Precision-activated T-cell engagers targeting HER2 or EGFR and CD3 mitigate on-target, off-tumor toxicity for immunotherapy in solid tumors

Nat Cancer. 2023 Apr;4(4):485-501. doi: 10.1038/s43018-023-00536-9. Epub 2023 Mar 30.

Abstract

To enhance the therapeutic index of T-cell engagers (TCEs), we engineered masked, precision-activated TCEs (XPAT proteins), targeting a tumor antigen (human epidermal growth factor receptor 2 (HER2) or epidermal growth factor receptor (EGFR)) and CD3. Unstructured XTEN polypeptide masks flank the N and C termini of the TCE and are designed to be released by proteases in the tumor microenvironment. In vitro, unmasked HER2-XPAT (uTCE) demonstrates potent cytotoxicity, with XTEN polypeptide masking providing up to 4-log-fold protection. In vivo, HER2-XPAT protein induces protease-dependent antitumor activity and is proteolytically stable in healthy tissues. In non-human primates, HER2-XPAT protein demonstrates a strong safety margin (>400-fold increase in tolerated maximum concentration versus uTCE). HER2-XPAT protein cleavage is low and similar in plasma samples from healthy and diseased humans and non-human primates, supporting translatability of stability to patients. EGFR-XPAT protein confirmed the utility of XPAT technology for tumor targets more widely expressed in healthy tissues.

MeSH terms

  • Animals
  • Antigens, Neoplasm / metabolism
  • CD3 Complex / metabolism
  • ErbB Receptors
  • Humans
  • Immunotherapy / adverse effects
  • Neoplasms* / drug therapy
  • T-Lymphocytes*
  • Tumor Microenvironment

Substances

  • Antigens, Neoplasm
  • EGFR protein, human
  • ErbB Receptors
  • CD3 Complex