TWI827057B - 疫苗、其用途及癌症疫苗混合物 - Google Patents
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Abstract
本發明是關於一種疫苗、其用途及癌症疫苗混合物。疫苗包含載體和轉基因,其中轉基因被包覆於載體中且編碼數個胜肽。所述胜肽依序包含分泌信號胜肽、至少一腫瘤抗原、至少一共抑制胜肽和Toll樣受體9拮抗序列。所述疫苗可以表達足夠的轉基因,並能降低病毒清除,提高腫瘤抗原表達量,於癌症治療上具有優異的治療效果。藉此,可用於製備治療癌症之藥物以及作為癌症疫苗混合物。
Description
本發明是有關於一種疫苗、其用途,以及一種癌症疫苗混合物,特別是一種對腫瘤抗原具有特異性的疫苗、其用途,以及包含所述疫苗的癌症疫苗混合物。
癌症治療主要以放射治療、化學治療、標靶治療與手術為主,然而,儘管近年藥物與手術技術的進步,晚期患者五年存活率仍然相當低,顯示新穎的治療策略之重要性,如免疫治療。免疫治療主要以提升免疫反應清除腫瘤細胞為主,包含免疫檢查點阻斷劑、細胞治療與腫瘤疫苗。免疫檢查點阻斷劑在不同癌症中均顯示其臨床反應佳,但臨床反應與腫瘤突變量高(如DNA錯配修復缺陷,僅占癌症患者10-15%)跟免疫細胞浸潤程度成正比,顯示開發新穎型態免疫治療策略極為重要,如腫瘤新抗原免疫治療。
腫瘤新抗原為腫瘤生長過程產生之突變蛋白片段,能有效誘發腫瘤專一免疫反應,因此隨著基因定序技術突破,藉由鑑定個人化腫瘤新抗原,發展腫瘤治療疫苗以活化腫瘤特異性免疫反應,而放射治療和化學治療不僅可以增加腫瘤抗原釋放,還可以將腫瘤微環境改變為更可允許使用個人化腫瘤新抗原疫苗的微環境。將可針對放化學治療或免疫治療效果不佳的患者,達到緩解腫瘤復發及轉移,長期癌症治癒的效果。
但腫瘤新抗原胜肽疫苗單獨作為治療性腫瘤疫苗效果不如預期,且腫瘤新抗原免疫治療的應用受限於腫瘤新抗原需個人化鑑定,導致花費過高且無法即時用於治療患者,因此近年著重於提升腫瘤新抗原疫苗之療效與鑑定共享型腫瘤新抗原(shared neoantigen),並優化基於新抗原的免疫療法的傳遞效果,為解決前述問題的新方向。
本發明之一目的是在提供一種表達足夠的轉基因,並能降低病毒清除,提高腫瘤抗原表達量的疫苗,其共表達至少一共抑制胜肽和TLR9拮抗序列,以增加至少一腫瘤抗原的表達,並激活腫瘤抗原特異性T細胞的免疫應答,於癌症治療上具有優異的治療效果。藉此,可用於製備至療癌症之藥物。
本發明之另一目的是在提供一種癌症疫苗混合物,其包含本發明之疫苗、增強劑和加強免疫劑,本發明之疫苗誘導先天性免疫系統對腫瘤抗原產生免疫反應,增強劑則可降低腫瘤細胞數量和改善腫瘤微環境,並可增加腫瘤抗原量以提高T細胞反應,而加強免疫劑則再次誘發免疫反應以清除殘餘腫瘤,是以本發明之癌症疫苗混合物可以有效地抑制腫瘤生長和抑制腫瘤復發。
本發明之一態樣之一實施方式是提供一種疫苗,包含載體和轉基因。所述轉基因被包覆於載體中,且編碼複數個胜肽。所述胜肽依序包含分泌信號胜肽、至少一腫瘤抗原、至少一共抑制胜肽和Toll樣受體9 (toll-like receptor 9, TLR9)拮抗序列。所述至少一腫瘤抗原於腫瘤細胞中相較於正常細胞為過度表達或新出現。所述至少一共抑制胜肽包含程式性死亡-配體1 (programmed death-ligand 1, PD-L1)拮抗劑、細胞程式性死亡蛋白-1 (programmed cell death protein-1, PD-1)拮抗劑或細胞毒性T淋巴細胞相關蛋白4 (cytotoxic T-lymphocyte-associated protein, CTLA4)拮抗劑。
依據前述之疫苗,可更包含共刺激胜肽,其可位於至少一共抑制胜肽和TLR9拮抗序列之間,其中共刺激胜肽可選自顆粒球巨噬細胞株刺激因子 (granulocyte-macrophage colony-stimulating factor, GM-CSF)、介白素12 (interleukin 12, IL12)和干擾素(interferon, IFNs)。
依據前述之疫苗,其中所述載體可為牛痘病毒載體
、腺相關病毒(adeno-associated virus, AAV)載體或奈米顆粒。
依據前述之疫苗,其中所述分泌信號胜肽可為介白素2信號胜肽(interleukin 2 signal peptide, IL2 sp)或介白素12信號胜肽(interleukin 2 signal peptide, IL12 sp)。
依據前述之疫苗,其中所述至少一腫瘤抗原可選自腫瘤相關抗原(tumor-associated antigen, TAA)、腫瘤特異性抗原(tumor-specific antigen, TSA)、致癌突變(oncogenic mutation)、異常表達的腫瘤特異性抗原(aberrantly expressed tumor-specific antigen, aeTSA)和共享型新抗原(shared neoantigen, neoAg)。
依據前述之疫苗,其中所述至少一腫瘤抗原可篩選自比較受試者之正常細胞及相應的腫瘤細胞之一全外顯子組定序的DNA序列。
依據前述之疫苗,其中所述PD-L1拮抗劑可包含PL-L1陷阱和PD-1胜肽,所述PD-1拮抗劑可包含PD-1陷阱和PD-L1/PD-L2胜肽,所述CTLA4拮抗劑可包含CTLA4陷阱和CTLA4拮抗抗體。
依據前述之疫苗,其中所述TLR9拮抗序列可選自CpG寡核苷酸TLR9結合域、TLR誘餌胜肽和CpG結合序列。
本發明之另一態樣之一實施方式是提供一種如前段所述之疫苗之用途,其係用於製備治療癌症之藥物。
依據前述之疫苗之用途,其中所述製備治療癌症之藥物可與放射線合併使用。
本發明之一態樣之另一實施方式是提供一種癌症疫苗混合物,其包含前段所述之疫苗、增強劑和加強免疫劑。所述疫苗用以誘導受試者對至少一腫瘤抗原產生免疫反應,且所述受試者需要癌症治療。增強劑用以增強所述受試者的局部腫瘤控制。加強免疫劑用以防止所述受試者的腫瘤局部復發和轉移。
依據前述之癌症疫苗混合物,其中所述至少一腫瘤抗原可選自腫瘤相關抗原、腫瘤特異性抗原、致癌突變、異常表達的腫瘤特異性抗原和共享型新抗原。
依據前述之癌症疫苗混合物,其中所述增強劑可為放射線、化學治療劑、免疫調節劑、靶向治療藥物、抗體藥物或其組合。
依據前述之癌症疫苗混合物,其中所述加強免疫劑可為包含至少一腫瘤抗原的癌症疫苗或包含至少一腫瘤抗原的治療細胞。所述癌症疫苗可為樹突狀細胞癌症疫苗或病毒載體癌症疫苗,所述治療細胞可為細胞因子誘導殺手細胞(cytokine-induced killer cell,CIK)、樹突細胞結合細胞因子誘導殺手細胞(Dendritic cell-cytokine-induced killer cell,DC-CIK)或負載neoAg的DC-CIK。而所述至少一腫瘤抗原可選自腫瘤相關抗原、腫瘤特異性抗原、致癌突變、異常表達的腫瘤特異性抗原和共享型新抗原。
依據前述之癌症疫苗混合物,其中所述加強免疫劑可為包含免疫檢查點蛋白、免疫抑制因子及/或免疫刺激因子的治療細胞。所述治療細胞可為嵌合抗原受體-T細胞(chimeric antigen receptor-T cell, CAR-T)、嵌合抗原受體-自然殺手細胞(chimeric antigen receptor-natural killer cell, CAR-NK)或過繼性T細胞(adoptive T cell)。
上述發明內容旨在提供本揭示內容的簡化摘要,以使閱讀者對本揭示內容具備基本的理解。此發明內容並非本揭示內容的完整概述,且其用意並非在指出本發明實施例的重要/關鍵元件或界定本發明的範圍。
請參照第1圖,其繪示本發明之疫苗100的構築示意圖。疫苗100包含載體110和轉基因120,其中轉基因120被包覆於載體110中。
載體110用以增強具有不同向性(tropism)的腫瘤抗原表達,其可為牛痘病毒載體、腺相關病毒(adeno-associated virus, AAV)載體或奈米顆粒。較佳地,AAV載體可以是腺相關病毒2(AAV2)載體或腺相關病毒6(AAV6)載體。奈米顆粒可以包括但不限於脂質體傳遞系統[例如磷酸二十六烷基酯-四亞乙基五胺基聚陽離子脂質體(TEPA-PCL)、脂質複合物(例如DOTMA/膽固醇/TPGS脂質複合物或DDAB/膽固醇/TPGS脂質複合物)、陽離子脂質體-透明質酸(LPH)奈米顆粒]、脂質奈米顆粒(LNP)、聚乙烯亞胺(PEI)或聚乙烯亞胺偶聯物、樹枝狀聚合物奈米顆粒、聚醯胺(PAMAM)奈米顆粒、聚乳酸與聚甘醇酸共聚物(PLGA)奈米顆粒、去端肽膠原奈米顆粒和二氧化矽奈米顆粒。
轉基因120編碼複數個胜肽,所述胜肽依序包含分泌信號胜肽121、至少一腫瘤抗原122、至少一共抑制胜肽123和Toll樣受體9 (toll-like receptor 9, TLR9)拮抗序列124。
分泌信號胜肽121用以輔助所述至少一腫瘤抗原122分泌。較佳地,所述分泌信號胜肽121可為介白素2信號胜肽(interleukin 2 signal peptide, IL2 sp)或介白素12信號胜肽(interleukin 2 signal peptide, IL12 sp)。
至少一腫瘤抗原122用以在需要癌症治療的受試者中增加抗腫瘤免疫應答,其中至少一腫瘤抗原122於腫瘤細胞中相較於正常細胞為過度表達或新出現。較佳地,至少一腫瘤抗原122可選自腫瘤相關抗原(tumor-associated antigen, TAA)、腫瘤特異性抗原(tumor-specific antigen, TSA)、致癌突變(oncogenic mutation)、異常表達的腫瘤特異性抗原(aberrantly expressed tumor-specific antigen, aeTSA)和共享型新抗原(neoAg)。此外,可以藉由全外顯子組定序來比較來自受試者的正常細胞及相應的腫瘤細胞的DNA序列,進而篩選至少一腫瘤抗原,以鑑定腫瘤特異性體細胞突變(新抗原),再從已存在的新抗原資料庫中選擇編碼新抗原的多核苷酸。其中TAA在腫瘤細胞中過度表達而在正常細胞中表達量較低,TAA更具體的實例包含但不限於,在乳腺中表達但乳腺癌中過表達的乳腺珠蛋白-A、前列腺特異性抗原(PSA)、T細胞識別的黑色素瘤抗原(MART 1)、黑色素細胞蛋白PMEL、Bcr/Abl酪氨酸激酶、HPVE6、E7、MZ2-E、MAGE-1和MUC-1。而TSA僅在腫瘤細胞上發現而未被發現於健康細胞,TSA更具體的實例包含但不限於,驅動基因KRAS-G12/13密碼子突變熱點、TP53突變熱點、PIK3CA突變熱點、BRAF突變和移碼突變。aeTSA為未突變轉錄物的異常表達,且其未在任何正常體細胞中表達,包括協調中樞免疫耐受的胸腺髓質表皮細胞(mTEC)。
至少一共抑制胜肽123用以阻斷樹突狀細胞(dendritic cell, DC)中的共抑制信號,增加DC的抗原呈遞能力。至少一共抑制胜肽123包含程式性死亡-配體1 (programmed death-ligand 1, PD-L1)拮抗劑、細胞程式性死亡蛋白-1 (programmed cell death protein-1, PD-1)拮抗劑或細胞毒性T淋巴細胞相關蛋白4 (cytotoxic T-lymphocyte-associated protein, CTLA4)拮抗劑。較佳地,所述PD-L1拮抗劑可包含PL-L1陷阱和PD-1胜肽,所述PD-1拮抗劑可包含PD-1陷阱和PD-L1/PD-L2胜肽,所述CTLA4拮抗劑可包含CTLA4陷阱和CTLA4拮抗抗體。
TLR9拮抗序列124是一種抗病毒清除序列,用於減弱先天性免疫系統對病毒的清除,並維持高抗原載量。所述TLR9拮抗序列124可選自CpG寡核苷酸TLR9結合域、TLR誘餌胜肽和CpG結合序列。
此外,本發明之疫苗100可更包含共刺激胜肽(圖未繪示)用以增加DC的募集和活化,其可位於至少一共抑制胜肽123和TLR9拮抗序列124之間。其中共刺激胜肽可選自顆粒球巨噬細胞株刺激因子 (granulocyte-macrophage colony-stimulating factor, GM-CSF)、介白素12 (interleukin 12, IL12)和干擾素(interferon, IFNs)。
依據本發明之另一個實施方式,前段所述之疫苗可用於製備治療癌症之藥物,其可誘導需要癌症治療的受試者對至少一腫瘤抗原產生免疫反應。較佳地,所述治療癌症之藥物可進一步與放射線合併使用。此外,本發明的疫苗中轉基因所編碼的胜肽被表達後,可協同作用促進受試者的腫瘤特異性免疫反應並協同地延長受試者存活時間。
本說明書所述之「癌症」是指或描述哺乳動物中以細胞生長失調為典型特徵的生理狀況。「腫瘤」包括一種或多種癌細胞。癌症的實例包含但不限於癌、淋巴瘤、母細胞瘤、肉瘤和白血病或淋巴惡性腫瘤。此類癌症的更具體的實例包含乳腺癌、大腸癌、直腸癌、大腸直腸癌、包含小細胞肺癌、非小細胞肺癌(NSCLC)、肺腺瘤和肺鱗癌在內的肺癌、鱗狀細胞癌(例如上皮鱗狀細胞癌)、腹膜癌、肝細胞癌、包含胃腸癌在內的胃癌、胰腺癌、膠質母細胞瘤、宮頸癌、卵巢癌、肝癌、膀胱癌、子宮內膜癌或子宮癌、唾液腺癌、腎癌、前列腺癌、外陰癌、甲狀腺癌、肛門癌、陰莖癌和頭頸癌。
本說明書所述之「有效量」是指有效「治療」受試者的疾病或病症的疫苗的量。有效量與所施用的組織、系統、動物或人的生物或醫學反應有一定程度上的相關性,例如當施用時其足以在一定程度上防止一種或多種疾病或病症的發展或減輕一種或多種所治療的病症或病症的症狀
。治療有效量將取決於疾病及其嚴重程度以及待治療的哺乳動物的年齡和體重等而變化。
請再參照第2A圖、第2B圖和第2C圖,其繪示本發明之疫苗遞送轉基因至受試者中以及所編碼的胜肽於受試者體內相互作用的作用機制示意圖。如圖所示,本發明之疫苗可有效抑制免疫檢查點、增加腫瘤抗原呈現量並激活腫瘤免疫反應。
茲以下列具體試驗例進一步示範說明本發明,用以有利於本發明所屬技術領域通常知識者,可在不需過度解讀的情形下完整利用並實踐本發明,而不應將這些試驗例視為對本發明範圍的限制,但用於說明如何實施本發明的材料及方法。例如以下實施例中使用的載體是AAV載體,但載體用於將轉基因傳遞到目標細胞,因此可預期其他可包覆轉基因的載體,如牛痘病毒載體或奈米顆粒亦達到同樣的效果。
實施例與比較例
實施例1-3
首先,我們發現經化學治療和放射治療後仍殘留的腫瘤中具有共享型新抗原(shared neoantigens,以下簡稱「neoAg(s)」),並建立難治性和復發性腫瘤的neoAgs圖譜,而前述neoAgs可用於開發體外診斷(
in vitrodiagnosis, IVD)測試和免疫治療的抗體藥物。此外,前述neoAgs可以做為提高DC疫苗和DC-DIK細胞治療的腫瘤特異性關鍵成分,並進一步開發neoAg癌症疫苗的免疫療法,以提高放射治療、化學治療和細胞治療的療效。請參照表一,其為小鼠大腸癌CT26細胞株(以下簡稱「CT26細胞」)中neoAgs的列表。
表一、CT26細胞中的neoAgs
neoAg | 基因來源 | 序列 | T細胞活化 |
1 | E2f8 | SEQ ID NO: 1 | CD8 |
2 | Slc20a1 | SEQ ID NO: 2 | CD4 |
3 | Phf3 | SEQ ID NO: 3 | CD8 |
4 | Dhx35 | SEQ ID NO: 4 | CD4 |
5 | Mtch1 | SEQ ID NO: 5 | CD8 |
6 | Slc4a3 | SEQ ID NO: 6 | ND |
7 | Agx2l2 | SEQ ID NO: 7 | ND |
8 | Glud1 | SEQ ID NO: 8 | CD8 |
此外,試驗上構築了一種包含上述neoAgs的neoAg癌症疫苗,並進一步以動物試驗確認其對癌症的治療效果。
請參照第3A圖,其繪示實施例1之neoAg癌症疫苗的構築示意圖。如第3A圖所示,實施例1之neoAg癌症疫苗(以下簡稱為「實施例1」)中的轉基因所編碼的胜肽包含IL12 sp、neoAgs和兩個卵白蛋白序列(OVA-CD4和OVA-CD8),將上述胜肽相應的核苷酸片段構築至由CMV啟動的pAAV-CMV表現載體中。IL12 sp用以增加neoAgs分泌至細胞的量,而IL12 sp的胺基酸序列如SEQ ID NO:11所示。neoAgs包含表一所列的neoAg 1至neoAg 8,並藉由RERK連接子將neoAg 1至neoAg 8融合。OVA-CD4和OVA-CD8作為陽性對照組,OVA-CD4和OVA-CD8的胺基酸序列分別如SEQ ID NO:9和SEQ ID NO:10所示。此外,比較例1為包含編碼IL12 sp片段但不包含編碼neoAgs片段的pAAV-CMV表現載體(以下簡稱為「比較例1」)。
請再參考第3B圖和表二,第3B圖繪示實施例1在動物治療試驗中結合放射治療的治療策略示意圖,表二為實施例1-2和比較例1-2的治療策略。
為了驗證實施例1的治療效果,試驗上先建立大腸直腸癌小鼠模型。將2×105個CT26細胞和20%基質膠(Corning,Union City,CA,USA)以皮下接種至6周大的雌性BALB/c小鼠的右下肢。8天後,將大腸直腸癌小鼠隨機分為不同組,每6天以肌肉注射實施例1或比較例1(1×108vg),共3次,並於第25天注射第4次的加強劑。而施用放射治療的組別,將大腸直腸癌小鼠在第11天完全麻醉後將右肢置於輻射場,局部腫瘤接受5Gy的分次放射治療,放射治療的次數為1次。於試驗期間大腸直腸癌小鼠每3天測量1次腫瘤體積,直到第28天犧牲。腫瘤體積的計算公式為:V=(L×W2)/2。收集的腫瘤組織用於後續的免疫分析。
請參考第3C圖,為實施例1和實施例2對大腸直腸癌治療效果的分析結果圖。第3C圖的結果顯示,與比較例1相比,實施例1單獨用neoAg癌症疫苗治療可以顯著抑制腫瘤生長,可以達到與比較例2(單獨施用放療治療)相似的效果。實施例2同時施用實施例1的neoAg癌症疫苗和放射治療,其抑制腫瘤生長的效果更顯著。上述結果顯示實施例1的neoAg癌症疫苗能提升放射治療的治療效果。
為了驗證實施例1對用於免疫細胞浸潤的抗腫瘤免疫作用影響,進一步將腫瘤浸潤淋巴細胞進行分離。試
驗上從實施例1、實施例2、比較例1和比較例2的大腸直腸癌小鼠分離新鮮腫瘤,在室溫下將腫瘤置於含有5ml RPMI 1640培養基的6cm培養皿中,再使用無菌刀將腫瘤切碎成大小約為1-2mm的小塊。準備1個50ml離心管,在頂部放置一個70μm細胞過濾器,以無菌滴管將所有腫瘤組織轉移到過濾器中。若還有組織碎片,則使用5mL的塑膠注射器注入RPMI 1640培養基,使組織碎片通過過濾器。小心地將所有細胞溶液轉移到底部含有Ficoll-Paque的15mL錐形管中。在20℃下以離心力1025×g離心20分鐘,同時緩慢加速並煞車關閉。使用無菌吸量管小心地將單核細胞層轉移到新的50ml離心管中,加入10mL的RPMI 1640培養基,並在20℃下以離心力650×g離心10分鐘。去除上清液,在10ml完全RPMI 1640培養基中輕輕重新懸浮細胞,再次在20℃下650×g離心10分鐘。去除上清液並加入1mL的RPMI 1640培養基重新懸浮,所得到的為分離後的腫瘤浸潤淋巴細胞(TIL)。
請參照第4A圖、第4B圖、第4C圖、第4D圖和第4E圖,為實施例1之neoAg癌症疫苗對免疫細胞浸潤的抗腫瘤免疫作用影響的分析結果圖,其中*代表p<0.05,**代表p<0.01,數據為使用單因子獨立變異數分析。第4A圖至第4E圖的結果顯示,與比較例1、比較例2和實施例1相比,實施例2同時施用實施例1的neoAg癌症疫苗和放射治療可顯著增加CD4+細胞、CD8+細胞、CD44
+細胞、Treg細胞和骨髓來源的抑制細胞(MDSC)的細胞數,其中CD4
+細胞的細胞數代表輔助性T淋巴細胞(Th)反應,CD8
+細胞的細胞數代表細胞毒性T淋巴細胞(CTL)反應,CD44
+細胞的細胞數代表效應/記憶T細胞反應,Treg細胞和MDSC的細胞數代表免疫抑制細胞反應。上述結果顯示實施例1之neoAg癌症疫苗藉由促進免疫細胞的浸潤以獲得抗腫瘤免疫。
請參照第5A圖、第5B圖、第5C圖、第5D圖、第5E圖和第5F圖,第5A圖繪示離體(
ex vivo)免疫分析的實驗流程示意圖,第5B圖、第5C圖、第5D圖、第5E圖和第5F圖為實施例1之neoAg癌症疫苗於離體免疫分析的分析結果圖。試驗上將小鼠脾臟的單細胞懸浮液以IFNγ ELISpot檢測試劑盒(Abcam)進行離體免疫分析。將脾細胞以密度2.5×10
5個/每孔種於含有2 mM L-麩醯胺酸、0.5 ug/mL刀豆球蛋白A和2 ng/mL m-IL2的完整 RPMI 1640培養基的96孔盤中,再培養2天。去除未貼覆的細胞後,再將培養基更換為添加1 μg/mL neoAg胜肽的培養基刺激脾細胞24小時。而陽性對照組為以添加1 ng/mL PMA和500ng/mL 離子黴素的RPMI 1640培養基進行培養的脾細胞。最後,進行定性測量以檢測IFNγ產生和分泌的部位。如第5B圖至第5F圖所示,結果顯示實施例1之neoAg癌症疫苗能誘導neoAg特異性CD8
+T細胞應答。
為了驗證實施例1之neoAg癌症疫苗在腫瘤微環境中的作用,試驗上將不同組別的大腸直腸癌小鼠進行了腫瘤浸潤淋巴細胞的分離。而不同組別的大腸直腸癌小鼠為將已建立的大腸直腸癌小鼠隨機分配,分別在第8天、第14天、第21天和第25天以肌肉注射實施例1、比較1 (1×10
8vg)和PBS,總共4次。而施用放射治療的組別,將大腸直腸癌小鼠在第11天和第18天完全麻醉後將右肢置於輻射場,局部腫瘤接受5 Gy的分次放射治療,放射治療的次數為2次。在第28天犧牲大腸直腸癌小鼠,收集的腫瘤組織進行免疫分析。實施例1和3、比較例1和3以及對照組1和3的治療策略請參照表三。
表三、實施例1和3、比較例1和3以及對照組1和3的治療策略
組別 | 癌症疫苗 | 放射治療 |
對照組1 | PBS | - |
對照組3 | PBS | 5 Gy×2 |
比較例1 | 比較例1 | - |
比較例3 | 比較例1 | 5 Gy×2 |
實施例1 | 實施例1 | - |
實施例3 | 實施例1 | 5 Gy×2 |
請參照第6A圖、第6B圖、第6C圖和第6D圖,第6A圖和第6B圖為實施例1之neoAg癌症疫苗對免疫細胞浸潤的抗腫瘤免疫作用影響的分析結果圖,第6C圖和第6D圖為實施例1之neoAg癌症疫苗在施用放射治療後對腫瘤微環境影響的分析結果圖。在第6A圖、第6B圖和第6D圖中,*代表
p<0.05,***代表
p< 0.001,數據為使用單因子獨立變異數分析。如第6A圖至第6D圖所示,與對照組1、對照組3,比較例1、比較例3和實施例1相比、實施例3同時施用實施例1的neoAg癌症疫苗和放射治療,顯著地增加了CD8
+T
EM的細胞數量和IFNγ
+CD8
+TILs和IFNγ
+CD8
+TIL/Treg比率。上述結果顯示放射治療增加腫瘤浸潤效應/記憶和細胞毒性CD8
+T細胞,而實施例1的neoAg癌症疫苗在施用放射治療後可以逆轉了腫瘤微環境中的免疫抑制狀態。
實施例4-9
接著試驗上另開發包含TLR9拮抗序列和不同腫瘤抗原的AAV癌症疫苗,以確認其對癌症的治療效果。請參照第7A圖,其繪示實施例4、實施例6和實施例8之AAV癌症疫苗的構築和治療策略示意圖。
如第7A圖所示,三種AAV癌症疫苗(實施例4、實施例6和實施例8)的設計為將兩個短TLR9抑制序列(在第7A圖以「TLR9i」表示)插入到包含IL12 sp的pAAV-CMV表現載體中,以逃避先天性免疫系統對病毒的清除,並延長腫瘤抗原表達。其中實施例4之AAV癌症疫苗中的轉基因所編碼的胜肽包含TAA癌胚胎抗原(carcinoembryonic antigen, CEA)作為至少一腫瘤抗原,CEA的胺基酸序列如SEQ ID NO: 12所示。實施例6之AAV癌症疫苗中的轉基因所編碼的胜肽包含表一所列的neoAg 1至neoAg 8並以RERK連接子融合作為至少一腫瘤抗原(在第7A圖以「neoAg」表示)。實施例8之AAV癌症疫苗中的轉基因所編碼的胜肽包含表四所列的aeTSA 1至aeTSA 7作為至少一腫瘤抗原(在第7A圖以「aeTSA」表示),其中ERE為內源性反轉錄因子的縮寫。兩個短 TLR9抑制序列的胺基酸序列分別如SEQ ID NO:20和SEQ ID NO:21所示。此外,比較例1為包含編碼IL12 sp片段但不包含編碼腫瘤抗原片段的pAAV-CMV表現載體。
表四、CT26細胞中的aeTSA
aeTSA | 基因來源 | 序列 |
1 | ERE | SEQ ID NO: 13 |
2 | ERE | SEQ ID NO: 14 |
3 | ERE | SEQ ID NO: 15 |
4 | ERE | SEQ ID NO: 16 |
5 | 內含子 | SEQ ID NO: 17 |
6 | 框內編碼的外顯子 | SEQ ID NO: 18 |
7 | 內含子 | SEQ ID NO: 19 |
為了驗證實施例4、實施例6和實施例8的治療效果,將大腸直腸癌小鼠隨機分配到不同組中。 將實施例4、實施例6、實施例8和比較例1 (1×10
8vg)分別在第8天、第14天、第21天和第25天以肌肉注射施用4次。而施用放射治療的組別,將大腸直腸癌小鼠在第11天完全麻醉後將右肢置於輻射場,局部腫瘤接受5 Gy的分次放射治療,放射治療的次數為1次。於試驗期間大腸直腸癌小鼠每3天測量1次腫瘤體積,直到第30天犧牲。腫瘤體積的計算公式為:V=(L×W
2)/2。收集的腫瘤組織用於後續的免疫分析。實施例4-9和比較例1-2的治療策略請參照表五。
表五、實施例4-9和比較例1-2的治療策略
組別 | 癌症疫苗 | 放射治療 |
比較例1 | 比較例1 | - |
比較例2 | 比較例1 | 5 Gy×1 |
實施例4 | 實施例4 | - |
實施例5 | 實施例4 | 5 Gy×1 |
實施例6 | 實施例6 | - |
實施例7 | 實施例6 | 5 Gy×1 |
實施例8 | 實施例8 | - |
實施例9 | 實施例8 | 5 Gy×1 |
請參照第7B圖、第7C圖、第7D圖、第7E圖和第7F圖,為實施例4、實施例6和實施例8之AAV癌症疫苗治療大腸直腸癌效果的分析結果圖,其中**代表
p<0.01,***代表
p<0.001,數據為使用單因子獨立變異數分析。如第7B圖至第7E圖所示,單獨施用實施例4之AAV癌症疫苗無法保護大腸直腸癌小鼠免受腫瘤發展,但單獨施用實施例6之AAV癌症疫苗或實施例8之AAV癌症疫苗的組別則略微延遲腫瘤生長。然而同時施用AAV癌症疫苗和放射治療法的組別(實施例5、實施例7和實施例9)具有顯著地抑制腫瘤生長的效果。此外,第7F圖的結果顯示,增殖細胞標誌物Ki67的表現量在實施例7和實施例9中也顯著降低。上述結果顯示實施例4、實施例6和實施例8之AAV癌症疫苗顯著地提高了放射治療的療效,並引發了腫瘤抗原特異性免疫反應而延緩腫瘤生長。
實施例10-12
試驗上進一步構築本發明一實施例之疫苗,並以動物試驗確認其對癌症的治療效果。請參照第8A圖,其繪示本發明之實施例10之疫苗的構築示意圖。如第8A圖所示,本發明之實施例10之疫苗中的轉基因所編碼的胜肽包含作為分泌信號胜肽的IL12 sp、作為至少一腫瘤抗原的neoAg 1至neoAg 8 (如表一所列)、PD-1陷阱和CTLA4陷阱作為至少一種共抑制胜肽,以及TLR9i作為TLR9拮抗序列。將上述胜肽相應的核苷酸片段構築至由CMV啟動的pAAV-CMV表現載體中。其中IL12 sp的胺基酸序列如SEQ ID NO:11所示。PD-1陷阱和CTLA4陷阱的胺基酸序列分別如SEQ ID NO:22和SEQ ID NO:23所示。TLR9i包括SEQ ID NO:20和SEQ ID NO:21所示的胺基酸序列。另外,比較例4是包含編碼IL12 sp、PD-1陷阱、CTLA4陷阱和TLR9i片段的pAAV-CMV表現載體。
請參照第8B圖和表六,第8B圖繪示本發明之實施例10之疫苗在動物治療試驗中結合放射治療的治療策略示意圖,表六為實施例10-12和比較例4-6的治療策略。
表六、實施例10-12和比較例4-6的治療策略
組別 | 疫苗 | 放射治療 |
比較例4 | 比較例4 | - |
比較例5 | 比較例4 | 5 Gy×1 |
比較例6 | 比較例4 | 5 Gy×2 |
實施例10 | 實施例10 | - |
實施例11 | 實施例10 | 5 Gy×1 |
實施例12 | 實施例10 | 5 Gy×2 |
為了驗證本發明之實施例10之疫苗的治療效果,將大腸直腸癌小鼠隨機分配到不同的組中。實施例10之疫苗和比較例4 (1×10
8vg)分別在第8天、第14天、第21天和第25天以肌肉注射施用4次。而施用放射治療的組別,將大腸直腸癌小鼠在第11天完全麻醉後將右肢置於輻射場,局部腫瘤接受5 Gy的分次放射治療1次。或在第11天和第17天以相同方式接受放射治療2次。於試驗期間大腸直腸癌小鼠每3天測量1次腫瘤體積,直到第28天犧牲。腫瘤體積的計算公式為:V=(L×W
2)/2。
請再參照第8C圖、第9圖和表七,第8C圖為本發明之實施例10之疫苗對大腸直腸癌治療效果的分析結果圖,第9圖為經本發明之實施例10之疫苗治療的大腸直腸癌小鼠的生存曲線,表七為實施例10-12和比較例4-6的完全緩解(complete response, CR)率。
表七、實施例10-12和比較例4-6的完全緩解率
組別 | 完全緩解率 |
比較例4 | 0/6 |
比較例5 | 0/6 |
比較例6 | 0/6 |
實施例10 | 1/6 |
實施例11 | 0/6 |
實施例12 | 2/5 |
第8C圖的結果顯示,與其他組相比,實施例12 (同時施用本發明之實施例10之疫苗和放射治療)的腫瘤體積顯著地降低,顯示本發明之實施例10之疫苗顯著地促進放射治療的療效。而第9圖和表七的結果顯示,40%的大腸直腸癌小鼠在施用本發明之實施例10之疫苗處理後達到完全緩解(2/5),此結果顯示本發明之實施例10之疫苗顯著地延長大腸直腸癌小鼠的存活時間。
實施例13-15
試驗上進一步構築本發明另一實施例之疫苗,並以動物試驗確認其對癌症的治療效果。請參照第10A圖和表八,第10A圖繪示本發明之實施例13之疫苗的構築示意圖及其在動物治療試驗中結合放射治療的治療策略示意圖,表八為實施例13-15、比較例7-9以及對照組1-3的治療策略。
如第10A圖所示,本發明之實施例13之疫苗中的轉基因所編碼的胜肽包含作為分泌信號胜肽的IL12 sp、neoAg/aeTSA作為至少一腫瘤抗原、PD-1陷阱和PD-L1 miRNA(在第10A圖中以「miR」表示)作為
至少一共抑制胜肽,TLR9i作為TLR9拮抗序列,將上述胜肽相應的核苷酸片段構築至由CMV啟動的pAAV-CMV表現載體中。IL12 sp的胺基酸序列如SEQ ID NO:11所示。neoAg/aeTSA包含表一所列的neoAg 1至neoAg 8和表四所列的aeTSA 1至aeTSA 7。PD-1陷阱的胺基酸序列如SEQ ID NO:22所示,PD-L1 miRNA的核苷酸序列如SEQ ID NO:24所示。TLR9i包括SEQ ID NO:20和SEQ ID NO:21所示的胺基酸序列。此外,比較例7是包含編碼IL12 sp、PD-1陷阱和TLR9i片段但不包含編碼腫瘤抗原片段和PD-L1 miRNA的pAAV-CMV表現載體。
為了驗證本發明之實施例13之疫苗的治療效果,將大腸直腸癌小鼠隨機分配到不同的組中。實施例13之疫苗、比較例7(1×108vg)和PBS分別在第8天、第14天、第21天和第25天以肌肉注射施用4次。而施用放射治療的組別,將大腸直腸癌小鼠在第11天完全麻醉後將右肢置於輻射場,局部腫瘤接受5Gy的分次放射治療1次。或在第11天和第18天以相同方式接受放射治療2次。此外,大腸直腸癌小鼠在第56天以皮下接種3×105個CT26細胞和20%基質膠以產生第二腫瘤。於試驗期間大腸直腸癌小鼠每3天測量1次腫瘤體積,腫瘤體積的計算公式為:V=(L×W2)/2。而於試驗的第30天以流式細胞儀進行分析。
請參照第10B圖、第10C圖、第10D圖、第10E圖、第10F圖、第10G圖、表九和表十,第10B圖、第10C圖、第10D圖、第10E圖、第10F圖和第10G圖為本發明之實施例13之疫苗對大腸直腸癌治療效果的分析結果圖,其中*代表
p<0.05,**代表
p<0.01,***代表
p<0.001,數據為使用單因子獨立變異數分析。表九為實施例13和15、比較例7和9以及對照組1和3的完全緩解率,表十為實施例13和15、比較例7和9以及對照組1和3的中位數存活時間。
表九、實施例13和15、比較例7和9以及對照組1和3的完全緩解率
組別 | 完全緩解率 |
對照組1 | 0/6 |
對照組3 | 0/6 |
比較例7 | 0/6 |
比較例9 | 0/6 |
實施例13 | 0/6 |
實施例15 | 3/7 |
表十、實施例13和15、比較例7和9以及對照組1和3的中位數存活時間
組別 | 中位數存活時間 |
對照組1 | 28 |
對照組3 | 51 |
比較例7 | 30.5 |
比較例9 | 62 |
實施例13 | 28.5 |
實施例15 | 181 |
第10B圖至第10D圖的結果顯示,與其他組相比,比較例9 (同時施用比較例7之疫苗和放射治療)的腫瘤體積和腫瘤重量顯著地減少了約70%。然而,實施例15 (同時施用本發明之實施例13之疫苗和放射治療)的腫瘤體積和腫瘤重量則顯著地降低約90%。第10E圖、第10F圖、表九以及表十的結果顯示,約40%的大腸直腸癌小鼠(3/7)在施用本發明之實施例13之疫苗後達到完全緩解,且其存活時間顯著地延長。此外,這些無腫瘤的大腸直腸癌小鼠以CT26細胞再種腫瘤370天後完全不會生長成第二腫瘤
,顯示施用本發明之實施例13之疫苗不僅可增加放射治療的療效,而且可以抑制腫瘤再生。而第10G圖為以肌肉注射本發明之實施例13之疫苗或比較例7之疫苗後,以Glud1/MHC-I特異性四聚體測定法測量大腸直腸癌小鼠血液中 Glud1
+CD8細胞的表現程度,結果顯示,接種本發明之實施例13之疫苗的大腸直腸癌小鼠的單核細胞中的neoAg特異性T細胞免疫應答顯著地增加。
實施例16-17
為了進一步證明本發明之疫苗觸發高新抗原免疫原性以提升放射治療的治療功效,試驗上另構築一種包含8個突變TSA的疫苗,再將其接種於帶有4T1腫瘤的BALB/c小鼠。請參照第11A圖和表十一,第11A圖繪本發明之實施例16之疫苗的構築示意圖及其在動物治療試驗中結合放射治療的治療策略示意圖,表十一為實施例16-17、比較例10-11以及對照組4-5的治療策略。
表十一、實施例16-17、比較例10-11以及對照組4-5的治療策略
組別 | 疫苗 | 放射治療 |
對照組4 | PBS | - |
對照組5 | PBS | 5 Gy×2 |
比較例10 | 比較例10 | - |
比較例11 | 比較例10 | 5 Gy×2 |
實施例16 | 實施例16 | - |
實施例17 | 實施例16 | 5 Gy×2 |
如第11A圖所示,本發明之實施例16之疫苗中的轉基因所編碼的胜肽包含IL12 sp作為分泌信號胜肽、neoAg作為至少一腫瘤抗原、PD-1陷阱和PD-L1 miRNA (第11A圖中以「miR」表示)作為至少一種共抑制胜肽,TLR9i作為TLR9拮抗序列,將上述胜肽相應的核苷酸片段構築至由CMV啟動的pAAV-CMV表現載體中。IL12 sp的胺基酸序列如SEQ ID NO: 11所示,neoAg包含表十二中所列的neoAg 9至neoAg 16,PD-1陷阱的胺基酸序列如SEQ ID NO: 22所示,PD-L1 miRNA的核苷酸序列如SEQ ID NO: 24,TLR9i包含SEQ ID NO: 20和SEQ ID NO: 21所示的胺基酸序列。此外,比較例10是包含編碼IL12 sp、PD-1陷阱和TLR9i片段但不包含編碼腫瘤抗原片段和PD-L1 miRNA的pAAV-CMV表現載體。
為了驗證本發明之實施例16之疫苗的治療效果,試驗上先建立乳腺癌小鼠模型。將3×105個4T1細胞和20%的基質膠(Corning,Union City,CA,USA)以皮下接種至6周大的雌性BALB/c小鼠,以獲得帶有4T1腫瘤的BALB/c小鼠,4T1腫瘤為免疫原性較差的乳腺癌細胞。8天後,將乳腺癌小鼠隨機分為不同組,將本發明之實施例16之疫苗、比較例10(1×108vg)和PBS分別在第8天、第14天、第21天和第25天以肌肉注射施用4次。而施用放射治療的組別,將乳腺癌小鼠在第11天和第18天完全麻醉後置於輻射場,局部腫瘤接受5Gy的分次放射治療2次。於試驗期間乳腺癌小鼠每3天測量1次腫瘤體積,腫瘤體積的計算公式為:V=(L×W2)/2。而於試驗的第31天以流式細胞儀進行分析。
請參照第11B圖、第11C圖、第11D圖、第11E圖、第11F圖和第11G圖,為本發明之實施例16之疫苗對乳腺癌治療效果的分析結果圖,其中*代表p<0.05,**代表p<0.01,數據為使用單因子獨立變異數分析。如第11B圖和第11C圖所示,實施例17(同時施用本發明之實施例16之疫苗和放射治療)腫瘤消退率和腫瘤重量約降
低了80%。第11D圖至第11F圖的結果顯示,實施例17中殘留腫瘤內腫瘤浸潤性CD4+細胞、CD8+細胞、CD4+TEM細胞、CD8+TEM細胞和IFNγ+CD8+ T細胞的細胞數量顯著地增加。第11G圖的結果顯示,在實施例17中,腫瘤浸潤PD-L1+ DCs的數量減少,顯示腫瘤浸潤性DC中的PD-L1表現程度也顯著地降低。上述結果顯示本發明之實施例16之疫苗可以抑制DC上的PD-L1表達,導致更好的抗原呈現和T細胞介導的免疫反應。其顯示本發明之實施例16之疫苗增加了放射治療在免疫原性差的乳腺癌動物模型中的治療效果。
實施例18-22
請參照第12A圖和第12B圖,第12A圖繪示本發明之癌症疫苗混合物用於治療癌症的治療策略示意圖,第12B圖繪示本發明之癌症疫苗混合物之一實施方式的示意圖。
依據本發明之另一實施方式,本發明提供一種癌症疫苗混合物,其包含前段所述之疫苗、增強劑和加強免疫劑。所述疫苗用以誘導受試者對至少一腫瘤抗原產生免疫反應,且所述受試者需要癌症治療。增強劑用以增強所述受試者的局部腫瘤控制。加強免疫劑用以防止所述受試者的腫瘤局部復發和轉移。
所述至少一腫瘤抗原可選自腫瘤相關抗原、腫瘤特異性抗原、致癌突變、異常表達的腫瘤特異性抗原和共享型新抗原。所述增強劑可為放射線、化學治療劑、免疫調
節劑、靶向治療藥物、抗體藥物或其組合。而所述加強免疫劑可為包含至少一腫瘤抗原的癌症疫苗或包含至少一腫瘤抗原的治療細胞。所述癌症疫苗可為樹突狀細胞癌症疫苗或病毒載體癌症疫苗,較佳地,所述治療細胞可為細胞因子誘導殺手細胞(cytokine-induced killer cell,CIK)、樹突細胞結合細胞因子誘導殺手細胞(Dendritic cell-cytokine-induced killer cell,DC-CIK)或負載neoAg的DC-CIK。此外,所述加強免疫劑亦可為包含免疫檢查點蛋白、免疫抑制因子及/或免疫刺激因子的治療細胞。較佳地,所述治療細胞可為嵌合抗原受體-T細胞(chimeric antigen receptor-T cell,CAR-T)、嵌合抗原受體-自然殺手細胞(chimeric antigen receptor-natural killer cell,CAR-NK)或過繼性T細胞(adoptive T cell)。
請參照第13A圖和表十三,第13A圖繪示本發明之癌症疫苗混合物之實施例在動物治療試驗中的治療策略示意圖,表十三為實施例18-22和比較例12的治療策略。
為了驗證本發明之癌症疫苗混合物的治療效果,將大腸直腸癌小鼠隨機分配到不同的組中。本發明之實施例13之疫苗和比較例7 (1×10
8vg)分別在第8天和第14天以肌肉注射施用2次。於此試驗中放射治療做為增強劑,施用增強劑的組別,將大腸直腸癌小鼠在第11天、第18天和第25天完全麻醉後將右肢置於輻射場,局部腫瘤接受5 Gy的分次放射治療3次。此外,於此試驗中neoAg-DC-CIK作為加強免疫劑,施用加強免疫劑的組別在第21天和第31天以肌肉注射neoAg-DC-CIK施用2次。此外,試驗上更包含施用免疫檢查點阻斷劑(ICB)的組別,其係於第16天和第23天施用2次αPD-1做為免疫檢查點阻斷劑。於試驗期間大腸直腸癌小鼠每3天測量1次腫瘤體積,直到第40天犧牲。腫瘤體積的計算公式為:V=(L×W
2)/2。
請參照第13B圖、第13C圖、第13D圖和表十四,第13B圖、第13C圖和第13D圖為本發明之癌症疫苗混合物對大腸直腸癌治療效果的分析結果圖,其中***代表
p<0.001,數據為使用單因子獨立變異數分析。表十四為實施例18-22和比較例12的完全緩解率。
第13B圖的結果顯示,與其他組相比,實施例19至實施例22的腫瘤體積皆顯著地縮小。此外,實施例20中約33%的大腸直腸癌小鼠獲得完全緩解(2/6),實施例22中約83%的大腸直腸癌小鼠獲得完全緩解(5/6)。第13C圖和第13D圖的結果顯示,實施例22的大腸直腸癌小鼠的單核細胞中腫瘤抗原特異性T細胞的免疫應答顯著地增加。上述結果顯示本發明之癌症疫苗混合物可以實現完全應答並誘導腫瘤抗原特異性T細胞的免疫應答。
綜上所述,本發明之疫苗共表達至少一共抑制胜肽和TLR9拮抗序列,以增加至少一腫瘤抗原的表達,並激活腫瘤抗原特異性T細胞的免疫應答,是以本發明之疫苗足夠的轉基因表達,並能降低病毒清除和提高腫瘤抗原表達量,具有臨床安全性使其大有前景和優勢。此外,本發明之疫苗可以提高放射治療對癌症的治療效果,是以本發明之疫苗可以協同放射治療用於癌症治療,提供了一種新的、安全和有效的基於腫瘤抗原的免疫療法。此外,本發明的癌症疫苗混合物,其包含本發明的疫苗、增強劑和加強免疫劑,可以有效地抑制腫瘤生長和抑制腫瘤復發。
然本發明已以實施方式揭露如上,然其並非用以限定本發明,任何熟習此技藝者,在不脫離本發明的精神和範圍內,當可作各種的更動與潤飾,因此本發明的保護範圍當視後附的申請專利範圍所界定者為準。
100:疫苗
110:載體
120:轉基因
121:分泌信號胜肽
122:腫瘤抗原
123:共抑制胜肽
124:Toll樣受體9拮抗序列
為讓本發明之上述和其他目的、特徵、優點與實施例能更明顯易懂,所附圖式之說明如下:
第1圖繪示本發明之疫苗的構築示意圖;
第2A圖、第2B圖和第2C圖繪示本發明之疫苗遞送轉基因至受試者中以及所編碼的胜肽於受試者體內相互作用的作用機制示意圖;
第3A圖繪示實施例1之neoAg癌症疫苗的構築示意圖;
第3B圖繪示實施例1之neoAg癌症疫苗在動物治療試驗中結合放射治療的治療策略示意圖;
第3C圖為實施例1之neoAg癌症疫苗對大腸直腸癌治療效果的分析結果圖;
第4A圖、第4B圖、第4C圖、第4D圖和第4E圖為實施例1之neoAg癌症疫苗對免疫細胞浸潤的抗腫瘤免疫作用影響的分析結果圖;
第5A圖繪示離體(
ex vivo)免疫分析的實驗流程示意圖;
第5B圖、第5C圖、第5D圖、第5E圖和第5F圖為實施例1之neoAg癌症疫苗於離體免疫分析的分析結果圖;
第6A圖和第6B圖為實施例1之neoAg癌症疫苗對免疫細胞浸潤的抗腫瘤免疫作用影響的分析結果圖;
第6C圖和第6D圖為實施例1之neoAg癌症疫苗在施用放射治療後對腫瘤微環境影響的分析結果圖;
第7A圖繪示實施例4、實施例6和實施例8之AAV癌症疫苗的構築和治療策略示意圖;
第7B圖、第7C圖、第7D圖、第7E圖和第7F圖為實施例4、實施例6和實施例8之AAV癌症疫苗治療大腸直腸癌效果的分析結果圖;
第8A圖繪示本發明之實施例10之疫苗的構築示意圖;
第8B圖繪示本發明之實施例10之疫苗在動物治療試驗中結合放射治療的治療策略示意圖;
第8C圖為本發明之實施例10之疫苗對大腸直腸癌治療效果的分析結果圖;
第9圖為經本發明之實施例10之疫苗治療的大腸直腸癌小鼠的生存曲線;
第10A圖繪示本發明之實施例13之疫苗的構築示意圖及其在動物治療試驗中結合放射治療的治療策略示意圖;
第10B圖、第10C圖、第10D圖、第10E圖、第10F圖和第10G圖為本發明之實施例13之疫苗對大腸直腸癌治療效果的分析結果圖;
第11A圖繪本發明之實施例16之疫苗的構築示意圖及其在動物治療試驗中結合放射治療的治療策略示意圖;
第11B圖、第11C圖、第11D圖、第11E圖、第11F圖和第11G圖為本發明之實施例16之疫苗對乳腺癌治療效果的分析結果圖;
第12A圖繪示本發明之癌症疫苗混合物用於治療癌症的治療策略示意圖;
第12B圖繪示本發明之癌症疫苗混合物之一實施方式的示意圖;
第13A圖繪示本發明之癌症疫苗混合物之實施例在動物治療試驗中的治療策略示意圖;以及
第13B圖、第13C圖和第13D圖為本發明之癌症疫苗混合物對大腸直腸癌治療效果的分析結果圖。
100:疫苗
110:載體
120:轉基因
121:分泌信號胜肽
122:腫瘤抗原
123:共抑制胜肽
124:Toll樣受體9拮抗序列
Claims (15)
- 一種疫苗,包含:一載體,其中該載體為腺相關病毒(adeno-associated virus,AAV)載體;以及一轉基因,其被包覆於該載體中,該轉基因編碼複數個胜肽,其中該些胜肽依序包含:一分泌信號胜肽;至少一腫瘤抗原,其中該至少一腫瘤抗原於一腫瘤細胞中相較於一正常細胞為過度表達或新出現,且該至少一腫瘤抗原為一異常表達的腫瘤特異性抗原(aberrantly expressed tumor-specific antigen,aeTSA)及/或一共享型新抗原(shared neoantigen,neoAg),其中該異常表達的腫瘤特異性抗原包含SEQ ID NO:13、14、15、16、17、18及19所示之胺基酸序列,該共享型新抗原包含SEQ ID NO:1、2、3、4、5、6、7及8所示之胺基酸序列或SEQ ID NO:25、26、27、28、29、30、31及32所示之胺基酸序列;至少一共抑制胜肽,其中該至少一共抑制胜肽包含一程式性死亡-配體1(programmed death-ligand 1,PD-L1)拮抗劑、一細胞程式性死亡蛋白-1(programmed cell death protein-1,PD-1)拮抗劑或一細胞毒性T淋巴細胞相關蛋白4(cytotoxic T-lymphocyte-associated protein,CTLA4)拮抗劑;以及 一Toll樣受體9(toll-like receptor 9,TLR9)拮抗序列。
- 如請求項1所述之疫苗,更包含一共刺激胜肽,該共刺激胜肽位於該至少一共抑制胜肽和該TLR9拮抗序列之間,其中該共刺激胜肽係選自顆粒球巨噬細胞株刺激因子(granulocyte-macrophage colony-stimulating factor,GM-CSF)、介白素12(interleukin 12,IL12)和干擾素(interferon,IFNs)。
- 如請求項1所述之疫苗,其中該分泌信號胜肽為介白素2信號胜肽(interleukin 2 signal peptide,IL2 sp)或介白素12信號胜肽(interleukin 2 signal peptide,IL12 sp)。
- 如請求項1所述之疫苗,其中該PD-L1拮抗劑包含一PL-L1陷阱和一PD-1胜肽。
- 如請求項1所述之疫苗,其中該PD-1拮抗劑包含一PD-1陷阱和一PD-L1胜肽或一PD-L2胜肽。
- 如請求項1所述之疫苗,其中該CTLA4拮抗劑包含一CTLA4陷阱和一CTLA4拮抗抗體。
- 如請求項1所述之疫苗,其中該TLR9拮抗序列係選自一CpG寡核苷酸TLR9結合域、一TLR誘餌胜肽和一CpG結合序列。
- 一種如請求項1所述之疫苗之用途,其係用於製備治療癌症之藥物。
- 如請求項8所述之疫苗之用途,其中該製備治療癌症之藥物與一放射線合併使用。
- 一種癌症疫苗混合物,包含:如請求項1所述之疫苗,用以誘導一受試者對該至少一腫瘤抗原產生免疫反應,且該受試者需要癌症治療;一增強劑,用以增強該受試者的局部腫瘤控制;以及一加強免疫劑,用以防止該受試者的腫瘤局部復發和轉移。
- 如請求項10所述之癌症疫苗混合物,其中該增強劑為一放射線、一化學治療劑、一免疫調節劑、一靶向治療藥物、一抗體藥物或其組合。
- 如請求項10所述之癌症疫苗混合物,其中該加強免疫劑為一包含該至少一腫瘤抗原的癌症疫苗或一包含該至少一腫瘤抗原的治療細胞。
- 如請求項12所述之癌症疫苗混合物,其中該癌症疫苗為一樹突狀細胞癌症疫苗或一病毒載體癌症疫苗,該治療細胞為一細胞因子誘導殺手細胞(cytokine-induced killer cell,CIK)、一樹突細胞結合細胞因子誘導殺手細胞(Dendritic cell-cytokine-induced killer cell,DC-CIK)或一負載neoAg的DC-CIK。
- 如請求項10所述之癌症疫苗混合物,其中該加強免疫劑為一包含免疫檢查點蛋白、免疫抑制因子及/或免疫刺激因子的治療細胞。
- 如請求項14所述之癌症疫苗混合物,其中該治療細胞為一嵌合抗原受體-T細胞(chimeric antigen receptor-T cell,CAR-T)、嵌合抗原受體-自然殺手細胞(chimeric antigen receptor-natural killer cell,CAR-NK)或過繼性T細胞(adoptive T cell)。
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