Many companies, including Strike Pharma, are developing biologicals for individualized immunotherapeutic cancer treatments. The possibility to combine a bispecific antibody with a myriad of endogenous antigenic peptides opens the doors for highly personalized therapies. Setting up and using analytical assays is key to evaluate aggregation and overcome aggregation patterns of biologicals during CMC development. The aim of this project was to assess size exclusion chromatography (SEC) as an analytical method and subsequently evaluate several drug formulations that could be suitable for subcutaneous administration of a peptide and antibody conjugate mix. The formulations were based on a 25 mM histidine buffer pH 6.0, that had been optimized for the antibody alone, with different additives. By utilizing SEC coupled to UV-detection at 280 nm, aggregates were detected and quantified. The most effective excipients were dimethyl sulfoxide, polyethylene glycol 400 and arginine. Two different peptide-tags were compared and the pTag9mer-mut2 variant was more favorable than pTag9mer-mut1 in limiting aggregate formation with highest success rates at 1.5 mg/mL protein concentrations and the fulfillment of the high molecular weight ≤ 5% criterion. Combining antibody and peptide containing pTag9mer-mut1 in a pH 9.0 histidine buffer with added arginine engendered the least aggregates compared to any pH 6.0 formulation. However, the instability of the antibody in pH 9.0 and the risk of deamidation makes this less suitable. Future considerations include changing the administration method or using pump injection strategy, which allows higher injection volumes to limit aggregation by lowering protein concentrations.

Le trastuzumab est le traitement de référence des cancers du sein « HER2 amplifié ». Outre les limitations inhérentes à toute IgG, cet anticorps est inefficace pour traiter les tumeurs exprimant que modérément (cancers hormonaux) ou faiblement (triple négatif) HER2. L'objectif de ces travaux de thèse est de concevoir de nouveaux anticorps bispécifiques destinés au traitement de cancers du sein échappant à l'action du trastuzumab. Nous nous sommes appuyés sur des formats innovants, basés sur l'utilisation d'anticorps simple domaine de lama (sdAb) comme unité de reconnaissance antigénique. Deux anticorps bispécifiques Fab-like (bsFab) ont été développés, l'un dirigé contre HER2 (HER2bsFab) et l'autre ciblant la mésothéline (MesobsFab), un antigène surexprimé dans 30 à 70% des cancers du sein « triple négatif ». En liant spécifiquement et de façon efficace FcγRIII, ces deux bsFabs ne compètent pas avec les IgG endogènes, ne fixent pas FcγRIIB et activent fortement les NKs. In vitro, HER2bsFab induit de fortes sécrétions de cytokines pro-inflammatoires et de puissantes ADCCs contre des lignées de cancer du sein indépendamment du niveau d'expression d'HER2 et du polymorphisme FcγRIIIA-158. In vivo, HER2bsFab montre une nette supériorité comparé au trastuzumab contre des tumeurs ne surexprimant que modérément HER2. HER2bsFab et MesobsFab induisent in vitro de fortes cytotoxicités contre deux lignées de cancer du sein « triple négatif » et des résultats préliminaires réalisés chez la souris semblent confirmer ces observations. A termes, l'utilisation de ces anticorps permettrait d'étendre la proportion de patientes traitables de façon efficace par immunothérapie. / Trastuzumab is established as standard of care for the treatment of HER2high breast cancers. However, in addition to Fc-related limitations inherent to IgG antibodies, trastuzumab is inefficient to treat low- (triple-negative) or moderate-HER2-overexpressing (hormone-receptor-positive) breast cancers. Based on the unique structural and functional properties of llama single domain antibodies (sdAbs), we report the design of two Fab-like bispecific antibodies targeted to HER2 (HER2bsFab) and mesothelin (MesobsFab), an antigen overexpressed in several human tumors, including triple-negative breast cancers. The two bsFabs display a unique, specific and high affinity for FcγRIII. As a consequence, they do not bind the FcγRIIB inhibitor receptor and bypass competition with endogenous IgGs. HER2bsFab mediated ADCC at picomolar concentration against HER2high as well as HER2moderate cell lines. In vivo HER2bsFab potently inhibited HER2high tumor growth and more importantly, exhibited a net superiority over trastuzumab at inhibiting HER2moderate tumor growth. Moreover, FcγRIIIA-engagement by HER2bsFab was independent of FcγRIIIA-158 polymorphism and induced a stronger NK cells activation in response to target cell recognition. Such findings led us to investigating the efficacy of bsFabs in a context of low-HER2-overexpression displays by triple-negative breast cancers. In vitro characterization showed that both HER2bsFab and MesobsFab trigger efficient lysis of two different triple-negative breast cancer cell lines. Altogether, these findings would enable the treatment of a broader population of patients than that eligible with current HER2-targeted therapies.

Le système immunitaire protège un organisme du développement de pathogènes et participe activement au maintien de la tolérance immunitaire. Les cellules dendritiques (DC) sont des cellules spécialisées dans l’équilibre pro et anti-inflammatoire de la réponse immunitaire. Les DC jouent un rôle important dans de nombreux contextes pathologiques notamment la transplantation d’organes, en oncologie et dans les pathologies inflammatoires. Elles sont modulables grâce à divers facteurs, intrinsèques et extrinsèques. Parce qu’elles sont capables d’induire une réponse tolérogène, ces cellules représentent des cibles intéressantes pour moduler la réponse immunitaire dans le contexte de la transplantation d’organes et des pathologies inflammatoires. Certains agents pathogènes utilisent des mécanismes d’échappement au système immunitaire en favorisant l’induction d’une tolérance immunitaire. Cette modulation est réalisée par le ciblage des récepteurs de reconnaissance des pathogènes (PRR) sur la présence des DC, induisant la synthèse d’une cytokine antiinflammatoire IL-10, un des inducteurs de la tolérance immunitaire. Notre stratégie a été de construire un anticorps bispécifique ciblant deux PRR différents à partir d’une banque d’anticorps anti-PRR. Notre travail montre que cet anticorps bispécifique est capable d’orienter les DC vers d’un profil tolérogène. Cet anticorps bispécifique induit un phénotype de DC semi-mature avec un profil de sécrétion pro-tolérogène avec de l’IL-10 et peu de cytokines inflammatoires. Le profil de tolérance immunitaire induite par ces cellules reste à explorer. Nos travaux ouvrent de perspectives intéressantes sur l’association des PRR en vue d’obtenir la modulation des cellules de l’immunité. / The immune system protects an organism from the development of pathogens and actively participates in maintaining immune tolerance. Dendritic cells (DC) are specialized cells in the balance and anti-inflammatory immune response. DC play an important role in many pathological contexts, including organ transplantation, oncology and inflammatory diseases. Various factors, both intrinsic and extrinsic, can modulate. Because they are capable to inducing a tolerogenic response, these cells represent interesting targets for the immune response in the context of organ transplantation and in inflammatory pathologies. Some pathogens use mechanisms of escape to the immune system by promoting the induction of immune tolerance. This modulation is achieved by targeting the pathogen recognition receptors (PRRs) present on the surface of DC, inducing the synthesis of an anti-inflammatory cytokine IL-10, one of the main inducers of immune tolerance. Our strategy was to construct a bispecific antibody targeting two different PPRs from an anti-PRR antibody library. Our work shows that this bispecific antibody is able to direct the DC to a pro-tolerogenic profile. This bispecific antibody induces a semi-mature DC phenotype with a secretion profile of pro-tolerogenic cytokines such as IL-10 and few inflammatory cytokines. The immune tolerance profile of these DC remains to be explored. Our work opens interesting perspectives on the association of PRRs in order to obtain the modulation of the cells of the immunity.

Despite the central role of IFNγ in vitiligo pathogenesis, systemic IFNγ neutralization is an impractical treatment option due to strong immunosuppression. However, most vitiligo patients present with less than 20% affected body surface area, which provides an opportunity for localized treatments that avoid systemic side effects. After identifying keratinocytes as key cells that amplify IFNγ signaling during vitiligo, I hypothesized that tethering an IFNγ neutralizing antibody to keratinocytes would limit anti-IFNγ effects to the treated skin for the localized treatment. To that end, I developed a bispecific antibody (BsAb) capable of blocking IFNγ signaling while binding to desmoglein expressed by keratinocytes. I characterized the effect of the BsAb in vitro, ex vivo, and in a mouse model of vitiligo. SPECT/CT biodistribution and serum assays after local footpad injection revealed that the BsAb had improved skin retention, faster elimination from the blood, and less systemic IFNγ inhibition than the non-tethered version. Furthermore, the BsAb conferred localized protection almost exclusively to the treated footpad during vitiligo that was not possible by local injection of the non-tethered anti-IFNγ antibody. Thus, keratinocyte-tethering proved effective while significantly diminishing off-tissue effects of IFNγ blockade, offering a new treatment strategy for localized skin diseases, including vitiligo.