Department of Surgery, Laboratory for Translational Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Surgery, Laboratory for Translational Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
J Immunother Cancer. 2023 Sep;11(9). doi: 10.1136/jitc-2023-006837.
BACKGROUND: CD73 is an ecto-enzyme that is involved in the conversion of pro-inflammatory extracellular ATP (eATP) excreted by cancer cells under stress to anti-inflammatory adenosine (ADO). A broad variety of solid cancer types was shown to exploit CD73 overexpression as a suppressive immune checkpoint. Consequently, CD73-antagonistic antibodies, most notably oleclumab, are currently evaluated in several multicenter trials for clinical applicability. However, the efficacy of conventional monospecific CD73-inhibiting antibodies may be limited due to on-target/off-tumor binding to CD73 on normal cells. Therefore, a novel approach that more selectively directs CD73 immune checkpoint inhibition towards cancer cells is warranted.
METHODS: To address this issue, we constructed a novel tetravalent bispecific antibody (bsAb), designated bsAb CD73xEGFR. Subsequently, the anticancer activities of bsAb CD73xEGFR were evaluated using in vitro and in vivo tumor models.
RESULTS: In vitro treatment of various carcinoma cell types with bsAb CD73xEGFR potently inhibited the enzyme activity of CD73 (71%) in an EGFR-directed manner. In this process, bsAb CD73xEGFR induced rapid internalization of antigen/antibody complexes, which resulted in a prolonged concurrent displacement of both CD73 and EGFR from the cancer cell surface. In addition, bsAb CD73xEGFR sensitized cancer to the cytotoxic activity of various chemotherapeutic agents and potently inhibited the proliferative/migratory capacity (40%) of cancer cells. Unexpectedly, we uncovered that treatment of carcinoma cells with oleclumab appeared to enhance several pro-oncogenic features, including upregulation and phosphorylation of EGFR, tumor cell proliferation (20%), and resistance towards cytotoxic agents and ionizing radiation (39%). Importantly, in a tumor model using immunocompetent BALB/c mice inoculated with syngeneic CD73/EGFR CT26 cancer cells, treatment with bsAb CD73xEGFR outperformed oleclumab (65% vs 31% tumor volume reduction). Compared with oleclumab, treatment with bsAb CD73xEGFR enhanced the intratumoral presence of CD8 T cells and M1 macrophages.
CONCLUSIONS: BsAb CD73xEGFR outperforms oleclumab as it inhibits the CD73/ADO immune checkpoint in an EGFR-directed manner and concurrently counteracts several oncogenic activities of EGFR and CD73. Therefore, bsAb CD73xEGFR may be of significant clinical potential for various forms of difficult-to-treat solid cancer types.
背景:CD73 是一种细胞外酶,参与将癌细胞在应激下分泌的促炎细胞外三磷酸腺苷(eATP)转化为抗炎腺苷(ADO)。广泛的实体瘤类型被证明利用 CD73 过表达作为抑制性免疫检查点。因此,CD73 拮抗抗体,特别是 oleclumab,目前正在多项多中心临床试验中评估其临床适用性。然而,由于常规的单特异性 CD73 抑制抗体可能与正常细胞上的 CD73 发生脱靶/肿瘤外结合,因此针对癌症细胞更具选择性地靶向 CD73 免疫检查点抑制的新方法是必要的。
方法:为了解决这个问题,我们构建了一种新型的四价双特异性抗体(bsAb),命名为 bsAb CD73xEGFR。随后,使用体外和体内肿瘤模型评估 bsAb CD73xEGFR 的抗癌活性。
结果:体外用 bsAb CD73xEGFR 处理各种癌性细胞类型,可强效地以 EGFR 为导向抑制 CD73 的酶活性(约 71%)。在此过程中,bsAb CD73xEGFR 诱导抗原/抗体复合物的快速内化,导致 CD73 和 EGFR 从癌细胞表面的同时持久置换。此外,bsAb CD73xEGFR 使癌症对各种化疗药物的细胞毒性活性敏感,并强效抑制癌细胞的增殖/迁移能力(约 40%)。出乎意料的是,我们发现用 oleclumab 处理癌细胞似乎增强了几种致癌特征,包括 EGFR 的上调和磷酸化、肿瘤细胞增殖(约 20%)以及对细胞毒性药物和电离辐射的耐药性(约 39%)。重要的是,在使用同源 BALB/c 小鼠接种 CD73/EGFR CT26 癌细胞的肿瘤模型中,bsAb CD73xEGFR 的治疗效果优于 oleclumab(肿瘤体积减少 65% vs 31%)。与 oleclumab 相比,bsAb CD73xEGFR 的治疗增强了肿瘤内 CD8 T 细胞和 M1 巨噬细胞的存在。
结论:bsAb CD73xEGFR 优于 oleclumab,因为它以 EGFR 为导向抑制 CD73/ADO 免疫检查点,同时抵消 EGFR 和 CD73 的几种致癌活性。因此,bsAb CD73xEGFR 可能对各种形式的难治性实体瘤具有重要的临床潜力。
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