EP4384152A1 - A therapeutic combination comprising a t1git antagonist, a pd-1 antagonist, and a chemotherapeutic agent(s) - Google Patents
A therapeutic combination comprising a t1git antagonist, a pd-1 antagonist, and a chemotherapeutic agent(s)Info
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- EP4384152A1 EP4384152A1 EP22856484.5A EP22856484A EP4384152A1 EP 4384152 A1 EP4384152 A1 EP 4384152A1 EP 22856484 A EP22856484 A EP 22856484A EP 4384152 A1 EP4384152 A1 EP 4384152A1
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- amino acid
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- acid sequence
- antagonist
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- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
- A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
- A61K39/39558—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against tumor tissues, cells, antigens
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- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/337—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
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- A61K31/555—Heterocyclic compounds containing heavy metals, e.g. hemin, hematin, melarsoprol
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- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
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- A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
- A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
- A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
- A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
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- A61K33/00—Medicinal preparations containing inorganic active ingredients
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- A61K33/243—Platinum; Compounds thereof
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- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
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- A61P35/00—Antineoplastic agents
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- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/2803—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/2803—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
- C07K16/2818—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against CD28 or CD152
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
- C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
- C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/2896—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against molecules with a "CD"-designation, not provided for elsewhere
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- A—HUMAN NECESSITIES
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- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
- A61K2039/507—Comprising a combination of two or more separate antibodies
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/545—Medicinal preparations containing antigens or antibodies characterised by the dose, timing or administration schedule
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/55—Medicinal preparations containing antigens or antibodies characterised by the host/recipient, e.g. newborn with maternal antibodies
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K2317/00—Immunoglobulins specific features
- C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
- C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K2317/00—Immunoglobulins specific features
- C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
- C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
- C07K2317/565—Complementarity determining region [CDR]
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Definitions
- a T cell immunoreceptor with Ig and ITIM domains TAGIT
- PD-1 programmed death I protein
- chemotherapeutic agents one or more chemotherapeutic agents.
- the instant application contains a Sequence Listing which has been submitted electronically in XML format and is hereby incorporated by reference in its entirety’.
- the XML file, created on August 1, 2022, is named 25305-WO-PCT_SL.XML and is 352 KB in size.
- TIGIT is an immunomodulatory receptor expressed primarily on activated T cells and NK cells. TIGIT is also blown as VSIG9, VSTM3, and WUCAM. Its structure shows one extracellular immunoglobulin domain, a type 1 transmembrane region and two ITIM motifs. TIGIT forms part of a co-stimulatoty network that consists of positive (CD226) and negative (TIGIT) immunomodulatory' receptors on T cells, and ligands expressed on APCs (CD155 and CD 112).
- TIGIT immunoreceptor tyrosine-based inhibition motif
- ITIM immunoreceptor tyrosine-based inhibition motif
- ligation of TIGIT by receptor-ligands CD155 and CD112 expressed by tumor cells or TAMS may contribute to the suppression of TCR-signaling and T cell activation, which is essential for mounting effective anti-tumor immunity.
- an antagonist antibody specific for TIGIT could inhibit the CD155 and CD112 induced suppression of T cell responses and enhance anti-tumor immunity.
- PD-1 is recognized as an important player in immune regulation and the maintenance of peripheral tolerance.
- Immune checkpoint therapies targeting PD-1 or its ligand have resulted in technological improvements in clinical response in multiple human cancer types (Brahmer et al., N Engl J Med, 366: 2455-2465 (2012); Garon et al., N Engl J Med, 372:2018-2028 (2015); Hamid et al., N Engl J Med, 369:134-144 (2013); Robert et al., Lancet, 384:1109-1117 (2014); Robert et al., N Engl J Med, 372: 2521-2532 (2015); Robert et al., N Engl J Med, 372:320-330 (2015); Topalian et al., N Engl J Med, 366:2443-2454 (2012); Topalian et al., J Clin Oncol, 32:1020-1030 (2014); Wolchok et al., N Engl J Med, 369:122-133 (2013)).
- Immune therapies targeting the PD-1 axis include monoclonal antibodies directed to the PD-1 receptor (e.g., KEYTRUDA ® (pembrolizumab), Merck and Co., Inc., Kenilworth, NJ; OPDIVO ® (nivolumab), Bristol-Myers Squibb Company, Princeton, NJ) and those that bind to the PD-L1 ligand (e.g., TECENTRIQ ® (atezolizumab), Genentech, San Francisco, CA).
- Chemotherapeutic agents typically provide non-specific usage of intracellular poisons to inhibit mitosis or induce DNA damage.
- chemotherapeutic agents are cytotoxic by means of interfering with cell division (mitosis) but cancer cells vary widely in their susceptibility to these agents. Chemotherapy can be thought of as a way to damage or stress cells, which may then lead to cell death if apoptosis is initiated.
- a combination of therapeutic agents e.g., a combination of antibodies or antigen binding fragments thereof.
- the present disclosure provides methods of treating a cancer, an infectious disease, or an infection using a combination of a TIGIT antagonist (e.g., antibody (e.g., monoclonal antibody) or antigen binding fragment thereof), a PD-1 antagonist (e.g., antibody (e.g., monoclonal antibody) or antigen binding fragment thereof), and one or more chemotherapeutic agents (e.g., alkylating agents, antimetabolites, anti-microtubule agents, etc.).
- a TIGIT antagonist e.g., antibody (e.g., monoclonal antibody) or antigen binding fragment thereof
- a PD-1 antagonist e.g., antibody (e.g., monoclonal antibody) or antigen binding fragment thereof
- chemotherapeutic agents e.g., alkylating agents, antimetabolites, anti-microtubule agents, etc.
- the present disclosure encompasses insights that certain combinations of immune checkpoint inhibitors (e.g., a TIGIT antagonist and a PD-1 antagonist) in combination with one or more chemotherapeutic agents (e.g., alkylating agents (e.g., cisplatin), antimetabolites (e.g., 5-fluorouracil, gemcitabine, capecitabine), anti- microtubule agents (e.g., paclitaxel), etc.) as provided herein may enhance the efficacy without significant added toxicity as compared with existing treatments.
- chemotherapeutic agents e.g., alkylating agents (e.g., cisplatin), antimetabolites (e.g., 5-fluorouracil, gemcitabine, capecitabine), anti- microtubule agents (e.g., paclitaxel), etc.
- the present disclosure provides methods of treating cancer (e.g., esophageal cancer, triple negative breast cancer (TNBC), biliary cancer, gastric cancer, etc.) using a combination of a TIGIT antagonist, a PD-1 antagonist, 5-fluorouracil represented by Formula (I), and cisplatin represented by Formula (II).
- cancer e.g., esophageal cancer, triple negative breast cancer (TNBC), biliary cancer, gastric cancer, etc.
- I) osure provides methods of treating cancer (e.g., esophageal cancer, TNBC, biliary cancer, gastric cancer etc.) using a combination of a TIGIT antagonist, a PD-1 antagonist, and paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- V) rovides methods of treating cancer e.g., esophageal cancer, TNBC, biliary cancer, etc.
- V) ides kits including a TIGIT antagonist, a PD-1 antagonist, 5-fluorouracil and cisplatin.
- the present disclosure further provides kits including a TIGIT antagonist, a PD-1 antagonist, and paclitaxel or a pharmaceutically acceptable salt thereof.
- kits including a TIGIT antagonist, a PD-1 antagonist, capecitabine or pharmaceutically acceptable salt thereof and oxaliplatin.
- a therapeutic combination for treating cancer e.g., esophageal cancer
- the therapeutic combination includes a TIGIT antagonist, a PD-1 antagonist, 5-fluorouracil and cisplatin.
- a therapeutic combination for treating cancer e.g., TNBC
- the therapeutic combination includes a TIGIT antagonist, a PD-1 antagonist, and paclitaxel or a pharmaceutically acceptable salt thereof.
- a therapeutic combination for treating cancer e.g., biliary cancer
- the therapeutic combination includes a TIGIT antagonist, a PD-1 antagonist, gemcitabine or pharmaceutically acceptable salt thereof and cisplatin.
- a therapeutic combination for treating cancer e.g., gastric cancer
- the therapeutic combination includes a TIGIT antagonist, a PD-1 antagonist, capecitabine or pharmaceutically acceptable salt thereof and oxaliplatin.
- a method of treating cancer comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil; and (d) cisplatin.
- provided herein are therapeutic combinations for use in treating cancer, comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a method of treating cancer comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine or pharmaceutically acceptable salt thereof; and (d) cisplatin.
- a method of treating cancer comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine or pharmaceutically acceptable salt thereof; and (d) oxaliplatin.
- the cancer is selected from the group consisting of osteosarcoma, rhabdomyosarcoma, neuroblastoma, kidney cancer, leukemia, renal transitional cell cancer, bladder cancer, Wilm’s cancer, ovarian cancer, pancreatic cancer, breast cancer, prostate cancer, bone cancer, lung cancer (e.g., non-small cell lung cancer), gastric cancer, colorectal cancer, cervical cancer, synovial sarcoma, head and neck cancer, squamous cell carcinoma, lymphoma (e.g., diffuse large B-cell lymphoma (DLBCL) or non- Hodgkin lymphoma (NHL)), multiple myeloma, renal cell cancer, retinoblastoma, hepatoblastoma, hepatocellular carcinoma, melanoma, rhabdoid tumor of the kidney, Ewing's sarcoma, chondrosarcoma, brain cancer, glioblastoma, meningio
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is esophageal cancer, TNBC, biliary cancer or gastric cancer.
- the cancer is metastatic.
- the cancer is relapsed.
- the cancer is refractory.
- the cancer is relapsed and refractory.
- the cancer is resectable.
- kits comprising: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil; and (d) cisplatin.
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, 5-fluorouracil, and cisplatin.
- a kit comprising: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, and paclitaxel or a pharmaceutically acceptable salt thereof.
- a kit comprising: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine or pharmaceutically acceptable salt thereof; and (d) cisplatin.
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, gemcitabine or a pharmaceutically acceptable salt thereof and cisplatin.
- kits comprising: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine or pharmaceutically acceptable salt thereof; and (d) oxaliplatin.
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, capecitabine or a pharmaceutically acceptable salt thereof and oxaliplatin.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil; and (d) cisplatin.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine or pharmaceutically acceptable salt thereof; and (d) cisplatin.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine or pharmaceutically acceptable salt thereof; and (d) oxaliplatin.
- the subject is a human patient.
- the methods, pharmaceutical compositions, kits, uses, or the combinations for use provided herein are for treating cancer.
- the cancer is esophageal cancer, TNBC, biliary cancer, or gastric cancer.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the PD-1 antagonist is an anti-human PD-L1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a humanized antibody.
- the anti-human PD-1 monoclonal antibody is a human antibody.
- the anti-human PD-L1 monoclonal antibody is a humanized antibody.
- the anti-human PD-L1 monoclonal antibody is a human antibody.
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a humanized antibody. In other embodiments of the methods, pharmaceutical compositions, kits, or uses provided herein, the anti-human TIGIT monoclonal antibody is a human antibody. In still other embodiments of the methods, pharmaceutical compositions, kits, uses provided herein, the anti-PD-1 antibody is independently selected from pembrolizumab, nivolumab, cemiplimab, sintilimab, tislelizumab, camrelizumab and toripalimab.
- the anti-human PD-1 monoclonal antibody is pembrolizumab. In another embodiment of the methods, pharmaceutical compositions, kits, or uses provided herein, the anti-human PD-1 monoclonal antibody is nivolumab. In another embodiment of the methods, pharmaceutical compositions, kits, or uses provided herein, the anti-human PD-1 monoclonal antibody is cemiplimab. In yet another embodiment of the methods, pharmaceutical compositions, kits, or uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is pidilizumab (U.S. Pat. No.7,332,582).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is AMP-514 (MedImmune LLC, Gaithersburg, MD).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is PDR001 (U.S. Pat. No.9,683,048).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is BGB-A317 (U.S. Pat. No.8,735,553).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is MGA012 (MacroGenics, Rockville, MD).
- the anti-human TIGIT monoclonal antibody comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295.
- the PD-1 antagonist is pembrolizumab; and the TIGIT antagonist is a monoclonal antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the
- the PD-1 antagonist is nivolumab; and the TIGIT antagonist is a monoclonal antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising
- the PD-1 antagonist is cemiplimab; and the TIGIT antagonist is a monoclonal antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising
- a method of enhancing T cell activity comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) 5-fluorouracil; and (d) cisplatin.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- 5-fluorouracil e.g., 5-fluorouracil
- cisplatin e.g., 5-fluorouracil
- a method of enhancing T cell activity comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- paclitaxel or a pharmaceutically acceptable salt thereof comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a method of enhancing T cell activity comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) gemcitabine or a pharmaceutically acceptable salt thereof; and (d) cisplatin.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- gemcitabine e.g., gemcitabine or a pharmaceutically acceptable salt thereof
- a method of enhancing T cell activity comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) capecitabine or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin.
- the enhancement of T cell activity occurs in vitro.
- the enhancement of T cell activity occurs in vivo.
- the enhancement is in a subject including but not limited to a human subject or human patient.
- the enhancement of T cell activity is measured by increased cytokine production.
- the enhancement of T cell activity is measured by increased cell proliferation.
- a method of increasing cytokine production of T cells comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) 5-fluorouracil; and (d) cisplatin.
- a method of increasing cytokine production of T cells comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- paclitaxel or a pharmaceutically acceptable salt thereof paclitaxel or a pharmaceutically acceptable salt thereof.
- a method of increasing cytokine production of T cells comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) gemcitabine or a pharmaceutically acceptable salt thereof; and (d) cisplatin.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- gemcitabine e.g., gemcitabine or a pharmaceutically acceptable salt thereof
- cisplatin e.g., gemcitabine or a pharmaceutically acceptable salt thereof.
- a method of increasing cytokine production of T cells comprising contacting the T cells with: (a) an anti-human TIGIT antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (b) an anti-human PD-1 antibody (e.g., monoclonal antibody) or antigen binding fragment thereof; (c) capecitabine or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin.
- an anti-human TIGIT antibody e.g., monoclonal antibody
- an anti-human PD-1 antibody e.g., monoclonal antibody
- capecitabine a pharmaceutically acceptable salt thereof
- oxaliplatin e.g., capecitabine or a pharmaceutically acceptable salt thereof.
- the human patient is administered about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab, and pembrolizumab is administered once every three weeks. In one embodiment, the human patient is administered about 200 mg pembrolizumab once every three weeks. In one embodiment, the human patient is administered about 240 mg pembrolizumab once every three weeks. In one embodiment, the human patient is administered about 2 mg/kg pembrolizumab once every three weeks. In certain embodiments of the methods, kits, or uses described herein, the human patient is administered about 400 mg pembrolizumab, and pembrolizumab is administered once every six weeks.
- the human patient is administered about 240 mg or about 3 mg/kg nivolumab once every two weeks, or about 480 mg nivolumab once every four weeks. In one specific embodiment, the human patient is administered about 240 mg nivolumab once every two weeks. In one specific embodiment, the human patient is administered about 3 mg/kg nivolumab once every two weeks. In one specific embodiment, the human patient is administered about 480 mg nivolumab once every four weeks. In yet other embodiments of the methods, kits, or uses described herein, the human patient is administered about 350 mg cemiplimab, and cemiplimab is administered once every three weeks.
- the human patient is administered about 200 mg, about 240 mg, or about 2 mg/kg of the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295, and the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof is administered once every three weeks.
- the human patient is administered about 200 mg of the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof once every three weeks.
- the human patient is administered about 240 mg of the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof once every three weeks. In one embodiment, the human patient is administered about 2 mg/kg of the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof once every three weeks.
- the human patient is administered about 400 mg of the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295, and e anti-human TIGIT monoclonal antibody or antigen binding fragment thereof is administered once every six weeks.
- the human patient is administered about 3000 mg/m 2 to about 4000 mg/m 2 5-fluorouracil, wherein the 5-fluorouracil is administered five times every three weeks.
- the human patient is administered about 600 or about 800 mg/m 2 5- fluorouracil a day. In some embodiments, the human patient is administered about 40 mg/m 2 to about 100 mg/m 2 cisplatin, wherein the cisplatin is administered once every three weeks. In some embodiments, the human patient is administered about 60 or about 80 mg/m 2 cisplatin, wherein the cisplatin is administered once every three weeks.
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three or six weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e.
- the human patient is administered: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e.g., about 600 mg/m 2 or 800 mg/m 2 per day five times every three weeks); and
- the human patient is administered: (a) about 240 mg pembrolizumab once every three weeks; (b) about 240 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e.g., about 600 mg/m 2 or 800 mg/m 2 per day five times every three weeks
- the human patient is administered: (a) about 2 mg/kg pembrolizumab once every three weeks; (b) about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e.g., about 600 mg/m 2 or 800 mg/m 2 per day five times every
- the human patient is administered: (a) about 400 mg pembrolizumab once every six weeks; (b) about 400 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every six weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e.g., about 600 mg/m 2 or 800 mg/m 2 per day five times every three weeks); and
- a method of treating esophageal cancer comprising administering to a human patient in need thereof: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil per cycle (e
- the human patient is administered about 70 mg/m 2 to about 100 mg/m 2 paclitaxel, wherein the paclitaxel is administered once every week. In some embodiments, the human patient is administered about 80 mg/m 2 or about 90 mg/m 2 paclitaxel, wherein the paclitaxel is administered once every week.
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three or six weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid
- the human patient is administered: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as
- the human patient is administered: (a) about 240 mg pembrolizumab once every three weeks; (b) about 240 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid
- the human patient is administered: (a) about 2 mg/kg pembrolizumab once every three weeks; (b) about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the
- the human patient is administered: (a) about 400 mg pembrolizumab once every six weeks; (b) about 400 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every six weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as
- a method of treating TNBC comprising administering to a human patient in need thereof: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel once every week.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:
- the human patient is administered about 500 mg/m 2 to about 1500 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof, wherein the gemcitabine or a pharmaceutically acceptable salt thereof is administered every three weeks.
- the human patient is administered about 800 mg/m 2 to about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof, wherein the gemcitabine or a pharmaceutically acceptable salt thereof is administered every three weeks.
- the human patient is administered about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof, wherein the gemcitabine or a pharmaceutically acceptable salt thereof is administered every three weeks.
- the human patient is administered about 10 mg/m 2 to about 50 mg/m 2 cisplatin, wherein the cisplatin is administered once every three weeks. In some embodiments, the human patient is administered about 20 mg/m 2 to about 25 mg/m 2 cisplatin, wherein the cisplatin is administered once every three weeks. In some embodiments, the human patient is administered about 20 or about 25 mg/m 2 cisplatin, wherein the cisplatin is administered once every three weeks.
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three or six weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and
- the human patient is administered: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and (d) about 20 mg/m 2 or 25 mg/m 2 cisplatin once every three weeks
- the human patient is administered: (a) about 240 mg pembrolizumab once every three weeks; (b) about 240 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and (d) about 20 mg/m 2 or 25 mg/m 2 cisplatin once every
- the human patient is administered: (a) about 2 mg/kg pembrolizumab once every three weeks; (b) about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and (d) about 20 mg/m 2 or 25 mg/m 2 cisplatin
- the human patient is administered: (a) about 400 mg pembrolizumab once every six weeks; (b) about 400 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every six weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and (d) about 20 mg/m 2 or 25 mg/m 2 cisplatin once every three weeks
- a method of treating biliary cancer comprising administering to a human patient in need thereof: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three weeks; and (
- the human patient is administered about 500 mg/m 2 to about 1500 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof, wherein the capecitabine or a pharmaceutically acceptable salt thereof is administered twice a day. In some embodiments, the human patient is administered about 750 mg/m 2 to about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof, wherein the capecitabine or a pharmaceutically acceptable salt thereof is administered twice a day. In some embodiments, the human patient is administered about 750 mg/m 2 or about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof, wherein the capecitabine or a pharmaceutically acceptable salt thereof is administered twice a day.
- the human patient is administered about 80 mg/m 2 to about 150 mg/m 2 oxaliplatin, wherein the oxaliplatin is administered once every three weeks. In some embodiments, the human patient is administered about 100 mg/m 2 to about 130 mg/m 2 oxaliplatin, wherein the oxaliplatin is administered once every three weeks. In some embodiments, the human patient is administered about 100 or about 130 mg/m 2 oxaliplatin, wherein the oxaliplatin is administered once every three weeks.
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three or six weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice
- the human patient is administered: (a) about 200 mg, about 240 mg, or about 2 mg/kg pembrolizumab once every three weeks; (b) about 200 mg, about 240 mg, or about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day
- the human patient is administered: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day; and (d) about 100 mg/m 2 or 130 mg/m 2 oxaliplatin once
- the human patient is administered: (a) about 240 mg pembrolizumab once every three weeks; (b) about 240 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day; and (d) about 100 mg/m 2 or 130 mg/m 2 oxalip
- the human patient is administered: (a) about 2 mg/kg pembrolizumab once every three weeks; (b) about 2 mg/kg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day; and (d) about 100 mg/m 2 or 130 mg/m 2 ox
- the human patient is administered: (a) about 400 mg pembrolizumab once every six weeks; (b) about 400 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every six weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day; and (d) about 100 mg/m 2 or 130 mg/m 2 oxaliplatin once
- a method of treating gastric cancer comprising administering to a human patient in need thereof: (a) about 200 mg pembrolizumab once every three weeks; (b) about 200 mg of an anti-human TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 once every three weeks; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day; and (
- the anti-human TIGIT monoclonal antibody and the anti-human PD-1 monoclonal antibody are administered on the same day. In some embodiments, the anti-human TIGIT monoclonal antibody and the anti-human PD-1 monoclonal antibody are administered sequentially. In other embodiments, the anti-human TIGIT monoclonal antibody and the anti-human PD-1 monoclonal antibody are administered concurrently. In some embodiments, the anti-human TIGIT monoclonal antibody and the anti-human PD-1 monoclonal antibody are co-formulated.
- Figure 1 shows tumor volume size as a function of time for one or more cancer treatments, including the combination treatment of a PD-1 antagonist, a TIGIT antagonist, 5- Fluorouracil (5-FU) and cisplatin.
- Figure 2 shows changes in tumor volume at Day 17 for one or more cancer treatments, including the combination treatment of a PD-1 antagonist, a TIGIT antagonist, 5- FU and cisplatin.
- Figure 3 depicts tumor volume size as a function of time for one or more cancer treatments, including the combination treatment of a PD-1 antagonist, a TIGIT antagonist, gemcitabine and cisplatin.
- Figure 4 depicts best overall response shown as percentage change in tumor volume at the end of study for one or more cancer treatments, including the combination treatment of a PD-1 antagonist, a TIGIT antagonist, gemcitabine and cisplatin.
- “About” when used to modify a numerically defined parameter e.g., the dose of an anti-TIGIT antibody or antigen binding fragment thereof, an anti-PD-1 antibody or antigen binding fragment thereof, 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin twice a day or the length of treatment time with a combination therapy described herein) means that the parameter is within 20%, within 15%, within 10%, within 9%, within 8%, within 7%, within 6%, within 5%, within 4%, within 3%, within 2%, within 1%, or less of the stated numerical value or range for that parameter; where appropriate, the stated parameter may be rounded to the nearest whole number.
- a dose of about 5 mg/kg may vary between 4.5 mg/kg and 5.5 mg/kg.
- the singular forms of words such as “a,” “an,” and “the,” include their corresponding plural references unless the context clearly dictates otherwise.
- administer refers to the act of injecting or otherwise physically delivering a substance as it exists outside the body (e.g., an anti-TIGIT antibody, an anti-PD-1 antibody, 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin as described herein) into a patient, such as by oral, mucosal, intradermal, intravenous, subcutaneous, intramuscular delivery, and/or any other methods of physical delivery described herein or known in the art.
- a substance as it exists outside the body e.g., an anti-TIGIT antibody, an anti-PD-1 antibody, 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin as described
- antibody refers to any form of immunoglobulin molecule that exhibits the desired biological or binding activity. Thus, it is used in the broadest sense and specifically covers, but is not limited to, monoclonal antibodies (including full length monoclonal antibodies), polyclonal antibodies, multispecific antibodies (e.g., bispecific antibodies), humanized, fully human antibodies, and chimeric antibodies. “Parental antibodies” are antibodies obtained by exposure of an immune system to an antigen prior to modification of the antibodies for an intended use, such as humanization of an antibody for use as a human therapeutic.
- the term “antibody” encompasses not only intact polyclonal or monoclonal antibodies, but also, unless otherwise specified, fusion proteins comprising an antigen binding portion, and any other modified configuration of the immunoglobulin molecule that comprises an antigen binding fragment thereof that competes with the intact antibody for specific binding.
- the basic antibody structural unit comprises a tetramer.
- Each tetramer includes two identical pairs of polypeptide chains, each pair having one “light” (about 25 kDa) and one “heavy” chain (about 50-70 kDa).
- the amino-terminal portion of each chain includes a variable region of about 100 to 110 or more amino acids primarily responsible for antigen recognition.
- the variable regions of each light/heavy chain pair form the antibody binding site.
- an intact antibody has two binding sites.
- the carboxy-terminal portion of the heavy chain may define a constant region primarily responsible for effector function.
- human light chains are classified as kappa and lambda light chains.
- human heavy chains are typically classified as mu, delta, gamma, alpha, or epsilon, and define the antibody’s isotype as IgM, IgD, IgG, IgA, and IgE, respectively.
- the variable and constant regions are joined by a “J” region of about 12 or more amino acids, with the heavy chain also including a “D” region of about 10 more amino acids.
- variable regions or “V region” or “V chain” as used herein means the segment of IgG chains which is variable in sequence between different antibodies.
- a “variable region” of an antibody refers to the variable region of the antibody light chain or the variable region of the antibody heavy chain, either alone or in combination.
- the variable region of the heavy chain may be referred to as “VH.”
- the variable region of the light chain may be referred to as “V L .”
- the variable regions of both the heavy and light chains comprise three hypervariable regions, also called complementarity determining regions (CDRs), which are located within relatively conserved framework regions (FR).
- CDRs complementarity determining regions
- the CDRs are usually aligned by the framework regions, enabling binding to a specific epitope.
- both light and heavy chains variable domains comprise FR1, CDR1, FR2, CDR2, FR3, CDR3, and FR4.
- the light chain CDRs are CDRL1, CDRL2 and CDRL3, respectively
- the heavy chain CDRs are CDRH1, CDRH2 and CDRH3, respectively.
- the assignment of amino acids to each domain is, generally, in accordance with the definitions of Sequences of Proteins of Immunological Interest, Kabat, et al.; National Institutes of Health, Bethesda, Md.; 5th ed.; NIH Publ.
- CDR refers to one of three hypervariable regions (H1, H2, or H3) within the non- framework region of the antibody VH ⁇ -sheet framework, or one of three hypervariable regions (L1, L2, or L3) within the non-framework region of the antibody V L ⁇ -sheet framework.
- CDRs are variable region sequences interspersed within the framework region sequences.
- CDR regions are well known to those skilled in the art and have been defined by, for example, Kabat as the regions of most hypervariability within the antibody variable domains.
- CDR region sequences also have been defined structurally by Chothia as those residues that are not part of the conserved b-sheet framework, and thus are able to adapt to different conformation. Both terminologies are well recognized in the art.
- CDR region sequences have also been defined by AbM, Contact, and IMGT. The positions of CDRs within a canonical antibody variable region have been determined by comparison of numerous structures (Al-Lazikani et al., 1997, J. Mol.
- the CDRs are as defined by the IMGT numbering system. In yet other embodiments, the CDRs are as defined by the AbM numbering system. In still other embodiments, the CDRs are as defined by the Chothia numbering system. In yet other embodiments, the CDRs are as defined by the Contact numbering system. Table 1.
- “Chimeric antibody” refers to an antibody in which a portion of the heavy and/or light chain contains sequences derived from a particular species (e.g., human) or belonging to a particular antibody class or subclass, while the remainder of the chain(s) is derived from another species (e.g., mouse) or belonging to another antibody class or subclass, as well as fragments of such antibodies, so long as they exhibit the desired biological activity.
- Human antibody refers to an antibody that comprises human immunoglobulin protein sequences or derivatives thereof.
- a human antibody may contain murine carbohydrate chains if produced in a mouse, in a mouse cell, or in a hybridoma derived from a mouse cell.
- mouse antibody or rat antibody refer to an antibody that comprises only mouse or rat immunoglobulin sequences or derivatives thereof, respectively.
- Humanized antibody refers to forms of antibodies that contain sequences from non- human (e.g., murine) antibodies as well as human antibodies. Such antibodies contain minimal sequence derived from non-human immunoglobulin.
- the 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 FR regions are those of a human immunoglobulin sequence.
- the humanized antibody optionally also will comprise at least a portion of an immunoglobulin constant region (Fc), typically that of a human immunoglobulin.
- Fc immunoglobulin constant region
- the humanized forms of rodent antibodies will generally comprise the same CDR sequences of the parental rodent antibodies, although certain amino acid substitutions may be included to increase affinity, increase stability of the humanized antibody, or for other reasons.
- “Monoclonal antibody” or “mAb” or “Mab”, as used herein, refers to a population of substantially homogeneous antibodies, i.e., the antibody molecules comprising the population are identical in amino acid sequence except for possible naturally occurring mutations that may be present in minor amounts.
- conventional (polyclonal) antibody preparations typically include a multitude of different antibodies having different amino acid sequences in their variable domains, particularly their CDRs, which are often specific for different epitopes.
- 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.
- the monoclonal antibodies to be used in accordance with the present disclosure may be made by the hybridoma method first described by Kohler et al. (1975) Nature 256: 495, or may be made by recombinant DNA methods (see, e.g., U.S. Pat. No.4,816,567).
- the “monoclonal antibodies” may also be isolated from phage antibody libraries using the techniques described in Clackson et al. (1991) Nature 352: 624-628 and Marks et al. (1991) J.
- antibody fragment or “antigen binding fragment” refers to a fragment of an antibody that retains the ability to bind specifically to the antigen, e.g., fragments that retain one or more CDR regions and the ability to bind specifically to the antigen.
- An antibody that “specifically binds to” TIGIT or PD-1 is an antibody that exhibits preferential binding to TIGIT or PD-1 (as appropriate) as compared to other proteins, but this specificity does not require absolute binding specificity.
- An antibody is considered “specific” for its intended target if its binding is determinative of the presence of the target protein in a sample, e.g., without producing undesired results such as false positives.
- Antibodies, or binding fragments thereof will bind to the target protein with an affinity that is at least two-fold greater, preferably at least ten times greater, more preferably at least 20-times greater, and most preferably at least 100-times greater than the affinity with non-target proteins.
- Antigen binding portions include, for example, Fab, Fab’, F(ab’)2, Fd, Fv, fragments including CDRs, and single chain variable fragment antibodies (scFv), and polypeptides that contain at least a portion of an immunoglobulin that is sufficient to confer specific antigen binding to the antigen (e.g., TIGIT or PD-1).
- An antibody includes an antibody of any class, such as IgG, IgA, or IgM (or sub-class thereof), and the antibody need not be of any particular class. Depending on the antibody amino acid sequence of the constant region of its heavy chains, immunoglobulins can be assigned to different classes.
- immunoglobulins 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., IgG1, IgG2, IgG3, IgG4, IgA1, and IgA2.
- the heavy-chain constant regions that correspond to the different classes of immunoglobulins are called alpha, delta, epsilon, gamma, and mu, respectively.
- the subunit structures and three- dimensional configurations of different classes of immunoglobulins are well known.
- the terms “at least one” item or “one or more” item each include a single item selected from the list as well as mixtures of two or more items selected from the list.
- the term “immune response” relates to any one or more of the following: specific immune response, non-specific immune response, both specific and non- specific response, innate response, primary immune response, adaptive immunity, secondary immune response, memory immune response, immune cell activation, immune cell- proliferation, immune cell differentiation, and cytokine expression.
- subject (alternatively “patient”) as used herein refers to a mammal that has been the object of treatment, observation, or experiment. The mammal may be male or female.
- the mammal may be one or more selected from the group consisting of humans, bovine (e.g., cows), porcine (e.g., pigs), ovine (e.g., sheep), capra (e.g., goats), equine (e.g., horses), canine (e.g., domestic dogs), feline (e.g., house cats), lagomorph (e.g., rabbits), rodent (e.g., rats or mice), Procyon lotor (e.g., raccoons).
- the subject is human.
- the term “subject in need thereof” as used herein refers to a subject diagnosed with or suspected of having cancer or an infectious disease as defined herein.
- enteral route refers to the administration via any part of the gastrointestinal tract.
- enteral routes include oral, mucosal, buccal, and rectal route, or intragastric route.
- Parenteral route refers to a route of administration other than enteral route.
- parenteral routes of administration examples include intravenous, intramuscular, intradermal, intraperitoneal, intratumor, intravesical, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, transtracheal, intraarticular, subcapsular, subarachnoid, intraspinal, epidural and intrasternal, subcutaneous, or topical administration.
- the therapeutic agents and compositions of the disclosure can be administered using any suitable method, such as by oral ingestion, nasogastric tube, gastrostomy tube, injection, infusion, implantable infusion pump, and osmotic pump.
- the suitable route and method of administration may vary depending on a number of factors such as the specific therapeutic agent being used, the rate of absorption desired, specific formulation or dosage form used, type or severity of the disorder being treated, the specific site of action, and conditions of the patient, and can be readily selected by a person skilled in the art.
- variant when used in relation to an antibody (e.g., an anti-TIGIT antibody or an anti-PD-1 antibody) or an amino acid region within the antibody may refer to a peptide or polypeptide comprising one or more (such as, for example, about 1 to about 25, about 1 to about 20, about 1 to about 15, about 1 to about 10, or about 1 to about 5) amino acid sequence substitutions, deletions, and/or additions as compared to a native or unmodified sequence.
- a variant of an anti-PD-1 antibody may result from one or more (such as, for example, about 1 to about 25, about 1 to about 20, about 1 to about 15, about 1 to about 10, or about 1 to about 5) changes to an amino acid sequence of a native or previously unmodified anti-PD-1 antibody.
- Variants may be naturally occurring or may be artificially constructed.
- Polypeptide variants may be prepared from the corresponding nucleic acid molecules encoding the variants.
- an antibody variant e.g., an anti- TIGIT antibody variant or an anti-PD-1 antibody variant
- an anti-TIGIT antibody variant binds to TIGIT and/or is antagonistic to TIGIT activity.
- an anti-PD-1 antibody variant binds to PD-1 and/or is antagonistic to PD-1 activity.
- Constantly modified variants or “conservative substitution” refers to substitutions of amino acids in a protein with other amino acids having similar characteristics (e.g., charge, side-chain size, hydrophobicity/hydrophilicity, backbone conformation and rigidity, etc.), such that the changes can frequently be made without altering the biological activity or other desired property of the protein, such as antigen affinity and/or specificity.
- conservatively modified variants or “conservative substitution” refers to substitutions of amino acids in a protein with other amino acids having similar characteristics (e.g., charge, side-chain size, hydrophobicity/hydrophilicity, backbone conformation and rigidity, etc.), such that the changes can frequently be made without altering the biological activity or other desired property of the protein, such as antigen affinity and/or specificity.
- the two Abs are homologous at that position.
- the percent of homology is the number of homologous positions shared by the two sequences divided by the total number of positions compared ⁇ 100. For example, if 8 of 10 of the positions in two sequences are matched when the sequences are optimally aligned then the two sequences are 80% homologous. Generally, the comparison is made when two sequences are aligned to give maximum percent homology.
- the comparison can be performed by a BLAST algorithm wherein the parameters of the algorithm are selected to give the largest match between the respective sequences over the entire length of the respective reference sequences.
- BLAST ALGORITHMS Altschul, S.F., et al., (1990) J. Mol. Biol.215:403-410; Gish, W., et al., (1993) Nature Genet.3:266-272; Madden, T.L., et al., (1996) Meth.
- sustained response means a sustained therapeutic effect after cessation of treatment as described herein.
- the sustained response has a duration that is at least the same as the treatment duration, or at least 1.5, 2.0, 2.5 or 3 times longer than the treatment duration.
- the term "treat” or “treating” means to administer a therapeutic combination of a PD-1 antagonist, a TIGIT antagonist, and one or more chemotherapeutic agents (e.g., an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin) or pharmaceutically acceptable salts thereof) to a subject or patient having one or more disease symptoms as provided herein.
- chemotherapeutic agents e.g., an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, and one or more chemotherapeutic agents (e
- the agents of the therapeutic combination are administered in an amount effective to alleviate one or more disease symptoms in the treated subject or population, whether by inducing the regression of or inhibiting the progression of such symptom(s) by any clinically measurable degree.
- the amount of the agents of the therapeutic combination that is effective to alleviate any particular disease symptom may vary according to factors such as the disease state, age, and weight of the patient, and the ability of the therapeutic combination to elicit a desired response in the subject. Whether a disease symptom has been alleviated can be assessed by any clinical measurement typically used by physicians or other skilled healthcare providers to assess the severity or progression status of that symptom.
- “Treat” or “treating” cancer as used herein means to administer a therapeutic combination of a PD-1 antagonist, a TIGIT antagonist, and one or more chemotherapeutic agents or pharmaceutically acceptable salts thereof (e.g., an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, and one or more chemotherapeutic agents (e.g., 5- fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin)) to a subject having cancer or diagnosed with cancer to achieve at least one positive therapeutic effect, such as, for example, reduced number of cancer cells, reduced tumor size, reduced rate of cancer cell infiltration into peripheral organs, or reduced rate of tumor metastasis or tumor growth, comprising administration by oral, mucosal, intradermal, intrave
- the therapeutic combination is a therapeutic combination of an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, 5-fluorouracil, and cisplatin; a therapeutic combination of an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, and paclitaxel or a pharmaceutically acceptable salt thereof; a therapeutic combination of an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, gemcitabine or a pharmaceutically acceptable salt thereof, and cisplatin; or a therapeutic combination of an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, capecitabine or a pharmaceutically acceptable salt thereof, and oxaliplatin.
- Treatment may include one or more of the following: inducing/increasing an antitumor immune response, decreasing the number of one or more tumor markers, halting or delaying the growth of a tumor or blood cancer or progression of disease such as cancer, stabilization of disease, inhibiting the growth or survival of tumor cells, eliminating or reducing the size of one or more cancerous lesions or tumors, decreasing the level of one or more tumor markers, ameliorating or abrogating the clinical manifestations of disease, reducing the severity or duration of the clinical symptoms, prolonging the survival or patient relative to the expected survival in a similar untreated patient, and inducing complete or partial remission of a cancerous condition, wherein the disease is cancer, and in certain embodiments wherein the cancer is selected from the group consisting of endometrial cancer cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, bladder cancer, breast cancer, triple negative breast cancer (TNBC), non-small cell lung cancer (NSCLC), colorectal cancer (CR
- the amount of a therapeutic agent that is effective to alleviate any particular disease symptom may vary according to factors such as the disease state, age, and weight of the patient, and the ability of the drug to elicit a desired response in the subject. Whether a disease symptom has been alleviated can be assessed by any clinical measurement typically used by physicians or other skilled healthcare providers to assess the severity or progression status of that symptom. Positive therapeutic effects in cancer can be measured in a number of ways (See, W. A. Weber, J. Nucl. Med.50:1S-10S (2009)). For example, with respect to tumor growth inhibition, according to NCI standards, a T/C ⁇ 42% is the minimum level of anti-tumor activity.
- the treatment achieved by a combination therapy of the disclosure is any of PR, CR, OR, PFS, DFS, and OS.
- PFS also referred to as “Time to Tumor Progression” indicates the length of time during and after treatment that the cancer does not grow, and includes the amount of time patients have experienced a CR or PR, as well as the amount of time patients have experienced SD.
- DFS refers to the length of time during and after treatment that the patient remains free of disease.
- OS refers to a prolongation in life expectancy as compared to naive or untreated individuals or patients.
- response to a combination therapy of the disclosure is any of PR, CR, PFS, DFS, or OR that is assessed using RECIST 1.1 response criteria.
- the treatment regimen for a combination therapy of the disclosure that is effective to treat a cancer patient may vary according to factors such as the disease state, age, and weight of the patient, and the ability of the therapy to elicit an anti-cancer response in the subject.
- any of the aspects of the disclosure may not be effective in achieving a positive therapeutic effect in every subject, it should do so in a statistically significant number of subjects as determined by any statistical test known in the art such as the Student’s t-test, the chi 2 -test, the U-test according to Mann and Whitney, the Kruskal-Wallis test (H-test), Jonckheere-Terpstra-test and the Wilcoxon-test.
- any statistical test known in the art such as the Student’s t-test, the chi 2 -test, the U-test according to Mann and Whitney, the Kruskal-Wallis test (H-test), Jonckheere-Terpstra-test and the Wilcoxon-test.
- “Treat” or “treating” an infectious disease or an infection as used herein means to administer a therapeutic combination of a PD-1 antagonist, a TIGIT antagonist, and one or more chemotherapeutic agents or pharmaceutically acceptable salts thereof (e.g., an anti- human PD-1 monoclonal antibody or antigen binding fragment thereof, an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin) or pharmaceutically acceptable salts thereof), to a subject having an infectious disease or an infection (e.g., caused by many pathogens, including bacteria, viruses, fungi) to achieve at least one positive therapeutic effect.
- chemotherapeutic agents or pharmaceutically acceptable salts thereof e.g., an anti
- co-formulation refers to a formulation comprising two or more of therapeutic agents.
- co-formulation comprises a TIGIT antagonist and a PD-1 antagonist.
- pharmaceutically acceptable carrier refers to any inactive substance that is suitable for use in a formulation for the delivery of a therapeutic agent.
- a carrier may be an anti-adherent, binder, coating, disintegrant, filler or diluent, preservative (such as antioxidant, antibacterial, or antifungal agent), sweetener, absorption delaying agent, wetting agent, emulsifying agent, buffer, and the like.
- Suitable pharmaceutically acceptable carriers include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like), dextrose, vegetable oils (such as olive oil), saline, buffer, buffered saline, and isotonic agents such as sugars, polyalcohols, sorbitol, and sodium chloride.
- the terms “combination,” “combination therapy,” and “therapeutic combination” refer to treatments in which at least one PD-1 antagonist, at least one TIGIT antagonist, and one or more chemotherapeutic agents or pharmaceutically acceptable salts thereof, and optionally additional therapeutic agents, each are administered to a patient in a coordinated manner, either sequentially, simultaneously or separately, over an overlapping period of time.
- the treatments are a combination of at least one anti- human TIGIT monoclonal antibody or antigen-binding fragment thereof, at least one anti- human PD-1 monoclonal antibody or antigen-binding fragment thereof, 5-fluorouracil and cisplatin; a combination of at least one anti-human TIGIT monoclonal antibody or antigen- binding fragment thereof, at least one anti-human PD-1 monoclonal antibody or antigen- binding fragment thereof, and paclitaxel or a pharmaceutically acceptable salt thereof; a combination of at least one anti-human TIGIT monoclonal antibody or antigen-binding fragment thereof, at least one anti-human PD-1 monoclonal antibody or antigen-binding fragment thereof, gemcitabine or a pharmaceutically acceptable salt thereof and cisplatin; or a combination of at least one anti-human TIGIT monoclonal antibody or antigen-binding fragment thereof, at least one anti-human PD-1 monoclonal antibody or antigen-binding fragment thereof, cape
- the period of treatment with the at least one TIGIT antagonist is the period of time that a patient undergoes treatment with the TIGIT antagonist, e.g., an anti-human TIGIT monoclonal antibody (or antigen-binding fragment thereof); that is, the period of time from the initial dosing with the TIGIT antagonist through the final day of a treatment cycle.
- the TIGIT antagonist e.g., an anti-human TIGIT monoclonal antibody (or antigen-binding fragment thereof).
- the period of treatment with the at least one PD-1 antagonist is the period of time that a patient undergoes treatment with the PD-1 antagonist, e.g., an anti- human PD-1 monoclonal antibody (or antigen-binding fragment thereof); that is, the period of time from the initial dosing with the PD-1 antagonist through the final day of a treatment cycle.
- the PD-1 antagonist e.g., an anti- human PD-1 monoclonal antibody (or antigen-binding fragment thereof).
- the period of treatment with 5-fluorouracil and/or cisplatin is the period of time that a patient undergoes treatment with 5-fluorouracil and/or cisplatin; that is, the period of time from the initial dosing with 5-fluorouracil and/or cisplatin through the final day of a treatment cycle.
- the anti-TIGIT treatment overlaps by at least one day with the anti-PD-1 treatment and overlaps by at least one day with the 5-FU/cisplatin treatment.
- the anti-TIGIT treatment, the anti-PD-1 treatment, and the 5-FU/cisplatin treatment are the same period of time.
- the anti-TIGIT treatment begins prior to the anti-PD-1 and/or the 5-FU/cisplatin treatment. In other embodiments, the anti- TIGIT treatment begins after the anti-PD-1 and/or the 5-FU/cisplatin treatment. In yet other embodiments, the anti-PD-1 treatment begins prior to the anti-TIGIT and/or the 5- FU/cisplatin treatment. In still other embodiments, the anti- PD-1 treatment begins after the anti-TIGIT and/or the 5-FU/cisplatin treatment. In some embodiments, the 5-FU/cisplatin treatment begins prior to the anti-PD-1 and/or the anti-TIGIT treatment.
- the 5-FU/cisplatin treatment begins after the anti-PD-1 and/or the anti-TIGIT treatment.
- the anti-TIGIT treatment is terminated prior to termination of the anti-PD-1 and/or the 5-FU/cisplatin treatment.
- the anti-TIGIT treatment is terminated after termination of the anti-PD-1 and/or the 5- FU/cisplatin treatment.
- the anti-PD-1 treatment is terminated prior to termination of the anti-TIGIT and/or the 5-FU/cisplatin treatment.
- the anti-PD-1 treatment is terminated after termination of the anti-TIGIT and/or the 5-FU/cisplatin treatment.
- the 5-FU/cisplatin treatment is terminated prior to termination of the anti-PD-1 and/or the anti-TIGIT treatment. In other embodiments, the 5-FU/cisplatin treatment is terminated after termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- the period of treatment with paclitaxel or a pharmaceutically acceptable salt thereof is the period of time that a patient undergoes treatment with paclitaxel or a pharmaceutically acceptable salt thereof; that is, the period of time from the initial dosing with paclitaxel or a pharmaceutically acceptable salt thereof through the final day of a treatment cycle.
- the anti-TIGIT treatment overlaps by at least one day with the anti-PD-1 treatment and overlaps by at least one day with the paclitaxel treatment.
- the anti-TIGIT treatment, the anti-PD-1 treatment, and the paclitaxel treatment are the same period of time.
- the anti-TIGIT treatment begins prior to the anti-PD-1 and/or the paclitaxel treatment.
- the anti-TIGIT treatment begins after the anti-PD-1 and/or the paclitaxel treatment.
- the anti-PD-1 treatment begins prior to the anti-TIGIT and/or the paclitaxel treatment.
- the anti- PD-1 treatment begins after the anti-TIGIT and/or the paclitaxel treatment. In some embodiments, the paclitaxel treatment begins prior to the anti-PD-1 and/or the anti-TIGIT treatment. In other embodiments, the paclitaxel treatment begins after the anti- PD-1 and/or the anti-TIGIT treatment. In certain embodiments, the anti-TIGIT treatment is terminated prior to termination of the anti-PD-1 and/or the paclitaxel treatment. In other embodiments, the anti-TIGIT treatment is terminated after termination of the anti-PD-1 and/or the paclitaxel treatment.
- the anti-PD-1 treatment is terminated prior to termination of the anti-TIGIT and/or the paclitaxel treatment. In still other embodiments, the anti-PD-1 treatment is terminated after termination of the anti-TIGIT and/or the paclitaxel treatment. In certain embodiments, the paclitaxel treatment is terminated prior to termination of the anti-PD-1 and/or the anti-TIGIT treatment. In other embodiments, the paclitaxel treatment is terminated after termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- the period of treatment with gemcitabine or a pharmaceutically acceptable salt thereof and/or cisplatin is the period of time that a patient undergoes treatment with gemcitabine or a pharmaceutically acceptable salt thereof and/or cisplatin; that is, the period of time from the initial dosing with gemcitabine or a pharmaceutically acceptable salt thereof and/or cisplatin through the final day of a treatment cycle.
- the anti-TIGIT treatment overlaps by at least one day with the anti-PD-1 treatment and overlaps by at least one day with the gemcitabine/cisplatin treatment.
- the anti-TIGIT treatment, the anti-PD-1 treatment, and the gemcitabine/cisplatin treatment are the same period of time. In some embodiments, the anti-TIGIT treatment begins prior to the anti-PD-1 and/or the gemcitabine/cisplatin treatment. In other embodiments, the anti-TIGIT treatment begins after the anti-PD-1 and/or the gemcitabine/cisplatin treatment. In yet other embodiments, the anti-PD-1 treatment begins prior to the anti-TIGIT and/or the gemcitabine/cisplatin treatment. In still other embodiments, the anti- PD-1 treatment begins after the anti-TIGIT and/or the gemcitabine/cisplatin treatment.
- the gemcitabine/cisplatin treatment begins prior to the anti-PD-1 and/or the anti-TIGIT treatment. In other embodiments, the gemcitabine/cisplatin treatment begins after the anti-PD-1 and/or the anti-TIGIT treatment. In certain embodiments, the anti-TIGIT treatment is terminated prior to termination of the anti-PD-1 and/or the gemcitabine/cisplatin treatment. In other embodiments, the anti-TIGIT treatment is terminated after termination of the anti-PD-1 and/or the gemcitabine/cisplatin treatment. In yet other embodiments, the anti-PD-1 treatment is terminated prior to termination of the anti-TIGIT and/or the gemcitabine/cisplatin treatment.
- the anti-PD-1 treatment is terminated after termination of the anti-TIGIT and/or the gemcitabine/cisplatin treatment.
- the gemcitabine/cisplatin treatment is terminated prior to termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- the gemcitabine/cisplatin treatment is terminated after termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- the period of treatment with capecitabine or a pharmaceutically acceptable salt thereof and/or oxaliplatin is the period of time that a patient undergoes treatment with capecitabine or a pharmaceutically acceptable salt thereof and/or oxaliplatin; that is, the period of time from the initial dosing with capecitabine or a pharmaceutically acceptable salt thereof and/or oxaliplatin through the final day of a treatment cycle.
- the anti-TIGIT treatment overlaps by at least one day with the anti-PD-1 treatment and overlaps by at least one day with the capecitabine/oxaliplatin treatment.
- the anti-TIGIT treatment, the anti-PD-1 treatment, and the capecitabine/oxaliplatin treatment are the same period of time.
- the anti-TIGIT treatment begins prior to the anti-PD-1 and/or the capecitabine/oxaliplatin treatment.
- the anti- TIGIT treatment begins after the anti-PD-1 and/or the capecitabine/oxaliplatin treatment.
- the anti-PD-1 treatment begins prior to the anti-TIGIT and/or the capecitabine/oxaliplatin treatment.
- the anti- PD-1 treatment begins after the anti-TIGIT and/or the capecitabine/oxaliplatin treatment.
- the capecitabine/oxaliplatin treatment begins prior to the anti-PD-1 and/or the anti-TIGIT treatment. In other embodiments, the capecitabine/oxaliplatin treatment begins after the anti-PD-1 and/or the anti-TIGIT treatment. In certain embodiments, the anti-TIGIT treatment is terminated prior to termination of the anti-PD-1 and/or the capecitabine/oxaliplatin treatment. In other embodiments, the anti-TIGIT treatment is terminated after termination of the anti-PD-1 and/or the capecitabine/oxaliplatin treatment. In yet other embodiments, the anti-PD-1 treatment is terminated prior to termination of the anti- TIGIT and/or the capecitabine/oxaliplatin treatment.
- the anti-PD- 1 treatment is terminated after termination of the anti-TIGIT and/or the capecitabine/oxaliplatin treatment.
- the capecitabine/oxaliplatin treatment is terminated prior to termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- the capecitabine/oxaliplatin treatment is terminated after termination of the anti-PD-1 and/or the anti-TIGIT treatment.
- treatment regimen “dosing protocol,” and “dosing regimen” are used interchangeably to refer to the dose and timing of administration of each therapeutic agent in a combination therapy of the disclosure.
- cancer refers 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, leukemia, blastoma, and sarcoma.
- cancers include, but are not limited to, squamous cell carcinoma, myeloma, small-cell lung cancer, non-small cell lung cancer, glioma, Hodgkin lymphoma, non-hodgkin's lymphoma, acute myeloid leukemia (AML), multiple myeloma, gastrointestinal (tract) cancer, renal cancer, ovarian cancer, liver cancer, lymphoblastic leukemia, lymphocytic leukemia, colorectal cancer, endometrial cancer, kidney cancer, prostate cancer, thyroid cancer, melanoma, chondrosarcoma, neuroblastoma, pancreatic cancer, glioblastoma multiforme, cervical cancer, brain cancer, stomach cancer, bladder cancer, hepatoma, hepatocellular carcinoma, biliary cancer, esophageal cancer, breast cancer, triple negative breast cancer, colon carcinoma, and head and neck cancer.
- squamous cell carcinoma myeloma
- Tumor as it applies to a subject diagnosed with, or suspected of having, a cancer refers to a malignant or potentially malignant neoplasm or tissue mass of any size, and includes primary tumors and secondary neoplasms.
- tumors include solid tumor (e.g., sarcoma (such as chondrosarcoma), carcinoma (such as colon carcinoma), blastoma (such as hepatoblastoma), etc.) and blood tumor (e.g., leukemia (such as acute myeloid leukemia (AML)), lymphoma (such as DLBCL), multiple myeloma (MM), etc.).
- solid tumor e.g., sarcoma (such as chondrosarcoma), carcinoma (such as colon carcinoma), blastoma (such as hepatoblastoma), etc.
- blood tumor e.g., leukemia (such as acute myeloid leukemia (AML)), lymphoma (such as DLBCL), multiple
- Tumor burden also referred to as “tumor load”, refers to the total amount of tumor material distributed throughout the body. Tumor burden refers to the total number of cancer cells or the total size of tumor(s), throughout the body, including lymph nodes and bone narrow. Tumor burden can be determined by a variety of methods known in the art, such as, e.g., by measuring the dimensions of tumor(s) upon removal from the subject, e.g., using calipers, or while in the body using imaging techniques, e.g., ultrasound, bone scan, computed tomography (CT) or magnetic resonance imaging (MRI) scans.
- CT computed tomography
- MRI magnetic resonance imaging
- Tumor size may be determined by a variety of methods known in the art, such as, e.g., by measuring the dimensions of tumor(s) upon removal from the subject, e.g., using calipers, or while in the body using imaging techniques, e.g., bone scan, ultrasound, CT or MRI scans.
- imaging techniques e.g., bone scan, ultrasound, CT or MRI scans.
- the term "effective amount” refer to an amount of a PD-1 antagonist, a TIGIT antagonist, and one or more chemotherapeutic agents or pharmaceutically acceptable salts thereof (e.g., an anti-TIGIT antibody or antigen binding fragment, an anti-PD-1 antibody or antigen binding fragment of the invention, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin)) that, when administered alone or in combination with an additional therapeutic agent to a cell, tissue, or subject, is effective to cause a measurable improvement in one or more symptoms of an infection or a disease, for example cancer or the progression of cancer.
- chemotherapeutic agents or pharmaceutically acceptable salts thereof e.g., an anti-TIGIT antibody or antigen binding fragment, an anti-PD-1 antibody or antigen binding fragment
- An effective amount further refers to that amount of the antibody or fragment sufficient to result in at least partial amelioration of symptoms, e.g., tumor shrinkage or elimination, lack of tumor growth, increased survival time.
- an effective amount refers to that ingredient alone.
- an effective amount refers to combined amounts of the active ingredients that result in the therapeutic effect, whether administered in combination, serially or simultaneously.
- An effective amount of a therapeutic may result in an improvement of a diagnostic measure or parameter by at least 10%; usually by at least 20%; preferably at least about 30%; more preferably at least 40%, and most preferably by at least 50%.
- An effective amount can also result in an improvement in a subjective measure in cases where subjective measures are used to assess disease severity.
- Toxicity and therapeutic efficacy of the antibodies or antigen binding fragments of the invention, administered alone or in combination with another therapeutic agent can be determined by any number of systems or means.
- the toxicity and therapeutic efficacy of the antibodies or antigen binding fragments or compounds of the invention can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose therapeutically effective in 50% of the population).
- the dose ratio between toxic and therapeutic effects is the therapeutic index (LD50/ ED50).
- the data obtained from these cell culture assays and animal studies can be used in formulating a range of dosage for use in human.
- the dosage of such compounds lies preferably within a range of circulating concentrations that include the ED50 with little or no toxicity.
- the dosage may vary within this range depending upon the dosage form employed and the route of administration. It is understood that wherever embodiments are described herein with the language “comprising,” otherwise analogous embodiments described in terms of “consisting of” and/or “consisting essentially of” are also provided. “Consists essentially of,” and variations such as “consist essentially of” or “consisting essentially of,” as used throughout the specification and claims, indicate the inclusion of any recited elements or group of elements, and the optional inclusion of other elements, of similar or different nature than the recited elements, that do not materially change the basic or novel properties of the specified dosage regimen, method, or composition.
- a range of 3 to 7 days is intended to include 3, 4, 5, 6, and 7 days.
- the term “or,” as used herein, denotes alternatives that may, where appropriate, be combined; that is, the term “or” includes each listed alternative separately as well as their combination.
- the present disclosure encompasses not only the entire group listed as a whole, but each member of the group individually and all possible subgroups of the main group, but also the main group absent one or more of the group members.
- the present disclosure also envisages the explicit exclusion of one or more of any of the group members in the claims.
- PD-1 antagonists or anti-human PD-1 monoclonal antibodies that can be used in any of the methods, compositions, kits, and uses disclosed herein, including any chemical compound or biological molecule that blocks binding of PD-L1 to PD-1 and preferably also blocks binding of PD-L2 to PD-1.
- any monoclonal antibodies that bind to a PD-1 polypeptide, a PD-1 polypeptide fragment, a PD-1 peptide, or a PD-1 epitope and block the interaction between PD-1 and its ligand PD-L1 or PD-L2 can be used.
- the anti-human PD-1 monoclonal antibody binds to a PD-1 polypeptide, a PD-1 polypeptide fragment, a PD-1 peptide, or a PD-1 epitope and blocks the interaction between PD-1 and PD-L1.
- the anti-human PD-1 monoclonal antibody binds to a PD-1 polypeptide, a PD- 1 polypeptide fragment, a PD-1 peptide, or a PD-1 epitope and blocks the interaction between PD-1 and PD-L2.
- the anti-human PD-1 monoclonal antibody binds to a PD-1 polypeptide, a PD-1 polypeptide fragment, a PD-1 peptide, or a PD-1 epitope and blocks the interaction between PD-1 and PD-L1 and the interaction between PD-1 and PD- L2.
- any monoclonal antibodies that bind to a PD-L1 polypeptide, a PD-L1 polypeptide fragment, a PD-L1 peptide, or a PD-L1 epitope and block the interaction between PD-L1 and PD-1 can also be used.
- the anti-human PD-1 monoclonal antibody is selected from the group consisting of pembrolizumab, nivolumab, cemiplimab, pidilizumab (U.S. Pat. No. 7,332,582), AMP-514 (MedImmune LLC, Gaithersburg, MD), PDR001 (U.S. Pat. No. 9,683,048), BGB-A317 (U.S. Pat.
- the anti-human PD-1 monoclonal antibody is pembrolizumab. In one embodiment, the anti-human PD-1 monoclonal antibody is pembrolizumab. In another embodiment, the anti-human PD-1 monoclonal antibody is nivolumab. In another embodiment, the anti-human PD-1 monoclonal antibody is cemiplimab. In yet another embodiment, the anti-human PD-1 monoclonal antibody is pidilizumab. In one embodiment, the anti-human PD-1 monoclonal antibody is AMP-514.
- the anti- human PD-1 monoclonal antibody is PDR001. In yet another embodiment, the anti-human PD-1 monoclonal antibody is BGB-A317. In still another embodiment, the anti-human PD-1 monoclonal antibody is MGA012. In some embodiments, an anti-human PD-1 antibody or antigen binding fragment thereof for use in the methods, kits, uses and co-formulations of the invention comprises three light chain CDRs of CDRL1, CDRL2 and CDRL3 and/or three heavy chain CDRs of CDRH1, CDRH2 and CDRH3.
- CDRL1 comprises the amino acid sequence as set forth in SEQ ID NO:1 or a variant of the amino acid sequence as set forth in SEQ ID NO:1
- CDRL2 comprises the amino acid sequence as set forth in SEQ ID NO:2 or a variant of the amino acid sequence as set forth in SEQ ID NO:2
- CDRL3 comprises the amino acid sequence as set forth in SEQ ID NO:3 or a variant of the amino acid sequence as set forth in SEQ ID NO:3.
- CDRH1 comprises the amino acid sequence as set forth in SEQ ID NO:6 or a variant of the amino acid sequence as set forth in SEQ ID NO:6
- CDRH2 comprises the amino acid sequence as set forth in SEQ ID NO: 7 or a variant of the amino acid sequence as set forth in SEQ ID NO:7
- CDRH3 comprises the amino acid sequence as set forth in SEQ ID NO:8 or a variant of the amino acid sequence as set forth in SEQ ID NO:8.
- the three light chain CDRs have the amino acid sequences as set forth in SEQ ID NO:1, SEQ ID NO:2, and SEQ ID NO:3 and the three heavy chain CDRs have the amino acid sequences as set forth in SEQ ID NO:6, SEQ ID NO:7 and SEQ ID NO:8.
- CDRL1 comprises the amino acid sequence as set forth in SEQ ID NO:11 or a variant of the amino acid sequence as set forth in SEQ ID NO:11
- CDRL2 comprises the amino acid sequence as set forth in SEQ ID NO:12 or a variant of the amino acid sequence as set forth in SEQ ID NO:12
- CDRL3 comprises the amino acid sequence as set forth in SEQ ID NO:13 or a variant of the amino acid sequence as set forth in SEQ ID NO:13.
- CDRH1 comprises the amino acid sequence as set forth in SEQ ID NO:16 or a variant of the amino acid sequence as set forth in SEQ ID NO:16
- CDRH2 comprises the amino acid sequence as set forth in SEQ ID NO:17 or a variant of the amino acid sequence as set forth in SEQ ID NO:17
- CDRH3 comprises the amino acid sequence as set forth in SEQ ID NO:18 or a variant of the amino acid sequence as set forth in SEQ ID NO:18.
- the three light chain CDRs have the amino acid sequences as set forth in SEQ ID NO:1, SEQ ID NO:2, and SEQ ID NO:3 and the three heavy chain CDRs have the amino acid sequences as set forth in SEQ ID NO:6, SEQ ID NO:7 and SEQ ID NO:8.
- the three light chain CDRs have the amino acid sequences as set forth in SEQ ID NO:11, SEQ ID NO:12, and SEQ ID NO:13 and the three heavy chain CDRs have the amino acid sequences as set forth in SEQ ID NO:16, SEQ ID NO:17 and SEQ ID NO:18.
- CDRL1 comprises the amino acid sequence as set forth in SEQ ID NO:21 or a variant of the amino acid sequence as set forth in SEQ ID NO:21
- CDRL2 comprises the amino acid sequence as set forth in SEQ ID NO:22 or a variant of the amino acid sequence as set forth in SEQ ID NO:22
- CDRL3 comprises the amino acid sequence as set forth in SEQ ID NO:23 or a variant of the amino acid sequence as set forth in SEQ ID NO:23.
- CDRH1 comprises the amino acid sequence as set forth in SEQ ID NO:24 or a variant of the amino acid sequence as set forth in SEQ ID NO:24
- CDRH2 comprises the amino acid sequence as set forth in SEQ ID NO: 25 or a variant of the amino acid sequence as set forth in SEQ ID NO:25
- CDRH3 comprises the amino acid sequence as set forth in SEQ ID NO:26 or a variant of the amino acid sequence as set forth in SEQ ID NO:26.
- the three light chain CDRs have the amino acid sequences as set forth in SEQ ID NO:21, SEQ ID NO:22, and SEQ ID NO:23 and the three heavy chain CDRs have the amino acid sequences as set forth in SEQ ID NO:24, SEQ ID NO:25 and SEQ ID NO:26.
- Some anti-human PD-1 antibody and antigen binding fragments of the invention comprise a light chain variable region and a heavy chain variable region.
- the light chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:4 or a variant of the amino acid sequence as set forth in SEQ ID NO:4, and the heavy chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:9 or a variant of the amino acid sequence as set forth in SEQ ID NO:9.
- the light chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:14 or a variant of the amino acid sequence as set forth in SEQ ID NO:14
- the heavy chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:19 or a variant of the amino acid sequence as set forth in SEQ ID NO:19.
- the heavy chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:27 or a variant of the amino acid sequence as set forth in SEQ ID NO:27 and the light chain variable region comprises the amino acid sequence as set forth in SEQ ID NO:28 or a variant of the amino acid sequence as set forth in SEQ ID NO:28, SEQ ID NO:29 or a variant of the amino acid sequence as set forth in SEQ ID NO:29, or SEQ ID NO:30 or a variant of the amino acid sequence as set forth in SEQ ID NO:30.
- a light chain variable region or heavy chain variable region sequence is identical to the reference sequence except having one, two, three, four or five amino acid substitutions.
- the substitutions are in the framework region (i.e., outside of the CDRs). In some embodiments, one, two, three, four or five of the amino acid substitutions are conservative substitutions.
- the anti-human PD-1 antibody or antigen binding fragment comprises a light chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:4 and a heavy chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:9.
- the anti-human PD-1 antibody or antigen binding fragment comprises a light chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:14 and a heavy chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:19.
- the anti-human PD-1 antibody or antigen binding fragment comprises a light chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:28 and a heavy chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:27.
- the anti-human PD-1 antibody or antigen binding fragment comprises a light chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:29 and a heavy chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:27.
- the antibody or antigen binding fragment comprises a light chain variable region comprising or consisting of the amino acid sequence as set forth in SEQ ID NO:30 and a heavy chain variable region comprising or consisting the the amino acid sequence as set forth in SEQ ID NO:27.
- the co-formulations, methods, kits or uses of the invention comprise an anti-human PD-1 antibody or antigen binding protein that has a V L domain and/or a V H domain with at least 95%, 90%, 85%, 80%, 75% or 50% sequence homology to one of the V L domains or V H domains described above, and exhibits specific binding to PD-1.
- the anti-human PD-1 antibody or antigen binding protein of the co- formulations of the invention comprises V L and V H domains having up to 1, 2, 3, 4, or 5 or more amino acid substitutions, and exhibits specific binding to PD-1.
- the PD-1 antagonist may be a full-length anti-PD-1 antibody or an antigen binding fragment thereof that specifically binds human PD-1.
- the PD-1 antagonist is a full-length anti-PD-1 antibody selected from any class of immunoglobulins, including IgM, IgG, IgD, IgA, and IgE.
- the antibody is an IgG antibody. Any isotype of IgG can be used, including IgG 1 , IgG 2 , IgG 3 , and IgG 4 . Different constant domains may be appended to the V L and V H regions provided herein.
- the PD-1 antagonist is an anti-PD-1 antibody comprising a light chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:5 and a heavy chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:10.
- the PD-1 antagonist is an anti-PD-1 antibody comprising a light chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:15 and a heavy chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:20.
- the PD-1 antagonist is an anti-PD-1 antibody comprising a light chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:32 and a heavy chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:31.
- the PD-1 antagonist is an anti-PD-1 antibody comprising a light chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:33 and a heavy chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:31.
- the PD-1 antagonist is an anti-PD-1 antibody comprising a light chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:34 and a heavy chain comprising or consisting of a sequence of amino acid residues as set forth in SEQ ID NO:31.
- the PD-1 antagonist is pembrolizumab or a pembrolizumab biosimilar. In some co-formulations, methods, kits or uses of the invention, the PD-1 antagonist is nivolumab or a nivolumab biosimilar.
- amino acid sequence variants of the anti-PD-1 antibodies and antigen binding fragments of the invention and the anti-TIGIT antibodies and antigen binding fragments will have an amino acid sequence having at least 75% amino acid sequence identity with the amino acid sequence of a reference antibody or antigen binding fragment (e.g.
- Identity or homology with respect to a sequence is defined herein as the percentage of amino acid residues in the candidate sequence that are identical with the reference antibody or antigen binding fragment residues, after aligning the sequences and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity. None of N- terminal, C-terminal, or internal extensions, deletions, or insertions into the antibody sequence shall be construed as affecting sequence identity or homology.
- Sequence identity refers to the degree to which the amino acids of two polypeptides are the same at equivalent positions when the two sequences are optimally aligned. Sequence identity can be determined using a BLAST algorithm wherein the parameters of the algorithm are selected to give the largest match between the respective sequences over the entire length of the respective reference sequences.
- the following references relate to BLAST algorithms often used for sequence analysis: BLAST ALGORITHMS: Altschul, S.F., et al., (1990) J. Mol. Biol.215:403-410; Gish, W., et al., (1993) Nature Genet.3:266-272; Madden, T.L., et al., (1996) Meth.
- Antibodies and antigen binding fragments comprising light and heavy chain CDRs of hPD- 1.08A in WO2008/156712 eavy c a Q : L ight chain VR SEQ ID NO:28 or SEQ ID NO:29 or SEQ ID NO:30 Light chain SEQ ID NO:32 or SEQ ID NO:33 or SEQ ID NO:34 TIGIT Antagonists
- anti-human TIGIT monoclonal antibodies or antigen binding fragments thereof that can be used in the methods, pharmaceutical compositions, kits, and uses disclosed herein.
- any monoclonal antibodies that bind to a TIGIT polypeptide, a TIGIT polypeptide fragment, a TIGIT peptide, or a TIGIT epitope and block the interaction between TIGIT and its ligand CD155 and/or CD112 can be used.
- the anti- human TIGIT monoclonal antibody binds to a TIGIT polypeptide, a TIGIT polypeptide fragment, a TIGIT peptide, or a TIGIT epitope and blocks the interaction between TIGIT and CD155.
- the anti-human TIGIT monoclonal antibody binds to a TIGIT polypeptide, a TIGIT polypeptide fragment, a TIGIT peptide, or a TIGIT epitope and blocks the interaction between TIGIT and CD112. In yet other embodiments, the anti-human TIGIT monoclonal antibody binds to a TIGIT polypeptide, a TIGIT polypeptide fragment, a TIGIT peptide, or a TIGIT epitope and blocks the interaction between TIGIT and CD155 and the interaction between TIGIT and CD112.
- the human constant region is selected from the group consisting of IgG1, IgG2, IgG3 and IgG4 constant regions, and in preferred embodiments, the human constant region is an IgG1 or IgG4 constant region.
- Exemplary anti-TIGIT antibody sequences are set forth below in Tables 6 and 7. Table 6.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:35, a CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO:36, a CDRH3 comprising any of the amino acid sequences as set forth in SEQ ID NOs:37, 103, 104, 105, 106, 107, or 160, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:38, a CDRL2 comprising any of the amino acid sequences as set forth in SEQ ID NOs:39, 89, 90, 91, 92, 93, 94, 95, 96, 97, or 161, and a CDRL3 comprising any of the amino acid sequences as set forth in SEQ ID NOs:40, 98, 99, 100, 101, 102, or 162.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:81, a CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO:82, a CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO:83, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:84, a CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:85, and a CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO:86.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:108, a CDRH2 comprising any of the amino acid sequences as set forth in SEQ ID NOs:109, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 154, 155 or 167, a CDRH3 comprising any of the amino acid sequences as set forth in SEQ ID NOs:110, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186 or 187, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:111, a CDRL2 comprising any of the amino acid sequences as set forth in SEQ ID NOs:112, 132, 133, 134, 135, 136, 137,
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:35, a CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO:36, a CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO:37, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:38, a CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:39, and a CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO:40.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:108, a CDRH2 comprising any one of the amino acid sequences as set forth in SEQ ID NO:109, 154 or 145, a CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO:110, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:111, a CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:112, and a CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO:113.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:108, a CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, a CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO:110, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:111, a CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:112, and a CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO:113.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region and a variable light chain variable region.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:41 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:42.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:87 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:88. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO: 114 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:115.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 43-58, 65-75 and 87 and a variable light chain region comprising any one of the amino acid sequences as set forth in SEQ ID NOs: 59-64, 76-80 and 88.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 144-149 and a variable light chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 150-153.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:148 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:152. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:147 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:150.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:148 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:153. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:163 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:165.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:169 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:171.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:164 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:166.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:170 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:172.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO:204, a CDRH2 comprising any of the amino acid sequences as set forth in SEQ ID NOs: 205, 256, 257, 258, 259, 260, 261, 262, or 263, a CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO:206, a CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:207, a CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:208, and a CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO:209.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region and a variable light chain variable region. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:194 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:195. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO:196 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:200.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO: 210 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:211. In one embodiment, the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising the amino acid sequence as set forth in SEQ ID NO: 212 and a variable light chain region comprising the amino acid sequence as set forth in SEQ ID NO:216.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 197, 198, 199, 223, 224, 225, 226, 227, 228, 229, 230, and 231 and a variable light chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 201, 202, 203, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, and 255.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a variable heavy chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 213, 214, 215, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, and 286 and a variable light chain region comprising any of the amino acid sequences as set forth in SEQ ID NOs: 217, 218, and 219.
- Additional anti-TIGIT antibodies which may be used in the formulations described herein include those disclosed, for example, in PCT International Application No.
- the anti-TIGIT antibody or antigen binding fragment thereof is an antibody comprising any of the variable heavy chains described above and any human heavy chain constant domain.
- the antibody or antigen binding fragment thereof of the invention is of the IgG isotype, and comprises a human IgG1, IgG2, IgG3 or IgG4 human heavy chain constant domain.
- the antibody or antigen binding fragment thereof of the invention comprises a human heavy chain IgG1 constant domain (SEQ ID NO: 291) or a variant thereof, wherein the variant comprises up to 20 modified amino acid substitutions.
- the antibody or antigen binding fragment thereof of the invention is an antibody comprising a human heavy chain IgG1 constant domain comprising the amino acid sequence as set forth in SEQ ID NO: 291.
- the antibody or antigen binding fragment thereof of the invention comprises a human heavy chain IgG1 constant domain wherein the IgG1 constant domain is afucosylated. In one embodiment, the antibody or antigen binding fragment thereof of the invention comprises a human heavy chain IgG4 constant domain or a variant thereof, wherein the variant comprises up to 20 modified amino acid substitutions. In another embodiment, the antibody or antigen binding fragment thereof of the invention comprises a human heavy chain IgG4 constant domain, wherein the amino acid at position 228 (using EU numbering scheme) has been substituted from Ser to Pro. In one embodiment, the antibody or antigen binding fragment thereof of the invention comprises a human heavy chain IgG4 constant domain comprising the amino acid sequence as set forth in SEQ ID NO: 292.
- the anti-TIGIT antibody or antigen binding fragment thereof can comprise any of the variable light chains described above and human light chain constant domain.
- the antibody or antigen binding fragment thereof of the invention comprises a human kappa light chain constant domain or a variant thereof, wherein the variant comprises up to 20 modified amino acid substitutions.
- the antibody or antigen binding fragment thereof of the invention comprises a human lambda light chain constant domain or a variant thereof, wherein the variant comprises up to 20 modified amino acid substitutions.
- the antibody or antigen binding fragment thereof of the invention comprises a human kappa light chain constant domain comprising the amino acid sequence as set forth in SEQ ID NO: 293.
- a combination of a PD-1 Antagonist, a TIGIT Antagonist, 5-fluorouracil, and Cisplatin are methods of treating cancer (e.g., esophageal cancer) using a combination of a TIGIT antagonist, a PD-1 antagonist, 5-fluorouracil and cisplatin.
- the TIGIT antagonist is an anti-TIGIT antibody or antigen binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody or antigen binding fragment thereof.
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil represented by Formula (I); and I) sented by Formula (II).
- the cancer is selected from the group consisting of: sarcoma (angiosarcoma, fibrosarcoma, rhabdomyosarcoma, liposarcoma), myxoma, rhabdomyoma, fibroma, lipoma and teratoma; Lung: bronchogenic carcinoma (squamous cell, undifferentiated small cell, undifferentiated large cell, adenocarcinoma), alveolar (bronchiolar) carcinoma, bronchial adenoma, sarcoma, lymphoma, chondromatous hamartoma, mesothelioma; Gastrointestinal: esophagus (squamous cell carcinoma, adenocarcinoma, leiomyosarcoma, lymphoma), stomach (carcinoma, lymphoma, leiomyosarcoma), pancreas (ductal adenocarcinoma, insulinom
- the cancer is selected from the group consisting of anal cancer, biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple myeloma, non-small cell lung cancer (NSCLC), ovarian cancer, pancreatic cancer, prostate cancer (e.g.
- anal cancer biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, and triple negative breast cancer (TNBC).
- HCC hepatocellular carcinoma
- HNSCC head and neck cancer
- TNBC triple negative breast cancer
- the cancer is esophageal cancer.
- the esophageal cancer is locally advanced unresectable.
- the esophageal cancer is metastatic adenocarcinoma.
- the esophageal cancer is squamous cell carcinoma of the esophagus (ESCC). In some embodiments, the esophageal cancer is advanced Siewert type 1 adenocarcinoma of the gastroesophageal junction (GEJ). In some embodiments, the esophageal cancer is metastatic Siewert type 1 adenocarcinoma of the gastroesophageal junction (GEJ). In some embodiments, a combination of a TIGIT antagonist, a PD-1 antagonist, 5- fluorouracil and cisplatin may provide enhanced efficacy as compared with existing treatments.
- TIGIT and PD-L1 are tightly co-expressed in adenocarcinoma and ESCC.
- a combination of a TIGIT antagonist, a PD-1 antagonist may provide added benefit over single-agent checkpoint blockade.
- chemotherapeutic agents may augment antitumor immune responses by (i) inducing immunogenic cell death, (ii) enhancing the maturation and activation of dendritic cells, (iii) increasing T-cell penetrance and function in the tumor, (iv) improving the presentation of tumor antigens, and (v) eliminating immunosuppressive cells.
- the tolerability of vibostolimab is a potential added benefit for combination with one or more chemotherapeutic agents and a PD-1 antagonist.
- the cancer is metastatic. In some embodiments, the cancer is relapsed. In other embodiments, the cancer is refractory. In yet other embodiments, the cancer is relapsed and refractory.
- esophageal cancer e.g., locally advanced unresectable, metastatic adenocarcinoma, ESCC, advanced Siewert type 1 adenocarcinoma of GEJ, or metastatic Siewert type 1 adenocarcinoma of GEJ
- administering comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist as disclosed in Section titled TIGIT Antagonists; (b) a PD-1 antagonist as disclosed in Section titled PD-1 Antagonists; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody.
- the anti-human PD-1 monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-L1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-L1 monoclonal antibody is a human antibody.
- the anti-human PD-L1 monoclonal antibody is a humanized antibody.
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is pembrolizumab.
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In another embodiment of the methods, compositions, kits and uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 of comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence
- the method for treating esophageal cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 compris
- the method for treating esophageal cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2
- the method for treating esophageal cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2
- a combination of a PD-1 Antagonist, a TIGIT Antagonist, and Paclitaxel or a Pharmaceutically Acceptable Salt Thereof are methods of treating cancer (e.g., TNBC) using a combination of a TIGIT antagonist, a PD-1 antagonist, and (c) paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- the TIGIT antagonist is an anti-TIGIT antibody or antigen binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody or antigen binding fragment thereof.
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- the cancer is selected from the group consisting of: sarcoma (angiosarcoma, fibrosarcoma, rhabdomyosarcoma, liposarcoma), myxoma, rhabdomyoma, fibroma, lipoma and teratoma; Lung: bronchogenic carcinoma (squamous cell, undifferentiated small cell, undifferentiated large cell, adenocarcinoma), alveolar (bronchiolar) carcinoma, bronchial adenoma, sarcoma, lymphoma, chondromatous hamartoma, mesothelioma; Gastrointestinal: esophagus (squamous cell carcinoma, adenocarcinoma, leiomyosarcoma, lymphoma), stomach (carcinoma, lymphoma, leiomyosarcoma), pancreas (ductal adenocarcinoma, insulinom
- the cancer is selected from the group consisting of anal cancer, biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple myeloma, non-small cell lung cancer (NSCLC), ovarian cancer, pancreatic cancer, prostate cancer (e.g.
- anal cancer biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, and triple negative breast cancer (TNBC).
- HCC hepatocellular carcinoma
- HNSCC head and neck cancer
- TNBC triple negative breast cancer
- the cancer is TNBC.
- the TNBC is recurrent unresectable.
- the TNBC is metastatic.
- a combination of a TIGIT antagonist, a PD-1 antagonist, and paclitaxel, or a pharmaceutically acceptable salt thereof may provide enhanced efficacy as compared with existing treatments.
- TNBC may be an immune-reactive disease amenable to immune modulation of the tumor microenvironment, and expresses TIGIT and PD-L1 highly.
- chemotherapeutic agents may augment antitumor immune responses by (i) inducing immunogenic cell death, (ii) enhancing the maturation and activation of dendritic cells, (iii) increasing T-cell penetrance and function in the tumor, (iv) improving the presentation of tumor antigens, and (v) eliminating immunosuppressive cells.
- the tolerability of vibostolimab is a potential added benefit for combination with chemotherapy and a PD-1 antagonist.
- the cancer is metastatic. In some embodiments, the cancer is relapsed. In other embodiments, the cancer is refractory. In yet other embodiments, the cancer is relapsed and refractory.
- provided herein is a method of treating TNBC, comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- a method of treating hepatocellular carcinoma comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist as disclosed in Section titled TIGIT Antagonists; (b) a PD-1 antagonist as disclosed in Section titled PD-1 Antagonists; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody. In other embodiments, the anti-human PD-1 monoclonal antibody is a humanized antibody. In certain embodiments, the PD-1 antagonist is an anti-human PD-L1 monoclonal antibody or antigen binding fragment thereof. In some embodiments, the anti-human PD-L1 monoclonal antibody is a human antibody. In other embodiments, the anti-human PD-L1 monoclonal antibody is a humanized antibody. In certain embodiments, the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof. In some embodiments, the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- provided herein is a method for treating cancer, comprising administering to a human patient in need thereof: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is pembrolizumab. In another embodiment of the methods, compositions, kits and uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In another embodiment of the methods, compositions, kits and uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- the method for treating TNBC comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- the method for treating TNBC comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- the method for treating TNBC comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- a combination of a PD-1 Antagonist, a TIGIT Antagonist, Gemcitabine, and Cisplatin are methods of treating cancer (e.g., biliary cancer) using a combination of a TIGIT antagonist, a PD-1 antagonist, gemcitabine and cisplatin.
- the TIGIT antagonist is an anti-TIGIT antibody or antigen binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody or antigen binding fragment thereof.
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the cancer is selected from the group consisting of: sarcoma (angiosarcoma, fibrosarcoma, rhabdomyosarcoma, liposarcoma), myxoma, rhabdomyoma, fibroma, lipoma and teratoma; Lung: bronchogenic carcinoma (squamous cell, undifferentiated small cell, undifferentiated large cell, adenocarcinoma), alveolar (bronchiolar) carcinoma, bronchial adenoma, sarcoma, lymphoma, chondromatous hamartoma, mesothelioma; Gastrointestinal: esophagus (squamous cell carcinoma, adenocarcinoma, leiomyosarcoma, lymphoma), stomach (carcinoma, lymphoma, leiomyosarcoma), pancreas (ductal adenocarcinoma, insulinom
- the cancer is selected from the group consisting of anal cancer, biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple myeloma, non-small cell lung cancer (NSCLC), ovarian cancer, pancreatic cancer, prostate cancer (e.g.
- anal cancer biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, and triple negative breast cancer (TNBC).
- HCC hepatocellular carcinoma
- HNSCC head and neck cancer
- TNBC triple negative breast cancer
- the cancer is biliary cancer.
- the biliary cancer is locally recurrent unresectable.
- the biliary cancer is metastatic.
- a combination of a TIGIT antagonist, a PD-1 antagonist, gemcitabine and cisplatin may provide enhanced efficacy as compared with existing treatments.
- TIGIT and PD-L1 are tightly co-expressed in adenocarcinoma and ESCC.
- a combination of a TIGIT antagonist, a PD-1 antagonist may provide added benefit over single-agent checkpoint blockade.
- chemotherapeutic agents may augment antitumor immune responses by (i) inducing immunogenic cell death, (ii) enhancing the maturation and activation of dendritic cells, (iii) increasing T-cell penetrance and function in the tumor, (iv) improving the presentation of tumor antigens, and (v) eliminating immunosuppressive cells.
- the tolerability of vibostolimab is a potential added benefit for combination with one or more chemotherapeutic agents and a PD-1 antagonist.
- the cancer is metastatic. In some embodiments, the cancer is relapsed. In other embodiments, the cancer is refractory.
- the cancer is relapsed and refractory.
- a method of treating biliary cancer comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist as disclosed in Section titled TIGIT Antagonists; (b) a PD-1 antagonist as disclosed in Section titled PD-1 Antagonists; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody.
- the anti-human PD-1 monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-L1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-L1 monoclonal antibody is a human antibody.
- the anti-human PD-L1 monoclonal antibody is a humanized antibody.
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is pembrolizumab.
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In another embodiment of the methods, compositions, kits and uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 compris
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2
- the method for treating biliary cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating biliary cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating biliary cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- a combination of a PD-1 Antagonist, a TIGIT Antagonist, Capecitabine, and Oxaliplatin are methods of treating cancer (e.g., gastric cancer) using a combination of a TIGIT antagonist, a PD-1 antagonist, capecitabine or a pharmaceutically acceptable salt thereof and oxaliplatin.
- the TIGIT antagonist is an anti-TIGIT antibody or antigen binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody or antigen binding fragment thereof.
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the cancer is selected from the group consisting of: sarcoma (angiosarcoma, fibrosarcoma, rhabdomyosarcoma, liposarcoma), myxoma, rhabdomyoma, fibroma, lipoma and teratoma; Lung: bronchogenic carcinoma (squamous cell, undifferentiated small cell, undifferentiated large cell, adenocarcinoma), alveolar (bronchiolar) carcinoma, bronchial adenoma, sarcoma, lymphoma, chondromatous hamartoma, mesothelioma; Gastrointestinal: esophagus (squamous cell carcinoma, adenocarcinoma, leiomyosarcoma, lymphoma), stomach (carcinoma, lymphoma, leiomyosarcoma), pancreas (ductal adenocarcinoma, insulinom
- the cancer is selected from the group consisting of anal cancer, biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple myeloma, non-small cell lung cancer (NSCLC), ovarian cancer, pancreatic cancer, prostate cancer (e.g.
- anal cancer biliary tract cancer, bladder cancer, breast cancer, cervical cancer, colon cancer, colorectal cancer (CRC), esophageal cancer, gastrointestinal cancer, glioblastoma, glioma, head and neck cancer (HNSCC), hepatocellular carcinoma (HCC), lung cancer, liver cancer, lymphoma, melanoma, mesothelioma, multiple
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is gastric cancer.
- the gastric cancer is advanced or GEJ adenocarcinoma.
- the gastric cancer is HER2 negative. In some embodiments, the gastric cancer is previously untreated.
- a combination of a TIGIT antagonist, a PD-1 antagonist, gemcitabine and cisplatin may provide enhanced efficacy as compared with existing treatments.
- TIGIT and PD-L1 are tightly co-expressed in adenocarcinoma and ESCC.
- a combination of a TIGIT antagonist, a PD-1 antagonist may provide added benefit over single-agent checkpoint blockade.
- chemotherapeutic agents may augment antitumor immune responses by (i) inducing immunogenic cell death, (ii) enhancing the maturation and activation of dendritic cells, (iii) increasing T-cell penetrance and function in the tumor, (iv) improving the presentation of tumor antigens, and (v) eliminating immunosuppressive cells.
- the tolerability of vibostolimab is a potential added benefit for combination with one or more chemotherapeutic agents and a PD-1 antagonist.
- the cancer is metastatic. In some embodiments, the cancer is relapsed. In other embodiments, the cancer is refractory.
- the cancer is relapsed and refractory.
- a method of treating gastric cancer comprising administering to a human patient in need thereof: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the method of treating cancer comprises administering to a human patient in need thereof: (a) a TIGIT antagonist as disclosed in Section titled TIGIT Antagonists; (b) a PD-1 antagonist as disclosed in Section titled PD-1 Antagonists; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody.
- the anti-human PD-1 monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-L1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-L1 monoclonal antibody is a human antibody.
- the anti-human PD-L1 monoclonal antibody is a humanized antibody.
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- a method for treating cancer comprising administering to a human patient in need thereof: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is pembrolizumab.
- the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In another embodiment of the methods, compositions, kits and uses provided herein, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti- TIGIT antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating gastric cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating gastric cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- the method for treating gastric cancer comprises administering to a human patient in need thereof: (a) an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- Dosing and Administration for treating cancer (e.g., esophageal cancer, TNBC, biliary cancer, gastric cancer) using a combination of a TIGIT antagonist (e.g., an anti-TIGIT monoclonal antibody or antigen binding fragment thereof), a PD-1 antagonist (e.g., an anti-PD-1 monoclonal antibody or antigen binding fragment thereof), and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin).
- a TIGIT antagonist e.g., an anti-TIGIT monoclonal antibody or antigen binding fragment thereof
- a PD-1 antagonist e.g., an anti-PD-1 monoclonal antibody or antigen binding fragment thereof
- chemotherapeutic agents e.g., 5-flu
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof), the PD-1 antagonist (e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof), or one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin) disclosed herein may be administered by doses administered, e.g., daily, 1-7 times per week, weekly, bi-weekly, tri-weekly, every four weeks, every five weeks, every 6 weeks, monthly, bimonthly, quarterly, semiannually, annually, etc.
- doses administered e.g., daily, 1-7 times per week, weekly, bi-weekly, tri-weekly,
- Doses may be administered, e.g., intravenously, subcutaneously, topically, orally, nasally, rectally, intramuscular, intracerebrally, intraspinally, or by inhalation.
- the doses are administered intravenously.
- the doses are administered subcutaneously.
- the doses are administered orally.
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti- TIGIT monoclonal antibody) or antigen binding fragment thereof) is administered subcutaneously or intravenously, on a weekly, biweekly, triweekly, every 4 weeks, every 5 weeks, every 6 weeks, every 8 weeks, every 9 weeks, every 10 weeks, every 12 weeks, monthly, bimonthly, or quarterly basis at about 10, about 20, about 50, about 80, about 100, about 200, about 300, about 400, about 500, about 1000 or about 2500 mg/subject.
- anti-TIGIT antibody e.g., anti- TIGIT monoclonal antibody
- antigen binding fragment thereof is administered subcutaneously or intravenously, on a weekly, biweekly, triweekly, every 4 weeks, every 5 weeks, every 6 weeks, every 8 weeks, every 9 weeks, every 10 weeks, every 12 weeks, monthly, bimonthly, or quarterly basis at about 10, about 20, about 50, about 80, about 100, about 200, about 300, about 400, about 500
- the dose of the TIGIT antagonist is from about 0.01 mg/kg to about 50 mg/kg, from about 0.05 mg/kg to about 25 mg/kg, from about 0.1 mg/kg to about 10 mg/kg, from about 0.2 mg/kg to about 9 mg/kg, from about 0.3 mg/kg to about 8 mg/kg, from about 0.4 mg/kg to about 7 mg/kg, from about 0.5 mg/kg to about 6 mg/kg, from about 0.6 mg/kg to about 5 mg/kg, from about 0.7 mg/kg to about 4 mg/kg, from about 0.8 mg/kg to about 3 mg/kg, from about 0.9 mg/kg to about 2 mg/kg, from about 1.0 mg/kg to about 1.5 mg/kg, from about 1.0 mg/kg to about 2.0 mg/kg, from about 1.0 mg/kg to about 3.0 mg/kg, or from about 2.0 mg/kg to
- the dose of the PD-1 antagonist is from about 10 mg to about 500 mg, from about 25 mg to about 500 mg, from about 50 mg to about 500 mg, from about 100 mg to about 500 mg, from about 200 mg to about 500 mg, from about 150 mg to about 250 mg, from about 175 mg to about 250 mg, from about 200 mg to about 250 mg, from about 150 mg to about 240 mg, from about 175 mg to about 240 mg, or from about 200 mg to about 240 mg.
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof
- the dose of the PD-1 antagonist is from about 10 mg to about 500 mg, from about 25 mg to about 500 mg, from about 50 mg to about 500 mg, from about 100 mg to about 500 mg, from about 200 mg to about 500 mg, from about 150 mg to about 250 mg, from about 175 mg to about 250 mg, from about 200 mg to about 250 mg, from about 150 mg to about 240 mg, from about 175 mg to
- the dose of the PD-1 antagonist is about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 240 mg, about 250 mg, about 300 mg, about 400 mg, or about 500 mg.
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof
- the dose of the PD-1 antagonist is about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 240 mg, about 250 mg, about 300 mg, about 400 mg, or about 500 mg.
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof) is administered subcutaneously or intravenously, on a weekly, biweekly, triweekly, every 4 weeks, every 5 weeks, every 6 weeks, every 8 weeks, every 9 weeks, every 10 weeks, every 12 weeks, monthly, bimonthly, or quarterly basis at about 10, about 20, about 50, about 80, about 100, about 200, about 300, about 400, about 500, about 1000 or about 2500 mg/subject.
- anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof e.g., antigen binding fragment thereof
- the dose of the PD-1 antagonist is from about 0.01 mg/kg to about 50 mg/kg, from about 0.05 mg/kg to about 25 mg/kg, from about 0.1 mg/kg to about 10 mg/kg, from about 0.2 mg/kg to about 9 mg/kg, from about 0.3 mg/kg to about 8 mg/kg, from about 0.4 mg/kg to about 7 mg/kg, from about 0.5 mg/kg to about 6 mg/kg, from about 0.6 mg/kg to about 5 mg/kg, from about 0.7 mg/kg to about 4 mg/kg, from about 0.8 mg/kg to about 3 mg/kg, from about 0.9 mg/kg to about 2 mg/kg, from about 1.0 mg/kg to about 1.5 mg/kg, from about 1.0 mg/kg to about 2.0 mg/kg, from about 1.0 mg/kg to about 3.0 mg/kg, or from about 2.0 mg/kg to about
- the dose of the PD-1 antagonist is from about 10 mg to about 500 mg, from about 25 mg to about 500 mg, from about 50 mg to about 500 mg, from about 100 mg to about 500 mg, from about 200 mg to about 500 mg, from about 150 mg to about 250 mg, from about 175 mg to about 250 mg, from about 200 mg to about 250 mg, from about 150 mg to about 240 mg, from about 175 mg to about 240 mg, or from about 200 mg to about 240 mg.
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof
- the dose of the PD-1 antagonist is from about 10 mg to about 500 mg, from about 25 mg to about 500 mg, from about 50 mg to about 500 mg, from about 100 mg to about 500 mg, from about 200 mg to about 500 mg, from about 150 mg to about 250 mg, from about 175 mg to about 250 mg, from about 200 mg to about 250 mg, from about 150 mg to about 240 mg, from about 175 mg to
- the dose of the PD-1 antagonist is about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 240 mg, about 250 mg, about 300 mg, about 400 mg, or about 500 mg.
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof
- the dose of the PD-1 antagonist is about 50 mg, about 75 mg, about 100 mg, about 125 mg, about 150 mg, about 175 mg, about 200 mg, about 225 mg, about 240 mg, about 250 mg, about 300 mg, about 400 mg, or about 500 mg.
- the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110, and the human patient is administered about 100 mg, about 150 mg, about 200 mg, about 240 mg, about 400 mg, about 480 mg, or about 720 mg, or about 2 mg/kg of the TIGIT antagonist, wherein the TIGIT antagonist
- the human patient is administered about 200 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every three weeks.
- the human patient is administered 240 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every three weeks.
- the human patient is administered 2 mg/kg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every three weeks.
- the human patient is administered 400 mg a TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every three weeks.
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof
- the TIGIT antagonist comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110,
- the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110, and the human patient is administered 200 mg, 240 mg, 400 mg, 480 mg, 720 mg, or 2 mg/kg of the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding
- the human patient is administered 200 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the human patient is administered 240 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the human patient is administered 400 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the human patient is administered about 480 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the human patient is administered 720 mg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the human patient is administered 2 mg/kg TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof) once every six weeks.
- the PD-1 antagonist, anti-PD- 1 antibody or anti-PD-1 monoclonal antibody is pembrolizumab
- the human patient is administered about 200 mg, about 240 mg, about 400 mg, about 480 mg, about 720 mg, or about 2 mg/kg pembrolizumab
- pembrolizumab is administered once every three or six weeks.
- the human patient is administered about 200 mg pembrolizumab once every three weeks.
- the human patient is administered about 240 mg pembrolizumab once every three weeks.
- the human patient is administered 2 mg/kg pembrolizumab once every three weeks.
- the human patient is administered 400 mg pembrolizumab once every three weeks.
- the PD-1 antagonist, anti- PD-1 antibody or anti-PD-1 monoclonal antibody is pembrolizumab
- the human patient is administered 400 mg pembrolizumab
- pembrolizumab is administered once every six weeks.
- the PD-1 antagonist, anti-PD- 1 antibody or anti-PD-1 monoclonal antibody is pembrolizumab
- the human patient is administered about 200 mg, about 240 mg, about 400 mg, about 480 mg, about 720 mg, or about 2 mg/kg pembrolizumab
- pembrolizumab is administered once every six weeks.
- the human patient is administered about 200 mg pembrolizumab once every six weeks.
- the human patient is administered about 240 mg pembrolizumab once every six weeks. In one embodiment, the human patient is administered about 400 mg pembrolizumab once every six weeks. In one embodiment, the human patient is administered 480 mg pembrolizumab once every six weeks. In one embodiment, the human patient is administered 720 mg pembrolizumab once every six weeks. In one embodiment, the human patient is administered 2 mg/kg pembrolizumab once every six weeks.
- the TIGIT antagonist e.g., anti-TIGIT antibody, or antigen binding fragment thereof
- the PD-1 antagonist e.g., anti-PD-1 antibody, or antigen binding fragment thereof
- the TIGIT antagonist e.g., anti-TIGIT antibody, or antigen binding fragment
- the PD-1 antagonist e.g., anti- PD-1 antibody, or antigen binding fragment thereof
- the administration occurs on the same day.
- the TIGIT antagonist e.g., anti-TIGIT antibody, or antigen binding fragment thereof
- the PD-1 antagonist e.g., anti-PD-1 antibody, or antigen binding fragment thereof
- the anti-TIGIT antibody or antigen binding fragment thereof and the anti-PD-1 antibody or antigen binding fragment thereof are administered sequentially on the same day (e.g., as separate formulations), in either order.
- the anti-TIGIT antibody or antigen binding fragment thereof is administered first.
- the anti-PD-1 antibody or antigen binding fragment thereof is administered first.
- the TIGIT antagonist e.g., anti- human TIGIT antibody or antigen binding fragment thereof
- the TIGIT antagonist comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110, the human patient is administered 200 mg of the TIGIT antagonist, and the TIGIT antagonist is administered once every three weeks.
- the TIGIT antagonist (e.g., anti- human TIGIT antibody or antigen binding fragment thereof) comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110, and the human patient is administered about 400 mg of the TIGIT antagonist, and the TIGIT antagonist is administered once every six weeks.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence
- the PD-1 antagonist or anti-human PD-1 monoclonal antibody is pembrolizumab
- the human patient is administered about 200 mg pembrolizumab
- pembrolizumab is administered once every three weeks.
- the PD-1 antagonist or anti-human PD-1 monoclonal antibody is pembrolizumab
- the human patient is administered about 400 mg pembrolizumab
- pembrolizumab is administered once every six weeks.
- the PD-antagonist or anti-human PD-1 monoclonal antibody is nivolumab
- the human patient is administered about 240 mg or about 3 mg/kg nivolumab
- nivolumab is administered once every two weeks.
- the human patient is administered about 240 mg nivolumab once every two weeks.
- the human patient is administered about 3 mg/kg nivolumab once every two weeks.
- the PD-1 antagonist or anti-human PD-1 monoclonal antibody is nivolumab
- the human patient is administered about 480 mg nivolumab
- nivolumab is administered once every four weeks.
- the PD-1 antagonist e.g, anti-human PD-1 monoclonal antibody or antigen binding fragment thereof
- cemiplimab is administered once every three weeks.
- the TIGIT antagonist e.g., an anti-TIGIT antibody
- the PD-1 antagonist e.g, anti-PD-1 antibody
- a co- formulated product with about 200 mg pembrolizumab or a pembrolizumab variant and 200 mg of an antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- a co-formulated product with 200 mg pembrolizumab or a pembrolizumab variant and 300 mg of antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- a co-formulated product with about 200 mg pembrolizumab or a pembrolizumab variant and about 400 mg of antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- a co-formulated product with about 200 mg of pembrolizumab or a pembrolizumab variant and about 500 mg of antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- a co-formulated product with of about 200 mg pembrolizumab or a pembrolizumab variant and about 600 mg of antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- a co-formulated product with about 200 mg of pembrolizumab or a pembrolizumab variant and about 700 mg of antibody comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 is used for intravenous infusion.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- 5-fluorouracil is administered intravenously (e.g., as a continuous IV infusion). In certain embodiments, 5-fluorouracil is administered five times every three weeks. In some embodiments, a human patient is administered a total of about 3000 mg/m 2 or about 4000 mg/m 2 5-fluorouracil per cycle. In some embodiments, a human patient is administered about 500 mg/m 2 , about 600 mg/m 2 , about 650 mg/m 2 , about 700 mg/m 2 , about 750 mg/m 2 , about 800 mg/m 2 , or about 900 mg/m 2 5-fluorouracil per day wherein the 5-fluorouracil is administered five times every three weeks.
- 5-fluorouracil is administered on the first five days of a 3-week cycle.
- cisplatin is administered intravenously (e.g., a 60 minutes to 120 minutes IV infusion).
- cisplatin is administered once every three weeks.
- a human patient is administered about 40 mg/m 2 to about 100 mg/m 2 cisplatin once every three weeks.
- a human patient is administered about 60 mg/m 2 to about 80 mg/m 2 cisplatin once every three weeks.
- the human patient is administered: (a) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg pembrolizumab; (c)
- the human patient is administered: (a) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL pembrolizumab; (c) a total of about 3000 mg/m 2 or 4
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) a total of about 3000 mg/m 2 or 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 60 mg/m 2 or 80 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), where
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) a total of about 3000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 60 mg/m 2 cisplatin represented by Formula (II), where
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), and (d) is administered once every three weeks, and wherein (c) is administered five times every three weeks.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; (c) a total of about 3000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 60 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), and (d) is administered once every three weeks, and wherein (c) is administered five times every three weeks.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), and (d) is administered once every three weeks, and wherein (c) is administered five times every three weeks.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; (c) a total of about 3000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 60 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), and (d) is administered once every three weeks, and wherein (c) is administered five times every three weeks.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295
- the human patient is administered: (a) about 240 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 240 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II
- the human patient is administered: (a) about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 2 mg/kg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (
- the human patient is administered: (a) about 400 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), where
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), where
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), where
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) a total of about 4000 mg/m 2 5-fluorouracil represented by Formula (I) per cycle; and (d) about 80 mg/m 2 cisplatin represented by Formula (II), where
- a co-formulation of pembrolizumab and of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113 and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 are administered by IV infusion.
- the co-formulation is administered for about 30 minutes every three weeks. In some embodiments, the co- formulation is administered for from about 25 to about 40 minutes every three weeks. In certain embodiments, paclitaxel or a pharmaceutically acceptable salt thereof is administered intravenously. In certain embodiments, paclitaxel or a pharmaceutically acceptable salt thereof is administered once every week. In some embodiments, a human patient is administered about 70 mg/m 2 to about 100 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof once every week. In some embodiments, a human patient is administered about 80 mg/m 2 to about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof once every week.
- a human patient is administered about 70 mg/m 2 , about 80 mg/m 2 , about 90 mg/m 2 , or about 100 mg/m 2 , paclitaxel or a pharmaceutically acceptable salt thereof once every week. In some embodiments, a human patient is administered about 80 mg/m 2 , or about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof once every week.
- the human patient is administered: (a) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg pembrolizumab; and (b) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or
- the human patient is administered: (a) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; and (b) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL pembrolizumab; and (c) about 80 mg/m 2 to about 90 mg/
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; and (c) about 80 mg/m 2 or about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a light chain CDRs: CDRL1 comprising the amino acid sequence as
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; and (c) about 80 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a light chain CDRs: CDRL1 comprising the amino acid sequence as
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQcomprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQcomprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a week.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQcomprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQcomprising the amino acid sequence as
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; and (c) about 80 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a week.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a week.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; and (c) about 80 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered once a week.
- the human patient is administered: (a) about 240 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 240 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c) is administered
- the human patient is administered: (a) about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 2 mg/kg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every three weeks, and wherein (c)
- the human patient is administered: (a) about 400 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every six weeks, and wherein (c) is administered once a light chain CDRs: CDRL1 comprising the amino acid sequence as
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein each of (a) and (b) is administered once every six weeks, and wherein (c) is administered once a pharmaceutically acceptable salt thereof, wherein each of (a) and (b
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein (a) is administered once every three weeks, wherein (b) is administered once every six weeks, and wherein (
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; and (c) about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, wherein (a) is administered once every three weeks, wherein (b) is administered once every six weeks, and wherein (
- gemcitabine or a pharmaceutically acceptable salt thereof is administered intravenously (e.g., as a continuous IV infusion). In certain embodiments, gemcitabine or a pharmaceutically acceptable salt thereof is administered once every three weeks. In some embodiments, a human patient is administered about 500 mg/m 2 to about 1500 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three week. In some embodiments, a human patient is administered about 800 mg/m 2 to about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three week.
- a human patient is administered about 500 mg/m 2 , about 600 mg/m 2 , about 700 mg/m 2 , about 800 mg/m 2 , about 900 mg/m 2 , about 1000 mg/m 2 , about 1100 mg/m 2 , about 1200 mg/m 2 , about 1300 mg/m 2 , about 1400 mg/m 2 , or about 1500 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three week.
- a human patient is administered about 800 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three week.
- a human patient is administered about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof once every three week.
- cisplatin is administered intravenously (e.g., a 60 minutes to 120 minutes IV infusion). In certain embodiments, cisplatin is administered once every three weeks. In some embodiments, a human patient is administered about 10 mg/m 2 to about 50 mg/m 2 cisplatin once every three weeks. In some embodiments, a human patient is administered about 20 mg/m 2 to about 25 mg/m 2 cisplatin once every three weeks.
- a human patient is administered about 10 mg/m 2 , about 15 mg/m 2 , about 20 mg/m 2 , about 25 mg/m 2 , about 30 mg/m 2 , about 35 mg/m 2 , about 40 mg/m 2 , about 45 mg/m 2 , or about 50 mg/m 2 cisplatin once every three weeks.
- the human patient is administered: (a) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg pembrolizumab; (c)
- the human patient is administered: (a) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL pembrolizumab; (c) about 800 mg/m 2 or 1000 mg/m 2 gem
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) about 800 mg/m 2 or 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 20 mg/m 2 or 25 mg/m 2 cis
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 25 mg/m 2 cisplatin represented by Formula (II), wherein each
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) about 800 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 20 mg/m 2 cisplatin represented by Formula (II), wherein each
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; (c) about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 25 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), (c) and (d) is administered once every three weeks.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; (c) about 800 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 20 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), (c) and (d) is administered once every three weeks.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; (c) about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 25 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), (c) and (d) is administered once every three weeks.
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; (c) about 800 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 20 mg/m 2 cisplatin represented by Formula (II), wherein each of (a), (b), (c) and (d) is administered once every three weeks.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295
- (b) about 200 mg pembrolizumab (c) about 800 mg
- the human patient is administered: (a) about 240 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 240 mg pembrolizumab; (c) about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 200 mg/m 2 or about 25 mg/m
- the human patient is administered: (a) about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 2 mg/kg pembrolizumab; (c) about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 200 mg/m 2 or about 25 mg
- the human patient is administered: (a) about 400 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 200 mg/m 2 or about 25 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 200 mg/m 2 or about 25 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine represented by Formula (IV) or a pharmaceutically acceptable salt thereof; and (d) about 200 mg/m 2 or about 25 mg/m 2
- capecitabine or a pharmaceutically acceptable salt thereof is administered orally. In certain embodiments, capecitabine or a pharmaceutically acceptable salt thereof is administered twice a day. In some embodiments, a human patient is administered about 500 mg/m 2 to about 1500 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day. In some embodiments, a human patient is administered about 750 mg/m 2 to about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day.
- a human patient is administered about 750 mg/m 2 , about 800 mg/m 2 , about 850 mg/m 2 , about 900 mg/m 2 , about 950 mg/m 2 , or about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day.
- a human patient is administered about 750 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day.
- a human patient is administered about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof twice a day.
- oxaliplatin is administered intravenously (e.g., a 60 minutes to 120 minutes IV infusion).
- oxaliplatin is administered once every three weeks.
- a human patient is administered about 80 mg/m 2 to about 150 mg/m 2 oxaliplatin once every three weeks.
- a human patient is administered about 100 mg/m 2 to about 130 mg/m 2 cisplatin once every three weeks.
- a human patient is administered about 100 mg/m 2 , about 120 mg/m 2 , or about 130 mg/m 2 oxaliplatin once every three weeks.
- the human patient is administered: (a) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 100 mg, about 150 mg, about 200 mg, about 250 mg, or about 400 mg, or about 2 mg/kg pembrolizumab; (c)
- the human patient is administered: (a) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg, about 240 mg, about 2 mg/kg or about 22 mg/mL pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 200 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152; (b) about 200 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m 2 oxaliplatin represented by Formula (VI), wherein each of (a), (b), and (d) is administered once every three weeks, and (c) is administered twice a day.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 295; (b) about 200 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m 2 oxaliplatin represented by Formula (VI), wherein each of (a), (b), and (d) is administered once every three weeks, and (c) is administered twice a day.
- an anti-TIGIT antibody or antigen binding fragment thereof comprising a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO: 294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:
- the human patient is administered: (a) about 240 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 240 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m
- the human patient is administered: (a) about 2 mg/kg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 2 mg/kg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg
- the human patient is administered: (a) about 400 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m 2
- the human patient is administered: (a) about 200 mg of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) about 400 mg pembrolizumab; (c) about 750 mg/m 2 or 1000 mg/m 2 capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) about 100 mg/m 2 or 130 mg/m 2
- a co-formulation of pembrolizumab and of an anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113 and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110 are administered by IV infusion.
- the co-formulation is administered for about 30 minutes every three weeks. In some embodiments, the co- formulation is administered for from about 25 to about 40 minutes every three weeks.
- at least one of the therapeutic agents e.g., the anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or binding fragment thereof, the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or binding fragment thereof, 5-fluorouracil, cisplatin, or paclitaxel
- the combination therapy is administered using the same dosage regimen (dose, frequency, and duration of treatment) that is typically employed when the agent is used as monotherapy for treating the same condition.
- the patient receives a lower total amount of at least one of the therapeutic agents (e.g., the anti- TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or binding fragment thereof, the anti- PD-1monoclonal antibody or binding fragment thereof, 5-fluorouracil, cisplatin, or paclitaxel) in the combination therapy than when the agent is used as monotherapy, e.g., smaller doses, less frequent doses, and/or shorter treatment duration.
- the therapeutic agents e.g., the anti- TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or binding fragment thereof, the anti- PD-1monoclonal antibody or binding fragment thereof, 5-fluorouracil, cisplatin, or paclitaxel
- a combination therapy disclosed herein may be used prior to or following surgery to remove a tumor and may be used prior to, during, or after radiation treatment.
- a combination therapy disclosed herein is administered to a patient who has not previously been treated with a biotherapeutic or chemotherapeutic agent, i.e., is treatment-na ⁇ ve.
- the combination therapy is administered to a patient who failed to achieve a sustained response after prior therapy with the biotherapeutic or chemotherapeutic agent, i.e., is treatment-experienced.
- the therapeutic combination disclosed herein may be used in combination with one or more other active agents, including but not limited to, other anti-cancer agents that are used in the prevention, treatment, control, amelioration, or reduction of risk of a particular disease or condition (e.g., cancer).
- Such other active agents may be administered, by a route and in an amount commonly used therefor, contemporaneously or sequentially with one or more of the therapeutic agents in the combinations disclosed herein.
- the one or more additional active agents may be co-administered with the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof), the PD-1 antagonist (e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof), or one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, or paclitaxel).
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or
- the additional active agent(s) can be administered in a single dosage form with one or more co-administered agent selected from the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof), the PD-1 antagonist, e.g., anti-PD-1 antibody (e.g., anti- PD-1 monoclonal antibody) or antigen binding fragment thereof), and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, or paclitaxel).
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti- PD-1 monoclonal antibody) or antigen binding fragment thereof
- chemotherapeutic agents e.g., 5-fluorouracil, c
- the additional active agent(s) can also be administered in separate dosage form(s) from the dosage forms containing the TIGIT antagonist (e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof), the PD-1 antagonist (e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof), or one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin).
- the TIGIT antagonist e.g., anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof
- the PD-1 antagonist e.g., anti-PD-1 antibody (e.g., anti-PD-1 monoclo
- Administration of a PD-1 antagonist and/or a TIGIT antagonist can be by any suitable route, and can be facilitated by agents such as hyaluronan degrading enzymes, including hyaluronidases, including soluble PH20 polypeptides, and variants thereof.
- the facilitating agents can be modified to increase pharmacological properties, such as serum half-life, by modifying the agents, such as with polymers. See, e.g., U.S. Patent Nos.7,767,429, 8,431,380, 7,871,607, International Publication No. WO 2020/022791, U.S. Patent Publication No.
- compositions comprising a PD-1 antagonist and/or a TIGIT antagonist and any one of a hyaluronan degrading enzyme, hyaluronidase, soluble hyaluronidase, soluble PH20 polypeptide, or a variant of any of the foregoing enzymes.
- the pharmaceutical composition comprises a PD-1 antagonist and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a TIGIT antagonist and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a PD-1 antagonist, a TIGIT antagonist and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a PD-1 antagonist, a TIGIT antagonist, 5-fluorouracil, cisplatin, and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a PD-1 antagonist, a TIGIT antagonist, paclitaxel or a pharmaceutically acceptable salt thereof, and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a PD-1 antagonist, a TIGIT antagonist, gemcitabine or a pharmaceutically acceptable salt thereof, cisplatin and a soluble PH20 polypeptide or a variant thereof.
- the pharmaceutical composition comprises a PD-1 antagonist, a TIGIT antagonist, capecitabine or a pharmaceutically acceptable salt thereof, oxaliplatin and a soluble PH20 polypeptide or a variant thereof.
- compositions comprising the therapeutic agents disclosed herein (e.g., a TIGIT antagonist, a PD-1 antagonist, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin)).
- the pharmaceutical composition further comprises a pharmaceutically acceptable carrier.
- compositions comprising an anti-human TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof, an anti-human PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin), can be prepared for storage by mixing the antibodies or compounds having the desired degree of purity with optionally physiologically acceptable carriers, excipients, or stabilizers (see, e.g., Remington, Remington’s Pharmaceutical Sciences (18 th ed.1980)) in the form of aqueous solutions or lyophilized or other dried forms.
- chemotherapeutic agents e.g., 5-fluorouracil, cisplatin,
- the pharmaceutically acceptable carriers, excipients, or stabilizers are non-toxic to the cell or mammalian being exposed thereto at the dosage and concentrations employed.
- the pharmaceutically acceptable carrier is an aqueous pH buffered solution.
- pharmaceutically acceptable carriers include buffers, such as phosphate, citrate, acetate, and other organic acids; antioxidants, such as ascorbic acid; low molecular weight (e.g., fewer than about 10 amino acid residues) polypeptide; proteins, such as serum albumin, gelatin, or immunoglobulin; hydrophilic polymers, such as polyvinylpyrrolidone; amino acids, such as glycine, glutamine, asparagine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates, including glucose, mannose, or dextrins; chelating agents, such as EDTA; sugar alcohols, such as mannitol or sorbitol; salt-forming counterions, such as sodium; and/
- the pharmaceutically acceptable carriers can also refer to a diluent, adjuvate (e.g., Freund’s adjuvate (complete or incomplete)), excipient, or vehicle.
- adjuvate e.g., Freund’s adjuvate (complete or incomplete)
- excipient or vehicle.
- Such carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable, or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil, and the like. Water is an exemplary carrier when a composition (e.g., a pharmaceutical composition) is administered intravenously.
- Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid carriers, particularly for injectable solutions.
- Suitable excipients include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol, and the like.
- the composition if desired, can also contain minor amounts of wetting or emulsifying agents, or pH buffering agents.
- Compositions can take the form of solutions, suspensions, emulsions, tablets, pills, capsules, powders, sustained-release formulations, and the like.
- kits comprising the therapeutic agents disclosed herein (e.g., a TIGIT antagonist, a PD-1 antagonist, and one or more chemotherapeutic agents (e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin)) or pharmaceutical compositions thereof, packaged into suitable packaging material.
- chemotherapeutic agents e.g., 5-fluorouracil, cisplatin, paclitaxel or a pharmaceutically acceptable salt thereof, gemcitabine or a pharmaceutically acceptable salt thereof, capecitabine or a pharmaceutically acceptable salt thereof, and/or oxaliplatin
- a kit optionally includes a label or packaging insert that include a description of the components or instructions for use in vitro, in vivo, or ex vivo, of the components therein.
- the kit comprises (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil represented by Formula (I) and (d) cisplatin represented by Formula (II).
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, 5-fluorouracil and cisplatin.
- the kit comprises: (a) one or more dosages of an anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof; (b) one or more dosages of an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof; (c) one or more dosages of 5-fluorouracil; (d) one or more dosages of cisplatin; and (e) instructions for administering to a human patient the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, 5-fluorouracil and cisplatin.
- an anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- an anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- 5-fluorouracil e.g., 5-fluorouracil
- the TIGIT antagonist is an anti-TIGIT antibody (e.g., anti- TIGIT monoclonal antibody) or antigen-binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen- binding fragment thereof.
- the PD-1 antagonist is an anti-PD-L1 monoclonal antibody or antigen-binding fragment thereof.
- the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In some embodiments, the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is cemiplimab.
- the dosages for the anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- 5-fluorouracil or cisplatin described herein can be used in various kits herein.
- a kit comprises dosages of each component sufficient for a certain period of treatment (e.g., 3, 6, 12, or 24 weeks, etc.).
- a kit can comprise a dosage of about 200 mg pembrolizumab, a dosage of about 200 mg anti-TIGIT antibody, 5 dosages of about 600 mg/m 2 or about 800 mg/m 2 5-fluorouracil, and a dosage of about 60 or 80 mg/m 2 cisplatin, which are sufficient for a 3-week treatment.
- kits can also comprise a dosage of about 400 mg pembrolizumab, 1 dosage of about 400 mg anti- TIGIT antibody, 10 dosages of about 600 mg/m 2 or about 800 mg/m 2 5-fluorouracil, and 2 dosages of about 60 or 80 mg/m 2 cisplatin, which are sufficient for a 6-week treatment.
- the kit comprises (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel represented by Formula (III) or a pharmaceutically acceptable salt thereof.
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, and paclitaxel or a pharmaceutically acceptable salt thereof.
- the kit comprises: (a) one or more dosages of an anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof; (b) one or more dosages of an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof; (c) one or more dosages of paclitaxel or a pharmaceutically acceptable salt thereof; and (d) instructions for administering to a human patient the anti- human TIGIT monoclonal antibody or antigen binding fragment thereof, the anti-human PD- 1 monoclonal antibody or antigen binding fragment thereof, and paclitaxel or a pharmaceutically acceptable salt thereof.
- an anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- an anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- paclitaxel or a pharmaceutically acceptable salt thereof paclitaxel or a pharmaceutically acceptable salt thereof.
- the TIGIT antagonist is an anti-TIGIT antibody (e.g., anti- TIGIT monoclonal antibody) or antigen-binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen- binding fragment thereof.
- the PD-1 antagonist is an anti-PD-L1 monoclonal antibody or antigen-binding fragment thereof.
- the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In some embodiments, the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is cemiplimab.
- the dosages for the anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- paclitaxel or a pharmaceutically acceptable salt thereof described herein can be used in various kits herein.
- a kit comprises dosages of each component sufficient for a certain period of treatment (e.g., 3, 6, 12, or 24 weeks, etc.).
- a kit can comprise a dosage of about 200 mg pembrolizumab, a dosage of about 200 mg anti-TIGIT antibody, and a dosage of about 80 mg/m 2 or about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, which are sufficient for a 3-week treatment.
- kits can also comprise a dosage of about 400 mg pembrolizumab, a dosage of about 400 mg anti- TIGIT antibody, 2 dosages of about 80 mg/m 2 or about 90 mg/m 2 paclitaxel or a pharmaceutically acceptable salt thereof, which are sufficient for a 6-week treatment.
- the kit comprises (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and (d) cisplatin represented by Formula (II).
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, gemcitabine or pharmaceutically acceptable salt thereof and cisplatin.
- the kit comprises: (a) one or more dosages of an anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof; (b) one or more dosages of an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof; (c) one or more dosages of gemcitabine or a pharmaceutically acceptable salt thereof; (d) one or more dosages of cisplatin; and (e) instructions for administering to a human patient the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, gemcitabine or a pharmaceutically acceptable salt thereof, and cisplatin.
- an anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- an anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- gemcitabine e.g., gemcitabine or a pharmaceutical
- the TIGIT antagonist is an anti-TIGIT antibody (e.g., anti- TIGIT monoclonal antibody) or antigen-binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen- binding fragment thereof.
- the PD-1 antagonist is an anti-PD-L1 monoclonal antibody or antigen-binding fragment thereof.
- the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In some embodiments, the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is cemiplimab.
- the dosages for the anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- gemcitabine or a pharmaceutically acceptable salt thereof or cisplatin described herein can be used in various kits herein.
- a kit comprises dosages of each component sufficient for a certain period of treatment (e.g., 3, 6, 12, or 24 weeks, etc.).
- a kit can comprise a dosage of about 200 mg pembrolizumab, a dosage of about 200 mg anti-TIGIT antibody, a dosage of about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof, and a dosage of about 20 mg/m 2 to about 25 mg/m 2 cisplatin, which are sufficient for a 3-week treatment.
- a kit can also comprise a dosage of about 400 mg pembrolizumab, 1 dosage of about 400 mg anti- TIGIT antibody, 2 dosages of about 800 mg/m 2 or about 1000 mg/m 2 gemcitabine or a pharmaceutically acceptable salt thereof, and about 20 mg/m 2 to about 25 mg/m 2 cisplatin, which are sufficient for a 6-week treatment.
- the kit comprises (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof and (d) oxaliplatin represented by Formula (VI).
- the kit further comprises instructions for administering to a human patient the TIGIT antagonist, the PD-1 antagonist, capecitabine or a pharmaceutically acceptable salt and oxaliplatin.
- the kit comprises: (a) one or more dosages of an anti-TIGIT antibody (e.g., anti-TIGIT monoclonal antibody) or antigen binding fragment thereof; (b) one or more dosages of an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof; (c) one or more dosages of capecitabine or a pharmaceutically acceptable salt; (d) one or more dosages of oxaliplatin; and (e) instructions for administering to a human patient the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof, the anti-human PD-1 monoclonal antibody or antigen binding fragment thereof, capecitabine or a pharmaceutically acceptable salt and oxaliplatin.
- an anti-TIGIT antibody e.g., anti-TIG
- the TIGIT antagonist is an anti-TIGIT antibody (e.g., anti- TIGIT monoclonal antibody) or antigen-binding fragment thereof.
- the PD-1 antagonist is an anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen- binding fragment thereof.
- the PD-1 antagonist is an anti-PD-L1 monoclonal antibody or antigen-binding fragment thereof.
- the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody or antigen binding fragment thereof is nivolumab. In some embodiments, the anti-PD-1 antibody (e.g., anti-PD-1 monoclonal antibody) or antigen binding fragment thereof is cemiplimab.
- the dosages for the anti-TIGIT antibody e.g., anti-TIGIT monoclonal antibody
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- capecitabine or a pharmaceutically acceptable salt or oxaliplatin described herein can be used in various kits herein.
- a kit comprises dosages of each component sufficient for a certain period of treatment (e.g., 3, 6, 12, or 24 weeks, etc.).
- a kit can comprise a dosage of about 200 mg pembrolizumab, a dosage of about 200 mg anti-TIGIT antibody, 62 dosages of about 750 or about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof, and a dosage of about 100 or about 130 mg/m 2 oxaliplatin, which are sufficient for a 3-week treatment.
- kits can also comprise a dosage of about 400 mg pembrolizumab, 1 dosage of about 400 mg anti- TIGIT antibody, 124 dosages of about 750 or about 1000 mg/m 2 capecitabine or a pharmaceutically acceptable salt thereof, and 2 dosages of about 100 or about 130 mg/m 2 oxaliplatin, which are sufficient for a 6-week treatment.
- the kit comprises means for separately retaining the components, such as a container, divided bottle, or divided foil packet.
- a kit of this disclosure can be used for administration of different dosage forms, for example, oral and parenteral, for administration of the separate compositions at different dosage intervals, or for titration of the separate compositions against one another.
- a therapeutic combination for treating cancer e.g., esophageal cancer
- the therapeutic combination comprises: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is metastatic.
- the cancer is relapsed. In other embodiments, the cancer is refractory. In yet other embodiments, the cancer is relapsed and refractory. In one embodiment, the cancer is esophageal cancer. In one embodiment, provided herein is use of a therapeutic combination for treating esophageal cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist as disclosed in the present disclosure; (b) a PD-1 antagonist as disclosed in the present disclosure; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody. In other embodiments, the anti-human PD-1 monoclonal antibody is a humanized antibody.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) 5-fluorouracil represented by Formula (I); and (d) cisplatin represented by Formula (II).
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating esophageal cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating esophageal cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating esophageal cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) 5-fluorouracil represented by Formula (I) and; (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer for treating cancer (e.g., TNBC) in a human patient
- the therapeutic combination comprises: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is metastatic.
- the cancer is relapsed. In other embodiments, the cancer is refractory.
- the cancer is relapsed and refractory.
- the cancer is TNBC.
- a therapeutic combination for treating TNBC in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a therapeutic combination for treating cancer in a patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist as disclosed in the present disclosure; (b) a PD-1 antagonist as disclosed in the present disclosure; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody.
- the anti-human PD-1 monoclonal antibody is a humanized antibody.
- provided herein is use of a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in S
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in
- a therapeutic combination for treating TNBC in a human patient in need thereof comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 11
- a therapeutic combination for treating TNBC in a human patient in need thereof comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:
- a therapeutic combination for treating TNBC in a human patient in need thereof comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; and (c) paclitaxel or a pharmaceutically acceptable salt thereof.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO:
- a therapeutic combination for treating cancer e.g., biliary cancer
- the therapeutic combination comprises: (c) a TIGIT antagonist; (d) a PD-1 antagonist; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is metastatic.
- the cancer is relapsed.
- the cancer is refractory. In yet other embodiments, the cancer is relapsed and refractory. In one embodiment, the cancer is biliary cancer. In one embodiment, provided herein is use of a therapeutic combination for treating biliary cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist as disclosed in the present disclosure; (b) a PD-1 antagonist as disclosed in the present disclosure; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody. In other embodiments, the anti-human PD-1 monoclonal antibody is a humanized antibody.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof; and (d) cisplatin represented by Formula (II).
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO:
- a therapeutic combination for treating biliary cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in SEQ
- a therapeutic combination for treating biliary cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in S
- a therapeutic combination for treating biliary cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) gemcitabine represented by Formula (IV) or pharmaceutically acceptable salt thereof and; (d) cisplatin represented by Formula (II).
- CDRL1 comprising the amino acid sequence as set forth in S
- a therapeutic combination for treating cancer e.g., biliary cancer
- the therapeutic combination comprises: (e) a TIGIT antagonist; (f) a PD-1 antagonist; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the cancer is selected from the group consisting of endometrial cancer, hepatocellular carcinoma (HCC), cervical cancer, head and neck cancer (HNSCC), biliary cancer, esophageal cancer, triple negative breast cancer (TNBC) and gastric cancer.
- the cancer is metastatic.
- the cancer is relapsed. In other embodiments, the cancer is refractory. In yet other embodiments, the cancer is relapsed and refractory. In one embodiment, the cancer is gastric cancer. In some embodiments, the gastric cancer is advanced or GEJ adenocarcinoma. In some embodiments, the gastric cancer is HER2 negative. In some embodiments, the gastric cancer is previously untreated.
- a therapeutic combination for treating biliary cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist; (b) a PD-1 antagonist; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- a therapeutic combination for treating cancer in a patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) a TIGIT antagonist as disclosed in the present disclosure; (b) a PD-1 antagonist as disclosed in the present disclosure; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the TIGIT antagonist is an anti-human TIGIT monoclonal antibody or antigen binding fragment thereof.
- the anti-human TIGIT monoclonal antibody is a human antibody.
- the anti-human TIGIT monoclonal antibody is a humanized antibody.
- the PD-1 antagonist is an anti-human PD-1 monoclonal antibody or antigen binding fragment thereof.
- the anti-human PD-1 monoclonal antibody is a human antibody. In other embodiments, the anti-human PD-1 monoclonal antibody is a humanized antibody.
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human or humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human or humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a human anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a human anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (V).
- a therapeutic combination for treating cancer in a human patient in need thereof wherein the therapeutic combination comprises an effective amount of: (a) a humanized anti-human TIGIT monoclonal antibody or antigen binding fragment thereof; (b) a humanized anti-human PD-1 monoclonal antibody or antigen binding fragment thereof; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is pembrolizumab.
- the anti-PD-1 antibody e.g., anti-PD-1 monoclonal antibody
- antigen binding fragment thereof is cemiplimab.
- the anti-TIGIT antibody or antigen binding fragment thereof comprises three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110.
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111
- CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112
- CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113
- CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108
- CDRH2 compris
- the anti-TIGIT antibody or antigen binding fragment thereof comprises a heavy chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 148 and a light chain variable region comprising the amino acid sequence as set forth in SEQ ID NO: 152.
- the anti-human TIGIT monoclonal antibody or antigen binding fragment thereof comprises a light chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:294 and a heavy chain comprising or consisting of an amino acid sequence as set forth in SEQ ID NO:295.
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ ID
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ
- a therapeutic combination for treating cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in SEQ
- a therapeutic combination for treating gastric cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) pembrolizumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in S
- a therapeutic combination for treating gastric cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) nivolumab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in
- a therapeutic combination for treating gastric cancer in a human patient in need thereof, wherein the therapeutic combination comprises an effective amount of: (a) anti-TIGIT antibody or antigen binding fragment thereof comprising three light chain CDRs: CDRL1 comprising the amino acid sequence as set forth in SEQ ID NO: 111, CDRL2 comprising the amino acid sequence as set forth in SEQ ID NO: 112, and CDRL3 comprising the amino acid sequence as set forth in SEQ ID NO: 113, and three heavy chain CDRs: CDRH1 comprising the amino acid sequence as set forth in SEQ ID NO: 108, CDRH2 comprising the amino acid sequence as set forth in SEQ ID NO: 154, and CDRH3 comprising the amino acid sequence as set forth in SEQ ID NO: 110; (b) cemiplimab; (c) capecitabine represented by Formula (V) or a pharmaceutically acceptable salt thereof; and (d) oxaliplatin represented by Formula (VI).
- CDRL1 comprising the amino acid sequence as set forth in
- Monoclonal, polyclonal, and humanized antibodies can be prepared (see, e.g., Sheperd and Dean (eds.) (2000) Monoclonal Antibodies, Oxford Univ. Press, New York, NY; Kontermann and Dubel (eds.) (2001) Antibody Engineering, Springer-Verlag, New York; Harlow and Lane (1988) Antibodies A Laboratory Manual, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY, pp.139-243; Carpenter, et al. (2000) J. Immunol.165:6205; He, et al. (1998) J. Immunol.160:1029; Tang et al. (1999) J. Biol. Chem.274:27371-27378; Baca et al.
- Antibodies can be conjugated, e.g., to small drug molecules, enzymes, liposomes, polyethylene glycol (PEG).
- Antibodies are useful for therapeutic, diagnostic, kit or other purposes, and include antibodies coupled, e.g., to dyes, radioisotopes, enzymes, or metals, e.g., colloidal gold (see, e.g., Le Doussal et al. (1991) J. Immunol.146:169-175; Gibellini et al.
- Fluorescent reagents suitable for modifying nucleic acids, including nucleic acid primers and probes, polypeptides, and antibodies, for use, e.g., as diagnostic reagents, are available (Molecular Probesy (2003) Catalogue, Molecular Probes, Inc., Eugene, OR; Sigma-Aldrich (2003) Catalogue, St. Louis, MO). Standard methods of histology of the immune system are described (see, e.g., Muller- Harmelink (ed.) (1986) Human Thymus: Histopathology and Pathology, Springer Verlag, New York, NY; Hiatt, et al.
- Analytical methods suitable for evaluating the product stability include size exclusion chromatography (SEC), dynamic light scattering test (DLS), differential scanning calorimetery (DSC), iso-asp quantification, potency, UV at 340 nm, UV spectroscopy, and Fourier-transform infrared spectroscopy (FTIR).
- SEC size exclusion chromatography
- DSC differential scanning calorimetery
- iso-asp quantification potency
- UV at 340 nm UV at 340 nm
- UV spectroscopy and Fourier-transform infrared spectroscopy (FTIR).
- SEC J. Pharm. Scien., 83:1645-1650, (1994); Pharm. Res., 11:485 (1994); J. Pharm. Bio. Anal., 15:1928 (1997); J. Pharm. Bio. Anal., 14:1133-1140 (1986)
- the kit uses the enzyme Protein Isoaspartyl Methyltransferase (PIMT) to specifically detect the presence of isoaspartic acid residues in a target protein.
- PIMT Protein Isoaspartyl Methyltransferase
- PIMT catalyzes the transfer of a methyl group from S-adenosyl-L-methionine to isoaspartic acid at the .alpha.-carboxyl position, generating S-adenosyl-L-homocysteine (SAH) in the process.
- SAH S-adenosyl-L-homocysteine
- This is a relatively small molecule, and can usually be isolated and quantitated by reverse phase HPLC using the SAH HPLC standards provided in the kit.
- the potency or bioidentity of an antibody can be measured by its ability to bind to its antigen.
- the specific binding of an antibody to its antigen can be quantitated by any method known to those skilled in the art, for example, an immunoassay, such as ELISA (enzyme- linked immunosorbant assay).
- Example 1 Clinical Trial of Administering a Combination of an Anti-TIGIT Antibody and an Anti-PD-1 Antibody with One or More Chemotherapeutic Agents in Esophageal Cancer, TNBC or Biliary Cancer Patients
- This study is a multicenter, open-label phase 2 study of an anti-TIGIT antagonist and an anti-PD-1 antagonist with or without one or more chemotherapeutic agents for the treatment of esophageal cancer or TNBC.
- Composition A formulation of pembrolizumab and vibostolimab; vibostolimab comprising heavy chain comprising the amino acid sequence as set forth in SEQ ID NO: 295 and light chain comprising the amino acid sequence as set forth in SEQ ID NO: 294) + 5-fluorouracil (5-FU) + cisplatin.
- a total of 40 participants will be allocated to receive Composition A plus the RP2D for 5- fluorouracil/cisplatin.
- TNBC approximately 40 participants with locally recurrent unresectable or metastatic TNBC, will be allocated by nonrandom assignment to Composition A + paclitaxel.
- a total of 40 participants will be allocated to receive Composition A plus the RP2D for paclitaxel.
- biliary cancer approximately 40 participants with locally recurrent unresectable or metastatic biliary cancer will be allocated by nonrandom assignment to Composition A. Approximately 10 to 14 participants with locally recurrent unresectable or metastatic biliary cancer will be allocated by nonrandom assignment to Composition A plus gemcitabine/cisplatin.
- a total of 10 participants will be allocated to receive Composition A plus the RP2D for gemcitabine/cisplatin.
- For gastric cancer approximately 40 participants with previously untreated, HER2 negative, advanced gastric or GEJ adenocarcinoma will be allocated by nonrandom assignment to Composition A in combination with capecitabine/oxaliplatin.
- Objective and Endpoints A listing of objectives and endpoints for the clinical trial substudy are shown in the table below. Table 9.
- mTPI modified Toxicity Probability Interval
- DLT target dose-limiting toxicity
- R2D Phase 2 dose
- the dose of 5- FU/cisplatin will be reduced while the dose of Composition A will remain fixed.
- mTPI calls for an additional de-escalation
- enrollment will be closed.
- Treatment with Composition A will continue for a total of 35 administrations (approximately 2 years) or until any of the discontinuation criteria are met.
- Treatment with the RP2D of 5-FU and cisplatin will continue until any of the discontinuation criteria are met.
- x TNBC An mTPI design with a target DLT rate of 30% will be used to identify the preliminary RP2D of paclitaxel to use in combination with Composition A for the treatment of participants with TNBC.
- mTPI de-escalation
- the dose of paclitaxel will be reduced while the dose of Composition A will remain fixed.
- x Biliary Cancer A total of 10 participants will be allocated to receive Composition A plus the RP2D for gemcitabine/cisplatin (Table 10).
- An mTPI design with a target DLT rate of 30% will be used to identify the preliminary RP2D of gemcitabine/cisplatin to use in combination with Composition A for the treatment of participants with biliary cancer. If de-escalation is called for by mTPI, the dose of gemcitabine/cisplatin will be reduced while the dose of Composition A will remain fixed. There are 2 predetermined dose levels of gemcitabine/cisplatin that may be explored in the mTPI design.
- x Gastric cancer A mTPI design with a target DLT rate of 30% will be used to identify the preliminary RP2D of capecitabine/oxaliplatin to use in combination with Composition A for the treatment of participants with gastric cancer.
- capecitabine/oxaliplatin will be reduced while the dose of Composition A will remain fixed.
- Dose Level 0 Dose Level –1 Participants are planned at the starting doses of chemotherapeutic agents as listed in Table 10. However, depending on the accrual rate, the completion of DLT evaluation period and number of DLTs observed, fewer participants may be enrolled at the starting dose. Participants will be closely followed for DLTs for the first cycle after the first dose of study intervention (the DLT evaluation period). The dose will be evaluated on an ongoing basis as participants complete the DLT evaluation period.
- E, S, D, and DU represent escalating the dose, staying at the same dose, de-escalating the dose, and excluding the dose from the study due to unacceptable toxicity, respectively. For example, if 2 out of 3 participants at this dose level develop a DLT, the dose will be de-escalated to the next lower dose level but may be re-escalated at a later time if the lower dose is well tolerated. If 3 out of 3 participants develop a DLT, this indicates an unacceptable toxicity at this dose.
- the dose should be de-escalated, if allowed per-protocol, and the current dose will not be explored further.
- Table 11 Dose-finding Rules per mTPI Design (Target Toxicity Rate up to 30%) Number of Participants Evaluable for DLT at Current Dose Number of participants 3 4 5 6 7 8 9 10 p p have completed enrollment at the starting dose, the enrollment at this dose level will be halted and a new set of participants will be enrolled and treated at the next lower dose level. This process will continue, with up to 10 DLT-evaluable participants enrolled at each dose explored, until 10 participants have been enrolled at any of the tested doses and a dosing decision of “S” (for staying at current dose) is made for the 10th participant evaluated.
- the dose may be escalated to a higher predetermined dose provided that the higher dose has not previously been discontinued due to a “DU” decision.
- a “D” or “DU” decision at the lowest dose level will stop the evaluation of the combination under study.
- An “E” decision at the highest dose level will result in staying at that level.
- it may be acceptable to de-escalate or escalate to an intermediate dose that was not predefined and not previously studied if evaluation of toxicity at such a dose is desired.
- the maximum dose/exposure allowed in this study is 200 mg vibostolimab / 200 mg pembrolizumab for up to 2 years (35 treatment cycles) of initial treatment/first course.
- the maximum dose/exposure of 5-FU allowed is 4000 mg/m 2 /cycle (21-day cycle) for up to 2 years (35 treatment cycles) of initial treatment.
- the maximum dose/exposure of cisplatin allowed is 80 mg/m 2 for up to 6 cycles.
- Paclitaxel will be administered as per the approved product label and applicable institutional standards. Based on global clinical practice patterns, gemcitabine at 1000 mg/m 2 on Day 1 and Day 8 of a 21-Day cycle will be administered until PD or unacceptable toxicity.
- Cisplatin at 25 mg/m 2 will be administered on Day 1 and Day 8 of a 21-Day cycle for a maximum of 8 cycles.
- the capecitabine/oxaliplatin dose regimen will be oxaliplatin (130 mg/m 2 IV) on Day 1 of each treatment cycle (Q3W) plus capecitabine (1000 mg/m 2 orally twice daily) on Days 1 to 14 of each treatment cycle (Q3W).
- Duration of oxaliplatin treatment may be capped at 6 cycles as per local country guidelines. Dose modifications in response to treatment-related AEs are permitted to keep the participant on study medication, when appropriate.
- Composition A may be interrupted together or separately at the Investigator’s discretion to determine which treatment component is the source for a given toxicity. Action may be taken independently for each component of study treatment (e.g., chemotherapy should be discontinued for prohibitive toxicity that is chemotherapy-related, but Composition A may continue if well tolerated). chemotherapy may be interrupted, dose reduced or discontinued. Composition A may only be interrupted or discontinued. AEs associated with Composition A exposure may represent an immune-related response.
- irAEs immune-related AEs
- IO immune- oncology
- the investigator may attribute each toxicity event to 5-FU, cisplatin, or Composition A and use a stepwise approach to dose reduction of 5-FU and cisplatin (Table 10). Participants may have a maximum of 2 dose reductions to each of the components throughout the course of the study. Once the dose has been reduced, it may not be re-escalated. If a participant experiences several toxicities and there are conflicting recommendations, follow the most conservative dose adjustment recommended (i.e., dose reduction appropriate to the most severe toxicity). Participants who require a third dose modification to any component will have that agent discontinued. Reduction of one chemotherapy agent and not the other is appropriate if, in the opinion of the investigator, the toxicity is clearly related to one of the agents.
- both drugs should be reduced according to recommended dose modifications. If the toxicity is related to the combination of all study intervention administered, chemotherapy should be reduced, interrupted, or discontinued, and Composition A should be interrupted or discontinued according to the recommended dose modifications. Participants may discontinue either 5-FU or cisplatin and continue receiving the other component in combination with Composition A. Participants may discontinue both 5-FU and cisplatin and continue receiving Composition A. Dose modification criteria for 5-FU and cisplatin are provided in Error! Reference source not found. and Error! Reference source not found., respectively. Table 13.
- paclitaxel should be reduced, interrupted, or discontinued, and Composition A should be interrupted or discontinued according to the recommended dose modifications. Participants may discontinue paclitaxel and continue receiving Composition A. If paclitaxel is discontinued, the participants does not need to come to the clinic on dates when only the chemotherapy would have been administered. Dose modification criteria for paclitaxel are provided in Table 15. Table 15.
- Gemcitabine should be discontinued at the first signs of any evidence of microangiopathic hemolytic anemia, such as rapidly falling hemoglobin with concomitant thrombocytopenia, elevation of serum bilirubin, serum creatinine, blood urea nitrogen, or LDH, which may indicate development of hemolytic uremic syndrome. Renal failure may not be reversible, even with discontinuation of therapy, and dialysis may be required. Maximal dose reduction permitted is up to 40% of starting dose of cisplatin (10 mg/m 2 ) and gemcitabine (400 mg/m 2 ). Doses below this level are not considered therapeutic and the participant will be discontinued from the related chemotherapy. Dose modification criteria for gemcitabine/cisplatin are provided in Table 16.
- 5-FU will be administered as a continuous IV infusion of 800 mg/m 2 /day on each of Days 1 to 5 Q3W according to approved prescribing information in each country/region or per local standard for 5-FU administration duration as long as total dose of 4000 mg/m 2 per 3-week cycle is followed (e.g., 1000 mg/m 2 /day on Days 1 to 4 Q3W is also acceptable).
- 5-FU will be administered after Composition A and cisplatin administration.
- Treatment with 5- FU may follow 1 to 2 days after Composition A (e.g., Day 2 or Day 3) as needed per local standard of care. Duration of 5-FU treatment will not exceed 35 cycles. Cisplatin 80 mg/m 2 will be administered as a 60- or 120-minute IV infusion (or per site’s standard practice) Q3W on Day 1 of each treatment cycle after Composition A administration according to approved prescribing information in each country/region or local institutional guidelines. Duration of cisplatin treatment will be capped at 6 doses; cisplatin dosing may occur after Cycle 6 if cisplatin was withheld for 1 or more cycles during Cycles 2 to 6.
- Treatment with cisplatin may follow 1 to 2 days after Composition A (e.g., Day 2 or Day 3) as needed per local standard of care.
- Paclitaxel Administration Paclitaxel will be administered as a dose of 90 mg/m 2 Q3W on Day 1, 8, and 15 of each 28-day treatment cycle according to approved prescribing information in each country/region or local institutional guidelines. When Composition A and paclitaxel are administered on the same day, paclitaxel will be administered after Composition A administration.
- Gemcitabine + Cisplatin Administration Cisplatin will be administered as an IV infusion on Day 1 and Day 8 of a 3 week cycle and should be immediately preceded and followed by hydration procedures and administered according to local guidelines/product label procedures.
- Cisplatin may be administered on Day 2, if required per local guidelines; however, Day 1 is the preferred day for intervention administration.
- Gemcitabine will be administered as an IV infusion on Days 1 and 8 of a 3 week cycle, according to local guidelines and product label procedures. Premedication with antiemetic therapy can be given prior to cisplatin and gemcitabine administration.
- MASCC Multinational Association of Supportive Care in Cancer
- Oxaliplatin 130 mg/m 2 will be administered as a 60- to 120 minute IV infusion or per the site’s standard practice on Day 1 of each treatment cycle.
- Capecitabine will be administered orally as a 1000 mg/m 2 dose twice daily from Day 1 to Day 14 of each treatment cycle. The evening dose of capecitabine should be taken approximately 12 hours after the morning dose.
- Capecitabine should be taken with food, or within 30 minutes after food/meal, with approximately 200 mL of water.
- Sites may follow local practice patterns regarding calculation of capecitabine milligram dose. Refer to the product label for additional guidance on administration procedures for capecitabine. If the participant is enrolled later in the day, it is acceptable for the first dose to be taken on Day 1, and twice daily dosing can continue on Days 2 to 14; the final dose will be taken in the morning of Day 15. Investigators are advised to counsel participants assigned to receive capecitabine about the risk of photosensitivity and to take sun protection measures accordingly. Participants receiving capecitabine should be carefully monitored for ophthalmological complications and skin reactions. Efficacy Endpoint This study will use objective response rate as the primary efficacy endpoint. Objective response rate is defined as the proportion of participants who have best response as CR or PR.
- ORR is defined as the percentage of participants who achieve a confirmed CR or PR per RECIST 1.1 as assessed by BICR.
- ORR is defined as the percentage of participants who achieve a confirmed CR or PR per RECIST 1.1 as assessed by investigator.
- PFS is defined as the time from randomization to the first documented disease progression per RECIST 1.1 by BICR or death due to any cause, whichever occurs first.
- PFS Progression-free survival is defined as the time from date of randomization/allocation until the first date of disease progression or death from any cause, whichever comes first, based on RECIST 1.1 criteria as assessed by BICR.
- PFS is defined as the time from the first dose of study intervention to the first documented disease progression per RECIST 1.1 by investigator or death due to any cause, whichever occurs first.
- OS is defined as an exploratory efficacy endpoint.
- Overall survival in this study is defined as the time from date of randomization/allocation to death from any cause.
- OS is defined as the time from randomization to death due to any cause.
- OS is defined as the time from the first dose of study intervention to death due to any cause.
- Inclusion criteria All participants will be given a participant identification card identifying them as participants in a research study.
- the card will contain study-site contact information (including direct telephone numbers) to be used in the event of an emergency.
- the investigator or qualified designee will provide the participant with a participant identification card immediately after the participant provides documented informed consent.
- site personnel At the time of intervention allocation/randomization, site personnel will add the treatment/randomization number to the participant identification card.
- the participant ID card also contains contact information for the emergency unblinding call center so that a health care provider can obtain information about study intervention in emergency situations where the investigator is not available.
- a medical history will be obtained by the investigator or qualified designee.
- the medical history will collect all active conditions and any condition diagnosed within the prior 10 years that the investigator considers to be clinically important. Details regarding the disease for which the participant has enrolled in this study will be recorded separately and not listed as medical history. If a medical condition is diagnosed at the time of screening due to the physical examination, laboratory tests, radiologic assessment, other assessment, and/or a combination of these evaluations, the medical condition is to be recorded as a baseline condition along with the participant’s other medical history unless due to any protocol-specified intervention (e.g., procedure, washout or run-in treatment including placebo run-in). Comprehensive details regarding the participant’s cancer history will be recorded separately and not listed as medical history.
- protocol-specified intervention e.g., procedure, washout or run-in treatment including placebo run-in.
- the investigator or qualified designee will review before medication use, including any protocol-specified washout requirement, and record prior medication taken by the participant within 28 days before the first dose of study intervention.
- the investigator or qualified designee will record medication, if any, taken by the participant during the study. All consented participants will be given a unique screening number that will be used to identify the participant for all procedures that occur before randomization/intervention allocation. Each participant will be assigned only 1 screening number. Screening numbers must not be reused for different participants.
- Any participant who is screened multiple times will retain the original screening number assigned at the initial screening Visit. All eligible participants will be allocated, by nonrandom assignment, and will receive a treatment/randomization number.
- the treatment/randomization number identifies the participant for all procedures occurring after treatment allocation/randomization. Once a treatment/randomization number is assigned to a participant, it can never be reassigned to another participant. A single participant cannot be assigned more than 1 treatment/randomization number. Exclusion criteria The participant must be excluded from the study if the participant: 1. Has a history of a second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 3 years.
- Neoadjuvant/adjuvant therapy should have been completed at least 6 months prior to diagnosis of advanced and/or unresectable disease, and participants should not have received gemcitabine and/or cisplatin in the neoadjuvant/adjuvant setting. Participants who received prior neoadjuvant/adjuvant therapy with R2 postoperative pathology of the oncologic resection are excluded. 4.
- Has received prior anticancer therapy e.g., transarterial chemoembolization (TACE), palliative surgery
- advanced unresectable biliary tract cancer intra-or extra hepatic cholangiocarcinoma or gallbladder cancer
- TACE transarterial chemoembolization
- INPVC extra hepatic cholangiocarcinoma or gallbladder cancer
- Participants may have received prior neoadjuvant and/or adjuvant therapy as long as it was completed at least 6 months prior to randomization.
- has received prior therapy with an agent directed to a stimulatory or coinhibitory T-cell receptor e.g., CTLA-4, OX 40, CD137.
- Participants with known untreated, asymptomatic brain metastases may participate but will require regular imaging of the brain as a site of disease.
- asymptomatic brain metastases i.e., no neurological symptoms, no requirement for corticosteroids, no or minimal surrounding edema, and no lesion >1.5 cm
- Known severe hypersensitivity ( ⁇ Grade 3) to Composition A or chemotherapy for the cohort to which the participant is allocated including dihydropyrimidine dehydrogenase deficiency for 5-FU and capecitabine, respectively) and/or any of their excipients.
- Hepatitis B and C screening tests are not required unless: known history of HBV and HCV infection, or as mandated by local health authority. 24.
- hepatitis B and C screening tests are not required unless: known history of HBV and HCV infection, or as mandated by local health authority. 24.
- TB Bacillus tuberculosis
- hypokalemia serum potassium less than the lower limit of normal. 26.
- the DLT window of observation will be during Cycle 1 for each dose level.
- the occurrence of any of the following toxicities during Cycle 1 of each dose level will be considered a DLT, if assessed by the investigator to be related to study intervention administration: a. Grade 4 nonhematologic toxicity (not laboratory).
- Any nonhematologic AE ⁇ Grade 3 in severity should be considered a DLT, with the following exceptions: Grade 3 fatigue lasting ⁇ 3 days; Grade 3 diarrhea, nausea, or vomiting without use of antiemetics or antidiarrheals per standard of care; Grade 3 rash without use of corticosteroids or anti-inflammatory agents per standard of care d.
- Any Grade 3 or Grade 4 nonhematologic laboratory value if: • Clinically significant medical intervention is required to treat the participant, or • The abnormality leads to hospitalization, or • The abnormality persists for >1 week • The abnormality results in a drug-induced liver injury (DILI) Exceptions: Clinically nonsignificant, treatable, or reversible laboratory abnormalities including liver function tests, uric acid, etc. e.
- DILI drug-induced liver injury
- Grade 3 is defined as absolute neutrophil count (ANC) ⁇ 1000/mm 3 with a single temperature of >38.3 degrees C (101 degrees F) or a sustained temperature of ⁇ 38 degrees C (100.4 degrees F) for more than 1 hour.
- Grade 4 is defined as ANC ⁇ 1000/mm 3 with a single temperature of >38.3 degrees C (101 degrees F) or a sustained temperature of ⁇ 38 degrees C (100.4 degrees F) for more than 1 hour, with life-threatening consequences and urgent intervention indicated.
- Grade 5 toxicity is defined as absolute neutrophil count (ANC) ⁇ 1000/mm 3 with a single temperature of >38.3 degrees C (101 degrees F) or a sustained temperature of ⁇ 38 degrees C (100.4 degrees F) for more than 1 hour.
- Radiographic disease progression based on RECIST 1.1 there is no distinct iRECIST assessment.
- Assessment and Decision at RECIST 1.1 Progression For participants who show radiological disease progression by RECIST 1.1, the investigator will decide whether to continue a participant on study intervention until repeat scans 4 to 8 weeks later are obtained. Tumor flare may manifest as any factor causing radiographic progression per RECIST 1.1, including: x Increase in the sum of diameters of target lesion(s) identified at baseline to ⁇ 20% and ⁇ 5 mm from nadir.
- the Response Evaluation Criteria in Solid Tumors 1.1 for immune-based therapeutics (iRECIST) publication uses the terminology “sum of measurements,” but “sum of diameters” will be used in this protocol, consistent with the original RECIST 1.1 terminology.
- x Unequivocal progression of nontarget lesion(s) identified at baseline x Development of new lesion(s) iRECIST defines new response categories, including iUPD (unconfirmed progressive disease) and iCPD (confirmed progressive disease).
- iUPD unconfirmed progressive disease
- iCPD confirmeded progressive disease
- the first visit showing progression according to RECIST 1.1 will be assigned a visit (overall) response of iUPD, regardless of which factors caused the progression.
- target and nontarget lesions identified at baseline by RECIST 1.1 will be assessed as usual.
- New lesions will be classified as measurable or nonmeasurable, using the same size thresholds and rules as for baseline lesion assessment in RECIST 1.1. From measurable new lesions, up to 5 lesions total (up to 2 per organ), may be selected as New Lesions – Target. The sum of diameters of these lesions will be calculated and kept distinct from the sum of diameters for target lesions at baseline. All other new lesions will be followed qualitatively as New Lesions – Nontarget.
- the participant On the confirmatory scans, the participant will be classified as progression confirmed (with an overall response of iCPD), or as showing persistent unconfirmed progression (with an overall response of iUPD), or as showing disease stability or response (stable disease by iRECIST (iSD) / partial response by iRECIST (iPR) / complete response by iRECIST (iCR)).
- the assessment of the subsequent confirmation scan proceeds in an identical manner, with possible outcomes of iCPD, iUPD, and iSD/iPR/iCR. Resolution of iUPD Progression is considered not confirmed, and the overall response becomes iSD/iPR/iCR, if: x None of the progression-confirming factors identified above occurs, AND x The target lesion sum of diameters (initial target lesions) is not above the disease progression threshold. The response is classified as iSD or iPR (depending on the sum of diameters of the target lesions), or iCR if all lesions resolve.
- the initial iUPD is considered to be pseudoprogression, and the level of suspicion for progression is “reset.” This means that the next visit that shows radiographic progression, whenever it occurs, is again classified as iUPD by iRECIST, and the confirmation process is repeated before a response of iCPD can be assigned.
- Management Following the Confirmatory Imaging If repeat scans do not confirm disease progression, and the participant continues to be clinically stable, study intervention is to continue. The regular scan schedule is to be followed. If disease progression is confirmed, participants may be discontinued from study intervention. If a participant has confirmed radiographic progression (iCPD) and clinically meaningful benefit, study intervention may be continued after consultation with the Sponsor. If study intervention is continued, tumor scans are to be performed after the intervals.
- x Target lesions o Sum of diameters reaches the disease progression threshold ( ⁇ 20% and ⁇ 5 mm increase from nadir) either for the first time, or after resolution of previous pseudoprogression. The nadir is always the smallest sum of diameters seen during the entire study, either before or after an instance of pseudoprogression.
- x Nontarget lesions o If nontarget lesions have never shown unequivocal progression, their doing so for the first-time results in iUPD.
- iUPD results from any significant further growth of nontarget lesions, taken as a whole.
- New lesions o New lesions appear for the first time
- Additional new lesions appear o Previously identified new target lesions show an increase of ⁇ 5 mm in the new lesion sum of diameters, from the nadir value of that sum o Previously identified nontarget lesions show any significant growth
- the overall response for that visit is iUPD, and the iUPD evaluation process (see Assessment at the Confirmatory Scan above) is repeated. Progression must be confirmed before iCPD can occur.
- the decision process on the subsequent iUPD is identical to the iUPD confirmation process for the initial disease progression, with one exception, which can occur if new lesions had occurred at a prior instance of iUPD, had not resolved, then worsened (increase in size or number) leading to the second iUPD. If new lesion worsening has not resolved at the confirmatory scan, then iUPD cannot resolve to iSD or iPR. It will remain iUPD until either a decrease in the new lesion burden allows resolution to iSD or iPR, or until new or worsening cause of progression indicates iCPD. Discontinuation Discontinuation of study intervention does not represent withdrawal from the study.
- participant As certain data on clinical events beyond study intervention discontinuation may be important to the study, they must be collected through the participant’s last scheduled follow- up, even if the participant has discontinued study intervention. Therefore, all participants who discontinue study intervention before completion of the protocol-specified treatment period will still continue to be monitored in the study and participate in the study visits and procedures unless the participant has withdrawn from the study. Participants may discontinue study intervention at any time for any reason or be discontinued from the study intervention at the discretion of the investigator should any untoward effect occur. In addition, a participant may be discontinued from study intervention by the investigator or the Sponsor if study intervention is inappropriate, the study plan is violated, or for administrative and/or other safety reasons.
- a participant must be discontinued from study intervention, but continue to be monitored in the study for any of the following reasons: x The participant or participant’s legally acceptable representative requests to discontinue study intervention. x Any prolonged interruption of study intervention beyond the permitted periods, for irAE or AE management or other allowed dose interruptions, require Sponsor consultation before restarting treatment. If treatment will not be restarted, the participant will continue to be monitored in the study and the reason for discontinuation of study intervention will be recorded in the medical record. x The participant has a medical condition or personal circumstance, which in the opinion of the investigator and/or Sponsor, placed the participant at unnecessary risk from continued administration of study intervention. x The participant has a confirmed positive serum pregnancy test.
- Radiographic disease progression (after obtaining informed consent addendum and Sponsor communication, the investigator may elect to continue treatment beyond imaging CRO (iCRO)-verified disease progression).
- iCRO CRO
- the participant requires any of the prohibited concomitant medication listed x Recurrence of a severe or life-threatening event, or of any of the laboratory abnormalities listed above, that are presumed to be immune-related. A participant must be withdrawn from the study if the participant or participant’s legally acceptable representative withdraws consent from the study.
- a participant withdraws from the study they will no longer receive study intervention or be followed at scheduled protocol visits. If a participant fails to return to the clinic for a required study visit and/or if the site is unable to contact the participant, the following procedures are to be performed: x The site must attempt to contact the participant and reschedule the missed visit. If the participant is contacted, the participant should be counseled on the importance of maintaining the protocol-specified visit schedule. x The investigator or designee must make every effort to regain contact with the participant at each missed visit (e.g., telephone calls and/or a certified letter to the participant’s last known mailing address or locally equivalent methods). These contact attempts should be documented in the participant’s medical record.
- a participant is not considered lost to follow-up until the last scheduled visit for the individual participant.
- the missing data for the participant will be managed via the prespecified statistical data handling and analysis guidelines.
- Informed Consent The investigator or medically qualified designee (consistent with local requirements) must obtain documented informed consent from each potential participant (or their legally acceptable representative) prior to participating in this clinical study If there are changes to the participant’s status during the study (e.g., health or age of majority requirements), the investigator or medically qualified designee must ensure the appropriate documented informed consent is in place.
- Tumor Imaging and Assessment of Disease The term “scan” refers to any medical imaging data used to assess tumor burden and may include cross-sectional imaging (such as CT or MRI), medical photography, or other methods as specified in this protocol.
- Bone scans may be performed to evaluate bone metastases. Any supplemental scans performed to support a positive or negative bone scan, such as plain X-rays acquired for correlation, should also be submitted to the iCRO. Other imaging modalities that may be collected, submitted to the iCRO, and included in the response assessment and those that should not be submitted to the iCRO and will not be included in response assessment are defined in the SIM. At screening, participant eligibility will require radiographic documentation of at least 1 lesion that meets the requirements for selection as a target lesion, before participant allocation. All scheduled scans for participants will be submitted to the iCRO.
- Initial Tumor Imaging Initial tumor scans at screening must be performed within 28 days before the date of randomization/allocation. Any scans obtained after Cycle 1 Day 1 cannot be included in the screening assessment. The site must review screening scans to confirm the participant has measurable disease per RECIST 1.1.
- Tumor scans performed as part of routine clinical management are acceptable for screening if they are of acceptable diagnostic quality and performed within 28 days of randomization and can be assessed by the iCRO. If brain scans are required to document the stability of existing metastases, the brain MRI should be acquired during screening. Bone scans are required at screening for participants with a history of bone metastases and/or for those participants with indicative clinical signs/symptoms such as bone pain or elevated alkaline phosphatase levels.
- Tumor Imaging During the Study The first on study scan should be performed at 9 weeks (63 days +7 days) from the date of randomization/allocation. Subsequent tumor scans should be performed every 9 weeks (63 days ⁇ 7 days) or more frequently if clinically indicated.
- Scan timing should follow calendar days and should not be adjusted for delays in cycle starts. Scans are to be performed until disease progression is identified by the investigator or notification by the Sponsor, or until the start of new anticancer treatment, withdrawal of consent, or death, whichever occurs first. Or should be confirmed by a repeat scan performed at least 4 weeks after the first indication of a response is observed. Participants will then return to the regular scan schedule, starting with the next scheduled time point. Participants who receive additional scans for confirmation do not need to undergo the next scheduled scan if it is fewer than 4 weeks later; scans may resume at the subsequent scheduled time point.
- Adverse Event An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
- study intervention includes any pharmaceutical product, biological product, vaccine, diagnostic agent, medical device, combination product, or protocol specified procedure whether investigational or marketed (including placebo, active comparator product, or run-in intervention), manufactured by, licensed by, provided by, or distributed by the Sponsor for human use in this study.
- AEs Any abnormal laboratory test results (hematology, clinical chemistry, or urinalysis) or other safety assessments (e.g., ECG, radiological scans, vital signs measurements), including those that worsen from baseline, considered clinically significant in the medical and scientific judgment of the investigator.
- x Exacerbation of a chronic or intermittent preexisting condition including either an increase in frequency and/or intensity of the condition.
- x New conditions detected or diagnosed after study intervention administration even though it may have been present before the start of the study.
- x Signs, symptoms, or the clinical sequelae of a suspected drug-drug interaction.
- x Signs, symptoms, or the clinical sequelae of a suspected overdose of either study intervention or a concomitant medication.
- x For all reports of overdose (whether accidental or intentional) with an associated AE, the AE term should reflect the clinical symptoms or abnormal test result. An overdose without any associated clinical symptoms or abnormal laboratory results is reported using the terminology “accidental or intentional overdose without adverse effect.”
- x Any new cancer that is not a condition of the study). Progression of the cancer under study is not a reportable event.
- x Medical or surgical procedure e.g., endoscopy, appendectomy: the condition that leads to the procedure is the AE.
- x Situations in which an untoward medical occurrence did not occur social and/or convenience admission to a hospital).
- Serious Adverse Event SAE If an event is not an AE per the above, then it cannot be an SAE even if serious conditions are met.
- An SAE is defined as any untoward medical occurrence that, at any dose: x Results in death.
- x Is life-threatening.
- life-threatening in the definition of “serious” refers to an event in which the participant was at risk of death at the time of the event. It does not refer to an event, which hypothetically might have caused death, if it were more severe.
- x Requires inpatient hospitalization or prolongation of existing hospitalization. Hospitalization is defined as an inpatient admission, regardless of length of stay, even if the hospitalization is a precautionary measure for continued observation. (Note: Hospitalization for an elective procedure to treat a pre-existing condition that has not worsened is not an SAE.
- a pre-existing condition is a clinical condition that is diagnosed prior to the use of the combinations disclosed herein and is documented in the participant’s medical history.
- x Results in persistent or significant disability/incapacity.
- disability means a substantial disruption of a person’s ability to conduct normal life functions. This definition is not intended to include experiences of relatively minor medical significance such as uncomplicated headache, nausea, vomiting, diarrhea, influenza, and accidental trauma (e.g., sprained ankle) that may interfere with or prevent everyday life functions but do not constitute a substantial disruption.
- x Is a congenital anomaly/birth defect. In offspring of participant taking the product regardless of time to diagnosis.
- x Other important medical events.
- g y Second Course – TNBC Post-treatment Visits Notes E Survi Second Course – TNBC Post-treatment Visits Notes E Survi s
- the present Example describes anti-tumor effects of a TIGIT antagonist and a PD-1 antagonist in combination with 5-Fluorouracil (5-FU) and Cisplatin chemotherapy, using mouse syngeneic models.
- Antibody reagents in this Example include: x Anti-PD-1 mIgG1 antibody, which is a murinized version of a rat anti–mouse PD1 Ab with a mouse IgG1 Fc; x Anti-TIGIT mIgG2a antibody having a mouse Fc region of mIgG2a subtype that is the murine counterpart isotype to human isotype IgG1; x Isotype mIgG1 antibody, which is a mouse IgG1 isotype-matched control monoclonal antibody specific for adenoviral hexon 25; and x Isotype mIgG2a antibody, which is a mouse IgG2a isotype-matched control monoclonal antibody specific for adenoviral hexon 25.
- Isotype mIgG1 control, a mouse monoclonal antibody specific for adenoviral hexon of the isotype IgG1, and anti-PD-1 antibodies were dosed intraperitoneally every 5 days at 5 mg/kg body weight.
- Isotype mIgG2a control, a mouse monoclonal antibody specific for adenoviral hexon of the isotype IgG2a, and anti-TIGIT antibodies were dosed intraperitoneally every 5 days at 10 mg/kg body weight.
- 5-FU was dosed intraperitoneally once weekly at 60 mg/kg body weight.
- Cisplatin was dosed intraperitoneally once weekly at 4 mg/kg body weight.
- Antibody reagents in this Example include: x Anti-PD-1 mIgG1 antibody, which is a murinized version of a rat anti–mouse PD1 Ab with a mouse IgG1 Fc; x Anti-TIGIT mIgG2a antibody having a mouse Fc region of mIgG2a subtype that is the murine counterpart isotype to human isotype IgG1; x Isotype mIgG1 antibody, which is a mouse IgG1 isotype-matched control monoclonal antibody specific for adenoviral hexon 25; and x Isotype mIgG2a antibody, which is a mouse IgG2a isotype-matched control monoclonal antibody specific for adenoviral hexon 25.
- the amino acid sequences of antibody reagents are listed in Table 24.
- Treatment groups consisted of: 1) Isotype mIgG1 antibody + Isotype mIgG2a antibody + 0.9% saline; 2) Anti-PD-1 mIgG1 antibody + Isotype mIgG2a antibody + 0.9% saline; 3) Anti-TIGIT mIgG2a antibody + Isotype mIgG1 antibody + 0.9% saline; 4) Anti-PD-1 mIgG1 antibody + anti-TIGIT mIgG2a antibody + 0.9% saline; 5) Gemcitabine + cisplatin + Isotype mIgG1 antibody + Isotype mIgG2a antibody; and 6) Anti-PD-1 mIgG1 antibody + anti-TIGIT mIgG2a antibody + gemcitabine + cisplatin.
- Isotype mIgG1 and anti-PD-1 antibodies were dosed intraperitoneally every 5 days at 5 mg/kg body weight.
- Isotype mIgG2a and anti-TIGIT antibodies were dosed intraperitoneally every 5 days at 10 mg/kg body weight.
- Gemcitabine was dosed intraperitoneally once weekly at 100 mg/kg body weight for four total doses.
- Cisplatin was dosed intraperitoneally once weekly at 4 mg/kg body weight for four total doses. Start of treatments was considered Day 0 and dosing based on schedules continued as described until Day 55. Caliper measurements of tumors and body weights were captured twice weekly.
- the quadruple combination group had more animals achieving PRs than the anti-PD-1 + anti-TIGIT groups, there was no statistically significant difference in tumor volumes, largely due to the variability in the latter group.
- a summary of relevant mean tumor volume comparisons at Day 14 when isotype treated group exited the study is shown in Table 27. There was no significant body weight loss or adverse events observed in any animals treated with the above therapies, indicating the treatments were well tolerated. Table 26.
- TGI tumor growth inhibition
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| PCT/US2022/039767 WO2023018677A1 (en) | 2021-08-10 | 2022-08-09 | A therapeutic combination comprising a t1git antagonist, a pd-1 antagonist, and a chemotherapeutic agent(s) |
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