Therapeutic combinations comprising anti-FOLR1 immunoconjugates
Therapeutic combinations of immunoconjugates that bind to FOLR1 (e.g., IMGN853) with anti-VEGF agents (e.g., bevacizumab), a platinum-based agent, and/or doxorubicin are provided. Methods of administering the combinations to treat cancers, e.g., ovarian cancers, with greater clinical efficacy and/or decreased toxicity are also provided.
1. A method for treating a patient having a FOLR1-expressing cancer comprising administering to said patient in need thereof bevacizumab in combination with an immunoconjugate that binds to folate receptor 1 (FOLR1), wherein said immunoconjugate comprises an antibody or antigen-binding fragment thereof comprising a heavy chain variable region (VH) complementary determining region (CDR)1 sequence of SEQ ID NO:9, a VH CDR2 sequence of SEQ ID NO:10, and a VH CDR3 sequence of SEQ ID NO:12, and a light chain variable region (VL) CDR1 sequence of SEQ ID NO:6, a VL CDR2 sequence of SEQ ID NO:7, and a VL CDR3 sequence of SEQ ID NO:8, wherein said immunoconjugate comprises a maytansinoid;
wherein the maytansinoid is linked to the antibody or antigen-binding fragment thereof by sulfo-N-succinimidyl 4-(2-pyridyldithio)butanoate (sulfo-SPDB);
wherein the immunoconjugate is administered once every three weeks at a dose of 5 mg/kg adjusted ideal body weight (AIBW) or 6 mg/kg AIBW, and wherein the bevacizumab is administered once every three weeks at a dose of 15 mg/kg; and
wherein the cancer has previously been treated with bevacizumab.
2. The method of claim 1 , wherein the immunoconjugate that binds to FOLR1 comprises an antibody or antigen-binding fragment thereof that comprises a VH comprising the sequence of SEQ ID NO:3 and a VL comprising the sequence of SEQ ID NO:5, wherein the maytansinoid is DM4, and wherein immunoconjugate is administered once every three weeks at a dose of 6 mg/kg AIBW.
3. The method of claim 2 , wherein the immunoconjugate is administered once every three weeks at a dose of 6 mg/kg AIBW.
4. The method of claim 1 , wherein the immunoconjugate comprises an antibody comprising (i) a heavy chain comprising the same amino acid sequence as the amino acid sequence of the heavy chain encoded by the plasmid deposited with the American Type Culture Collection (ATCC) as PTA-10772 and (ii) a light chain comprising the same amino acid sequence as the amino acid sequence of the light chain encoded by the plasmid deposited with the ATCC as PTA-10774, and the cytotoxin DM4, and wherein immunoconjugate is administered once every three weeks at a dose of 6 mg/kg AIBW.
5. The method of claim 1 , which further comprises administration of a steroid to the patient, wherein the steroid is administered as an eye drop.
6. The method of claim 1 , wherein the cancer is ovarian cancer, peritoneal cancer, fallopian cancer, endometrial cancer, or lung cancer.
7. The method of claim 6 , wherein the ovarian cancer is platinum-resistant epithelial ovarian cancer.
8. The method of claim 1 , wherein FOLR1 expression in the cancer is measured by immunohistochemistry (IHC).
9. The method of claim 8 , wherein at least 50% of cells in a sample obtained from the patient have an IHC score of at least 2.
10. The method of claim 8 , wherein at least 75% of cells in a sample obtained from the patient have an IHC score of at least 2.
11. The method of claim 8 , wherein at least 50% of cells in a sample obtained from the patient have an IHC score of at least 3.
12. The method of claim 8 , wherein at least 75% of cells in a sample obtained from the patient have an IHC score of at least 3.
13. The method of claim 1 , wherein the immunoconjugate and the bevacizumab are administered in separate pharmaceutical compositions.
14. The method of claim 1 , wherein the cancer is primary platinum refractory cancer or platinum resistant cancer.
15. The method of claim 1 , wherein the cancer is platinum sensitive cancer.
16. The method of claim 1 , wherein the administration is selected from the group consisting of a first-line therapy, a second-line therapy, a third-line therapy, a fourth-line therapy, and a fifth-line therapy.
17. A method for treating a patient having a FOLR1-expressing cancer comprising administering to said patient in need thereof bevacizumab in combination with an immunoconjugate that binds to folate receptor 1 (FOLR1), wherein said immunoconjugate comprises an antibody or antigen-binding fragment thereof comprising a heavy chain variable region (VH) complementary determining region (CDR)1 sequence of SEQ ID NO:9, a VH CDR2 sequence of SEQ ID NO:10, and a VH CDR3 sequence of SEQ ID NO:12, and a light chain variable region (VL) CDR1 sequence of SEQ ID NO:6, a VL CDR2 sequence of SEQ ID NO:7, and a VL CDR3 sequence of SEQ ID NO:8, wherein said immunoconjugate comprises a maytansinoid,
wherein the maytansinoid is linked to the antibody or antigen-binding fragment thereof by sulfo-N-succinimidyl 4-(2-pyridyldithio)butanoate (sulfo-SPDB), and
wherein the immunoconjugate is administered once every three weeks at a dose of 6 mg/kg AIBW, wherein the cancer is platinum-resistant epithelial ovarian cancer (EOC), and wherein the immunoconjugate and the bevacizumab are administered in separate pharmaceutical compositions.
18. The method of claim 17 , wherein the cancer has not previously been treated with bevacizumab.
19. The method of claim 17 , wherein FOLR1 expression in the cancer is measured by immunohistochemistry (IHC).
20. The method of claim 19 , wherein at least 50% of cells in a sample obtained from the patient have an IHC score of at least 2.
21. The method of claim 19 , wherein at least 75% of cells in a sample obtained from the patient have an IHC score of at least 2.
22. The method of claim 17 , which further comprises administration of a steroid to the patient, wherein the steroid is administered as an eye drop.
23. The method of claim 17 , wherein the maytansinoid is DM4.
24. The method of claim 23 , wherein the immunoconjugate that binds to FOLR1 comprises an antibody or antigen-binding fragment thereof that comprises a VH comprising the sequence of SEQ ID NO:3 and a VL comprising the sequence of SEQ ID NO:5.
25. The method of claim 17 , wherein the immunoconjugate comprises an antibody comprising (i) a heavy chain comprising the same amino acid sequence as the amino acid sequence of the heavy chain encoded by the plasmid deposited with the American Type Culture Collection (ATCC) as PTA-10772 and (ii) a light chain comprising the same amino acid sequence as the amino acid sequence of the light chain encoded by the plasmid deposited with the ATCC as PTA-10774, and the cytotoxin DM4.