NDI-101150

▎药明康德内容团队编辑本期看点1. Dyne Therapeutics公司治疗杜氏肌营养不良（DMD）等肌肉疾病的潜在“first-in-class”抗体偶联反义寡核苷酸（ASO）疗法的早期临床试验数据积极，可改善患者的肌肉功能。2. 在Orca Bio公司的在研同种异体T细胞免疫疗法Orca-T治疗急性髓系白血病（AML）的1期研究中，患者的一年总生存率达100%。3. iCell Gene Therapeutics公司的BCMA与CD19靶向复合嵌合抗原受体-T（BCMA-CD19 cCAR-T）细胞免疫疗法在早期临床试验中使系统性红斑狼疮（SLE）患者实现了长期无药物缓解。药明康德内容团队整理DYNE-101、DYNE-251：公布1/2期临床试验数据Dyne Therapeutics公司公布了分别用于治疗强直性肌营养不良1型（DM1）和DMD的抗体偶联ASO疗法DYNE-101和DYNE-251的积极1/2期临床试验结果。DYNE-101由与片段抗体（Fab）偶联的反义寡核苷酸组成，Fab与肌肉上高表达的转铁蛋白受体1（TfR1）结合。它旨在实现靶向肌肉组织递送，目的是减少细胞核中的有毒DMPK RNA、释放剪接蛋白、允许正常mRNA处理和正常蛋白翻译，并有可能阻止或逆转疾病进展。在1/2期临床试验ACHIEVE中，DYNE-101（5.4 mg/kg）在第3个月时表现出剂量依赖性剪接校正，剪接校正比例达到27%。此外，DYNE-101改善了患者的肌肉强直、肌肉力量以及多种患者报告的功能性和疲惫指标。DYNE-251由Fab偶联的磷酸二酰胺吗啉寡聚物（PMO）组成。它旨在实现靶向肌肉组织递送，促进外显子51跳跃，使肌肉细胞产生截短、功能性的抗肌萎缩蛋白（dystrophin），目标是停止或逆转疾病进展。在1/2期临床试验DELIVER中，DYNE-251（10 mg/kg）在6个月时将抗肌萎缩蛋白的表达水平提高到接受标准治疗患者的10倍。多种功能性检测也显示出接受DYNE-251治疗患者的功能改善。Orca-T：公布1b期临床试验数据 Orca Bio公司公布了其在研同种异体T细胞免疫疗法Orca-T用于治疗AML患者的1b期临床试验的积极结果。这款细胞疗法由富集的CD34+干细胞，以及通过高精度平台纯化、取材自单倍体匹配供体的特定T细胞亚群组合而成。Orca-Q有潜力改善患者的预后和降低移植物抗宿主疾病（GvHD）风险，并且无需对无法找到人类白细胞抗原（HLA）匹配的患者进行移植后环磷酰胺（PTCy）治疗。此次公布的结果显示，接受Orca-T治疗的37例AML患者中，12个月的无复发生存率和总生存率分别为82.5%和100%，12个月的非复发死亡率为0%。Orca-T在该亚组中的安全性与更大范围的1b期人群一致，没有发现新的安全性信号。Orca-T目前正在美国各大治疗中心进行关键性的3期临床试验评估。BCMA-CD19 cCAR-T：公布1期临床试验数据 iCell Gene Therapeutics宣布其BCMA-CD19 cCAR-T细胞免疫疗法的研究者发起临床试验（IIT）的积极结果。这款由iCell所设计的cCAR-T细胞免疫疗法，在单一结构中表达两种不同且功能齐全的CAR分子，一种靶向B细胞上的CD19分子，另一种靶向浆细胞上的BCMA。鉴于B细胞和长寿浆细胞具有独立的记忆，因此需要同时靶向B细胞和长寿浆细胞以消除所有升高的自身抗体。分析显示，所有接受足量初始剂量cCAR-T治疗的SLE/狼疮性肾炎（LN）患者，在治疗3个月后体内自身抗体呈现阴性，并在随访46个月时，均达到无症状和无药物缓解。ARO-RAGE：公布1/2期临床试验数据Arrowhead Pharmaceuticals公司公布了其用于治疗哮喘等肺部炎症性疾病的RNA干扰（RNAi）疗法ARO-RAGE的最新中期临床数据。高级糖化终产物受体（RAGE）是2型和非2型炎症级联的上游介质，与哮喘和多种炎症疾病的发病机制有关。ARO-RAGE通过RNAi抑制RAGE表达，旨在减少肺上皮细胞中RAGE蛋白的表达，从而有望减少RAGE依赖性炎症通路，以达到降低哮喘患者病情恶化的频率并改善其通气的目的。此次公布的中期结果表明，使用ARO-RAGE治疗后，正常健康受试者（NHV）和轻中度哮喘患者支气管肺泡灌洗液（BALF）和血清中的可溶性RAGE浓度呈剂量依赖性降低。轻度至中度哮喘患者使用两剂ARO-RAGE后，血清中的可溶性RAGE降低了88%，平均最大降幅达77%。此外，该候选疗法的安全性良好，药效学效应持续时间长，有望支持每两个月一次的给药频率。FG-3246：公布1期临床试验的新数据 FibroGen公布了其与Fortis Therapeutics联合开发的潜在“first-in-class”抗体偶联药物（ADC）FG-3246的1期临床试验的新数据。FG-3246旨在治疗转移性去势抵抗性前列腺癌和其他肿瘤类型，其靶向的CD46是一种细胞受体靶点，在前列腺癌和其他肿瘤类型中高度表达，并在大多数正常组织中表达非常有限。FG-3246由抗CD46抗体与抗有丝分裂剂MMAE连接而成，MMAE是一种已经过临床验证的ADC有效载荷。此次公布的结果显示，FG-3246联用恩杂鲁胺使未经生物标志物筛选的患者的中位放射学无进展生存期（PFS）达到10.2个月。此外，FG-3246具有可接受的安全性，不良事件与其他包含细胞毒性药物MMAE作为载荷的ADC一致。TTX-080：公布1b期临床试验数据 Tizona Therapeutics公司公布了其HLA-G靶向抗体TTX-080在转移性结直肠癌（mCRC）和局部晚期/转移性头颈部鳞状细胞癌（mHNSCC）患者中的1b期临床试验数据。TTX-080联用西妥昔单抗对野生型RAS、BRAF、HER2阴性mCRC患者具有抗肿瘤活性，这些患者之前接受过的中位治疗线数为2线（范围为1-5）。患者的中位PFS为24.4周，36周时的无进展生存率为47%。在14例可评估的患者中，4例患者（29%）获得部分缓解（PR），6例患者（43%）保持疾病稳定（SD），这10例（71%）患者的疾病控制了超过90天。TTX-080联用西妥昔单抗可在人乳头瘤病毒（HPV）阴性mHNSCC患者中产生抗肿瘤活性。这些患者之前接受过的中位治疗线数为1线（范围为1-2），所有患者之前都接受过免疫疗法。患者的中位PFS为23.9周，24周时的无进展生存率为43%。在7例可评估的患者中，1例（14%）患者达到了完全缓解（CR），3例（43%）患者达到了PR，1例（14%）患者达到了SD，这5例（71%）患者的疾病控制了超过90天。SON-1010：公布两项1期临床试验的新数据 Sonnet BioTherapeutics公司公布了其在研免疫调节重组蛋白SON-1010的两项1期临床试验的新数据。SON-1010为一重组蛋白，由单链人类IL-12蛋白与和白蛋白结合的抗体单链片段组合而成，具潜力通过刺激产生干扰素γ将像是非小细胞肺癌、黑色素瘤等肿瘤微环境由“冷”转“热”，活化先天免疫与适应性免疫细胞。这些肿瘤的肿瘤微环境中表达SPARC与GP60蛋白。目前，SON-1010研究共招募了61名受试者，患者已接受了25个周期的SON-1010单药治疗或10个周期的SON-1010联用Tecentriq治疗，在任何剂量水平上都未出现剂量限制性毒性。细胞因子数据显示，与重组人IL-12相比，SON-1010的半衰期延长了约10倍，可诱导长时间和可控的干扰素γ反应，且任何剂量下均未发现细胞因子释放综合征的证据。可评估的晚期实体瘤患者中有35%（8/23）在开始给药后的第四个月出现临床获益。Azenosertib：公布1期临床试验数据Zentalis Pharmaceuticals公司公布了新型、选择性口服生物可利用的WEE1抑制剂azenosertib联用吉西他滨治疗复发性或难治性骨肉瘤1期试验的最终结果。WEE1是G1-S和G2-M细胞周期检查点的主调控因子，通过对CDK1和CDK2的负调控来阻止DNA受损细胞的复制。通过抑制WEE1，azenosertib可使细胞周期在存在高水平DNA损伤的情况下继续进行，从而使癌细胞积累DNA损伤并最终死亡。 此次公布的结果显示，azenosertib联用吉西他滨的耐受性良好，与过去类似患者人群的队列相比，接受该组合疗法的患者的无事件生存率（EFS）的提高具有临床意义。前者16周的EFS大约为12%，后者18周时的EFS为39%（11/28）。NDI-101150：公布1/2期临床试验数据 Nimbus Therapeutics公司公布了其小分子HPK1抑制剂NDI-101150的早期临床试验的新数据。临床前研究发现，NDI-101150对HPK1的选择性是MAP4K家族相关蛋白的300多倍，这有望减少脱靶效应。此次公布的结果显示，NDI-101150的单药治疗为30例可评估患者中的5例（16.7%）带来了临床获益，包括1例CR（肾细胞癌）、1例PR（肾细胞癌）和3例SD。3名患有胰腺癌、肾细胞癌或子宫内膜癌的患者表现出了长时间（>6个月）的SD，肾细胞癌患者已保持疾病稳定21个月。此外，NDI-101150的耐受性良好，整体安全性可接受。KN-002：公布1b期临床试验数据 Kinaset Therapeutic公司公布了其口腔吸入式泛JAK抑制剂KN-002的1b期研究的积极结果。KN-002是一种对所有JAK亚型（即JAK1、JAK2、JAK3和TYK2）均有效的均衡抑制剂，目前正作为一种非侵入性抗炎治疗药物进行开发，适用于所有接受中高剂量吸入型糖皮质激素（ICS）或长效β2受体激动剂（LABA）维持治疗但病情控制不佳的嗜酸性粒细胞性和非嗜酸性粒细胞性哮喘患者以及慢性阻塞性肺病患者。KN-002配制成干粉，具有出色的递送效率和化学/物理稳定性。通过吸入进行局部给药，KN-002能够在肺部炎症部位达到治疗浓度，同时最大限度地降低全身暴露水平。这项随机、双盲、安慰剂对照研究报告称，在为未接受过吸入皮质类固醇治疗的轻度哮喘患者进行为期10天、每天剂量≤16 mg的治疗后，未发现安全性或耐受性问题。此外，每天使用一次和两次KN-002可在临床上显著降低部分呼出一氧化氮（FeNO）水平。▲欲了解更多前沿技术在生物医药产业中的应用，请长按扫描上方二维码，即可访问“药明直播间”，观看相关话题的直播讨论与精彩回放参考资料（可上下滑动查看）[1] GC Biopharma/Novel Pharma's Sanfilippo Syndrome Treatment Obtains FDA IND Approval. 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Pictured: 3D illustration of a tumor and its microenvironment/iStock, CIPhoto Nimbus Therapeutics’ small molecule drug candidate NDI-101150 showed strong potential for clinical benefit in patients with advanced solid tumors, the Boston-based biotech announced on Thursday. Results from a Phase I/II study, which will be presented at the American Society of Clinical Oncology annual meeting next week, demonstrated that five out of 30 evaluable patients, or 16.7%, drew clinical benefit from NDI-101150 monotherapy. One patient, who had renal cell carcinoma (RCC), achieved complete response, defined as the disappearance of a tumor and other signs of cancer. Another RCC patient in the dose-expansion cohort showed partial response. Both treatment responders had undergone several prior lines of treatment, including checkpoint inhibitors. Three other patients were able to reach and sustain stable disease for more than six months while undergoing treatment with Nimbus’ drug candidate. These patients had RCC, pancreatic cancer and endometrial cancer, respectively. In terms of safety, the biotech noted that NDI-101150 was “well-tolerated” and that its overall safety profile “remains acceptable.” According to the study’s abstract, 12.8% of treated patients, experienced grade ≥3 treatment-related adverse events. Most common side effects were nausea, vomiting, diarrhea and fatigue. While a 16.7% clinical benefit rate might seem low, Nimbus CMO Nathalie Franchimont in a statement said that the biotech is “encouraged” by these early data which further point to HPK1 “as a differentiated next-generation immunotherapy target” for solid tumors. “NDI-101150 is a potent and highly selective HPK1 inhibitor that has the potential to achieve significant tumor growth inhibition and make a meaningful difference for patients,” Franchimont added. Designed to be orally available, NDI-101150 is a reversible HPK1 inhibitor that works by boosting the activation of T cells, B cells and dendritic cells. The candidate allows the body to “mount a robust anti-tumor response, even under immunosuppressive conditions,” according to Nimbus’ website. NDI-101150 is Nimbus’ only candidate in the clinic and is being developed as a treatment for solid tumors. Aside from its clinical benefit, the Phase I/II study also sought to verify this mechanism of action. Using biopsy samples from an RCC patient on treatment, Nimbus found “increased infiltration” of activated CD8-positive T cells and dendritic cells versus archival biopsies, according to the abstract. A separate portion of the study is testing the combination of NDI-101150 with Merck’s Keytruda (pembrolizumab). Thursday’s readout comes more than a year after Nimbus sold its oral TYK2 inhibitor zasocitinib—along with its wholly owned subsidiary Nimbus Lakshmi—to Takeda for $4 billion upfront, plus potentially $2 billion more contingent on annual sales milestones. Tristan Manalac is an independent science writer based in Metro Manila, Philippines. Reach out to him on LinkedIn or email him at tristan@tristanmanalac.com or tristan.manalac@biospace.com.