Research and Development, Medicenna Therapeutics Inc, Toronto, Ontario, Canada.
Biologics Consulting Group Inc, Alexandria, Virginia, USA.
J Immunother Cancer. 2022 Jan;10(1). doi: 10.1136/jitc-2021-003155.
BACKGROUND: Recombinant human interleukin-2 (rhIL-2, aldesleukin) is Food and Drug Administration approved for the treatment of metastatic melanoma and renal cell carcinoma and has achieved durable response in a subset of patients. However, its utility as an immunotherapeutic drug is limited by undesirable activation of immune suppressive regulatory T cells (Tregs) and a short half-life requiring frequent high dose administration, leading to unacceptable toxicities. We have engineered MDNA11, a long-acting IL-2 superkine, to overcome these limitations by (1) modifying receptor selectivity in favor of anti-cancer immune cells to increase therapeutic efficacy and (2) fusion to human albumin to extend the pharmacokinetic (PK) profile, circumventing the need for frequent dosing. METHODS: MDNA11 was evaluated using in vitro and in vivo studies including: binding analyses to measure receptor affinity, IL-2 pathway signaling, PK studies in mice, and efficacy studies in syngeneic tumor models as single agent and in combination with immune checkpoint inhibitors. Finally, the safety and pharmacodynamic profile of MDNA11 was assessed in non-human primate (NHP). RESULTS: Binding studies with MDNA11 demonstrated increased affinity for IL-2Rβ (CD122) and no binding to IL-2Rα (CD25). As a result, MDNA11 exhibits reduced/limited Treg stimulation while triggering an enhanced activation of natural killer and naïve CD8 T cells compared with rhIL-2. When administered to animals with pre-established tumors, MDNA11 controlled tumor growth in a monotherapy setting and in combination with anti-PD1 or anti-CTLA4 to induce durable tumor clearance with a once weekly dosing regimen. In a NHP model, MDNA11 was well tolerated while triggering durable and potent immune responses including expansion of lymphocytes without significant effect on Tregs and eosinophils, the latter been linked to an increased risk of vascular leak syndrome. CONCLUSION: MDNA11 is a next generation long-acting IL-2 immunotherapeutic with a highly favorable pharmacodynamic profile that translates to a strong therapeutic efficacy in preclinical tumor models and a strong and durable immune response in NHP.
背景:重组人白细胞介素-2(rhIL-2,阿地白介素)已获得美国食品和药物管理局批准用于治疗转移性黑色素瘤和肾细胞癌,并在部分患者中取得了持久的缓解效果。然而,由于其免疫抑制调节性 T 细胞(Tregs)的不良激活和半衰期短,需要频繁给予高剂量,导致不可接受的毒性,其作为免疫治疗药物的应用受到限制。我们通过(1)修饰受体选择性,有利于抗癌免疫细胞,以提高治疗效果;(2)与人白蛋白融合,延长药代动力学(PK)特征,从而克服了这些限制,构建了长效白细胞介素-2 超级激动剂 MDNA11。 方法:采用体外和体内研究评价 MDNA11,包括:结合分析以测量受体亲和力、白细胞介素-2 通路信号、小鼠 PK 研究以及在同种异体肿瘤模型中作为单一药物和与免疫检查点抑制剂联合使用的疗效研究。最后,在非人类灵长类动物(NHP)中评估 MDNA11 的安全性和药效学特征。 结果:MDNA11 的结合研究表明,其对白细胞介素-2Rβ(CD122)的亲和力增加,而对白细胞介素-2Rα(CD25)无结合。因此,与 rhIL-2 相比,MDNA11 可减少/限制 Treg 的刺激,同时增强自然杀伤细胞和幼稚 CD8 T 细胞的激活。在预先建立肿瘤的动物中给予 MDNA11 治疗时,MDNA11 在单药治疗和与抗 PD1 或抗 CTLA4 联合治疗中控制肿瘤生长,诱导持久的肿瘤清除,每周一次给药。在 NHP 模型中,MDNA11 具有良好的耐受性,同时引发持久而有效的免疫反应,包括淋巴细胞的扩增,而对 Tregs 和嗜酸性粒细胞没有显著影响,后者与血管渗漏综合征的风险增加有关。 结论:MDNA11 是一种新型长效白细胞介素-2 免疫治疗药物,具有高度有利的药效学特征,可在临床前肿瘤模型中转化为强大的治疗效果,并在 NHP 中产生强大而持久的免疫反应。
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