Analysis of antibody-enzyme conjugate clearance by investigation of prodrug and active drug in an ADEPT clinical study.

Antibody-directed enzyme prodrug therapy (ADEPT) separates the cytotoxic function from the targeting function (5). An antibody-carboxypeptidase G2 (CPG2) enzyme is delivered prior to the nontoxic prodrug, CMDA, which is converted to a cytotoxic drug by the action of the localized conjugate at the tumor site. An indirect in vitro assay was developed to detect the presence of functional CPG2 in the plasma of patients in an ADEPT clinical trial. Compounds in the plasma of patients were characterized using liquid chromatography-mass spectrometry. Plasma at three different time points (prior to treatment, post-antibody-enzyme conjugate, and post-galactosylated anti-enzyme antibody clearing agent) was added to the CMDA prodrug and analyzed. Conversion of the CMDA prodrug to its active drug indicates that CPG2-conjugate remains in the plasma. This technique will provide essential data for the timing of prodrug administration in ADEPT.