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• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/12—Viral antigens
  • A61K39/245—Herpetoviridae, e.g. herpes simplex virus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/12—Viral antigens
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/12—Viral antigens
  • A61K39/21—Retroviridae, e.g. equine infectious anemia virus
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/39—Medicinal preparations containing antigens or antibodies characterised by the immunostimulating additives, e.g. chemical adjuvants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/127—Synthetic bilayered vehicles, e.g. liposomes or liposomes with cholesterol as the only non-phosphatidyl surfactant
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
  • A61P37/04—Immunostimulants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
  • A61K2039/525—Virus
  • A61K2039/5258—Virus-like particles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/545—Medicinal preparations containing antigens or antibodies characterised by the dose, timing or administration schedule
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
  • A61K2039/55511—Organic adjuvants
  • A61K2039/55572—Lipopolysaccharides; Lipid A; Monophosphoryl lipid A
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
  • A61K2039/55511—Organic adjuvants
  • A61K2039/55577—Saponins; Quil A; QS21; ISCOMS
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/70—Multivalent vaccine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/80—Vaccine for a specifically defined cancer
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2319/00—Fusion polypeptide
• • C—CHEMISTRY; METALLURGY
  • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
  • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
  • C12N2710/00—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA dsDNA viruses
  • C12N2710/00011—Details
  • C12N2710/16011—Herpesviridae
  • C12N2710/16111—Cytomegalovirus, e.g. human herpesvirus 5
  • C12N2710/16134—Use of virus or viral component as vaccine, e.g. live-attenuated or inactivated virus, VLP, viral protein
• • C—CHEMISTRY; METALLURGY
  • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
  • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
  • C12N2740/00—Reverse transcribing RNA viruses
  • C12N2740/00011—Details
  • C12N2740/10011—Retroviridae
  • C12N2740/13011—Gammaretrovirus, e.g. murine leukeamia virus
  • C12N2740/13023—Virus like particles [VLP]

Definitions

• This invention is in the field of immune-oncology, in particular adjuvanted virus like particle vaccines of use in the treatment of human cytomegalovirus (HCMV) associated cancers such as glioblastoma multiforme (GBM).
• HCMV human cytomegalovirus
• GBM glioblastoma multiforme
• HCMV infection has been associated with a number of cancers including: GBMs (Cobbs 2002; Mitchel 2008), breast cancer (Taher 2013; Harkins 2010); prostate; medulloblastoma (Baryawno 2011; Libard 2014); meningioma (Libard 2014) and neuroblastoma (Wolmer- Solberg 2013).
• GBM is the most common and aggressive primary form of brain tumour with median survival time being only three months without treatment. GBM affects 2 to 3 adults per 100,000 each year in the United States and Europe. In the United States alone each year, GBM is diagnosed in more than 20,000 people and is responsible for about 15,000 deaths.
• the present disclosure relates to compositions and methods useful for treatment of HCMV associated cancers including GBM. More particularly, the present disclosure provides adjuvanted compositions comprising virus like particles (VLPs) comprising a murine leukemia virus (MLV) gag protein and HCMV antigens gB and pp65, methods for their use and related aspects.
• VLPs virus like particles
• MMV murine leukemia virus
• the present invention provides an immunogenic composition comprising:
• a virus like particle comprising:
• an adjuvant comprising a saponin and a TLR4 agonist.
• the adjuvant comprises a saponin which is QS21 and a TLR4 agonist which is 3-de- O-acylated monophosphoryl lipid A (3D-MPL).
• a method for eliciting an immune response in a subject comprising the administration of a saponin, a TLR4 agonist and a virus like particle comprising:
• the saponin, TLR4 agonist and virus like particle are administered in the form of an immunogenic composition comprising the virus like particle and an adjuvant comprising the saponin and the TLR4 agonist.
• an immunogenic composition comprising:
• a virus like particle comprising:
• an adjuvant comprising a saponin and a TLR4 agonist; for use in the treatment of an HCMV associated cancer.
• the invention also provides a method for the treatment of an HCMV associated cancer in a subject, said method comprising the administration of an adjuvant comprising a saponin and a TLR4 agonist, and a virus like particle comprising:
• SEQ ID NO: 1 is an MMLV-Gag Amino Acid Sequence
• SEQ ID NO: 2 is MMLV-Gag Nucleotide Sequence
• SEQ ID NO: 3 is a Codon Optimized MMLV-Gag Nucleotide Sequence
• SEQ ID NO: 4 is a MMLV Gag - CMV pp65 Amino Acid Sequence
• SEQ ID NO: 5 is a MMLV Gag - CMV pp65 Nucleotide Sequence
• SEQ ID NO: 6 is a Codon Optimized MMLV Gag - CMV pp65 Nucleotide Sequence
• SEQ ID NO: 7 is a Codon Optimized MMLV Gag - CMV pp65 Nucleotide Sequence
• SEQ ID NO: 8 is a HCMV gB Amino Acid Sequence
• SEQ ID NO: 9 is a HCMV gB Nucleotide Sequence
• SEQ ID NO: 10 is a Codon Optimized HCMV gB Nucleotide Sequence
• SEQ ID NO: 11 is a HCMV pp65 Amino Acid Sequence
• SEQ ID NO: 12 is a HCMV pp65 Nucleotide Sequence
• SEQ ID NO: 13 is a Codon Optimized HCMV pp65 Nucleotide Sequence
• the present invention provides an immunogenic composition comprising:
• a virus like particle comprising:
• an adjuvant comprising a saponin and a TLR4 agonist.
• the adjuvant comprises a saponin which is QS21 and a TLR4 agonist which is 3-de- O-acylated monophosphoryl lipid A (3D-MPL).
• the saponin, TLR4 agonist and virus like particle are administered in the form of an immunogenic composition comprising the virus like particle and an adjuvant comprising the saponin and the TLR4 agonist.
• the elicited immune response will typically comprise an antigen specific antibody and/or CD4+ T cell and/or CD8+ T cell response, suitably an antibody, CD4+ T cell and CD8+ T cell response, to one or both (suitably both) pp65 and gB proteins.
• the invention also provides a method for the treatment of an HCMV associated cancer in a subject, said method comprising the administration of an adjuvant comprising a saponin and a TLR4 agonist, and a virus like particle comprising:
• the invention provides the use of a saponin, a TLR4 agonist and a virus like particle comprising:
• an HCMV glycoprotein B (gB) protein in the manufacture of a medicament, in particular in the manufacture of a medicament for the treatment of an HCMV associated cancer.
• an adjuvant comprising a saponin and a TLR4 agonist for use with a virus like particle comprising:
• compositions comprising a VLP, a saponin and a TLR4 agonist may be provided as a kit of parts including the VLP, the saponin and the TLR4 agonist.
• a first container may comprise the VLP and a second container comprise the saponin and the TLR4 agonist.
• a first container may comprise the VLP, a second container may comprise the saponin and a third container may comprise the TLR4 agonist.
• components of the composition are conveniently administered as a single mixture to a particular administration site, components may be administered separately (or in incomplete combinations) either to the same or different sites (see for example WO2018114982 incorporated herein by reference for the purposes of providing information regarding the delivery of saponin and TLR4 agonist based adjuvants).
• the administration is desirably sufficiently proximal in both administration time and administration location such that the outcome observed is substantially the same as would be observed through administration of a single mixture.
• Suitably separate administration is within 2 hours, such as within 30 minutes, at locations suitably draining to the same lymph node, such as within 10 cm.
• HCMV infection has been associated with a number of cancers (Naucler2019) including: GBMs (Cobbs 2002; Mitchel 2008), breast cancer (Taher 2013; Harkins 2010); prostate; medulloblastoma (Baryawno 2011; Libard 2014); meningioma (Libard 2014) and neuroblastoma (Wolmer-Solberg 2013).
• GBMs Cobbs 2002; Mitchel 2008
• breast cancer Taher 2013; Harkins 2010
• prostate medulloblastoma
• Board 2014 meningioma
• HCMV a b-herpesvirus
• HCMV associated cancer means a cancer wherein HCMV infection may be a contributory factor and wherein anti-HCMV treatment may be beneficial.
• Cancers associated with HCMV infection include breast, colon, ovarian and prostate cancer, rhabdomyosarcoma, hepatocellular cancer, salivary gland tumours, neuroblastoma and brain tumours (medulloblastoma and GBM). Consequently, in an embodiment of the invention the HCMV associated cancer is selected from breast, colon, ovarian and prostate cancer, rhabdomyosarcoma, hepatocellular cancer, salivary gland tumours, neuroblastoma and brain tumours (medulloblastoma and GBM). Of particular interest is GBM.
• Subjects with GBM may be those experiencing their first occurrence or may be those experiencing a reoccurrence of GBM.
• the subject is one having their first occurrence of GBM.
• the subject is one having a reoccurrence (such as the first reoccurrence) of GBM.
• tumours such as a maximum cross-section of 400 mm 2 or less based on two-dimensional magnetic resonance imaging. Typically, this will be at initiation of treatment.
• a human subject desirably has a CD4/CD8 ratio of at least 2, such as at least 2.5 and in particular at least 3 at initiation of treatment.
• a human subject may have a CD4/CD8 ratio of less than 3, such as less than 2.5 and in particular less than 2 at initiation of treatment.
• GBM responds poorly to treatment due to a number of factors including the localization of the tumour, the inherent resistance of the cells to chemotherapy, and brain cells’ poor capacity for self-repair.
• GBM tumours are surgically removed to the extent possible, however, complete removal is usually impossible due to the rapid invasion of GBM cells into surrounding tissue. Radiation and chemotherapy are often used following surgical treatment in an attempt to delay progression of the disease.
• GBM tumours usually recur and median survival time in treated patients is only between twelve and fifteen months.
• HCMV human cytomegalovirus
• HCMV glycoprotein B (gB) has been shown to mediate glioma cell entry by binding to the receptor tyrosine kinase PDGFR-alpha (PDGFRa), resulting in activation of the PI3 kinase/Akt signaling pathway, which enhances both tumour cell growth and invasiveness (Cobbs 2014).
• Low levels of HCMV expression have been correlated with improved overall survival in GBM patients (Rahbar 2012).
• HCMV antigens could constitute therapeutic targets for immunotherapeutic treatment.
• HCMV antigens are recognized immunologically as being “foreign,” and T cells have a much higher affinity for foreign antigens than for self antigens.
• HCMV-specific T cells CD4+ and CD8+ polyfunctional T cells
• CD4+ and CD8+ polyfunctional T cells were shown to recognize and kill autologous GBM tumour cells, providing evidence that HCMV antigens are presented by tumour cells at immunologically relevant levels.
• adoptive T cell therapy with autologous HCMV- specific T cells demonstrated encouraging early clinical results, with 4 out of 10 patients remaining disease free during the study period (Schuessler2014).
• GBM patients show a significantly lower immune response to HCMV compared to healthy persons (Liu 2018).
• GBM patients were shown to produce significantly lower anti-HCMV antibodies (IgG) compared to healthy subjects who are HCMV positive (Liu 2018).
• IgG anti-HCMV antibodies
• 31% of patients with GBM tumours that had HCMV completely lacked anti-CMV antibodies (Rahbar 2015). Accordingly, GBM patients have significant dysregulation of immunity against HCMV, which creates significant challenges in developing immunotherapeutic treatments based on HCMV antigens.
• the present disclosure provides an immunotherapeutic composition and method of its use for treatment of HCMV associated cancer such as GBM.
• the immunogenic composition of the invention stimulates anti-HCMV T cell immunity against HCMV-expressing tumours, such as HCMV-expressing GBM tumours.
• the immunotherapeutic composition comprises a virus-like particle (“VLP”).
• VLPs are multiprotein structures which are generally composed of one or more viral proteins. VLPs mimic the conformation of viruses but lack genetic material, and therefore are not infectious. They can form (or “self-assemble”) upon expression of a viral structural protein under appropriate circumstances. VLPs overcome some of the disadvantages of vaccines prepared using attenuated viruses because they can be produced without the need to have any live virus present during the production process.
• a wide variety of VLPs have been prepared. For example, VLPs including single or multiple capsid proteins either with or without envelope proteins and/or surface glycoproteins have been prepared. In some cases, VLPs are non- enveloped and assemble by expression of just one major capsid protein.
• VLPs are enveloped and can comprise multiple antigenic proteins found in the corresponding native virus.
• Self-assembly of enveloped VLPs is more complex than non-enveloped VLPs because of the complex reactions required for fusion with the host cell membrane (Garrone 2011) and “budding” of the VLP to form a fully enveloped separate particle. Formation of intact VLPs can be confirmed by imaging of the particles using electron microscopy.
• VLPs typically resemble their corresponding native virus and can be multivalent particulate structures. Presentation of surface glycoproteins in the context of a VLP is advantageous for induction of neutralizing antibodies against the polypeptide as compared to other forms of antigen presentation, e.g., soluble antigens not associated with a VLP. Neutralizing antibodies most often recognize tertiary or quaternary structures; this often requires presenting antigenic proteins, like envelope glycoproteins, in their native viral conformation.
• Antigens expressed on the surface of the VLPs also induce a CD4-restricted T helper cell response that can help elicit and sustain both neutralizing antibody and cytotoxic T lymphocyte (CTL) responses. In contrast, antigens expressed within the internal space of the VLP may promote CD8-restricted CTL responses through dendritic cell uptake of VLPs in a process referred to as cross-priming and presentation.
• CTL cytotoxic T lymphocyte
• the VLPs of use in the present invention are typically derived from a retroviral vector.
• Retroviruses are enveloped RNA viruses that belong to the family Retroviridae. After infection of a host cell by a retrovirus, RNA is transcribed into DNA via the enzyme reverse transcriptase. DNA is then incorporated into the host cell’s genome by an integrase enzyme and thereafter replicates as part of the host cell’s DNA.
• the Retroviridae family includes the following genera Alpharetrovirus, Betaretrovirus, Gammearetrovirus, Deltaretrovirus, Epsilonretrovirus, Lentivirus and Spumavirus.
• the hosts for this family of retroviruses generally are vertebrates. Retroviruses produce an infectious virion containing a spherical nucleocapsid (the viral genome in complex with viral structural proteins) surrounded by a lipid bilayer derived from the host cell membrane.
• Retroviral vectors can be used to generate VLPs that lack a retrovirus-derived genome and are therefore non-replicating. This is accomplished by replacement of most of the coding regions of the retrovirus with genes or nucleotide sequences to be transferred; so that the vector is incapable of making proteins required for additional rounds of replication. Depending on the properties of the glycoproteins present on the surface of the particles, VLPs have limited ability to bind to and enter the host cell but cannot propagate. Therefore, VLPs can be administered safely as an immunogenic composition.
• the present invention utilizes VLPs comprising Murine Leukemia Virus (MLV) Gag protein and, in particular, a Moloney Murine Leukemia Virus (MMLV). Genomes of these retroviruses are readily available in databases.
• MLV Murine Leukemia Virus
• MMLV Moloney Murine Leukemia Virus
• the Gag proteins of retroviruses have an overall structural similarity and, within each group of retroviruses, are generally conserved at the amino acid level. Retroviral Gag proteins primarily function in viral assembly. Expression of Gag of some viruses (e.g., murine leukemia viruses, such as MMLV) in some host cells, can result in self-assembly of the expression product into VLPs. The Gag gene expression product in the form of a polyprotein gives rise to the core structural proteins of the VLP. Functionally, the Gag polyprotein is divided into three domains: the membrane binding domain, which targets the Gag polyprotein to the cellular membrane, the interaction domain which promotes Gag polymerization and the late domain which facilitates release of nascent virions from the host cell.
• the membrane binding domain which targets the Gag polyprotein to the cellular membrane
• the interaction domain which promotes Gag polymerization
• late domain which facilitates release of nascent virions from the host cell.
• the form of the Gag protein that mediates viral particle assembly is the polyprotein.
• Retroviruses assemble an immature capsid composed of the Gag polyprotein but devoid of other viral elements like viral protease with Gag as the structural protein of the immature virus particle.
• the MMLV Gag gene encodes a 65kDa polyprotein precursor which is proteolytically cleaved into 4 structural proteins (Matrix (MA); p12; Capsid (CA); and Nucleocapsid (NC)), by MLV protease, in the mature virion. In the absence of MLV protease, the polyprotein remains uncleaved, and the resulting particle remains in an immature form.
• the gene encoding the MMLV nucleic acid is SEQ ID NO: 2.
• An exemplary codon optimized sequence of MMLV nucleic acid is provided as SEQ ID NO: 3.
• a Gag polypeptide suitable for the present invention is substantially homologous to an MMLV Gag polypeptide which is SEQ ID NO:1.
• a Gag polypeptide suitable for the present invention has an amino acid sequence at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO:1.
• a Gag polypeptide suitable for the present invention is substantially identical to, or identical to SEQ ID NO: 1.
• a suitable MMLV Gag polypeptide is encoded by a nucleic acid sequence having at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% sequence identity to SEQ ID NO:2. In some embodiments, a suitable MMLV Gag polypeptide is encoded by a nucleic acid sequence having SEQ ID NO: 2 or a codon degenerate version thereof.
• nucleic acid sequence As is well known to those of skill in the art, it is possible to improve the expression of a nucleic acid sequence in a host organism by replacing the nucleic acids coding for a particular amino acid (i.e. a codon) with another codon which is better expressed in the host organism.
• a codon The process of altering a nucleic acid sequence to achieve better expression based on codon preference is called codon optimization.
• codon optimization Various methods are known in the art to analyze codon use bias in various organisms and many computer algorithms have been developed to implement these analyses in the design of codon optimized gene sequences.
• a suitable MMLV Gag polypeptide is encoded by a codon optimized version of a nucleic acid sequence encoding MMLV Gag and having at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% sequence identity to SEQ ID NO:3.
• a suitable MMLV-Gag polypeptide is encoded by a nucleic acid sequence which is substantially identical to, or identical to, SEQ ID NO: 3.
• amino acid or nucleic acid sequences may be compared using any of a variety of algorithms, including those available in commercial computer programs such as BLASTN for nucleotide sequences and BLASTP, gapped BLAST, and PSI-BLAST for amino acid sequences. Examples of such programs are described in Altschul, et al., 1990, J. Mol. Biol., 215(3): 403-410; Altschul, et al., 1996, Methods in Enzymology 266:460-480; Altschul, et al., 1997 Nucleic Acids Res.
• two sequences are considered to be substantially homologous if at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more of their corresponding residues are homologous over a relevant stretch of residues.
• the relevant stretch is a complete sequence.
• the relevant stretch is at least 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500 or more residues.
• the Gag polypeptide used in the invention may be a modified retroviral Gag polypeptide containing one or more amino acid substitutions, deletions, and/or insertions as compared to a wild-type or naturally-occurring Gag polypeptide while retaining substantial self-assembly activity.
• a Gag protein includes a large C-terminal extension which may contain retroviral protease, reverse transcriptase, and integrase enzymatic activity. Assembly of VLPs, however, generally does not require the presence of such components.
• a retroviral Gag protein alone e.g., lacking a C-terminal extension, lacking one or more of genomic RNA, reverse transcriptase, viral protease, or envelope protein
• a retroviral Gag protein can self-assemble to form VLPs both in vitro and in vivo (Sharma 1997).
• the VLP comprises a pp65 protein comprising an amino acid sequence which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 11.
• the pp65 protein comprises a polypeptide encoded by a nucleic acid sequence at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 12.
• the Gag polypeptide for use in accordance with the present invention suitably lacks a C- terminal extension and is typically expressed as a fusion protein with the pp65 antigen from HCMV.
• pp65 is located within the tegument between the capsid and the viral envelope. It is a major target of the cytotoxic T-cell response and is known to stimulate formation of T-helper cells and also induce cytotoxic T lymphocytes (CTL) against HCMV.
• CTL cytotoxic T lymphocytes
• the pp65 polypeptide is spliced in frame into the Gag polypeptide coding sequence, e.g., at the 3’ end of the Gag polypeptide coding sequence.
• the Gag polypeptide coding sequence and the pp65 antigen are expressed by a single promoter.
• the VLP comprises a fusion protein having an amino acid sequence which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 4.
• the VLP comprises a fusion protein encoded by a nucleic acid sequence at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 5.
• the VLPs of use in the invention also express an HCMV gB envelope glycoprotein on the surface of the VLP.
• gB is one of the major B-cell antigens in HCMV, inducing neutralizing, protective immune responses including potent humoral immune responses.
• the immunogenic composition of the present invention may comprise a VLP comprising a wild type envelope HCMV gB polypeptide, the sequence of which is SEQ ID NO: 8 or a codon degenerate version of SEQ ID NO. 8.
• a nucleic acid which encodes for the polypeptide is shown as SEQ ID NO:
• SEQ ID NO: 10 A codon optimized version of SEQ ID NO: 9 is shown as SEQ ID NO: 10.
• the immunogenic composition of the invention comprises a VLP comprising a gB polypeptide comprising an amino acid sequence which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 8.
• the polypeptide is encoded by a nucleic acid sequence at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to SEQ ID NO: 9.
• the polypeptide is encoded by a codon optimized version of the nucleic acid sequence of SEQ ID NO: 9, which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more homologous to the SEQ ID NO: 10.
• the VLP comprises a gB polypeptide consisting of an amino acid sequence which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%,
• SEQ ID NO: 8 99% or more identical to SEQ ID NO: 8 and a Gag/pp65 fusion protein consisting of an amino acid sequence which is at least 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more identical to SEQ ID NO: 4.
• a composition comprising VLPs will typically include a mixture of VLPs with a range of sizes. It is to be understood that the diameter values listed below correspond to the most frequent diameter within the mixture. In some embodiments > 90% of the vesicles in a composition will have a diameter which lies within 50% of the most frequent value (e.g., 1000 ⁇ 500 nm). In some embodiments the distribution may be narrower, e.g., > 90% of the vesicles in a composition may have a diameter which lies within 40, 30, 20, 10 or 5% of the most frequent value. In some embodiments, sonication or ultra-sonication may be used to facilitate VLP formation and/or to alter VLP size. In some embodiments, filtration, dialysis and/or centrifugation may be used to adjust the VLP size distribution.
• VLPs of the present disclosure may be of any size.
• the composition may include VLPs with diameters in the range of about 20 nm to about 300 nm.
• a VLP is characterized in that it has a diameter within a range bounded by a lower limit of 20, 30, 40, 50, 60, 70, 80, 90, or 100 nm and bounded by an upper limit of 300, 290, 280, 270, 260, 250, 240, 230, 220, 210, 200, 190, 180, or 170 nm.
• VLPs within a population show an average diameter within a range bounded by a lower limit of 20, 30, 40, 50, 60, 70, 80, 90, or 100 nm and bounded by an upper limit of 300, 290, 280, 270, 260, 250, 240, 230, 220, 210, 200, 190, 180, or 170 nm.
• VLPs in a population have a polydispersity index that is less than 0.5 (e.g., less than 0.45, less than 0.4, or less than 0.3).
• VLP diameter is determined by nanosizing.
• VLP diameter is determined by electron microscopy.
• VLPs in accordance with the present invention may be prepared according to general methodologies known to the skilled person.
• nucleic acid molecules, reconstituted vectors or plasmids may be prepared using techniques well known to the skilled artisan.
• Recombinant expression of the polypeptides for VLPs requires construction of an expression vector containing a polynucleotide that encodes one or more polypeptide(s). Once a polynucleotide encoding one or more polypeptides has been obtained, the vector for production of the polypeptide may be produced by recombinant DNA technology using techniques known in the art.
• Expression vectors that may be utilized in accordance with the present invention include, but are not limited to mammalian and avian expression vectors, bacculovirus expression vectors, plant expression vectors (e.g., Cauliflower Mosaic Virus (CaMV), Tobacco Mosaic Virus (TMV)), plasmid expression vectors (e.g., Ti plasmid), among others.
• mammalian and avian expression vectors e.g., bacculovirus expression vectors, plant expression vectors (e.g., Cauliflower Mosaic Virus (CaMV), Tobacco Mosaic Virus (TMV)), plasmid expression vectors (e.g., Ti plasmid), among others.
• CaMV Cauliflower Mosaic Virus
• TMV Tobacco Mosaic Virus
• plasmid expression vectors e.g., Ti plasmid
• the VLPs of the invention may be produced in any available protein expression system.
• the expression vector is transferred to a host cell by conventional techniques and the transfected cells are then cultured by conventional techniques to produce VLPs.
• VLPs are produced using transient transfection of cells.
• VLPs are produced using stably transfected cells.
• Typical cell lines that may be utilized for VLP production include, but are not limited to, mammalian cell lines such as human embryonic kidney (HEK) 293, Wl 38, Chinese hamster ovary (CHO), monkey kidney (COS), HT1080,
• C10, HeLa, baby hamster kidney (BHK), 3T3, C127, CV-1, HaK, NS/O, and L-929 cells include, but are not limited to, BALB/c mouse myeloma line (NSO/I, ECACC No: 85110503); human retinoblasts (PER.C6 (CruCell, Leiden, The Netherlands)); monkey kidney CV1 line transformed by SV40 (COS-7, ATCC CRL 1651); human embryonic kidney line ( 293 cells subcloned for growth in suspension culture, Graham et al. , J.
• cell lines that may be utilized for VLP production include insect (e.g., Sf-9, Sf-21, Tn-368, Hi5) or plant (e.g., Leguminosa, cereal, or tobacco) cells.
• mammalian cells are preferable for protein expression and/or VLP production (see, e.g., Roldao A et al., 2010 Expt Rev Vaccines 9:1149-
• a cell strain may be chosen which modulates the expression of the inserted sequences, or modifies and processes the gene product in a specific way.
• Different cells have characteristic and specific mechanisms for post-translational processing and modification of proteins and gene products.
• Appropriate cell lines or host systems can be chosen to ensure the correct modification and processing of the foreign protein expressed.
• eukaryotic host cells also referred to as packaging cells (e.g., 293T human embryo kidney cells)
• packaging cells e.g., 293T human embryo kidney cells
• VLPs may be purified according to known techniques, such as centrifugation, gradients, sucrose-gradient ultracentrifugation, tangential flow filtration and chromatography (e.g., ion exchange (anion and cation), affinity and sizing column chromatography), or differential solubility, among others.
• cell supernatant may be used directly, with no purification step.
• Additional entities, such as additional antigens or adjuvants may be added to purified VLPs.
• cells are co-transfected with two expression vectors, a first vector encoding a Gag-pp65 fusion polypeptide and a second vector encoding a gB envelope glycoprotein.
• the co-transfected HCMV gB plasmid enables particles budding from the cell surface to incorporate the gB protein into the lipid bilayer.
• “bivalent” VLPs comprising a HCMV pp65 non-structural protein and a HCMV gB envelope glycoprotein are produced.
• HCMV VLP vaccines comprising a gB surface antigen presented in its native conformation which stimulated production of neutralizing antibodies, and a pp65 tegument protein which induced helper T cells (TH lymphocytes) and cytotoxic T cells (CTL) (see WO2013068847, which is incorporated herein by reference for the purposes of providing details on VLPs and their manufacture).
• TH lymphocytes helper T cells
• CTL cytotoxic T cells
• compositions, methods and uses of the present invention utilise a saponin and a TLR4 agonist.
• a suitable saponin for use in the present invention is Quil A and its derivatives.
• Quil A is a saponin preparation isolated from the South American tree Quillaja saponaria Molina and was first described as having adjuvant activity by Dalsgaard etal. in 1974 (“Saponin adjuvants”, Archiv. fur dieumble Virusforschung, Vol. 44, Springer Verlag, Berlin, p243-254). Purified fractions of Quil A have been isolated by HPLC which retain adjuvant activity without the toxicity associated with Quil A (see, for example, EP0362278). Fractions of general interest include QS7, QS17, QS18 and QS21, for example QS7 and QS21 (also known as QA7 and QA21). QS21 is a saponin of particular interest.
• the saponin is a derivative of Quillaja saponaria Molina Quil A, suitably an immunologically active fraction obtainable from Quil A, such as QS7, QS17, QS18 or QS21, in particular QS21.
• the saponin, such as Quil A and in particular QS21 is at least 90% pure, such as at least 95% pure, especially at least 98% pure, in particular 99% pure.
• Purity of QS21 components may be determined by UV absorbance at 214nm as the proportion (e.g. at least 95%, especially at least 98%, in particular 99%) of QS21 components in the saponin used.
• a beneficial feature of the present invention is that the saponin is presented in a less reactogenic composition where it is quenched with an exogenous sterol, such as cholesterol.
• QS21 is formulated with cholesterol-based liposomes as a delivery platform as further described herein.
• QS21 which is quenched with cholesterol shows equivalent immunostimulating properties to free QS21 but is less lytic and more stable (Garcon 2017).
• TLR4 agonist is a lipopolysaccharide, suitably a non-toxic derivative of lipid A, particularly a monophosphoryl lipid A and more particularly 3-de-O-acylated monophosphoryl lipid A (3D-MPL).
• 3D-MPL is sold under the name ‘MPL’ by GlaxoSmithKline Biologicals N.A. and is referred throughout the document as 3D-MPL. See, for example, US Patent Nos. 4,436,727; 4,877,611 ; 4,866,034 and 4,912,094.
• 3D-MPL can be produced according to the methods described in GB 2220211 A. Chemically it is a mixture of 3-deacylated monophosphoryl lipid A with 4, 5 or 6 acylated chains.
• small particle 3D-MPL may be used to prepare the aqueous adjuvant composition.
• Small particle 3D-MPL has a particle size such that it may be sterile-filtered through a 0.22 urn filter. Such preparations are described in W094/21292.
• powdered 3D-MPL is used to prepare aqueous adjuvant compositions of use in the present invention.
• TLR4 agonists which can be used are aminoalkyl glucosaminide phosphates (AGPs) such as those described in WO98/50399 or US patent No. 6,303,347 (processes for preparation of AGPs are also described). Some AGPs are TLR4 agonists, and some are TLR4 antagonists.
• AGPs aminoalkyl glucosaminide phosphates
• TLR4 agonists which may be of use in the present invention include Glucopyranosyl Lipid Adjuvant (GLA) such as described in W02008/153541 or W02009/143457 or the literature articles Coler RN et al. (2011) Development and Characterization of Synthetic Glucopyranosyl Lipid Adjuvant System as a Vaccine Adjuvant. PLoS ONE 6(1): e16333. doi: 10.1371/journal. pone.0016333 and Arias MA et al. (2012) Glucopyranosyl Lipid Adjuvant (GLA), a Synthetic TLR4 Agonist, Promotes Potent Systemic and Mucosal Responses to Intranasal Immunization with HIVgp140.
• GLA Glucopyranosyl Lipid Adjuvant
• the TLR4 agonist such as the lipopolysaccharide and in particular 3D-MPL, is at least 90% pure, such as at least 95% pure, especially at least 98% pure, in particular 99% pure.
• AGPs are TLR4 modulators. TLR4 recognizes bacterial LPS (lipopolysaccharide) and when activated initiates an innate immune response. AGPs are a monosaccharide mimetic of the lipid A portion of bacterial LPS and have been developed with ether and ester linkages on the “acyl chains” of the compound. Processes for making these compounds are known and disclosed, for example, in WO 2006/016997, U.S. Patent Nos. 7,288,640 and 6,113,918, and WO 01/90129, which are hereby incorporated by reference in their entireties for the purpose of defining AGPs of use in the present invention and their methods of manufacture. Other AGPs and related processes are disclosed in U.S. Patent No.
• AGP therefore includes a compound of the formula: wherein m is 0 to 6; n is 0 to 4;
• X is O or S, in particular O;
• Y is O or NH
• each Ri, R2, R3 is selected independently from the group consisting of a C1-20 acyl and a C1-20 alkyl;
• R4 is H or methyl
• R 5 is selected independently from the group consisting of -H, -OH, -(CrC4)alkoxy, -PO 3 R 8 R 9 , - OPO3R8R9, -SO3R8, -OSO3R8, -NR8R9, -SRe, -CN, -NO2, -CHO, -CO2R8, and -CONRsRg, wherein Rs and Rg are each independently selected from H and (C1-C4) alkyl; and each R 6 and R 7 is independently H or PO 3 H 2 .
• AGP may be present in the form of a salt, particularly in the form of a pharmaceutically acceptable salt.
• non-pharmaceutically acceptable salts may be used during manufacture, they are desirably avoided.
• the configuration of the 3’ stereogenic centres to which the normal fatty acyl residues (that is, the secondary acyloxy or alkoxy residues, e.g., R 1 O, R 2 O, and R 3 O) are attached is R or S, suitably R (as designated by Cahn-lngold-Prelog priority rules).
• Configuration of aglycon stereogenic centres to which R 4 and R 5 are attached can be R or S. All stereoisomers, both enantiomers and diastereomers, and mixtures thereof, are encompassed by the formula.
• the number of carbon atoms between heteroatom X and the aglycon nitrogen atom is determined by the variable “n”, which can be an integer from 0 to 4 (i.e. 0, 1 , 2, 3 or 4), suitably an integer from 0 to 2 (i.e. 0, 1 or 2).
• the chain length of normal fatty acids Ri, R2, and R3 will suitably be 6 to 20 carbons, especially 6 to 16 carbons, in particular 9 to 14 carbons.
• the chain lengths can be the same or different. Desirable embodiments include chain lengths where Ri, R2 and R3 are independently selected from 6, 8, 10, 12 or 14.
• Ri, R2 and R3 are the same. In a second embodiment all of Ri, R2 and R3 are different. In a third embodiment one of Ri, R2 and R3 is different from the other two.
• n 0, R5 is CO 2 H, R6 is PO 3 H 2 , and R7 is H.
• AGP compounds are therefore defined by Formula 1a: wherein X is O or S; Y is O or NH; Z is O or H; each Ri, R2, R3 is selected independently from the group consisting of a C1-20 acyl and a C1-20 alkyl; and R4 is H or methyl.
• Formula 1a the configuration of the 3’ stereogenic centres to which the normal fatty acyl residues (that is, the secondary acyloxy or alkoxy residues, e.g., R 1 O, R 2 O, and R 3 O) are attached as R or S, preferably R (as designated by Cahn-lngold-Prelog priority rules).
• Configuration of aglycon stereogenic centres to which R 4 and CO 2 H are attached can be R or S. All stereoisomers, both enantiomers and diastereomers, and mixtures thereof are encompassed by the formula.
• Formula 1a encompasses L/D-seryl, -threonyl, -cysteinyl ether or ester lipid AGPs, both agonists and antagonists.
• CRX601 A particular compound of Formula 1 is referred to as CRX601:
• GLA are TLR4 modulators such as described in WO2008/153541 or W02009/143457 or the literature articles Coler RN et al. (2011) Development and Characterization of Synthetic Glucopyranosyl Lipid Adjuvant System as a Vaccine Adjuvant. PLoS ONE 6(1): e16333. doi: 10.1371/journal. pone.0016333 and Arias MA et al. (2012) Glucopyranosyl Lipid Adjuvant
• GLA a Synthetic TLR4 Agonist, Promotes Potent Systemic and Mucosal Responses to Intranasal Immunization with HIVgp140.
• the term GLA therefore includes a compound of the formula: Formula 2 wherein:
• R 1 , R 3 , R 5 and R 6 are each independently Cn-2oalkyl; and R 2 and R 4 are each independently Ci2-2oalkyl; and salts, such as pharmaceutically acceptable salts, thereof.
• R 1 to R 6 are linear alkyl groups.
• each of R 1 , R 3 , R 5 and R 6 is independently selected from Cn-isalkyl.
• each of R 1 , R 3 , R 5 and R 6 is identical.
• each of R 1 , R 3 , R 5 and R 6 is Cualkyl.
• each of R 2 and R 4 is independently selected from Ci2-i6alkyl.
• each of R 2 and R 4 is identical.
• each of R 2 and R 4 is identical.
• each of R 2 and R 4 is C alkyl.
• TLR4 agonists of interest include:
• TLR4 agonist of interest is: A TLR agonist of interest is dLOS (as described in Han, 2014): outer core OS inner core OS Lipid A
• the TLR4 agonist is in the form of a salt, such as pharmaceutically acceptable salt. In a second embodiment the TLR4 agonist is not in the form of a salt.
• GLA is at least 90% pure, such as at least 95% pure, especially at least 98% pure, in particular 99% pure.
• the subject is typically a mammal and in particular is a human.
• the human may be a human child.
• a human subject may be less than 18 years old.
• the human may be a human adult.
• a human subject may be 18 to 60 years old, such as 18 to 40 years old.
• the human may be an elderly adult.
• a human subject may be greater than 60 years old (e.g. 60 to 80 years old), such as greater than 65 years old.
• the human may be 18-70 years of age.
• a typical human dose comprises VLPs having 1 to 25 ug of pp65 protein content, such as 5 to 20 ug, in particular 8 to 12 ug, especially 10 ug.
• a typical human dose comprises VLPs having a gB protein content of 1/200 th to 1/10 th of content of pp65, such as 1/120 th to 1/40 th of content of pp65, in particular 1/100 th to 1/60 th of content of pp65 on a weight basis. Protein content can be determined by methods such as quantitative ELISA. When the pp65 protein is present in a fusion protein, pp65 content is based on the pp65 portion of the fusion protein.
• compositions may comprise at least one additional pharmaceutically acceptable excipient(s), adjuvant(s) and/or carrier(s).
• Typical carriers include emulsions, ISCOMS and liposomes, particularly liposomes.
• liposome is well known in the art and defines a general category of vesicles which comprise one or more lipid bilayers surrounding an aqueous space. Liposomes thus consist of one or more lipid and/or phospholipid bilayers and can contain other molecules, such as proteins or carbohydrates, in their structure. Because both lipid and aqueous phases are present, liposomes can encapsulate or entrap water-soluble material, lipid-soluble material, and/or amphiphilic compounds.
• Liposome size may vary from 30 nm to several urn depending on the phospholipid composition and the method used for their preparation.
• the liposome size will be in the range of 50 nm to 200 nm, especially 60 nm to 180 nm, such as 70-165 nm.
• the liposomes should be stable and have a diameter of -100 nm to allow convenient sterilization by filtration.
• Structural integrity of the liposomes may be assessed by methods such as dynamic light scattering (DLS) measuring the size (Z-average diameter, Zav) and polydispersity of the liposomes, or, by electron microscopy for analysis of the structure of the liposomes.
• DLS dynamic light scattering
• the average particle size is between 95 and 120 nm, and/or, the polydispersity (Pdl) index is not more than 0.35, in particular not more than 0.3, such as not more than 0.25.
• the average particle size is between 95 and 120 nm, and/or, the polydispersity (Pdl) index is not more than 0.2.
• the liposomes of the present invention may contain phosphatidylcholine lipid, such as dioleoyl phosphatidylcholine (DOPC).
• DOPC dioleoyl phosphatidylcholine
• the liposomes also contain a sterol, such as cholesterol.
• the saponin such as QS21
• QS21 can be used at amounts between 1 and 100 ug per human dose such as 20 to 60 ug.
• QS21 may be used at a level of about 50 ug.
• suitable ranges are 40-60 ug, suitably 45-55 ug or 49-51 ug, such as 50 ug.
• the human dose comprises QS21 at a level of about 25 ug.
• Examples of lower ranges include 20-30 ug, suitably 22-28 ug or 24-26 ug, such as 25 ug.
• the TLR4 agonist such as 3D-MPL
• 3D-MPL may be used at a level of about 50 ug.
• suitable ranges are 40-60 ug, suitably 45-55 ug or 49-51 ug, such as 50 ug.
• the human dose comprises 3D-MPL at a level of about 25 ug.
• Examples of lower ranges include 20-30 ug, suitably 22-28 ug or 24-26 ug, such as 25 ug.
• the weight ratio of TLR4 agonist to saponin is suitably between 1:5 to 5:1, especially 1.2:1 to 1:1.2, such as 1:1.
• Human doses intended for children may be reduced compared to those intended for an adult (e.g. reduction by 50%).
• the ratio of saponin: DOPC will typically be in the order of 1:50 to 1:10 (w/w), suitably between 1:25 to 1:15 (w/w), and preferably 1:22 to 1:18 (w/w), such as 1:20 (w/w).
• a buffer is added to the composition.
• the pH of a liquid preparation is adjusted in view of the components of the composition and necessary suitability for administration to the subject.
• the pH of a liquid mixture is at least 4, at least 5, at least 5.5, at least 5.8, at least 6.
• the pH of the liquid mixture may be less than 9, less than 8, less than 7.5 or less than 7.
• pH of the liquid mixture is between 4 and 9, between 5 and 8, such as between 5.5 and 8. Consequently, the pH will suitably be between 6-9, such as 6.5-8.5.
• the pH is between 5.8 and 6.4.
• An appropriate buffer may be selected from acetate, citrate, histidine, maleate, phosphate, succinate, tartrate and TRIS.
• the buffer is a phosphate buffer such as Na/Na 2 P0 4 , Na/K 2 P0 4 or K/K 2 P0 4 .
• the buffer can be present in the liquid mixture in an amount of at least 6mM, at least 10 mM or at least 40mM.
• the buffer can be present in the liquid mixture in an amount of less than 100 mM, less than 60 mM or less than 40 mM.
• compositions of the present invention when reconstituted will have an osmolality in the range of 250 to 750 mOsm/kg, for example, the osmolality may be in the range of 250 to 550 mOsm/kg, such as in the range of 280 to 500 mOsm/kg. In a particularly preferred embodiment the osmolality may be in the range of 280 to 310 mOsm/kg.
• Osmolality may be measured according to techniques known in the art, such as by the use of a commercially available osmometer, for example the AdvancedTM Model 2020 available from Advanced Instruments Inc. (USA).
• An “isotonicity agent” is a compound that is physiologically tolerated and imparts a suitable tonicity to a formulation to prevent the net flow of water across cell membranes that are in contact with the formulation.
• the isotonicity agent used for the composition is a salt (or mixtures of salts), conveniently the salt is sodium chloride, suitably at a concentration of approximately 150 nM.
• the composition comprises a non-ionic isotonicity agent and the concentration of sodium chloride in the composition is less than 100 mM, such as less than 80 mM, e.g. less than 50 mM, such as less 40 mM, less than 30 mM and especially less than 20 mM.
• the ionic strength in the composition may be less than 100 mM, such as less than 80 mM, e.g. less than 50 mM, such as less 40 mM or less than 30 mM.
• the non-ionic isotonicity agent is a polyol, such as sucrose and/or sorbitol.
• concentration of sorbitol may e.g. between about 3% and about 15% (w/v), such as between about 4% and about 10% (w/v).
• Adjuvants comprising an immunologically active saponin fraction and a TLR4 agonist wherein the isotonicity agent is salt or a polyol have been described in WO2012/080369.
• a human dose volume is between 0.05 ml and 1 ml, such as between 0.1 and 0.5 ml, in particular a dose volume of about 0.5 ml, or 0.7 ml.
• the volumes of the compositions used may depend on the delivery route and location, with smaller doses being given by the intradermal route.
• a unit dose container may contain an overage to allow for proper manipulation of materials during administration of the unit dose.
• compositions may optionally be administered in combination with one or more additional therapeutically active substances such as chemotherapeutic treatments.
• compositions are intended for administration and therefore will typically be provided in a sterile injectable form (e.g., a form that is suitable for intramuscular injection).
• a sterile injectable form e.g., a form that is suitable for intramuscular injection
• pharmaceutical compositions are provided in a liquid (e.g. aqueous) dosage form that is suitable for injection.
• compositions comprise one or more pharmaceutically acceptable excipients (e.g., preservative, inert diluent, dispersing agent, surface active agent and/or emulsifier, buffering agent, etc.).
• suitable excipients include, for example, water, saline, dextrose, sucrose, trehalose, glycerol, ethanol, or similar, and combinations thereof.
• Remington s The Science and Practice of Pharmacy, 21 st Edition, A. R. Gennaro, (Lippincott, Williams & Wlkins, Baltimore, MD, 2006) discloses various excipients used in formulating pharmaceutical compositions and known techniques for the preparation thereof.
• compositions comprise one or more preservatives. In some embodiments, compositions comprise no preservative.
• compositions are provided in a form that can be refrigerated and/or frozen.
• reconstituted solutions and/or liquid dosage forms may be stored for a certain period of time after reconstitution (e.g., 2 hours, 12 hours, 24 hours, 2 days, 5 days, 7 days, 10 days, 2 weeks, a month, two months, or longer).
• storage of VLP formulations for longer than the specified time results in VLP degradation.
• Formulations of the compositions described herein may be prepared by any method known or hereafter developed in the art of pharmacology.
• such preparatory methods include the step of bringing active ingredient into association with one or more excipients and/or one or more other accessory ingredients, and then, if necessary and/or desirable, packaging the product into a desired single- or multi-dose unit.
• a composition in accordance with the invention may be prepared, packaged, and/or sold in bulk, as a single unit dose, and/or as a plurality of single unit doses.
• a “unit dose” is discrete amount of the pharmaceutical composition comprising a predetermined amount of the active ingredient.
• the amount of the active ingredient is generally equal to a dose which would be administered to a subject and/or a convenient fraction of such a dose such as, for example, one-half or one-third of such a dose.
• Relative amounts of active ingredient, pharmaceutically acceptable excipient, and/or any additional ingredients in a pharmaceutical composition in accordance with the invention may vary, depending upon the identity, size, and/or condition of the subject and/or depending upon the route by which the composition is to be administered.
• treatment includes multiple administrations, appropriately spaced in time, of the composition of the present disclosure.
• Compositions described herein will generally be administered for such a time as they continue to induce an immune response, or until such time as the patient experiences progression of their disease.
• the composition of the invention is administered every four weeks.
• the preferred dosage may vary from subject to subject and may depend on several factors. Thus, it will be appreciated that, in general, the precise dose used will be as determined by the prescribing physician and will depend not only on the weight of the subject, but also on the age of the subject and, possibly, the progression of the disease and the degree of immune dysregulation against HCMV in the patient.
• compositions may be formulated for delivery parenterally, e.g., by injection.
• administration may be, for example, intravenous, intramuscular, intradermal, or subcutaneous, or via by infusion or needleless injection techniques.
• the compositions are formulated for intramuscular injection.
• compositions according to the present invention may improve quality of life of the subject, alleviate symptoms, slow progression and/or extend survival.
• An immunogenic composition comprising:
• VLP virus like particle
• an adjuvant comprising a saponin and a TLR4 agonist.
• kits for the preparation of an immunogenic composition comprising:
• a first container comprising a virus like particle comprising:
• kits for the preparation of an immunogenic composition comprising:
• a first container comprising a virus like particle comprising:
• a virus like particle comprising:
• a TLR4 agonist to elicit an immune response in a subject.
• a virus like particle comprising:
• An adjuvant comprising a saponin and a TLR4 agonist for use with a virus like particle comprising:
• a method for eliciting an immune response in a subject comprising the administration of a saponin, a TLR4 agonist and a virus like particle comprising:
• a method for the treatment of an HCMV associated cancer in a subject comprising the administration of a saponin, a TLR4 agonist and a virus like particle comprising:
• an HCMV glycoprotein B (gB) protein in the manufacture of a medicament, in particular in the manufacture of a medicament for the treatment of an HCMV associated cancer.
• Clause 13 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 12, wherein the VLP comprises a MLV Gag polypeptide comprising, such as consisting of, an amino acid sequence at least 80%, such as at least 90%, in particular at least 95%, especially at least 98% identical to SEQ ID NO:1.
• Clause 14 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 13, wherein the VLP comprises a polypeptide encoded by a nucleic acid sequence having at least 80%, such as at least 90%, in particular at least 95%, especially at least 98% identical to SEQ ID NO:2.
• Clause 15 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 14, wherein the VLP comprises a gB protein comprising, such as consisting of, an amino acid sequence which is at least 80%, such as at least 90%, in particular at least 95%, especially at least 98% identical to SEQ ID NO: 8.
• Clause 16 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 15, wherein the VLP comprises a gB protein encoded by a nucleic acid sequence having at least 80%, such as at least 90%, in particular at least 95%, especially at least 98% identical to SEQ ID NO:9.
• Clause 18 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 17, wherein the VLP comprises pp65 protein encoded by a nucleic acid sequence having at least 80%, such as at least 90%, in particular at least 95%, especially at least 98% identical to SEQ ID NO: 12.
• Clause 19 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 18, wherein the VLP comprises a fusion of the MLV Gag and HCMV pp65 protein.
• Clause 20 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 19, wherein the MLV Gag is N-terminally fused, directly or indirectly, to the pp65 protein.
• Clause 22 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 21 , wherein the saponin is Quil A or a derivative thereof.
• Clause 24 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 23, wherein the TLR4 agonist is a lipopolysaccharide.
• Clause 25 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 24, wherein the lipopolysaccharide is a monophosphoryl lipid A.
• Clause 26 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 25, wherein the monophosphoryl lipid A is 3-de-O-acylated monophosphoryl lipid A (3D-MPL).
• Clause 27 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 24, wherein the TLR4 agonist is an AGP, such as a compound of Formula 1 or Formula 1a, in particular CRX601.
• Clause 32 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 31, for administration to a human, such as a human aged 18 to 70.
• Clause 33 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 32, for use in the treatment of an HCMV associated cancer selected from breast, colon, ovarian and prostate cancer, rhabdomyosarcoma, hepatocellular cancer, salivary gland tumours, neuroblastoma and brain tumours (such as medulloblastoma and GBM).
• an HCMV associated cancer selected from breast, colon, ovarian and prostate cancer, rhabdomyosarcoma, hepatocellular cancer, salivary gland tumours, neuroblastoma and brain tumours (such as medulloblastoma and GBM).
• Clause 34 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 33, for use in the treatment of GBM.
• Clause 35 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 34, for use in the treatment of GBM in a subject experiencing their first occurrence.
• Clause 36 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 34, for use in the treatment of GBM in a subject experiencing a reoccurrence, such as the first reoccurrence.
• Clause 37 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 34 to 36, for use in the treatment of GBM in a subject having a tumour with a maximum cross-sectional area of 400 mm 2 or less.
• Clause 38 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 37, for use in a subject having a CD4/CD8 ratio of at least 2, such as at least 2.5, at initiation of treatment.
• Clause 39 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to clause 38, for use in a subject having a CD4/CD8 ratio of at least 3 at initiation of treatment.
• Clause 40 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 37, for use in a subject having a CD4/CD8 ratio of less than 3, such as less than 2.5 and in particular less than 2 at initiation of treatment.
• Clause 41 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 40, for use in eliciting an antigen specific antibody response.
• Clause 42 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 41, for use in eliciting an antigen specific CD4+ T cell response.
• Clause 43 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 42, for use in eliciting an antigen specific CD8+ T cell response.
• Clause 44 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 43, wherein the antigen specific response is to pp65.
• Clause 45 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 44, wherein the antigen specific response is to gB.
• Clause 46 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 45, wherein administration is intramuscularly.
• Clause 47 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 46, wherein a human dose comprises 1 to 25 ug of pp65 protein content, such as 5 to 20 ug, in particular 8 to 12 ug, especially 10 ug.
• Clause 48 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 47, wherein a human dose comprises a gB protein content of 1/200 th to 1 /10 th of content of pp65, such as 1/120 th to 1 /40 th of content of pp65, in particular 1/100 th to 1 /60 th of content of pp65 on a weight basis.
• Clause 49 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 48, wherein a human dose comprises 1 to 100 ug saponin, such as 50 ug.
• Clause 50 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 49, wherein a human dose comprises 1 to 100 ug TLR4 agonist, such as 50 ug.
• Clause 51 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 50, wherein the saponin and/or TLR4 agonist are formulated with a liposomal carrier.
• a liposomal carrier comprising a sterol, such as cholesterol.
• Clause 53 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 53, wherein administration is repeated every week to every 6 months, such as every 2 weeks to every 6 weeks, such as every 4 weeks.
• Clause 54 The composition, kit, saponin, TLR4 agonist, adjuvant, method or use according to any one of clauses 1 to 53, wherein administration is intramuscularly with a composition comprising VLPs containing 10 ug pp65 protein, and an adjuvant comprising 50 ug of QS21 and 50 ug of 3D-MPL in a liposomal formulation and administration is repeated every 4 weeks.
• a standard expression plasmid generally consists of a promoter sequence of mammalian origin, an intron sequence, a PolyAdenylation signal sequence (PolyA), a pUC origin of replication sequence (pUC - pBR322 is a colE1 origin/site of replication initiation and is used to replicate plasmid in bacteria such as E. coli (DH5a)), and an antibiotic resistance gene as a selectable marker for plasmid plaque selection.
• pUC - pBR322 is a colE1 origin/site of replication initiation and is used to replicate plasmid in bacteria such as E. coli (DH5a)
• an antibiotic resistance gene as a selectable marker for plasmid plaque selection.
• Within the plasmid following the intron are a variety of restriction enzyme sites that can be used to splice in a gene or partial gene sequence of interest.
• the Propol II expression plasmid contains the pHCMV (early promoter for HCMV), a Beta- Globin Intron (BGL Intron), a rabbit Globin polyAdenylation signal sequence (PolyA), a pUC origin of replication sequence (pUC - pBR322 is a colE1 origin/site of replication initiation and is used to replicate plasmid in bacteria such as E. coli (DH5a)), and an ampicillin resistance gene b-lactamase (Amp R - selectable marker for plasmid confers resistance to ampicillin (100 pg/ml).
• pHCMV head promoter for HCMV
• BGL Intron Beta- Globin Intron
• PolyA rabbit Globin polyAdenylation signal sequence
• pUC - pBR322 is a colE1 origin/site of replication initiation and is used to replicate plasmid in bacteria such as E. coli (DH5a)
• An ampicillin resistance gene b-lactamase Amp R
• Gag MMLV expression construct a complementary DNA (cDNA) sequence encoding a Gag polyprotein of MMLV (Gag without its C terminus Pol sequence) (Seq ID NO: 3) was cloned in a Propol II expression vector.
• cDNA complementary DNA
• gB expression construct the full-length sequence of gB was codon-optimized for human expression (GenScript) (SEQ ID NO: 10) and was cloned in a Propol II expression vector including the extracellular portion, transmembrane domain (TM) and cytoplasmic portion (Cyto) of gB.
• Gag/pp65 a sequence encoding the Gag polyprotein of MMLV (Gag without its C terminus Pol sequence) was fused with the full-length sequence of pp65 codon-optimized for human expression (GenScript) (SEQ ID NO: 6) and cloned in a Propol II expression vector.
• DNA plasmids were amplified in competent E. coli (DH5a) and purified with endotoxin-free preparation kits according to standard protocols.
• This Example describes methods for production of virus-like particles containing various recombinant HCMV antigens described in Example 1.
• 293SF-3F6 cell line derived from HEK 293 cells are a proprietary suspension cell culture grown in serum-free chemically defined media (CA 2,252,972 and US 6,210,922). The cells were transiently transfected using calcium phosphate methods with an MMLV-Gag /pp65 DNA expression plasmid and co-transfected with a gB DNA expression plasmid described in Example 1. Expression of HCMV antigens by the HEK 293 cells was confirmed by flow cytometry.
• VLPs were harvested and filtered through 0.45 urn pore size membranes and further concentrated and purified by ultracentrifugation through a 20% sucrose cushion in a SW32 Beckman rotor (25,000 rpm, 2 hours, 4°C). Pellets were resuspended in sterile endotoxin-free PBS (GIBCO) to obtain 500 times concentrated VLP stocks. Total protein was determined on an aliquot by a Bradford assay quantification kit (BioRad). Purified VLPs were stored at -80°C until used.
• VLPs were analyzed for the expression of gB, and MMLV-Gag/pp65 fusion protein by SDS-Page and Western Blot with specific antibodies to gB (CH 28 mouse monoclonal antibody to gB; Virusys Corporation; Pereira, L et al. 1984 Virology 139:73-86), and pp65 (CH12 mouse monoclonal antibody to UL83/pp65; Virusys Corporation; Pereira, L. et al. 1982 Infect Immun 36: 924-932). Antibodies were detected using enhanced chemilluminescence (ECL).
• ECL enhanced chemilluminescence
• Example 3 Stimulation of T cells in PBMCs from Healthy HCMV-positive Subjects using gB/pp65Gag VLPs
• the objective of this study was to evaluate the ability of gB/pp65Gag VLPs produced as described in Example 2 and purified by sucrose cushion ultracentrifugation to activate pre existing HCMV-specific CD4 + and CD8 + T cells in peripheral blood mononuclear cells (“PBMCs”) from healthy HCMV-positive subjects.
• PBMCs peripheral blood mononuclear cells
• PBMCs Human peripheral blood was obtained from CMV + healthy donors.
• PBMCs were isolated from whole blood using Ficoll gradient separation and single use aliquots were created. PBMCs were used either fresh after separation or after storage at -170°C. Briefly, PBMCs were cultured at 1 x 10 6 cells/mL in 4 mL PP culture tubes. gB/pp65 eVLPs and controls were added to the cells. Cells were cultured for 3 hours with stimulating agents prior to addition of Monensin and cultured for an additional 10 hours.
• the bivalent gB/pp65Gag VLPs stimulate both CD4 + and CD8 + IFN-gamma-secreting T cell responses ex vivo.
• a combination of recombinant gB and pp65 proteins was less effective than the bivalent VLPs at stimulating CD8 + and particularly CD4 + T cell responses in the PBMCs from healthy subjects.
• Example 4 Clinical Trial of gB/pp65Gag VLPs in Human GBM patients
• the gB/pp65Gag VLPs will be tested in a Phase I/ll study to define the safety, tolerability and impact of an immunogenic composition
• gB/pp65Gag VLPs (10 ug gB/pp65Gag VLP based on pp65 protein content) formulated with liposomal adjuvant comprising QS21 (50 ug per dose) and 3D-MPL (50 ug per dose) on GBM patients.
• Clinical disease progression is monitored by measurement of tumour size using MRI.
• PFS Progression free survival
• CMI Cellular immunity
• Tumour response is shown as SD (stable disease) or PD (progressed disease).
• Neoadjuvant anti-PD-1 immunotherapy promotes a survival benefit with intratumoral and systemic immune responses in recurrent glioblastoma. Nature Medicine 2019 25: 477-486
• HCMV glycoprotein B is expressed in primary glioblastomas and enhances growth and invasiveness via PDGFR-alpha activation Oncotarget 2014; 5:1091-1100

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