Classifications

• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/53—Immunoassay; Biospecific binding assay; Materials therefor
  • G01N33/574—Immunoassay; Biospecific binding assay; Materials therefor for cancer
  • G01N33/57484—Immunoassay; Biospecific binding assay; Materials therefor for cancer involving compounds serving as markers for tumor, cancer, neoplasia, e.g. cellular determinants, receptors, heat shock/stress proteins, A-protein, oligosaccharides, metabolites
  • G01N33/57488—Immunoassay; Biospecific binding assay; Materials therefor for cancer involving compounds serving as markers for tumor, cancer, neoplasia, e.g. cellular determinants, receptors, heat shock/stress proteins, A-protein, oligosaccharides, metabolites involving compounds identifable in body fluids
• • C—CHEMISTRY; METALLURGY
  • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
  • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
  • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
  • C12N15/09—Recombinant DNA-technology
  • C12N15/63—Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
  • C12N15/79—Vectors or expression systems specially adapted for eukaryotic hosts
  • C12N15/85—Vectors or expression systems specially adapted for eukaryotic hosts for animal cells
  • C12N15/86—Viral vectors
  • C12N15/861—Adenoviral vectors
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
  • G01N33/6863—Cytokines, i.e. immune system proteins modifying a biological response such as cell growth proliferation or differentiation, e.g. TNF, CNF, GM-CSF, lymphotoxin, MIF or their receptors
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
  • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
  • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
  • G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
  • G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/545—Medicinal preparations containing antigens or antibodies characterised by the dose, timing or administration schedule
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
  • G01N2333/435—Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
  • G01N2333/705—Assays involving receptors, cell surface antigens or cell surface determinants
  • G01N2333/70503—Immunoglobulin superfamily, e.g. VCAMs, PECAM, LFA-3
  • G01N2333/70525—ICAM molecules, e.g. CD50, CD54, CD102
• • G—PHYSICS
  • G01—MEASURING; TESTING
  • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
  • G01N2800/00—Detection or diagnosis of diseases
  • G01N2800/52—Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis

Definitions

• the present invention relates to the field of immunology and, in particular, to immunotherapy of a patient against diseases caused for example by infection or cancers. More particularly, the invention relates to methods for predicting whether a subject is or is not susceptible to developing a prophylactic or therapeutic response, preferably immune response, after such immunotherapy. The present invention relates to methods and compositions for improving the immune response raised in vivo by an immunogenic composition, in particular a vaccine.
• Live vaccines are typically attenuated non- pathogenic versions of an infectious agent that are capable of priming an immune response directed against a pathogenic version of the infectious agent.
• the ideal viral vector In order to be utilized as a vaccine carrier, the ideal viral vector should be safe and enable efficient presentation of required pathogen-specific antigens to the immune system. Furthermore, the vector system must meet criteria that enable its production on a large-scale basis.
• IRMs immune response modifiers
• TLRs Toll-like receptors
• Such compounds have been shown to stimulate a rapid release of certain dendritic cell, monocyte/macrophage-derived cytokines and are also capable of stimulating B cells to secrete antibodies which play an important role in the antiviral and antitumor activities of IRM compounds.
• vaccination strategies have been proposed,- most of them being based on a prime-boost vaccination regimen.
• the immune system is first induced by administering to the patient a priming composition and then boosted by administration of a boosting second composition
• every member of a population may not be equally responsive to a particular treatment. For example, new compounds often fail in late clinical trials because of lack of efficacy in the population tested. While such compounds may not be effective in the overall population, there may be subpopulations sensitive to those failed compounds due to various reasons, including inherent differences in gene expression. By identifying a patient subpopulation sensitive to a compound, it is therefore possible to define method that can be used to rescue failed compounds. Subsequent-clinical trials restricted to a sensitive patient subpopulation may then demonstrate efficacy of a previously failed compound within that particular patient subpopulation, advancing the compound towards approval for use in that subpopulation. Accordingly, another way to improve immunotherapy efficacy, could be to determine patient population sensitive to the said therapy.
• Intracellular adhesion molecule 1 is an adhesion-related molecule belonging to the immunoglobulin superfamily. This molecule is found on the cell membrane of endothelial cells. When activated, ICAM-I allows stable leukocyte adhesion to the endothelial surface. Initially, it has been shown that the primary structure of ICAM-I has a typical hydrophobic transmembrane segment and is an insoluble molecule which is solubilized from cell membranes by lysing the cells in a non-ionic detergent (see EP0289949) .
• Soluble intercellular adhesion molecule-1 represents a circulating form of ICAM-I that is constitutively expressed or is inducible on the cell surface of different cell lines. Soluble ICAM-I has been found in such body fluids as serum, cerebrospinal fluid, synovial fluid, sputum, urine and bronchoalveolar lavage fluid. The release of soluble ICAM-I is modulated by several cytokines and various factors (TNF alpha, interleukins , interferons, etc..) .
• US20060199239 discloses a method of assessing cardiac health in a patient, by measuring inflammation risk factors including level of ICAM-I (disease level being defined above 285.2 ng/ml) .
• the present Invention relates to a method for treating a patient for human disease by administering an immunogenic composition comprising at least one antigen wherein said patient is selected in a patient population composed of patients that have low levels of siCAM-I (also named sCD54 or soluble ICAM-I or soluble CD54) .
• the present Invention thus relates to a method for treating a patient for human disease by administering an immunogenic composition comprising at least one antigen, said method comprising the following steps :
• the present Invention relates to a method for raising an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition wherein said patient is selected in a patient population composed of patients that have low levels of sICAM-I .
• the present Invention relates to a method for raising an immune response to at least one antigen (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition wherein said patient is selected in a patient population composed of patients that have low levels of sICAM- 1.
• the present Invention relates to a method for raising an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition wherein said patient is selected in a patient population composed of patients that have low levels of siCAM-I and wherein said raised immune response is innate immune response.
• the innate immune response is body's initial immune defense against pathogens and is elicited by a variety of cells including antigen-presenting cells or "APCs". These cells express surface and cytoplasmic receptors that recognize molecules of foreign origin (e.g.,. bacterial and viral nucleic acids, proteins, carbohydrates) .
• the dendritic cells and macrophage Upon detecting these signals, the dendritic cells and macrophage elicit a defensive response that includes the release of cytokines (including interferons, TNF-alpha and IL-12) and chemokines that attract cells such as immature dendritic cells, macrophage, NK cells, and granulocytes, to the site of challenge.
• cytokines including interferons, TNF-alpha and IL-12
• chemokines that attract cells such as immature dendritic cells, macrophage, NK cells, and granulocytes
• the present Invention thus relates to a method for raising an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition, said method comprising the following steps :
• the present Invention relates to a method for raising an immune response to at least one antigen (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition, said method comprising the following steps : - selection of patient in a patient population composed of patients that have low levels of siCAM-I,
• the present Invention relates to a method for raising an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition wherein said raised immune response is innate immune response, said method comprising the following steps :
• the present Invention relates to a method for inducing an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition, said method comprising the following steps : - measuring in the patient the levels of s ICAM-I, and administering to the patient the said immunogenic composition if said patient has low levels of sICAM- 1.
• the present Invention relates to a method for inducing an immune response to at least one antigen (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition, said method comprising the following steps : - measuring in the patient the levels of sICAM-1, and administering to the patient the said immunogenic composition if said patient has low levels of sICAM- 1.
• the present Invention relates to a method for inducing an immune response (i.e. the raised immune response) in a patient for treating human disease by administering an immunogenic composition wherein said raised immune response is innate immune response, said method comprising the following steps : - measuring in the patient the levels of siCAM-I, and administering to the patient the said immunogenic composition if said patient has low levels of sICAM- 1.
• the present Invention relates to a method for predicting whether a subject is or is not susceptible to developing prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response, by administration of an immunogenic composition, said method comprising the steps of: - obtaining a blood sample from the subject; and measuring levels of sICAM-1, wherein low levels of sICAM-I indicates that the subject is predicted to have an increased susceptibility to develop a prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response.
• the present Invention relates to a method for selecting a subject susceptible to developing prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response, by administration of an immunogenic composition, said method comprising the steps of: obtaining a blood sample from the subject; and - measuring levels of siCAM-I, wherein low levels of sICAM-I indicates that the subject has an increased susceptibility to developing a prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response.
• the present Invention relates to a method for predicting whether a subject is or is not susceptible to respond positively to a treatment comprising administration of an immunogenic composition, said method comprising the steps of: obtaining a blood sample from the subject; and measuring levels of s ICAM-I, wherein low levels of sICAM-I indicates that the subject is predicted to have an increased susceptibility to develop a prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response.
• the present Invention relates to a method for selecting a subject susceptible to respond positively to a treatment comprising administration of an immunogenic composition, said method comprising the steps of:
• sICAM-I measuring levels of s ICAM-I, wherein low levels of sICAM-I indicates that the subject has an increased susceptibility to developing a prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response, .
• the present Invention relates to an ex-vivo method for testing whether a subject will respond therapeutically to a method of treatment comprising administration of an immunogenic composition, wherein the testing method comprises the steps of: - obtaining a blood sample from the subject; and
• the present Invention relates to an ex-vivo method for testing whether a subject will respond therapeutically to a method of treating cancer by administration of an immunogenic composition, wherein the testing method comprises the steps of:
• the terms “a” and “an” are used in the sense that they mean “at least one”, “at least a first”, “one or more” or “a plurality” of the referenced compounds or steps, unless the context dictates otherwise.
• the term “a cell” includes a plurality of cells including a mixture thereof. More specifically, “at least one” and “one or more” means a number which is one or greater than one, with a special preference for one, two or three.
• the term “and/or” wherever used herein includes the meaning of "and”, “or” and “all or any other combination of the elements connected by said term” .
• patient refers to a vertebrate, particularly a member of the mammalian species and includes, but is not limited to, domestic animals, sport animals, primates including humans.
• a patient selected in a patient population composed of patients that have low levels of s ICAM-I should be understood as meaning a patient for who level of siCAM-I has been measured as disclosed herein, and who has low levels of s ICAM-I according to the Invention. When the number of patients tested is above 1, the said patients form a patient population.
• the terms "a patient will or is susceptible to respond therapeutically” mean that in said patient, after the administration of an immunogenic composition according to the Invention, an immune response is raised (i.e. the raised immune response) .
• the terms "a patient will or is susceptible to respond therapeutically” mean that the said patient has an increase of survival rate (see example section) .
• Invention with the reference treatment, i.e. without patient selection based on sICAM-I levels.
• an increase of survival rate is observed when the treated patient is still alive after 5 years, 2 years, 12 months, 8 months, 6 months, 1 month post treatment according to the Invention.
• the term “treatment” or “treating” encompasses prophylaxis and/or therapy. Accordingly the immunogenic combinations or methods of the present invention are not limited to therapeutic applications and can be used in prophylaxis ones. This is covered by the term “to developing a prophylactic or therapeutic response, preferably immune response,” herein. "Prophylaxis” is not limited to preventing immediate diseases (e.g. infectious diseases), it further encompasses prevention of long term consequences of these infections such as cirrhosis or cancer.
• an “effective amount” or a “sufficient amount” of an active compound is an amount sufficient to effect beneficial or desired results, including clinical results.
• An effective amount can be administered in one or more administrations.
• a “therapeutically effective amount” is an amount to effect beneficial clinical results, including, but not limited to, alleviation of one or more symptoms associated with tumor progression, viral infection as well as prevention of disease (e.g.
• sICAM-1 or sCD54 means soluble intercellular adhesion molecule-1 and represents a circulating form of ICAM-I. sICAM-I or sCD54 can be used interchangeably .
• the levels of siCAM-I can be determined by any method known in the art, for example the materials and methods of the present invention may be used with Luminex technology (Luminex Corporation, Austin, Tex.) or enzyme-linked immunosorbant assays (ELISA, numerous ELISA kits are commercially available e.g. by CliniScience, Diaclone, Biosource) .
• Luminex technology Luminex Corporation, Austin, Tex.
• ELISA enzyme-linked immunosorbant assays
• numerous ELISA kits are commercially available e.g. by CliniScience, Diaclone, Biosource
• the levels of siCAM-I can be determined on total blood sample or on plasma or serum. Accordingly, "obtaining a blood sample from the subject” should be understood as including further treatment of the said blood sample if s ICAM-I level has to be measured in plasma or serum.
• the level of sICAM-I is determined by using antibodies.
• said antibodies are monoclonal antibodies.
• said antibodies are tagged for example by fluorescence, radiolabel, enzyme, biotin, or any other methods designed to render sICAM-I labelled with said antibodies detectable. These techniques are widely used and known in the art.
• Anti ⁇ -CD54 antibodies especially monoclonal antibodies are widely available in the commerce. See for example antibody 3H1547 from Anticorps-enligne.fr, antibody 5540-P (Biocytex) .
• the terms "low levels of s ICAM-I” means levels fewer than about 300 ng/ml, preferably fewer than about 250 ng/ml, more preferably fewer than about 224 ng/ml and even preferably fewer than about 200 ng/ml. Said level can be measured by Multi-analyte plasma protein profiling using the Luminex® system (e . g. Luminex® xMAPTM technology, R&D Systems) .
• the terms "immunogenic composition” “vaccine composition”, “vaccine” or similar terms can be used interchangeably and mean an agent suitable for stimulating/inducing/increasing a subject's immune system to ameliorate a current condition or to protect against or to reduce present or future harm or infections (including viral, bacterial, parasitic infections), e.g.,- reduced tumour cell proliferation or survival, reduced pathogen replication or spread in a subject or a detectably reduced unwanted symptom (s) associated with a condition, extend patient survival.
• harm or infections including viral, bacterial, parasitic infections
• Said immunogenic composition can contain (i) all or part of at least one targeted antigen and/or (ii) at least one recombinant vector expressing in vivo all or part of at least one heterologous nucleotide sequence, especially an heterologous nucleotide sequence encoding all or part of at least one targeted antigen.
• the immunogenic composition of the Invention comprises (iii) at least one immune response modifier, alone or in combination with (i) and/or (ii) .
• IRMs immune response modifiers
• CpG oligonucleotides see US 6,194,388; US2006094683; WO 2004039829 for example
• lipopolysaccharides polyinosic : polycytidylic acid complexes
• polypeptides and proteins known to induce cytokine production from dendritic cells and/or monocyte/macrophages.
• IRMs immune response modifiers
• small organic molecule such as imidazoquinolinamines, imidazopyridine amines, 6,7- fused cycloalkylimidazopyridine amines, imidazonaphthyridine amines, oxazoloquinoline amines, thiazoloquinoline amines and 1,2-bridged imidazoquinoline amines (see for example US 4,689,338; US 5,389,640; US 6,110,929; and US 6,331,539) .
• the term "antigen” refers to any substance, including complex antigen (e.g. tumour cells, virus infected cells, etc%), that is capable of being the target of an immune response.
• An antigen may be the target of, for example, a cell-mediated and/or humoral immune response raised by a patient.
• the term "antigen” encompasses for example all or part of viral antigens, tumour-specific or tumour-related antigens, bacterial antigens, parasitic antigens, allergens and the like:
• Viral antigens include for example antigens from hepatitis viruses A, B, C, D and E, HIV, herpes viruses, cytomegalovirus , varicella zoster, papilloma viruses, Epstein Barr virus, influenza viruses, para-influenza viruses, adenoviruses, coxsakie viruses, picorna viruses, rotaviruses, respiratory syncytial viruses, pox viruses, rhinoviruses, rubella virus, papovirus, mumps virus, measles virus; some non-limiting examples of known viral antigens include the following : antigens derived from HIV-I such as tat, nef, gpl20 or gpl ⁇ O, gp40, p24, gag, env, vif, vpr, vpu, rev or part and/or combinations thereof; antigens derived from human herpes viruses such as gH, gL gM gB gC
• env protein El or E2 core protein, NS2, NS3, NS4a, NS4b, NS5a, NS5b, p7, or part and/or combinations thereof of HCV) ; antigens derived from human papilloma viruses (for example HPV6, 11, 16, 18, e.g. Ll, L2, El, E2, E3, E4, E5, E6, E7, or part and/or combinations thereof) ; antigens derived from other viral pathogens, such as Respiratory Syncytial virus (e.g. F and G proteins or derivatives thereof), parainfluenza virus, measles virus, mumps virus,- flaviviruses (e. g.
• Tumor-specific or -related antigens include but are not limited to, carcinoma, lymphoma, blastoma, sarcoma, and leukemia.
• cancers include breast cancer, prostate cancer, colon cancer, squamous cell cancer, small-cell lung cancer, non-small cell lung cancer, gastrointestinal cancer, pancreatic cancer, glioblastoma, cervical cancer, ovarian cancer, liver cancer, bladder cancer, hepatoma, colorectal cancer, endometrial carcinoma, salivary gland carcinoma, kidney cancer, liver cancer, vulval cancer, thyroid cancer, hepatic carcinoma and various types of head and neck cancer, renal cancer, malignant melanoma, laryngeal cancer, prostate cancer.
• Cancer antigens are antigens which can potentially stimulate apparently tumor-specific immune responses. Some of these antigens are encoded, although not necessarily expressed, by normal cells.
• cancer antigens can be characterized as those which are normally silent (i.e., not expressed) in normal cells, those that are expressed only at low levels or at certain stages of differentiation and those that are temporally expressed such as embryonic and fetal antigens.
• Other cancer antigens are encoded by mutant cellular genes, such as oncogenes (e.g., activated ras oncogene), suppressor genes (e.g., mutant p53), fusion proteins resulting from internal deletions or chromosomal translocations.
• Still other cancer antigens can be encoded by viral genes such as those carried on RNA and DNA tumor viruses.
• tumor-specific or -related antigens include MART- 1/Melan-A, gplOO, Dipeptidyl peptidase IV (DPPIV), adenosine deaminase-binding protein (ADAbp) , cyclophilin b, Colorectal associated antigen (CRC) -C017-1A/GA733, Carcinoembryonic Antigen (CEA) and its immunogenic epitopes CAP-I and CAP-2, etv ⁇ , amll, Prostate Specific Antigen (PSA) and its immunogenic epitopes PSA-I, PSA-2, and PSA-3, prostate- specific membrane antigen (PSMA), T-cell receptor/CD3-zeta chain, MAGE-family of tumor antigens (e.g., MAGE-Al, MAGE-A2,
• MAGE-B3 MAGE-Xp4 (MAGE-B4), MAGE-Cl, MAGE-C2, MAGE-C3,
• MAGE-C4, MAGE-C5) GAGE-family of tumor antigens (e.g., GAGE- 1, GAGE-2, GAGE-3, GAGE-4, GAGE-5, GAGE- ⁇ , GAGE-7, GAGE-8, GAGE-9), BAGE, RAGE, LAGE-I, NAG, GnT-V, MUM-I, CDK4, tyrosinase, p53, MUC family (e.g. MUC-I), HER2/neu, p21ras, RCASl, alpha-fetoprotein, E-cadherin, alpha-catenin, beta- catenin and gamma-catenin, ⁇ l20ctn, gplOO . sup.
• GAGE-family of tumor antigens e.g., GAGE- 1, GAGE-2, GAGE-3, GAGE-4, GAGE-5, GAGE- ⁇ , GAGE-7, GAGE-8, GAGE-9
• BAGE RAGE, LAGE-I, N
• Pmelll7 FRAME, NY-ESO-I, cdc27, adenomatous polyposis coli protein (APC), fodrin, Connexin 37, Ig-idiotype, pl5, gp75, GM2 and GD2 gangliosides, viral products such as human papilloma virus proteins, Smad family of tumor antigens, lmp-1, PlA, EBV- encoded nuclear antigen (EBNA)-I, brain glycogen phosphorylase, SSX-I, SSX-2 (HOM-MEL-40 ) , SSX-I, SSX-4, SSX-5, SCP-I and CT-7, and c-erbB-2;
• EBNA EBV- encoded nuclear antigen
• - bacterial antigens includes for example antigens from Mycobacteria causing TB and leprosy, pneumocci, aerobic gram negative bacilli, mycoplasma, staphyloccocal infections, streptococcal infections, salmonellae, chlamydiae, neisseriae; other antigens includes for example antigens from malaria, leishmaniasis, trypanosomiasis, toxoplasmosis, schistosomiasis, filariasis; - allergens refer to a substance that can induce an allergic or asthmatic response in a susceptible subject.
• allergens can include pollens, insect venoms, animal dander dust, fungal spores and drugs (e.g. penicillin) .
• drugs e.g. penicillin
• natural, animal and plant allergens include but are not limited to proteins specific to the following genuses: Canine (Canis familiaris) ; Dermatophagoides
• Ambrosia Ambrosia artemiisfolia; Lolium (e.g. Lolium perenne or Lolium multiflorum) ; Cryptomeria (Cryptomeria japonica); Alternaria (Alternaria alternata) ; Alder; Alnus (Alnus gultinoasa) ; Betula (Betula verrucosa); Quercus (Quercus alba); Olea (Olea europa) ; Artemisia (Artemisia vulgaris); Plantago (e.g. Plantago lanceolata) ; Parietaria (e.g.
• Parietaria officinalis or Parietaria judaica ; Blattella (e.g. Blattella germanica) ; Apis (e.g. Apis multiflorum) ; Cupressus (e.g. Cupressus sempervirens, Cupressus arizonica and Cupressus macrocarpa) ; Juniperus (e.g. Juniperus sabinoides, Juniperus virginiana, Juniperus communis and Juniperus ashei) ; Thuya (e.g. Thuya orientalis); Chamaecyparis (e.g. Chamaecyparis obtusa) ; Periplaneta (e.g.
• Periplaneta americana Periplaneta americana
• Agropyron e.g. Agropyron repens
• Secale e.g. Secale cereale
• Triticum e.g. Triticum aestivum
• Dactylis e.g. Dactylis glomerata
• Festuca e.g. Festuca elatior
• Anthoxanthum e.g.
• Anthoxanthum odoratum ; Arrhenatherum (e.g. Arrhenatherum elatius); Agrostis (e.g. Agrostis alba); Phleum (e.g. Phleum pratense) ; Phalaris (e.g. Phalaris arundinacea) ; Paspalum (e.g. Paspalum notatum) ; Sorghum (e.g. Sorghum halepensis); and Bromus (e.g. Bromus inermis) .
• said antigen is encoded by an heterologous nucleotide sequence and is expressed in vivo by a recombinant vector.
• heterologous nucleotide sequence of the present invention encodes one or more of all or part of the following antigens HBV-PreSl PreS2 and Surface env proteins, core and polHIV- gpl20 gp40,gpl60, p24, gag, pol, env, vif, vpr, vpu, tat, rev, nef; HPV-El, E2, E3, E4, E5, E6, E7, E8, Ll, L2 (see for example WO 90/10459, WO 98/04705, WO 99/03885); HCV env protein El or E2, core protein, NS2, NS3, NS4a, NS4b, NS5a, NS5b, p7 (see for example WO2004111082 , WO2005051420 ) ; Muc-1 (see for example US 5,861,381; US6,054,438; WO98/04727;
• the immunogenic composition contains at least two antigens, or an heterologous nucleotide sequence encoding at least two antigens, or at least two heterologous nucleotide sequences encoding at least two antigens, or any combination thereof.
• said heterologous nucleotide sequence of the present invention encodes all or part of HPV antigen (s) selected in the group consisting of E ⁇ early coding region of HPV, E7 early coding region of HPV and derivates or combination thereof.
• the HPV antigen encoded by the recombinant vector according to the invention is selected in the group consisting of an HPV E6 polypeptide, an HPV E7 polypeptide or both an HPV E6 polypeptide and an HPV E7 polypeptide.
• the present invention encompasses the use of any HPV E6 polypeptide which binding to p53 is altered or at least significantly reduced and/or the use of any HPV E7 polypeptide which binding to Rb is altered or at least significantly reduced (Munger et al., 1989, EMBO J. 8, 4099-4105; Crook et al., 1991, Cell 67, 547- 556; Heck et al., 1992, Proc. Natl. Acad. Sci.
• a non- oncogenic HPV-16 E6 variant which is suitable for the purpose of the present invention is deleted of one or more amino acid residues located from approximately position 118 to approximately position 122 (+1 representing the first methionine residue of the native HPV-16 E6 polypeptide) , with a special preference for the complete deletion of residues 118 to 122 (CPEEK) .
• HPV-16 E7 variant which is suitable for the purpose of the present invention is deleted of one or more amino acid residues located from approximately position 21 to approximately position 26 (+1 representing the first amino acid of the native HPV-16 E7 polypeptide, with a special preference for the complete deletion of residues 21 to 26 (DLYCYE) .
• the one or more HPV-16 early polypeptide (s) in use in the invention is/are further modified so as to improve MHC class I and/or MHC class II presentation, and/or to stimulate anti-HPV immunity.
• HPV E ⁇ and E7 polypeptides are nuclear proteins and it has been previously shown that membrane presentation permits to improve their therapeutic efficacy (see for example WO99/03885) .
• HPV early polypeptide s
• Membrane anchorage can be easily achieved by incorporating in the HPV early polypeptide a membrane- anchoring sequence and if the native polypeptide lacks it a secretory sequence (i.e. a signal peptide) .
• Secretory sequences are known in the art. Briefly, secretory sequences are present at the N-terminus of the membrane presented or secreted polypeptides and initiate their passage into the endoplasmic reticulum (ER) .
• Membrane-anchoring sequences are usually highly hydrophobic in nature and serves to anchor the polypeptides in the cell membrane (see for example Branden and Tooze, 1991, in Introduction to Protein Structure p. 202-214, NY Garland) .
• membrane-anchoring and secretory sequences which can be used in the context of the present invention is vast. They may be obtained from any membrane- anchored and/or secreted polypeptide comprising it (e.g. cellular or viral polypeptides) such as the rabies glycoprotein, of the HIV virus envelope glycoprotein or of the measles virus F protein or may be synthetic.
• the membrane anchoring and/or secretory sequences inserted in each of the early HPV-16 polypeptides used according to the invention may have a common or different origin.
• the preferred site of insertion of the secretory sequence is the N-terminus downstream of the codon for initiation of translation and that of the membrane-anchoring sequence is the C-terminus, for example immediately upstream of the stop codon.
• the HPV E6 polypeptide in use in the present invention is preferably modified by insertion of the secretory and membrane-anchoring signals of the measles F protein.
• the HPV E7 polypeptide in use in the present invention is preferably modified by insertion of the secretory and membrane-anchoring signals of the rabies glycoprotein.
• the therapeutic efficacy of the recombinant vector can also be improved by using one or more nucleic acid encoding immunopotentiator polypeptide (s) .
• s immunopotentiator polypeptide
• HSP70 Mycobacterium tuberculosis heat shock protein 70
• HSP70 Mycobacterium tuberculosis heat shock protein 70
• ubiquitin Roseudomonas aeruginosa exotoxin A
• ETA(d ⁇ II) Pseudomonas aeruginosa exotoxin A
• the recombinant vector according to the invention comprises a nucleic acid encoding one or more early polypeptide (s ) as above defined, and more particularly HPV-16 and/or HPV-18 early E6 and/or E7 polypeptides.
• said heterologous nucleotide sequence of the present invention encodes all or part of MUC 1 antigen or derivates thereof .
• said heterologous nucleotide sequence of the present invention encodes one or more of all or part of the followings: HCV env protein El or E2, core protein, NS2, NS3, NS4a, NS4b f NS5a, NS5b, p7 or derivates thereof.
• said heterologous nucleotide sequence of the present invention encodes one or more fusion protein wherein the configuration is not native in the sense that at least one of the NS polypeptides appears in an order which is distinct from that of the native configuration.
• the native configuration would be NS3-NS4A- NS5B with NS3 at the N-terminus and NS5B at the C-terminus.
• a non-native configuration can be NS5B-NS3-NS4A, NS5B-NS4A-NS3, NS4A-NS3-NS5B, NS4A-NS5B-NS3 or NS3-NS5B-NS4A.
• the fusion protein according to the invention comprises at least one of the followings: o A NS4A polypeptide fused directly or through a linker to the N-terminus of a NS3 polypeptide; o A NS3 polypeptide fused directly or through a linker to the N-terminus of a NS5B polypeptide; o A NS4B polypeptide fused directly or through a linker to the N-terminus of a NS5B polypeptide; o A NS4A polypeptide fused directly or through a linker to the N-terminus of a NS3 polypeptide which is fused directly or through a linker to the N- terminus of a NS4B polypeptide; and/or o A NS3 polypeptide fused directly or through a linker to the N-terminus of a NS4B polypeptide which is fused directly or through a linker to the N-terminus of a NS5B polypeptide.
• each of the NS polypeptides can be independently native or modified.
• the NS4A polypeptide included in the NS4A-NS3 portion can be native whereas the NS3 polypeptide comprises at least one of the modifications described below.
• the nucleic acid molecule in use in the invention may be optimized for providing high level expression of the targeted antigen (e.g. HPV early polypeptide (s) ) in a particular host cell or organism, e.g. a human host cell or organism.
• codon optimisation is performed by replacing one or more "native" (e.g.
• HPV HPV codon corresponding to a codon infrequently used in the mammalian host cell by one or more codon encoding the same amino acid which is more frequently used. This can be achieved by conventional mutagenesis or by chemical synthetic techniques (e.g. resulting in a synthetic nucleic acid) . It is not necessary to replace all native codons corresponding to infrequently used codons since increased expression can be achieved even with partial replacement. Moreover, some deviations from strict adherence to optimised codon usage may be made to accommodate the introduction of restriction site(s) .
• the term "recombinant vector” refers to viral as well as non viral vectors, including extrachromosomal (e.g. episome), multicopy and integrating vectors (i.e. for being incorporated into the host chromosomes) .
• extrachromosomal e.g. episome
• multicopy and integrating vectors i.e. for being incorporated into the host chromosomes
• vectors for use in gene therapy i.e. which are capable of delivering the nucleic acid to a host organism
• expression vectors for use in various expression systems are particularly important in the context of the invention.
• Suitable non viral vectors include plasmids such as pREP4, pCEP4 (Invitrogene) , pCI (Promega), pCDM8 (Seed, 1987, Nature 329, 840), pVAX and pgWiz (Gene Therapy System Inc; Himoudi et al . , 2002, J. Virol. 76, 12735-12746) .
• Suitable viral vectors may be derived from a variety of different viruses (e.g. retrovirus, adenovirus, AAV, poxvirus, herpes virus, measle virus, foamy virus and the like) .
• the term "viral vector” encompasses vector DNA/RNA as well as viral particles generated thereof.
• Viral vectors can be replication-competent, or can be genetically disabled so as to be replication- defective or replication-impaired.
• replication- competent encompasses replication-selective and conditionally-replicative viral vectors which are engineered to replicate better or selectively in specific host 5 cells (e.g. tumoral cells) .
• the recombinant vector in use in the invention is a recombinant adenoviral vector (for a review, see “Adenoviral vectors for gene therapy", 2002, Ed D. Curiel and J. Douglas, Academic Press) . It can be derived from a
• adenovirus serotypes 1 through 51 10 variety of human or animal sources and any serotype can be employed from the adenovirus serotypes 1 through 51. Particularly preferred are human adenoviruses 2 (Ad2), 5 (Ad5), 6 (Ad ⁇ ), 11 (AdIl), 24 (Ad24) and 35 (Ad35) . Such adenovirus are available from the American Type Culture
• the adenoviral vector in use in the present invention can be replication-competent.
• Numerous examples of replication- competent adenoviral vectors are readily available to those skill in the art (see, for example, Hernandez-Alcoceba et al.,
• the adenoviral vector in use in the invention is replication-defective (see for example WO94/28152; Lusky et al., 1998, J. Virol 72, 2022-2032) .
• Preferred replication-defective adenoviral vectors are El- defective (see for example US 6,136,594 and US 6,013,638), with an El deletion extending from approximately positions 459 to 3328 or from approximately positions 459 to 3510 (by reference to the sequence of the human adenovirus type 5 disclosed in the GeneBank under the accession number M 73260 and in Chroboczek et al., 1992, Virol. 186, 280-285) .
• the cloning capacity can further be improved by deleting additional portion (s) of the adenoviral genome (all or part of the non essential E3 region or of other essential E2, E4 regions) .
• Insertion of a nucleic acid in any location of the adenoviral vector can be performed through homologous recombination as described in Chartier et al. (1996, J. Virol. 70, 4805-4810) .
• the nucleic acid encoding the HPV-16 E6 polypeptide can be inserted in replacement of the El region and the nucleic acid encoding the HPV-16 E7 polypeptide in replacement of the E3 region or vice versa.
• the vector in use in the invention is a poxviral vector (see for example Cox et al. in "Viruses in Human Gene Therapy” Ed J. M. Hos, Carolina Academic Press) .
• poxviral vector see for example Cox et al. in "Viruses in Human Gene Therapy” Ed J. M. Hos, Carolina Academic Press
• suitable vaccinia viruses include without limitation the Copenhagen strain (Goebel et al., 1990, Virol. 179, 247-266 and 517-563; Johnson et al., 1993, Virol.
• the Wyeth strain and the highly attenuated attenuated virus derived thereof including MVA (for review see Mayr, A., et al., 1975, Infection 3, 6-14) and derivates thereof (such as MVA vaccinia strain 575 (ECACC V00120707 - US 6,913,752), NYVAC (see WO 92/15672 - Tartaglia et al., 1992, Virology, 188, 217-232) .
• MVA for review see Mayr, A., et al., 1975, Infection 3, 6-14
• derivates thereof such as MVA vaccinia strain 575 (ECACC V00120707 - US 6,913,752), NYVAC (see WO 92/15672 - Tartaglia et al., 1992, Virology, 188, 217-232) .
• the vector may also be obtained from any other member of the poxviridae, in particular fowlpox (e.g. TROVAC, see Paoletti et al, 1995, Dev Biol Stand., 84, 159-163); canarypox (e.g.
• the nucleic acid encoding the antigen of the Invention is preferably inserted in a nonessential locus of the poxviral genome, in order that the recombinant poxvirus remains viable and infectious.
• Nonessential regions are non-coding intergenic regions or any gene for which inactivation or deletion does not significantly impair viral growth, replication or infection.
• the antigen- 5 encoding nucleic acid is preferably inserted in the thymidine kinase gene (tk) (Hruby et al., 1983, Proc. Natl. Acad. Sci USA 80, 3411-3415 ; Weir et al., 1983, J. Virol. 46, 530-537) .
• tk thymidine kinase gene
• other insertion sites are also appropriate, e.g. in the hemagglutinin gene (Guo et al., 1989, J. Virol. 63, 4189-
• the antigen-encoding nucleic acid can be any suitable antigen-encoding nucleic acid.
• the antigen-encoding nucleic acid can be any suitable antigen-encoding nucleic acid.
• deletion II or III is preferred (Meyer et al., 1991, J. Gen. Virol. 72, 1031-1038
• the antigen-encoding nucleic acid is preferably introduced in the intergenic region situated between ORFs 7 and 9 (see for example EP 314 569 and
• said recombinant 30 vector is a recombinant plasmid DNA or a recombinant viral vector.
• said recombinant viral vector is a recombinant adenoviral vector.
• said recombinant viral vector is a recombinant vaccinia vector.
• said recombinant vaccinia vector is a recombinant MVA vector.
• the antigen-encoding nucleic acid in use in the invention is in a form suitable for its expression in a host cell or organism, which means that the nucleic acid sequence encoding the antigen are placed under the control of one or more regulatory sequences necessary for its expression in the host cell or organism.
• regulatory sequence refers to any sequence that allows, contributes or modulates the expression of a nucleic acid in a given host cell, including replication, duplication, transcription, splicing, translation, stability and/or transport of the nucleic acid or one of its derivative (i.e. mRNA) into the host cell.
• the choice of the regulatory sequences can depend on factors such as the host cell, the vector and the level of expression desired.
• the nucleic acid encoding the antigen is operatively linked to a gene expression sequence which directs the expression of the antigen nucleic acid within a eukaryotic cell.
• the gene expression sequence is any regulatory nucleotide sequence, such as a promoter sequence or promoter-enhancer combination, which facilitates the efficient transcription and translation of the antigen nucleic acid to which it is operatively linked.
• the gene expression sequence may, for example, be a mammalian or viral promoter, such as a constitutive or inducible promoter.
• Constitutive mammalian promoters include, but are not limited to, the promoters for the following genes: hypoxanthine phosphoribosyl transferase (HPRT) , adenosine deaminase, pyruvate kinase, b-actin promoter and other constitutive promoters.
• HPRT hypoxanthine phosphoribosyl transferase
• Exemplary viral promoters which function constitutively in eukaryotic cells include, for example, promoters from the cytomegalovirus (CMV) , simian virus (e.g., SV40), papilloma virus, adenovirus, human immunodeficiency virus (HIV), Rous sarcoma virus, cytomegalovirus, the long terminal repeats (LTR) of Moloney leukemia virus and other retroviruses, and the thymidine kinase promoter of herpes simplex virus.
• CMV cytomegalovirus
• simian virus e.g., SV40
• papilloma virus e.g., SV40
• HIV human immunodeficiency virus
• Rous sarcoma virus e.g., Rous sarcoma virus
• cytomegalovirus e.g., cytomegalovirus
• LTR long terminal repeats
• Inducible promoters are expressed in the presence of an inducing agent.
• the metallothionein promoter is induced to promote transcription and translation in the presence of certain metal ions.
• Other inducible promoters are known to those of ordinary skill in the art.
• the gene expression sequence shall include, as necessary, 5' non-transcribing and 5' non- translating sequences involved with the initiation of transcription and translation, respectively, such as a TATA box, capping sequence, CAAT sequence, and the like.
• 5 ' non-transcribing sequences will include a promoter region which includes a promoter sequence for transcriptional control of the operably joined antigen nucleic acid.
• the gene expression sequences optionally include enhancer sequences or upstream activator sequences as desired.
• Preferred promoters for use in a poxviral vector include without limitation vaccinia promoters 7.5K, H5R, TK, p28, pll and KlL, chimeric promoters between early and late poxviral promoters as well as synthetic promoters such as those described in Chakrabarti et al. (1997, Biotechniques 23, 1094-1097), Hammond et al. (1997, J. Virological Methods 66, 135-138) and Kumar and Boyle (1990, Virology 179, 151-158) .
• the promoter is of special importance and the present invention encompasses the use of constitutive promoters which direct expression of the nucleic acid in many types of host cells and those which direct expression only in certain host cells or in response to specific events or exogenous factors
• promoters are widely described in literature and one may cite more specifically viral promoters such as
• RSV, SV40, CMV and MLP promoters are preferred promoters for use in a poxviral vector.
• Preferred promoters for use in a poxviral vector include without limitation vaccinia promoters 7.5K, H5R, TK, p28, pll and KlL, chimeric promoters between early and late poxviral promoters as well as synthetic promoters such as those described in Chakrabarti et al . (1997,
• the regulatory elements controlling the expression of the nucleic acid molecule of the invention may further comprise additional elements for proper initiation, regulation and/or termination of transcription (e.g. polyA transcription termination sequences), mRNA transport (e.g. nuclear localization signal sequences), processing (e.g. splicing signals), and stability (e.g. introns and non-coding 5' and 3' sequences), translation (e.g. peptide signal, propeptide, tripartite leader sequences, ribosome binding sites, Shine-Dalgamo sequences, etc.) into the host cell or organism.
• transcription e.g. polyA transcription termination sequences
• mRNA transport e.g. nuclear localization signal sequences
• processing e.g. splicing signals
• stability e.g. introns and non-coding 5' and 3' sequences
• translation e.g. peptide signal, propeptide, tripartite leader sequences, ribosome binding sites, Shine-Dalgamo sequences,
• the recombinant vector in use in the present invention can further comprise at least one nucleic acid encoding at least one cytokine.
• Suitable cytokines include without limitation interleukins (e.g. IL-2, IL-7, IL- 15, IL-18, IL-21) and interferons (e.g. IFN ⁇ , INF ⁇ ) , with a special preference for interleukin IL-2.
• the recombinant vaccine of the invention comprises a cytokine-expressing nucleic acid
• said nucleic acid may be carried by the recombinant vector encoding the one or more antigen (s) or by an independent recombinant vector which can be of the same or a different origin.
• the recombinant in use in the present invention is encoding all or part of the MUCl antigen and at least one cytokines above listed, and preferably an interleukin, especially IL2.
• Infectious viral particles comprising the above-described recombinant viral vector can be produced by routine process.
• An exemplary process comprises the steps of: a. introducing the viral vector into a suitable cell line, b. culturing said cell line under suitable conditions so as to allow the production of said infectious viral particle, c. recovering the produced infectious viral particle from the culture of said cell line, and d. optionally purifying said recovered infectious viral particle .
• Cells appropriate for propagating adenoviral vectors are for example 293 cells, PERC6 cells, HER96 cells, or cells as disclosed in WO 94/28152, WO 97/00326, US 6,127,175.
• Cells appropriate for propagating poxvirus vectors are avian cells, and most preferably primary chicken embryo fibroblasts (CEF) prepared from chicken embryos obtained from fertilized eggs.
• CEF primary chicken embryo fibroblasts
• the infectious viral particles may be recovered from the culture supernatant or from the cells after lysis (e.g. by chemical means, freezing/thawing, osmotic shock, mecanic shock, sonication and the like) .
• the viral particles can be isolated by consecutive rounds of plaque purification and then purified using the techniques of the art (chromatographic methods, ultracentrifugation on caesium chloride or sucrose gradient) .
• the method or use for treating a patient for human disease human disease according to the Invention can be carried out in the selected patients in conjunction with one or more conventional therapeutic modalities (e.g. radiation, chemotherapy and/or surgery) .
• one or more conventional therapeutic modalities e.g. radiation, chemotherapy and/or surgery
• the use of multiple therapeutic approaches provides the selected patient with a broader based intervention.
• the method or use for treating a patient for human disease human disease according to the Invention can be preceded or followed by a surgical intervention. In another embodiment, it can be preceded or followed by radiotherapy (e.g. gamma radiation) .
• the method or use of the invention is associated to chemotherapy with one or more drugs (e.g. drugs which are conventionally used for treating or preventing viral infections, virus-associated pathologic conditions, cancer, and the like) .
• drugs e.g. drugs which are conventionally used for treating or preventing viral infections, virus-associated pathologic conditions, cancer, and the like.
• the present Invention thus relates to a method for improving the treatment of a cancer patient which is undergoing chemotherapeutic treatment with a chemotherapeutic agent, said method comprising the following steps :
• the administration of said chemotherapeutic agent is done before administration of said immunogenic composition.
• the administration of said chemotherapeutic agent is done after administration of said immunogenic composition. According to another embodiment, the administration of said chemotherapeutic agent is done concomitantly with administration of said immunogenic composition.
• the present Invention further concerns a method of improving cytotoxic effectiveness of cytotoxic drugs or radiotherapy which comprises co-treating a patient selected in a patient population composed of patients that have low levels of s ICAM-I with an immunogenic composition according to the Invention.
• chemotherapeutic agent or cytotoxic drugs include, e.g., Vincristine, .Cisplatin, Azaguanine, Etoposide,
• Methylpredrdsolone Methotrexate, Bleomycin, Methyl-GAG,
• radioactive chemotherapeutic agents include compounds containing alpha emitters such as astatine-21 1, bismuth-212, bismuth-213, lead-212, radium-223, actinium-225, and thorium-227, beta emitters such as tritium, strontium-90, cesium-137, carbon- 11, nitrogen- 13, oxygen-15, fluorine-18, iron-52, cobalt-55, cobalt ⁇ 60, copper-61, copper-62, copper- 64, zinc-62, zinc-63, arsenic-70, arsenic-71, arsenic-74, bromine-76, bromine ⁇ 79, rubidium-82 , yttrium-86, zirconium-89, indium-1 10, iodine-120, iodine-124, iodine-129, iodine-131, iodine-125, xenon- 122, technetium-94m, technetium-94 , technetium- 99m, and
• HERCEPTINTM gemtuzumab, Ibrirumomab, Edrecolomab, Tositumomab, CeaVac, Epratuzumab, Mitumomab, Bevacizumab, Cetuximab, Edrecolomab, Lintuzumab, MDX-210, IGN-101, MDX-OlO, MAb, AME ABX-EGF, EMD 72 000, Apolizumab, Labetuzumab, ior-tl, MDX-220, MRA, H-I 1 scFv, Oregovomab, huJ591 MAb, BZL Visilizumab.
• TriGem TriAb, R3, MT-201, G-250, unconjugated, ACA-125, Onyvax-105, CDP- 860, BrevaRex MAb AR54, IMC-ICl 1, GlioMAb-H, ING-I, Anti-LCG MAbs, MT-103, KSB- 303, Therex, KW- 2871, Anti-HMI.24, Anti-PTHrP, 2C4 antibody, SGN-30, TRAIL-RI MAb CAT, Prostate cancer antibody, H22xKi-4, ABX-MAl, Imuteran, and Monopharm-C.
• chemotherapeutic agents also include Acivicin;
• Aclarubicin Acodazole Hydrochloride; Acronine; Adozelesin;
• Carbetimer Carboplatin; Carmustine; Carubicin Hydrochloride; Carzelesin; Cedefingol; Chlorambucil; Cirolemycin; Cisplatin;
• Daunorubicin Hydrochloride Daunomycin; . Decitabine; Dexormaplatin; Dezaguanine; Dezaguanine Mesylate; Diaziquone;
• Docetaxel Dolasatins; Doxorubicin; Doxorubicin Hydrochloride;
• Droloxifene Droloxifene Citrate; Dromostanolone Propionate;
• Mitocarcin Mitocromin; Mitogillin; Mitomalcin; Mitomycin;
• Mitosper Mitosper; Mitotane; Mitoxantrone Hydrochloride; Mycophenolic Acid; Nocodazole; Nogalamycin; Ormaplatin; Oxisuran;
• Taxoid Tecogalan Sodium; Tegafur; Teloxantrone Hydrochloride;
• Temoporfin Tenyposide; Teroxirone; Testolactone; Thiamiprine;
• Verteporfin Vinblastine; Vinblastine Sulfate; Vincristine; Vincristine Sulfate; Vindesine; Vindesine Sulfate; Vinepidine
• Vinorelbine Tartrate Vinrosidine Sulfate
• BCNU (2-chloroethyl) -N-nitrosourea
• CCNU (2- chloroethyl) -N ' cyclohexyl-N-nitrosourea
• CCNU (2-chloroethyl) -N '-
• Daunomycin Epirubicin; darubicin; mitoxantrone; losoxantrone;
• Dactinomycin (Actinomycin D) ; amsacrine; pyrazoloacridine; all- trans retinol; 14-hydroxy-retro-retinol; all-trans retinoic acid; N- (4- Hydroxyphenyl) retinamide; 13-cis retinoic acid; 3-Methyl TTNEB; 9-cis retinoic acid; fludarabine (2-F-ara-AMP) ; or 2-chlorodeoxyadenosine (2-Cda) .
• chemotherapeutic agents include, but are not limited to, 20-pi-l,25 dihydroxyvitamin D3; 5-ethynyluracil; abiraterone; aclarubicin; acylfulvene; adecypenol; adozelesin; aldesleukin; ALL-TK antagonists; altretamine; ambamustine; amidox; amifostine; aminolevulinic acid; amrubicin; amsacrine; anagrelide; anastrozole; andrographolide; angiogenesis inhibitors; antagonist D; antagonist G; antarelix; anti- dorsalizing morphogenetic protein-1; antiandrogen, prostatic carcinoma; antiestrogen; antineoplaston; antisense _ oligonucleotides; aphidicolin glycinate; apoptosis gene modulators; apoptosis regulators; apurinic acid; ara-CDP-DL
• camptothecin derivatives e.g., 10-hydroxy-camptothecin
• canarypox HL-2 canarypox HL-2
• capecitabine carboxamide-amino-triazole; carboxyamidotriazole; CaRestM3; CARN 700; cartilage derived inhibitor; carzelesin; casein kinase inhibitors (ICOS); castanospermine; cecropin B; cetrorelix; chlorins; chloroquinoxaline sulfonamide; cicaprost; cis-porphyrin; cladribine; clomifene analogues; clotrimazole; collismycin A ; collismycin B; combretastatin A4 ; combretastatin analogue; conagenin; crambescidin 816 ; crisnatol; cryptophycin 8; cryptophycin A derivatives; curacin A ; cycl
• the method or use of the invention is carried out according to a prime boost therapeutic modality which comprises sequential administration of one or more primer composition (s) and one or more booster composition (s) .
• the priming and the boosting compositions use different vehicles which comprise or encode at least an antigenic domain in common.
• the priming composition is initially administered to the host organism and the boosting composition is subsequently administered to the same host organism after a period varying from one day to twelve months.
• the method of the invention may comprise one to ten sequential administrations of the priming composition followed by one to ten sequential administrations of the boosting composition. Desirably, injection intervals are a matter of one week to six months.
• the priming and boosting compositions can be administered at the same site or at alternative sites by the same route or by different routes of administration.
• the Invention relates to a method as above described wherein said human disease is cancer.
• said cancer is for example breast cancer, colon cancer, kidney cancer, rectal cancer, lung cancer, cancer of the head and neck, renal cancer, malignant melanoma, laryngeal cancer, ovarian cancer, cervical cancer, prostate cancer, non Small cell Lung Cancer (NSCLC), haematological cancers, gastric cancers, myeloma.
• NSCLC non Small cell Lung Cancer
• said cancer is non Small cell Lung Cancer (NSCLC) .
• the Invention relates to a method as above described wherein said human disease is infectious disease.
• said infectious disease is a viral induced disease, such as for example disease induced by HIV, HCV, HBV, HPV, and the like.
• an immunogenic composition comprising all or part of a targeted antigen for the manufacture of a medicament for treating a patient for human disease in a particular patient population wherein the patients of said population have low levels of s ICAM-I.
• an immunogenic composition for the manufacture of a medicament for raising an immune response (i.e. the raised immune response) in a patient for treating human disease in a particular patient population wherein the patients of said population have low levels of s ICAM-I.
• an immunogenic composition for the manufacture of a medicament for raising an immune response to at least one antigen (i.e. the raised immune response) in a patient for treating human disease in a particular patient population wherein the patients of said population have low levels of sICAM-1.
• an immunogenic composition for the manufacture of a medicament for raising an immune response (i.e. the raised immune response) in a patient for treating human disease in a particular patient population wherein the patients of said population have low levels of sICAM-I and wherein said raised immune response is innate immune response.
• said "raised immune response" in said patient population is directed towards a tumour-specific or -related antigens and/or viral antigen. According to one embodiment, said "raised immune response” in said patient population is directed towards distinct antigens. According to one special embodiment, said "raised immune response” in said patient population is directed towards MUCl antigen. According to another special embodiment, said "raised immune response” in said patient population is T cell immune response, and preferably CD8+
• said "raised immune response" in said patient population is a non specific immune response.
• said "raised immune response" in said patient population is a stimulation of the innate immune response.
• the ability to induce or stimulate an immune response upon administration in an animal or human organism can be evaluated either in vitro or in vivo using a variety of assays which are standard in the art.
• assays which are standard in the art.
• Measurement of cellular immunity can be performed by measurement of cytokine profiles secreted by activated effector cells including those derived from CD4+ and CD8+ T-cells (e.g.
• IL-IO or IFN gamma-producing cells by ELIspot), by determination of the activation status of immune effector cells (e.g. T cell proliferation assays by a classical [ 3 H] thymidine uptake) , by assaying for antigen-specific T lymphocytes in a sensitized subject (e.g. peptide-specific lysis in a cytotoxicity assay) or by detection of antigen specific T cells by fluorescent MHC and/or peptide multimers (e.g. tetramers) .
• the ability to stimulate a humoral response may be determined by antibody binding and/or competition in binding (see for example Harlow, 1989, Antibodies, Cold Spring Harbor Press) .
• the method of the invention can also be further validated in animal models challenged with an appropriate tumor-inducing agent (e.g. MUCl-expressing TCl cells) to determine anti-tumor activity, reflecting an induction or an enhancement of an anti-antigen immune response.
• an appropriate tumor-inducing agent e.g. MUCl-expressing TCl cells
• the present invention further concerns a method for extending the survival of a patient treated for human disease by administering an immunogenic composition, said method comprising the following steps :
• the present Invention relates to the use of sICAM-I as a biomarker for predicting whether a subject is or is not susceptible to developing prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response, by administration of an immunogenic composition.
• the present Invention relates to the use of the level of siCAM-I as a biomarker for predicting whether a subject is or is not susceptible to developing prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response, by administration of an immunogenic composition, wherein low levels of sICAM-I indicates that the subject is predicted to have an increased susceptibility to develop a prophylactic or therapeutic response, preferably prophylactic or therapeutic immune response .
• the present Invention relates to the use of the level of sICAM-I as a biomarker for predicting whether a subject is or is not susceptible to survive longer after administration of an immunogenic composition, wherein low levels of sICAM-I indicates that the subject is predicted to have a longer survival rate compared to treated patients who have higher levels of sICAM-1.
• kits which include parts for practicing the methods described herein and that will be apparent from the examples provided herein.
• the kit of parts, or kits may include reagents for collecting and or measuring total blood, serum or plasma levels of sICAM-1. Such reagents may include antibodies.
• the kits may further include equipment for collecting and/or processing biological samples.
• the kits are also likely to contain instructions for use, cut-off values and/or instructions for their determination, and instructions for interpreting the data obtained from the use of the kits .
• the said kit of parts, or kits may further include an immunogenic composition as above disclosed, and/or as disclosed in the Example section below .
• the invention further provides computer programs and/or algorithms for monitoring clinical trial and sICAM-llevels, determining whether such levels are above or below a threshold level, and/or recommending modifications to a treatment regiment to improve a patient's response to an immunotherapy treatment.
• the computer programs or algorithms may be provided along with necessary hardware, e.g., in the form of a kit or apparatus, which may also accept biological samples and measure the relative levels of s ICAM-I present therein.
• the above-described computer programs and/or apparatus are likely to be provided to physicians or clinical laboratories with appropriate instructions and reagents, including antibodies.
• Figure 2 Survival curves describing chemotherapy in lung cancer: patients with ⁇ or > 224 ng/ml sCD54 ⁇ Group 1 : Chemotherapy alone (without vaccine) in patients with low levels of sCD54. Low levels as defined as ⁇ 224 ng/ml sCD54 in peripheral blood plasma. 32 patients.
• Example 1 The immunogenic composition, noted vaccine TG4010, was used to treat non-small cell lung cancer (NSCLC) patients in combination with standard chemotherapy.
• NSCLC non-small cell lung cancer
• TG4010 is a recombinant Modified Virus Ankara (MVA) expressing both IL2 and the tumor-associated antigen MUCl.
• MVA Modified Virus Ankara
• PFS progression-free survival
• Plasma samples were taken prior to treatment and were shipped immediately to a central immunology lab where plasma samples were aliquoted and frozen. Frozen aliquots of plasma were shipped, in batch, on dry ice, to a second central lab where sCD54 levels were assessed.
• Plasma samples were assessed for content of sCD54 (sICAM-1) by Multi-analyte plasma protein profiling using the Luminex® system.
• the limit of 224 ng/ml was the median value for all 129 patient baseline plasma samples analysed.
• FIG. 2 demonstrate that the effect of selecting patients based on the plasma content of sCD54 (sICAM-1) is restricted to patients receiving the vaccine.
• Figure 2 illustrating the use of conventional chemotherapy alone (Cisplatin 75mg/m 2 on dl and Gemcitabine 1250mg/m 2 on day 1 and day 8 every 3 weeks for up to 6 cycles) , shows that patients with ⁇ or > 224 ng/ml sCD54 (ICAM-I) at baseline have not significantly different survival expectancy. Median survival of 12.2 months and 8.5 months for ⁇ and > 224 ng/ml sCD54 (ICAM-I), respectively, were observed.

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