Abstract 3431: Dose range finding study in non-human primates confirms the unique mechanism of action of CTX-8371, a novel bispecific antibody blocking PD-1 and PD-L1

Multiple antibodies blocking PD-1 or PD-L1 have been approved for clinical use. However, not all patients successfully respond to monotherapy and the need for combinations has become more apparent. CTX-8371 combines PD-1/PD-L1 targeting in one bispecific, tetravalent molecule. CTX-8371 potently blocks PD-1/PD-L1 in vitro and in vivo. This robust activity may be explained by the unique mechanism of action (MOA) of CTX-8371 which involves cell surface PD-1 cleavage. Here we present further in vivo evidence of PD-1 cleavage by CTX-8371 detected during a dose range finding (DRF) study in cynomolgus macaques. Results of this study as well as in vitro receptor occupancy (RO) and the PK/PD profile of CTX-8371 in tumor-bearing mice are described. CTX-8371 was administered to female cynomolgus monkeys (n=3/group) in a single intravenous infusion at 2 mg/kg or weekly infusions at 10 or 50 mg/kg, for a total of 2 doses. PBMCs were isolated before, 24 hours after the first dose, or 24 hours after the second dose (for 10 and 50 mg/kg groups). Immunophenotyping, including PD-1 and PD-L1, was performed on PBMCs by flow cytometry. Mean serum concentration-time data was analyzed to derive PK parameters using noncompartmental and two-compartment models. PK was also determined in tumor-bearing mice using an MSD ELISA-based assay and non-compartmental analysis. In monkeys, CTX-8371 administration resulted in a marked decrease of PD-1+CD4+ and PD-1+CD8+ T cells in PBMCs on days 2 and 9 at all dose levels, indicating PD-1 cleavage from the cell surface. These results confirm in vitro, and in vivo MOA data obtained from mouse studies. Clearance and half-life of CTX-8371 were calculated to be ~6.87 mL/day/kg and 5.45 days, respectively, which fall within the expected ranges for a human IgG1 antibody in non-human primates (NHP) with linear PK. CTX-8371 infusion was well tolerated in cynomolgus monkeys. In tumor-bearing mice, the dose which results in 50% of maximum tumor growth inhibition was found to be 1-2 mg/kg. The minimum effective dose, at which at least 50% of animals exhibit greater than 50% tumor growth inhibition over two consecutive days, was 1mg/kg. It was observed that 11% (1/9), 78% (7/9) and 100% (9/9) of mice in 0.1 mg/kg, 1 mg/kg and 10 mg/kg dose groups, respectively, meet the above criteria. CTX-8371 also showed dose-dependent in vitro RO on T cells from peripheral blood of human, cynomolgus monkey, and transgenic hPD-1hPD-L1 mice. Data presented here confirm th