Abstract: |
Bispecific T Cell Engagers (BTC) constitute an exciting antibody design in immuno-oncology that acts to bypass antigen presentation and forms a direct link between cancer and immune cells in the tumor microenvironment (TME). By design, BTCs are efficacious only when the drug is bound to both immune and cancer cell targets, and therefore approaches to maximize drug-target trimer in the TME should maximize the drug's efficacy. In this study, we quantitatively investigate how the concentration of ternary complex and its distribution depend on both the targets' specific properties and the design characteristics of the BTC, and specifically on the binding kinetics of the drug to its targets. A simplified mathematical model of drug-target interactions is considered here, with insights from the "three-body" problem applied to the model. Parameter identifiability analysis performed on the model demonstrates that steady-state data, which is often available at the early pre-clinical stages, is sufficient to estimate the binding affinity of the BTC molecule to both targets. The model is used to analyze several existing antibodies that are either clinically approved or are under development, and to explore the common kinetic features. We conclude with a discussion of the limitations of the BTCs, such as the increased likelihood of cytokine release syndrome, and an assessment for a full quantitative pharmacology model that accounts for drug distribution into the peripheral compartment. |