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Linderman, J. J.

Publications and source records attributed to Linderman, J. J..

8 recordsLinked to original sources

Agent-based modeling demonstrates how target-independent processes supplement killing by antibody-drug conjugates in cancer therapy

Antibody-drug conjugates (ADCs) have had remarkable clinical success in recent years with multiple new approvals. However, for some ADCs, the response rates dont closely correlate with clinical target expression. One particular ADC targeting HER2, trastuzumab deruxtecan or T-DXd, is notable due to its success at expression levels ranging from high to low and ultralow. This raises the question of the relative contributions of target-independent mechanisms on ADC efficacy in the clinic, and several such mechanisms have been proposed. However, in vitro and preclinical data have different doses and exposures, making it challenging to quantitatively extrapolate preclinical data to the clinic. In this work, we use our computational hybrid agent-based model, SimADC, to simulate target-dependent and -independent mechanisms, scaling from mice to humans. We first demonstrate that CD8+ T cells can significantly contribute to tumor regression, especially when the ADC further activates the immune cells. Next, we test target-independent payload-driven mechanisms including: 1) Fc-mediated internalization of ADC by intratumoral macrophages and payload release to neighboring cancer cells, 2) free payload circulating in the blood and re-entering the tumor, and 3) extracellular linker cleavage and payload release due to an abundance of proteases in the tumor. We find that free payload in the blood and extracellular linker cleavage had low and moderate impacts, respectively, while macrophage uptake and payload release resulted in high levels of efficacy. This is due to the macrophages ability to sustain free payload in the tumor. Moderate and high HER2 expression were more efficacious than target-independent mechanisms. Overall, our simulations demonstrate that moderate to high HER2 expression, immune activation, or macrophage uptake and payload release are sufficient for T-DXd tumor regression. Additionally, SimADC provides a robust framework for modeling both target-dependent and target-independent mechanisms for any ADC, providing the opportunity to engineer more effective therapeutic agents. Author SummaryCancer is one of the most prevalent diseases in the world, impacting the lives of millions of people every year. Antibody-drug conjugates (ADCs) are a form of targeted therapy that can deliver cytotoxic drugs directly to cancer cells, increasing efficacy. However, ADCs are complex to design and test, as each part of the ADC (targeting antibody, cytotoxic payload, and linker) must be optimally selected for delivery for each target and type of patient. Here, we studied ADCs using a computational model, which allowed us to simulate ADCs in varying cancer environments efficiently and economically. We validated our model using preclinical data to incorporate patient immune responses, target-independent payload release, and systemic payload uptake, allowing us to make accurate predictions in mice and extrapolate to human tumors. We compared multiple mechanisms by which ADCs can kill cancer cells to help identify the most effective methods. Besides high target expression, immune stimulation and target-independent release in the microenvironment can contribute to tumor regression. Investigating these mechanisms enables the design of ADCs and treatment regimens that maximize efficacy across a range of tumor types and target expression.

systems biology↗

Rankings of tuberculosis antibiotic treatment regimens are sensitive to spatial scale, detection limit, and initial host bacterial burden

Pulmonary infection after inhalation of Mycobacterium tuberculosis (Mtb) causes tuberculosis (TB). TB presents with lung granulomas - complex spheroidal structures composed of immune cells and bacteria. Granulomas often have centralized caseum (necrotic tissue) where mycobacteria are quarantined, complicating and prolonging multi-antibiotic regimens. Determining which antibiotic regimens are optimal for reducing treatment time and toxicity is a goal of recent TB eradication campaigns. Clinical trials are expensive and challenging, making it difficult to untangle which host-pathogen interactions drive the heterogeneous infection and treatment outcomes observed at between-host and within-host scales. To determine responses to antibiotic regimens, we simulate treatments in HostSim, our whole-host mechanistic, multi-scale computational model of Mtb-infection. HostSim tracks dynamics of pulmonary Mtb-infection over molecular, cellular, tissue, organ, and whole-host scales. We create a heterogenous virtual cohort, comprising distinct hosts, for virtual clinical trials. We represent drug treatments by newly-integrating pharmacokinetics / pharmacodynamics into HostSim, simulating treatment with commonly-prescribed TB antibiotic regimens (e.g., HRZE or BPaL). Our approach allows us to identify both (1) which hosts/granulomas most improve with treatment, and (2) which mechanisms influence outcome heterogeneity. By tracking experimental and clinical measurements, we virtually recreate several drug rankings from literature. We find that many methods of ranking treatment efficacy are strongly influenced by the definition of improvement used and, in some cases, the detection threshold of CFU. Other rankings depend on initial bacterial burden of hosts/granulomas. Our work suggests that metrics for regimen optimality may be orthogonal, which could explain seemingly-contradictory findings from prior studies.

systems biology↗

In vivo Auto-tuning of Antibody-Drug Conjugate Delivery for Effective Immunotherapy using High-Avidity, Low-Affinity Antibodies

Antibody-drug conjugates (ADCs) have experienced a surge in clinical approvals in the past five years. Despite this success, a major limitation to ADC efficacy in solid tumors is poor tumor penetration, which leaves many cancer cells untargeted. Increasing antibody doses or co-administering ADC with an unconjugated antibody can improve tumor penetration and increase efficacy when target receptor expression is high. However, it can also reduce efficacy in low-expression tumors where ADC delivery is limited by cellular uptake. This creates an intrinsic problem because many patients express different levels of target between tumors and even within the same tumor. Here, we generated High-Avidity, Low-Affinity (HALA) antibodies that can automatically tune the cellular ADC delivery to match the local expression level. Using HER2 ADCs as a model, HALA antibodies were identified with the desired HER2 expression-dependent competitive binding with ADCs in vitro. Multi-scale distribution of trastuzumab emtansine and trastuzumab deruxtecan co-administered with the HALA antibody were analyzed in vivo, revealing that the HALA antibody increased ADC tumor penetration in high-expression systems with minimal reduction in ADC uptake in low-expression tumors. This translated to greater ADC efficacy in immunodeficient mouse models across a range of HER2 expression levels. Furthermore, Fc-enhanced HALA antibodies showed improved Fc-effector function at both high and low expression levels and elicited a strong response in an immunocompetent mouse model. These results demonstrate that HALA antibodies can expand treatment ranges beyond high expression targets and leverage strong immune responses.

bioengineering↗

Optimizing tuberculosis treatment efficacy: comparing the standard regimen with Moxifloxacin-containing regimens

Tuberculosis (TB) continues to be one of the deadliest infectious diseases in the world, causing ~1.5 million deaths every year. The World Health Organization initiated an End TB Strategy that aims to reduce TB-related deaths in 2035 by 95%. Recent research goals have focused on discovering more effective and more patient-friendly antibiotic drug regimens to increase patient compliance and decrease emergence of resistant TB. Moxifloxacin is one promising antibiotic that may improve the current standard regimen by shortening treatment time. Clinical trials and in vivo mouse studies suggest that regimens containing moxifloxacin have better bactericidal activity. However, testing every possible combination regimen with moxifloxacin either in vivo or clinically is not feasible due to experimental and clinical limitations. To identify better regimens more systematically, we simulated pharmacokinetics/pharmacodynamics of various regimens (with and without moxifloxacin) to evaluate efficacies, and then compared our predictions to both clinical trials and nonhuman primate studies performed herein. We used GranSim, our well-established hybrid agent-based model that simulates granuloma formation and antibiotic treatment, for this task. In addition, we established a multiple-objective optimization pipeline using GranSim to discover optimized regimens based on treatment objectives of interest, i.e., minimizing total drug dosage and lowering time needed to sterilize granulomas. Our approach can efficiently test many regimens and successfully identify optimal regimens to inform pre-clinical studies or clinical trials and ultimately accelerate the TB regimen discovery process. Author summaryTuberculosis (TB) is a top global health concern and treatment for TB requires multiple antibiotics taken for long periods of time, which is challenging for TB patients. Therefore, identifying regimens that are more effective and more patient-friendly than the standard treatment is urgently needed. It is also known that non-compliance leads to the development of drug resistant TB. In this work, we pair computational and experimental models to predict new regimens for the treatment of TB that optimize how fast bacteria are cleared using minimal dosage. We apply novel approaches to this goal and validate our predictions using a non-human primate model. Our findings suggest that systems pharmacological modeling should be employed as a method to narrow the design space for drug regimens for tuberculosis and other diseases as well.

pharmacology and toxicology↗

Concomitant immunity to M. tuberculosis infection

Some persistent infections provide a level of immunity that protects against reinfection with the same pathogen, a process referred to as concomitant immunity. To explore the phenomenon of concomitant immunity during Mycobacterium tuberculosis infection, we utilized HostSim, a previously published virtual host model of the immune response following Mtb infection. By simulating reinfection scenarios and comparing with data from non-human primate studies, we predict that the durability of a concomitant immune response against Mtb is intrinsically tied to levels of tissue resident memory T cells (Trms) during primary infection, with a secondary but important role for circulating Mtb-specific T cells. Further, we compare HostSim reinfection experiments to observational TB studies from the pre-antibiotic era to predict that the upper bound of the lifespan of resident memory T cells in human lung tissue is likely 2-3 years. To the authors knowledge, this is the first estimate of resident memory T-cell lifespan in humans. Our findings are a first step towards demonstrating the important role of Trms in preventing disease and suggest that the induction of lung Trms is likely critical for vaccine success.

immunology↗

A virtual host model of Mycobacterium tuberculosis infection identifies early immune events as predictive of infection outcomes

Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis (Mtb), is one of the worlds deadliest infectious diseases and remains a significant global health burden. TB disease and pathology can present clinically across a spectrum of outcomes, ranging from total sterilization of infection to active disease. Much remains unknown about the biology that drives an individual towards various clinical outcomes as it is challenging to experimentally address specific mechanisms driving clinical outcomes. Furthermore, it is unknown whether numbers of immune cells in the blood accurately reflect ongoing events during infection within human lungs. Herein, we utilize a systems biology approach by developing a whole-host model of the immune response to Mtb across multiple physiologic and time scales. This model, called HostSim, tracks events at the cellular, granuloma, organ, and host scale and represents the first whole-host, multi-scale model of the immune response following Mtb infection. We show that this model can capture various aspects of human and non-human primate TB disease and predict that biomarkers in the blood may only faithfully represent events in the lung at early time points after infection. We posit that HostSim, as a first step toward personalized digital twins in TB research, offers a powerful computational tool that can be used in concert with experimental approaches to understand and predict events about various aspects of TB disease and therapeutics.

systems biology↗

A multi-scale pipeline linking drug transcriptomics with pharmacokinetics predicts in vivo interactions of tuberculosis drugs

Tuberculosis (TB) is the deadliest infectious disease worldwide. The design of new treatments for TB is hindered by the large number of candidate drugs, drug combinations, dosing choices, and complex pharmaco-kinetics/dynamics (PK/PD). Here we study the interplay of these factors in designing combination therapies by linking a machine-learning model, INDIGO-MTB, which predicts in vitro drug interactions using drug transcriptomics, with a multi-scale model of drug PK/PD and pathogen-immune interactions called GranSim. We calculate an in vivo drug interaction score (iDIS) from dynamics of drug diffusion, spatial distribution, and activity within lesions against various pathogen sub-populations. The iDIS of drug regimens evaluated against non-replicating bacteria significantly correlates with efficacy metrics from clinical trials. Our approach identifies mechanisms that can amplify synergistic or mitigate antagonistic drug interactions in vivo by modulating the relative distribution of drugs. Our mechanistic framework enables efficient evaluation of in vivo drug interactions and optimization of combination therapies.

systems biology↗

A computational model tracks whole-lung Mycobacterium tuberculosis infection and predicts factors that inhibit dissemination

Mycobacterium tuberculosis (Mtb), the causative infectious agent of tuberculosis (TB), kills more individuals per year than any other infectious agent. Granulomas, the hallmark of Mtb infection, are complex structures that form in lungs, composed of immune cells surrounding bacteria, infected cells, and a caseous necrotic core. While granulomas serve to physically contain and immunologically restrain bacteria growth, some granulomas are unable to control Mtb growth, leading to bacteria and infected cells leaving the granuloma and disseminating, either resulting in additional granuloma formation (local or non-local) or spread to airways or lymph nodes. Dissemination is associated with development of active TB. It is challenging to experimentally address specific mechanisms driving dissemination from TB lung granulomas. Herein, we develop a novel hybrid multi-scale computational model, MultiGran, that tracks Mtb infection within multiple granulomas in an entire lung. MultiGran follows cells, cytokines, and bacterial populations within each lung granuloma throughout the course of infection and is calibrated to multiple non-human primate (NHP) cellular, granuloma, and whole-lung datasets. We show that MultiGran can recapitulate patterns of in vivo local and non-local dissemination, predict likelihood of dissemination, and predict a crucial role for multifunctional CD8+ T cells and macrophage dynamics for preventing dissemination.\n\nAuthor SummaryTuberculosis (TB) is caused by infection with Mycobacterium tuberculosis (Mtb) and kills 3 people per minute worldwide. Granulomas, spherical structures composed of immune cells surrounding bacteria, are the hallmark of Mtb infection and sometimes fail to contain the bacteria and disseminate, leading to further granuloma growth within the lung environment. To date, the mechanisms that determine granuloma dissemination events have not been characterized. We present a computational multi-scale model of granuloma formation and dissemination within primate lungs. Our computational model is calibrated to multiple experimental datasets across the cellular, granuloma, and whole-lung scales of non-human primates. We match to both individual granuloma and granuloma-population datasets, predict likelihood of dissemination events, and predict a critical role for multifunctional CD8+ T cells and macrophage-bacteria interactions to prevent infection dissemination.

immunology↗