Antigen-targeted activation of Topo1 inhibitors via click chemistry - Abstract
Most drugs are administered systemically and spread throughout the body. Due to lack of specificity for the
pathological site, high doses are required to achieve effective therapeutic concentrations, causing toxicity and
adverse drug effects (ADEs) at sites of the body where they are not needed. Each year, there are approximately
1.2 million reports of ADEs in the U.S. alone, representing over 5% of all hospitalized patients. ADEs also
contribute to the 90% failure rate of drug candidates due to the inability to achieve therapeutic concentrations at
the target site or intolerable side effects, thus leading to high drug development costs and prices. Toxicity and
ADEs are extremely common in chemotherapeutic compounds administered systemically, such as exatecan, a
potent inhibitor of topoisomerase I. While these compounds exhibit potent anti-tumor activity, their use and
efficacy are hindered by severe and dose-limiting toxicities, including neutropenia and liver dysfunction.
However, even specific targeting by addition of antibody conjugation to these drugs (antibody-drug conjugates;
ADCs), such as Trastuzumab-deruxtecan (an exatecan analogue) have multiple limitations including systemic
release of the chemotherapy payload, poor penetration into solid tumors and limited internalization into tumor
cells. Additional factors such as low receptor copy numbers, required internalization for payload activation, and
inefficient subcellular trafficking to the lysosome all further limit the potential development of new ADCs. Shasqi
is developing a platform to activate drugs at a specific site in the body, thus enhancing their efficacy
while minimizing systemic toxicity and adverse drug events (ADEs). Shasqi’s modular click activated
prodrug (CAP) platform addresses a critical need and broad commercial opportunity for new technologies
capable of efficient activation of therapeutics with spatiotemporal control, making drugs more efficacious by
increasing target site concentrations while also improving safety by reducing systemic exposure. This platform
also has the potential to enable the reinvestigation and repurposing of drug candidates that may have previously
been shelved due to high levels of toxicity. To achieve the aims of this Direct to Phase II study, Shasqi will first
characterize and test a novel HER2-targeted activating agent conjugates with attenuated exatecan and
deruxtecan prodrugs in a HER2+ xenograft mouse model of gastric cancer. Then, the efficacy of the platform will
be confirmed and challenged within a low expressing HER2+ cancer model and orthotopic model and
pharmacokinetics will be evaluated in naïve rats. Finally, non-GLP toxicology studies of the selected exatecan
and deruxtecan conjugates in naïve rats will be performed prior to the final step of GLP manufacturing for the
final conjugate and protodrug in advance of IND-enabling toxicology studies. The above will identify novel
antigen-targeted structures for use in Shasqi’s Gen2 CAP and will advance an initial product toward the clinic,
which could also be used in future to develop site-directed treatments for other indications, including antibiotics
for site-specific infections, autoimmunity, and localized anti-inflammatory and pain management.