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drug_type
RELEVANT_DRUG
intervention_type
antibody-drug conjugate (ADC)
drug_description
A CD123-directed antibody-drug conjugate administered intravenously weekly or twice weekly in dose escalation. An anti-CD123 monoclonal antibody binds IL-3 receptor alpha (CD123) on malignant cells, is internalized, and releases a potent cytotoxic payload via linker cleavage to induce targeted death of CD123+ cells in relapsed/refractory AML, B-ALL, and high-risk MDS.
nci_thesaurus_concept_id
C201826
nci_thesaurus_preferred_term
Anti-CD123/Kinesin Spindle Protein Inhibitor Antibody-drug Conjugate VIP943
nci_thesaurus_definition
An antibody-drug conjugate (ADC) consisting of a monoclonal antibody against the interleukin-3 (IL3)-receptor alpha chain (CD123; IL-3RA), conjugated, via a legumain-cleavable linker, to a physicochemically-modiffied payload composed of a kinesin spindle protein inhibitor (KSPi), with potential antineoplastic activity. Upon administration of anti-CD123/KSPi ADC VIP943, the antibody moiety targets the cell surface antigen CD123. Upon antibody/antigen binding, internalization, and transport to the lysosome, the KSPi moiety is released upon cleavage by the tumor-specific protease legumain, thereby accumulating the hydrophobic KSP (kinesin-5 or Eg5) inhibitor inside the tumor cell. In turn, KSPi inhibits KSP, thereby inhibiting mitotic spindle assembly, leading to an induction of cell cycle arrest during the mitotic phase, and cell death in CD123-overexpressing tumor cells that are actively dividing. This prevents proliferation of CD123-expressing tumor cells. KSP is an ATP-dependent microtubule motor protein that is essential for the formation of bipolar spindles and the proper segregation of sister chromatids during mitosis. CD123 regulates the proliferation, survival and differentiation of hematopoietic cells. CD123 is overexpressed on a variety of cancers, including myeloid leukemia, and increased expression of CD123 on leukemic stem cells is associated with poor prognosis. The modified KSPi payload is hydrophilic and thereby prevents diffusion out of the cell, allowing intracellular accumulation and reduces off-target toxicities by preventing membrane permeability into healthy cells.
drug_mesh_term
Antibody-Drug Conjugates
drug_category
ANTIBODY DRUG CONJUGATE
drug_class
Conjugate
drug_delivery_route
Intravenous
drug_mechanism_of_action
Anti-CD123 monoclonal antibody binds IL-3 receptor alpha (CD123) on malignant cells, is internalized, and a legumain-cleavable linker releases a kinesin spindle protein (Eg5/KSP) inhibitor payload inside the cell, inhibiting mitotic spindle assembly and causing mitotic arrest and targeted death of CD123+ tumor cells.
drug_name
VIP943
nct_id_drug_ref
NCT06034275