News|Articles|September 23, 2026 (Updated: September 23, 2026)

SOT106 Lands Dual FDA Designations for Osteosarcoma and Soft Tissue Sarcoma

Author(s)OncLive Staff
Fact checked by: Riley Kandel
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Key Takeaways

  • Dual orphan drug and fast track status now covers both soft tissue sarcoma and osteosarcoma, despite absence of clinical data and pending first-in-human initiation.
  • LRRC15-directed antibody is site-specifically conjugated to MMAE; internalization and lysosomal cleavage inhibit microtubule polymerization, while membrane-permeable payload enables bystander cytotoxicity.
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SOT106 now holds both orphan drug and fast track designations across soft tissue sarcoma and osteosarcoma ahead of a first-in-human trial.

The FDA has granted orphan drug designation to SOT106, an investigational antibody-drug conjugate (ADC), for the treatment of patients with soft tissue sarcoma (STS), and fast track designation to the agent for the treatment of patients with osteosarcoma.1

Notably, with these additions, SOT106 now holds both designations in both indications. The agent previously received orphan drug designation for osteosarcoma in June 2026 and fast track designation for STS in August 2026.1,2,3

SOT106 has not yet entered clinical testing; the designations were supported by target biology and preclinical findings. SOT106 targets leucine-rich repeat-containing 15 (LRRC15), which is expressed across multiple prevalent sarcoma subtypes. Preclinical studies, including patient-derived xenograft (PDX) models of both osteosarcoma and STS, showed that SOT106 had antitumor activity and was well tolerated.1

In early preclinical studies, the ADC demonstrated tumor regression in an LRRC15 low-expressing PDX model of pediatric osteosarcoma in which a first-generation LRRC15-targeting ADC was ineffective, in addition to producing complete responses across STS subtypes, non–small cell lung cancer, and head and neck squamous cell carcinoma models.4

“These additional designations mark another important milestone for SOT106 and reflect the growing momentum behind our ADC portfolio,” said Radek Spisek, MD, PhD, chief executive officer of SOTIO in a news release.1 “Patients with sarcoma continue to face limited treatment options, underscoring the need for innovative targeted therapies. As we advance SOT106 toward the clinic, we believe it has the potential to become an important treatment option for patients in need.”

Sotio expects to initiate a first-in-human trial of SOT106 later in 2026, and no clinical efficacy or safety data for the agent have been reported to date.3

What Is the mechanism of action of SOT106?

SOT106 in Sarcoma: Regulatory Highlights

  • SOT106 now holds both orphan drug and fast track designations for osteosarcoma and STS.
  • The ADC has shown promising antitumor activity and was well tolerated in early preclinical studies
  • A first-in-human trial is expected to begin later in 2026; no clinical data have been reported.

SOT106 pairs a LRRC15-directed antibody conjugated to the microtubule-disrupting agent monomethyl auristatin E (MMAE), linked via LigaChem Biosciences' ConjuAll site-specific conjugation technology and releases the payload selectively within the tumor.1,4,5 Once the ADC binds LRRC15 at the cell surface, it is then internalized and trafficked to the lysosome, where the payload is released to block microtubule polymerization and induce cell death. Since MMAE is membrane permeable, the free payload can also enter neighboring cells, producing a bystander effect.

LRRC15 is expressed both on malignant cells and in the tumor stroma of mesenchymal cancers, including a broad subset of sarcomas, whereas its expression in normal adult tissue is limited, supporting its selection as an ADC target. Preclinical models showed a favorable pharmacokinetic and safety profile, in vivo stability, and a high therapeutic index, with Sotio describing SOT106 as a potentially best-in-class LRRC15-directed ADC.

What are the next steps for targeted therapies in sarcoma?

Targeted strategies have helped to improve outcomes in select sarcoma subtypes. In the phase 3 Peak study (NCT05208047) patients with gastrointestinal stromal tumor (GIST) that progressed on or was intolerant to imatinib (Gleevec) who received bezuclastinib plus sunitinib (Sutent; n = 204) experienced a reduction in the risk of progression or death by 50% vs sunitinib alone (n = 209; HR, 0.50; 95% CI, 0.39-0.65; P < .0001).6 Moreover, these patients experienced a median progression-free survival of 16.5 months vs 9.2 months for sunitinib alone.

Importantly, in May 2026, the FDA accepted a new drug application for the combination for previously treated GISTs with priority review and set a target action date of November 30, 2026.7

"Our preparations for expected bezuclastinib launches in both GIST and systemic mastocytosis later [in 2026] are well underway,” said Andrew Robbins, president and chief executive officer of Cogent Biosciences, stated in a news release about the regulatory decision.

References

  1. SOTIO advances SOT106 with dual FDA designations, further positioning the program as a potential best-in-class ADC for sarcoma. News release. Sotio Biotech. September 23, 2026. Accessed September 23, 2026. https://www.globenewswire.com/news-release/2026/09/23/3367416/0/en/sotio-advances-sot106-with-dual-fda-designations-further-positioning-the-program-as-a-potential-best-in-class-adc-for-sarcoma.html
  2. SOTIO receives US FDA orphan drug designation for SOT106, a potential best-in-class ADC for sarcoma. News release. Sotio Biotech. June 3, 2026. Accessed September 23, 2026. https://sotio.com/news-publications/news/sotio-receives-u-s-fda-orphan-drug-designation-for-sot106-a-potential-best-in-class-adc-for-sarcoma
  3. FDA grants fast track designation to Sotio’s SOT106 ADC for soft tissue sarcoma treatment, accelerating clinical development. News release. Sotio Biotech. August 26, 2026. Accessed September 23, 2026. https://sotio.com/news-publications/news/fda-grants-fast-track-designation-to-sotio-s-sot106-adc-for-soft-tissue-sarcoma-treatment-accelerating-clinical-development
  4. Sotio reports promising preclinical data on antibody-drug conjugates SOT109 and SOT106, underscoring best-in-class potential for solid tumor treatments. News release. Sotio Biotech. April 29, 2025. Accessed September 23, 2026. https://sotio.com/news-publications/news/sotio-reports-promising-preclinical-data-on-antibody-drug-conjugates-sot109-and-sot106-underscoring-best-in-class-potential-for-solid-tumor-treatments
  5. SOT106. Sotio Biotech. Accessed September 23, 2026. https://sotio.com/pipeline/antibody-drug-conjugates/sot106
  6. Wagner AJ, Trent JC, Tap WD, et al. Primary results of the phase 3 Peak study of bezuclastinib + sunitinib vs sunitinib monotherapy in advanced gastrointestinal stromal tumors (GIST). J Clin Oncol. 2026;44(suppl 16):11500. doi:10.1200/JCO.2026.44.16_suppl.11500
  7. Cogent Biosciences announces FDA acceptance of new drug application (NDA) with priority review for bezuclastinib in combination with sunitinib for patients with GIST. Cogent Biosciences. May 28, 2026. Accessed September 23, 2026. https://investors.cogentbio.com/news-releases/news-release-details/cogent-biosciences-announces-fda-acceptance-new-drug-0

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