Patent Application
20240150792
A sequence listing is provided herewith as a text file, “AMUN-N001WO_SEQ_LIST_ST25.txt,” created on Feb. 11, 2022 and having a size of 66000 bytes. The contents of the text file are incorporated by reference herein in their entirety.
Recently there has been a tremendous interest in developing oncolytic viruses for cancer therapy and for improving immunotherapies. However, to date only one oncolytic virus, Herpes virus expressing GM-CSF, has been approved for clinical use in treating melanomas. Therefore, there is a great need for oncolytic viruses that can be used for cancer therapy and for improving immunotherapies.
The present disclosure provides an oncolytic virus comprising a nucleic acid encoding a granulocyte-macrophage colony-stimulating factor (GM-CSF) and a soluble form of the TGF-B receptor-II (sTGF-BRII). The present disclosure also provides compositions comprising the oncolytic virus and treatment methods using the oncolytic virus. The treatment methods include local and/or systemic administration of the oncolytic virus for treating cancers, such as solid tumors.
In one aspect, the disclosure provides an oncolytic virus comprising a nucleic acid encoding a granulocyte-macrophage colony-stimulating factor (GM-CSF) and a soluble form of the TGF-B receptor-II (sTGF-BRII). In some embodiments, the oncolytic virus is an adenovirus, herpes virus, lentivirus, vaccinia virus, Reo virus, maraba virus, Newcastle disease virus, sendai virus, pox virus, poliovirus, myxoma virus, or retrovirus. In some embodiments, the oncolytic virus is an adenovirus. Some embodiments provide an oncolytic virus that preferentially replicates in cancer cells. In some embodiments, the expression of genes required for replication of the virus is under the control of a promoter active in the cancer cells, such as a telomerase reverse transcriptase (TERT) promoter. In some embodiments, the expression of sTGF-BRII is under the control of a cytomegalovirus (CMV) promoter. In some embodiments, the expression of GM-CSF is under the control of an adenoviral E1B promoter. In some embodiments, the virus comprises a capsid protein that specifically binds to a cancer cell that overexpresses an adenovirus receptor. In some embodiments, the cancer cell is a breast cancer cell, skin cancer cell, lung cancer cell, renal cancer cell, ovarian cancer cell, prostate cancer cell, pancreatic cancer cell, brain cancer cell, musculoskeletal cancer, astrocytoma cancer cell, cervical cancer cell, testicular cancer cell, hepatic cancer cell, lymphoma cancer cell, colon cancer cell, or bladder cancer cell. In some embodiments, the cancer cell is a breast cancer cell, such as a triple negative breast cancer cell. In some embodiments, the cancer cell is a skin cancer cell, such as a melanocyte. In some embodiments, the nucleic acid encoding the GM-CSF is codon-optimized to increase expression of the GM-CSF in a human subject. In some embodiments, the GM-CSF is a human GM-CSF. In some embodiments, the sTGF-BRII is fused to a heterologous protein. In some embodiments, the heterologous protein comprises a half-life-extending moiety, such as an immunoglobulin Fc region.
Another aspect of the disclosure is drawn to a pharmaceutical composition comprising: a therapeutically effective amount of the oncolytic virus described above and a pharmaceutically acceptable excipient, diluent, or carrier.
Still another aspect of the disclosure is directed to a method of treating cancer in a subject, the method comprising: administering a therapeutically effective amount of the oncolytic virus described above or the composition described above to the subject. In some embodiments of the method, the cancer is breast cancer, skin cancer, lung cancer, bladder cancer, renal cancer, astrocytoma, hepatic cancer, lymphoma, colon cancer, or head/neck cancer. In some embodiments, the administering comprises an intratumoral or intravenous administration. In some embodiments, the cancer is a primary cancer. In some embodiments, the cancer is metastatic cancer. In some embodiments, the method further comprises administering to the subject one or more of an immunotherapy, a chemotherapy, a surgical treatment, a radiation therapy, a hormone therapy, an anti-cancer small molecule, a growth factor inhibitor therapy, CAR-T therapy, or a cytokine therapy. In some embodiments, an immunotherapy is administered to the subject. In some embodiments, a chemotherapy is administered to the subject. In some embodiments, an immune checkpoint inhibitor is administered to the subject. In some embodiments, the immune checkpoint inhibitor comprises an inhibitor of PD-1, PD-L1, CTLA-4, LAG-3, BCH-3, BCH-4, or TIM-3. In some embodiments, the inhibitor is an antibody.
Other features and advantages of the disclosure will be apparent from the following detailed description and figures, and from the claims.
Included in the drawings are the following figures:
The present disclosure provides an oncolytic virus comprising a nucleic acid encoding a granulocyte-macrophage colony-stimulating factor (GM-CSF) and a soluble form of the TGF-B receptor-II (sTGF-BRII). The present disclosure provides compositions comprising the oncolytic virus and treatment methods using the oncolytic virus. The treatment methods include local and/or systemic administration of the oncolytic virus for treating cancers, such as solid tumors.
Before exemplary embodiments of the present invention are described, it is to be understood that this invention is not limited to particular embodiments described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limits of that range is also specifically disclosed. Each smaller range between any stated value or intervening value in a stated range and any other stated or intervening value in that stated range is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included or excluded in the range, and each range where either, neither or both limits are included in the smaller ranges is also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, some potential and exemplary methods and materials may now be described. Any and all publications mentioned herein are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited. It is understood that the present disclosure supersedes any disclosure of an incorporated publication to the extent there is a contradiction.
It must be noted that as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to “an adenovirus virion” includes a plurality of such virions and reference to “the vector” includes reference to one or more vectors, “a mutation” refers to one or more mutations, and so forth.
It is further noted that the claims may be drafted to exclude any element which may be optional. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely”, “only” and the like in connection with the recitation of claim elements, or the use of a “negative” limitation.
The publications discussed herein are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided may be different from the actual publication dates which may need to be independently confirmed. To the extent such publications may set out definitions of a term that conflicts with the explicit or implicit definition of the present disclosure, the definition of the present disclosure controls.
As will be apparent to those of skill in the art upon reading this disclosure, each of the individual embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.
A “recombinant adenovirus vector” as used herein refers to an adenovirus vector comprising a polynucleotide sequence not of adenoviral origin (i.e., a polynucleotide heterologous to the adenovirus), typically a sequence of interest for expression in a cell. In general, the heterologous polynucleotide is flanked by at least one, and generally by two inverted terminal repeat sequences (ITRs). The term recombinant adenovirus vector encompasses both adenoviral vector particles and adenoviral vector plasmids.
An “adenovirus” or “adenoviral particle” or “adenovirus vector particle” refers to a viral particle composed of at least one adenovirus capsid protein (typically of all of the capsid proteins of a wild-type adenovirus) and an encapsidated polynucleotide adenovirus vector. If the particle comprises a heterologous polynucleotide (i.e., a polynucleotide other than a wild-type adenovirus genome, such as a transgene to be delivered to a mammalian cell), it is typically referred to as a “recombinant adenovirus vector particle” or simply a “rAd vector”. Thus, production of rAd particle necessarily includes production of rAd vector, as such a vector contained within a rAd particle.
An “infectious” virus or viral particle is one that comprises a polynucleotide component which it is capable of delivering into a cell for which the viral species is tropic. The term does not necessarily imply any replication capacity of the virus. As used herein, an “infectious” virus or viral particle is one that can access a target cell, can infect a target cell, and can express a heterologous nucleic acid in a target cell. Thus, “infectivity” refers to the ability of a viral particle to access a target cell, infect a target cell, and express a heterologous nucleic acid in a target cell. Infectivity can refer to in vitro infectivity or in vivo infectivity. Assays for counting infectious viral particles are described in the art. Viral infectivity can be expressed as the ratio of infectious viral particles to total viral particles. Total viral particles can be expressed as the number of viral genome (vg) copies. The ability of a viral particle to express a heterologous nucleic acid in a cell can be referred to as “transduction.” The ability of a viral particle to express a heterologous nucleic acid in a cell can be assayed using a number of techniques, including assessment of a marker gene, such as a green fluorescent protein (GFP) assay (e.g., where the virus comprises a nucleotide sequence encoding GFP), where GFP is produced in a cell infected with the viral particle and is detected and/or measured; or the measurement of a produced protein, for example by an enzyme-linked immunosorbent assay (ELISA). Viral infectivity can be expressed as the ratio of infectious viral particles to total viral particles. Methods of determining the ratio of infectious viral particle to total viral particle are known in the art.
The term “polynucleotide” or “nucleic acid” refers to a polymeric form of nucleotides of any length, including deoxyribonucleotides or ribonucleotides, or analogs thereof. A polynucleotide may comprise modified nucleotides, such as methylated nucleotides and nucleotide analogs, and may be interrupted by non-nucleotide components. If present, modifications to the nucleotide structure may be imparted before or after assembly of the polymer. The term polynucleotide, as used herein, refers interchangeably to double- and single-stranded molecules. Unless otherwise specified or required, any embodiment of the invention described herein that is a nucleic acid encompasses both the double-stranded form and each of two complementary single-stranded forms known or predicted to make up the double-stranded form.
A “gene” refers to a polynucleotide containing at least one open reading frame that is capable of encoding a particular protein after being transcribed and translated.
“Recombinant,” as applied to a polynucleotide means that the polynucleotide is the product of various combinations of cloning, restriction or ligation steps, and other procedures that result in a construct that is distinct from a polynucleotide found in nature. A recombinant virus is a viral particle comprising a recombinant polynucleotide. The terms respectively include replicates of the original polynucleotide construct and progeny of the original virus construct.
A “control element” or “control sequence” is a nucleotide sequence involved in an interaction of molecules that contributes to the functional regulation of a polynucleotide, including replication, duplication, transcription, splicing, translation, or degradation of the polynucleotide. The regulation may affect the frequency, speed, or specificity of the process, and may be enhancing or inhibitory in nature. Control elements known in the art include, for example, transcriptional regulatory sequences such as promoters and enhancers. A promoter is a DNA region capable under certain conditions of binding RNA polymerase and initiating transcription of a coding region usually located downstream (in the 3′ direction) from the promoter. Reference to a gene promoter refers to both the promoter for the expression of the gene as found in nature as well as modified versions of the natural promoter, e.g., a shortened promoter, chimeric promoter, a mutated promoter, etc.
“Operatively linked” or “operably linked” refers to a juxtaposition of genetic elements, wherein the elements are in a relationship permitting them to operate in the expected manner. For instance, a promoter is operatively linked to a coding region if the promoter helps initiate transcription of the coding sequence. There may be intervening residues between the promoter and coding region so long as this functional relationship is maintained.
An “expression vector” is a vector comprising a region which encodes a polypeptide of interest, and is used for effecting the expression of the protein in an intended target cell. An expression vector also comprises control elements operatively linked to the coding region to facilitate expression of the protein in the target. The combination of control elements and a gene or genes to which they are operably linked for expression is sometimes referred to as an “expression cassette,” a large number of which are known and available in the art or can be readily constructed from components that are available in the art.
“Heterologous” means derived from a genotypically distinct entity from that of the rest of the entity to which it is being compared. For example, a polynucleotide introduced by genetic engineering techniques into a plasmid or vector derived from a different species is a heterologous polynucleotide. A promoter removed from its native coding sequence and operatively linked to a coding sequence with which it is not naturally found linked is a heterologous promoter. Thus, for example, a recombinant adenovirus that includes a heterologous nucleic acid encoding a heterologous gene product is an adenovirus that includes a nucleic acid not normally included in a naturally occurring, wild-type adenovirus, and the encoded heterologous gene product is a gene product not normally encoded by a naturally occurring, wild-type adenovirus.
As used herein, the terms “treatment,” “treating,” and the like, refer to obtaining a desired pharmacologic and/or physiologic effect. The effect may be prophylactic in terms of completely or partially preventing a disease or symptom thereof and/or may be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease. “Treatment,” as used herein, covers any treatment of a disease in a mammal, particularly in a human, and includes: a) inhibiting the disease, i.e., arresting or slowing its development; and (b) relieving the disease, i.e., causing regression of the disease. One form of treatment includes prevention of occurrence of a disease or delay in onset of the disease and/or reduced severity of the disease after onset of the disease in a subject which may be predisposed to the disease or at risk of acquiring the disease but has not yet been diagnosed as having it.
The terms “individual,” “host,” “subject,” and “patient” are used interchangeably herein, and refer to a mammal, including, but not limited to, human and non-human primates, including simians and humans; mammalian sport animals (e.g., horses, camels, etc.); mammalian farm animals (e.g., sheep, goats, cows); mammalian pets (dogs, cats, etc.); and rodents (e.g., mice, rats, etc.). In some cases, the individual is a human.
The term “pharmaceutically acceptable” refers to a non-toxic material which preferably does not interfere with the action of the active ingredient of the pharmaceutical composition. In particular, the term “pharmaceutically acceptable” means that the subject substance has been approved by a governmental regulatory agency for use in animals, and particularly humans, or in U.S. Pat. Pharmacopoeia, European Pharmacopoeia or other recognized pharmacopoeias for use in animals and in particular humans.
The term “cancer” as used herein refers to a cancer of any kind and origin including tumor-forming cells, blood cancers and/or transformed cells.
The term “cancer cell” includes cancer or tumor-forming cells, transformed cells or a cell that is susceptible to becoming a cancer or tumor-forming cell.
The term “recombinant oncolytic virus” refers to an engineered oncolytic virus, such as an adenovirus, generated in vitro using recombinant DNA technology and/or an oncolytic virus derived from such a recombined oncolytic virus (e.g., progeny virus).
The term “oncolytic” as used herein refers to a tumor-selective replicating virus that induces cell death in the infected cell, and/or tissue. Although normal or non-tumor cells may be infected, tumor cells are infected and lysed preferentially in comparison to the normal or non-tumor cells. For example, an oncolytic virus induces at least 5-fold, at least 6-fold, at least 10-fold, at least 15-fold, or at least 20-fold more cell death in a population of cancer cells compared to normal cells.
The term “normal tissue” as used herein refers to non-cancer tissue and/or tissue derived from a subject that is free of cancer of the particular tissue (e.g., when the tissue is pancreas, “normal tissue” can be derived from a subject that does not have pancreatic cancer). The term “normal cell of the same tissue type” as used herein refers to a cell or cells derived from such normal tissue.
The term “resistant cancer” or “chemotherapeutic resistant cancer” refers to a cancer that has decreased sensitivity to one or more chemotherapeutic drugs, for example by amplifying a gene that allows it to persist in the presence of the drug, for example by increasing expression of pumps that decrease amount of the drug inside a cancer cell, such as, MDR1.
The term “antibody” as used herein is intended to include monoclonal antibodies, polyclonal antibodies, chimeric antibodies, humanized antibodies. The antibody may be from recombinant sources and/or produced in transgenic animals. The term “antibody fragment” as used herein is intended to include Fab, Fab′, F(ab′)2, scFv, dsFv, ds-scFv, dimers, minibodies, diabodies, and multimers thereof and bi-specific antibody fragments. Antibodies can be fragmented using conventional techniques. For example, F(ab′)2 fragments can be generated by treating the antibody with pepsin. The resulting F(ab′)2 fragment can be treated to reduce disulfide bridges to produce Fab′ fragments. Papain digestion can lead to the formation of Fab fragments. Fab, Fab′ and F(ab′)2, scFv, dsFv, ds-scFv, dimers, minibodies, diabodies, bi-specific antibody fragments and other fragments can also be synthesized by recombinant techniques. Methods for making antibodies are well known in the art.
The term “nucleic acid” includes DNA and RNA and can be either double-stranded or single-stranded.
The term “sequence identity” as used herein refers to the percentage of sequence identity between two polypeptide sequences or two nucleic acid sequences. To determine the percent identity of two amino acid sequences or of two nucleic acid sequences, the sequences are aligned for optimal comparison purposes (e.g., gaps can be introduced in the sequence of a first amino acid or nucleic acid sequence for optimal alignment with a second amino acid or nucleic acid sequence). The amino acid residues or nucleotides at corresponding amino acid positions or nucleotide positions are then compared. When a position in the first sequence is occupied by the same amino acid residue or nucleotide as the corresponding position in the second sequence, then the molecules are identical at that position. The percent identity between the two sequences is a function of the number of identical positions shared by the sequences (i.e., % identity=number of identical overlapping positions/total number of positions times). The determination of percent identity between two sequences can also be accomplished using a mathematical algorithm. A preferred, non-limiting example of a mathematical algorithm utilized for the comparison of two sequences is the algorithm of Karlin and Altschul, 1990, Proc Natl Acad Sci USA 87 2264-2268, modified as in Karlin and Altschul, 1993, Proc Natl Acad Sci USA 90 5873-5877. Such an algorithm is incorporated into the NBLAST and)(BLAST programs.
As used herein, “contemporaneous administration” and “administered contemporaneously” mean that two substances are administered to a subject such that they are both biologically active in the subject at the same time. The exact details of the administration will depend on the pharmacokinetics of the two substances in the presence of each other, and can include administering one substance within 24 hours of administration of the other, if the pharmacokinetics are suitable. In particular embodiments, two substances will be administered substantially simultaneously, i.e. within minutes of each other, or in a single composition that comprises both substances.
As used herein, the phrase “effective amount” or “therapeutically effective amount” means an amount effective, at dosages and for periods of time necessary to achieve the desired result. For example, in the context or treating a cancer, an effective amount is an amount that for example induces remission, reduces tumor burden, and/or prevents tumor spread or growth compared to the response obtained without administration of the oncolytic virus provided herein. Effective amounts may vary according to factors such as the disease state, age, sex, weight of the subject. The amount of an oncolytic virus herein that will correspond to such an amount will vary depending upon various factors, such as the pharmaceutical formulation, the route of administration, the type of cancer, the severity of the cancer, and the like, but can nevertheless be routinely determined by one skilled in the art.
The term “replication competent” refers to any viral vector that is not deficient in any gene function required for viral replication in specific cells or tissues. The vector must be capable of replicating and being packaged, but might replicate only conditionally in specific cells or tissues. Replication competent adenoviral vectors disclosed herein may be engineered to reduce or eliminate their ability to replicate in normal cells while retaining their ability to replicate efficiently in cancer cells.
The present disclosure provides an oncolytic virus comprising a nucleic acid encoding a granulocyte-macrophage colony-stimulating factor (GM-CSF) and a soluble form of the transforming growth factor-beta (TGF-B) receptor-II (sTGF-BRII). This oncolytic virus may be used for treating cancer, such as solid tumors as well as metastatic cancer, in part by providing GM-CSF and sTGF-BRII in the blood stream of a subject receiving the oncolytic virus. In addition, the oncolytic virus may inhibit tumor metastasis.
The oncolytic virus may be an adenovirus, herpes virus, lentivirus (e.g., an integration deficient lentivirus), vaccinia virus, Reo virus, maraba virus, New Castle disease virus, sendai virus, pox virus, poliovirus, myxoma virus, or retrovirus. In certain aspects, the oncolytic virus may be a replication-competent oncolytic virus.
In certain aspects, the oncolytic virus is a vaccinia virus, such as an orthopox virus, non-limiting examples of which include Western Reserve, Wyeth, and Copenhagen strains, optionally modified to increase cancer selectivity. Such modifications include, but are not limited to non-functional thymidine kinase gene, non-functional vaccinia growth factor gene, and non-functional type 1 interferon-binding gene.
In another aspect, the oncolytic virus is a herpes simplex virus (HSV), such as HSV1, HSV2 or HSV1716 strain. The HSV may include mutations that allow the virus to replicate in actively dividing cells, such as in cancer cells but which prevent significant replication in normal cells. Such mutations include disruption of the genes encoding ICP34.5 (i.e., γ34.5), ICP6 and thymidine kinase.
In certain aspects, the oncolytic virus may be an adenovirus. The adenovirus may be a replication-competent adenovirus that can replicate in a host cell, such as, a mammalian cancer cell. The adenovirus may be of any of the 57 human adenovirus serotypes (HAdV-1 to 57). In one embodiment, the adenovirus is a subgroup B, for example Ad3, Ad5, Ad7, Ad11, Ad14, Ad16, Ad21, Ad34 or Ad51. In some examples, the oncolytic adenovirus is a replication competent Ad5 serotype adenovirus or a hybrid serotype adenovirus comprising an Ad5 component. The adenovirus may be a wild-type strain or may be genetically modified to enhance tumor selectivity, for example by attenuating the ability of the virus to replicate within normal quiescent cells without affecting the ability of the virus to replicate in tumor cells or by increasing replication of the virus in cancer cells as compared to normal cells. Non-limiting examples of replication competent oncolytic adenoviruses that can be used to provide sTGF-BRII and GM-CSF expression in a subject, such as a human, include Delta-24, Delta-24-RGD, ICOVIR-5, ICOVIR-7, ONYX-015, ColoAd1, H101 and AD5/3. Onyx-015 is a hybrid of virus serotype Ad2 and Ad5 with deletions in the E1B-55K and E3B regions to enhance cancer selectivity. H101 is a modified version of Onyx-015. ICOVIR-5 and ICOVIR-7 comprise an Rb-binding site deletion of E1A and a replacement of the E1A promoter by an E2F promoter. ColoAd1 is a chimeric Add11p/Ad3 serotype. AD5/3 is a serotype 5/3 capsid-modified adenovirus (the Ad5 capsid protein knob is replaced with a knob domain from serotype 3). In some cases, the oncolytic adenovirus may be an adenoviral d101/07 mutant that can replicate in a variety of cancer cells regardless of their genetic defects. The d101/07 mutant adenovirus includes a mutant E1A protein in which amino acids from position 4-25 and 111-123 are deleted. The mutant E1A protein cannot bind with p300 or Rb proteins. Thus, d101/07 is ineffective for S-phase progression in normal cells and cannot replicate in normal cells. However, cancer cells are able to progress to S-phase, permitting virus replication in cancer cells. In other cases, the adenovirus may include a wild type E1A protein that binds with p300 or Rb proteins. The expression of the E1A gene may be placed under the control of human TERT promoter to provide for selective replication of the virus in human cancer cells. The recombinant adenovirus may include an active E1A gene and an inactivated E1B 19 gene, an inactivated E1B 55 gene, or an inactivated E1B 19/E1B 55 gene. As used herein the term “inactivation” in the context of a gene means that the transcription and/or translation of the gene is reduced or absent, and thus the function of the protein encoded by the gene is reduced or undetectable. For example, the inactivated E1B 19 gene is a gene that cannot produce an active E1B 19 kDa protein due to mutation (substitution, addition, partial deletion or total deletion) of the gene. When E1B 19 is deleted, cell apoptosis can be increased, and when the E1B 55 gene is deleted, tumor cell specificity can be increased. The term deletion, used in connection with the viral genome sequence in the present disclosure, means complete deletion or partial deletion of a gene. The adenovirus of the present disclosure may include an active E1A gene, an inactivated E1B 19/E1B 55 gene, and an inactivated E3 gene.
The cancer cell that is targeted by the disclosed oncolytic virus may be a breast cancer cell, skin cancer cell, lung cancer cell, renal cancer cell, ovarian cancer cell, prostate cancer cell, pancreatic cancer cell, brain cancer cell, astrocytoma cancer cell, hepatic cancer cell, lymphoma cancer cell, colon cancer cell, or bladder cancer cell. In certain embodiments, the cancer cell may be a human cancer cell. In particular embodiments, the breast cancer cell may be a triple negative breast cancer cell, the skin cancer cell may be a melanocyte.
The nucleic acid(s), encoding the sTGF-BRII and GM-CSF proteins, present in the oncolytic virus may be a DNA or RNA which may be single- or double-stranded depending upon the type of oncolytic virus. In certain aspects, the nucleic acid may be double-stranded DNA. In certain aspects, the nucleic acid(s) encoding the human sTGF-BRII and human GM-CSF may be a codon-optimized sequence(s), where the codons are codons from highly expressed human genes. The nucleic acids may be present in a single vector, such as a viral vector, that includes, at a minimum, a nucleic acid encoding sTGF-BRII, a nucleic acid encoding GM-CSF, and one or more promoters controlling expression of sTGF-BRII and GM-CSF, and 5′ and 3′ inverted terminal repeats (ITRs) flanking the promoter(s), the sTGF-BRII-encoding polynucleotide, and the GM-CSF-encoding polynucleotide. The vector may also include polynucleotides encoding proteins required for replication of the oncolytic virus. In certain embodiments, the viral vector only provides expression of the two therapeutic proteins, sTGF-BRII and GM-CSF, while in other embodiments, the viral vector can include additional nucleic acids encoding other therapeutic proteins or polynucleotides, such as RNA.
Nucleic acids encoding sTGF-BRII and GM-CSF can be inserted, e.g., at any nonessential location in the oncolytic virus genome so long as the oncolytic virus remains replication-competent. In one embodiment, the oncolytic virus is an adenovirus with a heterologous nucleic acid comprising a sequence encoding sTGF-BRII inserted downstream of a heterologous promoter. In another embodiment, a heterologous nucleic acid comprising a sequence encoding GM-CSF is inserted in the E3 region of a replication-competent adenovirus backbone. The E3 region is nonessential for viral replication; however, the E3 proteins play a role in regulating host immune response. The replication-competent adenovirus can comprise a full or partial E3 deletion. For example, the replication-competent adenovirus can comprise deletions of one, two, three or more open reading frames (ORFs) in the E3 region, with the heterologous nucleic acid encoding GM-CSF inserted in its place. In one embodiment, the gpl9k and 6.7K genes are deleted and the heterologous nucleic acid encoding GM-CSF is inserted into a gpl9k/6.7K-deleted E3 region. In related aspects, the full E3 region is deleted from the replication-competent adenovirus backbone and the heterologous nucleic acid GM-CSF is inserted in place of the full E3 region.
The recombinant adenovirus of the present disclosure includes a promoter functional in animal cells, e.g., mammalian cells, such as, human cells. Suitable promoters include promoters derived from mammalian virus and promoters derived from the genome of mammalian cells, such as CMV (Cytomegalovirus) promoter, a chicken beta actin promoter, human β-actin/CMV hybrid promoter, chicken β-actin/CMV hybrid promoter, CMV-actin-globin (CAG) hybrid promoter, Math Promoter, VGLUT3 promoter, parvalbumin promoter, calretinin promoter, calbindin 28k promoter, prestin promoter, a liver-specific or liver-preferential promoter, e.g., albumin promoter, U6 promoter, H1 promoter, MLV (Murine Leukemia Virus) LTR (Long terminal repeat) promoter, adenovirus early promoter, adenovirus late promoter, vaccinia virus 7.5K promoter, SV40 promoter, HSV tk promoter, RSV promoter, EF1 alpha promoter, metallothionine promoter, beta-actin promoter, human IL-2 promoter of gene, promoter of human IFN gene, promoter of human IL-4 gene, promoter of human lymphotoxin gene, promoter of human GM-CSF gene, inducible promoter, cancer cell-specific promoter (e.g., TERT promoter, modified TERT Promoter, PSA promoter, PSMA promoter, CEA promoter, Survivin promoter, E2F promoter, modified E2F promoter, AFP promoter, modified AFP promoter, E2F-AFP hybrid promoter, and E2F-TERT hybrid promoter) and tissue-specific promoters (e.g., albumin promoter), human phosphoglycerate kinase (PGK) promoter, mouse phosphoglycerate kinase (PGK) promoter, etc. In certain aspects, two different promoters for controlling expression of GM-CSF and sTGF-B-RII are used. For example, a CMV promoter may be used to drive sTGF-B-RII expression and a E1B promoter may drive expression of GM-CSF. A polyadenylation sequence may be linked downstream of a nucleic acid encoding GM-CSF and/or sTGF-B-RII. The polyadenylation sequence may be a bovine growth hormone terminator, a polyadenylation sequence derived from SV40, HIV-1 polyA, f3-globin polyA, HSV TK polyA, or polyomavirus polyA, etc.
In certain instances, the recombinant vector may be an Ad5 vector or Ad2 vector. Adenovirus produced using Ad5 vector can transduce cell expressing Coxsackie-Adenovirus Receptor (CAR). Ad5 vector may include Ad5 ITRs. The absence or the presence of low levels of the coxsackievirus and adenovirus receptor (CAR) on several tumor types can limit the efficacy of the oncolytic adenovirus. Various peptide motifs may be added to the fiber knob, for instance an RGD motif (RGD sequences mimic the normal ligands of cell surface integrins), Tat motif, polylysine motif, NGR motif, CTT motif, CNGRL motif, CPRECES motif or a strept-tag motif. A motif can be inserted into the H1 loop of the adenovirus fiber protein. Modifying the capsid allows CAR-independent target cell infection. Specific receptors found exclusively or preferentially on the surface of cancer cells may be used as a target for adenoviral binding and infection, such as EGFRvIII.
In certain aspects, one or both of sTGF-BRII and GM-CSF may be a fusion protein where a heterologous protein is fused to the amino acid sequence of sTGF-BRII and/or GM-CSF at either the N-terminus or the C-terminus. For example, sTGF-BRII and/or GM-CSF may be fused to a heterologous protein that increases its serum half-life and/or increases solubility. Such heterologous proteins that increase serum half-life include the Fc region of immunoglobulins, e.g., human IgG1, human serum albumin, etc. Fusion to maltose binding protein may be used to increase solubility of sTGF-BRII and/or GM-CSF. In other examples, only sTGF-BRII may be expressed as a fusion protein, where the heterologous protein comprises a half-life-extending moiety. The half-life-extending moiety may be a Fc region of a human IgG1. As used herein, Fc region refers to the Fc region found in immunoglobulins and variants thereof. Variants can include sequences that have deletions, insertions, or substitutions or other modifications, such as modified glycosylation that retain the half-life-extending effect associated with the naturally occurring Fc region of an immunoglobulin.
The sTGF-BRII protein may be encoded by a nucleic acid comprising a polynucleotide sequence from any source, e.g., a cDNA or a synthetic sequence. The sTGF-BRII protein may include only the extracellular region of the TGF-BRII such that the receptor is secreted from cells expressing the receptor. The sTGF-BRII binds to the ligands for TGF-BRII but do not activate TGF-B signaling, thus decreasing TGF-B signaling. In certain aspects, the subject to whom the oncolytic virus is administered is a mammal and the polynucleotide sequence encoding sTGF-BRII protein is the TGF-BRII cDNA sequence from the mammal. In certain aspects, the subject may be human and the sTGF-BRII may be a human sTGF-BRII. The human sTGF-BRII may have an amino acid sequence that is at least 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% or a 100% identical to the amino acid sequence set forth in SEQ ID NO:1. In some instances, the human sTGF-BRII may include amino acid differences from SEQ ID NO:1, such as deletions, insertions, or substitutions. The amino acid differences may be such that they do not significantly affect binding to TGF-BRII ligands, such as, TGF-B1, TGF-B2, and/or TGF-B3. The sequence of SEQ ID NO:1 is as follows:
The nucleic acid encoding GM-CSF may be from any source and may encode a functionally active variant (e.g., fragment or mutant) of GM-CSF. In certain examples, the GM-CSF is secreted from cells infected with the oncolytic virus. In certain aspects, the subject to whom the oncolytic virus is administered is a mammal and the GM-CSF protein sequence matches (e.g. is identical to) the GM-CSF protein sequence from the mammal. In certain aspects, the subject may be a human and the GM-CSF may be a human GM-CSF. The human GM-CSF may have an amino acid sequence that is at least 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% or a 100% identical to the amino acid sequence set forth in SEQ ID NO:2. In some instances, the human GM-CSF may include amino acid differences from SEQ ID NO:2, such as deletions, insertions, or substitutions. The amino acid differences may be such that they do not significantly affect GM-CSF activity.
In certain aspects, the Fc region fused to the N-terminus and/or the C-terminus of GM-CSF or sTGF-BRII may include an amino acid sequence at least 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% or a 100% identical to the amino acid sequence set forth in SEQ ID NO:3. In some instances, the Fc region may include amino acid differences from SEQ ID NO:3, such as deletions, insertions, or substitutions. The amino acid differences may be such that they do not significantly affect the half-life-extending property of the Fc region. The sequence of SEQ ID NO:3 is as follows:
In certain instances, the oncolytic virus comprises a nucleic acid encoding a human GM-CSF and a sTGF-BRIIFc. sTGF-BRIIFc may have an amino acid sequence at least 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% or a 100% identical to the amino acid sequence set forth in SEQ ID NO:6.
Compositions Comprising Subject Oncolytic Virus
Also provided herein are compositions, such as pharmaceutical compositions comprising a therapeutically effective amount of the oncolytic virus disclosed herein and a pharmaceutically acceptable excipient, diluent, or carrier.
The compositions of the invention may comprise an oncolytic virus alone, or in combination with one or more other viruses (e.g., a second oncolytic virus comprising a nucleic acid encoding one or more different therapeutic genes). In some embodiments, a composition comprises 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or more different oncolytic viruses, each having one or more different therapeutic genes. In certain aspects, the composition may include an additional therapeutic agent for treatment of cancer.
Suitable carriers may be readily selected by one of skill in the art in view of the type of cancer for which the oncolytic virus is administered. For example, one suitable carrier includes saline, which may be formulated with a variety of buffering solutions (e.g., phosphate-buffered saline). Other exemplary carriers include sterile saline, lactose, sucrose, calcium phosphate, gelatin, dextran, agar, pectin, peanut oil, sesame oil, and water. Optionally, the compositions of the present disclosure may contain, in addition to the virus and carrier(s), other conventional pharmaceutical ingredients, such as preservatives, or chemical stabilizers. Suitable exemplary preservatives include chlorobutanol, potassium sorbate, sorbic acid, sulfur dioxide, propyl gallate, the parabens, ethyl vanillin, glycerin, phenol, and parachlorophenol. Suitable chemical stabilizers include gelatin and albumin.
In some embodiments, the oncolytic virus compositions are formulated to reduce aggregation of viral particles in the composition, particularly where high virus concentrations are present (e.g., about 1013 genome copies “GC”/ml or more). Methods for reducing aggregation of viral particles are well known in the art and include, for example, addition of surfactants, pH adjustment, and salt concentration adjustment.
Formulation of pharmaceutically acceptable excipients and carrier solutions is well-known to those of skill in the art, as is the development of suitable dosing and treatment regimens for using the particular compositions described herein in a variety of treatment regimens.
Typically, these formulations may contain at least about 0.1% of the oncolytic virus or more, although the percentage of the oncolytic virus may, of course, be varied and may conveniently be between about 1 about 80% (e.g., between about 2-70%) or more of the weight or volume of the total formulation. Naturally, the amount of oncolytic virus in each therapeutically useful composition may be prepared is such a way that a suitable dosage will be obtained in any given unit dose of the oncolytic virus. Factors such as solubility, bioavailability, biological half-life, route of administration, product shelf life, as well as other pharmacological considerations will be contemplated by one skilled in the art of preparing such pharmaceutical formulations, and as such, a variety of dosages and treatment regimens may be desirable.
The pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. Dispersions may also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof and in oils. Under ordinary conditions of storage and use, these preparations contain a preservative to prevent the growth of microorganisms. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (e.g., glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and/or vegetable oils. Proper fluidity may be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride.
For administration of an injectable aqueous solution, for example, the solution may be suitably buffered, if necessary, and the liquid diluent first rendered isotonic with sufficient saline or glucose. These particular aqueous solutions are especially suitable for intravenous, intramuscular, subcutaneous and intraperitoneal administration. In this connection, a sterile aqueous medium that can be employed will be known to those of skill in the art. For example, one dosage may be dissolved in 1 ml of isotonic NaCl solution and either added to 1000 ml of hypodermoclysis fluid or injected at the proposed site of infusion. Some variation in dosage will necessarily occur depending on the condition of the recipient.
Sterile injectable solutions are prepared by incorporating the active virions in the required amount in the appropriate solvent with various of the other ingredients enumerated herein, as required, followed by filtered sterilization. The viral compositions disclosed herein may also be formulated in a neutral or salt form. Pharmaceutically acceptable salts include the acid addition salts (formed with the free amino groups of the protein), which are formed with inorganic acids such as, for example, hydrochloric or phosphoric acids, or such organic acids as acetic, oxalic, tartaric, mandelic, and the like. Salts formed with the free carboxyl groups can also be derived from inorganic bases such as, for example, sodium, potassium, ammonium, calcium, or ferric hydroxides, and such organic bases as isopropylamine, trimethylamine, histidine, procaine and the like. Upon formulation, solutions will be administered in a manner compatible with the dosage formulation and in such amount as is therapeutically effective. The formulations are easily administered in a variety of dosage forms, such as injectable solutions, drug-release capsules, and the like.
Delivery vehicles such as liposomes, nanocapsules, microparticles, microspheres, lipid particles, vesicles, and the like, may be used for the introduction of the compositions of the present invention into target cells.
Treatment methods comprise administering to a subject having cancer a therapeutically effective amount of the oncolytic virus described in the present application. The administering may include a single administration, or alternatively comprises a series of administrations. For example, the oncolytic virus described herein may be administered at least once daily, once weekly, or once monthly over a period of two or more months. As another example, the oncolytic virus is administered once every 2, 3, or 4 weeks for 4 cycles. The length of the treatment period depends on a variety of factors, such as the severity of the disease, the age of the patient, the concentration, the activity of the oncolytic virus described herein, and/or a combination thereof. It will also be appreciated that the effective dosage used for the treatment or prophylaxis may increase or decrease over the course of a particular treatment or prophylaxis regimen. Changes in dosage may result and become apparent by standard diagnostic assays known in the art. In some instances, chronic administration may be required. In addition, the treatment regimen may change when another cancer therapy is administered.
The dosage administered will vary depending on the use and known factors such as the pharmacodynamic characteristics of the particular substance, and its mode and route of administration, age, health, and weight of the individual recipient, nature and extent of symptoms, kind of concurrent treatment, frequency of treatment, and the effect desired. Dosage regimen may be adjusted to provide the optimum therapeutic response.
A “therapeutically effective amount” will fall in a relatively broad range that can be determined through experimentation and/or clinical trials. For example, a therapeutically effective dose can be on the order of from about 106 to about 1015 of the virus particles, e.g., from about 108 to 1012 viral genomes (vg), from about 106 vg to about 1015 vg of the oncolytic virus, e.g., from about 108 vg to 1012 vg. Other effective dosages can be readily established by one of ordinary skill in the art through routine trials establishing dose-response curves. In some embodiments, more than one administration (e.g., two, three, four or more administrations) may be employed to achieve the desired level of gene expression. In some cases, the more than one administration is administered at various intervals, e.g., daily, weekly, twice monthly, monthly, every 3 months, every 6 months, yearly, etc. In some cases, multiple administrations are administered over a period of time from 1 month to 2 months, from 2 months to 4 months, from 4 months to 8 months, from 8 months to 12 months, from 1 year to 2 years, from 2 years to 5 years, or more than 5 years.
In certain aspects, the oncolytic virus provided herein may be administered sequentially or contemporaneously with at least one other anti-cancer therapy. The anti-cancer therapy may be an immunotherapy, a chemotherapy, a surgical treatment, a radiation therapy, a hormone therapy, an anti-cancer small molecule, a growth factor inhibitor therapy, or a cytokine therapy.
The type of cancer that can be treated in a subject by administering the oncolytic virus of the present disclosure may be a primary cancer or a metastasized tumor. In certain embodiment, the cancer is breast cancer (e.g., triple negative breast cancer), skin cancer (e.g., melanoma), head or neck cancer, astrocytoma, hepatic cancer, lymphoma (e.g., lymphocytic lymphoma, primary central nervous system lymphoma, or pediatric lymphoma), colon cancer, gastric cancer, lung cancer, non-small cell lung cancer, ovarian cancer, liver cancer, bronchial cancer, nasopharyngeal cancer, laryngeal cancer, pancreatic cancer, bladder cancer, cervical cancer, bone cancer, non-small cell cancer, bone cancer, blood cancer, uterine cancer, rectal cancer, cancer near the anus, fallopian tube cancer, endometrial cancer, vaginal cancer, vulvar cancer, Hodgkin's disease, esophageal cancer, small intestine cancer, endocrine adenocarcinoma, Thyroid cancer, parathyroid cancer, adrenal cancer, soft tissue sarcoma, urethral cancer, penile cancer, prostate cancer, chronic or acute leukemia, renal or ureteral cancer, renal cell carcinoma, renal pelvic carcinoma, salivary gland cancer, sarcoma cancer, pseudomyxoma, hepatoblastoma, testicular cancer, glioblastoma, cleft lip cancer, ovarian germ cell tumor, basal cell carcinoma, multiple myeloma, gallbladder cancer, choroidal melanoma, barter bulge cancer, peritoneal cancer, tongue cancer, small cell carcinoma, neuroblastoma, duodenal cancer, ureter cancer, meningioma, renal pelvis cancer, vulvar cancer, thymic cancer, central nervous system (CNS) tumor, spinal cord tumor, brain stem glioma, and pituitary adenoma. The cancer may be a recurrent cancer.
Recombinant Oncolytic Virus Administration Methods
The oncolytic virus provided herein may be delivered to a subject according to any appropriate methods known in the art. The virus, may be suspended in a physiologically compatible carrier or a pharmaceutically acceptable excipient or diluent (i.e., in a composition), may be administered to a subject, such as, for example, a human, mouse, rat, cat, dog, sheep, rabbit, horse, cow, goat, pig, guinea pig, hamster, chicken, turkey, or a non-human primate (e.g., Macaque).
The virus is administered in sufficient amounts to transfect the target cells, e.g., solid tumor cells, and to provide sufficient levels of gene transfer and expression without undue off-target effects. Conventional and pharmaceutically acceptable routes of administration include, but are not limited to, intravenous, direct delivery (e.g., by injection) into a tumor, direct delivery to the selected organ (e.g., intraportal or intrahepatic delivery to the liver, delivery to brain via a cannula), oral, inhalation (including intranasal and intratracheal delivery), intraocular, intramuscular, subcutaneous, intradermal, intrathecal, and other parenteral routes of administration. In certain aspects the administration may be into the brain, e.g., intraparenchymal, intracerebroventricular, intra cisterna magna or subpial. Routes of administration may be combined, if desired.
Moreover, in certain instances, it may be desirable to deliver the virions to the CNS of a subject. By “CNS” is meant all cells and tissue of the brain and spinal cord of a vertebrate. Thus, the term includes, but is not limited to, neuronal cells, glial cells, astrocytes, cerebrospinal fluid (CSF), interstitial spaces, bone, cartilage and the like. Recombinant oncolytic virus may be delivered directly to the CNS or brain by injection into, e.g., the ventricular region, as well as to the striatum (e.g., the caudate nucleus or putamen of the striatum), spinal cord and neuromuscular junction, or cerebellar lobule, with a needle, catheter or related device, using neurosurgical techniques known in the art, such as by stereotactic injection.
In a further aspect, the present invention provides a virion of the present invention or a pharmaceutical composition of the present invention for use as a medicament.
In a further aspect, the present invention provides an oncolytic virus of the present invention or a pharmaceutical composition of the present invention for use in a method of treating cancer in a subject in need thereof.
The dose of an oncolytic virus required to achieve a particular “therapeutic effect,” e.g., the units of dose in genome copies/per kilogram of body weight (GC/kg), will vary based on several factors including, but not limited to: the route of administration, the level of gene expression required to achieve a therapeutic effect, the type of cancer being treated, and the like.
An effective amount of an oncolytic virus is an amount sufficient to infect a desired number of cancer cells. The effective amount will depend primarily on factors such as the species, age, weight, health of the subject, and the size/location of the tumor, and may thus vary among animal and tissue. For example, an effective amount of an oncolytic virus is generally in the range of from about 1 ml to about 100 ml of solution containing from about 109 to 1016 genome copies. In some cases, a dosage between about 1011 to 1012 genome copies is appropriate. In certain embodiments, 1012 viral genome copies is effective to target brain, liver, and pancreatic tissues. In certain embodiments, the dosage of the oncolytic virus is 1010, 1011, 1012, 1013, or 1014 genome copies per kg. In certain embodiments, the dosage of the oncolytic virus is 1010, 1011, 1012, 1013, 1014, or 1015 genome copies per subject.
In certain aspects, a therapeutically effective dose of an oncolytic virus of the present disclosure provides a level and/or activity of GM-CSF in the subject that is at least 10% higher than the normal GM-CSF level and/or activity, respectively (e.g., at least 20%, at least 30%, at least 40%, at least 45%, at least 50%, or higher than the normal GM-CSF level). The GM-CSF level and/or activity may be determined using a blood sample or part thereof, e.g., serum or plasma from a subject who has been administered the virus. In certain aspects, a therapeutically effective dose of an oncolytic virus of the present disclosure provides a reduction in TGF-B activity that is at least 10% less (e.g., at least 20%, at least 30%, at least 40%, at least 45%, at least 50%, or even lower than the normal TGF-B activity). The TGF-B activity may be determined using a blood sample or part thereof, e.g., serum or plasma from a subject who has been administered the virus.
Combination Therapy
In certain aspects, the treatment of a subject having cancer with an oncolytic virus comprising a nucleic acid encoding a sTGF-BRII and a GM-CSF as disclosed herein may or may not involve another anti-cancer therapy, such as, an immunotherapy, a chemotherapy, a surgical treatment, a radiation therapy, a hormone therapy, an anti-cancer small molecule, a growth factor inhibitor therapy, CAR-T therapy, or a cytokine therapy.
In some instances, a subject may be treated systemically, including with the subject oncolytic virus, with or without one or more additional reagents. By “systemic treatment”, as used herein, is meant a treatment that is not directed solely to target a specific tumor (such as, e.g., a primary tumor or a defined secondary tumor) or a specific cancer containing tissue (such as, e.g., the liver in the case of liver cancer, the blood in the case of a blood cancer). Systemic treatments will generally be directed to the subject's body as a whole and may include, but are not limited to, e.g., systemic radiation therapy, systemic chemotherapy, systemic immunotherapy, combinations thereof and the like.
In some instances, a subject may be treated locally, including with the subject oncolytic virus, with or without one or more additional reagents. By “local treatment”, as used herein, is meant a treatment that is specifically directed to the location of a tumor (such as, e.g., a primary tumor or a defined secondary tumor) or specifically directed to a cancer containing tissue (such as, e.g., the liver in the case of liver cancer, the blood in the case of a blood cancer). In some instances, local treatment may also be administered in such a way as to affect the environment surrounding a tumor, such as tissue surrounding the tumor, such as tissue immediately adjacent to the tumor. Local treatment will generally not affect or not be targeted to tissues distant from the site of cancer including the site of a tumor, such as a primary tumor. Useful local treatments that may be administered in addition to, or in combination with, a subject oncolytic virus, e.g., include but are not limited to surgery, local radiation therapy, local cryotherapy, local laser therapy, local topical therapy, combinations thereof, and the like.
Radiation therapy includes, but is not limited to, x-rays or gamma rays that are delivered from either an externally applied source such as a beam, or by implantation of small radioactive sources.
Suitable antibodies for use in cancer treatment include, but are not limited to, naked antibodies, e.g., trastuzumab (Herceptin), bevacizumab (Avastin™), cetuximab (Erbitux™), panitumumab (Vectibix™), Ipilimumab (Yervoy™), rituximab (Rituxan), alemtuzumab (Lemtrada™), Ofatumumab (Arzerra™), Oregovomab (OvaRex™) Lambrolizumab (MK-3475), pertuzumab (Perjeta™), ranibizumab (Lucentis™), etc., and conjugated antibodies, e.g., gemtuzumab ozogamicin (Mylortarg™), Brentuximab vedotin (Adcetris™), 90Y-labelled ibritumomab tiuxetan (Zevalin™), 131I-labelled tositumoma (Bexxar™), etc.
Suitable antibodies for use in cancer treatment also include, but are not limited to, antibodies raised against tumor-associated antigens. Such antigens include, but are not limited to, CD20, CD30, CD33, CD52, EpCAM, CEA, gpA33, Mucins, TAG-72, CAIX, PSMA, Folate-binding protein, Gangliosides (e.g., GD2, GD3, GM2), Ley, VEGF, VEGFR, Integrin alpha-V-beta-3, Integrin alpha-5-beta-1, EGFR, ERBB2, ERBB3, MET, IGF1R, EPHA3, TRAILR1, TRAILR2, RANKL, FAP, Tenascin, Programmed Death-Ligand 1 (PD-L1), androgen receptor (AR), Bruton's Tyrosine Kinase (BTK), BCR-Abl, c-kit, PIK3CA, EML4-ALK, KRAS, ALK, ROS1, AKT1, BRAF, MEKJ, MEK2, NRAS, RAC1, ESR1, etc.
Biological response modifiers suitable for use in connection with the methods of the present disclosure include, but are not limited to, (1) inhibitors of tyrosine kinase (RTK) activity; (2) inhibitors of serine/threonine kinase activity; (3) tumor-associated antigen antagonists, such as antibodies that bind specifically to a tumor antigen; (4) apoptosis receptor agonists; (5) interleukin-2; (6) interferon-α; (7) interferon-γ; (8) inhibitors of angiogenesis; and (9) antagonists of tumor necrosis factor.
Chemotherapeutic agents or antineoplastic agents are non-peptidic (i.e., non-proteinaceous) compounds that reduce proliferation of cancer cells and/or kill cancer cells, and encompass cytotoxic agents and cytostatic agents. Non-limiting examples of chemotherapeutic agents include alkylating agents (e.g., nitrosoureas), antimetabolites (e.g., methotrexate), antitumor antibiotics (e.g., anthracyclins), plant alkaloids (e.g., vinca alkaloids, taxanes), toposiomerase inhibitors, and steroid hormones.
Agents that act to reduce cellular proliferation are known in the art and widely used. Such agents include alkylating agents, such as nitrogen mustards, nitrosoureas, ethylenimine derivatives, alkyl sulfonates, and triazenes, including, but not limited to, mechlorethamine, cyclophosphamide (Cytoxan™), melphalan (L-sarcolysin), carmustine (BCNU), lomustine (CCNU), semustine (methyl-CCNU), streptozocin, chlorozotocin, uracil mustard, chlormethine, ifosfamide, chlorambucil, pipobroman, triethylenemelamine, triethylenethiophosphoramine, busulfan, dacarbazine, and temozolomide.
Antimetabolite agents include folic acid analogs, pyrimidine analogs, purine analogs, and adenosine deaminase inhibitors, including, but not limited to, cytarabine (CYTOSAR-U), cytosine arabinoside, fluorouracil (5-FU), floxuridine (FudR), 6-thioguanine, 6-mercaptopurine (6-MP), pentostatin, 5-fluorouracil (5-FU), methotrexate, 10-propargyl-5,8-dideazafolate (PDDF, CB3717), 5,8-dideazatetrahydrofolic acid (DDATHF), leucovorin, fludarabine phosphate, pentostatine, and gemcitabine.
Hormone modulators and steroids (including synthetic analogs) that are suitable for use include, but are not limited to, adrenocorticosteroids, e.g., prednisone, dexamethasone; estrogens and pregestins, e.g., hydroxyprogesterone caproate, medroxyprogesterone acetate, megestrol acetate, estradiol, clomiphene, tamoxifen, and adrenocortical suppressants, e.g., aminoglutethimide; 17α-ethinylestradiol; diethylstilbestrol, testosterone, fluoxymesterone, dromostanolone propionate, testolactone, methylprednisolone, methyl-testosterone, prednisolone, triamcinolone, chlorotrianisene, hydroxyprogesterone, aminoglutethimide, estramustine, medroxyprogesterone acetate, leuprolide, Flutamide (Drogenil), Toremifene (Fareston), and Zoladex. Estrogens stimulate proliferation and differentiation, therefore compounds that bind to the estrogen receptor are used to block this activity. Corticosteroids may inhibit T cell proliferation.
Immune checkpoint inhibitor suitable for use include a PD-1 (programmed cell death-1) antagonist, a PD-L1 (programmed cell death-ligand 1) antagonist, a PD-L2 (programmed cell death-ligand 2) antagonist, a CD27 (cluster of differentiation 27) antagonist, CD28 (cluster of differentiation 28) antagonist, CD70 (cluster of differentiation 70) antagonist, CD80 (cluster of differentiation 80, also known as B7-1) antagonist, CD86 (cluster of differentiation 86, also known as B7-2) antagonist, CD137 (cluster of differentiation 137) antagonist, CD276 (cluster of differentiation 276) antagonist, KIRs (killer-cell immunoglobulin-like receptors) antagonist, LAG3 (lymphocyte-activation gene 3) antagonist, TNFRSF4 (tumor necrosis factor receptor superfamily, member 4, also known as CD134) antagonist, GITR (glucocorticoid-induced TNFR-related protein) antagonist, GITRL (glucocorticoid-induced TNFR-related protein ligand) antagonist, 4-1BBL (4-1BB ligand) antagonist, CTLA-4 (cytolytic T lymphocyte associated antign-4) antagonist, A2AR (Adenosine A2A receptor) antagonist, VTCN1 (V-set domain-containing T-cell activation inhibitor 1) antagonist, BTLA (B- and T-lymphocyte attenuator) antagonist, IDO (Indoleamine 2,3-dioxygenase) antagonist, TIM-3 (T-cell Immunoglobulin domain and Mucin domain 3) antagonist, VISTA (V-domain Ig suppressor of T cell activation) antagonist, KLRA (killer cell lectin-like receptor subfamily A) antagonists, and the like.
The immune checkpoint inhibitor may be an antibody. Examples of antibodies to checkpoint inhibitor molecules include Nivolumab (BMS-936558, MDX-1 106, ONO-4538), a fully human Immunoglobulin G4 (IgG4) monoclonal PD-1 antibody; Lambrolizumab (MK-3475), a humanized monoclonal IgG4 PD-1 antibody, BMS-936559, a fully human IgG4 PD-L1 antibody, LAG-3 antagonistic antibodies such as relatlimab (BMS-986016; Bristol-Myers Squibb), IMP701 (Immutep), TSR-033 (anti-LAG-3 mAb; TESARO, Inc.).
In certain aspects, a subject suitable for treatment using a method of the present disclosure include an individual having a cancer; an individual diagnosed as having a cancer; an individual being treated for a cancer with chemotherapy, radiation therapy, antibody therapy, surgery, etc.; an individual who has been treated for a cancer (e.g., with one or more of chemotherapy, radiation therapy, antibody therapy, surgery), and who has failed to respond to the treatment; an individual who has been treated for a cancer (e.g., with one or more of chemotherapy, radiation therapy, antibody therapy, surgery), and who initially responded to the treatment but who subsequently relapsed, i.e., the cancer recurred.
The methods of the present disclosure may be employed to target and treat a variety of cancers, including, e.g., primary cancer, secondary cancers, re-growing cancers, recurrent cancers, refractory cancers and the like. For example, in some instances, the methods of the present disclosure may be employed as an initial treatment of a primary cancer identified in a subject. In some instances, the methods of the present disclosure may be employed as a non-primary (e.g., secondary or later) treatment, e.g., in a subject with a cancer that is refractory to a prior treatment, in a subject with a cancer that is re-growing following a prior treatment, in a subject with a mixed response to a prior treatment (e.g., a positive response to at least one tumor in the subject and a negative or neutral response to at least a second tumor in the subject), and the like.
The methods of treating described herein may, in some instances, be performed in a subject that has previously undergone one or more conventional treatments. For example, the methods described herein may, in some instances, be performed following a conventional cancer therapy including, but not limited to, e.g., conventional chemotherapy, conventional radiation therapy, conventional immunotherapy, or surgery. In some instances, the methods described herein may be used when a subject has not responded to, or is refractory to, a conventional therapy. In some instances, the methods described herein may be used when a subject has responded to a conventional therapy.
Two, three, or more of the treatments described herein may be combined in any order for treating cancer in a subject, which treatments may be administered simultaneously or contemporaneously. Such treatments include a dual-therapy and a triple-therapy.
Aspects of the present disclosure also include kits. The kits may include, e.g., any combination of the oncolytic virus, reagents, compositions, formulations, cells, nucleic acids, viral vectors, or the like, described herein. A subject kit can include one or more of: an oncolytic virus, an oncolytic viral vector, a cell line for producing the oncolytic virus. Kits may be configured for various purposes, including, e.g., treatment kits (e.g., where a kit may include a dose of an oncolytic virus), kits for the oncolytic virus, kits comprising antibodies for detecting expression of GM-CSF and/or sTGF-BRII, and the like.
Optional components of the kit will vary and may include, e.g., a buffer; or a bacterial growth inhibitor. Where a subject kit comprises a subject nucleic acid, the nucleic acid may also have restriction sites, multiple cloning sites, primer sites, etc. and the kit may include restriction enzymes, primers, etc.
The various components of the kit may be present in separate containers or certain compatible components may be pre-combined into a single container, as desired.
In addition to the above-mentioned components, a subject kit can include instructions for using the components of the kit to practice a subject method. The instructions for practicing a subject method are generally recorded on a suitable recording medium. For example, the instructions may be printed on a substrate, such as paper or plastic, etc. As such, the instructions may be present in the kits as a package insert, in the labeling of the container of the kit or components thereof (i.e., associated with the packaging or subpackaging) etc. In other embodiments, the instructions are present as an electronic storage data file present on a suitable computer-readable storage medium, e.g., compact disc-read only memory (CD-ROM), digital versatile disk (DVD), diskette, etc. In yet other embodiments, the actual instructions are not present in the kit, but means for obtaining the instructions from a remote source, e.g., via the internet, are provided. An example of this embodiment is a kit that includes a web address where the instructions can be viewed and/or from which the instructions can be downloaded. As with the instructions, this means for obtaining the instructions is recorded on a suitable substrate.
Aspects, including embodiments, of the present subject matter described above may be beneficial alone or in combination with one or more other aspects or embodiments. Without limiting the foregoing description, certain non-limiting aspects of the disclosure are provided below. As will be apparent to those of ordinary skill in the art upon reading this disclosure, each of the individually numbered aspects may be used or combined with any of the preceding or following individually numbered aspects. This is intended to provide support for all such combinations of aspects and is not limited to combinations of aspects explicitly provided below. It will be apparent to one of ordinary skill in the art that various changes and modifications can be made without departing from the spirit or scope of the invention.
Such aspects may include:
As can be appreciated from the disclosure provided above, the present disclosure has a wide variety of applications. Accordingly, the following examples are put forth so as to provide those of ordinary skill in the art with a complete disclosure and description of how to make and use the present invention, and are not intended to limit the scope of what the inventors regard as their invention nor are they intended to represent that the experiments below are all or the only experiments performed. Those of skill in the art will readily recognize a variety of noncritical parameters that could be changed or modified to yield essentially similar results. Thus, the following examples are put forth so as to provide those of ordinary skill in the art with a complete disclosure and description of how to make and use the present invention, and are not intended to limit the scope of what the inventors regard as their invention nor are they intended to represent that the experiments below are all or the only experiments performed. Efforts have been made to ensure accuracy with respect to numbers used (e.g., amounts, dimensions) but some experimental errors and deviations should be accounted for.
Methods. To establish a mouse mammary tumor syngeneic mouse model, 2×106 4T1 cells per mouse were injected subcutaneously (day 0) into the dorsal right flank of female BALB/c mice (4-6 weeks old). Mice were monitored every day. On day 6, tumor dimensions were measured (in mm) using a caliper. Then, tumor-bearing mice were divided into seven groups without statistical differences between each group. The adenoviral vectors diagrammed in
The tumor volumes were monitored on various days shown in
Results. The results indicated that while the tumors treated with buffer grew over time, the intratumoral injection of all the adenoviruses inhibited tumor growth. Among the adenoviruses tested, rAd.sT.GM produced the strongest inhibition of the tumor growth. (
On day 25, mice were euthanized, and tumors were removed and weighed. Again, among all the treatment groups, rAd.sT.GM was most effective in reducing the tumor weights (
These results show that the direct injection of rAd.sT.GM virus into mammary tumors produces strong inhibition of tumor growth.
rAd.LIGHT adenovirus results in expression of LIGHT (also known as tumor-necrosis factor (TNF) superfamily member 14 (TNFSF14)). rAd.LIGHT adenovirus inhibits tumor growth via activation of anti-tumor immune responses (Dai et al., Cancer Gene Therapy 27, 923-933 (2020)). rAd.LIGHT reduced 4T1 mouse mammary tumor growth and tumor weight. However, the adenovirus expressing both LIGHT and sTGFbRIIFc, i.e., rAd.sT.LIGHT, was less effective in inhibiting tumor growth and volume compared to rAd. LIGHT and rAd.sT alone. This result shows the unpredictability of effect of combining two molecules, LIGHT and sTGFbRIIFc, that are each individually effective in treating cancer. This unpredictability makes the discovery of the combined synergistic effect of sTGFbRIIFc with GM-CSF for treating cancers even more important, since it provides for a significant improvement in treatment of cancer.
Cell lines and adenoviruses. The mouse mammary tumor cell line, 4T1, was purchased from ATCC. 4T1 cells were cultured in Eagle's Minimal Essential Medium (EMEM) plus 10% fetal calf serum (FCS). Human embryonic kidney cells, HEK293 (ATCC) were cultured in Dulbecco's Minimal Essential Medium (DMEM) supplement with 10% FCS. All adenoviruses were grown in HEK293 cells and purified by double cesium chloride gradients.
Animal studies. All procedures for animal experiments were approved by the Institutional Animal Care and Use Committee (IACUC) at NorthShore University Health System.
Statistical analysis. Data are presented as mean±s.e.m. All statistical analyses were performed using GraphPad Prism software version 5 (GraphPad software, San Diego, CA, USA). Longitudinal data were analyzed by using a two-way repeated measure ANOVA followed by Bonferroni post hoc tests for the tumor growth data obtained over-time. One-way ANOVA followed by Bonferroni post hoc tests were performed to analyze other data. Differences were considered significant at two-sided p<0.05.
rAd.sT.GM was constructed by using a modified system that have three gene expression units: CMVp-controlled sTGFβRIIFc, TERTp-controlled E1A and E1Bp-controlled GM-CSF that also harbors an IRES-linked E1B55K. Three control replicating adenoviruses: rAd.GM, rAd.sT and rAd.Null are devoid of either sTGFβRIIFc or GM-CSF, or both. Nonreplicating adenoviruse Ad(E1-). Null was constructed by the Ad-easy System.
Vector Construction.
Construction of Ad-GM-RE:
Construction of Ad-TGFβRIIFc-RE:
pShuttle-cmv-TGFβRIIFc-GM-RE (dIRES) was digested by SpeI and Dephosphorylated. Then, the larger fragment was recovered. TE-TP-E1A was digested with MfeI, and then the larger fragment was obtained.
Construction of Ad-Null-RE:
Method1:
pShuttle-cmv-TGFβRIIFc-RE was digested by XhoI, and the larger fragment was recovered.
Method2:
pShuttle-cmv-GM-RE (dIRES) was digested by SpeI and dephosphorylated. Then, the fragment was recovered. TE-TP-E1 A was digested by MfeI, and dephosphorylated. Then, the larger fragment was recovered.
(One 10 cm plate could be seeded into 15 wells.)
Day12-Day16: Adenovirus (rAd.Null) was collected and purified.
Construction of Ad-TGFβRIIFc-GM-RE
pShuttle-cmv-TGFβRIIFc-RE was digested by SpeI and dephosphorylated. Then, the larger fragment was recovered. TE-PPT-GM was digested with MfeI and EcoRI to get the 4.5 kb fragment.
Construction of rAd.sT.GM
(One 10 cm plate could be seeded into 15 wells.)
Cell lines and adenoviruses. Human mammary tumor cell lines, MCF-7 (ATCC, Manassas, VA), MDA-MB-231 (ATCC, Manassas, VA), and the mouse mammary tumor cell line, 4T1 (ATCC, Manassas, VA) are maintained as described earlier (Katayose, D., et al., (1995) Clin Cancer Res 1, 889-897; Craig, C., et al. (1997) Oncogene 14, 2283-2289; Zhang, Z., et al. (2012) Cancer Gene Ther 19, 630-636). All media components are purchased from Thermo Fisher Scientific (Waltham, MA).
sTGFβRHFc and GM-CSF expression in breast cancer cells infected with rAd.sT.GM
Experiments are conducted to examine if the infection of breast cancer cells can produce high levels of sTGFßRIIFc. Breast tumor cells (0.2×106 cells per well in 6-well plates) are plated in DMEM containing 10% FBS and incubated at 37° C. overnight. The next morning, cells are infected with 100 plaque-forming units (pfu)/cell of rAd.sT.GM, rAd.sT, rAd.GM, or rAd.Null adenovirus for 24 hours. Cells are washed and incubated with DMEM without FBS for 24 hours. Media and cells are subjected to Western blot analysis as previously described (Katayose, D., et al., (supra); Craig, C., (supra)). Blots are probed with antibody reactive against TGFßRII (H-567; Santa Cruz Biotechnology, Santa Cruz, CA), or actin protein (1-19; Santa Cruz Biotechnology, Santa Cruz, CA) as control.
Expected Results. Infection of MDA-MB-231 and MCF-7 cells with rAd.sT.GM and rAd.sT show a 60-80 Kd protein band of sTGFßRIIFc. in the extracellular media. However, sTGFßRIIFc protein is not detectable in the media of the tumor cells infected with rAd.GM or rAd.Null.
sTGFßRHFc and GMCSF Expression in Human Breast Cancer Cells Infected with rAd.sT.GM
Methods. Supernatants obtained from the rAd.sT.GM, rAd.sT, rAd.GM, or rAd.Null infected cells are also analyzed for sTGFßRIIFc and GM-CSF expression by ELISA, using a published method (Yang, Y. A., et al., (2002) J Clin Invest 109, 1607-1615). In brief, 96-well plates (Nunc, USA) are coated with the anti-human IgG-Fc specific capture antibody (Santa Cruz Biotechnology, Inc., Santa Cruz, CA), incubated with various dilutions of the samples, followed by detection with biotinylated anti-human TGFßRII antibody (R&D systems, Minneapolis, MN). The detection is carried out with streptavidin-conjugated peroxidase using the TMB/HRP substrate (BioFX Laboratories, Owing Mills, MD). After stopping the reaction with 1N HCl, the absorbance is measured at 450 nm using a SPECTRA max Plus ELISA plate reader (Molecular Devices, Sunnyvale, CA). Standard curves of sTGFßRIIFc are used to calculate the sTGFßRIIFc concentrations in the test samples. Human GM-CSF levels are determined using a commercially available ELISA kit from Invitrogen.
Expected Results. Based on the results reported in Example 1, incorporation of an additional GMCSF gene in rAd.sT.GM, does not seem to adversely affect the expression of sTGFßRIIFc. Thus, infection of breast tumor cells with rAd.sT.GM and rAd.sT is expected to produce sTGFßRIIFc that is subsequently released into the media and breast tumor cells infected with rAd.sT.GM or rAd.GM are expected to produce GMCSF.
Adenovirus cytotoxicity. Tumor cells are seeded in 96-well plates at a density of 1×103 cells/well, and the following day they are infected with various doses of oncolytic adenoviruses (rAd.sT.GM, rAd.sT, rAd.GM, or rAd.Null) and a non-replicating virus Ad(E1-). Null, ranging from 2 VPs/cell to 1.25×10 5 VPs/cell. Incubations are continued for seven days. Cell survival is determined by the sulforhodamine B staining assay (Katayose, D., et al., (supra)).
Expected Results. All oncolytic viruses including rAd.sT.GM are expected to produce dose-dependent cytotoxicity in human breast tumor cells, as well as mouse mammary tumor cells. Based on the IC50 values (viral dose required to kill 50% of the cells), oncolytic viruses are usually about 100 times more cytotoxic than a non-replicating virus such as Ad(E1-). Null.
Viral replication assay. Cells are plated in 6-well plates at about 70% confluence and the viral titers are examined using a published method (Seth, P., et al. (2006) Hum Gene Ther 17, 1152-1160; Wang, Z. G., et al. (2006) Mol Cancer Ther 5, 367-373) with some modifications. Cells are infected with rAd.sT.GM, rAd.sT, rAd.GM, rAd.Null or Ad(E1−). Null for 3 hours at a multiplicity of infection (MOI) of 100. Cells are washed with DMEM and incubated in 1 ml DMEM for additional one hour at 37° C. At the end of the incubation, cells are washed and either collected in 0.5 ml growth media and frozen at −70° C. or are maintained in 2 ml of growth media for an additional 48 hours. Media and cells are collected, and cells are subjected to three cycles of freezing and thawing to release the viruses. The viral titers in 3-hour or 48-hour crude viral lysates are determined using the Adeno-X Rapid titer kit (Clutch, Mountain view, CA). Viral burst size (an increase in hexon-expressing positive cells from 3 hours to 48 hours), is used as an indicator of viral replication, as described (Hu, Z., et al. (2012) Hum Gene Ther 23, 871-882).
Expected Results. rAd.sT.GM is expected to replicate in human breast cancer cells, MDA-MB-231 and MCF-7. At 3 hours, viral titers may be quite low, which should significantly increase at 48 hours (increase in viral titers from 3 hours to 48 hours is described as the “viral burst size”). On the other hand, infection of MDA-MB-231 or MCF-7 cells with Ad(E1″). Null is expected to result in less than a 2-fold increase in viral burst size, since Ad(E1″). Null is expected to be replication-deficient in the breast cancer cells.
Methods. 4T1luc2 mouse tumors are established in BALB/c mice. Various viruses (Ad.sT, rAd.sT.GM, rAd.GM and rAd.Null) and buffer are administered intratumorally into 4T1luc2 tumors (5.0×1010 VPs/mouse). After 48 hours, the sTGFβRIIFc levels in the blood are measured by ELISA, as described herein. To detect sTGFβRIIFc expression in the tumors, tumor sections are also subjected to immunohistochemical staining for sTGFβRIIFc.
Expected Results. The intratumoral injection of rAd.sT.GM and rAd.sT are expected to result in secretion of sTGFβRIIFc and its detection in the blood. Intratumoral injection of rAd.sT.GM and rAd.GM is expected to result in secretion of GMCSF and its detection in the blood. sTGFβRIIFc expression is expected to be readily detected in the subcutaneous tumors of mice injected with rA.sT.GM and rAd.sT.
To establish an orthotopic xenograft model of breast cancer, 6.5×105 4T1-luc cells (100 μl) are injected into number 3 and 4 mammary fat pads of BALB/c mice (4-6 weeks old). When tumors are visible (on day 7 after cell injection), tumor volumes are measured by caliper and calculated using the following formula: tumor volume=(Width2×Length)/2. The tumor burden is also analyzed by real-time bioluminescence imaging (BLI).
Methods. To establish subcutaneous tumors, 2×106 4T1luc2 cells per mouse (day 0) are injected into the dorsal right flank of female BALB/c mice (6-8 weeks old). Mice are monitored every day. When the solid subcutaneous tumors are established (day 12), rAd.sT.GM, rAd.sT, rAd.GM and the vehicle control (PBS buffer) are administered intratumorally (5.0×1010 VPs in 100 μl per mouse). Two days (48 hours) after the viral injection (on day 14), whole-mouse blood is withdrawn via cardiac puncture under anesthesia before animals are euthanized. Subcutaneous tumors are removed. Mouse serum is prepared from the blood and kept frozen. Tumor samples are fixed in 10% NBF solution for histology sample preparation and analyses are performed as described (Xu, W., et al. (2014) Mol Ther 22, 1504-1517).
Hepatic and systemic toxicity following the intratumoral administration of the test oncolytic viral vectors in BALB/c mice are evaluated. Serum samples obtained from the above experiment are analyzed for alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) levels. ALT is generally considered a good marker for hepatic damage and LDH is a good indicator of systemic toxicity (Xu, W., et al. (supra)). Commercially available kits are used to detect enzyme levels.
Expected Results. Subclinical hepatic injury is possible, but the serum values of ALT, AST and LDH are expected to be within normal limits and not to exceed 2.5 times the upper limit of normal in most individual test subjects.
The effectiveness of the combination of rAd.sT.GM with immune checkpoint inhibitors anti-PD-1 and anti-CTLA-4 in inhibiting tumor growth and metastases is tested using 4T1 tumors established in BALB/c mice.
Methods. As described above, 4T1 cells are injected (day 0) into the right flank of 4-6-week-old BALB/c mice (5×106 cells/mouse). On day 7 following tumor cell injections, tumor volumes are calculated by the following formula: tumor volume=(Width2×Length)/2. Tumor bearing mice are divided into these groups: (i) rAd.sT.GM, (ii) anti-PD-1, (iii) anti-CTLA-4, (iv) anti-PD1 and anti-CTLA-4, (v) rAd.sT.GM, anti-PD-1, (vi) rAd.sT.GM and anti-CTLA-4, (vii) rAd.sT.GM, anti-PD-1 and anti-CTLA-4, and (viii) buffer groups, without statistical differences among the groups. On day 7, rAd.sT,GM (2.5×1010 VPs in 100 μl) or PBS is administrated directly into the tumors. A second injection (2.5×1010 VPs or PBS) is administered on day 10. On days 8, 10, 13, and 15, anti-PD-1 and anti-CTLA-4 antibodies are administered individually or together intraperitoneally (0.2 mg per mouse/each antibody) in the groups indicated as receiving the listed agent. The tumor volumes in the injected areas are monitored on day 10, 14, 17, 21, and 25. Mice are euthanized on day 25. Whole lungs are excised and photographed. Lung-surface tumor lesions are counted for each group. Parts of the lungs are processed for H&E staining according to a published protocol (Yang, Y., et al. (2019) Hum Gene Ther 30, 1117-1132). Pulmonary metastatic burdens are quantified by using Image J software (NIH, Bethesda, MD) for each lung section.
Expected Results. The triple treatment is expected to be more effective in reducing tumor volume and metastasis than dual treatments and single treatment.
Statistical analysis. All data are analyzed using GraphPad Prism software version (GraphPad software, San Diego, CA). For all statistical analyses, data are plotted as the mean±standard error of the mean (SEM). Longitudinal data are analyzed using a two-way repeated measure ANOVA followed by Bonferroni post hoc pair wise tests for the data obtained over the time course. For multiple group analyses, one-way ANOVA followed by Bonferroni post hoc tests adjusting for multiplicity are performed. Student's t-tests are performed to compare two sets of data. Differences are considered significant at two-sided p<0.05.
All viral vectors were produced and purified to Good Laboratory Practice standards in Vector Development Lab/Gene Vector Core of Baylor College of Medicine, Houston, TX. They also determined the concentration and titers of these viruses and performed sterility and endotoxin assays for the quality control and verification. All were maintained in 20 mM Hepes, pH 7.8, 150 mM NaCl+10% glycerol buffer with the concentration of 5.0×1012 viral particles (VPs)/ml and stored in −80° C. deep freezer with 500 μl/aliquot. The total viral particles for each virus are ranging from 3.0-4.9×1013. Their titers are ranging from 1.6×1011-1.0×1012 pfu/ml. All viruses are tested negative for sterility. Their endotoxin levels are <0.1 EU/ml except for rAd.Null (0.15 EU/ml). They all are below the endotoxin limits set by FDA for an investigational drug in the early clinical development.
For characterization, adenoviral-mediated replication and cytotoxicity assays were performed and adenoviral-mediated sTGFβRIIFc and GM-CSF expression was examined in both human and mouse breast cancer cell lines.
Briefly, for replication assay, human breast cancer cells (MDA-MB-231 and MCF-7) and mouse breast cancer cells (4T1-luc2) were plated into a 6-well plates (2×105 cells/well). The next day, cells were infected with 2.5×104 VPs/cell of adenoviruses. Three hours after infection, cells were washed with phosphate-buffered saline buffer (PBS), and crude viral lysates were either collected immediately (3 h samples) or 48 hours after infection with completed cell culture media. The viral titers in 3- or 48-h crude viral lysates were determined using the Adeno-X Rapid Titer Kit (Clutch, Mountain view, CA). Viral burst size (an increase in hexon-expressing positive cells from 3 to 48 h) was used as an indicator of viral replication.
For cytotoxicity assay, breast cancer cells were seeded into 96-well plates (1.0×103 cells/well). The next day, cells were infected with various doses of adenoviruses (ranging from 80 to 1.25×106 VPs/cell and continued to culture for 7 days. Uninfected cells were used as the control. Cell survival was determined by sulforhodamine B staining and the lab's standard protocol described in previous publications.
For Adenoviral-mediated sTGFβRIIFc and GM-CSF expression, breast cancer cells were plated into a 6-well plates (2×105 cells/well). The next day, cells were infected with 2.5×104 VPs/cell of adenoviruses. Twenty-four hours after infection, cells were washed with PBS, and the media were changed to serum-free media. Then, the incubations continued for another 24 hours and media were collected. To quantify sTGFβRIIFc protein in media, enzyme-linked immunosorbent assay (ELISA) was conducted using anti-human IgG, Fcγ Fragment Specific antibody and biotinylated anti-TGFβ Ril (BAF241) antibody. To quantify GM-CSF protein in media, anti-human GM-CSF monoclonal antibody (Clone 6804, ELISA Capture) and biotinylated anti-human GM-CSF monoclonal antibody (Clone 3209, ELISA Detection) were used in ELISA.
Results
All replicating adenoviruses: rAd.sT.GM, rAd.GM, rAd.sT and rAd.Null produced much higher levels of viral replication in human breast cancer cells (MDA-MB-231 and MCF-7) (with an average ratio of 1506 for 231 and 2699 for MCF-7) than those in mouse breast cancer cells (4T1-luc2) (Average is 2.45). It is consistent with the nature of human adenovirus and our previous studies (Zhang, et al, 2021, doi:10.1038/cgt.2012.41; Xu, et al, 2020, DOI: 10.1089/hum.2020.078). However, when comparing to the control replication-deficient Ad(E1-), all replicating viruses have significantly higher replication levels in all cells.
Cytotoxicity assay. All adenoviruses: rAd.sT.GM, rAd.GM, rAd.sT, rAd.Null and replication-deficient Ad(E1-). Null produced dose-dependent cytotoxicity in both human and mouse breast cancer cells. Cytotoxicity of replicating adenoviruses (50% survival rate at 1.0-5.0×104 VPs/cell in human cells and 1.0×105 VPs/cell in mouse cells) is much greater than replication-deficient Ad(E1-). Null (50% survival rate is at around 1.0×106 VPs/cell in all cells). Mouse breast cancer cells 4T1, even with the much lower replication potentials for all replicating viruses, is susceptible to the killing ability of adenoviruses. See
Infection of the human and mouse breast cancer cells with rAd.sT.GM and rAd.sT produced high levels of sTGFβRIIFc protein, which was secreted into the cell culture media and detected by sTGFβRIIFc ELISA. sTGFβRIIFc protein concentration in those media are ranging from 3.9-5.3 μg/ml with an average amount of 4.5 μg/ml by our ELISA method. No sTGFβRIIFc expression was detected in cells infected with rAd.GM, rAd.Null and Ad(E1-). Null. There was no significant difference of sTGFβRIIFc expression levels among all cell types and between cell infected with rAd.sT.GM and those with rAd.sT.
For GM-CSF expression, the high levels of GM-CSF were detected only in cells infected with adenoviruses with GM-CSF gene: rAd.sT.GM and rAd.GM. GM-CSF concentration are ranging from 159-1398 ng/ml with an average amount of 547.5 ng/ml by ELISA. Human breast cancer cells 231 have higher levels of GM-CSF expression (Avg: 995.5 ng/ml) when compared to another human cell MCF7 (Avg: 338.5 ng/ml) and mouse cell 4T1 (Avg: 308.5 ng/ml). It can be due to high replication levels of adenovirus and endogenous expression of human GM-CSF in 231 cells, since a low levels of GM-CSF expression has been detected from the mock and Ad(E1-). Null infection in 231 cells (mock: 78 ng/ml; Ad(E1-). Null: 71 ng/ml). Importantly, 4T1 cells can express high levels of sTGFβRIIFc and/or human GM-CSF when infected with corresponding viruses. Also, the new adenoviruses: rAd.sT.GM elicited high levels of sTGFβRIIFc protein and human GM-CSF in all cells types including mouse breast cancer cell line: 4T1. See
The expression of sTGFβRIIFc and human GM-CSF in 4T1 tumors from all groups was also quantified by qRT-PCR. sTGFβRIIFc expression in tumors (day 10) from rAd.sT or rAd.sT.GM treated mice is 115717.69 or 118065.27 times (average value of relative quantification (RQ)) higher than that of the buffer group. By using non-parametric Kruskal-Wallis one-way analysis of variance to compare all groups, rAd.sT vs the buffer group is P<0.05 and rAd.sT.GM vs the buffer group is P<0.01. This statistical difference is due to the rAd.sT.GM-treated group has less variation in sTGFβRIIFc expression which can be visually assessed by the sizes of error bars on the graph. We also analyzed sTGFβRIIFc expression in day 25 tumor samples. sTGFβRIIFc mRNA level is 4.338 times (average) higher than that of the buffer group in rAd.sT-treated samples and 11.940 times (average) higher in rAd.sT.GM-treated samples. No significant difference has been detected among all groups by using Kruskal-Wallis test. Next, viral-induced human GM-CSF expression in tumors was determined by qRT-PCR. On day 10 (viruses were injected intratumorally on day 7 and day 9), the average expression levels by RQ are 74526.09 times higher than that of the buffer group in rAd.GM treated tumors, and 79320.71 times higher in rAd.sT.GM treated tumors. By non-parametric Kruskal-Wallis one-way analysis, rAd.GM vs the buffer group is P<0.05 and rAd.sT.GM vs the buffer group is P<0.01. The variation of GM-CSF expression in rAd.sT.GM treated group is smaller than that in rAd.GM group, and as a result, it is more significant by Kruskal-Wallis test. For day 25 samples, the average expression levels of human GM-CSF are 4.34 times higher than that of the buffer group in rAd.GM treated tumors, and 11.94 times higher in rAd.sT.GM treated tumors, but no significant difference has been detected among all day 25 groups by using Kruskal-Wallis test. When taken together with relative quantification data of sTGFβRIIFc, not only expression of either sTGFβRIIFc or human GM-CSF elicited by rAd.sT.GM didn't interfere with each other, but also rAd.sT.GM seems to have a more stable expression profile and a more prolonged presence of both sTGFβRIIFc and human GM-CSF in tumors. See
Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, it is readily apparent to those of ordinary skill in the art in light of the teachings of this invention that certain changes and modifications may be made thereto without departing from the spirit or scope of the appended claims. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
Accordingly, the preceding merely illustrates the principles of the invention. It will be appreciated that those skilled in the art will be able to devise various arrangements which, although not explicitly described or shown herein, embody the principles of the invention and are included within its spirit and scope. Furthermore, all examples and conditional language recited herein are principally intended to aid the reader in understanding the principles of the invention and the concepts contributed by the inventors to furthering the art, and are to be construed as being without limitation to such specifically recited examples and conditions. Moreover, all statements herein reciting principles, aspects, and embodiments of the invention as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents and equivalents developed in the future, i.e., any elements developed that perform the same function, regardless of structure. The scope of the present invention, therefore, is not intended to be limited to the exemplary embodiments shown and described herein. Rather, the scope and spirit of present invention is embodied by the appended claims.
This application claims priority benefit of U.S. Provisional Application No. 63/154,118, filed Feb. 26, 2021, the disclosure of which is incorporated herein by reference in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2022/017716 | 2/24/2022 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63154118 | Feb 2021 | US |
