An EGFR-CD3ε bispecific antibody can mediate bystander killing of EGFR-negative tumor cells (and potentially normal stromal cells) proximal to EGFR-expressing tumor cells via secreted cytokine induction of ICAM-1 and FAS on target cells, allowing activated T cells, expressing LFA-1 and FAS-ligand, to engage and target EGFR-negative cells in vitro and in a reconstructed xenograft model.
For targets that are homogenously expressed, such as CD19 on cells of the B lymphocyte lineage, immunotherapies can be highly effective. Targeting CD19 with blinatumomab, a CD19/CD3 bispecific antibody construct (BiTE(R)), or with chimeric antigen receptor T cells (CAR-T) has shown great promise for treating certain CD19-positive hematological malignancies. In contrast, solid tumors with heterogeneous expression of the tumor-associated antigen (TAA) may present a challenge for targeted therapies. To prevent escape of TAA-negative cancer cells, immunotherapies with a local bystander effect would be beneficial. As a model to investigate BiTE(R)-mediated bystander killing in the solid tumor setting, we used epidermal growth factor receptor (EGFR) as a target. We measured lysis of EGFR-negative populations in vitro and in vivo when co-cultured with EGFR-positive cells, human T cells and an EGFR/CD3 BiTE(R) antibody construct. Bystander EGFR-negative cells were efficiently lysed by BiTE(R)-activated T cells only when proximal to EGFR-positive cells. Our mechanistic analysis suggests that cytokines released by BiTE(R)-activated T-cells induced upregulation of ICAM-1 and FAS on EGFR-negative bystander cells, contributing to T cell-induced bystander cell lysis.
