US20110263512A1 - Conjugates for the treatment of mesothelioma - Google Patents

Conjugates for the treatment of mesothelioma Download PDF

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US20110263512A1
US20110263512A1 US12/992,524 US99252409A US2011263512A1 US 20110263512 A1 US20110263512 A1 US 20110263512A1 US 99252409 A US99252409 A US 99252409A US 2011263512 A1 US2011263512 A1 US 2011263512A1
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treatment
targeting peptide
conjugate
mesothelioma
cytokine
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Claudio Bordignon
Antonio Lambiase
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AGC Biologics SpA
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/52—Cytokines; Lymphokines; Interferons
    • C07K14/525—Tumour necrosis factor [TNF]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/191—Tumor necrosis factors [TNF], e.g. lymphotoxin [LT], i.e. TNF-beta
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/20—Interleukins [IL]
    • A61K38/208—IL-12
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/21—Interferons [IFN]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/21—Interferons [IFN]
    • A61K38/217—IFN-gamma
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/62—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid
    • A61K47/64—Drug-peptide, drug-protein or drug-polyamino acid conjugates, i.e. the modifying agent being a peptide, protein or polyamino acid which is covalently bonded or complexed to a therapeutically active agent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K7/00—Peptides having 5 to 20 amino acids in a fully defined sequence; Derivatives thereof
    • C07K7/04—Linear peptides containing only normal peptide links
    • C07K7/06—Linear peptides containing only normal peptide links having 5 to 11 amino acids

Definitions

  • the present invention relates to cancer therapy, particularly, to the use of conjugates of cytokines and targeting peptides for the treatment of Malignant Pleural Mesothelioma (MPM). More particularly, the invention relates to the use of a conjugate comprising a peptide containing NGR motif and TNF (NGR-TNF) for the treatment of MPM.
  • MPM Malignant Pleural Mesothelioma
  • MPM Malignant pleural mesothelioma
  • Performance status (PS) according to Eastern Cooperative Oncology Group (ECOG, Robert Comis M.D., Group Chair), are scales and criteria used by doctors and researchers to assess how a patient's disease is progressing, to assess how the disease affects the daily living abilities of the patients and determine appropriate treatment and prognosis (Oken, et al. 1982 Am J Clin Oncol 5:649-655). Performance status 2 identifies “ambulatory patients capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours”.
  • Pemetrexed disodium in combination with cisplatin is the first and only chemotherapy agent that has been granted a marketing approval for the treatment of chemotherapy na ⁇ ve patients with unresectable malignant pleural mesothelioma.
  • this chemotherapeutic approach achieved only a modest increase in terms of progression-free (5.7 versus 3.9 months) and overall survival (12.1 versus 9.3 months) in comparison with cisplatin monochemotherapy.
  • gefitinib (Iressa®), approved for the treatment of advanced non small cell lung cancer, and showing a marked anti-proliferative effect on mesothelioma cells in vitro (Janne et al., Cancer Res 2002, 62:5242-5247), resulted not active as front-line therapy, with a median progression free survival less than three months, although 97% of patients with mesothelioma had EGFR overexpression (Govindan et al. Clin Cancer Res, 2005; 11:2300-2304).
  • gefitinib showed a class specific toxicity profile with the most common grade 3 adverse events (grade 3: severe side-effects) being represented by diarrhoea, skin rash and fatigue.
  • Imatinib (Glivec®), a 2-phenylaminopyrimidine tyrosine kinase inhibitor known to affect both c-Kit and PDGF alpha and beta receptors and approved for the treatment of chronic myeloid leukaemia, didn't show to be effective as front-line single-agent therapy in terms of time to tumour progression ( ⁇ 3 months). Moreover, treatment was interrupted in the 40% of patients due to side effects. The main side effects were oedema (ankles, face, genitals and lungs) sometimes causing exacerbation of pleural or abdominal effusions, nausea and vomiting (Mathy et al. Lung cancer 2005 50:83-86).
  • angiogenesis inhibitors have been investigated (Ceresoli et al. The Oncologist 2007, 12:850-863). A certain activity was reported with SU5416, a highly selective receptor tyrosine kinase inhibitor that targets the VEGF receptors Flt-1 and KDR/Flk, hampered by an excessive risk for thrombosis.
  • Valatanib (PTK787) a VEGF and PDGF receptor tyrosine kinases inhibitor showed a median progression free survival of 4 months, when administered to chemotherapy-na ⁇ ve patients as front-line therapy.
  • Grade 3/4 toxicities (grade 3: severe side-effects, grade 4: life threatening or disabling side-effects) resulted in gastrointestinal bleeding, neutropenia, lymphopenia, nausea/vomiting, increased ALT/AST, hypertension (Jahan et al., J. Clin. Oncol., 2006 ASCO Annual Meeting Proceedings Part I. Vol. 24, N o 18S (June supplement), 2006:7081).
  • Bevacizumab a recombinant human anti-VEGF monoclonal antibody that blocks the binding of VEGF to its receptors, was evaluated as front-line treatment combined with chemotherapy in a double-blind, placebo controlled, randomized phase II trial.
  • the aim of a second-line treatment is not only the effectiveness in cancer treatment but also a relative safe and low toxicity profile for the patients.
  • conjugates comprising a targeting peptide and a cytokine are effective for the treatment of Malignant Pleural Mesothelioma and that such conjugates have a well tolerated toxicity profile.
  • WO 01/61017 discloses a conjugation product between TNF or IFN ⁇ and a ligand of the CD13 receptor, particularly a peptide containing the NGR motif. Data disclosed in the patent show that TNF conjugates are effective in the treatment of lymphoma and melanoma mouse models. In addition, conjugates of IFN ⁇ and a peptide containing the NGR motif have a potent antitumor effect in lymphoma and fibrosarcoma mouse models (Curnis et al., Cancer Res. 2005; 65(7):2906-2913).
  • Conjugates of various cytokines and tumor targeting moieties have been disclosed (WO 03/092737), and it has been demonstrated (WO 03/093478) that pharmaceutical compositions comprising such conjugates are effective at extremely low dosage that does not induce activation of negative feedback mechanism.
  • WO 2006/067633 discloses peptides containing degradation products of the NGR motif, that are able to target the ⁇ v ⁇ 3 integrin, and conjugates comprising these peptides and cytokines. None of these document discloses the effectiveness of cytokine conjugates for the treatment of Malignant Pleural Mesothelioma.
  • the present invention is related to the field of cancer therapy and particularly to the treatment of Malignant Pleural Mesothelioma.
  • a conjugate comprising a targeting peptide and a cytokine is effective for the treatment of mesothelioma, particularly in terms of increase of progression free survival and well tolerated toxicity profile of the conjugate.
  • NGR-hTNF doubled the progression free survival observed with best supportive care that is the reference treatment for this patient population lacking a standard therapy.
  • results obtained with NGR-hTNF in terms of progression free survival are comparable with those obtained with combination therapies, such as gemcitabine plus vinorelbine or bevacizumab plus erlotinib with the advantage of administering only one drug that does not have the toxicities associated with those drugs.
  • a conjugate comprising a targeting peptide and a cytokine for use in the treatment of mesothelioma.
  • the cytokine is TNF ⁇ , TNF ⁇ , IFN ⁇ , IL12.
  • the targeting peptide is a peptide containing the NGR or isoDGR or RGD motives.
  • the targeting peptide is a peptide containing the NGR motif.
  • the targeting peptide is selected from the group consisting of linear or cyclic CNGRCVSGCAGRC, NGRAHA, GNGRG, CVLNGRMEC, CNGRC, CNGRCG, LNGRE, YNGRT LQCICTGNGRGEWKCE, LQCISTGNGRGEWKCE, CICTGNGRGEWKC, CISTGNGRGEWKC, MRCTCVGNGRGEWTCY, MRCTSVGNGRGEWTCY, CTCVGNGRGEWTC and CTSVGNGRGEWTC
  • cytokine is TNF linked to the targeting peptide CNGRC through a spacer.
  • spacer is G (glycine).
  • a method for treating mesothelioma comprising administering a conjugate comprising a targeting peptide and a cytokine for the treatment of mesothelioma.
  • composition comprising an effective amount of a conjugate comprising a targeting peptide and a cytokine, together with pharmaceutically acceptable carriers and diluents.
  • a pharmaceutical composition comprising an effective amount of a conjugate comprising TNF linked to the targeting peptide CNGRC through the spacer G, together with pharmaceutically acceptable carriers and diluents.
  • the pharmaceutical composition is for the treatment of mesothelioma.
  • a pharmaceutical formulation containing a conjugate comprising TNF linked to the targeting peptide CNGRC through the spacer G at concentration in the range of 0.01 to 10 mg/ml together with pharmaceutically acceptable carriers and diluents.
  • the pharmaceutical formulation consists of 0.150 mg/ml of a conjugate comprising TNF linked to the targeting peptide CNGRC through the spacer G dissolved in a solution of 50 mM Na 2 HPO 4 , 150 mM NaCl.
  • polypeptide as used herein includes polypeptides and proteins.
  • polypeptide includes single-chain polypeptide molecules as well as multiple polypeptide complexes where individual constituent polypeptides are linked by covalent or non-covalent means.
  • polypeptide includes peptides of two or more amino acids in length, typically having more than 5, 10, 20, 30, 40, 50 or 100, amino acids.
  • Peptides that can be employed in the invention may include amino acids in D or L configuration.
  • modified peptides can be used, for example to reduce immunogenicity, to increase circulatory half-life in the body of the patient, to enhance bioavailability and/or to enhance efficacy and/or specificity.
  • Peptides can be linked to a variety of polymers, such as polyethylene glycol (PEG) and polypropylene glycol (PPG) (see for example U.S. Pat. Nos. 5,091,176, 5,214,131 and U.S. Pat. No.
  • PEG polyethylene glycol
  • PPG polypropylene glycol
  • bifunctional crosslinkers such as N-succinimidyl 3-(2pyridyldithio) propionate, succinimidyl 6-[3-(2 pyridyldithio) propionamido]hexanoate, and sulfosuccinimidyl 6-[3-(2 pyridyldithio) propionamido]hexanoate (see U.S. Pat. No. 5,580,853).
  • targeting peptide means a peptide as previously defined, that is able to bind to a receptor expressed on tumor-associated vessels or to a component of the extracellular matrix associated to the tumor vessels.
  • the targeting peptide of the conjugate may be targeted to the following receptors: CD13/Aminopeptidase N or integrins.
  • Aminopeptidases are a large group of enzymes involved in a number of biological processes such as maturation, regulation and degradation of proteins and polypeptides.
  • aminopeptidase N CD13/APN
  • the receptor for amino acid sequence NGR plays multiple roles in angiogenesis and is critical for the development of new blood vessels from existing vessels in pathological conditions, whereas it is not essential for de novo blood vessel formation in embrio-fetal development and normal adult function (Pasqualini, Koivunen et al. 2000; Arap, Kolonin et al. 2002 Bhagwat, Landenranta et al. 2001; Bhagwat, Petrovic et al. 2003; Fukasawa, Fujii et al. 2006; Rangel, Sun et al. 2007).
  • the targeting peptide is a peptide containing the NGR motif.
  • Peptide containing the NGR motif and the method for identifying such peptides are disclosed in WO 98/10795 and WO 99/13329 that are here incorporated by reference.
  • the targeting peptide is selected from the group consisting of linear or cyclic CNGRCVSGCAGRC, NGRAHA, GNGRG, CVLNGRMEC, CNGRC, CNGRCG, LNGRE, YNGRT LQCICTGNGRGEWKCE, LQCISTGNGRGEWKCE, CICTGNGRGEWKC, CISTGNGRGEWKC, MRCTCVGNGRGEWTCY, MRCTSVGNGRGEWTCY, CTCVGNGRGEWTC and CTCVGNGRGEWTC.
  • integrin molecule is composed of two noncovalently associated transmembrane glycoprotein subunits called ⁇ and ⁇ . Because the same integrin molecule in different cell types can have different ligand-binding specificities, it seems that additional cell-type-specific factors can interact with integrin modulate their binding activity. ⁇ and ⁇ subunits can combine in different ways to form integrin receptors. Natural ligands of integrin are adhesive proteins of the extracellular matrix proteins such as fibronectin, vitronectin, collagens, laminin.
  • integrins particularly ⁇ v ⁇ 3 integrin, recognize the amino acid sequence RGD (arginine-glycine-aspartic acid).
  • the targeting peptide is a peptide able to bind to the ⁇ v ⁇ 3 integrin, particularly a peptide containing the RDG motif.
  • ligands of ⁇ v ⁇ 3 integrin are peptides containing degradation products of the NGR motif. Details of these peptides are disclosed in WO 2006/067633 incorporated herein by reference.
  • the targeting peptide are peptides containing the degradation product of the NGR motif, particularly peptides containing the isoDGR motif.
  • the targeting peptides are selected from the group consisting of linear or cyclic CisoDGRCVSGCAGRC, isoDGRAHA, GisoDGRG, CVLisoDGRMEC, CisoDGRC, CisoDGRCG, LisoDGRE, YisoDGRT, LQCICTGisoDGRGEWKCE, LQCISTGisoDGRGEWKCE, CICTGisoDGRGEWKC, CISTGisoDGRGEWKC, MRCTCVGisoDGRGEWTCY, MRCTSVGisoDGRGEWTCY, CTCVGisoDGRGEWTC or CTSVGisoDGRGEWTC
  • the present invention relates a to the use of a conjugate comprising a targeting peptide linked to a cytokine for the treatment of mesothelioma.
  • cytokines that can be used in the conjugate of the present invention is TNF ⁇ , TNF ⁇ , IFN ⁇ , IFN ⁇ , IFN ⁇ , IL-I, 2, 4, 6, 7, 12, 15, EMAP II, vascular endothelial growth factor (VEGF), PDGF, PD-ECGF or a chemokine.
  • the cytokine is TNF ⁇ , TNF ⁇ , IFN ⁇ , IL12.
  • the term “linked” means that the targeting peptide is associated the cytokine through a chemical coupling so as to form a fusion protein wherein the first sequence (the targeting peptide) is able to transport the second sequence to a target cell. Therefore, the targeting peptide of the conjugate is linked to the cytokine via their polypeptide backbone and the resulting fusion protein is obtained through genetic expression in host cells of a DNA sequence encoding these protein, or direct synthesis of proteins or coupling of pre-formed sequences associated by a cross-linking agent.
  • the targeting peptide can be directly linked to the cytokine or indirectly through a spacer.
  • the spacer can be a single amino acid or amino acid sequence or an organic residue for example 6-aminocapryl-N-hydroxysuccinimide.
  • the targeting peptide preferably is linked to the cytokine N-terminus or C-terminus in order to avoid any interference in the binding of the cytokine to its receptor.
  • the peptide can be linked to amino acid residues which are amido- or carboxylic-bonds acceptors, naturally occurring on the molecule or artificially inserted with genetic engineering techniques.
  • the conjugate is prepared by use of a cDNA comprising a 5′-contiguous or a 3′contiguous sequence encoding the peptide.
  • TNF- ⁇ Human TNF- ⁇ is a 233 aa residue, nonglycosylated polypeptide that exists as either a transmembrane or soluble protein. When expressed as a 26 kDa membrane bound protein, TNF- ⁇ consists of a 29 aa residue cytoplasmic domain, a 28 aa residue transmembrane segment, and a 176 aa residue extracellular region.
  • the soluble protein is created by a proteolytic cleavage event via an 85 kDa TNF-alpha converting enzyme (TACE), which cleaves a fragment of 76 aa (residues 1-76 of the 233 aa sequence) and generates a 17 kDa, 157 aa residue molecule that normally circulates as a homotrimer.
  • TACE TNF-alpha converting enzyme
  • the sequence of TNF- ⁇ transmembrane and soluble protein can be found at ExPASy (Expert Protein Analysis System) proteomics server of the Swiss Institute of Bioinformatics, www.expasy.com, UniProtKB/Swiss-Prot database, entry P01375.
  • TNF- ⁇ is a pleiotropic transmembrane protein, with a broad spectrum of cellular and tissutal biologic activities, which range from enhancement of proliferation to direct cytotoxicity on tumour cells, activation of innate and adaptative immune response and effects on endothelium (Watanabe, Niitsu et al. 1988; Fajardo, Kwan et al. 1992).
  • a conjugation product between TNF and the CNGRC peptide in which, preferably, the amino-terminal of TNF is linked to the peptide, preferably through a spacer for use in the treatment of mesothelioma.
  • the spacer is G (glycine).
  • Interferon- ⁇ is a pleiotropic cytokine mainly produced by T-lymphocytes and natural killer cells (Farrar, et al., 1993; Boehm et al., 1997) promote anti-tumor responses.
  • IFN- ⁇ exists as a homodimer of two noncovalently bound polypeptide subunits. The sequence of human IFN- ⁇ can be found at NCBI (http://www.ncbi.nlm.nih.gov) website, Protein database, accession AAB59534.
  • IFN- ⁇ is able to promote antitumor response by inducing antiproliferative and pro-apoptotic effects on many tumor cell types, by inhibiting tumor angiogenesis and activating natural killer cells and macrophages against tumor cells.
  • a conjugation product between IFN ⁇ and the CNGRC peptide in which, preferably, the amino-terminal of IFN ⁇ is linked to the peptide, preferably through a spacer, preferably the spacer is G (glycine) for the treatment of mesothelioma.
  • IL12 (p70) is a glycosylated heterodimer composed of disulfide-linked p40 and p35 subunits, encoded by two separate genes. The correct heterodimer assembly occurs inside the producing cells. IL12 induces IFN ⁇ and other downstream proteins including the IFN ⁇ -inducible protein-10 (IP10) and the monokine induced by IFN ⁇ (Mig), activates immune responses and inhibits angiogenesis. Antitumor activity has been observed following IL12 peritumoral administration or by using tumor cells genetically modified to produce IL12.
  • IP10 IFN ⁇ -inducible protein-10
  • Mig monokine induced by IFN ⁇
  • human IL12 can be obtained from the NCBI (http://www.ncbi.nlm.nih.gov) website, Protein database, accession numbers M65271 (human p35 subunit) and M65272 human (p40 subunit).
  • a pharmaceutical formulation for treating an individual wherein the formulation comprises a therapeutically effective amount of a conjugate comprising a targeting peptide and a cytokine.
  • the pharmaceutical formulation comprises a conjugate of the cytokine TNF linked to the targeting peptide CNGRC through the spacer G (glycine), in a particularly preferred aspect the formulation is for the treatment of mesothelioma.
  • the formulation may comprise a pharmaceutically acceptable carrier, diluent, excipient or adjuvant.
  • a pharmaceutically acceptable carrier diluent, excipient or adjuvant.
  • the choice of pharmaceutical carrier, excipient or diluent can be selected on the basis of intended route of administration and standard pharmaceutical practice.
  • the pharmaceutical formulation may comprise as—or in addition to—the carrier, excipient or diluent any suitable binder(s), lubricant(s), suspending agent(s), coating agent(s), solubilising agent(s), and other carrier agents that may aid or increase the viral entry into the target site (such as for example a lipid delivery system).
  • Suitable carriers and diluents include isotonic saline solutions, for example phosphate-buffered saline.
  • the formulation of the invention may be for parenteral, intramuscular intravenous, subcutaneous, intraocular, oral or transdermal administration.
  • the formulation is for parenteral administration, in the form of a sterile aqueous solution which may contain other substances, for example enough salts or monosaccharides to make the solution isotonic with blood.
  • Formulations for parenteral administration comprise injectable solutions or suspensions and liquids for infusions.
  • an effective amount of the active ingredient will be dissolved or suspended in a sterile carrier, optionally adding excipients such as solubilizers, isotonicity agents, preservatives, stabilizers, emulsifiers or dispersing agents, and it will be subsequently distributed in sealed vials or ampoules.
  • excipients such as solubilizers, isotonicity agents, preservatives, stabilizers, emulsifiers or dispersing agents
  • compositions will be prepared for the administration daily, weekly or monthly in order to obtain the desired dosage.
  • the formulations can be prepared for a administration every 2, 4, 6, 8, 10 or 12 hours.
  • the conjugates, compositions and formulations of the present invention will be used in the therapeutic treatment of mesothelioma.
  • the word treatment include curative, palliative and prophylactic treatment.
  • Human recombinant NGR-TNF consisting of human soluble TNF ⁇ 1-157 linked to the C-terminus of the targeting peptide CNGRCG, was prepared by recombinant DNA technology and purified as described in WO01/61017 incorporated herein by reference.
  • Purified human recombinant NGR-TNF has been formulated to obtain a medicinal product to be administered in patients.
  • Pharmaceutical formulation consists in recombinant human NGR-TNF at concentration in the range of 0.01 to 10 mg/ml dissolved in phosphate buffered saline in 3 ml type I glass vials 1 ml/vial.
  • the medicinal product is stored at ⁇ 80° C.
  • NGR-hTNF in phosphate buffered saline is diluted to the appropriate concentration with 0.9% NaCl containing 1 mg/ml human serum albumin (HSA).
  • HSA human serum albumin
  • NGR-hTNF for the Treatment of Mesothelioma
  • the study was planned as multicenter phase II single arm, open-label, non-randomized study conducted using Simon's two-stage design method with 16 and 27 patients to be enrolled in the first and second stage, respectively.
  • the primary endpoint of this study was antitumor activity defined as progression free survival (PFS). Secondary end point included tumor growth control rate (TGCR), overall survival (OS) and safety. Experimental imaging (DCE-MRI) and pharmacokinetics studies were also included.
  • PFS progression free survival
  • TGCR tumor growth control rate
  • OS overall survival
  • DCE-MRI Experimental imaging
  • pharmacokinetics studies were also included.
  • Toxicity was registered according the NCI Common Toxicity Criteria version 3.0 grading system.
  • the protocol was subsequently amended to explore a more dense schedule of administration of NGR-hTNF given at same dosage of 0.8 ⁇ g/m 2 on a weekly basis.
  • protocol amendment in the case that ⁇ 1 of first 6 patients experienced any grade 4 hematologic or grade 3-4 nonhematological toxicity during the first three weeks with the exclusion of nausea, vomiting, and fever that can be rapidly controlled with appropriate measures, 6 additional patients would have been enrolled to test the feasibility of this weekly schedule on a larger cohort. Globally, this schedule was considered safe if ⁇ 2 of 12 patients experience any grade 4 hematologic or grade 3-4 non-hematologic toxicity.
  • NGR-hTNF NGR-hTNF at dose of 0.8 ⁇ g/m 2 by a 60-minute iv infusion every 3 weeks (q3w) or weekly.
  • treatment with paracetamol was allowed as prophylaxis for the subsequent cycles. No formal dose modification was required.
  • the duration of the treatment was related to the clinical outcome (documented by RECIST criteria). In case of stable disease or objective response the treatment was continued until progressive disease, unacceptable toxicity, patient refusal, or physician decision.
  • the patient baseline assessment included initial medical evaluation as well chemistry and instrumental examinations. All investigations had to be performed within 14 days before the start of treatment and consisted on a complete evaluation of the medical history, physical examination including vital signs such as blood pressure, body temperature and evaluation of all clinical symptoms as well as ECOG performance status, electrocardiograms (ECG); complete blood counts was performed to include red blood cells, hemoglobin, hematocrit, total white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils and other, platelets.
  • vital signs such as blood pressure, body temperature and evaluation of all clinical symptoms as well as ECOG performance status, electrocardiograms (ECG); complete blood counts was performed to include red blood cells, hemoglobin, hematocrit, total white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils and other, platelets.
  • Serum chemistry assessment was performed, including prothrombin time (PT, INR), partial thromboplastin time (PTT), creatinine, urea, total bilirubin, albumin, glucose, alkaline phosphatase (ALP), uric acid, lactate dehidrogenases (LDH), ⁇ -glutamyl-transpeptidase ( ⁇ GT), ALT, AST, electrolytes (Na + , K + , Ca ++ ).
  • Tumor assessment was ensured according to modified RECIST criteria for malignant mesothelioma. HIV, HBV, HCV screening tests were performed only at baseline if applicable by the local guideline. A serum pregnancy test was required in women of reproductive potential.
  • Tumor assessment was evaluated every 6 weeks: all sites that were found to be involved at the initial assessment were re-investigated by the same method, all lesions chosen as target during the initial assessment were measured by the same method and, if possible, by the same person.
  • the first-stage analysis was performed on the first 16 patients enrolled and treated, on a total of 42 patients recruited into the study during the first year. Patients received NGR-hTNF at dose of 0.8 ⁇ g/m 2 by a 60-minute iv infusion every 3 weeks (q3w). Approximately 75% of patients were males; the median age was 64 years old (range 48 to 80 years); ECOG performance status is 0 (7 pts) 1 (6 pts) and 2 (3 pts) respectively. Most of the patients (69%) had epithelial MPM in comparison with sarcomatoid (12.5%), mixed (6%) and unknown (12.5%) histologically confirmed MPM. Overall, 58 cycles (median 2, range 1-9) were completed.
  • SD stable disease
  • NGR-hTNF shows a favourable and manageable toxicity profile, with evidence of long lasting disease control in chemo-pre-treated MPM patients.

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EA201892619A1 (ru) 2011-04-29 2019-04-30 Роше Гликарт Аг Иммуноконъюгаты, содержащие мутантные полипептиды интерлейкина-2
CN111607005A (zh) * 2011-07-06 2020-09-01 江苏靶标生物医药研究所有限公司 一种肿瘤靶向性肿瘤坏死因子相关凋亡配体变体及其应用
WO2018207115A1 (en) * 2017-05-10 2018-11-15 Fondazione Centro San Raffaele Tumor-homing peptides, conjugation products thereof and their use in diagnostic and therapy
CN108178783B (zh) * 2017-12-21 2021-05-14 西南医科大学 肿瘤血管及m1型巨噬细胞靶向肽及其用途

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