Abstract Background: The three highly structurally related TGF-β isoforms (TGF-β1, TGF-β2, and TGF-β3) exert greatly different effects on cancer and immune cells under various physiological conditions. Efforts to target the TGF-β pathway have been hampered by systemic toxicity or limited efficacy due to challenges associated with the global inhibition of TGF-βs. Recently, TGF-β1 was proven to be a critical player in generating an immunosuppressive tumor microenvironment (TME). TGF-β1 is expressed as an inactive latent form (L-TGF-β1) and activated upon binding to integrins, and integrin αvβ8 is a key activator of TGF-β1 in TME. Here, an ADCC-enhanced αvβ8 blocking antibody, 2MW4991, was developed to specifically inhibit TGF-β1-mediated signaling for the treatment of αvβ8-expressing cancers. Methods: Binding ability, specificity, and affinity of antibodies were measured by Flow cytometry and Biacore T200. A blocking assay was performed using U251MG cells and TGF-β signaling reporter cells. Jurkat/h FcγRIIIa reporter system was used to assess the ADCC activity of 2MW4991. Mouse syngeneic tumor models were used to characterize the in vivo anti-tumor efficacy. A repeat dose administration study was performed in cynomolgus monkeys to evaluate the pharmacokinetic and toxicity profiles of 2MW4991. Results: ScRNA-seq analysis of kidney renal clear cell carcinoma (KIRC) and head and neck squamous cell carcinoma (HNSCC) clinical samples revealed that αvβ8 highly expresses in tumor and some myeloid-derived cells, suggesting the development of ADCC-enhanced αvβ8 blocking antibodies for the treatment of αvβ8-expressing cancers. 2MW4991 showed sub-nanomolar binding affinity and high specificity to αvβ8, with no cross-reactivity to other integrins. 2MW4991 could effectively block TGF-β1 release in a GARP/L-TGF-β1/αvβ8 reporter system. In an immune-excluded EMT6 syngeneic model, 2MW4991 promoted substantial tumor regression and reversed immune suppressive TME by significantly increasing tumor infiltration of CD8+ T and innate immune cells. As expected, TGF-β1 blockade significantly increased the sensitivity of anti-PD-1 therapy in a combination study. Furthermore, 2MW4991 displayed potent anti-tumor efficacy in the human αvβ8 knock-in syngeneic model mimicking αvβ8 expression in human cancers. In a repeat dose administration NHP study, 2MW4991 showed a good pharmacokinetic profile and was well tolerated at a high dose of 100 mg/kg, accompanied by significantly declined pharmacodynamic biomarker TGF-β1 in peripheral blood. Conclusion: Integrin αvβ8 is a main activator of TGF-β1 in the TME and overexpressed in some cancer types. 2MW4991 demonstrated potent anti-tumor activity by unleashing the immune cells suppressed by TGF-β1 in TME and Fc-mediated immune functions. These compelling preclinical results support further evaluation of 2MW4991 in clinical trials. Citation Format: Cuicui Guo, Zhen Han, Xiaowei Cen, Hai Wu, Jinchao Zhang, Xun Gui. 2MW4991, a novel ADCC-enhanced integrin αvβ8 blocker, exhibits high anti-tumor potency and was well tolerated in cynomolgus monkeys [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6349.
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