Development

Akeso advances third ADC into clinical trials with B7-H3-targeting AK157D1

China-based Akeso (HKEX: 9926.HK) has received clearance from China's National Medical Products Administration (NMPA) Center for Drug Evaluation (CDE) to...

Akeso advances third ADC into clinical trials with B7-H3-targeting AK157D1

China-based Akeso (HKEX: 9926) has received clearance from China's National Medical Products Administration (NMPA) to initiate a Phase I study of AK157D1, a B7-H3-targeting antibody-drug conjugate (ADC), in patients with advanced solid tumors. The clearance makes AK157D1 the third ADC from Akeso's internal platform to enter clinical development.

AK157D1 combines a humanized B7-H3 antibody with a DXd topoisomerase I inhibitor payload using Akeso's site-specific conjugation and MC-AAA linker technology. B7-H3 is highly expressed across multiple solid tumors, including lung, prostate, esophageal, colorectal, and breast cancers, while showing more limited expression in normal tissues, making it an increasingly competitive ADC target.

Akeso said AK157D1 demonstrated antitumor activity across multiple preclinical tumor models and was designed to improve the therapeutic window associated with B7-H3-directed ADCs. The company specifically highlighted hematologic toxicity and interstitial lung disease as safety issues it aims to mitigate through the molecule's antibody, linker, and conjugation design. Whether those characteristics translate into clinical differentiation will be a key focus of the Phase I study.

Akeso also plans to evaluate AK157D1 in combination with its approved bispecific antibodies, including ivonescimab, its PD-1/VEGF bispecific currently under US FDA review for EGFR-mutant non-small cell lung cancer, and cadonilimab (Caitanni), a PD-1/CTLA-4 bispecific approved for multiple indications in China.

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The program enters an increasingly crowded B7-H3 ADC field. Daiichi Sankyo and Merck's ifinatamab deruxtecan (I-DXd), which also uses a DXd payload, is among the most advanced programs in the class and has generated clinical activity in small cell lung cancer and other solid tumors. Earlier B7-H3 ADC development has also highlighted the challenge of balancing antitumor activity against payload-related toxicity, increasing the importance of the therapeutic window for newer entrants such as AK157D1.

AK157D1 follows two other Akeso ADCs into clinical development: AK146D1, a TROP2/Nectin-4 bispecific ADC now in Phase II development in NSCLC and breast cancer, and AK138D1, a HER3-targeting ADC. A fourth candidate, AK158D1, is a bispecific ADC that Akeso said is expected to enter clinical development shortly.


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