436132ToxStrategies, Research Blvd Building, Austin, TX, USA.
Scholar Rock, Inc., Cambridge, MA, USA.
Int J Toxicol. 2021 May-Jun;40(3):226-241. doi: 10.1177/1091581821998945. Epub 2021 Mar 19.
Checkpoint inhibitors offer a promising immunotherapy strategy for cancer treatment; however, due to primary or acquired resistance, many patients do not achieve lasting clinical responses. Recently, the transforming growth factor-β (TGFβ) signaling pathway has been identified as a potential target to overcome primary resistance, although the nonselective inhibition of multiple TGFβ isoforms has led to dose-limiting cardiotoxicities. SRK-181 is a high-affinity, fully human antibody that selectively binds to latent TGFβ1 and inhibits its activation. To support SRK-181 clinical development, we present here a comprehensive preclinical assessment of its pharmacology, pharmacokinetics, and safety across multiple species. In vitro studies showed that SRK-181 has no effect on human platelet function and does not induce cytokine release in human peripheral blood. Four-week toxicology studies with SRK-181 showed that weekly intravenous administration achieved sustained serum exposure and was well tolerated in rats and monkeys, with no treatment-related adverse findings. The no-observed-adverse-effect levels levels were 200 mg/kg in rats and 300 mg/kg in monkeys, the highest doses tested, and provide a nonclinical safety factor of up to 813-fold (based on C) above the phase 1 starting dose of 80 mg every 3 weeks. In summary, the nonclinical pharmacology, pharmacokinetic, and toxicology data demonstrate that SRK-181 is a selective inhibitor of latent TGFβ1 that does not produce the nonclinical toxicities associated with nonselective TGFβ inhibition. These data support the initiation and safe conduct of a phase 1 trial with SRK-181 in patients with advanced cancer.
检查点抑制剂为癌症治疗提供了一种有前景的免疫治疗策略;然而,由于原发性或获得性耐药,许多患者无法获得持久的临床反应。最近,转化生长因子-β(TGFβ)信号通路已被确定为克服原发性耐药的潜在靶点,尽管多种 TGFβ 同工型的非选择性抑制导致了剂量限制的心脏毒性。SRK-181 是一种高亲和力的全人源抗体,可选择性结合潜伏 TGFβ1 并抑制其激活。为了支持 SRK-181 的临床开发,我们在此介绍了其在多种物种中的药理学、药代动力学和安全性的全面临床前评估。体外研究表明,SRK-181 对人血小板功能没有影响,也不会诱导人外周血中细胞因子的释放。为期 4 周的 SRK-181 毒理学研究表明,每周静脉给药可实现持续的血清暴露,并在大鼠和猴子中耐受良好,无治疗相关的不良发现。大鼠的无观察到不良效应水平(NOAEL)为 200mg/kg,猴子为 300mg/kg,这是测试的最高剂量,为 80mg/3 周的首次人体试验剂量提供了高达 813 倍的非临床安全系数(基于 C)。总之,非临床药理学、药代动力学和毒理学数据表明,SRK-181 是潜伏 TGFβ1 的选择性抑制剂,不会产生与非选择性 TGFβ 抑制相关的非临床毒性。这些数据支持在晚期癌症患者中启动和安全进行 SRK-181 的 I 期试验。