BioAtla, Inc., San Diego, CA 92121.
Stanford University School of Medicine, Stanford University, Stanford, CA 94305
Proc Natl Acad Sci U S A. 2021 Mar 2;118(9). doi: 10.1073/pnas.2020606118.
Anticytotoxic T lymphocyte-associated protein 4 (CTLA4) antibodies have shown potent antitumor activity, but systemic immune activation leads to severe immune-related adverse events, limiting clinical usage. We developed novel, conditionally active biologic (CAB) anti-CTLA4 antibodies that are active only in the acidic tumor microenvironment. In healthy tissue, this binding is reversibly inhibited by a novel mechanism using physiological chemicals as protein-associated chemical switches (PaCS). No enzymes or potentially immunogenic covalent modifications to the antibody are required for activation in the tumor. The novel anti-CTLA4 antibodies show similar efficacy in animal models compared to an analog of a marketed anti-CTLA4 biologic, but have markedly reduced toxicity in nonhuman primates (in combination with an anti-PD1 checkpoint inhibitor), indicating a widened therapeutic index (TI). The PaCS encompass mechanisms that are applicable to a wide array of antibody formats (e.g., ADC, bispecifics) and antigens. Examples shown here include antibodies to EpCAM, Her2, Nectin4, CD73, and CD3. Existing antibodies can be engineered readily to be made sensitive to PaCS, and the inhibitory activity can be optimized for each antigen's varying expression level and tissue distribution. PaCS can modulate diverse physiological molecular interactions and are applicable to various pathologic conditions, enabling differential CAB antibody activities in normal versus disease microenvironments.
细胞毒性 T 淋巴细胞相关蛋白 4(CTLA4)抗体具有很强的抗肿瘤活性,但全身免疫激活会导致严重的免疫相关不良反应,限制了其临床应用。我们开发了新型的、条件激活的生物(CAB)抗 CTLA4 抗体,仅在酸性肿瘤微环境中具有活性。在健康组织中,这种结合通过一种使用生理化学物质作为蛋白相关化学开关(PaCS)的新型机制可逆地被抑制。在肿瘤中激活不需要酶或潜在的免疫原性抗体的共价修饰。与一种市售的抗 CTLA4 生物类似物相比,新型抗 CTLA4 抗体在动物模型中显示出相似的疗效,但在非人类灵长类动物(与抗 PD1 检查点抑制剂联合使用)中毒性明显降低,表明治疗指数(TI)加宽。PaCS 包含适用于广泛的抗体形式(例如 ADC、双特异性抗体)和抗原的机制。这里显示的例子包括针对 EpCAM、Her2、Nectin4、CD73 和 CD3 的抗体。现有的抗体可以很容易地被工程化以对 PaCS 敏感,并且可以针对每个抗原的不同表达水平和组织分布来优化抑制活性。PaCS 可以调节多种生理分子相互作用,适用于各种病理状况,从而在正常和疾病微环境中使 CAB 抗体的活性产生差异。
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