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Shatsky RA, Batra-Sharma H, Helsten T, Schwab RB, Pittman EI, Pu M, Weihe E, Ghia EM, Rassenti LZ, Molinolo A, Cabrera B, Breitmeyer JB, Widhopf GF, Messer K, Jamieson C, Kipps TJ, Parker BA. A phase 1b study of zilovertamab in combination with paclitaxel for locally advanced/unresectable or metastatic Her2-negative breast cancer. Breast Cancer Res 2024; 26:32. [PMID: 38408999 PMCID: PMC10895766 DOI: 10.1186/s13058-024-01782-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Zilovertamab is a humanized monoclonal antibody targeting ROR1, an onco-embryonic antigen expressed by malignant cells of a variety of solid tumors, including breast cancer. A prior phase 1 study showed that zilovertamab was well tolerated and effective in inhibiting ROR1-signaling, which leads to activation of ERK1/2, NF-κB, and NRF2 target genes. This phase 1b study evaluated the safety and tolerability of zilovertamab with paclitaxel in patients with advanced breast cancer. PATIENTS AND METHODS Eligible patients had locally advanced, unresectable, or metastatic HER2- breast cancer with Eastern Cooperative Group performance status of 0-2 and without prior taxane therapy in the advanced setting. Study treatment included 600 mg of zilovertamab administered intravenously (IV) on Days 1 and 15 of Cycle 1 and then Day 1 of each 28-day cycle along with paclitaxel weekly at 80 mg/m2 IV. RESULTS Study patients had received a median of 4 prior therapies (endocrine therapy + chemotherapy) for locally advanced, unresectable, or metastatic disease. No patient discontinued therapy due to toxicity ascribed to zilovertamab. Adverse events were consistent with the known safety profile of paclitaxel. Of 16 patients, 6 (38%) had a partial response, and 6/16 (38%) patients had stable disease as best tumor response. CONCLUSION The combination of zilovertamab and paclitaxel was safe and well tolerated in heavily pre-treated advanced breast cancer patients. Further evaluation of ROR1 targeting in breast cancer patients with zilovertamab is warranted. TRIAL REGISTRATION NCT02776917. Registered on ClinicalTrials.gov on 05/17/2016.
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Affiliation(s)
- Rebecca A Shatsky
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Hemali Batra-Sharma
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Teresa Helsten
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Richard B Schwab
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Emily I Pittman
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
| | - Minya Pu
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
| | - Elizabeth Weihe
- Department of Radiology, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Emanuela M Ghia
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Center for Novel Therapeutics, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Laura Z Rassenti
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Center for Novel Therapeutics, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Alfredo Molinolo
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
| | - Betty Cabrera
- University of California San Diego California Institute for Regenerative Medicine Alpha Clinic, La Jolla, San Diego, CA, USA
| | | | - George F Widhopf
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
- Center for Novel Therapeutics, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Karen Messer
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Catriona Jamieson
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA
- University of California San Diego California Institute for Regenerative Medicine Alpha Clinic, La Jolla, San Diego, CA, USA
- Sanford Stem Cell Institute, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Thomas J Kipps
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA
- Center for Novel Therapeutics, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Barbara A Parker
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive Mail Code 0987, La Jolla, San Diego, CA, 92093, USA.
- Department of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA.
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