Study of CDX-3379, a Human Monoclonal Antibody Targeting ERBB3, in Combination With the MEK Inhibitor, Trametinib, in Patients With Advanced Stage NRAS Mutant and BRAF/NRAS Wildtype (WT) Melanoma

The main goal of this study is to test if it is safe and effective to give CDX-3379 together to treat advanced melanoma in patients with the NRAS mutation and BRAF/NRAS wildtype.

开始日期2018-07-06

申办/合作机构

NYU Langone Health

[+1]

NCT02473731 / Completed临床1期

A Window of Opportunity Study of KTN3379 in Surgically Resectable Head and Neck Cancer Patients

The purpose of this study is to evaluate the activity and safety of KTN3379 in head and neck cancer patients and to explore downstream molecular pathways to identify tumor response and resistance mechanisms by evaluating various biomarkers before and after treatment.

开始日期2015-10-01

申办/合作机构

Celldex Therapeutics, Inc.

NCT02456701 / Completed临床1期

Enhancing Radioiodine (RAI) Incorporation Into BRAF Mutant, RAI Refractory Thyroid Cancers With the Combination of BRAF Inhibitor Vemurafenib and Anti-ErbB3 Antibody KTN3379: A Pilot Study With a Phase 1 Run-in

This is a patient pilot study testing the hypothesis that vemurafenib with the addition of KTN3379 can restore iodine incorporation in BRAF mutant (MUT), radioiodine-refractory (RAIR) thyroid cancer patients.

开始日期2015-06-01

申办/合作机构

Celldex Therapeutics, Inc.

[+1]

100 项与 KTN-3379 相关的临床结果

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100 项与 KTN-3379 相关的转化医学

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100 项与 KTN-3379 相关的专利（医药）

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项与 KTN-3379 相关的文献（医药）

2022-03-01·Thyroid : official journal of the American Thyroid Association1区 · 医学

Enhancing Radioiodine Incorporation in BRAF-Mutant, Radioiodine-Refractory Thyroid Cancers with Vemurafenib and the Anti-ErbB3 Monoclonal Antibody CDX-3379: Results of a Pilot Clinical Trial

1区 · 医学

Article

作者: Seshan, Venkatraman E. ; Pentlow, Keith S. ; Ho, Alan L. ; Haque, Sofia ; Baxi, Shrujal S. ; Grewal, Ravinder K. ; Tchekmedyian, Vatche ; Pfister, David G. ; Dunn, Lara ; Fagin, James A. ; Fish, Stephanie ; Walters, Jamie ; Sherman, Eric ; Knauf, Jeffrey A. ; Ghossein, Ronald A. ; Sabra, Mona M. ; Tuttle, R. Michael ; Larson, Steven M. ; Boucai, Laura

Background: Oncogenic activation of mitogen-activated protein kinase (MAPK) signaling is associated with radioiodine refractory (RAIR) thyroid cancer. Preclinical models suggest that activation of the receptor tyrosine kinase erbB-3 (HER3) mitigates the MAPK pathway inhibition achieved by BRAF inhibitors in BRAF^V600E mutant thyroid cancers. We hypothesized that combined inhibition of BRAF and HER3 using vemurafenib and the human monoclonal antibody CDX-3379, respectively, would potently inhibit MAPK activation and restore radioactive iodine (RAI) avidity in patients with BRAF-mutant RAIR thyroid cancer. Methods: Patients with BRAF^V600E RAIR thyroid cancer were evaluated by thyrogen-stimulated iodine-124 (¹²⁴I) positron emission tomography-computed tomography (PET/CT) at baseline and after 5 weeks of treatment with oral vemurafenib 960 mg twice daily alone for 1 week, followed by vemurafenib in combination with 1000 mg of intravenous CDX-3379 every 2 weeks. Patients with adequate ¹²⁴I uptake on the second PET/CT then received therapeutic radioactive iodine (¹³¹I) with vemurafenb+CDX-3379. All therapy was discontinued two days later. Treatment response was monitored by serum thyroglobulin measurements and imaging. The primary endpoints were safety and tolerability of vemurafenib+CDX-3379, as well as the proportion of patients after vemurafenb+CDX-3379 therapy with enhanced RAI incorporation warranting therapeutic ¹³¹I. Results: Seven patients were enrolled; six were evaluable for the primary endpoints. No grade 3 or 4 toxicities related to CDX-3379 were observed. Five patients had increased RAI uptake after treatment; in 4 patients this increased uptake warranted therapeutic ¹³¹I. At 6 months, 2 patients achieved partial response after ¹³¹I and 2 progression of disease. Next-generation sequencing of 5 patients showed that all had co-occurring telomerase reverse transcriptase promoter alterations. A deleterious mutation in the SWItch/Sucrose Non-Fermentable (SWI/SNF) gene ARID2 was discovered in the patient without enhanced RAI avidity after therapy and an RAI-resistant tumor from another patient that was sampled off-study. Conclusions: The endpoints for success were met, providing preliminary evidence of vemurafenib+CDX-3379 safety and efficacy for enhancing RAI uptake. Preclinical data and genomic profiling in this small cohort suggest SWI/SNF gene mutations should be investigated as potential markers of resistance to redifferentiation strategies. Further evaluation of vemurafenib+CDX-3379 as a redifferentiation therapy in a larger trial is warranted (ClinicalTrials.gov: NCT02456701).

2019-11-01·Molecular cancer therapeutics2区 · 医学

Neuregulin Signaling Is a Mechanism of Therapeutic Resistance in Head and Neck Squamous Cell Carcinoma

2区 · 医学

Article

作者: Lemmon, Mark A. ; Baro, Marta ; Contessa, Joseph N. ; Lopez Sambrooks, Cecilia ; Burtness, Barbara A.

Abstract:

EGFR signaling confers resistance to radiotherapy and is a validated target in head and neck squamous cell carcinoma (HNSCC). The inhibition of EGFR in combination with radiotherapy improves local control and overall survival in these patients; however, therapeutic resistance limits the efficacy of this approach. We therefore sought to identify cellular mechanisms that cause resistance to EGFR inhibition and radiotherapy in HNSCC. Though clonal isolation of carcinoma cells exposed to increasing concentrations of cetuximab, we found that resistant cells upregulate prosurvival ErbB3 and AKT signaling. Using EFM-19 cells and confirmatory analysis of protein levels, we demonstrate that cetuximab resistance is characterized by enhanced neuregulin expression identifying a novel adaptive mechanism of therapeutic resistance. Inhibition of this autocrine loop with CDX-3379 (an ErbB3 specific antibody) was sufficient to block ErbB3/AKT signaling in cetuximab resistant cells. The combination of CDX-3379 and cetuximab reduced proliferation and survival after radiotherapy in several HNSCC cell lines. These in vitro findings were confirmed in xenograft tumor growth experiments including an approach using growth factor–supplemented Matrigel. In vivo, the delivery of EGFR and ErbB3 antibodies significantly reduced tumor growth in cetuximab-resistant FaDu and CAL27 xenografts. In summary, this work demonstrates that autocrine NRG ligand secretion is a mechanism for therapeutic resistance to cetuximab and radiotherapy. This cross-resistance to both therapeutic modalities identifies NRG as an actionable therapeutic target for improving treatment regimens in HNSCC.

2019-10-01·Clinical cancer research : an official journal of the American Association for Cancer Research

Molecular and Clinical Activity of CDX-3379, an Anti-ErbB3 Monoclonal Antibody, in Head and Neck Squamous Cell Carcinoma Patients

Article

作者: Neumeister, Veronique M. ; Bauman, Julie E. ; Kim, Seungwon ; Alvarado, Diego ; Chenna, Ahmed ; Duvvuri, Umamaheswar ; Grandis, Jennifer R. ; Gedrich, Richard ; George, Jonathan ; Hawthorne, Thomas ; LaVallee, Theresa

Abstract:

Purpose::

ErbB3 and its ligand neuregulin-1 (NRG1) are widely expressed in head and neck squamous cell carcinoma (HNSCC) and associated with tumor progression. A “window-of-opportunity” study (NCT02473731) was conducted to evaluate the pharmacodynamic effects of CDX-3379, an anti-ErbB3 mAb, in patients with HNSCC.

Patients and Methods::

Twelve patients with newly diagnosed, operable HNSCC received two infusions of CDX-3379 (1,000 mg) at a 2-week interval prior to tumor resection. The primary study objective was to achieve ≥50% reduction in tumor ErbB3 signaling (phosphorylation of ErbB3; pErbB3) in ≥30% of patients. Other potential tumor biomarkers, pharmacokinetics, safety, and tumor measurements were also assessed.

Results::

pErbB3 was detectable in all tumors prior to treatment and decreased for 10 of 12 (83%) patients following CDX-3379 dosing, with ≥50% reduction in 7 of 12 (58%; P = 0.04; 95% confidence interval, 27.7%–84.8%). Target trough CDX-3379 serum levels were achieved in all patients. CDX-3379 treatment–related toxicity was grade 1–2 and included diarrhea, fatigue, and acneiform dermatitis. Five of 12 (42%) patients had shrinkage in tumor burden, including a marked clinical response in a patient with human papillomavirus–negative oral cavity HNSCC. All patients with tumor shrinkage had tumors that expressed both NRG1 and ErbB3 and demonstrated reduced pErbB3 with CDX-3379 treatment.

Conclusions::

This study demonstrates that CDX-3379 can inhibit tumor ErbB3 phosphorylation in HNSCC. CDX-3379 was well tolerated and associated with measurable tumor regression. A phase II study (NCT03254927) has been initiated to evaluate CDX-3379 in combination with cetuximab for patients with advanced HNSCC.

项与 KTN-3379 相关的新闻（医药）

2024-07-02

·同写意

大热ADC摔了一跤

同写意20周年大会：中国医药创新未来之路！“意”同创新，穿越周期，赢取未来。7月中旬，苏州金鸡湖畔，让我们与“新药写意人”一起为中国医药创新“同写意”！近日，备受关注的HER3 ADC接连遭遇挫折：先是宜联生物/BioNTech的YL202/BNT326一期临床被FDA要求暂停，接着默沙东/第一三共的HER3-DXd（U3-1402）因第三方生产设施问题被FDA延迟批准上市。不过，FDA并未对HER3-DXd的有效性和安全性提出异议，意味着整改好生产问题后，HER3-DXd仍将有望成为全球首款HER3 ADC药物。尽管新型ADC药物在临床试验中不时遭遇挫折，但以HER3为代表的广谱抗癌靶点，仍具备巨大的市场潜力。 1 HER3靶点的双刃剑属性 HER3与HER2属于同一家族，其中HER2是知名的广谱抗癌靶点，诞生了多款重磅炸弹药物，包括靶向HER2的曲妥珠单抗、第一三共的HER2 ADC药物Enhertu（DS-8201）。但由于HER2 ADC市场竞争激烈，全球药企都在寻求其他广谱抗癌靶点，最好是与明星靶点同类或功能近似。HER3自然成为热门布局方向。然而，HER3靶点却具备双刃剑属性。 HER3是潜在广谱抗癌靶点，在肺癌、乳腺癌、结直肠癌等多种实体瘤中高表达，且与疾病进展、预后不良以及对EGFR、HER2靶向治疗的耐药性密切相关。由此，HER3 ADC频频发生重磅BD交易：2023年10月，BioNTech斥资超10亿美元与宜联生物合作开发新一代的HER3 ADC药物，默沙东则与第一三共达成220亿美元的全球合作，共同开发HER3-DXd等3款ADC新药。同年12月，百利天恒就EGFR/HER3双抗ADC药物BL-B01D1与BMS达成最高84亿美元的合作，并创下了国产创新药海外授权新纪录。可BD大热的背后，却是HER3靶向疗法研发的困难重重。在过去30多年里，无论是靶向HER3的单抗还是双抗，都未能成药。例如，第一三共的Patritumab、KTN3379、Elgemtumab和Lumretuzumab等HER3单抗，皆因疗效不佳或安全性问题被终止研究；EGFR/HER3双抗Duligotuzumab、HER2/HER3双抗MM-111的临床开发也未能成功。归其原因，在于HER3几乎不具有胞内酪氨酸激酶活性，且激酶活性非常弱，使得直接针对HER3的单抗或双抗在疗效上受到限制。再加上，HER3与配体的结合力相对较低，增加了药物设计的难度，从而导致临床试验失败率高。不过，HER3无法成药的历史，或将被具有独特作用机制的ADC药物改写。 ADC药物由抗体、连接子和细胞毒素三部分组成，其独特之处在于：通过其抗体部分特异性地结合HER3，但并不完全依赖于HER3的激酶活性来发挥作用，而且有效载荷（毒素）的释放和细胞毒作用也不需要依赖HER3，就能发挥有效的抗肿瘤作用、引发旁观者效应。另外，HER3相比HER2和HER1（EGFR）具有更快的内化速度，更有利于ADC药物在肿瘤细胞内发挥药效，提高治疗效果。 2 HER3 ADC的挑战随着HER3 ADC药物在实体瘤的治疗潜力得到证实，不少药企纷纷布局。据中信建投研报披露，截至今年3月14日，国内共有17款HER3为靶点的ADC药物，其中5款已进入临床阶段，包括恒瑞医药SHR-A2009、信达生物IBI133和百利天恒BL-B01D1（EGFR/HER3双抗ADC）等。全球进度最快的是第一三共/默沙东的Patritumab deruxtecan（HER3-DXd，U3-1402），尽管因生产问题被FDA延迟批准上市，仍有望拿下全球首款HER3 ADC药物。作为第一三共继DS-8201、Dato-DXd（DS-1062）后推出的第3款潜在重磅药物，HER3-DXd的治疗潜力备受关注。 HER3-DXd的抗体部分为HER3单抗Patritumab，载荷与DS-8201相同，都是拓扑异构酶Ⅰ抑制剂（deruxtecan），并通过经典的马来酰亚胺-GGFG接头连接组成，DAR值为8。 HER3-DXd的上市申请是基于关键II期临床试验HERTHENA-Lung01的研究结果：在225例接受HER3-DXd（5.6 mg/kg）治疗的EGFR-TKI和铂类化疗后进展的EGFR突变局部晚期或转移性NSCLC患者中，ORR为29.8%，中位PFS为5.5个月，中位OS为11.9个月。另外，HER3-DXd针对3代EGFR-TKI治疗后耐药的患者也有相似的临床结果：ORR为29.2%，中位PFS、中位OS分别为5.5个月、11.9个月。第三代EGFR-TKI奥希替尼耐药市场广阔，是MNC巨头必争的大金矿，这也是默沙东重金押注的重要原因。安全性方面，4级以上TEAE发生率为28.9%，主要为血液相关不良事件，极少数患者发生间质性肺病（ILD），总体安全性可控，仅有7.1%治疗中出现的不良事件TEAE导致终止治疗。 HER3-DXd关键性II期研究HERTHENA-Lung01结果；（图源：Biotech前瞻）不过，虽然FDA未对HER3-DXd的有效性和安全性提出异议，但安全性仍有待提高。这也是HER3 ADC药物的研发挑战。此次FDA之所以会要求BioNTech/宜联生物暂停YL202/BNT326的Ⅰ期试验，主要是担忧：在较高剂量下，可能会使人类受试者面临不合理和重大的疾病或伤害风险。根据宜联生物在2024 ASCO会议上公布的I期临床数据，截至今年4月16日，共入组55人（非小细胞肺癌40人，乳腺癌15人），结果显示：全部剂量下共51例可评估病例，ORR为42.3%，DCR为94.2%，mPFS为6个月，mDOR为5.8个月；其中3.0mg/kg剂量组ORR为60%，DCR为100%。尽管YL202有望展现出BIC潜质，但在安全性方面：5.5mg/kg剂量组出现一例DLT事件（三级粒缺伴发热），4.0mg/kg和5.5mg/kg剂量组分别出现2例（中性粒和血细胞减少）和1例受试者死亡（新冠感染后间质性肺炎）。基于此数据，BioNTech/宜联生物后续或许将重点开发4.0mg/kg以下剂量的临床试验。 3 新型ADC药物：机会与风险并存尽管HER3 ADC药物仍有待改进，但相比频繁折戟的单抗和双抗，已经取得突破性进展。当前，围绕HER3靶点的国产ADC药物正在摩拳擦掌，包括恒瑞医药SHR-A2009、信达生物IBI133、映恩生物DB-1310，以及涉及HER3靶点的双抗药物，包括百利天恒BL-B01D1（EGFR/HER3双抗ADC）、康宁杰瑞JSKN016（HER3/TROP2双抗ADC）。其中，已有一些药物公布了积极的临床数据。据I期研究结果显示，SHR-A2009针对NSCLC患者的ORR为30%，DCR为76.7%，中位DoR为7个月（94.4%EGFR突变；80.6%患者对3代EGFR-TKI耐药）；BL-B01D1针对38例经过多次治疗（其中34例曾接受第三代EGFR-TKI治疗）的EGFR突变阳性NSCLC患者，ORR为63.2%，DCR为89.5%。除HER3 ADC外，还有不少新型ADC药物展现出巨大的商业价值，涉及TROP2、Claudin18.2、Nctin-4、B7-H3/B7-H4、FRα等靶点。例如，2020年，吉利德斥资210亿美元收购Immunomedics，拿下了全球首款TROP2 ADC药物Trodelvy；2023年，辉瑞豪掷430亿美元收购Seagen，后者已获批上市的ADC药物Adcetris、Padcev、Tivdak分别靶向CD30、Nectin-4、TF，无一重样，同年艾伯维也以101亿美元收购ImmunoGen，获得了全球首创的FRα ADC药物Elahere。 Claudin18.2作为广谱抗癌靶点，高度表达于胃癌、胰腺癌和乳腺癌等多个实体瘤中，也是必争之地。据统计，目前已有5项国产Claudin18.2 ADC实现BD交易，包括礼新医药LM-302、科伦博泰SKB315、石药集团SYSA1801、康诺亚/乐普生物CMG901、恒瑞医药SHR-A1904，潜在总交易额合计超过50亿美元。其中，信达生物、康诺亚和礼新医药的Claudin18.2 ADC已进入III期临床。此外，B7-H3和B7-H4靶点也受到MNC巨头的青睐。 2023年10月，默沙东斥资220亿美元与第一三共达成3款ADC新药合作，其中除HER3靶点外，还有靶向B7-H3和CDH6的ADC药物；同年10月、12月，翰森制药分别将B7-H4 ADC药物HS-20089、B7-H3 ADC药物HS-20093授予葛兰素史克（GSK），合计潜在交易总额超过30亿美元。当然，新型ADC药物走的都是前人没走过的路，必定会遇到研发风险。例如，吉利德的TROP2 ADC药物Trodelvy，今年已接连在非小细胞肺癌、尿路上皮癌和膀胱癌适应症研发失败，而竞争对手科伦博泰/默沙东的SKB264/MK2870有望展现出BIC潜质，且默沙东已启动了9项全球III期临床，意在竞争中抢占优势。另外，MacroGenics的B7H3 ADC新药Vobramitamab Duocarmazine，在针对前列腺癌患者的II期临床TAMARACK研究中出现5例患者死亡，导致股价暴跌近80%。结语：归根结底，新药研发本就是福祸相依，机会与风险并存。可即便新型ADC药物不定期爆出临床失利的消息，仍不会阻挡全球药企持续探索的脚步，尤其对于HER3、TROP2等广谱抗癌靶点，更是必须拿下的“金矿”。更多优质内容，欢迎关注↓↓↓

抗体药物偶联物临床1期临床2期申请上市上市批准

2024-02-07

·生物制品圈

靶向HER3治疗在头颈部鳞状细胞癌中的研究进展

中文摘要人类表皮生长因子受体3（human epidermal growth factor receptor 3，HER3）作为表皮生长因子受体家族中的一员，通过与其他受体形成异源二聚体发挥信号转导的功能。头颈部鳞状细胞癌（head and neck squamous cell carcinoma，HNSCC）是全球第6大常见癌症，起病隐匿且总体生存率低。HER3在HNSCC中高表达。HER3的表达和激活与HNSCC治疗中靶向其他受体的药物〔例如靶向表皮生长因子受体的单克隆抗体（单抗）西妥昔单抗或程序性死亡受体1阻断剂〕以及某些化学治疗药物的治疗获得性耐药有关。目前，HER3已经成为HNSCC治疗非常有前景的候选靶点。此文综合近年来国内外对靶向HER3治疗在HNSCC中的研究，对HER3参与HNSCC肿瘤进程的机制、HER3与HNSCC当下临床治疗策略的关联，以及包括处于临床试验的11种单抗药物、5种双特异性抗体药物及其他多种类型的靶向HER3的药物在HNSCC治疗中的开发进展进行综述。正文人类表皮生长因子受体3（human epidermal growth factor receptor 3，HER3）又称幼红细胞白血病病毒癌基因同源物3（erythroblastic leukemia viral oncogene homolog 3，ErbB3），是人体中经典的受体酪氨酸激酶（receptor tyrosine kinase，RTK），属于表皮生长因子受体（epidermal growth factor receptor，EGFR）家族。HER3 具有与家族其他成员不同的独特构型，胞内酪氨酸激酶活性较低，无法直接与三磷酸腺苷相结合，需与其他有酪氨酸激酶活性的EGFR家族成员形成异源二聚体复合物来发挥作用。而由于HER3胞内结构域11个酪氨酸磷酸化位点中有6个磷脂酰肌醇3激酶（phosphatidylinositol 3-kinase，PI3k）p85 亚基结合位点，使得HER3胞内区酪氨酸激酶羧基末端活化后与PI3K的p85亚基结合，可以强烈激活PI3K/Akt通路。PI3K/Akt通路作为促进肿瘤细胞增殖的主要信号通路，涉及调控基因表达、细胞代谢和细胞骨架重排。研究显示，对PI3K/Akt途径有直接和间接抑制作用的药物会引起叉头转录因子盒O依赖性HER3转录升高，并通过PI3K-Akt负反馈调节上调和激活HER3的表达，再次激活下游途径，从而出现耐药。另有研究表明，HER3主要配体神经调节蛋白1（neuregulin-1，NRG1）可以通过旁分泌与自分泌途径共同参与HER3信号转导等过程。HER3的主要相关蛋白、信号通路和功能见图1。1项对超过750个不同来源的肿瘤进行的定量逆转录PCR表达谱分析显示，头颈部鳞状细胞癌（head and neck squamous cell carcinoma，HNSCC）表达的NRG1水平最高。头颈部肿瘤是全球最常见的恶性肿瘤之一，超过95%的病理类型是鳞状细胞癌。HNSCC是指位于鼻旁窦、鼻腔、口腔、咽部和喉部由鳞状细胞引起的组织学癌症，是全球第6大癌症，起病隐匿，且总体生存率不高，中位生存期低于1年。在免疫检查点阻断（immunecheckpoint blockade，ICB）治疗出现之前，全身化学治疗（化疗）被用作标准的一线方案，即将顺铂或卡铂和5-氟尿嘧啶、人鼠嵌合抗EGFR单克隆抗体（单抗）西妥昔单抗联用。ICB疗法的发展为抗癌治疗提供了强有力的支撑，其中程序性死亡受体1（programmed death-1，PD-1）/程序性死亡受体配体1抑制剂在多项单药或联合用药临床试验中被证实可以有效延长HNSCC患者的生存时间，且较传统治疗方案不良反应发生率更低。然而，治疗获得性耐药在HNSCC患者中很常见，西妥昔单抗和PD-1/程序性死亡受体配体1抑制剂在HNSCC中均疗效有限，仅有＜20%的患者获得了持久的受益。HER3的表达和激活与HNSCC治疗中其他靶向药物和某些化疗药物的治疗获得性耐药有关，同时HER3的促进细胞增殖作用提示靶向HER3治疗具有一定的临床潜力。本文对HER3靶点靶向治疗在HNSCC中的研究现状及相关进展进行综述，总结HER3靶点与HNSCC当下治疗策略的关系，以及几种靶向HER3或与HER3相关的HNSCC治疗策略。1HER3与HNSCC当下临床治疗策略HER3在多种人类癌细胞中表达，其过表达与癌症包括头颈部肿瘤患者的生存率较低有关。在HNSCC中，主要于膜上过表达HER3的肿瘤预后较差。HER3高表达的原发性肿瘤似乎更倾向于发生淋巴结转移，且超过30%的转移淋巴结中存在HER3过表达。此外，与正常组织相比，在异型增生和HNSCC中发现了HER2/HER3、HER3/HER4、EGFR/HER2/HER3以及EGFR/HER2/HER3/HER4共表达。HER3与家族其他成员的这些共表达与生存率低、疾病进展和/或转移显著相关。由于当某个ErbB被阻断时，其他RTK可以补偿被阻断的受体丢失的信号传导，因此HER3表达可作为多种靶向治疗的旁路机制，异常的HER3信号传导导致了患者对多种靶向治疗药物及化疗药物的治疗获得性耐药。由于HER3还可以与HER2、HER4、原癌基因蛋白质c-Met等形成异源二聚体，导致EGFR信号传导的平行信号通路异常激活，因此西妥昔单抗对HER3和HER3相关二聚体的上调是HNSCC中EGFR靶向疗法获得性耐药的一种机制。早期研究表明，HER2/HER3介导的信号传导与头颈癌中的EGFR酪氨酸激酶抑制剂（tyrosine kinase inhibitor，TKI）吉非替尼治疗获得性耐药相关，在对EGFR/HER2双重TKI拉帕替尼敏感的细胞系中，拉帕替尼的敏感性与强活化的HER3和HER3配体NRG1的升高密切相关。后来也有人提出，自分泌NRG1信号传导上调以及HER2/HER3二聚体的增加，是HNSCC中西妥昔单抗对EGFR抑制的耐药机制。在TKI包括厄洛替尼和吉非替尼治疗获得性耐药患者中，HER2、HER3上调也被认为是耐药机制的一部分。同时，无论是在体外还是体内试验中，靶向抑制HER3都可以使西妥昔单抗耐药的HNSCC细胞对西妥昔单抗重新敏感。在另1项研究中，原癌基因c-met通过增加HER3/P13K信号传导引起吉非替尼和西妥昔单抗耐药，然而由于HNSCC中原癌基因c-met的拷贝数增加很少见（1%~2%TCGA队列），因此该机制只能解释先天耐药病例的一小部分。由于HER3是PI3K/Akt/哺乳动物雷帕霉素靶蛋白（mammalian target of rapamycin，mTOR）存活信号传导的重要激活剂，因此它也导致了其他靶向治疗的耐药性。在HNSCC临床前模型中，HER3靶向可以增强PI3Kα选择性抑制剂BYL719的生长抑制作用。此外，另1项研究提出HPV＋HNSCC相较于HPV﹣HNSCC对PI3K抑制剂存在内在耐药性，这种药物敏感性的差异可能归因于PI3K抑制剂治疗HPV﹣HNSCC细胞系后HER3对Akt激酶的再激活。同时，共靶向HER3和PI3K可能是克服HPV﹣HNSCC肿瘤中PI3K抑制剂耐药性的有效治疗策略。在ICB治疗的临床前研究中，抗体介导的靶向HER3阻断通过抑制HER3-PI3K-Akt-mTOR致癌信号传导，可以逆转免疫抑制肿瘤微环境，从而发挥有效的抗肿瘤作用。对HER3抗体偶联药物（antibody-drug conjugate，ADC）U3-1402的1项研究显示，U3-1402靶向HER3发挥其抗肿瘤作用的同时，可以通过免疫激活与PD-1阻断存在潜在的协同作用，使表达HER3的肿瘤对PD-1阻断重新敏感。此外，在1项针对HER3疫苗的研究中，使用编码全长人HER3的重组腺病毒载体Ad-HER3-FL进行免疫，可诱导HER3靶向疫苗激活HER3特异性T细胞并诱导抗HER3特异性抗体，改变肿瘤中的T细胞浸润，并影响对ICB的应答。因此，对于抗PD-1单抗的治疗受益有限群体而言，靶向HER3抑制的治疗策略与PD-1阻断联用，或许可以为HNSCC提供多模式精准免疫治疗方法。2靶向HER3的抗体药物在HNSCC治疗中的开发进展目前，已有11种靶向HER3的单抗产品正在针对HNSCC进行临床前或临床试验。这些靶向HER3的单抗抑制肿瘤的作用机制主要包括：阻断受体与配体的结合、使受体锁定为非活性构象、促进受体的内化与降解以及诱导抗体依赖细胞介导的细胞毒作用（antibody-dependent cell-mediated cytotoxicity，ADCC）和补体依赖的细胞毒作用（complement dependent cytotoxicity，CDC）直接杀死肿瘤细胞。这些靶向HER3的单抗均为IgG抗体，其中IgG1抗体8种，重组IgG1/IgG3抗体（GSK2849330）和IgG2抗体（MM-121）各1种。除单抗外，将适应证瞄准HNSCC的5种双特异性抗体（双抗）和2种ADC也在开发中。此外，正在研发的还有泛抗HER家族单抗混合物、HER3疫苗、嵌合抗原受体（chimeric antigen receptor，CAR）T 细胞疗法、抗金属蛋白酶抑制剂等。2.1单抗临床开发中与HNSCC相关且靶向HER3的单抗汇总如下。Barecetamab（ISU104）是由韩国ISU ABXIS公司开发的全人源IgG1单抗，与HER3胞外结构域Ⅲ结合，处于早期临床开发阶段。该抗体阻断HER3的激活及与其他HER伴侣的二聚化，并使HER3的下游信号失活。在体内，除HNSCC之外，ISU104同时也在非小细胞肺癌、结肠癌、胰腺癌、乳腺癌的皮下异种移植肿瘤模型中显示出超过70%的肿瘤生长抑制。ISU104在获得性西妥昔单抗耐药异种移植肿瘤模型中也显示出抗肿瘤作用。最近，Hong等报道了ISU104在NRG1表达高或具有NRG1融合或致癌ErbB3突变等遗传改变的模型中的抗肿瘤功效。CDX-3379（KTN3379）是由美国 Celldex 公司开发的人源IgG1λ单抗，与HER3结构域Ⅱ和Ⅲ之间边界的独特表位具有非常高的亲和力，该表位将HER3锁定在其非活性构象中，并抑制配体依赖性和配体非依赖性信号传导。因此，该抗体抑制配体依赖性和配体非依赖性HER3活化。临床前阶段，CDX-3379联合西妥昔单抗或BYL719可增强HNSCC异种移植模型的生长抑制。在近期1项临床前研究中，CDX-3379介导的HER3阻断通过抑制HER3-PI3K-Akt-mTOR致癌信号传导并伴随逆转免疫抑制肿瘤微环境，可以发挥有效的抗肿瘤作用，因此靶向HER3和PD1联合用药可能为PIK3CA野生型HNSCC提供多模式精准免疫治疗方法。在临床试验中，单独使用CDX-3379或与西妥昔单抗联合使用耐受性良好，并可使HNSCC肿瘤消退。Seribantumab（SAR256212，MM-121）是由美国Merrimack公司开发的靶向HER3的全人源IgG2单抗，与NRG1竞争结合HER3，阻止二聚化并诱导HER3内化和降解。该抗体由噬菌体展示的抗原结合片段（Fab）文库产生，被转化为全长人IgG2形式，目的是最大限度地减少免疫原性和免疫效应介导的脱靶不良反应。在HNSCC的临床前模型中，MM-121降低了HER3的磷酸化。此外，在HNSCC的细胞系和动物模型中，MM-121与西妥昔单抗联合用药通过抑制HER3、EGFR、PI3K/Akt和胞外信号调节激酶的活化显示出更有效的细胞和肿瘤生长抑制。同时发现，西妥昔单抗耐药的HNSCC模型中HER3上调，并且在HNSCC中，EGFR和HER3的双重靶向优于单独EGFR靶向。然而在进入临床后，MM-121虽可与几种药物安全联合使用且耐受性良好，但未产生明显的临床获益。Elgemtumab（LJM716）是从Morphosys HuCal Fab噬菌体展示文库中分离的全人源IgG1单抗，由瑞士诺华公司和法国赛诺菲安万特公司开发。LJM716可与位于HER3胞外结构域Ⅱ和Ⅳ之间的界面构象表位结合，将HER3捕获在无活性构象中并抑制配体依赖性和独立的HER3信号传导激活。LJM716在体内异种移植研究中显示出有效的抗肿瘤作用，并且在相关肿瘤模型中证明了与曲妥珠单抗或西妥昔单抗联合使用的肿瘤生长抑制效果。在日本1项对HNSCC、胃癌、HER2过表达乳腺癌患者的临床研究（NCT01911936）中，LJM716表现出良好的耐受性，并且队列中观察到一定程度的肿瘤缩小。该研究推荐扩增剂量为每周1次40 mg/kg QW（NCT01598077）。REGN1400是全人源IgG单抗，由美国再生元公司开发，可抑制HNSCC和乳腺癌细胞系及异种移植物的NRG结合、HER3和Akt的磷酸化以及这些肿瘤细胞系和异种移植物的体外生长。REGN1400联合抗EGFR或抗HER2抗体可更有效地抑制肿瘤生长，同时还会增加HNSCC异种移植模型中抗EGFR治疗的敏感性。REGN1400在Ⅰ期临床试验（NCT01727869）中，作为单药治疗或与厄洛替尼或西妥昔单抗联合使用，表现出良好的安全性和耐受性，该研究还计划在HNSCC和结直肠癌扩大队列。Patritumab（AMG-888，U3-1287）是全人源IgG1单抗，可抑制配体与HER3的结合并诱导受体内化和降解，由日本第一三共公司开发，是目前在临床开发中进展最快的HER3靶向药物。此外，没有检测到针对Patritumab的人抗人抗体，初步结果表明高HER3表达或扩增与临床疗效之间存在相关性趋势。Patritumab在HNSCC细胞和异种移植物中也显示出其作为单药以及与帕尼单抗联合使用的潜力。在HNSCC和肺癌模型中，Patritumab增强了放射敏感性。在2项Ⅰ期临床试验（NCT00730470和JapicCTI-101，262）中，U3-1287治疗耐受性高达20 mg/kg，具有良好的耐受性和良好的药代动力学特征。在另1项已经完成的Ⅰ期临床试验（NCT02350712）中，U3-1287（18 mg/kg负荷剂量，9 mg/kg维持剂量）联合西妥昔单抗和铂类治疗在HNSCC中可耐受且有效。GSK2849330是由英国葛兰素史克公司开发的IgG1/IgG3嵌合、糖工程人源化的单抗，针对HER3胞外结构域Ⅲ，由于分别与人Fc-γ受体（FcyRⅢa）和人补体蛋白C1q具有高结合亲和力，因此可以增强ADCC和CDC，也可以阻断癌细胞中的HER3/NRG1的信号传导，在NRG1融合肿瘤中表现出较好的抗肿瘤活性。GSK2849330在Ⅰ期临床试验（NCT01966445）中表现出良好的耐受性和安全性，每周30 mg/kg未出现剂量限制性毒性，同时观察到的最大血浆浓度为778.47 μg/ml。AV-203（CAN017）是由美国AVEO公司和美国Biogen公司开发的人源化IgG1κ单抗，可以阻断NRG1与受体的结合并诱导HER3降解。AV-203对患者来源的肿瘤异种移植模型（包括HNSCC、非小细胞肺癌、乳腺癌、肾癌、胰腺癌等）显示出临床前活性。此外，NRG1表达水平可预测AV-203在临床前人类癌症模型中对HER3抑制的反应。Ⅰ期临床试验（NCT01603979）证实，AV-203在最大剂量（每2周20 mg/kg）以下是安全的且耐受性良好。Lumretuzumab（GE-huMab-HER3，RG7116，RO5479599）是由瑞士罗氏公司开发的糖工程人源化IgG1单抗。该抗体与HER3的结构域Ⅰ结合，通过阻断HER3胞外结构域和NRG结合来抑制HER3信号传导的激活。其Fc区被糖化工程化以增加对免疫效应细胞上FcyRⅢa的亲和力。与非糖工程抗体相比，这种单抗使得ADCC在体内和体外都能得到更有效的激活。由于Lumretuzumab已被证明在体外存在和不存在HRG的情况下都能阻断HER3活化，因此Lumretuzumab不仅在治疗上靶向依赖于活性HER3信号传导的细胞，而且还靶向那些在细胞表面表达非活化HER3的细胞。在与HNSCC相关的临床试验NCT01482377中，RG7116加西妥昔单抗/厄洛替尼的Ⅰb期研究发现NRG是实体瘤患者的潜在生物标志物；此外，队列中有2例高HRG mRNA表达水平的患者获得了出乎意料的受益，其中1例HNSCC患者达到延长的完全缓解，1例卵巢癌患者达到延长的部分缓解。SIBP-A03是由上海生物制品研究所有限责任公司自主研发的IgG1单抗，为国内首家获得临床批件的抗HER3抗体药物。SIBP-A03与HER3的结构域Ⅲ结合，在黑色素瘤（A431细胞系）、胰腺癌（Bxpc3细胞系）的体外试验和小鼠肿瘤模型中，表现出明显的肿瘤生长抑制作用，并且与西妥昔单抗联合使用具有一定的协同作用。Ⅰa期临床试验（NCT05203601）正在进行中，患者队列主要为晚期HNSCC或乳腺癌患者。HMBD-001是由新加坡蜂鸟生物科技公司开发的IgG1抗体，已进入临床阶段。它直接结合并阻断HER3的异二聚化界面，并有可能抑制HER3的配体依赖性和独立激活以及致癌信号传导，通过靶向位于HER3与HER2或EGFR形成异二聚体的界面的关键表位，抑制所有HER3异二聚化的过程。在评估HMBD-001的临床前模型中，观察到HMBD-001与其他现有的抗HER3抗体相比，具有更好的亲和力和更强的肿瘤抑制作用。HMBD-001近期的开发计划或将侧重于4种适应证：NRG1融合驱动型癌症、转移性去势抵抗性前列腺癌、转移性结直肠癌和HNSCC。2.2双抗临床开发中与HNSCC相关且靶向HER3的双抗汇总如下。Duligotuzumab（MEHD7945A，RG7597）是由美国基因泰克公司开发的、靶向EGFR和HER3的全人源IgG1双抗，从噬菌体展示Fab文库中分离出来，包含2个相同的Fab。MEHD7945A在几种临床前模型中强烈抑制肿瘤包括人表皮样癌、胰腺癌、乳腺癌、结直肠癌、HNSCC和肺癌生长，特别是与化疗联合使用时。MEHD7945A单药治疗或与顺铂联合使用，在来自HNSCC和非小细胞肺癌的厄洛替尼和西妥昔单抗的耐药模型中证明了其疗效。值得关注的是，MEHD7945A还能诱导ADCC。然而2项临床试验（NCT01207323、NCT01577173）的结果显示，MEHD7945A的活性与西妥昔单抗相似，但并未展现出优于西妥昔单抗的效果。Zenocutuzumab（Zeno，MCLA-128）是荷兰Merus公司开发的靶向HER2（结构域Ⅰ）和HER3（结构域Ⅲ）的IgG1双抗，可以与HER2对接并阻断与HER3结合的配体，通过HER2-HER3异二聚体抑制致癌信号传导；同时由于IgG1的糖工程修饰还具有增强的ADCC活性。除了在对HER2靶向治疗（曲妥珠单抗和T-DM1）耐药的模型及乳腺癌、胃癌和胰腺癌模型中显示出疗效，该抗体在化疗耐药NRG1融合阳性转移性癌症患者中也显示出疗效，抑制NRG1融合阳性癌症模型的生长，在Ⅰ/Ⅱ期临床试验中也报告了良好的耐受性和抗肿瘤活性。SI-B001是四川百利天恒药业股份有限公司开发的靶向EGFR和HER3的IgG-单链Fv（ single-chain antibody fragment，scFv）2 四价双抗，由 1 个完整的IgG组成，具有2条重链和2条轻链，以及2个scFv段连接到重链或轻链的C端或N端。SI-B001在结肠癌、HNSCC或食道癌异种移植模型中证明了其疗效，在后两种模型中几乎完全抑制了肿瘤的生长，目前正在进行的国内外临床试验（NCT05022654、NCT05044897、NCT05054439、CTR20211979、CTR20212937）的患者队列选择也多为HNSCC及食管癌。MM-111是由美国Merrimack公司开发的靶向HER2和HER3的双抗，由2种不同的单链抗体组成，分别识别HER2和ErbB3，并融合到重组的人血清白蛋白分子的一侧，以延长体内半衰期。MM-111能够同时结合HER2和HER3形成无活性受体/三聚体复合物，最终导致体外和体内肿瘤细胞生长的抑制。此外，HER3结合scFv后可以阻断NRG与HER3的结合，并且在NRG刺激细胞时增强MM-111的抗增殖作用。然而，MM-111的治疗效果取决于两种受体的同时结合，并且MM-111的相对作用与癌细胞HER2过表达的水平相关。综上所述，研究结果表明MM-111可能对靶向也表达HER3的HER2过表达肿瘤有效。然而Ⅱ期临床试验中，MM-111加用紫杉醇+曲妥珠单抗后未改善无进展生存时间或总生存时间，导致进一步研究被终止。Istiratumab（MM-141）是由美国Merrimack公司开发的靶向ErBB3和胰岛素样生长因子（insulin-like growth factor，IGF）1 受体（IGF1 receptor，IGF1R）的四价双抗，由抗IGF-1R人IgG1抗体组成，重链羧基末端与两个抗HER3 scFv融合。该抗体的开发是基于仅靶向IGF-1R的抗体由于HER3介导的补偿信号传导而导致有效性低下的假设。MM-141可以在抑制NRG与ErbB3结合的同时抑制IGF-1/IGF-2与IGF1R的结合，并阻断下游PI3K/Akt途径信号传导，被证明可以增强化疗药物和mTOR抑制剂的抗肿瘤活性。在转移性胰腺癌相关的Ⅱ期临床试验（NCT02399137）中，MM-141联用化疗药物未能改善疗效，并且血清高IGF-1水平也被认为不是不良预后因素。然而鉴于其靶向广泛的受体谱，或许需要更多的研究来准确了解其在除转移性胰腺癌之外的人类肿瘤治疗中，相对于单特异性抗ErbB3抗体或双重特异性抗ErbB3-EGFR或抗ErbB3-抗HER2抗体的优越性。2.3ADC日本第一三共公司开发的ADCU3-1402（Patritumab deruxtecan，HER3-Dxd）是由裸抗U3-1287（Patritumab）和含有拓扑异构酶Ⅰ抑制剂依喜替康（exatecan，MAAA-1181a，Dxd）的药物接头共价偶联而成，每个抗体连接有8个Dxd。U3-1402的连接子和小分子药物与当下已获批上市的HER2 ADCDS8201一致，不但可以同其裸抗U3-1287一样通过与癌细胞表面的HER3特异性结合抑制HER3激活的信号传导；同时在被高效内吞到癌细胞内并转移到溶酶体后释放出依喜替康，可以诱导DNA损伤和细胞凋亡，具有一定的旁观者杀伤作用。U3-1402的临床试验已进展到Ⅲ期，但其主要研究方向目前并不在HNSCC，而在非小细胞肺癌和乳腺癌方面。鉴于其裸抗U3-1287在HNSCC中表现出来的治疗潜力，有理由相信这一ADC临床候选药物也能在HNSCC治疗领域展现出更多惊喜。此外，Capone等的基于自研抗HER3抗体EV20研发了多个ADC：EV20-Sap、EV20/MMAF、EV20-sss-vc/MMAF以及EV20/NMS-P945。其中，EV20/NMS-P945所偶联的是DNA小凹槽烷化剂NMS-P528，具有良好的终末半衰期和稳定性，并且耐受性良好，对包括HNSCC、前列腺癌、胰腺癌、黑色素瘤、胃癌和卵巢癌的模型都具有一定的治疗活性。2.4其他HER3相关HNSCC治疗策略2.4.1 Pan-HER治疗策略 Sym013由3对协同单抗的混合物组成，分别靶向EGFR、HER2和HER3，目的是防止和抑制任一种EGFR的代偿性激活。Sym013促进受体的降解，诱导ADCC和CDC，在配体存在下起作用并抑制PI3K和胞外信号调节激酶途径的激活。用Sym013在体内和体外针对100多种癌细胞系进行测试，可显著减弱癌细胞增殖并优于参考抗体（西妥昔单抗、曲妥珠单抗和MM-121）的活性。值得一提的是，Sym013可有效抑制化疗和HER靶向治疗耐药模型（例如西妥昔单抗、曲妥珠单抗和T-DM1）的生长。在非小细胞肺癌和HNSCC异种移植物（包括西妥昔单抗耐药模型）中，Sym013与单次或分次放射治疗（放疗）联合使用显示出更好的抗肿瘤作用和延迟再生。临床试验NCT02906670纳入32例既往未接受过EGFR/HER靶向治疗的患者，其中2例HNSCC患者每2周9 mg/kg治疗后病情稳定，1例病情稳定超过20周。但遗憾的是该药物相关的临床试验后因业务原因提前终止。2.4.2 CAR-T治疗策略 LEU-001是由伦敦国王大学开发的T4免疫疗法，包含表达T1E28z的工程自体T细胞，是一种与ErbB家族中包含HER3的几个成员结合的第2代CAR，以及一种嵌合细胞因子受体4αβ。它可将IL-4提供的弱促有丝分裂刺激转化为强而具选择性的生长信号，从而允许T4 T细胞在体外优先扩增和富集。LEU-001在体内对HNSCC细胞系和肿瘤发挥抗肿瘤活性，无明显毒性，目前主要研究方向是用于HNSCC的瘤内治疗。2013年3月，1项开放标签、非随机、剂量递增、单组、安全性的Ⅰ期临床研究（NCT01818323）在英国HNSCC患者中开展。2019年1月在欧盟CAR-T大会上公布的结果显示，15例注射患者中有9例生存率有潜在改善。2.4.3 HER3疫苗治疗策略目前有2项HER3疫苗的临床试验——NCT0434874和NCT03832855。NCT03832855是名为pING-hHER3FL的研究性癌症疫苗的Ⅰ期临床试验。pING-hHER3FL为环状DNA，可产生全长人HER3，在研究中用作免疫治疗剂靶向已知表达HER3的癌症，包括HNSCC。2.4.4 抗金属蛋白酶制剂治疗策略人ADAM17抑制抗体D1（A12）是特异性人ADAM17抑制抗体，可在体外和体内抑制EGFR配体和TNFα脱落。ADAM17是金属蛋白酶，也称TNFα转换酶，可将膜结合的TNFα前体释放成可溶形式，可以抑制EGFR、HER2、HER3和HER4多个酪氨酸残基的磷酸化。D1（A12）在体外可显著抑制HNSCC细胞系的增殖，降低了 HNSCC中的促肿瘤信号传导，未来或可作为治疗EGFR TKI耐药HNSCC的有效靶向药物之一。3小结与展望本综述总结了 HNSCC中HER3的作用机制、HER3靶点与HNSCC当下治疗策略的关系，以及靶向HER3或与HER3相关的HNSCC治疗策略。其中大多数与HNSCC中HER3相关的治疗策略都处于临床前开发阶段，同时目前尚无专门针对HER3的治疗方法被批准用于临床。然而，许多上文提及的药物都在针对HNSCC患者的研究中显示出显著的疗效。HER3在治疗获得性耐药和整体HER信号传导中起着至关重要的作用。因此，从HER3作用机制和临床或临床前单一用药的结果而言，同时抑制HER3以及其他RTK（包括EGFR家族成员）可能有助于患者获得更大的临床益处，即单纯的抗HER3单抗治疗策略可以通过与西妥昔单抗、曲妥珠单抗、化疗、放疗、免疫治疗联用，来达到更好的治疗效果。自1986年美国FDA批准第1个治疗性单抗药物以来，靶向药物从适应证探索到技术改进，从临床研究到商业化策略，各个方面日趋成熟。近几年，最令人期待的应当就是ADC。鉴于DS8201在HER2低表达患者中表现出的优异疗效，以及HER3 ADCU3-1402中裸抗U3-1287在HNSCC中表现出的治疗潜力，希望靶向HER3的ADC未来也能在HNSCC治疗中展现出更多的惊喜。目前在HNSCC中的靶向HER3治疗基本都经历了漫长的研发和不断试错的过程，都是来之不易的成果。面向未来，我们还需将研发侧重于：（1）加深对HER3靶点作用机制的认识，如处于研发阶段的抗HER3单抗应尽可能多地尝试与临床一/二线药物联用，或探索治疗获得性耐药的HNSCC难治患者的治疗潜力；（2）探索开发更多革新的技术，如双抗、ADC、使用2种以上不同有效载荷组合的ADC、核素偶联药物等。更大程度扩展可用于治疗HNSCC患者的武器库，有助于实现HNSCC的持久治愈和无复发生存。作者章权综述瞿爱东审校上海生物制品研究所有限责任公司第一研究室，上海 200051通信作者：瞿爱东，Email: quaidong1@sinopharm.com引用本文：章权, 瞿爱东. 靶向HER3治疗在头颈部鳞状细胞癌中的研究进展 [J]. 国际生物制品学杂志, 2023, 46(6): 381-390. DOI: 10.3760/cma.j.cn311962-20230220-00018识别微信二维码，添加生物制品圈小编，符合条件者即可加入生物制品微信群！请注明：姓名+研究方向！版权声明本公众号所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们联系(cbplib@163.com)，我们将立即进行删除处理。所有文章仅代表作者观点，不代表本站立场。

临床结果临床2期

2021-08-05

·GlobeNewswire

Celldex Reports Second Quarter 2021 Financial Results and

- Positive data from CDX-0159 Phase 1b Study in Chronic Inducible Urticaria presented at EAACI 2021 - - Raised $287 million in gross proceeds from a follow-on public offering of common stock, closed in July 2021 - HAMPTON, N.J., Aug. 05, 2021 (GLOBE NEWSWIRE) -- Celldex Therapeutics, Inc. (NASDAQ:CLDX) today reported financial results for the second quarter ended June 30, 2021 and provided a corporate update. “Last month, Celldex reported positive data from our ongoing Phase 1b study of CDX-0159 in chronic inducible urticaria, where a single dose demonstrated a rapid, profound and durable response,” said Anthony Marucci, Co-founder, President and Chief Executive Officer of Celldex Therapeutics. “These data not only spoke to the potential to bring patients suffering from urticaria an opportunity for fast, lasting and meaningful relief, but also showed that CDX-0159 safely depletes mast cells, a significant scientific and medical achievement that indicates CDX-0159’s potential to help other patients in need across a myriad of diseases with mast cell involvement.” Mr. Marucci continued, “Importantly, driven by these data, we successfully completed a $287.5 million follow-on offering which will support the expansion of the CDX-0159 program into later stage studies and additional indications, along with the continued development of our bispecific platform, which is exploring important pathways in inflammatory diseases, auto-immune disorders and oncology. We look forward to building on our successes in what promises to be an exciting second half of the year.” Recent Program Highlights CDX-0159 - KIT Inhibitor Program CDX-0159 is a humanized monoclonal antibody developed by Celldex that binds the KIT receptor with high specificity and potently inhibits its activity. The KIT receptor tyrosine kinase is expressed in a variety of cells, including mast cells, which mediate inflammatory responses such as hypersensitivity and allergic reactions. KIT signaling controls the differentiation, tissue recruitment, survival and activity of mast cells. CDX-1140 - CD40 Agonist Program CDX-1140 is a potent CD40 human agonist antibody developed by Celldex that the Company believes has the potential to successfully balance systemic doses for good tissue and tumor penetration with an acceptable safety profile. CDX-527 - Bispecific Antibody Program CDX-527 is the first candidate developed by Celldex from its bispecific platform and utilizes the Company’s proprietary highly active anti-PD-L1 and CD27 human antibodies to couple CD27 co-stimulation with blockade of the PD-L1/PD-1 pathway. Corporate Highlights While Celldex’s clinical development programs have not been significantly, negatively impacted by COVID-19 to date, the Company continues to carefully monitor the evolving situation closely across all development programs and work to minimize potential impact/disruptions. Second Quarter 2021 Financial Highlights and 2021 Guidance Cash Position: Cash, cash equivalents and marketable securities as of June 30, 2021 were $164.0 million compared to $176.1 million as of March 31, 2021. The decrease was primarily driven by second quarter cash used in operating activities of $11.9 million. At June 30, 2021, Celldex had 39.6 million shares outstanding. In July 2021, the Company issued 6,845,238 shares of its common stock in an underwritten public offering of common stock resulting in net proceeds to the Company of approximately $270.0 million, after deducting underwriting fees and offering expenses. Revenues: Total revenue was $3.5 million in the second quarter of 2021 and $4.2 million for the six months ended June 30, 2021, compared to $0.2 million and $3.0 for the comparable periods in 2020. The increase in revenue was primarily due to an increase in services performed under our contract manufacturing and research and development agreements with Rockefeller University and Gilead Sciences, partially offset by a decrease in revenue from product development and licensing agreements as a result of the $1.8 million milestone payment received from Rockefeller University in the first quarter of 2020 related to Celldex’s manufacturing and development services agreement. R&D Expenses: Research and development (R&D) expenses were $12.4 million in the second quarter of 2021 and $25.1 million for the six months ended June 30, 2021, compared to $9.7 million and $21.4 million for the comparable periods in 2020. The increase in R&D expenses was primarily due to an increase in clinical trial, contract research, and personnel expenses, partially offset by a decrease in rent expense. G&A Expenses: General and administrative (G&A) expenses were $4.3 million in the second quarter of 2021 and $8.4 million for the six months ended June 30, 2021, compared to $3.5 million and $7.2 million for the comparable periods in 2020. The increase in G&A expenses was primarily due to higher personnel expenses. Intangible Asset Impairment: The Company recorded a non-cash impairment charge of $3.5 million during the second quarter of 2020 due to the discontinuation of the CDX-3379 program. Changes in Fair Value Remeasurement of Contingent Consideration: The loss on fair value remeasurement of contingent consideration was $0.3 million for the second quarter of 2021 and $0.7 million for the six months ended June 30, 2021, primarily due to changes in discount rates and the passage of time. Net Loss: Net loss was $13.4 million, or ($0.34) per share, for the second quarter of 2021, and $29.9 million, or ($0.76) per share, for the six months ended June 30, 2021, compared to a net loss of $11.0 million, or ($0.50) per share, for the second quarter of 2020 and $23.7 million, or ($1.20) per share, for the six months ended June 30, 2020. Financial Guidance: Celldex believes that the cash, cash equivalents and marketable securities at June 30, 2021, along with the approximately $270.0 million in net proceeds raised in our July 2021 underwritten public offering of common stock, are sufficient to meet estimated working capital requirements and fund planned operations through 2025. KEYTRUDA® is a registered trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA. About Celldex Therapeutics, Inc.Celldex is a clinical stage biotechnology company dedicated to developing monoclonal and bispecific antibodies that address devastating diseases for which available treatments are inadequate. Our pipeline includes antibody-based therapeutics which have the ability to engage the human immune system and/or directly affect critical pathways to improve the lives of patients with inflammatory diseases and many forms of cancer. Visit . Forward Looking Statement This release contains "forward-looking statements" made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements are typically preceded by words such as "believes," "expects," "anticipates," "intends," "will," "may," "should," or similar expressions. These forward-looking statements reflect management's current knowledge, assumptions, judgment and expectations regarding future performance or events. Although management believes that the expectations reflected in such statements are reasonable, they give no assurance that such expectations will prove to be correct or that those goals will be achieved, and you should be aware that actual results could differ materially from those contained in the forward-looking statements. Forward-looking statements are subject to a number of risks and uncertainties, including, but not limited to, our ability to successfully complete research and further development and commercialization of Company drug candidates, including CDX-0159, in current or future indications; the uncertainties inherent in clinical testing and accruing patients for clinical trials; our limited experience in bringing programs through Phase 3 clinical trials; our ability to manage and successfully complete multiple clinical trials and the research and development efforts for our multiple products at varying stages of development; the effects of the outbreak of COVID-19 on our business and results of operations; the availability, cost, delivery and quality of clinical materials produced by our own manufacturing facility or supplied by contract manufacturers, who may be our sole source of supply; the timing, cost and uncertainty of obtaining regulatory approvals; the failure of the market for the Company's programs to continue to develop; our ability to protect the Company's intellectual property; the loss of any executive officers or key personnel or consultants; competition; changes in the regulatory landscape or the imposition of regulations that affect the Company's products; our ability to continue to obtain capital to meet our long-term liquidity needs on acceptable terms, or at all, including the additional capital which will be necessary to complete the clinical trials that we have initiated or plan to initiate; and other factors listed under "Risk Factors" in our annual report on Form 10-K and quarterly reports on Form 10-Q. All forward-looking statements are expressly qualified in their entirety by this cautionary notice. You are cautioned not to place undue reliance on any forward-looking statements, which speak only as of the date of this release. We have no obligation, and expressly disclaim any obligation, to update, revise or correct any of the forward-looking statements, whether as a result of new information, future events or otherwise. Company ContactSarah CavanaughSenior Vice President, Corporate Affairs & Administration(508) 864-8337scavanaugh@celldex.com Patrick TillSenior Director, Investor Relations & Corporate Communications(484) 788-8560ptill@celldex.com

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100 项与 KTN-3379 相关的药物交易

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适应症	最高研发状态	国家/地区	公司	日期
NRAS突变黑色素瘤	临床2期	美国	Celldex Therapeutics, Inc.	2018-07-06
乳腺癌	临床2期	美国	Celldex Therapeutics, Inc.	2018-03-27
头颈部肿瘤	临床2期	美国	Celldex Therapeutics, Inc.	-
头颈部肿瘤	临床2期	-	MedImmune LLC	-
黑色素瘤	临床2期	美国	New York University School of Medicine	-
头颈部鳞状细胞癌	临床1期	美国	Celldex Therapeutics, Inc.	2015-10-01
甲状腺癌	临床1期	美国	Celldex Therapeutics, Inc.	2015-06-01
晚期癌症	临床1期	美国	Celldex Therapeutics, Inc.	2014-01-01

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT02473731 (Pubmed) 人工标引	临床1期	头颈部鳞状细胞癌一线	12	CDX-3379	鹹壓鹽蓋糧遞選鹽簾餘(蓋構鹹獵築夢鏇糧網簾) = 選遞糧築積鬱積衊顧膚簾鑰鬱壓簾選獵壓衊衊 (餘鏇醖衊積鹹膚廠觸淵, 27.7 ~ 84.8) 更多	积极	2019-10-01
AACR2018	临床1期	头颈部鳞状细胞癌	12	CDX-3379	鏇鏇願醖獵遞衊簾艱繭(願憲願簾鏇遞衊顧膚淵) = 鹹簾蓋簾淵艱蓋網餘鹹獵觸餘獵積範觸膚鹽選 (觸糧網夢淵鑰糧顧簾夢 )	-	2018-07-01
NCT02014909 (ASCO2016) 人工标引	临床1期	肿瘤	58	cetuximab+erlotinib+vemurafenib+trastuzumab+KTN3379	觸願製憲窪範鏇艱鑰窪(壓醖構夢鑰鑰衊糧願艱) = No DLTs occurred in 21 pts. DLTs of diarrhea, mucositis and rash were observed in 5 of 37 pts treated with combinations. 糧衊網窪鹽製鹽廠糧觸 (鏇遞顧鏇願鹹憲繭築網 ) 更多	积极	2016-06-06