An Enzymatically Cleavable Tripeptide Linker for Maximizing the Therapeutic Index of Antibody-Drug Conjugates

Authors

Summer Y Y Ha
Yasuaki Anami
Chisato M Yamazaki
Wei Xiong
Candice M Haase
Scott D Olson
Jangsoon Lee
Naoto T Ueno
Ningyan Zhang
Zhiqiang An
Kyoji Tsuchikama

Publication Date

9-6-2022

Journal

Molecular Cancer Therapy

Abstract

Valine-citrulline is a protease-cleavable linker commonly used in many drug delivery systems, including antibody-drug conjugates (ADC) for cancer therapy. However, its suboptimal in vivo stability can cause various adverse effects such as neutropenia and hepatotoxicity, leading to dose delays or treatment discontinuation. Here, we report that glutamic acid-glycine-citrulline (EGCit) linkers have the potential to solve this clinical issue without compromising the ability of traceless drug release and ADC therapeutic efficacy. We demonstrate that our EGCit ADC resists neutrophil protease-mediated degradation and spares differentiating human neutrophils. Notably, our anti-HER2 ADC shows almost no sign of blood and liver toxicity in healthy mice at 80 mg kg-1. In contrast, at the same dose level, the FDA-approved anti-HER2 ADCs Kadcyla and Enhertu show increased levels of serum alanine aminotransferase and aspartate aminotransferase and morphologic changes in liver tissues. Our EGCit conjugates also exert greater antitumor efficacy in multiple xenograft tumor models compared with Kadcyla and Enhertu. This linker technology could substantially broaden the therapeutic windows of ADCs and other drug delivery agents, providing clinical options with improved efficacy and safety.

Keywords

Ado-Trastuzumab Emtansine, Animals, Antineoplastic Agents, Cell Line, Tumor, Citrulline, Humans, Immunoconjugates, Mice, Peptide Hydrolases, Therapeutic Index

Comments

Supplementary Materials

PMID: 35793453