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Enapotamab vedotin, an AXL-specific antibody-drug conjugate, shows preclinical antitumor activity in non-small cell lung cancer
Louise A. Koopman, Mikkel G. Terp, Gijs G. Zom, Maarten L. Janmaat, Kirstine Jacobsen, Elke Gresnigt-van den Heuvel, Marcel Brandhorst, Ulf Forssmann, Freddy de Bree, Nora Pencheva, Andreas Lingnau, Maria A. Zipeto, Paul W.H.I Parren, Esther C.W. Breij, Henrik J. Ditzel
Louise A. Koopman, Mikkel G. Terp, Gijs G. Zom, Maarten L. Janmaat, Kirstine Jacobsen, Elke Gresnigt-van den Heuvel, Marcel Brandhorst, Ulf Forssmann, Freddy de Bree, Nora Pencheva, Andreas Lingnau, Maria A. Zipeto, Paul W.H.I Parren, Esther C.W. Breij, Henrik J. Ditzel
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Research Article Oncology Therapeutics

Enapotamab vedotin, an AXL-specific antibody-drug conjugate, shows preclinical antitumor activity in non-small cell lung cancer

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Abstract

Targeted therapies and immunotherapy have shown promise in patients with non-small cell lung cancer (NSCLC). However, the majority of patients fail or become resistant to treatment, emphasizing the need for novel treatments. In this study, we confirm the prognostic value of levels of AXL, a member of the TAM receptor tyrosine kinase family, in NSCLC and demonstrate potent antitumor activity of the AXL-targeting antibody-drug conjugate enapotamab vedotin across different NSCLC subtypes in a mouse clinical trial of human NSCLC. Tumor regression or stasis was observed in 17/61 (28%) of the patient-derived xenograft (PDX) models and was associated with AXL mRNA expression levels. Significant single-agent activity of enapotamab vedotin was validated in vivo in 9 of 10 AXL-expressing NSCLC xenograft models. In a panel of EGFR-mutant NSCLC cell lines rendered resistant to EGFR inhibitors in vitro, we observed de novo or increased AXL protein expression concomitant with enapotamab vedotin–mediated cytotoxicity. Enapotamab vedotin also showed antitumor activity in vivo in 3 EGFR-mutant, EGFR inhibitor–resistant PDX models, including an osimertinib-resistant NSCLC PDX model. In summary, enapotamab vedotin has promising therapeutic potential in NSCLC. The safety and preliminary efficacy of enapotamab vedotin are currently being evaluated in the clinic across multiple solid tumor types, including NSCLC.

Authors

Louise A. Koopman, Mikkel G. Terp, Gijs G. Zom, Maarten L. Janmaat, Kirstine Jacobsen, Elke Gresnigt-van den Heuvel, Marcel Brandhorst, Ulf Forssmann, Freddy de Bree, Nora Pencheva, Andreas Lingnau, Maria A. Zipeto, Paul W.H.I Parren, Esther C.W. Breij, Henrik J. Ditzel

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Figure 2

EnaV shows antitumor activity in an NSCLC mouse PDX clinical trial.

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EnaV shows antitumor activity in an NSCLC mouse PDX clinical trial.
(A) ...
(A) Schematic representation of PDX clinical trial design. Fragments of NSCLC patient-derived tumor cells were injected in 2 nude mice. Per PDX model, 1 mouse received a PBS injection (control), and the other mouse received treatment (EnaV, 4 mg/kg). (B) Antitumor activity of EnaV in an NSCLC mouse PDX clinical trial. Nonresponder (red), intermediate (orange), and responder (green) PDX models are indicated as percentage of a total of 61 PDX models tested. (C) Examples of each response category. Left plot: responder; middle plot: intermediate; right plot: nonresponder. Nonresponders are defined as models with a Δtreatment group/Δcontrol group (T/ΔC) ratio more than 70%, intermediates as models with ΔT/ΔC ratio between 10% and 70%, and responders as models with ΔT/ΔC ratio more than 10% after EnaV treatment. (D) AXL mRNA expression in responder, intermediate, and nonresponder NSCLC PDX models included in the mouse clinical trial as determined by HTG EdgeSeq. The box plots depict the minimum and maximum values (whiskers), the upper and lower quartiles, and the median. The length of the box represents the interquartile range. Statistically significant differences between groups determined by Mann-Whitney U test; *P < 0.05, and ***P = 0.0001.

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