title: Cergutuzumab amunaleukin (CEA-IL2v), a CEA-targeted IL-2 variant-based immunocytokine for combination cancer immunotherapy: Overcoming limitations of aldesleukin and conventional IL-2-based immunocytokines.
abstract: We developed cergutuzumab amunaleukin (CEA-IL2v, RG7813), a novel monomeric CEA-targeted immunocytokine, that comprises a single IL-2 variant (IL2v) moiety with abolished CD25 binding, fused to the C-terminus of a high affinity, bivalent carcinoembryonic antigen (CEA)-specific antibody devoid of Fc-mediated effector functions. Its molecular design aims to (i) avoid preferential activation of regulatory T-cells vs. immune effector cells by removing CD25 binding; (ii) increase the therapeutic index of IL-2 therapy by (a) preferential retention at the tumor by having a lower dissociation rate from CEA-expressing cancer cells vs. IL-2R-expressing cells, (b) avoiding any FcγR-binding and Fc effector functions and (c) reduced binding to endothelial cells expressing CD25; and (iii) improve the pharmacokinetics, and thus convenience of administration, of IL-2. The crystal structure of the IL2v-IL-2Rβγ complex was determined and CEA-IL2v activity was assessed using human immune effector cells. Tumor targeting was investigated in tumor-bearing mice using89Zr-labeled CEA-IL2v. Efficacy studies were performed in (a) syngeneic mouse models as monotherapy and combined with anti-PD-L1, and in (b) xenograft mouse models in combination with ADCC-mediating antibodies. CEA-IL2v binds to CEA with pM avidity but not to CD25, and consequently did not preferentially activate Tregs.In vivo, CEA-IL2v demonstrated superior pharmacokinetics and tumor targeting compared with a wild-type IL-2-based CEA immunocytokine (CEA-IL2wt). CEA-IL2v strongly expanded NK and CD8+T cells, skewing the CD8+:CD4+ratio toward CD8+T cells both in the periphery and in the tumor, and mediated single agent efficacy in syngeneic MC38-CEA and PancO2-CEA models. Combination with trastuzumab, cetuximab and imgatuzumab, all of human IgG1 isotype, resulted in superior efficacy compared with the monotherapies alone. Combined with anti-PD-L1, CEA-IL2v mediated superior efficacy over the respective monotherapies, and over the combination with an untargeted control immunocytokine. These preclinical data support the ongoing clinical investigation of the cergutuzumab amunaleukin immunocytokine with abolished CD25 binding for the treatment of CEA-positive solid tumors in combination with PD-L1 checkpoint blockade and ADCC competent antibodies.
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Klein
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Inja
authors.initials: I
authors.lastname: Waldhauer
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Valeria G
authors.initials: VG
authors.lastname: Nicolini
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Freimoser-Grundschober
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Tapan
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authors.lastname: Nayak
authors.affiliation: Roche Pharma Research & Early Development, Department of Radiology & Nuclear Medicine, VU University Medical Center , Amsterdam, the Netherlands.
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Vugts
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Claire
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authors.lastname: Dunn
authors.affiliation: Roche Pharma Research & Early Development, Department of Radiology & Nuclear Medicine, VU University Medical Center , Amsterdam, the Netherlands.
authors.forename: Marije
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authors.lastname: Bolijn
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Jörg
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authors.lastname: Benz
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Martine
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authors.lastname: Stihle
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Sabine
authors.initials: S
authors.lastname: Lang
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Michaele
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authors.lastname: Roemmele
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Thomas
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authors.lastname: Hofer
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Erwin
authors.initials: E
authors.lastname: van Puijenbroek
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Wittig
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Samuel
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authors.lastname: Moser
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Oliver
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authors.lastname: Ast
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Brünker
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Munich , Penzberg, Germany.
authors.forename: Ingo H
authors.initials: IH
authors.lastname: Gorr
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Sebastian
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authors.lastname: Neumann
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: de Vera Mudry
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Heather
authors.initials: H
authors.lastname: Hinton
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Basel , Basel, Switzerland.
authors.forename: Flavio
authors.initials: F
authors.lastname: Crameri
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Jose
authors.initials: J
authors.lastname: Saro
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Evers
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerdes
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Marina
authors.initials: M
authors.lastname: Bacac
authors.affiliation: Roche Pharma Research & Early Development, Department of Radiology & Nuclear Medicine, VU University Medical Center , Amsterdam, the Netherlands.
authors.forename: Guus
authors.initials: G
authors.lastname: van Dongen
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Moessner
authors.affiliation: Roche Pharma Research & Early Development, Roche Innovation Center Zurich , Schlieren, Switzerland.
authors.forename: Pablo
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authors.lastname: Umaña
keywords: Antibody; CEA; CEACAM5; IL-2; IL2v; Immunocytokine