Abstract 5946: OBI-999, an anti-Globo H antibody drug conjugate, exhibits synergistic anti-tumor effect in combination with pembrolizumab
Authors: Wang Chun-Chung , Lu Chi-Huan , Yang Jhih-Jie , Li Wan-Fen , Lai Ming-Tain 
Published: April 2023

Abstract
Background: Globo H (GH) is highly expressed in a variety of epithelial tumors with a limited expression in normal tissues rendering it a novel therapeutic target. OBI-999 is an antibody drug conjugate (ADC) consisting of a GH-specific monoclonal antibody conjugated with monomethyl auristatin E (MMAE) through a cathepsin B cleavable linker. MMAE is known to induce immunogenic cell death (ICD) which involves in the activation of cytotoxic T lymphocyte-driven adaptive immunity with long-term immunological memory.
Aim: The aim of this study was to evaluate the synergistic effects of OBI-999 + pembrolizumab on tumor growth suppression in several xenograft tumor models.
Methods: OBI-999-induced ICD was examined in vitro by the detection of damaging-associated molecular patterns (DAMPs) such as calreticulin (CRT), HMGB1, and ATP in incubated Globo H expressing cells. The synergistic effects with the combination of OBI-999 and pembrolizumab as well as the ICD-related immunity were assessed in vivo using advanced severe immunodeficient mice that were reconstituted with human peripheral blood mononuclear cells (PBMCs).
Results: Incubation of OBI-999 with high GH expression cancer cell lines (HCC-1428, NCI-N87 and NCI-H526) and mid GH expression cancer cell line (SW-480) induced the release of DAMPs including CRT, HMGB1, and ATP, in a dose- and time-dependent manner, indicating that OBI-999 is capable of inducing ICD in vitro. In the high GH expression human breast cancer cell line HCC-1428 xenograft model, OBI-999+pembrolizumab exhibited significantly stronger inhibition of tumor growth compared to either OBI-999 or pembrolizumab alone. Similar synergistic effects were observed in other xenograft tumor models including gastric (NCI-N87), small cell lung (NCI-H526), and colorectal (SW-480) cancers. Analysis of tumor-infiltrating lymphocytes (TILs) in HCC-1428 humanized mice showed that OBI-999 + pembrolizumab induced populations of activated cytotoxic CD8 T-cells and mature dendritic cells. Pembrolizumab decreased PD-1 expression on CD8 and CD4 cells, and OBI-999 decreased PD-L1 expression on tumor cells, which reversed the exhausted status of immune cells and alleviated immunosuppression in the tumor microenvironment.
Conclusion: We demonstrated significant synergistic effects of OBI-999 and pembrolizumab in several animal models. These synergistic effects may be attributed to the ability of OBI-999 to induce ICD, as demonstrated by the release of DAMPs in vitro and tumor-specific immunity in vivo, suggesting that OBI-999 can create a tumor microenvironment that enhances the function of pembrolizumab. The results suggest that combination therapy with OBI-999 and immune checkpoint inhibitors is warranted in human clinical studies. OBI-999 is currently in Phase 1/2 clinical trials for the treatment of advanced solid tumors with high GH expression (NCT04084366).
Citation Format: Chun-Chung Wang, Chi-Huan Lu, Jhih-Jie Yang, Wan-Fen Li, Ming-Tain Lai. OBI-999, an anti-Globo H antibody drug conjugate, exhibits synergistic anti-tumor effect in combination with pembrolizumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5946.