JP2020524487A - キメラ抗原受容体を発現するt細胞 - Google Patents
キメラ抗原受容体を発現するt細胞 Download PDFInfo
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Abstract
Description
便宜上、本明細書、実施例、及び貼付の特許請求の範囲において用いられるいくつかの用語及び語句の意味は下記に提供される。特に断りのない限り、又は文脈から示唆されるように、以下の用語及び語句は、以下に提供される意味を含む。技術の範囲があくまで特許請求の範囲によって限定されないことから、定義は、特定の実施形態の記述に役立つように提供され、特許請求される技術を限定することが意図されない。特段の定義がされていない限り、本明細書で用いられるすべての科学技術用語は、この技術が属する当業者により一般に理解される意味と同じ意味を有する。当該技術分野における用語の使用と本明細書に提供されるその定義との間に明白な矛盾が存在する場合、本明細書中に提供される定義が採用されるものとする。
本明細書に記載の技術は、免疫療法における使用を意図した改善されたCARを提供する。以下、CAR及び様々な改善について論じる。
様々な実施形態では、本明細書に記載のCARは、抗体試薬又はその抗原結合ドメインを細胞外標的結合ドメインとして含む。
一般に、任意の細胞表面部分は、CARにより標的にされうる。最も多くは、標的は、T細胞応答について標的にすることが所望される細胞上で差次的に又は優先的に発現される細胞表面ポリペプチドとなる。これに関連して、腫瘍抗原又は腫瘍関連抗原は、魅力的な標的を提供し、腫瘍細胞を標的にする一方で、非腫瘍細胞又は組織へのコラテラルダメージを回避するか又は少なくとも限定するための手段を提供する。CD79b、又はCD79bとCD19の双方に特異的なCARが、本明細書に記載される。さらなる腫瘍抗原又は腫瘍関連抗原の非限定例として、CEA、未熟ラミニン受容体、TAG−72、HPV E6及びE7、BING−4、カルシウム活性化クロライドチャネル2、サイクリンB1、9D7、Ep−CAM、EphA3、Her2/neu、テロメラーゼ、メソテリン、SAP−1、サバイビン、BAGEファミリー、CAGEファミリー、GAGEファミリー、MAGEファミリー、SAGEファミリー、XAGEファミリー、NY−ESO−1/LAGE−1、PRAME、SSX−2、Melan−A/MART−1、Gp100/pmel17、チロシナーゼ、TRP−1/−2、MC1R、BRCA1/2、CDK4、MART−2、p53、Ras、MUC1、及びTGF−βRIIが挙げられる。これら抗原の1以上に対するCARは、当業者によって適切と判定される場合、本明細書に記載の、CD79b、又はCD79b及びCD19に対するCARと併用されうる。
本明細書に記載のような各CARは、細胞外標的結合ドメインをT細胞膜から隔てるヒンジドメインを含みうる。
本明細書に記載の各CARは、任意選択的には、同時刺激分子の1つ以上の細胞内ドメイン、又は同時刺激ドメインを含むことができる。本明細書で用いられるとき、用語「同時刺激ドメイン」は、同時刺激分子の細胞内シグナル伝達ドメインを指す。同時刺激分子は、Tリンパ球の抗原への結合時の効率的な活性化及び機能に要求される第2のシグナルを提供する抗原受容体又はFc受容体以外の細胞表面分子である。かかる同時刺激分子の例示的例として、CARD11、CD2、CD7、CD27、CD28、CD30、CD40、CD54(ICAM)、CD83、CD134(OX40)、CD137(4−1BB)、CD150(SLAMF1)、CD152(CTLA4)、CD223(LAG3)、CD270(HVEM)、CD273(PD−L2)、CD274(PD−L1)、CD278(ICOS)、DAP10、LAT、NKD2C SLP76、TRIM、及びZAP70が挙げられる。一実施形態では、細胞内ドメインは、4−1BBの細胞内ドメインである。
本明細書に記載のようなCARは、細胞内シグナル伝達ドメインを含む。「細胞内シグナル伝達ドメイン」は、標的抗原への有効なCARの結合のメッセージを免疫エフェクター細胞の内部に形質導入し、エフェクター細胞機能を誘導すること、例えば、活性化、サイトカイン産生、増殖及び細胞傷害性活性、例えば、細胞傷害性因子のCAR結合標的細胞への放出、又は細胞外CARドメインへの抗原結合後に誘発される他の細胞応答などに関与するCARポリペプチドの一部を指す。
いくつかの実施形態では、本明細書に記載の方法は、がん、形質細胞疾患若しくは障害、又は自己免疫疾患若しくは障害を有する又は有すると診断された対象を、本明細書に記載のCARポリペプチドのいずれか、又は本明細書に記載のCARポリペプチドのいずれかをコードする核酸を含む哺乳動物細胞を用いて治療することに関する。本明細書で用いられるとき、「本明細書に記載のようなCAR T細胞」は、本明細書に記載のCARポリペプチドのいずれか、又は本明細書に記載のCARポリペプチドのいずれかをコードする核酸を含む哺乳動物細胞を指す。本明細書で用いられるとき、「状態」は、がん、形質細胞疾患若しくは障害、又は自己免疫疾患若しくは障害を指す。状態を有する対象は、医師により状態を診断する現行の方法を用いて同定されうる。状態の症状及び/又は合併症は、これらの状態を特徴づけ、診断を補助するものであり、当該技術分野で周知であり、限定はされないが、疲労、持続性感染、及び持続性出血を含む。例えば状態の診断を補助することがある試験は、限定はされないが、血液スクリーニング及び骨髄検査が挙げられ、所与の状態にとって当該技術分野で公知である。状態における家族歴、又は状態におけるリスク因子への曝露もまた、対象が状態を有する可能性が高いか否かを判定する、又は状態の診断を行うことを補助しうる。
「単位剤形」は、用語が本明細書で用いられるとき、好適な単回投与のための用量を指す。例として、単位剤形は、送達装置、例えばシリンジ又は静脈内点滴バッグで処理される治療薬の量でありうる。一実施形態では、単位剤形は、単回投与で投与される。別の実施形態では、2以上の単位剤形が同時に投与されうる。
本明細書に記載の活性化CAR T細胞は、他の公知の薬剤及び治療法と併用されうる。一実施形態では、対象は、抗CD19療法及び抗CD79b療法が施される。別の実施形態では、対象は、抗BCMA療法がさらに施される。「組み合わせ」投与は、本明細書で用いられるとき、障害による対象の苦悩の過程において2(又は3以上)の異なる治療薬が対象に送達され、例えば、対象が障害を有すると診断されてから、また障害が治癒又は除去されている、又は他の理由で治療が終了している以前に2つ以上の治療薬が送達される。いくつかの実施形態では、一方の治療薬の送達が、第2の送達が開始する時、依然として行われていることで、投与については重複がある。これは、時として本明細書中で「同時」又は「併用送達」と称される。他の実施形態では、一方の治療薬の送達は、他方の治療薬の送達が開始する前に終了する。いずれかの場合のいくつかの実施形態では、治療薬は、組み合わせ投与が理由でより有効である。例えば、第2の治療薬がより有効であり、例えば、等価な効果が第2の治療薬の低減とともに見られる、又は第2の治療薬が、第2の治療薬が第1の治療薬の不在下で投与された場合に見られるよりも広範囲に症状を低減する、又は類似の状況が第1の治療薬の存在下で見られる。いくつかの実施形態では、送達は、症状における低減、又は障害に関する他のパラメータの程度が、一方の治療薬が他方の不在下で送達される場合に認められる場合よりも大きいようになされる。2つの治療薬の効果は、部分的に相加的、完全に相加的、又は相加的以上でありうる。送達は、送達される第1の治療薬の効果が、第2の治療薬が送達されるときに依然として検出可能であるようになされうる。本明細書に記載の活性化CAR T細胞及び少なくとも1つの追加的治療薬は、同時に、同じ組成物中で又は別々の組成物中で、又は逐次的に投与されうる。逐次投与においては、本明細書に記載のCARを発現する細胞が最初に投与可能であり、追加的薬剤が2番目に投与可能であり、又は投与順序が逆転可能である。CAR T療法及び/又は他の治療薬、手順又は様式は、活動的な障害の期間中、又は寛解若しくはあまり活動的でない疾患の期間中に実施することができる。CAR T療法は、別の治療前、治療と並行して、治療後、又は障害の寛解中に施すことができる。
;ビンブラスチン(ビンブラスチン硫酸塩、ビンカロイコブラスチン及びVLB、Alkaban−AQ(登録商標)及びVelban(登録商標)としても公知);及びビノレルビン(Navelbine(登録商標))が挙げられる。例示的なプロテオソーム阻害剤として、ボルテゾミブ(Velcade(登録商標));カルフィルゾミブ(PX−171−007、(5)−4−メチル−N−((5)−l−(((5)−4−メチル−l−((R)−2−メチルオキシラン−2−イル)−l−オキソペンタン−2−イル)アミノ)−l−オキソ−3−フェニルプロパン−2−イル)−2−((5,)−2−(2−モルホリノアセトアミド)−4−フェニルブタンアミド)−ペンタンアミド);マリゾミブ(NPT0052);イキサゾミブクエン酸塩(MLN−9708);デランゾミブ(CEP−18770);及びO−メチル−N−[(2−メチル−5−チアゾリル)カルボニル]−L−セリル−O−メチル−N−[(llS’)−2−[(2R)−2−メチル−2−オキシラニル]−2−オキソ−l−(フェニルメチル)エチル]−L−セリナミド(ONX−0912)が挙げられる。
例えば、本明細書に記載の状態の治療における、又は本明細書に記載のような応答(例えば、がん細胞における減少)を誘導するための活性化CAR T細胞の有効性は、熟練した臨床医により判定されうる。しかし、治療は、用語が本明細書で用いられ、本明細書に記載の状態の徴候又は症状の1つ以上が有利な様式で改変される場合、他の臨床的に認められた症状が改善され、又はさらに寛解され、又は所望される応答が誘導されるとき(例えば本明細書に記載の方法に従う治療後に少なくとも10%)、「有効な治療」と考えられる。有効性は、例えば、本明細書に記載の方法に従って治療される状態のマーカー、指標、症状、及び/若しくは発生率、又は任意の他の測定可能な適切なパラメータを測定することにより評価されうる。本明細書に記載の方法に従う治療は、状態のマーカー又は症状のレベルを、例えば、少なくとも10%、少なくとも15%、少なくとも20%、少なくとも25%、少なくとも30%、少なくとも40%、少なくとも50%、少なくとも60%、少なくとも70%、少なくとも80%若しくは少なくとも90%又はそれ以上低下させうる。
我々は、B細胞受容体(BCR)複合体の一部として、CD79bを標的にするCARを設計した。この手法を用いて、我々は、リンパ腫患者、例えばCD19 CAR療法後にCD19陰性疾患が再発しているリンパ腫患者に対する治療選択肢を増やしている。また、CD79bとCD19の双方を標的にする二重特異性CARを設計した。
我々は、CD8ヒンジ及び膜貫通ドメインを介して4−1BB及びCD3ζに融合された、scFvに基づく抗CD79bを有するCAR構築物を作製した。ヒト初代T細胞に、CD79b又はCD19 CARをレンチウイルスにより形質導入した。MCL細胞株Jeko−1に対する細胞傷害性、T細胞活性化、及びサイトカイン産生について評価した。さらに、Jeko−1腫瘍を有するマウス、及びMCL PDX腫瘍を有するマウスにおける異種移植片実験において、CD79b CARの細胞傷害性効果をCD19 CARと比べて評価した。
図1は、MCL細胞株Jeko−1の、CD79b及びCD19、並びにCD79a、CD37、BCMA、TACI、Fas、CD38、及びCD138の細胞表面発現についての特徴づけの結果を示す。ヒト初代T細胞に、CD19(H/L)CAR、CD79b(L/H)CAR、及びCD79b(H/L)CARを発現するレンチウイルス構築物(例えば図2を参照)を有効に形質導入した(図3)。図4は、非形質導入細胞、並びにCD79b(L/H)CAR及びCD79b(H/L)CAR形質導入細胞の増殖曲線を示す一方で、図5は、CD19又はCD79b CARを、CD19又はCD79bを発現する指定の標的細胞との一晩インキュベーション後に形質導入したJurkat NFATルシフェラーゼレポーター細胞の活性化のレベルを示す(n=3)。
CD79b CARは、高い腫瘍クリアランス、サイトカイン産生、抗原刺激の反復時の拡大、及びインビトロアッセイにおける活性化を示した。MCLの異種移植片モデルにおける腫瘍クリアランスの評価によると、複数の健常T細胞ドナーを通じて、CD79b CARの場合、CD19 CARと同等の完全な腫瘍クリアランスが示された。さらに、二重特異性CARが、CD19とCD79bの双方を発現する細胞により活性化されることが示された。
CD79bに特異的である、本発明の2つのCARポリペプチドの配列は、次の通り、提供及び記載される。
CD79bとCD19の双方に特異的である、本発明の2つのCARポリペプチドの配列は、次の通り、提供及び記載される。
1.CD79bに特異的に結合する配列を含む細胞外ドメインを含むキメラ抗原受容体(CAR)ポリペプチド。
2.CD79bに特異的に結合する配列が、CD79bに対する抗体の抗原結合領域を含む、パラグラフ1のCARポリペプチド。
3.CD79bに特異的に結合する配列が、CD79bに対する一本鎖抗体(scFv)を含む、パラグラフ1又は2のCARポリペプチド。
4.scFvが、軽鎖及び重鎖を含む、パラグラフ3のCARポリペプチド。
5.軽鎖が重鎖に対するN末端側である、パラグラフ4のCARポリペプチド。
6.重鎖が軽鎖に対するN末端側である、パラグラフ4のCARポリペプチド。
7.ヒンジドメイン、膜貫通ドメイン、同時刺激ドメイン、及びシグナル伝達ドメインの1、以上、又は全部をさらに含む、パラグラフ1〜6のいずれか1つのCARポリペプチド。
8.前記ヒンジドメイン、膜貫通ドメイン、同時刺激ドメイン、及びシグナル伝達ドメインの全部を含む、パラグラフ7のCARポリペプチド。
9.ヒンジドメイン及び膜貫通ドメインが、CD8ヒンジドメイン及び膜貫通ドメインである、パラグラフ7又は8のCARポリペプチド。
10.同時刺激ドメインが、4−1BB同時刺激ドメインである、パラグラフ7〜9のいずれか1つのCARポリペプチド。
11.シグナル伝達ドメインが、CD3ζシグナル伝達ドメインである、パラグラフ7〜10のいずれか1つのCARポリペプチド。
12.抗CD79b scFv、CD8ヒンジドメイン及び膜貫通ドメイン、4−1BB同時刺激ドメイン、及びCD3ζシグナル伝達ドメインを含む、パラグラフ1〜11のいずれか1つのCARポリペプチド。
13.細胞外ドメインが、CD19に特異的に結合する配列をさらに含む、パラグラフ1〜12のいずれか1つのCARポリペプチド。
14.CD19に特異的に結合する配列が、CD19に対する抗体の抗原結合領域を含む、パラグラフ13のCARポリペプチド。
15.CD19に結合する配列が、CD19に対する一本鎖抗体(scFv)を含む、パラグラフ13又は14のCARポリペプチド。
16.scFvが、軽鎖及び重鎖を含む、パラグラフ15のCARポリペプチド。
17.軽鎖が重鎖に対するN末端側である、パラグラフ16のCARポリペプチド。
18.重鎖が軽鎖に対するN末端側である、パラグラフ16のCARポリペプチド。
19.CD79bに結合する配列が、CD19に結合する配列に対するN末端側である、パラグラフ13〜18のいずれか1つのCARポリペプチド。
20.CD19に結合する前記配列が、CD79bに結合する配列に対するN末端側である、パラグラフ13〜18のいずれか1つのCARポリペプチド。
21.配列番号1、2、10、若しくは11の配列、若しくはその変異体を含み、ここで配列が、任意選択的には配列番号3のCD8リーダー配列を含まない、パラグラフ1〜20のいずれか1つのCARポリペプチド。
22.配列番号3のCD8リーダー配列、若しくはその変異体を含む、パラグラフ1〜21のいずれか1つのCARポリペプチド。
23.配列番号4の抗CD79b軽鎖配列、若しくはその変異体を含む、パラグラフ1〜22のいずれか1つのCARポリペプチド。
24.配列番号6の抗CD79b重鎖配列、若しくはその変異体を含む、パラグラフ1〜23のいずれか1つのCARポリペプチド。
25.配列番号5のリンカー配列、若しくはその変異体を含む、パラグラフ1〜24のいずれか1つのCARポリペプチド。
26.配列番号7のCD8膜貫通及びヒンジ配列、若しくはその変異体を含む、パラグラフ1〜25のいずれか1つのCARポリペプチド。
27.配列番号8の4−1BB ICD配列、若しくはその変異体を含む、パラグラフ1〜26のいずれか1つのCARポリペプチド。
28.配列番号9のCD3ζ ICD配列、若しくはその変異体を含む、パラグラフ1〜27のいずれか1つのCARポリペプチド。
29.配列番号13の抗CD19 scFv配列、若しくはその変異体を含む、パラグラフ13〜20のいずれか1つのCARポリペプチド。
30.パラグラフ1〜29のいずれか1つのCARポリペプチドをコードする配列を含む核酸分子。
31.パラグラフ30の核酸分子を含むベクター。
32.パラグラフ1〜29のいずれか1つのCARポリペプチド、パラグラフ30の核酸分子、又はパラグラフ31のベクターを含む細胞。
33.ヒト初代T細胞である、パラグラフ32に記載の細胞。
34.パラグラフ1〜29のいずれか1つのCARポリペプチド、パラグラフ30の核酸分子、パラグラフ31のベクター、又はパラグラフ32若しくは33の細胞を含む医薬組成物。
35.がんを有する又は発現するリスクがある対象を治療する方法であって、パラグラフ34の医薬組成物を対象に投与することを含む、方法。
36.がんがリンパ腫である、パラグラフ35の方法。
37.リンパ腫が非ホジキンリンパ腫であるパラグラフ36の方法。
38.非ホジキンリンパ腫が、マントル細胞リンパ腫(MCL)、びまん性大細胞型B細胞リンパ腫(DLBCL)、原発性縦隔B細胞リンパ腫(PMBCL)、慢性リンパ性白血病(CLL)、及び小リンパ球性リンパ腫(SLL))からなる群から選択される、パラグラフ37の方法。
39.CD19 CAR療法を受けた後でCD19陰性リンパ腫が再発している対象を治療する方法であって、パラグラフ34の医薬組成物を対象に投与することを含む、方法。
40.CD79b、又はCD79b及びCD19に特異的なCARを発現するCAR T細胞を作製する方法であって、パラグラフ30の核酸分子又はパラグラフ31のベクターをT細胞に導入することを含む、方法。
41.T細胞がヒト初代T細胞である、パラグラフ40の方法。
Claims (41)
- CD79bに特異的に結合する配列を含む細胞外ドメインを含むキメラ抗原受容体(CAR)ポリペプチド。
- CD79bに特異的に結合する前記配列が、CD79bに対する抗体の抗原結合領域を含む、請求項1に記載のCARポリペプチド。
- CD79bに特異的に結合する前記配列が、CD79bに対する一本鎖抗体(scFv)を含む、請求項1に記載のCARポリペプチド。
- 前記scFvが、軽鎖及び重鎖を含む、請求項3に記載のCARポリペプチド。
- 前記軽鎖が前記重鎖に対するN末端側である、請求項4に記載のCARポリペプチド。
- 前記重鎖が前記軽鎖に対するN末端側である、請求項4に記載のCARポリペプチド。
- ヒンジドメイン、膜貫通ドメイン、同時刺激ドメイン、及びシグナル伝達ドメインの1、以上、又は全部をさらに含む、請求項1に記載のCARポリペプチド。
- 前記ヒンジドメイン、膜貫通ドメイン、同時刺激ドメイン、及びシグナル伝達ドメインの全部を含む、請求項7に記載のCARポリペプチド。
- 前記ヒンジドメイン及び膜貫通ドメインが、CD8ヒンジドメイン及び膜貫通ドメインである、請求項7に記載のCARポリペプチド。
- 前記同時刺激ドメインが、4−1BB同時刺激ドメインである、請求項7に記載のCARポリペプチド。
- 前記シグナル伝達ドメインが、CD3ζシグナル伝達ドメインである、請求項7に記載のCARポリペプチド。
- 抗CD79b scFv、CD8ヒンジドメイン及び膜貫通ドメイン、4−1BB同時刺激ドメイン、及びCD3ζシグナル伝達ドメインを含む、請求項1に記載のCARポリペプチド。
- 前記細胞外ドメインが、CD19に特異的に結合する配列をさらに含む、請求項1に記載のCARポリペプチド。
- CD19に特異的に結合する前記配列が、CD19に対する抗体の抗原結合領域を含む、請求項13に記載のCARポリペプチド。
- CD19に結合する前記配列が、CD19に対する一本鎖抗体(scFv)を含む、請求項13に記載のCARポリペプチド。
- 前記scFvが、軽鎖及び重鎖を含む、請求項15に記載のCARポリペプチド。
- 前記軽鎖が前記重鎖に対するN末端側である、請求項16に記載のCARポリペプチド。
- 前記重鎖が前記軽鎖に対するN末端側である、請求項16に記載のCARポリペプチド。
- CD79bに結合する前記配列が、CD19に結合する前記配列に対するN末端側である、請求項13に記載のCARポリペプチド。
- CD19に結合する前記配列が、CD79bに結合する前記配列に対するN末端側である、請求項13に記載のCARポリペプチド。
- 配列番号1、2、10、若しくは11の配列、若しくはその変異体を含み、ここで前記配列が、任意選択的には配列番号3のCD8リーダー配列を含まない、請求項1に記載のCARポリペプチド。
- 配列番号3のCD8リーダー配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号4の抗CD79b軽鎖配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号6の抗CD79b重鎖配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号5のリンカー配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号7のCD8膜貫通及びヒンジ配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号8の4−1BB ICD配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号9のCD3ζ ICD配列、若しくはその変異体を含む、請求項1に記載のCARポリペプチド。
- 配列番号13の抗CD19 scFv配列、若しくはその変異体を含む、請求項13に記載のCARポリペプチド。
- 請求項1に記載のCARポリペプチドをコードする配列を含む核酸分子。
- 請求項30に記載の核酸分子を含むベクター。
- 請求項1に記載のCARポリペプチドを含む細胞。
- ヒト初代T細胞である、請求項32に記載の細胞。
- 請求項1に記載のCARポリペプチドを含む医薬組成物。
- がんを有する又は発現するリスクがある対象を治療する方法であって、請求項34に記載の医薬組成物を前記対象に投与することを含む、方法。
- 前記がんが、リンパ腫である、請求項35に記載の方法。
- 前記リンパ腫が、非ホジキンリンパ腫である、請求項36に記載の方法。
- 前記非ホジキンリンパ腫が、マントル細胞リンパ腫(MCL)、びまん性大細胞型B細胞リンパ腫(DLBCL)、原発性縦隔B細胞リンパ腫(PMBCL)、慢性リンパ性白血病(CLL)、及び小リンパ球性リンパ腫(SLL))からなる群から選択される、請求項37に記載の方法。
- CD19 CAR療法を受けた後でCD19陰性リンパ腫が再発している対象を治療する方法であって、請求項34に記載の医薬組成物を前記対象に投与することを含む、方法。
- CD79b、又はCD79b及びCD19に特異的なCARを発現するCAR T細胞を作製する方法であって、請求項30に記載の核酸分子を導入することを含む、方法。
- 前記T細胞が、ヒト初代T細胞である、請求項40に記載の方法。
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