A mechanistically novel peptide agonist of the IL-7 receptor that addresses limitations of IL-7 cytokine therapy

Interleukin (IL)-7 is broadly active on T-cell populations, and modified versions have been clinically evaluated for a variety of therapeutic applications, including cancer, lymphopenia and infectious diseases; and found to be relatively well-tolerated and biologically active. Here we describe novel IL-7R agonists that are unrelated in structure to IL-7, bind to the receptor subunits differently from IL-7, but closely emulate IL-7 biology. The small size, low structural complexity, and the natural amino acid composition of the pharmacologically active peptide MDK1472 allows facile incorporation into protein structures, such as the IgG2-Fc fusion MDK-703. This molecule possesses properties potentially better suited to therapeutic applications than native IL-7 or its derivatives. We compared these compounds with IL-7 for immune cell selectivity, induction of IL-7R signaling, receptor-mediated internalization, proliferation, and generation of immune cell phenotypes in human and non-human primate (NHP) peripheral blood cells in vitro; and found them to be similar in biological activity to IL-7. In cynomolgus macaques, MDK-703 exhibits a circulating half-life of 46 hr, and produces sustained T-cell expansion characteristic of IL-7 treatment. In the huCD34+-engrafted NSG mouse model of the human immune system, MDK-703 induces an immune cell profile very similar to that generated by IL-7-derived compounds; including the pronounced expansion of memory T-cells, particularly the population of stem-like memory T-cells (Tscm), which may be important for anti-tumor activities reported with IL-7 treatment. Clinical administration of IL-7 and modified variants has been reported to induce anti-drug antibodies (ADAs), including IL-7 neutralizing antibodies. The novel peptide agonist reported here scores very low in predicted immunogenicity, and because the peptide lacks sequence similarity with IL-7, the problematic immunogenic neutralization of endogenous cytokine should not occur.

[1]  Li Wang,et al.  Transgenic expression of IL-7 regulates CAR-T cell metabolism and enhances in vivo persistence against tumor cells , 2022, Scientific Reports.

[2]  Sung-Bae Kim,et al.  Phase 1b/2 study of GX-I7 plus pembrolizumab in patients with refractory or recurrent (R/R) metastatic triple-negative breast cancer (mTNBC): The KEYNOTE-899 Study. , 2022, Journal of Clinical Oncology.

[3]  J. Sosman,et al.  A phase 1b/2a study of safety and efficacy of NT-I7 in combination with anti-PD-L1 (atezolizumab) in patients with anti-PD-1/PD-L1 naïve or relapsed/refractory (R/R) high-risk skin cancers: The phase 1b report. , 2022, Journal of Clinical Oncology.

[4]  W. Leonard,et al.  Role of thymic stromal lymphopoietin in allergy and beyond , 2022, Nature Reviews Immunology.

[5]  Melissa L. Johnson,et al.  404 Initial biomarker and clinical data of a phase 2a study of NT-I7, a long-acting interleukin-7, plus pembrolizumab: cohort of subjects with checkpoint inhibitor-naïve advanced MSS-colorectal cancer , 2021, Journal for ImmunoTherapy of Cancer.

[6]  Su-fang Zhou,et al.  Immunotherapeutic Potential of T Memory Stem Cells , 2021, Frontiers in Oncology.

[7]  Han Wook Park,et al.  Hybrid Fc‐fused interleukin‐7 induces an inflamed tumor microenvironment and improves the efficacy of cancer immunotherapy , 2020, Clinical & translational immunology.

[8]  Se-Hwan Yang,et al.  hIL‐7‐hyFc, A Long‐Acting IL‐7, Increased Absolute Lymphocyte Count in Healthy Subjects , 2020, Clinical and translational science.

[9]  J. Barata,et al.  Flip the coin: IL-7 and IL-7R in health and disease , 2019, Nature Immunology.

[10]  J. Blay,et al.  ELYPSE-7: a randomized placebo-controlled phase IIa trial with CYT107 exploring the restoration of CD4+ lymphocyte count in lymphopenic metastatic breast cancer patients. , 2018, Annals of oncology : official journal of the European Society for Medical Oncology.

[11]  M. Lederman,et al.  Repeated Cycles of Recombinant Human Interleukin 7 in HIV-Infected Patients With Low CD4 T-Cell Reconstitution on Antiretroviral Therapy: Results of 2 Phase II Multicenter Studies. , 2016, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  Seong Hoon Jeong,et al.  Biophysical stability of hyFc fusion protein with regards to buffers and various excipients. , 2016, International journal of biological macromolecules.

[13]  E. Bord,et al.  Interleukin-7 treatment of PML in a patient with idiopathic lymphocytopenia , 2016, Neurology: Neuroimmunology & Neuroinflammation.

[14]  R. Dersimonian,et al.  Administration of interleukin-7 increases CD4 T cells in idiopathic CD4 lymphocytopenia. , 2016, Blood.

[15]  M. Čavar,et al.  IL‐7 induces clathrin‐mediated endocytosis of CD127 and subsequent degradation by the proteasome in primary human CD8 T cells , 2016, Immunology and cell biology.

[16]  S. Steinberg,et al.  Adjuvant Immunotherapy to Improve Outcome in High-Risk Pediatric Sarcomas , 2016, Clinical Cancer Research.

[17]  Leonard Moise,et al.  iVAX: An integrated toolkit for the selection and optimization of antigens and the design of epitope-driven vaccines , 2015, Human vaccines & immunotherapeutics.

[18]  Y. Wan,et al.  Mechanism of Action of IL-7 and Its Potential Applications and Limitations in Cancer Immunotherapy , 2015, International journal of molecular sciences.

[19]  W. Leonard The gamma c family of cytokines , 2012 .

[20]  E. Bonifacio,et al.  IL-7 Abrogates Suppressive Activity of Human CD4+CD25+FOXP3+ Regulatory T Cells and Allows Expansion of Alloreactive and Autoreactive T Cells , 2012, The Journal of Immunology.

[21]  M. Morre,et al.  Interleukin-7 and immune reconstitution in cancer patients: a new paradigm for dramatically increasing overall survival , 2012, Targeted Oncology.

[22]  J. Sprent,et al.  Normal T cell homeostasis: the conversion of naive cells into memory-phenotype cells , 2011, Nature Immunology.

[23]  T. Fry,et al.  Harnessing the biology of IL-7 for therapeutic application , 2011, Nature Reviews Immunology.

[24]  Jung-Hyun Park,et al.  Seeing Is Believing: Illuminating the Source of In Vivo Interleukin-7 , 2011, Immune network.

[25]  R. Gress,et al.  An overview of IL-7 biology and its use in immunotherapy , 2010, Journal of immunotoxicology.

[26]  R. Mazzucchelli,et al.  Interleukin-7 receptor expression: intelligent design , 2007, Nature Reviews Immunology.

[27]  A. Kelleher,et al.  The IL-7/IL-7 receptor axis: understanding its central role in T-cell homeostasis and the challenges facing its utilization as a novel therapy. , 2006, Current drug targets.

[28]  T. Gingeras,et al.  CD127 expression inversely correlates with FoxP3 and suppressive function of human CD4+ T reg cells , 2006, The Journal of experimental medicine.

[29]  T. Fry,et al.  The Many Faces of IL-7: From Lymphopoiesis to Peripheral T Cell Maintenance , 2005, The Journal of Immunology.

[30]  A. Singer,et al.  Suppression of IL7Ralpha transcription by IL-7 and other prosurvival cytokines: a novel mechanism for maximizing IL-7-dependent T cell survival. , 2004, Immunity.

[31]  J. Sprent,et al.  Interleukin (IL)-15 and IL-7 Jointly Regulate Homeostatic Proliferation of Memory Phenotype CD8+ Cells but Are Not Required for Memory Phenotype CD4+ Cells , 2002, The Journal of experimental medicine.

[32]  T. Fry,et al.  Interleukin-7: master regulator of peripheral T-cell homeostasis? , 2001, Trends in immunology.

[33]  Steven F. Ziegler,et al.  Defective IL7R expression in T-B+NK + severe combined immunodeficiency , 1998, Nature Genetics.

[34]  D. Baccanari,et al.  Peptide agonist of the thrombopoietin receptor as potent as the natural cytokine. , 1997, Science.

[35]  Ronald W. Barrett,et al.  Small Peptides as Potent Mimetics of the Protein Hormone Erythropoietin , 1996, Science.