小中大目前ImmunoGen以及Seattle Genetics为开发ADC药物的先驱,以两个公司为主并与其他药企合作开发ADC药物逐渐成为一种趋势。目前已有三个ADC药物经FDA批准上市,其中Wyeth(acquired by Pfizer)的Gemtuzumab ozogamicin(Mylotarg)与2000年批准,但由于其cytotoxic arm未起到预期的作用,于2010年主动退出市场。
另一个为2011年8月批准的bretuximab vedotin(Adcetris)。Bretuximab vedotin(Adcetris)由Seattle Genetics/Millennium Pharmaceuticals公司开发,FDA于2011年批准了其加速新药申报,用于治疗于霍奇金淋巴瘤和复发性间变性大细胞淋巴瘤(ALCL)两项适应症。Brentuximab vedotin在美国一年的销售额达到了US$136million(2011年10月-2012年9月)。
还有一个于2013年2月由FDA通过优先审查程序批准,ado-trastuzumabemtansine(Kadcyla(T-DM1),由Roche/Genentech/ImmunoGen开发用于治疗乳腺癌的药物,是FDA批准的第四个靶向HER2的蛋白药物。Roche/Genentech提供单抗trastuzumab,ImmunoGen公司提供毒性小分子药物DM1与偶联技术。专家预计Kadcyla在全球一年的销售额将超过US$1billion。
随着单克隆抗体靶向技术的发展,载体与小分子药物偶联技术的进步,以及高毒性小分子细胞毒药物的发现,成功制备高亲和力、靶向性、毒副作用小的ADC成为可能,ADC药物已成为肿瘤药物研究的新热点,以ImmunoGen以及Seattle Genetics为主,联合医药企业开合ADC药物,目前至少15个ADC药物正在进行临床试验,如表所示。
Table 2. ADCs in clinical trial
ADC
Target; indications
Clinical stage
Company
Gemtuzumab ozogamicin
Gemtuzumab-hydrazonecalichea icin (Mylotarg) CD33; myeloid leukemia FDA approved 2000,
withdrawn 2010 Wyeth/Pfizer
Inotuzumab ozogamicin
Inotuzumab-hydrazonecalicheami in (CMC-544) CD22; non-Hodgkin's lymphoma,
lymphocytic leukemia Phase III Wyeth
Brentuximab vedotin
Brentuximab-MC-VC-MMAE
(SGN-35) CD30; hematologic malignancies,
Hodgkin's lymphoma FDA approved 2011 Seattle Genetics
Glembatumumab vedotin
CDX-011-MC-VC-MMAE (CDX-011) GPNMB; melanoma,
breast cancer Phase II Celldex Therapeutics/
Seattle Genetics
3ee9-MMAE (BAY 79-4620) CAIX (MN); solid tumors Phase I Bayer/Seattle Genetics
1 C1- MC-MMAF (MEDI-547) EphA2; ovarian cancer, solid
tumors Phase I AstraZeneca MedImmune/
Seattle Genetics
SGN-70- MC-VC-MMAF (SGN-75) CD70; renal cell carcinoma,
non-Hodgkin's lymphoma Phase I Seattle Genetics
PSMA-ADC anti-PSMA-MMAE PSMA Phase I Progenics/Seattle Genetics
Trastuzumab emtansine
Trastuzumab-MCC-DM1 (T-DM1) HER2/neu; HER2t breast cancer FDA approved 2013 Genentech/Roche/ImmunoGen
Lorvotuzumab mertansine
HuN901-SPP-DM1 (IMGN901 CD56; Merkel cell cancer,
small cell lung cancer,
multiple myeloma
ovarian cancer Phase II ImmunoGen
SAR3419
huB4-SPDB-DM4 (huB4-DM4) CD19; B-cell lymphoma Phase I Sanofi/ImmunoGen
MGN388
Antibody-SPDB-DM4 Integrin; antivascular/ solid tumors Phase I Centocor (JnJ)/ImmunoGen
BIIB-015
Antibody-SPDB-DM4 Cripto; solid tumors Phase I Biogen-IDEC/ImmunoGen
BT-062
Anti-CD138-SPDB-DM4 CD138; multiple myeloma Phase I/II Biotest/ImmunoGen
SAR566658 huDS6-DM4 CA6 ovarian, cervical, breast Phase I Sanofi/ImmunoGen
MDX-1203-MC-VC-MGBA
(duocarmycin) CD70; renal cell carcinoma,
non-Hodgkin's lymphoma Phase I
Bristol-Myers Squibb