Id |
Subject |
Object |
Predicate |
Lexical cue |
T225 |
0-51 |
Sentence |
denotes |
Fc engineering for enhanced anticancer therapeutics |
T226 |
52-231 |
Sentence |
denotes |
IgG1 is the predominant subclass used in the development of cytotoxic mAbs where induction of an activation‐type response, ADCC or phagocytosis, is considered desirable.45, 76, 77 |
T227 |
232-324 |
Sentence |
denotes |
Cytotoxic mAb cancer therapeutics can control disease progression by one or more mechanisms. |
T228 |
325-481 |
Sentence |
denotes |
Their MOAs include direct induction of apoptotic cell death of the cancer cell (anti‐CD20, anti‐CD52) or blocking receptor signaling (anti‐HER2, anti‐EGFR). |
T229 |
482-894 |
Sentence |
denotes |
They may also harness FcγR effector functions, including ADCC in the tumor microenvironment.78 The approved mAbs, rituximab (anti‐CD20), trastuzumab (anti‐HER2) and cetuximab (anti‐EGFR), are formatted on a human IgG1 backbone and all require activating‐type FcγR engagement for optimal therapeutic activity.79, 80 This presents an example where context of therapeutic use is critical for therapeutic mAb design. |
T230 |
895-984 |
Sentence |
denotes |
IgG1 antibodies bind both the activating FcγR (e.g. FcγRIIIa) and the inhibitory FcγRIIb. |
T231 |
985-1134 |
Sentence |
denotes |
In some environments effector cells will coexpress FcγRIIb together with FcγRI, FcγRIIa and FcγIIIa, as may occur on a tumor‐infiltrating macrophage. |
T232 |
1135-1391 |
Sentence |
denotes |
Therapy with an IgG1 anti‐cancer cell mAb may then be compromised by the inhibitory action of FcγRIIb upon the ITAM signaling of the activating FcγR as both types of receptor would be coengaged on such an effector cell by the mAb bound to the target cell. |
T233 |
1392-1438 |
Sentence |
denotes |
This leads to reduced therapeutic mAb potency. |
T234 |
1439-1888 |
Sentence |
denotes |
Thus, the relative contributions of the activating (A) and inhibitory (I) FcγR to the response by an effector cell, the A‐to‐I ratio, may be an important determinant in clinical outcome of therapeutic mAb activity,76, 81, 82 that is, the higher the A‐to‐I ratio, the greater the proinflammatory response induced by the therapeutic mAb or conversely the lower the A‐to‐I ratio, the greater the inhibition or dampening of the proinflammatory response. |
T235 |
1889-2000 |
Sentence |
denotes |
Thus, the challenge for the development of more potent FcγR effector mAbs is to overcome three major obstacles. |
T236 |
2001-2193 |
Sentence |
denotes |
First, improving activation potency by selectively enhancing interaction with activating‐type FcγR, particularly FcγRIIIa owing to its predominant role in ADCC‐mediated killing of tumor cells. |
T237 |
2194-2260 |
Sentence |
denotes |
Second, reducing binding interactions with the inhibitory FcγRIIb. |
T238 |
2261-2335 |
Sentence |
denotes |
These two approaches improve the FcγR A‐to‐I ratio of cytotoxic IgG1 mAbs. |
T239 |
2336-2606 |
Sentence |
denotes |
Third, overcoming the significant affinity difference in the interaction with the main FcγRIII allelic forms of FcγRIIIa‐V158 and FcγRIIIa‐F158 76, 83, 84 which appears to be an important source of patient variability in responses to therapeutic mAb treatment of cancer. |
T240 |
2607-2692 |
Sentence |
denotes |
At the time of writing, some mAbs with improved potency are coming into clinical use. |
T241 |
2693-2825 |
Sentence |
denotes |
Their improved action has been achieved by modifying the N‐linked glycan or the amino acid sequence of the heavy‐chain Fc (Table 4). |
T242 |
2826-2932 |
Sentence |
denotes |
Table 4 Fc or hinge‐engineered monoclonal antibodies (mAbs) approved or in advanced clinical development. |
T243 |
2933-3042 |
Sentence |
denotes |
mAb name Target IgG backbone Fc modification Effect on mAb Therapy area Most advanced development stage |
T244 |
3043-3147 |
Sentence |
denotes |
Andecaliximab Matrix Metalloproteinase 9 (MMP9) IgG4 S228P Stabilize core hinge Oncology Phase III |
T245 |
3148-3308 |
Sentence |
denotes |
Anifrolumab Interferon alpha/beta receptor 1 IgG1 L234F; L235E; P331S Mimic IgG4 hinge and its CH2/F/G loop; plus ablate FcγR binding Immunology Phase III |
T246 |
3309-3398 |
Sentence |
denotes |
Atezolizumab PD‐L1 IgG1 Aglycosylated (N297A) Ablate FcγR binding Oncology Marketed |
T247 |
3399-3592 |
Sentence |
denotes |
Benralizumab Interleukin 5 IgG1 Afucosylated Selectively enhance FcγRIII interaction Respiratory dermatology; ear nose throat disorders; gastrointestinal; hematology; immunology; Marketed |
T248 |
3593-3722 |
Sentence |
denotes |
Durvalumab PD‐L1 IgG1 L234F; L235E; P331S Mimic IgG4 hinge and its CH2 F/G loop; plus ablate FcγR binding Oncology Marketed |
T249 |
3723-3832 |
Sentence |
denotes |
Evinacumab Angiopoietin‐related protein 3 IgG4 S228P Stabilize core hinge Metabolic disorders Phase III |
T250 |
3833-3957 |
Sentence |
denotes |
Inebilizumab CD19 IgG1 Afucosylated Selectively enhance FcγRIII interaction Central nervous system; oncology Phase III |
T251 |
3958-4082 |
Sentence |
denotes |
Ixekizumab Interleukin 17A IgG4 S228P Stabilize core hinge Dermatology; immunology; musculoskeletal disorders Marketed |
T252 |
4083-4204 |
Sentence |
denotes |
Margetuximab HER2 IgG1 F243L; L235V; R292P; Y300L; P396L Selectively enhance FcγRIII interaction Oncology Phase III |
T253 |
4205-4361 |
Sentence |
denotes |
Mogamulizumab C–C chemokine receptor type 4 (CCR4) IgG1 Afucosylated Selectively enhance FcγRIII interaction Central nervous system; oncology Marketed |
T254 |
4362-4480 |
Sentence |
denotes |
Tafasitamab (MOR208 XmAb 5574) CD19 IgG1 S239D; I332E Selectively enhance FcγRIII interaction Oncology Phase III |
T255 |
4481-4571 |
Sentence |
denotes |
Nivolumab PD‐1 IgG4 S228P Stabilize core hinge Infectious disease; oncology Marketed |
T256 |
4572-4683 |
Sentence |
denotes |
Obinutuzumab CD20 IgG1 Afucosylated Selectively enhance FcγRIII interaction Immunology; oncology Marketed |
T257 |
4684-4784 |
Sentence |
denotes |
Ocaratuzumab CD20 IgG1 P247I; A339Q Selectively enhance FcγRIII interaction Oncology Phase III |
T258 |
4785-4870 |
Sentence |
denotes |
Pembrolizumab PD‐1 IgG4 S228P Stabilize core hinge Infection; oncology Marketed |
T259 |
4871-4987 |
Sentence |
denotes |
Roledumab Rhesus D IgG1 Afucosylated Selectively enhance FcγRIII interaction Hematological disorders Phase III |
T260 |
4988-5100 |
Sentence |
denotes |
Spesolimab (BI‐655130) IL‐36R IgG1 L234A; L235A Ablate FcγR binding Gastrointestinal; immunology Phase III |
T261 |
5101-5188 |
Sentence |
denotes |
Teplizumab CD3 IgG1 L234A; L235A Ablate FcγR binding Metabolic disorders Phase II |
T262 |
5189-5409 |
Sentence |
denotes |
Tislelizumab PD‐1 IgG4 S228P; E233P; F234V; L235A; D265A; L309V; R409K Stabilize core hinge; mimic IgG2 lower hinge for restricted FcγR specificity; ablate FcγR binding; stabilize CH3 interaction Oncology Phase III |
T263 |
5410-5492 |
Sentence |
denotes |
Toripalimab (JS 001) PD‐1 IgG4 S228P Stabilize core hinge Oncology Phase III |
T264 |
5493-5616 |
Sentence |
denotes |
Ublituximab CD20 IgG1 Afucosylated Selectively enhance FcγRIII interaction Central nervous system; oncology Phase III |
T265 |
5617-5636 |
Sentence |
denotes |
Ig, immunoglobulin. |
T266 |
5637-5784 |
Sentence |
denotes |
John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. |
T267 |
5785-5967 |
Sentence |
denotes |
It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. |
T268 |
5969-5998 |
Sentence |
denotes |
Modification of the Fc glycan |
T269 |
5999-6279 |
Sentence |
denotes |
The typical complex N‐linked glycan attached to N297 of the heavy chain includes a core fucose.85 Antibodies that lack this fucose have approximately 50‐fold improved binding to FcγRIIIa and FcγRIIIb and importantly retain the weak, low‐affinity binding to the inhibitory FcγRIIb. |
T270 |
6280-6654 |
Sentence |
denotes |
Furthermore, this glycoengineering increased binding affinity of the modified IgG1 mAb for both FcγRIIIa V158 and F158 allelotypes.86, 87, 88 Afucosyl versions of the tumor targeting mAbs such as anti‐HER2, anti‐EGFR and anti‐CD20 had greater antitumor effects and increased survival,68, 88, 89 which is a reflection of the greatly increased, and selective, FcγRIII binding. |
T271 |
6655-6980 |
Sentence |
denotes |
Compared with their unmodified counterparts, the afucosyl mAbs showed dramatic improvement of FcγRIII‐related effector responses such as stronger NK cell‐mediated ADCC, or enhanced neutrophil‐mediated phagocytosis through FcγRIIIb and/or FcγRIIIa.23 However, certain neutrophil functions via FcγRIIa may be compromised.90, 91 |
T272 |
6981-7085 |
Sentence |
denotes |
There are six afucosylated antibodies in late‐stage clinical trials or approved for treatment (Table 4). |
T273 |
7086-7436 |
Sentence |
denotes |
Notable is obinutuzumab, an afucosyl anti‐CD20 mAb which nearly doubles progression‐free survival in chronic lymphocytic leukemia patients as compared with the fucose‐containing rituximab.68 This dramatic improvement in clinical utility reinforces the value of glycan engineering specifically and of Fc engineering generally in anticancer treatments. |
T274 |
7438-7468 |
Sentence |
denotes |
Mutation of the Fc amino acids |
T275 |
7469-7581 |
Sentence |
denotes |
Alteration of the amino acids in the heavy‐chain Fc can alter IgG specificity and affinity for activating FcγRs. |
T276 |
7582-7862 |
Sentence |
denotes |
The anti‐CD19 antibody MOR208 (XmAb 5574) is currently in phase III trials for the treatment of chronic lymphocytic leukemia.92 It contains two mutations in its IgG1 Fc, S329D and I332E, which increases affinity to FcγRIIIa, particularly the “lower‐affinity” FcγRIIIa F158 allele. |
T277 |
7863-7980 |
Sentence |
denotes |
The mAb shows increased FcγRIII‐mediated ADCC and phagocytosis in vitro, and reduced lymphoma growth in mouse models. |
T278 |
7981-8360 |
Sentence |
denotes |
Margetuximab is an ADCC‐enhanced IgG1 Fc‐engineered variant of the approved anti‐HER2 mAb trastuzumab in phase III for HER2‐expressing cancers.66, 93 Alteration of five amino acids (L235V, F243L, R292P, Y300L and P396L) enhanced binding to FcγRIIIa which also had the additional effect of decreasing binding to the inhibitory FcγRIIb, and thereby increased its A‐to‐I FcγR ratio. |
T279 |
8361-8575 |
Sentence |
denotes |
This was apparent when compared with unmodified trastuzumab the margetuximab showed enhanced ADCC against HER2+ cells in vitro and demonstrated superior antitumor effects in an HER2‐expressing tumor model in mice. |
T280 |
8576-8947 |
Sentence |
denotes |
The anti‐CD20 ocaratuzumab is an Fc‐engineered IgG1 mAb in late‐stage clinical trials for the treatment of a range of cancers, including non‐Hodgkin lymphoma and chronic lymphocytic leukemia.94 Two Fc mutations, P247I and A339Q, conferred about 20‐fold increase in binding to both major allelic variants of FcγRIIIa and elicited sixfold greater ADCC than unmodified IgG1. |
T281 |
8948-9109 |
Sentence |
denotes |
Thus, the engineering of the Fc domain or glycan for improved FcγRIIIa binding is a powerful tool to create more potent and clinically effective anticancer mAbs. |