Utilization of a Label-Free Real-Time Cell Analysis Technology for Cancer Immunotherapy Applications. Yama Abassi, Ph.D. VP, ACEA Biosciences

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1 Utilization of a Label-Free Real-Time Cell Analysis Technology for Cancer Immunotherapy Applications Yama Abassi, Ph.D. VP, ACEA Biosciences 1

2 Outline of Presentation Introduction to ACEA Biosciences and its Line of Products xcelligence RTCA Systems and Principle of Detection General Introduction to Cancer Immunotherapy Applications of xcelligence RTCA System for Cancer Immunotherapy 1. Natural Killer (NK) Cell Mediated Cytotoxicity 2. T Cell Mediated Cytotoxicity 3. Antibody-Dependent Cell Mediated Cytotoxicity (ADCC) 4. Genetically engineered T-Cell cytolysis (including CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) Summary & Conclusion 2

3 Outline of Presentation Introduction to ACEA Biosciences and its Line of Products xcelligence RTCA Systems and Principle of Detection General Introduction to Cancer Immunotherapy Applications of xcelligence RTCA System for Cancer Immunotherapy 1. Natural Killer (NK) Cell Mediated Cytotoxicity 2. T Cell Mediated Cytotoxicity 3. Antibody-Dependent Cell Mediated Cytotoxicity (ADCC) 4. Genetically engineered T-Cell cytolysis (including CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) Summary & Conclusion 3

4 ACEA Biosciences, Inc. o Founded 2002 o Headquarters: San Diego, CA. USA o Personnel 300+ FTEs, 30+ PhDs o The technology inventor of the xcelligence Real-Time Cell Analysis Systems o 29 Distributors Worldwide, Direct Sales/Support in the US 4

5 Innovation and Excellence Real-Time Cell Analysis TM NovoCyte Flow Cytometer RTCA-MP System RTCA-HT System RTCA-iCELLigence System RTCA-CardioECR System RTCA-SP System RTCA-DP System RTCA-Cardio System NovoCyte June 2008 Sep 2008 March 2009 Nov 2010 Nov 2010 July 2012 April 2014 October

6 # of Publication Solid Publication Track Record Over 700 peer-reviewed publications citing ACEA s Real-Time Cell Analysis Technology Real-Time Cell Analysis Year 6

7 Disease Related Application Areas Cancer Inflammation Immunity Real-Time Cell Analysis Infectious Diseases Safety Toxicity 7

8 Simple Workflow Real-Time Cell Analysis No cell labeling required, fully automated, physiological conditions 8

9 Real-Time Monitoring at Physiological Conditions Real-Time Cell Analysis Designed to be placed in regular tissue culture incubators. RTCA-DP (Dual Plate) 3 x E-Plate 16 3 x CIM-Plate 16 RTCA-SP (Single Plate) 1 x E-Plate 96 RTCA-MP (Multiple Plates) 6x E-Plate 96 9

10 Outline of Presentation Introduction to ACEA Biosciences and its Line of Products xcelligence RTCA Systems and Principle of Detection General Introduction to Cancer Immunotherapy Applications of xcelligence RTCA System for Cancer Immunotherapy 1. Natural Killer (NK) Cell Mediated Cytotoxicity 2. T Cell Mediated Cytotoxicity 3. Antibody-Dependent Cell Mediated Cytotoxicity (ADCC) 4. Genetically engineered T-Cell cytolysis (including CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) Summary & Conclusion 10

11 Impedance Biosensor Assay Principle 11

12 Cell Index Cell Index Immune Cell Killing ASSAY PRINCIPLE Microelectrodes + Adherent Tumor Cells + Non-adherent Effector Cells 100% Confluence Proliferation No Adhesion Minimal Signal Time (h) Time (h) 12

13 Cell Index Cell Index Immune Cell Killing ASSAY WORKFLOW Adherent Tumor Cells 100% Confluence Time (h) + Non-adherent Effector Cells + Effector Cells Effector : Target Ratio 0:1 (negative control) 1:1 Dead Target Cells Time (h) 4:1 16:1 13

14 Outline of Presentation Introduction to ACEA Biosciences and its Line of Products xcelligence RTCA Systems and Principle of Detection General Introduction to Cancer Immunotherapy Applications of xcelligence RTCA System for Cancer Immunotherapy 1. Natural Killer (NK) Cell Mediated Cytotoxicity 2. T Cell Mediated Cytotoxicity 3. Antibody-Dependent Cell Mediated Cytotoxicity (ADCC) 4. Genetically engineered T-Cell cytolysis (including CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) Summary & Conclusion 14

15 Cancer Immunotherapy: Utilizing the Full Complement of Innate and Adaptive Immunity to Target Cancer 15

16 Cancer Immunotherapy and Different Ways of Targeting Tumors by the Immune System Activated T-cell NK-cell ADCC Genetically engineered T-cell (e.g., CAR-T) Macrophage Target Cell Complement Mediated 1. NK-mediated cell cytotoxicity 2. T cell mediated cell cytotoxicity 3. Antibody-dependent cell cytotoxicity 4. Genetically engineered T-Cell cytolysis (e.g. CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) 16

17 Outline of Presentation Introduction to ACEA Biosciences and its Line of Products xcelligence RTCA Systems and Principle of Detection General Introduction to Cancer Immunotherapy Applications of xcelligence RTCA System for Cancer Immunotherapy 1. Natural Killer (NK) Cell Mediated Cytotoxicity 2. T Cell Mediated Cytotoxicity 3. Antibody-Dependent Cell Mediated Cytotoxicity (ADCC) 4. Genetically engineered T-Cell cytolysis (including CAR-T) 5. Macrophage mediated phagocytosis 6. Complement mediated cytolysis (CMC) Summary & Conclusion 17

18 1. NK-Mediated Cell Cytotoxicity NK-cell Granzyme and perforin Target Cell 1. NK-mediated cell cytotoxicity 18

19 1.1 NK-92-Mediated Cytolysis of MCF7 Target: MCF7 Higher sensitivity at lower E:T ratio Rapid detection of the NK lytic activity (2 hrs) Cell Index (CI) value correlated to a % of cytolysis % Cytolysis = CI (No Effector) CI (Effector) CI (No Effector) *100 Figure Adapted from ACEA s xcelligence Application Note #5 19

20 1.2 IL-2 Activated NK Cells from Patients Exhibit Differential Anti-tumor Activity PLoS ONE 2013, 8(10): e76928 Phenotypic and Functional Characteristics of Blood Natural Killer Cells from Melanoma Patients at Different Clinical Stages. Fregni G, Messaoudene M, Fourmentraux-Neves E, Mazouz-Dorval S, Chanal J, et al. INSERM & University Paris Descartes, France 20

21 2.2 NK cell-mediated Cytolysis of Daudi B Cell Lymphoma Tall-104 cell Daudi B cell anti-cd40 21

22 NK cell mediated cytolysis - References citing xcelligence: 1. Zhu J Wang X, Xu X, Abassi YA. Dynamic and label-free monitoring of natural killer cell cytotoxic activity using electronic cell sensor arrays. J Immunol Methods Feb 20;309(1-2): (ACEA Biosciences, USA) 2. Fregni G, Perier A, Pittari G, Jacobelli S, Sastre X, Gervois N, Allard M, Bercovici N, Avril MF, Caignard A. Unique functional status of natural killer cells in metastatic stage IV melanoma patients and its modulation by chemotherapy. Clin Cancer Res May 1;17(9): (INSERM, France) 3. Moodley K, Angel CE, Glass M, Graham ES. Real-time profiling of NK cell killing of human astrocytes using xcelligence technology. J Neurosci Methods Sep 15;200(2): (University of Auckland, Australia) 4. Perier A, Fregni G, Wittnebel S, Gad S, Allard M, Gervois N, Escudier B, Azzarone B, Caignard A. Mutations of the von Hippel-Lindau gene confer increased susceptibility to natural killer cells of clear-cell renal cell carcinoma. Oncogene Jun 9;30(23): (INSERM, France) 5. Park KH, Park H, Kim M, Kim Y, Han K, Oh EJ. Evaluation of NK Cell Function by Flowcytometric Measurement and Impedance Based Assay Using Real-Time Cell Electronic Sensing System. Biomed Res Int. 2013;2013: (Catholic University of Korea, South Korea) 6. Messaoudene M, Fregni G, Fourmentraux-Neves E, Chanal J, Maubec E, Mazouz-Dorval S, Couturaud B, Girod A, Sastre- Garau X, Albert S, Guédon C,Deschamps L, Mitilian D, Cremer I, Jacquelot N, Rusakiewicz S, Zitvogel L, Avril MF, Caignard A. Mature cytotoxic CD56(bright)/CD16(+) natural killer cells can infiltrate lymph nodes adjacent to metastatic melanoma. Cancer Res Jan 1;74(1): (Institut Cochin, France) 7. Fregni G1, Messaoudene M, Fourmentraux-Neves E, Mazouz-Dorval S, Chanal J, Maubec E, Marinho E, Scheer-Senyarich I, Cremer I, Avril MF, Caignard A. Phenotypic and functional characteristics of blood natural killer cells from melanoma patients at different clinical stages. PLoS One Oct 18;8(10):e (University of Lausanne, Switzerland) 8. Valencic E, Loganes C, Cesana S, Piscianz E, Gaipa G, Biagi E, Tommasini A. Inhibition of mesenchymal stromal cells by pre-activated lymphocytes and their culture media. Stem Cell Res Ther Jan 9;5(1):3. (Institute of Maternal and Child Health IRCCS Burlo Garofolo, Italy) 22

23 2. Cytotoxic T Lymphocyte-Mediated Cytotoxicity Activated T-cell NK-cell Target Cell 1. NK-mediated cell cytotoxicity 2. T cell mediated cell cytotoxicity 23

24 2.1 CD8 T cell-mediated Cytolysis of SKBR3 Tumor Cells T Cells Non-Adherent Property is Useful in Cytolytic Assay! SKBR3 co-cultured with Her-2 neu p369 specific T Cell Clone Control T Cells:SKBR3 = 1.5 :1 T Cells:SKBR3 = 40 :1 J Vis Exp Aug 8;(66):e3683. doi: /3683. Determining optimal cytotoxic activity of human Her2neu specific CD8 T cells by comparing the Cr51 release assay to the xcelligence system. Erskine CL, Henle AM, Knutson KL. Mayo Clinic, USA. 24

25 2.1 CD8 T cell-mediated Cytolysis of SKBR3 Tumor Cells SKBR3 10 hrs SKBR alone Higher sensitivity at lower ratio Continuous Kinetic Readout! 51 Cr measured at 5 hrs vs. xcelligence Killer T cell Activity is Dose Dependent J Vis Exp Aug 8;(66):e3683. doi: /3683. Determining optimal cytotoxic activity of human Her2neu specific CD8 T cells by comparing the Cr51 release assay to the xcelligence system. Erskine CL, Henle AM, Knutson KL. Mayo Clinic, USA. 25

26 T cell mediated cytolysis - References citing xcelligence: 1. Lengagne R, Pommier A, Caron J, Douguet L, Garcette M, Kato M, Avril MF, Abastado JP, Bercovici N,Lucas B, Prévost-Blondel A. T cells contribute to tumor progression by favoring pro-tumoral properties of intratumoral myeloid cells in a mouse model for spontaneous melanoma. PLoS One. 2011;6(5):e (INSERM, France) 2. Erskine CL, Henle AM, Knutson KL. Determining optimal cytotoxic activity of human Her2neu specific CD8 T cells by comparing the Cr51 releaseassay to the xcelligence system. J Vis Exp Aug 8;(66):e3683. (Mayo Clinic, USA) 3. Henle AM, Erskine CL, Benson LM, Clynes R, Knutson KL. Enzymatic discovery of a HER-2/neu epitope that generates cross-reactive T cells. J Immunol Jan 1;190(1): (Mayo Clinic, USA) 4. Soto-Pantoja DR, Terabe M, Ghosh A, Ridnour LA, DeGraff WG, Wink DA, Berzofsky JA, Roberts DD. CD47 in the tumor microenvironment limits cooperation between antitumor T-cell immunity and radiotherapy. Cancer Res Dec 1;74(23): (National Institutes of Health, USA) 5. Peper JK, Schuster H, Löffler MW, Schmid-Horch B, Rammensee HG, Stevanović S. An impedance-based cytotoxicity assay for real-time and label-free assessment of T-cell-mediated killing of adherent cells. J Immunol Methods Mar;405: (University of Tübingen, Auf dermorgenstelle, Germany) 6. Nguyen ST, Nguyen HL, Pham VQ, Nguyen GT, Tran CD, Phan NK, Pham PV. Targeting specificity of dendritic cells on breast cancer stem cells: in vitro and in vivo evaluations. Onco Targets Ther Jan 30;8: (Vietnam National University, Vietnam) 26

27 3. Antibody-Dependent Cell Cytotoxicity (ADCC) Activated T-cell ADCC NK-cell Target Cell 1. NK-mediated cell cytotoxicity 2. T cell mediated cell cytotoxicity 3. Antibody-dependent cell cytotoxicity 27

28 3.1 PBMC-Mediated Cytolysis of BT474 Cells in Presence and Absence of Trastuzumab Effector only Effector + trastuzumab Oncoimmunology Sep 1;1(6): Understanding key assay parameters that affect measurements of trastuzumab-mediated ADCC against Her2 positive breast cancer cells Kute T, Stehle Jr JR, Ornelles D, Walker N, Delbono O, Vaughn JP. Wake Forest University School of Medicine; USA. 28

29 3.3 Killing Tumors by Activating the Immune System via Bispecific T Cell Engager (BiTE) Clinical validation of bispecific antibody approach: Micromet: Bispecific T cell Engager (BiTE); scfv format acd3 acd19 Blinatumomab Links variable domains of xcd3 and xcd19 Cancer patients often mount weak tumorspecific T cell responses due to numerous immune escape mechanisms of tumor cells T cell B lymphoma Proliferation Apoptosis Facilitates cytotoxic T cell killing of B lymphoid tumor cells Slide Decks Courtesy of Dr. Judy Young (Genentech), USA 29

30 Normalized Cell Index Normalized Cell Index Normalized Cell Index Normalized Cell Index Normalized Cell Index Normalized Cell Index 3.3 Anti-tumor Antigen / CD3 Antibodies Kill Tumor Antigen-Expressing Cells Dose-dependently Cells expressing tumor antigen Time point for EC Bisfab, ng/ml Time (hours) Cells NOT 7 expressing tumor antigen Time (hours) Time (hours) Time (hours) Time (hours) Time (hours) Bispecific Ab clone 1 Bispecific Ab clone 2 Bispecific Ab clone 3 Slide Decks Courtesy of Dr. Judy Young (Genentech), USA 30

31 3.3 Relative Potencies of Bispecific Antibody Clones were Compared using % Cytolysis EC50 Values at 24 hr % Cytolysis = (CI target only CI target, effector, bispecific Ab ) * 100 CI target only Effector:Target ratio = 4:1 Clone 1 EC50 = 5.8 ng/ml Clone 2 EC50 = 3.9 ng/ml Clone 3 EC50 = N/A Clone 4 EC50 = N/A Slide Decks Courtesy of Dr. Judy Young (Genentech), USA 31

32 % Cytolysis % Cytolysis (PI staining) 3.3 xcelligence vs. FACS: Comparison of EC50 calculated at 24 hr xcelligence FACS Bispecific Ab (ng/ml) Bispecific Ab (ng/ml) Effector: Target Ratio xcelligence EC50 FACS EC50 1: : : Slide Decks Courtesy of Dr. Judy Young (Genentech), USA EC50 values from % cytolysis calculations are similar between xcelligence and FACS 32

33 Time (hours) Normalized Cell Index Normalized Cell Index 3.4 BiTE-Mediated Cytotoxicity in PC3 Prostate Cancer Cells 6 5 A EpCAM/CD3 BiTE PBMCs, BiTE Addition BiTE concentration 1 ug/ml 0.5 ug/ml 0.1 ug/ml No BiTE 1 C Time (hours) D CD19/CD3 BiTE BiTE Concentration 1 ug/ml 0.5 ug/ml 0.1 ug/ml * * * * * 20:1 10:1 5:1 2.5:1 1:1 PBMCs:PC3 Ratio PBMCs, BiTE Addition PBMCs:PC3 Ratio 20:1 10:1 5:1 2.5: Time (hours)

34 ADCC Reference 1. Glamann J, Hansen AJ. Dynamic detection of natural killer cell-mediated cytotoxicity and cell adhesion by electrical impedance measurements. Assay Drug Dev Technol Oct;4(5): (Novo Nordisk, Denmark) 2. Kute TE, Savage L, Stehle JR Jr, Kim-Shapiro JW, Blanks MJ, Wood J, Vaughn JP. Breast tumor cells isolated from in vitro resistance to trastuzumab remain sensitive to trastuzumab anti-tumor effects in vivo and to ADCC killing. Cancer Immunol Immunother Nov;58(11): (Wake Forest University School of Medicine, USA) 3. Yamashita-Kashima Y, Iijima S, Yorozu K, Furugaki K, Kurasawa M, Ohta M, Fujimoto-Ouchi K. Pertuzumab in combination with trastuzumab shows significantly enhanced antitumor activity in HER2-positive human gastric cancer xenograft models. Clin Cancer Res Aug 1;17(15): (Chugai Pharmaceutical, Japan) 4. Ha S, Ou Y, Vlasak J, Li Y, Wang S, Vo K, Du Y, Mach A, Fang Y, Zhang N. Isolation and characterization of IgG1 with asymmetrical Fc glycosylation. Glycobiology Aug;21(8): (Merck Research, USA) 5. Kute T, Stehle Jr JR, Ornelles D, Walker N, Delbono O, Vaughn JP. Understanding key assay parameters that affect measurements of trastuzumab-mediated ADCC against Her2 positive breast cancer cells. Oncoimmunology Sep 1;1(6): (Wake Forest University School of Medicine, USA) 6. Oberg HH, Peipp M, Kellner C, Sebens S, Krause S, Petrick D, Adam-Klages S, Röcken C, Becker T,Vogel I, Weisner D, Freitag-Wolf S, Gramatzki M, Kabelitz D, Wesch D. Novel bispecific antibodies increase γδ T cell cytotoxicity againstpancreatic cancer cells. Cancer Res Mar 1;74(5): (Christian-Albrechts-University Kiel, Germany) [Bispecific antibody] 7. Schanzer JM, Wartha K, Croasdale R, Moser S, Künkele KP, Ries C, Scheuer W, Duerr H,Pompiati S, Pollman J, Stracke J, Lau W, Ries S, Brinkmann U, Klein C, Umana P. A novel glycoengineered bispecific antibody format for targeted inhibition of epidermal growth factor receptor (EGFR) and insulin-like growth factor receptor type I (IGF-1R) demonstrating unique molecular properties. J Biol Chem Jul 4;289(27): (Roche Diagnostics, Germany) 8. Seidel UJ, Vogt F, Grosse-Hovest L, Jung G, Handgretinger R, Lang P. γδ T Cell-Mediated Antibody-Dependent Cellular Cytotoxicity with CD19Antibodies Assessed by an Impedance-Based Label-Free Real-Time Cytotoxicity Assay. Front Immunol Dec 2;5:618. (University Children s Hospital Tübingen, Germany) 9. Schmittnaegel M, Levitsky V, Hoffmann E, Georges G, Mundigl O, Klein C, Knoetgen H. Committing Cytomegalovirus-Specific CD8 T Cells to Eliminate Tumor Cellsby Bifunctional Major Histocompatibility Class I Antibody Fusion Molecules. Cancer Immunol Res Jul;3(7): (Roche Pharma Research and Early Development, Germany) [Bispecific T-cell engagers (BiTE).] 34

35 4. Genetically Engineered T Cell-Mediated Cytotoxicity Activated T-cell ADCC Genetically engineered T-cell (e.g., CAR-T) NK-cell Target Cell 1. NK-mediated cell cytotoxicity 4. Genetically engineered T-Cell cytolysis 2. T cell mediated cell cytotoxicity 3. Antibody-dependent cell cytotoxicity 35

36 Developing the Right CAR for Targeting the Right Tumor 36

37 4.1 CAR.OT-I Cells are More Effective Long-term Killers When Activated via Their TCRs. CAR TCR 51 Cr Release Assay Performed at 18 hrs xcelligence Reveals Kinetic Difference >20 hrs MC57 = mouse fibrosarcoma; HER2 is recognized by CAR expressed in CAR.OT-1 cells, OVA257 (ovalbumin peptide) is recognized by TCR in CAR.OT-1 cells. Cancer Immunol Res May;3(5): CAR-T Cells Inflict Sequential Killing of Multiple Tumor Target Cells. Darcy PK & Neeson PJ et al. University of Melbourne (Australia) 37

38 4.2 Glioblastoma cells treated with DAC are susceptible to lysis by T cells engineered to express the NY-ESO-1 TCR U-251MG Adding T-cells Adding T-cells MG Neuro-Oncology (In Press) Adoptive transfer immunotherapy targeting NY-ESO-1 for glioblastoma. Everson et al. University of California, Los Angles (US) 38

39 Genetically Modified T-cell (e.g., CAR-T cell) Mediated cell killing References 1. Chou J, Voong LN, Mortales CL, Towlerton AM, Pollack SM, Chen X, Yee C, Robbins PF, Warren EH. Epigenetic modulation to enable antigen-specific T-cell therapy of colorectal cancer. J Immunother Feb-Mar;35(2): (Fred Hutchinson Cancer Research Center, USA) 2. Davenport AJ, Jenkins MR, Cross RS, Yong CS, Prince HM, Ritchie DS, Trapani JA, Kershaw MH,Darcy PK, Neeson PJ. CAR-T Cells Inflict Sequential Killing of Multiple Tumor Target Cells. Cancer Immunol Res May;3(5): (Peter MacCallum Cancer Center, Australia) 3. Everson et al. Adoptive transfer immunotherapy targeting NY-ESO-1 for glioblastoma Neuro-Oncology (In Press) (University of California, Los Angels, USA) 39

40 Summary: Applications of xcelligence System for Cancer Immunotherapy Immune-Mediated Tumor Cell Killing Activated T-cell NK-cell ADCC Genetically engineered T-cell (e.g., CAR-T) Macrophage Target Cell Complement Mediated 1. NK-mediated cell cytotoxicity (8 xcell Pubs) 2. T cell mediated cell cytotoxicity (6 xcell Pubs) 3. ADCC (9 xcell Pubs) 4. Genetically engineered T-Cell cytolysis (3 xcell Pubs) 5. Macrophage mediated phagocytosis (2 xcell Pubs) 6. Complement mediated cytolysis (CMC) (2 xcell Pubs) 40

41 Cytotoxicity Assay Methods that Distinguish between Adherent Targets and Non-adherent Effector Cells End Point Methods: 1) FACS Laborious, Cell Removal Artifacts Possible 2) Radioisotope Release Need to Label Target Cells 3) Enzyme Release Dying Effector Cells Could Confound Reading 4) ATP Production Need to Wash Effectors Out of Well First Impedance assay: 1) Measurements in Real Time 2) No Labels or Secondary Readout Assays 3) Non-Labor Intensive Assay Development and Performance Slide Decks Courtesy of Dr. Judy Young (Genentech), USA

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