Faris, Jason, Bialucha, Carl, Ruan, Shiling, Zhu, Xu, DiDominick, Sarah, Wagner, Joel, Mansfield, Keith, Origuchi, Shizuka, Tran, Ben, Schoffski, Patrick, Concin, Nicole, Suarez, Cristina, Subbiah, Vivek and Ando, Yuichi (2021) A phase 1 study of a CDH6-Targeting antibody-drug conjugate in patients with advanced solid tumors with evaluation of inflammatory and neurological adverse events. Oncology Research and Treatment, 44 (10). pp. 547-556. ISSN 22965262

Abstract

Purpose: This first-in-human study (NCT02947152) evaluated the safety, tolerability, pharmacokinetics, and preliminary efficacy of HKT288, a first-in-class CDH6-targeting antibody-drug conjugate (ADC). Experimental Design: HKT288 was administered intravenously (IV) every 3 weeks until patients experienced unacceptable toxicity or progressive disease (PD). The starting dose of 0.3 mg/kg was determined based on the highest nonseverely toxic dose in monkeys, which was 2 mg/kg IV weekly. Based on preclinical toxicology, skin, eyes, bone marrow, and liver were expected targets of toxicity. Results: Nine patients were enrolled: 5 with renal cell carcinoma and 4 with epithelial ovarian cancer. The best overall response on the 0.3 mg/kg cohort in patients with measurable disease was RECIST v1.1 stable disease in 3 patients and PD in 2 patients. The most frequent adverse events (AEs) regardless of causality were pyrexia (44.4%), constipation (44.4%), fatigue (33.3%), and vomiting (33.3%). Three suspected-related neurologic AEs (Grade 2) were reported on the 0.75 mg/kg cohort: seizure in 1 patient and another patient with aphasia and encephalopathy. Further studies were unable to identify the underlying mechanism of the neurologic AEs, and the study was terminated early. Conclusions: Preclinical toxicology did not predict the neurotoxicity observed with HKT288, and a comprehensive assessment performed post hoc did not identify the mechanism of toxicity. The development of further CDH6-targeting ADCs should be pursued with caution.

Item Type:	Article
Keywords:	Advanced solid tumors Cadherin-6 HKT288 Neurological toxicity Phase 1
Date Deposited:	16 Nov 2021 00:45
Last Modified:	16 Nov 2021 00:45
URI:	https://oak.novartis.com/id/eprint/45192