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Wu H, Deng M, Xue D, Guo R, Zhang C, Gao J, Li H. PD-1/PD-L1 inhibitors for early and middle stage microsatellite high-instability and stable colorectal cancer: a review. Int J Colorectal Dis 2024; 39:83. [PMID: 38809459 PMCID: PMC11136714 DOI: 10.1007/s00384-024-04654-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Programmed cell death receptor 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are important immune checkpoint molecules that contribute to tumor immune evasion. However, the main treatment modalities for patients with early and intermediate stage colorectal cancer (CRC) are surgery, and the role of PD-1/PD-L1 inhibitors in these patients is not yet clear. Therefore, this study aims to review the treatment progress of PD-1/PD-L1 inhibitors for early- and intermediate-stage microsatellite high-instability (MSI-H) and stable (MSS) colorectal cancer, in order to provide more options for patients with early- and intermediate-stage colorectal cancer. MATERIALS AND METHODS A scoping review of clinical trial registries ( Clinicaltrials.gov and EU clinical trial registers) and PubMed/Medline database of trials on PD-1/PD-L1 Inhibitors for early and middle-stage MSI-H and MSS CRC was done up to March 2024. RESULTS A total of 19 trials related to early to mid-stage MSH-I or MSS CRC were included. Among them, 6 trials are in recruiting status, 3 trials are in active, not recruiting status, 3 trials are completed, 1 trial is terminated, and 1 trial is unknown. Of these, 9 trials involve MSI-H type CRC, and 10 trials involve MSS type CRC. Preclinical phase I/II trials are predominant, with only 3 clinical phase III trials. In trials related to MSI-H type CRC, 4 studies involve PD-1/PD-L1 inhibitors combined with neoadjuvant therapy, and 5 studies involve combination therapy. In trials related to MSS type CRC, 3 studies involve PD-1/PD-L1 inhibitors combined with targeted therapy, 2 studies involve PD-1/PD-L1 inhibitors combined with chemotherapy, 1 study involves PD-1/PD-L1 inhibitor combined immunotherapy, 1 study involves PD-1/PD-L1 inhibitors combined with bacterial therapy, and 3 studies involve PD-1/PD-L1 inhibitors combined with comprehensive therapy. As for primary outcome measures, 4 trials select pathological complete response rates, 3 trials select progression-free survival rate, 3 trials select objective response rate, 3 trials select overall survival rate, 4 trials select disease-free survival rate, 1 trial selects clinical complete response rate, and 1 trial selects percentage of participants with a dose-limiting toxicity. CONCLUSION For early- and middle-stage MSI-H and MSS CRC, PD-1/PD-L1 inhibitors have shown some therapeutic efficacy, as evidenced by phase I/II studies. However, contemporary trial designs exhibit heterogeneity, with relatively few inclusion criteria, the use of various drug combinations and regimens, and significant variations in reported endpoints. Nevertheless, more double-arm, multicenter, randomized controlled trials are still needed to confirm the efficacy of immunotherapy.
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Affiliation(s)
- Huiming Wu
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Min Deng
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Dingwen Xue
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Renkai Guo
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Chenyu Zhang
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Jiaqi Gao
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Huiyu Li
- Department of General Surgery, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
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2
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Segal NH, Melero I, Moreno V, Steeghs N, Marabelle A, Rohrberg K, Rodriguez-Ruiz ME, Eder JP, Eng C, Manji GA, Waterkamp D, Leutgeb B, Bouseida S, Flinn N, Das Thakur M, Elze MC, Koeppen H, Jamois C, Martin-Facklam M, Lieu CH, Calvo E, Paz-Ares L, Tabernero J, Argilés G. CEA-CD3 bispecific antibody cibisatamab with or without atezolizumab in patients with CEA-positive solid tumours: results of two multi-institutional Phase 1 trials. Nat Commun 2024; 15:4091. [PMID: 38750034 PMCID: PMC11096172 DOI: 10.1038/s41467-024-48479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Cibisatamab is a bispecific antibody-based construct targeting carcinoembryonic antigen (CEA) on tumour cells and CD3 epsilon chain as a T-cell engager. Here we evaluated cibisatamab for advanced CEA-positive solid tumours in two open-label Phase 1 dose-escalation and -expansion studies: as a single agent with or without obinutuzumab in S1 (NCT02324257) and with atezolizumab in S2 (NCT02650713). Primary endpoints were safety, dose finding, and pharmacokinetics in S1; safety and dose finding in S2. Secondary endpoints were anti-tumour activity (including overall response rate, ORR) and pharmacodynamics in S1; anti-tumour activity, pharmacodynamics and pharmacokinetics in S2. S1 and S2 enrolled a total of 149 and 228 patients, respectively. Grade ≥3 cibisatamab-related adverse events occurred in 36% of S1 and 49% of S2 patients. The ORR was 4% in S1 and 7% in S2. In S2, patients with microsatellite stable colorectal carcinoma (MSS-CRC) given flat doses of cibisatamab and atezolizumab demonstrated an ORR of 14%. In S1 and S2, 40% and 52% of patients, respectively, developed persistent anti-drug antibodies (ADAs). ADA appearance could be mitigated by obinutuzumab-pretreatment, with 8% of patients having persistent ADAs. Overall, cibisatamab warrants further exploration in immunotherapy combination strategies for MSS-CRC.
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MESH Headings
- Humans
- Antibodies, Bispecific/therapeutic use
- Antibodies, Bispecific/pharmacokinetics
- Antibodies, Bispecific/administration & dosage
- Antibodies, Bispecific/adverse effects
- Antibodies, Bispecific/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Female
- Male
- Middle Aged
- Aged
- CD3 Complex/immunology
- Adult
- Carcinoembryonic Antigen/immunology
- Neoplasms/drug therapy
- Neoplasms/immunology
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/pharmacokinetics
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Affiliation(s)
- Neil H Segal
- Memorial Sloan Kettering Cancer Center, New York, NY, United States; Weill Cornell Medical College, New York, NY, USA.
| | - Ignacio Melero
- Clínica Universidad de Navarra and CIMA University of Navarra, Navarra, Spain
- CIBERONC, Instituto de Salud Carlso III, Madrid, Spain
| | | | | | | | | | | | | | - Cathy Eng
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
| | | | | | | | | | - Nick Flinn
- F. Hoffmann-La Roche, Ltd, Basel, Switzerland
| | | | | | | | | | | | | | - Emiliano Calvo
- START Madrid-CIOCC, Centro Integral Oncológico Clara Campal, Madrid, Spain
| | | | - Josep Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - Guillem Argilés
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
- Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain
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3
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Stresser DM, Kopec AK, Hewitt P, Hardwick RN, Van Vleet TR, Mahalingaiah PKS, O'Connell D, Jenkins GJ, David R, Graham J, Lee D, Ekert J, Fullerton A, Villenave R, Bajaj P, Gosset JR, Ralston SL, Guha M, Amador-Arjona A, Khan K, Agarwal S, Hasselgren C, Wang X, Adams K, Kaushik G, Raczynski A, Homan KA. Towards in vitro models for reducing or replacing the use of animals in drug testing. Nat Biomed Eng 2023:10.1038/s41551-023-01154-7. [PMID: 38151640 DOI: 10.1038/s41551-023-01154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Affiliation(s)
- David M Stresser
- Quantitative, Translational & ADME Sciences, AbbVie, North Chicago, IL, USA.
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ), .
- IQ Microphysiological Systems Affiliate (IQ-), .
| | - Anna K Kopec
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Drug Safety Research & Development, Pfizer, Inc., Groton, CT, USA
| | - Philip Hewitt
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Chemical and Preclinical Safety, Merck KGaA, Darmstadt, Germany
| | - Rhiannon N Hardwick
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Toxicology, Pharmaceutical Candidate Optimization, Bristol Myers Squibb, San Diego, CA, USA
| | - Terry R Van Vleet
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology and Pathology, AbbVie, North Chicago, IL, USA
| | - Prathap Kumar S Mahalingaiah
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology and Pathology, AbbVie, North Chicago, IL, USA
| | - Denice O'Connell
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- Global Animal Welfare, AbbVie, North Chicago, IL, USA
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
| | - Gary J Jenkins
- Quantitative, Translational & ADME Sciences, AbbVie, North Chicago, IL, USA
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Translational and ADME Sciences Leadership Group (TALG)
| | - Rhiannon David
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Clinical Pharmacology & Safety Sciences, AstraZeneca, Cambridge, UK
| | - Jessica Graham
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- Product Quality & Occupational Toxicology, Genentech, Inc., South San Francisco, CA, USA
- IQ DruSafe
- Safety Assessment, Genentech, Inc., South San Francisco, CA, USA
| | - Donna Lee
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Safety Assessment, Genentech, Inc., South San Francisco, CA, USA
| | - Jason Ekert
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- UCB Pharma, Cambridge, MA, USA
| | - Aaron Fullerton
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology, Genentech, Inc., South San Francisco, CA, USA
| | - Remi Villenave
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Piyush Bajaj
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Global Investigative Toxicology, Preclinical Safety, Sanofi, Cambridge, MA, USA
| | - James R Gosset
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Pharmacokinetics, Dynamics and Metabolism, Medicine Design, Pfizer, Inc, Cambridge, MA, USA
| | - Sherry L Ralston
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Preclinical Safety, AbbVie, North Chicago, IL, USA
| | - Manti Guha
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Biology, Incyte, Wilmington, DE, USA
| | - Alejandro Amador-Arjona
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Biology, Incyte, Wilmington, DE, USA
| | - Kainat Khan
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Clinical Pharmacology & Safety Sciences, AstraZeneca, Cambridge, UK
| | - Saket Agarwal
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology, Early Development, Alnylam Pharmaceuticals, Cambridge, MA, USA
| | - Catrin Hasselgren
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ DruSafe
- Predictive Toxicology, Genentech, Inc., South San Francisco, CA, USA
| | - Xiaoting Wang
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Translational Safety & Bioanalytical Sciences, Amgen Research, Amgen Inc., South San Francisco, CA, USA
| | - Khary Adams
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Laboratory Animal Resources, Incyte, Wilmington, DE, USA
| | - Gaurav Kaushik
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Nonclinical Drug Safety, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Arkadiusz Raczynski
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Preclinical Safety Assessment, Vertex Pharmaceuticals, Inc, Boston, MA, USA
| | - Kimberly A Homan
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ), .
- IQ Microphysiological Systems Affiliate (IQ-), .
- Complex in vitro Systems Group, Genentech, Inc., South San Francisco, CA, USA.
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4
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Seckinger A, Majocchi S, Moine V, Nouveau L, Ngoc H, Daubeuf B, Ravn U, Pleche N, Calloud S, Broyer L, Cons L, Lesnier A, Chatel L, Papaioannou A, Salgado-Pires S, Krämer S, Gockel I, Lordick F, Masternak K, Poitevin Y, Magistrelli G, Malinge P, Shang L, Kallendrusch S, Strein K, Hose D. Development and characterization of NILK-2301, a novel CEACAM5xCD3 κλ bispecific antibody for immunotherapy of CEACAM5-expressing cancers. J Hematol Oncol 2023; 16:117. [PMID: 38087365 PMCID: PMC10717981 DOI: 10.1186/s13045-023-01516-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND T-cell retargeting to eliminate CEACAM5-expressing cancer cells via CEACAM5xCD3 bispecific antibodies (BsAbs) showed limited clinical activity so far, mostly due to insufficient T-cell activation, dose-limiting toxicities, and formation of anti-drug antibodies (ADA). METHODS We present here the generation and preclinical development of NILK-2301, a BsAb composed of a common heavy chain and two different light chains, one kappa and one lambda, determining specificity (so-called κλ body format). RESULTS NILK-2301 binds CD3ɛ on T-cells with its lambda light chain arm with an affinity of ≈100 nM, and the CEACAM5 A2 domain on tumor cells by its kappa light chain arm with an affinity of ≈5 nM. FcγR-binding is abrogated by the "LALAPA" mutation (Leu234Ala, Leu235Ala, Pro329Ala). NILK-2301 induced T-cell activation, proliferation, cytokine release, and T-cell dependent cellular cytotoxicity of CEACAM5-positive tumor cell lines (5/5 colorectal, 2/2 gastric, 2/2 lung), e.g., SK-CO-1 (Emax = 89%), MKN-45 (Emax = 84%), and H2122 (Emax = 97%), with EC50 ranging from 0.02 to 0.14 nM. NILK-2301 binds neither to CEACAM5-negative or primary colon epithelial cells nor to other CEACAM family members. NILK-2301 alone or in combination with checkpoint inhibition showed activity in organotypic tumor tissue slices and colorectal cancer organoid models. In vivo, NILK-2301 at 10 mg/kg significantly delayed tumor progression in colon- and a pancreatic adenocarcinoma model. Single-dose pharmacokinetics (PK) and tolerability in cynomolgus monkeys at 0.5 or 10 mg/kg intravenously or 20 mg subcutaneously showed dose-proportional PK, bioavailability ≈100%, and a projected half-life in humans of 13.1 days. NILK-2301 was well-tolerated. Data were confirmed in human FcRn TG32 mice. CONCLUSIONS In summary, NILK-2301 combines promising preclinical activity and safety with lower probability of ADA-generation due to its format compared to other molecules and is scheduled to enter clinical testing at the end of 2023.
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Affiliation(s)
- Anja Seckinger
- LamKap Bio Alpha AG, Bahnhofstrasse 1, 8808, Pfäffikon, SZ, Switzerland
| | - Sara Majocchi
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Valéry Moine
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Lise Nouveau
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Hoang Ngoc
- Institute of Anatomy, Leipzig University, Liebigstrasse 13, 04103, Leipzig, Germany
| | - Bruno Daubeuf
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Ulla Ravn
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Nicolas Pleche
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Sebastien Calloud
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Lucile Broyer
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Laura Cons
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Adeline Lesnier
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Laurence Chatel
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Anne Papaioannou
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Susana Salgado-Pires
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Sebastian Krämer
- Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | - Florian Lordick
- Department of Medicine II, University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Liebigstrasse 22, 04103, Leipzig, Germany
| | - Krzysztof Masternak
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Yves Poitevin
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Giovanni Magistrelli
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Pauline Malinge
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Limin Shang
- Light Chain Bioscience - Novimmune SA, Chemin du Pré-Fleuri 15, 1228, Plan-les-Ouates, Switzerland
| | - Sonja Kallendrusch
- Institute of Anatomy, Leipzig University, Liebigstrasse 13, 04103, Leipzig, Germany
- Institute of Clinical Research and System Medicine, Health and Medical University Potsdam, Schiffbauergasse 14, 14467, Potsdam, Germany
| | - Klaus Strein
- LamKap Bio Alpha AG, Bahnhofstrasse 1, 8808, Pfäffikon, SZ, Switzerland
| | - Dirk Hose
- LamKap Bio Alpha AG, Bahnhofstrasse 1, 8808, Pfäffikon, SZ, Switzerland.
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5
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Sánchez J, Claus C, Albrecht R, Gaillard BC, Marinho J, McIntyre C, Tanos T, Boehnke A, Friberg LE, Jönsson S, Frances N. A model-based approach leveraging in vitro data to support dose selection from the outset: A framework for bispecific antibodies in immuno-oncology. CPT Pharmacometrics Syst Pharmacol 2023; 12:1804-1818. [PMID: 37964753 PMCID: PMC10681425 DOI: 10.1002/psp4.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
FAP-4-1BBL is a bispecific antibody exerting 4-1BB-associated T-cell activation only while simultaneously bound to the fibroblast activation protein (FAP) receptor, expressed on the surface of cancer-associated fibroblasts. The trimeric complex formed when FAP-4-1BBL is simultaneously bound to FAP and 4-1BB represents a promising mechanism to achieve tumor-specific 4-1BB stimulation. We integrated in vitro data with mathematical modeling to characterize the pharmacology of FAP-4-1BBL as a function of trimeric complex formation when combined with the T-cell engager cibisatamab. This relationship was used to prospectively predict a range of clinical doses where trimeric complex formation is expected to be at its maximum. Depending on the dosing schedule and FAP-4-1BBL plasma: tumor distribution, doses between 2 and 145 mg could lead to maximum trimeric complex formation in the clinic. Due to the expected variability in both pharmacokinetic and FAP expression in the patient population, we predict that detecting a clear dose-response relationship would remain difficult without a large number of patients per dose level, highlighting that mathematical modeling techniques based on in vitro data could aid dose selection.
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Affiliation(s)
- Javier Sánchez
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center BaselBaselSwitzerland
- Department of PharmacyUppsala UniversityUppsalaSweden
| | - Christina Claus
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center ZurichSchlierenSwitzerland
| | - Rosmarie Albrecht
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center ZurichSchlierenSwitzerland
| | - Brenda C. Gaillard
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center ZurichSchlierenSwitzerland
| | - Joana Marinho
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center ZurichSchlierenSwitzerland
| | - Christine McIntyre
- Roche Pharma Research and Early DevelopmentRoche Innovation Center WelwynWelwyn Garden CityUK
| | - Tamara Tanos
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center BaselBaselSwitzerland
| | - Axel Boehnke
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center BaselBaselSwitzerland
| | | | - Siv Jönsson
- Department of PharmacyUppsala UniversityUppsalaSweden
| | - Nicolas Frances
- Roche Pharma Research and Early Development (pRED)Roche Innovation Center BaselBaselSwitzerland
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6
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Grimaldi C, Ibraghimov A, Kiessling A, Rattel B, Ji C, Fuller CL, Brennan FR, Regenass-Lechner F, Shenton J, Price KD, Piché MS, Steeves MA, Prell R, Dudal S, Kronenberg S, Freebern W, Blanset D. Current nonclinical approaches for immune assessments of immuno-oncology biotherapeutics. Drug Discov Today 2023; 28:103440. [PMID: 36375739 DOI: 10.1016/j.drudis.2022.103440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/30/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
Harnessing the immune system to kill tumors has been revolutionary and, as a result, has had an enormous benefit for patients in extending life and resulting in effective cures in some. However, activation of the immune system can come at the cost of undesirable adverse events such as cytokine release syndrome, immune-related adverse events, on-target/off-tumor toxicity, neurotoxicity and tumor lysis syndrome, which are safety risks that can be challenging to assess non-clinically. This article provides a review of the biology and mechanisms that can result in immune-mediated adverse effects and describes industry approaches using in vitro and in vivo models to aid in the nonclinical safety risk assessments for immune-oncology modalities. Challenges and limitations of knowledge and models are also discussed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sherri Dudal
- Roche Pharmaceutical Research and Early Development, United States
| | - Sven Kronenberg
- Roche Pharmaceutical Research and Early Development, United States
| | | | - Diann Blanset
- Boehringer Ingelheim Pharmaceuticals, Inc., United States.
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7
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Li DD, Tang YL, Wang X. Challenges and exploration for immunotherapies targeting cold colorectal cancer. World J Gastrointest Oncol 2023; 15:55-68. [PMID: 36684057 PMCID: PMC9850757 DOI: 10.4251/wjgo.v15.i1.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 01/10/2023] Open
Abstract
In recent years, immune checkpoint inhibitors (ICIs) have made significant breakthroughs in the treatment of various tumors, greatly improving clinical efficacy. As the fifth most common antitumor treatment strategy for patients with solid tumors after surgery, chemotherapy, radiotherapy and targeted therapy, the therapeutic response to ICIs largely depends on the number and spatial distribution of effector T cells that can effectively identify and kill tumor cells, features that are also important when distinguishing malignant tumors from “cold tumors” or “hot tumors”. At present, only a small proportion of colorectal cancer (CRC) patients with deficient mismatch repair (dMMR) or who are microsatellite instability-high (MSI-H) can benefit from ICI treatments because these patients have the characteristics of a “hot tumor”, with a high tumor mutational burden (TMB) and massive immune cell infiltration, making the tumor more easily recognized by the immune system. In contrast, a majority of CRC patients with proficient MMR (pMMR) or who are microsatellite stable (MSS) have a low TMB, lack immune cell infiltration, and have almost no response to immune monotherapy; thus, these tumors are “cold”. The greatest challenge today is how to improve the immunotherapy response of “cold tumor” patients. With the development of clinical research, immunotherapies combined with other treatment strategies (such as targeted therapy, chemotherapy, and radiotherapy) have now become potentially effective clinical strategies and research hotspots. Therefore, the question of how to promote the transformation of “cold tumors” to “hot tumors” and break through the bottleneck of immunotherapy for cold tumors in CRC patients urgently requires consideration. Only by developing an in-depth understanding of the immunotherapy mechanisms of cold CRCs can we screen out the immunotherapy-dominant groups and explore the most suitable treatment options for individuals to improve therapeutic efficacy.
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Affiliation(s)
- Dan-Dan Li
- Department of Abdominal Oncology/Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yuan-Ling Tang
- Department of Abdominal Oncology/Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xin Wang
- Department of Abdominal Oncology/Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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8
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Ball K, Dovedi SJ, Vajjah P, Phipps A. Strategies for clinical dose optimization of T cell-engaging therapies in oncology. MAbs 2023; 15:2181016. [PMID: 36823042 PMCID: PMC9980545 DOI: 10.1080/19420862.2023.2181016] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Innovative approaches in the design of T cell-engaging (TCE) molecules are ushering in a new wave of promising immunotherapies for the treatment of cancer. Their mechanism of action, which generates an in trans interaction to create a synthetic immune synapse, leads to complex and interconnected relationships between the exposure, efficacy, and toxicity of these drugs. Challenges thus arise when designing optimal clinical dose regimens for TCEs with narrow therapeutic windows, with a variety of dosing strategies being evaluated to mitigate key side effects such as cytokine release syndrome, neurotoxicity, and on-target off-tumor toxicities. This review evaluates the current approaches to dose optimization throughout the preclinical and clinical development of TCEs, along with perspectives for improvement of these strategies. Quantitative approaches used to aid the understanding of dose-exposure-response relationships are highlighted, along with opportunities to guide the rational design of next-generation TCE molecules, and optimize their dose regimens in patients.
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Affiliation(s)
- Kathryn Ball
- Clinical Pharmacology and Quantitative Pharmacology, Biopharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | | | - Pavan Vajjah
- Clinical Pharmacology and Quantitative Pharmacology, Biopharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Alex Phipps
- Clinical Pharmacology and Quantitative Pharmacology, Biopharmaceuticals R&D, AstraZeneca, Cambridge, UK
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9
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Determination of starting dose of the T cell-redirecting bispecific antibody ERY974 targeting glypican-3 in first-in-human clinical trial. Sci Rep 2022; 12:12312. [PMID: 35853994 PMCID: PMC9296674 DOI: 10.1038/s41598-022-16564-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Currently, ERY974, a humanized IgG4 bispecific T cell-redirecting antibody recognizing glypican-3 and CD3, is in phase I clinical trials. After a first-in-human clinical trial of an anti-CD28 agonist monoclonal antibody resulting in severe life-threatening adverse events, the minimal anticipated biological effect level approach has been considered for determining the first-in-human dose of high-risk drugs. Accordingly, we aimed to determine the first-in-human dose of ERY974 using both the minimal anticipated biological effect level and no observed adverse effect level approaches. In the former, we used the 10% effective concentration value from a cytotoxicity assay using the huH-1 cell line with the highest sensitivity to ERY974 to calculate the first-in-human dose of 4.9 ng/kg, at which maximum drug concentration after 4 h of intravenous ERY974 infusion was equal to the 10% effective concentration value. To determine the no observed adverse effect level, we conducted a single-dose study in cynomolgus monkeys that were intravenously infused with ERY974 (0.1, 1, and 10 μg/kg). The lowest dose of 0.1 μg/kg was determined as the no observed adverse effect level, and the first-in-human dose of 3.2 ng/kg was calculated, considering body surface area and species difference. For the phase I clinical trial, we selected 3.0 ng/kg as a starting dose, which was lower than the first-in-human dose calculated from both the no observed adverse effect level and minimal anticipated biological effect level. Combining these two methods to determine the first-in-human dose of strong immune modulators such as T cell-redirecting antibodies would be a suitable approach from safety and efficacy perspectives. Clinical trial registration: JapicCTI-194805/NCT05022927.
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10
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Dudal S, Bissantz C, Caruso A, David-Pierson P, Driessen W, Koller E, Krippendorff BF, Lechmann M, Olivares-Morales A, Paehler A, Rynn C, Türck D, Van De Vyver A, Wang K, Winther L. Translating pharmacology models effectively to predict therapeutic benefit. Drug Discov Today 2022; 27:1604-1621. [PMID: 35304340 DOI: 10.1016/j.drudis.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/03/2022] [Accepted: 03/11/2022] [Indexed: 12/26/2022]
Abstract
Many in vitro and in vivo models are used in pharmacological research to evaluate the role of targeted proteins in a disease. Understanding the translational relevance and limitation of these models for analyzing the disposition, pharmacokinetic/pharmacodynamic (PK/PD) profile, mechanism, and efficacy of a drug, is essential when selecting the most appropriate model of the disease of interest and predicting clinically efficacious doses of the investigational drug. Here, we review selected animal models used in ophthalmology, infectious diseases, oncology, autoimmune diseases, and neuroscience. Each area has specific challenges around translatability and determination of an efficacious dose: new patient-specific dosing methods could help overcome these limitations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ken Wang
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
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11
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Leclercq G, Servera LA, Danilin S, Challier J, Steinhoff N, Bossen C, Odermatt A, Nicolini V, Umaña P, Klein C, Bacac M, Giusti AM, Schneider A, Haegel H. Dissecting the mechanism of cytokine release induced by T-cell engagers highlights the contribution of neutrophils. Oncoimmunology 2022; 11:2039432. [PMID: 35186442 PMCID: PMC8855852 DOI: 10.1080/2162402x.2022.2039432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
T cell engagers represent a novel promising class of cancer-immunotherapies redirecting T cells to tumor cells and have some promising outcomes in the clinic. These molecules can be associated with a mode-of-action related risk of cytokine release syndrome (CRS) in patients. CRS is characterized by the rapid release of pro-inflammatory cytokines such as TNF-α, IFN-γ, IL-6 and IL-1β and immune cell activation eliciting clinical symptoms of fever, hypoxia and hypotension. In this work, we investigated the biological mechanisms triggering and amplifying cytokine release after treatment with T cell bispecific antibodies (TCBs) employing an in vitro co-culture assay of human PBMCs or total leukocytes (PBMCs + neutrophils) and corresponding target antigen-expressing cells with four different TCBs. We identified T cells as the triggers of the TCB-mediated cytokine cascade and monocytes and neutrophils as downstream amplifier cells. Furthermore, we assessed the chronology of events by neutralization of T-cell derived cytokines. For the first time, we demonstrate the contribution of neutrophils to TCB-mediated cytokine release and confirm these findings by single-cell RNA sequencing of human whole blood incubated with a B-cell depleting TCB. This work could contribute to the construction of mechanistic models of cytokine release and definition of more specific molecular and cellular biomarkers of CRS in the context of treatment with T-cell engagers. In addition, it provides insight for the elaboration of prophylactic mitigation strategies that can reduce the occurrence of CRS and increase the therapeutic index of TCBs.
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Affiliation(s)
- Gabrielle Leclercq
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
- Department of Pharmaceutical Sciences, Division of Molecular and Systems Toxicology, University of Basel, Basel, Switzerland
| | - Llucia Alberti Servera
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Basel, Basel, Switzerland
| | - Sabrina Danilin
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Basel, Basel, Switzerland
| | - John Challier
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Nathalie Steinhoff
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Claudia Bossen
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Basel, Basel, Switzerland
| | - Alex Odermatt
- Department of Pharmaceutical Sciences, Division of Molecular and Systems Toxicology, University of Basel, Basel, Switzerland
| | - Valeria Nicolini
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Pablo Umaña
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Christian Klein
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Marina Bacac
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Anna-Maria Giusti
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Anneliese Schneider
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
| | - Hélène Haegel
- Roche Pharma Research and Early Development, pRED, Roche Innovation Center Zurich, Zurich, Switzerland
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12
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Giuliano A. Companion Animal Model in Translational Oncology; Feline Oral Squamous Cell Carcinoma and Canine Oral Melanoma. BIOLOGY 2021; 11:biology11010054. [PMID: 35053051 PMCID: PMC8773126 DOI: 10.3390/biology11010054] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 12/16/2022]
Abstract
Simple Summary Laboratory rodents are the most common animal models used in preclinical cancer research. Companion animals with naturally occurring cancers are an under-utilized natural model for the development of new anti-cancer drugs. Dogs and cats develop several types of cancers that resemble those arising in humans with similar clinical and histopathological features and often with similar molecular and genetic backgrounds. Exposure to environmental carcinogens, including air, food and water are also common between people and their pets. Dogs and cats are a unique model that could be integrated between the preclinical laboratory animal model and human clinical trials. Abstract Companion animals with naturally occurring cancers can provide an advantageous model for cancer research and in particular anticancer drug development. Compared to commonly utilized mouse models, companion animals, specifically dogs and cats, share a closer phylogenetical distance, body size, and genome organization. Most importantly, pets develop spontaneous, rather than artificially induced, cancers. The incidence of cancer in people and companion animals is quite similar and cancer is the leading cause of death in dogs over 10 years of age. Many cancer types in dogs and cats have similar pathological, molecular, and clinical features to their human counterparts. Drug toxicity and response to anti-cancer treatment in dogs and cats are also similar to those in people. Companion animals share their lives with their owners, including the environmental and socioeconomic cancer-risk factors. In contrast to humans, pets have a shorter life span and cancer progression is often more rapid. Clinical trials in companion animals are cheaper and less time consuming compared to human trials. Dogs and cats with naturally occurring cancers are an ideal and unique model for human cancer research. Model selection for the specific type of cancer is of pivotal importance. Although companion animal models for translational research have been reviewed previously, this review will try to summarize the most important advantages and disadvantages of this model. Feline oral squamous cell carcinoma as a model for head and neck squamous cell carcinoma and canine oral melanoma as a model for mucosal melanoma and immunotherapy in people will be discussed as examples.
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Affiliation(s)
- Antonio Giuliano
- Department of Veterinary Clinical Science, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong
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13
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Pharmacokinetics and Pharmacodynamics of T-Cell Bispecifics in the Tumour Interstitial Fluid. Pharmaceutics 2021; 13:pharmaceutics13122105. [PMID: 34959386 PMCID: PMC8705663 DOI: 10.3390/pharmaceutics13122105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 12/17/2022] Open
Abstract
The goal of this study is to investigate the pharmacokinetics in plasma and tumour interstitial fluid of two T-cell bispecifics (TCBs) with different binding affinities to the tumour target and to assess the subsequent cytokine release in a tumour-bearing humanised mouse model. Pharmacokinetics (PK) as well as cytokine data were collected in humanised mice after iv injection of cibisatamab and CEACAM5-TCB which are binding with different binding affinities to the tumour antigen carcinoembryonic antigen (CEA). The PK data were modelled and coupled to a previously published physiologically based PK model. Corresponding cytokine release profiles were compared to in vitro data. The PK model provided a good fit to the data and precise estimation of key PK parameters. High tumour interstitial concentrations were observed for both TCBs, influenced by their respective target binding affinities. In conclusion, we developed a tailored experimental method to measure PK and cytokine release in plasma and at the site of drug action, namely in the tumour. Integrating those data into a mathematical model enabled to investigate the impact of target affinity on tumour accumulation and can have implications for the PKPD assessment of the therapeutic antibodies.
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14
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Van De Vyver A, Eigenmann M, Ovacik M, Pohl C, Herter S, Weinzierl T, Fauti T, Klein C, Lehr T, Bacac M, Walz AC. A Novel Approach for Quantifying the Pharmacological Activity of T-Cell Engagers Utilizing In Vitro Time Course Experiments and Streamlined Data Analysis. AAPS J 2021; 24:7. [PMID: 34862519 PMCID: PMC8817205 DOI: 10.1208/s12248-021-00637-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022] Open
Abstract
CD3-bispecific antibodies are a new class of immunotherapeutic drugs against cancer. The pharmacological activity of CD3-bispecifics is typically assessed through in vitro assays of cancer cell lines co-cultured with human peripheral blood mononuclear cells (PBMCs). Assay results depend on experimental conditions such as incubation time and the effector-to-target cell ratio, which can hinder robust quantification of pharmacological activity. In order to overcome these limitations, we developed a new, holistic approach for quantification of the in vitro dose–response relationship. Our experimental design integrates a time-independent analysis of the dose–response across different time points as an alternative to the static, “snap-shot” analysis based on a single time point commonly used in dose–response assays. We show that the potency values derived from static
in vitro experiments depend on the incubation time, which leads to inconsistent results across multiple assays and compounds. We compared the potency values from the time-independent analysis with a model-based approach. We find comparably accurate potency estimates from the model-based and time-independent analyses and that the time-independent analysis provides a robust quantification of pharmacological activity. This approach may allow for an improved head-to-head comparison of different compounds and test systems and may prove useful for supporting first-in-human dose selection.
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Affiliation(s)
- Arthur Van De Vyver
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Grenzacherstrasse 124, CH-4070, Basel, Switzerland.,Department of Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Miro Eigenmann
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Grenzacherstrasse 124, CH-4070, Basel, Switzerland
| | - Meric Ovacik
- Preclinical Translational Pharmacokinetics, South San Francisco, CA, Genentech, USA
| | - Christian Pohl
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Sylvia Herter
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Tina Weinzierl
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Tanja Fauti
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Christian Klein
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Thorsten Lehr
- Department of Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Marina Bacac
- Roche Pharma Research and Early Development, Roche Innovation Center Zürich, Wagistrasse 10, 8952, Schlieren, Switzerland
| | - Antje-Christine Walz
- Roche Pharma Research & Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Grenzacherstrasse 124, CH-4070, Basel, Switzerland.
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15
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Aschmoneit N, Kühl L, Seifert O, Kontermann RE. Fc-comprising scDb-based trivalent, bispecific T-cell engagers for selective killing of HER3-expressing cancer cells independent of cytokine release. J Immunother Cancer 2021; 9:jitc-2021-003616. [PMID: 34782429 PMCID: PMC8593740 DOI: 10.1136/jitc-2021-003616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bispecific T-cell engagers are an established therapeutic strategy for the treatment of hematologic malignancies but face several challenges when it comes to their application for the treatment of solid tumors, including on-target off-tumor adverse events. Employing an avidity-mediated specificity gain by introducing an additional binding moiety for the tumor-associated antigen can be achieved using formats with a 2+1 stoichiometry. Methods Besides biochemical characterization and validation of target cell binding to cancer cells with different HER3 expression, we used in vitro co-culture assays with human peripheral blood mononuclear cells (PBMCs) and HER3-expressing target cells to determine T-cell activation, T-cell proliferation and PBMC-mediated cancer cell lysis of HER3-positive cell lines by the trivalent, bispecific antibodies. Results In this study, we developed trivalent, bispecific antibodies comprising a silenced Fc region for T-cell retargeting to HER3-expressing tumor cells, combining a bivalent single-chain diabody (scDb) fused to a first heterodimerizing Fc chain with either an Fab or scFv fused to a second heterodimerizing Fc chain. All these HER3-targeting T-cell engagers comprising two binding sites for HER3 and one binding site for CD3 mediated target cell killing. However, format and orientation of binding sites influenced efficacy of target cell binding, target cell-dependent T-cell activation and T-cell-mediated target cell killing. Beneficial effects were seen when the CD3 binding site was located in the scDb moiety. These molecules showed efficient killing of medium HER3-expressing cancer cells with very low induction of cytokine release, while sparing target cells with low or undetectable HER3 expression. Conclusion Our study demonstrates that these trivalent, bispecific antibodies represent formats with superior interdomain spacing resulting in efficient target cell killing and a potential advantageous safety profile due to very low cytokine release.
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Affiliation(s)
- Nadine Aschmoneit
- Institute of Cell Biology and Immunology, University of Stuttgart, Stuttgart, Germany
| | - Lennart Kühl
- Institute of Cell Biology and Immunology, University of Stuttgart, Stuttgart, Germany
| | - Oliver Seifert
- Institute of Cell Biology and Immunology, University of Stuttgart, Stuttgart, Germany.,Stuttgart Research Center Systems Biology, University of Stuttgart, Stuttgart, Germany
| | - Roland E Kontermann
- Institute of Cell Biology and Immunology, University of Stuttgart, Stuttgart, Germany .,Stuttgart Research Center Systems Biology, University of Stuttgart, Stuttgart, Germany
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16
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Lee SC, Ma JSY, Kim MS, Laborda E, Choi SH, Hampton EN, Yun H, Nunez V, Muldong MT, Wu CN, Ma W, Kulidjian AA, Kane CJ, Klyushnichenko V, Woods AK, Joseph SB, Petrassi M, Wisler J, Li J, Jamieson CAM, Schultz PG, Kim CH, Young TS. A PSMA-targeted bispecific antibody for prostate cancer driven by a small-molecule targeting ligand. SCIENCE ADVANCES 2021; 7:7/33/eabi8193. [PMID: 34380625 PMCID: PMC8357232 DOI: 10.1126/sciadv.abi8193] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
Despite the development of next-generation antiandrogens, metastatic castration-resistant prostate cancer (mCRPC) remains incurable. Here, we describe a unique semisynthetic bispecific antibody that uses site-specific unnatural amino acid conjugation to combine the potency of a T cell-recruiting anti-CD3 antibody with the specificity of an imaging ligand (DUPA) for prostate-specific membrane antigen. This format enabled optimization of structure and function to produce a candidate (CCW702) with specific, potent in vitro cytotoxicity and improved stability compared with a bispecific single-chain variable fragment format. In vivo, CCW702 eliminated C4-2 xenografts with as few as three weekly subcutaneous doses and prevented growth of PCSD1 patient-derived xenograft tumors in mice. In cynomolgus monkeys, CCW702 was well tolerated up to 34.1 mg/kg per dose, with near-complete subcutaneous bioavailability and a PK profile supporting testing of a weekly dosing regimen in patients. CCW702 is being evaluated in a first in-human clinical trial for men with mCRPC who had progressed on prior therapies (NCT04077021).
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Affiliation(s)
- Sung Chang Lee
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Jennifer S Y Ma
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Min Soo Kim
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Eduardo Laborda
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Sei-Hyun Choi
- Department of Chemistry and Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Eric N Hampton
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Hwayoung Yun
- Department of Chemistry and Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Vanessa Nunez
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Michelle T Muldong
- Department of Urology, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Christina N Wu
- Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Wenxue Ma
- Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Anna A Kulidjian
- Department of Orthopedic Surgery, Scripps MD Anderson Cancer Center, La Jolla, CA 92093, USA
| | - Christopher J Kane
- Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Vadim Klyushnichenko
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Ashley K Woods
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Sean B Joseph
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Mike Petrassi
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - John Wisler
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Jing Li
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Christina A M Jamieson
- Department of Urology, Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Peter G Schultz
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA.
- Department of Chemistry and Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Chan Hyuk Kim
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA.
| | - Travis S Young
- Department of Biology, Calibr, The Scripps Research Institute, La Jolla, CA 92037, USA.
- Department of Chemistry and Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
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17
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Schaller TH, Snyder DJ, Spasojevic I, Gedeon PC, Sanchez-Perez L, Sampson JH. First in human dose calculation of a single-chain bispecific antibody targeting glioma using the MABEL approach. J Immunother Cancer 2021; 8:jitc-2019-000213. [PMID: 32273346 PMCID: PMC7254109 DOI: 10.1136/jitc-2019-000213] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background First-in-human (FIH) clinical trials require careful selection of a safe yet biologically relevant starting dose. Typically, such starting doses are selected based on toxicity studies in a pharmacologically relevant animal model. However, with the advent of target-specific and highly active immunotherapeutics, both the Food and Drug Administration and the European Medicines Agency have provided guidance that recommend determining a safe starting dose based on a minimum anticipated biological effect level (MABEL) approach. Methods We recently developed a T cell activating bispecific antibody that effectively treats orthotopic patient-derived malignant glioma and syngeneic glioblastoma in mice (hEGFRvIII:CD3 bi-scFv). hEGFRvIII:CD3 bi-scFv is comprized of two single chain antibody fragments (bi-scFvs) that bind mutant epidermal growth factor receptor variant III (EGFRvIII), a mutation frequently seen in malignant glioma, and human CD3ε on T cells, respectively. In order to establish a FIH dose, we used a MABEL approach to select a safe starting dose for hEGFRvIII:CD3 bi-scFv, based on a combination of in vitro data, in vivo animal studies, and theoretical human receptor occupancy modeling. Results Using the most conservative approach to the MABEL assessment, a dose of 57.4 ng hEGFRvIII:CD3 bi-scFv/kg body weight was selected as a safe starting dose for a FIH clinical study. Conclusions The comparison of our MABEL-based starting dose to our in vivo efficacious dose and the theoretical human receptor occupancy strongly supports that our human starting dose of 57.4 ng hEGFRvIII:CD3 bi-scFv/patient kg will be safe.
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Affiliation(s)
- Teilo H Schaller
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States.,Department of Pathology, Duke University Medical Center, Durham, North Carolina, United States
| | - David J Snyder
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Ivan Spasojevic
- PK/PD Core Laboratory, Duke Cancer Institute, Durham, North Carolina, United States.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States
| | - Patrick C Gedeon
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Luis Sanchez-Perez
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - John H Sampson
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States .,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States.,Department of Pathology, Duke University Medical Center, Durham, North Carolina, United States
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18
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Surowka M, Schaefer W, Klein C. Ten years in the making: application of CrossMab technology for the development of therapeutic bispecific antibodies and antibody fusion proteins. MAbs 2021; 13:1967714. [PMID: 34491877 PMCID: PMC8425689 DOI: 10.1080/19420862.2021.1967714] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 12/15/2022] Open
Abstract
Bispecific antibodies have recently attracted intense interest. CrossMab technology was described in 2011 as novel approach enabling correct antibody light-chain association with their respective heavy chain in bispecific antibodies, together with methods enabling correct heavy-chain association using existing pairs of antibodies. Since the original description, CrossMab technology has evolved in the past decade into one of the most mature, versatile, and broadly applied technologies in the field, and nearly 20 bispecific antibodies based on CrossMab technology developed by Roche and others have entered clinical trials. The most advanced of these are the Ang-2/VEGF bispecific antibody faricimab, currently undergoing regulatory review, and the CD20/CD3 T cell bispecific antibody glofitamab, currently in pivotal Phase 3 trials. In this review, we introduce the principles of CrossMab technology, including its application for the generation of bi-/multispecific antibodies with different geometries and mechanisms of action, and provide an overview of CrossMab-based therapeutics in clinical trials.
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19
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Van De Vyver AJ, Weinzierl T, Eigenmann MJ, Frances N, Herter S, Buser RB, Somandin J, Diggelmann S, Limani F, Lehr T, Bacac M, Walz AC. Predicting Tumor Killing and T-Cell Activation by T-Cell Bispecific Antibodies as a Function of Target Expression: Combining In Vitro Experiments with Systems Modeling. Mol Cancer Ther 2020; 20:357-366. [PMID: 33298591 DOI: 10.1158/1535-7163.mct-20-0269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/03/2020] [Accepted: 11/17/2020] [Indexed: 11/16/2022]
Abstract
Targeted T-cell redirection is a promising field in cancer immunotherapy. T-cell bispecific antibodies (TCB) are novel antibody constructs capable of binding simultaneously to T cells and tumor cells, allowing cross-linking and the formation of immunologic synapses. This in turn results in T-cell activation, expansion, and tumor killing. TCB activity depends on system-related properties such as tumor target antigen expression as well as antibody properties such as binding affinities to target and T cells. Here, we developed a systems model integrating in vitro data to elucidate further the mechanism of action and to quantify the cytotoxic effects as the relationship between targeted antigen expression and corresponding TCB activity. In the proposed model, we capture relevant processes, linking immune synapse formation to T-cell activation, expansion, and tumor killing for TCBs in vitro to differentiate the effect between tumor cells expressing high or low levels of the tumor antigen. We used cibisatamab, a TCB binding to carcinoembryonic antigen (CEA), to target different tumor cell lines with high and low CEA expression in vitro We developed a model to capture and predict our observations, as a learn-and-confirm cycle. Although full tumor killing and substantial T-cell activation was observed in high expressing tumor cells, the model correctly predicted partial tumor killing and minimal T-cell activation in low expressing tumor cells when exposed to cibisatamab. Furthermore, the model successfully predicted cytotoxicity across a wide range of tumor cell lines, spanning from very low to high CEA expression.
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Affiliation(s)
- Arthur J Van De Vyver
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland. .,Saarland University, Department of Clinical Pharmacy, Saarbrücken, Germany
| | - Tina Weinzierl
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Miro J Eigenmann
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Nicolas Frances
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Sylvia Herter
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Regula B Buser
- Roche Pharma Research and Early Development, Large Molecule Research, Roche Innovation Center, Zürich, Switzerland
| | - Jitka Somandin
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Sarah Diggelmann
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Florian Limani
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Thorsten Lehr
- Saarland University, Department of Clinical Pharmacy, Saarbrücken, Germany
| | - Marina Bacac
- Roche Pharma Research and Early Development, Cancer Immunotherapy Department 2, Roche Innovation Center, Zürich, Switzerland
| | - Antje-Christine Walz
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
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20
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Leach MW, Clarke DO, Dudal S, Han C, Li C, Yang Z, Brennan FR, Bailey WJ, Chen Y, Deslandes A, Loberg LI, Mayawala K, Rogge MC, Todd M, Chemuturi NV. Strategies and Recommendations for Using a Data-Driven and Risk-Based Approach in the Selection of First-in-Human Starting Dose: An International Consortium for Innovation and Quality in Pharmaceutical Development (IQ) Assessment. Clin Pharmacol Ther 2020; 109:1395-1415. [PMID: 32757299 DOI: 10.1002/cpt.2009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/02/2020] [Indexed: 01/27/2023]
Abstract
Various approaches to first-in-human (FIH) starting dose selection for new molecular entities (NMEs) are designed to minimize risk to trial subjects. One approach uses the minimum anticipated biological effect level (MABEL), which is a conservative method intended to maximize subject safety and designed primarily for NMEs having high perceived safety risks. However, there is concern that the MABEL approach is being inappropriately used for lower risk molecules with negative impacts on drug development and time to patient access. In addition, ambiguity exists in how MABEL is defined and the methods used to determine it. The International Consortium for Innovation and Quality in Pharmaceutical Development convened a working group to understand current use of MABEL and its impact on FIH starting dose selection, and to make recommendations for FIH dose selection going forward. An industry-wide survey suggested the achieved or estimated maximum tolerated dose, efficacious dose, or recommended phase II dose was > 100-fold higher than the MABEL-based starting dose for approximately one third of NMEs, including trials in patients. A decision tree and key risk factor table were developed to provide a consistent, data driven-based, and risk-based approach for selecting FIH starting doses.
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Affiliation(s)
- Michael W Leach
- Drug Safety Research and Development, Pfizer, Inc., Cambridge, Massachusetts, USA
| | - David O Clarke
- Nonclinical Safety Assessment, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA
| | - Sherri Dudal
- DMPK Project Leads and Translational M&S, Pharmaceutical Sciences, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Chao Han
- Biologics Development Sciences, Janssen Research and Development, LLC, Spring House, Pennsylvania, USA
| | - Chunze Li
- Department of Clinical Pharmacology, Genentech, Inc., South San Francisco, California, USA
| | - Zheng Yang
- Metabolism and Pharmacokinetics, Bristol-Myers Squibb Co., Princeton, New Jersey, USA
| | | | - Wendy J Bailey
- Safety Assessment and Laboratory Animal Resources, Merck & Co., Inc., West Point, Pennsylvania, USA
| | - Yingxue Chen
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Boston, Massachusetts, USA
| | - Antoine Deslandes
- Translational Medicine & Early Development, Sanofi R&D, Centre de Recherche Vitry-sur-Seine 13, Vitry-sur-Seine Cedex, France
| | - Lise I Loberg
- Preclinical Safety, AbbVie, North Chicago, Illinois, USA
| | - Kapil Mayawala
- Quantitative Pharmacology and Pharmacometrics, PPDM, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Mark C Rogge
- Quantitative and Translational Science, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Marque Todd
- Drug Safety Research and Development, Pfizer, Inc., San Diego, California, USA
| | - Nagendra V Chemuturi
- Pharmacokinetic Sciences, Novartis Institute of BioMedical Research, Inc., Cambridge, Massachusetts, USA
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21
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Betts A, van der Graaf PH. Mechanistic Quantitative Pharmacology Strategies for the Early Clinical Development of Bispecific Antibodies in Oncology. Clin Pharmacol Ther 2020; 108:528-541. [PMID: 32579234 PMCID: PMC7484986 DOI: 10.1002/cpt.1961] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/13/2020] [Indexed: 02/06/2023]
Abstract
Bispecific antibodies (bsAbs) have become an integral component of the therapeutic research strategy to treat cancer. In addition to clinically validated immune cell re‐targeting, bsAbs are being designed for tumor targeting and as dual immune modulators. Explorative preclinical and emerging clinical data indicate potential for enhanced efficacy and reduced systemic toxicity. However, bsAbs are a complex modality with challenges to overcome in early clinical trials, including selection of relevant starting doses using a minimal anticipated biological effect level approach, and predicting efficacious dose despite nonintuitive dose response relationships. Multiple factors can contribute to variability in the clinic, including differences in functional affinity due to avidity, receptor expression, effector to target cell ratio, and presence of soluble target. Mechanistic modeling approaches are a powerful integrative tool to understand the complexities and aid in clinical translation, trial design, and prediction of regimens and strategies to reduce dose limiting toxicities of bsAbs. In this tutorial, the use of mechanistic modeling to impact decision making for bsAbs is presented and illustrated using case study examples.
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Affiliation(s)
- Alison Betts
- Applied Biomath, Concord, Massachusetts, USA.,Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands
| | - Piet H van der Graaf
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.,Certara, Canterbury, UK
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22
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Klein C, Schaefer W, Regula JT, Dumontet C, Brinkmann U, Bacac M, Umaña P. Engineering therapeutic bispecific antibodies using CrossMab technology. Methods 2018; 154:21-31. [PMID: 30453028 DOI: 10.1016/j.ymeth.2018.11.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/19/2022] Open
Abstract
Bispecific antibodies have recently gained major interest as they allow novel mechanisms-of-action and/or therapeutic applications that cannot be achieved using conventional IgG-based antibodies. A major issue in engineering IgG-based bispecific antibodies has been to enable the correct association of heavy and light chains resulting in correct assembly of the desired bispecific antibody in sufficient yield. Various approaches have been described during recent years to tackle this challenge. We have developed the so-called CrossMab technology that enforces correct light chain association based on the domain crossover of immunoglobulin domains in the Fab region of the bispecific antibody. This versatile technology allows the generation of different bispecific antibody formats including asymmetric heterodimeric monovalent 1 + 1 bispecific antibodies and asymmetric heterodimeric bispecific antibodies with 2 + 1 valency in combination with approaches enabling Fc-hetermodimerization like knob-into-hole technology as well as the generation of tetravalent symmetric bispecific antibodies with 2 + 2 valency, also known as Tandem-Fab based IgG antibodies, using processes suitable for the large scale production of therapeutic bispecific antibodies. Notably, as of now, at least eight different bispecific antibodies using CrossMab technology entered clinical development, and additional CrossMabs are in late preclinical development. This review provides a summary of the status and progress with the engineering and generation of CrossMab technology based bispecific antibodies as well as their therapeutic application.
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Affiliation(s)
- Christian Klein
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Zurich, 8952 Schlieren, Switzerland.
| | - Wolfgang Schaefer
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, 82393 Penzberg, Germany
| | - Joerg T Regula
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, 82393 Penzberg, Germany
| | - Charles Dumontet
- Cancer Research Center of Lyon (CRCL), INSERM, 1052/CNRS, 69000 Lyon, France
| | - Ulrich Brinkmann
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, 82393 Penzberg, Germany
| | - Marina Bacac
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Zurich, 8952 Schlieren, Switzerland
| | - Pablo Umaña
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Zurich, 8952 Schlieren, Switzerland
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23
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Teaching an old dog new tricks: next-generation CAR T cells. Br J Cancer 2018; 120:26-37. [PMID: 30413825 PMCID: PMC6325111 DOI: 10.1038/s41416-018-0325-1] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023] Open
Abstract
Adoptive T cell therapy (ACT) refers to the therapeutic use of T cells. T cells genetically engineered to express chimeric antigen receptors (CAR) constitute the most clinically advanced form of ACT approved to date for the treatment of CD19-positive leukaemias and lymphomas. CARs are synthetic receptors that are able to confer antigen-binding and activating functions on T cells with the aim of therapeutically targeting cancer cells. Several factors are essential for CAR T cell therapy to be effective, such as recruitment, activation, expansion and persistence of bioengineered T cells at the tumour site. Despite the advances made in CAR T cell therapy, however, most tumour entities still escape immune detection and elimination. A number of strategies counteracting these problems will need to be addressed in order to render T cell therapy effective in more situations than currently possible. Non-haematological tumours are also the subject of active investigation, but ACT has so far shown only marginal success rates in these cases. New approaches are needed to enhance the ability of ACT to target solid tumours without increasing toxicity, by improving recognition, infiltration, and persistence within tumours, as well as an enhanced resistance to the suppressive tumour microenvironment.
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24
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Abstract
Bispecific antibodies have moved from being an academic curiosity with therapeutic promise to reality, with two molecules being currently commercialized (Hemlibra® and Blincyto®) and many more in clinical trials. The success of bispecific antibodies is mainly due to the continuously growing number of mechanisms of actions (MOA) they enable that are not accessible to monoclonal antibodies. One of the earliest MOA of bispecific antibodies and currently the one with the largest number of clinical trials is the redirecting of the cytotoxic activity of T-cells for oncology applications, now extending its use in infective diseases. The use of bispecific antibodies for crossing the blood-brain barrier is another important application because of its potential to advance the therapeutic options for neurological diseases. Another noteworthy application due to its growing trend is enabling a more tissue-specific delivery or activity of antibodies. The different molecular solutions to the initial hurdles that limited the development of bispecific antibodies have led to the current diverse set of bispecific or multispecific antibody formats that can be grouped into three main categories: IgG-like formats, antibody fragment-based formats, or appended IgG formats. The expanded applications of bispecific antibodies come at the price of additional challenges for clinical development. The rising complexity in their structure may increase the risk of immunogenicity and the multiple antigen specificity complicates the selection of relevant species for safety assessment.
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Affiliation(s)
- Bushra Husain
- Protein Chemistry Department, Genentech Inc., South San Francisco, CA, 94080, USA
| | - Diego Ellerman
- Protein Chemistry Department, Genentech Inc., South San Francisco, CA, 94080, USA.
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25
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Evaluation of the potential use of hybrid LC–MS/MS for active drug quantification applying the ‘free analyte QC concept’. Bioanalysis 2017; 9:1705-1717. [DOI: 10.4155/bio-2017-0158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: Assessment of active drug exposure of biologics may be crucial for drug development. Typically, ligand-binding assay methods are used to provide free/active drug concentrations. To what extent hybrid LC–MS/MS procedures enable correct ‘active’ drug quantification is currently under consideration. Experimental & results: The relevance of appropriate extraction condition was evaluated by a hybrid target capture immuno-affinity LC–MS/MS method using total and free/active quality controls (QCs). The rapid extraction (10 min) provided correct results, whereas overnight incubation resulted in significant overestimation of the free/active drug (monclonal antibody) concentration. Conventional total QCs were inappropriate to determine optimal method conditions in contrast to free/active QCs. Conclusion: The ‘free/active analyte QC concept’ enables development of appropriate extraction conditions for correct active drug quantification by hybrid LC–MS/MS.
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26
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In vitro assays supporting the safety assessment of immunomodulatory monoclonal antibodies. Toxicol In Vitro 2017; 45:296-308. [PMID: 28263892 DOI: 10.1016/j.tiv.2017.02.025] [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] [Received: 12/23/2016] [Revised: 02/08/2017] [Accepted: 02/28/2017] [Indexed: 01/11/2023]
Abstract
Many monoclonal antibodies (mAbs) licensed for human use or in clinical development for cancer and autoimmune disease directly interact with the immune system. These immunomodulatory mAbs have an inherent risk of adverse immune-mediated drug reactions, including infusion reactions, cytokine storms, immunosuppression and autoimmunity. A thorough understanding of the potential for immunotoxicity of a mAb is required to support administration to humans. This review will highlight the key role of in vitro assays in defining the immunopharmacology, immunotoxicity and immunogenicity of mAbs. A wide range of in vitro tests with multiple formats of different complexity can be utilized to characterize i) the antibody-binding domains of the mAb, such as on-target binding and downstream pharmacological effects (e.g. immunosuppression, immune activation, cytokine release) in both humans and animal species used for toxicology studies and off-target binding; ii) Fc-dependent effects such as Fc-mediated cellular activation (e.g. of leukocytes, platelets) and cytokine release, complement activation; and iii) product-related factors (sequence, physical-chemical properties and impurities) that can impact both pharmacological activity and immunogenicity potential of a mAb. These assays can be crucial to the selection of mAbs with an optimum balance of safety and efficacy, in defining whether a mAb is a high risk molecule, and together with animal data, can inform human safe starting doses and escalation schemes.
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27
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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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