First-in-Human Study of PF-06647020 (Cofetuzumab Pelidotin), an Antibody–Drug Conjugate Targeting Protein Tyrosine Kinase 7, in Advanced Solid Tumors

Abstract Purpose: We investigated safety, tolerability, pharmacokinetics, and antitumor activity of the protein tyrosine kinase 7 (PTK7)-targeted, auristatin-based antibody–drug conjugate (ADC) PF-06647020/cofetuzumab pelidotin (NCT02222922). Patients and Methods: Patients received PF-06647020 intravenously every 3 weeks at 0.2–3.7 mg/kg or every 2 weeks at 2.1–3.2 mg/kg, in sequential dose escalation, following a modified toxicity probability interval method. In dose expansion, pretreated patients with advanced, platinum-resistant ovarian cancer, non–small cell lung cancer (NSCLC), or triple-negative breast cancer (TNBC) received PF-06647020 2.8 mg/kg every 3 weeks. Results: The most common, treatment-related adverse events for PF-06647020 administered every 3 weeks were nausea, alopecia, fatigue, headache, neutropenia, and vomiting (45%–25%); 25% of patients had grade ≥ 3 neutropenia. Two patients experienced dose-limiting toxicities (grade 3 headache and fatigue) at the highest every 3 weeks dose evaluated. The recommended phase II dose was 2.8 mg/kg every 3 weeks. The overall safety profile observed with PF-06647020 administered every 2 weeks was similar to that of the every 3 weeks regimen. Systemic exposure for the ADC and total antibody generally increased in a dose-proportional manner. Antitumor activity was observed in treated patients with overall objective response rates of 27% in ovarian cancer (n = 63), 19% in NSCLC (n = 31), and 21% in TNBC (n = 29). Responders tended to have moderate or high PTK7 tumor expression by IHC. Conclusions: This PTK7-targeted ADC demonstrated therapeutic activity in previously treated patients with ovarian cancer, NSCLC, and TNBC at a dose range of 2.1–3.2 mg/kg, supporting further clinical evaluation to refine dose, schedule, and predictive tissue biomarker testing in patients with advanced malignancies.

Background:

The transmembrane protein tyrosine kinase 7 (PTK7), involved in Wnt signaling, is overexpressed in multiple tumor types, including advanced non-small-cell lung cancer (NSCLC), ovarian cancer (OvCa), and triple-negative breast cancer (TNBC). Also expressed in tumor-initiating cells (TICs) or cancer stem cells, PTK7 is a tumor-associated target for elimination of cancer cells and TICs.

PF-06647020 (cofetuzumab pelidotin) is a humanized, anti-PTK7 antibody─drug conjugate (ADC), designed to deliver an auristatin microtubule inhibitor payload (Aur0101) into target cells. It was shown to induce prolonged tumor regression in patient-derived, tumor xenograft preclinical models.

Methods:

In this first-in-human, dose-finding study, PF-06647020 administered every 2 or 3 weeks demonstrated a tolerable safety profile and preliminary clinical activity in previously treated patients with locally advanced/metastatic, PTK7-positive NSCLC, TNBC, and platinum-resistant OvCa.

Results:

(No separate results section is present in the provided text. The methods statement includes that the study "demonstrated a tolerable safety profile and preliminary clinical activity.")

Data Summary:

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Conclusions:

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Practical Significance:

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