Data from Fc Optimization of Therapeutic Antibodies Enhances Their Ability to Kill Tumor Cells <i>In vitro</i> and Controls Tumor Expansion <i>In vivo</i> via Low-Affinity Activating Fcγ Receptors

Monoclonal antibodies (mAb) are widely used in the treatment of non-Hodgkin's lymphoma and autoimmune diseases. Although the mechanism of action in vivo is not always known, the therapeutic activity of several approved mAbs depends on the binding of the Fcγ regions to low-affinity Fcγ receptors (FcγR) expressed on effector cells. We did functional genetic screens to identify IgG1 Fc domains with improved binding to the low-affinity activating Fc receptor CD16A (FcγRIIIA) and reduced binding to the low-affinity inhibitory Fc receptor, CD32B (FcγRIIB). Identification of new amino acid residues important for FcγR binding guided the construction of an Fc domain that showed a dramatically enhanced CD16A binding and greater than a 100-fold improvement in antibody-dependent cell-mediated cytotoxicity. In a xenograft murine model of B-cell malignancy, the greatest enhancement of an Fc-optimized anti-human B-cell mAb was accounted for by improved binding to FcγRIV, a unique mouse activating FcγR that is expressed by monocytes and macrophages but not natural killer (NK) cells, consistent with experimental and clinical data suggesting that mononuclear phagocytes, effector cells expressing both activating and inhibitory FcγR, are critical mediators of B-cell depletion in vivo. By using mice transgenic for human CD16A, enhanced survival was observed due to expression of CD16A-158^phe on monocytes and macrophages as well as on NK cells in these mice. The design of new generations of improved antibodies for immunotherapy should aim at Fc optimization to increase the engagement of activating FcγR present on the surface of tumor-infiltrating effector cell populations. [Cancer Res 2007;67(18):8882–90]