Application of a MABEL Approach for a T-Cell-Bispecific Monoclonal Antibody: CEA TCB

J Immunother. 2016 Sep;39(7):279-89. doi: 10.1097/CJI.0000000000000132.

Abstract

CEA TCB is a novel T-cell-bispecific (TCB) antibody targeting the carcinoembryonic antigen (CEA) expressed on tumor cells and the CD3 epsilon chain (CD3e) present on T cells, which is currently in Phase 1 clinical trials (NCT02324257) for the treatment of CEA-positive solid tumors. Because the human CEA (hCEA) binder of CEA TCB does not cross-react with cynomolgus monkey and CEA is absent in rodents, alternative nonclinical safety evaluation approaches were considered. These included the development of a cynomolgus monkey cross-reactive homologous (surrogate) antibody (cyCEA TCB) for its evaluation in cynomolgus monkey and the development of double-transgenic mice, expressing hCEA and human CD3e (hCEA/hCD3e Tg), as a potential alternative species for nonclinical safety studies. However, a battery of nonclinical in vitro/ex vivo experiments demonstrated that neither of the previous approaches provided a suitable and pharmacologically relevant model to assess the safety of CEA TCB. Therefore, an alternative approach, a minimum anticipated biological effect level (MABEL), based on an in vitro tumor lysis assay was used to determine the starting dose for the first-in-human study. Using the most conservative approach to the MABEL assessment, a dose of 52 μg was selected as a safe starting dose for clinical study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Bispecific / metabolism*
  • Apoptosis
  • CD3 Complex / immunology*
  • Carcinoembryonic Antigen / immunology*
  • Cells, Cultured
  • Clinical Trials, Phase I as Topic
  • Cross Reactions
  • Drug Dosage Calculations
  • Drug Evaluation, Preclinical
  • Humans
  • Immunotherapy / methods*
  • Macaca fascicularis
  • Mice
  • Mice, Transgenic
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Rats
  • Structural Homology, Protein

Substances

  • Antibodies, Bispecific
  • CD3 Complex
  • Carcinoembryonic Antigen