PO.CL05.04 · 临床研究
NTX1088首次实现DNAM1的临床恢复,定义了一条全新的免疫肿瘤学轴
NTX1088 demonstrates the first-ever clinical restoration of DNAM1, defining a novel immune-oncology axis
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
NTX1088是一种首创(first-in-class)的抗PVR(CD155)单克隆抗体,目前正在一项1期、开放标签、多中心研究(NCT05378425)中作为单药以及与pembrolizumab联合用于晚期实体恶性肿瘤患者进行评估。初步临床数据首次证明,经NTX1088阻断PVR后,外周T细胞和NK细胞上DNAM1(CD226)的表达和功能得以恢复。这一机制性突破在多个剂量水平上均得到稳健观察,使NTX1088区别于所有抗TIGIT策略而成为独特的免疫治疗药物——后者在临床环境中均未实现DNAM1的恢复。临床生物标志物分析证实,DNAM1在NK细胞、CD4+和CD8+ T细胞上显著上调,有效逆转了PVR介导的DNAM1下调——这一被公认的免疫逃逸和检查点抑制耐药机制。与未能恢复DNAM1的TIGIT阻断不同,NTX1088推动TIGIT/DNAM1比值向有利方向转变,并扩增强效效应细胞亚群,直接增强抗肿瘤免疫活性。为进一步剖析其转化影响和分子机制,我们利用健康志愿者的PBMC和Jurkat细胞系开展了大量体外工作。在这些体外实验中,DNAM1与CD3信号的同时接合导致激活标志物诱导增加、耗竭谱出现独特变化以及强劲的细胞因子分泌,这些功能特征表明DNAM1共信号有别于传统的CD28介导的共刺激。人源化小鼠模型中的一致发现揭示,NTX1088的肿瘤生长抑制和免疫效应激活作用大多依赖于DNAM1,且与未上调DNAM1的细胞相比,DNAM1阳性细胞的激活程度显著更高,且更倾向于发挥抗肿瘤活性。总体而言,这些数据确立了NTX1088作为首个实现DNAM1临床恢复的免疫疗法,验证了DNAM1诱导和TIGIT/DNAM1比值重塑均可作为评估药物效应、患者选择和未来免疫肿瘤学联合方案的可操作生物标志物。在阻断TIGIT、CD96和KIR2DL5A等其他PVR抑制性受体的同时恢复DNAM1,使NTX1088成为协同性IO/IO联合治疗的一种有吸引力的治疗药物,为下一代抗癌免疫开辟了变革性道路。
查看英文原文 English abstract
NTX1088, a first-in-class anti-PVR (CD155) monoclonal antibody, is currently being evaluated in a Phase 1, open-label, multi-center study (NCT05378425) as monotherapy and in combination with pembrolizumab in patients with advanced solid malignancies. Preliminary clinical data, for the first time, demonstrate restoration of DNAM1 (CD226) expression and function on peripheral T and NK cells following PVR blockade by NTX1088. This mechanistic breakthrough is robustly observed across multiple dose levels and distinguishes NTX1088 as a unique immunotherapeutic agent, unlike all anti-TIGIT strategies, which have not achieved DNAM1 restoration in clinical settings. Clinical biomarker analyses confirm significant upregulation of DNAM1 across NK cells, CD4+, and CD8+ T cells, effectively reversing PVR-mediated DNAM1 downmodulation, a recognized mechanism of immune escape and resistance to checkpoint inhibition. In contrast to TIGIT blockade, which fails to restore DNAM1, NTX1088 drives a favorable shift in the TIGIT/DNAM1 ratio and expands potent effector subsets, directly enhancing antitumor immune activity. To further dissect the translational impact and molecular mechanisms, extensive in vitro work was performed, using PBMCs from healthy volunteers and Jurkat cell line. In these in-vitro assays, simultaneous engagement of DNAM1 with CD3 signaling resulted in increased induction of activation markers, unique changes in exhaustion profiles, and robust cytokine secretion, functional signatures which showed DNAM1 co-signaling is distinct from conventional CD28-mediated costimulation. Concordant findings in humanized mouse models reveal that much of NTX1088's tumor growth inhibition and immune effector activation are DNAM1-dependent, and DNAM1 positive cells are significantly more activated and primed for anti-tumor activity compared to cells that did not upregulate DNAM1. Collectively, these data establish NTX1088 as the first immunotherapy to achieve clinical restoration of DNAM1, validating both DNAM1 induction and TIGIT/DNAM1 ratio remodeling as actionable biomarkers for drug effect, patient selection, and future immune-oncology combinations. The concurrent restoration of DNAM1, alongside blockade of other PVR inhibitory receptors like TIGIT, CD96, and KIR2DL5A, positions NTX1088 as an attractive therapeutic agent for synergistic IO/IO combinations, charting a transformative course for next-generation anticancer immunity
利益披露 Disclosure
A. Atieh, None..
A. Vitenshtein, None..
A. Obiedat, None..
S. Chechik, None..
R. Cashman, None..
G. Cinamon, None..
K. Paz, None.
Y. Daniely,
aMoon Fund Employment.
P. Kučan Brlić, None..
T. Lenac Roviš, None..
L. Hiršl, None..
M. mazor, None..
E. bellulovich, None..
S. Jonjic, None..
O. Mandelboim, None..
P. Tsukerman, None.