755 DEKA-1 a dose-finding Phase 1 trial: observing safety and biomarkers using DK210(EGFR) for inoperable locally advanced and/or metastatic EGFR+ tumors failing systemic therapy

Alexander I Spira, Douglas Orr, Aurélien Marabelle, Elizabeth C Moser, Deb Kientop, John Mumm
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引用次数: 0

Abstract

Background

Both interleukin-2 (IL-2) and interleukin-10 (IL-10) have been extensively studied for their stimulatory function on T cells and their potential to obtain sustainable tumor control in renal, melanoma, lung, and pancreatic cancers as monotherapy. While approved, IL-2 exhibits significant toxicity in a high percentage of the patient population, limiting its widespread use. The significant efforts undertaken to uncouple IL-2 toxicity from its anti-tumor function have been unsuccessful and early phase clinical safety observed with PEGylated IL-10 was not met in a blinded Phase 3 trial. Deka Biosciences has engineered a novel molecule coupling wild-type IL-2 to a high affinity variant of Epstein Barr Viral (EBV) IL-10 via a scaffold that binds to epidermal growth factor receptors (EGFR). This patented molecule, named DK210 (EGFR), is targeted to EGFR expressing cells and demonstrated to be retained at high levels within the tumor microenvironment days after dosing. In addition to overlapping and non-redundant anti-tumor function, IL-10 reduces IL-2 mediated cytokine release syndrome (CRS) risks and inhibits IL-2 mediated T regulatory cell proliferation.

Methods

DK210 (EGFR) is being evaluated in an open-label, dose-escalation (Phase 1) study (BOIN design) with five (0.025–0.3 mg/kg) monotherapy dose levels. DK210 (EGFR) is home-administered via subcutaneous injection three times a week. The objectives of this study include evaluating the safety, CRS occurrence, pharmacokinetics, pharmacodynamic and predictive biomarkers, presence of anti-drug antibodies, and antitumor activity.

Results

As of June 22, 2023, three patients were enrolled, and are continuing DK210 (EGFR) treatment. Subjects improved clinically and no drug related toxicities, nor CRS were observed in any of the patients. One subject with pancreatic cancer achieved stable disease by RECIST 1.1.

Conclusions

DK210 (EGFR) couples wild-type IL-2 with a high affinity IL-10 and targets cytokines directly to the tumor microenvironment significantly changing Il-2s therapeutic window. Preliminary human data shows an encouraging safety and efficiency profile. The dose-escalation study is expected to be completed by the end of this year (NCT05704985).

Acknowledgements

The authors would like to thank all patients who participated in this study and their families, as well as all the investigators and site staff who made the study possible.

Trial Registration

Trial Registration www.clinicaltrials.gov; NCT05704985

Ethics Approval

The study was approved by NEXT Oncology, Salus IRB, approval number NXVIR22.60, on 14-Feb-2023 and by Mary Crowley Medical Research Center Institutional Review Board, approval number 23–08, on 21-Apr-2023.

Consent

Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal
755 DEKA-1是一项剂量发现的1期试验:观察DK210(EGFR)治疗无法手术的局部晚期和/或转移性EGFR+肿瘤的安全性和生物标志物
白细胞介素-2 (IL-2)和白细胞介素-10 (IL-10)对T细胞的刺激功能以及它们作为单一疗法在肾癌、黑色素瘤、肺癌和胰腺癌中获得持续肿瘤控制的潜力已经被广泛研究。虽然获得批准,但IL-2在很大比例的患者群体中显示出显著的毒性,限制了其广泛使用。将IL-2毒性与其抗肿瘤功能分离的重大努力尚未成功,PEGylated IL-10在盲法3期试验中未达到早期临床安全性。Deka Biosciences公司设计了一种新型分子,通过结合表皮生长因子受体(EGFR)的支架,将野生型IL-2与eb病毒(EBV) IL-10的高亲和力变体偶联。这种专利分子名为DK210 (EGFR),针对表达EGFR的细胞,并在给药后数天内在肿瘤微环境中保持高水平。除了重叠和非冗余的抗肿瘤功能外,IL-10还可以降低IL-2介导的细胞因子释放综合征(CRS)风险,抑制IL-2介导的T调节性细胞增殖。DK210 (EGFR)正在一项开放标签、剂量递增(1期)研究(BOIN设计)中进行评估,该研究采用5个(0.025-0.3 mg/kg)单药剂量水平。DK210 (EGFR)通过皮下注射每周在家给药三次。本研究的目的包括评估安全性、CRS发生、药代动力学、药效学和预测性生物标志物、抗药物抗体的存在和抗肿瘤活性。截至2023年6月22日,3名患者入组,并继续接受DK210 (EGFR)治疗。受试者临床改善,无药物相关毒性,未观察到任何患者的CRS。1例胰腺癌患者通过RECIST 1.1达到病情稳定。结论DK210 (EGFR)将野生型IL-2与高亲和力IL-10偶联,将细胞因子直接靶向肿瘤微环境,显著改变Il-2s的治疗窗口期。初步的人体数据显示出令人鼓舞的安全性和有效性。剂量递增研究预计将于今年年底完成(NCT05704985)。作者要感谢所有参与这项研究的患者及其家属,以及所有使这项研究成为可能的研究者和现场工作人员。试验注册试验注册www.clinicaltrials.gov;该研究于2023年2月14日获得NEXT Oncology (Salus IRB)批准,批准号为NXVIR22.60,并于2023年4月21日获得Mary Crowley Medical Research Center机构审查委员会批准,批准号为23-08。本摘要及任何随附图片的发表均已获得患者的书面知情同意。一份书面同意书副本可供本刊编辑审阅
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