Abstract 843: Development of a quantitative systems pharmacology model for clinical dose and schedule optimization of RG6234, a T-cell engaging antibody targeting GPRC5D in multiple myeloma

Background: RG6234 is a GPRC5DxCD3 T-cell engaging bispecific antibody (TCB) that redirects T cells to target and eliminate cells expressing GPRC5D, including malignant plasma cells. RG6234 has a novel 2:1 (GPRC5D:CD3) configuration that confers bivalent binding to GPRC5D and increased T-cell directed killing compared with other molecular formats. RG6234 is initiated with Cycle 1 step-up dosing to mitigate the risk for severe cytokine release syndrome (CRS).

Introduction: We performed an in silico evaluation of the dynamics of soluble B-cell maturation antigen (sBCMA), used as a surrogate for tumor burden and informing probability of response, and of the maximum release of IL-8, used as a surrogate for immune activation and informing the probability of CRS, using a QSP model. The model was calibrated with clinical data from 43 relapsed/refractory Multiple Myeloma (R/R MM) patients from the ongoing IV dose escalation study (NCT04557150).

The model was set up to: 1) perform patient-specific calibrations and characterize the population with regard to patients’ sensitivity to tumor killing and immune activation and associated heterogeneity; and 2) simulate different dosing regimens in virtual populations and predict their probability of response and CRS.

Here we present the model development and calibration results.

Methods: The QSP model is a minimal mechanistic model integrating key elements of the Mechanism of Action (MoA) of RG6234. It describes immune activation by RG6234 and resulting MM cell killing. It comprises a system of two ordinary differential equations and 20 parameters, two of which are fitted to longitudinal clinical data (sBCMA and IL-8).

Mechanistic assumptions regarding the MM disease and the MoA of RG6234 are represented in the model and supported by clinical or preclinical evidence. Of note, the immune tolerance observed in Cycle 1, indicated by the progressive decrease of cytokine peak levels despite the increased step-up dose level, is captured in the model by limiting the number of activated and proliferating T cells in the tumor microenvironment.

Results: The calibrated model shows an accuracy of 92% in recapitulating Partial Response or better and of 78% in recapitulating CRS occurrence after the first step-up dose, demonstrating its appropriateness to address clinically relevant questions. Patient specific model calibrations show that the treated R/R MM population is more heterogeneous with regard to its sensitivity to RG6234-induced MM cell killing than to immune activation.

Conclusions: The mechanistic model is able to simulate RG6234-induced T-cell mediated tumor cell killing and can be utilized to predict response and CRS in virtual populations after IV administrations at different dosing regimens. A model validation is planned with data from the expansion cohort of the study.

Citation Format: Cristina C. Santini, Emilie Schindler, Jan Attig, Jan Eckmann, Suresh Vatakuti, Francesco Brizzi, Antoine Soubret, Sara Belli. Development of a quantitative systems pharmacology model for clinical dose and schedule optimization of RG6234, a T-cell engaging antibody targeting GPRC5D in multiple myeloma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 843.

The Application of Nanotechnology for Quantification of Circulating Tumour DNA in Liquid Biopsies: A Systematic Review

Technologies for quantifying circulating tumour DNA (ctDNA) in liquid biopsies could enable real-time measurements of cancer progression, profoundly impacting patient care. Sequencing methods can be too complex and time-consuming for regular point-of-care monitoring, but nanotechnology offers an alternative, harnessing the unique properties of objects tens to hundreds of nanometres in size. This systematic review was performed to identify all examples of nanotechnology-based ctDNA detection and assess their potential for clinical use. Google Scholar, PubMed, Web of Science, Google Patents, Espacenet and Embase/MEDLINE were searched up to 23rd March 2021. The review identified nanotechnology-based methods for ctDNA detection for which quantitative measures (e.g., limit of detection, LOD) were reported and biologically relevant samples were used. The pre-defined inclusion criteria were met by 66 records. LODs ranged from 10 zM to 50nM. 25 records presented an LOD of 10fM or below. Nanotechnology-based approaches could provide the basis for the next wave of advances in ctDNA diagnostics, enabling analysis at the point-of-care, but none are currently used clinically. Further work is needed in development and validation; trade-offs are expected between different performance measures e.g., number of sequences detected and time to result.

Quantitative Systems Pharmacology Modeling of Avadomide-Induced Neutropenia Enables Virtual Clinical Dose and Schedule Finding Studies

Avadomide is a cereblon E3 ligase modulator and a potent antitumor and immunomodulatory agent. Avadomide trials are challenged by neutropenia as a major adverse event and a dose-limiting toxicity. Intermittent dosing schedules supported by preclinical data provide a strategy to reduce frequency and severity of neutropenia; however, the identification of optimal dosing schedules remains a clinical challenge. Quantitative systems pharmacology (QSP) modeling offers opportunities for virtual screening of efficacy and toxicity levels produced by alternative dose and schedule regimens, thereby supporting decision-making in translational drug development. We formulated a QSP model to capture the mechanism of avadomide-induced neutropenia, which involves cereblon-mediated degradation of transcription factor Ikaros, resulting in a maturation block of the neutrophil lineage. The neutropenia model was integrated with avadomide-specific pharmacokinetic and pharmacodynamic models to capture dose-dependent effects. Additionally, we generated a disease-specific virtual patient population to represent the variability in patient characteristics and response to treatment observed for a diffuse large B-cell lymphoma trial cohort. Model utility was demonstrated by simulating the avadomide effect in the virtual population for various dosing schedules and determining the incidence of high-grade neutropenia, its duration, and the probability of recovery to low-grade neutropenia.

Operando XPS: A Novel Approach for Probing the Lithium/Electrolyte Interphase Dynamic Evolution

The coupling protocols combining photoemission spectroscopy and other characterization methods such as electrochemical, electrical, optical, thermal, or magnetic paved the way to considerable progress in the field of materials science. Access to complementary data on the same object is relevant, but in the vast majority of cases, it is carried out sequentially and separately. This raises the complex question of the equivalence of the analyzed surfaces subjected to these different characterizations. In the frame of lithium ion battery technology (LIB), several techniques have been developed to follow in operando condition the reactivity of electro-active materials toward liquid or solid electrolytes. Besides the knowledge of the redox processes obtained using operando protocols, especially at the interfaces, some limitations associated with material sensitivity and/or the characterization techniques are still a breakdown to widen our understanding of the origin of the LIB performance degradation processes. Herein, we propose a new design of an operando cell adapted to perform X-ray photoemission spectroscopy (XPS) at the interface between electrode and electrolyte under electrochemical solicitations. To illustrate its performance, the crucial issues associated with the lithium metal interface have been scrutinized using Li/Li symmetrical cells and two types of ionic liquids, 1-hexyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (C₁C₆ImTFSI) and 1-hexyl-3-methylimidazolium bis(fluorosulfonyl)imide (C₁C₆ImFSI) laden with LiTFSI salt. Our original setup allowed us to follow-up the lithium surface reactivity toward these ionic liquid based electrolytes in open circuit voltage condition and under polarization. Beside the gain of time and the matter saving, we highlighted and optimized the blocking issues to perform accurate OXPS measurement for probing the evolution of the chemical structure and the surface potential change at the interface lithium/electrolyte in dynamic mode.

New Interpretation of X-ray Photoelectron Spectroscopy of Imidazolium Ionic Liquid Electrolytes Based on Ionic Transport Analyses

We reported a new perspective on the correlation between the electronic structure of an ionic liquid (IL)-based electrolyte probed by X-ray photoelectron spectroscopy and the transport properties analyzed by impedance spectroscopy. We highlighted the core level chemical shifts of 1-hexyl-3-methylimidazolium (bis(trifluoromethanesulfonyl)imide) (C₁C₆ImTFSI), 1-hexyl-3-methylimidazolium bis(fluorosulfonyl)imide (C₁C₆ImFSI), and 1-hexyl-2,3-dimethylimidazolium bis(trifluoromethylsulfonyl)imide (C₁C₁C₆ImTFSI) laden with LiTFSI salt and vinylene carbonate (VC) or fluoroethylene carbonate (FEC) with regard to the transport properties of cations and anions. We pointed out based on detailed binding energy shift analyses a clear effect of the anion on the local organization of Li⁺ ions. The significant peak shift in the case of C₁C₆ImTFSI laden with LiTFSI corroborates the formation of [Li(TFSI)₂]^- complexes. On the contrary, the lower amplitude of the binding energy shift of C₁C₆ImFSI for both anion- and cation-related peaks indicates that the electronic distribution around the cation and the anion is not affected when the LiTFSI salt is added, which plays a strong role in the ion dynamics (lower viscosity) of the electrolyte. The X-ray photoelectron spectroscopy (XPS) result supports the preponderant role of imidazolium ionic liquid based on FSI anion to form an electrolyte less prone to form ionic complexes. The methylation of the imidazolium cation contributes to the reduction of the interaction between the C₁C₁C₆Im cation and TFSI anion, while additives VC and FEC contribute to the change of the alkyl configuration in C₁C₆Im cation, leading to the modification of the macroscopic properties of the ILs.

Electrochemical Impedance Spectroscopy and X-ray Photoelectron Spectroscopy Study of Lithium Metal Surface Aging in Imidazolium-Based Ionic Liquid Electrolytes Performed at Open-Circuit Voltage

Lithium reactivity toward an electrolytic media and dendrite growth phenomenon constitutes the main drawback for its use as an anode material for the lithium battery technology. Ionic liquids (ILs) were pointed out as promising electrolyte solvent candidates to prevent thermal runaway in a lithium battery system. However, the reactivity of lithium toward such a kind of an electrolyte is still under debate. In this study, the interaction between lithium metal and imidazolium-based ILs, 1-hexyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (C₁C₆ImTFSI) and 1-hexyl-3-methylimidazolium bis(fluorosulfonyl)imide (C₁C₆ImFSI), has been investigated based on the nondestructive methodology coupling electrochemical impedance spectroscopy (EIS) and X-ray photoelectron spectroscopy (XPS) in coin cells aged several days at open-circuit voltage. The main components detected by XPS in the bulk separator and at the surface of the lithium metal are the byproducts of cation and anion degradation. Similarities and differences were noticed depending on the anion nature of bis(trifluoromethylsulfonyl)imide versus bis(fluorosulfonyl)imide. The role of lithium salt addition (LiTFSI) was also pointed, giving rise to the stability improvement of the electrolytic solution toward the lithium anode. A direct correlation between the resistance of the bulk electrolyte and of the interface electrolyte/lithium and chemical composition changes were established based on a detailed EIS and XPS combined study.

Unmasking determinants of specificity in the human kinome

Protein kinases control cellular responses to environmental cues by swift and accurate signal processing. Breakdowns in this high-fidelity capability are a driving force in cancer and other diseases. Thus, our limited understanding of which amino acids in the kinase domain encode substrate specificity, the so-called determinants of specificity (DoS), constitutes a major obstacle in cancer signaling. Here, we systematically discover several DoS and experimentally validate three of them, named the αC1, αC3, and APE-7 residues. We demonstrate that DoS form sparse networks of non-conserved residues spanning distant regions. Our results reveal a likely role for inter-residue allostery in specificity and an evolutionary decoupling of kinase activity and specificity, which appear loaded on independent groups of residues. Finally, we uncover similar properties driving SH2 domain specificity and demonstrate how the identification of DoS can be utilized to elucidate a greater understanding of the role of signaling networks in cancer (Creixell et al., 2015 [this issue of Cell]).

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Residues driving specificity in the kinase and SH2 domains are globally identified

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Three new such residues, termed αC1, αC3, and APE-7, are experimentally validated

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Specificity and catalytic activity appear to be encoded in distinct sets of residues

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The global identification of determinants allows the modeling of rewiring mutations

Ru-core/Cu-shell bimetallic nanoparticles with controlled size formed in one-pot synthesis

Suspensions of bimetallic nanoparticles (NPs) of Ru and Cu have been synthesized by simultaneous decomposition of two organometallic compounds in an ionic liquid. These suspensions have been characterized by Anomalous Small-Angle X-ray Scattering (ASAXS) at energies slightly below the Ru K-edge. It is found that the NPs adopt a Ru-core, a Cu-shell structure, with a constant Ru core diameter of 1.9 nm for all Ru : Cu compositions, while the Cu shell thickness increases with Cu content up to 0.9 nm. The formation of RuCuNPs thus proceeds through rapid decomposition of the Ru precursor into RuNPs of constant size followed by the reaction of the Cu precursor and agglomeration as a Cu shell. Thus, the different decomposition kinetics of precursors make possible the elaboration of core-shell NPs composed of two metals without chemical affinity.

Targeting adequate thermal stability and fire safety in selecting ionic liquid-based electrolytes for energy storage

The energy storage market relating to lithium based systems regularly grows in size and expands in terms of a portfolio of energy and power demanding applications. Thus safety focused research must more than ever accompany related technological breakthroughs regarding performance of cells, resulting in intensive research on the chemistry and materials science to design more reliable batteries. Formulating electrolyte solutions with nonvolatile and hardly flammable ionic liquids instead of actual carbonate mixtures could be safer. However, few definitions of thermal stability of electrolytes based on ionic liquids have been reported in the case of abuse conditions (fire, shortcut, overcharge or overdischarge). This work investigates thermal stability up to combustion of 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl)imide ([C1C4Im][NTf2]) and 1-butyl-1-methylpyrrolidinium bis(trifluoromethanesulfonyl)imide ([PYR14][NTf2]) ionic liquids, and their corresponding electrolytes containing lithium bis(trifluoromethanesulfonyl)imide LiNTf2. Their possible routes of degradation during thermal abuse testings were investigated by thermodynamic studies under several experimental conditions. Their behaviours under fire were also tested, including the analysis of emitted compounds.

Personalized network-based treatments in oncology

Network medicine aims at unraveling cell signaling networks to propose personalized treatments for patients suffering from complex diseases. In this short review, we show the relevance of network medicine to cancer treatment by outlining the potential convergence points of the most recent technological and scientific developments in both drug design and signaling network analysis.