JP7214623B2 - ヒトctla-4に対する抗体 - Google Patents
ヒトctla-4に対する抗体 Download PDFInfo
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- JP7214623B2 JP7214623B2 JP2019505381A JP2019505381A JP7214623B2 JP 7214623 B2 JP7214623 B2 JP 7214623B2 JP 2019505381 A JP2019505381 A JP 2019505381A JP 2019505381 A JP2019505381 A JP 2019505381A JP 7214623 B2 JP7214623 B2 JP 7214623B2
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- C07K16/2803—Immunoglobulins [IGs], 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 [IGs], 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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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
- C07K16/30—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants from tumour cells
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Description
配列番号1のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号1と異なるアミノ酸配列を含む、重鎖可変領域CDR1、
配列番号1のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号2と異なるアミノ酸配列を含む、重鎖可変領域CDR2、
配列番号3のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号3と異なるアミノ酸配列を含む、重鎖可変領域CDR3、
配列番号4のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号4と異なるアミノ酸配列を含む、軽鎖可変領域CDR1、
配列番号5のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号5と異なるアミノ酸配列を含む、軽鎖可変領域CDR2、及び
配列番号6のアミノ酸配列、または1、2、3、もしくはそれ以上の保存的置換により配列番号6と異なるアミノ酸配列を含む、軽鎖可変領域CDR3。
a.配列番号1のアミノ酸配列を含む重鎖可変領域CDR1;
b.配列番号2のアミノ酸配列を含む重鎖可変領域CDR2;
c.配列番号3のアミノ酸配列を含む重鎖可変領域CDR3;
d.配列番号4のアミノ酸配列を含む軽鎖可変領域CDR1;
e.配列番号5のアミノ酸配列を含む軽鎖可変領域CDR2;
f.配列番号6のアミノ酸配列を含む軽鎖可変領域CDR3。
a.配列番号7のアミノ酸配列を含む可変重鎖、及び/または配列番号8のアミノ酸配列を含む可変軽鎖を含む、抗体またはその抗原結合断片;
b.配列番号10、12、14、16、18、もしくは20のアミノ酸配列を含む可変重鎖、及び/または配列番号22、24、26、または30のアミノ酸配列を含む可変軽鎖を含む、抗体またはその抗原結合断片;
c.配列番号10、12、14、16、18、もしくは20のいずれか1つに対し少なくとも90%、95%、96%、97%、98%、もしくは99%の同一性を備える可変重鎖、及び/または配列番号22、24、26、もしくは30のいずれか1つに対し少なくとも90%、95%、96%、97%、98%、もしくは99%の同一性を備える可変軽鎖を含む、抗体またはその抗原結合断片;
d.配列番号10、12、14、16、18、もしくは20のいずれか1つに対し少なくとも90%、95%、96%、97%、98%、もしくは99%の同一性を備える可変重鎖、及び/または配列番号22、24、26、もしくは30のいずれか1つに対し少なくとも90%、95%、95%、96%、97%、98%、または99%の同一性を備える可変軽鎖を含む抗体もしくはその抗原結合断片であって、任意の配列バリエーションが、抗体または抗原結合断片のフレームワーク領域内で生じる、抗体またはその抗原結合断片;
e.配列番号10、12、14、16、18、もしくは20のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変重鎖、及び/または配列番号22、24、26、もしくは30のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変軽鎖を含む、抗体またはその抗原結合断片;ならびに
f.配列番号10、12、14、16、18、もしくは20のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変重鎖、及び/または配列番号22、24、26、もしくは30のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変軽鎖を含む抗体またはその抗原結合断片であって、任意の前述の置換が、抗体または抗原結合断片のフレームワーク領域内で生じる、抗体またはその抗原結合断片。
a)ヒトCTLA-4に対し、表面プラズモン共鳴(例えば、BIACORE)または同様の技法(例えば、KinExaまたはOCTET)により少なくとも約1×10-9Mと測定されるKD値で結合する;
b)hCD80に対するhCTLA-4の結合を、約100nM以下のIC50でブロックする;
c)hCD86に対するhCTLA-4の結合を、約100nM以下のIC50でブロックする;
d)イピリムマブまたはトレメリムマブとは異なるCTLA-4エピトープに結合する。
g.ヒトCTLA-4に対し、表面プラズモン共鳴(例えば、BIACORE)または同様の技法(例えば、KinExaまたはOCTET)により少なくとも約1×10-9Mと測定されるKD値で結合する;
h.hCD80に対するhCTLA-4の結合を、約100nM以下のIC50でブロックする;
i.hCD86に対するhCTLA-4の結合を、約100nM以下のIC50でブロックする;
j.イピリムマブまたはトレメリムマブとは異なるCTLA-4エピトープに結合する。
k.抗PD1抗体またはその抗原結合断片;
l.抗LAG3抗体またはその抗原結合断片;
m.抗TIGIT抗体またはその抗原結合断片;
n.抗VISTA抗体またはその抗原結合断片;
o.抗BTLA抗体またはその抗原結合断片;
p.抗TIM3抗体またはその抗原結合断片;
q.抗CD27抗体またはその抗原結合断片;
r.抗HVEM抗体またはその抗原結合断片;
s.抗CD70抗体またはその抗原結合断片;
t.抗CD137抗体またはその抗原結合断片;
u.抗OX40抗体またはその抗原結合断片;
v.抗CD28抗体またはその抗原結合断片;
w.抗PDL1抗体またはその抗原結合断片;
x.抗PDL2抗体またはその抗原結合断片;
y.抗GITR抗体またはその抗原結合断片;
z.抗ICOS抗体またはその抗原結合断片;
aa.抗SIRPα抗体またはその抗原結合断片;
bb.抗ILT2抗体またはその抗原結合断片;
cc.抗ILT3抗体またはその抗原結合断片;
dd.抗ILT4抗体またはその抗原結合断片;
ee.抗ILT5抗体またはその抗原結合断片;
ff.抗4-1BB抗体またはその抗原結合断片;
gg.抗NK2GA抗体またはその抗原結合断片;
hh.抗NK2GC抗体またはその抗原結合断片;
ii.抗NK2GE抗体またはその抗原結合断片;
jj.抗TSLP抗体またはその抗原結合断片;
kk.STINGアゴニスト、及び;
ll.抗IL10抗体またはその抗原結合断片。
mm.本発明のいずれか1つの抗体または抗原結合断片の重鎖及び/または軽鎖をコードするポリヌクレオチドを含む宿主細胞を、ポリヌクレオチドの発現に好ましい条件下で培養することと、
nn.任意選択で、宿主細胞及び/または培地から、抗体または抗原結合断片を回収することと
を含む、方法にも関する。
oo.がんの処置;
pp.感染症もしくは感染性疾患の処置;または
qq.ワクチンアジュバントとして。
rr.免疫細胞活性化の増大;
ss.がんの処置;または
tt.感染症もしくは感染性疾患の処置。
ADCC 抗体依存性細胞傷害
CDC 補体依存性細胞傷害
CDR 免疫グロブリン可変領域における相補性決定領域(Kabatナンバリングシステムを用いて定義される)
CHO チャイニーズハムスター卵巣細胞
EC50 50%の総結合をもたらす濃度
ELISA 酵素結合免疫吸着アッセイ
FR 抗体フレームワーク領域:CDR領域を除外した免疫グロブリン可変領域
HRP ホースラディッシュペルオキシダーゼ
IFN インターフェロン
IC50 50%阻害の総シグナルをもたらす濃度
IgG 免疫グロブリンG
Kabat Elvin A.Kabat((1991)Sequences of Proteins of Immunological Interest,5th Ed.Public Health Service,National Institutes of Health,Bethesda,Md.)により開発された免疫グロブリンアラインメント及びナンバリングシステム
mAbまたはMabまたはMAb モノクローナル抗体
SEB StaphylococcusエンテロトキシンB
TT 破傷風トキソイド
V領域 異なる抗体間で配列が可変であるIgG鎖のセグメント。V領域は、軽鎖における109及び重鎖における113のKabat残基に及ぶ。
VH 免疫グロブリン重鎖可変領域
VL 免疫グロブリン軽鎖可変領域
VK 免疫グロブリンカッパ軽鎖可変領域
配列番号10の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号12の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号14の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号16の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号18の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号20の重鎖及び配列番号22の軽鎖を有する抗体;
配列番号10の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号12の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号14の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号16の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号18の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号20の重鎖及び配列番号24の軽鎖を有する抗体;
配列番号10の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号12の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号14の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号16の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号18の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号20の重鎖及び配列番号26の軽鎖を有する抗体;
配列番号10の重鎖及び配列番号30の軽鎖を有する抗体;
配列番号12の重鎖及び配列番号30の軽鎖を有する抗体;
配列番号14の重鎖及び配列番号30の軽鎖を有する抗体;
配列番号16の重鎖及び配列番号30の軽鎖を有する抗体;
配列番号18の重鎖及び配列番号30の軽鎖を有する抗体;
配列番号20の重鎖及び配列番号30の軽鎖を有する抗体。
本発明は、指定された構造的及び機能的特徴を有する抗CTLA-4抗体及びその抗原結合断片、ならびに疾患(例えば、がんまたは感染性疾患)の処置または予防における抗体またはその抗原結合断片の使用方法を提供する。これらは全て、実施例に記載のように見いだされた、配列番号32の重鎖及び配列番号34の軽鎖を有する(これらをコードするヌクレオチド配列は、それぞれ配列番号31及び33である)マウス抗体に由来するものである。
本発明はさらに、本発明の抗CTLA-4抗体またはその抗原結合断片のポリペプチドまたは免疫グロブリン鎖のいずれかをコードするポリヌクレオチドを含む。例えば、本発明は、配列番号1~30に記載のアミノ酸をコードするポリヌクレオチドを含む。
限定ではなく例として、本明細書で開示されている抗体及び抗原結合断片は、以下のアミノ酸配列:(配列番号36):
一部の実施形態において、本発明の抗体または抗原結合断片は、免疫細胞の活性を増大させる。免疫細胞の活性の増大は、当技術分野で公知の任意の方法を用いて検出することができる。一実施形態において、免疫細胞の活性の増大は、免疫細胞の増殖を測定することにより検出することができる。例えば、T細胞の活性の増大は、T細胞の増殖、またはシグナル伝達事象(例えば、転写調節因子にシグナルを伝える免疫受容体もしくは下流キナーゼのチロシンリン酸化)を測定することにより、検出することができる。他の実施形態において、免疫細胞の活性の増大は、特定の標的細胞に対するCTLもしくはNK細胞の細胞傷害機能、または抗腫瘍免疫の刺激に付随するIFNγサイトカイン応答を測定することにより、検出することができる。また他の実施形態において、免疫細胞の活性の増大は、対象に由来する試料においてT細胞活性化をex vivoで測定することにより、検出することができる。一実施形態において、T細胞活性の増大は、以下により決定される:(i)IL-2、TNFα、IL-17、IFNγ、IL-1β、GM-CSF、RANTES、IL-6、IL-8、IL-5、及びIL-13から選択される1つ以上の炎症促進性サイトカインのSEB(StaphylococcusエンテロトキシンB)誘導産生、またはCD25及びCD69からなる群からの膜活性化マーカーの上方制御、またはフローサイトメトリーもしくは3H取込みによる芽細胞形成の検出を用いた増殖の誘導を測定すること、あるいは(ii)IL-2、TNFα、IL-17、IFNγ、IL-1β、GM-CSF、RANTES、IL-6、IL-8、IL-5、及びIL-13からなる群から選択されるサイトカインの産生を誘導するための、混合リンパ球反応またはT細胞受容体(TCR)シグナリングの直接的抗CD3 mAb刺激、またはCD25及びCD69からなる群からの膜活性化マーカーの上方制御、またはフローサイトメトリーもしくは3H取込みによる芽細胞形成の検出を用いた増殖の誘導を測定すること。ある特定の実施形態において、本発明の抗CTLA-4抗体またはその抗原結合断片は、CD80及びCD86を発現するラージ細胞に提示されたときにCD3+ T細胞を刺激して、IL-2、TNFα、IL-17、IFNγ、IL-1β、GM-CSF、RANTES、IL-6、IL-8、IL-5、及びIL-13からなる群から選択される炎症促進性サイトカイン、またはCD25及びCD69からなる群からの膜活性化マーカーの上方制御、またはフローサイトメトリーもしくは3H取込みによる芽細胞形成の検出を用いた増殖の誘導をもたらす。ある特定の実施形態において、本発明の抗CTLA4抗体またはその抗原結合断片は、活性化T細胞によるIL-2及び/またはIFNγの産生を少なくとも1.5倍刺激する。実験部分から明らかであるように、本発明の抗体におけるT細胞活性化の特徴は、公知の先行技術のhCTLA4抗体イピリムマブ及びトレメリムマブにおけるT細胞刺激の特徴にほぼ等しい。
一部の実施形態において、本発明の抗CTLA-4抗体または抗原結合断片は、CTLA-4+制御性T細胞を枯渇させることができる。このようなエフェクター機能を発揮する抗体の能力は、当技術分野で公知の任意の方法を用いて決定することができる。一実施形態において、抗体依存性細胞媒介性細胞傷害を誘導する抗体の能力は、エフェクター細胞としてのナチュラルキラー細胞と、ヒトCTLA-4を安定的に発現する細胞株とを用いて決定する。実験セクションで示すように、ヒトIgG1 Fc部分を有するhCTLA-4抗体は、CTLA-4+細胞上でADCCを誘導することができる。
一部の実施形態において、本発明の抗CTLA-4抗体または抗原結合断片は、ヒトCD80及び/またはヒトCD86に対するヒトCTLA-4の結合をブロックすることができる。ヒトCD80及び/またはヒトCD86に対しヒトCTLA-4が結合するのをブロックする能力は、当技術分野で公知の任意の方法を用いて決定することができる。一実施形態において、ヒトCD80及び/またはヒトCD86に対するヒトCTLA-4の結合をブロックする抗体の能力は、ELISAアッセイを用いて決定する。
したがって、本発明は、本発明の抗CTLA-4抗体またはその抗原結合断片を作製する方法であって、抗体または断片を発現するハイブリドーマ細胞をこのような発現に好ましい条件下で培養することと、任意選択で、ハイブリドーマ及び/または成長培地(例えば、細胞培地)から抗体または断片を単離することとを含む、方法を含む。
さらに含まれるのは、抗CTLA-4抗体及びその抗原結合断片が、例えば、抗体または断片の特性を改善するために、親hCTLA4.27Aモノクローナル抗体の可変ドメイン内のフレームワーク残基に対する修飾を含むように操作された抗体である、実施形態である。典型的には、このようなフレームワーク修飾は、抗体または断片の免疫原性を低下させるために行われる。これは、通常、親(例えば、げっ歯類)抗体または断片における可変ドメイン(すなわち、フレームワーク残基)内の非CDR残基を、抗体が使用される種(例えば、ヒト用治療薬の場合にはヒト残基)の免疫レパートリーからの類似する残基で置き換えることにより、遂行される。このような抗体または断片は、「ヒト化」抗体または断片と呼ばれる。場合によっては、操作(例えば、ヒト化)された抗体の親和性を増大させるか、または特異性を改変することが望ましい。1つのアプローチは、1つ以上のフレームワーク残基を、対応する生殖系列配列に「復帰変異させる(backmutate)」ことである。より具体的には、体細胞変異を経た抗体または断片は、抗体が由来する生殖系列配列とは異なるフレームワーク残基を含有することができる。このような残基は、抗体または断片のフレームワーク配列を、抗体または断片が由来する生殖系列配列と比較することにより、同定することができる。もう1つのアプローチは、操作(例えば、ヒト化)された抗体の1つ以上の位置において元の親(例えば、げっ歯類)の残基に復帰して、例えば、フレームワーク残基を置き換えるプロセスで失われた可能性のある結合親和性を回復することである(例えば、米国特許第5,693,762号、米国特許第5,585,089号、及び米国特許第5,530,101号を参照)。
本明細書で開示されている抗体(例えば、ヒト化抗体)及びその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、Fc領域内に修飾を含むように、典型的には、血清半減期、補体結合、Fc受容体結合、及び/またはエフェクター機能(例えば、抗原依存的な細胞の細胞傷害性)のような、抗体の1つ以上の特性を変更するように、操作してもよい。さらに、本明細書で開示されている抗体及びその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、化学修飾し(例えば、1つ以上の化学的部分を抗体に付着させてもよい)、またはそのグリコシル化を改変するように修飾して、さらに抗体または断片の1つ以上の特性を変更してもよい。これらの実施形態の各々が、以下でさらに詳細に説明される。Fc領域内の残基のナンバリングは、KabatのEUインデックスナンバリングである。
一部の実施形態において、抗CTLA-4抗体のFc領域は、抗体または抗原結合断片におけるエフェクター機能媒介能力を向上させるように、及び/またはFcガンマ受容体(FcγRs)に対するそれらの結合を向上させるように、修飾される。
さらに別の実施形態において、本発明の抗体または抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、特定のグリコシル化パターンを含む。例えば、無フコシル化もしくは無グリコシル化された抗体または断片を作製することができる(すなわち、抗体が、それぞれフコースまたはグリコシル化を欠いている)。抗体または断片のグリコシル化パターンは、例えば、CTLA-4抗原に対する抗体または断片の親和性または結合活性を増大させるように改変することができる。このような修飾は、例えば、抗体または断片の配列内の1つ以上のグリコシル化部位を改変することにより、遂行することができる。例えば、1つ以上の可変領域フレームワークグリコシル化部位の除去をもたらし、それにより当該部位におけるグリコシル化を排除する、1つ以上のアミノ酸置換を行うことができる。このような無グリコシル化は、抗原に対する抗体または断片の親和性または結合活性を増大させ得る。例えば、米国特許第5,714,350号及び第6,350,861号を参照。
本明細書で開示されている抗体及びその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、さらに、軽鎖または重鎖いずれかの免疫グロブリン可変領域内の1つ以上のグリコシル化部位を含有することができる。このようなグリコシル化部位は、抗原結合の改変に起因して、抗体もしくは断片の免疫原性の増加、または抗体のpKの改変をもたらし得る(Marshall et al.(1972)Annu Rev Biochem 41:673-702;Gala and Morrison(2004)J Immunol 172:5489-94;Wallick et al(1988)J Exp Med 168:1099-109;Spiro(2002)Glycobiology 12:43R-56R;Parekh et al(1985)Nature 316:452-7;Mimura et al.(2000)Mol Immunol 37:697-706)。グリコシル化は、N-X-S/T配列を含有するモチーフで生じることが知られている。
本明細書で開示されている抗CTLA-4抗体及びその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、化学部分に結合していてもよい。化学部分は、特に、ポリマー、放射性核種、または細胞傷害性因子とすることができる。特定の実施形態において、化学部分は、対象の体内で抗体または断片の半減期を増大させるポリマーである。好適なポリマーとしては、以下に限定されないが親水性ポリマーが挙げられ、親水性ポリマーとしては、以下に限定されないが、ポリエチレングリコール(PEG)(例えば、2kDa、5kDa、10kDa、12kDa、20kDa、30kDa、または40kDaの分子量を有するPEG)、デキストラン、及びモノメトキシポリエチレングリコール(mPEG)が挙げられる。Lee,et al.,(1999)(Bioconj.Chem.10:973-981)は、PEG結合単鎖抗体を開示している。Wen,et al.,(2001)(Bioconj.Chem.12:545-553)は、放射性金属キレート剤(ジエチレントリアミン五酢酸(DTPA))に付着しているPEGとの結合抗体を開示している。
さらに提供されるのは、本明細書で開示されている単離された抗体またはその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)による処置を必要とする、対象(ヒト対象を含む)を処置する方法である。本発明の一実施形態において、このような対象は、感染症または感染性疾患を患っている。本発明の別の実施形態において、このような対象は、がんを患っている。一実施形態において、がんは、例えば、骨肉腫、横紋筋肉腫、神経芽腫、腎臓癌、白血病、腎移行上皮癌、膀胱癌、ウィルム癌、卵巣癌、膵癌、乳癌、前立腺癌、骨癌、肺癌(例えば、非小細胞肺癌)、胃癌、結腸直腸癌、子宮頚癌、滑膜肉腫、頭頚部癌、扁平上皮癌、多発性骨髄腫、腎細胞癌、網膜芽腫、肝芽腫、肝細胞癌、黒色腫、腎臓のラブドイド腫瘍、ユーイング肉腫、軟骨肉腫、脳癌、神経膠芽腫、髄膜腫、下垂体腺腫、前庭神経鞘腫、原始神経外胚葉性腫瘍、髄芽腫、星状細胞腫、未分化星状細胞腫、乏突起神経膠腫、脳室上皮腫、脈絡叢乳頭腫、真性多血症、血小板血症、特発性骨髄線維症、軟部組織肉腫、甲状腺癌、子宮内膜癌、カルチノイド癌または肝臓癌、乳癌または胃癌である。本発明の一実施形態において、当該がんは、(例えば、上記バラエティーの)転移性癌である。
本発明の抗CTLA-4抗体またはその抗原結合断片(例えば、抗体27Aまたはそのヒト化バージョン)は、親和性精製剤として使用することができる。このプロセスにおいて、抗CTLA-4抗体またはその抗原結合断片は、当技術分野で周知の方法を用いて、Sephadex、ガラスもしくはアガロース樹脂、または濾紙のような固相に固定される。固定された抗体または断片を、CTLA-4タンパク質(またはその断片)試料と接触させて精製し、その後に、試料中のCTLA-4タンパク質以外の実質的に全ての材料を除去する好適な溶媒で支持体を洗浄し、固定された抗体または断片に結合させる。最後に、結合したCTLA-4(例えば、プロテインA)を溶離させる溶媒で支持体を洗浄する。このような固定された抗体及び断片は、本発明の一部を形成する。
(a)基質(例えば、マイクロタイタープレートウェル(例えば、プラスチックプレート)の表面)を抗CTLA-4抗体またはその抗原結合断片でコーティングする;
(b)CTLA-4の有無を調べるために試験する試料を基質に適用する;
(c)プレートを洗浄して、試料中の結合していない材料を除去する;
(d)検出可能に標識され、またCTLA-4抗原に対し特異性も有する抗体(例えば、酵素結合抗体)を適用する;
(e)基質を洗浄し、結合していない標識された抗体を除去する;
(f)標識された抗体が酵素に結合している場合、酵素により蛍光シグナルに変換される化学物質を適用する;及び
(g)標識された抗体の存在を検出する。
基質に結び付いた標識の検出は、CTLA-4タンパク質が存在することを示す。
(1)任意選択で、CTLA-4の有無を調べるために試験する試料からの(例えば、試料中のタンパク質におけるPAGEまたはSDS-PAGE電気泳動分離からの)タンパク質を、当技術分野で公知の方法(例えば、セミドライブロッティングまたはタンクブロッティング)を用いて、膜または他の固体基質に移し、結合したCTLA-4の有無を調べるために試験する膜または他の固体基質を、本発明の抗CTLA-4抗体またはその抗原結合断片に接触させる。
このような、CTLA-4の有無を調べるために試験する、未変性PAGE(ポリアクリルアミドゲル電気泳動)ゲルまたはSDS-PAGE(ドデシル硫酸ナトリウム・ポリアクリルアミドゲル電気泳動)ゲル中のタンパク質を(例えば、ゲル中の電気泳動分離後に)移す対象となる膜は、ニトロセルロースまたはビニール系(例えば、ポリフッ化ビニリデン(PVDF))の膜の形態をとることができる。膜を抗CTLA-4抗体または断片に接触させる前に、任意選択で膜を(例えば、無脂肪粉乳などで)ブロックして、膜上で非特異的なタンパク質結合部位を結合させるようにする。
(2)膜を1回以上洗浄して、結合していない抗CTLA-4抗体または断片や、他の結合していない物質を除去する。
(3)結合した抗CTLA-4抗体または断片を検出する。
結合した抗体または断片の検出は、CTLA-4タンパク質が、膜または基質上及び試料中に存在することを示す。結合した抗体または断片の検出は、抗体または断片が、検出可能に標識された二次抗体(抗免疫グロブリン抗体)と結合し、次に二次抗体の存在を検出することによるものと考えられる。
(1)CTLA-4タンパク質の有無を調べるために試験する細胞(例えば、黒色腫細胞のような腫瘍細胞)を、本発明の抗CTLA-4抗体またはその抗原結合断片に接触させる;及び
(2)細胞上または細胞内の抗体または断片を検出する。
本発明の抗CTLA-4抗体及びその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)の医薬組成物または無菌組成物を調製するために、抗体またはその抗原結合断片は、医薬的に許容される担体または賦形剤と混合する。例えば、Remington’s Pharmaceutical Sciences and U.S.Pharmacopeia:National Formulary,Mack Publishing Company,Easton,PA(1984)を参照。
さらに提供されるのは、以下に限定されないが、本明細書で論じられている抗CTLA-4抗体または抗原結合断片(例えば、抗体27Aまたはそのヒト化バージョン)を含む1つ以上の構成成分を、以下に限定されないが、本明細書で論じられている医薬的に許容される担体及び/または治療剤を含む1つ以上の追加的構成成分に付随して含む、キットである。抗体もしくは断片及び/または治療剤は、純粋な組成物として製剤化しても、医薬的に許容される担体との併用で医薬組成物に製剤化してもよい。
利便性のため、本発明の抗CTLA-4抗体またはその抗原結合断片(例えば、抗体27A及びそのヒト化バージョン)は、キット、すなわち、所定量の試薬の組合せをパッケージ化したものを、診断アッセイまたは検出アッセイを実施するための使用説明書と共に提供してもよい。抗体または断片が酵素で標識される場合、キットは、酵素に必要な基質及び補因子(例えば、検出可能な発色団または蛍光団をもたらす基質前駆体)を含むことになる。加えて、安定化剤、緩衝液(例えば、ブロック緩衝液または溶解緩衝液)などのような他の添加物が含まれてもよい。種々の試薬の相対量は、試薬の溶液中濃度がアッセイの感受性を実質的に最適化するように、広範囲に変動させることができる。詳細には、試薬は、溶解すると適切な濃度の試薬溶液をもたらす賦形剤を含む、(通常は凍結乾燥された)乾燥粉末として提供することができる。
分子生物学における標準的な方法は、Sambrook,Fritsch and Maniatis(1982 & 1989 2nd Edition,2001 3rd Edition)Molecular Cloning,A Laboratory Manual,Cold Spring Harbor Laboratory Press,Cold Spring Harbor,NY;Sambrook and Russell(2001)Molecular Cloning,3rd ed.,Cold Spring Harbor Laboratory Press,Cold Spring Harbor,NY;Wu(1993)Recombinant DNA,Vol.217,Academic Press,San Diego,CAで説明されている。標準的な方法は、Ausbel,et al.(2001)Current Protocols in Molecular Biology,Vols.1-4,John Wiley and Sons,Inc.New York,NYにも掲載されており、細菌細胞におけるクローニング及びDNA変異誘発(Vol.1)、哺乳類細胞及び酵母におけるクローニング(Vol.2)、複合糖質及びタンパク質の発現(Vol.3)、及びバイオインフォマティクス(Vol.4)について説明されている。
ヒトCTLA-4タンパク質に対する抗体を単離するため、hCTLA-4をコードする発現コンストラクトでマウスを免疫化した。このコンストラクトを生成するため、hCTLA-4の全長オープンリーディングフレームをコードするcDNA(NCBI参照配列:NM_005214.4、配列番号35)をpCI-neo(Promega,Madison,WI)ベクターにサブクローニングした。Helios Gene gun(BioRad,Hercules,CA)及びDNAコーティング金弾丸(BioRad)を製造業者の指示に従って用いた遺伝子銃免疫化により、マウスを免疫化した。簡潔に述べると、1μmの金粒子を、2:1:1の比率のpCI-neo-CTLA-4 cDNAならびにマウスFlt3L及びマウスGM-CSFの市販の発現ベクター(いずれもAldevron(Frago,ND)製)でコーティングした。合計1μgのプラスミドDNAを使用して、500μgの金粒子をコーティングした。具体的には、7~8週齢のメスBALB/Cマウスの耳に対し遺伝子銃で免疫化を行い、両耳において4投与サイクルを受けさせた。3回のDNA免疫化後のマウス血清において、フローサイトメトリーにより、およそ1:125-625の抗hCTLA-4力価が検出された。このスクリーニングに関しては、Lipofectamine2000(Invitrogen)を用いてpCI-neo-CTLA-4コンストラクトを一時的に形質移入したCHO-K1細胞を使用した。形質移入細胞を一晩培養し、続いて細胞解離溶液(Sigma)を用いて単細胞懸濁液を得た。7,5*105個の細胞を、希釈したマウス血清の各試料と共に、4℃にて30分間インキュベートした。次に、細胞をリン酸緩衝食塩水(PBS)/2%のウシ胎児血清(FBS)で洗浄し、FITC標識ヤギ抗マウスIgG(BD Pharmingen)による染色を4℃にて30分間行った。再び細胞をPBS/2%のFBSで洗浄し、次にPBS/2%のFBSに再懸濁させ、FITC標識に基づいて抗体結合細胞を検出し、フローサイトメトリー(FACS Canto II;BD Biosciences)により評価した。hCTLA-4に対する反応性を示したマウスに対し、最後の4回目の免疫化を行い、4日後に屠殺した。赤血球枯渇脾臓及びリンパ節細胞集団を、先に説明されているように調製し(Steenbakkers et al.,1992,J.Immunol.Meth.152:69-77;Steenbakkers et al.,1994,Mol.Biol.Rep.19:125-134)、-140℃で凍結させた。
CDRグラフト技術により、マウスhCTLA4.27A抗体をヒト化した(例えば、米国特許第5,225,539号及びWilliams,D.G.et al.,2010,Antibody Engineering,volume 1,Chapter 21を参照)。
重鎖及び軽鎖のコンストラクトをコードするプラスミドを1:1の比(合計30μg)で混合し、293fectin形質移入試薬(Invitrogen)を製造業者の指示に従って用いた、FreeStyle 293-Fヒト胚腎細胞(HEK293T/17、ATCC-CRL-11268)への形質移入により、一時的に発現させた。7日後に上清(30ml)を採取し、MabSelect SureプロテインAを製造業者(GE Healthcare)の指示に従って用いて、抗体を精製した。Zeba脱塩カラム(Thermo Scientific)を用いて、緩衝液を10mMのヒスチジン、100mMのNaCl pH5.5緩衝液に交換した。精製した抗体の濃度をOD280(Nanodrop ND-1000)に基づいて決定した。製造業者(Lonza)の指示に従うLAL試験により、エンドトキシンレベルを決定した。
hCTLA-4に対するヒト化抗体の結合をCELISAフォーマットで調べた。CHO-K1.hCTLA-4細胞を、組織培養プレート中の培地(DMEM-F12(Gibco)に10%のウシ胎児血清(Hyclone)及びPen/Strep(Gibco)を加えたもの)に播種し、37℃、5%のCO2、及び95%の湿度にて、細胞がコンフルエントになるまで培養した。続いて培地を除去し、細胞を、精製されたhCTLA-4抗体(10μg/ml及びその希釈物)と共に、37℃、5%のCO2、及び95%の湿度にて1時間インキュベートした。次に、細胞をPBS/0.05%のTween(PBST)で洗浄し、ヤギ抗ヒトIgG-HRP(Southern Biotechnology)またはヤギ抗マウスIgG-HRP(Southern Biotechnology)と共に、37℃、5%のCO2、及び95%の湿度にて1時間インキュベートした。続いて、細胞をPBSTで3回洗浄し、抗hCTLA-4免疫反応性をTMB安定化色原体(Invitrogen)で可視化した。0.5MのH2SO4で反応を停止させ、450nm及び610nmにおける吸光度を読み取った。Graphpad Prism 6を用いて、EC50値(合計結合シグナルの50%が観察される濃度)を計算した。表5に、ヒト化hCTLA4.27抗体のEC50値を示す。
hCD80遮断の評価を、CELISAフォーマットでヒト化hCTLA4.27抗体の完全パネルに対し行った。CHO-K1.hCTLA-4細胞を組織培養プレートに播種し、37℃、5%のCO2、及び95%の湿度にて培地中でインキュベートした。ひとたび細胞がコンフルエントになったら培地を除去し、細胞を、ヒト化hCTL4.27抗体バリアント(10μg/ml及びその希釈物)と共に、37℃、5%のCO2、及び95%の湿度にて1時間インキュベートした。次に、細胞をPBS/0.05%のTween-20(PBST)で洗浄し、ビオチン化組換え型hCD80/Fcタンパク質と共に、37℃、5%のCO2、及び95%の湿度にて1時間インキュベートした。次に細胞をPBSTで洗浄し、次にストレプトアビジン-HRP結合体を細胞に添加し、これを37℃、5%のCO2、及び95%の湿度にて1時間インキュベートした。続いて細胞をPBSTで3回洗浄し、hCD80/Fcタンパク質の結合をTMB安定化色原体(Invitrogen)で可視化した。0.5MのH2SO4で反応を停止させ、450nm及び610nmにおける吸光度を読み取った。このデータからhCD80の遮断についてのIC50値を計算した。このIC50値を表6に示す。IC50値は、阻害の半数が観察される濃度に相当する。
Octet RED96上でバイオライトインターフェロメトリー(bio-light interferometry)を用いてhCTLA4.27の結合動態及び平衡結合定数をプロファイリングし、当技術分野で公知のいくつかの抗体と比較した。最初に、標準的なアミン化学を用いて抗hCTLA-4 mAbをアミン反応性第2世代バイオセンサー(Fortebio)に結合させた。次に、バイオセンサーに対するhCTLA-4の結合及び解離を様々なhCTLA-4濃度で観察した。アミン反応性バイオセンサーは、0.1MのMES pH=5.5を含むウェルに10分間浸漬することにより、予め湿らせた。次に、0.1MのNHS/0.4MのEDC混合物を用いてバイオセンサーを5分間活性化した。0.1MのMES中2.5または12ug/mLの抗体の溶液に7.5分間バイオセンサーを浸漬することにより、抗体を結合させた。1Mのエタノールアミンの溶液を用いてバイオセンサー表面を5分間クエンチした。バイオセンサーをOctet動態緩衝液(ForteBio)中で5分間平衡化した。様々なrhCTLA-4/Fc濃度(2.5-40nM)を含有するウェルにバイオセンサーを入れ、15分間インターフェロメトリーをモニタリングすることにより、rhCTLA-4/Fc(R&D Systems)の会合を観察した。バイオセンサーを動態緩衝液に移し、インターフェロメトリーシグナルを45分間モニタリングした後に、解離を測定した。このアッセイは、30℃のプレート温度で実行した。全試験濃度を含む1:1結合の全体的適合モデルを用いて、観察したオン速度及びオフ速度(kon及びkdis)を適合させ、平衡結合定数KDを計算した。表7に示すように、hCTLA4.27は、対照抗体と同様の結合親和性を有する。
一次抗体細胞におけるヒト化hCTLA4.27の機能性を確認するため、ヒトドナー血液のバフィーコートからPBMCを単離した。最初に、バフィーコートを室温にてPBSで希釈し混合して、合計体積180mlにした。Sepmateチューブ(Stemcell Technologies)内のFicoll-Paque Plus勾配上で分割量を装填し、遠心処理を1200gで10分間、20℃にてブレーキなしで行った。次に、血漿を吸引により除去し、血漿/Ficoll界面からPBMCを回収した。アッセイで使用する前に、PBMCをPBS中で3回洗浄した。PBMCをウェル当たり2*105細胞にて播種した。続いて、10%のウシ胎児血清を追加したRPMI 1650培地(Gibco)中にヒト化hCTLA4.27及び対照抗体を希釈し、10の平方根の希釈ステップによる100ug/mlで開始する濃度範囲で添加した。10%のウシ胎児血清を追加したRPMI 1640培地中に希釈したStaphylococcusエンテロトキシンB(Sigma)を、10μg/mlの濃度で添加した。プレートを37℃、5%のCO2、及び95%の湿度にて7時間インキュベートし、次に上清を単離した。
キメラhCTLA4.27A抗体:hCTLA4.27A.C1及びhCTLA4.27A.C4における抗体依存性細胞媒介性細胞傷害(ADCC)及び補体依存性細胞傷害(CDC)を誘導する能力について調べた。このADCCアッセイに関しては、ヒトNK細胞をエフェクター細胞として使用した。NK細胞は、ヒト血液から単離した。Rosette SEP NK濃縮カクテル(Stemcell Technologies)を用いてバフィーコートのNK細胞を濃縮した。続いて、バフィーコートをPBS/2%のFBSと1:1混合し、Ficol Paque plus(GE Healthcare)で層状化させた。遠心分離後に中間相を収集し、細胞をPBS/2%のFBSで洗浄した。フローサイトメトリーによる単離NK細胞のキャラクタリゼーションにより、CD16及びCD56の発現が確認された。
10D1(イピリムマブ)及びCP-675,206(トレメリムマブ)と比較してのhCTLA4.27の結合部位の違いを特徴づけるため、先に説明されているようにバイオライトインターフェロメトリーを用いて抗体間の競合をプロファイリングした。アミン反応性バイオセンサーは、0.1MのMES pH=5.5を含むウェルに10分間浸漬することにより、予め湿らせた。次に、0.1MのNHS/0.4MのEDC混合物を用いてバイオセンサーを5分間活性化した。ヒトIgG1またはヒトIgG4としてフォーマットされたhCTLA4.27を、0.1MのMES中12μg/mlのmAbの溶液に7.5分間バイオセンサーを浸漬することにより結合させた。1Mのエタノールアミンの溶液を用いてバイオセンサー表面を5分間クエンチした。バイオセンサーをOctet動態緩衝液(ForteBio)中で5分間平衡化した。固定濃度のrhCTLA-4/Fc(12μg/ml)を含有するウェルにバイオセンサーを入れ、15分間インターフェロメトリーをモニタリングすることにより、rhCTLA-4/Fcの会合を観察した。次に、さらなる2分間、バイオセンサーに結合させた同じ抗hCTLA-4 mAbを結合させて、全ての利用可能なrhCTLA-4/Fc結合部位の結合を確実にした。競合か非競合かの判定は、バイオセンサーを5分間、固定濃度(6μg/ml)の別のまたは同じ抗hCTLA-4 mAbを含有するウェルに入れるか、または動態緩衝液のみを含有する参照ウェルに入れることにより行った。表9に示すように、この直接競合アッセイでは、rhCTLA-4に対するhCTLA4.27の結合は、rhCTLA-4/Fcに対する対照抗体の結合をブロックしていない。
2つのhCTLA-4変異体を用いて、10D1及びCP-675,206と比較してのhCTLA4.27間の結合領域の違いを確認した。hCTLA-4を、半分がヒトで半分がマウスであるように設計した。CTLA-4の折り畳み、Ig様V型(免疫グロブリン様)ドメインに基づいて、タンパク質を2つのサブドメイン(1つは接続ループを含めてベータストランド1、2、5、及び6を含有し、1つは接続ループを含めてベータストランド3、4、7、8を含有する)に分けることができる。ヒト-マウスバリアント(配列番号42、Hum-Mou-CTLA-4)は、ストランド1、2、5、及び6にヒト残基を含有し、ストランド3、4、7、及び8にマウス残基(配列番号46)を含有する。マウス-ヒトバリアント(配列番号44、Mou-Hum-CTLA-4)は、ストランド1、2、5、及び6にマウス残基を含有し、ストランド3、4、7、及び8にヒト残基を含有する。
重水素化した化学架橋を行い、次に酵素消化を行い、質量分析法を用いて検出することを伴う手順により、hCTLA-4に対するhCTLA4.27Aの結合エピトープを解明した。最初に、抗体hCTLA4.27A及び抗原rhCTLA-4/Fc6His(R&D systems;配列番号59)をインキュベートして結合及び完全性を促進し、HM4相互作用モジュール(CovalX)を搭載したUltraflex III MALDI ToF質量分析計(Bruker)により、凝集レベルを検証した。この対照実験向けに、抗体または抗原の10μLの試料の希釈系列(1から128倍希釈、1mg/mLで開始)を調製した。各試料のうち、9μLは、K200 MALDI MS解析キットを製造業者(CovalX)の指示に従って用いて架橋に供し、180分間インキュベートした。一方、1μLは質量分析法解析(High-Mass MALDI)に直接使用した。質量分析法解析により、抗体及び抗原が予測された分子量を有することが示され、それぞれ152.25kDa(架橋剤を伴って160.94kDa)及び88.25kDa(架橋剤を伴って95.19kDa)であった。抗原-抗体複合体のキャラクタリゼーション向けに、2倍過剰の抗原(抗原:抗体の比は4μM:2μM)を用いて混合物を作製した。抗原-抗体複合体混合物のうち、9μLは、K200 MALDI MS解析キットを製造業者の指示に従って用いて架橋に供し、一方1μLは、質量分析法解析に直接使用した。検出された質量(抗体(149.916kDa)及び抗原(88.211))は、先に検出された分子量に対応している。抗原-抗体複合体は、架橋後、1:1(239.113kDa)及び1:2(326.415kDa)の化学量論(hCTLA4.27A:rhCTLA-4/Fc)を有する2つの非共有結合の複合体として検出された。非共有結合的に結合した抗体及び抗原、非共有結合の凝集体、または非特異性の多量体は検出されなかった。
Claims (11)
- ヒトCTLA-4に結合する抗体またはその抗原結合断片であって、a~fで定義されるポリペプチド配列のそれぞれを含む、前記抗体またはその抗原結合断片:
a.配列番号1のアミノ酸配列を含む、重鎖可変領域CDR1;
b.配列番号2のアミノ酸配列を含む、重鎖可変領域CDR2;
c.配列番号3のアミノ酸配列を含む、重鎖可変領域CDR3;
d.配列番号4のアミノ酸配列を含む、軽鎖可変領域CDR1;
e.配列番号5のアミノ酸配列を含む、軽鎖可変領域CDR2、及び
f.配列番号6のアミノ酸配列を含む、軽鎖可変領域CDR3。 - 以下からなる群から選択される、軽鎖免疫グロブリン、重鎖免疫グロブリン、または軽鎖及び重鎖両方の免疫グロブリンを含む、請求項1に記載のヒトCTLA-4に結合する抗体またはその抗原結合断片:
a.配列番号7のアミノ酸配列を含む可変重鎖、及び配列番号8のアミノ酸配列を含む可変軽鎖を含む、抗体またはその抗原結合断片;
b.配列番号10、12、14、16、18、もしくは20のアミノ酸配列を含む可変重鎖、及び配列番号22、24、26、または30のアミノ酸配列を含む可変軽鎖を含む、抗体またはその抗原結合断片;
c.配列番号10、12、14、16、18、もしくは20のいずれか1つに対し少なくとも90%の同一性を備える可変重鎖、及び配列番号22、24、26、もしくは30のいずれか1つに対し少なくとも90%の同一性を備える可変軽鎖を含む、抗体またはその抗原結合断片;
d.配列番号10、12、14、16、18、もしくは20のいずれか1つに対し少なくとも90%の同一性を備える可変重鎖、及び配列番号22、24、26、もしくは30のいずれか1つに対し少なくとも90%の同一性を備える可変軽鎖を含む抗体もしくはその抗原結合断片であって、任意の配列バリエーションが、前記抗体またはその抗原結合断片のフレームワーク領域内で生じる、前記抗体またはその抗原結合断片;
e.配列番号10、12、14、16、18、もしくは20のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変重鎖、及び配列番号22、24、26、もしくは30のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変軽鎖を含む、抗体またはその抗原結合断片;ならびに
f.配列番号10、12、14、16、18、もしくは20のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変重鎖、及び配列番号22、24、26、もしくは30のいずれか1つについて1、2、3、4、5、6、7、8、9、もしくは10のアミノ酸置換を含む可変軽鎖を含む抗体またはその抗原結合断片であって、任意の前記置換が、前記抗体またはその抗原結合断片のフレームワーク領域内で生じる、前記抗体またはその抗原結合断片。 - 前記抗体またはその抗原結合断片が、以下の特徴の1、2、3、または4つ全てを有する、請求項2に記載の抗体またはその抗原結合断片:
i.ヒトCTLA-4に対し、20nM未満と測定されるEC50値で結合する;
ii.hCD80に対するhCTLA-4の結合を、100nM以下のIC50でブロックする;
iii.hCD86に対するhCTLA-4の結合を、100nM以下のIC50でブロックする;
iv.イピリムマブまたはトレメリムマブとは異なるCTLA-4エピトープに結合する。 - ヒトCTLA-4に対する結合において抗体hCTLA4.27Aと競合する、抗体またはその抗原結合断片。
- 配列番号1~8、10、12、14、16、18、20、22、24、26、または30のいずれか1つのアミノ酸配列を含む、単離されたポリペプチド。
- 請求項1~4に記載のいずれか1つの抗体もしくは抗原結合断片または請求項5に記載のいずれか1つのポリペプチドをコードする、単離された核酸。
- 請求項6に記載の単離された核酸を含む、発現ベクター。
- 請求項1~7のいずれかに記載の抗体、結合断片、ポリペプチド、ポリヌクレオチド、または発現ベクターを含む、宿主細胞。
- Pichia細胞またはチャイニーズハムスター卵巣細胞である、請求項8に記載の宿主細胞。
- 対象におけるがんを処置する方法に用いるための組成物であって、ここにおいて組成物は、請求項1~4のいずれか1項に記載の抗体または抗原結合断片と、医薬的に許容される担体、希釈剤、賦形剤、または安定化剤とを含み、当該方法は、それを必要とする対象に、有効量の、前記組成物を投与することを含み、ここにおいて前記がんは、肺癌、黒色腫、腎臓癌、肝臓癌、骨髄腫、前立腺癌、乳癌、結腸直腸癌、胃癌、膵臓癌、甲状腺癌、血液癌、リンパ腫、骨髄腫、もしくは白血病、または前記がんの転移病変からなる群から選択される、組成物。
- 対象における免疫細胞の活性を増大させる方法に用いるための組成物であって、ここにおいて組成物は、請求項1~4のいずれか1項に記載の抗体または抗原結合断片と、医薬的に許容される担体、希釈剤、賦形剤、または安定化剤とを含み、前記方法は、それを必要とする対象に、有効量の前記組成物を投与することを含む、組成物。
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CN110088134A (zh) | 2019-08-02 |
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NL2017270B1 (en) | 2018-02-09 |
US10808030B2 (en) | 2020-10-20 |
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EP3494137A1 (en) | 2019-06-12 |
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