WO2020190902A1 - Récepteurs antigéniques chimériques à infiltration tumorale améliorée - Google Patents
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Classifications
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- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
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- C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
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- C07K2319/33—Fusion polypeptide fusions for targeting to specific cell types, e.g. tissue specific targeting, targeting of a bacterial subspecies
Definitions
- Suppressive tumor microenvironment contains not only suppressive immune effectors but also soluble mediators that inhibit cytotoxic lymphocytes. These barriers are able to prevent T and NK cells migration into tumor tissue, which is the major challenge for CAR-T targeting solid tumor antigens. Strategies to overcome this hurdle should aim to develop new CAR-T constructs that can attract and activate immune effectors within the tumor tissue.
- infiltrating lymphocytes (T and NK) within tumor tissue are absent of CX3CR1 , a key chemokine receptor specific for lymphocytes. Therefore, disclosed herein are chimeric antigen receptor in which the activating receptor NKG2D is fused to the CD3 z-chain of the T-cell receptor and 41 BB active signaling domain as well as co-expression of CX3CR1 , in order to enhance the infiltration of CAR-T cells into the tumor tissue. Also disclosed herein are CAR-T cells that co-express IL-15 in order to activate infiltration of NK cell. In some embodiments, the disclosed CAR-T cells express both CX3CR1 and IL-15 in combination with the CAR polypeptide.
- the disclosed CAR-T cells further express EGFR in combination with the CAR polypeptide.
- isolated nucleic acid sequences encoding chimeric antigen receptor (CAR) polypeptides as well as CX3CR1 , IL-15, EGFR, or a combination thereof.
- vectors comprising these isolated nucleic acids, and cells containing these vectors.
- the cell can be an immune effector cell selected from the group consisting of an alpha-beta T cells, a gamma-delta T cell, a Natural Killer (NK) cells, a Natural Killer T (NKT) cell, a B cell, an innate lymphoid cell (ILC), a cytokine induced killer (CIK) cell, a cytotoxic T lymphocyte (CTL), a lymphokine activated killer (LAK) cell, and a regulatory T cell.
- an immune effector cell selected from the group consisting of an alpha-beta T cells, a gamma-delta T cell, a Natural Killer (NK) cells, a Natural Killer T (NKT) cell, a B cell, an innate lymphoid cell (ILC), a cytokine induced killer (CIK) cell, a cytotoxic T lymphocyte (CTL), a lymphokine activated killer (LAK) cell, and a regulatory T cell.
- NK Natural Kill
- the disclosed CAR polypeptides contain in an ectodomain a ligand binding domain.
- the disclosed polypeptides can also contain a transmembrane domain and an endodomain capable of activating an immune effector cell.
- the endodomain can contain an intracellular signaling domain and optionally one or more co-stimulatory signaling regions.
- the ligand binding domain is in some embodiments an antibody fragment that specifically binds a tumor molecule, such as a tumor antigen or receptor.
- the antigen binding domain can be a Fab, a single-chain variable fragment (scFv), or a single-domain antibody (sdAb) of an antibody that specifically binds the tumor molecule.
- the ligand binding domain is in some embodiments an aptamer. Peptide aptamers can be selected, for example, from a random sequence pool based on its ability to bind the tumor molecule.
- ligand binding domain is an antibody fragment that specifically binds Glypcan-3 (GPC3).
- the ligand binding domain is an NKG2D decoy comprising a NKG2D protein, or a polypeptide comprising at least a portion of the extracellular domain of NKG2D, that is capable of binding induced-self proteins from MIC and RAET1/ULBP families.
- the cell exhibits an anti-tumor immunity when the antigen binding domain of the CAR binds to a tumor.
- Also disclosed is a method of providing an anti-tumor immunity in a subject that involves administering to the subject an effective amount of an immune effector cell expressing the CAR polypeptide with CX3CR1 , IL-15, or a combination thereof.
- FIG. 1 is an illustration of an embodiment CAR-T cell expressing an anti-GPC CAR, CX3R1 , and IL15. Although not shown, the CAR-T cell can also express EGFR.
- FIGs. 2A to 2C are illustrations of GPC3 CAR constructs GPC3- EGFR-IL15 (FIG. 2A), GPC3-EGFR-CXCR1 (FIG. 2B), and GPC3-EGFR-IL15- CX3CR1 (FIG. 2C).
- FIGs. 3A and 3B show GPC3 expression in HCC (FIG. 3A) and survival analysis in HCC patients as a function of GPC3 expression (FIG. 3B).
- mRNA study and IHC comparing normal liver and human HCC found that, although GPC3 is not expressed in the liver, the expression of this glypican is up-regulated in the majority of tumors (FIG. 3A). Also, GPC3 serum levels were significantly higher in patients with HCC than in non-HCC subjects (from 53%-93%).
- HCC patients with high GPC3 expression had a significantly shorter overall survival time than HCC patients with low GPC3 expression, and the risk of metastasis/recurrence after liver resection or liver transplant was increased up to three fold as compared to that of an HCC patient with low GPC3 expression (FIG. 3B).
- FIG. 4 is an illustration of GPC3 receptor signaling, which promotes cell proliferation through different signaling pathways in HCC by facilitating interactions of growth factors and receptors.
- FIG. 5 shows GPC3 surface expression in liver cancer cell lines.
- FIGs. 6A to 6F show GPC3-CX3CR1 or GPC3-IL-15 CAR-T cells effectively kill GPC3+ liver cancer cells in vitro.
- FIG. 7 shows that GPC3-CX3CR1 CAR-T cells effectively kill GPC3+ liver cancer cells in vivo in a human xenograft mouse model. Shown are images of luciferase demonstrating GPC3/CX3CR1 CAR-T can suppress tumor growth in human xenograft model bearing HepG2 cells.
- FIGs. 8A and 8B show GPC3-CX3CR1 CAR-T effectively kill GPC3+ liver cancer cells in vivo in human xenografts mouse model when compared with untransduced T cells.
- the killing efficacy is showed by mean of lumninoscores of 5 mice.
- FIGs. 9A and 9B show GPC3-IL15 or GPC3-CX3CR1 CAR-T specifically stimulate CAR-T proliferation in exposure of GPC3+ target cells.
- FIG. 10 is an illustration of an embodiment CAR-T cell expressing an anti-NKG2D CAR, CX3R1 , and IL15. Although not shown, the CAR-T cell can also express EGFR.
- FIGs. 11A to 11C are illustrations of NKG2D CAR constructs NKG2D- IL15 (FIG. 11A), NKG2D-CXCR1 (FIG. 11 B), and N KG2 D- 1 L15-CX3C R 1 (FIG. 11C).
- FIGs. 12A to 12D show effects of NKG2D-IL15 and NKG2D-CXCR1 CAR constructs on effector T cell proliferation after 5 (FIG. 12A), 10 (FIG.12B), 20 (FIG. 12C), and 30 days (FIG. 12D).
- EGFR expression was used to detect CAR levels.
- CX3CR1 CAR out grows untransduced cells, after 30 days expands to 80% of cell culture (unsorted cells).
- FIG. 13 shows EGFR and NKG2D expression in untransfected cells, NKG2D-IL15 CARs, and NKG2D-CXCR1 CAR T cells.
- FIGs. 14A to 14D show effects of NKG2D-IL15 (FIGs. 14A, 14C) and NKG2D-CXCR1 constructs (FIG. 14B, 14D) on HepG2 (FIG. 5A, 5B) and Huh7 (FIG. 14C, 14D) liver cancer cells in vitro.
- FIGs. 15A to 15D show effects of NKG2D-IL15 (FIGs. 15A, 15C) and NKG2D-CXCR1 constructs (FIG. 15B, 15D) on A549-CX3CL1 (FIG. 15A, 15B) and A549-Scr (FIG. 15C, 15D) lung cancer cells in vitro.
- FIG. 16A and 16B show effect of presorted NKG2D-CX3CR1 CAR-T cells on Huh7 (FIG. 16A) and HepG2 (FIG. 16B) liver cancer killing in vitro.
- FIG. 17A and 17B show comparison of NKG2D-IL15 and NKG2D- CXCR1 CAR constructs.
- FIG. 17A shows NKG2D-CX3CR1 CAR-T killed most of liver cancer cells after 5 days while NKG2D-IL15 CAR-T hasn’t reached plateau after 8 days.
- FIG. 17B shows NKG2D-CX3CR1 CAR-T, at low Effector: Target (E:T) ratio, responses and proliferates better upon cancer cells recognition and killing, showed by percentage of CAR-positive T cells (EGFR+) proliferated to 30% of total cells (10% initial).
- E:T Effector: Target
- FIG. 18 shows that in tumor bearing mice lymphocytes cannot migrate into tumor tissue but can be present in the peripheral blood, liver and spleen suggesting that tumor microenvironment has a decreased lymphocyte infiltration ability.
- FIG. 19 shows lymphocytes failing to migrate into the tumor bed in lung cancer xenograft model.
- FIG. 20 shows role of IL-15 in lymphocyte survival after injection in lung cancer xenograft model.
- FIG. 21 shows an immunophenotypic analysis of immune populations in the lung tumor microenvironment. In particular tumor as well as surrounding tissue was obtained from patients and immune populations isolated for flow cytometric analysis.
- FIGs. 22A to 22D show functional cytotoxic cells are excluded from tumor bed.
- FIGs. 22A and 22B show the immunoprofiling of lymphocytes in different areas (normal (N), adjacent (A) and tumor (T)) demonstrating that all activating receptors are downregulated while immunecheckpoint proteins/inhibitary receptors are upregulated.
- CX3CR1 which is known as a lymphocyte
- FIG. 22C shows that in histological staining there is a decrease of cytotoxic cell infiltration at the tumor site.
- FIG. 22D shows flow cytometric analysis indicating that lymphocyte infiltration is decreased in the tumor while there few remaining in the tumor are suppressive cells like Tregs.
- FIG. 23A shows a detailed analysis of downregulation of CX3CR1 in different effector lymphocytes subpopulation.
- FIG. 23B shows TCGA database analysis looking at the survival in patients separating for CX3CR1 and NKG2D high versus low patients, suggesting that cytotoxic lymphocytes with high
- CX3CR1 expression has a better survival.
- FIGs. 24A and 24B show functional comparison of NKG2D CARTs in vitro.
- A549 lung cancer cell line and Huh 7 cancer cells were incubated with both GPC3 and NKG2D CAR-T.
- the NKG2D constructs were the best and GPC3 car-T is unable to kill lung cancer cells.
- FIGs. 25A and 25B show activation (IFN production, FIG. 25A) and proliferation (FIG. 25B).
- FIGs. 26A to 26C show characterization of Car-T cells with increased immunecheckpoint proteins.
- FIG. 27 shows characterization of Car-T cells with increased immunecheckpoint proteins.
- FIGs. 28A to 28C show in vivo characterization of CAR-T cells from the HepG2 xenograft model demonstrating that there is an increased circulating Car- T population in blood (FIG. 28A), spleen (FIG. 28B), and liver (FIG. 28C).
- FIGs. 29A and 29B show increased tumor on site trafficking of Car-T cells into the xenografted tumor.
- FIG. 29 A shows histology staining for human lymphocytes.
- FIG. 29B shows the calculation of the density of infiltrating lymphocytes in each individual mice and summary data compared with control group.
- FIG. 30 shows CAR-T isolated from the tumor bearing mice retain their killing effect in vitro against the same tumor as the model.
- FIGs. 31A to 31C show CAR-T function in vivo in a liver model.
- 1x10 6 HepG2-Luc cells were used to establish liver cancer model in NSG mice.
- 5x10 6 NKG2D Car-T cells as indicated were injected via tail vein to establish a HepG2 tumor bearing mice.
- the tumor size was determined by luciferase induced image indicating Car-T effectively reduced tumor size (FIG. 31 A and 31 B).
- the overall survival (OS) were significantly prolonged in NKG2D-CX3CR1 Car-T treated group (FIG. 31C).
- FIGs. 32A to 32C show that CAR-T cells were able to maintain up to two month after the initial injection in vivo as monitored by EGFR staining.
- EGFR is a biomarker for human Car-T cells.
- FIGs. 33A to 33C show the therapeutic effect of NKG2D-CX3CR1 CAR-T constructs in vivo using a lung cancer (A549-Luc) xenograft model.
- FIG. 33A shows the schematics of the experimental design. 1x10 6 A549-Luc were used to establish the tumor in vivo. 5x10 6 CAR-T cells as indicated were injected via tail vein into the tumor bearing mice. The tumor size was determined by luciferase induced image indicating CAR-T effectively reduced tumor size (FIG. 33B). The results show the NKG2D-CX3CR1 CAR-T has the best effect in reduction of the tumor size and tumor were unable detectable in two of the mice after 8 weeks (FIG. 33C, indicated by arrow).
- FIG. 34A to 34C show best results occurred in week nine.
- FIGs. 35A to 35G show that there is an increased CX3CR1 expression in NKG2D-CX3CR1 CAR-T cells isolated from peripheral blood by monitoring EGFR/CX3CR1 double positive.
- Embodiments of the present disclosure will employ, unless otherwise indicated, techniques of chemistry, biology, and the like, which are within the skill of the art.
- amino acid sequence refers to a list of abbreviations, letters, characters or words representing amino acid residues.
- the amino acid abbreviations used herein are conventional one letter codes for the amino acids and are expressed as follows: A, alanine; B, asparagine or aspartic acid; C, cysteine; D aspartic acid; E, glutamate, glutamic acid; F, phenylalanine; G, glycine; H histidine; I isoleucine; K, lysine; L, leucine; M, methionine; N, asparagine; P, proline; Q, glutamine; R, arginine; S, serine; T, threonine; V, valine; W, tryptophan; Y, tyrosine;
- the term“antibody” refers to an immunoglobulin, derivatives thereof which maintain specific binding ability, and proteins having a binding domain which is homologous or largely homologous to an immunoglobulin binding domain. These proteins may be derived from natural sources, or partly or wholly synthetically produced.
- An antibody may be monoclonal or polyclonal.
- the antibody may be a member of any immunoglobulin class from any species, including any of the human classes: IgG, IgM, IgA, IgD, and IgE.
- antibodies used with the methods and compositions described herein are derivatives of the IgG class.
- fragments or polymers of those immunoglobulin molecules, and human or humanized versions of immunoglobulin molecules that selectively bind the target antigen are fragments or polymers of those immunoglobulin molecules, and human or humanized versions of immunoglobulin molecules that selectively bind the target antigen.
- aptamer refers to oligonucleic acid or peptide molecules that bind to a specific target molecule. These molecules are generally selected from a random sequence pool. The selected aptamers are capable of adapting unique tertiary structures and recognizing target molecules with high affinity and specificity.
- A“nucleic acid aptamer” is a DNA or RNA oligonucleic acid that binds to a target molecule via its conformation, and thereby inhibits or suppresses functions of such molecule.
- a nucleic acid aptamer may be constituted by DNA, RNA, or a combination thereof.
- A“peptide aptamer” is a combinatorial protein molecule with a variable peptide sequence inserted within a constant scaffold protein. Identification of peptide aptamers is typically performed under stringent yeast dihybrid conditions, which enhances the probability for the selected peptide aptamers to be stably expressed and correctly folded in an intracellular context.
- carrier means a compound, composition, substance, or structure that, when in combination with a compound or composition, aids or facilitates preparation, storage, administration, delivery, effectiveness, selectivity, or any other feature of the compound or composition for its intended use or purpose.
- a carrier can be selected to minimize any degradation of the active ingredient and to minimize any adverse side effects in the subject.
- chimeric molecule refers to a single molecule created by joining two or more molecules that exist separately in their native state.
- the single, chimeric molecule has the desired functionality of all of its constituent molecules.
- chimeric molecules One type of chimeric molecules is a fusion protein.
- fusion protein refers to a polypeptide formed by the joining of two or more polypeptides through a peptide bond formed between the amino terminus of one polypeptide and the carboxyl terminus of another polypeptide.
- the fusion protein can be formed by the chemical coupling of the constituent polypeptides or it can be expressed as a single polypeptide from nucleic acid sequence encoding the single contiguous fusion protein.
- a single chain fusion protein is a fusion protein having a single contiguous polypeptide backbone. Fusion proteins can be prepared using conventional techniques in molecular biology to join the two genes in frame into a single nucleic acid, and then expressing the nucleic acid in an appropriate host cell under conditions in which the fusion protein is produced.
- identity refers to sequence identity between two nucleic acid molecules or polypeptides. Identity can be determined by comparing a position in each sequence which may be aligned for purposes of comparison. When a position in the compared sequence is occupied by the same base, then the molecules are identical at that position. A degree of similarity or identity between nucleic acid or amino acid sequences is a function of the number of identical or matching nucleotides at positions shared by the nucleic acid sequences.
- Various alignment algorithms and/or programs may be used to calculate the identity between two sequences, including FASTA, or BLAST which are available as a part of the GCG sequence analysis package (University of Wisconsin, Madison, Wis.), and can be used with, e.g., default setting.
- FASTA Altschul et al.
- BLAST Garnier et al.
- polypeptides having at least 70%, 85%, 90%, 95%, 98% or 99% identity to specific polypeptides described herein and preferably exhibiting substantially the same functions, as well as polynucleotide encoding such polypeptides are contemplated. Unless otherwise indicated a similarity score will be based on use of BLOSUM62.
- BLASTP When BLASTP is used, the percent similarity is based on the BLASTP positives score and the percent sequence identity is based on the BLASTP identities score.
- BLASTP“Identities” shows the number and fraction of total residues in the high scoring sequence pairs which are identical; and BLASTP“Positives” shows the number and fraction of residues for which the alignment scores have positive values and which are similar to each other.
- Amino acid sequences having these degrees of identity or similarity or any intermediate degree of identity of similarity to the amino acid sequences disclosed herein are contemplated and encompassed by this disclosure.
- the polynucleotide sequences of similar polypeptides are deduced using the genetic code and may be obtained by conventional means, in particular by reverse translating its amino acid sequence using the genetic code.
- nucleic acid refers to a natural or synthetic molecule comprising a single nucleotide or two or more nucleotides linked by a phosphate group at the 3’ position of one nucleotide to the 5’ end of another nucleotide.
- the nucleic acid is not limited by length, and thus the nucleic acid can include
- DNA deoxyribonucleic acid
- RNA ribonucleic acid
- operably linked to refers to the functional relationship of a nucleic acid with another nucleic acid sequence. Promoters, enhancers,
- transcriptional and translational stop sites are examples of nucleic acid sequences operably linked to other sequences.
- operable linkage of DNA to a transcriptional control element refers to the physical and functional relationship between the DNA and promoter such that the transcription of such DNA is initiated from the promoter by an RNA polymerase that specifically recognizes, binds to and transcribes the DNA.
- pharmaceutically acceptable refers to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problems or complications commensurate with a reasonable benefit/risk ratio.
- protein domain refers to a portion of a protein, portions of a protein, or an entire protein showing structural integrity; this determination may be based on amino acid composition of a portion of a protein, portions of a protein, or the entire protein.
- A“spacer” as used herein refers to a peptide that joins the proteins comprising a fusion protein. Generally a spacer has no specific biological activity other than to join the proteins or to preserve some minimum distance or other spatial relationship between them. However, the constituent amino acids of a spacer may be selected to influence some property of the molecule such as the folding, net charge, or hydrophobicity of the molecule.
- a specified ligand or antibody“specifically binds” to its particular“target” e.g. an antibody specifically binds to an endothelial antigen
- a first molecule that“specifically binds” a second molecule has an affinity constant (Ka) greater than about 10 5 M- 1 (e.g., 10 6 IVM, 10 7 IVM, 10 8 IVM, 10 9 IVM, 10 10 IVM, 10 11 IVM, and 10 12 IVM or more) with that second molecule.
- Ka affinity constant
- the term“specifically deliver” as used herein refers to the preferential association of a molecule with a cell or tissue bearing a particular target molecule or marker and not to cells or tissues lacking that target molecule. It is, of course, recognized that a certain degree of non-specific interaction may occur between a molecule and a non- target cell or tissue. Nevertheless, specific delivery, may be distinguished as mediated through specific recognition of the target molecule.
- the term“subject” refers to any individual who is the target of administration or treatment.
- the subject can be a vertebrate, for example, a mammal.
- the subject can be a human or veterinary patient.
- patient refers to a subject under the treatment of a clinician, e.g., physician.
- the term“therapeutically effective” refers to the amount of the composition used is of sufficient quantity to ameliorate one or more causes or symptoms of a disease or disorder. Such amelioration only requires a reduction or alteration, not necessarily elimination.
- transformation and“transfection” mean the introduction of a nucleic acid, e.g., an expression vector, into a recipient cell including introduction of a nucleic acid to the chromosomal DNA of said cell.
- treatment refers to the medical management of a patient with the intent to cure, ameliorate, stabilize, or prevent a disease, pathological condition, or disorder.
- This term includes active treatment, that is, treatment directed specifically toward the improvement of a disease, pathological condition, or disorder, and also includes causal treatment, that is, treatment directed toward removal of the cause of the associated disease, pathological condition, or disorder.
- this term includes palliative treatment, that is, treatment designed for the relief of symptoms rather than the curing of the disease, pathological condition, or disorder; preventative treatment, that is, treatment directed to minimizing or partially or completely inhibiting the development of the associated disease, pathological condition, or disorder; and supportive treatment, that is, treatment employed to supplement another specific therapy directed toward the improvement of the associated disease, pathological condition, or disorder.
- variant refers to an amino acid or peptide sequence having conservative amino acid substitutions, non-conservative amino acid subsitutions (i.e. a degenerate variant), substitutions within the wobble position of each codon (i.e.
- DNA and RNA encoding an amino acid, amino acids added to the C-terminus of a peptide, or a peptide having 60%, 70%, 80%, 90%, 95%, 96%, 97%, 98%, 99% sequence identity to a reference sequence.
- the term“vector” refers to a nucleic acid sequence capable of transporting into a cell another nucleic acid to which the vector sequence has been linked.
- the term“expression vector” includes any vector, (e.g., a plasmid, cosmid or phage chromosome) containing a gene construct in a form suitable for expression by a cell (e.g., linked to a transcriptional control element).
- CAR-T cells that co-express CX3CR1 to enhance the infiltration of CAR-T cells into the tumor tissue.
- CAR-T refers to any immune effector cell engineered to express a chimeric antigen receptor.
- the cell can be an immune effector cell selected from the group consisting of an alpha-beta T cells, a gamma-delta T cell, a Natural Killer (NK) cells, a Natural Killer T (NKT) cell, a B cell, an innate lymphoid cell (ILC), a cytokine induced killer (CIK) cell, a cytotoxic T lymphocyte (CTL), a lymphokine activated killer (LAK) cell, and a regulatory T cell.
- an immune effector cell selected from the group consisting of an alpha-beta T cells, a gamma-delta T cell, a Natural Killer (NK) cells, a Natural Killer T (NKT) cell, a B cell, an innate lymphoid cell (ILC), a cytokine induced killer (CIK) cell, a cytotoxic T lymphocyte (CTL), a lymphokine activated killer (LAK) cell, and a regulatory T cell.
- NK Natural Kill
- CAR-T cells that co-express IL-15 in order to activate infiltration of NK cell.
- the disclosed CAR-T cells express both CX3CR1 and IL-15 in combination with the CAR polypeptide.
- the disclosed CAR-T cells further express EGFR in combination with the CAR polypeptide. Therefore, also disclosed are methods for providing an anti tumor immunity in a subject that involves adoptive transfer of the disclosed CAR-T cells.
- the CX3CR1 comprises an amino acid sequence:
- the CX3CR1 is encoded by the nucleic acid sequence:
- the IL-15 comprises an amino acid sequence: MYRMQLLSCIALSLALVTNSGANWVNVISDLKKIEDLIQSMHIDATLYTESDVHPSCK VTAMKCFLLELQVISLESGDASIHDTVENLIILANNSLSSNGNVTESGCKECEELEEK NIKEFLQSFVHIVQMFINTSE (SEQ ID NO:3).
- the IL15 is encoded by the nucleic acid sequence:
- the EGFR comprises an amino acid sequence: WLQSLLLLGTVACSISRKVCNGIGIGEFKDSLSINATNIKHFKNCTSISGDLHILPVAFR GDSFTHTPPLDPQELDILKTVKEITGFLLIQAWPENRTDLHAFENLEIIRGRTKQHGQ FSLAVVSLNITSLGLRSLKEISDGDVIISGNKNLCYANTINWKKLFGTSGQKTKIISNR GENSCKATGQVCHALCSPEGCWGPEPRDCVSCRNVSRGRECVDKCNLLEGEPRE FVENSECIQCHPECLPQAMNITCTGRGPDNCIQCAHYIDGPHCVKTCPAGVMGENN TLVWKYADAGHVCHLCHPNCTYGCTGPGLEGCPTNGPKIPSIATGMVGALLLLLVV ALGIGLFMP (SEQ ID NO:5).
- the EGFR is encoded by the nucleic acid sequence:
- the CAR polypeptide in the disclosed compositions and methods is generally made up of three domains: an ectodomain, a transmembrane domain, and an endodomain.
- the ectodomain comprises the ligand binding domain and is responsible for antigen recognition. It also optionally contains a signal peptide (SP) so that the CAR can be glycosylated and anchored in the cell membrane of the immune effector cell.
- SP signal peptide
- the transmembrane domain (TD) is as its name suggests, connects the ectodomain to the endodomain and resides within the cell membrane when expressed by a cell.
- the endodomain is the business end of the CAR that transmits an activation signal to the immune effector cell after antigen recognition.
- the endodomain can contain an intracellular signaling domain (ISD) and a co-stimulatory signaling region (CSR).
- ISD intracellular signaling domain
- CSR co-stimulatory signaling region
- the ligand binding domain specifically binds GPC3 on tumor cells.
- the anti-GPC3 region of the disclosed antibody or CAR is derived from hybridoma HN3, or combinations thereof.
- the anti-GPC3 region e.g. sdAb
- VH variable heavy domain having CDR1 , CDR2 and CDR3 sequences.
- the anti-GPC3 sdAb comprises the amino acid sequence:
- the anti-GPC3 sdAb is encoded by the nucleic acid sequence:
- the ligand binding domain is an NKG2D decoy.
- NKG2D is a major recognition receptor for the detection and elimination of transformed and infected cells as its ligands are induced during cellular stress, either as a result of infection or genomic stress such as in cancer. All NKG2D ligands are homologous to MHC class I molecules and are divided into two families: MIC and
- RAET1/ULBP Human MIC genes are located within the MHC locus and are composed of seven members (MICA-G), of which only MICA and MICB produce functional transcripts. In mice, MIC genes are absent. Among ten known human
- RAET1/ULBP genes six encode functional proteins: RAET1 E/ULBP4,
- RAET1G/ULBP5 RAET1 H/ULBP2, RAET1/ULBP1 , RAET1 L/ULBP6,
- RAET1 N/ULBP3 proteins from orthologous RAET1/ULBP family fall into three subfamiles: Rae-1 , H60, and MULT-1.
- the NKG2D decoy can be any mammalian NKG2D protein, but is preferably a human NKG2D protein.
- the protein sequence for NKG2D is known in the art.
- the ectodomain of NKG2D comprises an amino acid sequence having at least 65%, 70%, 71 %, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81 %, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%,
- NKG2D decoys based, for example, on human NKG2D ectodomain are known in the art and include those described in WO2017083545,
- the ectodomain of NKG2D comprises an amino acid sequence having at least 65%, 70%, 71 %, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81 %, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%,
- the ectodomain of NKG2D comprises an amino acid sequence having at least 65%, 70%, 71 %, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81 %, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%,
- the ectodomain of NKG2D comprises an amino acid sequence having at least 65%, 70%, 71 %, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81 %, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%,
- the ectodomain of NKG2D comprises an amino acid sequence having at least 65%, 70%, 71 %, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81 %, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%,
- an ectodomain of murine NKG2D comprises an amino acid sequence having at least 65%, 70%, 71%, 72%, 73%, 74%, 75%,
- an ectodomain of murine NKG2D comprises an amino acid sequence having at least 65%, 70%, 71%, 72%, 73%, 74%, 75%,
- an ectodomain of murine NKG2D comprises an amino acid sequence having at least 65%, 70%, 71%, 72%, 73%, 74%, 75%,
- the NKG2D decoy comprises at least two NKG2D monomers. In some embodiments the NKG2D decoy is in a multimeric form.
- the NKG2D decoy can include NKG2D monomers multimerized by linear concatenation, by ferritinbased multimerization, by coiled-coil multimerization, etc.
- the ligand binding domain recognizes a tumor-associated antigens (TAA).
- TAA tumor-associated antigens
- Tumor antigens are proteins that are produced by tumor cells that elicit an immune response, particularly T-cell mediated immune responses.
- the additional antigen binding domain can be an antibody or a natural ligand of the tumor antigen. The selection of the additional antigen binding domain will depend on the particular type of cancer to be treated.
- Tumor antigens are well known in the art and include, for example, a glioma-associated antigen, carcinoembryonic antigen (CEA), EGFRvlll, IL-IIRa, IL-13Ra, EGFR, FAP, B7H3, Kit, CA LX, CS-1 , MUC1 , BCMA, bcr-abl, HER2, b-human chorionic gonadotropin, alphafetoprotein (AFP),
- CEA carcinoembryonic antigen
- EGFRvlll IL-IIRa
- IL-13Ra IL-13Ra
- FAP B7H3, Kit
- CA LX CA LX
- CS-1 MUC1
- BCMA BCMA
- bcr-abl HER2
- HER2 b-human chorionic gonadotropin
- alphafetoprotein (AFP) alphafetoprotein
- the tumor antigen is selected from the group consisting of folate receptor (FRa), mesothelin, EGFRvlll, IL-13Ra, CD123, CD19, TIM3, BCMA, GD2, CLL-1 , CA-IX, MUCI, HER2, and any combination thereof.
- tumor antigens include the following:
- Differentiation antigens such as tyrosinase, TRP-1 , TRP-2 and tumor-specific multilineage antigens such as MAGE-1 , MAGE-3, BAGE, GAGE-1 , GAGE-2, pi 5; overexpressed embryonic antigens such as CEA; overexpressed oncogenes and mutated tumor-suppressor genes such as p53, Ras, HER-2/neu; unique tumor antigens resulting from chromosomal translocations; such as BCR-ABL, E2A-PRL, H4-RET, IGH-IGK, MYL-RAR; and viral antigens, such as the Epstein Barr virus antigens EBVA and the human papillomavirus (HPV) antigens E6 and E7.
- Epstein Barr virus antigens EBVA Epstein Barr virus antigens EBVA and the human papillomavirus (HPV) antigens E6 and E7.
- TLP TPS
- GPC3 MUC16
- LMP1 EBMA-1
- BARF-1 CS1
- CD319 HER1
- B7H6, L1CAM IL6, and MET.
- the disclosed polypeptides can also contain a transmembrane domain and an endodomain capable of activating an immune effector cell.
- the endodomain can contain a signaling domain and one or more co-stimulatory signaling regions.
- the intracellular signaling domain is a CD3 zeta (O ⁇ 3z) signaling domain.
- the costimulatory signaling region comprises the cytoplasmic domain of CD28, 4-1 BB, or a combination thereof. In some cases, the costimulatory signaling region contains 1 , 2, 3, or 4 cytoplasmic domains of one or more intracellular signaling and/or costimulatory molecules. In some embodiments, the co-stimulatory signaling region contains one or more mutations in the cytoplasmic domains of CD28 and/or 4-1 BB that enhance signaling.
- the CAR can be a TRUCK, Universal CAR, Self-driving CAR, Armored CAR, Self-destruct CAR, Conditional CAR, Marked CAR, TenCAR, Dual CAR, or sCAR.
- TRUCKS T cells redirected for universal cytokine killing
- CAR chimeric antigen receptor
- Cytokine expression may be constitutive or induced by T cell activation.
- CAR chimeric antigen receptor
- CAR specificity localized production of pro-inflammatory cytokines recruits endogenous immune cells to tumor sites and may potentiate an antitumor response.
- Universal, allogeneic CAR T cells are engineered to no longer express endogenous T cell receptor (TCR) and/or major histocompatibility complex (MHC) molecules, thereby preventing graft-versus-host disease (GVHD) or rejection, respectively.
- TCR T cell receptor
- MHC major histocompatibility complex
- CAR T cells engineered to be resistant to immunosuppression may be genetically modified to no longer express various immune checkpoint molecules (for example, cytotoxic T lymphocyte-associated antigen 4 (CTLA4) or programmed cell death protein 1 (PD1)), with an immune checkpoint switch receptor, or may be administered with a monoclonal antibody that blocks immune checkpoint signaling.
- CTL4 cytotoxic T lymphocyte-associated antigen 4
- PD1 programmed cell death protein 1
- a self-destruct CAR may be designed using RNA delivered by electroporation to encode the CAR.
- inducible apoptosis of the T cell may be achieved based on ganciclovir binding to thymidine kinase in gene-modified lymphocytes or the more recently described system of activation of human caspase 9 by a small-molecule dimerizer.
- a conditional CAR T cell is by default unresponsive, or switched‘off’, until the addition of a small molecule to complete the circuit, enabling full transduction of both signal 1 and signal 2, thereby activating the CAR T cell.
- T cells may be engineered to express an adaptor-specific receptor with affinity for subsequently administered secondary antibodies directed at target antigen.
- Marked CAR T cells express a CAR plus a tumor epitope to which an existing monoclonal antibody agent binds. In the setting of intolerable adverse effects, administration of the monoclonal antibody clears the CAR T cells and alleviates symptoms with no additional off-tumor effects.
- TanCAR T cell expresses a single CAR consisting of two linked antibody fragments that have different affinities fused to intracellular co stimulatory domain(s) and a ⁇ 3z domain. TanCAR T cell activation is achieved only when target cells co-express both targets.
- a dual CAR T cell expresses two separate CARs with different ligand binding targets; one CAR includes only the ⁇ 3z domain and the other CAR includes only the co-stimulatory domain(s). Dual CAR T cell activation requires co-expression of both targets on the tumor.
- a safety CAR (sCAR) consists of an extracellular scFv or sdAb fused to an intracellular inhibitory domain.
- sCAR T cells co-expressing a standard CAR become activated only when encountering target cells that possess the standard CAR target but lack the sCAR target.
- the antigen recognition domain of the disclosed CAR is usually an scFv or sdAb.
- An antigen recognition domain from native T-cell receptor (TCR) alpha and beta single chains have been described, as have simple ectodomains (e.g. CD4 ectodomain to recognize HIV infected cells) and more exotic recognition components such as a linked cytokine (which leads to recognition of cells bearing the cytokine receptor).
- TCR T-cell receptor
- the endodomain is the business end of the CAR that after antigen recognition transmits a signal to the immune effector cell, activating at least one of the normal effector functions of the immune effector cell.
- Effector function of a T cell may be cytolytic activity or helper activity including the secretion of cytokines. Therefore, the endodomain may comprise the“intracellular signaling domain” of a T cell receptor (TCR) and optional co-receptors. While usually the entire intracellular signaling domain can be employed, in many cases it is not necessary to use the entire chain. To the extent that a truncated portion of the intracellular signaling domain is used, such truncated portion may be used in place of the intact chain as long as it transduces the effector function signal.
- TCR T cell receptor
- Cytoplasmic signaling sequences that regulate primary activation of the TCR complex that act in a stimulatory manner may contain signaling motifs which are known as immunoreceptor tyrosine-based activation motifs (ITAMs).
- ITAMs immunoreceptor tyrosine-based activation motifs
- Examples of ITAM containing cytoplasmic signaling sequences include those derived from CD8, ⁇ 3z, CD36, CD3y, CD3s, CD32 (Fc gamma Rlla), DAP10, DAP12, CD79a, CD79b, FcyRIy, FcyRIIlY, FcsR ⁇ (FCERIB), and FcsRIy (FCERIG).
- the intracellular signaling domain is derived from CD3 zeta ( ⁇ 3z) (TCR zeta, GenBank accno. BAG36664.1).
- T-cell surface glycoprotein CD3 zeta ( ⁇ 3z) chain also known as T-cell receptor T3 zeta chain or CD247 (Cluster of Differentiation 247), is a protein that in humans is encoded by the CD247 gene.
- First-generation CARs typically had the intracellular domain from the ⁇ 3z chain, which is the primary transmitter of signals from endogenous TCRs.
- Second-generation CARs add intracellular signaling domains from various costimulatory protein receptors (e.g., CD28, 41 BB, ICOS) to the endodomain of the CAR to provide additional signals to the T cell.
- costimulatory protein receptors e.g., CD28, 41 BB, ICOS
- the endodomain of the CAR can be designed to comprise the O ⁇ 3z signaling domain by itself or combined with any other desired cytoplasmic domain(s) useful in the context of the CAR of the invention.
- the cytoplasmic domain of the CAR can comprise a ⁇ 3z chain portion and a costimulatory signaling region.
- the costimulatory signaling region refers to a portion of the CAR comprising the intracellular domain of a costimulatory molecule.
- a costimulatory molecule is a cell surface molecule other than an antigen receptor or their ligands that is required for an efficient response of lymphocytes to an antigen. Examples of such molecules include CD27, CD28, 4-1 BB (CD137), 0X40, CD30, CD40, ICOS, lymphocyte function-associated antigen-1 (LFA-1), CD2, CD7, LIGHT, NKG2C, B7-H3, and a ligand that specifically binds with CD83, CD8, CD4, b2c,
- CD80, CD86, DAP10, DAP12, MyD88, BTNL3, and NKG2D CD80, CD86, DAP10, DAP12, MyD88, BTNL3, and NKG2D.
- CD28 co-stimulatory signaling element
- costimulatory elements can be used alone or in combination with other co-stimulatory signaling elements.
- the CAR comprises a hinge sequence.
- a hinge sequence is a short sequence of amino acids that facilitates antibody flexibility (see, e.g., Woof et al., Nat. Rev. Immunol., 4(2): 89-99 (2004)).
- the hinge sequence may be positioned between the antigen recognition moiety and the transmembrane domain.
- the hinge sequence can be any suitable sequence derived or obtained from any suitable molecule. In some embodiments, for example, the hinge sequence is derived from a CD8a molecule or a CD28 molecule.
- the transmembrane domain may be derived either from a natural or from a synthetic source. Where the source is natural, the domain may be derived from any membrane-bound or transmembrane protein. For example, the
- transmembrane region may be derived from (i.e. comprise at least the
- CD 137 CD 137
- GITR GITR
- CD40 BAFFR
- HVEM LIGHTR
- SLAMF7 NKp80
- KLRF1 HVEM
- SLAMF7 SLAMF7
- NKp80 KLRF1
- CD160 CD19, IL2R beta, IL2R gamma, IL7R a, ITGA1 , VLA1 , CD49a, ITGA4, IA4, CD49D, ITGA6, VLA-6, CD49f, ITGAD, CD11d, ITGAE, CD103, ITGAL, CD11a, LFA-1 , ITGAM, CD11 b, ITGAX, CD11c, ITGB1 , CD29, ITGB2, CD18, LFA-1 , ITGB7, TNFR2, DNAM1 (CD226) , SLAMF4 (CD244, 2B4) , CD84, CD96 (Tactile) ,
- the transmembrane domain may be synthetic, in which case it will comprise predominantly hydrophobic residues such as leucine and valine. In some cases, a triplet of phenylalanine, tryptophan and valine will be found at each end of a synthetic transmembrane domain.
- a short oligo- or polypeptide linker such as between 2 and 10 amino acids in length, may form the linkage between the transmembrane domain and the endoplasmic domain of the CAR.
- the CAR has more than one transmembrane domain, which can be a repeat of the same transmembrane domain, or can be different transmembrane domains.
- the CAR is a multi-chain CAR, as described in WO2015/039523, which is incorporated by reference for this teaching.
- a multi-chain CAR can comprise separate extracellular ligand binding and signaling domains in different transmembrane polypeptides.
- the signaling domains can be designed to assemble in juxtamembrane position, which forms flexible architecture closer to natural receptors, that confers optimal signal transduction.
- the multi chain CAR can comprise a part of an FCERI alpha chain and a part of an FCERI beta chain such that the FCERI chains spontaneously dimerize together to form a CAR.
- the disclosed SP-VHH-CD8 hinge&TM-41 BB- CD3zeta-T2A-EGFRt-T2A-IL15-T2A-CX3CR1 CAR construct comprises an amino acid sequence:
- the SP-VHH-CD8 hinge&TM-41 BB-CD3zeta- T2A-EGFRt-T2A-IL15-T2A-CX3CR1 CAR construct is encoded by the nucleic acid sequence:
- AGCCT G AACAT AACATCCTTGGG ATT ACGCTCCCT CAAGG AG AT AAGTG AT GG A
- the disclosed SP-VHH-CD8 hinge&TM-41 BB- CD3zeta-T2A-EGFRt-T2A-IL15 CAR construct comprises an amino acid sequence: MALPVTALLLPLALLLHAARPQVQLVQSGGGLVQPGGSLRLSCAASYFDFDSYEMS WVRQAPGKGLEWIGSIYHSGSTYYNPSLKSRVTISRDNSKNTLYLQMNTLRAEDTA TYYCARVNMDRFDYWGQGTLVTVSSSTTTPAPRPPTPAPTIASQPLSLRPEACRPA AGGAVHTRGLDFACDIYIWAPLAGTCGVLLLSLVITLYCKRGRKKLLYIFKQPFMRPV QTTQEEDGCSCRFPEEEEGGCELRVKFSRSADAPAYKQGQNQLYNELNLGRREE YDVLDKRRGRDPEMGGKPRRKNPQEGLYNELQKDKMAEAYSEIGMKGERRRGKG HD
- the disclosed SP-VHH-CD8 hinge&TM-41 BB- CD3zeta-T2A-EGFRt-T2A-CX3CR1 CAR construct comprises an amino acid sequence:
- the disclosed SP-NKG2D-CD8hinge&TM- 41 BB-CD3zeta-T2A-EGFRt-T2A-IL15-T2A-CX3CR1 CAR construct comprises an amino acid sequence:
- the EF-1alpha promoter-SP-NKG2D- CD8hinge&TM-41 BB-CD3zeta-T2A-EGFRt-T2A-IL15-T2A-CX3CR1 CAR construct is encoded by the nucleic acid sequence:
- the disclosed SP-NKG2D-CD8 hinge&TM- 41 BB-CD3zeta-T2A-EGFRt-T2A-IL15 CAR construct comprises an amino acid sequence:
- the disclosed SP-NKG2D-CD8 hinge&TM- 41 BB-CD3zeta-T2A-EGFRt-T2A-CX3CR1 CAR construct comprises an amino acid sequence:
- VLCGRSVHVDFSSSESQRSRHGSVLSSNFTYHTSDGDALLLL (SEQ ID NO:24).
- the CAR polypeptide contains an incomplete endodomain.
- the CAR polypeptide can contain only an intracellular signaling domain or a co-stimulatory domain, but not both.
- the immune effector cell is not activated unless it and a second CAR polypeptide (or endogenous T-cell receptor) that contains the missing domain both bind their respective antigens. Therefore, in some embodiments, the CAR polypeptide contains a CD3 zeta ( ⁇ 3z) signaling domain but does not contain a costimulatory signaling region (CSR). In other embodiments, the CAR polypeptide contains the cytoplasmic domain of CD28, 4-1 BB, or a combination thereof, but does not contain a CD3 zeta ( ⁇ 3z) signaling domain (SD).
- polynucleotides and polynucleotide vectors encoding the disclosed CARs that allow expression of the CARs in the disclosed immune effector cells.
- Nucleic acid sequences encoding the disclosed CARs, and regions thereof can be obtained using recombinant methods known in the art, such as, for example by screening libraries from cells expressing the gene, by deriving the gene from a vector known to include the same, or by isolating directly from cells and tissues containing the same, using standard techniques.
- the gene of interest can be produced synthetically, rather than cloned.
- Expression of nucleic acids encoding CARs is typically achieved by operably linking a nucleic acid encoding the CAR polypeptide to a promoter, and incorporating the construct into an expression vector.
- Typical cloning vectors contain transcription and translation terminators, initiation sequences, and promoters useful for regulation of the expression of the desired nucleic acid sequence.
- the disclosed nucleic acid can be cloned into a number of types of vectors.
- the nucleic acid can be cloned into a vector including, but not limited to a plasmid, a phagemid, a phage derivative, an animal virus, and a cosmid.
- Vectors of particular interest include expression vectors, replication vectors, probe generation vectors, and sequencing vectors.
- the expression vector may be provided to a cell in the form of a viral vector.
- Viral vector technology is well known in the art and is described, for example, in Sambrook et al. (2001 , Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, New York), and in other virology and molecular biology manuals.
- Viruses, which are useful as vectors include, but are not limited to, retroviruses, adenoviruses, adeno-associated viruses, herpes viruses, and lentiviruses.
- a suitable vector contains an origin of replication functional in at least one organism, a promoter sequence, convenient restriction endonuclease sites, and one or more selectable markers.
- the polynucleotide vectors are lentiviral or retroviral vectors.
- retroviruses provide a convenient platform for gene delivery systems.
- a selected gene can be inserted into a vector and packaged in retroviral particles using techniques known in the art.
- the recombinant virus can then be isolated and delivered to cells of the subject either in vivo or ex vivo.
- One example of a suitable promoter is the immediate early
- CMV cytomegalovirus
- This promoter sequence is a strong constitutive promoter sequence capable of driving high levels of expression of any polynucleotide sequence operatively linked thereto.
- Another example of a suitable promoter is Elongation Growth FactoMa (EF-1a).
- constitutive promoter sequences may also be used, including, but not limited to the simian virus 40 (SV40) early promoter, MND (myeloproliferative sarcoma virus) promoter, mouse mammary tumor virus (MMTV), human immunodeficiency virus (HIV) long terminal repeat (LTR) promoter, MoMuLV promoter, an avian leukemia virus promoter, an Epstein-Barr virus immediate early promoter, a Rous sarcoma virus promoter, as well as human gene promoters such as, but not limited to, the actin promoter, the myosin promoter, the hemoglobin promoter, and the creatine kinase promoter.
- the promoter can alternatively be an inducible promoter. Examples of inducible promoters include, but are not limited to a metallothionine promoter, a glucocorticoid promoter, a progesterone promoter, and a tetracycline promoter.
- Additional promoter elements e.g., enhancers, regulate the frequency of transcriptional initiation.
- these are located in the region 30-110 bp upstream of the start site, although a number of promoters have recently been shown to contain functional elements downstream of the start site as well.
- the spacing between promoter elements frequently is flexible, so that promoter function is preserved when elements are inverted or moved relative to one another.
- the expression vector to be introduced into a cell can also contain either a selectable marker gene or a reporter gene or both to facilitate identification and selection of expressing cells from the population of cells sought to be transfected or infected through viral vectors.
- the selectable marker may be carried on a separate piece of DNA and used in a co-transfection procedure. Both selectable markers and reporter genes may be flanked with appropriate regulatory sequences to enable expression in the host cells. Useful selectable markers include, for example, antibiotic-resistance genes.
- Reporter genes are used for identifying potentially transfected cells and for evaluating the functionality of regulatory sequences.
- a reporter gene is a gene that is not present in or expressed by the recipient organism or tissue and that encodes a polypeptide whose expression is manifested by some easily detectable property, e.g., enzymatic activity. Expression of the reporter gene is assayed at a suitable time after the DNA has been introduced into the recipient cells.
- Suitable reporter genes may include genes encoding luciferase, beta-galactosidase, chloramphenicol acetyl transferase, secreted alkaline phosphatase, or the green fluorescent protein gene.
- Suitable expression systems are well known and may be prepared using known techniques or obtained commercially.
- the construct with the minimal 5' flanking region showing the highest level of expression of reporter gene is identified as the promoter.
- Such promoter regions may be linked to a reporter gene and used to evaluate agents for the ability to modulate promoter-driven transcription.
- the vector can be readily introduced into a host cell, e.g., mammalian, bacterial, yeast, or insect cell by any method in the art.
- the expression vector can be transferred into a host cell by physical, chemical, or biological means.
- Physical methods for introducing a polynucleotide into a host cell include calcium phosphate precipitation, lipofection, particle bombardment, microinjection, electroporation, and the like. Methods for producing cells comprising vectors and/or exogenous nucleic acids are well-known in the art. See, for example, Sambrook et al. (2001 , Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, New York).
- Biological methods for introducing a polynucleotide of interest into a host cell include the use of DNA and RNA vectors.
- Viral vectors, and especially retroviral vectors have become the most widely used method for inserting genes into mammalian, e.g., human cells.
- Chemical means for introducing a polynucleotide into a host cell include colloidal dispersion systems, such as macromolecule complexes,
- nanocapsules, microspheres, beads, and lipid-based systems including oil-in-water emulsions, micelles, mixed micelles, and liposomes.
- An exemplary colloidal system for use as a delivery vehicle in vitro and in vivo is a liposome (e.g., an artificial membrane vesicle).
- an exemplary delivery vehicle is a liposome.
- the nucleic acid may be associated with a lipid.
- the nucleic acid associated with a lipid may be encapsulated in the aqueous interior of a liposome, interspersed within the lipid bilayer of a liposome, attached to a liposome via a linking molecule that is associated with both the liposome and the oligonucleotide, entrapped in a liposome, complexed with a liposome, dispersed in a solution containing a lipid, mixed with a lipid, combined with a lipid, contained as a suspension in a lipid, contained or complexed with a micelle, or otherwise associated with a lipid.
- Lipid, lipid/DNA or lipid/expression vector associated compositions are not limited to any particular structure in solution. For example, they may be present in a bilayer structure, as micelles, or with a“collapsed” structure. They may also simply be interspersed in a solution, possibly forming aggregates that are not uniform in size or shape.
- Lipids are fatty substances which may be naturally occurring or synthetic lipids.
- lipids include the fatty droplets that naturally occur in the cytoplasm as well as the class of compounds which contain long-chain aliphatic hydrocarbons and their derivatives, such as fatty acids, alcohols, amines, amino alcohols, and aldehydes. Lipids suitable for use can be obtained from commercial sources.
- dimyristyl phosphatidylcholine can be obtained from Sigma, St. Louis, Mo.
- dicetyl phosphate can be obtained from K & K Laboratories (Plainview, N.Y.); cholesterol (“Choi”) can be obtained from Calbiochem-Behring; dimyristyl phosphatidylglycerol (“DMPG”) and other lipids may be obtained from Avanti Polar Lipids, Inc, (Birmingham, Ala.).
- immune effector cells that are engineered to express the disclosed CARs (also referred to herein as“CAR-T cells.” These cells are preferably obtained from the subject to be treated (i.e. are autologous). However, in some embodiments, immune effector cell lines or donor effector cells (allogeneic) are used. Immune effector cells can be obtained from a number of sources, including peripheral blood mononuclear cells, bone marrow, lymph node tissue, cord blood, thymus tissue, tissue from a site of infection, ascites, pleural effusion, spleen tissue, and tumors. Immune effector cells can be obtained from blood collected from a subject using any number of techniques known to the skilled artisan, such as FicollTM separation.
- immune effector cells are isolated from peripheral blood lymphocytes by lysing the red blood cells and depleting the monocytes, for example, by centrifugation through a PERCOLLTM gradient or by counterflow centrifugal elutriation.
- a specific subpopulation of immune effector cells can be further isolated by positive or negative selection techniques.
- immune effector cells can be isolated using a combination of antibodies directed to surface markers unique to the positively selected cells, e.g., by incubation with antibody-conjugated beads for a time period sufficient for positive selection of the desired immune effector cells.
- enrichment of immune effector cells population can be accomplished by negative selection using a combination of antibodies directed to surface markers unique to the negatively selected cells.
- the immune effector cells comprise any leukocyte involved in defending the body against infectious disease and foreign materials.
- the immune effector cells can comprise lymphocytes, monocytes, macrophages, dentritic cells, mast cells, neutrophils, basophils, eosinophils, or any combinations thereof.
- the immune effector cells can comprise T lymphocytes.
- T cells or T lymphocytes can be distinguished from other lymphocytes, such as B cells and natural killer cells (NK cells), by the presence of a T-cell receptor (TCR) on the cell surface. They are called T cells because they mature in the thymus (although some also mature in the tonsils). There are several subsets of T cells, each with a distinct function.
- T helper cells assist other white blood cells in immunologic processes, including maturation of B cells into plasma cells and memory B cells, and activation of cytotoxic T cells and macrophages. These cells are also known as CD4+ T cells because they express the CD4 glycoprotein on their surface. Helper T cells become activated when they are presented with peptide antigens by MHC class II molecules, which are expressed on the surface of antigen-presenting cells (APCs). Once activated, they divide rapidly and secrete small proteins called cytokines that regulate or assist in the active immune response. These cells can differentiate into one of several subtypes, including TH1 , TH2, TH3, TH17, TH9, or TFH, which secrete different cytokines to facilitate a different type of immune response.
- APCs antigen-presenting cells
- Cytotoxic T cells destroy virally infected cells and tumor cells, and are also implicated in transplant rejection. These cells are also known as CD8 + T cells since they express the CD8 glycoprotein at their surface. These cells recognize their targets by binding to antigen associated with MHC class I molecules, which are present on the surface of all nucleated cells. Through IL-10, adenosine and other molecules secreted by regulatory T cells, the CD8+ cells can be inactivated to an anergic state, which prevents autoimmune diseases.
- Memory T cells are a subset of antigen-specific T cells that persist long-term after an infection has resolved. They quickly expand to large numbers of effector T cells upon re-exposure to their cognate antigen, thus providing the immune system with“memory” against past infections. Memory cells may be either CD4 + or CD8 + . Memory T cells typically express the cell surface protein CD45RO.
- T reg cells Regulatory T cells
- suppressor T cells are crucial for the maintenance of immunological tolerance. Their major role is to shut down T cell-mediated immunity toward the end of an immune reaction and to suppress auto-reactive T cells that escaped the process of negative selection in the thymus.
- CD4 + T reg cells Two major classes of CD4 + T reg cells have been described— naturally occurring T reg cells and adaptive T reg cells.
- Natural killer T (NKT) cells (not to be confused with natural killer (NK) cells) bridge the adaptive immune system with the innate immune system. Unlike conventional T cells that recognize peptide antigens presented by major
- NKT cells recognize glycolipid antigen presented by a molecule called CD1d.
- the T cells comprise a mixture of CD4+ cells.
- the T cells are enriched for one or more subsets based on cell surface expression.
- the T comprise are cytotoxic CD8 +
- the T cells comprise gd T cells, which possess a distinct T-cell receptor (TCR) having one g chain and one d chain instead of a and b chains.
- TCR T-cell receptor
- Natural-killer (NK) cells are CD56 + CD3 _ large granular lymphocytes that can kill virally infected and transformed cells, and constitute a critical cellular subset of the innate immune system (Godfrey J, et al. Leuk Lymphoma 2012
- NK cells launch cytotoxicity against tumor cells without the requirement for prior sensitization, and can also eradicate MHC-l-negative cells (Narni-Mancinelli E, et al. Int Immunol 2011 23:427- 431). NK cells are safer effector cells, as they may avoid the potentially lethal complications of cytokine storms (Morgan RA, et al. Mol Ther 2010 18:843-851), tumor lysis syndrome (Porter DL, et al. N Engl J Med 2011 365:725-733), and on- target, off-tumor effects.
- NK cells have a well-known role as killers of cancer cells, and NK cell impairment has been extensively documented as crucial for progression of MM (Godfrey J, et al. Leuk Lymphoma 2012 53:1666-1676; Fauriat C, et al. Leukemia 2006 20:732-733), the means by which one might enhance NK cell- mediated anti-MM activity has been largely unexplored prior to the disclosed CARs.
- Immune effector cells expressing the disclosed CARs can elicit an anti-tumor immune response against cancer cells.
- the anti-tumor immune response elicited by the disclosed CAR-modified immune effector cells may be an active or a passive immune response.
- the CAR-mediated immune response may be part of an adoptive immunotherapy approach in which CAR-modified immune effector cells induce an immune response specific to the tumor antigen or receptor.
- the disclosed CAR-modified immune effector cells may be any suitable CAR-modified immune effector cells.
- compositions may comprise a target cell population as described herein, in combination with one or more pharmaceutically or physiologically acceptable carriers, diluents or excipients.
- Such compositions may comprise buffers such as neutral buffered saline, phosphate buffered saline and the like; carbohydrates such as glucose, mannose, sucrose or dextrans, mannitol;
- proteins proteins; polypeptides or amino acids such as glycine; antioxidants; chelating agents such as EDTA or glutathione; adjuvants (e.g., aluminum hydroxide); and
- compositions for use in the disclosed methods are in some
- compositions may be administered in any manner appropriate treat MM.
- the quantity and frequency of administration will be determined by such factors as the condition of the patient, and the severity of the patient's disease, although appropriate dosages may be determined by clinical trials.
- compositions of the present invention can be administered at a dosage of 10 4 to 10 9 cells/kg body weight, such as 10 5 to 10 6 cells/kg body weight, including all integer values within those ranges. T cell compositions may also be administered multiple times at these dosages.
- the cells can be administered by using infusion techniques that are commonly known in immunotherapy (see, e.g., Rosenberg et al., New Eng. J. of Med. 319:1676, 1988).
- the optimal dosage and treatment regime for a particular patient can readily be determined by one skilled in the art of medicine by monitoring the patient for signs of disease and adjusting the treatment accordingly.
- T cells can be activated from blood draws of from 10 cc to 400 cc.
- T cells are activated from blood draws of 20 cc, 30 cc, 40 cc, 50 cc, 60 cc, 70 cc, 80 cc, 90 cc, or 100 cc. Using this multiple blood draw/multiple reinfusion protocol may serve to select out certain populations of T cells.
- compositions described herein may be administered to a patient subcutaneously, intradermally, intratumorally, intranodally, intramedullary, intramuscularly, by intravenous (i.v.) injection, or intraperitoneally.
- i.v. intravenous
- the disclosed compositions are administered to a patient by intradermal or subcutaneous injection.
- the disclosed compositions are administered by i.v. injection.
- the compositions may also be injected directly into a tumor, lymph node, or site of infection.
- the disclosed CAR-modified immune effector cells are administered to a patient in conjunction with (e.g., before, simultaneously or following) any number of relevant treatment modalities, including but not limited to thalidomide, dexamethasone, bortezomib, and lenalidomide.
- the CAR-modified immune effector cells may be used in combination with
- immunosuppressive agents such as cyclosporin, azathioprine, methotrexate, mycophenolate, and FK506, antibodies
- immunoablative agents such as CAM PATH, anti-CD3 antibodies or other antibody therapies, cytoxin, fludaribine, cyclosporin, FK506, rapamycin, mycophenolic acid, steroids, FR901228, cytokines, and irradiation.
- the CAR- modified immune effector cells are administered to a patient in conjunction with (e.g., before, simultaneously or following) bone marrow transplantation, T cell ablative therapy using either chemotherapy agents such as, fludarabine, external-beam radiation therapy (XRT), cyclophosphamide, or antibodies such as OKT3 or
- the cell compositions of the present invention are administered following B-cell ablative therapy such as agents that react with CD20, e.g., Rituxan.
- B-cell ablative therapy such as agents that react with CD20, e.g., Rituxan.
- subjects may undergo standard treatment with high dose chemotherapy followed by peripheral blood stem cell transplantation.
- subjects receive an infusion of the expanded immune cells of the present invention.
- expanded cells are administered before or following surgery.
- the cancer of the disclosed methods can be any cell in a subject undergoing unregulated growth, invasion, or metastasis.
- the cancer can be any neoplasm or tumor for which radiotherapy is currently used.
- the cancer can be a neoplasm or tumor that is not sufficiently sensitive to
- the cancer can be a sarcoma, lymphoma, leukemia, carcinoma, blastoma, or germ cell tumor.
- a representative but non-limiting list of cancers that the disclosed compositions can be used to treat include lymphoma, B cell lymphoma, T cell lymphoma, mycosis fungoides, Hodgkin’s Disease, myeloid leukemia, bladder cancer, brain cancer, nervous system cancer, head and neck cancer, squamous cell carcinoma of head and neck, kidney cancer, lung cancers such as small cell lung cancer and non-small cell lung cancer, neuroblastoma/glioblastoma, ovarian cancer, pancreatic cancer, prostate cancer, skin cancer, liver cancer, melanoma, squamous cell carcinomas of the mouth, throat, larynx, and lung, endometrial cancer, cervical cancer, cervical carcinoma, breast cancer, epithelial cancer, renal cancer, genitourinary cancer, pulmonary cancer, esophageal carcinoma,
- hematopoietic cancers hematopoietic cancers
- testicular cancer colon and rectal cancers
- prostatic cancer pancreatic cancer
- the disclosed CARs can be used in combination with any compound, moiety or group which has a cytotoxic or cytostatic effect.
- Drug moieties include chemotherapeutic agents, which may function as microtubulin inhibitors, mitosis inhibitors, topoisomerase inhibitors, or DNA intercalators, and particularly those which are used for cancer therapy.
- the disclosed CARs can be used in combination with a checkpoint inhibitor.
- the two known inhibitory checkpoint pathways involve signaling through the cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed-death 1 (PD-1) receptors.
- CTLA-4 cytotoxic T-lymphocyte antigen-4
- PD-1 receptor also known as CD279
- CD279 is expressed on the surface of activated T cells. Its ligands, PD-L1 (B7-H1 ; CD274) and PD-L2 (B7-DC; CD273), are expressed on the surface of APCs such as dendritic cells or macrophages.
- PD-L1 is the predominant ligand, while PD-L2 has a much more restricted expression pattern.
- Checkpoint inhibitors include, but are not limited to antibodies that block PD-1 (Nivolumab (BMS-936558 or MDX1106), CT-011 , MK-3475), PD-L1 (MDX-1105 (BMS-936559), MPDL3280A, MSB0010718C), PD-L2 (rHlgM12B7), CTLA-4 (Ipilimumab (MDX-010),
- Tremelimumab (CP-675,206)), IDO, B7-H3 (MGA271), B7-H4, TIM3, LAG-3 (BMS- 986016).
- the PDL1 inhibitor comprises an antibody that specifically binds PDL1 , such as BMS-936559 (Bristol-Myers Squibb) or MPDL3280A (Roche).
- the PD1 inhibitor comprises an antibody that specifically binds PD1 , such as lambrolizumab (Merck), nivolumab (Bristol-Myers Squibb), or MEDI4736 (AstraZeneca).
- Human monoclonal antibodies to PD-1 and methods for treating cancer using anti-PD-1 antibodies alone or in combination with other immunotherapeutics are described in U.S. Patent No. 8,008,449, which is incorporated by reference for these antibodies.
- Anti-PD-L1 antibodies and uses therefor are described in U.S. Patent No. 8,552,154, which is incorporated by reference for these antibodies.
- Anticancer agent comprising anti-PD-1 antibody or anti-PD-L1 antibody are described in U.S. Patent No. 8,617,546, which is
- the disclosed CARs can be used in combination with other cancer immunotherapies.
- immunotherapy There are two distinct types of immunotherapy: passive
- immunotherapy uses components of the immune system to direct targeted cytotoxic activity against cancer cells, without necessarily initiating an immune response in the patient, while active immunotherapy actively triggers an endogenous immune response.
- Passive strategies include the use of the monoclonal antibodies (mAbs) produced by B cells in response to a specific antigen.
- mAbs monoclonal antibodies
- mAbs have been the biggest success story for immunotherapy; the top three best-selling anticancer drugs in 2012 were mAbs.
- rituximab (Rituxan, Genentech), which binds to the CD20 protein that is highly expressed on the surface of B cell malignancies such as non- Hodgkin’s lymphoma (NHL).
- Rituximab is approved by the FDA for the treatment of NHL and chronic lymphocytic leukemia (CLL) in combination with chemotherapy.
- trastuzumab (Herceptin; Genentech), which revolutionized the treatment of HER2 (human epidermal growth factor receptor 2)-positive breast cancer by targeting the expression of HER2.
- Generating optimal“killer” CD8 T cell responses also requires T cell receptor activation plus co-stimulation, which can be provided through ligation of tumor necrosis factor receptor family members, including 0X40 (CD134) and 4-1 BB (CD137).
- 0X40 is of particular interest as treatment with an activating (agonist) anti- 0X40 mAb augments T cell differentiation and cytolytic function leading to enhanced anti-tumor immunity against a variety of tumors.
- such an additional therapeutic agent may be selected from an antimetabolite, such as methotrexate, 6-mercaptopurine, 6- thioguanine, cytarabine, fludarabine, 5-fluorouracil, decarbazine, hydroxyurea, asparaginase, gemcitabine or cladribine.
- an antimetabolite such as methotrexate, 6-mercaptopurine, 6- thioguanine, cytarabine, fludarabine, 5-fluorouracil, decarbazine, hydroxyurea, asparaginase, gemcitabine or cladribine.
- such an additional therapeutic agent may be selected from an alkylating agent, such as mechlorethamine, thioepa, chlorambucil, melphalan, carmustine (BSNU), lomustine (CCNU), cyclophosphamide, busulfan, dibromomannitol, streptozotocin, dacarbazine (DTIC), procarbazine, mitomycin C, cisplatin and other platinum derivatives, such as carboplatin .
- an alkylating agent such as mechlorethamine, thioepa, chlorambucil, melphalan, carmustine (BSNU), lomustine (CCNU), cyclophosphamide, busulfan, dibromomannitol, streptozotocin, dacarbazine (DTIC), procarbazine, mitomycin C, cisplatin and other platinum derivatives, such as carboplatin .
- such an additional therapeutic agent may be selected from an anti-mitotic agent, such as taxanes, for instance docetaxel, and paclitaxel, and vinca alkaloids, for instance vindesine, vincristine, vinblastine, and vinorelbine.
- an additional therapeutic agent may be selected from a topoisomerase inhibitor, such as topotecan or irinotecan, or a cytostatic drug, such as etoposide and teniposide.
- such an additional therapeutic agent may be selected from a growth factor inhibitor, such as an inhibitor of ErbBI (EGFR) (such as an EGFR antibody, e.g. zalutumumab, cetuximab, panitumumab or nimotuzumab or other EGFR inhibitors, such as gefitinib or erlotinib), another inhibitor of ErbB2 (HER2/neu) (such as a HER2 antibody, e.g. trastuzumab, trastuzumab-DM I or pertuzumab) or an inhibitor of both EGFR and HER2, such as lapatinib).
- EGFR ErbBI
- HER2/neu another inhibitor of ErbB2
- HER2 antibody e.g. trastuzumab, trastuzumab-DM I or pertuzumab
- an inhibitor of both EGFR and HER2 such as lapatinib
- such an additional therapeutic agent may be selected from a tyrosine kinase inhibitor, such as imatinib (Glivec, Gleevec STI571) or lapatinib.
- a tyrosine kinase inhibitor such as imatinib (Glivec, Gleevec STI571) or lapatinib.
- a disclosed antibody is used in combination with ofatumumab, zanolimumab, daratumumab, ranibizumab, nimotuzumab, panitumumab, hu806, daclizumab (Zenapax), basiliximab (Simulect), infliximab (Remicade), adalimumab (Humira), natalizumab (Tysabri), omalizumab (Xolair), efalizumab (Raptiva), and/or rituximab.
- a therapeutic agent for use in combination with a CARs for treating the disorders as described above may be an anti-cancer cytokine, chemokine, or combination thereof.
- suitable cytokines and growth factors include IFNy, IL-2, IL-4, IL-6, IL-7, IL-10, IL-12, IL-13, IL-15, IL-18, IL- 23, IL-24, IL-27, IL-28a, IL-28b, IL-29, KGF, IFNa (e.g., INFa2b), IFN , GM-CSF, CD40L, Flt3 ligand, stem cell factor, ancestim, and TNFa.
- Suitable chemokines may include Glu-Leu-Arg (ELR)- negative chemokines such as IP-10, MCP-3, MIG, and SDF-la from the human CXC and C-C chemokine families.
- Suitable cytokines include cytokine derivatives, cytokine variants, cytokine fragments, and cytokine fusion proteins.
- a therapeutic agent for use in combination with a CARs for treating the disorders as described above may be a cell cycle
- a cell cycle control/apoptosis regulator may include molecules that target and modulate cell cycle control/apoptosis regulators such as (i) cdc-25 (such as NSC 663284), (ii) cyclin-dependent kinases that overstimulate the cell cycle (such as flavopiridol (L868275, HMR1275), 7- hydroxystaurosporine (UCN-01 , KW-2401), and roscovitine (R-roscovitine,
- telomerase modulators such as BIBR1532, SOT-095, GRN163 and compositions described in for instance US 6,440,735 and US 6,713,055
- telomerase modulators such as BIBR1532, SOT-095, GRN163 and compositions described in for instance US 6,440,735 and US 6,713,055
- Non- limiting examples of molecules that interfere with apoptotic pathways include TNF- related apoptosis-inducing ligand (TRAIL)/apoptosis-2 ligand (Apo-2L), antibodies that activate TRAIL receptors, IFNs, and anti-sense Bcl-2.
- a therapeutic agent for use in combination with a CARs for treating the disorders as described above may be a hormonal regulating agent, such as agents useful for anti-androgen and anti-estrogen therapy.
- hormonal regulating agents are tamoxifen, idoxifene, fulvestrant, droloxifene, toremifene, raloxifene, diethylstilbestrol, ethinyl estradiol/estinyl, an antiandrogene (such as flutaminde/eulexin), a progestin (such as such as hydroxyprogesterone caproate, medroxy- progesterone/provera, megestrol acepate/megace), an adrenocorticosteroid (such as hydrocortisone, prednisone), luteinizing hormone releasing hormone (and analogs thereof and other LHRH agonists such as buserelin and gose
- aminoglutethimide/cytraden, exemestane aminoglutethimide/cytraden, exemestane
- a hormone inhibitor such as octreotide/sandostatin
- a therapeutic agent for use in combination with an CARs for treating the disorders as described above may be an anti-cancer nucleic acid or an anti-cancer inhibitory RNA molecule.
- Combined administration may be simultaneous, separate, or sequential.
- the agents may be administered as one composition or as separate compositions, as appropriate.
- Radiotherapy may comprise radiation or associated administration of radiopharmaceuticals to a patient is provided.
- the source of radiation may be either external or internal to the patient being treated (radiation treatment may, for example, be in the form of external beam radiation therapy (EBRT) or brachytherapy (BT)).
- Radioactive elements that may be used in practicing such methods include, e.g., radium, cesium-137, iridium-192, americium-241 , gold- 198, cobalt-57, copper-67, technetium-99, iodide-123, iodide-131 , and indium-111.
- the disclosed CARs is administered in combination with surgery.
- CAR-T cells may be designed in several ways that enhance tumor cytotoxicity and specificity, evade tumor immunosuppression, avoid host rejection, and prolong their therapeutic half-life.
- TRUCK T-cells Redirected for Universal Cytokine Killing
- TRUCK T-cells Redirected for Universal Cytokine Killing
- cytokines such as IL-12 that promote tumor killing. Because these cells are designed to release a molecular payload upon activation of the CAR once localized to the tumor environment, these CAR-T cells are sometimes also referred to as ‘armored CARs’.
- cytokines as cancer therapies are being investigated both pre-clinically and clinically, and may also prove useful when similarly incorporated into a TRUCK form of CAR-T therapy.
- IL-2 IL-3.
- IL-4 IL-5, IL- 6, IL-7, IL-10, IL-12, IL-13, IL-15, IL-18, M-CSF, GM-CSF, IFN-a, IFN-g, TNF-a, TRAIL, FLT3 ligand, Lymphotactin, and TGF-b (Dranoff 2004).
- “Self-driving” or “homing” CAR-T cells are engineered to express a chemokine receptor in addition to their CAR. As certain chemokines can be upregulated in tumors, incorporation of a chemokine receptor aids in tumor trafficking to and infiltration by the adoptive T-cell, thereby enhancing both specificity and functionality of the CAR-T (Moon 2011).
- Universal CAR-T cells also possess a CAR, but are engineered such that they do not express endogenous TCR (T-cell receptor) or MHC (major histocompatibility complex) proteins. Removal of these two proteins from the signaling repertoire of the adoptive T-cell therapy prevents graft-versus-host-disease and rejection,
- Armored CAR-T cells are additionally so named for their ability to evade tumor immunosuppression and tumor-induced CAR-T hypofunction. These particular CAR-Ts possess a CAR, and may be engineered to not express checkpoint inhibitors. Alternatively, these CAR-Ts can be co-administered with a monoclonal antibody (mAb) that blocks checkpoint signaling. Administration of an anti-PDL1 antibody significantly restored the killing ability of CAR TILs (tumor infiltrating lymphocytes).
- mAb monoclonal antibody
- PD1-PDL1 and CTLA-4-CD80/CD86 signaling pathways have been investigated, it is possible to target other immune checkpoint signaling molecules in the design of an armored CAR-T including LAG-3, Tim-3, IDO- 1 , 2B4, and KIR.
- Other intracellular inhibitors of TILs include phosphatases (SHP1), ubiquitin-ligases (i.e., cbl-b), and kinases (i.e. , diacylglycerol kinase) .
- Armored CAR- Ts may also be engineered to express proteins or receptors that protect them against or make them resistant to the effects of tumor-secreted cytokines. For example,
- CTLs cytotoxic T lymphocytes transduced with the double negative form of the TGF-b receptor are resistant to the immunosuppression by lymphoma secreted TGF- b. These transduced cells showed notably increased antitumor activity in vivo when compared to their control counterparts.
- Tandem and dual CAR-T cells are unique in that they possess two distinct antigen binding domains.
- a tandem CAR contains two sequential antigen binding domains facing the extracellular environment connected to the intracellular costimulatory and stimulatory domains.
- a dual CAR is engineered such that one extracellular antigen binding domain is connected to the intracellular costimulatory domain and a second, distinct extracellular antigen binding domain is connected to the intracellular stimulatory domain. Because the stimulatory and costimulatory domains are split between two separate antigen binding domains, dual CARs are also referred to as“split CARs”. In both tandem and dual CAR designs, binding of both antigen binding domains is necessary to allow signaling of the CAR circuit in the T-cell. Because these two CAR designs have binding affinities for different, distinct antigens, they are also referred to as“bi-specific” CARs.
- CAR-T cells are a form of“living therapeutic” as a form of“living therapeutic”
- off-switches safety mechanisms
- conditional control mechanisms Both self-destruct and marked/tagged CAR-T cells for example, are engineered to have an“off-switch” that promotes clearance of the CAR-expressing T-cell.
- a self-destruct CAR-T contains a CAR, but is also engineered to express a pro-apoptotic suicide gene or“elimination gene” inducible upon administration of an exogenous molecule.
- HSV-TK herpes simplex virus thymidine kinase
- Fas iCasp9
- CD20 MYC tag
- truncated EGFR endothelial growth factor receptor
- HSK will convert the prodrug ganciclovir (GCV) into GCV-triphosphate that incorporates itself into replicating DNA, ultimately leading to cell death.
- GCV prodrug ganciclovir
- iCasp9 is a chimeric protein containing components of FK506-binding protein that binds the small molecule AP1903, leading to caspase 9 dimerization and apoptosis.
- a marked/tagged CAR-T cell is one that possesses a CAR but also is engineered to express a selection marker.
- Truncated EGFR is one such targetable antigen by the anti-EGFR mAb, and administration of cetuximab works to promotes elimination of the CAR-T cell.
- CARs created to have these features are also referred to as sCARs for‘switchable CARs’, and RCARs for‘regulatable CARs’.
- A“safety CAR”, also known as an “inhibitory CAR” (iCAR) is engineered to express two antigen binding domains. One of these extracellular domains is directed against a tumor related antigen and bound to an intracellular costimulatory and stimulatory domain.
- the second extracellular antigen binding domain however is specific for normal tissue and bound to an intracellular checkpoint domain such as CTLA4, PD1 , or CD45. Incorporation of multiple intracellular inhibitory domains to the iCAR is also possible. Some inhibitory molecules that may provide these inhibitory domains include B7-H1 , B7-1 , CD160, PIH, 2B4, CEACAM (CEACAM-1. CEACAM-3, and/or CEACAM-5), LAG-3, TIGIT, BTLA, LAIR1 , and T ⁇ Bb ⁇ . In the presence of normal tissue, stimulation of this second antigen binding domain will work to inhibit the CAR.
- iCARs are also a form of bi-specific CAR-T cells.
- the safety CAR-T engineering enhances specificity of the CAR-T cell for tumor tissue, and is advantageous in situations where certain normal tissues may express very low levels of a tumor associated antigen that would lead to off target effects with a standard CAR (Morgan 2010).
- a conditional CAR-T cell expresses an
- extracellular antigen binding domain connected to an intracellular costimulatory domain and a separate, intracellular costimulator.
- the costimulatory and stimulatory domain sequences are engineered in such a way that upon administration of an exogenous molecule the resultant proteins will come together intracellularly to complete the CAR circuit. In this way, CAR-T activation can be modulated, and possibly even‘fine-tuned’ or personalized to a specific patient. Similar to a dual CAR design, the stimulatory and costimulatory domains are physically separated when inactive in the conditional CAR; for this reason these too are also referred to as a “split CAR”.
- two or more of these engineered features may be combined to create an enhanced, multifunctional CAR-T.
- a CAR-T cell with either dual- or conditional- CAR design that also releases cytokines like a TRUCK.
- a dual-conditional CAR-T cell could be made such that it expresses two CARs with two separate antigen binding domains against two distinct cancer antigens, each bound to their respective costimulatory domains. The costimulatory domain would only become functional with the stimulatory domain after the activating molecule is administered.
- the cancer must express both cancer antigens and the activating molecule must be administered to the patient; this design thereby incorporating features of both dual and conditional CAR-T cells.
- CAR-T cells are created using a-b T cells, however g-d T cells may also be used.
- the described CAR constructs, domains, and engineered features used to generate CAR-T cells could similarly be employed in the generation of other types of CAR-expressing immune cells including NK (natural killer) cells, B cells, mast cells, myeloid-derived phagocytes, and NKT cells.
- a CAR-expressing cell may be created to have properties of both T-cell and NK cells.
- the transduced with CARs may be autologous or allogeneic.
- CAR expression may be used including retroviral transduction (including g-retroviral), lentiviral transduction,
- transposon/transposases Small Beauty and PiggyBac systems
- messenger RNA transfer-mediated gene expression Gene editing (gene insertion or gene deletion/disruption) has become of increasing importance with respect to the possibility for engineering CAR-T cells as well.
- CRISPR-Cas9, ZFN (zinc finger nuclease), and TALEN (transcription activator like effector nuclease) systems are three potential methods through which CAR-T cells may be generated.
- Example 1 Specific Glypican-3-Chemeric Antigen Receptor to modify T and NK cells by co-expression of CX3CR1, IL-15 or in combination to target solid malignancies
- FIG. 1A is an illustration of an embodiment CAR-T cell expressing an anti-GPC CAR, CX3R1 , and IL15. Although not shown, the CAR-T cell can also express EGFR.
- FIGs. 2A to 2C are illustrations of GPC3 CAR constructs GPC3- EGFR-IL15 (FIG. 2A), GPC3-EGFR-CXCR1 (FIG. 2B), and GPC3-EGFR-IL15- CX3CR1 (FIG. 2C).
- FIGs. 3A and 3B show GPC3 expression in HCC (FIG. 3A) and survival analysis in HCC patients as a function of GPC3 expression (FIG. 3B).
- mRNA study and IHC comparing normal liver and human HCC found that, although GPC3 is not expressed in the liver, the expression of this glypican is up-regulated in the majority of tumors (FIG. 3A). Also, GPC3 serum levels were significantly higher in patients with HCC than in non-HCC subjects (from 53%-93%).
- HCC patients with high GPC3 expression had a significantly shorter overall survival time than HCC patients with low GPC3 expression, and the risk of metastasis/recurrence after liver resection or liver transplant was increased up to three fold as compared to that of an HCC patient with low GPC3 expression (FIG.
- FIG. 4 is an illustration of GPC3 receptor signaling, which promotes cell proliferation through different signaling pathways in HCC by facilitating interactions of growth factors and receptors.
- FIG. 5 shows GPC3 surface expression in liver cancer cell lines.
- FIGs. 6A to 6F show GPC3-CX3CR1 or GPC3-IL-15 CAR-T cells effectively kill GPC3+ liver cancer cells in vitro.
- FIG. 7 shows that GPC3-CX3CR1 CAR-T cells effectively kill GPC3+ liver cancer cells in vivo in a human xenograft mouse model. Shown are images of luciferase demonstrating GPC3/CX3CR1 CAR-T can suppress tumor growth in human xenograft model bearing HepG2 cells.
- FIGs. 8A and 8B show GPC3-CX3CR1 CAR-T effectively kill GPC3+ liver cancer cells in vivo in human xenografts mouse model when compared with untransduced T cells.
- the killing efficacy is showed by mean of lumninoscores of 5 mice.
- FIGs. 9A and 9B show GPC3-IL15 or GPC3-CX3CR1 CAR-T specifically stimulate CAR-T proliferation in exposure of GPC3+ target cells.
- Example 2 Specific NKG2D-Chemeric Antigen Receptor to modify T and NK cells by co-expression of CX3CR1 , IL-15 or in combination to target solid malignancies
- FIG. 10 is an illustration of an embodiment CAR-T cell expressing an anti-NKG2D CAR, CX3R1 , and IL15. Although not shown, the CAR-T cell can also express EGFR.
- FIGs. 11A to 11C are illustrations of NKG2D CAR constructs NKG2D- IL15 (FIG. 11A), NKG2D-CXCR1 (FIG. 11 B), and N KG2 D- 1 L 15-CX3C R 1 (FIG. 11C).
- FIGs. 12A to 12D show effects of NKG2D-IL15 and NKG2D-CXCR1 CAR constructs on effector T cell proliferation after 5 (FIG. 12A), 10 (FIG. 12B), 20 (FIG. 12C), and 30 days (FIG. 12D).
- EGFR expression was used to detect CAR levels.
- CX3CR1 CAR out grows untransduced cells, after 30 days expands to 80% of cell culture (unsorted cells).
- FIG. 13 shows EGFR and NKG2D expression in untransfected cells, NKG2D-IL15 CARs, and NKG2D-CXCR1 CAR T cells.
- FIGs. 14A to 14D show effects of NKG2D-IL15 (FIGs. 14A, 14C) and NKG2D-CXCR1 constructs (FIG. 14B, 14D) on HepG2 (FIG. 14A, 14B) and Huh7 (FIG. 14C, 14D) liver cancer cells in vitro.
- FIGs. 15A to 15D show effects of NKG2D-IL15 (FIGs. 15A, 15C) and NKG2D-CXCR1 constructs (FIG. 15B, 15D) on A549-CX3CL1 (FIG. 15A, 15B) and A549-Scr (FIG. 15C, 15D) lung cancer cells in vitro.
- FIG. 16A and 16B show effect of presorted NKG2D-CX3CR1 CAR-T cells on Huh7 (FIG. 16A) and HepG2 (FIG. 16B) liver cancer killing in vitro.
- FIG. 17A and 17B show comparison of NKG2D-IL15 and NKG2D- CXCR1 CAR constructs.
- FIG.17A shows NKG2D-CX3CR1 CAR-T killed most of liver cancer cells after 5 days while NKG2D-IL15 CAR-T hasn’t reached plateau after 8 days.
- FIG. 17B shows NKG2D-CX3CR1 CAR-T, at low Effector: Target (E:T) ratio, responses and proliferates better upon cancer cells recognition and killing, showed by percentage of CAR-positive T cells (EGFR+) proliferated to 30% of total cells (10% initial).
- E:T Effector: Target
- FIG. 18 shows that in tumor bearing mice lymphocytes cannot migrate into tumor tissue but can be present in the peripheral blood, liver and spleen suggesting that tumor microenvironment has a decreased lymphocyte infiltration ability.
- FIG. 19 shows lymphocytes failing to migrate into the tumor bed in lung cancer xenograft model.
- FIG. 20 shows role of IL-15 in lymphocyte survival after injection in lung cancer xenograft model.
- FIG. 21 shows an immunophenotypic analysis of immune populations in the lung tumor microenvironment.
- tumor as well as surrounding tissue was obtained from patients and immune populations isolated for flow cytometric analysis.
- FIGs. 22A to 22D show functional cytotoxic cells are excluded from tumor bed.
- FIGs. 22A and 22B show the immunoprofiling of lymphocytes in different areas (normal (N), adjacent (A) and tumor (T)) demonstrating that all activating receptors are downregulated while immunecheckpoint proteins/inhibitary receptors are upregulated.
- CX3CR1 which is known as a lymphocyte
- FIG. 22C shows that in histological staining there is a decrease of cytotoxic cell infiltration at the tumor site.
- FIG. 22D shows flow cytometric analysis indicating that lymphocyte infiltration is decreased in the tumor while there few remaining in the tumor are suppressive cells like Tregs.
- FIG. 23A shows a detailed analysis of downregulation of CX3CR1 in different effector lymphocytes subpopulation.
- FIG. 23B shows TCGA database analysis looking at the survival in patients separating for CX3CR1 and NKG2D high versus low patients, suggesting that cytotoxic lymphocytes with high
- CX3CR1 expression has a better survival.
- FIGs. 24A and 24B show functional comparison of NKG2D CARTs in vitro. To test the specificity A549 lung cancer cell line and Huh 7 cancer cells were incubated with both GPC3 and NKG2D CAR-T. The NKG2D constructs were the best and GPC3 car-T is unable to kill lung cancer cells.
- FIGs. 25A and 25B show activation (IFN production, FIG. 25A) and proliferation (FIG. 25B).
- FIGs. 26A to 26C show characterization of Car-T cells with increased immunecheckpoint proteins.
- FIG. 27 shows characterization of Car-T cells with increased immunecheckpoint proteins.
- FIGs. 28A to 28C show in vivo characterization of CAR-T cells from the HepG2 xenograft model demonstrating that there is an increased circulating Car- T population in blood (FIG. 28A), spleen (FIG. 28B), and liver (FIG. 28C).
- FIGs. 29A and 29B show increased tumor on site trafficking of Car-T cells into the xenografted tumor.
- FIG. 29 A shows histology staining for human lymphocytes.
- FIG. 29B shows the calculation of the density of infiltrating lymphocytes in each individual mice and summary data compared with control group.
- FIG. 30 shows CAR-T isolated from the tumor bearing mice retain their killing effect in vitro against the same tumor as the model.
- FIGs. 31A to 31C show CAR-T function in vivo in a liver model.
- 1x10 6 HepG2-Luc cells were used to establish liver cancer model in NSG mice.
- 5x10 6 NKG2D Car-T cells as indicated were injected via tail vein to establish a HepG2 tumor bearing mice.
- the tumor size was determined by luciferase induced image indicating Car-T effectively reduced tumor size (FIG. 31 A and 31 B).
- the overall survival (OS) were significantly prolonged in NKG2D-CX3CR1 Car-T treated group (FIG. 31C).
- FIGs. 32A to 32C show that CAR-T cells were able to maintain up to two month after the initial injection in vivo as monitored by EGFR staining.
- EGFR is a biomarker for human Car-T cells.
- FIGs. 33A to 33C show the therapeutic effect of NKG2D-CX3CR1 CAR-T constructs in vivo using a lung cancer (A549-Luc) xenograft model.
- FIG. 33A shows the schematics of the experimental design. 1x10 6 A549-Luc were used to establish the tumor in vivo. 5x10 6 CAR-T cells as indicated were injected via tail vein into the tumor bearing mice. The tumor size was determined by luciferase induced image indicating CAR-T effectively reduced tumor size (FIG. 33B). The results show the NKG2D-CX3CR1 CAR-T has the best effect in reduction of the tumor size and tumor were unable detectable in two of the mice after 8 weeks (FIG. 33C, indicated by arrow).
- FIG. 34A to 34C show best results occurred in week nine.
- FIGs. 35A to 35G show that there is an increased CX3CR1 expression in NKG2D-CX3CR1 CAR-T cells isolated from peripheral blood by monitoring EGFR/CX3CR1 double positive.
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Abstract
L'invention concerne des cellules CAR-T à infiltration tumorale améliorée. Selon l'invention, les lymphocytes infiltrants (T et NK) dans le tissu tumoral sont dépourvus de CX3CR1, un récepteur des chimiokines clé spécifique des lymphocytes. Par conséquent, l'invention concerne des cellules CAR-T qui co-expriment CX3CR1 pour améliorer l'infiltration des cellules CAR-T dans le tissu tumoral. L'invention concerne également des cellules CAR-T qui co-expriment IL-15 afin d'activer l'infiltration des cellules NK. Dans certains modes de réalisation, les cellules CAR-T décrites expriment à la fois CX3CR1 et IL-15 en combinaison avec le polypeptide CAR. Dans certains modes de réalisation, les cellules CAR-T décrites expriment en outre EGFR en combinaison avec le polypeptide CAR.
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US11058725B2 (en) | 2019-09-10 | 2021-07-13 | Obsidian Therapeutics, Inc. | CA2 compositions and methods for tunable regulation |
CN113621582A (zh) * | 2021-09-23 | 2021-11-09 | 广州百吉生物制药有限公司 | 联合表达CCR2b的工程化免疫细胞及其制备和应用 |
WO2022228579A1 (fr) * | 2021-04-30 | 2022-11-03 | Nanjing Legend Biotech Co., Ltd. | Récepteurs antigéniques chimériques ciblant gpc3 et leurs procédés d'utilisation |
WO2023000685A1 (fr) * | 2021-07-20 | 2023-01-26 | 卡瑞济(北京)生命科技有限公司 | Cellule cart-t blindée qui augmente l'expression de la survivine et son utilisation antitumorale |
US12104178B2 (en) | 2017-03-03 | 2024-10-01 | Obsidian Therapeutics, Inc. | DHFR tunable protein regulation |
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