Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Universidad de Navarra, 31008 Pamplona, Spain.
Centro de Investigación Biomédica en Red de Cáncer, 28029 Madrid, Spain.
Proc Natl Acad Sci U S A. 2021 Jun 29;118(26). doi: 10.1073/pnas.2025930118.
Costimulation via CD137 (4-1BB) enhances antitumor immunity mediated by cytotoxic T lymphocytes. Anti-CD137 agonist antibodies elicit mild liver inflammation in mice, and the maximum tolerated dose of Urelumab, an anti-human CD137 agonist monoclonal antibody, in the clinic was defined by liver inflammation-related side effects. A protease-activated prodrug form of the anti-mouse CD137 agonist antibody 1D8 (1D8 Probody therapeutic, Pb-Tx) was constructed and found to be selectively activated in the tumor microenvironment. This construct, which encompasses a protease-cleavable linker holding in place a peptide that masks the antigen binding site, exerted antitumor effects comparable to the unmodified antibody but did not result in liver inflammation. Moreover, it efficaciously synergized with both PD-1 blockade and adoptive T-cell therapy. Surprisingly, minimal active Pb-Tx reached tumor-draining lymph nodes, and regional lymphadenectomy did not abrogate antitumor efficacy. By contrast, S1P receptor-dependent recirculation of T cells was absolutely required for efficacy. The preferential cleavage of the anti-CD137 Pb-Tx by tumor proteases offers multiple therapeutic opportunities, including neoadjuvant therapy, as shown by experiments in which the Pb-Tx is given prior to surgery to avoid spontaneous metastases.
CD137(4-1BB)共刺激增强了细胞毒性 T 淋巴细胞介导的抗肿瘤免疫。抗 CD137 激动剂抗体在小鼠中引起轻微的肝炎症,而 Urelumab(一种抗人 CD137 激动剂单克隆抗体)在临床中的最大耐受剂量是由肝炎症相关的副作用定义的。构建了一种抗小鼠 CD137 激动剂抗体 1D8 的蛋白酶激活前药形式(1D8 Probody 治疗剂,Pb-Tx),并发现其在肿瘤微环境中被选择性激活。该构建体包含一个可被蛋白酶切割的连接子,其中包含一个肽,该肽掩盖了抗原结合位点,其抗肿瘤作用与未修饰的抗体相当,但不会导致肝炎症。此外,它与 PD-1 阻断和过继性 T 细胞治疗具有协同作用。令人惊讶的是,很少量的有效 Pb-Tx 到达肿瘤引流淋巴结,而区域淋巴结切除术并不能消除抗肿瘤疗效。相比之下,T 细胞的 S1P 受体依赖性再循环对于疗效是绝对必需的。肿瘤蛋白酶对抗 CD137 Pb-Tx 的优先切割提供了多种治疗机会,包括新辅助治疗,如实验中在手术前给予 Pb-Tx 以避免自发转移。
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