Abstract B023: CNS and systemic pharmacokinetics of antibody-drug conjugate payloads through convection-enhanced delivery
Authors: Jessica I. Griffith, Jiayan Le, Kendra A. Porath, Sonia Jain, Katrina K. Bakken, Jann N. Sarkaria, William F. Elmquist
Journal: Cancer Research (2024)

Abstract Glioblastoma (GBM) is one of the most malignant central nervous system (CNS) tumors and accounts for more than 60% of primary brain tumors in adults [1]. While chemotherapy is a frequently employed treatment for GBM, its lack of specificity towards tumor cells leads to toxicity in healthy tissues. Antibody-drug conjugates (ADCs) are a prevalent targeted-drug delivery strategy that may enhance the therapeutic window. ADC development for GBM has progressed in recent years, yet recent clinical trials have thus far failed to demonstrate drug efficacy [2]. This is likely attributed to poor brain penetration and heterogeneous drug distribution within GBM [3]. Convection-enhanced delivery (CED) is an invasive delivery method that can achieve direct administration of therapeutics to brain tumors and potentially could be used to enhance the delivery and efficacy of ADCs. This study investigates the CNS and systemic pharmacokinetics and distribution of similar payload molecules following CED administration of two GBM-targeting ADCs, ABBV-221 and ABT-414. The ADC payloads are monomethyl auristatin E (MMAE) and monomethyl auristatin F (MMAF), respectively, and both are potent anti-tubulin toxins commonly used as warheads for ADCs. Both ADCs and free MMAE were administered as single doses to FVB mice via CED infusion or intraperitoneal (IP) injection. Plasma and brain samples were collected over 24 hours for ABBV-221 and 96 hours for ABT-414, and unconjugated payload molecules were quantified via LC-MS/MS analysis. The results showed that free (i.e., not bound to the targeting antibody) MMAE has a significantly higher exposure in brain compared to plasma when delivered via CED, and exposure in the right hemisphere was 10-fold higher than the left hemisphere, as the site of CED infusion was located in the right hemisphere for all trials. Similar results for MMAE payload were observed after the CED of ABBV-221. Systemic administration of ABBV-221 resulted in a nearly 100-fold decrease in unconjugated MMAE concentration in brain, indicating the poor brain penetration of the ADC. Similarly, following the CED of ABT-414, unconjugated payload concentration was the highest in right anterior brain among all brain regions, and plasma concentration was below the limit of quantification. Systemic injection of ABT-414 resulted in non-quantifiable payload concentrations in either brain or plasma samples. Taking these results as a whole, this study demonstrated significantly enhanced brain distribution of payload molecules from GBM-targeting ADCs following CED compared to systemic administration. The consistent payload delivery pattern observed in both ADCs further supports the potential of CED as an effective drug delivery method for the treatment of GBM. These findings highlight the promise of CED as a means to address the limitations of conventional chemotherapy and improve therapeutic outcomes in GBM treatment. 1. Sarkaria JN et al. Neuro Oncol. 2018; 20:184–91. 2. Lassman AB et al. Neuro Oncol. 2023; 25:339–50. 3. Marin B-M, et al. Neuro Oncol. 2021; 23:2042–53. Citation Format: Jessica I. Griffith, Jiayan Le, Kendra A. Porath, Sonia Jain, Katrina K. Bakken, Jann N. Sarkaria, William F. Elmquist. CNS and systemic pharmacokinetics of antibody-drug conjugate payloads through convection-enhanced delivery [abstract]. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_1):Abstract nr B023.