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Background BT1718 contains a constrained bicyclic peptide with high affinity and selectivity for cell surface target MT1-MMP (MMP14) linked to a toxin (DM1) via a cleavable disulphide linker. BT1718 has demonstrated significant anti-tumor activity in preclinical studies in tumors that express MT1-MMP. Following intravenous (IV) administration to preclinical species, BT1718 exhibited PK typical of a BTC. We report clinical progress on QW and BIW dosing, plasma and tumor PK results. Methods This is a first in human, multicenter, dose escalation study in advanced solid tumor pts with the aims of establishing the recommended phase 2 dose (RP2D) for QW & BIW IV BT1718 dosing (3 out of every 4 weeks per cycle), and exploratory PK. Following determination of RP2Ds, expansion cohorts will enroll to further explore efficacy, tolerability and PD of BT1718 in ∼70 pts with MT1-MMP expressing tumors such as NSCLC and TNBC. Results 24 pts were enrolled with various types of solid tumors across both dose escalation cohorts (see table). BIW RP2D was determined as 7.2 mg/m2. The 2 pts with DLTs at 9.6 mg/m2 BIW experienced grade 3 increased GGT or fatigue. QW dose escalation continues at 20 mg/m2. Mean number of cycles received = 2.3 months (N = 24), with no objective responses observed to date in this unselected population. Consistent with preclinical data, preliminary clinical PK results with BT1718 confirm moderate plasma clearance (∼10 mL/min/kg) linear with dose, a volume of distribution similar to extracellular fluid (∼0.20 L/kg) and a t1/2 of ∼0.3 h. Analysis of pts biopsy samples confirms distribution of DM1 in tumors at similar concentrations observed in mouse xenograft models. Results will be updated at time of presentation. Table . 464P BT1718 Dose (mg/m2) Twice weekly schedule (BIW) Once weekly schedule (QW) DLT evaluable pts DLTs DLT evaluable pts DLTs 0.6 1 0 NA NA 1.2 1 0 NA NA 2.4 1 0 NA NA 4.8 1 0 NA NA 7.2 6 0 NA NA 9.6 4 2 3 0 15 NA NA 3 0 20 NA NA 2 0 Conclusions BT1718 is a first in class BTC which is generally well tolerated at the present dose level. Current plasma and tumor PK data are consistent with proposed preclinical mechanism of tumor targeted toxin delivery. Clinical trial identification NCT03486730. Legal entity responsible for the study Cancer Research UK. Funding Cancer Research UK and BicycleRD Limited. Disclosure N. Cook: Advisory / Consultancy: Tarveda Therapeutics; Advisory / Consultancy: Epigene Therapeutics. U. Banerji: Advisory / Consultancy: Astellas; Advisory / Consultancy: Novartis; Advisory / Consultancy: Karus Therapeutics; Advisory / Consultancy: Phoenix ACT; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Astex; Advisory / Consultancy: Vernalis; Research grant / Funding (institution), ONX-0801: funding for investigator-initiated Phase I trial: Onyx Pharmaceuticals; Research grant / Funding (institution), ONX-0801: funding for investigator-initiated Phase I trial: BTG International; Research grant / Funding (institution), RAF/MEK: funding for investigator-initiated Phase I trial: Chugai; Research grant / Funding (institution), TAX-TORC: funding for investigator-initiated Phase I trial: AstraZeneca; Research grant / Funding (institution), FRAME: funding for investigator-initiated Phase I trial: Verastem; Full / Part-time employment, ICR is involved in the development of PI3K, HSP90, HDAC, AKT, ROCK, RAF and CHK1: Institute of Cancer Research. J. Evans: Speaker Bureau / Expert testimony: BMS, Eisai, Bayer, Roche, Celgene, MSD; Officer / Board of Directors, Committee Member: Genmab (chair), BMS; Advisory / Consultancy: Karus Therapeutics; Research grant / Funding (self): AstraZeneca, Basliea, BMS, Bayer, Celgene, MSD, MiNa therapeautics, Roche, Medicina, Pfizer, Sierra, Verastem, Lilly, Eisai, NuCana, GSK, Novartis, Immunocore, Bicycle Therapeutics, Haloxyme, Berg, JJ Leadership role, Non-remunerated: Cancer Research UK, NCRN, Breast Cancer Now, Pancreatic Cancer Research Fund, EORTC GI group member, British Council of Cancer, Wales Clinical Trial Unit, ILCA; Non-remunerated activity/ies, Member: BACR, EACT, ACP, ESMO, ASCO, AACR. A. Biondo: Full / Part-time employment, ICR is involved in the development of PI3K, HSP90, HDAC, AKT, ROCK, RAF and CHK1: Institute of Cancer Research. P. Jeffrey: Full / Part-time employment: BicycleRD Limited. M. Rigby: Full / Part-time employment: BicycleRD Limited. G. Bennett: Full / Part-time employment: BicycleRD Limited. S. Blakemore: Full / Part-time employment: BicycleRD Limited. All other authors have declared no conflicts of interest.

Background Depression has substantial effects on cancer patients' quality of life. Estimates of its prevalence vary widely. We aimed to systematically review published studies to obtain the best estimate of the prevalence of depression in clinically meaningful subgroups of cancer patients. Design Systematic review that addressed the limitations of previous reviews by (i) including only studies that used diagnostic interviews; (ii) including only studies that met basic quality criteria (random or consecutive sampling, ≥70% response rate, clear definition of depression caseness, sample size ≥100); (iii) grouping studies into clinically meaningful subgroups; (iv) describing the effect on prevalence estimates of different methods of diagnosing depression. Results Of 66 relevant studies, only 15 (23%) met quality criteria. The estimated prevalence of depression in the defined subgroups was as follows: 5% to 16% in outpatients, 4% to 14% in inpatients, 4% to 11% in mixed outpatient and inpatient samples and 7% to 49% in palliative care. Studies which used expert interviewers (psychiatrists or clinical psychologists) reported lower prevalence estimates. Conclusions Of the large number of relevant studies, few met our inclusion criteria, and prevalence estimates are consequently imprecise. We propose that future studies should be designed to meet basic quality criteria and employ expert interviewers.