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Principles of Immunogenicity Assessment Using Biacore T200 SPR System Presented by PD Dr. Arno Kromminga and Dr. Daniel Worms June 11, 2019 Immunogenicity Assessment INFLAMMATION AND INNATE ADAPTIVE IMMUNITY IMMUNITY CELL- CELLULAR

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  1. Principles of Immunogenicity Assessment Using Biacore ™ T200 SPR System Presented by PD Dr. Arno Kromminga and Dr. Daniel Worms June 11, 2019

  2. Immunogenicity Assessment INFLAMMATION AND INNATE ADAPTIVE IMMUNITY IMMUNITY CELL- CELLULAR HUMORAL ANTIBODY-MEDIATED MEDIATED COMPONENT COMPONENT T-dependent T-independent antigens antigens (T-D) (TI-1 and TI-2) 2

  3. Antibody-Mediated Immune Response Two categories of antigens regarding their recognition and the induction of humoral immune response: This is the best known (more classical / widespread) mechanism. T-cell dependent immune T-dependent (T-D) antigens: response characterized in vivo by formation of germinal centers in peripheral lymphoid • Endocytosed by antigen presenting cells (APCs) organs • Presentation to T H cells • T cell activation • T cell-dependent B cell activation and IgG secretion T-independent (T-I) antigens: • Directly recognized by B cells • Cross-linking of the B cell receptors • T cell-independent B cell activation and IgM secretion Sylvain et al., (2012). Biomolecules. 2. 435-466 3

  4. Immunogenicity of Biologics • Therapeutic proteins can induce an immune response (anti-drug antibodies). • Effects range from no clinical effect to serious adverse effects. • Immunogenicity testing is essential to ensure: • Clinical safety & efficacy • Regulatory compliance 4

  5. Causes of Immunogenicity Structural Properties Treatment Related • Sequence variation • Dose • treatmentre-existing antibodies PTM/Glycosylation • Route of application • Aggregation, oxidation, • Frequency of application degradation, deamination • Length of treatment • Conformational changes Immunogenicity Manufacturing Process Patient & Disease Related • • Contaminants/impurities Immune status of treatment • • mulation Production/purification Genetic background • • Storage conditions Concomitant treatment • • Formulation Pre-existing antibodies 5

  6. Consequences of Immunogenicity No Clinical Altered PK/PD Profile Effect • Increased/decreased drug exposure Hypersensitivity Neutralizing Antibodies • • Anaphylactic/ Reduced drug efficacy anaphylactoid • Neutralization of reactions endogeneous counterpart 6

  7. Examples of Serious ADA Effects Biotherapeutic Indication Consequences • MDGF induces Abs neutralizes the TPO leading to auto-immune rDNA Human MGDF Increase platelets during Thrombocytopenia Chemotherapy (Pegylated) • Cross reacted with endogenous protein and caused adverse effects. • NAb to EPO induces PRCA (pure red-cell aplasia) • Erythropoietin (EPO) Anemia Cause formulation change (particulate) and route of administration • Cross reacted with endogenous protein and caused adverse effects. • ~13% patients developed Abs (1/3 rd NAb cases) Glucocerebrosidase • Gaucher patients 90% of these patients become tolerized over time (Placental derived) • Loss in efficacy • Up to 35% patients develop Abs Hemophilia Factor VIII • Loss in efficacy • Up to 44% of patients, IgE Abs in ~5% patients with insulin allergy Diabetes mellitus Recombinant human Insulin • Note: Lipoatrophy with nonpurified bovine/porcine insulin 7

  8. Regulatory Requirements FDA (2019) “Screening assays [ … ] are used to detect antibodies that bind to the “For non-mucosal routes of administration and in therapeutic protein product. [ … ] the screening assay should be sensitive and the absence of a risk of anaphylaxis , the relevant designed to detect low levels of low- and high-affinity ADA [ … ]. ” ADA isotypes are IgM and IgG . ” “The specificity of ADA for the therapeutic protein product is usually “For mucosal routes of administration, IgA isotype established by competition with a therapeutic protein in a confirmatory assay. ” ADAs are also relevant. ” “Titration assays characterize the magnitude of the ADA response . It is “[… ] for therapeutic protein products where there is important to characterize this magnitude with titration assays because the a high risk for anaphylaxis or where anaphylaxis impact of ADA on pharmacokinetics, pharmacodynamics, safety, and efficacy has been observed , results from antigen-specific IgE assays may be informative. ” may correlate with ADA titer and persistence rather than incidence (Cohen and Rivera 2010). ” “[… ] generation of IgG4 antibodies has been “Neutralization assays assess ADA for neutralizing activity . It is important to associated with immune responses generated under characterize neutralizing activity of ADA because the impact of ADA on conditions of chronic antigen exposure , such as pharmacokinetics, pharmacodynamics, safety, and efficacy may correlate with factor VIII treatment, and in erythropoietin-treated NAb activity rather than ADA incidence (Calabresi et al. 2007; Goodin et al. subjects with pure red cell aplasia (Matsumoto et al. 2007; Cohen and Rivera 2010; Wang et al. 2016; Wu et al. 2016 )” 2001; Aalberse and Schuurman 2002). ” 8

  9. Tiered Approach for Antibody Response Assessment Characterization Screening Confirmatory • Titration • Isotyping Assay Assay • Binding stability • Neutralizing activity 9

  10. ADA Assay Validation Cut Point(s) Statistical threshold to distinguish positive/negative samples Limit of detection (~100 ng/mL); in presence of therapeutic Sensitivity & Drug Tolerance protein at trough levels Exclusively detect the target analyte; in presence of other Specificity & Selectivity sample components Precision Variability within and between assay runs Robustness & Stability Variations in method and instrument performance 10

  11. Biacore ™ T200 SPR Platform Biacore ™ T200 • Analyzes and characterizes ADAs and molecular interactions related to kinetics, specificity, and concentration. • Is a non-invasive label-free technology based on surface plasmon resonance (SPR) principle. • Reacts to changes in the concentration of molecules at the sensor surface as molecules bind to or detach from the surface. 11

  12. Biacore ™ T200 SPR Platform What is surface plasmon resonance (SPR)? • SPR allows real-time, label-free detection of biomolecular interactions. • SPR occurs when polarized light strikes an electrically conducting surface at the interface between two media. • This generates electron charge density waves called plasmons , reducing the intensity of reflected light at a specific angle known as the resonance angle , in proportion to the mass on a sensor surface. 12

  13. Biacore™ T200 SPR Platform What data can be obtained from an interaction? • Binding: Does the interacting partner bind to the target molecule? • Specificity: To what extent does an interacting partner cross-react with other molecules? • Concentration: How much of a given molecule is present and active? • Kinetics: What are the rates of association and dissociation? • Affinity: How strong is the binding? 13

  14. ADA – Screening Assay If ADAs are formed, His -tag enzymatically Immunogenic authorities may ask against removed after purification. byproducts/residuals? which target. 14

  15. ADA – Screening Assay 15

  16. ADA – Screening Assay Sample Regeneration 16

  17. ADA – Screening Assay – Cut Point 17

  18. ADA – Screening Assay – Sensitivity 18

  19. ADA – Screening Assay – Qualification Surface Minimum Minimum Required Regeneration Test Performance/ Required Dilution Stability Test Dilution Precision: Sensitivity: 3 Cut Points 2.8 %CV Intra-Assay 1 µg/mL 3.6 %CV Inter-Assay 19

  20. ADA – Screening Assay Lower sensitivity compared to ELISA, but allows detection of low-affinity ADAs. No. of Positives No. of Positives Drug (ELISA) (SPR) Iodine 131 chimeric tumor 4/78 7/78 necrosis mAb 1 Biotherapeutic drug, 19/62 25/62 Merck Serono 2 Panitumumab 3 2/612 25/604 rhEPO 4 6/8 8/8 1 Wang et al. Cancer Immuniol. Immunother. 57 (2008) 2 Presented at Immunogenicity for Biologics, Munich (2011) 3 Lofgren et al. J. Immunol. 178 (2007) 4 Swanson et al. Clin. Pract. 96 (2004) 20

  21. ADA – Confirmatory Assay • Drug depletion assay • Inhibition of response by adding excess of drug to the sample • Confirms that response derives from specific binding to the drug 21

  22. Clinical Relevance of Antibody Isotypes Concentration [µg/ml] IgM Heavy chain Molecular weight (kD) Concentration [mg/ml] Half life time [days] Complement activation Alternative pathway Affinity [1/mol] IgA / IgD / IgE / IgG Placenta transfer Binding to M  Binding to mast cells Reactivity to Protein A 22

  23. ADA Isotyping 27

  24. ADA Isotyping – Binding Stability Assessment of binding stability enables monitoring of ADA maturation. 28

  25. Neutralizing Antibodies • Competitive ligand binding (CLB) assay  for antagonistic drugs against humoral targets. • Needs to reflect Mechanism of Action. • Drug binds to soluble ligand, thereby preventing it from binding to receptor. • Presence of NAbs inhibit the antagonistic effect of the drug. 29

  26. Functional testing of TMAB 30

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