Drugs

3BNC117

Other Names: 3BNC117-LS Drug Class: Broadly Neutralizing Antibodies Registry Number: 1412902-17-0 (CAS) Organization: Rockefeller University Phase of Development: 3BNC117 is in Phase 2 development as a broadly neutralizing antibody for HIV treatment. (3BNC117 is also being developed for HIV prevention.)

(Compound details obtained from ChemIDplus Advanced,1 Nature article,2 Treatment Action Group website,and ClinicalTrials.gov4)

Pharmacology


Mechanism of Action: Broadly neutralizing antibody (bNAb). 3BNC117 is a recombinant human IgG1 kappa monoclonal antibody cloned from an HIV-infected viremic controller. It is a next-generation bNAb that targets the CD4 binding site on HIV envelope gp160.2,5

Next-generation HIV bNAbs are naturally occurring antibodies with potent neutralizing activity against a broad array of HIV strains. The utility of bNAbs is being researched for both HIV prevention and treatment/cure. By binding to sites on HIV envelope and through Fc receptor interactions, bNAbs can potentially 1) inhibit cell-free and cell-to-cell viral entry, 2) induce cellular phagocytosis and destruction by macrophages or antibody dependent cellular cytotoxicity (ADCC) by natural killer (NK) cells, and 3) promote the maturation and activity of dendritic cells.5–8 Because it is difficult to induce in vivo generation of bNAbs using conventional vaccination techniques, bNAbs may need to be given by passive transfer, whereby a bNAb is directly administered to an individual.5,9

3BNC117 is being developed for HIV prevention and as a possible component to HIV treatment or cure.3,4 A long-acting version of 3BNC117, called 3BNC117-LS, is also in clinical development.3

Half-life (T½): A Phase 1 study (NCT02018510) investigated a single intravenous (IV) infusion of 3BNC117 at four different dose levels (1, 3, 10, and 30 mg/kg) in adults with and without HIV and found that the average half-life of 3BNC117 was approximately 9 days in the HIV-infected group and 17 days in the HIV-uninfected group.9 In a Phase 2a trial (NCT02446847) of multiple IV infusions of 3BNC117 (30 mg/kg) in adults with HIV, the half-life of 3BNC117 ranged from 14.1 days in adults receiving four doses of 3BNC117 to 19.6 days in adults receiving two doses of 3BNC117.2

The half-life of 3BNC117-LS relative to 3BNC117 was measured in a study of macaques administered single IV infusions. 3BNC117-LS was found to have a median half-life of 2.8 weeks, an increase of 2.0-fold when compared to the half-life of 3BNC117 (median 1.4 weeks).10

Resistance: HIV has developed resistance to 3BNC117 in both a Phase 1 (NCT02018510) and 2a (NCT02446847) trial of 3BNC117.2,9 In the Phase 1 study, high-level resistance to 3BNC117 developed in some, although not all, participants by 28 days after a single 3BNC117 dose.9

In the Phase 2a study, eight out of 13 participants with HIV had rebound viruses that were more resistant to 3BNC117 when compared to pre-infusion viruses. In the majority of participants, viral rebound occurred at high 3BNC117 concentrations. Of eight participants who had sequence analysis performed on rebound viruses, six participants had viral genotypes indicating resistance to 3BNC117. Notably, five out of eight participants had rebound viruses that appeared to arise from a single reactivated virus from the latent reservoir. In all but two participants, rebound viruses did not demonstrate increased resistance to the investigational bNAb 10-1074.2


Select Clinical Trials


Study Identifier: NCT02588586
Sponsor: Rockefeller University
Phase: Phase 2 
Status: This study has been completed.
Study Purpose: The purpose of this open-label study was to evaluate the safety of 3BNC117 and its ability to delay or prevent viral rebound during a treatment interruption of ART.
Study Population:

  • Participants were adults with HIV who had HIV RNA <50 copies/mL for at least 12 months while on ART and had HIV RNA <20 copies/mL at screening.
  • Participants had CD4 counts >500 cells/mm3 and nadir CD4 counts >200 cells/mm3.11

Study Identifier: NCT02446847
Sponsor: Rockefeller University
Phase: 2a
Status: This study has been completed.
Study Purpose: The purpose of this open-label, dose-escalation study was to evaluate the safety and pharmacokinetics of 3BNC117 and its ability to delay or prevent viral rebound during a treatment interruption of ART.
Study Population:

  • Participants were adults with HIV who had HIV RNA <50 copies/mL for at least 12 months while on ART and had HIV RNA <20 copies/mL at screening.
  • Participants had CD4 counts >500 cells/mm3 and nadir CD4 counts ≥200 cells/mm3.
  • Participants had 3BNC117-sensitive viruses.3,12

Selected Study Results:

 

Study Identifiers: ROADMAP; NCT02850016
Sponsor: Rockefeller University
Phase: 1b/2a
Status: This study is ongoing, but not recruiting participants.
Study Purpose: The purpose of this open-label study is to compare the efficacy of the latency-reversing agent romidepsin plus 3BNC117 to the efficacy of romidepsin alone on delaying or preventing viral rebound during a treatment interruption of ART.
Study Population:

  • Participants are adults with HIV who have been on ART for at least 24 months.
  • Participants on a PI- or NNRTI-based ART regimen or on a cobicistat-containing regimen must be willing to switch to an INI-based regimen prior to enrollment.
  • Participants have had HIV RNA <50 copies/mL for at least 18 months and have CD4 counts >500 cells/mm3 at screening.13,14

Selected Study Results:


Study Identifiers: eCLEAR; NCT03041012
Sponsor: Aarhus University Hospital
Phase: 2 
Status: This study is currently recruiting participants.
Study Purpose: The purpose of this open-label study is to evaluate whether the early administration of romidepsin and/or 3BNC117 in treatment-naive individuals who are initiating ART can limit the size of the latent HIV reservoir.
Study Population:

  • Participants have HIV but have never received ART.
  • Participants have CD4 counts >200 cells/mm3 prior to study entry.15

 

Study Identifiers: TITAN; NCT03837756
Sponsor: University of Aarhus
Phase: 2a
Status: This study is currently recruiting participants.
Study Purpose: The purpose of this study is to evaluate the safety and efficacy of the TLR9 agonist lefitolimod plus the bNAbs 3BNC117 and 10-1074 in delaying the time to re-initiation of ART during a treatment interruption of ART.
Study Population:

  • Participants are adults with HIV who have been on ART for at least 18 months.
  • Participants have had HIV RNA <50 copies/mL for at least 15 months and have CD4 counts >500 cells/mm3 at screening.
  • Participants have HIV that is sensitive to 3BNC117 and 10-1074.16

 

Study Identifier: NCT03719664
Sponsor: Frontier Biotechnologies Inc.
Phase: 2
Status: This study is currently recruiting participants.
Study Purpose: The purpose of this open-label study is to determine an optimal dosage of 3BNC117 and the HIV fusion inhibitor albuvirtide and evaluate the safety and efficacy of this combination as long-acting maintenance treatment.
Study Population:

  • Participants are adults with HIV who have been receiving oral ART for the last 24 weeks.
  • Participants have been on a stable ART regimen for the past 4 weeks prior to screening and during the time between the screening visit and first treatment visit.
  • Participants have at least two alternative antiretroviral drug options available.
  • Participants have had HIV RNA <50 copies/mL within the last 24 weeks prior to screening and at screening and have CD4 counts >300 cells/mm3 at screening.17

 

Study Identifier: RIO; NCT04319367
Sponsor: Imperial College London
Phase: 2
Status: See the ClinicalTrials.gov record for this study’s status.
Study Purpose: The purpose of this study is to determine whether the combination of the two long-acting bNAbs 3BNC117-LS and 10-1074-LS can prevent viral rebound after a treatment interruption of ART.
Study Population:
  • Participants are adults with HIV who had previously been diagnosed with primary HIV infection and who had started ART during the primary HIV infection stage.
  • Participants have been receiving continuous suppressive ART for at least 1 year.
  • Participants have had undetectable HIV RNA for at least 1 year and have CD4 counts >500 cells/mm3. Participants’ nadir CD4 counts are >350 cells/mm3.
  • Participants show no evidence of viral insensitivity to either 10-1074 or 3BNC117.18

Additional studies evaluating 3BNC117 for HIV treatment have either been conducted or will be conducted, including the following early-phase trials of 3BNC117 and 10-1074:

  • NCT03526848: A Phase 1 study that will assess whether 3BNC117 and 10-1074 can control viral rebound in adults with HIV during a treatment interruption of ART. This study is ongoing, but not recruiting participants.19
  • NCT03571204: A Phase 1 study evaluating whether 3BNC117 and 10-1074 can control viral load levels in individuals with HIV who are currently not receiving ART and in individuals with HIV who stop ART during a treatment interruption. This study is currently recruiting participants.20
  • NCT03554408: A Phase 1 study investigating the safety and pharmacokinetics of 10-1074-LS when given alone and when given in combination with 3BNC117-LS in adults with and without HIV. This study is ongoing, but not recruiting participants.21
  • BEAT-2 (NCT03588715): A Phase 1 study that will evaluate whether peginterferon alfa-2b plus 3BNC117 and 10-1074 can control viral rebound and reduce the latent HIV reservoir in adults with HIV during a treatment interruption of ART. See the ClinicalTrials.gov record for this study's status.22
  • NCT04250636: A Phase 1 study that will evaluate the safety, pharmacokinetics, and antiviral activity of single infusions of both 3BNC117-LS and 10-1074-LS in adults with HIV who are off ART. See the ClinicalTrials.gov record for this study's status.23


Adverse Events


NCT02446847:
In this Phase 2a trial investigating multiple infusions of 3BNC117 in 13 individuals with HIV, most adverse events (AEs) that occurred during the study were transient and mild. Some participants experienced modest drops in CD4 counts during viral rebound, but most had their counts return to baseline by Week 12. Acute retroviral syndrome was not reported in any participants during rebound.2

ROADMAP (NCT02850016):
In this Phase 1b/2a trial, 11 participants were enrolled to receive romidepsin plus 3BNC117 and nine participants were enrolled to receive romidepsin alone. There were 109 reactogenicity AEs and 131 nonreactogenicity AEs reported. A total of 237 AEs occurred, the majority of which were Grade 1. Sixty-four (27.4%) of the AEs were at least possibly related to romidepsin or 3BNC117. The most common AEs were nausea (87%), headache (37%), fatigue (32%), malaise (42%), chills (26%), and vomiting (37%). After receiving romidepsin, two participants experienced QTc prolongation, which resolved by 1 week after infusion.13,14,24


Drug Interactions


Drug-drug interactions associated with 3BNC117 are currently unknown.


References


  1. United States National Library of Medicine. ChemIDplus Advanced: 3BNC117. https://chem.nlm.nih.gov/chemidplus/rn/1412902-17-0. Accessed April 27, 2020
  2. Scheid JF, Horwitz JA, Bar-On Y, et al. HIV-1 antibody 3BNC117 suppresses viral rebound in humans during treatment interruption. Nature. 2016;535(7613):556-560.
  3. Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed April 27, 2020
  4. Rockefeller University. A Phase 1 study of the safety and pharmacokinetics of the combination of 3BNC117 and 10-1074 in HIV-uninfected adults: In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on June 28, 2016. NLM Identifier: NCT02824536. https://clinicaltrials.gov/ct2/show/NCT02824536. Accessed April 27, 2020
  5. Halper-Stromberg A, Nussenzweig MC. Towards HIV-1 remission: potential roles for broadly neutralizing antibodies. J Clin Invest. 126(2):415-423.
  6. Jefferys R, Jacobson J. Therapeutic vaccines and immune-based therapies. CUREiculum: HIV/AIDS and cure basics – Module 12. PowerPoint presentation available on the AIDS Vaccine Advocacy Coalition (AVAC) website. http://www.avac.org/sites/default/files/u16/Theraeutic_Vaccine_Module_June.pptx. Accessed April 27, 2020
  7. Bruel T, Guivel-Benhassine F, Amraoui S, et al. Elimination of HIV-1-infected cells by broadly neutralizing antibodies. Nat Commun. 2016;7:10844.
  8. Stephenson KE, Barouch DH. Broadly neutralizing antibodies for HIV eradication. Curr HIV/AIDS Rep. 2016;13:31-37.
  9. Caskey M Klein F, Lorenzi JC, et al. 3BNC117 a broadly neutralizing antibody suppresses viremia in HIV-1-infected humans. Nature. 2015;522(7557):487-491.
  10. Gautam R, Nishimura Y, Gaughan N, et al. A single injection of crystallizable fragment domain- modified antibodies elicits durable protection from SHIV infection. Nat Med. 2018;24(5):610-616.
  11. Rockefeller University. An open label, Phase 2 study of the safety and antiretroviral activity of 3BNC117 in HIV-infected individuals on combination antiretroviral therapy. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on October 26, 2015. NLM Identifier: NCT02588586. https://clinicaltrials.gov/ct2/show/NCT02588586. Accessed April 27, 2020
  12. Rockefeller University. A Phase 2, open label study of the safety, antiretroviral activity and pharmacokinetics of 3BNC117 during a short analytical treatment interruption in HIV-infected subjects. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on March 17, 2015. NLM Identifier: NCT02446847. https://clinicaltrials.gov/ct2/show/NCT02446847. Accessed April 27, 2020
  13. Rockefeller University. A Phase 2a, randomized study of romidepsin with or without 3BNC117 to evaluate the effects on the HIV-1 reservoir (ROADMAP). In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on July 26, 2016. NLM Identifier: NCT02850016. https://clinicaltrials.gov/ct2/show/NCT02850016. Accessed April 27, 2020
  14. Gruell H, Cohen YZ, Gunst JD, et al. A randomized trial of the impact of 3BNC117 and romidepsin on the HIV-1 reservoir. Abstract presented at: Conference on Retroviruses and Opportunistic Infections (CROI); March 8-11, 2020; Boston, MA. Abstract 38. https://www.croiconference.org/abstract/a-randomized-trial-of-the-impact-of-3bnc117-and-romidepsin-on-the-hiv-1-reservoir/. Accessed April 27, 2020
  15. Aarhus University Hospital. Early administration of latency reversing therapy and broadly neutralizing antibodies to limit the establishment of the HIV-1 reservoir during initiation of antiretroviral treatment - a randomized controlled trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 20, 2017. NLM Identifier: NCT03041012. https://clinicaltrials.gov/ct2/show/NCT03041012. Accessed April 27, 2020
  16. University of Aarhus. Combining a TLR9 agonist with broadly neutralizing antibodies for reservoir reduction and immunological control of HIV infection: an investigator-initiated randomized, placebo-controlled, Phase IIa trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on February 7, 2019. NLM Identifier: NCT03837756. https://clinicaltrials.gov/ct2/show/NCT03837756. Accessed April 27, 2020
  17. Frontier Biotechnologies Inc. A Phase 2, multicenter, three-part study to establish the dosage, safety and antiviral activity of combination therapy with albuvirtide and 3BNC117 as long-acting maintenance therapy in virologically suppressed subjects with HIV-1 infection. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on October 22, 2018. NLM Identifier: NCT03719664. https://clinicaltrials.gov/ct2/show/NCT03719664. Accessed April 27, 2020
  18. Imperial College London. A randomised placebo controlled trial of ART plus dual long-acting HIV-specific broadly neutralising antibodies (bNAbs) vs ART plus placebo in treated primary HIV infection on viral control off ART. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on March 2, 2020. NLM Identifier: NCT04319367. https://clinicaltrials.gov/ct2/show/NCT04319367. Accessed April 27, 2020
  19. Rockefeller University. An open label, randomized study of the safety and antiretroviral activity of 3BNC117 and 10-1074 in HIV-infected individuals on combination antiretroviral therapy and during analytical treatment interruption. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on May 3, 2018. NLM Identifier: NCT03526848. https://clinicaltrials.gov/ct2/show/NCT03526848. Accessed April 27, 2020
  20. National Institute of Allergy and Infectious Diseases (NIAID). An exploratory study of combination therapy with 3BNC117 and 10-1074 in HIV-infected individuals. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on June 22, 2018. NLM Identifier: NCT03571204. https://clinicaltrials.gov/ct2/show/NCT03571204. Accessed April 27, 2020
  21. Rockefeller University. A Phase 1, dose escalation, first-in-human study of the safety and pharmacokinetics of the subcutaneous and intravenous administration of 10-1074-LS alone and in combination with 3BNC117-LS in HIV-infected and HIV-uninfected individuals. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on July 26, 2016. NLM Identifier: NCT03554408. https://clinicaltrials.gov/ct2/show/NCT03554408. Accessed April 27, 2020
  22. Luis Montaner. Pilot study on innate activation and viral control in HIV-infected adults undergoing an analytical treatment interruption after administration of pegylated interferon alpha 2b with broadly HIV-1 neutralizing antibodies (3BNC117, 10-1074). In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on July 17, 20185. NLM Identifier: NCT03588715. https://clinicaltrials.gov/ct2/show/NCT03588715. Accessed April 27, 2020
  23. Rockefeller University. An open label, single arm study of the safety, pharmacokinetics and antiretroviral activity of the combination of 3BNC117-LS and 10-1074-LS in viremic HIV-infected individuals. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on January 30, 2020. NLM Identifier: NCT04250636. https://clinicaltrials.gov/ct2/show/NCT04250636. Accessed April 27, 2020
  24. Søgaard OS. A randomized trial of the impact of 3BNC117 and romidepsin on the HIV-1 reservoir. Webcast presented at: Conference on Retroviruses and Opportunistic Infections (CROI); March 8-11, 2020; Boston, MA. http://www.croiwebcasts.org/console/player/44589?mediaType=slideVideo&. Accessed April 27, 2020


Last Reviewed: April 27, 2020