WO2025195402A1 - Method for treating cancer by using antibody-drug conjugate targeting trop2 - Google Patents
Method for treating cancer by using antibody-drug conjugate targeting trop2Info
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- WO2025195402A1 WO2025195402A1 PCT/CN2025/083410 CN2025083410W WO2025195402A1 WO 2025195402 A1 WO2025195402 A1 WO 2025195402A1 CN 2025083410 W CN2025083410 W CN 2025083410W WO 2025195402 A1 WO2025195402 A1 WO 2025195402A1
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- Prior art keywords
- amino acid
- antibody
- acid sequence
- trop2
- drug conjugate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/47—Quinolines; Isoquinolines
- A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
- A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
- A61K47/62—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid
- A61K47/65—Peptidic linkers, binders or spacers, e.g. peptidic enzyme-labile linkers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
- A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
- A61K47/68—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an antibody, an immunoglobulin or a fragment thereof, e.g. an Fc-fragment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
- A61P35/04—Antineoplastic agents specific for metastasis
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
Definitions
- the present invention relates to the field of disease treatment. Specifically, the present invention relates to a method for treating cancer (especially solid tumors) using an antibody-drug conjugate targeting TROP2.
- TROP2 a trophoblast cell surface antigen, also known as tumor-associated calcium signaling protein (TACSTD2), is overexpressed in a variety of human epithelial cancers, including breast, lung, gastric, colorectal, pancreatic, prostate, cervical, head and neck, and ovarian cancers (Yezhe Cheng et al., Frontiers in Oncology, 2022 Dec 23;12:951589).
- TACSTD2 tumor-associated calcium signaling protein
- TROP2-targeted therapies have entered clinical trials for the treatment of various cancers, and some indications have been approved.
- the IMMU-132-01 Phase I/II basket trial (NCT01631552) evaluated the safety and efficacy of SG in adult patients with various advanced epithelial malignancies who had progressed after at least one standard treatment regimen.
- the TROPHY trial was a single-arm, multicenter study that enrolled 112 patients with locally advanced or metastatic UC who had previously received platinum-based chemotherapy and a programmed death receptor 1 (PD-1) or its ligand PD-L1 inhibitor.
- Tumor assessments were performed by an independent review committee according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, resulting in an ORR of 27.7% and a median DoR of 7.2 months.
- the median PFS for SG vs. single-agent chemotherapy was 5.5 vs. 4.0 months, and the median OS was 14.4 vs. 11.2 months.
- SG showed statistically significant improvements in PFS and OS.
- anti-TROP2 ADCs have been approved for marketing in some indications, they are currently limited to second-line treatment for patients with triple-negative breast cancer, urothelial carcinoma, and HR-positive/HER-negative breast cancer.
- anti-TROP2 ADCs are worth further exploration, and there is still considerable room for further development of more effective and safe anti-TROP2 ADCs.
- the present invention meets the above unmet needs by providing methods for treating solid tumors using antibody-drug conjugates targeting TROP2.
- the present invention first provides a method for preventing or treating solid tumors, which comprises administering an effective amount of an antibody-drug conjugate targeting TROP2 to an individual in need thereof.
- the present invention also provides use of an antibody-drug conjugate targeting TROP2 in preparing a drug for preventing or treating solid tumors.
- the present invention also provides an antibody-drug conjugate targeting TROP2, which is used for preventing or treating solid tumors.
- the present invention also provides a single-dose unit, comprising: an effective amount of the above-mentioned antibody-drug conjugate targeting TROP2 of the present invention
- the antibody-drug conjugate targeting TROP2 is:
- Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
- p is the average drug to antibody ratio (ie, average DAR), for example, 1-15, 1-10, 2-8, 2-4, or 4-5.
- the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 as shown in the following amino acid sequences: SEQ ID NO: 1, 2 and 3, and LCDR1, LCDR2 and LCDR3 as shown in the following amino acid sequences: SEQ ID NO: 6, 7 and 8, respectively.
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and/or a light chain variable region, wherein the heavy chain variable region
- amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 4, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; and/or
- amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 9, and preferably, the amino acid changes do not occur in the CDR region.
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain and a light chain, wherein the heavy chain
- amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 5; and
- amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 10.
- the method comprises administering to the individual approximately 0.1 mg/kg to 100 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 0.2 mg/kg to 50 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 0.3 mg/kg to 30 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 0.3 mg/kg, 0.8 mg/kg, 1 mg/kg, 1.5 mg/kg, 1.6 mg/kg, 1.8 mg/kg, 2 mg/kg, 2.3 mg/kg, 2.5 mg/kg, 3 mg/kg, 3.2 mg/kg, 3.5 mg/kg, 3.8 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.4 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 9.5 mg/kg, 9.6 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 13.5 mg/kg, 14 mg/kg, 14.5 mg/kg, 15 mg/kg, 15.5 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2.
- the dosing cycle of this method is 2 weeks/14 days (Q2W) to 5 weeks/35 days (Q5W).
- the dosing cycle of this method is 2 weeks/14 days (Q2W), 3 weeks/21 days (Q3W) or 4 weeks/28 days (Q4W), and the drug is administered once on the first day of each cycle.
- the administration method includes intravenous administration.
- the antibody-drug conjugate targeting TROP2 is a lyophilized powder preparation.
- the present invention also provides a use of an antibody-drug conjugate targeting TROP2 for preparing a drug for treating solid tumors, wherein the antibody-drug conjugate targeting TROP2 is as described above.
- the present invention also provides a single-dose unit, comprising: an effective amount of the antibody-drug conjugate targeting TROP2 of the present invention.
- the present invention further provides a complete drug kit, which comprises the above-mentioned effective amount of the antibody-drug conjugate targeting TROP2 of the present invention.
- the antibody-drug conjugate targeting TROP2 of the present invention has certain safety and efficacy in treating solid tumors.
- anti-TROP2 antibody refers to antibodies that bind to TROP2 protein with sufficient affinity.
- the antibodies can be used as diagnostic and/or therapeutic agents targeting TROP2, or used to construct immunoconjugates, such as antibody-drug conjugates.
- full-length antibody refers to antibody molecules having the structure of a natural immunoglobulin molecule.
- a full-length antibody comprises two heavy chains (H) and two light chains (L) interconnected by disulfide bonds.
- a full-length antibody comprises two heavy chains (H) interconnected by disulfide bonds.
- the full-length antibody heavy chain is generally composed of a heavy chain variable region (abbreviated herein as VH) and a heavy chain constant region, wherein the heavy chain constant region comprises at least three domains: CH1, CH2, and CH3.
- the full-length antibody light chain is composed of a light chain variable region (abbreviated herein as VL) and a light chain constant region, wherein the light chain constant region consists of one domain: CL.
- Each heavy chain variable region VH and each light chain variable region consists of three CDRs and four FRs, arranged from amino terminus to carboxyl terminus in the following order: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4.
- antibody fragment includes a portion of an intact antibody.
- the antibody fragment is an antigen-binding fragment.
- Antigen-binding fragment refers to a molecule other than an intact antibody that comprises a portion of an intact antibody and binds to the antigen to which the intact antibody binds.
- antibody fragments include, but are not limited to, Fv, Fab, Fab', Fab'-SH, F(ab') 2 ; dAb (domain antibody); linear antibodies; single-chain antibodies (e.g., scFv); single-domain antibodies such as VHH; diabodies or fragments thereof; or camelid antibodies.
- antigen refers to a molecule that triggers an immune response. This immune response may involve the production of antibodies or the activation of specific immune cells, or both. It will be appreciated by those skilled in the art that any macromolecule, including substantially all proteins or peptides, can be used as an antigen. In addition, antigens can be derived from recombinant or genomic DNA. As used herein, the term “epitope” refers to a portion of an antigen (e.g., TROP2) that specifically interacts with an antibody molecule.
- an antigen e.g., TROP2
- CDR region is a region in an antibody variable domain that is highly variable in sequence and forms structurally determined loops ("hypervariable loops") and/or contains antigen contact residues ("antigen contact points"). CDRs are primarily responsible for binding to antigenic epitopes.
- the CDRs of the heavy and light chains are typically referred to as CDR1, CDR2, and CDR3, and are numbered sequentially starting from the N-terminus.
- the CDRs located within the antibody heavy chain variable domain are referred to as HCDR1, HCDR2, and HCDR3, while the CDRs located within the antibody light chain variable domain are referred to as LCDR1, LCDR2, and LCDR3.
- each CDR can be determined using any one or a combination of many well-known antibody CDR assignment systems, including, for example: Chothia based on the three-dimensional structure of the antibody and the topology of the CDR loops (Chothia et al. (1989) Nature 342:877-883, Al-Lazikani et al., "Standard conformations for the canonical structures of immunoglobulins", Journal of Molecular Biology, 273, 927-948 (1997)), Kabat based on antibody sequence variability (Kabat et al., Sequences of Proteins of Immunological Interest, 4th Edition, U.S.
- a CDR can also be identified based on having the same Kabat numbering position as a reference CDR sequence (eg, any of the exemplary CDRs of the invention).
- the residue positions in the antibody variable region refers to the numbering position according to the Kabat numbering system (Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed. Public Health Service, National Institutes of Health, Bethesda, Md. (1991)).
- the heavy chain variable region CDRs of the antibodies of the present invention are determined according to the following rules:
- VH CDR1 was determined according to the AbM rule; and VH CDR2 and 3 were both determined according to the Kabat rule.
- the light chain variable region CDRs of an antibody of the invention are determined according to the Kabat rules.
- the heavy chain variable region CDRs of the antibodies of the present invention are determined according to the following rules: VH CDR1 is determined according to the AbM rule; and VH CDR2 and 3 are both determined according to the Kabat rule; and the light chain variable region CDRs are respectively determined according to the Kabat rule.
- the boundaries of the CDRs of the variable regions of the same antibody obtained based on different assignment systems may be different. That is, the CDR sequences of the variable regions of the same antibody defined under different assignment systems may be different. Therefore, when referring to antibodies defined by specific CDR sequences defined in the present invention, the scope of the antibodies also covers antibodies whose variable region sequences contain the specific CDR sequences, but whose claimed CDR boundaries are different from the specific CDR boundaries defined in the present invention due to the application of different schemes (e.g., different assignment system rules or combinations).
- Fc region is used herein to define the C-terminal region of an immunoglobulin heavy chain that contains at least a portion of the constant region.
- the term includes native sequence Fc regions and variant Fc regions.
- a native immunoglobulin "Fc domain" comprises two or three constant domains, namely a CH2 domain, a CH3 domain, and an optional CH4 domain.
- the immunoglobulin Fc domain comprises the second and third constant domains (CH2 domain and CH3 domain) of two heavy chains derived from IgG, IgA, and IgD class antibodies; or the second, third, and fourth constant domains (CH2 domain, CH3 domain, and CH4 domain) of two heavy chains derived from IgM and IgE class antibodies.
- Fc region excludes the heavy chain variable region VH and light chain variable region VL as well as the heavy chain constant region CH1 and light chain constant region CL of an immunoglobulin, but may include the hinge region at the N-terminus of the heavy chain constant region in some cases.
- an "IgG-type antibody” refers to an antibody whose heavy chain constant region belongs to the IgG type. All antibodies of the same type have the same heavy chain constant region, while antibodies of different types differ in their heavy chain constant regions.
- an antibody of the IgG4 type refers to an antibody whose heavy chain constant region is derived from IgG4
- an antibody of the IgG1 type refers to an antibody whose heavy chain constant region is derived from IgG1.
- binding means that the binding effect is selective for the antigen and can be distinguished from unwanted or non-specific interactions.
- the ability of an antigen binding site to bind to a specific antigen can be determined by enzyme-linked immunosorbent assay (ELISA) or conventional binding assays known in the art, such as by radioimmunoassay (RIA) or thin-layer interferometry or MSD assays or surface plasmon resonance (SPR).
- ELISA enzyme-linked immunosorbent assay
- RIA radioimmunoassay
- MSD assays thin-layer interferometry
- SPR surface plasmon resonance
- antibody-drug conjugate refers to a structure obtained by linking an antibody to a drug.
- DAR drug:antibody ratio
- DAR drug:antibody ratio
- the DAR can be determined by p or q, for example, the DAR can be 1 to 20, such as 2-18, 4-16, 5-12, 6-10, 2-8, 3-8, 2-6, 4-6, 6-10, such as 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15.
- the DAR can also be calculated as the average DAR of the population of molecules in the product, i.e., the overall ratio of the small molecule drug moiety coupled to the Ab moiety described herein to the Ab moiety in the product as measured by a detection method (e.g., by conventional methods such as mass spectrometry, ELISA assay, electrophoresis, and/or HPLC), and this DAR is referred to herein as the average DAR.
- a detection method e.g., by conventional methods such as mass spectrometry, ELISA assay, electrophoresis, and/or HPLC
- the average DAR value of the conjugate of the invention is 1 to 20, e.g., 2-18, 4-16, 5-12, 6-10, 2-8, 3-8, 2-6, 4-6, 6-10, e.g., 1.0-8.0, 2.0-6.0, e.g., 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4, 4.1, 4.2, 4.3, 4.4 , 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.
- composition refers to a composition suitable for administration to an animal, preferably a mammal (including a human) comprising at least one active ingredient and at least one inactive ingredient, such as a pharmaceutically acceptable excipient.
- the pharmaceutical composition of the present invention is preferably in the form of parenteral administration, such as a solution, suspension, lyophilized powder, concentrated solution, etc.
- an antibody or fragment or composition or combination of the present invention which, after single or multiple doses, produces the desired effect in a patient in need of treatment or prevention.
- a “therapeutically effective amount” is an amount effective to achieve the desired therapeutic outcome at the desired dosage and for the desired period of time.
- a therapeutically effective amount is also an amount in which any toxic or deleterious effects of the antibody or antibody fragment or composition or combination are outweighed by the therapeutically beneficial effects.
- a “therapeutically effective amount” preferably inhibits a measurable parameter (e.g., tumor volume) by at least about 30%, even more preferably by at least about 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or even 100% relative to an untreated subject.
- prophylactically effective amount refers to an amount effective to achieve the desired preventive result, at the required dosage and for the required period of time. Typically, a prophylactic amount will be less than a therapeutically effective amount because a prophylactic dose is used in a subject prior to or at an earlier stage of disease.
- host cell refers to cells into which exogenous nucleic acid has been introduced, including the progeny of such cells.
- Host cells include “transformants” and “transformed cells,” which include the primary transformed cell and progeny derived therefrom, without regard to the number of passages. Progeny may not be completely identical in nucleic acid content to the parent cell, but may contain mutations. Mutant progeny screened or selected for the same function or biological activity as the initially transformed cell are included herein.
- label refers to a compound or composition that is directly or indirectly conjugated or fused to a reagent (such as a polynucleotide probe or antibody) and promotes the detection of the reagent to which it is conjugated or fused.
- the label itself can be detectable (e.g., a radioisotope label or a fluorescent label) or can catalyze a chemical change in a detectable substrate compound or composition in the case of an enzymatic label.
- the term is intended to encompass direct labeling of a probe or antibody by coupling (i.e., physically connecting) a detectable substance to the probe or antibody and indirect labeling of the probe or antibody by reacting with another reagent of the direct label.
- “Individual” or “subject” includes mammals. Mammals include, but are not limited to, domestic animals (e.g., cattle, sheep, cats, dogs, and horses), primates (e.g., humans and non-human primates such as monkeys), rabbits, and rodents (e.g., mice and rats). In some embodiments, the individual or subject is a human.
- an “isolated” antibody or other molecule is one that has been separated from a component of its natural environment or the environment in which it is expressed.
- the antibody or ADC molecule is purified to greater than 95% or 99% purity as determined by, for example, electrophoresis (e.g., SDS-PAGE, isoelectric focusing (IEF), capillary electrophoresis) or chromatography (e.g., ion exchange or reverse phase HPLC).
- anti-tumor effect refers to a biological effect that can be demonstrated by various means, including but not limited to, for example, a reduction in tumor volume, a reduction in tumor cell number, a reduction in tumor cell proliferation, or a reduction in tumor cell survival.
- tumor and cancer are used interchangeably herein to encompass both solid tumors and hematological tumors.
- cancers suitable for treatment by the antibodies of the invention include gastric cancer, pancreatic cancer, or gastroesophageal junction cancer, including metastatic forms of those cancers.
- tumor refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all precancerous and cancerous cells and tissues.
- cancer refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all precancerous and cancerous cells and tissues.
- cancer refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all precancerous and cancerous cells and tissues.
- cancer refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all precancerous and cancerous cells and tissues.
- Subject/patient/individual sample refers to a collection of cells or fluids obtained from a patient or subject.
- the source of a tissue or cell sample can be solid tissue, such as an organ or tissue sample or a biopsy sample or a puncture sample from a fresh, frozen and/or preserved organ; blood or any blood component; body fluids, such as cerebrospinal fluid, amniotic fluid (amniotic fluid), peritoneal fluid (ascites), or interstitial fluid; cells from any time during the subject's pregnancy or development.
- Tissue samples may contain compounds that are not naturally contaminated with tissue in nature, such as preservatives, anticoagulants, buffers, fixatives, nutrients, antibiotics, etc.
- kits of parts refers to a composition comprising one or more separate pharmaceutical compositions, at least one of which comprises an effective amount of an antibody-drug conjugate targeting TROP2, and preferably a package insert printed with instructions for using the antibody-drug conjugate targeting TROP2 for the prevention or treatment of solid tumors, in particular for administration according to the dosage regimen of the present invention.
- the kit of parts may also contain other therapeutic agents with the same or different activities. It will be understood that when the kit of parts contains multiple separate pharmaceutical compositions, each of the pharmaceutical compositions may contain different doses and/or be administered by different routes.
- single-dose unit refers to a discrete pharmaceutical unit containing an antibody or antigen-binding fragment thereof of the present invention to be administered to a patient, such as a vial, ampoule, prefilled needle or prefilled syringe for injection, which contains a solution or lyophilized powder of the drug, preferably a lyophilized powder.
- parenteral administration means modes of administration other than enteral and topical administration, usually by injection or infusion, and includes, but is not limited to, intravenous, intramuscular, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal, epidural, and intrasternal injection and infusion.
- pharmaceutically acceptable means that the substances, compositions, dosage forms, etc. described thereafter do not have excessive toxicity, irritation, allergic reactions or other undesirable properties to mammals, especially humans, and have a reasonable benefit/risk ratio when used in animals or humans.
- pharmaceutically acceptable excipient refers to an ingredient in a pharmaceutical formulation other than the active ingredient, which is non-toxic to a subject.
- standard anticancer treatment or “standard treatment” are used interchangeably in this article. They refer to the best treatment plan for a certain type of cancer that is widely recognized and widely used by the medical community at a specific time. It usually includes the separate or combined use of multiple treatment methods such as surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy.
- NCCN Clinical Practice Guidelines in Oncology describe the recognized standards for the treatment of various cancers.
- systemic anti-cancer therapy refers to treatments that target tumors through a systemic approach. Unlike localized treatments, systemic therapy aims to deliver drugs or treatments throughout the body via the bloodstream to control tumor growth, metastasis, and recurrence.
- first-line treatment refers to the first systemic treatment regimen received by patients with locally advanced, unresectable, recurrent or metastatic cancer. It is usually the best palliative treatment option for a specific type of cancer, and its purpose is to prolong patient survival. Generally speaking, standard treatment is selected for the first line of treatment.
- second-line treatment refers to the situation where, after the first line of treatment, the patient's tumor progresses again and is resistant to the first-line treatment regimen, and a regimen with a different anti-cancer mechanism needs to be replaced. Radical surgical resection or radiotherapy, preoperative neoadjuvant therapy, and postoperative adjuvant therapy are usually not counted as treatment lines.
- the present invention provides a method for preventing or treating solid tumors, which comprises administering an effective amount of an antibody-drug conjugate targeting TROP2 to an individual in need thereof.
- the present invention also provides use of the TROP2-targeting antibody-drug conjugate of the present invention in preparing a drug for preventing or treating solid tumors.
- the present invention also provides use of the TROP2-targeting antibody-drug conjugate of the present invention for preventing or treating solid tumors.
- the antibody-drug conjugate targeting TROP2 is selected from:
- Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
- p is the average drug to antibody ratio DAR (i.e., mean DAR), which is 1 to 15, such as 1-10, 2-8, 2-4 or 4-5, such as 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10, for example, p is 2-6; for example, p is a value between 2-6, 3-5, 4-5; preferably, the mean DAR is 4.
- mean DAR drug to antibody ratio
- the antibody-drug conjugate targeting TROP2 is selected from:
- Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
- q is the drug to antibody ratio DAR, which is 1 to 15, such as 1-10, 2-8, 2-4 or 4-5, such as 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10, for example, p is an integer between 2-6; for example, q is an integer between 2-6, 3-5, 4-5; preferably 4.
- the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 respectively containing the following amino acid sequences: SEQ ID NO: 1 (GYTFTNYGM), SEQ ID NO: 2 (WINTYTGEPTYTDDFKG) and SEQ ID NO: 3 (GGFGSSYWYFDV), and LCDR1, LCDR2 and LCDR3 respectively containing the following amino acid sequences: SEQ ID NO: 6 (KASQDVSIAVA), SEQ ID NO: 7 (SASYRYT) and SEQ ID NO: 8 (QQHYITPLT).
- the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 as shown in the following amino acid sequences, respectively: SEQ ID NO: 1 (GYTFTNYGM), SEQ ID NO: 2 (WINTYTGEPTYTDDFKG) and SEQ ID NO: 3 (GGFGSSYWYFDV), and LCDR1, LCDR2 and LCDR3 as shown in the following amino acid sequences, respectively: SEQ ID NO: 6 (KASQDVSIAVA), SEQ ID NO: 7 (SASYRYT) and SEQ ID NO: 8 (QQHYITPLT).
- SEQ ID NO: 1 GYTFTNYGM
- SEQ ID NO: 2 WINTYTGEPTYTDDFKG
- SEQ ID NO: 3 GGFGSSYWYFDV
- LCDR1, LCDR2 and LCDR3 as shown in the following amino acid sequences, respectively: SEQ ID NO: 6 (KASQDVSIAVA), SEQ ID NO: 7 (SASYRYT) and SEQ ID
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and/or a light chain variable region, wherein the heavy chain variable region
- amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 4, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; or
- amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 9, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; or
- (iii) comprises an amino acid sequence that is at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:9.
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and a light chain variable region, wherein
- the heavy chain variable region comprises the amino acid sequence shown in SEQ ID NO:4, and the light chain variable region comprises the amino acid sequence shown in SEQ ID NO:9.
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and a light chain variable region, wherein
- the heavy chain variable region consists of the amino acid sequence shown in SEQ ID NO:4, and the light chain variable region consists of the amino acid sequence shown in SEQ ID NO:9.
- the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a heavy chain constant region. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a light chain constant region. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a heavy chain constant region and a light chain constant region.
- the heavy chain constant region HC of the present invention is the heavy chain constant region of IgG1, IgG2, IgG3, or IgG4, preferably the heavy chain constant region of IgG1, such as the wild-type IgG1 heavy chain constant region.
- the heavy chain constant region HC of the present invention is the heavy chain constant region of human IgG1, IgG2, IgG3, or IgG4, preferably the heavy chain constant region of human IgG1, such as the wild-type human IgG1 heavy chain constant region.
- the light chain constant region of the present invention is a lambda or kappa light chain constant region. In some embodiments, the light chain constant region of the present invention is a human lambda or human kappa light chain constant region.
- the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a light chain. In some specific embodiments of the present invention, the heavy chain described herein comprises the heavy chain variable region and the heavy chain constant region, or consists of the heavy chain variable region and the heavy chain constant region. In some specific embodiments of the present invention, the light chain described herein comprises the light chain variable region and the light chain constant region, or consists of the light chain variable region and the light chain constant region.
- the antibody or antigen-binding fragment thereof targeting TROP2 described herein comprises a heavy chain and a light chain, wherein the heavy chain comprises or consists of the amino acid sequence of SEQ ID NO: 5 as shown below:
- amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 5; or
- amino acid sequence comprising an amino acid sequence that is at least 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:5;
- the light chain comprises or consists of the amino acid sequence shown below in SEQ ID NO: 10:
- amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 10; or
- amino acid sequence that is at least 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:5.
- the antibodies or antigen-binding fragments thereof targeting TROP2 described herein comprise a heavy chain and a light chain, wherein
- the heavy chain comprises the amino acid sequence shown in SEQ ID NO:5, and the light chain variable region comprises the amino acid sequence shown in SEQ ID NO:10.
- the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention comprises a heavy chain and a light chain, wherein
- the heavy chain consists of the amino acid sequence shown in SEQ ID NO:5, and the light chain consists of the amino acid sequence shown in SEQ ID NO:10.
- the antigen-binding fragment of the antibody targeting TROP2 is selected from Fab, Fab', F(ab')2, Fab'-SH, scFv or scFv-Fc.
- the antibody targeting TROP2 comprises two heavy chains and two light chains, for example, two identical heavy chains and two identical light chains.
- the antibody targeting TROP2 is a full-length antibody.
- the antibody targeting TROP2 is a humanized antibody.
- the antibody targeting TROP2 is a monoclonal antibody.
- the antibody targeting TROP2 also encompasses multispecific antibodies that specifically bind to TROP2, such as bispecific antibodies.
- the antibody-drug conjugate targeting TROP2 suitable for use in the present invention is an antibody-drug conjugate disclosed in PCT Application No. PCT/CN2024/121813, which is incorporated herein in its entirety as if fully set forth herein.
- the antibody-drug conjugate is the compound prepared in Example 4.1 of PCT Application No. PCT/CN2024/121813.
- the antibody-drug conjugate targeting TROP2 of the present invention can be formulated into a preparation for administration.
- the antibody-drug conjugate targeting TROP2 of the present invention is formulated into a liquid preparation or a lyophilized preparation, such as a lyophilized powder, such as a lyophilized powder injection for intravenous injection.
- the preparation of the antibody-drug conjugate targeting TROP2 is a lyophilized powder preparation, such as a lyophilized powder injection.
- the formulation of the TROP2-targeting antibody-drug conjugate of the present invention further comprises excipients such as histidine, histidine hydrochloride, sucrose, mannitol, and polysorbate 80.
- the administration of the TROP2 antibody-drug conjugate is by injection, such as subcutaneous injection or intravenous injection (e.g., infusion), preferably intravenous infusion or intravenous drip.
- the TROP2 antibody-drug conjugate is administered by intravenous injection. More preferably, the TROP2 antibody-drug conjugate is administered by intravenous infusion.
- the administration is administered through a peripheral vein.
- the administration is performed by intravenous infusion using a microinjection pump through an indwelling intravenous cannula, preferably, the intravenous cannula is placed in a peripheral vein.
- the administration is administered by a central venous catheter, an infusion port, or an infusion pump.
- the method of preventing or treating individual solid tumors of the present invention comprises administering to the individual 0.1 mg/kg-100 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.2 mg/kg-50 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.5 mg/kg-30 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.3 mg/kg-20 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-20 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-16 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-12 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 0.3 mg/kg, 0.8 mg/kg, 1 mg/kg, 1.5 mg/kg, 1.6 mg/kg, 1.8 mg/kg, 2 mg/kg, 2.3 mg/kg, 2.5 mg/kg, 3 mg/kg, 3.2 mg/kg, 3.5 mg/kg, 3.8 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.4 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 9.5 mg/kg, 9.6 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 13.5 mg/kg, 14 mg/kg, 14.5 mg/kg, 15 mg/kg, 15.5 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual 0.3 mg/kg-20 mg/kg or 1-16 mg/kg of an antibody-drug conjugate targeting TROP2.
- the method comprises administering to the individual approximately 1 mg/kg, 2 mg/kg, 3 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.5 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 14 mg/kg, 15 mg/kg, 16 mg/kg, 17 mg/kg, 18 mg/kg, 19 mg/kg, or 20 mg/kg.
- the antibody-drug conjugate targeting TROP2 can be administered continuously or discontinuously once or multiple times, for example, at least once, twice, three times or four times, for example, continuously administered at least four times.
- the number of administrations is determined based on the patient's assessment of the effect. Therefore, in some embodiments, more than 4 times of the antibody-drug conjugate targeting TROP2 can be administered.
- the doses administered each time may be equal or unequal, preferably equal.
- the dose is administered any integer number of times from 1 to 32 times, for example, 1 time, 5 times, 10 times, 15 times, 20 times, 25 times, 26 times, 27 times, 28 times, 29 times, 30 times, 31 times or 32 times.
- the dose is administered at intervals of 2 to 12 weeks, for example, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks or 12 weeks, preferably at intervals of 3 weeks.
- the doses are administered at intervals of 3 weeks.
- the same dose of antibody-drug conjugate targeting TROP2 is administered each time.
- each dose is administered on the 1st day of each interval, or on the 2nd day or on the 3rd day, preferably on the 1st day.
- the treatment phase lasts for 3 weeks to 24 months, for example, 3 months, 6 months, 12 months, 18 months or 24 months, from the first dose administration, preferably for 24 months.
- the method comprises continuous administration for up to 24 months. In one embodiment of the invention, the method comprises continuous administration for 24 months. In some specific embodiments, the method administers an antibody-drug conjugate targeting TROP2 to a patient in need thereof by intravenous infusion for 24 months at intervals of 3 weeks.
- the dosing cycle of the method is 2 weeks/14 days (Q2W) to 5 weeks/35 days (Q5W); further, the dosing cycle of the method is 2 weeks/14 days (Q2W), 3 weeks/21 days (Q3W), 4 weeks/28 days (Q4W) or 5 weeks/35 days (Q5W), and the drug is administered once on the 1st day of each cycle, or once on the 2nd day of each cycle, or once on the 3rd day of each cycle, preferably once on the 1st day of each cycle.
- the dosing cycle of the method is 3 weeks/21 days (Q3W), and the drug is administered once on the 1st day of each cycle.
- the method comprises administering 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg or 16 mg of an antibody-drug conjugate targeting TROP2 to the individual, with a dosing cycle of 3 weeks/21 days (Q3W), administered once on the first day of each cycle.
- the administration method of the present invention comprises intravenous administration.
- the method comprises administering to the individual intravenously (e.g., by infusion) 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2, with a dosing cycle of 3 weeks/21 days (Q3W), administered once on day 1 of each cycle.
- the method comprises administering to the individual intravenously (e.g., by infusion) 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2, with a dosing cycle of 3 weeks/21 days (Q3W), once on day 1 of each cycle, for 24 months.
- the solid tumor is a malignant solid tumor. In some embodiments, the solid tumor is an advanced solid tumor. In some embodiments, the solid tumor is an advanced malignant solid tumor. In some embodiments, the solid tumor is a solid tumor for which standard therapy has failed or is intolerant to standard therapy, or the patient refuses standard therapy, or for which no standard treatment options are available. In some embodiments, the solid tumor is an unresectable locally advanced or metastatic solid tumor, for example, an unresectable locally advanced solid tumor or metastatic advanced solid tumor with at least one measurable lesion as assessed according to RECIST v1.1.
- the solid tumor is an unresectable locally advanced or metastatic advanced solid tumor for which standard therapy has failed or is intolerant to standard therapy, or the patient refuses standard therapy and has at least one measurable lesion as assessed according to RECIST v1.1.
- the solid tumor is a solid tumor that has previously received at least one line of anticancer therapy (e.g., systemic anticancer therapy).
- the solid tumor is a solid tumor that has previously received one or two lines of anticancer therapy (e.g., systemic anticancer therapy).
- the solid tumor is a solid tumor that has previously received two or more lines of anticancer therapy (e.g., systemic anti-tumor therapy).
- the solid tumor is a solid tumor that has failed to be treated with a taxane or is intolerant to a taxane.
- the solid tumor is selected from breast cancer, such as triple-negative breast cancer, lung cancer, such as non-small cell lung cancer, or cervical cancer.
- the solid tumor is unresectable locally advanced or metastatic triple-differentiated breast cancer, non-small cell lung cancer, or cervical cancer.
- the solid tumor is unresectable locally advanced or metastatic advanced triple-differentiated breast cancer or non-small cell lung cancer or cervical cancer that has failed or is intolerant to standard treatment or the patient refuses standard treatment or has no standard treatment options, and has at least one measurable lesion assessed according to RECIST v1.1.
- the patient is a patient with locally advanced unresectable or metastatic triple-negative breast cancer who has failed or is intolerant to prior taxane therapy.
- the patient has previously received one or more treatments, such as other treatments for malignant tumors, such as treatments for other persistent disease conditions and palliative and supportive treatments for malignant tumors that are consistent with clinical intervention indications and institutional clinical standard procedures.
- treatments for malignant tumors such as treatments for other persistent disease conditions and palliative and supportive treatments for malignant tumors that are consistent with clinical intervention indications and institutional clinical standard procedures.
- the patient may also receive other treatments, including but not limited to
- radiotherapy such as radiotherapy that does not affect bone marrow function and is directed at non-target lesions to control pain
- immunosuppression or systemic hormone therapy preferably not exceeding 10 mg/day prednisone equivalents
- one or more treatments selected from the following:
- Hormonal therapy to improve appetite such as megestrol acetate
- Low-dose maintenance steroid therapy for other conditions e.g., asthma exacerbation, stable steroid therapy (excluding tapering of steroids) for cerebral edema);
- steroids may be used to treat acute intercurrent illnesses (such as immune-related AEs or other adverse events).
- acute intercurrent illnesses such as immune-related AEs or other adverse events.
- study drug treatment should be interrupted during immunosuppressive therapy.
- the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have tolerability, safety, and efficacy. In some embodiments of the present invention, the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have good hematological safety. In some embodiments of the present invention, the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have one or more of the following advantages:
- the present invention relates to a single dose unit comprising: an effective amount of an antibody-drug conjugate targeting TROP2 of the present invention.
- a fixed dose of 1-500 mg of an antibody-drug conjugate targeting TROP2 is included.
- a fixed dose of 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200 or 500 mg of an antibody-drug conjugate targeting TROP2 is included.
- the single dose unit is used for administration according to the dosing regimen of the present invention to prevent or treat solid tumors.
- the single dose unit described herein is preferably used for parenteral administration, for example, for injection, such as intravenous injection (including intravenous infusion) or subcutaneous injection.
- the single dose unit of the present invention is a solution or a lyophilized powder, preferably a lyophilized powder.
- the single dose unit can be a vial for injection, such as a vial, an ampoule, or a prefilled syringe, containing a solution or a lyophilized powder of an antibody-drug conjugate targeting TROP2, preferably a lyophilized powder.
- the single dose unit described herein is a vial, such as a vial, of a lyophilized powder of an antibody-drug conjugate targeting TROP2 for parenteral administration.
- the lyophilized powder formulation of the antibody-drug conjugate targeting TROP2 of the present invention is 50-150 mg/bottle (e.g., 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 mg/bottle).
- the single-dose unit described herein is 50-150 mg/vial (e.g., 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 mg/vial) of a lyophilized powder of an antibody-drug conjugate targeting TROP2.
- a formulation comprising an antibody-drug conjugate targeting TROP2, such as a lyophilized powder is reconstituted prior to administration.
- the volume of drug to be infused is calculated based on the planned drug dosage and the solution, and the calculated volume of reconstituted drug is diluted in an intravenous infusion bag, such as one containing 0.9% sodium chloride injection.
- the final concentration is in the range of approximately 1-9 mg/mL.
- the present invention also provides a complete drug kit, comprising an effective amount of the antibody-drug conjugate targeting TROP2 of the present invention
- a fixed dose of 1-500 mg of an antibody-drug conjugate targeting TROP2, or one or more single-dose units of an antibody-drug conjugate targeting TROP2, is included.
- a fixed dose of 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200 or 500 mg of an antibody-drug conjugate targeting TROP2 is included.
- the kit further comprises a package insert containing instructions for using the antibody-drug conjugate targeting TROP2 in an individual to prevent or treat a solid tumor in the individual.
- the kit further comprises other therapeutic agents that can be combined or co-administered with the TROP2-targeting antibody-drug conjugate of the present invention, such as other therapeutic agents that can be used in concomitant therapy with the antibody-drug conjugate, such as other therapeutic agents in concomitant therapy as described herein.
- the present invention also provides use of the single-dose unit or complete kit of the present invention in preparing a drug for preventing or treating solid tumors.
- the present invention also provides a method for preventing or treating solid tumors, which comprises administering the single-dose unit or kit of parts of the present invention to an individual in need thereof.
- the present invention also provides use of the single-dose unit or kit of parts of the present invention for preventing or treating solid tumors.
- the antibody-drug conjugate targeting TROP2 in various embodiments of the present invention may also be replaced by a stereoisomer or a pharmaceutically acceptable salt or solvate of the antibody-drug conjugate.
- dosage regimens described herein including antibody-drug conjugates with active agents targeting TROP2, dosage, mode of administration, dosing interval, number of doses, or duration of administration, etc.
- dosage, mode of administration, dosing interval, number of doses, or duration of administration, etc. may be applied to any aspect or embodiment of the present invention.
- technical features, definitions, and any combination thereof in any embodiment described herein may also be applied to other embodiments.
- Compound NT3 was prepared according to the method disclosed in Example 4 of WO2021173773A1. Its physicochemical data, including 1HNMR and mass spectrometry data, were consistent with those disclosed in WO2021173773A1.
- the antibody HRS7 was prepared by the following method (sequence see sequence listing, full length heavy chain: SEQ ID NO: 5; full length light chain: SEQ ID NO: 10).
- Expi293F cells (purchased from Gibco) were cultured with Expi293F medium (Gibco, REF#A14351-01). The cell density was checked one day before transfection (viability must be greater than 95%) and adjusted to 3 ⁇ 10 6 cells/mL with fresh Expi293F medium for continued culture. On the day of transfection, the cell density was adjusted to 3 ⁇ 10 6 cells/mL.
- Opti-MEM medium Gibco, REF#31985-070
- the DNA to be transfected at a ratio of 1 mg/L, with the light and heavy chain plasmids in a 1:1 ratio, mix well
- PEIMax Polysciences Inc. Cat#24765-1
- DNA:PEI mass ratio 1:3
- mix well add PEIMax (Polysciences Inc. Cat#24765-1) at a DNA:PEI mass ratio of 1:3, mix well, incubate at room temperature for 20 minutes, then gently pour the mixture into the Expi293F cell suspension while shaking.
- the cells are cultured on a shaker at 8% CO2 , 36.5°C, and 120 rpm.
- the cell suspension was supplemented with 2% (volume ratio) of 200 g/L feed (100 g/L Phytone Peptone + 100 g/L Difco Select Phytone), a glucose solution with a final concentration of 5 g/L, and valproic acid sodium salt (Merk, Cat# P4543-100G) with a final concentration of 2.2 mM.
- the suspension was gently mixed and cultured for 7 days at 8% CO2 , 36.5°C, and 120 rpm before sampling.
- the cell suspension was mixed with diatomaceous earth (Sartorius, Cat# 1000037025) (40 g diatomaceous earth per 1 L of cell suspension) and filtered using a 0.22 ⁇ m disposable vacuum filter.
- HiTrap MabSelect PrismA (GE Healthcare, Cat#17549853) affinity chromatography column was used for affinity capture. Before purification, 10-20 column volumes of 0.1 M NaOH were passed through the tubing and affinity chromatography column, and then 10-20 column volumes of distilled water were used to clean the tubing and column. The packed column was equilibrated with 5 column volumes of 1 ⁇ PBS (Gibco). The filtered cell feed was passed through the column, and then the packed column was washed with 10 column volumes of 1 ⁇ PBS to remove non-specific binding proteins.
- the packed column was rinsed with 5 column volumes of elution buffer (100 mM sodium citrate, pH 3.5), the eluate was collected, the pH was adjusted to 6.0 with 2 M Tris, and the column was sterilized by filtration. After the purity test was qualified, the antibody coupling for ADC was carried out.
- elution buffer 100 mM sodium citrate, pH 3.5
- the prepared antibody hRS7 was dissolved in PBS buffer (thermofisher, 10010023).
- a reducing agent solution (TCEP, Aldrich, Catalog Number 646547, dissolved in water) was added and the reaction mixture was allowed to react at room temperature for 2-4 hours.
- the optimal reaction temperature is 20-37°C
- the optimal pH value of the reaction is between 6.0 and 8.0.
- step (b) adding an excess of linker-toxin (MB-3, dissolved in DMSO) to react with the antibody reduced in step (a), and the reaction mixture is placed at room temperature for 1-2 hours, wherein
- HRS7-NT3 also refer to the preparation and property verification of the ADC molecule prepared in Example 4.1 of PCT/CN2024/121813, which is incorporated herein in its entirety.
- freeze-dried preparation formula is as follows:
- HRS7-NT3 stock solution histidine, histidine hydrochloride, sucrose, mannitol, and polysorbate 80.
- HRS7-NT3 preparation is packaged in vials, rubber stoppers, and aluminum-plastic caps.
- the placebo has no active ingredients and only contains excipients, the composition and pH of which are consistent with those of the antibody preparation for injection.
- the antibody preparation and excipients are both white to light yellow lumpy loose bodies.
- the appearance of the reconstituted sample is clear to slightly opalescent, colorless to slightly yellow liquid, and free of foreign matter.
- the antibody preparation/placebo must be reconstituted and further diluted before injection, and appropriate aseptic technique must be used during the operation.
- the dosage and administration of the product must be based on the corresponding research plan.
- the lyophilized powder is reconstituted with water for injection and diluted with 0.9% sodium chloride solution.
- the final concentration of HRS7-NT3 should be maintained between 1 and 9 mg/mL.
- HRS7-NT3 should be administered through an intravenous infusion tube equipped with a 0.2-5 ⁇ m in-line filter. During the preparation and handling of the preparation, avoid vigorous shaking and mixing. The prepared solution must be ensured to be sterile.
- Phase I/II Phase I/II, multicenter, open-label, first-in-human (FIH) study of the TROP2-targeting antibody-drug conjugate HRS7-NT3. It consists of Phase I and Phase II.
- Phase I includes three phases: dose escalation, dose expansion, and dose optimization, with the goal of determining the MTD/RP2D of the TROP2-targeting antibody-drug conjugate HRS7-NT3.
- the Phase II phase aims to explore the efficacy, safety, and tolerability of the TROP2-targeting antibody-drug conjugate HRS7-NT3 in specific solid tumor types at the RP2D.
- the Phase I dose-escalation phase will enroll patients with locally advanced, unresectable, or metastatic solid tumors.
- the escalation phase will utilize a modified continuous reassessment method (MCRM), employing a Bayesian logistic regression model (BLRM) under the principle of escalation with the overdose control (EWOC).
- MCRM continuous reassessment method
- BLRM Bayesian logistic regression model
- EWOC overdose control
- the BLRM model is designed to assess the dose-toxicity relationship, while the EWOC principle requires that the maximum recommended dose not be overtoxic (the probability of a DLT rate >33% is less than 25%).
- the starting human dose of HRS7-NT3, an antibody-drug conjugate targeting TROP2 is 1.0 mg/kg.
- the study will primarily be evaluated at nine provisional pre-specified dose levels (1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg, and 16 mg/kg), but additional and/or intermediate dose levels may be added during the study.
- additional and/or intermediate dose levels may be added during the study.
- the exploration of 14 mg/kg and 16 mg/kg dosing may be terminated based on emerging clinical data from lower dose level cohorts.
- the first two dose levels will use an accelerated titration method, with one subject enrolled in each group, starting at 1 mg/kg and 2 mg/kg, respectively. If any subject at a certain dose experiences a DLT during the DLT observation period, two additional subjects will be enrolled at that dose level, and BLRM dose escalation will be implemented starting from that dose group. If no DLT occurs, the next group will contain three subjects and enter the 4 mg/kg dose group. If more than one DLT occurs in the 4 mg/kg dose group, the dose will be forced downgraded to the 2 mg/kg dose group.
- the maximum recommended dose to which subjects can enter will be calculated based on the BLRM-EWOC model and incremental limits, where the incremental limits are: dose levels above 4 mg/kg should not be increased by more than 100%, dose levels above 6 mg/kg should not be increased by more than 50%, dose levels above 8 mg/kg should not be increased by more than 33%, and dose levels above 12 mg/kg should not be increased by more than 20%.
- the actual dose to which the subjects are admitted will be determined by the sponsor based on the maximum recommended dose (BLRM-EWOC model and incremental limits), clinical safety data, and PK data, but may not exceed the maximum recommended dose.
- the number of subjects enrolled simultaneously in each dose escalation cohort is 1 to 6.
- the dose escalation phase is terminated after the MTD or multiple recommended doses for expansion (RDE) are determined. Both the MTD and RDE must meet the following conditions:
- the dose group contains at least 6 subjects;
- the posterior probability of the target toxicity in this dose group is at least 50%, and it is the highest probability among the currently tested doses;
- a total of at least 20 evaluable subjects have been enrolled.
- Condition 3 The recommended MTD or RDE is determined by the investigator and the sponsor based on the current clinical data.
- the antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention is administered by intravenous infusion once every three weeks (Day1, Q3W).
- Day1, Q3W Day1, Q3W
- the subjects enter a 21-day DLT observation period after the first infusion of the antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention. At the end of the observation period, all relevant safety data will be reviewed.
- the subjects can continue to receive the antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention once every 3 weeks (Day1, Q3W) until intolerable toxicity occurs, disease progression, the subject withdraws informed consent, the study treatment is terminated for other reasons, or the treatment duration reaches 24 months (whichever occurs first).
- the treatment cycle will be continuous and uninterrupted unless there is an adverse event that requires intervention. After the end of the DLT observation period, the safety and tolerability of the subjects will continue to be observed. After the end of the study treatment, safety and long-term follow-up will continue.
- Blood samples will be collected for PK characterization and immunogenicity evaluation.
- intra-patient dose escalation is allowed.
- the subject must complete the DLT observation of the initially assigned dose group before entering the next higher dose. If the subject does not experience any DLT event during the DLT observation period that would prevent self-dose escalation, the subject may be considered for entry into the next higher dose level after the investigator and the sponsor have fully reviewed the data and believe that the subject's safety can be guaranteed. After the subject enters the next dose group, the subject cannot be evaluated for DLT again, but safety monitoring, PK sampling and tumor assessment can continue according to the previous visit plan. Each subject is only allowed to receive one self-dose escalation to the next dose level.
- additional subjects may be recruited at an evaluated dose level or an intermediate dose level below the estimated MTD before or during dose escalation by the investigator and sponsor.
- One or more dose levels may be expanded based on existing data.
- the Phase I dose-expansion phase will enroll patients with unresectable, locally advanced or metastatic triple-negative breast cancer (TNBC; Cohort A), non-small cell lung cancer (NSCLC; Cohort B), cervical cancer (CC; Cohort C), or other solid tumors who have failed, are intolerant of, or refuse standard therapy and have at least one measurable lesion as assessed by RECIST v1.1.
- TNBC locally advanced or metastatic triple-negative breast cancer
- NSCLC non-small cell lung cancer
- CC cervical cancer
- the dose-expansion phase plans to enroll 150 patients.
- dose optimization Up to three doses will be selected for dose optimization for each indication (possible dose levels: 4 mg/kg or 6 mg/kg, 8 mg/kg, possibly including 12 mg/kg Q3W). Enrollment will begin after the recommended dose for dose optimization is determined based on data from the Phase I dose escalation and dose expansion phases. For example, if two doses are selected for dose optimization in cohort A, subjects may be randomly assigned to dose optimization cohorts, referred to as Group A1 and Group A2. In Cohorts A, B, and C, the number of subjects treated at each dose level will be approximately 30. Approximately 60 to 150 subjects will be included in the dose optimization phase.
- the subjects are planned to receive the antibody-drug conjugate targeting TROP2 of the present invention on the first day of each cycle in a 21-day cycle (Q3W, or the interval determined by the investigator and the sponsor based on safety, toxicity and PK data) until unacceptable toxicity, disease progression, withdrawal of informed consent, termination of study treatment for other reasons, or a maximum of 24 months of treatment, whichever occurs first. After termination of study treatment, safety and survival follow-up will continue.
- RP2D will be determined based on the MTD estimated by mCRM and a comprehensive assessment of the safety, preliminary efficacy, and PK information of all subjects in Phase I.
- the sponsor will decide whether to conduct the Phase II study based on an overall evaluation of the safety data, preliminary efficacy data, and PK information of the enrolled subjects.
- Phase II will enroll three cohorts, with the following subjects in each cohort:
- Cohort A subjects with unresectable locally advanced or metastatic TNBC who have received at least one line of systemic anti-tumor therapy;
- Cohort B subjects with unresectable locally advanced or metastatic CC who have received at least one line of systemic anti-tumor therapy
- Cohort C subjects with unresectable locally advanced or metastatic NSCLC who have previously received 1 or 2 lines of systemic anti-tumor therapy.
- each cohort approximately 50 subjects will be enrolled and treated with the TROP2-directed antibody-drug conjugate HRS7-NT3 at the RP2D until unacceptable toxicity, disease progression, withdrawal of consent, discontinuation of study treatment for other reasons, or 24 months of treatment, whichever occurs first. Treatment cycles will continue without interruption unless an adverse event necessitates intervention. Subjects will continue to be followed for safety and survival after discontinuation of study treatment.
- CT computed tomography
- MRI magnetic resonance imaging
- ANC ⁇ 1.5 ⁇ 109/L; platelet count (PLT) ⁇ 100 ⁇ 109/L; hemoglobin (Hb) ⁇ 9.0 g/dL, and no erythropoietin (EPO), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), or blood transfusion (including red blood cell and platelet transfusion) within at least 14 days before the first dose;
- PHT platelet count
- Hb hemoglobin
- EPO erythropoietin
- G-CSF granulocyte colony-stimulating factor
- GM-CSF granulocyte-macrophage colony-stimulating factor
- blood transfusion including red blood cell and platelet transfusion
- Liver function Total bilirubin ⁇ 1.5 ⁇ Upper Limit of Normal (ULN); Albumin ⁇ 2.8 g/dL; Patients without liver metastasis require AST and ALT ⁇ 2.5 ⁇ ULN; patients with liver metastasis require AST and ALT ⁇ 5 ⁇ ULN ⁇ . Subjects receiving supportive care and with liver function within the above range are allowed to be enrolled;
- Renal function serum creatinine ⁇ 1.5 ⁇ ULN, or creatinine clearance ⁇ 60ml/min (using the Cockcroft-Gault formula); urine protein ⁇ 2+ or 24-hour urine protein quantitative ⁇ 1g.
- Coagulation function International Normalized Ratio (INR) ⁇ 1.5; Activated Partial Thromboplastin Time (APTT) ⁇ 1.5 ⁇ ULN (subjects receiving anticoagulant therapy and whose coagulation function is within the above range are allowed to be included);
- At least one evaluable lesion according to RECIST v1.1 At least one evaluable lesion according to RECIST v1.1.
- At least one measurable target lesion according to RECIST v1.1 At least one measurable target lesion according to RECIST v1.1.
- Subjects who have previously received at least one line of standard systemic anti-tumor treatment have undergone standard treatment or are intolerant to standard treatment, and currently have no standard systemic anti-tumor treatment options;
- At least one measurable target lesion according to RECIST v1.1 At least one measurable target lesion according to RECIST v1.1.
- At least one measurable target lesion according to RECIST v1.1 At least one measurable target lesion according to RECIST v1.1.
- CYP3A4 cytochrome P450 3A4
- CMOS central nervous system
- Subjects with asymptomatic CNS metastases i.e., no neurological symptoms, no need for corticosteroid treatment, and brain metastases ⁇ 1.5 cm) or whose condition is stable after treatment as determined by the investigator may be considered for participation in this study if: no midbrain, pons, cerebellum, meninges, medulla oblongata, or spinal cord metastases; clinical stability for at least 4 weeks, with clinical evidence confirming the absence of new or enlarged brain metastases; and discontinuation of corticosteroids or anticonvulsants for at least 2 weeks before the first dose of study drug.
- HIV human immunodeficiency virus
- HIV-1/2 antibody positive HIV-1/2 antibody positive
- Acute or chronic active hepatitis B (positive hepatitis B surface antigen [HBsAg] and/or positive hepatitis B core antibody [HBcAb], hepatitis B virus [HBV] DNA titer ⁇ 1 ⁇ 104 copies/ml or ⁇ 2000 IU/ml or above the limit of detection ⁇ ), or acute or chronic active hepatitis C (positive hepatitis C virus [HCV] antibody, HCV RNA >103 copies/ml);
- the tumor invades surrounding important organs (such as mediastinal vessels, superior vena cava, trachea, esophagus, etc.), or there is a risk of gastrointestinal/respiratory fistula;
- Esophageal or gastric varices requiring immediate intervention e.g., ligation or sclerotherapy
- escalated intervention e.g., ligation or sclerotherapy
- subjects with evidence of portal hypertension including splenomegaly found on imaging examinations
- a history of variceal bleeding must undergo endoscopic evaluation within 3 months prior to the first dose
- NCI CTCAE Common Terminology Criteria for Adverse Events
- DLT was defined as any of the following HRS7-NT3-related AEs occurring during the DLT observation period:
- DLT hematologic toxicity
- Grade 3 or higher febrile neutropenia (defined as an absolute neutrophil count (ANC) ⁇ 1.0 ⁇ 109/L and a single temperature >38.3°C or a temperature ⁇ 38°C for >1 hour) persisting for >7 days despite adequate supportive care;
- DLT DLT for non-hematologic toxicities
- Grade 3 skin reactions including rash, pruritus, dry skin, skin fissures, and paronychia
- Grade 3 nausea, vomiting, diarrhea, or decreased appetite that resolves to ⁇ Grade 2 within 3 days after adequate treatment;
- Grade 3-4 total bilirubin elevation that resolves to ⁇ Grade 2 within 3 days after adequate treatment;
- Isolated laboratory test results not associated with signs or symptoms including grade 3-4 elevated alkaline phosphatase (ALP), hyperuricemia, elevated serum amylase, and elevated lipase.
- ALP alkaline phosphatase
- Any grade 5 drug-related AE was defined as a DLT.
- AEs will be reported using NCI CTCAE v5.0, including all treatment-emergent adverse events (TEAEs), adverse events of special interest (AESIs), serious adverse events (SAEs), and those related to study drug.
- TEAEs treatment-emergent adverse events
- AESIs adverse events of special interest
- SAEs serious adverse events
- Vital signs including temperature, pulse, respiratory rate, oxygen saturation, and blood pressure
- physical examination weight and pulmonary/cardiac assessment at each visit
- 12-lead ECG ECOG performance status
- laboratory tests before, during, and after treatment.
- Adverse events are defined as any adverse medical events that occur to clinical trial subjects after they sign the informed consent form, regardless of whether they are causally related to the study drug. AEs include but are not limited to the following:
- Any new adverse medical condition including symptoms, signs, and newly diagnosed diseases
- a serious adverse event is an adverse event that meets at least one of the following criteria:
- Life-threatening is defined as an AE that carries a risk of death when it occurs, and does not include AEs that could result in death only if the event worsens).
- Same-day surgery e.g. outpatient/same-day/ambulatory surgery
- Hospitalization or prolonged hospitalization not related to worsening of an AE is not an SAE in itself.
- Examples include: hospitalization for a pre-existing condition without new AEs and worsening of the underlying condition (e.g., laboratory abnormalities that persisted even before the study); hospitalization for administrative reasons (e.g., annual physical examinations); hospitalization during a clinical trial that is protocol-mandated (e.g., to perform procedures as required by the protocol); elective hospitalization not related to worsening of an adverse event (e.g., elective surgery); scheduled treatments or surgical procedures that should be documented throughout the trial protocol and/or in the subject's individual baseline data; and hospitalization solely for the use of blood products.
- Adverse Event of Special Interest refers to an adverse event that requires close monitoring to improve the understanding of the safety of the investigational drug.
- AESI can be non-serious events and mainly include:
- Grade 3 or higher hematologic toxicity including grade 3 or higher leukopenia, grade 3 or higher neutropenia, grade 3 or higher anemia, and grade 3 or higher thrombocytopenia);
- Grade 3 or higher hepatic dysfunction including grade 3 or higher ALT/AST elevation, grade 3 or higher TBIL or DBIL elevation);
- AESIs were collected from the first dose of HRS7-NT3 to 30 days after the last dose. If a new anti-tumor treatment was initiated within 30 days of the last dose, only AESIs related to the study drug were collected.
- AESI should be reported to the sponsor within 24 hours of becoming aware of the event, regardless of severity (i.e., including serious and non-serious AEs), following the SAE procedures described above, and requiring enhanced data collection.
- Diagnostic imaging studies are used for disease assessment, among which tumor imaging studies usually use contrast-enhanced CT or enhanced MRI, and the examination sites must include the chest, abdomen, and pelvis. Screening imaging studies need to be performed within 28 days before the first dose of study drug (except bone scan). Tumor imaging assessments are performed every 6 weeks ( ⁇ 7 days) within 48 weeks after the first dose; after week 48, tumor imaging assessments are performed every 12 weeks ( ⁇ 7 days) until the start of new anti-tumor treatment, disease progression, subject withdrawal of informed consent, study termination, loss to follow-up, or death, whichever occurs first.
- target lesions including size, location, and type (nodular/non-nodular); sum of target lesion diameters, including location and type; non-target lesions; any new lesions found during the trial, including size, location, and type (nodular/non-nodular).
- DoR o Duration of remission
- TTR Time to remission
- PK parameters including but not limited to: AUC, Cmax, Tmax, CL, V and t1/2.
- NAb neutralizing antibodies
- ADA anti-drug antibody
- HRS7-NT3 HRS7-NT3.
- ADA-positive serum samples can be tested for neutralizing antibodies (NAb).
- NAb neutralizing antibodies
- 3.5 ml of whole blood will be collected using a vacutainer containing a clot activator. Serum will then be separated and stored frozen for ADA testing.
- HRS7-NT3 ADA The incidence of HRS7-NT3 ADA will be summarized in subjects who received at least one dose of study drug.
- Tumor TROP2 expression was confirmed using formalin-fixed and paraffin-embedded (FFPE) tissue sections.
- the Phase I study consists of a dose-escalation phase, a dose-expansion phase, and a dose-optimization phase.
- the sample size of the Phase I study depends on the number of dose levels evaluated, the occurrence of DLTs, and the number of dose expansion and optimization phases.
- the Phase I dose-escalation phase is planned to enroll approximately 20 to 32 subjects
- the Phase I dose-expansion phase is planned to enroll approximately 50 to 110 subjects
- the Phase I dose-optimization phase is planned to enroll approximately 60 to 150 subjects.
- Cohort A For the preferred dose, assuming an ORR of 27% with HRS7-NT3 and a 10% dropout rate in subjects with unresectable locally advanced or metastatic TNBC, a sample size of 50 subjects would provide 80% confidence that the lower limit of the 95% confidence interval would be greater than 12%.
- Adverse events will be graded using the NCI CTCAE v5.0 criteria. Coded TEAEs, TRAEs, AESIs, SAEs, and AEs leading to study drug discontinuation will be summarized by system organ class and preferred terminology.
- DLTs will be summarized descriptively by dose level.
- the PK data of HRS7-NT3 will be pooled for Pop PK analysis. If this analysis is performed, it will be reported separately.
- Descriptive statistics will be presented for quantitative laboratory test values and changes from baseline. Based on CTCAE v5.0, cross-tabulations will be used to describe the change in the most severe outcome from baseline.
- ADA and/or NAb will be summarized descriptively by dose level/cohort.
- ORR and DCR and their 95% confidence intervals (CI) will be calculated.
- PFS, DoR, TTR, and OS will be analyzed using the Kaplan-Meier method.
- the ORR is defined as the proportion of subjects who achieved a CR or PR.
- the number and percentage of subjects with a CR or PR will be summarized.
- the 95% confidence interval (CI) for the ORR will be estimated using the Clopper-Pearson method.
- DCR is defined as the proportion of subjects who achieved CR, PR, or SD.
- the analysis method for DCR is the same as that for ORR.
- DoR was defined as the time from the first achievement of a CR or PR to the first documented disease progression (based on RECIST v1.1) or death. Only subjects with a CR or PR were included in the DoR analysis. Subjects who were alive and without disease progression at the analysis cutoff date were censored. DoR was analyzed using the Kaplan-Meier method.
- PFS was defined as the time from the first dose of study drug to death or disease progression (based on RECIST v1.1), whichever occurred first. Subjects who were alive and without disease progression at the analysis cutoff date were censored at the end of the analysis.
- PFS will be analyzed using the Kaplan-Meier method.
- TTR time to complete remission
- CR complete response
- PR complete response
- OS was defined as the time from the first dose of study drug to death from any cause. Subjects who were alive at the analysis cutoff date were censored. OS was analyzed using the Kaplan-Meier method.
- Descriptive statistics will be performed on the PK parameters of the antibody-drug conjugate targeting TROP2 of the present invention.
- PK analysis will be performed on the PK analysis set.
- the densely sampled PK data will be analyzed primarily using non-compartmental methods.
- Key PK parameters will be determined for each subject, including but not limited to AUC, Cmax, Tmax, CL, V, and t1/2.
- the actual dose (mg) will be calculated based on the subject's body weight (kg).
- the first dose will be calculated based on the subject's baseline body weight. If the subject's body weight changes by less than ⁇ 10% from baseline (at the time of the first dose of study treatment), the baseline body weight will be used to calculate the dose. Otherwise, the actual dose will be calculated based on the body weight on the scheduled dosing day or the day before dosing.
- the study drug will be infused intravenously (IV) using a microsyringe pump through an indwelling venous cannula.
- IV intravenously
- the catheter can be placed in a peripheral vein (if accessible); administration through a central venous catheter or infusion port (if already in place) is permitted.
- the dosing cycle is 3 weeks/21 days (Q3W), with one dose given on Day 1 of each cycle. Dosing continues until intolerable toxicity occurs, disease progression, the subject withdraws informed consent, study treatment is terminated for other reasons, or the treatment duration reaches 24 months (whichever occurs first).
- TROP2-targeting antibody-drug conjugate of the present invention as an ADC with a bystander effect, exhibited significant tumor inhibition in a mouse tumor-bearing model. It is expected that the TROP2-targeting antibody-drug conjugate of the present invention will have good tolerability, safety, and efficacy.
- Treatment-emergent adverse events occurred in 68 patients (95.8%, of which 90.1% were treatment-related adverse events [TRAEs]), including 17 grade 3 (G3) events (23.9%, of which 15.5% were TRAEs). No grade 4 or 5 events occurred.
- Common TEAEs included stomatitis (52.1%, of which 9.9% were G3), nausea (31.0%, of which 2.8% were G3), and rash (31.0%, of which 1.4% were G3).
- Interstitial lung disease occurred in one patient (1.4%, G1). Only one patient (1.4%) experienced a grade 3 decreased lymphocyte count.
- HRS7-NT3 is well tolerated and has an excellent hematologic safety profile.
- the encouraging efficacy observed in patients with advanced TNBC supports its potential as a best-in-class TROP2 antibody-drug conjugate (ADC).
- subjects Prior to entry into or during the study, subjects may receive treatment for other ongoing medical conditions and palliative and supportive care for malignancies consistent with clinical indications and institutional standard clinical protocols, except as specified in the exclusion criteria.
- Prophylactic hematopoietic growth factors should not be administered during Cycle 1; thereafter, prophylactic use of growth factors is permitted based on clinical indications. If deemed necessary by the investigator, interventional/therapeutic use of growth factors is permitted during the study (including Cycle 1). The use of growth factors must comply with the corresponding product instructions.
- Radiotherapy For radiotherapy that does not affect bone marrow function and is performed on non-target lesions to control pain, the decision on whether to implement it should be discussed with the sponsor's medical monitor.
- Hormone therapy to improve appetite such as megestrol acetate
- Low-dose maintenance steroid therapy for other conditions e.g., asthma exacerbation, stable steroid therapy (excluding tapering of steroids) for cerebral edema);
- steroids may be used to treat acute intercurrent illnesses (e.g., immune-related AEs or other adverse events).
- acute intercurrent illnesses e.g., immune-related AEs or other adverse events.
- study drug treatment should be interrupted during immunosuppressive therapy.
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Abstract
Description
本发明涉及疾病治疗领域。具体而言,本发明涉及使用靶向TROP2的抗体-药物偶联物治疗癌症(尤其实体瘤)的方法。The present invention relates to the field of disease treatment. Specifically, the present invention relates to a method for treating cancer (especially solid tumors) using an antibody-drug conjugate targeting TROP2.
TROP2,一种滋养层细胞表面抗原,也称为肿瘤相关钙信号转导蛋白(TACSTD2)在多种人类上皮癌中过度表达,包括乳腺癌、肺癌、胃癌、结直肠癌、胰腺癌、前列腺癌、宫颈癌、头颈癌和卵巢癌等(Yezhe Cheng等,Frontiers in Oncology,2022 Dec 23;12:951589)。TROP2, a trophoblast cell surface antigen, also known as tumor-associated calcium signaling protein (TACSTD2), is overexpressed in a variety of human epithelial cancers, including breast, lung, gastric, colorectal, pancreatic, prostate, cervical, head and neck, and ovarian cancers (Yezhe Cheng et al., Frontiers in Oncology, 2022 Dec 23;12:951589).
过去的十年中已有数种TROP2靶向疗法进入临床试验阶段,拟用于治疗多种癌症,部分适应症上已经获得批准。Sacituzumab govitecan(SG,IMMU-132,商品名)由Immunomedics Inc.开发,是一种基于抗TROP2人源化单克隆抗体的ADC,是目前全球唯一获批的抗TROP2疗法。IMMU-132-01 I/II期篮子试验(NCT01631552)评估了SG在多种患有晚期上皮源性恶性肿瘤、接受过至少一种标准治疗方案治疗后出现疾病进展的成人患者中的安全性和有效性。结果显示,SG在非小细胞肺癌(n=47)、小细胞肺癌(Small Cell Lung Cancer,SCLC;n=50)、转移性尿路上皮癌(n=45)、转移性激素受体(Hormone Receptor,HR)阳性/人表皮生长因子受体2(Human Epidermal Growth Factor Receptor 2,HER2)阴性乳腺癌(n=54)和转移性三阴性乳腺癌(Metastatic Triple-negative Breast Cancer,MTNBC;n=108)中表现出抗肿瘤疗效。在mTNBC队列中,客观缓解率(Objective Response Rate,ORR)为33.3%,中位缓解持续时间(Duration of Response,DoR)为7.7个月,此结果支持了SG用于治疗既往接受过至少两种针对转移性疾病的治疗的mTNBC成人患者的加速上市批准。TROPHY试验是一项单臂、多中心研究,入组了112例局部晚期或转移性UC患者,这些患者既往接受过含铂化疗和程序性死亡受体-1(Programmed Death,PD-1)或其配体PD-L1抑制剂治疗。肿瘤评估由独立审查委员会评估按照实体瘤疗效评价标准(Response Evaluation Criteria in Solid Tumors,RECIST)v1.1标准进行,ORR为27.7%,中位DoR为7.2个月。该结果支持了SG用于治疗既往接受过含铂化疗和PD-(L)1抑制剂的局部晚期或转移性UC成人患者的加速批准。TROPiCS-02研究是一项多中心、开放标签、随机研究(NCT03901339),入组543例(SG组:n=272;单药化疗组:n=271)局部晚期或转移性HR阳性/HER阴性乳腺癌患者,SG vs单药化疗的中位PFS为5.5 vs4.0个月,中位OS为14.4 vs 11.2个月。与单药化疗相比,SG在PFS和OS方面表现出具有统计学意义的改善。该结果支持了SG进一步获批用于治疗HR阴性/HER2阳性乳腺癌患者,这些患者既往接受过内分泌治疗和至少两种针对转移性疾病的其他系统治疗。In the past decade, several TROP2-targeted therapies have entered clinical trials for the treatment of various cancers, and some indications have been approved. ) was developed by Immunomedics Inc. and is an ADC based on a humanized anti-TROP2 monoclonal antibody. It is currently the only approved anti-TROP2 therapy in the world. The IMMU-132-01 Phase I/II basket trial (NCT01631552) evaluated the safety and efficacy of SG in adult patients with various advanced epithelial malignancies who had progressed after at least one standard treatment regimen. The results showed that SG demonstrated anti-tumor efficacy in non-small cell lung cancer (n=47), small cell lung cancer (SCLC; n=50), metastatic urothelial carcinoma (n=45), metastatic hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (n=54), and metastatic triple-negative breast cancer (MTNBC; n=108). In the mTNBC cohort, the objective response rate (ORR) was 33.3%, with a median duration of response (DoR) of 7.7 months. These results support the accelerated approval of SG for the treatment of adult patients with mTNBC who have received at least two prior therapies for metastatic disease. The TROPHY trial was a single-arm, multicenter study that enrolled 112 patients with locally advanced or metastatic UC who had previously received platinum-based chemotherapy and a programmed death receptor 1 (PD-1) or its ligand PD-L1 inhibitor. Tumor assessments were performed by an independent review committee according to Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, resulting in an ORR of 27.7% and a median DoR of 7.2 months. These results support the accelerated approval of SG for the treatment of adult patients with locally advanced or metastatic UC who have previously received platinum-based chemotherapy and a PD-(L)1 inhibitor. The TROPiCS-02 study is a multicenter, open-label, randomized study (NCT03901339) that enrolled 543 patients (SG group: n=272; single-agent chemotherapy group: n=271) with locally advanced or metastatic HR-positive/HER-negative breast cancer. The median PFS for SG vs. single-agent chemotherapy was 5.5 vs. 4.0 months, and the median OS was 14.4 vs. 11.2 months. Compared with single-agent chemotherapy, SG showed statistically significant improvements in PFS and OS. These results support the further approval of SG for the treatment of patients with HR-negative/HER2-positive breast cancer who have previously received endocrine therapy and at least two other systemic therapies for metastatic disease.
对于晚期恶性肿瘤受试者,目前可选择的方案仍十分有限,存在未满足的临床需求。虽然抗TROP2 ADC已在一些适应症中获批上市,但目前仍仅局限于三阴性乳腺癌、尿路上皮癌、HR阳性/HER阴性乳腺癌患者的后线治疗。对于TROP2广泛高表达的其他恶性肿瘤,抗TROP2 ADC有进一步探索的价值,并且进一步开发更优效、安全的抗TROP2 ADC仍有较大探索空间。For patients with advanced malignancies, current options are very limited, and there is an unmet clinical need. Although anti-TROP2 ADCs have been approved for marketing in some indications, they are currently limited to second-line treatment for patients with triple-negative breast cancer, urothelial carcinoma, and HR-positive/HER-negative breast cancer. For other malignancies with widespread and overexpressed TROP2, anti-TROP2 ADCs are worth further exploration, and there is still considerable room for further development of more effective and safe anti-TROP2 ADCs.
发明概述SUMMARY OF THE INVENTION
本发明通过提供使用靶向TROP2的抗体-药物偶联物治疗实体瘤的方法满足上述未满足的需求。The present invention meets the above unmet needs by providing methods for treating solid tumors using antibody-drug conjugates targeting TROP2.
为了实现上述目的,本发明首先提供了一种预防或治疗实体瘤的方法,该方法包括向有需要个体施用有效量的靶向TROP2的抗体-药物偶联物。To achieve the above objectives, the present invention first provides a method for preventing or treating solid tumors, which comprises administering an effective amount of an antibody-drug conjugate targeting TROP2 to an individual in need thereof.
本发明还提供了靶向TROP2的抗体-药物偶联物在制备预防或治疗实体瘤的药物中的用途。The present invention also provides use of an antibody-drug conjugate targeting TROP2 in preparing a drug for preventing or treating solid tumors.
本发明还提供了靶向TROP2的抗体-药物偶联物,其用于预防或治疗实体瘤。The present invention also provides an antibody-drug conjugate targeting TROP2, which is used for preventing or treating solid tumors.
为了实现上述目的,本发明还提供了一种单次剂量单元,包括:有效量的本发明的上述靶向TROP2的抗体-药物偶联物;In order to achieve the above object, the present invention also provides a single-dose unit, comprising: an effective amount of the above-mentioned antibody-drug conjugate targeting TROP2 of the present invention;
其中,所述靶向TROP2的抗体-药物偶联物为:
Wherein, the antibody-drug conjugate targeting TROP2 is:
其中,Ab是靶向TROP2的抗体或其抗原结合片段;wherein Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
其中,p为药物与抗体比的平均值(即平均DAR),例如为1-15、1-10、2-8、2-4或4-5。Wherein, p is the average drug to antibody ratio (ie, average DAR), for example, 1-15, 1-10, 2-8, 2-4, or 4-5.
其中,所述靶向TROP2的抗体或其抗原结合片段包含分别如以下氨基酸序列所示的HCDR1、HCDR2、HCDR3:SEQ ID NO:1、2和3,以及分别如以下氨基酸序列所示的LCDR1、LCDR2和LCDR3:SEQ ID NO:6、7和8。Wherein, the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 as shown in the following amino acid sequences: SEQ ID NO: 1, 2 and 3, and LCDR1, LCDR2 and LCDR3 as shown in the following amino acid sequences: SEQ ID NO: 6, 7 and 8, respectively.
其中,靶向TROP2的抗体或其抗原结合片段包含重链可变区和/或轻链可变区,其中重链可变区The antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and/or a light chain variable region, wherein the heavy chain variable region
(i)包含SEQ ID NO:4的氨基酸序列或由所述氨基酸序列组成;或者(i) comprising or consisting of the amino acid sequence of SEQ ID NO:4; or
(ii)包含与SEQ ID NO:4的氨基酸序列相比具有1个或多个(优选不超过10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列由所述氨基酸序列组成,优选地,所述氨基酸改变不发生在CDR区中;和/或(ii) an amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 4, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; and/or
轻链可变区Light chain variable region
(i)包含SEQ ID NO:9的氨基酸序列或由所述氨基酸序列组成;或者(i) comprising or consisting of the amino acid sequence of SEQ ID NO:9; or
(ii)包含与SEQ ID NO:9的氨基酸序列相比具有1个或多个(优选不超过10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列由所述氨基酸序列组成,优选地,所述氨基酸改变不发生在CDR区中。(ii) an amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 9, and preferably, the amino acid changes do not occur in the CDR region.
其中,所述靶向TROP2的抗体或其抗原结合片段包含重链和轻链,其中重链The antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain and a light chain, wherein the heavy chain
包含SEQ ID NO:5的氨基酸序列或由所述氨基酸序列组成;或者comprising or consisting of the amino acid sequence of SEQ ID NO:5; or
包含与SEQ ID NO:5的氨基酸序列相比具有1个或多个(优选不超过20个或10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列或由所述氨基酸序列组成;且An amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 5; and
轻链light chain
包含SEQ ID NO:10的氨基酸序列或由所述氨基酸序列组成;或者Comprising or consisting of the amino acid sequence of SEQ ID NO: 10; or
包含与SEQ ID NO:10的氨基酸序列相比具有1个或多个(优选不超过20个或10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列或由所述氨基酸序列组成。An amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 10.
其中,该方法包括向所述个体施用大约0.1mg/kg-100mg/kg的靶向TROP2的抗体-药物偶联物。The method comprises administering to the individual approximately 0.1 mg/kg to 100 mg/kg of an antibody-drug conjugate targeting TROP2.
其中,该方法包括向所述个体施用大约0.2mg/kg-50mg/kg的靶向TROP2的抗体-药物偶联物。The method comprises administering to the individual approximately 0.2 mg/kg to 50 mg/kg of an antibody-drug conjugate targeting TROP2.
其中,该方法包括向所述个体施用大约0.3mg/kg-30mg/kg的靶向TROP2的抗体-药物偶联物。The method comprises administering to the individual approximately 0.3 mg/kg to 30 mg/kg of an antibody-drug conjugate targeting TROP2.
其中,该方法包括向所述个体施用大约0.3mg/kg、0.8mg/kg、1mg/kg、1.5mg/kg、1.6mg/kg、1.8mg/kg、2mg/kg、2.3mg/kg、2.5mg/kg、3mg/kg、3.2mg/kg、3.5mg/kg、3.8mg/kg、4mg/kg、5mg/kg、6mg/kg、6.4mg/kg、7mg/kg、8mg/kg、9mg/kg、9.5mg/kg、9.6mg/kg、10mg/kg、11mg/kg、12mg/kg、13mg/kg、13.5mg/kg、14mg/kg、14.5mg/kg、15mg/kg、15.5mg/kg或16mg/kg的靶向TROP2的抗体-药物偶联物。wherein the method comprises administering to the individual approximately 0.3 mg/kg, 0.8 mg/kg, 1 mg/kg, 1.5 mg/kg, 1.6 mg/kg, 1.8 mg/kg, 2 mg/kg, 2.3 mg/kg, 2.5 mg/kg, 3 mg/kg, 3.2 mg/kg, 3.5 mg/kg, 3.8 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.4 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 9.5 mg/kg, 9.6 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 13.5 mg/kg, 14 mg/kg, 14.5 mg/kg, 15 mg/kg, 15.5 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2.
其中,该方法包括向所述个体施用大约1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg/kg或16mg/kg的靶向TROP2的抗体-药物偶联物。The method comprises administering to the individual approximately 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2.
其中,该方法的给药周期为2周/14天(Q2W)-5周/35天(Q5W)。The dosing cycle of this method is 2 weeks/14 days (Q2W) to 5 weeks/35 days (Q5W).
其中,该方法的给药周期为2周/14天(Q2W)、3周/21天(Q3W)或4周/28天(Q4W),在每周期的第1天给药1次。The dosing cycle of this method is 2 weeks/14 days (Q2W), 3 weeks/21 days (Q3W) or 4 weeks/28 days (Q4W), and the drug is administered once on the first day of each cycle.
其中,所述施用方式包括静脉给药。Wherein, the administration method includes intravenous administration.
其中,所述靶向TROP2的抗体-药物偶联物为冻干粉制剂。Wherein, the antibody-drug conjugate targeting TROP2 is a lyophilized powder preparation.
本发明还提供了一种靶向TROP2的抗体-药物偶联物用于制备治疗实体瘤药物中的用途,其中,所述靶向TROP2的抗体-药物偶联物如上所述。The present invention also provides a use of an antibody-drug conjugate targeting TROP2 for preparing a drug for treating solid tumors, wherein the antibody-drug conjugate targeting TROP2 is as described above.
为了实现上述目的,本发明还提供了一种单次剂量单元,包括:有效量的本发明的靶向TROP2的抗体-药物偶联物。In order to achieve the above object, the present invention also provides a single-dose unit, comprising: an effective amount of the antibody-drug conjugate targeting TROP2 of the present invention.
本发明又提供了一种成套药盒,其中包含本发明的上述有效量的靶向TROP2的抗体-药物偶联物。The present invention further provides a complete drug kit, which comprises the above-mentioned effective amount of the antibody-drug conjugate targeting TROP2 of the present invention.
本发明的单次剂量单元或成套药盒在制备预防或治疗实体瘤的药物中的用途。Use of the single-dose unit or complete kit of parts of the present invention in preparing drugs for preventing or treating solid tumors.
预测本发明的靶向TROP2的抗体-药物偶联物治疗实体瘤具有一定的安全性和疗效。It is predicted that the antibody-drug conjugate targeting TROP2 of the present invention has certain safety and efficacy in treating solid tumors.
本发明的其它实施方案将通过参阅此后的详细说明而清楚明了。Other embodiments of the present invention will become apparent by reference to the detailed description which follows.
发明详述Detailed Description of the Invention
在详细描述本发明之前,应了解,本发明不受限于本说明书中的特定方法及实验条件,因为所述方法以及条件是可以改变的。另外,本文所用术语仅是供说明特定实施方案之用,而不意欲为限制性的。Before describing the present invention in detail, it should be understood that the present invention is not limited to the specific methods and experimental conditions in this specification, because the methods and conditions can be varied. In addition, the terminology used herein is only for describing specific embodiments and is not intended to be limiting.
定义definition
除非另有定义,否则本文中使用的所有技术和科学术语均具有与本领域一般技术人员通常所理解的含义相同的含义。为了本发明的目的,下文定义了以下术语。Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. For the purposes of the present invention, the following terms are defined below.
术语“约”在与数字数值联合使用时意为涵盖具有比指定数字数值小5%(例如4%、3%、2%或1%)的下限和比指定数字数值大5%(例如4%、3%、2%或1%)的上限的范围内的数字数值。The term "about" when used in conjunction with a numerical value is meant to encompass a range of numerical values having a lower limit that is 5% (e.g., 4%, 3%, 2% or 1%) less than the specified numerical value and an upper limit that is 5% (e.g., 4%, 3%, 2% or 1%) greater than the specified numerical value.
术语“和/或”当用于连接两个或多个可选项时,应理解为意指可选项中的任一项或可选项中的任意两项或多项。The term "and/or" when used to link two or more alternatives should be understood to mean any one of the alternatives or any two or more of the alternatives.
本文所用的术语“抗TROP2抗体”、“抗TROP2”、“TROP2抗体”或“抗TROP2的抗体”是指这样的抗体,所述抗体或其抗原结合片段能够以足够的亲合力结合TROP2蛋白。所述抗体可以用作靶向TROP2中的诊断剂和/或治疗剂,或用于构建免疫缀合物,例如抗体药物偶联物。As used herein, the terms "anti-TROP2 antibody," "anti-TROP2," "TROP2 antibody," or "anti-TROP2 antibody" refer to antibodies that bind to TROP2 protein with sufficient affinity. The antibodies can be used as diagnostic and/or therapeutic agents targeting TROP2, or used to construct immunoconjugates, such as antibody-drug conjugates.
术语“完全抗体”、“全抗体”或“全长抗体”在本文中可互换使用,是指具有天然免疫球蛋白分子结构的抗体分子。在常规四链IgG抗体的情况下,全长抗体包含由二硫键相互连接的两条重链(H)和两条轻链(L)。在仅具有重链而缺乏轻链的重链抗体情况下,全长抗体包含由二硫键相互连接的两条重链(H)。The terms "complete antibody", "whole antibody" or "full-length antibody" are used interchangeably herein and refer to antibody molecules having the structure of a natural immunoglobulin molecule. In the case of a conventional four-chain IgG antibody, a full-length antibody comprises two heavy chains (H) and two light chains (L) interconnected by disulfide bonds. In the case of a heavy chain antibody having only heavy chains and lacking light chains, a full-length antibody comprises two heavy chains (H) interconnected by disulfide bonds.
对于常规四链IgG抗体,全长抗体重链通常由重链可变区(本文中缩写为VH)和重链恒定区组成,其中重链恒定区至少包含3个结构域CH1、CH2和CH3。全长抗体轻链由轻链可变区(本文中缩写为VL)和轻链恒定区组成,其中轻链恒定区由一个结构域CL组成。每个重链可变区VH和每个轻链可变区都由三个CDR和4个FR组成,从氨基端到羧基端以如下顺序排列:FR1,CDR1,FR2,CDR2,FR3,CDR3,FR4。For conventional four-chain IgG antibodies, the full-length antibody heavy chain is generally composed of a heavy chain variable region (abbreviated herein as VH) and a heavy chain constant region, wherein the heavy chain constant region comprises at least three domains: CH1, CH2, and CH3. The full-length antibody light chain is composed of a light chain variable region (abbreviated herein as VL) and a light chain constant region, wherein the light chain constant region consists of one domain: CL. Each heavy chain variable region VH and each light chain variable region consists of three CDRs and four FRs, arranged from amino terminus to carboxyl terminus in the following order: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4.
术语“抗体片段”包括完整抗体的一部分。在优选的实施方案中,抗体片段为抗原结合片段。The term "antibody fragment" includes a portion of an intact antibody. In a preferred embodiment, the antibody fragment is an antigen-binding fragment.
“抗原结合片段”指与完整抗体不同的分子,其包含完整抗体的一部分且结合完整抗体所结合的抗原。抗体片段的例子包括但不限于Fv,Fab,Fab’,Fab’-SH,F(ab’)2;dAb(domain antibody);线性抗体;单链抗体(例如scFv);单结构域抗体例如VHH;双价抗体或其片段;或骆驼科抗体。"Antigen-binding fragment" refers to a molecule other than an intact antibody that comprises a portion of an intact antibody and binds to the antigen to which the intact antibody binds. Examples of antibody fragments include, but are not limited to, Fv, Fab, Fab', Fab'-SH, F(ab') 2 ; dAb (domain antibody); linear antibodies; single-chain antibodies (e.g., scFv); single-domain antibodies such as VHH; diabodies or fragments thereof; or camelid antibodies.
术语“抗原”是指引发免疫应答的分子。这种免疫应答可能涉及抗体产生或特异性免疫细胞的活化,或两者兼有。技术人员将理解,任何大分子,包括基本上所有的蛋白质或肽,都可以用作抗原。此外,抗原可以衍生自重组或基因组DNA。如本文所用,术语“表位”指抗原(例如,TROP2)中与抗体分子特异性相互作用的部分。The term "antigen" refers to a molecule that triggers an immune response. This immune response may involve the production of antibodies or the activation of specific immune cells, or both. It will be appreciated by those skilled in the art that any macromolecule, including substantially all proteins or peptides, can be used as an antigen. In addition, antigens can be derived from recombinant or genomic DNA. As used herein, the term "epitope" refers to a portion of an antigen (e.g., TROP2) that specifically interacts with an antibody molecule.
“互补决定区”或“CDR区”或“CDR”是抗体可变结构域中在序列上高变并且形成在结构上确定的环(“超变环”)和/或含有抗原接触残基(“抗原接触点”)的区域。CDR主要负责与抗原表位结合。重链和轻链的CDR通常被称作CDR1、CDR2和CDR3,从N-端开始顺序编号。位于抗体重链可变结构域内的CDR被称作HCDR1、HCDR2和HCDR3,而位于抗体轻链可变结构域内的CDR被称作LCDR1、LCDR2和LCDR3。在一个给定的轻链可变区或重链可变区氨基酸序列中,各CDR的精确氨基酸序列边界可以使用许多公知的抗体CDR指派系统的任一种或其组合确定,所述指派系统包括例如:基于抗体的三维结构和CDR环的拓扑学的Chothia(Chothia等人.(1989)Nature 342:877-883,Al-Lazikani等人,“Standard conformations for the canonical structures of immunoglobulins”,Journal of Molecular Biology,273,927-948(1997)),基于抗体序列可变性的Kabat(Kabat等人,Sequences of Proteins of Immunological Interest,第4版,U.S.Department of Health and Human Services,National Institutes of Health(1987)),AbM(University of Bath),Contact(University College London),国际ImMunoGeneTics database(IMGT)(在万维网上imgt.cines.fr/上),以及基于利用大量晶体结构的近邻传播聚类(affinity propagation clustering)的North CDR定义(North等,“ANew Clustering of Antibody CDR Loop Con格式ions”,Journal of Molecular Biology,406,228-256(2011))。"Complementarity determining region" or "CDR region" or "CDR" is a region in an antibody variable domain that is highly variable in sequence and forms structurally determined loops ("hypervariable loops") and/or contains antigen contact residues ("antigen contact points"). CDRs are primarily responsible for binding to antigenic epitopes. The CDRs of the heavy and light chains are typically referred to as CDR1, CDR2, and CDR3, and are numbered sequentially starting from the N-terminus. The CDRs located within the antibody heavy chain variable domain are referred to as HCDR1, HCDR2, and HCDR3, while the CDRs located within the antibody light chain variable domain are referred to as LCDR1, LCDR2, and LCDR3. In a given light chain variable region or heavy chain variable region amino acid sequence, the precise amino acid sequence boundaries of each CDR can be determined using any one or a combination of many well-known antibody CDR assignment systems, including, for example: Chothia based on the three-dimensional structure of the antibody and the topology of the CDR loops (Chothia et al. (1989) Nature 342:877-883, Al-Lazikani et al., "Standard conformations for the canonical structures of immunoglobulins", Journal of Molecular Biology, 273, 927-948 (1997)), Kabat based on antibody sequence variability (Kabat et al., Sequences of Proteins of Immunological Interest, 4th Edition, U.S. De Department of Health and Human Services, National Institutes of Health (1987)), AbM (University of Bath), Contact (University College London), the international ImMunoGeneTics database (IMGT) (on the World Wide Web at imgt.cines.fr/), and North's CDR definitions based on affinity propagation clustering using a large number of crystal structures (North et al., "A New Clustering of Antibody CDR Loop Concepts", Journal of Molecular Biology, 406, 228-256 (2011)).
以下为采用kabat、AbM、Chothia、Contact和IMGT方案定义的CDR的区域范围。
The following are the regional ranges of CDRs defined using the Kabat, AbM, Chothia, Contact, and IMGT schemes.
CDR也可以基于与参考CDR序列(例如本发明示例性CDR之任一)具有相同的Kabat编号位置而确定。A CDR can also be identified based on having the same Kabat numbering position as a reference CDR sequence (eg, any of the exemplary CDRs of the invention).
除非另有说明,否则在本发明中,术语“CDR”或“CDR序列”涵盖以上述任一种方式确定的CDR序列。Unless otherwise indicated, in the present invention, the term "CDR" or "CDR sequence" encompasses CDR sequences determined in any of the above-mentioned ways.
除非另有说明,否则在本发明中,当提及抗体可变区中的残基位置(包括重链可变区残基和轻链可变区残基)时,是指根据Kabat编号系统(Kabat等人,Sequences of Proteins of Immunological Interest,5th Ed.Public Health Service,National Institutes of Health,Bethesda,Md.(1991))的编号位置。Unless otherwise indicated, in the present invention, when referring to the residue positions in the antibody variable region (including heavy chain variable region residues and light chain variable region residues), it refers to the numbering position according to the Kabat numbering system (Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed. Public Health Service, National Institutes of Health, Bethesda, Md. (1991)).
在一个实施方案中,本发明抗体的重链可变区CDR按照如下规则确定:In one embodiment, the heavy chain variable region CDRs of the antibodies of the present invention are determined according to the following rules:
VH CDR1按照AbM规则确定;并且VH CDR2和3均按照Kabat规则确定。VH CDR1 was determined according to the AbM rule; and VH CDR2 and 3 were both determined according to the Kabat rule.
在一个实施方案中,本发明抗体的轻链可变区CDR按照Kabat规则确定。In one embodiment, the light chain variable region CDRs of an antibody of the invention are determined according to the Kabat rules.
在一个实施方案中,本发明抗体的重链可变区CDR按照如下规则确定:VH CDR1按照AbM规则确定;并且VH CDR2和3均按照Kabat规则确定;且轻链可变区CDR分别按照Kabat规则确定。In one embodiment, the heavy chain variable region CDRs of the antibodies of the present invention are determined according to the following rules: VH CDR1 is determined according to the AbM rule; and VH CDR2 and 3 are both determined according to the Kabat rule; and the light chain variable region CDRs are respectively determined according to the Kabat rule.
应该注意,基于不同的指派系统获得的同一抗体的可变区的CDR的边界可能有所差异。即不同指派系统下定义的同一抗体可变区的CDR序列有所不同。因此,在涉及用本发明定义的具体CDR序列限定抗体时,所述抗体的范围还涵盖了这样的抗体,其可变区序列包含所述的具体CDR序列,但是由于应用了不同的方案(例如不同的指派系统规则或组合)而导致其所声称的CDR边界与本发明所定义的具体CDR边界不同。It should be noted that the boundaries of the CDRs of the variable regions of the same antibody obtained based on different assignment systems may be different. That is, the CDR sequences of the variable regions of the same antibody defined under different assignment systems may be different. Therefore, when referring to antibodies defined by specific CDR sequences defined in the present invention, the scope of the antibodies also covers antibodies whose variable region sequences contain the specific CDR sequences, but whose claimed CDR boundaries are different from the specific CDR boundaries defined in the present invention due to the application of different schemes (e.g., different assignment system rules or combinations).
术语“Fc区”在本文中用来定义免疫球蛋白重链的含有至少一部分恒定区的C端区域。该术语包括天然序列Fc区和变体Fc区。天然的免疫球蛋白“Fc结构域”包含两个或三个恒定结构域,即CH2结构域、CH3结构域和可选的CH4结构域。例如,在天然抗体中,免疫球蛋白Fc结构域包含源自IgG、IgA和IgD类抗体的两条重链的第二和第三恒定结构域(CH2结构域和CH3结构域);或者包含源自IgM和IgE类抗体的两条重链的第二、第三和第四恒定结构域(CH2结构域、CH3结构域和CH4结构域)。除非本文中另外说明,否则Fc区或重链恒定区中的氨基酸残基编号根据如Kabat等人,Sequences of Proteins of Immunological Interes,第5版,Public Health Service,National Institutes of Health,Bethesda,MD,1991中所述的EU编号体系(也称作EU索引)进行编号。在本文中,术语“Fc区”不包括免疫球蛋白的重链可变区VH和轻链可变区VL以及重链恒定区CH1和轻链恒定区CL,但在一些情况下可以包括在重链恒定区N端的铰链区。The term "Fc region" is used herein to define the C-terminal region of an immunoglobulin heavy chain that contains at least a portion of the constant region. The term includes native sequence Fc regions and variant Fc regions. A native immunoglobulin "Fc domain" comprises two or three constant domains, namely a CH2 domain, a CH3 domain, and an optional CH4 domain. For example, in a native antibody, the immunoglobulin Fc domain comprises the second and third constant domains (CH2 domain and CH3 domain) of two heavy chains derived from IgG, IgA, and IgD class antibodies; or the second, third, and fourth constant domains (CH2 domain, CH3 domain, and CH4 domain) of two heavy chains derived from IgM and IgE class antibodies. Unless otherwise indicated herein, amino acid residues in the Fc region or heavy chain constant region are numbered according to the EU numbering system (also called the EU index) as described in Kabat et al., Sequences of Proteins of Immunological Interests, 5th ed., Public Health Service, National Institutes of Health, Bethesda, MD, 1991. As used herein, the term "Fc region" excludes the heavy chain variable region VH and light chain variable region VL as well as the heavy chain constant region CH1 and light chain constant region CL of an immunoglobulin, but may include the hinge region at the N-terminus of the heavy chain constant region in some cases.
“IgG形式的抗体”是指抗体的重链恒定区所属的IgG形式。所有同一型的抗体的重链恒定区都是相同的,不同型的抗体之间的重链恒定区不同。例如,IgG4形式的抗体是指其重链恒定区来自IgG4,或者IgG1形式的抗体是指其重链恒定区来自IgG1。An "IgG-type antibody" refers to an antibody whose heavy chain constant region belongs to the IgG type. All antibodies of the same type have the same heavy chain constant region, while antibodies of different types differ in their heavy chain constant regions. For example, an antibody of the IgG4 type refers to an antibody whose heavy chain constant region is derived from IgG4, and an antibody of the IgG1 type refers to an antibody whose heavy chain constant region is derived from IgG1.
如本文所用,术语“结合”或“特异性结合”意指结合作用对抗原是选择性的并且可以与不想要的或非特异的相互作用区别。抗原结合位点与特定抗原结合的能力可以通过酶联免疫吸附测定法(ELISA)或本领域已知的常规结合测定法如通过放射性免疫测定(RIA)或生物膜薄层干涉测定法或MSD测定法或表面等离子体共振法(SPR)测定。As used herein, the term "binding" or "specific binding" means that the binding effect is selective for the antigen and can be distinguished from unwanted or non-specific interactions. The ability of an antigen binding site to bind to a specific antigen can be determined by enzyme-linked immunosorbent assay (ELISA) or conventional binding assays known in the art, such as by radioimmunoassay (RIA) or thin-layer interferometry or MSD assays or surface plasmon resonance (SPR).
如本文所用的,“抗体-药物偶联物(ADC)”是指通过连接抗体与药物所得的结构。As used herein, "antibody-drug conjugate (ADC)" refers to a structure obtained by linking an antibody to a drug.
术语“药物:抗体比率”或“DAR”是指偶联于本文所述的Ab部分的小分子药物部分(D)与Ab部分的比例。在本文所述的一些实施方案中,DAR可由p或q确定,例如DAR可以为1至20,例如2-18、4-16、5-12、6-10、2-8、3-8、2-6、4-6、6-10,例如2、3、4、5、6、7、8、9、10、11、12、13、14或15。DAR也可被计算为产品中分子群体的平均DAR,即通过检测方法(例如通过常规方法如质谱法、ELISA测定、电泳和/或HPLC)测得的产品中偶联于本文所述的Ab部分的小分子药物部分与Ab部分的总体比例,此DAR在文中称为平均DAR。在一些实施方案中,本发明偶联物的平均DAR值是1至20,例如2-18、4-16、5-12、6-10、2-8、3-8、2-6、4-6、6-10,例如1.0-8.0,2.0-6.0,例如0.5、0.6、0.7、0.8、0.9、1、1.1、1.2、1.3、1.4、1.5、1.6、1.7、1.8、1.9、2、2.1、2.2、2.3、2.4、2.5、2.6、2.7、2.8、2.9、3、3.1、3.2、3.3、3.4、3.5、3.6、3.7、3.8、3.9、4、4.1、4.2、4.3、4.4、4.5、4.6、4.7、4.8、4.9、5.0、5.1、5.2、5.3、5.4、5.5、5.6、5.7、5.8、5.9、6.0、6.1、6.2、6.3、6.4、6.5、6.6、6.7、6.8、6.9、7.0、7.1、7.2、7.3、7.4、7.5、7.6、7.7、7.8、7.9、8.0、8.1、8.2、8.3、8.4、8.5、8.6、8.7、8.8、8.9、9.0、9.1、9.2、9.3、9.4、9.5、9.6、9.7、9.8、9.9或10.0,以这些数值中的两个作为端点的范围。The term "drug:antibody ratio" or "DAR" refers to the ratio of the small molecule drug moiety (D) coupled to the Ab moiety described herein to the Ab moiety. In some embodiments described herein, the DAR can be determined by p or q, for example, the DAR can be 1 to 20, such as 2-18, 4-16, 5-12, 6-10, 2-8, 3-8, 2-6, 4-6, 6-10, such as 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15. The DAR can also be calculated as the average DAR of the population of molecules in the product, i.e., the overall ratio of the small molecule drug moiety coupled to the Ab moiety described herein to the Ab moiety in the product as measured by a detection method (e.g., by conventional methods such as mass spectrometry, ELISA assay, electrophoresis, and/or HPLC), and this DAR is referred to herein as the average DAR. In some embodiments, the average DAR value of the conjugate of the invention is 1 to 20, e.g., 2-18, 4-16, 5-12, 6-10, 2-8, 3-8, 2-6, 4-6, 6-10, e.g., 1.0-8.0, 2.0-6.0, e.g., 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4, 4.1, 4.2, 4.3, 4.4 , 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9, 8.0, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9.0, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9 or 10.0, and ranges having two of these values as endpoints.
术语“药物组合物”或“制剂”指适合于向动物、优选哺乳动物(包括人)施用的包含至少一种活性成分和至少一种非活性成分、例如可药用赋形剂的组合物。本发明的药物组合物优选是胃肠外施用的形式,例如溶液剂、混悬剂、冻干粉末、浓缩溶液等形式。The term "pharmaceutical composition" or "formulation" refers to a composition suitable for administration to an animal, preferably a mammal (including a human) comprising at least one active ingredient and at least one inactive ingredient, such as a pharmaceutically acceptable excipient. The pharmaceutical composition of the present invention is preferably in the form of parenteral administration, such as a solution, suspension, lyophilized powder, concentrated solution, etc.
术语“有效量”指本发明的抗体或片段或组合物或组合的这样的量或剂量,其以单一或多次剂量施用患者后,在需要治疗或预防的患者中产生预期效果。The term "effective amount" refers to that amount or dosage of an antibody or fragment or composition or combination of the present invention which, after single or multiple doses, produces the desired effect in a patient in need of treatment or prevention.
“治疗有效量”指以需要的剂量并持续需要的时间段,有效实现所需治疗结果的量。治疗有效量也是这样的一个量,其中抗体或抗体片段或组合物或组合的任何有毒或有害作用不及治疗有益作用。相对于未治疗的对象,“治疗有效量”优选地抑制可度量参数(例如肿瘤体积)至少约30%、甚至更优选地至少约40%、45%、50%、55%、60%、65%、70%、75%、80%、85%、90%甚至100%。A "therapeutically effective amount" is an amount effective to achieve the desired therapeutic outcome at the desired dosage and for the desired period of time. A therapeutically effective amount is also an amount in which any toxic or deleterious effects of the antibody or antibody fragment or composition or combination are outweighed by the therapeutically beneficial effects. A "therapeutically effective amount" preferably inhibits a measurable parameter (e.g., tumor volume) by at least about 30%, even more preferably by at least about 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or even 100% relative to an untreated subject.
“预防有效量”指以需要的剂量并持续需要的时间段,有效实现所需预防结果的量。通常,由于预防性剂量在对象中在疾病较早阶段之前或在疾病较早阶段使用,故预防有效量将小于治疗有效量。A "prophylactically effective amount" refers to an amount effective to achieve the desired preventive result, at the required dosage and for the required period of time. Typically, a prophylactic amount will be less than a therapeutically effective amount because a prophylactic dose is used in a subject prior to or at an earlier stage of disease.
术语“宿主细胞”、“宿主细胞系”和“宿主细胞培养物”可交换地使用且是指其中引入外源核酸的细胞,包括这种细胞的后代。宿主细胞包括“转化体”和“转化的细胞”,其包括初级转化的细胞和来源于其的后代,而不考虑传代的数目。后代在核酸内容上可能与亲本细胞不完全相同,而是可以包含突变。本文中包括在最初转化的细胞中筛选或选择的具有相同功能或生物学活性的突变体后代。The terms "host cell," "host cell line," and "host cell culture" are used interchangeably and refer to cells into which exogenous nucleic acid has been introduced, including the progeny of such cells. Host cells include "transformants" and "transformed cells," which include the primary transformed cell and progeny derived therefrom, without regard to the number of passages. Progeny may not be completely identical in nucleic acid content to the parent cell, but may contain mutations. Mutant progeny screened or selected for the same function or biological activity as the initially transformed cell are included herein.
本文所使用的术语“标记”是指被直接或间接缀合或融合至试剂(诸如多核苷酸探针或抗体)并且促进其所缀合或融合的试剂的检测的化合物或组合物。标记本身可以是可检测的(例如,放射性同位素标记或荧光标记)或在酶促标记的情况下可以催化可检测的底物化合物或组合物的化学改变。术语旨在涵盖通过将可检测物质偶联(即,物理连接)至探针或抗体来直接标记探针或抗体以及通过与直接标记的另一种试剂反应来间接标记探针或抗体。The term "label" as used herein refers to a compound or composition that is directly or indirectly conjugated or fused to a reagent (such as a polynucleotide probe or antibody) and promotes the detection of the reagent to which it is conjugated or fused. The label itself can be detectable (e.g., a radioisotope label or a fluorescent label) or can catalyze a chemical change in a detectable substrate compound or composition in the case of an enzymatic label. The term is intended to encompass direct labeling of a probe or antibody by coupling (i.e., physically connecting) a detectable substance to the probe or antibody and indirect labeling of the probe or antibody by reacting with another reagent of the direct label.
“个体”或“受试者”包括哺乳动物。哺乳动物包括但不限于,家养动物(例如,牛,羊,猫,狗和马),灵长类动物(例如,人和非人灵长类动物如猴),兔,以及啮齿类动物(例如,小鼠和大鼠)。在一些实施方案中,个体或受试者是人。"Individual" or "subject" includes mammals. Mammals include, but are not limited to, domestic animals (e.g., cattle, sheep, cats, dogs, and horses), primates (e.g., humans and non-human primates such as monkeys), rabbits, and rodents (e.g., mice and rats). In some embodiments, the individual or subject is a human.
“分离的”抗体或其他分子(例如ADC分子)是这样的抗体或分子,其已经与其天然环境或表达其的环境的组分分离。在一些实施方案中,将抗体或ADC分子纯化至超过95%或99%纯度,如通过例如电泳(例如,SDS-PAGE,等电聚焦(IEF),毛细管电泳)或层析(例如,离子交换或反相HPLC)确定的。An "isolated" antibody or other molecule (e.g., ADC molecule) is one that has been separated from a component of its natural environment or the environment in which it is expressed. In some embodiments, the antibody or ADC molecule is purified to greater than 95% or 99% purity as determined by, for example, electrophoresis (e.g., SDS-PAGE, isoelectric focusing (IEF), capillary electrophoresis) or chromatography (e.g., ion exchange or reverse phase HPLC).
术语“抗肿瘤作用”指可以通过多种手段展示的生物学效果,包括但不限于例如,肿瘤体积减少、肿瘤细胞数目减少、肿瘤细胞增殖减少或肿瘤细胞存活减少。The term "anti-tumor effect" refers to a biological effect that can be demonstrated by various means, including but not limited to, for example, a reduction in tumor volume, a reduction in tumor cell number, a reduction in tumor cell proliferation, or a reduction in tumor cell survival.
术语“肿瘤”和“癌症”在本文中互换地使用,涵盖实体瘤和血液肿瘤。The terms "tumor" and "cancer" are used interchangeably herein to encompass both solid tumors and hematological tumors.
术语“癌症”和“癌性”指向或描述哺乳动物中特征通常为细胞生长不受调节的生理疾患。在某些实施方案中,适合于通过本发明的抗体来治疗的癌症包括胃癌、胰腺癌或胃食管交界癌,包括那些癌症的转移性形式。The terms "cancer" and "cancerous" refer to or describe the physiological condition in mammals that is typically characterized by unregulated cell growth. In certain embodiments, cancers suitable for treatment by the antibodies of the invention include gastric cancer, pancreatic cancer, or gastroesophageal junction cancer, including metastatic forms of those cancers.
术语“肿瘤”指所有赘生性(neoplastic)细胞生长和增殖,无论是恶性的还是良性的,及所有癌前(pre-cancerous)和癌性细胞和组织。术语“癌症”、“癌性”和“肿瘤”在本文中提到时并不互相排斥。The term "tumor" refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all precancerous and cancerous cells and tissues. The terms "cancer," "cancerous," and "tumor" are not mutually exclusive when referred to herein.
用于本文时,“治疗”指减缓、中断、阻滞、缓解、停止、降低、或逆转已存在的症状、病症、病况或疾病的进展或严重性。As used herein, "treat," ...
“受试者/患者/个体样品”指从患者或受试者得到的细胞或流体的集合。组织或细胞样品的来源可以是实体组织,像来自新鲜的、冷冻的和/或保存的器官或组织样品或活检样品或穿刺样品;血液或任何血液组分;体液,诸如脑脊液、羊膜液(羊水)、腹膜液(腹水)、或间隙液;来自受试者的妊娠或发育任何时间的细胞。组织样品可能包含在自然界中天然不与组织混杂的化合物,诸如防腐剂、抗凝剂、缓冲剂、固定剂、营养物、抗生素、等等。"Subject/patient/individual sample" refers to a collection of cells or fluids obtained from a patient or subject. The source of a tissue or cell sample can be solid tissue, such as an organ or tissue sample or a biopsy sample or a puncture sample from a fresh, frozen and/or preserved organ; blood or any blood component; body fluids, such as cerebrospinal fluid, amniotic fluid (amniotic fluid), peritoneal fluid (ascites), or interstitial fluid; cells from any time during the subject's pregnancy or development. Tissue samples may contain compounds that are not naturally contaminated with tissue in nature, such as preservatives, anticoagulants, buffers, fixatives, nutrients, antibiotics, etc.
术语“冻干制剂”是指通过液体制剂的冷冻干燥处理得到或能够得到的组合物。优选地,其为具有少于5%、优选少于3%水含量的固体组合物。术语“成套药盒”指包含一种或多种单独的药物组合物,其中至少一个药物组合物包含有效量的靶向TROP2的抗体-药物偶联物,以及优选地包装插页,所述插页印有将所述靶向TROP2的抗体-药物偶联物用于预防或治疗实体瘤的说明书,特别是按照本发明的给药方案进行施用。所述成套药盒还可以包含具有相同或不同活性的其它治疗剂。可以理解,当成套药盒包含多个单独的药物组合物时,所述药物组合物各自可以包含不同的剂量和/或通过不同的途径进行施用。The term "lyophilized preparation" refers to a composition obtained or obtainable by freeze-drying a liquid preparation. Preferably, it is a solid composition having a water content of less than 5%, preferably less than 3%. The term "kit of parts" refers to a composition comprising one or more separate pharmaceutical compositions, at least one of which comprises an effective amount of an antibody-drug conjugate targeting TROP2, and preferably a package insert printed with instructions for using the antibody-drug conjugate targeting TROP2 for the prevention or treatment of solid tumors, in particular for administration according to the dosage regimen of the present invention. The kit of parts may also contain other therapeutic agents with the same or different activities. It will be understood that when the kit of parts contains multiple separate pharmaceutical compositions, each of the pharmaceutical compositions may contain different doses and/or be administered by different routes.
如文中所用,术语“单次剂量单元”是指待施用于患者的包含本发明的抗体或其抗原结合片段的离散药物单元,例如注射用的小瓶、安瓿、预充针或预充式注射器,其中含有药物的溶液或冻干粉,优选地冻干粉。As used herein, the term "single-dose unit" refers to a discrete pharmaceutical unit containing an antibody or antigen-binding fragment thereof of the present invention to be administered to a patient, such as a vial, ampoule, prefilled needle or prefilled syringe for injection, which contains a solution or lyophilized powder of the drug, preferably a lyophilized powder.
如本文所使用,术语“肠胃外施用”意指肠内和局部给药以外的给药方式,通常通过注射或输注方式,并且包括但不限于,静脉内、肌内、动脉内、鞘内、囊内、眶内、心内、皮内、腹膜内、经气管、皮下、表皮下(subcuticular)、关节内、囊下、蛛网膜下、脊柱内、硬膜外和胸骨内注射以及输注。As used herein, the term "parenteral administration" means modes of administration other than enteral and topical administration, usually by injection or infusion, and includes, but is not limited to, intravenous, intramuscular, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal, epidural, and intrasternal injection and infusion.
术语“药学上可接受的”是指其后所述的物质、组合物、剂型等对哺乳动物、尤其是人没有过度的毒性、刺激性、过敏反应等不需要的性质,应用于动物或人时具有合理的益处/风险比。The term "pharmaceutically acceptable" means that the substances, compositions, dosage forms, etc. described thereafter do not have excessive toxicity, irritation, allergic reactions or other undesirable properties to mammals, especially humans, and have a reasonable benefit/risk ratio when used in animals or humans.
术语“药学上可接受的赋形剂”指药物制剂中除活性成分以外的成分,其对个体是无毒的。The term "pharmaceutically acceptable excipient" refers to an ingredient in a pharmaceutical formulation other than the active ingredient, which is non-toxic to a subject.
术语“抗癌标准治疗”或“标准治疗”在本文中可互换使用,是指在特定时期内,医学界广泛认可并被广泛应用的针对某种癌症的最佳治疗方案,其通常包括手术、放疗、化疗、靶向治疗、免疫治疗等多种治疗手段的单独应用或组合,例如美国国家综合癌症网络肿瘤临床实践指南(NCCN Clinical Practice Guidelines in Oncology)说明了各种癌症治疗的公认标准。The terms "standard anticancer treatment" or "standard treatment" are used interchangeably in this article. They refer to the best treatment plan for a certain type of cancer that is widely recognized and widely used by the medical community at a specific time. It usually includes the separate or combined use of multiple treatment methods such as surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. For example, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Clinical Practice Guidelines in Oncology) describe the recognized standards for the treatment of various cancers.
术语“系统性抗肿瘤治疗”是指是指通过全身性手段来对抗肿瘤的治疗方法。与局部治疗不同,系统性治疗的目标是通过血液循环将药物或治疗手段传递到全身各个部位,以达到控制肿瘤生长、转移和复发的目的。The term "systemic anti-cancer therapy" refers to treatments that target tumors through a systemic approach. Unlike localized treatments, systemic therapy aims to deliver drugs or treatments throughout the body via the bloodstream to control tumor growth, metastasis, and recurrence.
术语“1线治疗”是指肿瘤患者在局部晚期不可手术切除、复发或转移性阶段首次接受的系统性治疗方案,通常是针对特定癌症类型的最佳姑息性治疗选择,其目的是延长患者生存期。一般而言,1线治疗会选择标准治疗。术语“2线治疗”是在1线治疗后,患者再次出现肿瘤进展,且对1线治疗方案耐药,需要更换抗癌机理不同的方案。根治性手术切除或放疗、术前新辅助治疗和术后辅助治疗通常不计入治疗线数。The term "first-line treatment" refers to the first systemic treatment regimen received by patients with locally advanced, unresectable, recurrent or metastatic cancer. It is usually the best palliative treatment option for a specific type of cancer, and its purpose is to prolong patient survival. Generally speaking, standard treatment is selected for the first line of treatment. The term "second-line treatment" refers to the situation where, after the first line of treatment, the patient's tumor progresses again and is resistant to the first-line treatment regimen, and a regimen with a different anti-cancer mechanism needs to be replaced. Radical surgical resection or radiotherapy, preoperative neoadjuvant therapy, and postoperative adjuvant therapy are usually not counted as treatment lines.
治疗方法Treatment
本发明提供了一种预防或治疗实体瘤的方法,该方法包括向有需要个体施用有效量的靶向TROP2的抗体-药物偶联物。The present invention provides a method for preventing or treating solid tumors, which comprises administering an effective amount of an antibody-drug conjugate targeting TROP2 to an individual in need thereof.
本发明还提供了本发明的靶向TROP2的抗体-药物偶联物在用于制备预防或治疗实体瘤药物中的用途。The present invention also provides use of the TROP2-targeting antibody-drug conjugate of the present invention in preparing a drug for preventing or treating solid tumors.
本发明还提供了本发明的靶向TROP2的抗体-药物偶联物用于预防或治疗实体瘤的用途。The present invention also provides use of the TROP2-targeting antibody-drug conjugate of the present invention for preventing or treating solid tumors.
在本发明的一具体实施方式中,采用的靶向TROP2的抗体-药物偶联物选自:
In one embodiment of the present invention, the antibody-drug conjugate targeting TROP2 is selected from:
其中Ab是靶向TROP2的抗体或其抗原结合片段;wherein Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
p为药物与抗体比平均值DAR(即平均DAR),为1至15,例如1-10、2-8、2-4或4-5,例如1、2、3、4、5、6、7、8、9或10,例如,p为2-6;例如p为2-6、3-5、4-5之间的值;优选平均值DAR是4。p is the average drug to antibody ratio DAR (i.e., mean DAR), which is 1 to 15, such as 1-10, 2-8, 2-4 or 4-5, such as 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10, for example, p is 2-6; for example, p is a value between 2-6, 3-5, 4-5; preferably, the mean DAR is 4.
在本发明的一具体实施方式中,采用的靶向TROP2的抗体-药物偶联物选自:
In one embodiment of the present invention, the antibody-drug conjugate targeting TROP2 is selected from:
其中Ab是靶向TROP2的抗体或其抗原结合片段;wherein Ab is an antibody or an antigen-binding fragment thereof targeting TROP2;
q为药物与抗体比DAR,为1至15,例如1-10、2-8、2-4或4-5,例如1、2、3、4、5、6、7、8、9或10,例如p为2-6之间的整数;例如q为2-6、3-5、4-5之间的整数;优选为4。q is the drug to antibody ratio DAR, which is 1 to 15, such as 1-10, 2-8, 2-4 or 4-5, such as 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10, for example, p is an integer between 2-6; for example, q is an integer between 2-6, 3-5, 4-5; preferably 4.
在本发明的进一步具体实施方式中,所述靶向TROP2的抗体或其抗原结合片段包含分别含有以下氨基酸序列的HCDR1、HCDR2、HCDR3:SEQ ID NO:1(GYTFTNYGM)、SEQ ID NO:2(WINTYTGEPTYTDDFKG)和SEQ ID NO:3(GGFGSSYWYFDV),以及分别含有以下氨基酸序列的LCDR1、LCDR2和LCDR3:SEQ ID NO:6(KASQDVSIAVA)、SEQ ID NO:7(SASYRYT)和SEQ ID NO:8(QQHYITPLT)。In a further specific embodiment of the present invention, the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 respectively containing the following amino acid sequences: SEQ ID NO: 1 (GYTFTNYGM), SEQ ID NO: 2 (WINTYTGEPTYTDDFKG) and SEQ ID NO: 3 (GGFGSSYWYFDV), and LCDR1, LCDR2 and LCDR3 respectively containing the following amino acid sequences: SEQ ID NO: 6 (KASQDVSIAVA), SEQ ID NO: 7 (SASYRYT) and SEQ ID NO: 8 (QQHYITPLT).
在本发明的进一步具体实施方式中,所述靶向TROP2的抗体或其抗原结合片段包含分别如以下氨基酸序列所示的HCDR1、HCDR2、HCDR3:SEQ ID NO:1(GYTFTNYGM)、SEQ ID NO:2(WINTYTGEPTYTDDFKG)和SEQ ID NO:3(GGFGSSYWYFDV),以及分别如以下氨基酸序列所示的LCDR1、LCDR2和LCDR3:SEQ ID NO:6(KASQDVSIAVA)、SEQ ID NO:7(SASYRYT)和SEQ ID NO:8(QQHYITPLT)。In a further specific embodiment of the present invention, the antibody targeting TROP2 or its antigen-binding fragment comprises HCDR1, HCDR2, HCDR3 as shown in the following amino acid sequences, respectively: SEQ ID NO: 1 (GYTFTNYGM), SEQ ID NO: 2 (WINTYTGEPTYTDDFKG) and SEQ ID NO: 3 (GGFGSSYWYFDV), and LCDR1, LCDR2 and LCDR3 as shown in the following amino acid sequences, respectively: SEQ ID NO: 6 (KASQDVSIAVA), SEQ ID NO: 7 (SASYRYT) and SEQ ID NO: 8 (QQHYITPLT).
进一步地,所述靶向TROP2的抗体或其抗原结合片段包含重链可变区和/或轻链可变区,其中重链可变区Furthermore, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and/or a light chain variable region, wherein the heavy chain variable region
(i)包含SEQ ID NO:4的氨基酸序列或由所述氨基酸序列组成;或者(i) comprising or consisting of the amino acid sequence of SEQ ID NO:4; or
(ii)包含与SEQ ID NO:4的氨基酸序列相比具有1个或多个(优选不超过10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列由所述氨基酸序列组成,优选地,所述氨基酸改变不发生在CDR区中;或者(ii) an amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 4, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; or
(iii)包含与SEQ ID NO:4的氨基酸序列具有至少90%、91%、92%、93%、94%、95%、96%、97%、98%或99%同一性的氨基酸序列;(iii) comprising an amino acid sequence that is at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:4;
和/或and/or
轻链可变区Light chain variable region
(i)包含SEQ ID NO:9的氨基酸序列或由所述氨基酸序列组成;或者(i) comprising or consisting of the amino acid sequence of SEQ ID NO:9; or
(ii)包含与SEQ ID NO:9的氨基酸序列相比具有1个或多个(优选不超过10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列由所述氨基酸序列组成,优选地,所述氨基酸改变不发生在CDR区中;或者(ii) an amino acid sequence comprising one or more (preferably no more than 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 9, consisting of said amino acid sequence, preferably, said amino acid changes do not occur in the CDR regions; or
(iii)包含与SEQ ID NO:9的氨基酸序列具有至少90%、91%、92%、93%、94%、95%、96%、97%、98%或99%同一性的氨基酸序列。(iii) comprises an amino acid sequence that is at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:9.
在一些实施方案中,所述靶向TROP2的抗体或其抗原结合片段包含重链可变区和轻链可变区,其中In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and a light chain variable region, wherein
所述重链可变区包含SEQ ID NO:4所示的氨基酸序列,且所述轻链可变区包含SEQ ID NO:9所示的氨基酸序列。The heavy chain variable region comprises the amino acid sequence shown in SEQ ID NO:4, and the light chain variable region comprises the amino acid sequence shown in SEQ ID NO:9.
在一些实施方案中,所述靶向TROP2的抗体或其抗原结合片段包含重链可变区和轻链可变区,其中In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain variable region and a light chain variable region, wherein
所述重链可变区由SEQ ID NO:4所示的氨基酸序列组成,且所述轻链可变区由SEQ ID NO:9所示的氨基酸序列组成。The heavy chain variable region consists of the amino acid sequence shown in SEQ ID NO:4, and the light chain variable region consists of the amino acid sequence shown in SEQ ID NO:9.
在一些实施方案中,本发明的所述靶向TROP2的抗体或其抗原结合片段还包含重链恒定区。在一些实施方案中,本发明的所述靶向TROP2的抗体或其抗原结合片段还包含轻链恒定区。在一些实施方案中,本发明的所述靶向TROP2的抗体或其抗原结合片段还包含重链恒定区和轻链恒定区。In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a heavy chain constant region. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a light chain constant region. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention further comprises a heavy chain constant region and a light chain constant region.
在一些实施方案中,本发明的所述重链恒定区HC为IgG1、IgG2、IgG3或IgG4的重链恒定区,优选的IgG1的重链恒定区,例如野生型IgG1重链恒定区。在一些实施方案中,本发明的所述重链恒定区HC为人的IgG1、IgG2、IgG3或IgG4的重链恒定区,优选的人IgG1的重链恒定区,例如野生型人IgG1重链恒定区。在一些实施方案中,本发明的所述轻链恒定区为lambda或Kappa轻链恒定区。在一些实施方案中,本发明的所述轻链恒定区为人lambda或人Kappa轻链恒定区。In some embodiments, the heavy chain constant region HC of the present invention is the heavy chain constant region of IgG1, IgG2, IgG3, or IgG4, preferably the heavy chain constant region of IgG1, such as the wild-type IgG1 heavy chain constant region. In some embodiments, the heavy chain constant region HC of the present invention is the heavy chain constant region of human IgG1, IgG2, IgG3, or IgG4, preferably the heavy chain constant region of human IgG1, such as the wild-type human IgG1 heavy chain constant region. In some embodiments, the light chain constant region of the present invention is a lambda or kappa light chain constant region. In some embodiments, the light chain constant region of the present invention is a human lambda or human kappa light chain constant region.
在一些实施方案中,所述靶向TROP2的抗体或其抗原结合片段包含重链。在一些实施方案中,所述靶向TROP2的抗体或其抗原结合片段包含轻链。在本发明的一些具体实施方案中,本文所述的重链包含所述的重链可变区和重链恒定区,或由所述重链可变区和重链恒定区组成。在本发明的一些具体的实施方案中,本文所述的轻链包含所述的轻链可变区和轻链恒定区,或由所述轻链可变区和轻链恒定区组成。In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a heavy chain. In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 comprises a light chain. In some specific embodiments of the present invention, the heavy chain described herein comprises the heavy chain variable region and the heavy chain constant region, or consists of the heavy chain variable region and the heavy chain constant region. In some specific embodiments of the present invention, the light chain described herein comprises the light chain variable region and the light chain constant region, or consists of the light chain variable region and the light chain constant region.
更具体地,本文所述的靶向TROP2的抗体或其抗原结合片段包含重链和轻链,其中重链包含如下所示的SEQ ID NO:5的氨基酸序列或由所述氨基酸序列组成:
More specifically, the antibody or antigen-binding fragment thereof targeting TROP2 described herein comprises a heavy chain and a light chain, wherein the heavy chain comprises or consists of the amino acid sequence of SEQ ID NO: 5 as shown below:
或者or
包含与SEQ ID NO:5的氨基酸序列相比具有1个或多个(优选不超过20个或10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列或由所述氨基酸序列组成;或者An amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 5; or
包含与SEQ ID NO:5的氨基酸序列具有至少85%、90%、91%、92%、93%、94%、95%、96%、97%、98%或99%同一性的氨基酸序列;且comprising an amino acid sequence that is at least 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:5; and
轻链包含如下所示的SEQ ID NO:10的氨基酸序列或由所述氨基酸序列组成:
The light chain comprises or consists of the amino acid sequence shown below in SEQ ID NO: 10:
或者or
包含与SEQ ID NO:10的氨基酸序列相比具有1个或多个(优选不超过20个或10个,更优选不超过5、4、3、2、1个)的氨基酸改变(优选氨基酸置换,更优选氨基酸保守置换)的氨基酸序列或由所述氨基酸序列组成;或者An amino acid sequence comprising or consisting of one or more (preferably no more than 20 or 10, more preferably no more than 5, 4, 3, 2, or 1) amino acid changes (preferably amino acid substitutions, more preferably conservative amino acid substitutions) compared to the amino acid sequence of SEQ ID NO: 10; or
包含与SEQ ID NO:5的氨基酸序列具有至少85%、90%、91%、92%、93%、94%、95%、96%、97%、98%或99%同一性的氨基酸序列。An amino acid sequence that is at least 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% identical to the amino acid sequence of SEQ ID NO:5.
在一些实施方案中,本文所述的靶向TROP2的抗体或其抗原结合片段包含重链和轻链,其中In some embodiments, the antibodies or antigen-binding fragments thereof targeting TROP2 described herein comprise a heavy chain and a light chain, wherein
所述重链包含SEQ ID NO:5所示的氨基酸序列,且所述轻链可变区包含SEQ ID NO:10所示的氨基酸序列。The heavy chain comprises the amino acid sequence shown in SEQ ID NO:5, and the light chain variable region comprises the amino acid sequence shown in SEQ ID NO:10.
在一些实施方案中,本发明的靶向TROP2的抗体或其抗原结合片段包含重链和轻链,其中In some embodiments, the antibody or antigen-binding fragment thereof targeting TROP2 of the present invention comprises a heavy chain and a light chain, wherein
所述重链由SEQ ID NO:5所示的氨基酸序列组成,且所述轻链由SEQ ID NO:10所示的氨基酸序列组成。The heavy chain consists of the amino acid sequence shown in SEQ ID NO:5, and the light chain consists of the amino acid sequence shown in SEQ ID NO:10.
在一些实施方案中,所述靶向TROP2的抗体的抗原结合片段选自Fab、Fab'、F(ab')2、Fab'-SH、scFv或scFv-Fc。In some embodiments, the antigen-binding fragment of the antibody targeting TROP2 is selected from Fab, Fab', F(ab')2, Fab'-SH, scFv or scFv-Fc.
在一些实施方案中,所述靶向TROP2的抗体包含两条重链和两条轻链,例如包含两条相同的重链和两条相同的轻链。In some embodiments, the antibody targeting TROP2 comprises two heavy chains and two light chains, for example, two identical heavy chains and two identical light chains.
在一些实施方案中,所述靶向TROP2的抗体是全长抗体。In some embodiments, the antibody targeting TROP2 is a full-length antibody.
在一些实施方案中,所述靶向TROP2的抗体是人源化抗体。In some embodiments, the antibody targeting TROP2 is a humanized antibody.
在一些实施方案中,所述靶向TROP2的抗体是单克隆抗体。In some embodiments, the antibody targeting TROP2 is a monoclonal antibody.
在一些实施方案中,所述靶向TROP2的抗体还涵盖特异性结合TROP2的多特异性抗体,例如双特异性抗体。In some embodiments, the antibody targeting TROP2 also encompasses multispecific antibodies that specifically bind to TROP2, such as bispecific antibodies.
在一些实施方案中,适用于本发明的靶向TROP2的抗体-药物偶联物是PCT申请号PCT/CN2024/121813中公开的抗体药物偶联物,将该专利申请整体合并入本文,就如同其全部内容在本文中列出一样。优选地,所述抗体-药物偶联物是PCT申请号PCT/CN2024/121813中实施例4.1制备的化合物。In some embodiments, the antibody-drug conjugate targeting TROP2 suitable for use in the present invention is an antibody-drug conjugate disclosed in PCT Application No. PCT/CN2024/121813, which is incorporated herein in its entirety as if fully set forth herein. Preferably, the antibody-drug conjugate is the compound prepared in Example 4.1 of PCT Application No. PCT/CN2024/121813.
本发明的靶向TROP2的抗体-药物偶联物可以被配制成制剂以进行施用。在一些实施方案中,本发明的靶向TROP2的抗体-药物偶联物被配制成液体制剂或冻干制剂,例如冻干粉末,例如用于静脉内注射的冻干粉针制剂。The antibody-drug conjugate targeting TROP2 of the present invention can be formulated into a preparation for administration. In some embodiments, the antibody-drug conjugate targeting TROP2 of the present invention is formulated into a liquid preparation or a lyophilized preparation, such as a lyophilized powder, such as a lyophilized powder injection for intravenous injection.
在本发明进一步的实施方式中,采用的靶向TROP2的抗体-药物偶联物的制剂为冻干粉制剂,例如冻干粉针注射剂。In a further embodiment of the present invention, the preparation of the antibody-drug conjugate targeting TROP2 is a lyophilized powder preparation, such as a lyophilized powder injection.
例如,本发明的靶向TROP2的抗体-药物偶联物的制剂还包含辅料,例如组氨酸、盐酸组氨酸、蔗糖、甘露醇和聚山梨酯80。For example, the formulation of the TROP2-targeting antibody-drug conjugate of the present invention further comprises excipients such as histidine, histidine hydrochloride, sucrose, mannitol, and polysorbate 80.
在一些具体实施方案中,所述TROP2的抗体-药物偶联物的施用方式为注射给药,例如皮下注射或静脉注射(例如输注)给药,优选地静脉输注或静脉滴注给药。在一些具体的实施方案中,所述TROP2的抗体-药物偶联物通过静脉注射施用。更优选地,所述TROP2的抗体-药物偶联物通过静脉输注施用。在一些实施方案中,所述给药通过外周静脉给药。在一些实施方案中,所述给药使用微量注射泵通过留置静脉插管进行静脉输注,优选地,静脉插管置于外周静脉。在一些实施方案中,所述给药通过中心静脉导管、输液港或输液泵给药。In some specific embodiments, the administration of the TROP2 antibody-drug conjugate is by injection, such as subcutaneous injection or intravenous injection (e.g., infusion), preferably intravenous infusion or intravenous drip. In some specific embodiments, the TROP2 antibody-drug conjugate is administered by intravenous injection. More preferably, the TROP2 antibody-drug conjugate is administered by intravenous infusion. In some embodiments, the administration is administered through a peripheral vein. In some embodiments, the administration is performed by intravenous infusion using a microinjection pump through an indwelling intravenous cannula, preferably, the intravenous cannula is placed in a peripheral vein. In some embodiments, the administration is administered by a central venous catheter, an infusion port, or an infusion pump.
在本发明的一具体实施方式中,在本发明的预防或治疗个体实体瘤的方法中,包括向个体施用0.1mg/kg-100mg/kg的靶向TROP2的抗体-药物偶联物;进一步地,该方法包括向个体施用0.2mg/kg-50mg/kg的靶向TROP2的抗体-药物偶联物;更进一步地,该方法包括向个体施用0.5mg/kg-30mg/kg的靶向TROP2的抗体-药物偶联物;更进一步地,该方法包括向个体施用0.3mg/kg-20mg/kg的靶向TROP2的抗体-药物偶联物;更进一步地,该方法包括向个体施用1mg/kg-20mg/kg的靶向TROP2的抗体-药物偶联物;更进一步地,该方法包括向个体施用1mg/kg-16mg/kg的靶向TROP2的抗体-药物偶联物;更进一步地,该方法包括向个体施用1mg/kg-12mg/kg的靶向TROP2的抗体-药物偶联物。例如:该方法包括向个体施用大约0.3mg/kg、0.8mg/kg、1mg/kg、1.5mg/kg、1.6mg/kg、1.8mg/kg、2mg/kg、2.3mg/kg、2.5mg/kg、3mg/kg、3.2mg/kg、3.5mg/kg、3.8mg/kg、4mg/kg、5mg/kg、6mg/kg、6.4mg/kg、7mg/kg、8mg/kg、9mg/kg、9.5mg/kg、9.6mg/kg、10mg/kg、11mg/kg、12mg/kg、13mg/kg、13.5mg/kg、14mg/kg、14.5mg/kg、15mg/kg、15.5mg/kg或16mg/kg的靶向TROP2的抗体-药物偶联物。更进一步地,该方法包括向个体施用0.3mg/kg-20mg/kg或1-16mg/kg的靶向TROP2的抗体-药物偶联物。例如:该方法包括向个体施用大约1mg/kg、2mg/kg、3mg/kg、4mg/kg、5mg/kg、6mg/kg、6.5mg/kg、7mg/kg、8mg/kg、9mg/kg、10mg/kg、11mg/kg、12mg/kg、13mg/kg、14mg/kg、15mg/kg、16mg/kg、17mg/kg、18mg/kg、19mg/kg、20mg/kg。In a specific embodiment of the present invention, in the method of preventing or treating individual solid tumors of the present invention, it comprises administering to the individual 0.1 mg/kg-100 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.2 mg/kg-50 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.5 mg/kg-30 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 0.3 mg/kg-20 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-20 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-16 mg/kg of an antibody-drug conjugate targeting TROP2; further, the method comprises administering to the individual 1 mg/kg-12 mg/kg of an antibody-drug conjugate targeting TROP2. For example, the method comprises administering to the individual approximately 0.3 mg/kg, 0.8 mg/kg, 1 mg/kg, 1.5 mg/kg, 1.6 mg/kg, 1.8 mg/kg, 2 mg/kg, 2.3 mg/kg, 2.5 mg/kg, 3 mg/kg, 3.2 mg/kg, 3.5 mg/kg, 3.8 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.4 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 9.5 mg/kg, 9.6 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 13.5 mg/kg, 14 mg/kg, 14.5 mg/kg, 15 mg/kg, 15.5 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2. Furthermore, the method comprises administering to the individual 0.3 mg/kg-20 mg/kg or 1-16 mg/kg of an antibody-drug conjugate targeting TROP2. For example, the method comprises administering to the individual approximately 1 mg/kg, 2 mg/kg, 3 mg/kg, 4 mg/kg, 5 mg/kg, 6 mg/kg, 6.5 mg/kg, 7 mg/kg, 8 mg/kg, 9 mg/kg, 10 mg/kg, 11 mg/kg, 12 mg/kg, 13 mg/kg, 14 mg/kg, 15 mg/kg, 16 mg/kg, 17 mg/kg, 18 mg/kg, 19 mg/kg, or 20 mg/kg.
在一些实施方案中,所述靶向TROP2的抗体-药物偶联物可以连续或不连续给药一次或多次,例如至少一次、两次、三次或四次,例如连续给药至少四次。在一些实施方案中,根据患者评估效果确定给药次数。因此,在一些实施方案中,可以给与多于4次的靶向TROP2的抗体-药物偶联物。可以理解,每次给药剂量各自可以相等或不相等,优选的相等。优选地,所述剂量给予1-32次中的任何整数次数,例如1次、5次、10次、15次、20次、25次、26次、27次、28次、29次、30次、31次或32次。当给予多次剂量时,所述剂量以2-12周,例如2周、3周、4周、5周、6周、7周、8周、9周、10周、11周或12周间隔进行施用,优选地以3周间隔进行施用。在本发明的一些示例性的实施方案中,当施用多次剂量时,所述剂量以3周的间隔施用。优选地,每次给予相同剂量的靶向TROP2的抗体-药物偶联物。在一些实施方案中,每次剂量施用在每个间隔的第1天施用、或第2天施用或第3天施用,优选地第1天施用。在一些实施方案中,所述治疗阶段从第一次剂量施用起算持续3周-24个月,例如3个月、6个月、12个月、18个月或24个月,优选地的持续24个月。在本发明的一具体实施方式中,该方法包括持续给药最长24个月。在本发明一具体实施方式中,该方法包括持续给药24个月。在一些具体实施方案中,该方法以3周的间隔通过静脉输注向有需要的患者施用24个月的靶向TROP2的抗体-药物偶联物。In some embodiments, the antibody-drug conjugate targeting TROP2 can be administered continuously or discontinuously once or multiple times, for example, at least once, twice, three times or four times, for example, continuously administered at least four times. In some embodiments, the number of administrations is determined based on the patient's assessment of the effect. Therefore, in some embodiments, more than 4 times of the antibody-drug conjugate targeting TROP2 can be administered. It will be understood that the doses administered each time may be equal or unequal, preferably equal. Preferably, the dose is administered any integer number of times from 1 to 32 times, for example, 1 time, 5 times, 10 times, 15 times, 20 times, 25 times, 26 times, 27 times, 28 times, 29 times, 30 times, 31 times or 32 times. When multiple doses are administered, the dose is administered at intervals of 2 to 12 weeks, for example, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks or 12 weeks, preferably at intervals of 3 weeks. In some exemplary embodiments of the invention, when multiple doses are administered, the doses are administered at intervals of 3 weeks. Preferably, the same dose of antibody-drug conjugate targeting TROP2 is administered each time. In some embodiments, each dose is administered on the 1st day of each interval, or on the 2nd day or on the 3rd day, preferably on the 1st day. In some embodiments, the treatment phase lasts for 3 weeks to 24 months, for example, 3 months, 6 months, 12 months, 18 months or 24 months, from the first dose administration, preferably for 24 months. In one embodiment of the invention, the method comprises continuous administration for up to 24 months. In one embodiment of the invention, the method comprises continuous administration for 24 months. In some specific embodiments, the method administers an antibody-drug conjugate targeting TROP2 to a patient in need thereof by intravenous infusion for 24 months at intervals of 3 weeks.
在本发明的一具体实施方式中,该方法的给药周期为2周/14天(Q2W)-5周/35天(Q5W);进一步地,该方法的给药周期为2周/14天(Q2W)、3周/21天(Q3W)、4周/28天(Q4W)或5周/35天(Q5W),在每周期的第1天给药1次或者在每周期的第2天给药1次或者在每周期的第3天给药1次,优选地在每周期的第1天给药1次。优选地,该方法的给药周期为3周/21天(Q3W),在每周期的第1天给药1次。In a specific embodiment of the present invention, the dosing cycle of the method is 2 weeks/14 days (Q2W) to 5 weeks/35 days (Q5W); further, the dosing cycle of the method is 2 weeks/14 days (Q2W), 3 weeks/21 days (Q3W), 4 weeks/28 days (Q4W) or 5 weeks/35 days (Q5W), and the drug is administered once on the 1st day of each cycle, or once on the 2nd day of each cycle, or once on the 3rd day of each cycle, preferably once on the 1st day of each cycle. Preferably, the dosing cycle of the method is 3 weeks/21 days (Q3W), and the drug is administered once on the 1st day of each cycle.
在本发明的一具体实施方式中,该方法包括向所述个体施用1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg或16mg的靶向TROP2的抗体-药物偶联物,给药周期为3周/21天(Q3W),在每周期的第1天给药1次。In a specific embodiment of the present invention, the method comprises administering 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg or 16 mg of an antibody-drug conjugate targeting TROP2 to the individual, with a dosing cycle of 3 weeks/21 days (Q3W), administered once on the first day of each cycle.
在本发明的一具体实施方式中,本发明的方法的施用方式包括静脉给药。In one embodiment of the present invention, the administration method of the present invention comprises intravenous administration.
在本发明的一具体实施方式中,该方法包括向所述个体静脉内(例如输注)施用1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg/kg或16mg/kg的靶向TROP2的抗体-药物偶联物,给药周期为3周/21天(Q3W),在每周期的第1天给药1次。In a specific embodiment of the present invention, the method comprises administering to the individual intravenously (e.g., by infusion) 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2, with a dosing cycle of 3 weeks/21 days (Q3W), administered once on day 1 of each cycle.
在本发明的一具体实施方式中,该方法包括向所述个体静脉内(例如输注)施用1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg/kg或16mg/kg的靶向TROP2的抗体-药物偶联物,给药周期为3周/21天(Q3W),在每周期的第1天给药1次,持续24个月。In a specific embodiment of the present invention, the method comprises administering to the individual intravenously (e.g., by infusion) 1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg or 16 mg/kg of an antibody-drug conjugate targeting TROP2, with a dosing cycle of 3 weeks/21 days (Q3W), once on day 1 of each cycle, for 24 months.
在一些实施方案中,所述实体瘤是恶性实体瘤。在一些实施方案中,所述实体瘤是晚期实体瘤。在一些实施方案中,所述实体瘤是晚期恶性实体瘤。在一些实施方案中,所述实体瘤是标准治疗失败或对标准治疗不耐受或患者拒绝接受标准治疗或尚无标准治疗方案的实体瘤。在一些实施方案中,所述实体瘤是不可切除的局部晚期或转移性实体瘤,例如,所述实体瘤是根据RECIST v1.1评估至少有一个可测量病灶的不可切除的局部晚期实体瘤或转移性晚期实体瘤。在一些实施方案中,所述实体瘤是标准治疗失败或不耐受或患者拒绝接受标准治疗、且根据RECIST v1.1评估至少有一个可测量病灶的不可切除局部晚期或转移性晚期实体瘤。在一些实施方案中,所述实体瘤是既往接受过至少1线抗癌治疗(例如系统性抗肿瘤治疗)的实体瘤。在一些实施方案中,所述实体瘤是既往接受过1或2线抗癌治疗(例如系统性抗肿瘤治疗)的实体瘤。在一些实施方案中,所述实体瘤是既往接受过2线或2线以上抗癌治疗(例如系统性抗肿瘤治疗)的实体瘤。在一些实施方案中,所述实体瘤是用紫杉类药物治疗失败或对紫杉类药物不耐受的实体瘤。In some embodiments, the solid tumor is a malignant solid tumor. In some embodiments, the solid tumor is an advanced solid tumor. In some embodiments, the solid tumor is an advanced malignant solid tumor. In some embodiments, the solid tumor is a solid tumor for which standard therapy has failed or is intolerant to standard therapy, or the patient refuses standard therapy, or for which no standard treatment options are available. In some embodiments, the solid tumor is an unresectable locally advanced or metastatic solid tumor, for example, an unresectable locally advanced solid tumor or metastatic advanced solid tumor with at least one measurable lesion as assessed according to RECIST v1.1. In some embodiments, the solid tumor is an unresectable locally advanced or metastatic advanced solid tumor for which standard therapy has failed or is intolerant to standard therapy, or the patient refuses standard therapy and has at least one measurable lesion as assessed according to RECIST v1.1. In some embodiments, the solid tumor is a solid tumor that has previously received at least one line of anticancer therapy (e.g., systemic anticancer therapy). In some embodiments, the solid tumor is a solid tumor that has previously received one or two lines of anticancer therapy (e.g., systemic anticancer therapy). In some embodiments, the solid tumor is a solid tumor that has previously received two or more lines of anticancer therapy (e.g., systemic anti-tumor therapy).In some embodiments, the solid tumor is a solid tumor that has failed to be treated with a taxane or is intolerant to a taxane.
在一些实施方案中,所述实体瘤选自乳腺癌例如三阴性乳腺癌、肺癌例如非小细胞肺癌或宫颈癌。In some embodiments, the solid tumor is selected from breast cancer, such as triple-negative breast cancer, lung cancer, such as non-small cell lung cancer, or cervical cancer.
在一些实施方案中,所述实体瘤是患有不可切除的局部晚期或转移性三异性乳腺癌或非小细胞肺癌或宫颈癌。In some embodiments, the solid tumor is unresectable locally advanced or metastatic triple-differentiated breast cancer, non-small cell lung cancer, or cervical cancer.
在一些实施方案中,所述实体瘤是标准治疗失败或不耐受或患者拒绝接受标准治疗或者尚无标准治疗方案、且根据RECIST v1.1评估至少有一个可测量病灶的不可切除局部晚期或转移性晚期三异性乳腺癌或非小细胞肺癌或宫颈癌。In some embodiments, the solid tumor is unresectable locally advanced or metastatic advanced triple-differentiated breast cancer or non-small cell lung cancer or cervical cancer that has failed or is intolerant to standard treatment or the patient refuses standard treatment or has no standard treatment options, and has at least one measurable lesion assessed according to RECIST v1.1.
在一些实施方案中,既往紫杉烷类治疗失败或不耐受的局部晚期不可切除或转移灶三阴性乳腺癌。In some embodiments, the patient is a patient with locally advanced unresectable or metastatic triple-negative breast cancer who has failed or is intolerant to prior taxane therapy.
在本发明的一些实施方式中,患者在既往接受一种或多种治疗,例如接受过对恶性肿瘤的其他治疗,例如接受过符合临床干预指征和机构临床标准规程的、针对其他持续性疾病状况的治疗以及对恶性肿瘤的姑息和支持性治疗。In some embodiments of the invention, the patient has previously received one or more treatments, such as other treatments for malignant tumors, such as treatments for other persistent disease conditions and palliative and supportive treatments for malignant tumors that are consistent with clinical intervention indications and institutional clinical standard procedures.
在本发明的一些实施方式中,患者还可以伴随接受其他治疗,包括但不限于In some embodiments of the present invention, the patient may also receive other treatments, including but not limited to
(i)降低本发明的靶向TROP2的抗体-药物偶联物毒性的预防用药;(i) a preventive medication for reducing the toxicity of the antibody-drug conjugate targeting TROP2 of the present invention;
(ii)根据临床指征,用于治疗用药期间和随访期间发生的任何TRAE或并发疾病的药物;(ii) drugs used to treat any TRAEs or concurrent diseases that occurred during the medication and follow-up period, according to clinical indications;
(iii)血液制品和/或生长因子,其中在治疗第一周不给予;(iii) blood products and/or growth factors, which are not given during the first week of treatment;
(iv)放疗,例如不影响骨髓功能且针对非靶病灶进行的控制疼痛的放疗;(iv) radiotherapy, such as radiotherapy that does not affect bone marrow function and is directed at non-target lesions to control pain;
(v)为缓解肿瘤相关症状的支持性用药,例如针对骨转移的双膦酸盐和地舒单抗;(v) supportive medications to relieve tumor-related symptoms, such as bisphosphonates and denosumab for bone metastases;
(vi)免疫抑制或系统性激素疗法(优选不超过10mg/天泼尼松当量),以及任选地选自以下的一种或多种治疗:(vi) immunosuppression or systemic hormone therapy (preferably not exceeding 10 mg/day prednisone equivalents), and optionally one or more treatments selected from the following:
用于改善食欲的激素治疗(如醋酸甲地孕酮);Hormonal therapy to improve appetite (such as megestrol acetate);
·鼻用、眼用、吸入和外用糖皮质激素制剂;· Nasal, ophthalmic, inhaled, and topical glucocorticoid preparations;
·用于终末器官衰竭的标准剂量的激素替代治疗;Standard-dose hormone replacement therapy for end-organ failure;
·同于前列腺癌的稳定激素疗法*;Same as stable hormone therapy for prostate cancer*;
·用于卵巢抑制的稳定激素疗法、激素避孕疗法或绝经后激素替代疗法Stable hormone therapy for ovarian suppression, hormonal contraceptive therapy, or postmenopausal hormone replacement therapy
·用于预防造影剂反应的类固醇疗法;Steroid therapy to prevent contrast reactions;
·关节内类固醇注射;Intra-articular steroid injections;
·针对其他疾病的低剂量维持类固醇治疗(例如:哮喘加重、针对脑水肿的稳定类固醇疗法[不包括逐渐减量的类固醇]等);Low-dose maintenance steroid therapy for other conditions (e.g., asthma exacerbation, stable steroid therapy (excluding tapering of steroids) for cerebral edema);
·在疾病稳定或持续缓解的受试者中,使用更高剂量的类固醇治疗急性并发疾病(如免疫相关AE或其他不良状况)。此种情况下,应在免疫抑制治疗期间中断研究药物治疗。In subjects with stable disease or ongoing remission, higher doses of steroids may be used to treat acute intercurrent illnesses (such as immune-related AEs or other adverse events). In such cases, study drug treatment should be interrupted during immunosuppressive therapy.
在本发明的一些实施方案中,本发明的应用靶向TROP2的抗体-药物偶联物的治疗方法具有耐受性、安全性和疗效。在本发明的一些实施方案中,本发明的应用靶向TROP2的抗体-药物偶联物的治疗方法具有良好的血液学安全性。在本发明的一些实施方案中,本发明的应用靶向TROP2的抗体-药物偶联物的治疗方法具有以下一种或多种优势:In some embodiments of the present invention, the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have tolerability, safety, and efficacy. In some embodiments of the present invention, the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have good hematological safety. In some embodiments of the present invention, the therapeutic methods of the present invention using antibody-drug conjugates targeting TROP2 have one or more of the following advantages:
(i)不发生大于3级的治疗期不良事件;(i) No adverse events greater than grade 3 occurred during treatment;
(ii)客观缓解率大于或等于大约30%、40%或50%;(ii) objective response rate greater than or equal to approximately 30%, 40%, or 50%;
(iii)疾病控制率大于或等于大约70%、80%、90%或达到100%;和/或(iii) a disease control rate greater than or equal to approximately 70%, 80%, 90%, or 100%; and/or
(iv)无剂量限制性毒性,血液学安全性表现优异。(iv) No dose-limiting toxicity and excellent hematological safety.
单次剂量单元Single dose unit
在一些方面,本发明涉及一种单次剂量单元,包括:有效量的本发明的靶向TROP2的抗体-药物偶联物。优选地,包括1-500mg固定剂量的靶向TROP2的抗体-药物偶联物。例如,包括1、5、10、20、30、40、50、60、70、80、90、100、150、200或500mg固定剂量的靶向TROP2的抗体-药物偶联物。在一些实施方案中,所述单次剂量单元用于按照本发明的给药方案施用以预防或治疗实体瘤。In some aspects, the present invention relates to a single dose unit comprising: an effective amount of an antibody-drug conjugate targeting TROP2 of the present invention. Preferably, a fixed dose of 1-500 mg of an antibody-drug conjugate targeting TROP2 is included. For example, a fixed dose of 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200 or 500 mg of an antibody-drug conjugate targeting TROP2 is included. In some embodiments, the single dose unit is used for administration according to the dosing regimen of the present invention to prevent or treat solid tumors.
本文所述的单次剂量单元优选用于肠胃外施用,例如用于注射,例如静脉注射(包括静脉输注)或皮下注射。在一些实施方案中,本发明所述的单次剂量单元是溶液或冻干粉,优选地冻干粉。所述单次剂量单元可以是注射用的小瓶例如西林瓶、安瓿、预填充式注射器,其中含有靶向TROP2的抗体-药物偶联物的溶液或冻干粉,优选地冻干粉。更优选地,本文所述的单次剂量单元是用于肠胃外施用的包含靶向TROP2的抗体-药物偶联物的冻干粉末的小瓶例如西林瓶。在一些实施方案中,本发明的靶向TROP2的抗体-药物偶联物的冻干粉制剂为50-150mg/瓶(例如50、60、70、80、90、100、110、120、130、140或150mg/瓶)。在一些实施方案中,本文所述的单次剂量单元为50-150mg/西林瓶(例如50、60、70、80、90、100、110、120、130、140或150mg/西林瓶)的靶向TROP2的抗体-药物偶联物的冻干粉末。The single dose unit described herein is preferably used for parenteral administration, for example, for injection, such as intravenous injection (including intravenous infusion) or subcutaneous injection. In some embodiments, the single dose unit of the present invention is a solution or a lyophilized powder, preferably a lyophilized powder. The single dose unit can be a vial for injection, such as a vial, an ampoule, or a prefilled syringe, containing a solution or a lyophilized powder of an antibody-drug conjugate targeting TROP2, preferably a lyophilized powder. More preferably, the single dose unit described herein is a vial, such as a vial, of a lyophilized powder of an antibody-drug conjugate targeting TROP2 for parenteral administration. In some embodiments, the lyophilized powder formulation of the antibody-drug conjugate targeting TROP2 of the present invention is 50-150 mg/bottle (e.g., 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 mg/bottle). In some embodiments, the single-dose unit described herein is 50-150 mg/vial (e.g., 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, or 150 mg/vial) of a lyophilized powder of an antibody-drug conjugate targeting TROP2.
在一些实施方案中,在给药前将包含靶向TROP2的抗体-药物偶联物的制剂例如冻干粉复溶。在一些实施方案中,根据计划药物使用剂量,并根据溶液计算出需要输注的药物体积,并且将计算体积的复溶药物稀释于静脉输液袋中,例如其中包含有0.9%的氯化钠注射液。在一些实施方案中,配制终浓度范围为大约1-9mg/mL。In some embodiments, a formulation comprising an antibody-drug conjugate targeting TROP2, such as a lyophilized powder, is reconstituted prior to administration. In some embodiments, the volume of drug to be infused is calculated based on the planned drug dosage and the solution, and the calculated volume of reconstituted drug is diluted in an intravenous infusion bag, such as one containing 0.9% sodium chloride injection. In some embodiments, the final concentration is in the range of approximately 1-9 mg/mL.
成套药盒Complete set of medicine boxes
本发明还提供了一种成套药盒,其中包含本发明的有效量的靶向TROP2的抗体-药物偶联物;The present invention also provides a complete drug kit, comprising an effective amount of the antibody-drug conjugate targeting TROP2 of the present invention;
优选地,包括1-500mg固定剂量的靶向TROP2的抗体-药物偶联物,或者一个或多个单次剂量单元的靶向TROP2的抗体-药物偶联物。例如,包括1、5、10、20、30、40、50、60、70、80、90、100、150、200或500mg固定剂量的靶向TROP2的抗体-药物偶联物。Preferably, a fixed dose of 1-500 mg of an antibody-drug conjugate targeting TROP2, or one or more single-dose units of an antibody-drug conjugate targeting TROP2, is included. For example, a fixed dose of 1, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 150, 200 or 500 mg of an antibody-drug conjugate targeting TROP2 is included.
优选地,所述成套药盒还包含包装插页,其印有关于在个体中使用靶向TROP2的抗体-药物偶联物预防或治疗个体实体瘤的说明书。Preferably, the kit further comprises a package insert containing instructions for using the antibody-drug conjugate targeting TROP2 in an individual to prevent or treat a solid tumor in the individual.
在一些实施方案中,所述成套药盒还包含能够与本发明的靶向TROP2的抗体-药物偶联物组合或联合施用的其他治疗剂,例如可以与所述抗体-药物偶联物伴随治疗的其他治疗剂,例如如本文所述的伴随治疗中的其他治疗剂。In some embodiments, the kit further comprises other therapeutic agents that can be combined or co-administered with the TROP2-targeting antibody-drug conjugate of the present invention, such as other therapeutic agents that can be used in concomitant therapy with the antibody-drug conjugate, such as other therapeutic agents in concomitant therapy as described herein.
应用application
本发明还提供了本发明的单次剂量单元或成套药盒在制备预防或治疗实体瘤的药物中的用途。The present invention also provides use of the single-dose unit or complete kit of the present invention in preparing a drug for preventing or treating solid tumors.
本发明还提供了一种预防或治疗实体瘤的方法,该方法包括向有需要个体施用本发明的单次剂量单元或成套药盒。The present invention also provides a method for preventing or treating solid tumors, which comprises administering the single-dose unit or kit of parts of the present invention to an individual in need thereof.
本发明还提供了本发明的单次剂量单元或成套药盒用于预防或治疗实体瘤的用途。The present invention also provides use of the single-dose unit or kit of parts of the present invention for preventing or treating solid tumors.
本发明的各个具体实施方式中的靶向TROP2的抗体-药物偶联物还可以被替换为所述抗体-药物偶联物的立体异构体或药学上可接受的盐或溶剂合物。The antibody-drug conjugate targeting TROP2 in various embodiments of the present invention may also be replaced by a stereoisomer or a pharmaceutically acceptable salt or solvate of the antibody-drug conjugate.
本文所述的给药方案(包括活性剂靶向TROP2的抗体-药物偶联物、给药剂量、给药方式、给药间隔、给药次数或给药持续时间等)及其任意一个特征或适应证可以应用于本发明的任意一个方面或任意一个实施方式。而且,本文所述的任意实施方式中的技术特征、定义以及其任意组合同样可以应用于其它实施方式。The dosage regimens described herein (including antibody-drug conjugates with active agents targeting TROP2, dosage, mode of administration, dosing interval, number of doses, or duration of administration, etc.) and any one of their features or indications may be applied to any aspect or embodiment of the present invention. Moreover, the technical features, definitions, and any combination thereof in any embodiment described herein may also be applied to other embodiments.
本文所述的任意实施方案、技术特征以及定义可以任意组合,构成未在说明书中直接记载、但是符合本发明宗旨的实施方案,这些实施方案也囊括在本发明的范围内。Any embodiments, technical features and definitions described herein may be arbitrarily combined to form embodiments that are not directly recorded in the specification but are consistent with the spirit of the present invention, and these embodiments are also included in the scope of the present invention.
实施例1靶向TROP2的抗体-药物偶联物的制备Example 1 Preparation of Antibody-Drug Conjugates Targeting TROP2
根据WO2021173773A1的实施例4公开的方法,制备化合物NT3。其理化数据包括1HNMR和质谱数据与WO2021173773A1公开的一致。
Compound NT3 was prepared according to the method disclosed in Example 4 of WO2021173773A1. Its physicochemical data, including 1HNMR and mass spectrometry data, were consistent with those disclosed in WO2021173773A1.
如下方法制备抗体HRS7(序列见序列表,重链全长:SEQ ID NO:5;轻链全长:SEQ ID NO:10)。The antibody HRS7 was prepared by the following method (sequence see sequence listing, full length heavy chain: SEQ ID NO: 5; full length light chain: SEQ ID NO: 10).
用Expi293F培养基(Gibco,REF#A14351-01)培养Expi293F细胞(购自Gibco),转染前一天检测细胞密度(活力需大于95%),并用新鲜的Expi293F培养基调整到3×106个细胞/mL继续培养,转染当天将细胞密度调整为3×106个细胞/mL;Expi293F cells (purchased from Gibco) were cultured with Expi293F medium (Gibco, REF#A14351-01). The cell density was checked one day before transfection (viability must be greater than 95%) and adjusted to 3 × 10 6 cells/mL with fresh Expi293F medium for continued culture. On the day of transfection, the cell density was adjusted to 3 × 10 6 cells/mL.
取1/10转染终体积的Opti-MEM培养基(Gibco,REF#31985-070)作为转染缓冲液,按照1mg/L的比例加入待转染的DNA,其中轻重链质粒配比为1:1,混匀,按照DNA:PEI质量比1:3加入PEIMax(Polysciences Inc.Cat#24765-1),混匀,室温孵育20min,然后将混合物轻柔地倒入Expi293F细胞悬液中,边倒边摇,细胞置于摇床培养,培养条件为8%CO2、36.5℃、120rpm;Take 1/10 of the final transfection volume of Opti-MEM medium (Gibco, REF#31985-070) as the transfection buffer, add the DNA to be transfected at a ratio of 1 mg/L, with the light and heavy chain plasmids in a 1:1 ratio, mix well, add PEIMax (Polysciences Inc. Cat#24765-1) at a DNA:PEI mass ratio of 1:3, mix well, incubate at room temperature for 20 minutes, then gently pour the mixture into the Expi293F cell suspension while shaking. The cells are cultured on a shaker at 8% CO2 , 36.5°C, and 120 rpm.
培养16~18h后,向细胞悬液中补加2%(体积比)的浓度为200g/L的Feed(100g/LPhytone Peptone+100g/L Difco Select Phytone)、终浓度为5g/L的葡萄糖溶液和终浓度为2.2mM的Valproic acid sodium salt(Merk,Cat#P4543-100G),轻轻混匀,8%CO2、36.5℃、120rpm继续培养7天后收样。将细胞料液与硅藻土(Sartorius,Cat 1000037025)混匀(1L细胞料液加40g硅藻土),用0.22μm的一次性真空过滤装置进行过滤。After 16-18 hours of culture, the cell suspension was supplemented with 2% (volume ratio) of 200 g/L feed (100 g/L Phytone Peptone + 100 g/L Difco Select Phytone), a glucose solution with a final concentration of 5 g/L, and valproic acid sodium salt (Merk, Cat# P4543-100G) with a final concentration of 2.2 mM. The suspension was gently mixed and cultured for 7 days at 8% CO₂ , 36.5°C, and 120 rpm before sampling. The cell suspension was mixed with diatomaceous earth (Sartorius, Cat# 1000037025) (40 g diatomaceous earth per 1 L of cell suspension) and filtered using a 0.22 μm disposable vacuum filter.
亲和层析纯化目的蛋白:Purify target protein by affinity chromatography:
选用HiTrap MabSelect PrismA(GE Healthcare,Cat#17549853)亲和层析柱进行亲和捕获,纯化前用10-20倍柱体积的0.1M NaOH流经管路及亲和层析柱,然后用10-20倍柱体积的蒸馏水清洗管路以及柱子,用5倍柱体积的1×PBS(Gibco)平衡填料柱;将过滤后的细胞料液通过柱子,再用10倍柱体积的1×PBS清洗填料柱,去除非特异性结合蛋白;用5倍柱体积的洗脱缓冲液(100mM sodium citrate,pH 3.5)冲洗填料,收集洗脱液,用2M Tris调节pH至6.0,过滤除菌,待纯度检测合格后进行用于ADC的抗体偶联。HiTrap MabSelect PrismA (GE Healthcare, Cat#17549853) affinity chromatography column was used for affinity capture. Before purification, 10-20 column volumes of 0.1 M NaOH were passed through the tubing and affinity chromatography column, and then 10-20 column volumes of distilled water were used to clean the tubing and column. The packed column was equilibrated with 5 column volumes of 1×PBS (Gibco). The filtered cell feed was passed through the column, and then the packed column was washed with 10 column volumes of 1×PBS to remove non-specific binding proteins. The packed column was rinsed with 5 column volumes of elution buffer (100 mM sodium citrate, pH 3.5), the eluate was collected, the pH was adjusted to 6.0 with 2 M Tris, and the column was sterilized by filtration. After the purity test was qualified, the antibody coupling for ADC was carried out.
将制得的抗体hRS7溶于PBS缓冲液(thermofisher,10010023)。加入还原剂溶液(TCEP,Aldrich,Catalog Number 646547,溶于水),将反应混合物置于室温反应2-4小时,其中The prepared antibody hRS7 was dissolved in PBS buffer (thermofisher, 10010023). A reducing agent solution (TCEP, Aldrich, Catalog Number 646547, dissolved in water) was added and the reaction mixture was allowed to react at room temperature for 2-4 hours.
(i)hRS7的最佳浓度为2-10mg/mL,(i) The optimal concentration of hRS7 is 2-10 mg/mL,
(ii)TCEP/mAb的最佳摩尔比为10.0-20.0,(ii) The optimal molar ratio of TCEP/mAb is 10.0-20.0,
(iii)反应的最佳温度为20-37℃,(iii) The optimal reaction temperature is 20-37°C,
(iv)反应的最佳pH值为6.0到8.0之间。(iv) The optimal pH value of the reaction is between 6.0 and 8.0.
(b)加入过量的连接子-毒素(MB-3,溶解在DMSO中),与步骤(a)中还原的抗体反应,反应混合物放置在室温1-2小时,其中(b) adding an excess of linker-toxin (MB-3, dissolved in DMSO) to react with the antibody reduced in step (a), and the reaction mixture is placed at room temperature for 1-2 hours, wherein
(i)NT-3/mAb的最佳摩尔比为10.0~16.0,(i) The optimal molar ratio of NT-3/mAb is 10.0-16.0,
(ii)反应的最佳温度为20-37℃,(ii) The optimal reaction temperature is 20-37°C,
获得ADC粗产物。The crude ADC product was obtained.
(c)所得ADC粗产物经自旋脱盐、超滤或透析纯化得到最终ADC产物hRS7-NT3。(c) The obtained crude ADC product is purified by spin desalting, ultrafiltration or dialysis to obtain the final ADC product hRS7-NT3.
(d)使用RP-HPLC,根据UV280nm处的各个峰的峰面积计算DAR值,经计算,hRS7-NT3的DAR平均值为4.3,SEC纯度为98.42。(d) Using RP-HPLC, the DAR value was calculated based on the peak area of each peak at UV280 nm. The average DAR value of hRS7-NT3 was 4.3, and the SEC purity was 98.42.
HRS7-NT3的制备和活性验证还参见PCT/CN2024/121813中实施例4.1制备的ADC分子的制备和性质验证,所述专利申请以其全文并入本文。The preparation and activity verification of HRS7-NT3 also refer to the preparation and property verification of the ADC molecule prepared in Example 4.1 of PCT/CN2024/121813, which is incorporated herein in its entirety.
实施例2Example 2
1.受试抗体和其他药物1. Test antibodies and other drugs
研究药物:实施例1的靶向TROP2的抗体-药物偶联物的制剂(冻干粉针注射剂)处方规格:150mg/vial(西林瓶)Study drug: TROP2-targeting antibody-drug conjugate formulation of Example 1 (lyophilized powder injection) Prescription strength: 150 mg/vial (cillin bottle)
冻干制剂处方如下:The freeze-dried preparation formula is as follows:
HRS7-NT3原液、组氨酸、盐酸组氨酸、蔗糖、甘露醇和聚山梨酯80。HRS7-NT3制剂采用西林瓶、胶塞、铝塑盖包装。HRS7-NT3 stock solution, histidine, histidine hydrochloride, sucrose, mannitol, and polysorbate 80. HRS7-NT3 preparation is packaged in vials, rubber stoppers, and aluminum-plastic caps.
安慰剂无活性成分,仅含有辅料,辅料成分和pH与注射用抗体制剂一致。The placebo has no active ingredients and only contains excipients, the composition and pH of which are consistent with those of the antibody preparation for injection.
抗体制剂和辅料为均为白色至淡黄色块状疏松体,复溶后的样品外观为澄清至微乳光,无色至微黄色液体,无异物。The antibody preparation and excipients are both white to light yellow lumpy loose bodies. The appearance of the reconstituted sample is clear to slightly opalescent, colorless to slightly yellow liquid, and free of foreign matter.
注射前需将抗体制剂/安慰剂进行复溶,并进一步稀释,操作过程中需采用适当的无菌技术。产品的剂量和给药必须基于相应的研究方案,冻干粉末用注射用水复溶,并用0.9%氯化钠溶液稀释。HRS7-NT3的最终浓度应保持在1~9mg/mL之间。HRS7-NT3给药应通过配有0.2~5μm在线过滤器的静脉输液管进行。在制剂制备和处理过程中,避免剧烈振摇和混合。必须确保制备溶液无菌。The antibody preparation/placebo must be reconstituted and further diluted before injection, and appropriate aseptic technique must be used during the operation. The dosage and administration of the product must be based on the corresponding research plan. The lyophilized powder is reconstituted with water for injection and diluted with 0.9% sodium chloride solution. The final concentration of HRS7-NT3 should be maintained between 1 and 9 mg/mL. HRS7-NT3 should be administered through an intravenous infusion tube equipped with a 0.2-5 μm in-line filter. During the preparation and handling of the preparation, avoid vigorous shaking and mixing. The prepared solution must be ensured to be sterile.
2.研究目的和终点
2. Study objectives and endpoints
3.研究设计3. Study Design
本研究为所述靶向TROP2的抗体-药物偶联物HRS7-NT3的I/II期、多中心、开放标签、首次人体(First-in-human,FIH)研究。包括I期和II期。I期包括剂量递增、剂量扩展和剂量优化三个阶段,目的是确定靶向TROP2的抗体-药物偶联物HRS7-NT3的MTD/RP2D;II期阶段目的是探索靶向TROP2的抗体-药物偶联物HRS7-NT3在RP2D下在特定类型实体瘤中的有效性、安全性和耐受性。This study is a Phase I/II, multicenter, open-label, first-in-human (FIH) study of the TROP2-targeting antibody-drug conjugate HRS7-NT3. It consists of Phase I and Phase II. Phase I includes three phases: dose escalation, dose expansion, and dose optimization, with the goal of determining the MTD/RP2D of the TROP2-targeting antibody-drug conjugate HRS7-NT3. The Phase II phase aims to explore the efficacy, safety, and tolerability of the TROP2-targeting antibody-drug conjugate HRS7-NT3 in specific solid tumor types at the RP2D.
I期剂量递增阶段Phase I dose escalation phase
I期剂量递增阶段将入组局部晚期不可切除或转移性实体瘤受试者。递增阶段将使用改良的连续重评估方法(Modified Continuous Reassessment Method,MCRM),即在控制药物过量(Escalation with the Overdose Control,EWOC)原则下使用贝叶斯逻辑回归模型(Bayesian Logistic Regression Model,BLRM)。其中BLRM模型是用来评估剂量-毒性的关系,EWOC法则是指最大推荐剂量不能过毒(DLT发生率>33%的概率小于25%)。The Phase I dose-escalation phase will enroll patients with locally advanced, unresectable, or metastatic solid tumors. The escalation phase will utilize a modified continuous reassessment method (MCRM), employing a Bayesian logistic regression model (BLRM) under the principle of escalation with the overdose control (EWOC). The BLRM model is designed to assess the dose-toxicity relationship, while the EWOC principle requires that the maximum recommended dose not be overtoxic (the probability of a DLT rate >33% is less than 25%).
为确保试验的安全性以及执行的准确性,试验将按照如下规则执行:To ensure the safety and accuracy of the experiment, the experiment will be carried out in accordance with the following rules:
-基于临床前药理学和毒理学数据,靶向TROP2的抗体-药物偶联物HRS7-NT3的人体起始剂量为1.0mg/kg。-Based on preclinical pharmacology and toxicology data, the starting human dose of HRS7-NT3, an antibody-drug conjugate targeting TROP2, is 1.0 mg/kg.
-研究期间将主要基于给定的9个临时预设剂量水平(1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg/kg和16mg/kg)进行评估,但在研究过程中可能增加额外和/或中间剂量水平。此外,基于新出现的低剂量水平队列的临床数据,14mg/kg和16mg/kg给药的探索可能会终止。- The study will primarily be evaluated at nine provisional pre-specified dose levels (1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg, and 16 mg/kg), but additional and/or intermediate dose levels may be added during the study. In addition, the exploration of 14 mg/kg and 16 mg/kg dosing may be terminated based on emerging clinical data from lower dose level cohorts.
-前2个剂量水平使用加速滴定法,分别入组1例受试者,依次进入1mg/kg和2mg/kg,若某个剂量的任何受试者在DLT观察期内发生了DLT,则该剂量水平需额外入组2例受试者,且从该剂量组开始执行BLRM剂量爬坡。若均无DLT发生,下一组将包含3例受试者进入到4mg/kg,若在4mg/kg的剂量组出现超过1例DLT,则将强制降到2mg/kg剂量组。- The first two dose levels will use an accelerated titration method, with one subject enrolled in each group, starting at 1 mg/kg and 2 mg/kg, respectively. If any subject at a certain dose experiences a DLT during the DLT observation period, two additional subjects will be enrolled at that dose level, and BLRM dose escalation will be implemented starting from that dose group. If no DLT occurs, the next group will contain three subjects and enter the 4 mg/kg dose group. If more than one DLT occurs in the 4 mg/kg dose group, the dose will be forced downgraded to the 2 mg/kg dose group.
-受试者可以进入的最大推荐剂量将基于BLRM-EWOC模型计算和增量限制计算。其中增量限制为:高于4mg/kg的剂量水平不应增加超过100%,高于6mg/kg的剂量水平不应增加超过50%,高于8mg/kg的剂量水平不应增加超过33%,高于12mg/kg的剂量水平不应增加超过20%。- The maximum recommended dose to which subjects can enter will be calculated based on the BLRM-EWOC model and incremental limits, where the incremental limits are: dose levels above 4 mg/kg should not be increased by more than 100%, dose levels above 6 mg/kg should not be increased by more than 50%, dose levels above 8 mg/kg should not be increased by more than 33%, and dose levels above 12 mg/kg should not be increased by more than 20%.
-受试者进入的实际剂量将由申办者基于最大推荐剂量(BLRM-EWOC模型和增量限制)、临床安全性数据、PK数据来决定。但不可高于最大推荐剂量。-The actual dose to which the subjects are admitted will be determined by the sponsor based on the maximum recommended dose (BLRM-EWOC model and incremental limits), clinical safety data, and PK data, but may not exceed the maximum recommended dose.
-每次在每个剂量递增队列同时入组的例数为1~6例受试者。- The number of subjects enrolled simultaneously in each dose escalation cohort is 1 to 6.
-新的受试者需在当前最高剂量的受试者全部完成DLT评估且不超过1/3的DLT发生率后才可进入更高的未探索剂量。- New subjects may only enter a higher, unexplored dose after all subjects at the current highest dose have completed DLT assessments and the DLT rate does not exceed 1/3.
-剂量递增阶段在确定MTD或者多个剂量扩展推荐剂量(Recommended Dose for Expansion,RDE)后停止。其中MTD和RDE均需满足如下条件:The dose escalation phase is terminated after the MTD or multiple recommended doses for expansion (RDE) are determined. Both the MTD and RDE must meet the following conditions:
条件1:该剂量组至少包含6例受试者; Condition 1: The dose group contains at least 6 subjects;
条件2:满足如下任一标准 Condition 2: Meet any of the following criteria
该剂量组的目标毒性后验概率至少达到50%,且为当前已测剂量的最高概率; The posterior probability of the target toxicity in this dose group is at least 50%, and it is the highest probability among the currently tested doses;
共计至少20例可评估受试者已入组。 A total of at least 20 evaluable subjects have been enrolled.
条件3:由研究者和申办者基于当前临床数据讨论决定为推荐的MTD或RDE。 Condition 3: The recommended MTD or RDE is determined by the investigator and the sponsor based on the current clinical data.
本发明的靶向TROP2的抗体-药物偶联物HRS7-NT3通过静脉输注给药,每三周一次(Day1,Q3W)。I期剂量递增阶段,受试者在首次输注本发明的靶向TROP2的抗体-药物偶联物HRS7-NT3后,进入为期21天的DLT观察期。观察期结束时,将审查所有相关的安全性数据。完成第1周期后,受试者可继续接受本发明的靶向TROP2的抗体-药物偶联物HRS7-NT3每3周1次(Day1,Q3W)给药,直至出现不可耐受的毒性、疾病进展、受试者撤回知情同意、因其他原因终止研究治疗或治疗时长达到24个月(以先发生者为准)。治疗周期将连续进行,不中断,除非出现有必要干预的不良事件。在DLT观察期结束后,将继续观察受试者的安全性和耐受性。在研究治疗结束后,将继续进行安全性和长期随访。The antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention is administered by intravenous infusion once every three weeks (Day1, Q3W). In the Phase I dose escalation stage, the subjects enter a 21-day DLT observation period after the first infusion of the antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention. At the end of the observation period, all relevant safety data will be reviewed. After completing the first cycle, the subjects can continue to receive the antibody-drug conjugate HRS7-NT3 targeting TROP2 of the present invention once every 3 weeks (Day1, Q3W) until intolerable toxicity occurs, disease progression, the subject withdraws informed consent, the study treatment is terminated for other reasons, or the treatment duration reaches 24 months (whichever occurs first). The treatment cycle will be continuous and uninterrupted unless there is an adverse event that requires intervention. After the end of the DLT observation period, the safety and tolerability of the subjects will continue to be observed. After the end of the study treatment, safety and long-term follow-up will continue.
将采集血样进行PK表征和免疫原性评价。Blood samples will be collected for PK characterization and immunogenicity evaluation.
对于纳入≤4mg/kg剂量水平队列的某些受试者,允许患者自身剂量递增(intra-patient dose escalation)。受试者需在进入下一个更高剂量前完成最初指定剂量组的DLT观察。如果受试者没有在DLT观察期内出现任何会导致不能进行自身剂量递增的DLT事件,经研究者与申办者充分审查数据认为受试者安全性可得到保障的前提下,受试者可考虑进入下一个更高剂量水平。受试者进入下一个剂量组后,不可对受试者再次进行DLT评估,但仍可继续按照先前的访视计划进行安全监测、PK采样和肿瘤评估。每个受试者只允许接受一次自身剂量递增至下一个剂量水平。For certain subjects included in the ≤4 mg/kg dose level cohort, intra-patient dose escalation is allowed. The subject must complete the DLT observation of the initially assigned dose group before entering the next higher dose. If the subject does not experience any DLT event during the DLT observation period that would prevent self-dose escalation, the subject may be considered for entry into the next higher dose level after the investigator and the sponsor have fully reviewed the data and believe that the subject's safety can be guaranteed. After the subject enters the next dose group, the subject cannot be evaluated for DLT again, but safety monitoring, PK sampling and tumor assessment can continue according to the previous visit plan. Each subject is only allowed to receive one self-dose escalation to the next dose level.
I期剂量扩展阶段Phase I dose expansion phase
为进一步探索本发明的靶向TROP2的抗体-药物偶联物HRS7-NT3的安全性、耐受性、PK和初步有效性,允许在研究者和申办者进行剂量递增决定之前或进行剂量递增的同时,在已评估过的剂量水平或低于MTD估计值的中间剂量水平下增加招募受试者。基于现有数据,可扩展一个或多个剂量水平。To further explore the safety, tolerability, PK, and preliminary efficacy of the TROP2-targeting antibody-drug conjugate HRS7-NT3 of the present invention, additional subjects may be recruited at an evaluated dose level or an intermediate dose level below the estimated MTD before or during dose escalation by the investigator and sponsor. One or more dose levels may be expanded based on existing data.
I期剂量扩展阶段将入组标准治疗失败或不耐受或拒绝接受标准治疗、且根据RECIST v1.1评估至少有一个可测量病灶的不可切除局部晚期或转移性晚期三阴性乳腺癌(Triple negative Breast Cancer,TNBC,队列A)、非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC,队列B)、宫颈癌(Cervical Cancer,CC,队列C)等实体瘤受试者。扩展剂量阶段计划入组150例。The Phase I dose-expansion phase will enroll patients with unresectable, locally advanced or metastatic triple-negative breast cancer (TNBC; Cohort A), non-small cell lung cancer (NSCLC; Cohort B), cervical cancer (CC; Cohort C), or other solid tumors who have failed, are intolerant of, or refuse standard therapy and have at least one measurable lesion as assessed by RECIST v1.1. The dose-expansion phase plans to enroll 150 patients.
I期:剂量优化阶段Phase I: Dose optimization phase
每个适应症将选择最多三个剂量(可能的剂量水平:4mg/kg或6mg/kg、8mg/kg,可能包含12mg/kg Q3W)进行剂量优化。在根据I期剂量递增和剂量扩展阶段的数据确定剂量优化的推荐剂量后,将开始入组。例如,如果在队列A中选择两个剂量进行剂量优化,则受试者可能被随机分配到剂量优化队列,称为A1组和A2组。在队列A、B和C中,以每种剂量水平治疗的受试者人数约为30例。大约60~150例受试者将被纳入剂量优化阶段。Up to three doses will be selected for dose optimization for each indication (possible dose levels: 4 mg/kg or 6 mg/kg, 8 mg/kg, possibly including 12 mg/kg Q3W). Enrollment will begin after the recommended dose for dose optimization is determined based on data from the Phase I dose escalation and dose expansion phases. For example, if two doses are selected for dose optimization in cohort A, subjects may be randomly assigned to dose optimization cohorts, referred to as Group A1 and Group A2. In Cohorts A, B, and C, the number of subjects treated at each dose level will be approximately 30. Approximately 60 to 150 subjects will be included in the dose optimization phase.
受试者计划以每21天为一个周期,在每周期第1天接受本发明的靶向TROP2的抗体-药物偶联物治疗(Q3W,或以研究者和申办者根据安全性、毒性和PK数据确定的间隔时间为周期),直至出现不可接受的毒性、疾病进展、撤回知情同意、出现其他原因终止研究治疗,或最长治疗24个月,以先发生者为准。研究治疗终止后,将继续进行安全性和生存随访。RP2D将根据mCRM估计的MTD,以及I期所有受试者的安全性、初步有效性、PK信息综合评估确定。The subjects are planned to receive the antibody-drug conjugate targeting TROP2 of the present invention on the first day of each cycle in a 21-day cycle (Q3W, or the interval determined by the investigator and the sponsor based on safety, toxicity and PK data) until unacceptable toxicity, disease progression, withdrawal of informed consent, termination of study treatment for other reasons, or a maximum of 24 months of treatment, whichever occurs first. After termination of study treatment, safety and survival follow-up will continue. RP2D will be determined based on the MTD estimated by mCRM and a comprehensive assessment of the safety, preliminary efficacy, and PK information of all subjects in Phase I.
II期Phase II
II期研究将基于对已入组受试者的安全性数据、初步有效性数据和PK信息的总体评估,经申办者决定是否开展。The sponsor will decide whether to conduct the Phase II study based on an overall evaluation of the safety data, preliminary efficacy data, and PK information of the enrolled subjects.
II期将入组3个队列,各队列入组的受试者如下:Phase II will enroll three cohorts, with the following subjects in each cohort:
(4)队列A:患有不可切除的局部晚期或转移性TNBC,且既往接受过至少1线系统性抗肿瘤治疗的受试者;(4) Cohort A: subjects with unresectable locally advanced or metastatic TNBC who have received at least one line of systemic anti-tumor therapy;
(5)队列B:患有不可切除的局部晚期或转移性CC,且既往接受过至少1线系统性抗肿瘤治疗的受试者;(5) Cohort B: subjects with unresectable locally advanced or metastatic CC who have received at least one line of systemic anti-tumor therapy;
(6)队列C:患有不可切除的局部晚期或转移性NSCLC且既往接受过1或2线系统性抗肿瘤治疗的受试者。(6) Cohort C: subjects with unresectable locally advanced or metastatic NSCLC who have previously received 1 or 2 lines of systemic anti-tumor therapy.
在每个队列中,约50例受试者将入组接受RP2D下的向TROP2的抗体-药物偶联物HRS7-NT3治疗,直至出现不可接受的毒性、疾病进展、撤回知情同意、因其他原因终止研究治疗或治疗时长达到24个月,以先发生者为准。治疗周期将连续进行,不中断,除非出现有必要干预的不良事件。受试者在研究治疗终止后将继续接受安全性和生存随访。In each cohort, approximately 50 subjects will be enrolled and treated with the TROP2-directed antibody-drug conjugate HRS7-NT3 at the RP2D until unacceptable toxicity, disease progression, withdrawal of consent, discontinuation of study treatment for other reasons, or 24 months of treatment, whichever occurs first. Treatment cycles will continue without interruption unless an adverse event necessitates intervention. Subjects will continue to be followed for safety and survival after discontinuation of study treatment.
研究者将根据RECIST v1.1,采用增强计算机断层扫描(Computed Tomography,CT)或磁共振成像(Magnetic Resonance Imaging,MRI)进行肿瘤评估。在整个研究过程中,同一受试者的影像学检查方法应一致。Tumor assessment will be performed using contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) according to RECIST v1.1. Imaging methods should be consistent for the same subject throughout the study.
4.入选标准:4. Inclusion criteria:
1.理解并签署本试验的书面知情同意书,愿意并且能够遵循方案规定的访视及相关程序;1. Understand and sign the written informed consent for this trial, and be willing and able to follow the visits and related procedures specified in the protocol;
2.年龄≥18岁,性别不限;2. Age ≥ 18 years old, regardless of gender;
3.美国东部肿瘤协作组体能状态评分(Eastern Cooperative Oncology Group Performance Status,ECOGPS)为0或1分;3. Eastern Cooperative Oncology Group Performance Status (ECOGPS) score of 0 or 1;
4.预期生存时间≥12周;4. Expected survival time ≥ 12 weeks;
5.具有充分的骨髓和器官功能:5. Have adequate bone marrow and organ function:
ANC≥1.5×109/L;血小板计数(Platelet,PLT)≥100×109/L;血红蛋白(Hemoglobin,Hb)≥9.0g/dL,首次给药前至少14天内未接受促红细胞生成素(Erythropoietin,EPO)、粒细胞集落刺激因子(Granulocyte-colony Stimulating Factor,G-CSF)、粒细胞-巨噬细胞集落刺激因子(Granulocyte–Macrophage Colony Stimulating Factor,GM-CSF)和输血(包括红细胞和血小板输注);ANC ≥ 1.5 × 109/L; platelet count (PLT) ≥ 100 × 109/L; hemoglobin (Hb) ≥ 9.0 g/dL, and no erythropoietin (EPO), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), or blood transfusion (including red blood cell and platelet transfusion) within at least 14 days before the first dose;
肝功能:总胆红素≤1.5×正常值上限(Upper Limit of Normal,ULN);白蛋白≥2.8g/dL;无肝转移的患者要求AST和ALT≤2.5×ULN,有肝转移的患者要求AST和ALT≤5×ULN≥。允许接受支持治疗且肝功能在上述范围内的受试者入选;Liver function: Total bilirubin ≤ 1.5 × Upper Limit of Normal (ULN); Albumin ≥ 2.8 g/dL; Patients without liver metastasis require AST and ALT ≤ 2.5 × ULN; patients with liver metastasis require AST and ALT ≤ 5 × ULN ≥. Subjects receiving supportive care and with liver function within the above range are allowed to be enrolled;
肾功能:血清肌酐≤1.5×ULN,或肌酐清除率≥60ml/min(采用CockcroftGault公式);尿蛋白<2+或24h尿蛋白定量<1g。Renal function: serum creatinine ≤1.5×ULN, or creatinine clearance ≥60ml/min (using the Cockcroft-Gault formula); urine protein <2+ or 24-hour urine protein quantitative <1g.
凝血功能:国际标准化比值(International Normalized Ratio,INR)≤1.5;活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)≤1.5×ULN(允许接受抗凝治疗且凝血功能在上述范围内的受试者入选);Coagulation function: International Normalized Ratio (INR) ≤ 1.5; Activated Partial Thromboplastin Time (APTT) ≤ 1.5 × ULN (subjects receiving anticoagulant therapy and whose coagulation function is within the above range are allowed to be included);
6.无生育能力或同意在研究期间(从筛选开始或首次给药前2周内,以先发生者为准,持续至研究药物末次给药后6个月)使用至少一种有效避孕措施的男性和女性受试者。6. Male and female subjects who are infertile or agree to use at least one effective contraceptive method during the study (from the start of screening or within 2 weeks before the first dose, whichever occurs first, and continuing until 6 months after the last dose of study drug).
I期剂量递增阶段的额外入选标准:Additional inclusion criteria for the Phase I dose-escalation phase:
1.组织或细胞病理学确诊的局部晚期不可切除或转移性实体瘤,经标准治疗失败或对标准治疗不耐受或尚无标准治疗方案;1. Patients with locally advanced unresectable or metastatic solid tumors confirmed by histopathology or cytopathology, who have failed standard treatment or are intolerant to standard treatment or for whom there is no standard treatment option;
2.根据RECIST v1.1,至少有1个可评估病灶。2. At least one evaluable lesion according to RECIST v1.1.
I期剂量扩展阶段的额外入选标准:Additional inclusion criteria for the Phase I dose expansion phase:
1.组织或细胞病理学确诊的局部晚期不可切除或转移性TNBC、NSCLC、CC等晚期实体瘤受试者,经标准治疗失败或对标准治疗不耐受或尚无标准治疗方案;1. Subjects with locally advanced, unresectable or metastatic solid tumors such as TNBC, NSCLC, CC, confirmed by histopathology or cytopathology, who have failed standard treatment or are intolerant to standard treatment or for whom no standard treatment options are available;
2.根据RECIST v1.1,至少有1个可测量的靶病灶。2. At least one measurable target lesion according to RECIST v1.1.
II期队列A的额外入选标准:Additional inclusion criteria for Phase II Cohort A:
1.组织或细胞病理学确诊的局部晚期不可切除或转移性TNBC;1. Locally advanced unresectable or metastatic TNBC confirmed by histopathology or cytopathology;
2.既往接受过至少1线标准系统性抗肿瘤治疗,经标准治疗或对标准治疗不耐受,且目前尚无标准系统性抗肿瘤治疗方案的受试者;2. Subjects who have previously received at least one line of standard systemic anti-tumor treatment, have undergone standard treatment or are intolerant to standard treatment, and currently have no standard systemic anti-tumor treatment options;
3.根据RECIST v1.1,至少有1个可测量的靶病灶。3. At least one measurable target lesion according to RECIST v1.1.
II期队列B的额外入选标准:Additional inclusion criteria for Phase II Cohort B:
1.组织或细胞病理学确诊的局部晚期不可切除或转移性CC;1. Locally advanced unresectable or metastatic CC confirmed by histopathology or cytopathology;
2.既往接受过至少1线标准系统性抗肿瘤治疗且治疗失败或耐药,且目前尚无标准系统性抗肿瘤治疗方案;2. Patients who have received at least one line of standard systemic anti-tumor therapy and have failed or developed drug resistance, and there is currently no standard systemic anti-tumor treatment option;
3.根据RECIST v1.1,至少有1个可测量的靶病灶;3. At least one measurable target lesion according to RECIST v1.1;
II期队列C的额外入选标准:Additional inclusion criteria for Phase II Cohort C:
1.组织或细胞病理学确诊的局部晚期不可切除或转移性实体瘤,包括NSCLC;1. Locally advanced unresectable or metastatic solid tumors confirmed by histopathology or cytopathology, including NSCLC;
2.既往接受过1线或2线标准系统性抗肿瘤治疗且治疗失败或耐药,且目前尚无标准系统性抗肿瘤治疗方案;2. Patients who have previously received 1 or 2 lines of standard systemic anti-tumor therapy and have failed or developed drug resistance, and there is currently no standard systemic anti-tumor treatment option;
3.根据RECIST v1.1,至少有1个可测量的靶病灶。3. At least one measurable target lesion according to RECIST v1.1.
排除标准:Exclusion criteria:
如果受试者符合以下任一标准,则应从研究中排除:Subjects should be excluded from the study if they meet any of the following criteria:
1.正在参加其他干预性临床研究,除外观察性(非干预性)研究或处于干预性研究的生存期随访阶段。1. Participating in other interventional clinical studies, excluding observational (non-interventional) studies or those in the survival follow-up phase of interventional studies.
2.既往接受过TROP2靶向治疗。2. Patients have received TROP2 targeted therapy before.
3.在研究药物首次给药前4周内接受过既往抗肿瘤治疗,包括全身化疗、靶向治疗、免疫治疗、腹腔灌注化疗、化疗栓塞或介入性化疗。口服氟尿嘧啶类药物、小分子靶向治疗、内分泌/激素治疗及具有抗癌适应症的中草药洗脱期至少为2周或5个半衰期(以较长者为准)。3. Patients have received previous anti-cancer treatment within 4 weeks before the first dose of study drug, including systemic chemotherapy, targeted therapy, immunotherapy, intraperitoneal chemotherapy, chemoembolization, or interventional chemotherapy. The washout period for oral fluoropyrimidines, small molecule targeted therapy, endocrine/hormonal therapy, and Chinese herbal medicines with anti-cancer indications is at least 2 weeks or 5 half-lives (whichever is longer).
4.在研究药物首次给药前2周或5个半衰期(以较长的时间为准)内接受细胞色素P450 3A4(CYP3A4)强抑制剂治疗(仅适用于剂量递增阶段的受试者)。4. Receipt of a strong cytochrome P450 3A4 (CYP3A4) inhibitor within 2 weeks or 5 half-lives (whichever is longer) before the first dose of study drug (only applicable to subjects in the dose escalation phase).
5.计划在研究期间接受其他抗肿瘤治疗。以缓解症状(如疼痛)为目的的姑息性放疗除外,但该治疗必须在整个研究期间不影响肿瘤评估;5. Plan to receive other anti-tumor treatments during the study, except for palliative radiotherapy for the purpose of relieving symptoms (such as pain), but such treatment must not affect tumor assessment during the entire study period;
6.在研究药物首次给药前4周内或计划在研究期间接受减毒活疫苗接种;6. Received live attenuated vaccine within 4 weeks before the first dose of study drug or planned to receive vaccine during the study;
7.在研究药物首次给药前,既往抗肿瘤治疗导致的不良反应尚未缓解至NCI-CTCAE v5.0分级0~1级(脱发、乏力、色素沉着等研究者认为无安全性风险的情况除外);7. Before the first administration of the study drug, adverse reactions caused by previous anti-tumor treatment have not been alleviated to NCI-CTCAE v5.0 grade 0-1 (except for hair loss, fatigue, pigmentation, etc. that the researchers believe do not pose a safety risk);
8.研究药物首次给药前4周内接受过重大手术(开颅、开胸或开腹手术或由研究者定义的其它重大手术,不包括穿刺活检),或计划在研究期间接受大手术,或有严重未愈合的伤口、创伤、溃疡等;8. Patients who have undergone major surgery (craniotomy, thoracotomy, or laparotomy, or other major surgery defined by the investigator, excluding puncture biopsy) within 4 weeks before the first dose of study drug, or plan to undergo major surgery during the study, or have severe unhealed wounds, trauma, ulcers, etc.;
注:允许对孤立病灶的姑息性局部手术治疗,该治疗在整个研究期间不能影响肿瘤评估。Note: Palliative local surgical treatment of isolated lesions is allowed, provided that the treatment does not affect the tumor assessment during the entire study period.
9.幽门梗阻和/或持续反复呕吐(24小时内呕吐≥3次);9. Pyloric obstruction and/or persistent recurrent vomiting (vomiting ≥ 3 times within 24 hours);
10.研究药物首次给药前6个月内发生胃肠道穿孔和/或瘘,且经手术治疗未恢复者;10. Patients with gastrointestinal perforation and/or fistula occurring within 6 months before the first administration of study drug and not recovered after surgical treatment;
11.已知有症状的中枢神经系统(Central Nervous System,CNS)转移。对于无症状的CNS转移(即,无神经系统症状,不需要皮质类固醇治疗,且脑转移病灶均≤1.5厘米)或经研究者判断治疗后病情稳定的受试者,在以下情况可考虑参加本研究:无中脑、脑桥、小脑、脑膜、延髓或脊髓转移;临床上稳定至少4周,临床证据确切证实无新发或扩大的脑转移病灶;研究药物首次给药前停用皮质类固醇或抗惊厥类药物至少2周;11. Known symptomatic central nervous system (CNS) metastases. Subjects with asymptomatic CNS metastases (i.e., no neurological symptoms, no need for corticosteroid treatment, and brain metastases ≤ 1.5 cm) or whose condition is stable after treatment as determined by the investigator may be considered for participation in this study if: no midbrain, pons, cerebellum, meninges, medulla oblongata, or spinal cord metastases; clinical stability for at least 4 weeks, with clinical evidence confirming the absence of new or enlarged brain metastases; and discontinuation of corticosteroids or anticonvulsants for at least 2 weeks before the first dose of study drug.
12.有需要皮质类固醇治疗的肺炎病史,或具有临床意义的肺部疾病病史(包括间质性肺病、非感染性肺炎、或控制不佳的肺部疾病如肺纤维化、严重的放射性肺炎和急性肺损伤等),或在筛选期通过影像学检查怀疑患有此类疾病。12. Have a history of pneumonia requiring corticosteroid treatment, or a history of clinically significant lung disease (including interstitial lung disease, non-infectious pneumonia, or poorly controlled lung disease such as pulmonary fibrosis, severe radiation pneumonitis, and acute lung injury, etc.), or be suspected of having such diseases through imaging examinations during the screening period.
13.控制不佳的以下疾病:13. Poorly controlled diseases such as:
研究药物首次给药前2周内发生需要全身使用抗生素、抗病毒药物或抗真菌药物的活动性或临床控制不佳的感染;Active or clinically poorly controlled infection requiring systemic antibiotics, antivirals, or antifungals within 2 weeks before the first dose of study drug;
已知人类免疫缺陷病毒(Human Immunodeficiency Virus,HIV)感染,或HIV阳性(HIV-1/2抗体阳性);Known human immunodeficiency virus (HIV) infection, or HIV positive (HIV-1/2 antibody positive);
急性或慢性活动性乙型肝炎(乙型肝炎表面抗原[Hepatitis B Surface Antigen,HBsAg]阳性和/或乙型肝炎核心抗体[hepatitis B Core Antibody,HBcAb]阳性,乙型肝炎病毒[hepatitis B Virus,HBV]DNA滴度≥1×104拷贝/ml或≥2000IU/ml或高于检测下限≥≥),或急性或慢性活动性丙型肝炎(丙型肝炎病毒[Hepatitis C Virus,HCV]抗体阳性,HCV RNA>103拷贝/ml);Acute or chronic active hepatitis B (positive hepatitis B surface antigen [HBsAg] and/or positive hepatitis B core antibody [HBcAb], hepatitis B virus [HBV] DNA titer ≥1× 104 copies/ml or ≥2000 IU/ml or above the limit of detection ≥≥), or acute or chronic active hepatitis C (positive hepatitis C virus [HCV] antibody, HCV RNA >103 copies/ml);
活动性COVID-19感染;活动性结核感染,或仍在接受抗结核治疗,或在研究药物首次给药前1年内接受过抗结核治疗;需要治疗的活动性或潜伏期梅毒;症状性充血性心力衰竭II~IV级(基于纽约心脏病协会[New York Heart Association,NYHA]分级);症状性或控制不佳的心律失常,QTcF>480ms或有先天性长/短QT综合征个人或家族史;控制不佳的高血压(收缩压≥160mmHg或舒张压≥100mmHg);Active COVID-19 infection; active tuberculosis infection, or still receiving anti-tuberculosis treatment, or received anti-tuberculosis treatment within 1 year before the first dose of study drug; active or latent syphilis requiring treatment; symptomatic congestive heart failure class II-IV (based on New York Heart Association [NYHA] classification); symptomatic or poorly controlled arrhythmias, QTcF>480ms or personal or family history of congenital long/short QT syndrome; poorly controlled hypertension (systolic blood pressure ≥160mmHg or diastolic blood pressure ≥100mmHg);
14.研究药物首次给药前6个月内有动脉血栓栓塞事件史,包括心肌梗死、不稳定型心绞痛、脑血管卒中或短暂性脑缺血发作等;14. History of arterial thromboembolic events within 6 months before the first dose of study drug, including myocardial infarction, unstable angina, cerebrovascular stroke or transient ischemic attack;
15.肿瘤侵犯周围重要脏器(如纵隔血管、上腔静脉、气管、食管等),或存在发生胃肠道/呼吸道瘘的风险;15. The tumor invades surrounding important organs (such as mediastinal vessels, superior vena cava, trachea, esophagus, etc.), or there is a risk of gastrointestinal/respiratory fistula;
16.有临床症状且需要引流干预的腹水、胸水或心包积液;16. Ascites, pleural effusion, or pericardial effusion with clinical symptoms requiring drainage intervention;
17.需要立即干预的食管或胃静脉曲张(例如,结扎或硬化治疗)或根据研究者的意见或咨询胃肠病学专家或肝脏病学专家认为其出血风险较高;有门静脉高压证据(包括影像学检查发现脾大)或既往有静脉曲张出血病史的受试者在首次给药前3个月内必须接受内镜评估;17. Esophageal or gastric varices requiring immediate intervention (e.g., ligation or sclerotherapy) or considered to have a high risk of bleeding based on the opinion of the investigator or consultation with a gastroenterologist or hepatologist; subjects with evidence of portal hypertension (including splenomegaly found on imaging examinations) or a history of variceal bleeding must undergo endoscopic evaluation within 3 months prior to the first dose;
18.患有胆道梗阻,除外梗阻经内镜下支架置入术或经皮肝穿刺引流术等局部治疗且总胆红素降至1.5×ULN以下的受试者;18. Subjects with biliary obstruction, excluding those whose obstruction has been treated locally with endoscopic stent placement or percutaneous transhepatic drainage and whose total bilirubin has dropped below 1.5×ULN;
19.在研究药物首次给药前3个月内发生任何危及生命的出血事件或需要输血、内镜或手术治疗的3或4级胃肠道/静脉曲张出血事件;19. Any life-threatening bleeding event or grade 3 or 4 gastrointestinal/variceal bleeding event requiring blood transfusion, endoscopic or surgical treatment within 3 months before the first dose of study drug;
20.研究药物首次给药前3个月内有深静脉血栓形成、肺栓塞或任何其他严重静脉血栓栓塞史(植入式静脉输液港或导管源性血栓,或浅表静脉血栓形成不视为“严重”血栓栓塞);20. History of deep vein thrombosis, pulmonary embolism, or any other severe venous thromboembolism within 3 months before the first dose of study drug (implanted venous port or catheter-derived thrombosis, or superficial vein thrombosis is not considered "severe" thromboembolism);
21.肝性脑病、肝肾综合征或Child-Pugh B级或以上肝硬化;21. Hepatic encephalopathy, hepatorenal syndrome, or Child-Pugh grade B or above cirrhosis;
22.存在胃肠道梗阻或穿孔风险(包括但不限于:急性憩室炎、腹腔脓肿)或有炎症性肠病或广泛肠切除(部分结肠切除或广泛小肠切除伴慢性腹泻)、克罗恩病、溃疡性结肠炎或慢性腹泻病史;22. Risk of gastrointestinal obstruction or perforation (including but not limited to acute diverticulitis, intra-abdominal abscess) or history of inflammatory bowel disease or extensive intestinal resection (partial colectomy or extensive small bowel resection with chronic diarrhea), Crohn's disease, ulcerative colitis, or chronic diarrhea;
23.明显的营养不良,例如需要静脉输液;如营养不良在研究药物首次给药4周前已完成纠正,则可以入选;23. Obvious malnutrition, such as requiring intravenous infusion; patients may be included if malnutrition has been corrected 4 weeks before the first dose of study drug;
24.可能导致以下结果的其它急性或慢性疾病或实验室检测值异常:增加研究参与或研究药物给药的相关风险,或者干扰研究结果的解读,而且根据研究者的判断将受试者列为不符合参加本研究的资格;24. Other acute or chronic diseases or abnormal laboratory test values that may result in: increasing the risks associated with study participation or study drug administration, or interfering with the interpretation of study results, and according to the investigator's judgment, classifying the subject as ineligible for participation in this study;
25.已知5年内合并其他恶性肿瘤病史,除外已充分切除的非黑色素瘤皮肤癌、原位癌和已治愈的非浸润性肿瘤;25. Known history of other malignant tumors within 5 years, excluding fully resected non-melanoma skin cancer, carcinoma in situ, and cured non-invasive tumors;
26.已知免疫缺陷疾病史,包括先天性或获得性免疫缺陷疾病;26. History of known immunodeficiency disease, including congenital or acquired immunodeficiency disease;
27.已知器官移植、异基因骨髓移植或造血干细胞移植史;27. Known history of organ transplantation, allogeneic bone marrow transplantation, or hematopoietic stem cell transplantation;
28.已知对其他单克隆抗体或基于依喜替康(Exatecan)的治疗或本发明的靶向TROP2的抗体-药物偶联物的任何制剂成分过敏;28. Known hypersensitivity to other monoclonal antibodies or Exatecan-based treatments or any formulation components of the TROP2-targeting antibody-drug conjugates of the present invention;
29.允许既往使用伊立替康或其他喜树碱类药物(如拓扑替康),除非已知既往有此类药物过敏反应史或≥3级消化道毒性史;29. Previous use of irinotecan or other camptothecins (such as topotecan) is allowed, unless there is a known history of allergic reaction to such drugs or a history of grade 3 or higher gastrointestinal toxicity;
30.处于妊娠状态或哺乳期的女性受试者。30. Female subjects who are pregnant or breastfeeding.
31.符合以下特征的神经、精神疾病/社会状况:影响研究要求的依从性,显著增加不良事件风险,或影响受试者提供书面知情同意书的能力。31. Neurological or psychiatric illnesses/social conditions that affect compliance with study requirements, significantly increase the risk of adverse events, or affect the subject's ability to provide written informed consent.
32.研究者认为不符合参加本研究的资格。32. The researcher considers that the candidate is not eligible to participate in this study.
5.剂量限制毒性5. Dose-limiting toxicity
剂量限制性毒性(Dose-limiting Toxicity,DLT)的定义Definition of Dose-Limiting Toxicity (DLT)
将按照美国国家癌症研究所不良事件通用术语标准(National Institutes of Health Common Terminology Criteria for Adverse Events,NCI CTCAE)5.0版进行毒性评价。Toxicity evaluation will be performed according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0.
DLT定义为在DLT观察期内发生下列任何一种与HRS7-NT3相关的AE:DLT was defined as any of the following HRS7-NT3-related AEs occurring during the DLT observation period:
对于血液学毒性,DLT定义为:For hematologic toxicity, DLT was defined as:
·持续>7天的4级中性粒细胞减少症;Grade 4 neutropenia lasting for more than 7 days;
·≥3级发热性中性粒细胞减少症(定义为中性粒细胞绝对计数(Absolute Neutrophil Count,ANC)<1.0×109/L,且单次体温>38.3℃或体温≥38℃持续>1h),经过充分的支持治疗,持续>7天;Grade 3 or higher febrile neutropenia (defined as an absolute neutrophil count (ANC) <1.0 × 10⁹/L and a single temperature >38.3°C or a temperature ≥38°C for >1 hour) persisting for >7 days despite adequate supportive care;
·无法用基础疾病解释的4级贫血;Grade 4 anemia that cannot be explained by underlying disease;
·4级血小板减少;Grade 4 thrombocytopenia;
·持续>7天的≥3级血小板减少;Grade 3 or higher thrombocytopenia lasting for more than 7 days;
·伴有临床意义的出血的≥3级血小板减少。Grade 3 or higher thrombocytopenia with clinically significant bleeding.
对于非血液学毒性,DLT定义为:For non-hematologic toxicities, DLT was defined as:
1.任何≥3级非实验室检查异常表现的器官毒性,以下情况除外:1. Any organ toxicity ≥ Grade 3 without laboratory abnormalities, except for the following:
·3级关节痛;Grade 3 arthralgia;
·3级肌痛;Grade 3 myalgia;
·3级脱发;Grade 3 hair loss;
·3级疲劳/乏力;Grade 3 fatigue/asthenia;
·3级高血压或低血压;Grade 3 hypertension or hypotension;
·3级皮肤反应,包括皮疹、瘙痒、皮肤干燥、皮肤裂隙和甲沟炎;Grade 3 skin reactions, including rash, pruritus, dry skin, skin fissures, and paronychia;
·3级粘膜炎症或口腔黏膜炎,经充分治疗后7天内缓解至≤2级;Grade 3 mucosal inflammation or oral mucositis that resolves to ≤ Grade 2 within 7 days after adequate treatment;
·3级恶心、呕吐、腹泻或食欲下降,经充分治疗后3天内缓解至≤2级;Grade 3 nausea, vomiting, diarrhea, or decreased appetite that resolves to ≤ Grade 2 within 3 days after adequate treatment;
2.任何≥3级需要治疗或导致住院的血液学以外的其他实验室检查异常,以下情况除外:2. Any laboratory abnormality other than hematology that is grade 3 or higher and requires treatment or leads to hospitalization, except for the following:
·3级电解质异常;Grade 3 electrolyte abnormalities;
·3~4级γ-谷氨酰转移酶(Gamma Glutamyl Transpeptidase,GGT)升高;Grade 3-4 elevated gamma-glutamyltransferase (GGT);
·3~4级天门冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)或丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)升高,经充分治疗后7天内缓解至≤2级;Grade 3-4 aspartate aminotransferase (AST) or alanine aminotransferase (ALT) elevation that resolves to ≤ Grade 2 within 7 days after adequate treatment;
·3~4级总胆红素升高,经充分治疗后3天内缓解至≤2级;Grade 3-4 total bilirubin elevation that resolves to ≤ Grade 2 within 3 days after adequate treatment;
·与体征或症状无关的孤立实验室检查结果,包括3~4级碱性磷酸酶(Alkaline Phosphatase,ALP)升高、高尿酸血症、血清淀粉酶升高、脂肪酶升高等。Isolated laboratory test results not associated with signs or symptoms, including grade 3-4 elevated alkaline phosphatase (ALP), hyperuricemia, elevated serum amylase, and elevated lipase.
任何5级与药物相关的AE均定义为DLT。Any grade 5 drug-related AE was defined as a DLT.
经由研究者与安全性评估小组(Safety Evaluation Team,SET)讨论后确定为DLT的其 他AE。 Other AEs identified as DLTs after discussion between the investigator and the Safety Evaluation Team ( SET ).
6.评价指标6. Evaluation Metrics
6.1安全性评估6.1 Safety Assessment
·AE,将采用NCI CTCAE v5.0进行报告,包括:所有治疗期不良事件(Treatment-emergent Adverse Event,TEAE)、特别关注不良事件(Adverse Event of Special Interest,AESI)、严重不良事件(Serious Adverse Event,SAE)以及与研究药物的相关性。AEs will be reported using NCI CTCAE v5.0, including all treatment-emergent adverse events (TEAEs), adverse events of special interest (AESIs), serious adverse events (SAEs), and those related to study drug.
·治疗前、期间、后的生命体征(包括体温、脉搏、呼吸频率、血氧饱和度和血压)、体格检查(每次访视时的体重和肺/心脏评估)、12导联ECG、ECOG体能状态和实验室检查。Vital signs (including temperature, pulse, respiratory rate, oxygen saturation, and blood pressure), physical examination (weight and pulmonary/cardiac assessment at each visit), 12-lead ECG, ECOG performance status, and laboratory tests before, during, and after treatment.
不良事件的定义Definition of adverse events
不良事件定义为临床试验受试者在签署知情同意书开始发生的任何不良医疗事件,无论是否与研究药物有因果关系,均判定为不良事件,AE包括但不限于以下情况:Adverse events are defined as any adverse medical events that occur to clinical trial subjects after they sign the informed consent form, regardless of whether they are causally related to the study drug. AEs include but are not limited to the following:
·原有的(进入临床试验前)医学状况/疾病的加重(包括症状,体征,实验室检查异常的加重)。Exacerbation of existing medical conditions/diseases (including aggravation of symptoms, signs, and laboratory abnormalities) prior to entering the clinical trial.
·新发生的任何的不良医学状况(包括症状,体征,新诊断的疾病);Any new adverse medical condition (including symptoms, signs, and newly diagnosed diseases);
·异常的具有显著临床意义的实验室检查值或者结果。Abnormal clinically significant laboratory test values or results.
严重不良事件的定义Definition of serious adverse events
严重不良事件是指符合以下至少一条标准的不良事件:A serious adverse event is an adverse event that meets at least one of the following criteria:
·导致死亡,不包括研究适应症中因疾病进展导致的死亡。Resulting in death, excluding death due to disease progression in the investigational indication.
·危及生命(“危及生命”定义为当其发生时受试者有死亡风险的AE,而不包括如果事件加重才可能引起死亡的AE)。Life-threatening ("life-threatening" is defined as an AE that carries a risk of death when it occurs, and does not include AEs that could result in death only if the event worsens).
·需要住院或延长住院时间,不包括以下情况:·Requires hospitalization or prolonged hospitalization, excluding the following:
a)康复机构;a) Rehabilitation institutions;
b)疗养院;b) Nursing homes;
c)常规急诊室收治;c) routine emergency room admission;
d)当日手术(例如门诊/当日/非卧床的手术);d) Same-day surgery (e.g. outpatient/same-day/ambulatory surgery);
e)与AE恶化无关的住院治疗或住院时间延长本身不是SAE。例如:因原有疾病入院,并且没有新的AE和原发疾病加重(例如,检查甚至在研究试验之前就持续存在的实验室检查异常);因管理原因住院(如:每年例行的体检);临床试验期间试验方案规定的住院(如:按试验方案的要求进行操作);与不良事件恶化无关的择期住院(如:择期手术);已预定的治疗或外科手术应在整个试验方案和/或受试者个人的基线资料中予以记录;仅因为血液品使用而入院。e) Hospitalization or prolonged hospitalization not related to worsening of an AE is not an SAE in itself. Examples include: hospitalization for a pre-existing condition without new AEs and worsening of the underlying condition (e.g., laboratory abnormalities that persisted even before the study); hospitalization for administrative reasons (e.g., annual physical examinations); hospitalization during a clinical trial that is protocol-mandated (e.g., to perform procedures as required by the protocol); elective hospitalization not related to worsening of an adverse event (e.g., elective surgery); scheduled treatments or surgical procedures that should be documented throughout the trial protocol and/or in the subject's individual baseline data; and hospitalization solely for the use of blood products.
·导致永久或严重的残疾/能力丧失。· Resulting in permanent or severe disability/incapacity.
·导致先天性异常/出生缺陷。Cause congenital anomalies/birth defects.
·其他重要医学事件:定义为可能危及受试者且可能需要医疗或手术干预以预防上述结局的事件。Other important medical events: defined as events that could endanger the subject and may require medical or surgical intervention to prevent the above outcomes.
特别关注不良事件Special attention to adverse events
特别关注的不良事件(Adverse Event of Special Interest,AESI)指需要密切监测以增进对研究药物安全性的理解的不良事件。AESI可以是非严重事件,主要包括:Adverse Event of Special Interest (AESI) refers to an adverse event that requires close monitoring to improve the understanding of the safety of the investigational drug. AESI can be non-serious events and mainly include:
·≥3级血液学毒性(包括≥3级白细胞减少、≥3级中性粒细胞减少、≥3级贫血、≥3级血小板减少);Grade 3 or higher hematologic toxicity (including grade 3 or higher leukopenia, grade 3 or higher neutropenia, grade 3 or higher anemia, and grade 3 or higher thrombocytopenia);
·≥3级肝功能障碍(包括≥3级ALT/AST升高,≥3级TBIL或DBIL升高);Grade 3 or higher hepatic dysfunction (including grade 3 or higher ALT/AST elevation, grade 3 or higher TBIL or DBIL elevation);
·≥3级IRR,包括过敏反应;Grade 3 or higher IRR, including allergic reactions;
·≥3级口腔黏膜炎/口炎,包括粘膜炎症;Grade 3 or higher oral mucositis/stomatitis, including inflammation of the mucosa;
·≥2级眼表毒性。≥Grade 2 ocular surface toxicity.
AESI收集时间为HRS7-NT3首次给药至末次给药后30天。如果在末次给药后30天内开始新的抗肿瘤治疗,则仅收集与研究药物相关的AESI。AESIs were collected from the first dose of HRS7-NT3 to 30 days after the last dose. If a new anti-tumor treatment was initiated within 30 days of the last dose, only AESIs related to the study drug were collected.
AESI应在获知事件后24小时内报告给申办者,无论其严重性如何(即包括严重和非严重AE),遵循上述SAE程序,并需要加强数据收集。AESI should be reported to the sponsor within 24 hours of becoming aware of the event, regardless of severity (i.e., including serious and non-serious AEs), following the SAE procedures described above, and requiring enhanced data collection.
6.2有效性评估6.2 Effectiveness Evaluation
诊断性影像学检查用于疾病评估,其中肿瘤影像学检查通常采用造影剂增强CT或增强MRI,检查部位必须包括胸部、腹部以及盆腔。筛选期影像学检查需要在研究药物首次给药前28天内进行(除外骨扫描检查)。首次给药后48周内,每6周(±7天)进行一次肿瘤影像学评估;第48周后,每12周(±7天)进行一次肿瘤影像学评估,直到开始接受新的抗肿瘤治疗、疾病进展、受试者撤回知情同意、研究终止、失访或死亡,以先发生者为准。对于所有影像学检查时间点,将根据RECIST v1.1记录以下内容:靶病灶,包括大小、位置和类型(结节/非结节);靶病灶直径总和,包括位置和类型;非靶病灶;试验期间发现的任何新病灶,包括大小、位置和类型(结节/非结节)。Diagnostic imaging studies are used for disease assessment, among which tumor imaging studies usually use contrast-enhanced CT or enhanced MRI, and the examination sites must include the chest, abdomen, and pelvis. Screening imaging studies need to be performed within 28 days before the first dose of study drug (except bone scan). Tumor imaging assessments are performed every 6 weeks (±7 days) within 48 weeks after the first dose; after week 48, tumor imaging assessments are performed every 12 weeks (±7 days) until the start of new anti-tumor treatment, disease progression, subject withdrawal of informed consent, study termination, loss to follow-up, or death, whichever occurs first. For all imaging examination time points, the following will be recorded according to RECIST v1.1: target lesions, including size, location, and type (nodular/non-nodular); sum of target lesion diameters, including location and type; non-target lesions; any new lesions found during the trial, including size, location, and type (nodular/non-nodular).
根据RECIST v1.1,每6~12周进行一次肿瘤评估。Tumor assessments were performed every 6 to 12 weeks according to RECIST v1.1.
ο客观缓解率(ORR)Objective response rate (ORR)
ο缓解持续时间(DoR)o Duration of remission (DoR)
ο疾病控制率(DCR)οDisease control rate (DCR)
ο至缓解时间(TTR)Time to remission (TTR)
ο无进展生存期(PFS)οProgression-free survival (PFS)
ο总生存期(OS)Overall survival (OS)
6.3 PK评估:6.3 PK Assessment
·PK参数,包括但不限于:AUC、Cmax、Tmax、CL、V和t1/2。PK parameters, including but not limited to: AUC, Cmax, Tmax, CL, V and t1/2.
6.4免疫原性:6.4 Immunogenicity
·ADA和/或中和抗体(Neutralizing Antibody,NAb)的发生率和特征。The incidence and characteristics of ADA and/or neutralizing antibodies (NAb).
每例受试者进行抗药(HRS7-NT3)(Anti-drug Antibody,ADA)检测。ADA阳性血清样本可进行中和抗体(Neutralizing Antibody,NAb)检测。将使用含有凝块激活剂的真空采血管,采集3.5ml全血。然后分离血清并冷冻储存,用于ADA检测。Each subject will undergo anti-drug antibody (ADA) testing for HRS7-NT3. ADA-positive serum samples can be tested for neutralizing antibodies (NAb). 3.5 ml of whole blood will be collected using a vacutainer containing a clot activator. Serum will then be separated and stored frozen for ADA testing.
将在至少接受过一次研究药物给药的受试者中总结HRS7-NT3的ADA发生率。The incidence of HRS7-NT3 ADA will be summarized in subjects who received at least one dose of study drug.
6.5生物标志物评估:6.5 Biomarker Assessment:
·采用福尔马林固定和石蜡包埋(Formalin-fixed and Paraffin-embedded,FFPE)组织切片确认的肿瘤TROP2表达。Tumor TROP2 expression was confirmed using formalin-fixed and paraffin-embedded (FFPE) tissue sections.
7.统计方法7. Statistical Methods
样本量确定:Sample size determination:
I期研究包括剂量递增阶段、剂量扩展阶段和剂量优化阶段。I期研究的样本量取决于所评估的剂量水平数量、DLT的发生、剂量扩展和剂量优化。I期剂量递增阶段计划入组约20~32例受试者,I期剂量扩展阶段计划入组约50~110例受试者,I期剂量优化阶段计划入组约60~150例受试者。The Phase I study consists of a dose-escalation phase, a dose-expansion phase, and a dose-optimization phase. The sample size of the Phase I study depends on the number of dose levels evaluated, the occurrence of DLTs, and the number of dose expansion and optimization phases. The Phase I dose-escalation phase is planned to enroll approximately 20 to 32 subjects, the Phase I dose-expansion phase is planned to enroll approximately 50 to 110 subjects, and the Phase I dose-optimization phase is planned to enroll approximately 60 to 150 subjects.
II期研究的样本量情况如下:The sample sizes for the Phase II study are as follows:
队列A:对于首选剂量,假设HRS7-NT3在不可切除的局部晚期或转移性TNBC受试者中ORR为27%且脱落率10%,则样本量为50例时将有80%的把握观察到95%置信区间的下限大于12%。Cohort A: For the preferred dose, assuming an ORR of 27% with HRS7-NT3 and a 10% dropout rate in subjects with unresectable locally advanced or metastatic TNBC, a sample size of 50 subjects would provide 80% confidence that the lower limit of the 95% confidence interval would be greater than 12%.
队列B和C:样本量不进行正式统计假设。每个队列将有约50例受试者接受治疗。Cohorts B and C: No formal statistical assumptions are made about sample size. Approximately 50 subjects will be treated in each cohort.
统计分析方法:Statistical analysis methods:
若无特殊说明,将以适当方式按剂量水平/队列提供选定人口统计学、安全性、有效性和PK数据的描述性统计量。连续性变量采用例数、均数、标准差、中位数、最小值和最大值进行描述;分类变量采用例数和百分比进行描述。若适用,将以图的形式对数据进行呈现。Unless otherwise specified, descriptive statistics for selected demographic, safety, efficacy, and PK data are presented by dose level/cohort, as appropriate. Continuous variables are described using number of cases, mean, standard deviation, median, minimum, and maximum values; categorical variables are described using number of cases and percentages. Data are presented graphically, where applicable.
7.1安全性和耐受性分析7.1 Safety and Tolerability Analysis
·将采用NCI CTCAE v5.0标准对不良事件等级进行判断,对编码后的TEAEs、TRAEs、AESI、SAEs以及与导致研究药物停止的AEs将按照系统器官分类和首选术语进行汇总。Adverse events will be graded using the NCI CTCAE v5.0 criteria. Coded TEAEs, TRAEs, AESIs, SAEs, and AEs leading to study drug discontinuation will be summarized by system organ class and preferred terminology.
·将按剂量水平对DLT进行描述性总结。DLTs will be summarized descriptively by dose level.
·对治疗前后的生命体征、体格检查、12导联ECG、ECOG体能状态和实验室检查将按剂量水平/队列进行描述性总结。Pre- and post-treatment vital signs, physical examinations, 12-lead ECGs, ECOG performance status, and laboratory tests will be summarized descriptively by dose level/cohort.
·AEAE
根据国际医学用语词典(Medical Dictionary for Regulatory Activities,MedDRA)编码,将按系统器官分类、首选术语和剂量水平/队列汇总TEAE、TRAE、AESI、SAE、导致终止用药的AE等的发生率和严重程度(根据NCI CTCAE 5.0版)。The incidence and severity of TEAEs, TRAEs, AESIs, SAEs, and AEs leading to discontinuation of treatment will be summarized by system organ class, preferred term, and dose level/cohort based on Medical Dictionary for Regulatory Activities (MedDRA) codes (according to NCI CTCAE version 5.0).
如必要,将HRS7-NT3的PK数据汇总进行Pop PK分析。如果进行分析,将单独报告。If necessary, the PK data of HRS7-NT3 will be pooled for Pop PK analysis. If this analysis is performed, it will be reported separately.
对因不良事件而终止用药的受试者、发生SAE的受试者和死亡受试者会列表说明(包括AE开始日期、结束日期、严重程度、与药物的关系、采取的措施、转归等信息)。A list will be provided for subjects who discontinued medication due to adverse events, subjects who developed SAEs, and subjects who died (including the start date, end date, severity, relationship with the drug, measures taken, outcome, etc. of the AE).
·实验室检查Laboratory tests
将描述性统计实验室检查定量指标检测值及相对基线的变化值。基于CTCAE v5.0,将采用交叉表描述基线后最严重的结果相对基线的变化情况。Descriptive statistics will be presented for quantitative laboratory test values and changes from baseline. Based on CTCAE v5.0, cross-tabulations will be used to describe the change in the most severe outcome from baseline.
·心电图检查Electrocardiogram
将描述性统计ECG定量指标测量值及相对基线的变化值。将采用交叉表汇总基线后最严重的结果相对基线的变化情况。Descriptive statistics will be presented for ECG quantitative index measurements and changes from baseline. Cross-tabulations will be used to summarize the changes from baseline in the most severe outcome.
·生命体征、体格检查和其他安全性相关的检查Vital signs, physical examination, and other safety-related examinations
将描述性统计生命体征的测量值及相对基线的变化值。Descriptive statistics will be presented for the measurements of vital signs and the changes from baseline.
将对体格检查和其他安全性检查较基线有异常变化的受试者进行列表。Subjects with abnormal changes from baseline in physical examination and other safety studies will be listed.
7.2免疫原性:7.2 Immunogenicity
将按剂量水平/队列对ADA和/或NAb进行描述性总结。ADA and/or NAb will be summarized descriptively by dose level/cohort.
7.3有效性分析:7.3 Effectiveness Analysis:
将计算ORR和DCR及其95%置信区间(Confidence Interval,CI)。将采用Kaplan-Meier法分析PFS、DoR、TTR和OS。ORR and DCR and their 95% confidence intervals (CI) will be calculated. PFS, DoR, TTR, and OS will be analyzed using the Kaplan-Meier method.
ORR定义为达到CR或PR的受试者比例。将总结CR或PR受试者的例数和百分比。将采用Clopper-Pearson方法估计ORR的95%CI。The ORR is defined as the proportion of subjects who achieved a CR or PR. The number and percentage of subjects with a CR or PR will be summarized. The 95% confidence interval (CI) for the ORR will be estimated using the Clopper-Pearson method.
DCR定义为达到CR、PR或SD的受试者比例。DCR的分析方法同ORR。DCR is defined as the proportion of subjects who achieved CR, PR, or SD. The analysis method for DCR is the same as that for ORR.
DoR定义为从首次达到CR或PR至首次记录疾病进展(基于RECIST v1.1)或死亡的时间。DoR分析仅纳入CR或PR受试者。在分析截止日期仍存活且无疾病进展的受试者将被删失。将采用Kaplan-Meier法分析DoR。DoR was defined as the time from the first achievement of a CR or PR to the first documented disease progression (based on RECIST v1.1) or death. Only subjects with a CR or PR were included in the DoR analysis. Subjects who were alive and without disease progression at the analysis cutoff date were censored. DoR was analyzed using the Kaplan-Meier method.
PFS定义为从首次研究药物给药日期至死亡或疾病进展(基于RECIST v1.1)的时间,以先发生者为准。分析截止日期时存活且无疾病进展的受试者将删失于末PFS was defined as the time from the first dose of study drug to death or disease progression (based on RECIST v1.1), whichever occurred first. Subjects who were alive and without disease progression at the analysis cutoff date were censored at the end of the analysis.
次已知肿瘤评估。PFS将采用Kaplan-Meier法进行分析。PFS will be analyzed using the Kaplan-Meier method.
TTR定义为从首次研究药物给药日期至首次达到CR或PR(基于RECIST v1.1)的时间。TTR分析仅纳入CR或PR受试者。将采用Kaplan-Meier法总结TTR。The time to complete remission (TTR) was defined as the time from the first dose of study drug to the first complete response (CR) or complete response (PR) according to RECIST v1.1. Only subjects with a complete response (CR) or complete response (PR) were included in the TTR analysis. The Kaplan-Meier method was used to summarize the TTR.
OS定义为从研究药物首次给药日期至因任何原因死亡的时间。分析截止日期时仍存活的受试者将被删失。将采用Kaplan-Meier法对OS进行分析。OS was defined as the time from the first dose of study drug to death from any cause. Subjects who were alive at the analysis cutoff date were censored. OS was analyzed using the Kaplan-Meier method.
7.4药代动力学分析:7.4 Pharmacokinetic Analysis
将对本发明的靶向TROP2的抗体-药物偶联物的PK参数进行描述性统计。Descriptive statistics will be performed on the PK parameters of the antibody-drug conjugate targeting TROP2 of the present invention.
将对PK分析集进行PK分析。密集采样的PK数据将主要使用非房室模型方法分析。将确定受试者的主要PK参数,包括但不限于AUC、Cmax、Tmax、CL、V、t1/2。PK analysis will be performed on the PK analysis set. The densely sampled PK data will be analyzed primarily using non-compartmental methods. Key PK parameters will be determined for each subject, including but not limited to AUC, Cmax, Tmax, CL, V, and t1/2.
·探索性分析:Exploratory analysis:
若适用,将进一步地探索肿瘤TROP2表达与初步有效性之间的关系。If applicable, the relationship between tumor TROP2 expression and preliminary efficacy will be further explored.
8.给药方法及过程8. Method and process of administration
给药剂量:Dosage:
1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg、14mg/kg或16mg/kg。实际给药剂量(mg)将根据受试者的体重(kg)计算。首次给药剂量根据受试者基线体重计算。如果受试者的体重较基线(研究治疗首次给药时)变化小于±10%,则将使用基线体重计算给药量,否则,将根据计划给药日或给药前一天的体重计算实际剂量。1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg, 14 mg/kg, or 16 mg/kg. The actual dose (mg) will be calculated based on the subject's body weight (kg). The first dose will be calculated based on the subject's baseline body weight. If the subject's body weight changes by less than ±10% from baseline (at the time of the first dose of study treatment), the baseline body weight will be used to calculate the dose. Otherwise, the actual dose will be calculated based on the body weight on the scheduled dosing day or the day before dosing.
给药途径:Route of administration:
如符合指征,将使用微量注射泵通过留置静脉插管进行研究药物的静脉输注(Intravenously,IV)。导管可置入外周静脉(如果可及);允许通过中心静脉导管或输液港(如已放置在位)给药。If indicated, the study drug will be infused intravenously (IV) using a microsyringe pump through an indwelling venous cannula. The catheter can be placed in a peripheral vein (if accessible); administration through a central venous catheter or infusion port (if already in place) is permitted.
给药频率:Dosing frequency:
给药周期为3周/21天(Q3W),在每周期的第1天给药1次。给药直至出现不可耐受的毒性、疾病进展、受试者撤回知情同意、因其他原因终止研究治疗或治疗时长达到24个月(以先发生者为准)。The dosing cycle is 3 weeks/21 days (Q3W), with one dose given on Day 1 of each cycle. Dosing continues until intolerable toxicity occurs, disease progression, the subject withdraws informed consent, study treatment is terminated for other reasons, or the treatment duration reaches 24 months (whichever occurs first).
9.实验结果9. Experimental Results
本发明的靶向TROP2的抗体-药物偶联物作为有旁观者效应的ADC,在小鼠荷瘤模型中有显著的肿瘤抑制作用。预估本发明的靶向TROP2的抗体-药物偶联物同时具有良好的耐受性、安全性和疗效。The TROP2-targeting antibody-drug conjugate of the present invention, as an ADC with a bystander effect, exhibited significant tumor inhibition in a mouse tumor-bearing model. It is expected that the TROP2-targeting antibody-drug conjugate of the present invention will have good tolerability, safety, and efficacy.
截至2024年12月15日,共有71名患者来自中国和澳大利亚(中位年龄:60岁[范围:30-81岁],女性:85.9%,白人(Caucasian):16.9%,ECOGPS1:48.6%;既往接受过≥2线抗癌治疗:63.8%)。研究的中位随访时间为4.6个月(范围:0.8-9.7个月)。在剂量递增期间(1mg/kg、2mg/kg、4mg/kg、6mg/kg、8mg/kg、10mg/kg、12mg/kg),所有剂量水平均未观察到剂量限制性毒性(DLT,n=18)。中位治疗持续时间为18周(范围:3-45周),其中40名(56.3%)患者仍在接受治疗。治疗期间出现的不良事件(TEAEs)发生在68名(95.8%,其中90.1%为治疗相关不良事件[TRAEs])患者中,包括3级(G3)事件17名(23.9%,其中15.5%为TRAEs)。未发生4级或5级事件。常见的TEAEs(≥30%)包括口腔炎(52.1%,其中9.9%为G3)、恶心(31.0%,其中2.8%为G3)和皮疹(31.0%,其中1.4%为G3)。1名患者(1.4%,G1)发生间质性肺病。仅1名患者(1.4%)出现3级淋巴细胞计数下降。未观察到其他≥3级的血液学毒性。TRAEs导致5名(7.0%)患者剂量减少,1名(1.4%)患者治疗停止。在30名接受4/6/8/10mg/kg HRS7-NT3治疗的三阴性乳腺癌(TNBC)患者中(均为IV期,且96.7%用紫杉类药物治疗失败或对紫杉类药物不耐受),可评估HRS7-NT3的疗效。总体客观缓解率(ORR)为50.0%(95%CI:31.3-68.7),疾病控制率(DCR)为83.3%(95%CI:65.3-94.4)。对于不同剂量水平,4mg/kg(n=5)的ORR和DCR分别为40.0%(95%CI:5.3-85.3)和60.0%(95%CI:14.7-94.7),6mg/kg(n=5)的ORR和DCR分别为40.0%(95%CI:5.3-85.3)和80.0%(95%CI:28.4-99.5),8mg/kg(n=10)的ORR和DCR分别为50.0%(95%CI:18.7-81.3)和100%(95%CI:69.2-100.0),10mg/kg(n=10)的ORR和DCR分别为60.0%(95%CI:26.2-87.8)和80.0%(95%CI:44.4-97.5)。As of December 15, 2024, a total of 71 patients from China and Australia were enrolled (median age: 60 years [range: 30-81 years], female: 85.9%, white (Caucasian): 16.9%, ECOGP S1: 48.6%; previously received ≥2 lines of anticancer treatment: 63.8%). The median follow-up time of the study was 4.6 months (range: 0.8-9.7 months). During the dose escalation period (1 mg/kg, 2 mg/kg, 4 mg/kg, 6 mg/kg, 8 mg/kg, 10 mg/kg, 12 mg/kg), no dose-limiting toxicity (DLT, n=18) was observed at all dose levels. The median treatment duration was 18 weeks (range: 3-45 weeks), of which 40 (56.3%) patients are still receiving treatment. Treatment-emergent adverse events (TEAEs) occurred in 68 patients (95.8%, of which 90.1% were treatment-related adverse events [TRAEs]), including 17 grade 3 (G3) events (23.9%, of which 15.5% were TRAEs). No grade 4 or 5 events occurred. Common TEAEs (≥30%) included stomatitis (52.1%, of which 9.9% were G3), nausea (31.0%, of which 2.8% were G3), and rash (31.0%, of which 1.4% were G3). Interstitial lung disease occurred in one patient (1.4%, G1). Only one patient (1.4%) experienced a grade 3 decreased lymphocyte count. No other grade ≥3 hematologic toxicities were observed. TRAEs led to dose reductions in five patients (7.0%) and treatment discontinuation in one patient (1.4%). The efficacy of HRS7-NT3 was evaluated in 30 patients with triple-negative breast cancer (TNBC) (all stage IV patients, 96.7% of whom had failed or were intolerant to taxanes) who received 4, 6, 8, or 10 mg/kg of HRS7-NT3. The overall objective response rate (ORR) was 50.0% (95% CI: 31.3-68.7), and the disease control rate (DCR) was 83.3% (95% CI: 65.3-94.4). For different dose levels, the ORR and DCR of 4 mg/kg (n=5) were 40.0% (95% CI: 5.3-85.3) and 60.0% (95% CI: 14.7-94.7), the ORR and DCR of 6 mg/kg (n=5) were 40.0% (95% CI: 5.3-85.3) and 80.0% (95% CI: 28.4-99.5), the ORR and DCR of 8 mg/kg (n=10) were 50.0% (95% CI: 18.7-81.3) and 100% (95% CI: 69.2-100.0), and the ORR and DCR of 10 mg/kg (n=10) were 60.0% (95% CI: 26.2-87.8) and 80.0% (95% CI: 44.4-97.5).
因此,HRS7-NT3耐受性良好,血液学安全性表现优异。在晚期TNBC患者中观察到HRS7-NT3具有令人鼓舞的疗效,支持其作为同类最佳TROP2抗体偶联药物(ADC)的潜力。Therefore, HRS7-NT3 is well tolerated and has an excellent hematologic safety profile. The encouraging efficacy observed in patients with advanced TNBC supports its potential as a best-in-class TROP2 antibody-drug conjugate (ADC).
10.伴随治疗10. Concomitant treatment
在进入本研究之前或研究期间,受试者可接受符合临床干预指征和机构临床标准规程的、针对其他持续性疾病状况的治疗以及对恶性肿瘤的姑息和支持性治疗,除外在排除标准中规定的情况。Prior to entry into or during the study, subjects may receive treatment for other ongoing medical conditions and palliative and supportive care for malignancies consistent with clinical indications and institutional standard clinical protocols, except as specified in the exclusion criteria.
研究进行期间允许的其他治疗包括:Other treatments allowed during the study include:
1.IRR和研究药物相关毒性的预防:研究期间发生IRR的受试者应在每次研究药物给药前接受此方案里定义的标准治疗作为预防用药,以降低此类事件的风险。发生其他研究药物相关反应的受试者可预先接受标准治疗,以降低未来发生此类反应的可能性。1. Prevention of IRRs and Study Drug-Related Toxicity: Subjects who experience an IRR during the study should receive standard treatment as defined in the protocol as preventive medication before each dose of study drug to reduce the risk of such events. Subjects who experience other study drug-related reactions may receive standard treatment in advance to reduce the likelihood of such reactions in the future.
2.与研究药物相关的AE或并发疾病的处理:根据临床指征,用于治疗用药期间和随访期间发生的任何TRAE或并发疾病的药物。2. Management of AEs or concurrent diseases related to study drugs: Drugs used to treat any TRAEs or concurrent diseases occurring during the medication and follow-up period according to clinical indications.
3.血液制品和生长因子:在第1周期期间,不应给予预防性造血生长因子;此后,允许根据临床指征预防性使用生长因子。如果研究者认为有必要,则允许在研究期间(包括第1周期)干预性/治疗性使用生长因子。生长因子的使用须遵循相应的产品说明书。3. Blood Products and Growth Factors: Prophylactic hematopoietic growth factors should not be administered during Cycle 1; thereafter, prophylactic use of growth factors is permitted based on clinical indications. If deemed necessary by the investigator, interventional/therapeutic use of growth factors is permitted during the study (including Cycle 1). The use of growth factors must comply with the corresponding product instructions.
4.放疗:对于不影响骨髓功能且针对非靶病灶进行的控制疼痛的放疗,应与申办者的医学监查员讨论共同决定是否实施。4. Radiotherapy: For radiotherapy that does not affect bone marrow function and is performed on non-target lesions to control pain, the decision on whether to implement it should be discussed with the sponsor's medical monitor.
5.为缓解肿瘤相关症状的支持性用药,例如针对骨转移的双膦酸盐和地舒单抗。5. Supportive medications to relieve tumor-related symptoms, such as bisphosphonates and denosumab for bone metastases.
6.不超过10mg/天泼尼松当量的免疫抑制或系统性激素疗法,以及:6. Immunosuppression or systemic steroid therapy not exceeding 10 mg/day of prednisone equivalents, and:
·用于改善食欲的激素治疗(如醋酸甲地孕酮);Hormone therapy to improve appetite (such as megestrol acetate);
·鼻用、眼用、吸入和外用糖皮质激素制剂;· Nasal, ophthalmic, inhaled, and topical glucocorticoid preparations;
·用于终末器官衰竭的标准剂量的激素替代治疗;Standard-dose hormone replacement therapy for end-organ failure;
·同于前列腺癌的稳定激素疗法*;Same as stable hormone therapy for prostate cancer*;
·用于卵巢抑制的稳定激素疗法、激素避孕疗法或绝经后激素替代疗法;Stable hormone therapy for ovarian suppression, hormonal contraceptive therapy, or postmenopausal hormone replacement therapy;
·用于预防造影剂反应的类固醇疗法;Steroid therapy to prevent contrast reactions;
·关节内类固醇注射;Intra-articular steroid injections;
·针对其他疾病的低剂量维持类固醇治疗(例如:哮喘加重、针对脑水肿的稳定类固醇疗法[不包括逐渐减量的类固醇]等);Low-dose maintenance steroid therapy for other conditions (e.g., asthma exacerbation, stable steroid therapy (excluding tapering of steroids) for cerebral edema);
在疾病稳定或持续缓解的受试者中,使用更高剂量的类固醇治疗急性并发疾病(如免疫相关AE或其他不良状况)。此种情况下,应在免疫抑制治疗期间中断研究药物治疗。In subjects with stable disease or ongoing remission, higher doses of steroids may be used to treat acute intercurrent illnesses (e.g., immune-related AEs or other adverse events). In such cases, study drug treatment should be interrupted during immunosuppressive therapy.
*允许合并治疗;但是,受试者在研究开始前必须已接受稳定剂量至少6个月,如果继续接受研究治疗,则必须在接受研究治疗期间保持稳定剂量(即,在考虑受试者入组时,此类治疗将不被视为全身激素治疗)。*Concomitant therapies are allowed; however, subjects must have been receiving a stable dose for at least 6 months prior to study entry and, if continuing study treatment, must remain on a stable dose while receiving study treatment (i.e., such treatment will not be considered systemic hormonal therapy for the purpose of considering subject enrollment).
任何伴随治疗以及试验期间发生的其他干预或程序必须记录在受试者CRF的适当页面上。Any concomitant treatments and other interventions or procedures occurring during the trial must be recorded on the appropriate pages of the subject's CRF.
序列信息
Sequence information
以上描述了本发明的示例性实施方案,本领域技术人员应当理解的是,这些公开内容仅是示例性的,在本发明的范围内可以进行各种其它替换、适应和修改。因此,本发明不限于文中列举的具体实施方案。While the exemplary embodiments of the present invention have been described above, it should be understood by those skilled in the art that these disclosures are merely exemplary and that various other substitutions, adaptations, and modifications may be made within the scope of the present invention. Therefore, the present invention is not limited to the specific embodiments listed herein.
Claims (13)
Wherein, the antibody-drug conjugate targeting TROP2 is:
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| WO2019114666A1 (en) * | 2017-12-15 | 2019-06-20 | 四川科伦博泰生物医药股份有限公司 | Bioactive conjugate, preparation method therefor and use thereof |
| WO2021173773A1 (en) * | 2020-02-25 | 2021-09-02 | Mediboston, Inc. | Camptothecin derivatives and conjugates thereof |
| WO2022180581A2 (en) * | 2021-02-25 | 2022-09-01 | Mediboston Limited | Anti-her2 antibody-drug conjugates and uses thereof |
| WO2023138635A1 (en) * | 2022-01-18 | 2023-07-27 | 甘李药业股份有限公司 | Exatecan derivative-antibody conjugate and medical use thereof |
| WO2025067446A1 (en) * | 2023-09-28 | 2025-04-03 | 信达生物制药(苏州)有限公司 | Antibody-drug conjugate targeting trop2, and preparation method and use therefor |
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| WO2019114666A1 (en) * | 2017-12-15 | 2019-06-20 | 四川科伦博泰生物医药股份有限公司 | Bioactive conjugate, preparation method therefor and use thereof |
| WO2021173773A1 (en) * | 2020-02-25 | 2021-09-02 | Mediboston, Inc. | Camptothecin derivatives and conjugates thereof |
| WO2022180581A2 (en) * | 2021-02-25 | 2022-09-01 | Mediboston Limited | Anti-her2 antibody-drug conjugates and uses thereof |
| WO2023138635A1 (en) * | 2022-01-18 | 2023-07-27 | 甘李药业股份有限公司 | Exatecan derivative-antibody conjugate and medical use thereof |
| WO2025067446A1 (en) * | 2023-09-28 | 2025-04-03 | 信达生物制药(苏州)有限公司 | Antibody-drug conjugate targeting trop2, and preparation method and use therefor |
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