Nicoletta Bivi, PhD, Director, Assay Development, Immunogenicity and Immunoassays, Laboratory for Experimental Medicine (LEM), Eli Lilly and Company
The anti-PCSK9 antibody, Bococizumab, was terminated after Phase 3 due to high immunogenicity. We assessed its intrinsic immunogenicity risk using our current tools, consisting of in silico analyses, MAPPS, and T cell activation. We observed significant presentation of non-germline residues and Bococizumab-driven T cell activation in 90% and 56% of donors, respectively. In contrast, anti-PCSK9 antibodies with low immunogenicity (Evolocumab and Alirocumab) demonstrated low-to-moderate presentation of non-germline residues and no T cell activation.