primary, 27 baseline, and matched post-chemotherapy residual tumors), single-cell RNA sequencing (150,290 cells, 27 treatment-naïve tumors), and spatial transcriptomic (43 tumor sections, 22 TNBCs) analyses confirmed expression of CDK2 and its cyclin partners in basal-like/TNBCs, associated with EGFR. Spatiotemporal live-cell imaging and super-resolution confocal microscopy demonstrated ADC colocalization with late lysosomal clusters. The ADC inhibited cell cycle progression, induced cytotoxicity against high EGFR-expressing tumor cells, and bystander killing of neighboring EGFR-low tumor cells, but minimal effects on immune cells. Despite carrying a small molar fraction (1.65%) of the SNS-032 inhibitor, the ADC restricted EGFR-expressing spheroid and cell line/patient-derived xenograft tumor growth. Exploiting EGFR overexpression, and dysregulated cell cycle in aggressive and treatment-refractory tumors, a cetuximab-CDK inhibitor ADC may provide selective and efficacious delivery of cell cycle-targeted agents to basal-like/TNBCs, including chemotherapy-resistant residual disease.

An anti-EGFR antibody-drug conjugate overcomes resistance to HER2-targeted drugs

Trastuzumab-emtansine (T-DM1) is an antibody-drug conjugate (ADC) that was approved in 2013 to treat HER2+ breast cancer. Despite its efficacy in the clinic, some patients exhibit intrinsic or acquired resistance to such ADC. To characterize mechanisms of resistance to T-DM1, we isolated several HER2+ resistant clones derived from the HCC1954 HER2+ cell line. The isolated clones were different as per their transcriptomic profiles. However, all the T-DM1-resistant clones showed decreased HER2 levels. Yet, the clones were still oncogenically dependent on HER2, as indicated by knock down experiments. The decrease in HER2 expression caused acquired resistance to T-DM1 and to other anti-HER2 therapies. Antibody array analyses showed that the epidermal growth factor receptor (EGFR) was expressed in these T-DM1-resistant HCC1954 clones. Indeed, therapies targeting EGFR, particularly cetuximab-DM1, demonstrated a strong anti-proliferative action on cells with acquired resistance to T-DM1 and HER2 loss. The expression of EGFR in cells resistant to T-DM1 offers the possibility of using therapies directed to this receptor to combat resistance to anti-HER2 drugs and loss of HER2 overexpression.

Anti-EGFR antibody-drug conjugate for triple-negative breast cancer therapy.

Triple‐negative breast cancers (TNBCs) are highly aggressive, metastatic and recurrent. Cytotoxic chemotherapies with limited clinical benefits and severe side effects are the standard therapeutic strategies, but, to date, there is no efficacious targeted therapy. Literature and our data showed that epidermal growth factor receptor (EGFR) is overexpressed on TNBC cell surface and is a promising oncological target. The objective of this study was to develop an antibody‐drug conjugate (ADC) to target EGFR+ TNBC and deliver high‐potency drug. First, we constructed an ADC by conjugating anti‐EGFR monoclonal antibody with mertansine which inhibits microtubule assembly via linker Sulfo‐SMCC. Second, we confirmed the TNBC‐targeting specificity of anti‐EGFR ADC by evaluating its surface binding and internalization in MDA‐MB‐468 cells and targeting to TNBC xenograft in subcutaneous mouse mode. The live‐cell and live‐animal imaging with confocal laser scanning microscopy and In Vivo Imaging System (IVIS) confirmed the TNBC‐targeting. Finally, both in vitro toxicity assay and in vivo anti‐cancer efficacy study in TNBC xenograft models showed that the constructed ADC significantly inhibited TNBC growth, and the pharmacokinetics study indicated its high circulation stability. This study indicated that the anti‐EGFR ADC has a great potential to against TNBC.

First-in-human dose-escalation study of anti-EGFR ADC MRG003 in patients with relapsed/refractory solid tumors.

3550 Background: MRG003 is a novel antibody drug conjugate (ADC) composed of a fully human anti-EGFR IgG1 monoclonal antibody conjugated to a microtubule disrupting agent monomethyl auristatin E (MMAE). MRG003 is presently being tested in an ongoing phase I study for safety, pharmacokinetics, and preliminary antitumor activity in patients (pts) with solid tumors (CTR20180310). Methods: In the phase I dose escalation study of a traditional (3+3) design, pts with relapsed or refractory cancers received single agent MRG003 once every 3 weeks (Q3W) for a maximum of 8 treatment cycles. The starting dose of MRG003 is 0.1 mg/kg, followed by 0.3, 0.6, 1.0, 1.5, 2.0, 2.5, and 3.0 mg/kg. Observations included adverse events (AEs), dose-limiting toxicity (DLT), and antitumor activity which is assessed every two cycles. Results: A total of twenty-two pts with colorectal (CRC, n = 15), nasopharyngeal (NPC, n = 3), head and neck (H&N, n = 2), esophageal (EC, n = 1), and duodenal (DC, n = 1) cancer were enrolled in the dose escalation. The median age of pts was 56.5 years. The MTD identified was 2.5 mg/kg. Commonly observed adverse events were anemia (50%), AST increase (41%), decreased appetite (41%), rash (36%), pruritus (36%), asthenia (36%), and proteinuria (32%). Majority of AEs were mild to moderate in severity. EGFR expression in patients’ tumor samples was determined retrospectively by a validated IHC method in a central laboratory. Nine out of 22 pts tested were EGFR positive. Among these 9 EGFR positive pts, one with NPC in the 2.5 mg/kg cohort had partial response, four had stable disease (one with H&N in the 1.5 mg/kg, one each with NPC and H&N in the 2.0 mg/kg, and one with EC in the 2.5 mg/kg cohorts). The disease control rate (DCR) at doses ≥1.5 mg/kg was 100% for the EGFR positive pts. Conclusions: The dose escalation study of MRG003 showed manageable safety profiles and encouraging preliminary antitumor activity in pts with EGFR-positive solid tumors. MRG003 is currently being evaluated as a single agent in phase I dose expansion cohorts to further assess safety, PK, and antitumor activity. Clinical trial information: CTR20180310 .

Abstract A088: Novel anti-EGFR antibody-drug conjugate AVID100: A phase 2a trial in patients with EGFR-overexpressing advanced solid tumors

Abstract Background: Currently, no therapies are approved specifically for EGFR-overexpressing tumors. AVID100 is a novel anti-EGFR antibody drug conjugate (ADC, DM1 payload) that was rationally designed for anti-tumor efficacy without accompanying on-target, off-tumor toxicity by employing an EGFR function-blocking antibody moiety. Although EGFR is overexpressed in a multitude of malignancies including squamous non-small cell lung cancer (sqNSCLC), head and neck carcinoma (HNSCC) and triple-negative breast cancer (TNBC), historically limited activity has been reported for EGFR monoclonal antibodies or EGFR TKIs in unselected patients. This emphasizes the need to develop novel and more efficacious agents targeting EGFR, and for biomarker- directed approaches to enrich for patients likely to respond. In pre-clinical models, AVID100 showed potent anti-tumour efficacy and a Phase 1 dose-escalation study in patients with advanced solid malignancies concluded that AVID100 was well tolerated at doses expected to be therapeutically active. An RP2D of 220 mg/m2 (~6 mg/kg) was established. Methods: This open-label, multicenter, multicohort, prospective Phase 2a study (NCT03094169) is designed to further evaluate the safety, tolerability, and preliminary efficacy of AVID100 when administered at 6 mg/kg Q3W per iv infusion in patients with locally advanced/unresectable or metastatic solid tumor malignancies of epithelial origin, and with documented EGFR over-expression. Additional endpoints include PK profiling and exploratory biomarkers. sqNSCLC and HNSCC patients with EGFR IHC of 3+ as well as mTNBC patients whose EGFR IHC shows 3+ intensity in ≥ 50% of tumor cells, or ≥ 2+ intensity in ≥ 75% of tumor cells, are eligible to enroll. Patients must have measurable disease according to RECIST v1.1 at enrolment and disease status is assessed radiographically every 6 weeks. EGFR over-expression positivity is established by a validated IHC assay (DAKO EGFRpharmDX) conducted by a central laboratory. Initial validation of the EGFR IHC was carried out retrospectively on archival tissue microarrays (US Biomax, Derwood, MD) from advanced sqNSCLC, HNSCC and TNBC patients. Results Initial validation of the EGFR IHC assay conducted with archival tissue samples yielded EGFR 3+ positivity in ≥ 50% of tumor cells for 30% (32 out of 105 samples tested) of sqNSCLC and 22% (31 out of 140) of HNSCC samples. Among TNBC samples tested, 6% were EGFR 3+ in ≥ 50% of tumor cells and 25% EGFR 2 or 3+ in ≥ 50% of tumor cells (16 and 62 out of 249, respectively). The prospective Phase 2a trial assessing AVID100 in patients selected for EGFR overexpression was is actively accruing and one sqNSCLC, four SCCHN and three TNBC patients had been enrolled at time of writing. Conclusions A significant proportion of retrospectively assessed sqNSCLC, HNSCC and TNBC patient samples were found to overexpress the EGFR. The prospective Phase 2a trial assessing AVID100, a novel growth factor receptor function-blocking anti-EGFR ADC, remains ongoing and updated results will be presented at the meeting. Citation Format: Jason Melear, Nehal Lakhani, Joyce A O'Shaughnessy, Sharon T Wilks, Saad Khan, Sree R Chandana, Anthony W Tolcher, Kyri P Papadopoulos, Yvette Cole, Karla Rivas, Ria Ghosh, Sandra Sinclair, Robert Lutz, Paul I Nadler, Debra L Wood, Barbara Burtness. Novel anti-EGFR antibody-drug conjugate AVID100: A phase 2a trial in patients with EGFR-overexpressing advanced solid tumors [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr A088. doi:10.1158/1535-7163.TARG-19-A088

Abstract 218: AVID100 is an anti-EGFR ADC that promotes DM1-meditated cytotoxicity on cancer cells but not on normal cells

Abstract AVID100 is a novel rationally designed antibody drug conjugate (ADC) that specifically targets the epidermal growth factor receptor (EGFR). EGFR is highly expressed on a variety of cancers making it a promising target for ADCs. However, due to the presence of EGFR on normal skin cells, on-target off-tumor toxicity is a concern. AVID100 is an anti-EGFR-DM1 conjugate exhibiting high potency against cancer cells relative to unconjugated antibodies, while not exhibiting increased toxicity on normal cells. In a series of in vitro and in vivo experiments, we provide mechanistic evidence rationalizing why AVID100 shows higher cytotoxicity on tumor cells compared to normal cells. The antibody moiety of AVID100, denoted MAB100, was shown to have a high affinity for EGFR (approximately 2nM) and to compete with EGF for binding to the EGFR. Also, MAB100 prevented downstream signalling from EGFR. In addition to exhibiting full antagonist activity, MAB100 effectively delivered the microtubule inhibitor DM1 to tumor cells, as demonstrated by an increase in apoptosis in AVID100-treated tumor cells relative to MAB100-treated tumor cells. AVID100 was very effective on tumor cell lines derived from breast, head and neck, and lung cancers with the cytotoxic IC50 values generally correlating with the number of EGFR molecules on the cell surface. Importantly, on keratinocytes, AVID100 did not exhibit increased cytotoxicity relative to MAB100. We hypothesized that this lack of increase in cytotoxicity on keratinocytes is due to the antagonistic effect of MAB100 on EGFR signalling. Blocking the EGFR pathway in keratinocytes strongly inhibits their proliferation, which should protect them against the cytotoxic action of DM1. To address this hypothesis, we compared the effect of AVID100 to that of a non-antagonistic anti-EGFR ADC, huML66-DM1. As expected, both ADCs were highly effective at killing MDA-MB-468 cancer cells, confirming their ability to deliver DM1. In contrast, keratinocytes exhibited a significantly higher level of apoptosis in response to huML66-DM1 as compared to AVID100. These results confirm that the antagonistic nature of the antibody moiety of AVID100 plays a critical role in protecting keratinocytes from the cytotoxic effect of DM1. Finally, the activity of AVID100 was investigated in multiple mouse xenograft studies, including in MDA-MB-468 human breast adenocarcinoma, H292 NSCLC, and FaDu SSCHN models. AVID100 treatment significantly reduced tumor growth and caused tumor regressions in some of the mice, even when administered as a single dose. Toxicology studies in cynomolgus monkeys demonstrated that AVID100 was well tolerated at up to 4 weekly doses of 10mg/kg. AVID100 has completed a Phase 1 clinical trial with the recommended Phase 2 dose having been determined. The Phase 2 trial of AVID100 is ongoing. Citation Format: Michael J. Thwaites, Rene Figueredo, Gilles Tremblay, James Koropatnick, Victor Goldmacher, Maureen O’Connor-McCourt. AVID100 is an anti-EGFR ADC that promotes DM1-meditated cytotoxicity on cancer cells but not on normal cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 218.

Abstract CT056: A Phase Ia/IIa trial of AVID100, an anti-EGFR antibody-drug conjugate

Abstract Background AVID100, a rationally designed anti-EGFR-DM1 conjugate, showed potent activity in preclinical models, including cancer cell lines resistant to approved anti-EGFR monoclonal antibodies. In addition, AVID100 showed increased toxicity on tumor cells compared to the unconjugated antibody. There was no increased AVID100-mediated toxicity on keratinocytes. Methods In the completed Phase Ia segment, 24 patients with advanced or metastatic epithelial malignancies without available standard of care therapy and likely to express EGFR were enrolled into sequential dose-escalation cohorts to assess safety, tolerability, pharmacokinetic (PK) parameters, and to identify the recommended Phase II dose (R2PD) of 2 hour infusions on an every 3 week schedule. In the ongoing Phase IIa segment, preliminary antitumor activity is being assessed in expansion cohorts of patients with high EGFR expression, including triple-negative breast cancer (TNBC) (2+ expression in ≥75% or 3+ in ≥50% of tumor cells) or either squamous cell carcinoma of the head and neck (SCCHN) or squamous non-small cell lung carcinoma (sqNSCLC) (3+ expression in ≥ 50% of tumor cells). The DAKO PharmDx assay was validated and used for screening intensity of EGFR protein expression. Results During Phase Ia, no Cycle 1 dose limiting toxicities (DLTs) were observed in Cohorts 1-6 at doses (N) of 20 (1), 40 (1), 80 (3), 120 (3), 180 (3), and 220 (6) mg/m2. In Cohort 7 (6) (270 mg/m2; ~ 7.3 mg/kg) two patients experienced Cycle 1 DLTs (G3 asymptomatic lipase elevation, G4 reversible thrombocytopenia), exceeding the maximally tolerated dose. A third patient developed G3 reversible pneumonitis. As a result, 220 mg/m2 (~6 mg/kg) was selected as the R2PD. Tumor types in greater than one patient included: colorectal (13), breast (4), and ovarian (2). Preliminary PK results at the R2PD revealed exposure exceeding preclinically predicted therapeutic levels. Cmax increased proportionally with dose, plasma half-life was ~50 hours at the R2PD, and clearance decreased with increasing doses with saturation observed between 180-270 mg/m2. Safety and tolerability were acceptable. Other treatment-related adverse events included: infusion-related reactions that were ameliorated by premedication and infusion prolongation, rash, nausea, vomiting, fatigue, headache, anorexia, mucositis, punctate keratitis, diarrhea, elevated amylase, reversible transaminase and alkaline phosphatase elevations without other evidence of hepatotoxicity, hypomagnesemia, and hypokalemia. Prolonged disease stabilization was observed in 3 of these patients not selected for EGFR overexpression (colorectal, ovarian, cervical). Conclusions AVID100 is a well-tolerated anti-EGFR-DM1 conjugate with evidence for exposure levels at or above those observed for cetuximab and ado-trastuzumab emtansine. Antitumor activity is currently being evaluated in EGFR-overexpressing patients in Phase IIa. Citation Format: Nehal Lakhani, Sreenivasa Chandana, Anthony Tolcher, Yvette Cole, Karla Rivas, Sandra Sinclair, Paul I. Nadler, Debra L. Wood, Kyri P. Papadopoulos. A Phase Ia/IIa trial of AVID100, an anti-EGFR antibody-drug conjugate [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT056.

Abstract 537: Antibody drug conjugate to treat triple negative breast cancer

Abstract Triple negative breast cancer (TNBC) is characterized by rapid growth, metastasis, and high recurrence. The severe adverse effects and drug resistance associated with standard cytotoxic chemotherapies minimize their clinical benefits. The anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) had been developed and tested to treat TNBC, but no significant efficiency was demonstrated in clinical trials. The goal of this study was to develop a novel antibody-drug conjugate (ADC) to treat TNBC. Specifically, we established a platform to conjugate anti EGFR mAb with mertansine, which inhibits cell division by blocking tubulin polymerization, and also improved the conjugation efficiency by optimizing the linker and drug-to-antibody ratio. Flow cytometry and live cell confocal laser scanning microscopy analysis confirmed that the anti-EGFR ADC can specifically bind to multiple TNBC subtypes, is effectively internalized, and release potent drug intracellularly within 1 hour after mixing. The IC50 study showed that the anti-EGFR ADC killed >90% TNBC cells with dose of 5 nM. The TNBC xenograft mouse model also showed that the constructed ADC had high anticancer efficacy and successfully inhibited tumor growth. Moreover, the live-animal imaging using In Vivo Imaging System and the tissue microarray samples with immunohistochemical analysis of TNBC and organs indicated that our ADC specifically target TNBC in vivo. Further evaluations, such as maximal tolerated dose (MTD), pharmacokinetics (PK), and biodistribution, are needed. To summarize, we developed an EGFR-targeted ADC, which could provide an effective targeted therapy to treat TNBC and improve the life quality and survival rate of patients with TNBC. Note: This abstract was not presented at the meeting. Citation Format: Yingnan Si, Nghi Dang, Seulhee Kim, Lufang Zhou, Xiaosi Han, Runhua Liu, Xiaoguang (Margaret) Liu. Antibody drug conjugate to treat triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 537.

Discovery of A Novel EGFR-Targeting Antibody-Drug Conjugate, SHR-A1307, for the Treatment of Solid Tumors Resistant or Refractory to Anti-EGFR Therapies.

Although inhibiting EGFR-mediated signaling proved to be effective in treating certain types of cancers, a quickly evolved mechanism that either restores the EGFR signaling or activates an alternative pathway for driving the proliferation and survival of malignant cells limits the efficacy and utility of the approach via suppressing the EGFR functionality. Given the fact that overexpression of EGFR is commonly seen in many cancers, an EGFR-targeting antibody-drug conjugate (ADC) can selectively kill cancer cells independently of blocking EGFR-mediated signaling. Herein, we describe SHR-A1307, a novel anti-EGFR ADC, generated from an anti-EGFR antibody with prolonged half-life, and conjugated with a proprietary toxin payload that has increased index of EGFR targeting-dependent versus EGFR targeting-independent cytotoxicity. SHR-A1307 demonstrated strong and sustained antitumor activities in EGFR-positive tumors harboring different oncogenic mutations on EGFR, KRAS, or PIK3CA. Antitumor efficacy of SHR-A1307 correlated with EGFR expression levels in vitro and in vivo, regardless of the mutation status of EGFR signaling mediators and a resultant resistance to EGFR signaling inhibitors. Cynomolgus monkey toxicology study showed that SHR-A1307 is well tolerated with a wide therapeutic index. SHR-A1307 is a promising therapeutic option for EGFR-expressing cancers, including those resistant or refractory to the EGFR pathway inhibitors.

RN765C, a low affinity EGFR antibody drug conjugate with potent anti-tumor activity in preclinical solid tumor models

Epidermal growth factor receptor (EGFR) is a clinically validated target and often overexpressed in some solid tumors. Both EGFR tyrosine kinase inhibitors and ligand-blocking antibodies have been approved for treatment of NSCLC, head and neck cancers and colorectal cancers. However, clinical response is limited and often accompanied by significant toxicities due to normal tissue expression. To improve the effectiveness of targeting EGFR while minimizing the toxicities on normal tissues, we developed a low-affinity anti-EGFR antibody drug conjugate (ADC), RN765C. Potent in vitro cytotoxicity of RN765C, with nanomolar to subnanomolar EC50, was observed on a panel of cancer cell lines expressing moderate to high level of EGFR. In contrast, RN765C was less effective in killing normal human keratinocytes, presumably due to its lower receptor expression. Mechanistically, RN765C has multiple modes of action: inducing payload mediated mitotic arrest and cell death, blocking EGFR pathway signal and mediating antibody dependent cell cytotoxicity. In preclinical studies, a single dose of RN765C at 1.5-3 mg/kg was generally sufficient to induce tumor regression in multiple cell line and patient-derived xenograft models, including those that are resistant to EGFR-directed tyrosine kinase inhibitors. Our data support further investigation of RN765C in the clinic to treat EGFR expressing solid tumors.

$50 million total for trio of Texas biotechs

The Cancer Prevention & Research Institute of Texas is supporting 16 Texas institutions with more than $177 million. Three grants, totaling more than $50 million, are heading to a trio of biotech firms. Forbius will receive nearly $19 million to evaluate an anti-EGFR antibody-drug conjugate in Phase IIa clinical trials. Korysso Therapeutics will receive nearly $20 million to develop compounds that treat neurological damage caused by cancer chemotherapy. And CerRx will receive nearly $12 million to test combination drug therapies in lymphoma.

46O - A Phase 1a/2a trial of AVID100, an anti-EGFR antibody-drug conjugate

46O - A Phase 1a/2a trial of AVID100, an anti-EGFR antibody-drug conjugate

Abstract B32: A tumor microenvironment specific EGFR targeting antibody-drug conjugate promotes regression in KRAS or BRAF mutant tumors

Abstract The epidermal growth factor (EGF) signaling pathway relies on recognition by its receptor, EGFR, and subsequent downstream signaling by the KRAS and BRAF proteins to relay proper proliferative, migratory, and angiogenic functions. Cancers with activating KRAS or BRAF mutations are resistant to EGFR targeting agents and correspond to a significant unmet medical need. We hypothesized that an anti-EGFR antibody-drug conjugate (ADC) could be active against KRAS or BRAF mutated tumors, due to the cytotoxic mechanism of the ADC warhead. In an effort to eliminate the known dermal toxicity associated with anti-EGFR therapy, and to mitigate potential toxicities associated with treatment by an anti-EGFR ADC, we wished to engineer an antibody with enhanced specificity towards EGFR in the tumor microenvironment (TME) and attenuated binding to EGFR in normal tissue. This was achieved by screening a library of antibody variants (based on cetuximab) in a spatially addressed manner for binding to a recombinant version of the EGFR extracellular domain (EGFRECD) in two separate ELISA reaction conditions. High affinity binding to the EGFRECD was desired in the first condition, which approximated the physicochemical properties of the TME (acidic pH, high lactic acid concentration, 25% human serum). In the second assay condition, which approximated mAb binding to EGFRECD in normal tissue (neutral pH, low lactic acid concentration, 25% human serum), attenuated binding affinity was desired. We identified a lead mAb variant, cMab-1501, which possessed several fold reduced binding to EGFRECD in the neutral pH, low lactic acid condition, when compared to EGFRECD binding in the low-pH, high lactic acid, assay condition. To evaluate enhanced specificity for binding to EGFR in vivo, cMab-1501 was compared to cetuximab for binding to both human donor foreskin xenografts and human A431 tumor xenografts, using a DyLight 755 conjugated version of each antibody, and subsequent fluorescence detection with a Caliper IVIS system. cMab-1501 and cetuximab demonstrated relatively comparable binding towards human A431 tumor xenografts in vivo. In addition, cetuximab bound relatively equally between human tumor xenografts and human skin grafts. However, no binding to EGFR in the human skin graft was detected for cMab-1501 over all days measured; suggesting that cMab-1501 was highly specific for binding to EGFR in the TME. We next generated an cMab-1501 based ADC (antibody-drug conjugate), via maleimide chemistry carrying a protease cleavable valine-citrulline-p-aminobenzyloxycarbonyl monomethylauristatin E (vcPAB-MMAE) cytotoxic moiety, forming a cMab-1501-vcPAB-MMAE conjugate. Both the conjugated and un-conjugated versions of cMab-1501 were rapidly internalized by EGFR positive MDA-MB-231M tumor cells over several hours. In tumor xenograft models, the TME-specific anti-EGFR ADC demonstrated complete tumor regressions against two human EGFR overexpressing tumor types, MDA-MB-231M (TNBC, KRAS G13D) and HT-29 (CRC, BRAF V600E). In both in vivo models, tumors were resistant to treatment by cetuximab. These data suggest that it is possible to engineer a monoclonal antibody with enhanced specificity for its target within the TME and that an ADC-based approach could be utilized as potential treatment of EGFR overexpressing tumors with KRAS or BRAF mutations. Citation Format: Bob Veneziale, Lei Huang, Xiaoming Li, Qiping Zhao, Chunmei Zhao, Ryan Osgood, Jessica Cowell, Sanna Rosengren, Jason Parise, Ge Wei, Kim Phan, Robert Connor, Steve Rowe, Gilbert Keller, Gregory Frost, Dan Maneval, Curtis Thompson, Michael Shepard, Christopher Thanos. A tumor microenvironment specific EGFR targeting antibody-drug conjugate promotes regression in KRAS or BRAF mutant tumors. [abstract]. In: Proceedings of the AACR Special Conference: Function of Tumor Microenvironment in Cancer Progression; 2016 Jan 7–10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2016;76(15 Suppl):Abstract nr B32.

Efficacy of photoactivated generation of a meditope-enabled anti-EGFR antibody drug conjugate in RAS/RAF mutant colorectal carcinoma.

e14059Background: EGFR is a clinically validated target for advanced colorectal carcinoma, but EGFR targeted therapies are useless against EGFR expressing tumors with K/NRAS mutations. We hypothesi...

Antitumor effect of IMGN289, an anti-EGFR antibody-drug conjugate (ADC), in preclinical models of head and neck squamous cell carcinomas (HNSCC).

e17046 Background: IMGN289 is a novel ADC consisting of the humanized anti-EGFR antibody, J2898A, covalently linked to the potent cytotoxic maytansinoid, DM1. Methods: Effects of IMGN289 on clonoge...

Abstract A250: ABT-414: An anti-EGFR antibody-drug conjugate as a potential therapeutic for the treatment of patients with squamous cell tumors.

Abstract ABT-414 is an antibody-drug conjugate (ADC) comprised of an anti-EGFR antibody (ABT-806) conjugated to the potent cytotoxic monomethylauristatin F. ABT-414 binds a unique epitope of EGFR which is largely inaccessible when EGFR is expressed at physiological levels but is accessible in tumors that express EGFRde2-7 [also referred to as EGFR variant III (EGFRvIII)] and in tumors with wild-type amplified EGFR or excessive wild-type EGFR activation. These properties of ABT-414 should limit the effects of the toxin on normal tissues. ABT-414 is highly effective in both mutant and wild-type EGFR-positive human tumor xenografts in mice producing complete regressions and cures observed in the most sensitive models. Squamous cell tumors display a relatively high expression of EGFR. Immunohistochemical analysis reveals >70% of squamous lung and esophageal cancers and >90% of oral cavity tumors show moderate to strong staining for EGFR. Given the high unmet need in these patients and the in vivo data supporting improved ABT-414 efficacy in tumors with high EGFR expression, a Phase I/IIa study evaluating the safety, pharmacokinetics and efficacy of ABT-414 in subjects with EGFR-positive, refractory solid tumors has been initiated with a phase IIa expansion at the MTD in squamous NSCLC. Additionally, this study will evaluate the use of SPECT imaging with an indium-111-labeled parental antibody (ABT-806i) as a predictive tool for patient response. Tumor uptake by ABT-806i SPECT imaging correlates with antitumor response in xenograft models, and ABT-806i has been shown to effectively target tumor sites in select cancer patients. A fluorescent in situ hybridization (FISH) probe to detect EGFR amplification and EGFR IHC are also being evaluated with the goal of identifying patients who are most likely to respond to ABT-414 treatment. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A250. Citation Format: Andrew C. Phillips, Erwin R. Boghaert, Kedar S. Vaidya, Peter J. Ansell, David R. Shalinsky, Yumin Zhang, Martin J. Voorbach, Sarah Mudd, Kyle D. Holen, Rod A. Humerickhouse, Edward B. Reilly. ABT-414: An anti-EGFR antibody-drug conjugate as a potential therapeutic for the treatment of patients with squamous cell tumors. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A250.

Abstract 5677: The anti-EGFR ADC, IMGN289 displays favorable pharmacokinetic properties.

Abstract IMGN289 is an antibody-drug conjugate (ADC) in preclinical development for the treatment of EGFR-positive cancers. IMGN289 utilizes the same SMCC thioether linker and DM1 cytotoxic agent used in trastuzumab emtansine (T-DM1), and both conjugates contain approximately 3.5 DM1 molecules per antibody. The stability of the SMCC linker is exemplified by several reports that have shown maytansinoid release only after hydrolysis of the antibody backbone within cells and tissue to yield lysine-SMCC-DM1. Despite these findings, pharmacokinetic (PK) data for T-DM1 point to a faster clearance for conjugated antibody than for total antibody. Additionally, reports of payload release from non-maytansinoid, cysteine-linked ADCs via thiol-maleimide exchange in plasma have led to speculation of DM1 release from T-DM1, and of this occurring via a similar mechanism. Consequently, we conducted a series of studies in mice to examine the PK behavior of IMGN289, its unmodified antibody component (J2898A) and a version of IMGN289 (J2898A-(CH2)3-DM1) in which the SMCC linker is replaced with an all-carbon linker incapable of cleavage via thiol-maleimide exchange. PK was assessed in CD-1 mice administered a single bolus iv dose of the test article. Total antibody and ADC concentrations (species with at least one linked DM1) were measured at periodic intervals over 35 days using standard sandwich ELISA assays. We also employed radioactive assays to directly measure the antibody and ADC components in plasma. For total antibody detection, the antibody or ADC was labeled with the radioactive tracer, N-succinimidyl-2,3-[3H]propionate. For ADC detection, tritium was incorporated into the C20-methoxy group of its maytansinoid moiety. The PK profiles for the ADCs and their unmodified antibody were found to be similar using the ELISA and radioactive assays for total antibody, having only slight changes in the PK parameters for the ADC. Using the ELISA assays, we found the total antibody and ADC PK profiles were indistinguishable for IMGN289, in contrast to the reported PK for T-DM1 in mice. The profiles developed using the radioactive assays were in good agreement with these findings, supporting that the ELISA assays were reliable. To confirm our results were not unique to IMGN289, we repeated the experiments with two additional antibody-SMCC-DM1 conjugates and found similar results. Additionally, the PK profile for the all- carbon linked conjugate, J2898A-C3-[3H]DM1, was similar to that of J2898A-SMCC-[3H]DM1 conjugate, suggesting little if any thiol-maleimide exchange in the latter, consistent with the finding of similar total antibody and ADC PK profiles for Ab-SMCC-DM1 conjugates. In summary, IMGN289 appears to retain the PK properties of its antibody component and avoids the payload release via thiol-maleimide exchange described for cysteine-maleimide linked ADCs. Citation Format: Jose F. Ponte, Xiuxia Sun, Nicholas C. Yoder, Nathan Fishkin, Sharon Wilhelm, Susan J. Hawes, Wayne Widdison, Robert A. Mastico, Jan Pinkas, Ravi J. Chari, Robert J. Lutz, Hans K. Erickson. The anti-EGFR ADC, IMGN289 displays favorable pharmacokinetic properties. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5677. doi:10.1158/1538-7445.AM2013-5677