# Growth plate-targeted IGF1 to treat Turner Syndrome

> **NIH NIH R43** · CAVALRY BIOSCIENCES, INC · 2023 · $274,596

## Abstract

Turner syndrome (TS) is a rare disorder that occurs at a rate of 1 in 2500 live female births and is caused by
partial or complete monosomy of the X chromosome. Among the most common phenotypes in TS patients is
short stature, defined as at least 2 standard deviations below mean height for age, which is commonly treated
with daily injections of recombinant human growth hormone (GH) as the standard of care. While GH statistically
increases adult height, TS patients generally fail to reach their mid-parental height projection or even achieve
adult heights within the normal range. Additionally, TS patients are at particularly high risk for adverse effects
associated with prolonged GH treatment that include hyperglycemia, intracranial hypertension, growth of the
nasopharyngeal lymphoid tissues, insulin resistance, and acromegalic changes. Cavalry Biosciences’ goal is to
address the unmet clinical need in safety and efficacy by developing a targeted therapeutic consisting of IGF1
(GH effector that drives bone growth) and an anti-matrilin-3 (MATN3) antibody-based target arm that drives
localization to growth plates of long bones. In preclinical studies, prototypes of such a Growth Plate IGF1 (GP-
IGF1) biotherapeutics, selectively localized to and increased the size of growth plates in mouse models of GH
deficiency. The objective of our Phase 1 proposal is to optimize this prototype molecule into a lead that has PK-
PD-efficacy and manufacturability properties that are favorable for clinical advancement. To accomplish this
objective, we will pursue two specific aims. In the first aim, we will design and express next-generation GP-IGF1
fusions proteins with modifications that (i) improve MATN3 binding to optimize GP targeting, (ii) alter IGF1’s
affinity for IGF1R and/or ability to interact with activity inhibiting IGF-binding proteins, and (iii) optimize pharma-
cokinetics (PK). The resulting molecules will be tested for their ability to bind MATN3 and activate IGF1R in vitro
and in vivo using assays that we have developed in preliminary studies. Candidate molecules will be assessed
for PK and biodistribution properties in mice. In the second aim, we will use preclinical models to evaluate the
efficacy and safety of next-gen GP-IGF1 molecules relative to recombinant GH and IGF1. Growth plate height
measurements in GH-inhibited mice will be used for initial efficacy testing of the next-gen GP-IGF1 molecules
generated through our drug optimization program. Because growth plate height is a surrogate for chondrocyte
proliferation and bone growth, these experiments will be complemented with direct measurements of chondro-
cyte proliferation and bone formation. Lead molecules will then be murinized for use in longer-term experiments
that will critically evaluate (i) the extent to which they accelerate long bone growth and (ii) the potential for adverse
effects. At the successful completion of Phase 1, we will have identified a lead compound that has been test...

## Key facts

- **NIH application ID:** 10819340
- **Project number:** 1R43HD112213-01A1
- **Recipient organization:** CAVALRY BIOSCIENCES, INC
- **Principal Investigator:** Timothy Richard Stowe
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $274,596
- **Award type:** 1
- **Project period:** 2023-09-22 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10819340

## Citation

> US National Institutes of Health, RePORTER application 10819340, Growth plate-targeted IGF1 to treat Turner Syndrome (1R43HD112213-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10819340. Licensed CC0.

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