Development of a Companion Diagnostic Assay for Detection of ADAM8-Positive Cancers - Triple-negative breast cancers (TNBCs) account yearly for ~25% of all breast cancer deaths. The current
Standard-of-Care (SoC), surgery, radiation and chemotherapy (CT), is not curative. More effective, targeted
treatments are urgently needed. Recently, we identified the cell surface protein ADAM8 as a critical driver of
TNBC tumor growth and metastasis via its Metalloprotease (MP) and Disintegrin (DI) domains, respectively,
and showed that treatment with an ADAM8 dual MP/DI antagonist monoclonal antibody (mAb) reduces TNBC
primary growth and metastases in mice [1]. Thus, we proposed that ADAM8 dual antagonist antibody therapy
will become a new component of care for TNBC and founded Adecto Pharmaceuticals, Inc. (Adecto) to bring
this therapy to patients. With Phase I STTR funding, we generated a panel of highly specific anti-human
ADAM8 dual antagonist mAbs (termed ADPs) and identified 2 top inhibitors, ADP2 and ADP13, that reduced
pre-existing primary tumor growth and metastasis, and improved survival as monotherapies. Addition of
ADP13 to the SoC CT Abraxane (ABX) enhanced ABX-mediated tumor inhibition and disease-free and overall
survival. Thus, ADAM8 antibody combination therapy could dramatically improve patient outcome. Adecto was
recently awarded a Phase II SBIR grant to continued development of this therapy. Of note, high ADAM8 levels
correlate with poor patient prognosis, and are seen on 34% of primary TNBCs and 48% of all breast cancer
metastases [1]. Thus, to identify patients who can benefit from ADAM8-targeted therapy, a diagnostic assay
will be needed. As there is currently no FDA-approved product for diagnosis of ADAM8 cancers, here we
propose to begin development using immunohistochemistry (IHC) of formalin-fixed paraffin embedded (FFPE)
patient biopsies. As this procedure requires antibodies that recognize ADAM8 protein under fixed conditions
following retrieval from paraffin embedding, we propose first to identify an IHC appropriate, clinical-grade,
ADAM8 mAb for development using our panel of ADPs as a starting point. Twelve of the 18 ADPs detected
ADAM8 on the surface of fixed cells in FACS analysis. ADP2, 3, 4, 13 and 17 showed particularly strong
binding and were selected for further studies. Preliminary IHC with FFPE pellets of HEK-293 cells expressing
transfected human ADAM8 (HEK-A8) vs empty vector (HEK-EV) support continued assessment of these
mAbs. Here, our milestones are to: (1) select a lead ADP for IHC based on both efficacy (using HEK-EV vs
HEK-A8) and specificity (using FFPE samples of HEK cells expressing related proteins ADAM9, 12, 15 or 33);
(2) develop an IHC scoring system for staining standardization using a control cell microarray (CCM)
containing FFPE samples of breast cancer cell lines with a gradient of ADAM8 levels and confirm the range
with Patient-Derived Xenograft FFPE and tissue samples; (3) validate our lead ADP and CCM using TNBC
primary patient FFPE samples. Identification of an ADAM8 IHC antibody with a strong data package will help
us attract Phase II funding and a partner for full development of a diagnostic product for selection of patients
who can benefit from ADAM8 targeted therapy.