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  • C12N2750/14011—Parvoviridae
  • C12N2750/14111—Dependovirus, e.g. adenoassociated viruses
  • C12N2750/14141—Use of virus, viral particle or viral elements as a vector
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Definitions

• the suspension comprises 6.4 c 10 11 GC/mL of the rAAV8.aVEGF.
• Uses of these compositions for treating a human having wet age-related macular degeneration are also provided.
• the patients are dosed with 1.6 x 10 11 GC of rAAV8.aVEGF/treated eye.
• the patients are dosed with 1 x 10 11 GC of rAAV8.aVEGF/treated eye.
• the vector genome packaged within the rAAV8 capsid comprises:
• a method for delivering an anti-hVEGF Fab to a patient having wet age-related macular degeneration involves subretinally injecting the patient's eye with the liquid suspension comprising the rAAV8 vector carrying the expression construct for the anti-hVEGF Fab (i.e., rAAV8. anti-hVEGF Fab or rAAV8.aVEGF).
• the invention provides a rAAV as described herein, or a liquid suspension, administrable subretinally to a patient.
• a rAAV or a liquid suspension, for subretinal administration to a patient is provided.
• the patient may have been previously diagnosed with wet age-related macular degeneration, or another ocular condition as defined herein.
• FIGs 4A - 4D show expression of anti- VEGF Fab in anterior chamber fluid and blood for animals in Groups 5 and 6 as described in Example 3 in which cynomolgus monkeys were administered a single dose of 1.00 c 10 11 GC/eye of AAV2/8 vectors into each eye subretinally. Anterior chamber fluid and blood were collected at prespecified timepoints. Expression of the anti-VEGF Fab was determined using enzyme-linked immunosorbent assay. The results for Group 5 are presented in FIGS 4A and 4B and the results for Group 6 is presented in FIGS 4C and 4D. In FIGS 4B and 4D, the horizontal line in the panel presenting the results in serum denotes baseline levels. Circles denote females and squares denote males.
• VEGF vascular endothelial growth factor
• VIT vitreous.
• FIG 21 provides a representative SD-OCT cross-section through the uninjected retina (solid white arrow on the left) of a vehicle injected eye compared to segments within injected retina without (dashed white arrow in the center) and with (dotted arrow on the right) obvious NIR hypo-autofluorescence on NIR-FAF. Colored segments superimposed on the NIR-FAF image denote the location segments shown in the SD-OCT cross-section (data not shown). This animal shown is a vehicle-injected control. See, Example 14 for more details.
• the light and heavy chain each contain a heterologous leader peptide which directs nascent peptide into appropriate cellular compartment where leader peptide is processed away from the mature protein by the host cellular machinery.
• leader peptide is processed away from the mature protein by the host cellular machinery.
• the anti-VEGF Fab contains no HC or LC leader sequences. See, e.g., SEQ ID NO: 33.
• the coding sequences for the heavy chain and light chain of anti- VEGFvl are provided in SEQ ID NO: 24. More particularly, the heavy chain variable region open reading frame (ORF) is provided in nucleotides (nt) 1843 to 2211 and the heavy chain constant region (CH1) ORF is provided in nt 2212-2532, with reference to SEQ ID NO: 24.
• the aVEGFvl heavy chain, without the leader has the nucleic acid sequence of nt 1843 to 2532.
• the light chain variable region (VL) ORF is provided in nt 2680 to 3000 and the light chain constant region (CL) is provided in nt 3001 to 3321 of SEQ ID NO: 24.
• the aVEGFv2 light chain, without the leader has the nucleic acid sequence of nt 2680 to 3321 of SEQ ID NO: 24.
• the coding sequences for the heavy and light chain of aVEGFvl2 is provided within SEQ ID NO: 43.
• the heavy chain leader sequence is encoded by nt 1993 - 2052
• the VH ORF is encoded by nt 2053 - 2421
• the CH1 is encoded by nt 2422 - 2742 of SEQ ID NO: 43.
• the light chain leader sequence is encoded by nt 2830 - 2889; the VL ORF is provided in nt 2890 - 3210; the CL ORF is located at nt 3211 - 3531 of SEQ ID NO: 43.
• the processing of anti-VEGF Fab heavy chain and light chains is directed by leader peptides that are derived from human IL2 protein.
• the leader sequence is an interleukin (IL) IL-2 leader sequence, which may be the wild-type human IL2, MYRMQLLSCIALSLALVTNS [SEQ ID NO: 29], or a mutated leader, such as MYRMQLLLLIALSLALVTN S [SEQ ID NO: 30] or MRMQLLLLIALSLALVTNS [SEQ ID NO: 31]
• a human serpinF 1 secretion signal may be used as leader peptides.
• Other leader sequences can be used, or other leaders exogenous to the heavy and light chain.
• AAV 8 capsid refers to the AAV 8 capsid having the amino acid sequence of GenBank accession: YP_077l80 (SEQ ID NO: 48) encoded by nucleic acid sequence of NCBI Reference Sequence: NC_00626l.1 (SEQ ID NO: 49), both of which are incorporated by reference herein. Some variation from this encoded sequence is encompassed by the present invention, which may include sequences having about 99% identity to the referenced amino acid sequence in GenBank accession: YP_077l80;
• bipolar cells preferentially targets bipolar cells. See, WO 2014/024282, which is incorporated herein by reference.
• Such patients may include those with Acute Lymphoblastic Leukemia (ALL), Acute Myeloid Leukemia (AML), Adrenocortical Carcinoma, Adrenocortical Carcinoma, AIDS-Related Cancers, Kaposi Sarcoma, AIDS-Related Lymphoma, Primary CNS Lymphoma, Anal Cancer, Appendix Cancer, Astrocytomas, Atypical Teratoid/Rhabdoid Tumor, Basal Cell Carcinoma of the Skin, Bladder Cancer, Bone Cancer (includes Ewing Sarcoma and Osteosarcoma and Malignant Fibrous Histiocytoma), Brain Tumors, Breast Cancer, Bronchial Tumors, Burkitt Lymphoma, Non-Hodgkin Lymphoma, Carcinoid Tumors, Carcinoma of Unknown Primary, Cardiac Tumors, Central Nervous System Atypical Teratoid/Rhabdoid Tumor, Embryonal Tumors, Germ
• the dose of rAAV8.aVEGF administered to a patient is about 3 x 10 9 GC/eye, about 1 x 10 10 GC/eye, about 6 x 10 10 GC/eye, about 1.6 x 10 11 GC/eye, or about 2.5 x 10 11 GC/eye.
• patients may receive an rAAV8.aVEGF by subretinal administration by a retinal surgeon under local anesthesia.
• the procedure may involve standard 3 port pars plana vitrectomy with a core vitrectomy followed by subretinal delivery into the subretinal space by a subretinal cannula (36 to 41 gauge).
• 100 to 150 microliters of rAAV8.aVEGF will be delivered.
• VA improvement in the affected eye e.g., fibrosis, atrophy, or retinal epithelial tear in the center of the fovea
• Clinical objectives are determined by measuring BCVA (Best-Corrected Visual Acuity), intraocular pressure, slit lamp biomicroscopy, indirect ophthalmoscopy, and/or SD- OCT (SD-Optical Coherence Tomography).
• clinical objectives are determined by measuring mean change from baseline in BCVA over time, measuring the gain or loss of >15 letters compared to baseline as per BCVA, measuring mean change from baseline in CRT as measured by SD-OCT over time, measuring mean number of ranibizumab rescue injections over time, measuring time to I st rescue ranibizumab injection, measuring mean change from baseline in CNV and lesion size and leakage area based on FA over time, measuring mean change from baseline in aqueous aVEGF protein over time, performing vector shedding analysis in serum and urine, and/or measuring immunogenicity to rAAV.
• aVEGF i.e., measuring Nabs to AAV, measuring binding antibodies to AAV, measuring antibodies to aVEGF, and/or performing ELISpot.
• (a) Expression of Transgene Product in Anterior Chamber Fluid The transgene product was not expressed in anterior chamber fluid of any animal administered FFB-314. The transgene product was expressed in anterior chamber fluid of all animals administered AAV8.aVEGF test vector. Onset of expression was rapid, generally within 7 days. Steady-state expression levels were achieved within 1 month. All animals continued to express the transgene product at steady-state levels until the last evaluated timepoint.
• Animals were administered AAV8.aVEGF test vector or FFB-314 (control article) subretinally as described earlier in this Example. No sustained lgM, lgG, or T-cell responses to the anti-VEGF Fab transgene product were observed in any animal. Animals administered 1.00 x 10 12 GC/eye AAV8.aVEGF test vector developed a higher neutralizing antibody (Nab) response to AAV8 capsid than animals administered 1.00 c 10 10 GC/eye
• Anti-VEGF Fab transgene product was expressed in all animals administered AAV8.aVEGF test vector (Example 6). There was no significant lgM against the Anti- VEGF Fab transgene product in serum or in anterior chamber fluid of animals administered FFB-314. IgG against the Anti-VEGF Fab transgene product above baseline level was not observed in animals administered FFB-314.
• T-cell responses to AAV8.aVEGF test vector were observed in 1 animal administered FFB-314 at a single timepoint. In 1 animal, non-specific T cell responses were observed at all timepoints.
• retinal bleb Site of subretinal administration is denoted by a retinal bleb, which can be visualized by SD OCT. In all SD OCT images, retinal blebs are visible.
• Each dosing cohort includes 5 subjects.
• Time to lst rescue ranibizumab injection Mean change from baseline in CNV and lesion size and leakage area based on FA over time
• This Phase I, open-label, multiple-cohort, dose-escalation study is designed to evaluate the safety and tolerability of rAAV8.aVEGF gene therapy in subjects with previously treated neovascular AMD (nAMD). Five doses are studied in approximately 30 subjects. Subjects who meet the inclusion/exclusion criteria and have an
• rAAV8.aVEGF test vector 4 weeks after the last subject is dosed. Subjects have 3 visits within the first 4 weeks after treatment with rAAV8.aVEGF test vector. Starting 4 weeks after rAAV8.aVEGF test vector administration, subjects may receive intravitreal ranibizumab rescue therapy at the clinician’s discretion if they meet predefined rescue injection criteria. Immunogenicity to the vector and transgene of rAAV8.aVEGF test vector is assessed throughout the study.
• Any condition preventing visual acuity improvement in the study eye e.g., fibrosis, atrophy, or retinal epithelial tear in the center of the fovea.
• Cell Media Harvesting Transfected cells and media are harvested from each HS-36 using disposable bioprocess bags by aseptically draining the medium out of the units.
• Diafiltration in TFF applications involves addition of a fresh buffer to the recirculating sample at the same rate that liquid is passing through the membrane and to the waste stream. With increasing volumes of diafiltration, increasing amounts of the small molecules are removed from the recirculating sample. This results in a modest purification of the clarified product, but also achieves buffer exchange compatible with the subsequent affinity column chromatography step. Accordingly, a 100 kDa, PES membrane is used for concentration that is then diafiltered with a minimum of 4 diavolumes of a buffer composed of: 20 mM Tris pH 7.5 and 400 mM NaCl. The diafiltered product is stored overnight at 4°C and then further clarified with a 1.2/0.22 pm depth filter capsule to remove any precipitated material.
• Endotoxin Testing This assay is performed according to USP ⁇ 85>.
• In vitro Assay for Adventitious Agents The purpose of the in vitro assay for viral contaminants is to detect possible adventitious viruses introduced during AAV8.AMD vector production and is based upon CBER’s 1993 Points to Consider and ICH Q5A.
• the in vitro assays use 3 indicator cell lines - human diploid lung (MRC-5) cells, African green monkey kidney (Vero) cells, and human foreskin fibroblast (Hs68) cells.
• Assay endpoints are observation of cytopathic effects (CPE) over a course of at least 28 days as well as hemadsorption at the end of the assay period, which facilitates the detection of a broad range of viruses.
• CPE cytopathic effects
• Vector Genome Identity DNA Sequencing: Viral Vector genomic DNA is isolated and the sequence determined by 2-fold sequencing coverage using primer walking. Sequence alignment is performed and compared to the expected sequence.
• Vector Capsid Identity AAV Capsid Mass spectrometry of VP1 : Confirmation of the AAV2/8 serotype of the drug product is achieved by an assay based upon analysis of peptides of the AAV capsid protein.
• EXAMPLE 13 Safety of Subretinal Delivery of AAV8-anti-VEGF Fab in the Non- Non- Human Primate as Assessed by Full-Field ERG.

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