posted on 2023-04-03, 08:22authored byWeining Weng, Tao Meng, Qianqian Zhao, Yi Shen, Guoxiang Fu, Jing Shi, Yue Zhang, Zhaohui Wang, Mingqiao Wang, Rong Pan, Linjie Ma, Caiwei Chen, Lijun Wang, Biao Zhou, Hui Zhang, Junyi Pu, Jianjian Zhang, Yi Peter Hu, Guoqiang Hua, Yu Qian, Shu-Hui Liu, Wenhao Hu, Xun Meng
Supplementary note shows the analytical characterization of the ADCs, and synthesis of drug-linkers
Funding
Guangdong Provincial Key Laboratory of Chiral Molecule and Drug Discovery
History
ARTICLE ABSTRACT
Antibody–drug conjugates (ADC) using DNA topoisomerase I inhibitor DXd/SN-38 have transformed cancer treatment, yet more effective ADCs are needed for overcoming resistance. We have designed an ADC class using a novel self-immolative T moiety for traceless conjugation and release of exatecan, a more potent topoisomerase I inhibitor with less sensitivity to multidrug resistance (MDR). Characterized by enhanced therapeutic indices, higher stability, and improved intratumoral pharmacodynamic response, antibody–T moiety–exatecan conjugates targeting HER2, HER3, and TROP2 overcome the intrinsic or treatment resistance of equivalent DXd/SN-38 ADCs in low-target-expression, large, and MDR+ tumors. T moiety–exatecan ADCs display durable antitumor activity in patient-derived xenograft and organoid models representative of unmet clinical needs, including EGFR ex19del/T790M/C797S triple-mutation lung cancer and BRAF/KRAS–TP53 double-mutant colon cancer, and show synergy with PARP/ATR inhibitor and anti–PD-1 treatment. High tolerability of the T moiety–exatecan ADC class in nonhuman primates supports its potential to expand the responding patient population and tumor types beyond current ADCs.
ADCs combining a novel self-immolative moiety and topoisomerase I inhibitor exatecan as payload show deep and durable response in low-target-expressing and MDR+ tumors resistant to DXd/SN-38 ADCs without increasing toxicity. This new class of ADCs has the potential to benefit an additional patient population beyond current options.See related commentary by Gupta et al., p. 817.This article is highlighted in the In This Issue feature, p. 799