Andersson et al. described preclinical studies of ATOR-4066, a bispecific antibody that targets CEACAM5, which is expressed on most gastrointestinal carcinomas and others, and agonizes CD40. In vitro, ATOR-4066 induced CEACAM5-dependent activation of CD40+ APCs (MoDCs) and synergized with anti-PD-1. In a tumor model with heterogeneous CEACAM5 levels, ATOR-4066 showed superior efficacy compared to anti-CD40 alone. ATOR-4066 promoted migration and activation of myeloid cells and neutrophils in the TME, followed by activation of tumor-specific T cells, which were critical for long-term tumor control and memory.

Contributed by Katherine Turner

ABSTRACT: Despite recent progress within the field of immuno-oncology, immune suppression in the tumor microenvironment, defective antigen presentation, and low levels of tumor-specific T cells are key limitations of current cancer immunotherapies. CD40-targeting immunotherapies hold promises for addressing these limitations across solid tumors. Here, we describe ATOR-4066, a bispecific antibody that targets CD40 and CEACAM5 developed for immunotherapy of cancer using the Neo-X-Prime platform. ATOR-4066 showed potent CEACAM5-dependent activation in vitro with ability to activate intratumoral immune cells from patient derived material. In vivo, ATOR-4066 induced superior anti-tumor activity compared to CD40 mAb in MC38-CEA tumors and cured mice with well-established tumors with a heterogeneous CEACAM5 expression. Using RNA sequencing, flow cytometry and cytokine analysis, we show that ATOR-4066 promotes immune cell trafficking to tumors and activates both myeloid cells and T cells within the tumor microenvironment, with limited immune activation in the periphery. ATOR-4066 initially induces a T cell-independent anti-tumor response, yet a functional T cell response is critical for long-term tumor control and immunity directed to tumor antigens other than CEACAM5. Finally, we demonstrate that ATOR-4066 synergizes with PD-1 blockade in vitro. In conclusion, these data provide mechanistic evidence for the proposed mode of action and support further development of ATOR-4066 in CEACAM5 expressing cancers.

Author Info: (1) Alligator Bioscience (Sweden), Lund, Sweden. (2) Alligator Bioscience (Sweden), Lund, Sweden. (3) Lund University, Lund, Sweden. (4) Alligator Bioscience (Sweden), Lund, Sweden

Author Info: (1) Alligator Bioscience (Sweden), Lund, Sweden. (2) Alligator Bioscience (Sweden), Lund, Sweden. (3) Lund University, Lund, Sweden. (4) Alligator Bioscience (Sweden), Lund, Sweden. (5) Alligator Bioscience (Sweden), Lund, Sweden. (6) Alligator Bioscience (Sweden), Lund, Sweden. (7) Alligator Bioscience (Sweden), Lund, Sweden. (8) Alligator Bioscience AB, Lund, Sweden. (9) Alligator Bioscience AB, Lund, Sweden. (10) Alligator Bioscience AB, Lund, Sweden. (11) Alligator Bioscience (Sweden), Lund, Sweden. (12) Alligator Bioscience AB, Lund, Sweden. (13) Alligator Bioscience (Sweden), Lund, Sweden. (14) Alligator Bioscience (Sweden), Lund, Sweden. (15) Alligator Bioscience (Sweden), Lund, Sweden. (16) Alligator Bioscience (Sweden), Lund, Sweden. (17) Lund University, Lund, Sweden. (18) Alligator Bioscience (Sweden), Lund, Sweden.