By Steve Kennedy* and Anthony D. Sabatelli** --
Over the last decade, antibody-drug conjugates (ADCs) have emerged as a highly promising new class of biopharmaceuticals. By taking advantage of the specificity of monoclonal antibodies and the potency of small-molecule chemotherapy drugs, ADCs have proven to provide a highly effective combination -- particularly in the oncology space. The recent FDA approvals of Kadcyla (Genentech), Adcetris (Seattle Genetics), Mylotarg (Wyeth Holdings / Pfizer), and Besponsa (Wyeth Holdings / Pfizer), as well as the over sixty other ADCs in clinical trials, show that these drugs represent an increasing proportion of newly approved cancer therapies and will generate growing revenues for firms innovating in the field. Accompanying this burst in ADC development is the corresponding activity in the patent space. This article summarizes some of the important developments.
ADC Mechanism of Action
An ADC is composed of an antibody conjugated to a cytotoxic compound (the payload) via a chemical linker. Traditional chemotherapy drugs can be highly effective at destroying cancer cells, but in general their specificity for cancer tissue is extremely low, and many healthy cells are killed as well. However linking highly potent anticancer drugs to antibodies that bind to antigens present at high levels in tumor cells greatly improves drug specificity for the cancer cells and reduces side effects. Generally, once an ADC binds an antigen on the cancer cell surface, it is internalized and sent along the endosome/lysosome pathway for degradation. In the lysosome the payload is released either through specific cleavage of the linker by lysosome enzymes or general degradation of the antibody. The released cytotoxic compound then leaves the lysosome and causes death of the cancer cell. See the following scheme which illustrates this biochemical process.
Several processes by which ADCs specifically target and destroy cancer cells. Figure from Lu et al., "Linkers Having a Crucial Role in Antibody-Drug Conjugates," Int. J. Mol. Sci. 17(4): 561 (2016).
ADC Patent Landscape
The ADC research space and development pipeline are growing rapidly. This section is not meant as an exhaustive review of the patent landscape. Rather this section will provide insight into unique patent strategies employed for the intellectual property protection of ADC drugs. Because ADCs represent an extension of the well-established field of conventional therapeutic antibodies and a combination of biologic and organic drug components, the patent landscape is relatively crowded. However, the three components of an ADC, i.e. the antibody, the payload drug, and the linker, as well as their unique combination provide significant opportunities for innovation.
Early ADC therapies suffered from low potency relative to standard chemotherapy agents. However, developments in linker technologies and the use of cytotoxic agents that were otherwise too potent for direct administration greatly improved ADCs' effectiveness. The first ADC therapy approved by the FDA, is marketed as Mylotarg (acquired by Pfizer via Wyeth Holdings). This drug targets the antigen CD33, which is expressed at high levels on the surface of acute myeloid leukemia cells, to deliver a highly toxic calicheamicin payload. Mylotarg had a challenging history, and despite accelerated approval in 2000, it was voluntarily removed from the market after several early deaths in follow-on confirmatory trials. After significant adjustments to the dosing regimen, Mylotarg was reapproved in 2017. See, (US5773001)
Since Mylotarg's first introduction to the market, three other ADC drugs have been approved by the FDA. Besponsa (US9351986B2, Wyeth Holdings) employs the same payload and linker of Mylotarg conjugated to an anti-CD22 antibody that targets B-cell precursor acute lymphoblastic leukemia cells. Both Mylotarg and Besponsa employ hydrazone linkers that are specifically cleavable in the lysosome and are otherwise highly stable in circulation. The calicheamicin payloads delivered by these drugs had also been under investigation by other groups, such as American Cyanamid Company as seen by an early patent from this area (US5714586).
Adcetris (US7829531), licensed by Seattle Genetics, targets the antigen CD30, which is present at high levels in certain non-Hodgkins lymphoma cells. Its valine-citrulline linker (US7745394) is specifically cleavable by cathepsin B, a lysosome enzyme, allowing rapid release of the payload after internalization. Citrulline, biologically generated by post-translational modification of arginine residues, has higher stability in circulation than other amino acids and improves the bioavailability of valine-citrulline-linked ADCs. Other companies such as Ambrx (US9975936) have attempted to push this approach further through the use of nonnatural amino acids with even higher stability. Adcetris delivers a highly-potent MMAE payload (US6884869). Companies such as Mersana have developed several other auristatin compounds for use as ADC payloads (US9943609).
Kadcyla (US8337856), licensed by Genentech, targets the HER2 antigen expressed at high levels in certain metastatic breast cancers and delivers the chemotherapy agent DM1. Its linker is noncleavable, but degradation of the antibody in the acidic environment of the lysosome eventually leads to payload release. The DM1 payload is typical of the relatively large class of maytansinoid cytotoxic agents, which are under development by several companies such as ImmunoGen (US5208020).
As will be discussed in greater detail in future pieces, novel approaches to ADC antibodies, linkers, and payloads have been developed, both from a technological and IP perspective. The targeting of noninternalizing antigens (US20150030536, US20170028080A1) has generated particular excitement. Additionally novel antibody formats (US9290577, US9856314), the use of masked proproteins (US20130101555), and conditionally-active antibodies (US9637734B2) have provided new targeting mechanisms.
Linker technologies also present significant opportunities for innovation. Different biological conjugation and cleavage mechanisms have been developed, such as the use of reactive thiols on engineered cysteine residues (US7521541B2), sortase-mediated conjugation (US9872923), MTGase-mediated linkage (US15214331), and transglutaminase linkage (US20170106096A1). Several other proprietary linkers have been developed as well (US9540438B2, US7223837B2).
Payload development provides further opportunities for innovation. Both previously-developed and novel cytotoxic agents have been employed as ADC payloads, such as anthracyclin derivatives (US8900589), duocarmycins (US9629924B2, US5475092, US5585499), taxanes (US7390898), benzodiazepine derivatives (US9889207B2, US8765740, US9242013B2, US15724423), and tubulysins (US9801951B2).
As evidenced from this research and IP activity, ADCs provide an innovative solution to intractable cancers, and there are significant opportunities for technical innovation. It will be particularly interesting to see how companies manage the overlapping intellectual property landscape and nearing expirations of patents on naked antibodies and payloads that could be used in ADC therapies. Later in this series, we will discuss in greater depth advancements in antibody, linker, and payload technologies, as well as patent strategies for navigating the significant patent landscape.
* Steve Kennedy is a Ph.D. Candidate in the Chemistry Department at New York University. He specializes in biophysical characterization of protein complexes and is currently focused on the role of adaptor proteins in signaling pathways. Prior to attending NYU, Steve obtained his B.S. in Chemistry with Cum Laude honors at the University of Massachusetts - Boston, during which time he conducted bioanalytical mass spectrometry method development and lipidomics research.
** Dr. Sabatelli is a Partner with Dilworth IP
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