TWI359671B - Cd40 antibody formulation and methods - Google Patents
Cd40 antibody formulation and methods Download PDFInfo
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- TWI359671B TWI359671B TW093139794A TW93139794A TWI359671B TW I359671 B TWI359671 B TW I359671B TW 093139794 A TW093139794 A TW 093139794A TW 93139794 A TW93139794 A TW 93139794A TW I359671 B TWI359671 B TW I359671B
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Description
1359671 九、發明說明: t發明所屬_^技術領域】 發明領域 本發明係有關CD40抗體配方及方法。 5 【先前技術】 發明背景
CD40係腫瘤壞死素受體(Tnfr)超家族中之—員。其被 表現在抗原呈現細胞(B細胞、樹突細胞 '單嗔細胞)、造血 前驅細胞、内皮細胞、平滑肌細胞、上皮細胞,以及大部 10 分的人類腫瘤上(Grewal & Flavell, Ann, Rev. Immunol., 1996, 16: 111-35; Toes & Schoenberger, Seminars in Immunology,1998, 10(6): 443-8)。使用 CD40激動劑的研究 已報導出CD40受體的激活作用引發出一連串的與抗·腫瘤 活性有關的功效。例如,在抗原呈現細胞上的CD40受體激 15 活作用已顯示可促進其成熟、抗原-呈現功能、免疫調節性 細胞激素之共激活能力及其釋出(Lee et al., PNAS USA, 1999, 96(4): 1421-6; Celia et al., J. Exp. Med., 1996, 184(2): 747-52)。據報導CD40激動劑亦可促進CD40+腫瘤之細胞凋 亡並增進其被樹突細胞加工的能力(von Leoprechting et al., 20 Cancer Res., 1999, 59:1287-94; Sotomayo et a]., Nature Medicine,1999,5(7): 780-87; Eliopoulos et al., Mol.細胞 Biol., 2000, 29(15): 5503-15; Ziebold et al.5 Arch. Immunol. Therapiae Experimentalis, 2000, 48(4): 225-33; Hoffmann et al., J. Immunol., 200], 24(2): 162-7])。這些免疫激活作用及 5 1359671
直接抗-腫瘤功效之顯著性已於動物模式下說明,其中CD40 激動劑抗體已被顯示可防止腫瘤生長並恢復腫瘤耐性 (Diehl et al.s Nature Med., 1999, 5(7): 774-9; Francisco et al.5 Cancer Res.,2000, 60(12): 32225-31)。CD40抗體被指示於 5 下列專利公開案中:U.S. 5,786,456 ; U.S. 5,674,492 ; WO
02/088186 ; US 2003059427 ; US 20020142358 ; WO 01/56603 ; U.S. 5,801,227 ; EP 806963 ; WO 88/06891 ;及 WO 94/04570。然而,CD40抗體之高效能的投藥方法及配 方尚未曾被揭示。一適於用在此類治療之穩定配方亦可為 10 有用的。 I:發明内容:J 發明概要 本發明係關於一種在一需要治療之一病人中治療癌症 之方法’其包含有投藥至該病人一CD40激動抗體或一其片 I5 段’其中該坑體依據一至少二週期之間歇式給藥療法被投 藥,每一週期包含有(a) —給藥期間,在此期間一治療有致 量的該CD4〇激動抗體被投藥至該病人’及其後(b)—休藥期 間。在一實施例中,該投藥產生一 0.01 gg/ml至10 gg/mi之 血漿抗體濃度至少三小時,及該休藥期間係至少1週。在其 20 它實施例中,該給藥期間係至少一曰、1-5日,或1-3曰。在 其它實施例中,該休藥期間係自1-8、1-6週、2-5週,或3、4 週。 在特定實施例中,該治療有效量的CD40激動抗體產生 該抗體之血漿濃度大約〇.〇3 pg/rn丨至10 pg/ml、大約〇 6 1359671 吨/m丨至i吨/ml、大約〇_03 至〇 3 卜或大約〇」 吨編至0_3 持續3至120小時。在某些實施例中,該特 定的血焚濃度係被維持至少一日、24至3〇小時、24至36小 時、24至48小時、24至72小時、24至%小時,或継⑽小 5時。在某些實施例中,血聚濃度被維持如⑷技^小時。 在心疋貫知例中,在該給藥期間被投藥之⑶仙激動抗 體的治療有效量係大約0·03至3,〇 mg/kg/日、〇」至3 〇 mg/kg/日、0.1 至 l.〇mg/kg/日,大約 〇m〇3mg/kg/dayj 一實施例中,該劑量被投藥丨_5日或丨_3曰,連續或隔曰投藥。 10 CD40激動劑抗體之間歇式給藥療法,如上所述有關腫 瘤治療,於增強病人之免疫反應亦係有用的,且此類用途 因此亦為本發明所提供。在特定實施例中,一病人之免疫 反應的增強導致病人全血中B-細胞上之CD23或MHC-II表 現增加’例如’可在一給藥期間結束時計算。 15 在某些實施例中,該抗-CD40抗體被投藥至一患有原 型及/或複合型免疫不全症病人,包括具有過高-IgM症候之 CD40-依賴型免疫不全症、一般多變型免疫不全症(c_nlon Variable Immunodeficiency)、布魯頓氏τ*球蛋白缺乏症 (Bruton's Agammaglobulinemia)、IgG次類型不全症,及X-20 連鎖性SCID(共同7鏈突變)。在某些實施例中,該抗—CD40 抗體被投藥以治療一病人,其係被免疫抑制,例如由於化 療’或其具有一免疫衰弱疾病,包括任何後天免疫不全疾 病’諸如HIV。在某些實施例中,該抗-CD40抗體被投藥 以增強一年老病人之免疫力。在某些實施例中,該抗-CD40 7 1359671 抗體被投藥以治療一病人’其具有一細菌、病毒、真菌或 寄生蟲感染。在某些實施例中,一人類激動性抗_CD40抗體 可被預防性地投藥至一病人’其由於年齡、疾病或一般不 健康而容易感染’以防止或降低感染的次數或嚴重性。本 5發明亦提供一種於一病人中治療一腫瘤的方法,其包含有 投藥一CD40激動抗體及一DNA複製抑制劑,較佳地係一氣 胺舶(p]atin)-衍生物’特別是順氣胺鉑。在特定實施例中, 順氣胺紐被靜脈注射投藥。在某些實施例中,順氣胺鉑被 投藥之量以病人之體表面積計係自大約25至300 mg/m2、大 10約50至150 mg/m2 ’或大約75至100 mg/m2。在一實施例, 順氣胺鉑被以一劑投藥(例如一單一的靜脈注射)在另一實 施例中,其被投藥超過2-5日。在特定實施例中,與順氯胺 在白一起被投藥的該CD40抗體投藥量係一大約〇. 1至3.0 mg/kg之劑量,或大約〇丨至丨〇 mg/kg,或大約0.1至0.3 15 mg/kg。 另一方面’順氣胺鉑之投藥係結合CD40抗體之間歇式 給藥療法’在一或多次的給藥期間或休藥期間内投藥以順 氯胺#。另一方面,本發明係關於一種在一需要此類治療 之病人中治療腫瘤之方法,藉由投藥至該病人一 CD40激動 20抗體或其片段,以一低於I mg/kg/日之劑量,其中病人中來 自於該抗體投藥之(:_血清濃度係低於50 pg/m卜在一實施 例中’劑量係在0,1至0.3 mg/kg之間且在病人中之Cmax血清 抗體濃度係在0.5及]〇pg/ml之間。 另一方面,本發明係關於一種穩定的液體藥學配方適 5 平線指出° _究代表至少3組獨立的實驗。 第4圖减承~~ C D 4 0激動抗體在延遲由一 B細胞淋巴癌 (Daudi)所引發之死亡的功效。該數據點係指存活動物之平 岣數目,每-%N=l〇。 第5圖減币由一CD40激動抗體及順氯胺鉑之組合治療 所弓丨生的腫瘤堤化。 C實施令式】 較佳實施例之蛘細說明 10 15 本文中所用’用語「激動性CD40抗體」或「激動性抗 -CD40抗體」意指一抗體其專一地結合至人類CD4〇分子, 且當被加至一細胞、組織或表現CD40之有機體時,增進一 或多種CD40活性至少大約2〇%。在某些實施例中,該抗體 活化CD40活性至少 4〇〇/0 ' 50%、60%、70%、80%,或 85%。 在某些實施例中’活化作用係在CD40L之存在下發生的。 在某些實施例中’該活化抗體的活性的測算係使用一全也 表面分子規則分析。在另一實施例中,該活化抗體之活性 的測算係使用一樹突細胞分析來測算IL-12釋出。在另一實 施例中,該活化抗體之活性的測算係使用一活體内腫瘤模 式0 20 本文中所用的用5吾「抗體」係相一完整的抗體,或一 其之結合片段可與完整抗體競爭專一性結合。結合片段的 產生係藉由重組型DNA技術’或者藉由完整抗體之酵素性 或化學性切釗。結合片段包括Fab ' Fab1、F(ab,)2、Fv及單 鏈抗體。可以瞭解到’本文中指示之一完整(例如完全的、 10 1359671 全長等)抗體包括一在重鏈中具有一末端離胺酸刪除的抗 體,該刪除一般係在重組體表現期間發生。 較佳地,該激動的CD40抗體係一人類抗體。如本文中 所使用者,用語「人類抗體」意謂一其中可變及固定區塊 5 序列係衍生自人類序列的抗體。人類CD40抗體詳述於提申 於2001年11月9日之美國臨時申請案第60/348,980號及提申 於2002年11月8曰之PCT國際申請案第PCT/US02/36107號 (現公開為WO 03/040170)中,其完整的揭露内容在此被併 入為參考資料。在本發明之治療方法中,人類抗體提供一 10 實質的優點,如所預期的可在人類病人中使與非人類之使 用有關的免疫性及過敏性反應最小化。 用於本發明之例示的人類抗-CD40抗體包括具有以下 命名之抗體胺基酸序列的抗體:3.1.1、3.1.1H-A78T、 3.1.1H-A78T-V88A-V97A、7.1.2、10.8.3 ' 15.1.1、21.4.1、 15 21.2.1、22.1.卜 22.1.1H-C109A、23.5.1、23.25」、23.28.1、 23.28.1H-D16E' 23.29.1 ' 24.2.] > 3.1. 1H-A78T-V88A-V97A/ 3丄1!^4河丄83乂及23.28.11^92八,以及一包含有—任何 例示抗體之CDR或可變區域的抗體。 可辨識相同或相似抗原決定位或其一部分之抗體,如 2〇任何例示之抗體,亦可被用於本發明。亦即,熟習此藝者 可以瞭解的,基於本文中所提供之揭露内容,一與本發明 之柷體 〇H°3.1.1、3.1.1H-A78T、3.I.lH-A78T-V88A-v97A、7·]·2、]〇.8.3 ' ]5·1.1、21.4.1、21.2·]、22.1.]、 22·] .]H-C]09A、23.5,]、23.25.卜 23.28.1、23.28.1H-D16E、 11 1359671
23.29.1 ' 24.2.1 ' 3.1. 1H-A78T-V88A-V97A/3.1. 1L-L4M-1^83乂及23.28.11^-匚92八,及其類似者)競爭的抗體可被用作 為本文其它部分所揭示者。一所欲的可與一本文例示抗體 競爭的抗體可使用已知的用於定性抗體之方法被輕易地鑑 5 別出。較特別的,用於評估一抗體之特性,以及用於與其 它抗體比較結合特性的分析,係習知技藝所已熟知。此類 方法包括,但不限於,以ELISA為基礎的分析、使用BIAcore 結合研究,以及Walker等人在美國專利申請案第 2003/0157730A1號中所詳述者。用語「競爭」,如本文關於 10 一抗體所使用者,係意謂一第一抗體與一第二抗體競爭結 合,其中該第一抗體與其同系抗原決定位的結合,比較於 第一抗體在第二抗體不存在時的結合,在第二抗體存在下 係可測得地減少。’或者,可以但非必要地,該第二抗體結 合至其抗原決定位,在第一抗體的存在下亦係可測得地減 15 少。亦即,一第一抗體可抑制一第二抗體對其抗原決定位 的結合,而不必第二抗體抑制第一抗體對其相對抗原決定 位的結合。然而,每一抗體可測得地抑制其它抗體與其同 系抗原決定位或配位基的結合,無論是相同、較多或較小 的範圍,該抗體被稱為與其彼此「交叉競爭」結合其各別 20 的抗原決定位。例如,交叉競爭性抗體可結合至抗原決定 位 '或抗原決定位之部份,本發明之抗體(e.g., 3.1.1、 3·1_1.Η-Α78Τ、3.1.1H-A78T-V88A-V97A、7·1_2、10.8.3、 15·]·]、21·4_]、21·2.:1、22.1.]、22.1.]H-C109A、23.5.]、 23.25」、23.28」、23.28·] H-D]6E ' 23.29.]、24.2.1 ' 3.] ·]Η- 12 1359671 A78T-V88A_V97A/3_1.1L-L4M-L83V 及 23.28.1L-C92A)所 結合者。競爭性或交叉競爭性抗體二者均為本發明所涵 括。無關乎此一競爭或交叉競爭發生的機制(例如立體空間 障礙、結構變化或結合至一共同的抗原決定位、或其部分’ 5及其類似者),熟習此藝者可以瞭解到,基於本文所提供的 教示,此類競爭及/或交又競爭性抗體被包含且可被用於本 文中所揭示之方法中。
再者,δ亥例示抗體可進一步藉由一或多個胺基酸殘基 之取代、增加或刪除來修飾而未消減該抗體結合抗原之能 1〇力及行使其激動功能。實際上,一命名為 「3.1.1H-A78T-V88A-V97A/3.1.1L-L4M-L83V」之抗體包 含有在重鏈可變區域中三個胺基酸取代,亦即,一胺基酸 殘基第78號自丙胺酸取代為酥胺酸、一胺基酸殘基第88號 '自纈胺酸取代為丙胺酸,及一胺基酸殘基第97號自纈胺酸 15 取代為丙胺酸(序列辨識編號:9),全部對應於抗體3.1.1之 重鏈可變區域的胺基酸序列(序列辨識編號:1)。並且,該 3. UΗ-Α78T-V88A-V97Α/3· 1 · 1L-L4M-L83V抗體更包含有 在該輕鏈可變區域一胺基酸殘基第4號自白胺酸取代為曱 硫胺酸之胺基酸取代及一胺基酸殘基第83號自白胺酸取代 20 為纈胺酸(序列辨識編號:10),相較於抗體3.L1輕鏈可變區 域之胺基酸序列(序列辨識編號·· 3)。抗體3·] .1及 3 ].1H-A78T-V88A-V97A/3.1.1L-L4M-L83V之重鏈固定區 域的胺基酸序列(序列辨識編號:2)及輕鏈固定區域的胺基 酸序列(序列辨識編號:4)係相同的。抗體 13 1359671 3.1.1H-A78T-V88A-V97A/3.1.1L-L4M-L83V 亦指示為 「3.】JH3L2」以反映出該抗體相對於抗體3】丨包含有在重 .键有三個胺基酸取代基及在輕鏈有二個胺基酸取代基。 因此,在某些實施例中,例示抗體可被—至十 '一至 5 五、一至三個胺基酸殘基取代、增加或刪除來修飾,例如 在一CDR或骨架區域。這些例示抗體及其產生方法係被詳 述於提申於2001年11月9日之美國臨時申請案第60/348,980 號及提申於2002年11月8曰之PCT國際申請案第 PCT/US02/36107 (W0 03/040170)號。然而,本發明不限於 1〇 這些或任何其它的胺基酸取代。當然,熟習此藝者由本文 所提供的教示將可瞭解到一廣泛變化的胺基酸取代係為本 發明所涵蓋。 融合瘤 3.1.1 ' 7.1.2、10.8.3、15.1.1 及21.4.1 係於2001 年8月6日依據布達佩斯條約被寄存於American Type 15 Culture Collection (ATCC), 10801 University Boulevard, Manassas, VA 20110-2209。融合瘤 s 21_2.1、22.1.1、23.5.1、 23.25.1、23.28.1、23.29.1 及24.2·]於2002年7月 16 日被寄存 於ATCC。融合瘤已被指定下列寄存編號: 融合瘤 寄存編號 3.1.1 (LN 15848) PTA-3600 7.1.2 (LN 15849) PTA-3601 10.8.3 (LN 15850) PTA-3602 15.1.1 (LN 1585 1) PTA-3603 21.4.1 (LN 1 5853) PTA-3605 20 14 1359671 21.2.1 (LN 15874) PTA-4549 22.1.1 (LN 15875) PTA-4550 23.5.1 (LN 15855) PTA-4548 23.25.1 (LN15876) PTA-4551 23.28.1 (LN 15877) PTA-4552 23.29.1 (LN 15878) PTA-4553 24.2.1 (LN 15879) PTA-4554 這些抗體的序列係已知,記述於WO 03/040170中。為 方便起見,這些抗體中之二個的重鏈及輕鏈的胺基酸序列 10 列示於下: 抗體3.1.1 : 3.1.1 : 重鏈蛋 白質序 列 可變的(序列辨識編號:1): QVQLVESGGGVVQPGRSLRLSCAASGFTFSSYGMHWVRQA PGKGLEWVAVISKDGGNKYHADSVKGRFTISRDNSKNALYL QMNSLRVEDTAVYYCVRRGHQLVLGYYYYNGLDVWGQGTT VTVSS 固定的(序列辨識編號:2): ASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFPEPVTVSWN SGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSNFGTQTYTCN VDHKPSNTKVDKTVERKCCVECPPCPAPPVAGPSVFLFPPK PKDTLMISRTPEVTCVVVDVSHEDPEVQFNWYVDGVEVHNA KTKPREEQFNSTFRVVSVLTVVHQDWLNGKEYKCKVSNKGL PAP1EKTISKTKGQPREPQVYTLPPSREEMTKNQVSLTCLVK GFYPSDIAVEWESNGQPENNYKTTPPMLDSDGSFFLYSKLT VDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK 3.1.1 : 輕鏈蛋 白質序 列 可變的(序列辨識編號:3): DIVLTQSPLSLPVTPGEPASISCRSSQSLLYSNGYNFLDWYLQ KPGQSPQLLIYLGSNRASGVPDRFSGSGSGTDFTLK1SRLEA EDVGVYYCMQALQ 丁 PRTFGQGTKVEIK 固定的(序列辨識編號:4): RT\/AAPSVF1FPPSDEQLKSGTASVVCLLNNFYPREAKVQWK VDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHK VYACEVTHQGLSSPVTKSFNRGEC. 15 1359671
3.1.1H- A78T- V88A- V97A : 重鏈蛋 白質序 列 可變的(序列辨識編號:9): QVQLVESGGGVVQPGRSLRLSCAASGFTFSSYGMHWVRQA PGKGLEWVAVISKDGGNKYHADSVKGRFTISRDNSKNTLYL QMNSLRAEDTAVYYCARRGHQLVLGYYYYNGLDVWGQGTT VTVSS 固定的(序列辨識編號:2): ASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFPEPVTVSWN SGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSNFGTQTYTCN VDHKPSNTKVDKTVERKCCVECPPCPAPPVAGPSVFLFPPK PKDTLMISRTPEVTCVVVDVSHEDPEVQFNWYVDGVEVHNA KTKPREEQFNSTFRVVSVLTVVHQDWLNGKEYKCKVSNKGL PAPIEKTISKTKGQPREPQVYTLPPSREEMTKNQVSLTCLVK GFYPSDIAVEWESNGQPENNYKTTPPMLDSDGSFFLYSKLT VDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK 3.1.1L-L4M-L83V : 輕鏈蛋 白質序 列 可變的(序列辨識編號:10): DIVMTQSPLSLPVTPGEPASISCRSSQSLLYSNGYNFLDWYL QKPGQSPQLLIYLGSNRASGVPDRFSGSGSGTDFTLKISRVE AEDVGVYYCMQALQTPRTFGQGTKVEIK 固定的(序列辨識編號:4): RTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWK VDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHK VYACEVTHQGLSSPVTKSFNRGEC
抗體 21.4.1 : 21.4.1 : 重鏈蛋 白質序 列 可變的(序列辨識編號:5): QVQLVQSGAEVKKPGASVKVSCKASGY 丁 FTGYYMHWVRQA PGQGLEWMGWINPDSGGTNYAQKFQGRVTMTRDTSISTAY MELNRLRSDDTAVYYCARDQPLGYCTNGVCSYFDYWGQGT LVTVSS 固定的(序列辨識編號:6): ASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFPEPVTVSWN SGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSNFGTQTYTCN VDHKPSNTKVDKTVERKCCVECPPCPAPPVAGPSVFLFPPK PKDTLMISRTPEVTCVVVDVSHEDPEVQFNWYVDGVEVHNA KTKPREEQFNSTFRVVSVLTVVHQDWLNGKEYKCKVSNKGL PAPIEKTISKTKGQPREPQVYTLPPSREEMTKNQVSLTCLVK GFYPSD1AVEWESNGQPENNYKTTPPMLDSDGSFFLYSKLT VDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK 16 1359671
21.4.1 : 輕鏈蛋 白質序 列 可變的(序列辨識編號:7): DIQMTQSPSSVSASVGDRVTITCRASQGIYSWLAWYQQKPG KAPNLLIYTASTLQSGVPSRFSGSGSGTDFTLTISSLQPEDFA TYYCQQANIFPLTFGGGTKVEIK 固定的(序列辨識編號:8): RTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWK VDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHK VYACEVTHQGLSSPVTKSFNRGEC 因此,21.4.1抗體之胺基酸序列包含有記述於序列辨 識編號5-8中之胺基酸序列,3.1.1.抗體之胺基酸序列包含有 記述於序列辨識編號·· 1-4中之胺基酸序列,且該3.1.1 5 H-A78T-V88A-V97A/3.1.1L-L4M-L83V抗體之胺基酸序列 包含有記述於序列辨識編號:9、序列辨識編號:2 '序列 辨識編號10及序列辨識編號4中之序列。3.1.1及 3.L1H-A78T-V88A-V97A/3.1.1L-L4M-L83V之間不同的胺 基酸被標示底線。 10 要瞭解到’基於本文所提供之揭露内容,本發明之3.].1 抗體包括本文所述任何重鏈及/或輕鏈可變區域之組合。亦 即’一抗體可包含可變區域之任意組合,包括但不限於 3.1.IH (序列辨識編號·· ] )/3丨1L (序列辨識編號:3)、3.ι·ιη (序列辨識編號:1)/3.1.1L-L4M-L83V (序列辨識編號:]〇)、 15 3.1.1H-A78T-V88A-V97A (序列辨識編號:9)/3.1.1L (序列 辨識編號3) ’及較佳地,3,].1H-A78T-V88A-V97A (序列辨 識編號:9)/3·1·1Ι^4Μ·:ί83ν (序列辨識編號:1〇)。然而, 本發明並不限於這些或任何其它的特別組合。在特定的實 施例中’腫瘤治療抑制癌細胞增殖,抑制或預防腫瘤重量 17 1359671 或體積的增加,及/或致使腫瘤重量或體積的減少。在某些 實施例中,腫瘤治療延長病人存活壽命。在某些實施例中, 比較於未受治療者,腫瘤生長被抑制至少50% ' 55%、60%、 65°/。、70%或75%。在某些實施例中,腫瘤係CD40陽性的。 5 在某些實施例中,腫瘤係CD40陰性的。腫瘤可為一實體腫 瘤或一諸如淋巴癌之非實體腫瘤。在某些實施例中,一抗 -CD40抗體被投藥至一具有一癌性腫瘤之病人。 可以抗-C D 4 0抗體或抗體部分治療之病人包括,但不限 於,被診斷出具有下列病症之病人:腦癌、肺癌、骨癌、 10 胰臟癌、皮膚癌、頭頸部癌症、皮膚的或眼内的黑色素瘤、 子宮癌、卵巢癌、直腸癌、肛門區的癌症、胃癌(stomach cancer, gastric cancel·)、大腸直腸癌、大腸癌、婦科腫瘤(例如,子 宮肉瘤、輸卵管的癌、子宮内膜癌、子宮頸癌、陰道癌或 外陰癌)、食道癌、小腸癌、内分泌系統的癌(例如,甲狀腺、 15 副曱狀腺癌或腎上腺之癌)、軟組織癌、白血病、骨髓瘤、 多發性骨髓瘤、尿道癌、陰莖癌、前列腺癌、慢性或急性 白血病、兒童之實體腫瘤、霍奇金氏病、淋巴球淋巴癌、 非-霍奇金氏淋巴癌、膀胱癌、肝癌、腎癌、腎臟或輸尿管 的癌症(例如,腎細胞癌、腎盂癌),或中樞神經系統之贅瘤 20 (例如,主要CNS淋巴癌、脊軸腫瘤、腦幹神經膠瘤或垂體 腺瘤)、神經膠瘤或纖維肉瘤。 本文中使用的,用語「病人」係指一人類或一表現一 交叉反應的CD40之非人類哺乳動物(例如,一靈長動物、馬 來狼(cynomolgus)或值河狼(rhesus))。較佳地被治療的病人
1S 1359671 1ΛΜ1 :抗體對取自癌恭 '---SlTP細胞的作用
檢測一人類抗-CD40抗體(21 4 1)钭而A )對取自於經自體腫瘤 細胞激活之癌症病人的淋巴結細胞的作用。 淋巴結細胞及腫瘤採自於具右瞽 腎蜮、·.田胞癌、非小細胞 之 肺癌、膀胱之轉移細胞癌、大腸癌、前列_及頭頸痒< 病人。淋巴結細胞與_射經膠原蛋叫處理之腫瘤(取自 同-病人)在2山(1啦虮;6.7,存在或不存在下放在 一起培養。使用H-胸腺核苔96小時之怂— τ之後评估增殖作用。於 ίο 15 再激活之後以EUSPOT評估_7產生細胞的數旦 在經腫瘤抗原激活之淋巴結細胞的培養中$抗體增強 ㈣γ+陽性丁細胞的數量。並且這些淋巴結細胞反應於腫瘤 抗原的增殖作用係增強3 -4倍。 在以腫瘤抗原激活時,抗體增強了得自癌症病人之淋 巴結細胞的增殖作用及細胞激素的產生能力。 實施例2 :抗體對FcM的結合 檢測抗-CD40抗體(21 ·4· 1)對人類及馬來猴白血球上之 Fc受體的結合。 流式細胞光度計量研究指出FcR類型FcyRn (CD32)及 20 FCyRin (CD]6),以及極少量的FcyRI (CD64)被表現在人類 白血球上。21.4.1對人類或馬來猴周邊血液白血球上之Fc 受體(FcR)的結合,係藉由使用125μ2】4丨及一人類IgG丨對照 組mAb來測定。得自正常捐出者之人類白血球或馬來猴白 血球利用血漿膠被從全血分離並完全清洗,使得與受體結 2) 1359671 合的血清免疫球蛋白分離。經一蔑糖缓衝的離心作用被用 以分離經細胞結合及未經結合的抗體。研究係在4°C於疊氮 化納存在以防止受體内部化之下進行的。 藉由使用過多未標誌人類IgG2次類吻合抗體作為一競 5 爭物來檢測21.4.1對?〇尺的專一性結合。1251-21.4.1專一性結
合至人類白血球上之FcR(n=5捐出者)係-1.0± 8.5%,且專 一性結合至馬來猴白血球(n=4)上之FcR係15± 13%。加入 500倍過多未標誌的21.4.1,其將阻礙任何mI-21.4.1對白血 球CD40受體及FcR之專一性結合,該加入所得到的 10 i25I-21.4.1對人類白血球及馬來猴白血球之CD40受體的專 一性結合分別為49%及67% (對CD40之%專一性結合係以 總%專一性結合減去對F c R之%專一性結合)。作一對照組 時,125I-IgGl同樣地得到對人類及馬來猴白血球之專一性 結合。該IgGl對照組抗體對人類及馬來猴白血球上之FcR 15 的專一性結合分別計有總結合放射活性之56%及51 %。
這些研究指出該抗體顯示出對於人類及馬來猴白血球 上之Fc受體有最小的專一性結合。 實施例3 :全血的細胞激素釋出分析 一抗-CD40抗體(21.4.1)被檢測其自未經激活之人類全 20 血引發細胞激素釋出之能力,其使用一與人體内由抗體所 媒介之細胞激素釋出相關之活體外全血分析。21.4.1係在 1、10及100 pg/Ml被試驗,同時以一鼠抗-人類CD3 IgG]作 為一陽性對照組,其係經由一 Fc媒介路徑所引發細胞激素 釋出,以及以LPS作為一第二陽性對照組,其係藉由激活巨 22 1359671 嗟細胞引發細胞激素。所用的捐出者包括對鼠抗體及L P S 均有反應之個體(4捐出者),以及只對㈣有反應之個體 捐出者)。經肝素化之全血與214」培#5小時,收集血“ 藉由ELISA分析腫瘤壞死素α (TNF a)、干擾素以鮮讽 5間白素-6(IL-6)(使用購得的套組)。亦培育該培養⑽小時 並分析間白素-1召(IL-1 β)。 在與1或10 pg/mL之21.4.1培養之人類血液的血漿未檢 測到細胞激素。只有一個以1〇〇 ^/mL之抗體處理過之捐出 者顯不出二種細胞激素之低但可測得量(34 的TNF_a Η)及90Pg/mLIL-6)e此-捐出者其後被再試驗,並顯示出無 可測知的TNF-α或IL-6引發。在任何樣品中均無INPy或 IL-Ιβ的提南。 此一研究相出21.4.1不會在人類全血中引發炎性細胞 激素。 15 耋-施例4 :抗體之整物動力璺及華璺反應動力皋 CD40抗體(21.4.1)以各種劑量被靜脈注射投藥(1 mg/kg η - 4、3 mg/kg η = 4'5 mg/kg η = 2及 10 mg/kg π = 2) 至馬來狼。肝素化之血液在給藥前及後的各種時間點被取 出。s亥jk液被分裝並染色。使用一 Bect〇n Dickinson 20 FACSCalibur獲得數據並以CellQuest軟體分析。比較至給藥 前的數值以令央螢光密度的倍數增加計算結果。 MHC第11型表現,反應出B-細胞的活化狀態及抗原呈 現能力’對所有受試劑量而言,在給藥後24小時内增加2.5 至3倍,並未得到清楚的劑量_反應關係^ CD23表現,B-細 23 1359671 胞的另一標記,於2個動物中以3 mg/kg及一個動物中以IΟ mg/kg被評估。CD23表現在給藥後24小時時增加220-倍且 未得到無劑量效應。當21.4.1量維持約1 pg/ml時,二種表面 標記的向上調節持續著($2-倍增加)。CD71(轉鐵蛋白受體) 5 及CD86共激活分子的量亦顯示適度向上調節,而CD80表現 未有顯著改變。 21.4.1活體内向上調節馬來猴B-細胞之表面標記。於 CD20+細胞上之MHC第II型及CD23表現,係隨著處理而增 加,且1 mg/kg (對應於·--20 pg/mL之Cmax及曝露於一 2 0.1 10 pg/rnL之濃度歷時4'日)顯示於馬來猴B-細胞產生了 一飽和 藥物動力學反應。此一反應在較高劑量下反應期間更長。 在一 1、3、5或10 mg/kg之單一劑量之靜脈投藥後於馬 來猴中檢測一抗-CD40抗體(21.4.1)之藥學反應動力學特 性。21.4.1的特徵在於系統性清除性低(0.0133至0.0635 15 mL/min/kg)及穩態時分布之體積小(0.0459至0.0757 L/kg),得到一0.75至2.0曰之表觀平均消除半生期(表1)。該 21.4.1之藥學反應動力學顯示為隨所測劑量範圍變化的劑 量-依賴型。清除值一般隨劑量自1至10 mg/kg的增加而減 少,且表觀平均消除半生期自1 mg/kg時0.75曰增加至10 20 mg/kg時2.0曰。在穩態分布之體積在不同劑量時相似 (0.0575 L/kg之平均值)。 所得的劑量-依賴型清除性可能部分由於2] .4.]對廣泛 表現於正常組織中之CD40受體之結合,以及隨後該抗體-受體複合體内部化且消除。靈長動物抗-人類抗體(PAHA) 1359671 反應的發展亦可能在有些猴子内加速清除。由於2l4i存在 於受試血清中與分析paha產生干擾,PAHA僅在個體21 4 ^ 血清濃度達到計量之下限(LLOQ,0.03 gg/mL)時被評估。在 抗體投藥之後14至28日時偵測3、5、及10 mg/kg劑量組之 5 所有猴子中的抗-21.4.1抗體。 表1 在一以卜3、5及10 mg/kg單一 IV投藥後馬來猴中2141 之平均(± SD)藥學反應動力學參數 劑量 N/ CL (mg/kg)性別(mL/min/kg) Vdss (L/kg) t】/2 (曰) auc(〇-03) (Kgh/mL) 1 2/性 0.0635 土 0.0245 0.0757 + 0.0265 0.75 ± 0_21 298 ± 126 3 2/性 0.0213 土 0.0055 0.0459 ± 0.0055 1_4 士 0.3 2460 + 600 5 2F 0.0174 0.0488 1.4 4790 10 1/性 0.0133 0.0529 2.0 12500 1〇 實施例5 :抗體之抗-腫瘤活性 CD40抗體(21.4.1)之腫瘤生長抑制活性係於SCID_灰棕 色(SCID-beige)小鼠中決定的’以腫瘤細胞單獨(丨X丨〇7)或 與得自同一捐出者之人類DC(1 X ]05)及τ細胞(5 X 105)—起 被SC注射。腫瘤細胞對DC及T細胞的比例係1 〇〇 : 1 : 5。除 15 非另指,否則有關腫瘤的大小係以mm2呈現,在對照組動 物中的腫瘤生長達到一 300-400 mm2之大小時為一決定前 之固定時間點(來自反應動力學實驗),且其不長於人類持續 進行該貫驗。在所有狀況下’只有一個2 ]. 4.]的注射被投 藥,其在SC]D-灰棕色小鼠中具有一:>3〇日之丁w2。 20 實施例5(a):抗體對 25 1359671 檢測一 CD40抗體(21.4· 1)對CD40㈠腫瘤(例如紅白血 病(erythroleukemia)及大腸癌)生長的效應。特別是,K562 腫瘤被選擇以έ平估21.4· 1對抗CD40(-)低免疫性(第I及η型 陰性)腫瘤的功效。 5 SCID-灰棕色小鼠被SC注射以CD40㈠紅白血病腫瘤, Κ562 (ATCC CCL-243)單獨或在人類周邊血液τ細胞及dc 存在下。動物接受一 21.4.1單獨的IP注射,使用不同的劑 量,在腫瘤注射時或5日後。 當免疫細胞如所記述地在腫癌注入之第21日出現時, 10 21 ·4· 1之單一巧注射導致K562腫瘤生長的劑量-依賴型抑制 (第1圖)。致使一50%腫瘤生長抑制之21.4.1的量係〇 〇〇5 mg/kg ’對應於一 〇.〇5 pg/mL之(:觀血清濃度。對CD40(-) 大腸癌,Lovo (ATCC CCL-229),觀察到相似的結果。當 21 ·4_ 1在相對於腫瘤注入之第〇日或第+5曰投藥時,結果係 15相同的。這些CD40(-)腫瘤的生長在免疫細胞不存在之下係 不會被21.4.]抑制的。 當免疫細胞存在時21.4.1防止CD40(-)腫瘤的生長,表 示免疫所媒介的抗-腫瘤活性被增強。此證實可對抗一大腸 癌及一紅白血病腫瘤。此一抗-腫瘤活性在使用抗體3對 20 大腸癌及抗體 3.1.1H-A78T-V88A-V97A/3.1.1L-L4M-L83V (IC5〇 < 0.01 mg/kg)於紅白血病腫瘤中亦被證實。因此,本 文所揭露之數據證實了 3.].1H-A78T-V88A-V97A/3.1.1L-L4M-L83V抗體具有3.1.1抗體之活體内活性。這些活體内腫 瘤結果進一步支持了在比較該二抗體時所得到的相似活體 26 1359671 外數據,抗體3.1.1 及抗體3.1.1H-A78T-V88A-V97A/3.1.1L-L4M-L83V在活體内將以相似的方式表現。因此,使用3.1.1 所得的結果在此一或其它分析中適用至3.1.1H-A78T-V88A-V97A/3.1.1L-L4M-L83V。 5 實施例5(b):抗體對人類乳房及前列腺腫瘤的功效 檢測一抗-D40抗體(21.4.1)對防止乳房及前列腺腫瘤 生長的功效。 SCID-灰棕色小鼠被注入人類乳房腫瘤,BT 474 (ATCC HTB- 25 20),SC,與人類周邊血液T細胞及DC-10 起。在腫瘤注射的同時,動物接受一單一劑量的21.4.1 (IP)。 如第2圖中所示,一21.4.1之單一注射在免疫細胞存在 下防止了 BT 474細胞的生長。21.4.1致使腫瘤生長50%降低 之需要量為0.005 mg/kg,對應於一 0_05 pg/mL之Cmax血清濃 度。在對抗人類前列腺癌細胞株PC-3 (ATCC CRL-1435)觀 15 察到相似的結果。使用抗體3.1.1時此亦被證實且可預期到 對於3.1.1H-A78T-V88A-V97A/3.1 1L-L4M-L83 V的使用。 21.4.]防止人類乳房及前列腺腫瘤的生長。 實施例5(c):抗體對CD40(+)腫瘤的抗-腫瘤功钕 研究在免疫細胞存在及不存在下抗-CD40抗體(21.4.1) 20 對抗CD40(+)腫瘤之抗-腫瘤活性以及變化。 SCID-灰棕色小鼠被皮下注射CD40(+) Raji B細胞淋巴 癌(ATCC CCL-86) (SC),接著一在腫瘤注射時注射一單一 劑量的2 ] .4.1 (IP)。有些動物亦被注射以人類丁細胞及dc。 在第2]曰時評估腫瘤生長。 27 1359671 如第3圖所示,在免疫細胞不存在下導致腫瘤生長50〇/〇 抑制之21·41的量係〇·〇2 mg/kg,對應於一〇.2 Mg/mL之Cmax 血清濃度。當腫瘤細胞與免疫細胞共注射時,導致腫瘤生 長50%抑制之21.4.1的需要量減少20-倍至o.ooi mg/kg ((:丽 5 血〉月》辰度=0.01 pg/niL)。 這些結果說明21.4.1具有直接對抗CD40(+)腫瘤的抗-腫瘤活性。亦對3·l.lH-A78T-V88A-V97A/3.1.1L-L4]VI-L83V(IC50<0.0lmg/kg)作此一觀察。抗體21·4·l之此一抗 •腫瘤活性當免疫細胞存在下被增強,且此以抗體3.11亦被 10 證實且可對抗體 預期到。 f施例5(d):抗體對Β-細胞淋巴癌之抗-腫瘤功钤 評估本發明抗-CD40抗體(21.4.1)於一使用B細胞淋巴 癌之CD40(+)系統性腫瘤模式中延遲死亡的能力。 15 SCID-灰棕色小鼠被IV注射以B細胞淋巴癌Daudi (ATCC CCL-213)。21.4.1以一單一注射(IP)在腫瘤注射之同 時被投藥。監測死亡狀況歷時58曰。 如第4圖中所示’ 21.4.1的單一注射防止由一系統性投 與腫瘤細胞株所引發的死亡。 20 21 _4· 1在使用一 B細胞淋巴癌之CD40(+)系統性腫瘤模 式中延遲死亡。使用3 · 1.1亦證實得到此結果,並且可預期 對 3.1.1H-A78T-V88A-V97A/3.UL-L4M-L83V有相似的結 果。 實施例6 :抗體結合順氮胺相的治療功效 28
Claims (1)
1359671 第93139794號專利申請案申請專利範圍修正本 十、申請專利範圍: 5 ιορ^ιο 忐 補尤· 1. 一種一治療有效量的CD40激動抗體及一治療有效量的 DNA複製抑制劑之組合的用途,其供製造一用於在一需 要之病人中治療腫瘤之藥劑,其中該抗體係21.4.1,且該 DNA複製抑制劑係順氣胺鉑。 2. —種適用於非經腸道投藥之穩定的液態藥學配方,其包 含有一pH值在5.0-6.0之CD40激動抗體及一藥學上可接 受之載劑,該配方在一至少三個月的期間内係穩定的, 其中該抗體係21.4.1,且該配方具有一至少大約5 mg/ml 之該CD40抗體的濃度,其中該藥學上可接受之載劑包 含氣化納、醋酸鈉及聚山梨醇S旨80(polysorbate80)。 10
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