Optimal design, anti-tumour efficacy and tolerability of anti-CXCR4 antibody drug conjugates

Sci Rep. 2019 Feb 21;9(1):2443. doi: 10.1038/s41598-019-38745-x.

Abstract

Antibody-drug conjugates (ADCs) are promising therapies for haematological cancers. Historically, their therapeutic benefit is due to ADC targeting of lineage-restricted antigens. The C-X-C motif chemokine receptor 4 (CXCR4) is attractive for targeted therapy of haematological cancers, given its expression in multiple tumour types and role in cancer "homing" to bone marrow. However, CXCR4 is also expressed in haematopoietic cells and other normal tissues, raising safety challenges to the development of anti-CXCR4 ADCs for cancer treatment. Here, we designed the first anti-CXCR4 ADC with favourable therapeutic index, effective in xenografts of haematopoietic cancers resistant to standard of care and anti-CXCR4 antibodies. We screened multiple ADC configurations, by varying type of linker-payload, drug-to-antibody ratio (DAR), affinity and Fc format. The optimal ADC bears a non-cleavable linker, auristatin as payload at DAR = 4 and a low affinity antibody with effector-reduced Fc. Contrary to other drugs targeting CXCR4, anti-CXCR4 ADCs effectively eliminated cancer cells as monotherapy, while minimizing leucocytosis. The optimal ADC selectively eliminated CXCR4+ cancer cells in solid tumours, but showed limited toxicity to normal CXCR4+ tissues, sparing haematopoietic stem cells and progenitors. Our work provides proof-of-concept that through empirical ADC design, it is possible to target proteins with broad normal tissue expression.

MeSH terms

  • Animals
  • Antineoplastic Agents, Immunological* / administration & dosage
  • Antineoplastic Agents, Immunological* / adverse effects
  • Antineoplastic Agents, Immunological* / chemical synthesis
  • Antineoplastic Agents, Immunological* / chemistry
  • CHO Cells
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Cell Line, Tumor
  • Cells, Cultured
  • Cricetinae
  • Cricetulus
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives
  • Drug Design*
  • Female
  • Gemcitabine
  • Humans
  • Immunoconjugates* / administration & dosage
  • Immunoconjugates* / adverse effects
  • Immunoconjugates* / chemistry
  • Immunoglobulin Fab Fragments / administration & dosage
  • Immunoglobulin Fab Fragments / adverse effects
  • Immunoglobulin Fab Fragments / chemistry
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / pathology
  • Mice
  • Mice, Inbred C57BL
  • Mice, SCID
  • Mice, Transgenic
  • Models, Molecular
  • Protein Structure, Tertiary
  • Receptors, CXCR4 / antagonists & inhibitors
  • Receptors, CXCR4 / immunology*
  • Treatment Outcome
  • Xenograft Model Antitumor Assays

Substances

  • Antineoplastic Agents, Immunological
  • CXCR4 protein, human
  • Immunoconjugates
  • Immunoglobulin Fab Fragments
  • Receptors, CXCR4
  • Deoxycytidine
  • Gemcitabine