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靶向CLEVER-1的抗体bexmarilimab可支持HLA-DR表达,并改变骨髓恶性肿瘤对阿扎胞苷和维奈克拉的体外反应性。

CLEVER-1 targeting antibody, bexmarilimab, supports HLA-DR expression and alters ex vivo responsiveness to azacitidine and venetoclax in myeloid malignancies.

作者信息

Aakko Sofia, Ylitalo Arno, Kuusanmäki Heikki, Rannikko Jenna H, Björkman Mari, Mandelin Jami, Heckman Caroline A, Kontro Mika, Hollmén Maija

机构信息

Faron Pharmaceuticals Ltd, Turku, Finland.

Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland.

出版信息

Sci Rep. 2025 May 14;15(1):16775. doi: 10.1038/s41598-025-01675-y.

Abstract

Treatment of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) requires new therapy options, especially for patients uneligible for intense chemotherapy or with relapsed or refractory disease. CLEVER-1 is a myeloid checkpoint protein, which can be targeted with a therapeutic function blocking antibody, bexmarilimab. Bexmarilimab has shown clinical efficacy in different solid tumors. Here, we show preclinical data demonstrating expression of CLEVER-1 on immature malignant myeloid cells and their derivates in MDS and AML bone marrow samples and AML cell lines. Highest CLEVER-1 levels were observed in AML with monocytic differentiation. Ex vivo treatment of AML/MDS bone marrow samples with bexmarilimab led to an increase in antigen-presenting human leukocyte antigen DR isotype (HLA-DR) molecule expression. Combination of bexmarilimab with current standard-of-care (SoC) drugs, azacitidine and venetoclax, showed potential for HLA-DR induction and enhanced killing of leukemic cells, respectively. Our non-clinical findings support the feasibility of CLEVER-1 inhibition in AML/MDS to induce antigen presentating molecule expression and potentially, an anti-leukemic effect together with SoC. Therapeutic targeting of CLEVER-1 with bexmarilimab is currently undergoing clinical investigation in the BEXMAB trial (NCT05428969).

摘要

骨髓增生异常综合征(MDS)和急性髓系白血病(AML)的治疗需要新的治疗方案,尤其是对于不符合强化化疗条件或患有复发或难治性疾病的患者。CLEVER-1是一种髓系检查点蛋白,可被具有治疗功能阻断作用的抗体bexmarilimab靶向作用。Bexmarilimab已在不同实体瘤中显示出临床疗效。在此,我们展示临床前数据,证明CLEVER-1在MDS和AML骨髓样本以及AML细胞系中的未成熟恶性髓系细胞及其衍生物上表达。在具有单核细胞分化的AML中观察到最高的CLEVER-1水平。用bexmarilimab对AML/MDS骨髓样本进行体外处理导致抗原呈递人类白细胞抗原DR同种型(HLA-DR)分子表达增加。Bexmarilimab与当前标准治疗(SoC)药物阿扎胞苷和维奈克拉联合使用,分别显示出诱导HLA-DR表达和增强杀伤白血病细胞的潜力。我们的非临床研究结果支持在AML/MDS中抑制CLEVER-1以诱导抗原呈递分子表达以及潜在地与SoC一起产生抗白血病作用的可行性。目前,在BEXMAB试验(NCT05428969)中正在对用bexmarilimab治疗性靶向CLEVER-1进行临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2342/12078569/448634b194c0/41598_2025_1675_Fig5_HTML.jpg

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