compositions comprising a combination of an anti-lag-3 antibody, an inhibitor of the pd-1 pathway, a

专利摘要:
the present invention relates to methods for the clinical treatment of malignant tumors (e.g., advanced solid tumors) using a combination of an anti-lag-3 antibody, an anti-pd-1 antibody, and an immunotherapeutic agent.
公开号:BR112019018759A2
申请号:R112019018759
申请日:2018-05-30
公开日:2020-05-05
发明作者:J Korman Alan；Jackson Jeffrey；J Selby Mark；Lonberg Nils
申请人:Squibb Bristol Myers Co；
IPC主号:

专利说明:

Invention Patent Descriptive Report for COMPOSITIONS UNDERSTANDING A COMBINATION OF AN ANTI-LAG-3 ANTIBODY, AN INHIBITOR OF THE PD-1 ROUTE, AND AN IMMUNOTHERAPY AGENT.
CROSS REFERENCE WITH RELATED REQUIREMENTS [001] This application claims priority for United States Provisional Patent Requirements Nos. 62 / 512,618, filed on May 30, 2017 and 62 / 513,812, filed on June 1, 2017, which are incorporated here, in reference to this patent application, by reference, in their entirety.
FIELD OF THE INVENTION [002] The present invention provides methods for treating a malignant tumor (e.g., advanced solid tumors) with a pharmaceutical composition comprising a combination of an anti-LAG-3 antibody, an inhibitor of the PD-1 pathway, and an immunotherapeutic agent.
BACKGROUND OF THE INVENTION [003] Human cancers harbor numerous genetic and epigenetic changes, generating neoantigens potentially recognizable by the immune system (Sjoblom et a!., Science 314 (5797): 268-274 (2006)). The adaptive immune system, composed of T and B lymphocytes, has powerful anti-cancer potential, with a wide capacity and extraordinary specificity to respond to various tumor antigens. In addition, the immune system demonstrates considerable plasticity and a memory component. Successful use of all these attributes of the adaptive immune system would make immunotherapy unique among all cancer treatment modalities.
[004] Until recently, cancer immunotherapy has focused
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2/84 substantial effort on approaches that reinforce anti-tumor immune responses by adoptive transfer of activated effector cells, immunization against relevant antigens, or by providing nonspecific immunostimulatory agents such as cytokines. However, in the last decade, intensive efforts to develop specific inhibitors of the immunological control point pathway have started to provide new immunotherapeutic approaches for the treatment of cancer, including the development of an antibody (antibody), ipilimumab (YERVOY®), which binds to and inhibits CTLA-4 for the treatment of patients with advanced melanoma (Hodi et al., N Engl J Med 363: 711-723 (2010)) and the development of antibodies such as nivolumab and pembrolizumab (formerly lambrolizumab; USAN Council Statement , (2013)) that specifically bind to the programmed cell death receptor -1 (PD-1) and block the inhibitor PD-1 / PD-1 ligand pathway (Topalian et al., N Engl J Med 366: 244354 (2012a); Topalian et al., Curr Opin Immunol 24: 207-12 (2012b); Topalian et al., J Clin Oncol 32 (10): 1020-30 (2014); Hamid et al., N Engl J Med 369: 134-144 (2013); Hamid and Carvajal, Expert Opin Biol Ther 13 (6): 847-61 (2013); and McDermott and Atkins, Cancer Med 2 (5): 662-73 (2013)).
[005] However, the immune tolerance observed in the situation of tumor development and tumor recurrence, seems to be mediated by the coexpression of several regulatory T cell negative receptors, not only of LAG-3. Data from chronic viral infection models (Blackburn et al., Nat. Immunol 10: 29-37 (2009), Grosso et al.,
J. Clin. Invest. 117: 3383-3392 (2007), and Lyford-Pike et al., Cancer Fies. 73 (6): 1733-41 (2013)), knock-out mice (Woo et al., Cancer Fies. 72: 917-927 (2012); Okazaki et al., J. Exp Med. 208: 395- 407 (2011), and Bettini et al., J. Immunol. 187: 3493-3498 (2011)), tumor recurrence models (Goding et al., J. Immunol. 190 (9): 4899-4909 (2013) )
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3/84 and, to a more limited extent, human cancer patients (Matsuzaki et al., Proc. Natl. Acad. Sci., USA. 107: 7875-7880 (2010), and Gandhi Μ K, et a !. , Blood. 108: 2280-2289 (2006)) corroborate a model in which T cells that are continuously exposed to antigen become progressively inactivated through a process called exhaustion. Exhausted T cells are characterized by the expression of negative regulatory T cell receptors, predominantly CTLA-4, PD-1, and LAG-3, whose action is to limit the cells' ability to proliferate, produce cytokines, and destroy target cells and / or increase Treg activity. Therefore, a combination therapy comprising an anti-PD-1 antibody and an anti-LAG-3 antibody has had promising results in some types of cancers. (U.S. Patent Application Publication No. 2016/0222116 A1).
[006] The lymphocyte-3 activation gene (LAG-3; CD223) is a type I transmembrane protein that is expressed on the cell surface of activated CD4 + and CD8 + T cells and subgroups of NK and dendritic cells (Triebel et al. , J. Exp. Med. 171: 1393-1405 (1990); Workman et al., J. Immunol. 182 (4): 1885-91 (2009)). LAG-3 is closely related to CD4, which is a co-receptor for T helper cell activation. Both molecules have 4 Ig-like extracellular domains and require binding to their ligand, class II major histocompatibility complex (MHC), for their functional activity. In contrast to CD4, LAG-3 is only expressed on the cell surface of activated T cells and its dividing from the cell surface ends LAG-3 signaling. LAG-3 can also be found as a soluble protein, but it does not bind to MHC class II and its function is unknown.
[007] It has been reported that LAG-3 plays an important role in stimulating regulatory T cell activity (Treg) and in
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4/84 down-regulation of T cell activation and proliferation (Workman et al., J. Immunol. 174: 688-695 (2005)). Both natural and induced Treg express increased LAG-3, which is required for maximum suppressive function (Camisachi et al., J. Immunol. 184: 6545-6551 (2010) and Huang et al., Immunity. 21: 503- 513 (2004)). Furthermore, the ectopic expression of LAG-3 on CD4 + effector T cells reduced their proliferative capacity and conferred a potential regulator against third party T cells (Huang et al., Immunity. 21: 503-513 (2004)). Recent studies have also shown that high expression of LAG-3 on CD8 + T cells specific for the exhausted lymphocytic choriomeningitis virus (LCMV) contributes to its unresponsive state and limits the antitumor responses of CD8 + T cells (Blackburn et al., Nat. Immunol 10: 29-37 (2009) and Grosso et al., J. Clin. Invest. 117: 3383-3392 (2007)). In fact, LAG-3 maintained a tolerance for auto antigens and tumor antigens through direct effects on CD8 + T cells in 2 murine models (Grosso etal., J. Clin. Invest. 117: 3383-3392 (2007)).
[008] Programmed Cell Death 1 (PD-1, Programmed Cell Death-1) is a cell surface signaling receptor that plays a crucial role in regulating T cell activation and tolerance (Keir et al., Annu Rev Immunol 26 : 677-704 (2008)). It is a type I transmembrane protein and together with BTLA, CTLA-4, ICOS and CD28, comprise the CD28 family of T cell co-stimulatory receptors. PD-1 is essentially expressed on T cells, B cells, and activated myeloid cells (Dong et al., Nat Med. 5: 13651369 (1999)). It is also expressed on natural killer cells (NK) (Terme et al., Cancer Res 71: 5393-5399 (2011)). The binding of PD-1 by its ligands, PD-L1 and PD-L2, results in phosphorylation of the tyrosine residue in the tyrosine inhibitory domain of the proximal intracellular immune receptor, followed by recruitment of the SHP-2 phosphatase,
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5/84 eventually resulting in negative regulation of T cell activation. An important role of PD-1 is to limit the activity of T cells in peripheral tissues during an inflammatory response to infection, thereby limiting the development of autoimmunity (Pardoll Nat Rev Cancer 12: 252-264 (2012)). The evidence for this negative regulatory role comes from the discovery that PD-1 deficient mice develop autoimmune diseases similar to lupus, including arthritis and nephritis, along with cardiomyopathy (Nishimura H, et al., Immunity, 1999; 11: 141-151; and Nishimura H, et al., Science, 2001; 291: 319-322). In the case of a tumor, the consequence is the development of immune resistance within the tumor microenvironment. PD-1 is highly expressed on tumor infiltrating lymphocytes, and its ligands are upregulated on the cell surface of many different tumors (Dong H, et al., Nat Mee / 2002; 8: 793-800). Multiple murine cancer models have shown that ligand binding to PD-1 results in immune evasion. In addition, blocking this interaction results in anti-tumor activity (Topalian S L, et al. NEJM 2012; 366 (26): 24432454; Hamid O, et al., NEJM 2013; 369: 134-144). In addition, it has been shown that inhibition of the PD-1 / PD-L1 interaction mediates potent antitumor activity in preclinical models (U.S. Pat.
8,008,449 and 7,943,743).
[009] Patients with certain malignant tumors (for example, metastatic or refractory solid tumors) have a very poor prognosis (Rosenberg SA, et al., Cancer immunotherapy in Cancer: Principles & Practice of Oncology (Eds DeVita VT, Lawrence TS and Rosenberg SA) 2011; 332-344 (Lippincott Williams & Wilkins, Philadelphia Pa.)). Despite advances in multimodal therapy, increases in overall survival in this patient population have been limited. Therefore, it is a
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It is an object of the present invention to provide improved methods (for example, a composition comprising a combination of an anti-PD-1 antibody, an anti-LAG-3 antibody, and an immunotherapeutic agent) for the treatment of subjects with said tumors. (for example, advanced refractory solid tumors).
SUMMARY OF THE INVENTION [0010] The present invention provides a method for treating a subject affected with a malignant tumor comprising administering to the subject a therapeutically effective amount of (a) LAG-3 inhibitor, (b) an inhibitor the PD-1 pathway; and (c) an immunotherapeutic agent, in combination.
[0011] In certain embodiments, the LAG-3 inhibitor is an anti-LAG-3 antibody or an antigen-binding fragment thereof. In one embodiment, the anti-LAG-3 antibody is a bispecific antibody. In another embodiment, wherein the anti-LAG-3 antibody or antigen-binding fragment thereof comprises (a) a heavy chain variable region CDR1 comprising the sequence set forth in SEQ ID NO: 7; (b) a heavy chain variable region CDR2 comprising the sequence set forth in SEQ ID NO: 8; (c) a heavy chain variable region CDR3 comprising the sequence set forth in SEQ ID NO: 9; (d) a light chain variable region CDR1 comprising the sequence set forth in SEQ ID NO: 10; (e) a light chain variable region CDR2 comprising the sequence set forth in SEQ ID NO: 11; and (f) a CDR3 light chain variable region comprising the sequence set forth in SEQ ID NO: 12. In some embodiments, the anti-LAG-3 antibody or antigen binding fragment thereof comprises heavy and light chain variable regions comprising the sequences stipulated in SEQ ID NOs: 3 and 5, respectively. In one embodiment, the anti-LAG-3 antibody is BMS 986016, MK-4280 (28G
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10), REGN3767, GSK2831781, IMP731 (H5L7BW), BAP050, IMP-701 (LAG-5250), IMP321, TSR-033, LAG525, Bl 754111, or FS-118.
[0012] In certain embodiments, the LAG-3 inhibitor is a soluble LAG-3 polypeptide. In one embodiment, the soluble LAG3 polypeptide is a fusion polypeptide. In another embodiment, a soluble LAG-3 polypeptide comprises a ligand-binding fragment of the LAG-3 extracellular domain. In some embodiments, the ligand-binding fragment of the LAG-3 extracellular domain comprises an amino acid sequence with at least 90%, at least 95%, at least 98%, or at least 99% sequence identity with SEQ ID NO: 44. In certain embodiments, the soluble LAG-3 polypeptide additionally comprises an Fc domain.
[0013] In one embodiment, the inhibitor of the PD-1 pathway is an anti-PD-1 antibody or antigen-binding fragment thereof. In certain embodiments, the anti-PD-1 antibody is pembrolizumab (KEYTRUDA; MK-3475), pidilizumab (CT-011), nivolumab (OPDIVO; BMS-936558), PDR001, MEDI0680 (AMP-514), TSR-042, REGN2810, JS001, AMP-224 (GSK-2661380), PF-06801591, BGB-A317, BI 754091, or SHR-1210.
[0014] In one embodiment, the inhibitor of the PD-1 pathway is an anti-PD-L1 antibody or antigen-binding fragment thereof. In certain embodiments, the anti-PD-L1 antibody is atezolizumab (TECENTRIQ; RG7446; MPDL3280A; RO5541267), durvalumab (MEDI4736), BMS-936559, avelumab (bavencio), LY3300054, CX-072 (Proclaim-CX-072) FAZ053, KN035, or MDX-1105.
[0015] In one embodiment, the inhibitor of the PD-1 pathway is a small molecule drug. In certain embodiments, the PD-1 pathway inhibitor is CA-170. In another embodiment, the PD-1 pathway inhibitor is a cell-based therapy. In one embodiment, therapy based on
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8/84 cells is a PDHA-L1 / L2-silenced dendritic cell vaccine loaded with MiHA. In other embodiments, cell-based therapy is a programmed delular anti-death protein antibody 1 expressing pluripotent killer T lymphocyte, an autologous T lymphocyte modified by a PD-1 chimeric switch receptor, or an autologous knockout T lymphocyte. of PD-1.
[0016] In one embodiment, the inhibitor of the PD-1 pathway is an anti-PD-L2 antibody or antigen-binding fragment thereof. In another embodiment, the anti-PD-L2 antibody is rHlgM12B7.
[0017] In one embodiment, the PD-1 pathway inhibitor is a soluble PD-1 polypeptide. In certain embodiments, the soluble PD-1 polypeptide is a fusion polypeptide. In some embodiments, the soluble PD-1 polypeptide comprises a ligand-binding fragment of the PD-1 extracellular domain. In other embodiments, the soluble PD-1 polypeptide comprises a ligand-binding fragment of the PD-1 extracellular domain. In one embodiment, the ligand-binding fragment of the PD-1 extracellular domain comprises an amino acid sequence with at least 90%, at least 95%, at least 98%, or at least 99% sequence identity with SEQ ID NO: 29. In another embodiment, the soluble PD-1 polypeptide additionally comprises an Fc domain.
[0018] In one embodiment, the immunotherapeutic agent is a modulator of CTLA-4 activity, a modulator of CD28 activity, a modulator of CD80 activity, a modulator of CD86 activity, a modulator of 4-1 BB activity , a modulator of the activity of 0X40, a modulator of the activity of KIR, a modulator of the activity of Tim-3, a modulator of the activity of CD27, a modulator of the activity of CD40, a modulator of the activity of GITR, a modulator of the activity of TIGIT, a
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9/84 modulator of CD20 activity, modulator of CD96 activity, modulator of IDO1 activity, modulator of STING activity, modulator of GARP activity, modulator of A2aR activity, modulator of CEACAM1 activity , a modulator of CEA activity, a modulator of CD47 activity, a modulator of PVRIG activity, a modulator of TDO activity, a modulator of VISTA activity, a cytokine, a chemokine, an interferon, an interleukin, a lymphokine , a member of the tumor necrosis factor (TNF) family, or an immunostimulatory oligonucleotide.
[0019] In one embodiment, the immunotherapeutic agent is an inhibitor of the immunological control point. In certain embodiments, the immune checkpoint inhibitor is a CTLA-4 antagonist, a CD80 antagonist, a CD86 antagonist, a Tim-3 antagonist, a TIGIT antagonist, a CD20 antagonist, a CD96 antagonist , an IDO1 antagonist, a STING antagonist, a GARP antagonist, a CD40 antagonist, an A2aR antagonist, a CEACAM1 (CD66a) antagonist, a CEA antagonist, a CD47 antagonist, a PVRIG antagonist, an TDO antagonist, VISTA antagonist, or KIR antagonist.
[0020] In one embodiment, the immune control point inhibitor is a CTLA-4 antagonist. In certain embodiments, the CTLA-4 antagonist is an anti-CTLA-4 antibody or antigen-binding fragment thereof. In some embodiments, the anti-CTLA-4 antibody is ipilimumab (YERVOY), tremelimumab (ticilimumab; CP-675,206), AGEN-1884, or ATOR1015.
[0021] In one embodiment, the CTLA-4 antagonist is a soluble CTLA-4 polypeptide. In one embodiment, the polypeptide
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Soluble CTLA-4 is abatacept (Orencia), belatacept (Nulojix), RG2077, or RG-1046. In another embodiment, the CTLA-4 antagonist is a cell-based therapy. In some embodiments, the CTLA-4 antagonist is an autologous dendritic cell vaccine transfected with anti-CTLA4 mAb RNA / GITRL RNA or an autologous dendritic cell vaccine transfected with antiCTLA4 mAb RNA.
[0022] In one embodiment, the immune control point inhibitor is a KIR antagonist. In certain embodiments, the KIR antagonist is an anti-KIR antibody or antigen-binding fragment thereof. In some embodiments, the antiKIR antibody is lirilumab (1-7F9, BMS-986015, IPH 2101) or IPH4102.
[0023] In one embodiment, the immune control point inhibitor is a TIGIT antagonist. In one embodiment, the TIGIT antagonist is an anti-TIGIT antibody or antigen-binding fragment thereof. In certain embodiments, the anti-TIGIT antibody is BMS-986207, AB 154, COM902 (CGEN-15137), or OMP-313M32.
[0024] In one embodiment, the immune control point inhibitor is a Tim-3 antagonist. In certain embodiments, the Tim-3 antagonist is an anti-Tim-3 antibody or antigen-binding fragment thereof. In some embodiments, the anti-Tim-3 antibody is TSR-022 or LY3321367.
[0025] In one embodiment, the immune control point inhibitor is an IDO1 antagonist. In another embodiment, the IDO1 antagonist is indoximod (NLG8189; 1-methyl-D-TRP), epacadostat (INCB-024360, INCB-24360), KHK2455, PF-06840003, navoximod (RG6078, GDC-0919, NLG919), BMS-986205 (F001287), or pyrrolidine-2,5-dione derivatives.
[0026] In one mode, the control point inhibitor
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Immunological 11/84 is a STING antagonist. In certain embodiments, the STING antagonist is cyclic 2 'or 3'-mono-fluoro substituted di-nucleotides; 2 ', 5' - 3 ', 5' cyclic mixed bonded 2'3 '-difluoro di-nucleotides; bis-3 ', 5' cyclic, 2'-fluoro substituted di-nucleotides; 2 ', 2 "-diF-Rp, Rp, bis-3', 5 'cyclic di-nucleotides; or fluorinated cyclic di-nucleotides.
[0027] In one embodiment, the immune control point inhibitor is a CD20 antagonist. In some embodiments, the CD20 antagonist is an anti-CD20 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD20 antibody is rituximab (RITUXAN; IDEC-102; IDEC-C2B8), ABP 798, ofatumumab, or obinutuzumab.
[0028] In one embodiment, the immune control point inhibitor is a CD80 antagonist. In certain embodiments, the CD80 antagonist is an anti-CD80 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD80 antibody is galiximab or AV 1142742.
[0029] In one embodiment, the immune control point inhibitor is a GARP antagonist. In some embodiments, the GARP antagonist is an anti-GARP antibody or antigen-binding fragment thereof. In certain embodiments, the anti-GARP antibody is ARGX-115.
[0030] In one embodiment, the immune control point inhibitor is a CD40 antagonist. In certain embodiments, the CD40 antagonist is an anti-CD40 antibody for antigen-binding fragment thereof. In some embodiments, the anti-CD40 antibody is BMS3h-56, lucatumumab (HCD122 and CHIR-12.12), CHIR-5.9, or dacetuzumab (huS2C6, PRO 64553, RG 3636, SGN 14, SGN-40). In another embodiment, the CD40 antagonist is a soluble CD40 ligand (CD40-L). In a
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12/84 modality, the soluble CD40 linker is a fusion polypeptide. In one embodiment, the soluble CD40 linker is a CD40-L / FC2 or a monomeric CD40-L.
[0031] In one embodiment, the immunological control point inhibitor is an A2aR antagonist. In some embodiments, the A2aR antagonist is a small molecule. In certain embodiments, the A2aR antagonist is CPI-444, PBF-509, istradefiline (KW-6002), preladenant (SCH420814), tozadenant (SYN115), vipadenant (BIIB014), HTL-1071, ST1535, SCH42448, SCH441 , ZM241385, or AZD4635.
[0032] In one embodiment, the immunological control point inhibitor is an antagonist of CEACAM1. In some embodiments, the CEACAM1 antagonist is an antiCEACAM1 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CEACAM1 antibody is CM-24 (MK-6018).
[0033] In one embodiment, the immune control point inhibitor is a CEA antagonist. In one embodiment, the CEA antagonist is an anti-CEA antibody or antigen-binding fragment thereof. In certain embodiments, the anti-CEA antibody is cergutuzumab amunaleucine (RG7813, RO-6895882) or RG7802 (RO6958688).
[0034] In one embodiment, the immune control point inhibitor is a CD47 antagonist. In some embodiments, the CD47 antagonist is an anti-CD47 antibody or antigen-binding fragment thereof. In certain embodiments, the anti-CD47 antibody is HuF9-G4, CC-90002, TTI-621, ALX148, N1701, NI-1801, SRF231, or Effi-DEM.
[0035] In one embodiment, the immunological control point inhibitor is a PVRIG antagonist. In certain embodiments, the PVRIG antagonist is an anti-PVRIG antibody or
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13/84 fragment of antigen binding thereof. In one embodiment, the anti-PVRIG antibody is COM701 (CGEN-15029).
[0036] In one embodiment, the immune control point inhibitor is an TDO antagonist. In one embodiment, the TDO antagonist is a derivative of 4- (indol-3-yl) -pyrazole, a substituted derivative of 3-indole, or a derivative of a 3- (indol-3-yl) pyridine. In another embodiment, the immune control point inhibitor is a double antagonist of IDO and TDO. In one embodiment, the double antagonist of IDO and TDO is a small molecule.
[0037] In one embodiment, the immune control point inhibitor is a VISTA antagonist. In some embodiments, the VISTA antagonist is CA-170 or JNJ-61610588.
[0038] In one embodiment, the immunotherapeutic agent is a reinforcer or stimulator of the immunological control point. In one embodiment, immune booster booster or stimulator is a CD28 agonist, a 4-1 BB agonist, a 0X40 agonist, a CD27 agonist, a CD80 agonist, a CD86 agonist, a CD40 agonist , an ICOS agonist, a CD70 agonist, or a GITR agonist.
[0039] In a modality, reinforcer or stimulator of the immunological control point is a 0X40 agonist. In certain embodiments, the 0X40 agonist is an anti-OX40 antibody or antigen-binding fragment thereof. In some embodiments, the anti-OX40 antibody is tavolixizumab (MEDI-0562), pogalizumab (MOXR0916, RG7888), GSK3174998, ATOR-1015, MEDI-6383, MEDI-6469, BMS 986178, PF-04518600, or RG7888 (MOX . In another embodiment, the 0X40 agonist is a cell-based therapy. In certain modalities, the 0X40 agonist is a GINAKIT cell (T lymphocytes expressing IC9-GD2Petition 870190089572, of 10/09/2019, page 30/165
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CD28-OX40).
[0040] In one modality, immune booster booster or stimulator is a CD40 agonist. In some embodiments, the CD40 agonist is an anti-CD40 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD40 antibody is ADC-1013 (JNJ-64457107), RG7876 (RO7009789), HuCD40-M2, APX005M (EPI-0050), or Chi Lob 7/4. In another embodiment, the CD40 agonist is a soluble CD40 ligand (CD40-L). In one embodiment, the soluble CD40 linker is a fusion polypeptide. In certain embodiments, the soluble CD40 ligand is a trimeric CD40-L (AVREND®).
[0041] In one modality, the immune control point booster or stimulator is a GITR agonist. In certain embodiments, the GITR agonist is an anti-GITR antibody or antigen-binding fragment thereof. In one embodiment, the anti-GITR antibody is BMS-986156, TRX518, GWN323,
INCAGN01876, or MEDI1873. In one embodiment, the GITR agonist is a soluble GITR ligand (GITRL). In some embodiments, the soluble GITR linker is a fusion polypeptide. In another embodiment, the GITR agonist is a cell-based therapy. In one embodiment, cell-based therapy is an autologous dendritic cell vaccine transfected with antiCTLA4 mAb RNA / GITRL RNA or an autologous dendritic cell vaccine transfected with GITRL RNA.
[0042] In one modality, immune booster booster or stimulator is a 4-1 BB agonist. In some embodiments, the 4-1 BB agonist is an anti-4-1BB antibody or antigen-binding fragment thereof. In one embodiment, the anti-4-1BB antibody is urelumab or PF-05082566.
[0043] In a modality, reinforcer or stimulator of the point of
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15/84 immune control is a CD80 agonist or a CD86 agonist. In some embodiments, the CD80 agonist or CD86 agonist is a soluble CD80 or CD86 ligand (CTLA-4). In certain embodiments, the soluble CD80 or CD86 linker is a fusion polypeptide. In one embodiment, the CD80 or CD86 ligand is either CTLA4-lg (CTLA4-lgG4m, RG2077, or RG1046) or abatacept (ORENCIA, BMS188667). In other embodiments, the CD80 agonist or CD86 agonist is cell-based therapy. In one embodiment, the cell-based therapy is MGN1601 (an allogeneic renal cell carcinoma vaccine).
[0044] In one modality, immune booster booster or stimulator is a CD28 agonist. In some embodiments, the CD28 agonist is an anti-CD28 antibody or antigen-binding fragment thereof. In certain embodiments, the anti-CD28 antibody is TGN1412.
[0045] In one embodiment, the CD28 agonist is a cell-based therapy. In certain embodiments, the cell-based therapy is JCAR015 (anti-CD19CD28-zeta modified CD3 + CAR lymphocyte); T lymphocyte expressing CD28CAR / CD137CAR; similar allogeneic Th1 T cells from CD4 + / anti-CD3 / anti-CD28 memory attached to microparticles; autologous T lymphocytes KTE-C19 transduced by anti-CD19 / CD28 / CD3zeta CAR gamma-retroviral vector; autologous T lymphocytes transduced by anti-CEA lgCD28TCR; allogeneic T lymphocytes transduced by anti-EGFRv111 CAR; autologous T lymphocytes expressing CD123CAR-CD28-CD3zeta-EGFRt; autologous T lymphocytes expressing CD171-specific zeta-4-1-BB-EGFRt CAR-CD28; autologous T cells enriched with expressing CD19CAR-CD28-CD3zeta-EGFRt; autologous T-lymphocytes modified with PD-1 chimeric switch receptor (CD28 chimera); Tem-enriched T lymphocytes expressing
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CD19CAR-CD28-CD3zeta-EGFRt; T lymphocytes enriched with Τη / mem expressing CD19CAR-CD28-CD3zeta-EGFRt; allogeneic T lymphocytes expressing CD19CAR-CD28zeta-4-1BB; autologous T lymphocytes expressing CD19CAR-CD3zeta-4-1BB-CD28; T lymphocytes expressing CD28CAR / CD137CAR; autologous T lymphocytes sensitized with a CD3 / CD28 co-stimulated vaccine; or T lymphocytes expressing IC9-GD2-CD28-OX40.
[0046] In one modality, immune booster or stimulator is a CD27 agonist. In certain embodiments, the CD27 agonist is an anti-CD27 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD27 antibody is varlilumab (CDX-1127).
[0047] In one modality, immune booster booster or stimulator is a CD70 agonist. In some embodiments, the CD70 agonist is an anti-CD70 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD70 antibody is ARGX-110.
[0048] In one embodiment, the immune booster booster or stimulator is an ICOS agonist. In certain embodiments, the ICOS agonist is an anti-ICOS antibody or antigen-binding fragment thereof. In some embodiments, the anti-ICOS antibody is BMS986226, MEDI-570, GSK3359609, or JTX-2011. In other embodiments, the ICOS agonist is a soluble ICOS ligand. In some embodiments, the soluble ICOS ligand is a fusion polypeptide. In one embodiment, the soluble ICOS binder is AMG 750.
[0049] In one embodiment, the immunotherapeutic agent is an anti-CD73 antibody or antigen-binding fragment thereof. In certain embodiments, the anti-CD73 antibody is MEDI9447.
[0050] In one embodiment, the immunotherapeutic agent is a
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17/84 TLR9 agonist. In one embodiment, the TLR9 agonist is sodium agatolimod.
[0051] In one embodiment, the immunotherapeutic agent is a cytokine. In certain embodiments, the cytokine is a chemokine, an interferon, an interleukin, a lymphokine, or a member of the tumor necrosis factor family. In some embodiments, the cytokine is IL-2, IL-15, or gamma interferon.
[0052] In one embodiment, the immunotherapeutic agent is a TGF-β antagonist. In some embodiments, the TGF-β antagonist is fresolimumab (GC-1008); NIS793; BMI-TR1 (LY3022859); ISTH0036; trabedersen (AP 12009); recombinant transforming growth factor-beta-2; autologous TGF beta resistant T lymphocytes specific for HPV-16/18 E6 / E7; or TGF beta resistant LMP-specific cytotoxic T lymphocytes.
[0053] In one embodiment, the immunotherapeutic agent is an iNOS antagonist (N.T .: iNOS, inducible nitric oxide synthase). In some embodiments, the iNOS antagonist is N-Acetyl cysteine (NAC), aminoguanidine, L-nitroarginine methyl ester, or S, S-1,4-phenylene-bis (1,2-ethanediyl) bis-isothiourea).
[0054] In one embodiment, the immunotherapeutic agent is an SHP-1 antagonist.
[0055] In one embodiment, the immunotherapeutic agent is an antagonist of CSF1R (macrophage colony stimulating factor receptor 1). In certain embodiments, the CSF1R antagonist is an anti-CSF1R antibody or antigen-binding fragment thereof. In some embodiments, the antiCSF1R antibody is emactuzumab.
[0056] In one embodiment, the immunotherapeutic agent is an agonist for a member of the TNF family. In some embodiments, the TNF family member's agonist is ACTOR 1016, ABBV-621, or
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Adalimumab.
[0057] In one embodiment, the immunotherapeutic agent is aldesleukin, tocilizumab, or MEDI5083.
[0058] In one embodiment, the immunotherapeutic agent is a CD160 (NK1) agonist. In certain embodiments, the CD160 agonist (NK1) is an anti-CD160 antibody or antigen-binding fragment thereof. In one embodiment, the anti-CD160 antibody is BY55.
[0059] In one embodiment, the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated for intravenous administration. In some embodiments, the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated together. In another embodiment, the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated separately.
[0060] In one embodiment, the malignant tumor is selected from the group consisting of liver cancer, bone cancer, pancreatic cancer, skin cancer, oral cancer, head or neck cancer, breast cancer, lung cancer - including small cell and non-small cell lung cancer, cutaneous or intraocular malignant melanoma, kidney cancer, uterine cancer, ovarian cancer, colorectal cancer, colon cancer, rectal cancer, anal region cancer, stomach cancer, testicular cancer, uterine cancer, fallopian tube carcinoma, endometrial carcinoma, cervical carcinoma, vagina carcinoma, vulvar carcinoma, non-Hodgkin's lymphoma, esophageal cancer, small intestine cancer, endocrine cancer, thyroid gland cancer, cancer parathyroid gland, adrenal gland cancer, soft tissue sarcoma, urethral cancer, penis cancer, childhood cancers, lymphocytic lymphoma, bladder cancer, kidney or ureter cancer, skin carcinoma renal vein, neoplasm of the central nervous system
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19/84 (CNS), primary central nervous system lymphoma, tumor angiogenesis, spinal axis tumor, brain stem glioma, pituitary adenoma, Kaposi's sarcoma, epidermoid cancer, squamous cell cancer, environmentally induced cancers including those induced by asbestos, haematological malignancies including, for example, multiple myeloma, B cell lymphoma, Hodgkin's lymphoma / primary mediastinal B cell lymphoma, non-Hodgkin's lymphoma, acute myeloid lymphoma, chronic myeloid leukemia, chronic lymphoid leukemia, follicular lymphoma, diffuse lymphoma large B cell lymphoma, Burkitt lymphoma, large cell immunoblastic lymphoma, precursor B cell lymphoma, moanto cell lymphoma, acute lymphoblastic leukemia, mycosis fungoides, anaplastic large cell lymphoma, T cell lymphoma, and lymphoblastic lymphoma precursor T cells, and any combination thereof.
[0061] In one embodiment, the malignant tumor is non-small cell lung cancer (NSCLC), a cancer-related tumor related to viruses, or gastric adenocarcinoma. In some embodiments, the malignant tumor is melanoma, gastric cancer, cancer of the gastroesophageal junction, non-small cell lung cancer, bladder cancer, squamous cell carcinoma of the head and neck, or cancer of kidney cells. In one embodiment, the tumor is lung cancer, melanoma, squamous cell carcinoma of the head and neck, kidney cancer, gastric cancer, or hepatocellular carcinoma.
[0062] In one embodiment, the anti-LAG-3 antibody or antigen-binding fragment thereof and the immunotherapeutic agent are administered as a first line of treatment. In another embodiment, the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are administered as a second line of treatment. In certain modalities, the malignant tumor is
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20/84 refractory to the first treatment line.
[0063] In one embodiment, the method for treating a subject effected with a malignant tumor as described above additionally comprises administering at least one additional therapeutic agent. In certain embodiments, the at least one additional therapeutic agent is a chemotherapeutic agent.
[0064] Other features and advantages of the present invention will be evident from the detailed description and examples that follow, which should be considered as limiting. DETAILED DESCRIPTION OF THE INVENTION
I. Terms [0065] A patient as used here, in this patent application, includes any patient who is affected with cancer (for example, melanoma). The terms subject and patient are used interchangeably here, in this patent application.
[0066] As used herein, in this patent application, the term administration refers to the physical introduction of a composition comprising a therapeutic agent (for example, combination of an anti-PD-1 antibody, an anti-LAG-3 antibody, and an additional immunotherapeutic agent) to a subject, using any of the various delivery methods and systems known to those skilled in the art. Routes of administration include intravenous, intramuscular, subcutaneous, intraperitoneal, spinal or other parenteral routes of administration, for example, by injection or infusion. The term parenteral administration as used herein, in this patent application, means direct modes of administration for enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intralymphatic, intralesional, intracapsular injection and infusion. , intraorbital, intracardiac, intradermal, intraperitoneal,
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21/84 transtracheal, subcutaneous, subcuticular, intra-articular, subcapsular, subarachnoid, intraspinal, epidural and intrasternal, as well as in vivo electroporation. Other non-parenteral routes include a topical, epidermal or mucosal route, for example, intranasally, vaginally, rectally, sublingually or topically. Administration can also be carried out, for example, once, a plurality of times, and / or during one or more prolonged periods.
[0067] As used here, in this patent application, effective treatment refers to a treatment that produces a beneficial effect, for example, the improvement of at least one symptom of a disease or disorder. A beneficial effect can take the form of an improvement over the baseline, that is, an improvement over a measurement or observation made before the start of therapy according to the method. A beneficial effect can also take the form of stopping, slowing down, slowing down, or stabilizing the deleterious progression of a solid tumor marker. Effective treatment may refer to relieving at least one symptom of a solid tumor. Such effective treatment can, for example, reduce the patient's pain, reduce the size and / or the number of lesions, can reduce or prevent metastasis of a tumor, and / or can slow the growth of the tumor.
[0068] The term effective amount refers to an amount of an agent that provides the desired biological, therapeutic, and / or prophylactic result. This result can be the reduction, improvement, attenuation, decrease, delay, and / or relief of one or more of the signs, symptoms, or causes of an illness, or any other desired change in a biological system. In reference to solid tumors, an effective amount comprises an amount sufficient to cause the tumor to shrink and / or to decrease
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22/84 the rate of tumor growth (such as to suppress tumor growth) or to prevent or delay other unwanted cell proliferation. In some embodiments, an effective amount is an amount sufficient to slow the development of the tumor. In some embodiments, an effective amount is an amount sufficient to prevent or delay tumor recurrence. An effective amount can be administered in one or more administrations. The effective amount of the drug or composition can: (i) reduce the number of cancer cells; (ii) reducing the size of the tumor; (iii) inhibit, delay, slow down to some extent and can stop the infiltration of cancer cells into peripheral organs; (iv) inhibit (that is, slow down to some extent and may interrupt tumor metastasis; (v) inhibit tumor growth; (vi) prevent or delay the occurrence and / or recurrence of the tumor; and / or (vii ) relieve to some extent one or more of the symptoms associated with cancer. In one example, an effective amount is the amount of anti-LAG-3 antibody and the amount of anti-PD-1 antibody, in combination, clinically proven to perform a significant reduction in cancer or to slow the progression of cancer, such as an advanced solid tumor. As used here, in this patent application, the terms fixed dose, fixed dose and fixed dose are used interchangeably and refer to a dose that is administered to a patient unrelated to the patient's weight or body surface area (BSA). Therefore, the fixed or fixed dose is not proportioned as a dose in mg / kg, but rather is an amount of the agent (for example, the anti-LAG-3 antibody and / or u antiPD-1 antibody).
[0069] As used here, in this patent application, the term immunotherapy refers to the treatment of an affected subject
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23/84 with, or at risk of contracting or relapsing from, a disease by a method comprising induction, reinforcement, suppression or modification in a manner other than an immune response. Treatment or therapy of a subject refers to any type of intervention or process performed on, or the administration of, an active agent (e.g., composition comprising a combination of an anti-PD-1 antibody, an anti-LAG-3 antibody, and an additional immunotherapeutic agent) to the subject in order to reverse, relieve, improve, inhibit, delay or prevent the onset, progression, development, severity or recurrence of a symptom, complication or condition, or biochemical evidence associated with a disease.
[0070] As used herein, in this patent application, the terms cell-based therapy, cell therapy, cell therapy, or cytotherapy refer to the transplantation of cellular material into a patient for the purposes of treating a disease or disorder (for example, a malignant tumor). The cellular material can be a cell fragment or a living, intact cell (for example, T lymphocytes, dendritic cells, or stem cells).
[0071] The use of the term fixed dose with respect to a composition of the invention means that two or more different antibodies in a single composition are present in the composition in particular (fixed) proportions with each other. In some embodiments, the fixed dose is based on the weight (for example, mg) of the antibodies. In certain embodiments, the fixed dose is based on the concentration (eg mg / ml) of the antibodies. In some embodiments, the ratio 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
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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, about 1: 200, about 200: 1, about 180: 1, about 160: 1, about 140: 1, about 120: 1, about 100: 1, about 90: 1, about 80: 1, about 70: 1, about 60: 1, about 50: 1, about 40: 1, about 30: 1, about 20: 1, about 15: 1, about 10: 1, about 9: 1, about 8: 1, about 7: 1, about 6: 1, about 5: 1, about 4: 1, about 3: 1, or about 2: 1 mg of the first antibody to mg of the second antibody. For example, the 3: 1 ratio of a first antibody to a second antibody may mean that a vial can contain about 240 mg of the first antibody and 80 mg of the second antibody or about 3 mg / ml of the first antibody and 1 mg / ml of the second antibody.
[0072] The use of the term fixed dose with respect to the composition of the invention means a dose that is administered to a patient unrelated to the patient's weight or body surface area (BSA). Therefore, the fixed dose is not provided as a dose in mg / kg, but instead as an absolute amount of the agent (for example, anti-LAG-3 antibody and / or anti-PD-1 antibody). For example, a 60 kg person and a 100 kg person would receive the same dose of the composition (for example, 240 mg of an anti-PD-1 antibody and 80 mg of an anti-LAG-3 antibody in a single bottle fixed dosage formulation containing either 240 mg of an anti-PD-1 antibody or 80 mg of an anti-LAG-3 antibody (or two vials of fixed dosage formulations containing 120 mg of an anti-PD-1 antibody and 40 mg of an anti-LAG-3 antibody, etc.)).
[0073] The term dose based on weight as referred to herein, in this patent application, means that a dose that is administered to a patient is calculated based on the patient's weight. For example, when a patient weighing 60 kg
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25/84 body requires 3 mg / kg of an anti-LAG-3 antibody in combination with 3 mg / kg of an anti-PD-1 antibody, you can extract the appropriate amounts of the anti-LAG-3 antibody (ie ie, 180 mg) and anti-PD-1 antibody (i.e., 180 mg) at once from a fixed dosage formulation of an anti-LAG3 antibody and an anti-PD-1 antibody in a ratio of 1 :1.
[0074] An antibody (Ab) will include, without limitation, an immunoglobulin glycoprotein which specifically binds to an antigen and comprises at least two heavy chains (H) and two light chains (L) interconnected by disulfide bonds, or one antigen-binding portion of the same. Each heavy chain is composed of a heavy chain variable region (abbreviated here, in this patent application, as Vh) and a heavy chain constant region (abbreviated here, in this patent application, as CH). In some antibodies, for example, naturally occurring IgG antibodies, the heavy chain constant region is made up of a joint and three domains, CH1, CH2 and CH3. In some antibodies, for example, naturally occurring IgG antibodies, each light chain is comprised of a variable light chain region (abbreviated here, in this patent application, such as V1) and a light chain constant region. The light chain constant region is made up of a domain (abbreviated here, in this patent application, as CL). The Vh and Vl regions can be further subdivided into regions of hypervariability, called complementarity determining regions (CDR), interspersed with regions that are more conserved, called main structure regions (FR). Each Vh and Vl is composed of three CDRs and four FRs, arranged from the amino terminus to the carboxy terminus in the following order: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4. The variable regions of the heavy and light chains contain a binding domain
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26/84 that interacts with an antigen. The antibody constant regions can mediate the binding of immunoglobulin to host factors or tissues, including various cells of the immune system (for example, effector cells) and the first component (C1q) of the classic complement system. A heavy chain may have Cterminal lysine or not. Unless otherwise specified here, in this patent application, the amino acids in the variable regions are numbered using the Kabat numbering system and the amino acids in the constants are numbered using the EU numbering system.
[0075] An immunoglobulin can be of any of the known isotypes, including IgA, secretory IgA, IgD, IgE, IgG, and IgM. The IgG isotype is divided into subclasses in certain species: lgG1, lgG2, lgG3 and lgG4 in humans, and lgG1, lgG2a, lgG2b and lgG3 in mice. Isotype refers to the class or subclass of antibodies (for example, IgM or IgG1) that is encoded by heavy chain constant region genes. The term antibody includes, by way of example, monoclonal and polyclonal antibodies; chimeric and humanized antibodies; human or non-human antibodies; fully synthetic antibodies; and single chain antibodies. A non-human antibody can be humanized by recombinant methods in order to reduce its immunogenicity in man. Where not expressly stated, and unless the context otherwise indicates, the term antibody includes monospecific, bispecific, or multispecific antibodies, as well as a single chain antibody. In embodiments, the antibody is a bispecific antibody. In other embodiments, the antibody is a monospecific antibody.
[0076] As used here, in this patent application, an IgG antibody has the structure of an IgG antibody that occurs
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27/84 naturally, that is, it has the same number of heavy and light chains and disulfide bonds as a naturally occurring IgG antibody from the same subclass. For example, an anti-ICOS lgG1, lgG2, lgG3 or lgG4 antibody consists 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 IgG1, IgG2, IgG3 and IgG4 antibodies, respectively (unless the antibody has been mutated to modify disulfide bonds).
[0077] An isolated antibody refers to an antibody that is substantially free of other antibodies having different antigen specificities (for example, an isolated antibody that specifically binds to PD-1 is substantially free of antibodies that specifically bind to antigens other than PD-1). However, an isolated antibody that specifically binds to PD-1 may cross-react with other antigens, such as PD-1 molecules from different species. In addition, an isolated antibody can be substantially free of other cellular material and / or chemicals.
[0078] The antibody can be an antibody that has been altered (for example, by mutation, deletion, substitution, conjugation to a non-antibody moiety). For example, an antibody can include one or more variant amino acids (compared to a naturally occurring antibody) which modify a property (for example, a functional property) of the antibody. For example, numerous similar changes are known in the art which affect, for example, half-life, effector function, and / or immune responses to the antibody in a patient. The term antibody also includes artificial polypeptide constructs which comprise at least one antibody-derived antigen-binding site.
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28/84 [0079] The term monoclonal antibody (mAb) refers to a preparation of antibody molecules that does not naturally occur with a single molecular composition, that is, antibody molecules whose primary sequences are essentially identical, and which have a specificity and binding affinity unique to a particular epitope. A monoclonal antibody is an example of an isolated antibody. MAbs can be produced by hybridoma, recombinant, transgenic or other techniques known to those skilled in the art.
[0080] A human antibody (HuMAb) refers to an antibody having variable regions in which both the main structure and CDR regions are derived from immunoglobulin sequences of the human germline. Furthermore, if the antibody contains a constant region, the constant region is also derived from human germline immunoglobulin sequences. The human antibodies of the invention may include amino acid residues not encoded by human germline immunoglobulin sequences (for example, mutations introduced by random or site-specific mutagenesis in vitro or by somatic mutation in vivo). However, the term human antibody, as used herein, in this patent application, is not intended to include antibodies in which CDR sequences derived from the germline of another species of mammal, such as a mouse, have been grafted onto structure sequences main human. The terms human antibodies and fully human antibodies are used interchangeably.
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 corresponding amino acids derived from human immunoglobulins. In a
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29/84 modality of a humanized form of an antibody, some, most or all of the amino acids outside the CDR domains have been replaced with human immunoglobulin amino acids, while some, most or all of the amino acids within one or more regions of CDR are unchanged. Small additions, deletions, insertions, substitutions or modifications of amino acids are permissible, as long as they do not negate the ability of the antibody to bind to a particular antigen. A humanized antibody maintains an antigen specificity similar to that of the original antibody.
[0082] A chimeric antibody refers to an antibody in which the variable regions are derived from one species and the constant regions are derived from another species, such as an antibody in which the variable regions are derived from a mouse antibody and the regions constants are derived from a human antibody.
[0083] An anti-antigen antibody refers to an antibody that specifically binds to the antigen. For example, an antiPD-1 antibody specifically binds to PD-1 and an anti-CTLA-4 antibody specifically binds to CTLA-4.
[0084] An antigen-binding portion of an antibody (also called an antigen-binding fragment) refers to one or more fragments of an antibody that retain the ability to specifically bind to the antigen bound by the entire antibody. It has been shown that the antigen-binding function of an antibody can be performed by fragments or portions of a full-length antibody. Examples of binding fragments encompassed within the term antigen binding portion or antigen binding fragment of an antibody, for example, an anti-ICOS antibody described herein, in this patent application, include:
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30/84 [0085] (1) a Fab fragment (papain divination fragment) or a similar monovalent fragment consisting of the VL, VH, LCeCHI domains;
[0086] (2) an F (ab ') 2 fragment (pepsin dividing fragment) or a similar divalent fragment comprising two Fab fragments linked by a disulfide bridge in the hinge region;
[0087] (3) an Fd fragment consisting of the VH and CH1 domains;
[0088] (4) an Fv fragment consisting of the VL and VH domains of a single arm of an antibody, [0089] (5) a single domain antibody (dAb) fragment (Ward et al., (1989) Nature 341 : 544-46), which consists of a VH domain;
[0090] (6) a single double domain antibody which consists of two VH domains linked by a joint (double affinity redirect antibodies (DARTs));
[0091] (7) a double variable domain immunoglobulin;
[0092] (8) an isolated complementarity determining region (CDR); and [0093] (9) a combination of two or more isolated CDRs, which optionally can be joined by a synthetic linker. Furthermore, although the two domains of the Fv fragment, VL and VH, are encoded by separate genes, they can be joined, using recombinant methods, by a synthetic linker that allows them to be produced as a single protein chain in which the pair from VL and VH regions form monovalent molecules (known as single chain Fv (scFv); see, for example, Bird et al. (1988) Science 242: 423-426; and Huston et al. (1988) Proc. Natl. Acad. Sci. USA 85: 5879-5883). The single chain antibodies referred to are also intended to be encompassed within the term
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31/84 antigen or antigen-binding fragment of an antibody. These antibody fragments are obtained using conventional techniques known to those skilled in the art, and the fragments are screened for utility in the same way that intact antibodies are screened. Antigen-binding moieties can be produced by recombinant DNA techniques, or by enzymatic or chemical dividing of intact immunoglobulins.
[0094] The term LAG-3, LAG3, or Lymphocyte Activation Gene-3 refers to Lymphocyte Activation Gene-3. The term LAG-3 as used herein, in this patent application, includes human LAG-3 (hLAG-3), variants, isoforms, and homologues of hLAG-3 species, and analogs having at least one epitope in common with hLAG -3. The term LAG-3 as used here, in this patent application, includes variants, isoforms, homologs, orthologs and the like. For example, antibodies specific to a human LAG-3 protein, in certain cases, can cross-react with a LAG-3 protein of a species other than human. In other embodiments, antibodies specific to a human LAG-3 protein may be completely specific to the human LAG-3 protein and may not be cross-reactive between species or other types of cross-reactivity, or may be cross-reactive with LAG-3 from some other species, but not all other species (for example, cross-react with monkey LAG-3, but not with mouse LAG-3). The term human LAG-3 refers to the human LAG-3 sequence, such as the complete amino acid sequence of human LAG-3 having Access on GenBank No. NP_002277 (SEQ ID NO: 13). The term mouse LAG-3 refers to the mouse LAG-3 sequence, such as the complete amino acid sequence of mouse LAG-3 having Access on No. GenBank.
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NP_032505. LAG-3 is also known in the art, for example, CD223. The sequence of human LAG-3 may differ from the human LAG3 of Access in GenBank No. No. NP_002277 in that it has, for example, conserved mutations or mutations in non-conserved regions and LAG-3 has substantially the same biological function as LAG-3 GenBank Access Human Reference No. NP_002277 (SEQ ID NO: 44). For example, a biological function of human LAG-3 is to have an epitope in the extracellular domain of LAG-3 that is specifically linked by an antibody of the present invention or a biological function of human LAG-3 is binding to MHC Class II molecules.
[0095] A particular human LAG-3 sequence will generally be at least 90% identical in amino acid sequence to Human Access LAG3 in GenBank No. NP_002277 and contains amino acid residues that identify the amino acid sequence as being human when compared with LAG-3 amino acid sequences from other species (for example, murines). In some cases, a human LAG-3 can be at least 95%, or even at least 96%, 97%, 98%, or 99% identical in amino acid sequence to Access LAG-3 on GenBank No. NP_002277. In certain embodiments, a human LAG-3 sequence will exhibit no more than 10 amino acid differences from the Access LAG-3 sequence in the GenBank of No. NP_002277. In certain embodiments, human LAG-3 can have no more than 5, or even no more than 4, 3, 2, or 1 amino acids different from the Access LAG-3 sequence in GenBank No. NP_002277. The percentage of identity can be determined as described here, in this patent application.
[0096] As used here, in this patent application, the terms Programmed Death 1, Programmed Cell Death 1,
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PD-1, PD-1, PD1, PDCD1, hPD-1 and hPD-1 protein are used interchangeably, and include variants, isoforms, homologues of human PD-1 species, and analogs having at least one epitope in common with PD-1. The complete PD-1 sequence can be found under GenBank Access Nos. U64863 (SEQ ID NO: 29) and AAC51773.1 (SEQ ID NO: 45).
[0097] Programmed Cell Death Protein 1 (PD-1) is an inhibitory member of the CD28 receptor family, which also includes CD28, CTLA-4, ICOS and BTLA. PD-1 is expressed on B cells, T cells, and activated myeloid cells (Agata et al., Supra; Okazaki et al. (2002) Curr. Opin. Immunol. 14: 391779-82; Bennett et al. (2003) J Immunol 170: 711-8). The initial family members, CD28 and ICOS, were discovered for functional effects on increased proliferation of T cells after the addition of monoclonal antibodies (Hutloff et al. Nature (1999); 397: 263-266; Hansen et al. Immunogenics (1980); 10: 247-260). PD-1 was discovered through screening for differential expression in apototic cells (Ishida et al. EMBO J (1992); 11: 3887-95). The other members of the family, CTLA-4 and BTLA, were discovered through screening for differential expression in cytotoxic T lymphocytes and TH1 cells, respectively. CD28, ICOS and CTLA-4 all have an unpaired cysteine residue which enables homodimerization. In contrast, it has been suggested that PD-1 exists as a monomer, lacking the characteristic unpaired cysteine residue in other members of the CD28 family.
[0098] The PD-1 gene is a 55 kDa type I transmembrane protein that is part of the Ig gene superfamily (Agata et al. (1996) Int Immunol 8: 765-72). PD-1 contains a proximal membrane-proximal tyrosine inhibitor motif (ITIM) and a membrane-distal tyrosine-based switch motif (ITSM) (Thomas, ML (1995) J Exp Med 181: 1953-6; Vivier, E and Daeron, M (1997) Immunol Today
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18: 286-91). Although structurally similar to CTLA-4, PD-1 lacks the MYPPPY motif which is crucial for B7-1 and B7-2 binding. Two ligands have been identified for PD-1, PD-L1 and PD-L2, which have been shown to negatively regulate T cell activation after binding to PD-1 (Freeman et al. (2000) J Exp Med 192: 102734 ; Latchman et al. (2001) Nat Immunol 2: 261-8; Carter et al. (2002) Eur J Immunol 32: 634-43). Both PD-L1 and PD-L2 are B7 homologues that bind to PD-1, but do not bind to other members of the CD28 family. PD-L1 is abundant in a variety of human cancers (Dong et al. (2002) Nat. Med. 8: 787-9). The interaction between PD1 and PD-L1 results in a decrease in tumor infiltration by lymphocytes, a decrease in proliferation mediated by T cell receptors, and an immune avoidance by cancer cells (Dong et al. (2003) J. Mol. Med. 81: 281-7; Blank et al. (2005) Cancer Immunol. Immunother. 54: 307-314; Konishi et al. (2004) Clin. Cancer Res. 10: 5094-100). Immune suppression can be reversed by inhibiting the local interaction of PD-1 with PD-L1, and the effect is additive when the interaction of PD-1 with PD-L2 is also blocked (Iwai et al. (2002) Proc. Nat 'L. Acad. Sci. USA 99: 12293-7; Brown et al. (2003) J. Immunol. 170: 1257-66).
[0099] Consistent with PD-1 being an inhibitory member of the CD28 family, PD-1 deficient animals develop several autoimmune phenotypes, including autoimmune cardiomyopathy and a lupus-like syndrome with arthritis and nephritis (Nishimura et al. (1999) Immunity 11 : 141-51; Nishimura et al. (2001) Science 291: 319-22). Additionally, PD-1 was seen to have a role in autoimmune encephalomyelitis, systemic lupus erythematosus, graft-versus-host disease (GVHD), type I diabetes, and rheumatoid arthritis (Salama et al. (2003) J Exp Med 198: 71-78; Prokunina and AlarconRiquelme (2004) Hum Mol Genet 13: R143; Nielsen et al. (2004) Lupus
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13: 510). In a murine B cell tumor line, PD-1 ITSM has been shown to be essential to block BCR-mediated Ca2 + flow and tyrosine phosphorylation of effector molecules downstream (Okazaki et al. (2001) PNAS 98: 13866-71).
[00100] Programmed Cell Death Ligand -1 (PD-L1) is one of two cell surface glycoprotein ligands for PD-1 (the other being PD-L2) that negatively regulates the activation of Tea cells to cytokine secretion after connection to PD-1. The term PD-L1 as used herein, in this patent application, includes human PD-L1 (hPD-L1), variants, isoforms, and homologues of hPD-L1 species, and 5 analogs having at least one epitope in common with hPD -L1. The complete hPD-L1 sequence can be found under GenBank Access No. Q9NZQ7.
[00101] The terms Programmed Cell Death Ligand-2 and PDL2 as used here, in this patent application, include human PDL2 (hPD-L2), variants, isoforms, and homologues of hPD-L2 species, and analogs having at least an epitope in common with hPD-L2. The complete hPD-L2 sequence can be found under GenBank Access No. Q9BQ51.
[00102] A cancer refers to a wide group of various diseases characterized by the uncontrolled growth of abnormal cells in the body. Deregulated cell division and growth results in the formation of malignant tumors that invade neighboring tissues and can also metastasize to distant parts of the body through the lymphatic system or the bloodstream. A cancer or cancerous tissue can include a tumor.
[00103] The term tumor as used here, in this patent application, refers to any tissue mass that results from excessive cell growth or excessive cell proliferation, whether benign (non-cancerous) or malignant (cancerous), including prePetition lesions 870190089572, of 10/09/2019, p. 52/165
36/84 cancerous.
[00104] The term and / or where used here, in this patent application, must be taken as specific disclosure for each of the two characteristics or each of the two specified components with or without the other. Accordingly, the term and / or as used in an expression such as A and / or B here, in this patent application, is intended to include A and B, A or B, A (isolated), and B (isolated). Likewise, the term and / or as used in an expression such as A, B, and / or C is intended to encompass 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; A (isolated); B (isolated); and C (isolated).
[00105] It should be understood that whenever aspects are described here, in this patent application, with the term comprising, analogous aspects are also provided in different ways described in terms of consisting of and / or consisting essentially of.
[00106] The terms about or essentially comprising refer to a value or composition that is within an acceptable error range for the particular value or composition as determined by a person skilled in the art, which will depend in part on how the value or composition is measured or determined, that is, the limitations of the measurement system. For example, about or essentially comprising can mean within 1 or more than 1 standard deviation according to practice in the art. Alternatively, about or essentially comprising of can mean a range of up to 10% or 20% (i.e., ± 10% or ± 20%). For example, about 3 mg can include any number between 2.7 mg and 3.3 mg (for 10%) or between 2.4 mg and 3.6 mg (for 20%). Furthermore, particularly with respect to systems or processes
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37/84 biological, the terms can mean up to an order of magnitude or up to 5 times of a value. When particular values or compositions are provided in the application and in the claims, unless otherwise stated, the meaning of about or essentially comprising of should be assumed to be within an acceptable error range for that particular value or composition.
[00107] As described here, in this patent application, any concentration range, percentage range, proportion range or range of integers should be understood as including the value of any integer within the mentioned range and, where appropriate, fractions thereof. (such as one tenth and one hundredth of an integer), unless otherwise stated.
[00108] Unless otherwise defined, all technical and scientific terms used herein, in this patent application, have the same meaning as is commonly understood by a person skilled in the art to which this invention is related. For example, the Concise Dictionary of Biomedicine and Molecular Biology, Juo, PeiShow, 2nd ed., 2002, CRC Press; The Dictionary of Cell and Molecular Biology, 5th ed., 2013, Academic Press; and the Oxford Dictionary Of Biochemistry And Molecular Biology, 2006, Oxford University Press, provide an expert with a general dictionary of many of the terms used in this invention.
[00109] Units, prefixes, and symbols are denoted in their accepted form by the Système International de Unites (SI). Numeric ranges are inclusive of numbers defining the range. The titles provided here, in this patent application, are not limitations on the various aspects of the invention, which can be taken by reference to the specification as a whole. Per
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38/84 therefore, the terms defined immediately below are more fully defined by reference to the specification in its entirety.
[00110] Various aspects of the invention are described in further detail in the subsections that follow.
Ila. Anti-LAG-3 antibodies [00111] Human anti-LAG-3 antibodies (or VH / VL domains derived therefrom) suitable for use in the invention can be generated using methods known in the art. Alternatively, anti-LAG-3 antibodies recognized in the art can be used. For example, the anti-human LAG-3 antibody described in patent application No. US2011 / 0150892 A1, the teachings of which are hereby incorporated by reference, and referred to as monoclonal antibody 25F7 (also known as 25F7 and LAG3, can be used). .1). Other antiLAG-3 antibodies recognized in the art that can be used include IMP731 (H5L7BW) described in US Patent 2011/007023, MK-4280 (28G10) described in WO2016028672, REGN3767 described in the Journal for ImmunoTherapy of Cancer, (2016) Vol. 4, Supp. Supplement 1 Abstract Number: P195, BAP050 described in WO2017 / 019894, IMP701 (LAG-525), IMP321 (eftilagimod alpha)), Sym022, TSR-033, MGD013, BI754111, FS118, AVA-017 and GSK2831781. These and other anti-LAG-3 antibodies useful in the claimed invention can be found, for example, in: WO2016 / 028672, W02017 / 106129,
WO2017 / 062888,
WO2016 / 126858,
WO2015 / 200119,
WO2017 / 220555,
WO2017 / 015560,
WO2017 / 087901,
W02009 / 044273,
WO2014 / 179664,
WO2017 / 019846,
WO2017 / 220569,
WO2017 / 025498,
WO2018 / 083087,
WO2018 / 069500,
WO2016 / 200782,
WO2017 / 198741,
WO2018 / 071500,
WO2017 / 087589,
WO2017 / 149143,
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WO2017 / 219995, US2017 / 0260271, WO2017 / 086367,
WO / 2017/086419, WO2018 / 034227, and W02014 / 140180. The contents of each of these references are incorporated into this patent application by reference.
[00112] Antibodies that compete with any of the antibodies for binding to LAG-3 recognized in the above mentioned technique can be used.
[00113] An example of an anti-LAG-3 antibody is BMS-986016 comprising heavy and light chains comprising the sequences shown in SEQ ID NOs: 1 and 2, respectively, or antigen binding fragments and variants thereof, as described in US Patent No. 9,505,839, which is hereby incorporated into this patent application by reference.
[00114] In other embodiments, the antibody has the CDRs of heavy and light chains or variable regions of BMS-986016. Therefore, in one embodiment, the antibody comprises the CDR1, CDR2, and CDR3 domains of the VH region of BMS-986016 having the sequence stipulated in SEQ ID NO: 3, and the CDR1, CDR2 and CDR3 domains of the VL region of BMS- 986016 having the sequence stipulated in SEQ ID NO: 5. In another embodiment, the antibody comprises the domains CDR1, CDR2 and CDR3 comprising the sequences stipulated in SEQ ID NOs: 7, 8, and 9, respectively, and the CDR1, CDR2 domains and CDR3 comprising the sequences stipulated in SEQ ID NOs: 10, 11, and 12, respectively. In another embodiment, the antibody comprises the VH and / or VL regions comprising the amino acid sequences stipulated in SEQ ID NO: 3 and / or SEQ ID NO: 5, respectively. In another embodiment, the antibody comprises the heavy chain variable (VH) and / or light chain variable (VL) regions encoded by the nucleic acid sequences stipulated in SEQ ID NO: 4 and / or SEQ ID NO: 6,
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40/84 respectively. In another embodiment, the antibody competes for binding with and / or binds to the same epitope on LAG-3 as the antibodies mentioned above. In another embodiment, the antibody binds to a human LAG-3 epitope comprising the amino acid sequence PGHPLAPG (SEQ ID NO: 14). In another embodiment, the antibody binds to an epitope of human LAG-3 comprising the amino acid sequence HPAAPSSW (SEQ ID NO: 15) or PAAPSSWG (SEQ ID NO: 16).
[00115] In another embodiment, the antibody has at least about 90% sequence region amino acid identity with the above mentioned antibodies (for example, at least about 90%, 95% or 99% region identity variable with SEQ ID NO: 3 or SEQ ID NO: 5).
[00116] In embodiments, the anti-LAG-3 antibody is a bispecific antibody. In embodiments, the anti-LAG-3 antibody is a bispecific antibody that binds to both PD-1 and LAG-3.
Ib. Anti-PD-1 Antibodies [00117] Human monoclonal antibodies (HuMAbs) that specifically bind PD-1 with high affinity have been disclosed in US Patent Nos. 8,008,449 and 8,779,105. Other anti-PD-1 mAbs have been described, for example, in US Patent Nos. 6,808,710, 7,488,802, 8,168,757 and 8,354,509, and in PCT International Patent Publication No. WO 2012/145493. Each of the anti-PD-1 HuMAbs disclosed in US Patent No. 8,008,449 has been shown to exhibit one or more of the following characteristics: (a) it binds to human PD-1 with a Kd of 1 x 10 ' ⁷ M or less, as determined by superficial plasmon resonance using a Biacore biosensor system; (b) does not substantially bind to human CD28, CTLA-4 or ICOS; (c) increases T cell proliferation in a Mixed Lymphocyte Reaction (MLR) assay; (d) increases the
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41/84 interferon-γ production in an MLR assay; (e) increases IL-2 secretion in an MLR assay; (f) binds to human PD-1 and monkey cynomolgus PD-1; (g) inhibits the binding of PD-L1 and / or PD-L2 to PD-1; (h) stimulates antigen-specific memory responses; (i) stimulates antibody responses; and (j) inhibits the growth of tumor cells in vivo. Anti-PD-1 antibodies useful for the present invention include mAbs that specifically bind to human PD-1 and exhibit at least one, preferably at least five, of the preceding characteristics.
[00118] In one embodiment, the anti-PD-1 antibody is nivolumab. Nivolumab (also known as OPDIVO®; BMS-936558; previously designated 5C4, BMS-936558, MDX-1106, or ONO4538) is an antibody to the PD1 immune control point inhibitor of fully human IgG4 (S228P) that selectively prevents interaction with PD-1 ligands (PD-L1 and PD-L2), thereby blocking the negative regulation of anti-tumor T cell functions (US Patent No. 8,008,449; Wang et al., 2014 Cancer Immunol Res. 2 (9 ): 846-56). In another embodiment, the anti-PD1 antibody or fragment thereof cross-competes with nivolumab. In other embodiments, the anti-PD-1 antibody or fragment thereof binds to the same epitope as nivolumab. In certain embodiments, the anti-PD-1 antibody has the same CDRs as nivolumab. [00119] In another embodiment, the anti-PD-1 antibody is pembrolizumab. Pembrolizumab is a humanized monoclonal lgG4 antibody (S228P) directed against the human cell surface receptor PD-1 (programmed death -1 or programmed cell death -1). Pembrolizumab is described, for example, in U.S. Patent Nos. 8,354,509 and 8,900,587.
[00120] Anti-human PD-1 antibodies (or VH and / or VL domains
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42/84 derived therefrom) suitable for use in the invention can be generated using methods known in the art. Alternatively, anti-PD-1 antibodies recognized in the art can be used. For example, monoclonal antibodies 5C4 (referred to here, in this patent application, such as Nivolumab or BMS-936558), 17D8, 2D3, 4H1, 4A11, 7D3, and 5F4, described in WO 2006/121168, whose teachings are by this incorporated by reference. Other known antibodies against PD-1 include lambrolizumab (MK-3475) described in WO 2008/156712, and AMP-514 described in WO 2012/145493, the teachings of which are hereby incorporated by reference. Additional known anti-PD-1 antibodies and other PD1 inhibitors include those described in WO 2009/014708, WO 03/099196, WO 2009/114335 and WO 2011/161699, the teachings of which are hereby incorporated by reference. In one embodiment, the anti-PD-1 antibody is REGN2810. In one embodiment, the anti-PD-1 antibody is PDR001. Another known anti-PD-1 antibody is pidilizumab (CT011). Antibodies or antigen-binding fragments can also be used that compete with any of these antibodies or inhibitors for binding to PD-1.
[00121] Other monoclonal anti-PD-1 antibodies have been described, for example, in U.S. Patent Nos. 6,808,710, 7,488,802, 8,168,757 and 8,354,509, in US Patent Publication No. 2016/0272708, and in PCT International Patent Publication Nos. WO 2012/145493, WO 2008/156712, WO 2015/112900, WO 2012/145493, WO 2015/112800, WO 2014/206107, WO 2015/35606, WO 2015/085847, WO 2014/179664, WO 2017/020291, WO 2017/020858, WO 2016/197367, WO 2017/024515, WO 2017/025051, WO 2017/123557, WO
2016/106159, WO 2014/194302, WO 2017/040790, WO 2017/133540, WO 2017/132827, WO 2017/024465, WO 2017/025016, WO
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2017/106061, WO 2017/19846, WO 2017/024465, WO 2017/025016, WO 2017/132825, and WO 2017/133540, each of which is hereby incorporated into this patent application by reference. [00122] In some embodiments, the anti-PD-1 antibody is selected from the group consisting of nivolumab (also known as OPDIVO®, 5C4, BMS-936558, MDX-1106, and ONO4538), 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. / 0: 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. / 0: 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. / 0: 136 (2017)), AM-0001 ( Armo), STI-1110 (Sorrento Therapeutics; see WO 2014/194302), AGEN2034 (Agenus; see WO 2017/040790), MGA012 (Macrogenics, see WO 2017/19846), and IBI308 (Innovent; see WO 2017/024465, WO 2017/025016, WO 2017/132825, and WO 2017/133540), whose references are hereby incorporated into this patent application by reference.
[00123] In another embodiment, the anti-PD-1 antibody or antigen-binding fragment of the same performs cross-competition with pembrolizumab. In some embodiments, the anti-PD-1 antibody or antigen-binding fragment of the same binds to the same epitope as pembrolizumab. In certain embodiments, the antibody
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44/84 anti-PD-1 or antigen-binding fragment of the same has the same CDRs as pembrolizumab. In another embodiment, the anti-PD-1 antibody is pembrolizumab. Pembrolizumab (also known as KEYTRUDA®, lambrolizumab, and MK-3475) is a humanized monoclonal lgG4 antibody directed against the human cell surface receptor PD-1 (programmed death -1 or programmed cell death -1). Pembrolizumab is described, for example, in U.S. Patent Nos. 8,354,509 and 8,900,587; see also http: // www. cancer. gov / drugdictionary cdrid = 695789 (last accessed: 25 May 2017). Pembrolizumab has been approved by the American agency FDA for the treatment of relapsing melanoma or refractory melanoma.
[00124] In other modalities, the anti-PD-1 antibody or antigen-binding fragment of the same performs cross-competition with MEDI0608. In still other embodiments, the anti-PD-1 antibody or antigen-binding fragment of the same binds to the same epitope as MEDI0608. In certain embodiments, the anti-PD1 antibody has the same CDRs as MEDI0608. In other embodiments, the anti-PD-1 antibody is MEDI0608 (formerly AMP-514), which is a monoclonal antibody. MEDI0608 is described, for example, in U.S. Patent No. 8,609,089 or at http://www.cancer.gov/drugdictionary cdrid=756047 (last accessed May 25, 2017).
[00125] In other modalities, the anti-PD-1 antibody or antigen-binding fragment of the same performs cross-competition with the BGB-A317. In some embodiments, the anti-PD-1 antibody or antigen-binding fragment of the same is bound to the same epitope as BGB-A317. In certain embodiments, the anti-PD-1 antibody or antigen-binding fragment of the same has the same CDRs as the BGB-A317. In certain embodiments, the anti-PD antibody
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45/84 or antigen-binding fragment thereof is BGB-A317, which is a humanized monoclonal antibody. BGB-A317 is described in U.S. Patent Publication No. 2015/0079109.
[00126] Anti-PD-1 antibodies useful for the disclosed compositions also include isolated antibodies that specifically bind to human PD-1 and cross-compete for binding to human PD-1 with nivolumab (see, for example, US Patents) Nos. 8,008,449 and 8,779,105; and International Patent Publication No. WO 2013/173223). The ability of antibodies to cross-compete for binding to an antigen indicates that these antibodies bind to the same epitopic region as the antigen and sterically prevent the binding of other cross-competition antibodies to that particular epitopic region. These cross-competition antibodies are expected to have functional properties very similar to those of nivolumab due to their binding to the same epitopic region as PD-1. Cross-competition antibodies can be readily identified based on their ability to cross-compete with nivolumab in routine PD-1 binding assays such as Biacore analysis, ELISA assays or flow cytometry (see, for example, Patent Publication International No. WO 2013/173223).
[00127] Anti-PD-1 antibodies useful in the disclosed 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 disclosed here, in this application patent, for example, nivolumab (see, for example, US Patents No. 8,008,449 and 8,779,105; and WO 2013/173223, which are hereby incorporated into this patent application by reference) . In some embodiments, the anti-PD-1 antibody binds to the same epitope as any of the anti-PD-1 antibodies described
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46/84 here, in this patent application, for example, nivolumab. The ability of antibodies to perform cross-competition for binding to an antigen indicates that these monoclonal antibodies bind to the same epitopic region as the antigen and sterically prevent the binding of other cross-competition antibodies to that particular epitopic region. These cross-competition antibodies are expected to have functional properties very similar to those of the reference antibody, for example, nivolumab, due to their binding to the same epitopic region of PD-1. Cross-competition antibodies can be readily identified based on their ability to cross-compete with nivolumab in routine PD-1 binding assays such as Biacore analysis, ELISA assays or flow cytometry (see, for example, WO 2013 / 173223).
[00128] In certain modalities, antibodies or antigen-binding fragments thereof that cross-compete for binding to human PD-1 with, or that bind to the same epitopic region as human PD-1, nivolumab are mAbs. For administration to human patients, these cross-competition antibodies can be chimeric antibodies, or humanized or human antibodies. The chimeric, humanized or human mAbs referred to can be prepared and isolated by methods known in the art.
[00129] Anti-PD-1 antibodies useful for the compositions of the disclosed invention also include antigen-binding portions of the above antibodies. It has been widely demonstrated that the antigen-binding function of an antibody can be performed by fragments of a full-length antibody. Examples of binding fragments encompassed within the term antigen binding portion of an antibody include (i) a Fab fragment, a
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47/84 monovalent fragment consisting of the VL, VH, CL and CH1 domains; (ii) an F (ab ') 2 fragment, a divalent fragment comprising two Fab fragments linked by a disulfide bridge in the hinge region; (iii) an Fd fragment consisting of the VH and CH1 domains; and (iv) an Fv fragment consisting of the VL and VH domains of a single arm of an antibody.
[00130] Anti-PD-1 antibodies suitable for use in the disclosed 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 immunosuppressive effect of the pathway PD-1 signaling system. In certain embodiments, the anti-PD-1 antibody or antigen-binding portion of the same performs cross-competition with nivolumab for binding to human PD-1. In other embodiments, the anti-PD-1 antibody or antigen-binding portion thereof is a chimeric, humanized or human monoclonal antibody or a portion thereof. In certain embodiments, the antibody is a humanized antibody. In other embodiments, the antibody is a human antibody. Antibodies of an isotype of IgG1, IgG2, IgG3 or IgG4 can be used.
[00131] In certain embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises a heavy chain constant region which is an isotype of human IgG1 or IgG4. In some other embodiments, the sequence of the lgG4 heavy chain constant region of the anti-PD-1 antibody or antigen-binding fragment thereof contains an S228P mutation, which replaces a serine residue in the hinge region with the proline normally found in the corresponding position in antibodies of the lgG1 isotype. This mutation, which is present in nivolumab, prevents the Fab branch exchange with endogenous lgG4 antibodies, while retaining the low
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48/84 affinity for activation of Fc receptors associated with wild-type IgG4 antibodies (Wang et al., 2014). In yet other embodiments, the antibody comprises a light chain constant region which is a human cap or lamina constant region. In other embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof is a mAb or antigen-binding portion thereof. In certain embodiments of any of the therapeutic methods described herein, in this patent application, comprising administering an anti-PD-1 antibody, the anti-PD-1 antibody is nivolumab. In other embodiments, the anti-PD-1 antibody is pembrolizumab. In other embodiments, the antiPD-1 antibody is chosen from the human antibodies 17D8, 2D3, 4H1,4A11, 7D3 and 5F4 described in U.S. Patent No. 8,008,449. In still other embodiments, the anti-PD-1 antibody is MEDI0608 (formerly AMP514), AMP-224, or Pidilizumab (CT-011).
[00132] In embodiments, the anti-PD-1 antibody is a bispecific antibody. In embodiments, the anti-PD-1 antibody is a bispecific antibody that binds to both PD-1 and LAG-3.
Ilc. Anti-PD-L1 Antibodies [00133] Human anti-PD-L1 antibodies (or VH and / or VL domains derived therefrom) suitable for use in the invention can be generated using methods known in the art. Examples of anti-PD-L1 antibodies useful in the methods of the present invention include the antibodies disclosed in US Patent No. 9,580,507, incorporated herein, to this patent application, by reference. The anti-human PDL1 monoclonal antibodies disclosed in US Patent No. 9,580,507 have been shown to have one or more of the following characteristics: (a) they bind to human PD-L1 with a KD of 1 x 10 ' ⁷ M or less, as determined by superficial plasmon resonance using a biosensor system
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Biacore; (b) increase the proliferation of T cells in a mixed lymphocyte reaction experiment (MLR, Mixed Lymphocyte Reaction); (c) increase the production of interferon-γ in an MLR assay; (d) increase IL-2 secretion in an MLR assay; (e) stimulate antibody reactions; and (f) reverse the effect of regulatory T cells on T cell effector cells and / or dendritic cells. Anti-PD-L1 antibodies useful in the present invention include monoclonal antibodies that specifically bind to human PD-L1 and exhibit at least one, in some embodiments, at least five, of the preceding characteristics.
[00134] Some recognized anti-PD-L1 antibodies can be used. For example, anti-human PD-L1 antibodies disclosed in U.S. Patent No. 7,943,743, the content of which is hereby incorporated by reference, can be used. Anti-PD-L1 antibodies referred to include 3G10, 12A4 (also referred to as BMS-936559), 10A5, 5F8, 10H10, 1B12, 7H1, 11E6, 12B7, and 13G4. Other anti-PD-L1 antibodies recognized in the art which can be used include those described, for example, in U.S. Patent Nos. 7,635,757 and 8,217,149, in U.S. Patent Publication No. 2009/0317368, and in International Patent Publication PCT Nos. WO 2011/066389 and WO 2012/145493, whose teachings are also hereby incorporated by reference. Other examples of an anti-PD-L1 antibody include atezolizumab (TECENTRIQ; RG7446), or durvalumab (IMFINZI; MEDI4736) or avelumab (Bavencio). Antibodies or antigen-binding fragments thereof that compete with any of these antibodies or inhibitors for binding to PD-L1 recognized in the art can also be used.
[00135] In certain embodiments, the anti-PD-L1 antibody is BMS-936559 (formerly 12A4 or MDX-1105) (see, for example, U.S. Patent No. 7,943,743; WO 2013/173223). In others
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50/84 modalities, the anti-PD-L1 antibody is MPDL3280A (also known as RG7446 and atezolizumab) (see, for example, Herbst et al. 2013 J Clin Oncol 31 (suppl): 3000; US Patent No. 8,217,149), MEDI4736 (Khleif, 2013, In: Proceedings from the European Cancer Congress 2013; September 27-October 1, 2013; Amsterdam, Netherlands. Abstract 802), or MSB0010718C (also called Avelumab; see US 2014/0341917). In certain embodiments, antibodies that cross-compete for binding to human PD-L1 with, or bind to, the same epitopic region of human PD-L1 as the antibodies to PD-L1 in the above references are mAbs. For administration to human patients, these cross-competition antibodies can be chimeric antibodies, or they can be humanized or human antibodies. The chimeric, humanized or human mAbs referred to can be prepared and isolated by methods known in the art. In certain embodiments, the anti-PD-L1 antibody is selected from the group consisting of BMS936559 (also known as 12A4, MDX-1105; see, for example, US Patent No. 7,943,743 and WO 2013/173223), atezolizumab (Roche; also known as TECENTRIQ®; MPDL3280A, RG7446; see US Patent No. 8,217,149; see also Herbst et al. (2013) J Clin Oncol 31 (suppl): 3000), durvalumab (AstraZeneca; also known as IMFINZI ™, MEDI-4736; see WO 2011/066389), avelumab (Pfizer; also known as BAVENCIO®, MSB-0010718C; see WO 2013/079174), STI-1014 (Sorrento; see WO2013 / 181634), CX -072 (Cytomx; see
WO2016 / 149201), KN035 (3D Med / Alphamab; see Zhang et al., Cell Discov. 7: 3 (March 2017), LY3300054 (Eli Lilly Co .; see, for example, WO 2017/034916), and CK- 301 (Checkpoint Therapeutics; see Gorelik et al., AACR: Abstract 4606 (Apr 2016)).
[00136] In certain embodiments, the antibody against PD-L1 is
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51/84 atezolizumab (TECENTRIQ®). Atezolizumab is a fully humanized anti-PD-L1 monoclonal antibody to IgG1.
[00137] In certain embodiments, the antibody against PD-L1 is durvalumab (IMFINZI ™). Durvalumab is a monoclonal antiPD-Ll human IgG1 kappa antibody.
[00138] In certain embodiments, the antibody against PD-L1 is avelumab (BAVENCIO®). Avelumab is a human IgG anti-PDD-Ll monoclonal antibody.
[00139] In other embodiments, the monoclonal anti-PD-L1 antibody is selected from the group consisting of 28-8, 28-1, 28-12, 29-8, 5H1, and any combination thereof.
[00140] Anti-PD-L1 antibodies useful in the disclosed 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 disclosed here, in this application of patent, for example, atezolizumab, durvalumab, and / or avelumab. In some embodiments, the anti-PD-L1 antibody binds the same epitope as any of the anti-PD-L1 antibodies described herein, in this patent application, 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 epitopic region as the antigen and sterically prevent the binding of other cross-competition antibodies to that particular epitopic 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 epitopic region as PD-L1. Cross-competition antibodies can be readily identified based on their ability to cross-compete with the
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52/84 atezolizumab and / or avelumab in routine PD-L1 binding assays such as Biacore analysis, ELISA assays or flow cytometry (see, for example, WO 2013/173223).
[00141] In certain embodiments, antibodies that cross-compete for binding to human PD-L1 with, or bind to the same epitopic region as the antibody to human PD-L1 that, atezolizumab, durvalumab, and / or avelumab, are monoclonal antibodies. For administration to human patients, these cross-competition antibodies are chimeric antibodies, antibodies produced by genetic engineering, or humanized or human antibodies. Said chimeride antibodies, produced by genetic engineering, humanized or monoclonal humans can be prepared and isolated by methods of general knowledge in the art.
[00142] Anti-PD-L1 antibodies useful in the methods of the disclosed invention also include antigen-binding portions of the above antibodies. It has been widely demonstrated that the antigen-binding function of an antibody can be performed by fragments of a full-length antibody.
[00143] Anti-PD-L1 antibodies suitable for use in the disclosed 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 PD signaling pathway -1 signaling pathway. In any of the compositions or methods disclosed herein, in this patent application, an anti-PD-L1 antibody includes an antigen-binding portion or fragment that binds to PD-L1 and has functional properties similar to those of whole antibodies in inhibition receptor binding and positive regulation of the immune system. In certain embodiments, the anti-PD-L1 antibody or antigen-binding portion of the same performs competition
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53/84 crossed with atezolizumab, ο durvalumab, and / or avelumab for binding to human PD-L1.
Ild. Immunotherapeutic Agents [00144] Immunotherapeutic agent and immuno-oncological drugs as used in the present invention include any agent, compound, or biological that is capable of modulating the host's immune system. The immunotherapeutic agent can be an inhibitor of the immune control point, a reinforcer or stimulator of the immune control point. The immunotherapeutic agents described herein, in this patent application, can be used in combination with one or more additional immunotherapeutic agents (for example, anti-PD-1 antibody and anti-LAG-3 antibody).
[00145] In one embodiment, the immunotherapeutic agent is an inhibitor of the immunological control point. Non-limiting examples of similar immunotherapeutic agents include:
[00146] (i) a CTLA-4 (CD152) antagonist (e.g.,
YERVOY® (ipilimumab) (U.S. Patent No. 6,984,720); tremelimumab (formerly ticilimumab and CP-675,206); AGEN-1884; and ATOR-1015 (a bispecific anti-OX40 and anti-CTLA-4 antibody). Human monoclonal antibodies that specifically bind to CTLA-4 with high affinity have been disclosed 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, 6,051,227, 6,682,736, and 7,034,121 and in International Patent Publication Nos. WO 2012/122444, WO 2007/113648, WO 2016/196237, and WO 2000/037504.
[00147] (ii) TIM-3 antagonist (HAVCR2) (for example, TSR-022 and LY3321367);
[00148] (iii) TIGIT antagonist (T-cell immunoreceptor with Ig and ITIM domains) (for example, BMS-986207, OMP-313M32, COM902 (CGEN-15137), and AB154);
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54/84 [00149] (iv) an IDO1 antagonist (indoleamine-2,3-dioxigenase 1) (for example, indoximod (NLG8189, 1-methyl-D-TRP), epacadostat (INCB-024360), KHK2455, PF -06840003 (Publication of
PCT International Patent Application No. WO 2016/181348 A1), pyrrolididine-2,5-dione derivatives (PCT International Patent Application Publication No. WO 2015/173764 A1), navoximod (RG6078, GDC-0919, NLG919) , and BMS-986205 (F001287));
[00150] (v) KIR antagonist (immunoglobulin-like receptor of killer cells) (for example, lirilumab (I-7F9, BMS-980615, or IPH2101) and IPH4102 (an antiKIR3DL2 monoclonal antibody);
[00151] (vi) TDO (tryptophan 2,3-dioxigenase) antagonist (for example, 4- (indol-3-yl) -pyrazole derivatives (US Patent No. 9,126,984 B2 and US Patent Application Publication No. 2016/0263087 A1); substituted 3-indole derivatives (PCT International Patent Application Publication No. WO 2015140717 A1, WO 2017025868 A1, WO 2016147144 A1), 3- (indol3-yl) -pyridine derivatives (Publication US Patent Application No. 20150225367 A1 and PCT International Patent Application Publication No. WO 2015121812 A1);
[00152] (vii) double IDO / TDO antagonist (e.g., small molecule IDO / TDO inhibitors as disclosed in PCT International Patent Application Publication Nos. WO 2015150097 A1, WO 2015082499 A2, WO 2016026772 A1, WO 2016071283 A1, WO 2016071293 A2, and WO 2017007700 A1);
[00153] (viii) CD40 antagonist (for example, Lineage BMS3h56 (US Patent No. 9,475,879), lucatumumab (HCD122 and CHIR12.12), CHIR-5.9, and dacetuzumab (huS2C6, PRO 64553, RG 3636, SGN 14, SGN-40));
[00154] (ix) A2a adenosine receptor antagonist (A2aR) (for example
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55/84 example, CPI-444, PBF-509, istradefiline (KW-6002), preladenant (SCH420814), tozadenant (SYN115), vipadenant (BIIB014), HTL-1071, ST1535, SCH412348, SCH442416, SCH58261, AZD4635 (a small molecule A2aR inhibitor));
[00155] (x) VISTA antagonist (T cell activation suppressor containing V domain immunoglobulin (Ig)) (e.g., CA-170 (anti-PD-L1 / L2 and small anti-VISTA molecule) and JNJ61610588) ;
[00156] (xi) CEACAM1 (CD66a) antagonist (e.g., CM24 (MK-6018));
[00157] (xii) CEA antagonist (carcinoembryonic antigen) (for example, amunaleucine cergutuzumab (RG7813, RO-6895882), RG7802 (RO6958688));
[00158] (xiii) CD47 antagonist (e.g., HuF9-G4, CC90002, TTI-621, ALX148, NI-1701, NI-1801, SRF231, and Effi-DEM);
[00159] (xiv) PVRIG antagonist (poliovirus receptor-related immunoglobulin-containing domain, CD122R) (e.g., COM701);
[00160] (xv) GARP antagonist (predominant glycoprotein A repeats) (for example, ARGX-115);
[00161] (xvi) a STING agonist (IFN gene stimulator) (e.g., 2 ', 5' - 3 ', 5' substituted 2'3'di-fluoro or 2 'mixed-link cyclic or substituted 3'-mono-fluoro (PCT International Patent Application Publication No. WO 2017/075477 A1); bis-3 ', cyclic 5', substituted 2'-fluoro and 2 ', 2 ”dinucleotides - diF-Rp, Rp, bis-3 ', 5' cyclic (International PCT Patent Application Publication No. WO 2016/145102 A1); and fluorinated cyclic di-nucleotides (PCT International Patent Application Publication No. WO 2016 / 096174 A1);
[00162] (xvii) CD20 agonist (for example, RITUXAN® and ABP
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56/84
798);
[00163] (xviii) CD80 antagonist (e.g., galiximab (IDEC114) and AV 1142742 (RhuDex);
[00164] (xix) CD86 antagonist; and [00165] (xx) CD96 antagonist.
[00166] In another modality, the immunotherapeutic agent is a stimulator or reinforcer of the immunological control point. Non-limiting examples of similar immunotherapeutic agents include: (i) a CD28 agonist (for example, TGN1412 (an anti-CD28 antibody) and JCAR015 (an anti-CD19-CD28-zeta modified chimeric antigen receptor));
[00168] (ii) a CD80 or CD86 agonist (e.g., CTLA4-lg fusion construct (CTLA-4-lgG4m, RG2077, or RG1046); ORENCIA® (abatacept or BMS-188667); and MGN1601;
[00169] (iii) ICOS or ICOS ligand agonist (for example, BMS986226, MEDI-570, GSK3359609, JTX-2011, and AMG 570);
[00170] (iv) 4-1 BB agonist (CD137) (for example, urelumab and PF-05082566);
[00171] (v) 0X40 agonist (CD134 or TNFRS4) (e.g., tavolixizumab (MEDI-0562); pogalizumab (MOXR0916, RG7888); GSK3174998; ACTOR-1015 (a bispecific anti-OX40 and anti-CTLA-4 antibody ); MEDI-6383; MEDI-6469; BMS 986178; PF-04518600; and GINAKIT cells (T lymphocytes expressing IC9-GD2-CD28-OX40));
[00172] (vi) CD27 agonist (e.g., varilumab (CDX1127));
[00173] (vii) CD40 agonist (e.g., ADC-1013 (JNJ64457107), RG7876 (RO-7009789), HuCD40-M2; APX005M (EPI0050) (US Patent No. 9,556,278); Chi Lob 7/4 (monoclonal antibody to CD40 chimeric IgG 1 agonist));
[00174] (viii) CD70 agonist (for example, ARGX-110); and
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57/84 [00175] (ix) GITR agonist (e.g., BMS-986156, TRX518, GWN323, INCAGN01876, and MEDI1873).
[00176] In one embodiment, the immunotherapeutic agent is a cytokine, such as a chemokine, an interferon (eg, gamma interferon), an interleukin (eg, aldesleukin (recombinant IL-2 analog with immunoregulatory and antineoplastic activities), tocilizumab (anti-IL-6 receptor antibody); a lymphokine, or a member of the tumor necrosis factor (TNF) family (for example, ATOR-1016, ABBV-621, and adalimumab). Examples of other immunotherapeutic agents include: CSF1R antagonist (colony stimulating factor 1 receptor, CD115) (for example, emactuzumab); Toll-like 9 receptor agonist (TLR9) (for example, sodium agatolimod); CD160 (NK1) agonist (for example, BY55); CD73 antagonist (5'-nucleotidase or ecto-5'nucleotidase) (for example, MEDI9447); iNOS antagonist (NO inducible synthase, NOS2) (for example, N-Acetyl cysteine (NAC), aminoguanidine, L-nitroarginine methyl ester, S, S-1,4-phenylenob / s (1,2-ethanediil) b / s-isothiourea); and SHP-1 antagonist (protein tyrosine phosphatase 1 containing the homology domain 2 Src) (see Watson etal., Biochem Soc Trans 44 (2): 356-362 (2016)).
III. Pharmaceutical Compositions [00177] Pharmaceutical compositions suitable for administration to human patients are typically formulated for parenteral administration, for example, in a liquid carrier, or suitable for reconstitution in liquid solution or suspension for intravenous administration.
[00178] In general, said compositions typically comprise a pharmaceutically acceptable carrier. As used here, in this patent application, the term pharmaceutically acceptable means approved by an agency
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58/84 government regulatory or listed in the United States Pharmacopoeia or other pharmacopoeia generally recognized for use in animals, particularly in humans. The term vehicle refers to a diluent, adjuvant, excipient, or vehicle with which the compound is administered. Pharmaceutical carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil, glycerol polyethylene glycol ricinoleate , and the like. Water or aqueous saline solution and aqueous dextrose and glycerol solutions can be employed as carriers, particularly for injectable solutions (for example, comprising an anti-PD-1 antibody, an anti-LAG-3 antibody, and / or another immunotherapeutic agent) . Liquid compositions for parenteral administration can be formulated for administration by injection or continuous infusion. Routes of administration by injection or infusion include intravenous, intraperitoneal, intramuscular, intrathecal and subcutaneous. In one embodiment, the composition comprising an anti-PD-1 antibody, an anti-LAG-3 antibody, and an immunotherapeutic agent are administered intravenously (for example, in separate formulations or together (in the same formulation or in separate formulations) ).
IV. Patient Populations [00179] Clinical methods for treating solid tumor cancer (e.g., advanced refractory solid tumors) in human patients using a combination of an anti-LAG-3 antibody, a inhibitor of the PD-1 pathway, and an additional immunotherapeutic agent.
[00180] Examples of cancers that can be treated using the methods of the invention include liver cancer, bone cancer, pancreatic cancer, skin cancer, head or neck cancer, cancer
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Oral 59/84, breast cancer, lung cancer - including small cell and non-small cell lung cancer, cutaneous or intraocular malignant melanoma, kidney cancer, uterine cancer, ovarian cancer, colorectal cancer, colon cancer, cancer rectal, anal cancer, stomach cancer, testicular cancer, uterine cancer, fallopian tube carcinoma, endometrial carcinoma, cervical carcinoma, vagina carcinoma, vulva carcinoma, non-Hodgkin's lymphoma, esophageal cancer, bowel cancer thin, cancer of the endocrine system, cancer of the thyroid gland, cancer of the parathyroid gland, cancer of the adrenal gland, soft tissue sarcoma, cancer of the urethra, penis cancer, solid childhood tumors, lymphocytic lymphoma, bladder cancer, kidney cancer or ureter, renal pelvis carcinoma, neoplasm of the central nervous system (CNS), primary lymphoma of the central nervous system, tumor angiogenesis, spinal axis tumor, brain stem glioma, adenoma d and pituitary, Kaposi's sarcoma, epidermoid cancer, squamous cell cancer, environmentally induced cancers including asbestos-induced cancers, hematological malignancies including, for example, multiple myeloma, B cell lymphoma, Hodgkin's lymphoma / primary mediastinal B-cell lymphoma, non-Hodgkin's lymphomas, acute myeloid lymphoma, chronic myeloid leukemia, chronic lymphoid leukemia, follicular lymphoma, diffuse large B-cell lymphoma, Burkitt's lymphoma, large-cell immunoblastic lymphoma, precursor B-cell lymphoma, moant cell lymphoma, leukemia acute lymphoblastic, fungal mycosis, anaplastic large cell lymphoma, T cell lymphoma, and precursor T cell lymphoblastic lymphoma, and any combinations of said cancers. The present invention is also applicable to the treatment of metastatic cancers.
[00181] In one embodiment, the human patient suffers from cancer
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60/84 non-small cell lung (NSCLC) or a virus-related cancer (for example, a tumor related to human papilloma virus (HPV)) or gastric adenocarcinoma. In a particular embodiment, the HPV-related tumor is HPV + head and neck cancer (HNC). In another particular embodiment, gastric adenocarcinoma is associated with infection by the EpsteinBarr virus (EBV).
[00182] Patients can be tested or selected for one or more of the clinical attributes described above before, during or after treatment.
V. Combination Therapy [00183] The combination therapies provided herein, in this patent application, involve the administration of an anti-LAG-3 antibody, an inhibitor of the PD-1 pathway, and another immunotherapeutic agent that blocks an inhibitory immune receptor (for example, a receptor, which after binding to its natural ligand, inhibits / neutralizes activity, such as cytotoxic activity), to treat subjects having malignant tumors (for example, advanced refractory solid tumors).
[00184] In one embodiment, the invention provides an anti-LAG-3 antibody, an anti-PD-1 antibody, and another immunotherapeutic agent, in combination, according to a defined clinical dosing regimen, to treat subjects having a tumor malignant (for example, an advanced refractory solid tumor). In a particular embodiment, the anti-LAG-3 antibody is BMS-986016. In another embodiment, the anti-PD1 antibody is BMS-936558. In another embodiment, dosage regimens are adjusted to provide the optimal desired response (for example, an effective response).
[00185] As used herein, in this patent application, adjuvant or combined administration (co-administration) includes simultaneous administration of the compounds in the same form as
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61/84 dosage or in different dosage form, or separate administration of the compounds (for example, sequential administration). In this way, the anti-LAG-3 antibody, the inhibitor of the PD1 pathway, and the immunotherapeutic agent can be administered simultaneously in a single formulation. Alternatively, the anti-LAG-3 antibody, the inhibitor of the PD-1 pathway, and the immunotherapeutic agent can be formulated for separate administration and are administered concomitantly or sequentially (for example, an antibody is administered within about 30 minutes before administration of the second antibody), and in any order.
[00186] For example, the anti-PD-1 antibody can be administered first, followed (for example, followed immediately) by administration of the anti-LAG-3 antibody and / or the immunotherapeutic agent. In one embodiment, the PD-1 pathway inhibitor is administered prior to administration of the anti-LAG-3 antibody and / or the immunotherapeutic agent. In another embodiment, the PD-1 pathway inhibitor is administered after administration of the anti-LAG-3 antibody and / or the immunotherapeutic agent. In another embodiment, the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and the immunotherapeutic agent are administered concomitantly. Said concomitant or sequential administration preferably results in all three components being present simultaneously in the treated patients.
SAW. Treatment Protocols [00187] Suitable treatment protocols for treating a malignant tumor in a human patient include, for example, administering to the patient an effective amount of each of: [00188] (a) an anti-LAG antibody -3, such as one comprising the CDR1, CDR2 and CDR3 domains of the heavy chain variable region having the sequence set forth in SEQ ID NO: 3, and the CDR1, CDR2 and CDR3 domains of the light chain variable region having the
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62/84 sequence set forth in SEQ ID NO: 5, [00189] (b) an anti-PD-1 antibody, such as one comprising the CDR1, CDR2 and CDR3 domains of the heavy chain variable region having the sequence set forth in SEQ ID NO: 19, and the light chain variable region CDR1, CDR2 and CDR3 domains having the sequence stipulated in SEQ ID NO: 21, [00190] (c) an immunotherapeutic agent, [00191] where the method comprises at least one administration cycle, where the cycle is an eight-week period, where for each of at least one cycle, at least four doses of anti-LAG-3 antibody are administered at a fixed dose of about 1, 3, 10, 20, 50, 80, 100, 130, 150, 180, 200, 240 or 280 mg, at least four doses of anti-PD-1 antibody are administered in a fixed dose of about 50, 80, 100, 130 , 150, 180, 200, 240 or 280 mg, and at least four doses of the immunotherapeutic agent are administered in a fixed dose of about. In another embodiment, four doses of the anti-LAG-3 antibody are administered at a dose of 0.01.0.03, 0.25, 0.1.0.3, 1 or 3, 5, 8 or 10 mg / kg of body weight, four doses of anti-PD-1 antibody are administered in a dose of 0.1,0,3, 1,3, 5, 8 or 10 mg / kg of body weight, and four doses of the immunotherapeutic agent are administered in a fixed dose of about.
[00192] In one embodiment, the dose of the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and / or the immunotherapeutic agent is calculated by body weight, for example, mg / kg body weight. In another embodiment, the dose of the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and / or the immunotherapeutic agent is a fixed dose. In another embodiment, the dose of the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and / or the immunotherapeutic agent is varied over time. For example, the anti-LAG-3 antibody, the anti PD-1 antibody, and / or the agent
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63/84 immunotherapy can initially be administered in a high dose and can be reduced over time. In another embodiment, the anti-LAG-3 antibody, the inhibitor of the PD-1 pathway, and / or the immunotherapeutic agent is initially administered in a low dose and increased over time.
[00193] In another embodiment, the amount of the anti-LAG3 antibody, the PD-1 pathway inhibitor, and / or the immunotherapeutic agent administered is constant for each dose. In another embodiment, the amount of antibody and / or immunotherapeutic agent administered varies with each dose. For example, the maintenance (or subsequent) dose of the antibody and / or immunotherapeutic agent may be higher or the same as the loading dose which is administered first. In another embodiment, the maintenance dose of the antibody and / or immunotherapeutic agent may be less than or the same as the loading dose.
[00194] In another embodiment, the anti-LAG-3 antibody, the inhibitor of the PD-1 pathway, and / or the immunotherapeutic agent are formulated for intravenous administration. In one embodiment, the anti-PD-1 antibody is administered on Days 1, 15, 29, and 43 of each cycle. In another embodiment, the anti-LAG-3 antibody is administered on Days 1.15, 29, and 43 of each cycle. In some modality, the therapeutic agent is administered on Days 1, 15, 29, and 43 of each cycle.
[00195] In other embodiments, the anti-LAG-3 antibody, the inhibitor of the PD-1 pathway, and / or the immunotherapeutic agent are administered once a week, once every two or three weeks, once a month or as long as a clinical benefit is observed or until there is a complete response, confirmed progressive disease or uncontrollable toxicity.
[00196] In another modality, an administration cycle is eight weeks, which can be repeated, if necessary. In another modality, treatment consists of up to 12 cycles.
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64/84 [00197] In another embodiment, 4 doses of the PD-1 pathway inhibitor are administered per eight-week cycle. In another embodiment, 4 doses of the PD-1 pathway inhibitor are administered per eight-week cycle. In some embodiment, 4 doses of the therapeutic agent are administered per eight-week cycle.
[00198] In another embodiment, the inhibitor of the PD-1 pathway, the anti-LAG-3 antibody, and / or the immunotherapeutic agent are administered as a first line of treatment (for example, the initial treatment or first treatment). In another embodiment, the inhibitor of the PD-1 pathway, the anti-LAG-3 antibody, and / or the immunotherapeutic agent are administered as a second line of treatment (for example, after the initial treatment or the first treatment, including after relapse and / or where the first treatment has failed).
[00199] In another aspect, the invention features any of the aforementioned modalities, wherein the anti-PD-1 antibody is replaced by, or combined with, an anti-PD-L1 or antiPD-L2 antibody.
VII. Results [00200] Patients treated according to the methods disclosed here, in this patent application, preferentially experimentally improves at least one sign of cancer. In one embodiment, improvement is measured by a reduction in the number and / or size of measurable tumor lesions. In another modality, the lesions can be measured on chest X-rays or computed tomography or magnetic resonance imaging films. In another modality, cytology or histology can be used to assess responsiveness to a therapy.
[00201] In one mode, the treated patient presents a complete response (CR), a partial response (PR), stable disease (SD), immuno-related complete disease (irCR), partial response
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65/84 immune-related (irPR), or stable immune-related disease (irSD). In another embodiment, the treated patient experiences shrinkage of the tumor and / or decrease in the growth rate, that is, suppression of tumor growth. In another embodiment, unwanted cell proliferation is reduced or inhibited. In yet another embodiment, one or more of the following may occur: the number of cancer cells may be reduced; the size of the tumor can be reduced; infiltration of cancer cells into peripheral organs can be inhibited, delayed, slowed, 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.
[00202] In other embodiments, the administration of effective amounts of the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and the immunotherapeutic agent according to any of the methods provided here, in this patent application, produces at least a therapeutic effect selected from the group consisting of reducing the size of a tumor, reducing the number of metastatic lesions that appear over time, complete remission, partial remission, or stable disease. In still other modalities, the treatment methods produce a comparable clinical benefit rate (CBR = CR + PR + SD> 6 months) better than that obtained by an anti-LAG-3 antibody, an inhibitor of the PD-1 pathway, or an isolated immunotherapeutic agent. In other modalities, the improvement in the clinical benefit rate is about 20% 20%, 30%, 40%, 50%, 60%, 70%, 80% or more compared to an anti-LAG-3 antibody, a inhibitor of the PD-1 pathway, or an isolated immunotherapeutic agent.
VIII. Dosage Unit Forms and Kits [00203] are also provided here, in this application requirement
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66/84 patent, kits which include a pharmaceutical composition comprising an anti-LAG-3 antibody (for example, BMS-986016), an inhibitor of the PD-1 pathway (for example, BMS-936558), an immunotherapeutic agent, and a pharmaceutically acceptable carrier, in a therapeutically effective amount adapted for use in the foregoing methods. Kits can optionally also include instructions, for example, comprising administration schedules, to allow a practitioner (for example, a doctor, nurse, or patient) to administer the composition contained therein to administer the composition to a patient having cancer (for example, example, a solid tumor). The kit can also include a syringe.
[00204] Optionally, the kits include multiple packages of single-dose pharmaceutical compositions, each containing an effective amount of the anti-LAG-3 antibody, the PD-1 pathway inhibitor, and / or the immunotherapeutic agent for a single administration of according to the methods provided above. Instruments or devices necessary for the administration of one or more pharmaceutical compositions can also be included in the kits. For example, a kit can provide one or more pre-filled syringes containing an effective amount of the anti-LAG-3 antibody, the anti-PD-1 antibody, and / or the immunotherapeutic agent.
[00205] In one embodiment, the present invention provides a kit for treating a malignant tumor in a human patient, the kit comprising, for example:
[00206] (a) a dose of an anti-LAG-3 antibody, such as one comprising the heavy chain variable region CDR1, CDR2 and CDR3 domains having the sequence stipulated in SEQ ID NO: 3, and the CDR1 domains, CDR2 and CDR3 of the light chain variable region having the sequence stipulated in SEQ ID NO: 5;
[00207] (b) a dose of inhibitor of the PD-1 pathway, such as an antibody
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67/84 antibody comprising the CDR1, CDR2 and CDR3 domains of the heavy chain variable region having the sequence stipulated in SEQ ID NO: 19, and the CDR1, CDR2 and CDR3 domains of the light chain variable region having the sequence stipulated in SEQ ID NO: 21;
[00208] (c) a dose of an immunotherapeutic agent; and [00209] (d) instructions for using the anti-LAG-3 antibody, the anti-PD-1 inhibitor, and the immunotherapeutic agent in the methods described herein, in this patent application.
[00210] The following examples are illustrative only and should not be considered as limiting the scope of this invention in any way, since many variations and equivalents will become apparent to those skilled in the art after reading the present invention.
EXAMPLES
EXAMPLE 1
Treatment of Malignant Tumor with Monotherapy with Nivolumab v. Nivolumab + BMS 986016 (anti-LAG-3 antibody) + Immunotherapy Agent [00211] In order to determine whether there is an improvement in overall survival (OS) compared to monotherapy with nivolumab, a pharmaceutical composition comprising a combination of nivolumab, BMS 986016 , and an immunotherapeutic agent is tested in patients with recurrent metastatic tumors. A formal paired comparison of overall survival between the experimental arms is conducted (i.e., nivolumab monotherapy v. Nivolumab combination therapy + BMS 986016 + immunotherapeutic agent).
[00212] The study also compares progression-free survival (PFS) and objective response rate (ORR), based on the assessment by the Blinded Independent Central Review (BICR, N.T .: Central Review
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Blind Independent) of the combination of nivolumab, BMS 986016, and an immunotherapeutic agent (combined therapy) with nivolumab monotherapy in subjects with recurrent metastatic tumor. Differences in PFS and ORR between the different arms are evaluated. [00213] Other objectives of the study include: 1) assessment of the general safety and tolerability of combination therapy compared with monotherapy with nivolumab; 2) characterizing the pharmacokinetics of combination therapy and exploring the relationship between exposure-safety and exposure-efficacy; 3) characterization of the immunogenicity of the combination therapy; 4) characterization of immune correlates of combination therapy; 5) evaluation of tumoral and peripheral predictive biomarkers of the clinical response to combination therapy; and 6) assessment of general health status using the EQ-5D index and visual analog scale in subjects treated with combination therapy.
Methods
Study Design [00214] The study is a randomized, open, 2-arm study in male and female adult subjects (aged 18 years and over) with non-small cell lung cancer (NSCLC) stage IV or recurrent, positive or negative PD-L1, not previously treated for advanced disease. [00215] The key inclusion criteria include: 1) ECOG Performance Status of more than or equal to 1; 2) Patients with histologically confirmed or recurrent Stage IV non-small cell lung cancer (according to the 7th International Association for the Study of Lung Cancer classification of squamous or non-squamous histology), without previous systemic anticancer therapy (including EGFR and ALK inhibitors) administered as primary therapy for advanced or metastatic disease; and 3) Illness
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69/84 measurable by CT or MRI according to the RECIST 1.1 criteria. [00216] Key exclusion criteria include: 1) Subjects with known EGFR mutations who are sensitive to therapy with available targeted inhibitors; 2) Subjects with known ALK translocations who are sensitive to therapy with the available targeted inhibitors; 3) Subjects with untreated central nervous system metastases; 4) Subjects with an active, known or suspected autoimmune disease (subjects with type I diabetes mellitus, hypothyroidism only needing hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions that do not expected to relapse in the absence of an external trigger are allowed for registration); and 5) Subjects with a condition requiring systemic treatment with either corticosteroids (> 10 mg daily of prednisone equivalent) or other immunosuppressive medications within 14 days of randomization (inhaled or topical steroids, and adrenal replacement steroid> 10 mg daily) equivalent of prednisone, are allowed in the absence of active autoimmune disease).
[00217] The subjects are randomized 1: 1: 1: 1, and stratified by histology (Squamous versus Non-squamous) and PD-L1 status. The status of PD-L1 is determined by immunohistochemical staining (IHC) of the PD-L1 protein in a tumor sample submitted prior to randomization. Subjects are identified as positive for PDL1 if more than or equal to 5% of tumor cell membrane staining is observed in a minimum of one hundred evaluable tumor cells, or PD-L1 negative if less than 5% staining is observed tumor cell membrane in a minimum of one hundred evaluable tumor cells.
[00218] The subjects receive open treatment from one of the two
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70/84 arms of the study. The dosing schedule is shown in Table 1. Table 1. Dosing schedule *
Week1 Week2 Week3 Week4 Week5 Week6 Braco A: Nivolumab 240 mg ^at q 2 weeks Day 1NivolumaBDay 1NivolumaBDay 1NivolumaBBraco B: Nivolumab 1 mg / kg + BMS 986016 1 mg / kg q 3 weeks x4 ^a + Immunotherapeutic agent 1 mg / kg Day 1Nivoluma b+BMS 986016+Immunotherapeutic agent Day 1Nivoluma b+BMS 986016+Immunotherapeutic agent
* Both nivolumab and BMS 986016 can be administered as infusions for 30 minutes ^and continue until disease progression, discontinuation due to unacceptable toxicity, withdrawal of consent, or study closure [00219] Tumor evaluation in the study starts at Week 6 after randomization (± 7 days) and is performed every 6 weeks (± 7 days) until Week 48. After Week 48, the tumor evaluation is performed every 12 weeks (± 7 days) until progression or until discontinuation of treatment, whichever occurs later. Subjects who are receiving nivolumab or combination therapy in addition to the progression defined by RECIST 1.1 assessed by the investigator must also continue tumor assessments until that treatment is discontinued. The registration will end after approximately 1200 subjects are randomized. The outcome
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The study's primary 71/84 is Overall Survival (OS). The duration of the study from the start of registration until the analysis of the primary OS outcome is expected to be approximately 48 months. Study Arms
Monotherapy with Nivolumab (Arm A) [00220] Nivolumab 240 mg is administered intravenously (IV) on day 1 of each cycle for 30 minutes every 2 weeks until disease progression, discontinuation due to unacceptable toxicity, withdrawal of consent or study closure. Treatment in addition to the progression defined by RECIST 1.1 assessed by the initial investigator is permitted if the subject has clinical benefit assessed by the investigator and is tolerant of treatment. After completing the dosing schedule, the subjects enter the Follow-up Phase.
Combination Therapy with Nivolumab + BMS 986016 + Immunotherapeutic Agent (Arm B) [00221] Nivolumab at 1 mg / kg is administered IV over 30 minutes combined with BMS 986016 at 1 mg / kg and immunotherapeutic agent administered IV over 30 minutes every 3 weeks for four cycles until disease progression, unacceptable toxicity, withdrawal of consent, or termination of the study. Treatment in addition to the progression defined by RECIST 1.1 assessed by the initial investigator is permitted if the subject has clinical benefit assessed by the investigator and is tolerant of treatment. After completing the dosing schedule, the subjects enter the Follow-up Phase.
Post-Treatment Monitoring [00222] Post-treatment monitoring starts when the decision is made to discontinue a subject from all treatment; this includes optional continuation maintenance therapy. The subjects
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72/84 who discontinue treatment for reasons other than disease progression will continue to have tumor assessments (if clinically viable) until progression or until the start of any subsequent therapy, whichever comes first. The subjects are followed for drug-related toxicities until these toxicities are resolved, until they return to baseline or until they are considered irreversible. All adverse events are documented for a minimum of 100 days after the last dose of study medication. After completing the first two follow-up visits, subjects are followed every 3 months for survival.
Sample Size [00223] Approximately 1200 subjects are randomized to the 4 treatment groups in a 1: 1: 1: 1 ratio. The final analysis is conducted after 257 events have occurred in the control group, and these events will be monitored by the unblinded independent statistician corroborating the DMC. Assuming a screening failure rate of 20%, it is estimated that approximately 1500 subjects will be registered in order to have 1200 randomized subjects, assuming a constant accumulation rate by parts (8 subjects / month during Months 1 to 2, 40 subjects / month during Months 3 to 4, 85 subjects / month during Months 5 to 6, 138 subjects / month during Months 7 to 8, 170 subjects / month after Month 8), it will take approximately 48 months to obtain the number of deaths required for the analysis of final overall survival (14 months for competence and 34 months for monitoring survival).
Outcome [00224] Overall survival (OS) is a primary outcome for this study. If the superiority of overall survival is demonstrated for at least one comparison, a gatekeeping test approach for key secondary outcomes will be applied to
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73/84 additional experimental vs. comparisons control as described in the statistical analysis plan. Key secondary outcomes include PFS and ORR based on BICR assessments.
[00225] Each of the three primary OS analyzes will be conducted using a two-sided log-rank test for histology and PD-L1 status in all randomized subjects using the Hochberg procedure to treat multiplicity. The corresponding risk rates (HR) and% of two-sided confidence intervals (Cl) (a adjusted to 1) will be estimated using a Cox proportional hazard model, with treatment groups as a single covariate, stratified by factors above. The overall survival curves (OS), medians of overall survival with 95% confidence intervals, and the general survival rates at 12 and 24 months with 95% confidence intervals will be estimated using the Kaplan-Meier methodology. If overall survival superiority is demonstrated for at least one comparison, a gatekeeping test approach for key secondary outcomes will be applied to additional experimental vs. comparisons. control as described in the statistical analysis plan. The key secondary outcomes will be tested in the following hierarchical order:
[00226] 1) Progression-free survival (PFS) analyzes (based on BICR assessments) will be conducted using a two-sided log-rank test stratified by histology and PD-L1 status in all subjects randomized to compare each of the three experimental treatments with the control group. The risk rates and% of confidence intervals (a adjusted to 1) on two corresponding sides will be estimated using a Cox proportional hazard model, with treatment group as a single covariate, stratified by the above factors. Progression-free survival curves, medians of progression-free survival with
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74/84 95% confidence intervals, and progression-free survival rates at 6 and 12 months with 95% confidence intervals will be estimated using the Kaplan-Meier methodology.
[00227] 2) Objective response rate (ORR) analyzes (based on BICR assessments) will be conducted using a two-sided Cochran-Mantel-Haenszel (CMH) test stratified by PD-L1 status and histology for compare each of the three treatments of the experiment with the control group. The proportions of associated probabilities and the% of confidence intervals (adjusted to 1) will also be calculated. In addition, the objective response rates (ORRs) and their 95% confidence intervals correspond to the exact correspondents will be calculated using the Clopper-Pearson method for each of the four treatment groups.
[00228] 3) A paired comparison of overall survival between experimental arms will be conducted using a two-sided logrank test stratified by histology and PD-L1 status. The risk rates and the% of two-sided confidence intervals (CI) corresponding to (adjusted to 1) will be estimated using a Cox proportional hazard model, with treatment group as a single covariate, stratified by the above factors.
Analyzes [00229] The analysis of PD-L1 expression will be descriptive. The distribution of PD-L1 expression will be examined based on the global population. Potential associations between the expression of PD-L1 and measures of effectiveness (ORR, OS and PFS) will be evaluated. If there is an indication of a significant association, an additional assessment will be conducted to explore PD-L1 expression as a predictive biomarker estimating the interaction effect between PD-L1 expression and treatment.
[00230] Results show whether combination therapy (nivolumab
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75/84 + BMS 986016 + immunotherapeutic agent) will improve overall survival (OS) compared to monotherapy with nivolumab.
SEQUENCES
SEQ ID NO: 1 Heavy Chain Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
QVQLQQWGAGLLKPSETLSLTCAVYGGSFSDYYWNWIRQPPGKGL EWIGEINHRGSTNSNPSLKSRVTLSLDTSKNQFSLKLRSVTAADTAVY YCAFGYSDYEYNWFDPWGQGTLVTVSSASTKGPSVFPLAPCSRSTS ESTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLS SVVTVPSSSLGTKTYTCNVDHKPSNTKVDKRVESKYGPPCPPCPAP EFLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSQEDPEVQFNWYV DGVEVHNAKTKPREEQFNSTYRVVSVLTVLHQDWLNGKEYKCKVSN KGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFY PSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQE GNVFSCSVMHEALHNHYTQKSLSLSLGK
SEQ ID NO: 2 Light Chain Amino Acid Sequence; AntiLAG-3 mAb (BMS-986016)
EIVLTQSPATLSLSPGERATLSCRASQSISSYLAWYQQKPGQAPRLLI YDASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQRSNWP LTFGQGTNLEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPRE AKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKH KVYACEVTHQGLSSPVTKSFNRGEC
SEQ ID NO: 3 Heavy Chain Variable Region (VH) Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
QVQLQQWGAGLLKPSETLSLTCAVYGGSFSDYYWNWIRQPPGKGL EWIGEINHRGSTNSNPSLKSRVTLSLDTSKNQFSLKLRSVTAADTAVY YCAFGYSDYEYNWFDPWGQGTLVTVSS
SEQ ID NO: 4 Heavy Chain Variable Region (VH) Nucleotide Sequence; Anti-LAG-3 mAb (BMS-986016) caggtgcagctacagcagtggggcgcaggactgttgaagccttcggagaccctgtccctcacct
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76/84 gcgctgtctatggtgggtccttcagtgattactactggaactggatccgccagcccccagggaagg g g g g ctg tg ATTG g g g g g aag tg aaatcaatcatcg caccaactccaacccg tccctcaag g tcgagtcaccctatcactagacacgtccaagaaccagttctccctgaagctgaggtctgtgaccgc cgcggacacggctgtgtattactgtgcgtttggatatagtgactacgagtacaactggttcgacccc tggggccagggaaccctggtcaccgtctcctca
SEQ ID NO: 5 Light Chain Variable Region (VL) Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
EIVLTQSPATLSLSPGERATLSCRASQSISSYLAWYQQKPGQAPRLLI YDASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQRSNWP LTFGQGTNLEIK
SEQ ID NO: 6 Light Chain Variable Region (VL) Nucleotide Sequence; mAb Anti-LAG-3 (BMS-986016) gaaattgtgttgacacagtctccagccaccctgtctttgtctccaggggaaagagccaccctctcct gcagggccagtcagagtattagcagctacttagcctggtaccaacagaaacctggccaggctcc caggctcctcatctatgatgcatccaacagggccactggcatcccagccaggttcagtggcagtg ggtctgggacagacttcactctcaccatcagcagcctagagcctgaag attttg cag cag cag tttattactg t g g tag caactg cctctcacttttg CCAG g g g g g g accaacctg atcaaa
SEQ ID NO: 7 Heavy Chain CDR1 Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
DYYWN
SEQ ID NO: 8 Heavy Chain CDR2 Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
EINHRGSTNSNPSLKS
SEQ ID NO: 9 Heavy Chain CDR3 Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
GYSDYEYNWFDP
SEQ ID NO: 10 Light Chain CDR1 Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
RASQSISSYLA
SEQ ID NO: 11 Light Chain CDR2 Amino Acid Sequence;
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77/84 Anti-LAG-3 mAb (BMS-986016)
DASNRAT
SEQ ID NO: 12 Light Chain CDR3 Amino Acid Sequence; Anti-LAG-3 mAb (BMS-986016)
QQRSNWPLT
SEQ ID NO: 13 Human LAG-3 Amino Acid Sequence
MWEAQFLGLLFLQPLWVAPVKPLQPGAEVPVVWAQEGAPAQLPCS PTIPLQDLSLLRRAGVTWQHQPDSGPPAAAPGHPLAPGPHPAAPSS WGPRPRRYTVLSVGPGGLRSGRLPLQPRVQLDERGRQRGDFSLWL RPARRADAGEYRAAVHLRDRALSCRLRLRLGQASMTASPPGSLRAS DWVILNCSFSRPDRPASVHWFRNRGQGRVPVRESPHHHLAESFLFL PQVSPMDSGPWGCILTYRDGFNVSIMYNLTVLGLEPPTPLTVYAGAG SRVGLPCRLPAGVGTRSFLTAKWTPPGGGPDLLVTGDNGDFTLRLE DVSQAQAGTYTCHIHLQEQQLNATVTLAIITVTPKSFGSPGSLGKLLC EVTPVSGQERFVWSSLDTPSQRSFSGPWLEAQEAQLLSQPWQCQL YQGERLLGAAVYFTELSSPGAQRSGRAPGALPAGHLLLFLTLGVLSL LLLVTGAFGFHLWRRQWRPRRFSALEQGIHPPQAQSKIEELEQEPEP EPEPEPEPEPEPEPEQL
SEQ ID NO: 14 LAG-3 epitope
PGHPLAPG
SEQ ID NO: 15 LAG-3 epitope
HPAAPSSW
SEQ ID NO: 16 LAG-3 epitope
PAAPSSWG
SEQ ID NO: 17 Heavy Chain Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
QVQLVESGGGVVQPGRSLRLDCKASGITFSNSGMHWVRQAPGKGL EWVAVIWYDGSKRYYADSVKGRFTISRDNSKNTLFLQMNSLRAEDTA VYYCATNDDYWGQGTLVTVSSASTKGPSVFPLAPSSVSFPS
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SSSLGTKTYTCNVDHKPSNTKVDKRVESKYGPPCPPCPAPEFLGGP SVFLFPPKPKDTLMISRTPEVTCVVVDVSQEDPEVQFNWYVDGVEVH NAKTKPREEQFNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKGLPSSI EKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPSDIAV EWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFS CSVMHEALHNHYTQKSLSLSLGK
SEQ ID NO: 18 Light Chain Amino Acid Sequence; AntiPD-1 mAb (BMS936558)
EIVLTQSPATLSLSPGERATLSCRASQSVSSYLAWYQQKPGQAPRLLI YDASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQSSNWP RTFGQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPRE AKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLLSKADYEKHK VYACEVTHQGLSSPVTKSFNRGEC
SEQ ID NO: 19 Heavy Chain Variable Region (VH) Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
QVQLVESGGGVVQPGRSLRLDCKASGITFSNSGMHWVRQAPGKGL EWVAVIWYDGSKRYYADSVKGRFTISRDNSKNTLFLQMNSLRAEDTA VYYCATNDDYWGQGTLVTVSS
SEQ ID NO: 20 Heavy Chain Variable Region (VH) Nucleotide Sequence; mAb Anti-PD-1 (BMS936558) caggtgcagctggtggagtctgggggaggcgtggtccagcctgggaggtccctgagactcgact gtaaagcgtctggaatcaccttcagtaactctggcatgcactgggtccgccaggctccaggcaag gggctggagtgggtggcagttatttggtatgatggaagtaaaagatactatgcagactccgtgaag attcaccatctccag g g g ccg ctg acaattccaag aacacg tttctg caaatg aacag CCTG g agccgaggacacggctgtgtattactgtgcgacaaacgacgactactggggccagggaaccct ggtcaccgtctcctca
SEQ ID NO: 21 Light Chain Variable Region (VL) Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
EIVLTQSPATLSLSPGERATLSCRASQSVSSYLAWYQQKPGQAPRLLI YDASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQSSNWP
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79/84
RTFGQGTKVEIK
SEQ ID NO: 22 Sequence of Light Chain Variable Region (VL) Nucleotides; mAb Anti-PD-1 (BMS936558) gaaattgtgttgacacagtctccagccaccctgtctttgtctccaggggaaagagccaccctctcct gcagggccagtcagagtgttagtagttacttagcctggtaccaacagaaacctggccaggctccc aggctcctcatctatgatgcatccaacagggccactggcatcccagccaggttcagtggcagtgg tctg g g g g cctag acag acttcactctcaccatcag cag cag attttg CCTG aag tc tttattactg agcagagtagcaactggcctcggacgttcggccaagggaccaaggtggaaatcaaa
SEQ ID NO: 23 Heavy Chain CDR1 Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
NSGMH
SEQ ID NO: 24 Chain CDR2 Amino Acid Sequence
Heavy; Anti-PD-1 mAb (BMS936558)
VIWYDGSKRYYADSVKG
SEQ ID NO: 25 Chain CDR3 Amino Acid Sequence
Heavy; Anti-PD-1 mAb (BMS936558)
NDDY
SEQ ID NO: 26 Light Chain CDR1 Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
RASQSVSSYLA
SEQ ID NO: 27 Light Chain CDR2 Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
DASNRAT
SEQ ID NO: 28 Light Chain CDR3 Amino Acid Sequence; Anti-PD-1 mAb (BMS936558)
QQSSNWPRT
SEQ ID NO: 29 Sequence of PD-1 Homo sapiens Full agtttcccttccgctcacctccgcctgagcagtggagaaggcggcactctggtggggctgctccag gcatgcagatcccacaggcgccctggccagtcgtctgggcggtgctacaactgggctggcggcc atg g g g g ttcttag actccccag acag ccctg g ctcg t aacccccccaccttcttcccag ccctg
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80/84 ggtgaccgaaggggacaacgccaccttcacctgcagcttctccaacacatcggagagcttcgtg ctaaactggtaccgcatgagccccagcaaccagacggacaagctggccgccttccccgagga ccgcagccagcccggccaggactgccgcttccgtgtcacacaactgcccaacgggcgtgacttc cacatgagcgtggtcagggcccggcgcaatgacagcggcacctacctctgtggggccatctccc cccccaag tg g g g g g cag atcaaag CCTG cag gg g gg g ctcag tg acag aa ag ag gggcagaagtgcccacagcccaccccagcccctcacccaggccagccggccagttccaaac cctggtggttggtgtcgtgggcggcctgctgggcagcctggtgctgctagtctgggtcctggccgtc atetg ctcccg gg g gg GCC CAG acaatag g g g g caccg g CCAG CCAG cccctg aag g aggacccctcagccgtgcctgtgttctctgtggactatggggagctggatttccagtggcgagaga agaccccggagccccccgtgccctgtgtccctgagcagacggagtatgccaccattg tctttccta g g g AATG gg cacctcatcccccg CCCG cag ggg ctcag ccg acg g ccctcg g g tg cccag ccactg g g CCTG g g atg g acactg ctcttg g cccctctg accg g cttccttg g ccaccag tg ttc tg cag accctccaccatg g CCCG gG TCAG g catttcctcag g g aag cag g cag gg tg cag gccattgcaggccgtccaggggctgagctgcctgggggcgaccggggctccagc ctgcacctg caccag g cacag ccccaccacag g actcatg tctcaatg cccacag tg g cccag g cag cag gtgtcaccgtcccctacagggagggccagatgcagtcactgcttcaggtcctgccagcacagag TSG CCTG eg tccag ctccctg aatctctg GTS GTS GTS GTS GTS GTS GTS GTS GTS CCTG g g CCCG g ggctgaaggcgccgtggccctgcctgacgccccggagcctcctgcctgaacttgggggctggttg g g atg g ccttg g ag CAG ccaag g tg cccctg g CAG TG g catcccg aaacg ccctg g acg ac gggcccaagactgggcacaggagtgggaggtacatggggctggggactccccaggagttatct gctccctgcaggcctagagaagtttcagggaaggtcagaagagctcctggctgtggtgggcagg g cag g aaacccctcccacctttacacatg cccag g cag cacctcag g ccctttg tg ggg cag gg aag etg g g cag TAAG g gg cag g cag g etg g g g cctttcag g CCAG CCAG cactctg gC ctcctg ccg ccg cattccaccccag cccctcacaccactcg g gg g gg g acatcctacg TCCC aaggtcaggagggcagggctggggttgactcaggcccctcccagctgtggccacctgggtgttg gg g gg g cag cag aag tg tg cccaccctg ccccccatg cacctag gg gg g g ctctccttg aa cccattcctg aaattatttaaag ggg ttg ccg gg g gg ctcccaccag CCTG gg gg aag tg g taca g g eg ttcccccg g g g cctag tacccccg eg tg g cctatccactcctcacatccacacactg cacc cccactcctg g g g cag g g ccaccag catccag g eg g ccag cag g cacctg ag tg g etg g g ac aag g g atccccattttctg tg
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81/84
SEQ ID NO: 30 Heavy Chain Nucleotide Sequence; mAb Anti-LAG-3 (BMS-986016) caggtgcagctacagcagtggggcgcaggactgttgaagccttcggagaccctgtccctcacct gcgctgtctatggtgggtccttcagtgattactactggaactggatccgccagcccccagggaagg gg ctg g g tg g ATTG ggg aaatcaatcatcg tg g aag caccaactccaacccg tccctcaag g tcgagtcaccctatcactagacacgtccaagaaccagttctccctgaagctgaggtctgtgaccgc cgcggacacggctgtgtattactgtgcgtttggatatagtgactacgagtacaactggttcgacccc tg ggg CCAG gg aaccctg g tcaccg tctcctcag CTAG caccaag gg cccatccg tcttccccct gg g ccctg ctccag g g cacctccg ccctg ag ag gg cacag ccg ctg g CCTG tcaag g cttccccgaaccggtgacggtgtcgtggaactcaggcgccctgaccagcggcgtgcacaccttc minutes ccggctgtcctacagtcctcaggactctactccctcagcagcgtggtgaccgtgccctccagcagc ttgggcacgaagacctacacctgcaacgtagatcacaagcccagcaacaccaaggtggacaa gagagttgagtccaaatatggtcccccatgcccaccatgcccagcacctgagttcctgggggga ccatcag tcttcctg ttccccccaaaacccaag acactctcatg atctcccg g g g g acccctg tc acgtgcgtggtggtggacgtgagccaggaagaccccgaggtccagttcaactggtacgtggatg gcgtggaggtgcataatgccaagacaaagccgcgggaggagcagttcaacagcac gtaccgt gtggtcagcgtcctcaccgtcctgcaccaggactggctgaacggcaaggagtacaagtgcaag g tctccaacaaag g cctcccg tcctccatcg g aaaaccatctccaaag ccaaag gg cag ccc cgagagccacaggtgtacaccctgcccccatcccaggaggagatgaccaagaaccaggtca g CCTG acctg CCTG g tcaaag g cttctaccccag g acatcg GCC TG g g tg gg g g caatg gg cag ccg g g aacaactacaag accacg cctcccg tg ctg g actccg acg g ctccttcttcctct acagcaggctaaccgtggacaagagcaggtggcaggaggggaatgtcttctcatgctccgtgat g catg ag g ctctg cacaaccactacacacag aag ag cctctccctg tetetg gg taaatg a
SEQ ID NO: 31 Light Chain Nucleotide Sequence; LAG-3 mAb (BMS-986016) gaaattgtgttgacacagtctccagccaccctgtctttgtctccaggggaaagagccaccctctcct gcagggccagtcagagtattagcagctacttagcctggtaccaacagaaacctggccaggctcc caggctcctcatctatgatgcatccaacagggccactggcatcccagccaggttcagtggcagtg ggtctgggacagacttcactctcaccatcagcagcctagagcctgaag attttg cag t tttattactg cagcagcgtagcaactggcctctcacttttggccaggggaccaacctggagatcaaacgtacgg
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82/84 g tg ctg atg ag caccatctg tcttcatcttcccg ccatctg aaatctg cag ttg ttg T g AACTG cctctg gtgcctgctgaataacttctatcccagagaggccaaagtacagtggaaggtggataacgccctcc aatcgggtaactcccaggagagtgtcacagagcaggacagcaaggacagcacctacagcctc caccctg g acg cag cag ctg ag caaag actacg g aaacacaaag tctacg CCTG g aag t cacccatcagggcctgagctcgcccgtcacaaagagcttcaacaggggagagtgttag SEQ ID NO: 32 Reason
MYPPPY
SEQ ID NO: 33 Heavy Chain Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
EVQLVESGGGLVKPGGSLRLSCAASGFTFSDYFMHWVRQAPGKGL EWVGVIDTKSFNYATYYSDLVKGRFTISRDDSKNTLYLQMNSLKTED TAVYYCTATIAVPYYFDYWGQGTLVTVSSASTKGPSVFPLAPSSKST SGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSL SSVVTVPSSSLGTQTYICNVNHKPSNTKVDKRVEPKSCDKTHTCPPC PAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVEHEDPEVKFN WYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKC KVSNKALPAPIEKTISKAKGQPREPQVYTLPPSREEMTKNQVSLTCLV KGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSR WQQGNVFSCSVMHEALHNHYTQKSLSLSPG
SEQ ID NO: 34 Light Chain Amino Acid Sequence; AntiAIDS mAb (BMS986226)
DIQMTQSPSSLSASVGDRVTITCQASQDISNYLSWYQQKPGKAPKLLI YYTNLLAEGVPSRFSGSGSGTDFTFTISSLQPEDIATYYCQQYYNYRT FGPGTKVDIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAK VQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKV YACEVTHQGLSSPVTKSFNRGEC
SEQ ID NO: 35 Heavy Chain Variable Region (VH) Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
EVQLVESGGGLVKPGGSLRLSCAASGFTFSDYFMHWVRQAPGKGL EWVGVIDTKSFNYATYYSDLVKGRFTISRDDSKNTLYLQMNSLKTED
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TAVYYCTATIAVPYYFDYWGQGTLVTVSS
SEQ ID NO: 36 Light Chain Variable Region (VL) Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
DIQMTQSPSSLSASVGDRVTITCQASQDISNYLSWYQQKPGKAPKLLI YYTNLLAEGVPSRFSGSGSGTDFTFTISSLQPEDIATYYCQQYYNYRT FGPGTKVDIK
SEQ ID NO: 37 Chain CDR1 Amino Acid Sequence
Heavy; Anti-ICOS mAb (BMS986226)
GFTFSDYFMH
SEQ ID NO: 38 Chain CDR2 Amino Acid Sequence
Heavy; Anti-ICOS mAb (BMS986226)
VIDTKSFNYATYYSDLVKG
SEQ ID NO: 39 Chain CDR3 Amino Acid Sequence
Heavy; Anti-ICOS mAb (BMS986226)
TIAVPYYFDY
SEQ ID NO: 40 Amino Acid Sequence of Light Chain CDR1; Anti-ICOS mAb (BMS986226)
QASQDISNYLS
SEQ ID NO: 41 Light Chain CDR2 Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
YTNLLAE
SEQ ID NO: 42 Light Chain CDR3 Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
QQYYNYRT
SEQ ID NO: 43 Light Chain CDR3 Amino Acid Sequence; Anti-ICOS mAb (BMS986226)
QQYYNYRT
SEQ ID NO: 44 Lymphocyte Activation Gene 3 Protein Amino Acid Sequence (Homo Sapiens, NP_002277)
MWEAQFLGLLFLQPLWVAPVKPLQPGAEVPVVWAQEGAPAQLPCS
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PTIPLQDLSLLRRAGVTWQHQPDSG
PPAAAPGHPLAPGPHPAAPSSWGPRPRRYTVLSVGPGGLRSGRLPL QPRVQLDERGRQRGDFSLWLRPAR
RADAGEYRAAVHLRDRALSCRLRLRLGQASMTASPPGSLRASDWVI LNCSFSRPDRPASVHWFRNRGQGR
VPVRESPHHHLAESFLFLPQVSPMDSGPWGCILTYRDGFNVSIMYNL TVLGLEPPTPLTVYAGAGSRVGL
PCRLPAGVGTRSFLTAKWTPPGGGPDLLVTGDNGDFTLRLEDVSQA QAGTYTCHIHLQEQQLNATVTLAI
ITVTPKSFGSPGSLGKLLCEVTPVSGQERFVWSSLDTPSQRSFSGP WLEAQEAQLLSQPWQCQLYQGERL
LGAAVYFTELSSPGAQRSGRAPGALPAGHLLLFLILGVLSLLLLVTGAF GFHLWRRQWRPRRFSALEQGI
HPPQAQSKIEELEQEPEPEPEPEPEPEPEPEPEQLQL
SEQ ID NO: 45 PD-1 Amino Acid Sequence (Homo Sapiens,
AAC51773.1)
MQIPQAPWPVVWAVLQLGWRPGWFLDSPDRPWNPPTFFPALLVVT EGDNATFTCSFSNTSESFVLNWYRM
SPSNQTDKLAAFPEDRSQPGQDCRFRVTQLPNGRDFHMSVVRARR NDSGTYLCGAISLAPKAQIKESLRA
ELRVTERRAEVPTAHPSPSPRPAGQFQTLVVGVVGGLLGSLVLLVW VLAVICSRAARGTIGARRTGQPLK
EDPSAVPVFSVDYGELDFQWREKTPEPPVPCVPEQTEYATIVFPSG MGTSSPARRGSADGPRSAQPLRPE

权利要求:
Claims (164)
[1]
1. Method of treating a malignant tumor in a human patient characterized by the fact that it comprises the administration of a therapeutically effective amount of:
a LAG-3 inhibitor;
an inhibitor of the PD-1 pathway; and an immunotherapeutic agent.
[2]
Method according to claim 1, characterized by the fact that the LAG-3 inhibitor is an antiLAG-3 antibody or an antigen-binding fragment thereof.
[3]
Method according to claim 1 or 2, characterized in that the anti-LAG-3 antibody is a bispecific antibody.
[4]
Method according to any one of claims 1 to 3, characterized in that the antiLAG-3 antibody or antigen-binding fragment thereof comprises (a) a heavy chain variable region CDR1 comprising the sequence stipulated in SEQ ID NO: 7; (b) a heavy chain variable region CDR2 comprising the sequence set forth in SEQ ID NO: 8; (c) a heavy chain variable region CDR3 comprising the sequence set forth in SEQ ID NO: 9; (d) a light chain variable region CDR1 comprising the sequence set forth in SEQ ID NO: 10; (e) a light chain variable region CDR2 comprising the sequence set forth in SEQ ID NO: 11; and (f) a light chain variable region CDR3 comprising the sequence set forth in SEQ ID NO: 12.
[5]
Method according to any one of claims 1 to 4, characterized in that the antiLAG-3 antibody or antigen-binding fragment thereof comprises variable regions of heavy and light chains comprising the
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2/22 sequences stipulated in SEQ ID NOs: 3 and 5, respectively.
[6]
Method according to any one of claims 1 to 5, characterized in that the antiLAG-3 antibody is BMS 986016, MK-4280 (28G-10), REGN3767, GSK2831781, IMP731 (H5L7BW), BAP050, IMP- 701 (LAG-5250), IMP321, TSR-033, LAG525, BI 754111, or FS-118.
[7]
Method according to claim 1, characterized in that the LAG-3 inhibitor is a soluble LAG-3 polypeptide.
[8]
Method according to claim 7, characterized in that the soluble LAG-3 polypeptide is a fusion polypeptide.
[9]
Method according to claim 7 or 8, characterized in that the soluble LAG-3 polypeptide comprises a ligand-binding fragment of the LAG-3 extracellular domain.
[10]
Method according to claim 9, characterized in that the ligand-binding fragment of the LAG-3 extracellular domain comprises an amino acid sequence with at least 90%, at least 95%, at least 98%, or at least minimum 99% sequence identity with SEQ ID NO: 44.
[11]
Method according to any one of claims 7 to 10, characterized in that the soluble LAG-3 polypeptide additionally comprises an Fc domain.
[12]
Method according to any one of claims 1 to 11, characterized in that the inhibitor of the PD-1 pathway is an anti-PD-1 antibody or antigen-binding fragment thereof.
[13]
13. Method according to claim 12, characterized in that the anti-PD-1 antibody is pembrolizumab
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3/22 (KEYTRUDA; MK-3475), pidilizumab (CT-011), nivolumab (OPDIVO; BMS-936558), PDR001, MEDI0680 (AMP-514), TSR-042, REGN2810, JS001, AMP-224 (GSK- 2661380), PF-06801591, BGB-A317, Bl 754091, or SHR-1210.
[14]
Method according to any one of claims 1 to 11, characterized in that the inhibitor of the PD-1 pathway is an anti-PD-L1 antibody or antigen-binding fragment thereof.
[15]
15. Method according to claim 14, characterized in that the anti-PD-L1 antibody is atezolizumab (TECENTRIQ; RG7446; MPDL3280A; RO5541267), durvalumab (MEDI4736), BMS-936559, avelumab (bavencio), LY3300054, CX-072 (Proclaim-CX-072), FAZ053, KN035, or MDX-1105.
[16]
16. Method according to any one of claims 1 to 11, characterized in that the inhibitor of the PD-1 pathway is a small molecule drug.
[17]
17. Method according to claim 16, characterized in that the inhibitor of the PD-1 pathway is CA-170.
[18]
18. Method according to claim 16, characterized in that the inhibitor of the PD-1 pathway is a cell-based therapy.
[19]
19. Method according to claim 18, characterized in that the cell-based therapy is a MiHA-loaded PD-L1 / L2 silenced dendritic vaccine.
[20]
20. Method according to claim 19, characterized in that the cell-based therapy is a programmed cell death antiprotein antibody 1 expressing pluripotent killer T lymphocyte, an autologous T lymphocyte modified by a chimeric switch receptor directed to PD- 1, or one
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4/22 PD-1 knockout autologous T lymphocyte.
[21]
21. Method according to any one of claims 1 to 11, characterized in that the inhibitor of the PD-1 pathway is an anti-PD-L2 antibody or antigen-binding fragment thereof.
[22]
22. Method according to claim 21, characterized in that the anti-PD-L2 antibody is rHlgM12B7.
[23]
23. Method according to claims 1 to 11, characterized in that the inhibitor of the PD-1 pathway is a soluble PD-1 polypeptide.
[24]
24. The method of claim 23, characterized in that the soluble PD-1 polypeptide is a fusion polypeptide.
[25]
25. The method of claim 23 or 24, characterized in that the soluble PD-1 polypeptide comprises a ligand-binding fragment of the PD-1 extracellular domain.
[26]
26. The method of any one of claims 23 to 25, characterized in that the soluble PD-1 polypeptide comprises a ligand-binding fragment of the PD-1 extracellular domain.
[27]
27. Method according to claim 26, characterized in that the ligand-binding fragment of the PD-1 extracellular domain comprises an amino acid sequence of at least 90%, at least 95%, at least 98%, or at least minimum 99% sequence identity with SEQ ID NO: 45.
[28]
28. The method of any one of claims 23 to 27, characterized in that the soluble PD-1 polypeptide additionally comprises an Fc domain.
[29]
29. Method according to any of the
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5/22 claims 1 to 28, characterized by the fact that the immunotherapeutic agent is a modulator of CTLA-4 activity, a modulator of CD28 activity, a modulator of CD80 activity, a modulator of CD86 activity, a modulator of 41BB activity, 0X40 activity modulator, KIR activity modulator, Tim-3 activity modulator, CD27 activity modulator, CD40 activity modulator, GITR activity modulator, modulator of TIGIT activity, a modulator of CD20 activity, a modulator of CD96 activity, a modulator of IDO1 activity, a modulator of STING activity, a modulator of GARP activity, a modulator of A2aR activity, a modulator of activity of CEACAM1, a modulator of CEA activity, a modulator of CD47 activity, a modulator of PVRIG activity, a modulator of TDO activity, a modulator of VISTA activity, a cytokine, a chemokine, an interferon, an interleukin , a li nfocin, a member of the tumor necrosis factor (TNF) family, or an immunostimulatory oligonucleotide.
[30]
30. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is an inhibitor of the immunological control point.
[31]
31. The method of claim 30, characterized by the fact that the immunological checkpoint inhibitor is a CTLA-4 antagonist, a CD80 antagonist, a CD86 antagonist, a Tim-3 antagonist, an antagonist of Tim TIGIT, a CD20 antagonist, a CD96 antagonist, an IDO1 antagonist, a STING antagonist, a GARP antagonist, a CD40 antagonist, an A2aR antagonist, a CEACAM1 (CD66a) antagonist, a CEA antagonist, an antagonist of CD47, an antagonist of PVRIG, an antagonist of
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6/22
TDO, a VISTA antagonist, or a KIR antagonist.
[32]
32. The method of claim 31, characterized in that the immunological control point inhibitor is a CTLA-4 antagonist.
[33]
33. The method of claim 32, characterized in that the CTLA-4 antagonist is an anti-CTLA-4 antibody or antigen-binding fragment thereof.
[34]
34. Method according to claim 33, characterized in that the anti-CTLA-4 antibody is ipilimumab (YERVOY), tremelimumab (ticilimumab; CP-675,206), AGEN-1884, or ACTOR-1015.
[35]
35. The method of claim 32, characterized in that the CTLA-4 antagonist is a soluble CTLA-4 polypeptide.
[36]
36. The method of claim 35, characterized in that the soluble CTLA-4 polypeptide is abatacept (Orencia), belatacept (Nulojix), RG2077, or RG-1046.
[37]
37. The method of claim 32, characterized in that the CTLA-4 antagonist is a cell-based therapy.
[38]
38. The method of claim 37, characterized in that the CTLA-4 antagonist is an autologous dendritic cell vaccine transfected with antiCTLA4 mAb RNA from GITRL or an autologous dendritic cell vaccine transfected with mAb RNA. anti-CTLA4.
[39]
39. Method according to claim 31, characterized in that the immunological control point inhibitor is a KIR antagonist
[40]
40. Method according to claim 39, characterized in that the KIR antagonist is an antibody
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7/22 anti-KIR or antigen-binding fragment thereof.
[41]
41. Method according to claim 40, characterized in that the anti-KIR antibody is lirilumab (1-7F9, BMS-986015, IPH 2101) or IPH4102.
[42]
42. The method of claim 31, characterized in that the immunological control point inhibitor is a TIGIT antagonist.
[43]
43. The method of claim 42, characterized in that the TIGIT antagonist is an anti-TIGIT antibody or antigen-binding fragment thereof.
[44]
44. Method according to claim 43, characterized in that the anti-TIGIT antibody is BMS-986207, AB 154, COM902 (CGEN-15137), or OMP-313M32.
[45]
45. Method according to claim 31, characterized in that the immunological control point inhibitor is a Tim-3 antagonist.
[46]
46. The method of claim 45, characterized in that the Tim-3 antagonist is an anti-Tim-3 antibody or antigen-binding fragment thereof.
[47]
47. Method according to claim 46, characterized in that the anti-Tim-3 antibody is TSR-022 or LY3321367.
[48]
48. Method according to claim 31, characterized in that the immunological control point inhibitor is an IDO1 antagonist.
[49]
49. Method according to claim 48, characterized in that the IDO1 antagonist is indoximod (NLG8189; 1-methyl- _D- TRP), epacadostat (INCB-024360, INCB-24360), KHK2455, PF-06840003, navoximod (RG6078, GDC-0919, NLG919), BMS-986205 (F001287), or pyrrolidine-2,5-dione derivatives.
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8/22
[50]
50. Method according to claim 31, characterized in that the immunological control point inhibitor is a STING antagonist.
[51]
51. The method of claim 50, characterized in that the STING antagonist is cyclic 2 'or 3'-mono-fluoro substituted dinucleotides; 2 ', 5' - 3 ', 5' cyclic mixed bonded 2'3 '-difluoro di-nucleotides; bis-3 ', 5' cyclic, 2'-fluoro substituted dinucleotides; 2 ', 2 "-diF-Rp, Rp, bis-3', 5 'cyclic di-nucleotides; or fluorinated cyclic di-nucleotides.
[52]
52. The method of claim 31, characterized in that the immunological control point inhibitor is a CD20 antagonist.
[53]
53. The method of claim 52, characterized in that the CD20 antagonist is an anti-CD20 antibody or antigen-binding fragment thereof.
[54]
54. The method of claim 53, characterized in that the anti-CD20 antibody is rituximab (RITUXAN; IDEC-102; IDEC-C2B8), ABP 798, ofatumumab, or obinutuzumab.
[55]
55. Method according to claim 31, characterized in that the immunological control point inhibitor is a CD80 antagonist.
[56]
56. The method of claim 55, characterized in that the CD80 antagonist is an anti-CD80 antibody or antigen-binding fragment thereof.
[57]
57. Method according to claim 56, characterized in that the anti-CD80 antibody is galiximab or AV 1142742.
[58]
58. Method according to claim 31, characterized by the fact that the control point inhibitor
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Immune 9/22 is a GARP antagonist.
[59]
59. The method of claim 58, characterized in that the GARP antagonist is an anti-GARP antibody or antigen-binding fragment thereof.
[60]
60. The method of claim 59, characterized in that the anti-GARP antibody is ARGX-115.
[61]
61. The method of claim 31, characterized in that the immunological control point inhibitor is a CD40 antagonist.
[62]
62. The method of claim 61, characterized in that the CD40 antagonist is an anti-CD40 antibody is an antigen-binding fragment thereof.
[63]
63. Method according to claim 62, characterized in that the anti-CD40 antibody is BMS3h-56, lucatumumab (HCD122 and CHIR-12.12), CHIR-5.9, or dacetuzumab (huS2C6, PRO 64553, RG 3636, SGN 14, SGN-40).
[64]
64. The method of claim 61, characterized in that the CD40 antagonist is a soluble CD40 ligand (CD40-L).
[65]
65. The method of claim 64, characterized in that the soluble CD40 linker is a fusion polypeptide.
[66]
66. The method of claim 64 or 65, characterized in that the soluble CD40 linker is a CD40L / FC2 or a monomeric CD40-L.
[67]
67. The method of claim 31, characterized in that the immunological control point inhibitor is an A2aR antagonist.
[68]
68. Method according to claim 67, characterized in that the A2aR antagonist is a molecule
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10/22 small.
[69]
69. The method of claim 67 or 68, characterized in that the A2aR antagonist is CPI-444, PBF509, istradefiline (KW-6002), preladenant (SCH420814), tozadenant (SYN115), vipadenant (BIIB014), HTL-1071, ST1535, SCH412348, SCH442416, SCH58261, ZM241385, or AZD4635.
[70]
70. The method of claim 31, characterized in that the immunological control point inhibitor is a CEACAM1 antagonist.
[71]
71. Method according to claim 70, characterized in that the CEACAM1 antagonist is an anti-CEACAM1 antibody or antigen-binding fragment thereof.
[72]
72. Method according to claim 71, characterized in that the anti-CEACAM1 antibody is CM-24 (MK-6018).
[73]
73. The method of claim 31, characterized in that the immunological control point inhibitor is a CEA antagonist.
[74]
74. The method of claim 73, characterized in that the CEA antagonist is an anti-CEA antibody or antigen-binding fragment thereof.
[75]
75. Method according to claim 74, characterized in that the anti-CEA antibody is cergutuzumab amunaleucine (RG7813, RO-6895882) or RG7802 (RO6958688).
[76]
76. The method of claim 31, characterized in that the immunological control point inhibitor is a CD47 antagonist.
[77]
77. Method according to claim 76, characterized in that the CD47 antagonist is an antibody
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11/22 anti-CD47 or antigen-binding fragment thereof.
[78]
78. The method of claim 77, characterized in that the anti-CD47 antibody is HuF9-G4, 0090002, TTI-621, ALX148, NI-1701, NI-1801, SRF231, or Effi-DEM.
[79]
79. The method of claim 31, characterized in that the immunological control point inhibitor is a PVRIG antagonist.
[80]
80. The method of claim 79, characterized in that the PVRIG antagonist is an anti-PVRIG antibody or antigen-binding fragment thereof.
[81]
81. Method according to claim 80, characterized in that the anti-PVRIG antibody is COM701 (CGEN-15029).
[82]
82. The method of claim 31, characterized in that the immunological control point inhibitor is an TDO antagonist.
[83]
83. The method of claim 82, characterized in that the TDO antagonist is a 4- (indol-3-yl) -pyrazole derivative, a substituted 3-indole derivative, or a derivative of a 3- (indol-3-yl) -pyridine.
[84]
84. Method according to claim 31, characterized in that the immunological control point inhibitor is a double antagonist of IDO and TDO.
[85]
85. The method of claim 84, characterized by the fact that the double antagonist of IDO and TDO is a small molecule.
[86]
86. Method according to claim 31, characterized in that the immunological control point inhibitor is a VISTA antagonist.
[87]
87. The method of claim 86,
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12/22 characterized by the fact that the VISTA antagonist is CA-170 or JNJ-61610588.
[88]
88. Method according to any of claims 1 to 29, characterized in that the immunotherapeutic agent is an enhancer or stimulator of the immunological control point.
[89]
89. The method of claim 88, characterized in that the immune booster or enhancer is a CD28 agonist, a 4-1 BB agonist, a 0X40 agonist, a CD27 agonist, a CD27 agonist CD80, a CD86 agonist, a CD40 agonist, an ICOS agonist, a CD70 agonist, or a GITR agonist.
[90]
90. Method according to claim 89, characterized in that the immune booster reinforcer or stimulator is a 0X40 agonist.
[91]
91. Method according to claim 90, characterized in that the 0X40 agonist is an anti-OX40 antibody or antigen-binding fragment thereof.
[92]
92. Method according to claim 91, characterized in that the anti-OX40 antibody is tavolixizumab (MEDI-0562), pogalizumab (MOXR0916, RG7888), GSK3174998, ACTOR-1015, MEDI-6383, MEDI-6469, BMS 986178, PF-04518600, or RG7888 (MOXR0916).
[93]
93. The method of claim 90, characterized in that the 0X40 agonist is a cell-based therapy.
[94]
94. The method of claim 93, characterized in that the 0X40 agonist is a GINAKIT cell.
[95]
95. The method of claim 89,
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13/22 characterized by the fact that the immune booster booster or stimulator is a CD40 agonist.
[96]
96. Method according to claim 95, characterized in that the CD40 agonist is an anti-CD40 antibody or antigen-binding fragment thereof.
[97]
97. Method according to claim 96, characterized in that the anti-CD40 antibody is ADC-1013 (JNJ-64457107), RG7876 (RO-7009789), HuCD40-M2, APX005M (EPI-0050), or Chi Lob 7/4.
[98]
98. Method according to claim 95, characterized in that the CD40 agonist is a soluble CD40 ligand (CD40-L).
[99]
99. The method of claim 98, characterized in that the soluble CD40 linker is a fusion polypeptide.
[100]
100. Method according to claim 98 or 99, characterized in that the soluble CD40 ligand is a trimeric CD40-L (AVREND).
[101]
101. Method according to claim 89, characterized in that the immune control booster or stimulator is a GITR agonist.
[102]
102. The method of claim 101, characterized by the fact that the GITR agonist is an antiGITR antibody or antigen-binding fragment thereof.
[103]
103. Method according to claim 102, characterized in that the anti-GITR antibody is BMS-986156, TRX518, GWN323, INCAGN01876, or MEDI1873.
[104]
104. Method according to claim 101, characterized in that the GITR agonist is a soluble GITR ligand (GITRL).
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14/22
[105]
105. The method of claim 104, characterized in that the soluble GITR linker is a fusion polypeptide.
[106]
106. Method according to claim 101, characterized in that the GITR agonist is a cell-based therapy.
[107]
107. Method according to claim 106, characterized in that the cell-based therapy is an autologous dendritic cell vaccine transfected with GITRL anti-CTLA4 mAb RNA or an autologous dendritic cell vaccine transfected with RNA of GITRL.
[108]
108. Method according to claim 89, characterized in that the immune booster booster or stimulator is a 4-1 BB agonist.
[109]
109. The method of claim 108, characterized in that the 4-1 BB agonist is an anti-4-1 BB antibody or antigen-binding fragment thereof.
[110]
110. Method according to claim 109, characterized in that the anti-4-1 BB antibody is urelumab or PF-05082566.
[111]
111. Method according to claim 89, characterized in that the immune control booster or stimulator is a CD80 agonist or a CD86 agonist.
[112]
112. Method according to claim 111, characterized in that the CD80 agonist or CD86 agonist is a soluble CD80 or CD86 ligand (CTLA-4).
[113]
113. The method of claim 112, characterized in that the soluble CD80 or CD86 ligand is a fusion polypeptide.
[114]
114. The method of claim 112 or 113,
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15/22 characterized by the fact that the CD80 or CD86 linker is CTLA4-lg (CTLA4-lgG4m, RG2077, or RG1046) or abatacept (ORENCIA, BMS188667).
[115]
115. The method of claim 111, characterized in that the CD80 agonist or CD86 agonist is a cell-based therapy.
[116]
116. Method according to claim 115, characterized in that the cell-based therapy is MGN1601.
[117]
117. Method according to claim 89, characterized in that the immune control booster or stimulator is a CD28 agonist.
[118]
118. The method of claim 117, characterized in that the CD28 agonist is an anti-CD28 antibody or antigen-binding fragment thereof.
[119]
119. Method according to claim 118, characterized in that the anti-CD28 antibody is TGN1412.
[120]
120. The method of claim 117, characterized in that the CD28 agonist is a cell-based therapy.
[121]
121. Method according to claim 120, characterized in that the cell-based therapy is JCAR015 (anti-CD19-CD28-zeta modified CD3 + CAR lymphocyte); T lymphocyte expressing CD28CAR / CD137CAR; similar allogeneic Th1 T cells from CD4 + / anti-CD3 / anti-CD28 memory attached to microparticles; autologous T lymphocytes KTE-C19 transduced by anti-CD19 / CD28 / CD3zeta CAR gamma-retroviral vector; autologous T lymphocytes transduced by anti-CEA lgCD28TCR; allogeneic T lymphocytes transduced by anti-EGFRv111 CAR; autologous T lymphocytes expressing CD123CAR-CD28-CD3zeta-EGFRt; T lymphocytes
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16/22 autologous expressing CD171-specific zeta-4-1-BB-EGFRt CAR-CD28; autologous T cells enriched with expressing CD19CAR-CD28-CD3zeta-EGFRt; autologous T-lymphocytes modified with PD-1 chimeric switch receptor (CD28 chimera); Tem-enriched T lymphocytes expressing CD19CAR-CD28-CD3zeta-EGFRt; T lymphocytes enriched with Τη / mem expressing CD19CAR-CD28-CD3zeta-EGFRt; allogeneic T lymphocytes expressing CD19CAR-CD28zeta-4-1BB; autologous T lymphocytes expressing CD19CAR-CD3zeta-4-1BB-CD28; T lymphocytes expressing CD28CAR / CD137CAR; autologous T lymphocytes sensitized with a CD3 / CD28 co-stimulated vaccine; or T lymphocytes expressing IC9-GD2-CD28-OX40.
[122]
122. Method according to claim 89, characterized in that the immune booster booster or stimulator is a CD27 agonist.
[123]
123. The method of claim 122, characterized in that the CD27 agonist is an anti-CD27 antibody or antigen-binding fragment thereof.
[124]
124. Method according to claim 123, characterized in that the anti-CD27 antibody is varlilumab (CDX-1127).
[125]
125. Method according to claim 89, characterized in that the immune booster booster or stimulator is a CD70 agonist.
[126]
126. Method according to claim 125, characterized in that the CD70 agonist is an anti-CD70 antibody or antigen-binding fragment thereof.
[127]
127. Method according to claim 126, characterized in that the anti-CD70 antibody is ARGX-110.
[128]
128. The method of claim 89,
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17/22 characterized by the fact that the immune booster reinforcer or stimulator is an ICOS agonist.
[129]
129. The method of claim 128, characterized by the fact that the ICOS agonist is an antiICOS antibody or antigen-binding fragment thereof.
[130]
130. The method of claim 129, characterized in that the anti-ICOS antibody is BMS986226, MEDI-570, GSK3359609, or JTX-2011.
[131]
131. Method according to claim 128, characterized in that the ICOS agonist is a soluble ICOS binder.
[132]
132. The method of claim 131, characterized in that the soluble ICOS ligand is a fusion polypeptide.
[133]
133. Method according to claim 131 or 132, characterized in that the soluble ICOS binder is AMG 750.
[134]
134. Method according to claim 89, characterized in that the immunotherapeutic agent is an anti-CD73 antibody or antigen-binding fragment thereof.
[135]
135. Method according to claim 134, characterized in that the anti-CD73 antibody is MEDI9447.
[136]
136. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is a TLR9 agonist.
[137]
137. Method according to claim 136, characterized in that the TLR9 agonist is sodium agatolimod.
[138]
138. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is a cytokine.
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18/22
[139]
139. Method according to claim 138, characterized in that the cytokine is a chemokine, an interferon, an interleukin, a lymphokine, or a member of the tumor necrosis factor family.
[140]
140. Method according to claim 138 or 139, characterized in that the cytokine is IL-2, IL-15, or gamma interferon.
[141]
141. Method according to any of claims 1 to 28, characterized in that the immunotherapeutic agent is a TGF-β antagonist.
[142]
142. Method according to claim 141, characterized in that the TGF-β antagonist is fresolimumab (GC-1008), NIS793, IMC-TR1 (LY3022859), ISTH0036, trabedersen (AP 12009), transforming growth factor -recombinant beta-2, autologous TGF beta resistant T lymphocytes specific for HPV16 / 18 E6 / E7, or LMP-specific cytotoxic T lymphocytes resistant to TGF beta.
[143]
143. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is an iNOS antagonist.
[144]
144. Method according to claim 143, characterized in that the iNOS antagonist is N-Acetyl cysteine (NAC), aminoguanidine, L-nitroarginine methyl ester, or S, S-1,4-phenylene-bis ( 1,2-ethanediyl) bis-isothiourea).
[145]
145. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is an SHP-1 antagonist.
[146]
146. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is a CSF1R antagonist (receptor of the factor
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19/22 macrophage colony stimulant 1).
[147]
147. Method according to claim 146, characterized in that the CSF1R antagonist is an anti-CSF1 R antibody or antigen-binding fragment thereof.
148. Method in wake up with claim 147, featured by the fact in that the anti-CSF1R antibody is emactuzumab. 149. Method in wake up with any of the
claims 1 to 28, characterized by the fact that the immunotherapeutic agent is an agonist of a member of the TNF family.
[148]
150. Method according to claim 149, characterized in that the agonist of the TNF family member is ACTOR 1016, ABBV-621, or Adalimumab.
[149]
151. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is aldesleukin, tocilizumab, or MEDI5083.
[150]
152. Method according to any one of claims 1 to 28, characterized in that the immunotherapeutic agent is a CD160 (NK1) agonist.
[151]
153. Method according to claim 152, characterized in that the CD 160 agonist (NK1) is an anti-CD160 antibody or antigen-binding fragment thereof.
[152]
154. Method according to claim 152 or 153, characterized in that the anti-CD160 antibody is BY55.
[153]
155. Method according to any one of claims 1 to 154, characterized in that the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated for intravenous administration.
[154]
156. Method according to any one of claims 1 to 155, characterized in that the inhibitor of
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20/22
LAG-3, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated together.
[155]
157. Method according to any one of claims 1 to 155, characterized in that the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are formulated separately.
[156]
158. Method according to any of claims 1 to 157, characterized by the fact that the malignant tumor is selected from the group consisting of liver cancer, bone cancer, pancreatic cancer, skin cancer, head or neck cancer, breast cancer, lung cancer, malignant cutaneous or intraocular melanoma, kidney cancer, uterine cancer, ovarian cancer, colorectal cancer, colon cancer, rectal cancer, anal region cancer, stomach cancer, testicular cancer, uterine cancer, carcinoma fallopian tubes, carcinoma of the uterine cervix, carcinoma of the uterine cervix, carcinoma of the vagina, carcinoma of the vulva, non-Hodgkin's lymphoma, cancer of the esophagus, cancer of the small intestine, cancer of the endocrine system, cancer of the thyroid gland, cancer of the parathyroid gland, adrenal gland cancer, soft tissue sarcoma, urethral cancer, penis cancer, childhood cancers, lymphocytic lymphoma, bladder cancer, kidney or ureter cancer, renal pelvis carcinoma, neoplasm central nervous system (CNS) symptoms, primary central nervous system lymphoma, tumor angiogenesis, spinal axis tumor, brain stem glioma, pituitary adenoma, Kaposi's sarcoma, epidermoid cancer, squamous cell cancer, environmentally induced cancers including asbestos-induced, hematological malignancies including, for example, multiple myeloma, B-cell lymphoma, Hodgkin's lymphoma / primary mediastinal B-cell lymphoma, non-Hodgkin's lymphoma, acute myeloid lymphoma, chronic myeloid leukemia, lymphoid leukemia
Petition 870190089572, of 10/09/2019, p. 162/165
21/22 chronic, follicular lymphoma, diffuse large B cell lymphoma, Burkitt lymphoma, immunoblastic large cell lymphoma, precursor B cell lymphoma, moantum cell lymphoma, acute lymphoblastic leukemia, fungal mycosis, anaplastic large cell lymphoma , T-cell lymphoma, and precursor T-cell lymphoblastic lymphoma, and any combination thereof.
[157]
159. Method according to claim 158, characterized in that the malignant tumor is non-small cell lung cancer (NSCLC), a tumor-related tumor related to viruses, or gastric adenocarcinoma.
[158]
160. Method according to any one of claims 1 to 157, characterized by the fact that the malignant tumor is melanoma, gastric cancer, cancer of the gastroesophageal junction, non-small cell lung cancer, bladder cancer, squamous cell carcinoma of head and neck, or kidney cell cancer.
[159]
161. Method according to any one of claims 1 to 157, characterized in that the tumor is lung cancer, melanoma, squamous cell carcinoma of the head and neck, kidney cancer, gastric cancer, or hepatocellular carcinoma.
[160]
162. Method according to any one of claims 1 to 161, characterized in that the antiLAG-3 antibody or antigen-binding fragment thereof and the immunotherapeutic agent are administered as a first line of treatment.
[161]
163. Method according to any one of claims 1 to 161, characterized in that the LAG-3 inhibitor, the PD-1 pathway inhibitor, and the immunotherapeutic agent are administered as a second line of treatment.
Petition 870190089572, of 10/09/2019, p. 163/165
22/22
[162]
164. Method according to any one of claims 1 to 163, characterized in that the malignant tumor is refractory to the first line of treatment.
[163]
165. Method according to any one of claims 1 to 164, characterized in that it additionally comprises the administration of at least one additional therapeutic agent.
[164]
166. Method according to claim 165, characterized in that at least one additional therapeutic agent is a chemotherapeutic agent.

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同族专利:

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公开号 | 公开日

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MX2019012038A|2019-11-18|

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AU2018277559A1|2019-10-17|

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KR20200010500A|2020-01-30|

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US20210340250A1|2021-11-04|

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JP2020522495A|2020-07-30|

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法律状态:
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