Abstract 1694: Preclinical evaluation of a novel bispecific targeted toxin for the treatment of sarcomas

Introduction: EGFuPA is a bispecific ligand-targeted toxin consisting of epidermal growth factor (EGF) and urokinase (uPA) on the same molecule with truncated Pseudomonas exotoxin. The toxin was mutated to remove amino acids recognized by B-cells. EGFuPA is uniquely designed to simultaneously target EGF receptors (EGFR) and/or urokinase receptors (uPAR) on tumor cells and uPAR in the microenvironment. EGFuPA is safe and effective in laboratory animals and has excellent in vitro activity against sarcomas. Because EGFuPA crosses species platforms, an adaptive phase 1/2 study was undertaken using canine hemangiosarcoma (HSA) as a model of a highly aggressive, metastatic vascular sarcoma. We hypothesized that six-month survival would exceed 50% for dogs enrolled. Canine HSA is a tumor derived from blood vessel forming cells, which can overexpress both uPAR and EGFR rendering it an excellent target for the drug. It bears similarity to human angiosarcoma. Methods: Enrollment began in November 2012. Dogs with histologically confirmed, non-metastatic stage-I or II splenic HSA were eligible after splenectomy. EGFuPA was administered intravenously for one cycle on Days 1, 3, and 5. Adjuvant doxorubicin was given according to standard of care (SOC) protocols starting seven days after the last dose of EGFuPA. Results: EGFuPA was detectable in the systemic circulation 5 minutes post-infusion with clearance by 15 minutes. The drug was well tolerated with self-limiting, reversible hypovolemia at the highest dose. Thus far, 50 μg/kg appears to be the optimal dose. When compared to a historical control group of 19 dogs treated with SOC between 2008 and 2011, median survival is significantly longer for all 16 dogs treated with EGFuPA (SRCBST group, 240 vs. 129 days, p = 0.03) and for the 10 dogs in the Optimal Dose group (MS not reached, p = 0.01). Six-month survival for the Optimal Dose group was 65%. Overall survival at 400 days was 7% for the SOC group, 32.7% for the SRCBST group, and 56% for the Optimal Dose group. Outcomes were not affected by the presence of neutralizing antibodies. Conclusions: A biologically active dose of EGFuPA was established and found to be safe in companion dogs with HSA in the minimal residual disease setting. The unique nature of its bispecific targeting and the observed significant, biologic activity warrants consideration of EGFuPA for a phase 1 study for drug-refractory sarcomas in human patients. Citation Format: Antonella Borgatti, Amber Winter, Kathleen Stuebner, Joseph Koopmeiners, Jaime F. Modiano, Daniel Vallera. Preclinical evaluation of a novel bispecific targeted toxin for the treatment of sarcomas. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1694. doi:10.1158/1538-7445.AM2015-1694