Therapeutic index improvement of antibody-drug conjugates

The commentary by Colombo and Rich recently published in Cancer Cell provides a timely and comprehensive review of the clinical maximum tolerated doses (MTDs) of antibody−drug conjugates (ADCs) and their corresponding small molecules/chemotherapies. The authors identified similarities between their...

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Main Authors: Hans-Peter Gerber, Sanjeev Gangwar, Alison Betts
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:mAbs
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Online Access:https://www.tandfonline.com/doi/10.1080/19420862.2023.2230618
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author Hans-Peter Gerber
Sanjeev Gangwar
Alison Betts
author_facet Hans-Peter Gerber
Sanjeev Gangwar
Alison Betts
author_sort Hans-Peter Gerber
collection DOAJ
description The commentary by Colombo and Rich recently published in Cancer Cell provides a timely and comprehensive review of the clinical maximum tolerated doses (MTDs) of antibody−drug conjugates (ADCs) and their corresponding small molecules/chemotherapies. The authors identified similarities between their MTDs and therefore question the historic assumptions made for ADCs, namely, that they increase the MTDs of their corresponding cytotoxic molecules. However, the authors did not address the superior anti-tumor responses of ADCs compared to their corresponding chemotherapies, as reported in clinical trials. In this point of view, we propose a revised model wherein the anti-tumor activities of ADCs and consequently their therapeutic indexes (TIs) are not solely associated with changes not only in their MTDs but also in their minimal effective doses (MEDs). In addition, when using an exposure-based TI calculation method, the superior anti-tumor activities of ADCs relative to their corresponding chemotherapy can readily be explained. We discussed the clinical and preclinical data in support of lower MEDs of ADCs and generated a revised graph illustrating the TI improvements of ADCs vs chemotherapy more accurately. We believe that our revised model can provide a blueprint for future improvements in protein engineering and chemical engineering of toxins to further advance ADC research and development.
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spelling doaj-art-673ab86c44f94f4f85c9c6e310d5b5a62025-07-23T08:12:01ZengTaylor & Francis GroupmAbs1942-08621942-08702023-12-0115110.1080/19420862.2023.2230618Therapeutic index improvement of antibody-drug conjugatesHans-Peter Gerber0Sanjeev Gangwar1Alison Betts2Department of Research and Development, Codeable Therapeutics, Palo Alto, CA, USADepartment of Research and Development, Codeable Therapeutics, Palo Alto, CA, USADepartment of DMPK & Modeling, Applied BioMath, Concord, MA, USAThe commentary by Colombo and Rich recently published in Cancer Cell provides a timely and comprehensive review of the clinical maximum tolerated doses (MTDs) of antibody−drug conjugates (ADCs) and their corresponding small molecules/chemotherapies. The authors identified similarities between their MTDs and therefore question the historic assumptions made for ADCs, namely, that they increase the MTDs of their corresponding cytotoxic molecules. However, the authors did not address the superior anti-tumor responses of ADCs compared to their corresponding chemotherapies, as reported in clinical trials. In this point of view, we propose a revised model wherein the anti-tumor activities of ADCs and consequently their therapeutic indexes (TIs) are not solely associated with changes not only in their MTDs but also in their minimal effective doses (MEDs). In addition, when using an exposure-based TI calculation method, the superior anti-tumor activities of ADCs relative to their corresponding chemotherapy can readily be explained. We discussed the clinical and preclinical data in support of lower MEDs of ADCs and generated a revised graph illustrating the TI improvements of ADCs vs chemotherapy more accurately. We believe that our revised model can provide a blueprint for future improvements in protein engineering and chemical engineering of toxins to further advance ADC research and development.https://www.tandfonline.com/doi/10.1080/19420862.2023.2230618Antibody-drug conjugatesoncology drug development, linker payload developmentpharmacologyprotein engineeringtherapeutic indextoxicology
spellingShingle Hans-Peter Gerber
Sanjeev Gangwar
Alison Betts
Therapeutic index improvement of antibody-drug conjugates
mAbs
Antibody-drug conjugates
oncology drug development, linker payload development
pharmacology
protein engineering
therapeutic index
toxicology
title Therapeutic index improvement of antibody-drug conjugates
title_full Therapeutic index improvement of antibody-drug conjugates
title_fullStr Therapeutic index improvement of antibody-drug conjugates
title_full_unstemmed Therapeutic index improvement of antibody-drug conjugates
title_short Therapeutic index improvement of antibody-drug conjugates
title_sort therapeutic index improvement of antibody drug conjugates
topic Antibody-drug conjugates
oncology drug development, linker payload development
pharmacology
protein engineering
therapeutic index
toxicology
url https://www.tandfonline.com/doi/10.1080/19420862.2023.2230618
work_keys_str_mv AT hanspetergerber therapeuticindeximprovementofantibodydrugconjugates
AT sanjeevgangwar therapeuticindeximprovementofantibodydrugconjugates
AT alisonbetts therapeuticindeximprovementofantibodydrugconjugates