Guangdong Key Laboratory of Chiral Molecule and Drug Discovery, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, P.R. China.
Multitude Therapeutics, Shanghai, P.R. China.
Mol Cancer Ther. 2023 Sep 5;22(9):1013-1027. doi: 10.1158/1535-7163.MCT-23-0198.
HER3 is a unique member of the EGFR family of tyrosine kinases, which is broadly expressed in several cancers, including breast, lung, pancreatic, colorectal, gastric, prostate, and bladder cancers and is often associated with poor patient outcomes and therapeutic resistance. U3-1402/Patritumab-GGFG-DXd is the first successful HER3-targeting antibody-drug conjugate (ADC) with clinical efficacy in non-small cell lung cancer. However, over 60% of patients are nonresponsive to U3-1402 due to low target expression levels and responses tend to be in patients with higher target expression levels. U3-1402 is also ineffective in more challenging tumor types such as colorectal cancer. AMT-562 was generated by a novel anti-HER3 antibody Ab562 and a modified self-immolative PABC spacer (T800) to conjugate exatecan. Exatecan showed higher cytotoxic potency than its derivative DXd. Ab562 was selected because of its moderate affinity for minimizing potential toxicity and improving tumor penetration purposes. Both alone or in combination therapies, AMT-562 showed potent and durable antitumor response in low HER3 expression xenograft and heterogeneous patient-derived xenograft/organoid models, including digestive system and lung tumors representing of unmet needs. Combination therapies pairing AMT-562 with therapeutic antibodies, inhibitors of CHEK1, KRAS, and tyrosine kinase inhibitor showed higher synergistic efficacy than Patritumab-GGFG-DXd. Pharmacokinetic and safety profiles of AMT-562 were favorable and the highest dose lacking severe toxicity was 30 mg/kg in cynomolgus monkeys. AMT-562 has potential to be a superior HER3-targeting ADC with a higher therapeutic window that can overcome resistance to generate higher percentage and more durable responses in U3-1402-insensitive tumors.
HER3 是表皮生长因子受体(EGFR)家族酪氨酸激酶的独特成员,广泛表达于多种癌症中,包括乳腺癌、肺癌、胰腺癌、结直肠癌、胃癌、前列腺癌和膀胱癌,并且通常与患者预后不良和治疗耐药有关。U3-1402/Patritumab-GGFG-DXd 是首个在非小细胞肺癌中具有临床疗效的针对 HER3 的靶向抗体药物偶联物(ADC)。然而,超过 60%的患者对 U3-1402 无反应,这是由于靶标表达水平低,并且反应往往发生在靶标表达水平较高的患者中。U3-1402 在更具挑战性的肿瘤类型(如结直肠癌)中也无效。AMT-562 是通过新型抗 HER3 抗体 Ab562 和改良的自毁性 PABC 间隔物(T800)与依喜替康偶联而产生的。依喜替康的细胞毒性比其衍生物 DXd 更强。选择 Ab562 是因为其对最小化潜在毒性和改善肿瘤穿透性具有中等亲和力。单独或联合治疗,AMT-562 在低 HER3 表达的异种移植和异质患者衍生的异种移植/类器官模型中表现出强大且持久的抗肿瘤反应,包括消化系统和肺部肿瘤,这些肿瘤代表了未满足的需求。与 AMT-562 联合治疗的组合疗法包括与治疗性抗体、CHEK1、KRAS 和酪氨酸激酶抑制剂联合使用,显示出比 Patritumab-GGFG-DXd 更高的协同疗效。AMT-562 的药代动力学和安全性特征良好,在食蟹猴中最高剂量为 30mg/kg 且无严重毒性。AMT-562 有可能成为一种具有更高治疗窗口的卓越 HER3 靶向 ADC,能够克服耐药性,在 U3-1402 不敏感的肿瘤中产生更高比例和更持久的反应。