ANTI-ICOS AGONIST ANTIBODIES AND USES OF THE SAME

专利摘要:
The present invention provides isolated monoclonal antibodies (e.g., humanized and human monoclonal antibodies) that bind to the human inducible T cell co-stimulator (ICOS) and exhibit therapeutically desirable functional properties, for example, the ability to stimulate human ICOS activity. Nucleic acid molecules encoding the antibodies of the invention, expression vectors, host cells, and methods for expressing the antibodies of the invention are also provided. Immunoconjugates, bispecific molecules, and pharmaceutical compositions comprising the antibodies of the invention are also provided. The antibodies of the invention can be used, for example, as an agonist to stimulate or enhance an immune response in an individual, for example, antigen-specific T cell responses against a tumor or viral antigen. The antibodies of the invention can also be used in combination with other antibodies (for example, PD-1, PD-L1, and / or CTLA-4 antibodies) to treat, for example, cancer. Consequently, antibodies can be used in therapeutic methods and applications to detect the ICOS protein.
公开号:BR112019013597A2
申请号:R112019013597-9
申请日:2018-04-05
公开日:2020-06-23
发明作者:J. Engelhardt John；John J. ENGELHARDT；J. Selby Mark；Mark J. Selby；J. Korman Alan；Alan J. Korman；Diane Feingersh Mary；Mary Diane Feingersh；L. Stevens Brenda；Brenda L. Stevens
申请人:Bristol-Myers Squibb Company；
IPC主号:

专利说明:

[001] [001] The present invention relates to anti-inducible T cell co-stimulator (ICOS) agonist antibodies and pharmaceutical compositions thereof, and methods for using such antibodies, for example, to treat cancer by administering anti-ICOS agonist antibodies and pharmaceutical compositions. RELATED REQUESTS
[002] [002] This Order claims the priority benefit of U.S. Provisional Orders No. 62 / 483,158 (deposited on April 7, 2017), 62 / 514,151 (deposited on June 2, 2017), 62 / 545,732 (deposited on August 15, 2017) and 62 / 581,412 (deposited on November 3, 2017) . The content of the aforementioned requests is hereby incorporated by reference in its entirety. SEQUENCE LISTING
[003] [003] This application contains a Sequence Listing that has been electronically deposited in ASCII format and is hereby incorporated by reference in its entirety. Said ASCII copy, created on March 30, 2018, is called MXI-556PC_SL.txt and is 321,751 bytes in size. BACKGROUND
[004] [004] There is a need to fight the global cancer epidemic. Cancer is a major cause of disease and the second leading cause of death in the world. Cancer was responsible for 8.8 million deaths in 2015. Overall, almost one in six deaths is due to cancer. In 2018, there will be an estimate of
[005] [005] Traditional cancer treatments include surgery, radiation and chemotherapy, among other therapies. In recent years, immuno-oncology has emerged as a new option for the treatment of cancer. Immuno-oncology is different from traditional cancer treatments, which, for example, attempted to attack tumors directly or interrupt the tumor's blood supply. Instead, immuno-oncology is designed to use the patient's immune response to treat cancer. Understanding how the immune system affects the development of cancer and how it can be used to treat cancer has been a challenging and complicated problem. For example, patients may not respond to certain immuno-cancer drugs, and some develop resistance mechanisms, such as T-cell exhaustion, which is when a T-cell, a specific type of white blood cell, no longer functions properly. (Dempke et al., Eur. J. of Cancer, 74 55-72 (2017)).
[006] [006] An important role of the immune system is its ability to differentiate between normal cells and "foreign" cells. The immune system can thus attack foreign cells and leave normal cells alone. To do this, the immune system uses "checkpoints", which are molecules in certain cells of the immune system that need to be activated or inactivated to initiate an immune response. Sometimes, tumor cells can use these checkpoints to avoid being attacked by the immune system. Some immunological drugs target these checkpoints by acting as checkpoint inhibitors. Programmed death protein 1 (PD-1) is a checkpoint inhibitor that typically acts as a brake to prevent T cells from attacking other cells in the body. PD-1 does this when it binds to the programmed death ligand 1 (PD-L1), a protein in some normal (and cancerous) cells. When PD-1 binds to PD-L1, this interaction tells the T cell not to attack other cells. Some cancer cells have large amounts of PD-L1, which helps them to escape the immune attack. Therapeutic agents, such as monoclonal antibodies that target this PD-1 / PD-L1 interaction, such as nivolumab (Opdivo®), can block the binding of PD-1 / PD-L1 to increase the body's immune response against tumor cells .
[007] [007] There is a need for drugs that target different mechanisms of action that work alone or in combination with checkpoint inhibitors to safely and effectively treat cancer and other diseases or conditions. The activation and function of T cells are regulated by the innate immune system through costimulatory molecules in the CD28 superfamily (for example, positive and negative costimulatory molecules that promote or inhibit the activation of the T cell receptor signal, respectively). The inducible molecule of the co-stimulator (ICOS), also known as CD278, is an immunological checkpoint protein that is a member of this CD28 superfamily. ICOS is a 55-60 kDa type I transmembrane protein that is expressed in T cells after T cell activation and co-stimulates T cell activation after binding its ligand, ICOS-L (B7H2). ICOS is expressed by CD4 + cells, CD8 + cells and regulatory T cells (Treg). ICOS has also been shown to be a key factor in the function of follicular helper T cells (Tfhs) and in the humoral immune response.
[008] [008] The magnitude and quality of the T cell immune response depends in part on the complicated balance between the co-stimulatory and inhibitory signals for T cells. To improve patient response rates after immunotherapy and to overcome drug resistance, there is the need for new immuno-oncology therapies. SUMMARY OF THE INVENTION
[009] [009] The present invention provides isolated monoclonal antibodies (for example, human and humanized monoclonal antibodies) that bind to human ICOS (SEQ ID NO: 1), that is, anti-water antibodies, and exhibit therapeutically desirable functional properties. The antibodies of the invention can be used as an agonist to stimulate or enhance an immune response in an individual, for example, to stimulate human ICOS activity and / or to provide antigen-specific T cell responses against a viral or tumor antigen. The antibodies of the invention can also be used in combination with other antibodies (for example, PD-1, PD-L1, and / or CTLA-4 antibodies) to treat various conditions, for example, cancer. Consequently, the antibodies described herein, alone or in combination with other agents, can be used to treat various conditions or diseases, including cancer. In other embodiments, the antibodies described herein can be used in methods to detect ICOS
[0010] [0010] In one aspect, the isolated antibody is an isolated humanized antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS- Human L) to human ICOS and induces proliferation and production of interferon-gamma (IFN-γ) in CD25-CD4 + T cells with an EC50 of about 0.01 to about 0.16 nM in an in-co-culture assay vitro CHO-OKT3-CD32A; and / or induces IFN-γ production in CD25- CD4 + T cells with an EC50 of about 0.002 nM to about 0.4 nM in a staphylococal B enterotoxin in a CD25- CD4 + T cell co-culture assay .
[0011] [0011] In another embodiment, the antibody (or antigen-binding portion thereof) exhibits one or more of the following characteristics: it binds to human T cells with an EC50 of about 0.7 nM and cinomolg T cells with a EC50 of about 0.3 nM; binds to human activated CD4 + T cells; does not bind to human CD28 or human CTLA-4; activates at least one primary T lymphocyte, such as a CD4 + effector T cell (Teff), an auxiliary follicular T cell (Tfh), and a regulatory T cell (Treg); induces protein kinase B (pAkt) phosphorylation in an in vitro primary T cell signaling assay with an EC50 of about 30 nM; induces the production of interleukin-10 (IL-10) in response to staphylococcal B enterotoxin in a Tfh and infant B cell coculture assay; induces an increased proliferation of CD3-stimulated Teffs compared to CD45RA + Tregs and CD45RO + Tregs in an in vitro assay; reduces the suppression of Teff by Tregs; does not increase cytokine production in a 10 μg / mL whole blood cell assay; increases the secretion of at least one of IL-10 and IFN-g by Tfh cells in vitro; stimulates ICOS-mediated signaling; has increased affinity for CD32B and / or CD32A; and / or has decreased affinity for CD16.
[0012] [0012] In another embodiment, the isolated antibody is a humanized isolated antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS- Human L) to human ICOS and induces proliferation and production of interferon-gamma (IFN-γ) in CD25-CD4 + T cells with an EC50 of about 0.083 nM in an in vitro CHO-OKT3-CD32A co-culture assay. In another embodiment, the isolated antibody is a humanized isolated antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, human ICOS-L) to human ICOS and induces proliferation and interferon-gamma (IFN-γ) production in CD25-CD4 + T cells with an EC50 of about 0.01 to about 0.1 Nm in a CHO-OKT3 co-culture assay -CD32A in vitro.
[0013] [0013] In one aspect, the isolated antibody is a humanized isolated antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS- Human L) to human ICOS and induces IFN-γ production in CD25-CD4 + T cells with an EC50 of about 0.2 nM in a staphylococcal B enterotoxin in a CD25-CD4 + T cell and B cell coculture assay. In another aspect, the isolated antibody is a humanized isolated antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, human ICOS-L) to human ICOS and induces IFN-γ production in CD25-CD4 + T cells with an EC50 of about 0.01 - 0.1 nM in a staphylococcal B enterotoxin in a CD25-CD4 + T cell and B cell coculture assay .
[0014] [0014] In another embodiment, the antibody (or antigen-binding portion of it) binds to human ICOS, cinomolgo, mouse and rat.
[0015] [0015] In another aspect, the isolated antibody binds to the human inducible co-stimulator molecule (ICOS) and comprises:
[0016] [0016] In another aspect, the isolated antibody binds to the human inducible co-stimulator molecule (ICOS), and the variable regions of heavy and light chains comprise: the amino acid sequences of SEQ ID NO: 5 and 6, respectively; the amino acid sequences of SEQ ID NOs: 16 and 176, respectively; the amino acid sequences of SEQ ID NOs: 24 and 25, respectively; the amino acid sequences of SEQ ID NOs: 32 and 33, respectively; the amino acid sequences of SEQ ID NOs: 40 and 41, respectively; the amino acid sequences of SEQ ID NOs: 40 and 48, respectively; or the amino acid sequences of SEQ ID NOs: 186 and 189, respectively.
[0017] [0017] In another aspect, the humanized, life-size monoclonal antibody that binds to the human inducible co-stimulator molecule (ICOS) comprises heavy chains that comprise the amino acid sequence mentioned in SEQ ID NO: 7 and the light chains that comprise amino acid sequence in SEQ ID NO: 8.
[0018] [0018] In one embodiment, the isolated antibody competes for binding to ICOS with or binds to the same epitope as an antibody that blocks the interaction of human ICOS and human ICOS-L. In another embodiment, the isolated antibody specifically binds to one or more residues of human ICOS SIFDPPPFKVTL (SEQ ID NO: 203). In another embodiment, the ICOS epitope comprises amino acid residues SIFDPPPFKVTL (SEQ ID NO: 203) from human ICOS.
[0019] [0019] In one embodiment, the antibodies of the invention are antibodies of natural size, for example, of an IgG1, IgG2, IgG2a or IgG4 isotope. In another embodiment, antibodies are binding fragments, such as Fab, Fab 'or (Fab') 2 fragments, or single chain antibodies.
[0020] [0020] In one aspect, anti-ICOS antibodies, or antigen-binding portion of these, bind to Fc receptors, such as one or more activating Fc gamma receptors (FcγRs). In certain embodiments, the antibody comprises at least one amino acid substitution in the Fc region compared to the human IgG1 sequence (SEQ ID NO: 206), which enhances the antibody's affinity to an FcγR, for example, FcγRIIb, such as one or more amino acid substitution at a position comprising at least one of 234, 235, 236, 237, 239, 266, 267, 268, 325, 326, 327, 328, and / or 332, according to the EU index, for example, 234D, 234E, 234F, 234W, 235D, 235F, 235R, 235Y, 236D, 236N, 237D, 237N, 239D, 239E, 266M, 267D, 267E, 268D, 268E, 327D, 327E, 328F, 328W, 328Y, and / or 332E. In other embodiments, the Fc region comprises at least two substitutions of 235Y-267E, 236D-267E, 239D-268D, 239D-267E, 267E-268D,
[0021] [0021] In another aspect, the invention provides immunoconjugates comprising an antibody of the invention, or antigen-binding portion thereof, attached to a therapeutic agent, for example, a cytotoxic agent or a radioactive isotope, as well as bispecific molecules comprising an antibody, or antigen binding portion thereof, of the invention, attached to a second functional portion having a different binding specificity than said antibody, or antigen binding portion thereof.
[0022] [0022] Compositions (e.g., pharmaceutical compositions) comprising an antibody, or antigen-binding portion thereof, or immunoconjugate or bispecific molecule of the invention and a pharmaceutically acceptable carrier are also provided. In another aspect, the composition also comprises a soluble neutral active hyaluronidase glycoprotein.
[0023] [0023] The nucleic acid molecules encoding the antibodies (e.g., cDNA), or the antigen-binding portions thereof (e.g., variable regions and / or CDRs) of the invention are also provided, as well as the expression vectors comprising such nucleic acids and host cells comprising such expression vectors. Methods for producing anti-ICOS antibodies by expressing the antibody in such host cells and isolating the antibody from the host cell are also provided.
[0024] [0024] In one aspect, the antibody alone reduced the antibody dependent cell-mediated cytotoxicity (ADCC) activity compared to an IgG1 control antibody.
[0025] [0025] In another aspect, the invention provides methods of stimulating immune responses using anti-ICOS antibodies, or antigen-binding portions thereof, of the invention. In one embodiment, the method includes stimulating an antigen-specific T cell response by contacting the T cells with an antibody, or an antigen-binding portion thereof, of the invention, such that an antigen-specific T cell response is stimulated . In another embodiment, the production of interleukin-2 by the antigen-specific T cell is stimulated. In yet another modality, the individual has a tumor (s), and an immune response against the tumor is stimulated. In another embodiment, the individual has a virus, and an immune response against the virus is stimulated.
[0026] [0026] In yet another aspect, the invention provides a method for inhibiting tumor cell development in an individual comprising administering to the individual an antibody, or antigen-binding portion thereof, of the invention, such that tumor growth is inhibited on the individual. In another aspect, the invention provides a method for treating viral infection in an individual comprising administering to the individual an antibody, or antigen binding portion thereof, of the invention such that the viral infection is treated in the individual. Such methods comprise administering an antibody, or antigen-binding portion thereof, a bispecific, or immunoconjugate composition of the invention.
[0027] [0027] In yet another aspect, the invention provides a method for stimulating an immune response in an individual comprising administering to the individual an antibody, or antigen binding portion thereof, of the invention, for example, in combination with at least one therapeutic agent such as an anti-PD-1 antibody, an anti-PD-L1 antibody and / or an anti-CTLA-4 antibody, such that an immune response is stimulated in the subject, for example, to inhibit tumor growth or stimulate an antiviral response. In one embodiment, the additional immunostimulatory antibody is an anti-PD-1 antibody. In another embodiment, the additional immunostimulating agent is an anti-PD-L1 antibody. In yet another embodiment, the additional immunostimulating agent is an anti-CTLA-4 antibody. In yet another embodiment, an antibody, or antigen-binding portion thereof, of the invention is administered with a cytokine (for example, IL-2, modified IL-2, and / or IL-21), or a costimulatory antibody (for example, example, an anti-CD137 and / or anti-GITR antibody). In some embodiments, the antibodies are, for example, human, chimeric or humanized antibodies.
[0028] [0028] In one embodiment, the isolated antibody is administered to one or more additional therapeutic agent (s) to the human. In another embodiment, the additional therapeutic agent is a chemotherapeutic agent.
[0029] [0029] Methods for treating cancer in an individual (e.g., a human patient) are also provided here, comprising administering to the patient an anti-ICOS antibody, or a combination of an anti-ICOS antibody and at least one additional antibody (for example, an anti-PD-1 antibody, an anti-PD-L1 antibody, and / or an anti-CTLA-4 antibody), in which the anti-ICOS antibody, or combination of antibodies, is administered according to a particular dosing regimen (that is, in a particular dosage amount and according to a specific dosing schedule). In one aspect, the method comprises at least one cycle of administration and, for each of at least one cycle, at least one dose of the antibody is administered in a dose of about 375 mg. In another aspect, the antibody is administered in an amount or frequency sufficient to obtain and / or maintain a receptor occupation of less than about 80%. In another embodiment, the method comprises administration at an interval of once a week, once every two weeks, once every three weeks, once every four weeks, once every five weeks, once every six weeks, once every seven weeks, once every eight weeks, once every nine weeks, once every ten weeks, once every eleven weeks, or once every twelve weeks.
[0030] [0030] The methods described here include the treatment of cancers, such as colorectal cancer (CRC), squamous cell carcinoma of the head and neck (HNSCC), non-small cell lung cancer (NSCLC), prostate cancer (PRC) , urothelial carcinoma (UCC), bladder cancer, breast cancer, uterine / cervical cancer, ovarian cancer, testicular cancer, esophageal cancer, gastrointestinal cancer, pancreatic cancer, colon cancer, kidney cancer, stomach cancer, cancer germ cell, bone cancer, liver cancer, thyroid cancer, skin cancer, central nervous system neoplasm, lymphoma, leukemia, myeloma, sarcoma, or virus-related cancer.
[0031] [0031] In yet another embodiment, antibodies are formulated for intravenous administration. In another embodiment, antibodies are formulated for subcutaneous administration. In another embodiment, antibodies are administered simultaneously (for example, in a single formulation or concurrently as separate formulations). Alternatively, in another embodiment, antibodies are administered sequentially (for example, as separate formulations).
[0032] [0032] The effectiveness of the treatment methods provided here can be assessed using any suitable methods. In some modalities, treatment reduces the size of the tumor, reduces the number of metastatic lesions over time, produces a complete response, produces partial results, and / or results in stable disease.
[0033] [0033] In another aspect, the invention provides anti-ICOS antibodies, or antigen-binding portions thereof, and compositions of the invention for use in the previous methods, or for the manufacture of a medicament for use in the previous methods (for example , for the treatment of various conditions).
[0034] [0034] Also provided are kits that include a pharmaceutical composition containing an anti-ICOS antibody in a therapeutically effective amount adapted for use in the methods described here. In another embodiment, the kit includes an anti-ICOS antibody and another antibody (for example, an anti-PD-1 antibody, anti-PD-L1 antibody, and / or an anti-CTLA-4 antibody) in therapeutically effective amounts adapted for use in the methods described here. For example, the kit comprises: a dose of an anti-ICOS antibody; a dose of an anti-PD-1 antibody, anti-PD-L1 antibody, and / or an anti-CTLA-4 antibody; and instructions for employing the antibodies in a method of the invention.
[0035] [0035] In another aspect, an anti-ICOS antibody is provided for administration (or co-administration with another antibody, for example, an anti-PD-1 antibody, anti-PD-L1 antibody, and / or an anti-CTLA- antibody 4) according to the methods described here.
[0036] [0036] Other characteristics and advantages of this description will be evident from the following examples and detailed description, which should not be interpreted as limiting. The contents of all references, GenBank records, patents and published patent applications cited throughout this application are expressly incorporated here by reference. BRIEF DESCRIPTION OF THE FIGURES
[0037] [0037] Figure 1 shows the sequence of human ICOS (SEQ ID NO:
[0038] [0038] Figure 2 shows a portion of the sequence of the human IgG1f constant domain (SEQ ID NO: 52, renumbered as residues 118 - 446) that can be used in the Fc sequence variants described here. Residues shown in bold are examples of residues subject to variation. The altered amino acid is provided in bold below the particular residue. The replacement for D270E is underlined. A C-terminal lysine residue A (K) has been omitted from the sequence of SEQ ID NO: 52, however, in some embodiments, it is present. Also, in some embodiments, the nucleic acids encoding these modalities include nucleotides encoding the extra lysine at the 3 'end of the nucleic acid.
[0039] [0039] Figure 3 shows the alignment sequence of the human light and heavy chain germline sequences used to humanize the parental hamster antibody (C398.4). VH3-15 was selected for the heavy chain, and VKI O18 was selected for the light chain based on the homology of the structural sequence. The human germline FW4, JK3, was also selected for the light chain based on sequence homology. The human germline FW4, JH4, was selected for the heavy chain based on sequence similarity, and did not contain residues that could represent a potential hazard risk. Asterisks and underscores indicate that the amino acid residues differ between the germline sequences and the parental hamster antibody sequence (C398.4).
[0040] [0040] Figure 4 shows the sequences of the light and heavy chain variable region of the anti-ICOS S267E IgG1f antibody from ICOS.33. The CDR1, 2, and 3 regions of the variable regions of light and heavy chains are in bold, underlined and labeled.
[0041] [0041] Figures 5A and 5B are graphs showing the production of interferon-gamma (IFN-γ) and S267E-induced cell proliferation of ICOS.33 IgG1f in cocultures of CD25- CD4 + T cells and CHO-OKT3- cells CD32A.
[0042] [0042] Figure 6 is a graph illustrating the induction of IFN-γ by anti-ICOS antibodies in a CD25-CD4 + T cell and B cell SEB co-culture assay.
[0043] [0043] Figures 7A and 7B are graphs showing the induction of IL-10 and IFN-γ in a SEf-stimulated Tfh and infant B cell co-culture assay. Average: 4.4-fold induction.
[0044] [0044] Figures 8A and 8B are graphs showing the elimination of suppression of Teff by Tregs with co-stimulation of anti-ICOS antibody.
[0045] [0045] Figures 9A and 9B are graphs that compare the ability of S267E to IgG1f from ICOS.33 and ICOS.33 IgG1 to induce ADCC using cells from two different donors (Donors 9 and 12).
[0046] [0046] Figure 10 is a graph of the results of an ELISA assay comparing the ability of S267E to IgG1f from ICOS.33 and ICOS.33 IgG1 to bind to the human complement component C1q.
[0047] [0047] Figures 11A-C are graphs showing the antitumor activity of Fc variants of the ICOS, ICOS IgG1 SE ("ICOS hg1 SE") and ICOS IgG1 ("ICOS hg1") antibodies, and an IgG1 isotype control antibody ("hIgG1") in an MC38 tumor model.
[0048] [0048] Figures 12A-E are graphs showing the tumor growth curves by treatment group. The mice were treated with the mG1 isotype control, ICOS.1 mg1 D265A, ICOS.4 mg1, ICOS.4 hg1, or ICOS.4 mg2a on days 7, 10, and 14 after Sa1N cell implantation.
[0049] [0049] Figures 13A and 13B are graphs that illustrate the median and average tumor growth curves by treatment group. The mice were treated with the mG1 isotype control, ICOS.1 mg1 D265A, ICOS.4 mg1, ICOS.4 hg1, or ICOS.4 mg2a on days 7, 10, and 14 after Sa1N cell implantation.
[0050] [0050] Figures 14A-D are graphs showing the percentage of Foxp3 + Treg cells, CD4 + Teff cells, and CD8 + T cells in tumors on Day 15. The mice were treated with mG1 isotype control, ICOS.1 mg1 D265A, ICOS .4 mg1, ICOS.4 hg1, or ICOS.4 mg2a on days 7, 10, and 14 after Sa1N cell implantation.
[0051] [0051] Figures 15A-J are graphs showing the tumor growth curves for individual mice by treatment group: antibodies mIgG1, mIgG1 anti-PD-1 D265A ("PD-1"), and / or anti- ICOS.4 mIgG1 ("ICOS.4 mg1") for isotype control.
[0052] [0052] Figures 16A and 16B are graphs showing the median and average tumor growth curves by treatment group: antibodies mIgG1, anti-PD-1 mg1, and / or anti-ICOS.4 mIgG1 ("ICOS.4 mg1 ") of isotype control.
[0053] [0053] Figures 17A-D are graphs showing the average percentages (SEM) of Foxp3 +, CD8 +, Ki-67, and Granzima B in tumors. The mice were treated with isotype control mIgG1, anti-PD-1 mg1, and / or anti-ICOS.4 mIgG1 ("ICOS.4 mg1") antibodies.
[0054] [0054] Figures 18A-I are graphs showing the tumor growth curves for the individual mice by treatment group: antibodies mIgG1, mIgG1 anti-PD-1 D265A ("PD-1"), and / or anti- ICOS.4 mIgG1 ("ICOS") for isotype control.
[0055] [0055] Figures 19A and 19B are graphs showing the mean and median tumor growth curves by treatment group: antibodies mIgG1, mIgG1 anti-PD-1 D265A ("PD-1"), and / or anti-ICOS .4 isotype control mIgG1 ("ICOS").
[0056] [0056] Figures 20A-D are graphs showing the percentage of Foxp3 + Treg cells, CD4 + Teff cells, and CD8 + T cells in the tumors. The mice were treated with the isotype control antibodies mIgG1, mIgG1 anti-PD-1 ("PD-1"), and / or anti-ICOS.4 mIgG1 ("ICOS").
[0057] [0057] Figures 21A-C are graphs showing the average percentages of Ki-67 in tumors. The mice were treated with the isotype control antibodies mIgG1, mIgG1 anti-PD-1 ("PD-1"), and / or anti-ICOS.4 mIgG1 ("ICOS").
[0058] [0058] Figures 22A-D are graphs showing the expression of ICOS-L in B cells in the spleen and PBMC. The mice were treated with the D265A anti-PD-1 mIgG1, mIgG1 antibodies ("PD-1"), and / or isotype control anti-ICOS.4 mIgG1 ("ICOS").
[0059] [0059] Figures 23A-F are graphs showing tumor growth curves for individual mice by treatment group: antibodies mIgG1, anti-CTLA-4 mIgG2b ("CTLA-4 mg2b"), anti-ICOS.4 mIgG1 ("ICOS.4 mg1"), and / or anti-ICOS.4 mIgG2a ("ICOS.4 mg2a") for isotype control.
[0060] [0060] Figures 24A and 24B are graphs showing the mean and median tumor growth curves by treatment group: antibodies mIgG1, anti-CTLA-4 mIgG2b ("CTLA-4 mg2b"), anti-ICOS.4 mIgG1 ("ICOS.4 mg1"), and / or anti-ICOS.4 mIgG2a ("ICOS.4 mg2a") for isotype control.
[0061] [0061] Figures 25A and 25B are graphs showing the binding of IC26.3 IgG1f S267E to human T cells, cynomolgus monkeys, rats and mice, as measured using FACS.
[0062] [0062] Figures 26A and 26B are graphs that show that the ICOS.33 IgG1f antibody has greater avidity of binding to CD4 + T cells as calculated by EC50 values compared to two competing anti-ICOS antibodies.
[0063] [0063] Figure 27 is a schematic illustration of a study of a dose escalation clinical trial using the anti-ICOS antibody in combination with the anti-PD-1 antibody and / or anti-CTLA-4 antibody.
[0064] [0064] Figure 28 is a graph showing the effects of increasing doses of anti-ICOS antibody, IC26.3 IgG1f S267E, in combination with an anti-PD1 antibody and the effect on inhibition of tumor growth in a mouse model. DETAILED DESCRIPTION
[0065] [0065] The present invention provides isolated antibodies, such as monoclonal antibodies, for example, humanized or human monoclonal antibodies, which specifically bind to human ICOS ("huICOS") and have agonist activity to stimulate an immune response. In some embodiments, the antibodies described herein comprise particular structural characteristics such as CDR regions comprising the particular amino acid sequences. In other embodiments, antibodies compete for binding to the human ICOS protein with, or bind to the same epitope as, the antibodies of the present invention.
[0066] [0066] Also provided herein are methods of preparing such antibodies, immunoconjugates, and bispecific molecules comprising such antibodies or antigen-binding fragments thereof, and pharmaceutical compositions formulated to contain the antibodies or antibody fragments. Also provided herein are methods of employing the antibodies, alone or in combination with other agents, for example, other immunostimulatory agents (for example, antibodies), to enhance the immune response to, for example, treat cancer and / or infections. Consequently, the anti-huICOS antibodies described herein can be used to treat a variety of conditions, including, for example, inhibiting tumor growth.
[0067] [0067] In order for the present description to be more easily understood, certain terms are first defined. Additional definitions are provided throughout the detailed description. The titles provided here are not limitations on the various aspects of the description, which can be understood by reference to the specification as a whole. Consequently, the terms defined immediately below are more fully defined by reference to the specification in its entirety.
[0068] [0068] As used here, ICOS refers to the "inducible T cell co-stimulatory protein" which in humans is encoded by the ICOS gene. ICOS is also known as "inducible co-stimulator," "activation inducible lymphocyte molecule," AILIM, CVID1, and CD278. Human ICOS is also described in GENE ID NO: 29851 and MIM (Mendelian Inheritance in Man):
[0069] [0069] Below are the amino acid sequences of the two isoforms of human ICOS.
[0070] [0070] Isoform 1 (Q9Y6W8) MKSGLWYFFL FCLRIKVLTG EINGSANYEM FIFHNGGVQI LCKYPDIVQQ FKMQLLKGGQ ILCDLTKTKG SGNTVSIKSL KFCHSQLSNN SVSFFLYNLD HSHANYYFCN LSIFDPPPFK
[0071] [0071] Isoform 2 (Q9Y6W8-2) MKSGLWYFFLFCLRIKVLTGEINGSANYEMFIFHNGGVQILCKY PDIVQQFKMQLLKGGQILCDLTKTKGSGNTVSIKSLKFCHSQLS NNSVSFFLYNLDHSHANYYFCNLSIFDPPPFKVTLTGGYLHIYE
[0072] [0072] The signal sequence of isoforms 1 and 2 corresponds to amino acids 1-20 (underlined above). Thus, mature isoforms 1 and 2 consist of amino acids 21-199 of SEQ ID NO: 1 and amino acids 21-158 of SEQ ID NO: 205.
[0073] [0073] ICOS interacts with the ICOS ligand (ICOS-L), which is also known as ICOSL, ICOS-LG, LICOS, B7H2, B7-H2, B7RP1, B7RP-1, CD275 and GL50. Human ICOS-L is also described in GENE ID NO: 23308 and MIM: 605717. The human ICOS-L sequence (NP_001269979.1), including the amino acid signal sequence 18, is provided in SEQ ID NO: 2. , the mature form of ICOS-L consists of amino acids 19-302 of SEQ ID NO: 2.
[0074] [0074] The term "antibody" or "immunoglobulin," which is used intermittently here, refers to a protein comprising at least two heavy chains (H) and two light chains (L) interconnected by disulfide bonds. Each heavy chain is comprised of a heavy chain variable region (abbreviated here as VH) and a heavy chain constant region (abbreviated here as CH). In certain embodiments, for example, naturally occurring IgG antibodies, the heavy chain constant region is comprised of a joint and three domains, CH1, CH2 and CH3. In certain antibodies, for example, naturally occurring IgG antibodies, each light chain is comprised of a light chain variable region (abbreviated here as VL) and a light chain constant region. The light chain constant region is comprised of a domain (abbreviated here as CL). The VH and VL regions can also be subdivided into regions of hypervariability, called regions of complementarity determination (CDR), interspersed with regions that are more conserved, called regions of structure (FR).
[0075] [0075] As used here, an "IgG antibody" has the structure of a naturally occurring IgG antibody, that is, it has the same number of heavy and light chains and disulfide bonds as a naturally occurring IgG antibody of the same subclass . For example, an anti-ICOS antibody IgG1, IgG2, IgG3 or IgG4 consist of two heavy chains (HCs) and two light chains (LCs), where the two heavy chains and light chains are linked by the same number and location of disulfides that occur in naturally occurring antibodies IgG1, IgG2, IgG3 and IgG4, respectively (unless the antibody has been mutated to modify disulfide bonds).
[0076] [0076] An "antigen" is a molecule or substance that activates an immune response and to which an antibody binds. Antibodies typically bind specifically to their cognate antigen with high affinity, reflected by a constant dissociation (KD) of 10-7 to 10-11 M or less. Any KD greater than about 10-6 M is generally considered to indicate non-specific binding. As used here, an antibody that "specifically binds" to an antigen refers to an antibody that binds to the antigen and, in some cases, substantially identical antigens, with high affinity, which methods having a KD of 10- 7 M or less, 10-8 M or less, 5 x 10-9 M or less, or between 10-8 M and 10-10 M or less, but does not bind with high affinity to unrelated antigens. An antigen is "substantially identical" to a supplied antigen if it exhibits a high degree of sequence identity to the supplied antigen, for example, if it exhibits at least 80%, at least 90%, at least 95%, at least 97% , or at least 99% sequence identity to the supplied antigen sequence. As an example, an antibody that specifically binds to human ICOS, in some modalities, also cross-reacts with the ICOS antigens of certain non-human primate species (eg, cynomolgus monkey), but does not cross-react with ICOS of others species or with an antigen other than ICOS.
[0077] [0077] As used herein, the term "antigen-binding portion" or "antigen-binding fragment" of an antibody refers to one or more parts of an antibody that retain the ability to specifically bind to an antigen ( for example, human ICOS). It has been shown that the antigen-binding function of an antibody can be performed by fragments or portions of a life-sized antibody.
[0078] The term "human acceptor structure" refers to a structure comprising the amino acid sequence of a light chain variable domain (VL) structure or a heavy chain variable domain (VH) structure derived from a structure human immunoglobulin or a human consensus framework. An acceptor human structure "derived from" a human immunoglobulin structure or a human consensus structure may have the same amino acid sequence as the naturally occurring human immunoglobulin structure or human consensus structure, or it may have amino acid sequence changes compared to the naturally occurring wild-type human immunoglobulin structure or human consensus structure. In some embodiments, the number of amino acid changes are 10, 9, 8, 7, 6, 5, 4, 3 or 2, or 1. In some embodiments, the human VL acceptor structure is identical in sequence to the human immunoglobulin VL or the human consensus framework sequence.
[0079] [0079] "Hinge," "hinge domain," or "hinge region," or "antibody hinge region" refers to the domain of a heavy chain constant region that links the CH1 domain to the CH2 domain and comprises upper, middle and lower portions. (Roux and others (1998) J. Immunol. 161: 4083). Depending on its amino acid sequence, a joint provides varying levels of flexibility between the antigen-binding domain and the effector region of an antibody and also provides sites for intermolecular disulfide binding between the two heavy chain constant regions. As used here, a joint starts at E216 and ends at G237 for all IgG isotypes (by EU numbering). Id. The sequences of IgG1, IgG2, IgG3 and IgG4 wild type joints are shown in Table 1. Table 1 - Ig Type Articulation Sequences C Termination CH1 * Upper Joint Middle Joint Lower Joint IgG1 VDKRV EPKSCDKTHT CPPCP APELLGG (SEQ ID NO. : 66) (SEQ ID NO: 67) (SEQ ID NO: 68) (SEQ ID NO: 69) IgG2 VDKTV ERK CCVECPPCP APPVAG (SEQ ID NO: 70) (SEQ ID NO: 71) (SEQ ID NO: 72) IgG3 (17-15- VDKRV ELKTPLGDTTHT CPRCP APELLGG 15-15) (SEQ ID NO: 66) (SEQ ID NO: 73) (EPKSCDTPPPCPRCP) 3 (SEQ ID NO: 69) (SEQ ID NO: 74) IgG3 (17- 15- VDKRV ELKTPLGDTTHT CPRCP APELLGG 15) (SEQ ID NO: 66) (SEQ ID NO: 73) (EPKSCDTPPPCPRCP) 2 (SEQ ID NO: 69) (SEQ ID NO: 75) IgG3 (17-15) VDKRV ELKTPLGDTTHT CPRCP APELLG (SEQ ID NO: 66) (SEQ ID NO: 73) (EPKSCDTPPPCPRCP) 1 (SEQ ID NO: 69) (SEQ ID NO: 76) IgG3 (15-15- VDKRV EPKS CDTPPPCPRCP APELLGG 15) (SEQ ID NO: 66) ) (SEQ ID NO: 77) (EPKSCDTPPPCPRCP) 2 (SEQ ID NO: 69) (SEQ ID NO: 78) IgG3 (15) VDKRV EPKS CDTPPPCPRCP APELLGG (SEQ ID NO: 66) (SEQ ID NO: 77) (SEQ ID NO: 77) (SEQ ID NO: 77) (SEQ ID NO: 77) (SEQ ID NO: 77) ID NO: 79) (SEQ ID NO: 69) IgG4 VDKRV ESKYGPP CPSCP APEFLGG (SEQ ID NO: 66) (SEQ ID NO: 80) (SEQ ID NO: 81) (SEQ ID NO: 82) C-terminus amino acid sequences of domains CH1.
[0080] [0080] The term "joint" includes wild type joints (such as those shown in Table 1), as well as variants of these (for example, unnatural joints or modified joints). For example, the term "IgG2 joint" includes wild type IgG2 joint, as shown in Table 1, and variants having 1 or more mutations (for example, substitutions, deletions and / or additions), for example, 1, 2, 3, 4, 5, 1 to 3, 1 to 5, 3 to 5 and / or at most 5, 4, 3, 2, or 1 mutations. Exemplary IgG2 joint variants include IgG2 joints in which 1, 2, 3 or all 4 cysteines (C219, C220, C226 and C229) are switched to another amino acid, for example, serine. In a specific modality, the IgG2 articulation region has a C219S substitution. In certain embodiments, the joint comprises sequences of at least two isotypes. For example, the joint may comprise the upper, middle or lower joint of an isotype, and the joint residue of one or more other isotypes. For example, the joint may be an IgG2 / IgG1 joint, and may comprise, for example, the upper and middle IgG2 joints and the lower IgG1 joint. A joint can have an effector function or be deprived of an effector function. For example, the lower joint of wild-type IgG1 provides an effective function. The term "CH1 domain" refers to the heavy chain constant region linking the variable domain to the hinge in a heavy chain constant domain. As used here, a CH1 domain starts at A118 and ends at V215. The term "CH2 domain" refers to the heavy chain constant region linking the hinge to the CH3 domain in a heavy chain constant domain. As used here, a CH2 domain starts at P238 and ends at K340. The term "CH3 domain" refers to the heavy chain constant region that is C-terminus for the CH2 domain in a heavy chain constant domain. As used here, a CH3 domain starts at G341 and ends at K447.
[0081] [0081] A "bifunctional" or "bispecific" antibody is an artificial hybrid antibody having two different binding specificities, for example, two different heavy / light chain pairs, giving rise to two antigen binding sites with specificity for different antigens . Bispecific antibodies can be produced by a variety of methods including fusion of hybridomas or ligation of Fab 'fragments. See, for example, Songsivilai & Lachmann, Clin. Exp. Immunol. 79: 315-321 (1990); Kostelny and others, J. Imunol. 148, 1547-1553 (1992).
[0082] [0082] As used herein, the term "monoclonal antibody" refers to an antibody obtained from a population of substantially homogeneous antibodies, that is, the individual antibodies in the population are substantially similar and bind to the same (s) ) epitope (s) (for example, antibodies exhibit a unique affinity and specificity of binding), except for the possible variants that may arise during the production of the monoclonal antibody, such variants generally being present in smaller amounts. "Monoclonal" indicates the characteristic of the antibody as having been obtained from a substantially homogeneous population of antibodies, and does not require production of the antibody by any particular method. The term "human monoclonal antibody" refers to an antibody from a population of substantially homogeneous antibodies that exhibit single binding specificity and that have optional and variable constant regions derived from human germline immunoglobulin sequences. In one embodiment, human monoclonal antibodies are produced using the hybridoma method, a transgenic non-human animal, for example, a transgenic mouse, is exposed to an antigen, and a white blood cell known as a B cell produces antibodies that bind to the antigen, which is harvested from the transgenic non-human animal. Isolated B cells are fused with an immortalized cell to produce a hybrid cell line called a hydridoma. In one embodiment, the hybridoma has a genome comprising a human heavy chain transgene and a light chain transgene fused to an immortalized cell.
[0083] [0083] Antigen-binding fragments (including scFvs) from such immunoglobulins are also covered by the term "monoclonal antibody" as used herein. Monoclonal antibodies are highly specific, being directed against a single antigenic site. In addition, in contrast to conventional (polyclonal) antibody preparations, which typically include different antibodies directed against different epitopes on the antigen, each monoclonal antibody is directed against a single epitope. Monoclonal antibodies can be prepared using any recognized technique and those described here such as, for example, a hybridoma method, a transgenic animal, recombinant DNA methods (see, for example, United States Patent No.
[0084] [0084] As used herein, the term "recombinant human antibody" includes all human antibodies that are prepared, expressed, raised or isolated by recombinant methods, such as (1) antibodies isolated from an animal (for example, a mouse) that is transgenic or transchromosomal to human immunoglobulin genes or a hybridoma prepared from them, (2) antibodies isolated from a host cell transformed to express the antibody, for example, from a transfectome, (3) antibodies isolated from a combinatorial human antibody library , recombinant, and (4) antibodies prepared, expressed, created or isolated by any other methods that involve the joining of human immunoglobulin gene sequences to other DNA sequences. Such recombinant human antibodies comprise constant and variable regions that use particular human germline immunoglobulin sequences are encoded by the germline genes, but include subsequent recombination and mutations that occur, for example, during antibody maturation. As known in the art (see, for example, Lonberg (2005) Nature Biotech. 23 (9): 1117-1125), the variable region contains the antigen-binding domain, which is encoded by several genes that rearrange themselves to form an antibody specific to a foreign antigen. In addition to the reorganization, the variable region can also be modified by multiple single amino acid changes (referred to as somatic mutation or hypermutation) to increase the antibody's affinity for the foreign antigen. The constant region will vary in another response to an antigen (that is, isotype change). Thus, the somatically mutated and rearranged nucleic acid molecules encoding the heavy chain and light chain immunoglobulin polypeptides in response to an antigen cannot have sequence identity with the original nucleic acid molecules, however, they will instead be substantially identical or similar (for example, have at least 80% identity).
[0085] [0085] As used herein, a "human antibody" refers to an antibody having variable regions in which the structure and CDR regions are also derived from human germline immunoglobulin sequences. In addition, if the antibody contains a constant region, the constant region is also derived from human germline immunoglobulin sequences. The anti-huICOS antibodies described herein can include amino acid residues not encoded by human germline immunoglobulin sequences (for example, because of the mutations introduced by site-specific or random mutagenesis in vitro or by somatic mutation in vivo). However, the term "human antibody" is not intended to include antibodies in which the CDR sequences derived from the germline of another species of non-human mammal, such as a mouse, have been grafted into the human structure sequences. As used herein, the terms "human" and "fully human" antibodies are used interchangeably.
[0086] A "humanized" antibody refers to an antibody in which some, most, or all of the amino acids outside the CDR domains of a non-human antibody are replaced with the corresponding amino acids derived from human antibodies. In an embodiment of a humanized form of an antibody, some, most, or all of the amino acids outside the CDR domains have been replaced with the amino acids of human antibodies, while some, most, or all of the amino acids within one or more CDR regions are unchanged. Small additions, deletions, insertions, substitutions, or modifications of amino acids are permissible as long as they do not prevent the antibody from binding to a particular antigen. A "humanized" antibody retains an antigen specificity similar to that of the original antibody.
[0087] [0087] A "chimeric antibody" refers to an antibody in which the variable regions are derived from one species and the constant regions are derived from other species, such as an antibody in which the variable regions are derived from a mouse antibody and the constant regions are derived from a human antibody. A "hybrid" antibody refers to an antibody having different light and heavy chains, such as a mouse or hamster (parent) heavy chain and a humanized light chain, or vice versa. Chimeric or hybrid antibodies can be constructed, for example, by genetic engineering, from immunoglobulin gene segments belonging to different species.
[0088] [0088] As used herein, "isotype" refers to the class of antibody (for example, IgG (including antibody IgG1, IgG2, IgG3, and IgG4), IgM,
[0089] [0089] "Allotype" refers to naturally occurring variants within a specific isotype group. (See, for example, Jefferis and other (2009) 1: 1 mAbs).
[0090] [0090] The terms "an antibody recognizing an antigen" and "an antibody specific for an antigen" are used interchangeably here with the term "an antibody that specifically binds an antigen".
[0091] [0091] As used herein, an "isolated antibody" refers to an antibody that is substantially free of other proteins and cellular materials. As used herein, an "effector function" refers to the interaction of an antibody Fc region with an Fc ligand or receptor, or a biochemical event that results from it. Exemplary "effector functions" include C1q binding, complement-dependent cytotoxicity (CDC), Fc receptor binding, FcγR-mediated effector functions such as ADCC and antibody dependent cell-mediated phagocytosis (ADCP), and subregulation of an receptor cell surface (for example, the B cell receptor; BCR). Such effector functions generally require the Fc region to be combined with a binding domain (for example, an antibody variable domain).
[0092] [0092] An "Fc receptor" or "FcR" is a receptor that binds to the Fc region of an immunoglobulin. FcRs that bind to an IgG antibody comprise receptors of the FcγR family, including allelic variants and alternatively spliced forms of these receptors. The FcγR family consists of three activation receptors (FcγRI, FcγRIII, and FcγRIV in mice; FcγRIA, FcγRIIA, and FcγRIIIA in humans) and an inhibitor (FcγRIIb, or equivalently FcγRIIB). Several exemplary properties of human FcγRs are summarized in Table 2. Most types of effector cells co-express one or more activation FcγR and inhibitory FcγRIIb, while natural killer cells (NK) selectively express an activation Fc receptor ( FcγRIII in mice and FcγRIIIA in humans), but not inhibitory FcγRIIb in mice and humans. Human IgG1 binds to most human Fc receptors and is considered equivalent to murine IgG2a with respect to the types of activation Fc receptors it binds to. Table 2 Exemplary properties of human FcγRs Fcγ Variants Affinity for Cell Distribution Preference allele human IgG isotype FcγRI None High (KD = about IgG1 = 3> 4 >> 2 Monocytes, macrophages, described 10 nM) activated neutrophils, dendritic cells FcγRIIA H131 Low mean IgG1> 3> 2> 4 Neutrophils, monocytes, macrophages, eosinophils, dendritic cells, R131 Low IgG1> 3> 4> 2 platelets FcγRIIIA V158 Average IgG1 = 3 >> 4> 2 Natural killer cells (NK), monocytes, F158 Low IgG1 = 3 >> 4> 2 macrophages, mast cells, eosinophils, dendritic cells FcγRIIb I232 Low IgG1 = 3 = 4> 2 B cells, monocytes, macrophages, T232 cells Low IgG1 = 3 = 4> 2 dendritic, mast cells
[0093] [0093] As used herein, an "Fc region" (fragment crystallizable region) or "Fc domain" or "Fc" refers to the C-termination region of an antibody heavy chain that mediates immunoglobulin binding to tissues hosts or factors, including binding to Fc receptors located on various cells of the immune system (eg, effector cells) or to the first component (C1q) of the classical complement system. Thus, an Fc region comprises the antibody constant region excluding the first immunoglobulin domain of the constant region (for example, CH1 or CL). In the IgG, IgA, and IgD antibody isotypes, the Fc region comprises the constant domains CH2 and CH3 in each of the two antibody heavy chains; the Fc IgM and IgE regions comprise three heavy chain constant domains (CH domains 2-4) in each polypeptide chain. For IgG, the Fc region comprises Cγ2 and Cγ3 immunoglobulin domains and the articulation between Cγ1 and Cγ2. Although the boundaries of the Fc region of an immunoglobulin heavy chain may vary, the human IgG heavy chain Fc region is normally defined to extend from an amino acid residue at position C226 or P230 (or an amino acid between these two amino acids) to the heavy chain carboxy, where the number is according to the EU index as in Kabat. (Kabat and others (1991) Sequences of Proteins of Immunological Interest, National Institutes of Health, Bethesda, MD). The CH2 domain of a human IgG Fc region extends from about amino acid 231 to about amino acid 340, while the CH3 domain is positioned next to the C-terminus of a CH2 domain in an Fc region, that is, it extends from about from amino acid 341 to about amino acid 447 of an IgG (including a C-terminating lysine). As used here, the Fc region can be a native sequence Fc, including any allotypic variant, or an Fc variant (for example, an unnaturally occurring Fc). The Fc region refers to this region in isolation or in the context of a protein polypeptide comprising Fc such as a "binding protein comprising an Fc region," also referred to as an "Fc fusion protein" (for example, a antibody or immunoadhesin).
[0094] An "Fc region" (fragment crystallizable region) or "Fc domain" or "Fc" refers to the C-termination region of an antibody heavy chain that mediates the binding of immunoglobulin to host tissues or factors, including binding to Fc receptors located on various cells of the immune system (for example, effector cells) or to the first component (C1q) of the classic complement system.
[0095] [0095] An "native sequence Fc region" or "native sequence Fc" has an amino acid sequence that is identical to the amino acid sequence of an Fc region found in nature. The native sequence human Fc regions include a native sequence human IgG1 Fc region (for example, SEQ ID NO: 206); the native sequence human IgG2 Fc region; native sequence IgG3 Fc region; and native sequence human IgG4 Fc region as well as their naturally occurring variants. Native sequence Fc includes the various Fcs allotypes. (See, for example, Jefferis and other (2009) 1: 1 mAbs).
[0096] [0096] The term "epitope" or "antigenic determinant" refers to a site on an antigen (e.g., huICOS) to which an immunoglobulin or antibody specifically binds. Epitopes can also be formed from contiguous amino acids (usually a linear epitope) or non-contiguous amino acids juxtaposed by tertiary duplication of the protein (usually a conformational epitope). Epitopes formed from contiguous amino acids are typically, but not always, retained in exposure to denaturing solvents, whereas epitopes formed by tertiary duplication are typically lost in treatment with denaturing solvents. An epitope typically includes at least 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, or 22 amino acids in a single spatial conformation.
[0097] [0097] The term "epitope mapping" refers to the process of identifying the molecular determinants in the antigen involved in the recognition of antibody antigen. Methods for determining what epitopes are linked by a supplied antibody are well known in the art and include, for example, immunoblotting and immunoprecipitation assays, in which contiguous peptides or overlapping (for example, from ICOS) are tested for reactivity with a supplied antibody (for example, anti-ICOS antibody); x-ray crystallography; mutational antigen analysis, two-dimensional nuclear magnetic resonance; yeast exposure; and hydrogen exchange / deuterium-mass spectrometry (HDX-MS) (see, for example, Epitope Mapping Protocols in Methods in Molecular Biology, Vol. 66, G. E. Morris, Ed. (1996)).
[0098] [0098] The term "binds to the same epitope" with reference to two or more antibodies means that the antibodies bind to the same segment of the amino acid residues, as determined by a method provided. Techniques for determining whether antibodies bind to the "same epitope in ICOS" with the antibodies described here include, for example, epitope mapping methods, such as x-ray analyzes of antigen: antibody crystals, which provide atomic resolution of the epitope, and HDX-MS. Other methods monitor the binding of the antibody to antigen fragments (eg, proteolytic fragments) or mutated variations of the antigen where it loses binding due to a modification of an amino acid residue within the antigen sequence is often considered to be an indication of a component of epitope, such as alanine scanning mutagenesis (Cunningham & Wells (1985) Science 244: 1081) or yeast display of mutant target sequence variants (see Example 16). In addition, computational combinatorial methods for epitope mapping can also be used. These methods rely on the ability of the antibody of interest to the affinity of specific small peptides isolated from combinatorial phage display peptide libraries. Antibodies having the same VH and VL sequences or the same CDR1, 2 and 3 are expected to bind to the same epitope.
[0099] [0099] Antibodies that "compete with another antibody to bind
[00100] [00100] Competitive binding assays to determine whether two antibodies compete, or cross competition for binding, include competition for binding to T cells expressing ICOS, for example, by flow cytometry. Other methods include: surface plasmon resonance (SPR) (for example, BIACORE®), direct or indirect solid phase radioimmunoassay (RIA), direct or indirect solid phase enzyme immunoassay (EIA), sandwich competition assay (see Stahli et al., Methods in Enzymology 9: 242 (1983)); Direct solid phase biotin-avidin EIA (see Kirkland et al., J. Immunol. 137: 3614 (1986)); direct solid phase labeled assay, direct solid phase labeled sandwich assay (see Harlow and Lane, Antibodies: A Laboratory Manual, Cold Spring Harbor Press (1988)); Direct solid phase labeling RIA using 1-125 labels (see Morel et al., Mol. Immunol. 25 (1): 7 (1988)); Direct solid phase biotin-avidin EIA (Cheung et al., Virology 176: 546 (1990)); and RIA labeled direct. (Moldenhauer and others, Scand. J. Imunol. 32:77 (1990)).
[00101] [00101] As used here, the terms "specific binding," "selective binding," "selectively binds," and "specifically binds," refer to antibody binding to an epitope on a predetermined antigen . Typically, the antibody: (1) binds with an equilibrium dissociation constant (KD) of approximately less than 10-7 M, such as approximately less than 10 -8 M, 10-9 M or 10-10 M or even lower when determined by, for example, SPR technology in a SPR BIACORE® 2000 instrument using the predetermined antigen, for example, recombinant human ICOS as the analyte and the antibody as the ligand, or analysis of Scatchard binds the antibody to positive antigen cells, and (2) binds the predetermined antigen with an affinity that is at least twice as high as its affinity for binding to a non-specific antigen (e.g., BSA, casein) other than the predetermined antigen or a closely related antigen. Accordingly, an antibody that "specifically binds to human ICOS" refers to an antibody that binds to human cell-bound or soluble ICOS with a KD of 10-7 M or less, such as approximately less than 10 - 8 M, 10-9 M or 10-10 M or less. An antibody that "cross-reacts with ICOS cinomolgo" refers to
[00102] [00102] The term "kassoc" or "ka", as used here, refers to the constant association rate of a particular antibody-antigen interaction, while the term "kdis" or "kd," as used here, refers to the rate of constant dissociation of a particular antibody-antigen interaction. The term "KD", as used here, refers to the equilibrium dissociation constant, which is obtained from the ratio of kd to ka (i.e., kd / ka) and is expressed as a molar concentration (M). KD values for antibodies can be determined using methods well established in the art. The available methods for determining the KD of an antibody is bi-layer interferometry (BLI) analysis, such as using a ForteBio Octet RED, SPR device, preferably employing a biosensor system such as a SPR BIACORE® system, or analysis Scatchard and flow cytometry.
[00103] [00103] The term "EC50", in the context of an in vitro or in vivo assay using an antibody or antigen binding fragment thereof, refers to the concentration of an antibody or an antigen binding fragment that it induces a response that is 50% of the maximum response, that is, halfway between the maximum response and the reference line.
[00104] [00104] The term "binds to immobilized ICOS" refers to the ability of an antibody described here to bind to ICOS, for example, expressed on the surface of a cell or attached to a solid support.
[00105] [00105] The term "cross-reacts," as used here, refers to the ability of an antibody described here to bind to ICOS of a different species. For example, an antibody described here that binds to human ICOS can also bind to ICOS of another species (for example, ICOS cinomolgo). As used herein, cross-reactivity can be measured by detecting specific reactivity with purified antigen in binding assays (for example, SPR, ELISA) or binding to, or otherwise functionality interacting with, physiologically expressing ICOS cells. Methods for determining cross-reactivity include standard binding assays as described here, for example, by SPR analysis using a SPR BIACORE® 2000 instrument (Biacore AB, Uppsala, Sweden), or flow cytometric techniques.
[00106] [00106] "Receptor occupation" or "receptor occupation", as used here, refers to the amount of agonistic antibody (for example, the anti-ICOS antibodies described here) that is bound to the immunostimulatory receptor (for example, human ICOS ). "% receiver occupancy" or "% receiver occupancy" can be calculated using the following formula: ([Test ΔMFI] / [ΔMFI of Total]) x 100. ΔMFI (change in mean fluorescence unit) is calculated by subtracting the base staining MFI with an MFI isotype control antibody from the bound agonistic antibody. The level of total receptor is determined by adding an amount of agonistic antibody saturation to determine the maximum expression and, therefore, MFI of the particular immunostimulatory receptor. An alternative method for calculating total receptor expression is to employ an antibody against the same immunostimulatory receptor that does not compete with the agonistic antibody for which receptor occupation is being calculated.
[00107] [00107] As used here, the term "naturally occurring" as applied to a substance that is present in nature that has not been intentionally modified by a person. For example, a polypeptide or polynucleotide sequence that is present in an organism
[00108] [00108] A "polypeptide" refers to a chain comprising at least two consecutively linked amino acid residues, with no upper limit on the length of the chain. One or more amino acid residues in the protein may contain a modification such as, but not limited to, glycosylation, phosphorylation or a disulfide bond. A "protein" can comprise one or more polypeptides.
[00109] [00109] The term "nucleic acid molecule," as used here, is intended to include DNA molecules and RNA molecules. A nucleic acid molecule can be single-stranded or double-stranded, and it can be cDNA.
[00110] [00110] The term "cDNA" refers to a non-naturally occurring nucleic acid molecule that was created or derived from mRNA, that is, the non-coding regions have been removed.
[00111] [00111] The term "mRNA" or "messenger RNA" is a nucleic acid intermediate that specifies the amino acid sequence of a polypeptide during translation.
[00112] [00112] As used herein, the term "conservative sequence modifications" refers to amino acid modifications that do not significantly affect or alter the binding characteristics of the antibody containing the amino acid sequence. Such conservative modifications include amino acid substitution, additions and deletions. Modifications can be introduced into an antibody of the invention by standard techniques known in the art, such as site-directed mutagenesis and polymerase chain reaction (PCR) mediated mutagenesis. Conservative amino acid substitutions are those in which the amino acid residue is replaced with an amino acid residue having a similar side chain. Families of amino acid residues having similar side chains have been defined in the art. These families include amino acids with basic side chains (for example, lysine, arginine, histidine), acidic side chains (for example, aspartic acid, glutamic acid), uncharged polar side chains (for example, glycine, asparagine, glutamine, serine, threonine, tyrosine, cysteine, tryptophan), non-polar side chains (e.g., alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine), beta-branched side chains (e.g., threonine, valine, isoleucine), and chains aromatic sides (eg tyrosine, phenylalanine, tryptophan, histidine). In this way, one or more amino acid residues within the CDR regions of an antibody of the invention can be replaced with other amino acid residues from the same side chain family and the altered antibody can be tested for the retained function (i.e., the functions shown here ) using the functional tests described here. In certain embodiments, a non-essential amino acid residue provided for in an anti-ICOS antibody is replaced with another amino acid residue from the same side chain family. Methods of identifying conservative amino acid and nucleotide substitutions that do not eliminate antigen binding are well known in the art (see, for example, Brummell and others, Biochem. 32: 1180-1187 (1993); Kobayashi and others (s) Protein Eng. 12 (10): 879-884 (1999); and Burks and other (s) Proc. Natl. Acad. Sci. USA 94: 412-417 (1997)).
[00113] [00113] For nucleic acids, the term "substantial homology" indicates that two nucleic acids, or designated sequences thereof, when optimally aligned and compared, are identical, with appropriate nucleotide deletions or insertions, in at least about 80% of the nucleotides, at least about 90% to 95%, or at least about 98% to 99.5% of the nucleotides. Alternatively,
[00114] [00114] For polypeptides, the term "substantial homology" indicates that two polypeptides, or designated sequences thereof, when optimally aligned and compared, are identical, with the appropriate amino acid deletions or insertions, at least about 80% of the amino acids at least about 90% to 95%, or at least about 98% to 99.5% of the amino acids.
[00115] [00115] The percentage of identity between two strings is a function of the number of positions shared by the strings when the strings are optimally aligned (ie% homology = (number of identical positions) / (total number of positions) x 100), taking into account the number of intervals and the length of each intervention, which needs to be introduced for the optimal alignment of the two sequences. The comparison of the sequences and the determination of the percentage of identity between the two sequences can be obtained using a mathematical algorithm, as described below.
[00116] [00116] The percentage of identity between the two nucleotide sequences can be determined, for example, using the GAP program in the GCG software package, using an nwsgapdna.cmp matrix and an interval weight of 40, 50, 60, 70, or 80 and a weight of 1, 2, 3, 4, 5, or 6. The percentage of identity between the two amino acid or nucleotide sequences can also be determined using the E. Meyers algorithm and W. Miller (CABIOS, 4: 11-17 (1989)), which was incorporated into the ALIGN program (version 2.0), using a PAM120 weight residue table, a 12-point gap penalty and a interval penalty of 4. In addition, the percentage of identity between the two amino acid sequences can be determined using the Needleman and Wunsch algorithm (J. Mol. Biol. (48): 444-453 (1970)), the which was incorporated into the GAP program in the GCG software package, using a Blossum 62 matrix or a PAM250 matrix, and a weight of range of 16, 14, 12, 10, 8, 6 or 4 and a weight of length of 1, 2, 3, 4, 5 or 6.
[00117] [00117] The nucleic acid and protein sequences, described here, can also be used as a "queri sequence" to perform a search against the public database, for example, to identify related sequences. Such searches can be carried out using the programs NBLAST and XBLAST (version
[00118] [00118] Nucleic acids can be present in whole cells, for example, a host cell, in a cell lysate, or in a substantially pure or partially purified form. A nucleic acid is "isolated" or "substantially pure rendered"
[00119] [00119] The term "vector", as used here, is intended to refer to a nucleic acid molecule capable of transporting another nucleic acid to which it has been attached. One type of vector is a "plasmid," which refers to a circular double-stranded DNA loop into which additional DNA segments can be ligated. Another type of vector is a viral vector, in which additional DNA segments can be linked in the viral genome. Certain vectors are capable of autonomous replication in a host cell in which they are introduced (for example, bacterial vectors having a bacterial origin of replication and episomic mammalian vectors). Other vectors (for example, non-episomal mammalian vectors) can be integrated into the genome of a host cell upon introduction into the host cell, and thus are replicated together with the host genome. In addition, certain vectors are able to direct the expression of genes to which they are operatively linked. Such vectors are referred to here as "recombinant expression vectors" (or simply, "expression vectors"). Expression vectors useful in recombinant DNA techniques include plasmids. As used here, "plasmid" and "vector" can be used interchangeably, as the plasmid is the most commonly employed form of vector. However, other forms of expression vectors, such as viral vectors (for example, replication defective retroviruses, adenoviruses and adeno-associated viruses), which serve equivalent functions, are also included.
[00120] [00120] The term "host cell" or "recombinant host cell", which is used interchangeably, refers to a cell that comprises a nucleic acid that is not naturally present in the cell, and may be a cell in which a vector of recombinant expression was introduced. It should be understood that such terms refer not only to the cell of the particular individual, but to the progeny of that cell. Because of certain modifications that can occur in succeeding generations due to mutation or environmental influences, such progeny may, in fact, not be identical to the source cell, but are still included within the scope of the term "host cell" as used on here.
[00121] [00121] An "immune response" is a biological response in an organism against foreign agents, for example, antigens, which protect the organism against these agents and diseases caused by them. An immune response is mediated by the action of an immune system cell (for example, a T lymphocyte, B lymphocyte, natural killer cell (NK), macrophage, eosinophil, mast cell, dendritic or neutrophil cell) and soluble macromolecules produced by any of these cells or liver (including antibodies, cytokines, and complement) that result in selective targeting, binding to, damage to, destruction of, and / or elimination of the body's body from invading pathogens, cells or tissues infected with pathogens, cancer cells or other abnormal, or, in cases of autoimmunity or pathological inflammation, normal tissues or cells, including, for example, human tissues or cells. An immune reaction includes, for example, the activation or inhibition of a T cell, for example, an effector T cell or an auxiliary T cell (Th), such as a CD4 + or CD8 + T cell, or the inhibition or depletion of a cell Treg. "Effector T" cells ("Teff") are T cells (for example, CD4 + and CD8 + T cells) with cytolytic activities. Helper T cells (Th) secrete cytokines and activate and target other immune cells, but do not include regulatory T cells (Treg cells). Regulatory T cells ("Treg") are a subpopulation of T cells that modulate the immune system, maintain tolerance to autoantigens, and prevent autoimmune disease. Memory B cells are a subtype of B cell that are formed within germinal centers after primary infection and are important in generating an accelerated and more robust antibody-mediated immune response in the event of re-infection (also known as an immune response secondary). NK cells are a type of cytotoxic lymphocyte critical to the innate immune system. NK cells play a role analogous to that of cytotoxic T cells in the vertebrate adaptive immune response. NK cells provide rapid responses to virus-infected cells and respond to tumor formation.
[00122] [00122] As used herein, the term "T cell mediated response" refers to the T cell mediated response, for example, effector T cells (for example, CD8 + cells) and helper T cells (for example, CD4 + cells) . T cell-mediated responses include, for example, T cell proliferation and cytotoxicity.
[00123] [00123] As used herein, the term "cytotoxic T lymphocyte response (CTL)" refers to an immune response induced by cytotoxic T cells. CTL responses are mediated by, for example, CD8 + T cells.
[00124] [00124] An "immunomodulator" or "immunoregulator" refers to an agent, for example, a component of a signaling pathway that can be involved in the modulation, regulation or modification of an immune response. "Modulation," "regulation," or "modification" of an immune response refers to any change in an immune system cell or in the activity of that cell (for example, an effector T cell, such as a Th1 cell). Such modulation includes the stimulation or suppression of the immune system, which can be manifested by an increase or decrease in the number of various types of cells, an increase or decrease in the activity of these cells, and / or any other changes that may occur within the immune system. . Both inhibitory and stimulating immunomodulators have been identified, some of which may have enhanced function in a tumor microenvironment. In some embodiments, the immunomodulator is located on the surface of a T cell. An "immunomodulatory target" or "immunoregulatory target" is an immunomodulator that is targeted for binding by, and whose activity is altered by, the binding of, a substance, agent, portion , compound or molecule. Immunomodulatory targets include, for example, receptors on the surface of a cell ("immunomodulatory receptors") and receptor ligands ("immunomodulatory ligands").
[00125] [00125] "Immunotherapy" refers to the treatment of an individual afflicted with or at risk of contracting or experiencing a recurrence of a disease by a method comprising inducing, enhancing, suppressing or otherwise modifying an immune response.
[00126] [00126] "Immunostimulatory Therapy" or "Immunostimulatory Therapy" refers to a therapy that results in increasing (inducing or enhancing) an immune response in an individual, for example, to treat cancer.
[00127] [00127] "Potentiating an endogenous immune response" means the efficacy or potency of an immune response to exist in an individual. This increase in efficacy and potency can be obtained, for example, by overcoming the mechanisms that suppress the immune response of an endogenous host or by stimulating the mechanisms that enhance the immune response of an endogenous host.
[00128] [00128] As used here, the term "linked (a)" refers to the association of two or more molecules. The bond can be covalent or non-covalent. The bond can also be genetic (that is, recombinantly fused). Such bonds can be obtained using a wide variety of techniques recognized in the art, such as chemical conjugation and recombinant protein production.
[00129] [00129] As used herein, "administer" refers to the physical introduction of a composition comprising a therapeutic agent, for example, an anti-ICOS antibody, to an individual, using any of several known delivery system methods by those skilled in the art. "Administer" includes, for example, administration to a human patient by another, such as, for example, one or more health care providers, and self-administration by the human patient. Various routes of administration for the antibodies described herein include intravenous, intraperitoneal, intramuscular, subcutaneous, spinal or other parenteral routes of administration, for example, by injection or infusion. The phrase "parenteral administration" as used herein means methods of administration other than enteral and topical administration, such as by injection and includes, without limitation, intravenous, intraperitoneal, intramuscular, intraarterial, intrathecal, intralymphatic, intralesional, intracapsular, intraorbital injection , intracardiac, intradermal, transtracheal, subcutaneous, subcuticular, intra-articular, subcapsular, subarachnoid, intraspinal, epidural and intrasternal and infusion, as well as in vivo electroporation. Alternatively, an antibody described herein can be administered via a non-parenteral route, such as a topical, epidermal or mucosal route of administration, for example, intranasally, orally, vaginally, rectally, sublingually or topically. Administration can also be performed, for example, once, a plurality of times, and / or during one or more extended periods.
[00130] [00130] As used herein, "adjunct" or "combined" (co-administration) administration includes simultaneous administration of the compounds in the same or different dosage form, or separate administration of the compounds (for example, sequential administration). In this way, a first antibody, for example, the anti-ICOS antibody, and a second, third, or more antibodies can be administered simultaneously in a single formulation. Alternatively, the first and second (or more) antibodies can be formulated for separate administration and are administered concurrently or sequentially. "Combination" therapy, as used here, means the administration of two or more therapeutic agents in a coordinated form, and includes, but is not limited to, two or more therapeutic agents in a coordinated dosage, and includes, but is not limited to a, concurrent dosage. Specifically, combination therapy also encompasses co-administration (for example, administration of a co-formulation or simultaneous administration of separate therapeutic compositions) and serial or sequential administration, provided that the administration of a therapeutic agent is conditioned in some way on the administration of another. therapeutic agent. For example, a therapeutic agent can be administered only after a different therapeutic agent has been administered and left to act for a prescribed period of time. (See, for example, Kohrt and others (2011) Blood 117: 2423).
[00131] [00131] For example, the anti-ICOS antibody can be administered first, followed by (for example, immediately followed by) administration of a second antibody, or vice versa. In one embodiment, the anti-ICOS antibody is administered prior to administration of the second antibody. In another embodiment, the anti-ICOS antibody is administered, for example, within about 30 minutes of the second antibody. Such concurrent or sequential administration results in both antibodies being simultaneously present in treated patients.
[00132] [00132] As used here, the terms "inhibits" or "blocks" are used interchangeably and also cover partial and complete inhibition / blocking by at least about 50%, 60%, 70%, 80%, 90%, 95% , 99% or 100%, as determined, for example, by the methods described here.
[00133] [00133] As used here, "cancer" refers to a broad group of diseases characterized by the uncontrolled growth of abnormal cells in the body. The unregulated cell division or growth can result in the formation of malignant tumors or cells that invade neighboring tissues and can metastasize distant parts of the body through the lymphatic system or bloodstream.
[00134] [00134] The terms "treat", "treating" and "treatment", as used here, refer to any type of intervention or process performed in, or administering an active agent to, the individual, with the aim of reversing, relieving, improve, inhibit or slow down or prevent the progression, development, severity or recurrence of a symptom, complication, condition or biochemical evidence associated with a disease. In contrast, "prophylaxis" or "prevention" refers to administration to an individual who does not have a disease to prevent the disease from occurring. "Treating", "treating" and "treatment" do not cover prophylaxis or prevention.
[00135] [00135] The term "effective dose" or "effective dosage" is defined as an amount sufficient to obtain or at least partially achieve a desired effect. A "therapeutically effective amount" or "therapeutically effective dosage" of a drug or therapeutic agent is any amount of the drug that, when used alone or in combination with another therapeutic agent, promotes regression of the disease evidenced by a decrease in the severity of the symptoms of illness, an increase in the frequency and duration of symptom-free periods of illness, or a prevention of impairment or disability due to illness affliction. A "prophylactically effective amount" or "prophylactically effective dosage" of a drug is an amount of the drug that, when administered alone or in combination with another therapeutic agent to an individual at risk of developing a disease or experiencing a recurrence of the disease, prevents the development or recurrence of the disease. The ability of a therapeutic agent to promote regression of the disease or a prophylactic agent to prevent the development or recurrence of the disease can be assessed using a variety of methods known to the skilled practitioner, such as in human subjects during clinical experiments, in animal models predictive of efficacy in humans, or by testing agent activity in in vitro assays.
[00136] [00136] Administration of effective amounts of anti-ICOS antibody alone, or anti-ICOS antibody combined with anti-PD-1 antibody, combined with anti-PD-L1 antibody, or combined with anti-CTLA-4 antibody, according to with any of the methods provided here, it may result in at least one therapeutic effect, including, for example, reduced tumor size or growth, reduced number of metastatic lesions appearing over time, complete remission, partial remission, or stable disease. For example, treatment methods produce a comparable clinical benefit rate (CBR = complete remission (CR) + partial remission (PR) + persistent stable disease (SD) ≥ 6 months) better than that achieved without administration of the anti antibody -ICOS, or that obtained with the administration of any of the combined antibodies, for example, the improvement in the rate of clinical benefit is about 20% 20%, 30%, 40%, 50%, 60%, 70 %, 80% or more.
[00137] [00137] As an example, an anticancer agent is a drug that slows down the progression of cancer or promotes cancer regression in an individual. In some embodiments, a therapeutically effective amount of the drug promotes cancer regression to the point of eliminating the cancer. "Promoting cancer regression" means that administration of an effective amount of the drug, alone or in combination with an antineoplastic agent, results in a reduction in tumor size or development, tumor necrosis, a decrease in the severity of at least one symptom of the disease, an increase in the frequency and duration of periods free of the symptom of the disease, a prevention of impairment or disability due to the affliction of the disease, or otherwise the improvement of the symptoms of the disease in the patient. "Pharmacological efficacy," "effectiveness," or "efficacy" refers to the drug's ability to promote cancer regression in the patient. "Physiological safety" refers to an acceptably low level of toxicity or other adverse physiological effects at the cellular, organ and / or organism level (adverse effects) resulting from the administration of the drug.
[00138] [00138] As an example, for the treatment of tumors, a therapeutically effective amount or dosage of the drug inhibits the growth of the tumor cell by at least about 20%, at least about 30% at least about 40%, at least about 50%, at least about 60%, at least over 70%, at least about 80% for untreated individuals, or at least about 90%. In some embodiments, a therapeutically effective amount or dosage of the drug that completely inhibits cell growth or tumor growth, i.e., inhibits cell growth or tumor growth by 100%. The ability of a compound, including an antibody, to inhibit tumor growth can be assessed using the assays described here. Alternatively, this property of a composition can be evaluated by examining the compound's ability to inhibit cell growth; such inhibition can be measured in vitro by assays known to the skilled practitioner. In some embodiments, tumor growth inhibition may not be immediate after treatment, and may only occur after a period of time or after repeated administration. In other embodiments described here, tumor regression is observed and continues for at least about 20 days, at least about 30 days, at least about 40 days, at least about 50 days, or at least about 60 days , or more.
[00139] [00139] As used here, the terms "fixed dose", "flat dose" and "flat fixed dose" are used interchangeably and refer to a dose that is administered to a patient regardless of the weight or area of the patient's body surface. The flat or fixed dose is therefore not provided as a mg / kg dose, but as an absolute amount of the therapeutic agent.
[00140] [00140] As used here, the term dose or dosage "based on weight" means that a dose administered to a patient is calculated based on the patient's weight. For example, when a 60 kg patient requires 3 mg / kg of an anti-ICOS antibody, someone can calculate and use the appropriate amount of the anti-ICOS antibody (i.e., 180 mg) for administration.
[00141] [00141] The term "patient" includes human subjects and other mammals receiving therapeutic or prophylactic treatment.
[00142] [00142] The term "individual" includes any human or non-human animal. For example, the methods and compositions described here can be used to treat an individual having cancer. A non-human animal includes all vertebrates, for example, mammals and non-mammals, including non-human primates, sheep, dogs, cows,
[00143] [00143] As used herein, the term entity "one" or "one" refers to one or more of those entities unless otherwise specified; for example, "a nucleotide sequence," is understood to represent one or more nucleotide sequences. As such, the terms "one" or "one", "one or more" and "at least one" can be used interchangeably here.
[00144] [00144] As used here, "and / or" should be taken as a specific description of each of the two components or characteristics specified with or without the other. Thus, the term "and / or" as used in a sentence such as "A and / or B" includes "A and B," "A or B," "A" only, and "B" only. Also, the term "and / or" as used in a sentence such as "A, B, and / or C" covers each of the following: A, B and C; A, B or C; A or C; A or B; B or C; A and C; A and B; B and C; Just; B only; and C only.
[00145] [00145] It is understood that wherever aspects are described here with the language "comprising," other analogous aspects described in terms of "consisting of" and / or "consisting essentially of" are also provided.
[00146] [00146] Units, prefixes, and symbols are denoted in their acceptable form in the International System of Units (SI). The numerical variations are inclusive of the numbers defining the range. Unless otherwise indicated, nucleotide sequences are written from left to right in the 5 'to 3' orientation. The amino acid sequences are written from left to right in the amino orientation for carboxy.
[00147] [00147] As used here, the term "about" means approximately, more or less, around, or in the region of. When the term "about" is used in conjunction with a numerical range, it modifies that range by extending the limits above and below the numerical values shown. In general, the term "about" can modify a numerical value above and below the value established by a variance of, for example, 10 percent, above or below (greater or lesser).
[00148] [00148] The titles provided here are not limitations on the various aspects of the description, they should be read by reference to the specification as a whole. Consequently, the terms defined immediately below are more fully defined by reference to the specification in its entirety. Several aspects described here are described in more detail in the following subsections. Anti-ICOS Antibodies
[00149] [00149] The present invention describes, in some embodiments, antibodies, such as fully human antibodies, with desirable functions or properties. Agonistic anti-human (anti-huICOS) ICOS antibodies with desirable properties for use as therapeutic agents in the treatment of diseases such as cancers are described herein. These properties include one or more of the ability to bind to human ICOS with high affinity, acceptably low immunogenicity in human subjects, the ability to preferentially bind to FcγRIIb (a specific type of IgG Fc receptor) and the absence of sequence liabilities which reduce the chemical stability of the antibody. The antibodies of the invention are also useful, for example, for diagnosing cancer and other disorders associated with ICOS expression and / or activity.
[00150] [00150] The anti-ICOS antibodies described herein by the amino acid sequence bind to specific epitopes in human ICOS, as described in the Examples. Anti-huICOS Antibodies with Specific Functional Properties
[00151] [00151] The antibodies of the invention are characterized by particular functional characteristics or properties. For example, antibodies specifically bind to human ICOS with high affinity. In some embodiments, antibodies specifically bind to the ICOS site to which ICOS-L binds. Binding to human ICOS can be assessed using one or more techniques well established in the art. For example, in some embodiments, the antibody can be tested by a flow cytometry assay in which the antibody is reacted with a cell line that expresses human ICOS, such as CHO cells that have been transfected to express human ICOS on their cell surface. Additionally or alternatively, antibody binding, including binding kinetics (e.g., KD value) can be tested in Biacore binding assays. Still other suitable binding assays include ELISA assays using, for example, a recombinant human ICOS protein.
[00152] [00152] In one embodiment, the antibody, or its antigen-binding portion, of the invention binds to an ICOS protein with a KD of 5 x 10-8 M or less, binds to an ICOS protein with a KD of 2 x 10-8 M or less, binds to an ICOS protein with a KD of 5 x 10-9 M or less, binds to an ICOS protein with a KD of 4 x 10-9 M or less, binds binds to an ICOS protein with a KD of 3 x 10-9 M or less, binds to an ICOS protein with a KD of 2 x 10-9 M or less, binds to an ICOS protein with a KD of 1 x 10-9 M or less, binds to an ICOS protein with a KD of 5 x 10-10 M or less, or binds to an ICOS protein with a KD of 1 x 10-10 M or less.
[00153] [00153] In another embodiment, the antibody binds one or more residues of human ICOS SIFDPPPFKVTL (SEQ ID NO: 203). In another embodiment, the antibody binds to an epitope comprising the amino acid residues SIFDPPPFKVTL (SEQ ID NO: 203) from human ICOS. In another embodiment, the antigen-binding portion of the antibody binds to an epitope comprising the amino acid residues SIFDPPPFKVTL (SEQ ID NO: 203) of human ICOS.
[00154] [00154] In another embodiment, the antibody binds to human ICOS and stimulates an immune response, for example, an antigen-specific T cell response. The ability of the antibody to stimulate an immune response can be tested by measuring tumor growth, as in a tumor graft model in vivo (see, for example, Examples 6, 7, 8 and 9).
[00155] [00155] In another embodiment, the antibody, or its antigen-binding portion, binds to human ICOS and exhibits at least one of the following properties: binding to one or more residues within SIFDPPPFKVTL (SEQ ID NO: 203) of Human ICOS; binding to the same epitope in human ICOS as the ICOS.33, 17C4, 9D5, 3E8, 1D7 or 2644 antibody; compete for binding to human ICOS with the ICOS.33, 17C4, 9D5, 3E8, 1D7 or 2644 antibody; reduce ADCC activity compared to an IgG1 control antibody; increase the specificity for binding to the FcγRIIb receptor; blocking the binding of an ICOS ligand (ICOS-L) to human ICOS; block the interaction of human ICOS and human ICOS-L; binding to human, cynomolgus, mouse and rat ICOS; binding to activated human and cynomolgus T cells; binding to human T cells with an EC50 of about 0.7 nM and cinomolgus T cells with an EC50 of about 0.3 nM; no binding to human CD28 or human CTLA-4; activation of at least one primary T lymphocyte, such as a CD4 + Teff cell, a Tfh cell and a Treg cell;
[00156] [00156] In another embodiment, the isolated antibody is a humanized isolated antibody (or antigen-binding portion thereof) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS -L human) to human ICOS and induces proliferation and production of interferon-gamma (IFN-y) in CD25- T cells
[00157] [00157] In one aspect, the isolated antibody is a humanized isolated antibody (or antigen binding portion thereof) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS -L human) to human ICOS and induce IFN- production in CD25-CD4 + T cells with an EC50 of about 0.2 nM in a staphylococcal B enterotoxin in a CD25-CD4 + T cell and B cell co-culture assay In another aspect, the isolated antibody is a humanized isolated antibody (or antigen-binding portion of it) that binds to human ICOS and blocks the binding and / or interaction of an ICOS ligand (for example, ICOS-L human) to human ICOS and induces IFN-γ production in CD25-CD4 + T cells with an EC50 of about 0.01-0.1 nM in a staphylococcal B enterotoxin in a CD25-CD4 + T cell co-culture assay and B cells.
[00158] [00158] In some embodiments, the antibodies of the invention include humanized and fully human monoclonal antibodies. In other embodiments, the antibodies are, for example, chimeric monoclonal antibodies. IC26 IgG1f Monoclonal Antibodies S267E of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644
[00159] [00159] In some embodiments, the antibodies of the invention are the humanized and human monoclonal antibodies S267E of IgG1f of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644, which are isolated and structurally characterized as described in the following Examples. The IC26 S267E IgG1f amino acid sequences of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644 and the ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644 S267E IgG1f amino acid sequences are shown in Table 35
[00160] [00160] Since each of these antibodies can bind to human ICOS, the VH and VL sequences can be "mixed and matched" to create other anti-water binding molecules of the invention. In some embodiments, when the VH and VL chains are mixed and matched, a VH sequence from a particular VH / VL pairing is replaced by a structurally similar VH sequence. Likewise, in some embodiments, a VL sequence of a particular VH / VL pairing is replaced by a structurally similar VL sequence.
[00161] [00161] Therefore, in one aspect, this invention provides an isolated monoclonal antibody, or antigen binding portion thereof, comprising: a heavy chain variable region comprising an amino acid sequence set forth in SEQ ID NOs: 5, 16 , 24, 32, 40 or 186; and a light chain variable region comprising an amino acid sequence in SEQ ID NO: 6, 17, 25, 33, 41, 48 or 189; wherein the antibody specifically binds to human ICOS.
[00162] [00162] In some embodiments, light and heavy chain variable region combinations include: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 5 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 6; a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 16 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 17; a heavy chain variable region, comprising the amino acid sequence of SEQ ID NO: 24 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 25; a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 32 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 33; a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 40 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 41; a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 40 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 48; or a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 186 and a light chain variable region comprising the amino acid sequence of SEQ ID NO: 186
[00163] [00163] In another aspect, this invention provides antibodies which comprise the ICR.33, 17C4, 9D5, 3E8, 1D7 and 2644 heavy chain and CDR1s, CDR2s and CDR3 of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644. The amino acid sequences of the IC26.3 IgG1f S267E VH CDR1s of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644 are shown in SEQ ID NOs: 9, 18, 26, 34, 42 and 191, respectively. The amino acid sequences of the IC26.3 IgG1f S267E VH CDR2s of ICOS.33, 17C4, 9D5, 3E8, 1D7 and 2644 are shown in SEQ ID NO:
[00164] [00164] Since each of these antibodies can bind to human ICOS and the specificity of antigen binding is provided mainly by the CDR1, CDR2 and CDR3 regions, the VH CDR1, CDR2 and CDR3 sequences and the CDR1 sequences, VL CDR2 and CDR3 can be "mixed and matched" (ie, CDRs of different antibodies can be mixed and matched, although each antibody must contain a VH CDR1, CDR2 and CDR3 and a VL CDR1, CDR2 and CDR3) for creating other anti-water binding molecules of the invention. The ICOS binding of such "mixed and combined" antibodies can be tested using the binding assays described herein, including in the Examples (for example, ELISAs, Biacore® analysis). In some embodiments, when the VH CDR sequences are mixed and matched, the CDR1, CDR2 and / or CDR3 sequence of a particular VH sequence is replaced by a structurally similar CDR sequence (s). In the same way,
[00165] [00165] Therefore, in another aspect, this invention provides an isolated monoclonal antibody or antigen binding portion thereof comprising: a variable region of the heavy chain CDR1 comprising an amino acid sequence set forth in SEQ ID NO: 9, 18, 26 , 34, 42 or 191; a variable region of the CDR2 heavy chain comprising an amino acid sequence set forth in SEQ ID NO: 10, 19, 27, 35, 43 or 192; a variable region of the heavy chain CDR3 comprising an amino acid sequence set forth in SEQ ID NO: 11, 20, 28, 36, 44 or 193; a variable region of the CDR1 light chain comprising an amino acid sequence set forth in SEQ ID NOs: 12, 21, 29, 37, 49 or 194; e) a variable region of the CDR2 light chain comprising an amino acid sequence established in SEQ ID NO: 14, 22, 30, 38, 50 or 195; and (f) a CDR3 light chain variable region comprising an amino acid sequence set forth in SEQ ID NO: 15, 23, 31, 39, 51 or 196;
[00166] [00166] In one embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 9; a heavy chain variable region CDR2 comprising SEQ ID NO: 10; a heavy chain variable region CDR3 comprising SEQ ID NO: 11; a light chain variable region CDR1 comprising SEQ ID NO: 12; a light chain variable region CDR2 comprising SEQ ID NO: 14; and a CDR3 light chain variable region comprising SEQ ID NO: 15.
[00167] [00167] In another embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 18; a heavy chain variable region CDR2 comprising SEQ ID NO: 19; a heavy chain variable region CDR3 comprising SEQ ID NO: 20; a light chain variable region CDR1 comprising SEQ ID NO: 21; a light chain variable region CDR2 comprising SEQ ID NO: 22; and a CDR3 light chain variable region comprising SEQ ID NO: 23.
[00168] [00168] In another embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 26;
[00169] [00169] In another embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 34; a heavy chain variable region CDR2 comprising SEQ ID NO: 35; a heavy chain variable region CDR3 comprising SEQ ID NO: 36; a light chain variable region CDR1 comprising SEQ ID NO: 37; a light chain variable region CDR2 comprising SEQ ID NO: 38; and a CDR3 light chain variable region comprising SEQ ID NO: 39.
[00170] [00170] In another embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 42; a heavy chain variable region CDR2 comprising SEQ ID NO: 43; a heavy chain variable region CDR3 comprising SEQ ID NO: 44;
[00171] [00171] In another embodiment, the antibody comprises: a heavy chain variable region CDR1 comprising SEQ ID NO: 191; a heavy chain variable region CDR2 comprising SEQ ID NO: 192; a heavy chain variable region CDR3 comprising SEQ ID NO: 193; a light chain variable region CDR1 comprising SEQ ID NO: 194; a light chain variable region CDR2 comprising SEQ ID NO: 195; and a light chain variable region CDR3 comprising SEQ ID NO: 196.
[00172] [00172] It is well known in the art that the CDR3 domain, regardless of the CDR1 and / or CDR2 domain (s), alone can determine the binding specificity of an antibody to a cognate antigen and that multiple antibodies can be generated predictably having the same binding specificity based on a common CDR3 sequence. (See, for example, Klimka et al., British J. of Cancer 83 (2): 252-260 (2000). Therefore, the present invention provides monoclonal antibodies comprising one or more domains of light chain and / or CDR3 heavy weight of an antibody derived from a human or non-human animal, wherein the monoclonal antibody is capable of specifically binding to human ICOS In certain respects, the present invention provides monoclonal antibodies comprising one or more light chain and / or CDR3 domains or heavy of a non-human antibody, such as a mouse or rat antibody, in which the monoclonal antibody is capable of specifically binding to human ICOS In some embodiments, such inventive antibodies comprising one or more light chain and / or CDR3 domains or heavy of a non-human antibody (a) are capable of competing for binding with; (b) retaining functional characteristics; (c) binding to the same epitope; and / or (d) having a binding affinity similar to that of parental non-human antibody runs spondente.
[00173] [00173] In other respects, the present invention provides monoclonal antibodies comprising one or more CDR3 light and / or heavy chain domains of a human antibody, such as, for example, a human antibody obtained from a non-human animal, wherein the human antibody is able to specifically bind to human ICOS. In other respects, the present invention provides monoclonal antibodies comprising one or more CDR3 light and / or heavy chain domains of a first human antibody, such as, for example, a human antibody obtained from a non-human animal, wherein the first antibody human is able to specifically bind to human ICOS and where the CDR3 domain of the first human antibody replaces a CDR3 domain in a human antibody that lacks binding specificity for ICOS to generate a second human antibody that is capable of specifically binding to Human ICOS. In embodiments, such inventive antibodies comprising one or more light and / or heavy chain CDR3 domains of the first human antibody (a) are capable of competing for binding with; (b) retain the functional characteristics; (c) attach to the same epitope; and / or (d) have a binding affinity similar to that of the corresponding parental non-human antibody.
[00174] [00174] The present invention also provides anti-huICOS antibodies comprising the new variable domain sequences described herein and constant domains with modified Fc regions having increased affinity for FcRIIb compared to their affinity for other Fc receptors. In some embodiments, such agonistic anti-huICOS antibodies with increased FcRIIb specificity exhibit superior efficacy in the treatment of cancer. In other embodiments, such agonistic anti-huICOS antibodies with improved FcRIIb specificity exhibit superior efficacy in the treatment of various disorders, for example, cancer. Without wishing to be limited by mechanistic theory, such FcRIIb-specific agonist anti-ICOS monoclonal antibodies may exhibit enhanced adjuvant effects, increasing the maturation of dendritic cells, thus promoting the expansion and activation of cytotoxic CD8 + T cells, which leads to a greater antitumor response. Without wishing to be limited by theory, the increase in the FcR-mediated signal of agonist ICOS antibodies due to the increase in receptor clustering, or "crosslinking" of the present invention, may be a major contributor to therapeutic efficacy. Crosslinking of ICOS agonist antibodies by the involvement of FcR by the Fc portion of the antibody can increase the signal strength and thereby increase cell activation.
[00175] [00175] The relative binding affinity of antibodies to activate inhibitory Fc (A) versus (I) receptors can be expressed as the "A / I" ratio and is typically a function of the structure of the Fc region of an IgG antibody. See WO 2012/087928. Antibodies having increased specificity for binding to the inhibitory FcγRIIb receptor have lower A / I ratios. In some embodiments, the agonistic anti-huICOS antibodies described herein have A / I ratios less than 5, 4, 3, 2, 1, 0.5, 0.3, 0.1, 0.05, 0.03 or 0.01.
[00176] [00176] Examples of human IgG1 constant domains comprising mutations to increase the specificity of FcγRIIb are described herein and are also provided in the Sequence Listing.
[00177] [00177] Additional Fc Sequence Variants with greater affinity for FcγRIIb are described in Yu et al. (2013) J. Am. Chem. Soc. 135: 9723 (and WO 2014/184545), including V262E and V264E, for example, for use in combination with S267E and L328F. Antibodies with Conservative Modifications
[00178] [00178] In certain embodiments, an antibody of the invention comprises a heavy chain variable region comprising CDR1, CDR2, and CDR3 sequences and a light chain variable region comprising CDR1, CDR2, and CDR3 sequences, wherein one or more of those CDR sequences comprise Amino Acid Sequences based on the antibodies described here (for example, ICOS.33, 17C4, 9D5, 3E8, 1D7, and 2644 IgG1f S267E), or conservative modifications thereof, and in which the antibodies retain the desired functional properties of anti-water antibodies of the invention. It is understood in the art that certain conservative sequence modifications can be made that do not remove binding to the antigen. (See, for example, Brummell et al. (1993) Biochem 32: 1180-8). Accordingly, this description provides an isolated monoclonal antibody, or antigen binding portion thereof, comprising a heavy chain variable region comprising CDR1, CDR2, and CDR3 sequences and a light chain variable region comprising CDR1, CDR2 and CDR3 sequences, in that: (a) The heavy chain variable region comprising a CDR3 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 11, 20, 28, 36, 44 or 193, or conservative modifications thereof; (b) the light chain variable region comprising a CDR3 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 15, 23, 31, 39, 51, or 196, or conservative modifications thereof; and
[00179] [00179] Additionally or alternatively, the antibody may have one or more of the functional properties described herein, such as high affinity for binding to human ICOS, and / or the ability to stimulate antigen-specific T cell responses.
[00180] [00180] In some embodiments, the heavy chain variable region comprising a CDR2 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 10, 19, 27, 35, 43, or 192, or conservative modifications thereof; and the light chain variable region comprising a CDR2 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 14, 22, 30, 38, 50, or 195, or conservative modifications thereof. In another embodiment, the heavy chain variable region comprises a CDR1 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 9, 18, 26, 34, 42, or 191, or conservative modifications thereof; and the light chain variable region comprising a CDR1 sequence comprising an Amino Acid Sequence mentioned in SEQ ID NO: 12, 21, 29, 37, 49, or 194, or conservative modifications thereof.
[00181] [00181] In several embodiments, the antibody can be, for example, human antibodies, humanized antibodies or chimeric antibodies. Antibodies that bind to the same epitope as Anti-huICOS Antibodies
[00182] [00182] In another embodiment, this description provides antibodies that bind to the same epitope in human ICOS as any of the anti-huICOS monoclonal antibodies of the invention (i.e., antibodies that have the ability to cross-compete for binding to human ICOS with any of the monoclonal antibodies of the invention). In some embodiments, the reference antibody for cross-sectional competition studies are the IC26 IgG1f monoclonal antibodies of ICOS.33, 17C4, 9D5, 3E8, 1D7, and
[00183] [00183] Such cross-mode competition antibodies can be identified based on their ability to cross-compete with ICOS IgG1f S267E.33, 17C4, 9D5, 3E8, 1D7, and / or 2644 in ICOS binding assays standard human. For example, standard ELISA assays can be used in which a recombinant human ICOS protein is immobilized on the plate, one of the antibodies is fluorescently labeled, and the ability of unlabeled antibodies to compete with the binding of the labeled antibody is assessed. In addition, or alternatively, Biacore analysis can be used to assess the ability of antibodies to cross-compete. The ability of a test antibody to inhibit the binding of, for example, IC26.3 IgG1f S267E to ICOS.33, 17C4, 9D5, 3E8, 1D7, and / or 2644 to human ICOS demonstrates that the test antibody can compete with S267E IgG1f from ICOS.33, 17C4, 9D5, 3E8, 1D7, and / or 2644 to bind to human ICOS and thus bind to the same epitope on human ICOS as ICOS.33, 17C4, 9D5, 3E8, 1D7 IgG1f S267E , and / or
[00184] [00184] As further described in Example 16, the binding of human ICOS 9D5, S267E to IgG1f from ICOS.33 and 3E8 was mapped to ICOS residues 112 - 123 (SEQ ID NO: 1), or the SIFDPPPFKVTL ( SEQ ID NO: 203). Accordingly, in one embodiment, the invention provides an anti-huICOS antibody that binds to one or more residues of human SIFDPPPFKVTL (SEQ ID NO: 203), for example, as determined by HDX-MS. In another embodiment, the anti-huICOS antibody binds to an epitope comprising the amino acid residues SIFDPPPFKVTL (SEQ ID NO: 203) from human ICOS.
[00185] [00185] These humanized or human monoclonal antibodies can be prepared and isolated as described herein. For example, anti-huICOS antibodies that bind to epitopes equal to or similar to the antibodies described herein can be created using immunization protocols, for example, those described herein. The resulting antibodies can be screened for high affinity binding to human ICOS. The selected antibodies can then be studied, for example, in the yeast display assay in which huICOS Sequence Variants are displayed on the surface of yeast cells, or by hydrogen-deuterium exchange experiments, to determine the precise epitope attached by the antibody.
[00186] [00186] Epitope determinations can be made by any method known in the art. In some embodiments, anti-huICOS antibodies are considered to bind to the same Epitope as an anti-huICOS mAb described here if they make contact with one or more of the same residues within at least one region of huICOS; whether they make contact with most waste within at least one water region; whether they make contact with the majority of waste within each region of the huICOS; whether they make contact with most contacts over the entire length of the huICOS; whether they make contacts within all the same regions other than human ICOS; whether they make contact with all waste in any region of the human ICOS; or whether they make contact with all the same waste in all the same regions. The "regions" of the Epitope are waste clusters along, but not necessarily adjacent to, the primary sequence.
[00187] [00187] Techniques for determining antibodies that bind to the "same Epitope in huICOS" with the antibodies described here include X-ray analyzes of antigen crystals: antibody complexes, which provide atomic resolution of the epitope. Other methods monitor the binding of the antibody to antigen fragments or mutated variations of the antigen in which the loss of binding due to an amino acid modification within the antigen sequence indicates the epitope component. The methods can also be based on the ability of an antibody of interest to affinity isolate specific short peptides (in native three-dimensional or denatured form) from combined peptide libraries displaying phage or a protease digest of the target protein. The peptides are then considered as drivers for the definition of the Epitope corresponding to the antibody used to screen the peptide library. For Epitope mapping, computational algorithms were also developed that map conformational discontinuous epitopes.
[00188] [00188] The epitope or region comprising the Epitope can also be identified by screening for binding to a series of overlapping peptides spanning ICOS. Alternatively, the method by Jespers et al. (1994) Biotechnology 12: 899 can be used to guide the selection of antibodies that have the same Epitope and, therefore, properties similar to the anti-ICOS antibodies described here. Using the phage display, first, the heavy chain of the anti-ICOS antibody is paired with a repertoire of (for example, human) light chains to select an ICOS-binding antibody, and then the new light chains are paired with a repertoire of, (e.g., human) heavy chains to select an antibody (for example, human) that binds to ICOS having the same Epitope or Epitope region as an anti-human antibody described herein.
[00189] [00189] Alanine scan mutagenesis, as described by Cunningham and Wells (1989) Science 244: 1081, or some other form of point mutagenesis of amino acid residues in ICOS (such as the yeast display method provided in the Example 16) can also be used to determine the functional Epitope for an anti-ICOS antibody.
[00190] [00190] The Epitope or Epitope region (a "Epitope region" is a region comprising the epitope or overlap with the epitope) linked by a specific antibody can also be determined by assessing the antibody's binding to peptides comprising ICOS fragments . A series of overlapping peptides spanning the sequence of ICOS (for example, human ICOS) can be synthesized and screened for binding, for example, in a direct ELISA, a competitive ELISA (where the peptide is evaluated for its ability to prevent binding of an antibody to ICOS attached to a microtiter plate well) or chip. Such peptide screening methods may not be able to detect some discontinuous functional epitopes, that is, functional epitopes that involve amino acid residues that are not continuous along the primary sequence of the ICOS polypeptide chain.
[00191] [00191] An epitope can also be identified by means of MS-based protein footprints, such as HDX-MS and rapid photochemical protein oxidation (FPOP). HDX-MS can be conducted, for example, as described in Wei et al. (2014) Drug Discovery Today 19:95, the methods of which are specifically incorporated by reference here. FPOP can be conducted as described, for example, in Hambley & Gross (2005) J. American Soc. Mass Spectrometry
[00192] [00192] The epitope attached to anti-ICOS antibodies can also be determined by structural methods, such as determination of X-ray crystal structure (for example, WO 2005/044853), molecular modeling and nuclear magnetic resonance (NRM) spectroscopy , including NRM determination of HD exchange rates for labile amide hydrogens in ICOS when free and when bound in a complex with an antibody (Zinn-Justin et al. (1992) Biochemistry 31: 11335; Zinn-Justin et al (1993) Biochemistry 32: 6884).
[00193] [00193] Unless otherwise indicated, and with reference to the claims, the antibody-linked epitope is the epitope as determined by the HDX-MS methods. Antihyperic Antibodies Derived from Hamster Antibodies
[00194] [00194] Examples of chimeric and humanized antibodies comprising CDRs and / or antibodies from variable regions of heavy chain and / or light chain that have been derived from hamster sequences are described herein. The chimeric or humanized antibodies described herein can be prepared based on the sequence of a monoclonal antibody, for example, mouse or hamster, prepared by various methods known in the art. The DNA encoding heavy and light chain immunoglobulins can be obtained from a hybridoma of interest and modified to contain human immunoglobulin sequences using standard molecular biology techniques. For example, to create a chemical antibody, the variable regions of, for example, a mouse or hamster antibody can be linked to human constant regions using methods known in the art (see, for example, US Patent No. 4816567 to Cabilly et al. .). To create a humanized antibody, CDR regions can be inserted into a human structure using methods known in the art (see, for example, U.S. Patent No.
[00195] [00195] In some embodiments, the anti-water antibodies of the present invention bind to water with high affinity, such as the anti-water antibodies described herein, making them effective therapeutic agents. In various embodiments, the anti-huICOS antibodies of the present invention bind to huICOS with a KD of less than 10 nM, 5 nM, 2 nM, 1 nM, 300 pM or 100 pM. In other embodiments, the anti-water antibodies of the present invention bind to water with a KD between 2 nM and 100 pM. Standard assays to assess the binding ability of antibodies against water include ELISA, RIA, Western blot, bi-layer interferometry (BLI) and BIACORE® SPR analysis (see Example 10). Anti-ICOS Antibody Sequence Variants
[00196] [00196] Anti-ICOS antibody sequence variants described herein maintain the desirable functional properties described herein. CDR regions are outlined using the Kabat system (Kabat et al., 1991). In some embodiments, the present invention further provides human or humanized anti-huICOS antibodies comprising CDR sequences that are at least 70%, 75%, 80%, 85%, 90% or 95%, 96%, 97%, 98%, or 99% identical to the CDR sequences of the antibodies described herein. The present invention also provides anti-huICOS antibodies comprising heavy and / or light chain variable domain sequences that are at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98 %, or 99% identical to the sequences of heavy and / or light chain variable domains of the antibodies described herein, as well as anti-huICOS antibodies comprising full length light and / or heavy chain sequences that are at least 70%, 75% , 80%, 85%, 90%, 95%, 96%, 97%, 98% or 99% identical to the heavy and / or light chain sequences of the antibodies described herein. II. Antibodies Built and Modified VH and VL Regions
[00197] [00197] Also provided are constructed and modified antibodies that can be prepared using an antibody having one or more of the VH and / or VL sequences described herein as starting material for manipulating a modified antibody, whose modified antibody may have altered properties since the antibody of departure. In some embodiments, an antibody as described herein has been constructed by modifying one or more residues within one or both of the variable regions (i.e., VH and / or VL), for example, within one or more CDR and / or within one or more structure regions. Additionally or alternatively, an antibody as described herein has been constructed by modifying residues within the constant region (s), for example, to alter the antibody's effective function (s).
[00198] [00198] In one embodiment, the engineering of the variable region includes CDR grafting. Such a graft is of particular use in the humanization of non-human anti-ICOS antibodies, for example, anti-huICOS antibodies that compete for binding with the anti-huICOS antibodies described here and / or bind to the same Epitope as the selected anti-huICOS antibodies described here. The antibodies interact with the target antigens predominantly through the amino acid residues that are located on heavy and light chain CDRs. CDRs are hypervariable in sequence and / or form structurally defined loops ("hypervariable loops"). Expression vectors can be constructed so that they include CDR sequences from a specific reference antibody (also called "parental")
[00199] [00199] Such structural sequences can be obtained from public DNA databases or published references that include germline antibody gene sequences. For example, germline DNA sequences for human light and heavy chain variable region genes can be found in the "VBase" human germline sequence database, as well as in Kabat, EA, et al., 1991 ); Tomlinson, I. M., et al. (1992) "The Repertoire of Human Germline VH Sequences Reveals about Fifty Groups of VH Segments with Different Hypervariable Loops" J. Mol. Biol. 227: 776-798; and Cox, J. P. L. et al. (1994) "A Directory of Human Germ-line VH Segments Reveals a Strong Bias in their Usage," Eur. J. Immunol. 24: 827-836; the content of each is expressly incorporated here by reference.
[00200] [00200] In some embodiments, structural sequences for use in the antibodies described here are those that are structurally similar to the structural sequences used by the antibodies described here. The VH CDR1, 2 and 3 sequences and the VL CDR1, 2 and 3 sequences can be grafted into structural regions that have the sequence identical to that found in the germline immunoglobulin gene from which the structural sequence is derived or CDR sequences can be grafted into structural regions that contain up to 20 amino acid substitutions, including conservative amino acid substitutions, compared to germline sequences. For example, it has been found that in certain cases, it is beneficial to mutate residues within the structural regions to maintain or increase the antibody's antigen-binding capacity (see, for example, US Patent Nos. 5,530,101, 5,585,089, 5,693,762 and
[00201] The constructed antibodies described herein include those in which modifications have been made to structural residues within VH and / or VL, for example, to improve the properties of the antibody, such as decreasing the immunogenicity of the antibody. For example, one approach is to "reverse mutate" one or more structure residues to the corresponding germline sequence. More specifically, an antibody that has undergone somatic mutation may contain structural residues that differ from the germline sequence from which the antibody is derived. Such residues can be identified by comparing the structural sequences of the antibody with the germline sequences from which the antibody is derived. To return to the structural region sequences for their germline configuration, somatic mutations can be "mutated" to the germline sequence, for example, by site-directed mutagenesis or PCR-mediated mutagenesis. These "mutated" antibodies are also included in this description.
[00202] [00202] Another type of structure modification involves mutating one or more residues within the structure region, or even within one or more CDR regions, to remove T cell epitopes to thereby reduce the potential immunogenicity of the antibody. This method is also referred to as "de-immunization" and is described in more detail in U.S. Patent Publication No. 20030153043 by Carr et al.
[00203] [00203] Another type of modification of the variable region is to mutate the amino acid residues in the CDR regions to improve one or more binding properties (for example, affinity) of the antibody of interest. Site-directed mutagenesis or PCR-mediated mutagenesis can be performed to introduce the mutation (s) and the effect on antibody binding, or other functional property of interest. Preferably, conservative modifications are introduced. The mutations can be additions, deletions or substitutions of amino acids. In some modalities, no more than one, two, three, four or five residues within a CDR region are altered.
[00204] [00204] Methionine residues in antibody CDRs can be oxidized, resulting in potential chemical degradation and consequent reduction in the potency of the antibody. Accordingly, anti-ICOS antibodies are also provided herein which have one or more methionine residues in the heavy and light chain CDRs replaced by amino acid residues that do not undergo oxidative degradation. Similarly, deamidation sites can be removed from anti-ICOS antibodies, particularly on CDRs. Also provided here are antibodies in which potential glycosylation sites within the antigen-binding domain have been eliminated to prevent glycosylation which can interfere with antigen binding. See, for example, U.S. Patent No.
[00205] [00205] In some embodiments, the antibodies disclosed herein are modified to limit their binding to specific cells and / or tissue. In one embodiment, such antibodies comprise a blocking peptide "mask" that specifically binds to the antigen-binding surface of the antibody and interferes with antigen binding. In some embodiments, the mask is attached to each antibody binding arm by a protease-cleavable linker. See, for example, U.S. Patent No. 8,518,404 of CytomX. Antibodies with protease-cleavable ligands are useful for the treatment of cancers in which protease levels are greatly increased in the tumor microenvironment compared to non-tumor tissues. The selective cleavage of the cleavable ligand in the tumor microenvironment allows the dissociation of the masking / blocking peptide, allowing the antigen to selectively bind to the tumor, instead of peripheral tissues in which binding to the antigen can cause unwanted side effects.
[00206] [00206] In another embodiment, a bivalent binding compound ("masking ligand") comprising two antigen-binding domains is developed that binds to both antibody antigen-binding surfaces (bivalent) and interferes with the binding of the antigen. In one embodiment, the two binding domain masks are linked to each other (but not to the antibody) by a cleavable linker, for example, cleavable by a peptidase. (See, for example, WO 2010/077643 by Tegopharm Corp). Masking ligands can comprise or be derived from the antigen to which the antibody is intended to bind, or can be generated independently (for example, anti-idiotypic binding fragments). Such masking ligands are useful for the treatment of cancers in which protease levels are greatly increased in the tumor microenvironment compared to non-tumor tissues. The selective cleavage of the cleavable ligand in the tumor microenvironment allows the dissociation of the two binding domains from each other, reducing the avidity for the antigen-binding surfaces of the antibody. The dissociation resulting from the antibody masking ligand allows the antigen to selectively bind to the tumor, rather than to peripheral tissues where binding to the antigen can cause unwanted side effects. Fcs and modified Fc regions
[00207] [00207] In one embodiment, the antibodies described herein may comprise Fc regions selected based on the biological activities of the antibody. Salfeld (2007) Nat. Biotechnol. 25: 1369. Human IgGs, for example, can be classified into four subclasses, IgG1, IgG2, IgG3 and IgG4. Each of these subclasses comprises an Fc region that has a unique binding profile to one or more Fc receptors (FcγRI (CD64), FcγRIIA, FcγRIIC (CD32a, c) activation receptors; FcγRIIIA and FcγRIIIB (CD16a, b) and inhibitor of FcγRIIB receptor (CD32b) and for the first complement component (C1q) Human IgG1 and IgG3 bind to all Fcγ receptors; IgG2 binds to FcγRIIAH131, and with less affinity to FcγRIIAR131 FcγRIIIAV158; IgG4 binds to FγγRIIAH131; , FcγRIIA, FcγRIIB, FcγRIIC, and FcγRIIIAV158; and the inhibitory FcγRIIB receptor has a lower affinity for IgG1, IgG2 and IgG3 than all other Fcγ receptors. (Bruhns et al. (2009) Blood 113: 3716). Studies have shown that FcγRI does not bind to IgG2 and FcγRIIIB does not bind to IgG2 or IgG4. Id. In general, with respect to ADCC activity, Human IgG1 ≧ IgG3 ≫ IgG4 ≧ IgG2 In some modalities, an IgG1 constant domain , instead of an IgG2 or IgG4, is chosen, for example, for use in a therapeutic composition because the ADCC is desired. In other embodiments, IgG3 is chosen because activation of NK cells, monocytes or macrophages that express FcγRIIIA is desirable. In other modalities, IgG4 is chosen because the antibody is used to desensitize allergic patients. IgG4 is also selected so that the antibody does not have all the effector functions.
[00208] The anti-huICOS antibody variable regions described herein can be linked (e.g., covalently linked or fused) to an Fc, for example, an IgG1, IgG2, IgG3 or IgG4 Fc, which can be of any allotype or isoalotype , for example, IgG1: G1m, G1m1 (a), G1m2 (x), G1m3 (f), G1m17 (z); for IgG2: G2m, G2m23 (n); for IgG3: G3m, G3m21 (g1), G3m28 (g5), G3m11 (b0), G3m5 (b1), G3m13 (b3), G3m14 (b4), G3m10 (b5), G3m15 (s), G3m16 (t), G3m6 (c3), G3m24 (c5), G3m26 (u), G3m27 (v). (See, for example, Jefferis et al. (2009) mAbs 1: 1). Allotype selection can be influenced by potential immunogenicity concerns, for example, to minimize the formation of anti-drug antibodies.
[00209] [00209] In some embodiments, the anti-ICOS antibodies of the present invention have an Fc region that binds or improves binding to FcγRIIb, which provides improved agonism. See, for example, WO 2012/087928; Li & Ravetch (2011) Science 333: 1030; Wilson et al. (2011) Cancer Cell 19: 101; White et al. (2011) J. Immunol. 87: 1754. In some embodiments, the variable regions described herein can be linked to Fc variants that increase the affinity for the inhibitory FcyRIIb receptor, for example, to increase apoptosis-inducing or adjuvant activity. Li & Ravetch (2012) Proc. Nat'l Acad. Sci. (USA) 109: 10966; U.S. Patent Application Publication 2014/0010812. Such variants provide an antibody with immunomodulatory activities related to FcγRIIb + cells, including, for example, B cells and monocytes. In one embodiment, the Fc variants provide a selectively increased affinity for FcγRIIb relative to one or more activation receptors. Such variants can also exhibit enhanced FcR-mediated crosslinking, resulting in increased therapeutic efficacy. Modifications to alter the binding to FcγRIIb include one or more modifications, for example, at positions 234, 235, 236, 237, 239, 266, 267, 268, 325, 326, 327, 328 or 332, according to the index European. Exemplary substitutions to increase the affinity of FcγRIIb include, but are not limited to 234D, 234E, 234F, 234W, 235D, 235F, 235R, 235Y, 236D, 236N, 237D, 237N, 239D, 239E, 266M, 267D, 267E, 268D , 268E, 327D, 327E, 328F, 328W, 328Y, and 332E. Exemplary replacements include 235Y, 236D, 239D, 266M, 267E, 268D, 268E, 328F, 328W, and 328Y. Other Fc variants to increase binding to FcγRIIb include 235Y- 267E, 236D-267E, 239D-268D, 239D-267E, 267E-268D, 267E-268E, and 267E- 328F. Specifically, variants S267E, G236D, S239D, L328F and I332E, including the double variant S267E-L328F, of Human IgG1 are of particular value in specifically increasing affinity for the inhibitory FcγRIIb receptor. Chu et al. (2008) Mol. Immunol. 45: 3926; U.S. Patent Application Publication No. 2006/024298; WO 2012/087928. Enhanced specificity for FcγRIIb (as distinct from FcγRIIaR131) can be obtained by adding the P238D substitution and other mutations (Mimoto et al. (2013) Protein. Eng. Des. & Selection 26: 589; WO 2012/1152410), as well as V262E and V264E (Yu et al. (2013) J. Am. Chem. Soc. 135: 9723, and WO 2014/184545. Non-IgG2 Heavy Chain Constant Domains with IgG2 Articulation Regions
[00210] [00210] In some embodiments, the anti-ICOS antibodies described herein exhibit increased agonist activity, at least in part, due to modifications that have increased binding to, and / or specificity for, FcγRIIb. An alternative approach is to design the Fc region to provide an FcγR-independent enhancement of agonism. Examples of antibodies to other targets with modified IgG2 domains that provide such an improved agonism are described in WO 2015/145360 and White et al. (2015) Cancer Cell 27: 138, the descriptions of which are incorporated herein by reference in their entirety. Specifically,
[00211] [00211] An IgG2 hinge variant can also comprise non-IgG2 hinge sequence elements (a "chimeric hinge"). In some embodiments, the stiffness of the chimeric joint is at least similar to that of a wild-type IgG2 joint. For example, in one embodiment, an IgG2 hinge variant comprises a lower wild-type IgG1 hinge. See Table 2.
[00212] [00212] Table 4 below provides examples of sequences of the "IgG2 hinge" human heavy chain constant region that differ in the isotypic origins of the CH1, CH2 and CH3 domains. As used herein, "IgG2 hinge antibody" refers not only to antibodies comprising IgG2-derived hinge regions, but also CH1 regions derived from IgG2 CH1. The asterisk (*) in Table 4 indicates that the indicated domain can be of any isotype, or it can be completely absent. In certain embodiments, a modified Heavy Chain constant region comprises a variant CH1 domain, for example, including A114C mutations and / or
[00213] [00213] Examples of antibody constant domains comprising combinations of IgG2 CH1 and hinge sequences with other isotypic sequences, and selection of amino acid substitutions, are provided in Table 5 below. Table 5 - Examples of human heavy chain constant regions of "IgG2 articulation" Construction SEQ ID NO: Description IgG1f 104 IgG1f wild type IgG1.1f 109 IgG1.1f inert standard IgG2.3 105 Form A of IgG2 (C219S) IgG2.5 108 IgG2 Form B (C131S) 107 CH1, upper joint and lower / upper joint CH2 of IgG2.3G1-KH IgG2.3, all other IgG1f 116 CH1, upper joint and lower / upper joint CH2 of IgG2.5G1-KH IgG2.5, all other IgG1f IgG2.3G1-AY 106 CH1 and upper IgG2.3 joint, all other IgG1f IgG2.5G1-AY 115 CH1 and upper IgG2.5 joint, all other IgG1f 119 CH1 of IgG1 , upper joint and lower / upper joint IgG1-G2.3G1-KH CH2 of IgG2.3, all other IgG1f 118 CH1 of IgG1, upper joint of IgG2.3, all other IgG1-G2.3G1-AY IgG1f 110 CH1 , upper joint and lower / upper joint CH2 of IgG2.3G1.1f-KH IgG2.3, all other IgG1.1f 114 CH1, upper joint and joint in lower / upper CH2 IgG2.5G1.1f-KH IgG2.5, all other IgG1.1f IgG1-deltaTHT 111 IgG1 with THT sequence removed from the IgG2.3-plusTHT 112 IgG2.3 joint with THT (from IgG1) sequence added to the IgG2.5-plusTHT 117 hinge IgG2.5 with THT (IgG1) sequence added to the IgG2.3-plusGGG hinge 113 IgG2.3 with flexible GGG sequence added to the joint
[00214] [00214] Additional specific examples of antibody constant domains comprising combinations of IgG2 CH1 and hinge sequences with other isotypic sequences, and selection of amino acid substitutions, are provided in Table 6 below.
[00215] [00215] Anti-ICOS antibodies, including antibodies comprising the CDR and / or variable domain sequences described herein, may incorporate the "IgG2 hinge" constant domain sequences described herein, for example, to increase FcγR-independent agonist activity. Examples of such IgG2 articulation constant domains include those described in Table 5 (SEQ ID NOs: 104-108 and 110-119) and Table 6 (SEQ ID NOs: 120-151), and also those described in SEQ ID NOs: 101 -108. Half-life extension
[00216] [00216] In some embodiments, the anti-ICOS antibody is modified to increase its biological half-life, for example, the half-life of the antibody in serum. Various approaches are known in the art. For example, the half-life of an antibody can be extended by increasing the binding affinity of the Fc region to FcRn. In one embodiment, the antibody is altered within the CH1 or CL region to contain a rescue receptor binding epitope taken from two loops of a CH2 domain of an IgG Fc region, as described in U.S. Patent Nos. 5,869,046 and 6,121,022 by Presta et al. Other examples of Fc variants that increase binding to FcRn and / or improve pharmacokinetic properties include substitutions at positions 259, 308 and 434, including for example 259I, 308F, 428L, 428M, 434S, 434H, 434F, 434Y, and 434M. Other variants that enhance Fc binding to FcRn include: 250E, 250Q, 428L, 428F, 250Q / 428L (Hinton et al., 2004, J. Biol. Chem. 279 (8): 6213-6216, Hinton et al. 2006 Journal of Immunology 176: 346-356), 256A, 272A, 305A, 307A, 31 1A, 312A, 378Q, 380A, 382A, 434A (Shields et al, Journal of Biological Chemistry, 2001, 276 (9): 6591- 6604), 252F, 252Y, 252W, 254T, 256Q, 256E, 256D, 433R, 434F, 434Y, 252Y / 254T / 256E, 433K / 434F / 436H (Dall'Acqua et al. Journal of Immunology, 2002, 169: 5171 -5180, Dall'Acqua et al., 2006, Journal of Biological Chemistry 281: 23514-
[00217] [00217] Modification of certain residues conserved in IgG Fc (I253, H310, Q311, H433, N434), such as the N434A variant (Yeung et al. (2009) J. Immunol. 182: 7663), has been proposed as a way of increase affinity for FcRn, thereby increasing the circulating antibody half-life. (See, for example, WO 98/023289). The combination Fc variant comprising M428L and N434S has been shown to increase FcRn binding and increase serum half-life by up to five times. (Zalevsky et al. (2010) Nat. Biotechnol. 28: 157). The combination Fc variant comprising modifications of T307A, E380A and N434A also prolongs the half-life of IgG1 antibodies. (Petkova et al. (2006) Int. Immunol. 18: 1759). In addition, the combination Fc variant, comprising variants M252Y-M428L, M428L-N434H, M428L-N434F, M428L-N434Y, M428L-N434A, M428L-N434M, and M428L- N434S have also been shown to prolong half-life. (WO 2009/086320).
[00218] [00218] In addition, a combination Fc variant comprising M252Y, S254T and T256E, increases the half-life almost four times. (Dall'Acqua et al. (2006) J. Biol. Chem. 281: 23514). A related IgG1 modification providing greater FcRn affinity but reduced pH dependency (M252Y-S254T-T256E-H433K-N434F) was used to create an IgG1 construct ("MST-HN Abdeg") for use as a competitor to prevent binding other antibodies to FcRn, resulting in increased clearance of this other antibody, either endogenous IgG (for example, in an autoimmune environment) or another exogenous (therapeutic) mAb. (Vaccaro et al. (2005) Nat. Biotechnol. 23: 1283; WO 2006/130834).
[00219] [00219] Other modifications to increase FcRn binding are described in Yeung et al. (2010) J. Immunol. 182: 7663-7671; 6,277,375;
[00220] [00220] In certain embodiments, the hybrid IgG isotypes can be used to increase FcRn binding and potentially increase half-life. For example, a hybrid variant of IgG1 / IgG3 can be constructed by replacing the positions of IgG1 in the CH2 and / or CH3 region with the IgG3 amino acids in positions where the two isotypes differ. Thus, a hybrid variant IgG antibody may be constructed which comprises one or more substitutions, for example, 274Q, 276K, 300F, 339T, 356E, 358M, 384S, 392N, 397M, 422I, 435R and 436F. In other embodiments described here, a hybrid variant IgG1 / IgG2 can be constructed by replacing the positions of IgG2 in the CH2 and / or CH3 region with IgG1 amino acids in positions where the two isotypes differ. Thus, a hybrid variant IgG antibody can be constructed which comprises one or more substitutions, for example, one or more of the following amino acid substitutions: 233E, 234L, 235L, -236G (referring to an insertion of a glycine in the 236) and 327A. See U.S. Patent No. 8,629,113. A hybrid of IgG1 / IgG2 / IgG4 sequences was generated that supposedly increases serum half-life and improves expression. U.S. Patent No. 7,867,491 (sequence number 18).
[00221] [00221] The serum half-life of the antibodies described here can also be increased by pegylation. An antibody can be pegylated, for example, to increase the biological half-life (for example, serum) of the antibody. To pegylate an antibody, the antibody, or fragment thereof, is typically reacted with a polyethylene glycol (PEG) reagent, such as a reactive PEG ether derivative or aldehyde, under conditions where one or more PEG groups bind to the antibody or antibody fragment. Preferably, pegylation is carried out via an acylation reaction or an alkylation reaction with a reactive PEG molecule (or a water-soluble reactive polymer analog). As used herein, the term "polyethylene glycol" is intended to encompass any of the forms of PEG that have been used to derive other proteins, such as mono (C1-C10) alkoxy or aryloxy-polyethylene glycol or polyethylene glycol-maleimide. In certain embodiments, the antibody to be pegylated is an aglycosylated antibody. Methods for protein pegylation are known in the art and can be applied to the antibodies described herein. (See, for example, EP 0154316 by Nishimura et al. And EP 0401384 by Ishikawa et al.).
[00222] [00222] In some cases, it may be desirable to decrease the half-life of an antibody, instead of increasing it. In some embodiments, the antibodies described here include modifications to decrease their half-life. Modifications such as I253A (Hornick et al. (2000) J. Nucl. Med. 41: 355) and H435A / R, I253A or H310A (Kim et al. (2000) Eur. J. Immunol. 29: 2819) in Fc Human IgG1 can decrease the binding of FcRn, thereby shortening the half-life (increasing clearance) for use in situations where rapid clearance is preferred, such as for medical imaging. (See also Kenanova et al. (2005) Cancer Res. 65: 622). Other methods for enhancing clearance include formatting the antigen-binding domains of the present invention as antibody fragments that are unable to bind to FcRn, such as Fab fragments. Such modification can, for example, reduce the circulating half-life of an antibody from 2 weeks to hours. Selective pegylation of antibody fragments can then be used to increase the half-life of antibody fragments when desired. (Chapman et al. (1999) Nat. Biotechnol. 17: 780). Antibody fragments can also be fused with human serum albumin, for example, in a fusion protein construct, to increase half-life. (Yeh et al. (1992) Proc. Nat'l Acad. Sci. 89: 1904). Alternatively, a bispecific antibody can be constructed with a first antigen-binding domain of the present invention and a second antigen-binding domain that binds human serum albumin (HSA). (See WO 2009/127691 and patent references cited here). Alternatively, specialized polypeptide sequences can be added to antibody fragments to increase the half-life, for example, "XTEN" polypeptide sequences. (Schellenberger et al. (2009) Nat. Biotechnol. 27: 1186; International Patent Application Publication WO 2010/091122). Additional Fc Variants
[00223] [00223] In some embodiments, when using an IgG4 constant domain, it may be advantageous to include the S228P substitution, which mimics the IgG1 hinge sequence and thus stabilizes the IgG4 molecules, for example, by reducing the exchange of the Fab arm between the therapeutic antibody and the endogenous IgG4 in the patient being treated. (Labrijn et al. (2009) Nat. Biotechnol. 27: 767; Reddy et al. (2000) J. Immunol. 164: 1925).
[00224] [00224] A potential protease cleavage site in the joint of IgG1 constructs can be eliminated by modifications of D221G and K222S, increasing the stability of the antibody. (WO 2014/043344).
[00225] [00225] The affinities and binding properties of an Fc variant to its ligands (Fc receptors) can be determined by a variety of in vitro assay methods (for example, biochemical or immunological assays) known in the art, including, but not limited to a, equilibrium methods (for example, immunoenzymatic assay (ELISA) or radioimmunoassay (RIA)) or kinetic (for example, BIACORE® SPR analysis) and other methods, such as indirect binding assays, competitive inhibition assays, energy transfer by fluorescence resonance (FRET), gel electrophoresis and chromatography (eg gel filtration). These and other methods may use a label on one or more of the components to be examined and / or employ a variety of detection methods including, but not limited to, chromogenic, fluorescent, luminescent or isotopic markings. A detailed description of binding affinities and kinetics can be found in Paul, W.E., ed., Fundamental Immunology, 4th Ed., Lippincott-Raven, Philadelphia (1999), which focuses on antibody-immunogen interactions.
[00226] [00226] In yet other embodiments, the glycosylation of an antibody is modified to increase or decrease the effector function. For example, an aglycolated antibody that does not have the full effector function can be produced by mutating the conserved asparagine residue at position 297 (for example, N297A), thus abolishing the complement and the FcγRI bond. (Bolt et al. (1993) Eur. J. Immunol. 23: 403. See also Tao & Morrison (1989) J. Immunol. 143: 2595 (using N297Q in IgG1 to eliminate glycosylation at position 297)).
[00227] [00227] Although aglycolated antibodies generally do not have an effective function, mutations can be introduced to restore that function. Aglycosylated antibodies, for example, those that result from N297A / C / D / or H mutations or produced in systems (for example, E. coli) that do not glycosylate proteins, can still be mutated to restore the FcγR binding, for example, S298G and / or T299A / G / or H (WO 2009/079242), or E382V and M428I (Jung et al. (2010) Proc. Nat'l Acad. Sci. (USA) 107: 604).
[00228] [00228] Glycoengineering can also be used to modify the anti-inflammatory properties of an IgG construct by altering the α2,6 sialyl content of the Asn297 linked carbohydrate chains in the Fc regions, in which an increased proportion of α2 sialylated forms, 6 results in increased anti-inflammatory effects. (See Nimmerjahn et al. (2008) Ann. Rev. Immunol. 26: 513). Conversely, a reduction in the proportion of antibodies with α2,6 sialylated carbohydrates may be useful in cases where anti-inflammatory properties are not desired. Methods of modifying the α2,6 sialylation content of antibodies, for example, by selective purification of α2,6 sialylated forms or by enzymatic modification, are provided in U.S. Patent Application Bar No. 2008/0206246. In other embodiments, the Fc Region Amino Acid Sequence can be modified to mimic the effect of α2,6 sialylation, for example, by including an F241A modification. (WO 2013/095966). III. Physical Properties of the Antibody
[00229] [00229] In certain embodiments, the antibodies described herein contain one or more glycosylation sites in any of the light or heavy chain regions. Such glycosylation sites can result in increased antibody immunogenicity or an altered antibody pharmacokinetics due to altered antigen binding (Marshall et al (1972) Ann. Rev. Biochem. 41: 673-702; Gala and Morrison (2004) J. Immunol. 172: 5489-94; Wallick et al (1988) J. Exp. Med. 168: 1099-109; Spiro (2002) Glycobiology 12: 43R-56R; Parekh et al (1985) Nature 316: 452-7; Mimura et al. (2000) Mol Immunol 37: 697-706). Glycosylation is known to occur in motifs that contain an N-X-S / T sequence. In some embodiments, the anti-huICOS antibody does not contain glycosylation of the variable region. Such antibodies can be obtained by selecting antibodies that do not contain the glycosylation motif in the variable region or by mutating residues within the glycosylation region.
[00230] [00230] In certain embodiments, the antibodies described herein do not contain asparagine isomerism sites. Deamidation of asparagine can occur in the N-G or D-G sequences and result in the creation of an isoaspartic acid residue that introduces a twist in the polypeptide chain and decreases its stability (known as the isoaspartic acid effect).
[00231] [00231] In some embodiments, the antibodies described here have an isoelectric point (pI) in the pH range between 6 and 9.5. In some embodiments, the antibodies described here have a pI in the pH range of 7-9.5 or 6-8. Antibodies with pI within a desired pI range can be obtained by selecting antibodies with pI in the pH range of a group of candidates or by mutating charged surface residues of a particular antibody.
[00232] [00232] In some embodiments, the antibodies described here are selected and / or modified with an initial split temperature (TM1) greater than 60 ° C, greater than 65 ° C or greater than 70 ° C. The melting point of an antibody can be measured using differential scanning calorimetry (Chen et al (2003) Pharm Res 20: 1952-60; Ghirlando et al (1999) Immunol Lett. 68: 47-52) or circular dichroism ( Murray et al. (2002) J. Chromatogr. Sci. 40: 343-9).
[00233] [00233] In some embodiments, the antibodies described herein are selected and / or constructed to have advantageous degradation properties, for example, slow degradation in vitro and / or in vivo. Antibody degradation can be measured using capillary electrophoresis (CE) and MALDI-MS (Alexander A J and Hughes D E (1995) Anal Chem. 67: 3626-32). In some embodiments, the antibodies described herein are selected and / or constructed to have favorable aggregation properties, for example, antibodies that show minimal aggregation in vitro and / or in vivo, which can induce an unwanted immune response and / or altered pharmacokinetic properties or unfavorable. In some embodiments, the antibodies described herein show aggregation of 25% or less, 20% or less, 15% or less, 10% or less, or 5% or less compared to the aggregation of the parental antibody. Aggregation can be measured by several techniques, including size exclusion column (SEC), high performance liquid chromatography (HPLC) and light scattering. IV. Nucleic Acid Molecules and Recombinant Methods
[00234] [00234] Another aspect described herein refers to nucleic acid molecules that encode the anti-huICOS antibodies described herein. Nucleic acids can be present in whole cells, for example, a host cell, in a cell lysate or in a partially purified or substantially pure form. A nucleic acid is "isolated" or "made substantially pure" when purified from other cellular components or other contaminants, for example, other cellular nucleic acids (for example, other chromosomal DNA, for example, the chromosomal DNA that is linked to isolated DNA in nature) or proteins, by standard techniques, including alkaline / SDS treatment, CsCl banding, column chromatography, restriction enzymes, agarose gel electrophoresis and others well known in the art. (See, F. Ausubel, et al., Ed. (1987) Current Protocols in Molecular Biology, Greene Publishing and Wiley Interscience, New York). A nucleic acid described herein can be, for example, DNA or RNA and may or may not contain introns. In certain embodiments, the nucleic acid is a cDNA molecule.
[00235] [00235] The nucleic acids described herein can be obtained using standard molecular biology techniques. For antibodies expressed by hybridomas (for example, hybridomas prepared from transgenic mice carrying human immunoglobulin genes as described below), cDNAs encoding the heavy and / or light chains of the antibody produced by the hybridoma can be obtained by amplification by Standard PCR or cDNA cloning techniques. For antibodies obtained from an immunoglobulin gene library (for example, using phage display techniques), the nucleic acid encoding the antibody can be recovered from the library.
[00236] [00236] Once DNA fragments encoding VH and VL segments are obtained, these DNA fragments can be constructed by standard recombinant DNA techniques, for example, to convert genes from the variable region into full-length antibody chain genes , Fab fragment genes or an scFv gene. In these manipulations, a fragment of DNA encoding VL or VH is operably linked to another fragment of DNA encoding another protein, such as an antibody constant region or a flexible ligand. The term "operably linked", as used in this context, means that the two DNA fragments are joined so that the amino acid sequence encoded by the two DNA fragments remains within the structure.
[00237] [00237] Isolated DNA encoding the VH region can be converted into a full-length heavy chain gene by operatively linking the VH encoding DNA to another DNA molecule encoding constant regions of the heavy chain (joint, CH1, CH2 and / or CH3). The gene sequences of the human heavy chain constant region are known in the art (see, for example, Kabat, et al., 1991) and the DNA fragments that span these regions can be obtained by conventional PCR amplification. The heavy chain constant region can be an IgG (IgG1, IgG2, IgG3 or IgG4), IgA, IgE, IgM or IgD constant region, for example, an IgG1 region. For a Fab heavy chain gene fragment, the DNA encoding VH can be operably linked to another DNA molecule encoding only the CH1 heavy chain constant region.
[00238] [00238] Isolated DNA encoding the VL region can be converted into a full-length light chain gene (as well as a Fab gene) by operatively linking the VL encoding DNA to another DNA molecule encoding the light chain constant region, CL. The sequences of genes from the human light chain constant region are known in the art (see, for example, Kabat, et al., 1991). Sequences of Proteins of Immune Interest, Fifth Edition, US Department of Health and Human Services, NIH Publication No. 91-3242), and the DNA fragments that span these regions can be obtained by conventional PCR amplification. The light chain constant region can be a kappa or lambda constant region.
[00239] [00239] To create a scFv gene, the DNA fragments encoding VH and VL are operably linked to another fragment encoding a flexible linker, for example, encoding the Amino Acid Sequence (Gly4-Ser) 3, such that the VH sequences and VL can be expressed as a contiguous single chain protein, with the VL and VH regions joined by the flexible ligand (see, for example, Bird et al. (1988) Science 242: 423-426; Huston et al. (1988) Proc. Natl. Acad. Sci. USA 85: 5879-5883; McCafferty et al., (1990) Nature 348: 552-554). V. Generation of Antibodies
[00240] [00240] Various antibodies of the present invention, for example, those that bind to the same Epitope as selected human anti-ICOS antibodies described herein, can be produced using a variety of known techniques, such as the standard somatic cell hybridization technique described by Kohler and Milstein, Nature 256: 495 (1975). Other techniques for the production of monoclonal antibodies can also be employed, for example, viral or oncogenic transformation of B lymphocytes, a phage display technique using human antibody gene libraries.
[00241] [00241] An exemplary animal system for the preparation of hybridomas is the murine system. The production of hybridoma in mice is a well-established procedure. Immunization protocols and techniques for isolating splenocytes immunized for fusion are known in the art. Fusion partners (eg, murine myeloma cells) and fusion procedures are also known.
[00242] [00242] The chemical or humanized antibodies described herein can be prepared based on the sequence of a murine monoclonal antibody prepared as described above. The DNA encoding the light and heavy chain immunoglobulins can be obtained from the murine hybridoma of interest and modified to contain non-murine (e.g., human) immunoglobulin sequences using standard molecular biology techniques. For example, to create a chimeric antibody, murine variable regions can be linked to human constant regions using methods known in the art (see, for example, U.S. Patent No. 4,866,567 to Cabilly et al.). To create a humanized antibody, murine CDR regions can be inserted into a human structure using methods known in the art (see, for example, US Patent No. 5,225,539 to Winter and US Patent No. 5,530,101; 5,585,089; 5,693,762 and 6,180,370 to Queen et al.).
[00243] [00243] In one embodiment, the antibodies described herein are human monoclonal antibodies. Such human monoclonal antibodies directed against human ICOS can be generated using transgenic or trans-chromosomal mice that transport parts of the human immune system instead of the mouse system. These transgenic and trans-chromosomal mice include mice referred to herein as HuMAb mice and KM mice, respectively, and are collectively referred to as "human Ig mice".
[00244] [00244] HuMAb mouse® (Medarex, Inc.) contains minilocs from the human immunoglobulin gene encoding non-rearranged human κ and ordered (µ and γ) light chain immunoglobulins, along with targeted mutations that inactivate µ endogenous sequences and κ chain loci (see, for example, Lonberg, et al. (1994) Nature 368 (6474): 856-859). Thus, mice exhibit reduced expression of mouse IgM or κ, and in response to immunization, introduced human light and heavy chain transgenes undergo class mutation and somatic mutation to generate high-affinity human IgGκ monoclonal antibodies (Lonberg, N et al. (1994), supra; revised in Lonberg, N. (1994) Handbook of Experimental Pharmacology 113: 49-101; Lonberg, N. and Huszar, D. (1995) Intern. Rev. Immunol. 13: 65 -93, and Harding, F. and Lonberg, N. (1995) Ann. NY Acad. Sci. 764: 536-546). The preparation and use of HuMan mice, and the genome modifications carried by such mice, are described in Taylor, L. et al. (1992) Nucleic Acids Research 20: 6287-6295; Chen, J. et al. (1993) International Immunology 5: 647-656; Tuaillon et al. (1993) Proc. Natl. Acad. Sci. USA 90: 3720-3724; Choi et al. (1993) Nature Genetics 4: 117-123; Chen, J. et al. (1993) EMBO J. 12: 821-830; Tuaillon et al. (1994) J. Immunol. 152: 2912-2920; Taylor, L. et al. (1994) International Immunology 6: 579-591; and Fishwild, D. et al. (1996) Nature Biotechnology 14: 845-851, the contents of which are all specifically incorporated by reference in their entirety. (See, also, U.S. Patent No. 5,545,806;
[00245] [00245] In certain embodiments, the antibodies described here are created using a mouse that carries human immunoglobulin sequences in transgenes and transchromosomes, such as a mouse that carries a human heavy chain transgene and a human light chain transchromosome. Such mice, referred to herein as "KM mice", are described in detail in PCT publication WO 02/43478 by Ishida et al ..
[00246] [00246] Furthermore, alternative transgenic animal systems expressing human immunoglobulin genes are available in the art and can be used to create anti-huICOS antibodies described herein. For example, an alternative transgenic system referred to as the Xenomouse (Abgenix, Inc.) can be used; such as mice are described, for example, in U.S. Patent Nos.
[00247] [00247] In addition, alternative transchromosomal animal systems expressing human immunoglobulin genes are available in the art and can be used to create anti-ICOS antibodies described herein. For example, mice carrying both a human heavy chain transchromosome and a human light chain transchromosome, called "TC mice" can be used; these mice are described in Tomizuka et al. (2000) Proc. Natl. Acad. Sci. USA 97: 722-727. In addition, cows carrying human light and heavy chain transchromosomes have been described in the art (Kuroiwa et al. (2002) Nature Biotechnology 20: 889-894) and can be used to raise the anti-water antibodies described herein.
[00248] [00248] Additional mouse systems described in the art for raising human antibodies, for example, human anti-huICOS antibodies, include (i) the VELOCIMMUNE ® mouse (Regeneron Pharmaceuticals, Inc.), in which the variable regions of light and heavy chains of endogenous mice were replaced by homologous recombination, with variable regions of human light and heavy chains, operably linked to the constant regions of endogenous mice, such that chimeric antibodies (human V / mouse C) are elevated in mice and subsequently converted to fully human antibodies using recombinant DNA techniques; and (ii) the MeMo® mouse (Merus Biopharmaceuticals, Inc.), in which the mouse contains a non-rearranged human heavy chain variable region, but a single rearranged human common light chain variable region. Such mice, and their use to raise antibodies, are described, for example, in WO 2009/15777, US 2010/0069614, WO 2011/072204, WO 2011/097603, WO 2011/163311, WO 2011/163314, WO 2012 / 148873, US 2012/0070861 and US 2012/0073004.
[00249] [00249] The human monoclonal antibodies described herein can also be prepared using phage display methods for screening libraries of human immunoglobulin genes. These phage display methods for isolating human antibodies are established in the art. (See, for example, U.S. Patent Nos.
[00250] [00250] The human monoclonal antibodies described herein can also be prepared using mice with severe combined immunodeficiency (SCID) in which human immune cells have been reconstituted so that a human antibody response can be generated after immunization. Such mice are described, for example, in U.S. Patent Nos. 5,476,996 and 5,698,767 by Wilson et al. Immunizations
[00251] [00251] To generate fully human antibodies to human ICOS, transgenic or trans-chromosomal mice or mice containing human immunoglobulin genes (for example, HCo12, HCo7 or KM mice) can be immunized with a purified or enriched preparation of the ICOS antigen and / or cells that express ICOS, as described for other antigens,
[00252] [00252] Transgenic HuMAb mice can be initially immunized intraperitoneally or subcutaneously (SC) with antigen in Ribi's adjuvant, followed by IP / SC immunizations every other week (up to a total of 10) with antigen in Ribi's adjuvant. The immune response can be monitored throughout the immunization protocol with plasma samples being obtained by retro-orbital bleeding. Plasma can be screened by ELISA and FACS (as described below), and mice with sufficient titers of human anti-ICOS immunoglobulin can be used for fusion. Mice can be boosted intravenously with antigen three days before sacrifice and removal of the spleen and lymph nodes. Two to three fusions for each immunization can be performed. Between 6 and 24 mice can be immunized for each antigen. In some modalities, strains of HCo7, HCo12 and KM are used. In addition, both the HCo7 and HCo12 transgene can be bred together in a single mouse that has two different human heavy chain transgenes (HCo7 / HCo12).
[00253] [00253] To generate hybridomas producing monoclonal antibodies described herein, splenocytes and / or lymph node cells from immunized mice can be isolated and fused to an appropriate immortalized cell line, such as a mouse myeloma cell line. The resulting hybridomas can be analyzed for the production of specific antibodies to the antigen. For example, single cell suspensions of splenic lymphocytes from immunized mice can be fused with non-secreting Sp2 / 0 mouse myeloma cells (ATCC, CRL 1581) with 50% PEG. The cells are washed at approximately 2 x 105 in a flat-based microtiter plate, followed by two weeks of incubation in selective medium containing 10% fetal clone serum, 18% conditioning medium "653", 5% Origen (IGEN) , 4 mM L-glutamine, 1 mM sodium pyruvate, 5 mM HEPES, 0.055 mM 2-mercaptoethanol, 50 units / ml penicillin, 50 mg / ml streptomycin, 50 mg / ml gentamicin and 1X gentamicin HAT (Sigma). After approximately two weeks, cells can be grown in the medium where HAT is replaced with HT. The individual wells can then be analyzed by ELISA for human IgM and IgG monoclonal antibodies. Once extensive hybridoma growth occurs, the medium can usually be seen after 10 to 14 days. The antibodies that secrete hybridomas can be replaced, analyzed again, if they are still positive for human IgG, monoclonal antibodies can be subcloned at least twice by limiting dilution. The stable subclones can then be cultured in vitro to generate small amounts of antibodies in tissue culture medium for characterization.
[00254] [00254] To purify monoclonal antibodies, the selected hybridomas can be grown in two-liter spinner flasks for purification of monoclonal antibodies. Supernatants can be filtered and concentrated before protein A-Sepharose affinity chromatography (Pharmacia, Piscataway, N.J.). The eluted IgG can be checked by gel electrophoresis and high performance liquid chromatography to ensure purity. The buffer solution can be exchanged in PBS and the concentration can be determined by OD280 using the extinction coefficient 1.43. Monoclonal antibodies can be aliquoted and stored at -80 ° C. SAW. Antibody Manufacturing Generation of Transfectomas that produce Monoclonal Antibodies for ICOS
[00255] [00255] Antibodies of the present invention, including both specific antibodies for which the sequences are provided and other related anti-ICOS antibodies, can be produced in a host cell transfectome using, for example, a combination of recombinant DNA techniques and gene transfection methods well known in the art (Morrison, S. (1985) Science 229: 1202).
[00256] [00256] For example, to express antibodies, or antibody fragments thereof, DNAs encoding full-length heavy and light chains can be obtained by standard molecular biology techniques (for example, PCR amplification or cDNA cloning using a hybridoma that expresses the antibody of interest), and DNAs can be inserted into expression vectors in such a way that the genes are operably linked to transcription and translation control sequences. In this context, the term "operably linked" is intended to mean that an antibody gene is linked to a vector such that the transcription and translation control sequences within the vector serve its intended function of regulating the transcription and translation of the antibody gene. The expression vector and expression control sequences are chosen to be compatible with the expression host cell used. The antibody light chain gene and the antibody heavy chain gene can be inserted into separate vectors or both genes are inserted into the same expression vector. The antibody genes are inserted into the expression vector (s) by standard methods (for example, binding complementary restriction sites on the gene fragment and antibody vector, or blunt-ended binding if no restriction sites are present ). The variable region of heavy and light chains of the antibodies described herein can be used to create whole antibody genes of any antibody isotype, inserting them into expression vectors that encode light chain and heavy chain constant regions of the desired isotype, such that the VH segment is operationally linked to the CH segment (s) within the vector and the VL segment is operatively linked to the CL segment within the vector. In addition or alternatively, the recombinant expression vector can encode a signal peptide that facilitates secretion of the antibody chain from a host cell. The antibody chain gene can be cloned into the vector such that the signal peptide is linked in the structure to the amino terminus of the antibody chain gene. The signal peptide can be an immunoglobulin signal peptide or a heterologous signal peptide (i.e., a signal peptide from a non-immunoglobulin protein).
[00257] [00257] In addition to the antibody chain genes, recombinant expression vectors can contain regulatory sequences that control the expression of the antibody chain genes in a host cell. The term "regulatory sequence" includes promoters, enhancers and other expression control elements (e.g., polyadenylation signals) that control the transcription or translation of the antibody chain genes. Such regulatory sequences are described, for example, in Goeddel (Gene Expression Technology. Methods in Enzymology 185, Academic Press, San Diego, CA (1990)). It will be appreciated by those skilled in the art that the design of the expression vector, including the selection of regulatory sequences, may depend on factors such as the choice of host cell to be transformed, the level of expression of the desired protein, among other factors. Preferred regulatory sequences for mammalian host cell expression include viral elements that drive high levels of protein expression in mammalian cells, such as promoters and / or stimulators derived from cytomegalovirus (CMV), Simian Virus 40 (SV40), adenovirus (by example, adenovirus major late promoter (AdMLP) and polyomavirus. Alternatively, non-viral regulatory sequences, such as the ubiquitin promoter or the globin promoter, can be used. Furthermore, regulatory elements composed of sequences from different sources, such as the system SRα promoter, which contains SV40 early promoter sequences and the long terminal repeat of human T-cell leukemia virus type 1 (Takebe, Y. et al. (1988) Mol. Cell. Biol. 8: 466-472).
[00258] [00258] In addition to antibody chain genes and regulatory sequences, recombinant expression vectors may carry additional sequences, such as sequences that regulate vector replication in host cells (e.g., origins of replication) and selectable marker genes. The selectable marker gene facilitates the selection of host cells into which the vector has been introduced (see, for example, U.S. Patent Nos. 4,399,216, 4,634,665 and 5,179,017, all by Axel et al.). For example, typically the selectable marker gene confers resistance to drugs, such as G418, hygromycin or methotrexate, in a host cell into which the vector has been introduced. Exemplary selectable marker genes include the gene for
[00259] [00259] For expression of heavy and light chains, the expression vector (s) encoding the heavy and light chains is transfected into a host cell by standard techniques. The various forms of the term "transfection" encompass a wide variety of techniques commonly used for the introduction of exogenous DNA into a prokaryotic or eukaryotic host cell, for example, electroporation, precipitation with calcium phosphate, transfection with DEAE-dextran and the like. Although it is theoretically possible to express the antibodies described herein in prokaryotic or eukaryotic host cells, expression of antibodies in eukaryotic cells, and more preferably mammalian host cells, is most preferred because such eukaryotic cells, and in particular mammalian cells, are more likely than prokaryotic cells to assemble and secrete a properly folded and immunologically active antibody. Prokaryotic expression of antibody genes has been reported to be ineffective for producing high yields of active antibodies (Boss, M. A. and Wood, C. R. (1985) Immunology Today 6: 12-13). The antibodies of the present invention can also be produced in glycol-manipulated yeast strains. (Pichia pastoris. Li et al. (2006) Nat. Biotechnol. 24: 210).
[00260] Exemplary mammalian host cells to express the recombinant antibodies described herein include the Chinese Hamster Ovary (CHO cells) (including dhfr-CHO cells, described in Urlaub and Chasin, (1980) Proc. Natl. Acad. Sci. 77: 4216 - 4220, used with a selectable dihydrofolate reductase (DHFR) marker, for example, as described in RJ Kaufman and PA Sharp (1982) Mol. Biol. 159: 601-621), NSO myeloma cells, cells
[00261] [00261] The N and C terminals of the antibody polypeptide chains of the present invention may differ from the expected sequence due to commonly observed post-translational modifications. For example, C-terminating lysine residues are often absent from the heavy chain antibody. (Dick et al. (2008) Biotechnol. Bioeng. 100: 1132). N-terminated glutamine residues and, to a lesser extent, glutamate residues, are often converted to pyroglutamate residues of both light and heavy chains of therapeutic antibodies. (Dick et al. (2007) Biotechnol. Bioeng. 97: 544; Liu et al. (2011) JBC 28611211; Liu et al. (2011) J. Biol. Chem. 286: 11211).
[00262] [00262] Amino Acid Sequence for various anti-huICOS agonist antibodies of the present invention are provided in the Sequence List, which is summarized in Table 35. For the reasons discussed above, the C-terminating lysine is not included in many of the sequences in the Sequences for heavy chains or constant domain of heavy chains. However, in an alternative embodiment, each heavy chain for anti-HIV antibodies
[00263] [00263] Antibodies described here can be tested for binding to ICOS, for example, by standard ELISA. For example, microtiter plates are coated with purified ICOS at 1-2 µg / ml in PBS, and then blocked with 5% bovine serum albumin in PBS. Antibody dilutions (for example, dilutions of mouse plasma immunized with ICOS) are added to each well and incubated for one to two hours at 37 ° C. The plates are washed with PBS / Tween and then incubated with secondary reagent (for example, by human antibodies, or antibodies otherwise having a human heavy chain constant region, a goat anti-human IgG specific fc polyclonal reagent) horseradish peroxidase (HRP) for one hour at 37 ° C. After washing, the plates are developed with ABTS substrate (Moss Inc, product: ABTS-1000) and analyzed by a spectrophotometer in OD 415-495. Immunized mouse serum is then screened by flow cytometry for binding to a cell line expressing human ICOS, but not to a control cell line that does not express ICOS. Briefly, the binding of anti-ICOS antibodies is assessed by incubating ICOS expressing CHO cells with the anti-ICOS antibody at 1:20 dilution. The cells are washed and ligation is detected with a PE labeled anti-human IgG Ab. Flow cytometric analyzes are performed using FACScan flow cytometry (Becton Dickinson, San Jose, CA). Preferably, mice that develop the highest titers will be used for mergers. Similar experiments can be performed using anti-mouse detection antibodies if mouse anti-human antibodies are to be detected.
[00264] [00264] An ELISA, for example, as described above can be used for antibody analysis and thus hybridomas that produce antibodies that show positive reactivity with the ICOS immunogen. Hybridomas that produce antibodies that bind, preferably with high affinity, to ICOS can then be subcloned and then characterized. A clone of each hybridoma, which retains the reactivity of the source cells (by ELISA), can then be chosen to make a cell bank, and for antibody purification.
[00265] [00265] To purify anti-ICOS antibodies, selected hybridomas can be grown in two-liter spinner flasks for purification of monoclonal antibody. Supernatants can be filtered and concentrated before protein A-sepharose affinity chromatography (Pharmacia, Piscataway, NJ). Eluted IgG can be checked by gel electrophoresis and liquid chromatography and high performance to ensure purity. The buffer solution can be exchanged in PBS, and the concentration can be determined by OD 280 using an extinction coefficient of 1.43. Monoclonal antibodies can be aliquoted and stored at -80 ° C.
[00266] [00266] To determine whether anti-ICOS monoclonal antibodies bind to unique epitopes, each antibody can be biotinylated using commercially available reagents (Pierce, Rockford, IL). Biotinylated MAb binding can be detected with a probe labeled with streptavidin. Competition studies using unlabeled monoclonal antibodies and biotinylated monoclonal antibodies can be performed using ELISA plates reviewed with ICOS as described above.
[00267] [00267] To determine the isotype of purified antibodies, ELISA isotype can be performed using specific reagents for antibodies of a particular isotype. For example, to determine the isotype of a human monoclonal antibody, microtiter plate wells can be coated with 1 µg / ml of anti-human immunoglobulin overnight at 4 ° C. After blocking with 1% BSA, the plates are reacted with 1 µg / ml or less of monoclonal antibody tests or purified isotype controls, at room temperature for one to two hours. The wells can then be reacted with Human IgG1 or probes conjugated to human IgM specific alkaline phosphatase. Plates are developed and analyzed as described above.
[00268] [00268] To test the binding of monoclonal antibodies to living cells expressing ICOS, flow cytometry can be used. Briefly, cell lines expressing membrane-bound ICOS (growth under standard growth conditions) are mixed with various concentrations of monoclonal antibodies in PBS containing 0.1% BSA at 4 ° C for one hour. After washing, the cells are reacted with Anti-IgG antibody labeled with Phycoerythrin (PE) under the same conditions as the primary antibody stain. Samples can be analyzed by a FACScan instrument using light and lateral dispersion properties to block individual cells and binding of labeled antibodies is determined. An alternative assay using fluorescence microscopy can be used (in addition to or instead of) the flow cytometry assay. Cells can be stained exactly as described above and examined by fluorescence microscopy. This method allows visualization of individual cells, but can decrease sensitivity depending on the density of the antigen.
[00269] [00269] Anti-huICOS antibodies can also be tested for reactivity with the ICOS antigen by Western blotting. In summary, cell extracts from cells expressing ICOS can be prepared and subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis. After electrophoresis, the separated antigens will be transferred to nitrocellulose membranes, blocked with 20% of mouse serum, and probed with the monoclonal antibodies to be tested. IgG binding can be detected using anti-IgG alkaline phosphatase and developed with BCIP / NBT substrate tablets (Sigma Chem. Co., St. Louis, MO).
[00270] [00270] Methods for analyzing binding affinity, cross-reactivity, and binding kinetics of various anti-ICOS antibodies include standard assays known in the art, for example, Biolayer Interferometry (BLI) analysis, and BIACORE® SPR analysis using a BIACORE® instrument 2000 SPR (Biacore AB, Uppsala, Sweden).
[00271] [00271] In one embodiment, an anti-huICOS antibody specifically binds to the extracellular region of human ICOS. In one embodiment, the antibody binds to a particular domain (for example, a functional domain) within the ICOS extracellular domain. In one embodiment, the anti-huICOS antibody specifically binds to the human ICOS extracellular region and the cinomolgus ICOS extracellular region. In one embodiment, the anti-huICOS antibody binds to human ICOS with high affinity. VIII. Multispecific Molecules
[00272] [00272] In certain embodiments, antibodies described here can be multispecific, for example, bispecific or triespecific molecules. Multispecific antigen-binding molecules, such as multispecific antibodies, comprise two or more antigen-binding sites, each specific for a different epitope. The different epitope may be part of the same or different antigens. In one embodiment, one antigen-binding site is specific for human ICOS and the others for a different antigen. In one embodiment, an anti-huICOS antibody, or antigen-binding fragments thereof, as described herein is linked to another antigen-binding molecule, for example, another peptide or protein (for example, another antibody or antibody fragment, or a linker for a receptor) having a different binding specificity to generate a bispecific molecule that binds to at least two different binding sites or target molecules. In one embodiment, the antibody described here is derivatized or linked to more than one antigen-binding molecule to generate multispecific molecules that bind to more than two different binding sites and / or target molecules. Therefore, provided here are bispecific molecules comprising at least a first binding specificity for ICOS and a second binding specificity for a second target epitope. In an embodiment described here in which the bispecific molecule is multispecific, the molecule can also include a third binding specificity.
[00273] [00273] In one embodiment, the bispecific molecules described here comprise as a binding specificity in at least one antibody, or an antibody fragment thereof, including, for example, a Fab, Fab ', F (ab') 2, Fv, or a single chain Fv. The antibody can also be a Light Chain or Heavy Chain dimer, or any minimal fragment thereof such as an Fv or a single chain construct as described in Ladner et al. U.S. Patent No. 4,946,778, the contents of which are expressly incorporated by reference.
[00274] [00274] While human monoclonal antibodies are preferred, other antibodies that can be used in the bispecific molecules described here are murine, chimeric and humanized monoclonal antibodies.
[00275] [00275] The bispecific molecules described herein can be prepared by conjugating the constituent binding specificities using methods known in the art. For example, each bispecific molecule binding specificity can be generated separately and conjugated to one another. When binding specificities are proteins or peptides, a variety of coupling or crosslinking agents can be used for covalent conjugation. Examples of cross-linking agents include protein A, carbodiimide, N-succinimidyl-S-acetyl-thioacetate (SATA), 5,5'-dithiobis (2-nitrobenzoic acid) (DTNB), o-phenylenediamleimide (oPDM), N -sucinimidyl-3- (2-pyridyldithio) propionate (SPDP), and sulfosucinimidyl 4- (N-maleimidomethyl) cyclohexane-1-carboxylate (sulfo-SMCC) (see, for example, Karpovsky et al. (1984) J Exp. Med. 160: 1686; Liu, MA et al. (1985) Proc. Natl. Acad. Sci. USA 82: 8648). Other methods include those described in Paulus (1985) Behring Ins. Mitt. No. 78, 118-132; Brennan et al. (1985) Science 229: 81-83), and Glennie et al. (1987) J. Immunol. 139: 2367-2375). Preferred conjugating agents are SATA and sulfo-SMCC, both available from Pierce Chemical Co. (Rockford, IL).
[00276] [00276] When the binding specificities are antibodies, they can be conjugated by means of sulfhydryl binding of the C-terminating hinge regions of the two heavy chains. In a particularly preferred embodiment, the hinge region is modified to contain an odd number of sulfhydryl residues, preferably one, prior to conjugation.
[00277] [00277] Alternatively, both binding specificities can be encoded in the same vector and expressed and assembled in the same host cell. This method is particularly useful where the bispecific molecule has a combination of binding specificities such as a fusion protein (mAb x mAb), (mAb x Fab), (Fab x F (ab ') 2) or (linker x Fab) . A bispecific molecule described herein can be a single chain molecule comprising a single chain antibody and a binding determinant, or a bispecific single chain molecule comprising two binding determinants. Bispecific molecules can comprise at least two single chain molecules. Methods for preparing bispecific molecules are described, for example, in U.S. Patent Number
[00278] [00278] Binding of bispecific molecules to their specific targets can be confirmed using methods recognized in the art, such as using ELISA, radioimmunoassay (RIA), FACS analysis, bioassay (eg, growth inhibition), or Western blot assay. Each of these assays generally detects the presence of protein-antibody complexes of particular interest employing a labeled reagent (for example, an antibody) specific to the complex of interest. IX. Compositions
[00279] [00279] Also provided are compositions, for example, pharmaceutical compositions, containing one or more anti-ICOS antibodies, or antigen binding fragment (s) thereof, as described herein, formulated together with a pharmaceutically acceptable carrier. Therefore, the compositions of the present invention include humanized or human anti-huICOS antibodies (or antigen-binding fragments) thereof having the CDR sequences, the light and / or heavy chain variable region sequences, or the light chain sequences and / or full-length heavy in Table
[00280] [00280] Such compositions also include one or a combination of (for example, two or more different) antibodies, or immunoconjugates or bispecific molecules described herein. For example, a pharmaceutical composition described herein can comprise a combination of antibodies (or immunoconjugates or bispecific antibodies) that bind to different epitopes on the target antigen or that have complementary activities.
[00281] [00281] Pharmaceutical compositions described here can also be administered as combination therapy, for example, anti-ICOS antibodies combined with other agents. For example, the combination therapy may include an anti-ICOS antibody described here combined with at least one other anti-cancer and / or T cell stimulant (e.g., activation) agent. Examples of therapeutic agents that can be used in combination therapy are described in more detail below in the section on uses of the antibodies described here.
[00282] [00282] In some embodiments, pharmaceutical compositions disclosed herein may include other compounds, drugs, and / or agents used for the treatment of cancer. Such compounds, drugs, and / or agents can include, for example, chemotherapeutic drugs, small molecule drugs or antibodies that stimulate the immune response to a given cancer. In some embodiments, a pharmaceutical composition comprises a first antibody specific for antihyperics and a second antibody.
[00283] [00283] In some embodiments, the first antibody and the second antibody are present in the composition in a fixed dose (for example, a fixed ratio). In other embodiments, this fixed dose is between at least about 1: 200 to at least about 200: 1, at least about 1: 150 to at least about 150: 1, at least about 1: 100 at least at least about 100: 1, at least about 1:75 to at least about 75: 1, at least about 1:50 to at least about 50: 1, at least about 1:25 to at least about from 25: 1, at least about 1:10 to at least about 10: 1, at least about 1: 5 to at least about 5: 1, at least about 1: 4 to at least about 4 : 1, at least about 1: 3 to at least about 3: 1, or at least about 1: 2 to at least about 2: 1 mg antihyperic antibody to mg second antibody. In some embodiments, the fixed dose is at least about 1: 1, about 1: 2, about 1: 3, about 1: 4, about 1: 5, about 1: 6, about 1: 7, about 1: 8, about 1: 9, about 1:10, about 1:15, about 1:20, about 1:30, about 1:40, about 1:50, about 1:60, about 1:70, about 1:80, about 1:90, about 1: 100, about 1: 120, about 1: 140, about 1: 160, about 1: 180, or about 1: 200 anti-huICOS antibody for second antibody. In some embodiments, the fixed dose is at least about 2: 1, about 3: 1, about 4: 1, about 5: 1, about 6: 1, about 7: 1, about 8: 1, about 9: 1, about 10: 1, about 15: 1, about 20: 1, about 30: 1, about 40: 1, about 40: 1, about 50: 1, about 60: 1, about 70: 1, about 80: 1, about 90: 1, about 100: 1, about 120: 1, about 140: 1, about 160: 1, about 160: 1, about 180: 1, or about 200: 1 mg of first antibody to mg of second antibody. For example, in one embodiment, the anti-huICOS antibody and the second antibody are administered as described in Example 18.
[00284] [00284] Additional antibodies include, for example, one or more of an anti-CTLA-4 antibody, an anti-PD-1 antibody, an anti-
[00285] [00285] As used herein, "pharmaceutically acceptable carrier" includes any and all solvents, dispersion medium, coatings, and antibacterial and antifungal agents, isotonic and absorption retarding agents, and the like that are physically compatible. In some embodiments, the vehicle is suitable for intravenous, intramuscular, subcutaneous, parenteral, spinal or epidermal administration (for example, by injection or infusion). In some embodiments, the vehicle is suitable for intravenous administration. In other embodiments, the vehicle is suitable for subcutaneous administration. In some embodiments, the composition comprising anti-ICOS antibody is released subcutaneously using Halozyme's ENHANZE® drug delivery technology, which includes a recombinant human hyaluronidase enzyme (rHuPH20) that temporarily degrades hyaluronan. In some embodiments, the ENHANZE® drug delivery technology allows subcutaneous administration of compositions that is faster when compared to intravenous administration. In other embodiments, depending on the route of administration, the active compound, for example, antibody, immunoconjugate, or bispecific molecule, can be coated in a material to protect the compound from the action of acids and other natural conditions that can inactivate the compound.
[00286] [00286] The pharmaceutical compounds described herein can include one or more pharmaceutically acceptable salts. A "pharmaceutically acceptable salt" refers to a salt that retains the desired biological activity of the parent compound and does not transmit any undesired toxicological effects (see, for example, Berge, S.M., et al.
[00287] [00287] A pharmaceutical composition described here can also include a pharmaceutically acceptable antioxidant. Examples of pharmaceutically acceptable antioxidants include: (1) water-soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisol (BHA), butylated hydroxytoluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like.
[00288] [00288] Examples of suitable aqueous and non-aqueous vehicles that can be used in the pharmaceutical compositions described here include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like), and suitable mixtures thereof, vegetable oils, such as olive oil, and injectable organic esters, such as ethyl oleate. Adequate fluidity can be maintained, for example, by using coating materials, such as lecithin, by maintaining the required particle size in the case of dispersions, and by using surfactants.
[00289] [00289] These compositions can also be adjuvants such as preservatives, wetting agents, emulsifying agents and dispersing agents. Prevention of the presence of microorganisms can be guaranteed by sterilization procedures, above, and by the inclusion of antibacterial and antifungal agents, for example, paraben, chlorobutanol, phenol sorbic acid, and the like. It may also be desirable to include isotonic agents, such as sugars, sodium chloride, and the like in the compositions. In addition, prolonged absorption of the injectable pharmaceutical form can be caused by the inclusion of agents that delay absorption such as aluminum monostearate and gelatin.
[00290] [00290] Pharmaceutically acceptable vehicles include sterile and post-sterile aqueous solutions or dispersions for the extemporaneous preparation of sterile injectable solutions or dispersions. Exemplary pharmaceutically acceptable vehicles here also include interstitial drug dispersing agents such as soluble neutral active hyaluronidase glycoproteins (sHASEGP), for example, human soluble PH-20 hyaluronidase glycoproteins, such as rHuPH20 (HYLENEX ™, Baxter International, Inc.) . Certain exemplary sHASEGPs and methods of use, including rHuPH20, are described in U.S. Patent Publication Nos. 2005/0260186 and 2006/0104968. In one aspect, a sHASEGP is combined with one or more additional glycosaminoglycanases such as chondroitinases.
[00291] [00291] The use of such means and agents for pharmaceutically active substances is known in the art. Except to the extent that any conventional medium or agent is compatible with the active compound, use of it in the pharmaceutical compositions described here is contemplated. Supplementary active compounds can also be incorporated into the compositions.
[00292] [00292] Therapeutic compositions must typically be sterile under the conditions of manufacture and storage. The composition can be formulated as a solution, microemulsion, liposome, or other ordered structure suitable for high drug concentration. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), and suitable mixtures thereof. Adequate fluidity can be maintained, for example, by using a coating such as lecithin, by maintaining the required particle size in the case of dispersion and by using surfactants. In many cases, it will be preferable to include isotonic agents, for example, sugars, polyalcohols such as mannitol, sorbitol, or sodium chloride in the composition. Prolonged absorption of the injectable compositions can be achieved by including in the composition an agent that delays absorption, for example, monostearate salts and gelatin.
[00293] [00293] Sterile injectable solutions can be prepared by incorporating the active compound in the required amount in an appropriate solvent with one or a combination of ingredients listed above, as required, followed by sterilization microfiltration. Generally, dispersions are prepared by incorporating the active compound in a sterile vehicle that contains a basic dispersion medium and the other required ingredients from those described above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum drying and freeze drying (lyophilization) which produce an active ingredient powder plus any desired additional ingredient from a previously filtered sterile solution of the same .
[00294] [00294] The amount of active ingredient that can be combined with a carrier material to produce a single dosage form will vary depending on the individual being treated, and the particular mode of administration. The amount of active ingredient that can be combined with a carrier material to produce a single dosage form will generally be that amount of the composition that produces a therapeutic effect. Out of one hundred percent, this amount can range from about 0.01 percent to about ninety-nine percent of the active ingredient, for example, from about 0.1 percent to about 70 percent, for example from about 1 percent to about 30 percent of the active ingredient in combination with a pharmaceutically acceptable carrier.
[00295] [00295] In some embodiments, the composition includes an anti-ICOS antibody, such as the ICOS.33 IgG1f antibody S267E, at a concentration of 10 mg / ml. The composition is a sterile, non-pyrogenic, isotonic, aqueous solution for single use, preservative-free for intravenous administration. The composition can be administered undiluted or also diluted with 0.9% sodium chloride injection to the required protein concentrations before infusion. In some embodiments, the anti-ICOS antibody includes the following excipients: L-histine, L-histidine hydrochloride monohydrate, sucrose, pentacetic acid (also known as diethylenetriaminapentaacetic acid, polysorbate 80, and water for injection.
[00296] [00296] Dosing regimens are adjusted to provide the optimal desired response (for example, a therapeutic response). For example, a single bolus may be administered, several divided doses may be administered over time, or the dose may be proportionally reduced or increased as indicated by the requirements of the therapeutic situation. It is especially advantageous to formulate parenteral compositions in unit dosage form to facilitate administration and uniformity of dosage. Unit dosage form as used herein refers to physically discrete units suitable as unit dosages for the individuals to be treated; each unit contains a predetermined amount of active compound calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier. The specifications for the unit dosage forms described here are dictated by and directly dependent on (a) the unique characteristics of the active compound and the particular therapeutic effect to be achieved, and (b) the limitations inherent in the technique of composing such an active compound for the treatment of sensitivity in individuals.
[00297] [00297] For administration of the antibody, the dosage can vary from about 0.0001 to 100 mg / kg, and more usually 0.01 to 5 mg / kg, of the host's body weight. For example, dosages can be 0.3 mg / kg body weight, 1 mg / kg body weight, 3 mg / kg body weight, 5 mg / kg body weight or 10 mg / kg body weight or within range from 1 to 10 mg / kg. Alternatively, administration of the antibody is a fixed dose that can vary from 2 mg to 800 mg, for example, a dose of 25 mg, 80 mg, 200 mg, or 400 mg. An exemplary treatment regimen involves administration once a week, once every two weeks, once every three weeks, once every four weeks, once a month, once every two months, once every three weeks months, once every four months, once every five months, or once every six months. In some embodiments, the treatment regimen includes an initial dose, and then the maintenance dose for a different dose amount in an intermittent dose range.
[00298] [00298] In some embodiments, two or more monoclonal antibodies with different binding specificities are administered simultaneously, in which case the dosage of each antibody administered falls within the indicated range. In some embodiments, the therapeutic antibody is administered on multiple occasions. Intervals between single dosages can be, for example, weekly, once every three weeks, once every four weeks, monthly, every three months or annually. Intervals can also be irregular as indicated by blood levels of antibody measurement to the target antigen in the patient. In some embodiments, dosage is adjusted to achieve a plasma antibody concentration of about 1 to 1000 µg / ml and in some methods about 25 to 300 µg / ml.
[00299] [00299] In some embodiments, the antibody can be administered as a sustained release formulation. Administration via sustained release formulations may require less frequent administration. Dosage and frequency vary depending on the half-life of the antibody in the patient. Dosage and frequency of administration may vary depending on whether the treatment is prophylactic or therapeutic. In prophylactic applications, a relatively low dosage is administered at relatively infrequent intervals over a long period of time. Some patients continue to receive treatment for the rest of their lives. In some embodiments, a relatively high dosage at relatively short intervals is administered for therapeutic treatment. In some embodiments, a relatively high dosage is administered until the progression of the disease is reduced or stopped, for example, until the patient shows partial or complete improvement in symptoms of the disease. In some modalities, prophylactic treatment is administered to the patient after therapeutic treatment.
[00300] [00300] Current dosage levels of the active ingredients in the pharmaceutical compositions described herein can be varied in order to obtain an amount of the active ingredient that is effective in achieving the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic to the patient. The dosage level selected will depend on a variety of pharmacokinetic factors including the activity of the particular compositions described herein employed, or the ester, salt or amide thereof, the route of administration, the time of administration, the rate of excretion of the particular compound being used, the duration of treatment, other drugs, compounds and / or materials used in combination with the particular compositions employed, the age, sex, weight, condition, general health and previous medical history of the patient being treated, and well-known similar factors in medical techniques.
[00301] [00301] A "therapeutically effective dosage" of an anti-ICOS antibody described here preferably results in a decrease in the severity of disease symptoms, an increase in the frequency and duration of disease-free periods, or a prevention of deficiency or disability due to the affliction of the disease. In the context of cancer, a therapeutically effective dose preferably also prevents deterioration of physical symptoms associated with cancer. Cancer symptoms are well known in the art and include, for example, unusual mole aspects, a change in the appearance of a mole, including asymmetry, boundaries, color and / or diameter, a newly pigmented skin area, an abnormal mole , darkened area under the nail, breast lumps, nipple changes, breast cysts, chest pain, death, weight loss, strength, excessive fatigue, difficulty eating, loss of appetite, chronic cough, worsening shortness of breath, cough with blood, blood in the urine, blood in the stool, nausea, vomiting, liver metastases, lung metastases, bone metastases, abdominal fullness, swelling, peritoneal cavity fluid, vaginal bleeding, constipation, abdominal distention, colon perforation, acute peritonitis (infection, fever, pain), pain, bloody vomiting, heavy sweating, fever, high blood pressure, anemia, diarrhea, jaundice, dizziness, chills, muscle spasms, colon metastases, lung metastases, bladder metastases, liver metastases, bone metastases, kidney metastases, and pancreatic metastases, difficulty in swallowing, and the like. Therapeutic efficacy can be observed immediately after the first administration of an agonistic anti-huICOS monoclonal antibody of the present invention, or it can be observed only after a period of time and / or a series of doses. Such delayed efficacy can only be observed after many months of treatment, for example, up to 6, 9 or 12 months.
[00302] [00302] A therapeutically effective dose can prevent or delay the onset of cancer, as may be desired when early or preliminary signs of the disease are present. Therefore, any clinical or biochemical assay that monitors any of the above can be used to determine whether a particular treatment is a therapeutically effective dose for treating cancer. One skilled in the art should be able to determine such quantities based on such factors as the size of the individual, the severity of the individual's symptoms, and the particular composition or route of administration selected.
[00303] [00303] A composition described herein can be administered via one or more routes of administration using one or more varieties of methods known in the art. As will be appreciated by the skilled technician, the route and / or method of administration will vary depending on the desired results. Exemplary routes of administration for antibodies described herein include intravenous, intramuscular, intradermal, intraperitoneal, subcutaneous, spinal or other parenteral routes of administration, for example, by injection or infusion.
[00304] Alternatively, an antibody described herein can be administered via a non-parenteral route such as topical, epidermal or mucosal route, for example,
[00305] [00305] The active compounds can be prepared with vehicles that will protect the compound against rapid release, such as a controlled release formulation, including implants, transdermal patches, and microencapsulated delivery systems. Biocompatible, biodegradable polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyesters, and polylactic acid. Many methods for preparing such formulations are patented or generally known to one skilled in the art. See, for example, Sustained and Controlled Release Drug Delivery Systems, J.R. Robinson, ed., Marcel Dekker, Inc., New York,
[00306] [00306] Therapeutic compositions can be administered with medical devices known in the art. For example, in a preferred embodiment, a therapeutic composition described herein can be administered with a needle-free hypodermic injection device, such as the devices disclosed in U.S. Patent Nos.
[00307] [00307] In certain embodiments, the anti-water antibodies described here can be formulated to ensure adequate distribution in vivo. For example, the blood-brain barrier (BBB) excludes many highly hydrophilic compounds. To ensure that the therapeutic compounds described here cross the BBB (if desired), they can be formulated, for example, in liposomes. For methods of making liposomes, see, for example, U.S. Patents 4,522,811;
[00308] [00308] Also within the scope described here are kits comprising the antibody compositions described here (for example, human antibodies, bispecific or multispecific molecules, or immunoconjugates) and instructions for use. The kit can also contain at least one additional reagent, or one or more additional human antibodies described here. Kits may include a label indicating the intended use of the kit's contents. The term label includes any written or recorded material provided with or with the kit or that otherwise accompanies the kit. X. Methods of Use
[00309] [00309] The antibodies, antibody compositions and methods described here have numerous uses in vitro and in vivo involving, for example, increased immune response by stimulating ICOS signaling. In one embodiment, the antibodies described here are human or humanized monoclonal antibodies. In one embodiment, anti-huICOS antibodies described herein (for example, ICOS.33, 17C4, 9D5, 3E8, 1D7, and 2644 IgG1f S267E) can be administered to cultured cells, in vitro or ex vivo, or to individuals to increase immunity in a variety of diseases. In a particular embodiment, agonistic antibodies to anti-huICOS antibodies, i.e., anti-huICOS agonists. Provided here are methods of modifying an immune response in an individual comprising administering to the individual an antibody, or an antigen-binding fragment thereof, described herein so that the immune response in the individual is enhanced, stimulated or regulated. In one embodiment, administration of an anti-huICOS antibody (for example, the agonist anti-huICOS antibody) according to the methods described here increases co-stimulation of T cell responses. In one embodiment, administration of the anti-huICOS antibody according to the methods described here stimulate, increase or regulate antigen-specific T cell responses to a tumor. A tumor can be a solid tumor or a liquid tumor, for example, a hematological malignancy. In certain embodiments, a tumor is an immunogenic tumor. In certain embodiments, a tumor is non-immunogenic. In certain embodiments, a tumor is PD-L1 positive. In certain embodiments, a tumor is PD-L1 negative. An individual can also be a virus-carrying individual and an immune response against the virus is increased. In one embodiment, administration of the anti-huICOS antibody according to the methods described here stimulates, increases or regulates CD4 + and CD8 + T cell responses. T cells can be Teff cells, for example, Teff CD4 + cells, Teff CD8 + cells, T helper (Th) cells and cytotoxic T cells (Tc).
[00310] [00310] In one embodiment, the methods result in an increase in an immune response in a human being where such an increase has a desirable effect. In one embodiment, the human being is a human patient having a disorder that can be treated by increasing an immune response, for example, the T cell-mediated immune response. In a particular embodiment, the human patient has cancer. In one embodiment, anti-huICOS antibodies described here can be administered together with an antigen of interest or the antigen may already be present in the individual being treated, for example, an individual carrying a tumor or carrying a virus. When antibodies to ICOS are administered together with another agent, the two can be administered separately or simultaneously.
[00311] [00311] Also provided are methods for inhibiting growth of a tumor cell in an individual comprising administering to the individual an anti-huICOS antibody described herein such that tumor cell growth is inhibited in the individual. Also provided are methods of treating chronic viral infection in an individual comprising administering to the individual an anti-huICOS antibody described herein so that chronic viral infection is treated in the individual.
[00312] [00312] In some embodiments, an agonist anti-huICOS antibody is administered to an individual, for example, a human patient, as an auxiliary therapy, adjuvant therapy, or neo-therapy
[00313] [00313] These and other methods described here are described in more detail below. Cancer
[00314] [00314] Provided here are methods for treating an individual having cancer, comprising administering to the individual an anti-huICOS antibody described herein, so that the individual is treated, for example, so that the growth of cancerous tumors is inhibited or reduced and / or that the tumor returns. An anti-huICOS antibody can be used alone to inhibit the growth of cancerous tumors. Alternatively, an anti-huICOS antibody can be used in conjunction with another agent, for example, other immunogens, standard cancer treatments, or other antibodies, as described below. Combination with a PD-1 inhibitor, such as an anti-PD-1 antibody or an anti-PD-L1, is also provided. Combination with a CTLA-4 inhibitor, such as an anti-CTLA-4 antibody, is also provided. Combination with a PD-1 inhibitor and a CTLA-4 inhibitor is also provided.
[00315] [00315] In one aspect, provided herein are methods of treating cancer in an individual, comprising administering to the individual a therapeutically effective amount of an anti-huICOS antibody described herein, for example, a humanized form of an anti-ICOS antibody of hamster or antigen-binding fragment thereof. In one embodiment, the anti-human antibodies can be a chimeric antibody, a human antibody, or a humanized anti-human antibodies, for example, any of the humanized anti-human antibodies described herein. In one embodiment, the methods of treating a cancer described herein comprise administration of a humanized anti-huICOS antibody that contacts human ICOS in one or more amino acid residues of SEQ ID NO: 203 of human ICOS protein. In another embodiment, the method comprises administering IC26.3 IgG1f antibody S267E. In another embodiment, the method comprises administering a composition comprising IC26.3 IgG1f antibody S267E.
[00316] [00316] Examples of cancer include, but are not limited to, squamous cell carcinoma, small cell lung cancer (SCLC), non-small cell lung cancer, non-small squamous cell cancer (NSCLC), no NSCLC, glioma, gastrointestinal cancer, kidney cancer (e.g., clear cell carcinoma), ovarian cancer, liver cancer, colorectal cancer, endometrial cancer, kidney cancer (e.g., renal cell carcinoma), prostate cancer ( for example, hormone-refractory prostate adenocarcinoma), thyroid cancer, neuroblastoma, pancreatic cancer, glioblastoma (glioblastoma multiforme), cervical cancer, stomach cancer, bladder cancer, hepatoma, breast cancer, colon carcinoma, and cancer of head and neck (or carcinoma), gastric cancer, germ cell tumor, pediatric sarcoma, natural sinonasal exterminator, melanoma (eg, metastatic malignant melanoma, such as cutaneous or intraocular malignant melanoma), cancer bone er, skin cancer, uterine cancer, cancer of the anal region, testicular cancer, fallopian tube carcinoma, endometrial carcinoma, cervix carcinoma, vagina carcinoma, vulva carcinoma, esophageal cancer, small bowel cancer, cancer of the endocrine system, cancer of the parathyroid gland, cancer of the adrenal gland, soft tissue sarcoma, cancer of the urethra, cancer of the penis, solid childhood tumors, cancer of the ureter, carcinoma of the renal pelvis, neoplasm of the central nervous system (CNS) , primary CNS lymphoma, tumor angiogenesis, spinal axis tumor, brain cancer including brain stem glioma, pituitary adenoma, Kaposi's sarcoma, epidermoid cancer, squamous cell cancer, T cell lymphoma, environmentally induced cancers including those induced asbestos, cancer-related cancers (for example, tumor related to human papilloma virus (HPV)), and hematological malignancies derived from or from both healthy cell lines major nguineas, for example, the myeloid cell line (which produces granulocytes, erythrocytes, thrombocytes, macrophages, and mast cells) or lymphoid cell line (which produces B, T, NK, and plasma cells), as do all types of leukemia, lymphomas , and myelomas, for example, acute, chronic, lymphocytic and / or myelogenous leukemias, such as acute leukemia (ALL), acute myelogenous leukemia (AML), chronic lymphocytic leukemia (CLL), and chronic myelogenous leukemia (CML), undifferentiated AML (M0), myeloblastic leukemia (M1), myeloblastic leukemia (M2; with cell maturation), promyelocytic leukemia (M3 or M3 variant [M3V]), myelomonocytic leukemia (M4 or M4 variant with eosinophilia [M4E]), monocytic leukemia (M5), erythroleukemia (M6), megakaryoblastic leukemia (M7), isolated granulocytic sarcoma, and chloroma; lymphomas, such as Hodgkin's lymphoma (HL), non-Hodgkin's lymphoma (NHL), B-cell lymphomas, T-cell lymphomas, lymphoplasmacytoid lymphoma, monocytoid B-cell lymphoma, mucosal lymphoid tissue lymphoma (MALT), lymphoma large anaplastic cell (for example, Ki 1+), adult T cell lymphoma / leukemia, mantle cell lymphoma, immunoblastic angio T cell lymphoma, angiocentric lymphoma, intestinal T cell lymphoma, primary mediastinal B cell lymphoma, precursor T lymphoblastic lymphoma, lymphoblastic T; and lymphoma / leukemia (T-Lbly / T-ALL), peripheral T-cell lymphoma, lymphoblastic lymphoma, post-transplant lymphoprophylative disorder, true histiocystic lymphoma, primary central nervous system lymphoma, primary effusion lymphoma, lymphoblastic lymphoma (LBL) , hematopoietic tumors of lymphoid lineage, acute lymphoblastic leukemia, diffuse large B cell lymphoma, Burkitt lymphoma, follicular lymphoma, diffuse histiocytic lymphoma (DHL), immunoblastic large cell lymphoma, precursor B lymphoblastic lymphoma, cutaneous T cell lymphoma (CTLC ) (also called mycosis fungoides syndrome or Sezary), and lymphoplasmacytoid lymphoma (LPL) with Waldenstrom's macroglobulinemia; myelomas, such as IgG myeloma, light chain myeloma, non-secretory myeloma, latent myeloma (also called indolent myeloma), solitary plasmacytoma, and multiple myelomas, chronic lymphocytic leukemia (CLL), hair cell lymphoma; hematopoietic tumors of myeloid lineage, tumors of mesenchymal origin, including fibrosarcoma and rhabdomyosarcoma; seminoma, teratocarcinoma, tumors of the central and peripheral nerves, including astrocytoma, schwannomas; tumors of mesenchymal origin, including fibrosarcoma, rhabdomyosarcoma, and osteosarcoma; and other tumors, including melanoma, xeroderma pigmentosum, keratoacanthoma, seminoma, follicular cancer of the thyroid and teratocarcinoma, hematopoietic tumors of lymphoid lineage, for example T and B cell tumors, including, but not limited to, T cell disorders such as prolymphocytic leukemia T (T-PLL), including small cell and cerebriform cell type; large granular lymphocyte leukemia (LGL) preferably of the T cell type; a / d hepatosplenic T-NHL lymphoma;
[00317] [00317] In one embodiment, the anti-huICOS antibody can be administered as a monotherapy. In one embodiment, the agonist anti-huICOS antibody is administered as the sole stimulating agent. In one embodiment, the anti-human ICOS agonist antibody is administered to a patient with another agent. In one embodiment, an anti-huICOS antibody is administered with an immunogenic agent. In one embodiment, the anti-human ICOS agonist antibody is administered in conjunction with a cancer vaccine. In some embodiments, the cancer vaccine comprises cancer cells, purified tumor antigens (including recombinant proteins, peptides, and carbohydrate molecules), cells, and cells transfected with genes encoding immune stimulating cytokines (He et al. (2004) J Immunol 173: 4919-28). In some embodiments, the cancer vaccine is a peptide cancer vaccine, which in some embodiments is a personalized peptide vaccine. In some embodiments, the peptide cancer vaccine is a long multivalent peptide, a multipeptide, a peptide cocktail, a hybrid peptide, or a peptide-pulsed dendritic cell vaccine (see, for example, Yamada et al., Cancer Sci, 104: 14-21, 2013). In some embodiments, an anti-human ICOS agonist antibody can be administered in conjunction with an adjuvant. Non-limiting examples of tumor vaccines that can be used include peptides from melanoma antigens, such as gp100 peptides, MAGE, Trp-2, MART1 and / or tyrosinase antigens, or tumor cells transfected to express the GM-CSF cytokine. Many experimental strategies for tumor vaccination have been devised (see, Rosenberg, S., 2000, Development of Cancer Vaccines, ASCO Educational Book Spring: 60-62; Logothetis, C., 2000, ASCO Educational Book Spring: 300-302; Khayat, D. 2000, ASCO Educational Book Spring: 414-428; Foon, K. 2000, ASCO Educational Book Spring: 730-738; see also Restifo, N. and Sznol, M., Cancer Vaccines, Ch. 61, pp. 3023-3043 in DeVita et al. (Eds.), 1997, Cancer: Principles and Practice of Oncology, Fifth Edition). In one of these strategies, a vaccine is prepared using autologous or allogeneic tumor cells. These cellular vaccines have been shown to be effective when tumor cells are transfected to express GM-CSF. GM-CSF has been shown to be a potent antigen presentation activator for tumor vaccination. Dranoff et al. (1993) Proc. Natl. Acad. Sci. U.S.A. 90: 3539-43.
[00318] [00318] Other cancer vaccines may include the viral proteins implicated in human cancers such as a Human Papilloma Virus (HPV), Hepatitis Virus (HBV and HCV) and Kaposi's Herpes Sarcoma Virus (KHSV). Another form of tumor specific antigen that can be used in conjunction with ICOS inhibition is purified heat shock proteins (HSP) isolated from the tumor tissue itself. These heat shock proteins contain protein fragments from tumor cells and these HSPs are highly efficient in releasing cells presenting antigen to provoke tumor immunity (Suot & Srivastava (1995) Science 269: 1585-1588; Tamura et al. (1997 ) Science 278: 117-120).
[00319] [00319] Dendritic cells are potent cells presenting antigen that can be used to generate specific antigen responses. Dendritic cells can be produced ex vivo and loaded with various proteins and peptide antigens as well as tumor cell extracts (Nestle et al. (1998) Nature Medicine 4: 328-332). Dendritic cells can also be transduced by genetic means to express those tumor antigens as well. DCs have also been fused directly to tumor cells for immunization purposes (Kugler et al. (2000) Nature Medicine 6: 332- 336). As a method of vaccination, dendritic cell immunization can effectively be combined with ICOS agonism to activate (trigger) more potent antitumor responses.
[00320] [00320] In some embodiments, an anti-human ICOS agonist antibody is administered in conjunction with a standard of care, for example, surgery, radiation and / or chemotherapy. In some embodiments, an anti-ICOS antibody can be administered in conjunction with a chemotherapeutic agent. In some embodiments, the anti-ICOS antibody is administered in conjunction with one or more of carboplatin, cisplatin, paclitaxel, nab-paclitaxel, gemcitabine or FOLFOX. In some embodiments, an anti-human agonist antibody can be administered in conjunction with carboplatin or nab-paclitaxel. In some embodiments, an anti-human ICOS agonist antibody can be administered in conjunction with carboplatin and paclitaxel. In some embodiments, an anti-human ICOS agonist antibody can be administered in conjunction with cisplatin and pemetrexed. In some embodiments, an anti-human ICOS agonist antibody may be administered in conjunction with cisplatin and gemcitabine. In some embodiments, an anti-human ICOS agonist antibody can be administered in conjunction with FOLFOX. In some embodiments, an anti-human ICOS agonist antibody can be administered in conjunction with FOLFIRI. In one embodiment, an anti-huICOS antibody is administered in combination with decarbazine for the treatment of melanoma. In some embodiments, cisplatin is administered intravenously as a dose of 100 mg / ml once every four weeks. In some embodiments, an anti-human ICOS agonist antibody may be administered in conjunction with doxorubicin (adriamycin), cisplatin bleomycin sulfate, carmustine, chlorambucil, dacarbazine and / or cyclophosphamide hydroxyurea. In some embodiments, adriamycin is administered intravenously as a dose of 60 mg / ml to 75 mg / ml once every 21 days. In one embodiment, the anti-huICOS antibody is administered to a human patient that is resistant to treatment with at least one drug, wherein administration of the anti-huICOS antibody reduces, relieves, or cancels resistance to at least one drug.
[00321] [00321] The combination therapies noted above encompass combined administration (where two or more therapeutic agents are included in the same or in separate formulations), and separate administration, in which case, administration of the antibody of the invention can occur before, simultaneously, and / or after, administration of the additional therapeutic agent and / or adjuvant. Antibodies of the invention can also be used in combination with radiation therapy.
[00322] [00322] Another example of such a combination is an anti-huICOS antibody in combination with interleukin-2 (IL-2). In some embodiments, the combination of anti-huICOS and IL-2 antibodies is to treat various cancers, including for the treatment of renal cell carcinoma and melanoma. In some embodiments, the anti-huICOS antibodies described here are combined with an IL-2 pathway agonist to treat various cancers. The combination includes several IL-2 pathway agonists, such as those described in WO 2012/065086 (Nektar Therapeutics) and WO 2015/125159 (Nektar Therapeutics), the contents of which are incorporated by reference in their entirety. WO
[00323] [00323] In some embodiments, the combination of an anti-huICOS antibody as described here, such as ICOS.33 IgG1 S267E, and an IL-2 pathway agonist, such as NKTR-214, is administered to patients to treat cancer . As described in more detail below, NKTR-214 is produced by combining an average of about six polyethylene glycol (PEG) reagents based on FMOC (fluorenylmethyloxycarbonyl chloride) having the following structure derived from (mPEG2-C2-fomc-20K- N-Hydroxysucinimidate, 20 kDa, ("mPEG2-C2-fmoc-20K-NHS"): to a protein having the following Amino Acid Sequence 132:
[00324] [00324] PTSSSTKKTQLQLEHLLLDLQMILNGINNYKNPKLTRMLTF KFYMPKKATELKHLQCLEE 60
[00325] [00325] ELKPLEEVLNLAQSKNFHLRPRDLISNINVIVLELKGSETTFMC EYADETATIVEFLNRW 120
[00326] [00326] ITFSQSIISTLT 132 (SEQ ID NO: 219)
[00327] [00327] WO 2012/065086 provides conjugates of a portion of IL-2 and one or more water-soluble non-peptide polymers, including polyethylene glycol or a derivative thereof. Specifically, example 2 (paragraphs 202-204) of WO 2012/065086 describes PILylation of rIL-2 with mPEG2-C2-fmoc-20K-NHS to result in the structure of mPEG2-C2-fmoc-20K-NHS provided above. Example 1 (paragraphs 63-66) WO 2015/125159 describes an expanded approach to PEGylation of IL-2 with mPEG2-C2-fmoc-20K-NHS that results in RSLAIL-2 (NKTR-214). NKTR-214 is a cytokine that is designed to target CD122, (also known as interleukin-2 receptor beta subunit, IL-2Rβ), a protein found in certain immune cells (for example, CD8 + T cells and NK cells ), to expand these cells to promote their anti-tumor effects.
[00328] [00328] In some embodiments, an anti-huICOS antibody can be administered in combination with an anti-angiogenic agent.
[00329] [00329] Other combination therapies that can result in synergy with ICOS agonism through cell death are radiation, surgery, and hormone deprivation.
[00330] [00330] In some embodiments, anti-water antibodies described here can be administered in conjunction with bispecific antibodies. Bispecific antibodies can be used to target two separate antigens. In one embodiment, anti-huICOS antibodies are used in combination with bispecific antibodies that target effector cells expressing Fcα or Fcγ receptor for tumor cells (see, for example, U.S. Patent Nos. 5,922,845 and 5,837,243). For example, bispecific anti-Fc receptor / antitumor antigen antibodies (for example, Her-2 / neu) were used to target macrophages at the tumor site. In one embodiment, the T cell arm of these responses is augmented by ICOS agonism with an anti-huICOS antibody. Alternatively, antigen can be released directly to DCs by using bispecific antibodies that bind to tumor antigen and a dendritic cell-specific cell surface marker. In some embodiments, anti-huICOS antibodies are used in combination with antibodies that reduce or inactivate the immunosuppressive proteins expressed by a tumor, for example,
[00331] [00331] In another aspect, the invention described here provides a method of treating an infectious disease in an individual comprising administering to the individual an anti-huICOS antibody, or antigen-binding fragment thereof, so that the individual is treated for infectious disease.
[00332] [00332] Similar to its application in tumors as described above, antibody-mediated ICOS agonism can be used alone, or as an adjuvant, in combination with vaccines, to improve immune response to pathogens, toxins and autoantigens. Examples of pathogens for which this therapeutic method can be particularly useful include pathogens for which there is currently no effective vaccine, or pathogens for which conventional vaccines are less than completely effective. These include, but are not limited to HIV, Hepatitis (A, B, & C), Influenza, Herpes, Giardia, Malaria, Leishmania, Staphylococcus aureus, Pseudomonas aeruginosa. ICOS agonism is particularly useful against infections established by agents such as human immunodeficiency virus (HIV) that presents altered antigens during the course of infections. These new epitopes are recognized as foreign at the time of administration of anti-human ICOS antibody, thus eliciting a strong T cell response.
[00333] [00333] Some examples of pathogenic viruses that cause infections treatable by the methods described here include HIV, hepatitis (A, B, or C), herpes virus (for example, VZV, HSV-1, HAV-6, HSV-II, and CMV, Epstein Barr virus), adenovirus, influenza virus, flavivirus, ecovirus, rhinovirus, coxsackie virus, coronavirus, respiratory syncytial virus, mumps virus, rotavirus, measles virus, rubella virus, parvovirus, vaccinia virus, HTLV virus , dengue virus, papillomavirus, molluscum virus, poliovirus, rabies virus, JC virus and arboviral encephalitis virus.
[00334] [00334] Some examples of pathogenic bacteria that cause infections treatable by the methods described here include chlamydia, rickettsial bacteria, mycobacteria, staphylococcus, streptococcus, pneumonococcus, meningococcus and gonococcus, klebsiella, proteus, serratia, pseudomonas, legionella, diphtheria, salmonella, bacillus cholera, tetanus, botulism, anthrax, plague, leptospirosis, and Lyme disease bacteria.
[00335] [00335] Some examples of pathogenic fungi that cause infections treatable by the methods described here include Candida (albicans, krusei, glabrata, tropicalis, etc.), Cryptococcus neoformans, Aspergillus (fumigatus, niger, etc.), Genus Mucorales (mucor, absidia , rhizopus), Sporothrix schenkii, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Coccidioides immitis and Histoplasma capsulatum.
[00336] [00336] Some examples of pathogenic parasites that cause infections treatable by methods described here include Entamoeba histolytica, Balantidium coli, Naegleriafowleri, Acanthamoeba sp., Giardia lambia, Cryptosporidium sp., Pneumocystis carinii, Plasmodium vivax, Babesia microti, Trypanosi bri, , Leishmania donovani, Toxoplasma gondii, Nippostrongylus brasiliensis.
[00337] [00337] The methods described here for administering anti-huICOS antibodies to an individual can be combined with other forms of immunotherapy such as cytokine treatment (for example, interferons, GM-CSF, G-CSF, IL-2), or bispecific antibody therapy. Combination Therapy
[00338] [00338] In one aspect, provided here are methods of combination therapy, for example, for the treatment of cancer, in which an anti-huICOS antibody (for example, an agonist anti-huICOS antibody) is administered in conjunction with one or more additional agents, for example, antibodies, which are effective in stimulating immune responses to thereby increase, stimulate or regulate immune responses in an individual. Provided here are methods for treating or delaying cancer progression in an individual comprising administering to the individual an anti-huICOS antibody (e.g., ICOS.33, 17C4, 9D5, 3E8, 1D7, w 2644 IgG1f antibody) together with another anticancer agent or cancer therapy. In some embodiments, an anti-huICOS antibody may be administered in conjunction with a chemotherapy or chemotherapeutic agent or with radiation therapy or radiotherapeutic agent, as described above. In some embodiments, an anti-huICOS antibody may be administered together. In some embodiments, an anti-huICOS antibody may be administered in conjunction with a targeted therapy or targeted therapeutic agent. In some embodiments, an anti-huICOS antibody may be administered in conjunction with an immunotherapy or immunotherapeutic agent, for example, a monoclonal antibody.
[00339] [00339] In some embodiments, an anti-huICOS antibody described here can be combined with (i) an agonist of another co-stimulatory receptor and / or (ii) an inhibitor of an inhibitory signal in T cells. In some embodiments, an combination therapy comprising an anti-huICOS antibody and the agonist and / or antagonist results in an increased antigen-specific T cell response in an individual. In some embodiments, anti-ICOS antibodies described here can be administered in conjunction with an agent that targets co-stimulatory and co-inhibitory molecules that are members of the immunoglobulin superfamily (IgSF) to enhance an immune response. In some embodiments, anti-ICOS antibodies (for example, IC26.3 IgG1f S267E from ICOS.33, 17C4, 9D5, 3E8, 1D7, and
[00340] [00340] In another aspect, anti-huICOS antibodies can be used in combination with cytokine antagonists that inhibit T cell activation (for example, IL-6, IL-10, TGF-ß, VEGF; or other "immunosuppressive cytokines, "or cytokines that stimulate T cell activation, to stimulate an immune response, for example, to treat proliferative diseases, such as cancer.
[00341] [00341] In one aspect, T cell responses are stimulated by a combination of an anti-huICOS antibody described here and one or more of (i) a protein antagonist that inhibits T cell activation (e.g., point inhibitors immunoassay) such as CTLA-4, PD-1, PD-L1, PD-L2, LAG-3, TIM-3, Galectin 9, CEACAM-1, BTLA, CD69, Galectin-1, TIGIT, CD113, GPR56 , VISTA, 2B4, CD48, GARP, PD1H, LAIR1, TIM-1, and TIM-4, and (ii) a protein agonist that stimulates T cell activation such as B7-1, B7-2, CD28, 4 -1BB (CD137), 4-1BBL, CD40, ICOS-L, OX40, OX40L, GITR, GITRL, CD70, CD27, DR3 and CD28H.
[00342] [00342] Exemplary agents that modulate one of the above proteins and can be combined with agonist anti-huICOS antibodies, for example, those described here, for cancer treatment, include: YERVOY® / ipilimumab or tremelimumab (for CTLA-4), galiximab (for B7.1), BMS-936558 (for PD-1), pidilizumab / CT-011 (for PD-1), KEYTRUDA® / pembrolizumab / MK-3475 (for PD-1), AMP224 (for B7-DC / PD-L2), BMS-936559 (for B7-H1), MPDL3280A (for B7-H1), CP-870893 or dacetuzumab / SGN-40 (CD40 - Kirkwood et al. (2012) CA Cancer J. Clin. 62 : 309; Vanderheide & Glennie (2013) Clin. Cancer Res. 19: 1035), AMG557 (for B7H2), MGA271 (for B7H3 - WO 11/109400), IMP321 (for LAG-3), urelumab / BMS-663513 and PF- 05082566 (for CD137 / 4-1BB), varlilumab / CDX-1127 (for CD27), MEDI-6383 and MEDI-6469 (for OX40), RG-7888 (for OX40L - WO 06/029879), Atacicept (for TACI), muromonabe-CD3 (for CD3), ipilumumab (for CTLA-4). Therefore, in one embodiment an anti-huICOS antibody (such as IC26.3 IgG1f S267E) is combined with an anti-PD-1 antibody (such as nivolumab) and / or an anti-CTLA-4 antibody (such as ipilimumab ).
[00343] [00343] Other molecules that can be combined with anti-huICOS antibodies agonists for the treatment of cancer include inhibitory receptor antagonists in NK cells or activation receptor agonists in NK cells. For example, agonist anti-huICOS antibodies can be combined with KIR antagonists (for example, lirilumab).
[00344] [00344] Still other agents for combination therapies include agents that inhibit or deplete macrophages or monocytes, including, but not limited to, CSF-1R antagonists such as CSF-1R antagonist antibodies including RG7155 (WO 11/70024, WO 11 / 107553, WO 11/131407, WO 13/87699, WO 13/119716, WO 13/132044) or FPA-008 (WO 11/140249; WO 13/169264; WO 14/036357).
[00345] [00345] In some embodiments, agonistic anti-huICOS antibodies described here are used with one or more agonistic agents that bind to positive co-stimulatory receptors, blocking agents that attenuate signaling through inhibitory receptors, and one or more agents that systematically increase the frequency of antitumor T cells, agents that result in immune suppressive pathways within the tumor microenvironment (for example, inhibitory receptor involvement block (for example, PD-L1 / PD-1 interactions), deplete or inhibit (for example, using a monoclonal anti-CD25 antibody (eg, daclizumab) or by depletion of anti-CD25 beads ex vivo), inhibit metabolic enzymes such as IDO, or reverse / prevent T cell anergy or exhaustion) and agent that trigger innate immune activation and / or inflammation at the tumor site.
[00346] [00346] Provided here are methods for stimulating an immune response in an individual comprising administration to an individual of an ICOS agonist, for example, an antibody, and one or more additional immunostimulatory antibodies, such as a PD-1 antagonist. , for example, antagonist antibodies, a PD-L1 antagonist, for example, antagonist antibody, a CTLA-4 antagonist, for example, antagonist antibody and / or an LAG3 antagonist, for example, an antagonist antibody, so that an immune response is stimulated in the individual, for example, to inhibit tumor growth, or to stimulate an antiviral response. In one embodiment, the individual is administered an agonist anti-huICOS antibody and an antagonist anti-PD-1 antibody. In one embodiment, the individual is administered an agonist anti-huICOS antibody and an antagonist anti-PD-L1 antibody. In one embodiment, the individual is administered an agonist anti-huICOS antibody and an antagonist anti-CTLA-4 antibody. In one embodiment, at least one additional immunostimulatory antibody (for example, an antagonist anti-PD-1 antibody, an antagonist anti-PD-L1, an anti-CTLA-4 antagonist and / or an antagonist anti-LAG3) is a human antibody . Alternatively, at least one additional immunostimulatory antibody can be, for example, a chimeric or humanized antibody (for example, prepared from an anti-PD-1, anti-PD-L1, anti-CTLA-4 and / or anti-LAG3 antibody mouse or hamster).
[00347] [00347] Provided here are methods for treating a hyperproliferative disease (e.g., cancer), which comprises administering an agonist anti-huICOS antibody and an antagonist PD-1 antibody to an individual. In some modalities the cancer is non-small cell lung cancer (NSCLC) or colorectal cancer (CRC). In some modalities, cancer is characterized by tumors with (i) high expression of CD32A / CD32B (FcγRIIa / Fcγ), and / or (ii-a) high expression of ICOS or (ii-b) reduced expression of ICOS-L, for example, as detected by flow cytometry or immunohistochemistry (IHC). Tumor types with moderate to high ICOS RNA expression include head and neck, lung, cervical, renal, pancreatic, breast and colorectal cancers, suggesting that these cancers may also exhibit high ICOS protein expression. In certain embodiments, the agonist is administered in a subtherapeutic dose, the anti-PD-1 antibody is administered in a subtherapeutic dose, or both are administered in a subtherapeutic dose. Also provided here are methods for altering an adverse event associated with treating a hyperproliferative disease with an immunostimulatory agent. In one embodiment, the method comprises administering an agonist anti-huICOS antibody and a sub-therapeutic dose of anti-PD-1 antibody to an individual. In some modalities, the individual is a human. In some embodiments, the anti-PD-1 antibody is a human monoclonal antibody and the agonist anti-huICOS antibody is a humanized monoclonal antibody, such as an antibody comprising the CDRs or variable regions of the antibodies disclosed herein.
[00348] [00348] Anti-PD-1 antibodies that are known in the art can be used in the methods presently described. Several human monoclonal antibodies that specifically bind to PD-1 with high affinity have been described in U.S. Patent No. 8,008,449. Human anti-PD-1 antibodies disclosed in U.S. Patent No. 8,008,449 have been shown to exhibit one or more of the following characteristics: (a) bind to human PD-1 with a KD of 1 x 10-7 M or less, as determined by surface plasmon resonance using a Biacore biosensor system ; (b) do not substantially bind to human CD28, CTLA-4 or ICOS; (c) increase T cell proliferation in a Mixed Lymphocyte Reaction (MLR) assay; (d) increase interferon-γ production in an MLR assay; (e) increase IL-2 secretion in an MLR assay; (f) bind to human PD-1 and cynomolgus monkey PD-1; (g) inhibit the binding of PD-L1 and / or PD-L2 to PD-1; (h) stimulate antigen-specific memory responses; (i) stimulate antibody responses; and (j) inhibit tumor cell growth in vivo. Anti-PD-1 antibodies useful in the present invention include monoclonal antibodies that specifically bind to human PD-1 and exhibit at least one, in some embodiments, at least five, of the preceding characteristics.
[00349] [00349] Other monoclonal anti-PD-1 antibodies have been described in, for example, U.S. Patent Nos. 6,808,710, 7,488,802, 8,168,757 and
[00350] [00350] In some embodiments, the anti-PD-1 antibody is nivolumab (also known as OPDIVO®, 5C4, BMS-936558, MDX-1106, and ONO-4538), pembrolizumab (Merck; also known as KEYTRUDA®, lambrolizumab , and MK-3475; see WO2008 / 156712), PDR001 (Novartis; see WO 2015/112900), MEDI-0680 (AstraZeneca; also known as AMP-514; see, WO 2012/145493), cemiplimab (Regeneron; also known as REGN-2810; see WO 2015/112800), JS001 (TAIZHOU JUNSHI PHARMA; see, Si-Yang Liu et al., J. Hematol. Oncol. 10: 136 (2017)), BGB-A317 (Beigene; see WO 2015/35606 and US 2015/0079109), INCSHR1210 (Jiangsu Hengrui Medicine; also known as SHR-1210; see WO 2015/085847; Si-Yang Liu et al., J. Hematol. Oncol. 10: 136 (2017)) , TSR-042 (Tesaro Biopharmaceutical; also known as ANB011; see WO2014 / 179664), GLS-010 (Wuxi / Harbin Gloria Pharmaceuticals; also known as WBP3055; see Si-Yang Liu et al., J. Hematol. Oncol. 10 : 136 (2017)), AM-0001 (Armo), STI-1110 (Sorrento Therape utics; see WO 2014/194302), AGEN2034 (Agenus; see WO 2017/040790), MGA012 (Macrogenics, see WO 2017/19846), or IBI308 (Innovent; see WO 2017/024465, WO 2017/025016, WO 2017/132825, and WO 2017/133540).
[00351] [00351] In one embodiment, the anti-PD-1 antibody is nivolumab. Nivolumab is a completely human IgG4 PD-1 immune checkpoint inhibitor antibody (S228P) that selectively prevents interaction with PD-1 ligands (PD-L1 and PD-L2), thereby blocking the regulation of T cell functions antitumor (US Patent
[00352] [00352] In another embodiment, the anti-PD-1 antibody is pembrolizumab. Pembrolizumab is a humanized monoclonal IgG4 antibody (S228P) directed against human cell surface PD-1 receptor (programmed death 1 or programmed cell death 1). Pembrolizumab is described, for example, in U.S. Patent Nos.
[00353] [00353] Anti-PD-1 antibodies usable in the described methods also include isolated antibodies that specifically bind to human PD-1 and cross-compete for binding to human PD-1 with any anti-PD-1 antibody described here, for example, nivolumab (see, for example, US Patent Nos. 8,008,449 and
[00354] [00354] In certain embodiments, antibodies that cross-compete for binding to human PD-1 with, or bind to the same epitope region as the human PD-1 antibody, nivolumab, are monoclonal antibodies. For administration to human subjects, these cross-competition antibodies are chimeric antibodies, modified antibodies, or humanized or human antibodies. Such chimeric, modified, humanized or human monoclonal antibodies can be prepared and isolated by methods well known in the art.
[00355] [00355] Anti-PD-1 antibodies usable in the methods of the described invention also include antigen-binding portions of the above antibodies. It has been widely demonstrated that an antibody's antigen-binding function can be performed by fragments of a life-sized antibody.
[00356] [00356] Anti-PD-1 antibodies suitable for use in the described methods or compositions are antibodies that bind to PD-1 with high specificity and affinity, block the binding of PD-L1 and / or PD-L2 and inhibit the effect immunosuppressant of the PD-1 signaling pathway. In any of the compositions or methods described herein, an anti-PD-1 "antibody" includes an antigen-binding portion or fragment that binds to the PD-1 receptor and exhibits functional properties similar to those of total antibodies in inhibiting the binding of the ligand and over-regulation of the immune system. In certain embodiments, the anti-PD-1 antibody or antigen-binding portion of the same competes crosswise with nivolumab for binding to human PD-1.
[00357] [00357] Here are provided methods for the treatment of a hyperproliferative disease (e.g., cancer), comprising administering an agonist anti-huICOS antibody and a PD-L1 antagonist antibody to an individual. In certain embodiments, the anti-huICOS antibody agonist is administered in a subtherapeutic dose, the anti-PD-L1 antibody is administered in a subtherapeutic dose, or both are administered in a subtherapeutic dose. Methods are provided herein to alter an adverse event associated with the treatment of a hyperproliferative disease with an immunostimulatory agent, comprising administering an anti-huICOS agonist antibody and a subtherapeutic dose of anti-PD-L1 antibody to an individual. In certain modalities, the individual is human. In certain embodiments, the anti-PD-L1 antibody is a human sequence monoclonal antibody and the agonist anti-huICOS antibody is a humanized monoclonal antibody, such as an antibody comprising the CDRs or variable regions of the antibodies described herein.
[00358] [00358] Anti-PD-L1 antibodies that are known in the art can be used in the methods of the present invention. Examples of anti-PD-L1 antibodies useful in the methods of the present invention include the antibodies described in U.S. Patent No. 9,580,507. The anti-PD-L1 human monoclonal antibodies described in U.S. Patent No.
[00359] [00359] In certain embodiments, the anti-PD-L1 antibody is BMS-936559 (also known as 12A4, MDX-1105; see, for example, U.S. Patent No. 7,943,743 and WO 2013/173223), atezolizumab (Roche;
[00360] [00360] In certain embodiments, the PD-L1 antibody is atezolizumab (TECENTRIQ®). Azolizumab is a fully humanized anti-PD-L1 monoclonal IgG1 antibody.
[00361] [00361] In certain embodiments, the PD-L1 antibody is durvalumabee (IMFINZI ™). Durvalumabee is a human IgG1 kappa monoclonal anti-PD-L1 antibody.
[00362] [00362] In certain embodiments, the PD-L1 antibody is avelumab (BAVENCIO®). Avelumab is a human IgG1 lambda anti-PD-L1 monoclonal antibody.
[00363] [00363] In other embodiments, the anti-PD-L1 monoclonal antibody is 28-8, 28-1, 28-12, 29-8, 5H1, or any combination thereof.
[00364] [00364] Anti-PD-L1 antibodies usable in the described methods also include isolated antibodies that specifically bind to human PD-L1 and cross-compete for binding to human PD-L1 with any anti-PD-L1 antibody described herein, for example example, atezolizumab, durvalumab and / or avelumab. In some embodiments, the anti-PD-L1 antibody binds to the same epitope as any of the anti-PD-L1 antibodies described herein, for example, atezolizumab, durvalumab and / or avelumab. The ability of antibodies to cross-compete for binding to an antigen indicates that these antibodies bind to the same epitope region as the antigen and sterically prevent cross-linking of other competing antibodies to that particular epitope region. These cross-competition antibodies are expected to have functional properties very similar to those of the reference antibody, for example, atezolizumab and / or avelumab, due to their binding to the same PD-L1 epitope region. Cross-competition antibodies can be easily identified based on their ability to cross-compete with atezolizumab and / or avelumab in standard PD-L1 binding assays such as Biacore analysis, ELISA assays or flow cytometry (see, for example) example, WO 2013/173223).
[00365] [00365] In certain embodiments, antibodies that cross-compete for binding to human PD-L1 with, or bind to the same epitope region as the human PD-L1 antibody such as, atezolizumab, durvalumab, and / or avelumab, are antibodies monoclonal. For administration to human subjects, these cross-competition antibodies are chimeric antibodies, modified antibodies, or humanized or human antibodies. Such chimeric, modified, humanized or human monoclonal antibodies can be prepared and isolated by methods well known in the art.
[00366] [00366] Anti-PD-L1 antibodies usable in the methods of the described invention also include antigen-binding portions of the above antibodies. It has been widely demonstrated that an antibody's antigen-binding function can be performed by fragments of a life-sized antibody.
[00367] [00367] Anti-PD-L1 antibodies suitable for use in the described methods or compositions are antibodies that bind to PD-L1 with high specificity and affinity, block the binding of PD-1 and inhibit the immunosuppressive effect of the signaling pathway. PD-1. In any of the compositions or methods described herein, an anti-PD-L1 "antibody" includes an antigen-binding portion or fragment that binds to PD-L1 and exhibits functional properties similar to those of total antibodies in inhibiting receptor binding and over-regulation of the immune system. In certain embodiments, the anti-PD-L1 antibody or antigen-binding portion thereof cross-competes with atezolizumab, durvalumab, and / or avelumab for binding to human PD-L1.
[00368] [00368] In one embodiment, the anti-huICOS antibody agonist of the present invention is combined with a PD-1 / PD-L1 signaling antagonist, such as a PD-1 antagonist (for example, nivolumab, also known as MDX1106 , as described in WO 06/121168) or a PD-L1 antagonist, in combination with a third immunotherapeutic agent (for example, an anti-ICOS antibody, such as ICOS.33 IgG1f S267E, combined with nivolumab and ipilimumab) . In one embodiment, the third immunotherapeutic agent is a CTLA-4 antagonist antibody. In certain embodiments, the anti-CTLA-4 antibody is YERVOY® (ipilimumab or 10D1 antibody, described in PCT Publication WO 01/14424) or tremelimumab (formerly ticilimumab, CP-675206). In one embodiment, the third immunotherapeutic agent is a GITR antagonist or an OX-40 antagonist, such as the anti-GITR or anti-OX40 antibodies described herein. In one embodiment, the third immunotherapeutic agent is a GITR agonist, such as a GITR agonist antibody. Suitable GITR antibodies include, for example, BMS-986153, BMS-986156, TRX-518 (WO 06/105021, WO 09/009116) and MK-4166 (WO 11/028683). In one embodiment, the third immunotherapeutic agent is an IDO antagonist. Suitable IDO antagonists include, for example, INCB-024360 (WO 2006/122150, WO 07/75598, WO 08/36653, WO 08/36642), indoximod or NLG-919 (WO 09/73620, WO 09/1156652, WO 11/56652, WO 12/142237).
[00369] [00369] Here are provided methods for the treatment of a hyperproliferative disease (e.g., cancer), comprising administering an agonist anti-huICOS antibody described herein, and a CTLA-4 antagonist antibody to an individual. In certain embodiments, the anti-huICOS agonist antibody is administered in a subtherapeutic dose, the anti-CTLA-4 antibody is administered in a subtherapeutic dose, or both are administered in a subtherapeutic dose. Methods are provided herein to alter an adverse event associated with the treatment of a hyperproliferative disease with an immunostimulatory agent, comprising administering an anti-huICOS agonist antibody and a subtherapeutic dose of anti-CTLA-4 antibody to an individual. In certain modalities, the individual is human.
[00370] [00370] Anti-CTLA-4 antibodies that are known in the art can be used in the methods of the present invention. The anti-CTLA-4 antibodies of the present invention bind to human CTLA-4 in order to interrupt the interaction of CTLA-4 with a human B7 receptor. Since the interaction of CTLA-4 with B7 transduces a signal that leads to inactivation of T cells carrying the CTLA-4 receptor, disruption of the interaction effectively induces, enhances or prolongs the activation of such T cells, inducing, enhancing or prolonging a response immune.
[00371] [00371] Human monoclonal antibodies that specifically bind to CTLA-4 with high affinity have been described in U.S. Patent No. 6,984,720. Other anti-CTLA-4 monoclonal antibodies have been described, for example, in U.S. Patent Nos. 5,977,318,
[00372] [00372] In certain embodiments, the CTLA-4 antibody is ipilimumab (also known as YERVOY®, MDX-010, 10D1; see US Patent No. 6,984,720), MK-1308 (Merck), AGEN-1884 (Agenus Inc. ; see WO 2016/196237), or tremelimumab (AstraZeneca; also known as ticilimumab, CP-675.206; see WO 2000/037504 and Ribas, Update Cancer Ther. 2 (3): 133-39 (2007)). In particular embodiments, the anti-CTLA-4 antibody is ipilimumab.
[00373] [00373] In particular embodiments, the CTLA-4 antibody is ipilimumab for use in the methods described herein. Ipilimumab is a fully human IgG1 monoclonal antibody that blocks the binding of CTLA-4 to its B7 ligands, thereby stimulating T cell activation and improving overall survival (OS) in patients with advanced melanoma.
[00374] [00374] In particular embodiments, the CTLA-4 antibody is tremelimumab.
[00375] [00375] In particular embodiments, the CTLA-4 antibody is MK-
[00376] [00376] In particular modalities, the CTLA-4 antibody is AGEN-
[00377] [00377] Anti-CTLA-4 antibodies usable in the described methods also include isolated antibodies that specifically bind to human CTLA-4 and cross-compete for binding to human CTLA-4 with any anti-CTLA-4 antibody described herein, for example example, ipilimumab and / or tremelimumab. In some embodiments, the anti-CTLA-4 antibody binds to the same epitope as any of the anti-CTLA-4 antibodies described herein, for example, ipilimumab and / or tremelimumab. The ability of antibodies to cross-compete for binding to an antigen indicates that these antibodies bind to the same epitope region as the antigen and sterically prevent cross-linking of other competing antibodies to that particular epitope region. These cross-competition antibodies are expected to have functional properties very similar to those of the reference antibody, for example, ipilimumab and / or tremelimumab, by virtue of their binding to the same CTLA-4 epitope region. Cross-competition antibodies can be easily identified based on their ability to cross-compete with ipilimumab and / or tremelimumab in standard CTLA-4 binding assays such as Biacore analysis, ELISA assays or flow cytometry (see, for example) example, WO 2013/173223).
[00378] [00378] In certain embodiments, antibodies that cross-compete for binding to human CTLA-4 with, or bind to the same epitope region as the human CTLA-4 antibody such as, ipilimumab and / or tremelimumab, are monoclonal antibodies. For administration to human subjects, these cross-competition antibodies are chimeric antibodies, modified antibodies, or humanized or human antibodies. Such chimeric, modified, humanized or human monoclonal antibodies can be prepared and isolated by methods well known in the art.
[00379] [00379] Anti-CTLA-4 antibodies usable in the methods of the described invention also include antigen-binding portions of the antibodies mentioned above. It has been widely demonstrated that an antibody's antigen-binding function can be performed by fragments of a life-sized antibody.
[00380] [00380] Anti-CTLA-4 antibodies suitable for use in the described methods or compositions are antibodies that bind to CTLA-4 with high specificity and affinity, block the activity of CTLA-4 and disrupt the interaction of CTLA-4 with a human B7 receptor. In any of the compositions or methods described herein, an anti-CTLA-4 "antibody" includes an antigen-binding portion or fragment that binds to CTLA-4 and exhibits functional properties similar to those of total antibodies in inhibiting the interaction of CTLA-4 with a human B7 receptor and over-regulation of the immune system. In certain embodiments, the anti-CTLA-4 antibody or antigen-binding portion of the same competes crosswise with ipilimumab and / or tremelimumab for binding to human CTLA-4.
[00381] [00381] In one embodiment, the anti-huICOS antibody agonist of the present invention is combined with an anti-CTLA-4 antibody, in combination with a third immunotherapeutic agent. In one embodiment, the third immunotherapeutic agent is a GITR antagonist or an OX-40 antagonist, such as the anti-GITR or anti-OX40 antibodies described herein. In one embodiment, the third immunotherapeutic agent is a GITR agonist, such as an agonistic GITR antibody. Suitable GITR antibodies include, for example, BMS-986153, BMS-986156, TRX-518 (WO 06/105021, WO 09/009116) and MK-4166 (WO 11/028683). In one embodiment, the third immunotherapeutic agent is an IDO antagonist. Suitable IDO antagonists include, for example, INCB-024360 (WO 2006/122150, WO 07/75598,
[00382] [00382] Methods are provided herein for the treatment of a hyperproliferative disease (e.g., cancer), comprising administering an agonist anti-huICOS antibody and an anti-LAG-3 antibody to an individual. In other embodiments, the anti-huICOS antibody agonist is administered in a subtherapeutic dose, the anti-LAG-3 antibody is administered in a subtherapeutic dose, or both are administered in a subtherapeutic dose. Methods are provided herein to alter an adverse event associated with the treatment of a hyperproliferative disease with an immunostimulatory agent, comprising administering an anti-huICOS agonist antibody and a subtherapeutic dose of anti-LAG-3 antibody to an individual. In certain modalities, the individual is human. In certain embodiments, the anti-LAG-3 antibody is a human sequence monoclonal antibody and the agonist anti-huICOS antibody is a humanized monoclonal antibody, such as an antibody comprising the CDRs or variable regions of the antibodies described herein. Examples of anti-LAG3 antibodies include antibodies comprising the CDR or variable regions of antibodies 25F7, 26H10, 25E3, 8B7, 11F2 or 17E5, which are described in U.S. Patent Publication No.2011 / 0150892 and WO 2014/008218. In one embodiment, an anti-LAG-3 antibody is BMS-986016. Other anti-LAG-3 antibodies that can be used include IMP731 described in US 2011/007023 or IMP-321. Anti-LAG-3 antibodies that compete with and / or bind to the same epitope as any of these antibodies can also be used in combination treatments.
[00383] [00383] In certain embodiments, the anti-LAG-3 antibody binds to human LAG-3 with a KD of 5 x 10-8 M or less, binds to human LAG-3 with a KD of 1 x 10 -8 M or less, binds to human LAG-3 with a KD of 5 x 10-9 M or less, or binds to human LAG-3 with a KD between 1 × 10−8 M and 1 × 10 -10 M or less.
[00384] [00384] Administration of anti-huICOS agonist antibodies described herein and antagonists, for example, antagonist antibodies, to one or more second target antigens, such as LAG-3 and / or CTLA-4 and / or PD-1 and / or PD-L1 can increase the immune response to cancer cells in the patient. Cancers whose growth can be inhibited using the antibodies of the present invention include cancers typically responsive to immunotherapy. Examples of cancers for treatment with the combination therapy described herein include, but are not limited to, those described above in the discussion of monotherapy with agonist anti-huICOS antibodies.
[00385] [00385] In certain embodiments, the combination of therapeutic antibodies described herein can be administered concomitantly as a single composition in a pharmaceutically acceptable carrier, or concomitantly as separate compositions with each antibody in a pharmaceutically acceptable carrier. In another embodiment, the combination of therapeutic antibodies can be administered sequentially. For example, an anti-CTLA-4 antibody and an agonist anti-huICOS antibody can be administered sequentially, with the anti-CTLA-4 antibody being administered first and the agonist anti-huICOS antibody second, or the anti-huICOS antibody agonist being administered first and anti-CTLA-4 antibody second. In addition or alternatively, an anti-PD-1 antibody and an agonist anti-huICOS antibody can be administered sequentially, with the anti-PD-1 antibody being administered first and the agonist anti-huICOS antibody second, or the anti- huICOS agonist being administered first and anti-PD-1 antibody second. In addition or alternatively, an anti-PD-L1 antibody and an agonist anti-huICOS antibody can be administered sequentially, such as anti-PD-L1 antibody being administered first and an agonist anti-huICOS antibody second, or agonist anti-huICOS antibody being administered first and anti-PD-L1 antibody second. In addition or alternatively, an anti-LAG-3 antibody and an agonist anti-huICOS antibody may be administered sequentially, with the anti-LAG-3 antibody being administered first and the agonist anti-huICOS antibody second, or the anti-agonist antibody huICOS agonist being administered first and anti-LAG-3 antibody second.
[00386] [00386] Furthermore, if more than one dose of combination therapy is administered sequentially, the order of sequential administration can be reversed or maintained in the same order at each time of administration, sequential administrations can be combined with concurrent administrations, or any combination thereof. For example, the first administration of a combination of anti-CTLA-4 antibody and agonist anti-huICOS antibody can be concomitant, the second administration can be sequential with anti-CTLA-4 antibody first and agonist anti-huICOS antibody second, and the third administration can be sequential with agonist anti-huICOS antibody first and anti-CTLA-4 antibody second, etc. Additionally or alternatively, the first administration of a combination of anti-PD-1 antibody and agonist anti-huICOS antibody may be concomitant, the second administration may be sequential with the second anti-PD-1 antibody and the second agonist anti-huICOS antibody place, and the third administration can be sequential with agonist anti-huICOS antibody first and anti-PD-1 antibody second, etc. Additionally or alternatively, the first administration of a combination anti-PD-L1 antibody and agonist anti-huICOS antibody may be concomitant, the second administration may be sequential with anti-PD-L1 antibody first and anti-huicos antibody second, and the third administration can be sequential with agonist anti-huICOS antibody first and anti-PD-L1 antibody second, etc. In addition or alternatively, the first administration of a combination anti-LAG-3 antibody and agonist anti-huICOS antibody may be concomitant, the second administration may be sequential with first anti-LAG-3 antibody and second agonist anti-huICOS antibody , and the third administration can be sequential with agonist anti-huICOS antibody first and anti-LAG-3 antibody second, etc. Another representative dosing schedule may involve a first sequential administration with the first agonist anti-huICOS antibody and anti-CTLA-4 (and / or anti-PD-1 antibody and / or anti-PD-L1 and / or anti- Antibody LAG-3) second, and subsequent administrations can be concomitant.
[00387] [00387] In one embodiment, an anti-huICOS agonist antibody, as the sole immunotherapeutic agent, or the combination of an agonist anti-huICOS antibody and one or more additional immunotherapeutic antibodies (for example, anti-CTLA-4 and / or anti- PD-1 and / or anti-PD-L1 and / or anti-LAG-3 antibody) can also be combined with an immunogenic agent, such as cancer cells, purified tumor antigens (including recombinant protein, peptide and carbohydrate molecules) , cells, and cells transfected with genes encoding immunostimulating cytokines (He et al. (2004) J. Immunol. 173: 4919-28). Non-limiting examples of tumor vaccines that can be used include peptides from melanoma antigens, such as gp100 peptides, MAGE, Trp-2, MART1 and / or tyrosinase antigens or tumor cells transfected to express the GM-CSF cytokine (also described below) ). An ICOS agonist and one or more additional antibodies (for example, blocking CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3) can also be combined with standard cancer treatments. For example, an ICOS agonist and one or more additional antibodies (for example, blocking CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3) can be combined with chemotherapeutic regimens. In one embodiment, an anti-huICOS agonist antibody is administered to a patient with an anti-CTLA-4 antibody and / or anti-PD-1 antibody and / or anti-PD-L1 antibody and / or anti-LAG-3 antibody in combination with decarbazine for the treatment of melanoma. In one embodiment, an agonist anti-huICOS antibody is administered to a patient with an anti-CTLA-4 antibody and / or anti-PD-1 antibody and / or anti-PD-L1 antibody and / or anti-LAG-3 antibody in combination with interleukin-2 (IL-2) for the treatment of cancer, including melanoma. Without wishing to be bound by theory, the combined use of ICOS agonism and CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3 antagonism with chemotherapy can work synergistically, since the cytotoxic action of Most chemotherapy compounds can result in increased levels of tumor antigen in the antigen presentation pathway. Other combination therapies that may result in synergy with a combined ICOS agonism with or without, and antagonism of CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3 through cytotoxicity include radiation, surgery or hormone deprivation. In another embodiment, angiogenesis inhibitors can be combined with an anti-huICOS antibody and CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3 antagonism.
[00388] [00388] In one embodiment, an anti-huICOS antibody as the sole immunotherapeutic agent, or a combination of an anti-huICOS antibody and CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG blocking antibodies -3 can also be used in combination with bispecific antibodies that target effector cells that express the Fcα or Fc receptor for tumor cells. See, for example, U.S. Patent Nos. 5,922,845 and 5,837,243. Bispecific antibodies can be used to target two separate antigens. The T cell branching of these responses would be increased by the use of a combined ICOS agonism and blocking CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3.
[00389] [00389] In one embodiment, an anti-ICOS antibody as the sole immunotherapeutic agent or a combination of an anti-ICOS antibody and an additional immunostimulating agent, for example, anti-CTLA-4 and / or anti-PD-1 antibody and / or anti-PD-L1 antibody and / or anti-LAG-3 antibody, can be used in conjunction with an antineoplastic agent, such as RITUXAN® (rituximab), HERCEPTIN® (trastuzumab), BEXXAR® (tositumomab), ZEVALIN® ( ibritumomab), CAMPATH® (alemtuzumab), LYMPHOCIDE® (eprtuzumab), AVASTIN® (bevacizumab) and TARCEVA® (erlotinib). As an example and not wishing to be bound by theory, treatment with an anti-cancer antibody or a toxin-conjugated anti-cancer antibody can lead to the death of cancer cells (eg, tumor cells) that can potentiate an agent-mediated immune response immunostimulatory, for example, anti-ICOS antibody, anti-TIGIT antibody, anti-CTLA-4 antibody, anti-PD-1 antibody, anti-PD-L1 antibody or anti-LAG-3 antibody. In one embodiment, a treatment of a hyperproliferative disease (for example, a cancerous tumor) may include an anti-cancer agent, for example, antibody, in combination with an agonist anti-huICOS antibody and optionally an additional immunostimulating agent, for example, anti-CTLA-4 antibody and / or anti-PD-1 antibody and / or anti-PD-L1 antibody and / or anti-LAG-3 antibody, concomitantly or sequentially or any combination thereof, which may potentiate an anti-tumor immune response by the host.
[00390] [00390] Methods are provided herein to reduce, ameliorate or cancel an adverse event associated with the treatment of a hyperproliferative disease (e.g., cancer) with an immunostimulatory agent, comprising administering an agonist anti-huICOS antibody with or without an anti -CTLA-4 and / or anti-PD-1 and / or anti-PD-L1 and / or anti-LAG-3 antibody to an individual.
[00391] [00391] In one embodiment, an anti-ICOS antibody with or without CTLA-4 and / or PD-1 and / or PD-L1 and / or LAG-3 antagonist (i.e., immunostimulatory therapeutic antibodies against ICOS and optionally antibodies anti-CTLA-4 and / or anti-PD-1 and / or anti-PD-L1 and / or anti-LAG-3) together with a non-absorbable steroid can also be combined with a salicylate. Salicylates include 5-ASA agents such as, for example: sulfasalazine (AZULFIDINE®, Pharmacia &UpJohn); olsalazine (DIPENTUM®, Pharmacia and UpJohn); balsalazide (COLAZAL®, Salix Pharmaceuticals, Inc.); and mesalamine (ASACOL®, Procter & Gamble Pharmaceuticals; PENTASA®, Shire US; CANASA®, Axcan Scandipharm, Inc .; ROWASA®, Solvay).
[00392] [00392] According to the methods described herein, a salicylate administered in combination with an anti-huICOS antibody with or without anti-CTLA-4 and / or anti-PD-1 and / or anti-PD-L1 and / or LAG-3 and a non-absorbable steroid can include any overlapping or sequential administration of salicylate and non-absorbable steroid for the purpose of decreasing the incidence of immunostimulatory antibody-induced colitis. Thus, for example, methods for reducing the incidence of colitis induced by the immunostimulatory antibodies described here include the administration of a salicylate and a non-absorbable concomitantly or sequentially (for example, a salicylate is administered 6 hours after a non-absorbable steroid), or any combination thereof. In addition, a salicylate and a non-absorbable steroid can be administered by the same route (for example, both are administered orally) or by different routes (for example, a salicylate is administered orally and a non-absorbable steroid is administered rectally), which may differ from the route (s) used to administer anti-water and anti-CTLA-4 and / or anti-PD-1 and / or anti-PD-L1 and / or anti-LAG- 3.
[00393] [00393] The anti-huICOS agonist antibodies and combination antibody therapies described herein can also be used in conjunction with other well-known therapies that are selected for their particular utility against the indication being treated (for example, cancer). Combinations of the agonist anti-huICOS antibodies described herein can be used sequentially with known pharmaceutically acceptable agent (s).
[00394] [00394] In one embodiment, the anti-huICOS agonist antibodies and the combination antibody therapies described herein can be used in combination (for example, simultaneously or separately) with an additional treatment, such as irradiation, chemotherapy (for example, using camptothecin (CPT-11), 5-fluorouracil (5-FU), cisplatin, doxorubicin, irinotecan, paclitaxel, gemcitatin, cisplatin, paclitaxel, carboplatin-paclitaxel (Taxol), doxorubicin, 5-fu or camptothecin (apo2 / +2) 6X combo)), one or more proteasome inhibitors (for example, bortezomib or MG132), one or more Bcl-2 inhibitors (for example, BH3I-2 '(bcl-xl inhibitor), indoleamine dioxigenase inhibitor 1 (IDO1) (for example, INCB24360), AT-101 (derived from R - (-) - gossypol), ABT-263 (small molecule), GX-15-070 (obatoclax) or MCL-1 antagonists (protein - 1 myeloid leukemia cell differentiation)), iAP antagonists (apoptosis protein inhibitor) (eg smac7, s mac4, smac mimetic small molecule, smac synthetic peptides (see Fulda et al., Nat Med 2002; 8: 808-15), ISIS23722 (LY2181308) inhibitors, or AEG-35156 (GEM-640)), HDAC (histone deacetylase), anti-CD20 antibodies (by rituximab), angiogenesis inhibitors (for example,
[00395] [00395] The agonist anti-uuICOS antibodies and the combination antibody therapies described herein can further be used in combination with one or more antiproliferative cytotoxic agents. Classes of compounds that can be used as antiproliferative cytotoxic agents include, but are not limited to, the following:
[00396] [00396] Alkylating agents (including, without limitation, nitrogen mustards, ethyleneimine derivatives, alkylsulfonates, nitrosoureas and triazenes): Uracil mustard, Chlormetin, Cyclophosphamide (CYTOXAN ™) Phosphamide, Melfalan, Chloramethyl, Triamethylamine, Trophylamine , Carmustine, Lomustine, Streptozocin, Dacarbazine and temozolomide.
[00397] [00397] Antimetabolites (including, without limitation, folic acid antagonists, pyrimidine analogs, purine analogs and adenosine deaminase inhibitors): Methotrexate, 5-Fluorouracil, Floxuridine, Cytarabine, 6-Mercaptopurine, 6-Thiofanine, Phosphate Fludarabine, Pentostatin and Gemcitabine.
[00398] [00398] Antiproliferative agents suitable for combination with anti-uuIC agonist antibodies, without limitation, taxanes, paclitaxel (paclitaxel is commercially available as TAXOL ™), docetaxel,
[18] [18] dehydrodeoxypotilone B, C12,13-cyclopropyl-epothilone A, C6-C8 bridged epothilone A, trans-9,10-dehydroeptyline D, cis-9,10-dehydroepothilone D, 16-demethylpotylone B, epothilone B10, discoderomolide , patupilone (EPO-906), KOS-862, KOS-1584, ZK-EPO, ABJ-789, XAA296A (Discodermolide), TZT-1027 (soblidotine), ILX-651 (tasidotine hydrochloride), Halicondrine B, mesylate eribulin (E-7389), Hemiasterin (HTI-286), E-7974, Cyrptohycins, LY-355703, maytansinoid immunoconjugates (DM-1), MKC-1, ABT-751, T1- 38067, T-900607, SB -715992 (ispinesib), SB-743921, MK-0731, STA-5312, eleuterobin, 17beta-acetoxy-2-ethoxy-6-oxo-B-homo-estra- 1,3,5 (10) -trien-3 -ol, cyclostreptin, isolaulimalide, laulimalide, 4-epi-7-dehydroxy-14,16-didemethyl - (+) - discodermolides and cryptotilone 1, in addition to other microtubulin stabilizing agents known in the art.
[00399] [00399] In some embodiments it may be desirable to make cells aberrantly proliferative quiescent in conjunction with or before treatment with anti-huICOS agonist antibodies described herein, for example, by administering to the patient hormones and steroids (including synthetic analogs), such as 17a- Ethinylestradiol, Diethylstilbestrol, Testosterone, Prednisone, Fluoxymesterone, Dromostanolone propionate, Testolactone, Megestrolacetate, Methylprednisolone, Methyl-testosterone, Prednisolone, Triamcinolone, Chlorotrianisene, Hydroxyprogesterone, Floxyprogesterone, Aminoglutamine, Estrogen When the methods or compositions described herein are used, other agents used in the modulation of tumor growth or metastasis in a clinical context, such as antimimetics,
[00400] [00400] Methods for the safe and effective administration of chemotherapeutic agents are known to those skilled in the art. In addition, its administration is described in the standard literature. For example, the administration of many of the chemotherapeutic agents is described in Physicians' Desk Reference (PDR), for example, 1996 edition (Medical Economics Company, Montvale, N.J. 07645-1742, USA); the description of which is incorporated herein by reference.
[00401] [00401] Chemotherapeutic agents and / or radiation therapy can be administered according to therapeutic protocols known in the art. It will be evident to those skilled in the art that the administration of the chemotherapeutic agent (s) and / or radiation therapy can be varied depending on the disease to be treated and the known effects of the chemotherapeutic agent (s) (s) and / or radiation therapy in this disease. In addition, according to the knowledge of the qualified clinician, therapeutic protocols (for example, dosage amounts and administration times) can be varied in view of the observed effects of the therapeutic agents administered to the patient, and in view of the observed responses of the disease therapeutic agents administered. Results
[00402] [00402] The response of the tumor is determined, for example, by the Response Assessment Criteria modified in Solid Tumors (RECIST) established by the NCI.
[00403] [00403] With respect to target lesions, responses to therapy may include:
[00404] [00404] With respect to non-target lesions, responses to therapy may include:
[00405] [00405] Patients treated according to the methods described here preferably experience improvement in at least one sign of cancer. In one embodiment, improvement is measured by a reduction in the amount and / or size of measurable tumor lesions. In another modality, the lesions can be measured on chest X-rays or computed tomography (CT) or magnetic resonance imaging (MRI) films. In another modality, cytology or histology can be used to assess the responsiveness to a therapy.
[00406] [00406] In one embodiment, the treated patient exhibits a complete response (CR), a partial response (PR), stable disease (SD), immune-related complete disease (irCR), immune-related partial response (irPR) or disease immune-related stable (irSD). In another embodiment, the treated patient experiences shrinkage of the tumor and / or decrease in the rate of growth, that is, suppression of tumor growth. In another embodiment, unwanted cell proliferation is reduced or inhibited. In yet another modality, one or more of the following may occur: the number of cancer cells can be reduced; tumor size can be reduced; infiltration of cancer cells into peripheral organs can be inhibited, delayed, slowed down or stopped; tumor metastasis can be slowed or inhibited; tumor growth can be inhibited; tumor recurrence can be prevented or delayed; one or more of the symptoms associated with cancer can be relieved to some extent.
[00407] [00407] In other embodiments, administration of effective amounts of the anti-ICOS antibody (or combinations of anti-ICOS antibody and at least one additional antibody, for example, an anti-PD-1 antibody or anti-CTLA-4 antibody) according to any of the methods provided here it produces a reduction in the size of a tumor, reduction in the number of metastatic lesions that appear over time, complete remission, partial remission or stable disease. In yet other modalities, treatment methods produce a comparable clinical benefit rate (CBR = CR + PR + DP ≥ 6 months) better than that obtained by an anti-ICOS antibody only (or any of the combined antibodies only). In other modalities, the improvement in the clinical benefit rate is about 20% 20%, 30%, 40%, 50%, 60%, 70%, 80% or more compared to the anti-ICOS antibody only (or any of the individually combined antibodies). Vaccine Adjuvants
[00408] [00408] Anti-huICOS antibodies described herein can be used to enhance antigen-specific immune responses by co-administering an anti-huICOS antibody with an antigen of interest, for example, a vaccine. Accordingly, methods are provided here to enhance an immune response to an antigen in an individual, comprising administering to the individual: (i) the antigen; and (ii) an anti-huICOS antibody, or antigen-binding fragment thereof, so that an immune response to the antigen in the individual is increased. The antigen can be, for example, a tumor antigen, a viral antigen, a bacterial antigen or a pathogen antigen. Non-limiting examples of such antigens include those described in the sections above, such as the tumor antigens (or tumor vaccines) described above, or antigens from the viruses, bacteria or other pathogens described above. Detection and Diagnostics
[00409] [00409] In another aspect, methods are provided here to detect the presence of human ICOS antigen in a sample, or to measure the amount of human ICOS antigen, comprising contacting the sample and a control sample with an anti-ICOS antibody, for example , a monoclonal anti-human ICOS antibody, or an antigen-binding fragment thereof, which specifically binds to human ICOS, under conditions that allow a complex to form between the antibody or fragment thereof and human ICOS. The formation of a complex is then detected, in which a difference in complex formation between the sample compared to the control sample is indicative of the presence of human ICOS antigen in the sample. In addition, the anti-ICOS antibodies described herein can be used to purify human ICOS through immunoaffinity purification.
[00410] [00410] The present invention is also illustrated by the following examples, which should not be construed as limiting. The content of all figures and all references, Genbank strings, patents and published patent applications cited throughout this application are expressly incorporated herein by reference. EXAMPLES
[00411] [00411] The following are non-limiting examples of antibodies, compositions and methods of the invention. It is understood that several other modalities can be practiced according to the general description provided here. EXAMPLE 1 Generation of Fully Human Antibodies
[00412] [00412] Fully human anti-huICOS monoclonal antibodies, and fully human antibodies that bind to the same epitope and / or cross-block the binding of fully human anti-ICOS antibodies are described herein. Such antibodies can be generated using transgenic mice that express human antibody genes, as described in the following example. Hybridoma technology using HuMab mouse® and / or a Kunming mouse (KM) ®
[00413] [00413] Anti-ICOS antibodies have been generated
[00414] [00414] Human anti-ICOS monoclonal antibodies were generated by immunizing the HC2 / KCo7 strain of transgenic HuMAb® mice ("HuMAb®" is a trademark of Medarex, Inc., Princeton, New Jersey) and KM mice (a strain of mouse KM® contains the SC20 transchromosome as described in WO 02/43478) with 1) a soluble human ICOS antigen and 2) a Hek293T cell line that has been transfected with the human ICOS gene that expresses human ICOS, a cell line of Chinese Hamster Ovary (CHO) that expresses ICOS, and a 300-19 cell line that expresses ICOS. HuMAb KC2 / KCo7 mice and KM mice were generated as described in U.S. Patent Nos.
[00415] [00415] The antigens were a soluble fusion protein comprising an extracellular ICOS domain fused to an antibody Fc domain (recombinant human mouse-ICOS chimeric protein), Hek293T cells, CHO cells or 300-19 cells that were transfected into surface expression of human ICOS. The antigens were mixed with RIBI monophosphoryl lipid A (MPL) plus TDM adjuvant system (Sigma) for immunizations. The above described mice that were immunized with the ICOS protein soluble in 15-25 µg of recombinant ICOS antigen soluble in PBS or 1 x 107 CHO cells, Hek293T cells or 300-19 cells transfected for surface expression of human ICOS in PBS were mixed 1: 1 with the adjuvant. The mice were injected with 200 µl of the antigens prepared in the peritoneal or subcutaneous cavity or footpad every two to fourteen days. The mice were injected with 100-200 µl of recombinant mouse IL21 following immunizations with ICOS antigen. Mice that developed anti-ICOS titers were administered an intravenous injection and / or foot pad injection of 10-20 µg of soluble recombinant ICOS antigen or 5 x 106 CHO cells, or 300-19 cells transfected for human ICOS surface expression or more intraperitoneal injection of 15 µg of recombinant mouse IL21 protein in 100 µl of PBS, three to two days before fusion. Mouse lymph nodes and / or mouse spleens were harvested and isolated lymph node cells and / or splenocytes were used to prepare the hybridoma.
[00416] [00416] To select a mouse HuMab or mouse KM® that produced ICOS-binding antibodies, the sera of immunized mice were tested by enzyme-linked immunosorbent assay (ELISA). In summary, the microtiter plates were coated with purified recombinant human ICOS mouse Fc at 1-2 µg / mL in PBS; 50 µl / well were incubated at 4 ° C overnight, then blocked with 200 ° C / well of 5% chicken serum in PBS / Tween (0.05%). Plasma dilutions of mice immunized with ICOS were added to each well and incubated for one hour at room temperature. The plates were washed with PBS / Tween and then incubated with a goat anti-human IgG Fc polyclonal antibody conjugated to horseradish peroxidase (HRP) for one hour at room temperature. After washing, the plates were developed with ABTS substrate (Moss Inc., product: ABTS-1000) and analyzed by spectrophotometer at 415-495 Optical Density (OD). Sera from immunized mice were then further analyzed by flow cytometry for binding to a cell line that expressed human ICOS, but not to a control cell line that did not express ICOS. In summary, the binding of anti-ICOS antibodies was assessed by incubating CHO cells that express ICOS or 300-19 cells with the anti-ICOS antibody at a 1:20 dilution. The cells were washed and binding was detected with an anti-human IgG antibody labeled with phycoerythrin (PE). Flow cytometric analyzes were performed using a FACScan ™ flow cytometer (Becton Dickinson, San Jose, CA). Mice that developed the highest anti-ICOS antibody titers were used for fusions. The mergers were carried out as described below. Hybridoma supernatants were tested for anti-ICOS activity by ELISA and fluorescence-activated cell cytometry (FACS). Hybridoma preparation
[00417] [00417] Mouse splenocytes and / or lymphocytes isolated from a mouse HuMab® and / or a mouse KM® were fused with a mouse myeloma cell line using electrofusion based on an electric field using a cell fusion electroporator from Cyto Pulse large chamber (Cyto Pulse Sciences, Inc. Glen Burnie, MD). In summary, single cell suspensions of splenic lymphocytes from immunized mice were fused with an equal number of Sp2 / 0 non-secreting mouse myeloma cells (ATCC cell lines, CRL 1581). The cells were seeded at approximately 2 x 104 / well in flat-bottomed microtiter plates, then incubated for about two weeks in selective medium containing 10% fetal bovine serum, 10% P388D1 conditioned medium (ATCC, CRL TIB- 63), 3-5% Origen (IGEN) in DMEM (Mediatech, CRL 10013, high in glucose, L-glutamine and sodium pyruvate) plus 5 mM HEPES, 0.055 mM 2-mercaptoethanol, 50 mg / ml gentamicin and 1x hypoxanthine-aminopterin-thymidine (HAT) medium (Sigma, CRL P-7185). After one to two weeks, the cells were grown in a medium in which HAT was replaced by hypoxanthine and thymidine (HT) medium. Approximately 10 to 14 days after cell sowing, supernatants from individual wells were analyzed first to determine whether they contained human gamma and kappa antibodies. Supernatants that were rated positive for human gamma and kappa antibodies were subsequently analyzed by ELISA and FACS for human anti-ICOS monoclonal IgG antibodies. The antibody-secreting hybridomas were transferred to 24-well plates, analyzed again and, if still positive for human anti-ICOS monoclonal antibodies, were subcloned at least twice by limiting dilution. The stable subclones were then cultured in vitro to generate small amounts of antibody in tissue culture medium for further characterization. The human monoclonal antibodies produced were then purified by protein A column chromatography. Isolated antibodies of particular interest were designated as 17C4, 9D5, 3E8, 1D7-a and 1D7-b, as described in Table 7 below. Table 7 - Isolated Antibodies Antibody Heavy Chain Light Chain Variable Domain Variable Domain Name of light chain heavy chain CDR 1, 2, and 3 CDR 1, 2, and 3 SEQ ID No. SEQ ID No. SEQ ID No. SEQ ID No. 17C4 18, 19, and 20 21, 22, and 23 16 17 9D5 26, 27, and 28 29, 30, and 31 24 25 3E8 34, 35, and 36 37, 38, and 39 32 33 1D7 - to 42, 43, and 44 45, 46, and 47 40 41 1D7 - b 42, 43, and 44 49, 50, and 51 40 48 B. PROfusion® mRNA display system
[00418] [00418] KM # 333819 and # 333821 mice were immunized with CHO cells that overexpress human ICOS, and the mouse spleen and lymph nodes were subsequently harvested. The total RNA was extracted from the spleen and lymph node cells and was reverse transcribed using specific primers for the antibody's constant regions. The antibody cDNA was used to generate a single stranded variable fragment library (scFv) that was expressed in mRNA display, where each scFv protein was fused to its coding mRNA via a puromycin link. The library was selected against 10 nM of recombinant human ICOS-Fc, and any bound molecules were recovered using capture with magnetic Protein G beads and amplified by polymerase chain reaction (PCR) to proceed to the next cycle. A total of six cycles were completed, after which a significant signal of ICOS binding was observed by quantitative PCR (qPCR). The final population was sequenced and the unique variable regions were cloned into IgG expression vectors. IgG proteins were expressed using transient Hek293T cell transfection to generate material for binding and functional assays. IgG-2644 antibody, as described in Table 8 below, was selected. Table 8 - IgG-2644 Antibody Heavy Chain Light Chain Domain Variable Domain Domain Domain Chain light chain variable Antibody CDR 1, 2, and 3 CDR 1, 2, and 3 chain SEQ ID Light heavy name Name SEQ ID NOs SEQ ID Heavy numbers SEQ ID
[00419] [00419] An anti-hamster mouse ICOS monoclonal antibody, C398.4A Monoclonal Antibody (anti-H4 / ICOS), referred to herein as "parental hamster antibody" or "C398.4A" antibody, was obtained from BioLegend®. The C398.4A antibody was sequenced using mass spectrometry. Specifically, C398.4A was denatured in 5.3 M guanidine HCl, reduced with dithiothreitol (40 mM) and alkylated with iodoacetamide (80 mM). After desalting with a 6 kDa MW Zeba desalination column, the antibody was enzymatically digested with trypsin, chymotrypsin, pepsin, Lys-C, AspN or GluC and analyzed by mass spectrometry. Peptide mapping and MS / MS were used to identify the resulting peptides and confirm the amino acid sequence. The intact heavy and light chain masses were generated by cleaving the glycan with PNGaseF, reducing the antibody with dithiothreitol and alkylating with iodoacetic acid. The resulting antibody chains were analyzed by LC-MS.
[00420] [00420] The resulting peptide fragmentation data was aligned with a custom protein database consisting of three light chain and heavy chain antibody sequences for Cricetulus migratorius present on GenBank along with antibody sequences determined internally via RNA sequencing monoclonal antibodies derived from armenian hamsters. A search in the database identified the GenBank CMU17870 sequence locus (Access U17870) as similar to the C398.4A light chain. The amino acid substitutions in CDR3 and the framework region were observed in the C398.4A sequence when compared to the CMU17870 light chain sequence. The database search identified the gene locus of the GenBank sequence, CMU17166 (Access U17166) as similar to the heavy chain variable region C398.4A. Region J coincides with an internally identified hamster sequence HA-VH-7. The heavy chain constant region coincided with the same isotype as the HL4E10 antibody (Accession HM369133). Region D was determined to be new and was identified by resequencing the peptide fragmentation data. The amino acid substitutions in CDR1, CDR2, CDR3 and the variable structure region were observed when compared to the CMU17166 and HA-VH-7 heavy chain sequences. Generation and Evaluation of ICOS.4 Chimeric Antibody Based on C398.4A Antibody
[00421] [00421] The protein sequence of the C398.4A antibody was again translated into the cDNA sequence. The isoleucine / leucine residue (I / L) at position 96 in region D (CDRH3) was expressed with isoleucine or leucine at this position. The variable regions were cloned into expression vectors containing a signal sequence and constant regions of human IgG1f, and transfected into CHO-S cells for the expression of the chimeric human antibody, ICOS.4. The chimeric antibodies were purified using 2 L of supernatant, each using 250 mL of Protein A column in AKTA Avant and were analyzed for activity in the CHO-OKT3-CD32a / CD25-CD4 + T cell assay. The CHO-OKT3-CD32a / CD25-CD4 + T cell assay was a coculture of irradiated (growth stopped) CHO cells transfected with a low level of single chain CD3 (OKT3 clone) and a higher level of CD32A (to bind the cross-antibody) with CD25 + depleted CD25 + T cells in a 1: 4 CHO: T cell ratio. The CHO cell line was grown in shaking flasks and irradiated on the day of the assay assembly. T cells were selected from a fresh leukocyte layer (Stanford Blood Bank) using the CD4 + RosetteSep T cell isolation kit (Catalog 15062) followed by depletion of CD25 + cells using the Miltenyi® CD25 microcounts (Catalog 130-092-983 ), following the instructions in the AutoMACS® exhaust kit.
[00422] [00422] The ICOS antibody or isotype control was titrated from 5 µg / mL by 5 serial dilutions, with each condition established in triplicate. Cultures were prepared in 96-well Costar® plates treated with flat-base CT with 5x104 T cells and 1.25x104 CHO cells in 200 µL of complete medium (RPMI-1640 (Corning®, Catalog 10-040-CM) + serum 10% fetal bovine (FBS) (Gibco®, Catalog 25140) + 1x Pen Strep (Corning Catalog 30-002-CL) + 10 mM HEPES (Corning Catalog 25-000-CL) + 1 mM sodium pyruvate ( Corning Catalog 25-000Cl) + 1xMEM (Corning Catalog 25030-
[00423] [00423] Culture supernatants (50 µL / well) were collected on Day 3 for analysis of interferon-gamma concentrations using homogeneous time resolved fluorescence assay (HTRF) (Cisbio®), reading using the Rubystar microplate reader ® and calculating the concentrations of a standard curve using the Softmax Pro® software. The ICOS.4 antibody was tested in a functional T cell assay using CHO-OKT3-CD32 and CD4 + CD25-T cells with the titrated antibody to compare the relative levels of dose-dependent costimulation when measured by gamma-interferon secretion. . ICOS.4 exhibited an EC50 value of 0.018 µg / mL. Isotype Selection
[00424] [00424] The selection of isotypes for therapeutic antibodies of immuno-oncology and, specifically, for agonist targets, is influenced by two different considerations downstream of binding to FcRs. As detailed by Ravetch and colleagues (Li and Ravetch, Science 2011; 333: 1030-4; Otten et al., J Immunol. 2008; 181: 6829-36), antibody binding to activation receptors can lead to mediated cytotoxicity by antibody dependent cell (ADCC) or antibody dependent cell phagocytosis (ADCP) from cells expressing the target. On the other hand, the binding of antibodies preferably to the inhibitory FcR can mediate multivalent crosslinking of the receptor and agonist signaling. Since ICOS can be highly expressed in CD8 + and CD4 + Teffs in the tumor microenvironment, the use of an isotype that can mediate ADCC or ADCP was considered a less attractive option. The in vitro ADCC activity of anti-ICOS antibodies also suggested that anti-ICOS antibodies were highly competent in mediating ADCC and supported the idea that ADCC-inducing isotypes should be avoided. Antibodies that increase the affinity of human IgG1 to CD32B were instead considered as alternative isotypes. The considered isotypes were the S267E mutation of IgG1, SELF mutations and V12 mutations of human IgG1, as shown in Table 3 above. All mutations increase affinity for CD32B and varying degrees CD32A, while decreasing affinity for CD16 (as shown in Table 9). This decrease was predicted to reduce ADCC activity, since it is the FcR that probably mediates the depletion of T cells in the tumor. Table 9 - Comparison of the binding properties of wild-type and S267E variant of human IgG1 (µM Kd) Protein IgG1f IgG1f-S267E CD16-V 97 950 CD16-F 200> 5000 CD32A-H131 530 650 CD32A-R131 960 31 CD32B 3400 87 CD64 0.2 0.2 C1q + ++
[00425] [00425] Activity in vitro in the SEB assay using CD4 + T cells and B cells showed superior activity of IgG1f S267E antibody compared to Human IgG1 and other isotypes, as described above. Based on the data from these functional experiments, IgG1f S267E was chosen as the inducer antibody. A complication in the choice of IgG1f S267E was that this isotype binds to the complement C1q with greater affinity than human IgG1, which represented a possible increase in the risk of complement-dependent cytolysis (CDC). Surprisingly, IgG1f S267E had no greater CDC activity compared to Human IgG1 in an in vitro test. Therefore, the S267E mutation did not result in an increased risk of CDC.
[00426] [00426] The ICOS.4 antibody was humanized by grafting hamster CDR into human germline genes (Figure 3), VH3-15 was selected for the heavy chain and VKI O18 was selected for the light chain based on homology of the structural sequence. The human germline FW4, JK3, was also selected for the light chain based on sequence homology. The human germline FW4, JH4, was selected for the heavy chain based on sequence similarity, and did not contain residues that could represent a potential liability risk. A panel of 26 antibodies was evaluated in the CHO-OKT3- CD32A / CD4 + CD25-T cell assay, with a range of antibodies to 0.2 µg / mL and titrated by four dilutions, to identify humanized sequences that retain similar binding to the parent hamster antibody (C398.4A, i.e., the parent hamster antibody having heavy region and light chain sequences with SEQ ID NOs: 3 and 4, respectively).
[00427] [00427] An amino acid residue substitution (T94A) has been identified to restore the binding of the grafted antibody with humanized CDR, and is located at the junction of FR3 and CDRH3. In addition, three chimeric antibodies with mutations of responsibility in the D56, G57 sequence were also evaluated to see if the potential isomerization site in the VL could be removed without affecting activity. The substitution of residues D56E was selected to eliminate the potential isomerization site (D56, G57) in the light chain and incorporated in the humanized sequence. Humanized antibodies were analyzed with the IgG1f isotype, however, the IC26.3 IgG1f S267E was re-expressed using the IgG1f S267E isotype. A description of the generated antibodies is provided in Table 10 below.
[00428] [00428] A set of four humanized antibodies based on C398.4A was tested in the functional CHO-OKT3-CD32a / CD4 + CD25-T cell assay, compared to the original chimeric hamster antibody, as described below in Example 3. IC26.3 IgG1f S267E was selected for further characterization and development. The heavy and light chain variable region sequences for IC26.3 IgG1f S267E are shown in SEQ ID NOs: 5 and 6, respectively, and in Figure 4 EXAMPLE 3 Antibody selection CHO-scFv-CD3-CD32A cell assay / T CD25-CD4 +
[00429] [00429] The initial functional assay evaluation was performed using CHO cells that express the anti-CD3 single-chain variable (scFv) fragment (OKT3) and human CD32A to stimulate primary human T cells. This assay was a co-culture of irradiated (growth-interrupted) CHO cells transfected with a low level of single-chain variable fragment CD3 (OKT3 clone) and a higher level of CD32A (for antibody cross-linking) with depleted CD4 + T cells. CD25 in a 1: 4 CHO: T cell ratio. The CHO cell line was grown in shaking flasks and irradiated on the day of the assay assembly. T cells were selected from fresh leukocyte layers (Stanford Blood Bank) using the CD4 + RosetteSep T cell isolation kit. The CD25 + cells were depleted using Miltenyi CD25 microcounts, following the instructions in the kit for exhaustion in AutoMACS.
[00430] [00430] ICOS antibody or isotype control (ie antibody of the same isotype as the ICOS antibody, but which does not bind to any naturally occurring human protein, for example, antibodies against keyhole keyhole limpet (KLH) , diphtheria toxin, among others) was titrated to 2 µg / mL by five serial dilutions, with each condition configured in triplicate using T cells from two donors. Cultures were prepared in 96-well plates treated with flat-base TC (Costar) with 5 x 104 T cells and 1.25 x 104 CHO cells in 200 µL of complete medium per well and incubated for three days at 37 ° C and 5% CO2
[00431] [00431] Culture supernatants (50 µL / well) were collected on Day 3 for analysis of interferon-gamma (IFN-) concentrations using the homogeneous time resolved fluorescence assay (HTRF) (Cisbio). The concentrations were determined using the Rubystar microplate reader and calculated from a standard curve using the Softmax Pro software. The plates were then pulsed with 0.5 µCi of tritiated thymidine per well for eight hours and frozen. The cells were harvested on filter plates (Perkin Elmer) for analysis of the incorporation of tritiated thymidine to assess proliferation.
[00432] [00432] The CD32A of FcR allowed cross-linking of antibodies, regardless of the antibody's Fc subtype. This cross-linking allowed the co-stimulation of T cells through ICOS agonism, resulting in enhanced proliferation and cytokine release compared to cells treated with isotype control. This activity was observed in CD8 +, CD4 + and CD25-CD4 + T cells. Due to the superior signal-to-noise in the depleted CD25-CD4 + T cell assay, these cells were used for hybridoma analysis. The best performing antibodies were selected for subcloning, purification and further characterization. Parental hamster monoclonal antibody was included in the antibody panel analysis. As described above, activity in the CHO-CD3-CD32 assay was used to select a lead panel of antibodies, which were re-expressed as human IgG1 antibodies or other modified versions of human IgG1. ICOS.33 IgG1f S267E exhibited dose-dependent induction of IFN- sec secretion and proliferation in the CHO-scFv-CD3-CD32A / T CD25-CD4 + cell assay, as shown in Figure 5. The mean EC50 of this effect was 0.083 nM (± 0.067, n = 6) for proliferation and 0.083 nM (± 0.074, n = 6) for IFN- induction. The proliferation induction ranged from 2 to 5 times in the three highest concentrations tested in a total of 6 donors, while IFN- induction ranged from 2 to 9 times in the same experiments compared to the control. Previous experiments using CHO-scFv-CD3 (no CD32A) confirmed that cross-linking is required for the agonistic activity of all tested ICOS antibodies. CD25-CD4 + T cell and B-SEB cell assay
[00433] [00433] New characterization of the functional activity of anti-ICOS antibodies was performed using Staphylococcal Enterotoxin B (SEB) as a T cell receptor (TCR) stimulus and the addition of anti-ICOS antibodies to test co-stimulation. When human peripheral blood cells (PBMC) were used in the assay, anti-ICOS antibodies showed no functional activity. However, when CD4 + T cells (total or depleted CD25 + T cells from CD25) were used in conjunction with purified B cells, anti-ICOS antibodies showed enhanced interferon-gamma (IFN-) secretion compared to control antibodies.
[00434] [00434] This assay involved coculture of autologous CD25-CD4 + T cells and B cells. SEB was added to a fixed final concentration of 85 ng / mL to provide submaximal stimulation, and the ICOS antibody was titrated to show a costimulation effect dose dependent. The purpose of this assay was to measure the ability of ICOS antibodies to enhance T cell activation in the context of a primary activation signal (SEB + B cells), as evidenced by the levels of IFN- induction. It is beneficial to induce higher levels of IFN-, because it is a measure of T cell activation that reflects the potency of the different antibodies that exhibit ICOS receptor agonism and IFN- is a known mediator of antitumor immunity.
[00435] [00435] T cells were isolated by positive selection from two fresh leukocyte layers, followed by detachment of beads to generate unhandled CD4 + T cells (Invitrogen). CD25 + cells were then depleted of CD4 + T cells using CD25 microcounts (Miltenyi), following the instructions in the kit for exhaustion using AutoMACS. The negative fractions from the CD4 isolations were then used to isolate autologous B cells using Miltenyi CD20 beads, following the kit instructions for positive selection using AutoMACS.
[00436] [00436] T cells were seeded in 96-well flat-treated CT culture plates at 5 x 104 cells / well with autologous B cells at 3 to 5x104 cells / well (depending on the yield of each donor) with SEB included to a final concentration of 85 ng / mL. The ICOS antibody or isotype control was titrated from 5 µg / mL in 5 serial dilutions for a total of seven points, each tested in triplicate. The assay was established in a complete medium with 200 µL / well of final volume. The plates were incubated for 3 days at 37 ° C and 5% CO2.
[00437] [00437] Culture supernatants (50 µL / well) were collected on Day 3 for analysis of IFN- concentrations using the HTRF assay (Cisbio). The concentrations were determined using the Rubystar microplate reader and calculated from a standard curve using the Softmax Pro software.
[00438] [00438] SEB co-culture experiments compared the production of IFN- for anti-ICOS antibodies, ICOS.33 IgG1f, IC26.3 IgG1f S267E, 9D5 IgG1f, 9D5 IgG1f S267E, 2644 IgG1f S267E, and Ig1f control control control KLH antibody (Figure 6). The humanized lead antibody ICOS.33 with the S267E mutation (ICOS.33 IgG 1f S267E, as depicted in the complete descending triangle in Figure 6) induced higher levels of IFN- than the same antibody with the wild type Fc (ICOS .33 IgG1f). The other comparator antibodies tested, that is, 95D IgG1f, 9D5 IgG1f S267E and 2644 IgG1, also exhibited less activity than IC26.3 IgG1f S267E. The KLH control Ig 1f showed no activity. The ICOS.33 IgG 1f IgG1f antibody increased IFN- production up to 2.3 times compared to the control antibody in a dose-dependent manner in CD25-CD4 + and B T cell cultures stimulated by a sub-ideal dose of SEB. A total of 20 donors were tested using this assay, all showing the highest S267E agonist activity of IgG1f from ICOS.33, with an EC50 of 0.020 nM (± 0.018).
[00439] [00439] The activity of ICOS antibodies in follicular helper T cells (Tfhs) was tested in this way. In comparison with the control antibody 1D12, enhanced secretion of IL-10 was observed after the addition of anti-ICOS antibodies 9D5 and ICOS.4. Tfh cells were classified as PBMCs after enrichment by selection of CD4 (Invitrogen kit) by staining cells enriched with CD4 to CD4, CD14, CXCR5, CD45RA and CD123 and classification for Tfh cells (CD4 + CXCR5 + CD45RA-CD123-CD14-) using the Aria II FACS. Naïve B cells were isolated from the CD4 negative fraction using the Miltenyi kit. Tfh and naïve B cells were co-cultured in 96-well flat-based CT plates with 5 and 4 cells / well each and stimulated with SEB for 2 days when IL-10 and IFN were measured by ELISA (BD) and showed enhanced by ICOS antibodies. This enhanced cytokine secretion did not require an exogenous cross-linking agent and can be enhanced by including the S267E mutation to Human IgG1 (Figures 7A and 7B).
[00440] [00440] IC26.3 IgG1f S267E was selected for further development due to its ability to stimulate IFN- production in the CHO FcR assay and induce cell proliferation (Figure 5), as well as its greater functional activity in the assay of SEB compared to the other anti-ICOS antibodies tested (Figure 6).
[00441] [00441] The purpose of this study was to determine the effect of IC26.3 IgG1f S267E on the effector T cell proliferation (Teff) and on Treg-mediated suppression.
[00442] [00442] U-base plates were coated for three hours at 37 ° C with anti-CD3 (3 µg / ml) in combination with ICOS.33 IgG1f S267E (10 µg / ml) or anti-KLH, a isotype control that does not bind to the ICOS protein (10 µg / mL) in PBS. CD4 + T cells were isolated from fresh whole leukocyte layers using RosetteSep CD4 + T cell enrichment cocktail in conjunction with Ficoll-Paque separation, following the manufacturer's RosetteSep instructions. Enriched CD4 + T cells were stained with fluorophore-conjugated monoclonal antibodies directed against CD4, CD25, CD127, CD45RA and CD45RO in FACS classification buffer. The CD4 + T cells were then selected from Teff cell populations (CD4 + CD25loCD127hi), RA + Treg (CD4 + CD25hiCD127lo / CD45RA + / CD45RO-) and RO + Treg (CD4 + CD25hiCD127lo / CD45RA- / CD45RO +) using a FACSAria II cell classifier. The classified Tregs were marked with CellTrace ™ Violet proliferation dye (CTV) according to the manufacturer's instructions at a concentration of 5 µM. The classified Teffs were marked with the CellTrace CFSE ™ (CFSE) proliferation dye according to the manufacturer's instructions, except that they were used at a greater dilution of 1.25 µM to reduce the cytotoxic effects seen in previous experiments.
[00443] [00443] Fifty thousand CFSE-labeled Teffs and classified in 100 µL of complete medium were added to each well of the 96-well plate coated with ICOS.33 IgG1f anti-CD3 and S267E or isotype control. These were prepared with or without anti-CD28 added at 2 µg / ml (for a final concentration of 1 µg / ml). The titration numbers of Tregs marked with CTV and classified in 100 µL of complete medium were then added to each cvidde starting with 5x104 Tregs (1: 1 Treg for Teff) and reducing twice in subsequent wells (1: 2, 1: 4, etc.).
[00444] [00444] Cultures were incubated for six days at 37 ° C when cells were stained with fixable viability dye Ghost Red-780 to exclude dead cells. Flow cytometry data was collected using a BD FACSCanto II flow cytometer. The percentage of Teff proliferation was determined using FACSDiva flow cytometric analysis software. The percentage of Teffs proliferation was determined by blocking Teffs that had diluted their CellTrace CFSE proliferation dye after at least one division cycle.
[00445] [00445] This example showed that the IC26.3 IgG1f S267E both reversed Treg-mediated suppression and enhanced Teff proliferation, as shown in Figures 8A and 8B. The values shown in the legend in Figures 8A and 8B are the Teff: Teg ratios. Thus, a value of 1 means a ratio of 1 Teff to 1 Treg, a value of 2 means 2 Teff to 1 Treg and so on, essentially titling the Tregs. In the 1: 1 ratio, the IC26.3 IgG1f S267E showed an approximately 4-fold increase in proliferation and an evident reversal of RA + Treg-mediated suppression. A 7-fold increase in proliferation and an evident reversal of suppression mediated by RO + Treg was also observed, measured by the difference in percentage of Teff division between the isotype control and the ICOS antibody. As the Tregs were titrated, there was a proportional decrease in evident suppression and in the absence of Treg there was an increase of approximately 1.5 times in the percentage of
[00446] [00446] The purpose of this study was to evaluate the antibody-dependent cellular cytotoxicity (ADCC) and the C1q factor binding activities of the IC26.3 IgG1f complement of S267E. Target Cell Marking with Calcein AM
[00447] [00447] CD4 + T cells from Donor 2 (Stanford Blood ID W0 70516511239) were isolated, activated and labeled with Calcein AM. In synthesis, peripheral blood mononuclear cells (PBMC) were purified from heparinized leukocyte layer by density gradient centrifugation and washed with phosphate buffered saline (PBS) supplemented with 2% FBS (HyClone). CD4 + T cells were isolated by negative selection using a magnetic bead-based separation kit (StemCell Technologies) and an automated RoboSep cell separator (StemCell Technologies). From the isolation of CD4 + T cells, CD25 + Tregs were depleted using a separation kit based on magnetic beads (Miltenyi Biotec). Purified CD4 + T cells were resuspended at 2.5 x 106 cells / mL in R10 medium and activated with the T Cell Activation / Expansion kit (Miltenyi Biotec) in a two-cell bead for three days at 37 ° C. On day 3, cells were counted, pelleted, and resuspended at 1 x 106 cells / ml in PBS in a 15 ml conical tube. Calcein reagent AM was prepared by adding 20 µL of ultrapure DMSO to the reagent tube containing 50 µg of lyophilized reagent. A volume of 2 µL of reconstituted Calcein AM was added to suspended cells for each 1 mL of volume. The cells were centrifuged and placed in an incubator at 37 ° C for 30 minutes. After the incubation period, the labeled target cells were washed three times with ADCC assay medium, and their concentration was adjusted to 105 cells / ml in assay medium. Antibody-Dependent Cell Cytotoxicity (Adcc) Assay With Cd4 + T Cells Activated As Targets
[00448] [00448] Primary human NK effector cells were purified from fresh PBMC from two different donors (DDC Donors 9 and 12) and stimulated with IL-2. In summary, PBMCs were purified from heparinized whole blood samples by density gradient centrifugation and washed with PBS supplemented with 2% FBS (HyClone). NK cells were isolated from PBMC by negative selection using a separation kit based on a magnetic bill (Miltenyi Biotech) and an autoMACs Separator (Miltenyi Biotech). Purified NK cells were resuspended at 1x106 cells / ml in MyeloCult medium supplemented with 500 IU / ml IL-2 and incubated overnight at 37 ° C.
[00449] [00449] The following day, activated NK effector cells were washed twice in assay medium and their concentration was adjusted to 4.33-5x105 cells / mL in assay medium. Labeled target cells (50 µL / well) were added to a 96-well U-based plate containing 50 µL / well of test or control antibody. Activated NK effector cells were then added (100 µL / well) to result in a final effector cell to target cell (E: T) ratio of 10: 1 and a final antibody concentration ranging from 0.0002 µg / mL to 1 µg / mL. The plate was then placed in a humidified 37 ° C incubator for two hours. The supernatant (50 µL / well) was transferred to a 96-well optical black optical plate, and the fluorescence intensity was read on an EnVision plate reader defined for 485 excitation and 535 emission filters.
[00450] [00450] Target cells incubated with effector cells in the absence of antibody enabled control for antibody-independent lysis base (spontaneous lysis), while target cells lysed with 20 µL or 100 µL / well of Delfia Lysis buffer represented maximum release in the test.
[00451] [00451] The percentage of antibody-dependent cell lysis was calculated based on the mean fluorescence intensity (MFI) with the following formula:
[00452] [00452] Percentage of target cell lysis was plotted for each antibody using GraphPad Inc.'s Prism v5.01 software ADCC Results of Primary NK with Target Activated CD4 + T Cells
[00453] [00453] The anti-ICOS S267E IgG1f antibody from ICOS.33 was tested for its ability to induce ADCC from CD4 + T cells expressing ICOS as targets and compared to ICOS.33 IgG1 ADCC. Two experiments were performed with donors of target cell donor and NK cell. In each case, IC26.3 IgG1f S267E with the modified IgG1 isotype induced less activated CD4 + T cell ADCC than ICOS.33 IgG1. The data from these experiments are summarized in Table 11 and Figures 9A and 9B.
[00454] [00454] The binding of IC26.3 IgG1f S267E to human C1q was investigated by ELISA. All antibodies were coated on a high-binding immunoassay plate at 10 µg / mL in PBS at 50 µL per well. A non-specific binding control with wells coated with PBS only was included. The plate was incubated overnight at 4 ° C. The next day, the plate and all reagents were equilibrated at room temperature; all subsequent steps were performed at room temperature. Unoccupied protein binding sites were blocked with SmartBlock® at 200 µL per well for 30 minutes. The plate was washed 3 times with washing solution (PBS + 0.05% Tween-20) at 200 µL / well. Gradual doses of human C1q (48.00 to 0.76 µM) in ELISA assay buffer were added at 50 µL / well. The plate was incubated for two hours and washed three times with washing solution. The binding of human C1q to immobilized antibodies was detected by a biotinylated mouse anti-C1q mAb diluted 1: 1000 in ELISA assay buffer and incubated for one hour. After the plate was washed three times, streptavidin-poly-HRP, diluted 1: 5000 in conjugated buffer, was added to 50 µl / well and incubated for 30 minutes. A final washing step was completed, and the plate was developed with TMB substrate at 50 µL / well for 5 minutes. The optical density was read at 650 nm on the SpectraMax 340PC384 Microplate Reader (Molecular Device). The data were plotted using Prism, version
[00455] [00455] The anti-ICOS S267E IgG1f antibody from ICOS.33 was tested for its ability to bind to the human complement component C1q compared to ICOS.33 IgG1 in an ELISA assay. ICOS.33 IgG1f S267E has been found to bind to human C1q with higher affinity than ICOS.33 IgG1. The data are summarized in Figure 10 and Table 12. Table 12 IC26.3 IgG1f S267E of Human C1q Alloy. =,
[00456] [00456] IgG1f S267E from ICOS.33 with a modified IgG1 induced less ADCC mediated death of CD4 + T cells expressing ICOS, however bound with greater affinity to human C1q than an anti-ICOS antibody with wild-type IgG1. EXAMPLE 6 Antitumor Activity in vivo Antitumor Activity of ICOS Anti-Mouse as Monotherapy or Combined with Other Agents
[00457] [00457] Variations in the isotype of antibodies that are specific for T cell surface receptors (both co-stimulatory and co-inhibitory) can alter antitumor activity. The mouse Fc isotype variants of both 17G9 and ICOS.4 were generated and expressed as mouse IgG2a isotypes. Both showed superior antitumor activity compared to mouse IgG1 variants, as described below. Although not linked to any theory, this was probably due to the depletion of regulatory T cells (Tregs) at the tumor site, as well as the expansion of effector T cells (Teff) from ICOS antibody-mediated agonism. Studies of mice with 17G9 Ab have also shown under-regulation of the ICOS receptor in populations of T cells in both the spleen and the tumor. It was observed that the expression of ICOS is lower in mice treated with Ab isotypes involving FcR (mIgG1 and mIgG2a), while the receptor levels were unchanged in the mice treated with an Ab without FcR binding (mIgG1 D265A, also referred to as "ICOS.1 D265A"). The dependence on interaction with FcR suggested that crosslinking is necessary for this sub-regulation. It is important to note that antitumor activity has been demonstrated even though the receptor has been under-regulated.
[00458] [00458] Variants of mouse IgG1 from both 17G9 (ICOS.1)
[00459] [00459] To determine whether Human IgG1 S267E behaves similarly to mouse IgG1 antibodies, but with more potency with respect to the binding of FcR to CD32, and the involvement of the agonist receptor, additional model experiments were performed tumor. Specifically, to evaluate variants of the anti-human ICOS isotype in transgenic mice of the human Fc receptor (FcR), the following antibodies were constructed:
[00460] [00460] hIgG1 Anti-ICOS - Monoclonal antibody to mouse ICOS, hamster / chimeric mouse anti-ICOS, IgG1 isotype (ICOS.4 hg1);
[00461] [00461] Anti-ICOS hIgG1 SE - monoclonal antibody to mouse ICOS, hamster / chimeric mouse anti-ICOS, IgG1 SE isotype (ICOS.4 hg1 SE), which has a mutation that allows it to bind to CD32R and CD32B better than the unmodified version; and
[00462] [00462] IgG1 isotype control - a fully human IgG1 isotype control (DT-1D12 hg1).
[00463] [00463] MC38 murine colon carcinoma cells were implanted subcutaneously on the right flanks of the mice. The mice were divided into three treatment groups and dosed with 60 µg of (1) anti-ICOS IgG1 or (2) anti-ICOS IgG1 SE or (3) IgG1 isotype control antibody (that is, antibody of the same isotype than the ICOS antibody, however it does not bind to any naturally occurring murine protein, for example, antibodies against KLH, diphtheria toxin, among others) on Days 7, 10 and 14 after implantation. Body weight and tumor size were measured twice a week until the study was completed on Day 52. If the tumors were ≥ 2000 mm3 or appeared to be ulcerated, the animal was euthanized. Enhancement of antitumor activity was observed with treatment with anti-ICOS IgG1 SE mAb at 60 µg per mouse; the mean inhibition of tumor growth (TGI) was 76% compared to 63% for anti-ICOS IgG1 without SE modification, as shown in Table 14 and Figures 11A-C. No significant changes in body weight were associated with the treatments, nor were any evident signs of clinical toxicity observed. Results
[00464] [00464] In the human FcR transgenic mouse model, administration of ICOS IgG1 SE and ICOS IgG1 mAbs resulted in 76% and 63% mean tumor growth inhibition (TGI), respectively (as shown in Table 14 ). Five complete regressions were observed in each group at the dose level (60 µg / mouse) tested (Tables 14 and Figures 11A-C). No physical signs of toxicity or loss of body weight were observed.
[00465] [00465] In a study of Ravetch's syngeneic tumor model (summarized in Table 15), both anti-ICOS monotherapies promoted modest anti-tumor activity, with anti-ICOS IgG1 SE demonstrating slightly greater efficacy on day 30 (76% vs. 63 % of mean TGI) (Table 14). No significant changes in body weight were associated with the treatments, nor were any evident signs of clinical toxicity observed. Overall, anti-ICOS monotherapies promoted anti-tumor activity, with anti-ICOS IgG1 SE showing slightly greater efficacy on day 30 (76% vs. 63% of mean TGI). Both treatments resulted in five mice that got rid of their tumor. No significant changes in body weight were associated with the treatments, nor were any evident signs of clinical toxicity observed. Table 15 - In vivo Pharmacology Studies Type of Schedule / Route / Duration of the Animal Range per Study / Species / Study / Vehicle / Doses Group (M / F) Cepe Formulation (g / camundo ngo) Activity Antibodies administered IP after 60 9 per group; Antitumor implant on Days 7, 10, and 14 g / mouse Cohorts of tumor model the mixed gender Isotype control of human IgG1 MC38 / mouse C57 / B6 Anti-ICOS.4 hg1 Transgenic Anti-ICOS.4 hg1 SE Human FcyR EXAMPLE 7 Sa1N tumor model
[00466] [00466] The mouse model with Sa1N fibrosarcoma was used to evaluate the anti-tumor activity of chimeric anti-ICOS monoclonal antibodies. The ICOS.4 mIgG1 is a good substitute for the ICOS.33 IgG1s S267E, because this ICOS.4 variant binds preferentially to the mouse inhibitory Fc receptor. Since the tumor model is performed on a mouse Fc receptor expressing mouse, this makes the ICOS.4 variant a good substitute for the human antibody. The ICOS.4 mIgG2a variant is a good substitute for the ICOS.33 IgG1 antibody, because this variant
[00467] [00467] To assess antitumor activity in the Sa1N fibrosarcoma model after treatment with substitute chimeric anti-ICOS monoclonal antibodies, Sa1N cells were implanted subcutaneously on the right flanks of mice. Mice received doses of mAb in five treatment groups on days 7, 10 and 14 after implantation: Chimeric murine anti-ICOS.1 IgG1 (mIgG1) chimera, anti-ICOS.4 mIgG1.4 hIgG1 anti-ICOS.4, mIgG2a anti-ICOS.4, or IgG1 isotype control, each at 10 mg / kg.
[00468] [00468] On day 15, the tumor and spleen were harvested from four mice per group for immunomonitoring analysis. In the remaining mice, body weight and tumor size were measured twice a week until the end of the study on Day
[00469] [00469] On the 23rd day after implantation, the last day on which the median tumor growth inhibition (TGI) could be calculated based on 60% of the animals in the treatment group that remained alive, the effectiveness of treating the anti isotypes -ICOS in Sa1N tumors was evident when compared to the control treatment isotype. The median TGI values were 21% (IC26 MIgG1 D265A), 55% (ICOS.4 mIgG1), 69% (ICOS.4 hIgG1) and 84% (ICOS.4 mIgG2a). No toxicity was evident in any treatment group, as demonstrated by mean and median losses of body weight below 20%.
[00470] [00470] Immunological monitoring data indicated varying levels of intratumoral Treg depletion in all anti-ICOS isotypes. In addition, high levels of intratumoral CD8 + T cells were observed in all treatments with anti-mICOS.4.
[00471] [00471] Tumor responses were partly correlated with the reduction in Treg on Day 15, which agrees with the relative binding of these mAbs to Fc receptors. These data suggested that an anti-ICOS mAb that reduced Tregs would be more potent than one that did not. Antitumor Treatment
[00472] [00472] On the 7th day after implantation (February 2, 2015), 70 mice were randomized to five groups of 14 rats according to the tumor volume (LxWxH / 2). The average tumor volumes were approximately 134 mm3 for each group. On days 7, 10 and 14, the isotype control or the designated mAb was administered. The mice were dosed intraperitoneally (IP). Immuno-Monitoring of T Cell Populations
[00473] [00473] To also study antitumor activity at the cellular level, immunomonitoring was performed to examine subsets of immune cells at tumor sites and to determine whether there is a link between antibody treatment and changes in lymphoid cell populations. On day 15, four mice from each treatment group were collected by the operator of the animal facility for tumors and spleens. The tissues were first processed in a gentleMACS Octo Dissociator® (Miltenyi, San Diego, CA) and then stained for different T cell markers. The samples were analyzed by flow cytometry on the Fortessa cytometer (BD Biosciences, San Jose, CA ). Post-treatment monitoring
[00474] [00474] The tumors and body weights of the mice were measured twice a week until the end of the study. Tumors were measured in three dimensions with an electronic digital caliper, and data were electronically recorded using Studylog Systems StudyDirector software (South San Francisco, CA). Mice were checked daily for postural changes, personal and respiratory care, as well as lethargy. The mice were euthanized when the tumors reached the 2000 mm3 endpoint or appeared ulcerated. Results Tumor response
[00475] [00475] The last day on which all mice in the study were alive was the 14th day after implantation, the last day of IP dosing. As a result, mean tumor growth inhibition (TGI) could not be calculated. On the 23rd day after implantation, the last day on which the median TGI could be calculated, the efficacy of treating anti-ICOS isotypes in Sa1N tumors was evident when compared to the isotype control treatment. The median TGI values were 21% (IC26 MIgG1 D265A), 55% (ICOS.4 mIgG1), 69% (ICOS.4 hIgG1) and 84% (ICOS.4 mIgG2a).
[00476] [00476] Tumor growth curves by treatment group are shown in Figure 12A-E. TGI is summarized by treatment group in Table 16. The mean and median tumor growth curves by treatment group are shown in Figures 13A and 13B.
[00477] [00477] Differences in efficacy between anti-ICOS isotypes demonstrated a hierarchy of D265A from mIgG2a> hIgG1> mIgG1> mIgG1. The D265A variant of inert mIgG1, which cannot bind FcR, exhibited some antitumor activity with a median 21% TGI on day 23. The unmodified mIgG1 isotype, which may involve the inhibitory Fc receptor, FcRIIB, may potentiate agonism and in this study showed 55% median TGI on day 23. Consistent with their higher TGI values, the mIgG2a and hIgG1 isotypes can bind murine activation receptors and mediate ADCC or antibody-dependent cell phagocytosis (ADCP) of Tregs that express ICOS. In addition, reduced levels of intratumoral Tregs have been associated with increased tumor regression in mouse tumor models. No toxicity was evident in any treatment group, since the mean and median changes in body weight were below 20%.
[00478] [00478] Treg depletion was observed on Day 15 in groups treated with anti-ICOS mAb mIgG2a and hIgG1 variants.4, as the percentages of Foxp3 + cells were significantly lower in these groups than in the isotype control group , as shown in Figure 14A-D. The same trend was also observed in the group treated with the anti-depleting anti-ICOS antibody (mIgG1). In addition, the increase in CD4 + effector T cells (Teffs) was evident in all treatment groups with the following classification: mIgG1> hIgG1> mIgG2a. This observation suggested that some CD4 + Teffs, which are probably ICOS +, may have been depleted by the mIgG2a isotype, which has the greatest potential for depletion. Elevated levels of intratumoral CD8 + T cells were also observed in all treatments with anti-mICOS.4. Conclusion
[00479] [00479] As summarized in Table 17, in a staged singenic tumor model Sa1N, the chimeric anti-ICOS isotypes promoted varying levels of antitumor activity, ranging from 21% to 84% median TGI on day 23. The antitumor potencies of the variants of isotype in this study were classified as follows: D265A of mIgG2a> hIgG1> mIgG1> mIgG1. Tumor responses were partly correlated with Treg depletion on Day 15, which agrees with the relative binding of these mAbs to Fc receptors.
[00480] [00480] The results of this study showed that the choice of the isotype is an important determinant of treatment with anti-ICOS antibody. The anti-ICOS mIgG2a isotype, which binds to activating Fc receptors equivalent to the Human IgG1 isotype, was able to deplete intratumoral Tregs and showed the greatest effectiveness in inhibiting tumor growth. Variants of the chimeric anti-ICOS isotype promoted varying levels of antitumor activity. Tumor responses were partly correlated with Treg depletion on day 15, according to the relative binding of these mAbs to Fc receptors. Results suggested that mg2a promoted the best antitumor activity. Table 17 - In vivo Pharmacology Studies Type of Schedule / Route / Duration of the Animal Range Study / Species / Strain Study / Vehicle / Doses by Formulation Group (g / camun- (M / F) dongo) Antitumor Activity of Antibodies administered IP after 10 mg / kg 14 by anti-ICOS implant variants on Days 7, 10, and 14; group; P isotype in the Sa1N Tumor Isotype Control Mouse with IgG1, ICOS.1 mIgG1 Anti-D265A immunomonitoring, immune cell subsets / anti-ICOS.4 A / J mIgG1 mice, ICOS.4 anti-hIgG1. , Anti-ICOS.4 mIgG2a EXAMPLE 8 Combination of Anti-ICOS Antibodies with an Anti-PD-1 Antibody Study 1
[00481] [00481] To assess antitumor activity in the CT26 colorectal carcinoma model after treatment with a substituted anti-ICOS monoclonal antibody, ICOS.4 (mouse IgG1 variant of the parental hamster antibody), in varying doses and / or anti mAb -PD-1, CT26 cells were implanted subcutaneously on the right flanks of mice. When the tumors reached 31 mm3, the mice were randomized into nine treatment groups of 10 to 14 mice each. Each mouse was dosed on Days 7, 10 and 14 after implantation with mAb or an isotype control (ie, an antibody of the same isotype, but which does not bind to any naturally occurring mouse proteins, for example, antibodies against KLH, diphtheria toxin, among others).
[00482] [00482] The mice were weighed and the tumors were measured twice a week until the end of the study on Day 35. If the tumors were ≥ 2000 mm3 or appeared to be ulcerated, the animals were euthanized. On the 15th day after implantation, four mice in four treatment groups were sacrificed to collect the spleen and tumor. Tissues were processed in individual cell suspensions and cells were stained using flow cytometry antibodies to analyze T cell populations.
[00483] [00483] On the 21st day after implantation, the last day on which the mean tumor growth inhibition (TGI) in relation to the isotype control antibody could be calculated, the TGI values for anti-ICOS monotherapy were 37% and 33% at 3 mg / kg and 10 mg / kg, respectively; The TGI value for anti-PD-1 monotherapy was 22%. When anti-ICOS at 10 mg / kg, 3 mg / kg or 1 mg / kg was combined with anti-PD-1 mAb, mean TGI values> 54% were observed. When anti-ICOS at 0.3, 0.1 or 0.03 mg / kg was combined with anti-PD-1 mAb, mean TGI values <40 but> 20%. No toxicity was evident in any treatment group. Antibody Treatment
[00484] [00484] On day 7 post-implantation of CT26 cells, 120 mice were randomized to 10 groups of 10 to 14 mice each, according to the tumor volume. The groups had an average tumor volume of approximately 31 mm3. The mice were dosed with antibodies on days 7, 10 and 14. Post-treatment monitoring
[00485] [00485] The mice were checked daily for postural changes, personal and respiratory care, as well as lethargy. The animals were weighed at least twice a week and were euthanized when the weight loss was ≥ 20%. The flanks of each animal were checked for the presence and size of tumors at least twice a week until death, euthanasia or the end of the study period. Tumors were measured in three dimensions (length [L], width [W] and height [H]) with an electronic digital caliper and recorded. Tumor volumes were calculated using the equation: Volume = (LxWxHx0.5). Response to treatment was measured as a function of tumor growth inhibition (TGI) and was calculated as: (reference mm3 - test article mm3) / reference mm3x100. When the tumor reached a volume greater than approximately 2000 mm3 or appeared ulcerated, the animal was euthanized. Immunomonitoring of T cell populations
[00486] [00486] To investigate the effect of the ICOS antibody on T cell populations, tissues were harvested from four mice each in four treatment groups on day 15 after implantation. The spleens and tumors were homogenized in a gentleMACS Octo Dissociator ™ (Miltenyi, San Diego, CA). Unicellular suspensions were stained for T cell markers using fluorochrome-conjugated antibodies. Antibody fluorescence was detected by flow cytometry on a Fortessa cytometer (BD Biosciences, San Jose, CA) and the results were analyzed using FlowJo software (FlowJo, LLC, Ashland, OR). Statistical analysis
[00487] [00487] The mean, standard deviation (SD) and median values of tumor sizes and mean body weight values were calculated. The average value was calculated while 100% of the animals in the study remained alive; and the median value was calculated while at least 60% of the animals in the study remained alive. One-way analysis of variance (ANOVA) was used to determine whether the means between treatment groups were statistically significantly different; Values of p≤0.05 were considered to be significantly different. GraphPad Prism® software version 5.01 (GraphPad Software, La Jolla, CA) was used to plot data and determine statistical differences between groups. Tumor growth curves for individual mice by treatment group can be seen in Figures 15A-J. The average and median tumor growth curves by treatment group are shown in Figures 16A and 16B. Results Tumor Growth Inhibition
[00488] [00488] On the 21st day after tumor implantation, the last day on which the median TGI could be calculated, mice treated with anti-ICOS.4 mIgG1.4 as monotherapy at 10 mg / kg showed 33% median TGI compared to mice treated with control mIgG1 antibody. Mice treated with anti-ICOS.4 mIgG1 monotherapy at 3 mg / kg showed 37% TGI and the single agent anti-PD-1 4H2 mAb showed 22% TGI. At the end of the study period (Day 35), the proportions of tumor-free mice were 0/10 in the control antibody group, 0/10 in the anti-PD-1 group, 1/10 in the anti-mIgG1 group ICOS.4 at 10 mg / kg and 0/10 in the anti-ICOS.4 mIgG1 group at 3 mg / kg. The combination of anti-mouse PD-1 with anti-ICOS.4 mIgG1 in various doses (10, 3 or 1 mg / kg) showed antitumor activity superior to that of any monotherapy (TGI values of 54%, 60% and 66% , respectively). The numbers of tumor-free mice at the end of the study were the same in these groups (1/10 tumor-free mice), with the exception of the 3 mg / kg dose that had 4/10 tumor-free mice. In addition, the median TGI was also calculated over the 21 days using the relative difference in the area under the effect curve between the control and treatment groups (Table 18).
[00489] [00489] Immunomonitoring was performed on day 15 after implantation in certain treatment groups (Figure 17A-D). Depletion of Foxp3 + Tregs in tumor infiltrating lymphocytes (TILs) was observed in the groups treated with single agent anti-ICOS.4 mIgG1 (10 mg / kg and 3 mg / kg) (Figure 17A). Mice treated with anti-PD-1 mIgG1 did not show a reduction in Teg Tregs. The groups treated with anti-PD1 or anti-ICOS.4 mIgG1 at 3 mg / kg also showed an increase in the subset of CD8 + T cells in TILs (Figure 17B). At 10 mg / kg, treatment with single agent anti-ICOS.4 appeared to have the same levels as this subset compared to the control group.
[00490] [00490] Ki-67 levels, a marker for cell proliferation, were increased in the subset of CD4 + effector T cells after treatment with a single agent with anti-ICOS.4 mIgG1 at 3 mg / kg (Figure 17C). The percentage of granzyme B positive cells, a marker for cytolytic activity in CD8 + T cells, was also attributed to being higher in groups treated with anti-ICOS mIgG1 at 3 mg / kg or with anti-PD-1 alone (Figure 17D ).
[00491] [00491] In a CT26 singenene tumor model staged, anti-ICOS.4 mIgG1 as monotherapy demonstrated more potent TGI when anti-ICOS.4 mIgG1 was dosed at 3 mg / kg (37% TGI on day 21, 0 / 10 tumor-free mice) vs. 10 mg / kg (33% TGI on day 21, 0/10 tumor-free mice). Immunomonitoring data showed a higher percentage of CD8 + T cells, higher levels of Ki-67 in CD4 + effectors and higher levels of granzyme B in CD8 + T cells in the 3 mg / kg anti-ICOS mIgG1 treatment group than in the 10 mg / kg treatment group. These data suggest that, for anti-ICOS monotherapy, a dose of 3 mg / kg has more antitumor activity than a dose of 10 mg / kg.
[00492] [00492] The combined treatment of anti-ICOS.4 mIgG1 mAb at 10 mg / kg, 3 mg / kg and 1 mg / kg with anti-PD-1 mIgG1 resulted in mean TGI values> 54%, with 1 / 10 of mouse tumor free for these treatment groups, except anti-ICOS.4 at 3 mg / kg, which had 4/10 tumor-free mice. These results suggest comparable levels of anti-tumor activity of anti-ICOS mIgG1 in combination with anti-PD-1 mIgG1 treatments at the three highest doses. Study 2
[00493] [00493] This study was designed to assess antitumor activity in the CT26 colorectal carcinoma model after treatment with a substituted anti-ICOS monoclonal antibody, ICOS.4 (mouse IgG1 variant of the parental hamster antibody) at varying doses and / or anti-PD-1 mAb. CT26 cells were implanted subcutaneously in the right flanks of mice. When the tumors reached 45 mm3, the mice were randomized into nine treatment groups of 15 to 20 mice each. Each mouse was dosed on days 9, 12 and 15 after implantation with mAb or irrelevant isotype control. The mice were weighed and the tumors were measured twice a week until the end of the study on day 51. If the tumors were ≥ 2000 mm3 or appeared to be ulcerated, the animals were euthanized. Whole blood samples were taken from mice at various time points (day 9, day 15 and day 16 after tumor implantation) for analysis. On day 16 after tumor implantation, five mice in eight treatment groups were sacrificed to collect the spleen and tumor. Tissues were processed in individual cell suspensions and cells were stained using flow cytometry antibodies to analyze T cell populations.
[00494] [00494] On the 29th day after tumor implantation, the last day on which the mean tumor growth inhibition (TGI) relative to the isotype control antibody could be calculated, the TGI values for anti-ICOS monotherapy were 5 % at 30 mg / kg and 33% at 3 mg / kg; anti-PD 1 monotherapy showed a 74% TGI value. When anti-ICOS at 30 mg / kg, 10 mg / kg, 3 mg / kg or 1 mg / kg was combined with anti-PD-1 mAb, mean TGI values> 74% were observed. No toxicity was evident in any treatment group. Antibody Treatment
[00495] [00495] On the 9th day after tumor implantation, 200 mice were randomized to nine groups of 15 to 20 mice each, according to the tumor volume. The groups had an average tumor volume of approximately 45 mm3. The mice were dosed with antibodies on days 9, 12 and 15. Post-treatment monitoring
[00496] [00496] The animals were checked daily for postural changes, personal and respiratory care, as well as lethargy. The animals were weighed at least twice a week and were euthanized if the weight loss was ≥ 20%. The flanks of each animal were checked for the presence and size of the tumors at least twice a week until death, euthanasia or the end of the study period. Tumors were measured in three dimensions (length [L], width [W] and height [H]) with electronic and recorded digital calibrators. Tumor volumes were calculated using the equation: Volume = (L x W x H x 0.5). Response to treatment was measured as a function of tumor growth inhibition (GIT) and was calculated as: (reference mm3 - test article mm3) / reference mm3 x 100. When the tumor reached a volume greater than approximately 2000 mm3 or appeared ulcerated, the animal was euthanized. Immunomonitoring of T Cell Populations
[00497] [00497] Various methods were used to investigate the effect of the ICOS antibody on T and B cell populations. Whole blood samples were collected from mice at various time points (day 9, day 15 and day 16) and then processed for analysis. In addition, tissues were harvested from five mice each in eight treatment groups on day 16 after implantation. The spleens and tumors were homogenized in a gentleMACS Octo Dissociator ™ (Miltenyi, San Diego, CA). Unicellular suspensions were stained for T cell markers using fluorochrome-conjugated antibodies. Antibody fluorescence was detected by flow cytometry on a Fortessa cytometer (BD Biosciences, São José, CA) and the results were analyzed using FlowJo software (FlowJo, LLC, Ashland, OR). Statistical analysis
[00498] [00498] The mean, standard deviation (SD) and median values of tumor size and mean values of body weight were calculated. The average value was calculated while 100% of the animals in the study remained alive; the median value was calculated while at least 60% of the animals in the study remained alive. One-way analysis of variance (ANOVA) was used to determine whether the means between treatment groups were statistically significantly different; Values of p ≤ 0.05 were considered significantly different. GraphPad Prism® software version 7.02 (GraphPad Software, La Jolla, CA) was used to plot data and determine statistical differences between groups. Tumor growth curves for individual mice by treatment group can be seen in Figures 18A-I. The average and median tumor growth curves by treatment group are shown in Figures 19A and 19B. Results Tumor Growth Inhibition
[00499] [00499] On the 29th day after tumor implantation, on the last day the mean TGI could be calculated, the efficacy of the treatment of anti-ICOS mAb therapies in CT26 tumors was observed as monotherapy and in combination with anti-PD mAb -1 (Table 19). Mice treated with anti-ICOS.4 mIgG1 monotherapy at 3 mg / kg showed 33% TGI and the single agent anti-PD-1 4H2 mAb showed 74% TGI. At the end of the study period (day 51), the number of tumor-free mice was 0/10 in the control antibody group, 8/15 in the anti-PD-1 group and 1/15 in all doses of anti mIgG1 -ICOS.4 (30 mg / kg, 10 mg / kg or 3 mg / kg). The combination of anti-PD-1 with anti-ICOS.4 mIgG1 in various doses (30 mg / kg, 10 mg / kg, 3 mg / kg and 1 mg / kg) showed antitumor activity greater than or equal to that of monotherapy (values 74%, 80%, 87% and 78%, respectively). The number of tumor-free mice at the end of the study ranged from 8-11 / 15 in the four combination groups.
[00500] [00500] Immunomonitoring was performed at various time points after implantation in certain treatment groups (Figure 20A-D). On day 16 after tumor implantation, a depletion of Foxp3 + Tregs was observed in tumor infiltrating lymphocytes (TILs) in all groups treated with anti-ICOS mIgGl mAb.4 (Figures 20A and 20B). Mice with CT26 tumor treated with anti-PD-1 mIgG1 alone did not show a reduction in TIL Tregs. Although more variable, CD8 + T cells increased in TILs in all treatment versus control groups (Figure 20D).
[00501] [00501] Ki-67 protein levels, a marker of cell proliferation, increased in the subset of CD4 + effector T cells after treatment with a single agent with anti-PD-1 (moderate increase) or anti-ICOS.4 mIgG1 (increase elevated) (FIGs 21A-C). An additional increase in Ki-67 levels was seen in the combination treatment groups of anti-PD-1 and anti-ICOS mIgG1.4.
[00502] [00502] ICOS-L, the ligand for ICOS, showed higher levels of mean fluorescence intensity (MFI) in B cells after treatment with anti-ICOS antibodies.4. MFI levels of ICOS-L were also elevated in whole blood collected on day 9, day 15 and day 16 after tumor implantation and in the spleen on day 16 after tumor implantation. A trend appears to arise in which the highest dose of anti-ICOS.4 mIgG1 has the highest MFI for ICOS-L (Figure 22A-D).
[00503] [00503] Observing the levels of ICOS, the loss of expression of the receptor in CD4 + T cells was observed after treatment with antibody. This was most evident in the TILS tumor (Table 20). Higher doses of anti-ICOS.4 mIgG1 correlated with lower levels of ICOS. Antibody dosage (isotype control at 30 mg / kg and D265A of anti-PD-1 mIgG1 at 5 mg / kg; anti-ICOS.4 mIgG1 mAb at 1 mg / kg, 3 mg / kg, 10 mg / kg and 30 mg / kg of dose levels) was by intraperitoneal injection on days 9, 12 and 15 after CT26 cell implantation. Whole blood was collected at various points in time (day 9, day 15 and day 16 after implantation) and the tumor was collected on day 16 after implantation of five mice in certain treatment groups. Immuno-monitoring analysis using flow cytometry was performed on processed samples.
[00504] [00504] As summarized in Table 21, in a CT26 syngeneic tumor model staged, treatment with anti-ICOS.4 mIgG1 mAb showed anti-tumor activity as a single agent or when combined with anti-PD-1 mAb. As monotherapy, similar levels of antitumor activity were observed when anti-ICOS.4 mIgG1 was dosed at 30 mg / kg, 10 mg / kg or 3 mg / kg, although the dose of 3 mg / kg has the highest mean TGI ( 33%) on day 29. Immunomonitoring data showed increased depletion of Foxp3 + Tregs (tumor), higher percentage of CD8 + T cells (tumor), higher levels of Ki-67 protein in CD4 + effectors (tumor), higher levels of ICOS-L in B cells (whole blood and spleen) and loss of ICOS expression in CD4 + T cells (whole blood and spleen) with all doses of groups treated with anti-ICOS mIgG1.4. These data showed that anti-ICOS monotherapy is effective in this tumor model.
[00505] [00505] Treatment with anti-PD-1 mIgG1 had a very strong activity in this experiment. The combined treatment of anti-ICOS.4 mIgG1 mAb at 30 mg / kg, 10 mg / kg, 3 mg / kg and 1 mg / kg, with anti-PD-1 mIgG1 resulted in mean TGI values ≥ 74%, with 8-11 / 15 tumor-free mice for these treatment groups. These results showed comparable levels of anti-tumor activity of anti-ICOS mIgG1 in combination with anti-PD-1 mIgG1 treatments at all doses.
[00506] [00506] To assess antitumor activity in the CT26 colorectal carcinoma model after treatment with a variable Fcs-substituted anti-ICOS monoclonal antibody, ICOS.4 (mouse IgG1 or IgG2 variant of the parental hamster antibody), and / or mAb anti-CTAL-4, CT26 cells were implanted subcutaneously in the right flanks of mice. When the tumors reached 96 mm3, the mice were randomized into six treatment groups of 10 to 15 mice each. Each mouse was dosed on days 13, 16 and 20 after implantation with mAb or isotype control (that is, antibody of the same isotype, but which does not bind to any naturally occurring mouse proteins, for example, antibodies against KLH, diphtheria toxin, among others). The mice were weighed and the tumors were measured twice a week until the end of the study on Day 66. If the tumors were ≥ 2000 mm3 or appeared to be ulcerated, the animals were euthanized.
[00507] [00507] On the 30th day after implantation, the last day on which the median tumor growth inhibition (TGI) in relation to the isotype control antibody could be calculated, the TGI values for anti-ICOS monotherapy were 15 % and 69% with variants of mIgG1 and mIgG2a (for example, chimeric mouse antibody with VH / VL sequences SEQ ID NO: 3 and 4 + IgG1 or IgG2), respectively; anti-CTLA-4 monotherapy showed a TGI value of -7%. When anti-ICOS mAbs were combined with anti-CTLA-4 mAb, mean TGI values of 40% (mIgG1) and 79% (mIgG2a) were observed. No toxicity was evident in any treatment group.
[00508] [00508] The following antibodies have been constructed:
[00509] [00509] Anti-mouse ICOS mouse IgG1 antibody - anti-ICOS.4 mAb, isotype mouse IgG1, was expressed from Chinese hamster ovary (CHO) cell lines;
[00510] [00510] IgOS Antibody Mouse IgG2a Antibody - Anti-ICOS.4 mAb, isotype mouse IgG2a isotype, was expressed from CHO cell lines;
[00511] [00511] Anti-mouse CTLA-4 9D9 mouse IgG2b antibody - monoclonal antibody to mouse CTLA-4 clone 9D9, isotype mouse IgG2b, was expressed from a transfected and formulated CHO cell line in PBS ; and
[00512] [00512] Mouse IgG1 isotype control - A totally murine IgG1 antibody, not binding to ICOS; prepared at 10 mg / kg in PBS. Tumor Cell Preparation
[00513] [00513] Murine colon carcinoma CT26 cells were purchased from American Type Culture Collection (ATCC, Catalog CRL-2638) and maintained in vitro in sterile culture of Dulbecco's modified Eagle's medium (DMEM) + 10% fetal bovine serum heat inactivated (FBS) for less than 10 passes. The cells were confirmed to be virus-free by the mouse antibody production test. Tumor implantation
[00514] [00514] CT26 cells were cultured in RPMI-1640 medium (HyClone / GE Healthcare, Logan UT, Catalog 10-040-CM, Lot 16915003) supplemented with 10% fetal bovine serum (FBS) (Gibco, Life Technologies, Catalog 26140 -079, Lot 1704315). The cells were divided 1:10 every three to four days. The right flank of each mouse was implanted subcutaneously with 1x106 CT26 cells in 0.2 mL of PBS using a 1 cm syringe and a 26-inch half-inch needle. Antibody Treatment
[00515] [00515] On day 13 post-implantation of CT26 cells, 120 mice were randomized into six groups of 10 to 15 mice each, according to the tumor volume. The groups had an average tumor volume of approximately 96 mm3. The mice were dosed with antibodies on days 13, 16 and 20. Post-treatment monitoring
[00516] [00516] The animals were checked daily for postural changes, personal and respiratory care, as well as lethargy. The animals were weighed at least twice a week and were euthanized if the weight loss was greater than or equal to 20%. The flanks of each animal were checked for the presence and size of the tumors at least twice a week until death, euthanasia or the end of the study period. Tumors were measured in three dimensions (length [L], width [W] and height [H]) with electronic and recorded digital calibrators. Tumor volumes were calculated using the equation: Volume = (L x W x H x 0.5). Response to treatment was measured as a function of tumor growth inhibition (GIT) and was calculated as: (reference mm3 - test article mm3) / reference mm3 x 100. When the tumor reached a volume greater than approximately 2000 mm3 or appeared ulcerated, the animal was euthanized. Results
[00517] [00517] As shown in Table 22, on the 30th day after the tumor implantation, the last day on which the median TGI could be calculated, the efficacy of treatment of anti-ICOS mAb therapies in CT26 tumors was observed as monotherapy and in combination with anti-CTLA-4 mAb.
[00518] [00518] The average and median tumor growth curves by treatment group are shown in Figures 24A and 24B. No toxicity was evident in any treatment group, since the mean and median changes in body weight were less than 20%. Table 22 Tumor Growth Inhibition by Treatment Group Day 30% TGI Volume Treatment Group Median Median Tumor (mm3) mIgG1 Isotype Control, 20 mg / kg 1981 N / A anti-ICOS.4 mIgG1, 10 mg / kg 1686 15% mIgG2a anti-ICOS.4, 10 mg / kg 614 69% mIgG2b of 9D9 anti-CTLA-4, 10 mg / kg 2114 -7% mIgG1 anti-ICOS.4, 10 mg / kg + mIgG2b of 9D9 anti-1195 40% CTLA-4, 10 mg / kg mIgG2a anti-ICOS.4, 10 mg / kg + 9D9 410 mIgG2b 79% anti-CTLA-4, 10 mg / kg
[00519] [00519] As summarized in Table 23, in a staged CT26 syngene tumor model, both anti-ICOS Fc variant monotherapies (i.e., IgOS1 or IgG2 variant of the ICOS.4 mouse from the parental hamster antibody) promoted modest activity antitumor, with anti-ICOS.4 mIgG2a demonstrating greater efficacy than anti-ICOS.4 mIgG1 at day 30 (69% versus 15% median TGI). The combination of anti-ICOS.4 treatments with anti-CTLA-4 mAb increased the effectiveness with the average TGI increasing to 79% (mIgG2a) and 40% (mIgG1). No significant changes in body weight were associated with the treatments nor were any evident signs of clinical toxicity observed. Anti-ICOS monotherapies promoted anti-tumor activity, with anti-ICOS mIgG2a.4 demonstrating greater anti-tumor efficacy on day 30 (69% versus 15% median TGI). Anti-tumor efficacy increased when combined with the treatment of anti-CTA-4 mAb, with the combination group of anti-ICOS.4 mIgG2a at 79% TGI and anti-ICOS.4 mIgG1 at 40% TGI.
[00520] [00520] Human CD4 + T cells, cynomolg PBMC and rat and mouse splenocytes were activated by incubation with species-specific anti-CD3 attached to the plate (coated in a 6-well plate with 2 mL / well of a 4 µg solution / mL in PBS for 3 hours at 37 ° C and washed twice with 1 mL of medium), + 1 µg / mL of species-specific anti-CD28 soluble in fresh medium with 1-2 x 106 cells / mL for 3- 4 days. It should be noted that cynomolgus PBMC and mouse and rat splenocytes become mainly T cells after three to four days of activation of
[00521] [00521] As illustrated in Figures 25A and 25B, IC26.3 IgG1f S267E exhibits strong binding to human, cynomolgus monkey, rat and mouse T cells with EC50 values that are not significantly different between the three species.
[00522] [00522] Furthermore, the avidity of binding of S257E to IgG1f from ICOS.33 was compared with two different competing anti-ICOS antibodies. In synthesis, the antibodies were incubated with activated CD4 + T cells on ice for thirty minutes. The cells were then washed and the bound antibodies were detected with a secondary anti-human IgG-PE reagent. The signal was measured by flow cytometry and the average fluorescence intensity was calculated. As shown in Figures 26A-B, IC26.3 IgG1f S267E showed greater avidity of binding to activated CD4 + T cells, as calculated by EC50 compared to the two competing antibodies. As described herein, the term "EC50", in the context of an in vitro assay using an antibody or an antigen-binding fragment thereof, refers to the concentration of an antibody or an antigen-binding fragment thereof that induces a response that is 50% of the maximum response, that is, halfway between the maximum response and the baseline. In Figure 26A, the IC50 of ICOS.33 IgG1f S267E was about 0.07 µg / mL, while the EC50 of competing antibody 1 was about 1.4 µg / mL and the EC50 of competing antibody 2 was of about 0.4 µg / mL. In other words, the IC50 of S267E of IgG1f of ICOS.33 was about 20 times lower than the EC50 of competitor antibody 1 and about 6 times lower than the EC50 for competitor antibody 2. In Figure 26B, the EC50 of IgG1f S267E of ICOS.33 was about 0.08 µg / ml, while the EC50 of competing antibody 1 was about 2.4 µg / ml and the EC50 of competing antibody 2 was about 1.0 µg / ml. In other words, the IC50 of S267E of IgG1f of ICOS.33 was about 30 times lower than the EC50 of competing antibody 1 and about 12 times lower than the EC50 for competing antibody 2. Affinity Studies
[00523] [00523] Since human monomeric ICOS was not available, experiments to determine the true affinity of IC26.3 IgG1f S267E were performed using the ICOS.33 IgG1f S267E Fab fragment (Lot PC-1804-04) and human ICOS Fc antigen (R & D Systems, 169-CS-050) with Biacore ™ T200 equipment. The binding experiments were carried out at 37oC to obtain (or model) the antibody's affinity with the antigen under in vivo conditions. A CM4 chip was covalently coated with anti-hFc capture reagent from Biacore. The surface was blocked with ethylenediamine. Then, human ICOS with an Fc tag was captured on the CM4 chip and the ICOS.33 IgG1f S267E Fab fragment was drained at concentrations of 0.91, 2.7, 25, 74, 667 and 2000 nM.
[00524] [00524] The association rate constant (kon) and the dissociation rate constant (koff) were plotted by time and response units (UK) using the BIAevaluation software, Version 3.2. The data were fitted to a Langmuir 1: 1 model. The koff / kon ratio was represented by the dissociation constant (KD) of the antibody-antigen complex. The Biacore chip was regenerated with 50 mM sodium hydroxide solution at a flow rate of 100 µL / min. The antibody affinity for the human ICOS antigen, as measured by the ICOS.33 IgG1f S267E Fab fragment, was 52 nM to 65 nM. Biophysical Analysis
[00525] [00525] The identity of S267E to IgG1f from ICOS.33 was confirmed by liquid chromatography / mass spectrometry (LC-MS). For light and heavy chain mass measurements, the sample was deglycosylated, reduced and alkylated by the standard test method and analyzed using a Waters LCT Premier ESI-TOF instrument. The mass of light and heavy chains of IC26.3 IgG1f S267E were equivalent to their predicted mass assignments of 23,795 Da and 50,161 Da, respectively, based on the amino acid sequence derived from the DNA sequence.
[00526] [00526] The antibody identity was determined by analyzing the Edman sequence. The sequencing of N-terminating amino acids from antibody light and heavy chains was performed with an ABI Procise Automated Protein Sequence Analyzer. The N-terminated amino acid sequences observed from S267E to IgG1f from ICOS.33 were compatible with the predicted amino acid sequences for light and heavy chains.
[00527] [00527] Using the Agilent 2100 BioAnalyzer system, it was determined that the IC26.3 IgG1f S267E migrated to approximately 160 kDa under non-reducing conditions (NR). Under reducing conditions (R), the heavy chain migrated at about 60 kDa and the light chain migrated at about 25 kDa.
[00528] [00528] The purity of IC26.3 IgG1f S267E was determined by capillary sodium dodecyl sulfate electrophoresis (CE-SDS). The samples were analyzed with a Beckman Coulter Proteome Lab PA 800 plus, under non-reducing and reducing conditions. IC26.3 IgG1f S267E contained 93.45% IgG intact by CE-SDS under non-reducing conditions. The antibody fragments detected were as follows: a light chain (1.85%), a light-heavy chain (0.45%), two heavy chains (0.88%) and two heavy chains and one light (3, 37%). The IC26.3 IgG1f S267E purity was 96.51% (62.22% heavy chain + 34.29% light chain) by CE-SDS under reducing conditions.
[00529] [00529] IC26.3 IgG1f S267E was characterized by hydrophobic interaction chromatography (HIC) to determine the level of heterogeneity of the product. IC26.3 IgG1f S267E showed low heterogeneity with 98.1% of main peak, 0.4% of peak in front of main peak and 1.5% tailing shoulder, indicating low chemical or conformational heterogeneity.
[00530] [00530] Capillary isoelectric focusing (cIEF) was used to characterize IC26.3 IgG1f S267E for charge isoforms. The sample was analyzed using an iCE Analyzer Model iCE3. IC26.3 IgG1f S267E exhibited an isoelectric point range (pI) from 7.30 to 7.72 with a major peak at 7.72 (45.19%). Other peaks observed were 7.30 (7.51%), 7.40 (16.21%) and 7.56 (31.10%). The observed pI range was within the normal range expected for IgG1 antibody samples.
[00531] [00531] Size exclusion chromatography (SEC; gel filtration) coupled with multi-angle light scattering (MALS) was performed to determine the monomer content and MW distribution of the main IC26 S267E IgG1f impurities.33 . ICOS.33 IgG1f S267E was found to contain more than 99.8% monomer. The allocation of MW by MALS indicated that the monomer component had an MW of 144,300 Da. A very small amount of aggregate had an evident MW of 626,800 Da.
[00532] [00532] Fingerprinting and peptide sequencing were performed by analyzing peptides digested by LC-MS on a Waters Acquity UPLC with an Acquity UPLC BEH C18 1.7 µm (2.1 x 150 mm; Waters Corporation) coupled to a LTQ-Orbitrap XL mass spectrometer. The identification of the light and heavy chain sequence was 100% using MS / MS data from various digestions, including trypsin, chymotrypsin and pepsin. Peptide sequencing confirmed that the allotype was human IgG1 and matched the expected amino acid sequence as predicted by the DNA sequence. A single N-glycosylation site was confirmed to be N297 on the heavy chain. Disulfide bonds have been found to be, as expected, for a human IgG1 monoclonal antibody. The S267E mutation made to increase the binding of the CD32b receptor was also identified in the sequence.
[00533] [00533] The oligosaccharide profile of N-linked sugars present in IC26.3 IgG1f S267E was determined by capillary laser-induced fluorescence (cLIF) using a Beckman MDQ instrument. N-linked glycans present in S267E of IgG1f from ICOS.33 comprised a mixture of asialo-biantenary sugars without fucose that varied in relation to the level of galactose incorporation. The main glycan structures were G0F (30.64%) and G1F (43.65%) and, to a lesser extent, G2F (19.07%).
[00534] [00534] A VP-capillary differential scanning calorimeter was used to determine the thermal stability and reversibility of the antibody. Data were analyzed using Origin 7 software. Thermal stability was within the acceptable range for a typical human monoclonal antibody. In thermal scanning experiments, many antibodies show three solvable melting temperatures; the first is due to the split of the CH2 domain, the second is due to the split of the Fab domain, and the third is due to the split of the CH3 domain. The IC26.3 IgG1f S267E presented a thermogram with these three deployment temperatures: 65.2 ° C (Tm1), 83.2 ° C (Tm2), 86.3 ° C (Tm3). Thermal reversibility is a marker of the ability of a protein to redouble itself to its native shape after a disturbance, in this case, heat. Experiments of thermal reversibility at 83.2 ° C (the second melting temperature) showed 55.2% reversibility, which suggests that the antibody has robust refolding properties.
[00535] [00535] The stability of the IC26.3 IgG1f S267E is summarized in Table 24. Table 24 - ICOS IgG1f S267E stability.33 Property Method Results Freeze / Thaw UV, SEC No risk of (one hour at -80 ° C, one hour at RT stability of F / T x 6) revealed Solubility / Concentration Profile UV, SEC At least 50 mg / ml in buffer (20 mM histidine, pH 6.0, 260 mM sucrose) Stability Study in Shaking 350 rpm in RT in No buffering problem (histidine to aggregation observed 20 mM, pH 6.0, sucrose at 260 mM) +/- 0.05% PS80 for 7 days (50 and 10 mg / mL)
[00536] [00536] The binding of human Fc ץ Rs to IC26.33 IgG1f S267E was studied by surface plasmon resonance (SPR) and compared with the anti-ICOS IgG1f control antibody. The antibodies were captured on a protein A sensor surface, and a series of Fc ץ Rs titrations was injected as analytes.
[00537] [00537] For these studies, protein A was immobilized in flow cells 1-4 of the CM5 sensor chip using standard ethyl (dimethylaminopropyl) carbodiimide (EDC) / N-hydroxysuccinimide (NHS) chemistry, with ethanolamine blocking, in a 10 mM HEPES execution buffer, pH 7.4, 150 mM NaCl, 3 mM EDTA, 0.05% p20 surfactant, at a density of ~ 3000 RU. ICOS.33 IgG1f S267E (3 µg / mL) or hIgG1f control antibodies (3 µg / mL) were captured on the surface of protein A at a density of ~ 400 - 500 RU, and binding of Fc analytes ץ R was tested in execution buffer consisting of 10 mM NaPO4, 130 mM NaCl, 0.05% p20, buffer (PBS-T) pH 7.1 at 25oC, using an association time of 120 seconds and a dissociation time of 180 seconds at a flow rate of 30 µL / min. To determine the kinetics and binding affinity, a series of concentrations of Fc (R (3: 1 dilution) from 1 µM to 0.15 nM (CD64 proteins) or 10 µM to 1.5 nM ( all other Fc ץ Rs). The kinetic data were fitted to a 1: 1 Langmuir model or to a steady state model using the Biacore T200 evaluation software.
[00538] [00538] The data from the sensogram that demonstrated very fast association and dissociation rates with steady-state binding were fitted to a 1: 1 steady-state affinity model, while those that showed slower kinetics were fitted to a Langmuir model. 1: 1. The data in single analyte concentrations (hCD64 at 0.11 µM and hCD32a-H131, hCD32a-R131, hCD32b, hCD16a-V158, hCD16a-F158, hCD16b-NA1 and hCD16b-AN21 at 1.1 µM) were compared for the anti-ICOS and S267E IgG1f control antibody from ICOS.33, with S267E from IgG1f from ICOS.33 showing a higher binding response and lower dissociation rate for several of the Fc ץ Rs, with hCD32a-R131 and hCD32b having the most notable increases in connection and slower decoupling rates.
[00539] The best-adjusted kinetic and affinity values are shown in Table 25. These data demonstrated quantitatively that the S267E mutation alters binding affinity for various FcRs compared to the hlgGl control antibody. For example, hCD32a-R131 binding improved from a 1500 nM KD (hIgG1f control) to 34 nM (IC26.3 IgG1f S267E), which was an improvement of over 40 times and hCD32b binding improved from one KD of more than 5000 nM (hIgG1f control) to 170 nM (IC26.3 IgG1f S267E), which was an improvement of at least 29 times. Binding to CD32a and CD32b of cinomolgos was less than that observed for human CD32a and CD32b.
[00540] [00540] IC26.3 IgG1f S267E for Human FcγRs EXAMPLE 12 IC26 IgG1f S267E Pharmaceuticals (ICK.33)
[00541] [00541] The PK parameters obtained from a single dose of PK / PD and tolerance study with IC26.3 IgG1f S267E are summarized in Table 26. Exposure was proportional to the dose between 1 mg / kg and 10 mg / kg, with a half-life of 13 to 14 days. Anti-drug antibodies (ADA) were detected seven days after the dose in three of the four cynomolgus monkeys in the 1 mg / kg dose group and continued to increase until 42 days after the dose. The increase in the ADA signal corresponded to the rapid clearance of the antibody in these monkeys, and this part of the data affected by the ADA was not included in the analysis of the PK data.
[00542] [00542] The pharmacokinetics of an anti-mouse ICOS replacement mAb (ICOS.4, mouse IgG1 variant of the parental hamster antibody) after a single intravenous dose at 1 mg / kg and a single intraperitoneal administration (at 0.1 mg / kg, 1 mg / kg and 10 mg / kg) were evaluated in BALB / c mice without tumors, which is an albino strain created in the laboratory of the domestic mouse. The antibody showed a greater than proportional increase in the dose on display over a dose range of 1 mg / kg-10 mg / kg, as shown in Table 27. Half-life ranged from 0.53 days with the lowest dose from 1 mg / kg to 1.5 days at the highest dose of 10 mg / g. Non-linear PK in mice appeared to be due, at least in part, to the target-mediated drug availability.
[00543] [00543] Binding assays demonstrated that the affinity of IC26.3 IgG1f S267E (EC50) for activated CD4 + T cells was similar in mice, rats, cynomolgus monkeys and humans.
[00544] [00544] In tissue cross-reactivity analysis, ICOS.33 IgG1f S267E conjugated to FITC was applied to frozen sections (fixed acetone or acetone / formalin) from 20 normal human tissues, one to four donors each. Specific staining has been observed in subsets of lymphocytes in lymphoid tissues (thymus, amygdala and spleen) and lymphoid-rich (stomach and small intestine), as well as very rare dispersed mononuclear cells (MNCs) in various tissues (thyroid, skin, lung, uterus and testicles), which are largely associated with the underlying inflammation. No positive marking was observed in the brain, cerebellum, heart, liver, kidney, pancreas, peripheral nerve, colon, pituitary and prostate. In lymphoid tissues, positive lymphocytes were distributed mainly in the medulla of the thymus and in the light zone of the germinal center and interfolicular region of the amygdala. These results are consistent with previous immunohistochemistry (IHC) with the parental antibody ICOS.4.
[00545] [00545] IgG1f S267E-FITC staining was also evaluated by immunohistochemistry (IHC) in frozen sections of 10 normal tissues of cynomolgus monkeys, including brain, heart, liver, lung, kidney, spleen, thymus, tonsil, skin and testicles. In general, the staining patterns were similar to those of human tissues. Specific staining was observed in subsets of lymphocytes in lymphoid tissues (amygdala, spleen and thymus). No unexpected staining was observed in the examined tissues. EXAMPLE 14 Cytokine release, complement activation and tolerability Cytokine release in human whole blood treated with ICOS IgG1f S267E.33
[00546] [00546] This study was designed to assess cytokine responses in human peripheral blood cells after treatment with ICOS.33 IgG1f S267E in fresh whole blood samples.
[00547] [00547] Heparinized whole blood with fresh normal sodium (100 µl) was added to 96 well round base plates. 100 µl of S267E IgG1f from ICOS.33 or ICOS.33 diluted in serum-free AIM V medium, anti-KLH-hIgG2-2F5 mAb isotype control, or TGN anti-CD28 mAb (5.11A1) were added to the wells to obtain a final antibody concentration of 10 µg / ml per well and a final volume of 200 µL per well. SEB (100 µL) diluted in AIM V medium was added to the wells to a final concentration of 100 ng / ml SEB to obtain a final volume of 200 µL per well. CD3-CD28 (100 µL) diluted in AIM V medium was added to the wells for a final concentration of 1 µg / ml of CD3-CD28 and a final volume of 200 µL per well. LPS (100 µL) diluted in AIM V medium was added to the wells to a final concentration of 10 µg / ml LPS and a final volume of 200 µL per well. The plates were incubated in a 5% to 7% CO2 atmosphere incubator for 20 hours at 37 ° C. Plasma cell culture supernatants from each well were collected after 20 hours and stored at –20 ° C. The samples were sent to BMS Lawrenceville, NJ (LVL) in a container with dry ice for assay performance.
[00548] [00548] To assess cytokine secretion, 12 µL of pre-mixed standards, controls and samples were transferred to the assay plates. Magnetic beads (6 µl) were added to each 384 well plate, then sealed and incubated for two hours at room temperature on a plate shaker. After two hours of incubation, the magnetic beads were washed twice and 6 µl of detection antibodies were added to each well. The plates were resealed and incubated at room temperature on a plate shaker. Streptavidin-phycoerythrin (6 µL) was added to each well containing the detection antibodies, then incubated for 30 minutes at room temperature and washed twice using a plate washer. Coating fluid (80 µL) was added to each well and the beads were resuspended for five minutes on a plate shaker. Plate samples were read using the Bioplex 3D instrument matrix system. The raw data were measured as mean fluorescent intensity (MFI). The concentration (pg / mL) was calculated using the Xponent software.
[00549] [00549] A panel of 75 cytokines was evaluated in blood from eight normal human donors for S267E-mediated cytokine release of IgG1f from ICOS.33. The addition of ICOS.33 IgG1f S267E to donor whole blood did not mediate cytokine secretion compared to isotype control. These data showed that treatment with IC261 IgG1f S267E does not lead to cytokine release syndrome (CRS) in whole blood. Intermittent dose intravenous toxicity study in monkeys
[00550] [00550] This study was conducted to determine the potential toxicity and biological activity of IC26.3 IgG1f S267E when administered intravenously to monkeys once a week or once every three weeks for a month to assess the reversibility of any observed changes, to determine systemic exposures to IC26.3 IgG1f S267E, to assess immune responses and to provide data to support the use of ICOS.33 IgG1f S267E in humans. IC26.3 IgG1f S267E was administered intravenously as a slow bolus injection at doses of 0 (vehicle, once a week on Days 1, 8, 15, 22 and 29), 1.5 mg / kg (once every 3 weeks on days 1 and 22), 15 mg / kg (once a week) or 75 mg / kg (once a week) to groups of five female monkeys and five male monkeys. All doses were administered at 2 ml / kg in a vehicle / carrier consisting of 20 mM histidine, 260 mM sucrose, 50 µM penta-acetic diethylene triamine acid and 0.05% (w / v) 80 polysorbate (pH 6.0). As potential pharmacodynamic measures at least in part, all monkeys were immunized with keyhole keyhole limpet hemocyanin (KLH, immunogen to stimulate the primary response), viral vectors Adenovirus-5 (Ad5) -Gag and Ad5-Nef (immunogen for stimulate antigen-specific CD8 T cell response) and tetanus toxoid (immunogen to stimulate the secondary response) on Day 1. For example, immunizing with tetanus toxoid allows for the expansion of the number of T cell specific for tetanus toxoid, and allows the PK / PD assessment of a specific antigen population.
[00551] [00551] Criteria for evaluation included survival, toxicokinetics, clinical observations (including eating behavior), body weights, physical (including respiratory, cardiovascular and neurological) and eye exams, clinical pathology assessments, immunogenicity assessment (of anti-S267E antibody IgG1f from ICOS.33; ADA), immunotoxicological and pharmacological evaluations (including receptor occupation and receptor expression in CD4 helper T cells, T cell dependent antibody response (TDAR) to KLH or tetanus toxoid, lymphocyte phenotyping of peripheral blood, T cell activation, antigen-specific T cell phenotyping, and ex vivo recall response to KLH, Gag or Nef peptides), organ weights and macroscopic and microscopic pathological analyzes. Scheduled necropsies were performed after 1 month (three / group / sex) and after an 8-week recovery period (two / group / sex).
[00552] [00552] After repeated dosing, systemic exposures of IC26.3 IgG1f S267E (AUC [0-T]) increased approximately dose proportionally from 15 mg / kg to 75 mg / kg (once a week) without any substantial difference in gender observed in all doses. After repeated dosing of 1.5 mg / kg (once every three weeks), mean systemic exposures to IC26.3 IgG1f S267E (AUC [0- 504h]) were lower (0.4x) than those after dosage on day 1, whereas AUC values (0-168h) after repeated dosing of 15 mg / kg and 75 mg / kg (QW) were slightly higher (2.1 times to 2.6 times) than those after dosing on Day 1, suggesting accumulation.
[00553] [00553] ADA responses emerging from treatment were detected in 8 and 2 of 10 monkeys / group at 1.5 mg / kg (once every three weeks) and 15 mg / kg (once a week), respectively, in or after Day 8. During the recovery phase, ADAs were only detected in monkeys at 1.5 mg / kg. After repeated dosing, serum concentrations of IC26.3 IgG1f S267E in monkeys with ADAs were generally immeasurable (ie, <lower limit of quantification; LLOQ) or lower than those in monkeys with no 1.5 mg / ADA. kg and 15 mg / kg, and the presence of ADAs contributed to reduce the average value of AUC to 1.5 mg / kg.
[00554] [00554] The toxicokinetic summary for IC26.3 IgG1f S267E is shown in Table 28. Table 28 - Toxicokinetic Summary - Combined Mean Values by Sex to Values were calculated by including / excluding data from animals with detectable ADAs emerging from treatment on or / and after Day 8 (168 hours after the first dose) b Mean systemic exposure value was assessed from individual AUC (0-72 h) and AUC (0-168 h) values. c Mean systemic exposure value was assessed from individual values of AUC (0-168 h) and AUC (0-336 h), and AUC (0-504 h). d Mean systemic exposure value was assessed from individual AUC (0-72 h) and AUC (0-168 h), AUC (0-336 h), and AUC (0-504 h) values. NA = Not applicable.
[00555] [00555] IC26.3 IgG1f S267E was well tolerated at all doses with no clinical observation related to ICOS.33 IgG1f S267E or effect on body weight, physical (including respiratory, cardiovascular and neurological) and ophthalmological assessments, hematology, coagulation, serum chemistry, urinalysis, organ weights and macroscopic or microscopic pathology. In addition, there was no effect related to IC26.3 IgG1f S267E on tetanus toxoid TDAR, absolute numbers of cytotoxic T cells, B cells and NK cells, T cell subtypes (including naïve CD4 T cells, CD4 T cells effector memory, CD25 + activated CD4 T cells, HLA-DR + activated CD4 T cells, naïve CD8 T cells, effector memory CD8 + CD25 + activated T cells and HLA-DR + activated CD8 T cells), proliferation of CD8 + T cells,
[00556] [00556] Evidence of S267E-mediated effects of IgG1f from ICOS.33 was observed at all doses. ICOS receptor expression in CD4 helper T cells was close to 0% four hours after the dose on Day 1 at all doses, which suggested under-regulation and / or internalization of the ICOS receptor, and remained generally below the period dosage and recovery at 15 mg / kg. The low expression of the ICOS receptor prevented a significant evaluation of the ICOS receptor occupation. At 1.5 mg / kg administered once every three weeks, expression of the ICOS receptor on CD4 helper T cells began to recover after Day 8, increased to 41% before administration on Day 22, decreased to 4 % after dose on Day 22 and increased to 42% on day 29. A complete recovery of receptor expression was seen on day 43 (91%). Receptor occupation is generally correlated with receptor expression (for example, 71% and 85% RO on Days 22 [before administration] and 29). In general, the levels of expression of the ICOS receptor were inversely correlated with the serum concentrations of S267E of IgG1f of ICOS.33. This was consistent with the conclusion that the IC26.3 IgG1f S267E antibody caused loss of the receptor.
[00557] [00557] There was an independent suppression of the dose of key hemocyanin-specific IgM (KLH) from keyhole keyhole (KLH) (up to 52% on day 8) and IgG responses (up to 78% on day 29) compared to control vehicle. Suppression of the T cell-dependent antibody response to KLH by S267E of ICG.33 IgG1f may represent an alternative mode of action, and was observed in a previous study in cynomolgus monkeys. Although not linked by any mechanism, suppression of TDAR by an agonist of the ICOS costimulation pathway may be related to impaired agonism of helper T cells as a result of premature and sustained regulation of ICOS expression.
[00558] [00558] Other effects related to IC26.3 IgG1f S267E at all or some of the dose levels during dosing and / or recovery period included decreases in the mean absolute numbers of total T cells and CD4 helper T cells, percentage of cells Regulatory CD4 T cells, percentage of CD4 + T cells in central memory, percentage of CD8 + T cells in central memory, percentage of Ki67 + CD4 + T cells and percentage of CD8Gag + and Nef + T cells.
[00559] [00559] In conclusion, IC26.3 IgG1f S267E was clinically tolerated by monkeys for one month at intravenous doses ≤ 75 mg / kg administered once a week. S267E-related effects of IgG1f from ICOS.33 were observed at all doses, as demonstrated by the expression of the ICOS receptor and changes in receptor occupation, suppression of the T cell-dependent antibody response to KLH, decreased levels of certain subsets of T cells, decreased activation of CD4 T cells and decreased percentages of antigen-specific CD8 T cells. Many of these changes were still evident at the end of the recovery period at ≥15 mg / kg QW consistent with the continued exposure of IC26 IgG1f S267E throughout the recovery period and the subsequent sustained sub-regulation of expression of ICOS receptor at these doses. The lowest dose of 1.5 mg / kg administered once every three weeks resulted in lower serum concentrations of IC26.3 IgG1f S267E after the first dose and allowed the receptor to recover on the cell surface before the second dose. There were no adverse results related to S267E of IgG1f from ICOS.33. Thus, the level of unobserved adverse effect (NOAEL) was considered to be 75 mg / kg (mean AUC [0-168h] of 452,000 µg ● h / mL). In addition, for the potential determination of the maximum recommended human initial dose, 75 mg / kg was also considered the highest non-severely toxic dose (HNSTD). Single dose intravenous pharmacokinetics and receptor occupation study in monkeys
[00560] [00560] The pharmacokinetics of S267E of IgG1f from ICOS.33 were evaluated in monkeys naïve in protein. All monkeys were immunized intramuscularly with 2.5 mg of keyhole keyhole limpet hemocyanin (KLH). After immunization, monkeys were administered intravenously IC26.33 IgG1f S267E in 20 mM histidine (pH 6.0), 250 mM sucrose, 50 µM pentetic acid (DPTA) and 0.05% polysorbate 80 in doses of 0, 1 mg / kg, or 10 mg / kg (groups of N = 2 / sex for vehicle and 1 mg / kg and 10 mg / kg) via the femoral vein. Serial blood samples (about 0.5 mL) were collected at pre-dose and 6, 24, 72, 168, 240, 336, 408, 504, 672, 840 and 1008 hours after dose. Blood samples were allowed to clot and then centrifuged at 4ºC (1500-2000 x g) to obtain serum. If serum samples were stored at -20ºC and released for analysis on dry ice. Samples not analyzed on the day of reception were stored frozen in a freezer to maintain a temperature of ≤ 70 ° C until analyzed.
[00561] [00561] Cinomolgo monkey serum samples were analyzed using a qualified Gyros® immunoassay for the detection of ICOS.33 IgG1f S267E. Biotinylated human ICOS mG1 (batch # 22Oct2015-biotin) was used as the capture molecule for IC26.3 IgG1f S267E. Samples, standards and QCs were brought to a final matrix concentration of 10% cinomolgo serum and loaded into Gyrolab. The Wash 2 V2 Wizard method with Gyrolab Bioaffy 200 CD was used. After the final washing steps,
[00562] [00562] The range of the IC26.3 IgG1f S267E calibration curve was 3 ng / mL to 30,000 ng / mL in cynomolgus monkey serum. The upper and lower limits of quantification were 30,000 ng / mL and 3 ng / mL, respectively (ie ULOQ 30,000 ng / mL, LLOQ 3 ng / mL). Quality control samples were prepared at 20 ng / mL, 200 ng / mL, 2,000 ng / mL and 20,000 ng / mL in cinomolgo monkey serum and analyzed on each CD to ensure acceptable test performance. Calibrators, QCs and samples were diluted 10 times in PTB. Assay performance was within the acceptable range:% CV of standards was below 25% and QC recovery was within ± 30% of nominal values.
[00563] [00563] Monkey serum samples were analyzed by ABO / BAS, Lawrenceville, New Jersey, using a qualified electrochemiluminescence immunoassay on the Meso Scale Discovery (MSD) platform for the presence of anti-ICOS.33 IgG1f S267E ADA. Supernatant from mouse anti-idiotypic antibody cells of ICOS.33 IgG1f S267E was used to prepare the positive control (PC). Biotinylated anti-ICOS.33 IgG1f S267E was used as a capture molecule and Sulfo Tag-labeled ICOS.33 IgG1f S267E was used as a detection reagent. The biotinylated ICOS.33 IgG1f S267E and Sulfo Tag-labeled ICOS.33 IgG1f S267E were diluted in PTB and combined to generate a master mix with biotinylated ICOS.33 IgG1f S267E final concentration of 1,000 ng / mL and 1,000 ng / mL of S267E of IgG1f of ICOS.33 marked with Sulfo Tag. The samples were diluted to 10% of the minimum required dilution (MRD) in the master mix and incubated at 22 ° C for 2 hours. The master mix was then transferred to a 50 µL / well streptavidin coated MSD plate. After an additional hour of incubation at 22 ° C, the plate was washed and was added with the MSD reading buffer. The plate was then read immediately on the MSD Sector Imager 6000. The presence of detectable anti-ICOS.33 IgG1f S267E antibodies in monkey serum samples was determined using the sample signal ratio and the negative sample signal.
[00564] [00564] Monkey serum samples were analyzed by BAR, Lawrenceville, New Jersey. Samples of Cinomolgos monkey serum were analyzed for IC26.33 "total" IgG1f S267E using reverse phase trypsin digestion (LC / MS / MS) tandem mass spectrometry. Monkey serum samples were also analyzed for ICOS.33 deamidated and unmodified Ig26f S267E at position N329 using immunoaffinity enrichment target capture LC / MS / MS. The standard curves that define the assay range were prepared in commercially obtained cinomolgo serum and analyzed with the study samples as a complete analytical set. Concentrations for S267E of IgOSf from ICOS.33 "total" were reported in µg / mL using an Excel spreadsheet for toxicokinetic and pharmacokinetic interpretation.
[00565] [00565] PK parameter values were calculated using the non-compartmental analysis method (Phoenix WinNonlin 6.4, Certara, Princeton, New Jersey). Exposure values below the lower limit of quantification (LLOQ: <10 ng / mL (0.07 nM) for S267E of IgG1f of
[00566] [00566] The pharmacokinetic parameters of IC26.3 IgG1f S267E after a single intravenous dose of 1 mg / kg and 10 mg / kg for cynomolgus monkeys are summarized in Table 29. After intravenous administration, the plasma concentrations of IgG1f S267E of ICOS.33 exhibited exponential decline. Accelerated clearance was seen in three of four monkeys in a 1 mg / kg group after Day 7. As a result, only concentration time data up to Day 14 was used for all animals in the 1 mg dose group. / kg for analysis and AUC (0-14d) has been reported to eliminate the influence of ADAs. Immunogenicity testing of plasma samples suggested that five of the eight monkeys included in the study developed ADAs, and that monkeys with higher levels of ADA showed faster clearance at a dose of 1 mg / kg. AUC (0- 42d) was reported for the 10 mg / kg group. IC26.3 IgG1f S267E exhibited an almost dose-proportional increase in Cmax and AUC (0-T) and AUC (0-INF). With the increment of the dose in the proportion of 1:10, the Cmax in the male and female monkeys increased in the ratio of 1: 8 and 1: 8, respectively; and AUC (0-T) increased at 1:16 and 1:11, respectively, and AUC (0-INF) increased at 1:11 and 1:11, respectively.
[00567] [00567] IC26.3 IgG1f S267E concentrations intact and the deamidated product after an intravenous dose of 10 mg / kg were quantified using LCMS / MS. The concentrations of the deamidated product varied between 0.5% and 8% of the total ICOS.33 IgG1f S267E at all measured time points. The AUC (0-42d) for the deamidated product was 2.9% of the total S267E IgG1f exposure of ICOS.33.
[00568] [00568] Although increased C1q binding has been observed in vitro, the absence of clinical signs evident in the single-dose study in monkeys and the absence of hemodynamic effects in a model of cardiovascular instrumented monkey showed a low risk of complement activation. ICOS.33 IgG1f S267E was well tolerated when administered intravenously as a single dose at 1 mg / kg or 10 mg / kg in cynomolgus monkeys with a proportional increase in the exposure dose. No findings of adverse clinical pathology were observed. EXAMPLE 15 Anti-ICOS Antibody Binding Competition
[00569] [00569] Epitope storage experiments were conducted to determine which anti-ICOS antibodies compete with others that bind to huICOS. Epitope storage is a process that uses a competitive immunoassay to test antibodies in a paired combinatorial manner, and antibodies that compete for the same binding region, that is, the same or a closely related epitope of an antigen, are grouped together in boxes. Peer competition between anti-huICOS antibodies was determined as follows. A reference antibody (i.e., ICOS.33, 20H4, 27B9, 23B6, 12D10, 23A10, 15B7, 12F3, 13B4, 17H9, 26E11, 23H5, 6D1,
[00570] [00570] The binding competition experiments determined that the antibodies ICOS.33, 20H4, 27B9, 23B6, 12D10, 23A10, 15B7, 12F3, 13B4, 17H9, 26E11, 23H5, 6D1, 12A9, 5C4, 10B10, 17C4, 1D7 , 21E1, 9F11, 15H11, 25B10, 8A10, 4D11, 6D5, 7C6 and 26E9 compete crosswise and block the ligand (B7-H2; ICOS-L) from binding to the water. Antibodies 3E8, 16H4 and 25E4 compete with each other, but do not block the ligand from binding to water. In contrast, while antibody 2644 was found to cross-compete with antibody 3E8, it was also able to block ligand binding to ICOS. EXAMPLE 16 Mapping of Anti-ICOS Antibody Epitope Mapping of Anti-ICOS Antibody Epitope by Yeast View
[00571] [00571] Epitopes for anti-huICOS antibodies 3E8 and ICOS.4 were determined to exhibit randomly mutagenized variants of the human ICOS extracellular domain (residues 21 - 134 of NP_036224.1, provided as SEQ ID NO: 173) by yeast cells ( Saccharomyces cerevisiae), and classify yeast cells based on their binding or not binding to particular antibodies. Selected yeast cells were amplified and subjected to additional rounds of selection based on their ability to bind to tested anti-ICOS antibodies. See, for example, Chao et al. (2004) J. Mol. Biol. 342: 539. Sequences for huICOS variants were determined for the resulting yeast and analyzed for the effects of each residue on antibody binding. The binding epitope for the antibodies of the present invention has been determined as the loci within the huICOS sequence where single mutations of amino acids interrupt binding to the anti-huICOS antibodies of the present invention.
[00572] [00572] In summary, error-prone PCR was used to clone DNA encoding human ICOS (encoding residues 21 - 134 of SEQ ID NO: 1) in constructs that allow expression of the huICOS variants as amino terminating portions of proteins fusion cells further comprising a myc marker sequence and yeast cell wall protein Aga1p. Such constructs, when expressed in yeast (Saccharomyces cerevisiae), exhibit variant polypeptides from huICOS on the surface of yeast cells, anchored to the cell surface by the Aga1p polypeptide. The c-myc marker was used as a positive control to classify yeast cells that exhibit water fusion proteins. These yeast cells were then also classified for those that expressed properly folded huICOS fusion proteins (as determined by binding to a control mouse anti-huICOS antibody detected by an allophychocyanin-labeled goat anti-IgG secondary (APC) )), but did not bind to the antibodies of the present invention (as determined by detection with a goat anti-human IgG labeled with phycoerythrin (PE) as a secondary). These selected yeast cells were grouped, amplified and used in a subsequent selection cycle. The huICOS sequence was determined for yeast constructions remaining after selection.
[00573] [00573] Yeast populations that bind to ICOS.4 and 3E8 show different mutation patterns, indicating that different epitopes have been recognized by these two antibodies. Similar experiments were carried out with the 9D5 antibody, which blocks the binding of the ICOS ligand to ICOS and which competes with ICOS.4. For the 9D5 experiments, a molecular model of the three-dimensional structure of ICOS based on the crystal structure of the CTLA-4 / B7-2 complex (for example, Stamper et al. (2001) Nature 410: 608) was used to distinguish which amino acid residues are buried and are exposed on the surface to determine which of the selected mutations were more likely to be specific antibody contact residues (i.e., epitope residues) as opposed to mere structurally disruptive mutations. The inferred yeast display epitopes for ICOS.4, 3E8 and 9D5 are provided in Table
[00574] [00574] Similar yeast display experiments were performed with ICOS-L (B7-H2) instead of anti-ICOS mAbs to determine which residues in ICOS are critical for the interaction of
[00575] [00575] Deuterium exchange experiments with antibodies ICOS.4 and 9D5 confirmed that the S112 and L123 region is contacted when ICOS is linked to ICOS-L, which suggested an Epitope functional region from ICOS residues 112-123 (SEQ ID NO: 1), or SIFDPPPFKVTL (SEQ ID NO: 203). This region overlaps with the C-terminating portion of the epitope, determined by yeast display, and represents the largest cluster of residues along the primary sequence.
[00576] [00576] The epitopes for the anti-water antibodies ICOS.4 and 9D5 were determined by hydrogen / deuterium exchange mass spectrometry (HDX-MS) see, for example, Epitope Mapping Protocols in Methods in Molecular Biology, Vol. 66 , GE Morris, Ed. (1996) as described herein. ICOS-Fc was mixed with mAbs in a 1: 1 ratio and HDX-MS was run for one minute, 10 minutes, 4 hours in duplicate.
[00577] [00577] The results show that ICOS.4 and 9D5 bind to the same discontinuous epitope, which is shown below (epitope is underlined) and in Figure 1
[00578] [00578] MKSGLWYFFLFCLRIKVLTGEINGSANYEMFIFHNGGVQIL CKYPDIVQQFKMQLLKGGQ 60
[00579] [00579] ILCDLTKTKGSGNTVSIKSLKFCHSQLSNNSVSFFLYNLDH SHANYYFCNLSIFDPPPFK 120
[00580] [00580] VTLTGGYLHIYESQLCCQLKFWLPIGCAAFVVVCILGCILIC WLTKKKYSSSVHDPNGEY 180
[00581] [00581] MFMRAVNTAKKSRLTDVTL 199
[00582] [00582] (SEQ ID NO: 1) EXAMPLE 17 Expression of ICOS in Peripheral Blood and Infiltrating Tumor Lymphocytes of Patients with Lung, Kidney and Colon Cancer
[00583] [00583] Understanding the expression of ICOS in tumor infiltrating lymphocytes (TIL) in different types of tumors and patient populations helped to identify the relevant disease indication and patient population for effective ICOS.33 IgG1f S267E therapy , especially in combination with anti-PD-1 agents such as nivolumab. The frequency and magnitude of ICOS and PD-1 expression in peripheral blood and TIL cells (CD8 + and CD4 + T cells) were profiled in non-small cell, renal and colorectal lung (CRC) specimens.
[00584] [00584] Fresh tumor tissues and corresponding peripheral blood samples were obtained from patients with lung cancer, kidney cancer or CRC (ConversantBio, MT Group, Benaroya) and sent overnight at 4 ° C in hypothermosol FRS (Biolife Solutions) and ACD A solution (BD Biosciences), respectively. All samples were processed and stained within 24 hours of surgery. Tumor tissues were weighed and dissociated using the Miltenyi dissociation kit (Miltenyi, Catalog 130-095-929), while peripheral blood cells were isolated after lysis of red blood cells (RBC) in RBC Lysis Buffer ( BioLegend, Catalog 420301). Cell suspensions (from tumor tissues or peripheral blood) were washed twice in HBSS (no Ca, no Mg), stained with NIR Viability Dye (Molecular Probes by Life Technologies, Catalog L34976), blocked with human AB serum in buffered saline by Dulbecco's phosphate (dPBS), and added to wells containing antibody cocktails (Table 31) for incubation on ice in the dark for 45 minutes. The cells were then washed twice with dPBS / BSA / Na azide, fixed and permeabilized using the FOXP3 buffer kit (BioLegend, Catalog 421403). Fluorescence controls minus one (FMO) were prepared for all antibodies and used to determine positive cell populations. Samples were acquired on the Fortessa flow cytometer (BD Biosciences) and the data were analyzed using FlowJo Software (TreeStar).
[00585] [00585] As shown in Table 31, a panel was designed to examine the expression of multiple markers and the expression of ICOS in CD8 + and CD4 + T cells was analyzed. Table 31 Antibodies used for immunofluorescence staining for T-cell subsets
[00586] [00586] For staining of Treg, Teff cells, B and NK cells, fresh tumors of the head and neck, lung, CRC and endometrial cancers were placed in a 6-well plate seated on ice, immersed in 1-2 mL of medium dissociation. The tumors were cut into small pieces and the tumor solution was placed in the Dounce homogenizer for dissociation. The tumor solutions were filtered through a 70 µm filter with additional dissociation media and centrifuged. The resulting cells were resuspended in the staining buffer. The fresh omentum metastatic tumor tissue sample was dissociated using the Miltenyi dissociation kit (Miltenyi, Catalog 130-095-929). Frozen tumor samples were thawed and DNase was added dropwise (2 ml DNase solution). The thawing medium (8 mL heated in a 37 ° C bath) was added to the tumor and DNase solution and filtered through a 70 µm filter. The cells were centrifuged and resuspended in staining buffer.
[00587] [00587] ICOS expression in TIL was evaluated by FACS analysis. Tumor-derived cell suspensions were blocked with staining buffer containing the Dead Cell Near-IR dye. Surface cell population markers were stained with antibodies (as shown in Table 32) to determine positive cell populations, followed by FOXP3 intracellular staining after fixation and permeabilization. Flow cytometric data were collected using a Fortessa X-20 flow cytometer. After controlling the parameters of the FSC-SSC-Live / Dead markers to exclude debris and dead cells, the frequency of ICOS + cells was determined for subsets of CD4 + Teff, Treg, CD8 + T cell, B cell and NK cell subsets. Cytometric analysis of CD4 + flow was performed with the FlowJo analysis software.
[00588] [00588] ICOS expression was assessed using the anti-ICOS clone C398.4a in whole blood samples from 16 healthy donors and 14 lung cancer patients, 22 from CCR and 14 from CCR. In comparison with healthy donors, the frequencies of CD4 + ICOS T cells obtained from cancer patients were higher (Table 33, P <0.001 for all groups of cancer patients compared to healthy donors, Mann-Whitney test). The frequencies of ICOS + CD8 + T cells from patients with CCR were significantly higher compared to healthy donors. Table 33, P <0.01, Mann-Whitney). In blood samples from patients with lung cancer and CRC, the percentages of ICOS + CD8 + T cells were also higher than in samples from healthy donors without reaching statistical significance (Table 33).
[00589] [00589] Because higher frequencies were observed than reported in the literature and because clone C398.4a positively stained more T cells than the other commonly used clone ISA-3,6,7,8,9,10,
[00590] [00590] Next, the expression of ICOS was evaluated in TIL of 11 patients with lung cancer, 21 RCC and 8 patients with CRC. Frequencies of ICOS + CD4 + and ICOS + CD8 + TIL were similar between tumor types (Table 34). As in peripheral blood, the high expression of ICOS by CD4 + and CD8 + TIL cells was measured. On average, a higher percentage of CD4 + T cells expressed higher levels of ICOS than CD8 + T cells (Table 34). Coexpression of ICOS and PD-1 in TIL was also measured. High levels of PD-1 (PD-1hi) were expressed by ICOShi CD4 + TIL with great inter-patient variability (Table 34). In comparison with ICOShi CD4 + TIL, a higher proportion of ICOShi cd8 + T cells co-expressed high levels of PD-1 (Table 34). Table 33 - AVERAGE Frequencies ± ICOS + SD and ICOShi CD4 + and CD8 + T Cells in Peripheral Blood Samples from Healthy Donors and Cancer Patients.
[00591] [00591] Human tumor samples from patients with two lung adenocarcinomas, an endometrial adenocarcinoma, a serous papillary carcinoma metastasis, a colorectal adenocarcinoma liver metastasis and a head and neck squamous cell carcinoma were dissociated and stained for analysis flow cytometry of ICOS expression in various lymphocyte populations. Of the five different lymphocyte populations represented (CD4 + Teff cells, Tregs, CD8 +, B cells, NK cells), CD4 + Teff and Tregs expressed the highest ICOS frequencies. In cell populations that expressed ICOS (T4 CD4 Teff cells, Tregs, CD8 and NK cells), Tregs expressed more ICOS on a per cell basis compared to other cell types.
[00592] [00592] In summary, ICOS was expressed at higher levels in CD4 + T cells than in CD8 + T cells in peripheral blood and TIL. ICOS expression was variable between patients and was similar for the three types of tumor tested. On average, 33% to 48% of ICOShi CD4 + TIL and 62% to 71% of ICOShi CD8 + TIL co-expressed high levels of PD-1. In addition, Tregs expressed higher levels of ICOS than CD4 + Teffs, CD8 + T cells, NK cells and B cells in the human tumor microenvironment.
[00593] [00593] Phase 1/2, open, S267E IgG1f study of ICOS.33 administered as a monotherapy or in combination with an anti-PD-1 antibody, an anti-PD-L1 antibody, and / or an anti - CTLA-4 (for example, nivolumab and / or ipilimumab) is performed on participants with advanced solid tumors. The study includes the following parts: dose escalation monotherapy (Preliminary Safety Cohorts and Part A); combined dose escalation therapy with nivolumab (Part B) or ipilimumab (Part C); and dose expansion phase with nivolumab (Part D) or ipilimumab (Part E). Goals
[00594] [00594] The main objective of this study is to characterize the safety and tolerance of the IC26.3 IgG1f S267E administered alone and in combination with nivolumab or ipilimumab in participants with advanced solid tumors.
[00595] [00595] Secondary objectives include exploring the preliminary efficacy of IC26.3 IgG1f S267E administered alone and in combination with nivolumab or ipilimumab in participants with advanced solid tumors; characterize the PK of S267E of IgG1f from ICOS.33 when administered alone and in combination with nivolumab or ipilimumab in participants with advanced solid tumors; characterize the immunogenicity of S267E to IgG1f from ICOS.33 when administered alone and in combination with nivolumab or ipilimumab in participants with advanced solid tumors; and to monitor the target involvement of IC26.3 IgG1f S267E administered alone and in combination with nivolumab or ipilimumab in participants with advanced solid tumors.
[00596] [00596] In addition, exploratory objectives include examining the association between antitumor activity and specific measures of biomarkers in tumor tissue and peripheral blood before treatment and after administration of IC26.3 IgG1f S267E alone and in combination with nivolumab or ipilimumab; characterize the relationship (s) between IC26 S267E IgG1f PK of ICOS.33 alone and in combination with nivolumab PK or ipilimumab PK and safety, efficacy, and / or clinical biomarkers; evaluate the overall survival rate (OSR) in participants treated with IgG1f S267E from ICOS.33 alone and in combination with nivolumab or ipilimumab; characterize the PK and immunogenicity of nivolumab and ipilimumab when administered in combination with IC261 IgG1f S267E; characterize the immunogenicity of nivolumab and ipilimumab when administered in combination with IC261 IgG1f S267E; to evaluate the potential effect of IC26.3 IgG1f S267E on the corrected QT interval (QTc); and to explore associations between selected biomarkers of peripheral blood and incidence of adverse events (AEs) and serious adverse events (SAEs). General Planning
[00597] [00597] A scheme for planning the study is shown in Figure 27.
[00598] [00598] Monotherapy consists of two different cohorts, as follows:
[00599] [00599] Preliminary Safety Cohorts: IC26.3 IgG1f S267E administered as monotherapy at 2 mg and 8 mg once every four weeks for 24 weeks.
[00600] [00600] Part A: ICOS.33 IgG1f S267E administered as 25 mg, 80 mg, 200 mg, 400 mg and 800 mg once every four weeks for 24 weeks.
[00601] [00601] Parts B and C consist of different combination cohorts, including:
[00602] [00602] B1: ICOS.33 IgG1f S267E administered once every 12 weeks + nivolumab 480 mg once every 4 weeks at an ICOS.33 IgG1f S267E starting dose level recommended by the Bayesian Logistic Regression Model (BLRM) - Copula model and PK / PD data available from Part A.
[00603] [00603] B2: ICOS.33 IgG1f S267E once every 4 weeks + nivolumab 480 mg once every 4 weeks at an ICOS.33 IgG1f S267E dose level recommended by the Bayesian Logistic Regression Model (BLRM ) –Copula Model (BLRM-RD) and PK / PD data available from Part A.
[00604] [00604] C1: IC26.3 IgG1f S267E once every 12 weeks + ipilimumab 3 mg / kg once every 4 weeks at an ICOS.33 IgG1f S267E starting dose level recommended by the Bayesian Regression Model Logistics (BLRM) - Copula model and PK / PD data available from Part A.
[00605] [00605] C2: ICOS.33 IgG1f S267E once every 4 weeks + ipilimumab 3 mg / kg once every 4 weeks at an ICOS.33 IgG1f S267E dose level recommended by the Bayesian Logistic Regression Model (BLRM) - Copula model and PK / PD data available from Part A.
[00606] [00606] Parts B1 and C1 are registered simultaneously. Parts B2 and C2 are recorded only if additional safety data, PK or PD are needed to optimize the dose and / or schedule selection.
[00607] [00607] S267E IgG1f doses from ICOS.33 for Parts B and
[00608] [00608] At no time does the IC26.3 IgG1f S267E dose administered in combination with nivolumab or ipilimumab (Parts B and C) exceed the ICOS.33 IgG1f S267E dose that is demonstrated to be safe in the escalation arm of monotherapy dose (Part A), or at any time during combination therapy in Parts B and C the dose of IC26.33 IgG1f S267E exceeds the highest dose determined to be tolerated in the monotherapy dose escalation arm ( Part A). In addition, the initial dose level of IC26.3 IgG1f S267E used in combination with nivolumab or ipilimumab (Parts B and C) is a lower dose level than the monotherapy dose (Part A) that eliminated the DLT period .
[00609] [00609] Parts B1 and C1 consist of a substudy of
[00610] [00610] Doses other than IC26.3 IgG1f S267E are administered in Parts B1 and C1:
[00611] [00611] Doses that induce or are expected to induce different levels of sub-regulation of the ICOS receptor, including at least one dose that induces almost complete sub-regulation of the receptor (and / or change in selected target bioinvolvement / pharmacodynamics) ) for a period of at least 4 weeks. These dose levels allow the characterization of the re-expression kinetics of the ICOS receptor after an almost complete sub-regulation for a period of time equal to, less than, and / or exceeding the dosage ranges used in Part A. kinetics of the ICOS receptor, may help inform the testing of the IC26.3 IgG1f S267E dosing ranges in future studies.
[00612] [00612] BLRM-RD: Dose levels are determined based on all available safety data (clinical and laboratory) and PK, as well as changes in peripheral markers of target involvement (eg, sub-regulation of ICOS in T and B ICOS + cells) of previous or complete portions of current cohorts, and / or the BLRM / BLRM-Copula model, when applicable.
[00613] [00613] After 24 weeks of treatment in monotherapy, or two years of combination therapy, the participant may be eligible for retreatment. For Part A, scans are collected centrally and can be reviewed by blind independent central review (BICR) at a later date, or at any time during the study. For parts B and C, scans are collected centrally to be reviewed in real time by the BICR.
[00614] [00614] Physical exams, vital signs measurements, 12-lead electrocardiogram (ECG) and clinical laboratory evaluations are performed at selected times during the dosing interval.
[00615] [00615] Participants are closely monitored for AEs during the study. Blood is collected at follow-up visits 30, 60 and 100 days after administration of the study treatment for pharmacokinetic analysis.
[00616] [00616] Participants complete up to four phases of the study: screening, treatment, safety monitoring and response / survival monitoring, as described below. The total duration of participation in the study is approximately 2 years. Tetanus vaccine
[00617] [00617] All patients in Parts A, B and C receive an approved tetanus vaccine. The administration of a potent recall antigen, such as tetanus toxoid, stimulates the immune system, induces an immune response and promotes a more immunogenic state.
[00618] [00618] The ability of IC26.3 IgG1f S267E to increase recall response will be determined by monitoring tetanus antibodies and proliferative and cytokine responses by CD4 + T cells after vaccination against tetanus. Approximately 70% of the general population has protective tetanus antibodies. However, cellular immune responses are generally detectable in peripheral blood one month after the tetanus vaccine. Tetanus has been used as a reporter antigen in cancer patients receiving immunotherapy with vaccines and can be easily monitored. Consequently, vaccination against tetanus may provide a potent recall response with S267E of IgG1f from ICOS.33 alone and in combination with nivolumab or ipilimumab.
[00619] [00619] The screening phase lasts up to 28 days and occurs before the first administration of the study treatment. During the screening phase, the participant's initial eligibility is established and written informed consent is obtained. Tumor biopsies are collected for all participants, assessed centrally for the expression of ICOS by immunohistochemistry, and the results are evaluated before the administration of the first dose of the study treatment. Participants are registered using Interactive Response Technology (IRT). Treatment Phase
[00620] [00620] The treatment phase in the Preliminary Safety Cohort and Part A consists of up to six treatment cycles of four weeks (1 cycle = 28 days). In the Preliminary Safety Cohort and Part A, each treatment cycle consists of IC26.3 IgG1f S267E monotherapy for a total of 24 weeks.
[00621] [00621] Dose levels for Parts B and C are determined based on all available safety (clinical and laboratory) and pharmacokinetic data, as well as changes in peripheral markers of target involvement (eg, sub-regulation of ICOS in T and B cells ICOS +) from previous and complete portions of the current cohorts, and are guided by the BLRM / BLRM-Copula model, when applicable.
[00622] [00622] In Parts B1 and C1, four-week cycles are used, so that IC26.3 IgG1f S267E + nivolumab or ipilimumab is administered from Cycle 1 Day 1. Nivolumab and ipilimumab are administered on Day 1 of each cycle. IC26.3 IgG1f S267E is administered once every 12 weeks, or on Day 1 of each third cycle (Cycle 1 Day 1, Cycle 4 Day 1, Cycle 7 Day 1, etc.). Participants in Parts B1 and C1 continue treatment for up to a total of 2 years.
[00623] [00623] The treatment phase in Parts B2 and C2 consists of IC26.3 IgG1f S267E + nivolumab or ipilimumab administered on Day 1 of each cycle for up to a total of 2 years, and are recorded only if additional safety data, PK or PD are needed to optimize the dose and / or schedule selection.
[00624] [00624] After each treatment cycle, the decision to treat a participant with additional study treatment cycles is based on tumor evaluation assessments performed every 12 weeks (once every 12 weeks ± 1 week) and completed before the first dose in the next cycle. Tumor progression or response purposes are assessed using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 or Prostate Cancer Working Group Guidelines 3 (PCGW3), for prostate only (Scher et al., 2016. Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3. Clin Oncol. 34 (12): 1402-1418).
[00625] [00625] Treatment in addition to progression with additional study treatment cycles is allowed for up to a maximum of 24 weeks for Part A and two years for Parts B, C, D and E in selected participants with initial RECIST v1.1 or PCGW3 (prostate only) defined PD after discussion and agreement between Principal Investigator and BMS Study Medical Director / Director that benefit / risk assessment favors continued administration of study treatment (eg, participants continue to experiment clinical benefit as assessed by the investigator, tolerating treatment, and meeting other specific criteria).
[00626] [00626] Participants with an unconfirmed progressive disease response (PD), stable disease (SD), partial response (PR) or complete response (CR) at the end of a given cycle continue into the next treatment cycle. Participants are generally allowed to continue treatment for the study until the first occurrence of 1) completion of the maximum number of cycles, 2) confirmation of PD, 3) clinical deterioration suggesting that no additional treatment benefits are likely, 4) therapy intolerance or 5) a participant who meets the criteria to discontinue study treatment. Individual participants with confirmed CR have the option to discontinue study treatment on a case-by-case basis, after specific consultation and agreement between the investigator and the BMS medical monitor / study director, in situations where benefit / risk justifies discontinuing treatment of study. Security monitoring
[00627] [00627] After completing 24 weeks of study treatment for Part A (or up to a maximum of 48 weeks, if applicable) or two years for Parts B, C, D and E (or up to a maximum of four years , if applicable), the decision is made to discontinue the study treatment participant (for example, at the end of treatment [EOT]) and all participants enter the safety follow-up period.
[00628] [00628] For participants who complete all scheduled therapy cycles, the EOT visit is the same as the last visit scheduled and completed on treatment and the start of the week 1 safety follow-up visit. For participants who have not completed For all scheduled study treatment cycles, the EOT visit is the most recent treatment visit (with all safety and response data available) and is considered the start of the safety follow-up visit.
[00629] [00629] After the EOT visit, all participants are evaluated for any new AEs for at least 100 days after the last dose of study treatment. Follow-up visits to monitor AEs occur on days 30, 60 and 100 after the last dose or on the date of discontinuation (± 7 days). All participants are required to complete the 3 clinical safety follow-up visits, regardless of whether or not they start new anti-cancer treatment, except for participants who withdraw consent to participate in the study. Survival Monitoring
[00630] [00630] After the completion of the safety follow-up visits, all participants treated with monotherapy and combination therapy enter the follow-up period of survival. Participants are followed approximately every three months (12 weeks) until death, loss of follow-up, withdrawal of consent or completion of the study, whichever comes first. The duration of this phase is up to two years from the first dose of the study treatment, although a longer follow-up period is considered in selected cases, if a sign of effectiveness is evident. Response Tracking
[00631] [00631] After completing the security follow-up period, participants with SD, RP or CR on the EOT visit enter the response follow-up period. This period occurs simultaneously with the survival follow-up period for the mentioned participants. Participants continue to have radiological and clinical assessments of the tumor approximately every 3 months (12 weeks) until death, loss of follow-up, withdrawal of consent or completion of the study, whichever comes first. Assessments of radiological tumors for participants who have continued clinical benefits continue to be collected after participants complete the study's survival phase. Participants who have disease progression after the initial course of treatment under study are not assessed for response beyond the visit to the EOT and may receive other therapy directed at the tumor,
[00632] [00632] All participants are treated for 24 weeks of monotherapy or combination therapy, unless the criteria for discontinuing the study treatment are met previously. All participants who completed treatment with ongoing disease control (RC, RP or DP) or unconfirmed PD are eligible for an additional 24 weeks of treatment under study for Part A or for a total of two years for combination therapy, on a case-by-case basis, after careful evaluation and discussion with the BMS Medical Monitor / Study Director to determine whether the risk / benefit ratio supports the administration of additional treatment under study. Upon completion of the additional treatment period under study, all participants enter the safety follow-up period. Treatment beyond progression
[00633] [00633] Treatment beyond progression is allowed in selected participants with the initial defined PD RECIST v1.1 or PCGW3 (prostate only) after discussion and agreement with the BMS Medical Monitor / Study Director that the benefit / risk assessment favors the continued administration of study treatment (for example, participants continue to experience clinical benefit as assessed by the investigator, tolerating treatment and meeting other criteria).
[00634] [00634] Participants are again authorized with an informed consent form addendum (ICF) to continue treatment beyond progression. Treatment beyond progression requires continued tumor assessments.
[00635] [00635] New treatment is allowed in this study with the disease progressing during the Response Follow-up period. Participants who completed approximately 24 weeks of treatment under study (or up to a maximum of 48 weeks, if applicable) for Part A and approximately two years of treatment under study (or up to a maximum of 4 years, if applicable) for Parts B , C, D and E or less in case of discontinuation due to CR, who enter the follow-up period of response with ongoing disease control (CR, PR or SD) and without any significant toxicity are eligible for further treatment after subsequent progression of the disease confirmed within 12 months of the last dose of treatment under study, on a case-by-case basis, after careful evaluation and discussion with the BMS Medical Monitor / Study Director to determine whether the risk / benefit ratio supports administration again treatment under study and the participant continues to meet the eligibility criteria for treatment with treatment under study.
[00636] [00636] Participants who meet the criteria for re-treatment are treated with the monotherapy or combination therapy regimen (for example, the same dose and dose schedule administered during the first 24 weeks), unless the dose (s) (s) and the schedule are subsequently found to exceed the most recent BLRM-RD, in which case the participant is treated with the BLRM-RD. Participants entering this phase follow the procedural schedule. Samples for PK and pharmacodynamics are collected less frequently (in the predose of each treatment cycle). During the new treatment, the pharmacodynamic biomarker samples obtained from blood are collected. Type of Participant and Characteristics of the Target Disease
[00637] [00637] Participants must be at least 18 years of age and have histological or cytological confirmation of metastatic and / or unresectable colorectal cancer (CRC), squamous cell carcinoma of the head and neck (CECP), non-small cell lung cancer (CPNPC), prostate adenocarcinoma (CPR) and urothelial carcinoma (CCU) with disease measurable by RECIST v1.1 or PCGW3 (prostate only) and have at least 1 lesion accessible for biopsy in addition to the target lesion.
[00638] [00638] Presence of at least 1 lesion with measurable disease, as defined by RECIST v1.1 or PCGW3 (prostate only) for solid tumors to assess the response. Participants with injuries in a previously irradiated field as the only measurable disease site are allowed to register, provided the injury (s) has demonstrated a clear progression and can be measured.
[00639] [00639] Participants must have received, and then progressed or been intolerant to, at least 1 standard treatment regimen in the advanced or metastatic context, if such therapy exists, and was considered for all other potentially effective therapies prior to enrollment.
[00640] [00640] Participants with prior exposure to therapy with any agent specifically aimed at inhibiting the checkpoint pathway (such as anti-PD-1, anti-PD-L1 or anti-CTLA-4) are allowed after a cleaning period any time longer than 4 weeks from the last treatment. Colorectal cancer tumor types (RCC)
[00641] [00641] Histologically confirmed CRC that is metastatic or recurrent with documented disease progression.
[00642] [00642] Document microsatellite instability, incompatibility repair, KRAS and BRAF status if known.
[00643] [00643] Prior therapy requirement: participants must have received at least 1, but not more than 3, previous systemic therapies for metastatic and / or unresectable disease (or have progressed within 6 months of adjuvant therapy).
[00644] [00644] The participant must have incurable metastatic disease (that is, patients with a disease that is potentially curable by surgical resection are not eligible for treatment).
[00645] [00645] head and neck squamous cell carcinoma (HNSCC) (oral cavity, pharynx, larynx)
[00646] [00646] HNSCC Histologically confirmed incurable, locally advanced, recurrent or metastatic (oral cavity, pharynx, larynx), Stage III or IV and not subject to local therapy with curative intention (surgery or radiotherapy with or without chemotherapy).
[00647] [00647] Must have documented HPV STATUS and subtype, especially HPV16 and HPV18.
[00648] [00648] Participants must have received and then progressed or were intolerant or refractory to at least 1, but not more than 2 previous systemic therapy regimens (eg, platinum-based chemotherapy) for the treatment of metastatic disease or non-disease locally advanced resectable.
[00649] [00649] Previous curative radiation therapy must have been completed at least 4 weeks before the treatment under study is administered. The previous focal palliative radiotherapy must have been completed at least two weeks before the treatment under study is administered. non-small cell lung cancer (NSCLC)
[00650] [00650] Participants must have histological or cytological confirmation of NSCLP (by the seventh International Association for the Study of Lung Cancer [IASLC]) with scaly or non-scaly histology that is advanced (metastatic and / or unresectable).
[00651] [00651] (1). Participants must have at least 1, but not more than 2, previous systemic therapies for NSCLC. Maintenance, adjuvant, or neoadjuvant therapy (chemotherapy or chemoradiotherapy) does not count as an additional treatment line.
[00652] [00652] (2). Participants should have received platinum-based chemotherapy for NSCLC. Platinum-based chemotherapy may have been in an adjuvant, neoadjuvant, or chemoradiation context. Participants with recurrent / metastatic disease who have returned within 6 months of completing such treatment are considered eligible for the treatment under study. Pre-adjuvant or neoadjuvant chemotherapy is allowed as long as the last administration of the previous regimen took place at least 4 weeks before enrollment.
[00653] [00653] (3). Previous definitive chemoradiation for locally advanced disease is also allowed as long as the last administration of chemotherapy or radiotherapy (which was done last) occurred at least 4 weeks before enrollment.
[00654] [00654] (4). Participants with known EGFR mutations or ALK rearrangements must have received EGFR or ALK inhibitors, respectively. The mutational status of EGFR, ALK, KRAS and ROS1 should be documented, if known. prostate adenocarcinoma (PRC)
[00655] [00655] Histological or cytological confirmation of prostate adenocarcinoma.
[00656] [00656] Participants were treated by orchiectomy or are receiving a luteinizing hormone releasing hormone analogue, and have a testosterone level ≤ 50 ng / dL.
[00657] [00657] Metastatic disease by any of the following modalities: computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy.
[00658] [00658] Histological or cytological evidence of metastatic or surgically unresectable transitional cell carcinoma of the urothelium involving the bladder, urethra, ureter or renal pelvis. Dose-Limiting Toxicities of IC26 IgG1f S267E (DLTs)
[00659] [00659] For the purpose of guiding dose escalation, DLTs are defined based on the incidence, intensity and duration of AEs for which no clear alternative cause is identified. The DLT period is 35 days (5 weeks).
[00660] [00660] In the Preliminary Safety Cohorts, participants who receive 1 dose of S267E IgG1f from ICOS.33 and complete, or discontinue due to a DLT in the DLT period of 4 weeks, are considered participants evaluable by DLT for monotherapy with IC26.3 IgG1f S267E.
[00661] [00661] In Part A, participants who receive two doses of S267E of IgG1f from ICOS.33 and complete, or who discontinue due to a DLT in the DLT period of 5 weeks, are considered participants evaluable by DLT for monotherapy with S267E of IgG1f from ICOS.33.
[00662] [00662] In Parts B, C, D and E, participants receiving 1 dose of IC26.3 IgG1f S267E or two doses of nivolumab or ipilimumab, or participants discontinuing due to a DLT in the DLT combination treatment period 5 weeks, are considered as participants evaluated by DLT for the combination treatment. Participants who drop out of the study during the DLT assessment period or receive less than two doses for reasons other than a DLT on monotherapy (Part A) or a dose on combination therapy (Parts B, C, D, E) they are not considered as participants evaluable by DLT and are not replaced by a new participant with the same dose level. Participants in Part A who are delayed in their dose during the evaluation period by DLT for reasons other than DLT, are considered participants eligible for DLT if they receive at least two doses of therapy.
[00663] [00663] For the purpose of controlling participants, any AE that meets the DLT criteria, regardless of the cycle in which it occurs, leads to the discontinuation of the treatment under study. Participants who drop out of the study during the 5-week DLT evaluation period, for reasons other than DLT, can be replaced by a new participant with the same dose level. The incidence of DLT (s) during the 5-week DLT assessment period is used in dose escalation decisions and to define BLRM-RD. AEs occurring after the DLT period are considered for the purposes of defining the BLRM-RD by agreement between the Sponsor, the Medical Monitor / Study Director and the investigators.
[00664] [00664] Participants who experience a DLT enter the safety monitoring period of the study. DLTs that occur after the 4-week DLT observation period for Preliminary Safety Cohort or 5-week DLT observation period for Parts A, B and C are considered in determining the maximum administered dose (MAD) for the combination.
[00665] [00665] This study will show that the administered anti-ICOS antibodies are safe and effective in the treatment of cancer. EXAMPLE 19 Effects of Combining Increasing Doses of Anti-ICOS Antibody on Tumor Growth
[00666] [00666] The effect of increasing doses of anti-ICOS agonist antibody, S267E of IgG1f from ICOS.33, in combination with an anti-PD-1 antibody was evaluated on inhibiting tumor growth in a mouse model. As shown in Figure 28, the combination exhibited reduced efficacy at higher doses, that is, the "hook effect", where concentrations close to antibody saturation or saturation result in decreased efficacy compared to the antibody's effectiveness at lower concentrations, that is, concentrations that do not result in saturation.
[00667] [00667] In summary, mice (averaging about 20 mg by weight) with established CT26 tumors were treated by anti-PD-1 monotherapy or in combination with IC26.3 IgG1f S267E. Scaling of the anti-ICOS dose was initiated from 0.1 mg / kg with a three-fold increase to 10 mg / kg (or a maximum dose of approximately 200 µg / level dose of mouse). The anti-PD-1 antibody was dosed at 10 mg / kg (or a minimum dose of approximately 200 µg // level dose of mouse). Anti-ICOS and anti-PD1 antibodies were administered on the same schedule (that is, every 4 days starting on day 7) after tumor implantation.
[00668] [00668] As shown in Figure 28, maximum tumor growth inhibition (TGI) in anti-ICOS and anti-PD1 combination therapy was observed with a lower dose of anti-ICOS antibody (3 mg / kg) than maximum tested dose (10 mg / kg), demonstrating a decrease in GIT in doses above 3 mg / kg, that is, maximum effectiveness is achieved in sub-saturation doses.
Table 35
Sequence Listing Summary
SEQ ID No. String Name String
1 Human ICOS (NP_036224.1) MKSGLWYFFL FCLRIKVLTG EINGSANYEM FIFHNGGVQI 40
LCKYPDIVQQ FKMQLLKGGQ ILCDLTKTKG SGNTVSIKSL 80
KFCHSQLSNN SVSFFLYNLD HSHANYYFCN LSIFDPPPFK 120
VTLTGGYLHI YESQLCCQLK FWLPIGCAAF VVVCILGCIL 160
ICWLTKKKYS SSVHDPNGEY MFMRAVNTAK KSRLTDVTL 199
2 Human ICOS-L MRLGSPGLLF LLFSSLRADT QEKEVRAMVG SDVELSCACP 40 (NP_001269979.1) EGSRFDLNDV YVYWQTSESK TVVTYHIPQN SSLENVDSRY 80
RNRALMSPAG MLRGDFSLRL FNVTPQDEQK FHCLVLSQSL 120
GFQEVLSVEV TLHVAANFSV PVVSAPHSPS QDELTFTCTS 160
INGYPRPNVY WINKTDNSLL DQALQNDTVF LNMRGLYDVV 200
SVLRIARTPS VNIGCCIENV LLQQNLTVGS QTGNDIGERD 240
KITENPVSTG EKNAATWSIL AVLCLLVVVA VAIGWVCRDR 280
CLQHSYAGAW AVSPETELTE SWNLLLLLS 309
3 EVQLVESGGG LVKPAGSLTL SCVASGFTFS DYFMHWVRQA 40 heavy chain parental hamster PGKGLEWVAV IDTKSFNYAT YYSDLVKGRF TVSRDDSQGM 80
VYLQMNNLRK EDTATYYCTA TIAVPYYFDY WGQGTMVTVS 120
SATTTAPSVY PLAPACDSTT STTNTVTLGC LVKGYFPEPV 160
TVSWNSGALT SGVHTFPSVL HSGLYSLSSS VTVPSSTWPS 200
QTVTCNVAHP ASSTKVDKKI VPGDGSGCKP CTCPGPEVSS 240
VFIFPPKPKD VLTISLSPKV TCVVVDISQD DPEVQFSWFI 280
DGKEVHTAVT QPREEQFNST YRMVSVLPIL HQDWLNGKEF 320
KCKVNSPAFP VPIEKTISKR RGQLQVPQVY TMPPPKEQLT 360
QSQVSLTCMI KGFYPEDIDV AWQKNGQPEQ SFKNTPPVLD 400
TDETYFLYSK LDVKKDDWEK GDTFTCSVVH EALHNHHTEK 440
TLSQRPGK 448
4 DIQMTQSPSS LPASLGDRVT INCQASQDIS NYLSWYQQKP 40 antibody hamster parental hamster GKAPKLLIYY TNLLADGVPS RFSGSGSGRD YSFTISSLES 80
EDIGSYYCQQ YYNYRTFGPG TKLEIKRADA KPTVSIFPPS 120
SEQLGTGSAT LVCFVNNFYP KDINVKWKVD GSEKRDGVLQ 160
SVTDQDSKDS TYSLSSTLSL TKADYERHNL YTCEVTHKTS 200
TAAIVKTLNR NEC 213
5 String Variable Domain EVQLVESGGG LVKPGGSLRL SCAASGFTFS DYFMHWVRQA 40 Heavy IgG1f S267E of PGKGLEWVGV IDTKSFNYAT YYSDLVKGRF TISRDDSKNT 80 ICOS.33 LYLQMVYYYTTAGY
S 121
6 Light chain variable domain DIQMTQSPSS LSASVGDRVT ITCQASQDIS NYLSWYQQKP 40 ICOS IgG1f S267E.33 GKAPKLLIYY TNLLAEGVPS RFSGSGSGTD FTFTISSLQP 80
EDIATYYCQQ YYNYRTFGPG TKVDIK 106
7 IgG1f Heavy Chain S267E EVQLVESGGG LVKPGGSLRL SCAASGFTFS DYFMHWVRQA 40 by ICOS.33 PGKGLEWVGV IDTKSFNYAT YYSDLVKGRF TISRDDSKNT 80
LYLQMNSLKT EDTAVYYCTA TIAVPYYFDY WGQGTLVTVS 120
SASTKGPSVF PLAPSSKSTS GGTAALGCLV KDYFPEPVTV 160
SWNSGALTSG VHTFPAVLQS SGLYSLSSVV TVPSSSLGTQ 200
TYICNVNHKP SNTKVDKRVE PKSCDKTHTC PPCPAPELLG 240
GPSVFLFPPK PKDTLMISRT PEVTCVVVDV EHEDPEVKFN 280
WYVDGVEVHN AKTKPREEQY NSTYRVVSVL TVLHQDWLNG 320
KEYKCKVSNK ALPAPIEKTI SKAKGQPREP QVYTLPPSRE 360
EMTKNQVSLT CLVKGFYPSD IAVEWESNGQ PENNYKTTPP 400
VLDSDGSFFL YSKLTVDKSR WQQGNVFSCS VMHEALHNHY 440
TQKSLSLSPG 450
8 ICOS IgG1f S267E.33 DIQMTQSPSS LSASVGDRVT ITCQASQDIS NYLSWYQQKP 40 Light Chain GKAPKLLIYY TNLLAEGVPS RFSGSGSGTD FTFTISSLQP 80
EDIATYYCQQ YYNYRTFGPG TKVDIKRTVA APSVFIFPPS 120
DEQLKSGTAS VVCLLNNFYP REAKVQWKVD NALQSGNSQE 160
SVTEQDSKDS TYSLSSTLTL SKADYEKHKV YACEVTHQGL 200
SSPVTKSFNR GEC 213
9 IC26.3 IgG1f S267E DYFMH 5 CDRH1
10 ICOS IgG1f S267E.33 VIDTKSFNYA TYYSDLVKG 19 CDRH2
11 ICOS.33 IgG1f S267E TIAVPYYFDY 10 CDRH3
12 ICOS IgG1f S267E.33 QASQDISNYL S 11 CDRL1
13 YTNLLAD 7 parental hamster CDRL2 antibody
14 CDRL2 of S267E of IgG1f of YTNLLAE 7 ICOS.33
15 CDRL3 of S267E of IgG1f of QQYYNYRT 8 ICOS.33
16 String variable domain MDILCSTLLL LTVPSWVLSQ VTLRESGPAL VKPTQTLTLT 40 heavy 17C4 CTFSGFSLST SGMCVSWIRQ PPGKALEWLA LIDWDDDKFY 80
STSLKTRLTI SKDTSKNQVV LTMTNMDPVD TATYYCARMS 120
TPTYYGLDVW GQGTTVTVSS 140
17 Light chain variable domain MRVLAQLLGL LLLCFPGARC DIQMTQSPSS LSASVGDRVT 40 17C4 ITCRASQGIS SWLAWYQQKP EKAPKSLIYA ASSLQSGVPS 80
RFSGSGSGTD FTLTISSLQP EDFATYYCQQ YNSYPLTFGG 120
GTKVEIK 127
18 CDRH1 of 17C4 TSGMCVS 7
19 17C4 CDRH2 LIDWDDDKFY STSLKT 16
20 CDRH3 of 17C4 MSTPTYYGLD V 11
21 CDRL1 of 17C4 RASQGISSWL A 11
22 CDRL2 of 17C4 AASSLQS 7
23 CDRL3 of 17C4 QQYNSYPLT 9
24 String Variable Domain MDTLCSTLLL LTIPSWVLSQ ITLKESGPTL VKPTQTLTLT 40 9D5 Heavy CTFSGFSLGT SGLGVGWIRQ PPGKALEWLA FIYWDDDKRY 80
SPSLKSRLTI TKDTSKNQVV LTMTNMDPVD TATYYCAHRR 120
GFFDYWGQGT LVTVSS 136
25 Chain Variable Domain MRVLAQLLGL LLLCFPGARC DIQMTQSPSS LSASVGDRVT 40 Light 9D5 ITCRASQGIS SWLAWYQQKP EKAPKSLIYA ASSLQSGVPS 80
RFSGSGSGTD FTLTISSLQP EDFATYYCQQ YNSYPLTFGG 120
GTKVEIK 127
26 CDRH1 of 9D5 TSGLGVG 7
27 CDRH2 of 9D5 FIYWDDDKRY SPSLKS 16
28 CDRH3 of 9D5 RRGFFDY 7
29 CDRL1 of 9D5 RASQGISSWL A 11
30 CDRL2 of 9D5 AASSLQS 7
31 CDD3 of 9D5 QQYNSYPLT 9
32 Domain Variable chain MEFGLTWVFL VALLRGVQCQ VQLVESGGGV VQPGMSLRLS 40 heavy 3E8 CAASGFTFST YGMQWVRQAP GKGLEWVTVI WHDGSHKDYA 80
DSVKGRFTIS RDNSKNTMYL QMNSLRAEDT AVYYCARDRQ 120
TGEGYFDFWG QGTLVTVSS 139
33 Light chain variable domain MRVLAQLLGL LLLCFPGARC DIQMTQSPSS LSASVGDRVT 40 of 3E8 ITCRASQGIS SWLAWYQQKP EKAPKSLIYA ASSLQSGVPS 80
RFSGSGSGTD FTLTISSLQP EDFATYYCQQ YNSYPYTFGQ 120
GTKLEIK 127
34 CDRH1 of 3E8 TYGMQ 5
35 CDRH2 of 3E8 VIWHDGSHKD YADSVKG 17
36 CDRH3 of 3E8 DRQTGEGYFD F 11
37 CDRL1 of 3E8 RASQGISSWL A 11
38 CDRL2 of 3E8 AASSLQS 7
39 CDRL3 of 3E8 QQYNSYPYT 9
40 Chain variable domain MDTLCSTLLL LTIPSWVLSQ ITLKESGPTL VKPTQTLTLT 40 1D7 heavy CTFSGFSLGS NGLGVGWIRQ PPGKALEWLA LIYWDDDKRY 80
SPSLKSRLTI TKDSSKNQVV LTMTNMDPVD TATYYCAHRN 120
SGFDYWGQGI LVTVSS 136
41 Light Domain Variable Domain MRVLAQLLGL LLLCFPGARC DIQMTQSPSS LSASVGDRVT 40 of 1D7 ITCRASQGFS SWLAWYQQKP EKAPKSLIYA ASSLQSGVPS 80
RFSGSGSGTD FTLTISSLQP EDFATYYCQQ YNSYPYTFGQ 120
GTKLEIK 127
42 CDRH1 of 1D7 SNGLGVG 7
43 CDRH2 of 1D7 LIYWDDDKRY SPSLKS 16
44 CDRH3 of 1D7 RNSGFDY 7
45 CDRL1-a of 1D7 RASQGFSSWL A 11
46 CDRL2-a of 1D7 AASSLQS 7
47 CDRL3-a of 1D7 QQYNSYPYT 9
48 Chain Variable Domain MRVLAQLLGL LLLCFPGARC DIQMTQSPSS LSASVGDRVT 40 1D7 Light ITCRASQGIS SWLAWYQQKP EKAPKSLIYA ASSLQSGVPS 80
RFSGSGSGTD FTLTISSLQP EDFATYYCQQ YNSYPLTFGG 120
GTKVEIK 127
49 CDRL1-b of 1D7 RASQGISSWL A 11
50 CDRL2-b of 1D7 AASSLQS 7
51 CDRL3-b of 1D7 QQYNSYPLT 9
52 Domain Constant of chain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 huIgG1f heavy WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
53 Domain Constant of chain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 huIgG1f heavyweight S267E WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 ("SE") YICNVNCPKKTVE
PSVFLFPPKP KDTLMISRTP EVTCVVVDVE HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
54 ASTKGPSVFP chain constant domain LAPSSKSTSG GTAALGCLVK 40 DYFPEPVTVS heavy S267E / L328F of WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 huIgG1f ( "SELF") YICNVNHKPS NTKVDKRVEP KSCDKTHTCP 120 PCPAPELLGG
PSVFLFPPKP KDTLMISRTP EVTCVVVDVE HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA FPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
55 Constant Chain Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 huIgG1f P238D Heavy WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
56 String Constant Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 P238D / P271G Heavy from WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 huIgG1f ("VVKKYNT")
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
57 String Constant Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 P238D / P271G ("V4") PCHKGHKNGHKGHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHGHH
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEEGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
58 String Constant Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 Heavy WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 E233D / P238D / P271G / A330R ("VGKKDHTDHTDHTDHTDHTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT2T2TTTT3THTTTHKTWKW hWVDHWPDHTTWPDHTTTV_W_D_Z_V, HD, HD_PV",,,
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPRPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
Chain Constant Domain 59 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK 40 DYFPEPVTVS heavy WNSGALTSGV HTFPAVLQSS GLYSLSSVVT 80 VPSSSLGTQT G237D / P238D / H268D // P271G ( "V8") of huIgG1f YICNVNHKPS NTKVDKRVEP KSCDKTHTCP 120 PCPAPELLGD
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS DEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
60 String Constant Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 WNSGALTSGV Heavy HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 G237D / P238D / P271G / A330K (NTKKDHVKKDHVKKDHVKKDHV)
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPRPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
61 String Constant Domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 G237D / P238D / P271G / A330R D270E Heavy
("V9") by huIgG1f YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGD 120
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEEGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPRPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
62 Chain constant domain ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 heavy from WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 G237D / P238D / H268D / P271GTKVKHVKHVKHVKHVKHVHHHVHHHHHV "
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS DEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPRPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
Chain Constant Domain 63 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK 40 DYFPEPVTVS heavy WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 E233D / G237D / P238D / H268D / 71G P2 / A330R ( "V12") of huIgG1f YICNVNHKPS NTKVDKRVEP KSCDKTHTCP 120 PCPAPDLLGD
DSVFLFPPKP KDTLMISRTP EVTCVVVDVS DEDGEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPRPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
64 Domain String constant RTVAAPSVFI FPPSDEQLKS GTASVVCLLN NFYPREAKVQ 40 light huKappa WKVDNALQSG NSQESVTEQD SKDSTYSLSS TLTLSKADYE 80
KHKVYACEVT HQGLSSPVTK SFNRGEC 107
65 Signal sequence MRAWIFFLLC LAGRALA 17
66 IgG1 C-termination CH1 (VDKRV 5 same for IgG3 (17-15-15-15), igG3 (17-15-15), IgG3 (17-15),
IgG3 (15-15-15), IgG3 (15), and IgG4
67 upper IgG1 joint EPKSCDKTHT 10
68 median IgG1 joint CPPCP 5
69 lower IgG1 joint (the same APELLGG 7 for IgG3 (17-15-15-15), IgG3 (17-15-15), IgG3 (17-15), IgG3 (15-15-15), IgG3 (15 ), and IgG4)
70 IgG2 C termination CH1 VDKTV 5
71 median IgG2 joint CCVECPPCP 9
72 lower IgG2 joint APPVAG 6
73 IgG3 (17-15-15-15) articulation ELKTPLGDTT HT 12 superior (the same for IgG3 (17-15-15) and IgG3 (17-15))
74 IgG3 (17-15-15-15) joint CPRCPEPKSC DTPPPCPRCP EPKSCDTPPP CPRCPEPKSC 40 median DTPPPCPRCP 50
75 IgG3 (17-15-15) joint CPRCPEPKSC DTPPPCPRCP EPKSCDTPPP CPRCP 35 median
76 IgG3 (17-15) joint CPRCPEPKSC DTPPPCPRCP 20 median
77 IgG3 (15-15-15) upper EPKS 4 joint (the same for IgG3 (15))
78 IgG3 (15-15-15) joint CDTPPPCPRC PEPKSCDTPP PCPRCPEPKS CDTPPPCPRC 40 median P 41
79 IgG3 (15) median joint CDTPPPCPRC P 11
80 IgG4 upper joint ESKYGPP 7
81 IgG4 median joint CPSCP 5
82 IgG4 lower joint APEFLGG 7
83 Human IgG1 CH1 type ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 wild WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKV 98
84 CH1 of Human IgG2 type ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40 wild
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTV 98
85 CH2 of Human IgG1 Type PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 40 Wild YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 80
EYKCKVSNKA LPAPIEKTIS KAK 103
86 Human IgG1 CH2 with PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 40 A330S / P331S YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 80
EYKCKVSNKA LPSSIEKTIS KAK 103
87 CH3 Human IgG1 type GQPREPQVYT LPPSREEMTK NQVSLTCLVK GFYPSDIAVE 40 wild WESNGQPENN YKTTPPVLDS DGSFFLYSKL TVDKSRWQQG 80
NVFSCSVMHE ALHNHYTQKS LSLSPG 106
88 IgG1-IgG2-IgG1f ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KCCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPG 326
89 IgG1-IgG2CS-IgG1f ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
90 IgG1-IgG2-IgG1.1f ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPSS IEKTISKAKG QPREPQVYTL PPSRREMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
91 IgG1-IgG2CS-IgG1.1f ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPSS IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
92 IgG1-IgG2-1gG1f2 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
93 IgG1-IgG2 (C219S) -IgG1f2 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
94 IgG2-IgG1f2 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
95 IgG2 (C219S) -IgG1f2 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPG 325
96 Articulation of human IgG2 type ERKCCVECPP CPAPPVAG 18 wild
97 Articulation of Human IgG2 with ERKSCVECPP CPAPPVAG 18 C219S
98 IgG2 / IgG1 Articulation ERKCCVECPP CPAPELLGG 19
99 IgG2 Joint ERKSCVECPP CPAPELLGG 19 (C219S) / IgG1
100 Articulation of human IgG1 type EPKSCDKTHT CPPCPAPELL GG 22 wild
101 IgG1.1 Joint EPKSCDKTHT CPPCPAPEAE GA 22 (L234A / L235E / G237A
102 CH2 of human IgG2 type PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVQFNW 40 wild YVDGVEVHNA KTKPREEQFN STFRVVSVLT VVHQDWLNGK 80
EYKCKVSNKG LPAPIEKTIS KTK 103
103 CH3 of human IgG2 type GQPREPQVYT LPPSREEMTK NQVSLTCLVK GFYPSDIAVE 40 wild WESNGQPENN YKTTPPMLDS DGSFFLYSKL TVDKSRWQQG 80
NVFSCSVMHE ALHNHYTQKS LSLSPGK 107
104 IgG1f with K termination C ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
105 IgG2.3 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
106 IgG2.3G1-AY ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
107 IgG2.3G1-KH ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
108 IgG2.5 ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
109 IgG1.1f ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPEAEGA 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPSSIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
110 IgG2.3G1.1f-KH ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPSS IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
111 IgG1-deltaTHT ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKCPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
112 IgG2.3-maisTHT ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVETHTCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPML 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPGK 329
113 IgG2.3-plusGGG ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVEGGGCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPML 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPGK 329
114 IgG2.5G1.1f-KH ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPSS IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
115 IgG2.5G1-AY ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
116 IgG2.5G1-KH ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
117 IgG2.5-maisTHT ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVETHTCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPML 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPGK 329
118 IgG1-G2.3G1-AY ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVER KSCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
119 IgG1-G2.3G1-KH ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
120 G2-G1-G1-G1 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
121 G2.5-G1-G1-G1 ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
122 G1-G2.3-G2-G2 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
123 G1-KRGEGSSNLF ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
124 G1-KRGEGS ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
125 G1-SNLF ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
126 IgG1-ITNDRTPR ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
127 G1-SNLFPR ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YICNVNHKPS NTKVDKRVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
128 G2-RKEGSGNSFL ASTKGPSVFP LAPCSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
129 G2-RKEGSG ASTKGPSVFP LAPCSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
130 G2-NSFL ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
131 IgG2-TIDNTRRP ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YICNVNHKPS NTKVDKRVEP KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
132 G2-NSFLRP ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YTCNVDHKPS NTKVDKTVEP KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
133 G1-G1-G2-G1-AY ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVQFNW 160
YVDGVEVHNA KTKPREEQFN STFRVVSVLT VVHQDWLNGK 200
EYKCKVSNKG LPAPIEKTIS KTKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
134 G1-G1-G2-G1-KH ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPVL 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPGK 329
135 G2-G2.3-G1-G2-KH ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
136 G2.5-G2.3-G1-G2-KH ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
137 G2-G2.3-G1-G2-AY ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPMLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPG 326
138 G2.5-G2.3-G1-G2-AY ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPMLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
139 G1-G2.3-G1-G1-KH ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVKFNWYVDG 160
VEVHNAKTKP REEQYNSTYR VVSVLTVLHQ DWLNGKEYKC 200
KVSNKALPAP IEKTISKAKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPVLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
140 G2-G1-G2-G2-AY ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVQFNW 160
YVDGVEVHNA KTKPREEQFN STFRVVSVLT VVHQDWLNGK 200
EYKCKVSNKG LPAPIEKTIS KTKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPM 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
141 G2.5-G1-G2-G2-AY ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVQFNW 160
YVDGVEVHNA KTKPREEQFN STFRVVSVLT VVHQDWLNGK 200
EYKCKVSNKG LPAPIEKTIS KTKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPM 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
142 G1-G2-G1-G1-AY ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCVECPPCP APELLGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVKFNWYVD 160
GVEVHNAKTK PREEQYNSTY RVVSVLTVLH QDWLNGKEYK 200
CKVSNKALPA PIEKTISKAK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPVLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
143 G2-G1-G2-G2-KH ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPML 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPG 328
144 G2.5-G1-G2-G2-KH ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCDKTHTCP PCPAPPVAGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVQFNWY 160
VDGVEVHNAK TKPREEQFNS TFRVVSVLTV VHQDWLNGKE 200
YKCKVSNKGL PAPIEKTISK TKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPML 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPGK 329
145 IgG1-delta joint ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KCPPCPAPEL LGGPSVFLFP 120
PKPKDTLMIS RTPEVTCVVV DVSHEDPEVK FNWYVDGVEV 160
HNAKTKPREE QYNSTYRVVS VLTVLHQDWL NGKEYKCKVS 200
NKALPAPIEK TISKAKGQPR EPQVYTLPPS REEMTKNQVS 240
LTCLVKGFYP SDIAVEWESN GQPENNYKTT PPVLDSDGSF 280
FLYSKLTVDK SRWQQGNVFS CSVMHEALHN HYTQKSLSLS 320
PGK 323
146 IgG2-deltaHinge ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCPPCPAPPV AGPSVFLFPP 120
KPKDTLMISR TPEVTCVVVD VSHEDPEVQF NWYVDGVEVH 160
NAKTKPREEQ FNSTFRVVSV LTVVHQDWLN GKEYKCKVSN 200
KGLPAPIEKT ISKTKGQPRE PQVYTLPPSR EEMTKNQVSL 240
TCLVKGFYPS DIAVEWESNG QPENNYKTTP PMLDSDGSFF 280
LYSKLTVDKS RWQQGNVFSC SVMHEALHNH YTQKSLSLSP 320
GK 322
147 IgG2.5-delta joint ASTKGPSVFP LAPSSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCPPCPAPPV AGPSVFLFPP 120
KPKDTLMISR TPEVTCVVVD VSHEDPEVQF NWYVDGVEVH 160
NAKTKPREEQ FNSTFRVVSV LTVVHQDWLN GKEYKCKVSN 200
KGLPAPIEKT ISKTKGQPRE PQVYTLPPSR EEMTKNQVSL 240
TCLVKGFYPS DIAVEWESNG QPENNYKTTP PMLDSDGSFF 280
LYSKLTVDKS RWQQGNVFSC SVMHEALHNH YTQKSLSLSP 320
GK 322
148 IgG1-deltaG237 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKRVEP KSCDKTHTCP PCPAPELLGP 120
SVFLFPPKPK DTLMISRTPE VTCVVVDVSH EDPEVKFNWY 160
VDGVEVHNAK TKPREEQYNS TYRVVSVLTV LHQDWLNGKE 200
YKCKVSNKAL PAPIEKTISK AKGQPREPQV YTLPPSREEM 240
TKNQVSLTCL VKGFYPSDIA VEWESNGQPE NNYKTTPPVL 280
DSDGSFFLYS KLTVDKSRWQ QGNVFSCSVM HEALHNHYTQ 320
KSLSLSPG 328
149 IgG2-maisG237 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSCVECPPCP APPVAGGPSV 120
FLFPPKPKDT LMISRTPEVT CVVVDVSHED PEVQFNWYVD 160
GVEVHNAKTK PREEQFNSTF RVVSVLTVVH QDWLNGKEYK 200
CKVSNKGLPA PIEKTISKTK GQPREPQVYT LPPSREEMTK 240
NQVSLTCLVK GFYPSDIAVE WESNGQPENN YKTTPPMLDS 280
DGSFFLYSKL TVDKSRWQQG NVFSCSVMHE ALHNHYTQKS 320
LSLSPGK 327
150 IgG2.4 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCSVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
151 IgG2.3 / 4 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KSSVECPPCP APPVAGPSVF 120
LFPPKPKDTL MISRTPEVTC VVVDVSHEDP EVQFNWYVDG 160
VEVHNAKTKP REEQFNSTFR VVSVLTVVHQ DWLNGKEYKC 200
KVSNKGLPAP IEKTISKTKG QPREPQVYTL PPSREEMTKN 240
QVSLTCLVKG FYPSDIAVEW ESNGQPENNY KTTPPMLDSD 280
GSFFLYSKLT VDKSRWQQGN VFSCSVMHEA LHNHYTQKSL 320
SLSPGK 326
152 IgG2 Joint C220S ERKCSVECPP CPAPPVAG 18
153 ERKCSVECPP CPAPELLGG 19 IgG2 / IgG1 articulation C220S
154 IgG2 Joint Portion ERKCCVECPP CPAP 14 Wild Type
155 C219S of IgG2 Joint ERKSCVECPP CPAP 14 portion
156 C220S of IgG2n Joint ERKCSVECPP CPAP 14
157 Joint portion C219X ERKXCVECPP CPAP 14 IgG2
158 C220X of IgG2 Articulation portion ERKCXVECPP CPAP 14
159 IgG2 Articulation CH1 + IgG2 ASTKGPSVFP LAPCSRSTSE STAALGCLVK DYFPEPVTVS 40 (wild type) WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSNFGTQT 80
YTCNVDHKPS NTKVDKTVER KCCVECPPCP APPVAG 116
160 IgG2 with C219X ERKXCVECPP CPAPPVAG 18
161 IgG2 with C220X ERKCXVECPP CPAPPVAG 18
162 IgG2 / IgG1 hybrid with ERKXCVECPP CPAPELLGG 19 C219X
163 IgG2 / IgG1 hybrid with ERKCXVECPP CPAPELLGG 19 C220X
164 deltaG of IgG2 / IgG1 hybrid ERKCCVECPP CPAPELLG 18
165 IgG2 / IgG1 hybrid with ERKSCVECPP CPAPELLG 18 C219S deltaG
166 IgG2 / IgG1 hybrid with ERKCSVECPP CPAPELLG 18 C220S deltaG
167 IgG2 / IgG1 hybrid with ERKXCVECPP CPAPELLG 18 C219X deltaG
168 IgG2 / IgG1 hybrid with ERKCXVECPP CPAPELLG 18 C220X deltaG
169 Hinge portion of IgG2 PVAG 4
170 IgG1 hinge portion SCDKTHT 7
171 IgG1 articulation portion 1 ELLG 4
172 IgG1 articulation portion 2 ELLGG 5
173 Mature Extracellular Domain of EINGSANYEM FIFHNGGVQI LCKYPDIVQQ FKMQLLKGGQ 40 huicos (21 - 134 from ILCDLTKTKG SGNTVSIKSL KFCHSQLSNN SVSFFLYNLD 80 NP_036224.1) HSHANYYGK LSIFPT
174 ATG Nucleotide Sequence GAG TTT GGG CTG ACC TGG GTT TTC CTC GTT GCT 36
Chain Variable Domain CTT TTA AGA GGT GTC CAG TGT CAG GTG CAG CTG GTG 72 Heavy 3E8 GAG TCT GGG GGA GGC GTG GTC CAG CCT GGG ATG TCC 108
CTG AGA CTC TCC TGT GCA GCG TCT GGA TTC ACC TTC 144
AGT ACC TAT GGC ATG CAG TGG GTC CGC CAG GCT CCA 180
GGC AAG GGG CTG GAG TGG GTG ACA GTT ATA TGG CAT 216
GAT GGA AGT CAT AAA GAC TAT GCA GAC TCC GTG AAG 252
GGC CGA TTC ACC ATC TCC AGA GAC AAT TCC AAG AAC 288
ACG ATG TAT CTG CAA ATG AAC AGC CTG AGA GCC GAG 324
GAC ACG GCT GTG TAT TAC TGT GCG AGA GAT CGG CAA 360
ACT GGG GAG GGC TAC TTT GAC TTC TGG GGC CAG GGA 396
ACC CTG GTC ACC GTC TCC TCA 417
175 ATG Nucleotide Sequence AGG GTC CTC GCT CAG CTC CTG GGG CTC CTG CTG 36 Chain Variable Domain CTC TGT TTC CCA GGT GCC AGA TGT GAC ATC CAG ATG 72 Light 3E8 ACC CAG TCT CCA TCC TCA CTG TCT GCA TCT GTA GGA 108
GAC AGA GTC ACC ATC ACT TGT CGG GCG AGT CAG GGT 144
ATT AGC AGC TGG TTA GCC TGG TAT CAG CAG AAA CCA 180
GAG AAA GCC CCT AAG TCC CTG ATC TAT GCT GCA TCC 216
AGT TTG CAA AGT GGG GTC CCA TCA AGG TTC AGC GGC 252
AGT GGA TCT GGG ACA GAT TTC ACT CTC ACC ATC AGC 288
AGC CTG CAG CCT GAA GAT TTT GCA ACT TAT TAC TGC 324
CAA CAG TAT AAT AGT TAC CCG TAC ACT TTT GGC CAG 360
GGG ACC AAG CTG GAG ATC AAA 381
176 ATG Nucleotide Sequence GAC ATA CTT TGT TCC ACG CTC CTG CTA CTG ACT 36 Chain Variable Domain GTC CCG TCC TGG GTC TTA TCC CAG GTC ACC TTG AGG 72 Heavy 17C4 GAG TCT GGT CCT GCG CTG GTG AAA CCC ACA CAG ACC 108
CTC ACA CTG ACC TGC ACC TTC TCT GGG TTC TCA CTC 144
AGC ACT AGT GGA ATG TGT GTG AGC TGG ATC CGT CAG 180
CCC CCA GGG AAG GCC CTG GAG TGG CTT GCA CTC ATT 216
GAT TGG GAT GAT GAT AAA TTC TAC AGC ACA TCT CTG 252
AAG ACC AGG CTC ACC ATC TCC AAG GAC ACC TCC AAA 288
AAC CAG GTG GTC CTT ACA ATG ACC AAC ATG GAC CCT 324
GTG GAC ACA GCC ACG TAT TAC TGT GCA CGG ATG TCA 360
ACA CCT ACC TAC TAC GGT TTG GAC GTC TGG GGC CAA 396
GGG ACC ACG GTC ACC GTC TCC TCA 420
177 ATG Nucleotide Sequence AGG GTC CTC GCT CAG CTC CTG GGG CTC CTG CTG 36 CTC Chain Variable Domain TGT TTC CCA GGT GCC AGA TGT GAC ATC CAG ATG 72 Light 17C4 ACC CAG TCT CCA TCC TCA CTG TCT GCA TCT GTA GGA 108
GAC AGA GTC ACC ATC ACT TGT CGG GCG AGT CAG GGT 144
ATT AGC AGC TGG TTA GCC TGG TAT CAG CAG AAA CCA 180
GAG AAA GCC CCT AAG TCC CTG ATC TAT GCT GCA TCC 216
AGT TTG CAA AGT GGG GTC CCA TCA AGG TTC AGC GGC 252
AGT GGA TCT GGG ACA GAT TTC ACT CTC ACC ATC AGC 288
AGC CTG CAG CCT GAA GAT TTT GCA ACT TAT TAC TGC 324
CAA CAG TAT AAT AGT TAC CCT CTC ACT TTC GGC GGA 360
GGG ACC AAG GTG GAG ATC AAA 381
178 ATG Nucleotide Sequence GAC ACA CTT TGC TCC ACG CTC CTG CTG CTG ACC 36 ATC Chain Variable Domain CCT TCA TGG GTC TTG TCC CAG ATC ACC TTG AAG 72 Heavy 1D7 GAG TCT GGT CCT ACG CTG GTG AAA CCC ACA CAG ACA 108
CTC ACG CTG ACC TGC ACC TTC TCT GGG TTC TCA CTC 144
GGC TCT AAT GGA CTG GGT GTG GGC TGG ATC CGT CAG 180
CCC CCA GGA AAG GCC CTG GAG TGG CTT GCA CTC ATT 216
TAT TGG GAT GAT GAT AAG CGC TAC AGT CCA TCT CTG 252
AAG AGC AGG CTC ACC ATC ACC AAG GAC TCC TCC AAA 288
AAC CAG GTG GTC CTT ACA ATG ACC AAC ATG GAC CCT 324
GTG GAC ACA GCC ACG TAT TAC TGT GCA CAC AGG AAC 360
AGT GGC TTT GAC TAC TGG GGC CAG GGA ATC CTG GTC 396
ACC GTC TCC TCA 408
179 ATG Nucleotide Sequence AGG GTC CTC GCT CAG CTC CTG GGG CTC CTG CTG 36 Light Chain Variable Domain CTC TGT TTC CCA GGT GCC AGA TGT GAC ATC CAG ATG 72 1D7 ACC CAG TCT CCA TCC TCA CTG TCT GCA 108
GAC AGA GTC ACC ATC ACT TGT CGG GCG AGT CAG GGT 144
TTT AGC AGC TGG TTA GCC TGG TAT CAG CAG AAA CCA 180
GAG AAA GCC CCT AAG TCC CTG ATC TAT GCT GCA TCC 216
AGT TTG CAA AGT GGG GTC CCA TCA AGG TTC AGC GGC 252
AGT GGA TCT GGG ACA GAT TTC ACT CTC ACC ATC AGC 288
AGC CTG CAG CCT GAA GAT TTT GCA ACT TAT TAC TGC 324
CAA CAG TAT AAT AGT TAC CCT TAC ACT TTT GGC CAG 360
GGG ACC AAG CTG GAG ATC AAA 381
180 ATG Nucleotide Sequence AGG GTC CTC GCT CAG CTC CTG GGG CTC CTG CTG 36 Domain CTC TGT TTC CCA GGT GCC AGA TGT GAC ATC CAG ATG 72 Light Chain Variable-b 1D7 ACC CAG TCT CCA TCC TCA CTG TCT GCA TCT GTA GGA 108
GAC AGA GTC ACC ATC ACT TGT CGG GCG AGT CAG GGT 144
ATT AGC AGC TGG TTA GCC TGG TAT CAG CAG AAA CCA 180
GAG AAA GCC CCT AAG TCC CTG ATC TAT GCT GCA TCC 216
AGT TTG CAA AGT GGG GTC CCA TCA AGG TTC AGC GGC 252
AGT GGA TCT GGG ACA GAT TTC ACT CTC ACC ATC AGC 288
AGC CTG CAG CCT GAA GAT TTT GCA ACT TAT TAC TGC 324
CAA CAG TAT AAT AGT TAC CCT CTC ACT TTC GGC GGA 360
GGG ACC AAG GTG GAG ATC AAA 381
181 ATG Nucleotide Sequence GAC ACA CTT TGC TCC ACG CTC CTG CTG CTG ACC 36 ATC Chain Variable Domain CCT TCA TGG GTC TTG TCC CAG ATC ACC TTG AAG 72 Heavy 9D5 GAG TCT GGT CCT ACG CTG GTG AAA CCC ACA CAG
CTC ACG CTG ACC TGC ACC TTC TCT GGG TTC TCA CTC 144
GGC ACT AGT GGA CTG GGT GTG GGC TGG ATC CGT CAG 180
CCC CCA GGA AAG GCC CTG GAG TGG CTT GCA TTC ATT 216
TAT TGG GAT GAT GAT AAG CGC TAC AGC CCA TCT CTG 252
AAG AGC AGG CTC ACC ATC ACC AAG GAC ACC TCC AAA 288
AAC CAG GTG GTC CTT ACA ATG ACC AAC ATG GAC CCT 324
GTG GAC ACA GCC ACA TAT TAC TGT GCA CAC AGA CGG 360
GGC TTT TTT GAC TAC TGG GGC CAG GGA ACC CTG GTC 396
ACC GTC TCC TCA 408
182 ATG Nucleotide Sequence AGG GTC CTC GCT CAG CTC CTG GGG CTC CTG CTG 36 CTC Chain Variable Domain TGT TTC CCA GGT GCC AGA TGT GAC ATC CAG ATG 72 Light 9D5
ACC CAG TCT CCA TCC TCA CTG TCT GCA TCT GTA GGA 108
GAC AGA GTC ACC ATC ACT TGT CGG GCG AGT CAG GGT 144
ATT AGC AGC TGG TTA GCC TGG TAT CAG CAG AAA CCA 180
GAG AAA GCC CCT AAG TCC CTG ATC TAT GCT GCA TCC 216
AGT TTG CAA AGT GGG GTC CCA TCA AGG TTC AGC GGC 252
AGT GGA TCT GGG ACA GAT TTC ACT CTC ACC ATC AGC 288
AGC CTG CAG CCT GAA GAT TTT GCA ACT TAT TAC TGC 324
CAA CAG TAT AAT AGT TAC CCG CTC ACT TTC GGC GGA 360
GGG ACC AAG GTG GAG ATC AAA 381
183 GAC Nucleotide Sequence ATC CAG ATG ACC CAG TCT CCA TCC TCC CTG TCT 36 ICOS.33kappa GCA TCT GTA GGA GAC AGA GTC ACC ATC ACT TGC CAG 72
GCC AGT CAG GAC ATT AGC AAT TAT TTA AGC TGG TAT 108
CAG CAG AAA CCA GGG AAA GCC CCT AAG CTC CTG ATC 144
TAC TAT ACA AAT CTA TTG GCA GAA GGG GTC CCA TCA 180
AGG TTC AGT GGA AGT GGA TCT GGG ACA GAT TTT ACT 216
TTC ACC ATC AGC AGC CTG CAG CCT GAA GAT ATT GCA 252
ACA TAT TAC TGT CAA CAG TAT TAT AAC TAT CGG ACG 288
TTC GGC CCT GGG ACC AAA GTG GAT ATC AAA CGT ACG 324
GTG GCT GCA CCA TCT GTC TTC ATC TTC CCG CCA TCT 360
GAT GAG CAG TTG AAA TCT GGA ACT GCC TCT GTT GTG 396
TGC CTG CTG AAT AAC TTC TAT CCC AGA GAG GCC AAA 432
GTA CAG TGG AAG GTG GAT AAC GCC CTC CAA TCG GGT 468
AAC TCC CAG GAG AGT GTC ACA GAG CAG GAC AGC AAG 504
GAC AGC ACC TAC AGC CTC AGC AGC ACC CTG ACG CTG 540
AGC AAA GCA GAC TAC GAG AAA CAC AAA GTC TAC GCC 576
TGC GAA GTC ACC CAT CAG GGC CTG AGC TCG CCC GTC 612
ACA AAG AGC TTC AAC AGG GGA GAG TGT TAG 642
184 GAG Nucleotide Sequence GTG CAG CTG GTG GAG TCT GGG GGA GGC TTG GTA 36 ICOS.33-g1f-S267E AAG CCT GGG GGG TCC CTT AGA CTC TCC TGT GCA GCC 72
TCT GGA TTC ACT TTC AGT GAC TAT TTC ATG CAC TGG 108
GTC CGC CAG GCT CCA GGG AAG GGG CTG GAG TGG GTT 144
GGC GTC ATA GAC ACT AAA AGT TTT AAT TAT GCA ACC 180 TAT TAC TCT GAT TTG GTG AAA GGC AGA TTC ACC ATC 216 TCA AGA GAT GAT TCA AAA AAC ACG CTG TAT CTG CAA 252 ATG AAC AGC CTG AAA ACC GAG GACA GCC TAT 288 TAC TGT ACC GCA ACC ATC GCT GTC CCA TAT TAC TTC 324 GAT TAC TGG GGC CAG GGA ACC CTG GTC ACC GTC TCC 360 TCA GCT AGC ACC AAG GGC CCA TCG GTC TTC CCC CTG 396 GCA CCC TCC TCC AAG AGC ACG TCG GGC ACA GCG 432 GCC CTG GGC TGC CTG GTC AAG GAC TAC TTC CCC GAA 468 CCG GTG ACG GTG TCG TGG AAC TCA GGC GCC CTG ACC 504 AGC GGC GTG CAC ACC TTC CCG GCT GTC CTA CAG TCC AGC TAC TCC GCC CTC T40 AGC GTG GTG ACC GTG 576 CCC TCC AGC AGC TTG GGC ACC CAG ACC TAC ATC TGC 612 AAC GTG AAT CAC AAG CCC AGC AAC ACC AAG GTG GAC 648 AAG AGA GTT GAG CCC AAA TCT TGT GAC AAA ACT CAC 684 ACA TGC CCA CCA GCA CCT GAA CTC CTG GGG 720 GGA CCG TCA GTC TTC CTC TTC CCC CCA AAA CCC AAG 756 GAC ACC CTC ATG ATC TCC CGG ACC CCT GAG GTC ACA 792 TGC GTG GTG GTG GAC GTG GAG CAC GAA GAC CCT GAG 828 GTCAAC TGG TAC GTG GAC GGC GTG GAG GTG 864 CAT AAT GCC AAG ACA AAG CCG CGG GAG GAG CAG TAC 900 AAC AGC ACG TAC CGT GTG GTC AGC GTC CTC ACC GTC 936 CTG CAC CAG GAC TGG CTG AAT GGC AAG GAG TAC A 972 AAG GTC TCC AAC AAA GCC CTC CCA GCC CCC ATC 1008 GAG AAA ACC ATC TCC AAA GCC AAA GGG CAG CCC CGA 1044
GAA CCA CAG GTG TAC ACC CTG CCC CCA TCC CGG GAG 1080 GAG ATG ACC AAG AAC CAG GTC AGC CTG ACC TGC CTG 1116 GTC AAA GGC TTC TAT CCC AGC GAC ATC GCC GTG GAG 1152
TGG GAG AGC AAT GGG CAG CCG GAG AAC AAC TAC AAG 1188 ACC ACG CCT CCC GTG CTG GAC TCC GAC GGC TCC TTC 1224
TTC CTC TAT AGC AAG CTC ACC GTG GAC AAG AGC AGG 1260
TGG CAG CAG GGG AAC GTC TTC TCA TGC TCC GTG ATG 1296
CAT GAG GCT CTG CAC AAC CAC TAC ACG CAG AAG AGC 1332
CTC TCC CTG TCC CCG GGT TGA 1353
185 EVQLLESGGG LVQPGGSLRL SCEASGFIFK YYAMSWVRQA amino acid sequence 40 IgG-2644 heavy chain PGKGLEWVSG ISGSGGSTYY ADSVKGRFTI SRDNSKHTLY 80
LQMNSLRAED TAVYYCAKDG DFDWIHYYYG MDVWGQGTTV 120
TVSSASTKGP SVFPLAPSSK STSGGTAALG CLVKDYFPEP 160
VTVSWNSGAL TSGVHTFPAV LQSSGLYSLS SVVTVPSSSL 200
GTQTYICNVN HKPSNTKVDK RVEPKSCDKT HTCPPCPAPE 240
LLGGPSVFLF PPKPKDTLMI SRTPEVTCVV VDVSHEDPEV 280
KFNWYVDGVE VHNAKTKPRE EQYNSTYRVV SVLTVLHQDW 320
LNGKEYKCKV SNKALPAPIE KTISKAKGQP REPQVYTLPP 360
SREEMTKNQV SLTCLVKGFY PSDIAVEWES NGQPENNYKT 400
TPPVLDSDGS FFLYSKLTVD KSRWQQGNVF SCSVMHEALH 440
NHYTQKSLSL SPG 453
186 EVQLLESGGG LVQPGGSLRL SCEASGFIFK YYAMSWVRQA amino acid sequence 40 chain variable domain PGKGLEWVSG ISGSGGSTYY ADSVKGRFTI SRDNSKHTLY 80 IgG-2644 heavy LQMNSLRAED TAVYQYGHVYGYGD
TVSS 124
187 ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 amino acid sequence WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT VPSSSLGTQT 80 IgG-2644 YICNVNHKPS NTKVDGKKPKKTKKCPHKKKTTKKTKKKTKKKKTKKT
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPG 329
188 AIQLTQSPSS LSASVGDRVT ITCRASQGIS SALAWYQQKP 40 IgG-2644 light chain GKAPKLLIYD ASSLESGVPS RFSGSGSGTD FTLTISSLQP 80 Amino acid sequence
EDFATYYCQQ FNSYPHTFGG GTKVEIKRTV AAPSVFIFPP 120 SDEQLKSGTA SVVCLLNNFY PREAKVQWKV DNALQSGNSQ 160 ESVTEQDSKD STYSLSSTLT LSKADYEKHK VYACEVTHQG 200 LSSPVTKSFN RGEC 214 189 Amino Acid Sequence AIQLTQSPSS LSASVGDRVT ITCRASQGIS SALAWYQQKP 40 light chain variable domain GKAPKLLIYD ASSLESGVPS RFSGSGSGTD FTLTISSLQP 80 IgG-2644 EDFATYYCQQ FNSYPHTFGG GTKVEIK 107 190 IgG-2644 light chain Constant RTVAAPSVFI FPPSDEQLKS GTASVVCLLN NFYPREAKVQ 40 domain WKVDNALQSG sequence NSQESVTEQD SKDSTYSLSS TLTLSKADYE 80 Amino KHKVYACEVT HQGLSSPVTK SFNRGEC 107 191 IgG-2644 CDRH1 YYAMS sequence 5 amino acid 192 IgG-2644 CDRH2 GISGSGGSTY sequence YADSVKG 17 Amino acid 193 amino acid sequence of DGDFDWIHYY YGMDV 15 IgG-2644 CDRH3 194 RASQGISSAL A Amino Acid Sequence 11 IgG-2644 CDRL1 195 DASSLES Amino Acid Sequence 7 IgG-2644 CDRL2 196 QQFNSYPHT Amino Acid Sequence 9 IgG-2644 CDRL3 GAG GG Nucleotide Sequence CTG TTG GAG TCT GGG GGA GG C TTG GTA 36 IgG-2644 heavy chain CAG CCT GGG GGG TCC CTG AGA CTC TCC TGT GAA GCC 72 TCT GGA TTC ATC TTT AAA TAC TAT GCC ATG AGC TGG 108
GTC CGC CAG GCT CCA GGG AAG GGG CTG GAG TGG GTC 144 TCA GGT ATT AGT GGT AGT GGT GGT AGC ACA TAC TAC 180 GCA GAC TCC GTG AAG GGC CGG TTC ACC ATC TCC AGA 216 GAC AAT TCC AAG TAC A AAC 252 AGC CTG AGA GCC GAG GAC ACG GCC GTT TAT TAC TGT 288 GCG AAA GAT GGG GAT TTT GAC TGG ATC CAC TAT TAC 324 TAT GGT ATG GAC GTC TGG GGC CAA GGG ACC ACG GTC 360
ACC GTC TCC TCA GCG TCG ACC AAG GGC CCA TCC GTC 396
TTC CCC CTG GCA CCC TCC TCC AAG AGC ACC TCT GGG 432
GGC ACA GCG GCC CTG GGC TGC CTG GTC AAG GAC TAC 468
TTC CCC GAA CCG GTG ACG GTG TCG TGG AAC TCA GGC 504
GCC CTG ACC AGC GGC GTG CAC ACC TTC CCG GCT GTC 540
CTA CAG TCC TCA GGA CTC TAC TCC CTC AGC AGC GTG 576
GTG ACC GTG CCC TCC AGC AGC TTG GGC ACC CAG ACC 612
TAC ATC TGC AAC GTG AAT CAC AAG CCC AGC AAC ACC 648
AAG GTG GAC AAG AGA GTT GAG CCC AAA TCT TGT GAC 684
AAA ACT CAC ACA TGC CCA CCG TGC CCA GCA CCT GAA 720
CTC CTG GGG GGA CCG TCA GTC TTC CTC TTC CCC CCA 756
AAA CCC AAG GAC ACC CTC ATG ATC TCC CGG ACC CCT 792
GAG GTC ACA TGC GTG GTG GTG GAC GTG AGC CAC GAA 828
GAC CCT GAG GTC AAG TTC AAC TGG TAC GTG GAC GGC 864
GTG GAG GTG CAT AAT GCC AAG ACA AAG CCG CGG GAG 900
GAG CAG TAC AAC AGC ACG TAC CGT GTG GTC AGC GTC 936
CTC ACC GTC CTG CAC CAG GAC TGG CTG AAT GGC AAG 972
GAG TAC AAG TGC AAG GTC TCC AAC AAA GCC CTC CCA 1008
GCC CCC ATC GAG AAA ACC ATC TCC AAA GCC AAA GGG 1044
CAG CCC CGA GAA CCA CAG GTG TAC ACC CTG CCC CCA 1080
TCC CGG GAG GAG ATG ACC AAG AAC CAG GTC AGC CTG 1116
ACC TGC CTG GTC AAA GGC TTC TAT CCC AGC GAC ATC 1152
GCC GTG GAG TGG GAG AGC AAT GGG CAG CCG GAG AAC 1188
AAC TAC AAG ACC ACG CCT CCC GTG CTG GAC TCC GAC 1224
GGC TCC TTC TTC CTC TAT AGC AAG CTC ACC GTG GAC 1260
AAG AGC AGG TGG CAG CAG GGG AAC GTC TTC TCA TGC 1296
TCC GTG ATG CAT GAG GCT CTG CAC AAC CAC TAC ACG 1332
CAG AAG AGC CTC TCC CTG TCC CCG GGT 1359
198 GAG Nucleotide Sequence GTG CAG CTG TTG GAG TCT GGG GGA GGC TTG GTA 36 CAG Chain Variable Domain CCT GGG GGG TCC CTG AGA CTC TCC TGT GAA GCC 72 Heavy IgG-2644 TCT GGA TTC ATC TTT AAA TAC TAT GCC AGC TGG 108
GTC CGC CAG GCT CCA GGG AAG GGG CTG GAG TGG GTC 144
TCA GGT ATT AGT GGT AGT GGT GGT AGC ACA TAC TAC 180
GCA GAC TCC GTG AAG GGC CGG TTC ACC ATC TCC AGA 216
GAC AAT TCC AAG CAC ACG CTG TAT CTG CAA ATG AAC 252
AGC CTG AGA GCC GAG GAC ACG GCC GTT TAT TAC TGT 288
GCG AAA GAT GGG GAT TTT GAC TGG ATC CAC TAT TAC 324
TAT GGT ATG GAC GTC TGG GGC CAA GGG ACC ACG GTC 360
ACC GTC TCC TCA 372
199 GCG Nucleotide Sequence TCG ACC AAG GGC CCA TCC GTC TTC CCC CTG GCA 36 Constant Chain Domain CCC TCC TCC AAG AGC ACC TCT GGG GGC ACA GCG GCC 72 Heavy IgG-2644 CTG GGC TGC CTG GTC AAG GAC TAC TACTC GAA CCG 108
GTG ACG GTG TCG TGG AAC TCA GGC GCC CTG ACC AGC 144
GGC GTG CAC ACC TTC CCG GCT GTC CTA CAG TCC TCA 180
GGA CTC TAC TCC CTC AGC AGC GTG GTG ACC GTG CCC 216
TCC AGC AGC TTG GGC ACC CAG ACC TAC ATC TGC AAC 252
GTG AAT CAC AAG CCC AGC AAC ACC AAG GTG GAC AAG 288
AGA GTT GAG CCC AAA TCT TGT GAC AAA ACT CAC ACA 324
TGC CCA CCG TGC CCA GCA CCT GAA CTC CTG GGG GGA 360
CCG TCA GTC TTC CTC TTC CCC CCA AAA CCC AAG GAC 396
ACC CTC ATG ATC TCC CGG ACC CCT GAG GTC ACA TGC 432
GTG GTG GTG GAC GTG AGC CAC GAA GAC CCT GAG GTC 468
AAG TTC AAC TGG TAC GTG GAC GGC GTG GAG GTG CAT 504
AAT GCC AAG ACA AAG CCG CGG GAG GAG CAG TAC AAC 540
AGC ACG TAC CGT GTG GTC AGC GTC CTC ACC GTC CTG 576
CAC CAG GAC TGG CTG AAT GGC AAG GAG TAC AAG TGC 612
AAG GTC TCC AAC AAA GCC CTC CCA GCC CCC ATC GAG 648
AAA ACC ATC TCC AAA GCC AAA GGG CAG CCC CGA GAA 684
CCA CAG GTG TAC ACC CTG CCC CCA TCC CGG GAG GAG 720
ATG ACC AAG AAC CAG GTC AGC CTG ACC TGC CTG GTC 756
AAA GGC TTC TAT CCC AGC GAC ATC GCC GTG GAG TGG 792
GAG AGC AAT GGG CAG CCG GAG AAC AAC TAC AAG ACC 828
ACG CCT CCC GTG CTG GAC TCC GAC GGC TCC TTC TTC 864
CTC TAT AGC AAG CTC ACC GTG GAC AAG AGC AGG TGG 900
CAG CAG GGG AAC GTC TTC TCA TGC TCC GTG ATG CAT 936
GAG GCT CTG CAC AAC CAC TAC ACG CAG AAG AGC CTC 972
TCC CTG TCC CCG GGT 987
200 GCC Nucleotide Sequence ATC CAG TTG ACC CAG TCT CCA TCC TCC CTG TCT 36 IgG-2644 Light Chain GTA TCT GTA GGA GAC AGA GTC ACC ATC ACT TGC CGG 72
GCA AGT CAG GGC ATT AGC AGT GCT TTA GCC TGG TAT 108
CAG CAG AAA CCA GGG AAA GCT CCT AAG CTC CTG ATC 144
TAT GAT GCC TCC AGT TTG GAA AGT GGG GTC CCA TCA 180
AGG TTC AGC GGC AGT GGA TCT GGG ACA GAT TTC ACT 216
CTC ACC ATC AGC AGC CTG CAG CCT GAA GAT TTT GCA 252
ACT TAT TAC TGT CAA CAG TTT AAT AGT TAC CCT CAC 288
ACT TTC GGC GGA GGG ACC AAG GTG GAG ATC AAA CGT 324
ACG GTG GCT GCA CCA TCT GTC TTC ATC TTC CCG CCA 360
TCT GAT GAG CAG TTG AAA TCT GGA ACT GCC TCT GTT 396
GTG TGC CTG CTG AAT AAC TTC TAT CCC AGA GAG GCC 432
AAA GTA CAG TGG AAG GTG GAT AAC GCC CTC CAA TCG 468
GGT AAC TCC CAG GAG AGT GTC ACA GAG CAG GAC AGC 504
AAG GAC AGC ACC TAC AGC CTC AGC AGC ACC CTG ACG 540
CTG AGC AAA GCA GAC TAC GAG AAA CAC AAA GTC TAC 576
GCC TGC GAA GTC ACC CAT CAG GGC CTG AGC TCG CCC 612
GTC ACA AAG AGC TTC AAC AGG GGA GAG TGT 642
201 GCC Nucleotide Sequence ATC CAG TTG ACC CAG TCT CCA TCC TCC CTG TCT 36 GCA Chain Variable Domain TCT GTA GGA GAC AGA GTC ACC ATC ACT TGC CGG 72 Light IgG-2644 GCA AGT CAG GGC ATT AGC AGT GCT TTA GCC TGG TAT 108
CAG CAG AAA CCA GGG AAA GCT CCT AAG CTC CTG ATC 144
TAT GAT GCC TCC AGT TTG GAA AGT GGG GTC CCA TCA 180
AGG TTC AGC GGC AGT GGA TCT GGG ACA GAT TTC ACT 216
CTC ACC ATC AGC AGC CTG CAG CCT GAA GAT TTT GCA 252
ACT TAT TAC TGT CAA CAG TTT AAT AGT TAC CCT CAC 288
ACT TTC GGC GGA GGG ACC AAG GTG GAG ATC AAA 321
202 CGT Nucleotide Sequence ACG GTG GCT GCA CCA TCT GTC TTC ATC TTC CCG 36 Constant Chain Domain CCA TCT GAT GAG CAG TTG AAA TCT GGA ACT GCC TCT 72 Light IgG-2644 GTT GTG TGC CTG CTG AAT AAC TTC TAT CCC AGA GAG 108
GCC AAA GTA CAG TGG AAG GTG GAT AAC GCC CTC CAA 144
TCG GGT AAC TCC CAG GAG AGT GTC ACA GAG CAG GAC 180
AGC AAG GAC AGC ACC TAC AGC CTC AGC AGC ACC CTG 216
ACG CTG AGC AAA GCA GAC TAC GAG AAA CAC AAA GTC 252
TAC GCC TGC GAA GTC ACC CAT CAG GGC CTG AGC TCG 288
CCC GTC ACA AAG AGC TTC AAC AGG GGA GAG TGT 321
203 SIFDPPPFKV TL 12 Amino Acid Sequence ICOS Epitope.4
204 Domain Constant ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40 weighed with terminating lysine WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80 C huIgG1f YICNVNHKPS NTCPVDK
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSREE 240
MTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
205 Isoform 2 (Q9Y6W8-2) MKSGLWYFFL FCLRIKVLTG EINGSANYEM FIFHNGGVQI 40
LCKYPDIVQQ FKMQLLKGGQ ILCDLTKTKG SGNTVSIKSL 80
KFCHSQLSNN SVSFFLYNLD HSHANYYFCN LSIFDPPPFK 120
VTLTGGYLHI YESQLCCQLK FWLPIGCAAF VVVCILGCIL 160
ICWLTKKM 168
206 Human IgG1 (P01857-1) ASTKGPSVFP LAPSSKSTSG GTAALGCLVK DYFPEPVTVS 40
WNSGALTSGV HTFPAVLQSS GLYSLSSVVT VPSSSLGTQT 80
YICNVNHKPS NTKVDKKVEP KSCDKTHTCP PCPAPELLGG 120
PSVFLFPPKP KDTLMISRTP EVTCVVVDVS HEDPEVKFNW 160
YVDGVEVHNA KTKPREEQYN STYRVVSVLT VLHQDWLNGK 200
EYKCKVSNKA LPAPIEKTIS KAKGQPREPQ VYTLPPSRDE 240
LTKNQVSLTC LVKGFYPSDI AVEWESNGQP ENNYKTTPPV 280
LDSDGSFFLY SKLTVDKSRW QQGNVFSCSV MHEALHNHYT 320
QKSLSLSPGK 330
207 VKI O18 DIQMTQSPSS LSASVGDRVT ITCQASQDIS NYLNWYQQKP 40
GKAPKLLIYD ASNLETGVPS RFSGSGSGTD FTFTISSLQP 80
EDIATYYCQQ YDNLP 95
208 JK3 FTFGPGTKVD IK 12
209 VH3-15 EVQLVESGGG LVKPGGSLRL SCAASGFTFS NAWMSWVRQA 40
PGKGLEWVGR IKSKTDGGTT DYAAPVKGRF TISRDDSKNT 80 LYLQMNSLKT EDTAVYYCTT 100
210 JH4 YFDYWGQGTL VTVSS 15
211 mICOS Heavy Chain.1- EVDLVETGGG LVQPGGSLKL SCVASGFTFS RYWMFWIRQA 40 mG1 PGKGLEWVSS VSTDGRSTYY PDSVQGRFTI SRNDAENTVY 80
LQMNSLRSED TATYYCAKEG YYDGSYYAYY FDYWGQGVTV 120
TVSSAKTTPP SVYPLAPGSA AQTNSMVTLG CLVKGYFPEP 160
VTVTWNSGSL SSGVHTFPAV LQSDLYTLSS SVTVPSSTWP 200
SETVTCNVAH PASSTKVDKK IVPRDCGCKP CICTVPEVSS 240
VFIFPPKPKD VLTITLTPKV TCVVVDISKD DPEVQFSWFV 280
DDVEVHTAQT QPREEQFNST FRSVSELPIM HQDWLNGKEF 320
KCRVNSAAFP APIEKTISKT KGRPKAPQVY TIPPPKEQMA 360
KDKVSLTCMI TDFFPEDITV EWQWNGQPAE NYKNTQPIMD 400
TDGSYFVYSK LNVQKSNWEA GNTFTCSVLH EGLHNHHTEK 440
SLSHSPGK 448
212 mICOS.1-mG1 Light Chain DVQMAQSPSS LAASPGESVS INCKASKSIS KYLAWYQQKP 40
GKANKLLIYS GSTLQSGTPS RFSGSGSGTD FTLTIRNLEP 80
EDFGLYYCQQ HNAYPPTFGT GTKLELKRAD AAPTVSIFPP 120
SSEQLTSGGA SVVCFLNNFY PKDINVKWKI DGSERQNGVL 160
NSWTDQDSKD STYSMSSTLT LTKDEYERHN SYTCEATHKT 200
STSPIVKSFN RNEC 214
213 ICOS.4-mG1 Heavy Chain EVQLVESGGG LVKPAGSLTL SCVASGFTFS DYFMHWVRQA 40
PGKGLEWVAV IDTKSFNYAT YYSDLVKGRF TVSRDDSQGM 80
VYLQMNNLRK EDTATYYCTA TIAVPYYFDY WGQGTMVTVS 120
SAKTTPPSVY PLAPGSAAQT NSMVTLGCLV KGYFPEPVTV 160
TWNSGSLSSG VHTFPAVLQS DLYTLSSSVT VPSSTWPSET 200
VTCNVAHPAS STKVDKKIVP RDCGCKPCIC TVPEVSSVFI 240
FPPKPKDVLT ITLTPKVTCV VVDISKDDPE VQFSWFVDDV 280
EVHTAQTQPR EEQFNSTFRS VSELPIMHQD WLNGKEFKCR 320
VNSAAFPAPI EKTISKTKGR PKAPQVYTIP PPKEQMAKDK 360
VSLTCMITDF FPEDITVEWQ WNGQPAENYK NTQPIMDTDG 400
SYFVYSKLNV QKSNWEAGNT FTCSVLHEGL HNHHTEKSLS 440
HSPGK 445
214 ICOS.4-mG1 Light Chain DIQMTQSPSS LPASLGDRVT INCQASQDIS NYLSWYQQKP 40
GKAPKLLIYY TNLLADGVPS RFSGSGSGRD YSFTISSLES 80
EDIGSYYCQQ YYNYRTFGPG TKLEIKRADA APTVSIFPPS 120
SEQLTSGGAS VVCFLNNFYP KDINVKWKID GSERQNGVLN 160
SWTDQDSKDS TYSMSSTLTL TKDEYERHNS YTCEATHKTS 200
TSPIVKSFNR NEC 213
215 ICOS Heavy Chain.34-G1f EVQLVESGGG LVKPGGSLRL SCAASGFTFS DYFMHWVRQA 40
PGKGLEWVGV IDTKSFNYAT YYSDLVKGRF TISRDDSKNT 80
LYLQMNSLKT EDTAVYYCTT TIAVPYYFDY WGQGTLVTVS 120
SASTKGPSVF PLAPSSKSTS GGTAALGCLV KDYFPEPVTV 160
SWNSGALTSG VHTFPAVLQS SGLYSLSSVV TVPSSSLGTQ 200
TYICNVNHKP SNTKVDKRVE PKSCDKTHTC PPCPAPELLG 240
GPSVFLFPPK PKDTLMISRT PEVTCVVVDV SHEDPEVKFN 280
WYVDGVEVHN AKTKPREEQY NSTYRVVSVL TVLHQDWLNG 320
KEYKCKVSNK ALPAPIEKTI SKAKGQPREP QVYTLPPSRE 360
EMTKNQVSLT CLVKGFYPSD IAVEWESNGQ PENNYKTTPP 400
VLDSDGSFFL YSKLTVDKSR WQQGNVFSCS VMHEALHNHY 440
TQKSLSLSPG 450
216 ICOS Light Chain.34-G1f DIQMTQSPSS LSASVGDRVT ITCQASQDIS NYLSWYQQKP 40
GKAPKLLIYY TNLLADGVPS RFSGSGSGTD FTFTISSLQP 80
EDIATYYCQQ YYNYRTFGPG TKVDIKRTVA APSVFIFPPS 120
DEQLKSGTAS VVCLLNNFYP REAKVQWKVD NALQSGNSQE 160
SVTEQDSKDS TYSLSSTLTL SKADYEKHKV YACEVTHQGL 200
SSPVTKSFNR GEC 213
217 ICOS.35-G1f Heavy Chain EVQLVESGGG LVKPGGSLRL SCAASGFTFS DYFMHWVRQA 40
PGKGLEWVGV IDTKSFNYAT YYSDLVKGRF TISRDDSKNT 80
LYLQMNSLKT EDTAVYYCTA TIAVPYYFDY WGQGTLVTVS 120
SASTKGPSVF PLAPSSKSTS GGTAALGCLV KDYFPEPVTV 160
SWNSGALTSG VHTFPAVLQS SGLYSLSSVV TVPSSSLGTQ 200
TYICNVNHKP SNTKVDKRVE PKSCDKTHTC PPCPAPELLG 240
GPSVFLFPPK PKDTLMISRT PEVTCVVVDV SHEDPEVKFN 280
WYVDGVEVHN AKTKPREEQY NSTYRVVSVL TVLHQDWLNG 320
KEYKCKVSNK ALPAPIEKTI SKAKGQPREP QVYTLPPSRE 360
EMTKNQVSLT CLVKGFYPSD IAVEWESNGQ PENNYKTTPP 400
VLDSDGSFFL YSKLTVDKSR WQQGNVFSCS VMHEALHNHY 440
TQKSLSLSPG 450
218 ICOS Light Chain.35-G1f DIQMTQSPSS LSASVGDRVT ITCQASQDIS NYLSWYQQKP 40
GKAPKLLIYY TNLLADGVPS RFSGSGSGTD FTFTISSLQP 80
EDIATYYCQQ YYNYRTFGPG TKVDIKRTVA APSVFIFPPS 120
DEQLKSGTAS VVCLLNNFYP REAKVQWKVD NALQSGNSQE 160
SVTEQDSKDS TYSLSSTLTL SKADYEKHKV YACEVTHQGL 200
SSPVTKSFNR GEC 213
219 NKTR-214 pathway agonist PTSSSTKKTQ LQLEHLLLDL QMILNGINNY KNPKLTRMLT 40 FKFYMPKKAT ELKHLQCLEE ELKPLEEVLN LAQSKNFHLR 80 IL-2 PRDLISNINV IVLELKGSETM
ITFSQSIIST LT 132

权利要求:
Claims (48)
[1]
1. Isolated humanized antibody that binds to the human inducible co-stimulator molecule (ICOS), characterized by the fact that the antibody blocks the binding and / or interaction of an ICOS ligand to human ICOS and in which the antibody: (a) induces proliferation and production of interferon-gamma (IFN-γ) in CD25-CD4 + T cells with an EC50 of about 0.01 to about 0.16 nM in an in vitro CHO-OKT3-CD32A co-culture assay ; and / or (b) induces IFN-γ production in CD25-CD4 + T cells with an EC50 of about 0.002 to about 0.4 nM in a staphylococcal B enterotoxin in a CD25-CD4 + T cell and a coculture assay of cell B.
[2]
2. Isolated antibody according to claim 1, characterized by the fact that the antibody has one or more of the following characteristics: (a) it binds to human T cells with an EC50 of about 0.7 nM and cinomolgus T cells with an EC50 of about 0.3 nM; (b) binds to human activated CD4 + T cells; (c) does not bind to human CD28 or human CTLA-4; (d) activates at least one primary T lymphocyte, such as an effector CD4 + T cell (Teff), a follicular helper T cell (Tfh), and a regulatory T cell (Treg); (e) induces protein kinase B (pAkt) phosphorylation in an in vitro primary T cell signaling assay with an EC50 of about 30 nM; (f) induces the production of interleukin-10 (IL-10) in response to staphylococcal enterotoxin B in an infant B cell and Tfh co-culture assay;
(g) induces a greater increase in the proliferation of CD3-stimulated Teffs compared to CD45RA + Tregs and CD45RO + Tregs in an in vitro assay; (h) reduces the suppression of Teff by Tregs; (i) where 10 μg / mL of the antibody does not increase cytokine production in an entire blood cell assay; (j) increases the secretion of at least one of IL-10 and IFN-g by Tfh cells in vitro; (k) stimulates ICOS-mediated signaling; (l) has increased affinity for CD32B and / or CD32A; and / or (m) has decreased affinity for CD16.
[3]
An isolated antibody according to claim 1 or 2, characterized in that the antibody blocks the interaction of human ICOS and human ICOS-L.
[4]
4. Isolated antibody according to any one of the preceding claims, characterized by the fact that the antibody binds to human ICOS, cinomolg, mouse and rat.
[5]
5. Isolated antibody that binds to the human inducible co-stimulator molecule (ICOS), characterized by the fact that the antibody comprises: (a) heavy chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 9, 10 and 11, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 12, 14 and 15, respectively; (b) heavy chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 18, 19 and 20, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 21, 22 and 23, respectively; (c) heavy chain variable domain comprising the CDR1, CDR2, and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 26, 27 and 28, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 29, 30 and 31, respectively; (d) heavy chain variable domain comprising the CDR1, CDR2, and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 34, 35 and 36, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 37, 38 and 39, respectively; (e) heavy chain CDR1, CDR2, and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 42, 43, and 44, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the sequences amino acid of SEQ ID Nos: 45, 46, and 47, respectively; (f) heavy chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 42, 43, and 44, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 49, 50, and 51, respectively; or (g) heavy chain variable domain comprising the CDR1, CDR2 and CDR3 regions comprising the amino acid sequences of SEQ ID Nos: 191, 192, and 193, respectively, and a light chain variable domain comprising the CDR1, CDR2 and CDR3 comprising the amino acid sequences of SEQ ID Nos: 194, 195, and 196, respectively.
[6]
6. Isolated antibody that binds to the human inducible co-stimulator molecule (ICOS), characterized by the fact that the variable regions of heavy and light chains comprise: (a) the amino acid sequences of SEQ ID Nos: 5 and 6, respectively; (b) the amino acid sequences of SEQ ID Nos: 16 and 17, respectively; (c) the amino acid sequences of SEQ ID Nos: 24 and 25, respectively; (d) the amino acid sequences of SEQ ID Nos: 32 and 33, respectively; (e) the amino acid sequences of SEQ ID Nos: 40 and 41, respectively; (f) the amino acid sequences of SEQ ID Nos: 40 and 48, respectively; or (g) the amino acid sequences of SEQ ID Nos: 186 and 189, respectively.
[7]
7. Isolated antibody characterized by the fact that it competes for ICOS binding with or binds to the same epitope as the antibody according to claim 6.
[8]
8. Isolated anti-ICOS antibody characterized by the fact that it specifically binds to one or more residues of human ICOS SIFDPPPFKVTL (SEQ ID NO: 203).
[9]
An isolated antibody according to claim 8, characterized in that the ICOS epitope comprises amino acid residue SIFDPPPFKVTL (SEQ ID NO: 203) from human ICOS.
[10]
10. Isolated antibody according to any one of the preceding claims, characterized in that the antibody is a life-size antibody.
[11]
An isolated antibody according to any one of the preceding claims, characterized in that the antibody is an IgG1 or IgG2a natural-sized antibody.
[12]
12. Isolated antibody according to any one of the preceding claims, characterized in that the antibody comprises at least one amino acid substitution in the Fc region compared to the human IgG1 sequence as mentioned in SEQ ID NO:
206.
[13]
An isolated antibody according to claim 12, characterized in that one or more amino acid substitutions enhance the antibody's affinity for FcγRIIb.
[14]
An isolated antibody according to claim 12, characterized by the fact that one or more amino acid substitutions are at position 234, 235, 236, 237, 239, 266, 267, 268, 325, 326, 327, 328, or 332, according to EU index, or in position 234D, 234E, 234F, 234W, 235D, 235F, 235R, 235Y, 236D, 236N, 237D, 237N, 239D, 239E, 266M, 267D, 267E, 268D, 268E , 327D, 327E, 328F, 328W, 328Y, and / or 332E, or where the Fc region comprises at least two substitutions in 235Y-267E, 236D-267E, 239D-268D, 239D-267E, 267E-268D, 267E- 268E, and / or 267E-328F.
[15]
An isolated antibody according to claim 12, characterized by the fact that the amino acid substitution in the Fc region is S267E compared to the human IgG1 sequence as mentioned in SEQ ID NO: 206.
[16]
16. Isolated antibody according to claim 15, characterized by the fact that the antibody reduced the antibody dependent cell-mediated cytotoxicity (ADCC) activity compared to an IgG1 control antibody.
[17]
An isolated antibody according to any one of claims 1 to 9 or 12 to 16, characterized in that the antibody is an antibody fraction.
[18]
An isolated antibody according to claim 17, characterized in that the antibody fragment is a Fab, Fab ', (Fab') 2, Fv, or scFv fragment.
[19]
19. Isolated antibody according to any of the preceding claims, characterized in that the antibody is a monoclonal antibody.
[20]
20. Isolated antibody according to any one of claims 5 to 19, characterized in that the antibody is a human, humanized or chimeric antibody.
[21]
21. Humanized, isolated, human-sized monoclonal antibody that binds to the human inducible co-stimulator molecule (ICOS), characterized by the fact that the heavy chain comprises the amino acid sequence mentioned in SEQ ID NO: 7, and the light chain comprises the amino acid sequence mentioned in SEQ ID NO: 8.
[22]
22. Humanized, isolated, natural-sized monoclonal antibody that binds to the human inducible co-stimulator molecule (ICOS), characterized by the fact that the heavy chain consists of the amino acid sequence mentioned in SEQ ID NO: 7, and the light chain consists in the amino acid sequence mentioned in SEQ ID NO: 8.
[23]
23. Isolated nucleic acid molecule, characterized by the fact that it encodes the heavy chain variable region and / or light chain variable region of the antibody as defined in claim 5 or 6.
[24]
24. Isolated nucleic acid according to claim 23, characterized in that the nucleic acid is a cDNA.
[25]
25. Vector characterized by the fact that it comprises the nucleic acid molecule as defined in claim 23 or 24.
[26]
26. Host cell characterized by the fact that it comprises the vector as defined in claim 25.
[27]
27. Method of producing an antibody, characterized in that it comprises culturing the host cell as defined in claim 26, in which the antibody is produced.
[28]
28. The method of claim 27, characterized in that it also comprises recovering the antibody from the host cell.
[29]
29. Bispecific molecule characterized by the fact that it comprises the antibody as defined in any one of claims 1 to 22 linked to a second functional moiety.
[30]
30. Composition characterized by the fact that it comprises the antibody as defined in any one of claims 1 to 22, or the bispecific molecule as defined in claim 29, and a pharmaceutically acceptable carrier and / or a soluble neutral active hyaluronidase glycoprotein.
[31]
31. Composition according to claim 30, characterized in that it also comprises an additional therapeutic agent.
[32]
32. Composition according to claim 31, characterized in that the additional therapeutic agent is an anti-PD-1 antibody, anti-PD-L1 antibody, and / or an anti-CTLA-
4.
[33]
33. Antibody according to any one of claims 1 to 22, characterized by the fact that it is for use as a medicine.
[34]
34. Antibody according to any one of claims 1 to 22, characterized by the fact that it is for use in the treatment of cancer.
[35]
35. Antibody according to claim 34, characterized by the fact that the cancer is bladder cancer, breast cancer, uterine / cervical cancer, ovarian cancer, prostate cancer, testicular cancer, esophageal cancer, gastrointestinal cancer, cancer pancreatic cancer, colon cancer, kidney cancer, head and neck cancer, lung cancer, stomach cancer, germ cell cancer, bone cancer, liver cancer, thyroid cancer, skin cancer, central nervous system neoplasm , lymphoma, leukemia, myeloma, sarcoma, or cancer-related cancer.
[36]
36. Method according to claim 34, characterized by the fact that the cancer is colorectal cancer (CRC), squamous cell carcinoma of the head and neck (HNSCC), melanoma, type NSCLC-adenocarcinoma (NSCLC-AD), cell type squamous NSCLC (NSCLC-SQC), prostate adenocarcinoma (PRC), renal cell carcinoma (RCC), or urothelial carcinoma (UCC).
[37]
37. Antibody according to any one of claims 1 to 22, characterized by the fact that it is for use in enhancing an immune response.
[38]
38. Use of the antibody as defined in any of claims 1 to 22, characterized by the fact that it is in the manufacture of a drug for the treatment of cancer.
[39]
39. Method for treating or delaying the progression of cancer in a human being characterized by the fact that it comprises administering to the human being an effective amount of antibody as defined in any one of claims 1 to 22, or the bispecific molecule as defined in claim 29 , or composition as defined in claim 30, 31, or 32.
[40]
40. Method according to claim 39, characterized by the fact that the cancer is bladder cancer, breast cancer, uterine / cervical cancer, ovarian cancer, prostate cancer, testicular cancer, esophageal cancer, gastrointestinal cancer, cancer pancreatic cancer, colorectal cancer, colon cancer, kidney cancer, head and neck cancer, lung cancer, stomach cancer, germ cell cancer, bone cancer, liver cancer, thyroid cancer, skin cancer, cancer of the central nervous system, lymphoma, leukemia, myeloma, sarcoma, or cancer-related cancer.
[41]
41. Method according to claim 39, characterized in that it also comprises administering one or more additional therapeutic agent to the human being.
[42]
42. The method of claim 41, characterized in that the additional therapeutic agent is a chemotherapeutic agent.
[43]
43. The method of claim 41, characterized in that the additional therapeutic agent is an anti-PD-1 antibody, anti-PD-L1 antibody, and / or an anti-CTLA-4 antibody.
[44]
44. Method according to claims 39 to 43, characterized in that the method comprises at least one cycle of administration, where for each of at least one cycle, at least one dose of the antibody is administered in a dose of about 375 mg.
[45]
45. Method of stimulating an immune response in a human being characterized by the fact that it comprises administering to the human an effective amount of the antibody as defined in any one of claims 1 to 22 or the composition as defined in claim 30, 31, or 32 .
[46]
46. Method according to claim 45, characterized by the fact that the individual has a tumor and an immune response against the tumor is stimulated.
[47]
47. Method according to claim 45, characterized by the fact that the individual has a chronic viral infection and an immune response against the viral infection is stimulated.
[48]
48. Method according to claim 45, characterized in that the antibody is administered in an amount or frequency sufficient to obtain and / or maintain a receptor occupation of less than about 80%.

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CL2019002052A1|2019-10-25|

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SG10201913022YA|2020-02-27|

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SG11201905699XA|2019-10-30|

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TW201843173A|2018-12-16|

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KR20190137850A|2019-12-11|

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CA3054824A1|2018-10-11|

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US10493140B2|2019-12-03|

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US20190175705A1|2019-06-13|

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AU2018250301A1|2019-07-11|

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JP2020515239A|2020-05-28|

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MX2019009408A|2019-11-28|

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US10898556B2|2021-01-26|

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CO2019007868A2|2019-07-31|

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法律状态:
2021-11-03| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US201762483158P| true| 2017-04-07|2017-04-07|

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US62/483,158|2017-04-07|

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US201762514151P| true| 2017-06-02|2017-06-02|

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