U.S. patent application number 10/231735 was filed with the patent office on 2003-05-01 for interleukin-3 gene therapy for cancer.
Invention is credited to Bekkum, Dirk Willem van, Bout, Abraham, Kaaden, Marie Elisabeth Draijer-van der.
Application Number | 20030082137 10/231735 |
Document ID | / |
Family ID | 8228545 |
Filed Date | 2003-05-01 |
United States Patent
Application |
20030082137 |
Kind Code |
A1 |
Kaaden, Marie Elisabeth Draijer-van
der ; et al. |
May 1, 2003 |
Interleukin-3 gene therapy for cancer
Abstract
A method for treating of tumors, in particular malignant solid
tumors, using adenovirus-derived material and IL-3, so that the
adenovirus preferably encodes IL-3 activity, which is given
systematically to a mammal, optionally in an isolated perfusion
setting. Preferably, IL-3 activity is combined with other cytotoxic
activity.
Inventors: |
Kaaden, Marie Elisabeth Draijer-van
der; (Leiden, NL) ; Bout, Abraham;
(Moerkapelle, NL) ; Bekkum, Dirk Willem van;
(Rotterdam, NL) |
Correspondence
Address: |
TRASK BRITT
P.O. BOX 2550
SALT LAKE CITY
UT
84110
US
|
Family ID: |
8228545 |
Appl. No.: |
10/231735 |
Filed: |
August 28, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10231735 |
Aug 28, 2002 |
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09481201 |
Jan 11, 2000 |
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6495131 |
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09481201 |
Jan 11, 2000 |
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PCT/NL98/00406 |
Jul 13, 1998 |
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Current U.S.
Class: |
424/85.2 ;
424/93.2; 604/890.1 |
Current CPC
Class: |
A61K 48/00 20130101;
A61K 38/202 20130101 |
Class at
Publication: |
424/85.2 ;
424/93.2; 604/890.1 |
International
Class: |
A61K 048/00; A61K
038/20; A61K 009/22 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 11, 1997 |
EP |
97202167.9 |
Claims
What is claimed is:
1. A localized perfusion system for treating sarcoma and
osteosarcoma tumors comprising a pharmaceutical composition having
IL-3 activity and a pharmaceutical composition having cytostatic
activity.
2. The localized perfusion system of claim 1, wherein the IL-3
activity is provided by a recombinant adenoviral vector encoding
said activity.
3. The localized perfusion system of claim 1, wherein the
pharmaceutical composition having cytostatic activity is in a
single dosage unit for injection into a solid tumor.
4. The localized perfusion system of claim 1, wherein the
pharmaceutical composition comprising IL-3 activity is a perfusion
fluid.
5. The localized perfusion system of claim 1, wherein the perfusion
fluid comprises a recombinant adenoviral vector in the form of a
virus-like particle.
6. The localized perfusion system of claim 5, wherein the
virus-like particle is present in an amount of from about
1.times.10.sup.6 to 5.times.10.sup.9 iu.
7. The localized perfusion system of claim 5, wherein both
activities are present in a single combination.
8. The localized perfusion system of claim 1, wherein the
cytostatic activity is at least one of TNF-activity, Melphalan and
adriamycin.
9. A pharmaceutical composition for localized treatment of sarcoma
and osteosarcoma tumors, said pharmaceutical composition consisting
of: a recombinant adenoviral vector comprising genetic information
encoding IL-3 activity; and a diluent.
10. The pharmaceutical composition of claim 9, wherein the
recombinant adenoviral vector is in the form of virus-like
particles
11. The pharmaceutical composition of claim 10, wherein the
virus-like particles are present in said pharmaceutical composition
an amount of about 1.times.10.sup.6 to 5.times.10.sup.9 in.
12. The pharmaceutical composition of claim 9, wherein a virus-like
particle is a human homolog of a recombinant adenovirus
IG.Ad.CMV.rIL-3 deposited at the ECACC under accession number
V96071634.
13. A kit of parts for the reduction of growth of sarcoma and
osteosarcoma tumors, said kit of parts comprising a pharmaceutical
composition having IL-3 activity and cytostatic activity; means for
isolating certain tissues; and means for perfunding said isolated
tissues.
14. The kit of parts of claim 13, wherein said cytostatic activity
is TNF-activity.
15. The kit of parts of claim 13, wherein the pharmaceutical
composition having cytostatic activity is a single dosage unit for
injection into a solid tumor.
16. The kit of parts of claim 13, wherein the pharmaceutical
composition comprises at least one of Melphalan and adriamycin.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application is a continuation of co-pending application
Ser. No. 09/481,201 filed Jan. 11, 2000, now U.S. Pat. No. ______,
which is a continuation of International Application No.
PCT/NL98/00406, filed on Jul. 13, 1998 designating the United
States of America, the contents of which is incorporated by this
reference.
FIELD OF THE INVENTION
[0002] The present invention lies in the field of anticancer (gene)
therapy. In particular, the invention relates to selective killing
of (solid) tumor cells in a mammal by gene delivery via the blood
circulation.
BACKGROUND
[0003] Many different kinds of solid tumors occur in the body of
mammals, including humans. In many cases, these tumors are
extremely difficult to treat, especially in advanced cancer with
metastases. Currently available therapies include surgery,
radiation therapy, chemotherapy, radio-immunotherapy, cytokine
treatment and hyperthermia. All these therapies have important
limitations and disadvantages. For example, surgery can only be
performed on localized, accessible tumors; radiation and
chemotherapy are associated with both acute and latent toxicity,
and responses are often limited; radio-immunotherapy and
hyperthermia have limited application and effectivity; and cytokine
administration is often associated with toxicity and evokes many
pleiotropic side effects. Often those therapies are combined to
improve efficacy and to decrease toxic side effects. However, in
general, the effectivity of those therapies and their combinations
is still unsatisfactory.
[0004] More recently, gene therapy has been proposed as a novel
approach to treat malignancies. The concept of gene therapy
comprises the introduction of a molecule carrying genetic
information into cells of a host, whereby the genetic information
has a functional format. Genetic information may comprise a nucleic
acid molecule that encodes a protein. In this case, "functional
format" means that the protein can be expressed by the machinery of
the host cell. The genetic information may also comprise or encode
nucleic acid molecules with a sequence that is complementary to
that of a nucleic acid molecule present in the host cell. The
functional format in this case is that the introduced nucleic acid
molecule or copies made thereof in situ are capable of base pairing
with the complementary nucleic acid molecule present in the host
cell. Genetic information may furthermore comprise a nucleic acid
molecule that encodes or is itself a so-called ribozyme or
deoxyribozyme. In this case, "functional format" means that the
nucleic acid molecule or copies made thereof in situ are capable of
specifically cleaving a nucleic acid molecule present in the host
cell. The genetic information may furthermore comprise a nucleic
acid molecule that encodes or is itself a so-called decoy molecule.
In this case, "functional format" means that the nucleic acid
molecule or copies made thereof in situ (nucleic acid molecules or
proteins) are capable of specifically binding a peptide molecule
present in the host cell.
[0005] Introduction of a molecule carrying genetic information into
cells of a host is achieved by various methods known in the art.
Those methods include, but are not limited to, direct injection of
naked DNA constructs, bombardment with gold particles loaded with
constructs, and macromolecule-mediated gene transfer using, e.g.,
liposomes, biopolymers, and the like. Preferred methods use gene
delivery vehicles derived from viruses, including but not limited
to adenoviruses, retroviruses, vaccinia viruses and
adeno-associated viruses. Because of the much higher efficiency as
compared to, e.g., vectors derived from retroviruses, vectors
derived from adenoviruses (so-called adenoviral vectors) are the
preferred gene delivery vehicles for transferring nucleic acid
molecules into host cells in vivo.
[0006] The adenovirus genome is a linear double-stranded DNA
molecule of approximately 36,000 base pairs ("bp"). The adenovirus
DNA contains identical Inverted Terminal Repeats (ITR) of
approximately 100 base pairs with the exact length depending on the
serotype. The viral origins of replication are within the ITRs
exactly at the genome ends. Adenoviruses can be rendered
replication defective by deletion of the early-region 1 (E1) of
their genome. Vectors derived from human adenoviruses (so-called
adenoviral vectors), in which at least the E1 region has been
deleted and replaced by a gene of interest, have been used
extensively for gene therapy experiments in both preclinical and
clinical phases. Apart from replication defective adenoviral
vectors, helper independent or replication competent vectors,
either or not containing a gene of interest, can also be used for
gene therapy purposes. Adenoviral vectors have a number of features
that make them particularly useful for gene therapy for
malignancies. These features include (1) the biology of
adenoviruses is characterized in detail, (2) adenoviruses are not
associated with severe human pathology, (3) adenoviruses are
extremely efficient in introducing their DNA into host cells, (4)
adenoviruses can infect a wide variety of cells and have a broad
host-range, (5) adenoviral vectors allow insertion of relatively
large fragments of foreign DNA, (6) adenoviruses can be produced in
large quantities with relative ease, and (7) adenoviral vectors are
capable of transferring nucleic acid molecules very efficiently
into host cells in vivo (Brody and Crystal, Ann. N.Y. Acad. Sci.
716:90-101, 1994).
[0007] The present inventors and their coworkers as well as others
have demonstrated that recombinant adenoviral vectors efficiently
transfer nucleic acid molecules to the liver of rats (Herz and
Gerard, Proc. Natl. Acad. Sci. U.S.A., 96:2812-2816,1993) and to
airway epithelium of rhesus monkeys (Bout et al., Gene Ther.,
1:385-394,1994; Bout et al., Hum. Gene Ther., 5:3-10,1994). In
addition, the present inventors, their coworkers and others have
observed a very efficient in vivo adenoviral vector-mediated gene
transfer into a variety of established solid tumors in animal
models (lung tumors, glioma) and into human solid tumor xenografts
in immune-deficient mice (lung) (Haddada et al., Biochem. Biophys.
Res. Comm. 195:1174-1183, 1993; Vincent et al., Hum. Gene Ther.,
7:197-205, 1996; reviewed by Blaese et al., Cancer Gene Ther.,
2:291-297, 1995). Thus, preferred methods for in vivo gene transfer
into tumor cells of nucleic acid molecules that encode molecules
that can be used to kill tumor cells make use of adenoviral vectors
as gene delivery vehicles.
[0008] The molecules that can be used to kill tumor cells include
but are not restricted to suicide enzymes that convert a nontoxic
prodrug into a toxic compound (e.g., the HSV-tk/ganciclovir
system), cytokines, antisense nucleic acid molecules, ribozymes,
and tumor suppressor proteins. In addition, treatment of cancer by
gene therapy methods also includes the delivery of replicating
vectors that are toxic to the tumor cells by themselves.
[0009] Gene therapy by introduction of nucleic acid molecules
encoding suicide enzymes has been widely tested on a variety of
tumor models. Especially the transfer of the Herpes simplex virus
thymidine kinase (HSV-tk) gene into tumor cells in conjunction with
systemic administration of the nontoxic substrate ganciclovir has
proven to be an effective way of killing tumor cells in vivo
(Esandi et al., Gene Ther., 4:280-287, 1997; Vincent et al., J.
Neurosurg., 85:648-654,1996; Vincent et al., Hum. Gene Ther.,
7:197-205, 1996). An important advantage of the HSV-tk/ganciclovir
system is that, upon ganciclovir treatment, HSV-tk transduced tumor
cells mediate a significant killing effect on neighboring
untransduced tumor cells, the so-called bystander effect (Culver et
al., Science 256:550-1552, 1992). Thus, using this approach, there
is no absolute need for gene transfer into every individual cell in
a solid tumor to achieve successful gene therapy. A limitation of
this approach, however, is that the effect remains local.
Consequently, the HSV-tk gene needs to be delivered into every
individual solid tumor or metastasis throughout the body.
[0010] Gene therapy for cancer by the introduction of nucleic acid
molecules encoding cytokines is based on the concept of enhancing
the immune response against the tumor cells. The ultimate goal of
this approach is to obtain regression of the treated tumor and
simultaneously induce such a high degree of immunity that
coexisting metastases are also destroyed. The mechanism by which
the cytokine enhances the immune response against the tumor cells
most likely in many cases involves eliciting an inflammatory type
cell infiltration that results in improved antigen presentation.
During the local inflammation, invading cells may lyse the tumor
cells, releasing tumor antigens in a form that can be presented by
other subpopulations of the invaders to T lymphocytes. These, in
their turn, could act against coexisting metastases. Compared to
administration of a cytokine protein, the gene transfer approach
has the important advantage of high-level production of the
cytokine at the site of the tumor, while systemic concentrations of
the cytokine remain low. This avoids any pleiotropic and toxic side
effects associated with cytokine. Signs of (partially) successful
cancer treatment have been obtained with tumor cells expressing
interleukin 2 (IL-2) (Fearon et al., Cell 60:397-401, 1990);
Gansbacher et al., J. Exp. Med. 172:1217,1990), IL-4 (Golumbek et
al., Science 254:713-716, 1991; Platzer et al., Eur. J. Immunol.
22:1729-1733, 1992), interferon-gamma (Gansbacher et al., Cancer
Res. 50:7820-7824,1990), interferon-alpha (Ferrantini et al.,
Cancer Res. 53:1107-1112, 1993), TNF alpha (Blankenstein et al., J.
Exp. Med. 173:1047-1052, 1991), IL-7 (Hock et al., J. Exp. Med.
174:1291-1298,1991; McBride et al., Cancer Res. 52:3931-3937,1992),
G-CSF (Colombo et al., J. Exp. Med. 173:889-897, 1991), GM-CSF
(Dranoff et al., Proc. Natl. Acad. Sci. U.S.A. 90:3539-3543, 1993),
IL-12 (Tahara et al., Cancer Res. 54:182-189,1994), IL-1 (Apte et
al., In: Cytokine-induced tumor immunogenicity, Acad. Press London,
pp. 97-112, 1994; Apte et al., Folia Biol. Praha 40:1-18, 1994;
Douvdevani et al, Int. J. Cancer 51:822-830, 1992; Nakata et al.,
Cancer Res. 48:584-588,1988; Zoller et al., Int. J. Cancer
50:443-449,1992) and IL-3 (McBride et al., Folia Biol. Praha
40:62-73, 1993; Pulaski et al., Cancer Res. 53:2112-2117,1993). The
present inventors and their coworkers have previously observed
partial regression of a nonimmunogenic solid tumor (L42 nonsmall
cell lung cancer; Kal et al., NCI Monographs 6:111-114,1988; Kal et
al., Radiother. Oncol. 6:231-238, 1986; Kal et al., J. Natl. Cancer
Inst. 76:943-946, 1986) growing subcutaneously in WAG/Rij rats
after intratumor injection of adenoviral vectors expressing IL-1a
or IL-3. This regression occurred both in the injected tumor and in
an untreated distant (contralateral) L42 tumor (patent application
EP 96.202725, incorporated herein by reference).
[0011] Interleukin-3 (IL-3) is a cytokine well described as a
hematopoietic growth factor that has a wide range of target cells
including progenitor cells of every lineage, excluding cells
committed to the T and B lymphoid lineage (Schrader et al., In:
Lymphokines, Acad. Press, San Diego, 1988). The main production of
IL-3 by activated T cells has led to the hypothesis that IL-3 is
not involved in steady-state hematopoiesis but functions as a link
between, on one hand, the T lymphocytes of the immune system, which
sense invasion of the body by foreign materials, and, on the other
hand, the hematopoietic system which generates the cellular
elements that mediate defense and repair responses (Ihle, In:
Immunoregulatory cytokines and cell growth, Karger, Basel, 1989).
IL-3 exerts a broad spectrum of biological properties (Ihle et al.,
J. Immunol. 131:282, 1983), including stimulatory activity on
several myeloid leukemia cell lines, formation of
granulocyte-macrophage colonies, mast cell growth factor activity,
P cell-stimulating activity and histamine-producing
cell-stimulating factor activity. In addition, IL-3 is capable of
promoting the proliferation of megakaryocyte colony-forming cells,
of supporting the differentiation of eosinophils and pre-B-cell
precursors, of supporting proliferation of Natural Cytotoxic (NC)
cells but not Natural Killer (NK) cells and of promoting the
formation of osteoblasts. IL-3 also stimulates the effector
functions of monocytes, eosinophils and basophils, thereby having
the potential to regulate inflammation and allergy (Elliott et al.,
J. Immunol. 145:167, 1990; Haak-Frendesco et al., J. Clin. Invest.
82:17, 1988; Lopez et al., J. Cell. Physiol. 145:69, 1990). Human
endothelial cells express the IL-3 receptor, which expression is
enhanced by tumor necrosis factor alpha (TNF-.alpha.). IL-3
stimulation of TNF-.alpha.-activated endothelial cells enhances
IL-8 production, E-selectin expression and neutrophil
transmigration (Korpelainen et al., Proc. Natl. Acad. Sci. U.S.A.
90:11137, 1993). This suggests that IL-3 plays a role in
inflammation not only by stimulating effector functions of mature
leukocytes but also by regulating their localization to sites of
inflammation through its action on the endothelium.
[0012] There are several ways to administer recombinant adenoviral
vectors with therapeutic genes into solid tumors that grow in a
mammalian animal body. Currently, cancer gene therapy protocols
predominantly use direct injection of the recombinant vector into
the tumor (e.g., Haddada et al., Biochem. Biophys. Res. Comm.
195:1174-1183, 1993; Vincent et al., Hum. Gene Ther. 7:197-205,
1996). The major disadvantage of this application route is that
metastases, and in particular micrometastases, in advanced cancer
are practically impossible to reach with this approach. Therefore,
such a gene therapy relies solely on a distant (immune mediated)
effect of the introduced genetic information. Using current
technology, the distant effect may not be expected to be complete
and, consequently, may not be expected to cure the disease.
[0013] An alternative, and possibly better way of delivering
genetic material into solid tumors and/or their metastases, could
be by administering the recombinant adenoviral vector via the blood
or lymphatic circulation. All established tumors, both primary and
metastatized, that are larger than a few millimeters in diameter
are vascularized (Folkman et al., J. Nat. Cancer Inst. 82:4, 1990;
Folkman and Shing, J. Biol. Chem. 267:10931-10934,1992). In
addition, distant metastases usually emerge after migration of
tumor cells from the primary tumor through the blood or lymphatic
circulation. Thus, all solid tumors are in close contact with the
circulation and, in principle, could be reached via the
circulation. Moreover, killing of a solid tumor does not
necessarily depend on gene transfer into the tumor cells
themselves. Gene therapy strategies have been proposed where
genetic material (e.g., the HSV-tk gene) is introduced into
endothelial cells of the tumor vasculature (e.g., W096/21416). This
should result in destruction of the tumor vasculature, ultimately
leading to tumor necrosis.
[0014] The total capillary surface area in an adult human is
approximately 100 m.sup.2 comprising approximately
1.times.10.sup.12 endothelial cells, whereas the endothelial cell
content of the vasculature of a solid tumor is about 4-log less
(Chan and Harris, In: The Internet Book of Gene Therapy; Cancer
Therapeutics, eds. R. E. Sobol and K. J. Scanlon, 1995, Appleton
& Lange, CT, pp. 211-227). Based on these estimations,
intravascularly administered adenoviral vectors only have a 0.01%
chance of interacting with endothelial cells in the vasculature of
a distant tumor. The proliferation index of endothelial cells in
the vasculature of a tumor is about 100-fold higher than that of
normal endothelial cells (Hobson and Denekamp, Br. J. Cancer,
1984,49:405-413). Thus, if gene delivery would preferentially occur
into actively proliferating cells, the gene transfer efficiency
into the chosen target cells could be raised to approximately 1%.
However, because adenoviral vectors, in contrast to retroviral
vectors, transduce both replicating and nonreplicating cells, the
estimate of 0.01% gene transfer into cells of the tumor vasculature
is more realistic. In any event, administering the adenoviral
vector via the circulation is expected to result in at least 99% of
the adenoviral vectors interacting and possibly being taken up by
cells in normal tissues. This is highly undesirable with respect to
toxic side effects of the procedure. For example, the introduction
and expression of a suicide gene or an inflammation-eliciting
cytokine gene should obviously not take place in the endothelium of
the normal vasculature. Therefore, until the present invention, the
common belief in the field has been that administering the
adenoviral vector to the tumor via the circulation requires some
sort of specific targeting of the adenoviral vector to the tumor or
its vasculature (e.g., PCT International Publication No. WO
96/25947). Specific targeting may include specific interaction with
and uptake by the intended target cells, as well as specific
expression of the introduced genetic information in the intended
target cells. Specific targeting was felt to be necessary to ensure
efficient gene transfer and to avoid toxic side effects in other
tissues. Many different molecules that are specifically expressed
or upregulated on the cell surface of tumor cells or their vascular
endothelial cells have been proposed as targets for specific uptake
of gene transfer vectors. Examples of such molecules are
carcinoembryonic antigen (CEA; Walther et al., Head-Neck
15:230-235, 1993), surface-bound vascular endothelial growth factor
(VEGF; Plate et al., Int. J. Cancer 59:520-529, 1994; Brown et al.,
Hum. Pathol. 26:86-91, 1995), the avb.sub.3 integrin (Brooks et al,
Science 264:569-571, 1994), endosialin (Rettig et al., Proc. Natl.
Acad. Sci. USA 89:10832-10826, 1992) and radiation-induced
E-selectin (WO 96/25947). However, specific interaction with and
uptake by the intended target cells is extremely difficult to
achieve, for two reasons; i.e. (1) most of the proposed target
molecules are also expressed on normal tissue, albeit at lower
levels, and (2) it is difficult to construct targeted gene delivery
vehicles. Many years of research have been invested by many
different investigators in devising targeted gene delivery vehicles
for this purpose, without significant success. Perhaps eventually
this goal will be reached, but not without a major research effort
and significant investment.
[0015] As a further alternative way to accomplish functional
expression of genetic material in the vasculature of tumors, it has
been proposed to transfer genetic material into cultured
endothelial cells ex vivo, followed by administration of cultured
endothelial cells via the circulation (PCT International
Publication No. WO 93/13807). This should result in selective
incorporation of cultured endothelial cells at sites of active
angiogenesis, including the vasculature of solid tumors. However,
such a selective incorporation into the vasculature of solid tumors
has not been shown to occur. Furthermore, the disadvantage of this
approach is that it involves the isolation, ex vivo manipulation,
and readministration of endothelial cells.
BRIEF SUMMARY OF THE INVENTION
[0016] The present invention provides an effective and relatively
safe treatment of (solid) tumors in the bodies of mammals. This is
accomplished by administration via the circulation of recombinant
adenoviral vectors with a wild-type infection spectrum that carry
an interleukin-3 gene in a functional format.
[0017] Thus, the invention provides the use of a recombinant
adenoviral vector encoding IL-3 activity for manufacturing a
pharmaceutical composition for the systemic treatment of tumors.
For the present invention, IL-3 activity is defined as the protein
itself, derivatives and/or fragments thereof having at least but
preferably most or all of the biological functions of IL-3,
although the amounts of activity displayed by these derivatives
and/or fragments may vary. It is preferred that the systemic
treatment is restricted to certain tissues, organs, or extremities,
or certain combinations thereof, because adenovirus is, in
principle, capable of infecting almost any cells in the host, so
that the restriction enables one to avoid unnecessary infection, as
well as a higher probability of infection of the proper targets.
Thus, in a preferred embodiment, the invention provides a systemic
treatment which includes isolated tissue perfusion. Tissue
perfusion is intended to read on isolated tissues as well as organs
and/or extremities or any combination thereof. Two approaches of
isolated perfusion are provided, one whereby the isolated perfunded
tissue includes the tumor and one whereby the isolated perfunded
tissue excludes the tumor. In the second case, organs or body parts
which are liable to be damaged by the treatment or which are likely
to influence the uptake of virus by the target cells can be
excluded from the system to which the adenoviral vector encoding
IL-3 activity is provided. A preferred organ to be excluded
according to the invention is the liver.
[0018] In the other isolated perfusion route, the vector is
delivered to the isolated part only. It is preferred to deliver the
vector in the form of a virus-like particle. This means that the
vector is packed in an adenovirus shell. The most preferred
virus-like particle is the human homolog of recombinant adenovirus
IG.Ad.CMV.rIL-3 deposited at the ECACC under accession number
V96071634 or a functional derivative thereof.
[0019] IL-3 is not only capable of inducing regression of tumors,
but it is also capable of retarding or halting the growth of tumors
over prolonged periods of time. Many cytostatic agents are also
capable of accomplishing regression of tumors, but are not capable
of holding the regressed tumor in check over a prolonged period of
time. It is, therefore, advantageous to make combinations of IL-3
activity and other cytostatic activity to have the best of both
worlds. Regression of the tumor by administration of one or a
number of doses of a cytotoxic agent and obtaining further
regression as well as retarding or halting the growth of the
regressed tumor is accomplished by providing IL-3 activity.
[0020] Thus, the invention further provides a means for treating
tumors comprising a pharmaceutical composition comprising IL-3
activity and a pharmaceutical composition comprising cytostatic
activity. Preferably, the IL-3 activity is provided by a
recombinant adenoviral vector (preferably in a virus-like particle)
encoding activity to be given systemically, either in an isolated
perfusion format or not. Preferably, the pharmaceutical composition
comprising cytostatic activity is in a single dosage unit for
injection into a solid tumor, to be given once or several times
until the required dosage is reached.
[0021] Typically, the virus-like particle is present in an amount
of from about 1.times.10.sup.6 to 5.times.10.sup.9 i.u. in a
perfusion fluid. It is, of course, also possible that both
activities are present in one composition.
[0022] Preferably, the cytostatic or cytotoxic activity is
TNF-activity, Melphalan, or adriamycin. The invention further
provides a pharmaceutical composition for systemic treatment of
tumors comprising IL-3 activity provided by a recombinant
adenoviral vector encoding such activity, whereby the
pharmaceutical composition is a perfusion fluid. Preferably, the
recombinant adenoviral vector is provided in the form of virus-like
particles. Preferably, the virus-like particles are present in an
amount of about 1.times.10.sup.6 to 5.times.10.sup.9 i.u.
[0023] The most preferred virus is the human homolog of recombinant
adenovirus IG.Ad.CMV.rIL-3 deposited at the ECACC under accession
number V96071634 or a functional derivative thereof.
[0024] The invention further provides a kit of parts for the
treatment of tumors comprising a pharmaceutical composition
comprising IL-3 activity, means for isolating certain tissues, and
means for perfunding the isolated tissues. Hereby, the essential
elements for performing a method of treatment according to the
invention are given. The means for perfunding are preferably
heart-lung machines or other equipment capable of perfunding and
preferably oxygenating. Means for excluding certain organs, limbs
and/or tissues are known in the art and references thereto can be
found herein. If it is possible to exclude, then it is, of course,
also possible to limit perfusion to organs, tissues or limbs which
can be excluded. Of course, the IL-3 activity in the kit of parts
is again preferably provided by a recombinant adenoviral
vector-encoding activity, preferably in the form of a virus-like
particle, preferably present in an amount of about 1.times.10.sup.6
to 5.times.10.sup.9 i.u. Preferably the kit of parts further
comprises a pharmaceutical composition comprising cytostatic
activity for the reasons already disclosed herein.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0025] In the drawings, which illustrate what is currently
considered to be the best mode for carrying out the invention:
[0026] FIG. 1 is a schematic presentation of the Ad5.pCLIP
vector.
[0027] FIG. 2 depicts isolated limb perfusion or direct
intratumoral injection with an adenoviral vector carrying the
thymidine kinase gene, followed by treatment of ganciclovir. Rats
bearing a BN175 tumor in their hind limb underwent ILP
(.circle-solid., n=5) or were directly injected intratumoral
(.largecircle., n=9) with an adenoviral vector carrying the
thymidine kinase gene (TK), followed by treatment with ganciclovir
(GCV). Sham ILP rats underwent a control ILP without adenovirus
(.box-solid., n=2). Data represent the average.+-.SEM. When the
error bars are not visible, errors are within the symbol size.
[0028] FIG. 3 illustrates isolated limb perfusion or direct
intratumoral injection of BN175 sarcoma with an adenoviral vector
carrying the interleukin-3 gene. Rats bearing a BN175 tumor in
their hind limb underwent ILP (.circle-solid., n=9) or were
directly injected intratumoral (.largecircle., n=11) with an
adenoviral vector carrying the interleukin-3 gene
(IG.Ad.CMV.rIL-3.beta.). Sham ILP rats underwent a control ILP
without adenovirus (.box-solid., n=5). Nontreated BN175 bearing
rats were not treated (.quadrature., n=4). Data represent the
average.+-.SEM. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0029] FIG. 4 illustrates isolated limb perfusion or direct
intratumoral injection of ROS-1 osteosarcoma with an adenoviral
vector without a therapeutic gene. Rats bearing a ROS-1 tumor in
their hind limb underwent ILP (.circle-solid., n=4) or were
directly injected intratumoral (.largecircle., n=4) with
1.times.10.sup.9 i.u. of a control adenoviral vector without a
therapeutic gene (Ad5.PL+C). Sham ILP rats underwent a control ILP
without adenovirus (.box-solid., n=6). Nontreated ROS-1 bearing
rats were not treated (.quadrature., n=8). Data represent the
average.+-.SEM. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0030] FIG. 5 depicts isolated limb perfusion or direct
intratumoral injection of ROS-1 osteosarcoma with an adenoviral
vector carrying the interleukin-3 gene. Rats bearing a ROS-1 tumor
in their hind limb underwent ILP (.circle-solid., n=9) or were
directly injected intratumoral (.largecircle., n=6) with an
adenoviral vector carrying the interleukin-3 gene
(IG.Ad.CMV.rIL-3.beta.). Sham ILP rats underwent a control ILP
without adenovirus (.box-solid., n=6 (this curve represents the
same group as described in FIG. 4)). Data represent the
average.+-.SEM. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0031] FIG. 6 illustrates isolated limb perfusion or direct
intratumoral injection of ROS-1 osteosarcoma with an adenoviral
vector carrying the interleukin-3 gene driven by a weaker promoter,
namely the MLP promoter. Rats bearing a ROS-1 tumor in their hind
limb underwent ILP (.box-solid., n=4) or were directly injected
intratumoral (.quadrature., n=4) with 1.times.10.sup.9 i.u. of an
adenoviral vector carrying the interleukin-3 gene driven by the MLP
promoter (IG.Ad.MLP.rIL-3.beta.). Sham ILP rats underwent a control
ILP without adenovirus (.circle-solid., n=6) and nontreated rats
were implanted with ROS-1 tumors but not treated (.largecircle.,
n=8) (the latter two curves represent the same group as described
in FIG. 4). Data represent the average.+-.SEM. When the error bars
are not visible, errors are within the symbol size. Curves are
fitted using an exponential model.
[0032] FIG. 7 illustrates the antitumor effect of varying doses of
an adenoviral vector carrying the interleukin-3 gene administered
via the circulation (isolated limb perfusion). Rats bearing a ROS-1
tumor in their hind limb underwent ILP with 1.times.10.sup.5 i.u.
(.largecircle., n=7), 1.times.10.sup.7 i.u. (.circle-solid., n=6),
1.times.10.sup.8 i.u. (.quadrature., n=6) or 1.times.10.sup.10 i.u.
(.DELTA., n=2) of IG.Ad.CMV.rIL-3. The sham ILP curve
(.diamond-solid., n=6) and the 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 ILP curve (.box-solid., n=9) are obtained from
example 7 and are shown as reference curves. Data represent the
average.+-.SEM. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0033] FIG. 8 illustrates antitumor effect of doses below
1.times.10.sup.9 i.u. administered via the circulation (isolated
limb perfusion) of an adenoviral vector carrying the interleukin-3
gene. Rats bearing a BN175 tumor in their hind limb underwent ILP
with 1.times.10.sup.5 (.circle-solid., n=5), 1.times.10.sup.7 i.u.
(.largecircle., n=5) of an adenoviral vector carrying the
interleukin-3 gene. The sham ILP curve (.quadrature., n=6) and the
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 ILP curve (.box-solid., n=9)
are obtained from example 7 and are shown as reference curves. Data
represent the average.+-.SEM. When the error bars are not visible,
errors are within the symbol size. Curves are fitted using an
exponential model.
[0034] FIG. 9 depicts growth curves of ROS-1 tumors after isolated
limb perfusions with 2.times.10.sup.8 i.u. and 5.times.10.sup.8
i.u. with an adenoviral vector carrying the interleukin-3 gene.
Rats bearing a ROS-1 tumor in their hind limb underwent ILP for 15
minutes with 2.times.10.sup.8 i.u. (.tangle-solidup., n=5) or
5.times.10.sup.8 i.u. (.DELTA., n=4) IG.Ad.CMV.rIL-3. The 15
minutes sham ILP (.circle-solid., n=6) and 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 (.largecircle., n=9) ILP curves are obtained from
example 7 and shown as reference curves. Data represent the
average.+-.SEM. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0035] FIG. 10 depicts growth curves of ROS-1 tumors after a 30
minute isolated limb perfusion with 1.times.10.sup.5 i.u. or
1.times.10.sup.7 i.u. of an adenoviral vector carrying the
interleukin-3 gene. Rats bearing a ROS-1 tumor in their hind limb
underwent ILP for 30 minutes with 1.times.10.sup.5 (.largecircle.,
n=2) or 1.times.10.sup.7 i.u. (.quadrature., n=2) of
IG.Ad.CMV.rIL-3. The sham ILP curve (.circle-solid., n=6) is
obtained from example 7 and shown as a reference curve. Data
represent the average.+-.STD. When the error bars are not visible,
errors are within the symbol size. Curves are fitted using an
exponential model.
[0036] FIG. 11 illustrates growth curves of ROS-1 tumors after an
isolated limb perfusion with an adenoviral vector carrying the
interleukin-3 gene and the cytostatic melphalan. Rats bearing a
ROS-1 tumor in their hind limb underwent ILP for 15 minutes with
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 in combination with 40 .mu.g
melphalan (.box-solid., n--5) or with 40 .mu.g melphalan alone
(.quadrature., n=5). The sham ILP (.circle-solid., n=6) and
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 curves (.largecircle., n=9)
are obtained from example 7 and shown as reference curves. Data
represent the average.+-.STD. When the error bars are not visible,
errors are within the symbol size. Curves are fitted using an
exponential model.
[0037] FIG. 12 depicts growth curves of ROS-1 tumors after isolated
limb perfusion with an adenoviral vector carrying the interleukin-3
gene and TNF.alpha.. Rats bearing a ROS-1 tumor in their hind limb
underwent ILP for 15 minutes with 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 in combination with 50 .mu.g TNF (.box-solid.,
n=5), with 50 .mu.g TNF.alpha. alone (.quadrature., n=4) or with 50
.mu.g TNF.alpha. and 40 .mu.g melphalan (.tangle-solidup., n=5).
The sham ILP (.circle-solid., n=6) and 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 curves (.largecircle., n=9) are obtained from
example 7 and shown as reference curves. Data represent the
average.+-.STD. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0038] FIG. 13 illustrates growth curves of ROS-1 tumors after an
isolated limb perfusion with an adenoviral vector carrying the
interleukin-3 gene and the cytostatic doxorubicin. Rats bearing a
ROS-1 tumor in their hind limb underwent ILP for 15 minutes with
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 and 200 .mu.g doxorubicin
(.circle-solid., n=4) or 200 .mu.g doxorubicin alone (.quadrature.,
n=5). The sham ILP (.box-solid., n=6) and 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 (.largecircle., n=9) curves are obtained from
example 7 and shown as reference curves. Data represent the
average.+-.STD. When the error bars are not visible, errors are
within the symbol size. Curves are fitted using an exponential
model.
[0039] FIG. 14 illustrates growth curves of ROS-1 tumors after
isolated limb perfusions for 2 or 5 minutes with an adenoviral
vector carrying the interleukin-3 gene. Rats bearing a ROS-1 tumor
in their hind limb underwent ILP for 2 minutes (.largecircle., n=1)
or 5 minutes (.quadrature., n=6) with 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 or underwent a sham ILP for 5 minutes (.box-solid.,
n=6). The 15 minute sham ILP (.diamond-solid., n=6) and
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 (.circle-solid., n=9) ILP
curve is obtained from example 7 and shown as a reference curve.
Data represent the average.+-.SEM. When the error bars are not
visible, errors are within the symbol size. Curves are fitted using
an exponential model.
[0040] FIG. 15 depicts generation of pMLPI.TK.
[0041] FIG. 16 is a map of the adapter plasmid pAd5/L420-HSA.
[0042] FIG. 17 shows the results of the expression assay and
biological activity assay of the hIL-3 transgene of the
IG.Ad5.CLIP.hIL-3 adenoviral vector.
[0043] FIG. 17A depicts an hIL-3 ELISA. Since the A.sub.450 nm is
0.541, it was concluded that the hIL-3 production was >2000
pg/ml (high production). hIL-3 transgene is produced.
[0044] FIG. 17B depicts a TF-1 bioactivity assay. TF-1 cells are,
for their growth, dependent on the presence of hIL-3 in the culture
medium. The less hIL-3 is present, the less well the cells grow. By
a colorimetric assay with MTS/PMS (Promega), the proliferation can
be monitored at A.sub.490 nm. A high proliferation (enough hIL-3)
correlates with a high A.sub.490 nm. A dilution range of the
samples is made to determine the hIL-3 present. The sample dilution
table shows that the cells are proliferating (dilution 1: A 0.989)
and that by dilution of the supernatant containing the hIL-3
protein, the proliferation of the cells decreases. Functional hIL-3
is formed.
DETAILED DESCRIPTION OF THE INVENTION
[0045] Despite the high potential of cancer gene therapy, the
results of experimental treatment of solid tumors have until now
been very disappointing. Direct injection of gene delivery vectors,
mostly adenoviral vectors, carrying therapeutic genetic information
into solid tumors has resulted in efficient gene transfer into
tumor cells and has shown some, although still incomplete, tumor
regression (e.g., see patent applications WO 95/05835 and EP 0
707071). The major limitation of this approach, however, has been
that every solid tumor has to be individually injected. This makes
clinical application of such a treatment far from realistic for
most cancers, in particular for advanced cancers with metastases.
The alternative approach, i.e., therapeutic gene delivery via the
circulation after systemic intravascular administration of the gene
delivery vector, has been associated with extremely low gene
transfer efficiency into the tumor. The common belief in the field
has been, therefore, that the gene transfer efficiency should be
increased to obtain a significant therapeutic effect. It is also
generally accepted that this should not be done by administering
more gene delivery vectors, but by promoting the specific uptake of
the gene delivery vector into the tumor cells or into the
endothelial cells aligning the tumor vasculature. The reason for
this is that high concentrations of untargeted gene delivery
vectors cause (1) a stronger immune response, and (2) more toxicity
due to delivery of the antitumor gene to other tissues.
Furthermore, it is difficult and expensive to produce extremely
high concentrations of gene delivery vectors.
[0046] The present inventors have made the surprising observation
that adenoviral vector-mediated delivery of an interleukin-3 gene
through administration via the circulation into the vasculature of
solid tumors results in a very effective cancer treatment.
Circulation is meant to include both the blood circulation and the
lymphatic circulation. An adenoviral vector is not treated in any
way to promote its specific uptake by the solid tumor cells or the
endothelial cells aligning the tumor vasculature. The therapeutic
effect of delivery is much more dramatic than could be expected
from the low transduction efficiency (less than 1% transduced
cells) that is obtained with administration via the circulation.
Established solid tumors growing in relevant animal models
regressed completely. The therapeutic effect is shown to be
dependent on both administration via the circulation and the
biological activity of the interleukin-3 encoded by the introduced
gene.
[0047] The present invention, among other things, provides a
recombinant adenoviral vector that carries a nucleic acid molecule
that encodes interleukin-3 or a functional derivative or a fragment
thereof. The nucleic acid molecule is provided with a format that
allows functional expression of interleukin-3 in solid tumor cells
and/or in endothelial cells of the vasculature of a solid tumor in
the body of a mammal after administration of a recombinant
adenoviral vector to the circulation of the mammal. The term
"functional expression" is understood to mean production of
interleukin-3 with biological activity that leads to killing of
solid tumor cells. The format is conferred upon a nucleic acid
molecule by including upstream of a nucleic acid molecule an
activator (promoter and/or enhancer) nucleic acid molecule that
preferably interacts with one or more transactivating transcription
factors that are present in tumor cells or in cells of the
vasculature of a tumor and downstream of the nucleic acid molecule
a eukaryotic polyadenylation signal. An activator molecule may be
derived from the adenovirus used to construct an adenoviral vector
or from a different adenovirus. Alternatively, an activator
molecule is of exogenous origin. Useful activator molecules in this
aspect of the invention are derived from, e.g., the Cytomegalovirus
Immediate Early promoter/enhancer or the Rous Sarcoma Virus LTR
promoter/enhancer, but may also be derived from other activator
molecules known in the art. In this aspect of the invention, it is
preferred that the nucleic acid molecule encoding interleukin-3 is
a functional derivative from or includes at least a functional
fragment of a nucleic acid molecule isolated from the same species
as a mammal. Because in most applications of the invention the
mammal is a human, it is in most applications of the invention
preferred that the nucleic acid molecule is a functional derivative
from or includes at least a functional fragment of a nucleic acid
molecule isolated from a human. The terms "functional derivative"
and "functional fragment" are used here to indicate that the
nucleic acid molecule encodes a peptide molecule with the same
biological activity in kind, but not necessarily in amount, as
interleukin-3. Many different examples of nucleic acid molecules
encoding mutants of human interleukin-3 with functional
interleukin-3 activity are given in European patent EP 0 413 383.
It is furthermore preferred that the biological activity of
interleukin-3 includes the elicitation of an intense local
inflammation associated with an inflammatory-type cell
infiltration. The recombinant adenoviral vectors according to the
invention may be derived from any wild-type adenovirus serotype
that allows the functional expression of interleukin-3 in solid
tumor cells and/or in endothelial cells of the vasculature of a
solid tumor in the body of a mammal after administration of the
recombinant adenoviral vector to the circulation of the mammal. In
the examples given infra to illustrate the present invention,
recombinant adenoviral vectors are derived from human adenovirus
type 5. It is to be understood, however, that those skilled in the
art will be able to apply other recombinant adenoviral vectors
without departing from the invention. Methods for the construction
of recombinant adenoviral vectors according to the invention and
for their propagation on useful packaging cells have been described
in patent applications EP 0 707 071 and WO 97/00326, incorporated
herein by reference. Other examples of vectors and packaging
systems useful in the invention include, but are not limited to,
those given in patent applications WO 93/19191, WO 94/28152, WO
96/10642, and WO 97/04119.
[0048] The present invention furthermore provides a pharmaceutical
composition that comprises the recombinant adenoviral vector
defined supra in combination with a diluent that is not toxic to
the recipient mammal at the dosage used and that retains sufficient
stability of the infectivity of the recombinant adenoviral vector
for a time long enough to allow uptake of the recombinant
adenoviral vector into the solid tumor cells and/or endothelial
cells of the vasculature of a solid tumor after administration of
the composition to the circulation of the recipient mammal. A
typical nonlimiting example of a diluent according to this aspect
of the invention is an isotonic saline solution that is sterile and
that is buffered at a physiological pH. Preferably, the diluent
furthermore contains serum-substituting ingredients. In the
examples given infra to illustrate the present invention, Haemaccel
(Behring Pharma) is used as a suitable diluent. It is to be
understood, however, that those skilled in the art will be able to
apply other diluents without departing from the invention. For some
applications of the invention, it is furthermore preferred that the
pharmaceutical composition is oxygenated prior to administration.
Optionally, the recombinant adenoviral vector (or virus) is
prepared in lyophilized form. In the latter case, the recombinant
adenoviral vector is suspended in solution to obtain the
pharmaceutical composition before administering the pharmaceutical
composition to the circulation of the recipient mammal. Typically,
a pharmaceutical composition comprising one dose contains at least
about 1.times.10.sup.6, preferably about 1.times.10.sup.8
infectious units (i.u.) of the adenoviral vector of the invention,
but in certain conditions it is preferred that it contains at least
about 1.times.10.sup.9, more preferred 1.times.10.sup.10, or even
more preferred 1.times.10.sup.11 i.u. The amount of virus to be
provided depends on many parameters. As disclosed herein, only a
very limited portion of the administered virus actually infects the
target cells. This may be one reason to increase the amount of
virus to be administered. Also the size of the tumor and/or the
degree of its vascularization will influence the amount of virus
required to get an effect. Another important aspect is, of course,
the amount of IL-3 activity expressed by a cell infected with one
or more viruses. This, of course, depends on the cell, but also on
the promoter that drives the expression and its interaction with
cell components of the expression machinery, etc.
[0049] Based on the rat studies, where a CMV promoter is driving
the rat IL-3 gene, antitumor activity was measured after perfusion
with 1.times.10.sup.9 i.u. of IG.Ad.CMV.rIL-3. Perfusion time was
15 minutes. The size of this tumor was approximately 1 cm.sup.3.
Dose-finding studies are performed, where the range of the
administered [perfused] adenoviral vector will increase from
1.times.10.sup.6 Up to 1.times.10.sup.10 i.u. Antitumor activity is
measured according to the methods described. The lowest dose
resulting in a maximal antitumor effect will be used to calculate
the dose to be delivered to human tumors, assuming that the same
promoter is used in the adenoviral vector harboring the human IL-3
gene or a derivative thereof. It is assumed that the infection of
human cells by recombinant adenoviral vectors is 10.times. more
efficient than rat cells. Furthermore, we assume the vascular bed
or the tumor to be proportional to the tumor volume. Therefore, the
optimal dose assessed in the rat model is extrapolated to the human
situation by the following calculation: 1 dose delivered to humans
= [ effective dose in rat ] .times. [ tumor volume ( human ) ] [ 10
.times. tumor volume ( rat ) ]
[0050] In another aspect, the invention provides a method to
deliver the nucleic acid molecule that encodes interleukin-3 to
solid tumor cells and/or endothelial cells of the vasculature of a
solid tumor in the body of a mammal, whereby the adenoviral vector
or pharmaceutical composition defined supra is administered to a
site in the circulation of the mammal. "Circulation" is meant to
include both the blood circulation and the lymphatic circulation.
Thus, the administration is performed to any site in the body of
the recipient mammal where the blood or lymph fluids of the mammal
pass. Preferred sites of administration are intravenous or
intraarterial, where it is further preferred that administration is
into an artery located upstream of the tumor vasculature. There are
several means to perform administration to the circulation. One of
the means is by injection using, for example, a syringe, a catheter
or another infusion system known in the art. Preferably, injection
is performed at a controlled infusion rate. A much preferred means
to perform administration to the circulation is by perfusion.
Perfusion is a technique whereby the administered pharmaceutical
composition is caused to pass through the circulation or through a
part of the circulation. When the administration is performed by
perfusion, it is furthermore preferred that perfusion is done
multiple times by creating a closed circuit and repassaging the
pharmaceutical composition through the circulation or part of the
circulation. Typically, the causing to pass is done by using a pump
device and perfusion is performed at a rate depending on the
species of the mammal to which the pharmaceutical composition is
being administered. For humans, the rate is often in the range of
approximately 40-80 ml/min and perfusion is continued for a period
of 60-90 minutes, but depending on the patient, type of tumor, and
location thereof, these parameters may vary. For short treatment
times (approximately 5-30 minutes) with the adenoviral construct,
an anoxic perfusion can be performed by those skilled in the art by
using balloon catheters to make a closed circuit. No heart-lung
machine is necessary.
[0051] In this aspect of the invention, part of the circulation
comprises the vasculature of the tumor or tumors to which gene
delivery is performed. For optimal delivery of the nucleic acid
molecule that encodes interleukin-3 to solid tumor cells and/or
endothelial cells of the vasculature of a solid tumor, it is
preferred that the adenoviral vector or composition of the
invention does not pass through the liver or a part of the liver of
the recipient mammal. Thus, part of the circulation does preferably
not include the circulation of the liver or of a part of the liver,
except when the tumor is located in or very close to the liver. For
optimal delivery of the nucleic acid molecule that encodes
interleukin-3 to solid tumor cells and/or endothelial cells of the
vasculature of a solid tumor, it is furthermore preferred that the
blood of the mammal is first washed away from the closed circuit
(e.g., by precirculation with the diluent of the pharmaceutical
composition only) before the pharmaceutical composition is
administered. Optionally, the blood that is washed away is
collected and readministered at the end of the procedure. Surgical
techniques for perfusion of parts of the circulation according to
the present invention are under development and are already
available for various specific parts of the circulation, such as,
e.g., the liver (Fraker et al., Circulatory shock, 44, p. 45-50,
1994), the lung (Progrebniak et al., Ann. Thorac. Surg., 57, p.
1477-83, 1994), and the kidney (Veen van de et al, Eur. J. Surg.
Oncol. 20, p. 404-405, 1994). A typical nonlimiting example of a
routine perfusion technique useful in the invention is isolated
limb perfusion (ILP), where a closed circuit is created between the
femoral artery and the femoral vein. Alternatively, essentially the
same perfusion techniques can be employed in the invention to
exclude the delivery of the nucleic acid molecule to a part or
parts of the circulation. In this aspect of the invention, the part
or parts of the circulation to which the delivery is unwanted are
perfused with a diluent according to the invention while the
pharmaceutical composition is administered to the circulation
systemically (hence, outside the perfusion circulation). An
important example of this embodiment of the invention is exclusion
of the liver circulation from delivery of the nucleic acid
molecule.
[0052] The invention furthermore provides genetically modified
solid tumor cells and cells of the vasculature of a solid tumor
expressing the interleukin-3 in the body of a mammal. These cells
expressing the interleukin-3 are obtained by administering the
composition containing the adenoviral vector according to the
invention using the method according to the invention via the
circulation of a mammal. The expression of interleukin-3 in a solid
tumor cell or cells of the vasculature of a solid tumor results in
an effective killing of the cells. Thus, the present invention also
provides a gene therapy treatment for solid tumors. All tumors that
are in close contact with the circulation can be treated according
to the invention. Although leukemias and lymphomas are not
excluded, vascularized solid tumors are especially suited for
treatment according to the invention. Examples of types of solid
tumors include, but are not limited to, carcinomas (e.g., of the
lung, bladder, kidney, breast, stomach, pancreas, urogenital tract,
and intestine), sarcomas (e.g., soft tissue sarcomas, osteogenic
sarcomas, or Kaposi's sarcoma), gliomas and melanomas. Also benign
types oftumors, such as, e.g., angiomas and fibrocytomas, can be
treated according to the invention. It is to be understood,
however, that the scope of the present invention is not to be
limited to the treatment of any particular type of tumor.
[0053] It is furthermore to be understood that the cancer treatment
according to the invention may be combined with other methods of
cancer treatment known in the art. Such treatment combinations are
also part of the present invention.
[0054] The invention is illustrated by means of the following
examples. It is to be understood that the examples are not meant to
limit the scope of the invention in any way.
[0055] Example 1 teaches the production of adenoviral vectors and
pharmaceutical compositions according to the invention.
[0056] Example 2 teaches the cloning and production of an
adenoviral vector with the human IL-3 gene and the pharmaceutical
composition according to the invention.
[0057] Examples 3 and 4 show the gene transfer efficiency that is
obtained when adenoviral vectors are administered to a solid tumor
via the circulation or by direct intratumor injection, as well as
the unwanted gene transfer into nontumor cells in both cases, and
the type of cells in the tumor that are transduced using these
administration methods. It is shown that the direct injection
results in approximately 87 times more expression of the introduced
gene in the tumor than administration via the circulation. The
direct injection efficiently transduces many tumor cells along the
needle tract, whereas administration via the circulation mainly
transduces endothelial cells of the tumor vasculature, a few solid
tumor cells adjacent to the vascular endothelial cells and some
cells in or near the capsule of the tumor. Gene transfer into
tissues other than the tumor hardly occurs using either method.
[0058] Examples 5, 6, 7 and 8 clearly demonstrate the effective
antitumor effect that is accomplished by administering an
adenoviral vector carrying the interleukin-3 gene into two types of
solid tumors via the circulation. Complete regression of the tumors
occurs. Experiments show that this effective antitumor effect is
not obtained by direct intratumor injection or by using an
adenoviral vector that expresses the IL-3 gene at low levels.
[0059] Control isolated limb perfusion experiments show that this
effective antitumor effect is not obtained by an isolated limb
perfusion without the addition of the adenoviral vector with the
interleukin-3 gene or by treatment with an adenoviral vector
without effector gene. After the latter treatment, some delay in
tumor growth is observed when ROS-1 osteosarcomas were used, but
the tumors do not regress. The latter growth delay is not observed
when BN175 tumors were treated.
[0060] Example 5 shows that the antitumor effect is specific for
the activity of the interleukin-3 gene. Anticancer treatment by
administering adenoviral vectors expressing the HSV-tk gene via the
circulation followed by ganciclovir injections shows only
incomplete effects.
[0061] Examples 9, 10 and 12 demonstrate that in the rats with the
two tumor models studied, the optimal dose for administering of the
adenoviral vector carrying the interleukin-3 gene via the
circulation is 1.times.10.sup.9 i.u. (infectious units), and that
15 minutes perfusion results in good antitumor effects.
[0062] Example 11 clearly demonstrates that the administration via
the circulation of 1.times.10.sup.9 i.u. of the adenoviral vector
carrying the interleukin-3 gene is at least as efficient as the
established combination therapy with TNF (and Melphalan).
EXAMPLES
Example 1
Generation of Recombinant Adenoviral Vectors and Production of
Pharmaceutical Compositions Containing the Recombinant Adenoviral
Vectors for Administration via the Circulation of a Mammal
[0063] The cloning, sequence analysis and generation of E1-deleted
adenoviral vectors has been described in detail in patent
application EP 95 20 2213 incorporated herein by reference.
[0064] The adenovirus vector is deleted for the E1, but the E3
region was retained in this vector. The gene is driven by the
Cytomegalovirus promoter (CMV) or the adenovirus-2 derived Major
late promotor (MLP). The names of the viruses are IG.Ad.CMV.rIL-3
(this vector contains the rat IL-3 cDNA), IG.Ad.MLP.Luc (this
vector contains the luciferase marker gene), IG.Ad.CMV.LacZ (this
vector contains the LacZ marker gene) and Ad.CMV.TK (this vector
contains the TK (thymidine kinase) gene).
[0065] Recombinant adenovirus IG.Ad.CMV.rIL-3 has been deposited at
the ECACC under accession number V96071634.
[0066] The generation and propagation of these vectors on
E1-complementing cell lines has been described in European patent
application EP 95 20 2213 and in references Esandi et al. (1997)
and Vincent et al. (1996a, 1996b). Propagation of the vectors on
E1-complementing PER.C6 is described in patent application WO
97100326. The PER.C6 cell line has been deposited at the ECACC
under deposition number 96022940. After propagation, the
recombinant viruses were purified by CsC 1 density centrifugation
and dialyzed according to standard procedures. Titration of the
viruses was performed by end-point dilution on 911 cells. The
vectors are stored in phosphate-buffered saline (PBS) supplemented
with 10% (v/v) glycerol or 5% (w/v/) sucrose and stored at
-80.degree. C.
Example 2
Generation of a Recombinant Adenoviral Vector with the Human IL-3
Gene (pAd5.CLIP.hIL-3) and Production of Pharmaceutical
Compositions Containing the Recombinant Adenoviral Vector
(IG.Ad5.CLIP.hIL-3) for Administration via the Circulation
[0067] 2.1.1. Generation of the Adenoviral Vector pAd5.CLIP:
[0068] The pAd5.CLIP adenoviral vector contains a deleted E1 gene,
but the E3 region was retained in this vector. The adenoviral
vector consists of a Cytomegalovirus promoter (CMV), polylinker,
intron and polyA sequence. For those skilled in the art, it is
possible to insert in the polylinker site of the pAd5.CLIP vector
any piece of DNA of interest. In this case, the human interleukin-3
coding sequence was inserted (as described in example 2.2).
[0069] The cloning strategy of the pAd5.CLIP adenoviral vector is
shown in FIG. 1 and described below.
[0070] PcDNA1 (Life Technologies) was digested with the restriction
enzymes HhaI and AvrII. The sticky ends of the 1567 bp fragment
were filled in with the enzyme T4-polymerase. The plasmid
pAd/L420-HSA (the generation of this adapter plasmid is described
in the next subparagraph of this example (2.1.2)) was digested with
the restriction enzymes AvrII and BglII, followed by treatment with
Klenow polymerase (Life Technologies), resulting in a 5.5 kb DNA
fragment. The purified 5.5 kb pAd/L420-HSA fragment was
dephosphorylated with Tsap (Thermo Sensitive Alkaline Phosphatase,
Life Technologies) and ligated with the purified 1.5 kb
pcDNA1/Amp/HhaI/AVrII fragment. The ligation product was added to
transformation-competent DH5 (E. coli cells) and plated on
ampicillin-containing plates. The resulting pAd5.CLIP plasmid DNA
was isolated and checked by restriction digestion analysis.
[0071] 2.1.2. Construction of the Adapter Plasmid pAd/L420-HSA:
[0072] The absence of sequence overlap between the recombinant
adenovirus and E1 sequences in the packaging cell line is essential
for safe, RCA-free generation and propagation of new recombinant
viruses. The adapter plasmid pMLPI.TK was designed for use
according to the invention in combination with the improved
packaging cell lines of the invention. The plasmid pAd/L420-HSA is
derived out of the adapter plasmid pMLPI.TK. The construction
strategy is described below (subparagraphs 2.1.2.1 and
2.1.2.2).
[0073] 2.1.2.1. Construction of pMLPI.TK:
[0074] The recombinant adenovirus vectors used (pE1A.E1B, pMLP.TK,
see patent application EP 95/202213) are deleted for E1 sequences
from nt. 459 to 3328. As construct pE1A.E1B contains Ad5 sequences
nt. 459 to 3510, there is a sequence overlap of 183 nt between E1B
sequences in the packaging construct pIG.E1 A.E.sub.1B and
recombinant adenoviruses, such as, for example, IG.Ad.MLP.TK. The
overlapping sequences were deleted from the new adenoviral vectors.
In addition, noncoding sequences derived from LacZ, which are
present in the original constructs, were deleted as well. This was
achieved (see FIG. 15) by PCR amplification of the SV40 poly(A)
sequences from pMLP.TK using primers SV40-1
(5'-GGGGGATCCGAACTTGTTTATTGCAGC-3' (SEQ ID NO: 1): introduces a
BamHI site) and SV40-2 (5'-GGGAGATCTAGACATGATAAGATAC-3' (SEQ ID
NO:2): introduces a BglII site). In addition, Ad5 sequences present
in this construct were amplified from nt. 2496 using primer Ad5-1
(GGGAGATCTGTACTGAAATGTGTGGGC-3' (SEQ ID NO:3): introduces a BglII
site) to nt. 2779 using primer Ad5-2
(5'-GGAGGCTGCAGTCTCCAACGGCGT-3' (SEQ ID NO:4)). Both PCR fragments
were digested with BglII and were ligated. The ligation product was
PCR amplified using primers SV40-1 and Ad5-2 (sequence described
above). The PCR product obtained was cut with BamHI and AflII and
was ligated into pMLP.TK predigested with the same enzymes. The
resulting construct, named pMLPI.TK, contains a deletion in
adenovirus El sequences from nt. 459-3510.
[0075] 2.1.2.2. Construction of the pAd/L420-HSA Adapter
Plasmid:
[0076] The pMLPI.TK plasmid was used as the starting material to
make a new vector in which nucleic acid molecules comprising
specific promoter and gene sequences can be easily exchanged.
First, a PCR fragment was generated from pZip(Mo+PyF101(N-)
template DNA (described in PCT/NL96/00195) with the following
primers: LTR-1:5'-CTGTACGTACCAGT GCACTGGCCTAGGCATGGAAAAATACATAACTG
3' (SEQ ID NO: 5) and
LTR-2:5'-GCGGATCCTTCGAACCATGGTAAGCTTGGTACCGCTAGCGTTAACCGGGCGACTC
AGTCAATCG-3' (SEQ ID NO:6). Pwo DNA polymerase (Boeringer Mannheim)
was used according to the manufacturer's protocol with the
following temperature cycles: once 5 minutes at 95.degree. C.; 3
minutes at 55.degree. C.; and 1 minute at 72.degree. C., and 30
cycles of 1 minute at 95.degree. C., 1 minute at 60.degree. C., 1
minute at 72.degree. C., followed by once 10 minutes at 72.degree.
C. The PCR product was then digested with BamHI and ligated into a
pMLP10 (Levrero et al., Gene 101: 195-202, 1991) vector digested
with PvuII and BamHI, thereby generating vector pLTR10. This vector
contains adenoviral sequences from bp 1 up to bp 454 followed by a
promoter which includes part of the Mo-MuLVLTR in which the
wild-type enhancer sequences are replaced by the enhancer from a
mutant polyoma virus (PyF101). The promoter fragment was designated
L420.
[0077] Next, the coding region of the murine HSA-gene was inserted.
pLTR10 was digested with BstBI followed by Klenow treatment and
digestion with NcoI. The HSA-gene was obtained by PCR amplification
of pUC18-HSA (Kay et al., J. Immunol. 145:1952-1959, 1990) using
the following primers: HSA 1:5'-GCGCCACCATGGGCAGAGCGATGGTGG C-3'
(SEQ ID NO:7) and
HSA2:5'-GTTAGATCTAAGCTTGTCGACATCGATCTACTAACAGTAGAGA TGTAGAA-3' (SEQ
ID NO:8). The 269 bp amplified fragment was subcloned in a shuttle
vector using the NcoI and BglII sites. Sequencing confirmed
incorporation of the correct coding sequence of the HSA-gene, but
with an extra TAG insertion directly following the TAG stop codon.
The coding region of the HSA-gene, including the TAG duplication,
was then excised as an NcoI (sticky)-SalI(blunt) fragment and
cloned into the 3.5 kb NcoI (sticky)/BstI (blunt) fragment from
pLTR10, resulting in pLTR-HSA10.
[0078] Finally, pLTR-HSA10 was digested with EcoRI and BamHI after
which the fragment containing the left ITR, packaging signal, L420
promoter and HSA-gene was inserted into vector pMLPI.TK and
digested with the same enzymes, thereby replacing the promoter and
the gene sequences. This resulted in the new adapter plasmid
pAd/L420-HSA (FIG. 16) that contains convenient recognition sites
for various restriction enzymes around the promoter and gene
sequences. SnaBI and AvrII can be combined with HpaI, NheI, KpnI,
or HindIII to exchange promoter sequences, while the latter sites
can be combined with the ClaI or BamHI sites 3' from the USA-coding
region to replace genes in this construct.
[0079] 2.2. Generation of pAd5.CLIP.hIL-3:
[0080] PcDNA3.hIL-3 (PCT International Publication No. W088/04691,
Gist Brocades (GB)) was digested with the restriction enzymes
HindIII and BamHI to obtain a 1 kb fragment that contains the
functional hIL-3 sequence (hIL-3/BamHI/HindIII (GB)). The plasmid
pAd5.CLIP was digested with BamHI and HindIII (in the multiple
cloning site) and purified. Next, the pAd5.CLIP/BamHI/HindIII DNA
was dephosphorylated by Tsap. The pcDNA3.hIL-3/BamHI/HindIII and
pAd5.CLIP/BamHI/HindIII DNA fragments were ligated and the ligation
product was added to transformation-competent DH5 E. coli cells.
The pAd5.CLIP.hIL-3(GB) plasmid DNA was isolated and checked by
digestion with EcoRI. Because of possible unknown sequences at the
HindIII site of the hIL-3 gene (pcDNA3.hIL-3 plasmid generated
previously by Gist Brocades) and the presence of a polyA tail on
the BamHI site, the hIL-3 cDNA coding sequence is amplified out of
the pAd5.CLIP.huIL-3 (GB) by means of PCR. The primers used were:
huIL3-forward: CCCCAAGCTTGCCACCATGAGCCGCCTGCCCGTC (SEQ ID NO:9) and
huIL3-reverse: GCGGGATCCTCAAAAGATCGCGAGGC (SEQ ID NO:10) (Life
Technologies). The PCR product (484 bp) was digested with the
restriction enzymes BamHI and HindIII and the huIL-3/BamHI/HindIII
(PCR) fragment (475 bp) was cloned in pAd5.CLIP.HindIII/BamHI.
Plasmid DNA was obtained via transformation of competent DH5 E.
coli cells. The 7131 bp construct is termed: pAd5.CLIP.hIL-3. The
DNA was checked by restriction enzyme and sequence analysis. The
expression and biological activity of the hIL-3 transgene was shown
by transfection of the human PERC6 cell line (patent number WO
97/1000326, ECACC no. 96022940) with the pAd5.CLIP.hIL-3 plasmid
followed by an hIL-3 protein ELISA (Quantikine kit, R & D) and
hIL-3 bioactivity assay using TF-1 cells (human IL-3 protein
dependent for their growth) of the secreted hIL-3 protein in the
PER.C6 culture medium. The data of these two experiments (huIL-3
ELISA, TF-1 bioactivity assay) are shown in FIG. 17.
[0081] 2.3.Generation of Recombinant Adenovirus
(IG.pAd5.CLIP.hIL-3):
[0082] A general protocol as outlined below and meant as a
nonlimiting example of the present invention has been performed to
produce the IG.pAd5.CLIP.hIL-3 recombinant adenovirus. Adenoviral
packaging cells (PER.C6) were seeded in 25 cm.sup.2 flasks, and the
next day when they were at approx. 80% confluency, the cells were
transfected with a mixture of DNA and lipofectamine agent (Life
Technologies) as described by the manufacturer. Routinely, 40 .mu.l
lipofectamine, 4 .mu.g adapter plasmid and 4 .mu.g of the
complementing adenovirus genome fragment AFLII-rITR were used. Two
days later, cells were passaged to 80 cm.sup.2 flasks and further
cultured. Approximately five days later, a cytopathic effect (CPE)
was observed, indicating that functional adenovirus has been
formed. Cells and medium were harvested upon full CPE and
recombinant IG.pAd5.CLIP.hIL-3 adenovirus was released by
freeze-thawing. An extra amplification step in an 80 cm.sup.2 flask
was performed to increase the yield. After amplification, viruses
were harvested and plaque purified on PER.C6 cells. Individual
plaques were tested for production of viruses with the active IL-3
transgene by the hIL-3 ELISA and TF-1 bioactivity assay as
described above. Functional IG.pAd5.CLIP.hIL-3 adenovirus was
formed with an active IL-3 transgene.
[0083] Propagation of the vector on E1-complementing PER.C6 cells
is described in PCT International Publication No. WO 97/100326. The
PER.C6 cell line has been deposited at the ECACC under deposition
number 96022940.
[0084] After propagation, the recombinant IG.pAd5.CLIP.hIL-3
adenovirus was purified by CsCl density centrifugation and dialyzed
according to standard procedures. Titration of the viruses was
performed by end-point dilution on 911 cells. The vector is stored
in phosphate buffered saline (PBS) supplemented with 10% (v/v)
glycerol or 5% (w/v) sucrose and stored at -80.degree. C.
Example 3
Comparison of Gene Transfer Efficiencies That are Achieved Using
Recombinant Adenoviral Vectors That are Administered Either by
Perfusion of the Circulation of a Tumor or by Direct Intratumor
Injection
[0085] 3.1. Tumor models
[0086] The BN175 sarcoma (Marquet et al. (1983), Kort et al.
(1984)) originated as a spontaneous tumor in the pancreatic,
retroperitoneal region of a BN rat. The BN175 was implanted
subcutaneously in the flank of donor BN rats and passaged serially.
BN175 is a nonimmunogenic (Manusama (1996)), rapidly growing and
metastazing tumor with a tumor doubling time of 2 days.
[0087] The rapidly growing ROS-l osteosarcoma originated
spontaneously in the tibia of a Wag/Rij rat (Barendsen et al.
(1987)). The ROS-1 was implanted subcutaneously in the flank of
donor Wag/Rij rats and passaged serially. The ROS-1 has a tumor
doubling time of 5 days.
[0088] Fragments of the BN 175 or ROS-1 (osteo)sarcoma were
subcutaneously implanted into the right hind limb of the
experimental animals just above the ankle. The tumor size was
measured regularly by caliper measurement in two dimensions. When
the tumor reached a volume of 180-524 mm.sup.3 (diameter between 7
and 10 mm) an isolated limb perfusion (ILP) with the recombinant
adenoviral vector was performed. As a control, tumor-bearing rats
underwent ILP without the addition of the recombinant adenoviral
vectors (termed "sham ILP").
[0089] Another group of tumor-bearing rats underwent a direct
intratumor injection with the recombinant adenoviral vector. The
tumor volume was between 180-524 mm.sup.3. After ILP or direct
intratumor injection, the tumor size was measured every
(Mon-Fri)day.
[0090] 3.2. Surgical and Perfusion Techniques.
[0091] Surgical procedures were performed under Hypnorm anaesthesia
(Janssen Pharmaceutica, Tilburg, The Netherlands). For isolated
limb perfusion (ILP), a modification of the perfusion technique
originally described by Brenckhuijsen et al. (1982) was used
(Manusama et al. (1996)). After an incision parallel to the
inguinal ligament, the femoral and vein were approached and
cannulated with silastic tubing (0.30 mm ID, 0.64 mm OD; 0.64 mm,
1.19 OD, respectively, Degania Silicone, Degania Bet, Israel).
Collaterals were temporarily occluded by the application of a
tourniquet around the groin, which was fixed to the inguinal
ligament. An oxygenation reservoir and a roller pump (Masterflex)
were included in the vascularly isolated circuit, which was,
initially, perfused with Haemaccel (Behring Pharma, Amsterdam, The
Netherlands) for 3 minutes at a flow speed of 2 ml/min to wash out
the blood. After the first wash-out step, recirculation was
performed with recombinant adenoviruses (50 .mu.l-1 ml, containing
approximately 1.times.10.sup.9 infectious units (i.u.)) dissolved
in 2.5-3.5 ml Haemaccel at the same flow rate for a time period
ranging from 5 to 30 minutes, followed by a second perfusion step
of 5 minutes to wash out the nonbound virus with Haemaccel. During
the perfusion and recirculation steps, the rat hind leg was kept at
a constant temperature of 37-38.degree., and a warm water mattress
was applied around the leg. After the second wash-out step, the
vascularly isolated circuit was discontinued and, after cannule
removal, the femoral vessels were ligated. Previous experiments
have shown that the collateral circulation via the internal iliac
artery to the leg is so extensive that ligation of the femoral
vessels can be performed without detrimental effects.
[0092] 3.3. Results: The ILP or a direct intratumor injection was
performed as described above with 50 .mu.l (containing approx.
5.times.10.sup.8 i.u.) of IG.Ad.MLP.Luc. Two days after the ILP or
direct intratumoral injection, the rats were sacrificed and the
tumor was removed. The luciferase activity was determined as
described before (Fortunati et al., 1996). The luciferase activity
was expressed in an amount of luciferase units per total volume of
tumor lysate.
1TABLE I Effectivity of the transfer of adenoviral vector
containing the Luciferase marker gene to a BN175 tumor via ILP or
direct intratumor injection. perfusion time: (min) luciferase
activity: No. rats 5 2039 .+-. 1197 6 15 4835 .+-. 2448 6 30 5647
.+-. 3308 6 intratumoral injection 422296 .+-. 271179 6
[0093] The luciferase activity is given as the mean value of 6
experiments.+-.S.D.
[0094] Conclusion: Direct intratumor injection results in an
87-fold higher expression of the luciferase activity in the tumor
than ILP for 15 min.
[0095] ILP for 15 minutes results in an acceptable level of
luciferase activity in the tumor compared to 30 minutes of ILP.
Therefore, 15 min. of ILP is used throughout the experiments.
2TABLE II Transfer of adenoviral vector containing the Luciferase
marker gene to other organs after ILP or direct intratumor
injection. perfusion time: Luciferase activity: No. of rats:
Skeletal muscle of (min) Liver: the isolated limb: 5 65 138 6 15 51
178 6 30 69 211 6 intratumor injection 38 196 6
[0096] The luciferase activity is given as the mean value of 6
experiments.
[0097] Conclusion: No high uptake of IG.Ad.MLP.Luc by the liver or
skeletal muscle of the isolated limb after ILP or intratumor
injection.
Example 4
Histocytological Examination of the Transduced Cells in a Tumor
After Administration of a Recombinant Adenoviral Vector by Either
Perfusion of the Circulation of the Tumor or Direct Injection into
the Tumor
[0098] The ILP or direct intratumor injection of BN175
tumor-bearing BN rats with 5.times.10.sup.8 or 1.times.10.sup.10
i.u. IG.Ad.CMV.LacZ was performed as described above. Two days
after treatment, the animals were sacrificed and tumors were
removed. In these tissues the lacZ positive cells were localized by
staining with X-gal as described in detail before (Bout et al.,
1994).
[0099] Briefly, tumors were cut into slices of approximately 5 mm
thickness, fixed for 2-3 hours in PBS containing 2%
paraformaldehyde and 0.25% glutaraldehyde. After staining with
X-gal, the tissue was post-fixed in 4% phosphate-buffered formalin
and embedded in paraffin. 5 .mu.m sections were prepared according
to routine histochemical methods. The sections were examined
microscopically for the presence of blue (=LacZ positive)
cells.
[0100] Results: Direct injection of the tumors with IG.Ad.CMV.LacZ
resulted in staining along the track of the needle.
[0101] Staining of the tissues after ILP showed no blue color in
the tumor. The color was restricted to the areas directly adjacent
to the blood vessels of the tumor including the endothelial cells
and in or near the capsule of the tumor.
[0102] The amount of blue-stained cells was much larger in the
direct intratumoral-injected tumors than in the ILP-treated
tumors.
Example 5
Effect of Direct Intratumor Injection or Administration Via the
Circulation (Isolated Limb Perfusion) of an Adenoviral Vector
Carrying the Thymine Kinase Gene
[0103] Rats bearing a BN175 tumor in their hind limb (as described
in example 3.1) underwent ILP with 100 .mu.l of IG.Ad.CMV.TK
(approx. 1.times.10.sup.9 i.u.) followed by intraperitoneal
injection twice a day of ganciclovir (GCV). The tumor sizes were
followed in time. The results are depicted in FIG. 2. Another group
of BN rats was injected intratumorally in the BN175 tumor with 100
.mu.l of IG.Ad.CMV.TK followed by intraperitoneal injection twice a
day of ganciclovir (GCV). The tumor sizes were followed in time.
The results are depicted in FIG. 2.
[0104] Other rats underwent ILP without the addition of virus
(control perfusion termed "sham ILP"). The tumor sizes were
followed in time. The results are depicted in FIG. 2.
[0105] Results and conclusions: Isolated limb perfusion (ILP) with
TK/GCV (suicide gene therapy) is not effective, neither is a
control ILP (sham ILP) without the addition of virus.
Example 6
Effect of Direct Intratumoral Injection or Administration Via the
Circulation (Isolated Limb Perfusion) of BN175 Sarcomas with an
Adenoviral Vector Carrying the Interleukin-3 Gene
[0106] Rats bearing a BN175 tumor in their hind limb (as described
in example 3.1) were injected intratumorally (IT) with
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3.
[0107] An other group of rats bearing a BN175 tumor in their hind
limb underwent ILP for 15 minutes with 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3 or perfusion buffer alone (the latter control
perfusion is termed: "sham ILP"). The tumor sizes were followed in
time. The results are depicted in FIG. 3.
[0108] Results and conclusions: Delivery of rIL-3.beta. (via an
adenoviral vector) results in a relative delay of the tumor growth
of 15 days (determined for an arbitrarily chosen tumor volume of
1000 mm.sup.3 and compared to the control sham ILP) in 8/9 of the
treated BN 175 tumors when the vector is delivered via ILP. One out
of nine treated tumors shows no antitumor response (normal growth).
Direct intratumoral injection of the IG.Ad.CMV.rIL-3.beta. does not
influence the tumor growth.
Example 7
Effect of Direct Intratumoral Injection or Administration Via the
Circulation (Isolated Limb Perfusion) of ROS-1 Osteosarcomas with
an Adenoviral Vector Carrying the Interleukin-3 Gene
[0109] ROS-1 tumor bearing rats (as described in example 3.1) were
injected intratumorally (IT) with 1.times.10.sup.9 i.u.
Ad5.PL+C.
[0110] Ad5.PL+C is an adenovirus that is E1 deleted and has no tg
containing adenoviral sequences and carries no gene (=an "empty"
control vector).
[0111] Another group of rats underwent ILP for 15 minutes with
1.times.10.sup.9 i.u. Ad5.PL+C.
[0112] The tumor sizes were followed in time. The results are
depicted in FIG. 4.
[0113] Another group of rats bearing a ROS-1 tumor in their hind
limb was injected intratumorally (IT) with 1.times.10.sup.9 i.u.
IG.Ad.CMV.rIL-3.
[0114] Other ROS-1-bearing rats underwent ILP for 15 minutes with
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 or perfusion buffer alone
(the latter control perfusion is termed "sham ILP").
[0115] The tumor sizes were followed in time. The results are
depicted in FIG. 5.
[0116] Results and conclusions: Delivery of IG.Ad.CMV.rIL-3 results
in an antitumor effect (regression of the tumor growth) of all
treated ROS-1 tumors when the adenovirus is delivered by ILP.
Direct intratumoral injection with the same amount of
IG.Ad.CMV.rIL-3 (10.sup.9 i.u.) is not effective.
[0117] The observed antitumor response is caused by the IL-3 gene
and not by the adenovirus itself since the control virus Ad5.PL+C
does not influence the tumor growth.
[0118] A mock ILP without the addition of adenovirus or drug
(termed "sham ILP") delays the tumor growth compared to the
nontreated tumors by 4 days (at the arbitrary chosen tumor volume
of 2000 mm.sup.3). Compared to the sham ILP, the ILP treatment with
10.sup.9 i.u. IG.Ad.CMV.rIL-3 results in a 9-day delay in tumor
growth. The observed delay in tumor growth after a sham ILP is
explained by the wash out of growth factor(s) or the need for
oxygen for the growth of the ROS-1 tumor and is characteristic for
ROS-1.
[0119] In conclusion: Similar antitumor responses are observed
after isolated limb perfusion with 1.times.10.sup.9 i.u. of
IG.Ad.CMV.rIL-3 in two types of tumors.
Example 8
Antitumor Effect of an Adenoviral Vector Harboring the IL-3 Gene
Driven by a Weaker Promoter, Namely the MLP Promoter
[0120] Rats bearing the ROS-1 tumor in their hind limb (as
described in example 3.1) underwent ILP for 15 minutes with
1.times.10.sup.9 i.u. IG.Ad.MLP.rIL-3 (IG.Ad.MLP.rIL-3 is an
adenovirus similar to IG.Ad.CMV.rIL-3; the only difference is the
approximately 10-fold weaker MLP (major late promoter)
promoter).
[0121] Another group of rats bearing the ROS-1 tumor in their hind
limb was injected intratumorally with 1.times.10.sup.9 i.u.
IG.Ad.MLP.rIL-3. The tumor sizes were followed in time. The results
are depicted in FIG. 6.
[0122] Results and conclusions: The results show that isolated limb
perfusions or direct intratumoral injections of ROS-1 osteosarcoma
with an adenoviral vector with the IL-3 gene driven by a (10-fold)
weaker promoter (IG.Ad.MLP.rIL-3.beta.) is not effective.
Example 9
Antitumor Effect of Varying Doses of an Adenoviral Vector Carrying
the Interleukin-3 Gene Administered Via the Circulation (Isolated
Limb Perfusion)
[0123] Rats bearing a ROS-1 tumor in their hind limb (as described
in example 3.1) underwent ILP with 1.times.10.sup.5 i.u.,
1.times.10.sup.7 i.u., 1.times.10.sup.8 i.u. and 1.times.10.sup.10
i.u. of IG.Ad .CMV.rIL-3 for 15 minutes. The tumor sizes were
followed in time. The results are depicted in FIG. 7.
[0124] Another group of rats with BN175 sarcomas in their hind limb
(as described in chapter 3.1) underwent ILP for 15 minutes with
1.times.10.sup.5 i.u. and 1.times.10.sup.7 i.u. of IG.Ad.CMV.rIL-3.
The tumor sizes were followed in time. The results are depicted in
FIG. 8.
[0125] Other rats with ROS-1 tumors underwent ILP for 15 minutes
with 2.times.10.sup.8 i.u. or 5.times.10.sup.8 i.u. of
IG.Ad.CMV.rIL-3. The tumor sizes were followed in time. The results
are depicted in FIG. 9.
[0126] Results and conclusions: The results show that doses of
1.times.10.sup.5 i.u. or 1.times.10.sup.7 i.u. IG.Ad.CMV.rIL-3
result in no regression of the tumor growth after ILP both for
ROS-1 and BN175 tumors.
[0127] Isolated limb perfusions of ROS-1 tumors with
1.times.10.sup.8 i.u. of IG.Ad.CMV.rIL-3 show a small regression of
the tumor growth. ILP of ROS-1 with 2.times.10.sup.8 i.u. and
5.times.10.sup.8 i.u. (performed with another breed of rats, but
with the same virus batch) did not show a regression of the tumor
growth.
[0128] Isolated limb perfusions of ROS-1 osteosarcomas with
1.times.10.sup.10 i.u. of IG.Ad.CMV.rIL-3 is lethal for the rats.
At day 8 after treatment, both rats were dead, probably due to
severe leucocytosis (leucocytes increased approx. 17-fold to
200-300.times.10.sup.3 leucocytes/mm.sup.3). At this dose an arrest
in tumor growth is observed.
[0129] In conclusion: the most optimal dose of IG.Ad.CMV.rIL-3
tested for isolated limb perfusion so far is 1.times.10.sup.9
i.u.
Example 10
Antitumor Effect of 30-Minute Isolated Limb Perfusions with a Low
Dose of an Adenoviral Vector Carrying the Interleukin-3 Gene
[0130] ROS-1 tumor-bearing rats (as described in example 3.1)
underwent ILP for 30 minutes with 1.times.10.sup.7 i.u. or
1.times.10.sup.5 i.u. of IG.Ad.CMV.rIL-3. The tumor sizes were
followed in time. The results are depicted in FIG. 10.
[0131] Results and conclusions: An increase of the perfusion time
from 15 to 30 minutes does not result in a better antitumor effect
when a dose of 1.times.10.sup.5 i.u. or 1.times.10.sup.7 i.u.
IG.Ad.CMV.rIL-3 is used.
Example 11
Antitumor Effect of Administration Via the Circulation (Isolated
Limb Perfusion) of an Adenoviral Vector Carrying the Interleukin-3
gene and TNF.alpha. or Melphalan
[0132] Rats bearing a ROS-1 osteosarcoma in their hind limb (as
described in example 3.1) underwent ILP with a mixture of a dose of
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 and a dose of 40 .mu.g
(=effective dose) of the cytostatic melphalan (Alkeran.RTM., Glaxo
Wellcome, UK) per rat. The drug and recombinant adenoviral vector
were added to the oxygenation chamber of the perfusion system
immediately after each other. The tumor sizes were followed in
time.
[0133] Another group of rats was ILP treated with a total dose of
40 .mu.g melphalan per rat. The results are depicted in FIG.
11.
[0134] Other ROS-1 bearing rats underwent ILP with a mixture of a
dose of 1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 and a total dose of
50 .mu.g TNF.alpha. (Boehringer Ingelheim, Germany) per rat or a
dose of 50 .mu.g TNF.alpha. alone (=the effective concentration).
The tumor sizes were followed in time.
[0135] Another group of rats was ILP treated with a mixture of a
dose of 50 .mu.g TNF.alpha. and a dose of 40 .mu.g melphalan per
animal. The tumor sizes were followed in time. The results are
depicted in FIG. 12.
[0136] Another group of rats bearing a ROS-1 tumor in their hind
leg under went ILP with 1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 and a
dose of 200 .mu.g doxorubicin (Adriblastina RTU, Farmitalia Carlo
Erba) per rat. Rats underwent ILP with a dose of 200 .mu.g
doxorubicin per animal. The tumor sizes were followed in time. The
results are depicted in FIG. 13.
[0137] Results and conclusions: ILP with a monotherapy of
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3 in the ROS-1 osteosarcoma
model is at least as efficient as the established
TNF.alpha./melphalan combination therapy (similar antitumor
effects).
[0138] Addition of TNF.alpha., melphalan or doxorubicin to the
IG.Ad.CMV.rIL-3 perfusion does not influence the antitumor
response. This indicates that there is no additional benefit of
these established antitumor agents when used at their indicated
effective concentrations.
Example 12
Effect of Shorter Perfusion Times on the Antitumor Effect of an
Adenoviral Vector Carrying the Interleukin-3 Gene
[0139] Rats bearing a ROS-1 osteosarcoma in their hind limb (as
described in example 3.1) underwent ILP (as described in example
3.2) with 1.times.10.sup.9 i.u. of IG.Ad.CMV.rIL-3 for 5 or 2
minutes. As a control, a group of rats underwent ILP for 5 minutes
with perfusion buffer alone (=sham ILP). The tumor sizes were
followed in time. The results are depicted in FIG. 14.
[0140] Results and conclusions: The results show that regression of
the tumor growth comparable to a 15-minute ILP is not observed when
the perfusion time is reduced to 5 or 2 minutes.
Example 13
In Vitro Experiments with Human Cells with an Adenoviral Vector
Carrying the Human Interleukin-3 Gene
[0141] Human melanoma, sarcoma, Karposi sarcoma cells and human
umbilical vein endothelial cells (HUVEC) are infected with an
adenovirus with the human interleukin-3 gene (IG.Ad5.CLIP.hIL-3
(described in example 2)). The effect of adenoviral infection and
hIL-3 protein expression is studied by the determination of the
growth curve of the cells in the presence and absence of
IG.Ad5.CLIP.hIL-3 for a period of 3-4 weeks after the
infection.
[0142] Other cultures of the above-described cells are infected in
a similar way. The protein production of the huIL-3 transgene is
determined for 3 weeks by means of an huIL-3 ELISA (Quantikine, R
& D systems) and a TF-1 cell activity assay.
Example 14
In Vitro Experiments with Rat Tumor Cells with an Adenoviral Vector
Carrying the Rat Interleukin-3 Gene
[0143] Rat sarcoma (BN175) and osteosarcoma (ROS-1) cell lines are
infected with an adenovirus with the rat interleukin-3 gene
(IG.Ad.CMV.rIL-3 (described in example 1)). The effect of
adenoviral infection and rIL-3 protein expression is studied by the
determination of the growth curve of the cells in the presence and
absence of IG.Ad.CMV.rIL-3 adenovirus for a period of 3-4
weeks.
[0144] Other cultures of the same tumor cells are infected in a
similar way. The protein production of the rat IL-3 transgene is
determined for 3 weeks by means of an FDCP-1 cell activity
assay.
Example 15
[0145] In vivo experiments with tumor-bearing rats with an
adenoviral vector carrying the human interleukin-3 gene. ROS-1
osteosarcoma-bearing rats are treated via ILP (as described in
section 3.2) for 15-30 minutes with 1.times.10.sup.9 i.u. of
IG.Ad5.CLIP.hIL-3. Blood is sampled and tumor sizes are measured in
time. The amount of huIL-3 in the rat blood is determined by means
of an huIL-3 ELISA (Quantikine, R&D systems).
Example 16
Effect of Administration Via the Circulation (Isolated Limb
Perfusion or Intraarterial Infusion) of an Adenoviral Vector
Carrying the Rat Interleukin-3 Gene with the Liver Excluded From
the Circulation
[0146] 16.1. Isolated Liver Perfusion Technique.
[0147] Surgical procedures are performed under ether anaesthesia.
For isolated liver perfusion, the protocol as described in detail
by Marinelli et al. (1990) was used.
[0148] Isolated liver perfusion (ILP) involves complete vascular
isolation of the liver during perfusion. For this, a mid-line
abdominal incision is made and two limbs of inflow were established
by inserting cannulas into the pyloric branch of the portal vein
and into the gastroduodenal branch of the common hepatic artery
with their tips into the portal vein and the hepatic artery,
respectively. The outflow limb is a cannula inserted into the caval
vein. For a complete vascular isolation of the liver, all normal
in- and outflow routes are clamped, the caval vein between the
liver and diaphragm and between the cannula and the renal veins,
the aorta proximal of the coeliac axis, the common hepatic artery
and portal vein just proximal of the cannulas. The liver is
perfused with the isotone perfusion fluid Haemmaccel (Behring
Pharma, The Netherlands) for a time period of 10-45 minutes
depending on the study protocol.
[0149] 16.2. Experimental Setup:
[0150] Rats receive implants in their hind limb with ROS-1 or BN175
tumors (as described in example 3.1). The liver is isolated from
the blood circulation by means of an isolated liver perfusion as
described in example 16.1. At the time the liver is excluded from
the circulation, the rats are intravenously or intra-arterially
injected with 1.times.10.sup.5-10.sup.10 i.u. of
IG.Ad.CMV.rIL-3.
[0151] The isolated liver perfusion is performed for 10-45 minutes,
after which the blood circulation in the liver is restored. Another
group of tumor-bearing rats is intravenously or intraarterially
injected with 1.times.10.sup.5-10.sup.10 i.u. of IG.Ad.CMV.rIL-3
without an isolated liver perfusion.
[0152] The tumor size development of the treated rats is followed
in time. At the end, organ pathology is performed.
Example 17
Effect of a Longer Perfusion Time with 2.times.10.sup.8 i.u. on the
Antitumor Effect of an Adenoviral Vector Carrying the Interleukin-3
Gene
[0153] ROS-1 osteosarcoma-bearing rats are treated via ILP (as
described in section 3.2) for 30 Minutes with 2.times.10.sup.8 i.u.
of IG.Ad5.CLIP.hIL-3. The antitumor effect is determined by daily
tumor size measurement.
Example 18
Effect of an Intravenous or Intraarterial Injection of
1.times.10.sup.9 i.u. of an Adenoviral Vector Carrying the
Interleukin-3 Gene on the Organ Pathology
[0154] BN rats are injected intravenously or intraarterially with
1.times.10.sup.9 i.u. IG.Ad.CMV.rIL-3. Health and behavior of the
animals are monitored daily. The organ pathology is studied at day
0, 3, 7, 14, 28 after injection.
Example 19
Phase I Study Synopsis in Patients
[0155] 2.1. Compound: IG.Ad5.CLIP.hIL-3
[0156] 2.2. Study title: Isolated limb perfusion (ILP) with an
adenoviral vector containing the IL-3 gene in patients with
extremity sarcoma or melanoma, a dose escalation study.
[0157] 2.3. Development phase: Phase I-II
[0158] 2.4. Centers and countries: NL, CU, Other TED
[0159] 2.5. Study Objectives:
[0160] Primary: determine the regional and the systemic
tolerability of escalating doses up to 1.times.10.sup.11 particles
of IG.Ad5.CLIP.hIL-3 administered in conjunction with ILP to
patients with extremity melanoma or sarcoma, assessed by clinical
and laboratory parameters.
[0161] Secondary: determine the biological activity of
IG.Ad5.CLIP.hIL-3 after ILP-assessing clinical, radiological and
laboratory parameters, determine pathological and clinical tumor
response, assessed by histology and clinical parameters.
[0162] 2.6. Design: Prospective, open label, dose escalation,
multicenter study.
[0163] 2.7. Patients: Key inclusion criteria: age 18-80 years,
failure of standard treatment of sarcoma or melanoma, measurable
disease, ability to give informed consent, any other anticancer
therapy completed at least 4 weeks prior to study entry, fertile
patients willing to practice contraception during 3 months
following the gene therapy.
[0164] Key exclusion criteria: any active or recent (within 7 days)
infection, previous gene therapy of any kind, hematological
disorder, autoimmune disease, plans for any additional anticancer
therapy within 4 weeks after IG.Ad5.CLIP.hIL-3.
[0165] 2.8. Sample size: Sequential cohorts of 3 patients will be
entered at each of the planned dose levels. At the dose where
.gtoreq.2/3 patients show a complete response (CR) or a partial
response (PR), additional patients will be treated up to a total
sample size of 24 of that level. If the MTD or the highest planned
dose level is reached and <2/3 patients at a given dose level
show a CR or PR, then additional patients, to a sample size of 5,
will be treated at the MTD or the highest level. If .gtoreq.2/5
patients show CR or PR, the sample size is expanded to a total of
24 at that dose; if <2/5 show PR or CR, the study is closed.
[0166] 2.9. Dose level of IG.Ad5.CLIP.hIL-3: 1.times.10.sup.8,
5.times.10.sup.8, 1.times.10.sup.9, 5.times.10.sup.9,
1.times.10.sup.10, 5.times.10.sup.11 and 1.times.10.sup.11 vector
particles added to the perfusate used for ILP and perfused for 90
minutes.
[0167] 2.10. Dose escalation plan: Dose escalation will proceed
until 1.times.10.sup.11 particles; if, however, at any dose level
grade 3 or 4 (severe) systemic and/or .gtoreq.grade 4 local adverse
events judged to be probably or definitely related to
IG.Ad5.CLIP.hIL-3 occur in .gtoreq.2/3 patients in the 7 days
following the ILP, then the MTD of IG.Ad5.CLIP.hIL-3 shall be
defined as the dose below the one where these adverse events
occurred.
[0168] 2.11. Safety criteria: Physical examination, vital signs,
laboratory evaluation, adverse events and concomitant medication
usage will assess safety and tolerability. Regional toxicity in the
affected limbs will be graded according to Wieberdink.
[0169] 2.12. Efficacy criteria: Tumor response will be established
at month 3 after the ILP. Complete response (CR) is defined as the
disappearance of all evidence of disease with no new areas of
diseases appearing within the perfusion field. Partial response
(PR) is defined as a greater than 50% decrease in the sum of the
perpendicular diameters of all measurable lesions with no single
lesion increasing in the size and no new lesions appearing in the
perfusion field. No change (NC) is defined as regression of less
than 50% of the sum of diameters or progression of less than 25%
and progressive disease (PD) is defined as greater than 25%
increase in the sum of the diameters. Disease outside the perfused
limb will also be measured and assessed according to standard WHO
criteria.
[0170] 2.13. Follow-up: Patients will have regular clinical and
laboratory examinations during 3 months following the gene therapy
and will then be followed for survival only lifelong.
REFERENCES
[0171] 1. Esandi, M. d. C., van Someren, G. G., Vincent, A. J. P.
E., van Bekkum, D. W., Valerio, D., Bout, A., Noteboom, J. L.
(1997). Treatment of malignant mesothelioma in an immunocompetent
rat model using a recombinant adenovirus expressing the HSV-tk
gene. Gene Therapy 4: 280-287.
[0172] 2. Vincent, A. J. P. E., Esandi, M. d. C., van Someren, G.
D., Noteboom, J. L., Vecht, C. J. J. C., Smitt, P. A. E. S., van
Bekkum, D. W., Valerio, D., Hoogerbrugge, P. M., Bout, A. (1996a).
Treatment of Leptomeningeal metastasis in a rat model using a
recombinant adenovirus containing the HSV-tk gene. J. Neurosurgery
85: 648-654.
[0173] 3. Vincent, A. J. P. E., Vogels, R., van Someren, G.,
Esandi, M. d. C., Noteboom, J. L., Avezaat, C. J. J., Vecht, V. C.,
van Bekkum, D. W., Valerio, D., Bout, A., Hoogerbrugge, P. M.
(1996b). Herpes Simplex Virus Thymidine kinase gene therapy for rat
malignant brain tumors. Human Gene Therapy 7: 197-205.
[0174] 4. Manusama, E. R., Nooijen, P. T. G. A., Stavast, J.,
Durante, N. M. C., Marquet, R. L., Eggermont, A. M. M. (1996).
Synergistic antitumor effect of recombinant human tumor necrosis
factor a with melphalan in isolated limb perfusion in the rat.
British Journal of Surgery 83: 511-555.
[0175] 5. Benckhuijsen, C., van Dijk, W. J., van't Hoff, S. C.
(1982). High-flow isolation perfusion of the rat hind limb in vivo.
Journal of Surgical Oncology 21: 249-257.
[0176] 6. Fortunati, E., Bout, A., Zanta, M. A., Valerio, D.,
Scarpa, N. (1996). In vitro and in vivo gene transfer to pulmonary
cells mediated by cationic liposomes. Biochim. Biophys. Acta. in
press.
[0177] 7. Bout, A., Perricaudet, N., Baskin, G., Imler, J. L.,
Scholte, B. J., Pavirani, A., Valerio, D. (1994). Lung gene
therapy: in vivo adenovirus mediated gene transfer to rhesus monkey
airway epithelum. Human Gene Therapy 5: 3-10.
[0178] 8. Barendsen, G. W., Janse, H. C. Differences in
effectiveness of combined treatments with ionizing radiation and
vinblastine, evaluation for experimental sarcomas and squamous cell
carcinomas in rats. Int. J. Radiat. Oncol. Biol. Phys (1987) 4:
95-102.
[0179] 9. Marquet, R. L., Schellekens, H., Westbroek, D. L.,
Jeekel, J. Effect of treatment with interferon and cyclophosphamide
on the growth of a spontaneous liposarcoma in rats. Int. J. Cancer
(1983) 31: 323-226.
[0180] 10. Kort, W. J., Zondervan, P. E., Hulsman L. O., Weijma, I.
M., Westbroek, D. L. Incidence of spontaneous tumors in a group of
retired breeder female brown norway rats. J. Natl. Cancer Inst
(1984) 72: 709-713.
[0181] 11. Marinelli, A. W. K. S., Van de Velde, C. J. H., Kuppen
P. J. K., Franken, H. C. M., Souverij, J. H. M., Eggermont, A. M.
M. A comparative study of isolated liver perfusion versus hepatic
artery infusion with Mitomycin C in rats. Br. J. Cancer (1990) 62,
891-896.
Sequence CWU 1
1
10 1 27 DNA Unknown Organism Description of Unknown OrganismPRIMER
SV40-1 1 gggggatccg aacttgttta ttgcagc 27 2 25 DNA Unknown Organism
Description of Unknown OrganismPRIMER SV40-2 2 gggagatcta
gacatgataa gatac 25 3 27 DNA Unknown Organism Description of
Unknown OrganismPRIMER AD5-1 3 gggagatctg tactgaaatg tgtgggc 27 4
24 DNA Unknown Organism Description of Unknown OrganismPRIMER AD5-2
4 ggaggctgca gtctccaacg gcgt 24 5 47 DNA Unknown Organism
Description of Unknown OrganismPRIMER LTR-1 5 ctgtacgtac cagtgcactg
gcctaggcat ggaaaaatac ataactg 47 6 64 DNA Unknown Organism
Description of Unknown OrganismPRIMER LTR-2 6 gcggatcctt cgaaccatgg
taagcttggt accgctagcg ttaaccgggc gactcagtca 60 atcg 64 7 28 DNA
Unknown Organism Description of Unknown OrganismPRIMER HSA1 7
gcgccaccat gggcagagcg atggtggc 28 8 50 DNA Unknown Organism
Description of Unknown OrganismPRIMER HSA2 8 gttagatcta agcttgtcga
catcgatcta ctaacagtag agatgtagaa 50 9 34 DNA Unknown Organism
Description of Unknown OrganismPRIMER huIL3-forward 9 ccccaagctt
gccaccatga gccgcctgcc cgtc 34 10 26 DNA Unknown Organism
Description of Unknown OrganismPRIMER hu-IL3-reverse 10 gcgggatcct
caaaagatcg cgaggc 26
* * * * *