JP2022189827A - 癌を治療するための免疫調節剤と組み合わせた低酸素活性化型プロドラッグの投与 - Google Patents
癌を治療するための免疫調節剤と組み合わせた低酸素活性化型プロドラッグの投与 Download PDFInfo
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Abstract
Description
本出願は、2016年8月1日に出願された米国仮特許出願第62/369,691号に係る優先権の利益を主張するものであり、該仮特許出願を全体として参照により本明細書に援用する。
発明の分野
低酸素性癌細胞を標的化することによって癌を治療するための特定の剤が作られた(例えば、低酸素活性化型プロドラッグ(HAP)を開示する米国特許第7,550,496号;同第8,299,088号;同第8,003,625号;同第8,507,464号;同第8,664,204号;同第9,226,932号;同第8,552,048号;および同第8,946,275号、ならびに米国特許出願第13/806,088号;同第13/809,135号;同第14/009,068号;同第14/110,819号;同第14/033491号;同第14/367,188号;同第14/367,152号;同第14/375,417号;同第14/380,054号;同第14/783776、号;および同第14/907,190号、ならびにPCT国際特許出願第PCT/US2014/062532号;同第PCT/US2015/029297号;同第PCT/US2015/040642号;同第PCT/US15/41100号;および同第PCT/US2015/61248号(そのそれぞれを参照により本明細書に援用する)を参照)。斯かるHAPの一例は、TH-302またはエボフォスファミドである。
第一の態様において、本発明は、癌を治療する方法を提供するものであり、前記方法は、斯かる治療を必要とする患者に、治療的有効量の免疫調節剤または免疫調節物質、例えば、これだけに限定されるものではないが、イピリムバブ、ペムブロリズマブおよびニボルマブを含めた抗CTLA-4、抗PD-1、抗PD-L1、抗PD-L2抗体または作動性4-1BB抗体など、と組み合わせた治療的有効量のHAPを投与すること含む。
本発明の実施は、当該分野の技術の範囲内の有機化学、分子生物学(組み換え技術など)、微生物学、細胞生物学、生化学および免疫学の従来の技術の使用を含む。
以下の明細書および特許請求の範囲において、以下の意味を有する多くの用語に対する参照がなされる。全ての数値指定、例えばpH、温度、時間、濃度および重量(それらのそれぞれの範囲を含む)は、適切な場合に0.1、1.0または10.0の増分により典型的に(+)または(-)に変化し得る近似値である。全ての数値指定は、用語「約」が前につくと理解され得る。本明細書に記載される試薬は、当該技術分野で公知であり得るものの典型および同等物である。
一態様において、本発明は、癌の治療を必要とする患者に、治療的有効量のHAPおよび治療的有効量の免疫調節物質を投与し、それにより癌を治療することを含む、癌の治療方法を提供する。一実施形態において、以前に免疫調節物質またはHAPで治療されたが、治療にも関わらず癌が進行しているか、または癌の進行のために治療が中断された患者に併用療法が施与される。他の実施形態において、患者は、任意の抗癌薬で以前に治療されていない。他の実施形態において、患者は、免疫調節物質またはHAP以外の抗癌薬で以前に治療されている。
以下の化合物は、本発明にしたがってHAPと組み合わせた投与に有用である。
i.対象の癌を治療する方法であって、対象に、本明細書に記載されたHAPおよび免疫調節剤を投与することを含む方法。
ii.免疫チェックポイント分子の阻害剤が、PD-1、PD-L1、PD-L2、およびCTLA4から選択される、先の実施形態i~iiiのいずれか一項に記載の方法。
iii.免疫チェックポイント分子の阻害剤が、PD-1、PD-L1、もしくはCTLA4の阻害剤またはそれらの任意の組み合わせから選択される、実施形態i~iiのいずれか一項に記載の方法。
iv.免疫チェックポイント分子の阻害剤が、免疫チェックポイント分子に結合する可溶性リガンドまたは抗体またはそれらの抗原結合フラグメントである、実施形態i~iiiのいずれか一項に記載の方法。
v.抗体分子が、PD-1またはPD-L1に対する第1の結合特異性、およびPD-L2に対する第2の結合特異性を有する二重特異性または多重特異性抗体分子である、実施形態i~ivのいずれか一項に記載の方法。
vi.免疫調節剤が、ニボルマブ、ペムブロリズマブまたはピジリズマブから選択される抗PD-1抗体である、実施形態i~vのいずれか一項に記載の方法。
vii.免疫調節剤が、YW243.55.S70、MPDL3280A、MEDI-4736、MSB-0010718C、またはMDX-1105から選択される抗PD-L1抗体である、実施形態i~xのいずれか一項に記載の方法。
viii.免疫調節剤が、注射(例えば、皮下にまたは静脈内に)により、約1から30mg/kg、例えば、約5から25mg/kg、約10から20mg/kg、約1から5mg/kg、または約3mg/kgの用量で、例えば、1週間に1回から2、3、または4週間ごとに1回投与される抗PD-1抗体分子である、実施形態i~viiのいずれか一項に記載の方法。
ix.抗PD-1抗体分子が、1週おきに約10から20mg/kgの用量で投与される、実施形態viiiの方法。
x.抗PD-1抗体分子、例えばニボルマブが、2週間ごとに約1mg/kgから3mg/kg、例えば、約1mg/kg、2mg/kgまたは3mg/kgの用量で静脈内に投与される、実施形態ixの方法。
xi.抗PD-1抗体分子、例えば、ニボルマブが、静脈内に約2mg/kgの用量で、3週間の間隔で投与される、実施形態xの方法。
5×105~1×106個のTRAMP-C2、C57BL/6J、B6、FVB F1細胞、および/またはルシフェラーゼを発現するPanc02膵管腺癌細胞を、アルビノまたはODD-Lucレポーターマウスの右側の皮下に同所移殖する。マウスを、合間に1週間の安静を伴った、TRAMP細胞移殖の1週間、3週間または16週間後のいずれかにTH-302単独(50mg/kgのi.p.、5日間にわたり毎日)を用いて治療される。一部のマウスもまた、1~3サイクルにわたる1、4、7日目および13、16および19日目にi.p.で与えられるCTLA-4遮断抗体9H10、PD-1遮断抗体RMP1-14、および/または作動性4-1BB抗体を用いて治療する。マウスを、生存率(ログ-ランク、マンテル-コックス検定)を観察し、さらに腫瘍増殖を、腫瘍移殖後最長140日間、1週間に一度IVISによって観察した。次いで、マウスを屠殺し、それらの臓器を計量し、そして、腫瘍を、単離し、パラホルムアルデヒドまたはアセトンにより固定し、OCT内に包埋/封入し、凍結させ、薄片にし、抗ピミニダゾールFITC、GR-1 V450、CD11b Alexa546、および/またはF4/80 Alexa647を用いて低酸素状態について染色した。データは、TH-302単独または免疫調節物質単独と共に、増殖遅延を生じたこと、およびTH-302と免疫調節物質の組み合わせにより、いずれかの薬物単独と比較して、腫瘍体積倍加に必要な時間が有意に延長されたことを実証した。
Claims (24)
- 癌を治療する方法であって、斯かる治療を必要とする患者に、治療的有効量の免疫調節物質と組み合わせた治療的有効量の低酸素活性化型プロドラッグ(HAP)を投与することを含む方法。
- 癌を治療する方法であって、以下のステップ:
(i)単独の免疫療法に対して不応性であるかまたは不応性であろう癌に罹患している患者を同定し;および
(ii)単独の免疫療法に対して不応性であるかまたは不応性であろうと同定された患者に、治療的有効量の単独の免疫調節物質と組み合わせた治療的有効量の低酸素活性化型プロドラッグ(HAP)を投与すること、
を含む方法。 - 前記患者がヒトである、請求項1または2に記載の方法。
- 前記化合物がTH-302である、請求項3に記載の方法。
- 前記免疫調節物質が、CTLA-4抗体およびPD-1抗体から成る群から選択される、請求項1~4のいずれか1項に記載の方法。
- 前記免疫調節物質が、イピリムバブ、ペムブロリズマブ、およびニボルマブから成る群から選択される、請求項5に記載の方法。
- 前記免疫調節物質がイピリムバブである、請求項6に記載の方法。
- 前記免疫調節物質がペムブロリズマブである、請求項6に記載の方法。
- 前記免疫調節物質がニボルマブである、請求項6に記載の方法。
- 前記TH-302が、約320mg/m2未満の用量で投与される、請求項4~9のいずれか1項に記載の方法。
- 前記TH-302が1もしくは複数の投薬量サイクルにわたって投与されるものであり、それぞれのサイクルが、約320mg/m2または400mg/m2~約480mg/m2の範囲内のTH-302の注入を含む、請求項4~9のいずれか1項に記載の方法。
- 前記TH-302が、約1~約6時間の注入時間をかけて投与される、請求項10または11に記載の方法。
- 前記TH-302が、5週間サイクルの1、8、29および36日目に一度投与される、請求項12に記載の方法。
- 前記免疫調節物質が、イピリムバブであり、かつ、1もしくは複数の投薬量サイクルにわたって投与されるものであり、それぞれのサイクルが、12週間サイクルの3週間ごとに一度の、約1~2時間の注入時間をかける約3mg/kgの単位用量でのイピリムバブの注入を含む、請求項13に記載の方法。
- 前記免疫調節物質が、TH-302の投与と異なった日に投与される、請求項3~14のいずれか1項に記載の方法。
- 前記免疫調節物質が、TH-302の投与と同じ日に投与される、請求項14に記載の方法。
- 同じ日に投与される場合に、前記TH-302が、免疫調節物質の投与前に投与される、請求項16に記載の方法。
- 同じ日に投与される場合に、前記TH-302が、免疫調節物質の投与後に投与される、請求項16に記載の方法。
- 以下の:
a)約320mg/m2未満の範囲内での注入のために処方されたTH-302の用量;および
b)免疫調節物質の用量、
を含む医薬品組み合わせ物。 - 以下の:
a)約320mg/m2~約480mg/m2の範囲の注入のために処方されたTH-302の用量;および
b)約3mg/kgの注入のために処方されたイピリムバブの用量、
を含む医薬品組み合わせ物。 - 一緒にパッケージ化された、請求項19または20に記載の医薬品組み合わせ物。
- 前記癌が、前立腺癌、膵臓癌、黒色腫、および頭頸部癌から成る群から選択される、請求項1~21のいずれか一項に記載の方法または組み合わせ物。
- 前記頭頸部癌が、ヒトパピローマウイルス(HPV)陰性頭頸部癌である、請求項22に記載の方法または組み合わせ物。
- 前記パッケージ化された医薬品組み合わせ物が、前立腺癌、膵臓癌、黒色腫および頭頸部癌から成る群から選択される癌を治療する際の組み合わせ物の取扱説明書を含んでいる、請求項19または20に記載の医薬品組み合わせ物。
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