The document discusses antibody-drug conjugates (ADCs), which are monoclonal antibodies conjugated to cytotoxic agents. It provides an overview of ADC structure, stability considerations, safety issues, and the future of ADC development. Regarding structure, it describes key concepts like drug-antibody ratio and distribution of payloads. It also discusses the types of cytotoxic agents and linkers commonly used in ADCs. The document outlines guidance for assessing ADC stability and unique stability characteristics. It notes potential occupational safety hazards from ADC handling and describes ongoing research to evaluate ADC toxicity following degradation. Finally, it reviews the current ADC development pipeline and areas of focus, such as increasing specificity and overcoming drug efflux.
Antibody drug conjugates current status and future perspectivesPranav Sopory
ADC are an emerging class of new anti-cancer agents.
They are the future of oncological management.
Discussed here are their past, present and probable future.
This slide is a briefly introduction of antibody-drug conjugate. All my introduction includes the general introduction, structure of ADC, action mechanism of ADC, toxicity risk of ADC, it's development trend, and what we can provide with you.
The basic knowledge of Antibody-drug conjugates (ADC) - Creative BiolabsCreative-Biolabs
In this powerpoint, Creative Biolabs will describe basic knowledge of Antibody-Drug Conjugates (ADC), which includes in definition and mechanism of ADC, and its features and future development direction. We hope this video can help you understand what is ADC and what its application. If you have any question, welcome to cantact us at info@creative-biolabs.com.
Antibody drug conjugates current status and future perspectivesPranav Sopory
ADC are an emerging class of new anti-cancer agents.
They are the future of oncological management.
Discussed here are their past, present and probable future.
This slide is a briefly introduction of antibody-drug conjugate. All my introduction includes the general introduction, structure of ADC, action mechanism of ADC, toxicity risk of ADC, it's development trend, and what we can provide with you.
The basic knowledge of Antibody-drug conjugates (ADC) - Creative BiolabsCreative-Biolabs
In this powerpoint, Creative Biolabs will describe basic knowledge of Antibody-Drug Conjugates (ADC), which includes in definition and mechanism of ADC, and its features and future development direction. We hope this video can help you understand what is ADC and what its application. If you have any question, welcome to cantact us at info@creative-biolabs.com.
A Brief Introduction of Antibody Drug Conjugate
Antibody-Drug Conjugates (ADCs) are monoclonal antibodies (mAbs) attached to biologically active drugs (cytotoxic payload) by chemical linkers with labile bonds.
Global antibody-drug-conjugate-adc-clinical-trial-reviewEchoHan4
As innovative next-generation immunotherapeutic agents, antibody-drug conjugates (ADCs) are being developed worldwide as a major strategy to combat cancer and other immunological disorders. With the combination of a monoclonal antibody and extremely toxic chemical payloads, these biomacromolecule “warheads” are by far one of the most powerful weapons in the immunotherapy arsenal, bearing the hope as “the beginning of the end” to the battle against cancer. https://www.creative-biolabs.com/adc/druglnk-custom-synthesis.htm
Immuno-Oncology: An Evolving Approach to Cancer Care
Review a downloadable slide deck by Thomas F. Gajewski, MD, PhD, covering the most clinically relevant new data reported from Immuno-Oncology: An Evolving Approach to Cancer Care.
Target Audience
This activity is designed to meet the educational needs of oncologists and other healthcare professionals involved in cancer care.
Format: Microsoft PowerPoint (.ppt) | File size: 26.2 MB | Date posted: 6/20/2012
Slide Deck Disclaimer
This slide deck in its original and unaltered format is for educational purposes and is current as of June 2012. All materials contained herein reflect the views of the faculty, and not those of IMER, the CE provider, or the commercial supporter. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. Readers should not rely on this information as a substitute for professional medical advice, diagnosis, or treatment. The use of any information provided is solely at your own risk, and readers should verify the prescribing information and all data before treating patients or employing any therapeutic products described in this educational activity.
Usage Rights
This slide deck is provided for educational purposes and individual slides may be used for personal, non-commercial presentations only if the content and references remain unchanged. No part of this slide deck may be published in print or electronically as a promotional or certified educational activity without prior written permission from IMER. Additional terms may apply. See Terms of Service on IMERonline.com for details.
the presentation include the different type of mechanism used by cancer cells to protect them from anticancer agents lead to produce resistance. the slide include definition of cancer as per WHO, type of tumors, treatment of cancer, goal of treatment, problem associated with chemotherapeutic agents, need of studing mechanisms of resistance for anticancer agents, resistance, different mechanism of drug resistance, epigenetics, drug efflux, drug inactivation, DNA damage repair, drug target alteration and cell death inhibitiond
How can immunotherapy be used to treat metastatic breast cancer? Ian Krop, MD, PhD, discusses the latest research and treatment options.
This presentation was originally given as part of the 2015 Metastatic Breast Cancer Forum, held on October 17 and hosted by the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute in Boston, Mass.
For more information, visit www.susanfsmith.org
Macrophages as Targets in Cancer Immunotherapy - Creative BiolabsCreative-Biolabs
Due to the limitations and shortages of traditional cancer treatments, immunotherapy has become the most promising cancer treatment. Various cancer immunotherapy strategies have emerged. These include adoptive cellular immunotherapy, tumor vaccines, antibodies, immune checkpoint inhibitors, and small molecule inhibitors. Although most of these strategies are not meant to target macrophages directly or originally, macrophages contribute significantly to the final outcomes.
As a CRO company, Creative Biolabs offers first-in-class macrophage therapeutic development services. Please don’t hesitate to contact us if you are interested in our services or if you have any questions.
Brief Introduction of Antibody Drug ConjugatesBOC Sciences
BOC Sciences is a life sciences group with its headquarters in the NY. BOC Sciences provides the most complete set of solutions in antibody-drug conjugate (ADC) drug development services in the pharmaceutical industry. Please visit https://adc.bocsci.com/ for more information.
The Butterfly Effect: How to see the impact of small changes to your ADCMilliporeSigma
Watch this webinar here: https://bit.ly/31PRr2z
Small changes to the design of antibody-drug conjugate can have a dramatic effect on its structure and biological activity. Effective product characterization is essential to understanding the impact of these changes. Here we discuss methods to provide insight at critical junctures in ADC development.
There are many different design considerations facing developers of antibody-drug conjugates: these variables must be tuned to achieve the right balance of efficacy and safety. For example, the choice of linker can influence an ADC's potency, toxicity and pharmacokinetics.
In this webinar we explore the influence of various PEG linkers on the structure of a model ADC by identifying specific sites of conjugation by peptide mapping, investigating changes in higher order structure by HDX mass spectrometry, and examining the impact on binding by SPR spectroscopy.
We demonstrate that employing a range of orthogonal methods is critical to understanding the structure-function relationships of an ADC.
In this webinar, you will learn about:
• How the choice of linker can influence an ADC's activity
• Information-rich methods to probe ADC structure and function
• Effective strategies for thorough characterization of ADC products
A Brief Introduction of Antibody Drug Conjugate
Antibody-Drug Conjugates (ADCs) are monoclonal antibodies (mAbs) attached to biologically active drugs (cytotoxic payload) by chemical linkers with labile bonds.
Global antibody-drug-conjugate-adc-clinical-trial-reviewEchoHan4
As innovative next-generation immunotherapeutic agents, antibody-drug conjugates (ADCs) are being developed worldwide as a major strategy to combat cancer and other immunological disorders. With the combination of a monoclonal antibody and extremely toxic chemical payloads, these biomacromolecule “warheads” are by far one of the most powerful weapons in the immunotherapy arsenal, bearing the hope as “the beginning of the end” to the battle against cancer. https://www.creative-biolabs.com/adc/druglnk-custom-synthesis.htm
Immuno-Oncology: An Evolving Approach to Cancer Care
Review a downloadable slide deck by Thomas F. Gajewski, MD, PhD, covering the most clinically relevant new data reported from Immuno-Oncology: An Evolving Approach to Cancer Care.
Target Audience
This activity is designed to meet the educational needs of oncologists and other healthcare professionals involved in cancer care.
Format: Microsoft PowerPoint (.ppt) | File size: 26.2 MB | Date posted: 6/20/2012
Slide Deck Disclaimer
This slide deck in its original and unaltered format is for educational purposes and is current as of June 2012. All materials contained herein reflect the views of the faculty, and not those of IMER, the CE provider, or the commercial supporter. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. Readers should not rely on this information as a substitute for professional medical advice, diagnosis, or treatment. The use of any information provided is solely at your own risk, and readers should verify the prescribing information and all data before treating patients or employing any therapeutic products described in this educational activity.
Usage Rights
This slide deck is provided for educational purposes and individual slides may be used for personal, non-commercial presentations only if the content and references remain unchanged. No part of this slide deck may be published in print or electronically as a promotional or certified educational activity without prior written permission from IMER. Additional terms may apply. See Terms of Service on IMERonline.com for details.
the presentation include the different type of mechanism used by cancer cells to protect them from anticancer agents lead to produce resistance. the slide include definition of cancer as per WHO, type of tumors, treatment of cancer, goal of treatment, problem associated with chemotherapeutic agents, need of studing mechanisms of resistance for anticancer agents, resistance, different mechanism of drug resistance, epigenetics, drug efflux, drug inactivation, DNA damage repair, drug target alteration and cell death inhibitiond
How can immunotherapy be used to treat metastatic breast cancer? Ian Krop, MD, PhD, discusses the latest research and treatment options.
This presentation was originally given as part of the 2015 Metastatic Breast Cancer Forum, held on October 17 and hosted by the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute in Boston, Mass.
For more information, visit www.susanfsmith.org
Macrophages as Targets in Cancer Immunotherapy - Creative BiolabsCreative-Biolabs
Due to the limitations and shortages of traditional cancer treatments, immunotherapy has become the most promising cancer treatment. Various cancer immunotherapy strategies have emerged. These include adoptive cellular immunotherapy, tumor vaccines, antibodies, immune checkpoint inhibitors, and small molecule inhibitors. Although most of these strategies are not meant to target macrophages directly or originally, macrophages contribute significantly to the final outcomes.
As a CRO company, Creative Biolabs offers first-in-class macrophage therapeutic development services. Please don’t hesitate to contact us if you are interested in our services or if you have any questions.
Brief Introduction of Antibody Drug ConjugatesBOC Sciences
BOC Sciences is a life sciences group with its headquarters in the NY. BOC Sciences provides the most complete set of solutions in antibody-drug conjugate (ADC) drug development services in the pharmaceutical industry. Please visit https://adc.bocsci.com/ for more information.
The Butterfly Effect: How to see the impact of small changes to your ADCMilliporeSigma
Watch this webinar here: https://bit.ly/31PRr2z
Small changes to the design of antibody-drug conjugate can have a dramatic effect on its structure and biological activity. Effective product characterization is essential to understanding the impact of these changes. Here we discuss methods to provide insight at critical junctures in ADC development.
There are many different design considerations facing developers of antibody-drug conjugates: these variables must be tuned to achieve the right balance of efficacy and safety. For example, the choice of linker can influence an ADC's potency, toxicity and pharmacokinetics.
In this webinar we explore the influence of various PEG linkers on the structure of a model ADC by identifying specific sites of conjugation by peptide mapping, investigating changes in higher order structure by HDX mass spectrometry, and examining the impact on binding by SPR spectroscopy.
We demonstrate that employing a range of orthogonal methods is critical to understanding the structure-function relationships of an ADC.
In this webinar, you will learn about:
• How the choice of linker can influence an ADC's activity
• Information-rich methods to probe ADC structure and function
• Effective strategies for thorough characterization of ADC products
The Butterfly Effect: How to see the impact of small changes to your ADCMerck Life Sciences
Watch this webinar here: https://bit.ly/31PRr2z
Small changes to the design of antibody-drug conjugate can have a dramatic effect on its structure and biological activity. Effective product characterization is essential to understanding the impact of these changes. Here we discuss methods to provide insight at critical junctures in ADC development.
There are many different design considerations facing developers of antibody-drug conjugates: these variables must be tuned to achieve the right balance of efficacy and safety. For example, the choice of linker can influence an ADC's potency, toxicity and pharmacokinetics.
In this webinar we explore the influence of various PEG linkers on the structure of a model ADC by identifying specific sites of conjugation by peptide mapping, investigating changes in higher order structure by HDX mass spectrometry, and examining the impact on binding by SPR spectroscopy.
We demonstrate that employing a range of orthogonal methods is critical to understanding the structure-function relationships of an ADC.
In this webinar, you will learn about:
• How the choice of linker can influence an ADC's activity
• Information-rich methods to probe ADC structure and function
• Effective strategies for thorough characterization of ADC products
Our third webinar in the MDC Connects Series 2021 | A Guide to Complex Medicines.
This slide deck takes a closer look at the challenges of determining drug levels and pk profiles for complex drug modalities.
Robert Wheller, LGC
What is therapeutic drug monitoring (TDM)? Therapeutic drug monitoring (TDM) is testing that measures the amount of certain medicines in your blood. It is done to make sure the amount of medicine you are taking is both safe and effective. Not all medications require therapeutic monitoring. Most drugs have a wide therapeutic index and can be prescribed based upon pre-established dosing schedules. The effectiveness of these treatments has been evaluated, but monitoring the concentration of the drug in the blood is not required for dosing.Aminoglycoside antibiotics (gentamicin) Antiepileptics (such as carbamazepine, phenytoin and valproic acid).Why do I need TDM? You may need testing when you first start taking a medicine. This helps your provider figure out the most effective dose for you. Once that dose is determined, you may be tested regularly to make sure the medicine is still effective without being harmful.
drug execipent compatibilty studies is of prime importance for the better formulation of the new drug and also for reducing cost by verfication of the data at the earlier atage.
this presentation will give the brief explanation of the goal, importance, dteps involve to studi the drug execient compatibility studies with different examples suitable accordiingly.
The ADMET SIG meeting at SLAS2014, January 21 in San Diego, featured a presentation by SIG Chair David M. Stresser, Ph.D., of Corning® GentestSM Contract Research Services. View his presentation, Time-Dependent Inhibition of Cytochrome P450: A Deep Dive Into Methods for Abbreviated Testing, here.
Monoclonal antibodies: functional improvements at SPC shelf life limitsPharmaxo
Monoclonal antibody (mAb) therapeutics are one of the fastest growing sectors in the pharmaceutical industry and have already established themselves as frontline therapies in oncology.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Questions
1. When was the first ADC licensed?
2. What guidance is specifically for
ADC stability studies?
3. What do DAR and DOP mean?
4. What amino acids do current
ADCs utilize for attachment?
5. What makes ADCs so hazardous?
2
3. Introductions
3
• Bath ASU is collaborating with the
University of Bath to enable valid
stability assessments of ADCs
• This research is partially funded
through a government KTP grant
• Go to mabstalk.com and check out
the ADC mini-series for more detail
5. 1. Introduction
• Central Concepts
• Timeline
• Licensed ADCs
• Mode of Action
• ADCs VS Gold Standards
5
6. 1.1 Central Concepts
• Monoclonal antibodies are
comprised of four sub-units
• Two pairs of identical heavy
and light tertiary proteins
• The chains are joined by
disulfide bonds
6
HeavyHeavy
Disulfide
Bond
7. CH2CH3
• Conserved subunits
create the majority of
structure in all mAbs
• The variable sub-units
enable specific binding
• Antigen binding occurs
at either Fab region
• The Fc region recruits
the immune system
7
Fc
Fab
1.1 Central Concepts
Fab
8. • An antibody complexed to a pharmacologically cytotoxic toxic agent is
antibody drug conjugate (ADC)
• The Antibody is primarily
responsible for delivery
• The Linker is primarily
responsible for release
• The Warhead is primarily
responsible for apoptosis
8
Payload
Warhead
Linker
1.1 Central Concepts
9. 1.2 Timeline
9
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
2013 – Kadcyla
approved
1982 – Adriamycin-Antibody
conjugate demonstratably
superior than co-administration
2000 – Mylotarg
approved
2011 – Adcetris
approved
1958 – (First ADC) Methotrexate
linked to cancer targeting antibody
1906 - Dr Paul Ehrlich
proposes conjugating
antibodies to toxins to
target tumour cells
10. 1.3 Licensed ADCs
• Gemtuzumab ozogamicin, marketed as Mylotarg™
– An anti-CD33 antibody conjugated to calicheamicin
warheads by hydrazone linkers
• Brentuximab vedotin, marketed as Adcetris™
– An anti-CD30 antibody conjugated to mono-methyl
auristatin E (MMAE) warheads by dipeptide linkers
• Trastuzumab emtansine, marketed as Kadcyla™
– An anti-HER2 antibody conjugated to DM-1 warheads by
thioether linkers
10
12. 1.5 ADCs VS Gold Standards
12
• ADC toxicity is more directed and specific
• ADCs are harder to develop resistance to
• ADC therapy has better therapeutic outcomes
13. 1.5 ADCs VS Gold Standards
13
Increased specificity means wider a therapeutic index
14. 1.5 ADCs VS Gold Standards
• ADC toxicity is more directed and specific
• ADCs are harder to develop resistance to
• ADC therapy has better therapeutic outcomes
14
15. 1.5 ADCs VS Gold Standards
15
ADCs exert their potent activity more directly
16. 1.5 ADCs VS Gold Standards
• ADC toxicity is more directed and specific
• ADCs are harder to develop resistance to
• ADC therapy has better therapeutic outcomes
16
17. 1.5 ADCs VS Gold Standards
17
Adapted from from: Hurvitz et al., 2013, JCO, 44:2967-2977
Increased specificity and reduced resistance creates a more
effective and tolerable therapy
19. 2.1 Antibodies
• Early ADCs and mAbs were murine
which raised immune responses
• Chimeric, humanised or human
antibodies limit immune responses
• Complete activity is retained in ADCs
• Antibodies are used to direct the
warheads and not for their activity
19
I
20. 2.2 DAR & DOP
• Drug antibody ratio (DAR) is the
number of payloads per antibody
• High DAR = diminished stability
and pharmacokinetic profile
• Low DAR = reduced potency
• Distribution of payloads (DOP) is
the location of payload attachment
20
21. 2.2 DAR & DOP
21
• Currently attach via cysteine or lysine residues
• Cysteine linked = more restricted DAR & DOP
• Lysine linked = more stable ADC
Attachment
22. 2.2 DAR & DOP
22
Licensed ADC medicines are heterogeneous mixtures
25. 2.3 Warheads
• Early ADCs targeted conventional
chemotherapeutic agents
• Current ADCs use warheads too
potent for unconjugated use
• Favoured warhead types:
– Anti-mitotic agents
– Agents that damage DNA
– Agents that prevent DNA synthesis
25
Warhead
26. 2.3 Warheads
Maytansinoids
• Inhibitors of tubulin reorganisation
• Sourced from Maytenus tree bark
• DM1:
– Warhead of Ado-Trastuzumab Emtansine
– About 1000x more potent than doxorubicin
26
27. 2.3 Warheads
Auristatins
• Inhibitors of tubulin reorganisation
• Derived from Dolastatins produced by
Dolabella auricularia
• Monomethyl auristatin E (MMAE)
– Warhead of Brentuximab Vedotin
– Up to 1000x more potent than doxorubicin
27
28. 2.3 Warheads
Calicheamicins
• Bind to the minor groove of
DNA and cause DNA strand
scission
• Isolated from bacteria in the
“Caliche pits” in Texas
• Calicheamicin γ1
– Warhead of Mylotarg & CMC-544
– 4000 x more potent than
doxorubicin
28
30. 2.4 Linkers
Thioether Bonds
• Used in Kadcyla
• High serum stability
• Warhead remains attached to
to linker and a lysine residue
[Lysine - Linker - Warhead]
30
31. 2.4 Linkers
Dipeptide constructs
31
• Two most common:
– Valine–Citrulline
– Phenylalanine–Lysine
• Brentuximab vedotin uses Val-Cit
– Linker contains “self-destructing”
moiety to liberate intact MMAE
warhead
• Stable in serum
• Cleaved by cathepsin B
Val-Cit Phe-Lys
32. Brentuximab Vedotin:
Release of MMAE ‘Warhead’
32
Cathepsin B
Breakdown of carbamate to
release Drug + CO2
MMAE
Self-destruction of PABC spacer
33. 2.4 Linkers
Hydrazone bonds
• Gemtuzumab ozogamicin
• Acid-labile (pH < 4.5)
• Relatively poor serum stability
– 50% warhead release over 48h
• Linker remains attached to
warhead or mAb
34. 34
3. Stability
• Parental drug stability
• Stability studies
• Assessing mAb stability
• Unique ADC characteristics
• Stability of ADCs
35. 3.1 Parenteral Drug Stability
The stability of a drug is dependent on:
• Formulation conditions
– Concentration
– Diluent
– pH
– Container material
• Environmental conditions
– Light
– Temperature
• In-process compounding procedures
– Shaking / filters / equipment
35
36. 3.2 Assessing mAb stability
36
• Assessing the stability of ADCs is complex
– Analytical methods must indicate physical, chemical & functional stability
• Ready to use parenteral drugs require extended shelf lives
– Currently 2 NHS guidance documents relating to parenteral drug stability
– However, these do not provide adequate scope for ADC stability testing
37. Processes contributing to degradation of mAbs
Native protein
Chemical Stability Physical stability/Aggregation
Oxidation
Deamidation
Hydrolysis
Proteolysis
Conformational Stability
(2ry, 3ry, 4ry structure)
Colloidal Stability
(multimers, sub-visible/visible particles)
Unfolded states Aggregates
Free energy change Intermolecular
interactions
3.3 Stability Studies (biopharmaceutials)
39. 3.4 ADC Specific
39
Characteristic Importance Technique/s
Cytotoxic
Selectivity
Loss of selectivity indicates
increased off target activity
Multicellular Bioassay
(in vitro)
40. 3.5 ADC Specific
40
Characteristic Importance Technique/s
DAR Profile
Average DAR
Reduced DAR indicates
less potency per ADC
Hydrophobic Interaction
Chromatography / LC-MS
41. 3.5 ADC Specific
41
Characteristic Importance Technique/s
% Naked Antibody
Naked antibody acts as an
antagonist of the ADC
Hydrophobic Interaction
Chromatography / LC-MS
42. 3.5 ADC Specific
42
Characteristic Importance Technique/s
Unconjugated
species
Unconjugated species may
be strongly cytotoxic
Multi-phase monolith
chromatography / LC-MS
43. 3.6 Stability of ADCs
• ADC stability is subject to guidance relating to both
biopharmaceuticals and small molecules
• ADC stability is less straightforward
– Heterogeneous nature of ADCs poses characterisation challenges
• Need to demonstrate stability of:
– Each individual component (mAb, linker and warhead)
– Analytical characterisation must confidently demonstrate that
warhead remains attached to mAb
43
44. 4. Safety
• Occupational Exposure
• Potential hazards to Pharmacy Operators
• Ongoing Investigational Work at Bath ASU
44
45. 4.1 Occupational Exposure
• Monoclonal antibodies are highly active biological agents
– Capable of powerful pharmacological effects
• Occupational exposure associated with 2 main types of risk:
– Immunogenic reactions
– Biological effects of the mAb engaging with its target antigen
• Toxicity profile of mAbs are poorly characterised
– Occupational hazards from long-term, low-level exposure unknown
– Hazards extrapolated from side-effects observed at therapeutic doses
• What about ADCs?
45
?
48. 48
NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2014
Taken from Center for Disease Control and Prevention Website: http://www.cdc.gov/niosh/docs/2014-138/
4.1 Occupational Exposure
49. 4.2 ADCs: potential handling risks
• mAbs are proteins – routes of absorption are limited
– This is also the case for ADCs… providing they are intact
• Breakdown of ADC and cytotoxic agent release
– Contact with stainless steel (e.g. spillage within isolator)
– Following exposure to sterilising gases or cleaning agents
– Following contact with skin (dermal esterases)
– Following ingestion by other routes (e.g. swallowing, eye contact)
49
51. 4.2 ADCs: potential handling risks
• mAbs are proteins – routes of absorption are limited
– This is also the case for ADCs… providing they are intact
• Breakdown of ADC and cytotoxic agent release
– Contact with stainless steel (e.g. spillage within isolator)
– Following exposure to sterilising gases or cleaning agents
– Following contact with skin (dermal esterases)
– Following ingestion by other routes (e.g. swallowing, eye contact)
• ADC / cytotoxic warhead residue cleaning
– mAb is water soluble; warhead is organic soluble
– Potential contamination risk of subsequent products
• Permeation of warhead through gloves
51
52. Questions we should be asking with regard to ADC handling…
• Are ADCs susceptible to degradation during handling?
• How hazardous are warheads in trace amounts?
• To what extent are they absorbed?
• Are current arrangements adequate?
– Containment
– Ventilation
– Appropriate PPE
– Cleaning protocols
52
4.2 Potential Handling Hazards
53. 4.3 Research @ Bath ASU
• in vitro toxicity of ADCs (e.g. hepatocytes / keratinocytes)
– Is the toxicity of an ADC increased following:
• Spillage on a variety of contact surfaces
• Following contact with cleaning agents / sterilants
• Is the increase in toxicity a result of linker breakdown and
warhead release?
– HPLC characterisation method currently in development
– Heterogeneity of ADCs poses significant characterisation challenge
53
57. 57
• MMAF has a charged residue that reduces its ability to
cross cell membranes, thereby increasing specificity
5.2 Increasing specificity
58. 58
• To overcome issues of solid tumour penetration, smaller
portion of mAbs are being used as the delivery system
5.3 Beyond antibodies
59. 59
• DM4 is an example of a drug not affected by multi-drug
efflux pump 1
5.4 Overcoming efflux
60. 5.5 Key points
• ADCs are promising therapeutic agents
– Targeted therapy + very potent cytotoxicity
• Linker effectiveness is fundamental
– Directed warhead release: cornerstone of ADCs
– Beast is subdued only when leashed
• Potential OE of pharmacy staff to warheads
– Unique chemical nature of ADCs poses questions
relating to safety during aseptic compounding
60