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Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Molecular Cancer Large Molecule Therapeutics Therapeutics Single-Domain Antibody–Based and Linker-Free Bispecific Antibodies Targeting FcgRIII Induce Potent Antitumor Activity without Recruiting Regulatory T Cells CarolineRozan1,2,3,4,9,Ame(cid:1)lieCornillon1,2,3,4,9,CorinnePe(cid:1)tiard1,2,3,4,9,MartineChartier1,2,3,4,9, GhislaineBehar1,2,3,4,9,CharlotteBoix5,6,7,9,BrigitteKerfelec1,2,3,4,9,BrunoRobert8,9,Andre(cid:1)Pe(cid:3)legrin8,9, PatrickChames1,2,3,4,9,Jean-LucTeillaud5,6,7,9,andDanielBaty1,2,3,4,9,þ Abstract Antibody-dependentcell-mediatedcytotoxicity,oneofthemostprominentmodesofactionofantitumor antibodies,suffersfromimportantlimitationsduetotheneedforoptimalinteractionswithFcgreceptors.In thiswork,wereportthedesignofanewbispecificantibodyformat,compactandlinker-free,basedontheuseof llamasingle-domainantibodiesthatarecapableofcircumventingmostoftheselimitations.Thisbispecific antibody format was created by fusing single-domain antibodies directed against the carcinoembryonic antigen and the activating FcgRIIIa receptor to human Ck and CH1 immunoglobulin G1 domains, acting as a natural dimerization motif. In vitro and in vivo characterization of these Fab-like bispecific molecules revealedfavorablefeaturesforfurtherdevelopmentasatherapeuticmolecule.Theyareeasytoproducein Escherichiacoli,verystable,andelicitpotentlysisoftumorcellsbyhumannaturalkillercellsatpicomolar concentrations. Unlike conventional antibodies, they do not engage inhibitory FcgRIIb receptor, do not compete with serumimmunoglobulins G forreceptor binding, andtheircytotoxic activity isindependent ofFcglycosylationandFcgRIIIapolymorphism.Asopposedtoanti-CD3bispecificantitumorantibodies,they donotengageregulatoryTcellsastheselattercellsdonotexpressFcgRIII.Studiesinnonobesediabetic/severe combined immunodeficient gammamice xenografted with carcinoembryonic antigen–positive tumorcells showed that Fab-like bispecific molecules in the presence of human peripheral blood mononuclear cells significantly slow down tumor growth. This new compact, linker-free bispecific antibody format offers a promisingapproachforoptimizingantibody-basedtherapies.MolCancerTher;12(8);1481–91.(cid:2)2013AACR. Introduction clinical trial results support an important role of anti- body-dependent cell-mediated cytotoxicity (ADCC) for Almost30monoclonalantibodies(mAb)arenowinthe both lymphomas and solid tumors (3). The affinity market,including15mAbsforcancertherapyinEurope between the Fc portion of human IgG1 and FcgRIIIa and the United States. Most of these mAbs (9/15) are (CD16a),anactivatingreceptormostlyexpressedbynat- human immunoglobulin G1 (IgG1) that trigger various uralkiller(NK)cells,monocytes,andmacrophages,hasa mechanisms,suchastargetsignalinginhibition,apoptosis, profoundimpactonADCCexertedbyantibodies(4,5). activation of the classical complement pathway, and/or Correlation of clinical responses to mAb therapy with ofimmuneeffectorcellsexpressingFcg receptors(FcgR; FcgRIIIa polymorphism has been observed with more refs.1,2).Althoughitisdifficulttoassessthecontribution favorable response in patients homozygous for the of each of these mechanisms in their in vivo efficacy, high-affinityFcgRIIIa(V158;refs.6,7).Thefactthatabout 80%oftheCaucasianpopulationishomozygous(F/F)or heterozygous (F/V) for low-affinity FcgRIIIa (F158) is Authors'Affiliations:1INSERMU1068,CRCM;2CNRSUMR7258;3Insti- tutPaoli-Calmettes;4Universite(cid:1)Aix-Marseille;5INSERMU872,Centre likely an important issue for antibody-based immuno- deRecherchedesCordeliers;6Universite(cid:1)PierreetMarieCurie,UMR-S therapy. Moreover, the in vivo efficacy of therapeutic 872;7Universite(cid:1)ParisDescartes,UMR-S872,Paris;8IRCM,INSERM, U896, Universite(cid:1) Montpellier 1, CRLC Val d'Aurelle, Montpellier; antibodiesishinderedbythepresenceoffucoseresidues 9GDR3260,CNRS,Tours,France in the N-glycosylation motif (N297 residue) of the Fc regionthatmarkedlydecreasestheiraffinityforFcgRIIIa Note:SupplementarydataforthisarticleareavailableatMolecularCancer TherapeuticsOnline(http://mct.aacrjournals.org/). (8–10).Therapeuticantibodiesalsocompetewithserum IgG for binding to the high-affinity FcgRI and to the CorrespondingAuthor:Daniel Baty,INSERMU1068,163Avenuede Luminy, Marseille 13009, France. Phone: 33-491828823; Fax: 33- intermediate-affinityFcgRIIIa.Strikingly,mostantibodies 491826083;E-mail:[email protected] have to be injected at high doses to reach a serum con- doi:10.1158/1535-7163.MCT-12-1012 centrationbetween10and100mg/mLwhiletheyusually (cid:2)2013AmericanAssociationforCancerResearch. elicitamaximalcytotoxicactivityat10ng/mLininvitro www.aacrjournals.org 1481 Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Rozanetal. ADCC experiments. Competition with patient IgG has ingastrongcytotoxicityagainstCEA-positivetumorcells been proposed to account for this large difference of by human NK cells in vitro, and of inhibiting tumor concentration(11).Finally,theuseoftherapeuticantibo- growthinaninvivomousemodel. dies may be hampered by their ability to engage the inhibitoryFcgRIIbreceptor.FcgRIIbpossessesaninhibi- Materials and Methods tory immunoreceptor tyrosine-based inhibitory motif in Expressionvectordesignandgenerationof itscytoplasmicdomainandhasbeenshowntoimpactthe recombinantantibodies antitumor efficacy of therapeutic antibodies in mouse Bicistronicexpressionvectorsweredesignedtoexpress models (12). Several approaches such as site-directed bsFabmoleculesinperiplasm(fordetailsseeSupplemen- mutagenesis,computationalstructure–baseddesign,gly- taryMethods). cosylation engineering, and selection-based methods havebeenusedtoincreaseFcbindingtoactivatingrecep- Productionandpurificationofantibodies tors (FcgRI,FcgRIIa,and FcgRIIIa) andtodecreasetheir bsFabswerepurifiedfromperiplasmofEscherichiacoli interaction with inhibitory FcgRIIb (3, 13, 14). Variants (E.coli)DH5aandsdAbC17-Fcfromculturesupernatant possessingupto100-foldincreasedaffinityforFcgRIIIa, ofHEK293Tcells(fordetailsseeSupplementaryMethods). resultingin100-foldenhancedinvitroADCC(3,15),have beenselected. Celllines Attractive alternative to recruit and activate effector Jurkat(ATCCTIB-152),LS174T(ATCCCL-188),BXPC3 cells is to use bispecific antibodies (bsAb) capable of (ATCC CRL-1687), LAN-1 (16), HT29 (ATCC HTB-38), simultaneously binding to a target antigen and to an and HEK293T (ATCC CRL-11268) cells purchased from activating receptor such as FcgRI or FcgRIIIa (16, 17). AmericanTypeCultureCollection(ATCC)werecultured Althoughtheinvitroandinvivoantitumorefficienciesof in RPMI-1640 þ GlutaMax-I medium (Invitrogen) sup- bsAbshavebeenlargelyshownoverthelasttwodecades, plementedwith10%FBS(PAA).SKOV3(ATCCHTB-77) theirdevelopmenthasbeenseverelyhinderedbydifferent andCO115(anestablishedCEA-negativesubclonefroma factors, including immunogenicity and the difficulty to human colon carcinoma cell line; refs. 31, 32) were cul- efficientlyproducelargeamountsofactivemolecules(18). turedinDulbecco’sModifiedEagleMedium(DMEM)þ With the development of antibody engineering, several GlutaMax-I medium (Invitrogen) supplemented with innovative recombinant formats have been proposed, 10%FBS(PAA).MC38andC15.4.3.AP(MC38-CEA)cells including diabodies, tandem single-chain variable frag- are murine colorectal cancer cells (33). MC38-CEA cells ments (scFvs), and minibodies (17, 19, 20), and some of areMC38cellstransfectedwithacDNAencodingCEA. thesemoleculesarebeingtestedintheclinics(21).How- MC38 were cultured in DMEM þ GlutaMax-I medium ever,mostdescribedrecombinantbsAbsheavilyrelyon supplementedwith10%FBSandMC38-CEAinDMEMþ the use of peptide linkers. Although these linkers have GlutaMax-Imediumsupplementedwith10%FBSand0.5 obvious advantages in terms of antibody engineering, mg/mLofgeneticin.Jurkat-huFcgRIIIa/gcellsareJurkat theirhydrophilicnaturemakesthempronetoproteolytic lymphomaTcellstransfectedwithacDNAencodingthe cleavage, potentially leading to production issues, poor extracellulardomainofFcgRIIIafusedtothetransmem- antibody stability, aggregation, and increased immuno- braneandintracellulardomainsoftheg chain(generous genicity (22). Llama single-domain antibodies (sdAb), gift of Prof. E. Vivier, CIML, Marseille, France; ref. 34). derivedfromheavy-chainantibodiesnaturallydevoidof These cells were cultured in RPMI-1640 þ GlutaMax-I lightchains(23)aresmall(13kDa),wellexpressed,and mediumsupplementedwith10%FBSand0.5mg/mLof extremelystablefragments.Theyarehighlyhomologous geneticin. SKOV3-CEA-Luc are SKOV3 human ovarian totheVHIIIsubsetfamilyofhumanVH(24,25),which carcinoma transfected with a cDNA encoding the extra- shouldresultinalowantigenicityinhuman,ifany,and cellulardomainofCEAandwithacDNAencodinglucif- whichmakesthehumanizationprocesseasierifneeded erase;cellswereculturedinDMEMþGlutaMax-Imedium (26).Becauseoftheirsmallsizeandsingle-domainnature, supplementedwith10%FBS,0.5mg/mLofgeneticin,and sdAbs can recognize epitope usually not accessible to 0.4mg/mLhygromycinB.Allcelllinesweregrownina conventionalantibodies.Thesefragmentsrepresentideal humidified37(cid:2)Cincubatorcontaining5%CO . 2 molecularbuildingunitsforbsAbconstruction(27).Ina AllcelllinespurchasedfromATCCwerenotcultured previouswork,weisolatedtwosdAbscapableofbinding formorethan2months.Othercelllinesusedinthisstudy and activating FcgRIIIa while showing no binding to havenotbeenauthenticated. FcgRI,FcgRIIa,orinhibitoryreceptorFcgRIIb(28)aswell asonesdAbabletobindcarcinoembryonicantigen(CEA) HumanNKcellpurification with high specificity (29), a well-characterized tumor Human peripheral blood mononuclear cells (PBMC) markerofinterestformAb-basedcancertherapy. were isolated from fresh peripheral blood of healthy In the present work, we have exploited the natural donors (Etablissement Franc¸ais du Sang, Marseille and affinityofhumanCH1andCkIgGdomainsasanhetero- Ho^tel-Dieu hospital, Paris, France) by Ficoll LSM 1077 dimerization motif (30) to produce Fab-like bispecific (PAA) gradient centrifugation. Cells were counted and antibodies(bsFab),devoidoflinkerandcapableofinduc- tested for viability by Trypan blue exclusion assay. NK 1482 MolCancerTher;12(8)August2013 MolecularCancerTherapeutics Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Anti-FcgRIII(cid:3)CEABispecificFab-likeAntibodies cells were isolated by depleting non-NK cells using the 4hours.Rosetteformationwasthenobservedbyoptical NKcellisolationkit(MiltenyiBiotec)asdescribedbythe microscopy. manufacturer. Interleukin-2secretionassay Flowcytometryassays Jurkat-huFcgRIIIa/gcells(106;ornontransfectedJurkat IncreasingconcentrationsofbsFabs(1.2–100nmol/L) cellsasnegativecontrol)wereincubatedfor18hoursin were used for staining 2 (cid:3) 105 Jurkat-huFcgRIIIa/g or RPMI-1640medium,containing5%FBS,10ng/mLphor- 2 (cid:3) 105 MC38-CEA cells in 50 mL PBS supplemented bol 12-myristate 13-acetate (PMA; Sigma Aldrich) and with2%bovineserumalbuminat4(cid:2)Cfor1hour.Bound bsFabs (50 nmol/L) or anti-FcgRIII mAb 3G8 (35) used bsFabsweredetectedbyincubatingcellswitheitheran at50nmol/Lasapositivecontrol.Insomeexperiments, anti-flag mAb M2 (4 mg/mL; Sigma Aldrich) or anti-c- anti-flagM2mAbwasadded(4mg/mL)topromotebsFab myc mAb 9E10 (10 mg/mL; Santa Cruz Biotechnology) dimerization. In some experiments, 105 LS174T cells (or (cid:2) for30minutesat4 Cfollowedbyafluoresceinisothio- LAN-1cellsusedasanegativecontrol)wereusedastarget cyanate (FITC)-conjugated goat anti-mouse IgG F(ab’) cells.Afterincubation,cellswerecentrifugedfor5min- 2 (10mg/mL;JacksonImmunoResearch)incubated30min- utesat1,200(cid:3)gandhumaninterleukin(IL)-2presentin (cid:2) utesat4 C.Afterwashing,labeledcellswereanalyzedby the culture medium was measured by ELISA using flowcytometryusingaFACSCalibur(BDBiosciences)or READY-SET-GOhumanIL-2Kit(eBioscience). MACSQuant(MiltenyiBiotec)flowcytometers. Forserumstabilityassays,bsFabswereincubatedat1 ADCCassay mmol/Lin90%humanserum(notheat-inactivated;Sig- Targetcells (BxPC3,HT29, LS174T,SKOV3-CEA-Luc, ma Aldrich) at 37(cid:2)C for various periods of time (7–168 or SKOV3;5(cid:3)103cells/well) weremixedwith5(cid:3)104 hours). Samples were collected at different time points, freshly isolated human NK cells (effector/target ratio: frozen,andkeptat(cid:4)20(cid:2)C.Theremainingbindingactivity 10:1). Variable concentrations of bsFabs or sdAb C17-Fc of the samples after storage was determined by flow were addedto the cells in a final volume of200 mL. All cytometryusingnonsaturatingbsFabconcentrations(10 proceduresweredoneintriplicatewithdifferentdonors. (cid:2) nmol/L for bsFab C21 and 100 nmol/L for bsFab C28 Following overnight incubation at 37 C, target cell via- against Jurkat-huFcgRIIIa/g, and 100 nmol/L for both bility was quantified with CellTiter-Glo viability assay againstMC38-CEA). (Promega) according to manufacturer’s protocol. The ForbindingcompetitionassayswithserumIgG,Jur- formula used for % lysis calculation was: % lysis ¼ [T- kat-huFcgRIIIa/gcellswerepreincubatedwithincreas- (T -E)]/[T-T ](cid:3)100(T¼target,E¼effector,T ¼ EAb dead dead ingconcentrationsofhumanserum(12.5%–100%)at4(cid:2)C target lysed with 1% Triton solution, T ¼ target þ EAb for 1 hour then incubated with a constant amount of effectorþantibodyluminescentsignal). bsFab C21 (4 nmol/L) or bsFab C28 (36 nmol/L) or To investigate the effect of soluble CEA, target and biotinylatedsdAbC17-Fc(200nmol/L).Boundantibo- effector cells were incubated as previously described dies were detected using either mouse anti-flag mAb withvariableconcentrationsofbsFabandconstantcon- M2 (4 mg/mL; Sigma Aldrich) followed by incubation centration (0.1 mg/mL or 1 mg/mL) of soluble CEA with FITC-conjugated goat anti-mouse IgG F(ab0) (10 (Chemicon).FcgRIIIagenotypingofdonorswascarried 2 mg/mL; Jackson ImmunoResearch Laboratories) for outasdescribed(36).Dose–responsecurvesweretreated bsFab labeling or streptavidin-phycoerythrin diluted by nonlinear regression analysis using Prism software 1:10 (Beckman Coulter) for biotinylated sdAb C17-Fc (GraphPad Software). Data were expressed as mean (cid:5) labeling. In another setting, Jurkat-huFcgRIIIa/g cells SEM. were preincubated with constant concentrations of human serum (90%) or PBS 1(cid:3) at 4(cid:2)C for 1 hour and Biodistributionassay then incubated with various amounts of bsFab C21 or Swiss female nude mice (Charles River Laboratories,) bsFabC28.Boundantibodiesweredetectedasdescribed bearinghumancoloncarcinomaLS174T(CEApositive)or previously. CO115(forCEA-negativecontrol)tumorsontherightand ForCEAdetection,cellswerepreincubatedwithanti- leftflanks,respectively,wereinjectedintravenouslywith CEA sdAb C17 (10 mg/mL) for 1 hour at 4(cid:2)C. Bound 125I-labeled bsFab C21 (2.8 (cid:3) 105 Bq, 3 mg) 14 days after antibody was detected using mouse anti-6his mAb (1 subcutaneoustumorcellinjection.Fourgroupsof3mice mg/mL; Novagen) followed by incubation with FITC- weresacrificedat3,6,15,or24hoursafterbsFabinjection. conjugatedgoatanti-mouseIgGF(ab0) (10mg/mL;Jack- Bloodwascollectedandtissuesandorganswereweighted 2 sonImmunoResearch). anddissectedateachtimepoint.Radioactivitywasquan- tified using a g- counter COBRAII (Packard) and results Rosetteformationassay wereexpressedas%injecteddose/gtissue(%ID/g).Mice A total of 5 (cid:3) 104 MC38-CEA and 25 (cid:3) 104 Jurkat- housed in individual cages with laboratory chow and huFcgRIIIa/gwerecoculturedinRPMI-1640þGlutaMax- water.Allexperimentswerecarriedoutaccordingtothe Imediumsupplementedwith10%FBSand0.5mg/mL FrenchAnimalProtectionLawwiththepermissionfrom ofgeneticinwithorwithoutbsFabs(2mg/mL)at37(cid:2)Cfor thelocalauthorities. www.aacrjournals.org MolCancerTher;12(8)August2013 1483 Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Rozanetal. Results Tumorgrowthinhibition Seven-week-oldfemalenonobesediabetic/severecom- bsFabdesignandproduction bined immunodeficient gamma (NSG) mice (Charles ForconstructionofbsFabs,wedesignedabicistronic River Laboratories; n ¼ 8/group) were xenografted expression vector allowing the coexpression of one subcutaneously with human pancreatic carcinoma sdAbdirectlyfusedtothehumanCkchainandanother CEA-positiveBxPC3(2(cid:3)106cells/mouse)ontheright sdAb directly fused to the human CH1 chain in the flank and were injected with freshly purified human periplasm of E. coli (Fig. 1A). We used the anti-CEA PBMCs [30 (cid:3) 106/mouse, intraperitoneally (i.p.)] and sdAb C17 previously characterized (K : 8 nmol/L; d bsFab C21 (100 mg/mouse) or PBS (i.p.) at day 0. At ref.29)fortargetingCEA-positivecellsandtwodiffer- days1and2,micewereinjectedintraperitoneallywith ent anti-FcgRIII sdAbs for targeting FcgRIIIa-positive bsFab C21 (50 mg/mouse) or PBS. Tumor growth was effectorcells.Theanti-FcgRIIIsdAbC28waspreviously measured with a Vernier caliper during 28 days to shown (28) to display an apparent affinity for FcgRIII permit calculation of tumor volumes [V ¼ (L(cid:3)W2)/2, (K :82nmol/L)intherangeoftheFcportionofhuman d where L and W were length and width, respectively]. IgG1(>100nmol/L),whereastheanti-FcgRIIIsdAbC21 Allanimalsweresacrificedattheendofexperimentin displays a higher affinity of K : 10 nmol/L for FcgRIII d accordancewiththeInstitutionalguidelines.Micewere (28). The resulting bispecific Fab-like fragments were housed in individual cages with laboratory chow and namedbsFabC21andbsFabC28,respectively(Fig.1B). water. All experiments were carried out according to bsFabs were produced in E. coli periplasm and affinity theFrenchAnimalProtectionLawwiththepermission purified by anti-CH1 followed by anti-Ck columns. As from the local authorities. showninFig.1C,SDS-PAGEanalysesofthesecondstep of bsFab C21 purification reveal, under nonreducing Statisticalanalysis conditions,onebandintheexpectedrangeofsize(50– Data are presented as mean (cid:5) SEM. Cytotoxicity 55 kDa) due to heterodimerization. assays were statistically analyzed using a one-way Inparallel,wedevelopedahumanFcfusionprotein, ANOVA test. In vivo studies were analyzed using Stu- sdAbC17-Fc,byfusinganti-CEAsdAbC17tothehinge, dentttest. Forall tests,P<0.05wasconsideredstatis- CH2 and CH3 domains of IgG1 (Fig. 1B). Anti-CEA tically significant. sdAbC17–Fcwasproducedbytransienttransfectionin A Ptac RRBBSS1 55 sdAb αCEA Cκ F RRBBSS2 wt sdAb αFcγRIII CH1 C6H Figure1. Antibodyformats. A,abiscistronicconstructwas PΒ-act KKoozzaacc µp sdAb αCEA H CH2 CH3 designedtoallowtheproduction ofbsFabintheperiplasmofE.coli. B Darkgray,portionofhinge(H)and CkandCH1-3constantdomains ofhumanIgG1;lightgray,sdAbs; Ptac,tacpromoter;RBS1and H H RBS2,ribosome-bindingsites;55, Cκ optimizedPelBsignalsequence; CH1 CH2 WT,PelBwild-typesignal sequence;F,Flagtag;C,c-myc CH2 tag;6H,hexahistag;Pb-act, C F CH3 chickenb-actinpromoter;Kozac, 6H ribosome-bindingsite;mp, CH3 microphosphatasesignal bsFab sequence.B,schemeofantibody formatsusedinthisstudy.C, sdAb C17-Fc analysisofpurifiedbsFabsby Coomassieblue–stained C LoadFTWashMW Elution kDa SchDrSom-PaAtGogEraapftheyroafnfinIgitGy–CH1 184 matrixfollowedonLC–kmatrix. 98 64 MW,molecularweightladder; 50 FT,flowthrough. 36 22 1484 MolCancerTher;12(8)August2013 MolecularCancerTherapeutics Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Anti-FcgRIII(cid:3)CEABispecificFab-likeAntibodies HEK293T cells and purified from culture supernatant MC38 and Jurkat cells was observed with any of these byaffinitychromatographyonaG-proteincolumn.This bsFabs(datanotshown). construction was designed to provide a molecule with TheabilityofbsFabstosimultaneouslybindtoMC38- the same epitope specificity of bsFabs, but triggering CEAandJurkat-huFcgRIIIa/gcellswasshowedbyrosette ADCC via a conventional Fc/FcgR interaction. formationbetweenthetwotypesofcells.Theadditionof bsFabsinMC38-CEAandJurket-huFcgRIIIa/g coculture BindinganalysisofbsFabs ledtorosetteformationbetweenJurkat-huFcgRIIIa/gand BindingspecificitiesofbsFabstoFcgRIIIAandCEAwere MC38-CEAcells(upto9Jurkat-huFcgRIIIa/gcellsbound analyzed by flow cytometry using Jurkat-huFcgRIIIA/g tooneMC38-CEAcellhavebeenobserved;Fig.2B).Inthe and MC38-CEA cells, respectively. As shown in Fig. 2A, absenceofbsFab,norosetteformationwasobserved. bothbsFabsefficientlyboundtothesecellsinadose-depen- dent manner. To ensure that signals were generated by InvitrostabilityofbsFabsinhumanserum heterodimers,bsFabbindingtoMC38-CEAcellswasass- In vitro stability was analyzed by incubation of each (cid:2) essedusingthec-myctagfusedtothechainbearingtheanti- bsFab in human serum at 37 C for up to168 hoursand FcgRIIIA sdAb and vice-versa. A marked shift in mean subsequentexaminationofCEAandFcgRIIIabindingby fluorescenceintensitywasobservedwhencomparingbsFab flow cytometry. Figure 2C shows that bsFab C21 and C21 and bsFab C28 binding with Jurkat-huFcgRIIIA/g, bsFab C28 retain their full binding on both target and likely related to the 8-fold difference of affinity between effectorcells,evenafter168hoursofincubation,showing theseanti-FcgRIIIasdAbs(28).Asexpected,bsFabC21and aremarkablestability.SDS-PAGEandWesternblotanal- C28,bothbearingthesameanti-CEAsdAbC17exhibiteda yses showed the absence of breakdown products of similarbindingprofiletoMC38-CEAcells.Nobindingto both bsFabs (data not shown), further confirming that A FAi,gbusrFea2b.sbwseFraebi-nbciunbdaintegdawnaitlhysis. cells MC38-CEA antigen-positivecellsatvarious of concentrations.BindingonMC38- er Jurkat-huFcγγRIIIa/γ b CEAandJurkat-huFcgRIIIa/gwas m detectedusinganti-c-mycoranti- Nu 0 1.2 3.7 11 33 100 flagantibodies,respectively, bsFab (nmol/L) followedbygoatanti-mouse Fluorescence intensity labeledantibodies.Filledblack, isotypecontrol;filledgray,bsFab B C21;openblack,bsFabC28.B, MC38-CEA(blackarrow)and Jurkat-huFcgRIIIa/g(dottedarrow) werecoculturedwithorwithout bsFabsC21orbsFabC28. Rosetteformationwasobserved byopticalmicroscopy.C,bsFab MC38-CEA + Jurkat-huFcγRIIIa/γ MC38-CEA + Jurkat-huFcγRIIIa/γ MC38-CEA + Jurkat-huFcγRIIIa/γ stabilityinhumanserum.bsFabs + bsFab C21 + bsFab C28 wereincubatedat1mmol/Lin90% serumforupto168hours.Binding Time (h) C experimentswerenextcarriedout byflowcytometryusing 7 nonsaturatingconcentrations 24 (10nmol/LforbsFabC21and 100nmol/LforbsFabC28against 31 Jurkat-huFcgRIIIa/g,and100 48 nmol/LforbothagainstMC38- CEA).Filledblack,isotypecontrol; 72 openblack,bsFabincubatedfor varioustimesat37(cid:2)CinPBS;filled 96 gray,bsFabincubatedforvarious s 168 timesat37(cid:2)Cin90%human ell sFlinecergu.RmII.IaC:EJuAr:kMatC-h3u8F-cCgERAIIIcae/glllcineell. ber of c FcγRIIIa CEA FcγRIIIa CEA Control m bsFab C21 bsFab C28 u N Fluorescence intensity www.aacrjournals.org MolCancerTher;12(8)August2013 1485 Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Rozanetal. 40,000 L) m 30,000 Figure3. IL-2releaseassays. g/ JurkatorJurkat-huFcgRIIIa/gcells p 2 ( wereprestimulatedwithPMAand L- 20,000 incubatedwith50nmol/LofbsFab d I oranti-FcgRIIIabivalentmAb3G8. e Insomecase,anti-FlagtagmAb cret 10,000 wasaddedtoinducebsFab e dimerization.TheadditionofCEA- S positiveLS174Ttumorcellscould induceIL-2secretion,whereas 0 CEA-negativeLAN-1human Jurkat + + + tumorcellsdidnot.IL-2secretedin Jurkat-huFcγγRIIIa/γ + + + + + + + + + + + + themediumwasquantifiedby bsFab C21 + + + + + ELISA.ErrorbarsrepresenttheSD bsFab C28 + + + + + ofexperimentscarriedoutin triplicates. Anti-flag mAb + + 3G8 + LS174T (CEA+) + + + + + + LAN-1 (CEA-) + + + both bsFabs are stable up to 168 hours in physiologic absence of target cells (Fig. 3), unlike bivalent anti- conditions. FcgRIIIa mAb 3G8. The low difference in IL-2 secretion observedbetweenthetwobsFabscouldbeexplainedby CompetitionwithhumanIgGforFcgRIIIabinding their different affinityfor FcgRIIIaand/or different epi- Thepotentialimpactofserum,containinghighamount topes. The addition of a monoclonal antibody targeting of endogenous IgG, on FcgRIIIa binding by bsFabs was the Flag tag fused to the C-terminus of Ck domain and explored. Jurkat-huFcgRIIIa/g cells were preincubated thusleadingtobsFabdimerizationledtoIL-2secretionas inthepresenceofvariousvolumesofhumanserumand expected (Fig. 3). These results show that monovalent thenstainedwithbsFabs.SdAbC17-Fcwasusedascon- bsFabdonotinduceeffectorcellactivationintheabsence trol. As shown in Supplementary Fig. S1A, both bsFabs oftargetcells. retainbindinginthepresenceofhumanserum,whereas However, the coculture of Jurkat-huFcgRIIIa/g with sdAb C17-Fc binding is, as expected, strongly inhibited. CEA-positiveLS174TtumorcellsinthepresenceofbsFab Competition assays were also conducted on Jurkat- C21 or C28 could lead to IL-2 secretion. This activation huFcgRIIIa/g cellsinthepresenceof90% humanserum was not seen in the absence of bsFab, or when using andvariousconcentrationsofbsFabs(SupplementaryFig. nontransfected Jurkat cells or CEA-negative LAN-1 S1B). The interaction of bsFabs with FcgRIIIa was not humantumorcellsinthepresenceofbsFab,asnegative hinderedbythepresenceofhumanIgG,evenatlowbsFab controls (Fig. 3). These results show in vitro that the concentrations.Thesameresultswereobservedwithpuri- efficientactivationofeffectorcellsbymonovalentbsFabs fiedhumanpolyclonalIgGinacompetitionassay(datanot isdependentonthepresenceofcellsexpressingthetumor shown).Theseresultsareinagreementwithourprevious antigen,anddoesnotleadtounwantedcytokinerelease data (28) showing that sdAbs C21 and C28 recognize byFcgRIII-positiveeffectorcellsintheabsenceoftumor FcgRIIIa epitopes different from those bound by human cells. IgGFcportion. bsFab-dependentNKcell-mediatedcytotoxicity IL-2releaseassays The cell-mediated cytotoxicity of bsFabs was investi- Onepossiblesideeffectofantibodiestargetingactivat- gatedusingapaneloffourdifferenthumantumorcells ing receptors is the activation of effector cells in the expressing various levels of CEA, as shown in Fig. 4A. absence of target cells, potentially leading to a systemic Freshly purified human NK cells were used as effector inflammatoryresponse(cytokinestorm).Toevaluatethis cellsatanE:Tratioof10:1.Dose–responsecurvesallowed possibility, Jurkat and Jurkat-huFcgRIIIa/g cells were thedeterminationofEC values(Fig.4B)andpercentages 50 cultured in the presence of monovalent bsFab. Bivalent ofmaximallysis.BothbsFabstriggeredastrongcytotox- anti-FcgRIIIamAb3G8,abletocrosslinkthereceptorand icityagainstSKOV3-CEAcellsinadose-dependentman- triggeractivation,wasusedaspositivecontrol.Monova- nerbutwereineffectivewhenCEA-negativeSKOV3cells lentbsFabsonlyledtoamarginalIL-2secretion,indicat- weretested(Fig.4B).CellsfromallCEA-positivetumor ingthatFcgRIIIa-positivecellscannotbeactivatedinthe celllineswerekilledwithasimilarefficiency,leadingto 1486 MolCancerTher;12(8)August2013 MolecularCancerTherapeutics Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Anti-FcgRIII(cid:3)CEABispecificFab-likeAntibodies Figure4. bsFab-dependentNK cytotoxicity.A,CEAexpressionof varioustumorcelllineswas assessedbyflowcytometry(open black,isotypecontrol;filledgray, anti-CEAsdAbC17)onSKOV3, SKOV3-CEA,BxPC3,LS174T,or HT29cells.B,humanNKcellswere mixedatratio10:1withCEA- positivecellsinthepresenceof indicatedconcentrationsof bsFabs.Targetcellviabilitywas measuredbyCellTiter-Gloviability assayafterovernightincubationat 37(cid:2)Cinthepresenceofindicated concentrationsofbsFabC21(open circle),bsFabC28(opensquare), exceptforSKOV3cellsforwhich bsFabC21isrepresentedbyopen triangleandbsFabC28byopen diamond.Table1summarizes EC50(pmol/L)ofeachbsFab determinedforeverytumorcell line.ErrorbarsrepresenttheSDof experimentscarriedoutin triplicates. EC inthe10pmol/Lrangeusingthreedifferentdonors. cytotoxic activity triggered by sdAb C17-Fc was lower 50 Inallthreecases,aslightlyhigherefficiencywasobserved thanthatofbsFabC21,bothintermsofEC (valuesinthe 50 withbsFabC21,potentiallyduetoitshigheraffinityfor nmol/Lrange)andofmaximallysis(<50%),despiteits FcgRIIIa(Table1). bivalentbindingtoCEA.This resultislikelyduetothe weakerinteractionoftheFcportionofsdAbC17-Fcwith SensitivitytoFcgRIIIapolymorphism FcgRIIIa,ascomparedwithbsFabC21.Moreimportantly, BecausetheefficiencyofADCCisaffectedbyFcgRIIIa the lytic activity of sdAb C17-Fc varied according to polymorphismatposition158,experimentswerecarried FcgRIIIa polymorphism, NK cells from 158F/F donor out using SKOV3-CEA cells as target cells and purified being significantly less efficient than NK cells from NKcellsfromFcgRIIIa158V/V,F/F,orV/Fdonorsand 158V/V and 158V/F donors. In contrast, the cytotoxic bsFab C21 or sdAb C17-Fc. As shown in Fig. 5A, the activity of bsFab C21 was very similar whatever the FCGR3genotypeofthedonor.Theseresultsconfirmthat theepitoperecognizedbysdAbC21isnotaffectedbythe Table 1. Half maximal effective concentration nature of residue 158, and show that bsFab can trigger (EC ) of bsFabs inADCC assay 50 highly potenttumorkilling atverylowdoses,indepen- dentlyofFcgRIIIapolymorphism. EC (pmol/L) 50 Celllines bsFabC21 bsFabC28 SensitivitytothepresenceofsolubleCEA SKOV3-CEA 4(cid:5)0.2 6(cid:5)0.5 It is well known that CEA can be released by phos- LS174T 3(cid:5)1.5 4(cid:5)0.4 pholipasesfromthecellsurfacethroughcleavageofits BxPC3 8(cid:5)3 17(cid:5)6 glycosyl-phosphatidyl-inositol linkage, leading to the HT29 5(cid:5)1.5 27(cid:5)10 appearanceofasolubleformintheblood(37).Itrepre- sents a valuable tumor marker because its serum level www.aacrjournals.org MolCancerTher;12(8)August2013 1487 Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Rozanetal. therapy,inparticularinclinicalsettingswherelevelsof solubleCEAarelow. BiodistributionofbsFabinxenograftedmice ThebiodistributionofbsFabC21,whichexhibitedthe most favorable in vitro characteristics in terms of cell bindingandcytotoxicity,wasstudiedusingxenografted nude mice. bsFab C21 was labeled with 125I and was injectedintravenouslyinmicebearingbothLS174Tcells (CEA-positive colorectal tumor; right flank) and CO115 cells(CEA-negativecolorectaltumor;leftflank,asnega- tivecontrol).Miceweresacrificed3,6,15,24hoursafter bsFabinjectiontoquantifythepresenceofbsFabinblood, variousorgans,andtumors.Besttumor-to-normalorgan ratioswereobserved15hoursafterinjection(Fig.6A)with A 25 20 e u s 15 s Ti % ID/g 10 n.*s*** * 5 Fdmiegixpueerdneda5et.nrtaInNtifloKu1ec0ne:lc1lecwyotiftohFtocSxgKiRcOiItIVyIa.3A-pC,ohElyuAmm–oparonpshFiticsivgmeRILoIIurac-s1-op5luo8bsVil/teFivCNeEKcAeclolesnllsinbwstheFeraeb- 0BlCoEodA+ tuCEmoAr- tumorLiverKidney LungSpleenHeartMuscle Bone SkIinntestineColon presenceofvariousconcentrationsofbsFabC21orsdAbC17-Fc.Target cellviabilitywasmeasuredbyCellTiter-Gloviabilityassayafterovernight B incubationat37(cid:2)C.bsFabC21(blackcircle)orsdAbC17-Fc(opencircle) 1,000 with158V/VNKcells,bsFabC21(blacksquare)orsdAbC17-Fc(open 3m) 800 square)with158F/VNKcells,andbsFabC21(blacktriangle)orsdAb m C17-Fc(opentriangle)with158F/FNKcells.(cid:6),asignificantdifference me ( 600 betweensdAbC17-Fcwith158V/VNKcellsgroupandsdAbC17-Fcwith u E15rr8oFr/bFaNrsKrceeplrlsesgeronutpth(e(cid:6),SsiDgnoififceaxnptedriimffeernetnscceabreritewdeoeuntginroturpipsliPca<te0s.0.5B),. or vol 400 * humanNKcellsweremixedataratioof10:1withBxPC3cellsinthe um 200 presenceofvariousconcentrationsofbsFabC21andofsolubleCEA. T TargetcellviabilitywasmeasuredbyCellTtiter-Gloviabilityassayafter 0 0 5 10 15 20 25 30 overnightincubationat37(cid:2)C.bsFabC21(opencircle)orbsFabC21with Days 1mg/mL(opensquare)or0.1mg/mL(opentriangle)ofsolubleCEA.No significantdifferencewasfoundbetweenbsFabC21with1mg/mLof solubleCEAgrouporbetweenbsFabC21with0.1mg/mLofsolubleCEA Figure6. bsFabinxenograftedmice.A,biodistribution:125I-labeledbsFab groupversuscontrolbsFabC21group.ErrorbarsrepresenttheSDof C21wasinjectedintravenouslyintoLS174T(CEApositive)andCo115 experimentscarriedoutintriplicates. (CEAnegative)xenograftednudemice.Mice(n¼3/group)weresacrificed atindicatedtimes3hours(black),6hours(darkgray),15hours(lightgray), and24hours(white)andradioactivityofeachorganwasmeasured correlates disease progression. However, this soluble andplottedas%injecteddose/goftissue.ThesignificanceofbsFab form of CEA could also interfere with antibody-based retentioninCEA-positivetumorversusCEA-negativetumorwas immunotherapy by competing with membrane-bound comparedateachtime.(cid:6),significantdifferencebetweengroups: CEA for antibody binding. Thus, we conducted ADCC (cid:6)(cid:6),P<0.005,(cid:6),P<0.05;andn.s,nonsignificant.Errorbarsrepresentthe assays using BxPC3 tumor cells in presence of interme- SDofexperimentscarriedoutintriplicates.B,tumorgrowthinhibition assay:atday0,NSGmice(n¼8/group)werexenografted(s.c.)with diate (0.1 mg/mL) or high (1 mg/mL) concentrations of BxPC3cellsandinjectedintraperitoneallywithhumanPBMCsandbsFab soluble CEA. As shown in Fig. 5B, soluble CEA has a C21(100mg)orPBS,followedatdays1and2by50mgofbsFabC21 detectablebutmoderateeffectontheantitumorefficacyof orPBS(i.p.).TumorgrowthwasfollowedusingaVerniercaliper.PBS bsFabC21.EC valuesincreasedtoaround100pmol/Lat (opencircle),bsFabC21(opensquare),PBMCsandPBS(opentriangle), 50 andPBMCsandbsFabC21(opendiamond).(cid:6),significantdifference thehighestCEAconcentration,althoughitdidnotaffect betweenPBMCsandbsFabC21groupandPBMCsandPBSgroup themaximallysisvalue.Theseresultssuggestthatcircu- (P<0.05).ErrorbarsrepresenttheSDofexperimentscarriedoutwith8 latingCEAshouldnotcriticallyimpacttheeffectofbsFab micepergroup. 1488 MolCancerTher;12(8)August2013 MolecularCancerTherapeutics Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Anti-FcgRIII(cid:3)CEABispecificFab-likeAntibodies morethan4.5%ID/gofbsFabbeinglocalizedintheCEA- produce.Thus,wehavestudiedaformatrelyingonthe positivetumor,whereaslessthan0.8%ID/gremainedin useofllamasdAbsthatpossessvaluablefunctionaland the blood or other organs and CEA-negative tumor, structuralpropertiesandofhumanCH1/Ckdomainsas except for kidneys (around 1%). Nontumor infiltrated heterodimerization motif, to produce Fab-like bispecific organswithnoticeablelevelofbsFabwerekidneys,prob- antibodyfragments. ablyduetobsFabclearance. Asaproof-of-concept,weconstructedbsFabstargeting CEA-positive tumor cells and human FcgRIIIa–positive bsFabinvivoefficacyinxenograftedmice immune effector cells, using previously isolated anti- To determine whether the potent in vitro activity of FcgRIIIa sdAbs–binding epitopes located outside the bsFabwouldtranslateintoinhibitionoftumorgrowthin Fc-binding site, and an anti-CEA sdAb chosen for its vivo,anadoptivetransfermodelwasused.Atday0,NSG affinity comparable with conventional anti-CEA mAbs, micewereengraftedsubcutaneouslywith CEA-positive despiteitslackofbivalency. human pancreatic cancer BxPC3 cells and with human These molecules were easily produced in E. coli with PBMCsfromhealthydonorsandtreatedwith100mgof routine yield ranging from 0.5 to 2 mg/L of culture in bsFabC21byintraperitonealinjection.InjectionsofbsFab nonoptimalshakerflaskconditionsinanacademiclabo- C21(50mg)weredoneforthe2followingdays(cumula- ratory,whichcomparesfavorablywithotherformatssuch tivedose/mouse¼200mg).Micetreatedonlywitheither as tandem scFv (the BiTE format) requiring eukaryotic PBS, bsFab C21, or PBMC þ PBS were used as control cellsforproduction(41).ThehighstabilityofthesebsFabs groups (n ¼ 8). As shown in Fig. 6B, significant tumor conferredbytheabsenceoflinkersisillustratedbythefact growthinhibitionwasvisibleinmicetreatedwithPBMCs thattheyretainedtheirfullbindingactivityatleastfor7 andbsFabC21ascomparedwithPBSorbsFabtreatment daysinhumanserumat37(cid:2)C,evenatlowconcentration. alone.Aslightreductionoftumorgrowthwasobserved One of the key issues with bsAbs is their capacity to withhumanPBMCstreatmentalone. triggeranefficientcell-mediatedcytotoxicity.Ourinvitro datashowedastrongandspecificNKcell–mediatedlysis Discussion ofCEA-expressingtumorcells(frompancreaticandcolo- Redirectingthecytotoxicpotentialofleukocytestoelim- rectalcancers)atpicomolarconcentrations,thatis,orders inatetumorcellshasbeenamajorimpulseforthedevel- of magnitude lower than conventional mAbs (10, 42). opment of bsAbs for cancer immunotherapy. FcgRIIIa These results suggest that a high affinity for FcgRIIIa is an attractive candidate to recruit effector cells. It is translatesintoimprovedcytotoxicactivityofeffectorcells stronglyexpressedbyNKcellsthatplayacriticalrolein in vitro, a finding also described with mutated and gly- theinductionofADCC,oneofthemajormodesofaction coengineeredantibodies(43,44).Asopposedtoclassical ofantitumorantibodies.Inaddition,FcgRIIIaisalsoexp- mAbs such as rituximab, target antigen density did not ressedonmonocytesandmacrophagesthatareimportant significantlyimpactbsFab-mediatedADCCasshownby actorsofantitumorimmunity.Anti-FcgRIIIabsAbshave theuseoftumorcelllinesexpressingdifferentamountsof the potential to bypass several important limitations CEA.Thesignificantinhibitionoftumorgrowthobserved facedbytherapeuticantibodies.However,difficultiesin upon human PBMCs adoptive transfer to CEA-positive producing sufficient amounts of functional and stable tumor–bearingNSGmicesupportstheinvivoefficacyof bsAbsatreasonablecostshavestronglyhamperedtheir thebsFabformat.ThelowlevelofINF-gsecretionbyNK developmentformanyyears,althoughearlyclinicaltrials cellsinducedbybsFabintheabsenceoftargetcellsinvitro hadbeenpromising(38,39).Molecularconstructs,such suggests in addition that bsFabs should not induce any as bispecific diabodies, single-chain diabodies, tandem systemic activation of NK cells in vivo and should not 0 scFvsandF(ab)obtainedbyrecombinantDNAtechnol- provokecytokinestorm. ogy,mightcircumventtheabovelimits.Theseformatscan Importantly, by carefully choosing the anti-FcgRIII be expressed in bacteria or mammalian cells and may sdAb,wehaveconstructedbsFabswhoseactionisinsen- showbenefitsduetotheirsmallsize,althoughtheycan sitive to FcgRIIIa polymorphism and that do not bind presentmanufacturingchallengesrelatedtotheirproduc- inhibitoryFcgRIIb. tionandinvitroandinvivostability.Notably,thevariable Because of their high efficiency and the absence of andunpredictableexpressionyieldsobservedfordiffer- competitionwithserumIgG,thesemoleculesshouldbe ent scFvs hamper their widespread use. Moreover, the clinicallyactiveatmuchlowerconcentrationsthanthose linker connecting the VH and VL in the scFv and that usedforconventionalmAbsasalreadyreportedforthe between different scFvs can provoke aggregation of the bispecific T-cell engager format (21). These properties, molecule. Shortening the linkers to produce diabodies addedtothepossibilitytoproduceeasilythesefragments does not always guarantee success, as the linkers can inE.coliinlargeamounts,havethepotentialtosubstan- induceanerroneousanglebetweentheVH–VLpair,thus tiallyreducethehighmanufacturingcostsassociatedwith formingpoorlyfunctionalantibodies(40). mAbtherapy. Animportantmotivationoftheworkreportedherein TheretargetingofFcgRIII-expressingcellshasanother þ wasthereforetodesignanewlinker-freebispecificformat advantage over CD3 T-cell retargeting by bsAb. Anti- to avoid aggregation and stability issues and easy to CD3 bsAbshave been shown tolead to the recruitment www.aacrjournals.org MolCancerTher;12(8)August2013 1489 Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research. Published OnlineFirst June 11, 2013; DOI: 10.1158/1535-7163.MCT-12-1012 Rozanetal. and the activation of regulatory T cells (T ; ref. 45) activityirrespectiveofFcgRIIIapolymorphism,glycosyl- reg possibly leading to a downregulation of the antitumor ation,andcompetingendogenousIgGissues.Altogether, response. FcgRIII retargeting does not activate the T thesepropertiesassociatedtoasignificantcytotoxicactiv- reg subset,anddoesnottriggerimmunosuppression. ityinapreclinicalinvivomodelconfertothisbispecific A possible limitation of anti-CEA bsFabs might be Fab-like antibody format the potential to lead to a new thepresenceofshedextracellulardomainsofCEAinthe generation of highly active therapeutic antibodies for serumofpatientswithcancer,possiblyblockingtheanti- tumortherapy. CEA–bindingsite.Here,weshowthatbsFab-dependent cytotoxicityisonlyslightlyimpactedbytheconcentration DisclosureofPotentialConflictsofInterest of soluble CEA exceeding concentrations found in the J.-L.Teillaudisaconsultant/advisoryboardmemberofBiotechCom- pany.Nopotentialconflictsofinterestweredisclosedbytheotherauthors. majority of patients with cancer (46). Thus, as already suggestedbysomeclinicalstudiesusinganti-CEAanti- Authors'Contributions bodies(47,48),solubleCEAshouldnothaveasignificant Conceptionanddesign:C.Rozan,A.P(cid:3)elegrin,P.Chames,J.-L.Teillaud, impactontheclinicalefficacyofthebsAb. D.Baty Anotherimportantissuefacedbytherapeuticantibody Development of methodology: C. Rozan, A. Cornillon, C. P(cid:1)etiard, M.Chartier,G.Behar,C.Boix,P.Chames,D.Baty fragmentsdevoidofFcportionistheirpharmacokinetic Acquisitionofdata(providedanimals,acquiredandmanagedpatients, property.Asalikelyconsequenceoftheirsmallsizeandof providedfacilities,etc.):C.Rozan,A.Cornillon,C.P(cid:1)etiard,B.Robert Analysisandinterpretationofdata(e.g.,statisticalanalysis,biostatis- theirlackofinteractionwithFcRn,Fabfragmentshavea tics,computationalanalysis):C.Rozan,A.Cornillon,C.P(cid:1)etiard,G.Behar, meanretentiontimeinthebody35-foldlowerthanfull- B.Kerfelec,B.Robert,P.Chames,J.-L.Teillaud length IgG (49). Despite this disadvantage, it has been Writing,review,and/orrevisionofthemanuscript:C.Rozan,A.Cornil- lon,B.Kerfelec,P.Chames,J.-L.Teillaud,D.Baty shownthattheirsmallersizeascomparedwithwholeIgG Administrative,technical,ormaterialsupport(i.e.,reportingororga- limitstheirretentioninnontargetedorgansandincreases nizingdata,constructingdatabases):G.Behar,P.Chames theirtumorpenetration.Consistentwiththosedata,bio- Studysupervision:A.P(cid:3)elegrin,D.Baty distributionexperimentscarriedoutinnudemicebearing Acknowledgments CEA-positivetumorxenograftsrevealedarapidincrease TheauthorsthankSabrinaSeddikandSt(cid:1)ephanieCharlesforskilled ofCEA-positivetoCEA-negativetumorratiouptoalmost technicalassistanceandIsabelleTeulon,JacquesBarbet,Herv(cid:1)eWatier, 7-foldat15hours,showingaspecificandefficienttumor S(cid:1)everineBarth,andMathieuCollinforhelpfuldiscussion. targeting of bsFabs. Nevertheless, the bsFab format GrantSupport authorizesthelinker-freeadditionofsingle-domainanti- ThisworkwassupportedbyINSERM,INSERM-Transfert(ProCop).C. bodiesattheC-terminusofCH1orCkdomains(datanot BoixwassupportedbyagrantfromthePo^ledeComp(cid:1)etitivit(cid:1)eM(cid:1)editech shown).Itcanthereforebeenvisagedtoconstructtrispe- Sant(cid:1)e,Ile-de-France(Immucanproject).C.P(cid:1)etiardwassupportedbya cific formats by adding an anti-human serum albumin grantfromInserm-Transfert(ProCop). Thecostsofpublicationofthisarticleweredefrayedinpartbythe sdAb, a method that has been shown to significantly paymentofpagecharges.Thisarticlemustthereforebeherebymarked increasetumorretentionandhalf-life(50,51). advertisementinaccordancewith18U.S.C.Section1734solelytoindicate thisfact. Inconclusion,wehavedesignedanewclassofsingle- domain–based bispecific antibodies that combines easy ReceivedOctober17,2012;revisedMay14,2013;acceptedJune5,2013; production, high stability, and potent in vitro ADCC publishedOnlineFirstJune11,2013. References 1. ChamesP,VanRegenmortelM,WeissE,BatyD.Therapeuticanti- HER-2/neu-positivemetastaticbreastcancer.JClinOncol2008; bodies:successes,limitationsandhopesforthefuture.BrJPharmacol 26:1789–96. 2009;157:220–33. 8. SiberilS,DutertreCA,FridmanWH,TeillaudJL.FcgammaR:thekeyto 2. BorossP,LeusenJH.MechanismsofactionofCD20antibodies.AmJ optimize therapeutic antibodies?CritRevOncolHematol2007;62: CancerRes2012;2:676–90. 26–33. 3. DesjarlaisJR,LazarGA,ZhukovskyEA,ChuSY.Optimizingengage- 9. Shinkawa T,NakamuraK, Yamane N, Shoji-HosakaE, Kanda Y, mentoftheimmunesystembyanti-tumorantibodies:anengineer's SakuradaM,etal.Theabsenceoffucosebutnotthepresenceof perspective.DrugDiscovToday2007;12:898–910. galactoseorbisectingN-acetylglucosamineofhumanIgG1com- 4. GloriusP,BaerenwaldtA,KellnerC,StaudingerM,DechantM,Stauch plex-type oligosaccharides shows the critical role of enhancing M,etal.Thenoveltribody[(CD20)(2)xCD16]efficientlytriggerseffector antibody-dependent cellular cytotoxicity. J Biol Chem 2003;278: cell-mediatedlysisofmalignantBcells.Leukemia2013;27:190–201. 3466–73. 5. UmanaP,Jean-MairetJ,MoudryR,AmstutzH,BaileyJE.Engineered 10. deRomeufC,DutertreCA,LeGarff-TavernierM,FournierN,Gaucher glycoformsofanantineuroblastomaIgG1withoptimizedantibody- C,GlacetA,etal.Chroniclymphocyticleukaemiacellsareefficiently dependentcellularcytotoxicactivity.NatBiotechnol1999;17:176–80. killedbyananti-CD20monoclonalantibodyselectedforimproved 6. CartronG,DacheuxL,SallesG,Solal-CelignyP,BardosP,Colombat engagement of FcgammaRIIIA/CD16. Br J Haematol 2008;140: P, et al. Therapeutic activity of humanized anti-CD20 monoclonal 635–43. antibodyandpolymorphisminIgGFcreceptorFcgammaRIIIagene. 11. PreithnerS,ElmS,LippoldS,LocherM,WolfA,daSilvaAJ,etal. Blood2002;99:754–8. HighconcentrationsoftherapeuticIgG1antibodiesareneededto 7. MusolinoA,NaldiN,BortesiB,PezzuoloD,CapellettiM,Missale compensateforinhibitionofantibody-dependentcellularcytotox- G, etal.Immunoglobulin GfragmentC receptor polymorphisms icity by excess endogenous immunoglobulin G. Mol Immunol andclinicalefficacyoftrastuzumab-basedtherapyinpatientswith 2006;43:1183–93. 1490 MolCancerTher;12(8)August2013 MolecularCancerTherapeutics Downloaded from mct.aacrjournals.org on April 10, 2019. © 2013 American Association for Cancer Research.

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Abstract. Antibody-dependent cell-mediated cytotoxicity, one of the most prominent modes of action of antitumor antibodies, suffers from important limitations due to the need for optimal interactions with Fcg receptors. In this work, we report the design of a new bispecific antibody format, compact
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