LICR Targeted Therapies
Targeted Antibody Therapies
Targeted antibodies have emerged as an important
therapeutic modality for treating cancer. Although results from clinical
trials with antibodies do show some efficacy, the widely-predicted success
of several targeted antibodies has failed to fully materialize thus far.
LICR believes that the full potential of this type of therapy will only
be realized by more comprehensive study.
LICR First in Man Antibody Investigation
LICR utilizes its own clinical investigation model to efficiently and
comprehensively evaluate the potential of a mAb for clinical development.
The objective is to acquire as much information as possible in a single
clinical trial about the mAb’s safety, immunogenicity, targeting,
pharmacokinetics and anti-tumor activity.
- Safety:
The health and welfare of patients following antibody transfusions
are key concerns of all clinical trials. All adverse events experienced
by patients while on study are reported to the central LICR Office
of Clinical Trials Management and assessed for relationship to the
therapy.
- Immunogenecity:
Blood samples are tested for the presence of secondary antibodies
- human anti-human antibodies (HAHA), or human anti-chimeric antibodies
(HACA) - that indicate the mAb is immunogenic. HAHA and HACA build
up over time, and are thus most effectively monitored using a multiple
infusion and testing strategy such as that employed by LICR.
- Targeting:
Utilization of a trace-labeled mAb enables the visualization of
tumor targeting and distribution to normal tissues, and the duration
of mAb binding (see figure at right). In addition, the rate of clearance
of a second injection of trace-labelled mAb after completing a course
of antibody treatment provides another way to assess immunogenicity.
More rapid clearance indicates that the mAb has elicited an immune
reaction and is therefore unlikely to be of clinical value.
- Pharmacokinetics:
The mAb protein concentration in blood is used to calculate half-life,
body clearance, volume of distribution and other pharmacokinetic
parameters, which will be used to establish dose and delivery.
- Tumor Response:
The tumor response to mAb treatment is evaluated in accordance with
the accepted standards of clinical practice and patient care.
Clinical Development
To optimize targeting and therapeutic efficiency, preclinical and clinical
investigations are addressing the many variables involved in evolving
successful antibody-based therapies:
- Antibody
Variants : The LICR Antibody Targeting Program is assessing
the therapeutic potential of chimeric, humanized, and scFv antibodies.
The smaller scFv constructs may be better suited to the delivery
of particular isotopes/toxins to certain tumors. In addition, antibody-cytokine
fusion proteins have been constructed as a way to deliver inflammatory
or immunomodulatory cytokines, eg tumor necrosis factor (TNF) to
the tumor site.
- Isotopes/Toxins:
LICR is assessing several different radioisotopes for their potential
for RIT, or for diagnostic imaging using PET and SPECT. Different
isotopes have different physical properties making them better suited
to therapy or diagnostic imaging depending on the half-life of the
mAb and the radioisotope. The therapeutic potential of selected
drugs and toxins is also being investigated.
- Antibody Fate:
The first objective of LICR’s Antibody Targeting Program is
to identify antibodies with high selectivity for tumor cells, no
immunogenicity, and excellent tumor targeting characteristics in
humans. Much attention is now being focused on the fate of the different
antibodies in the LICR portfolio after they bind to the tumor cell
surface. Some antibodies remain on the cell surface for extended
periods, others are promptly taken up by the cell, in a process
called internalization, and directed to various cellular compartments.
Understanding the fate of the antibody after localization to the
tumor will help define the optimal therapeutic strategies for different
antibodies and antibody constructs.
Antibody Table
| LICR Antibodies in Clinical Discovery |
| |
Ongoing or completed clinical trials. |
| Antibody |
Target |
Tumor |
mAb |
mAb + CT |
RIT |
RIT + CT |
PET |
| Humanized A33 |
Colonocyte differentiation antigen |
Colorectal |
X |
X |
X |
X |
X |
| Chimeric G250 |
Carbonic anhydrase IX |
Renal Cell Carcinoma |
X |
X |
X |
|
X |
| Humanized F19 |
FAPα in stroma (connecting tissue around tumors) |
Breast, Colorectal, Non small cell, Head and Neck |
X |
|
X |
|
|
| Chimeric KW2871 |
GD3 ganglioside |
Melanoma |
X |
|
|
|
|
| Humanized 3S193 |
LewisY blood group antigen |
Breast, Colorectal, Small cell lung, Ovarian |
X |
|
|
|
|
| Humanized LK26 |
Folate binding protein |
Ovarian |
X |
|
|
|
|
| Chimeric 806 |
Overexpressed EGFR and Δ2-7 EGFR |
|
X |
|
|
|
|
| LICR Antibodies in Clinical Discovery |
| MX35 |
Unknown target antigen |
Ovarian |
|
|
|
|
|
| A34 |
Differentiation antigen |
Gastric |
|
|
|
|
|
| Lewisb |
Lewisb blood group antigen |
Gastric |
|
|
|
|
|
| Legend: mAb = monoclonal antibody; CT = chemotherapy; RIT = radiotherapy; PET = positron emission tomography |