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T. Iskra etal.
stability issues can still be encountered. One example is low pH instability that is sometimes observed in the charge-based approach. The mutations incorporated in the homodimer molecules to enable correct formation of the heterodimer can also have the potential to adversely impact product stability. As described previously, these mutations consist of charged amino acids that work to destabilize the homodi­mers when produced as full-length antibodies (parents) as the charges repel each other [15]. In some cases, this destabilization is great enough that the full antibodies can separate into half antibodies under normal conditions without the addition of reductant. Additional molecular design can minimize or even prevent these issues altogether, but in some cases, there may be no solution. In this circumstance, limit­ing exposure to the low pH condition required for elution from the Protein A capture column, such as raising the elution buffer pH and/or neutralizing the product pool quickly postelution may be necessary. Depending upon how sensitive the mole­cules are a Protein A capture step may not even be possible. Alternative capture steps may be required; however, this will likely require additional development to effectively design a process capable of delivering a product that meets acceptable quality. This possibility further highlights the importance of performing molecular assessment upfront on candidate molecules and, as needed, providing the necessary time to potentially re-engineer a candidate molecule prior to moving forward with development.
5.3.2.3 Reduction andOxidation (REDOX) Step
There are two strategies for producing multispecics using atwo cell line approach: the homodimers can be produced as either half antibodies or full antibodies. In the case of the half antibody approach, each half antibody contains a different binding epitope. In order to ensure that these combine in the correct conguration to form the desired multispecic, knob into hole technology is employed such that one half antibody contains amino acid mutations to create the knob, while the other half antibody contains amino acid mutations to create the corresponding hole in the Fc region. These half antibodies are produced with the inter disulde bond cysteines being cyclized or capped. For the full antibodies two completely intact antibodies are produced such that each contains a different epitope. These two antibodies also contain mutations in the hinge and CH3 region that enable reduction and ultimately oxidation creating the desired multispecic. In both cases, a redox reaction is needed, consisting of a reduction and oxidation of the disuldes for full antibodies [15] or the removal of the caps or recyclization of the cysteines for half antibodies [9]. Traditional reducing agents such as dithiothreitol (DTT), 2-mercaptoethanol (BME), and tris(2-carboxyethyl)phosphine (TCEP) are very common reducing agents for refolding or analytical analysis of disulde bonds [38]; however, these are considered strong reducing agents and tend to reduce all of the disulde bonds within an antibody, not just the inter-HC disulde bonds that must be reduced and then reoxidized to form the desired multispecic. Mild reducing agents such as reduced glutathione, 2-mercaptoethylamine, or cysteine have proven successful in
5 Process Development and Manufacturing Considerations for Multispecic…
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these cases as they primarily impact the intra-HC disulde bonds or the caps or cyclized cysteines without signicantly reducing the LC-HC or intrachain disulde bonds [9, 15, 39]. The choice of reducing agent depends on several factors including the ability to successfully reduce the molecule, availability, cost, toxicity, and the ability to remove the reducing agent following the redox reaction.
There are several key parameters that should be considered when developing the redox reaction step including buffering capacity/pH, temperature, reductant stoichi­ometry, molar ratio of proteins, mixing, and oxygen levels. Optimizing the reaction timing or kinetics and the interplay of these parameters on timing/kinetics must be understood when optimizing formation of the desired multispecic. Reduction and oxidation occur under alkaline conditions and sufcient buffering capacity to con­trol the pH above neutral is important. Higher pH conditions tend to drive the reac­tion faster [40]; however, elevated pH can destabilize the proteins and potentially impact the charged species prole (e.g., asparagine deamidation).
Similar to pH optimization, the impact of temperature must also be well under­stood. Operating at elevated temperatures (30–37 °C) will drive faster reaction kinetics than operating at room temperature but exposing the molecule to elevated temperatures may also lead to instability. In most cases, reactions operating at room temperature provides acceptable reaction kinetics and is more stable. This is more amenable when considering manufacturing facilities as warmer temperatures require jacketed or temperature controlled rooms or tanks [41].
In addition to the reductant employed, the ratio of reductant to protein is also a critical parameter. There is a strong correlation between increased reductant and more rapid reaction kinetics. This increase is seen until the reductant level is satu­rated [42]. There is also the potential to add too much reductant leading to degrada­tion of the molecule due to reduction of additional disulde bonds. Beyond the ratio of reductant to protein, the molar ratio of each half antibody or full antibody is also a parameter that should be considered. A 1:1 molar ratio of either the full antibodies or half antibodies to each other is typically employed during the reaction as this will lead to full conversion to the multispecic, eliminating half antibodies or homodi­mers, thus simplifying subsequent purication steps [9, 43]. This ratio can be adjusted in certain cases if there is a driver such as enabling a more efcient and robust downstream process.
Once the molecules are reduced, the oxidation can occur naturally over time by ensuring sufcient oxygen is present. Oxidation can be accelerated through the addition of either the oxidized form of the reducing agent and/or metals that are known to promote oxidation. Ensuring sufcient levels of oxygen may consist of either sparging with oxygen or providing an air overlay while continuously mixing. If there is insufcient oxygen, then other means such as chemical oxidation or buf­fer exchange to remove the reductant can be considered.
Another consideration is the potential for undesired reduction of the molecule as has been observed during harvest and clarication operations using depth ltration [44]. Although not a part of the desired process, it has been observed that in harvest and clarication using a depth lter there is the potential of reduction of disulde bonds. Depending on the format chosen, this might have signicant impact on the
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molecule. This may result in undesirable impurities such as fragments and should be carefully considered and or evaluated for each molecule and appropriate correc­tions made to prevent reduction during harvest and clarication.
5.4 Manufacturing ofMultispecics
The production of multispecic antibodies is complex; although extensive develop­ment work is done to ensure that processes are robust, efcient, consistent, and scalable there are several important considerations when manufacturing these mol­ecules. The need for additional process operations, stability data to support hold times and manufacture scheduling considerations are just a few. An evaluation of both multispecic approaches, KiH and electrostatic, may initially favor the single cell line KiH approach, as this eliminates the need for a second series of upstream process operations, but other aspects of each process need to be considered in deter­mining which process to use.
As such, one aspect to consider is protein stability and the potential need for additional hold times. In the case of a two-cell line multispecic process, the opera­tion of the production bioreactors may require additional hold time if the bioreac­tors are operated sequentially. This challenge may be circumvented by operating homodimer production bioreactors in parallel. Considering the risk mentioned above, if operating two bioreactors and one fails and hold times are not sufcient to cover the time needed to generate a back-up reactor, this would have signicant impact on both manufacturing time and cost. Another consideration with the two­cell line approach is that one homodimer might be used for other multispecic mol­ecules. Thus, it is extremely important to carefully consider homodimer stability in the early design of the manufacturing process for these types of multispecics.
Another consideration for manufacturing of multispecics is cost. If total pro­cess yield is equal, the single cell line approach would likely be favored in terms of cost, as two bioreactors run either in parallel or sequentially will have higher overall costs due to an increased need for more raw materials, equipment, and personnel. Extending this, the cost of failure for a two-cell line approach would also be higher. In our experience, however, total process yield between the single cell line and dual cell line approach is not equal, with the dual cell line approach typically having signicantly higher yield. This demonstrates the need for a careful risk-benet anal­ysis when considering cost of the multispecic heterodimerization strategy. Other variables that may need consideration here are anticipated product demand and drug substance stability.
Considering the complexities associated with the production of multispecics, scheduling and equipment utilization should not be ignored. Production using two cell lines either means that the manufacturing suite is occupied longer if the bioreac­tors are run sequentially or more bioreactors are occupied if the homodimers or half antibodies are produced in parallel.
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5 Process Development and Manufacturing Considerations for Multispecic…
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In addition to these considerations, when manufacturing multispecic proteins thoughtful handling of product contact waste streams is necessary for multispecic molecules with high potency designations. Multispecic oncology therapeutics tra­ditionally have very high potency and therefore can reach potentially toxic concen­trations within the bioreactor. As a result, special considerations are needed in treating product contact waste streams and properly protecting personnel during the handling of such potent biologics.
As the realm of biotherapeutics expands from the standard monoclonal antibody to multispecic modalities, complexities and challenges are introduced to nearly every step of development. Early development choices, such as molecular format and heterodimerization strategy, can have a profound impact on subsequent devel­opment steps. To make the optimal choice, one needs to consider all program aspects, including but not limited to cell line generation, process development, man­ufacturing, as well as product safety proles, and material demands.
5.5 Case Study: Challenges inRemoval ofBispecic Product
Related Impurities
A case study is presented to highlight some of the challenges that multispecics (in this case a bispecic) may encounter compared to traditional mAbs. This case study highlights development strategies and process adjustments that were made to enable manufacture of a product with acceptable quality. The case study focuses on using a single cell line to produce the bispecic, utilizing the knob into hole technology.
The molecule presented in this case study is a diabody fused to an Fc domain (diabody-Fc) [45]. The diabody portion of the molecule is comprised of two peptide chains, each chain consisting of an scFv (single chain fragment variable) region with VL (variable light)/VH (variable heavy) domains having afnity for different targets. In the nal molecule, each Fv is comprised of a VL from one chain and a VH from the other chain (Fig. 5.4). Compact packaging of the properly paired VL-VH is facilitated by short linkers in the scFv peptides; these structural con­straints favor the formation of the diabody without domain exchange [46]. To favor
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Fig. 5.4 Molecular architecture of the molecule described in the case study
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high yields of the heterodimer, knob into hole technology was engineered into the Fc domains [47]. The choice of the knob into hole molecular design was in part facilitated by the relatively low number of theoretical product related impurities that would be predominantly present (two—the K/K homodimer and the H/H homodi­mer) in the expression of the two chain diabody-Fc format.
While molecular design inhibits biological activity of the K/K and H/H homodi­mers, a downstream process capable of generating drug substance with low homodi­mer impurity is desired. This is especially important in this case study as drug substance stability was impacted by homodimer levels of approximately 4% and HMMS impurity levels of approximately 3%. This impact was eliminated when these two impurities were reduced to 1% for each impurity. As outlined in the case study below to robustly deliver stable drug substance, strategic decisions had to be made during both the design of the cell line and throughout biomanufacturing pro­cess development. Consideration and understanding of the biophysical characteris­tics of the homodimer impurities helped to drive several project decisions which resulted in a robust process capable of delivering drug substance with acceptable quality.
5.5.1 Vector Orientation andCell Line
The host cell line selected for the expression of this diabody-Fc molecule utilizes targeted integration, which harbors one landing pad previously engineered into the host cell at a dened chromosomal location, competent for receipt of the vector payload [20, 24]. Given the use of this host, cell line generation efforts were likely to yield clonal cell lines harboring one integration of the expression vector.
To express the molecule, the vector contained a single copy of both the gene cod­ing for the hole and knob transcripts, under the control of identical transcriptional promoters and terminators. With chromosomal integration and transcriptional pro­moting signals being equal, the conguration of the cell line vector can be manipu­lated to differentially impact expression levels of hole and knob transcripts.
Since recombinase-mediated cassette exchange in this host cell is directional, vector conguration will dictate which chain is upstream of the other in the host cell genome. In our experience, when comparing similar genes/transcripts at a xed chromosomal location, the upstream chain is slightly more transcriptionally active than the downstream gene. For example, in Fig.5.5, a vector conguration using orientation 1 (the knob transcript preceding the hole transcript) will bias for higher expression levels of knob protein while orientation 2 (the hole transcript preceding the knob transcript) will bias higher expression levels of hole protein.
Knowledge of heterodimerized knob into hole (KiH) Fc domains and corre­sponding homodimerized H/H and K/K Fc domains has been gained through X-ray crystal structures [36]. As previously discussed, homodimerized H/H Fc domains are more open than KiH and K/K Fc domains. The differentially exposed surface
5 Process Development and Manufacturing Considerations for Multispecic…
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Host Cell Landing Pad

TK
PAC
Vector Cassee
Exchange
 

KNOB HOLE
(RMCE)
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Trace Moderate Moderate Trace
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HOLE
KNOB
Fig. 5.5 For targeted integration systems, vector orientation impacts the types of product-related impurities observed. Host cell landing pad diagram adopted from Zhang etal. (2015). RMCE— recombinase mediated cassette exchange; HH—hole-hole; KK—knob-knob; TK—thymidine kinase gene; PAC—puromycin N-acetyltransferase gene
areas of H/H homodimers provide unique handles for removal through various pro­tein purication techniques.
In this case study, orientation 2 was selected for the vector design to bias higher expression levels of the hole protein. In doing so, the H/H homodimer impurity, an impurity easier to separate from the heterodimer product than K/K homodimer, had levels of approximately 20% H/H in the Protein A pools (Fig.5.5) while the K/K homodimer was undetected.
5.5.2 Downstream Process Design: Removal ofImpurities
5.5.2.1 H/H Removal
By intentionally designing the single cell line to preferentially produce the hole HC, H/H homodimer was observed in the Protein A captured pool. H/H levels of over 20% were observed after Protein A capture. Although it is easier to remove the H/H homodimer, due to the signicant presence of this impurity, signicant downstream removal capacity is required.
Through high-throughput resin screening and additional development experi­ments, two differentiating biophysical properties between H/H homodimer and the heterodimer product were identied and leveraged to design a robust downstream process:
1. H/H bound more tightly to anion exchange (AEX) resin than heterodimer
(Table5.1).
2. H/H had reduced low pH stability than heterodimer with H/H converting to
HMMS during low pH exposure (Fig.5.6).
126
Table 5.1 Impurity data from AEX resin screen
Conditions Load impurity levels: 20% HMMS, 23% H/H
pH Anion
level Lower Low 6 16 78 Medium 5 7 88 Higher 3 5 92
% HMMS—Eluate pool
%H/H—Eluate pool
T. Iskra etal.
% heterodimer—Eluate pool
Fig. 5.6 Impact of low pH on product of interest (POI), hole/hole homodimer (H/H), and high molecular mass species (HMMS) levels for knob into hole (KiH) demonstrating conversion of H/H homodimer to HMMS under low pH conditions
5.5.2.2 HMMS Removal
HMMS is a very common product-related impurity observed during mAb manufac­ture. Several different chromatography modalities (such as ion exchange, hydropho­bic, multi-modal) under optimized conditions have proven capable of separating HMMS from the monomer mAbs. Similarly, these modalities can also be applied to bispecic antibodies.
In this case study, HMMS levels of up to 20% were observed following Protein A capture, thus requiring signicant downstream removal capacity for this product­related impurity.
Both anion exchange (AEX) and cation exchange (CEX) chromatography pro­vided robust HMMS clearance (Tables 5.1 and 5.2). CEX was observed to have high HMMS capacity, but unlike AEX, had very limited H/H capacity. Identifying more than one step capable of removing HMMS was necessary given the high level of HMMS observed in the Protein A capture pool.
5 Process Development and Manufacturing Considerations for Multispecic…
Table 5.2 CEX impurity results from resin screen
Conditions Load impurity levels: 5% HMMS, 5% H/H pH Anion level % HMMS—pool %H/H—pool %Heterodimer—pool
Lower Low NMT 0.2 4 96 Lower Medium NMT 0.2 4 96 Higher Low 1 5 94 Higher Medium 1 5 94
NMTnot more than
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5.5.2.3 Balancing H/H andHMMS Removal
Due to the high level of H/H homodimer and HMMS present signicant removal capacity for these impurities was needed to build a robust downstream process capa­ble of delivering >99% product purity. To achieve this, several strategies were employed during the design of the downstream process based on previously described experimental observations.
The AEX resin demonstrated limited capacity for HMMS removal, but reason­able capacity to remove H/H homodimer. Although the reduction was signicant, the AEX was still limited and could only decrease H/H levels to approximately 5%. The CEX resin demonstrated capacity to remove all the HMMS but could not remove any of the H/H homodimer. The combination of these two process steps (AEX and CEX) demonstrated that the process was capable to clearing all the HMMS, but additional capacity to remove the H/H homodimer was required to achieve the desired drug substance H/H homodimer purity targets. To increase the capacity of the process to remove H/H homodimer, a strategic placement of a low pH step within the downstream process was used to drive a conversion of H/H homodimer to HMMS.In doing so, H/H homodimer, a difcult to remove impurity, would be converted to HMMS, which is an easier to remove impurity from the pro­cess stream.
The placement of the low pH step was inuenced by the anion concentration ranges that were in use for the AEX and CEX steps. Robust operating conditions for the AEX resin were achieved at high pH, low anion concentrations (Table5.1), and robust operating conditions for the CEX resin were achieved at low pH and low-to­medium anion concentrations (Table5.2). Placement of the low pH step following Protein A capture, a traditional location for mAb processes, would have had a nega­tive impact on AEX step performance. The introduction of anions into the AEX load through the low pH titration of the Protein A pool would shift the AEX into a medium anion operating space, impacting impurity removal over this step. Placement of the low pH titration after the AEX step introduced additional anions into the CEX load but well within the anion concentration range and robust operat­ing space for impurity removal over the CEX.
By rearranging the placement of the low pH hold from a traditional mAb pro­cess, the capacity for unique bispecic process impurity removal increased while negating the need for in-process pool dilution or an intermediate dialtration step.
128
Fig. 5.7 Downstream process overview for knob into hole molecule case study
Table 5.3 In-process impurity levels and yields for KiH case study
Step Yield (%) HCP (ppm) DNA (ppb) rProA (ppm) H/H (%) HMMS (%)
Harvest 90 230,000 2,000,000 N/A N/A N/A ProA pool 90 500 10 10 20 20 AEX pool 65 BLOQ BLOQ BLOQ 3 4 Low pH pool 98 BLOQ 7 CEX pool 85 BLOQ VRF 98 UF/DF 98
BLOQ below limit of quantitation, VRF virus retentive ltration, UF/DF ultraltration/dialtra­tion, N/A not applicable
T. Iskra etal.
The overall downstream process is illustrated in Fig.5.7 with typical in-process impurity levels highlighted in Table5.3.

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