MGD011, A CD19 x CD3 Dual-Affinity Retargeting Bi-specific Molecule Incorporating Extended Circulating Half-life for the Treatment of B-Cell Malignancies

Purpose: CD19, a B-cell lineage-specific marker, is highly represented in B-cell malignancies and an attractive target for therapeutic interventions. MGD011 is a CD19 x CD3 DART bispecific protein designed to redirect T lymphocytes to eliminate CD19-expressing cells. MGD011 has been engineered with a modified human Fc domain for improved pharmacokinetic (PK) properties and designed to cross-react with the corresponding antigens in cynomolgus monkeys. Here, we report on the preclinical activity, safety and PK properties of MGD011. Experimental Design: The activity of MGD011 was evaluated in several in vitro and in vivo models. PK, safety and pharmacodynamic activity was also assessed in dose-escalation and repeat-dose studies of MGD011 administered once weekly in cynomolgus monkeys. Results: MGD011 mediated killing of human B-cell lymphoma lines by human or cynomolgus monkey PBMCs as well as autologous B-cell depletion in PBMCs from both species. MGD011-mediated killing was accompanied by target-dependent T-cell activation and expansion, cytokine release and upregulation of perforin and granzyme B. MGD011 demonstrated antitumor activity against localized and disseminated lymphoma xenografts reconstituted with human PBMCs. In cynomolgus monkeys, MGD011 displayed a terminal half-life of 6.7 days; once weekly intravenous infusion of MGD011 at doses up to 100 μg/kg, the highest dose tested, was well tolerated and resulted in dose-dependent, durable decreases in circulating B cells accompanied by profound reductions of B lymphocytes in lymphoid organs. Conclusions: The preclinical activity, safety and PK profile support clinical investigation of MGD011 as a therapeutic candidate for the treatment of B-cell malignancies. Clin Cancer Res; 23(6); 1506–18. ©2016 AACR.

[1]  H. Liao,et al.  Dual-Affinity Re-Targeting proteins direct T cell-mediated cytolysis of latently HIV-infected cells. , 2015, The Journal of clinical investigation.

[2]  P. Moore,et al.  Targeting HIV Reservoir in Infected CD4 T Cells by Dual-Affinity Re-targeting Molecules (DARTs) that Bind HIV Envelope and Recruit Cytotoxic T Cells , 2015, PLoS pathogens.

[3]  P. Moore,et al.  A CD3xCD123 bispecific DART for redirecting host T cells to myelogenous leukemia: Preclinical activity and safety in nonhuman primates , 2015, Science Translational Medicine.

[4]  D. Nagorsen,et al.  Unleashing the clinical power of T cells: CD19/CD3 bi-specific T cell engager (BiTE®) antibody construct blinatumomab as a potential therapy. , 2015, International immunology.

[5]  C. Fegan,et al.  Blinatumomab induces autologous T-cell killing of chronic lymphocytic leukemia cells , 2013, Haematologica.

[6]  Y. Oki,et al.  Developing novel strategies to target B-cell malignancies. , 2013, American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting.

[7]  Delong Liu,et al.  CD19: a biomarker for B cell development, lymphoma diagnosis and therapy , 2012, Experimental Hematology & Oncology.

[8]  K. Haas,et al.  A c-Myc and Surface CD19 Signaling Amplification Loop Promotes B Cell Lymphoma Development and Progression in Mice , 2012, The Journal of Immunology.

[9]  O. Hammer CD19 as an attractive target for antibody-based therapy , 2012, mAbs.

[10]  Andreas Wolf,et al.  Immunopharmacologic response of patients with B-lineage acute lymphoblastic leukemia to continuous infusion of T cell-engaging CD19/CD3-bispecific BiTE antibody blinatumomab. , 2012, Blood.

[11]  W. Wilson,et al.  Treatment-Induced Oxidative Stress and Cellular Antioxidant Capacity Determine Response to Bortezomib in Mantle Cell Lymphoma , 2011, Clinical Cancer Research.

[12]  P. Moore,et al.  Application of dual affinity retargeting molecules to achieve optimal redirected T-cell killing of B-cell lymphoma. , 2011, Blood.

[13]  J. Timmer,et al.  untreated indolent B-cell lymphoma and very early CLL Definition and characterization of the systemic T-cell dysregulation in , 2011 .

[14]  P. Moore,et al.  Effector cell recruitment with novel Fv-based dual-affinity re-targeting protein leads to potent tumor cytolysis and in vivo B-cell depletion. , 2010, Journal of molecular biology.

[15]  J. Byrd,et al.  Chronic lymphocytic leukemia T cells show impaired immunological synapse formation that can be reversed with an immunomodulating drug. , 2008, The Journal of clinical investigation.

[16]  P. Kufer,et al.  T-cell activation and B-cell depletion in chimpanzees treated with a bispecific anti-CD19/anti-CD3 single-chain antibody construct , 2006, Cancer Immunology, Immunotherapy.

[17]  M. Kalos,et al.  Development and application of CD19-specific T cells for adoptive immunotherapy of B cell malignancies. , 2004, Blood cells, molecules & diseases.

[18]  P. Lydyard,et al.  Expansion of CD4+ T cells with a cytotoxic phenotype in patients with B‐chronic lymphocytic leukaemia (B‐CLL) , 2001, Clinical and experimental immunology.

[19]  P. Parren,et al.  In vitro characterization of five humanized OKT3 effector function variant antibodies. , 2000, Cellular immunology.

[20]  N. Ling,et al.  Preclinical studies with the anti-CD19-saporin immunotoxin BU12-SAPORIN for the treatment of human-B-cell tumours. , 1995, British Journal of Cancer.

[21]  D. Kranz,et al.  Partial elucidation of an anti-hapten repertoire in BALB/c mice: comparative characterization of several monoclonal anti-fluorescyl antibodies. , 1981, Molecular immunology.