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• • 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
  • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
• • 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
  • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
  • A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
  • A61K39/39558—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against tumor tissues, cells, antigens
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  • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
  • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
  • C07K16/2803—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
  • C07K16/2818—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against CD28 or CD152
• • 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
  • A61K39/0005—Vertebrate antigens
  • A61K39/0011—Cancer antigens
  • A61K39/001102—Receptors, cell surface antigens or cell surface determinants
  • A61K39/001129—Molecules with a "CD" designation not provided for elsewhere
• • A—HUMAN NECESSITIES
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  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
  • A61P37/06—Immunosuppressants, e.g. drugs for graft rejection
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/08—Antiallergic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
  • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
• • 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
  • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
  • C07K2317/24—Immunoglobulins specific features characterized by taxonomic origin containing regions, domains or residues from different species, e.g. chimeric, humanized or veneered
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/55—Fab or Fab'
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
  • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/60—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments
  • C07K2317/62—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments comprising only variable region components
  • C07K2317/622—Single chain antibody (scFv)
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
  • C07K2317/76—Antagonist effect on antigen, e.g. neutralization or inhibition of binding

Definitions

• the present invention relates to the treatment and prevention of human diseases using novel humanised antibodies against human CTLA4 and methods of treating or preventing human diseases using these antibodies.
• T lymphocytes T cells
• APC Antigen-presenting cells
• MHC major histocompatibility complex
• T cell receptor T cell receptor
• B7-1 also called B7, B7.1, or CD80
• B7-2 also called B7.2 or CD86
• CTLA4 Cytotoxic Lymphocyte Associated Antigen, also designated CD 152
• CD 152 Cytotoxic Lymphocyte Associated Antigen
• CTLA4 is a member of the Ig superfamily and comprises a single extracellular Ig domain.
• the role of CTLA4 is primarily to inhibit T cell activation and this was shown in CTLA4 deficient mice (Chambers et al., (1997) Immunity. 7:8855-8959) which suffer from massive lymphoproliferation.
• blockage of CTLA4 was shown to enhance T cell responses in vitro (Walunas et al., (1994)) Immunity. 1:405- 413 and in vivo (Kearney (1995) J. Immunol. 155: 1032-1036) and also to increase antitumour immunity (Leach (1996) Science. 271: 1734-1736). Therefore, blockage of CTLA4 might provide new treatments for disease, especially human diseases where immune stimulation might be beneficial such as for treatment of cancers and infectious diseases. Development of blockers of CTLA4 function has focused on the use of monoclonal antibodies, especially antibodies derived from transgenic mice engrafted with genes encoding human immunoglobulins (and deficient in host mouse immunoglobulin genes).
• the present invention relates to novel humanised antibodies which specifically bind to human CTLA4.
• the invention also provides humanised antibodies where binding to human CTLA4 inhibits the binding of human CTLA4 to human B7.
• the invention also provides humanised antibodies that bind to human CTLA4 with an equilibrium dissociation constant (Kd) of at least 10 - " 8 M.
• Kd equilibrium dissociation constant
• the invention also provides humanised antibodies that specifically bind to human CTLA4 that block binding of human CTLA4 to human B7 by at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 99%, or 100%.
• the invention also provides humanised antibodies that specifically bind to human CTLA4 having an antibody heavy chain of either isotype IgGl, IgG2, IgG3 or IgG4, or having a mutated IgG constant region, for example to inhibit binding to Fc receptors or to inhibit binding to complement.
• the invention also provides humanised antibodies wherein the antibody light chain is a kappa light chain.
• the humanised antibody can be encoded by human IgG heavy chain and human kappa light chain nucleic acids that encode protein sequences in their variable regions as set forth in SEQ ID NO:31 through SEQ ID NO:50.
• the humanised antibody comprises variable regions from SEQ ID NO:45 and SEQ ID NO:49 (otherwise referred to as "VH5:VK4').
• the present invention also provides humanised antibodies that specifically bind to human CTLA4 whereby the antibody variable regions have been selected or modified to exclude one or more human CD4+ T cell epitopes.
• the present invention also provides human antibodies that specifically bind to human CTLA4 whereby the antibody variable regions have been formed primarily by fusing segments of sequences from existing human antibody variable region sequences.
• the present invention also provides humanised antibodies of the invention comprising heavy chain CDRl, CDR2, and CDR3 amino acid sequences, "DYNMD” (SEQ ID No.9), “NINPNSESTSYNQKFKG” (SEQ ID No.10) and “DGNRYDAWFAY” (SEQ ID No.
• the present invention also provides humanised antibodies of the invention comprising heavy chain CDRl, CDR2, and CDR3 amino acid sequences, "SYWIN” (SEQ ID No.15), “RIAPGSGTTYYNEVFKG” (SEQ ID No.16) and “GDYGSY” (SEQ ID No.17), respectively, and light chain CDRl, CDR2, and CDR3 amino acid sequences, “SASSSISYMH” (SEQ ID No.18), “DTSKLAS” (SEQ ID No.19), and “HQRTSYPLT” (SEQ ID No.20), respectively.
• Humanised antibodies of the present invention can be composed of any of the above CDR sequences SEQ ID No.9 to SEQ ID No.20 and minor variants of these CDR sequences where alterations of one or more amino acids does not significantly alter binding to human CTLA4.
• Humanised antibodies can be created by joining together the CDR sequences with sequences from human variable region frameworks where such framework sequences are derived from single or multiple other human antibody variable region framework sequences. Commonly such human variable region framework sequences will include one or more mutations which contribute to optimal or improved binding of the humanised antibodies to CTLA4.
• such human variable region framework sequences in the humanised antibodies are derived entirely from sequences in other human antibody variable regions as described in methods of EP1844074 (Antitope Ltd).
• humanised antibodies also contain CDR sequences derived from CDR sequences, framework sequences or part framework/CDR sequences from other human antibody variable regions together with human constant regions, thus creating humanised antibodies in which the variable region sequences are derived entirely from sequences in other human antibody variable regions together with human constant regions, thus creating a "fully human” antibody.
• the invention also provides humanised antibodies that specifically bind to human CTLA4, wherein said humanised antibody is produced by a mammalian cell line, especially CHO or NSO cells.
• the invention also provides a humanised antibody that specifically binds to human CTLA4 that is a Fab fragment or a single chain Fv (scFv).
• the invention also provides multispecific antibodies (two or more different antibody molecules joined together to give two or more different specifities) including at least one humanised antibody from the sequences SEQ ID NOS:31 to 35 for the heavy chain and SEQ ID NOS:36 to 40 for the light chain for antibody 3B 10; or humanised antibody from the sequences SEQ ID NOS:41 to 45 for the heavy chain and SEQ ID NOS:46 to 50 for the light chain for the antibody 8H5, each of which specifically binds to human CTLA4.
• the invention provides multispecific antibodies with variable regions consisting of SEQ ID NOS:45 for the heavy chain and SEQ ID NOS:49 for the light chain.
• the different antibodies included in each multispecific antibody can be linked to each other either covalently or non-covalently.
• the invention provides a pharmaceutical composition
• a pharmaceutical composition comprising a humanised antibody that specifically binds to human CTLA4 and a pharmaceutically acceptable carrier.
• the pharmaceutical composition can further comprise an agent effective to induce an immune response against a target antigen, or one or more chemotherapeutic agents.
• the invention provides a method for inducing, augmenting or prolonging an immune response to an antigen in a patient, comprising administering to the patient an effective dosage of a humanised antibody that specifically binds to human CTLA4, wherein the antibody blocks binding of human CTLA4 to human B7.
• the antigen can include a tumour antigen, an antigen associated with a pathogen, an antigen associated with a disease of the central nervous system (CNS), an antigen associated with diseases of the blood system including hypertension and atherosclerosis, an antigen associated with an inflammatory disease including rheumatoid arthritis and autoimmune diseases, or an antigen associated with an allergy.
• Tumour antigens can be one or more antigens on the cell surface of a tumour, one or more molecules which interact with the tumour, one or more MHC complexes of peptides derived from tumour antigens, or antigens not directly associated with tumours but where immune responses to the antigen will have an adverse effect on the tumour such as antigens associated with the tumour vasculature.
• Pathogens can be a virus, a bacterium, a fungus or a parasite.
• CNS antigens include beta amyloid associated with plaque deposits in Alzheimer's disease.
• Blood system antigens include integrins and adhesins, as well as antigens associated with plaque deposits in atherosclerosis.
• Inflammatory disease antigens include cytokines and cytokine receptors. Allergy antigens include antigens associated with food, plant, chemical and environmental allergens.
• the method of the invention can also include administering the antigen, or a fragment or an analogue thereof, to the patient, whereby the antigen in combination with the humanised antibody induces, augments or prolongs the immune response.
• the invention also provides a method of suppressing an immune response in a patient, comprising administering to the patient an effective dosage of a multivalent preparation comprising at least two humanised antibodies to human CTLA4 linked to each other resulting, for example, in the induction of regulatory T cells or the down regulation of CTLA4.
• the invention also provides a method of suppressing an immune response in a patient, comprising administering to the patient an effective dosage of a polyclonal preparation comprising at least two humanised antibodies to human CTLA4.
• the present invention further provides humanised monoclonal antibodies which specifically bind to human CTLA4, as well as compositions containing one or a combination of such antibodies.
• Some of the humanised antibodies of the invention are characterised by binding to human CTLA4 with high affinity, and/or by blocking the interaction of human CTLA4 with its ligand, the human B7-1 and B7-2 molecules. Accordingly, such humanised antibodies of the invention can be used as diagnostic or therapeutic agents in vivo and in vitro.
• the humanised antibodies of the invention can encompass various antibody isotypes, or mixtures thereof, such as IgGl, IgG2, IgG3, IgG4, IgM, IgAl, IgA2, IgAsec, IgD, IgE or mutated forms of these IgGs such as mutations which reduce of eliminate binding to Fc receptors.
• IgG4 e.g. IgG4k
• IgGl e.g. IgGlk
• the humanised antibodies can be full-length (e.g., an IgG4 or IgGl antibody) or can include only an antigen-binding portion (e.g., a Fab, F(ab')2, Fv or a scFv fragment).
• Some humanised anti-CTLA4 antibodies of the present invention can be characterised by one or more of the following properties: a) specificity for human CTLA4 (specifically binding to human CTLA4); b) a binding affinity to human CTLA4 with an equilibrium dissociation constant (Kd) of at least 10 - " 8 M.
• the invention provides nucleic acid molecules encoding the humanised antibodies, or antigen-binding portions, of the invention.
• recombinant expression vectors that include the antibody-encoding nucleic acids of the invention, and host cells transfected with such vectors, are also encompassed by the invention, as are methods of making the antibodies of the invention by culturing these host cells.
• Anti-human CTLA4 humanised monoclonal antibodies of the invention can be derivatised or linked to another functional molecule, e.g., another peptide or protein (e.g., a Fab' fragment).
• another functional molecule e.g., another peptide or protein (e.g., a Fab' fragment).
• an antibody or antigen-binding portion of the humanised antibodies of the invention can be functionally linked (e.g., by chemical coupling, genetic fusion, noncovalent association or otherwise) to one or more other molecular entities.
• the humanised anti-CTLA4 antibody, or antigen binding fragment thereof can be conjugated to a therapeutic moiety, e.g., a cytotoxic drug, an enzymatically active toxin, or a fragment thereof, a radioisotope, a therapeutic nucleic acid, or a small molecule anti-cancer drug.
• a therapeutic moiety e.g., a cytotoxic drug, an enzymatically active toxin, or a fragment thereof, a radioisotope, a therapeutic nucleic acid, or a small molecule anti-cancer drug.
• the antibodies of the invention can also be conjugated to cytotoxic pharmaceuticals, e.g., radiolabeled with a cytotoxic agents such as, e.g. 1311, or can be coupled to a ribosome inactivating protein, e.g.
• pseudomonas exotoxin PE38 fragment, plant or bacterial toxins such as ricin, the oc-chain of ricin, saporin, pokeweed antiviral protein, diphtheria toxin, or Pseudomonas exotoxin A (Kreitman and Pastan (1998) Adv. Drug Delivery Rev. 31:53.).
• compositions e.g., pharmaceutical and diagnostic compositions, comprising a pharmaceutically acceptable carrier and at least one humanised monoclonal antibody of the invention, or an antigen-binding portion thereof, which specifically binds to human CTLA4.
• compositions may also comprise a combination of the humanised antibodies or antigen-binding portions of the invention.
• compositions may also comprise combinations with one or more other biologically active molecules as separate molecules, for example, a combination of at least one humanised monoclonal antibody of the invention and another biologically active molecule, or may combine combinations with one or more other biologically active molecules in the same molecule, for example as a bispecific or multispecific molecule either as a combination of two or more humanised antibodies of the invention or as a combination with one or more other biologically active molecules.
• the antibody, or antigen-binding portion thereof can be administered to a human subject suffering from a T-cell -related disease, or a disease that can be ameliorated or prevented by inducing, augmenting, prolonging or suppressing an immune response.
• Humanised monoclonal antibody compositions of the invention also can be administered in combination with other known therapies, e.g., an anti-cancer therapy.
• the invention provides a method for treating cancer in a subject comprising administering a therapeutically effective amount of a pharmaceutical composition of a humanised antibody together with a pharmaceutical carrier to the subject.
• Some such methods include combination with a vaccine.
• Some such vaccines include a tumour cell vaccine, a GM-CSF-modified tumour cell vaccine, a nucleic acid (such as DNA) vaccine, and a tumour-associated antigen or an antigen-loaded dendritic cell vaccine.
• Humanised antibodies to human CTLA4 can be used in methods of treatment requiring either stimulation of immune responses or suppression. Stimulation is achieved using antibodies that block binding of human CTLA4 to human B7 and diseases amenable to treatment by stimulation and augmentation of prolonging of immune responses include cancers of the prostate, kidney, colon, lung or breast; pathogenic infections; diseases associated with the CNS e.g. amyloidogenic diseases including Alzheimer's disease; and diseases with inflammatory or allergic components. Immunosuppression can also be achieved using humanised antibodies to human CTLA4, for example through induction of regulatory T cells (Coquerelle et al., Gut 2009;58: 1363-1373). Diseases amenable to treatment include graft versus host disease, host versus graft disease, allergy, autoimmune diseases and other inflammatory diseases.
• the present invention provides a method using antibodies of the invention for detecting in vitro or in vivo the presence of human CTLA4 antigen in a sample, e.g., for diagnosing a human CTLA4-related disease.
• this is achieved by contacting a sample to be tested, along with a control sample, with a humanised monoclonal antibody of the invention, or an antigen-binding portion thereof (or a bispecific or multispecific molecule), under conditions that allow for formation of a complex between the antibody and human CTLA4.
• Complex formation is then detected (e.g., by ELISA) in the test samples, and any statistically significant increase in the formation of complexes between the test and control samples is indicative the presence of human CTLA4 antigen in the test sample.
• variable region sequences of the humanised antibodies of the present invention SEQ ID NO:31 through SEQ ID NO:50
• CDRs of the humanised antibodies of the present invention SEQ ID NO:9 through SEQ ID NO:20
• variable region sequences of the humanised antibodies should be considered to be within the scope of the present invention where the variable region sequences of such variants have significant homology to the humanised sequences of the present invention.
• a variant nucleic acid may be determined to be within the scope of the invention where this includes sequences containing or substantially identical to SEQ ID NO:21 through SEQ ID NO:30 as determined by its ability to hybridise under stringent conditions to a nucleic acid of the present invention.
• a nucleic acid sequence can be determined to be within the scope of the invention (e.g., is substantially identical to SEQ ID NO:21 through SEQ ID NO:30) by its ability to hybridise under stringent conditions to a nucleic acid within the scope of the invention (such as SEQ ID NO:21 through SEQ ID NO:30).
• hybridise refers to the binding, duplexing, or hybridising of a molecule to a particular nucleotide sequence under stringent hybridisation conditions when that sequence is present in a complex mixture (e.g. total cellular or library DNA or RNA), wherein the particular nucleotide sequence is detected at least at about 10 times background.
• Stringent hybridisation conditions will be selected, for example, to be 5-10°C lower than the thermal melting point (Tm) for the specific sequence at a defined ionic strength pH.
• Figure 1 binding of murine antibodies to CTLA4-Fc.
• Figure 2 competition ELISA of murine antibodies for binding to CTLA4-Fc against biotinylated B7.1.
• Figure 3 competition ELISA of murine antibodies for binding to CTLA4-Fc against biotinylated B7.2.
• Figure 4 binding of chimeric 3B 10 and 8H5 human IgGl antibodies to CTLA4-Fc.
• Figure 5 competition ELISA of chimeric 3B 10 and 8H5 human IgGl antibodies for binding to CTLA4-Fc against biotinylated B7.1.
• Figure 6 competition ELISA of chimeric 3B 10 and 8H5 human IgGl antibodies for binding to CTLA4-Fc against biotinylated B7.2.
• Figure 7 T cell proliferation of human PBMC in response to chimeric 3B 10 and 8H5 human IgGl antibodies.
• Figure 8 - pANT antibody expression vector maps.
• Figure 9 - 3B 10 variable region (VH and VK) DNA sequences.
• Figure 10 - 8H5 VH and VK DNA sequences.
• Figure 11 - 3B 10 VH and VK amino acid sequences.
• Figure 12 8H5 VH and VK amino acid sequences.
• Figure 13 Humanised 3B 10 VH amino acid sequences.
• Figure 14 Humanised 3B 10 VK amino acid sequences.
• Figure 15 Humanised 8H5 VH amino acid sequences.
• Figure 16 Humanised 8H5 VK amino acid sequences.
• Figure 18 IFN% secretion by lead humanised VH5/VK4 anti-CTLA4 and MDX0101 in a human mixed lymphocyte reaction with donor pairs.
• Figure 19 Growth of MC38 tumour in human CTLA4 knock-in mice with weekly antibody doses starting at Day 2.
• Table 1 Primer sequences for amplification of murine cDNA variable regions.
• CTLA4-fusion protein comprising the extracellular domain of human CTLA4 fused to the human IgGl constant domain was purchased from R&D Systems (Oxford, UK).
• Extracellular CTLA4 fragment was prepared by proteolytic cleavage of the CTLA4-Fc fusion protein with Factor Xa (Qiagen, Crawley, UK) followed by subsequent removal of the protease using Factor Xa removal resin (Qiagen) and of the cleaved Fc fragment using Protein A-agarose to leave the CTLA4 extracellular domain only.
• mice Female Balb/c mice were immunised subcutaneously with 200ul of a 1: 1 emulsion of Freunds Complete Adjuvant (Sigma- Aldrich, Dorset, UK) containing 20ug of CTLA4- Fc fusion protein. Immunised mice were subsequently boosted approximately every 3 weeks with up to three intraperitoneal injections of a 1: 1 emulsion of Freunds Incomplete Adjuvant (Sigma-Aldrich) containing 20ug of CTLA4-Fc. 3 days prior to myeloma fusion, the two mice showing the highest antibody titre received an intrasplenic boost of either whole antigen or CTLA4 extracellular domain.
• a 1: 1 emulsion of Freunds Complete Adjuvant Sigma- Aldrich, Dorset, UK
• Immunised mice were subsequently boosted approximately every 3 weeks with up to three intraperitoneal injections of a 1: 1 emulsion of Freunds Incomplete Adjuvant (Sigma-Aldrich) containing 20ug of CTLA4
• Spleens were extracted and homogenised to yield a single cell suspension. 1x10 spleen cells were fused with 5 xlO NS0 mouse myeloma cells (2: 1 ratio) using polyethylene glycol (PEG). The fused cells were resuspended in 200ml of DMEM / 20% FCS / 5% BM Condimed HI (Roche, Burgess Hill, UK) containing the hybridoma selection agents azaserine and hypoxanthine - "HAZA medium” and pipetted in 200ul volumes into 10 x 96 well plates.
• PEG polyethylene glycol
• cells counts were determined using a haemocytometer and cells diluted serially in medium containing 2.5% BM Condimed HI until cell densities of 5 to 15 cells/ml were achieved.
• 200ul of cell solution was pipetted into 48 wells with a density of 1 to 3 cells per well. Cultures were maintained at 37°C in 5% C0 2 for 2 weeks with an additional medium feed of half a volume after 1 week. Culture medium was tested for the presence of antibodies specific for anti-CTLA4- fusion protein by ELISA.
• ELISA positive clones were selected and expanded to 10ml cultures in DMEM / 20% FCS / 2.5% BM Condimed HI.
• Clones were then frozen in medium containing 10% DMSO and stored in liquid N2, and also expanded further for antibody purification.
• Two hybridomas designated 3B 10 and 8H5 were subcloned and subclones were then frozen and used for monoclonal antibody production in further studies.
• ELISA plates (VWR, Lutterworth, UK) were coated overnight at 4°C with lOOul/well of either recombinant CTLA4 fusion protein or human IgGl (Sigma- Aldrich, Poole, UK) at O ⁇ g/ml in PBS. Plates were washed and blocked with 150ul/well PBS containing 2% BSA. Cell culture supernatants or purified antibodies were diluted in PBS/2% BSA and lOOul added to each plate followed by incubation for 1 hour at room temperature.
• Plates were washed three times with PBS-Tween (0.05%) and incubated for 1 hour with lOOul/well goat anti-mouse Ig (Fab-specific) conjugated to Horseradish Peroxidase (Sigma-Aldrich). Plates were washed three times with PBS- Tween following which SigmaFast OPD substrate (Sigma-Aldrich) was added and incubated at room temperature in the dark for 4 minutes. The reaction was stopped by adding 50 ⁇ of 3M HC1. Plates were read at 490nm using a Dynex plate reader (Dynex, Worthing, UK).
• Monoclonal antibodies were isotyped using the Rapid ELISA Mouse Antibody Isotyping Kit (Perbio, Cramlington, UK). Antibodies were purified on a 1ml Protein A-sepharose column (GE Healthcare, Little Chalfont, UK). Prior to purification, both the tubing and the Protein A column were depyrogenated using 0.4M NaOH. The column was re-equilibrated with 20 CV of lx PBS pH 7.4. Hybridoma cell culture supernatants were harvested, adjusted to lx PBS pH 7.4 using lOx PBS and filter sterilised. Filtered supernatant was pumped through the column at 0.5 ml/min.
• the column was washed with lx PBS pH 7.4 and IgG was eluted using sterile 0.1M Sodium Citrate pH3, with 0.9 ml fractions collected and neutralised with 0.1ml of sterile 1M Tris-HCl pH 9. Under sterile conditions, the product was buffer exchanged into PBS pH 7.4 to remove any elution buffer and concentrate the sample. After concentration, antibodies were quantified by OD280nm using an extinction coefficient, Ec (0.1%) of 1.4. Purified antibodies were analysed by SDS-PAGE using a Novex NuPAGE electrophoresis system with 4-12% NuPage gel (Invitrogen, Paisley, UK) and MES running buffer.
• Test antibodies at various concentrations were premixed with either biotinylated-B7.1-Ig (0.36 ⁇ g/ml final concentration) or biotinylated-B7.2-Ig (0.65 ⁇ g/ml final concentration) and then added to the CTLA4-Ig plate (80 ⁇ 1 final volume). All samples were tested in duplicate. Plates were incubated lh at room temperature and washed 3 times with wash buffer. 80 ⁇ 1 of a 1 in 500 dilution of Streptavidin HRP (Sigma-Aldrich) was added and incubated for 1 hour at room temperature.
• a flow cytometric analysis was performed.
• Human peripheral T cells were isolated from human PBMC (peripheral blood mononuclear cells) and stimulated to enhance expression of CTLA4.
• CD4+ cells were purified from PBMC using a CD4 + T Cell Isolation Kit (Miltenyi Biotec, Bisley, UK), plated out in a 24 well plate (lxlO 6 cells/well) in AEVI-V Medium (Invitrogen, Paisley, UK) and incubated at 37°C overnight.
• Cells were stimulated with Ionomycin ( ⁇ g/ml) and PMA (phorbol 12-myristate 13 -acetate) (50ng/ml) and incubated 4h at 37°C. Cells were washed once in AIM-V medium, fixed in PBS containing 2% formaldehyde for 15 min, and resuspended in FACS buffer (D-PBS containing 1%BSA, 0.05% sodium azide and 0.1% Saponin) at 2xl0 6 cells/ml and incubated 30 min at 4°C.
• FACS buffer D-PBS containing 1%BSA, 0.05% sodium azide and 0.1% Saponin
• 2xl0 5 cells were stained using either a 1 in 10 dilution of anti-CTLA4-PE conjugated antibody (BNI3) (Abeam, Cambridge, UK) as a positive control or with 5 ⁇ g/ml of individual anti-CTLA4 monoclonal antibodies together with a 1 in 50 dilution of anti- mouse IgG-PE conjugated antibody (Sigma).
• Mouse IgG (Sigma) was also included as separate controls for the different murine isotypes present within the lead monoclonal antibodies. Cells were stained for 1 hour at 4°C. An anti-mouse IgG-PE conjugated antibody only control was also included.
• Subclones 3B 10-4F7, 3B 10-6E3, 8H5-1A1 and 8H5-1B 1 producing the lead monoclonal antibodies 8H5 and 3B 10 were subjected to variable region (V-region) sequence analysis.
• Total RNA was extracted from 3 to lOxlO 6 hybridoma cells using the RNAqueous-4PCPv Kit (Ambion, Warrington, UK) and used to synthesis cDNA.
• Murine immunoglobulin heavy and kappa light chain V-region fragments were amplified by PCR using degenerate mouse leader sequence primers (Sigma) and unique constant domain primers (Sigma) as shown in Table 1.
• the heavy and light chain variable domain sequences of the lead 3B 10 and 8H5 monoclonal antibodies were PCR amplified and subcloned into pANT antibody expression vectors ( Figure 8) with heavy and light chain V-regions cloned into pANT17 and pANT13 respectively.
• Heavy chain V-region genes were cloned into pANT17 via Mlul and Hindlll sites in frame with either the human ⁇ heavy chain gene (Glm3 (Glm(f)) allotype) or the human ⁇ 4 heavy chain gene, and light chain V- region genes were cloned into pANT13 via BssHII and BamHI sites in frame with the human kappa light chain constant region gene (Km3 allotype).
• pANT17 plasmid contained a mutant dhfr minigene (Simonsen & Levinson 1983, PNAS 80:2495-2499) under the control of a SV40 promoter and polyA sequence for selection in eukaryotic cells.
• Both pANT17 and pANT13 contained a ⁇ -lactamase (Ap R ) gene for prokaryotic selection and a pMB l origin of replication for propagation in prokaryotic cells. All plasmids were propagated in E. coli XLl-blue (Stratagene Cat. No. 200130). Primers used to amplify the V-region genes for cloning into the pANT expression vectors are shown in Table 2.
• the heavy and light chain expression constructs were then co-transfected either transiently into HEK293 cells by calcium phosphate-based transfection or stably transfected into NS0 cells by electroporation.
• Secreted antibody was purified from the cell culture supernatants by Protein A chromatography.
• CTLA4 binding ELISA Figure 4
• CTLA4 competition ELISA against B7.1 and B7.2 Figures 5 and 6
• CTLA4 expressed on T cells by flow cytometry as in Example 1
• both 3B 10 and 8H5 chimeric antibodies were shown to retain the CTLA4 binding of the starting monoclonal antibodies.
• PBMC peripheral blood mononuclear cells
• PBMC peripheral blood mononuclear cells
• anti-human CD2, anti-human CD3 and anti-human CD28 antibodies Miltenyi Biotec, Bisley, Surrey.
• 5xl0 5 cells were plated out into each well of a 96- well plate in AIM- V medium with beads added to cells at a ratio of 1 bead per cell.
• Test or isotype control antibodies were diluted as appropriate in AEVI-V medium and 50 ⁇ 1 per well added to the cells, giving a final volume of 200 ⁇ 1.
• Medium only (no antibody) controls were also included.
• Humanised antibodies were generated using methods described in EP 1844074 (Antitope Ltd). Structural models of the mouse V-regions were produced using Swiss PDB and analysed in order to identify important amino acids from the 3B 10 and 8H5 V-regions that were likely to be important for the CTLA4 binding properties of the antibody ('constraining residues'). A database of human V-region sequences was used to identify segments of human V-region sequences containing each of the constraining residues to be used in design of the humanised antibodies. Typically two or more alternative V-region sequence segments were used to provide each constraining residue resulting in a large range of possible sequences of humanised anti-CTLA4 V- region sequences for both 8H5 and 3B 10.
• VH1 to VH5, and VK1 to VK5 respectively were selected for each of 8H5 (SEQ ID Nos 41 to 45 and 46 to 50 respectively) and 3B 10 (SEQ ID Nos 31 to 35 and 36 to 40 respectively).
• DNA encoding humanised variant V-regions was synthesised and subcloned into the expression vectors pANT17 and pANT13 as described in Example 3. All combinations of humanised VH and VK chains (i.e. a total of 25 pairings for each of 8H5 and 3B 10) were transiently transfected into HEK293 and also transfected into NSO cells, and antibody was purified by protein A chromatography from the culture supernatants as described in Example 3.
• the binding of HEK-derived and NSO-derived 8H5 and 3B 10 humanised variants to recombinant CTLA4 was assessed in a competition ELISA against the appropriate parent chimeric antibody.
• the parental 8H5 and 3B 10 chimeric antibodies were biotinylated using Biotin TagTM Micro Biotinylation kit (Sigma-Aldrich).
• 96 well MaxiSorp plates (Nunc) were coated with 0 ⁇ g/ml recombinant human CTLA4-Ig in Dulbecco's PBS ( ⁇ final volume) at 4°C overnight.
• CTLA4-Ig was discarded and plates were blocked with Dulbecco's PBS-2%BSA for 1 hour at room temperature.
• All lead 8H5 humanised variants displayed competitive binding profiles similar to the 8H5 chimeric antibody although variants containing the kappa chain VK5 showed slightly decreased binding compared to other variants ( Figure 17).
• all lead humanised 3B 10 variants displayed competitive binding profiles similar to the 3B 10 chimeric antibody.
• all lead humanised 8H5 and 3B 10 variants when tested in the CTLA4 competition ELISA against B7.1 and B7.2 (Example 3) gave very similar competitive binding profiles to the chimeric antibody shown in Figures 5 and 6 whereby >90% of B7.1 or B7.2 binding was inhibited at the maximum concentrations of the lead humanised variants.
• a lead humanised variant VH5/VK4 (SEQ ID Nos 45 and 39 respectively) was chosen as the lead antibody for further studies.
• Humanised 8H5 and 3B 10 variants from Example 6 were converted into scFv's and cloned into M13 phage display vectors as described in Benhar I. and Reiter Y., Current Protocols in Immunology, Unit 10.19B, Wiley Online Library, May 2002 (htt ://www .currentprotocols .com/protocol/im 101 b ) using the pCANTAB5E vector RPAS Expression Module (Amersham Pharmacia Biotech, Little Chalfont, UK). Humanised VH and VK genes were amplified using primers which provided terminal Sfil and Notl restriction sites, an internal Gly4Ser linker and a C terminal his6 tag.
• scFv constructs were inserted into the pCANTAB5E vector as Sfil-Notl fragments and transformed into E.coli HB2151 resulting in scFv exported to the periplasm and partially to the growth medium.
• scFv's were purified from growth medium by nickel-chelate affinity chromatography using HIS-Select HF Cartridges (Sigma- Aldrich). Purified scFv's were tested in B7.1-Ig and B7.2-Ig competition assay as detailed in Example 1 and all humanised scFvs exhibited competitive binding to CTLA4.
• Humanised 8H5 and 3B 10 variants from Example 6 were also converted into Fab's using the method used for scFv's except that amplified humanised VH and VK genes were further amplified with CHI and CK constant region genes to form VH- CH1 and VK-CK fragments which were further amplified with primers to join these fragments with a 22 amino acid pelB leader sequence (Lei S.P., Lin H.C., Wang S.S., Callaway J., and Wilcox G., J Bacterid. 169 (1987) p4379-4383) between the upstream VH-CH1 and downstream VK- CK gene fragments resulting in a dicistronic Fab gene.
• Fab's from humanised antibody variants were generated and purified as above for scFv's and tested in B7.1-Ig and B7.2-Ig competition assay as detailed in Example 1. All humanised Fab's exhibited competitive binding to CTLA4.
• PBMCs were isolated from healthy community donor buffy coats (from blood drawn within 24 hours) obtained from the UK National Blood Transfusion Service (Addenbrooke's Hospital, Cambridge, UK) and according to approval granted by Addenbrooke's Hospital Local Research Ethics Committee. PBMCs were isolated from buffy coats by Lymphoprep (Axis-shield, Dundee, UK) density centrifugation and CD8 + T cells were depleted using CD8 + RosetteSepTM (StemCell Technologies Inc, London, UK). Donors were characterised by identifying HLA-DR haplotypes using an HLA SSP-PCR based tissue-typing kit (Biotest, Solihull, UK).
• T cell responses to control antigens including the recall antigen tetanus toxin were also determined (KLH Pierce, Cramlingtom, UK and peptides derived from Influenza A and Epstein Barr viruses). PBMC were then frozen and stored in liquid nitrogen until required.
• PBMCs monocyte derived dendritic cells
• AIM-V® culture medium CD14 + cells isolated using Miltenyi CD 14 Microbeads and LS columns (Miltenyi Biotech, Oxford, UK).
• Monocytes were resuspended in AIM-V® supplemented with lOOOU/ml IL-4 and lOOOU/ml GM-CSF ("DC culture medium") to 4-6xl0 6 PBMC/ml and then distributed in 24 well plates (2ml final culture volume).
• DCs were fed on day 2 by half volume DC culture medium change.
• monocytes had differentiated to semi-mature DC which were pre-incubated with either 40ug/ml of test humanised or chimeric antibody, 100 ⁇ g/ml KLH or medium only.
• Semi-mature DC were incubated with antigen for 24 hours after which excess test antibody was removed by washing the cells twice and resuspending in DC culture medium supplemented with 50ng/ml TNF-a (Peprotech, London, UK).
• DCs were fed on day 7 by a half volume DC culture medium (supplemented with 50ng/ml TNFa) change before harvesting mature DC on day 8. The harvested mature DC were counted and viability assessed using trypan blue dye exclusion.
• the DC were then ⁇ - irradiated (4000 rads) and resuspended at 2xl0 5 cells per ml in AIM-V medium before use in the ELISpot and proliferation assays. Additionally, on day 8, fresh CD4+ T cells were also prepared. To purify CD4+ T cells, PBMCs were revived in AIM-V® culture medium and CD4 + cells isolated using Miltenyi CD4 Microbeads and LS columns (Miltenyi Biotech, Oxford, UK) and resuspended in AIM-V® medium at 2xl0 6 cells/ml.
• T cell proliferation assays were established whereby lxlO 5 autologous CD4 + T cells were added to lxlO 4 humanised or chimeric antibody-loaded DC (ratio of 10: 1) in 96 well U-bottomed plates, with AIM-V® medium added to a final volume 200ul/well).
• assay plates were pulsed with luCi [3H] (Perkin Elmer, Beaconsfield, UK) per well in 25ul AIMV for 6 hours before harvesting onto filter mats (Perkin Elmer) using a TomTec Mach III (Hamden CT, USA) cell harvester. All antibody preparations were tested in sextuplet cultures.
• Counts per minute (cpm) for each well were determined by MeltilexTM (Perkin Elmer) scintillation counting on a 1450 Microbeta Wallac Trilux Liquid Scintillation Counter (Perkin Elmer) in paralux, low background counting. Counts per minute for each antibody sample were normalised to the AIM V® medium only control.
• ELISpot assays ELISpot plates (Millipore, Watford, UK) were coated with ⁇ /well IL-2 capture antibody (R&D Systems, Abingdon, UK) in PBS. Plates were then washed twice in PBS, incubated overnight in block buffer (1% BSA (Sigma) in PBS) and washed in AIM V® medium. On day 8, lxlO 5 autologous CD4 + T cells were added to lxlO 4 antigen loaded DC (ratio of 10: 1) in 96 well ELISpot plates. All antibody preparations were tested in sextuplet cultures. For each donor PBMC, a negative control (AIM V® medium alone), no cells control and a PHA (lOug/ml) positive control were also included.
• ELISpot plates were developed by three sequential washes in dH 2 0 and PBS prior to the addition of ⁇ filtered biotinylated detection antibody (R&D Systems, Abingdon, UK) in PBS/1% BSA. Following incubation at 37°C for 1.5 hour, plates were further washed three times in PBS and ⁇ filtered streptavidin-AP (R&D Systems) in PBS/1% BSA was added for 1 hour (incubation at room temperature). Streptavidin-AP was discarded and plates were washed four times in PBS. BCIP/NBT (R&D Systems) was added to each well and incubated for 30 minutes at room temperature. Spot development was stopped by washing the wells and the backs of the wells three times with dH 2 0. Dried plates were scanned on an Immunoscan Analyser and spots per well (spw) were determined using Immunoscan Version 4 software.
• results were expressed as a Stimulation Index (SI) defined as the ratio of cpm (proliferation assay) or spots (ELISpot assay) for the test antibody against a medium-only control using a threshold of SI equal to or greater than 2 (SI>2.0) for positive T cell responses.
• SI Stimulation Index
• DNA with V-region sequences from the fully human anti-CTLA4 antibodies MDX010 (Ipilimumab) (Keler et al.. ibid) and Tremelimumab (Ribas et al.. ibid) were synthesised and used to produce recombinant IgGl/kappa forms of these antibodies with methods as detailed in Example 5.
• NSO-derived preparations of these antibodies were then tested with the same 50 donor PBMCs as above for induction of CD4+ helper T cell responses in sextuplicate cultures.
• a mixed lymphocyte reaction assay was used to measure the effect of blocking the CTLA4 pathway on IFN- ⁇ secretion as a measure of human T cell activation.
• Fresh blood from multiple human donors (obtained from UK National Blood Transfusion Service, Example 8) was diluted 1:1 with PBS/2% human serum and layered on Lymphoprep solution (Nycomed) for centrifugation at 900g.
• PBMCs were removed from the interface, washed and resuspended in AEVI-V medium (Invitrogen).
• PBMCs generated from different mismatched donor pairs were then combined at a 1: 1 ratio and plated in a 96 well plate to provide a total of 2.5xl0 5 PBMCs per sample well.
• PHA phytohemaglutinin, Sigma Aldrich
• PHA phytohemaglutinin, Sigma Aldrich
• Either the lead VH5/VK4 anti- CTLA4 antibody, the MDX010 anti-CTLA4 control antibody (example 8) or an isotype control IgGl antibody were added to a final concentration of 150 ⁇ g/ml.
• 5 ⁇ g/ml CTLA4-Fc was also used instead of antibody as a control to demonstrate inhibition of IFN- ⁇ secretion.
• Total final volume per well was 150 ⁇ 1 and each antibody was tested five times per donor combination.
• tumour animal model was used for the in vivo analysis of anti-human CTLA4 antibodies in inhibiting tumour growth.
• MC38 murine colon tumour cells (Corbett et al., (1975) Cancer Res 35:2434-2439, supplied by Oncolmmune, Inc., Ann Arbor, USA) were grown in human CTLA4 knock-in mice (Oncolmmune, Inc.).
• CTLA4 knock-in mice (7-10 weeks old, males and females distributed equally across groups) were injected subcutaneously in the flank with 5xl0 5 MC38 tumour cells in 0.1ml volume.
• Either the lead VH5/VK4 anti-CTLA4 antibody, MDX010 (Example 8) or an isotype matched control antibody were injected at either 5mg/kg or lOmg/kg doses (dosing volume lOml/kg) weekly starting the day following tumour cell administration ("Day 2").
• Tumour measurements were taken biweekly during the course of the experiment by caliper measurement and tumour size was expressed as the cubic volume (mm ). Animals were followed either until a tumour volume of 2000 mm was reached or at day 45 after injection of tumour cells.
• the results shown in Example 19 demonstrate an improved inhibition of tumour growth by the lead VH5/VK4 anti-CTLA4 antibody compared to MDX010.

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