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Table S1 shows expression of IGF1R on human tissues Table S2 shows expression of IGF1R on Tumor and Normal cells Table S3 shows DAR calculation Table S4 shows impact of W0101 on cell cycle Figure S1 shows the flowchart for selection of m208F2 Figure S2 shows kinetics of internalization of murine anti-IGF1R antibodies Figure S3 shows inhibition of binding and phosphorylation of IGF-1R Figure S4 shows binding and internalisation of W0101 on MCF7 cells Figure S5 shows impact of W0101 on apoptose compared to MMAE and isotype control ADC Figure S6 shows in vivo activity of naked antibody on MCF7 and NCI-H2122 models Figure S7 demonstrated the absence of bystander effect of W0101

The insulin-like growth factor type 1 receptor (IGF-1R) is important in tumorigenesis, and its overexpression occurs in numerous tumor tissues. To date, therapeutic approaches based on mAbs and tyrosine kinase inhibitors targeting IGF-1R have only shown clinical benefit in specific patient populations. We report a unique IGF-1R–targeted antibody–drug conjugate (ADC), W0101, designed to deliver a highly potent cytotoxic auristatin derivative selectively to IGF-1R overexpressing tumor cells. The mAb (hz208F2-4) used to prepare the ADC was selected for its specific binding properties to IGF-1R compared with the insulin receptor, and for its internalization properties. Conjugation of a novel auristatin derivative drug linker to hz208F2-4 did not alter its binding and internalization properties. W0101 induced receptor-dependent cell cytotoxicity in vitro when applied to various cell lines overexpressing IGF-1R, but it did not affect normal cells. Efficacy studies were conducted in several mouse models expressing different levels of IGF-1R to determine the sensitivity of the tumors to W0101. W0101 induced potent tumor regression in certain mouse models. Interestingly, the potency of W0101 correlated with the expression level of IGF-1R evaluated by IHC. In an MCF-7 breast cancer model with high-level IGF-1R expression, a single injection of W0101 3 mg/kg led to strong inhibition of tumor growth. W0101 provides a potential new therapeutic option for patients overexpressing IGF-1R. A first-in-human trial of W0101 is currently ongoing to address clinical safety.

Summary Purpose To determine the maximum tolerated dose (MTD) of F14512, a topoisomerase II inhibitor designed to target cancer cells through the polyamine transport system, (three-hour daily infusion given for 3 consecutive days every 3 weeks) in platinum-refractory or resistant ovarian cancer. Other objectives were safety, pharmacokinetics (PK), PK/pharmacodynamics relationship, and efficacy. Methods This was an open-label, dose-escalation, multicenter phase I study. Results Eleven patients were enrolled and were treated at dose levels (DLs) of 10 and 5 mg/m2/day. All patients received the 3 injections per cycle as per study protocol (median, 1 cycle (Ferlay et al. Int J Cancer 136:E359–386, 2015; Siegel et al. CA Cancer J Clin 65:5–29, 2015; Oronsky et al. Med Oncol 34:103, 2017; Barret et al. Cancer Res 68:9845–9853, 2008; Ballot et al. Apoptosis 17:364–376, 2012; Brel et al. Biochem Pharmacol 82:1843–1852, 2011; Gentry et al. Biochemistry 50:3240–3249, 2011; Kruczynski et al. Investig New Drugs 29:9–21, 2011; Chelouah et al. PLoS One 6:e23597, 2011)) with no dose reductions. At DL 10 mg/m2/day, 6 dose-limiting toxicities (DLTs) were reported (3/4 evaluable patients: 2 grade 3 febrile neutropenia, 1 grade 4 neutropenia lasting at least 7 days, 1 grade 3 nausea, 1 decreased appetite, and 1 grade 3 asthenia). At dose 5 mg/m2/day, 2 DLTs were reported (2/6 treated patients: 2 grade 3 febrile neutropenia). Both DLs were defined as MTD. Stable disease was reported as best overall response in 2 (40%) patients having both received 9 cycles, one at each DL. 90.9% of patients experienced grade 4 neutropenia, but for only one (9.1%) it was reported as a serious adverse event. Conclusion Although there was some encouraging efficacy signal, grade 4 neutropenia led to complications and it was decided to stop the study. A DL below 5 mg/m2/day was not tested as this would not allow reaching the minimum serum concentration needed for the pharmacological activity of the drug.

Background V-domain Ig suppressor of T cell Activation (VISTA) is a negative checkpoint regulator of T cell response.1 VISTA is expressed within the tumor microenvironment, where its blockade can enhance antitumor immune responses.2 Furthermore, an increase in VISTA expression has been reported after treatment by anti-PD1/L1 and anti-CTLA4.3,4 This confirms that VISTA may play a key role as a mechanism of resistance to the currently used immunotherapies. VISTA/PSGL1 pH-selective biochemical interaction has been recently demonstrated.5 VISTA and PSGL1 expression pattern, their correlation and their relationship to myeloid infiltrates have been evaluated in samples from patients with solid tumors. K01401-020 (W0180) is a novel anti-VISTA antibody that has the potential to activate T cells when given as a monotherapy6, and thus to generate added activity when combined with anti-PD1/L1 antibodies in cancer patients. Methods This phase I/Ib for W0180 consists of 2 parts: an initial dose escalation phase I followed by an expansion cohorts phase Ib. In the dose escalation phase, 2 cohorts of patients will be assessed in parallel: the first cohort will be given W0180 as a single agent and the second cohort will receive W0180 in combination with pembrolizumab. The first dose and the schedule of administration of W0180 in combination with pembrolizumab will be determined using safety and pharmacokinetic data generated in monotherapy. The phase I will allow to determine the Maximum Tolerated Dose and Schedule (MTDS), to characterize Dose-Limiting Toxicities (DLTs) and explore pharmacodynamic activity of W0180 in monotherapy and combination with pembrolizumab. The dose-toxicity relationships will support the dose escalation process and will be used to assess the MTDS and recommended doses for expansion. Following completion of the dose escalation phase, the expansion phase will enroll cohorts of patients with homogeneous tumors to validate the dose/schedule, assess preliminary activity and to explore the potential relationship with VISTA and PSGL1 expression. Results N/A Conclusions N/A Trial Registration N/A Ethics Approval The study was approved by National French Ethic committee (CPP Ile de France V) and National Spanish Ethic committee (Comite Etico de Investigacion Clinica de Navarra) and was registered in the European database (EudraCT: 2019-002299-15). Consent N/A References Wang L, Rubinstein R, Lines JL, Wasiuk A, Ahonen C, Guo Y, Lu LF, Gondek D, Wang Y, Fava RA, Fiser A, Almo S, Noelle RJ, VISTA, a novel mouse Ig superfamily ligand that negatively regulates T cell responses. J Exp Med 2011;208:577–92. Lines JL, Pantazi E, Mak J, Sempere LF, Wang L, O’Connell S, Ceeraz S, Suriawinata AA, Yan S, Ernstoff MS, Noelle R, VISTA is an immune checkpoint molecule for human T cells. Cancer Res 2014;74:1924–32. Gao J, Ward JF, Pettaway CA, Shi LZ, Subudhi SK, Vence LM, Zhao H, Chen J, Chen H, Efstathiou E, Troncoso P, Allison JP, Logothetis CJ, Wistuba II, Sepulveda MA, Sun J, Wargo J, Blando J, Sharma P, VISTA is an inhibitory immune checkpoint that is increased after ipilimumab therapy in patients with prostate cancer. Nat Med 2017;23:551–555. Kakavand H, Jackett LA, Menzies AM, Gide TN, Carlino MS, Saw RPM, Thompson JF, Wilmott JS, Long GV, Scolyer RA, Negative immune checkpoint regulation by VISTA: a mechanism of acquired resistance to anti-PD-1 therapy in metastatic melanoma patients. Mod Pathol 2017;30:1666–1676. Johnston RJ, Su LJ, Pinckney J, Critton D, Boyer E, Krishnakumar A, Corbett M, Rankin AL, Dibella R, Campbell L, Martin GH, Lemar H, Cayton T, Huang RY, Deng X, Nayeem A, Chen H, Ergel B, Rizzo JM, Yamniuk AP, Dutta S, Ngo J, Shorts AO, Ramakrishnan R, Kozhich A, Holloway J, Fang H, Wang YK, Yang Z, Thiam K, Rakestraw G, Rajpal A, Sheppard P, Quigley M, Bahjat KS, Korman AJ, VISTA is an acidic pH-selective ligand for PSGL-1. Nature 2019;574:565–570 Libon C, Vandenberghe I, Marlin R, Gros W, Leonec M, Gomez-Pacheco M, Gallouet M, Fraboul F, Mahfoudi A, Dereuddre-Bosquet N, Ferre P, K0401-020 anti-VISTA antibody monotherapy increases specific CD8 T cell response in non-human primates. AACR Annual meeting 2020.

The insulin-like growth factor type 1 receptor (IGF-1R) is important in tumorigenesis, and its overexpression occurs in numerous tumor tissues. To date, therapeutic approaches based on mAbs and tyrosine kinase inhibitors targeting IGF-1R have only shown clinical benefit in specific patient populations. We report a unique IGF-1R–targeted antibody–drug conjugate (ADC), W0101, designed to deliver a highly potent cytotoxic auristatin derivative selectively to IGF-1R overexpressing tumor cells. The mAb (hz208F2-4) used to prepare the ADC was selected for its specific binding properties to IGF-1R compared with the insulin receptor, and for its internalization properties. Conjugation of a novel auristatin derivative drug linker to hz208F2-4 did not alter its binding and internalization properties. W0101 induced receptor-dependent cell cytotoxicity in vitro when applied to various cell lines overexpressing IGF-1R, but it did not affect normal cells. Efficacy studies were conducted in several mouse models expressing different levels of IGF-1R to determine the sensitivity of the tumors to W0101. W0101 induced potent tumor regression in certain mouse models. Interestingly, the potency of W0101 correlated with the expression level of IGF-1R evaluated by IHC. In an MCF-7 breast cancer model with high-level IGF-1R expression, a single injection of W0101 3 mg/kg led to strong inhibition of tumor growth. W0101 provides a potential new therapeutic option for patients overexpressing IGF-1R. A first-in-human trial of W0101 is currently ongoing to address clinical safety.

We describe the rationale and design of the ongoing randomized, active-controlled, multicenter, Phase III study evaluating the efficacy of pixantrone and rituximab versus gemcitabine and rituximab in patients with diffuse large B-cell lymphoma or follicular grade 3 lymphoma, who are ineligible for high-dose chemotherapy and stem cell transplantation, and who failed front-line regimens containing rituximab. The administration schedule is pixantrone 50 mg/m2 intravenously (iv.) or gemcitabine 1000 mg/m2 iv. on days 1, 8 and 15, combined with rituximab 375 mg/m2 iv. on day 1, up to six cycles. Pixantrone has a conditional European marketing approval for monotherapy in adults with multiple relapsed or refractory aggressive B-cell non-Hodgkin lymphoma. Our trial explores the efficacy of combining pixantrone with rituximab and completes postauthorization measures. Trial registration number: NCT01321541.

// Guillemette Fouquet 1, * , Stephanie Guidez 2, 11, * , Valentine Richez 2 , Anne-Marie Stoppa 3 , Christophe Le Tourneau 4 , Margaret Macro 5 , Cecile Gruchet 2 , Arthur Bobin 2 , Niels Moya 2 , Thomas Syshenko 2 , Florence Sabirou 2 , Anthony Levy 2 , Paul Franques 2 , Helene Gardeney 2 , Lionel Karlin 6 , Lotfi Benboubker 7 , Monia Ouali 10 , Jean-Claude Vedovato 10 , Pierre Ferre 10 , Mariya Pavlyuk 10 , Michel Attal 8 , Thierry Facon 9 and Xavier Leleu 2, 11 1 Institut Imagine, Unite Inserm U1163, Centre National de la Recherche Scientifique CNRS ERL8254, Paris, France 2 Hopital La Miletrie, Centre Hospitalier Universitaire, Poitiers, France 3 Institut Paoli Calmettes, Marseille, France 4 Institut Curie, Paris, France 5 Centre Hospitalier Universitaire, Caen, France 6 Centre Hospitalier Lyon Sud, Lyon, France 7 Centre Hospitalier Universitaire Tours, Tours, France 8 Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France 9 Service des Maladies du Sang, Centre Hospitalier Regional Universitaire, Lille, France 10 Institut de Recherche Pierre Fabre, Toulouse, France 11 Inserm Centre d’Investigation Clinique U1402, Centre Hospitalier Universitaire, Poitiers, France * Co-first author Correspondence to: Xavier Leleu, email: xavier.leleu@chu-poitiers.fr Keywords: multiple myeloma; CXCR4; monoclonal antibody; immunotherapy; homing of tumor cells Received: January 08, 2018 Accepted: March 29, 2018 Published: May 08, 2018 ABSTRACT Purpose: Multiple myeloma (MM) remains an incurable disease as tumor cells ultimately resist to all available drugs. Homing of tumor cells to the bone marrow microenvironment, involving especially the CXCR4/SDF-1 axis, allows them to survive, proliferate and resist to therapy. F50067, a humanized anti-CXCR4 IgG1 antibody, has promising preclinical activity in MM. We present a phase I multicenter escalation study in relapsed/refractory MM (RRMM) to determine the maximum tolerated dose (MTD) for F50067 alone and in combination with lenalidomide and low dose dexamethasone (Len-Dex). Experimental design: 14 end-stage RRMM patients received F50067 single agent ( n = 10) or in combination with Len-Dex ( n = 4). Results: One dose-limiting toxicity was observed, a grade 4 neutropenia lasting more than 7 days in combination arm. MTD could not be established. Thrombocytopenia was observed in 100% and neutropenia in 92.9% of patients with no cases of febrile neutropenia and no severe bleeding or hematoma. Non-hematological adverse events were of mild to moderate severity. Nine patients (6 in single arm and 3 in combination arm) were evaluable for response, with 66.7% overall response rate (≥PR) in combination arm, and 33.3% of disease control (≥SD) in single agent arm. At the time of study termination, 55.6% had progressed. Conclusion: This study suggests that egression of tumor cells to the blood stream can represent a novel therapeutic strategy for MM. However, because of significant hematological toxicity, this study had to be discontinued. Further studies are needed to validate the feasibility of this approach in clinical practice.

This post hoc analysis of a phase 3 trial explored the effect of pixantrone in patients (50 pixantrone, 47 comparator) with relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (NHL) confirmed by centralized histological review. Patients received 28-d cycles of 85 mg/m(2) pixantrone dimaleate (equivalent to 50 mg/m(2) in the approved formulation) on days 1, 8 and 15, or comparator. The population was subdivided according to previous rituximab use and whether they received the study treatment as 3rd or 4th line. Median number of cycles was 4 (range, 2-6) with pixantrone and 3 (2-6) with comparator. In 3rd or 4th line, pixantrone was associated with higher complete response (CR) (23·1% vs. 5·1% comparator, P = 0·047) and overall response rate (ORR, 43·6% vs. 12·8%, P = 0·005). In 3rd or 4th line with previous rituximab (20 pixantrone, 18 comparator), pixantrone produced better ORR (45·0% vs. 11·1%, P = 0·033), CR (30·0% vs. 5·6%, P = 0·093) and progression-free survival (median 5·4 vs. 2·8 months, hazard ratio 0·52, 95% confidence interval 0·26-1·04) than the comparator. Similar results were found in patients without previous rituximab. There were no unexpected safety issues. Pixantrone monotherapy is more effective than comparator in relapsed or refractory aggressive B-cell NHL in the 3rd or 4th line setting, independently of previous rituximab.

Insulin-like growth factor type 1 receptor (IGF-1R) has been recognized for decades for its role in tumorigenesis and growth1. In addition, overexpression of this receptor has been largely documented in numerous tumor tissues. However, so far, previous therapeutic approaches based on monoclonal antibodies and tyrosine kinase inhibitors failed to show clinical benefit in the overall patient population2. Here we disclose for the first time a novel IGF-1R targeted Antibody Drug Conjugate (ADC), W0101, designed to deliver highly potent cytotoxic drugs selectively to IGF-1R over-expressing tumor cells. The naked antibody for our ADC was selected on the basis of its specific binding properties to IGF-1R compared to insulin receptor (IR), and for its internalization properties. After coupling of a proprietary auristatin derivative to the naked antibody, neither the binding nor the internalization properties of W0101 evaluated by FACS analysis, were modified. Interestingly, the capacity of W0101 to induce cytotoxicity was evaluated in vitro in various cell lines and was demonstrated to be independent of effector functions. Mouse efficacy studies with various doses and schedules of administration were conducted in several models expressing different level of IGF-1Rin order to determine their sensitivity to W0101. The sensitivity of W0101 was correlated to the expression level of IGF-1R evaluated by IHC. And in a 3+ MCF-7 breast cancer model, a single injection of W0101 at 3mg/kg led to more than 90% tumor growth inhibition (TGI), associated with a modulation of the IGF-1R expression on the tumor cells (IHC study). The first in-human trial of W0101 is currently on going to address clinical safety. We believe that W0101 will bring a new therapeutic option for patients that overexpress IGF-IR. 1Pollak M. Insulin and insulin-like growth factor signaling in neoplasia. Nat Rev Cancer, 2008,8:915-928. 2Corvaia N, Beck A, Caussanel V, Goetsch L. Insulin-like growth factor receptor type I as a target for cancer therapy. Frontiers in Bioscience, Scholar, 5, 439-450, January 1, 2013 Citation Format: Barbara Akla, Noureddine Loukili, Alain Robert, Charlotte Beau-Larvor, Martine Malissard, Jean-Francois Haeuw, Alain Beck, Michel Perez, Cyrille Dreyfus, Mariya Pavlyuk, Eric Chetaille, Nathalie Corvaia. New approach for old target: W0101 antibody drug conjugate effectively inhibits tumor growth in preclinical models of IGF-1R overexpressing solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 815.