U.S. patent application number 15/184966 was filed with the patent office on 2017-01-12 for methods of treating her2-positive cancers using pd-1 axis binding antagonists and anti-her2 antibodies.
This patent application is currently assigned to Genentech, Inc.. The applicant listed for this patent is Genentech, Inc.. Invention is credited to Mark S. DENNIS, Allen EBENS, Bryan IRVING, Teemu T. JUNTTILA, Ji LI.
Application Number | 20170008971 15/184966 |
Document ID | / |
Family ID | 52293262 |
Filed Date | 2017-01-12 |
United States Patent
Application |
20170008971 |
Kind Code |
A1 |
DENNIS; Mark S. ; et
al. |
January 12, 2017 |
METHODS OF TREATING HER2-POSITIVE CANCERS USING PD-1 AXIS BINDING
ANTAGONISTS AND ANTI-HER2 ANTIBODIES
Abstract
The invention provides compositions and methods for treating
HER2-postitive cancers. The method comprising administering a PD-1
axis binding antagonist and an antibody that targets HER2.
Inventors: |
DENNIS; Mark S.; (South San
Francisco, CA) ; EBENS; Allen; (South San Francisco,
CA) ; IRVING; Bryan; (South San Francisco, CA)
; JUNTTILA; Teemu T.; (South San Francisco, CA) ;
LI; Ji; (San Mateo, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Genentech, Inc. |
South San Francisco |
CA |
US |
|
|
Assignee: |
Genentech, Inc.
South San Francisco
CA
|
Family ID: |
52293262 |
Appl. No.: |
15/184966 |
Filed: |
June 16, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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PCT/US2014/070992 |
Dec 17, 2014 |
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15184966 |
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61917264 |
Dec 17, 2013 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
C07K 2317/524 20130101;
A61K 47/643 20170801; C07K 16/30 20130101; C07K 16/3038 20130101;
C07K 2317/94 20130101; C07K 16/32 20130101; A61P 35/00 20180101;
C07K 16/2827 20130101; A61P 37/04 20180101; C07K 2317/76 20130101;
A61K 31/282 20130101; C07K 2317/52 20130101; A61K 39/3955 20130101;
C07K 2317/31 20130101; C07K 2317/41 20130101; C07K 2317/526
20130101; C07K 16/2803 20130101; A61K 45/06 20130101; C07K 2317/73
20130101; C07K 16/3023 20130101; C07K 16/2818 20130101; A61P 43/00
20180101; A61K 31/337 20130101; A61K 39/39558 20130101; A61K
2039/507 20130101; A61K 2039/505 20130101; C07K 16/2809 20130101;
C07K 2317/92 20130101; A61P 37/02 20180101; C07K 16/3015 20130101;
C07K 2317/24 20130101; C07K 16/303 20130101; C07K 16/3069 20130101;
A61K 31/337 20130101; A61K 2300/00 20130101; A61K 39/39558
20130101; A61K 2300/00 20130101 |
International
Class: |
C07K 16/32 20060101
C07K016/32; A61K 39/395 20060101 A61K039/395; A61K 45/06 20060101
A61K045/06; C07K 16/28 20060101 C07K016/28; C07K 16/30 20060101
C07K016/30 |
Claims
1. A method for treating or delaying progression of cancer in an
individual comprising administering to the individual an effective
amount of a human PD-1 axis binding antagonist and an anti-HER2
antibody.
2. The method of claim 1, wherein the PD-1 axis binding antagonist
is selected from the group consisting of a PD-1 binding antagonist,
a PD-L1 binding antagonist and a PD-L2 binding antagonist.
3. The method of claim 2, wherein the PD-1 axis binding antagonist
is a PD-1 binding antagonist.
4. The method of claim 3, wherein the PD-1 binding antagonist
inhibits the binding of PD-1 to its ligand binding partners.
5. The method of claim 4, wherein the PD-1 binding antagonist
inhibits the binding of PD-1 to PD-L1.
6. The method of claim 4, wherein the PD-1 binding antagonist
inhibits the binding of PD-1 to PD-L2.
7. The method of claim 4, wherein the PD-1 binding antagonist
inhibits the binding of PD-1 to both PD-L1 and PD-L2.
8. The method of claim 4, wherein the PD-1 binding antagonist is an
antibody.
9. The method of claim 4, wherein the PD-1 binding antagonist is
selected from the group consisting of MDX-1106 (nivolumab), MK-3475
(lambrolizumab), CT-011 (pidilizumab), and AMP-224.
10. The method of claim 2, wherein the PD-1 axis binding antagonist
is a PD-L1 binding antagonist.
11. The method of claim 10, wherein the PD-L1 binding antagonist
inhibits the binding of PD-L1 to PD-1.
12. The method of claim 10, wherein the PD-L1 binding antagonist
inhibits the binding of PD-L1 to B7-1.
13. The method of claim 10, wherein the PD-L1 binding antagonist
inhibits the binding of PD-L1 to both PD-1 and B7-1.
14. The method of claim 11, wherein the PD-L1 binding antagonist is
an antibody.
15. The method of claim 10, wherein the PD-L1 binding antagonist is
selected from the group consisting of: YW243.55.S70, MPDL3280A,
MDX-1105, and MEDI4736.
16. The method of claim 14, wherein the antibody comprises a heavy
chain comprising HVR-H1 sequence of SEQ ID NO:19, HVR-H2 sequence
of SEQ ID NO:20, and HVR-H3 sequence of SEQ ID NO:21; and a light
chain comprising HVR-L1 sequence of SEQ ID NO:22, HVR-L2 sequence
of SEQ ID NO:23, and HVR-L3 sequence of SEQ ID NO:24.
17. The method of claim 14, wherein the antibody comprises a heavy
chain variable region comprising the amino acid sequence of SEQ ID
NO:25 or 26 and a light chain variable region comprising the amino
acid sequence of SEQ ID NO:4.
18. The method of claim 2, wherein the PD-1 axis binding antagonist
is a PD-L2 binding antagonist.
19. The method of claim 18, wherein the PD-L2 binding antagonist is
an antibody.
20. The method of claim 18, wherein the PD-L2 binding antagonist is
an immunoadhesin.
21. The method of claim 1, wherein the anti-HER2 antibody is
trastuzumab or pertuzumab.
22. The method of claim 1, wherein the anti-HER2 antibody comprises
a heavy chain variable region comprising HVR-H1 sequence of SEQ ID
NO:38, HVR-H2 sequence of SEQ ID NO:50, and HVR-H3 sequence of SEQ
ID NO:40; and/or a light chain variable region comprising HVR-L1
sequence of SEQ ID NO:41, HVR-L2 sequence of SEQ ID NO:42, and
HVR-L3 sequence of SEQ ID NO:43.
23. The method of claim 1, wherein the anti-HER2 antibody comprises
a heavy chain variable region comprising the amino acid sequence of
SEQ ID NO:34 and/or a light chain variable region comprising the
amino acid sequence of SEQ ID NO:35.
24. The method of claim 1, wherein the anti-HER2 antibody is a
multispecific antibody.
25. The method of claim 1, wherein the anti-HER2 antibody is a
bispecific antibody.
26. The method of claim 25, wherein the bispecific antibody
comprises a first antigen binding domain that binds to HER2, and a
second antigen binding domain that binds to CD3.
27. The method of claim 26, wherein the first antigen binding
domain comprises a heavy chain variable region (V.sub.HHER2) and a
light chain variable region (V.sub.LHER2), and the second antigen
binding domain comprises a heavy chain variable region (V.sub.HCD3)
and a light chain variable region (V.sub.LCD3).
28. The method of claim 27, wherein the first antigen binding
domain comprises a heavy chain variable region (V.sub.HHER2)
comprising HVR-H1 sequence of SEQ ID NO:38, HVR-H2 sequence of SEQ
ID NO:50, and HVR-H3 sequence of SEQ ID NO:40; and/or a light chain
variable region (V.sub.LHER2) comprising HVR-L1 sequence of SEQ ID
NO:41, HVR-L2 sequence of SEQ ID NO:42, and HVR-L3 sequence of SEQ
ID NO:43.
29. The method of claim 28, wherein the heavy chain variable region
(V.sub.HHER2) comprises the amino acid sequence of SEQ ID NO:34
and/or a light chain variable region (V.sub.LHER2) comprises the
amino acid sequence of SEQ ID NO:35.
30. The method of claim 26, wherein the second antigen binding
domain binds to a human CD3 polypeptide.
31. The method of claim 30, wherein the CD3 polypeptide is a human
CD3c polypeptide or a human CD3.gamma. polypeptide.
32. The method of claim 31, wherein the second antigen binding
domain binds to a human CD3c polypeptide or a human CD3.gamma.
polypeptide in a native T-cell receptor (TCR) complex in
association with other TCR subunits.
33. The method of claim 25, wherein the bispecific antibody is a
single-chain bispecific antibody comprising the first antigen
binding domain and the second antigen binding domain.
34. The method of claim 33, wherein the single-chain bispecific
antibody comprises variable regions, as arranged from N-terminus to
C-terminus, selected from the group consisting of (1)
V.sub.HHER2-V.sub.LHER2-V.sub.HCD3-V.sub.LCD3, (2)
V.sub.HCD3-V.sub.LCD3-V.sub.HHER2-V.sub.LHER2, (3)
V.sub.HCD3-V.sub.LCD3-V.sub.LHER2-V.sub.HHER2, (4)
V.sub.HHER2-V.sub.LHER2-V.sub.LCD3-V.sub.HCD3, (5)
V.sub.LHER2-V.sub.HHER2-V.sub.HCD3-V.sub.LCD3, or (6)
V.sub.LCD3-V.sub.HCD3-V.sub.HHER2-V.sub.LHER2.
35. The method of claim 25, wherein (a) the first antigen binding
domain comprises one or more heavy chain constant domains, wherein
the one or more heavy chain constant domains are selected from a
first CH1 (CH1.sub.1) domain, a first CH2 (CH2.sub.1) domain, a
first CH3 (CH3.sub.1) domain; and (b) the second antigen binding
domain comprises one or more heavy chain constant domains, wherein
the one or more heavy chain constant domains are selected from a
second CH1 (CH1.sub.2) domain, second CH2 (CH2.sub.2) domain, and a
second CH3 (CH3.sub.2) domain.
36. The method of claim 35, wherein at least one of the one or more
heavy chain constant domains of the first antigen binding domain is
paired with another heavy chain constant domain of the second
antigen binding domain.
37. The method of claim 36, wherein the CH3.sub.1 and CH3.sub.2
domains each comprise a protuberance or cavity, and wherein the
protuberance or cavity in the CH3.sub.1 domain is positionable in
the cavity or protuberance, respectively, in the CH3.sub.2
domain.
38. The method of claim 37, wherein the CH3.sub.1 and CH3.sub.2
domains meet at an interface between said protuberance and
cavity.
39. The method of claim 35, wherein the CH2.sub.1 and CH2.sub.2
domains each comprise a protuberance or cavity, and wherein the
protuberance or cavity in the CH2.sub.1 domain is positionable in
the cavity or protuberance, respectively, in the CH2.sub.2
domain.
40. The method of claim 39, wherein the CH2.sub.1 and CH2.sub.2
domains meet at an interface between said protuberance and
cavity.
41. The method of claim 1, wherein the anti-HER2 antibody comprises
an aglycosylation site mutation.
42. The method of claim 41, wherein the aglycosylation site
mutation is a substitution mutation.
43. The method of claim 42, wherein the substitution mutation is at
amino acid residue N297, L234, L235, and/or D265 (EU
numbering).
44. The method of claim 43, wherein the substitution mutation is
selected from the group consisting of N297G, N297A, L234A, L235A,
and D265A.
45. The method of claim 43, wherein the substitution mutation is a
D265A mutation and an N297G mutation.
46. The method of claim 41, wherein the aglycosylation site
mutation reduces effector function of the anti-HER2 antibody.
47. The method of claim 1, wherein the cancer is a HER2-positive
cancer.
48. The method of claim 47, wherein the cancer is breast cancer,
lung cancer, ovarian cancer, gastric cancer, bladder cancer,
pancreatic cancer, endometrial cancer, colon cancer, kidney cancer,
esophageal cancer, or prostate cancer.
49. The method of claim 1, wherein the individual has cancer or has
been diagnosed with cancer.
50. The method of claim 49, wherein cancer cells in the individual
express PD-L1.
51. The method of claim 49, wherein the individual has cancer that
is resistant to a HER2 targeted therapy.
52. The method of claim 49, wherein the individual is refractory to
a HER2 targeted therapy.
53. The method of claim 51, wherein the HER2 targeted therapy is a
treatment with an anti-HER2 antibody or an inhibitor of the HER2
pathway.
54. The method of claim 53, wherein the HER2 targeted therapy is a
treatment with trastuzumab, pertuzumab, ado-trastuzumab emtansine,
or lapatinib.
55. The method of claim 1, wherein the treatment results in a
sustained response in the individual after cessation of the
treatment.
56. The method of claim 1, wherein the anti-HER2 antibody is
administered before the PD-1 axis binding antagonist, simultaneous
with the PD-1 axis binding antagonist, or after the PD-1 axis
binding antagonist.
57. A method of enhancing immune function in an individual having
cancer comprising administering an effective amount of a PD-1 axis
binding antagonist and an anti-HER2 antibody.
58. The method of claim 57, wherein CD8 T cells in the individual
have enhanced priming, activation, proliferation and/or cytolytic
activity relative to prior to the administration of the PD-1 axis
binding antagonist and the anti-HER2 antibody.
59. The method of claim 57, wherein the number of CD8 T cells is
elevated relative to prior to administration of the
combination.
60. The method of claim 59, wherein the CD8 T cell is an
antigen-specific CD8 T cell.
61. The method of claim 57, wherein Treg function is suppressed
relative to prior to the administration of the combination.
62. The method of claim 57, wherein T cell exhaustion is decreased
relative to prior to the administration of the combination.
63. The method of claim 57, wherein the PD-1 axis binding
antagonist is selected from the group consisting of a PD-1 binding
antagonist, a PD-L1 binding antagonist and a PD-L2 binding
antagonist.
64. The method of claim 63, wherein the PD-1 axis binding
antagonist is a PD-1 binding antagonist.
65-69. (canceled)
70. The method of claim 64, wherein the PD-1 binding antagonist is
selected from the group consisting of MDX-1106 (nivolumab), MK-3475
(lambrolizumab), CT-011 (pidilizumab), and AMP-224.
71. The method of claim 63, wherein the PD-1 axis binding
antagonist is a PD-L1 binding antagonist.
72-74. (canceled)
75. The method of claim 71, wherein the PD-L1 binding antagonist is
an antibody.
76. The method of claim 71, wherein the PD-L1 binding antagonist is
selected from the group consisting of: YW243.55.S70, MPDL3280A,
MDX-1105, and MEDI4736.
77. (canceled)
78. (canceled)
79. The method of claim 63, wherein the PD-1 axis binding
antagonist is a PD-L2 binding antagonist.
80. (canceled)
81. (canceled)
82. The method of claim 57, wherein the anti-HER2 antibody is
trastuzumab or pertuzumab.
83. (canceled)
84. (canceled)
85. The method of claim 57, wherein the anti-HER2 antibody is a
multispecific antibody.
86. The method of claim 57, wherein the anti-HER2 antibody is a
bispecific antibody.
87-90. (canceled)
91. The method of claim 86, wherein the bispecific antibody
comprises a first antigen binding domain that binds to HER2, and a
second antigen binding domain that binds to CD3, and wherein the
second antigen binding domain binds to a human CD3 polypeptide.
92-101. (canceled)
102. The method of claim 57, wherein the anti-HER2 antibody
comprises an aglycosylation site mutation.
103. The method of claim 102, wherein the aglycosylation site
mutation is a substitution mutation.
104. The method of claim 103, wherein the substitution mutation is
at amino acid residue N297, L234, L235, and/or D265 (EU
numbering).
105-108. (canceled)
109. The method of claim 57, wherein the cancer is breast cancer,
lung cancer, ovarian cancer, gastric cancer, bladder cancer,
pancreatic cancer, endometrial cancer, colon cancer, kidney cancer,
esophageal cancer, or prostate cancer.
110. (canceled)
111. The method of claim 57, wherein the individual has cancer that
is resistant to a HER2 targeted therapy.
112. The method of claim 57, wherein the individual is refractory
to a HER2 targeted therapy.
113. The method of claim 111, wherein the HER2 targeted therapy is
a treatment with an anti-HER2 antibody or an inhibitor of the HER2
pathway.
114. The method of claim 113, wherein the HER2 targeted therapy is
a treatment with trastuzumab, pertuzumab, ado-trastuzumab
emtansine, or lapatinib.
115. (canceled)
116. The method of claim 1, further comprising administering a
chemotherapeutic agent for treating or delaying progression of
cancer.
117-120. (canceled)
121. A kit comprising a medicament comprising a PD-1 axis binding
antagonist and an optional pharmaceutically acceptable carrier, and
a package insert comprising instructions for administration of the
medicament in combination with a composition comprising an
anti-HER2 antibody and an optional pharmaceutically acceptable
carrier for treating or delaying progression of cancer in an
individual.
122. (canceled)
123. (canceled)
124. A kit comprising a medicament comprising an anti-HER2 antibody
and an optional pharmaceutically acceptable carrier, and a package
insert comprising instructions for administration of the medicament
in combination with a composition comprising a PD-1 axis binding
antagonist and an optional pharmaceutically acceptable carrier for
treating or delaying progression of cancer in an individual.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the priority benefit of U.S.
Provisional Application No. 61/917,264, filed Dec. 17, 2013, which
is hereby incorporated by reference in its entirety.
SUBMISSION OF SEQUENCE LISTING ON ASCII TEXT FILE
[0002] The content of the following submission on ASCII text file
is incorporated herein by reference in its entirety: a computer
readable form (CRF) of the Sequence Listing (file name:
146392022840 SeqList.txt, date recorded: Dec. 16, 2014, size: 37
KB).
FIELD OF THE INVENTION
[0003] This invention relates to methods of treating HER2-positive
cancers by administering a PD-1 axis binding antagonist and an
anti-HER2 antibody.
BACKGROUND OF THE INVENTION
[0004] The provision of two distinct signals to T-cells is a widely
accepted model for lymphocyte activation of resting T lymphocytes
by antigen-presenting cells (APCs). Lafferty et al, Aust. J. Exp.
Biol. Med. Sci 53: 27-42 (1975). This model further provides for
the discrimination of self from non-self and immune tolerance.
Bretscher et al, Science 169: 1042-1049 (1970); Bretscher, P. A.,
Proc. Nat. Acad. Sci. USA 96: 185-190 (1999); Jenkins et al, J.
Exp. Med. 165: 302-319 (1987). The primary signal, or antigen
specific signal, is transduced through the T-cell receptor (TCR)
following recognition of foreign antigen peptide presented in the
context of the major histocompatibility-complex (MHC). The second
or co-stimulatory signal is delivered to T-cells by co-stimulatory
molecules expressed on antigen-presenting cells (APCs), inducing
T-cells to promote clonal expansion, cytokine secretion and
effector function. Lenschow et al., Ann Rev. Immunol. 14:233
(1996). In the absence of co-stimulation, T-cells can become
refractory to antigen stimulation, do not mount an effective immune
response, and further may result in exhaustion or tolerance to
foreign antigens.
[0005] In the two-signal model T-cells receive both positive and
negative secondary co-stimulatory signals. The regulation of such
positive and negative signals is critical to maximize the host's
protective immune responses, while maintaining immune tolerance and
preventing autoimmunity. Negative secondary signals seem necessary
for induction of T-cell tolerance, while positive signals promote
T-cell activation. While the simple two-signal model still provides
a valid explanation for naive lymphocytes, a host's immune response
is a dynamic process, and co-stimulatory signals can also be
provided to antigen-exposed T-cells. The mechanism of
co-stimulation is of therapeutic interest because the manipulation
of co-stimulatory signals has shown to provide a means to either
enhance or terminate cell-based immune response. Recently, it has
been discovered that T cell dysfunction or anergy occurs
concurrently with an induced and sustained expression of the
inhibitory receptor, programmed death 1 polypeptide (PD-1). As a
result, therapeutic targeting of PD-1 and other molecules which
signal through interactions with PD-1, such as programmed death
ligand 1 (PD-L1) and programmed death ligand 2 (PD-L2) are an area
of intense interest.
[0006] PD-L1 is overexpressed in many cancers and is often
associated with poor prognosis (Okazaki T et al., Intern. Immun
2007 19(7):813) (Thompson R H et al., Cancer Res 2006, 66(7):3381).
Interestingly, the majority of tumor infiltrating T lymphocytes
predominantly express PD-1, in contrast to T lymphocytes in normal
tissues and peripheral blood T lymphocytes indicating that
up-regulation of PD-1 on tumor-reactive T cells can contribute to
impaired antitumor immune responses (Blood 2009 114(8):1537). This
may be due to exploitation of PD-L1 signaling mediated by PD-L1
expressing tumor cells interacting with PD-1 expressing T cells to
result in attenuation of T cell activation and evasion of immune
surveillance (Sharpe et al., Nat Rev 2002) (Keir M E et al., 2008
Annu. Rev. Immunol. 26:677). Therefore, inhibition of the
PD-L1/PD-1 interaction may enhance CD8+ T cell-mediated killing of
tumors.
[0007] Therapeutic targeting PD-1 and other molecules which signal
through interactions with PD-1, such as programmed death ligand 1
(PD-L1) and programmed death ligand 2 (PD-L2) are an area of
intense interest. The inhibition of PD-L1 signaling has been
proposed as a means to enhance T cell immunity for the treatment of
cancer (e.g., tumor immunity) and infection, including both acute
and chronic (e.g., persistent) infection. An optimal therapeutic
treatment may combine blockade of PD-1 receptor/ligand interaction
with an agent that directly inhibits tumor growth. There remains a
need for an optimal therapy for treating, stabilizing, preventing,
and/or delaying development of various cancers.
[0008] All references cited herein, including patent applications,
patent publications, and UniProtKB/Swiss-Prot Accession numbers are
herein incorporated by reference in their entirety, as if each
individual reference were specifically and individually indicated
to be incorporated by reference.
SUMMARY OF THE INVENTION
[0009] In one aspect, provided herein is a method for treating or
delaying progression of cancer in an individual comprising
administering to the individual an effective amount of a human PD-1
axis binding antagonist and an anti-HER2 antibody.
[0010] In another aspect, provided herein is a method of enhancing
immune function in an individual having cancer comprising
administering an effective amount of a PD-1 axis binding antagonist
and an anti-HER2 antibody.
[0011] In another aspect, provided herein is use of a human PD-1
axis binding antagonist in the manufacture of a medicament for
treating or delaying progression of cancer in an individual,
wherein the medicament comprises the human PD-1 axis binding
antagonist and an optional pharmaceutically acceptable carrier, and
wherein the treatment comprises administration of the medicament in
combination with a composition comprising an anti-HER2 antibody and
an optional pharmaceutically acceptable carrier.
[0012] In another aspect, provided herein is use of an anti-HER2
antibody in the manufacture of a medicament for treating or
delaying progression of cancer in an individual, wherein the
medicament comprises the anti-HER2 antibody and an optional
pharmaceutically acceptable carrier, and wherein the treatment
comprises administration of the medicament in combination with a
composition comprising a human PD-1 axis binding antagonist and an
optional pharmaceutically acceptable carrier.
[0013] In another aspect, provided herein is a composition
comprising a human PD-1 axis binding antagonist and an optional
pharmaceutically acceptable carrier for use in treating or delaying
progression of cancer in an individual, wherein the treatment
comprises administration of said composition in combination with a
second composition, wherein the second composition comprises an
anti-HER2 antibody and an optional pharmaceutically acceptable
carrier.
[0014] In another aspect, provided herein is a composition
comprising an anti-HER2 antibody and an optional pharmaceutically
acceptable carrier for use in treating or delaying progression of
cancer in an individual, wherein the treatment comprises
administration of said composition in combination with a second
composition, wherein the second composition comprises a human PD-1
axis binding antagonist and an optional pharmaceutically acceptable
carrier.
[0015] In another aspect, provided herein is a kit comprising a
medicament comprising a PD-1 axis binding antagonist and an
optional pharmaceutically acceptable carrier, and a package insert
comprising instructions for administration of the medicament in
combination with a composition comprising an anti-HER2 antibody and
an optional pharmaceutically acceptable carrier for treating or
delaying progression of cancer in an individual.
[0016] In another aspect, provided herein is a kit comprising a
first medicament comprising a PD-1 axis binding antagonist and an
optional pharmaceutically acceptable carrier, and a second
medicament comprising an anti-HER2 antibody and an optional
pharmaceutically acceptable carrier. In some embodiments, the kit
further comprises a package insert comprising instructions for
administration of the first medicament and the second medicament
for treating or delaying progression of cancer in an
individual.
[0017] In another aspect, provided herein is a kit comprising a
medicament comprising an anti-HER2 antibody and an optional
pharmaceutically acceptable carrier, and a package insert
comprising instructions for administration of the medicament in
combination with a composition comprising a PD-1 axis binding
antagonist and an optional pharmaceutically acceptable carrier for
treating or delaying progression of cancer in an individual.
[0018] In some embodiments of the methods, uses, compositions, and
kits described above and herein, the PD-1 axis binding antagonist
is selected from the group consisting of a PD-1 binding antagonist,
a PD-L1 binding antagonist and a PD-L2 binding antagonist. In some
embodiments, the PD-1 axis binding antagonist is an antibody. In
some embodiments, the antibody is a humanized antibody, a chimeric
antibody or a human antibody. In some embodiments, the antibody is
an antigen binding fragment. In some embodiments, the
antigen-binding fragment is selected from the group consisting of
Fab, Fab', F(ab').sub.2, and Fv.
[0019] In some embodiments, the PD-1 axis binding antagonist is a
PD-1 binding antagonist. In some embodiments, the PD-1 binding
antagonist inhibits the binding of PD-1 to its ligand binding
partners. In some embodiments, the PD-1 binding antagonist inhibits
the binding of PD-1 to PD-L1. In some embodiments, the PD-1 binding
antagonist inhibits the binding of PD-1 to PD-L2. In some
embodiments, the PD-1 binding antagonist inhibits the binding of
PD-1 to both PD-L1 and PD-L2. In some embodiments, the PD-1 binding
antagonist is an antibody. In some embodiments, the PD-1 binding
antagonist is selected from the group consisting of MDX-1106
(nivolumab), MK-3475 (pembrolizumab, lambrolizumab), CT-011
(pidilizumab), and AMP-224.
[0020] In some embodiments, the PD-1 axis binding antagonist is a
PD-L1 binding antagonist. In some embodiments, the PD-L1 binding
antagonist inhibits the binding of PD-L1 to PD-1. In some
embodiments, the PD-L1 binding antagonist inhibits the binding of
PD-L1 to B7-1. In some embodiments, the PD-L1 binding antagonist
inhibits the binding of PD-L1 to both PD-1 and B7-1. In some
embodiments, the PD-L1 binding antagonist is an antibody. In some
embodiments, the PD-L1 binding antagonist is selected from the
group consisting of: Y17%1243.55.870, MPDL3280A, MDX-1105, and
MEDI4736. In some embodiments, the anti-PD-L1 antibody comprises a
heavy chain comprising HVR-H1 sequence of SEQ ID NO:19, HVR-H2
sequence of SEQ ID NO:20, and HVR-H3 sequence of SEQ ID NO:21;
and/or a light chain comprising HVR-L1 sequence of SEQ ID NO:22,
HVR-L2 sequence of SEQ ID NO:23, and HVR-L3 sequence of SEQ ID
NO:24. In some embodiment, the anti-PD-L1 antibody comprises a
heavy chain variable region comprising the amino acid sequence of
SEQ ID NO:25 or 26 and/or a light chain variable region comprising
the amino acid sequence of SEQ ID NO:4. In some embodiments, the
anti-PD-L1 antibody comprises the three heavy chain HVR sequences
of antibody YW243.55.570 and/or the three light chain HVR sequences
of antibody YW24355.570 described in WO 2010/077634 and U.S. Pat.
No. 8,217,149, which are incorporated herein by reference. In some
embodiments, the anti-PD-L1 antibody comprises the heavy chain
variable region sequence of antibody YW243.55.570 and/or the light
chain variable region sequence of antibody YW24355.570.
[0021] In some embodiments, the PD-1 axis binding antagonist is a
PD-L2 binding antagonist. In some embodiments, the PD-L2 binding
antagonist is an antibody. In some embodiments, the PD-L2 binding
antagonist is an immunoadhesin.
[0022] In some embodiments of the methods, uses, compositions, and
kits described above and herein, the anti-HER2 antibody is
trastuzumab (HERCEPTIN.RTM., Genentech) or pertuzumab
(PERJETA.RTM., Genentech). In some embodiments, the anti-HER2
antibody comprises a heavy chain comprising HVR-H1 sequence of SEQ
ID NO:38, HVR-H2 sequence of SEQ ID NO:50, and HVR-H3 sequence of
SEQ ID NO:40; and/or a light chain comprising HVR-L1 sequence of
SEQ ID NO:41, HVR-L2 sequence of SEQ ID NO:42, and HVR-L3 sequence
of SEQ ID NO:43. In some embodiments, the anti-HER2 antibody
comprises a heavy chain variable region comprising the amino acid
sequence of SEQ ID NO:34 and/or a light chain variable region
comprising the amino acid sequence of SEQ ID NO:35. In some
embodiments, the anti-HER2 antibody comprises a heavy chain
comprising the amino acid sequence of SEQ ID NO:36 and/or a light
chain comprising the amino acid sequence of SEQ ID NO:37. In some
embodiments that can be combined with any other embodiments, the
anti-HER2 antibody is not trastuzumab or pertuzumab.
[0023] In some embodiments of the methods, uses, compositions, and
kits described above and herein, the anti-HER2 antibody is a
multispecific antibody. In some embodiments, the anti-HER2 antibody
is a bispecific antibody. In some embodiments, the bispecific
antibody comprises a first antigen binding domain that binds to
HER2, and a second antigen binding domain that binds to CD3. In
some embodiments, the second antigen binding domain binds to a
human CD3 polypeptide. In some embodiments, the CD3 polypeptide is
a human CD3.epsilon. polypeptide or a human CD3.gamma. polypeptide.
In some embodiments, the second antigen binding domain binds to a
human CD3.epsilon. polypeptide or a human CD3.gamma. polypeptide in
native T-cell receptor (TCR) complex in association with other TCR
subunits. In some embodiments, the first antigen binding domain
comprises a heavy chain variable region (V.sub.HHER2) and a light
chain variable region (V.sub.LHER2), and the second antigen binding
domain comprises a heavy chain variable region (V.sub.HCD3) and a
light chain variable region (V.sub.LCD3). In some embodiments, the
first antigen binding domain comprises a heavy chain variable
region (V.sub.HHER2) comprising HVR-H1 sequence of SEQ ID NO:38,
HVR-H2 sequence of SEQ ID NO:50, and HVR-H3 sequence of SEQ ID
NO:40; and/or a light chain variable region (V.sub.LHER2)
comprising HVR-L1 sequence of SEQ ID NO:41, HVR-L2 sequence of SEQ
ID NO:42, and HVR-L3 sequence of SEQ ID NO:43. In some embodiment,
the first antigen binding domain comprises a heavy chain variable
region (V.sub.HHER2) comprising the amino acid sequence of SEQ ID
NO:34 and/or a light chain variable region (V.sub.LHER2) comprising
the amino acid sequence of SEQ ID NO:35. In some embodiments, the
bispecific antibody is a single-chain bispecific antibody
comprising the first antigen binding domain and the second antigen
binding domain. In some embodiments, the single-chain bispecific
antibody comprises variable regions, as arranged from N-terminus to
C-terminus, selected from the group consisting of (1)
V.sub.HHER2-V.sub.LHER2-V.sub.HCD3-V.sub.LCD3, (2)
V.sub.HCD3-V.sub.LCD3-V.sub.HHER2-V.sub.LHER2, (3)
V.sub.HCD3-V.sub.LCD3-V.sub.LHER2-V.sub.HHER2, (4)
V.sub.HHER2-V.sub.LHER2-V.sub.LCD3-V.sub.HCD3, (5)
V.sub.LHER2-V.sub.HHER2-V.sub.HCD3-V.sub.LCD3, or (6)
V.sub.LCD3-V.sub.HCD3-V.sub.HHER2-V.sub.LHER2.
[0024] In some embodiments, the bispecific antibody comprises a
first antigen binding domain that binds to HER2 and a second
antigen binding domain that binds to CD3, wherein the first antigen
binding domain comprises one or more heavy chain constant domains,
wherein the one or more heavy chain constant domains are selected
from a first CH1 (CH1.sub.1) domain, a first CH2 (CH2.sub.1)
domain, a first CH3 (CH3.sub.1) domain; and wherein the second
antigen binding domain comprises one or more heavy chain constant
domains, wherein the one or more heavy chain constant domains are
selected from a second CH1 (CH1.sub.2) domain, second CH2
(CH2.sub.2) domain, and a second CH3 (CH3.sub.2) domain. In some
embodiments, at least one of the one or more heavy chain constant
domains of the first antigen binding domain is paired with another
heavy chain constant domain of the second antigen binding domain.
In some embodiments, the CH3.sub.1 and CH3.sub.2 domains each
comprise a protuberance or cavity, and wherein the protuberance or
cavity in the CH3.sub.1 domain is positionable in the cavity or
protuberance, respectively, in the CH3.sub.2 domain. In some
embodiments, the CH3.sub.1 and CH3.sub.2 domains meet at an
interface between said protuberance and cavity. In some
embodiments, the CH2.sub.1 and CH2.sub.2 domains each comprise a
protuberance or cavity, and wherein the protuberance or cavity in
the CH2.sub.1 domain is positionable in the cavity or protuberance,
respectively, in the CH2.sub.2 domain. In some embodiments, the
CH2.sub.1 and CH2.sub.2 domains meet at an interface between said
protuberance and cavity.
[0025] In some embodiments, the antibody described herein (e.g., a
PD-1 axis binding antagonist antibody, an anti-HER2 antibody, or a
bispecific antibody that binds to HER2 and a CD3) comprises an
aglycosylation site mutation. In some embodiments, the
aglycosylation site mutation is a substitution mutation. In some
embodiments, the substitution mutation is at amino acid residue
N297, L234, L235, and/or D265 (EU numbering). In some embodiments,
the substitution mutation is selected from the group consisting of
N297G, N297A, L234A, L235A, and D265A. In some embodiments, the
substitution mutation is a D265A mutation and an N297G mutation. In
some embodiments, the aglycosylation site mutation reduces effector
function of the antibody. In some embodiments, the PD-1 axis
binding antagonist (e.g., an anti-PD-1 antibody, an anti-PD-L1
antibody, or an anti-PD-L2 antibody) is a human IgG1 having Asn to
Ala substitution at position 297 according to EU numbering.
[0026] In some embodiments of the methods, uses, compositions and
kits described above and herein, the cancer is a HER2-positive
cancer. In some embodiments, the cancer is breast cancer, lung
cancer, ovarian cancer, gastric cancer, bladder cancer, pancreatic
cancer, endometrial cancer, colon cancer, kidney cancer, esophageal
cancer, prostate cancer, or other cancers described herein. In some
embodiments, the individual has cancer or has been diagnosed with
cancer. In some embodiments, the cancer cells in the individual
express PD-L1. In some embodiments, the individual has cancer that
is resistant to a HER2 targeted therapy. In some embodiments, the
individual is refractory to a HER2 targeted therapy. In some
embodiments, the HER2 targeted therapy is a treatment with an
anti-HER2 antibody or an inhibitor of the HER2 pathway. In some
embodiments, the HER2 targeted therapy is a treatment with
trastuzumab (HERCEPTIN.RTM., Genentech), pertuzumab (PERJETA.RTM.,
Genentech), ado-trastuzumab emtansine (KADCYLA.RTM., Genentech), or
lapatinib.
[0027] In some embodiments of the methods, uses, compositions, and
kits described above and herein, the treatment or administration of
the human PD-1 axis binding antagonist and the anti-HER2 antibody
results in a sustained response in the individual after cessation
of the treatment. In some embodiments, the anti-HER2 antibody is
administered before the PD-1 axis binding antagonist, simultaneous
with the PD-1 axis binding antagonist, or after the PD-1 axis
binding antagonist. In some embodiments, the PD-1 axis binding
antagonist and the anti-HER2 antibody are in the same composition.
In some embodiments, the PD-1 axis binding antagonist and the
anti-HER2 antibody are in separate compositions.
[0028] In some embodiments of the methods, uses, compositions, and
kits described above and herein, the PD-1 axis binding antagonist
and/or the anti-HER2 antibody is administered intravenously,
intramuscularly, subcutaneously, topically, orally, transdermally,
intraperitoneally, intraorbitally, by implantation, by inhalation,
intrathecally, intraventricularly, or intranasally. In some
embodiments of the methods, uses, compositions, and kits described
above and herein, the treatment further comprises administering a
chemotherapeutic agent for treating or delaying progression of
cancer in an individual. In some embodiments, the individual has
been treated with a chemotherapeutic agent before the combination
treatment with the PD-1 axis binding antagonist and the anti-HER2
antibody. In some embodiments, the individual treated with the
combination of the PD-1 axis binding antagonist and/or the
anti-HER2 antibody is refractory to a chemotherapeutic agent
treatment. Some embodiments of the methods, uses, compositions, and
kits described throughout the application, further comprise
administering a chemotherapeutic agent for treating or delaying
progression of cancer.
[0029] In some embodiments of the methods, uses, compositions and
kits described above and herein, CD8 T cells in the individual have
enhanced priming, activation, proliferation and/or cytolytic
activity relative to prior to the administration of the
combination. In some embodiments, the number of CD8 T cells is
elevated relative to prior to administration of the combination. In
some embodiments, the CD8 T cell is an antigen-specific CD8 T cell.
In some embodiments, Treg function is suppressed relative to prior
to the administration of the combination. In some embodiments, T
cell exhaustion is decreased relative to prior to the
administration of the combination.
[0030] It is to be understood that one, some, or all of the
properties of the various embodiments described herein may be
combined to form other embodiments of the present invention. These
and other aspects of the invention will become apparent to one of
skill in the art. These and other embodiments of the invention are
further described by the detailed description that follows.
BRIEF DESCRIPTION OF THE DRAWINGS
[0031] FIGS. 1A-1G show the generation of a full length HER2-CD3
bispecific antibody using knobs-into-holes technology and T cell
independent properties of HER2-TDB. (FIG. 1A) Amino acid
substitutions were generated to C.sub.H3 domains of the `knob`
(.alpha.-HER2 4D5) and `hole` (.alpha.-CD3 UCHT1.v9) heavy chains,
which selectively promote heterodimerization to generate bispecific
full length IgG1. (FIG. 1B) Overview of the TDB purification.
ProA=Protein A affinity purification, HIC=hydrophobic interaction
chromatography, QC=quality control, SEC=size exclusion
chromatography. (FIG. 1C) Size exclusion chromatography
demonstrated low levels of aggregate or single arms. (FIG. 1D) MS
analysis indicated undetectable levels of homodimeric species.
(FIG. 1E) Binding to SKBR-3 was determined by competition binding
of .sup.125I-trastuzumab Fab with non-labeled trastuzumab (black),
trastuzumab-fab (blue) or bispecific HER2-TDB (red). Data points
shown represent the mean of 3 measurements. (FIG. 1F) Direct effect
on proliferation of SKBR-3 cells was analyzed after 6 days of
treatment with antibodies using CellTiter-Glo.RTM. Luminescent Cell
Viability Assay. Data points shown represent the mean of 3
measurements. (FIG. 1G) The ability of trastuzumab, trastuzumab
produced in E. coli, and HER2-TDB to mediate in vitro ADCC by NK
cells was measured using assay detecting LDH released from lysed
cells. Timepoint 4 h. Error bars=S.D.
[0032] FIGS. 2A-2F show that target dependent T cell mediated
cytotoxicity of HER2-TDB. (FIG. 2A) T cell activation was detected
by staining cells for CD8/CD69/Granzyme B followed by FACS
analysis. Effectors CD8+ T cells, target SKBR-3, E:T ratio 3:1,
time point 48 h. Data presented as mean of two repeats. (FIG. 2B)
Soluble granzymes and perforin were detected from the media using
ELISA and cytotoxicity using LDH release assay. Effectors PBMC,
target SKBR-3, E:T ratio 30:1, time point 18 h, ABs 10 ng/ml. (FIG.
2C) Elevated caspase activity (Caspase 3/7 glo assay) and apoptosis
(Cell Death Detection ELISAs assay) corresponded with LDH-release
after treatment with 1 ng/ml bispecific antibody. Effectors PBMC,
targets SKBR-3, E:T ratio 10:1, time point 24 h. Error bar=S.D. in
panels C-F. (FIG. 2D) The ability of HER2-TDB to induce killing of
HER2 (red) or vector-transfected (blue) 3T3 was measured using an
LDH release assay. Effectors PBMC, E:T ratio 10:1, time point 19 h.
(FIG. 2E) Blocking HER2-arm binding using trastuzumab Fab (1
.mu.g/ml, black) or soluble HER2 extracellular domain (1 .mu.g/ml,
blue) efficiently inhibited cytotoxic activity of HER2-TDB.
Effectors CD8+ T cells, target BT474, E:T ratio 5:1, time point 24
h. Cytotoxicity was detected using an LDH release assay. (FIG. 2F)
Killing activity of PBMC was compared before and after depletion of
CD3 positive cells with CD3 MicroBeads. Target SKBR3, E:T ratio
20:1, time point 19 h. Cytotoxicity was detected using FACS
assay.
[0033] FIGS. 3A & 3B show the characteristics of T cell
activation and killing induced by HER2-TDB. (FIG. 3A) T cell
activation was detected at various timepoints by staining cells for
CD8, CD69, and CD107a followed by FACS analysis. T cell activation
data presented as mean of two repeats. Effectors CD8+ T cells,
target SKBR-3, E:T ratio 3:1. Cytotoxicity was detected using FACS
assay. Effectors CD8+, target SKBR-3, E:T ratio 3:1, Error bar=S.D.
in all panels. (FIG. 3B) Cytotoxicity was detected using LDH
release assay. Effectors CD8+ T cells, target BT474, E:T ratio
indicated in the figure, time point 19 h. T cell activation was
measured as in panel A.
[0034] FIGS. 4A-4C demonstrate that activation of T cells by
HER2-TDB induces T cell proliferation. (FIG. 4A) Proliferation of T
cells was measured at day 3 as dilution of CFSE in CD8+/PI- cells
with cell divisions. (FIGS. 4B-4C) HER2-TDB induced T cell
expansion. Purified CD8+ T cells were labeled with CFSE according
to manufacturer's protocol (Invitrogen, #C34554). CFSE-labeled CD8+
T cells were incubated with target cells in the presence or absence
of TDB for 19 hours. T cells were collected, washed and cultured
for 2-7 days (RPMI+10% FBS, +/-20 ng/ml IL2). Live CD8+ cell number
(CD8+/PI-) and the percentage of CFSE.sub.dim cells was detected by
FACS.
[0035] FIGS. 5A-5E demonstrate that HER2-TDB activity correlates
with the target cell HER2 expression level. (FIG. 5A) HER2-levels
in different cancer cells were detected by Western blot. (FIG. 5B)
Cytotoxicity was detected using LDH release assay. Effectors PBMCs,
E:T 25:1, time point 26 h. (FIG. 5C) MCF-7 cells were labeled with
CFSE and mixed with SKBR3 and PBMC (E:T 20:1) followed by 19 h
treatment with HER2-TDB. Cells were stained with anti-HER2 APC and
PI. The number of living SKBR3 (HER2 high, PI-) and MCF7 (CFSE+.
PI-) cells were analyzed by FACS and normalized to fluorescent
beads. (FIG. 5D) BJAB cells were labeled with CFSE and mixed with
SKBR3 and PBMCs (E:T 20:1) followed by 19 h treatment with
HER2-TDB. Cells were stained with anti-HER2 APC and PI. The number
of living SKBR3 (HER2 high, PI-) and BJAB (CFSE+PI-) cells was
normalized to fluorescent beads. (FIG. 5E) HER2 copy number was
previously reported (Aguilar et al., Oncogene, 18:6050-62, 1999).
EC.sub.50 values were calculated from dose response data in FIG.
6B. Calculation of HER2 occupancy is described in text.
[0036] FIGS. 6A-6C show the efficient killing of HER2+ cancer cells
refractory to anti-HER2 therapies and regardless of tissue type,
PI3K pathway mutation status, or sensitivity to trastuzumab or
lapatinib. (FIG. 6A) Cytotoxicity against various cell lines was
detected using LDH release assay. Effectors PBMC, E:T 10:1, time
point 19 h. (FIG. 6B) Parental and T-DM1 resistant BT474-M1 clones
were treated with T-DM1 for 3 days. Cell viability was measured
using Cell titer Glo. (FIG. 6C) Parental and T-DM1 resistant
BT474-M1 clones were treated with HER2-TDB. Cytotoxicity was
detected using FACS assay. Effectors CD8+ T cells, E:T ratio 3:1,
time point 24 h. Error bar=S.D.
[0037] FIG. 7 shows the pharmacokinetic profile of HER2-TDB. Single
intravenous doses of 10 mg/kg trastuzumab (open symbols) or
HER2-TDB (black symbols) were injected into Sprague-Dawley Rats.
Serum samples were assayed for test agent by ELISA. Mean+/-SD.
HER2-TDB N=4, trastuzumab N=3.
[0038] FIGS. 8A-8G demonstrate that HER2-TDB inhibits growth of
HER2+ tumors. (FIG. 8A) In vivo efficacy of HER2-TDB was tested in
NOD-SCID mice. 5.times.10.sup.6 MCF7-neo/HER2 cells were injected
together with 1.times.10.sup.7 unstimulated human PBMC from two
healthy donors (PBMC 1, 2). Mice (N=5-10) were treated with 0.5
mg/kg i.v. doses of HER2-TDB on days 0, 7 and 14. Tumor volumes
from individual mice and fitted tumor volumes of treatment groups
are presented; mice terminated prior to study end are shown as red
traces whereas mice remaining on study to study end are shown as
grey traces. Fitted tumor volume for each treatment group are shown
as a solid black line with fitted tumor volume for comparator
control group are shown as a dashed blue line. (FIG. 8B)
MMTV-huHER2 transgenic animals with established mammary tumors were
treated with 0.5 mpk 4D5/2C11-TDB (red; mCD3 reactive 2C11
surrogate arm; qwk.times.5, IV, starting on day 0) or vehicle
(black). (FIG. 8C) Progression of MMTV-huHER2 transgenic tumors and
maximum percentage of tumor shrinkage by HER2-TDB treatment are
shown. (FIG. 8D) 4D5/2C11-TDB (0.5 mpk, qwk.times.5, IV, starting
on day 0) is effective in treatment of large (>1000 mm.sup.3)
MMTV-huHER2 transgenic tumors. (FIG. 8E) Growth of MMTV-huHER2
transgenic tumors was not affected by control TDBs in which the CD3
arm was switched to human CD3 specific (4D5/SP34-TDB; blue), or in
which the target arm was switched to irrelevant (CTRL/2C11-TDB;
grey). (FIG. 8F) In vivo efficacy of HER2-TDB in huCD3 transgenic
mice. Established CT26-HER2 tumors were treated with vehicle or
with 0.5 mg/kg HER2-TDB (4D5/SP34-TDB) qwk.times.3, IV, starting on
day 0. (FIG. 8G) In vivo efficacy of HER2-TDB with mCD3 reactive
2C11 surrogate arm (4D5/2C11-TDB) was tested in Balb/c mice. Dosing
was administered as described above. 15 mg/kg TDM-1 was dosed
qwk.times.3, IV. Control TDB is 2C11 paired with irrelevant target
arm.
[0039] FIGS. 9A & 9B show that CD3-TG T cells express both
mouse and human CD3 at approximately 50% of the level of respective
Balb/c mouse or human T cells. (FIGS. 9A & 9B) T cells were
extracted from spleens of CD3-TG (diamonds), BALB/c mice (squares)
or from peripheral blood from healthy human donors (circles) and
stained with mouse or human CD8 and either human CD3 (clone UCHT1;
FIG. 9A) or mouse CD3 (clone 2C11; FIG. 9B). The figure is gated on
CD8+ cells.
[0040] FIGS. 10A & 10B show TDB mediated killing by CD3-TG
splenic T cells. (FIGS. 10A & 10B) T cells were extracted from
spleens of CD3-TG (diamonds), BALB/c mice (squares) or from
peripheral blood from healthy human donors (circles). In vitro
killing activity of CT26-HER2 cells was tested using human
CD3-specific (UCHT1.v9) HER2-TDB (FIG. 10A) or mouse CD3-specific
(2C11) HER2-TDB (FIG. 10B). E:T=20:1 Assay time: 40 hours. In vitro
cytotoxicity was monitored by flow cytometry.
[0041] FIG. 11 demonstrates that the anti-tumor activity of
HER2-TDB is T cell dependent. 0.1 million CT26-HER2 antibodies were
injected subcutaneously into BALB/c mice. Mice with established
tumors were treated with vehicle or human CD3-specific HER2-TDB
(0.5 mg/kg, qwx3, IV, n=10).
[0042] FIG. 12 shows that T cells in CT26-HER2 tumors display the
CD69 activation marker. 0.1 million CT26-HER2 were injected
subcutaneously into BALB/c mice. Mice with established tumors were
treated with vehicle, human CD3-specific HER2-TDB, or a CTRL-TDB
with irrelevant target arm (0.5 mg/kg, qwx3, IV). Tumors were
harvested 11-35 days after cell injection. Tissues were cut into
small pieces and transferred into gentleMACS.TM. C-tubes (Miltenyi,
#130-093-237). Samples were digested with Collagenase D (1 mg/ml)
and DNase I (0.2 mg/ml) in rotating incubator for 15 minutes then
dissociated to achieve single cell suspension. After anti-CD16/CD32
FcR blocking, cells were stained with the cocktails of surface
markers (N=2/group, NT=non treated).
[0043] FIG. 13 shows the expression of PD-1 and PD-L1 by CT-26-HER2
tumor-infiltrating T cells and CT-26-HER2 tumor cells,
respectively. (A) FACS analysis demonstrated that CT-26-HER2
tumor-infiltrating T cells express PD-1. (B) FACS analysis
demonstrated that CT-26-HER2 tumor cells express PD-L1.
[0044] FIGS. 14A-14D show that the PD1/PD-L1 signaling limits the
response to HER2-TDB. (FIG. 14A) Flow cytometric analysis revealed
that stimulation of human T cells by TDB and target cells induced
PD-1 expression. (FIG. 14B) Expression of PD-L1 in target cells
(293) was sufficient to inhibit TDB-mediated T cell killing
activity. Cytotoxicity of target cells was measured upon addition
of primed T cells to 293 cells expressing PD-L1 (triangles), 293
cells expressing PD-L1 treated in the presence of anti-PD-L1
antibody (circles), or vector-transfected, control 293 cells
(squares). (FIG. 14C) The combination of HER2-TDB (4D5/SP34-TDB)
and anti-PD-L1 antibody significantly inhibited growth of
established CT26-HER2 tumors in huCD3 transgenic mice. TDB dosing
was administered as in FIG. 8F, and anti-PD-L1 antibody (25A1) was
dosed 10 mg/kg tiw.times.3, IP. Control TDB binds to huCD3 but has
an irrelevant target arm. TTP=time to tumor progression
(2.times.day 0 volume). (FIG. 14D) The combination of HER2-TDB
(4D5/SP34-TDB) and anti-PD-L1 antibody resulted in complete,
long-term responses by treatment of CT26-HER2 tumors in huCD3
transgenic mice. Dosing was administered as described above. CR=no
detectable tumor, PR=at least 50% tumor shrinkage from Day 0.
[0045] FIGS. 15A & 15B show that the activity of HER2-TDB in
NOD-SCID mice is dependent on human PBMCs. (FIG. 15A)
5.times.10.sup.6 MCF7-neo/HER2 cells were injected into mice
without human PBMCs. Mice (n=7) were treated with 0.5 mg/kg i.v.
doses of HER2-TDB on days 0, 7, and 14. Tumor volumes from
individual mice and fitted tumor volumes of treatment groups are
presented; mice terminated prior to study end are shown as red
traces, whereas mice remaining to study end are shown as grey
traces. Fitted tumor volumes for each treatment group are shown as
a solid black line with fitted tumor volume for comparator control
groups are shown as a dashed blue line. (FIG. 15B) Control TDB that
shares the same CD3-arm as HER2-TDB but has an irrelevant
non-binding target arm has no effect on tumor growth.
5.times.10.sup.6 MCF7-neo/HER2 cells were injected together with
1.times.10.sup.7 unstimulated human PBMCs. Mice were treated as in
FIG. 15A.
DETAILED DESCRIPTION
[0046] The inventors of this application demonstrated that PD-L1
expressed by cancer cells can inhibit the activity of T cell
recruiting antibodies and this inhibition can be reversed by an
anti-PD-L1 antibody. The data in the application show that the
combination of a HER2 T cell dependent bispecific antibody
(HER2-TDB) with anti-PD-L1 immune therapy resulted in enhanced
inhibition of tumor growth, increased response rates and durable
responses. The inventors demonstrated the benefit of combining two
immune therapies: direct polyclonal recruitment of T cell activity
together with inhibiting the T cell suppressive PD-1/PD-L1
signaling results in enhanced and durable long term responses.
[0047] In one aspect, provided herein are methods, compositions and
uses for treating or delaying progression of cancer in an
individual comprising administering an effective amount of a human
PD-1 axis binding antagonist and an anti-HER2 antibody.
[0048] In another aspect, provided herein are methods, compositions
and uses for enhancing immune function in an individual having
cancer comprising administering an effective amount of a human PD-1
axis binding antagonist and an anti-HER2 antibody.
I. DEFINITIONS
[0049] Before describing the invention in detail, it is to be
understood that this invention is not limited to particular
compositions or biological systems, which can, of course, vary. It
is also to be understood that the terminology used herein is for
the purpose of describing particular embodiments only, and is not
intended to be limiting.
[0050] As used in this specification and the appended claims, the
singular forms "a", "an" and "the" include plural referents unless
the content clearly dictates otherwise. Thus, for example,
reference to "a molecule" optionally includes a combination of two
or more such molecules, and the like.
[0051] The term "about" as used herein refers to the usual error
range for the respective value readily known to the skilled person
in this technical field. Reference to "about" a value or parameter
herein includes (and describes) embodiments that are directed to
that value or parameter per se.
[0052] It is understood that aspects and embodiments of the
invention described herein include "comprising," "consisting," and
"consisting essentially of" aspects and embodiments.
[0053] The term "PD-1 axis binding antagonist" refers to a molecule
that inhibits the interaction of a PD-1 axis binding partner with
either one or more of its binding partner, so as to remove T-cell
dysfunction resulting from signaling on the PD-1 signaling
axis--with a result being to restore or enhance T-cell function
(e.g., proliferation, cytokine production, target cell killing). As
used herein, a PD-1 axis binding antagonist includes a PD-1 binding
antagonist, a PD-L1 binding antagonist and a PD-L2 binding
antagonist.
[0054] The term "PD-1 binding antagonist" refers to a molecule that
decreases, blocks, inhibits, abrogates or interferes with signal
transduction resulting from the interaction of PD-1 with one or
more of its binding partners, such as PD-L1, PD-L2. In some
embodiments, the PD-1 binding antagonist is a molecule that
inhibits the binding of PD-1 to one or more of its binding
partners. In a specific aspect, the PD-1 binding antagonist
inhibits the binding of PD-1 to PD-L1 and/or PD-L2. For example,
PD-1 binding antagonists include anti-PD-1 antibodies, antigen
binding fragments thereof, immunoadhesins, fusion proteins,
oligopeptides and other molecules that decrease, block, inhibit,
abrogate or interfere with signal transduction resulting from the
interaction of PD-1 with PD-L1 and/or PD-L2. In one embodiment, a
PD-1 binding antagonist reduces the negative co-stimulatory signal
mediated by or through cell surface proteins expressed on T
lymphocytes mediated signaling through PD-1 so as render a
dysfunctional T-cell less dysfunctional (e.g., enhancing effector
responses to antigen recognition). In some embodiments, the PD-1
binding antagonist is an anti-PD-1 antibody. In a specific aspect,
a PD-1 binding antagonist is MDX-1106 (nivolumab) described herein.
In another specific aspect, a PD-1 binding antagonist is MK-3475
(lambrolizumab) described herein. In another specific aspect, a
PD-1 binding antagonist is CT-011 (pidilizumab) described herein.
In another specific aspect, a PD-1 binding antagonist is AMP-224
described herein.
[0055] The term "PD-L1 binding antagonist" refers to a molecule
that decreases, blocks, inhibits, abrogates or interferes with
signal transduction resulting from the interaction of PD-L1 with
either one or more of its binding partners, such as PD-1, B7-1. In
some embodiments, a PD-L1 binding antagonist is a molecule that
inhibits the binding of PD-L1 to its binding partners. In a
specific aspect, the PD-L1 binding antagonist inhibits binding of
PD-L1 to PD-1 and/or B7-1. In some embodiments, the PD-L1 binding
antagonists include anti-PD-L1 antibodies, antigen binding
fragments thereof, immunoadhesins, fusion proteins, oligopeptides
and other molecules that decrease, block, inhibit, abrogate or
interfere with signal transduction resulting from the interaction
of PD-L1 with one or more of its binding partners, such as PD-1,
B7-1. In one embodiment, a PD-L1 binding antagonist reduces the
negative co-stimulatory signal mediated by or through cell surface
proteins expressed on T lymphocytes mediated signaling through
PD-L1 so as to render a dysfunctional T-cell less dysfunctional
(e.g., enhancing effector responses to antigen recognition). In
some embodiments, a PD-L1 binding antagonist is an anti-PD-L1
antibody. In a specific aspect, an anti-PD-L1 antibody is
YW243.55.S70 described herein. In another specific aspect, an
anti-PD-L1 antibody is MDX-1105 described herein. In still another
specific aspect, an anti-PD-L1 antibody is MPDL3280A described
herein. In still another specific aspect, an anti-PD-L1 antibody is
MEDI4736 described herein.
[0056] The term "PD-L2 binding antagonist" refers to a molecule
that decreases, blocks, inhibits, abrogates or interferes with
signal transduction resulting from the interaction of PD-L2 with
either one or more of its binding partners, such as PD-1. In some
embodiments, a PD-L2 binding antagonist is a molecule that inhibits
the binding of PD-L2 to one or more of its binding partners. In a
specific aspect, the PD-L2 binding antagonist inhibits binding of
PD-L2 to PD-1. In some embodiments, the PD-L2 antagonists include
anti-PD-L2 antibodies, antigen binding fragments thereof,
immunoadhesins, fusion proteins, oligopeptides and other molecules
that decrease, block, inhibit, abrogate or interfere with signal
transduction resulting from the interaction of PD-L2 with either
one or more of its binding partners, such as PD-1. In one
embodiment, a PD-L2 binding antagonist reduces the negative
co-stimulatory signal mediated by or through cell surface proteins
expressed on T lymphocytes mediated signaling through PD-L2 so as
render a dysfunctional T-cell less dysfunctional (e.g., enhancing
effector responses to antigen recognition). In some embodiments, a
PD-L2 binding antagonist is an immunoadhesin.
[0057] The term "dysfunction" in the context of immune dysfunction,
refers to a state of reduced immune responsiveness to antigenic
stimulation. The term includes the common elements of both
exhaustion and/or anergy in which antigen recognition may occur,
but the ensuing immune response is ineffective to control infection
or tumor growth.
[0058] The term "dysfunctional", as used herein, also includes
refractory or unresponsive to antigen recognition, specifically,
impaired capacity to translate antigen recognition into down-stream
T-cell effector functions, such as proliferation, cytokine
production (e.g., IL-2) and/or target cell killing.
[0059] The term "anergy" refers to the state of unresponsiveness to
antigen stimulation resulting from incomplete or insufficient
signals delivered through the T-cell receptor (e.g. increase in
intracellular Ca.sup.+2 in the absence of ras-activation). T cell
anergy can also result upon stimulation with antigen in the absence
of co-stimulation, resulting in the cell becoming refractory to
subsequent activation by the antigen even in the context of
costimulation. The unresponsive state can often be overriden by the
presence of Interleukin-2. Anergic T-cells do not undergo clonal
expansion and/or acquire effector functions.
[0060] The term "exhaustion" refers to T cell exhaustion as a state
of T cell dysfunction that arises from sustained TCR signaling that
occurs during many chronic infections and cancer. It is
distinguished from anergy in that it arises not through incomplete
or deficient signaling, but from sustained signaling. It is defined
by poor effector function, sustained expression of inhibitory
receptors and a transcriptional state distinct from that of
functional effector or memory T cells. Exhaustion prevents optimal
control of infection and tumors. Exhaustion can result from both
extrinsic negative regulatory pathways (e.g., immunoregulatory
cytokines) as well as cell intrinsic negative regulatory
(costimulatory) pathways (PD-1, B7-H3, B7-H4, etc.).
[0061] "Enhancing T-cell function" means to induce, cause or
stimulate a T-cell to have a sustained or amplified biological
function, or renew or reactivate exhausted or inactive T-cells.
Examples of enhancing T-cell function include: increased secretion
of .gamma.-interferon from CD8.sup.+ T-cells, increased
proliferation, increased antigen responsiveness (e.g., viral,
pathogen, or tumor clearance) relative to such levels before the
intervention. In one embodiment, the level of enhancement is as
least 50%, alternatively 60%, 70%, 80%, 90%, 100%, 120%, 150%,
200%. The manner of measuring this enhancement is known to one of
ordinary skill in the art.
[0062] A "T cell dysfunctional disorder" is a disorder or condition
of T-cells characterized by decreased responsiveness to antigenic
stimulation. In a particular embodiment, a T-cell dysfunctional
disorder is a disorder that is specifically associated with
inappropriate increased signaling through PD-1. In another
embodiment, a T-cell dysfunctional disorder is one in which T-cells
are anergic or have decreased ability to secrete cytokines,
proliferate, or execute cytolytic activity. In a specific aspect,
the decreased responsiveness results in ineffective control of a
pathogen or tumor expressing an immunogen. Examples of T cell
dysfunctional disorders characterized by T-cell dysfunction include
unresolved acute infection, chronic infection and tumor
immunity.
[0063] "Tumor immunity" refers to the process in which tumors evade
immune recognition and clearance. Thus, as a therapeutic concept,
tumor immunity is "treated" when such evasion is attenuated, and
the tumors are recognized and attacked by the immune system.
Examples of tumor recognition include tumor binding, tumor
shrinkage and tumor clearance.
[0064] "Immunogenecity" refers to the ability of a particular
substance to provoke an immune response. Tumors are immunogenic and
enhancing tumor immunogenicity aids in the clearance of the tumor
cells by the immune response. Examples of enhancing tumor
immunogenicity include treatment with a PD-1 axis binding
antagonist and an anti-HER2 antibody.
[0065] "Sustained response" refers to the sustained effect on
reducing tumor growth after cessation of a treatment. For example,
the tumor size may remain to be the same or smaller as compared to
the size at the beginning of the administration phase. In some
embodiments, the sustained response has a duration at least the
same as the treatment duration, at least 1.5.times., 2.0.times.,
2.5.times., or 3.0.times. length of the treatment duration.
[0066] The term "pharmaceutical formulation" refers to a
preparation which is in such form as to permit the biological
activity of the active ingredient to be effective, and which
contains no additional components which are unacceptably toxic to a
subject to which the formulation would be administered. Such
formulations are sterile. "Pharmaceutically acceptable" excipients
(vehicles, additives) are those which can reasonably be
administered to a subject mammal to provide an effective dose of
the active ingredient employed.
[0067] As used herein, the term "treatment" refers to clinical
intervention designed to alter the natural course of the individual
or cell being treated during the course of clinical pathology.
Desirable effects of treatment include decreasing the rate of
disease progression, ameliorating or palliating the disease state,
and remission or improved prognosis. For example, an individual is
successfully "treated" if one or more symptoms associated with
cancer are mitigated or eliminated, including, but are not limited
to, reducing the proliferation of (or destroying) cancerous cells,
decreasing symptoms resulting from the disease, increasing the
quality of life of those suffering from the disease, decreasing the
dose of other medications required to treat the disease, and/or
prolonging survival of individuals.
[0068] As used herein, "delaying progression of a disease" means to
defer, hinder, slow, retard, stabilize, and/or postpone development
of the disease (such as cancer). This delay can be of varying
lengths of time, depending on the history of the disease and/or
individual being treated. As is evident to one skilled in the art,
a sufficient or significant delay can, in effect, encompass
prevention, in that the individual does not develop the disease.
For example, a late stage cancer, such as development of
metastasis, may be delayed.
[0069] An "effective amount" is at least the minimum amount
required to effect a measurable improvement or prevention of a
particular disorder. An effective amount herein may vary according
to factors such as the disease state, age, sex, and weight of the
patient, and the ability of the antibody to elicit a desired
response in the individual. An effective amount is also one in
which any toxic or detrimental effects of the treatment are
outweighed by the therapeutically beneficial effects. For
prophylactic use, beneficial or desired results include results
such as eliminating or reducing the risk, lessening the severity,
or delaying the onset of the disease, including biochemical,
histological and/or behavioral symptoms of the disease, its
complications and intermediate pathological phenotypes presenting
during development of the disease. For therapeutic use, beneficial
or desired results include clinical results such as decreasing one
or more symptoms resulting from the disease, increasing the quality
of life of those suffering from the disease, decreasing the dose of
other medications required to treat the disease, enhancing effect
of another medication such as via targeting, delaying the
progression of the disease, and/or prolonging survival. In the case
of cancer or tumor, an effective amount of the drug may have the
effect in reducing the number of cancer cells; reducing the tumor
size; inhibiting (i.e., slow to some extent or desirably stop)
cancer cell infiltration into peripheral organs; inhibit (i.e.,
slow to some extent and desirably stop) tumor metastasis;
inhibiting to some extent tumor growth; and/or relieving to some
extent one or more of the symptoms associated with the disorder. An
effective amount can be administered in one or more
administrations. For purposes of this invention, an effective
amount of drug, compound, or pharmaceutical composition is an
amount sufficient to accomplish prophylactic or therapeutic
treatment either directly or indirectly. As is understood in the
clinical context, an effective amount of a drug, compound, or
pharmaceutical composition may or may not be achieved in
conjunction with another drug, compound, or pharmaceutical
composition. Thus, an "effective amount" may be considered in the
context of administering one or more therapeutic agents, and a
single agent may be considered to be given in an effective amount
if, in conjunction with one or more other agents, a desirable
result may be or is achieved.
[0070] As used herein, "in conjunction with" refers to
administration of one treatment modality in addition to another
treatment modality. As such, "in conjunction with" refers to
administration of one treatment modality before, during, or after
administration of the other treatment modality to the
individual.
[0071] A "disorder" is any condition that would benefit from
treatment including, but not limited to, chronic and acute
disorders or diseases including those pathological conditions which
predispose the mammal to the disorder in question.
[0072] The terms "cell proliferative disorder" and "proliferative
disorder" refer to disorders that are associated with some degree
of abnormal cell proliferation. In one embodiment, the cell
proliferative disorder is cancer. In one embodiment, the cell
proliferative disorder is a tumor.
[0073] "Tumor," as used herein, refers to all neoplastic cell
growth and proliferation, whether malignant or benign, and all
pre-cancerous and cancerous cells and tissues. The terms "cancer",
"cancerous", "cell proliferative disorder", "proliferative
disorder" and "tumor" are not mutually exclusive as referred to
herein.
[0074] The terms "cancer" and "cancerous" refer to or describe the
physiological condition in mammals that is typically characterized
by unregulated cell growth. Examples of cancer include but are not
limited to, carcinoma, lymphoma, blastoma, sarcoma, and leukemia or
lymphoid malignancies. More particular examples of such cancers
include, but not limited to, squamous cell cancer (e.g., epithelial
squamous cell cancer), lung cancer including small-cell lung
cancer, non-small cell lung cancer, adenocarcinoma of the lung and
squamous carcinoma of the lung, cancer of the peritoneum,
hepatocellular cancer, gastric or stomach cancer including
gastrointestinal cancer and gastrointestinal stromal cancer,
pancreatic cancer, glioblastoma, cervical cancer, ovarian cancer,
liver cancer, bladder cancer, cancer of the urinary tract,
hepatoma, breast cancer, colon cancer, rectal cancer, colorectal
cancer, endometrial or uterine carcinoma, salivary gland carcinoma,
kidney or renal cancer, prostate cancer, vulval cancer, thyroid
cancer, hepatic carcinoma, anal carcinoma, penile carcinoma,
melanoma, superficial spreading melanoma, lentigo maligna melanoma,
acral lentiginous melanomas, nodular melanomas, multiple myeloma
and B-cell lymphoma (including low grade/follicular non-Hodgkin's
lymphoma (NHL); small lymphocytic (SL) NHL; intermediate
grade/follicular NHL; intermediate grade diffuse NHL; high grade
immunoblastic NHL; high grade lymphoblastic NHL; high grade small
non-cleaved cell NHL; bulky disease NHL; mantle cell lymphoma;
AIDS-related lymphoma; and Waldenstrom's Macroglobulinemia);
chronic lymphocytic leukemia (CLL); acute lymphoblastic leukemia
(ALL); hairy cell leukemia; chronic myeloblastic leukemia; and
post-transplant lymphoproliferative disorder (PTLD), as well as
abnormal vascular proliferation associated with phakomatoses, edema
(such as that associated with brain tumors), Meigs' syndrome,
brain, as well as head and neck cancer, and associated metastases.
In certain embodiments, cancers that are amenable to treatment by
the antibodies of the invention include breast cancer, colorectal
cancer, rectal cancer, non-small cell lung cancer, glioblastoma,
non-Hodgkins lymphoma (NHL), renal cell cancer, prostate cancer,
liver cancer, pancreatic cancer, soft-tissue sarcoma, kaposi's
sarcoma, carcinoid carcinoma, head and neck cancer, ovarian cancer,
mesothelioma, and multiple myeloma. In some embodiments, the cancer
is selected from: small cell lung cancer, gliblastoma,
neuroblastomas, melanoma, breast carcinoma, gastric cancer,
colorectal cancer (CRC), and hepatocellular carcinoma. Yet, in some
embodiments, the cancer is selected from: non-small cell lung
cancer, colorectal cancer, glioblastoma and breast carcinoma,
including metastatic forms of those cancers.
[0075] The term "cytotoxic agent" as used herein refers to any
agent that is detrimental to cells (e.g., causes cell death,
inhibits proliferation, or otherwise hinders a cellular function).
Cytotoxic agents include, but are not limited to, radioactive
isotopes (e.g., At.sup.211, I.sup.131, I.sup.125, Y.sup.90,
Re.sup.186, Re.sup.188, Sm.sup.153, Bi.sup.212, P.sup.32,
Pb.sup.212 and radioactive isotopes of Lu); chemotherapeutic
agents; growth inhibitory agents; enzymes and fragments thereof
such as nucleolytic enzymes; and toxins such as small molecule
toxins or enzymatically active toxins of bacterial, fungal, plant
or animal origin, including fragments and/or variants thereof.
Exemplary cytotoxic agents can be selected from anti-microtubule
agents, platinum coordination complexes, alkylating agents,
antibiotic agents, topoisomerase II inhibitors, antimetabolites,
topoisomerase I inhibitors, hormones and hormonal analogues, signal
transduction pathway inhibitors, non-receptor tyrosine kinase
angiogenesis inhibitors, immunotherapeutic agents, proapoptotic
agents, inhibitors of LDH-A, inhibitors of fatty acid biosynthesis,
cell cycle signalling inhibitors, HDAC inhibitors, proteasome
inhibitors, and inhibitors of cancer metabolism. In one embodiment
the cytotoxic agent is a taxane. In one embodiment the taxane is
paclitaxel or docetaxel. In one embodiment the cytotoxic agent is a
platinum agent. In one embodiment the cytotoxic agent is an
antagonist of EGFR. In one embodiment the antagonist of EGFR is
N-(3-ethynylphenyl)-6,7-bis(2-methoxyethoxy)quinazolin-4-amine
(e.g., erlotinib). In one embodiment the cytotoxic agent is a RAF
inhibitor. In one embodiment, the RAF inhibitor is a BRAF and/or
CRAF inhibitor. In one embodiment the RAF inhibitor is vemurafenib.
In one embodiment the cytotoxic agent is a PI3K inhibitor.
[0076] "Chemotherapeutic agent" includes compounds useful in the
treatment of cancer. Examples of chemotherapeutic agents include
erlotinib (TARCEVA.RTM., Genentech/OSI Pharm.), bortezomib
(VELCADE.RTM., Millennium Pharm.), disulfiram, epigallocatechin
gallate, salinosporamide A, carfilzomib, 17-AAG (geldanamycin),
radicicol, lactate dehydrogenase A (LDH-A), fulvestrant
(FASLODEX.RTM., AstraZeneca), sunitib (SUTENT.RTM., Pfizer/Sugen),
letrozole (FEMARA.RTM., Novartis), imatinib mesylate (GLEEVEC.RTM.,
Novartis), finasunate (VATALANIB.RTM., Novartis), oxaliplatin
(ELOXATIN.RTM., Sanofi), 5-FU (5-fluorouracil), leucovorin,
Rapamycin (Sirolimus, RAPAMUNE.RTM., Wyeth), Lapatinib
(TYKERB.RTM., GSK572016, Glaxo Smith Kline), Lonafamib (SCH 66336),
sorafenib (NEXAVAR.RTM., Bayer Labs), gefitinib (IRESSA.RTM.,
AstraZeneca), AG1478, alkylating agents such as thiotepa and
CYTOXAN.RTM. cyclosphosphamide; alkyl sulfonates such as busulfan,
improsulfan and piposulfan; aziridines such as benzodopa,
carboquone, meturedopa, and uredopa; ethylenimines and
methylamelamines including altretamine, triethylenemelamine,
triethylenephosphoramide, triethylenethiophosphoramide and
trimethylomelamine; acetogenins (especially bullatacin and
bullatacinone); a camptothecin (including topotecan and
irinotecan); bryostatin; callystatin; CC-1065 (including its
adozelesin, carzelesin and bizelesin synthetic analogs);
cryptophycins (particularly cryptophycin 1 and cryptophycin 8);
adrenocorticosteroids (including prednisone and prednisolone);
cyproterone acetate; 5.alpha.-reductases including finasteride and
dutasteride); vorinostat, romidepsin, panobinostat, valproic acid,
mocetinostat dolastatin; aldesleukin, talc duocarmycin (including
the synthetic analogs, KW-2189 and CB1-TM1); eleutherobin;
pancratistatin; a sarcodictyin; spongistatin; nitrogen mustards
such as chlorambucil, chlomaphazine, chlorophosphamide,
estramustine, ifosfamide, mechlorethamine, mechlorethamine oxide
hydrochloride, melphalan, novembichin, phenesterine, prednimustine,
trofosfamide, uracil mustard; nitrosoureas such as carmustine,
chlorozotocin, fotemustine, lomustine, nimustine, and ranimnustine;
antibiotics such as the enediyne antibiotics (e.g., calicheamicin,
especially calicheamicin .gamma.1I and calicheamicin .omega.1I
(Angew Chem. Intl. Ed. Engl. 1994 33:183-186); dynemicin, including
dynemicin A; bisphosphonates, such as clodronate; an esperamicin;
as well as neocarzinostatin chromophore and related chromoprotein
enediyne antibiotic chromophores), aclacinomysins, actinomycin,
authramycin, azaserine, bleomycins, cactinomycin, carabicin,
caminomycin, carzinophilin, chromomycinis, dactinomycin,
daunorubicin, detorubicin, 6-diazo-5-oxo-L-norleucine,
ADRIAMYCIN.RTM. (doxorubicin), morpholino-doxorubicin,
cyanomorpholino-doxorubicin, 2-pyrrolino-doxorubicin and
deoxydoxorubicin), epirubicin, esorubicin, idarubicin,
marcellomycin, mitomycins such as mitomycin C, mycophenolic acid,
nogalamycin, olivomycins, peplomycin, porfiromycin, puromycin,
quelamycin, rodorubicin, streptonigrin, streptozocin, tubercidin,
ubenimex, zinostatin, zorubicin; anti-metabolites such as
methotrexate and 5-fluorouracil (5-FU); folic acid analogs such as
denopterin, methotrexate, pteropterin, trimetrexate; purine analogs
such as fludarabine, 6-mercaptopurine, thiamiprine, thioguanine;
pyrimidine analogs such as ancitabine, azacitidine, 6-azauridine,
carmofur, cytarabine, dideoxyuridine, doxifluridine, enocitabine,
floxuridine; androgens such as calusterone, dromostanolone
propionate, epitiostanol, mepitiostane, testolactone; anti-adrenals
such as aminoglutethimide, mitotane, trilostane; folic acid
replenisher such as frolinic acid; aceglatone; aldophosphamide
glycoside; aminolevulinic acid; eniluracil; amsacrine; bestrabucil;
bisantrene; edatraxate; defofamine; demecolcine; diaziquone;
elfomithine; elliptinium acetate; an epothilone; etoglucid; gallium
nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids such as
maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidamnol;
nitraerine; pentostatin; phenamet; pirarubicin; losoxantrone;
podophyllinic acid; 2-ethylhydrazide; procarbazine; PSK.RTM.
polysaccharide complex (JHS Natural Products, Eugene, Oreg.);
razoxane; rhizoxin; sizofuran; spirogermanium; tenuazonic acid;
triaziquone; 2,2',2''-trichlorotriethylamine; trichothecenes
(especially T-2 toxin, verracurin A, roridin A and anguidine);
urethan; vindesine; dacarbazine; mannomustine; mitobronitol;
mitolactol; pipobroman; gacytosine; arabinoside ("Ara-C");
cyclophosphamide; thiotepa; taxoids, e.g., TAXOL (paclitaxel;
Bristol-Myers Squibb Oncology, Princeton, N.J.), ABRAXANE.RTM.
(Cremophor-free), albumin-engineered nanoparticle formulations of
paclitaxel (American Pharmaceutical Partners, Schaumberg, Ill.),
and TAXOTERE.RTM. (docetaxel, doxetaxel; Sanofi-Aventis);
chloranmbucil; GEMZAR.RTM. (gemcitabine); 6-thioguanine;
mercaptopurine; methotrexate; platinum analogs such as cisplatin
and carboplatin; vinblastine; etoposide (VP-16); ifosfamide;
mitoxantrone; vincristine; NAVELBINE.RTM. (vinorelbine);
novantrone; teniposide; edatrexate; daunomycin; aminopterin;
capecitabine (XELODA.RTM.); ibandronate; CPT-11; topoisomerase
inhibitor RFS 2000; difluoromethylornithine (DMFO); retinoids such
as retinoic acid; and pharmaceutically acceptable salts, acids and
derivatives of any of the above.
[0077] Chemotherapeutic agent also includes (i) anti-hormonal
agents that act to regulate or inhibit hormone action on tumors
such as anti-estrogens and selective estrogen receptor modulators
(SERMs), including, for example, tamoxifen (including
NOLVADEX.RTM.; tamoxifen citrate), raloxifene, droloxifene,
iodoxyfene, 4-hydroxytamoxifen, trioxifene, keoxifene, LY117018,
onapristone, and FARESTON.RTM. (toremifine citrate); (ii) aromatase
inhibitors that inhibit the enzyme aromatase, which regulates
estrogen production in the adrenal glands, such as, for example,
4(5)-imidazoles, aminoglutethimide, MEGASE.RTM. (megestrol
acetate), AROMASIN.RTM. (exemestane; Pfizer), formestanie,
fadrozole, RIVISOR.RTM. (vorozole), FEMARA.RTM. (letrozole;
Novartis), and ARIMIDEX.RTM. (anastrozole; AstraZeneca); (iii)
anti-androgens such as flutamide, nilutamide, bicalutamide,
leuprolide and goserelin; buserelin, tripterelin,
medroxyprogesterone acetate, diethylstilbestrol, premarin,
fluoxymesterone, all transretionic acid, fenretinide, as well as
troxacitabine (a 1,3-dioxolane nucleoside cytosine analog); (iv)
protein kinase inhibitors; (v) lipid kinase inhibitors; (vi)
antisense oligonucleotides, particularly those which inhibit
expression of genes in signaling pathways implicated in aberrant
cell proliferation, such as, for example, PKC-alpha, Ralf and
H-Ras; (vii) ribozymes such as VEGF expression inhibitors (e.g.,
ANGIOZYME.RTM.) and HER2 expression inhibitors; (viii) vaccines
such as gene therapy vaccines, for example, ALLOVECTIN.RTM.,
LEUVECTIN.RTM., and VAXID.RTM.; PROLEUKIN.RTM., rIL-2; a
topoisomerase 1 inhibitor such as LURTOTECAN.RTM.; ABARELIX.RTM.
rmRH; and (ix) pharmaceutically acceptable salts, acids and
derivatives of any of the above.
[0078] Chemotherapeutic agent also includes antibodies such as
alemtuzumab (Campath), bevacizumab (AVASTIN.RTM., Genentech);
cetuximab (ERBITUX.RTM., Imclone); panitumumab (VECTIBIX.RTM.,
Amgen), rituximab (RITUXAN.RTM., Genentech/Biogen Idec), pertuzumab
(OMNITARG.RTM., 2C4, Genentech), trastuzumab (HERCEPTIN.RTM.,
Genentech), tositumomab (Bexxar, Corixia), and the antibody drug
conjugate, gemtuzumab ozogamicin (MYLOTARG.RTM., Wyeth). Additional
humanized monoclonal antibodies with therapeutic potential as
agents in combination with the compounds of the invention include:
apolizumab, aselizumab, atlizumab, bapineuzumab, bivatuzumab
mertansine, cantuzumab mertansine, cedelizumab, certolizumab pegol,
cidfusituzumab, cidtuzumab, daclizumab, eculizumab, efalizumab,
epratuzumab, erlizumab, felvizumab, fontolizumab, gemtuzumab
ozogamicin, inotuzumab ozogamicin, ipilimumab, labetuzumab,
lintuzumab, matuzumab, mepolizumab, motavizumab, motovizumab,
natalizumab, nimotuzumab, nolovizumab, numavizumab, ocrelizumab,
omalizumab, palivizumab, pascolizumab, pecfusituzumab, pectuzumab,
pexelizumab, ralivizumab, ranibizumab, reslivizumab, reslizumab,
resyvizumab, rovelizumab, ruplizumab, sibrotuzumab, siplizumab,
sontuzumab, tacatuzumab tetraxetan, tadocizumab, talizumab,
tefibazumab, tocilizumab, toralizumab, tucotuzumab celmoleukin,
tucusituzumab, umavizumab, urtoxazumab, ustekinumab, visilizumab,
and the anti-interleukin-12 (ABT-874/J695, Wyeth Research and
Abbott Laboratories) which is a recombinant exclusively
human-sequence, full-length IgG.sub.1.lamda. antibody genetically
modified to recognize interleukin-12 p40 protein.
[0079] Chemotherapeutic agent also includes "EGFR inhibitors,"
which refers to compounds that bind to or otherwise interact
directly with EGFR and prevent or reduce its signaling activity,
and is alternatively referred to as an "EGFR antagonist." Examples
of such agents include antibodies and small molecules that bind to
EGFR. Examples of antibodies which bind to EGFR include MAb 579
(ATCC CRL HB 8506), MAb 455 (ATCC CRL HB8507), MAb 225 (ATCC CRL
8508), MAb 528 (ATCC CRL 8509) (see, U.S. Pat. No. 4,943,533,
Mendelsohn et al.) and variants thereof, such as chimerized 225
(C225 or Cetuximab; ERBUTIX.RTM.) and reshaped human 225 (H225)
(see, WO 96/40210, Imclone Systems Inc.); IMC-11F8, a fully human,
EGFR-targeted antibody (Imclone); antibodies that bind type II
mutant EGFR (U.S. Pat. No. 5,212,290); humanized and chimeric
antibodies that bind EGFR as described in U.S. Pat. No. 5,891,996;
and human antibodies that bind EGFR, such as ABX-EGF or Panitumumab
(see WO98/50433, Abgenix/Amgen); EMD 55900 (Stragliotto et al. Eur.
J. Cancer 32A:636-640 (1996)); EMD7200 (matuzumab) a humanized EGFR
antibody directed against EGFR that competes with both EGF and
TGF-alpha for EGFR binding (EMD/Merck); human EGFR antibody,
HuMax-EGFR (GenMab); fully human antibodies known as E1.1, E2.4,
E2.5, E6.2, E6.4, E2.11, E6. 3 and E7.6. 3 and described in U.S.
Pat. No. 6,235,883; MDX-447 (Medarex Inc); and mAb 806 or humanized
mAb 806 (Johns et al., J. Biol. Chem. 279(29):30375-30384 (2004)).
The anti-EGFR antibody may be conjugated with a cytotoxic agent,
thus generating an immunoconjugate (see, e.g., EP659439A2, Merck
Patent GmbH). EGFR antagonists include small molecules such as
compounds described in U.S. Pat. Nos. 5,616,582, 5,457,105,
5,475,001, 5,654,307, 5,679,683, 6,084,095, 6,265,410, 6,455,534,
6,521,620, 6,596,726, 6,713,484, 5,770,599, 6,140,332, 5,866,572,
6,399,602, 6,344,459, 6,602,863, 6,391,874, 6,344,455, 5,760,041,
6,002,008, and 5,747,498, as well as the following PCT
publications: WO98/14451, WO98/50038, WO99/09016, and WO99/24037.
Particular small molecule EGFR antagonists include OSI-774
(CP-358774, erlotinib, TARCEVA.RTM. Genentech/OSI Pharmaceuticals);
PD 183805 (CI 1033, 2-propenamide,
N-[4-[(3-chloro-4-fluorophenyl)amino]-7-[3-(4-morpholinyl)propoxy]-6-quin-
azolinyl]-, dihydrochloride, Pfizer Inc.); ZD1839, gefitinib
(IRESSA.RTM.)
4-(3'-Chloro-4'-fluoroanilino)-7-methoxy-6-(3-morpholinopropoxy)quinazoli-
ne, AstraZeneca); ZM 105180
((6-amino-4-(3-methylphenyl-amino)-quinazoline, Zeneca); BIBX-1382
(N8-(3-chloro-4-fluoro-phenyl)-N2-(1-methyl-piperidin-4-yl)-pyrimido[5,4--
d]pyrimidine-2,8-diamine, Boehringer Ingelheim); PM-166
((R)-4-[4-[(1-phenylethyl)amino]-1H-pyrrolo[2,3-d]pyrimidin-6-yl]-phenol)-
;
(R)-6-(4-hydroxyphenyl)-4-[(1-phenylethyl)amino]-7H-pyrrolo[2,3-d]pyrimi-
dine); CL-387785
(N-[4-[(3-bromophenyl)amino]-6-quinazolinyl]-2-butynamide); EKB-569
(N-[4-[(3-chloro-4-fluorophenyl)amino]-3-cyano-7-ethoxy-6-quinolinyl]-4-(-
dimethylamino)-2-butenamide) (Wyeth); AG1478 (Pfizer); AG1571 (SU
5271; Pfizer); dual EGFR/HER2 tyrosine kinase inhibitors such as
lapatinib (TYKERB.RTM., GSK572016 or N-[3-chloro-4-[(3
fluorophenyl)methoxy]phenyl]-6[5[[[2methylsulfonyl)ethyl]amino]methyl]-2--
furanyl]-4-quinazolinamine).
[0080] Chemotherapeutic agents also include "tyrosine kinase
inhibitors" including the EGFR-targeted drugs noted in the
preceding paragraph; small molecule HER2 tyrosine kinase inhibitor
such as TAK165 available from Takeda; CP-724,714, an oral selective
inhibitor of the ErbB2 receptor tyrosine kinase (Pfizer and OSI);
dual-HER inhibitors such as EKB-569 (available from Wyeth) which
preferentially binds EGFR but inhibits both HER2 and
EGFR-overexpressing cells; lapatinib (GSK572016; available from
Glaxo-SmithKline), an oral HER2 and EGFR tyrosine kinase inhibitor;
PM-166 (available from Novartis); pan-HER inhibitors such as
canertinib (CI-1033; Pharmacia); Raf-1 inhibitors such as antisense
agent ISIS-5132 available from ISIS Pharmaceuticals which inhibit
Raf-1 signaling; non-HER targeted TK inhibitors such as imatinib
mesylate (GLEEVEC.RTM., available from Glaxo SmithKline);
multi-targeted tyrosine kinase inhibitors such as sunitinib
(SUTENT.RTM., available from Pfizer); VEGF receptor tyrosine kinase
inhibitors such as vatalanib (PTK787/ZK222584, available from
Novartis/Schering AG); MAPK extracellular regulated kinase I
inhibitor CI-1040 (available from Pharmacia); quinazolines, such as
PD 153035,4-(3-chloroanilino) quinazoline; pyridopyrimidines;
pyrimidopyrimidines; pyrrolopyrimidines, such as CGP 59326, CGP
60261 and CGP 62706; pyrazolopyrimidines,
4-(phenylamino)-7H-pyrrolo[2,3-d] pyrimidines; curcumin (diferuloyl
methane, 4,5-bis (4-fluoroanilino)phthalimide); tyrphostines
containing nitrothiophene moieties; PD-0183805 (Warner-Lamber);
antisense molecules (e.g. those that bind to HER-encoding nucleic
acid); quinoxalines (U.S. Pat. No. 5,804,396); tryphostins (U.S.
Pat. No. 5,804,396); ZD6474 (Astra Zeneca); PTK-787
(Novartis/Schering AG); pan-HER inhibitors such as CI-1033
(Pfizer); Affinitac (ISIS 3521; Isis/Lilly); imatinib mesylate
(GLEEVEC.RTM.); PM 166 (Novartis); GW2016 (Glaxo SmithKline);
CI-1033 (Pfizer); EKB-569 (Wyeth); Semaxinib (Pfizer); ZD6474
(AstraZeneca); PTK-787 (Novartis/Schering AG); INC-1C11 (Imclone),
rapamycin (sirolimus, RAPAMUNE.RTM.); or as described in any of the
following patent publications: U.S. Pat. No. 5,804,396; WO
1999/09016 (American Cyanamid); WO 1998/43960 (American Cyanamid);
WO 1997/38983 (Warner Lambert); WO 1999/06378 (Warner Lambert); WO
1999/06396 (Warner Lambert); WO 1996/30347 (Pfizer, Inc); WO
1996/33978 (Zeneca); WO 1996/3397 (Zeneca) and WO 1996/33980
(Zeneca).
[0081] Chemotherapeutic agents also include dexamethasone,
interferons, colchicine, metoprine, cyclosporine, amphotericin,
metronidazole, alemtuzumab, alitretinoin, allopurinol, amifostine,
arsenic trioxide, asparaginase, BCG live, bevacuzimab, bexarotene,
cladribine, clofarabine, darbepoetin alfa, denileukin, dexrazoxane,
epoetin alfa, elotinib, filgrastim, histrelin acetate, ibritumomab,
interferon alfa-2a, interferon alfa-2b, lenalidomide, levamisole,
mesna, methoxsalen, nandrolone, nelarabine, nofetumomab,
oprelvekin, palifermin, pamidronate, pegademase, pegaspargase,
pegfilgrastim, pemetrexed disodium, plicamycin, porfimer sodium,
quinacrine, rasburicase, sargramostim, temozolomide, VM-26, 6-TG,
toremifene, tretinoin, ATRA, valrubicin, zoledronate, and
zoledronic acid, and pharmaceutically acceptable salts thereof.
[0082] Chemotherapeutic agents also include hydrocortisone,
hydrocortisone acetate, cortisone acetate, tixocortol pivalate,
triamcinolone acetonide, triamcinolone alcohol, mometasone,
amcinonide, budesonide, desonide, fluocinonide, fluocinolone
acetonide, betamethasone, betamethasone sodium phosphate,
dexamethasone, dexamethasone sodium phosphate, fluocortolone,
hydrocortisone-17-butyrate, hydrocortisone-17-valerate,
aclometasone dipropionate, betamethasone valerate, betamethasone
dipropionate, prednicarbate, clobetasone-17-butyrate,
clobetasol-17-propionate, fluocortolone caproate, fluocortolone
pivalate and fluprednidene acetate; immune selective
anti-inflammatory peptides (ImSAIDs) such as
phenylalanine-glutamine-glycine (FEG) and its D-isomeric form (feG)
(IMULAN BioTherapeutics, LLC); anti-rheumatic drugs such as
azathioprine, ciclosporin (cyclosporine A), D-penicillamine, gold
salts, hydroxychloroquine, leflunomideminocycline, sulfasalazine,
tumor necrosis factor alpha (TNF.alpha.) blockers such as
etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira),
certolizumab pegol (Cimzia), golimumab (Simponi), Interleukin 1
(IL-1) blockers such as anakinra (Kineret), T cell costimulation
blockers such as abatacept (Orencia), Interleukin 6 (IL-6) blockers
such as tocilizumab (ACTEMERA.RTM.); Interleukin 13 (IL-13)
blockers such as lebrikizumab; Interferon alpha (IFN) blockers such
as Rontalizumab; Beta 7 integrin blockers such as rhuMAb Beta7; IgE
pathway blockers such as Anti-M1 prime; Secreted homotrimeric LTa3
and membrane bound heterotrimer LTa1/.beta.2 blockers such as
Anti-lymphotoxin alpha (LTa); radioactive isotopes (e.g.,
At.sup.211, I.sup.131, I.sup.125, Y.sup.90, Re.sup.186, Re.sup.188,
Sm.sup.153, Bi.sup.212, P.sup.32, Pb.sup.212 and radioactive
isotopes of Lu); miscellaneous investigational agents such as
thioplatin, PS-341, phenylbutyrate, ET-18-OCH.sub.3, or farnesyl
transferase inhibitors (L-739749, L-744832); polyphenols such as
quercetin, resveratrol, piceatannol, epigallocatechine gallate,
theaflavins, flavanols, procyanidins, betulinic acid and
derivatives thereof; autophagy inhibitors such as chloroquine;
delta-9-tetrahydrocannabinol (dronabinol, MARINOL.RTM.);
beta-lapachone; lapachol; colchicines; betulinic acid;
acetylcamptothecin, scopolectin, and 9-aminocamptothecin);
podophyllotoxin; tegafur (UFTORAL.RTM.); bexarotene
(TARGRETIN.RTM.); bisphosphonates such as clodronate (for example,
BONEFOS.RTM. or OSTAC.RTM.), etidronate (DIDROCAL.RTM.), NE-58095,
zoledronic acid/zoledronate (ZOMETA.RTM.), alendronate
(FOSAMAX.RTM.), pamidronate (AREDIA.RTM.), tiludronate
(SKELID.RTM.), or risedronate (ACTONEL.RTM.); and epidermal growth
factor receptor (EGF-R); vaccines such as THERATOPE.RTM. vaccine;
perifosine, COX-2 inhibitor (e.g. celecoxib or etoricoxib),
proteosome inhibitor (e.g. PS341); CCI-779; tipifarnib (R11577);
orafenib, ABT510; Bcl-2 inhibitor such as oblimersen sodium
(GENASENSE.RTM.); pixantrone; farnesyltransferase inhibitors such
as lonafarnib (SCH 6636, SARASAR.TM.); and pharmaceutically
acceptable salts, acids or derivatives of any of the above; as well
as combinations of two or more of the above such as CHOP, an
abbreviation for a combined therapy of cyclophosphamide,
doxorubicin, vincristine, and prednisolone; and FOLFOX, an
abbreviation for a treatment regimen with oxaliplatin
(ELOXATIN.TM.) combined with 5-FU and leucovorin.
[0083] Chemotherapeutic agents also include non-steroidal
anti-inflammatory drugswith analgesic, antipyretic and
anti-inflammatory effects. NSAIDs include non-selective inhibitors
of the enzyme cyclooxygenase. Specific examples of NSAIDs include
aspirin, propionic acid derivatives such as ibuprofen, fenoprofen,
ketoprofen, flurbiprofen, oxaprozin and naproxen, acetic acid
derivatives such as indomethacin, sulindac, etodolac, diclofenac,
enolic acid derivatives such as piroxicam, meloxicam, tenoxicam,
droxicam, lornoxicam and isoxicam, fenamic acid derivatives such as
mefenamic acid, meclofenamic acid, flufenamic acid, tolfenamic
acid, and COX-2 inhibitors such as celecoxib, etoricoxib,
lumiracoxib, parecoxib, rofecoxib, rofecoxib, and valdecoxib.
NSAIDs can be indicated for the symptomatic relief of conditions
such as rheumatoid arthritis, osteoarthritis, inflammatory
arthropathies, ankylosing spondylitis, psoriatic arthritis,
Reiter's syndrome, acute gout, dysmenorrhoea, metastatic bone pain,
headache and migraine, postoperative pain, mild-to-moderate pain
due to inflammation and tissue injury, pyrexia, ileus, and renal
colic.
[0084] A "growth inhibitory agent" when used herein refers to a
compound or composition which inhibits growth of a cell either in
vitro or in vivo. In one embodiment, growth inhibitory agent is
growth inhibitory antibody that prevents or reduces proliferation
of a cell expressing an antigen to which the antibody binds. In
another embodiment, the growth inhibitory agent may be one which
significantly reduces the percentage of cells in S phase. Examples
of growth inhibitory agents include agents that block cell cycle
progression (at a place other than S phase), such as agents that
induce G1 arrest and M-phase arrest. Classical M-phase blockers
include the vincas (vincristine and vinblastine), taxanes, and
topoisomerase II inhibitors such as doxorubicin, epirubicin,
daunorubicin, etoposide, and bleomycin. Those agents that arrest G1
also spill over into S-phase arrest, for example, DNA alkylating
agents such as tamoxifen, prednisone, dacarbazine, mechlorethamine,
cisplatin, methotrexate, 5-fluorouracil, and ara-C. Further
information can be found in Mendelsohn and Israel, eds., The
Molecular Basis of Cancer, Chapter 1, entitled "Cell cycle
regulation, oncogenes, and antineoplastic drugs" by Murakami et al.
(W.B. Saunders, Philadelphia, 1995), e.g., p. 13. The taxanes
(paclitaxel and docetaxel) are anticancer drugs both derived from
the yew tree. Docetaxel (TAXOTERE.RTM., Rhone-Poulenc Rorer),
derived from the European yew, is a semisynthetic analogue of
paclitaxel (TAXOL.RTM., Bristol-Myers Squibb). Paclitaxel and
docetaxel promote the assembly of microtubules from tubulin dimers
and stabilize microtubules by preventing depolymerization, which
results in the inhibition of mitosis in cells.
[0085] By "radiation therapy" is meant the use of directed gamma
rays or beta rays to induce sufficient damage to a cell so as to
limit its ability to function normally or to destroy the cell
altogether. It will be appreciated that there will be many ways
known in the art to determine the dosage and duration of treatment.
Typical treatments are given as a one-time administration and
typical dosages range from 10 to 200 units (Grays) per day.
[0086] A "subject" or an "individual" for purposes of treatment
refers to any animal classified as a mammal, including humans,
domestic and farm animals, and zoo, sports, or pet animals, such as
dogs, horses, cats, cows, etc. Preferably, the mammal is human.
[0087] The term "antibody" herein is used in the broadest sense and
specifically covers monoclonal antibodies (including full length
monoclonal antibodies), polyclonal antibodies, multispecific
antibodies (e.g., bispecific antibodies), and antibody fragments so
long as they exhibit the desired biological activity.
[0088] An "isolated" antibody is one which has been identified and
separated and/or recovered from a component of its natural
environment. Contaminant components of its natural environment are
materials which would interfere with research, diagnostic or
therapeutic uses for the antibody, and may include enzymes,
hormones, and other proteinaceous or nonproteinaceous solutes. In
some embodiments, an antibody is purified (1) to greater than 95%
by weight of antibody as determined by, for example, the Lowry
method, and in some embodiments, to greater than 99% by weight; (2)
to a degree sufficient to obtain at least 15 residues of N-terminal
or internal amino acid sequence by use of, for example, a spinning
cup sequenator, or (3) to homogeneity by SDS-PAGE under reducing or
nonreducing conditions using, for example, Coomassie blue or silver
stain. Isolated antibody includes the antibody in situ within
recombinant cells since at least one component of the antibody's
natural environment will not be present. Ordinarily, however,
isolated antibody will be prepared by at least one purification
step.
[0089] "Native antibodies" are usually heterotetrameric
glycoproteins of about 150,000 daltons, composed of two identical
light (L) chains and two identical heavy (H) chains. Each light
chain is linked to a heavy chain by one covalent disulfide bond,
while the number of disulfide linkages varies among the heavy
chains of different immunoglobulin isotypes. Each heavy and light
chain also has regularly spaced intrachain disulfide bridges. Each
heavy chain has at one end a variable domain (V.sub.H) followed by
a number of constant domains. Each light chain has a variable
domain at one end (V.sub.L) and a constant domain at its other end;
the constant domain of the light chain is aligned with the first
constant domain of the heavy chain, and the light chain variable
domain is aligned with the variable domain of the heavy chain.
Particular amino acid residues are believed to form an interface
between the light chain and heavy chain variable domains.
[0090] The term "constant domain" refers to the portion of an
immunoglobulin molecule having a more conserved amino acid sequence
relative to the other portion of the immunoglobulin, the variable
domain, which contains the antigen binding site. The constant
domain contains the C.sub.H1, C.sub.H2 and C.sub.H3 domains
(collectively, CH) of the heavy chain and the CHL (or CL) domain of
the light chain.
[0091] The "variable region" or "variable domain" of an antibody
refers to the amino-terminal domains of the heavy or light chain of
the antibody. The variable domain of the heavy chain may be
referred to as "V.sub.H." The variable domain of the light chain
may be referred to as "V.sub.L." These domains are generally the
most variable parts of an antibody and contain the antigen-binding
sites.
[0092] The term "variable" refers to the fact that certain portions
of the variable domains differ extensively in sequence among
antibodies and are used in the binding and specificity of each
particular antibody for its particular antigen. However, the
variability is not evenly distributed throughout the variable
domains of antibodies. It is concentrated in three segments called
hypervariable regions (HVRs) both in the light-chain and the
heavy-chain variable domains. The more highly conserved portions of
variable domains are called the framework regions (FR). The
variable domains of native heavy and light chains each comprise
four FR regions, largely adopting a beta-sheet configuration,
connected by three HVRs, which form loops connecting, and in some
cases forming part of, the beta-sheet structure. The HVRs in each
chain are held together in close proximity by the FR regions and,
with the HVRs from the other chain, contribute to the formation of
the antigen-binding site of antibodies (see Kabat et al., Sequences
of Proteins of Immunological Interest, Fifth Edition, National
Institute of Health, Bethesda, Md. (1991)). The constant domains
are not involved directly in the binding of an antibody to an
antigen, but exhibit various effector functions, such as
participation of the antibody in antibody-dependent cellular
toxicity.
[0093] The "light chains" of antibodies (immunoglobulins) from any
mammalian species can be assigned to one of two clearly distinct
types, called kappa (".kappa.") and lambda (".lamda."), based on
the amino acid sequences of their constant domains.
[0094] The term IgG "isotype" or "subclass" as used herein is meant
any of the subclasses of immunoglobulins defined by the chemical
and antigenic characteristics of their constant regions.
[0095] Depending on the amino acid sequences of the constant
domains of their heavy chains, antibodies (immunoglobulins) can be
assigned to different classes. There are five major classes of
immunoglobulins: IgA, IgD, IgE, IgG, and IgM, and several of these
may be further divided into subclasses (isotypes), e.g., IgG.sub.1,
IgG.sub.2, IgG.sub.3, IgG.sub.4, IgA.sub.1, and IgA.sub.2. The
heavy chain constant domains that correspond to the different
classes of immunoglobulins are called .alpha., .gamma., .epsilon.,
.gamma., and .mu., respectively. The subunit structures and
three-dimensional configurations of different classes of
immunoglobulins are well known and described generally in, for
example, Abbas et al. Cellular and Mol. Immunology, 4th ed. (W.B.
Saunders, Co., 2000). An antibody may be part of a larger fusion
molecule, formed by covalent or non-covalent association of the
antibody with one or more other proteins or peptides.
[0096] The terms "full length antibody," "intact antibody" and
"whole antibody" are used herein interchangeably to refer to an
antibody in its substantially intact form, not antibody fragments
as defined below. The terms particularly refer to an antibody with
heavy chains that contain an Fc region.
[0097] A "naked antibody" for the purposes herein is an antibody
that is not conjugated to a cytotoxic moiety or radiolabel.
[0098] "Antibody fragments" comprise a portion of an intact
antibody, preferably comprising the antigen binding region thereof.
In some embodiments, the antibody fragment described herein is an
antigen-binding fragment. Examples of antibody fragments include
Fab, Fab', F(ab').sub.2, and Fv fragments; diabodies; linear
antibodies; single-chain antibody molecules; and multispecific
antibodies formed from antibody fragments.
[0099] Papain digestion of antibodies produces two identical
antigen-binding fragments, called "Fab" fragments, each with a
single antigen-binding site, and a residual "Fc" fragment, whose
name reflects its ability to crystallize readily. Pepsin treatment
yields an F(ab').sub.2 fragment that has two antigen-combining
sites and is still capable of cross-linking antigen.
[0100] "Fv" is the minimum antibody fragment which contains a
complete antigen-binding site. In one embodiment, a two-chain Fv
species consists of a dimer of one heavy- and one light-chain
variable domain in tight, non-covalent association. In a
single-chain Fv (scFv) species, one heavy- and one light-chain
variable domain can be covalently linked by a flexible peptide
linker such that the light and heavy chains can associate in a
"dimeric" structure analogous to that in a two-chain Fv species. It
is in this configuration that the three HVRs of each variable
domain interact to define an antigen-binding site on the surface of
the VH-VL dimer. Collectively, the six HVRs confer antigen-binding
specificity to the antibody. However, even a single variable domain
(or half of an Fv comprising only three HVRs specific for an
antigen) has the ability to recognize and bind antigen, although at
a lower affinity than the entire binding site.
[0101] The Fab fragment contains the heavy- and light-chain
variable domains and also contains the constant domain of the light
chain and the first constant domain (CH1) of the heavy chain. Fab'
fragments differ from Fab fragments by the addition of a few
residues at the carboxy terminus of the heavy chain CH1 domain
including one or more cysteines from the antibody hinge region.
Fab'-SH is the designation herein for Fab' in which the cysteine
residue(s) of the constant domains bear a free thiol group.
F(ab').sub.2 antibody fragments originally were produced as pairs
of Fab' fragments which have hinge cysteines between them. Other
chemical couplings of antibody fragments are also known.
[0102] "Single-chain Fv" or "scFv" antibody fragments comprise the
VH and VL domains of antibody, wherein these domains are present in
a single polypeptide chain. Generally, the scFv polypeptide further
comprises a polypeptide linker between the VH and VL domains which
enables the scFv to form the desired structure for antigen binding.
For a review of scFv, see, e.g., Pluckthun, in The Pharmacology of
Monoclonal Antibodies, vol. 113, Rosenburg and Moore eds.,
(Springer-Verlag, New York, 1994), pp. 269-315.
[0103] The term "diabodies" refers to antibody fragments with two
antigen-binding sites, which fragments comprise a heavy-chain
variable domain (VH) connected to a light-chain variable domain
(VL) in the same polypeptide chain (VH-VL). By using a linker that
is too short to allow pairing between the two domains on the same
chain, the domains are forced to pair with the complementary
domains of another chain and create two antigen-binding sites.
Diabodies may be bivalent or bispecific. Diabodies are described
more fully in, for example, EP 404,097; WO 1993/01161; Hudson et
al., Nat. Med. 9:129-134 (2003); and Hollinger et al., Proc. Natl.
Acad. Sci. USA 90: 6444-6448 (1993). Triabodies and tetrabodies are
also described in Hudson et al., Nat. Med. 9:129-134 (2003).
[0104] The term "monoclonal antibody" as used herein refers to an
antibody obtained from a population of substantially homogeneous
antibodies, e.g., the individual antibodies comprising the
population are identical except for possible mutations, e.g.,
naturally occurring mutations, that may be present in minor
amounts. Thus, the modifier "monoclonal" indicates the character of
the antibody as not being a mixture of discrete antibodies. In
certain embodiments, such a monoclonal antibody typically includes
an antibody comprising a polypeptide sequence that binds a target,
wherein the target-binding polypeptide sequence was obtained by a
process that includes the selection of a single target binding
polypeptide sequence from a plurality of polypeptide sequences. For
example, the selection process can be the selection of a unique
clone from a plurality of clones, such as a pool of hybridoma
clones, phage clones, or recombinant DNA clones. It should be
understood that a selected target binding sequence can be further
altered, for example, to improve affinity for the target, to
humanize the target binding sequence, to improve its production in
cell culture, to reduce its immunogenicity in vivo, to create a
multispecific antibody, etc., and that an antibody comprising the
altered target binding sequence is also a monoclonal antibody of
this invention. In contrast to polyclonal antibody preparations,
which typically include different antibodies directed against
different determinants (epitopes), each monoclonal antibody of a
monoclonal antibody preparation is directed against a single
determinant on an antigen. In addition to their specificity,
monoclonal antibody preparations are advantageous in that they are
typically uncontaminated by other immunoglobulins.
[0105] The modifier "monoclonal" indicates the character of the
antibody as being obtained from a substantially homogeneous
population of antibodies, and is not to be construed as requiring
production of the antibody by any particular method. For example,
the monoclonal antibodies to be used in accordance with the
invention may be made by a variety of techniques, including, for
example, the hybridoma method (e.g., Kohler and Milstein, Nature,
256:495-97 (1975); Hongo et al., Hybridoma, 14 (3): 253-260 (1995),
Harlow et al., Antibodies: A Laboratory Manual, (Cold Spring Harbor
Laboratory Press, 2nd ed. 1988); Hammerling et al., in: Monoclonal
Antibodies and T-Cell Hybridomas 563-681 (Elsevier, N.Y., 1981)),
recombinant DNA methods (see, e.g., U.S. Pat. No. 4,816,567),
phage-display technologies (see, e.g., Clackson et al., Nature,
352: 624-628 (1991); Marks et al., J. Mol. Biol. 222: 581-597
(1992); Sidhu et al., J. Mol. Biol. 338(2): 299-310 (2004); Lee et
al., J. Mol. Biol. 340(5): 1073-1093 (2004); Fellouse, Proc. Natl.
Acad. Sci. USA 101(34): 12467-12472 (2004); and Lee et al., J.
Immunol. Methods 284(1-2): 119-132 (2004), and technologies for
producing human or human-like antibodies in animals that have parts
or all of the human immunoglobulin loci or genes encoding human
immunoglobulin sequences (see, e.g., WO 1998/24893; WO 1996/34096;
WO 1996/33735; WO 1991/10741; Jakobovits et al., Proc. Natl. Acad.
Sci. USA 90: 2551 (1993); Jakobovits et al., Nature 362: 255-258
(1993); Bruggemann et al., Year in Immunol. 7:33 (1993); U.S. Pat.
Nos. 5,545,807; 5,545,806; 5,569,825; 5,625,126; 5,633,425; and
U.S. Pat. No. 5,661,016; Marks et al., Bio/Technology 10: 779-783
(1992); Lonberg et al., Nature 368: 856-859 (1994); Morrison,
Nature 368: 812-813 (1994); Fishwild et al., Nature Biotechnol. 14:
845-851 (1996); Neuberger, Nature Biotechnol. 14: 826 (1996); and
Lonberg and Huszar, Intern. Rev. Immunol. 13: 65-93 (1995).
[0106] The monoclonal antibodies herein specifically include
"chimeric" antibodies in which a portion of the heavy and/or light
chain is identical with or homologous to corresponding sequences in
antibodies derived from a particular species or belonging to a
particular antibody class or subclass, while the remainder of the
chain(s) is identical with or homologous to corresponding sequences
in antibodies derived from another species or belonging to another
antibody class or subclass, as well as fragments of such
antibodies, so long as they exhibit the desired biological activity
(see, e.g., U.S. Pat. No. 4,816,567; and Morrison et al., Proc.
Natl. Acad. Sci. USA 81:6851-6855 (1984)) Chimeric antibodies
include PRIMATTZED.RTM. antibodies wherein the antigen-binding
region of the antibody is derived from an antibody produced by,
e.g., immunizing macaque monkeys with the antigen of interest.
[0107] "Humanized" forms of non-human (e.g., murine) antibodies are
chimeric antibodies that contain minimal sequence derived from
non-human immunoglobulin. In one embodiment, a humanized antibody
is a human immunoglobulin (recipient antibody) in which residues
from a HVR of the recipient are replaced by residues from a HVR of
a non-human species (donor antibody) such as mouse, rat, rabbit, or
nonhuman primate having the desired specificity, affinity, and/or
capacity. In some instances, FR residues of the human
immunoglobulin are replaced by corresponding non-human residues.
Furthermore, humanized antibodies may comprise residues that are
not found in the recipient antibody or in the donor antibody. These
modifications may be made to further refine antibody performance.
In general, a humanized antibody will comprise substantially all of
at least one, and typically two, variable domains, in which all or
substantially all of the hypervariable loops correspond to those of
a non-human immunoglobulin, and all or substantially all of the FRs
are those of a human immunoglobulin sequence. The humanized
antibody optionally will also comprise at least a portion of an
immunoglobulin constant region (Fc), typically that of a human
immunoglobulin. For further details, see, e.g., Jones et al.,
Nature 321:522-525 (1986); Riechmann et al., Nature 332:323-329
(1988); and Presta, Curr. Op. Struct. Biol. 2:593-596 (1992). See
also, e.g., Vaswani and Hamilton, Ann. Allergy, Asthma &
Immunol. 1:105-115 (1998); Harris, Biochem. Soc. Transactions
23:1035-1038 (1995); Hurle and Gross, Curr. Op. Biotech. 5:428-433
(1994); and U.S. Pat. Nos. 6,982,321 and 7,087,409.
[0108] A "human antibody" is one which possesses an amino acid
sequence which corresponds to that of an antibody produced by a
human and/or has been made using any of the techniques for making
human antibodies as disclosed herein. This definition of a human
antibody specifically excludes a humanized antibody comprising
non-human antigen-binding residues. Human antibodies can be
produced using various techniques known in the art, including
phage-display libraries. Hoogenboom and Winter, J. Mol. Biol.,
227:381 (1991); Marks et al., J. Mol. Biol., 222:581 (1991). Also
available for the preparation of human monoclonal antibodies are
methods described in Cole et al., Monoclonal Antibodies and Cancer
Therapy, Alan R. Liss, p. 77 (1985); Boerner et al., J. Immunol.,
147(1):86-95 (1991). See also van Dijk and van de Winkel, Curr.
Opin. Pharmacol., 5: 368-74 (2001). Human antibodies can be
prepared by administering the antigen to a transgenic animal that
has been modified to produce such antibodies in response to
antigenic challenge, but whose endogenous loci have been disabled,
e.g., immunized xenomice (see, e.g., U.S. Pat. Nos. 6,075,181 and
6,150,584 regarding XENOMOUSE.TM. technology). See also, for
example, Li et al., Proc. Natl. Acad. Sci. USA, 103:3557-3562
(2006) regarding human antibodies generated via a human B-cell
hybridoma technology.
[0109] A "species-dependent antibody" is one which has a stronger
binding affinity for an antigen from a first mammalian species than
it has for a homologue of that antigen from a second mammalian
species. Normally, the species-dependent antibody "binds
specifically" to a human antigen (e.g., has a binding affinity (Kd)
value of no more than about 1.times.10.sup.-7 M, preferably no more
than about 1.times.10.sup.-8 M and preferably no more than about
1.times.10.sup.-9 M) but has a binding affinity for a homologue of
the antigen from a second nonhuman mammalian species which is at
least about 50 fold, or at least about 500 fold, or at least about
1000 fold, weaker than its binding affinity for the human antigen.
The species-dependent antibody can be any of the various types of
antibodies as defined above, but preferably is a humanized or human
antibody.
[0110] The term "hypervariable region," "HVR," or "HV," when used
herein refers to the regions of an antibody variable domain which
are hypervariable in sequence and/or form structurally defined
loops. Generally, antibodies comprise six HVRs; three in the VH
(H1, H2, H3), and three in the VL (L1, L2, L3). In native
antibodies, H3 and L3 display the most diversity of the six HVRs,
and H3 in particular is believed to play a unique role in
conferring fine specificity to antibodies. See, e.g., Xu et al.,
Immunity 13:37-45 (2000); Johnson and Wu, in Methods in Molecular
Biology 248:1-25 (Lo, ed., Human Press, Totowa, N.J., 2003).
Indeed, naturally occurring camelid antibodies consisting of a
heavy chain only are functional and stable in the absence of light
chain. See, e.g., Hamers-Casterman et al., Nature 363:446-448
(1993); Sheriff et al., Nature Struct. Biol. 3:733-736 (1996).
[0111] A number of HVR delineations are in use and are encompassed
herein. The Kabat Complementarity Determining Regions (CDRs) are
based on sequence variability and are the most commonly used (Kabat
et al., Sequences of Proteins of Immunological Interest, 5th Ed.
Public Health Service, National Institutes of Health, Bethesda, Md.
(1991)). Chothia refers instead to the location of the structural
loops (Chothia and Lesk J. Mol. Biol. 196:901-917 (1987)). The AbM
HVRs represent a compromise between the Kabat HVRs and Chothia
structural loops, and are used by Oxford Molecular's AbM antibody
modeling software. The "contact" HVRs are based on an analysis of
the available complex crystal structures. The residues from each of
these HVRs are noted below.
TABLE-US-00001 Loop Kabat AbM Chothia Contact L1 L24-L34 L24-L34
L26-L32 L30-L36 L2 L50-L56 L50-L56 L50-L52 L46-L55 L3 L89-L97
L89-L97 L91-L96 L89-L96 H1 H31-H35B H26-H35B H26-H32 H30-H35B
(Kabat Numbering) H1 H31-H35 H26-H35 H26-H32 H30-H35 (Chothia
Numbering) H2 H50-H65 H50-H58 H53-H55 H47-H58 H3 H95-H102 H95-H102
H96-H101 H93-H101
[0112] HVRs may comprise "extended HVRs" as follows: 24-36 or 24-34
(L1), 46-56 or 50-56 (L2) and 89-97 or 89-96 (L3) in the VL and
26-35 (H1), 50-65 or 49-65 (H2) and 93-102, 94-102, or 95-102 (H3)
in the VH. The variable domain residues are numbered according to
Kabat et al., supra, for each of these definitions.
[0113] "Framework" or "FR" residues are those variable domain
residues other than the HVR residues as herein defined.
[0114] The term "variable domain residue numbering as in Kabat" or
"amino acid position numbering as in Kabat," and variations
thereof, refers to the numbering system used for heavy chain
variable domains or light chain variable domains of the compilation
of antibodies in Kabat et al., supra. Using this numbering system,
the actual linear amino acid sequence may contain fewer or
additional amino acids corresponding to a shortening of, or
insertion into, a FR or HVR of the variable domain. For example, a
heavy chain variable domain may include a single amino acid insert
(residue 52a according to Kabat) after residue 52 of H2 and
inserted residues (e.g. residues 82a, 82b, and 82c, etc. according
to Kabat) after heavy chain FR residue 82. The Kabat numbering of
residues may be determined for a given antibody by alignment at
regions of homology of the sequence of the antibody with a
"standard" Kabat numbered sequence.
[0115] The Kabat numbering system is generally used when referring
to a residue in the variable domain (approximately residues 1-107
of the light chain and residues 1-113 of the heavy chain) (e.g.,
Kabat et al., Sequences of Immunological Interest. 5th Ed. Public
Health Service, National Institutes of Health, Bethesda, Md.
(1991)). The "EU numbering system" or "EU index" is generally used
when referring to a residue in an immunoglobulin heavy chain
constant region (e.g., the EU index reported in Kabat et al.,
supra). The "EU index as in Kabat" refers to the residue numbering
of the human IgG1 EU antibody.
[0116] The expression "linear antibodies" refers to the antibodies
described in Zapata et al. (1995 Protein Eng, 8(10):1057-1062).
Briefly, these antibodies comprise a pair of tandem Fd segments
(VH-CH1-VH-CH1) which, together with complementary light chain
polypeptides, form a pair of antigen binding regions. Linear
antibodies can be bispecific or monospecific.
[0117] As use herein, the term "binds", "specifically binds to" or
is "specific for" refers to measurable and reproducible
interactions such as binding between a target and an antibody,
which is determinative of the presence of the target in the
presence of a heterogeneous population of molecules including
biological molecules. For example, an antibody that binds to or
specifically binds to a target (which can be an epitope) is an
antibody that binds this target with greater affinity, avidity,
more readily, and/or with greater duration than it binds to other
targets. In one embodiment, the extent of binding of an antibody to
an unrelated target is less than about 10% of the binding of the
antibody to the target as measured, e.g., by a radioimmunoassay
(RIA). In certain embodiments, an antibody that specifically binds
to a target has a dissociation constant (Kd) of .ltoreq.1 .mu.M,
.ltoreq.100 nM, .ltoreq.10 nM, .ltoreq.1 nM, or .ltoreq.0.1 nM. In
certain embodiments, an antibody specifically binds to an epitope
on a protein that is conserved among the protein from different
species. In another embodiment, specific binding can include, but
does not require exclusive binding.
II. PD-1 AXIS BINDING ANTAGONISTS
[0118] Provided herein is a method for treating or delaying
progression of cancer in an individual comprising administering to
the individual an effective amount of a PD-1 axis binding
antagonist and an anti-HER2 antibody. Also provided herein is a
method of enhancing immune function in an individual having cancer
comprising administering to the individual an effective amount of a
PD-1 axis binding antagonist and an anti-HER2 antibody. For
example, a PD-1 axis binding antagonist includes a PD-1 binding
antagonist, a PD-L1 binding antagonist and a PD-L2 binding
antagonist. PD-1 (programmed death 1) is also referred to in the
art as "programmed cell death 1", PDCD1, CD279 and SLEB2. PD-L1
(programmed death ligand 1) is also referred to in the art as
"programmed cell death 1 ligand 1", PDCD1LG1, CD274, B7-H, and
PDL1. PD-L2 (programmed death ligand 2) is also referred to in the
art as "programmed cell death 1 ligand 2", PDCD1LG2, CD273, B7-DC,
Btdc, and PDL2. In some embodiments, PD-1, PD-L1, and PD-L2 are
human PD-1, PD-L1 and PD-L2.
[0119] In some embodiments, the PD-1 binding antagonist is a
molecule that inhibits the binding of PD-1 to its ligand binding
partners. In a specific aspect the PD-1 ligand binding partners are
PD-L1 and/or PD-L2. In another embodiment, a PD-L1 binding
antagonist is a molecule that inhibits the binding of PD-L1 to its
binding partners. In a specific aspect, PD-L1 binding partners are
PD-1 and/or B7-1. In another embodiment, the PD-L2 binding
antagonist is a molecule that inhibits the binding of PD-L2 to its
binding partners. In a specific aspect, a PD-L2 binding partner is
PD-1. The antagonist may be an antibody, an antigen binding
fragment thereof, an immunoadhesin, a fusion protein, or
oligopeptide.
[0120] In some embodiments, the PD-1 binding antagonist is an
anti-PD-1 antibody (e.g., a human antibody, a humanized antibody,
or a chimeric antibody). In some embodiments, the anti-PD-1
antibody is selected from the group consisting of MDX-1106
(nivolumab), MK-3475 (lambrolizumab), and CT-011 (pidilizumab). In
some embodiments, the PD-1 binding antagonist is an immunoadhesin
(e.g., an immunoadhesin comprising an extracellular or PD-1 binding
portion of PD-L1 or PD-L2 fused to a constant region (e.g., an Fc
region of an immunoglobulin sequence). In some embodiments, the
PD-1 binding antagonist is AMP-224. In some embodiments, the PD-L1
binding antagonist is anti-PD-L1 antibody. In some embodiments, the
anti-PD-L1 binding antagonist is selected from the group consisting
of YW243.55.S70, MPDL3280A, MDX-1105, and MEDI4736. Antibody
YW243.55.S70 is an anti-PD-L1 described in WO 2010/077634.
MDX-1105, also known as BMS-936559, is an anti-PD-L1 antibody
described in WO2007/005874. MEDI4736, is an anti-PD-L1 monoclonal
antibody described in WO2011/066389 and US2013/034559. Nivolumab,
also known as MDX-1106-04, MDX-1106, ONO-4538, BMS-936558, and
OPDIVO.RTM., is an anti-PD-1 antibody described in WO2006/121168.
Pembrolizumab, also known as MK-3475, Merck 3475, lambrolizumab,
KEYTRUDA.RTM., and SCH-900475, is an anti-PD-1 antibody described
in WO2009/114335. CT-011, also known as hBAT, hBAT-1 or
pidilizumab, is an anti-PD-1 antibody described in WO2009/101611.
AMP-224, also known as B7-DCIg, is a PD-L2-Fc fusion soluble
receptor described in WO2010/027827 and WO2011/066342.
[0121] In some embodiments, the PD-1 axis binding antagonist is an
anti-PD-L1 antibody. In some embodiments, the anti-PD-L1 antibody
is capable of inhibiting binding between PD-L1 and PD-1 and/or
between PD-L1 and B7-1. In some embodiments, the anti-PD-L1
antibody is a monoclonal antibody. In some embodiments, the
anti-PD-L1 antibody is an antibody fragment selected from the group
consisting of Fab, Fab'-SH, Fv, scFv, and (Fab').sub.2 fragments.
In some embodiments, the anti-PD-L1 antibody is a humanized
antibody. In some embodiments, the anti-PD-L1 antibody is a human
antibody.
[0122] Examples of anti-PD-L1 antibodies useful for the methods of
this invention, and methods for making thereof are described in PCT
patent application WO 2010/077634, WO2007/005874, WO2011/066389,
and US2013/034559, which are incorporated herein by reference. The
anti-PD-L1 antibodies useful in this invention, including
compositions containing such antibodies, may be used in combination
with an anti-HER2 antibody to treat cancer.
[0123] Anti-PD1 Antibodies
[0124] In some embodiments, the anti-PD-1 antibody is MDX-1106.
Alternative names for "MDX-1106" include MDX-1106-04, ONO-4538,
BMS-936558 or Nivolumab. In some embodiments, the anti-PD-1
antibody is Nivolumab (CAS Registry Number: 946414-94-4). In a
still further embodiment, provided is an isolated anti-PD-1
antibody comprising a heavy chain variable region comprising the
heavy chain variable region amino acid sequence from SEQ ID NO:1
and/or a light chain variable region comprising the light chain
variable region amino acid sequence from SEQ ID NO:2. In a still
further embodiment, provided is an isolated anti-PD-1 antibody
comprising a heavy chain and/or a light chain sequence,
wherein:
[0125] (a) the heavy chain sequence has at least 85%, at least 90%,
at least 91%, at least 92%, at least 93%, at least 94%, at least
95%, at least 96%, at least 97%, at least 98%, at least 99% or 100%
sequence identity to the heavy chain sequence:
TABLE-US-00002 (SEQ ID NO: 1)
QVQLVESGGGVVQPGRSLRLDCKASGITFSNSGMHWVRQAPGKGLEWVA
VIWYDGSKRYYADSVKGRFTISRDNSKNTLFLQMNSLRAEDTAVYYCAT
NDDYWGQGTLVTVSSASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFP
EPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTKTYTC
NVDHKPSNTKVDKRVESKYGPPCPPCPAPEFLGGPSVFLFPPKPKDTLM
ISRTPEVTCVVVDVSQEDPEVQFNWYVDGVEVHNAKTKPREEQFNSTYR
VVSVLTVLHQDWLNGKEYKCKVSNKGLPSSIEKTISKAKGQPREPQVYT
LPPSQEEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLD
SDGSFFLYSRLTVDKSRWQEGNVFSCSVMHEALHNHYTQKSLSLSLGK, and
[0126] (b) the light chain sequences has at least 85%, at least
90%, at least 91%, at least 92%, at least 93%, at least 94%, at
least 95%, at least 96%, at least 97%, at least 98%, at least 99%
or 100% sequence identity to the light chain sequence:
TABLE-US-00003 (SEQ ID NO: 2)
EIVLTQSPATLSLSPGERATLSCRASQSVSSYLAWYQQKPGQAPRLLIY
DASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQSSNWPRTF
GQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQ
WKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEV
THQGLSSPVTKSFNRGEC.
[0127] Anti-PDL1 Antibodies
[0128] In some embodiments, the antibody in the formulation
comprises at least one tryptophan (e.g., at least two, at least
three, or at least four) in the heavy and/or light chain sequence.
In some embodiments, amino acid tryptophan is in the CDR regions,
framework regions and/or constant regions of the antibody. In some
embodiments, the antibody comprises two or three tryptophan
residues in the CDR regions. In some embodiments, the antibody in
the formulation is an anti-PDL1 antibody. PD-L1 (programmed death
ligand 1), also known as PDL1, B7-H1, B7-4, CD274, and B7-H, is a
transmembrane protein, and its interaction with PD-1 inhibits
T-cell activation and cytokine production. In some embodiments, the
anti-PDL1 antibody described herein binds to human PD-L1. Examples
of anti-PDL1 antibodies that can be used in the methods described
herein are described in PCT patent application WO 2010/077634 A1
and U.S. Pat. No. 8,217,149, which are incorporated herein by
reference.
[0129] In some embodiments, the anti-PDL1 antibody is capable of
inhibiting binding between PD-L1 and PD-1 and/or between PD-L1 and
B7-1. In some embodiments, the anti-PDL1 antibody is a monoclonal
antibody. In some embodiments, the anti-PDL1 antibody is an
antibody fragment selected from the group consisting of Fab,
Fab'-SH, Fv, scFv, and (Fab').sub.2 fragments. In some embodiments,
the anti-PDL1 antibody is a humanized antibody. In some
embodiments, the anti-PDL1 antibody is a human antibody.
[0130] Anti-PDL1 antibodies described in WO 2010/077634 A1 and U.S.
Pat. No. 8,217,149 may be used in the methods described herein. In
some embodiments, the anti-PDL1 antibody comprises a heavy chain
variable region sequence of SEQ ID NO:3 and/or a light chain
variable region sequence of SEQ ID NO:4. In a still further
embodiment, provided is an isolated anti-PDL1 antibody comprising a
heavy chain and/or a light chain sequence, wherein:
[0131] (a) the heavy chain sequence has at least 85%, at least 90%,
at least 91%, at least 92%, at least 93%, at least 94%, at least
95%, at least 96%, at least 97%, at least 98%, at least 99% or 100%
sequence identity to the heavy chain sequence:
TABLE-US-00004 (SEQ ID NO: 3)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSA, and
[0132] (b) the light chain sequences has at least 85%, at least
90%, at least 91%, at least 92%, at least 93%, at least 94%, at
least 95%, at least 96%, at least 97%, at least 98%, at least 99%
or 100% sequence identity to the light chain sequence:
TABLE-US-00005 (SEQ ID NO: 4)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATF GQGTKVEIKR.
[0133] In one embodiment, the anti-PDL1 antibody comprises a heavy
chain variable region polypeptide comprising an HVR-H1, HVR-H2 and
HVR-H3 sequence, wherein:
TABLE-US-00006 (a) (SEQ ID NO: 5) the HVR-H1 sequence is
GFTFSX.sub.1SWIH; (b) (SEQ ID NO: 6) the HVR-H2 sequence is
AWIX.sub.2PYGGSX.sub.3YYADSVKG; (c) (SEQ ID NO: 7) the HVR-H3
sequence is RHWPGGFDY;
[0134] further wherein: X.sub.1 is D or G; X.sub.2 is S or L;
X.sub.3 is T or S. In one specific aspect, X.sub.1 is D; X.sub.2 is
S and X.sub.3 is T.
[0135] In another aspect, the polypeptide further comprises
variable region heavy chain framework sequences juxtaposed between
the HVRs according to the formula:
(HC-FR1)-(HVR-H1)-(HC-1-R2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4). In
yet another aspect, the framework sequences are derived from human
consensus framework sequences. In a further aspect, the framework
sequences are VH subgroup III consensus framework. In a still
further aspect, at least one of the framework sequences is the
following:
TABLE-US-00007 (SEQ ID NO: 8) HC-1-R1 is EVQLVESGGGLVQPGGSLRLSCAAS
(SEQ ID NO: 9) HC-1-R2 is WVRQAPGKGLEWV (SEQ ID NO: 10) HC-1-R3 is
RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR (SEQ ID NO: 11) HC-1-R4 is
WGQGTLVTVSA.
[0136] In a still further aspect, the heavy chain polypeptide is
further combined with a variable region light chain comprising an
HVR-L1, HVR-L2 and HVR-L3, wherein:
TABLE-US-00008 (SEQ ID NO: 12) (a) the HVR-L1 sequence is
RASQX.sub.4X.sub.5X.sub.6TX.sub.7X.sub.8A; (SEQ ID NO: 13) (b) the
HVR-L2 sequence is SASX.sub.9LX.sub.10S,; (SEQ ID NO: 14) (c) the
HVR-L3 sequence is
QQX.sub.11X.sub.12X.sub.13X.sub.14PX.sub.15T;
wherein: X.sub.4 is D or V; X.sub.5 is V or I; X.sub.6 is S or N;
X.sub.7 is A or F; X.sub.8 is V or L; X.sub.9 is F or T; X.sub.10
is Y or A; X.sub.11 is Y, G, F, or S; X.sub.12 is L, Y, F or W;
X.sub.13 is Y, N, A, T, G, F or I; X.sub.14 is H, V, P, T or I;
X.sub.15 is A, W, R, P or T. In a still further aspect, X.sub.4 is
D; X.sub.5 is V; X.sub.6 is 5; X.sub.7 is A; X.sub.8 is V; X.sub.9
is F; X.sub.10 is Y; X.sub.11 is Y; X.sub.12 is L; X.sub.13 is Y;
X.sub.14 is H; X.sub.15 is A.
[0137] In a still further aspect, the light chain further comprises
variable region light chain framework sequences juxtaposed between
the HVRs according to the formula:
(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-1-R3)-(HVR-L3)-(LC-FR4). In
a still further aspect, the framework sequences are derived from
human consensus framework sequences. In a still further aspect, the
framework sequences are VL kappa I consensus framework. In a still
further aspect, at least one of the framework sequence is the
following:
TABLE-US-00009 (SEQ ID NO: 15) LC-FR1 is DIQMTQSPSSLSASVGDRVTITC
(SEQ ID NO: 16) LC-FR2 is WYQQKPGKAPKLLIY (SEQ ID NO: 17) LC-FR3 is
GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC (SEQ ID NO: 18) LC-FR4 is
FGQGTKVEIKR.
[0138] In another embodiment, provided is an isolated anti-PDL1
antibody or antigen binding fragment comprising a heavy chain and a
light chain variable region sequence, wherein: [0139] (a) the heavy
chain comprises and HVR-H1, HVR-H2 and HVR-H3, wherein further:
TABLE-US-00010 [0139] (SEQ ID NO: 5) (i) the HVR-H1 sequence is
GFTFSX.sub.1SWIH; (SEQ ID NO: 6) (ii) the HVR-H2 sequence is
AWIX.sub.2PYGGSX.sub.3YYADSVKG (SEQ ID NO: 7) (iii) the HVR-H3
sequence is RHWPGGFDY, and
[0140] (b) the light chain comprises and HVR-L1, HVR-L2 and HVR-L3,
wherein further:
TABLE-US-00011 [0140] (SEQ ID NO: 12) (i) the HVR-L1 sequence is
RASQX.sub.4X.sub.5X.sub.6TX.sub.7X.sub.8A (SEQ ID NO: 13) (ii) the
HVR-L2 sequence is SASX.sub.9LX.sub.10S; and (SEQ ID NO: 14) (iii)
the HVR-L3 sequence is
QQX.sub.11X.sub.12X.sub.13X.sub.14PX.sub.15T;
[0141] wherein: X.sub.1 is D or G; X.sub.2 is S or L; X.sub.3 is T
or S; X.sub.4 is D or V; X.sub.5 is V or I; X.sub.6 is S or N;
X.sub.7 is A or F; X.sub.8 is V or L; X.sub.9 is F or T; X.sub.10
is Y or A; X.sub.11 is Y, G, F, or S; X.sub.12 is L, Y, F or W;
X.sub.13 is Y, N, A, T, G, F or I; X.sub.14 is H, V, P, T or I;
X.sub.15 is A, W, R, P or T. In a specific aspect, X.sub.1 is D;
X.sub.2 is S and X.sub.3 is T. In another aspect, X.sub.4 is D;
X.sub.5 is V; X.sub.6 is S; X.sub.7 is A; X.sub.8 is V; X.sub.9 is
F; X.sub.10 is Y; X.sub.11 is Y; X.sub.12 is L; X.sub.13 is Y;
X.sub.14 is H; X.sub.15 is A. In yet another aspect, X.sub.1 is D;
X.sub.2 is S and X.sub.3 is T, X.sub.4 is D; X.sub.5 is V; X.sub.6
is S; X.sub.7 is A; X.sub.8 is V; X.sub.9 is F; X.sub.10 is Y;
X.sub.11 is Y; X.sub.12 is L; X.sub.13 is Y; X.sub.14 is H and
X.sub.15 is A.
[0142] In a further aspect, the heavy chain variable region
comprises one or more framework sequences juxtaposed between the
HVRs as:
(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-1-R3)-(HVR-H3)-(HC-FR4),
and the light chain variable regions comprises one or more
framework sequences juxtaposed between the HVRs as:
(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-FR4). In
a still further aspect, the framework sequences are derived from
human consensus framework sequences. In a still further aspect, the
heavy chain framework sequences are derived from a Kabat subgroup
I, II, or III sequence. In a still further aspect, the heavy chain
framework sequence is a VH subgroup III consensus framework. In a
still further aspect, one or more of the heavy chain framework
sequences are set forth as SEQ ID NOs:8, 9, 10 and 11. In a still
further aspect, the light chain framework sequences are derived
from a Kabat kappa I, II, II or IV subgroup sequence. In a still
further aspect, the light chain framework sequences are VL kappa I
consensus framework. In a still further aspect, one or more of the
light chain framework sequences are set forth as SEQ ID NOs:15, 16,
17 and 18.
[0143] In a still further specific aspect, the antibody further
comprises a human or murine constant region. In a still further
aspect, the human constant region is selected from the group
consisting of IgG1, IgG2, IgG2, IgG3, IgG4. In a still further
specific aspect, the human constant region is IgG1. In a still
further aspect, the murine constant region is selected from the
group consisting of IgG1, IgG2A, IgG2B, IgG3. In a still further
aspect, the murine constant region if IgG2A. In a still further
specific aspect, the antibody has reduced or minimal effector
function. In a still further specific aspect the minimal effector
function results from an "effector-less Fc mutation" or
aglycosylation. In still a further embodiment, the effector-less Fc
mutation is an N297A or D265A/N297A substitution in the constant
region.
[0144] In yet another embodiment, provided is an anti-PDL1 antibody
comprising a heavy chain and a light chain variable region
sequence, wherein: [0145] (a) the heavy chain further comprises an
HVR-H1, HVR-H2 and an HVR-H3 sequence having at least 85% sequence
identity to GFTFSDSWIH (SEQ ID NO:19), AWISPYGGSTYYADSVKG (SEQ ID
NO:20) and RHWPGGFDY (SEQ ID NO:21), respectively, or [0146] (b)
the light chain further comprises an HVR-L1, HVR-L2 and an HVR-L3
sequence having at least 85% sequence identity to RASQDVSTAVA (SEQ
ID NO:22), SASFLYS (SEQ ID NO:23) and QQYLYHPAT (SEQ ID NO:24),
respectively. In a specific aspect, the sequence identity is 86%,
87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or
100%.
[0147] In another aspect, the heavy chain variable region comprises
one or more framework sequences juxtaposed between the HVRs as:
(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and
the light chain variable regions comprises one or more framework
sequences juxtaposed between the HVRs as:
(LC-1-R1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-1-R4).
In yet another aspect, the framework sequences are derived from
human consensus framework sequences. In a still further aspect, the
heavy chain framework sequences are derived from a Kabat subgroup
I, II, or III sequence. In a still further aspect, the heavy chain
framework sequence is a VH subgroup III consensus framework. In a
still further aspect, one or more of the heavy chain framework
sequences are set forth as SEQ ID NOs:8, 9, 10 and 11. In a still
further aspect, the light chain framework sequences are derived
from a Kabat kappa I, II, II or IV subgroup sequence. In a still
further aspect, the light chain framework sequences are VL kappa I
consensus framework. In a still further aspect, one or more of the
light chain framework sequences are set forth as SEQ ID NOs:15, 16,
17 and 18.
[0148] In a still further specific aspect, the antibody further
comprises a human or murine constant region. In a still further
aspect, the human constant region is selected from the group
consisting of IgG1, IgG2, IgG2, IgG3, IgG4. In a still further
specific aspect, the human constant region is IgG1. In a still
further aspect, the murine constant region is selected from the
group consisting of IgG1, IgG2A, IgG2B, IgG3. In a still further
aspect, the murine constant region if IgG2A. In a still further
specific aspect, the antibody has reduced or minimal effector
function. In a still further specific aspect the minimal effector
function results from an "effector-less Fc mutation" or
aglycosylation. In still a further embodiment, the effector-less Fc
mutation is an N297A or D265A/N297A substitution in the constant
region.
[0149] In another further embodiment, provided is an isolated
anti-PDL1 antibody comprising a heavy chain and a light chain
variable region sequence, wherein:
[0150] (a) the heavy chain sequence has at least 85% sequence
identity to the heavy chain sequence:
TABLE-US-00012 (SEQ ID NO: 25)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSS,
and/or
[0151] (b) the light chain sequences has at least 85% sequence
identity to the light chain sequence:
TABLE-US-00013 (SEQ ID NO: 4)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIYS
ASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATFGQ GTKVEIKR.
In a specific aspect, the sequence identity is 86%, 87%, 88%, 89%,
90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or 100%. In
another aspect, the heavy chain variable region comprises one or
more framework sequences juxtaposed between the HVRs as:
(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-FR3)-(HVR-H3)-(HC-FR4), and
the light chain variable regions comprises one or more framework
sequences juxtaposed between the HVRs as:
(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-1-R3)-(HVR-L3)-(LC-FR4). In
yet another aspect, the framework sequences are derived from human
consensus framework sequences. In a further aspect, the heavy chain
framework sequences are derived from a Kabat subgroup I, II, or III
sequence. In a still further aspect, the heavy chain framework
sequence is a VH subgroup III consensus framework. In a still
further aspect, one or more of the heavy chain framework sequences
are set forth as SEQ ID NOs:8, 9, 10 and WGQGTLVTVSS (SEQ ID
NO:27).
[0152] In a still further aspect, the light chain framework
sequences are derived from a Kabat kappa I, II, II or IV subgroup
sequence. In a still further aspect, the light chain framework
sequences are VL kappa I consensus framework. In a still further
aspect, one or more of the light chain framework sequences are set
forth as SEQ ID NOs:15, 16, 17 and 18.
[0153] In a still further specific aspect, the antibody further
comprises a human or murine constant region. In a still further
aspect, the human constant region is selected from the group
consisting of IgG1, IgG2, IgG2, IgG3, IgG4. In a still further
specific aspect, the human constant region is IgG1. In a still
further aspect, the murine constant region is selected from the
group consisting of IgG1, IgG2A, IgG2B, IgG3. In a still further
aspect, the murine constant region if IgG2A. In a still further
specific aspect, the antibody has reduced or minimal effector
function. In a still further specific aspect, the minimal effector
function results from production in prokaryotic cells. In a still
further specific aspect the minimal effector function results from
an "effector-less Fc mutation" or aglycosylation. In still a
further embodiment, the effector-less Fc mutation is an N297A or
D265A/N297A substitution in the constant region.
[0154] In a further aspect, the heavy chain variable region
comprises one or more framework sequences juxtaposed between the
HVRs as:
(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-1-R3)-(HVR-H3)-(HC-FR4),
and the light chain variable regions comprises one or more
framework sequences juxtaposed between the HVRs as:
(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-1-R4). In
a still further aspect, the framework sequences are derived from
human consensus framework sequences. In a still further aspect, the
heavy chain framework sequences are derived from a Kabat subgroup
I, II, or III sequence. In a still further aspect, the heavy chain
framework sequence is a VH subgroup III consensus framework. In a
still further aspect, one or more of the heavy chain framework
sequences is the following:
TABLE-US-00014 HC-FR1 (SEQ ID NO: 29)
EVQLVESGGGLVQPGGSLRLSCAASGFTFS HC-1-R2 (SEQ ID NO: 30)
WVRQAPGKGLEWVA HC-1-R3 (SEQ ID NO: 10)
RFTISADTSKNTAYLQMNSLRAEDTAVYYCAR HC-1-R4 (SEQ ID NO: 27)
WGQGTLVTVSS.
[0155] In a still further aspect, the light chain framework
sequences are derived from a Kabat kappa I, II, II or IV subgroup
sequence. In a still further aspect, the light chain framework
sequences are VL kappa I consensus framework. In a still further
aspect, one or more of the light chain framework sequences is the
following:
TABLE-US-00015 LC-FR1 (SEQ ID NO: 15) DIQMTQSPSSLSASVGDRVTITC
LC-FR2 (SEQ ID NO: 16) WYQQKPGKAPKLLIY LC-FR3 (SEQ ID NO: 17)
GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC LC-FR4 (SEQ ID NO: 28)
FGQGTKVEIK.
[0156] In a still further specific aspect, the antibody further
comprises a human or murine constant region. In a still further
aspect, the human constant region is selected from the group
consisting of IgG1, IgG2, IgG2, IgG3, IgG4. In a still further
specific aspect, the human constant region is IgG1. In a still
further aspect, the murine constant region is selected from the
group consisting of IgG1, IgG2A, IgG2B, IgG3. In a still further
aspect, the murine constant region if IgG2A. In a still further
specific aspect, the antibody has reduced or minimal effector
function. In a still further specific aspect the minimal effector
function results from an "effector-less Fc mutation" or
aglycosylation. In still a further embodiment, the effector-less Fc
mutation is an N297A or D265A/N297A substitution in the constant
region.
[0157] In yet another embodiment, provided is an anti-PDL1 antibody
comprising a heavy chain and a light chain variable region
sequence, wherein: [0158] (c) the heavy chain further comprises an
HVR-H1, HVR-H2 and an HVR-H3 sequence having at least 85% sequence
identity to GFTFSDSWIH (SEQ ID NO:19), AWISPYGGSTYYADSVKG (SEQ ID
NO:20) and RHWPGGFDY (SEQ ID NO:21), respectively, and/or [0159]
(d) the light chain further comprises an HVR-L1, HVR-L2 and an
HVR-L3 sequence having at least 85% sequence identity to
RASQDVSTAVA (SEQ ID NO:22), SASFLYS (SEQ ID NO:23) and QQYLYHPAT
(SEQ ID NO:24), respectively. In a specific aspect, the sequence
identity is 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%,
97%, 98%, 99% or 100%.
[0160] In another aspect, the heavy chain variable region comprises
one or more framework sequences juxtaposed between the HVRs as:
(HC-FR1)-(HVR-H1)-(HC-FR2)-(HVR-H2)-(HC-1-R3)-(HVR-H3)-(HC-FR4),
and the light chain variable regions comprises one or more
framework sequences juxtaposed between the HVRs as:
(LC-FR1)-(HVR-L1)-(LC-FR2)-(HVR-L2)-(LC-FR3)-(HVR-L3)-(LC-1-R4). In
yet another aspect, the framework sequences are derived from human
consensus framework sequences. In a still further aspect, the heavy
chain framework sequences are derived from a Kabat subgroup I, II,
or III sequence. In a still further aspect, the heavy chain
framework sequence is a VH subgroup III consensus framework. In a
still further aspect, one or more of the heavy chain framework
sequences are set forth as SEQ ID NOs:8, 9, 10 and WGQGTLVTVSSASTK
(SEQ ID NO:31).
[0161] In a still further aspect, the light chain framework
sequences are derived from a Kabat kappa I, II, II or IV subgroup
sequence. In a still further aspect, the light chain framework
sequences are VL kappa I consensus framework. In a still further
aspect, one or more of the light chain framework sequences are set
forth as SEQ ID NOs:15, 16, 17 and 18. In a still further specific
aspect, the antibody further comprises a human or murine constant
region. In a still further aspect, the human constant region is
selected from the group consisting of IgG1, IgG2, IgG2, IgG3, IgG4.
In a still further specific aspect, the human constant region is
IgG1. In a still further aspect, the murine constant region is
selected from the group consisting of IgG1, IgG2A, IgG2B, IgG3. In
a still further aspect, the murine constant region if IgG2A. In a
still further specific aspect, the antibody has reduced or minimal
effector function. In a still further specific aspect the minimal
effector function results from an "effector-less Fc mutation" or
aglycosylation. In still a further embodiment, the effector-less Fc
mutation is an N297A or D265A/N297A substitution in the constant
region.
[0162] In a still further embodiment, provided is an isolated
anti-PDL1 antibody comprising a heavy chain and a light chain
variable region sequence, wherein:
[0163] (a) the heavy chain sequence has at least 85% sequence
identity to the heavy chain sequence:
TABLE-US-00016 (SEQ ID NO: 26)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSSASTK,
or
[0164] (b) the light chain sequences has at least 85% sequence
identity to the light chain sequence:
TABLE-US-00017 (SEQ ID NO: 4)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATF GQGTKVEIKR.
[0165] In some embodiments, provided is an isolated anti-PDL1
antibody comprising a heavy chain and a light chain variable region
sequence, wherein the light chain variable region sequence has at
least 85%, at least 86%, at least 87%, at least 88%, at least 89%,
at least 90%, at least 91%, at least 92%, at least 93%, at least
94%, at least 95%, at least 96%, at least 97%, at least 98%, at
least 99% or 100% sequence identity to the amino acid sequence of
SEQ ID NO:4. In some embodiments, provided is an isolated anti-PDL1
antibody comprising a heavy chain and a light chain variable region
sequence, wherein the heavy chain variable region sequence has at
least 85%, at least 86%, at least 87%, at least 88%, at least 89%,
at least 90%, at least 91%, at least 92%, at least 93%, at least
94%, at least 95%, at least 96%, at least 97%, at least 98%, at
least 99% or 100% sequence identity to the amino acid sequence of
SEQ ID NO:26. In some embodiments, provided is an isolated
anti-PDL1 antibody comprising a heavy chain and a light chain
variable region sequence, wherein the light chain variable region
sequence has at least 85%, at least 86%, at least 87%, at least
88%, at least 89%, at least 90%, at least 91%, at least 92%, at
least 93%, at least 94%, at least 95%, at least 96%, at least 97%,
at least 98%, at least 99%, or 100% sequence identity to the amino
acid sequence of SEQ ID NO:4 and the heavy chain variable region
sequence has at least 85%, at least 86%, at least 87%, at least
88%, at least 89%, at least 90%, at least 91%, at least 92%, at
least 93%, at least 94%, at least 95%, at least 96%, at least 97%,
at least 98%, at least 99%, or 100% sequence identity to the amino
acid sequence of SEQ ID NO:26. In some embodiments, one, two,
three, four or five amino acid residues at the N-terminal of the
heavy and/or light chain may be deleted, substituted or
modified.
[0166] In a still further embodiment, provided is an isolated
anti-PDL1 antibody comprising a heavy chain and a light chain
sequence, wherein:
[0167] (a) the heavy chain sequence has at least 85% sequence
identity to the heavy chain sequence:
TABLE-US-00018 (SEQ ID NO: 32)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLV
KDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGT
QTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSVFLFP
PKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPRE
EQYASTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNY
KTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKS LSLSPG,
and/or
[0168] (b) the light chain sequences has at least 85% sequence
identity to the light chain sequence:
TABLE-US-00019 (SEQ ID NO: 33)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATF
GQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQ
WKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEV
THQGLSSPVTKSFNRGEC
In a still further embodiment, provided is an isolated anti-PDL1
antibody comprising a heavy chain and a light chain sequence,
wherein:
[0169] (a) the heavy chain sequence has at least 85% sequence
identity to the heavy chain sequence:
TABLE-US-00020 (SEQ ID NO: 54)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLV
KDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGT
QTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSVFLFP
PKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPRE
EQYASTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNY
KTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKS LSLSPGK,
and/or
[0170] (b) the light chain sequences has at least 85% sequence
identity to the light chain sequence:
TABLE-US-00021 (SEQ ID NO: 33)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIYS
ASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATFGQ
GTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKV
DNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQG
LSSPVTKSFNRGEC.
[0171] In some embodiments, provided is an isolated anti-PDL1
antibody comprising a heavy chain and a light chain sequence,
wherein the light chain sequence has at least 85%, at least 86%, at
least 87%, at least 88%, at least 89%, at least 90%, at least 91%,
at least 92%, at least 93%, at least 94%, at least 95%, at least
96%, at least 97%, at least 98%, or at least 99% sequence identity
to the amino acid sequence of SEQ ID N0:33. In some embodiments,
provided is an isolated anti-PDL1 antibody comprising a heavy chain
and a light chain sequence, wherein the heavy chain sequence has at
least 85%, at least 86%, at least 87%, at least 88%, at least 89%,
at least 90%, at least 91%, at least 92%, at least 93%, at least
94%, at least 95%, at least 96%, at least 97%, at least 98%, or at
least 99% sequence identity to the amino acid sequence of SEQ ID
N0:32 or 54. In some embodiments, provided is an isolated anti-PDL1
antibody comprising a heavy chain and a light chain sequence,
wherein the light chain sequence has at least 85%, at least 86%, at
least 87%, at least 88%, at least 89%, at least 90%, at least 91%,
at least 92%, at least 93%, at least 94%, at least 95%, at least
96%, at least 97%, at least 98%, or at least 99% sequence identity
to the amino acid sequence of SEQ ID N0:33 and the heavy chain
sequence has at least 85%, at least 86%, at least 87%, at least
88%, at least 89%, at least 90%, at least 91%, at least 92%, at
least 93%, at least 94%, at least 95%, at least 96%, at least 97%,
at least 98%, or at least 99% sequence identity to the amino acid
sequence of SEQ ID N0:32 or 54.
[0172] In some embodiments, the isolated anti-PDL1 antibody is
aglycosylated. Glycosylation of antibodies is typically either
N-linked or O-linked. N-linked refers to the attachment of the
carbohydrate moiety to the side chain of an asparagine residue. The
tripeptide sequences asparagine-X-serine and
asparagine-X-threonine, where X is any amino acid except proline,
are the recognition sequences for enzymatic attachment of the
carbohydrate moiety to the asparagine side chain. Thus, the
presence of either of these tripeptide sequences in a polypeptide
creates a potential glycosylation site. O-linked glycosylation
refers to the attachment of one of the sugars N-aceylgalactosamine,
galactose, or xylose to a hydroxyamino acid, most commonly serine
or threonine, although 5-hydroxyproline or 5-hydroxylysine may also
be used. Removal of glycosylation sites form an antibody is
conveniently accomplished by altering the amino acid sequence such
that one of the above-described tripeptide sequences (for N-linked
glycosylation sites) is removed. The alteration may be made by
substitution of an asparagine, serine or threonine residue within
the glycosylation site another amino acid residue (e.g., glycine,
alanine or a conservative substitution).
[0173] In any of the embodiments herein, the isolated anti-PDL1
antibody can bind to a human PD-L1, for example a human PD-L1 as
shown in UniProtKB/Swiss-Prot Accession No. Q9NZQ7.1, or a variant
thereof.
[0174] In a still further embodiment, provided is an isolated
nucleic acid encoding any of the antibodies described herein. In
some embodiments, the nucleic acid further comprises a vector
suitable for expression of the nucleic acid encoding any of the
previously described anti-PDL1 antibodies. In a still further
specific aspect, the vector is in a host cell suitable for
expression of the nucleic acid. In a still further specific aspect,
the host cell is a eukaryotic cell or a prokaryotic cell. In a
still further specific aspect, the eukaryotic cell is a mammalian
cell, such as Chinese hamster ovary (CHO) cell.
[0175] The antibody or antigen binding fragment thereof, may be
made using methods known in the art, for example, by a process
comprising culturing a host cell containing nucleic acid encoding
any of the previously described anti-PDL1 antibodies or
antigen-binding fragment in a form suitable for expression, under
conditions suitable to produce such antibody or fragment, and
recovering the antibody or fragment.
III. ANTI-HER2 ANTIBODIES
[0176] Provided herein is a method for treating or delaying
progression of cancer in an individual comprising administering to
the individual an effective amount of a PD-1 axis binding
antagonist and an anti-HER2 antibody. Also provided herein is a
method of enhancing immune function in an individual having cancer
comprising administering to the individual an effective amount of a
PD-1 axis binding antagonist and an anti-HER2 antibody.
[0177] Provided herein are antibodies that bind to a human
epidermal growth factor receptor 2 (HER2). Alternative names for
"HER2" include ERBB2, Neu, CD340, and p185. The term "HER2" as used
herein, refers to any native HER2 from any human source. The term
encompasses "full-length" and unprocessed HER2 as well as any form
of HER2 that results from processing in the cell (e.g., mature
protein). The term also encompasses naturally occurring variants
and isoforms of HER2, e.g., splice variants or allelic variants.
For example, descriptions of HER2 and sequences are provided at
www.uniprot.org/uniprot/P04626.
[0178] In some embodiments, the anti-HER antibody binds to HER2 and
inhibits cell proliferation or growth of HER2+ cancer cells. In
some embodiments, the anti-HER2 antibody binds to HER2 and inhibits
dimerization of HER2 with other HER receptors. In some embodiments,
the anti-HER2 antibody is trastuzumab or pertuzumab.
[0179] In some embodiments, the antigen binding domain of an
antibody that binds to a HER2 comprises a heavy chain variable
region (V.sub.HHER2) comprising the amino acid sequence:
TABLE-US-00022 (SEQ ID NO: 34)
EVQLVESGGGLVQPGGSLRLSCAASGFNIKDTYIHWVRQAPGKGLEWVAR
IYPTNGYTRYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCSRWG
GDGFYAMDYWGQGTLVTVSS,
and/or a light chain variable region (V.sub.LHER2) comprising the
amino acid sequence:
TABLE-US-00023 (SEQ ID NO: 35)
DIQMTQSPSSLSASVGDRVTITCRASQDVNTAVAWYQQKPGKAPKLLIYS
ASFLYSGVPSRFSGSRSGTDFTLTISSLQPEDFATYYCQQHYTTPPTFGQ GTKVEIK.
In some embodiments, the heavy chain of the anti-HER2 antibody
comprises the amino acid sequence:
TABLE-US-00024 (SEQ ID NO: 36)
EVQLVESGGGLVQPGGSLRLSCAASGFNIKDTYIHWVRQAPGKGLEWVA
RIYPTNGYTRYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCSR
WGGDGFYAMDYWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGC
LVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSL
GTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSVFL
FPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKP
REEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAK
GQPREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPEN
NYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQ KSLSLSPG,
and/or the light chain of the anti-HER2 antibody comprises the
amino acid sequence:
TABLE-US-00025 (SEQ ID NO: 37)
DIQMTQSPSSLSASVGDRVTITCRASQDVNTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSRSGTDFTLTISSLQPEDFATYYCQQHYTTPPTF
GQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQ
WKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEV
THQGLSSPVTKSFNRGEC.
In some embodiments, the anti-HER2 antibody comprises a heavy chain
variable region comprising an HVR-H1 sequence of DTYIH (SEQ ID
NO:38), an HVR-H2 sequence of RIYPTNGYTRYADSVKG (SEQ ID NO:50), and
an HVR-H3 sequence of WGGDGFYAMDY (SEQ ID NO:40) and a light chain
variable region comprising an HVR-L1 sequence of RASQDVNTAVA (SEQ
ID NO:41), an HVR-L2 sequence of SASFLYS (SEQ ID NO:42), and an
HVR-L3 sequence of QQHYTTPPT (SEQ ID NO:43).
[0180] Bispecific Antibodies
[0181] In some embodiments, the anti-HER2 is a multispecific
antibody or a bispecific antibody. In some embodiments, the
bispecific antibody comprises a first antigen binding domain that
binds a HER2, and a second antigen binding domain that binds to a
human CD3 polypeptide.
[0182] CD3 (cluster of differentiation 3) T-cell co-receptor is a
protein complex and is composed of four distinct chains. In
mammals, the complex contains a CD3.gamma. chain, a CD3.delta.
chain, and two CD3.epsilon. chains. These chains associate with the
T-cell receptor (TCR) and the .zeta.-chain to generate an
activation signal in T lymphocytes. The TCR, .zeta.-chain, and CD3
molecules together form the TCR complex. The term "CD3" as used
herein, refers to any native CD3 from any human source. The term
encompasses "full-length" and unprocessed protein as well as any
form of the protein or one or more of the CD3 chains (polypeptides)
that result from processing in the cell (e.g., mature
polypeptides). The term also encompasses naturally occurring
variants and isoforms of CD3, e.g., splice variants or allelic
variants. For example, descriptions of CD3.gamma. chain, CD3.delta.
chain, and CD3.epsilon. chains and sequences are provided at
www.uniprot.org/uniprot/P04234, www.uniprot.org/uniprot/P07766, and
www.uniprot.org/uniprot/P09693.
[0183] In some embodiments, the bispecific antibody binds to a
human CD3 epsilon (CD3.epsilon.) polypeptide. In some embodiments,
the bispecific antibody binds to a human CD3 epsilon polypeptide in
native T-cell receptor (TCR) complex in association with other TCR
subunits. In some embodiments, the bispecific antibody binds to a
human CD3 gamma (CD3.gamma.) polypeptide. In some embodiments, the
bispecific antibody binds a human CD3 gamma polypeptide in native
T-cell receptor (TCR) complex in association with other TCR
subunits.
[0184] In one aspect, assays are provided for identifying anti-CD3
antibodies thereof having biological activity. Biological activity
may include, for example, binding to a CD3 polypeptide (e.g., CD3
on the surface of a T cell), or a peptide fragment thereof, either
in vivo, in vitro, or ex vivo. In the case of a multispecific
(e.g., bispecific) anti-CD3 antibody of the invention (e.g., a TDB
antibody having one anti-HER2 arm and another arm that recognizes a
CD3 polypeptide), biological activity may also include, for
example, effector cell activation (e.g., T cell (e.g., CD8+ and/or
CD4+ T cell) activation), effector cell population expansion (i.e.,
an increase in T cell count), target cell population reduction
(i.e., a decrease in the population of cells expressing HER2 on
their cell surfaces), and/or target cell killing. Antibodies having
such biological activity in vivo and/or in vitro are provided. In
certain embodiments, an antibody of the invention is tested for
such biological activity.
[0185] In some embodiments, the antigen binding domain of a
bispecific antibody that binds to a HER2 comprises a heavy chain
variable region (V.sub.HHER2) comprising the amino acid sequence of
SEQ ID NO:34, and a light chain variable region (V.sub.LHER2)
comprising the amino acid sequence of SEQ ID NO:35. In some
embodiments, the antigen binding domain that binds to a HER2
comprises a heavy chain variable region comprising an HVR-H1
sequence of DTYIH (SEQ ID NO:38), an HVR-H2 sequence of
RIYPTNGYTRYASDVKG (SEQ ID NO:39), and an HVR-H3 sequence of
WGGDGFYAMDY (SEQ ID NO:40) and comprises a light chain comprising
an HVR-L1 sequence of RASQDVNTAVA (SEQ ID NO:41), an HVR-L2
sequence of SASFLYS (SEQ ID NO:42), and an HVR-L3 sequence of
QQHYTTPPT (SEQ ID NO:43). In some embodiments, the antigen binding
domain that binds to a HER2 comprises a heavy chain variable region
comprising an HVR-H1 sequence of DTYIH (SEQ ID NO:38), an HVR-H2
sequence of RIYPTNGYTRYADSVKG (SEQ ID NO:50), and an HVR-H3
sequence of WGGDGFYAMDY (SEQ ID NO:40) and a light chain variable
region comprising an HVR-L1 sequence of RASQDVNTAVA (SEQ ID NO:41),
an HVR-L2 sequence of SASFLYS (SEQ ID NO:42), and an HVR-L3
sequence of QQHYTTPPT (SEQ ID NO:43). In some embodiments, the
antigen binding domain that binds to HER2 comprises a heavy chain
variable region comprising an HVR-H1 sequence of DTYIH (SEQ ID
NO:38), an HVR-H2 sequence of RIYPTNGYTRYDPKFQD (SEQ ID NO:51), and
an HVR-H3 sequence of WGGDGFYAMDY (SEQ ID NO:40) and comprises a
light chain variable region comprising an HVR-L1 sequence of
KASQDVNTAVA (SEQ ID NO:52), an HVR-L2 sequence of SASFRYT (SEQ ID
NO:53), and an HVR-L3 sequence of QQHYTTPPT (SEQ ID NO:43).
[0186] In some embodiments, the antigen binding domain of a
bispecific antibody that binds to a CD3 comprises a heavy chain
variable region (V.sub.HCD3) amino acid sequences and a light chain
variable region (V.sub.LCD3) amino acid sequences as described in
Zhu et al., Int J Cancer 62:319-24, 1995 and Rodrigues et al., Int
J Cancer Suppl 7:45-50, 1992. In some embodiments, the antigen
binding domain that binds to a CD3 comprises a heavy chain variable
region comprising an HVR-H1 sequence of GYTMN (SEQ ID NO:44), an
HVR-H2 sequence of LINPYKGVSTYNQKFKD (SEQ ID NO:45), and an HVR-H3
sequence of SGYYGDSDWYFDV (SEQ ID NO:46) and comprises a light
chain comprising an HVR-L1 sequence of RASQDIRNYLN (SEQ ID NO:47),
an HVR-L2 sequence of YTSRLES (SEQ ID NO:48), and an HVR-L3
sequence of QQGNTLPWT (SEQ ID NO:49). See CDR sequences of antibody
huxCD3v9 in Rodrigues et al., Int. J. Cancer: Supplement 7, 45-50,
1992. In some embodiments, the antigen binding domain that binds to
a human CD3 polypeptide comprises the VH and VL sequences described
in WO2004/106381, WO2005/061547, WO2007/042261, WO2008/119567, and
Rodrigues et al., Int J Cancer Suppl 7:45-50, 1992.
[0187] In some embodiments, the first antigen binding domain of the
bispecific antibody comprises one or more heavy chain constant
domains, wherein the one or more heavy chain constant domains are
selected from a first CH1 (CH1.sub.1) domain, a first CH2
(CH2.sub.1) domain, a first CH3 (CH3.sub.1) domain; and the second
antigen binding domain of the bispecific antibody comprises one or
more heavy chain constant domains, wherein the one or more heavy
chain constant domains are selected from a second CH1 (CH1.sub.2)
domain, second CH2 (CH2.sub.2) domain, and a second CH3 (CH3.sub.2)
domain. In some embodiments, at least one of the one or more heavy
chain constant domains of the first antigen binding domain is
paired with another heavy chain constant domain of the second
antigen binding domain. In some embodiments, the CH3.sub.1 and
CH3.sub.2 domains each comprise a protuberance or cavity, and
wherein the protuberance or cavity in the CH3.sub.1 domain is
positionable in the cavity or protuberance, respectively, in the
CH3.sub.2 domain. In some embodiments, the CH3.sub.1 and CH3.sub.2
domains meet at an interface between said protuberance and cavity.
Exemplary sets of amino acid substitutions in CH3.sub.1 and
CH3.sub.2 domains are shown in Table 2 herein. In some embodiments,
the CH2.sub.1 and CH2.sub.2 domains each comprise a protuberance or
cavity, and wherein the protuberance or cavity in the CH2.sub.1
domain is positionable in the cavity or protuberance, respectively,
in the CH2.sub.2 domain. In some embodiments, the CH2.sub.1 and
CH2.sub.2 domains meet at an interface between said protuberance
and cavity. In some embodiments, the CH3.sub.1 and/or CH3.sub.2
domain of an IgG contain one or more amino acid substitutions at
residues selected from the group consisting of 347, 349, 350, 351,
366, 368, 370, 392, 394, 395, 398, 399, 405, 407, and 409 according
to the amino acid numbering as shown in FIG. 5 of the U.S. Pat. No.
8,216,805. In some embodiments, the protuberance comprises one or
more introduced residues selected from the group consisting of
arginine (R) residue, phenylalanine (F) residue, tyrosine (Y)
residue, and tryptophan (W) residue. In some embodiments, the
cavity comprises one or more introduced residues selected from the
group consisting of alanine (A) residue, serine (S) residue,
threonine (T) residue, and valine (V) residue. In some embodiments,
the CH3 and/or CH2 domains are from an IgG (e.g., IgG1 subtype,
IgG2 subtype, IgG2A subtype, IgG2B subtype, IgG3, subtype, or IgG4
subtype). In some embodiments, one CH3 domain of the bispecific
antibody comprises amino acid substitution T366Y, and the other CH3
domain comprises amino acid substitution Y407T. In some
embodiments, one CH3 domain comprises amino acid substitution
T366W, and the other CH3 domain comprises amino acid substitution
Y407A. In some embodiments, one CH3 domain comprises amino acid
substitution F405A, and the other CH3 domain comprises amino acid
substitution T394W. In some embodiments, one CH3 domain comprises
amino acid substitutions T366Y and F405A, and the other CH3 domain
comprises amino acid substitutions T394W and Y407T. In some
embodiments, one CH3 domain comprises amino acid substitutions
T366W and F405W, and the other CH3 domain comprises amino acid
substitutions T394S and Y407A. In some embodiments, one CH3 domain
comprises amino acid substitutions F405W and Y407A, and the other
CH3 domain comprises amino acid substitutions T366W and T394S. In
some embodiments, one CH3 domain comprises amino acid substitution
F405W, and the other CH3 domain comprises amino acid substitution
T394S. The mutations are denoted by the original residue, followed
by the position using the Kabat numbering system, and then the
import residues. See also numbering in FIG. 5 of U.S. Pat. No.
8,216,805.
[0188] In some embodiments, the bispecific antibody having a heavy
chain Fc region comprises an aglycosylation site mutation. In some
embodiments, the aglycosylation site mutation is a substitution
mutation. In some embodiments, the substitution mutation is at
amino acid residue N297, L234, L235, and/or D265 (EU numbering). In
some embodiments, the substitution mutation is selected from the
group consisting of N297G, N297A, L234A, L235A, and D265A. In some
embodiments, the substitution mutation is a D265A mutation and an
N297G mutation. In some embodiments, the aglycosylation site
mutation reduces effector function of the anti-HER2 antibody.
[0189] In some embodiments, the bispecific antibody is a
single-chain bispecific antibody comprising the first antigen
binding domain and the second antigen binding domain. In some
embodiments, the single-chain bispecific antibody comprises
variable regions, as arranged from N-terminus to C-terminus,
selected from the group consisting of (1)
V.sub.HHER2-V.sub.LHER2-V.sub.HCD3-V.sub.LCD3, (2)
V.sub.HCD3-V.sub.LCD3-V.sub.HHER2-V.sub.LHER2, (3)
V.sub.HCD3-V.sub.LCD3-V.sub.LHER2-V.sub.HHER2, (4)
V.sub.HHER2-V.sub.LHER2-V.sub.LCD3-V.sub.HCD3, (5)
V.sub.LHER2-V.sub.HHER2-V.sub.HCD3-V.sub.LCD3, and (6)
V.sub.LCD3-V.sub.HCD3-V.sub.HHER2-V.sub.LHER2.
IV. ANTIBODY PREPARATION
[0190] The antibody described herein is prepared using techniques
available in the art for generating antibodies, exemplary methods
of which are described in more detail in the following
sections.
[0191] The antibody is directed against an antigen of interest
(i.e., PD-L1 (such as a human PD-L1), HER2, or CD3 (such as a human
CD3)). Preferably, the antigen is a biologically important
polypeptide and administration of the antibody to a mammal
suffering from a disorder can result in a therapeutic benefit in
that mammal.
[0192] In certain embodiments, an antibody provided herein has a
dissociation constant (Kd) of .ltoreq.1 .mu.M, .ltoreq.150 nM,
.ltoreq.100 nM, .ltoreq.50 nM, .ltoreq.10 nM, .ltoreq.1 nM,
.ltoreq.0.1 nM, .ltoreq.0.01 nM, or .ltoreq.0.001 nM (e.g.
10.sup.-8M or less, e.g. from 10.sup.-8M to 10.sup.-13M, e.g., from
10.sup.-9M to 10.sup.-13 M).
[0193] In one embodiment, Kd is measured by a radiolabeled antigen
binding assay (RIA) performed with the Fab version of an antibody
of interest and its antigen as described by the following assay.
Solution binding affinity of Fabs for antigen is measured by
equilibrating Fab with a minimal concentration of
(.sup.125I)-labeled antigen in the presence of a titration series
of unlabeled antigen, then capturing bound antigen with an anti-Fab
antibody-coated plate (see, e.g., Chen et al., J. Mol. Biol.
293:865-881(1999)). To establish conditions for the assay,
MICROTITER.RTM. multi-well plates (Thermo Scientific) are coated
overnight with 5 .mu.g/ml of a capturing anti-Fab antibody (Cappel
Labs) in 50 mM sodium carbonate (pH 9.6), and subsequently blocked
with 2% (w/v) bovine serum albumin in PBS for two to five hours at
room temperature (approximately 23.degree. C.). In a non-adsorbent
plate (Nunc #269620), 100 pM or 26 pM [.sup.125I]-antigen are mixed
with serial dilutions of a Fab of interest. The Fab of interest is
then incubated overnight; however, the incubation may continue for
a longer period (e.g., about 65 hours) to ensure that equilibrium
is reached. Thereafter, the mixtures are transferred to the capture
plate for incubation at room temperature (e.g., for one hour). The
solution is then removed and the plate washed eight times with 0.1%
polysorbate 20 (TWEEN-20.RTM.) in PBS. When the plates have dried,
150 .mu.l/well of scintillant (MICROSCINT-20.TM.; Packard) is
added, and the plates are counted on a TOPCOUNT.TM. gamma counter
(Packard) for ten minutes. Concentrations of each Fab that give
less than or equal to 20% of maximal binding are chosen for use in
competitive binding assays.
[0194] According to another embodiment, Kd is measured using
surface plasmon resonance assays using a BIACORE.RTM.-2000 or a
BIACORE.RTM.-3000 (BIAcore, Inc., Piscataway, N.J.) at 25.degree.
C. with immobilized antigen CMS chips at .about.10 response units
(RU). Briefly, carboxymethylated dextran biosensor chips (CMS,
BIACORE, Inc.) are activated with
N-ethyl-N'-(3-dimethylaminopropyl)-carbodiimide hydrochloride (EDC)
and N-hydroxysuccinimide (NHS) according to the supplier's
instructions. Antigen is diluted with 10 mM sodium acetate, pH 4.8,
to 5 .mu.g/ml (.about.0.2 .mu.M) before injection at a flow rate of
5 .mu.l/minute to achieve approximately 10 response units (RU) of
coupled protein. Following the injection of antigen, 1 M
ethanolamine is injected to block unreacted groups. For kinetics
measurements, two-fold serial dilutions of Fab (0.78 nM to 500 nM)
are injected in PBS with 0.05% polysorbate 20 (TWEEN-20.TM.)
surfactant (PBST) at 25.degree. C. at a flow rate of approximately
25 .mu.l/min Association rates (k.sub.on) and dissociation rates
(k.sub.off) are calculated using a simple one-to-one Langmuir
binding model (BIACORE.RTM. Evaluation Software version 3.2) by
simultaneously fitting the association and dissociation
sensorgrams. The equilibrium dissociation constant (Kd) is
calculated as the ratio k.sub.off/k.sub.on. See, e.g., Chen et al.,
J. Mol. Biol. 293:865-881 (1999). If the on-rate exceeds 10.sup.6
M.sup.-1 s.sup.-1 by the surface plasmon resonance assay above,
then the on-rate can be determined by using a fluorescent quenching
technique that measures the increase or decrease in fluorescence
emission intensity (excitation=295 nm; emission=340 nm, 16 nm
band-pass) at 25.degree. C. of a 20 nM anti-antigen antibody (Fab
form) in PBS, pH 7.2, in the presence of increasing concentrations
of antigen as measured in a spectrometer, such as a stop-flow
equipped spectrophometer (Aviv Instruments) or a 8000-series
SLM-AMINCO.TM. spectrophotometer (ThermoSpectronic) with a stirred
cuvette.
[0195] (i) Antigen Preparation
[0196] Soluble antigens or fragments thereof, optionally conjugated
to other molecules, can be used as immunogens for generating
antibodies. For transmembrane molecules, such as receptors,
fragments of these (e.g. the extracellular domain of a receptor)
can be used as the immunogen. Alternatively, cells expressing the
transmembrane molecule can be used as the immunogen. Such cells can
be derived from a natural source (e.g. cancer cell lines) or may be
cells which have been transformed by recombinant techniques to
express the transmembrane molecule. Other antigens and forms
thereof useful for preparing antibodies will be apparent to those
in the art.
[0197] (ii) Certain Antibody-Based Methods
[0198] Polyclonal antibodies are preferably raised in animals by
multiple subcutaneous (sc) or intraperitoneal (ip) injections of
the relevant antigen and an adjuvant. It may be useful to conjugate
the relevant antigen to a protein that is immunogenic in the
species to be immunized, e.g., keyhole limpet hemocyanin, serum
albumin, bovine thyroglobulin, or soybean trypsin inhibitor using a
bifunctional or derivatizing agent, for example, maleimidobenzoyl
sulfosuccinimide ester (conjugation through cysteine residues),
N-hydroxysuccinimide (through lysine residues), glutaraldehyde,
succinic anhydride, SOCl.sub.2, or R'N.dbd.C.dbd.NR, where R and
R.sup.1 are different alkyl groups.
[0199] Animals are immunized against the antigen, immunogenic
conjugates, or derivatives by combining, e.g., 100 .mu.g or 5 .mu.g
of the protein or conjugate (for rabbits or mice, respectively)
with 3 volumes of Freund's complete adjuvant and injecting the
solution intradermally at multiple sites. One month later the
animals are boosted with 1/5 to 1/10 the original amount of peptide
or conjugate in Freund's complete adjuvant by subcutaneous
injection at multiple sites. Seven to 14 days later the animals are
bled and the serum is assayed for antibody titer. Animals are
boosted until the titer plateaus. Preferably, the animal is boosted
with the conjugate of the same antigen, but conjugated to a
different protein and/or through a different cross-linking reagent.
Conjugates also can be made in recombinant cell culture as protein
fusions. Also, aggregating agents such as alum are suitably used to
enhance the immune response.
[0200] Monoclonal antibodies of the invention can be made using the
hybridoma method first described by Kohler et al., Nature, 256:495
(1975), and further described, e.g., in Hongo et al., Hybridoma, 14
(3): 253-260 (1995), Harlow et al., Antibodies: A Laboratory
Manual, (Cold Spring Harbor Laboratory Press, 2nd ed. 1988);
Hammerling et al., in: Monoclonal Antibodies and T-Cell Hybridomas
563-681 (Elsevier, N.Y., 1981), and Ni, Xiandai Mianyixue,
26(4):265-268 (2006) regarding human-human hybridomas. Additional
methods include those described, for example, in U.S. Pat. No.
7,189,826 regarding production of monoclonal human natural IgM
antibodies from hybridoma cell lines. Human hybridoma technology
(Trioma technology) is described in Vollmers and Brandlein,
Histology and Histopathology, 20(3):927-937 (2005) and Vollmers and
Brandlein, Methods and Findings in Experimental and Clinical
Pharmacology, 27(3):185-91 (2005).
[0201] For various other hybridoma techniques, see, e.g., US
2006/258841; US 2006/183887 (fully human antibodies), US
2006/059575; US 2005/287149; US 2005/100546; US 2005/026229; and
U.S. Pat. Nos. 7,078,492 and 7,153,507. An exemplary protocol for
producing monoclonal antibodies using the hybridoma method is
described as follows. In one embodiment, a mouse or other
appropriate host animal, such as a hamster, is immunized to elicit
lymphocytes that produce or are capable of producing antibodies
that will specifically bind to the protein used for immunization.
Antibodies are raised in animals by multiple subcutaneous (sc) or
intraperitoneal (ip) injections of a polypeptide of the invention
or a fragment thereof, and an adjuvant, such as monophosphoryl
lipid A (MPL)/trehalose dicrynomycolate (TDM) (Ribi Immunochem.
Research, Inc., Hamilton, Mont.). A polypeptide of the invention
(e.g., antigen) or a fragment thereof may be prepared using methods
well known in the art, such as recombinant methods, some of which
are further described herein. Serum from immunized animals is
assayed for anti-antigen antibodies, and booster immunizations are
optionally administered. Lymphocytes from animals producing
anti-antigen antibodies are isolated. Alternatively, lymphocytes
may be immunized in vitro.
[0202] Lymphocytes are then fused with myeloma cells using a
suitable fusing agent, such as polyethylene glycol, to form a
hybridoma cell. See, e.g., Goding, Monoclonal Antibodies:
Principles and Practice, pp. 59-103 (Academic Press, 1986). Myeloma
cells may be used that fuse efficiently, support stable high-level
production of antibody by the selected antibody-producing cells,
and are sensitive to a medium such as HAT medium. Exemplary myeloma
cells include, but are not limited to, murine myeloma lines, such
as those derived from MOPC-21 and MPC-11 mouse tumors available
from the Salk Institute Cell Distribution Center, San Diego, Calif.
USA, and SP-2 or X63-Ag8-653 cells available from the American Type
Culture Collection, Rockville, Md. USA. Human myeloma and
mouse-human heteromyeloma cell lines also have been described for
the production of human monoclonal antibodies (Kozbor, J. Immunol.,
133:3001 (1984); Brodeur et al., Monoclonal Antibody Production
Techniques and Applications, pp. 51-63 (Marcel Dekker, Inc., New
York, 1987)).
[0203] The hybridoma cells thus prepared are seeded and grown in a
suitable culture medium, e.g., a medium that contains one or more
substances that inhibit the growth or survival of the unfused,
parental myeloma cells. For example, if the parental myeloma cells
lack the enzyme hypoxanthine guanine phosphoribosyl transferase
(HGPRT or HPRT), the culture medium for the hybridomas typically
will include hypoxanthine, aminopterin, and thymidine (HAT medium),
which substances prevent the growth of HGPRT-deficient cells.
Preferably, serum-free hybridoma cell culture methods are used to
reduce use of animal-derived serum such as fetal bovine serum, as
described, for example, in Even et al., Trends in Biotechnology,
24(3), 105-108 (2006).
[0204] Oligopeptides as tools for improving productivity of
hybridoma cell cultures are described in Franek, Trends in
Monoclonal Antibody Research, 111-122 (2005). Specifically,
standard culture media are enriched with certain amino acids
(alanine, serine, asparagine, proline), or with protein hydrolyzate
fractions, and apoptosis may be significantly suppressed by
synthetic oligopeptides, constituted of three to six amino acid
residues. The peptides are present at millimolar or higher
concentrations.
[0205] Culture medium in which hybridoma cells are growing may be
assayed for production of monoclonal antibodies that bind to an
antibody of the invention. The binding specificity of monoclonal
antibodies produced by hybridoma cells may be determined by
immunoprecipitation or by an in vitro binding assay, such as
radioimmunoassay (RIA) or enzyme-linked immunoadsorbent assay
(ELISA). The binding affinity of the monoclonal antibody can be
determined, for example, by Scatchard analysis. See, e.g., Munson
et al., Anal. Biochem., 107:220 (1980).
[0206] After hybridoma cells are identified that produce antibodies
of the desired specificity, affinity, and/or activity, the clones
may be subcloned by limiting dilution procedures and grown by
standard methods. See, e.g., Goding, supra. Suitable culture media
for this purpose include, for example, D-MEM or RPMI-1640 medium.
In addition, hybridoma cells may be grown in vivo as ascites tumors
in an animal. Monoclonal antibodies secreted by the subclones are
suitably separated from the culture medium, ascites fluid, or serum
by conventional immunoglobulin purification procedures such as, for
example, protein A-Sepharose, hydroxylapatite chromatography, gel
electrophoresis, dialysis, or affinity chromatography. One
procedure for isolation of proteins from hybridoma cells is
described in US 2005/176122 and U.S. Pat. No. 6,919,436. The method
includes using minimal salts, such as lyotropic salts, in the
binding process and preferably also using small amounts of organic
solvents in the elution process.
[0207] (iii) Library-Derived Antibodies
[0208] Antibodies of the invention may be isolated by screening
combinatorial libraries for antibodies with the desired activity or
activities. For example, a variety of methods are known in the art
for generating phage display libraries and screening such libraries
for antibodies possessing the desired binding characteristics such
as the methods described in Example 3. Additional methods are
reviewed, e.g., in Hoogenboom et al. in Methods in Molecular
Biology 178:1-37 (O'Brien et al., ed., Human Press, Totowa, N.J.,
2001) and further described, e.g., in the McCafferty et al., Nature
348:552-554; Clackson et al., Nature 352: 624-628 (1991); Marks et
al., J. Mol. Biol. 222: 581-597 (1992); Marks and Bradbury, in
Methods in Molecular Biology 248:161-175 (Lo, ed., Human Press,
Totowa, N.J., 2003); Sidhu et al., J. Mol. Biol. 338(2): 299-310
(2004); Lee et al., J. Mol. Biol. 340(5): 1073-1093 (2004);
Fellouse, Proc. Natl. Acad. Sci. USA 101(34): 12467-12472 (2004);
and Lee et al., J. Immunol. Methods 284(1-2): 119-132(2004).
[0209] In certain phage display methods, repertoires of VH and VL
genes are separately cloned by polymerase chain reaction (PCR) and
recombined randomly in phage libraries, which can then be screened
for antigen-binding phage as described in Winter et al., Ann. Rev.
Immunol., 12: 433-455 (1994). Phage typically display antibody
fragments, either as single-chain Fv (scFv) fragments or as Fab
fragments. Libraries from immunized sources provide high-affinity
antibodies to the immunogen without the requirement of constructing
hybridomas. Alternatively, the naive repertoire can be cloned
(e.g., from human) to provide a single source of antibodies to a
wide range of non-self and also self-antigens without any
immunization as described by Griffiths et al., EMBO J, 12: 725-734
(1993). Finally, naive libraries can also be made synthetically by
cloning unrearranged V-gene segments from stem cells, and using PCR
primers containing random sequence to encode the highly variable
CDR3 regions and to accomplish rearrangement in vitro, as described
by Hoogenboom and Winter, J. Mol. Biol., 227: 381-388 (1992).
Patent publications describing human antibody phage libraries
include, for example: U.S. Pat. No. 5,750,373, and US Patent
Publication Nos. 2005/0079574, 2005/0119455, 2005/0266000,
2007/0117126, 2007/0160598, 2007/0237764, 2007/0292936, and
2009/0002360.
[0210] Antibodies or antibody fragments isolated from human
antibody libraries are considered human antibodies or human
antibody fragments herein.
[0211] (iv) Chimeric, Humanized and Human Antibodies
[0212] In certain embodiments, an antibody provided herein is a
chimeric antibody. Certain chimeric antibodies are described, e.g.,
in U.S. Pat. No. 4,816,567; and Morrison et al., Proc. Natl. Acad.
Sci. USA, 81:6851-6855 (1984)). In one example, a chimeric antibody
comprises a non-human variable region (e.g., a variable region
derived from a mouse, rat, hamster, rabbit, or non-human primate,
such as a monkey) and a human constant region. In a further
example, a chimeric antibody is a "class switched" antibody in
which the class or subclass has been changed from that of the
parent antibody. Chimeric antibodies include antigen-binding
fragments thereof.
[0213] In certain embodiments, a chimeric antibody is a humanized
antibody. Typically, a non-human antibody is humanized to reduce
immunogenicity to humans, while retaining the specificity and
affinity of the parental non-human antibody. Generally, a humanized
antibody comprises one or more variable domains in which HVRs,
e.g., CDRs, (or portions thereof) are derived from a non-human
antibody, and FRs (or portions thereof) are derived from human
antibody sequences. A humanized antibody optionally will also
comprise at least a portion of a human constant region. In some
embodiments, some FR residues in a humanized antibody are
substituted with corresponding residues from a non-human antibody
(e.g., the antibody from which the HVR residues are derived), e.g.,
to restore or improve antibody specificity or affinity.
[0214] Humanized antibodies and methods of making them are
reviewed, e.g., in Almagro and Fransson, Front. Biosci.
13:1619-1633 (2008), and are further described, e.g., in Riechmann
et al., Nature 332:323-329 (1988); Queen et al., Proc. Nat'l Acad.
Sci. USA 86:10029-10033 (1989); U.S. Pat. Nos. 5,821,337,
7,527,791, 6,982,321, and 7,087,409; Kashmiri et al., Methods
36:25-34 (2005) (describing SDR (a-CDR) grafting); Padlan, Mol.
Immunol. 28:489-498 (1991) (describing "resurfacing"); Dall'Acqua
et al., Methods 36:43-60 (2005) (describing "FR shuffling"); and
Osbourn et al., Methods 36:61-68 (2005) and Klimka et al., Br. J.
Cancer, 83:252-260 (2000) (describing the "guided selection"
approach to FR shuffling).
[0215] Human framework regions that may be used for humanization
include but are not limited to: framework regions selected using
the "best-fit" method (see, e.g., Sims et al. J. Immunol. 151:2296
(1993)); framework regions derived from the consensus sequence of
human antibodies of a particular subgroup of light or heavy chain
variable regions (see, e.g., Carter et al. Proc. Natl. Acad. Sci.
USA, 89:4285 (1992); and Presta et al. J. Immunol., 151:2623
(1993)); human mature (somatically mutated) framework regions or
human germline framework regions (see, e.g., Almagro and Fransson,
Front. Biosci. 13:1619-1633 (2008)); and framework regions derived
from screening FR libraries (see, e.g., Baca et al., J. Biol. Chem.
272:10678-10684 (1997) and Rosok et al., J. Biol. Chem.
271:22611-22618 (1996)).
[0216] In certain embodiments, an antibody provided herein is a
human antibody. Human antibodies can be produced using various
techniques known in the art. Human antibodies are described
generally in van Dijk and van de Winkel, Curr. Opin. Pharmacol. 5:
368-74 (2001) and Lonberg, Curr. Opin. Immunol. 20:450-459
(2008).
[0217] Human antibodies may be prepared by administering an
immunogen to a transgenic animal that has been modified to produce
intact human antibodies or intact antibodies with human variable
regions in response to antigenic challenge. Such animals typically
contain all or a portion of the human immunoglobulin loci, which
replace the endogenous immunoglobulin loci, or which are present
extrachromosomally or integrated randomly into the animal's
chromosomes. In such transgenic mice, the endogenous immunoglobulin
loci have generally been inactivated. For review of methods for
obtaining human antibodies from transgenic animals, see Lonberg,
Nat. Biotech. 23:1117-1125 (2005). See also, e.g., U.S. Pat. Nos.
6,075,181 and 6,150,584 describing XENOMOUSE.TM. technology; U.S.
Pat. No. 5,770,429 describing HUMAB.RTM. technology; U.S. Pat. No.
7,041,870 describing K-M MOUSE.RTM. technology, and U.S. Patent
Application Publication No. US 2007/0061900, describing
VELOCIMOUSE.RTM. technology). Human variable regions from intact
antibodies generated by such animals may be further modified, e.g.,
by combining with a different human constant region.
[0218] Human antibodies can also be made by hybridoma-based
methods. Human myeloma and mouse-human heteromyeloma cell lines for
the production of human monoclonal antibodies have been described.
(See, e.g., Kozbor J. Immunol., 133: 3001 (1984); Brodeur et al.,
Monoclonal Antibody Production Techniques and Applications, pp.
51-63 (Marcel Dekker, Inc., New York, 1987); and Boerner et al., J.
Immunol., 147: 86 (1991).) Human antibodies generated via human
B-cell hybridoma technology are also described in Li et al., Proc.
Natl. Acad. Sci. USA, 103:3557-3562 (2006). Additional methods
include those described, for example, in U.S. Pat. No. 7,189,826
(describing production of monoclonal human IgM antibodies from
hybridoma cell lines) and Ni, Xiandai Mianyixue, 26(4):265-268
(2006) (describing human-human hybridomas). Human hybridoma
technology (Trioma technology) is also described in Vollmers and
Brandlein, Histology and Histopathology, 20(3):927-937 (2005) and
Vollmers and Brandlein, Methods and Findings in Experimental and
Clinical Pharmacology, 27(3):185-91 (2005).
[0219] Human antibodies may also be generated by isolating Fv clone
variable domain sequences selected from human-derived phage display
libraries. Such variable domain sequences may then be combined with
a desired human constant domain. Techniques for selecting human
antibodies from antibody libraries are described below.
[0220] (v) Antibody Fragments
[0221] Antibody fragments may be generated by traditional means,
such as enzymatic digestion, or by recombinant techniques. In
certain circumstances there are advantages of using antibody
fragments, rather than whole antibodies. The smaller size of the
fragments allows for rapid clearance, and may lead to improved
access to solid tumors. For a review of certain antibody fragments,
see Hudson et al. (2003) Nat. Med. 9:129-134.
[0222] Various techniques have been developed for the production of
antibody fragments. Traditionally, these fragments were derived via
proteolytic digestion of intact antibodies (see, e.g., Morimoto et
al., Journal of Biochemical and Biophysical Methods 24:107-117
(1992); and Brennan et al., Science, 229:81 (1985)). However, these
fragments can now be produced directly by recombinant host cells.
Fab, Fv and ScFv antibody fragments can all be expressed in and
secreted from E. coli, thus allowing the facile production of large
amounts of these fragments. Antibody fragments can be isolated from
the antibody phage libraries discussed above. Alternatively,
Fab'-SH fragments can be directly recovered from E. coli and
chemically coupled to form F(ab').sub.2 fragments (Carter et al.,
Bio/Technology 10:163-167 (1992)). According to another approach,
F(ab').sub.2 fragments can be isolated directly from recombinant
host cell culture. Fab and F(ab').sub.2 fragment with increased in
vivo half-life comprising salvage receptor binding epitope residues
are described in U.S. Pat. No. 5,869,046. Other techniques for the
production of antibody fragments will be apparent to the skilled
practitioner. In certain embodiments, an antibody is a single chain
Fv fragment (scFv). See WO 93/16185; U.S. Pat. Nos. 5,571,894; and
5,587,458. Fv and scFv are the only species with intact combining
sites that are devoid of constant regions; thus, they may be
suitable for reduced nonspecific binding during in vivo use. scFv
fusion proteins may be constructed to yield fusion of an effector
protein at either the amino or the carboxy terminus of an scFv. See
Antibody Engineering, ed. Borrebaeck, supra. The antibody fragment
may also be a "linear antibody", e.g., as described in U.S. Pat.
No. 5,641,870, for example. Such linear antibodies may be
monospecific or bispecific.
[0223] (vi) Multispecific Antibodies
[0224] Multispecific antibodies have binding specificities for at
least two different epitopes, where the epitopes are usually from
different antigens. While such molecules normally will only bind
two different epitopes (i.e. bispecific antibodies, BsAbs),
antibodies with additional specificities such as trispecific
antibodies are encompassed by this expression when used herein.
Bispecific antibodies can be prepared as full length antibodies or
antibody fragments (e.g. F(ab').sub.2 bispecific antibodies).
[0225] Methods for making bispecific antibodies are known in the
art. Traditional production of full length bispecific antibodies is
based on the coexpression of two immunoglobulin heavy chain-light
chain pairs, where the two chains have different specificities
(Millstein et al., Nature, 305:537-539 (1983)). Because of the
random assortment of immunoglobulin heavy and light chains, these
hybridomas (quadromas) produce a potential mixture of 10 different
antibody molecules, of which only one has the correct bispecific
structure. Purification of the correct molecule, which is usually
done by affinity chromatography steps, is rather cumbersome, and
the product yields are low. Similar procedures are disclosed in WO
93/08829, and in Traunecker et al., EMBO J., 10:3655-3659
(1991).
[0226] One approach known in the art for making bispecific
antibodies is the "knobs-into-holes" or "protuberance-into-cavity"
approach (see, e.g., U.S. Pat. No. 5,731,168). In this approach,
two immunoglobulin polypeptides (e.g., heavy chain polypeptides)
each comprise an interface. An interface of one immunoglobulin
polypeptide interacts with a corresponding interface on the other
immunoglobulin polypeptide, thereby allowing the two immunoglobulin
polypeptides to associate. These interfaces may be engineered such
that a "knob" or "protuberance" (these terms may be used
interchangeably herein) located in the interface of one
immunoglobulin polypeptide corresponds with a "hole" or "cavity"
(these terms may be used interchangeably herein) located in the
interface of the other immunoglobulin polypeptide. In some
embodiments, the hole is of identical or similar size to the knob
and suitably positioned such that when the two interfaces interact,
the knob of one interface is positionable in the corresponding hole
of the other interface. Without wishing to be bound to theory, this
is thought to stabilize the heteromultimer and favor formation of
the heteromultimer over other species, for example homomultimers.
In some embodiments, this approach may be used to promote the
heteromultimerization of two different immunoglobulin polypeptides,
creating a bispecific antibody comprising two immunoglobulin
polypeptides with binding specificities for different epitopes.
[0227] In some embodiments, a knob may be constructed by replacing
a small amino acid side chain with a larger side chain. In some
embodiments, a hole may be constructed by replacing a large amino
acid side chain with a smaller side chain. Knobs or holes may exist
in the original interface, or they may be introduced synthetically.
For example, knobs or holes may be introduced synthetically by
altering the nucleic acid sequence encoding the interface to
replace at least one "original" amino acid residue with at least
one "import" amino acid residue. Methods for altering nucleic acid
sequences may include standard molecular biology techniques well
known in the art. The side chain volumes of various amino acid
residues are shown in the following table. In some embodiments,
original residues have a small side chain volume (e.g., alanine,
asparagine, aspartic acid, glycine, serine, threonine, or valine),
and import residues for forming a knob are naturally occurring
amino acids and may include arginine, phenylalanine, tyrosine, and
tryptophan. In some embodiments, original residues have a large
side chain volume (e.g., arginine, phenylalanine, tyrosine, and
tryptophan), and import residues for forming a hole are naturally
occurring amino acids and may include alanine, serine, threonine,
and valine.
TABLE-US-00026 TABLE 1 Properties of amino acid residues Accessible
One-letter Mass.sup.a Volume.sup.b surface area.sup.c Amino acid
abbreviation (daltons) (.ANG..sup.3) (.ANG..sup.2) Alanine (Ala) A
71.08 88.6 115 Arginine (Arg) R 156.20 173.4 225 Asparagine (Asn) N
114.11 117.7 160 Aspartic Acid (Asp) D 115.09 111.1 150 Cysteine
(Cys) C 103.14 108.5 135 Glutamine (Gln) Q 128.14 143.9 180
Glutamic Acid (Glu) E 129.12 138.4 190 Glycine (Gly) G 57.06 60.1
75 Histidine (His) H 137.15 153.2 195 Isoleucine (Ile) I 113.17
166.7 175 Leucine (Leu) L 113.17 166.7 170 Lysine (Lys) K 128.18
168.6 200 Methionine (Met) M 131.21 162.9 185 Phenylalanine (Phe) F
147.18 189.9 210 Proline (Pro) P 97.12 122.7 145 Serine (Ser) S
87.08 89.0 115 Threonine (Thr) T 101.11 116.1 140 Tryptophan (Trp)
W 186.21 227.8 255 Tyrosine (Tyr) Y 163.18 193.6 230 Valine (Val) V
99.14 140.0 155 .sup.aMolecular weight of amino acid minus that of
water. Values from Handbook of Chemistry and Physics, 43.sup.rd ed.
Cleveland, Chemical Rubber Publishing Co., 1961. .sup.bValues from
A.A. Zamyatnin, Prog. Biophys. Mol. Biol. 24: 107-123, 1972.
.sup.cValues from C. Chothia, J. Mol. Biol. 105: 1-14, 1975. The
accessible surface area is defined in FIGS. 6-20 of this
reference.
[0228] In some embodiments, original residues for forming a knob or
hole are identified based on the three-dimensional structure of the
heteromultimer. Techniques known in the art for obtaining a
three-dimensional structure may include X-ray crystallography and
NMR. In some embodiments, the interface is the CH3 domain of an
immunoglobulin constant domain. In these embodiments, the CH3/CH3
interface of human IgG.sub.1 involves sixteen residues on each
domain located on four anti-parallel .beta.-strands. Without
wishing to be bound to theory, mutated residues are preferably
located on the two central anti-parallel .beta.-strands to minimize
the risk that knobs can be accommodated by the surrounding solvent,
rather than the compensatory holes in the partner CH3 domain. In
some embodiments, the mutations forming corresponding knobs and
holes in two immunoglobulin polypeptides correspond to one or more
pairs provided in the following table.
TABLE-US-00027 TABLE 2 Exemplary sets of corresponding knob-and
hole-forming mutations CH3 of first immunoglobulin CH3 of second
immunoglobulin T366Y Y407T T366W Y407A F405A T394W Y407T T366Y
T366Y:F405A T394W:Y407T T366W:F405W T394S:Y407A F405W:Y407A
T366W:T394S F405W T394S
Mutations are denoted by the original residue, followed by the
position using the Kabat numbering system, and then the import
residue (all residues are given in single-letter amino acid code).
Multiple mutations are separated by a colon.
[0229] In some embodiments, an immunoglobulin polypeptide comprises
a CH3 domain comprising one or more amino acid substitutions listed
in Table 2 above. In some embodiments, a bispecific antibody
comprises a first immunoglobulin polypeptide comprising a CH3
domain comprising one or more amino acid substitutions listed in
the left column of Table 2, and a second immunoglobulin polypeptide
comprising a CH3 domain comprising one or more corresponding amino
acid substitutions listed in the right column of Table 2.
[0230] Following mutation of the DNA as discussed above,
polynucleotides encoding modified immunoglobulin polypeptides with
one or more corresponding knob- or hole-forming mutations may be
expressed and purified using standard recombinant techniques and
cell systems known in the art. See, e.g., U.S. Pat. Nos. 5,731,168;
5,807,706; 5,821,333; 7,642,228; 7,695,936; 8,216,805; U.S. Pub.
No. 2013/0089553; and Spiess et al., Nature Biotechnology 31:
753-758, 2013. Modified immunoglobulin polypeptides may be produced
using prokaryotic host cells, such as E. coli, or eukaryotic host
cells, such as CHO cells. Corresponding knob- and hole-bearing
immunoglobulin polypeptides may be expressed in host cells in
co-culture and purified together as a heteromultimer, or they may
be expressed in single cultures, separately purified, and assembled
in vitro. In some embodiments, two strains of bacterial host cells
(one expressing an immunoglobulin polypeptide with a knob, and the
other expressing an immunoglobulin polypeptide with a hole) are
co-cultured using standard bacterial culturing techniques known in
the art. In some embodiments, the two strains may be mixed in a
specific ratio, e.g., so as to achieve equal expression levels in
culture. In some embodiments, the two strains may be mixed in a
50:50, 60:40, or 70:30 ratio. After polypeptide expression, the
cells may be lysed together, and protein may be extracted. Standard
techniques known in the art that allow for measuring the abundance
of homo-multimeric vs. hetero-multimeric species may include size
exclusion chromatography. In some embodiments, each modified
immunoglobulin polypeptide is expressed separately using standard
recombinant techniques, and they may be assembled together in
vitro. Assembly may be achieved, for example, by purifying each
modified immunoglobulin polypeptide, mixing and incubating them
together in equal mass, reducing disulfides (e.g., by treating with
dithiothreitol), concentrating, and reoxidizing the polypeptides.
Formed bispecific antibodies may be purified using standard
techniques including cation-exchange chromatography and measured
using standard techniques including size exclusion chromatography.
For a more detailed description of these methods, see Speiss et
al., Nat Biotechnol 31:753-8, 2013. In some embodiments, modified
immunoglobulin polypeptides may be expressed separately in CHO
cells and assembled in vitro using the methods described above.
[0231] According to a different approach, antibody variable domains
with the desired binding specificities (antibody-antigen combining
sites) are fused to immunoglobulin constant domain sequences. The
fusion preferably is with an immunoglobulin heavy chain constant
domain, comprising at least part of the hinge, CH2, and CH3
regions. It is typical to have the first heavy-chain constant
region (CH1) containing the site necessary for light chain binding,
present in at least one of the fusions. DNAs encoding the
immunoglobulin heavy chain fusions and, if desired, the
immunoglobulin light chain, are inserted into separate expression
vectors, and are co-transfected into a suitable host organism. This
provides for great flexibility in adjusting the mutual proportions
of the three polypeptide fragments in embodiments when unequal
ratios of the three polypeptide chains used in the construction
provide the optimum yields. It is, however, possible to insert the
coding sequences for two or all three polypeptide chains in one
expression vector when the expression of at least two polypeptide
chains in equal ratios results in high yields or when the ratios
are of no particular significance.
[0232] In one embodiment of this approach, the bispecific
antibodies are composed of a hybrid immunoglobulin heavy chain with
a first binding specificity in one arm, and a hybrid immunoglobulin
heavy chain-light chain pair (providing a second binding
specificity) in the other arm. It was found that this asymmetric
structure facilitates the separation of the desired bispecific
compound from unwanted immunoglobulin chain combinations, as the
presence of an immunoglobulin light chain in only one half of the
bispecific molecule provides for a facile way of separation. This
approach is disclosed in WO 94/04690. For further details of
generating bispecific antibodies see, for example, Suresh et al.,
Methods in Enzymology, 121:210 (1986).
[0233] According to another approach described in WO96/27011, the
interface between a pair of antibody molecules can be engineered to
maximize the percentage of heterodimers which are recovered from
recombinant cell culture. One interface comprises at least a part
of the C.sub.H 3 domain of an antibody constant domain. In this
method, one or more small amino acid side chains from the interface
of the first antibody molecule are replaced with larger side chains
(e.g. tyrosine or tryptophan). Compensatory "cavities" of identical
or similar size to the large side chain(s) are created on the
interface of the second antibody molecule by replacing large amino
acid side chains with smaller ones (e.g. alanine or threonine).
This provides a mechanism for increasing the yield of the
heterodimer over other unwanted end-products such as
homodimers.
[0234] Bispecific antibodies include cross-linked or
"heteroconjugate" antibodies. For example, one of the antibodies in
the heteroconjugate can be coupled to avidin, the other to biotin.
Such antibodies have, for example, been proposed to target immune
system cells to unwanted cells (U.S. Pat. No. 4,676,980), and for
treatment of HIV infection (WO 91/00360, WO 92/200373, and EP
03089). Heteroconjugate antibodies may be made using any convenient
cross-linking methods. Suitable cross-linking agents are well known
in the art, and are disclosed in U.S. Pat. No. 4,676,980, along
with a number of cross-linking techniques.
[0235] Techniques for generating bispecific antibodies from
antibody fragments have also been described in the literature. For
example, bispecific antibodies can be prepared using chemical
linkage. Brennan et al., Science, 229: 81 (1985) describe a
procedure wherein intact antibodies are proteolytically cleaved to
generate F(ab').sub.2 fragments. These fragments are reduced in the
presence of the dithiol complexing agent sodium arsenite to
stabilize vicinal dithiols and prevent intermolecular disulfide
formation. The Fab' fragments generated are then converted to
thionitrobenzoate (TNB) derivatives. One of the Fab'-TNB
derivatives is then reconverted to the Fab'-thiol by reduction with
mercaptoethylamine and is mixed with an equimolar amount of the
other Fab'-TNB derivative to form the bispecific antibody. The
bispecific antibodies produced can be used as agents for the
selective immobilization of enzymes.
[0236] Recent progress has facilitated the direct recovery of
Fab'-SH fragments from E. coli, which can be chemically coupled to
form bispecific antibodies. Shalaby et al., J. Exp. Med., 175:
217-225 (1992) describe the production of a fully humanized
bispecific antibody F(ab').sub.2 molecule. Each Fab' fragment was
separately secreted from E. coli and subjected to directed chemical
coupling in vitro to form the bispecific antibody.
[0237] Various techniques for making and isolating bispecific
antibody fragments directly from recombinant cell culture have also
been described. For example, bispecific antibodies have been
produced using leucine zippers. Kostelny et al., J. Immunol.,
148(5):1547-1553 (1992). The leucine zipper peptides from the Fos
and Jun proteins were linked to the Fab' portions of two different
antibodies by gene fusion. The antibody homodimers were reduced at
the hinge region to form monomers and then re-oxidized to form the
antibody heterodimers. This method can also be utilized for the
production of antibody homodimers. The "diabody" technology
described by Hollinger et al., Proc. Natl. Acad. Sci. USA,
90:6444-6448 (1993) has provided an alternative mechanism for
making bispecific antibody fragments. The fragments comprise a
heavy-chain variable domain (V.sub.H) connected to a light-chain
variable domain (V.sub.L) by a linker which is too short to allow
pairing between the two domains on the same chain. Accordingly, the
V.sub.H and V.sub.L domains of one fragment are forced to pair with
the complementary V.sub.L and V.sub.H domains of another fragment,
thereby forming two antigen-binding sites. Another strategy for
making bispecific antibody fragments by the use of single-chain Fv
(sFv) dimers has also been reported. See Gruber et al, J. Immunol,
152:5368 (1994).
[0238] Another technique for making bispecific antibody fragments
is the "bispecific T cell engager" or BiTE.RTM. approach (see,
e.g., WO2004/106381, WO2005/061547, WO2007/042261, and
WO2008/119567). This approach utilizes two antibody variable
domains arranged on a single polypeptide. For example, a single
polypeptide chain includes two single chain Fv (scFv) fragments,
each having a variable heavy chain (V.sub.H) and a variable light
chain (V.sub.L) domain separated by a polypeptide linker of a
length sufficient to allow intramolecular association between the
two domains. This single polypeptide further includes a polypeptide
spacer sequence between the two scFv fragments. Each scFv
recognizes a different epitope, and these epitopes may be specific
for different cell types, such that cells of two different cell
types are brought into close proximity or tethered when each scFv
is engaged with its cognate epitope. One particular embodiment of
this approach includes a scFv recognizing a cell-surface antigen
expressed by an immune cell, e.g., a CD3 polypeptide on a T cell,
linked to another scFv that recognizes a cell-surface antigen
expressed by a target cell, such as a malignant or tumor cell.
[0239] As it is a single polypeptide, the bispecific T cell engager
may be expressed using any prokaryotic or eukaryotic cell
expression system known in the art, e.g., a CHO cell line. However,
specific purification techniques (see, e.g., EP1691833) may be
necessary to separate monomeric bispecific T cell engagers from
other multimeric species, which may have biological activities
other than the intended activity of the monomer. In one exemplary
purification scheme, a solution containing secreted polypeptides is
first subjected to a metal affinity chromatography, and
polypeptides are eluted with a gradient of imidazole
concentrations. This eluate is further purified using anion
exchange chromatography, and polypeptides are eluted using with a
gradient of sodium chloride concentrations. Finally, this eluate is
subjected to size exclusion chromatography to separate monomers
from multimeric species.
[0240] Antibodies with more than two valencies are contemplated.
For example, trispecific antibodies can be prepared. Tuft et al. J.
Immunol. 147: 60 (1991).
[0241] (vii) Single-Domain Antibodies
[0242] In some embodiments, an antibody of the invention is a
single-domain antibody. A single-domain antibody is a single
polypeptide chain comprising all or a portion of the heavy chain
variable domain or all or a portion of the light chain variable
domain of an antibody. In certain embodiments, a single-domain
antibody is a human single-domain antibody (Domantis, Inc.,
Waltham, Mass.; see, e.g., U.S. Pat. No. 6,248,516 B1). In one
embodiment, a single-domain antibody consists of all or a portion
of the heavy chain variable domain of an antibody.
[0243] (viii) Antibody Variants
[0244] In some embodiments, amino acid sequence modification(s) of
the antibodies described herein are contemplated. For example, it
may be desirable to improve the binding affinity and/or other
biological properties of the antibody Amino acid sequence variants
of the antibody may be prepared by introducing appropriate changes
into the nucleotide sequence encoding the antibody, or by peptide
synthesis. Such modifications include, for example, deletions from,
and/or insertions into and/or substitutions of, residues within the
amino acid sequences of the antibody. Any combination of deletion,
insertion, and substitution can be made to arrive at the final
construct, provided that the final construct possesses the desired
characteristics. The amino acid alterations may be introduced in
the subject antibody amino acid sequence at the time that sequence
is made.
[0245] (ix) Substitution, Insertion, and Deletion Variants
[0246] In certain embodiments, antibody variants having one or more
amino acid substitutions are provided. Sites of interest for
substitutional mutagenesis include the HVRs and FRs. Conservative
substitutions are shown in Table 1 under the heading of
"conservative substitutions." More substantial changes are provided
in Table 1 under the heading of "exemplary substitutions," and as
further described below in reference to amino acid side chain
classes Amino acid substitutions may be introduced into an antibody
of interest and the products screened for a desired activity, e.g.,
retained/improved antigen binding, decreased immunogenicity, or
improved ADCC or CDC.
TABLE-US-00028 TABLE 3 Exemplary Substitutions. Original Preferred
Residue Exemplary Substitutions Substitutions Ala (A) Val; Leu; Ile
Val Arg (R) Lys; Gln; Asn Lys Asn (N) Gln; His; Asp, Lys; Arg Gln
Asp (D) Glu; Asn Glu Cys (C) Ser; Ala Ser Gln (Q) Asn; Glu Asn Glu
(E) Asp; Gln Asp Gly (G) Ala Ala His (H) Asn; Gln; Lys; Arg Arg Ile
(I) Leu; Val; Met; Ala; Phe; Norleucine Leu Leu (L) Norleucine;
Ile; Val; Met; Ala; Phe Ile Lys (K) Arg; Gln; Asn Arg Met (M) Leu;
Phe; Ile Leu Phe (F) Trp; Leu; Val; Ile; Ala; Tyr Tyr Pro (P) Ala
Ala Ser (S) Thr Thr Thr (T) Val; Ser Ser Trp (W) Tyr; Phe Tyr Tyr
(Y) Trp; Phe; Thr; Ser Phe Val (V) Ile; Leu; Met; Phe; Ala;
Norleucine Leu
[0247] Amino acids may be grouped according to common side-chain
properties:
[0248] a. hydrophobic: Norleucine, Met, Ala, Val, Leu, Ile;
[0249] b. neutral hydrophilic: Cys, Ser, Thr, Asn, Gln;
[0250] c. acidic: Asp, Glu;
[0251] d. basic: His, Lys, Arg;
[0252] e. residues that influence chain orientation: Gly, Pro;
[0253] f. aromatic: Trp, Tyr, Phe.
[0254] Non-conservative substitutions will entail exchanging a
member of one of these classes for another class.
[0255] One type of substitutional variant involves substituting one
or more hypervariable region residues of a parent antibody (e.g. a
humanized or human antibody). Generally, the resulting variant(s)
selected for further study will have modifications (e.g.,
improvements) in certain biological properties (e.g., increased
affinity, reduced immunogenicity) relative to the parent antibody
and/or will have substantially retained certain biological
properties of the parent antibody. An exemplary substitutional
variant is an affinity matured antibody, which may be conveniently
generated, e.g., using phage display-based affinity maturation
techniques such as those described herein. Briefly, one or more HVR
residues are mutated and the variant antibodies displayed on phage
and screened for a particular biological activity (e.g. binding
affinity).
[0256] Alterations (e.g., substitutions) may be made in HVRs, e.g.,
to improve antibody affinity. Such alterations may be made in HVR
"hotspots," i.e., residues encoded by codons that undergo mutation
at high frequency during the somatic maturation process (see, e.g.,
Chowdhury, Methods Mol. Biol. 207:179-196 (2008)), and/or SDRs
(a-CDRs), with the resulting variant VH or VL being tested for
binding affinity. Affinity maturation by constructing and
reselecting from secondary libraries has been described, e.g., in
Hoogenboom et al. in Methods in Molecular Biology 178:1-37 (O'Brien
et al., ed., Human Press, Totowa, N.J., (2001).) In some
embodiments of affinity maturation, diversity is introduced into
the variable genes chosen for maturation by any of a variety of
methods (e.g., error-prone PCR, chain shuffling, or
oligonucleotide-directed mutagenesis). A secondary library is then
created. The library is then screened to identify any antibody
variants with the desired affinity. Another method to introduce
diversity involves HVR-directed approaches, in which several HVR
residues (e.g., 4-6 residues at a time) are randomized HVR residues
involved in antigen binding may be specifically identified, e.g.,
using alanine scanning mutagenesis or modeling. CDR-H3 and CDR-L3
in particular are often targeted.
[0257] In certain embodiments, substitutions, insertions, or
deletions may occur within one or more HVRs so long as such
alterations do not substantially reduce the ability of the antibody
to bind antigen. For example, conservative alterations (e.g.,
conservative substitutions as provided herein) that do not
substantially reduce binding affinity may be made in HVRs. Such
alterations may be outside of HVR "hotspots" or SDRs. In certain
embodiments of the variant VH and VL sequences provided above, each
HVR either is unaltered, or contains no more than one, two or three
amino acid substitutions.
[0258] A useful method for identification of residues or regions of
an antibody that may be targeted for mutagenesis is called "alanine
scanning mutagenesis" as described by Cunningham and Wells (1989)
Science, 244:1081-1085. In this method, a residue or group of
target residues (e.g., charged residues such as arg, asp, his, lys,
and glu) are identified and replaced by a neutral or negatively
charged amino acid (e.g., alanine or polyalanine) to determine
whether the interaction of the antibody with antigen is affected.
Further substitutions may be introduced at the amino acid locations
demonstrating functional sensitivity to the initial substitutions.
Alternatively, or additionally, a crystal structure of an
antigen-antibody complex to identify contact points between the
antibody and antigen. Such contact residues and neighboring
residues may be targeted or eliminated as candidates for
substitution. Variants may be screened to determine whether they
contain the desired properties.
[0259] Amino acid sequence insertions include amino- and/or
carboxyl-terminal fusions ranging in length from one residue to
polypeptides containing a hundred or more residues, as well as
intrasequence insertions of single or multiple amino acid residues.
Examples of terminal insertions include an antibody with an
N-terminal methionyl residue. Other insertional variants of the
antibody molecule include the fusion to the N- or C-terminus of the
antibody to an enzyme (e.g., for ADEPT) or a polypeptide which
increases the serum half-life of the antibody.
[0260] (x) Glycosylation Variants
[0261] In certain embodiments, an antibody provided herein is
altered to increase or decrease the extent to which the antibody is
glycosylated. Addition or deletion of glycosylation sites to an
antibody may be conveniently accomplished by altering the amino
acid sequence such that one or more glycosylation sites is created
or removed.
[0262] Where the antibody comprises an Fc region, the carbohydrate
attached thereto may be altered. Native antibodies produced by
mammalian cells typically comprise a branched, biantennary
oligosaccharide that is generally attached by an N-linkage to
Asn297 of the CH2 domain of the Fc region. See, e.g., Wright et al.
TIBTECH 15:26-32 (1997). The oligosaccharide may include various
carbohydrates, e.g., mannose, N-acetyl glucosamine (GlcNAc),
galactose, and sialic acid, as well as a fucose attached to a
GlcNAc in the "stem" of the biantennary oligosaccharide structure.
In some embodiments, modifications of the oligosaccharide in an
antibody of the invention may be made in order to create antibody
variants with certain improved properties.
[0263] In one embodiment, antibody variants are provided comprising
an Fc region wherein a carbohydrate structure attached to the Fc
region has reduced fucose or lacks fucose, which may improve ADCC
function. Specifically, antibodies are contemplated herein that
have reduced fusose relative to the amount of fucose on the same
antibody produced in a wild-type CHO cell. That is, they are
characterized by having a lower amount of fucose than they would
otherwise have if produced by native CHO cells (e.g., a CHO cell
that produce a native glycosylation pattern, such as, a CHO cell
containing a native FUT8 gene). In certain embodiments, the
antibody is one wherein less than about 50%, 40%, 30%, 20%, 10%, or
5% of the N-linked glycans thereon comprise fucose. For example,
the amount of fucose in such an antibody may be from 1% to 80%,
from 1% to 65%, from 5% to 65% or from 20% to 40%. In certain
embodiments, the antibody is one wherein none of the N-linked
glycans thereon comprise fucose, i.e., wherein the antibody is
completely without fucose, or has no fucose or is afucosylated. The
amount of fucose is determined by calculating the average amount of
fucose within the sugar chain at Asn297, relative to the sum of all
glycostructures attached to Asn 297 (e. g. complex, hybrid and high
mannose structures) as measured by MALDI-TOF mass spectrometry, as
described in WO 2008/077546, for example. Asn297 refers to the
asparagine residue located at about position 297 in the Fc region
(Eu numbering of Fc region residues); however, Asn297 may also be
located about +3 amino acids upstream or downstream of position
297, i.e., between positions 294 and 300, due to minor sequence
variations in antibodies. Such fucosylation variants may have
improved ADCC function. See, e.g., US Patent Publication Nos. US
2003/0157108 (Presta, L.); US 2004/0093621 (Kyowa Hakko Kogyo Co.,
Ltd). Examples of publications related to "defucosylated" or
"fucose-deficient" antibody variants include: US 2003/0157108; WO
2000/61739; WO 2001/29246; US 2003/0115614; US 2002/0164328; US
2004/0093621; US 2004/0132140; US 2004/0110704; US 2004/0110282; US
2004/0109865; WO 2003/085119; WO 2003/084570; WO 2005/035586; WO
2005/035778; WO2005/053742; WO2002/031140; Okazaki et al. J. Mol.
Biol. 336:1239-1249 (2004); Yamane-Ohnuki et al. Biotech. Bioeng.
87: 614 (2004). Examples of cell lines capable of producing
defucosylated antibodies include Lec13 CHO cells deficient in
protein fucosylation (Ripka et al. Arch. Biochem. Biophys.
249:533-545 (1986); US Pat Appl No US 2003/0157108 A1, Presta, L;
and WO 2004/056312 A1, Adams et al., especially at Example 11), and
knockout cell lines, such as alpha-1,6-fucosyltransferase gene,
FUT8, knockout CHO cells (see, e.g., Yamane-Ohnuki et al. Biotech.
Bioeng. 87: 614 (2004); Kanda, Y. et al., Biotechnol. Bioeng.,
94(4):680-688 (2006); and WO2003/085107).
[0264] Antibody variants are further provided with bisected
oligosaccharides, e.g., in which a biantennary oligosaccharide
attached to the Fc region of the antibody is bisected by GlcNAc.
Such antibody variants may have reduced fucosylation and/or
improved ADCC function. Examples of such antibody variants are
described, e.g., in WO 2003/011878 (Jean-Mairet et al.); U.S. Pat.
No. 6,602,684 (Umana et al.); US 2005/0123546 (Umana et al.), and
Ferrara et al., Biotechnology and Bioengineering, 93(5): 851-861
(2006). Antibody variants with at least one galactose residue in
the oligosaccharide attached to the Fc region are also provided.
Such antibody variants may have improved CDC function. Such
antibody variants are described, e.g., in WO 1997/30087 (Patel et
al.); WO 1998/58964 (Raju, S.); and WO 1999/22764 (Raju, S.).
[0265] In certain embodiments, the antibody variants comprising an
Fc region described herein are capable of binding to an
Fc.gamma.RIII. In certain embodiments, the antibody variants
comprising an Fc region described herein have ADCC activity in the
presence of human effector cells or have increased ADCC activity in
the presence of human effector cells compared to the otherwise same
antibody comprising a human wild-type IgG1Fc region.
[0266] (xi) Fc Region Variants
[0267] In certain embodiments, one or more amino acid modifications
may be introduced into the Fc region of an antibody provided
herein, thereby generating an Fc region variant. The Fc region
variant may comprise a human Fc region sequence (e.g., a human
IgG1, IgG2, IgG3 or IgG4 Fc region) comprising an amino acid
modification (e.g. a substitution) at one or more amino acid
positions.
[0268] In certain embodiments, the invention contemplates an
antibody variant that possesses some but not all effector
functions, which make it a desirable candidate for applications in
which the half life of the antibody in vivo is important yet
certain effector functions (such as complement and ADCC) are
unnecessary or deleterious. In vitro and/or in vivo cytotoxicity
assays can be conducted to confirm the reduction/depletion of CDC
and/or ADCC activities. For example, Fc receptor (FcR) binding
assays can be conducted to ensure that the antibody lacks
Fc.gamma.R binding (hence likely lacking ADCC activity), but
retains FcRn binding ability. The primary cells for mediating ADCC,
NK cells, express Fc(RIII only, whereas monocytes express Fc(RI,
Fc(RII and Fc(RIII. FcR expression on hematopoietic cells is
summarized in Table 3 on page 464 of Ravetch and Kinet, Annu. Rev.
Immunol. 9:457-492 (1991). Non-limiting examples of in vitro assays
to assess ADCC activity of a molecule of interest is described in
U.S. Pat. No. 5,500,362 (see, e.g. Hellstrom, I. et al. Proc. Nat'l
Acad. Sci. USA 83:7059-7063 (1986)) and Hellstrom, I et al., Proc.
Nat'l Acad. Sci. USA 82:1499-1502 (1985); U.S. Pat. No. 5,821,337
(see Bruggemann, M. et al., J. Exp. Med. 166:1351-1361 (1987)).
Alternatively, non-radioactive assays methods may be employed (see,
for example, ACTI.TM. non-radioactive cytotoxicity assay for flow
cytometry (CellTechnology, Inc. Mountain View, Calif.; and CytoTox
96.RTM. non-radioactive cytotoxicity assay (Promega, Madison,
Wis.). Useful effector cells for such assays include peripheral
blood mononuclear cells (PBMC) and Natural Killer (NK) cells.
Alternatively, or additionally, ADCC activity of the molecule of
interest may be assessed in vivo, e.g., in an animal model such as
that disclosed in Clynes et al. Proc. Nat'l Acad. Sci. USA
95:652-656 (1998). C1q binding assays may also be carried out to
confirm that the antibody is unable to bind C1q and hence lacks CDC
activity. See, e.g., C1q and C3c binding ELISA in WO 2006/029879
and WO 2005/100402. To assess complement activation, a CDC assay
may be performed (see, for example, Gazzano-Santoro et al., J.
Immunol. Methods 202:163 (1996); Cragg, M. S. et al., Blood
101:1045-1052 (2003); and Cragg, M. S. and M. J. Glennie, Blood
103:2738-2743 (2004)). FcRn binding and in vivo clearance/half life
determinations can also be performed using methods known in the art
(see, e.g., Petkova, S. B. et al., Int'l. Immunol. 18(12):1759-1769
(2006)).
[0269] Antibodies with reduced effector function include those with
substitution of one or more of Fc region residues 238, 265, 269,
270, 297, 327 and 329 (U.S. Pat. No. 6,737,056). Such Fc mutants
include Fc mutants with substitutions at two or more of amino acid
positions 265, 269, 270, 297 and 327, including the so-called
"DANA" Fc mutant with substitution of residues 265 and 297 to
alanine (U.S. Pat. No. 7,332,581).
[0270] Certain antibody variants with improved or diminished
binding to FcRs are described. (See, e.g., U.S. Pat. No. 6,737,056;
WO 2004/056312, and Shields et al., J. Biol. Chem. 9(2): 6591-6604
(2001).)
[0271] In certain embodiments, an antibody variant comprises an Fc
region with one or more amino acid substitutions which improve
ADCC, e.g., substitutions at positions 298, 333, and/or 334 of the
Fc region (EU numbering of residues). In an exemplary embodiment,
the antibody comprising the following amino acid substitutions in
its Fc region: S298A, E333A, and K334A.
[0272] In some embodiments, alterations are made in the Fc region
that result in altered (i.e., either improved or diminished) C1q
binding and/or Complement Dependent Cytotoxicity (CDC), e.g., as
described in U.S. Pat. No. 6,194,551, WO 99/51642, and Idusogie et
al. J. Immunol. 164: 4178-4184 (2000).
[0273] Antibodies with increased half lives and improved binding to
the neonatal Fc receptor (FcRn), which is responsible for the
transfer of maternal IgGs to the fetus (Guyer et al., J. Immunol.
117:587 (1976) and Kim et al., J. Immunol. 24:249 (1994)), are
described in US2005/0014934A1 (Hinton et al.)). Those antibodies
comprise an Fc region with one or more substitutions therein which
improve binding of the Fc region to FcRn. Such Fc variants include
those with substitutions at one or more of Fc region residues: 238,
256, 265, 272, 286, 303, 305, 307, 311, 312, 317, 340, 356, 360,
362, 376, 378, 380, 382, 413, 424 or 434, e.g., substitution of Fc
region residue 434 (U.S. Pat. No. 7,371,826). See also Duncan &
Winter, Nature 322:738-40 (1988); U.S. Pat. No. 5,648,260; U.S.
Pat. No. 5,624,821; and WO 94/29351 concerning other examples of Fc
region variants.
[0274] (xii) Antibody Derivatives
[0275] The antibodies of the invention can be further modified to
contain additional nonproteinaceous moieties that are known in the
art and readily available. In certain embodiments, the moieties
suitable for derivatization of the antibody are water soluble
polymers. Non-limiting examples of water soluble polymers include,
but are not limited to, polyethylene glycol (PEG), copolymers of
ethylene glycol/propylene glycol, carboxymethylcellulose, dextran,
polyvinyl alcohol, polyvinyl pyrrolidone, poly-1,3-dioxolane,
poly-1,3,6-trioxane, ethylene/maleic anhydride copolymer,
polyaminoacids (either homopolymers or random copolymers), and
dextran or poly(n-vinyl pyrrolidone)polyethylene glycol,
propropylene glycol homopolymers, prolypropylene oxide/ethylene
oxide copolymers, polyoxyethylated polyols (e.g., glycerol),
polyvinyl alcohol, and mixtures thereof. Polyethylene glycol
propionaldehyde may have advantages in manufacturing due to its
stability in water. The polymer may be of any molecular weight, and
may be branched or unbranched. The number of polymers attached to
the antibody may vary, and if more than one polymer are attached,
they can be the same or different molecules. In general, the number
and/or type of polymers used for derivatization can be determined
based on considerations including, but not limited to, the
particular properties or functions of the antibody to be improved,
whether the antibody derivative will be used in a therapy under
defined conditions, etc.
[0276] (xiii) Vectors, Host Cells, and Recombinant Methods
[0277] Antibodies may also be produced using recombinant methods.
For recombinant production of an anti-antigen antibody, nucleic
acid encoding the antibody is isolated and inserted into a
replicable vector for further cloning (amplification of the DNA) or
for expression. DNA encoding the antibody may be readily isolated
and sequenced using conventional procedures (e.g., by using
oligonucleotide probes that are capable of binding specifically to
genes encoding the heavy and light chains of the antibody). Many
vectors are available. The vector components generally include, but
are not limited to, one or more of the following: a signal
sequence, an origin of replication, one or more marker genes, an
enhancer element, a promoter, and a transcription termination
sequence.
[0278] (a) Signal Sequence Component
[0279] An antibody of the invention may be produced recombinantly
not only directly, but also as a fusion polypeptide with a
heterologous polypeptide, which is preferably a signal sequence or
other polypeptide having a specific cleavage site at the N-terminus
of the mature protein or polypeptide. The heterologous signal
sequence selected preferably is one that is recognized and
processed (e.g., cleaved by a signal peptidase) by the host cell.
For prokaryotic host cells that do not recognize and process a
native antibody signal sequence, the signal sequence is substituted
by a prokaryotic signal sequence selected, for example, from the
group of the alkaline phosphatase, penicillinase, 1pp, or
heat-stable enterotoxin II leaders. For yeast secretion the native
signal sequence may be substituted by, e.g., the yeast invertase
leader, a factor leader (including Saccharomyces and Kluyveromyces
.alpha.-factor leaders), or acid phosphatase leader, the C.
albicans glucoamylase leader, or the signal described in WO
90/13646. In mammalian cell expression, mammalian signal sequences
as well as viral secretory leaders, for example, the herpes simplex
gD signal, are available.
[0280] (b) Origin of Replication
[0281] Both expression and cloning vectors contain a nucleic acid
sequence that enables the vector to replicate in one or more
selected host cells. Generally, in cloning vectors this sequence is
one that enables the vector to replicate independently of the host
chromosomal DNA, and includes origins of replication or
autonomously replicating sequences. Such sequences are well known
for a variety of bacteria, yeast, and viruses. The origin of
replication from the plasmid pBR322 is suitable for most
Gram-negative bacteria, the 2.mu., plasmid origin is suitable for
yeast, and various viral origins (SV40, polyoma, adenovirus, VSV or
BPV) are useful for cloning vectors in mammalian cells. Generally,
the origin of replication component is not needed for mammalian
expression vectors (the SV40 origin may typically be used only
because it contains the early promoter.
[0282] (c) Selection Gene Component
[0283] Expression and cloning vectors may contain a selection gene,
also termed a selectable marker. Typical selection genes encode
proteins that (a) confer resistance to antibiotics or other toxins,
e.g., ampicillin, neomycin, methotrexate, or tetracycline, (b)
complement auxotrophic deficiencies, or (c) supply critical
nutrients not available from complex media, e.g., the gene encoding
D-alanine racemase for Bacilli.
[0284] One example of a selection scheme utilizes a drug to arrest
growth of a host cell. Those cells that are successfully
transformed with a heterologous gene produce a protein conferring
drug resistance and thus survive the selection regimen. Examples of
such dominant selection use the drugs neomycin, mycophenolic acid
and hygromycin.
[0285] Another example of suitable selectable markers for mammalian
cells are those that enable the identification of cells competent
to take up antibody-encoding nucleic acid, such as DHFR, glutamine
synthetase (GS), thymidine kinase, metallothionein-I and -II,
preferably primate metallothionein genes, adenosine deaminase,
ornithine decarboxylase, etc.
[0286] For example, cells transformed with the DHFR gene are
identified by culturing the transformants in a culture medium
containing methotrexate (Mtx), a competitive antagonist of DHFR.
Under these conditions, the DHFR gene is amplified along with any
other co-transformed nucleic acid. A Chinese hamster ovary (CHO)
cell line deficient in endogenous DHFR activity (e.g., ATCC
CRL-9096) may be used.
[0287] Alternatively, cells transformed with the GS gene are
identified by culturing the transformants in a culture medium
containing L-methionine sulfoximine (Msx), an inhibitor of GS.
Under these conditions, the GS gene is amplified along with any
other co-transformed nucleic acid. The GS selection/amplification
system may be used in combination with the DHFR
selection/amplification system described above.
[0288] Alternatively, host cells (particularly wild-type hosts that
contain endogenous DHFR) transformed or co-transformed with DNA
sequences encoding an antibody of interest, wild-type DHFR gene,
and another selectable marker such as aminoglycoside
3'-phosphotransferase (APH) can be selected by cell growth in
medium containing a selection agent for the selectable marker such
as an aminoglycosidic antibiotic, e.g., kanamycin, neomycin, or
G418. See U.S. Pat. No. 4,965,199.
[0289] A suitable selection gene for use in yeast is the trp1 gene
present in the yeast plasmid YRp7 (Stinchcomb et al., Nature,
282:39 (1979)). The trp1 gene provides a selection marker for a
mutant strain of yeast lacking the ability to grow in tryptophan,
for example, ATCC No. 44076 or PEP4-1. Jones, Genetics, 85:12
(1977). The presence of the trp1 lesion in the yeast host cell
genome then provides an effective environment for detecting
transformation by growth in the absence of tryptophan. Similarly,
Leu2-deficient yeast strains (ATCC 20,622 or 38,626) are
complemented by known plasmids bearing the Leu2 gene.
[0290] In addition, vectors derived from the 1.6 .mu.m circular
plasmid pKD1 can be used for transformation of Kluyveromyces
yeasts. Alternatively, an expression system for large-scale
production of recombinant calf chymosin was reported for K. lactis.
Van den Berg, Bio/Technology, 8:135 (1990). Stable multi-copy
expression vectors for secretion of mature recombinant human serum
albumin by industrial strains of Kluyveromyces have also been
disclosed. Fleer et al., Bio/Technology, 9:968-975 (1991).
[0291] (d) Promoter Component
[0292] Expression and cloning vectors generally contain a promoter
that is recognized by the host organism and is operably linked to
nucleic acid encoding an antibody. Promoters suitable for use with
prokaryotic hosts include the phoA promoter, .beta.-lactamase and
lactose promoter systems, alkaline phosphatase promoter, a
tryptophan (trp) promoter system, and hybrid promoters such as the
tac promoter. However, other known bacterial promoters are
suitable. Promoters for use in bacterial systems also will contain
a Shine-Dalgarno (S.D.) sequence operably linked to the DNA
encoding an antibody.
[0293] Promoter sequences are known for eukaryotes. Virtually all
eukaryotic genes have an AT-rich region located approximately 25 to
30 bases upstream from the site where transcription is initiated.
Another sequence found 70 to 80 bases upstream from the start of
transcription of many genes is a CNCAAT region where N may be any
nucleotide. At the 3' end of most eukaryotic genes is an AATAAA
sequence that may be the signal for addition of the poly A tail to
the 3' end of the coding sequence. All of these sequences are
suitably inserted into eukaryotic expression vectors.
[0294] Examples of suitable promoter sequences for use with yeast
hosts include the promoters for 3-phosphoglycerate kinase or other
glycolytic enzymes, such as enolase, glyceraldehyde-3-phosphate
dehydrogenase, hexokinase, pyruvate decarboxylase,
phosphofructokinase, glucose-6-phosphate isomerase,
3-phosphoglycerate mutase, pyruvate kinase, triosephosphate
isomerase, phosphoglucose isomerase, and glucokinase.
[0295] Other yeast promoters, which are inducible promoters having
the additional advantage of transcription controlled by growth
conditions, are the promoter regions for alcohol dehydrogenase 2,
isocytochrome C, acid phosphatase, degradative enzymes associated
with nitrogen metabolism, metallothionein,
glyceraldehyde-3-phosphate dehydrogenase, and enzymes responsible
for maltose and galactose utilization. Suitable vectors and
promoters for use in yeast expression are further described in EP
73,657. Yeast enhancers also are advantageously used with yeast
promoters.
[0296] Antibody transcription from vectors in mammalian host cells
can be controlled, for example, by promoters obtained from the
genomes of viruses such as polyoma virus, fowlpox virus, adenovirus
(such as Adenovirus 2), bovine papilloma virus, avian sarcoma
virus, cytomegalovirus, a retrovirus, hepatitis-B virus, Simian
Virus 40 (SV40), or from heterologous mammalian promoters, e.g.,
the actin promoter or an immunoglobulin promoter, from heat-shock
promoters, provided such promoters are compatible with the host
cell systems.
[0297] The early and late promoters of the SV40 virus are
conveniently obtained as an SV40 restriction fragment that also
contains the SV40 viral origin of replication. The immediate early
promoter of the human cytomegalovirus is conveniently obtained as a
HindIII E restriction fragment. A system for expressing DNA in
mammalian hosts using the bovine papilloma virus as a vector is
disclosed in U.S. Pat. No. 4,419,446. A modification of this system
is described in U.S. Pat. No. 4,601,978. See also Reyes et al.,
Nature 297:598-601 (1982) on expression of human .beta.-interferon
cDNA in mouse cells under the control of a thymidine kinase
promoter from herpes simplex virus. Alternatively, the Rous Sarcoma
Virus long terminal repeat can be used as the promoter.
[0298] (e) Enhancer Element Component
[0299] Transcription of a DNA encoding an antibody of this
invention by higher eukaryotes is often increased by inserting an
enhancer sequence into the vector. Many enhancer sequences are now
known from mammalian genes (globin, elastase, albumin,
.alpha.-fetoprotein, and insulin). Typically, however, one will use
an enhancer from a eukaryotic cell virus. Examples include the SV40
enhancer on the late side of the replication origin (bp 100-270),
the cytomegalovirus early promoter enhancer, the polyoma enhancer
on the late side of the replication origin, and adenovirus
enhancers. See also Yaniv, Nature 297:17-18 (1982) on enhancing
elements for activation of eukaryotic promoters. The enhancer may
be spliced into the vector at a position 5' or 3' to the
antibody-encoding sequence, but is preferably located at a site 5'
from the promoter.
[0300] (f) Transcription Termination Component
[0301] Expression vectors used in eukaryotic host cells (yeast,
fungi, insect, plant, animal, human, or nucleated cells from other
multicellular organisms) will also contain sequences necessary for
the termination of transcription and for stabilizing the mRNA. Such
sequences are commonly available from the 5' and, occasionally 3',
untranslated regions of eukaryotic or viral DNAs or cDNAs. These
regions contain nucleotide segments transcribed as polyadenylated
fragments in the untranslated portion of the mRNA encoding
antibody. One useful transcription termination component is the
bovine growth hormone polyadenylation region. See WO94/11026 and
the expression vector disclosed therein.
[0302] (g) Selection and Transformation of Host Cells
[0303] Suitable host cells for cloning or expressing the DNA in the
vectors herein are the prokaryote, yeast, or higher eukaryote cells
described above. Suitable prokaryotes for this purpose include
eubacteria, such as Gram-negative or Gram-positive organisms, for
example, Enterobacteriaceae such as Escherichia, e.g., E. coli,
Enterobacter, Erwinia, Klebsiella, Proteus, Salmonella, e.g.,
Salmonella typhimurium, Serratia, e.g., Serratia marcescans, and
Shigella, as well as Bacilli such as B. subtilis and B.
licheniformis (e.g., B. licheniformis 41P disclosed in DD 266,710
published 12 Apr. 1989), Pseudomonas such as P. aeruginosa, and
Streptomyces. One preferred E. coli cloning host is E. coli 294
(ATCC 31,446), although other strains such as E. coli B, E. coli
X1776 (ATCC 31,537), and E. coli W3110 (ATCC 27,325) are suitable.
These examples are illustrative rather than limiting.
[0304] Full length antibody, antibody fusion proteins, and antibody
fragments can be produced in bacteria, in particular when
glycosylation and Fc effector function are not needed, such as when
the therapeutic antibody is conjugated to a cytotoxic agent (e.g.,
a toxin) that by itself shows effectiveness in tumor cell
destruction. Full length antibodies have greater half-life in
circulation. Production in E. coli is faster and more cost
efficient. For expression of antibody fragments and polypeptides in
bacteria, see, e.g., U.S. Pat. No. 5,648,237 (Carter et. al.), U.S.
Pat. No. 5,789,199 (Joly et al.), U.S. Pat. No. 5,840,523 (Simmons
et al.), which describes translation initiation region (TIR) and
signal sequences for optimizing expression and secretion. See also
Charlton, Methods in Molecular Biology, Vol. 248 (B. K. C. Lo, ed.,
Humana Press, Totowa, N.J., 2003), pp. 245-254, describing
expression of antibody fragments in E. coli. After expression, the
antibody may be isolated from the E. coli cell paste in a soluble
fraction and can be purified through, e.g., a protein A or G column
depending on the isotype. Final purification can be carried out
similar to the process for purifying antibody expressed e.g., in
CHO cells.
[0305] In addition to prokaryotes, eukaryotic microbes such as
filamentous fungi or yeast are suitable cloning or expression hosts
for antibody-encoding vectors. Saccharomyces cerevisiae, or common
baker's yeast, is the most commonly used among lower eukaryotic
host microorganisms. However, a number of other genera, species,
and strains are commonly available and useful herein, such as
Schizosaccharomyces pombe; Kluyveromyces hosts such as, e.g., K.
lactis, K fragilis (ATCC 12,424), K. bulgaricus (ATCC 16,045), K.
wickeramii (ATCC 24,178), K. waltii (ATCC 56,500), K. drosophilarum
(ATCC 36,906), K. thermotolerans, and K. marxianus; yarrowia (EP
402,226); Pichia pastoris (EP 183,070); Candida; Trichoderma reesia
(EP 244,234); Neurospora crassa; Schwanniomyces such as
Schwanniomyces occidentalis; and filamentous fungi such as, e.g.,
Neurospora, Penicillium, Tolypocladium, and Aspergillus hosts such
as A. nidulans and A. niger. For a review discussing the use of
yeasts and filamentous fungi for the production of therapeutic
proteins, see, e.g., Gerngross, Nat. Biotech. 22:1409-1414
(2004).
[0306] Certain fungi and yeast strains may be selected in which
glycosylation pathways have been "humanized," resulting in the
production of an antibody with a partially or fully human
glycosylation pattern. See, e.g., Li et al., Nat. Biotech.
24:210-215 (2006) (describing humanization of the glycosylation
pathway in Pichia pastoris); and Gerngross et al., supra.
[0307] Suitable host cells for the expression of glycosylated
antibody are also derived from multicellular organisms
(invertebrates and vertebrates). Examples of invertebrate cells
include plant and insect cells. Numerous baculoviral strains and
variants and corresponding permissive insect host cells from hosts
such as Spodoptera frugiperda (caterpillar), Aedes aegypti
(mosquito), Aedes albopictus (mosquito), Drosophila melanogaster
(fruitfly), and Bombyx mori have been identified. A variety of
viral strains for transfection are publicly available, e.g., the
L-1 variant of Autographa californica NPV and the Bm-5 strain of
Bombyx mori NPV, and such viruses may be used as the virus herein
according to the invention, particularly for transfection of
Spodoptera frugiperda cells.
[0308] Plant cell cultures of cotton, corn, potato, soybean,
petunia, tomato, duckweed (Leninaceae), alfalfa (M. truncatula),
and tobacco can also be utilized as hosts. See, e.g., U.S. Pat.
Nos. 5,959,177, 6,040,498, 6,420,548, 7,125,978, and 6,417,429
(describing PLANTIBODIES.TM. technology for producing antibodies in
transgenic plants).
[0309] Vertebrate cells may be used as hosts, and propagation of
vertebrate cells in culture (tissue culture) has become a routine
procedure. Examples of useful mammalian host cell lines are monkey
kidney CV1 line transformed by SV40 (COS-7, ATCC CRL 1651); human
embryonic kidney line (293 or 293 cells subcloned for growth in
suspension culture, Graham et al., J. Gen Virol. 36:59 (1977));
baby hamster kidney cells (BHK, ATCC CCL 10); mouse sertoli cells
(TM4, Mather, Biol. Reprod. 23:243-251 (1980)); monkey kidney cells
(CV1 ATCC CCL 70); African green monkey kidney cells (VERO-76, ATCC
CRL-1587); human cervical carcinoma cells (HELA, ATCC CCL 2);
canine kidney cells (MDCK, ATCC CCL 34); buffalo rat liver cells
(BRL 3A, ATCC CRL 1442); human lung cells (W138, ATCC CCL 75);
human liver cells (Hep G2, HB 8065); mouse mammary tumor (MMT
060562, ATCC CCL51); TRI cells (Mather et al., Annals N.Y. Acad.
Sci. 383:44-68 (1982)); MRC 5 cells; FS4 cells; and a human
hepatoma line (Hep G2). Other useful mammalian host cell lines
include Chinese hamster ovary (CHO) cells, including DHFR.sup.- CHO
cells (Urlaub et al., Proc. Natl. Acad. Sci. USA 77:4216 (1980));
and myeloma cell lines such as NS0 and Sp2/0. For a review of
certain mammalian host cell lines suitable for antibody production,
see, e.g., Yazaki and Wu, Methods in Molecular Biology, Vol. 248
(B. K. C. Lo, ed., Humana Press, Totowa, N.J., 2003), pp.
255-268.
[0310] Host cells are transformed with the above-described
expression or cloning vectors for antibody production and cultured
in conventional nutrient media modified as appropriate for inducing
promoters, selecting transformants, or amplifying the genes
encoding the desired sequences.
[0311] (h) Culturing the Host Cells
[0312] The host cells used to produce an antibody of this invention
may be cultured in a variety of media. Commercially available media
such as Ham's F10 (Sigma), Minimal Essential Medium ((MEM),
(Sigma), RPMI-1640 (Sigma), and Dulbecco's Modified Eagle's Medium
((DMEM), Sigma) are suitable for culturing the host cells. In
addition, any of the media described in Ham et al., Meth. Enz.
58:44 (1979), Barnes et al., Anal. Biochem. 102:255 (1980), U.S.
Pat. Nos. 4,767,704; 4,657,866; 4,927,762; 4,560,655; or 5,122,469;
WO 90/03430; WO 87/00195; or U.S. Pat. Re. 30,985 may be used as
culture media for the host cells. Any of these media may be
supplemented as necessary with hormones and/or other growth factors
(such as insulin, transferrin, or epidermal growth factor), salts
(such as sodium chloride, calcium, magnesium, and phosphate),
buffers (such as HEPES), nucleotides (such as adenosine and
thymidine), antibiotics (such as GENTAMYCIN.TM. drug), trace
elements (defined as inorganic compounds usually present at final
concentrations in the micromolar range), and glucose or an
equivalent energy source. Any other necessary supplements may also
be included at appropriate concentrations that would be known to
those skilled in the art. The culture conditions, such as
temperature, pH, and the like, are those previously used with the
host cell selected for expression, and will be apparent to the
ordinarily skilled artisan.
[0313] (xiv) Purification of Antibody
[0314] When using recombinant techniques, the antibody can be
produced intracellularly, in the periplasmic space, or directly
secreted into the medium. If the antibody is produced
intracellularly, as a first step, the particulate debris, either
host cells or lysed fragments, are removed, for example, by
centrifugation or ultrafiltration. Carter et al., Bio/Technology
10:163-167 (1992) describe a procedure for isolating antibodies
which are secreted to the periplasmic space of E. coli. Briefly,
cell paste is thawed in the presence of sodium acetate (pH 3.5),
EDTA, and phenylmethylsulfonylfluoride (PMSF) over about 30 min.
Cell debris can be removed by centrifugation. Where the antibody is
secreted into the medium, supernatants from such expression systems
are generally first concentrated using a commercially available
protein concentration filter, for example, an Amicon or Millipore
Pellicon ultrafiltration unit. A protease inhibitor such as PMSF
may be included in any of the foregoing steps to inhibit
proteolysis and antibiotics may be included to prevent the growth
of adventitious contaminants.
[0315] The antibody composition prepared from the cells can be
purified using, for example, hydroxylapatite chromatography,
hydrophobic interaction chromatography, gel electrophoresis,
dialysis, and affinity chromatography, with affinity chromatography
being among one of the typically preferred purification steps. The
suitability of protein A as an affinity ligand depends on the
species and isotype of any immunoglobulin Fc domain that is present
in the antibody. Protein A can be used to purify antibodies that
are based on human .gamma.1, .gamma.2, or .gamma.4 heavy chains
(Lindmark et al., J. Immunol. Meth. 62:1-13 (1983)). Protein G is
recommended for all mouse isotypes and for human .gamma.3 (Guss et
al., EMBO J. 5:15671575 (1986)). The matrix to which the affinity
ligand is attached is most often agarose, but other matrices are
available. Mechanically stable matrices such as controlled pore
glass or poly(styrenedivinyl)benzene allow for faster flow rates
and shorter processing times than can be achieved with agarose.
Where the antibody comprises a C.sub.H3 domain, the Bakerbond
ABX.TM. resin (J. T. Baker, Phillipsburg, N.J.) is useful for
purification. Other techniques for protein purification such as
fractionation on an ion-exchange column, ethanol precipitation,
Reverse Phase HPLC, chromatography on silica, chromatography on
heparin SEPHAROSE.TM. chromatography on an anion or cation exchange
resin (such as a polyaspartic acid column), chromatofocusing,
SDS-PAGE, and ammonium sulfate precipitation are also available
depending on the antibody to be recovered.
[0316] In general, various methodologies for preparing antibodies
for use in research, testing, and clinical are well-established in
the art, consistent with the above-described methodologies and/or
as deemed appropriate by one skilled in the art for a particular
antibody of interest.
[0317] C. Selecting Biologically Active Antibodies
[0318] Antibodies produced as described above may be subjected to
one or more "biological activity" assays to select an antibody with
beneficial properties from a therapeutic perspective or selecting
formulations and conditions that retain biological activity of the
antibody. The antibody may be tested for its ability to bind the
antigen against which it was raised. For example, methods known in
the art (such as ELISA, Western Blot, etc.) may be used.
[0319] For example, for an anti-PDL1 antibody, the antigen binding
properties of the antibody can be evaluated in an assay that
detects the ability to bind to PDL1. In some embodiments, the
binding of the antibody may be determined by saturation binding;
ELISA; and/or competition assays (e.g. RIA's), for example. Also,
the antibody may be subjected to other biological activity assays,
e.g., in order to evaluate its effectiveness as a therapeutic. Such
assays are known in the art and depend on the target antigen and
intended use for the antibody. For example, the biological effects
of PD-L1 blockade by the antibody can be assessed in CD8+T cells, a
lymphocytic choriomeningitis virus (LCMV) mouse model and/or a
syngeneic tumor model e.g., as described in U.S. Pat. No.
8,217,149.
[0320] To screen for antibodies which bind to a particular epitope
on the antigen of interest (e.g., those which block binding of the
anti-PDL1 antibody of the example to PD-L1), a routine
cross-blocking assay such as that described in Antibodies, A
Laboratory Manual, Cold Spring Harbor Laboratory, Ed Harlow and
David Lane (1988), can be performed. Alternatively, epitope
mapping, e.g. as described in Champe et al., J. Biol. Chem.
270:1388-1394 (1995), can be performed to determine whether the
antibody binds an epitope of interest.
[0321] D. Pharmaceutical Compositions and Formulations
[0322] Also provided herein are pharmaceutical compositions and
formulations comprising a PD-1 axis binding antagonist and/or an
antibody described herein (such as an anti-PD-L1 antibody, an
anti-HER2 antibody, or a bispecific antibody that binds HER2 and
CD3) and a pharmaceutically acceptable carrier.
[0323] Pharmaceutical compositions and formulations as described
herein can be prepared by mixing the active ingredients (such as an
antibody or a polypeptide) and/or an anti-HER2 antibody having the
desired degree of purity with one or more optional pharmaceutically
acceptable carriers (Remington's Pharmaceutical Sciences 16th
edition, Osol, A. Ed. (1980)), in the form of lyophilized
formulations or aqueous solutions. Pharmaceutically acceptable
carriers are generally nontoxic to recipients at the dosages and
concentrations employed, and include, but are not limited to:
buffers such as phosphate, citrate, and other organic acids;
antioxidants including ascorbic acid and methionine; preservatives
(such as octadecyldimethylbenzyl ammonium chloride; hexamethonium
chloride; benzalkonium chloride; benzethonium chloride; phenol,
butyl or benzyl alcohol; alkyl parabens such as methyl or propyl
paraben; catechol; resorcinol; cyclohexanol; 3-pentanol; and
m-cresol); low molecular weight (less than about 10 residues)
polypeptides; proteins, such as serum albumin, gelatin, or
immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone;
amino acids such as glycine, glutamine, asparagine, histidine,
arginine, or lysine; monosaccharides, disaccharides, and other
carbohydrates including glucose, mannose, or dextrins; chelating
agents such as EDTA; sugars such as sucrose, mannitol, trehalose or
sorbitol; salt-forming counter-ions such as sodium; metal complexes
(e.g. Zn-protein complexes); and/or non-ionic surfactants such as
polyethylene glycol (PEG). Exemplary pharmaceutically acceptable
carriers herein further include insterstitial drug dispersion
agents such as soluble neutral-active hyaluronidase glycoproteins
(sHASEGP), for example, human soluble PH-20 hyaluronidase
glycoproteins, such as rHuPH20 (HYLENEX.RTM., Baxter International,
Inc.). Certain exemplary sHASEGPs and methods of use, including
rHuPH20, are described in US Patent Publication Nos. 2005/0260186
and 2006/0104968. In one aspect, a sHASEGP is combined with one or
more additional glycosaminoglycanases such as chondroitinases.
[0324] Exemplary lyophilized antibody formulations are described in
U.S. Pat. No. 6,267,958. Aqueous antibody formulations include
those described in U.S. Pat. No. 6,171,586 and WO2006/044908, the
latter formulations including a histidine-acetate buffer.
[0325] In some embodiments, the anti-PDL1 antibody described herein
is in a formulation comprising the antibody in a concentration of
about 60 mg/mL, histidine acetate in a concentration of about 20
mM, sucrose in a concentration of about 120 mM, and polysorbate
(e.g., polysorbate 20) in a concentration of 0.04% (w/v), and the
formulation has a pH of about 5.8. In some embodiments, the
anti-PDL1 antibody described herein is in a formulation comprising
the antibody in a concentration of about 125 mg/mL, histidine
acetate in a concentration of about 20 mM, sucrose is in a
concentration of about 240 mM, and polysorbate (e.g., polysorbate
20) in a concentration of 0.02% (w/v), and the formulation has a pH
of about 5.5. In some embodiments, the anti-HER2 antibody described
herein is in a formulation comprising the antibody,
.alpha.,.alpha.-trehalose dihydrate, L-histidine HCL buffer,
L-histidine and a polysorbate. In some embodiments, the anti-HER2
antibody described herein is in a formulation comprising the
antibody in a concentration of about 22.+-.2 mg/mL, histidine in a
concentration of about 4.4 mM, trehalose in a concentration of
about 54 mM, and polysorbate 20 in a concentration of about 0.009%,
and the formulation has a pH of about 6.0.
[0326] The composition and formulation herein may also contain more
than one active ingredients as necessary for the particular
indication being treated, preferably those with complementary
activities that do not adversely affect each other. Such active
ingredients are suitably present in combination in amounts that are
effective for the purpose intended.
[0327] Active ingredients may be entrapped in microcapsules
prepared, for example, by coacervation techniques or by interfacial
polymerization, for example, hydroxymethylcellulose or
gelatin-microcapsules and poly-(methylmethacylate) microcapsules,
respectively, in colloidal drug delivery systems (for example,
liposomes, albumin microspheres, microemulsions, nano-particles and
nanocapsules) or in macroemulsions. Such techniques are disclosed
in Remington's Pharmaceutical Sciences 16th edition, Osol, A. Ed.
(1980).
[0328] Sustained-release preparations may be prepared. Suitable
examples of sustained-release preparations include semipermeable
matrices of solid hydrophobic polymers containing the antibody,
which matrices are in the form of shaped articles, e.g. films, or
microcapsules. The formulations to be used for in vivo
administration are generally sterile. Sterility may be readily
accomplished, e.g., by filtration through sterile filtration
membranes.
IV. METHODS OF TREATMENT
[0329] Provided herein are methods for treating or delaying
progression of cancer in an individual comprising administering to
the individual an effective amount of a PD-1 axis binding
antagonist and an anti-HER2 antibody. In some embodiments, the
treatment results in a sustained response in the individual after
cessation of the treatment. The methods described herein may find
use in treating conditions where enhanced immunogenicity is desired
such as increasing tumor immunogenicity for the treatment of
cancer. Also provided herein are methods of enhancing immune
function in an individual having cancer comprising administering to
the individual an effective amount of a PD-1 axis binding
antagonist and an anti-HER2 antibody. Any of the PD-1 axis binding
antagonists and the anti-HER2 antibodies known in the art or
described herein may be used in the methods.
[0330] In some embodiments, the individual is a human. In some
embodiments, the individual has HER-2 positive cancer. In some
embodiments, HER-2 positive cancer is breast cancer, lung cancer,
ovarian cancer, gastric cancer, bladder cancer, pancreatic cancer,
endometrial cancer, colon cancer, kidney cancer, esophageal cancer,
or prostate cancer. In some embodiments, the breast cancer is a
breast carcinoma or a breast adenocarcinoma. In some embodiments,
the breast carcinoma is an invasive ductal carcinoma. In some
embodiments, the lung cancer is a lung adenocarcinoma. In some
embodiments, the colon cancer is a colorectal adenocarcinoma. In
some embodiments, the cancer cells in the individual express PD-L1.
In some embodiments, the cancer cells in the individual express
HER-2 protein at a level that is detectable (e.g., detectable using
methods known in the art).
[0331] In some embodiments, the individual has been treated with a
HER2 targeted therapy before the combination treatment with a PD-1
axis binding antagonist and an anti-HER2 antibody. In some
embodiments, the HER2 targeted therapy includes treatment with one
or more antibodies, e.g., trastuzumab or pertuzumab. In some
embodiments, the HER2 targeted therapy includes treatment with one
or more antibody-drug conjugates, e.g., ado-trastuzumab emtansine
(KADCYLA.RTM., Genentech). In some embodiments, the HER2 targeted
therapy includes treatment with one or more small molecules, e.g.,
lapatinib. In some embodiments, the individual has cancer that is
resistant to one or more HER2 targeted therapies. In some
embodiments, resistance to HER2 targeted therapy includes
recurrence of cancer or refractory cancer. Recurrence may refer to
the reappearance of cancer, in the original site or a new site,
after treatment. In some embodiments, resistance to HER2 targeted
therapy includes progression of the cancer during treatment with
the HER2 targeted therapy. In some embodiments, resistance to HER2
targeted therapy includes cancer that does not response to
treatment. The cancer may be resistant at the beginning of
treatment or it may become resistant during treatment. In some
embodiments, the cancer is at early stage or at late stage.
[0332] In some embodiments, the combination therapy of the
invention comprises administration of a PD-1 axis binding
antagonist and an anti-HER2 antibody. The PD-1 axis binding
antagonist and the anti-HER2 antibody may be administered in any
suitable manner known in the art. For example, The PD-1 axis
binding antagonist and the anti-HER2 antibody may be administered
sequentially (at different times) or concurrently (at the same
time). In some embodiments, the PD-1 axis binding antagonist is in
a separate composition as the anti-HER2 antibody. In some
embodiments, the PD-1 axis binding antagonist is in the same
composition as the anti-HER2 antibody.
[0333] The PD-1 axis binding antagonist and the anti-HER2 antibody
may be administered by the same route of administration or by
different routes of administration. In some embodiments, the PD-1
axis binding antagonist is administered intravenously,
intramuscularly, subcutaneously, topically, orally, transdermally,
intraperitoneally, intraorbitally, by implantation, by inhalation,
intrathecally, intraventricularly, or intranasally. In some
embodiments, the anti-HER2 antibody is administered intravenously,
intramuscularly, subcutaneously, topically, orally, transdermally,
intraperitoneally, intraorbitally, by implantation, by inhalation,
intrathecally, intraventricularly, or intranasally. An effective
amount of the PD-1 axis binding antagonist and the anti-HER2
antibody may be administered for prevention or treatment of
disease. The appropriate dosage of the PD-1 axis binding antagonist
and/or the anti-HER2 antibody may be determined based on the type
of disease to be treated, the type of the PD-1 axis binding
antagonist and the anti-HER2 antibody, the severity and course of
the disease, the clinical condition of the individual, the
individual's clinical history and response to the treatment, and
the discretion of the attending physician.
[0334] As a general proposition, the therapeutically effective
amount of the antibody administered to human will be in the range
of about 0.01 to about 50 mg/kg of patient body weight whether by
one or more administrations. In some embodiments, the antibody used
is about 0.01 to about 45 mg/kg, about 0.01 to about 40 mg/kg,
about 0.01 to about 35 mg/kg, about 0.01 to about 30 mg/kg, about
0.01 to about 25 mg/kg, about 0.01 to about 20 mg/kg, about 0.01 to
about 15 mg/kg, about 0.01 to about 10 mg/kg, about 0.01 to about 5
mg/kg, or about 0.01 to about 1 mg/kg administered daily, for
example. In some embodiments, the antibody is administered at 15
mg/kg. However, other dosage regimens may be useful. In one
embodiment, an anti-PDL1 antibody described herein is administered
to a human at a dose of about 100 mg, about 200 mg, about 300 mg,
about 400 mg, about 500 mg, about 600 mg, about 700 mg, about 800
mg, about 900 mg, about 1000 mg, about 1100 mg, about 1200 mg,
about 1300 mg or about 1400 mg on day 1 of 21-day cycles. The dose
may be administered as a single dose or as multiple doses (e.g., 2
or 3 doses), such as infusions. The dose of the antibody
administered in a combination treatment may be reduced as compared
to a single treatment. The progress of this therapy is easily
monitored by conventional techniques.
[0335] In some embodiments, the methods may further comprise an
additional therapy. The additional therapy may be radiation
therapy, surgery (e.g., lumpectomy and a mastectomy), chemotherapy,
gene therapy, DNA therapy, viral therapy, RNA therapy,
immunotherapy, bone marrow transplantation, nanotherapy, monoclonal
antibody therapy, or a combination of the foregoing. The additional
therapy may be in the form of adjuvant or neoadjuvant therapy. In
some embodiments, the additional therapy is the administration of
small molecule enzymatic inhibitor or anti-metastatic agent. In
some embodiments, the additional therapy is the administration of
side-effect limiting agents (e.g., agents intended to lessen the
occurrence and/or severity of side effects of treatment, such as
anti-nausea agents, etc.). In some embodiments, the additional
therapy is radiation therapy. In some embodiments, the additional
therapy is surgery. In some embodiments, the additional therapy is
a combination of radiation therapy and surgery. In some
embodiments, the additional therapy is gamma irradiation. In some
embodiments, the additional therapy is therapy targeting
PI3K/AKT/mTOR pathway, HSP90 inhibitor, tubulin inhibitor,
apoptosis inhibitor, and/or chemopreventative agent. The additional
therapy may be one or more of the chemotherapeutic agents described
herein.
[0336] Other Combination Therapies
[0337] Also provided herein are methods for treating or delaying
progression of cancer in an individual comprising administering to
the individual a human PD-1 axis binding antagonist in conjunction
with another anti-cancer agent or cancer therapy. In the
embodiments described herein, the method may further comprise
administering an anti-HER2 antibody described herein for treating a
HER2 positive cancer.
[0338] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a chemotherapy or chemotherapeutic
agent. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a radiation therapy or
radiotherapeutic agent. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with a targeted
therapy or targeted therapeutic agent. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with an
immunotherapy or immunotherapeutic agent, for example a monoclonal
antibody.
[0339] Without wishing to be bound to theory, it is thought that
enhancing T cell stimulation, by promoting an activating
co-stimulatory molecule or by inhibiting a negative co-stimulatory
molecule, may promote tumor cell death thereby treating or delaying
progression of cancer. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with an agonist
directed against an activating co-stimulatory molecule. In some
embodiments, an activating co-stimulatory molecule may include
CD40, CD226, CD28, OX40, GITR, CD137, CD27, HVEM, or CD127. In some
embodiments, the agonist directed against an activating
co-stimulatory molecule is an agonist antibody that binds to CD40,
CD226, CD28, OX40, GITR, CD137, CD27, HVEM, or CD127. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an antagonist directed against an inhibitory
co-stimulatory molecule. In some embodiments, an inhibitory
co-stimulatory molecule may include CTLA-4 (also known as CD152),
PD-1, TIM-3, BTLA, VISTA, LAG-3, B7-H3, B7-H4, IDO, TIGIT, MICA/B,
or arginase. In some embodiments, the antagonist directed against
an inhibitory co-stimulatory molecule is an antagonist antibody
that binds to CTLA-4, PD-1, TIM-3, BTLA, VISTA, LAG-3, B7-H3,
B7-H4, IDO, TIGIT, MICA/B, or arginase.
[0340] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an antagonist directed against
CTLA-4 (also known as CD152), e.g., a blocking antibody. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with ipilimumab (also known as MDX-010, MDX-101, or
Yervoy.RTM.). In some embodiments, a PD-1 axis binding antagonist
may be administered in conjunction with tremelimumab (also known as
ticilimumab or CP-675,206). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with an
antagonist directed against B7-H3 (also known as CD276), e.g., a
blocking antibody. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with MGA271. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an antagonist directed against a TGF beta, e.g.,
metelimumab (also known as CAT-192), fresolimumab (also known as
GC1008), or LY2157299.
[0341] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a treatment comprising adoptive
transfer of a T cell (e.g., a cytotoxic T cell or CTL) expressing a
chimeric antigen receptor (CAR). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with a
treatment comprising adoptive transfer of a T cell comprising a
dominant-negative TGF beta receptor, e.g, a dominant-negative TGF
beta type II receptor. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with a treatment
comprising a HERCREEM protocol (see, e.g., ClinicalTrials.gov
Identifier NCT00889954).
[0342] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an agonist directed against CD137
(also known as TNFRSF9, 4-1BB, or ILA), e.g., an activating
antibody. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with urelumab (also known as
BMS-663513). In some embodiments, a PD-1 axis binding antagonist
may be administered in conjunction with an agonist directed against
CD40, e.g., an activating antibody. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
CP-870893. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an agonist directed against
OX40 (also known as CD134), e.g., an activating antibody. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an anti-OX40 antibody (e.g., AgonOX). In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an agonist directed against CD27, e.g., an
activating antibody. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with CDX-1127. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an antagonist directed against
indoleamine-2,3-dioxygenase (IDO). In some embodiments, with the
IDO antagonist is 1-methyl-D-tryptophan (also known as 1-D-MT).
[0343] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an antibody-drug conjugate. In
some embodiments, the antibody-drug conjugate comprises mertansine
or monomethyl auristatin E (MMAE). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with and
anti-NaPi2b antibody-MMAE conjugate (also known as DNIB0600A or
RG7599). In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with trastuzumab emtansine (also known
as T-DM1, ado-trastuzumab emtansine, or KADCYLA.RTM., Genentech).
In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with DMUC5754A. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with an antibody-drug conjugate targeting the endothelin B receptor
(EDNBR), e.g., an antibody directed against EDNBR conjugated with
MMAE.
[0344] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an angiogenesis inhibitor. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an antibody directed against a VEGF, e.g., VEGF-A.
In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with bevacizumab (also known as
AVASTIN.RTM., Genentech). In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with an antibody
directed against angiopoietin 2 (also known as Ang2). In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with MEDI3617.
[0345] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an antineoplastic agent. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an agent targeting CSF-1R (also known as M-CSFR or
CD115). In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with anti-CSF-1R (also known as
IMC-CS4). In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an interferon, for example
interferon alpha or interferon gamma. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
Roferon-A (also known as recombinant Interferon alpha-2a). In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with GM-CSF (also known as recombinant human
granulocyte macrophage colony stimulating factor, rhu GM-CSF,
sargramostim, or Leukine.RTM.). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with IL-2
(also known as aldesleukin or Proleukin.RTM.). In some embodiments,
a PD-1 axis binding antagonist may be administered in conjunction
with IL-12. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an antibody targeting CD20. In
some embodiments, the antibody targeting CD20 is obinutuzumab (also
known as GA101 or Gazyva.RTM.) or rituximab. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with an antibody targeting GITR. In some embodiments, the antibody
targeting GITR is TRX518.
[0346] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a cancer vaccine. In some
embodiments, the cancer vaccine is a peptide cancer vaccine, which
in some embodiments is a personalized peptide vaccine. In some
embodiments the peptide cancer vaccine is a multivalent long
peptide, a multi-peptide, a peptide cocktail, a hybrid peptide, or
a peptide-pulsed dendritic cell vaccine (see, e.g., Yamada et al.,
Cancer Sci, 104:14-21, 2013). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with an
adjuvant. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with a treatment comprising a TLR
agonist, e.g., Poly-ICLC (also known as Hiltonol.RTM.), LPS, MPL,
or CpG ODN. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with tumor necrosis factor (TNF)
alpha. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with IL-1. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
HMGB1. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an IL-10 antagonist. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an IL-4 antagonist. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with an
IL-13 antagonist. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with an HVEM
antagonist. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an ICOS agonist, e.g., by
administration of ICOS-L, or an agonistic antibody directed against
ICOS. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a treatment targeting CX3CL1. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a treatment targeting CXCL9. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a treatment targeting CXCL10. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a treatment targeting CCL5. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with an LFA-1 or ICAM1 agonist. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with a Selectin agonist.
[0347] In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with a targeted therapy. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an inhibitor of B-Raf. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
vemurafenib (also known as Zelboraf.RTM.). In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with dabrafenib (also known as Tafinlar.RTM.). In some embodiments,
a PD-1 axis binding antagonist may be administered in conjunction
with erlotinib (also known as Tarceva.RTM.). In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with an inhibitor of a MEK, such as MEK1 (also known as MAP2K1) or
MEK2 (also known as MAP2K2). In some embodiments, a PD-1 axis
binding antagonist may be administered in conjunction with
cobimetinib (also known as GDC-0973 or XL-518). In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with trametinib (also known as Mekinist.RTM.). In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with an inhibitor of K-Ras. In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with an
inhibitor of c-Met. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with onartuzumab
(also known as MetMAb). In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with an inhibitor of
Alk. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with AF802 (also known as CH5424802 or
alectinib). In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an inhibitor of a
phosphatidylinositol 3-kinase (PI3K). In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
BKM120. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with idelalisib (also known as GS-1101
or CAL-101). In some embodiments, a PD-1 axis binding antagonist
may be administered in conjunction with perifosine (also known as
KRX-0401). In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with an inhibitor of an Akt. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with MK2206. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with GSK690693. In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with GDC-0941. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with an inhibitor of mTOR. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with sirolimus (also
known as rapamycin). In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with temsirolimus
(also known as CCI-779 or Torisel.RTM.). In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with everolimus (also known as RAD001). In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
ridaforolimus (also known as AP-23573, MK-8669, or deforolimus). In
some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with OSI-027. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with AZD8055. In some embodiments, a PD-1 axis binding antagonist
may be administered in conjunction with INK128. In some
embodiments, a PD-1 axis binding antagonist may be administered in
conjunction with a dual PI3K/mTOR inhibitor. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with XL765. In some embodiments, a PD-1 axis binding antagonist may
be administered in conjunction with GDC-0980. In some embodiments,
a PD-1 axis binding antagonist may be administered in conjunction
with BEZ235 (also known as NVP-BEZ235). In some embodiments, a PD-1
axis binding antagonist may be administered in conjunction with
BGT226. In some embodiments, a PD-1 axis binding antagonist may be
administered in conjunction with GSK2126458. In some embodiments, a
PD-1 axis binding antagonist may be administered in conjunction
with PF-04691502. In some embodiments, a PD-1 axis binding
antagonist may be administered in conjunction with PF-05212384
(also known as PKI-587).
V. ARTICLES OF MANUFACTURE OR KITS
[0348] In another embodiment of the invention, an article of
manufacture or a kit is provided comprising a PD-1 axis binding
antagonist and/or an anti-HER2 antibody. In some embodiments, the
article of manufacture or kit further comprises package insert
comprising instructions for suing the PD-1 axis binding antagonist
in conjunction with an anti-HER2 antibody to treat or delay
progression of cancer in an individual or to enhance immune
function of an individual having cancer. Any of the PD-1 axis
binding antagonist and/or anti-HER antibodies described herein may
be included in the article of manufacture or kits.
[0349] In some embodiments, the PD-1 axis binding antagonist and
the anti-HER2 antibody are in the same container or separate
containers. Suitable containers include, for example, bottles,
vials, bags and syringes. The container may be formed from a
variety of materials such as glass, plastic (such as polyvinyl
chloride or polyolefin), or metal alloy (such as stainless steel or
hastelloy). In some embodiments, the container holds the
formulation and the label on, or associated with, the container may
indicate directions for use. The article of manufacture or kit may
further include other materials desirable from a commercial and
user standpoint, including other buffers, diluents, filters,
needles, syringes, and package inserts with instructions for use.
In some embodiments, the article of manufacture further includes
one or more of another agent (e.g., a chemotherapeutic agent, and
anti-neoplastic agent). Suitable containers for the one or more
agent include, for example, bottles, vials, bags and syringes.
[0350] The specification is considered to be sufficient to enable
one skilled in the art to practice the invention. Various
modifications of the invention in addition to those shown and
described herein will become apparent to those skilled in the art
from the foregoing description and fall within the scope of the
appended claims. All publications, patents, and patent applications
cited herein are hereby incorporated by reference in their entirety
for all purposes.
EXAMPLES
[0351] The invention will be more fully understood by reference to
the following examples. They should not, however, be construed as
limiting the scope of the invention. It is understood that the
examples and embodiments described herein are for illustrative
purposes only and that various modifications or changes in light
thereof will be suggested to persons skilled in the art and are to
be included within the spirit and purview of this application and
scope of the appended claims.
Example 1
HER2 T Cell Dependent Bispecific Antibody (HER2-TDB) for Treatment
of HER2 Positive Cancers
[0352] Based on recent clinical success of tumor immunotherapies
that block immune suppressive mechanisms to restore T cell
function, there is a profound interest in the clinical development
of T cell targeted therapies. To meet this demand, described herein
is a trastuzumab-based HER2 T cell dependent bispecific antibody
(HER2-TDB). This full-length human IgG format bispecific antibody
conditionally activated T cells resulting in lysis of HER2
expressing cancer cells at low picomolar concentrations
Importantly, HER2-TDB was able to eliminate cells refractory to
currently approved HER2 therapies. The potent anti-tumor activity
of HER2-TDB was demonstrated using four model systems including
MMTV-huHER2 and huCD3 transgenic mice. These results demonstrated
inhibitory effect of PD-L1 expression on the activity of bispecific
T cell recruiting antibodies. This resistance mechanism was
reversed by anti-PD-L1 antibody treatment and combination of
HER2-TDB and anti-PD-L1 immune therapy resulted in enhanced
inhibition of tumor growth, increased response rates and durable
responses.
[0353] Materials and Methods
Antibody Expression and Purification
[0354] The `knob` arm of HER2 huIgG1 TDB was humanized anti-HER2
4D5 (trastuzumab) (Carter et al., Proc Natl Acad Sci USA,
89:4285-9, 1992) and `hole` arm was humanized anti-CD3 UCHT1.v9
(Zhu et al., Int J Cancer, 62:319-24, 1995). The huIgG1 bispecific
antibodies were produced by two different approaches as described
earlier (Spiess et al., Nat Biotechnol., 2013): co-culture of
bacteria expressing each of the two antibody arms, or by expressing
each arm separately and then annealing them in vitro.
[0355] To avoid immune response towards the TDB, a murine IgG2a
isotype HER2-TDB was used in experiments with immune competent
mice. For expression as muIgG2a, equivalent knob-into-hole
mutations (Atwell et al., J Mol BioL, 270:26-35, 1997) were
introduced into the Fc region, as well as D265A and N297G (EU
numbering) to abolish effector function. In muIgG2a HER2-TDBs the
"knob" arm is murine anti-HER2 4D5 and the "hole" is either
chimeric anti-murine CD3 2C11 (Leo et al., Proc Natl Acad Sci USA,
84:1374-8, 1987) (4D5/2C11-TDB) or mouse anti-hu CD3 SP34 (Pessano
et al., The EMBO journal, 4:337-44, 1985) (4D5/SP34-TDB). The
muIgG2a bispecific antibodies were expressed in CHO cells and
assembled by in vitro assembly. Bispecific antibodies were purified
from contaminants by hydrophobic interaction chromatography (HIC)
as described elsewhere (Speiss et al., Nat Biotechnol 31:753-8,
2013). The resulting material was analyzed for endotoxin levels
using an Endosafe.RTM. portable test system (Charles River, USA)
and when needed, the endotoxin content was reduced by washing the
protein with 0.1% Triton X-114.
Antibody Characterization
[0356] The molecular weight of the bispecific antibody was analyzed
by mass spectrometry (LC-ESI/TOF) as described before (Jackman et
al., The Journal of biological chemistry, 285:20850-9, 2010). The
antibodies were also analyzed by analytical size exclusion
chromatography in a Zenix.TM. SEC-300 column (Sepax Technologies,
USA) using an Agilent 1,100 HPLC system (Agilent Technologies,
USA). The presence of residual antibody fragments was quantified by
electrohoresis using a 2100 Bioanalyzer and a Protein 230 Chip
(Agilent Technologies).
HER2-TDB Affinity
[0357] The competitive Scatchard assay was described in detail
elsewhere (Ramirez-Carrozzi et al., Nature immunology, 12:1159-66,
2011).
Breast Cancer Cell Proliferation
[0358] Breast cancer cell proliferation/viability was detected
using CellTiter-Glo.RTM. Luminescent Cell Viability Assay (Promega,
Madison, Wis.). For the assay, 5.times.10.sup.3 cells/well were
plated in 96-well plates and incubated overnight for cell
attachment before treatments.
Blood Cell Fractionation
[0359] PBMCs were separated from the blood of healthy volunteers
using lymphocyte separation medium (MP biomedicals, Solon, Ohio).
CD8+ cells were extracted from PBMC using human CD8+ Isolation Kit
from Miltenyi (#130-094-156) by negative selection. CD3+-depletion
was done using CD3+ MicroBeads from Miltenyi (#130-050-101).
In Vitro Cytotoxicity Assays (In Vitro ADCC, T Cell Killing)
[0360] In vitro cytotoxicity assays (Cytotoxicity Detection Kit;
LDH; Roche, Mannheim, Germany) were performed as previously
described (Junttila et al., Cancer Res., 70:4481-9, 2010).
Alternatively, in vitro cytotoxicity was monitored by flow
cytometry. Target cells were labeled with CFSE (Invitrogen,
#C34554). The labeled target cells and CD8+ cells were mixed with
or without TDB for 4-26 hours. At the end of the incubation, the
cells were lifted by trypsin and collected from the plate. The
cells were resuspended in equal volume of PBS+2% FBS+1 mM
EDTA+propidium iodine (PI). Flow cytometry analysis was done on a
FACSCalibur in automation format. The number of live target cells
was counted by gating on CFSE+/PI negative cells. The percentage of
cytotoxicity was calculated as follows: % cytotoxicity (live target
cell number w/o TDB--live target cell number w/TDB)/(live target
cell number w/o TDB).times.100.
Analysis of T Cell Activation
[0361] Cells were stained with CD8-FITC (BD Bioscience, 555634)
CD69-PE (BD Bioscience, 555531) and CD107a-Alexa-Fluor647
(eBioscience, 51-1079). Alternatively, cells were fixed and
permeabilized with Cytofix/CytoPerm.TM. solution (BD Bioscience,
554722) and stained with anti-granzyme B-Alexa-Fluor647 (BD
Bioscience, 560212).
Detection of Soluble Granzymes and Perforin
[0362] Soluble perforin (Cell Sciences), granzyme A and granzyme B
(eBioscience) were detected from growth media by ELISA according to
manufacturer's protocols.
PD-1 Induction and Effect of PD-L1 Expression on TDB Activity
[0363] Purified CD8+ T cells from human peripheral blood were
primed with 100 ug/ml of HER2-TDB and SKBR3 cell at 3:1 ratio for
24 h. After 24 hours incubation the cell pellet was digested with
Non-Enzyme Cell Dissociation Solution (Sigma, #C5789) at 37 C for
10 min and CD8+ T cells recovered using Human CD8+ Microbeads
(Miltenyi, #130-045-201). The primed-CD8+ T cells were used for in
vitro cytotoxicity assay. In flat-bottom 96 well plate,
CFSE-labeled 293 cells or 293-PDL1 cells were mixed with primed
effector cells in 3:1 ratio in the presence or absence of HER2-TDB
and anti-PD-L1 antibody (clone 6E11, mIgG2A, D265A and N297A).
After 24 hours, cytotoxicity was measured by counting live CFSE+
target cells by flow cytometry.
Pharmacokinetic (PK) Study in Rats
[0364] Eight rats (n=4/group) were randomized into two dosing
groups that received a single intravenous (IV) bolus of either
HER2-TDB or trastuzumab at 10 mg/kg. Samples were taken from 4 rats
per group at time points through 35 days post dose. Approximately
0.2 mL of whole blood was collected via the jugular vein (under
CO.sub.2/O.sub.2 anesthesia). The samples were allowed to clot and
centrifuged under refrigeration (5.degree. C. for 10 minutes at
2000.times.g) to obtain serum. Serum samples were assayed for human
IgG by ELISA, where Donkey anti-huFc coated to microtiter plate is
used to capture the humanized anti HER2 antibodies in circulation
and goat anti-huFc-HRP (mouse adsorbed) for detection. PK
parameters were determined with a 2-compartment method (Model 7)
using WinNonlin.RTM., version 5.2.1 (Pharsight Corp., Mountain
View, Calif.).
In Vivo Efficacy
[0365] NOD/SCID mice (NOD.CB17-Prkdcscid/J, Jackson Labs West) were
implanted with 0.36 mg, 60 day sustained release estrogen pellets
(Innovative Research of America) 1 to 3 days prior to cell
inoculation, subcutaneously over the opposite flank of tumor
inoculation. On Day 0, 5 million MCF7 neo/HER2 and 10 million
non-activated human PBMCs in HBSS-matrigel were inoculated in right
2/3 mammary fat-pad. The first treatments were administered 2 hours
post-inoculation. All treatments were administered 1.times./week by
i. v. tail vein injection for a total of 3 doses.
[0366] MMTV-huHER2 transgenic mice have been previously described
(Finkle et al., Clinical Cancer Research 10:2499-511, 2004). For
experiments with syngeneic tumors, 0.1 million CT26-HER2 cells were
injected subcutaneously to Balb/c or human CD3.epsilon. transgenic
mice (de la Hera et al., J Exp Med., 173:7-17, 1991). Treatment of
mice with established tumors is indicated in the figure legends. To
avoid immune response towards the TDB, a murine IgG2A version of
the HER2-TDB was used in experiments with immune competent mice.
Anti-PD-L1 antibody clone 25A1 (mIgG2A, D265A and N297A) was used
for therapeutic blockade of PD-L1.
[0367] Results
Generation and Purification of Full Length HER2-CD3 Bispecific
Antibody (HER2-TDB) Using Knobs-into-Holes Technology
[0368] HER2-TDB was generated using a knobs-into-holes strategy
(Jefferis, Trends in pharmacological sciences, 30:356-62, 2009)
(FIG. 1A). The anti-CD3 arm (UCHT1.v9; hole) and the anti-HER2 arm
(4D5; trastuzumab; knob) were expressed in separate E. coli
cultures or, alternatively, co-cultured (FIG. 1B). The fully
assembled antibody was isolated on Protein A and then purified from
antibody fragments by hydrophobic interaction chromatography. Size
exclusion chromatography showed a very low level of aggregation
(FIG. 1C, <0.2% to 0.9%) and mass spectrometry analysis showed a
main mass deconvolution peak corresponding to the heterodimer and
the absence of significant amounts of either homodimer (FIG. 1D).
These results demonstrate that high quality HER2-TDB can be
efficiently produced using standard expression and purification
methods.
T Cell Independent Properties of HER2-TDB
[0369] Unlike trastuzumab, HER2-TDB is monovalent and is produced
in E. coli. The T cell independent properties of HER2-TDB were
compared to trastuzumab and trastuzumab-Fab fragments (FIG. 1E-F).
Target arm binding affinity of HER2-TDB by Scatchard analysis
(K.sub.D=5.4 nM, FIG. 1E) was similar to monovalent trastuzumab Fab
(K.sub.D=3.9 nM) and lower than the affinity of bivalent
trastuzumab to HER2 (K.sub.D=0.7 nM). The K.sub.D for CD3-arm
binding affinity to Jurkat cells was 4.7 nM (not shown). The
ability of HER2-TDB to directly inhibit SKBR3 proliferation was
reduced as compared to bivalent trastuzumab (FIG. 1F). Antibodies
produced in E. coli are not glycosylated, which results in impaired
Fc.gamma.R binding, which is required to mediate antibody-dependent
cell-mediated cytotoxicity (ADCC) (Jefferis, Trends in
pharmacological sciences, 30:356-62, 2009; Simmons et al., Journal
of immunological methods, 263:133-47, 2002). E. coli produced
trastuzumab and HER2 TDB were unable to induce NK cell mediated
ADCC (FIG. 1G).
Target Dependent T Cell Activation and Cytotoxicity
[0370] T cell activation was not detected when CD8+ cells were
incubated with HER2-TDB or target cells that do not express human
HER2 (BJAB cells, FIG. 2A). A robust T cell activation was seen
when HER2+ SKBR3 cells were used as targets accompanied by release
of cytotoxic granules. Soluble perforin, granzyme A and B were
detected in the growth media by ELISA (FIG. 2B), but only when all
the key components (HER2-TDB, T cells, HER2 expressing cells) were
included in the reaction. Granule exocytosis coincided with
significant HER2-TDB induced elevation of caspase 3/7 activity,
apoptosis and cytotoxicity (lactate dehydrogenase (LDH) release;
FIG. 2C).
[0371] No killing of vector-transfected 3T3-cells was detected
(FIG. 2D); in contrast, the HER2 transfected 3T3-cells were very
efficiently killed. Addition of HER2-ECD or trastuzumab Fab to the
killing assay efficiently inhibited the killing activity (FIG. 2E).
To confirm T cell dependence of killing, CD3+ cells were depleted
from the PBMC (FIG. 2F). The depletion resulted in loss of target
cell killing activity.
Kinetics of T Cell Activation and Killing Induced by HER2-TDB
[0372] Early signs of T cell activation (CD69) appeared 4 h after
HER2-TDB treatment was initiated (FIG. 3A). However, late
activation markers (extracellular CD107a) were detected later at
the 24 h time point. Activation of T cells was reflected in killing
of HER2+ breast cancer cells (FIG. 3A). No significant killing
activity was detected at 4-12 h. Robust killing was detected at 24
h and killing activity increased over time.
HER2-TDB Induces T Cell Proliferation
[0373] Cytotoxicity was significantly reduced by effector cell
titration (FIG. 3B). However even with an E:T ratio of .ltoreq.1:1
a weak LDH signal and robust activation of T cells was detected. To
investigate whether HER2-TDB induces T cell proliferation, CD8+ T
cells, target cells (SKBR3) and 0.1 ug/ml HER2-TDB were
co-cultured, followed by T cell culture in absence of target cells
and HER2-TDB. After 3 days 75% of the T cells pulsed with TDB and
target cells had undergone a cell division (FIG. 4), however the
cell number did not increase. Supplementing the growth media with
IL-2 (20 ng/ml) provided a survival signal to CD8+ cells, and a
robust T cell proliferation was detected in the T cells, but only
if they were exposed to both HER2-TDB and target cells (FIG.
4).
HER2-TDB Activity Correlates with the Target Cell HER2 Expression
Level
[0374] To investigate the relationship between target copy number
and TDB activity, a panel of cancer cell lines with pre-determined
number of HER2-receptors on the cell membrane was selected (FIGS.
5A & E, (Aguilar et al., Oncogene, 18:6050-62, 1999)). HER2
amplified/overexpressing cell lines were significantly more
sensitive to the TDB mediated killing (p=0.015, t-test) and were
efficiently lysed at femtomolar to low picomolar concentrations
(EC.sub.50=0.8-3 pM; FIG. 5B). Cell lines expressing low levels of
HER2 were significantly less sensitive to HER2-TDB antibody
(EC.sub.50=33-51 pM). As low as <1000 copies of target antigen
was sufficient to support T cell killing.
[0375] Next, MCF7 (low HER2 expression) or BJAB cells (no HER2
expression) were co-targeted with HER2 amplified SKBR3 cells in the
same killing assay. No killing of MCF7 cells was detectable at the
EC.sub.50 for SKBR3 killing (FIG. 5C). No significant killing of
BJAB cells was detectable at any HER2-TDB concentration (FIG.
5D).
Very Low Target Occupancy is Sufficient for TDB Activity
[0376] HER2 occupancy at EC.sub.50 for HER2-TDB was calculated
using formula [D]/[D]+K.sub.D (where the D=drug and K.sub.D for
HER2-TDB was 5.4 nM). In all tested cell lines, less than 1% target
occupancy was sufficient for efficient killing (FIG. 5E), and in
the case of the high HER2 expressing cell lines, the required
occupancy was even lower (0.01-0.05%). The calculated absolute
number of TDB bound to HER2 at the EC.sub.50 was as low as 10-150
in the low expressing cell lines. These results showcase the
extreme potency of HER2-TDB and are consistent with studies of TCR
triggering which suggest as few as 1-25 TCRs need to be engaged to
trigger T cell responses (Irvine et al., Nature, 419:845-9, 2002;
Purbhoo et al., Nature immunology, 5:524-30, 2004; Sykulev et al.,
Immunity, 4:565-71, 1996).
HER2-TDB is Efficient in Killing of HER2+ Cancer Cells Refractory
to Anti-HER2 Therapies
[0377] Next, cell lines that have previously been shown to express
high levels of HER2 but are insensitive to the direct cellular
effects of trastuzumab and lapatinib in vitro were examined
(Junttila et al., Cancer Cell, 15:429-40, 2009; Junttila et al.,
Breast Cancer Res Treat, 2010). For some cell lines, activation of
the PI3K pathway due to acquired activating mutations in the PI3K
catalytic subunit (KPL4, HCC202) or by PTEN loss (HCC1596) may
cause resistance. Sensitivity of the cell lines to T-DM1 has been
previously reported (Junttila et al., Breast Cancer Res Treat,
2010; Lewis Phillips et al., Cancer Res., 68:9280-90, 2008).
EC.sub.50 for HER2-TDB mediated killing was in the femtomolar or
low picomolar range (FIG. 6A). In addition, HER2-TDB was effective
in killing HER2+ lung cancer cells. Using two independent cell line
models (BT474, FIG. 6B-C; KPL-4, not shown), acquired resistance to
T-DM1 did not affect the sensitivity to HER2-TDB.
Pharmacokinetics of HER2-TDB in Rat
[0378] To assess the pharmacokinetic (PK) profile of HER2-TDB,
Sprague-Dawley rats were administered a single intravenous (IV)
dose of 10 mg/kg of either HER2-TDB or trastuzumab. HER2-TDB does
not cross react with rat CD3 or rat HER2 and displayed a biphasic
disposition typical of an IgG1 with of a short distribution phase
and slow elimination phase (FIG. 7). Both the clearance and
half-life of HER2-TDB were similar to trastuzumab, and within
expected range of a typical IgG1 in rats.
HER2-TDB Inhibits Tumor Growth In Vivo in Immuno-Compromised
Mice
[0379] In vivo efficacy of HER2-TDB was tested in NOD-SCID mice,
which lack endogenous functional T and B cells and have reduced
levels of NK, DC and macrophage cell types. MCF7-neo/HER2 cells
were grafted together with non-activated human PBMCs from healthy
donors to mammary fat pads of mice. Mice were dosed intravenously
on a weekly schedule with 0.5 mg/kg of HER2-TDB or control-TDB,
starting on the day of tumor cell inoculation. HER2-TDB prevented
growth of HER2 expressing tumors (FIG. 8A). As expected no efficacy
was detected in mice when huPBMC were omitted (FIG. 15A). A control
TDB that shares the same CD3-arm as HER2-TDB (but has an irrelevant
target arm that does not bind to MCF7-neo/HER2, human PBMC or mouse
cells) had no effect on the tumor growth (FIG. 15B).
HER2-TDB Causes Regression of Large Mammary Tumors in huHER2
Transgenic Mice
[0380] To model the activity of HER2-TDB in immuno-competent mice,
human MMTV-huHER2 transgenic mice were used (Finkle et al.;
Clinical Cancer Research; 10:2499-511; 2004), and a surrogate TDB
using a mouse CD3 reactive antibody clone 2C11 (Leo et al., Proc
Natl Acad Sci USA, 84:1374-8, 1987) was generated. The in vitro
activity of 4D5/2C11-TDB was similar to human CD3 reactive HER2-TDB
(FIG. 10). With the exception of one tumor, 4D5/2C11-TDB resulted
in regression (FIG. 8B-C). >50% tumor regression was detected in
57% mice and 43% mice had no detectable tumor. Responders included
tumors that were >1000 mm.sup.3 at the start of the treatment
(FIG. 8D). Tumor growth was not affected by control TDBs, in which
the CD3 arm was switched to human CD3 specific, or the target arm
was switched to irrelevant (FIG. 8E).
HER2-TDB Inhibits Growth of Established Tumors in Immuno-Competent
Mice
[0381] Human CD3.epsilon. transgenic mice (CD3-TG, (de la Hera et
al., J Exp Med., 173:7-17, 1991)) were used to model the activity
of HER2-TDB in immuno-competent mice. CD3-TG T cells express both
mouse and human CD3 on approximately 50% of respective Balb/c mouse
or human T cells (FIG. 9). CD3-TG T cells killed human HER2
expressing target cells in vitro (FIG. 10), although killing
activity of mouse splenic T cells was consistently lower compared
to human peripheral T cells. Human HER2 transfected CT26 tumor
cells were grown in the CD3-TG mice subcutaneously and established
tumors were treated with weekly 0.5 mg/kg IV doses of HER2-TDB.
HER2-TDB clearly inhibited the growth of established tumors, but
the effect was transient and no complete responses were seen (FIG.
8F). The activity of HER2-TDB was dependent on T cells, since
HER2-TDB had no effect in non-CD3 transgenic mice (FIG. 11). The in
vivo responses detected in Balb/c mice using 4D5/2C11 TDB were
similar to the responses seen in CD3-TG mice with human specific
CD3-arm based TDB (FIG. 8F-G). Despite incomplete responses,
HER2-TDB significantly prolonged the time to tumor progression
(Log-Rank p-value <0.0001). Control-TDB with irrelevant tumor
arm had no effect on tumor growth. In addition, the tumors were
insensitive to T-DM1 (FIG. 8G).
PD-L1 Expression in Target Cells Inhibits HER2-TDB Activity
[0382] The cellular composition of the CT26-HER2 tumors was further
analyzed to characterize the incomplete tumor response. 10-30% of
CD45+ cells in CT26-HER2 tumors were CD8+ T cells (FIG. 12-13).
Almost all T cells displayed markers of activation and were
positive for PD-1 (80-95% CD69+, 95% PD-1+). All CD45- cells were
positive for PD-L1. To test whether the PD-1/PD-L1 signaling
interferes with HER2-TDB activity, human T cells were used.
Upregulation of PD-1 in T cells was detected upon overnight
co-culture with SKBR3 cells and HER2-TDB (FIG. 14A). T cells were
then transferred on PD-L1 or vector transfected 293 cells. 293
cells express low levels of HER2, and the primed T cells
efficiently killed the 293 cells, but only when the HER2-TDB was
added (FIG. 14B). Expression of PD-L1 in 293 cells significantly
inhibited the killing activity, but this inhibition was completely
reversed by PD-L1 blocking antibody. Together these results
demonstrate the therapeutic benefit of HER2-TDB and antiPD-L1
combination treatment.
HER2-TDB+Anti-PDL1 Combination is Effective in Treatment of
Established CT26-HER2 Tumors
[0383] In the next experiment using CD3-TG mice, a similar
transient but significant response was seen with the HER2-TDB. In
contrast to previous study, 2 complete responses were observed
(FIG. 14C). Tumor growth was significantly slower in both of the
single agent cohorts compared to the control mice, and the
combination of HER2-TDB and PD-L1 blockade further improved the
response (FIG. 14C). Combination resulted in durable responses; 60%
of the mice lived tumor free until the study was terminated at 80
days after the first dose (not shown). In a repeat study (FIG.
14D), all mice responded to the combination, with 82% showing
complete responses, and tumor growth was controlled by the
treatment in all but one mouse in the combination cohort. In
summary, combination of HER2-TDB with anti-PD-L1 immune therapy
resulted in enhanced inhibition of tumor growth, increased response
rates and durable responses.
[0384] The activity of HER2-TDB was characterized in this study and
no evidence of T cell activation without HER2 binding was found.
When target-expressing cells were present, HER2-TDB treatment
resulted in a robust activation of T cells, release of cytotoxic
granules, and death of the HER2 expressing cells Importantly, no
bystander effect on non-target expressing cells was detected in
conditions where most HER2+ cells in the same culture were killed.
HER2-TDB induced proliferation and polyclonal expansion of T cells
which may be critical for amplification of tumor-infiltrating
lymphocytes.
[0385] The potency of HER2-TDB was consistently in the low
picomolar to femtomolar range. Furthermore, as few as 10-500
HER2-bound TDBs were sufficient to induce significant in vitro
cytotoxicity. As few as .about.1000 copies of HER2 on the plasma
membrane were sufficient to induce killing. These studies also
demonstrated a correlation between target expression levels and in
vitro sensitivity to HER2-TDB.
[0386] Finally, recruitment of T cell killing activity with
HER2-TDB is dependent on HER2 expression, but independent of HER2
signaling pathway, which suggests that HER2-TDB may be efficient in
treatment of tumors that are refractory to current anti-HER2
therapies. In accordance, data demonstrated equal activity in
treatment of multiple trastuzumab/lapatinib resistant cell lines
compared to sensitive cells. Resistance in these cells is generated
by various mechanisms affecting HER2 pathway. Data presented here
suggest that switching to alternative mechanism of action by using
HER2-TDB may broadly enable overcoming resistance to antibody-drug
conjugates (e.g., T-DM1), targeted small molecule inhibitors (e.g.,
lapatinib) and therapeutic monoclonal antibodies that block the
pathway signaling (e.g. trastuzumab). The study demonstrated the
potent in vivo activity of HER2-TDB using four independent model
systems, including dramatic responses in MMTV-huHER2 transgenic
mice. HuCD3 transgenic mice can be used as a novel efficacy model
for the huCD3 targeting molecules Importantly, this study
discovered that PD-L1 expressed by the tumor cells can inhibit the
activity of T cell recruiting antibodies and that this inhibition
can be reversed by antiPD-L1 antibody. The finding suggests a
potential general resistance mechanism for T cell recruiting
molecules with vast diagnostic impact. The finding also provides a
mechanistic rationale for combination of HER2-TDB with the PD-L1
blockade, which resulted in significant enhancement of responses
and durable long term cures.
[0387] Taken together, this study presents a new immune-therapy for
HER2+ breast cancer with an alternative, extremely potent mechanism
of action that is broadly effective in cells resistant to current
HER2 targeted therapies. Several significant advances are provided
to bispecific T cell recruiting antibodies: i) charactering a
critical resistance mechanism, ii) discovering a potential
diagnosic, iii) introducing a novel huCD3 transgenic efficacy model
and iv) significantly improving the drug-like properties by using
technology based on full length antibodies with natural
architecture. The benefit of combining two immune therapies: direct
polyclonal recruitment of T cell activity together with inhibiting
the T cell suppressive PD-1/PD-L1 signaling) results enhanced and
durable long term responses, was demonstrated.
Sequences of the Antibody Used in the Examples
.alpha.-PDL1 Light Chain Variable Region:
TABLE-US-00029 [0388] (SEQ ID NO: 4)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATF GQGTKVEIKR
.alpha.-PDL1 Heavy Chain Variable Region:
TABLE-US-00030 [0389] (SEQ ID NO: 26)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSSASTK
.alpha.-PDL1 Full Length Light Chain:
TABLE-US-00031 [0390] (SEQ ID NO: 33)
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIY
SASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATF
GQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQ
WKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEV
THQGLSSPVTKSFNRGEC
.alpha.-PDL1 Full Length Heavy Chain:
TABLE-US-00032 [0391] (SEQ ID NO: 32)
EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVA
WISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCAR
RHWPGGFDYWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLV
KDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGT
QTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSVFLFP
PKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPRE
EQYASTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQ
PREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNY
KTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKS LSLSPG
Sequence CWU 1
1
541440PRTArtificial SequenceSynthetic Construct 1Gln Val Gln Leu
Val Glu Ser Gly Gly Gly Val Val Gln Pro Gly Arg1 5 10 15 Ser Leu
Arg Leu Asp Cys Lys Ala Ser Gly Ile Thr Phe Ser Asn Ser 20 25 30
Gly Met His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val 35
40 45 Ala Val Ile Trp Tyr Asp Gly Ser Lys Arg Tyr Tyr Ala Asp Ser
Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Arg Asp Asn Ser Lys Asn
Thr Leu Phe65 70 75 80 Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr
Ala Val Tyr Tyr Cys 85 90 95 Ala Thr Asn Asp Asp Tyr Trp Gly Gln
Gly Thr Leu Val Thr Val Ser 100 105 110 Ser Ala Ser Thr Lys Gly Pro
Ser Val Phe Pro Leu Ala Pro Cys Ser 115 120 125 Arg Ser Thr Ser Glu
Ser Thr Ala Ala Leu Gly Cys Leu Val Lys Asp 130 135 140 Tyr Phe Pro
Glu Pro Val Thr Val Ser Trp Asn Ser Gly Ala Leu Thr145 150 155 160
Ser Gly Val His Thr Phe Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr 165
170 175 Ser Leu Ser Ser Val Val Thr Val Pro Ser Ser Ser Leu Gly Thr
Lys 180 185 190 Thr Tyr Thr Cys Asn Val Asp His Lys Pro Ser Asn Thr
Lys Val Asp 195 200 205 Lys Arg Val Glu Ser Lys Tyr Gly Pro Pro Cys
Pro Pro Cys Pro Ala 210 215 220 Pro Glu Phe Leu Gly Gly Pro Ser Val
Phe Leu Phe Pro Pro Lys Pro225 230 235 240 Lys Asp Thr Leu Met Ile
Ser Arg Thr Pro Glu Val Thr Cys Val Val 245 250 255 Val Asp Val Ser
Gln Glu Asp Pro Glu Val Gln Phe Asn Trp Tyr Val 260 265 270 Asp Gly
Val Glu Val His Asn Ala Lys Thr Lys Pro Arg Glu Glu Gln 275 280 285
Phe Asn Ser Thr Tyr Arg Val Val Ser Val Leu Thr Val Leu His Gln 290
295 300 Asp Trp Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val Ser Asn Lys
Gly305 310 315 320 Leu Pro Ser Ser Ile Glu Lys Thr Ile Ser Lys Ala
Lys Gly Gln Pro 325 330 335 Arg Glu Pro Gln Val Tyr Thr Leu Pro Pro
Ser Gln Glu Glu Met Thr 340 345 350 Lys Asn Gln Val Ser Leu Thr Cys
Leu Val Lys Gly Phe Tyr Pro Ser 355 360 365 Asp Ile Ala Val Glu Trp
Glu Ser Asn Gly Gln Pro Glu Asn Asn Tyr 370 375 380 Lys Thr Thr Pro
Pro Val Leu Asp Ser Asp Gly Ser Phe Phe Leu Tyr385 390 395 400 Ser
Arg Leu Thr Val Asp Lys Ser Arg Trp Gln Glu Gly Asn Val Phe 405 410
415 Ser Cys Ser Val Met His Glu Ala Leu His Asn His Tyr Thr Gln Lys
420 425 430 Ser Leu Ser Leu Ser Leu Gly Lys 435 440 2
214PRTArtificial SequenceSynthetic Construct 2Glu Ile Val Leu Thr
Gln Ser Pro Ala Thr Leu Ser Leu Ser Pro Gly1 5 10 15 Glu Arg Ala
Thr Leu Ser Cys Arg Ala Ser Gln Ser Val Ser Ser Tyr 20 25 30 Leu
Ala Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu Ile 35 40
45 Tyr Asp Ala Ser Asn Arg Ala Thr Gly Ile Pro Ala Arg Phe Ser Gly
50 55 60 Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser Leu
Glu Pro65 70 75 80 Glu Asp Phe Ala Val Tyr Tyr Cys Gln Gln Ser Ser
Asn Trp Pro Arg 85 90 95 Thr Phe Gly Gln Gly Thr Lys Val Glu Ile
Lys Arg Thr Val Ala Ala 100 105 110 Pro Ser Val Phe Ile Phe Pro Pro
Ser Asp Glu Gln Leu Lys Ser Gly 115 120 125 Thr Ala Ser Val Val Cys
Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala 130 135 140 Lys Val Gln Trp
Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln145 150 155 160 Glu
Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser 165 170
175 Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val Tyr
180 185 190 Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr
Lys Ser 195 200 205 Phe Asn Arg Gly Glu Cys 210 3118PRTArtificial
SequenceSynthetic Construct 3Glu Val Gln Leu Val Glu Ser Gly Gly
Gly Leu Val Gln Pro Gly Gly1 5 10 15 Ser Leu Arg Leu Ser Cys Ala
Ala Ser Gly Phe Thr Phe Ser Asp Ser 20 25 30 Trp Ile His Trp Val
Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val 35 40 45 Ala Trp Ile
Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr Ala Asp Ser Val 50 55 60 Lys
Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser Lys Asn Thr Ala Tyr65 70 75
80 Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys
85 90 95 Ala Arg Arg His Trp Pro Gly Gly Phe Asp Tyr Trp Gly Gln
Gly Thr 100 105 110 Leu Val Thr Val Ser Ala 115 4 108PRTArtificial
SequenceSynthetic Construct 4Asp Ile Gln Met Thr Gln Ser Pro Ser
Ser Leu Ser Ala Ser Val Gly1 5 10 15 Asp Arg Val Thr Ile Thr Cys
Arg Ala Ser Gln Asp Val Ser Thr Ala 20 25 30 Val Ala Trp Tyr Gln
Gln Lys Pro Gly Lys Ala Pro Lys Leu Leu Ile 35 40 45 Tyr Ser Ala
Ser Phe Leu Tyr Ser Gly Val Pro Ser Arg Phe Ser Gly 50 55 60 Ser
Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser Leu Gln Pro65 70 75
80 Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln Tyr Leu Tyr His Pro Ala
85 90 95 Thr Phe Gly Gln Gly Thr Lys Val Glu Ile Lys Arg 100 105
510PRTArtificial SequenceSynthetic Construct 5Gly Phe Thr Phe Ser
Xaa Ser Trp Ile His1 5 10 618PRTArtificial SequenceSynthetic
Construct 6Ala Trp Ile Xaa Pro Tyr Gly Gly Ser Xaa Tyr Tyr Ala Asp
Ser Val1 5 10 15 Lys Gly79PRTArtificial SequenceSynthetic Construct
7Arg His Trp Pro Gly Gly Phe Asp Tyr1 5 825PRTArtificial
SequenceSynthetic Construct 8Glu Val Gln Leu Val Glu Ser Gly Gly
Gly Leu Val Gln Pro Gly Gly1 5 10 15 Ser Leu Arg Leu Ser Cys Ala
Ala Ser 20 25 913PRTArtificial SequenceSynthetic Construct 9Trp Val
Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val1 5 10 1032PRTArtificial
SequenceSynthetic Construct 10Arg Phe Thr Ile Ser Ala Asp Thr Ser
Lys Asn Thr Ala Tyr Leu Gln1 5 10 15 Met Asn Ser Leu Arg Ala Glu
Asp Thr Ala Val Tyr Tyr Cys Ala Arg 20 25 30 1111PRTArtificial
SequenceSynthetic Construct 11Trp Gly Gln Gly Thr Leu Val Thr Val
Ser Ala1 5 10 1211PRTArtificial SequenceSynthetic Construct 12Arg
Ala Ser Gln Xaa Xaa Xaa Thr Xaa Xaa Ala1 5 10 137PRTArtificial
SequenceSynthetic Construct 13Ser Ala Ser Xaa Leu Xaa Ser1 5
149PRTArtificial SequenceSynthetic Construct 14Gln Gln Xaa Xaa Xaa
Xaa Pro Xaa Thr1 5 1523PRTArtificial SequenceSynthetic Construct
15Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly1
5 10 15 Asp Arg Val Thr Ile Thr Cys 20 1615PRTArtificial
SequenceSynthetic Construct 16Trp Tyr Gln Gln Lys Pro Gly Lys Ala
Pro Lys Leu Leu Ile Tyr1 5 10 15 1732PRTArtificial
SequenceSynthetic Construct 17Gly Val Pro Ser Arg Phe Ser Gly Ser
Gly Ser Gly Thr Asp Phe Thr1 5 10 15 Leu Thr Ile Ser Ser Leu Gln
Pro Glu Asp Phe Ala Thr Tyr Tyr Cys 20 25 30 1811PRTArtificial
SequenceSynthetic Construct 18Phe Gly Gln Gly Thr Lys Val Glu Ile
Lys Arg1 5 10 1910PRTArtificial SequenceSynthetic Construct 19Gly
Phe Thr Phe Ser Asp Ser Trp Ile His1 5 10 2018PRTArtificial
SequenceSynthetic Construct 20Ala Trp Ile Ser Pro Tyr Gly Gly Ser
Thr Tyr Tyr Ala Asp Ser Val1 5 10 15 Lys Gly219PRTArtificial
SequenceSynthetic Construct 21Arg His Trp Pro Gly Gly Phe Asp Tyr1
5 2211PRTArtificial SequenceSynthetic Construct 22Arg Ala Ser Gln
Asp Val Ser Thr Ala Val Ala1 5 10 237PRTArtificial
SequenceSynthetic Construct 23Ser Ala Ser Phe Leu Tyr Ser1 5
249PRTArtificial SequenceSynthetic Construct 24Gln Gln Tyr Leu Tyr
His Pro Ala Thr1 5 25118PRTArtificial SequenceSynthetic Construct
25Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly1
5 10 15 Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp
Ser 20 25 30 Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu
Glu Trp Val 35 40 45 Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr
Tyr Ala Asp Ser Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Ala Asp
Thr Ser Lys Asn Thr Ala Tyr65 70 75 80 Leu Gln Met Asn Ser Leu Arg
Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ala Arg Arg His Trp
Pro Gly Gly Phe Asp Tyr Trp Gly Gln Gly Thr 100 105 110 Leu Val Thr
Val Ser Ser 115 26122PRTArtificial SequenceSynthetic Construct
26Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly1
5 10 15 Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp
Ser 20 25 30 Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu
Glu Trp Val 35 40 45 Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr
Tyr Ala Asp Ser Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Ala Asp
Thr Ser Lys Asn Thr Ala Tyr65 70 75 80 Leu Gln Met Asn Ser Leu Arg
Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ala Arg Arg His Trp
Pro Gly Gly Phe Asp Tyr Trp Gly Gln Gly Thr 100 105 110 Leu Val Thr
Val Ser Ser Ala Ser Thr Lys 115 120 2711PRTArtificial
SequenceSynthetic Construct 27Trp Gly Gln Gly Thr Leu Val Thr Val
Ser Ser1 5 10 2810PRTArtificial SequenceSynthetic Construct 28Phe
Gly Gln Gly Thr Lys Val Glu Ile Lys1 5 10 2930PRTArtificial
SequenceSynthetic Construct 29Glu Val Gln Leu Val Glu Ser Gly Gly
Gly Leu Val Gln Pro Gly Gly1 5 10 15 Ser Leu Arg Leu Ser Cys Ala
Ala Ser Gly Phe Thr Phe Ser 20 25 30 3014PRTArtificial
SequenceSynthetic Construct 30Trp Val Arg Gln Ala Pro Gly Lys Gly
Leu Glu Trp Val Ala1 5 10 3115PRTArtificial SequenceSynthetic
Construct 31Trp Gly Gln Gly Thr Leu Val Thr Val Ser Ser Ala Ser Thr
Lys1 5 10 15 32447PRTArtificial SequenceSynthetic Construct 32Glu
Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly1 5 10
15 Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp Ser
20 25 30 Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu
Trp Val 35 40 45 Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr
Ala Asp Ser Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr
Ser Lys Asn Thr Ala Tyr65 70 75 80 Leu Gln Met Asn Ser Leu Arg Ala
Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ala Arg Arg His Trp Pro
Gly Gly Phe Asp Tyr Trp Gly Gln Gly Thr 100 105 110 Leu Val Thr Val
Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe Pro 115 120 125 Leu Ala
Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu Gly 130 135 140
Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp Asn145
150 155 160 Ser Gly Ala Leu Thr Ser Gly Val His Thr Phe Pro Ala Val
Leu Gln 165 170 175 Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val Val Thr
Val Pro Ser Ser 180 185 190 Ser Leu Gly Thr Gln Thr Tyr Ile Cys Asn
Val Asn His Lys Pro Ser 195 200 205 Asn Thr Lys Val Asp Lys Lys Val
Glu Pro Lys Ser Cys Asp Lys Thr 210 215 220 His Thr Cys Pro Pro Cys
Pro Ala Pro Glu Leu Leu Gly Gly Pro Ser225 230 235 240 Val Phe Leu
Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile Ser Arg 245 250 255 Thr
Pro Glu Val Thr Cys Val Val Val Asp Val Ser His Glu Asp Pro 260 265
270 Glu Val Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn Ala
275 280 285 Lys Thr Lys Pro Arg Glu Glu Gln Tyr Ala Ser Thr Tyr Arg
Val Val 290 295 300 Ser Val Leu Thr Val Leu His Gln Asp Trp Leu Asn
Gly Lys Glu Tyr305 310 315 320 Lys Cys Lys Val Ser Asn Lys Ala Leu
Pro Ala Pro Ile Glu Lys Thr 325 330 335 Ile Ser Lys Ala Lys Gly Gln
Pro Arg Glu Pro Gln Val Tyr Thr Leu 340 345 350 Pro Pro Ser Arg Glu
Glu Met Thr Lys Asn Gln Val Ser Leu Thr Cys 355 360 365 Leu Val Lys
Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu Ser 370 375 380 Asn
Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu Asp385 390
395 400 Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys
Ser 405 410 415 Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met
His Glu Ala 420 425 430 Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser
Leu Ser Pro Gly 435 440 445 33214PRTArtificial SequenceSynthetic
Construct 33Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser
Val Gly1 5 10 15 Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp
Val Ser Thr Ala 20 25 30 Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys
Ala Pro Lys Leu Leu Ile 35 40 45 Tyr Ser Ala Ser Phe Leu Tyr Ser
Gly Val Pro Ser Arg Phe Ser Gly 50 55 60 Ser Gly Ser Gly Thr Asp
Phe Thr Leu Thr Ile Ser Ser Leu Gln Pro65 70 75 80 Glu Asp Phe Ala
Thr Tyr Tyr Cys Gln Gln Tyr Leu Tyr His Pro Ala 85 90 95 Thr Phe
Gly Gln Gly Thr Lys Val Glu Ile Lys Arg Thr Val Ala Ala 100 105 110
Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly 115
120 125 Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu
Ala 130 135 140 Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly
Asn Ser Gln145 150 155 160 Glu Ser Val Thr Glu Gln Asp Ser Lys Asp
Ser Thr Tyr Ser Leu Ser
165 170 175 Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys
Val Tyr 180 185 190 Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro
Val Thr Lys Ser 195 200 205 Phe Asn Arg Gly Glu Cys 210
34120PRTArtificial SequenceSynthetic Construct 34Glu Val Gln Leu
Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly1 5 10 15 Ser Leu
Arg Leu Ser Cys Ala Ala Ser Gly Phe Asn Ile Lys Asp Thr 20 25 30
Tyr Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val 35
40 45 Ala Arg Ile Tyr Pro Thr Asn Gly Tyr Thr Arg Tyr Ala Asp Ser
Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser Lys Asn
Thr Ala Tyr65 70 75 80 Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr
Ala Val Tyr Tyr Cys 85 90 95 Ser Arg Trp Gly Gly Asp Gly Phe Tyr
Ala Met Asp Tyr Trp Gly Gln 100 105 110 Gly Thr Leu Val Thr Val Ser
Ser 115 120 35107PRTArtificial SequenceSynthetic Construct 35Asp
Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly1 5 10
15 Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Asn Thr Ala
20 25 30 Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys Leu
Leu Ile 35 40 45 Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser
Arg Phe Ser Gly 50 55 60 Ser Arg Ser Gly Thr Asp Phe Thr Leu Thr
Ile Ser Ser Leu Gln Pro65 70 75 80 Glu Asp Phe Ala Thr Tyr Tyr Cys
Gln Gln His Tyr Thr Thr Pro Pro 85 90 95 Thr Phe Gly Gln Gly Thr
Lys Val Glu Ile Lys 100 105 36449PRTArtificial SequenceSynthetic
Construct 36Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro
Gly Gly1 5 10 15 Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Asn
Ile Lys Asp Thr 20 25 30 Tyr Ile His Trp Val Arg Gln Ala Pro Gly
Lys Gly Leu Glu Trp Val 35 40 45 Ala Arg Ile Tyr Pro Thr Asn Gly
Tyr Thr Arg Tyr Ala Asp Ser Val 50 55 60 Lys Gly Arg Phe Thr Ile
Ser Ala Asp Thr Ser Lys Asn Thr Ala Tyr65 70 75 80 Leu Gln Met Asn
Ser Leu Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys 85 90 95 Ser Arg
Trp Gly Gly Asp Gly Phe Tyr Ala Met Asp Tyr Trp Gly Gln 100 105 110
Gly Thr Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val 115
120 125 Phe Pro Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala
Ala 130 135 140 Leu Gly Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val
Thr Val Ser145 150 155 160 Trp Asn Ser Gly Ala Leu Thr Ser Gly Val
His Thr Phe Pro Ala Val 165 170 175 Leu Gln Ser Ser Gly Leu Tyr Ser
Leu Ser Ser Val Val Thr Val Pro 180 185 190 Ser Ser Ser Leu Gly Thr
Gln Thr Tyr Ile Cys Asn Val Asn His Lys 195 200 205 Pro Ser Asn Thr
Lys Val Asp Lys Lys Val Glu Pro Lys Ser Cys Asp 210 215 220 Lys Thr
His Thr Cys Pro Pro Cys Pro Ala Pro Glu Leu Leu Gly Gly225 230 235
240 Pro Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile
245 250 255 Ser Arg Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser
His Glu 260 265 270 Asp Pro Glu Val Lys Phe Asn Trp Tyr Val Asp Gly
Val Glu Val His 275 280 285 Asn Ala Lys Thr Lys Pro Arg Glu Glu Gln
Tyr Asn Ser Thr Tyr Arg 290 295 300 Val Val Ser Val Leu Thr Val Leu
His Gln Asp Trp Leu Asn Gly Lys305 310 315 320 Glu Tyr Lys Cys Lys
Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu 325 330 335 Lys Thr Ile
Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr 340 345 350 Thr
Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu 355 360
365 Thr Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp
370 375 380 Glu Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr Pro
Pro Val385 390 395 400 Leu Asp Ser Asp Gly Ser Phe Phe Leu Tyr Ser
Lys Leu Thr Val Asp 405 410 415 Lys Ser Arg Trp Gln Gln Gly Asn Val
Phe Ser Cys Ser Val Met His 420 425 430 Glu Ala Leu His Asn His Tyr
Thr Gln Lys Ser Leu Ser Leu Ser Pro 435 440 445
Gly37214PRTArtificial SequenceSynthetic Construct 37Asp Ile Gln Met
Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly1 5 10 15 Asp Arg
Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Asn Thr Ala 20 25 30
Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys Leu Leu Ile 35
40 45 Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser Arg Phe Ser
Gly 50 55 60 Ser Arg Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser
Leu Gln Pro65 70 75 80 Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln His
Tyr Thr Thr Pro Pro 85 90 95 Thr Phe Gly Gln Gly Thr Lys Val Glu
Ile Lys Arg Thr Val Ala Ala 100 105 110 Pro Ser Val Phe Ile Phe Pro
Pro Ser Asp Glu Gln Leu Lys Ser Gly 115 120 125 Thr Ala Ser Val Val
Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala 130 135 140 Lys Val Gln
Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln145 150 155 160
Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser 165
170 175 Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val
Tyr 180 185 190 Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val
Thr Lys Ser 195 200 205 Phe Asn Arg Gly Glu Cys 210
385PRTArtificial SequenceSynthetic Construct 38Asp Thr Tyr Ile His1
5 3917PRTArtificial SequenceSynthetic Construct 39Arg Ile Tyr Pro
Thr Asn Gly Tyr Thr Arg Tyr Ala Ser Asp Val Lys1 5 10 15
Gly4011PRTArtificial SequenceSynthetic Construct 40Trp Gly Gly Asp
Gly Phe Tyr Ala Met Asp Tyr1 5 10 4111PRTArtificial
SequenceSynthetic Construct 41Arg Ala Ser Gln Asp Val Asn Thr Ala
Val Ala1 5 10 427PRTArtificial SequenceSynthetic Construct 42Ser
Ala Ser Phe Leu Tyr Ser1 5 439PRTArtificial SequenceSynthetic
Construct 43Gln Gln His Tyr Thr Thr Pro Pro Thr1 5 445PRTArtificial
SequenceSynthetic Construct 44Gly Tyr Thr Met Asn1 5
4517PRTArtificial SequenceSynthetic Construct 45Leu Ile Asn Pro Tyr
Lys Gly Val Ser Thr Tyr Asn Gln Lys Phe Lys1 5 10 15
Asp4613PRTArtificial SequenceSynthetic Construct 46Ser Gly Tyr Tyr
Gly Asp Ser Asp Trp Tyr Phe Asp Val1 5 10 4711PRTArtificial
SequenceSynthetic Construct 47Arg Ala Ser Gln Asp Ile Arg Asn Tyr
Leu Asn1 5 10 487PRTArtificial SequenceSynthetic Construct 48Tyr
Thr Ser Arg Leu Glu Ser1 5 499PRTArtificial SequenceSynthetic
Construct 49Gln Gln Gly Asn Thr Leu Pro Trp Thr1 5
5017PRTArtificial SequenceSynthetic Construct 50Arg Ile Tyr Pro Thr
Asn Gly Tyr Thr Arg Tyr Ala Asp Ser Val Lys1 5 10 15
Gly5117PRTArtificial SequenceSynthetic Construct 51Arg Ile Tyr Pro
Thr Asn Gly Tyr Thr Arg Tyr Asp Pro Lys Phe Gln1 5 10 15
Asp5211PRTArtificial SequenceSynthetic Construct 52Lys Ala Ser Gln
Asp Val Asn Thr Ala Val Ala1 5 10 537PRTArtificial
SequenceSynthetic Construct 53Ser Ala Ser Phe Arg Tyr Thr1 5
54448PRTArtificial SequenceSynthetic Construct 54Glu Val Gln Leu
Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly1 5 10 15 Ser Leu
Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp Ser 20 25 30
Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val 35
40 45 Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr Ala Asp Ser
Val 50 55 60 Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser Lys Asn
Thr Ala Tyr65 70 75 80 Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr
Ala Val Tyr Tyr Cys 85 90 95 Ala Arg Arg His Trp Pro Gly Gly Phe
Asp Tyr Trp Gly Gln Gly Thr 100 105 110 Leu Val Thr Val Ser Ser Ala
Ser Thr Lys Gly Pro Ser Val Phe Pro 115 120 125 Leu Ala Pro Ser Ser
Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu Gly 130 135 140 Cys Leu Val
Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp Asn145 150 155 160
Ser Gly Ala Leu Thr Ser Gly Val His Thr Phe Pro Ala Val Leu Gln 165
170 175 Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser
Ser 180 185 190 Ser Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His
Lys Pro Ser 195 200 205 Asn Thr Lys Val Asp Lys Lys Val Glu Pro Lys
Ser Cys Asp Lys Thr 210 215 220 His Thr Cys Pro Pro Cys Pro Ala Pro
Glu Leu Leu Gly Gly Pro Ser225 230 235 240 Val Phe Leu Phe Pro Pro
Lys Pro Lys Asp Thr Leu Met Ile Ser Arg 245 250 255 Thr Pro Glu Val
Thr Cys Val Val Val Asp Val Ser His Glu Asp Pro 260 265 270 Glu Val
Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn Ala 275 280 285
Lys Thr Lys Pro Arg Glu Glu Gln Tyr Ala Ser Thr Tyr Arg Val Val 290
295 300 Ser Val Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys Glu
Tyr305 310 315 320 Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala Pro
Ile Glu Lys Thr 325 330 335 Ile Ser Lys Ala Lys Gly Gln Pro Arg Glu
Pro Gln Val Tyr Thr Leu 340 345 350 Pro Pro Ser Arg Glu Glu Met Thr
Lys Asn Gln Val Ser Leu Thr Cys 355 360 365 Leu Val Lys Gly Phe Tyr
Pro Ser Asp Ile Ala Val Glu Trp Glu Ser 370 375 380 Asn Gly Gln Pro
Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu Asp385 390 395 400 Ser
Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys Ser 405 410
415 Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu Ala
420 425 430 Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro
Gly Lys 435 440 445
* * * * *
References