Antibody-dependent cellular cytotoxicity (ADCC) assays assess the ability of an antibody like nivolumab to recruit immune effector cells, such as natural killer (NK) cells, to target and kill cancer cells. However, nivolumab, an IgG4 monoclonal antibody (mAb), is generally designed to avoid ADCC due to its checkpoint inhibitor function, which is primarily intended to restore T-cell activity rather than direct cytotoxicity. Nevertheless, ADCC assays are still conducted in early drug development to confirm that nivolumab has minimal or no ADCC activity, especially since unintended cytotoxicity could lead to adverse effects.
Principle of ADCC Assay
ADCC occurs when an antibody binds to a target cell, such as a cancer cell, and its Fc region is recognized by Fc receptors (FcγR) on the surface of effector cells like NK cells. When the antibody-coated target cell is brought into proximity with the effector cell, the effector cell becomes activated and releases cytotoxic granules, leading to target cell lysis.
For nivolumab, an ADCC assay would confirm the absence of significant ADCC activity due to its IgG4 backbone, which interacts minimally with FcγR receptors and therefore has reduced cytotoxic potential.
Step-by-Step Procedure for ADCC Assay
Preparation of Target Cells (Cancer Cells)
- Culture a suitable target cell line that expresses the PD-1 ligand (PD-L1 or PD-L2). Use cell lines relevant to the nivolumab target, such as PD-L1-expressing tumor cells.
- Label target cells with a fluorescent dye like calcein AM, or with a radioactive marker such as chromium-51 (^51Cr), depending on the detection method. Labeling helps quantify cell lysis by measuring released fluorescence or radioactivity after cell death.
Preparation of Effector Cells (NK Cells)
- Isolate peripheral blood mononuclear cells (PBMCs) from healthy donors, or use NK-92 cells, which are engineered NK cells that express Fc receptors and are effective in ADCC assays.
- For optimal results, ensure an effector-to-target (E) cell ratio (commonly 25:1 or 50:1) that provides sufficient sensitivity in detecting any ADCC activity.
Addition of Nivolumab
- Add nivolumab at various concentrations to the target cells. Include a positive control antibody (such as a therapeutic IgG1 antibody known to induce ADCC) and a negative control (such as an IgG4 isotype control) to validate the assay.
- Incubate the antibody-target cell mixture briefly to allow nivolumab to bind to the target cells.
Co-Culture of Effector and Target Cells
- Combine the effector cells with the target cells at the specified Eratio.
- Incubate the co-culture for a specific period, typically 4 hours, to allow interaction and possible cell lysis.
Detection of Target Cell Lysis
For fluorescent assays: Measure fluorescence released into the supernatant from lysed cells using a fluorescence plate reader.
For radioactive assays: Measure radioactivity in the supernatant, which correlates with the number of lysed cells.
Calculate the percentage of specific lysis using the formula:
Analysis and Interpretation
- Determine the ADCC activity of nivolumab by comparing it to the positive and negative controls.
- For nivolumab, minimal to no lysis should be observed, indicating that it does not induce significant ADCC activity due to its IgG4 Fc region. The positive control should demonstrate strong lysis, while the IgG4 isotype control should show minimal ADCC activity.
Key Considerations
- IgG4 Backbone of Nivolumab: As an IgG4 antibody, nivolumab is engineered to avoid binding strongly to Fcγ receptors, which is reflected in a low ADCC response in this assay.
- Positive and Negative Controls: Including an IgG1 antibody as a positive control is crucial to verify that the assay system can detect ADCC activity effectively.
- Effector-to-Target Ratio: The Eratio can affect the sensitivity of the assay; higher ratios may yield better sensitivity but should be consistent across replicates.
Summary
This ADCC assay confirms that nivolumab lacks significant ADCC activity, aligning with its primary mechanism of blocking PD-1 to activate T-cells rather than directly mediating cell killing.