Research & Development, Affimed GmbH, Heidelberg, Germany.
Formerly Affimed GmbH, Heidelberg, Germany. Now: Arjuna Therapeutics, Santiago De Compostela, Spain.
MAbs. 2021 Jan-Dec;13(1):1950264. doi: 10.1080/19420862.2021.1950264.
Epidermal growth factor receptor (EGFR)-targeted cancer therapy such as anti-EGFR monoclonal antibodies and tyrosine kinase inhibitors have demonstrated clinical efficacy. However, there remains a medical need addressing limitations of these therapies, which include a narrow therapeutic window mainly due to skin and organ toxicity, and primary and secondary resistance mechanisms of the EGFR-signaling cascade (e.g., RAS-mutated colorectal cancer). Using the redirected optimized cell killing (ROCK®) antibody platform, we have developed AFM24, a novel bispecific, IgG-scFv fusion antibody targeting CD16A on innate immune cells, and EGFR on tumor cells. We herein demonstrate binding of AFM24 to CD16A on natural killer (NK) cells and macrophages with values in the low nanomolar range and to various EGFR-expressing tumor cells. AFM24 was highly potent and effective for antibody-dependent cell-mediated cytotoxicity via NK cells, and also mediated antibody-dependent cellular phagocytosis via macrophages . Importantly, AFM24 was effective toward a variety of EGFR-expressing tumor cells, regardless of EGFR expression level and KRAS/BRAF mutational status. , AFM24 was well tolerated up to the highest dose (75 mg/kg) when administered to cynomolgus monkeys once weekly for 28 days. Notably, skin and other toxicities were not observed. A transient elevation of interleukin-6 levels was detected at all dose levels, 2-4 hours post-dose, which returned to baseline levels after 24 hours. These results emphasize the promise of bispecific innate cell engagers as an alternative cancer therapy and demonstrate the potential for AFM24 to effectively target tumors expressing varying levels of EGFR, regardless of their mutational status. ADA: antidrug antibody; ADCC: antibody-dependent cell-mediated cytotoxicity; ADCP: antibody-dependent cellular phagocytosis; AUC: area under the curve; CAR: chimeric-antigen receptor; CD: Cluster of differentiation; CRC :colorectal cancer; ECD: extracellular domain; EGF: epidermal growth factorEGFR epidermal growth factor receptor; ELISA: enzyme-linked immunosorbent assay; FACS: fluorescence-activated cell sorting; Fc: fragment, crystallizableFv variable fragment; HNSCC: head and neck squamous carcinomaIL interleukinm; Ab monoclonal antibody; MOA: mechanism of action; NK :natural killer; NSCLC: non-small cell lung cancer; PBMC: peripheral blood mononuclear cell; PBS: phosphate-buffered saline; PD: pharmacodynamic; ROCK: redirected optimized cell killing; RSV: respiratory syncytial virus; SABC: specific antibody binding capacity; SD: standard deviation; TAM: tumor-associated macrophage; TKI: tyrosine kinase inhibitor; WT: wildtype.
表皮生长因子受体 (EGFR)-靶向癌症疗法,如抗 EGFR 单克隆抗体和酪氨酸激酶抑制剂,已显示出临床疗效。然而,这些疗法仍存在一些局限性,需要进一步研究,其中包括治疗窗口狭窄,主要是由于皮肤和器官毒性,以及 EGFR 信号级联的原发性和继发性耐药机制(例如,RAS 突变的结直肠癌)。我们使用定向优化细胞杀伤(ROCK®)抗体平台,开发了一种新型双特异性 IgG-scFv 融合抗体 AFM24,该抗体靶向天然免疫细胞上的 CD16A 和肿瘤细胞上的 EGFR。我们在此证明 AFM24 与 NK 细胞和巨噬细胞上的 CD16A 结合, 值在纳摩尔范围内,与各种表达 EGFR 的肿瘤细胞结合。AFM24 对 NK 细胞介导的抗体依赖性细胞介导的细胞毒性非常有效,也对巨噬细胞介导的抗体依赖性细胞吞噬作用有效。重要的是,无论 EGFR 表达水平和 KRAS/BRAF 突变状态如何,AFM24 对各种表达 EGFR 的肿瘤细胞均有效。在给食蟹猴每周一次给药 28 天,最高剂量(75mg/kg)时,AFM24 耐受性良好。值得注意的是,未观察到皮肤和其他毒性。在所有剂量水平下,给药后 2-4 小时检测到白细胞介素 6 水平短暂升高,24 小时后恢复基线水平。这些结果强调了双特异性天然细胞衔接子作为替代癌症疗法的前景,并证明了 AFM24 有效靶向表达不同水平 EGFR 的肿瘤的潜力,无论其突变状态如何。ADA:抗药物抗体;ADCC:抗体依赖性细胞介导的细胞毒性;ADCP:抗体依赖性细胞吞噬作用;AUC:曲线下面积;CAR:嵌合抗原受体;CD:分化群;CRC:结直肠癌;ECD:细胞外结构域;EGF:表皮生长因子;EGFR:表皮生长因子受体;ELISA:酶联免疫吸附试验;FACS:荧光激活细胞分选;Fc:片段可结晶;Fv:可变片段;HNSCC:头颈部鳞状细胞癌;IL:白细胞介素;mAb:单克隆抗体;MOA:作用机制;NK:自然杀伤;NSCLC:非小细胞肺癌;PBMC:外周血单核细胞;PBS:磷酸盐缓冲盐水;PD:药效学;ROCK:定向优化细胞杀伤;RSV:呼吸道合胞病毒;SABC:特异性抗体结合能力;SD:标准差;TAM:肿瘤相关巨噬细胞;TKI:酪氨酸激酶抑制剂;WT:野生型。
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