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Borazanci E, Schram AM, Garralda E, Brana I, Vieito Villar M, Spreafico A, Oliva M, Lakhani NJ, Hoffman K, Hallett RM, Maetzel D, Hua F, Hilbert J, Giblin P, Anido J, Kelly A, Vickers PJ, Wasserman R, Seoane J, Siu LL, Hyman DM, Hoff DV, Tabernero J. Phase I, first-in-human study of MSC-1 (AZD0171), a humanized anti-leukemia inhibitory factor monoclonal antibody, for advanced solid tumors. ESMO Open 2022; 7:100530. [PMID: 35921760 PMCID: PMC9434412 DOI: 10.1016/j.esmoop.2022.100530] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/26/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - A M Schram
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - E Garralda
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - I Brana
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - M Vieito Villar
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - A Spreafico
- Princess Margaret Cancer Centre, Toronto, Canada
| | - M Oliva
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | - K Hoffman
- Northern Biologics, Inc., Toronto, Canada
| | | | - D Maetzel
- Northern Biologics, Inc., Toronto, Canada
| | - F Hua
- Applied BioMath, Concord, USA
| | | | - P Giblin
- Northern Biologics, Inc., Toronto, Canada
| | - J Anido
- Northern Biologics, Inc., Toronto, Canada
| | - A Kelly
- Northern Biologics, Inc., Toronto, Canada
| | | | | | - J Seoane
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Universitat Autònoma de Barcelona (UAB), CIBERONC, Barcelona
| | - L L Siu
- Princess Margaret Cancer Centre, Toronto, Canada
| | - D M Hyman
- Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain; UVic-UCC, IOB-Quiron, Barcelona, Spain
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Schram A, Borazanci E, Brana I, Villar MV, Garralda E, Spreafico A, Oliva M, Lakhani N, Wasserman R, Hoffmann K, Hallett R, Anido J, Maetzel D, Giblin P, Moran E, Kelly A, Seoane J, Von Hoff DD, Siu L, Tabernero J. Abstract CT147: Phase 1 dose escalation of MSC-1, a humanized anti-LIF monoclonal antibody, in patients with advanced solid tumors. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-ct147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Leukemia Inhibitory Factor (LIF) is a pleiotropic cytokine, which is highly expressed in a subset of tumors and correlates with poor prognosis. LIF is hypothesized to contribute to tumor microenvironment immunosuppression and regulation of cancer stem cells. MSC-1 is a first-in-class humanized IgG1 monoclonal antibody that potently and selectively inhibits LIF. In pre-clinical models, MSC-1 decreases tumor growth through inhibition of STAT3 signaling, promoting immune stimulatory macrophages and increasing tumor infiltration of CD8 T and NK cells.
The Phase Ia clinical study employed an accelerated 3 + 3 escalation design to explore safety and tolerability, dose-limiting toxicities (DLTs), preliminary efficacy, define a recommended phase II dose (RP2D), and evaluate exploratory tumor biomarkers. Eligible patients had advanced relapsed/refractory solid tumors and received treatment with MSC-1 intravenously (75mg-1500 mg) once every 3-weeks as a single agent until disease progression. The three highest dose cohorts were expanded to further assess safety, PK, engagement of LIF in the periphery, and assess immuno-regulatory tumor activity in matched pre- and on-treatment tumor biopsies.
Forty-one patients (pts) were enrolled (14 in dose escalation; 27 in expanded cohorts) with the last pt completing the study on September 23, 2019. The most common tumor types were pancreatic (13), colorectal (5), head & neck (4) and ovarian (4). Pts had received a median of 3 prior lines of therapy. All pts experienced at least one adverse event (AE). The most common considered drug-related AEs were fatigue (N=8, 20%) and gastrointestinal disorder (N=8, 20%), and there was 1 considered drug-related SAE (Gr 2 osteonecrosis of jaw in a head and neck cancer patient who previously received radiation to the area and denosumab). There were no Dose Limiting Toxicities observed during the first cycle of treatment and 2 pts discontinued treatment due to AEs.
The PK profile of MSC-1 was linear with an estimated terminal half-life of ∼13 days and benign anti-drug antibody profile. There was evidence of durable peripheral saturation of LIF binding demonstrating high level of target engagement. Results supported the selection of a RP2D of 1500 mg Q3W. Prolonged stable disease (≥ 16 weeks) was observed in 9 pts. Analysis of paired biopsies collected from matched metastatic lesions supported MSC-1 mediated STAT3 signaling inhibition, stimulatory (M1) to suppressive (M2) macrophage skewing in the majority of paired biopsies evaluated and increased CD8 T-cell infiltration in a subset of samples.
Single agent MSC-1 was well tolerated in doses ranged from 75 mg to 1500 mg IV OD in patients with advanced solid tumors, showed promising activity as an anti-cancer therapy, and is Phase 1b/2 ready for combination with other agents. The updated final safety, efficacy, PK, LIF stabilization analyses, and tumor biopsy data will be presented.
Citation Format: Alison Schram, Erkut Borazanci, Irene Brana, Maria Vieito Villar, Elena Garralda, Anna Spreafico, Marc Oliva, Nehal Lakhani, Robert Wasserman, Kimberly Hoffmann, Robin Hallett, Judit Anido, Dorotea Maetzel, Patricia Giblin, Enda Moran, Adrianne Kelly, Joan Seoane, Daniel D. Von Hoff, Lillian Siu, Josep Tabernero. Phase 1 dose escalation of MSC-1, a humanized anti-LIF monoclonal antibody, in patients with advanced solid tumors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr CT147.
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Affiliation(s)
- Alison Schram
- 1Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Irene Brana
- 3Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Elena Garralda
- 3Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anna Spreafico
- 4Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Marc Oliva
- 4Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | | | | | | | | | - Judit Anido
- 6Northern Biologics, Toronto, Ontario, Canada
| | | | | | - Enda Moran
- 6Northern Biologics, Toronto, Ontario, Canada
| | | | - Joan Seoane
- 7Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | | | - Lillian Siu
- 4Princess Margaret Cancer Center, Toronto, Ontario, Canada
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