201
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Saber H, Del Valle P, Ricks TK, Leighton JK. An FDA oncology analysis of CD3 bispecific constructs and first-in-human dose selection. Regul Toxicol Pharmacol 2017; 90:144-152. [PMID: 28887049 DOI: 10.1016/j.yrtph.2017.09.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/31/2017] [Accepted: 09/02/2017] [Indexed: 12/25/2022]
Abstract
We retrospectively examined the nonclinical studies conducted with 17 CD3 bispecific constructs in support of first-in-human (FIH) trials in oncology. We also collected information on the design of dose-finding clinical trials. Sponsors have used different MABEL approaches for FIH dose selection. To better assess acceptable approaches, FIH doses were computed from nonclinical studies and compared to the maximum tolerated doses (MTDs) in patients, to the highest human doses (HHDs) when an MTD was not identified, or to the recommended human dose (RHD) for blinatumomab. We concluded that approaches based on receptor occupancy, highest non-severely toxic dose, or no-observed adverse effect level are not acceptable for selecting the FIH dose as they resulted in doses close to or above the MTDs, HHDs, or the RHD. A FIH dose corresponding to 10%-30% pharmacologic activity (PA) was an acceptable approach. A FIH dose corresponding to 50% PA was acceptable for all except one construct, potentially due to its biological or structural properties. The most common toxicities in animals and patients were those related to cytokine release. Doses were better tolerated when intra-animal or intra-patient dose escalation was used. Exposing naïve patients to an MTD achieved with intra-patient dose escalation design may be unsafe.
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Affiliation(s)
- Haleh Saber
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Hematology and Oncology Products, 10903 New Hampshire Ave, Silver Spring, MD 20903, United States.
| | - Pedro Del Valle
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Hematology and Oncology Products, 10903 New Hampshire Ave, Silver Spring, MD 20903, United States
| | - Tiffany K Ricks
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Hematology and Oncology Products, 10903 New Hampshire Ave, Silver Spring, MD 20903, United States
| | - John K Leighton
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Hematology and Oncology Products, 10903 New Hampshire Ave, Silver Spring, MD 20903, United States
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202
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Kruse RL, Shum T, Legras X, Barzi M, Pankowicz FP, Gottschalk S, Bissig KD. In Situ Liver Expression of HBsAg/CD3-Bispecific Antibodies for HBV Immunotherapy. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2017; 7:32-41. [PMID: 29018834 PMCID: PMC5626922 DOI: 10.1016/j.omtm.2017.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/24/2017] [Indexed: 02/07/2023]
Abstract
Current therapies against hepatitis B virus (HBV) do not reliably cure chronic infection, necessitating new therapeutic approaches. The T cell response can clear HBV during acute infection, and the adoptive transfer of antiviral T cells during bone marrow transplantation can cure patients of chronic HBV infection. To redirect T cells to HBV-infected hepatocytes, we delivered plasmids encoding bispecific antibodies directed against the viral surface antigen (HBsAg) and CD3, expressed on almost all T cells, directly into the liver using hydrodynamic tail vein injection. We found a significant reduction in HBV-driven reporter gene expression (184-fold) in a mouse model of acute infection, which was 30-fold lower than an antibody only recognizing HBsAg. While bispecific antibodies triggered, in part, antigen-independent T cell activation, antibody production within hepatocytes was non-cytotoxic. We next tested the bispecific antibodies in a different HBV mouse model, which closely mimics the transcriptional template for HBV, covalently closed circular DNA (cccDNA). We found that the antiviral effect was noncytopathic, mediating a 495-fold reduction in HBsAg levels at day 4. At day 33, bispecific antibody-treated mice exhibited 35-fold higher host HBsAg immunoglobulin G (IgG) antibody production versus untreated groups. Thus, gene therapy with HBsAg/CD3-bispecific antibodies represents a promising therapeutic strategy for patients with HBV.
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Affiliation(s)
- Robert L Kruse
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas Shum
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xavier Legras
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mercedes Barzi
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Frank P Pankowicz
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Karl-Dimiter Bissig
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
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203
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Emdal KB, Dittmann A, Reddy RJ, Lescarbeau RS, Moores SL, Laquerre S, White FM. Characterization of In Vivo Resistance to Osimertinib and JNJ-61186372, an EGFR/Met Bispecific Antibody, Reveals Unique and Consensus Mechanisms of Resistance. Mol Cancer Ther 2017; 16:2572-2585. [PMID: 28830985 DOI: 10.1158/1535-7163.mct-17-0413] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/21/2017] [Accepted: 08/10/2017] [Indexed: 12/28/2022]
Abstract
Approximately 10% of non-small cell lung cancer (NSCLC) patients in the United States and 40% of NSCLC patients in Asia have activating epidermal growth factor receptor (EGFR) mutations and are eligible to receive targeted anti-EGFR therapy. Despite an extension of life expectancy associated with this treatment, resistance to EGFR tyrosine kinase inhibitors and anti-EGFR antibodies is almost inevitable. To identify additional signaling routes that can be cotargeted to overcome resistance, we quantified tumor-specific molecular changes that govern resistant cancer cell growth and survival. Mass spectrometry-based quantitative proteomics was used to profile in vivo signaling changes in 41 therapy-resistant tumors from four xenograft NSCLC models. We identified unique and tumor-specific tyrosine phosphorylation rewiring in tumors resistant to treatment with the irreversible third-generation EGFR-inhibitor, osimertinib, or the novel dual-targeting EGFR/Met antibody, JNJ-61186372. Tumor-specific increases in tyrosine-phosphorylated peptides from EGFR family members, Shc1 and Gab1 or Src family kinase (SFK) substrates were observed, underscoring a differential ability of tumors to uniquely escape EGFR inhibition. Although most resistant tumors within each treatment group displayed a marked inhibition of EGFR as well as SFK signaling, the combination of EGFR inhibition (osimertinib) and SFK inhibition (saracatinib or dasatinib) led to further decrease in cell growth in vitro This result suggests that residual SFK signaling mediates therapeutic resistance and that elimination of this signal through combination therapy may delay onset of resistance. Overall, analysis of individual resistant tumors captured unique in vivo signaling rewiring that would have been masked by analysis of in vitro cell population averages. Mol Cancer Ther; 16(11); 2572-85. ©2017 AACR.
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Affiliation(s)
- Kristina B Emdal
- Department of Biological Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Antje Dittmann
- Department of Biological Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Raven J Reddy
- Department of Biological Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Rebecca S Lescarbeau
- Department of Biological Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Sheri L Moores
- Oncology, Janssen Research and Development, LLC, Spring House, Pennsylvania
| | - Sylvie Laquerre
- Oncology, Janssen Research and Development, LLC, Spring House, Pennsylvania
| | - Forest M White
- Department of Biological Engineering and David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts.
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204
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Chang CH, Wang Y, Li R, Rossi DL, Liu D, Rossi EA, Cardillo TM, Goldenberg DM. Combination Therapy with Bispecific Antibodies and PD-1 Blockade Enhances the Antitumor Potency of T Cells. Cancer Res 2017; 77:5384-5394. [PMID: 28819027 DOI: 10.1158/0008-5472.can-16-3431] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/24/2017] [Accepted: 08/04/2017] [Indexed: 11/16/2022]
Abstract
The DOCK-AND-LOCK (DNL) method is a platform technology that combines recombinant engineering and site-specific conjugation to create multispecific, multivalent antibodies of defined composition with retained bioactivity. We have applied DNL to generate a novel class of trivalent bispecific antibodies (bsAb), each comprising an anti-CD3 scFv covalently conjugated to a stabilized dimer of different antitumor Fabs. Here, we report the further characterization of two such constructs, (E1)-3s and (14)-3s, which activate T cells and target Trop-2- and CEACAM5-expressing cancer cells, respectively. (E1)-3s and (14)-3s, in the presence of human T cells, killed target cells grown as monolayers at subnanomolar concentrations, with a similar potency observed for drug-resistant cells. Antitumor efficacy was demonstrated for (E1)-3s coadministered with human peripheral blood mononuclear cells (PBMC) in NOD/SCID mice harboring xenografts of MDA-MB-231, a triple-negative breast cancer line constitutively expressing Trop-2 and PD-L1. Growth inhibition was observed following treatment with (E1)-3s or (14)-3s combined with human PBMC in 3D spheroids generated from target cell lines to mimic the in vivo behavior and microenvironment of these tumors. Moreover, addition of an antagonistic anti-PD-1 antibody increased cell death in 3D spheroids and extended survival of MDA-MB-231-bearing mice. These preclinical results emphasize the potential of combining T-cell-redirecting bsAbs with antagonists or agonists that mitigate T-cell inhibition within the tumor microenvironment to improve immunotherapy of solid cancers in patients. They also support the use of 3D spheroids as a predictive alternative to in vivo models for evaluating T-cell functions. Cancer Res; 77(19); 5384-94. ©2017 AACR.
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Affiliation(s)
- Chien-Hsing Chang
- Immunomedics, Inc., Morris Plains, New Jersey. .,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| | - Yang Wang
- Immunomedics, Inc., Morris Plains, New Jersey
| | - Rongxiu Li
- Immunomedics, Inc., Morris Plains, New Jersey
| | | | - Donglin Liu
- Immunomedics, Inc., Morris Plains, New Jersey.,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
| | | | | | - David M Goldenberg
- Immunomedics, Inc., Morris Plains, New Jersey.,IBC Pharmaceuticals, Inc., Morris Plains, New Jersey
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205
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Xing J, Lin L, Li J, Liu J, Zhou C, Pan H, Shu R, Dong B, Cao D, Li Q, Wang Z. BiHC, a T-Cell-Engaging Bispecific Recombinant Antibody, Has Potent Cytotoxic Activity Against Her2 Tumor Cells. Transl Oncol 2017; 10:780-785. [PMID: 28797938 PMCID: PMC5548338 DOI: 10.1016/j.tranon.2017.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/09/2017] [Accepted: 07/14/2017] [Indexed: 12/26/2022] Open
Abstract
Among different cancer immunotherapy approaches, bispecific antibodies (BsAbs) are of great interest due to their ability to recruit immune cells to kill tumor cells directly. Various BsAbs against Her2 tumor cells have been proposed with potent cytotoxic activities. However, most of these formats require extensive processing to obtain heterodimeric bispecific antibodies. In this study, we describe a bispecific antibody, BiHC (bispecific Her2-CD3 antibody), constructed with a single-domain anti-Her2 and a single-chain Fv (variable fragment) of anti-CD3 in an IgG-like format. In contrast to most IgG-like BsAbs, the two arms in BiHC have different molecular weights, making it easier to separate hetero- or homodimers. BiHC can be expressed in Escherichia coli and purified via Protein A affinity chromatography. The purified BiHC can recruit T cells and induce specific cytotoxicity of Her2-expressing tumor cells in vitro. The BiHC can also efficiently inhibit the tumor growth in vivo. Thus, BiHC is a promising candidate for the treatment of Her2-positive cancers.
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Affiliation(s)
- Jieyu Xing
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Limin Lin
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Jing Li
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Jiayu Liu
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Changhua Zhou
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Haitao Pan
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Rui Shu
- Ying Rui Inc., Guangzhou, Guangdong, China 510009.
| | - Bin Dong
- School of Biosciences and Biopharmaceutics, Guangdong pharmaceutical University, Guangzhou, Guangdong, China 510009.
| | - Donglin Cao
- Department of Laboratory Medicine, Guangdong No. 2 Provincial People's Hospital, Guangzhou, China 510317.
| | - Qing Li
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
| | - Zhong Wang
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China 510006; Center for Cellular & Structural Biology, Sun Yat-Sen University, Guangzhou, China 510006.
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206
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Freedman JD, Hagel J, Scott EM, Psallidas I, Gupta A, Spiers L, Miller P, Kanellakis N, Ashfield R, Fisher KD, Duffy MR, Seymour LW. Oncolytic adenovirus expressing bispecific antibody targets T-cell cytotoxicity in cancer biopsies. EMBO Mol Med 2017; 9:1067-1087. [PMID: 28634161 PMCID: PMC5538299 DOI: 10.15252/emmm.201707567] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/15/2017] [Accepted: 05/18/2017] [Indexed: 12/21/2022] Open
Abstract
Oncolytic viruses exploit the cancer cell phenotype to complete their lytic life cycle, releasing progeny virus to infect nearby cells and repeat the process. We modified the oncolytic group B adenovirus EnAdenotucirev (EnAd) to express a bispecific single-chain antibody, secreted from infected tumour cells into the microenvironment. This bispecific T-cell engager (BiTE) binds to EpCAM on target cells and cross-links them to CD3 on T cells, leading to clustering and activation of both CD4 and CD8 T cells. BiTE transcription can be controlled by the virus major late promoter, limiting expression to cancer cells that are permissive for virus replication. This approach can potentiate the cytotoxicity of EnAd, and we demonstrate using primary pleural effusions and peritoneal malignant ascites that infection of cancer cells with the BiTE-expressing EnAd leads to activation of endogenous T cells to kill endogenous tumour cells despite the immunosuppressive environment. In this way, we have armed EnAd to combine both direct oncolysis and T cell-mediated killing, yielding a potent therapeutic that should be readily transferred into the clinic.
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Affiliation(s)
| | - Joachim Hagel
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Avinash Gupta
- Churchill Hospital, Oxford University Hospital NHS Trust, Oxford, UK
| | - Laura Spiers
- Churchill Hospital, Oxford University Hospital NHS Trust, Oxford, UK
| | - Paul Miller
- Churchill Hospital, Oxford University Hospital NHS Trust, Oxford, UK
| | - Nikolaos Kanellakis
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Kerry D Fisher
- Department of Oncology, University of Oxford, Oxford, UK
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207
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Yamazaki T, Galluzzi L. Blinatumomab bridges the gap between leukemia and immunity. Oncoimmunology 2017; 6:e1358335. [PMID: 29147620 DOI: 10.1080/2162402x.2017.1358335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 07/14/2017] [Indexed: 01/25/2023] Open
Affiliation(s)
- Takahiro Yamazaki
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Lorenzo Galluzzi
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA.,Sandra and Edward Meyer Cancer Center, New York, NY, USA.,Université Paris Descartes/Paris V, Paris, France
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208
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Ransohoff JD, Kwong BY. Cutaneous Adverse Events of Targeted Therapies for Hematolymphoid Malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:834-851. [PMID: 28918995 DOI: 10.1016/j.clml.2017.07.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/10/2017] [Indexed: 12/11/2022]
Abstract
The identification of oncogenic drivers of liquid tumors has led to the rapid development of targeted agents with distinct cutaneous adverse event (AE) profiles. The diagnosis and management of these skin toxicities has motivated a novel partnership between dermatologists and oncologists in developing supportive oncodermatology clinics. In this article we review the current state of knowledge of clinical presentation, mechanisms, and management of the most common and significant cutaneous AEs observed during treatment with targeted therapies for hematologic and lymphoid malignancies. We systematically review according to drug-targeting pathway the cutaneous AE profiles of these drugs, and offer insight when possible into whether pharmacologic target versus immunologic modulation primarily underlie presentation. We include discussion of tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib, bosutinib, ponatinib), blinatumomab, ibrutinib, idelalisib, anti-B cell antibodies (rituximab, ibritumomab, obinutuzumab, ofatumumab, tositumomab), immune checkpoint inhibitors (nivolumab, pembrolizumab), alemtuzumab, brentuximab, and proteasome inhibitors (bortezomib, carfilzomib, ixazomib). We highlight skin reactions seen with antiliquid but not solid tumor agents, draw attention to serious cutaneous AEs that might require therapy modification or cessation, and offer management strategies to permit treatment tolerability. We emphasize the importance of early diagnosis and treatment to minimize disruptions to care, optimize prognosis and quality of life, and promptly address life-threatening skin or infectious events. This evolving partnership between oncologists and dermatologists in the iterative characterization and management of skin toxicities will contribute to a better understanding of these drugs' cutaneous targets and improved patient care.
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Affiliation(s)
- Julia D Ransohoff
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA
| | - Bernice Y Kwong
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA.
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209
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Santiago R, Vairy S, Sinnett D, Krajinovic M, Bittencourt H. Novel therapy for childhood acute lymphoblastic leukemia. Expert Opin Pharmacother 2017; 18:1081-1099. [PMID: 28608730 DOI: 10.1080/14656566.2017.1340938] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION During recent decades, the prognosis of childhood acute lymphoblastic leukemia (ALL) has improved dramatically, nowadays, reaching a cure rate of almost 90%. These results are due to a better management and combination of old therapies, refined risk-group stratification and emergence of minimal residual disease (MRD) combined with treatment's intensification for high-risk subgroups. However, the subgroup of patients with refractory/relapsed ALL still presents a dismal prognosis indicating necessity for innovative therapeutic approaches. Areas covered: We performed an exhaustive review of current first-line therapies for childhood ALL in the worldwide main consortia, summarized the major advances for front-line and relapse treatment and highlighted recent and promising innovative therapies with an overview of the most promising ongoing clinical trials. Expert opinion: Two major avenues marked the beginning of 21st century. First, is the introduction of tyrosine-kinase inhibitor coupled to chemotherapy for treatment of Philadelphia positive ALL opening new treatment possibilities for the recently identified subgroup of Ph-like ALL. Second, is the breakthrough of immunotherapy, notably CAR T-cell and specific antibody-based therapy, with remarkable success observed in initial studies. This review gives an insight on current knowledge in these innovative therapeutic directions, summarizes currently ongoing clinical trials and addresses challenges these approaches are faced with.
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Affiliation(s)
- Raoul Santiago
- a CHU Sainte-Justine Research Center , Charles-Bruneau Cancer Center , Montreal , Quebec , Canada.,b Department of Pediatrics, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada
| | - Stéphanie Vairy
- a CHU Sainte-Justine Research Center , Charles-Bruneau Cancer Center , Montreal , Quebec , Canada.,b Department of Pediatrics, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada
| | - Daniel Sinnett
- a CHU Sainte-Justine Research Center , Charles-Bruneau Cancer Center , Montreal , Quebec , Canada.,b Department of Pediatrics, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada
| | - Maja Krajinovic
- a CHU Sainte-Justine Research Center , Charles-Bruneau Cancer Center , Montreal , Quebec , Canada.,b Department of Pediatrics, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada.,c Department of Pharmacology and Physiology, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada
| | - Henrique Bittencourt
- a CHU Sainte-Justine Research Center , Charles-Bruneau Cancer Center , Montreal , Quebec , Canada.,b Department of Pediatrics, Faculty of Medicine , University of Montreal , Montreal , Quebec , Canada
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210
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Treatment of hepatocellular carcinoma with a GPC3-targeted bispecific T cell engager. Oncotarget 2017; 8:52866-52876. [PMID: 28881778 PMCID: PMC5581077 DOI: 10.18632/oncotarget.17905] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/04/2017] [Indexed: 12/23/2022] Open
Abstract
There are limited strategies for the treatment of hepatocellular carcinoma (HCC). In this study, we prepared a Bispecific T cell engager (BiTE) targeting Glypican 3 (GPC3) and CD3. The GPC3/CD3 BiTE was prepared by fusing the single-chain variable fragment (scFv) of the humanized anti-GPC3 antibody (9F2) with the scFv of the anti-CD3 antibody (OKT3). The in vitro and in vivo cytotoxic activities of the GPC3/CD3 BiTE were evaluated against various HCC cell lines. The GPC3/CD3 BiTE could efficiently mediate the T cell killing of GPC3-positive HCC in vitro, which was dependent on GPC3 expression on the surface of HCC cells. Moreover, our study indicates that, in the presence of the GPC3/CD3 BiTE, T cells could efficiently destroy GPC3-positive human HCC cells in vitro and in vivo. Additionally, our study further proved that GPC3 is not expressed in normal tissues. Thus, GPC3 may be a cancer-specific antigen. Collectively, these findings suggest that this anti-GPC3 BiTE might be a promising anti-tumor reagent for patients with GPC3-positive HCC.
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211
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Abstract
Hematological malignancies manifest as lymphoma, leukemia, and myeloma, and remain a burden on society. From initial therapy to endless relapse-related treatment, societal burden is felt not only in the context of healthcare cost, but also in the compromised quality of life of patients. Long-term therapeutic strategies have become the standard in keeping hematological malignancies at bay as these cancers develop resistance to each round of therapy with time. As a result, there is a continual need for the development of new drugs to combat resistant disease in order to prolong patient life, if not to produce a cure. This review aims to summarize advances in targeting lymphoma, leukemia, and myeloma through both cutting-edge and well established platforms. Current standard of treatment will be reviewed for these malignancies and emphasis will be made on new therapy development in the areas of antibody engineering, epigenetic small molecule inhibiting drugs, vaccine development, and chimeric antigen receptor cell engineering. In addition, platforms for the delivery of these and other drugs will be reviewed including antibody-drug conjugates, micro- and nanoparticles, and multimodal hydrogels. Lastly, we propose that tissue engineered constructs for hematological malignancies are the missing link in targeted drug discovery alongside mouse and patient-derived xenograft models.
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212
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Godbersen C, Coupet TA, Huehls AM, Zhang T, Battles MB, Fisher JL, Ernstoff MS, Sentman CL. NKG2D Ligand-Targeted Bispecific T-Cell Engagers Lead to Robust Antitumor Activity against Diverse Human Tumors. Mol Cancer Ther 2017; 16:1335-1346. [PMID: 28500232 DOI: 10.1158/1535-7163.mct-16-0846] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/16/2017] [Accepted: 04/28/2017] [Indexed: 01/06/2023]
Abstract
Two new bispecific T-cell engaging (BiTE) molecules with specificity for NKG2D ligands were developed and functionally characterized. One, huNKG2D-OKT3, was derived from the extracellular portion of the human NKG2D receptor fused to a CD3ε binding single-chain variable fragment (scFv), known as OKT3. NKG2D has multiple ligands, including MICA, which are expressed by a variety of malignant cells. A second molecule, B2-OKT3, was created in the tandem scFv BiTE format that targets MICA on tumor cells and CD3ε on human T cells. Both BiTEs specifically activated T cells to kill human tumor cell lines. Cytotoxicity by B2-OKT3, but not huNKG2D-OKT3, is blocked by soluble rMICA. The huNKG2D-OKT3 induced greater T-cell cytokine production in comparison with B2-OKT3. No T-cell pretreatment was required for IFNγ production upon coculture of B2-OKT3 or huNKG2D-OKT3 with T cells and target cells. The effector memory T-cell compartment was the primary source of IFNγ, and culture of T cells and these BiTEs with plate-bound rMICA showed ligand density-dependent production of IFNγ from both CD4+ and CD8+ T cells. There was 2-fold more IFNγ produced per CD8+ T cell and 5-fold greater percentage of CD8+ T cells producing IFNγ compared with CD4+ T cells. In addition, both BiTEs elicited significant antitumor responses against human metastatic melanoma tumor samples using autologous or healthy donor T cells. These data demonstrate the robust antitumor activity of these NKG2D ligand-binding bispecific proteins and support their further development for clinical use. Mol Cancer Ther; 16(7); 1335-46. ©2017 AACR.
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Affiliation(s)
- Claire Godbersen
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Tiffany A Coupet
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Amelia M Huehls
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Tong Zhang
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Michael B Battles
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | | | | | - Charles L Sentman
- Department of Microbiology & Immunology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
- The Center for Synthetic Immunity, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
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213
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Yuraszeck T, Kasichayanula S, Benjamin JE. Translation and Clinical Development of Bispecific T-cell Engaging Antibodies for Cancer Treatment. Clin Pharmacol Ther 2017; 101:634-645. [PMID: 28182247 PMCID: PMC5763312 DOI: 10.1002/cpt.651] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/01/2017] [Accepted: 02/04/2017] [Indexed: 02/06/2023]
Abstract
Bispecific T‐cell Engagers (BiTE®) antibody constructs enable a polyclonal T‐cell response to cell‐surface tumor‐associated antigens, bypassing the narrow specificities of T‐cell receptors and the need for antigen presentation through the major histocompatibility complex pathways. Blinatumomab, a CD19xCD3 BiTE® antibody construct, received accelerated approval for the treatment of relapsed/refractory Philadelphia chromosome negative acute lymphoblastic leukemia. Herein we review the pharmacology, safety, and efficacy observed in studies of blinatumomab and other BiTE® antibody constructs. Quantitative systems pharmacology is envisioned as a means to optimize dosing decisions for trials in which BiTE® antibody constructs are administered as monotherapy or in combination with other immunotherapies.
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Affiliation(s)
- T Yuraszeck
- Clinical Pharmacology, Modeling, and Simulation, Amgen Inc., Thousand Oaks, California, USA
| | - S Kasichayanula
- Clinical Pharmacology, Modeling, and Simulation, Amgen Inc., Thousand Oaks, California, USA
| | - J E Benjamin
- Global Development, Oncology, Amgen Inc., Thousand Oaks, California, USA
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214
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Immune Characterization of the Programmed Death Receptor Pathway in High Risk Prostate Cancer. Clin Genitourin Cancer 2017; 15:577-581. [PMID: 28461179 DOI: 10.1016/j.clgc.2017.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/26/2017] [Accepted: 04/03/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Programmed cell death-1 (PD-1), a T-cell inhibitory receptor, and its ligand, PD-L1, have been reported to be expressed in many tumor types, and this expression has led to the development of many drugs targeting the PD-1 pathway. The objective of this study was to determine the expression of PD-1 and PD-L1 in high-grade prostate cancer tissues, and correlate the expression with disease and patient characteristics. MATERIALS AND METHODS Immunohistochemistry for PD-1 (CD279), PD-L1 (B7-H1), and CD3 was performed and scored from 0 to 5 on prostatectomy/biopsy tissue samples taken from 25 men with high-grade prostate cancer. Charts were then retrospectively reviewed for numerous patient and disease characteristics. Statistical analyses were done to investigate the association of these patient and disease characteristics with PD-1, PD-L1, and CD3 expression. RESULTS A score of 3 to 5 on the semiquantitative 0 to 5 score was deemed "high" expression whereas a score of 0 to 2 was deemed "low" expression. Of the 25 samples, 2 (8%) scored high for PD-1 expression, 2 (8%) scored high for PD-L1 expression, and 18 (72%) scored high for CD3 expression. There was no statistically significant difference between high and low expression groups of PD-1, PD-L1, or CD3 for any of the variables we collected. CONCLUSION An overall low expression of PD-1 and PD-L1, and a concurrent high expression of CD3+ T cells was found in high-risk prostate cancer tissue. No significant association was found between expression of PD-1, PD-L1, or CD3, and patient or disease characteristics. Because of this, one might be able to question the role of PD-L1 in local immune suppression in prostate cancer.
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215
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Thota S, Advani A. Inotuzumab ozogamicin in relapsed B-cell acute lymphoblastic leukemia. Eur J Haematol 2017; 98:425-434. [DOI: 10.1111/ejh.12862] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Swapna Thota
- Department of Hematology/Oncology; Cleveland Clinic; Taussig Cancer Institute; Cleveland OH USA
| | - Anjali Advani
- Department of Hematology/Oncology; Cleveland Clinic; Taussig Cancer Institute; Cleveland OH USA
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216
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Pemmaraju N, Kantarjian H, Jorgensen JL, Jabbour E, Jain N, Thomas D, O'Brien S, Wang X, Huang X, Wang SA, Konopleva M, Konoplev S, Kadia T, Garris R, Pierce S, Garcia‐Manero G, Cortes J, Ravandi F. Significance of recurrence of minimal residual disease detected by multi-parameter flow cytometry in patients with acute lymphoblastic leukemia in morphological remission. Am J Hematol 2017; 92:279-285. [PMID: 28052371 DOI: 10.1002/ajh.24629] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/17/2016] [Accepted: 12/21/2016] [Indexed: 12/16/2022]
Abstract
We sought to determine the significance of minimal residual disease (MRD) relapse in patients with ALL after achieving MRD negative status following induction and consolidation therapy. Between January 2003 and September 2014, 647 newly diagnosed patients were treated [HyperCVAD-based (n = 531); Augmented BFM (n = 116)]. Six hundred and one (93%) achieved complete remission (CR), and 546 (91%) became MRD negative. Fifty-five patients [HyperCVAD-based (n = 49); Augmented BFM (n = 6)] developed recurrence of MRD while still in morphological CR and are the subjects of this study. MRD was assessed by 6-color (4-color prior to 2009) multi-parameter flow cytometry (MFC) at CR and multiple time points thereafter. Their median age was 44 years (range, 18-72 years), median WBC at initial presentation was 7.3 K/µL-1 (range, 0.6-303.8 K/µL-1 ) and median bone marrow blast percentage 88% (range, 26-98%). The median time to MRD relapse was 14 months (range 3-58 months). Forty-four (80%) patients subsequently developed morphological relapse after median of 3 months (range, <1-33 months) from detection of MRD recurrence. Treatments received after MRD positivity and prior to morphological relapse: 16 continued maintenance chemotherapy; 15 received late intensification; 9 allogeneic stem cell transplant, 9 changed chemotherapy, 6 no further therapy. Only six remain alive and in CR1 and nine are alive after morphological relapse. MRD relapse detected by MFC at any time after achieving CR is associated with a high risk for morphological relapse. SCT can result in long-term remission in some patients. Prospective studies of long-term MRD assessments, together with less toxic treatment strategies to eradicate MRD, are warranted.
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Affiliation(s)
- Naveen Pemmaraju
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Hagop Kantarjian
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Jeffrey L. Jorgensen
- Department of PathologyUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Elias Jabbour
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Nitin Jain
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Deborah Thomas
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Susan O'Brien
- Division of Hematology/Oncology, University of California, Chao Family Comprehensive Cancer Center, Irvine California
| | - Xuemei Wang
- Department of BiostatisticsUniversity of Texas, MD Anderson Cancer Center Texas
| | - Xuelin Huang
- Department of BiostatisticsUniversity of Texas, MD Anderson Cancer Center Texas
| | - Sa A. Wang
- Department of PathologyUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Marina Konopleva
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Sergej Konoplev
- Department of PathologyUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Tapan Kadia
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Rebecca Garris
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Sherry Pierce
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | | | - Jorge Cortes
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
| | - Farhad Ravandi
- Department of LeukemiaUniversity of Texas, MD Anderson Cancer CenterHouston Texas
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217
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Whiteside TL, Demaria S, Rodriguez-Ruiz ME, Zarour HM, Melero I. Emerging Opportunities and Challenges in Cancer Immunotherapy. Clin Cancer Res 2016; 22:1845-55. [PMID: 27084738 DOI: 10.1158/1078-0432.ccr-16-0049] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 02/25/2016] [Indexed: 12/20/2022]
Abstract
Immunotherapy strategies against cancer are emerging as powerful weapons for treatment of this disease. The success of checkpoint inhibitors against metastatic melanoma and adoptive T-cell therapy with chimeric antigen receptor T cells against B-cell-derived leukemias and lymphomas are only two examples of developments that are changing the paradigms of clinical cancer management. These changes are a result of many years of intense research into complex and interrelated cellular and molecular mechanisms controling immune responses. Promising advances come from the discovery of cancer mutation-encoded neoantigens, improvements in vaccine development, progress in delivery of cellular therapies, and impressive achievements in biotechnology. As a result, radical transformation of cancer treatment is taking place in which conventional cancer treatments are being integrated with immunotherapeutic agents. Many clinical trials are in progress testing potential synergistic effects of treatments combining immunotherapy with other therapies. Much remains to be learned about the selection, delivery, and off-target effects of immunotherapy used alone or in combination. The existence of numerous escape mechanisms from the host immune system that human tumors have evolved still is a barrier to success. Efforts to understand the rules of immune cell dysfunction and of cancer-associated local and systemic immune suppression are providing new insights and fuel the enthusiasm for new therapeutic strategies. In the future, it might be possible to tailor immune therapy for each cancer patient. The use of new immune biomarkers and the ability to assess responses to therapy by noninvasive monitoring promise to improve early cancer diagnosis and prognosis. Personalized immunotherapy based on individual genetic, molecular, and immune profiling is a potentially achievable future goal. The current excitement for immunotherapy is justified in view of many existing opportunities for harnessing the immune system to treat cancer.
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Affiliation(s)
- Theresa L Whiteside
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sandra Demaria
- Department of Radiation Oncology, University of Cornell, New York, New York
| | - Maria E Rodriguez-Ruiz
- Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain. Clinica Universidad de Navarra, Pamplona, Spain
| | - Hassane M Zarour
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ignacio Melero
- Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain. Clinica Universidad de Navarra, Pamplona, Spain.
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218
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Bispecific Antibodies as a Development Platform for New Concepts and Treatment Strategies. Int J Mol Sci 2016; 18:ijms18010048. [PMID: 28036020 PMCID: PMC5297683 DOI: 10.3390/ijms18010048] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/11/2022] Open
Abstract
With the development of molecular cloning technology and the deep understanding of antibody engineering, there are diverse bispecific antibody formats from which to choose to pursue the optimal biological activity and clinical purpose. The single-chain-based bispecific antibodies usually bridge tumor cells with immune cells and form an immunological synapse because of their relatively small size. Bispecific antibodies in the IgG format include asymmetric bispecific antibodies and homodimerized bispecific antibodies, all of which have an extended blood half-life and their own crystalline fragment (Fc)-mediated functions. Besides retargeting effector cells to the site of cancer, new applications were established for bispecific antibodies. Bispecific antibodies that can simultaneously bind to cell surface antigens and payloads are a very ideal delivery system for therapeutic use. Bispecific antibodies that can inhibit two correlated signaling molecules at the same time can be developed to overcome inherent or acquired resistance and to be more efficient angiogenesis inhibitors. Bispecific antibodies can also be used to treat hemophilia A by mimicking the function of factor VIII. Bispecific antibodies also have broad application prospects in bone disorders and infections and diseases of the central nervous system. The latest developments of the formats and application of bispecific antibodies will be reviewed. Furthermore, the challenges and perspectives are summarized in this review.
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219
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The Immune System in Cancer Pathogenesis: Potential Therapeutic Approaches. J Immunol Res 2016; 2016:4273943. [PMID: 28116316 PMCID: PMC5220497 DOI: 10.1155/2016/4273943] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/09/2016] [Indexed: 12/13/2022] Open
Abstract
Interplay among immune activation and cancer pathogenesis provides the framework for a novel subspecialty known as immunooncology. In the rapidly evolving field of immunooncology, understanding the tumor-specific immune response enhances understanding of cancer resistance. This review highlights the fundamentals of incorporating precision medicine to discover new immune biomarkers and predictive signatures. Using a personalized approach may have a significant, positive impact on the use of oncolytics to better guide safer and more effective therapies.
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220
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Huguet F, Tavitian S. Emerging biological therapies to treat acute lymphoblastic leukemia. Expert Opin Emerg Drugs 2016; 22:107-121. [DOI: 10.1080/14728214.2016.1257606] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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221
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Boyiadzis M, Bishop MR, Abonour R, Anderson KC, Ansell SM, Avigan D, Barbarotta L, Barrett AJ, Van Besien K, Bergsagel PL, Borrello I, Brody J, Brufsky J, Cairo M, Chari A, Cohen A, Cortes J, Forman SJ, Friedberg JW, Fuchs EJ, Gore SD, Jagannath S, Kahl BS, Kline J, Kochenderfer JN, Kwak LW, Levy R, de Lima M, Litzow MR, Mahindra A, Miller J, Munshi NC, Orlowski RZ, Pagel JM, Porter DL, Russell SJ, Schwartz K, Shipp MA, Siegel D, Stone RM, Tallman MS, Timmerman JM, Van Rhee F, Waller EK, Welsh A, Werner M, Wiernik PH, Dhodapkar MV. The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of hematologic malignancies: multiple myeloma, lymphoma, and acute leukemia. J Immunother Cancer 2016; 4:90. [PMID: 28018601 PMCID: PMC5168808 DOI: 10.1186/s40425-016-0188-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/07/2016] [Indexed: 12/24/2022] Open
Abstract
Increasing knowledge concerning the biology of hematologic malignancies as well as the role of the immune system in the control of these diseases has led to the development and approval of immunotherapies that are resulting in impressive clinical responses. Therefore, the Society for Immunotherapy of Cancer (SITC) convened a hematologic malignancy Cancer Immunotherapy Guidelines panel consisting of physicians, nurses, patient advocates, and patients to develop consensus recommendations for the clinical application of immunotherapy for patients with multiple myeloma, lymphoma, and acute leukemia. These recommendations were developed following the previously established process based on the Institute of Medicine's clinical practice guidelines. In doing so, a systematic literature search was performed for high-impact studies from 2004 to 2014 and was supplemented with further literature as identified by the panel. The consensus panel met in December of 2014 with the goal to generate consensus recommendations for the clinical use of immunotherapy in patients with hematologic malignancies. During this meeting, consensus panel voting along with discussion were used to rate and review the strength of the supporting evidence from the literature search. These consensus recommendations focus on issues related to patient selection, toxicity management, clinical endpoints, and the sequencing or combination of therapies. Overall, immunotherapy is rapidly emerging as an effective therapeutic strategy for the management of hematologic malignances. Evidence-based consensus recommendations for its clinical application are provided and will be updated as the field evolves.
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Affiliation(s)
- Michael Boyiadzis
- Division of Hematology-Oncology, Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh Cancer Institute, University of Pittsburgh Medical Center, 5150 Centre Avenue, Suite 564, Pittsburg, PA 15232 USA
| | - Michael R. Bishop
- Hematopoietic Cellular Therapy Program, University of Chicago, 5841 S. Maryland Avenue, Chicago, IL 60637 USA
| | - Rafat Abonour
- Indiana University School of Medicine, 980 W. Walnut St., Walther Hall-R3, C400, Indianapolis, IN 46202 USA
| | | | | | - David Avigan
- Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215 USA
| | - Lisa Barbarotta
- Smilow Cancer Hospital at Yale New Haven, 35 Park Street, New Haven, CT 06519 USA
| | - Austin John Barrett
- National Institutes of Health, Building 10-CRC Room 3-5330, Bethesda, MD 20814 USA
| | - Koen Van Besien
- Weill Cornell Medical College, 407 E 71st St, New York, NY 10065 USA
| | | | - Ivan Borrello
- Johns Hopkins School of Medicine, 1650 Orleans St, Baltimore, MD 21231 USA
| | - Joshua Brody
- Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029 USA
| | - Jill Brufsky
- University of Pittsburgh Cancer Institute, 5150 Centre Avenue, Pittsburgh, PA 15232 USA
| | - Mitchell Cairo
- New York Medical College at Maria Fareri Children’s Hospital, 100 Woods Road, Valhalla, New York 10595 USA
| | - Ajai Chari
- Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029 USA
| | - Adam Cohen
- Abramson Cancer Center at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Jorge Cortes
- MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA
| | - Stephen J. Forman
- City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010 USA
| | - Jonathan W. Friedberg
- Wilmot Cancer Institute, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14642 USA
| | - Ephraim J. Fuchs
- Johns Hopkins University School of Medicine, 401 N. Broadway, Baltimore, MD 21231 USA
| | - Steven D. Gore
- Yale Cancer Center, 333 Cedar Street, New Haven, CT 06511 USA
| | - Sundar Jagannath
- Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY 10029 USA
| | - Brad S. Kahl
- Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110 USA
| | - Justin Kline
- The University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637 USA
| | - James N. Kochenderfer
- National Institutes of Health, National Cancer Institute, 8500 Roseweood Drive, Bethesda, MD 20814 USA
| | - Larry W. Kwak
- City of Hope National Medical Center, 1500 E. Duarte Road, Beckman Bldg., Room 4117, Duarte, CA 91010 USA
| | - Ronald Levy
- Division of Medical Oncology, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305 USA
| | - Marcos de Lima
- Department of Medicine-Hematology and Oncology, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106 USA
| | - Mark R. Litzow
- Department of Hematology, Mayo Clinic Cancer Center, 200 First Street SW, Rochester, MN 55905 USA
| | - Anuj Mahindra
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, Box 0324, San Francisco, CA 94143 USA
| | - Jeffrey Miller
- Division of Hematology/Oncology, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Nikhil C. Munshi
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Dana B106, Boston, MA 02215 USA
| | - Robert Z. Orlowski
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 429, Houston, TX 77030 USA
| | - John M. Pagel
- Swedish Cancer Institute, 1221 Madison Street, Suite 1020, Seattle, WA 98104 USA
| | - David L. Porter
- University of Pennsylvania, 3400 Civic Center Blvd, PCAM 12 South Pavilion, Philadelphia, PA 19104 USA
| | | | - Karl Schwartz
- Patients Against Lymphoma, 3774 Buckwampum Road, Riegelsville, PA 18077 USA
| | - Margaret A. Shipp
- Dana-Farber Cancer Institute, 450 Brookline Ave, Mayer 513, Boston, MA 02215 USA
| | - David Siegel
- Hackensack University Medical Center, 92 2nd St., Hackensack, NJ 07601 USA
| | - Richard M. Stone
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215 USA
| | - Martin S. Tallman
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| | - John M. Timmerman
- University of California, Los Angeles, 10833 LeConte Ave., Los Angeles, CA 90095 USA
| | - Frits Van Rhee
- University of Arkansas for Medical Sciences, Myeloma Institute, 4301 W Markham #816, Little Rock, AR 72205 USA
| | - Edmund K. Waller
- Winship Cancer Institute, Emory University, 1365B Clifton Road NE, Atlanta, GA 30322 USA
| | - Ann Welsh
- University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213 USA
| | - Michael Werner
- Patient Advocate, 33 East Bellevue Place, Chicago, IL 60611 USA
| | - Peter H. Wiernik
- Cancer Research Foundation of New York, 43 Longview Lane, Chappaqua, NY 10514 USA
| | - Madhav V. Dhodapkar
- Department of Hematology & Immunobiology, Yale University, 333 Cedar Street, Box 208021, New Haven, CT 06510 USA
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Ferrari G, Haynes BF, Koenig S, Nordstrom JL, Margolis DM, Tomaras GD. Envelope-specific antibodies and antibody-derived molecules for treating and curing HIV infection. Nat Rev Drug Discov 2016; 15:823-834. [PMID: 27725635 PMCID: PMC5549020 DOI: 10.1038/nrd.2016.173] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
HIV-1 is a retrovirus that integrates into host chromatin and can remain transcriptionally quiescent in a pool of immune cells. This characteristic enables HIV-1 to evade both host immune responses and antiretroviral drugs, leading to persistent infection. Upon reactivation of proviral gene expression, HIV-1 envelope (HIV-1 Env) glycoproteins are expressed on the cell surface, transforming latently infected cells into targets for HIV-1 Env-specific monoclonal antibodies (mAbs), which can engage immune effector cells to kill productively infected CD4+ T cells and thus limit the spread of progeny virus. Recent innovations in antibody engineering have resulted in novel immunotherapeutics such as bispecific dual-affinity re-targeting (DART) molecules and other bi- and trispecific antibody designs that can recognize HIV-1 Env and recruit cytotoxic effector cells to kill CD4+ T cells latently infected with HIV-1. Here, we review these immunotherapies, which are designed with the goal of curing HIV-1 infection.
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Affiliation(s)
- Guido Ferrari
- Department of Surgery, Duke University, Durham, North Carolina 27710, USA
- Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina 27710, USA
- Duke Human Vaccine Institute, Duke University, Durham, North Carolina 27710, USA
| | - Barton F Haynes
- Duke Human Vaccine Institute, Duke University, Durham, North Carolina 27710, USA
- Department of Medicine, Duke University, Durham, North Carolina 27710, USA
- Department of Immunology, Duke University, Durham, North Carolina 27710, USA
| | | | | | - David M Margolis
- University of North Carolina at Chapel Hill HIV Cure Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Georgia D Tomaras
- Department of Surgery, Duke University, Durham, North Carolina 27710, USA
- Department of Molecular Genetics and Microbiology, Duke University, Durham, North Carolina 27710, USA
- Duke Human Vaccine Institute, Duke University, Durham, North Carolina 27710, USA
- Department of Immunology, Duke University, Durham, North Carolina 27710, USA
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223
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Fisher AC, Lee SL, Harris DP, Buhse L, Kozlowski S, Yu L, Kopcha M, Woodcock J. Advancing pharmaceutical quality: An overview of science and research in the U.S. FDA's Office of Pharmaceutical Quality. Int J Pharm 2016; 515:390-402. [PMID: 27773853 DOI: 10.1016/j.ijpharm.2016.10.038] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
Abstract
Failures surrounding pharmaceutical quality, particularly with respect to product manufacturing issues and facility remediation, account for the majority of drug shortages and product recalls in the United States. Major scientific advancements pressure established regulatory paradigms, especially in the areas of biosimilars, precision medicine, combination products, emerging manufacturing technologies, and the use of real-world data. Pharmaceutical manufacturing is increasingly globalized, prompting the need for more efficient surveillance systems for monitoring product quality. Furthermore, increasing scrutiny and accelerated approval pathways provide a driving force to be even more efficient with limited regulatory resources. To address these regulatory challenges, the Office of Pharmaceutical Quality (OPQ) in the Center for Drug Evaluation and Research (CDER) at the U.S. Food and Drug Administration (FDA) harbors a rigorous science and research program in core areas that support drug quality review, inspection, surveillance, standards, and policy development. Science and research is the foundation of risk-based quality assessment of new drugs, generic drugs, over-the-counter drugs, and biotechnology products including biosimilars. This is an overview of the science and research activities in OPQ that support the mission of ensuring that safe, effective, and high-quality drugs are available to the American public.
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Affiliation(s)
- Adam C Fisher
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Sau L Lee
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States.
| | - Daniel P Harris
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Lucinda Buhse
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Steven Kozlowski
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Lawrence Yu
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Michael Kopcha
- Food and Drug Administration, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Silver Spring, MD 20993, United States
| | - Janet Woodcock
- Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, MD 20993, United States
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224
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Catch me if you can: Leukemia Escape after CD19-Directed T Cell Immunotherapies. Comput Struct Biotechnol J 2016; 14:357-362. [PMID: 27761200 PMCID: PMC5061074 DOI: 10.1016/j.csbj.2016.09.003] [Citation(s) in RCA: 214] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 01/10/2023] Open
Abstract
Immunotherapy is the revolution in cancer treatment of this last decade. Among multiple approaches able to harness the power of the immune system against cancer, T cell based immunotherapies represent one of the most successful examples. In particular, biotechnological engineering of protein structures, like the T cell receptor or the immunoglobulins, allowed the generation of synthetic peptides like chimeric antigen receptors and bispecific antibodies that are able to redirect non-tumor specific T cells to recognize and kill leukemic cells. The anti-CD19/CD3 bispecific antibody blinatumomab and anti-CD19 chimeric antigen receptor T cells (CART19) have produced deep responses in patients with relapsed and refractory B-cell acute leukemias. However, although the majority of these patients responds to anti-CD19 immunotherapy, a subset of them still relapses. Interestingly, a novel family of leukemia escape mechanisms has been described, all characterized by the apparent loss of CD19 on the surface of leukemic blasts. This extraordinary finding demonstrates the potent selective pressure of CART19/blinatumomab that drives extreme and specific escape strategies by leukemic blasts. Patients with CD19-negative relapsed leukemia have very poor prognosis and novel approaches to treat and ideally prevent antigen-loss are direly needed. In this review we discuss the incidence, mechanisms and therapeutic approaches for CD19-negative leukemia relapses occuring after CD19-directed T cell immunotherapies and present our future perspective.
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225
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Blinatumomab vs historical standard therapy of adult relapsed/refractory acute lymphoblastic leukemia. Blood Cancer J 2016; 6:e473. [PMID: 27662202 PMCID: PMC5056974 DOI: 10.1038/bcj.2016.84] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/28/2016] [Indexed: 12/19/2022] Open
Abstract
We compared outcomes from a single-arm study of blinatumomab in adult patients with B-precursor Ph-negative relapsed/refractory acute lymphoblastic leukemia (R/R ALL) with a historical data set from Europe and the United States. Estimates of complete remission (CR) and overall survival (OS) were weighted by the frequency distribution of prognostic factors in the blinatumomab trial. Outcomes were also compared between the trial and historical data using propensity score methods. The historical cohort included 694 patients with CR data and 1112 patients with OS data compared with 189 patients with CR and survival data in the blinatumomab trial. The weighted analysis revealed a CR rate of 24% (95% CI: 20–27%) and a median OS of 3.3 months (95% CI: 2.8–3.6) in the historical cohort compared with a CR/CRh rate of 43% (95% CI: 36–50%) and a median OS of 6.1 months (95% CI: 4.2–7.5) in the blinatumomab trial. Propensity score analysis estimated increased odds of CR/CRh (OR=2.68, 95% CI: 1.67–4.31) and improved OS (HR=0.536, 95% CI: 0.394–0.730) with blinatumomab. The analysis demonstrates the application of different study designs and statistical methods to compare novel therapies for R/R ALL with historical data.
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226
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Ströhlein MA, Heiss MM, Jauch KW. The current status of immunotherapy in peritoneal carcinomatosis. Expert Rev Anticancer Ther 2016; 16:1019-27. [PMID: 27530056 DOI: 10.1080/14737140.2016.1224666] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Peritoneal carcinomatosis (PC) is a cancer disease with an urgent need for effective treatment. Conventional chemotherapy failed to show acceptable results. Cytoreductive surgery and hyperthermic chemoperfusion (HIPEC) are only beneficial in few patients with resectable peritoneal metastasis. Immunotherapy could be attractive against PC, as all requirements for immunotherapy are available in the peritoneal cavity. AREAS COVERED This review analyzes the present literature for immunotherapy of PC. Advances from immune stimulators, radionucleotide-conjugated- and bispecific antibodies to future developments like adoptive engineered T-cells with chimeric receptors are discussed. The clinical development of catumaxomab, which was the first intraperitoneal immunotherapy to be approved for clinical treatment, is discussed. The requirements for future developments are illustrated. Expert commentary: Immunotherapy of peritoneal carcinomatosis is manageable, showing striking cancer cell killing. Improved profiles of adverse events by therapy-induced cytokine release, enhanced specific killing and optimal treatment schedules within multimodal treatment will be key factors.
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Affiliation(s)
- Michael Alfred Ströhlein
- a Department of Abdominal, Vascular and Transplant Surgery, Cologne Merheim Medical Center , Witten/Herdecke University , Cologne , Germany
| | - Markus Maria Heiss
- a Department of Abdominal, Vascular and Transplant Surgery, Cologne Merheim Medical Center , Witten/Herdecke University , Cologne , Germany
| | - Karl-Walter Jauch
- b Medical Center of the Ludwig Maximilian University Munich , Munich , Germany
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227
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Malm M, Frejd FY, Ståhl S, Löfblom J. Targeting HER3 using mono- and bispecific antibodies or alternative scaffolds. MAbs 2016; 8:1195-1209. [PMID: 27532938 PMCID: PMC5058629 DOI: 10.1080/19420862.2016.1212147] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The human epidermal growth factor receptor 3 (HER3) has in recent years been recognized as a key node in the complex signaling network of many different cancers. It is implicated in de novo and acquired resistance against therapies targeting other growth factor receptors, e.g., EGFR, HER2, and it is a major activator of the PI3K/Akt signaling pathway. Consequently, HER3 has attracted substantial attention, and is today a key target for drugs in clinical development. Sophisticated protein engineering approaches have enabled the generation of a range of different affinity proteins targeting this receptor, including antibodies and alternative scaffolds that are either mono- or bispecific. Here, we describe HER3 and its role as a key tumor target, and give a comprehensive review of HER3-targeted proteins currently in development, including discussions on the opportunities and challenges of targeting this receptor.
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Affiliation(s)
- Magdalena Malm
- a Division of Protein Technology, School of Biotechnology, KTH-Royal Institute of Technology, SE , Stockholm
| | - Fredrik Y Frejd
- b Affibody AB, SE, Stockholm , Sweden.,c Department of Immunology , Genetics and Pathology, Uppsala University , Uppsala , Sweden
| | - Stefan Ståhl
- a Division of Protein Technology, School of Biotechnology, KTH-Royal Institute of Technology, SE , Stockholm
| | - John Löfblom
- a Division of Protein Technology, School of Biotechnology, KTH-Royal Institute of Technology, SE , Stockholm
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228
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Walseng E, Nelson CG, Qi J, Nanna AR, Roush WR, Goswami RK, Sinha SC, Burke TR, Rader C. Chemically Programmed Bispecific Antibodies in Diabody Format. J Biol Chem 2016; 291:19661-73. [PMID: 27445334 DOI: 10.1074/jbc.m116.745588] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Indexed: 12/21/2022] Open
Abstract
Chemically programmed bispecific antibodies (biAbs) endow target cell-binding small molecules with the ability to recruit and activate effector cells of the immune system. Here we report a platform of chemically programmed biAbs aimed at redirecting cytotoxic T cells to eliminate cancer cells. Two different antibody technologies were merged together to make a novel chemically programmed biAb. This was achieved by combining the humanized anti-hapten monoclonal antibody (mAb) h38C2 with the humanized anti-human CD3 mAb v9 in a clinically investigated diabody format known as Dual-Affinity Re-Targeting (DART). We show that h38C2 × v9 DARTs can readily be equipped with tumor-targeting hapten-derivatized small molecules without causing a systemic response harming healthy tissues. As a proof of concept, we chemically programmed h38C2 × v9 with hapten-folate and demonstrated its selectivity and potency against folate receptor 1 (FOLR1)-expressing ovarian cancer cells in vitro and in vivo Unlike conventional biAbs, chemically programmed biAbs in DART format are highly modular with broad utility in terms of both target and effector cell engagement. Most importantly, they provide tumor-targeting compounds access to the power of cancer immunotherapy.
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Affiliation(s)
| | - Christopher G Nelson
- the Chemical Biology Laboratory, Center for Cancer Research, NCI, National Institutes of Health, Frederick, Maryland 21702
| | | | - Alex R Nanna
- From the Departments of Cancer Biology, Chemistry, and
| | | | - Rajib K Goswami
- the Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037, and
| | - Subhash C Sinha
- the Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037, and
| | - Terrence R Burke
- the Chemical Biology Laboratory, Center for Cancer Research, NCI, National Institutes of Health, Frederick, Maryland 21702
| | - Christoph Rader
- From the Departments of Cancer Biology, Molecular Therapeutics, The Scripps Research Institute, Jupiter, Florida 33458,
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229
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Bacac M, Klein C, Umana P. CEA TCB: A novel head-to-tail 2:1 T cell bispecific antibody for treatment of CEA-positive solid tumors. Oncoimmunology 2016; 5:e1203498. [PMID: 27622073 PMCID: PMC5007959 DOI: 10.1080/2162402x.2016.1203498] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 06/13/2016] [Accepted: 06/13/2016] [Indexed: 11/03/2022] Open
Abstract
Carcinoembryonic antigen T cell bispecific antibody (CEA TCB) is a bispecific antibody used to recognize CEA and CD3e via a novel molecular format (2:1) that induces T cell-mediated killing of CEA over-expressing tumors while sparing primary cells with low CEA expression. CEA TCB treatment inhibits tumor growth and generates a highly inflamed tumor microenvironment.
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Affiliation(s)
- Marina Bacac
- Roche Pharmaceutical Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland
| | - Christian Klein
- Roche Pharmaceutical Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland
| | - Pablo Umana
- Roche Pharmaceutical Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland
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230
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Elimination of Latently HIV-infected Cells from Antiretroviral Therapy-suppressed Subjects by Engineered Immune-mobilizing T-cell Receptors. Mol Ther 2016; 24:1913-1925. [PMID: 27401039 PMCID: PMC5154472 DOI: 10.1038/mt.2016.114] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/24/2016] [Indexed: 01/06/2023] Open
Abstract
Persistence of human immunodeficiency virus (HIV) in a latent state in long-lived CD4+ T-cells is a major barrier to eradication. Latency-reversing agents that induce direct or immune-mediated cell death upon reactivation of HIV are a possible solution. However, clearance of reactivated cells may require immunotherapeutic agents that are fine-tuned to detect viral antigens when expressed at low levels. We tested the antiviral efficacy of immune-mobilizing monoclonal T-cell receptors against viruses (ImmTAVs), bispecific molecules that redirect CD8+ T-cells to kill HIV-infected CD4+ T-cells. T-cell receptors specific for an immunodominant Gag epitope, SL9, and its escape variants were engineered to achieve supraphysiological affinity and fused to a humanised CD3-specific single chain antibody fragment. Ex vivo polyclonal CD8+ T-cells were efficiently redirected by immune-mobilising monoclonal T-cell receptors against viruses to eliminate CD4+ T-cells from human histocompatibility leukocyte antigen (HLA)-A*0201-positive antiretroviral therapy-treated patients after reactivation of inducible HIV in vitro. The efficiency of infected cell elimination correlated with HIV Gag expression. Immune-mobilising monoclonal T-cell receptors against viruses have potential as a therapy to facilitate clearance of reactivated HIV reservoir cells.
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231
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Abstract
Cancer immunotherapy has recently generated much excitement after the continuing success of the immunomodulating anti-CTLA-4 and anti-PD-1 antibodies against various types of cancers. Aside from these immunomodulating antibodies, bispecific antibodies, chimeric antigen receptor T cells, and other technologies are being actively studied. Among the various approaches to cancer immunotherapy, 2 bispecific antibodies are currently approved for patient care. Many more bispecific antibodies are now in various phases of clinical development and will become the next generation of antibody-based therapies. Further understanding of immunology and advances in protein engineering will help to generate a greater variety of bispecific antibodies to fight cancer. Here, we focus on bispecific antibodies that recruit immune cells to engage and kill tumor cells.
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Affiliation(s)
- Siqi Chen
- a School of Pharmaceutical Sciences, Sun Yat-Sen University , Guangzhou , China.,b Center for Cellular & Structural Biology, Sun Yat-Sen University , Guangzhou , China
| | - Jing Li
- a School of Pharmaceutical Sciences, Sun Yat-Sen University , Guangzhou , China.,b Center for Cellular & Structural Biology, Sun Yat-Sen University , Guangzhou , China
| | - Qing Li
- a School of Pharmaceutical Sciences, Sun Yat-Sen University , Guangzhou , China.,b Center for Cellular & Structural Biology, Sun Yat-Sen University , Guangzhou , China
| | - Zhong Wang
- a School of Pharmaceutical Sciences, Sun Yat-Sen University , Guangzhou , China.,b Center for Cellular & Structural Biology, Sun Yat-Sen University , Guangzhou , China
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232
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Concurrent blinatumomab and donor lymphocyte infusions for treatment of relapsed pre-B-cell ALL after allogeneic hematopoietic cell transplant. Bone Marrow Transplant 2016; 51:1253-5. [DOI: 10.1038/bmt.2016.104] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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233
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Barth MJ, Chu Y, Hanley PJ, Cairo MS. Immunotherapeutic approaches for the treatment of childhood, adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2016; 173:597-616. [PMID: 27062282 DOI: 10.1111/bjh.14078] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
With the introduction of the anti-CD20 monoclonal antibody rituximab, B-cell non-Hodgkin lymphoma was the first malignancy successfully treated with an immunotherapeutic agent. Since then, numerous advances have expanded the repertoire of immunotherapeutic agents available for the treatment of a variety of malignancies, including many lymphoma subtypes. These include the introduction of monoclonal antibodies targeting a variety of cell surface proteins, including the successful targeting of immunoregulatory checkpoint receptors present on T-cells or tumour cells. Additionally, cellular immunotherapeutic approaches utilize T- or Natural Killer-cells generated with chimeric antigen receptors against cell surface proteins or Epstein-Barr virus-associated latent membrane proteins. The following review describes the current state of immunotherapy for non-Hodgkin lymphoma including a summary of currently available data and promising agents currently in clinical development with future promise in the treatment of childhood, adolescent and young adult non-Hodgkin lymphoma.
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Affiliation(s)
- Matthew J Barth
- Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, NY, USA.,Division of Pediatric Hematology/Oncology, University at Buffalo, Buffalo, NY, USA
| | - Yaya Chu
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Patrick J Hanley
- Program for Cell Enhancement and Technologies for Immunotherapy, Division of Blood and Marrow Transplantation, Sheikhz Zayed Institute for Pediatric Surgical Innovation, Washington, D.C., USA.,Center for Cancer and Immunology Research, Children's National Health System, The George Washington University, Washington, D.C., USA
| | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA.,Department of Medicine, New York Medical College, Valhalla, NY, USA.,Department of Pathology, New York Medical College, Valhalla, NY, USA.,Department of Microbiology & Immunology, New York Medical College, Valhalla, NY, USA.,Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA
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234
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Benjamin JE, Stein AS. The role of blinatumomab in patients with relapsed/refractory acute lymphoblastic leukemia. Ther Adv Hematol 2016; 7:142-56. [PMID: 27247755 DOI: 10.1177/2040620716640422] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Adults with relapsed/refractory B-acute lymphoblastic leukemia (ALL) have a complete remission (CR) rate of 20-45% and median overall survival of 3-9 months, depending on the duration of the first remission and number of lines of salvage therapy. Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the only curative option for adult patients with relapsed/refractory ALL, and achievement of CR is a crucial step before alloHSCT. Blinatumomab is a bispecific T-cell engager (BiTE®) antibody construct with dual specificity for CD19 and CD3, simultaneously binding CD3-positive cytotoxic T cells and CD19-positive B cells, resulting in T-cell-mediated serial lysis of normal and malignant B cells. It recently gained accelerated approval by the US Food and Drug Administration (FDA) for the treatment of relapsed/refractory Philadelphia chromosome-negative ALL, based on a large phase II trial of 189 adults with relapsed/refractory B-ALL, which showed a CR/CRh (CR with partial hematologic recovery) of 43% after two cycles of treatment. Toxicities include cytokine-release syndrome (CRS) and neurologic events (encephalopathy, aphasia, and seizure). CRS can be alleviated by step-up dosing and dexamethasone, without affecting the cytotoxic effect of blinatumomab. The cause of neurologic toxicity is unclear but is also observed with other T-cell therapies and may relate to variable expression of CD19 within the brain. This review encompasses the preclinical rationale of using the BITE® class of compounds (blinatumomab being the only one that is FDA approved), with clinical data using blinatumomab in the relapsed/refractory setting (pediatrics and adults), the minimal residual disease setting (adults), as well as Philadelphia chromosome-positive ALL. The review also examines the main adverse events: their prevention, recognition, and management; possible mechanisms of resistance; causes of relapse. It also summarizes future trials evaluating the drug earlier in the treatment course to improve activity.
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Affiliation(s)
| | - Anthony S Stein
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, 1500 East Duarte Road, Duarte, CA 91010-3000, USA
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Bispecific CD3/HER2 Targeting FynomAb Induces Redirected T Cell-Mediated Cytolysis with High Potency and Enhanced Tumor Selectivity. Antibodies (Basel) 2015. [DOI: 10.3390/antib4040426] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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236
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Cancer immunotherapy: Strategies for personalization and combinatorial approaches. Mol Oncol 2015; 9:2043-53. [PMID: 26548534 DOI: 10.1016/j.molonc.2015.10.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 10/09/2015] [Accepted: 10/12/2015] [Indexed: 12/30/2022] Open
Abstract
The results of recent clinical trials using novel immunotherapy strategies such as immune checkpoint blockade and adoptive T-cell therapy approaches including CAR T-cell therapy have clearly established immunotherapy as an important modality for the treatment of cancer besides the traditional approaches of surgery, radiotherapy, and chemotherapy or targeted therapy. However, to date immunotherapy has been shown to induce durable clinical benefit in only a fraction of the patients. The use of combination strategies is likely to increase the number of patients that might benefit from immunotherapy. Indeed, over the last decade, the characterization of multiple immune resistance mechanisms used by the tumor to evade the immune system and the development of agents that target those mechanisms has generated a lot of enthusiasm for cancer immunotherapy. But a critical issue is to determine how best to combine such agents. This review will focus on novel immunotherapy agents currently in development and discuss strategies to develop and personalize combination cancer immunotherapy strategies.
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