Xilio Therapeutics, Waltham, Massachusetts, USA
Molecular Medicine, City of Hope National Medical Center, Beckman Research Institute, Duarte, California, USA.
J Immunother Cancer. 2023 Dec 12;11(12):e007785. doi: 10.1136/jitc-2023-007785.
The clinical benefit of the anti-CTLA-4 monoclonal antibody (mAb) ipilimumab has been well established but limited by immune-related adverse events, especially when ipilimumab is used in combination with anti-PD-(L)1 mAb therapy. To overcome these limitations, we have developed XTX101, a tumor-activated, Fc-enhanced anti-CTLA-4 mAb.
XTX101 consists of an anti-human CTLA-4 mAb covalently linked to masking peptides that block the complementarity-determining regions, thereby minimizing the mAb binding to CTLA-4. The masking peptides are designed to be released by proteases that are typically dysregulated within the tumor microenvironment (TME), resulting in activation of XTX101 intratumorally. Mutations within the Fc region of XTX101 were included to enhance affinity for FcγRIII, which is expected to enhance potency through antibody-dependent cellular cytotoxicity.
Biophysical, biochemical, and cell-based assays demonstrate that the function of XTX101 depends on proteolytic activation. In human CTLA-4 transgenic mice, XTX101 monotherapy demonstrated significant tumor growth inhibition (TGI) including complete responses, increased intratumoral CD8+T cells, and regulatory T cell depletion within the TME while maintaining minimal pharmacodynamic effects in the periphery. XTX101 in combination with anti-PD-1 mAb treatment resulted in significant TGI and was well tolerated in mice. XTX101 was activated in primary human tumors across a range of tumor types including melanoma, renal cell carcinoma, colon cancer and lung cancer in an ex vivo assay system.
These data demonstrate that XTX101 retains the full potency of an Fc-enhanced CTLA-4 antagonist within the TME while minimizing the activity in non-tumor tissue, supporting the further evaluation of XTX101 in clinical studies.
抗 CTLA-4 单克隆抗体(mAb)伊匹单抗的临床获益已得到充分证实,但受免疫相关不良事件的限制,尤其是当伊匹单抗与抗 PD-(L)1 mAb 联合治疗时。为了克服这些限制,我们开发了 XTX101,一种肿瘤激活的、Fc 增强的抗 CTLA-4 mAb。
XTX101 由与人 CTLA-4 结合的抗 CTLA-4 mAb 组成,通过与封闭互补决定区的掩蔽肽共价连接,从而最大程度地减少 mAb 与 CTLA-4 的结合。掩蔽肽设计为在肿瘤微环境(TME)中通常失调的蛋白酶所释放,从而导致 XTX101 在肿瘤内激活。XTX101 的 Fc 区的突变被包括在内,以增强对 FcγRIII 的亲和力,这有望通过抗体依赖性细胞毒性增强效力。
生物物理、生化和基于细胞的测定表明,XTX101 的功能取决于蛋白水解激活。在人 CTLA-4 转基因小鼠中,XTX101 单药治疗显示出显著的肿瘤生长抑制(TGI),包括完全缓解,增加肿瘤内 CD8+T 细胞和 TME 中的调节性 T 细胞耗竭,同时在外周保持最小的药效学作用。XTX101 与抗 PD-1 mAb 联合治疗在小鼠中显示出显著的 TGI 且耐受性良好。在包括黑色素瘤、肾细胞癌、结肠癌和肺癌在内的一系列肿瘤类型的原发性人类肿瘤中,XTX101 在体外检测系统中被激活。
这些数据表明,XTX101 在 TME 中保留了 Fc 增强的 CTLA-4 拮抗剂的全部效力,同时最大限度地减少了非肿瘤组织中的活性,支持在临床研究中进一步评估 XTX101。