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Ding X, Xue L, Wang M, Zhu S, Zhu K, Jiang S, Wu J, Miao L. Dynamics and implications of anti-drug antibodies against adalimumab using ultra-sensitive and highly drug-tolerant assays. Front Immunol 2024; 15:1429544. [PMID: 39238635 PMCID: PMC11374634 DOI: 10.3389/fimmu.2024.1429544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/05/2024] [Indexed: 09/07/2024] Open
Abstract
Background Adalimumab induces the production of anti-drug antibodies (ADA) that may lead to reduced drug concentration and loss-of-response, posing significant clinical challenges. However, traditional immunoassays have limitations in terms of sensitivity and drug-tolerance, hindering the insights of ADA response. Methods Herein, we developed an integrated immunoassay platform combining the electrochemiluminescence immunoassay with immunomagnetic separation strategy. A longitudinal cohort study involving 49 patients with ankylosing spondylitis was carried out to analyze the dynamic profiles of ADA and to investigate the impact of ADA on adalimumab pharmacokinetics using a population pharmacokinetic model. Additionally, cross-sectional data from 12 patients were collected to validate the correlation between ADA levels and disease relapse. Results The ADA assay demonstrated high sensitivity (0.4 ng/mL) and drug-tolerance (100 μg/mL), while the neutralizing antibodies (NAB) assay showed a sensitivity of 100 ng/mL and drug-tolerance of 20 μg/mL. Analysis of the longitudinal cohort revealed that a majority of patients (44/49, 90%) developed persistent ADA within the first 24 weeks of treatment. ADA levels tended to plateau over time after an initial increase during the early immune response phase. Further, nearly all of the tested patients (26/27, 96%) were classified as NAB positive, with a strong correlation between ADA levels and neutralization capacity (R2 = 0.83, P < 0.001). Population pharmacokinetic modeling revealed a significant positive association between model-estimated individual clearance and observed ADA levels. Higher ADA levels were associated with adalimumab clearance and disease relapse in a cross-sectional cohort, suggesting a promising ADA threshold of 10 for potential clinical application. Moreover, the IgG class was the primary contributor to ADA against adalimumab and the apparent affinity exhibited an increasing trend over time, indicating a T-cell dependent mechanism for ADA elicitation by adalimumab. Conclusion In summary, this integrated immunoassay platform shows promise for in-depth analysis of ADA against biologics, offering fresh insights into immunogenicity and its clinical implications.
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Affiliation(s)
- Xiaoliang Ding
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
| | - Ling Xue
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
| | - Mingjun Wang
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shengxiong Zhu
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Kouzhu Zhu
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Sheng Jiang
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
| | - Jian Wu
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Liyan Miao
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute for Interdisciplinary Drug Research and Translational Sciences, Soochow University, Suzhou, China
- College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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2
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Cowan KJ, Champion L, Dyer D, Carlsen MF, Geary L, Genin JC, Golob M, Goodman J, Kromminga A, Nelson R, Revell H, Rieger M, de Vyver OV, Venema F, Timmerman P. The European Bioanalysis Forum recommendation on establishing appropriate drug tolerance levels in antidrug antibody assays. Bioanalysis 2024:1-7. [PMID: 39101618 DOI: 10.1080/17576180.2024.2376950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
The European Bioanalysis Forum, in collaboration with several key industry stakeholders, has recently led discussions that address international immunogenicity guidance documents, specifically the three tier approach for immunogenicity testing strategies, after more than 20 years of experience with biotherapeutics. As part of this, the strategy and methods used to assess drug tolerance across all immunogenicity assays are challenged, emphasizing that bioanalytical scientists need to consider the context-of-use of each assay. Here, recommendations for drug tolerance assessments, driven by strong scientific rationale and subject to reevaluation as needed, are provided. This includes carefully considering the drug and positive control concentrations considered to be appropriate and which tiers are most relevant for performing drug tolerance assessments.
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Affiliation(s)
- Kyra J Cowan
- Merck KGaA, Research & Development, Drug Metabolism & Pharmacokinetics New Biological Entities, Darmstadt, 64293, Germany
| | - Lysie Champion
- Celerion Switzerland AG, Bioanalytical Services, Fehraltorf, 8320, Switzerland
| | - Daniel Dyer
- Labcorp, Immunochemistry Method Development, Harrogate, HG3 1PY, UK
| | | | - Laura Geary
- Resolian Bioanalytics, Immunoassay Bioanalysis, Fordham, CB7 5WW, UK
| | | | | | - Joanne Goodman
- Bioanalytical Services, Celerion, Lincoln, NE 68502, USA
- AstraZeneca, Cambridge, CB21 6GH, United Kingdom
| | | | - Rob Nelson
- BioAgilytix Laboratories, Hamburg, 22339, Germany
| | - Heather Revell
- Labcorp, Immunochemistry Method Development, Harrogate, HG3 1PY, UK
| | - Martin Rieger
- MorphoSys AG, Clinical Pharmacology, Planegg, 82152, Germany
| | | | - Foka Venema
- Ardena Bioanalysis, AJ Assen, 9403, The Netherlands
| | - Philip Timmerman
- European Bioanalysis Forum vzw (EBF), Havenlaan 86c b204, Brussels, 1000, Belgium
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Fu R, Xu J, Guo Q, Liu T, Su X, Xu M, Zhao X, Wang F, Ji L, Qian W, Hou S, Li J, Zhang D, Guo H. Highly drug/target-tolerant neutralizing antibody (NAb) assay development through target-based drug depletion and drug-based NAb extraction for an anti-EGFR therapeutic monoclonal antibody. J Pharm Biomed Anal 2024; 241:116006. [PMID: 38309099 DOI: 10.1016/j.jpba.2024.116006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
The reduction of immunogenicity is fundamental for the development of biobetter Erbitux, given that the development of an immune response reduces treatment efficacy and may lead to potential side effects. One of the requirements for the clinical research of a Erbitux biobetter candidate (CMAB009) is to develop a neutralizing antibody (NAb) assay, and sufficient drug and target tolerance for the assay is necessary. Here, we describe the development of a competitive ligand binding (CLB) assay for CMAB009 with high drug and target tolerance through target-based drug depletion and drug-based NAb extraction, the integrated experimental strategy was implemented to simultaneously mitigate drug interference and enhance target tolerance. Following troubleshooting and optimization, the NAb assay was validated for clinical sample analysis with the sensitivity of 92 ng/mL, drug tolerance of 70 μg/mL and target tolerance of 798 ng/mL. The innovative drug depletion and NAb extraction achieved though the combination of drug and target beads would enable the development of reliable NAb assays for many other therapeutics that overcome drug and its target interference for more precise and sensitive NAb assessment.
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Affiliation(s)
- Rongrong Fu
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China
| | - Jin Xu
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Qingcheng Guo
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China; Taizhou Mabtech Pharmaceuticals Co., Ltd, Taizhou, China
| | - Tao Liu
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China; Department of Oncology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinyi Su
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, Shanghai Zhangjiang Biotechnology Co., Ltd, Shanghai, China
| | - Mengjiao Xu
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China
| | - Xiang Zhao
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China
| | - Fugui Wang
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China
| | - Lusha Ji
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Weizhu Qian
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Sheng Hou
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jun Li
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China.
| | - Dapeng Zhang
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China.
| | - Huaizu Guo
- State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, China; NMPA Key Laboratory for Quality Control of Therapeutic Monoclonal Antibodies, Shanghai, China; State key laboratory of macromolecular drugs and large-scale manufacturing, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China; State key laboratory of macromolecular drugs and large-scale manufacturing, Shanghai Zhangjiang Biotechnology Co., Ltd, Shanghai, China.
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Garlits J, McAfee S, Taylor JA, Shum E, Yang Q, Nunez E, Kameron K, Fenech K, Rodriguez J, Torri A, Chen J, Sumner G, Partridge MA. Statistical Approaches for Establishing Appropriate Immunogenicity Assay Cut Points: Impact of Sample Distribution, Sample Size, and Outlier Removal. AAPS J 2023; 25:37. [PMID: 37016171 DOI: 10.1208/s12248-023-00806-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/23/2023] [Indexed: 04/06/2023] Open
Abstract
The statistical assessments needed to establish anti-drug antibody (ADA) assay cut points (CPs) can be challenging for bioanalytical scientists. Poorly established CPs that are too high could potentially miss treatment emergent ADA or, when set too low, result in detection of responses that may have no clinical relevance. We evaluated 16 validation CP datasets generated with ADA assays at Regeneron's bioanalytical laboratory and compared results obtained from different CP calculation tools. We systematically evaluated the impact of various factors on CP determination including biological and analytical variability, number of samples for capturing biological variability, outlier removal methods, and the use of parametric vs. non-parametric CP determination. In every study, biological factors were the major component of assay response variability, far outweighing the contribution from analytical variability. Non-parametric CP estimations resulted in screening positivity in drug-naïve samples closer to the targeted rate (5%) and were less impacted by skewness. Outlier removal using the boxplot method with an interquartile range (IQR) factor of 3.0 resulted in screening positivity close to the 5% targeted rate when applied to entire drug-naïve dataset. In silico analysis of CPs calculated using different sample sizes showed that using larger numbers of individuals resulted in CP estimates closer to the CP of the entire population, indicating a larger sample size (~ 150) for CP determination better represents the diversity of the study population. Finally, simpler CP calculations, such as the boxplot method performed in Excel, resulted in CPs similar to those determined using complex methods, such as random-effects ANOVA.
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Affiliation(s)
- John Garlits
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Sean McAfee
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Jessica-Ann Taylor
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Enoch Shum
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Qi Yang
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
- Kriya Therapeutics, 4105 Hopson Rd, Durham, North Carolina, 27713, USA
| | - Emily Nunez
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Kristina Kameron
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Keilah Fenech
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Jacqueline Rodriguez
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Albert Torri
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Jihua Chen
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Giane Sumner
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Michael A Partridge
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA.
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Irvin SC, D’Orvilliers A, Bloch N, Boccio K, Pennucci J, Brouwer-Visser J, Ullman E, Rajadhyaksha M, Hassanein M, Potocky T, Torri A, Hermann A, Partridge MA. Interference in a Neutralizing Antibody Assay for Odronextamab, a CD20xCD3 Bispecific mAb, from Prior Rituximab Therapy and Possible Mitigation Strategy. AAPS J 2022; 24:76. [DOI: 10.1208/s12248-022-00724-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
AbstractA cell-based assay was developed to detect neutralizing anti-drug antibodies (NAbs) against odronextamab, a CD20xCD3 bispecific monoclonal antibody (mAb) under investigation for treatment of CD20+ B cell malignancies. In this assay, odronextamab bridges between two cell types, CD20-expressing HEK293 cells and CD3-expressing Jurkat T cells that generate a luciferase signal upon CD3 clustering. Patient samples containing NAbs directed to either arm of the bispecific drug block the odronextamab bridge formation between the cell lines thus preventing the generation of the luciferase signal. We determined that other anti-CD20 therapeutics also block bridge formation, resulting in false-positive results. In patient samples from odronextamab clinical trials, approximately 30% of baseline samples had a strong false-positive NAb signal that correlated with the presence of prior rituximab (anti-CD20) therapy. We determined that rituximab interference can be minimized by the addition of anti-rituximab antibodies in the NAb assay. Understanding and mitigating the impact of prior biologic exposure is increasingly important for implementing a successful bioanalytical strategy to support clinical drug development, especially in the immuno-oncology field.
Graphical Abstract
Odronextamab neutralizing antibody assay, interference, and mitigation. A Design of the odronextamab neutralizing antibody (NAb) assay where anti-CD20xCD3 drug bridges between CD20-expressing HEK293 cells and Jurkat T cells expressing an NFAT response element and luciferase reporter. True NAb prevents odronextamab from bridging between target and effector cells, thus preventing the expression of luciferase. B Interference with odronextamab from other anti-CD20 therapeutic antibodies (e.g., rituximab) from prior disease treatment generates a false-positive NAb result. Assay interference can be mitigated with an anti-idiotypic antibody against the interfering therapy.
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Assessment of clinically relevant immunogenicity for mAbs; are we over reporting ADA? Bioanalysis 2020; 12:1325-1336. [PMID: 32946271 DOI: 10.4155/bio-2020-0174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Immunogenicity is recognized as a possible clinical risk due to the development of anti drug antibodies (ADAs) that can adversely impact drug safety and efficacy. Although robust assays are currently used to assess the ADA, there is a debate on how best to generate the most appropriate immunogenicity data. There are several factors that can trigger ADA formation including the immunity status of the target population and the severity of the disease indication. Immunogenicity testing has defaulted to the most conservative approach regardless of the inherent risk of the molecule or the patient population. For low-risk biotherapeutics such as human monoclonal antibodies, ADA data that provide clinically relevant information should be prioritized when establishing immunogenicity monitoring plans.
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