1. Bifunctional PD-1 × αCD3 × αCD33 fusion protein reverses adaptive immune escape in acute myeloid leukemia
- Author
-
Marion Subklewe, Bettina Brauchle, Christina Krupka, Nadja C. Fenn, Ana Ogrinc Wagner, Felicitas Rataj, Katrin Deiser, Sebastian Kobold, Karsten Spiekermann, Monika Herrmann, Anetta Marcinek, Klaus H. Metzeler, Ralph Mocikat, and Karl-Peter Hopfner
- Subjects
0301 basic medicine ,Cell cycle checkpoint ,Myeloid ,CD3 Complex ,Recombinant Fusion Proteins ,Programmed Cell Death 1 Receptor ,Sialic Acid Binding Ig-like Lectin 3 ,Immunology ,CD33 ,Adaptive Immunity ,Biochemistry ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Mice, Inbred NOD ,Cell Line, Tumor ,medicine ,Animals ,Humans ,biology ,Chemistry ,Myeloid leukemia ,Cell Biology ,Hematology ,medicine.disease ,Xenograft Model Antitumor Assays ,Immune checkpoint ,Neoplasm Proteins ,Leukemia, Myeloid, Acute ,Cytolysis ,Leukemia ,HEK293 Cells ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,biology.protein ,Cancer research ,Antibody ,Single-Chain Antibodies - Abstract
The CD33-targeting bispecific T-cell engager (BiTE) AMG 330 proved to be highly efficient in mediating cytolysis of acute myeloid leukemia (AML) cells in vitro and in mouse models. Yet, T-cell activation is correlated with upregulation of programmed cell death-ligand 1 (PD-L1) and other inhibitory checkpoints on AML cells that confer adaptive immune resistance. PD-1 and PD-L1 blocking agents may counteract T-cell dysfunction, however, at the expense of broadly distributed immune-related adverse events (irAEs). We developed a bifunctional checkpoint inhibitory T cell–engaging (CiTE) antibody that combines T-cell redirection to CD33 on AML cells with locally restricted immune checkpoint blockade. This is accomplished by fusing the extracellular domain of PD-1 (PD-1ex), which naturally holds a low affinity to PD-L1, to an αCD3.αCD33 BiTE-like scaffold. By a synergistic effect of checkpoint blockade and avidity-dependent binding, the PD-1ex attachment increases T-cell activation (3.3-fold elevation of interferon-γ) and leads to efficient and highly selective cytotoxicity against CD33+PD-L1+ cell lines (50% effective concentration = 2.3-26.9 pM) as well as patient-derived AML cells (n = 8). In a murine xenograft model, the CiTE induces complete AML eradication without initial signs of irAEs as measured by body weight loss. We conclude that our molecule preferentially targets AML cells, whereas high-affinity blockers, such as clinically approved anticancer agents, also address PD-L1+ non-AML cells. By combining the high efficacy of T-cell engagers with immune checkpoint blockade in a single molecule, we expect to minimize irAEs associated with the systemic application of immune checkpoint inhibitors and suggest high therapeutic potential, particularly for patients with relapsed/ refractory AML.
- Published
- 2018