Abstract 222: Novel protein drug conjugates targeting ROR1 through the development and exploitation of a drug discovery platform based on small, engineered VNAR domains

Whilst antibody drug conjugates (ADCs) have been successfully used to target highly potent cytotoxic agents to tumours, there is a continued emphasis on developing technologies for improving the therapeutic effectiveness of this class of agents. The vast majority of ADCs that have entered the clinic have been based on large intact immunoglobulins, however, there is significant interest in exploiting small protein domains as the payload delivery vehicle. These offer a number of potential benefits over full length antibodies including increased tumour penetration, amenability to protein engineering and site-specific conjugation, and improved tolerability. To this end, we have developed a therapeutics platform based on shark Variable New Antigen Receptor (VNAR) proteins. Shark VNAR domains are the smallest naturally occurring antigen binding domain (~11 kDa), with a binding mechanism distinct from traditional antibodies. Here we report the application of this platform to the development of homogenous VNAR-drug conjugates targeting the onco-embryonic receptor tyrosine kinase ROR1. ROR1 expression has been observed across a broad range of solid tumours and haematological malignancies, and is reported to correlate with poor clinical outcome for a number of cancer indications, but is largely absent from normal adult tissue. As such, the expression pattern of ROR1, coupled with its functional role in tumourogenesis and disease progression, make it an attractive PDC target. Using a combination of direct immunisation and synthetic VNAR library screening, we have generated high affinity binders to the extracellular domain of ROR1 which show species cross-reactivity, do not bind the closely related family member ROR2, and can target distinct non-overlapping regions of the protein. By exploiting the ability of VNAR domains to be flexibly reformatted, the lead sequences have been configured as a series of bivalent Fc fusions, VNAR multimers and novel bi-paratopic binders, and constructs identified that show further enhanced binding to ROR1 and which can induce internalisation and lysosomal trafficking in ROR1 expressing cancer cell-lines. Subsequent attachment of highly potent DNA-damaging cytotoxic payloads yielded homogenous VNAR-drug conjugates which demonstrated extremely potent (sub-nanomolar) in vitro cytotoxicity against selected cancer cell-lines in a receptor mediated fashion. Studies to assess the in vivo efficacy of these conjugates are in progress. These ROR1 VNAR constructs have also been successfully fused to sdAbs and scFv directed to other cell-surface protein targets, demonstrating the power of the platform and opening the way for novel bi-specific approaches for targeting both solid and haematological tumours. Citation Format: Graham Cotton, Jennifer Thom, Paul Trumper, Stacey Bell, Andrei Kamenski, Mark Wappett, Caroline Barelle, Marina Kovaleva, John Steven, Andy Porter, Estelle McLean, Chiara Saladino, Aidan McCann, Aaron Cranston, Tim Harrison. Novel protein drug conjugates targeting ROR1 through the development and exploitation of a drug discovery platform based on small, engineered VNAR domains [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 222.