WO2018164262A1 - 治療有効性の予測方法 - Google Patents
治療有効性の予測方法 Download PDFInfo
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- WO2018164262A1 WO2018164262A1 PCT/JP2018/009199 JP2018009199W WO2018164262A1 WO 2018164262 A1 WO2018164262 A1 WO 2018164262A1 JP 2018009199 W JP2018009199 W JP 2018009199W WO 2018164262 A1 WO2018164262 A1 WO 2018164262A1
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Definitions
- the present invention relates to a method for predicting the effectiveness of drugs and treatments mainly using experimental animals.
- model animals produced by transplanting human-derived cancer (tumor) cells or tissues into experimental animals for example, tumor-bearing mice produced using mice as experimental animals, cancer It may be used as an experimental system that reproduces the environment inside a patient.
- tumor-bearing mice By using such tumor-bearing mice, the efficacy and safety of the drug or its candidate substance in a relatively human environment, even in the stage of drug discovery research or non-clinical trials conducted prior to human testing. Sex (toxicity) can be verified.
- cultured cancer cell transplanted mice prepared by planting cultured cells in mice and growing in mice, or tumor tissues or tumor cells collected from patients are planted in mice and grown in mice.
- a patient tumor tissue-transplanted mouse and the like produced by this method are known.
- a cultured cancer cell transplanted mouse is prepared using a cultured cell obtained by culturing a tumor cell collected from a patient in a test tube and cloning it. Since such cultured cells can be easily transplanted into mice, mice transplanted with cultured cancer cells can be created relatively easily, and mice transplanted with cloned cultured cells inherit the clonal elements. Multiple tumor-bearing mice with little individual difference can be produced. Because of these advantages, cultured cancer cell transplanted mice have been classically established as experimental animals.
- a patient tumor-transplanted mouse which has started to be widely used in recent years, is produced by implanting a tumor tissue (tumor part) or tumor cell taken out from a patient.
- a patient tumor tissue-transplanted mouse prepared by implanting a tumor tissue derived from a patient (human) into an acquired immunodeficient mouse and growing it in the body of the mouse for a certain period of time is PDX (Patient-derived tumoror xenograft (patient-derived tumor). Xenografts)) are called model mice.
- diagnosis / treatment methods methods for obtaining an index for diagnosis or treatment
- non-clinical test methods using PDX model mice it is considered that the effect and safety of drugs can be evaluated in a form that highly reproduces the actual human pathology, that is, in an environment close to a human lesion.
- Non-Patent Document 2 the amount of protein expression in tumor tissue of PDX model mice is evaluated by the IHC (immunohistochemistry) method.
- IHC immunohistochemistry
- a staining method in the IHC method a method in which an enzyme-labeled antibody is bound to a target protein (antigen) by a direct method or an indirect method and then reacted with a substrate to develop a color, for example, peroxidase and diaminobenzidine are used.
- the DAB staining method is widely used.
- staining with an enzyme such as DAB staining in the IHC method has a problem in that it is difficult to accurately estimate the amount of an actual antigen or the like from the staining concentration because the staining concentration greatly depends on environmental conditions such as temperature and time. There is.
- the evaluation is often expressed by a score of several stages based on the staining concentration and the like, which is close to qualitative evaluation rather than quantitative.
- the “qualitative” method correlates with the expression level of the protein and the number of expressed cells, but does not directly handle those numbers or index values closely related to them, but within a predetermined range. This is a method of evaluating with several levels of scores based on a certain number or index value, and typically means a method that relies on the subjective and empirical factors of the observer. For example, an IHC method using DAB staining for HER2 protein expressed on a cell membrane such as a breast cancer cell, and evaluating with a four-stage score based on the staining property and the staining intensity (staining pattern) (“ “HER2 Test Guide 3rd Edition”, created by Trastuzumab Pathology Committee, September 2009) falls under the “qualitative” approach.
- the “quantitative” method directly deals with the expression level of the protein, the number of expressed cells, or an index value closely related to them, and typically relies on the objective measurement result using an apparatus. This is a method for evaluating.
- Non-Patent Document 2 only the qualitative analysis of protein expression level in tumor tissue of patients and PDX mice by the IHC (immunohistochemistry) method is performed.
- companies such as a mouse provider company, a test contract company, and medical institutions such as hospitals have little interest in accurately evaluating protein expression levels. That is, it can be said that the technical significance of quantitatively and accurately grasping the expression level of protein in tumor tissues and the like of PDX mice is not yet known.
- nano-sized fluorescent particles for example, particles in which fluorescent materials such as fluorescent dyes and quantum dots are integrated as a matrix such as a resin (phosphor integrated particles, Phosphor Integrated Dot: PID). Proposed and put to practical use. Labeling the target protein with fluorescent particles and irradiating it with excitation light suitable for the fluorescent substance, it is possible to observe the protein as a bright spot, so it is expressed The amount of protein can be assessed quantitatively.
- Patent Document 1 International Publication WO2012 / 029752
- Patent Document 2 International Publication WO2013 / 035703
- PID phosphor integrated particles
- Non-Patent Document 3 suggests the possibility that the effects of treatments and drugs can be predicted based on information derived from tumor tissue gene mutations.
- a biomolecule specific to the tumor tissue (hereinafter referred to as a specific biomarker) from the genetic information obtained by genetic testing of the tumor tissue, there is a possibility that the effect of treatment or drug can be predicted.
- the genetic information merely suggests the possibility that a specific biomarker related to the gene is expressed, and does not demonstrate that the specific biomarker is expressed. That is, it is not possible to confirm that the specific biomarker is actually expressed or the specific biomarker is actually involved in, for example, the drug efficacy from the result of the genetic test alone.
- the present invention has been made in view of the above problems, and by using a laboratory animal transplanted with a human lesion (lesioned tissue), information on the expression state of a specific biomarker is obtained and analyzed.
- Another object of the present invention is to provide means for predicting the effects and side effects of treatments that are predicted when treatment is actually performed in a patient.
- the present invention takes the following means in order to solve the above problems. That is, specific biomarkers (protein, RNA, miRNA, etc.) related to human-specific mutation information by analyzing gene information (gene mutation information) of a diseased tissue (lesion site) collected from a human (eg, patient, clinical specimen, etc.) ). Furthermore, the expression state of the specific biomarker in the transplanted diseased tissue of the experimental animal transplanted with the diseased tissue is specified. As a means for specifying such an expression state, preferably, fluorescent staining using fluorescent nanoparticles such as phosphor-aggregated particles is used.
- the expression state can be quantitatively measured, observed, and further analyzed.
- the present inventors are able to predict the effects and efficacy of treatment and medication in treatment and clinical trials (clinical trials, clinical research) of individual patients. I found it.
- a database that integrates such information on the expression state of a specific biomarker, its analysis results, and drug information as a series of information is created, and clinical trials (clinical trials) and A method for predicting the effectiveness in therapy with high accuracy is provided.
- the effectiveness of drugs and treatments can be achieved at an unprecedented level by analyzing information on the expression state of specific biomarkers from various angles using experimental animals carrying human diseased tissues (lesioned parts). Can be done accurately.
- FIG. 1 illustrates a distribution pattern of a specific biomarker, which is one piece of information on the expression state of a specific biomarker.
- Pattern A shows that the specific biomarker is localized in the periphery of the tumor tissue region
- Pattern B shows that the specific biomarker is localized in the periphery of the tumor tissue region
- Pattern C shows the tumor tissue The state where the specific biomarker is localized in a colony shape at the center of the region is schematically shown.
- FIG. 2 is a block diagram of database creation in which one or more information groups including information on the expression state of a specific biomarker are integrated.
- FIG. 3 is a schematic diagram of database production.
- FIG. 4 is a block diagram showing an example of a method for predicting the effectiveness of treatment using a database.
- FIG. 5 is a block diagram showing an example of a method of using a database in a clinical trial.
- FIG. 6 is a block diagram showing an example of a method for selecting a treatment policy using a
- the present invention relates to a method for obtaining one or more pieces of information including information related to a specific biomarker described later using a specimen that is a lesion part collected from a human and using the information to predict the effectiveness of treatment. Including.
- Another aspect of the present invention relates to the expression state of a specific biomarker using a specimen of a lesion part collected from a transplanted part of a laboratory animal transplanted with a tissue of a lesion part collected from a human or a cell derived therefrom. It includes a method of obtaining one or more information including information and using it to predict the effectiveness of a treatment.
- one or more information including information on the expression state of a specific biomarker is obtained using a specimen that is a lesion part collected from a human, and the tissue of the lesion part collected from the human is further obtained. Or, using a specimen that is a lesion taken from the transplanted part of a laboratory animal transplanted with cells derived from it, obtain one or more pieces of information including information on the expression state of a specific biomarker. Methods used in combination to predict the effectiveness of the treatment.
- the information may include, for example, information on the form of cells expressing the specific biomarker and the expression state of other biomolecules.
- Information other than information regarding cells expressing a specific biomarker, such as the occupancy rate of blood vessels in the specimen, may be included.
- a “human” is a human having a disease (cancer or the like) to be treated as described later or a human suspected of having a disease, and may be referred to as a patient in the present specification.
- “having a disease” is diagnosed by a doctor or the like, and “suspected of having a disease” is determined to be possibly affected by any known technique. It has been done.
- the “lesion site” is generally a site that changes as the disease develops and progresses, and includes a diseased tissue (lesion tissue), but can also include surrounding normal tissue.
- a “lesion” in a cancer patient is a tumor site (or a portion suspected of having a tumor), and may include tumor tissue and surrounding normal tissues and cells.
- specimen refers to a tissue section or cells collected from a transplant site of a laboratory animal transplanted with a tissue or cell of a lesion site collected from a human or a tissue or cell derived from a human lesion site. In general, it takes the form of a specimen slide prepared according to a predetermined procedure as conventionally used when evaluating the expression of a target protein by immunostaining.
- the experimental animal is specifically preferably an experimental animal transplanted with a tissue of a human lesion or a cell derived therefrom.
- a human when the lesion of a human (patient) is a tumor, it may be an experimental animal transplanted with a tumor tissue or cancer cell collected from the tumor portion, or the collected tumor tissue or cancer cell is cloned. It may be an experimental animal transplanted with cultured cells.
- the “experimental animal” is a tumor-bearing animal.
- various experimental animals such as an Alzheimer's disease model, a diabetes model, a genetic disease model, an infectious disease model, and the like can be used as experimental animals depending on the purpose.
- mice examples include mice, rats, rabbits, guinea pigs, gerbils, hamsters, ferrets, dogs, minipigs, monkeys, cows, horses, sheep, etc. Although animals having the requirements are mentioned, mice are widely used especially from the viewpoint of easy breeding and experiments.
- the technique for causing the experimental animal to retain the tumor part is not particularly limited, and a known technique can be used.
- various techniques have been attempted, such as incising the mouse body and transplanting a tumor block of the patient, or inserting a tumor tissue removed from the patient or a cultured cell derived therefrom by injection.
- Tumor bearing model mouse When using a tumor-bearing animal as the experimental animal of the present invention, it is preferable to use a tumor-bearing model mouse, and it is more preferable to use a PDX model mouse described later.
- Tumor-bearing model mice can be broadly classified into naturally induced tumor mice, cultured cancer cell transplanted mice, and patient tumor tissue transplanted mice (see Table 1; Kohrt et al., Defining the optimal murine models to investigate immune checkpoint blockers). and their combination with other immunotherapies. Annals of Oncology 00: 1-9, 2016).
- Cultured cancer cell transplanted mice are prepared by culturing tumor cells collected from humans (patients) in test tubes and transplanting the cloned cultured cells into acquired immunodeficient mice.
- Examples of cultured cancer cell transplanted mice include CDX [Cell-line-derived xenograft] model mice.
- Examples of mice transplanted with tumor tissues collected from humans (patients) include PDX [Patient-derived xenograft] model mice, Immuno-avatar model mice, hematopoietic lymphoid humanized model mice, and Immune- PDX model mouse etc. are mentioned.
- PDX mice are created by transplanting patient-derived tumor tissue into acquired immunodeficient mice.
- Immuno-avatar model mice, hematopoietic lymphoid humanized model mice and Imune-PDX model mice were transplanted with human peripheral blood mononuclear cells, CD34 + human hematopoietic stem cells and their progenitor cells (HSPC) or tumor infiltrating lymphocytes, respectively. It is produced by transplanting tumor tissue from a patient into the acquired immunodeficient mouse.
- HSPC progenitor cells
- mice transplanted with patient tumor tissue were transplanted (passaged) with a mouse (first generation: 0th generation) that had been grown for a certain period after transplanting a patient-derived tumor tissue and a 0th generation tumor site.
- a mouse and all of the (n + 1) generation mice transplanted (passaged) with a subsequent n generation (n ⁇ 1) tumor site are included.
- the “specimen” is a part of the tumor-bearing mouse that has been transplanted with tumor cells or tumor tissue, and is prepared from a part that has passed any time after the transplantation. obtain.
- the “specific biomarker” is a biological material (protein, nucleic acid, etc.) existing in a human lesion, preferably a biological material expressing cells contained in a human lesion. Typically, it is a biological material that is specifically expressed in cells contained in a diseased tissue.
- a specific biomarker is a gene analysis of a specimen prepared from a lesion (lesioned tissue) collected from a patient by genetic testing, analyzing gene mutation information in the specimen, and specifying based on the mutation information of the gene Can do. For example, predicting the effectiveness of a molecular target drug targeting a specific biomarker by using the protein encoded by the gene causing the mutation as a specific biomarker and acquiring and analyzing information on the specific biomarker can do.
- mutation information of the gene is analyzed using a tumor tissue or the like collected from a patient, and a protein encoded by the mutated gene is specified as a specific biomarker.
- a molecular target that targets the specific biomarker to the laboratory animal
- the specific biomarker is not particularly limited as long as it is present in the specimen, and a specific one kind of biological substance present in the specimen may be selected as the specific biomarker. Two or more types of biological substances may be selected as specific biomarkers.
- the nucleic acid may be various RNAs such as mRNA, tRNA, miRNA, siRNA, and non-coding-RNA derived from the genome of a cell contained in a tissue of a lesion (lesioned tissue).
- RNAs such as mRNA, tRNA, miRNA, siRNA, and non-coding-RNA derived from the genome of a cell contained in a tissue of a lesion (lesioned tissue).
- miR21, miR34a, miR197, miR200, miR513, miR-133a, miR-143, exosomal micro-RNA (miR-181c, miR-27b), let-7a, miR-122, iR4717 and the like are preferable. It is preferable.
- the protein is preferably a protein that is phosphorylated in cells contained in a tissue of a lesion (lesioned tissue), and examples of such phosphorylated protein include HER2 HER3, EGFR, VEGFR and the like.
- the information on the specific biomarker includes the total expression level of the protein, the ratio of the phosphorylated protein to the total expression level of the protein, and the phosphorylated type protein. Information such as only the amount may be included.
- the cells contained therein include not only tumor cells but also cells other than tumor cells, for example, cells such as immune cells that interact with tumor cells. Therefore, the specific biomarker in the present specification is preferably a cancer-related protein expressed in tumor cells and / or a protein expressed in immune cells.
- Cancer-related protein typically include “immune system proteins expressed in cancer cells”, “pathway proteins expressed in cancer cells”, and “metastatic proteins expressed in cancer cells”. It is done. Various types of cancer-related proteins are known, and appropriate ones can be selected according to the purpose of diagnosis or treatment, the mechanism of action of the drug used, etc. It is not something.
- genes (770 genes) of the immune system panel, pathway system panel, and metastasis system panel included in the cancer-related gene expression panel provided by nCounter are encoded. These proteins correspond to immune system proteins, pathway proteins, and metastasis proteins expressed in cancer cells, respectively. Mutant proteins corresponding to mutant genes of these genes can also be included in immune system proteins, pathway proteins, and transfer proteins.
- immune system proteins expressed in cancer cells include CD40, TL1A, GITR-L, 4-188-L, CX4D-L, CD70, HHLA2, ICOS-L, CD85, which are immune checkpoint proteins.
- pathway proteins expressed in cancer cells include cancer cell growth factor or cancer cell growth factor receptor EGFR (HER1), HER2, HER3, HER4, IGFR, HGFR; cell surface antigen, VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, PlGF-1, PlGF-2 which are vascular growth factors or vascular growth factor receptors; interferon and interleukin which are cytokines or cytokine receptors , G-CSF, M-CSF, EPO, SCF, EGF, FGF, IGF, NGF, PDGF, TGF and the like.
- HER1 cancer cell growth factor or cancer cell growth factor receptor EGFR
- HER2 HER2, HER3, HER4, IGFR
- HGFR cell surface antigen
- VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, PlGF-1, PlGF-2 which are vascular growth factors or vascular growth factor receptor
- metastatic proteins expressed in cancer cells include, for example, cancer metastasis markers, ACTG2, ALDOA, APC, BRMS1, CADM1, CAMK2A, CAMK2B, CAMK2D, CCL5, CD82, CDKN1A, CDKN2A, CHD4, CNN1, CST7, CTSL, CXCR2, YBB, DCC, DENR, DLC1, EGLN2, EGLN2, EIF4E2, EIF4EBP1, ENO1, ENO2, ENO3, ETV4, FGFR4, GSN, HK2, HK3, HKDC1, KDM1, HLA-DPB11, HLA-DPB11 LDHA, LIFR, MED23, MET, MGAT5, MAP2K4, MT3, MTA1, MTBP, MTOR, MYCL, MYH11, NDRG1, NF2, N KB1, NME1, NME4, NOS2, NR4A3, PDK1, PEBP4, PFKFB1, PF
- proteins expressed in immune cells include PD-1, CTLA-4, TIM3, Foxp3, CD3, CD4, CD8, CD25, CD27, CD28, CD70, CD40, CD40L, CD80, CD86, CD160, CD57 CD226, CD112, CD155, OX40 (CD134), OX40L (CD252), ICOS (CD278), ICOSL (CD275), 4-1BB (CD137), 4-1BBL (CD137L), 2B4 (CD244), GITR (CD357) , B7-H3 (CD276), LAG-3 (CD223), BTLA (CD272), HVEM (CD270), GITRL, Galectin-9 (Galectin-9), B7-H4, B7-H5, PD-L2, KLRG- 1, E- Cadherin, N-Cadherin, R-Cadherin and IDO, TDO, CSF-1R, HDAC, CXCR4, FLT-3, T
- the specific biomarker in the present specification may be expressed in cells other than tumor cells and immune cells.
- Specific examples of biological substances expressed in cells other than tumor cells and immune cells include proteins contained in the stroma.
- “Stromal” mainly consists of stromal cells such as fibroblasts, endothelial cells, leukocytes (lymphocytes, monocytes, neutrophils, eosinophils, basophils) and proteins such as collagen and proteoglycans. Composed of an extracellular matrix.
- stromal cells such as fibroblasts, endothelial cells, leukocytes (lymphocytes, monocytes, neutrophils, eosinophils, basophils) and proteins such as collagen and proteoglycans.
- Biological material present in either stromal cells or extracellular matrix may be used as a specific biomarker, but the effect on the characteristics of transplanted lesions (eg, tumor cells) carried by experimental animals is thought to be greater
- an appropriate protein can be selected and used from the following membrane proteins, which are stromal cell markers.
- CD140a is a membrane protein expressed on the surface of cells such as fibroblasts, megakaryocytes, monocytes, erythrocytes, myeloid progenitor cells, and endothelial cells, and is preferable as a stromal cell marker in the present invention.
- CD106 VCAM-1, INCAM-110) ... activated vascular endothelial cells, dendritic cells; CD109 (Platelet activation factor, 8A3, E123) ... activated T cells, platelets, vascular endothelium, megakaryocytes, CD34 + progenitor cell subset; CD140a (PDGF-R, PDGFR2) ... fibroblasts, megakaryocytes, monocytes, erythrocytes, myeloid progenitor cells, endothelial cells; CD140b (PDGF-R, PDGFR1) ...
- endothelial cells stromal cells
- CD141 Thrombomodulin.
- vascular endothelium myeloid cells, platelets, smooth muscle
- CD142 Tissue Factor (TF), Thromboplastin): epithelial cells, activated monocytes, activated vascular endothelium
- CD143 ACE: angiotensin converting enzyme
- CD144 VE-Cadherin, Cadherin-5) ... vascular endothelium
- CD145 (7E9, P7A5) ... endothelial cells
- CD146 MUC18, s-endo, Mel-CAM
- vascular endothelium activated T cells, melanoma
- CD147 Basigin, M6, EMMRRIN
- white blood cells red blood cells
- vascular endothelium platelets
- CD201 EPCR: Vascular Endothelial Cell Protein C Receptor
- CD202 TIE2, TEK
- Vascular endothelium hematopoietic stem cell subset
- CD280 Endo180, TEM22, uPARAP (uPAR-associated protein)
- bone marrow progenitor cells fibroblasts, endothelial cell subsets, macrophage subsets
- CD299 DC-SIGN-related, L-SIGN (Liver / Lympho node specific ICAM3-grabbing nonintegrin)
- CD309 Vascular endothelial growth factor receptor2 (Vascular endothelial growth factor receptor2), KDR
- endothelial cells megakaryocytes, platelets, stem cell subsets
- CD322 Jobctional adhesion molecule 2
- endothelial cells monocytes, B cells, T cell subsets
- CD331 FGFR1 (Fibroblast growth factor receptor 1)
- fibroblasts epithelial cells
- CD332 FGFR2, Keratinocyte growth factor receptor
- CD333 FGFR3, JTK4
- CD334 FGFR4, JTK2, TKF
- CD339 Jagged-1, JAG1 ... stromal cells, epithelial cells.
- the expression state of a specific biomarker in the present invention refers to the expression level of the specific biomarker, the type, number and / or form of cells expressing the specific biomarker, the expression site of the specific biomarker (tumor bearing animal as an experimental animal) In the case of using a model, it refers to a feature formed by information such as tumor tissue or distribution in a tumor part, and a dedicated area.
- Information on the expression state of the specific biomarker in the method of the present invention includes, for example, (1) the expression level of the specific biomarker per cell or per unit area of the tissue in the specimen (specimen slide), and (2) the specific biomarker Histogram expressed by the expression level per cell of the marker and the number of cells corresponding thereto, (3) Curve expressed by the expression level per cell of the specific biomarker and the number of cells corresponding thereto, (4) Multiple specific bio Information on the mutual position information (distance) of markers, (5) Localization patterns of specific biomarkers in cells, stations in a region of interest (ROI) of a specific cell group (for example, cancer cell group) For example, information relating to a pattern such as a current pattern is included.
- ROI region of interest
- Pieces of information are preferably acquired as image information (including those converted as digital images), and more preferably can be converted as quantitative information.
- the information on the expression state is not limited to any one of the above, but may be a combination of a plurality of information, or a plurality of specific biomarkers may be selected and information on the expression state may be combined. There may be.
- a method for acquiring information on the expression state of a specific biomarker as image information is not particularly limited.
- a digital image can be obtained by photographing a specimen (specimen slide) using a high-resolution whole slide scanner (Whole slide Scanner).
- the converted image information can be acquired, and information on the expression state of the specific biomarker can be quantitatively analyzed by image analysis of the image information. This analysis may be performed using any algorithm generally used for digital image processing or analysis, or may be performed using an algorithm optimized according to a specific biomarker or a detection target.
- organic fluorescent dyes, quantum dots, or particles such as organic fluorescent dyes or quantum dots integrated on a matrix such as resin are used.
- the staining method (PID method) performed using the phosphor-aggregated particles is particularly suitable as a method used in the present invention, but is not particularly limited, and may be another method having the same degree of accuracy. There may be.
- a basic embodiment of the PID method is known from a plurality of patent documents or non-patent documents as described above.
- the information on the expression state is obtained by performing the PID method in an embodiment according to the case where pathological diagnosis is performed using a specimen slide.
- a method for acquiring information on the expression state of a specific biomarker by the PID method which is an example of an embodiment of the present invention, will be described in detail.
- the sample is fluorescently immunized using an anti-specific biomarker antibody bound with phosphor-aggregated particles. After staining and irradiating the stained specimen slide with excitation light having a wavelength corresponding to the used phosphor accumulated particle, observation and imaging are performed, and the phosphor accumulated particle labeled with a specific biomarker appears as a bright spot. Images can be obtained. The number of bright spots in the acquired fluorescent staining image may be used as an index value for the expression level of the specific biomarker.
- the brightness (luminance, fluorescence intensity) of one luminescent spot is separately measured.
- the number of phosphor-aggregated particles contained in the bright spot can be calculated, and the number of particles may be used as an index value for the expression level of the specific biomarker.
- the expression level of a specific biomarker per unit area of a tissue measure the number of bright spots or particles in cells contained in the tissue in a specific region in the image, and then divide by the area of the tissue do it.
- staining is performed so that the shape of the cells can be identified with a staining agent for morphological observation (for example, eosin) together with the fluorescent immunostaining, and observation and imaging in the bright field are performed, whereby a specific image in the entire image or in the image is identified.
- a staining agent for morphological observation for example, eosin
- observation and imaging in the bright field are performed, whereby a specific image in the entire image or in the image is identified.
- the number of cells contained in a region for example, only tumor tissue
- the number of bright spots and the number of particles representing the specific biomarker expressed in each cell can be measured.
- the average expression level per cell calculated by dividing the number of bright spots or particles contained in the entire image by the number of cells may be used, or the number of bright spots of each cell.
- an average value calculated by measuring the number of particles may be used.
- the specific biomarker is a nucleic acid
- a method of specifically staining a gene using a probe labeled with phosphor-aggregated particles eg, FISH method
- the expression level per unit area can be specified.
- the distribution (histogram or curve shape, number of peaks), the average value or median, and the variance (CV) value
- a histogram it is possible to obtain information such as the number of cells (frequency) at which the segment having the maximum number of bright spots or particles per cell is present.
- the histograms and curves were originally graphed after measuring the expression level (number of bright spots or particles) and the number of expressed cells of a specific biomarker and directly handling those numbers. Therefore, it is classified into information obtained by using a “quantitative” method instead of “qualitative”.
- the distance between the phosphor integrated particles (bright spots) labeled with the specific biomarkers is determined as the distance between the specific biomarkers. Can be considered.
- the same specimen tissue section, etc.
- fluorescent staining for a specific biomarker and fluorescent staining for another specific biomarker (multiple immunostaining).
- fluorescent labels that fluoresce at different wavelengths to distinguish each specific biomarker.
- an image (dark-field image) in which phosphor-aggregated particles labeled with the specific biomarker appear as bright spots and a cell shape are represented.
- the distribution state in the image showing the distribution of the biomarker in each cell obtained by superimposing the images stained in the image (bright-field image) by image processing in any number of patterns (for example, in the center of the cell) Accumulation, accumulation in the cell edge (near the cell membrane), diffusion in the whole cell, etc.). It is also possible to determine the localization pattern of a specific biomarker in the specimen (tissue) by determining the one that occupies the largest number among the localization patterns of all the cells included in the image.
- the region that becomes the region of interest in the image obtained by superimposing the bright field image and the dark field image is set and specified What is necessary is just to classify the localization pattern in a cell group (for example, cancer cell group).
- a specific biomarker is identified based on mutation information obtained by genetic analysis of a specimen that is a lesion (lesion tissue) collected from a patient, and a lesion of an experimental animal transplanted with the lesion Information on the state of expression of the specific biomarker in the tissue (including image information) and its analysis results, treatment information (drugs) in the experimental animal, drug information such as side effects and prognosis, etc.
- the disease to be treated is not particularly limited, and is, for example, a neurological disease, an infectious disease, a genetic disease, a tumor (cancer), and typically a tumor (cancer).
- the tumor is not particularly limited, but for example, cell tumor, melanoma, sarcoma, brain tumor, head and neck cancer, stomach cancer, lung cancer, breast cancer, liver cancer, colon cancer, cervical cancer, prostate , Solid cancer such as bladder cancer, leukemia, lymphoma, and multiple myeloma.
- the treatment method is not particularly limited as long as it is applicable to the target disease.
- examples include surgery, radiation (proton beam, proton beam) therapy, drug therapy, etc., typically by administration of anticancer drugs, hormone drugs, immunostimulants, etc.
- Drug therapy especially molecular targeting drugs that target specific biomarkers (for example, antibody drugs that recognize the biomarkers and ADC (Antibody-Drug Conjugate) drugs) are preferably used. .
- the drug before administering the drug to the patient, it is administered to an experimental animal (for example, PDX mouse) transplanted with the above-mentioned lesion of the patient and the effect or side effect of the drug is evaluated. ”Can be used to obtain a more accurate prediction result.
- an experimental animal for example, PDX mouse
- the method for evaluating the effect of the drug is not particularly limited.
- a change in the size of a transplanted lesion (tumor) before and after administration of the drug may be used as an index, or a known tumor marker or infection marker in blood. It is also possible to use numerical values such as these, or the results (changes) of other pathological tests as indices.
- the method for evaluating side effects and the like is not particularly limited, but the numerical value of blood cells, the result of a histopathological examination of the digestive tract, and the like can be used as an index.
- one or more information including information on the expression state of a specific biomarker can be provided for predicting and evaluating the effectiveness of the treatment.
- a method for treating a disease by providing, for example, a medical institution or company as a database that integrates a group of information including information on the expression state of a specific biomarker, analysis results thereof, medical information, and other information -It can be usefully used in various situations such as prediction of drug effects, clinical trials / clinical trials, construction of treatment plans, etc.
- These pieces of information may include publicly known information, and may include information acquired by performing fluorescent immunostaining using fluorescent nanoparticles in various specimens.
- the creation and use form of a database using a PDX mouse will be described, but it is not particularly limited.
- a tumor tissue is collected from a PDX mouse to prepare a specimen (specimen slide).
- Gene analysis of tumor tissue based on information on gene mutation occurring in the tumor cell, a protein related to the mutation information, for example, a protein encoded by a mutated gene is used as a specific biomarker, Furthermore, by performing fluorescent immunostaining for labeling the specific biomarker with PID, the expression state of the specific biomarker in the specimen is imaged, and the image information is analyzed to obtain the expression state information.
- the drug is administered to PDX mice, and the effect of the drug is evaluated by means such as measuring the tumor volume before and after administration, or by sampling the digestive organs, blood and behavior, etc. Information such as determining the presence or absence of side effects.
- Each of the drugs to be administered may be administered as a single agent, or a plurality of drugs may be administered in combination. Further, more detailed information can be obtained by changing the administration form, administration route, administration period, administration frequency, and the like.
- a database is created by assembling genetic (mutation) information, biomarker expression status, and pharmaceutical information in PDX mice carrying tumor tissue derived from various patients by the above procedure.
- Such a database is provided so that it can be used by a user via a network.
- an optical disc compact disc (CD), digital versatile disc (DVD), etc.
- flash memory SSD (Solid State Drive)
- It can be provided to the user in a state stored in a computer-readable recording medium such as a memory card.
- the accuracy of prediction of the drug effect and the like can be further increased. Furthermore, by adding the expression status and medical information of the specific biomarker acquired in this PDX mouse to the database and accumulating the information, it is possible to increase the amount of information in the database and improve the accuracy of the information provided. it can.
- PDX mice and their databases can also be used effectively in clinical trials and clinical trials. For example, in clinical trials, there are three stages called 1 to 3 phases, and the safety and effectiveness of the drug at each stage are confirmed.
- a PDX mouse is produced by transplanting tumor tissues collected from a plurality of clinical trial participants who are cancer patients who are candidates for a therapeutic candidate drug into an acquired immunodeficient mouse. An expression state of a specific biomarker that is a target molecule of a candidate therapeutic drug in each PDX mouse and pharmaceutical information obtained by administering the candidate therapeutic drug to each mouse are acquired. From these pieces of information, it is possible to predict the degree of drug efficacy and the possible side effects that can be expected from the administration of candidate therapeutics in each patient.
- the information on the expression state is similar.
- Can extract one or more samples from the database predict the effects and risks of drugs that can be expected from the drug information contained in the samples, and determine whether or not they are appropriate for the target person.
- the clinical trial can be conducted while suppressing the above.
- the expression status of specific biomarkers in PDX mice and pharmaceutical information obtained in this way are further added to the database to accumulate information, thereby increasing the amount of information in the database and improving the accuracy of the information provided. It can be used to predict the effects of drugs and possible side effects when taking medication as an actual therapeutic means.
- the database can be used to determine a treatment policy for a specific patient. For example, information on the expression status of various specific biomarkers (for example, multiple cancer-related proteins and nucleic acids) in a sample collected from a cancer patient or a sample of a PDX mouse transplanted with a tissue collected from a patient is obtained. By extracting a sample with similar information on the expression state by collating with the database, it is predicted which drug will be selected and how it will be effectively administered to the tumor tissue I can do it.
- various specific biomarkers for example, multiple cancer-related proteins and nucleic acids
- the drug to be administered can be determined more efficiently and a dosage plan can be established. can do.
- the amount of information in that area included in the database can be further enhanced. And more accurate prediction is possible.
- the linker reagent “Maleimide-PEG2-Biotin” (Thermo Scientific, product number 21901) was adjusted to 0.4 mM using DMSO. 8.5 ⁇ L of this linker reagent solution was added to the antibody solution, mixed, and reacted at 37 ° C. for 30 minutes to bind biotin to the anti-rabbit IgG antibody via the PEG chain.
- the reaction solution was purified through a desalting column.
- the absorbance at a wavelength of 300 nm was measured using a spectrophotometer (Hitachi “F-7000”) to calculate the concentration of protein (biotin-modified secondary antibody) in the reaction solution.
- a solution in which the concentration of the biotin-modified secondary antibody was adjusted to 250 ⁇ g / mL using a 50 mM Tris solution was used as a biotin-modified secondary antibody solution.
- the cooled solution was dispensed into a plurality of centrifuge tubes and centrifuged at 12,000 rpm for 20 minutes to precipitate Texas red-integrated melamine resin particles contained in the solution as a mixture.
- the supernatant was removed and the precipitated particles were washed with ethanol and water.
- the average particle size was 152 nm.
- the Texas red-integrated melamine resin particles thus produced were surface-modified with streptavidin according to the following procedure, and the resulting streptavidin-modified Texas red-integrated melamine resin particles were converted into the phosphor-integrated particles in Examples 1 and 3 ( PID).
- the particles subjected to the above surface amination treatment are adjusted to 3 nM using PBS (phosphate buffered saline) containing 2 mM of EDTA (ethylenediaminetetraacetic acid), and the final concentration of this solution is 10 mM.
- SM (PEG) 12 manufactured by Thermo Fisher Scientific, succinimidyl-[(N-maleimidopropionamido) -dodecaethyleneglycol] ester
- streptavidin manufactured by Wako Pure Chemical Industries, Ltd.
- SATA N-succinimidyl S-acetylthioacetate
- the above Texas Red-integrated melamine resin particles and streptavidin were mixed in PBS containing 2 mM of EDTA and reacted at room temperature for 1 hour. 10 mM mercaptoethanol was added to stop the reaction. After the obtained solution was concentrated with a centrifugal filter, unreacted streptavidin and the like were removed using a gel filtration column for purification to produce streptavidin-modified Texas red integrated melamine resin particles.
- Tumor volume was measured before and after administration, and tissue sections (tumor tissues) were collected from mice sacrificed at each time point before the first administration, 1 week, 2 weeks, 3 weeks and 4 weeks after the first administration. did.
- tissue sections tumor tissues
- formalin fixation and paraffin embedding were performed according to a conventional method, and further sliced to prepare two specimen slides for each mouse at each treatment point.
- Example 1 Immunostaining of HER2 protein (1-1) Sample slide pretreatment The sample slide prepared in Evaluation Preparation-1 was deparaffinized and then washed with water. The washed specimen slide was autoclaved at 121 ° C. for 15 minutes in 10 mM citrate buffer (pH 6.0) to carry out antigen activation treatment. The tissue slide after the activation treatment was washed with PBS, and the washed specimen slide was subjected to blocking treatment with PBS containing 1% BSA for 1 hour.
- the sample was dropped onto each of two specimen slides corresponding to the above, and reacted at 4 ° C. overnight.
- a solution of the biotin-modified anti-rabbit IgG antibody prepared in Preparation Example 1 and further diluted to 6 ⁇ g / mL using PBS containing 1 W / W% BSA was dropped onto a specimen slide washed with PBS. The reaction was allowed to proceed for 30 minutes at room temperature.
- the specimen was irradiated with excitation light corresponding to Texas Red contained in the phosphor-aggregated particles used for HER2 staining to emit fluorescence, and an immunostained image was taken in that state.
- the wavelength of the excitation light was set to 575 to 600 nm using the excitation light optical filter provided in the fluorescence microscope, and the wavelength of the fluorescence to be observed was set to 612 to 692 nm using the fluorescence optical filter.
- the intensity of the excitation light at the time of observation and image photographing with a fluorescence microscope was such that the irradiation energy near the center of the visual field was 900 W / cm 2 .
- the exposure time at the time of image shooting was adjusted within a range in which the luminance of the image was not saturated, and set to, for example, 4000 ⁇ sec.
- Such fluorescent immunostained images and morphological observation stained images were taken in the same visual field, then the same operation was repeated while changing the visual field, and 5 visual fields were performed per specimen slide.
- the stained image for morphological observation and the fluorescent immunostained image were overlapped by image processing to extract bright spots representing Texas Red integrated melamine resin particles labeled with HER2 expressed on the cell membrane. Since HER2 is not expressed in the stromal cell region, the bright spot located in the stromal cell was treated as a nonspecific signal, that is, noise.
- the number of shining spots on the cell membrane whose brightness is equal to or higher than a predetermined value is measured, and the brightness of the luminescent spot is divided by the brightness per one phosphor integrated particle (PID) particle, and converted to the number of particles.
- PID phosphor integrated particle
- the expression level (number of particles) of HER2 was measured for 1000 cells per specimen slide (5 fields of view), and the average value was calculated as the “PID score” of the specimen slide. Furthermore, the average value of the PID score in each of the two specimen slides corresponding to each patient (AE) was calculated.
- trastuzumab is selected as a therapeutic agent for patient A, while another therapeutic agent is selected and administered to patient E. It will be possible to select and judge a treatment (medication) method suitable for each patient, and to construct an efficient medication and treatment plan.
- PID score information on such genetic information, medical information, and expression information
- EGFR immunostaining was performed in the same manner as HER2, except that an anti-EGFR rabbit monoclonal antibody (clone “5B7” Roche) was used instead of the anti-HER2 rabbit monoclonal antibody “4B5” (Ventana).
- the average value of the PID score was calculated by performing photographing and image processing, and classified into three patterns of localization A to C based on the localized state in the cell.
- Table 3 summarizes information on gene mutation of each patient, drug resistance to gefitinib at 100 days after administration, and changes in EGFR expression pattern and tumor volume at each time point for the corresponding mice.
- PDX mice prepared by transplanting tumor tissues of patients F and H whose drug resistance was confirmed on the 100th day after drug administration, the tumor volume once decreased at 100 days, but the tumor volume increased thereafter. It can be determined that resistance to gefitinib has appeared. Further, in the tumor tissues collected from these PDX mice, it was observed that the localization state of EGFR changed between the first day and the 100th day after administration of gefitinib.
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Abstract
Description
本発明において実験動物は、具体的にはヒトの病変部の組織またはそれに由来する細胞が移植された実験動物であることが好ましい。例えば、ヒト(患者)の病変部が腫瘍である場合、腫瘍部から採取した腫瘍組織またはがん細胞を移植した実験動物であってもよいし、採取した腫瘍組織またはがん細胞をクローン化した培養細胞を移植した実験動物であってもよく、換言すればそのような場合「実験動物」は担腫瘍動物である。またその他にも、目的に応じて様々な実験動物、例えば、アルツハイマー病モデル、糖尿病モデル、遺伝病モデル、感染症モデルなどの病変モデル動物を実験動物として用いることができる。動物種の例としては、マウス、ラット、ウサギ、モルモット、スナネズミ、ハムスター、フェレット、イヌ、ミニブタ、サル、ウシ、ウマ、ヒツジなど、ある程度の遺伝学的な制御がなされており、均質な遺伝的要件を備えている動物が挙げられるが、飼育や実験が容易であるという観点から特にマウスが広く用いられている。
(担腫瘍モデルマウス)
本発明の実験動物として担腫瘍動物を用いる場合、担腫瘍モデルマウスを用いることが好ましく、後述するPDXモデルマウスを用いることがより好ましい。担腫瘍モデルマウスは、大きく自然誘発腫瘍マウス、培養がん細胞移植マウス、患者腫瘍組織移植マウスの3つに分類できる(表1参照;Kohrt et al., Defining the optimal murine models to investigate immune checkpoint blockers and their combination with other immunotherapies. Annals of Oncology 00: 1-9, 2016)。
(特定バイオマーカー)
本発明において「特定バイオマーカー」とは、ヒトの病変部に存在している生体物質(タンパク質、核酸等)であり、好ましくはヒトの病変部に含まれる細胞が発現している生体物質であり、典型的には病変組織に含まれる細胞に特異的に発現する生体物質である。
「がん関連タンパク質」としては、代表的には「がん細胞に発現する免疫系タンパク質」、「がん細胞に発現するパスウェイ系タンパク質」、「がん細胞に発現する転移系タンパク質」が挙げられる。それぞれに分類されるがん関連タンパク質には様々なものが知られており、診断または治療の目的、使用する薬剤の作用機序等に応じて適切なものを選択することができ、特に限定されるものではない。なお、nCounterが提供するがん関連遺伝子発現パネルに含まれる、免疫系(Immune)遺伝子パネル、パスウェイ系(Pathway)遺伝子パネル、転移系(Progression)遺伝子パネルの遺伝子(各770遺伝子)がコードしているタンパク質が、それぞれがん細胞に発現する免疫系タンパク質、パスウェイ系タンパク質、転移系タンパク質に該当する。また、これらの遺伝子の変異遺伝子に対応する変異タンパク質も、免疫系タンパク質、パスウェイ系タンパク質、転移系タンパク質に含むことができる。
「免疫細胞に発現するタンパク質」としては、例えば、PD-1、CTLA-4、TIM3、Foxp3、CD3、CD4、CD8、CD25、CD27、CD28、CD70、CD40、CD40L、CD80、CD86、CD160、CD57、CD226、CD112、CD155、OX40(CD134)、OX40L(CD252)、ICOS(CD278)、ICOSL(CD275)、4-1BB(CD137)、4-1BBL(CD137L)、2B4(CD244)、GITR(CD357)、B7-H3(CD276)、LAG-3(CD223)、BTLA(CD272)、HVEM(CD270)、GITRL、ガレクチン-9(Galectin-9)、B7-H4、B7-H5、PD-L2、KLRG-1、E-Cadherin、N-Cadherin、R-CadherinおよびIDO、TDO、CSF-1R、HDAC、CXCR4、FLT-3、TIGITが挙げられる。
また、本明細書における特定バイオマーカーは、腫瘍細胞および免疫細胞以外の細胞において発現するものであってもよい。腫瘍細胞および免疫細胞以外の細胞において発現する生体物質の具体例としては、間質に含まれるタンパク質等が挙げられる。
CD109(Platelet activation factor、 8A3、 E123)…活性化T細胞、血小板、血管内皮、巨核球、CD34+前駆細胞サブセット;
CD140a(PDGF-R、 PDGFR2)…線維芽細胞、巨核球、単球、赤血球、骨髄系前駆細胞、内皮細胞;
CD140b(PDGF-R、 PDGFR1)…内皮細胞、ストローマ細胞;
CD141(Thrombomodulin)…血管内皮、骨髄系細胞、血小板、平滑筋;
CD142(Tissue Factor(TF)、 Thromboplastin)…上皮細胞、活性化単球、活性化血管内皮;
CD143(ACE: アンジオテンシン転換酵素)…血管内皮、上皮細胞、活性化マクロファージ;
CD144(VE-Cadherin、 Cadherin-5)…血管内皮;
CD145(7E9、 P7A5)…内皮細胞;
CD146(MUC18、 s-endo、Mel-CAM)…血管内皮、活性化T細胞、黒色腫;
CD147(Basigin、 M6、 EMMRRIN)…白血球、赤血球、血管内皮、血小板;
CD201(EPCR:血管内皮細胞プロテインCレセプター)…血管内皮;
CD202(TIE2、TEK)…血管内皮、造血幹細胞サブセット;
CD280(Endo180、TEM22、uPARAP(uPAR-associated protein))…骨髄前駆細胞,線維芽細胞,内皮細胞サブセット,マクロファージサブセット;
CD299(DC-SIGN-related、 L-SIGN(Liver/Lympho node specific ICAM3-grabbing nonintegrin))…内皮細胞;
CD309(VEGFR2( Vascular endothelial growth factor receptor2)、 KDR)…内皮細胞、巨核球、血小板、幹細胞サブセット;
CD322(JAM2(Junctional adhesion molecule 2))…内皮細胞、単球、B細胞、T細胞サブセット;
CD331(FGFR1(Fibroblast growth factor receptor1))…線維芽細胞、上皮細胞;
CD332(FGFR2、Keratinocyte growth factor receptor)…上皮細胞;
CD333(FGFR3、 JTK4)…線維芽細胞、上皮細胞;
CD334(FGFR4、JTK2、 TKF)…線維芽細胞、上皮細胞;
CD339(Jagged-1、 JAG1)…ストローマ細胞、上皮細胞。
(特定バイオマーカーの発現状態)
本発明における特定バイオマーカーの発現状態とは、特定バイオマーカーの発現量、特定バイオマーカーを発現している細胞の種類、数および/または形態、特定バイオマーカーの発現部位(実験動物として担腫瘍動物モデルを用いる場合には、腫瘍組織または腫瘍部内の分布、専有面積)等の情報によって形作られる特徴をいう。
本発明の方法における特定バイオマーカーの発現状態の情報としては、例えば検体(標本スライド)における、(1)特定バイオマーカーの細胞当たりの、または組織の単位面積あたりの発現量、(2)特定バイオマーカーの細胞あたりの発現量とそれに対応する細胞数によって表されるヒストグラム、(3)特定バイオマーカーの細胞あたりの発現量とそれに対応する細胞数によって表される曲線、(4)複数の特定バイオマーカーの相互の位置情報(距離)に関する情報、(5)特定バイオマーカーの細胞内における局在パターン、特定細胞群(例えば、がん細胞群)の注目領域内(ROI:region of intrest)における局在パターンなどのパターンに係る情報等が挙げられる。これらの情報は画像情報(デジタル画像として変換されたものを含む)として取得されたものであることが好ましく、さらに定量的な情報として変換し得るものであることが好ましい。発現状態の情報は上記のいずれか一つだけでなく、複数が組み合わされたものであってもよいし、また、特定バイオマーカーを複数選択してそれぞれの発現状態の情報が組み合わされたものであってもよい。
同様に特定バイオマーカーの組織の単位面積あたりの発現量を求める場合、画像中の特定の領域にある組織に含まれる細胞における輝点数または粒子数について計測した後、その組織の面積で割るようにすればよい。
本発明の1つの側面においては、患者から採取した病変部(病変組織)である検体の遺伝子解析による変異情報をもとに特定バイオマーカーを特定し、さらに当該病変部を移植した実験動物の病変組織における当該特定バイオマーカーの発現状態の情報(画像情報を含む)およびその解析結果、当該実験動物における治療(薬剤)の効果や副作用および予後などの医薬情報などを一連の情報として関連付けて多角的に解析することで、当該患者における治療の有効性について精度の高い予測が可能となる。
本発明のさらなる側面では、特定バイオマーカーの発現状態の情報を含む1以上の情報を治療の有効性の予測や評価のために提供することができる。具体的には特定バイオマーカーの発現状態の情報、その解析結果、医薬情報およびその他の情報を含めた情報群を統合したデータベースとして、例えば医療機関や企業等に提供することで、疾患の治療方法・薬剤の効果の予測、治験・臨床試験、治療計画の構築等、様々な場面で有用に用いることができる。これらの情報は公開されている公知の情報が含まれてもよく、さまざまな検体における蛍光ナノ粒子を用いた蛍光免疫染色を行なうことによって取得した情報が含まれていてもよい。以下、PDXマウスを用いたデータベースの作製や利用形態について説明するが、特に限定されるものではない。
例えば患者から採取した検体、または患者から採取した組織を移植したPDXマウスの検体における特定バイオマーカーの発現状態と前記データベースとを照合して、発現状態に係る情報が類似しているサンプルをデータベースから1以上抽出し、そのサンプルに含まれる医薬情報を参照して、当該患者における薬剤の効果や副作用を投薬前に予測することが可能となる。
また、PDXマウスやそのデータベースを治験や臨床試験において有効に使用することもできる。例えば治験では1~3の3つのフェーズと呼ばれる各段階があり、それぞれの段階での薬剤の安全性や有効性を確認している。実際に患者(ヒト)において候補となる薬剤を投与する前に、PDXマウスを作製し、試験を行なうことで、薬効の期待度や起こり得るリスクを予測することができる。以下にその具体的な一例をあげる。
さらに、データベースに含まれるサンプルの多い、つまり対象患者の多い領域(例えば乳がんや肺がんなど)においては、ある特定の患者の治療方針を決定するためにデータベースを利用することもできる。例えば、あるがん患者から採取した検体、または患者から採取した組織を移植したPDXマウスの検体において様々な特定バイオマーカー(例えば複数のがん関連タンパク質や核酸等)の発現状態の情報を取得し、データベースとを照合して発現状態に係る情報が類似しているサンプルを抽出することで、その腫瘍組織にはどの薬剤を選択し、さらにどのように投与することが効果的であるかを予測できることができる。
50mMTris溶液に、2次抗体として用いる抗ウサギIgG抗体50μgを溶解した。この溶液に、最終濃度3mMとなるようにDTT(ジチオトレイトール)溶液を添加、混合し、37℃で30分間反応させた。その後、反応溶液を脱塩カラム「Zeba Desalt Spin Columns」(サーモサイエンティフィック社、Cat.#89882)に通して、DTTで還元化した2次抗体を精製した。精製した抗体全量のうち200μLを50mMTris溶液に溶解して抗体溶液を調製した。その一方で、リンカー試薬「Maleimide-PEG2-Biotin」(サーモサイエンティフィック社、製品番号21901)を、DMSOを用いて0.4mMとなるように調整した。このリンカー試薬溶液8.5μLを前記抗体溶液に添加、混合し、37℃で30分間反応させることにより、抗ウサギIgG抗体にPEG鎖を介してビオチンを結合させた。この反応溶液を脱塩カラムに通して精製した。脱塩した反応溶液について、波長300nmにおける吸光度を、分光高度計(日立製「F-7000」)を用いて測定することにより、反応溶液中のタンパク質(ビオチン修飾2次抗体)の濃度を算出した。50mMTris溶液を用いて、ビオチン修飾2次抗体の濃度を250μg/mLに調整した溶液を、ビオチン修飾2次抗体の溶液とした。
テキサスレッド色素分子「Sulforhodamine 101」(シグマアルドリッチ社)2.5mgを純水22.5mLに溶解した後、ホットスターラーにより溶液の温度を70℃に維持ながら20分間撹拌した。撹拌後の溶液に、メラミン樹脂「ニカラックMX-035」(日本カーバイド工業株式会社)1.5gを加え、さらに同一条件で5分間加熱撹拌した。撹拌後の溶液にギ酸100μLを加え、溶液の温度を60℃に維持しながら20分間攪拌した後、その溶液を放置して室温まで冷却した。冷却した後の溶液を複数の遠心用チューブに分注して、12,000rpmで20分間遠心分離して、溶液に混合物として含まれるテキサスレッド集積メラミン樹脂粒子を沈殿させた。上澄みを除去し、沈殿した粒子をエタノールおよび水で洗浄した。得られた粒子の1000個についてSEM観察を行い、平均粒子径を測定したところ、平均粒子径152nmであった。このようにして作製されたテキサスレッド集積メラミン樹脂粒子を、次の手順に従ってストレプトアビジンで表面修飾し、得られたストレプトアビジン修飾テキサスレッド集積メラミン樹脂粒子を実施例1および3における蛍光体集積粒子(PID)として使用した。
作製例2で得られた粒子0.1mgをEtOH1.5mL中に分散し、アミノプロピルトリメトキシシラン「LS-3150」(信越化学工業社製)2μLを加えて8時間反応させて表面アミノ化処理を行なった。
5名の乳がん患者(A~E)それぞれの乳がん組織について網羅的遺伝子解析を行い、得られた遺伝子の変異情報に基づいてバイオマーカーを特定した。特定されたバイオマーカー(特定バイオマーカー)は、HER2およびERであった。また当該5名の患者の乳がん組織から単離したがん細胞をSCID(Sevefe Combined ImmunoDeficiency)マウスの皮下に移植した(各患者の腫瘍組織に対して5匹ずつ作製、計25匹)作製した。腫瘍体積が約100mm3となった時点(移植約3か月後)から、これらのマウスにトラスツズマブ(商品名:ハーセプチン)尾静脈内投与を開始した(15mg/kg:4日に1回:計4回)。投与前後における腫瘍体積の測定を行なうとともに、初回投与前、初回投与から1週間後、2週間後、3週間後および4週間後の各時点において堵殺したマウスから組織切片(腫瘍組織)を採取した。採取した各組織切片について常法に従ってホルマリン固定およびパラフィン包埋を行い、さらに薄切することで、各処理時点のマウスについてそれぞれ二枚ずつの標本スライドを作製した。
(1)HER2タンパク質の免疫染色
(1-1)標本スライド前処理
評価準備-1において作製した標本スライドを脱パラフィン処理した後、水で洗浄した。洗浄した標本スライドを10mMクエン酸緩衝液中(pH6.0)中で121℃、15分間オートクレーブ処理することで、抗原の賦活化処理を行った。賦活化処理後の組織スライドをPBSにより洗浄し、洗浄した標本スライドに対してBSAを1%含有するPBSを用いて1時間ブロッキング処理を行った。
上記処理を行った各処理時点のマウスの標本スライドについて目的タンパク質HER2の蛍光免疫染色を行った。
蛍光標識処理を行った標本スライドを、マイヤーヘマトキシリン液で5分間染色してヘマトキシリン染色を行った後、45℃の流水で3分間洗浄した。
各染色を終えた標本スライドに対して、純エタノールに5分間浸漬する操作を4回行う固定化・脱水処理を行った。続いて、キシレンに5分間浸漬する操作を4回行う透徹処理を行った。最後に、標本に封入剤「エンテランニュー」(メルク社)を載せて、カバーガラスを被せる封入処理を行い、観察に用いる標本とした。
(2-1)観察・撮影工程
この工程における励起光の照射および蛍光の発光の観察には蛍光顕微鏡「BX-53」(オリンパス株式会社)を用い、蛍光免疫染色像および形態観察用染色像(各400倍)の撮影には、当該蛍光顕微鏡に取り付けた顕微鏡用デジタルカメラ「DP73」(オリンパス株式会社)を用いた。
この工程における画像処理には、画像処理ソフトウェア「ImageJ」(オープンソース)を用いた。
(1‐2)において抗HER2ウサギモノクローナル抗体「4B5」を抗ERウサギポリクローナル抗体「ab180900、アブカム社」を用いる以外は、HER2と同様の方法によってERの免疫染色および発現状態の評価を行った。
実施例1および2の結果を表2-1および表2-2に示す。遺伝子が大きな変異をおこしている患者由来のPDXマウスの方が、投薬によるHER2タンパク質の減少率が大きいことが確認された。また、遺伝子情報との関連性が大きいと判断された患者A、B間、あるいは遺伝子情報との関連性が中程度とされた患者C、D間であっても、HER2の発現量(PIDスコア)の推移には若干の差が見られる。
さらにこのような遺伝情報、医薬情報、発現情報(PIDスコア)についての情報を集積し、他の患者の治療にあたっても当該患者の情報と蓄積された情報とを照合することで、当該患者においてもその医薬の有効性の有無を判断することができるという可能性を提示することができる。
肺がん患者4名(F、G、H、I)から採取した腫瘍組織について遺伝子解析を行ない、特定バイオマーカーとしてEGRFを特定した。さらに各患者に投薬を開始すると同時に腫瘍組織を採取し、当該腫瘍組織の2mm角をSCID(Sevefe Combined ImmunoDeficiency)マウスの皮下へ移植した(各患者の腫瘍組織に対してマウス5匹ずつ作製、計20匹)。腫瘍体積が約300mm3となった時点(移植約1か月後)から各マウスに、抗ヒトEGFRモノクローナル抗体医薬品であるゲフィチニブ(商品名;イレッサ(Iressa))100mg/kgを1日2回、計4回尾静脈内投与した。投与1日後および投与100日後のマウスから腫瘍組織を採取して評価準備-1と同様の手法を用いて標本スライドを作製した。
抗HER2ウサギモノクローナル抗体「4B5」(ベンタナ社)の代わりに、抗EGFRウサギモノクローナル抗体(clone「5B7」ロッシュ社)を用いる以外は、HER2と同様の方法によってEGFRの免疫染色を行ない、さらに観察・撮影・画像処理を行ってPIDスコアの平均値をそれぞれ算出するとともに、細胞内における局在状態に基づいて局在A~Cの3パターンに分類した。
(考察)
以上の結果から、薬剤耐性を引き起こした患者の腫瘍組織から作製したPDXマウスにおいては患者と同様に薬剤耐性が確認されることがわかる。このことから、候補となる治療薬を実際に患者に投与する前にPDXマウスに投与することで、患者が薬剤耐性を引き起こす可能性があるかどうかをあらかじめ予測することが可能となるのではないかと考えられる。また、薬剤耐性(医療情報)と特定バイオマーカーの発現を関連させた情報を集積することで、より短い日数で薬剤耐性が起きる可能性を予測することができるようになる。本実施例を例にあげると、100日後の時点でPDXマウスにおいて薬剤耐性が確認されず、特定バイオマーカー(EGFR)の局在が変化していなかったら薬剤耐性は発現しないことが期待できる。一方で、100日後の時点でPDXマウスにおいて薬剤耐性が確認されなかったとしても、特定バイオマーカーの局在(EGFR)が変化していたら薬剤耐性が起きる可能性があると予測され、患者においても同様に薬剤耐性が引き起こされると予測することができ、その時点で他の薬や治療法を選択するという決定が可能になり得る。
Claims (16)
- ヒトから採取した病変部である検体を用いて、特定バイオマーカーの発現状態の情報を含む1以上の情報を取得して、当該情報を治療の有効性の予測のために用いる方法。
- ヒトから採取した病変部の組織またはそれに由来する細胞を移植した実験動物の、当該移植部から採取した病変部である検体を用いて、特定バイオマーカーの発現状態の情報を含む1以上の情報を取得して、当該情報を治療の有効性の予測のために用いる方法。
- ヒトから採取した病変部である検体を用いて、特定バイオマーカーの発現状態の情報を含む1以上の情報を取得し、さらに当該ヒトから採取した病変部の組織またはそれに由来する細胞を移植した実験動物の、当該移植部から採取した病変部である検体を用いて、特定バイオマーカーの発現状態の情報を含む1以上の情報を取得し、取得された情報を組み合わせて治療の有効性の予測のために用いる方法。
- 遺伝子検査により、前記検体における遺伝子の変異情報を解析し、当該遺伝子の変異情報から前記特定バイオマーカーを特定する、請求項1または3に記載の方法。
- 前記治療が、特定バイオマーカーをターゲットとした薬剤である分子標的薬の投薬である請求項1~4のいずれか一項に記載の方法。
- 前記特定バイオマーカーが、免疫チェックポイントタンパク質、がん細胞増殖因子、がん細胞増殖因子受容体、細胞表面抗原、血管増殖因子、血管増殖因子受容体、サイトカインおよびサイトカイン受容体からなる群より選択される少なくとも1つである、請求項1~5のいずれか一項に記載の方法。
- 前記病変部が腫瘍である請求項1~6のいずれか一項に記載の方法。
- 前記特定バイオマーカーが、腫瘍組織に発現するタンパク質である、請求項1~7のいずれか一項に記載の方法。
- 前記分子標的薬が抗がん剤である請求項5~8のいずれか一項に記載の方法。
- 前記特定バイオマーカーの発現状態の情報が当該特定バイオマーカーの発現量および発現分布を含む、請求項1~9のいずれか一項に記載の方法。
- 前記特定バイオマーカーの発現状態の情報が画像情報によって取得される、請求項1~10のいずれか一項に記載の方法。
- 前記特定バイオマーカーの発現状態の情報が画像情報を解析することによって取得される、請求項1~11のいずれか一項に記載の方法。
- 前記画像情報が、蛍光ナノ粒子の輝点が表された蛍光画像である、請求項11または12に記載の方法。
- 前記画像情報が、蛍光ナノ粒子を用いた免疫染色法により取得される、請求項11~13のいずれか一項に記載の方法。
- 前記特定バイオマーカーが、リン酸化されるタンパク質である、請求項1~14のいずれか一項に記載の試験方法。
- 前記発現状態の情報が、検体中の血管占有率に関する情報を含む、請求項1~15のいずれか一項に記載の方法。
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JP2020169994A (ja) * | 2019-04-03 | 2020-10-15 | メクウィンズ, エセ.アー.Mecwins, S.A. | バイオマーカを光学的に検出するための方法 |
WO2024090265A1 (ja) * | 2022-10-28 | 2024-05-02 | 株式会社biomy | 情報処理装置、情報処理方法及びプログラム |
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CN115910214B (zh) * | 2022-10-13 | 2023-10-13 | 南京普恩瑞生物科技有限公司 | 一种利用肿瘤活组织生物样本库模拟临床试验评估抗肿瘤药物药效的方法及其应用 |
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JPWO2018164262A1 (ja) | 2020-01-09 |
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