JP6748157B2 - 抗上皮成長因子受容体変異体iiiキメラ抗原受容体及び癌の治療のためのその使用 - Google Patents
抗上皮成長因子受容体変異体iiiキメラ抗原受容体及び癌の治療のためのその使用 Download PDFInfo
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Description
本特許出願は、2011年4月8日出願の米国仮特許出願第61/473,409号(参照によりその全体が本願明細書中に組み込まれる)の利益を主張する。
本願明細書と同時提出される、以下:
24,425バイトのASCII(テキスト)ファイル1件(名称「709980_ST25.TXT」、2012年3月5日作成)、
と特定される、コンピューターで可読なヌクレオチド/アミノ酸の配列表が、本明細書中、参照によりその全体が組み込まれる。
米国癌協会により、米国では毎年おおよそ20,500件の、原発性脳腫瘍及び神経系腫瘍の新規症例が発生し、おおよそ12,740人の患者が当該癌の結果死亡すると推定されている(Jemal et al.,Cancer J.Clin.,57:43−66(2007))。脳腫瘍は、全ての中枢神経系悪性腫瘍のうちおおよそ85〜90%を占める。膠芽細胞腫は、最も侵襲的且つ最も一般的な神経膠腫であり、全ての神経膠腫の51%を占める(CBTRUS 2008 統計報告:米国における原発性脳腫瘍−CBTRUS,2000−2004(2008))。外科的切除、放射線治療、及び化学療法等の従来治療の進歩にもかかわらず、神経膠腫並びに他のタイプの脳及び神経系の癌の予後は不良であり得る。例えば、多形性膠芽腫(GBM)の患者が生存するのは、大抵、診断から15ヶ月未満である。従って、癌、特に神経膠腫に対して、満たされていない更なる治療のニーズが存在する。
本発明の1実施形態は、ヒト抗体139の抗原結合ドメイン、細胞外ヒンジドメイン、膜貫通ドメイン、及び細胞内T細胞シグナル伝達ドメインを含む、キメラ抗原受容体(CAR)を提供する。
本発明の1実施形態は、ヒト抗体139(h139Ab)の抗原結合ドメイン、細胞外ヒンジドメイン、膜貫通ドメイン及び細胞内T細胞シグナル伝達ドメインを含む、キメラ抗原受容体(CAR)を提供する。
列番号1を含む軽鎖可変領域及び/又は配列番号2を含む重鎖可変領域を含む。
的変異体の生物活性が増加する。
2001;及びAusubelら,Current Protocols in Molecular Biology,Greene Publishing Associates and John Wiley&Sons,NY,1994を参照。さらに、本発明のCAR(その機能的部分及び機能的変異体を含む)のあるものは、植物、細菌、昆虫、哺乳動物(例えば、ラット、ヒトなど)などの供給源から、単離及び/又は精製され得る。単離及び精製の方法は当該分野で周知である。或いは、本明細書中に記載されるCAR(その機能的部分及び機能的変異体を含む)は、Synpep(Dublin,CA)、Peptide Technologies Corp.(Gaithersburg,MD)及びMultiple Peptide Systems(San Diego,CA)などの企業によって商業的に合成され得る。これに関して、本発明のCARは、合成、組換え、単離及び/又は精製され得る。
61−67(1984)、並びにRoderら,Methods Enzymol.,121,140−67(1986))、及びバクテリオファージベクター発現系(例えば、Huseら,Science,246,1275−81(1989)を参照))。さらに、非ヒト動物において抗体を産生する方法が、例えば、米国特許第5,545,806号,同第5,569,825号及び同第5,714,352号、並びに米国特許出願公開2002/0197266A1に記載されている。
発明の1実施形態は、(リーダー配列、ヒト抗体139の軽鎖可変領域、リンカーペプチド、及びヒト抗体139の重鎖可変領域をコードする)配列番号12を含むヒト抗体139の抗原結合ドメインをコードする核酸配列を含む核酸を提供する。これに関して、本発明の1実施形態は、表2のヌクレオチド配列を含むか、これからなるか又は本質的にこれからなる核酸を提供する。
アクリジン置換ヌクレオチド)を使用して、化学的に合成され得る。核酸を生成するために使用され得る修飾ヌクレオチドの例としては、以下が挙げられるがこれらに限定されない:5−フルオロウラシル、5−ブロモウラシル、5−クロロウラシル、5−ヨードウラシル、ヒポキサンチン、キサンチン、4−アセチルシトシン、5−(カルボキシヒドロキシメチル)ウラシル、5−カルボキシメチルアミノメチル−2−チオウリジン、5−カルボキシメチルアミノメチルウラシル、ジヒドロウラシル、β−D−ガラクトシルキューオシン(β−D−galactosylqueosine)、イノシン、N6−イソペンテニルアデニン、1−メチルグアニン、1−メチルイノシン、2,2−ジメチルグアニン、2−メチルアデニン、2−メチルグアニン、3−メチルシトシン、5−メチルシトシン、N6−置換アデニン、7−メチルグアニン、5−メチルアミノメチルウラシル、5−メトキシアミノメチル−2−チオウラシル、β−D−マンノシルキューオシン(β−D−mannosylqueosine)、5’−メトキシカルボキシメチルウラシル、5−メトキシウラシル、2−メチルチオ−N6−イソペンテニルアデニン、ウラシル−5−オキシ酢酸(v)、ワイブトキソシン(wybutoxosine)、シュードウラシル(pseudouracil)、キューオシン(queosine)、2−チオシトシン、5−メチル−2−チオウラシル、2−チオウラシル、4−チオウラシル、5−メチルウラシル、ウラシル−5−オキシ酢酸メチルエステル、3−(3−アミノ−3−N−2−カルボキシプロピル)ウラシル及び2,6−ジアミノプリン。或いは、本発明の核酸の1以上は、Macromolecular Resources(Fort Collins,CO)及びSynthegen(Houston,TX)などの企業から購入できる。
核酸を提供する。
(2005)及びKirinら,Inorg Chem.44(15):5405−5415(2005)を参照)。
E.coli細胞、チャイニーズハムスター卵巣細胞、サルVERO細胞、COS細胞、HEK293細胞などが挙げられる。組換え発現ベクターを増幅又は複製する目的のために、宿主細胞は、DH5α細胞などの原核生物細胞であり得る。組換えCARを産生する目的のために、宿主細胞は哺乳動物細胞であり得る。宿主細胞はヒト細胞であり得る。宿主細胞は任意の細胞型のものであり得、任意の組織型に由来し得、任意の発生段階のものであり得るが、宿主細胞は、末梢血リンパ球(PBL)又は末梢血単核球(PMBC)であり得る。宿主細胞はT細胞であり得る。
調製物である。かかる宿主細胞は、例えば、標準的な精製技術によって生成され得る。いくつかの実施形態において、宿主細胞の調製物は、その調製物の総細胞含量の少なくとも約50%、例えば少なくとも約70%を宿主細胞が占めるように、精製される。例えば、純度は、少なくとも約50%であり得、約60%、約70%又は約80%より高くてもよく、或いは約100%であり得る。
ippincott Williams&Wilkins;第21版(2005年5月1日)。
エタノールアミン塩が挙げられ、適切な洗剤には以下が挙げられる:(a)カチオン性洗剤(例えば、ジメチルジアルキルアンモニウムハライド及びアルキルピリジニウムハライド)、(b)アニオン性洗剤(例えば、アルキル、アリール及びオレフィンスルホン酸塩、アルキル、オレフィン、エーテル及びモノグリセリド硫酸塩及びスルホコハク酸塩)、(c)非イオン性洗剤(例えば、脂肪アミンオキシド、脂肪酸アルカノールアミド及びポリオキシエチレンポリプロピレンコポリマー)、(d)両性洗剤(例えば、アルキル−β−アミノプロピオン酸塩及び2−アルキル−イミダゾリン第4級アンモニウム塩)、並びに(e)それらの混合物。
であり得る。
適合している。
び/又は細胞に対して実験法を行なうために、個体から組織及び/又は細胞を収集するためのものであり得る。この実験法は、個体が特定の状態又は疾患状態(disease−state)を有する及び/又はそれらに罹患しているか否かを決定するための実験を含み得る。状態又は疾患は、例えば癌であり得る。
この実施例により、EGFRvIIIで改変された標的細胞株との共培養後に、配列番号10(h139Ab−hCD828BBZ)又は配列番号11(h139Ab−hCD28Z)を含むCARにより、IFNガンマが産生されることが証明される。
出(表3A及び3B)で測定された生物学的活性により、異なる2つのベクターで形質導入されたT細胞は、EGFRvIIIを発現する神経膠腫細胞株U87及びU251への反応性が同等であることが証明された。
この実施例により、配列番号10(h139Ab−hCD828BBZ)又は配列番号11(h139Ab−hCD28Z)を含むCARによって、変異型EGFRvIIIを発現するよう改変された細胞株が、特異的に溶解されることが証明される。
この実施例により、腫瘍幹細胞(TSC)株との共培養後に、抗EGFRvIII CAR(配列番号10(h139Ab−hCD828BBZ))により、IFN−ガンマが産生されることが証明される。
この実施例により、CARで改変されたT細胞がT細胞数の増大後に反応性を保持することが証明される。
01(1990))により入手できる。139−28BBZ(h139Ab−hCD828BBZ)CARで形質導入したT細胞が患者の治療に十分な数に増殖でき、依然反応性を維持できることを確認するため、これらのT細胞をREPに供して試験した。表4に示すとおり、139−CARで形質導入したT細胞は、特異的にIFN−γを産生するその能力を保持した。
この実施例により、細胞に形質導入するためのウイルスベクター上清を製造するために有用な産生細胞クローンの生成が証明される。
この実施例により、患者に配列番号10(h139Ab−hCD828BBZ)を含むCARを投与することを含む、ヒト患者における癌を治療又は予防する方法が実証される。
適格患者は、免疫組織化学(IHC)によって決定された、EGFRvIIIを発現する、組織学的に証明された膠芽細胞腫;化学療法を伴うか、又は伴わない放射線療法による標準的な前治療の失敗;60%を超えるか、又はそれに等しいカルノフスキースコア;許容限度内の心臓、肺、及び実験のパラメータを有する。
研究は第I/II相のデザインを用いて行う。患者は、臨床試験における2群:1)治
療の開始時にステロイドの使用を必要とする再発悪性神経膠腫の患者又は2)治療開始時にステロイドの使用を必要としない再発悪性神経膠腫の患者、の第I相部及び第II相部の両方に登録されている。試験の第I相部において、個々の各群について最大耐量が決定されると、研究が第II相部へと進む。再び、患者を同じ2つのグループに登録する。評価した二群のそれぞれについて、単一段階第II相のデザインを用いて研究を行う。
白血球分離(約1X1010細胞)によってPBMCを得る。PBMC全体を、T細胞増殖を刺激するために、抗CD3(OKT3)及びアルデスロイキンの存在下で培養する。形質導入は、抗EGFRvIII CARレトロウイルスベクターを含有する上清に約1×107〜5×108細胞を曝露することよって開始する。これらの形質導入細胞を増殖させ、その抗腫瘍活性について試験する。CAR遺伝子導入の成功はCARタンパク質についてのFACS分析によって決定し、抗腫瘍反応性はEGFRvIIIを発現する細胞に対するサイトカイン放出の測定によって試験する。それぞれの形質導入PBL集団についてのCAR遺伝子導入の成功は、10%超のCAR陽性細胞として定義するが、生物活性については、ガンマ−インターフェロンの分泌が少なくとも200pg/mlで、且つバックグラウンドの2倍のレベルでなければならない。
PBLは、キメラの抗EGFRvIII CARを含有するレトロウイルス上清で形質導入される。抗原EGFRvIIIに対するキメラ抗原受容体(CAR)をコードするレトロウイルスベクターの上清(PG13−139−F10)を、現行の品質管理規則(cGMP)の条件に従って調製し、保存する。レトロウイルスベクターは、MSGV1レトロウイルスベクターの主鎖を利用しており、マウス幹細胞ウイルス由来の5’LTR(プロモーター)、スプライシングドナー(SD)及びスプライシングアクセプター部位を含むパッケージングシグナル、シグナルペプチドシグナル(ヒトGM−CSFR)、139軽鎖可変領域、リンカーペプチド、139重鎖可変領域、CD8(ヒンジ、膜貫通)、CD28(細胞質領域)、4−1BB(細胞質領域)、及びTCRゼータ(細胞質領域)を含有するヒト抗EGFRvIIIのscFv(mAb139)をベースにしたCARタンパク質、続いてマウス幹細胞ウイルス3’LTRを含む4,032bpを含む。ベクターは、配列番号10のアミノ酸配列をコードする、配列番号13のヌクレオチド配列を含む。物理的な力価は、提供者の証明書に従ってRNAドットブロットにより測定する。24時間体制での温度モニタリングを伴う、−80℃での製造が完了した際に、上清をSBVPFに保存する。求められれば、上清はドライアイスに置いて配送し、in vitro形質導入において用いられる。別の患者のために、同一ユニットの上清を再利用することはない。レトロウイルスの力価は、即時解凍及び即時投与(予めレトロネクチンでコーティングされた組織培養ウェルのコーティング)の後で安定であることが示されている。ベクターの取り扱いはバイオセーフティレベル2(BSL−2)のガイドラインに従う。
プロトコルは、8コホート及び2つの異なる群(治療時にステロイドを受容している患者のためのものと、ステロイドを受容してしない患者のためのもの)による、第1相の用量漸増デザインから始まる。各グループは、完全に独立した用量漸増試験として扱われる。
大耐量の安全性を更に特性分析するために、さらに3人の患者を、最低用量に次ぐ低用量において登録する。
治療日程を表6に記載する:
治療に先立って、また治療の4〜6週間後に、アフェレシス療法を行う。別の時点で、フィコールクッションによる遠心分離を用いて精製することにより患者の末梢血リンパ球(PBL)を全血から得る。これらのPBMCのアリコートを、1)細胞機能の免疫学的モニタリングのために凍結保存し、2)CARのPCR分析及びベクターコピー数推定のためにDNA及びRNAの抽出に供し、そして3)リンパ球を直接、及びインビトロ培養後に試験する。直接の免疫学的モニタリングとしては、CAR特異的染色を用いたFACS分析によって、EGFRvIIIに反応性のあるT細胞を定量することが挙げられる。十分な細胞が利用可能であれば、ex vivoでの免疫学的アッセイとしては、バルクPBL(+/−抗原刺激)によるサイトカイン放出及び細胞溶解等の他の実験的研究によるサイトカイン放出が挙げられる。細胞数が限られている場合、好ましくは、免疫学的活性を直接分析することが好ましい。免疫学的アッセイは、1)PBMCの前注入、及び2)注入時に凍結保存された、改変されたPBLのアリコート、を含めることによって標準化される。一般に、これらのアッセイでの2〜3倍の違いが真の生物学的相違を示す。
改変された細胞の生存:PBMC試料におけるCAR及びベクターの存在を、確立されたPCR技術を用いて定量する。CAR特異的染色を用いた免疫学的モニタリングを、PCRベースの解析を増補するために使用する。これにより、注入された細胞に由来するリ
ンパ球のin vivoでの生存率を推定するためのデータが提供される。更に、CD4T細胞及びCD8T細胞の測定を行い、血流中のこれらのT細胞サブセットを、それぞれのレトロウイルスベクターで改変されたT細胞についてのユニークなDNA配列を検出することができる特異的PCRアッセイを用いて測定し調査する。
日常的経過観察:患者は初期治療法後4週間(+/−7日)(最後のアルデスロイキン投与の終了時と定義される)に評価される。患者にSD又は腫瘍の縮小がある場合、完全な評価を12ヶ月間、毎月(+/−7日間)繰り返し行い、次いで1−2ヶ月(+/−7日)ごとに適宜行う。
を各評価で行う。
細胞注入後5年間、毎年理学的検査を行い、文書化して長期的な安全性を評価する。5年後、健康状態のデータを、電話連絡又は郵送のアンケートを通して生存患者から得る。レトロウイルスベクターの長期の経過観察期間は15年である。
この試験の一環としてだけでなく、腫瘍の進行の判定に役立てるために、患者の腫瘍における画像的変化を経時的に観察するよう全力で取り組む。
明確な、測定可能な、又は評価可能な腫瘍がない。
完全寛解(CR):完全寛解には以下:少なくとも4週間持続する、測定可能及び測定不可能なすべての増強病変の完全な消失;新たな病変がないこと;非増強(T2/FLAIR)病変の安定又は改善;のすべてが必要であり、患者はコルチコステロイドを受容していないか、又は生理的補充用量のみ受容していて、且つ臨床的に安定であるか、又は改善されていなければならない。4週間後にスキャンを確認しないときは、この寛解は安定病変に過ぎないとみなす。
ときに得られたスキャンである。
評価可能病変を各評価で記録する。FLAIR像又はT2強調像も、適宜評価可能病変と判断すべきである。
+3=腫瘍の消失(CR)
+2=明確に好転(PR)
+1=好転の可能性あり
0 =不変
−1=悪化の可能性あり
−2=明確に悪化(PD)
−3=新たな病変の発生(PD)
をMRIスキャンの相対変化を指定するために用いる。
完全寛解(CR)は、MRIスキャンが+3にランク付けされ、神経画像で腫瘍がもはや見られない状況、及び腫瘍で惹起される脳浮腫抑制のためのステロイドを患者がもはや必要としない状況と定義する。
の参考文献が参照によって組み込まれることが個々に且つ具体的に示されているのと同程度又はその全体が本明細書中に記載されているのと同程度まで、参照によって本明細書中に組み込まれる。
Claims (16)
- (a)ヒト抗体139の抗原結合ドメイン、ヒトCD8の細胞外ヒンジドメイン、ヒトCD8の膜貫通ドメイン、ヒトCD28の細胞内T細胞シグナル伝達ドメイン、ヒト4−1BBの細胞内T細胞シグナル伝達ドメイン、及びヒトCD3ζの細胞内T細胞シグナル伝達ドメイン;又は
(b)ヒト抗体139の抗原結合ドメイン、ヒトCD28の細胞外ヒンジドメイン、ヒトCD28の膜貫通ドメイン、ヒトCD28の細胞内T細胞シグナル伝達ドメイン、及びヒトCD3ζの細胞内T細胞シグナル伝達ドメイン
を含む、キメラ抗原受容体(CAR)であって、
宿主細胞において該CARが発現すると、EGFRvIIIポジティブ細胞を特異的に溶解させる能力を付与し、
ここで前記抗原結合ドメインが、配列番号1で示されるアミノ酸配列を含む軽鎖可変領域及び配列番号2で示されるアミノ酸配列を含む重鎖可変領域を含み、
上記(a)を含むCARは、配列番号10で示されるアミノ酸配列と少なくとも90%同一性を有するアミノ酸配列を含み、上記(b)を含むCARは、配列番号11で示されるアミノ酸配列と少なくとも90%同一性を有するアミノ酸配列を含み、
CARを発現する宿主細胞は、EGFRvIIIを発現する細胞と共培養すると、インターフェロン−γを分泌する、
CAR。 - 抗原結合ドメインが、配列番号3を含むリンカーペプチドを含む、請求項1に記載のCAR。
- 抗原結合ドメインが、配列番号4を含むリーダー配列を含む、請求項1又は2に記載のCAR。
- 抗原結合ドメインが、配列番号5を含む、請求項1〜3のいずれか1項に記載のCAR。
- 細胞内ヒンジドメインをさらに含む、請求項1〜4のいずれか1項に記載のCAR。
- CD8の細胞外ヒンジドメイン及びCD8の膜貫通ドメイン(配列番号6)を含む、請求項1〜5のいずれか1項に記載のCAR。
- CD28の細胞内T細胞シグナル伝達ドメイン、4−1BBの細胞内T細胞シグナル伝達ドメイン、及びCD3ζの細胞内T細胞シグナル伝達ドメイン(配列番号7)を含む、請求項1〜6のいずれか1項に記載のCAR。
- CD28の細胞外ヒンジドメイン、CD28の膜貫通ドメイン、及びCD28の細胞内T細胞シグナル伝達ドメイン(配列番号8)並びにCD3ζの細胞内T細胞シグナル伝達ドメイン(配列番号9)を含む、請求項1〜4のいずれか1項に記載のCAR。
- 請求項1〜8のいずれか1項に記載のCARをコードするヌクレオチド配列を含む、核酸。
- 配列番号12のヌクレオチド配列を含む、請求項9に記載の核酸。
- 請求項9又は10に記載の核酸を含む、組換え発現ベクター。
- 請求項11に記載の組換え発現ベクターを含む、単離された宿主細胞。
- 請求項12に記載の宿主細胞を少なくとも1つ含む、細胞集団。
- 請求項1〜8のいずれか1項に記載のCAR、請求項9又は10に記載の核酸、請求項11に記載の組換え発現ベクター、請求項12に記載の宿主細胞、又は請求項13に記載の細胞集団と、医薬上許容される担体とを含む、医薬組成物。
- 宿主における癌の存在を検出する方法であって、
(a)宿主由来の1以上の細胞を含むサンプルを、請求項1〜8のいずれか1項に記載のCAR、請求項9又は10に記載の核酸、請求項11に記載の組換え発現ベクター、請求項12に記載の宿主細胞、又は請求項13に記載の細胞集団と接触させることによって、複合体を形成する工程、及び
(b)複合体を検出する工程であって、該複合体の検出が宿主における癌の存在を示す、工程、
を含む、方法。 - 癌の治療用又は予防用医薬組成物であって、請求項1〜8のいずれか1項に記載のCAR、請求項9又は10に記載の核酸、請求項11に記載の組換え発現ベクター、請求項12に記載の宿主細胞、請求項13に記載の細胞集団、又は請求項14に記載の医薬組成物を含む、医薬組成物。
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