MGD019, a PD-1 x CTLA-4 Bispecific DART Molecule, Provides ... · Valentina Ciccarone, Ralph...
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MGD019, a PD-1 x CTLA-4 Bispecific DART ® Molecule, Provides Simultaneous Blockade of PD-1 and CTLA-4 Checkpoint Pathways Alexey Berezhnoy, Kurt Stahl, Kalpana Shah, Tim Gaynutdinov, Daorong Liu, Ross La Motte-Mohs R, Jessica Saul, Jonathan Li*, Douglas Smith*, Jill Rillema*, Sergey Gorlatov, Valentina Ciccarone, Ralph Alderson, Hua Li, James Tamura, Jennifer Brown, Bradley Sumrow, Jon Wigginton, Ezio Bonvini, Syd Johnson, Paul A. Moore MacroGenics, Inc., Rockville, MD and *Brisbane, CA Presented at the 2019 Keystone Symposia Conference, “Uncovering Mechanisms of Immune-Based Therapy in Cancer and Autoimmunity”, February 18–22, 2019, Breckenridge, Colorado Poster 1012 http://ir.macrogenics.com/events.cfm MGD019 Pharmacokinetics and Receptor Occupancy 0 7 14 21 28 35 42 49 56 63 70 77 84 91 0 50 100 150 10 2 10 4 10 6 Study Day % Binding MGD019 Serum Concentration (ng/mL) CD4+/PD-1+ Cells 0 mg/kg 10 mg/kg 40 mg/kg 100 mg/kg ■ MGD019 demonstrates good pharmacokinetics consistent with IgG4 Fc backbone ■ MGD019 receptor occupancy correlate with its serum concentration Cynomolgus monkey (3F/3M) were infused with 10, 40 or 100 mg/kg/dose MGD019 at Day 1, 8, 15, and 22. Serum concentration was measured by ELISA (right axis) and receptor occupancy was measured by flow cytometry (left axis). MGD019 Supports Homeostatic Proliferation of T Cells In Vivo 0 100 200 300 400 0 200 400 600 800 1000 T-cell Proliferation in Peripheral Blood Time (hours) CD4+Ki67+ Cells % Change from Baseline Vehicle PD-1 x CTLA-4 DART (MGD019) PD-1 mAb (MGA012) Group 1 Vehicle Group 2 (10 mg/kg) Group 3 (40 mg/kg) Group 4 (100 mg/kg) 0 5 10 15 20 25 Activated CD8 Cells CD25+ CD8 Cells (%) 0 10 20 30 40 50 CD8 T-cell Proliferation Ki67+ CD8 Cells (%) 0 20 40 60 80 ICOS Expression on CD4 T Cells ICOS+ CD4 Cells (%) A. B. C. 0.00 0.05 0.10 Spleen Weights Mean Spleen to Brain Weight Ratio at Terminal Necropsy PD-1 x CTLA-4 DART (MGD019) Vehicle PD-1 mAb (MGA012) A. Cynomolgus monkeys were infused IV Q1W for 3 weeks with 75 mg/kg MGD019 (3M/3F) and, in a separate study, 100 mg/kg MGA012 (anti-PD-1, 2M/2F). Ki67 expression was quantified by flow cytometry. B. Spleen weights at terminal necropsy were calculated as fraction of brain weight. C. Cynomolgus monkey were injected weekly with indicated amounts of MGD019. Shortly after 4th injection, splenocytes of necropsied animals were analyzed for expression of CD25, Ki-67, and ICOS. MGD019 Induces Memory T Cells In Vivo 0 20 40 60 80 Memory CD28+CD95 CD4 Cells (%) 0 5 10 15 Effectors CD28-Low CD4 Cells (%) Group 1 Vehicle Group 2 (10 mg/kg) Group 3 (40 mg/kg) Group 4 (100 mg/kg) 0 20 40 60 80 Naïve CD28+CD95- CD4 Cells (%) Vehicle 100 mg/kg CD28 CD95 Cynomolgus monkeys were injected weekly with indicated amounts of MGD019. Shortly after 4th injection, T cells of necropsied animals were analyzed for expression of CD28 and CD95 by flow cytometry. MGD019 Phase 1 Study (Started 2H2018) An ongoing Phase 1, open-label study will characterize safety, dose-limiting toxicities (DLTs), and maximum tolerated/administered dose (MTD/MAD) of MGD019. Dose escalation will occur in a 3+3+3 design in patients with advanced solid tumors of any histology. Once the MTD/MAD is determined, a Cohort Expansion Phase will be enrolled to further characterize safety and initial anti-tumor activity in patients with specific tumor types anticipated to be sensitive to dual checkpoint blockade. Conclusions ■ T cells co-expressing PD-1 and CTLA-4 are more prevalent in tumors compared to healthy tissues ■ MGD019 binds to and blocks its targets with increased activity on dual PD-1/CTLA-4- expressing cells ■ MGD019 induces a unique transcriptional activation pattern partially overlapping that induced by the combination of individual mAbs ■ In cynomolgus monkeys, MGD019 demonstrates IgG4-like PK and a good safety profile similar to that observed with PD-1 blockade alone, while demonstrating biological effects of CTLA-4 antagonism Reference 1. Selby M. et al. Preclinical Development of Ipilimumab and Nivolumab Combination Immunotherapy: Mouse Tumor Models, In Vitro Functional Studies, and Cynomolgus Macaque Toxicology. PLoS One. 2016 Sep 9;11(9):e0161779: Group M/F Treatment Dose (mg/kg) Diarrhea (n/N) Mean SpleenWeight (g) Spleen Pathology (n/N) Gastrointestinal Pathology (n/N) Day 30 M/F Day 59 M/F 1 5/5 Saline control — 0/10 3.9/2.8 3.5/3.7 0/6 0/6 2 5/5 Nivolumab + ipilimumab 10 3 2/10 4.0/3.6 4.3/2.4 2/6 2/6 3 5/5 Nivolumab + ipilimumab 50 10 4/10 6.1/4.47 7.5/3.2 4/5 3/5 Abstract Combinatorial blockade of PD-1 and CTLA-4 has shown clinical benefit beyond that observed with individual mAbs, albeit with increased toxicity. MGD019 is a PD-1 x CTLA-4 tetravalent bispecific molecule with a human IgG4 backbone to limit effector function and designed to engage each target in a bivalent modality. MGD019 demonstrated independent blockade of CTLA-4/B7 and PD-1/PD-L(1/2) with a potency comparable to that achieved by replicas of the approved ipilimumab (ipi) and nivolumab (nivo). MGD019 enhanced antigen-driven in vitro T-cell activation to a level comparable to the combinatorial PD-1 plus CTLA-4 blockade. Tumor microenvironment models that recapitulate vascular or stromal compartments confirmed MGD019 induced in vitro immune response profiles comparable to those observed with replicas of ipi plus nivo. Multiplex ISH showed enrichment of PD-1/CTLA-dual positive cells in tumor-infiltrating lymphocytes (TILs) relative to normal tissues, where distinct populations expressed CTLA-4 or PD-1. MGD019 mediated enhanced blockade of CTLA-4 ligand interaction to CTLA4/PD1 dual-expressing cells compared to cells expressing CTLA-4 alone. MGD019 was well-tolerated in cynomolgus monkeys, with no mortality or significant adverse findings up to 100 mg/kg QWx4. T-cell proliferation in the periphery and expansion in lymphoid organs was observed, with increases in ICOS+ CD4 cells and memory T cells, findings attributable to the CTLA-4 blocking arm, since the anti-PD-1 mAb precursor was devoid of these activities. MGD019 offers the convenience of single molecule administration for dual checkpoint blockade. In addition to providing full blockade on cells expressing PD-1 or CTLA-4 individually, MGD019 exploits dual target avidity resulting in preferential engagement and enhanced blockade on cells that express both checkpoint molecules, a feature that could provide additional benefits given the preeminent co-expression of CTLA-4 and PD-1 by TILs. MGD019 was well tolerated in cynomolgus monkeys, while demonstrating biological effects of CTLA-4 antagonism. Taken together, these data support clinical testing of MGD019 in cancer patients. Introduction T Cells Co-expressing PD-1 and CTLA-4 are More Prevalent Among TILs Compared to Healthy Tissues Ovarian Cancer Normal Tonsil Expression of PD-1 (red) and CTLA-4 (blue) mRNA in tissue samples of ovarian cancer (left) or normal human tonsils (right) visualized by RNAscope™. MGD019, a Tetravalent Bispecific DART Molecule *TDLN: Tumor-draining lymph node. PD-1+CTLA-4 Combo: PD-1xCTLA-4 DART: Tumor Healthy Tissues Circulation ++ ++ ++ +++ ++ + TDLN* PD-1++/ CTLA-4+ PD-1+/ CTLA-4++ PD-1+ CTLA-4+ MGD019 Molecular Structure T Cell PD-1 CTLA-4 T Cell PD-1 CTLA-4 T Cell CTLA-4 T Cell PD-1 PD-1 Rationale for PD-1xCTLA-4 Dual Checkpoint Targeting Strategy CTLA-4 PD-1 CTLA-4 PD-1 IgG4 10 -8 10 -6 10 -4 10 -2 10 0 10 2 0.0 1.0 2.0 3.0 4.0 5.0 PD1/CTLA-4 Dimerization Concentration (nM) Relative Dimerization Activity Control IgG CTLA-4 mAb (parental) aPD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo PD-1 x CTLA-4 DART (MGD019) 0.0001 0.01 1 100 0.0001 0.01 1 100 0 1000 2000 3000 4000 Binding to PD-1+ Cells Concentration (nM) MFI 0 2000 4000 6000 8000 Binding to CTLA-4+ Cells Concentration (nM) MFI 0.0001 0.01 1 100 0 10000 20000 30000 Binding to PD-1+/CTLA-4+ Primary T Cells Concentration (μg/mL) MFI A. C. D. B. MGD019 Co-engages PD-1 and CTLA-4 Binding of MGD019 or control molecules to Jurkat/PD-1 (A) or Jurkat/CTLA-4 (B) cells measured by flow cytometry. C. Binding of MGD019 or control molecules to in vitro activated primary human T cells by flow cytometry. D. Co-engagement of PD-1 and CTLA-4 on the cell surface by MGD019 measured by DiscoverX™ enzyme complementation assay. ©2019 MacroGenics, Inc. All rights reserved. Results Enhanced Blockade of CTLA-4 by MGD019 on Dual Expressing Cells 0 5000 10000 15000 20000 PD-1 Blockade on PD-1+CTLA-4- Cells mAbs or DARTs (nM) PD-L1 Binding (MFI) 0 1000 2000 3000 4000 CTLA-4 Blockade on PD-1-CTLA-4+ Cells mAbs or DARTs (nM) B7-1 Binding (MFI) 0 200 400 600 800 1000 1200 PD-1 Blockade on PD-1+CTLA-4+ Cells PD-L1 Binding (MFI) 0 200 400 600 800 1000 1200 1400 CTLA-4 Blockade on PD-1+CTLA-4+ Cells B7-1 Binding (MFI) 10 -3 10 -2 10 -1 10 0 10 1 10 3 10 2 10 -8 10 -6 10 -4 10 -2 10 0 10 4 10 2 mAbs or DARTs (nM) mAbs or DARTs (nM) 10 -4 10 -3 10 -2 10 -1 10 0 10 2 10 1 10 -4 10 -3 10 -2 10 -1 10 0 10 2 10 1 Control IgG CTLA-4 mAb (parental) PD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo PD-1 x CTLA-4 DART (MGD019) Single Positive Cells Dual Expressing Cells PD-1 or CTLA-4 binding to their respective soluble ligands on Jurkat cells engineered to express PD-1 and/or CTLA-4 was measured by flow cytometry. MGD019 Enhances T-cell Activation A. B. 0 0.00010.003 0.06 1.25 25 500 0 500 1000 1500 2000 2500 SEB Concentration (ng/mL) IL-2 pg/mL Activation of Primary T Cells 0 2000 4000 6000 8000 10000 Dual PD-1/CTLA-4 Reporter Assay mAbs or DARTs (nM) Luminecence 10 -2 10 -1 10 0 10 1 10 2 10 3 Control IgG CTLA-4 mAb (parental) PD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo PD-1 x CTLA-4 DART (MGD019) A. PBMC were activated by SEB in the presence of 10 µg/mL of the indicated molecules. IL-2 secretion was measured at 96h by ELISA. B. Expression of IL-2 reporter cassette in Jurkat cells co-expressing PD-1 and CTLA-4 (Promega) co-incubated with APC in the presence of the indicated molecules. Characterization of MGD019-Enhanced T-cell Activation Tumor Microenvironment Models Transcriptional Changes in Allo-activated T Cells MGD019 46 genes upregulated Ipilimumab + nivolumab 36 genes upregulated -0.5 -0.4 -0.3 -0.2 -0.1 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 Log Ratio Ipilimumab* + nivolumab* (20 nM) Ipilimumab + nivolumab (6.7 nM) Ipilimumab + nivolumab (2.2 nM) Ipilimumab + nivolumab (0.74 nM) -0.5 -0.4 -0.3 -0.2 -0.1 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 CCL2/MCP1 CD106/VCAM1 CD40 CD69 uPAR CEACAM5/CD66e Collagen IV CXCL10/IP10 CXCL9/MIG Keratin 20 PBMC Cytotoxicity Granzyme B IL10 IL17A IL2 IL6 SRB Log Ratio MGD019 (20 nM) MGD019 (6.7 nM) MGD019 (2.2 nM) MGD019 (0.74 nM) CD106/VCAM1 CD87/uPAR CEACAM5/CD66e Collagen I Collagen III CXCL10/IP10 Keratin 20 MMP9 PAII PBMC Cytotoxicity Granzyme B IFNγ IFNγ IL10 IL17A IL2 IL6 SRB TNFα TNFα sVEGF TIMP2 tPA uPA StroHT29 VascHT29 Ipilimumab + Nivolumab MGD019 23 genes 23 genes IL-10 IL-2 13 genes IL-10 Transcriptional changes in MLR assay: T cells were re-isolated from 72h MLR assay after treatment with 1 μg/mL each ipilimumab and nivolumab or MGD019 at 1 μg/mL, and RNAseq was performed using Illumina HiSeq platform. Gene alignment, filtering for 750 immune- related genes and differential expression analysis were done using Strand NGS software. Genes were clustered based on upregulation in both donors. DiscoverX StroHT29 and VascHT29 TME models: HT-29 colorectal cells were cultured with stromal cells and PBMCs to recapitulate a tumor microenviroment (DiscoverX). Protein expression was measured following treatment with mAbs or MGD019. *Replicas of nivolumab and ipilimumab were constructed on the basis of the published sequences. MGD019 GLP Toxicology Study Dose Level (mg/kg) Dose Route Dose Days No. of Animals Terminal Necropsy (Week 4) Recovery Necropsy (Week 14) 0 (vehicle) IV infusion for 30 minutes 1, 8, 15, 22 3M / 3F 2M / 2F 10 3M / 3F 2M / 2F 40 3M / 3F 2M / 2F 100 3M / 3F 2M / 2F Finding MGD019 (PD-1xCTLA-4) MGA012 (PD-1) 10 mg/kg 40 mg/kg 100 mg/kg ≥100 mg/kg Adverse clinical signs - - - - Body weight loss - - - - Increased spleen weight + ++ ++ - Lymphoid hyperplasia in spleen - + ++ - GI tract inflammation - - - - Circulating cytokines - - - - T cell proliferation (Ki67+) + ++ ++ +/- ■ MGD019 is relatively well-tolerated compared to prior reported PD1+CTLA4 mAb combination 1 NCT03761017
Transcript of MGD019, a PD-1 x CTLA-4 Bispecific DART Molecule, Provides ... · Valentina Ciccarone, Ralph...
MGD019, a PD-1 x CTLA-4 Bispecific DART® Molecule, Provides Simultaneous Blockade of PD-1 and CTLA-4 Checkpoint Pathways
Alexey Berezhnoy, Kurt Stahl, Kalpana Shah, Tim Gaynutdinov, Daorong Liu, Ross La Motte-Mohs R, Jessica Saul, Jonathan Li*, Douglas Smith*, Jill Rillema*, Sergey Gorlatov, Valentina Ciccarone, Ralph Alderson, Hua Li, James Tamura, Jennifer Brown, Bradley Sumrow, Jon Wigginton, Ezio Bonvini, Syd Johnson, Paul A. Moore
MacroGenics, Inc., Rockville, MD and *Brisbane, CA
Presented at the 2019 Keystone Symposia Conference, “Uncovering Mechanisms of Immune-Based Therapy in Cancer and Autoimmunity”, February 18–22, 2019, Breckenridge, Colorado
Poster 1012
http://ir.macrogenics.com/events.cfm
MGD019 Pharmacokinetics and Receptor Occupancy
0 7 14 21 28 35 42 49 56 63 70 77 84 910
50
100
150 102
104
106
Study Day
% B
indi
ng
MG
D019 Serum
Concentration (ng/mL)
CD4+/PD-1+ Cells
0 mg/kg 10 mg/kg 40 mg/kg 100 mg/kg
■■ MGD019 demonstrates good pharmacokinetics consistent with IgG4 Fc backbone■■ MGD019 receptor occupancy correlate with its serum concentration
Cynomolgus monkey (3F/3M) were infused with 10, 40 or 100 mg/kg/dose MGD019 at Day 1, 8, 15, and 22. Serum concentration was measured by ELISA (right axis) and receptor occupancy was measured by flow cytometry (left axis).
MGD019 Supports Homeostatic Proliferation of T Cells In Vivo
0 100 200 300 4000
200
400
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1000T-cell Proliferation in Peripheral Blood
Time (hours)
CD4+
Ki67
+ Ce
lls%
Cha
nge
from
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Vehicle PD-1 x CTLA-4 DART (MGD019)PD-1 mAb (MGA012)
Group 1 Vehicle Group 2 (10 mg/kg) Group 3 (40 mg/kg) Group 4 (100 mg/kg)0
5
10
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25Activated CD8 Cells
CD
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8 C
ells
(%)
0
10
20
30
40
50CD8 T-cell Proliferation
Ki6
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D8
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ls (%
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20
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ICOS Expression onCD4 T Cells
ICO
S+ C
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0.00
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PD-1 x CTLA-4 DART(MGD019)
Vehicle PD-1 mAb(MGA012)
A. Cynomolgus monkeys were infused IV Q1W for 3 weeks with 75 mg/kg MGD019 (3M/3F) and, in a separate study, 100 mg/kg MGA012 (anti-PD-1, 2M/2F). Ki67 expression was quantified by flow cytometry. B. Spleen weights at terminal necropsy were calculated as fraction of brain weight. C. Cynomolgus monkey were injected weekly with indicated amounts of MGD019. Shortly after 4th injection, splenocytes of necropsied animals were analyzed for expression of CD25, Ki-67, and ICOS.
MGD019 Induces Memory T Cells In Vivo
0
20
40
60
80 Memory
CD28
+CD
95
CD4
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10
15 Effectors
CD28
-Low
CD
4 Ce
lls (%
)
Group 1 Vehicle Group 2 (10 mg/kg)Group 3 (40 mg/kg) Group 4 (100 mg/kg)
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40
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80 Naïve
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+CD
95-
CD4
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Vehicle 100 mg/kg
CD28
CD95
Cynomolgus monkeys were injected weekly with indicated amounts of MGD019. Shortly after 4th injection, T cells of necropsied animals were analyzed for expression of CD28 and CD95 by flow cytometry.
MGD019 Phase 1 Study (Started 2H2018)An ongoing Phase 1, open-label study will characterize safety, dose-limiting toxicities (DLTs), and maximum tolerated/administered dose (MTD/MAD) of MGD019. Dose escalation will occur in a 3+3+3 design in patients with advanced solid tumors of any histology. Once the MTD/MAD is determined, a Cohort Expansion Phase will be enrolled to further characterize safety and initial anti-tumor activity in patients with specific tumor types anticipated to be sensitive to dual checkpoint blockade.
Conclusions■■ T cells co-expressing PD-1 and CTLA-4 are more prevalent in tumors compared to healthy tissues■■ MGD019 binds to and blocks its targets with increased activity on dual PD-1/CTLA-4-expressing cells■■ MGD019 induces a unique transcriptional activation pattern partially overlapping that induced by the combination of individual mAbs■■ In cynomolgus monkeys, MGD019 demonstrates IgG4-like PK and a good safety profile similar to that observed with PD-1 blockade alone, while demonstrating biological effects of CTLA-4 antagonism
Reference1. Selby M. et al. Preclinical Development of Ipilimumab and Nivolumab Combination Immunotherapy: Mouse Tumor Models, In Vitro Functional Studies, and Cynomolgus Macaque Toxicology. PLoS One. 2016 Sep 9;11(9):e0161779:
Group M/F Treatment Dose(mg/kg)
Diarrhea(n/N)
Mean SpleenWeight (g) Spleen Pathology (n/N)
Gastrointestinal Pathology (n/N)Day 30 M/F Day 59 M/F
1 5/5 Saline control — 0/10 3.9/2.8 3.5/3.7 0/6 0/62 5/5 Nivolumab + ipilimumab 10 3 2/10 4.0/3.6 4.3/2.4 2/6 2/63 5/5 Nivolumab + ipilimumab 50 10 4/10 6.1/4.47 7.5/3.2 4/5 3/5
Abstract
Combinatorial blockade of PD-1 and CTLA-4 has shown clinical benefit beyond that observed with individual mAbs, albeit with increased toxicity. MGD019 is a PD-1 x CTLA-4 tetravalent bispecific molecule with a human IgG4 backbone to limit effector function and designed to engage each target in a bivalent modality. MGD019 demonstrated independent blockade of CTLA-4/B7 and PD-1/PD-L(1/2) with a potency comparable to that achieved by replicas of the approved ipilimumab (ipi) and nivolumab (nivo). MGD019 enhanced antigen-driven in vitro T-cell activation to a level comparable to the combinatorial PD-1 plus CTLA-4 blockade. Tumor microenvironment models that recapitulate vascular or stromal compartments confirmed MGD019 induced in vitro immune response profiles comparable to those observed with replicas of ipi plus nivo. Multiplex ISH showed enrichment of PD-1/CTLA-dual positive cells in tumor-infiltrating lymphocytes (TILs) relative to normal tissues, where distinct populations expressed CTLA-4 or PD-1. MGD019 mediated enhanced blockade of CTLA-4 ligand interaction to CTLA4/PD1 dual-expressing cells compared to cells expressing CTLA-4 alone. MGD019 was well-tolerated in cynomolgus monkeys, with no mortality or significant adverse findings up to 100 mg/kg QWx4. T-cell proliferation in the periphery and expansion in lymphoid organs was observed, with increases in ICOS+ CD4 cells and memory T cells, findings attributable to the CTLA-4 blocking arm, since the anti-PD-1 mAb precursor was devoid of these activities. MGD019 offers the convenience of single molecule administration for dual checkpoint blockade. In addition to providing full blockade on cells expressing PD-1 or CTLA-4 individually, MGD019 exploits dual target avidity resulting in preferential engagement and enhanced blockade on cells that express both checkpoint molecules, a feature that could provide additional benefits given the preeminent co-expression of CTLA-4 and PD-1 by TILs. MGD019 was well tolerated in cynomolgus monkeys, while demonstrating biological effects of CTLA-4 antagonism. Taken together, these data support clinical testing of MGD019 in cancer patients.
Introduction
T Cells Co-expressing PD-1 and CTLA-4 are More Prevalent Among TILs Compared to Healthy Tissues
Ovarian Cancer Normal Tonsil
Expression of PD-1 (red) and CTLA-4 (blue) mRNA in tissue samples of ovarian cancer (left) or normal human tonsils (right) visualized by RNAscope™.
MGD019, a Tetravalent Bispecific DART Molecule
*TDLN: Tumor-draining lymph node.
PD-1+CTLA-4 Combo:PD-1xCTLA-4 DART:
TumorHealthyTissuesCirculation
++ ++ +++++ ++ +
TDLN*PD-1++/CTLA-4+
PD-1+/CTLA-4++
PD-1+ CTLA-4+
MGD019 Molecular Structure
T CellPD-1
CTLA-4
T CellPD-1
CTLA-4
T Cell
CTLA-4
T CellPD-1 PD-1
Rationale for PD-1xCTLA-4Dual Checkpoint Targeting Strategy
CTLA-4
PD-1
CTLA-4
PD-1
IgG4
10-8 10-6 10-4 10-2 100 1020.0
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2.0
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PD1/CTLA-4 Dimerization
Concentration (nM)
Rela
tive
Dim
eriz
atio
n A
ctiv
ity
Control IgGCTLA-4 mAb (parental)aPD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo
PD-1 x CTLA-4 DART (MGD019)
0.0001 0.01 1 100 0.0001 0.01 1 1000
1000
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4000
Binding to PD-1+ Cells
Concentration (nM)
MFI
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MFI
A.
C. D.
B.
MGD019 Co-engages PD-1 and CTLA-4
Binding of MGD019 or control molecules to Jurkat/PD-1 (A) or Jurkat/CTLA-4 (B) cells measured by flow cytometry. C. Binding of MGD019 or control molecules to in vitro activated primary human T cells by flow cytometry. D. Co-engagement of PD-1 and CTLA-4 on the cell surface by MGD019 measured by DiscoverX™ enzyme complementation assay.
©2019 MacroGenics, Inc. All rights reserved.
Results
Enhanced Blockade of CTLA-4 by MGD019 on Dual Expressing Cells
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mAbs or DARTs (nM)
PD-L
1 Bi
ndin
g (M
FI)
0
1000
2000
3000
4000CTLA-4 Blockade on PD-1-CTLA-4+ Cells
mAbs or DARTs (nM)
B7-1
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(MFI
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PD-L
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ndin
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FI)
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1400CTLA-4 Blockade on PD-1+CTLA-4+ Cells
B7-1
Bin
ding
(MFI
)
10-3 10-2 10-1 100 101 10310210-8 10-6 10-4 10-2 100 104102
mAbs or DARTs (nM) mAbs or DARTs (nM)10-4 10-3 10-2 10-1 100 10210110-4 10-3 10-2 10-1 100 102101
Control IgGCTLA-4 mAb (parental)PD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo
PD-1 x CTLA-4 DART (MGD019)
Single Positive Cells
Dual Expressing Cells
PD-1 or CTLA-4 binding to their respective soluble ligands on Jurkat cells engineered to express PD-1 and/or CTLA-4 was measured by flow cytometry.
MGD019 Enhances T-cell ActivationA. B.
0 0.00010.003 0.06 1.25 25 5000
500
1000
1500
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2500
SEB Concentration (ng/mL)
IL-2
pg/
mL
Activation of Primary T Cells
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2000
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Dual PD-1/CTLA-4 Reporter Assay
mAbs or DARTs (nM)
Lum
inec
ence
10-2 10-1 100 101 102 103
Control IgGCTLA-4 mAb (parental)PD-1 mAb (MGA012) PD-1 + CTLA-4 mAbs combo
PD-1 x CTLA-4 DART (MGD019)
A. PBMC were activated by SEB in the presence of 10 µg/mL of the indicated molecules. IL-2 secretion was measured at 96h by ELISA. B. Expression of IL-2 reporter cassette in Jurkat cells co-expressing PD-1 and CTLA-4 (Promega) co-incubated with APC in the presence of the indicated molecules.
Characterization of MGD019-Enhanced T-cell ActivationTumor Microenvironment Models Transcriptional Changes in
Allo-activated T CellsMGD01946 genes
upregulated
Ipilimumab + nivolumab36 genes
upregulated
-0.5-0.4-0.3-0.2-0.10.00.10.20.30.40.50.60.7
Log
Rati
o
Ipilimumab* + nivolumab* (20 nM) Ipilimumab + nivolumab (6.7 nM)Ipilimumab + nivolumab (2.2 nM) Ipilimumab + nivolumab (0.74 nM)
-0.5-0.4-0.3-0.2-0.10.00.10.20.30.40.50.60.7
CCL2
/MCP
1CD
106/
VCAM
1CD
40CD
69uP
ARCE
ACAM
5/CD
66e
Colla
gen
IVCX
CL10
/IP1
0CX
CL9/
MIG
Kera
tin 2
0PB
MC
Cyto
toxi
city
Gra
nzym
e B
IL10
IL17
AIL
2IL
6SR
B
Log
Rati
o
MGD019 (20 nM) MGD019 (6.7 nM)MGD019 (2.2 nM) MGD019 (0.74 nM)
CD10
6/VC
AM1
CD87
/uPA
RCE
ACAM
5/CD
66e
Colla
gen
ICo
llage
n III
CXCL
10/I
P10
Kera
tin 2
0M
MP9
PAII
PBM
C Cy
toto
xici
tyG
ranz
yme
BIF
Nγ
IFN
γ
IL10
IL17
AIL
2IL
6SR
BTN
Fα
TNFα
sVEG
FTI
MP2 tPA
uPA
StroHT29 VascHT29
Ipilimumab + Nivolumab
MGD01923 genes 23 genes
IL-10 IL-213 genes
IL-10
Transcriptional changes in MLR assay: T cells were re-isolated from 72h MLR assay after treatment with 1 µg/mL each ipilimumab and nivolumab or MGD019 at 1 µg/mL, and RNAseq was performed using Illumina HiSeq platform. Gene alignment, filtering for 750 immune- related genes and differential expression analysis were done using Strand NGS software. Genes were clustered based on upregulation in both donors.
DiscoverX StroHT29 and VascHT29 TME models: HT-29 colorectal cells were cultured with stromal cells and PBMCs to recapitulate a tumor microenviroment (DiscoverX). Protein expression was measured following treatment with mAbs or MGD019. *Replicas of nivolumab and ipilimumab were constructed on the basis of the published sequences.
MGD019 GLP Toxicology StudyDose Level
(mg/kg)Dose Route
Dose Days
No. of Animals
Terminal Necropsy (Week 4) Recovery Necropsy (Week 14)0 (vehicle)
IV infusion for 30
minutes
1, 8, 15, 22
3M / 3F 2M / 2F
10 3M / 3F 2M / 2F
40 3M / 3F 2M / 2F
100 3M / 3F 2M / 2F
FindingMGD019 (PD-1xCTLA-4) MGA012 (PD-1)
10 mg/kg 40 mg/kg 100 mg/kg ≥100 mg/kgAdverse clinical signs - - - -
Body weight loss - - - -
Increased spleen weight + ++ ++ -
Lymphoid hyperplasia in spleen - + ++ -
GI tract inflammation - - - -
Circulating cytokines - - - -
T cell proliferation (Ki67+) + ++ ++ +/-
■■ MGD019 is relatively well-tolerated compared to prior reported PD1+CTLA4 mAb combination1
NCT03761017
