Targeting CD47 to involve macrophages and dendritic cells in a holistic anti-tumor immune response

Transcription

1 Targeting CD47 to involve macrophages and dendritic cells in a holistic anti-tumor immune response Marie Kosco-Vilbois, PhD CSO Novimmune SA 1

2 CD47 is an immune checkpoint receptor Cell Macrophage Activating eat me signal CRT LRP1 CD47 is an ubiquitously expressed protein inhibiting phagocytosis and dendritic cell maturation over expressed by various cancers 2 CD47 SIRPα Inhibitory don t eat me signal Poor clinical prognosis correlates with increased levels of CD47 expression

3 Tumor cells Human macrophages Anti-CD47 bodies 3

4 CD47 blockade = serial killing Nalm-6 tumor cells Human macrophages Plus bodies 4

5 Targeting CD47 biology Problematic with a mab approach huigg1 control α-cd47 mab #1 α-cd47 mab #2 CD47 CD47 Red Blood Cells Ubiquitous expression of CD47 leads to: Hematoxicity Poor PK Lymphocytes (B / T cells) 5 tumor

6 Targeting CD47 biology Attractive with a biab approach CO-ENGAGEMENT CD47 Tumor antigen (TAA) Tumor cell (phagocytosis) NI-171 = a-cd47/cd19 BiAb B cell maligancies IND/CTA 217 NI-181 = a-cd47/mesothelin BiAb Solid tumors Candidate selection Tumor cell No ENGAGEMENT Healthy cell Tumor cell 6

7 Targeting CD47 biology Bi-specific antibody approach CD47 CD19 B cells huigg1 control α-cd47 mab #1 α-cd47 mab #2 CD47/CD19 biab T cells RBCs 7

8 Phagocytosis Evaluating the effect plus/minus RBCs CD47+/CD19- CD47+/CD19+ 8

9 P h a g o c y t o s is % % p h a g o c y to s is % p h a g o c y to s is Phagocytosis Evaluating the effect of RBCs in vitro CD47 CD47 8 a-cd47 mab (higg4) 8 SIRPa-Fc (higg1) a n tib o d y [n M ] a n tib o d y [n M ] CD47 CD47 8 a-cd47 mab (higg4) RBC affect the killing potential of monospecific CD47 inhibitors a n tib o d y [n M ]

10 P h a g o c y t o s is % P h a g o c y t o s is % % p h a g o c y to s is % p h a g o c y to s is Phagocytosis Evaluating the effect of RBCs in vitro CD47 CD47 8 a-cd47 mab (higg4) 8 SIRPa-Fc (higg1) a n tib o d y [n M ] a n tib o d y [n M ] CD47 CD47 8 a-cd47 mab (higg4) 8 NI CD47 CD a n tib o d y [n M ] a n tib o d y [n M ]

11 Targeting CD47 therapeutically 1. Selectivity 2. In vivo efficacy 3. Safety and pharmacokinetics 11

12 T u m o u r v o lu m e (m m 3 ) SC tumor xenograft model 2 Is o ty p e c o n tro l A b C D 1 9 x C D 4 7 b ia b (NI-171) D a y p o s t s ta r t tr e a tm e n t 12

13 T u m o u r v o lu m e (m m 3 ) SC tumor xenograft model 2 Is o ty p e c o n tro l A b C D 4 7 m o n o v a le n t A b 1 5 C D 1 9 m o n o v a le n t A b 1 5 C D 1 9 x C D 4 7 b ia b D a y p o s t s ta r t tr e a tm e n t CD19/CD47 biab more efficacious than monovalent «arms» Abs

14 T u m o u r v o lu m e (m m 3 ) SC tumor xenograft model Is o ty p e c o n tro l A b C D 4 7 m o n o v a le n t A b C D 1 9 m A b C D 1 9 m o n o v a le n t A b 1 5 C D 1 9 x C D 4 7 b ia b (NI-171) D a y p o s t s ta r t tr e a tm e n t Synergistic effect of targeting CD19 combined with CD47 blockage

15 Disseminated tumor xenograft model B-ALL patient cell in NSG mice huigg1 control NI-171 Blood Bone Marrow Bone Marrow Bone Marrow 15 B-ALL: B cell acute lymphocytic leukemia

16 T u m o u r v o lu m e (m m 3 ) T u m o u r v o lu m e (m m 3 ) T u m o u r v o lu m e (m m 3 ) Combining targeted CD47 blockade with Rituximab IgG ctrl vs RTX 2 R itu x im a b Improves survival IgG ctrl Nvs I- 1 7NI N I R itu x im a b IgG ctrl vs COMBO P e r c e n t s u r v iv a l D a y p o s t s t a r t in g t r e a t m e n t D a y p o s t tr e a tm e n t End point : 14mm 3

17 Targeting CD47 therapeutically 1. Selectivity 2. In vivo efficacy 3. Safety Mechanism and pharmacokinetics foiling the tumor microenvironment 17

18 Dissecting the tumor microenvironment (TME) D7 NI-171 huigg1 control D14 NI-171 huigg1 control 18 Unpaired t test, **** p<.1, Mean±SEM

19 % o f C D % o f F 4 / 8 + % o f F 4 / 8 + Blocking CD47 creates an anti-tumor microenvironment NI-171 IgG1 control 1 5 G-iMDSC pro-tumor *** ** M1 macrophages anti-tumor 8 **** **** 7 M2 macrophages pro-tumor * D 7 D 1 4 D 7 D D 7 D 1 4 In the tumor microenvironment: Reduce granulocytic-inhibitory myeloid-derived suppressor cells (G-iMDSC) Augment number of M1 macrophages Decrease M2 macrophages 19 Unpaired t test, *p<.5, ** p<.1, *** p<.1

20 Enhance tumoricidal macrophage function NI-171 huigg1 control 2 Unpaired t test, *** p<.1, **** p<.1 Mean±SD

21 CD47 blockade = serial killing + IgG control + NI-171 B-ALL tumor cells Human macrophages 21

22 Durable immune responses Getting the dendritic cells involved (syngeneic model) Part 1: Tumor ENGRAFTMENT Part 2: Tumor RECHALLENGE hcd19 A2 Lymphoma A2 Lymphoma hcd19 Engraftment Treatment Evaluation Rechallenge Evaluation s.c. A2-hCD19 In Balb/c mice CTX: 1 dose i.p. biab: 3 doses i.t. PBS: 3 doses i.t. s.c. A2-hCD19 engraftment (opposite side) 22 CTX: cyclophosphamide

23 Targeting CD47 synergizes with chemotherapy t u m o r V o lu m e (m m 3 ) t u m o r V o lu m e (m m 3 ) t u m o r V o lu m e (m m 3 ) tu m o r V o lu m e (m m 3 ) 1 1 Treatment period PBS 6 4 CD47/CD19 biab D a y p o s t e n g r a ftm e n t D a y p o s t e n g r a ftm e n t 1/ CTX 6 CTX + CD47/CD19 biab / / D a y p o s t e n g r a ftm e n t D a y p o s t e n g r a ftm e n t

24 Durable immune responses Rechallenge in the syngeneic model Part 1: Tumor ENGRAFTMENT Part 2: Tumor RECHALLENGE hcd19 A2 Lymphoma A2 Lymphoma hcd19 Engraftment Treatment Evaluation Rechallenge Evaluation s.c. A2-hCD19 In Balb/c CTX: 1 dose i.p. BiAb: 3 doses i.t. PBS: 3 doses i.t. s.c. A2-hCD19 engraftment (opposite side) 24

25 Durable immune responses Getting the dendritic cells involved induces T cell memory t u m o r V o lu m e (m m 3 ) 6 Re-challenge Priming CTX + biab 1/1 t u m o r v o lu m e (m m 3 ) / D a y p o s t e n g r a ftm e n t D a y p o s t e n g r a ftm e n t 25

26 Targeting CD47 therapeutically 1. Selectivity 2. In vivo efficacy 3. Safety and pharmacokinetics 3. Safety and pharmacokinetics 26

27 4-week toxicity study in nonhuman primates No hematological toxicity after 4 doses <1mg/kg Dose groups: Vehicle NI-171 Red blood cells Platelets 27 DOSING DAYS

28 Single dose PK study in nonhuman primates Linear kinetics observed 28 Suggesting no target mediated-clearance

29 Manufacturing clinical supply for κλ bodies 29

30 body Effective purification bodies contain 3 different constant regions for which affinity resins exist κλ body Constant Kappa Constant Lambda CH2-CH3 (Fc) Enable effective purification via affinity chromatography Platform downstream processing at any scale (3 to 1 liters) Ensures high purity and integrity of the final product (>99%) 3

31 Consistent κλ body expression at harvest At different manufacturing scales Batch body titer (g/l) 1L (lab scale; NI) 1.3 1L (lab scale; Lonza) L (Pilot; Lonza) 1.2 1L (GMP; Lonza) 1.2 Consistent cell culture performance from 1 to 1L Successful GMP manufacture in 1L Single Use Bioreactor 31

32 Formulation Polishing Capture Platform purification process CaptoL } ReadyToProcess MabSelectSure LambdaFab Select CHT Type I UF DF 32 Excipient addition and bulk filtration

33 Consistent purification process performance 1L (Lab scale), 25L (Pilot) and 5L (GMP) Process step Purity (% ) Recovery (% ) Aggregates (%) Overall recovery (% ) 1L Pilot GMP 1L Pilot GMP 1L Pilot GMP 1L Pilot GMP MabSelect Sure LambdaFabSelect CaptoL CHT UF/DF High purity Consistent recovery between scales Low aggregates 33 CHT: ceramic hydroxyapatite UF/DF: ultrafiltration/diafiltration

34 Summary Blocking CD47 with biabs in vivo Reduces tumor growth by favoring an antitumor microenvironment: increased macrophage tumoricidal potential promotes anti-tumor M1 macrophage subtype decreases imdsc infiltrate Harnesses the immune response to control tumor growth Gets the Dendritic cells involved & induces T cell memory responses Platform manufacturing process (1L scale) Avoids toxicities & poor PK linked to monoclonal CD47 targeting Potential for combination therapy enhanced when combined with anti-cd2 mabs or chemotherapy 34

35 Novimmune s pipeline Product Target Indication Status Milestone mabs NI-51 NI-11 Breakthrough Therapy - FDA Prime - EMEA IFNg TLR4 Hemophagocytic lymphohistiocytosis (HLH); Other interferonopathies Autoimmune and inflammatory diseases Phase 2 ongoing Phase 1 Completed Approval Start Proof-of- Concept Phase 2 NI-141 IL-17 Autoimmune and inflammatory diseases Phase 1 Completed Not disclosed NI-41 CD3 Ɛ Autoimmune diseases and transplant Phase 1/2a Completed Start Proof-of- Concept Phase 2 NI-121 IL-6R Autoimmune and inflammatory diseases Preclinical Not disclosed Bispecific Antibody Platform; Κλ body NI-171 CD47/CD19 B cell maliganacies Preclinical Phase I NI-181 CD47/mesothelin Solid tumors Discovery Drug candidates NIBX-211 Undisclosed Undisclosed Discovery Drug candidates 35

36 Acknowledgements Novimmune W Ferlin N Fischer K Masternak K Wilson A Papaioannou E Hatterer L Broyer V Moine X Chauchet B Daubeuf S Limin Z Johnson S Salgado-Pires V Buatois 36 A Michie, MD E Cosimo, MD Pr A Fielding A Dey K Bailey Pr S Hughes J Dubrot Armendariz John DiPersio, MD PhD