靶向巨噬细胞的癌症治疗策略
Macrophage-directed therapeutic strategies in cancer.
肿瘤相关巨噬细胞(TAMs)是肿瘤微环境的主要组成部分,具有显著的功能可塑性,根据所处的微环境信号,既可表现为促进肿瘤进展的免疫抑制细胞,也可表现为支持抗肿瘤免疫的免疫刺激细胞。
英文原题:CB307: A Dual Targeting Costimulatory Humabody VH Therapeutic for Treating PSMA-Positive Tumors.
CB307是一种首创的免疫治疗药物,能够触发强效的PSMA依赖性T细胞激活,从而减轻针对无限制CD137激动作用的毒理学担忧。
CD137是一种T细胞和NK细胞共刺激受体,参与巩固免疫反应。强效CD137激动剂urelumab作为癌症免疫治疗药物已显示出临床前景,但其开发受到靶向非肿瘤毒性的阻碍。针对前列腺特异性膜抗原(PSMA)的CD137激动剂,PSMA在去势抵抗性转移性前列腺癌(mCRPC)肿瘤细胞上频繁且高表达,可能为这种免疫学上难以应对的疾病带来有效的免疫治疗。
我们设计并制备了CB307,一种新型半衰期延长的双特异性共刺激Humabody VH治疗药物,旨在仅在PSMA高表达的肿瘤微环境(TME)中引发CD137激动作用。CB307的功能活性在基于细胞的试验和同基因小鼠抗肿瘤药理学研究中进行了评估。CB307的非临床毒理学和毒代动力学特性在一项符合良好实验室规范(GLP)的食蟹猴研究中进行了评估。
CB307以PSMA依赖的方式提供有效的CD137激动作用,在体外和体内均具有抗肿瘤活性,与检查点抑制剂联合使用时具有额外活性。一种经过验证的新型PSMA/CD137 IHC检测显示,与原发性病灶相比,PSMA表达的人mCRPC TME中CD137阳性细胞的患病率更高。CB307在非人灵长类动物中未显示出显著毒性,并表现出支持每周临床给药的血浆半衰期。
PURPOSE: CD137 is a T- and NK-cell costimulatory receptor involved in consolidating immunologic responses. The potent CD137 agonist urelumab has shown clinical promise as a cancer immunotherapeutic but development has been hampered by on-target off-tumor toxicities. A CD137 agonist targeted to the prostate-specific membrane antigen (PSMA), frequently and highly expressed on castration-resistant metastatic prostate cancer (mCRPC) tumor cells, could bring effective immunotherapy to this immunologically challenging to address disease. EXPERIMENTAL DESIGN: We designed and manufactured CB307, a novel half-life extended bispecific costimulatory Humabody VH therapeutic to elicit CD137 agonism exclusively in a PSMA-high tumor microenvironment (TME). The functional activity of CB307 was assessed in cell-based assays and in syngeneic mouse antitumor pharmacology studies. Nonclinical toxicology and toxicokinetic properties of CB307 were assessed in a good laboratory practice (GLP) compliant study in cynomolgus macaques. RESULTS: CB307 provides effective CD137 agonism in a PSMA-dependent manner, with antitumor activity both in vitro and in vivo, and additional activity when combined with checkpoint inhibitors. A validated novel PSMA/CD137 IHC assay demonstrated a higher prevalence of CD137-positive cells in the PSMA-expressing human mCRPC TME with respect to primary lesions. CB307 did not show substantial toxicity in nonhuman primates and exhibited a plasma half-life supporting weekly clinical administration. CONCLUSIONS: CB307 is a first-in-class immunotherapeutic that triggers potent PSMA-dependent T-cell activation, thereby alleviating toxicologic concerns against unrestricted CD137 agonism.
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