JPWO2020123836A5 - - Google Patents

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JPWO2020123836A5
JPWO2020123836A5 JP2021533540A JP2021533540A JPWO2020123836A5 JP WO2020123836 A5 JPWO2020123836 A5 JP WO2020123836A5 JP 2021533540 A JP2021533540 A JP 2021533540A JP 2021533540 A JP2021533540 A JP 2021533540A JP WO2020123836 A5 JPWO2020123836 A5 JP WO2020123836A5
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antibody
antigen
seq
linker
cancer
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JP2022512401A (en
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Priority claimed from PCT/US2019/066029 external-priority patent/WO2020123836A2/en
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Claims (20)

下記式:
Figure 2020123836000001

で表される化合物又はその薬学的に許容可能な塩であるスプライシング調節薬[式中:
Yは、O、S、NR、及びCRから選択され;
、R、及びRは、各々独立に、水素、ヒドロキシル、-O-(C~Cアルキル)基、-O-C(=O)-(C~Cアルキル)基、-C(=O)-O-(C~Cアルキル)基、及びC~Cアルキル基から選択され;
、C ~Cアルキル基、-C(=O)-(C~Cアルキル)基、-C(=O)-(C~Cカルボシクリル)基、-C(=O)-(C~Cヘテロシクリル)基、及び-C(=O)-NRから選択され;
は、水素、ヒドロキシル、-CH-OH、-COH、-C(=O)-O-(C~Cアルキル)基、-C(=O)-NR、-NR-C(=O)-R、-O-C(=O)-NR、-NR-C(=O)-R、及び-NR-C(=O)-NRから選択され;
及びRは、各々独立に、水素、-R、-C(=O)-R、及び-C(=O)-O-Rから選択され;及び
は、C~Cアルキル基、C~Cカルボシクリル基、及びC~Cヘテロシクリル基から選択され、
ここでR、R、R、R、R、R、R、及びRは、各々独立に、ハロゲン、ヒドロキシル、C~Cアルキル基、-O-(C~Cアルキル)基、-COH、-C(=O)-(C~Cアルキル)基、-C(=O)-(C~Cカルボシクリル)基、-C(=O)-(C~Cヘテロシクリル)基、-NR、C~Cカルボシクリル基、C~Cアルキルヒドロキシ基、C~Cアルキルアルコキシ基、ベンジル基、及びC~Cヘテロシクリル基(この各々は、ハロゲン、ヒドロキシル、C~Cアルキル基、C~Cアルコキシ基、C~Cハロアルキル基、-NH-C(=O)(C~Cアルキル)、及び-NH-C(=O)-O-(C~Cアルキル)から選択される0又は1個の基で独立に置換されていてもよい)から独立に選択される0~3個の基で置換される]。
The formula below:
Figure 2020123836000001

A splicing regulator that is a compound represented by or a pharmaceutically acceptable salt thereof [wherein:
Y is selected from O, S, NR6 , and CR6R7 ;
R 1 , R 2 and R 3 are each independently hydrogen, hydroxyl, —O—(C 1 -C 6 alkyl) group, —O—C(=O)-(C 1 -C 6 alkyl) group , —C(=O)—O—(C 1 -C 6 alkyl) groups, and C 1 -C 6 alkyl groups;
R 4 is a C 1 -C 6 alkyl group, -C(=O)-(C 1 -C 6 alkyl) group, -C(=O)-(C 3 -C 8 carbocyclyl) group, -C(= O)-(C3 - C8 heterocyclyl) group, and -C ( =O) -NR6R7 ;
R 5 is hydrogen, hydroxyl, —CH 2 —OH, —CO 2 H, —C(=O)—O—(C 1 -C 6 alkyl) group, —C(=O)—NR 6 R 7 , -NR 6 -C(=O)-R 8 , -OC(=O)-NR 6 R 7 , -NR 6 -C(=O)-R 8 , and -NR 6 -C(=O) - NR 6 R 7 ;
R 6 and R 7 are each independently selected from hydrogen, -R 8 , -C(=O)-R 8 , and -C(=O)-OR 8 ; and R 8 is C 1 -C6 alkyl groups, C3 - C8 carbocyclyl groups , and C3 - C8 heterocyclyl groups;
wherein R 1 , R 2 , R 3 , R 4 , R 5 , R 6 , R 7 and R 8 are each independently halogen, hydroxyl, C 1 -C 6 alkyl, —O—(C 1 -C6 alkyl) group, -CO2H , -C(=O)-(C1 - C6 alkyl) group, -C ( =O)-(C3 - C8 carbocyclyl) group, -C ( = O)—(C 3 -C 8 heterocyclyl) group, —NR 6 R 7 , C 3 -C 8 carbocyclyl group, C 1 -C 6 alkylhydroxy group, C 1 -C 6 alkylalkoxy group, benzyl group, and C 3 - C8 heterocyclyl groups, each of which is represented by halogen, hydroxyl, C1-C3 alkyl groups, C1 - C3 alkoxy groups, C1 - C3 haloalkyl groups , -NH - C ( =O) (C1 -C 3 alkyl), and -NH-C(=O)-O-(C 1 -C 3 alkyl) optionally substituted independently with 0 or 1 groups selected from substituted with 0 to 3 groups that are
前記化合物が下記式:
Figure 2020123836000002

で表される化合物又はその薬学的に許容可能な塩[式中:
は、C~Cヘテロシクリル基から選択され;及び
10は、水素原子及びC~Cアルキル基から選択され、
ここでR及びR10は、各々独立に、ハロゲン、ヒドロキシル、C~Cアルキル基、C~Cアルコキシ基、-NH、-NH-(C~Cアルキル)、及び-N-(C~Cアルキル)から独立に選択される0~3個の基で置換される]である、請求項に記載のスプライシング調節薬。
The compound has the formula:
Figure 2020123836000002

A compound represented by or a pharmaceutically acceptable salt thereof [wherein:
R 9 is selected from C 3 -C 8 heterocyclyl groups; and R 10 is selected from hydrogen atoms and C 1 -C 6 alkyl groups,
wherein R 9 and R 10 are each independently halogen, hydroxyl, C 1 -C 3 alkyl group, C 1 -C 3 alkoxy group, —NH 2 , —NH—(C 1 -C 3 alkyl), and -N-(C 1 -C 3 alkyl) 2 substituted with 0 to 3 groups independently selected from].
前記化合物が下記式:
Figure 2020123836000003

で表される化合物又はその薬学的に許容可能な塩[式中:
11は、
Figure 2020123836000004

(式中、は、R11が化合物の残りの部分に結合する点を表す)から選択され;
12及びR13は、各々独立に、水素原子及びメチルから選択される]であって、
前記化合物は
Figure 2020123836000005

並びにそれらの薬学的に許容可能な塩から選択されてもよい、請求項1又は2に記載のスプライシング調節薬。
The compound has the formula:
Figure 2020123836000003

A compound represented by or a pharmaceutically acceptable salt thereof [wherein:
R 11 is
Figure 2020123836000004

wherein * represents the point of attachment of R 11 to the remainder of the compound;
R 12 and R 13 are each independently selected from a hydrogen atom and methyl] ,
Said compound is
Figure 2020123836000005

and pharmaceutically acceptable salts thereof .
前記化合物がthe compound is
Figure 2020123836000006
Figure 2020123836000006

並びにそれらの薬学的に許容可能な塩から選択され、前記化合物がand pharmaceutically acceptable salts thereof, wherein the compound comprises
Figure 2020123836000007
Figure 2020123836000007

又はそれらの薬学的に許容可能な塩であってもよい、請求項1~3のいずれか一項に記載のスプライシング調節薬。or a pharmaceutically acceptable salt thereof.
式L-Hで表されるリンカー-ペイロードを含む化合物又はその薬学的に許容可能な塩であって、Lはリンカーであり、Hは請求項1~4のいずれか一項に記載のスプライシング調節薬であり、Hは任意の原子を介してLに共有結合的に結び付いており、ここでLに共有結合的に結び付いている原子の原子価を超えることはなく、Lは切断可能リンカーであってもよい、化合物又はその薬学的に許容可能な塩。A compound comprising a linker-payload of formula LH or a pharmaceutically acceptable salt thereof, wherein L is a linker and H is splicing modulation according to any one of claims 1-4. is a drug, H is covalently attached to L via any atom, where the valence of the atom covalently attached to L is not exceeded, and L is a cleavable linker; compound or a pharmaceutically acceptable salt thereof. 下記式:
Figure 2020123836000008

[式中、Lはリンカーであり、リンカーは切断可能リンカーであってもよい]から選択される化合物又はその薬学的に許容可能な塩。
The formula below:
Figure 2020123836000008

A compound selected from: wherein L is a linker, the linker may be a cleavable linker, or a pharmaceutically acceptable salt thereof.
リンカーが少なくとも1つの切断可能部分を含む切断可能リンカーであり、かつリンカーが、the linker is a cleavable linker comprising at least one cleavable moiety, and the linker is
(i)切断可能なペプチド部分であって、バリン-シトルリン(Val-Cit)若しくはバリン-アラニン(Val-Ala)を含んでもよい、切断可能なペプチド部分;又は(i) a cleavable peptide moiety, which may comprise valine-citrulline (Val-Cit) or valine-alanine (Val-Ala); or
(ii)切断可能なグルクロニド部分であって、前記切断可能なグルクロニド部分が酵素によって切断可能であってよく、前記切断可能なグルクロニド部分がグルクロニダーゼによって切断可能であってよく、前記切断可能なグルクロニド部分がβ-グルクロニダーゼによって切断可能であってよい、切断可能なグルクロニド部分(ii) a cleavable glucuronide moiety, wherein said cleavable glucuronide moiety may be cleavable by an enzyme, said cleavable glucuronide moiety may be cleavable by a glucuronidase, said cleavable glucuronide moiety; may be cleavable by β-glucuronidase, a cleavable glucuronide moiety
を含む、請求項5又は6に記載の化合物。7. A compound according to claim 5 or 6, comprising
リンカーはマレイミド(Mal)部分を含み、前記マレイミド部分はマレイミドカプロイル(MC)を含んでよく、リンカーはMC-Val-Cit又はMC-Val-Alaを含んでもよい、請求項7に記載の化合物。8. The compound of claim 7, wherein the linker comprises a maleimide (Mal) moiety, said maleimide moiety may comprise maleimidocaproyl (MC), and the linker may comprise MC-Val-Cit or MC-Val-Ala. . 前記リンカーは少なくとも1つのスペーサー単位を含み、said linker comprises at least one Spacer unit,
(i)前記スペーサー単位はポリエチレングリコール(PEG)部分を含み、前記PEG部分は-(PEG)(i) said Spacer unit comprises a polyethylene glycol (PEG) moiety, wherein said PEG moiety is -(PEG) m -を含んでよく、ここでmは1~10の整数であり、mは2;又は-, where m is an integer from 1 to 10 and m is 2; or
(ii)前記スペーサー単位はアルキル部分を含み、前記アルキル部分が-(CH(ii) said Spacer unit comprises an alkyl moiety, wherein said alkyl moiety is —(CH 2 ) n -を含んでよく、ここでnが1~10の整数であり、nは2、5又は6、-, where n is an integer from 1 to 10, n is 2, 5 or 6;
であってよく、前記スペーサー単位はマレイミド(Mal)部分に結びついていてもよい(「Mal-スペーサー単位」)、請求項7又は8に記載の化合物。and said spacer unit may be attached to a maleimide (Mal) moiety (“Mal-spacer unit”).
リンカーの切断可能部分はスプライシング調節薬に直接つなぎ合わされるか、又はスペーサー単位がリンカーの切断可能部分をスプライシング調節薬に結び付け、前記切断可能部分の切断により前記リンカーから前記スプライシング調節薬が放出されてよく、前記リンカーの切断可能部分をスプライシング調節薬に結び付ける前記スペーサー単位は自己犠牲性であってもよい、請求項7~9のいずれか一項に記載の化合物。Either the cleavable portion of the linker is directly tethered to the splicing modulating agent, or a spacer unit connects the cleavable portion of the linker to the splicing modulating agent, and cleavage of the cleavable portion releases the splicing modulating agent from the linker. A compound according to any one of claims 7 to 9, optionally wherein the Spacer unit connecting the cleavable portion of the linker to the splicing regulator may be self-immolative. 前記リンカーの切断可能部分をスプライシング調節薬に結び付けるスペーサー単位はp-アミノベンジル(pAB)又はp-アミノベンジルオキシカルボニル(pABC)を含み、pAB又はpABCはリンカーの切断可能部分をスプライシング調節薬に結び付けてよく、リンカーの切断可能部分は、Val-Cit又はVal-Alaを含む切断可能なペプチド部分又はアミノ酸単位を含んでもよく、リンカーはVal-Cit-pAB、Val-Ala-pAB、Val-Cit-pAB又はVal-Ala-pABCを含んでもよく、リンカーはMC-Val-Cit-pAB、MC-Val-Ala-pAB、MC-Val-Cit-pAB又はMC-Val-Ala-pABCを含んでもよい、請求項10に記載の化合物。The spacer unit that links the cleavable portion of the linker to the splicing modulator comprises p-aminobenzyl (pAB) or p-aminobenzyloxycarbonyl (pABC), pAB or pABC linking the cleavable portion of the linker to the splicing modulator. and the cleavable portion of the linker may comprise a cleavable peptide portion or amino acid unit comprising Val-Cit or Val-Ala, the linker being Val-Cit-pAB, Val-Ala-pAB, Val-Cit- pAB or Val-Ala-pABC, the linker may comprise MC-Val-Cit-pAB, MC-Val-Ala-pAB, MC-Val-Cit-pAB or MC-Val-Ala-pABC; 11. A compound according to claim 10. 式(I):
Ab-(L-H) (I)
[式中:
Abは、新生物細胞を標的化する抗体又は抗原結合断片であり;
Hは、スプライシング調節薬であり;
Lは、AbをHに共有結合的に結び付けるリンカーであり;及び
pは、1~15の整数である]
の抗体-薬物コンジュゲート。
Formula (I):
Ab-(LH) p (I)
[In the formula:
Abs are antibodies or antigen-binding fragments that target neoplastic cells;
H is a splicing regulator;
L is a linker that covalently links the Ab to H; and p is an integer from 1 to 15]
of antibody-drug conjugates.
前記抗体又は抗原結合断片が、wherein the antibody or antigen-binding fragment is
(i)B細胞悪性腫瘍、白血病、リンパ腫、骨髄腫、急性骨髄性白血病及び多発性骨髄腫から選択されてもよい血液学的悪性腫瘍に由来する新生物細胞;又は(i) neoplastic cells derived from hematologic malignancies which may be selected from B-cell malignancies, leukemia, lymphoma, myeloma, acute myelogenous leukemia and multiple myeloma; or
(ii)乳癌、胃癌、前立腺癌、卵巣癌、肺癌、子宮癌、唾液管癌、黒色腫、結腸癌、子宮頸癌、膵癌、腎癌、結腸直腸癌、及び食道癌から選択されてもよい固形腫瘍に由来する新生物細胞(ii) may be selected from breast cancer, gastric cancer, prostate cancer, ovarian cancer, lung cancer, uterine cancer, salivary duct cancer, melanoma, colon cancer, cervical cancer, pancreatic cancer, renal cancer, colorectal cancer, and esophageal cancer Neoplastic cells derived from solid tumors
を標的化する、請求項12に記載の抗体-薬物コンジュゲート。13. The antibody-drug conjugate of claim 12, which targets
前記抗体又は抗原結合断片が、wherein the antibody or antigen-binding fragment is
(i)HER2発現細胞を標的化し、(i) targeting HER2-expressing cells;
前記抗体又は抗原結合断片が抗HER2抗体又は抗原結合断片であって; wherein said antibody or antigen-binding fragment is an anti-HER2 antibody or antigen-binding fragment;
前記抗体又は抗原結合断片が、配列番号1(HCDR1)、配列番号2(HCDR2)、及び配列番号3(HCDR3)のアミノ酸配列を含む3つの重鎖相補性決定領域(HCDR1、HCDR2、及びHCDR3)と;配列番号4(LCDR1)、配列番号5(LCDR2)、及び配列番号6(LCDR3)のアミノ酸配列を含む3つの軽鎖相補性決定領域(LCDR1、LCDR2、及びLCDR3)とを含んで;及び/若しくは、 three heavy chain complementarity determining regions (HCDR1, HCDR2, and HCDR3), wherein said antibody or antigen-binding fragment comprises the amino acid sequences of SEQ ID NO: 1 (HCDR1), SEQ ID NO: 2 (HCDR2), and SEQ ID NO: 3 (HCDR3); three light chain complementarity determining regions (LCDR1, LCDR2, and LCDR3) comprising the amino acid sequences of SEQ ID NO:4 (LCDR1), SEQ ID NO:5 (LCDR2), and SEQ ID NO:6 (LCDR3); and / or
前記抗体又は抗原結合断片が、配列番号19のアミノ酸配列を含む重鎖可変領域と、配列番号20のアミノ酸配列を含む軽鎖可変領域とを含んで The antibody or antigen-binding fragment comprises a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 19 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 20.
よく、ここでwell here
前記抗体又は抗原結合断片がヒトIgG1重鎖定常領域を含んで;及び/若しくは、 said antibody or antigen-binding fragment comprises a human IgG1 heavy chain constant region; and/or
前記抗体又は抗原結合断片がヒトIgカッパ軽鎖定常領域を含んで said antibody or antigen-binding fragment comprises a human Ig kappa light chain constant region
もよい;also good;
(ii)CD138発現細胞を標的化し、(ii) targeting CD138-expressing cells;
前記抗体又は抗原結合断片が抗CD138抗体又は抗原結合断片であって; wherein said antibody or antigen-binding fragment is an anti-CD138 antibody or antigen-binding fragment;
前記抗体又は抗原結合断片が、配列番号7(HCDR1)、配列番号8(HCDR2)、及び配列番号9(HCDR3)のアミノ酸配列を含む3つの重鎖相補性決定領域(HCDR1、HCDR2、及びHCDR3)と;配列番号10(LCDR1)、配列番号11(LCDR2)、及び配列番号12(LCDR3)のアミノ酸配列を含む3つの軽鎖相補性決定領域(LCDR1、LCDR2、及びLCDR3)とを含んで;及び/若しくは、 three heavy chain complementarity determining regions (HCDR1, HCDR2, and HCDR3), wherein said antibody or antigen-binding fragment comprises the amino acid sequences of SEQ ID NO: 7 (HCDR1), SEQ ID NO: 8 (HCDR2), and SEQ ID NO: 9 (HCDR3); three light chain complementarity determining regions (LCDR1, LCDR2, and LCDR3) comprising the amino acid sequences of SEQ ID NO: 10 (LCDR1), SEQ ID NO: 11 (LCDR2), and SEQ ID NO: 12 (LCDR3); and / or
前記抗体又は抗原結合断片が、配列番号21のアミノ酸配列を含む重鎖可変領域と、配列番号22のアミノ酸配列を含む軽鎖可変領域とを含んで The antibody or antigen-binding fragment comprises a heavy chain variable region comprising the amino acid sequence of SEQ ID NO:21 and a light chain variable region comprising the amino acid sequence of SEQ ID NO:22
よく、ここでwell here
前記抗体又は抗原結合断片がヒトIgG2a重鎖定常領域を含んで;及び/若しくは、 said antibody or antigen-binding fragment comprises a human IgG2a heavy chain constant region; and/or
前記抗体又は抗原結合断片がヒトIgカッパ軽鎖定常領域を含んで said antibody or antigen-binding fragment comprises a human Ig kappa light chain constant region
もよい;又は、or
(iii)EPHA2発現細胞を標的化し、(iii) targeting EPHA2-expressing cells;
前記抗体又は抗原結合断片が抗EPHA2抗体又は抗原結合断片であって; wherein the antibody or antigen-binding fragment is an anti-EPHA2 antibody or antigen-binding fragment;
前記抗体又は抗原結合断片が、配列番号13(HCDR1)、配列番号14(HCDR2)、及び配列番号15(HCDR3)のアミノ酸配列を含む3つの重鎖相補性決定領域(HCDR1、HCDR2、及びHCDR3)と;配列番号16(LCDR1)、配列番号17(LCDR2)、及び配列番号18(LCDR3)のアミノ酸配列を含む3つの軽鎖相補性決定領域(LCDR1、LCDR2、及びLCDR3)とを含んで;及び/若しくは、 three heavy chain complementarity determining regions (HCDR1, HCDR2, and HCDR3), wherein said antibody or antigen-binding fragment comprises the amino acid sequences of SEQ ID NO: 13 (HCDR1), SEQ ID NO: 14 (HCDR2), and SEQ ID NO: 15 (HCDR3); and; three light chain complementarity determining regions (LCDR1, LCDR2, and LCDR3) comprising the amino acid sequences of SEQ ID NO: 16 (LCDR1), SEQ ID NO: 17 (LCDR2), and SEQ ID NO: 18 (LCDR3); / or
前記抗体又は抗原結合断片が、配列番号23のアミノ酸配列を含む重鎖可変領域と、配列番号24のアミノ酸配列を含む軽鎖可変領域とを含んで The antibody or antigen-binding fragment comprises a heavy chain variable region comprising the amino acid sequence of SEQ ID NO:23 and a light chain variable region comprising the amino acid sequence of SEQ ID NO:24.
よく、ここでwell here
前記抗体又は抗原結合断片がヒトIgG1重鎖定常領域を含んで;及び/若しくは said antibody or antigen-binding fragment comprises a human IgG1 heavy chain constant region; and/or
前記抗体又は抗原結合断片がヒトIgカッパ軽鎖定常領域を含んで said antibody or antigen-binding fragment comprises a human Ig kappa light chain constant region
もよい、請求項12又は13に記載の抗体-薬物コンジュゲート。14. The antibody-drug conjugate of claim 12 or 13, which may be
(i)請求項1~4のいずれか一項に記載のスプライシング調節薬又はその薬学的に許容可能な塩;(ii)請求項5~11のいずれか一項に記載の化合物、又は(iii)請求項12~14のいずれか一項に記載の抗体-薬物コンジュゲートと、薬学的に許容可能な担体とを含む医薬組成物。(i) a splicing regulator of any one of claims 1-4, or a pharmaceutically acceptable salt thereof; (ii) a compound of any one of claims 5-11, or (iii) ) A pharmaceutical composition comprising the antibody-drug conjugate of any one of claims 12-14 and a pharmaceutically acceptable carrier. 新生物性障害の治療における使用のための、請求項1~4のいずれか一項に記載のスプライシング調節薬又はその薬学的に許容可能な塩、請求項5~11のいずれか一項に記載の化合物又は請求項12~14のいずれか一項に記載の抗体-薬物コンジュゲート。A splicing modulator according to any one of claims 1 to 4, or a pharmaceutically acceptable salt thereof, according to any one of claims 5 to 11, for use in the treatment of neoplastic disorders. or the antibody-drug conjugate of any one of claims 12-14. 新生物性障害の治療用医薬品の製造における使用のための、請求項1~4のいずれか一項に記載のスプライシング調節薬又はその薬学的に許容可能な塩、請求項5~11のいずれか一項に記載の化合物又は請求項12~14のいずれか一項に記載の抗体-薬物コンジュゲート。A splicing modulator according to any one of claims 1 to 4 or a pharmaceutically acceptable salt thereof, any one of claims 5 to 11, for use in the manufacture of a medicament for the treatment of neoplastic disorders A compound according to one claim or an antibody-drug conjugate according to any one of claims 12-14. 前記新生物性障害が、wherein the neoplastic disorder is
(i)HER2を発現する乳癌、卵巣癌、胃癌、肺癌、子宮癌、骨肉腫、又は唾液管癌であり、前記肺癌が肺腺癌であって及び/若しくは前記子宮癌が漿液性子宮内膜癌であってもよい;(i) HER2-expressing breast cancer, ovarian cancer, gastric cancer, lung cancer, uterine cancer, osteosarcoma, or salivary duct cancer, wherein said lung cancer is lung adenocarcinoma and/or said uterine cancer is serous endometrium may be cancer;
(ii)CD138を発現する多発性骨髄腫である;又は、(ii) multiple myeloma expressing CD138; or
(iii)EPHA2を発現する乳癌、前立腺癌、卵巣癌、肺癌、黒色腫、結腸癌、又は食道癌である、(iii) breast cancer, prostate cancer, ovarian cancer, lung cancer, melanoma, colon cancer, or esophageal cancer that expresses EPHA2;
請求項16又は17に記載の使用のためのスプライシング調節薬、化合物又は抗体-薬物コンジュゲート。A splicing modulator, compound or antibody-drug conjugate for use according to claim 16 or 17.
CTLA4、PD1、PDL1、OX40、CD40、GITR、LAG3、TIM3、及び/又はKIRを標的化するチェックポイント阻害薬と組み合わせた新生物性障害の治療に使用するための、請求項16~18のいずれか一項に記載の使用のためのスプライシング調節薬、化合物又は抗体-薬物コンジュゲート。Any of claims 16-18 for use in the treatment of neoplastic disorders in combination with checkpoint inhibitors targeting CTLA4, PD1, PDL1, OX40, CD40, GITR, LAG3, TIM3 and/or KIR A splicing modulator, compound or antibody-drug conjugate for use according to claim 1. 少なくとも1つのネオ抗原ペプチド又は少なくとも1つのネオ抗原mRNAを含む、ネオ抗原ワクチンであって、前記少なくとも1つのネオ抗原ペプチド又は少なくとも1つのネオ抗原mRNAは、有効量の請求項1~4のいずれか一項に記載のスプライシング調節薬又はその薬学的に許容可能な塩、請求項5~11のいずれか一項に記載の化合物又は請求項12~14のいずれか一項に記載の抗体-薬物コンジュゲートを新生物細胞に接触させることにより誘導されるネオ抗原配列を含む、ネオ抗原ワクチン。A neo-antigen vaccine comprising at least one neo-antigen peptide or at least one neo-antigen mRNA, wherein said at least one neo-antigen peptide or at least one neo-antigen mRNA is in an effective amount. The splicing modulator of claim 1 or a pharmaceutically acceptable salt thereof, the compound of any one of claims 5-11 or the antibody-drug conjugate of any one of claims 12-14. A neo-antigen vaccine comprising a neo-antigen sequence induced by contacting the gate with a neoplastic cell.
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