POTENT AND SELECTIVE A2AR MONOCLONAL ANTIBODY ANTAGONIST FOR THE TREATMENT OF CANCER

BACKGROUND AND SIGNIFICANCE: The presence of adenosine at abnormally high concentrations in tumor microenvironment leads to the activation of adenosine receptor 2A (A2aR) and represents one of the mechanisms for cancer patients to be resistance to immune checkpoint blockade therapies. CD39 and CD73 play an important role in converting ATP to adenosine. Currently antibodies or small molecule inhibitors (SMIs) targeting CD39 and CD73, as well as SMIs targeting adenosine receptors, are under preclinical investigation and early clinical development. However, effective biologics targeting adenosine receptors has not been reported. Here we demonstrated that humanized anti-A2aR antibodies represent promising novel therapeutic candidates for developing immunotherapy to restore anti-tumor responses in solid tumors that only partially respond or are completely resistance to ICB therapies. METHODS: Humanized anti-human A2aR monoclonal antibodies (mAbs) were generated from mouse hybridoma antibody via classic CDR grafting method. The A2aR binding and non-human primate cross-reactivity were measured by FACS using human A2aR-expressing HEK293 cells as well as human and cynomolgus monkey PBMCs. Internalizing properties were determined by FACS and immunofluorescent method. The cellular potency of these mAbs was assessed by their capability of inhibiting cAMP production induced by A2aR agonist adenosine and NECA in hA2aR-overexpressing HEK293 cells. The ability of lead candidates to reverse adenosine-mediated suppression of human effector cell function was determined using standard CD3/CD28 activation conditions in the presence of A2aR agonist NECA. RESULTS AND CONCLUSION: We successfully humanized anti-A2aR antibody discovered via hybridoma technology. Humanized anti-A2aR antibodies maintain binding, cross-reactivity to human and cynomolgus monkey A2aR, as well as internalizing property and A2aR-antagonizing potency, in comparison with parental antibody. Humanized antibodies are 5~10 fold more potent than clinical stage small molecule inhibitors CPI-444 and AB928 in inhibiting cAMP production. Blockade of A2aR with humanized antibody can restore activation and cytokine production of human T and NK cells suppressed by A2aR agonist adenosine or NECA. Thus, antibody-mediated blockade of A2aR pathway represents a novel strategy to mitigate adenosine-mediated tumor resistance to immune checkpoint blockade therapies.