Angela Romanelli

The Antitumor Activity of IMGN529, a CD37-Targeting Antibody-Drug Conjugate, Is Potentiated by Rituximab in Non-Hodgkin Lymphoma Models

Naratuximab emtansine (IMGN529) is an investigational antibody-drug conjugate consisting of a CD37-targeting antibody conjugated to the maytansine-derived microtuble disruptor, DM1. IMGN529 has shown promising preclinical and clinical activity in non-Hodgkin lymphoma, including diffuse large B-cell lymphoma (DLBCL). Due to the aggressive nature of the disease, DLBCL is often treated with combination therapies to maximize clinical outcomes; therefore, we investigated the potential of combining IMGN529 with both standard-of-care and emerging therapies against multiple oncology-relevant targets and pathways. The strongest enhancement in potency was seen with anti-CD20 antibodies, including rituximab. The combination of IMGN529 and rituximab was more potent than either agent alone, and this combinatorial benefit was associated with increased apoptotic induction and cell death. Additional studies revealed that rituximab treatment increased the internalization and degradation of the CD37-targeting antibody moiety of IMGN529. The combination of IMGN529 and rituximab was highly efficacious in multiple xenograft models, with superior antitumor efficacy seen compared to either agent alone or treatment with R-CHOP therapy. These findings suggest a novel mechanism whereby the potency of IMGN529 can be enhanced by CD20 binding, which results in the increased internalization and degradation of IMGN529 leading to the generation of greater amounts of cytotoxic catabolite. Overall, these data provide a biological rationale for the enhanced activity of IMGN529 in combination with rituximab and support the ongoing clinical evaluation of IMGN529 in combination with rituximab in patients with relapsed and/or refractory DLBCL.

Abstract 45:In vitroandin vivoactivity of a novel c-Met-targeting antibody-drug conjugate using a DNA-alkylating, indolinobenzodiazepine payload

Purpose: c-Met dysregulation and/or overexpression are associated with tumor progression, metastasis and poor prognosis in numerous cancers. Despite strong pre-clinical evidence that blocking c-Met activity inhibits tumor cell growth and metastasis, targeted therapies have thus far failed to deliver an effective treatment option to the majority of patients. To address patients with both c-Met over-expressing and MET amplified tumors, we designed an antibody-drug conjugate (ADC) comprised of a humanized anti-c-Met monoclonal antibody linked to a highly potent indolinobenzodiazepine DNA-alkylating payload (DGN549) to enable activity against not only MET amplified but also c-Met over-expressing tumors. Experimental Design: Panels of monoclonal antibodies (Abs) against c-Met were generated and screened for antagonistic and agonistic activity in the presence or absence of the c-Met ligand, HGF. Lead Abs were humanized and conjugated to DGN549 either through lysine (Drug-to-Ab ratio (DAR) = 2.5) or engineered cysteine residues (DAR 2.0). Abs were also conjugated via lysine residues to the potent anti-microtubule maytansine derivative, DM4, using a sulfo-SPDB linker (DAR 3.5). Binding and cytotoxicity of ADCs were tested in vitro on normal and cancer cell lines with varying c-Met levels. Expression of c-Met was evaluated in patient tumors and xenografts along with normal human tissues using the CONFIRM immunohistochemistry assay. In vivo efficacy of anti-c-Met-DGN549 and anti-c-Met-DM4 ADCs was tested in both MET amplified and c-Met over-expressed (but non-amplified) xenograft tumor models. Results: A humanized anti-c-Met antibody, hucMet27, was identified which exhibits low c-Met agonist activity. Conjugates of hucMet27 were prepared with two different payloads, DGN549 and DM4, and in vitro and in vivo activity were determined. Both DGN549 and DM4 conjugates of hucMet27 bound with similar sub-nanomolar affinity to c-Met-expressing cells. hucMet27-DGN549 conjugates exhibited potent cytotoxicity against a large panel of c-Met expressing cell lines. By contrast, the potency of the hucMet27-DM4 conjugate was restricted mainly to cell lines harboring MET amplification, despite all cell lines demonstrating sensitivity to the unconjugated payload. When tested in mice bearing human xenograft tumors, both hucMet27-DGN549 and hucMet-DM4 conjugates were highly active in a MET amplified model, whereas hucMet27-DGN549 was more potent in inducing regressions in a model with c-Met over-expression without MET amplification. Conclusion: hucMet27-DGN549 exhibits compelling c-Met targeted anti-cancer activity in vitro and in vivo, and represents a promising therapeutic strategy to deliver a potent cytotoxic agent to tumor cells bearing a wide range of c-Met expression. Citation Format: Katharine C. Lai, Asli Muvaffak, Min Li, Marian Themeles, Surina Sikka, Kerry Donahue, Stuart W. Hicks, Angela Romanelli, Thomas Chittenden. In vitro and in vivo activity of a novel c-Met-targeting antibody-drug conjugate using a DNA-alkylating, indolinobenzodiazepine payload [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 45. doi:10.1158/1538-7445.AM2017-45

Abstract 1073: Increased internalization and processing of the CD37-targeting antibody-drug conjugate, naratuximab emtansine (IMGN529), in the presence of rituximab leads to enhanced potency in diffuse large B-cell lymphoma models

Naratuximab emtansine (IMGN529) is an investigational CD37-targeting antibody-drug conjugate (ADC) that has shown both preclinical and clinical activity in DLBCL . We have shown that rituximab, an anti-CD20 monoclonal antibody, enhances the preclinical activity of IMGN529. The combination of IMGN529 and rituximab is more active than either agent alone, and this benefit is associated with an increase in apoptosis and cell death, resulting in enhanced potency in DLBCL models. Efficacy of ADCs, such as IMGN529, relies on the internalization, intracellular trafficking and degradation of the ADC leading to the release of the cytotoxic catabolite. To explore the mechanism underlying the enhanced activity of the combination, we investigated the effect of rituximab treatment on the binding, internalization and processing of IMGN529 in vitro. To evaluate the effect on the internalization of IMGN529, DLBCL cell lines were incubated with fluorescently-labeled K7153A antibody (the CD37 targeting moiety of IMGN529) alone or in combination with rituximab or a non-targeting control antibody. K7153A internalization was similar whether incubated alone or with the non-targeting control. However, when cells were co-incubated with K7153A and rituximab, the internalization of K7153A significantly increased. This increase was also observed with other anti-CD20 antibodies suggesting an anti-CD20 class effect. Radiolabeled processing studies were performed to determine if the observed increase in internalization led to a corresponding increase in antibody degradation, which is required for the release of the cytotoxic agent in IMGN529. By trace-labeling the K7153A antibody with tritiated propionate (3H-K7153A), we were able to follow binding, uptake, and degradation of the antibody component of IMGN529 in DLBCL cell lines. Following pulse exposure, the amount of 3H-K7153A degraded after 24 hours remained the same whether treated alone or in combination with other B-cell targeting antibodies. However, when combined with rituximab the percentage of degraded 3H-K7153A increased as much as 3-fold and a similar increase of 3H catabolite was generated. When compared, the combination of K7153A and rituximab produced considerably more catabolite (~6-fold, p-value These findings suggest a novel mechanism where the increased potency of IMGN529 and rituximab can be explained by CD20 binding resulting in an increase in internalization and degradation of IMGN529, leading to generation of greater amounts of cytotoxic agent. Overall, these data provide a biological rationale for the enhanced activity of the rituximab plus IMGN529 combination, further supporting the clinical development strategy of this combination in DLBCL. Citation Format: Stuart W. Hicks, Katharine C. Lai, Yong Yi, Prerak Shah, Cristina L. Gavrilescu, Joe Ponte, Callum M. Sloss, Angela Romanelli. Increased internalization and processing of the CD37-targeting antibody-drug conjugate, naratuximab emtansine (IMGN529), in the presence of rituximab leads to enhanced potency in diffuse large B-cell lymphoma models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1073. doi:10.1158/1538-7445.AM2017-1073

Abstract 3400A: Development and application of an immunohistochemistry-based clinical assay for evaluating Folate Receptor Alpha (FRα) expression in a phase I clinical trial of IMGN853

Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA A biomarker-based patient selection strategy, coupled with the co-development of a companion diagnostic, is key to the successful development of molecularly targeted cancer therapeutics. IMGN853 is a Folate Receptor Alpha (FRα)-targeting antibody-drug conjugate (ADC) consisting of an anti-FRα antibody linked to DM4, a highly cytotoxic maytansinoid, via a cleavable disulfide linker. FRα is a glycosyl-phosphatidylinositol-linked membrane protein commonly over-expressed in several solid tumor types including epithelial ovarian cancer (EOC), endometrial cancer and lung adenocarcinoma, with limited expression in normal tissues. Previously reported preclinical data demonstrated regression or significant inhibition of tumor growth by the conjugate in tumor models with clinically relevant levels of FRα expression. IMGN853 is currently in a phase I clinical trial for safety and tolerability in patients with FRα-positive solid tumors. Preliminary evidence of clinical activity has been observed in patients receiving IMGN853 treatment. Immunohistochemistry (IHC) is one of the most widely adopted techniques in clinical labs for semi-quantitative determination of protein expression in different cellular compartments. We have developed an IHC assay to support the FRα-expression based patient selection strategy in the clinical development of IMGN853. To this end, a novel murine monoclonal antibody with high specificity for human FRα was generated. This antibody, 353-2.1, is compatible with formalin fixed and paraffin embedded (FFPE) tissue samples and can recognize the same pool of FRα molecules as IMGN853, making it an ideal candidate for a companion diagnostic for IMGN853. The antibody was used to develop and optimize an assay that covers a broad dynamic range of FRα expression, allowing discrimination among high, moderate and low levels of expression. Data from tissue microarrays that cover a broad range of normal and tumor tissue types, as well as additional prevalence data in selected tumor types, were used to validate this assay. They also demonstrate that the FRα-expression data generated using this assay are consistent with previous findings. This clinical FRα IHC assay has been successfully used to measure FRα expression in more than 100 patient tumor samples submitted for testing in the ongoing IMGN853 phase I trial. A summary of FRα staining pattern and expression level data from these patients will be presented, as well as the prevalence in each tumor type. Citation Format: Jianhua Zhao, Alyssa LaBelle, Olga Ab, Krista Acosta, Al Yates, Yinghui Zhou, Angela Romanelli. Development and application of an immunohistochemistry-based clinical assay for evaluating Folate Receptor Alpha (FRα) expression in a phase I clinical trial of IMGN853. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3400A. doi:10.1158/1538-7445.AM2015-3400A

Abstract 4765: Drug synergies observed for antibody and toxin components of SAR3419 ADC contribute to overall conjugate efficacy and can be combination drug or tumor cell line dependent

SAR3419, a novel antibody-drug conjugate (ADC), is composed of a humanized monoclonal IgG1 anti-CD19 antibody (huB4) attached by a cleavable linker to DM4, a derivative of cytotoxic agent maytansine (an inhibitor of microtubule polymerization). CD19 expression is restricted to B-cells and treatment of CD19-positive human lymphoma cells with SAR3419 can result in cell cycle arrest followed by apoptosis. As traditional monotherapies can rarely treat cancer effectively, particularly in non-solid tumours, a combination high throughput screen (cHTS) was performed where SAR3419 was combined with two hundred potential enhancer compounds across a panel of twenty cell lines using a 6x6 combination dose response matrix. The enhancer compounds compose a library of approved, emerging oncology drugs, and well-defined molecular probes. Robust synergies were observed between SAR3419 and PI3K inhibitors and examined further. Target/pathway inhibitor redundancy for the class of compounds served to validate PI3K inhibition as important for combination synergy. Surprisingly, for several of the cell lines, the molecular mechanism important for SAR3419-dependent combination activity is distinct. For example, for the Daudi and REC-1 tumor cell lines, PI3K inhibitor synergy can be attributed to the toxin DM4. In contrast for SU-DHL4 and SU-DHL6 cell lines, little combination activity is observed with toxin alone while the conjugate is strongly synergistic. By examining three-way combination activities (PI3K inhibitor x DM4 x huB4) using high resolution matrices, we show that the anti-CD19 antibody huB4 contributes to the synergy in the SU-DHL6 cell line and linkage of DM4 to huB4 (SAR3419) shifts both the potency and maximum activity for PI3K inhibitor combinations. The results demonstrate that the antibody component of an ADC can contribute to combination activity for specific drug pairings in a drug and cell-type specific manner and has wide ranging implications with respect to combination drug design. Citation Format: Richard J. Rickles, Thomas P. Giordano, Shakira F. Cotard, Jill M. Grenier, Angela Romanelli, Ti Cai. Drug synergies observed for antibody and toxin components of SAR3419 ADC contribute to overall conjugate efficacy and can be combination drug or tumor cell line dependent. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4765. doi:10.1158/1538-7445.AM2014-4765