Monoclonal antibody TGN1412 trial failure explained by species differences in CD28 expression on CD4+ effector memory T‐cells

BACKGROUND AND PURPOSE In 2006, a life‐threatening ‘cytokine storm’, not predicted by pre‐clinical safety testing, rapidly occurred in all six healthy volunteers during the phase I clinical trial of the CD28 superagonist monoclonal antibody (mAb) TGN1412. To date, no unequivocal explanation for the failure of TGN1412 to stimulate profound cytokine release in vitro or in vivo in species used for pre‐clinical safety testing has been established. Here, we have identified a species difference almost certainly responsible for this disparate immunopharmacology.

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