Exploiting the Receptor-Binding Domains of R-Spondin 1 to Target Leucine-Rich Repeat-Containin G-Coupled Protein Receptor 5-Expressing Stem Cells in Ovarian Cancer

Leucine-rich repeat-containing G-protein-coupled receptor (LGR5) and LGR6 mark epithelial stem cells in normal tissues and tumors. They are expressed by stem cells in the ovarian surface and fallopian tube epithelia from which ovarian cancer arises. High-grade serous ovarian cancer is unique in expressing unusually high levels of LGR5 and LGR6 mRNA. R-spondins are the natural ligands for LGR5 and LGR6 to which they bind with nanomolar affinity. To target stem cells in ovarian cancer, we used the sortase reaction to site-specifically conjugate the potent cytotoxin monomethyl auristatin E (MMAE) via a protease sensitive linker to the two furin-like domains of RSPO1 (Fu1-Fu2) that mediate its binding to LGR5 and LGR6 and their co-receptors Zinc And Ring Finger 3 and Ring Finger Protein 43 via a protease-cleavable linker. An immunoglobulin Fc domain added to the N-terminal end served to dimerize the receptor-binding domains so that each molecule carries two MMAE. The resulting molecule, FcF2-MMAE, demonstrated: 1) selective LGR5-dependent low nanomolar cytotoxicity against ovarian cancer cells in vitro; 2) selectivity that was dependent on binding to both the LGR receptors and ubiquitin ligase co-receptors; 3) favorable stability and plasma pharmacokinetic properties when administered intravenously with an elimination half-life of 29.7 hours; 4) selective inhibition of LGR5-rich as opposed to isogenic LGR5-poor tumors in vivo; and, 5) therapeutic efficacy in three aggressive wild-type human ovarian cancer xenograft models. These results demonstrate the successful use of the Fu1-Fu2 domain of RSPO1 as a drug carrier and the ability of FcF2-MMAE to target cells in tumors that express stem cell markers. SIGNIFICANCE STATEMENT: FcF2-MMAE is a novel cancer therapeutic that exploits the high-affinity binding domains of RSPO1 to target monomethyl auristatin E to tumor stem cells that express LGR5. FcF2-MMAE has low nanomolar LGR5-dependent cytotoxicity in vitro, favorable pharmacokinetics, and differential efficacy in an isogenic LGR5-poor versus LGR5-rich ovarian cancer xenograft model when given on a weekly schedule.

Therapeutic Targeting of Tumor Cells Rich in LGR Stem Cell Receptors

LGR5 and LGR6 mark epithelial stem cells in many niches including the ovarian surface and fallopian tube epithelia from which ovarian cancer arises. Human ovarian cancers express these receptors at high levels and express one of their ligands, RSPO1, at levels uniquely higher than all other tumor types except mesothelioma. Reasoning that these receptors are also important to tumor stem cells, arming the LGR binding domain of RSPO1 with a cytotoxin may permit depletion of the tumor stem cells. The Fu₁-Fu₂ receptor binding domain of RSPO1 (R1FF), containing a sortase recognition sequence at the C-terminal end, was produced in bacteria and a single molecule of MMAE was attached to each R1FF through a val-cit-PAB linker using the sortase reaction, thus producing a homogeneous population of armed molecules. R1FF-MMAE demonstrated (1) selective LGR-dependent binding, uptake, and cytotoxicity; (2) low nM cytotoxicity to multiple types of human tumor cell lines in vitro; (3) favorable plasma pharmacokinetic properties when administered iv with an elimination half-life of 27.8 h; (4) favorable absorption from the peritoneal cavity; and (5) therapeutic activity in aggressive xenograft models of ovarian cancer in the absence of any weight loss or other adverse events. These results demonstrate that the Fu₁-Fu₂ domain of RSPO1 can be exploited to deliver a potent cytotoxin to tumor cells that express the LGR4-6 family of stem cell receptors.

Abstract 5206: IND enabling investigations of MVT-1075, a CA19-9 targeting radioimmunotherapy

Rationale: The CA19-9 antigen is overexpressed in pancreatic and other GI tumors. MVT-5873 (HuMab-5B1), a fully human monoclonal antibody currently in phase I study, targets the sialyl Lewis A (sLea) epitope on CA19-9, and is a promising platform for development of a targeted radioimmunotherapy (RIT). MVT-5873 was conjugated with the chelator CHX-A″-DTPA and radiolabeled with Lutetium-177 (177Lu) to form MVT-1075 (177Lu- CHX-A″-DTPA-HuMAb-5B1). We have completed IND enabling process development, stability, and characterization investigations and plan to initiate a phase I trial in patients with pancreatic cancer and other CA19-9 positive malignancies early in 2017.

Methods: Reproducible conditions to conjugate the chelator (p-SCN-Bn-CHX-A˝-DTPA) to MVT-5873 were developed by evaluating chelator to antibody ratios and incubation times. The stability of MVT-1075 was assessed in formulation buffer at shipping/handling conditions, and in human serum via thin layer chromatography (iTLC), size exclusion chromatography (SEC) and ion-exchange chromatography (CEX). The immunoreactive fraction was determined at each time point using a microsphere based LINDMO method developed for this program.

Results: MVT-5873 was buffer exchanged into 100mM sodium bicarbonate buffer at pH9 and combined with p-SCN-Bn-CHX-A˝-DTPA at 32.5°C for 90 min. Unincorporated chelator was removed by buffer exchange into 1M ammonium acetate buffer at pH7. The resulting conjugate, MVT-7814 (CHX-A˝-DTPA-HuMab-5B1), was characterized for degree and location of conjugation by MS, aggregates, ELISA binding, purity by CEX and pI determination. These analyses indicated a single CHX-A˝-DTPA on the heavy chain as the primary conjugate. In vitro binding by ELISA was comparable to MVT-5873. Purity by SEC was 99% showing minimal aggregation. MVT-7814 is stored frozen at <-60°C and stable to 5 freeze-thaw cycles.

To qualify MVT-1075 for clinical use, MVT-7814 was radiolabeled with 177Lu. Purity data indicate a high degree (>98%) of 177Lu incorporation by iTLC and stability in formulation buffer up to 120 hours (< -15oC) and 24 hours ambient by immunoreactivity as assessed by a LINDMO method (> 90%) at both conditions. Serum stability at 37oC showed radiochemical purity >82% by iTLC and immunoreactivity >62% after 5 days, further supporting the use of this product in clinical trials.

Conclusions: The conjugation of MVT-5873 with p-SCN-Bn-CHX-A˝-DTPA reproducibly yields a well characterized bulk intermediate (MVT-7814) modified on the heavy chain. Radiolabeling with 177Lu and stability studies in formulation buffer and human serum indicate that MVT-1075 maintains radiochemical purity and target immunoreactivity to support clinical use. The results of these studies were consistent with specifications and support the clinical utility and submission of the MVT-1075 IND application with an expected FIH date early in 2017.

Citation Format: Dennis Gately, Marvin Peterson, Sara Dao, Scott Rudge, George St. George, Shannon Phillips, Paul Maffuid. IND enabling investigations of MVT-1075, a CA19-9 targeting radioimmunotherapy [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 5206. doi:10.1158/1538-7445.AM2017-5206

Novel Phosphate Modified Cathepsin B Linkers: Improving Aqueous Solubility and Enhancing Payload Scope of ADCs

In an effort to examine the utility of antibody-drug conjugates (ADCs) beyond oncology indications, a novel phosphate bridged Cathepsin B sensitive linker was developed to enable the targeted delivery of glucocorticoids. Phosphate bridging of the Cathepsin B sensitive linkers allows for payload attachment at an aliphatic alcohol. As small molecule drug-linkers, these aqueous soluble phosphate containing drug-linkers were found to have robust plasma stability coupled with rapid release of payload in a lysosomal environment. Site-specific ADCs were successfully made between these drug-linkers and an antibody against human CD70, a receptor specifically expressed in immune cells but also found aberrantly expressed in multiple human carcinomas. These ADCs demonstrated in vitro targeted delivery of glucocorticoids to a representative cell line as measured by changes in glucocorticoid receptor (GR) mediated gene mRNA levels. This novel linker expands the scope of potential ADC payloads by allowing an aliphatic alcohol to be a stable, yet cleavable attachment site. This phosphate linker may have broad utility for internalizing ADCs as well as other targeted delivery platforms.

Discovery of Pyrophosphate Diesters as Tunable, Soluble, and Bioorthogonal Linkers for Site-Specific Antibody-Drug Conjugates

As part of an effort to examine the utility of antibody-drug conjugates (ADCs) beyond oncology indications, a novel pyrophosphate ester linker was discovered to enable the targeted delivery of glucocorticoids. As small molecules, these highly soluble phosphate ester drug linkers were found to have ideal orthogonal properties: robust plasma stability coupled with rapid release of payload in a lysosomal environment. Building upon these findings, site-specific ADCs were made between this drug linker combination and an antibody against human CD70, a receptor specifically expressed in immune cells but also found aberrantly expressed in multiple human carcinomas. Full characterization of these ADCs enabled procession to in vitro proof of concept, wherein ADCs 1-22 and 1-37 were demonstrated to afford potent, targeted delivery of glucocorticoids to a representative cell line, as measured by changes in glucocorticoid receptor-mediated gene mRNA levels. These activities were found to be antibody-, linker-, and payload-dependent. Preliminary mechanistic studies support the notion that lysosomal trafficking and enzymatic linker cleavage are required for activity and that the utility for the pyrophosphate linker may be general for internalizing ADCs as well as other targeted delivery platforms.

Development and validation of an antibody-dependent cell-mediated cytotoxicity-reporter gene assay

Humanized monoclonal antibodies (mAbs) are the fastest growing class of biological therapeutics that are being developed for various medical indications, and more than 30 mAbs are already approved and in the market place. Antibody-dependent cell-mediated cytotoxicity (ADCC) is an important biological function attributed to the mechanism of action of several therapeutic antibodies, particularly oncology targeting mAbs. The ADCC assay is a complicated and highly variable assay. Thus, the use of an ADCC assay as a lot release test or a stability test for clinical trial batches of mAbs has been a substantial challenge to install in quality control laboratories. We describe here the development and validation of an alternate approach, an ADCC-reporter gene assay that is based on the key attributes of the PBMC-based ADCC assay. We tested the biological relevance of this assay using an anti-CD20 based model and demonstrated that this ADCC-reporter assay correlated well with standard ADCC assays when induced with the drugable human isotypes [IgG1, IgG2, IgG4, IgG4S > P (S228P) and IgG4PAA (S228P, F234A, L235A)] and with IgG1 isotype variants with varying amounts of fucosylation. This data demonstrates that the ADCC-reporter gene assay has performance characteristics (accuracy, precision and robustness) to be used not only as a potency assay for lot release and stability testing for antibody therapeutics, but also as a key assay for the characterization and process development of therapeutic molecules.

Stimulation of DNA synthesis and c-fos expression in corneal endothelium by insulin or insulin-like growth factor-I

PURPOSE

To study the growth regulation of bovine corneal endothelium, the effects of insulin and insulin-like growth factor-I on the expression of the c-fos proto-oncogene as well as on DNA synthesis were analyzed. Bovine corneal endothelial cells were also analyzed for the presence of insulin and insulin-like growth factor-I receptors.

METHODS

Indirect immunofluorescence was used to assess the effect of stimulation by insulin and insulin-like growth factor-I on c-fos protein expression and DNA synthesis quiescent bovine corneal endothelium. Receptor number was determined by 125I-insulin or 125I-IGF-I binding studies.

RESULTS

Fetal bovine serum strongly stimulated c-fos protein expression and DNA synthesis. Insulin-like growth factor-I was less effective while insulin was effective only at high concentrations. Scatchard analysis of 125I-insulin-like growth factor-I and 125I-insulin binding to bovine corneal endothelium revealed 180,000 IGF-I receptors and 7,000 insulin receptors.

CONCLUSION

The number of insulin-like growth factor-I receptors far exceeds the number of insulin receptors in bovine corneal endothelium, suggesting that the effects of insulin on c-fos gene expression and mitogenesis were likely to be mediated through the insulin-like growth factor-I receptor.

Expression of SV40 virus large T antigen by recombinant adenoviruses activates proliferation of corneal endothelium in vitro

Infection with the Ad5-SVR4 virus was used to introduce the large T antigen encoding region of the SV40 virus into bovine and human corneal endothelial cells. Expression of large T antigen occurred in 40% of bovine corneal endothelial cells after a 24-h incubation time versus 12% after 8 h of incubation. By 48 h after infection, almost all (92.8%) bovine corneal endothelial cells expressed large T antigen. Bovine and human corneal endothelial cells which expressed large T antigen proliferated and the characteristic morphologic features of corneal endothelium were maintained. This method may enable growth of enough corneal endothelium to perform studies to elucidate the biochemical mechanisms involved in regulating endothelial cell function.

Fos expression and growth regulation in bovine corneal endothelial cells

The authors evaluated the effects of stimulation (by serum, wounding, and three peptide growth factors: fibroblast growth factor [FGF], insulin, and transforming growth factor-beta [TGF-beta 1]) on the expression of the protein product of the immediate early gene, c-fos in bovine corneal endothelial (BCE) cells. These results were compared with those of cells which were made quiescent by serum starvation. They also examined the effect of these same growth factors or wounding on DNA synthesis. Quiescent cells expressed low levels of c-fos protein. Serum was the most potent stimulator, whereas FGF and insulin were modest stimulators. TGF-beta 1 did not significantly stimulate c-fos protein production. The results from DNA synthesis were different. Serum and FGF were still the most potent stimulators; insulin and TGF-beta 1 were weak stimulators. These data suggest that growth factors induce c-fos protein in BCE cells and that this may in part regulate the downstream event, cellular proliferation. Further investigation into the regulation of this and other protooncogene products may provide insight into the mechanisms which modulate corneal endothelial cell growth in humans.