Introduction: XMT-1660 is a first-in-class Dolasynthen Antibody-Drug Conjugate (ADC) targeting B7-H4 and carrying a DolaLock payload with controlled bystander effect. B7-H4 is an immunoregulatory protein that is expressed in breast, ovarian and endometrial tumors. Expression of B7-H4 has been described in both tumor cells and in tumor associated macrophages, and B7-H4 shows infrequent co-expression with PD-L1, suggesting distinct immunoregulatory functions. XMT-1660 is built on the Dolasynthen platform which incorporates several attributes, including site-specific bioconjugation and precise control over drug-antibody ratio (DAR). The XMT-1660 ADC contains 6 DolaLock Auristatin F-hydroxypropyl amide (AF-HPA) anti-tubulin payloads per antibody (DAR-6). Previously, we demonstrated the cytotoxic effect of XMT-1660 in cell line xenograft and patient derived xenograft models of breast cancer known to have B7-H4 target expression. The purpose of this study was to evaluate the anti-tumor activity of XMT-1660 across an unselected panel of breast cancer patient derived xenograft (PDX) models, evaluate the level of B7-H4 expression across this panel of breast PDX models, and assess the correlation between B7-H4 expression and anti-tumor activity following a single dose of XMT-1660.

Methods: A panel of 30 breast cancer patient-derived xenograft models, annotated by prior treatment history, and divided between TNBC and ER-positive subtypes, was implanted into athymic Nude-Foxn1n mice. When tumors reached an average volume of 150-300 mm3, animals (n=3) were treated with a single administration of either XMT-1660 0.15mg/kg (calculated by payload dose)/4.71 mg/kg (calculated by antibody dose) IV/QD X1 or saline vehicle. Tumor volumes were evaluated until the planned endpoint of mean tumor volume of control group of 1500 mm3 or day 28. At the endpoint, xenografts, or tumor beds (in the case of no palpable mass) were collected as formalin fixed paraffin embedded material. The xenograft material was evaluated for B7-H4 expression by protein and RNA methods and expression was compared to the anti-tumor activity.

Results: In this panel of breast patient derived xenograft models, a range of anti-tumor activities has been observed following administration of a single dose of XMT-1660. The relationship between XMT-1660 anti-tumor activity and B7-H4 expression was demonstrated.

Conclusion: XMT-1660 elicits a range of anti-tumor activity across a series of primary breast cancer xenograft models. XMT-1660 is currently in IND-enabling studies and is expected to enter a Phase I dose escalation clinical study in 2022. The efficacy/expression relationship of B7-H4 will be further evaluated in an upcoming clinical study with a goal to identify patients most likely to respond to XMT-1660.

Citation Format: Scott D. Collins, Pamela S. Shaw, Shawn P. Fessler, Jason Wang, Rebecca Mosher. Antitumor effect of XMT1660, a B7H4 targeting antibody drug conjugate, in an unselected panel of patient derived xenograft models of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1756.