Phase 1 trial of LM-299, an anti-PD-1/VEGF BsAb, initiated in China for advanced solid tumors following promising preclinical results demonstrating strong inhibition of tumor growth and well-tolerated safety profile IND for LM-299 in the US expected to be submitted in the second half of 2024 Proceeds from the completed Series C1 financing will be primarily used to advance the clinical development of the Company's pipeline, including lead candidates LM-299 (anti-PD-1/VEGF BsAb), LM-302 (anti-CLDN 18.2 ADC) and LM-108 (anti-CCR8 mAb) Financing led by Sino Biopharmaceuticals, with participation of new and current investors SHANGHAI, Oct. 18, 2024 /PRNewswire/ -- LaNova Medicines Limited ("LaNova" or "The Company"), a privately-held clinical-stage innovation-driven biotech specializing in ADCs and immuno-oncology, announced the initiation of its Phase 1 clinical trial of LM-299, an anti-PD-1/VEGF BsAb, in China for advanced solid tumors and the successful completion of its $42 million Series C1 financing. Founded in September 2019, LaNova's R&D engine is based on three proprietary platforms adept at tackling challenging targets and versatile modality development, which has so far enabled the in-house development of more than ten innovative programs, including monoclonal antibodies, ADCs and bispecific antibodies. Following promising preclinical results demonstrating LM-299's strong inhibition of tumor growth in hPBMCs-humanized mice and well tolerated safety profile in NHP GLP tox study, LaNova has initiated its first-in-human clinical trial in China for advanced solid tumors. LaNova is planning to initiate an additional Phase 1 clinical trial in the US and expects to submit an IND in the second half of 2024. The completed Series C1 financing was led by Sino Biopharmaceuticals and included participation from new investors Pudong Innovation Investment and Zhangjiang Haoheng, and existing investors, Qiming Venture Partners and Shanghai Healthcare Capital. Zhong Lun Law Firm acted as the legal advisor for this round of financing. LaNova has recently initiated its Series C2 financing round. Proceeds will be primarily used to advance the clinical development of the Company's pipeline, including lead candidates: LM-302 (anti-CLDN 18.2 ADC): ongoing Phase III registrational clinical trial in China for gastric cancers, making it one of the top three candidates globally in terms of development progress for this target; US Phase II trial expected to start in H2 2025 LM-108 (anti-CCR8 mAb): ongoing Phase II clinical trials in China for multiple solid tumors, making it one of the top three most advanced projects worldwide targeting CCR8; US Phase II trial expected to start in H2 2024 LM-299 (anti-PD-1/VEGF BsAb): Phase I clinical trial in China is currently enrolling patients for advanced solid tumors Dr. Crystal Qin, LaNova's founder, chairwoman and CEO, stated: "Since its establishment, LaNova has been dedicated to original innovation, with a focus on the tumor microenvironment and the development of tumor-specific targeted ADCs and immune-modulating biologics. We have established a robust pipeline of differentiated innovative drugs, with independent intellectual property rights and profiles that are competitive on a global scale. We are thrilled to have initiated our Phase 1 trial for LM-299 and completed our series C1 financing round. We are especially grateful for the continued support and confidence of our new and long-standing investors during this challenging period for pharmaceutical investments. Proceeds from this financing will allow us to expedite the development of our late-stage clinical programs, LM-302 and LM-108, moving us closer to market approval. We will also accelerate the clinical development of LM-299, which is currently in Phase 1 clinical trials with best-in-class potential. We look forward to strengthening our partnerships across the industry and enhancing our self-sustainability through business development collaborations. Together, we aspire to bring China's innovative drugs to a global stage, ultimately providing high-quality treatment solutions to more patients and promoting healthier lives worldwide." About LaNova Medicines Ltd. Founded in September 2019, LaNova Medicines Ltd. is a privately held biotech company headquartered in Shanghai. With the mission of "Care for life, Dedicate to innovation", the Company focuses on discovering novel biologic therapies in the fields of ADC and Immuno-Oncology, with a commitment to developing best-in-class or first-in-class therapies that address significant unmet medical needs. LaNova's robust portfolio is made possible by an industry-leading R&D engine, which includes three distinct platform: a proprietary antibody platform capable of generating antibodies against a range of targets, including multi-transmembrane proteins and GPCRs; a next-generation ADC platform that utilizes proprietary payload and linker technologies to produce highly differentiated ADCs; and a modular 4-1BB-based T-cell engager (TCE) platform for developing bispecific antibodies targeting distinct tumor-associated antigens (TAAs). Currently, LaNova's pipeline includes 6 clinical-stage assets and over 10 innovative preclinical programs. Its leading clinical-stage candidates include LM-302, a differentiated anti-Claudin 18.2 ADC in Phase 3 development in China; LM-108, a potential best-in-class CCR8-targeting monoclonal antibody in Phase 2 in China; and several Phase 1 programs including LM-299 (anti-PD-1/VEGF bispecific antibody), LM-101 (anti-SIPRα monoclonal antibody), LM-305 (anti-GPRC5D ADC with global rights licensed to AstraZeneca), and LM-24C5 (anti-CEACAM5 bispecific antibody). Through internal R&D innovation and strategic external partnerships, LaNova is committed to advancing its pipeline to benefit patients worldwide. LaNova's key clinical stage pipeline programs and expected upcoming milestones LM-299 (Anti-PD-1/VEGF bispecific antibody) LM-299 is a bispecific antibody developed by LaNova that targets both PD-1 and VEGF. This innovative therapy can simultaneously block the PD-1/PD-L1 and VEGF/VEGFR signaling pathways, achieving a synergistic anti-tumor effect that combines tumor immunity with anti-angiogenesis. LM-299 features a differentiated molecular design, comprising an anti-VEGF antibody linked to a C-terminal anti-PD-1 antibody, which ensures high expression, optimal druggability, and best-in-class potential. Preliminary studies have demonstrated that LM-299 effectively inhibits the PD-1 and VEGF signaling pathways, enhancing anti-tumor efficacy. Additionally, toxicological and pharmacokinetic evaluations indicated that LM-299 possesses a superior safety profile. As a promising cornerstone therapy for the next generation of tumor immunotherapy, LM-299 can be combined with various treatment modalities, including immuno-oncology drugs, small molecule targeted therapies, antibody-drug conjugates and T cell activators, thereby significantly broadening the market potential for LM-299-based combination therapies. The Phase I clinical trial for LM-299 is currently enrolling patients. LM-302 (Anti-Claudin 18.2 ADC) LM-302 is an innovative antibody-drug conjugate (ADC) developed by LaNova, targeting Claudin 18.2, using the company's proprietary multi-transmembrane protein antibody discovery platform. The drug consists of a Claudin 18.2-specific antibody linked to the cytotoxic agent monomethyl auristatin E (MMAE) via a cleavable VC-PAB linker. Claudin 18.2 is a transmembrane protein highly expressed in gastrointestinal cancers, including gastric, gastroesophageal junction, pancreatic, and biliary tract cancers. Treatments targeting Claudin 18.2 have shown significant anti-cancer potential in clinical settings. In the first quarter of 2024, LM-302 entered a Phase III registrational clinical trial in China, making it one of the top three candidates globally in terms of development progress for this target. Additionally, Phase II clinical trials exploring LM-302 in combination with PD-1 monoclonal antibodies are actively underway. Phase III GC/GEJ monotherapy: interim data readout expected in H2 2025 Phase II 1L GC/GEJ combination study in US to be initiated in H2 2025 LM-108 (Anti-CCR8 monoclonal antibody) LM-108 is a monoclonal antibody targeting CCR8, independently developed by LaNova using its proprietary multi-transmembrane protein antibody discovery platform. LM-108 effectively eliminates tumor-infiltrating regulatory T cells (Tregs) via antibody-dependent cell-mediated cytotoxicity (ADCC), while sparing peripheral Tregs. This enhances the immune system's ability to attack tumor cells. Due to the specificity of CCR8, many global pharmaceutical companies are pursuing this target. LaNova has advanced LM-108 to Phase II clinical trials, making it one of the top three most advanced projects worldwide targeting CCR8. Preliminary clinical data show that LM-108 has demonstrated excellent safety and efficacy across multiple solid tumor types with significant unmet clinical needs. LM-108 holds promise as a new immunotherapy option, particularly for patients with advanced tumors who have become resistant to PD-1 treatments. Phase III registrational trial to be initiated in China in H2 2024 Phase II combination trial to be initiated in US in H2 2024 SOURCE LaNova Medicines WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

临床1期临床2期免疫疗法临床申请抗体药物偶联物

2024-09-07

·药渡

Claudin 18.2：癌症治疗的新靶点

前言胃癌在癌症相关死亡率中排名第三，被认为是全世界最难治愈的癌症之一。在晚期或转移性胃癌或胃食管交界处（GEJ）腺癌患者中，中位总生存期（mOS）不超过10个月。虽然人类表皮生长因子受体2（HER-2）靶向治疗和免疫检查点抑制剂已经为特定人群带来福音，但在进展期胃癌中寻找其他靶点势在必行，claudin18.2（CLDN18.2）随之而来。 Claudins是一个蛋白质家族，其作用是维持控制细胞间分子交换的紧密连接。广泛分布于胃、胰腺和肺组织，可用于诊断和治疗。CLDN18.2亚型是一种胃特异性亚型，自从Sahin发现CLDN18.2是一种高度选择性的分子，并且只在癌细胞中广泛表达，它就成为一种理想的靶点。CLDN18.2通常埋藏在胃粘膜中，正常组织中的单克隆抗体基本上接触不到，恶性肿瘤的发生会导致紧密连接的破坏，使肿瘤细胞表面的CLDN18.2表位暴露出来，成为特定的靶点。因此，CLDN18.2赋予靶向治疗的特异性。最近发现在胰腺癌（50%）、食管癌和肺癌中的表达也显示了诊断和治疗其他肿瘤的潜力。 Claudin18.2的结构和生物学作用 Claudins是一个组成紧密连接（TJs）的完整膜蛋白家族，TJs是主要的细胞间连接，充当通透性屏障，通过划分膜上下区域赋予上皮细胞极性。目前，哺乳动物claudin家族由27种蛋白质组成，许多选择性剪接claudin蛋白在各种组织中表达。 Claudins是四次跨膜蛋白，包括四个跨膜结构域（TM1-4）、细胞内N端和C末端以及两个细胞外环（ECL1和ECL2）。ECL1包含四条β链和一条胞外螺旋（ECH），ECL2包含一条β链和一个细胞表面暴露的部分跨膜结构域。 ECL参与claudin链之间相互作用的形成，并通过两个可变区域形成基于claudin的闸门功能。根据生理学研究，提出了两种闸门功能机制：“孔隙”机制，其中溶质或离子通过由TJ链形成的细胞旁通道，以及“泄漏”机制，溶质可能通过TJ链中的断裂。此外，通过与许多其他信号分子的相互作用，claudin主要作为抑制因子发挥作用，从而影响细胞生长、存活、增殖和分化。 Claudin18.2异常的致癌作用包括claudins在内的紧密连接复合体被认为在致癌作用中具有抑制作用，类似于细胞粘附分子的肿瘤抑制功能。CDH1突变引起的钙粘蛋白表达不足已认为是肿瘤发生的机制之一。大约20-30%的胃癌claudin 18.2表达下调或缺失，claudin 18.2的下调也被认为与癌细胞侵袭和增殖水平的增加有关。然而，支持claudin 18.2下调与胃癌发生之间相关性的证据仍然有限。除了claudin 18.2表达的变化外，在胃癌患者中还检测到涉及CLDN18的融合。在3%的胃癌患者和10%的扩散型胃癌患者中检测到CLDN18-ARHGAP融合基因。这些融合破坏了连接复合体，可能是由于C末端结构域的缺失以及由此导致的与肌动蛋白调节蛋白的相互作用的缺失，再加上ARHGAP的Rho-GTPase结构域的异位定位，这种破坏导致转化蛋白RHOA的下游失活，可能导致恶性转化。然而，目前仍然没有确凿的证据表明claudin 18.2的表达与致癌作用之间存在直接联系。 Claudin18.2阳性胃癌的临床病理特征各种研究已经描述了claudin 18.2在胃癌中表达的临床病理特征和预后意义。在SPOTLIGHT和GLOW试验中使用了43-14A抗claudin 18抗体识别claudin 18.1和claudin 18.2的C末端。使用43-14A分析的样本的阳性标准被定义为IHC评分>2+和染色≥癌细胞表面积的75%。在SPOTLIGHT和GLOW试验的联合分析中，38.4%的患者被认为患有claudin 18.2阳性肿瘤。当排除HER2阳性癌症患者时，这一百分比增加到42.3%。白人（42.3%）和亚裔（36.4%）患者的claudin 18.2阳性率存在统计学显著差异（P = 0.0004)。此外，根据对SPOTLIGHT和GLOW试验样本的生物标志物分析，中国大陆claudin 18.2阳性胃癌患者的百分比（35.0%）与北美（37.7%）相似，但低于欧洲和中东（44.0%）。claudin 18.2的表达与年龄或性别之间也存在统计学上显著的相关性。在≤65岁的患者（40.9%）中观察到的claudin 18.2阳性肿瘤比例高于>65岁的患者（34.3%），在≤75岁的患者中（39.0%）高于>75岁的患者（30.9%）。claudin 18.2阳性癌症的女性患者比例（43.7%）高于男性患者（36.9%）。在弥漫型组织学肿瘤中观察到claudin 18.2阳性的发生率（48.3%）高于肠型组织学（38.8%）。值得注意的是，尽管已经报道了claudin 18.2状态与几个患者或临床特征之间具有统计学意义的相关性，但大多数组之间claudin 182阳性率的数字差异通常很小。此外，胃癌和GEJ癌之间claudin 18.2阳性率没有一致性差异。 Claudin18.2阳性胃癌的基因组和免疫学特征分子表征方法的进展揭示了胃癌独特的分子特征。在TCGA分析中，研究人员提出了四种分子亚型：EB病毒（EBV）阳性、微卫星不稳定（MSI）、基因组稳定（GS）和染色体不稳定（CIN）肿瘤。一项研究的结果表明，Claudin18.2在EBV阳性癌症中的阳性率仅为26%。关于claudin 18.2在其他TCGA癌症亚型中表达率的数据有限，claudin 18.2在20.8%的错配修复缺陷（dMMR）癌症中表达。其他研究报道了claudin 18.2阳性与MSI-H之间的有限关联，特别是对于具有高水平claudin 18.2-表达的肿瘤。 claudin 18.2的表达与其他生物标志物之间的关系也有研究。三项独立的回顾性研究分析了claudin 18.2和HER2的重叠表达，患者的重叠阳性率约为3.4%-4.9%。对SPOTLIGHT和GLOW数据的探索性分析表明，17.2%的claudin 18.2阳性进展期胃癌（AGCs）也是PD-L1阳性（定义为CPS≥5）。此外，还评估了claudin 18.2阳性胃癌及其肿瘤微环境（TME）的免疫学特征。自然杀伤（NK）细胞计数减少和中性粒细胞计数升高是claudin 18.2阳性胃癌的普遍特征。转录分析还表明，TME中调节性CD4+T细胞、CD8+T细胞和髓系树突状细胞数量有限，B细胞水平升高，而巨噬细胞存在的数据在各研究中不一致。对80个癌症标本的多重IHC分析显示，在claudin 18.2阳性肿瘤中，不表达免疫检查点和/或其相关配体（如PD-1、PD-L1、LAG3和TIM3）的CD8+T细胞比例较高。这些发现表明，claudin 18.2阳性胃癌可能具有“冷”免疫表型，具有有限的免疫细胞浸润和免疫抑制性TME。 Claudin18.2的靶向治疗 Claudin 18.2作为极具前景的肿瘤靶向治疗靶点，众多创新药企争相布局，成为必争之靶点高地。目前为止，国际国内20多家药企布局了claudin 18.2靶向药物的临床开发，大部分在研项目属于单靶点抗体药物，此外还包括claudin 18.2双抗药物、ADC和CAR-T等。单克隆抗体 Zolbetuximab（IMAB362，claudixmab）是第一种针对该靶点的开发药物，是一种嵌合的IgG1单克隆抗体，在肿瘤细胞表面与CLDN18.2特异结合，从而引发抗体依赖性细胞毒性（ADCC）、补体依赖性细胞毒性（CDC），凋亡和抑制细胞增殖。临床前研究已经成功地证实了它具有清除癌细胞和控制疾病的强大能力。随后，通过多个I/II期试验评估了其临床疗效和安全性。第一项人体临床试验（NCT00909025）旨在确定剂量递增队列中Zolbetuximab的最大耐受剂量和推荐剂量，15名先前接受过治疗的进展期胃腺癌/GEJ腺癌患者进入评估。最后评估使用600 mg/m2的剂量为后续的推荐研究剂量。 IIa期临床试验（NCT01197885，MONO 2013）研究了其对54例难治性晚期或转移性CLDN18.2阳性胃腺癌患者的疗效和安全性。研究结果显示，中位无进展生存期（mPFS）提高到14.5周，受试者的平均响应时间延长至24.6周。10例患者获得临床改善，其中PR 4例（9%），SD 6例（14%），其中90%的患者CLDN18.2高表达。 2023年7月6日，根据SPOTLIGHT和GLOW的数据，美国食品药品监督管理局（FDA）授予Zolbetuximab优先审评地位，作为不可切除、局部晚期或转移、HER2阴性、claudin 18.2阳性胃癌或GEJ腺癌患者的一线治疗。此外，其它进入临床研究的单克隆抗体还包括Osemitamab（TST001）、AB011、MIL93、ASKB589和ZL-1211等。双特异性抗体 Gresonitamab、ASP2138、AZD5863和QLS31905都是设计用于结合claudin 18.2和CD3的双特异性抗体。Gresonitamab已在一项涉及AGC或PDAC患者的国际多中心I期研究中进行了测试（NCT04260191）。QLS31905在一项I期试验中进行了测试，该试验涉及经过大量预处理的晚期实体瘤患者，在接受剂量≥200μg/kg的27名患者中，ORR和DCR分别为11.1%和63.0%。在胃癌或GEJ癌患者中未观察到任何反应。测试ASP2138（NCT05365581）和AZD5863（NCT06005493）的I期研究正在进行中。 Q-1802是一种靶向claudin 18.2和PD-L1的人源化双特异性抗体。Q-1802正在一项开放标签单臂I期试验中进行测试（NCT04856150）。剂量递增阶段已经完成，未检测到剂量限制毒性，最高可达20 mg/kg剂量。恶心（62.1%）、呕吐（62.1%）和腹痛（27.6%）是最常见的任何级别的不良事件。在剂量扩展队列的9名患者中，2名患者出现部分响应，4名患者疾病稳定。 PT886是一种针对claudin 18.2和CD47的新型双特异性抗体。该药物正在一项开放标签的I期试验中进行测试，该试验涉及晚期胃癌和GEJ腺癌或PDAC患者。 Givastomig（TJ-CD4B/ABL111）是一种创新的双特异性抗体，同时靶向claudin 18.2和4-1BB。Givastomig目前正在美国和中国的中心进行一期试验（NCT04900818）。这项研究的初步数据表明，有三名患者（16.6%）出现部分反应。常见的毒性包括1-2级恶心（22%）、疲劳（14%）和呕吐（12%），共报告了7起3级事件。 CAR-T细胞 CT041是靶向claudin 18.2的第二代CAR-T细胞产品，包含CD8α铰链区、CD28共刺激结构域和CD3ζ信号结构域。临床前数据表明，在小鼠异种移植物模型中，具有强大的抗肿瘤活性，不会对非恶性胃组织或其他器官造成明显损伤。在一项I期研究中，CT041在转移性claudin 18.2阳性的胃腺癌或胰腺癌患者中显示出相当大的潜力（ORR 33.3%，中位PFS 130天）。在第二阶段试验中，所有癌症患者的ORR为48.6%，胃癌为57.1%；DCR所有癌症为73.0%，胃癌为75.0%。其他几种claudin 18.2靶向CAR T细胞疗法目前正在早期研究中进行测试，包括配备有4-1BB共刺激结构域的第二代CAR LB1908以及第四代CAR-T，第四代的两种细胞都被设计为分泌特异性细胞因子和趋化因子RD07（NCT05284968）和CT048（NCT05393986）。 ADC SYSA1801（EO3021）是一种特异性靶向claudin 18.2的ADC，其使用药物抗体比（DAR）约为2的MMAE有效载荷。在一项正在进行的I期试验中，33名晚期、重度预处理的claudin 18.2阳性胃癌或胰腺癌患者接受了SYSA1801单药治疗。在21名可评估疗效的患者中，观察到ORR为38.1%，DCR为57.1%，AGC患者的ORR和DCR分别增加到47.1%和64.7%。大多数接受的患者出现恶心和呕吐，≥3级的反应为42.9%和28.6%。33名患者中有7名（21.2%）出现干眼症，这也被认为与治疗有关。 CMG901（AZD0901）是以一种人源化IgG1抗claudin 18.2抗体，该抗体通过DAR约为4的可裂解连接子与MMAE有效载荷偶联。CMG901显示出强大的临床前活性。在包含113名晚期、预处理的GEJ或胃癌患者的I期临床试验中，ORR为42%，最常见的不良反应为贫血和中性粒细胞计数减少。此外，其他大多数ADC仍处于早期临床测试中，包括TPX-4589/LM-302（NCT05001516、NCT05934331）、RC118（NCT04914117、NCT05205850）、SKB315（NCT05367635）、SOT102（NCT05525286）、TORL-2-307-ADC（NCT05156866）和JS107（NCT05502393）。其它疗法 BNT141是一种创新的基于RNA的治疗药物，编码包裹在脂质纳米颗粒中的抗claudin 18.2抗体，是该类治疗药物中首批进入临床测试的产品之一。BNT141的临床前评估表明，与传统抗体药物相比，剂量-暴露比更有利。一项测试BNT141的I/II期、开放标签、多中心试验（NCT04683939）于2020年12月启动，但申办方于2023年10月停止了这项研究，原因未披露。 CLDN18.2靶向治疗的未来首先，CLDN18.2可能是继HER-2之后胃癌的第二重要靶点。在高表达的人群，它甚至超过了HER-2。FAST试验中OS的疗效不亚于HER-2。需要进一步研究以确定CLDN18.2水平的理想界限值，以获得最佳效益。第二，联合治疗是值得期待的。随着Zolbetuximab联合化疗方案的兴起，与其他靶向药物联合治疗可能也值得研究。值得注意的是，联合应用Zolbetuximab和免疫治疗可刺激T细胞浸润，这与免疫检查点抑制剂相协调。最后，更多的预测预后的意义需要进一步的调查。分子亚型在指导精确的药物治疗方面具有更大的潜力，如CLDN18-ARHGAP26/6融合，表明生存率和化疗抵抗力较差。更多的CLDN18.2的预测因子可以被探索和验证，从而使特殊人群受益。 CLDN18.2在HER-2阴性胃癌患者中是一个很有前途的靶点，不仅选择性高，而且在人群患病率方面也很有潜力，是胃癌靶向治疗的理想补充。新型抗体zolbtuximab，无论是单药治疗还是联合化疗，都显示出显著的优越疗效和安全性。CLDN18.2CAR-T细胞治疗最近以其优异的表现探索了另一种可能性。该策略将进展到第三阶段临床试验，当与其他疗法相结合时，将可能进一步的提升疗效。随着分子结构和临床试验的不断完善，抗CLDN18.2治疗将完美地回答各种疑问，并在未来带来更多惊喜。参考文献： 1. Claudin 18.2 as a novel therapeutic target. Nat Rev Clin Oncol. 2024 Mar 19 2. Evaluation and reflection on claudin 18.2 targeting therapy in advanced gastric cancer. Chin J Cancer Res. 2020 Apr; 32(2): 263–270. 3. clinicaltrials.gov 药渡媒体商务合作媒体公关 | 新闻&会议发稿张经理：18600036371（微信同号）点击下方“药渡“，关注更多精彩内容免责声明 “药渡”公众号所转载该篇文章来源于其他公众号平台，主要目的在于分享行业相关知识，传递当前最新资讯。图片、文章版权均属于原作者所有，如有侵权，请及时告知，我们会在24小时内删除相关信息。微信公众号的推送规则又双叒叕改啦，如果您不点个“在看”或者没设为"星标"，我们可能就消散在茫茫文海之中~点这里，千万不要错过药渡的最新消息哦！👇👇👇

100 项与抗Claudin 18.2抗体(TriOar) 相关的药物交易

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