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Repp R, van Ojik HH, Valerius T, Groenewegen G, Wieland G, Oetzel C, Stockmeyer B, Becker W, Eisenhut M, Steininger H, Deo YM, Blijham GH, Kalden JR, van de Winkel JGJ, Gramatzki M. Phase I clinical trial of the bispecific antibody MDX-H210 (anti-FcgammaRI x anti-HER-2/neu) in combination with Filgrastim (G-CSF) for treatment of advanced breast cancer. Br J Cancer 2004; 89:2234-43. [PMID: 14676800 PMCID: PMC2395280 DOI: 10.1038/sj.bjc.6601367] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A phase I study of the bispecific antibody MDX-H210 in combination with granulocyte colony-stimulating factor (G-CSF) was performed in stage IV breast carcinoma patients, overexpressing HER-2/neu. MDX-H210, constructed by crosslinking antigen binding fragments (F(ab') fragments) of monoclonal antibody (mAb) H22 to Fc gamma receptor I (FcgammaRI), and mAb 520C9 to HER-2/neu, respectively, mediates the lysis of tumour cells in vitro, and in human FcgammaRI transgenic mouse models. The proto-oncogene HER-2/neu is overexpressed in approximately 30% of breast cancer patients, and represents a promising target for antibody-based immunotherapy. Fc gamma receptor I (CD64) is an effective trigger molecule, which is expressed on monocytes/macrophages, immature dendritic cells, and G-CSF-primed polymorphonuclear cells (PMN). Patients received G-CSF (Filgrastim) for 8 consecutive days, and cohorts of three patients were treated on day 4 with escalating, single doses of MDX-H210. A total of 30 patients were included, and treatment was generally well tolerated, without reaching dose-limiting toxicity. Side effects consisted mainly of fever and short periods of chills, which were timely related to elevated plasma levels of interleukin 6 and tumour necrosis factor alpha. In the last two cohorts, MDX-H210 plasma levels exceeded 1 microg ml(-1), and on circulating myeloid cells >50% saturation of FcgammaRI was found until day 4. These effector cells were highly effective in antibody-dependent cell-mediated cytotoxicity. Immunohistochemical analyses of tumour biopsies in individual patients documented infiltration of monocytes and PMN after MDX-H210 infusion. Although the clinical course of the disease was not altered by the single dose of MDX-H210, a favourable toxicity profile--even at high doses--and remarkable biological effects were seen when combined with G-CSF. Therefore, the combination of G-CSF and MDX-H210 should be evaluated in further immunotherapeutical strategies.
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Affiliation(s)
- R Repp
- Department of Medicine III, Division of Hematology/Oncology, University of Erlangen-Nürnberg, Krankenhausstrasse 12, Erlangen 91054, Germany.
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Ioan-Facsinay A, de Kimpe SJ, Hellwig SMM, van Lent PL, Hofhuis FMA, van Ojik HH, Sedlik C, da Silveira SA, Gerber J, de Jong YF, Roozendaal R, Aarden LA, van den Berg WB, Saito T, Mosser D, Amigorena S, Izui S, van Ommen GJB, van Vugt M, van de Winkel JGJ, Verbeek JS. FcgammaRI (CD64) contributes substantially to severity of arthritis, hypersensitivity responses, and protection from bacterial infection. Immunity 2002; 16:391-402. [PMID: 11911824 DOI: 10.1016/s1074-7613(02)00294-7] [Citation(s) in RCA: 245] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The high-affinity receptor for IgG, FcgammaRI, shares its capacity to bind IgG2a immune complexes (IgG2a-IC) with the low-affinity receptor FcgammaRIII and complement factors, hampering the definition of its biological role. Moreover, in vivo, FcgammaRI is occupied by monomeric IgG2a, reducing its accessibility to newly formed IgG2a-IC. By using a variety of FcgammaR(-/-) mice, we demonstrate that in the absence of FcgammaRI, the IgG2a-IC-induced cellular processes of phagocytosis, cytokine release, cellular cytotoxicity, and antigen presentation are impaired. FcgammaRI(-/-) mice showed impaired hypersensitivity responses, strongly reduced cartilage destruction in an arthritis model, and impaired protection from a bacterial infection. We conclude that FcgammaRI contributes substantially to a variety of IgG2a-IC-dependent immune functions and immunopathological responses.
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Affiliation(s)
- A Ioan-Facsinay
- Department of Human Genetics, Leiden University Medical Center, 2333 AL Leiden, The Netherlands
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Abstract
Bispecific antibodies constitute a novel approach to improve antibody efficacy. In vitro, constructs to recruit myeloid effector cells have been extensively investigated, and first animal data in human Fc receptor transgenic mice confirmed their promising therapeutic potential. Clinical experience with these constructs demonstrated acceptable toxicity, and support therapeutic efficacy in subgroups of patients. However, limited availability, unacceptable immunogenicity, and unfavorable pharmacokinetics of bispecific compared to conventional antibodies often hampered clinical studies. As solutions to these problems are available today, bispecific antibodies hold promise to improve therapeutic efficacy of antibody-based approaches in the near future.
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Affiliation(s)
- H H van Ojik
- Department of Immunology, Immunotherapy Laboratory, University Medical Center, Utrecht, The Netherlands
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Abstract
Bispecific antibodies (BsAb) can, by virtue of combining two binding specificities, improve the selectivity and efficacy of antibody-based treatment of human disease. Recent studies underline the importance of both the 'anti-trigger' and 'anti-target' modalities of BsAb for therapeutic efficacy. Several BsAb induce effective cytotoxicity as well as 'vaccine effects' in vivo. Here, Annemiek van Spriel and colleagues discuss how these results have catalysed renewed efforts to translate BsAb concepts into effective therapies.
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Affiliation(s)
- A B van Spriel
- Immunotherapy Laboratory, Dept of Immunology and Medarex Europe, University Medical Center Utrecht, Room KC02.085.2, Lundlaan 6, 3584 EA Utrecht, The Netherlands
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Heijnen IA, Rijks LJ, Schiel A, Stockmeyer B, van Ojik HH, Dechant M, Valerius T, Keler T, Tutt AL, Glennie MJ, van Royen EA, Capel PJ, van de Winkel JG. Generation of HER-2/neu-specific cytotoxic neutrophils in vivo: efficient arming of neutrophils by combined administration of granulocyte colony-stimulating factor and Fcgamma receptor I bispecific antibodies. J Immunol 1997; 159:5629-39. [PMID: 9548506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abs are able to induce inflammatory antitumor responses by recruiting IgG Fc receptor (FcgammaR)-bearing cytotoxic effector cells. We recently described the capacity of the high affinity FcgammaRI (CD64) to trigger cytotoxic activity of neutrophils (PMN) during granulocyte CSF (G-CSF) treatment. To take advantage of FcgammaRI as a cytotoxic trigger molecule on PMN, two Ab constructs were prepared. We show that a chimeric human IgG1 Ab (Ch520C9) and an anti-FcgammaRI bispecific Ab (BsAb; 22x520C9), both directed to the proto-oncogene product HER-2/neu, interact with FcgammaRI. In addition, both Ab constructs mediate enhanced lysis of HER-2/neu-expressing tumor cells by G-CSF-primed PMN. However, engagement of FcgammaRI by Ch520C9 was inhibited by human serum IgG, thereby abrogating the enhanced Ch520C9-mediated cytotoxicity. BsAb 22x520C9, which binds FcgammaRI outside the ligand binding domain, effectively recruits the cytotoxic potential of FcgammaRI on G-CSF-primed PMN regardless of the presence of human serum. These results indicate that under physiologic conditions, serum IgG impairs activation of FcgammaRI-mediated cytotoxicity by conventional antitumor Abs. The IgG blockade can be circumvented with anti-FcgammaRI BsAbs. Using human FcgammaRI transgenic mice we demonstrate that BsAb 22x520C9 is able to engage FcgammaRI in vivo. BsAb 22x520C9 injected i.v. was readily detected on circulating PMN of G-CSF-treated transgenic animals. In addition, we showed that PMN remain "armed" with BsAb 22x520C9 during migration to inflammatory sites, and that after isolation such PMN specifically lyse HER-2/neu-expressing tumor cells. These results point to the possibility of targeting anti-FcgammaRI BsAbs to G-CSF-primed PMN in vivo, endowing them with specific anti-tumor activity.
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Affiliation(s)
- I A Heijnen
- Department of Immunology, University Hospital Utrecht, The Netherlands
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Heijnen IA, Rijks LJ, Schiel A, Stockmeyer B, van Ojik HH, Dechant M, Valerius T, Keler T, Tutt AL, Glennie MJ, van Royen EA, Capel PJ, van de Winkel JG. Generation of HER-2/neu-specific cytotoxic neutrophils in vivo: efficient arming of neutrophils by combined administration of granulocyte colony-stimulating factor and Fcgamma receptor I bispecific antibodies. The Journal of Immunology 1997. [DOI: 10.4049/jimmunol.159.11.5629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Abs are able to induce inflammatory antitumor responses by recruiting IgG Fc receptor (FcgammaR)-bearing cytotoxic effector cells. We recently described the capacity of the high affinity FcgammaRI (CD64) to trigger cytotoxic activity of neutrophils (PMN) during granulocyte CSF (G-CSF) treatment. To take advantage of FcgammaRI as a cytotoxic trigger molecule on PMN, two Ab constructs were prepared. We show that a chimeric human IgG1 Ab (Ch520C9) and an anti-FcgammaRI bispecific Ab (BsAb; 22x520C9), both directed to the proto-oncogene product HER-2/neu, interact with FcgammaRI. In addition, both Ab constructs mediate enhanced lysis of HER-2/neu-expressing tumor cells by G-CSF-primed PMN. However, engagement of FcgammaRI by Ch520C9 was inhibited by human serum IgG, thereby abrogating the enhanced Ch520C9-mediated cytotoxicity. BsAb 22x520C9, which binds FcgammaRI outside the ligand binding domain, effectively recruits the cytotoxic potential of FcgammaRI on G-CSF-primed PMN regardless of the presence of human serum. These results indicate that under physiologic conditions, serum IgG impairs activation of FcgammaRI-mediated cytotoxicity by conventional antitumor Abs. The IgG blockade can be circumvented with anti-FcgammaRI BsAbs. Using human FcgammaRI transgenic mice we demonstrate that BsAb 22x520C9 is able to engage FcgammaRI in vivo. BsAb 22x520C9 injected i.v. was readily detected on circulating PMN of G-CSF-treated transgenic animals. In addition, we showed that PMN remain "armed" with BsAb 22x520C9 during migration to inflammatory sites, and that after isolation such PMN specifically lyse HER-2/neu-expressing tumor cells. These results point to the possibility of targeting anti-FcgammaRI BsAbs to G-CSF-primed PMN in vivo, endowing them with specific anti-tumor activity.
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Affiliation(s)
- I A Heijnen
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - L J Rijks
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - A Schiel
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - B Stockmeyer
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - H H van Ojik
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - M Dechant
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - T Valerius
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - T Keler
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - A L Tutt
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - M J Glennie
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - E A van Royen
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - P J Capel
- Department of Immunology, University Hospital Utrecht, The Netherlands
| | - J G van de Winkel
- Department of Immunology, University Hospital Utrecht, The Netherlands
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van Ojik HH, Repp R, Groenewegen G, Valerius T, van de Winkel JG. Clinical evaluation of the bispecific antibody MDX-H210 (anti-Fc gamma RI x anti-HER-2/neu) in combination with granulocyte-colony-stimulating factor (filgrastim) for treatment of advanced breast cancer. Cancer Immunol Immunother 1997; 45:207-9. [PMID: 9435875 PMCID: PMC11037793 DOI: 10.1007/s002620050434] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- H H van Ojik
- Department of Internal Medicine, University Hospital, Utrecht, The Netherlands
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