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 of treating a FOLR1-expressing cancer in a patient comprising administering to said patient in need thereof:
(a) an immunoconjugate that binds to folate receptor 1 (FOLR1), wherein said immunoconjugate comprises
(i) an anti-FOLR1 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;
(ii) a sulfo-SPDB linker; and
(iii) a maytansinoid linked to the anti-FOLR1 antibody or antigen-binding fragment thereof by a the sulfo-SPDB linker, and
(b) bevacizumab; and
(c) carboplatin;
wherein the cancer has previously been treated with bevacizumab.
2. The method of claim 1 , wherein the maytansinoid is DM4.
3. The method of claim 1 , wherein the anti-FOLR1 antibody or antigen-binding fragment thereof comprises a VH comprising the sequence of SEQ ID NO:3 and a VL comprising the sequence of SEQ ID NO:5.
4. The method of claim 1 , wherein the anti-FOLR1 antibody comprises (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 wherein the maytansionid is DM4.
5. The method of claim 1 , wherein the immunoconjugate is administered once every three weeks at a dose of 6 mg/kg adjusted ideal body weight (AIBW).
6. The method of claim 1 , wherein the bevacizumab is administered once every three weeks at a dose of 15 mg/kg.
7. The method of claim 1 , wherein the carboplatin is administered once every three weeks at a dose to obtain an area under the curve (AUC) of 4 mg/ml·min, 5 mg/ml·min, 6 mg/ml·min, or 7 mg/ml·min.
8. The method of claim 1 , which further comprises administration of a steroid to the patient, wherein the steroid is administered as an eye drop.
9. The method of claim 1 , which the immunoconjugate comprises from about 1 maytansinoid per antibody to about 8 maytansinoids per antibody.
10. The method of claim 1 , wherein the cancer is selected from the group consisting of ovarian cancer, cancer of the peritoneal, fallopian cancer, endometrial cancer, or lung cancer.
11. The method of claim 10 , wherein the ovarian cancer is platinum-resistant epithelial ovarian cancer.
12. The method of claim 10 , wherein the ovarian cancer is platinum sensitive recurrent epithelial ovarian cancer.
13. The method of claim 1 , wherein the FOLR1 expression is measured by immunohistochemistry (IHC).
14. The method of claim 13 , wherein at least 50% of cells in a sample obtained from the patient have an IHC score of at least 2.
15. The method of claim 13 , wherein at least 50% of cells in a sample obtained from the patient have an IHC score of at least 3.
16. The method of claim 1 , wherein the immunoconjugate, the bevacizumab and the carboplatin are administered in separate pharmaceutical compositions.
17. The method of claim 1 , wherein the cancer is primary platinum refractory or platinum resistant.
18. The method of claim 1 , wherein the cancer is platinum sensitive.
19. The method claim 1 , wherein the anti-FOLR1 antibody or antigen-binding fragment thereof 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; wherein the immunoconjugate is administered once every three weeks at a dose of 6 mg/kg AIBW; wherein the bevacizumab is administered once every three weeks at a dose of 15 mg/kg; and wherein the carboplatin is administered once every three weeks at a dose to obtain an AUC of 5 mg/ml·min.
20. The method of claim 1 , wherein the immunoconjugate is administered once every three weeks at a dose of 5 mg/kg AIBW.
21. The method of claim 13 , 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 13 , wherein at least 75% of cells in a sample obtained from the patient have an IHC score of at least 3.
23. The method of claim 19 , wherein the FOLR1 expression is measured by IHC and at least 50% of cells in a sample obtained from the patient have an IHC score of at least 2.
24. The method of claim 19 , wherein the FOLR1 expression is measured by IHC and at least 75% of cells in a sample obtained from the patient have an IHC score of at least 2.