Enhancement of CD117-Targeted Bispecific T-cell Engagement by CD33-Targeted Bispecific T-cell Costimulation in Acute

Mara Hofstetter1,2, Laura Volta1,2, Christian Koch1,2

  • 1Department of Medical Oncology and Hematology, University and University Hospital Zürich, Zürich, Switzerland.

Acute myeloid leukemia (AML) originates from the hematopoietic stem and progenitor cell compartment and is associated with an overall poor clinical outcome. T cell-engaging bispecific antibodies (TCE), binding to a tumor-associated antigen and to CD3, redirect T cells to target antigen-expressing cells in an MHC/TCR-independent fashion. The development of TCEs for clinical application is facing several challenges. First, it is difficult to identify a tumor-selective, non-MHC-presented tumor target, not expressed on the tissue of tumor origin, thus limiting specificity. Second, CD3-directed TCEs do not provide a second, T cell-activating signal, such as the stimulation of CD28 or 41BB, thus possibly limiting T-cell efficacy. To address both aspects, we generated a CD33xCD28 IgG4-scFv2 with CD28 agonistic activity and tested it in combination with a previously by us reported CD117xCD3 TCE in AML. Combining these two bispecific antibodies significantly improved T cell-mediated lysis of AML cell lines and primary AML samples by enhancing T-cell activation, proliferation, and cytokine release in vitro. Furthermore, the addition of CD33xCD28 IgG4-scFv2 showed faster time to cell attachment, increased lytic events, and improved specificity toward double-target-expressing cells. In summary, the data indicate that combining costimulation via a second tumor-associated antigen to CD3-TCEs enhances T-cell lytic activity and simultaneously increases specificity against double-target-expressing AML cells.