Combination immunotherapy with anti-CD20 and anti-CD22 mAbs shows promising activity in non-Hodgkin lymphoma. Therefore, bispecific mAbs (bsAbs) were recombinantly constructed from veltuzumab (humanized anti-CD20) and epratuzumab (humanized anti-CD22) and evaluated in vitro and in vivo. While none of the parental mAbs alone or mixed had notable antiproliferative activity against Burkitt lymphoma cells when not crosslinked, the bsAbs [eg, anti-CD20 IgG-anti-CD22 (scFv) 2 ] were inhibitory without cross-linking and synergistic with B-cell antigen (BCR)-mediated inhibition. The bsAbs demonstrated higher antibodydependent cellulary cytoxicity (ADCC) activity than the parental mAbs, but not complement-dependent cytoxicity (CDC) of the parental CD20 mAb. Cross-linking both CD20 and CD22 with the bsAbs resulted in the prominent redistribution of not only CD20 but also CD22 and BCR into lipid rafts. Surprisingly, appreciable translocation of CD22 into lipid rafts was also observed after treatment with epratuzumab. Finally, the bsAbs inhibited Daudi lymphoma transplant growth, but showed a significant advantage over the parental anti-CD20 mAb only at the highest dose tested. These results suggest that recombinantly fused, complementary, bispecific, anti-CD20/22 antibodies exhibit functional features distinct from their parental antibodies, perhaps representing new candidate therapeutic molecules.
IntroductionCD20 is the principal target in the immunotherapy of B-cell lymphomas, 1,2 while a mAb against CD22, epratuzumab, also has promising activity as a single agent. [3][4][5] Despite encouraging results with these mAbs, there are ongoing efforts to improve immunotherapy, because durable responses are only achieved in a portion of patients. 5 One emerging approach is combination therapy with different biologic agents, 6,7 such as 2 mAbs directed against distinct cell-surface antigens. Ideally, the 2 mAbs would have distinct mechanisms of action so that the therapeutic outcome would be additive or synergistic, and the combined antitumor effects would mitigate resistance to either of the mAbs.In vitro cell-based studies have shown that the combination of epratuzumab and rituximab has a greater antiproliferative effect than either mAb alone. 8 The results of 3 phase 2 clinical trials showed that epratuzumab combined with rituximab was well tolerated and suggested an improved activity in non-Hodgkin lymphoma (NHL), compared with historical reports of rituximab in similar patients. 9-11 However, combination mAb therapy involves sequential administration, thus requiring lengthy infusion times and potentially higher costs. The objectives of this study were to generate a single agent, namely a bsAb that targets both CD20 and CD22 antigens, and to evaluate its properties.A bsAb can be prepared by chemical conjugation, and this was used to prepare a bsAb Fab'x Fab' from hA20 (veltuzumab), a humanized anti-CD20 mAb, 12 and hLL2 (epratuzumab), a humanized anti-CD22 mAb, 13 in earlier studies. While chemical linkage to prepare bsAbs ...