@article {Mandele004859, author = {Ilana Mandel and Dana Haves Ziv and Ilana Goldshtein and Tsuri Peretz and Dror Alishekevitz and Anna Fridman Dror and Motti Hakim and Sharon Hashmueli and Itay Friedman and Yair Sapir and Rita Greco and Hongjing Qu and Frank Nestle and Dmitri Wiederschain and Lily Pao and Sharad Sharma and Tehila Ben Moshe}, title = {BND-22, a first-in-class humanized ILT2-blocking antibody, promotes antitumor immunity and tumor regression}, volume = {10}, number = {9}, elocation-id = {e004859}, year = {2022}, doi = {10.1136/jitc-2022-004859}, publisher = {BMJ Specialist Journals}, abstract = {Background Cancer immunotherapy has revolutionized cancer treatment. However, considering the limited success of immunotherapy to only some cancer types and patient cohorts, there is an unmet need for developing new treatments that will result in higher response rates in patients with cancer. Immunoglobulin-like transcript 2 (ILT2), a LILRB family member, is an inhibitory receptor expressed on a variety of immune cells including T cells, natural killer (NK) cells and different myeloid cells. In the tumor microenvironment, binding of class I MHC (in particular HLA-G) to ILT2 on immune cells mediates a strong inhibitory effect, which manifests in inhibition of antitumor cytotoxicity of T and NK cells, and prevention of phagocytosis of the tumor cells by macrophages.Methods We describe here the development and characteristics of BND-22, a novel, humanized monoclonal antibody that selectively binds to ILT2 and blocks its interaction with classical MHC I and HLA-G. BND-22 was evaluated for its binding and blocking characteristics as well as its ability to increase the antitumor activity of macrophages, T cells and NK cells in various in vitro, ex vivo and in vivo systems.Results Collectively, our data suggest that BND-22 enhances activity of both innate and adaptive immune cells, thus generating robust and comprehensive antitumor immunity. In humanized mice models, blocking ILT2 with BND-22 decreased the growth of human tumors, hindered metastatic spread to the lungs, and prolonged survival of the tumor-bearing mice. In addition, BND-22 improved the antitumor immune response of approved therapies such as anti-PD-1 or anti-EGFR antibodies.Conclusions BND-22 is a first-in-human ILT2 blocking antibody which has demonstrated efficient antitumor activity in various preclinical models as well as a favorable safety profile. Clinical evaluation of BND-22 as a monotherapy or in combination with other therapeutics is under way in patients with cancer.Trial registration number NCT04717375.All data relevant to the study are included in the article or uploaded as supplementary information.}, URL = {https://jitc.bmj.com/content/10/9/e004859}, eprint = {https://jitc.bmj.com/content/10/9/e004859.full.pdf}, journal = {Journal for ImmunoTherapy of Cancer} }