fasn inhibitor tvb -2640 shows pharmacodynamic …€¦ · fasn inhibitor tvb -2640 shows...
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FASN inhibitor TVB-2640 shows pharmacodynamic effect and evidence of clinical activity in KRAS mutant NSCLC patients in a Phase 1 study
Fatty Acid Synthase (FASN)• Mediates neoplastic lipogenesis• Generates palmitate
o Acylation of signaling proteins such as KRASo Building block for long chain fatty acids, membranes and lipid raftso Converts glucose and other carbon sources into lipids to support
cancer cell signaling• Upregulated in tumor vs normal tissue• Correlates with poor prognosis in certain tumor types including NSCLC
(Visca et al., 2004)• KRAS-mutant cell lines show increased sensitivity to FASN inhibitors
than KRAS-WT cell lines (Ventura et al., 2015, Heuer et al., AACR 2016
Summary• TVB-2640 is a first in class FASN inhibitor • Inhibition of FASN and inhibition of de novo lipogenesis shown • KRAS-MUT NSCLC pts show increased clinical activity, and provide
a niche population with unmet need for clinical development of TVB-2640
• Potential mechanisms include KRAS4a palmitoylation, KRAS reliance on metabolism, maintenance of membrane architecture, and acylation of other signaling proteins
• Additional biomarker analyses are ongoing• Additional opportunities in other RAS mutant populations
• TVB-2640 is an oral, first-in-class, small-molecule reversible inhibitor of FASN with IC50 < 0.05 μM
• Multicenter, open label, phase 1 FIH study• Oral, once daily with 21 day continuous cycles (monotherapy)• TVB-2640 has a half-life of approx. 16 hours• Ongoing expansion phase dose of 100 mg/m2
• To date, 10 evaluable NSCLC patients enrolled on monotherapy
Marie O’Farrell, Tim Heuer, Katharine Grimmer, Richard Crowley, Joanna Waszczuk, Marina Fridlib, Richard Ventura, Claudia Rubio, Julie Lai, Arjun Panda, Doug Buckley, William McCulloch, George Kemble
3-V Biosciences, Menlo Park, USA.
TVB-2640 inhibits FASN in both KRAS-WT and KRAS-MUT NSCLC patients
FFPE sections stained with FASN CST rabbit Ab C20G5 using a validated method. ELISA for FASN performed on human sera using a commercially available ELISA kit (Immtech), log scale.
FASN palmitate
Malonyl-CoA
Acetyl-CoA
Citrate ACLY
ACC
SCD ELOVLs
Lipid signaling eg. diacylglycerol,
Energy production
Energy storage
Protein signaling eg. palmitoylation myristoylation
Structural role in membranes and rafts eg. phosphatidylcholine.
Fatty Acid Synthesis
Potential mechanism of action against KRAS-MUT
KRAS-MUT NSCLC patients have longer duration on study than KRAS-WT
Phase 1 solid tumor study 3V2640-CLIN-002with TVB-2640, a novel FASN inhibitor
• Tumor RNA expression showed high MUC5AC in Pt 042 (KRAS-MUT, prolonged stable disease) versus other patients
• Serum ELISAs showed higher baseline MUC5AC in Pt 042 and other NSCLC KRAS-MUT patients, decreased with TVB-2640 treatment
• MUC5AC has a palmitoylation site conserved with other mucins, which may require FASN-derived palmitate for function
FASN%
Palmitoyla)on+of+KRAS4a/H/N+
SREPB+mediated+transcrip)on+of+FASN+
Signaling%protein%acyla2on%%Membrane%synthesis%Second%messengers%Protein%trafficking%Metabolic%pathway%regula2on%
palmitate%%%%Acetyl>CoA%%Malonyl>CoA%
KRAS%palmitoyl)farnesyl)
Tumor&growth&and&metabolism&
TVB@2640+
• N=10 NSCLC; 3 KRAS-MUT, 5 KRAS-WT, 2 KRAS-unknown• Similar plasma TVB-2640 exposure across groups
• 100% (3/3) KRAS-MUT > 12 weeks on study • 0% (0/5) KRAS-WT > 12 weeks on study
Comprehensive biomarker sampling for first in class agent
MUC5AC is a potential biomarker of response in KRAS-MUT patients
Malonyl-CoA
FASN Palmitate in complex lipids
Acetyl-CoA
Malonyl Carnitine
TVB-2640
(serum)
(serum, sebum)
Sebum was collected using Sebutape® patches on the forehead for 30 minutes, and profiled by GC-MS and MS-flame ionization detection for lipid content at Metabolon. Normal donors were not administered TVB-2640. Similar inhibition of DNL observed across all patients tested (approx. 20).
Serum used for global metabolite profiling by UPLC-MS/MS, performed at Metabolon. All NSCLC monotherapy patients with data available are shown. Similar effect observed in other tumor types.
RNA-Seq (50 milion paired end reads, Illumina Hi-Seq2500) of fresh pre-treatment biopsies or archival tumor from 14 patients including 2 NSCLC (042 and 051). MUC5AC ELISA performed on serum from 8 NSCLC patients.
Thanks to the clinical site teams, the patients and their families. Also to Metabolon, Mosaic, Personalis, Trovagene and BioAgilityx for sample analysis. Poster available at www.3vbio.com
Acknowledgements
FASN expression in human NSCLC
TVB-2640 inhibits de novo lipogenesis
TVB-2640 plasma PK parameters calculated from day 1 of administration. All NSCLC monotherapypatients with PK data available are shown. Pts 094 and 121 pending.Un-monitored clinical data
Novel Non-Invasive Sebum Lipidomics
E. Dean1, G. Falchook2, M. Patel3, A. Brenner4, J. Infante5, HT. Arkenau6, E. Borazanci7,J. Lopez8, K. Moore9, P. Schmid10, AE. Frankel111The Christie NHS Foundation Trust, Manchester, UK, 2Sarah Cannon Research Institute at HealthONE, Denver, CO, 3Sarah Cannon Research Institute/Florida Cancer Specialists, FL, 4Cancer Therapy & Research Center, San Antonio, TX, 5Sarah Cannon Research Institute/Tennessee Oncology, 6Sarah Cannon Research Institute, London, 7Honor Health Research Institute/Translational Genomics Research Institute, AZ, 8The Royal Marsden/Institute of Cancer Research, Sutton, UK, 9Sarah Cannon Research Institute Univ. of Oklahoma, OK, 10Barts Cancer Institute, London, UK, 11Univ. of Texas Southwestern Medical Center, Dallas, TX
Phase 1 Investigators: 3V2640-CLIN-002
042$054$024$
003$105$043$045$051$
094$121$
Pt$ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
2 2 2 2 2
2 2 2 2 2
2 2 2 2
2 2 2
2 2 2
2 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
KRAS$MUT$KRAS$MUT$KRAS$MUT$
KRAS$WT$KRAS$WT$KRAS$WT$KRAS$WT$KRAS$WT$
TBD$TBD$
Serum Metabolomics
0"
3"
6"
9"
12"
15"
Pre$PD$ Post$PD$ Pre$SD$ Post$SD$
Malon
ylcarni1ne
$(Serum
)$
0"
0.2"
0.4"
0.6"
0.8"
1"
1.2"
Pre$PD$ Post$PD$ Pre$SD$ Post$SD$
Tripalma0
n$(Serum
)$$
Progressive)disease)2)KRAS1WT,)1)KRAS1UK)
Stable)disease)3)KRAS1MUT)
Pt)051)
Pt)045)Pt)043)
Pt)042)
Pt)024)
Pt)054)
Progressive)disease)2)KRAS1WT,)1)KRAS1UK)
Stable)disease)3)KRAS1MUT)
Pt)045)
Pt)051)Pt)043)
Pt)042)
Pt)024)
Pt)054)
0.01
0.1
1
10
1 2 8 22 1 2 8 22 1 2 8 22 1 2 8 22 1 2 8 22 1 2 8 22
Fold
chn
age
vers
us C
1D1
pred
ose
Time (days)
Wax esters Triacylglycerols Free fatty acids Diacylglycerols Squalenes
Pt#042#KRAS+MUT#
Normal##donor#X#
Pt#054#KRAS+MUT#
Pt#043#KRAS+WT#
Pt#051#KRAS+WT#
Normal##donor#Y#
0 8 22 43 64 85 127 169 211 0 8 22 64 1270
250
500
750
0
50
100
150
200
Time (days)
nmol
es p
er s
ebut
ape
Sapenic Acid TG Sat + Monounsat TG
nmoles per sebutape
Pt#042,#KRAS,MUT# Pt#054,#KRAS,MUT#
4 20 28 39 48 58 59 72 37 38 73 82 42 510123
100
200
300
Patient number
Tum
or M
UC
5AC
leve
ls(m
RN
A, R
PK
M)
0"
20"
40"
60"
80"
100"
Pre$PD$ Post$PD$ Pre$SD$ Post$SD$
MUC5
AC$(n
g/ml)$
Progressive)disease)3)KRAS1WT,)2)KRAS1UK)
Stable)disease)3)KRAS1MUT)
Pt)094)
Pt)043,)041)
Pt)042)
Pt)024)
Pt)054)Pt)045,)051)
Tumor&Genotype&
Tumor&&RNA0Seq&
Tumor&IHC&
Serum&Proteomics&
Serum&Metabolomics&
Sebum&Lipidomics&
FASN Tumor IHCSurvival FASN Serum ELISA
NSC
LC
0
50
100
150
200
250
FASN
IHC
(H s
core
in tu
mor
cel
ls)
50# 100# 150# 200#Months'
FASN*nega/ve#
FASN*posi/ve###########(p=0.1)#
Survival'Fun
c1on
'
0.2#
0.4#
0.6#
0.8#
1.0#
(Visca#et#al.,#2004)#
Nor
mal
mal
e
Nor
mal
fem
ale
NS
CLC
Sec
rete
d FA
SN
(ng/
ml)
!!!!!!!!Low
!!!!!!!!!Mod
erate!!!!!!!!!H
igh!!!
Weeks on study for monotherapy NSCLC patients
!Pt!
!KRAS!
Dose!!(mg,!mg/m2)!
Cmax!!(ng/ml)!
AUC0:24!(hr*ng/ml)!
024$ MUT$Q61H$ 100,$$80$ 3320$ 41360$042$ MUT$G13C$ 250,$130$ 3460$ $40900$
054$ MUT$(nd)$ 150,$100$ 3990$ 42490$
Average$ 3950$ 41583$
!Pt!
!KRAS!
Dose!!(mg,!mg/m2)!
Cmax!!(ng/ml)!
AUC0:24!(hr*ng/ml)!
003$ WT$$ 450,$240$ 4650$ 72740$
043$ WT$ 250,$130$ 7410$ $101200$
045$ WT$ 150,$100$ 2800$ 43960$
051$ WT$ 200,$100$ 3320$ 45440$
Average$ 4545$ 65835$