OR26-02 VRDN-001, A Full Antagonist Antibody To IGF-1 Receptor In Development For Thyroid Eye Disease (TED), Binds To A Distinct Epitope From Teprotumumab

Disclosure: V. Bedian: Employee; Self; Viridian Therapeutics Inc. J.C. Tsai: Employee; Self; Viridian Therapeutics Inc. R.N. Newell: Employee; Self; Viridian Therapeutics Inc. Y. Zhao: Employee; Self; Viridian Therapeutics Inc. Introduction: VRDN-001, a full antagonist antibody to IGF-1 receptor (IGF-1R), is under development for the treatment of thyroid eye disease (TED). Clinical and preclinical evidence confirm IGF-1R antagonism reduces the inflammation and proptosis that occur in TED. As different anti-IGF-1R antibodies may have distinct characteristics, we compared the binding epitope and in vitro antagonist properties of VRDN-001 with teprotumumab. Methods: We generated a panel of IGF-1R extracellular domain point mutants of 40 potential IGF-1 interacting residues and 3 N-terminal truncations and assessed the binding pattern of the 2 antibodies to these variants by bio-layer interferometry (Octet). Antagonist characteristics were determined by dose-responses of inhibition of biotinylated IGF-1 binding to IGF-1R expressing FreeStyle™ 293-F cells by flow cytometry and inhibition of IGF-1 mediated signaling in primary human ocular choroidal fibroblasts. Results: VRDN-001 binding was affected by the same domain deletions/truncations as teprotumumab but was not affected by the same point mutations; while teprotumumab binding was reduced or abolished by 2 of the mutations, VRDN-001 binding was not affected by any of the 40-point mutations. These results are consistent with overlapping binding sites but distinct receptor interactions. In antagonism studies, at ≥50 nM, VRDN-001 nearly completely inhibited IGF-1 binding, while teprotumumab only partially inhibited IGF-1 binding through 300 nM. Similarly, VRDN-001 more completely antagonized IGF-1 mediated signaling (phosphorylation of IGF-1R and AKT) than teprotumumab. Conclusion: Despite having overlapping epitopes, VRDN-001 is distinct from teprotumumab in both its mutational signature and its more complete antagonism of IGF-1 mediated signaling. VRDN-001’s unique binding and functional antagonism characteristics may contribute to the robust pharmacodynamic responses observed in healthy volunteers and favorable efficacy signals observed in early clinical trials of TED patients. Presentation: Saturday, June 17, 2023