Abstract 1918: LX-101, a novel, clinical stage, payload-bearing targeted therapy directed to the insulin-like growth factor receptor (IGF-1R), demonstrates potent preclinical anti-tumor activity against multiple cancer types with well-established ties to the IGF-1/IGF-1R pathway

Abstract Objective: LX-101 is a next-generation, targeted therapy directed to the insulin-like growth factor 1 receptor (IGF-1R). LX-101 consists of a proprietary IGF-1 variant coupled to a cytotoxic methotrexate payload. LX-101 was previously evaluated in Phase 1 trials of adult patients with advanced, pretreated cancers, where it was well-tolerated and demonstrated single agent activity. Neither a dose limiting toxicity, nor a maximum tolerated dose was reached, leaving potential room for additional dose escalation and schedule optimization. Multiple aggressive cancers of unmet need have genetic alterations affecting the IGF-1R pathway and/or high IGF-1R expression that correlates with poor outcomes, including certain cancers of the breast, head and neck, Ewing’s sarcoma, osteosarcoma, and others. Prior attempts at inhibiting IGF-1R with non-payload bearing naked monoclonal antibodies or small molecules produced a range of clinical outcomes including some partial and complete responses. None of these agents, however, were ultimately approved, potentially due to suboptimal potency that allowed for escape mechanisms, including redundant signaling pathways, and the lack of enrichment for select tumor types with strong ties to the IGF-1/IGF-1R pathway. Herein, we investigated the anti-tumor activity of the payload-bearing agent LX-101 against IGF-1R-involved cancer cell lines. Methods: Cell lines were incubated with LX-101 (~1. 6 - 2500nM). Cell viability was assessed by CellTiter-Glo after 4 days. IC50s were calculated using GraphPad PRISM software. Results: LX-101 displayed potency against head and neck cancer (FaDu, IC50 = 9 nM), triple negative breast cancer (BT-20, IC50 = 17 nM), Ewing’s sarcoma, including EWSR1-FLI1 gene fusion-positive cell lines RD-ES (IC50 = 10 nM), A-673 (IC50 = 14 nM), and SK-ES-1 (IC50 = 29 nM) and EWSR1-ERG gene fusion-positive cell line CADO-ES1 (IC50 = 14 nM). LX-101 was also potent against PAX3-FOXO1 gene fusion positive alveolar rhabdomyosarcoma (SJCRH30, IC50 = 23 nM), osteosarcoma (143B, IC50 = 6 nM; HOS, IC50 = 7 nM; U2OS, IC50 = 32 nM), and neuroblastoma (SK-N-AS, IC50 = 16 nM; IMR-32, IC50 = 20 nM; SH-SY5Y, IC50 = 30 nM). Conclusion: These results demonstrate that LX-101 has potent preclinical anti-tumor activity against multiple cancer cell lines with well-established ties to the IGF-1/IGF-1R pathway, including with different genetic and epigenetic alterations. These data support further clinical development of LX-101 in IGF-1R-involved cancers. New clinical trials are planned. Citation Format: Matt Hoberman, Arkadiusz Z. Dudek. LX-101, a novel, clinical stage, payload-bearing targeted therapy directed to the insulin-like growth factor receptor (IGF-1R), demonstrates potent preclinical anti-tumor activity against multiple cancer types with well-established ties to the IGF-1/IGF-1R pathway abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 1918.