Phase 1 Study of ACE-041, a First-in-Class Inhibitor of Vascular Development in Patients with...
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0 1 2 3 4 5 6 7 8 P ancreatic O varian N S C LC C olon/R ectal H ead and N eck C arcinoid C ervix N S C LC H ead and N eck P ancreatic H ead and N eck E sophageal Angiosarcoma N S C LC Angiosarcoma U nknow n prim ary M etsynovialsarcom a Hemangiopericytoma Osteosarcom a 0.1 m g/kg 0.2 m g/kg 0.4 m g/kg 0.8 mg/kg 1.6 m g/kg 3.2 m g/kg C ycles Phase 1 Study of ACE-041, a First-in-Class Inhibitor of Vascular Development in Patients with Advanced Solid and Hematologic Tumors N. G. Borgstein 1 , S. Sharma 2 , J. C. Bendell 3 , M. S. Gordon 4 , H. Hurwitz 5 , N. Solban 1 , D. Mitchell 1 , A. Mulivor 1 , S. Pearsall 1 , C. H. Condon 1 , J. Seehra 1 , M. L. Sherman 1 1 Acceleron Pharma, Cambridge, MA; 2 Huntsman Cancer Institute ,Salt Lake City, UT; 3 Sarah Cannon Research Institute, Nashville, TN; 4 Premiere Oncology of Arizona, Scottsdale, AZ; 5 Duke University Medical Center, Durham, NC ALK1 a Novel Target for Angiogenesis Inhibition SMAD1/5/8 SRE ALK1 Type I Type II P SMAD4 BMP9 BMP10 Activin Receptor-Like Kinase (ALK1) Involves a Unique Signaling Pathway for Angiogenesis ALK1 is a Type 1 receptor that binds with high affinity to BMP9 and BMP10, proteins in the TGF- β protein superfamily. Signals transduced through R-Smads, including Smad1, Smad5, Smad8. The Role of ALK1 Signaling in Angiogenesis ACE-041 is a First-in-Class Angiogenesis Inhibitor Basement Membrane Plug Assay ALK1 Regulates Development of Functional Vasculature The TGF-β superfamily of proteins regulates growth, differentiation, and development of tissue systems, including vasculature Activin Receptor-Like Kinase 1 (ALK1) is a Type 1 receptor that binds to BMP9 and BMP10, which are members of the TGF-β protein superfamily ALK1 receptor is expressed exclusively on arterial endothelium, and only during active angiogenesis. − In contrast, VEGF receptors are constitutively expressed on numerous tissues ALK1 signaling is required to complete development of functional vasculature, during normal and pathologic angiogenesis − Expression of ALK1 is activated during embryogenesis, wound healing and tumor angiogenesis Phase 1 Study of ACE-041 in Advanced Cancer ACE-041 Inhibits Multiple Pro-Angiogenic Growth Factors ACE-041 Inhibits Tumor Growth by Inhibiting Angiogenesis ACE-041 Prevents Signaling Through ALK1 Receptor ALK1 signaling is essential to guide development of endothelial cells into a functional vessel system − Regulates proliferation, migration, differentiation, maturation, tube formation, and several other functions of endothelial cells Complete or partial loss-of-function mutation of ALK1 impairs angiogenesis and results in structural abnormalities, which form during development of new vasculature − Homozygous deletion of ALK1 is embryonic lethal due to severe vascular malformations − Hemizygous deletion of ALK1 results in a similar but milder phenotype • In adult humans, Hereditary Hemorrhagic Telangiectasia (HHT2) patients develop sporadic arteriovenous malformations, recurrent epistaxis, and telangiectasias, which manifest later in life • In animal studies, crossing HHT2 mice with RIP1-Tag2 mice (an animal model of pancreatic islet cell tumors) suppresses tumor growth and progression by inhibiting angiogenesis Characteristic structural abnormalities are arteriovenous shunts, abnormal looping, and the absence of intervening capillary beds, which produce new vasculature that is incapable of oxygen delivery ACE-041 is a Fully Human ALK1-Fc Fusion Protein ACE-041 is a first-in-class angiogenesis inhibitor that works by inhibiting ALK1 signaling ACE-041 is a fully-human, recombinant fusion protein produced by joining the extracellular domain of the human ALK1 to the Fc portion of a human antibody This creates a ligand “trap”, which intercepts BMP9 and BMP10 before these proteins can activate ALK1 signaling ACE-041 binds with high affinity to BMP9 and BMP10, but does not bind to VEGF, FGF, or TGF-β Chick Chorioallantoic Membrane (CAM) Assay Study Status - currently ongoing Study Objectives Evaluate the safety, tolerability, and pharmacokinetics of ACE-041 Identify a maximum tolerated dose (MTD) of ACE-041 to advance into phase 2 studies Assess for pharmacodynamic and anti-tumor activity of ACE-041 Study Design Open-label, multiple-dose, 3+3 dose-escalation study in patients with advanced cancer ACE-041 administered q3w SC for 4 injections; patients with SD or better allowed to continue therapy Patients with advanced solid tumors or relapsed / refractory multiple myeloma Study Overview Pharmacodynamic Measures RECIST 1.1 imaging criteria to assess tumor response DCE-MRI scans to assess changes in blood flow and vascular permeability PET-CT scans to assess metabolic activity Panel of exploratory, serum biomarkers of angiogenesis and TGF-β protein superfamily ALK1 is a Novel Therapeutic Target for Cancer ACE-041 is a potent inhibitor of tumor angiogenesis Treatment with ACE-041 inhibits tumor growth and progression in numerous animal models of cancer − Breast cancer − Pancreatic islet cell cancer − Lung cancer (not shown) − Multiple myeloma (not shown) ACE-041 represents a unique approach to therapeutic angiogenesis, and has potential as a novel treatment for cancer MCF-7 Orthotopic Breast Cancer Model RIP1-Tag2 Pancreatic Islet Cell Tumor Model CONTROL RAP-041 References: Cunha et al. (2010) J Exp Med. 207:85- 100 Mitchell et al. (2010) MCT 9:379-88 Park et al. (2009) JCI 119:3487 Oh et al. (2000) PNAS 97:2626-31 Seki et al. (2003) Circ Res 93:683-89 Suzuki et al. (2010) J Cell Sci. 123:1684-1692 Conclusions ACE-041 is a novel inhibitor of vascular maturation targeting ALK1 Preclinical evidence of antitumor activity observed with ACE-041 in numerous animal tumor models CONTROL RAP-041 CD31 ALK1 IgG1 Antibody Extracellular Domain of ALK1 Fc Domain of IgG1 Antibody ACE-041 ALK1-Fc fusion protein + + + + + + + + still on treatment + +
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Transcript of Phase 1 Study of ACE-041, a First-in-Class Inhibitor of Vascular Development in Patients with...
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PancreaticOvarianNSCLC
Colon/Rectal Head and Neck
CarcinoidCervix
NSCLCHead and Neck
PancreaticHead and Neck
EsophagealAngiosarcoma
NSCLCAngiosarcoma
Unknown primaryMet synovial sarcomaHemangiopericytoma
Osteosarcoma
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Phase 1 Study of ACE-041, a First-in-Class Inhibitor of Vascular Development in Patients with Advanced Solid and Hematologic TumorsN. G. Borgstein1, S. Sharma2, J. C. Bendell3, M. S. Gordon4, H. Hurwitz5, N. Solban1, D. Mitchell1, A. Mulivor1, S. Pearsall1, C. H. Condon1, J. Seehra1 , M. L. Sherman1
1Acceleron Pharma, Cambridge, MA; 2Huntsman Cancer Institute ,Salt Lake City, UT; 3Sarah Cannon Research Institute, Nashville, TN; 4Premiere Oncology of Arizona, Scottsdale, AZ; 5Duke University Medical Center, Durham, NC
ALK1 a Novel Target for Angiogenesis Inhibition
SMAD1/5/8
SRE
ALK1Type I
Type II
P
SMAD4
BMP9 BMP10
Activin Receptor-Like Kinase (ALK1) Involves a Unique Signaling Pathway for AngiogenesisALK1 is a Type 1 receptor that binds with high affinity to BMP9 and BMP10, proteins in the TGF-β protein superfamily. Signals transduced through R-Smads, including Smad1, Smad5, Smad8.
The Role of ALK1 Signaling in Angiogenesis ACE-041 is a First-in-Class Angiogenesis Inhibitor
Basement Membrane Plug Assay
ALK1 Regulates Development of Functional Vasculature
The TGF-β superfamily of proteins regulates growth, differentiation, and development of tissue systems, including vasculature
Activin Receptor-Like Kinase 1 (ALK1) is a Type 1 receptor that binds to BMP9 and BMP10, which are members of the TGF-β protein superfamily
ALK1 receptor is expressed exclusively on arterial endothelium, and only during active angiogenesis.
− In contrast, VEGF receptors are constitutively expressed on numerous tissues
ALK1 signaling is required to complete development of functional vasculature, during normal and pathologic angiogenesis
− Expression of ALK1 is activated during embryogenesis, wound healing and tumor angiogenesis
Phase 1 Study of ACE-041 in Advanced Cancer
ACE-041 Inhibits Multiple Pro-Angiogenic Growth Factors
ACE-041 Inhibits Tumor Growth by Inhibiting Angiogenesis
ACE-041 Prevents Signaling Through ALK1 Receptor
ALK1 signaling is essential to guide development of endothelial cells into a functional vessel system
− Regulates proliferation, migration, differentiation, maturation, tube formation, and several other functions of endothelial cells
Complete or partial loss-of-function mutation of ALK1 impairs angiogenesis and results in structural abnormalities, which form during development of new vasculature
− Homozygous deletion of ALK1 is embryonic lethal due to severe vascular malformations
− Hemizygous deletion of ALK1 results in a similar but milder phenotype
• In adult humans, Hereditary Hemorrhagic Telangiectasia (HHT2) patients develop sporadic arteriovenous malformations, recurrent epistaxis, and telangiectasias, which manifest later in life
• In animal studies, crossing HHT2 mice with RIP1-Tag2 mice (an animal model of pancreatic islet cell tumors) suppresses tumor growth and progression by inhibiting angiogenesis
Characteristic structural abnormalities are arteriovenous shunts, abnormal looping, and the absence of intervening capillary beds, which produce new vasculature that is incapable of oxygen delivery
ACE-041 is a Fully Human ALK1-Fc Fusion Protein ACE-041 is a first-in-class angiogenesis inhibitor that works by
inhibiting ALK1 signaling
ACE-041 is a fully-human, recombinant fusion protein produced by joining the extracellular domain of the human ALK1 to the Fc portion of a human antibody
This creates a ligand “trap”, which intercepts BMP9 and BMP10 before these proteins can activate ALK1 signaling
ACE-041 binds with high affinity to BMP9 and BMP10, but does not bind to VEGF, FGF, or TGF-β
Chick Chorioallantoic Membrane (CAM) Assay
Study Status - currently ongoing
Study Objectives Evaluate the safety, tolerability, and pharmacokinetics of ACE-041
Identify a maximum tolerated dose (MTD) of ACE-041 to advance into phase 2 studies
Assess for pharmacodynamic and anti-tumor activity of ACE-041
Study Design Open-label, multiple-dose, 3+3 dose-escalation study in patients with advanced cancer
ACE-041 administered q3w SC for 4 injections; patients with SD or better allowed to continue therapy
Patients with advanced solid tumors or relapsed / refractory multiple myeloma
Study Overview
Pharmacodynamic Measures RECIST 1.1 imaging criteria to assess tumor response
DCE-MRI scans to assess changes in blood flow and vascular permeability
PET-CT scans to assess metabolic activity
Panel of exploratory, serum biomarkers of angiogenesis and TGF-β protein superfamily
ALK1 is a Novel Therapeutic Target for Cancer ACE-041 is a potent inhibitor of tumor angiogenesis
Treatment with ACE-041 inhibits tumor growth and progression in numerous animal models of cancer
− Breast cancer
− Pancreatic islet cell cancer
− Lung cancer (not shown)
− Multiple myeloma (not shown)
ACE-041 represents a unique approach to therapeutic angiogenesis, and has potential as a novel treatment for cancer
MCF-7 Orthotopic Breast Cancer Model
RIP1-Tag2 Pancreatic Islet Cell Tumor Model
CONTROL RAP-041References: Cunha et al. (2010) J Exp Med. 207:85-100Mitchell et al. (2010) MCT 9:379-88Park et al. (2009) JCI 119:3487
Oh et al. (2000) PNAS 97:2626-31Seki et al. (2003) Circ Res 93:683-89Suzuki et al. (2010) J Cell Sci. 123:1684-1692
Conclusions ACE-041 is a novel inhibitor of vascular maturation targeting ALK1
Preclinical evidence of antitumor activity observed with ACE-041 in numerous animal tumor models
CONTROL RAP-041
CD31
ALK1
IgG1Antibody
Extracellular Domain of ALK1
Fc Domain of IgG1 Antibody
ACE-041ALK1-Fc
fusion protein
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+ still on treatment
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+
