Classifications

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  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
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  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/4965—Non-condensed pyrazines
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  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
• • A—HUMAN NECESSITIES
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  • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
• • A—HUMAN NECESSITIES
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  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/66—Phosphorus compounds
  • A61K31/683—Diesters of a phosphorus acid with two hydroxy compounds, e.g. phosphatidylinositols
  • A61K31/685—Diesters of a phosphorus acid with two hydroxy compounds, e.g. phosphatidylinositols one of the hydroxy compounds having nitrogen atoms, e.g. phosphatidylserine, lecithin
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  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
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  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
  • A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
  • A61K39/3955—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against proteinaceous materials, e.g. enzymes, hormones, lymphokines
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  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans
  • C07K16/28—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
  • C07K16/2803—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
  • C07K16/2818—Immunoglobulins [IG], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against CD28 or CD152
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  • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
  • C12N15/09—Recombinant DNA-technology
  • C12N15/11—DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
  • C12N15/113—Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing
  • C12N15/1131—Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing against viruses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
• • 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
  • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K2317/00—Immunoglobulins specific features
  • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
  • C07K2317/21—Immunoglobulins specific features characterized by taxonomic origin from primates, e.g. man
• • C—CHEMISTRY; METALLURGY
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  • C12N2310/00—Structure or type of the nucleic acid
  • C12N2310/10—Type of nucleic acid
  • C12N2310/14—Type of nucleic acid interfering nucleic acids [NA]

Definitions

• TLR-8 The toll-like receptor family plays a fundamental role in pathogen recognition and activation of innate immunity.
• Toll-like receptor 8 (TLR-8) is predominantly expressed by myeloid immune cells and activation of this receptor stimulates a broad immunological response.
• Agonists of TLR-8 activate myeloid dendritic cells, monocytes, monocyte-derived dendridic cells and Kupffer cells leading to the production of proinflammatory cytokines and chemokines, such as interleukin- 18 (IL-18), interleukin- 12 (IL-12), tumor necrosis factor-alpha (TNF-a), and interferon-gamma (IFN-g).
• IL-18 interleukin- 18
• IL-12 interleukin- 12
• TNF-a tumor necrosis factor-alpha
• IFN-g interferon-gamma
• TLR8 modulating compounds include those described in U.S. Patent No. 9,670,205.
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double
• the present disclosure describes a method of treating and/or preventing a heptatis B viral infection in a subject in need thereof comprising administering a therapeutically effective amount of a combination of a toll-like receptor 8 (TLR8) modulator, an anti-HBV siRNA or dsRNA, and a programmed cell death protein 1 (PD-1) / programmed death- ligand 1 (PD-L1) inhibitor.
• TLR8 toll-like receptor 8
• PD-1) / programmed death- ligand 1 (PD-L1) inhibitor a programmed cell death protein 1 (PD-1) / programmed death- ligand 1 (PD-L1) inhibitor.
• the methods of the present disclosure may also include other additional therapeutic agents.
• references to “about” a value or parameter herein includes (and describes) embodiments that are directed to that value or parameter per se.
• the term “about” includes the indicated amount +10%.
• the term “about” includes the indicated amount +5%.
• the term “about” includes the indicated amount +1%.
• to the term “about X” includes description of “X”.
• the singular forms “a” and “the” include plural references unless the context clearly dictates otherwise.
• reference to “the compound” includes a plurality of such compounds and reference to “the assay” includes reference to one or more assays and equivalents thereof known to those skilled in the art.
• beneficial or desired results include, but are not limited to, alleviation of a symptom and/or diminishment of the extent of a symptom and/or preventing a worsening of a symptom associated with a disease or condition.
• treatment includes one or more of the following: a) inhibiting the disease or condition (e.g., decreasing one or more symptoms resulting from the disease or condition, and/or diminishing the extent of the disease or condition); b) slowing or arresting the development of one or more symptoms associated with the disease or condition (e.g., stabilizing the disease or condition, delaying the worsening or progression of the disease or condition); and c) relieving the disease or condition, e.g., causing the regression of clinical symptoms, ameliorating the disease state, delaying the progression of the disease, increasing the quality of life, and/or prolonging survival.
• inhibiting the disease or condition e.g., decreasing one or more symptoms resulting from the disease or condition, and/or diminishing the extent of the disease or condition
• slowing or arresting the development of one or more symptoms associated with the disease or condition e.g., stabilizing the disease or condition, delaying the worsening or progression of the disease or condition
• relieving the disease or condition e.g., causing the regression of
• prevention refers to a regimen that protects against the onset of the disease or disorder such that the clinical symptoms of the disease do not develop.
• prevention relates to administration of a therapy (e.g., administration of a therapeutic substance) to a subject before signs of the disease are detectable in the subject (e.g., administration of a therapeutic substance to a subject in the absence of detectable infectious agent (e.g., vims) in the subject).
• the subject may be an individual at risk of developing the disease or disorder, such as an individual who has one or more risk factors known to be associated with development or onset of the disease or disorder.
• the term “preventing HBV infection” or “preventing hepatitis B viral infection” refers to administering to a subject who does not have a detectable HBV infection an anti-HBV therapeutic substance. It is understood that the subject for anti- HBV preventative therapy may be an individual at risk of contracting the HBV virus.
• hepatitis B viral infection refers to a viral infection that affects the liver, and is caused by the hepatitis B virus.
• hepatitis D viral infection refers to a viral infection that affects the liver, and is caused by the hepatitis D vims.
• subject refers to animals such as mammals, including, but not limited to, primates (e.g., humans), cows, sheep, goats, horses, dogs, cats, rabbits, rats, mice and the like. In certain embodiments, the subject is a human.
• administering refers to oral administration, administration as a suppository, topical contact, parenteral, intravenous, subcutaneous, intraperitoneal, intramuscular, intralesional, intranasal or subcutaneous administration, intrathecal administration, or the implantation of a slow-release device e.g., a mini-osmotic pump, to the subject.
• a slow-release device e.g., a mini-osmotic pump
• the term “therapeutically effective amount” or “effective amount” refers to an amount that is effective to elicit the desired biological or medical response, including the amount of a compound that, when administered to a subject for treating a disease, is sufficient to effect such treatment for the disease.
• the effective amount will vary depending on the compound, the disease, and its severity and the age, weight, etc., of the subject to be treated.
• the effective amount can include a range of amounts.
• an effective amount may be in one or more doses, i.e., a single dose or multiple doses may be required to achieve the desired treatment endpoint.
• an effective amount may be considered in the context of administering one or more therapeutic agents, and a single agent may be considered to be given in an effective amount if, in conjunction with one or more other agents, a desirable or beneficial result may be or is achieved. Suitable doses of any co-administered compounds may optionally be lowered due to the combined action (e.g., additive or synergistic effects) of the compounds.
• “combination therapy regimen” refers to administering two or more therapeutic agents to a subject in need thereof. In some non-limiting examples, the two or more therapeutic agents are administered at different times. In some examples, the two or more therapeutic agents are administered at the same time. The combination therapy regimen is administered by any method described herein.
• Administration can also include co-administration such that two or more therapeutic agents are delivered together during the course of the treatment.
• two or more therapeutic agents may be co-formulated into a single dosage form or “combined dosage unit”, or formulated separately and subsequently combined into a combined dosage unit, as is typically for intravenous administration or oral administration as a mono or bilayer tablet or capsule.
• “Pharmaceutically acceptable” or “physiologically acceptable” refer to compounds, salts, compositions, dosage forms and other materials which are useful in preparing a pharmaceutical composition that is suitable for human pharmaceutical use.
• “pharmaceutically acceptable salts” refers to salts derived from an appropriate base, such as an alkali metal (for example, sodium, potassium), an alkaline earth metal (for example, magnesium), ammonium and NXT (wherein X is C 1 -C 4 alkyl).Also included are base addition salts, such as sodium or potassium salts. Pharmaceutically acceptable salts are non-toxic salts of a free base form of a compound that possesses the desired pharmacological activity of the free base. These salts may be derived from inorganic or organic acids or bases. For example, a compound that contains a basic nitrogen may be prepared as a pharmaceutically acceptable salt by contacting the compound with an inorganic or organic acid.
• Non-limiting examples of pharmaceutically acceptable salts include sulfates, pyrosulfates, bisulfates, sulfites, bisulfites, phosphates, monohydrogen-phosphates, dihydrogenphosphates, metaphosphates, pyrophosphates, chlorides, bromides, iodides, acetates, propionates, decanoates, caprylates, acrylates, formates, isobutyrates, caproates, heptanoates, propiolates, oxalates, malonates, succinates, suberates, sebacates, fumarates, maleates, butyne-l,4-dioates, hexyne-l,6-dioates, benzoates, chlorobenzoates, methylbenzoates, dinitrobenzoates, hydroxybenzoates, methoxybenzoates, phthalates, sulfonates, methylsulfonates, propylsulf
• double stranded ribonucleic acid refers to a complex of ribonucleic acid molecules, having a duplex structure comprising two anti-parallel and substantially complementary nucleic acid strands, referred to as having “sense” and “antisense” orientations with respect to a target RNA, i.e., an HBV gene.
• a dsRNA triggers the degradation of a target RNA, e.g., an mRNA, through a post-transcriptional gene- silencing mechanism referred to herein as RNA interference or RNAi.
• PD-1/PD-L1 inhibitors refers to checkpoint inhibitors that block the activity of a programmed cell death protein 1 (PD-1) / programmed death- ligand 1 (PD-L1) immune checkpoint proteins.
• the PD-1/PD-L1 inhibitors can act to inhibit associating programed death-ligand 1 (PD-L1) with its receptor, programed cell death protein 1 (PD-1).
• fasting refers to not eating and/or drinking for a specific amount of time.
• fasting may refer to a subject who has not eaten and/or consumed liquid from 8 to 24 hours since the last meal.
• fasting may refer to a subject who has not eaten and/or consumed liquid from 8 to 12 hours since the last meal.
• the subject may not have eaten and/or consumed liquid for between 6 to 12 hours since the last meal.
• viral load refers to the quantity of a vims in an amount of fluid, which may be measured volumetrically. Viral load can be expressed as viral or infectious particles per mL. Viral load can be expressed as international units per milliliter (IU/mL). A higher viral load may correlate with the severity of an active viral infection. Tests for determining viral load may include, but are not limited to reverse transcription-polymerase chain reaction (RT-PCR) tests, branched DNA (bDNA) tests, Qualitative Transcription-Mediated Amplification Assays, and nucleic acid sequence-based amplification (NASBA) tests.
• RT-PCR reverse transcription-polymerase chain reaction
• bDNA branched DNA
• NASBA nucleic acid sequence-based amplification
• the present disclosure describes combinations of a TLR8-modulating compound, an anti-HBV siRNA or dsRNA therapeutic, and a PD-1/PD-L1 inhibitor.
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) comprising SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2’-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3’
• the method comprises treating or preventing the hepatitis B viral infection in the subject in need thereof. In some embodiments, the method comprises treating the hepatitis B viral infection in the subject in need thereof. In some embodiments, provided herein is a method of treating a hepatitis B viral infection in a subject in need thereof, comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor,
• a combination therapy regimen compris
• a method of treating a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) comprising SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'- phosphate,
• dsRNA double stranded rib
• the method comprises preventing the hepatitis B viral infection in the subject in need thereof.
• a method of preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection
• dsRNA double stranded ribonucle
• a method of preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) comprising SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'- phosphate
• dsRNA double stranded rib
• the combination therapy regimens of the present disclosure can also be used to treat and/or prevent a hepatitis D viral infection in a subject in need thereof.
• a method of treating and/or preventing a hepatitis D viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, thereby
• a method of treating and/or preventing a hepatitis D viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) comprising SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'
• the combination therapy regimens of the present disclosure can include a variety of toll-like receptor 8 (TLR8) modulators.
• the compound of Formula (I) is a toll-like receptor 8 (TLR8) modulator.
• TLR-8 modulators include, but are not limited to, GS-9688, also referred to as selgantolimod or (R)-2-((2-amino-7- fluoropyrido[3,2-d]pyrimidin-4-yl)amino)-2-methylhexan-l-ol, and has the following structure: [0035]
• the compound of Formula (I) is described in Example 98 of USPN 9,670,205 and WO 2016/141092.
• Other forms of the compound of Formula (I) are described in WO 2020/214663 and WO 2020/214652.
• TLR8 modulators that can be administered include, but are not limited to, E-6887, IMO-4200, IMO-8400, IMO-9200, MCT-465, MEDI-9197, motolimod, resiquimod, selgantolimod (GS-9688), HRS-9950, VTX-1463, VTX-763, 3M- 051, 3M-052, and the compounds disclosed in USPN 9,670,205 (Gilead Sciences), USPN 10,285,990 (Gilead Sciences), US2019/0282576 (Gilead Sciences), WO2016/141092 (Gilead Sciences), US2016/0289229 (Gilead Sciences), US2014/0045849 (Janssen),
• the compound of Formula (I) is selgantolimod (SLGN).
• the compound of Formula (I) has the structure:
• the combination therapy regimens of the present disclosure can include a variety of hepatitis B virus double-stranded RNA (dsRNA) for inhibiting expression of the hepatitis B virus.
• dsRNA hepatitis B virus double-stranded RNA
• Representative dsRNA useful in the combination therapy regimen of the present disclosure are described in WO 2020/036862.
• Other dsRNA useful for inhibiting expression of the hepatitis B virus are known to one of skill in the art.
• the dsRNA is a small interfering RNA (siRNA).
• the dsRNA can include, but is not limited to, the dsRNA described in WO2020/036862.
• the dsRNA is chemically modified to enhance stability or other beneficial characteristics.
• the dsRNA further comprises a ligand.
• the ligand can be conjugated to the 3’ end of the sense strand of the dsRNA.
• the ligand can be an N- acetylgalactosamine (GalNAc) derivative.
• the ligand can be:
• the dsRNA is conjugated to the ligand as shown in the following schematic: wherein X is O or S. In some embodiments, X is O.
• the dsRNA is modified to include one or more adenosine- glycol nucleic acid (“GNA”).
• GAA adenosine- glycol nucleic acid
• the term “GNA” refers to glycol nucleic acid which is a polymersimilartoDNAorRNAbutdifferinginthecompositionofits“backbone”inthatitiscomposedofrepeatingglycerolunitslinkedbyphosphodiesterbonds: whereineachBisindependentlyanucleobase. Adescriptionofadenosine-GNAcanbefound,forexample,inZhang,etal.(JACS127(12):4174-75(2005)).
• thedsRNAin includesanantisensestrandandasensestrand.Insomeembodiments,theantisensestrandisSEQIDNO.:1.TheantisensestrandofSEQIDNO.:lcorrespondstoSEQIDNO:16ofWO2020/036862.
• the PD-1/PD-L1 inhibitor is nivolumab, pembrolizumab, pidilzumab, BGB-108, SHR-1210, PDR-001, PF-06801591, IBI-308, GB-226, STI-1110, or mDX-400, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is nivolumab or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is nivolumab.
• Nivolumab (Opdivo) is a programmed death receptor- 1 (PD-1) blocking antibody, a IgG4 kappa immunoglobulin having a calculated molecular mass of about 146 kDa.
• the PD-1/PD-L1 inhibitor is pembrolizumab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is pidilzumab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is BGB-108, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is SHR-1210, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is PDR-001, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is PF-06801591, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is IBI-308, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is GB-226, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is STI-1110, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is mDX-400, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is GS-4224, atezolizumab, avelumab, zimberelimab, AMP-224, MEDI-0680, RG-7446, GX-P2, durvalumab, KY-1003, KD-033, MSB-0010718C, TSR-042, ALN-PDL, STI-A1014, CX-072, or BMS-936559, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is GS-4224, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is atezolizumab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is avelumab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is zimberelimab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is AMP-224, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is MEDI-0680, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is RG-7446, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is GX-P2, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is durvalumab, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is KY-1003, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is KD-033, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is MSB-0010718C, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is TSR-042, or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is ALN-PDL, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is STI-A1014, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is CX-072, or a pharmaceutically acceptable salt thereof. In some embodiments, the PD-1/PD-L1 inhibitor is BMS-936559, or a pharmaceutically acceptable salt thereof.
• Additional PD-1/PD-L1 inhibitors include, but are not limited to, compounds described in U.S. Patent Nos. 10,710,986 and 10,774,071.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• the PD-1/PD-L1 inhibitor is: or a pharmaceutically acceptable salt thereof.
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and nivolumab, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• dsRNA double stranded ribonucleic acid
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and pembrolizumab, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• dsRNA double stranded ribonucleic acid
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3’-phosphate, each g is 2'-O-methylguanosine-3'-
• each Gf is 2’-fluoroguanosine-3'- phosphate
• Uf is 2'-f!uorouridine-3'-phosphate
• (Agn) is adenosine-glycol nucleic acid (GNA)
• each s is a phosphorothioate linkage
• L96 is N - [tris(GalN Ac-alkyl)- amidodecanoyl)] -4-hydroxyprolinol, and pembrolizumab, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and pidilzumab, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• dsRNA double stranded ribonucleic acid
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methy]cytidine-3'-phosphate, each g is 2'-O-methylguanosine
• dsRNA double stranded rib
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methy1adenosine-3'- phosphate, each c is 2’-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine
• dsRNA double stranded rib
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and durvalumab, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• dsRNA double stranded ribonucleic acid
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2’ -O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidme-3'-phosphate, each g is 2'-O-methylguanosine-3
• dsRNA double stranded rib
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2’-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3’-
• dsRNA double stranded rib
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3'-
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and the compound: or a pharmaceutically acceptable salt thereof, thereby treating and/or preventing the hepatitis B viral infection in the subject.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine-3'- phosphate, each c is 2’-O-methylcytidine-3'-phosphate, each g is 2'-O-methylguanosine-3’-
• dsRNA double stranded rib
• compositions including an agent of the present disclosure, or a pharmaceutically acceptable salt thereof, in combination with one or more (e.g., one, two, three, four, one or two, one to three, or one to four) additional therapeutic agents, and a pharmaceutically acceptable excipient are provided.
• kits including an agent of the present disclosure, or a pharmaceutically acceptable salt thereof, in combination with one or more (e.g., one, two, three, four, one or two, one to three, or one to four) additional therapeutic agents are provided.
• one or more e.g., one, two, three, four, one or two, one to three, or one to four
• an agent of the present disclosure, or a pharmaceutically acceptable salt thereof is combined with one, two, three, four or more additional therapeutic agents. In certain embodiments, an agent of the present disclosure, or a pharmaceutically acceptable salt thereof, is combined with two additional therapeutic agents. In certain embodiments, an agent of the present disclosure, or a pharmaceutically acceptable salt thereof, is combined with three additional therapeutic agents. In certain embodiments, an agent of the present disclosure, or a pharmaceutically acceptable salt thereof, is combined with four additional therapeutic agents.
• the one, two, three, four or more additional therapeutic agents can be different therapeutic agents selected from the same class of therapeutic agents, and/or they can be selected from different classes of therapeutic agents.
• an agent of the present disclosure when combined with one or more additional therapeutic agents as described herein, the components of the composition are administered as a simultaneous or sequential regimen. When administered sequentially, the combination may be administered in two or more administrations.
• Co-administration of an agent disclosed herein with one or more additional therapeutic agents generally refers to simultaneous or sequential administration of an agent disclosed herein and one or more additional therapeutic agents, such that therapeutically effective amounts of each agent are present in the body of the patient.
• Co-administration includes administration of unit dosages of the agents disclosed herein before or after administration of unit dosages of one or more additional therapeutic agents.
• the agent disclosed herein may be administered within seconds, minutes, or hours of the administration of one or more additional therapeutic agents.
• a unit dose of an agent disclosed herein is administered first, followed within seconds or minutes by administration of a unit dose of one or more additional therapeutic agents.
• a unit dose of one or more additional therapeutic agents is administered first, followed by administration of a unit dose of an agent disclosed herein within seconds or minutes.
• a unit dose of an agent disclosed herein is administered first, followed, after a period of hours (e.g., 1-12 hours), by administration of a unit dose of one or more additional therapeutic agents.
• a unit dose of one or more additional therapeutic agents is administered first, followed, after a period of hours (e.g., 1-12 hours), by administration of a unit dose of an agent disclosed herein.
• an agent of the present disclosure is combined with one or more additional therapeutic agents in a unitary dosage form for simultaneous administration to a patient, for example as a solid dosage form for oral administration.
• an agent of the present disclosure is combined with one, two, three, four or more additional therapeutic agents selected from HBV combination drugs, HBV vaccines, HBV DNA polymerase inhibitors, immunomodulators, toll-like receptor (TLR) modulators, interferon alpha receptor ligands, hyaluronidase inhibitors, hepatitis B core antigen (HBcAg) inhibitors, hepatitis B surface antigen (HBsAg) inhibitors, cytotoxic T- lymphocyte-associated protein 4 (ipi4) inhibitors, cyclophilin inhibitors, HBV viral entry inhibitors, antisense oligonucleotide targeting viral mRNA, short interfering RNAs (siRNA)and ddRNAi, endonuclease modulators, ribonucelotide reductase inhibitors, HBV E antigen inhibitors, covalently closed circular DNA (cccDNA) inhibitors, famesoid X receptor agonists,
• an agent as described herein may be used or combined with one or more of a chemotherapeutic agent, an immunomodulator, an immunotherapeutic agent, a therapeutic antibody, a therapeutic vaccine, a bispecific antibody and “antibody-like” therapeutic protein (such as DARPins®, anti-pMHC TCR-like antibodies, DARTs®, Duobodies®, Bites®, XmAbs®, TandAbs®, Fab derivatives), an antibody-drug conjugate (ADC), gene modifiers or gene editors (such as CRISPR Cas9, zinc finger nucleases, homing endonucleases, homing meganucleases (e.g., ARCUS), synthetic nucleases, TALENs), cell therapies such as CAR-T (chimeric antigen receptor T-cell ), and TCR-T (an engineered T cell receptor) agent or any combination thereof.
• a chemotherapeutic agent such as DARPins®, anti-pMHC TCR-like
• an agent as described herein is combined with one, two, three, four or more additional therapeutic agents, e.g., as 3-dioxygenase (IDO) inhibitors, apolipoprotein A1 modulator, arginase inhibitors, B- and T-lymphocyte attenuator inhibitors, Bruton’s tyrosine kinase (BTK) inhibitors, CCR2 chemokine antagonist, CD137 inhibitors, CD160 inhibitors, CD305 inhibitors, CD4 agonist and modulator, compounds targeting hepatitis B core antigen (HBcAg), core protein allosteric modulators, covalently closed circular DNA (cccDNA) inhibitors, cyclophilin inhibitors, cytotoxic T-lymphocyte- associated protein 4 (ipi4) inhibitors, DNA polymerase inhibitor, endonuclease modulators, epigenetic modifiers, Farnesoid X receptor agonists, free fatty acid (Ffa) receptor 2 (IDO) inhibitors, a
• Non canonical RNA polymerase PAPD7 inhibitors modulators of CD70, modulators of GITR, modulators of HEVEM, modulators of ICOS, modulators of Mer, modulators of NKG2A, modulators of NKG2D, modulators of OX40, modulators of SIRPalpha, modulators of TIGIT, modulators of Tim-4, modulators of Tyro, Na+-taurocholate cotransporting polypeptide (NTCP) inhibitors, natural killer cell receptor 2B4 inhibitors, NOD2 gene stimulator, Nucleoprotein inhibitor, nucleoprotein modulators, OX-40 receptor agonist, PD-1 inhibitors, PD-L1 inhibitors, peptidylprolyl isomerase inhibitor, phosphatidylinositol-3 kinase (PI3K) inhibitors, Retinoic acid-inducible gene 1 stimulator, Reverse transcriptase inhibitor, Ribonuclease inhibitor, RNA DNA polymerase inhibitor, SLC10A1 gene inhibitor, S
• combination drugs for the treatment of HBV include, but are not limited to, TRUVADA ® (tenofovir disoproxil fumarate and emtricitabine), and adefovir.
• Examples of other drugs for the treatment of HBV include, but are not limited to, alpha-hydroxytropolones, amdoxovir, antroquinonol, beta-hydroxycytosine nucleosides, ARB-199, CCC-0975, ccc-R08, elvucitabine, ezetimibe, cyclosporin A, gentiopicrin (gentiopicroside), HH-003, hepalatide, JNJ-56136379, nitazoxanide, birinapant, NJK14047, NOV-205 (molixan, B AM-205), oligotide, mivotilate, feron, GST-HG-131, levamisole, Ka Shu Ning, alloferon, WS-007, Y-101 (Ti Fen Tai), rSIFN-co, PEG-IIFNm, KW-3, BP-Inter- 014, oleanolic acid, Hep
• HBV vaccines include both prophylactic and therapeutic vaccines.
• HBV prophylactic vaccines include, but are not limited to, Vaxelis, Hexaxim, Heplisav, Mosquirix, DTwP-HBV vaccine, Bio-Hep-B, D/T/P/HBV/M (LB VP-0101; LBVW-0101), DTwP-Hepb-Hib-IPV vaccine, Heberpenta L, DT wP-HepB - Hib , V-419, CVI-HBV-001, Tetrabhay, hepatitis B prophylactic vaccine (Advax Super D), Hepatrol-07, GSK-223192A, ENGERIX B ® , recombinant hepatitis B vaccine (intramuscular, Kangtai Biological Products), recombinant hepatitis B vaccine (Hansenual polymorpha yeast, intramuscular, Hualan Biological Engineering), recombinant
• HBV therapeutic vaccines include, but are not limited to, HBsAG- HBIG complex, ARB-1598, Bio-Hep-B, NASVAC, abi-HB (intravenous), ABX-203, Tetrabhay, GX-110E, GS-4774, peptide vaccine (epsilonPA-44), Hepatrol-07, NASVAC (NASTERAP), IMP-321, BEVAC, Revac B mcf, Revac B+, MGN-1333, KW-2, CVI-HBV- 002, AltraHepB, VGX-6200, FP-02, FP-02.2 (HepTcell), NU-500, HBVax, im/TriGrid/antigen vaccine, Mega-CD40L-adjuvanted vaccine, HepB-v, RG7944 (INO- 1800), recombinant VLP-based therapeutic vaccine (HBV infection, VLP Biotech), hepatitis B therapeutic DNA vaccine, AdTG
• HBV DNA polymerase inhibitors include, but are not limited to, adefovir (HEPSERA ® ), emtricitabine (EMTRIVA ® ), tenofovir disoproxil fumarate (VIREAD ® ), tenofovir alafenamide, tenofovir, tenofovir disoproxil, tenofovir alafenamide fumarate, tenofovir alafenamide hemifumarate, tenofovir dipivoxil , tenofovir dipivoxil fumarate, tenofovir octadecyloxyethyl ester, CMX-157, tenofovir exalidex, besifovir, entecavir (BARACLUDE ® ), entecavir maleate, telbivudine (TYZEKA ® ), filocilovir, pradefovir, clevudine,
• immunomodulators include, but are not limited to, rintatolimod, imidol hydrochloride, ingaron, dermaVir, plaquenil (hydroxychloroquine), proleukin, hydroxyurea, mycophenolate mofetil (MPA) and its ester derivative mycophenolate mofetil (MMF), JNJ- 440, WF-10,AB-452, ribavirin, IL-12, INO-9112, polymer polyethyleneimine (PEI), Gepon, VGV-1, MOR-22, CRV-431, JNJ-0535, TG-1050, ABI-H2158, BMS-936559, GS-9688, RO- 7011785, RG-7854, RO-6871765, AIC-649, and IR-103.
• rintatolimod imidol hydrochloride
• ingaron dermaVir
• plaquenil hydroxychloroquine
• MMF mycophenolate mofetil
• MMF
• TLR Toll-Like Receptor
• the agents as described herein are combined with an agonist of a toll-like receptor (TLR), e.g., an agonist of TLR1 (NCBI Gene ID: 7096), TLR2 (NCBI Gene ID: 7097), TLR3 (NCBI Gene ID: 7098), TLR4 (NCBI Gene ID: 7099), TLR5 (NCBI Gene ID: 7100), TLR6 (NCBI Gene ID: 10333), TLR7 (NCBI Gene ID: 51284), TLR8 (NCBI Gene ID: 51311), TLR9 (NCBI Gene ID: 54106), and/or TLR10 (NCBI Gene ID: 81793), TLR11, TLR12 and TLR13.
• TLR toll-like receptor
• TLR modulators include, but are not limited to, AK-0701
• TLR3 modulators include, but are not limited to, rintatolimod, poly- ICLC, RIBOXXON ® , Apoxxim, RIBOXXIM ® , IPH-33, MCT-465, MCT-475 and ND-1.1.
• TLR4 agonists include, but are not limited to, G-100, and GSK- 1795091.
• Example TLR7 agonists that can be co-administered include without limitation AL- 034, DSP-0509, GS-9620 (vesatolimod), LHC-165, TMX-101 (imiquimod), GSK-2245035, resiquimod, DSR-6434, DSP-3025, IMO-4200, MCT-465, MEDI-9197, 3M-051, SB-9922, 3M-052, Limtop, TMX-30X, TMX-202, RG-7863, RG-7854, RG-7795, and the compounds disclosed in US20100143301 (Gilead Sciences), US20110098248 (Gilead Sciences), and US20090047249 (Gilead Sciences), US20140045849 (Janssen), US20140073642 (Janssen), WO2014/056953 (Janssen), WO2014/076221 (Janssen), WO2014/128189 (Janssen), US20140350031 (
• TLR7/TLR8 agonist that can be co-administered is NKTR-262, telratolimod and BDB-001.
• TLR-8 inhibitors include, but are not limited to, ZG- 170607
• Example TLR8 agonists that can be co-administered include without limitation E- 6887, IMO-4200, IMO-8400, IMO-9200, MCT-465, MEDI-9197, motolimod, resiquimod, selgantolimod (GS-9688), HRS-9950, VTX-1463, VTX-763, 3M-051, 3M-052, and the compounds disclosed in US2016289229 (Gilead Sciences), US20140045849 (Janssen), US20140073642 (Janssen), WO2014/056953 (Janssen), WO2014/076221 (Janssen), WO2014/128189 (Janssen), US20140350031 (Janssen), WO2014/023813 (Janssen), US20080234251 (Array Biopharma), US20080306050 (Array Biopharma), US20100029585 (Ventirx Pharma), US20110092485 (Ventirx Pharma), US201101
• Patent No. 9670205 (Gilead Sciences, Inc.), US20160289229 (Gilead Sciences, Inc.), WO2017/048727 (Gilead Sciences, Inc.), US20180065938 (Gilead Sciences, Inc.), and US20180086755 (Gilead Sciences, Inc.).
• Example TLR9 agonists that can be co-administered include without limitation AST-008, cobitolimod, CMP-001, IMO-2055, IMO-2125, S-540956, litenimod, MGN-1601, BB-001, BB-006, IMO-3100, IMO-8400, IR-103, IMO-9200, agatolimod, DIMS-9054, DV- 1079, DV-1179, AZD-1419, lefitolimod (MGN-1703), CYT-003, CYT-003-QbG10, tilsotolimod and PUL-042.
• TLR7, TLR8 and TLR9 modulators include, but are not limited to, the compounds disclosed in WO2017047769 (Teika Seiyaku), WO2015014815 (Janssen), WO2018045150(Gilead Sciences Inc), WO2018045144 (Gilead Sciences Inc),
• WO2015162075 (Roche), WO2017034986 (University of Kansas), WO2018095426 (Jiangsu Hengrui Medicine Co Ltd), WO2016091698(Roche), WO2016075661 (GlaxoSmithKline Biologicals), WO2016180743 (Roche), WO2018089695 (Dynavax Technologies), WO2016055553 (Roche), WO2015168279 (Novartis), WO2016107536 (Medshine Discovery), WO2018086593 (Livo (Shanghai) Pharmaceutical), WO2017106607 (Merck), WO2017061532 (Sumitomo Dainippon Pharma), WO2016023511 (Chia Tai Tianqing Pharmaceutical), WO2017076346 (Chia Tai Tianqing Pharmaceutical), WO2017046112 (Roche), WO2018078149 (Roche), WO2017040233 (3M Co),WO2016141092 (Gilead Sciences), WO
• an agent as described herein is co-administered with a TLR7, TLR8 or TLR9 agonist.
• interferon alpha receptor ligands examples include interferon alpha- 2b (INTRON A ® ), pegylated interferon alpha-2a (PEGASYS ® ), PEGylated interferon alpha- lb, interferon alpha lb (HAPGEN ® ), Veldona, Infradure, Roferon-A, YPEG-interferon alfa-2a (YPEG- rhIFNalpha-2a), P-1101, Algeron, Alfarona, Ingaron (interferon gamma), rSIFN-co (recombinant super compound interferon), Ypeginterferon alfa-2b (YPEG-rhIFNalpha-2b), MOR-22, peginterferon alfa-2b (PEG-INTRON ® ), Bioferon, Novaferon, Inmutag (Inferon), MULTIFERON®, interferon alf a-n 1 (
• hyaluronidase inhibitors include, but are not limited to, astodrimer.
• HsAg Hepatitis B Surface Antigen
• HBsAg inhibitors include, but are not limited to, AK-074, HBF-0259, GP-605, PBHBV-001, PBHBV-2-15, PBHBV-2-1, REP-9AC, REP-9C, REP-9, REP-2139, REP-2139-Ca, REP-2055, REP-2163, REP-2165, REP-2053, REP-2031, REP-006, and REP- 9AC'.
• HBsAg secretion inhibitors include, but are not limited to, BM601, GST-HG-131, AB-452, and ALG-010093.
• CLA4 Cytotoxic T-lymphocyte-associated protein 4
• Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) inhibitors include, but are not limited to, AGEN-2041, AGEN-1884, ipilumimab, belatacept, PSI-001, PRS-010, Probody mAbs, tremelimumab, and JHL-1155.
• cyclophilin inhibitors include, but are not limited to, CPI-431-32, EDP-494, OCB-030, SCY-635, NVP-015, NVP-018, NVP-019, STG-175, and the compounds disclosed in US8513184 (Gilead Sciences), US20140030221 (Gilead Sciences), US20130344030 (Gilead Sciences), and US20130344029 (Gilead Sciences).
• HBV viral entry inhibitors include, but are not limited to, Myrcludex B.
• Hepatitis B large envelope protein inhibitors include, but are not limited to, GP-605, GST-HG-121, ALG-010093, and ALG-01013.
• antisense oligonucleotide targeting viral mRNA examples include, but are not limited to, ISIS-HBVRx, IONIS-HBVRx, IONIS-HBV-LRx, IONIS-GSK6-LRx, GSK- 3389404, BNC-1701 and RG-6004.
• Short Interfering RNAs siRNA
• ddRNAi short Interfering RNAs
• siRNA examples include, but are not limited to, TKM-HBV (TKM-HepB), ALN-HBV, SR-008, HepB-nRNA, ARC-520, ARC-521, ARB-1740, ARB-1467, AB-729, DCR-HBVS, RG-6084 (PD-L1), RG-6217, ALN-HBV-02, JNJ-3989 (ARO-HBV), STSG- 0002, ALG-010133, ALG-ASO, LUNAR-HBV and DCR-HBVS (DCR-S219).
• TKM-HBV TKM-HBV
• ALN-HBV ALN-HBV
• SR-008 HepB-nRNA
• ARC-520 ARC-521
• ARB-1740 ARB-1740
• ARB-1467 ARB-1467
• AB-729 DCR-HBVS
• RG-6084 PD-L1
• RG-6217 ALN-HBV-02
• ddRNAi DNA-directed RNA interference
• endonuclease modulators include, but are not limited to, PGN-514.
• inhibitors of ribonucleotide reductase include, but are not limited to, Trimidox.
• NRTIs Nonnucleoside Reverse Transcriptase Inhibitors
• Examples of Nonnucleoside Reverse Transcriptase Inhibitors include, but are not limited to, the compounds disclosed in WO2018118826 (Merck), WO2018080903(Merck), WO2018119013 (Merck), WO2017100108 (Idenix), WO2017027434 (Merck), WO2017007701 (Merck), WO2008005555 (Gilead).
• hepatitis B vims replication inhibitors include, but are not limited to, GP-31502, isothiafludine, IQP-HBV, RM-5038, and Xingantie.
• HIV-1 reverse transcriptase inhibitors HIV-1 reverse transcriptase inhibitors
• HIV-1 reverse transcriptase inhibitors include, but are not limited to, 2,5,6-substituted pyrimidone derivative (HBV).
• Non canonical RNA polymerase PAPD5 and PAPD7 inhibitors include, but are not limited to, PAPD5 and PAPD7 targeting locked nucleic acid antisense oligonucleotides (HBV infection).
• cccDNA inhibitors include, but are not limited to, BSBI-25, ccc-R08, and CHR-101.
• Farnesoid X receptor agonists include, but are not limited to, BSBI-25, ccc-R08, and CHR-101.
• Examples of farnesoid x receptor agonists include, but are not limited to, e.g., EYP- 001, cilofexor (GS-9674), EDP-305, MET-409, Tropifexor, AKN-083, RDX-023, BWD-100, LMB-763, INV-3, NTX-023-1, EP-024297 and GS-8670.
• Caspase-9 stimulators include, but are not limited to, ENOB-HB-01.
• CD3 modulators include, but are not limited to, IMC-I109V.
• Ffar2 and Ffar3 agonists include, but are not limited to, SFA-001.
• HBV antibodies targeting the surface antigens of the hepatitis B vims include, but are not limited to, lenvervimab (GC-1102), XTL-17, XTL-19, KN-003, IV Hepabulin SN, VIR-3434, and fully human monoclonal antibody therapy (hepatitis B virus infection, Humabs BioMed).
• HBV antibodies including monoclonal antibodies and polyclonal antibodies
• monoclonal antibodies and polyclonal antibodies include, but are not limited to, Zutectra, Shang Sheng Gan Di, Uman Big (Hepatitis B Hyperimmune), Omri-Hep-B, Nabi-HB, Hepatect CP, HepaGam B, igantibe, Niuliva, CT-P24, hepatitis B immunoglobulin (intravenous, pH4, HBV infection, Shanghai RAAS Blood Products), and Fovepta (BT-088).
• Examples of fully human monoclonal antibodies include, but are not limited to, HBC-34.
• CCR2 chemokine antagonists include, but are not limited to, propagermanium.
• thymosin agonists include, but are not limited to, Thymalfasin, and recombinant thymosin alpha 1 (GeneScience).
• cytokines include, but are not limited to, recombinant IL-7, CYT-107, interleukin-2 (IL-2, Immunex), recombinant human interleukin-2 (Shenzhen Neptunus), IL- 15, IL-21, IL-24, and celmoleukin.
• the agents described herein are combined with an interleukin agonist, such as IL-2, IL-7, IL-15, IL-10, IL-12 agonists;
• IL-2 agonists such as proleukin (aldesleukin, IL-2); pegylated IL-2 (eg NKTR-214); modified variants of IL-2 (eg THOR-707), bempegaldesleukin, AIC-284, ALKS-4230, CUI-101, Neo- 2/15;
• examples of IL-15 agonists such as ALT-803, NKTR-255, and hetIL-15, interleukin- 15/Lc fusion protein, AM-0015, NIZ-985, SO-C101, IL-15 Synthorin (pegylated 11-15), P- 22339, and a IL-15 -PD-1 fusion protein N-809;
• examples of IL-7 include CYT-107.
• Nucleoprotein modulators may be either HBV core or capsid protein inhibitors.
• nucleoprotein modulators include, but are not limited to, GS-4882, AB-423, AB-836, AT-130, ALG-001075, ALG-001024, ALG-000184, EDP-514, GLS4, NVR-1221, NVR-3778, AL-3778, BAY 41-4109, morphothiadine mesilate, ARB-168786, ARB-880, ARB-1820, GST-HG-141, JNJ-379, JNJ-632, RG-7907, GST-HG-141, HEC-72702, KL- 060332, AB-506, ABI-H0731, ABI-H3733, JNJ-440, AK-0605, HRS-5091, VNRX-9945, ABI-H2158, CB-HBV-001, AK-0605, SOC-10, SOC-11 and DVR-23.
• capsid inhibitors include, but are not limited to, the compounds disclosed in US2018161307 (Gilead Sciences), US20140275167 (Novira Therapeutics), US20130251673 (Novira Therapeutics), US20140343032 (Roche), WO2014037480 (Roche), US20130267517 (Roche), WO2014131847 (Janssen), WO2014033176 (Janssen), WO2014033170 (Janssen), WO2014033167 (Janssen), WO2015/059212 (Janssen), WO2015118057(Janssen), WO2015011281 (Janssen), WO2014184365 (Janssen), WO2014184350 (Janssen), WO2014161888 (Janssen), WO2013096744 (Novira), US20150225355 (Novira), US20140178337 (Novira), US20150315159 (Novira), US20150197533 (Novira), US201502
• WO2018043747 Kelzan Univ
• US20180065929 Janssen
• WO2016168619 Indiana University
• WO2016195982 The Penn State Foundation
• WO2017001655 Janssen
• WO2017048950 Alignment Biosciences
• WO2017048954 Alignment Biosciences
• WO2017048962 Alignment Biosciences
• US20170121328 Novira
• US20170121329 Novira
• transcript inhibitors include, but are not limited to, the compounds disclosed in WO2017013046 (Roche), WO2017016960 (Roche), WO2017017042 (Roche), WO2017017043 (Roche), WO2017061466 (Toyoma chemicals), WO2016177655 (Roche), WO2016161268 (Enanta), WO2017001853 (Redex Pharma), WO2017211791 (Roche), WO2017216685 (Novartis), WO2017216686 (Novartis), WO2018019297 (Ginkgo Pharma), WO2018022282 (Newave Pharma), US20180030053 (Novartis), and WO2018045911 (Zhejiang Pharma).
• the agents described herein are combined with a stimulator of interferon genes (STING).
• STING receptor agonist or activator is selected from the group consisting of ADU-S100 (MIW-815), SB-11285, MK- 1454, SR-8291, AdVCA0848, STINGVAX, GSK-532, SYN-STING, MSA-1, SR-8291, 5,6- dimethylxanthenone-4-acetic acid (DMXAA), cyclic-GAMP (cGAMP) and cyclic -di- AMP.
• the agents described herein are combined with a RIG-I modulator such as RGT-100, or NOD2 modulator, such as SB-9200, and IR-103.
• STING agonists include, but are not limited to, the compounds disclosed in WO 2018065360 (Biolog Life Science Institute Klaslabor und Biochemica-Vertrieb GmbH, Germany), WO 2018009466 (Aduro Biotech), WO 2017186711 (InvivoGen), WO 2017161349 (Immune Sensor), WO 2017106740 (Aduro Biotech), US 20170158724 (Glaxo Smithkiline), WO 2017075477 (Aduro Biotech), US 20170044206 (Merck), WO 2014179760 (University of California), WO2018098203 (Janssen), WO2018118665 (Merck), WO2018118664 (Merck), WO2018100558 (Takeda), WO2018067423 (Merck), and WO2018060323 (B
• Examples of stimulators of retinoic acid-inducible gene 1 include, but are not limited to, inarigivir soproxil (SB-9200), SB-40, SB-44, ORI-7246, ORI-9350, ORI-7537, ORI-9020, ORI-9198, ORI-7170, and RGT-100.
• Examples of stimulators of NOD2 include, but are not limited to, inarigivir soproxil (SB-9200).
• PI3K inhibitors include, but are not limited to, idelalisib, ACP-319, AZD-8186, AZD-8835, buparlisib, CDZ-173, CLR-457, pictilisib, neratinib, rigosertib, rigosertib sodium, EN-3342, TGR-1202, alpelisib, duvelisib, IPI-549, UCB-5857, taselisib, XL-765, gedatolisib, ME-401, VS-5584, copanlisib, CAI orotate, perifosine, RG-7666, GSK- 2636771, DS-7423, panulisib, GSK-2269557, GSK-2126458, CUDC-907, PQR-309, INCB- 40093, pilaralisib, BAY-1082439, puquitin
• the agents as described herein are combined with one or more blockers or inhibitors of inhibitory immune checkpoint proteins or receptors and/or with one or more stimulators, activators or agonists of one or more stimulatory immune checkpoint proteins or receptors.
• Blockade or inhibition of inhibitory immune checkpoints can positively regulate T-cell or NK cell activation and prevent immune escape of infected cells.
• Activation or stimulation of stimulatory immune check points can augment the effect of immune checkpoint inhibitors in infective therapeutics.
• the immune checkpoint proteins or receptors regulate T cell responses (e.g., reviewed in Xu et ak, J Exp Clin Cancer Res. (2016) 37:110).
• the immune checkpoint proteins or receptors regulate NK cell responses (e.g., reviewed in Davis et ak, Semin Immunol. (2017) 31:64-75 and Chiossone et ak, Nat Rev Immunol. (2016) 18(ll):671-688).
• immune checkpoint proteins or receptors include without limitation CD27, CD70; CD40, CD40LG; CD47, CD48 (SLAMF2), transmembrane and immunoglobulin domain containing 2 (TMIGD2, CD28H), CD84 (LY9B, SLAMF5), CD96, CD160, MS4A1 (CD20), CD244 (SFAMF4); CD276 (B7H3); V-set domain containing T cell activation inhibitor 1 (VTCN1, B7H4); V-set immunoregulatory receptor (VSIR, B7H5, VISTA); immunoglobulin superfamily member 11 (IGSF11, VSIG3); natural killer cell cytotoxicity receptor 3 ligand 1 (NCR3FG1, B7H6); HERV-H ETR-associating 2 (HHLA2, B7H7); inducible T cell co- stimulator (ICOS, CD278); inducible T cell costimulator ligand (ICOSLG, B7H2); TNF receptor superfamily
• CD270 TNFSF14 (HVEML); CD272 (B and T lymphocyte associated (BTLA));
• TNFRSF17 BCMA, CD269), TNFSF13B (BAFF); TNFRSF18 (GITR), TNFSF18 (GITRL); MHC class I polypeptide-related sequence A (MICA); MHC class I polypeptide-related sequence B (MICB); CD274 (CD274, PDL1, PD-L1); programmed cell death 1 (PDCD1, PD1, PD-1); cytotoxic T-lymphocyte associated protein 4 (CTLA4, CD152); CD80 (B7-1), CD28; nectin cell adhesion molecule 2 (NECTIN2, CD112); CD226 (DNAM-1); Poliovirus receptor (PVR) cell adhesion molecule (PVR, CD155); PVR related immunoglobulin domain containing (PVRIG, CD112R); T cell immunoreceptor with Ig and ITIM domains (TIGIT); T cell immunoglobulin and mucin domain containing 4 (TIMD4; TIM4); hepatitis A virus cellular receptor 2 (HAVCR
• T-cell inhibitory immune checkpoint proteins or receptors include without limitation CD274 (CD274, PDL1, PD-L1); programmed cell death 1 ligand 2 (PDCD1LG2, PD-L2, CD273); programmed cell death 1 (PDCD1, PD1, PD-1); cytotoxic T- lymphocyte associated protein 4 (CTLA4, CD152); CD276 (B7H3); V-set domain containing T cell activation inhibitor 1 (VTCN1, B7H4); V-set immunoregulatory receptor (VSIR,
• B7H5, VISTA immunoglobulin superfamily member 11
• IGSF11, VSIG3 immunoglobulin superfamily member 11
• TNFRSF14 HVEM, CD270
• TNFSF14 HVEML
• CD272 B and T lymphocyte associated (BTLA)
• PVR related immunoglobulin domain containing PVRIG, CD112R
• T cell immunoreceptor with Ig and ITIM domains TAGIT
• lymphocyte activating 3 LAG3, CD223)
• HAVCR2, TIMD3, TIM3 hepatitis A virus cellular receptor 2
• LGALS9 killer cell immunoglobulin like receptor, three Ig domains and long cytoplasmic tail 1 (KIR,
• the agents, as described herein, are combined with one or more agonist or activators of one or more T-cell stimulatory immune checkpoint proteins or receptors.
• T-cell stimulatory immune checkpoint proteins or receptors include without limitation CD27, CD70; CD40, CD40LG; inducible T cell costimulator (ICOS, CD278); inducible T cell costimulator ligand (ICOSLG, B7H2); TNF receptor superfamily member 4 (TNFRSF4, OX40); TNF superfamily member 4 (TNFSF4, OX40L); TNFRSF9 (CD137), TNFSF9 (CD137L); TNFRSF18 (GITR), TNFSF18 (GITRL); CD80 (B7-1), CD28; nectin cell adhesion molecule 2 (NECTIN2, CD112); CD226 (DNAM-1); CD244 (2B4, SLAMF4), Poliovirus receptor (PVR) cell adhesion molecule (PVR, CD155). See, e.g., Xu et al., J Exp Clin Cancer Res. (2018)
• NK-cell inhibitory immune checkpoint proteins or receptors include without limitation killer cell immunoglobulin like receptor, three Ig domains and long cytoplasmic tail 1 (KIR, CD158E1); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 1 (KIR2DL1); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 2 (KIR2DL2); killer cell immunoglobulin like receptor, two Ig domains and long cytoplasmic tail 3 (KIR2DL3); killer cell immunoglobulin like receptor, three Ig domains and long cytoplasmic tail 1 (KIR3DL1); killer cell lectin like receptor Cl (KLRC1, NKG2A, CD 159 A); and killer cell lectin like receptor D1 (KLRD1, CD94).
• NK-cell stimulatory immune checkpoint proteins or receptors include without limitation CD 16, CD226 (DNAM-1); CD244 (2B4, SLAMF4); killer cell lectin like receptor K1 (KLRK1, NKG2D, CD314); SLAM family member 7 (SLAMF7). See, e.g., Davis et ak, Semin Immunol. (2017) 31:64-75; Fang et ak, Semin Immunol. (2017) 31:37-54; and Chiossone et ak, Nat Rev Immunol. (2016) 18(ll):671-688.
• the one or more immune checkpoint inhibitors comprises a proteinaceous (e.g., antibody or fragment thereof, or antibody mimetic) inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
• the one or more immune checkpoint inhibitors comprises a small organic molecule inhibitor of PD-L1 (CD274), PD-1 (PDCD1) or CTLA4.
• the small molecule inhibitor of CD274 or PDCD1 is selected from the group consisting of GS-4224, GS-4416, INCB086550 and MAX10181. Additional examples of small molecule PD-L1 inhibitors include, but are not limited to, those disclosed in U.S. Publication No.
• the small molecule inhibitor of CTLA4 comprises BPI-002.
• inhibitors of CTLA4 that can be co-administered include without limitation ipilimumab, tremelimumab, BMS-986218, AGEN1181, AGEN1884, BMS- 986249, MK-1308, REGN-4659, ADU-1604, CS-1002, BCD-145, APL-509, JS-007, BA- 3071, ONC-392, AGEN-2041, JHL-1155, KN-044, CG-0161, ATOR-1144, PBI-5D3H5,
• B PI-002 as well as multi-specific inhibitors FPT-155 (CTLA4/PD-L1/CD28), PF-06936308 (PD-1/ CTLA4), MGD-019 (PD-1/CTLA4), KN-046 (PD-1/CTLA4), MEDI-5752 (CTLA4/PD-1), XmAb-20717 (PD-1/CTLA4), and AK-104 (CTLA4/PD-1).
• FPT-155 CTLA4/PD-L1/CD28
• PF-06936308 PD-1/ CTLA4
• MGD-019 PD-1/CTLA4
• KN-046 PD-1/CTLA4
• MEDI-5752 CTLA4/PD-1
• XmAb-20717 PD-1/CTLA4
• AK-104 CTLA4/PD-1).
• inhibitors of PD-L1 (CD274) or PD-1 (PDCD1) include without limitation pembrolizumab, nivolumab, cemiplimab, pidilizumab, AMP-224, MEDI0680 (AMP-514), spartalizumab, atezolizumab, avelumab, durvalumab, ALN-PDL, BMS-936559, CK-301, PF-06801591, BGB-108, BGB-A317 (tislelizumab), GLS-010 (WBP-3055), AK-103 (HX-008), GB-226, AK-105, CS-1003, HLX- 10, MGA-012, BI-754091, PDR-001, AGEN-2034, JS-001 (toripalimab), JNJ-63723283, genolimzumab (CBT-501), LZM-009,
• Examples of PD-1 inhibitors include, but are not limited to, the compounds disclosed in WO2017112730 (Incyte Corp), WO2017087777 (Incyte Corp), WO2017017624, WO2014151634 (BristolMyers Squibb Co), WO201317322 (BristolMyers Squibb Co), WO2018119286 (Incyte Corp), WO2018119266 (Incyte Corp), WO2018119263 (Incyte Corp), WO2018119236 (Incyte Corp), WO2018119221(Incyte Corp), WO2018118848 (BristolMyers Squibb Co), WO20161266460(BristolMyers Squibb Co), WO2017087678 (BristolMyers Squibb Co), WO2016149351 (BristolMyers Squibb Co), WO2015033299 (Aurigene Discovery Technologies Ltd), WO2015179615 (Eisai
• WO2016142835 Aurigene Discovery Technologies Ltd; Individual
• WO2016142833 Aurigene Discovery Technologies Ltd
• WO2018085750 BristolMyers Squibb Co
• WO2015033303 Aurigene Discovery Technologies Ltd
• WO2017205464 Incyte Corp
• WO2016019232 (3M Co; Individual; Texas A&M University System
• WO2015160641 BristolMyers Squibb Co
• WO2017079669 Incyte Corp
• WO2015033301 Aurigene Discovery Technologies Ltd
• WO2015034820 BristolMyers Squibb Co
• WO2018073754 Aurigene Discovery Technologies Ltd
• WO2016077518 BristolMyers Squibb Co
• WO2016057624 BristolMyers Squibb Co
• WO2018044783 Incyte Corp
• WO2016100608 BristolMyers Squibb Co
• WO2016100285 BristolMy
• the agents as described herein are combined with anti- TIGIT antibodies, such as BMS-986207, RG-6058, and AGEN-1307.
• TNF Receptor Superfamily (TNFRSF) Member Agonists or Activators
• the agents as described herein are combined with an agonist of one or more TNF receptor superfamily (TNFRSF) members, e.g., an agonist of one or more of TNFRSF1A (NCBI Gene ID: 7132), TNFRSF1B (NCBI Gene ID: 7133), TNFRSF4 (OX40, CD134; NCBI Gene ID: 7293), TNFRSF5 (CD40; NCBI Gene ID: 958), TNFRSF6 (FAS, NCBI Gene ID: 355), TNFRSF7 (CD27, NCBI Gene ID: 939), TNFRSF8 (CD30, NCBI Gene ID: 943), TNFRSF9 (4-1BB, CD137, NCBI Gene ID: 3604), TNFRSF10A (CD261, DR4, TRAILR1, NCBI Gene ID: 8797), TNFRSF10B (CD262, DR5, TRAILR2, NCBI Gene ID: 8795), TNFRSF10C (CD263,
• TNFRSF10A
• Example anti-TNFRSF4 (OX40) antibodies that can be co- administered include without limitation, MEDI6469, MEDI6383, MEDI0562 (tavolixizumab), MOXR0916, PF- 04518600, RG-7888, GSK-3174998, INCAGN1949, BMS-986178, GBR-8383, ABBV-368, IB I- 101 and those described in WO2016179517, WO2017096179, WO2017096182, WO2017096281, and WO2018089628.
• Example anti-TNFRSF5 (CD40) antibodies that can be co-administered include without limitation RG7876, SEA-CD40, APX-005M and ABBV-428.
• the anti-TNFRSF7 (CD27) antibody varlilumab (CDX-1127) is co-administered.
• Example anti-TNFRSF9 (4-1BB, CD137) antibodies that can be co-administered include without limitation urelumab, utomilumab (PF-05082566), AGEN2373 and ADG-106.
• Example anti-TNFRSF18 (GITR) antibodies that can be co-administered include without limitation, MEDI1873, FPA-154, INCAGN-1876, TRX-518, BMS-986156, MK- 1248, GWN-323, and those described in WO2017096179, WO2017096276,
• an antibody, or fragment thereof, co-targeting TNFRSF4 (OX40) and TNFRSF18 (GITR) is co-administered.
• OX40 co-targeting TNFRSF4
• GITR TNFRSF18
• the agents as described herein are combined with an inhibitor of indoleamine 2,3-dioxygenase 1 (IDOl; NCBI Gene ID: 3620).
• IDOl inhibitors include without limitation, BLV-0801, epacadostat, resminostat, F-001287, GBV-1012, GBV-1028, GDC-0919, indoximod, NKTR-218, NLG-919-based vaccine, PF- 06840003, pyranonaphthoquinone derivatives (SN-35837), SBLK-200802, BMS-986205, and shIDO-ST, EOS-200271, KHK-2455, LY-3381916, and the compounds disclosed in US20100015178 (Incyte), US2016137652 (Flexus Biosciences, Inc.), WO2014073738 (Flexus Biosciences, Inc.), and WO2015188085 (Flexus Biosciences, Inc.
• the agents as described herein are combined with an anti- TIM-3 antibody, such as TSR-022, LY-3321367, MBG-453, and INCAGN-2390.
• the agents described herein are combined with an anti LAG-3 (Lymphocyte-activation) antibody, such as relatlimab (ONO-4482), LAG-525, MK- 4280, REGN-3767, and INCAGN2385.
• LAG-3 Lymphocyte-activation antibody
• Examples of additional immune-based therapies that can be combined with an agent of this disclosure include interferon alfa; interferon alfa-2b; interferon alfa-n3; pegylated interferon alfa; interferon gamma; Flt3 agonists; gepon; normferon, peginterferon alfa-2a, peginterferon alfa- 2b, RPI-MN.
• IAPs apoptosis proteins family proteins
• IAP inhibitors include, but are not limited to, APG-1387.
• Examples of recombinant thymosin alpha- 1 include, but are not limited to, NL-004 and PEGylated thymosin alpha- 1.
• BTK inhibitors include, but are not limited to, ABBV-105, acalabrutinib (ACP-196), ARQ-531, BMS-986142, dasatinib, ibrutinib, GDC-0853, PRN- 1008, SNS-062, ONO-4059, BGB-3111, ML-319, MSC-2364447, RDX-022, X-022, AC- 058, RG-7845, spebrutinib, TAS-5315, TP-0158, TP-4207, HM-71224, KBP-7536, M-2951, TAK-020, AC-0025, and the compounds disclosed in US20140330015 (Ono Pharmaceutical), US20130079327 (Ono Pharmaceutical), and US20130217880 (Ono Pharmaceutical). KDM Inhibitors
• KDM5 inhibitors include, but are not limited to, the compounds disclosed in WO2016057924 (Genentech/Constellation Pharmaceuticals), US20140275092 (Genentech/Constellation Pharmaceuticals), US20140371195 (Epitherapeutics), US20140371214 (Epitherapeutics), US20160102096 (Epitherapeutics), US20140194469 (Quanticel), US20140171432, US20140213591 (Quanticel), US20160039808 (Quanticel), US20140275084 (Quanticel), and WO2014164708 (Quanticel).
• KDM1 inhibitors include, but are not limited to, the compounds disclosed in US9186337B2 (Oryzon Genomics), GSK-2879552, RG-6016, and ORY-2001.
• Arginase inhibitors include, but are not limited to, e CB-1158, C-201, and resminostat.
• the agents as described herein are combined with a bispecific NK-cell engager (BiKE) or a tri-specific NK-cell engager (TriKE) (e.g., not having an Fc) or bi-specific antibody (e.g., having an Fc) against an NK cell activating receptor, e.g., CD16A, C-type lectin receptors (CD94/NKG2C, NKG2D, NKG2E/H and NKG2F), natural cytotoxicity receptors (NKp30, NKp44 and NKp46), killer cell C-type lectin-like receptor (NKp65, NKp80), Fc receptor FcyR (which mediates antibody-dependent cell cytotoxicity), SLAM family receptors (e.g., 2B4, SLAM6 and SLAM7), killer cell immunoglobulin-like receptors (KIR) (KIR-2DS and KIR-3DS), DNAM-1 and CD137 (41BB).
• a bispecific NK-cell engager
• the anti-CD 16 binding bi-specific molecules may or may not have an Fc.
• Illustrative bispecific NK-cell engagers that can be co-administered target CD16 and one or more HBV- associated antigens as described herein.
• BiKEs and TriKEs are described, e.g., in Felices, et al., Methods Mol Biol. (2016) 1441:333-346; Fang, et al., Semin Immunol. (2017) 31:37-54.
• Long acting entecavir subcutaneous depot
• long acting tenofovir TAF
• devices devices
• subcutaneous depot An example of long acting entecavir is described in Exploration of long-acting implant formulations of hepatitis B drug entecavir., Eur J Pharm Sci. 2019 Aug 1 ; 136: 104958. Gene Therapy and Cell Therapy
• the agents described herein are combined with a gene or cell therapy regimen.
• Gene therapy and cell therapy include without limitation the genetic modification to silence a gene; genetic approaches to directly kill the infected cells; the infusion of immune cells designed to replace most of the patient’ s own immune system to enhance the immune response to infected cells, or activate the patient’s own immune system to kill infected cells, or find and kill the infected cells; genetic approaches to modify cellular activity to further alter endogenous immune responsiveness against the infection.
• the genome editing system is selected from the group consisting of: a CRISPR/Cas9 system, a zinc finger nuclease system, a TALEN system, a homing endonucleases system, and a meganuclease system (e.g., an ARCUS system); e.g., cccDNA elimination via targeted cleavage, and altering one or more of the hepatitis B vims (HBV) viral genes. Altering (e.g., knocking out and/or knocking down) the PreC, C, X, PreSI,
• PreS2, S, P or SP gene refers to (1) reducing or eliminating PreC, C, X, PreSI, PreS2, S, P or SP gene expression, (2) interfering with Precore, Core, X protein, Long surface protein, middle surface protein, S protein (also known as HBs antigen and HBsAg), polymerase protein, and/or Hepatitis B spliced protein function (HBe, HBc, HBx, PreSI, PreS2, S, Pol, and/or HBSP or (3) reducing or eliminating the intracellular, serum and/or intraparenchymal levels of HBe, HBc, HBx, LHBs, MHBs, SHBs, Pol, and/or HBSP proteins.
• Knockdown of one or more of the PreC, C, X, PreSI, PreS2, S, P and/or SP gene(s) is performed by targeting the gene(s) within HBV cccDNA and/or integrated HBV DNA.
• Additional examples genome editing systems include, but are not limited to, those disclosed in US2019284543 (Gilead Sciences), and US2019338263 (Gilead Sciences).
• Example of gene therapy such as liver targeted anti-HBV gene therapy (using ARCUS technology), or using CRISPR/Cas9 gene editing technology, or EBT-106 (LNP- delivered CRISPR/CasX nuclease.
• CAR-T cell therapy includes, but is not limited to, a population of immune effector cells engineered to express a chimeric antigen receptor (CAR), wherein the CAR includes an HBV antigen-binding domain.
• the antigen-binding domain is a domain disclosed herein.
• the antigen-binding domain is other than a domain disclosed herein.
• the antigen is HBsAg (i.e., HbsAg- CART).
• the immune effector cell is a T-cell or an NK cell.
• the T- cell is a CD4+ T-cell, a CD8+ T-cell, a NK cell or a combination thereof.
• Cells can be autologous or allogeneic. An example of a CART directed to HBV is described in Cytotherapy. 2018 May;20(5):697-705. doi: 10.1016/j.jcyt.2018.02.
• TCR-T cell therapy includes, but is not limited to, T cells expressing HBV-specific T cell receptors.
• TCR-T cells are engineered to target HBV derived peptides presented on the surface of virus -infected cells.
• An example of a TCR directed to HBV is described in Wiss Mein, K. et al. T cell receptor grafting allows virological control of hepatitis B vims infection. J Clin Invest. 2019;129(7):2932-2945.
• TCR-T cell therapy includes, but is not limited to, T-Cells expressing HBV surface antigen (HBsAg)-specific TCR.
• HBV surface antigen HBsAg
• TCR-T cell therapy includes, but is not limited to, TCR-T therapy directed to treatment of HBV, such as LTCR-H2-1.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with an HBV DNA polymerase inhibitor, one or two additional therapeutic agents selected from the group consisting of immunomodulators, TLR modulators, HBsAg inhibitors, HBsAg secretion or assembly inhibitors, HBV therapeutic vaccines, HBV antibodies including HBV antibodies targeting the surface antigens of the hepatitis B virus and bispecific antibodies and “antibody-like” therapeutic proteins (such as DARTs®, DUOBODIES®, BITES®, XmAbs®, TandAbs®, Fab derivatives, or TCR-like antibodies), cyclophilin inhibitors, stimulators of retinoic acid-inducible gene 1, stimulators of RIG-I like receptors, PD-1 inhibitors, PD-L1 inhibitors, Arginase inhibitors, PI3K inhibitors, IDO inhibitors, and stimulators of NOD2, and one or two additional therapeutic agents selected from the group consisting of HBV viral entry
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with at least a second additional therapeutic agent selected from the group consisting of: HBV DNA polymerase inhibitors, immunomodulator, TLR modulators, HBsAg inhibitors, HBV therapeutic vaccines, HBV antibodies including HBV antibodies targeting the surface antigens of the hepatitis B vims and bispecific antibodies and “antibody-like” therapeutic proteins (such as DARPins®, anti-pMHC TCR- like antibodies, DARTs®, DUOBODIES®, BITES®, XmAbs®, TandAbs®, Fab derivatives, or TCR-like antibodies), cyclophilin inhibitors, stimulators of retinoic acid-inducible gene 1, stimulators of RIG-I like receptors, PD-1 inhibitors, PD-L1 inhibitors, Arginase inhibitors, PI3K inhibitors, IDO inhibitors, and stimulators of NOD2.
• HBV DNA polymerase inhibitors such as DARPins
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with at least a second additional therapeutic agent selected from the group consisting of: HBV DNA polymerase inhibitors, HBV viral entry inhibitors, NTCP inhibitors, HBx inhibitors, cccDNA inhibitors, HBV antibodies targeting the surface antigens of the hepatitis B vims, siRNA, miRNA gene therapy agents, sshRNAs, KDM5 inhibitors, and nucleoprotein modulators (HBV core or capsid protein inhibitors).
• a second additional therapeutic agent selected from the group consisting of: HBV DNA polymerase inhibitors, HBV viral entry inhibitors, NTCP inhibitors, HBx inhibitors, cccDNA inhibitors, HBV antibodies targeting the surface antigens of the hepatitis B vims, siRNA, miRNA gene therapy agents, sshRNAs, KDM5 inhibitors, and nucleoprotein modulators (HBV core or capsid protein inhibitors).
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with compounds such as those disclosed in U.S. Publication No. 2010/0143301 (Gilead Sciences), U.S. Publication No. 2011/0098248 (Gilead Sciences), U.S. Publication No. 2009/0047249 (Gilead Sciences), U.S. Patent No. 8722054 (Gilead Sciences), U.S. Publication No. 2014/0045849 (Janssen), U.S. Publication No. 2014/0073642 (Janssen), WO2014/056953 (Janssen), WO2014/076221 (Janssen), WO2014/128189 (Janssen), U.S.
• WO2013144129 (Roche), US20100015178 (Incyte), US2016137652 (Flexus Biosciences, Inc.), WO2014073738 (Flexus Biosciences, Inc.), WO2015188085(Flexus Biosciences, Inc.), U.S. Publication No. 2014/0330015 (Ono Pharmaceutical), U.S. Publication No. 2013/0079327 (Ono Pharmaceutical), U.S. Publication No. 2013/0217880 (Ono pharmaceutical), WO2016057924 (Genentech/Constellation Pharmaceuticals), US20140275092 (Genentech/Constellation Pharmaceuticals), US20140371195 (Epitherapeutics) and US20140371214 (Epitherapeutics).
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 5-30 mg tenofovir alafenamide fumarate, tenofovir alafenamide hemifumarate, or tenofovir alafenamide.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 5-10; 5-15; 5-20; 5-25; 25-30; 20-30; 15-30; or 10-30 mg tenofovir alafenamide fumarate, tenofovir alafenamide hemifumarate, or tenofovir alafenamide.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 10 mg tenofovir alafenamide fumarate, tenofovir alafenamide hemifumarate, or tenofovir aiafenamide. In certain embodiments, an agent disclosed herein, or a pharmaceutically acceptable salt thereof, is combined with 25 mg tenofovir alafenamide fumarate, tenofovir alafenamide hemifumarate, or tenofovir alafenamide.
• An agent as disclosed herein may be combined with the agents provided herein in any dosage amount of the compound (e.g., from 50 mg to 500 mg of compound) the same as if each combination of dosages were specifically and individually listed.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 100-400 mg tenofovir disoproxil fumarate, tenofovir disoproxil hemifumarate, or tenofovir disoproxil.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 100-150; 100-200, 100-250; 100-300; 100-350; 150-200; 150-250; 150-300; 150-350; 150-400; 200-250; 200-300; 200- 350; 200-400; 250-350; 250-400; 350-400 or 300-400 mg tenofovir disoproxil fumarate, tenofovir disoproxil hemifumarate, or tenofovir disoproxil.
• an agent disclosed herein, or a pharmaceutically acceptable salt thereof is combined with 300 mg tenofovir disoproxil fumarate, tenofovir disoproxil hemifumarate, or tenofovir disoproxil. In certain embodiments, an agent disclosed herein, or a pharmaceutically acceptable salt thereof, is combined with 250 mg tenofovir disoproxil fumarate, tenofovir disoproxil hemifumarate, or tenofovir disoproxil.
• an agent herein, or a pharmaceutically acceptable salt thereof is combined with 150 mg tenofovir disoproxil fumarate, tenofovir disoproxil hemifumarate, or tenofovir disoproxil.
• An agent as disclosed herein may be combined with the agents provided herein in any dosage amount of the compound (e.g., from 50 mg to 500 mg of compound) the same as if each combination of dosages were specifically and individually listed.
• Illustrative examples of pharmaceutically acceptable salts are mineral acid (hydrochloric acid, hydrobromic acid, phosphoric acid, and the like) salts, organic acid (acetic acid, propionic acid, glutamic acid, citric acid and the like) salts, quaternary ammonium (methyl iodide, ethyl iodide, and the like) salts. It is understood that the pharmaceutically acceptable salts are non-toxic. Additional information on suitable pharmaceutically acceptable salts can be found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., 1985, which is incorporated herein by reference.
• Salts derived from inorganic bases include, by way of example only, sodium, potassium, lithium, ammonium, calcium and magnesium salts.
• Salts derived from organic bases include, but are not limited to, salts of primary, secondary and tertiary amines, such as alkyl amines, dialkyl amines, trialkyl amines, substituted alkyl amines, di(substituted alkyl) amines, tri(substituted alkyl) amines, alkenyl amines, dialkenyl amines, trialkenyl amines, substituted alkenyl amines, di(substituted alkenyl) amines, tri(substituted alkenyl) amines, cycloalkyl amines, di(cycloalkyl) amines, tri(cycloalkyl) amines, substituted cycloalkyl amines, substituted cycloalkyl amines, substituted
• Amines are of general structure N(R 30 )(R 31 )(R 32 ), wherein mono-substituted amines have two of the three substituents on nitrogen (R 30 , R 31 , and R 32 ) as hydrogen, di-substituted amines have one of the three substituents on nitrogen (R 30 , R 31 , and R 32 ) as hydrogen, whereas tri-substituted amines have none of the three substituents on nitrogen (R 30 , R 31 , and R 32 ) as hydrogen.
• R 30 , R 31 , and R 32 are selected from a variety of substituents such as hydrogen, optionally substituted alkyl, aryl, heteroaryl, cycloalkyl, cycloalkenyl, heterocyclyl, and the like.
• Suitable amines include, by way of example only, isopropyl amine, trimethyl amine, diethyl amine, tri(iso-propyl) amine, tri(n-propyl) amine, ethanolamine, diethanolamine, 2-dimethylamino ethanol, lysine, arginine, histidine, caffeine, procaine, hydrabamine, choline, betaine, ethylenediamine, glucosamine, N-alkylglucamines, theobromine, purines, piperazine, piperidine, morpholine, N-ethylpiperidine, and the like.
• Salts derived from inorganic acids include hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like.
• Salts derived from organic acids include acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, malic acid, malonic acid, succinic acid, maleic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluene-sulfonic acid, salicylic acid, and the like.
• the combination therapy regimens of the present disclosure can be delivered by any suitable means, including oral, parenteral and topical methods.
• Other administration methods include intravenous administration and subcutaneous administration.
• Intravenous administration is the administration of substances directly into a vein, or “intravenously.” Compared with other routes of administration, the intravenous (IV) route is a faster way to deliver fluids and medications throughout the body.
• An infusion pump can allow precise control over the flow rate and total amount of medication delivered. However, in cases where a change in the flow rate would not have serious consequences, or if pumps are not available, the drip is often left to flow simply by placing the bag above the level of the patient and using the clamp to regulate the rate. Alternatively, a rapid infuser can be used if the patient requires a high flow rate and the IV access device is of a large enough diameter to accommodate it.
• intermittent infusion is used which does not require additional fluid. It can use the same techniques as an intravenous drip (pump or gravity drip), but after the complete dose of medication has been given, the tubing is disconnected from the IV access device.
• Some medications are also given by IV push or bolus, meaning that a syringe is connected to the IV access device and the medication is injected directly (slowly, if it might irritate the vein or cause a too-rapid effect).
• compound(s) or combination of compounds described herein may be administered by IV administration alone or in combination with administration of certain components of the treatment regimen by oral or parenteral routes.
• Oral administration is a route of administration where a substance is taken through the mouth, and includes buccal, sub labial, and sublingual administration, as well as enteral administration and that through the respiratory tract, unless made through e.g., tubing so the medication is not in direct contact with any of the oral mucosa.
• Typical form for the oral administration of therapeutic agents includes the use of tablets or capsules.
• compound(s) or combination of compounds described herein may be administered by oral route alone or in combination with administration of certain components of the treatment regimen by IV or parenteral routes.
• each component of the combination therapy regimen of the present disclosure can be administered at any suitable frequency, interval and duration.
• each component of the combination therapy regimen of the present disclosure can be administered once an hour, or two, three or more times an hour, once a day, or two, three, or more times per day, or once every 2, 3, 4, 5, 6, or 7 days, so as to provide the preferred dosage level.
• Each component of the combination therapy regimen of the present disclosure can be administered once a week, or once every 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,
• each component of the combination therapy regimen of the present disclosure can be administered once, twice, or three or more times, for an hour, for 1 to 6 hours, for 1 to 12 hours, for 1 to 24 hours, for 6 to 12 hours, for 12 to 24 hours, for a single day, for 1 to 7 days, for a single week, for 1 to 4 weeks, for a month, for 1 to 12 months, for a year or more, or even indefinitely.
• the combination therapy regimen can also include other compatible therapeutic agents.
• the components described herein can be used in combination with one another, with other active agents, or with adjunctive agents that may not be effective alone, but may contribute to the efficacy of the active agent.
• the compound of Formula (I) is administered at any suitable time as known by one of skill in the art.
• Representative time periods for administration of the compound of Formula (I) include, but are not limited to, about 4 weeks, or 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100, or about 104 weeks.
• the compound of Formula (I) is administered once a week for 12 weeks to 60 weeks.
• the compound of Formula (I) is administered once a week for 12 weeks to 48 weeks.
• the compound of Formula (I) is administered once a week for 12 weeks to 24 weeks.
• the compound of Formula (I) is administered once a week for 104 weeks. In some embodiments, the compound of Formula (I) is administered once a week for 52 weeks. In some embodiments, the compound of Formula (I) is administered once a week for 48 weeks. In some embodiments, the compound of Formula (I) is administered once a week for 24 weeks.
• the compound of Formula (I) can be administered to the subject by any suitable means including, but not limited to, oral administration. In some embodiments, the compound of Formula (I) is administered orally. In some embodiments, the compound of Formula (I) is administered orally once a week for 24 weeks.
• the dsRNA is administered at any suitable time as known by one of skill in the art.
• the dsRNA can be administered once a week, or once every 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or 26 weeks.
• Representative time periods for administration of the dsRNA include, but are not limited to, about 4 weeks, or 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100, or about 104 weeks.
• the dsRNA is administered once every week, once every 2 weeks, once every 4 weeks, once every 6 weeks, once every 8 weeks, or once every 12 weeks for any suitable time as known by one of skill in the art. In some embodiments, the dsRNA is administered for 12 weeks to 60 weeks. In some embodiments, the dsRNA is administered for 12 weeks to 48 weeks. In some embodiments, the dsRNA is administered for 12 weeks to 24 weeks.
• the dsRNA is administered once every 4 weeks for 104 weeks. In some embodiments, the dsRNA is administered once every 12 weeks for 104 weeks. In some embodiments, the dsRNA is administered once every 4 weeks for 52 weeks. In some embodiments, the dsRNA is administered once every 12 weeks for 52 weeks. In some embodiments, the dsRNA is administered once every 4 weeks for 48 weeks. In some embodiments, the dsRNA is administered once every 12 weeks for 48 weeks. In some embodiments, the dsRNA is administered once every 12 weeks for 24 weeks. In some embodiments, the dsRNA is administered once every 4 weeks for 24 weeks.
• the dsRNA can be administered to the subject by any suitable means including, but not limited to, intravenous injection or subcutaneous injection.
• the dsRNA is administered by subcutaneous injection.
• the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks.
• the dsRNA is administered by intravenous injection.
• the dsRNA is administered by intravenous injection once every 4 weeks for 24 weeks.
• the PD-1/PD-L1 inhibitors described herein can be administered at any suitable time as known by one of skill in the art.
• the PD- 1/PD-Ll inhibitor can be administered once a week, or once every 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or 26 weeks.
• the PD-1/PD-L1 inhibitors described herein can be administered once every week, once every 2 weeks, once every 4 weeks, once every 6 weeks, once every 8 weeks, or once every 12 weeks for any suitable time as known by one of skill in the art.
• Representative time periods for administration of the PD-1/PD-L1 inhibitor include, but are not limited to, about 4 weeks, or 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100, or about 104 weeks.
• the PD-1/PD-L1 inhibitors is administered for 12 weeks to 60 weeks.
• the PD-1/PD-L1 inhibitors described herein is administered for 12 weeks to 48 weeks.
• the PD-1/PD-L1 inhibitors is administered for 12 weeks to 24 weeks.
• the PD-1/PD-L1 inhibitor is nivolumab.
• the nivolumab can be administered at any suitable time as known by one of skill in the art.
• the nivolumab can be administered once a week, or once every 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 or 26 weeks.
• the nivolumab can be administered once every week, once every 2 weeks, once every 4 weeks, once every 6 weeks, once every 8 weeks, or once every 12 weeks for any suitable time as known by one of skill in the art.
• Representative time periods for administration of the nivolumab include, but are not limited to, about 4 weeks, or 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100, or about 104 weeks.
• the nivolumab is administered for 12 weeks to 60 weeks.
• the nivolumab described herein is administered for 12 weeks to 48 weeks.
• the nivolumab is administered for 12 weeks to 24 weeks.
• the nivolumab is administered once every 4 weeks for 104 weeks. In some embodiments, the nivolumab is administered once every 12 weeks for 104 weeks. In some embodiments, the nivolumab is administered once every 4 weeks for 52 weeks. In some embodiments, the nivolumab is administered once every 12 weeks for 52 weeks. In some embodiments, the nivolumab is administered once every 4 weeks for 48 weeks. In some embodiments, the nivolumab is administered once every 12 weeks for 48 weeks. In some embodiments, the nivolumab is administered once every 12 weeks for 24 weeks. In some embodiments, the nivolumab is administered once every 4 weeks for 24 weeks.
• the PD-1/PD-L1 inhibitor can be administered to the subject by any suitable means including, but not limited to, orally, intravenous injection or subcutaneous injection. In some embodiments, the PD-1/PD-L1 inhibitor is administered orally. In some embodiments, the PD-1/PD-L1 inhibitor is administered by intravenous injection. In some embodiments, the PD-1/PD-L1 inhibitor is administered by subcutaneous injection. In some embodiments, the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks. In some embodiments, the nivolumab and is administered by subcutaneous injection once every 4 weeks for 24 weeks.
• the method comprises administering the compound of Formula I, the dsRNA, and nivolumab. In some embodiments, the method comprises administering the compound of Formula I, the dsRNA, and nivolumab at any suitable time as described herein.
• the dsRNA is administered by subcutaneous injection once every 4 weeks for 36 weeks starting at day 1. In some embodiments, the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1.
• the compound of Formula I is administered while the subject is fasting. In some embodiments, the compound of Formula I is administered orally once a week for 48 weeks starting at day 1 while the subject is fasting. In some embodiments, the compound of Formula I is administered orally once a week for 36 weeks starting at day 1 while the subject is fasting.
• the nivolumab is administered by intravenous injection once every 4 weeks for 36 weeks starting at day 1. In some embodiments, the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at day 1.
• the compound of Formula I is administered orally once a week for 24 weeks starting at day 1 while the subject is fasting, the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at day 1.
• the compound of Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting.
• the nivolumab is administered by subcutaneous injection or intravenous injection every 4 weeks for 24 weeks starting at week 12.
• the nivolumab is administered by intravenous injection every 4 weeks for 24 weeks starting at week 12.
• the compound of Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting, the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and the nivolumab is administered by intravenous injection every 4 weeks for 24 weeks starting at week 12.
• the combination therapy regimen of the present disclosure can exclude a nucleotide.
• the subject is not administered a nucleotide.
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen consisting of a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, thereby
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen consisting of a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) comprising SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methy1adenosine-3'- phosphate, each c is 2'-O-methylcytidme-3'-phosphate, each g is 2'-O-methyl
• the combination therapy regimen includes at least one additional agent.
• the additional agent includes tenofovir alafenamide, or tenofovir alafenamide fumarate. In some embodiments, the additional agent is tenofovir alafenamide. In some embodiments, the additional agent is tenofovir alafenamide fumarate.
• the method of the present disclosure further comprises administering to the subject an additional therapeutic agent.
• the method further comprises administering to the subject a compound of Formula (II): or a pharmaceutically acceptable salt thereof.
• the compound of Formula II has the structure: (II) .
• the compound of Formula II has the structure:
• the compound of Formula II can be administered by any suitable method and within any suitable time as described herein.
• the compound of Formula II can be administered for any suitable period of time including, but not limited to, 4 weeks, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100 or about 104 weeks.
• the compound of Formula II is administered orally.
• the compound of Formula II is administered once daily for 84 weeks starting at day 1.
• the compound of Formula II is administered once daily for 48 weeks starting at day 1.
• the compound of Formula II is administered once daily for 42 weeks starting at day 1.
• the compound of Formula II is administered once daily for 104 weeks starting at day 1. In some embodiments, the compound of Formula II is administered once daily for 36 to 84 weeks starting at day 1. In some embodiments, the compound of Formula II is administered once daily for 52 weeks starting at day 1. In some embodiments, the compound of Formula II is administered once daily for at least 36 weeks starting at day 1. In some embodiments, the compound of Formula II is administered once daily for 36 weeks starting at day 1. In some embodiments, the compound of Formula II is administered once daily for 24 weeks starting at day 1.
• administration of the compound of Formula II is terminated if after 36 weeks the subject is characterized by: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• administration of the compound of Formula II is terminated if after 36 weeks the subject is characterized by: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) negative for the hepatitis B surface antigen (HBsAg).
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• administration of the compound of Formula II is terminated if after 36 weeks the subject is characterized by: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than the lower limit of quantitation
• HBeAg negative for the hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• administration of the compound of Formula II is terminated if after 36 weeks the subject is characterized by: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) negative for the hepatitis B surface antigen (HBsAg).
• the method comprises administering the compound of Formula II, the compound of Formula I, the dsRNA, and nivolumab. In some embodiments, the method comprises administering the compound of Formula II, the compound of Formula I, the dsRNA, and nivolumab at any suitable time as described herein.
• the compound of Formula II is administered orally once daily for 48 weeks. In some embodiments, the compound of Formula II is administered orally once daily for 36 weeks. In some embodiments, the compound of Formula II is administered orally once daily for 36 weeks starting at day 1. In some embodiments, the compound of Formula II is administered orally once daily for 24 weeks. In some embodiments, the compound of Formula II is administered orally once daily for 24 weeks starting at day 1.
• the dsRNA is administered by subcutaneous injection once every 4 weeks for 36 weeks. In some embodiments, the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks. In some embodiments, the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1.
• the compound of Formula I is administered orally once a week for 36 weeks while the subject is fasting. In some embodiments, the compound of Formula I is administered orally once a week for 24 weeks while the subject is fasting. In some embodiments, the compound of Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting.
• the nivolumab is administered by intravenous injection every 4 weeks for 36 weeks. In some embodiments, the nivolumab is administered by intravenous injection every 4 weeks for 24 weeks starting at day 1. In some embodiments, the nivolumab is administered by intravenous injection every 4 weeks for 24 weeks starting at week 12.
• the compound of Formula II is administered orally once daily for 36 weeks starting at day 1
• the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1
• the compound of Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• the nivolumab is administered by intravenous injection every 4 weeks for 24 weeks starting at week 12.
• compositions of the present disclosure include a combination of the compound of formula (I), or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA), and a PD-1-PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, optionally in combination with an additional agent such as, for example, tenofovir alafenamide, or a pharmaceutically acceptable salt thereof.
• dsRNA double stranded ribonucleic acid
• PD-1-PD-L1 inhibitor a PD-1-PD-L1 inhibitor
• an additional agent such as, for example, tenofovir alafenamide, or a pharmaceutically acceptable salt thereof.
• Each component of the combination therapy regimen can be administered by injection and include aqueous solutions, oil suspensions, emulsions (with sesame oil, com oil, cottonseed oil, or peanut oil) as well as elixirs, mannitol, dextrose, or a sterile aqueous solution, and similar pharmaceutical vehicles.
• Aqueous solutions in saline are also conventionally used for injection.
• Ethanol, glycerol, propylene glycol, liquid polyethylene glycol, and the like (and suitable mixtures thereof), cyclodextrin derivatives, and vegetable oils may also be employed.
• the proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion and/or by the use of surfactants.
• a coating such as lecithin
• surfactants for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.
• Sterile injectable solutions are prepared by incorporating the component compound(s) in the required amount in the appropriate solvent with various other ingredients as enumerated above or as required, followed by filtered sterilization.
• dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above.
• the preferred methods of preparation are vacuum-drying and freeze-drying techniques which yield a powder of the active ingredient(s) plus any additional desired ingredient from a previously sterile-filtered solution thereof.
• excipients include lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, sterile water, syrup, and methyl cellulose.
• the formulations can additionally include: lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl- and propylhydroxy-benzoates; sweetening agents; and flavoring agents.
• compositions are preferably formulated in a unit dosage form.
• unit dosage forms or “combined dosage unit” refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of one or more of the active materials (e.g., compound (I), optionally in combination with an additional agent calculated to produce the desired effect, in association with a suitable pharmaceutical excipient in for example, a tablet, capsule, ampoule or vial for injection.
• each active agent actually administered will be determined by a physician, in the light of the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compounds administered and their relative activity, the age, weight, and response of the individual patient, the severity of the patient's symptoms, and the like.
• the principal active ingredient(s) is/are mixed with a pharmaceutical excipient to form a solid pre-formulation composition containing a homogeneous mixture of a compound of the present disclosure.
• a pharmaceutical excipient for preparing solid compositions such as tablets, the principal active ingredient(s) is/are mixed with a pharmaceutical excipient to form a solid pre-formulation composition containing a homogeneous mixture of a compound of the present disclosure.
• these pre-formulation compositions as homogeneous, it is meant that the active ingredient(s) are dispersed evenly throughout the composition so that the composition may be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules.
• Each component of the combination therapy regimen can be provided in a pharmaceutical preparation preferably in unit dosage form.
• the preparation is subdivided into unit doses containing appropriate quantities of the compounds of the present disclosure.
• the unit dosage form can be a packaged preparation, the package containing discrete quantities of preparation, such as packeted tablets, capsules, and powders in vials or ampoules.
• the unit dosage form can be a capsule, tablet, cachet, or lozenge itself, or it can be the appropriate number of any of these in packaged form.
• Each component of the combination therapy regimen of the present disclosure can be present in any suitable amount, and can depend on various factors including, but not limited to, weight and age of the subject, state of the disease, etc.
• Suitable dosage ranges for the compound of the present disclosure include from about 0.1 mg to about 10,000 mg, or about 1 mg to about 1000 mg, or about 10 mg to about 750 mg, or about 25 mg to about 500 mg, or about 50 mg to about 250 mg.
• Suitable dosages for the compound of the present disclosure include about 1 mg, 5, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 200, 300, 400, 500, 600, 700, 800, 900 or 1000 mg.
• Each component of the combination therapy regimen of the present disclosure and the active agent can be present in the compositions of the present disclosure in any suitable weight ratio, such as from about 1:100 to about 100:1 (w/w), or about 1:50 to about 50:1, or about 1:25 to about 25:1, or about 1:10 to about 10:1, or about 1:5 to about 5:1 (w/w).
• the compound of the present disclosure and the other active agent can be present in any suitable weight ratio, such as about 1:100 (w/w), 1:50, 1:25, 1:10, 1:5, 1:4, 1:3, 1:2, 1:1, 2:1, 3:1, 4:1, 5:1, 10:1, 25:1, 50:1 or 100:1 (w/w).
• Other dosages and dosage ratios of the compound of the present disclosure and the active agent are suitable in the compositions and methods of the present disclosure.
• the compound of Formula I is administered in any suitable amount known by one of skill in the art.
• the compound of Formula I is administered to the subject in an amount of 0.5 to 20 mg.
• the compound of Formula I is administered to the subject in an amount of 1 to 10 mg.
• Other amounts of the compound of Formula I that can be administered to the subject include, but are not limited to, about 1.0 mg, or about 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2.0, 2.5 or about 3.0 mg.
• the compound of Formula I is administered to the subject in an amount of about 3 mg.
• the compound of Formula I can be administered in two equal amounts, or two unequal amounts. In some embodiments, the compound of Formula I can be administered in two equal amounts. In some embodiments, the compound of Formula I is administered to the subject in two 1.5 mg doses.
• the dsRNA is administered in any suitable amount known by one of skill in the art.
• the dsRNA is administered to the subject in an amount of 100 to 300 mg.
• the dsRNA is administered to the subject in an amount of 150 to 250 mg.
• Representative amounts of the dsRNA administered to the subject include, but are not limited to, about 100 mg, or about 105, 110, 115, 120, 125, 130, 135, 140, 145, 150, 155, 160, 165, 170, 175, 180, 185, 190, 195, 200, 210, 220, 230, 240, or about 250 mg.
• the dsRNA is administered to the subject in an amount of about 200 mg.
• the PD-1/PD-L1 inhibitors described herein can be administered in any suitable amount known by one of skill in the art. In some embodiments, the PD-1/PD-L1 inhibitors described herein is administered to the subject in an amount of 0.01 to 5 mg/kg. In some embodiments, the PD-1/PD-L1 inhibitors described herein is administered to the subject in an amount of 0.1 to 1 mg/kg.
• Representative amounts of the PD-1/PD-L1 inhibitors administered to the subject include, but are not limited to, about 0.1 mg/kg, or about 0.15, 0.20, 0.25, 0.30, 0.35, 0.40, 0.45, 0.50, 0.55, 0.60, 0.65, 0.70, 0.75, 0.80, 0.85, 0.90, 0.95, or about 1.0 mg/kg.
• the PD-1/PD-L1 inhibitors described herein is administered to the subject in an amount of 0.1 to 0.5 mg/kg.
• the PD-1/PD-L1 inhibitors described herein is administered to the subject in an amount of about 0.3 mg/kg.
• the PD-1/PD-L1 inhibitors can be administered in any suitable amount known by one of skill in the art.
• the compound of Formula I is administered to the subject in an amount 0.1 to 1000 mg.
• Representative amounts of the PD-1/PD-L1 inhibitor administered to the subject include, but are not limited to, from 0.1 to 500 mg, 1 to 100 mg, 1 to 50 mg, or from 10 to 50 mg.
• Other amounts of the PD-1/PD-L1 inhibitor administered to the subject include, but are not limited to, about 1 mg, or 2, 3, 4, 5, 6, 7, 8, 9, 10,15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, or about 100 mg.
• the compound of Formula I is administered to the subject in an amount of 1 to 10 mg.
• Other amounts of the compound of Formula I that can be administered to the subject include, but are not limited to, about 1.0 mg, or about 1.1, 1.2,
• the compound of Formula I is administered to the subject in an amount of about 3 mg.
• the nivolumab can be administered in any suitable amount known by one of skill in the art. In some embodiments, the nivolumab is administered to the subject in an amount of 0.1 to 1 mg/kg. In some embodiments, the nivolumab is administered to the subject in an amount of 0.1 to 0.5 mg/kg. In some embodiments, the nivolumab is administered to the subject in an amount of about 0.3 mg/kg.
• the compound of Formula II can be administered in any suitable amount known by one of skill in the art. In some embodiments, the compound of Formula II is administered to the subject in an amount of 10 to 50 mg. In some embodiments, the compound of Formula II is administered to the subject in an amount of 20 to 40 mg. In some embodiments, the compound of Formula II is administered to the subject in an amount of 20 to 30 mg. Representative amounts of the compound of Formula II include, but are not limited to, about 1 mg, or 2, 3, 4, 5, 6, 7, 8, 9, 10,15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90,
• the compound of Formula II is administered to the subject in an amount of about 25 mg. In some embodiments, the compound of Formula II is administered to the subject in an amount of about 28 mg.
• the method of the present disclosure can reduce the viral load in a subject following completion of treatment.
• the subject has a hepatitis B viral load of less than about 300 international units per milliliter (IU/mL) following completion of treatment.
• the subject has a hepatitis B viral load of less than about 200 international units per milliliter (IU/mL) following completion of treatment.
• the subject has a hepatitis B viral load of less than about 100 international units per milliliter (IU/mL) following completion of treatment.
• the subject has a hepatitis B viral load of less than about 50 international units per milliliter (IU/mL) following completion of treatment.
• the subject has a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL) following completion of treatment. In some embodiments, the subject has a hepatitis B viral load of less than about 5 international units per milliliter (IU/mL) following completion of treatment. In some embodiments, the subject has a hepatitis B viral load of less than the lower limit of quantitation (LLOQ) following completion of treatment.
• LLOQ lower limit of quantitation
• the method of the present disclosure can reduce the hepatitis B surface antigen (HBsAg) concentration in a subject following completion of treatment.
• the subject has a hepatitis B surface antigen (HBsAg) concentration of less than about 200 international units per milliliter (IU/mL) following completion of treatment.
• the subject has a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL) following completion of treatment.
• the subject is negative for the hepatitis B surface antigen (HBsAg) following completion of treatment.
• the subject is negative for the hepatitis B e-antigen (HBeAg) following completion of treatment.
• HBeAg hepatitis B e-antigen
• the method of the present disclosure can reduce the alanine aminotransferase (ALT) concentration in a subject following completion of treatment.
• the subject has an alanine aminotransferase (ALT) concentration of less than about 2 times the upper limit of normal (ULN).
• the upper limit of normal can be about 100 international units per liter (IU/L), or about 95, 90, 85, 80, 75, 70, 65, 60, 55, 50, 45, 40, 35, 30, 25, 20, 15, or about 10 IU/L.
• the alanine aminotransferase concentration upper limit of normal is about 40 IU/L.
• the subject following the termination of treatment, is characterized by at least one of: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by at least one of: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) negative for the hepatitis B surface antigen (HBsAg).
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by at least one of: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than the lower limit of quantitation
• HBeAg negative for the hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by at least one of: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) negative for the hepatitis B surface antigen (HBsAg).
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) negative for the hepatitis B surface antigen (HBsAg) .
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL)
• HBeAg hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than the lower limit of quantitation
• HBeAg negative for the hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than the lower limit of quantitation; (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) negative for the hepatitis B surface antigen (HBsAg).
• HBeAg hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); and (iii) negative for the hepatitis B surface antigen (HBsAg).
• a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL)
• HBeAg hepatitis B e-antigen
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) a hepatitis B surface antigen (HBsAg) concentration of less than about 100 international units per milliliter (IU/mL).
• a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• the subject following the termination of treatment, is characterized by: (i) a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL); (ii) negative for the hepatitis B e-antigen (HBeAg); (iii) alanine aminotransferase less than about twice the upper limit of normal; and (iv) negative for the hepatitis B surface antigen (HBsAg).
• a hepatitis B viral load of less than about 0.05 international units per milliliter (IU/mL)
• HBeAg negative for the hepatitis B e-antigen
• alanine aminotransferase less than about twice the upper limit of normal
• HBsAg hepatitis B surface antigen
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at day 1 while the subject is fasting
• a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2 wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at day 1 while the subject is fasting
• a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2 wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising 3 mg of a compound of Formula (I): or a pharmaceutically acceptable salt thereof, wherein the compound of
• Formula I is administered orally once a week for 24 weeks starting at day 1 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine- 3'-phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2’-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2'-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3'-phosphate, each Gf is 2'-fluoroguanosine-3'-phosphate, Uf is 2’-fluor
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at day 1 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2' ⁇ O ⁇ methyladenosme ⁇ 3’-phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2’-fluoroadenosine ⁇ 3 !
• each Cf is 2'-fluorocytidine-3 ! - phosphate
• each Gf is 2'-fluoroguanosine-3’-phosphate
• Uf is 2'-fluorouridine- 3'-phosphate
• (Agn) is adenosine-glycol nucleic acid (GNA)
• each s is a phosphorothioate linkage
• L96 is N-[tris(GalNAc-alkyl)-amidodecanoyl)]- 4-hydroxyprolinol
• the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2 wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, wherein following completion of treatment, the subject is characterized by
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2 wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1, and 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine- 3'-phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2’-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2'-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3'-phosphate, each Gf is 2'-fluoroguanosine-3'-phosphate, Uf is 2’-fluor
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2’-O-methyladenosine- 3'-phosphate, each c is 2'-O-methylcytidine-3’-phosphate, each g is 2'-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2’-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3’- phosphate, each Gf is 2'-fluoroguanosine-3'-phosphate, Uf is 2’-fluor
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1,
• nivolumab 0.3 mg/kg of nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by (i) a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1,
• nivolumab 0.3 mg/kg of nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B viral load of less than the lower limit of quantitation;
• HBeAg negative for the hepatitis B e-antigen
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine- 3'-phosphate, each c is 2'-O-methy1cytidine-3'-phosphate, each g is 2'-O- methyIguanosine-3'-phosphate, each u is 2'-Q-methyIuridine-3'-phosphate, each Af is 2'-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3'- phosphate, each Gf is 2'-fluoroguanosine-3'-phosphate,
• nivolumab 0.3 mg/kg of nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O-methyladenosine- 3'-phosphate, each c is 2'-O-methylcytidine ⁇ 3' ⁇ phosphate, each g is 2'-O- methyIguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2'-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3'-phosphate, each Gf is 2'-fluoroguanosine-3'-phosphate, Uf is 2’
• nivolumab 0.3 mg/kg of nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting, 200 mg of a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1,
• nivolumab 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting, 200 mg of a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1,
• nivolumab 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting, 200 mg of a dsRNA of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2’-O-methyIadenosme- S'-phosphate, each e is 2’-O-methyleytidine-3’-phosphate, each g is 2’-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2'-fluoroadenosine-3'-phosphate, each Cf is 2'-fluorocytidine-3'- phosphate,
• nivolumab 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• a hepatitis B viral load of less than about 20 international units per milliliter (IU/mL);
• a method of treating and/or preventing a hepatitis B viral infection in a subject in need thereof comprising administering to the subject a therapeutically effective amount of a combination therapy regimen comprising
• Formula I is administered orally once a week for 24 weeks starting at week 12 while the subject is fasting
• SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2' ⁇ O ⁇ methyladenosme ⁇ 3’-phosphate, each c is 2'-O-methylcytidine-3'-phosphate, each g is 2'-O- methylguanosine-3'-phosphate, each u is 2'-O-methyluridine-3'-phosphate, each Af is 2’-fluoroadenosine ⁇ 3 !
• each Cf is 2'-fluorocytidine-3 ! - phosphate
• each Gf is 2'-fluoroguanosine-3’-phosphate
• Uf is 2'-fluorouridine- 3'-phosphate
• (Agn) is adenosine-glycol nucleic acid (GNA)
• each s is a phosphorothioate linkage
• L96 is N-[tris(GalNAc-alkyl)-amidodecanoyl)]- 4-hydroxyprolinol, and wherein the dsRNA is administered by subcutaneous injection once every 4 weeks for 24 weeks starting at day 1,
• nivolumab 0.3 mg/kg nivolumab, wherein the nivolumab is administered by intravenous injection once every 4 weeks for 24 weeks starting at week 12, and 25 mg of a compound of Formula (II): wherein the compound of Formula II is administered orally once daily for 36 weeks starting at day 1 , wherein following completion of treatment, the subject is characterized by
• hepatitis B surface antigen HBsAg
• the present disclosure provides a method for manufacturing a medicament for treating and/or preventing a hepatitis B viral infection in a subject in need thereof, characterized in that a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.: 1 and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, is used.
• a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid
• the present disclosure provides a method for manufacturing a medicament for treating and/or preventing a hepatitis B viral infection in a subject in need thereof, characterized in that a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.:l and SEQ ID
• SEQ ID NO.: 2 wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O- methyladenosine-3'-phosphate, each c is 2'-O-methyIcytidine-3'- phosphate, each g is 2'-O-methylguanosine-3’-phosphate, each u is 2 !
• each Af is 2'-fluoroadenosine-3'- phosphate
• each Cf is 2'-fluorocytidine-3'-phosphate
• each Gf is 2'- fluoroguanosine-3'-phosphate
• Uf is 2'-f]uorouridine-3'-phosphate
• (Agn) is adenosine-glycol nucleic acid (GNA)
• each s is a phosphorothioate linkage
• L96 is N-[tris(GalNAc-alkyl)- amidodecanoyl)]-4-hydroxyprolinol
• a PD-1/PD-L1 inhibitor or a pharmaceutically acceptable salt thereof, is used.
• the present disclosure provides use of a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, for the manufacture of a medicament for the treatment and/or prevention of a hepatitis B viral infection in a subject in need thereof.
• dsRNA double stranded ribonucleic acid
• the present disclosure provides use of a therapeutically effective amount of a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O- methy
• the present disclosure provides a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, for use in the treatment and/or prevention of a hepatitis B viral infection in a subject in need thereof.
• dsRNA double stranded ribonucleic acid
• the present disclosure provides a combination therapy regimen comprising a compound of Formula (I): or a pharmaceutically acceptable salt thereof, a double stranded ribonucleic acid (dsRNA) of SEQ ID NO.:l and SEQ ID NO.: 2, wherein SEQ ID NO.:l is 5’- usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'- gsusguGfcAfCfUfucgcuucacaL96-3', wherein SEQ ID NO.:l is 5'-usGfsuga(Agn)gCfGfaaguGfcAfcacsusu-3' and SEQ ID NO.:2 is 5'-gsusguGfcAfCfUfucgcuucacaL96-3', wherein each a is 2'-O- methyladenosine-3'-phosphate
• dsRNA double
• -fluorouridine-3'-phosphate (Agn) is adenosine-glycol nucleic acid (GNA), each s is a phosphorothioate linkage, and L96 is N-[tris(GalNAc-alkyl)- amidodecanoyl)]-4-hydroxyprolinol, and a PD-1/PD-L1 inhibitor, or a pharmaceutically acceptable salt thereof, for use in the treatment and/or prevention of a hepatitis B viral infection in a subject in need thereof.
• NUC nucleos(t)ide(s)
• HBV DNA including digital droplet polymerase chain reaction [ddPCR] if available
• ddPCR digital droplet polymerase chain reaction
• HBeAg hepatitis B core-related antigen
• HBeAg hepatitis B core-related antigen
• HBsAg glycosylated fraction of HBsAg (if applicable) during and after study treatment(s) discontinuation.
• CHB chronic hepatitis B
• the study will consist of 3 cohorts (Cohorts 1, 2, and 3). Approximately 40 NUC-suppressed and 80 viremic CHB-infected subjects, may be enrolled and assigned into a cohort below. Each cohort will enroll an approximate ( ⁇ 10%) equal number of HBeAg positive and negative subjects; and up to 20% of subjects can have HBsAg ⁇ 100 IU/mL
• TAF Tenofovir alafenamide
• VIR-2218200 mg administered as subcutaneous (SC) injection once every 4 weeks for 24 weeks (total 6 doses)
• Cohort 2 has completed enrollment.
• HBV DNA ⁇ 20 TTJ/mL; (2) HBeAg negative; and (3) — HBsAg ⁇ 100 IU/mL. • All remaining subjects will continue on TAF or other NUC treatment and enter a FU period.
• Target Population Adult, noncirrhotic, subjects with CHB infection who are viremic or virally suppressed on a commercially approved HBV NUC treatment.
• TAF 25 mg tablet will be administered orally once daily for up to 84 weeks, as applicable, in Cohort 1
• VIR-2218200 mg SC will be administered once every 4 weeks for 24 weeks (6 doses)
• Nivolumab 0.3 mg/kg IV will be administered once every 4 weeks for 24 weeks (6 doses)
• Treatment Period Visits Baseline/Day 1, Weeks 4, 8, 12, 13, 14, 16, 20, 24, 28, 32, and 36 • FU Visits: Weeks 1, 2, 4, 8, 12, 16 (for women of childbearing potential), 24 (Primary), 36, and 48
• Treatment Period Visits Baseline/Day 1, Weeks 4, 8, 12, 13, 14, 16, 20, 24, 28,
• Treatment Period Visits Baseline/Day 1, Weeks 1, 2, 4, 8, 12, , 14, 16, 20, and 24
• Treatment Period Visits Baseline/Day 1, Weeks 1, 2, 4, 8, 12, , 14, 16, 20, and 24
• Test Product, Dose, and Mode of Administration Selgantolimod will be supplied as tablets in strengths of 1.5 mg. SLGN 3 mg (2 x 1.5-mg tablets) will be administered while fasting, once a week, on the same day. Subjects must be fasting for at least 8 hours overnight (no food or drinks, except water) and continue through the morning, with no food or drinks, including water, 1 hour before to 2 hours after dosing. After 2 hours post dose, water is allowed and after 4 hours post dose, subjects are allowed food and drinks. Subjects should take their other prescribed medications, including NUC treatment, no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• NUC treatment no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• the secondary endpoints of this study are as follows: • The proportion of subjects with HBsAg loss with and without anti-HBsAg seroconversion during the study.
• HBV DNA >69 IU/mL for 2 consecutive visits after having been ⁇ 20 IU/mL or confirmed HBV DNA >1 logio IU/mL increase from nadir The proportion of subjects experiencing HBV virologic breakthrough (defined as HBV DNA >69 IU/mL for 2 consecutive visits after having been ⁇ 20 IU/mL or confirmed HBV DNA >1 logio IU/mL increase from nadir) during study treatment(s).
• Cohort 2 has completed enrollment.
• TAF 25 mg tablet will be administered orally once daily up to 84 weeks, as applicable, in Cohort 1
• VIR-2218200 mg SC will be administered once every 4 weeks for 24 weeks (6 doses)
• Nivolumab 0.3 mg/kg IV will be administered once every 4 weeks for 24 weeks (6 doses)
• SLGN 3 mg (2 x 1.5-mg tablets) will be administered orally while fasting once a week on the same day for 24 weeks (total 24 doses).
• HBV DNA 20 IU/mL
• HBeAg negative HBeAg negative
• HBsAg HBsAg ⁇ 100 IU/mL
• Cohorts 1-3 will enroll approximately 120 male and nonpregnant female subjects, ages 18 to 65 years, inclusive, with CHB infection without the presence of cirrhosis, and who are viremic or virally suppressed on NUC for at least 6 months.
• HBV DNA > 2000 IU/mL (HBeAg-negative) and HBV DNA > 20,000 IU/mL (HBeAg-positive)
• Selgantolimod [0313] Selgantolimod.
• Selgantolimod tablets 1.5 mg, have been formulated with microcrystalline cellulose, mannitol, croscarmellose sodium, and magnesium stearate. Tablets are round, plain-faced, film-coated and white.
• the white tablet film-coating contains polyvinyl alcohol, titanium dioxide, polyethylene glycol (PEG) 3350, and talc.
• Nivolumab Commercially available product of nivolumab injection will be used for this study. Further information regarding formulation is available in the current approved product label for nivolumab.
• Each film-coated tablet contains tenofovir alafenamide fumarate equivalent to 25 mg of TAF and have been formulated with croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
• the tablets are yellow, round, film-coated, and debossed with “GSI” on one side of the tablet and “25” on the other side of the tablet.
• VIR-2218 is a clear, colorless to pale yellow solution, which will be supplied by the sponsor as a sterile solution for SC injection at a free acid concentration of 200 mg/mL.
• Selgantolimod will be supplied as tablets in strengths of 1.5 mg. SLGN 3 mg (2 x 1.5-mg tablets) will be administered fasting once a week, on the same day. Subjects must be fasting for at least 8 hour overnight (no food or drinks, except water) and continue through the morning, with no food or drinks, including water, 1 hour before to 2 hours after dosing. After 2 hours post dose, water is allowed and after 4 hours post dose, subjects are allowed food and drinks. Subjects should take their other prescribed medications, including NUC treatment, no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• Nivolumab Nivolumab (Opdivo ® ) 40 mg/4 mL solution for injection will be supplied as single dose vials. Nivolumab 0.3 mg/kg will be administered as IV infusion over 30 minutes.
• Tenofovir Alafenamide TAF 25-mg tablet orally once daily with food.
• VIR-2218 VIR-2218, 200 mg/mL, solution for injection will be supplied as 0.5 ml. single dose vials. VIR-2218200 mg (2 x 0.5 mL solution) will be administered subcutaneously.
• NUC nucleos(t)ide(s)
• HBV DNA including digital droplet polymerase chain reaction [ddPCR] if available
• ddPCR digital droplet polymerase chain reaction
• HBeAg hepatitis B core-related antigen
• HBeAg hepatitis B core-related antigen
• HBsAg glycosylated fraction of HBsAg (if applicable) during and after study treatment(s) discontinuation.
• CHB chronic hepatitis B
• the study will consist of 3 cohorts (Cohorts 1, 2, and 3). Approximately 40 NUC-suppressed and 80 viremic CHB-infected subjects, may be enrolled and assigned into a cohort below. Each cohort will enroll a minimum of 20% HBeAg positive subjects; and up to 20% of subjects can have HBsAg ⁇ 100 IU/mL
• TAF Tenofovir alafenamide
• VIR-2218200 mg administered as subcutaneous (SC) injection once every 4 weeks for 24 weeks (total 6 doses)
• Cohort 2 Subjects will be randomized 2: 1 into Cohort 2 Groups A and B and stratified by HBsAg > or ⁇ 3 i ogi o IU/mL.
• Group A (n 40): • VIR-2218200 mg administered as SC injection once every 4 weeks for 24 weeks (total 6 doses)
• Cohort 2 has completed enrollment.
• HBV DNA ⁇ LLOQ (1) HBeAg negative; and (3) — HBsAg ⁇ 100 IU/mL.
• Target Population Adult, noncirrhotic, subjects with CHB infection who are viremic or virally suppressed on a commercially approved HBV NUC treatment.
• TAF 25 mg tablet will be administered orally once daily for up to 84 weeks, as applicable, in Cohort 1
• VIR-2218200 mg SC will be administered once every 4 weeks for 24 weeks (6 doses)
• Nivolumab 0.3 mg/kg IV will be administered once every 4 weeks for 24 weeks (6 doses)
• Treatment Period Visits Baseline/Day 1, Weeks 4, 8, 12, 13, 14, 16, 20, 24, 28,
• Treatment Period Visits Baseline/Day 1, Weeks 1, 2, 4, 8, 12, , 14, 16, 20, and 24
• Treatment Period Visits Baseline/Day 1, Weeks 1, 2, 4, 8, 12, , 14, 16, 20, and 24
• Test Product, Dose, and Mode of Administration Selgantolimod will be supplied as tablets in strengths of 1.5 mg. SLGN 3 mg (2 x 1.5-mg tablets) will be administered while fasting, once a week, on the same day. Subjects must be fasting for at least 8 hours overnight (no food or drinks, except water) and continue through the morning, with no food or drinks, including water, 1 hour before to 2 hours after dosing. After 2 hours post dose, water is allowed and after 4 hours post dose, subjects are allowed food and drinks. Subjects should take their other prescribed medications, including NUC treatment, no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• NUC treatment no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• HBV DNA >69 IU/mL for 2 consecutive visits after having been ⁇ LLOQ or confirmed HBV DNA >1 logio IU/mL increase from nadir The proportion of subjects experiencing HBV virologic breakthrough (defined as HBV DNA >69 IU/mL for 2 consecutive visits after having been ⁇ LLOQ or confirmed HBV DNA >1 logio IU/mL increase from nadir) during study treatment(s).
• Cohort 2 Subjects will be randomized 2: 1 into Cohort 2 (Groups A and B) and stratified by HBsAg > or ⁇ 3 logio IU/mL.
• Group A (n 40): • VIR-2218200 mg administered via SC injection once every 4 weeks for 24 weeks (total 6 doses)
• Cohort 2 has completed enrollment.
• TAF 25 mg tablet will be administered orally once daily up to 84 weeks, as applicable, in Cohort 1
• VIR-2218200 mg SC will be administered once every 4 weeks for 24 weeks (6 doses)
• Nivolumab 0.3 mg/kg IV will be administered once every 4 weeks for 24 weeks (6 doses)
• SLGN 3 mg (2 x 1.5-mg tablets) will be administered orally while fasting once a week on the same day for 24 weeks (total 24 doses).
• HBeAg-positive subjects meeting all of the above criteria with the exception of HBeAg status may also discontinue NUC treatment upon agreement between the investigator and the sponsor’s medical monitor.
• Subjects who do not meet the above criteria but choose to discontinue NUC treatment at EOT may do so upon agreement between the investigator and the sponsor’ s medical monitor approval.
• Subjects who meet the above criteria but the investigator wants to continue NUC treatment at EOT may do so upon agreement between the investigator and the sponsor’s medical monitor after discussion to evaluate risks and benefits.
• Cohorts 1-3 will enroll approximately 120 male and nonpregnant female subjects, ages 18 to 65 years, inclusive, with CHB infection without the presence of cirrhosis, and who are viremic or virally suppressed on NUC for at least 6 months.
• Subjects in Cohort 1 should meet the following additional criteria to be eligible to participate in this study: • Have been on a commercially available HBV NUC treatment(s) (i.e., TAF, TDF, entecavir, adefovir, lamivudine, telbivudine, either as single agents or in combination) with no change in regimen for 3 months prior to screening and willing to initiate TAF 25 mg.
• HBV NUC treatment(s) i.e., TAF, TDF, entecavir, adefovir, lamivudine, telbivudine, either as single agents or in combination
• HBV DNA > 2000 IU/mL (HBeAg-negative) and HBV DNA > 20,000 IU/mL (HBeAg-positive)
• Nivolumab Commercially available product of nivolumab injection will be used for this study. Further information regarding formulation is available in the current approved product label for nivolumab.
• Each film-coated tablet contains tenofovir alafenamide fumarate equivalent to 25 mg of TAF and have been formulated with croscarmellose sodium, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
• the tablets are yellow, round, film-coated, and debossed with “GSI” on one side of the tablet and “25” on the other side of the tablet.
• VIR-2218 is a clear, colorless to pale yellow solution, which will be supplied by the sponsor as a sterile solution for SC injection at a free acid concentration of 200 mg/mL.
• Selgantolimod will be supplied as tablets in strengths of 1.5 mg. SLGN 3 mg (2 x 1.5-mg tablets) will be administered fasting once a week, on the same day. Subjects must be fasting for at least 8 hour overnight (no food or drinks, except water) and continue through the morning, with no food or drinks, including water, 1 hour before to 2 hours after dosing. After 2 hours post dose, water is allowed and after 4 hours post dose, subjects are allowed food and drinks. Subjects should take their other prescribed medications, including NUC treatment, no earlier than 2 hours after SLGN dosing or, if medications require dosing with food, no earlier than 4 hours after SLGN dosing.
• Nivolumab (Opdivo ® ) 40 mg/4 mL solution for injection will be supplied as single dose vials. Nivolumab 0.3 mg/kg will be administered as IV infusion over 45-60 minutes.
• VIR-2218 VIR-2218, 200 mg/mL, solution for injection will be supplied as 0.5 mL single dose vials. VIR-2218200 mg (2 x 0.5 mL solution) will be administered subcutaneously.

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