Targeting of immune checkpoint regulator V-domain Ig suppressor of T-cell activation (VISTA) with <sup>89</sup>Zr-labelled CI-8993.

Burvenich, Ingrid Julienne Georgette; Wichmann, Christian Werner; McDonald, Alexander Franklin; Guo, Nancy; Rigopoulos, Angela; Huynh, Nhi; Vail, Mary; Allen, Stacey et al. · Eur J Nucl Med Mol Imaging · 2024

basic_science · Level V

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Abstract

CI-8993 is a fully human IgG1κ monoclonal antibody (mAb) that binds specifically to immune checkpoint molecule VISTA (V-domain Ig suppressor of T-cell activation). Phase I safety has been established in patients with advanced cancer (NCT02671955). To determine the pharmacokinetics and biodistribution of CI-8993 in patients, we aimed to develop <sup>89</sup>Zr-labelled CI-8993 and validate PET imaging and quantitation in preclinical models prior to a planned human bioimaging trial. CI-8993 and human isotype IgG1 control were conjugated to the metal ion chelator p-isothiocyanatobenzyl-desferrioxamine (Df). Quality of conjugates were assessed by SE-HPLC, SDS-PAGE, and FACS. After radiolabelling with zirconium-89 (<sup>89</sup>Zr), radioconjugates were assessed for radiochemical purity, immunoreactivity, antigen binding affinity, and serum stability in vitro. [<sup>89</sup>Zr]Zr-Df-CI-8993 alone (1 mg/kg, 4.6 MBq) or in combination with 30 mg/kg unlabelled CI-8993, as well as isotype control [<sup>89</sup>Zr]Zr-Df-IgG1 (1 mg/kg, 4.6 MBq) were assessed in human VISTA knock-in female (C57BL/6 N-Vsir<sup>tm1.1(VSIR)Geno</sup>, huVISTA KI) or control C57BL/6 mice bearing syngeneic MB49 bladder cancer tumours; and in BALB/c nu/nu mice bearing pancreatic Capan-2 tumours. Stable constructs with an average chelator-to-antibody ratio of 1.81 were achieved. SDS-PAGE and SE-HPLC showed integrity of CI-8993 was maintained after conjugation; and ELISA indicated no impact of conjugation and radiolabelling on binding to human VISTA. PET imaging and biodistribution in MB49 tumour-bearing huVISTA KI female mice showed specific localisation of [<sup>89</sup>Zr]Zr-Df-CI-8993 to VISTA in spleen and tumour tissues expressing human VISTA. Specific tumour uptake was also demonstrated in Capan-2 xenografted BALB/c nu/nu mice. We radiolabelled and validated [<sup>89</sup>Zr]Zr-Df-CI-8993 for specific binding to huVISTA in vivo. Our results demonstrate that <sup>89</sup>Zr-labelled CI-8993 is now suitable for targeting and imaging VISTA expression in human trials.

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