Micromet Inc., Bethesda, MD, USA.
MAbs. 2011 Jan-Feb;3(1):31-7. doi: 10.4161/mabs.3.1.14193. Epub 2011 Jan 1.
Ectodomains of target antigens for antibody-based therapies can be shed from the target cell surface and found in sera of patients. Shed ectodomains of therapeutic targets not only pose the risk of sequestering therapeutic antibodies but, in a multimeric form, of triggering T cell activation by bispecific antibodies binding to CD3 on T cells. Recently, epithelial cell adhesion molecule (EpCAM) has been shown to be activated by release of its ectodomain, called EpEX. Here, we show that only very low amounts of EpEX are detectable in sera of cancer patients. Among 100 cancer patient samples tested, only 17 (17%) showed serum levels of EpEX in excess of 0.05 ng/ml with highest EpEX concentrations of 5.29, 1.37 and 0.52 ng/ml. A recombinant form of human EpEX (recEpEX) was produced to assess its possible effect on redirected lysis and T cell activation by EpCAM/CD3-bispecific BiTE antibody MT110, currently being tested in patients with solid tumor malignancies. RecEpEX had a very minor effect on redirected lysis by MT110 with an approximate IC 50 value of 3,000 ng/ml, which is a concentration close to three orders of magnitude higher than the highest EpEX concentration found in cancer patients. Concentrations of 30 ng/ml EpEX in combination with 250 ng/ml MT110 were minimally required to induce a detectable activation of CD4 (+) and CD8 (+) T cells. We conclude that soluble EpEX in sera of cancer patients is unlikely to pose an issue for the efficacy or safety of MT110, and perhaps other antibodies binding to N-terminal epitopes of EpCAM.
抗体治疗的靶抗原的外显子域可以从靶细胞表面脱落,并在患者的血清中发现。治疗靶点的脱落外显子不仅存在与治疗性抗体结合的风险,而且在多聚体形式下,还存在与双特异性抗体结合的 CD3 触发 T 细胞激活的风险。最近,已证实上皮细胞黏附分子(EpCAM)通过其外显子域 EpEX 的释放而被激活。在这里,我们显示只有非常低量的 EpEX 可在癌症患者的血清中检测到。在测试的 100 个癌症患者样本中,只有 17 个(17%)的患者血清 EpEX 水平超过 0.05ng/ml,最高 EpEX 浓度分别为 5.29、1.37 和 0.52ng/ml。产生了人 EpEX 的重组形式(recEpEX),以评估其对 EpCAM/CD3 双特异性 BiTE 抗体 MT110 重定向溶解和 T 细胞激活的可能影响,该抗体目前正在实体瘤恶性肿瘤患者中进行测试。recEpEX 对 MT110 的重定向溶解仅有很小的影响,近似 IC 50 值为 3000ng/ml,这一浓度接近癌症患者中发现的最高 EpEX 浓度的三个数量级。在与 250ng/ml MT110 联合使用时,仅需 30ng/ml EpEX 浓度即可检测到 CD4(+)和 CD8(+)T 细胞的可检测激活。我们得出结论,癌症患者血清中的可溶性 EpEX 不太可能对 MT110 的疗效或安全性构成问题,也许对其他结合 EpCAM N 端表位的抗体也是如此。