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Design and Efficacy of a Monovalent Bispecific PD-1/CTLA4 Antibody That Enhances CTLA4 Blockade on PD-1+ Activated T Cells
Published version of a preprint
Abstract
The clinical benefit of PD-1 blockade can be improved by combination with CTLA4 inhibition but is commensurate with significant immune-related adverse events suboptimally limiting the doses of anti-CTLA4 mAb that can be used. MEDI5752 is a monovalent bispecific antibody designed to suppress the PD-1 pathway and provide modulated CTLA4 inhibition favoring enhanced blockade on PD-1+ activated T cells. We show that MEDI5752 preferentially saturates CTLA4 on PD-1+ T cells versus PD-1− T cells, reducing the dose required to elicit IL2 secretion. Unlike conventional PD-1/CTLA4 mAbs, MEDI5752 leads to the rapid internalization and degradation of PD-1. Moreover, we show that MEDI5752 preferentially localizes and accumulates in tumors providing enhanced activity when compared with a combination of mAbs targeting PD-1 and CTLA4 in vivo. Following treatment with MEDI5752, robust partial responses were observed in two patients with advanced solid tumors. MEDI5752 represents a novel immunotherapy engineered to preferentially inhibit CTLA4 on PD-1+ T cells. Significance: The unique characteristics of MEDI5752 represent a novel immunotherapy engineered to direct CTLA4 inhibition to PD-1+ T cells with the potential for differentiated activity when compared with current conventional mAb combination strategies targeting PD-1 and CTLA4. This molecule therefore represents a step forward in the rational design of cancer immunotherapy. See related commentary by Burton and Tawbi, p. 1008. This article is highlighted in the In This Issue feature, p. 995
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“Numerous bispecific antibodies have been developed, including CTLA-4 × PD-L1 (KN046) [281], CTLA-4 × PD-1 (MGD019 and MEDI5752) [282, 283], LAG-3 × PD-L1 (IBI323) [284], LAG-3 × PD-1 (Tebotelimab) [285], TIM-3 × PD-L1 (LY3415244) [286], TIM-3 × PD-1 [305], TIGIT×PD-L1 [287].”
From Combination strategies with PD-1/PD-L1 blockade: current advances and future directions (2022) · cites this paper as [283]
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Metadata
- Authors
- Dovedi, S. J., Elder, M. J., Yang, C., Sitnikova, S. I., Irving, L., Hansen, A., Hair, J., Jones, D. C., Hasani, S., Wang, B., Im, S.-A., Tran, B., Subramaniam, D. S., Gainer, S. D., Vashisht, K., Lewis, A., Jin, X., Kentner, S., Mulgrew, K., Wang, Y., Overstreet, M. G., Dodgson, J., Wu, Y., Palazon, A., Morrow, M., Rainey, G. J., Browne, G. J., Neal, F., Murray, T. V., Toloczko, A. D., Dall'Acqua, W., Achour, I., Freeman, D. J., Wilkinson, R. W., & Mazor, Y.
- Affiliations
- 1Early Oncology R&D, AstraZeneca.
- 2Antibody Discovery and Protein Engineering, R&D, AstraZeneca.
- 3Translational Science and Experimental Medicine, Respiratory and Immunology (RI), Biopharmaceuticals R&D, AstraZeneca.
- Seoul National University (KR)
- Peter MacCallum Cancer Centre (AU)
- ORCID
- Dovedi, Simon J.
- Yang, Chunning
- Sitnikova, Suzanne I.
- Irving, Lorraine
- Hansen, Anna
- Jones, Des C.
- Hasani, Sumati
- Wang, Bo
- Im, Seock-Ah
- Tran, Ben
- Gainer, Shelby D.
- Vashisht, Kapil
- Lewis, Arthur
- Jin, Xiaofang
- Mulgrew, Kathy
- Wang, Yaya
- Overstreet, Michael G.
- Wu, Yanli
- Palazon, Asis
- Morrow, Michelle
- Rainey, Godfrey J.
- Browne, Gareth J.
- Neal, Frances
- Murray, Thomas V.
- Achour, Ikbel
- Wilkinson, Robert W.
- Mazor, Yariv
- Venue
- Cancer Discovery
- Published
- 2021-01-08
- Volume
- 11
- Issue
- 5
- Pages
- 1100-1117
- ISSN
- 2159-8274 (ISSN-L)
- 2159-8290
- OpenAlex
- W3121059150
- Cited by
- 186
- References
- 63
- Citations by year
- 2026: 20 · 2025: 35 · 2024: 48 · 2023: 38 · 2022: 31 · 2021: 14
- FWCI
- 11.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cancer Discovery (publishedVersion)
- PubMed (publishedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Funders
- AstraZeneca
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Monoclonal and Polyclonal Antibodies Research
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- bispecific antibodies, PD-1, CTLA-4, immune checkpoint blockade, PD-1+ T cells, tumor-infiltrating lymphocytes, IL-2 secretion, tumor localization, solid tumors, cancer immunotherapy, immune-related adverse events
- MeSH terms
- Adenocarcinoma, Humans, Immunotherapy, Kidney Neoplasms, Male, Middle Aged, Stomach Neoplasms, T-Lymphocytes, Adenocarcinoma, Clear Cell, CTLA-4 Antigen, Programmed Cell Death 1 Receptor, Antibodies, Monoclonal, Humanized
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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