CD19 targeting of chronic lymphocytic leukemia with a novel Fc-domain-engineered monoclonal antibody

Blood. 2010 Feb 11;115(6):1204-13. doi: 10.1182/blood-2009-06-229039. Epub 2009 Dec 2.

Abstract

CD19 is a B cell-specific antigen expressed on chronic lymphocytic leukemia (CLL) cells but to date has not been effectively targeted with therapeutic monoclonal antibodies. XmAb5574 is a novel engineered anti-CD19 monoclonal antibody with a modified constant fragment (Fc)-domain designed to enhance binding of FcgammaRIIIa. Herein, we demonstrate that XmAb5574 mediates potent antibody-dependent cellular cytotoxicity (ADCC), modest direct cytotoxicity, and antibody-dependent cellular phagocytosis but not complement-mediated cytotoxicity against CLL cells. Interestingly, XmAb5574 mediates significantly higher ADCC compared with both the humanized anti-CD19 nonengineered antibody it is derived from and also rituximab, a therapeutic antibody widely used in the treatment of CLL. The XmAb5574-dependent ADCC is mediated by natural killer (NK) cells through a granzyme B-dependent mechanism. The NK cell-mediated cytolytic and secretory function with XmAb5574 compared with the nonengineered antibody is associated with enhanced NK-cell activation, interferon production, extracellular signal-regulated kinase phosphorylation downstream of Fcgamma receptor, and no increased NK-cell apoptosis. Notably, enhanced NK cell-mediated ADCC with XmAb5574 was enhanced further by lenalidomide. These findings provide strong support for further clinical development of XmAb5574 as both a monotherapy and in combination with lenalidomide for the therapy of CLL and related CD19(+) B-cell malignancies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibody-Dependent Cell Cytotoxicity / physiology*
  • Antigens, CD19 / immunology*
  • Apoptosis
  • Blotting, Western
  • Cytotoxicity, Immunologic / immunology
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Flow Cytometry
  • Granzymes / metabolism
  • Humans
  • Immunoglobulin Fc Fragments / genetics*
  • Immunoglobulin Fc Fragments / immunology
  • Killer Cells, Natural / immunology*
  • Leukemia, B-Cell / genetics
  • Leukemia, B-Cell / immunology
  • Leukemia, B-Cell / therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Phagocytosis
  • Phosphorylation
  • RNA, Messenger / genetics
  • RNA, Messenger / metabolism
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • Antibodies, Monoclonal
  • Antigens, CD19
  • Immunoglobulin Fc Fragments
  • RNA, Messenger
  • Extracellular Signal-Regulated MAP Kinases
  • Granzymes