Patent Application
20240209076
The present application is being filed along with a Sequence Listing in electronic format. The Sequence Listing is provided as a file entitled KDIAK115WO.txt, created May 2, 2021 which is 395,419 bytes in size. The information in the electronic format of the Sequence Listing is incorporated herein by reference in its entirety.
In some embodiments, anti-IL-6 antibodies, fusions, and conjugates thereof are provided, which deposited in the American Type Culture Collection (ATCC), in accordance with the Budapest Treaty, under the numbers PTA-125807 & PTA-125808, on Mar. 13, 2019.
These deposits are made under the provisions of the Budapest Treaty on the International Recognition of the Deposit of Microorganisms for the Purposes of Patent Procedure and the Regulations thereunder (Budapest Treaty). This assures maintenance of the deposit for 30 years from date of deposit. The deposit will be made available by the ATCC under the terms of the Budapest Treaty, and subject to an agreement between Applicant and the ATCC, which assures permanent and unrestricted availability of the deposit to the public upon issuance of the pertinent U.S. patent or upon laying open to the public of any U.S. or foreign patent application, whichever comes first, and assures availability of the deposit to one determined by the U.S. Commissioner of Patents and Trademarks to be entitled thereto according to 35 U.S.C. § 122 and the Commissioner's Rules pursuant thereto (including 37 C.F.R. § 1.14). Availability of the deposited biological material is not to be construed as a license to practice the present disclosure in contravention of the rights granted under the authority of any Government in accordance with its Patent Laws.
The present disclosure relates generally to constructs that bind to IL-6 and/or VEGF, and methods of use thereof for the treatment or prophylaxis of a disorder relating to an over-reactive immune response to an infection, e.g., a viral infection, or other immune stimuli, and/or vascular permeability dysregulation.
Vascular endothelial growth factor A (VEGF-A) is a signal protein that mediates pro-angiogenic functions such as endothelial cell survival, proliferation, migration, and vascular permeability. Various therapeutic molecules have been developed to inhibit VEGF function. Among these, anti-VEGF monoclonal antibodies such as Ranibizumab and Bevacizumab have been shown to be safe and effective treatments against pathological angiogenesis, such as tissue edema resulting from dysregulation of vascular permeability. More recently, recombinantly made VEGFR fusion proteins such as Aflibercept (Eylea) and Conbercept (China), which act as VEGF “traps,” are proving to be also effective.
Provided herein is a method for the treatment or prophylaxis of a disorder related to an over-reactive immune response to an infection or other immune stimuli and/or dysregulation of vascular permeability related to an infection and/or edema, in a patient in need thereof, said method comprising administering to the patient an effective amount of a fusion protein comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent a disorder related to an over-reactive immune response to and/or dysregulation of vascular permeability related to an infection and/or edema and/or other immune stimuli. In some embodiments, the disorder comprises a viral infection-related disorder, or a disorder related to an immunotherapy. Also provided herein is a method for the treatment or prophylaxis of a disorder related to a viral infection in a patient in need thereof, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent the disorder related to the viral infection. Optionally, the viral infection is a coronavirus infection or an influenza virus infection. In some embodiments the viral infection is a MERS-COV, SARS-COV, or a SARS-CoV-2 (COVID-19) infection.
In some embodiments, the disorder comprises one or more of: pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, dysregulated tissue permeability, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage. Optionally, the immune-mediated and/or vascular permeability-mediated tissue damage comprises immune-mediated damage to the lung, heart, brain, liver, and/or kidney. In some embodiments, the immune-mediated tissue damage comprises organ damage, inflammation and/or failure.
In some embodiments, the severity of the disorder is increasing in the patient. In some embodiments, the method includes determining the patient is at risk of developing a severe disorder related to the viral infection. In some embodiments, the disorder is severe.
In some embodiments, the patient has or is identified as having an elevated serum level of one or more cytokines. Optionally, the one or more cytokines comprises IL-6 and/or IL-1.
In some embodiments, the patient has or is identified as having an elevated tissue (intrapulmonary, intrakidney, intracardiac) or serum VEGF level.
In some embodiments, the method includes detecting a level of one or more cytokines and/or VEGF in a sample from the patient. Optionally, the method includes obtaining the sample from the patient. In some embodiments, the sample comprises blood, serum, plasma, pulmonary lavage, or pulmonary aspirate.
In some embodiments, the patient is intubated and/or is under ventilator support. In some embodiments, the patient is under treatment in an intensive care unit (ICU).
In some embodiments, the patient has one or more comorbidities. Optionally, the one or more comorbidities comprises one or more of hypertension, diabetes, obesity, coronary artery disease, chronic kidney disease, obstructive sleep apnea, history of smoking, a respiratory disease, old age, history of cancer, liver disease, advanced age, male sex, non-Caucasian ethnicity, history of cancer, chronic liver disease, history of stroke, and/or history of autoimmune disease. In some embodiments, the patient does not have a comorbidity.
In some embodiments, the method includes diagnosing the viral infection in the patient. Optionally, diagnosing comprises performing a clinical examination, contact tracing, and/or a diagnostic test for the viral infection. In some embodiments, the method includes administering a treatment for the viral infection or a symptom thereof. Optionally, the treatment for the viral infection or a symptom thereof comprises a therapeutic agent. Optionally, the therapeutic agent comprises an anti-viral agent and/or an anti-inflammatory agent. In some embodiments, the treatment for the viral infection or a symptom thereof comprises ventilator support. Optionally, the method includes intubating the patient. In some embodiments, the treatment-related tissue damage or inflammation comprises tissue damage or inflammation induced by intubation.
In some embodiments, the method includes comprising administering another treatment for the disorder. Optionally, the treatment for the disorder comprises an antibiotic and/or an anti-inflammatory agent.
Also provided herein is a method for the treatment or prophylaxis of a systemic inflammatory condition, or a disorder related to the systemic inflammatory condition, in a patient in need thereof, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent the systemic inflammatory condition or the disorder related thereto. In some embodiments, the systemic inflammatory condition comprises systemic inflammation or cytokine release syndrome (CRS). In some embodiments, the systemic inflammatory condition is related to an infectious disease. Optionally, the method includes administering a treatment for the infectious disease. In some embodiments, the systemic inflammatory condition is related to a treatment for a disease. In some embodiments, the disease is cancer. In some embodiments, the treatment comprises an immunotherapy. In some embodiments, the immunotherapy comprises a chimeric antigen receptor (CAR) T-cell therapy. Optionally, the method includes administering the treatment for the disease.
In some embodiments, the systemic inflammatory condition is related to one or more of sepsis, pancreatitis, fat embolism, and trauma suffered by the patient. In some embodiments, the disorder related to the systemic inflammatory condition comprises immune-mediated tissue damage. In some embodiments, the immune-mediated tissue damage comprises organ damage, inflammation and/or failure.
Also provided is a method for the treatment or prophylaxis of treatment-induced tissue damage, inflammation and/or vascular permeability dysregulation in a patient in need thereof, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent treatment-induced tissue damage, inflammation and/or vascular permeability dysregulation. In some embodiments, the treatment-induced tissue damage, inflammation, and/or vascular permeability dysregulation comprises tissue damage, inflammation, and/or vascular permeability dysregulation induced by intubation. Optionally, the method includes intubating the patient.
In some embodiments, methods of the present disclosure include parenterally administering the effective amount of the fusion protein. In some embodiments, methods of the present disclosure include parenterally administering a first amount of the fusion protein; and administering a second amount of the fusion protein intranasally or by inhalation, to thereby administer to the patient the effective amount of the fusion protein. In some embodiments, parenterally administering comprises administering intravenously, intra-arterially, subcutaneously, intraperitoneally, or intramuscularly. In some embodiments, methods of the present disclosure include administering the effective amount of the fusion protein by inhalation or nebulization.
In some embodiments of various methods of the present disclosure, the isolated antagonist antibody comprises: a heavy chain amino acid variable region that comprises a heavy chain that has a sequence of at least one of SEQ ID NOs: 7-13, 19-27, 89, 90, 256-262; and a light chain amino acid variable region that comprises the light chain that has a sequences of at least one of SEQ ID NOs: 91-93, 28-30. In some embodiments of various methods of the present disclosure, the isolated antagonist antibody comprises: a heavy chain variable region (VH) comprising 3 complementarity determining regions (CDR): VH CDR1, VH CDR2, and VH CDR3 having an amino acid sequence from the CDRs listed in SEQ ID NO: 256; and a light chain variable region (VL) comprising a VL CDR1, VL CDR2, and VL CDR3 having an amino acid sequence selected from the group of CDRs listed in SEQ ID NO: 91-93. In some embodiments of various methods of the present disclosure, the isolated antagonist antibody comprises at least one of the following mutations based on EU numbering: L234A, L235A, and G237A. In some embodiments of various methods of the present disclosure, the isolated antagonist antibody comprises: a CDRH1 that is a CDRH1 in SEQ ID NO: 172; a CDRH2 that is a CDRH2 in SEQ ID NO: 173; a CDRH3 that is a CDRH3 in SEQ ID NO: 174: a CDRL1 that is a CDRL1 in SEQ ID NO: 199; a CDRL2 that is a CDRL2 in SEQ ID NO: 200; a CDRL3 that is a CDRL3 in SEQ ID NO: 201; and at least one of the following mutations (EU numbering): L234A, L235A, and G237A.
In some embodiments, the antibody binds human IL-6 with an affinity of between about 10 pM to about 1 nM. In some embodiments, a heavy chain constant domain of the antibody comprises a cysteine residue introduced by recombinant DNA technology. Optionally, the cysteine residue is selected from the group consisting of Q347C and L443C (EU numbering). Optionally, the cysteine residue is L443C (EU numbering).
In some embodiments, the VEGF Trap is positioned either (i) at an N-terminal end of a heavy chain comprising IL-6 VH; or (ii) between a hinge region and after a CH1 domain of a heavy chain comprising IL-6 VH. Optionally, the VEGF Trap is at an N-terminal end of the heavy chain comprising IL-6 VH. Optionally, the VEGF Trap is between the hinge region and after a CH1 domain of the heavy chain comprising IL-6 VH.
In some embodiments, the VEGF Trap comprises a VEGF binding domain comprising VEGFR1 domain 2 and VEGFR2 domain 3. Optionally, the VEGF binding domain consists of the sequence of SEQ ID NO: 114.
In some embodiments, the fusion protein comprises: an IL-6 VH; an IL-6 VL; an IL-6 Fc; and a VEGF Trap, wherein the VEGF Trap is fused to IL-6 in one of the following manners: (i) to an N-terminal end of a heavy chain comprising IL-6 VH; or (ii) between a hinge region and after a CH1 domain of a heavy chain comprising IL-6 VH. Optionally, the VEGF Trap comprises a VEGFR1 domain 2 and then a VEGFR2-Domain 3, in that order. In some embodiments, the fusion protein comprises a mutation at position 94 in the VEGF Trap sequence.
In some embodiments, the fusion protein comprises a mutation at position 95 in the VEGF Trap sequence. In some embodiments, the fusion protein comprises mutations of T94I and/or H95I in the VEGF Trap sequence.
In some embodiments, the fusion protein is a VEGFR-Anti-IL-6 dual inhibitor, wherein the VEGFR-Anti-IL-6 dual inhibitor comprises a trap antibody fusion of an anti-IL 6 antibody and an anti-VEGF trap (VEGFR1/2), wherein the dual inhibitor includes at least one point mutation within a VEGFR sequence to reduce cleavage of the VEGFR protein. Optionally, a molecular weight of the VEGFR-anti-IL-6 dual inhibitor is 1.0 MDa. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a constant heavy, a constant light, a fragment antigen binding, a fragment crystallizable (Fc), a vascular endothelial growth factor receptor (VEGFR), a variable heavy, and a variable light regions. Optionally, the variable heavy region sequences is selected from options SEQ ID NO: 7-13, 89, 90, and/or 256-262. In some embodiments, the VEGF trap sequences is selected from at least one of SEQ ID Nos: 145, 15, 16, or 17. In some embodiments, the linker sequence is SEQ ID NO: 18. In some embodiments, the heavy chain sequence for Anti-IL-6 molecules is selected from at least one of SEQ ID NOs 19-27 or includes at least the sequence in one of SEQ ID NOs: 89, 90, 256-262. In some embodiments, the light chain sequence for Anti-IL-6 molecules comprises at least 1, 2, or 3 light chain CDRs from at least one of SEQ ID NOs 76-84. In some embodiments, the heavy chain sequence for the Anti-IL-6 molecule comprises at least 1, 2, or 3 heavy chain CDRs from at least one of SEQ ID NOs 49-75. In some embodiments, the fusion protein comprises a VEGFR-Fc sequence from at least one of SEQ ID NOs 85-88. In some embodiments, the fusion protein comprises one or more of the sequences in any one or more of SEQ ID Nos 7-13, 145, 15-17, 18-84. Optionally, the fusion protein comprises an IL-6 VH; an IL-6 VL; an IL-6 Fc; a VEGF Trap; and a linker. Optionally, the IL-6 VH comprises a sequence from an IL6 VH sequence in any one of SEQ ID NOs 19-27, 31-39, 89, 90, or 256-262. Optionally, the IL-6 VL comprises a sequence from an IL6 VL sequence in any one of SEQ ID Nos 28-30 or 91-93. In some embodiments, the Fc comprises a sequence from a Fc sequence in any one of SEQ ID NOs 40-48. In some embodiments, the VEGF Trap comprises a sequence from a VEGF trap sequence in any one of SEQ ID NOs: 145, 15, 16, or 17.
In some embodiments, the fusion protein comprises: at least 3 heavy chain CDRs; at least 3 light chain CDRs; a VEGF trap sequence; and a linker sequence, wherein each of the sequences is selected from a corresponding sequence within
In some embodiments, the fusion protein comprises: an IL-6 antibody VH; an IL-6 antibody VL; an IL-6 antibody Fc; and a VEGF Trap, wherein the fusion protein alters HUVEC proliferation. Optionally, altering HUVEC proliferation is inhibiting VEGF/IL6 mediated proliferation.
In some embodiments, the antibody comprises a) an amino acid sequence of SEQ ID NO: 169 and 170 or b) an amino acid sequence that is at least 80% identical to SEQ ID NO: 169 and at least 80% identical to SEQ ID NO: 170.
In some embodiments, the fusion protein comprises a) an amino acid sequence of SEQ ID NO: 169 and 170 or b) an amino acid sequence that is at least 80% identical to SEQ ID NO: 169 and at least 80% identical to SEQ ID NO: 170.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a) an amino acid sequence of SEQ ID NO: 169 and 170 or b) an amino acid sequence that is at least 80% identical to SEQ ID NO: 169 and at least 80% identical to SEQ ID NO: 170.
Also provided herein is a use of a fusion protein to treat one or more of: pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, vascular permeability dysregulation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage, wherein the fusion protein comprises: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap.
Also provided is a method for the treatment or prophylaxis of a disorder related to an over-reactive immune response to an infection or other immune stimuli and/or vascular permeability dysregulation related to an infection and/or symptom thereof, in a patient in need thereof, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6, wherein the isolated antagonist antibody comprises: a CDRH1 that is a CDRH1 in SEQ ID NO: 172; a CDRH2 that is a CDRH2 in SEQ ID NO: 173; a CDRH3 that is a CDRH3 in SEQ ID NO: 174: a CDRL1 that is a CDRL1 in SEQ ID NO: 199; a CDRL2 that is a CDRL2 in SEQ ID NO: 200; a CDRL3 that is a CDRL3 in SEQ ID NO: 201; and at least one of the following mutations (EU numbering): L234A, L235A, and G237A; and a VEGF Trap, to thereby treat and/or prevent a disorder related to an over-reactive immune response to an infection or other immune stimuli and/or vascular permeability dysregulation related to an infection and/or symptom thereof. In some embodiments, the disorder related to an over-reactive immune response to an infection or other immune stimuli and/or dysregulation of vascular permeability related to an infection and/or edema comprises one or more of pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, increased vascular permeability, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage.
Also provided herein is a method for the treatment or prophylaxis of a disorder, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent the disorder, wherein the disorder is a viral infection-related disorder, or a disorder related to an immunotherapy. In some embodiments, the isolated antagonist antibody that specifically binds to IL-6; and the VEGF Trap are as disclosed in any one of the embodiments provided in the present claims or specification or figures.
Further provided herein is a method for the treatment or prophylaxis of a disorder, said method comprising administering to the patient an effective amount of a fusion protein comprising: an isolated antagonist antibody that specifically binds to IL-6; and a VEGF Trap, to thereby treat and/or prevent the disorder, wherein the disorder comprises one or more of: pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, vascular permeability dysregulation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage.
Pro-inflammatory cytokines, such as IL-1 and IL-6, have been implicated in hyperinflammatory responses in patients suffering from an infectious disease, e.g., a viral infection, or can be induced by certain treatment, such as CAR-T therapy.
As disclosed herein, it is theorized that anti-IL-6 therapy will benefit patients with cytokine release syndrome (CRS) and immune-mediated tissue damage, including COVID-19 patients with severe acute respiratory distress syndrome (ARDS) and/or multi-organ damage. ARDS is the leading cause of mortality in COVID-19 patients and therapies to prevent and/or halt ARDS may decrease the mortality rate associated with a COVID-19 pandemic.
As disclosed herein, it is theorized VEGF will play a pathological role in tissue injury, such as lung, heart, or kidney injury, and can be a potent inducer of vascular permeability. Anti-VEGF agents have transformed the care of retinal vascular diseases with proven effectiveness in decreasing excess vascular permeability and resolving retinal edema. Likewise, the anti-permeability benefit of VEGF inhibition can be observed in malignancies such as glioblastoma. Emerging data show VEGF levels are elevated in COVID-19 patients.
In some embodiments, a fusion protein of the present disclosure can have high binding affinity to both IL-6 and VEGF simultaneously. In some embodiments, the fusion protein may synergistically inhibit IL-6 and VEGF signaling pathways and may benefit, e.g., lung and kidney tissues hard hit by COVID-19 and associated pathology. In some embodiments, the fusion protein includes a Fc region that is immunologically inert and does not activate immune effector functions. In some embodiments, administering the fusion protein prevents further immune-mediated tissue damage in the lung, kidney, heart, and other organs that are affected in severe COVID-19 infections. In some embodiments, the fusion protein is administered to a COVID-19 patients with severe symptomatology or patients who are trending away from a mild-to-moderate symptomatology.
In some embodiments, a fusion protein for use in the methods of the present disclosure is a dual inhibitor trap-antibody-fusion (TAF) molecule designed to target both VEGF and IL-6. In some embodiments, the TAF protein binds specifically and simultaneously to its targets. In some embodiments, each fusion protein is capable of binding to two VEGF and two IL-6 molecules.
In some embodiments, the present fusion protein includes two VEGF binding domains from human VEGF receptors which together act as a trap, or soluble receptor decoy, to bind the most abundant isoforms of VEGF and related ligands. In some embodiments, the VEGF trap domains are fused to a novel, high-affinity IgG1 antibody that binds with high specificity and affinity to IL-6. Without being bound by theory, it is understood that the binding of the antibody to IL-6 disrupts the ligand's association with its cognate IL-6 receptor. In some embodiments, the Fc domain is engineered to be immunologically inert and reduce immune effector function. In some embodiments, the IL-6 antibody, VEGF trap or a fusion protein of the two is immunologically inert, or does not substantially contribute to an inflammatory response when administered to the patient according to methods of the present disclosure. In some embodiments, the fusion protein exhibits synergistic inhibition of VEGF and IL-6, e.g., in vitro. In some embodiments, the fusion protein synergistically inhibits VEGF/IL-6 mediated HUVEC proliferation better than either aflibercept (a VEGF trap) or anti-IL-6 monotherapy alone. In some embodiments, the fusion protein blocks LPS stimulated HUVEC tubule formation more effectively than either aflibercept or anti-IL-6 monotherapy.
In some embodiments, the therapeutic agents or compositions of the present disclosure are produced by a cell line, e.g., prokaryotic, eukaryotic, or mammalian cells, modified by insertion of light and heavy chain genes coding for the fusion protein. In some embodiments, the fusion protein is produced by a cell line, e.g., a CHOK1SV-GS-KO (Glutamine Synthetase Knock Out) cell line modified by insertion of light and heavy chain genes coding for the fusion protein.
Methods of the present disclosure include administering an effective amount of a therapeutic agents or compositions that target IL-6 and/or VEGF signaling to a patient in need of treatment or prophylaxis of a disorder, such as acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS), related to or caused by an over-reactive immune system response to an infection, e.g., a viral infection, or other immune stimuli, and/or dysregulation of vascular permeability. In some embodiments, the disorder is a viral infection-related disorder, e.g., a disorder related to a COVID-19 or influenza infection. In some embodiments, the disorder is one or more of pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage. In some embodiments, the therapeutic agent is: an isolated antagonist antibody that specifically binds to IL-6; a VEGF Trap; an anti-VEGF antibody; and/or a fusion protein comprising the IL-6 isolated antagonist antibody fused to the VEGF Trap. In some embodiments, a fusion protein of the present disclosure is a conjugate, as described herein. In some embodiments of methods of the present disclosure, a fusion protein administered to the patient in need of treating or preventing a disorder related to or caused by an over-reactive immune system response to an infection, e.g., a viral infection, or other immune stimuli, and/or dysregulation of vascular permeability and/or edema can be any conjugate, as described herein.
Without being bound by theory, it is understood SARS-COV-2 can cause highly acute respiratory syndrome leading to release of pro-inflammatory cytokines (IL-1 and IL-6) when it infects the upper and lower respiratory tract. It can also cause tissue damage to other tissues such as the heart, kidney, the digestive system, and brain. COVID-19 patients can show elevated IL-6 and ferritin levels, and it is theorized, as disclosed herein, mortality is due to virally driven hyperinflammation. Likewise, it is theorized higher serum levels of IL-6 will be predictive of respiratory failure in symptomatic COVID-19 patients (Herold III et al., medRxiv 2020.04.01.20047381). Inhibition of the family of IL-1 cytokines and of IL-6 can have therapeutic efficacy in inflammatory diseases, including viral infections (Conti P., J Biol Regul Homeost Agents. 2020 March; 34(2):1).
Without being bound by theory, it is theorized the IL-6 pathway will contribute to the overactive inflammatory response in the lungs of patients with COVID-19. By targeting the soluble cytokine IL-6 directly, and by not further activating immune effector function, the fusion protein of the present disclosure, in some embodiments, will have benefit beyond that observed with conventional IL-6 targeted medicines when used to treat COVID-19 patients.
Respiratory failure from ARDS is the leading cause of mortality in COVID-19 patients. Without being bound by theory, it is theorized VEGF plays a pathological role in lung injury and can be a potent inducer of excess vascular permeability (Medford A R L., Thorax. 2006 Jul. 1; 61(7):621-626; Zhang et al., Biomed Pharmacother. 2019 January; 109:2434-2440; Thickett et al., Am J Respir Crit Care Med. 2001 Nov. 1; 164(9):1601-5; Kaner et al., Am J Respir Cell Mol Biol. 2000; 22(6):657-664). For example, VEGF can cause pulmonary hemorrhage, hemosiderosis, and air space enlargement in neonatal mice (Le Cras et al., Am J Physiol-Lung Cell Mol Physiol. 2004 July; 287(1):L134-L142). Further, murine models with induced acute lung injury exhibited elevated intrapulmonary levels of VEGF following injury for 96 hours, mirroring increases in bronchoalveolar lavage fluid protein and neutrophils with significant VEGF localization to lung epithelium (Karmpaliotis et al., Am J Physiol-Lung Cell Mol Physiol. 2002 Sep. 1; 283(3):L585-L595). In COVID-19 patients, elevated levels of VEGF can be associated with severe disease (Bevacizumab in Severe or Critical Patients With COVID-19 Pneumonia. ClinicalTrials.gov [Internet]. [cited 2020 Apr. 4]. Available from: https://clinicaltrials.gov/ct2/show/NCT04275414). Additionally, the cyclic stretch induced by the high pressure and hyperoxia associated with mechanical ventilation of COVID-19 patients can exacerbate pulmonary inflammation through the VEGF pathway signaling (Gawlak et al., Am J Physiol Lung Cell Mol Physiol. 2016; 310(11):L1062-L1070; Huang et al., Int J Mol Sci. 2019; 20(7): 1771; Shi et al., PLOS One. 2016; 11(10):e0165317).
Without being bound by theory, anti-VEGF therapy can suppress VEGF-induced pulmonary edema and can be efficacious in treating pulmonary edema (Watanabe et al., Hum Gene Ther. 2009 June; 20(6):598-610). Bevacizumab, a VEGF inhibitor, can be used safely in COVID-19 patients and be effective. Intravitreal anti-VEGF biologics such as Eylea (aflibercept) and Lucentis (ranibizumab) can resolve edema fluid in the retina in patients with neovascular age-related macular degeneration, diabetic macular edema and retinal vein occlusion, and the anti-VEGF mechanism can function as an anti-permeability/anti-edema agent. Additionally, the anti-VEGF antibody Avastin (bevacizumab) can provide symptomatic relief from edema rather than the anti-angiogenesis effect in brain cancers (Shen et al., Chin Med J (Engl). 2015; 128(15):2126-2129; Meng et al., Medicine (Baltimore). 2017; 96(44):e8280).
Provided herein are methods for the treatment or prophylaxis of a disorder, such as acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) or pulmonary and/or tissue edema, related to or caused by a patient's over-reactive immune system response and/or other tissue localized vascular permeability dysfunctions related to an infection, e.g., a viral infection, or other immune stimuli, by administering therapeutic agent(s) to simultaneously block the functions of the pro-inflammatory cytokine IL-6 and the pro-angiogenic signal protein VEGF. The disorders treated or prevented by the disclosed methods can increase the risk of mortality or other adverse outcome among patients suffering from a health condition, e.g., an infectious disease, or receiving treatment such as immunotherapy for a health condition, e.g., a cancer. In some embodiments, methods of the present disclosure can treat dysregulation of vascular permeability, such as pathological increased vascular permeability and/or tissue edema resulting from dysregulation of vascular permeability. The methods disclosed herein can reduce the concurrent inflammation and defective angiogenesis underlying the disorders, e.g., IL-6 and/or VEGF related disorders. In some embodiments, methods of the present disclosure involve the use of one or more of an isolated antagonist antibody that specifically binds to IL-6, a VEGF Trap, an anti-VEGF antibody, and/or a fusion protein comprising the IL-6 isolated antagonist antibody fused to the VEGF Trap, to thereby treat and/or prevent the disorder. In some embodiments, methods of the present disclosure involve the use of designed molecules, e.g., dual inhibitor molecules, that simultaneously block the functions of the pro-inflammatory cytokine IL-6 and the pro-angiogenic signal protein VEGF. In some embodiments, these molecules are comprised of (1) an anti-IL-6 monoclonal antibody fused to (2) two VEGF binding domains of VEGF receptors (VEGFRs). The anti-IL-6 moiety specifically binds IL-6 and inhibits its interaction with the IL-6 receptor (IL-6R). The VEGF Trap moiety includes of a fusion of two VEGF binding domains (VEGFR1 domain 2, VEGFR2 domain 3) that work as a VEGF trap, preventing VEGF from binding to VEGF receptors. Additionally, in some embodiments, each of these dual inhibitor molecules is equipped with an unpaired cysteine at its C-terminus which can be conjugated with a half-life extending phosphorylcholine based biopolymer. In some embodiments, the dual inhibitor molecules do not have an unpaired cysteine at its C-terminus. In some embodiments, the dual inhibitor molecules are not conjugated with the phosphorylcholine based biopolymer. In some embodiments, the method includes administering an anti-IL-6 monoclonal antibody and a VEGF Trap to the patient, where the antibody and the VEGF Trap are not fused.
Various embodiments provided herein will employ, unless otherwise indicated, conventional techniques of molecular biology (including recombinant techniques), microbiology, cell biology, biochemistry and immunology, which are within the skill of the art. Such techniques are explained fully in the literature, such as, Molecular Cloning: A Laboratory Manual, second edition (Sambrook et al., 1989) Cold Spring Harbor Press; Oligonucleotide Synthesis (M. J. Gait, ed., 1984); Methods in Molecular Biology, Humana Press; Cell Biology: A Laboratory Notebook (J. E. Cellis, ed., 1998) Academic Press; Animal Cell Culture (R. I. Freshney, ed., 1987); Introduction to Cell and Tissue Culture (J. P. Mather and P. E. Roberts, 1998) Plenum Press; Cell and Tissue Culture: Laboratory Procedures (A. Doyle, J. B. Griffiths, and D. G. Newell, eds., 1993-1998) J. Wiley and Sons; Methods in Enzymology (Academic Press, Inc.); Handbook of Experimental Immunology (D. M. Weir and C. C. Blackwell, eds.); Gene Transfer Vectors for Mammalian Cells (J. M. Miller and M. P. Calos, eds., 1987); Current Protocols in Molecular Biology (F. M. Ausubel et al., eds., 1987); PCR: The Polymerase Chain Reaction, (Mullis et al., eds., 1994); Current Protocols in Immunology (J. E. Coligan et al., eds., 1991); Short Protocols in Molecular Biology (Wiley and Sons, 1999); Immunobiology (C. A. Janeway and P. Travers, 1997); Antibodies (P. Finch, 1997); Antibodies: a practical approach (D. Catty., ed., IRL Press, 1988-1989); Monoclonal antibodies: a practical approach (P. Shepherd and C. Dean, eds., Oxford University Press, 2000); Using antibodies: a laboratory manual (E. Harlow and D. Lane (Cold Spring Harbor Laboratory Press, 1999); The Antibodies (M. Zanetti and J. D. Capra, eds., Harwood Academic Publishers, 1995).
The following terms, unless otherwise indicated, shall be understood to have the following meanings: the term “isolated molecule” as referring to a molecule (where the molecule is, for example, a polypeptide, a polynucleotide, or an antibody) that by virtue of its origin or source of derivation (1) is not associated with naturally associated components that accompany it in its native state, (2) is substantially free of other molecules from the same source, e.g., species, cell from which it is expressed, library, etc., (3) is expressed by a cell from a different species, or (4) does not occur in nature. Thus, a molecule that is chemically synthesized, or expressed in a cellular system different from the system from which it naturally originates, will be “isolated” from its naturally associated components. A molecule also may be rendered substantially free of naturally associated components by isolation, using purification techniques well known in the art. Molecule purity or homogeneity may be assayed by a number of means well known in the art. For example, the purity of a polypeptide sample may be assayed using polyacrylamide gel electrophoresis and staining of the gel to visualize the polypeptide using techniques well known in the art. For certain purposes, higher resolution may be provided by using HPLC or other means well known in the art for purification.
As used herein, unless designated otherwise, the term “IL-6” or “IL6” refers to human IL-6. In some embodiments, other forms of IL-6 are contemplated, and will be designated by specific reference to the other organisms, e.g., canine, feline, equine, and bovine. One exemplary human IL-6 is found as UniProt Accession Number P05231.
Anti-IL-6 antibodies or other biologics described herein are typically provided in isolated form. This means that an antibody is typically at least 50% w/w pure of interfering proteins and other contaminants arising from its production or purification but does not exclude the possibility that the antibody is combined with a pharmaceutically acceptable excipient intended to facilitate its use. Sometimes antibodies are at least 60, 70, 80, 90, 95 or 99% w/w pure of interfering proteins and contaminants from production or purification. Often an antibody (or antibody conjugate) is the predominant macromolecular species remaining after its purification.
An “antibody” is an immunoglobulin molecule capable of specific binding to a target, such as a carbohydrate, polynucleotide, lipid, polypeptide, etc., through at least one antigen recognition site, located in the variable region of the immunoglobulin molecule. As used herein, the term encompasses not only intact polyclonal or monoclonal antibodies, but also, unless otherwise specified, any antigen binding portion thereof that competes with the intact antibody for specific binding, fusion proteins comprising an antigen binding portion, and any other modified configuration of the immunoglobulin molecule that comprises an antigen recognition site. Antigen binding portions include, for example, Fab, Fab′, F(ab′)2, Fd, Fv, domain antibodies (dAbs, e.g., shark and camelid antibodies), fragments including complementarity determining regions (CDRs), single chain variable fragment antibodies (scFv), maxibodies, minibodies, intrabodies, diabodies, triabodies, tetrabodies, v-NAR and bis-scFv, and polypeptides that contain at least a portion of an immunoglobulin that is sufficient to confer specific antigen binding to the polypeptide. An antibody includes an antibody of any class, such as IgG, IgA, or IgM (or sub-class thereof), and the antibody need not be of any particular class. Depending on the antibody amino acid sequence of the constant region of its heavy chains, immunoglobulins can be assigned to different classes. There are five major classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM, and several of these may be further divided into subclasses (isotypes), e.g., IgG1, IgG2, IgG3, IgG4, IgA1 and IgA2. The heavy-chain constant regions that correspond to the different classes of immunoglobulins are called alpha, delta, epsilon, gamma, and mu, respectively. The subunit structures and three-dimensional configurations of different classes of immunoglobulins are well known.
A “variable region” of an antibody refers to the variable region of the antibody light chain or the variable region of the antibody heavy chain, either alone or in combination. As known in the art, the variable regions of the heavy and light chains each consist of four framework regions (FRs) connected by three complementarity determining regions (CDRs) also known as hypervariable regions, and contribute to the formation of the antigen binding site of antibodies. If variants of a subject variable region are desired, particularly with substitution in amino acid residues outside of a CDR region (i.e., in the framework region), appropriate amino acid substitution, preferably, conservative amino acid substitution, can be identified by comparing the subject variable region to the variable regions of other antibodies which contain CDR1 and CDR2 sequences in the same canonincal class as the subject variable region (Chothia and Lesk, J Mol Biol 196(4): 901-917, 1987).
In certain embodiments, definitive delineation of a CDR and identification of residues comprising the binding site of an antibody is accomplished by solving the structure of the antibody and/or solving the structure of the antibody-ligand complex. In certain embodiments, that can be accomplished by any of a variety of techniques known to those skilled in the art, such as X-ray crystallography. In certain embodiments, various methods of analysis can be employed to identify or approximate the CDR regions. In certain embodiments, various methods of analysis can be employed to identify or approximate the CDR regions. Examples of such methods include, but are not limited to, the Kabat definition, the Chothia definition, the IMGT approach (Lefranc et al., 2003) Dev Comp Immunol. 27:55-77), computational programs such as Paratome (Kunik et al., 2012, Nucl Acids Res. W521-4), the AbM definition, and the conformational definition.
The Kabat definition is a standard for numbering the residues in an antibody and is typically used to identify CDR regions. See, e.g., Johnson & Wu, 2000, Nucleic Acids Res., 28: 214-8. The Chothia definition is similar to the Kabat definition, but the Chothia definition takes into account positions of certain structural loop regions. See, e.g., Chothia et al., 1986, J. Mol. Biol., 196: 901-17; Chothia et al., 1989, Nature, 342: 877-83. The AbM definition uses an integrated suite of computer programs produced by Oxford Molecular Group that model antibody structure. See, e.g., Martin et al., 1989, Proc Natl Acad Sci (USA), 86:9268-9272; “AbM™, A Computer Program for Modeling Variable Regions of Antibodies,” Oxford, UK; Oxford Molecular, Ltd. The AbM definition models the tertiary structure of an antibody from primary sequence using a combination of knowledge databases and ab initio methods, such as those described by Samudrala et al., 1999, “Ab Initio Protein Structure Prediction Using a Combined Hierarchical Approach,” in PROTEINS, Structure, Function and Genetics Suppl., 3:194-198. The contact definition is based on an analysis of the available complex crystal structures. See, e.g., MacCallum et al., 1996, J. Mol. Biol., 5:732-45. In another approach, referred to herein as the “conformational definition” of CDRs, the positions of the CDRs may be identified as the residues that make enthalpic contributions to antigen binding. See, e.g., Makabe et al., 2008, Journal of Biological Chemistry, 283:1156-1166. Still other CDR boundary definitions may not strictly follow one of the above approaches, but will nonetheless overlap with at least a portion of the Kabat CDRs, although they may be shortened or lengthened in light of prediction or experimental findings that particular residues or groups of residues do not significantly impact antigen binding. As used herein, a CDR may refer to CDRs defined by any approach known in the art, including combinations of approaches. The methods used herein may utilize CDRs defined according to any of these approaches. For any given embodiment containing more than one CDR, the CDRs may be defined in accordance with any of Kabat, Chothia, extended, IMGT, Paratome, AbM, and/or conformational definitions, or a combination of any of the foregoing.
As known in the art, a “constant region” of an antibody refers to the constant region of the antibody light chain or the constant region of the antibody heavy chain, either alone or in combination.
As used herein, “monoclonal antibody” refers to an antibody obtained from a population of substantially homogeneous antibodies, i.e., the individual antibodies comprising the population are identical except for possible naturally-occurring mutations that may be present in minor amounts. Monoclonal antibodies are highly specific, being directed against a single antigenic site. Furthermore, in contrast to polyclonal antibody preparations, which typically include different antibodies directed against different determinants (epitopes), each monoclonal antibody is directed against a single determinant on the antigen. The modifier “monoclonal” indicates the character of the antibody as being obtained from a substantially homogeneous population of antibodies, and is not to be construed as requiring production of the antibody by any particular method. For example, the monoclonal antibodies to be used in accordance with the present disclosure may be made by the hybridoma method first described by Kohler and Milstein, 1975, Nature 256:495, or may be made by recombinant DNA methods such as described in U.S. Pat. No. 4,816,567. The monoclonal antibodies may also be isolated from phage libraries generated using the techniques described in McCafferty et al., 1990, Nature 348:552-554, for example. As used herein, “humanized” antibody refers to forms of non-human (e.g. murine) antibodies that are chimeric immunoglobulins, immunoglobulin chains, or fragments thereof (such as Fv, Fab, Fab′, F(ab′)2 or other antigen-binding subsequences of antibodies) that contain minimal sequence derived from non-human immunoglobulin. Preferably, humanized antibodies are human immunoglobulins (recipient antibody) in which residues from a CDR of the recipient are replaced by residues from a CDR of a non-human species (donor antibody) such as mouse, rat, or rabbit having the desired specificity, affinity, and capacity. The humanized antibody may comprise residues that are found neither in the recipient antibody nor in the imported CDR or framework sequences, but are included to further refine and optimize antibody performance.
A “human antibody” is one which possesses an amino acid sequence which corresponds to that of an antibody produced by a human and/or has been made using any of the techniques for making human antibodies as disclosed herein. This definition of a human antibody specifically excludes a humanized antibody comprising non-human antigen binding residues.
The term “chimeric antibody” is intended to refer to antibodies in which the variable region sequences are derived from one species and the constant region sequences are derived from another species, such as an antibody in which the variable region sequences are derived from a mouse antibody and the constant region sequences are derived from a human antibody. The term “epitope” refers to that portion of a molecule capable of being recognized by and bound by an antibody at one or more of the antibody's antigen-binding regions. Epitopes often consist of a surface grouping of molecules such as amino acids or sugar side chains and have specific three-dimensional structural characteristics as well as specific charge characteristics. In some embodiments, the epitope can be a protein epitope. Protein epitopes can be linear or conformational. In a linear epitope, all of the points of interaction between the protein and the interacting molecule (such as an antibody) occur linearly along the primary amino acid sequence of the protein. A “nonlinear epitope” or “conformational epitope” comprises noncontiguous polypeptides (or amino acids) within the antigenic protein to which an antibody specific to the epitope binds. The term “antigenic epitope” as used herein, is defined as a portion of an antigen to which an antibody can specifically bind as determined by any method well known in the art, for example, by conventional immunoassays. Once a desired epitope on an antigen is determined, it is possible to generate antibodies to that epitope, e.g., using the techniques described in the present specification. Alternatively, during the discovery process, the generation and characterization of antibodies may elucidate information about desirable epitopes. From this information, it is then possible to competitively screen antibodies for binding to the same epitope. An approach to achieve this is to conduct competition and cross-competition studies to find antibodies that compete or cross-compete with one another for binding to IL-6, e.g., the antibodies compete for binding to the antigen.
The term “compete,” as used herein with regard to an antibody, means that a first antibody, or an antigen-binding portion thereof, binds to an epitope in a manner sufficiently similar to the binding of a second antibody, or an antigen-binding portion thereof, such that the result of binding of the first antibody with its cognate epitope is detectably decreased in the presence of the second antibody compared to the binding of the first antibody in the absence of the second antibody. The alternative, where the binding of the second antibody to its epitope is also detectably decreased in the presence of the first antibody, can, but need not be the case. That is, a first antibody can inhibit the binding of a second antibody to its epitope without that second antibody inhibiting the binding of the first antibody to its respective epitope. However, where each antibody detectably inhibits the binding of the other antibody with its cognate epitope or ligand, whether to the same, greater, or lesser extent, the antibodies are said to “cross-compete” with each other for binding of their respective epitope(s). Both competing and cross-competing antibodies are encompassed by the present disclosure. Regardless of the mechanism by which such competition or cross-competition occurs (e.g., steric hindrance, conformational change, or binding to a common epitope, or portion thereof), the skilled artisan would appreciate, based upon the teachings provided herein, that such competing and/or cross-competing antibodies are encompassed and can be useful for the methods disclosed herein.
As used herein, an antibody “interacts with” IL-6 when the equilibrium dissociation constant is equal to or less than 20 nM, preferably less than about 6 nM, more preferably less than about 1 nM, most preferably less than about 0.75 nM. In some embodiments, the affinity of the antibody is between 400 and 800 pM, e.g., 450-700, or 500-600 pM.
An IL-6 antagonist antibody encompasses antibodies that block, antagonize, suppress or reduce (to any degree including significantly) a IL-6 biological activity such as binding to IL-6R, IL-6/IL-6R complex binding to gp130, phosphorylation and activation of Stat3, cell proliferation, and stimulation of IL-6 mediated inflammatory or pro-angiogenic pathways. For purpose of the present disclosure, it will be explicitly understood that the term “IL-6 antagonist antibody” encompasses all the previously identified terms, titles, and functional states and characteristics whereby the IL-6 itself, an IL-6 biological activity, or the consequences of the biological activity, are substantially nullified, decreased, or neutralized in any meaningful degree. In some embodiments, an IL-6 antagonist antibody binds IL-6. Examples of IL-6 antagonist antibodies are provided herein.
An antibody that “preferentially binds” or “specifically binds” (used interchangeably herein) to an epitope is a term well understood in the art, and methods to determine such specific or preferential binding are also well known in the art. A molecule is said to exhibit “specific binding” or “preferential binding” if it reacts or associates more frequently, and/or more rapidly, and/or with greater duration and/or with greater affinity with a particular cell or substance than it does with alternative cells or substances. An antibody “specifically binds” or “preferentially binds” to a target if it binds with greater affinity, and/or avidity, and/or more readily, and/or with greater duration than it binds to other substances. For example, an antibody that specifically or preferentially binds to an IL-6 epitope is an antibody that binds this epitope with greater affinity, and/or avidity, and/or more readily, and/or with greater duration than it binds to other IL-6 epitopes or non-IL-6 epitopes. It is also understood by reading this definition that, for example, an antibody (or moiety or epitope) that specifically or preferentially binds to a first target may or may not specifically or preferentially bind to a second target. As such, “specific binding” or “preferential binding” does not necessarily require (although it can include) exclusive binding. Generally, but not necessarily, reference to binding means preferential binding.
As used herein, “substantially pure” refers to material which is at least 50% pure (i.e., free from contaminants), more preferably, at least 90% pure, more preferably, at least 95% pure, yet more preferably, at least 98% pure, and most preferably, at least 99% pure.
A “host cell” includes an individual cell or cell culture that can be or has been a recipient for vector(s) for incorporation of polynucleotide inserts. Host cells include progeny of a single host cell, and the progeny may not necessarily be completely identical (in morphology or in genomic DNA complement) to the original parent cell due to natural, accidental, or deliberate mutation. A host cell includes cells transfected in vivo with a polynucleotide(s) of this disclosure.
As known in the art, the term “Fc region” is used to define a C-terminal region of an immunoglobulin heavy chain. The “Fc region” may be a native sequence Fc region or a variant Fc region. Although the boundaries of the Fc region of an immunoglobulin heavy chain might vary, the human IgG heavy chain Fc region is usually defined to stretch from an amino acid residue at position Cys226, or from Pro230, to the carboxyl-terminus thereof. The numbering of the residues in the Fc region is that of the EU index as in Kabat. Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed. Public Health Service, National Institutes of Health, Bethesda, Md., 1991. The Fc region of an immunoglobulin generally comprises two constant domains, CH2 and CH3. As is known in the art, an Fc region can be present in dimer or monomeric form.
As used in the art, “Fc receptor” and “FcR” describe a receptor that binds to the Fc region of an antibody. The preferred FcR is a native sequence human FcR. Moreover, a preferred FcR is one which binds an IgG antibody (a gamma receptor) and includes receptors of the FcγRI, FcγRII, and FcγRIII subclasses, including allelic variants and alternatively spliced forms of these receptors. FcγRII receptors include FcγRIIA (an “activating receptor”) and FcγRIIB (an “inhibiting receptor”), which have similar amino acid sequences that differ primarily in the cytoplasmic domains thereof. FcRs are reviewed in Ravetch and Kinet, 1991, Ann. Rev. Immunol., 9:457-92; Capel et al., 1994, Immunomethods, 4:25-34; and de Haas et al., 1995, J. Lab. Clin. Med., 126:330-41. “FcR” also includes the neonatal receptor, FcRn, which is responsible for the transfer of maternal IgGs to the fetus (Guyer et al., 1976, J. Immunol., 117:587; and Kim et al., 1994, J. Immunol., 24:249).
A “functional Fc region” possesses at least one effector function of a native sequence Fc region. Exemplary “effector functions” include C1q binding; complement dependent cytotoxicity; Fc receptor binding; antibody-dependent cell-mediated cytotoxicity; phagocytosis; down-regulation of cell surface receptors (e.g. B cell receptor), etc. Such effector functions generally require the Fc region to be combined with a binding domain (e.g. an antibody variable domain) and can be assessed using various assays known in the art for evaluating such antibody effector functions.
A “native sequence Fc region” comprises an amino acid sequence identical to the amino acid sequence of an Fc region found in nature. A “variant Fc region” comprises an amino acid sequence which differs from that of a native sequence Fc region by virtue of at least one amino acid modification, yet retains at least one effector function of the native sequence Fc region. Preferably, the variant Fc region has at least one amino acid substitution compared to a native sequence Fc region or to the Fc region of a parent polypeptide, e.g. from about one to about ten amino acid substitutions, and preferably, from about one to about five amino acid substitutions in a native sequence Fc region or in the Fc region of the parent polypeptide. The variant Fc region herein will preferably possess at least about 80% sequence identity with a native sequence Fc region and/or with an Fc region of a parent polypeptide, and most preferably, at least about 90% sequence identity therewith, more preferably, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99% sequence identity therewith.
As used herein, “treatment” is an approach for obtaining beneficial or desired clinical results.
As used herein, a “disorder” or “disorders” treated or prevented by methods of the present disclosure includes, for example, tissue-specific disorders and systemic disorders. Tissue-specific disorders include, without limitation, disorders of the lung, heart and/or kidney. In some embodiments, the disorders are related to an underlying disease or pathology. In some embodiments, the disorders are responsive to treatment by one or more therapeutic agents that target IL-6 and/or VEGF, as disclosed herein. In some embodiments, the disorder is an IL-6 and/or VEGF related disorder. In some embodiments, disorders include, without limitation, pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage. IL-6 related disorders also include disorders where there is an elevated level of IL-6 activity due to IL-6 interacting with IL-6R or soluble IL-6R (sIL-6R). In some embodiments, any one or more of the IL-6 antibodies provided herein, any one of more of the VEGF Traps provided herein, any one or more of the fusion proteins provided herein and/or any one or more of the conjugates provided herein can be used for treatment or prevention of any one or more of the disorders caused by an over-reactive immune system responding to an infection, e.g., a viral infection, or other immune stimuli and/or dysregulation of vascular permeability, e.g., increased tissue vascular permeability caused by the infection. In some embodiments, the disorders are IL-6 and/or VEGF related disorders. In some embodiments, the disorders include systemic diseases that affect the lungs, kidney or heart, such as ARDS and CRS. In some embodiments, the disorders include cytokine release syndrome following CAR-T therapy or similar immune-oncology therapeutics.
Additionally, anti-IL6 molecules abrogate the induction of IL-6 expression observed following treatment with anti-PD-1/PD-L1 molecules (Tsukamoto et al, Cancer Res; 2018 78(17); 5011-22). It has also been shown that VEGF signaling blockade can improve anti-PD-L1 treatment (Allen et al, Sci Transl Med 2017 Apr. 12: 9(385)). Thus, these dual inhibitors can be used in combination with PD-1/PDL-1 modulators and/or other immune checkpoint inhibitors, to synergistically treat cancer. Other disorders can include cerebral edema in glioblastoma where anti-IL6 therapy may show additional benefits to anti-VEGF treatments. Other disorders include those with solid tumors.
As used herein, “Ameliorating” means a lessening or improvement of one or more symptoms as compared to not administering an IL-6 antibody, IL-6 antibody-VEGF Trap fusion, conjugate of IL-6 antibody, and/or conjugate of IL-6 antibody-VEGF Trap fusion. “Ameliorating” also includes shortening or reduction in duration of a symptom.
As used herein, “VEGF Trap” or similar term denotes the VEGF binding domains (e.g., VEGFR1 domain 2, VEGFR2 domain 3). This fragment allows for the protein to work as a VEGF trap, preventing VEGF from binding to cellularly expressed VEGF receptors. An example of this sequence can be found in Table 1C. In some embodiments, the VEGF Trap only includes VEGFR1 domain 2, VEGFR2 domain 3. Various embodiments of Trap proteins are known in the art and can be found, for example in U.S. Pub. No. 20150376271, the entirety of which, with respect to various VEGF Trap embodiments (which are VEGFR proteins or fragments thereof) and fusions thereof, is incorporated herein by reference. In some embodiments, the term “VEGF Trap” or similar term refers to a full length extracellular region or any portion thereof, or combination of portions from different VEGF receptors that can antagonize signaling between at least one VEGF and VEGFR. In some embodiments, a VEGF trap includes VEGF binding domains fused to an Fc region, e.g., a human Fc region. In some embodiments, a VEGF trap includes a VEGFR-Fc fusion sequence.
As used herein, “IL-6 antibody-VEGF Trap fusion”, “IL-6 antibody-VEGF Trap”, “Ab IL-6-VEGF Trap”, “AntiIL-6-VEGF Trap”, “VEGFR-AntiIL6”, “VEGFR-AntiIL-6”, “VEGF Trap-anti-IL6 Antibody Fusion (TAF)”, “VEGF Trap-IL6”, “VEGFR IL-6”, “IL6-VEGFR” or similar term or inverse terms (e.g. “VEGF Trap-IL-6 Ab,” “VEGF Trap-IL-6 antibody fusion,” etc.) denote the fusion between the IL-6 antibody and the VEGF Trap. Embodiments are depicted in
As used herein, the term “biopolymer” denotes that a polymer has been linked to the protein of interest. The term can also be described as the “conjugated” form of the protein. This can be done for all of the proteins described herein. Thus, IL-6 Ab biopolymers and IL-6 antibody-VEGF Trap biopolymers are contemplated for all such IL-6 Ab and IL-6 antibody-VEGF Trap provided herein. In addition, VEGF Trap biopolymers are also provided.
As used herein, “Antagonistic antibody” denotes an antibody that blocks one or more function or activity of the molecule that the antibody binds to.
As used herein, an “effective dosage” or “effective amount” of “therapeutically effective amount” of drug, compound, or pharmaceutical composition is an amount sufficient to effect any one or more beneficial or desired results. In more specific aspects, an effective amount prevents, alleviates or ameliorates symptoms of disease or disorder, and/or prolongs the survival of the subject being treated. For prophylactic use, beneficial or desired results include eliminating or reducing the risk, lessening the severity, or delaying the onset of the disease or disorder, including biochemical, histological and/or behavioral symptoms of the disease, its complications and intermediate pathological phenotypes presenting during development of the disease or disorder. For therapeutic use, beneficial or desired results include clinical results such as reducing one or more symptoms of a disease or disorder such as, for example, ARDS or CRS, decreasing the dose of other medications required to treat the disease or disorder, enhancing the effect of another medication, and/or delaying the progression of the disease or disorder in patients. An effective dosage can be administered in one or more administrations. For purposes of this disclosure, an effective dosage of drug, compound, or pharmaceutical composition is an amount sufficient to accomplish prophylactic or therapeutic treatment either directly or indirectly. As is understood in the clinical context, an effective dosage of a drug, compound, or pharmaceutical composition may or may not be achieved in conjunction with another drug, compound, or pharmaceutical composition. Thus, an “effective dosage” may be considered in the context of administering one or more therapeutic agents, and a single agent may be considered to be given in an effective amount if, in conjunction with one or more other agents, a desirable result may be or is achieved.
Anti-IL-6 antibodies are administered in an effective regime meaning a dosage, route of administration and frequency of administration that delays the onset, reduces the severity, inhibits further deterioration, and/or ameliorates at least one sign or symptom of a disorder. If a patient is already suffering from a disorder, the regime can be referred to as a therapeutically effective regime. If the patient is at elevated risk of the disorder relative to the general population but is not yet experiencing symptoms, the regime can be referred to as a prophylactically effective regime. In some instances, therapeutic or prophylactic efficacy can be observed in an individual patient relative to historical controls or past experience in the same patient. In other instances, therapeutic or prophylactic efficacy can be demonstrated in a preclinical or clinical trial in a population of treated patients relative to a control population of untreated patients.
Anti-IL-6-VEGF Traps are administered in an effective regime meaning a dosage, route of administration and frequency of administration that delays the onset, reduces the severity, inhibits further deterioration, and/or ameliorates at least one sign or symptom of a disorder. If a patient is already suffering from a disorder, the regime can be referred to as a therapeutically effective regime. If the patient is at elevated risk of the disorder relative to the general population but is not yet experiencing symptoms, the regime can be referred to as a prophylactically effective regime. In some instances, therapeutic or prophylactic efficacy can be observed in an individual patient relative to historical controls or past experience in the same patient. In other instances, therapeutic or prophylactic efficacy can be demonstrated in a preclinical or clinical trial in a population of treated patients relative to a control population of untreated patients.
The “biological half-life” of a substance is a pharmacokinetic parameter which specifies the time required for one half of the substance to be removed from an organism following introduction of the substance into the organism.
The term “preventing” or “prevent” refers to (a) keeping a disorder from occurring (b) delaying the onset of a disorder or onset of symptoms of a disorder, or (c) slowing the progression of an existing condition. Unless denoted otherwise, “preventing” does not require the absolute prohibition of the event from occurring.
An “individual” or a “subject” is a mammal or bird, more preferably, a human. Mammals also include, but are not limited to, farm animals (e.g., cows, pigs, horses, chickens, etc.), sport animals, pets, primates, horses, dogs, cats, mice and rats.
As used herein, “vector” means a construct, which is capable of delivering, and, preferably, expressing, one or more gene(s) or sequence(s) of interest in a host cell. Examples of vectors include, but are not limited to, viral vectors, naked DNA or RNA expression vectors, plasmid, cosmid or phage vectors, DNA or RNA expression vectors associated with cationic condensing agents, DNA or RNA expression vectors encapsulated in liposomes, and certain eukaryotic cells, such as producer cells.
As used herein, “expression control sequence” means a nucleic acid sequence that directs transcription of a nucleic acid. An expression control sequence can be a promoter, such as a constitutive or an inducible promoter, or an enhancer. The expression control sequence is operably linked to the nucleic acid sequence to be transcribed.
As used herein, “pharmaceutically acceptable carrier” or “pharmaceutical acceptable excipient” includes any material which, when combined with an active ingredient, allows the ingredient to retain biological activity and is non-reactive with the subject's immune system. Examples include, but are not limited to, any of the standard pharmaceutical carriers such as a phosphate buffered saline solution, water, emulsions such as oil/water emulsion, various types of wetting agents, detergents such as polysorbate 20 to prevent aggregation, and sugars such as sucrose as cryoprotectant. Preferred diluents for aerosol or parenteral administration are phosphate buffered saline (PBS) or normal (0.9%) saline. Compositions comprising such carriers are formulated by well-known conventional methods (see, for example, Remington's Pharmaceutical Sciences, 18th edition, A. Gennaro, ed., Mack Publishing Co., Easton, P A, 1990; and Remington, The Science and Practice of Pharmacy 20th Ed. Mack Publishing, 2000).
The term “kon”, as used herein, refers to the rate constant for association of an antibody (or bioconjugate) to an antigen. Specifically, the rate constants (kon and koff) and equilibrium dissociation constants are measured using full-length antibodies and/or Fab antibody fragments (i.e. univalent) and IL-6.
The term “koff”, as used herein, refers to the rate constant for dissociation of an antibody (or bioconjugate) from the antibody/antigen complex.
The term “KD”, as used herein, refers to the equilibrium dissociation constant of an antibody-antigen (or bioconjugate-antigen) interaction.
Reference to “about” a value or parameter herein includes (and describes) embodiments that are directed to that value or parameter per se. For example, description referring to “about X” includes description of “X.” Numeric ranges are inclusive of the numbers defining the range.
The term “patient” includes human and other subjects (including mammals) that receive either prophylactic or therapeutic treatment.
For purposes of classifying amino acids substitutions as conservative or nonconservative, amino acids are grouped as follows: Group I (hydrophobic side chains): met, ala, val, leu, ile; Group II (neutral hydrophilic side chains): cys, ser, thr; Group III (acidic side chains): asp, glu; Group IV (basic side chains): asn, gln, his, lys, arg; Group V (residues influencing chain orientation): gly, pro; and Group VI (aromatic side chains): trp, tyr, phe. Conservative substitutions involve substitutions between amino acids in the same class. Non-conservative substitutions constitute exchanging a member of one of these classes for a member of another.
Percentage sequence identities are determined with antibody sequences maximally aligned by the Kabat numbering convention for a variable region or EU numbering for a constant region. After alignment, if a subject antibody region (e.g., the entire mature variable region of a heavy or light chain) is being compared with the same region of a reference antibody, the percentage sequence identity between the subject and reference antibody regions is the number of positions occupied by the same amino acid in both the subject and reference antibody region divided by the total number of aligned positions of the two regions, with gaps not counted, multiplied by 100 to convert to percentage. Sequence identities of other sequences can be determined by aligning sequences using algorithms, such as BESTFIT, FASTA, and TFASTA in the Wisconsin Genetics Software Package Release 7.0, Genetics Computer Group, 575 Science Dr., Madison, WI, using default gap parameters, or by inspection, and the best alignment (i.e., resulting in the highest percentage of sequence similarity over a comparison window). Percentage of sequence identity is calculated by comparing two optimally aligned sequences over a window of comparison, determining the number of positions at which the identical residues occurs in both sequences to yield the number of matched positions, dividing the number of matched positions by the total number of positions in the window of comparison (i.e., the window size), and multiplying the result by 100 to yield the percentage of sequence identity.
The term “antibody-dependent cellular cytotoxicity”, or ADCC, is a mechanism for inducing cell death that depends upon the interaction of antibody-coated target cells (i.e., cells with bound antibody) with immune cells possessing lytic activity (also referred to as effector cells). Such effector cells include natural killer cells, monocytes/macrophages and neutrophils. ADCC is triggered by interactions between the Fc region of an antibody bound to a cell and Fcγ receptors, particularly FcγRI and FcγRIII, on immune effector cells such as neutrophils, macrophages and natural killer cells. The target cell is eliminated by phagocytosis or lysis, depending on the type of mediating effector cell. Death of the antibody-coated target cell occurs as a result of effector cell activity.
A humanized antibody is a genetically engineered antibody in which the CDRs from a non-human “donor” antibody are grafted into a human “acceptor” antibody sequences (see, e.g., Queen, U.S. Pat. Nos. 5,530,101 and 5,585,089; Winter, U.S. Pat. No. 5,225,539, Carter, U.S. Pat. No. 6,407,213, Adair, U.S. Pat. No. 5,859,205 6,881,557, Foote, U.S. Pat. No. 6,881,557). The acceptor antibody sequences can be, for example, a mature human antibody sequence, a composite of such sequences, a consensus sequence of human antibody sequences, or a germline region sequence. Thus, a humanized antibody is an antibody having some or all CDRs entirely or substantially from a donor antibody and variable region framework sequences and constant regions, if present, entirely or substantially from human antibody sequences. Similarly a humanized heavy chain has at least one, two and usually all three CDRs entirely or substantially from a donor antibody heavy chain, and a heavy chain variable region framework sequence and heavy chain constant region, if present, substantially from human heavy chain variable region framework and constant region sequences. Similarly a humanized light chain has at least one, two and usually all three CDRs entirely or substantially from a donor antibody light chain, and a light chain variable region framework sequence and light chain constant region, if present, substantially from human light chain variable region framework and constant region sequences. Other than nanobodies and dAbs, a humanized antibody comprises a humanized heavy chain and a humanized light chain. A CDR in a humanized antibody is substantially from a corresponding CDR in a non-human antibody when at least 85%, 90%, 95% or 100% of corresponding residues (as defined by Kabat) are identical between the respective CDRs. The variable region framework sequences of an antibody chain or the constant region of an antibody chain are substantially from a human variable region framework sequence or human constant region respectively when at least 85, 90, 95 or 100% of corresponding residues defined by Kabat are identical.
Although humanized antibodies often incorporate all six CDRs (preferably as defined by Kabat) from a mouse antibody, they can also be made with less than all CDRs (e.g., at least 3, 4, or 5 CDRs from a mouse antibody) (e.g., Pascalis et al, J. Immunol. 169:3076, 2002; Vajdos et al., Journal of Molecular Biology, 320: 415-428, 2002; Iwahashi et al., Mol. Immunol. 36: 1079-1091, 1999; Tamura et al, Journal of Immunology, 164: 1432-1441, 2000).
A chimeric antibody is an antibody in which the mature variable regions of light and heavy chains of a non-human antibody (e.g., a mouse) are combined with human light and heavy chain constant regions. Such antibodies substantially or entirely retain the binding specificity of the mouse antibody and are about two-thirds human sequence.
A veneered antibody is a type of humanized antibody that retains some and usually all of the CDRs and some of the non-human variable region framework residues of a non-human antibody but replaces other variable region framework residues that may contribute to B- or T-cell epitopes, for example exposed residues (Padlan, Mol. Immunol. 28:489, 1991) with residues from the corresponding positions of a human antibody sequence. The result is an antibody in which the CDRs are entirely or substantially from a non-human antibody and the variable region frameworks of the non-human antibody are made more human-like by the substitutions. A human antibody can be isolated from a human, or otherwise result from expression of human immunoglobulin genes (e.g., in a transgenic mouse, in vitro or by phage display). Methods for producing human antibodies include the trioma method of Oestberg et al., Hybridoma 2:361-367 (1983); Oestberg, U.S. Pat. No. 4,634,664; and Engleman et al., U.S. Pat. No. 4,634,666, use of transgenic mice including human immunoglobulin genes (see, e.g., Lonberg et al., WO93/12227 (1993); U.S. Pat. Nos. 5,877,397, 5,874,299, 5,814,318, 5,789,650, 5,770,429, 5,661,016, 5,633,425, 5,625,126, 5,569,825, 5,545,806, Nature 148, 1547-1553 (1994), Nature Biotechnology 14, 826 (1996), Kucherlapati, WO 91/10741 (1991) and phage display methods (see, e.g. Dower et al., WO 91/17271 and McCafferty et al., WO 92/01047, U.S. Pat. Nos. 5,877,218, 5,871,907, 5,858,657, 5,837,242, 5,733,743 and 5,565,332.
A “polymer” is a molecule composed of many repeating subunits. The subunits, also sometimes referred to as “monomers” can be the same or different. There are both natural and synthetic polymers. DNA, protein and complex carbohydrates are examples of natural polymers. Poly-styrene and poly-acrylamide are examples of synthetic polymers. A polymer composed of repeating units of a single monomer is called a homopolymer. A polymer composed of two or more monomers is called a copolymer or sometimes a heteropolymer. A copolymer in which certain monomer types are clustered together are sometimes called block copolymers. Polymers can be linear or branched. When the polymer is branched, polymer chains having a common origin are sometimes referred to as a polymer arm(s).
An “initiator” is a compound capable of serving as a substrate on which one or more polymerizations can take place using monomers or comonomers as described herein. The polymerization can be a conventional free radical polymerization or preferably a controlled/“living” radical polymerization, such as Atom Transfer Radical Polymerization (ATRP), Reversible Addition-Fragmentation-Termination (RAFT) polymerization or nitroxide mediated polymerization (NMP). The polymerization can be a “pseudo” controlled polymerization, such as degenerative transfer. Initiators suitable for ATRP contain one or more labile bonds which can be homolytically cleaved to form an initiator fragment, I, being a radical capable of initiating a radical polymerization, and a radical scavenger, I′, which reacts with the radical of the growing polymer chain to reversibly terminate the polymerization. The radical scavenger I′ is typically a halogen, but can also be an organic moiety, such as a nitrile. In some embodiments of the present disclosure, the initiator contains one or more 2-bromoisobutyrate groups as sites for polymerization via ATRP.
A “chemical linker” refers to a chemical moiety that links two groups together, such as a half-life extending moiety and a protein. The linker can be cleavable or non-cleavable. Cleavable linkers can be hydrolysable, enzymatically cleavable, pH sensitive, photolabile, or disulfide linkers, among others. Other linkers include homobifunctional and heterobifunctional linkers. A “linking group” is a functional group capable of forming a covalent linkage consisting of one or more bonds to a bioactive agent. Non-limiting examples include those illustrated in Table 1 of WO2013059137 (incorporated by reference).
The term “reactive group” refers to a group that is capable of reacting with another chemical group to form a covalent bond, i.e. is covalently reactive under suitable reaction conditions, and generally represents a point of attachment for another substance. The reactive group is a moiety, such as maleimide or succinimidyl ester, is capable of chemically reacting with a functional group on a different moiety to form a covalent linkage. Reactive groups generally include nucleophiles, electrophiles and photoactivatable groups.
As used herein, “phosphorylcholine,” also denoted as “PC,” refers to the following:
where * denotes the point of attachment. The phosphorylcholine is a zwitterionic group and includes salts (such as inner salts), and protonated and deprotonated forms thereof.
As used herein, “phosphorylcholine-based polymer” is a polymer that contains phosphorylcholine. “Zwitterion containing polymer” refers to a polymer that contains a zwitterion.
Poly(acryloyloxyethyl phosphorylcholine) containing polymer refers to a polymer containing 2-(acryloyloxy)ethyl-2-(trimethylammonium)ethyl phosphate as monomer.
Poly(methacryloyloxyethyl phosphorylcholine) containing polymer refers to a polymer containing 2-(methacryloyloxy)ethyl-2-(trimethylammonium)ethyl phosphate as monomer.
As used herein, “molecular weight” in the context of the polymer can be expressed as either a number average molecular weight, or a weight average molecular weight or a peak molecular weight. Unless otherwise indicated, all references to molecular weight herein refer to the peak molecular weight. These molecular weight determinations, number average (Mn), weight average (Mw) and peak (Mp), can be measured using size exclusion chromatography or other liquid chromatography techniques. Other methods for measuring molecular weight values can also be used, such as the use of end-group analysis or the measurement of colligative properties (e.g., freezing-point depression, boiling-point elevation, or osmotic pressure) to determine number average molecular weight, or the use of light scattering techniques, ultracentrifugation or viscometry to determine weight average molecular weight. In a preferred embodiment of the present disclosure, the molecular weight is measured by SEC-MALS (size exclusion chromatography—multi angle light scattering). The polymeric reagents of the present disclosure are typically polydisperse (i.e., number average molecular weight and weight average molecular weight of the polymers are not equal). The Poly Dispersity Index (PDI) provides a measure for the dispersity of polymers in a mixture. PDI is given by the formula Mw/Mn. In this regard a homogenous protein will have a PDI of 1.0 (Mn is the same as Mw). Typically, the PDI for polymers will be above 1.0. Polymers in accordance with the present disclosure preferably have relatively low polydispersity (PDI) values of, for example, less than about 1.5, as judged, for example, by SEC-MALS. In other embodiments, the polydispersities (PDI) are more preferably in the range of about 1.4 to about 1.2, still more preferably less than about 1.15, and still more preferably less than about 1.10, yet still more preferably less than about 1.05, and most preferably less than about 1.03.
As used herein, “protected,” “protected form,” “protecting group” and “protective group” refer to the presence of a group (i.e., the protecting group) that prevents or blocks reaction of a particular chemically reactive functional group in a molecule under certain reaction conditions. Protecting groups vary depending upon the type of chemically reactive group being protected as well as the reaction conditions to be employed and the presence of additional reactive or protecting groups in the molecule, if any. Suitable protecting groups include those such as found in the treatise by Greene et al., “Protective Groups In Organic Synthesis,” 3rd Edition, John Wiley and Sons, Inc., New York, 1999.
As used herein, “alkyl” refers to a straight or branched, saturated, aliphatic radical having the number of carbon atoms indicated. For example, C1-C6 alkyl includes, but is not limited to, methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, tert-butyl, pentyl, isopentyl, hexyl, etc. Other alkyl groups include, but are not limited to heptyl, octyl, nonyl, decyl, etc. Alkyl can include any number of carbons, such as 1-2, 1-3, 1-4, 1-5, 1-6, 1-7, 1-8, 1-9, 1-10, 2-3, 2-4, 2-5, 2-6, 3-4, 3-5, 3-6, 4-5, 4-6 and 5-6 carbons.
The term “lower” referred to above and hereinafter in connection with organic radicals or compounds respectively defines a compound or radical which can be branched or unbranched with up to and including 7, preferably up to and including 4 and (as unbranched) one or two carbon atoms.
As used herein, “alkylene” refers to an alkyl group, as defined above, linking at least two other groups, i.e., a divalent hydrocarbon radical. The two moieties linked to the alkylene can be linked to the same atom or different atoms of the alkylene. For instance, a straight chain alkylene can be the bivalent radical of —(CH2)n, where n is 1, 2, 3, 4, 5 or 6. Alkylene groups include, but are not limited to, methylene, ethylene, propylene, isopropylene, butylene, isobutylene, sec-butylene, pentylene and hexylene.
Substituents for the alkyl, alkenyl, alkylene, heteroalkyl, heteroalkylene, heteroalkenyl, alkynyl, cycloalkyl, heterocycloalkyl, cycloalkenyl, and heterocycloalkenyl radicals can be one or more of a variety of groups selected from, but not limited to: —OR′, ═O, ═NR′, ═N—OR′, —NR′R″, —SR′, -halogen, —SiR′R″R′″, —OC(O)R′, —C(O)R′, —CO2R′, —CONR′R″, —OC(O)NR′R″, —NR″C(O)R′, —NR′—C(O)NR″R′″, —NR″C(O)2R′, —NR—C(NR′R″R′″)═NR″″, —NR—C(NR′R″)═NR′″, —S(O)R′, —S(O)2R′, —S(O)2NR′R″, —NRSO2R′, —CN and —NO2 in a number ranging from 1 to (2m′+1), where m′ is the total number of carbon atoms in such radical. Each of R′, R″, R′″ and R″″ independently refers to hydrogen, substituted or unsubstituted heteroalkyl, substituted or unsubstituted aryl, e.g., aryl substituted with 1-3 halogens, substituted or unsubstituted alkyl, alkoxy or thioalkoxy groups, or arylalkyl groups. When R′ and R″ are attached to the same nitrogen atom, they can be combined with the nitrogen atom to form a 5-, 6-, or 7-membered ring. For example, —NR′R″ is meant to include, but not be limited to, 1-pyrrolidinyl and 4-morpholinyl.
As used herein, “alkoxy” refers to alkyl group attached to an oxygen atom and forms radical —O—R, wherein R is alkyl. Alkoxy groups include, for example, methoxy, ethoxy, propoxy, iso-propoxy, butoxy, 2-butoxy, iso-butoxy, sec-butoxy, tert-butoxy, pentoxy, hexoxy, etc. The alkoxy groups can be further substituted with a variety of substituents described herein. For example, the alkoxy groups can be substituted with halogens to form a “halo-alkoxy” group.
As used herein, “carboxyalkyl” means an alkyl group (as defined herein) substituted with a carboxy group. The term “carboxycycloalkyl” means an cycloalkyl group (as defined herein) substituted with a carboxy group. The term alkoxyalkyl means an alkyl group (as defined herein) substituted with an alkoxy group. The term “carboxy” employed herein refers to carboxylic acids and their esters.
As used herein, “haloalkyl” refers to alkyl as defined above where some or all of the hydrogen atoms are substituted with halogen atoms. Halogen (halo) preferably represents chloro or fluoro, but may also be bromo or iodo. For example, haloalkyl includes trifluoromethyl, fluoromethyl, 1,2,3,4,5-pentafluoro-phenyl, etc. The term “perfluoro” defines a compound or radical which has all available hydrogens that are replaced with fluorine. For example, perfluorophenyl refers to 1,2,3,4,5-pentafluorophenyl, perfluoromethyl refers to 1,1,1-trifluoromethyl, and perfluoromethoxy refers to 1,1,1-trifluoromethoxy. Haloalkyl can also be referred to as halo-substitute alkyl, such as fluoro-substituted alkyl.
As used herein, “cytokine” in the context of this disclosure is a member of a group of protein signaling molecules that may participate in cell-cell communication in immune and inflammatory responses. Cytokines are typically small, water-soluble glycoproteins that have a mass of about 8-35 kDa.
As used herein, “cycloalkyl” refers to a saturated mono- or multi-cyclic aliphatic ring system that contains from about 3 to 12, from 3 to 10, from 3 to 7, or from 3 to 6 carbon atoms. When cycloalkyl group is composed of two or more rings, the rings may be joined together with a fused ring or a spiro ring structure. When cycloalkyl group is composed of three or more rings, the rings may also join together forming a bridged ring structure. Monocyclic rings include, for example, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, and cyclooctyl. Bicyclic and polycyclic rings include, for example, bicyclo[1.1.1]pentane, bicyclco[2.1.1]heptane, norbornane, decahydronaphthalene and adamantane. For example, C3-8 cycloalkyl includes cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclooctyl, and norbornane.
As used herein, “endocyclic” refers to an atom or group of atoms which comprise part of a cyclic ring structure.
As used herein, “exocyclic” refers to an atom or group of atoms which are attached but do not define the cyclic ring structure.
As used herein, “cyclic alkyl ether” refers to a 4 or 5 member cyclic alkyl group having 3 or 4 endocyclic carbon atoms and 1 endocyclic oxygen or sulfur atom (e.g., oxetane, thietane, tetrahydrofuran, tetrahydrothiophene); or a 6 to 7 member cyclic alkyl group having 1 or 2 endocyclic oxygen or sulfur atoms (e.g., tetrahydropyran, 1,3-dioxane, 1,4-dioxane, tetrahydrothiopyran, 1,3-dithiane, 1,4-dithiane, 1,4-oxathiane).
As used herein, “alkenyl” refers to either a straight chain or branched hydrocarbon of 2 to 6 carbon atoms, having at least one double bond. Examples of alkenyl groups include, but are not limited to, vinyl, propenyl, isopropenyl, 1-butenyl, 2-butenyl, isobutenyl, butadienyl, 1-pentenyl, 2-pentenyl, isopentenyl, 1,3-pentadienyl, 1,4-pentadienyl, 1-hexenyl, 2-hexenyl, 3-hexenyl, 1,3-hexadienyl, 1,4-hexadienyl, 1,5-hexadienyl, 2,4-hexadienyl, or 1,3,5-hexatrienyl. Alkenyl groups can also have from 2 to 3, 2 to 4, 2 to 5, 3 to 4, 3 to 5, 3 to 6, 4 to 5, 4 to 6 and 5 to 6 carbons.
As used herein, “alkenylene” refers to an alkenyl group, as defined above, linking at least two other groups, i.e., a divalent hydrocarbon radical. The two moieties linked to the alkenylene can be linked to the same atom or different atoms of the alkenylene. Alkenylene groups include, but are not limited to, ethenylene, propenylene, isopropenylene, butenylene, isobutenylene, sec-butenylene, pentenylene and hexenylene.
As used herein, “alkynyl” refers to either a straight chain or branched hydrocarbon of 2 to 6 carbon atoms, having at least one triple bond. Examples of alkynyl groups include, but are not limited to, acetylenyl, propynyl, 1-butynyl, 2-butynyl, isobutynyl, sec-butynyl, butadiynyl, 1-pentynyl, 2-pentynyl, isopentynyl, 1,3-pentadiynyl, 1,4-pentadiynyl, 1-hexynyl, 2-hexynyl, 3-hexynyl, 1,3-hexadiynyl, 1,4-hexadiynyl, 1,5-hexadiynyl, 2,4-hexadiynyl, or 1,3,5-hexatriynyl. Alkynyl groups can also have from 2 to 3, 2 to 4, 2 to 5, 3 to 4, 3 to 5, 3 to 6, 4 to 5, 4 to 6 and 5 to 6 carbons.
As used herein, “alkynylene” refers to an alkynyl group, as defined above, linking at least two other groups, i.e., a divalent hydrocarbon radical. The two moieties linked to the alkynylene can be linked to the same atom or different atoms of the alkynylene. Alkynylene groups include, but are not limited to, ethynylene, propynylene, butynylene, sec-butynylene, pentynylene and hexynylene.
As used herein, “cycloalkylene” refers to a cycloalkyl group, as defined above, linking at least two other groups, i.e., a divalent hydrocarbon radical. The two moieties linked to the cycloalkylene can be linked to the same atom or different atoms of the cycloalkylene. Cycloalkylene groups include, but are not limited to, cyclopropylene, cyclobutylene, cyclopentylene, cyclohexylene, and cyclooctylene.
As used herein, “heterocycloalkyl” refers to a ring system having from 3 ring members to about 20 ring members and from 1 to about 5 heteroatoms such as N, O and S. Additional heteroatoms can also be useful, including, but not limited to, B, Al, Si and P. The heteroatoms can also be oxidized, such as, but not limited to, —S(O)— and —S(O)2—. For example, heterocycle includes, but is not limited to, tetrahydrofuranyl, tetrahydrothiophenyl, morpholino, pyrrolidinyl, pyrrolinyl, imidazolidinyl, imidazolinyl, pyrazolidinyl, pyrazolinyl, piperazinyl, piperidinyl, indolinyl, quinuclidinyl and 1,4-dioxa-8-aza-spiro[4.5]dec-8-yl.
As used herein, “heterocycloalkylene” refers to a heterocyclalkyl group, as defined above, linking at least two other groups. The two moieties linked to the heterocycloalkylene can be linked to the same atom or different atoms of the heterocycloalkylene.
As used herein, “aryl” refers to a monocyclic or multicyclic (e.g., fused bicyclic, tricyclic or greater) aromatic ring assembly containing 6 to 16 carbon atoms. For example, aryl may be phenyl, benzyl or naphthyl, preferably phenyl. Aryl groups can be mono-, di- or tri-substituted by one, two or three radicals selected from alkyl, alkoxy, aryl, hydroxy, halogen, cyano, amino, amino-alkyl, trifluoromethyl, alkylenedioxy and oxy-C2-C3-alkylene; all of which are optionally further substituted, for instance as hereinbefore defined; or 1- or 2-naphthyl; or 1- or 2-phenanthrenyl. Alkylenedioxy is a divalent substitute attached to two adjacent carbon atoms of phenyl, e.g. methylenedioxy or ethylenedioxy. Oxy-C2-C3-alkylene is also a divalent substituent attached to two adjacent carbon atoms of phenyl, e.g. oxyethylene or oxypropylene. An example for oxy-C2-C3-alkylene-phenyl is 2,3-dihydrobenzofuran-5-yl.
Preferred as aryl is naphthyl, phenyl or phenyl mono- or disubstituted by alkoxy, phenyl, halogen, alkyl or trifluoromethyl, especially phenyl or phenyl-mono- or disubstituted by alkoxy, halogen or trifluoromethyl, and in particular phenyl.
Examples of substituted phenyl groups as R are, e.g. 4-chlorophen-1-yl, 3,4-dichlorophen-1-yl, 4-methoxyphen-1-yl, 4-methylphen-1-yl, 4-aminomethylphen-1-yl, 4-methoxyethylaminomethylphen-1-yl, 4-hydroxyethylaminomethylphen-1-yl, 4-hydroxyethyl-(methyl)-aminomethylphen-1-yl, 3-aminomethylphen-1-yl, 4-N-acetylaminomethylphen-1-yl, 4-aminophen-1-yl, 3-aminophen-1-yl, 2-aminophen-1-yl, 4-phenyl-phen-1-yl, 4-(imidazol-1-yl)-phenyl, 4-(imidazol-1-ylmethyl)-phen-1-yl, 4-(morpholin-1-yl)-phen-1-yl, 4-(morpholin-1-ylmethyl)-phen-1-yl, 4-(2-methoxyethylaminomethyl)-phen-1-yl and 4-(pyrrolidin-1-ylmethyl)-phen-1-yl, 4-(thiophenyl)-phen-1-yl, 4-(3-thiophenyl)-phen-1-yl, 4-(4-methylpiperazin-1-yl)-phen-1-yl, and 4-(piperidinyl)-phenyl and 4-(pyridinyl)-phenyl optionally substituted in the heterocyclic ring.
As used herein, “arylene” refers to an aryl group, as defined above, linking at least two other groups. The two moieties linked to the arylene are linked to different atoms of the arylene. Arylene groups include, but are not limited to, phenylene.
As used herein, “arylene-oxy” refers to an arylene group, as defined above, where one of the moieties linked to the arylene is linked through an oxygen atom. Arylene-oxy groups include, but are not limited to, phenylene-oxy.
Similarly, substituents for the aryl and heteroaryl groups are varied and are selected from: -halogen, —OR′, —OC(O)R′, —NR′R″, —SR′, —R′, —CN, —NO2, —CO2R′, —CONR′R″, —C(O)R′, —OC(O)NR′R″, —NR″C(O)R′, —NR″C(O)2R′, —NR′—C(O)NR″R′″, —NH—C(NH2)═NH, —NR′C(NH2)═NH, —NH—C(NH2)═NR′, —S(O)R′, —S(O)2R′, —S(O)2NR′R″, —N3, —CH(Ph)2, perfluoro(C1-C4)alkoxy, and perfluoro(C1-C4)alkyl, in a number ranging from zero to the total number of open valences on the aromatic ring system; and where R′, R″ and R′″ are independently selected from hydrogen, (C1-C8)alkyl and heteroalkyl, unsubstituted aryl and heteroaryl, (unsubstituted aryl)-(C1-C4)alkyl, and (unsubstituted aryl)oxy-(C1-C4)alkyl.
Two of the substituents on adjacent atoms of the aryl or heteroaryl ring may optionally be replaced with a substituent of the formula -T-C(O)—(CH2)q—U—, wherein T and U are independently —NH—, —O—, —CH2— or a single bond, and q is an integer of from 0 to 2. Alternatively, two of the substituents on adjacent atoms of the aryl or heteroaryl ring may optionally be replaced with a substituent of the formula -A-(CH2)r—B—, wherein A and B are independently —CH2—, —O—, —NH—, —S—, —S(O)—, —S(O)2—, —S(O)2NR′— or a single bond, and r is an integer of from 1 to 3. One of the single bonds of the new ring so formed may optionally be replaced with a double bond. Alternatively, two of the substituents on adjacent atoms of the aryl or heteroaryl ring may optionally be replaced with a substituent of the formula —(CH2)s—X—(CH2)t—, where s and t are independently integers of from 0 to 3, and X is —O—, —NR′—, —S—, —S(O)—, —S(O)2—, or —S(O)2NR′—. The substituent R′ in —NR′— and —S(O)2NR′— is selected from hydrogen or unsubstituted (C1-C6)alkyl.
As used herein, “heteroaryl” refers to a monocyclic or fused bicyclic or tricyclic aromatic ring assembly containing 5 to 16 ring atoms, where from 1 to 4 of the ring atoms are a heteroatom each N, O or S. For example, heteroaryl includes pyridyl, indolyl, indazolyl, quinoxalinyl, quinolinyl, isoquinolinyl, benzothienyl, benzofuranyl, furanyl, pyrrolyl, thiazolyl, benzothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl, pyrazolyl, imidazolyl, thienyl, or any other radicals substituted, especially mono- or di-substituted, by e.g. alkyl, nitro or halogen. Pyridyl represents 2-, 3- or 4-pyridyl, advantageously 2- or 3-pyridyl. Thienyl represents 2- or 3-thienyl. Quinolinyl represents preferably 2-, 3- or 4-quinolinyl. Isoquinolinyl represents preferably 1-, 3- or 4-isoquinolinyl. Benzopyranyl, benzothiopyranyl represents preferably 3-benzopyranyl or 3-benzothiopyranyl, respectively. Thiazolyl represents preferably 2- or 4-thiazolyl, and most preferred, 4-thiazolyl. Triazolyl is preferably 1-, 2- or 5-(1,2,4-triazolyl). Tetrazolyl is preferably 5-tetrazolyl.
Preferably, heteroaryl is pyridyl, indolyl, quinolinyl, pyrrolyl, thiazolyl, isoxazolyl, triazolyl, tetrazolyl, pyrazolyl, imidazolyl, thienyl, furanyl, benzothiazolyl, benzofuranyl, isoquinolinyl, benzothienyl, oxazolyl, indazolyl, or any of the radicals substituted, especially mono- or di-substituted.
The term “heteroalkyl” refers to an alkyl group having from 1 to 3 heteroatoms such as N, O and S. Additional heteroatoms can also be useful, including, but not limited to, B, Al, Si and P. The heteroatoms can also be oxidized, such as, but not limited to, —S(O)— and —S(O)2—. For example, heteroalkyl can include ethers, thioethers, alkyl-amines and alkyl-thiols.
The term “heteroalkylene” refers to a heteroalkyl group, as defined above, linking at least two other groups. The two moieties linked to the heteroalkylene can be linked to the same atom or different atoms of the heteroalkylene.
As used herein, “electrophile” refers to an ion or atom or collection of atoms, which may be ionic, having an electrophilic center, i.e., a center that is electron seeking, capable of reacting with a nucleophile. An electrophile (or electrophilic reagent) is a reagent that forms a bond to its reaction partner (the nucleophile) by accepting both bonding electrons from that reaction partner.
As used herein, “nucleophile” refers to an ion or atom or collection of atoms, which may be ionic, having a nucleophilic center, i.e., a center that is seeking an electrophilic center or capable of reacting with an electrophile. A nucleophile (or nucleophilic reagent) is a reagent that forms a bond to its reaction partner (the electrophile) by donating both bonding electrons. A “nucleophilic group” refers to a nucleophile after it has reacted with a reactive group. Non limiting examples include amino, hydroxyl, alkoxy, haloalkoxy and the like.
As used herein, “maleimido” refers to a pyrrole-2,5-dione-1-yl group having the structure:
which upon reaction with a sulfhydryl (e.g., a thio alkyl) forms an —S-maleimido group having the structure
where “•” indicates the point of attachment for the maleimido group and “” indicates the point of attachment of the sulfur atom the thiol to the remainder of the original sulfhydryl bearing group.
For the purpose of this disclosure, “naturally occurring amino acids” found in proteins and polypeptides are L-alanine, L-arginine, L-asparagine, L-aspartic acid, L-cysteine, L-glutamine, L-glutamic acid, L-glycine, L-histidine, L-isoleucine, L-leucine, L-lysine, L-methionine, L-phenylalanine, L-proline, L-serine, L-threonine, L-tryptophan, L-tyrosine, and or L-valine. “Non-naturally occurring amino acids” found in proteins are any amino acid other than those recited as naturally occurring amino acids. Non-naturally occurring amino acids include, without limitation, the D isomers of the naturally occurring amino acids, and mixtures of D and L isomers of the naturally occurring amino acids. Other amino acids, such as 4-hydroxyproline, desmosine, isodesmosine, 5-hydroxylysine, epsilon-N-methyllysine, 3-methylhistidine, although found in naturally occurring proteins, are considered to be non-naturally occurring amino acids found in proteins for the purpose of this disclosure as they are generally introduced by means other than ribosomal translation of mRNA.
As used herein, “linear” in reference to the geometry, architecture or overall structure of a polymer, refers to polymer having a single polymer arm.
As used herein, “branched,” in reference to the geometry, architecture or overall structure of a polymer, refers to a polymer having 2 or more polymer “arms” extending from a core structure contained within an initiator. The initiator may be employed in an atom transfer radical polymerization (ATRP) reaction. A branched polymer may possess 2 polymer chains (arms), 3 polymer arms, 4 polymer arms, 5 polymer arms, 6 polymer arms, 7 polymer arms, 8 polymer arms, 9 polymer arms or more. Each polymer arm extends from a polymer initiation site. Each polymer initiation site is capable of being a site for the growth of a polymer chain by the addition of monomers. For example and not by way of limitation, using ATRP, the site of polymer initiation on an initiator is typically an organic halide undergoing a reversible redox process catalyzed by a transition metal compound such as cuprous halide. Preferably, the halide is a bromine.
As used herein, “pharmaceutically acceptable excipient” refer to an excipient that can be included in the compositions of the present disclosure and that causes no significant adverse toxicological effect on the patient and is approved or approvable by the FDA for therapeutic use, particularly in humans. Non-limiting examples of pharmaceutically acceptable excipients include water, NaCl, normal saline solutions, lactated Ringer's, normal sucrose, normal glucose and the like.
As used herein, “OG1786” is a 9-arm initiator used for polymer synthesis with the structure shown in
As used herein, “OG1801” is an approximately (+/−15%) 750 kDa polymer (either by Mn or Mp) made using OG1786 as an initiator for ATRP synthesis using the monomer HEMA-PC. The structure of OG1801 is shown in
As used herein, “OG1802” is OG1801 with a maleimide functionality added, and it has the structure shown in
Unless otherwise defined, 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 disclosure belongs. In case of conflict, the present specification, including definitions, will control. Throughout this specification and claims, the word “comprise,” or variations such as “comprises” or “comprising” will be understood to imply the inclusion of a stated integer or group of integers but not the exclusion of any other integer or group of integers. Unless otherwise required by context, singular terms shall include pluralities and plural terms shall include the singular. Any example(s) following the term “e.g.” or “for example” is not meant to be exhaustive or limiting.
The phrase “a” or “an” entity refers to one or more of that entity; for example, a compound refers to one or more compounds or at least one compound. As such, the terms “a” (or “an”), “one or more”, and “at least one” can be used interchangeably herein.
As used herein, “about” means variation one might see in measurements taken among different instruments, samples, and sample preparations.
As used herein, CDR positions follow their order of appearance in variable domain when described. For example, heavy chain positions can be described as S35H or G66D. As used herein, Fc positions follow EU numbering when described or when noted to be in EU numbering. For example, mutations of antibodies can be described as L234A or L235A, which would be according to EU numbering. Positions may also be defined according to specified positions within a specific SEQ ID or sequence provided herein.
Multi-angle light scattering (MALS) is a technique of analyzing macromolecules where the laser light impinges on the molecule, the oscillating electric field of the light induces an oscillating dipole within it. This oscillating dipole will re-radiate light and can be measured using a MALS detector such as Wyatt miniDawn TREOS. The intensity of the radiated light depends on the magnitude of the dipole induced in the macromolecule which in turn is proportional to the polarizability of the macromolecule, the larger the induced dipole, and hence, the greater the intensity of the scattered light. Therefore, in order to analyze the scattering from a solution of such macromolecules, one should know their polarizability relative to the surrounding medium (e.g., the solvent). This may be determined from a measurement of the change, Δn, of the solution's refractive index n with the molecular concentration change, Δc, by measuring the dn/dc (=Δn/Δc) value using a Wyatt Optilab T-rEX differential refractometer. Two molar weight parameters that MALS determination employ are number average molecular weight (Mn) and weight average molecular weight (Mw) where the polydispersity index (PDI) equals Mw divided by Mn. SEC also allows another average molecular weight determination of the peak molecular weight Mp which is defined as the molecular weight of the highest peak at the SEC.
The PDI is used as a measure of the broadness of a molecular weight distribution of a polymer and bioconjugate which is derived from conjugation of a discrete protein to a polydisperse biopolymer (e.g., OG1802). For a protein sample, its polydispersity is close to 1.0 due to the fact that it is a product of translation where every protein molecule in a solution is expected to have almost the same length and molar mass. In contrast, due to the polydisperse nature of the biopolymer where the various length of polymer chains are synthesized during the polymerization process, it is very important to determine the PDI of the sample as one of its quality attribute for narrow distribution of molecular weight.
Size exclusion chromatography (SEC) is a chromatography technique in which molecules in solution are separated by their size. Typically an aqueous solution is applied to transport the sample through the column which is packed with resins of various pore sizes. The resin is expected to be inert to the analyte when passing through the column and the analytes separate from each other based on their unique size and the pore size characteristics of the selected column.
Coupling the SEC with MALS or SEC/MALS provides accurate distribution of molar mass and size (root mean square radius) as opposed to relying on a set of SEC calibration standards. This type of arrangement has many advantages over traditional column calibration methods. Since the light scattering and concentration are measured for each eluting fraction, the molar mass and size can be determined independently of the elution position. This is particularly relevant for species with non-globular shaped macromolecules such as the biopolymers (OG1802) or bioconjugates; such species typically do not elute in a manner that might be described by a set of column calibration standards.
In some embodiments, a SEC/MALS analysis includes a Waters HPLC system with Alliance 2695 solvent delivery module and Waters 2996 Photodiole Array Detector equipped with a Shodex SEC-HPLC column (7.8×300 mm). This is connected online with a Wyatt miniDawn TREOS and Wyatt Optilab T-rEX differential refractometer. The Empower software from Waters can be used to control the Waters HPLC system and the ASTRA V 6.1.7.16 software from Wyatt can be used to acquire the MALS data from the Wyatt miniDawn TREOS, dn/dc data from the T-rEX detector and the mass recovery data using the A280 absorbance signal from the Waters 2996 Photodiole Array detector. SEC can be carried out at 1 ml/min in 1×PBS pH 7.4, upon sample injection, the MALS and RI signals can be analyzed by the ASTRA software for determination of absolute molar mass (Mp, Mw, Mn) and polydisperse index (PDI). In addition, the calculation also involves the input dn/dc values for polymer and protein as 0.142 and 0.183, respectively. For bioconjugates dn/dc value, the dn/dc is calculated based on the weighted MW of the polymer and the protein to be about 0.148 using the formula below:
Conjugate dn/dc=0.142×[MWpolymer/(MWpolymer+MWprotein)]+0.183×[MWprotein/(MWpolymer+MWprotein)]
Where MWpolyme.r for OG1802 measured by SEC-MALS is about 800 kDa and the MWprotein for anti-IL-6 measured by SEC-MALS is about 145 kDa, the expected total molecular weight of the bioconjugate measured by SEC-MALS is about 1000 kDa. The MWprotein for the antiIL-6 VEGF Trap or VEGF Trap-antiIL-6 is about 192 kDa, and the expected total molecular weight of the bioconjugate is 1000-1100 kDa.
Exemplary methods and materials are described herein, although methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present disclosure. The materials, methods, and examples are illustrative only and not intended to be limiting.
Provided herein are methods for the treatment or prophylaxis of a disorder, e.g., a disorder, such as acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) or pulmonary edema, caused by an over-reactive immune or tissue-specific response to an infection or other immune stimuli, and/or dysregulation of vascular permeability related to an infection and/or edema in a patient in need thereof. In general terms, the methods includes administering to the patient an effective amount of a therapeutic agents or compositions that target IL-6 and/or VEGF signaling. In some embodiments, the therapeutic agent or composition includes an isolated antagonist antibody that specifically binds to IL-6, a VEGF Trap, an anti-VEGF antibody, and/or a fusion protein comprising the IL-6 isolated antagonist antibody fused to the VEGF Trap, to thereby treat and/or prevent the disorder. In some embodiments, the method includes administering to the patient an effective amount of an isolated antagonist antibody that specifically binds to IL-6 and an effective amount of a VEGF Trap, where the IL-6 antagonist antibody may or may not be fused to the VEGF Trap. In some embodiments, the method includes administering to the patient an effective amount of a fusion protein that includes an isolated antagonist antibody that specifically binds to IL-6 and that is also fused to a VEGF Trap. In some embodiments, administering to the patient an effective amount of an isolated antagonist antibody that specifically binds to IL-6 and an effective amount of a VEGF Trap, as separate molecules, or as a fusion protein of the antibody and VEGF Trap, synergistically inhibits IL-6 and VEGF signaling pathways, to thereby treat or prevent the disorder. In some embodiments, the isolated IL-6 antagonist antibody or the fusion protein is a conjugate, e.g., a polymer conjugate. Any suitable isolated IL-6 antagonist antibodies, VEGF Traps, fusion proteins, and conjugates as disclosed herein can be used in the present methods for the treatment or prophylaxis of a disorder.
A variety of disorders can be treated and/or prevented by the present methods. In some embodiments, a disorder treated by the present methods is caused by an over-reactive immune or tissue-specific response to and/or dysregulation of vascular permeability related to an infection and/or edema, e.g., a viral infection, or other immune stimuli. In some embodiments, a disorder treated and/or prevented by the present methods is an IL-6 and/or VEGF related disorder. In some embodiments, the disorder is related to inflammation, e.g., hyper-inflammation and/or defective angiogenesis. In some embodiments, the disorder is related to inflammation, e.g., hyper-inflammation. In some embodiments, the disorder is associated with elevated levels of pro-inflammatory cytokine signaling in the patient. In some embodiments, the disorder is associated with elevated systemic levels of one or more pro-inflammatory cytokines in the patient. In some embodiments, the disorder is associated with, caused by, or exacerbated by, elevated serum levels of one or more pro-inflammatory cytokines in the patient. In some embodiments, the patient has or is identified as having an elevated serum level or one or more cytokines. In some embodiments, the cytokine is IL-1 and/or IL-6.
The level of pro-inflammatory cytokine or signaling thereof may be elevated compared to a threshold level of pro-inflammatory cytokine or signaling thereof. In some embodiments, the threshold level of pro-inflammatory cytokine or signaling thereof is determined based on the level, or range of levels, in healthy individuals. In some embodiments, the level of pro-inflammatory cytokine or signaling thereof is elevated above the range of levels in healthy individuals. In some embodiments, the threshold level of pro-inflammatory cytokine or signaling thereof is determined based on the level, or range of levels, in individuals who are not suffering from the disorder. In some embodiments, the level of pro-inflammatory cytokine or signaling thereof is elevated above the range of levels in individuals who are not suffering from the disorder.
In some embodiments, the disorder is associated with inflammation, e.g., hyper-inflammation, and/or with defective angiogenesis. In some embodiments, the disorder is related to dysregulation of vascular permeability. In some embodiments, the disorder is caused by and/or related to, without limitation, increased vascular permeability and tissue edema. In some embodiments, the disorder is vascular permeability-mediated tissue damage, e.g., damage to the lung, heart, kidney, liver and/or brain. In some embodiments, the disorder is associated with elevated levels of VEGF signaling in the patient. In some embodiments, the disorder is associated with elevated systemic levels of VEGF. In some embodiments, the disorder is associated with, caused by, or exacerbated by, elevated serum levels of VEGF. In some embodiments, the disorder is associated with elevated levels of VEGF, e.g., in a tissue such as the lungs of the patient. In some embodiments, the disorder is associated with, caused by, or exacerbated by, elevated levels of VEGF, e.g., in a tissue such as the lungs of the patient. In some embodiments, the patient has or is identified as having an elevated intrapulmonary VEGF level.
The level of VEGF or signaling thereof may be elevated compared to a threshold level of VEGF or signaling thereof. In some embodiments, the threshold level of VEGF or signaling thereof is determined based on the level, or range of levels, in healthy individuals. In some embodiments, the level of VEGF or signaling thereof is elevated above the range of levels in healthy individuals. In some embodiments, the threshold level of VEGF or signaling thereof is determined based on the level, or range of levels, in individuals who are not suffering from the disorder. In some embodiments, the level of VEGF or signaling thereof is elevated above the range of levels in individuals who are not suffering from the disorder.
In some embodiments, the method includes detecting a level of one or more cytokines and/or VEGF in a sample from the patient. In some embodiments, the method includes obtaining a sample from the subject and detecting a level of one or more cytokines and/or VEGF in the sample. The sample can include any suitable tissue, cells, and/or biomolecules collected from the subject. In some embodiments, the sample includes any suitable bodily fluid, including, without limitation, blood, serum, plasma, saliva, urine, etc. In some embodiments, the sample includes blood, serum, plasma, pulmonary lavage, and/or pulmonary aspirate.
In some embodiments, the disorder is related to or caused by a patient's over-reactive immune response to and/or tissue-specific vascular permeability dysregulation related to an infection, or other immune stimuli. The disorder may be related one or more of a variety infections. In some embodiments, the infection is, without limitation, a viral infection. With reference to
The present methods can treat disorders related to a variety of infectious diseases. In some embodiments, the infection is a viral, bacterial, fungal, or parasitic infection. In some embodiments, the infection is a viral infection. In some embodiments, the viral infection is, without limitation, a coronavirus infection or an influenza virus infection. The coronavirus infection can include an infection by one or more of a variety of coronaviruses. In some embodiments, the coronavirus is, without limitation, an alpha coronavirus, beta coronavirus, and/or a gamma coronavirus. In some embodiments, the coronavirus is, without limitation, Middle East Respiratory Syndrome coronavirus (MERS-COV), severe acute respiratory syndrome coronavirus (SARS-COV), SARS-COV-2 (COVID-19), human coronavirus 229E, human coronavirus NL63, human coronavirus OC43, or human coronavirus HKU1.
The influenza virus infection can include an infection by one or more of a variety of influenza viruses. In some embodiments, the influenza virus is, without limitation, influenza A, influenza B or influenza C. In some embodiments, the influenza virus is, without limitation, H1N1, H2N2, H3N2, H5N1, H7N7, H1N2, H9N2, H7N2, H7N3, H10N7, H7N9 or H6N1.
In some embodiments, the viral infection is an infection by one or more of, without limitation, human immunodeficiency viruses, such as HIV-1; polio viruses, hepatitis A virus; enteroviruses, human Coxsackie viruses, rhinoviruses, echoviruses; equine encephalitis viruses, rubella viruses; dengue viruses, encephalitis viruses, yellow fever viruses; vesicular stomatitis viruses, rabies viruses; Ebola viruses; parainfluenza viruses, mumps virus, measles virus, respiratory syncytial virus; Hantaan viruses, bunga viruses, phleboviruses and Nairo viruses; hemorrhagic fever viruses; reoviruses, orbiviruses and rotaviruses; Hepatitis B virus; parvoviruses; papilloma viruses, polyoma viruses; adenoviruses; herpes simplex virus (HSV) 1 and 2, varicella zoster virus, cytomegalovirus (CMV), herpes viruses; variola viruses, vaccinia viruses, pox viruses; and African swine fever virus; Hepatitis C virus, etc.
In some embodiments, the infection is a bacterial infection. In some embodiments, the infection is by one or more of Escherichia coli, Salmonella enterica, Shigella, Shigella dysenteriae, Vibrio cholerae, Vibrio vulnificus, Vibrio parahaemolyticus, Virio vulnificus, Campylobacter jejuni, Klebsiella, Enterobacter, Serratia, Proteus, Providencia, and Morganella, Bacillus anthracis, Bacillus cereus, Clostridium tetani, Clostrium botulinum, Clostridium perfringens, Clostridium difficile, Mycobacterium tuberculosis Legionella pneumophilla, Vibrio cholera, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus pyogenes, Streptococcus agalactiae, Enterococcus faecalis, Streptococcus bovis, Streptococcus pneumoniae, Streptococcus viridans, Pseudomonas aeruginosa, Corynebacterium diphtheriae, Listeria monocytogenes, Brucella, Francisella tularensis, Yersinia enterocolitica, Yersinia pseudotuberculosis, Yersinia pestis, Pasteurella multocida, Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium avium, Mycobacterium leprae, Actinomyces israelii, Nocardia asteroides, Mycoplasma pneumoniae, Treponema pallidum, Borrelia brugdorferi, Leptospira interrogans, Chlamydia psittaci, Chlamydia trachomatis, Chlamydia pneumoniae, R. rickettsii, Coxiella burnetii, R. prowazekii, Gardnerella vaginalis, Lactobacillus, Peptococcus, Peptostreptococcus, Propionibacterium, Tropheryma, Burkholderia pseudomallei, and Burkholderia mallei.
In some embodiments, the infection is a fungal infection. In some embodiments, the infection is by one or more of Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, Chlamydia trachomatis, Candida albicans.
In some embodiments, the method includes diagnosing an infection, e.g., a viral infection in the patient. Diagnosing can be done using any suitable option. In some embodiments, diagnosing comprises performing a clinical examination, contact tracing, and/or a diagnostic test for the infection, e.g., viral infection. In some embodiments, the patient is diagnosed for the viral infection before administering an effective amount of a therapeutic agent or composition that targets IL-6 and VEGF signaling. In some embodiments, the patient is diagnosed for the infection, e.g., viral infection after administering an effective amount of a therapeutic agent or composition that targets IL-6 and VEGF signaling.
In some embodiments, the patient has a viral infection, e.g., a coronavirus infection such as a COVID-19 infection, or an influenza virus infection. In some embodiments, the patient exhibits one or more symptoms of the viral infection, such as, but not limited to, fever, headache, joint pain, coughing, diarrhea, fatigue, dizziness, loss of taste, loss of smell, etc. In some embodiments, the patient is asymptomatic with respect to the viral infection. In some embodiments, the patient does not exhibit any clinical symptom of the viral infection. In some embodiments, the patient has one or more endogenous antibodies against the viral infection, e.g., one or more endogenous antibodies against the S protein of the virus causing the viral infection. In some embodiments, the patient has tested positively to a serological test for the virus causing the viral infection. In some embodiments, the patient has tested negatively to a serological test for the virus causing the viral infection.
In some embodiments, the method includes administering a treatment for the infection or a symptom thereof. Any suitable treatment for the infection or a symptom thereof can be administered. In some embodiments, the treatment for the infection or a symptom thereof includes ventilator support. In some embodiments, the patient is intubated. In some embodiments, the method include intubating the patient. In some embodiments, the treatment for the infection or a symptom thereof comprises a therapeutic agent, e.g., an anti-infection agent and/or an anti-inflammatory agent.
In some embodiments, the infection is a viral infection, and the therapeutic agent includes an anti-viral agent. In some embodiments, the anti-viral agent includes, without limitation, remdesivir, Abacavir, Ziagen, Trizivir, Kivexa/Epzicom, Aciclovir, Acyclovir, Adefovir, Amantadine, Amprenavir, Ampligen, Arbidol, Atazanavir, Atripla, Balavir, Cidofovir, Combivir, Dolutegravir, Darunavir, Delavirdine, Didanosine, Docosanol, Edoxudine, Efavirenz, Emtricitabine, Enfuvirtide, Entecavir, Ecoliever, Famciclovir, Fomivirsen, Fosamprenavir, Foscarnet, Fosfonet, Ganciclovir, Ibacitabine, Imunovir, Idoxuridine, Imiquimod, Indinavir, Inosine, Integrase inhibitor, Interferon type III, Interferon type II, Interferon type I, Interferon, Lamivudine, Lopinavir, Loviride, Maraviroc, Moroxydine, Methisazone, Nelfinavir, Nevirapine, Nexavir, Nucleoside analogues, Novir, Oseltamivir (Tamiflu). Peginterferon alfa-2a, Penciclovir, Peramivir, Pleconaril, Podophyllotoxin, Protease inhibitor, Raltegravir, Reverse transcriptase inhibitor, Ribavirin, Rimantadine, Ritonavir, Pyramidine, Saquinavir, Sofosbuvir, Stavudine, Synergistic enhancer, Tea tree oil, Telaprevir, Tenofovir, Tenofovir disoproxil, Tipranavir, Trifluridine, Trizivir, Tromantadine, Truvada, Valaciclovir (Valtrex), Valganciclovir, Vicriviroc, Vidarabine, Viramidine, Zalcitabine, Zanamivir, Zidovudine, and combinations thereof.
In some embodiments, the anti-inflammatory agent includes non-steroidal anti-inflammatory agents and steroidal anti-inflammatory agents. In some embodiments, NSAIDS include, without limitation, propionic acid derivatives such as ketoprofen, flurbiprofen, ibuprofen, naproxen, fenoprofen, benoxaprofen, indoprofen, pirprofen, carprofen, oxaprozin, pranoprofen, suprofen, alminoprofen, butibufen, fenbufen and tiaprofenic acid; acetylsalicylic acid; apazone; diclofenac; difenpiramide; diflunisal; etodolac; flufenamic acid; indomethacin; ketorolac; meclofenamate; mefenamic acid; nabumetone; phenylbutazone; piroxicam; salicylic acid; sulindac; tolmetin; oxicams such as meloxicam and piroxicam; nabumetone; phenylbutazone; piroxicam; salicylates such as salsalate and acetylsalicylic acid; sulfasalazine; sulindac; tolmetin; and COX-2 inhibitors such as celecoxib, rofecoxib, and valdecoxib. In some embodiments, steroidal anti-inflammatory agents include, without limitation, corticosteroids of varying potency. Representative corticosteroids of lower to moderate potency include hydrocortisone, hydrocortisone-21-monoesters (e.g., hydrocortisone-21-acetate, hydrocortisone-21-butyrate, hydrocortisone-21-propionate, hydrocortisone-21-valerate, etc.), hydrocortisone-17,21-diesters (e.g., hydrocortisone-17,21-diacetate, hydrocortisone-17-acetate-21-butyrate, hydrocortisone-17,21-dibutyrate, etc.), alclometasone, dexamethasone, flumethasone, prednisolone, and methylprednisolone, betamethasone, typically as betamethasone benzoate or betamethasone dipropionate; fluocinonide; prednisone; and triamcinolone, typically as triamcinolone acetonide.
In some embodiments, the infection is a bacterial infection, and the therapeutic agent includes an antibiotic. In some embodiments, the antibiotic includes, without limitation, tetracycline, chlortetracycline, oxytetracycline, demeclocycline, methacycline, doxycycline, rolitetracycline; erythromycin, clarithromycin, azithromycin; quinupristin, dalfopristin; penicillins (e.g., penicillin G, penicillin VK), antistaphylococcal penicillins (e.g., cloxacillin, dicloxacillin, nafcillin, oxacillin), extended spectrum penicillins (e.g., ampicillin amoxicillin, carbenicillin), cephalosporins (e.g., cefadroxil, cefepime, cephalexin, cefazolin, cefoxitin, cefotetan, cefuroxime, cefotaxime, ceftazidime, ceftriazone), imiprenem, meropenem, aztreonam; streptomycin, gentamicin, tobramycin, amikacin, neomycin; vancomycin, teicoplanin; sulfacetamide, sulfabenzamide, sulfadiazine, sulfadoxine, sulfamerazine, sulfamethazine, sulfamethizole, sulfamethoxazole; ciprofloxacin, nalidixic acid, ofloxacin; isoniazid, rifampin, rifabutin, ethambutol, pyrazinamide, ethionamide, aminosalicylic, cycloserine; chloramphenicol, spectinomycin, polymycin B (colistin), and bacitracin.
In some embodiments, the infection is a fungal infection, and the therapeutic agent includes an anti-fungal agent. In some embodiments, the anti-fungal agent includes, without limitation, itraconazole, ketoconazole, fluconazole, and amphotericin B.
In some embodiments, the infection is a parasitic infection, and the therapeutic agent includes an anti-parasitic agent. In some embodiments, the anti-parasitic agent includes, without limitation, nitazoxanide; artemisins, mefloquine, lumefantrine, tinidazole, miltefosine; mebendazole, thiabendazole, ivermectin; rifampin and amphotericin B.
In some embodiments, the disorder is one or more of pneumonia, cytokine release syndrome (CRS), acute respiratory distress syndrome (ARDS), pulmonary edema, myocarditis, acute renal insufficiency, lymphopenia, sepsis, systemic inflammation, treatment-related inflammation, treatment-related tissue damage, and immune-mediated tissue damage. In some embodiments, the immune-mediated tissue damage comprises immune-mediated damage to the lung, heart and/or kidney. In some embodiments, the immune-mediated tissue damage comprises immune-mediated damage to one or more organs such as, without limitation, the lung, heart and/or kidney. In some embodiments, the tissue damage is, without limitation, organ damage, organ inflammation or organ failure. In some embodiments, the treatment-related inflammation or tissue damage is inflammation or tissue damage induced by intubation.
The severity of the disorder may vary. In some embodiments, the disorder is a severe disorder, where, e.g., the risk of death or permanent disability as a result of the disorder is elevated. In some embodiments, a severe disorder necessitates hospitalization of the patient. In some embodiments, the patient is hospitalized. In some embodiments, a severe disorder necessitates treatment of the patient in an intensive care unit (ICU). In some embodiments, the patient is under ICU treatment. In some embodiments, a severe disorder necessitates treatment of the patient using ventilator support. In some embodiments, the method includes treating the patient using ventilator support. In some embodiments, treating the patient using ventilator support includes intubating the patient. In some embodiments, the patient is intubated and/or is under ventilator support.
In some embodiments, the patient exhibits one or more symptoms of the disorder indicating a severe disorder. In some embodiments, the severity of the disorder is characterized by one or more clinical or physiological measures. The severity of the disorder can be characterized by any one or combination of suitable clinical measures (e.g., blood pressure, heart rate, body temperature, consciousness, breathing rate, alertness, appearance, clinical history, family history, genetic profile, etc.) of the patient. In some embodiments, the patient exhibits, without limitation, one or more of persistent fever, hypoxemia, shortness of breath, cough, respiratory failure, hypotension, pneumonia (e.g., bilateral pneumonia with ground-glass opacities on chest Xray or CT scan), elevated D-dimer levels, lymphopenia. In some embodiments, the patient has an elevated level of one or more cytokines, e.g., pro-inflammatory cytokines, as described herein. In some embodiments, the patient is deemed to have a severe disorder when at least the patient's serum level of one or more cytokines is above a threshold serum level of the corresponding cytokine.
In some embodiments, the severity of the disorder is increasing in the patient. In some embodiments, the severity of the disorder increases when one or more symptoms, clinical characteristics, or physiological characteristics of the patient, as described herein, worsens over time. In some embodiments, the severity of the disorder increases when the patient exhibits over time one or more new or additional symptoms, clinical characteristics, or physiological characteristics of the patient, as described herein. In some embodiments, a disorder increasing in severity is more severe compared to the severity of the disorder 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 70, 80, 90, 100, 110, 120 minutes or any number of minutes in a range defined by any two of the preceding values, before administering an effective amount of a therapeutic agent or composition that targets IL-6 and VEGF signaling. In some embodiments, a disorder increasing in severity is more severe compared to the severity of the disorder 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 16, 18, 24, 30, 36, 42, 48, 54, 60, 70, 80, 90, 100, 110, 120 hours or any number of hours in a range defined by any two of the preceding values, before administering an effective amount of a therapeutic agent or composition that targets IL-6 and VEGF signaling.
In some embodiments, the patient has one or more comorbidities that increases the risk of an adverse outcome for the patient. In some embodiments, the one or more comorbidities increases the risk of developing a severe disorder. In some embodiments, the comorbidities include, without limitation, one or more of hypertension, diabetes, obesity, coronary artery disease, chronic kidney disease, obstructive sleep apnea, history of smoking, a respiratory disease, old age, history of cancer, liver disease, advanced age, male sex, non-Caucasian ethnicity, history of cancer, chronic liver disease, history of stroke, and/or history of autoimmune disease. In some embodiments, the patient does not have a comorbidity.
In some embodiments, the method includes administering another treatment for the disorder. In some embodiments, the method include administering an antibiotic and/or an anti-inflammatory agent to treat the disorder. The anti-inflammatory agent can be any suitable agent, e.g., steroidal or non-steroidal anti-inflammatory agent), as described herein. The antibiotic can be any suitable antibiotic.
In some embodiments, a method for the treatment or prophylaxis of a disease in a patient in need thereof is provided. In some embodiments, the method comprises administering to the patient any of the isolated antagonist antibodies (and/or VEGF Trap and/or IL-6 Ab-VEGF Trap) disclosed herein. In some embodiments, the method comprises administering to the patient any of the conjugates disclosed herein. In some embodiments, the method comprises administering to the patient any of the compositions disclosed herein. In some embodiments, the method comprises identifying a patient having hyperactive IL-6 activity and administering to the patient any of the isolated antagonist antibodies disclosed herein. In some embodiments, the method comprises identifying a patient having hyperactive IL-6 activity and administering to the patient any of the conjugates disclosed herein. In some embodiments, the method comprises identifying a patient having hyperactive IL-6 activity and administering to the patient any of the compositions disclosed herein. In some embodiments, the patient has elevated VEGF activity instead of, or in addition to, the elevated IL-6 activity.
Also provided herein are methods for the treatment or prophylaxis of a systemic inflammatory condition, or a disorder related to the systemic inflammatory condition, in a patient in need thereof. With reference to
The systemic inflammatory condition may be associated with and/or caused by a variety of underlying causes. In some embodiments, the systemic inflammatory condition is related to (e.g., associated with, caused by, or exacerbated by) an infectious disease, e.g., a viral, bacterial, fungal or parasitic infection. In some embodiments, the method includes administering 4220 a treatment for the infectious disease. In some embodiments, the treatment for the infectious disease is administered before, after, and/or concurrently with administering the fusion protein.
In some embodiments, the systemic inflammatory condition is related to (e.g., associated with, caused by, or exacerbated by) a treatment for a disease, e.g., treatment for cancer. In some embodiments, the treatment includes immunotherapy, such as, but not limited to chimeric antigen receptor (CAR) T-cell therapy. In some embodiments, the method includes administering 4230 a treatment for the disease, e.g., cancer, where the treatment, e.g., immunotherapy, can induce a systemic inflammatory condition. In some embodiments, the treatment for the disease is administered before, after, and/or concurrently with administering the fusion protein.
A variety of disorders related to the systemic inflammatory condition may be treated or prevented by the present methods. In some embodiments, the disorder is any one or more IL-6 and/or VEGF related disorders, as described herein. In some embodiments, the disorder is immune-mediated tissue damage. In some embodiments, the immune-mediated tissue damage comprises organ damage, inflammation and/or failure, as described herein.
Also provided herein are methods for the treatment or prophylaxis of treatment-induced tissue damage or inflammation in a patient in need thereof. With reference to
In some embodiments, the isolated antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap, conjugate (and/or IL-6 Ab-VEGF Trap-conjugate), composition or a combination thereof is administered once every 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 16, 20, 24 or more hours, or any number of hours in a range defined by any two of the preceding values. In some embodiments, the isolated antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap, conjugate (and/or IL-6 Ab-VEGF Trap-conjugate), composition or a combination thereof is administered once every 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 14, 21, 28 or more days, or any number of days in a range defined by any two of the preceding values. In some embodiments, the isolated antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap, conjugate (and/or IL-6 Ab-VEGF Trap-conjugate), composition or a combination thereof is administered once every 1, 2, 3, 4, 5, 6, 9, 12, 18, 24 or more months, or any number of months in a range defined by any two of the preceding values. In some embodiments, the isolated antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap, conjugate (and/or IL-6 Ab-VEGF Trap-conjugate), composition or a combination thereof is administered no more frequently than once a month. In some embodiments, the isolated antibody, conjugate, composition or a combination thereof is administered no more frequently than once every two months. In some embodiments, the isolated antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap, conjugate (and/or IL-6 Ab-VEGF Trap)-conjugate, composition or a combination thereof is administered no more frequently than once every three months. In some embodiments, the isolated construct (e.g., Ab and/or Trap and/or Ab-Trap and/or polymer conjugate) is administered with a frequency between once a year and once every two months. In some embodiments, the treatment can be a single application of the antibody and/or Trap. In some embodiments, the treatment can be as many applications of the antibody and/or Trap as needed or desired for an outcome.
The IL-6 antagonist antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap or conjugate thereof can be administered to a patient via any suitable route. It should be apparent to a person skilled in the art that the examples described herein are not intended to be limiting but to be illustrative of the techniques available. Accordingly, in some embodiments, the IL-6 antagonist antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap is administered to a patient in accord with known methods, such as intravenous administration, e.g., as a bolus or by continuous infusion over a period of time, by intramuscular, intraperitoneal, intracerebrospinal, transdermal, subcutaneous, intra-articular, sublingually, intrasynovial, via insufflation, intrathecal, oral, inhalation or topical routes. Administration can be systemic, e.g., intravenous administration, or localized. Commercially available nebulizers for liquid formulations, including jet nebulizers and ultrasonic nebulizers are useful for administration. Liquid formulations can be directly nebulized and lyophilized powder can be nebulized after reconstitution. Alternatively, IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) can be aerosolized using a fluorocarbon formulation and a metered dose inhaler, or inhaled as a lyophilized and milled powder.
For administration to mammals, and particularly humans, it is expected that the dosage of the active agent is from 0.01 mg/kg body weight, to typically around 20 mg/kg, for systemic administrations. The physician can determine the actual dosage most suitable for an individual which depends on factors including the age, weight, sex and response of the individual, the disease or disorder being treated and the age and condition of the individual being treated. The above dosages are exemplary of the average case. There can, of course, be instances where higher or lower dosages are merited. In some embodiments, the dosage can be an initial amount (such as a bolus) followed by a lower amount over time. In some embodiments, the initial amount is 1-100 mg/kg (such as 1, 5, 10, 20, 30, 40, 50 04 100 mg/kg, including any range defined there between) and the following amount is 0.1 to 10 mg/kg (e.g., 0.1, 0.2, 0.5, 1, 2, 5, or 10, including any range defined therebetween), within a number of hours of the bolus (e.g., 1, 2, 3, 4, 5, 6, 10, 12, 24h, including any range defined therebetween). In some embodiments, one or more subsequent dosages can also be administered, e.g., 2, 3, 4, 5, 6, 10, 12, 20, etc dosages a day or more apart, following the initial two dosages.
This dosage may be repeated as often as appropriate (e.g., weekly, fortnightly, monthly, quarterly). If side effects develop the amount and/or frequency of the dosage can be reduced, in accordance with normal clinical practice. In one embodiment, the pharmaceutical composition may be administered once every one to thirty days. In some embodiments, an active agent of the present disclosure, e.g., IL-6 antibody, VEGF trap, a fusion protein of the two, is administered at an interval of about 4 hours, about 5 hours, about 6 hours, about 7 hours, about 8 hours, about 9 hours, about 10 hours, about 11 hours, about 12 hours, about 14 hours, about 16 hours, about 18 hours, about 20 hours, about 22 hours, about 24 hours, or an interval of time within a range defined by any two of the previous values. In some embodiments, consecutive intervals between administration of the active agent of the present disclosure, e.g., IL-6 antibody, VEGF trap, a fusion protein of the two, are different lengths of time. In some embodiments, a first interval between administration of two doses of the active agent is shorter than a second interval between administration of a third dose after the second dose. In some embodiments, the second interval is longer than the first interval by about 6 hours, about 12 hours, about 18 hours, about 24 hours, about 30 hours, about 36 hours, about 72 hours, or more, or by an interval of time in a range defined by any two of the preceding values. In some embodiments, the amount of the active agent administered between consecutive doses is different. In some embodiments, a first amount of the active agent in a first dose is greater than a second amount of the active agent in a second dose administered after the first dose. In some embodiments, the second amount is less than the first amount by about 10%, about 20%, about 30%, about 40%, about 50%, about 60%, about 70%, about 80%, about 90, or about 95%, or by a percentage in a range defined by any of the preceding values.
The IL-6 antagonist antibodies and/or VEGF Trap and/or IL-6 Ab-VEGF Trap of the present disclosure may be employed in accordance with the instant disclosure by expression of such polypeptides in vivo in a patient, i.e., gene therapy. There are two major approaches to getting the nucleic acid (optionally contained in a vector) into the patient's cells: in vivo and ex vivo. For in vivo delivery the nucleic acid is injected directly into the patient, usually at the sites where the therapeutic protein is required, i.e., where biological activity of the therapeutic protein is needed. For ex vivo treatment, the patient's cells are removed, the nucleic acid is introduced into these isolated cells, and the modified cells are administered to the patient either directly or, for example, encapsulated within porous membranes that are implanted into the patient (see, e.g., U.S. Pat. Nos. 4,892,538 and 5,283,187). There are a variety of techniques available for introducing nucleic acids into viable cells. The techniques vary depending upon whether the nucleic acid is transferred into cultured cells in vitro, or transferred in vivo in the cells of the intended host. Techniques suitable for the transfer of nucleic acid into mammalian cells in vitro include the use of liposomes, electroporation, microinjection, transduction, cell fusion, DEAE-dextran, the calcium phosphate precipitation method, etc. Transduction involves the association of a replication-defective, recombinant viral (preferably retroviral) particle with a cellular receptor, followed by introduction of the nucleic acids contained by the particle into the cell. A commonly used vector for ex vivo delivery of the gene is a retrovirus.
The currently preferred in vivo nucleic acid transfer techniques include transfection with viral or non-viral vectors (such as adenovirus, lentivirus, Herpes simplex I virus, or adeno-associated virus (AAV)) and lipid-based systems (useful lipids for lipid-mediated transfer of the gene are, for example, DOTMA, DOPE, and DC-Chol; see, e.g., Tonkinison et al., Cancer Investigation, 14(1): 54-65 (1996)). The most preferred vectors for use in gene therapy are viruses, most preferably adenoviruses, AAV, lentiviruses, or retroviruses. A viral vector such as a retroviral vector includes at least one transcriptional promoter/enhancer or locus-defining element(s), or other elements that control gene expression by other means such as alternate splicing, nuclear RNA export, or post-translational modification of messenger. In addition, a viral vector such as a retroviral vector includes a nucleic acid molecule that, when transcribed in the presence of a gene encoding the therapeutic protein, is operably linked thereto and acts as a translation initiation sequence. Such vector constructs also include a packaging signal, long terminal repeats (LTRs) or portions thereof, and positive and negative strand primer binding sites appropriate to the virus used (if these are not already present in the viral vector). In addition, such vector typically includes a signal sequence for secretion of the PRO polypeptide from a host cell in which it is placed. Preferably the signal sequence for this purpose is a mammalian signal sequence, most preferably the native signal sequence for the therapeutic protein. Optionally, the vector construct may also include a signal that directs polyadenylation, as well as one or more restriction sites and a translation termination sequence. By way of example, such vectors will typically include a 5′ LTR, a tRNA binding site, a packaging signal, an origin of second-strand DNA synthesis, and a 3′ LTR or a portion thereof. Other vectors can be used that are non-viral, such as cationic lipids, polylysine, and dendrimers.
In some situations, it is desirable to provide the nucleic acid source with an agent that targets the target cells, such as an antibody specific for a cell-surface membrane protein or the target cell, a ligand for a receptor on the target cell, etc. Where liposomes are employed, proteins that bind to a cell-surface membrane protein associated with endocytosis may be used for targeting and/or to facilitate uptake, e.g., capsid proteins or fragments thereof tropic for a particular cell type, antibodies for proteins that undergo internalization in cycling, and proteins that target intracellular localization and enhance intracellular half-life. The technique of receptor-mediated endocytosis is described, for example, by Wu et al., J. Biol. Chem., 262: 4429-4432 (1987); and Wagner et al., Proc. Natl. Acad. Sci. USA, 87: 3410-3414(1990). For a review of the currently known gene marking and gene therapy protocols, see, Anderson et al., Science, 256: 808-813 (1992). See also WO 93/25673 and the references cited therein.
Suitable gene therapy and methods for making retroviral particles and structural proteins can be found in, e.g., U.S. Pat. No. 5,681,746.
In accordance with some aspects, a method for treatment or prophylaxis of an in a mammal is presented in which a nucleic acid molecule that encodes an IL-6 antagonist antibody and/or VEGF Trap and/or IL-6 Ab-VEGF Trap is administered.
In some embodiments, the conjugate (or the various proteins) is useful for prevention of any one or more of the disorders provided herein.
With respect to all methods described herein, reference to IL-6 antagonist antibodies and/or VEGF Trap and/or IL-6 Ab-VEGF Trap also includes compositions comprising one or more additional agents. These compositions may further comprise suitable excipients, such as pharmaceutically acceptable excipients including buffers, which are well known in the art. The present therapeutic agents or compositions that target IL-6 and/or VEGF signaling can be used alone or in combination with other methods of treatment.
Therapeutic formulations of the IL-6 antagonist antibodies (and/or IL-6 Ab-VEGF Trap) and IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) conjugates used in accordance with the present disclosure are prepared for storage by mixing an antibody having the desired degree of purity with optional pharmaceutically acceptable carriers, excipients or stabilizers (Remington, The Science and Practice of Pharmacy 20th Ed. Mack Publishing, 2000), in the form of lyophilized formulations or aqueous solutions. Acceptable carriers, excipients, or stabilizers are nontoxic to recipients at the dosages and concentrations employed, and may comprise buffers such as phosphate, citrate, and other organic acids; salts such as sodium chloride; antioxidants including ascorbic acid and methionine; preservatives (such as octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride, benzethonium chloride; phenol, butyl or benzyl alcohol; alkyl parabens, such as methyl or propyl paraben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol); low molecular weight (less than about 10 residues) polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, histidine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrins; chelating agents such as EDTA; sugars such as sucrose, mannitol, trehalose or sorbitol; salt-forming counter-ions such as sodium; metal complexes (e.g. Zn-protein complexes); and/or non-ionic surfactants such as TWEEN™, PLURONICS™ or polyethylene glycol (PEG).
In some embodiments, liposomes containing the IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) and/or IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) conjugate are prepared by methods known in the art, such as described in Epstein, et al., Proc. Natl. Acad. Sci. USA 82:3688 (1985); Hwang, et al., Proc. Natl Acad. Sci. USA 77:4030 (1980); and U.S. Pat. Nos. 4,485,045 and 4,544,545. Liposomes with enhanced circulation time are disclosed in U.S. Pat. No. 5,013,556. In some embodiments, particularly useful liposomes can be generated by the reverse phase evaporation method with a lipid composition comprising phosphatidylcholine, cholesterol and PEG-derivatized phosphatidylethanolamine (PEG-PE). Liposomes can be extruded through filters of defined pore size to yield liposomes with the desired diameter.
The active ingredients may also be entrapped in microcapsules prepared, for example, by coacervation techniques or by interfacial polymerization, for example, hydroxymethylcellulose or gelatin-microcapsules and poly-(methylmethacrylate) microcapsules, respectively, in colloidal drug delivery systems (for example, liposomes, albumin microspheres, microemulsions, nano-particles and nanocapsules) or in macroemulsions. Such techniques are disclosed in Remington, The Science and Practice of Pharmacy 20th Ed. Mack Publishing (2000).
Sustained-release preparations may be prepared. Suitable examples of sustained-release preparations include semipermeable matrices of solid hydrophobic polymers containing the antibody, which matrices are in the form of shaped articles, e.g. films, or microcapsules. Examples of sustained-release matrices include polyesters, hydrogels (for example, poly(2-hydroxyethyl-methacrylate), or poly(vinylalcohol)), polylactides (U.S. Pat. No. 3,773,919), copolymers of L-glutamic acid and 7 ethyl-L-glutamate, non-degradable ethylene-vinyl acetate, degradable lactic acid-glycolic acid copolymers such as the LUPRON DEPOT™ (injectable microspheres composed of lactic acid-glycolic acid copolymer and leuprolide acetate), sucrose acetate isobutyrate, and poly-D-(−)-3-hydroxybutyric acid.
The formulations to be used for in vivo administration must be sterile. This is readily accomplished by, for example, filtration through sterile filtration membranes. Therapeutic IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) and/or antibody (and/or IL-6 Ab-VEGF Trap) conjugate compositions are generally placed into a container having a sterile access port, for example, an intravenous solution bag or vial having a stopper pierceable by a hypodermic injection needle. In some embodiments, the antibody and/or antibody conjugate compositions are placed into a syringe to provide a prefilled syringe.
In some embodiments, the composition is a pyrogen-free composition which is substantially free of endotoxins and/or related pyrogenic substances. Endotoxins include toxins that are confined inside a microorganism and are released only when the microorganisms are broken down or die. Pyrogenic substances also include fever-inducing, thermostable substances from the outer membrane of bacteria and other microorganisms. Both of these substances can cause fever, hypotension and shock if administered to humans. Due to the potential harmful effects, even low amounts of endotoxins must be removed from intravenously administered pharmaceutical drug solutions. For systemic injection such as IV or IP, the Food & Drug Administration (“FDA”) has set an upper limit of 5 endotoxin units (EU) per dose per kilogram body weight in a single one hour period for intravenous drug applications (The United States Pharmacopeial Convention, Pharmacopeial Forum 26 (1):223 (2000)). When therapeutic proteins are administered in amounts of several hundred or thousand milligrams per kilogram body weight, as can be the case with proteins of interest (e.g., antibodies), even trace amounts of harmful and dangerous endotoxin must be removed. In some embodiments, the endotoxin and pyrogen levels in the composition are less than 10 EU/mg, or less than 5 EU/mg, or less than 1 EU/mg, or less than 0.1 EU/mg, or less than 0.01 EU/mg.
The compositions according to the present disclosure may be in unit dosage forms such as tablets, pills, capsules, powders, granules, solutions or suspensions, or suppositories, for oral, parenteral or rectal administration, or administration by inhalation or insufflation.
For preparing solid compositions such as tablets, the principal active ingredient is mixed with a pharmaceutical carrier, e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other pharmaceutical diluents, e.g. water, to form a solid preformulation composition containing a homogeneous mixture of a compound of the present disclosure, or a non-toxic pharmaceutically acceptable salt thereof. When referring to these preformulation compositions as homogeneous, it is meant that the active ingredient is dispersed evenly throughout the composition so that the composition may be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules. This solid preformulation composition is then subdivided into unit dosage forms of the type described above containing from about 0.1 to about 500 mg of the active ingredient of the present disclosure. The tablets or pills of the novel composition can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action. For example, the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former. The two components can be separated by an enteric layer that serves to resist disintegration in the stomach and permits the inner component to pass intact into the duodenum or to be delayed in release. A variety of materials can be used for such enteric layers or coatings, such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol and cellulose acetate.
Suitable surface-active agents include, in particular, non-ionic agents, such as Polysorbate or polyoxyethylenesorbitans (e.g. Tween™ 20, 40, 60, 80 or 85) and other sorbitans (e.g. Span™ 20, 40, 60, 80 or 85). Compositions with a surface-active agent will conveniently comprise between 0.01%, and 5% surface-active agent, and can be between 0.01 and 0.02% or 0.1 and 2.5% (polysorbate 20 or 80). It will be appreciated that other ingredients may be added, for example mannitol or other pharmaceutically acceptable vehicles, if necessary.
Suitable emulsions may be prepared using commercially available fat emulsions, such as INTRALIPID™, LIPOSYN™, INFONUTROL™, LIPOFUNDIN™ and LIPIPHYSAN™. The active ingredient may be either dissolved in a pre-mixed emulsion composition or alternatively it may be dissolved in an oil (e.g. soybean oil, safflower oil, cottonseed oil, sesame oil, corn oil or almond oil) and an emulsion formed upon mixing with a phospholipid (e.g. egg phospholipids, soybean phospholipids or soybean lecithin) and water. It will be appreciated that other ingredients may be added, for example glycerol or glucose, to adjust the tonicity of the emulsion. Suitable emulsions will typically contain up to 20% oil, for example, between 5 and 20%. The fat emulsion can comprise fat droplets between 0.1 and 1.0 μm, particularly 0.1 and 0.5 μm, and have a pH in the range of 5.5 to 8.0.
The emulsion compositions can be those prepared by mixing an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) with Intralipid™ or the components thereof (soybean oil, egg phospholipids, glycerol and water).
Compositions for inhalation or insufflation include solutions and suspensions in pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders. The liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as set out above. In some embodiments, the compositions are administered by the oral or nasal respiratory route for local or systemic effect. Compositions in preferably sterile pharmaceutically acceptable solvents may be nebulised by use of gases. Nebulised solutions may be breathed directly from the nebulising device or the nebulising device may be attached to a face mask, tent or intermittent positive pressure breathing machine. Solution, suspension or powder compositions may be administered, preferably orally or nasally, from devices which deliver the formulation in an appropriate manner.
II. IL-6 Antagonist Antibodies, IL-6 AB-VEGF Traps and/or Conjugates Thereof
Provided herein are anti-IL-6 antibodies that block, suppress or reduce (including significantly reduces) IL-6 biological activity, including downstream events mediated by IL-6. In some embodiments, the IL-6 antagonist antibody will have one or more of the CDR sequences provided herein. The IL-6 antagonist antibodies herein can be used in any of the methods provided herein.
In some embodiments, the isolated antagonist antibody specifically binds to IL-6.
In some embodiments, the antibody preferably reacts with IL-6 in a manner that inhibits IL-6 signaling function. In some embodiments, the IL-6 antagonist antibody specifically binds primate IL-6.
The antibodies useful in the present disclosure can encompass monoclonal antibodies, polyclonal antibodies, antibody fragments (e.g., Fab, Fab′, F(ab′)2, Fv, Fc, etc.), chimeric antibodies, bispecific antibodies, heteroconjugate antibodies, single chain (ScFv), mutants thereof, fusion proteins comprising an antibody portion (e.g., a domain antibody), humanized antibodies, and any other modified configuration of the immunoglobulin molecule that comprises an antigen recognition site of the required specificity, including glycosylation variants of antibodies, amino acid sequence variants of antibodies, and covalently modified antibodies. The antibodies may be murine, rat, human, or any other origin (including chimeric or humanized antibodies). In some embodiments, the IL-6 antagonist antibody is a monoclonal antibody. In some embodiments, the antibody is a human or humanized antibody.
In some embodiments, the antibody comprises a heavy chain amino acid variable region as shown in Table 1A or
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided. The antibody comprises a heavy chain constant domain comprising one or more mutations to reduce effector function. In some embodiments, the one or more mutations reduce effector functions of the antibody related to the complement cascade, for example, a reduced activation of the complement cascade. In some embodiments, the reduction in effector function is at least about 50%.
In some embodiments, an isolated antagonist antibody that specifically binds to IL-6 comprising a heavy chain variable region (VH) and a light chain variable region (VL), wherein the antibody comprises the mutations L234A, L235A, and G237A (based on EU numbering) is provided. In some embodiments, the isolated antagonist antibody comprises the mutations L234A, L235A, and G237A. In some embodiments, the isolated antagonist antibody with mutations has minimized binding to FC gamma receptors or C1q. In some embodiments, the isolated antagonist antibody with mutations L234A, L235A, and G237A has minimized binding to FC gamma receptors or C1q. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the mutation(s) is located at one or more of the following amino acid positions (EU numbering): E233, L234, L235, G236, G237, A327, A330, and P331. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the mutation (s) is selected from the group consisting of E233P, L234V, L234A, L235A, G237A, A327G, A330S, and P331S.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided. The heavy chain constant domain further comprises a cysteine residue introduced by recombinant DNA technology. In some embodiments, the cysteine residue is selected from the group consisting of Q347C and L443C (EU numbering). In some embodiments, the cysteine residue is L443C (EU numbering).
In some embodiments, the antibody comprises all three of the following mutations (EU numbering) L234A, L235A, and G237A. In some embodiments, the antibody is a human IgG1, and a heavy chain constant domain of the antibody comprises one or more mutations that reduce an immune-mediated effector function.
In some embodiments, an isolated antagonist antibody is provided that binds an epitope on human IL-6 that is the same as or overlaps with the epitope recognized by an antibody comprising the amino acid sequences in any one or more of Tables: 1A and 1B, and/or 11.3. In some embodiments, an isolated antagonist antibody is provided that binds an epitope on human IL-6 that is the same as or overlaps with the epitope recognized by an antibody having light chain or heavy chain amino acid sequences that each independently is at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to a corresponding heavy chain or light chain amino acid sequence in any one or more of Tables: 1A and 1B, and/or 11.3. In some embodiments, an isolated antagonist antibody is provided that binds an epitope on human IL-6 that is the same as or overlaps with the epitope recognized by an antibody having light chain or heavy chain amino acid sequences that each independently differs by 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 or more amino acid residues from a corresponding heavy chain or light chain amino acid sequence in any one or more of Tables: 1A and 1B, and/or 11.3. In some embodiments, an IL-6 antibody with a cys and that is linked through that cysteine to a polymer is provided (as shown in Formula 17, herein).
In some embodiments, an isolated antagonist antibody that binds to IL-6 is provided. In some embodiments, the isolated antagonist antibody that binds to IL-6 comprises a heavy chain comprising the amino acid sequence shown in Tables 1A, 1B, 0.1 and/or 0.2, with or without the C-terminal lysine and a light chain comprising the amino acid sequence shown in Tables 1A, 1B, 0.1 and/or 0.2. In some embodiments, the antibody comprises a heavy chain having a variable region amino acid sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of the variable region sequences shown in Table 1A or
In some embodiments, an isolated antagonist antibody that binds to IL-6 is provided. In some embodiments, the antibody comprises a VH comprising the amino acid sequence shown in Tables 1A, 0.1A and/or 0.1B, or a sequence that is at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical thereto, having amino acid substitutions in residues that are not within a CDR. In some embodiments, the antibody comprises a VH comprising the amino acid sequence shown in Tables 1A, 0.1A and/or 0.1B, or a sequence that differs by 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 or more amino acid residues therefrom, having amino acid substitutions in residues that are not within a CDR. In some embodiments, the antibody comprises a VL comprising the amino acid sequence shown in Tables 1B, 0.2A and/or 0.2B, or a sequence that is at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical thereto, having amino acid substitutions in residues that are not within a CDR. In some embodiments, the antibody comprises a VL comprising the amino acid sequence shown in Tables 1B, 0.2A and/or 0.2B, or a sequence that differs by 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 or more amino acid residues therefrom, having amino acid substitutions in residues that are not within a CDR. In some embodiments, the antibody comprises one or more of: HCDR1: in
In some embodiments, an antibody that binds to IL-6 is provided, wherein the antibody comprises a CDRH1 that is the CDRH1 in Tables 1A, 1B, 0.1 and/or 0.2, a CDRH2 that is the CDRH2 in Tables 1A, 1B, 0.1 and/or 0.2, a CDRH3 that is the CDRH3 in Tables 1A, 1B, 0.1 and/or 0.2, a CDRL1 that is the CDRL1 in Tables 1A, 1B, 0.1 and/or 0.2, a CDRL2 that is the CDRL2 in Tables 1A, 1B, 0.1 and/or 0.2, a CDRL3 that is the CDRL3 in Tables 1A, 1B, 0.1 and/or 0.2, at least one of the following mutations: L234A, L235A, and G237A based on EU numbering.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided. The heavy chain variable region of the antibody comprises three complementarity determining regions (CDRs) comprising the amino acid sequences shown in Table 1A. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the light chain variable region of the antibody comprises three complementarity determining regions (CDRs) comprising the amino acid sequences shown in Table 1B. In some embodiments, the antibody is one that contains one or more of the identified sequences in
In some embodiments, an isolated antagonist anti-IL-6 antibody comprises a heavy chain variable region (VH) that comprises three CDRs comprising the amino acid sequences shown in Table 1A, and the light chain variable region (VL) of the antibody comprises three CDRs comprising the amino acid sequences shown in Table 1B.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided. The VH comprises the amino acid sequences shown in Table 1A and the light chain variable region of the antibody comprises three CDRs comprising the amino acid sequences shown in Table 1B.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody comprises a VL comprising the amino acid sequence shown in Table 1B, or a variant thereof with one amino acid substitution in amino acids that are not within a CDR. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody comprises a VH comprising the amino acid sequence shown in Table 1A, or a variant thereof with several amino acid substitutions in amino acids that are not within a CDR.
In some embodiments, an isolated antagonist antibody is provided, wherein the antibody comprises a heavy chain comprising the amino acid sequence shown in Table 1A, with a C-terminal lysine, and a light chain comprising the amino acid sequence shown in Table 1B. In some embodiments, an isolated antagonist antibody is provided, wherein the antibody comprises a heavy chain comprising the amino acid sequence shown in Table 1A, without a C-terminal lysine, and a light chain comprising the amino acid sequence shown in Table 1B.
The IL-6 antagonist antibodies may be made by any method known in the art. General techniques for production of human and mouse antibodies are known in the art and/or are described herein.
IL-6 antagonist antibodies can be identified or characterized using methods known in the art, whereby reduction, amelioration, or neutralization of IL-6 biological activity is detected and/or measured. In some embodiments, an IL-6 antagonist antibody is identified by incubating a candidate antibody with IL-6 and monitoring binding to IL-6R or IL-6/IL-6R binding to gp130 and/or attendant reduction or neutralization of a biological activity of IL-6. The binding assay may be performed with, e.g., purified IL-6 polypeptide(s), or with cells naturally expressing (e.g., various strains), or transfected to express, IL-6 polypeptide(s). In one embodiment, the binding assay is a competitive binding assay, where the ability of a candidate antibody to compete with a known IL-6 antagonist antibody for IL-6 binding is evaluated. The assay may be performed in various formats, including the ELISA format.
Following initial identification, the activity of a candidate IL-6 antagonist antibody can be further confirmed and refined by bioassays, known to test the targeted biological activities. In some embodiments, an in vitro cell assay is used to further characterize a candidate IL-6 antagonist antibody.
IL-6 antagonist antibodies may be characterized using methods well known in the art. For example, one method is to identify the epitope to which it binds, or “epitope mapping.” There are many methods known in the art for mapping and characterizing the location of epitopes on proteins, including solving the crystal structure of an antibody-antigen complex, competition assays, gene fragment expression assays, and synthetic peptide-based assays, as described, for example, in Chapter 11 of Harlow and Lane, Using Antibodies, a Laboratory Manual, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, New York, 1999. In an additional example, epitope mapping can be used to determine the sequence to which an IL-6 antagonist antibody binds. IL-6 antagonist antibody Epitope mapping is commercially available from various sources, for example, Pepscan Systems (Edelhertweg 15, 8219 PH Lelystad, The Netherlands). The epitope can be a linear epitope, i.e., contained in a single stretch of amino acids, or a conformational epitope formed by a three-dimensional interaction of amino acids that may not necessarily be contained in a single stretch. Peptides of varying lengths (e.g., at least 4-6 amino acids long) can be isolated or synthesized (e.g., recombinantly) and used for binding assays with an IL-6 antagonist antibody. In another example, the epitope to which the IL-6 antagonist antibody binds can be determined in a systematic screening by using overlapping peptides derived from the IL-6 sequence and determining binding by the IL-6 antagonist antibody. According to the gene fragment expression assays, the open reading frame encoding IL-6 is fragmented either randomly or by specific genetic constructions and the reactivity of the expressed fragments of IL-6 with the antibody to be tested is determined. The gene fragments may, for example, be produced by PCR and then transcribed and translated into protein in vitro, in the presence of radioactive amino acids. The binding of the antibody to the radioactively labeled IL-6 fragments is then determined by immunoprecipitation and gel electrophoresis. Certain epitopes can also be identified by using large libraries of random peptide sequences displayed on the surface of phage particles (phage libraries) or yeast (yeast display). Alternatively, a defined library of overlapping peptide fragments can be tested for binding to the test antibody in simple binding assays. In an additional example, mutagenesis of an antigen, domain swapping experiments and alanine scanning mutagenesis can be performed to identify residues required, sufficient, and/or necessary for epitope binding. For example, alanine scanning mutagenesis experiments can be performed using a mutant IL-6 in which various residues of the IL-6 polypeptide have been replaced with alanine. By assessing binding of the antibody to the mutant IL-6, the importance of the particular IL-6 residues to antibody binding can be assessed.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody binds human IL-6 with an affinity of between about 0.01 pM to about 10 nM. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody binds human IL-6 with an affinity of between about 0.1 pM to about 2 nM. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody binds human IL-6 with an affinity of about 0.01, 0.05, 0.1, 0.5, 1, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000 pM.
The binding affinity (KD) of an IL-6 antagonist antibody to IL-6 can be about 0.001 to about 200 nM. In some embodiments, the binding affinity is any of about 200 nM, about 100 nM, about 50 nM, about 10 nM, about 1 nM, about 500 pM, about 100 pM, about 60 pM, about 50 pM, about 20 pM, about 15 pM, about 10 pM, about 5 pM, about 2 pM, or about 1 pM. In some embodiments, the binding affinity is less than any of about 250 nM, about 200 nM, about 100 nM, about 50 nM, about 10 nM, about 1 nM, about 500 pM, about 100 pM, about 50 pM, about 20 pM, about 10 pM, about 5 pM, about 2 pM, about 1 pM, about 0.5 pM, about 0.1 pM, about 0.05 pM, about 0.01 pM, about 0.005 pM, or about 0.001 pM.
In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody binds human IL-6 with a koff that is at least 5.0E−03 at 37 degrees. In some embodiments the koff is 5E−04. In some embodiments, an isolated antagonist anti-IL-6 antibody is provided, wherein the antibody binds human IL-6 with a koff that is better than 5.0E−04 at 37 degrees.
In some embodiments, binding affinity can be defined in terms of one or more of association constant (ka), dissociation constant (kd), and analyte concentration that achieves half-maximum binding capacity (KD). In some embodiments, ka can range from about 0.50E+05 to about 5.00E+08. In some embodiments, ka can range from about 0.50E−06 to about 5.00E−03. In some embodiments, KD can range from about 0.50E−12 to about 0.50E−07.
In some embodiments, a pharmaceutical composition comprising any of the antibodies disclosed herein is provided. In some embodiments, a pharmaceutical composition comprising any of the conjugates disclosed herein is provided. In some embodiments, the pharmaceutical composition comprises one or more pharmaceutically acceptable carriers. In some embodiments, the pharmaceutical composition is a liquid. In some embodiments, the pharmaceutical composition has an endotoxin level less than about 0.2 EU/ml. In some embodiments, the pharmaceutical composition is a liquid and has an endotoxin level less than about 0.2 EU/ml. In some embodiments, the pharmaceutical composition is a liquid and has an endotoxin level less than about 2.0, 1, 0.5, 0.2 EU/ml. In some embodiments, for example in intravitreal injection, the endotoxin limit is 0.01-0.02 EU/injection/eye.
Some embodiments provide any of the following, or compositions (including pharmaceutical compositions) comprising an antibody having a partial light chain sequence and a partial heavy chain sequence as found in Tables 1A and 1B, or variants thereof. In Tables 1A and 1B, the underlined sequences are some embodiments of CDR sequences as provided herein.
In some embodiments, the antibody does not have one or more (or any) of the following CDRs, Table 1E (which includes Table 1E1, Table 1E2, and/or Table 1E3).
In some embodiments, a composition as disclosed herein comprises an antibody having a partial or complete light chain sequence and a partial or complete heavy chain sequence from any of the options provided in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B, or variants thereof. In some embodiments, the antibody (or binding fragment thereof) can include any one or more of the CDRs provided in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B. In some embodiments, the antibody (or binding fragment thereof) can include any three or more of the CDRs provided in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B. In some embodiments, the antibody (or binding fragment thereof) can include any all six of the CDRs provided in Tables 1A, 1B, 0.1 and/or 0.2. In some embodiments, the heavy and/or light chain can be any one or more of the other antibody constructs provided herein, including, for example, those provided in
In some embodiments, a composition as disclosed herein comprises an antibody having a partial or complete light chain CDR sequence and a partial or complete heavy chain CDR sequence from any of the options provided in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B.
In some embodiments, CDR portions of IL-6 antagonist antibodies are also provided. Determination of CDR regions is well within the skill of the art. It is understood that in some embodiments, CDRs can be a combination of the IMGT and Paratome CDRs (also termed “combined CDRs” or “extended CDRs”). Determination of CDRs is well within the skill of the art. In some embodiments, the CDRs are the IMGT CDRs. In other embodiments, the CDRs are the Paratome CDRs. In other embodiments, the CDRs are the extended, AbM, conformational, Kabat, or Chothia CDRs. In embodiments with more than one CDR, the CDRs may be any of IMGT, Paratome, extended, Kabat, Chothia, AbM, conformational CDRs, or combinations thereof. In some embodiments, other CDR definitions may also be used. In some embodiments, only residues that are in common between 2, 3, 4, 5, 6, or 7 of the above definitions are used (resulting in a shorter sequence). In some embodiments, any residue in any of 2, 3, 4, 5, 6, or 7 of the above definitions can be used (resulting in a longer sequence).
In some embodiments, an IL-6 antagonist antibody comprises three CDRs of any one of the heavy chain variable regions shown in Tables 1A, 0.1A and/or 0.1B. In some embodiments, the antibody comprises three CDRs of any one of the light chain variable regions shown in Tables 1B, 0.2A and/or 0.2B. In some embodiments, the antibody comprises three CDRs of any one of the heavy chain variable regions shown in Tables 1A, and three CDRs of any one of the light chain variable regions shown in Tables 1B. In some embodiments, the CDRs are one or more of those designated in Tables 0.1 (which includes Table 0.1A and/or 0.1B) or 0.2 (which includes Table 0.1A and/or 0.1B) below:
In some embodiments, the antibody used for binding to IL-6 can be one that includes one or more of the sequences in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B, or one or more sequences that are each independently at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical to one or more of the sequences in Tables 1A or 1B. In some embodiments, the antibody used for binding to IL-6 can be one that includes three or more of the sequences in Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B, or three or more sequences that are each independently at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical to three or more of the sequences in Tables 1A or 1B. In some embodiments, the antibody used for binding to IL-6 can be one that includes six of the sequences in any one of Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B, or six sequences that are each independently at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical to six of the sequences in Tables 1A or 1B. In some embodiments, the antibody that binds to IL-6 can be one that competes for binding with an antibody that includes 6 of the specified CDRs in any one of Tables 1A, 1B, 0.1A, 0.1B, 0.2A and/or 0.2B, or six sequences that are each independently at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or by any percentage within a range defined by any two of the preceding values, identical to six of the sequences in Tables 1A or 1B.
Also provided herein are VEGF Trap sequences that can be used, e.g., as a fusion protein with an anti-IL-6 antagonist antibody or as an independent molecule, in any method as disclosed herein. In some embodiments, the anti-IL-6 antagonist antibody can be linked or fused to a VEGF Trap sequence. In some embodiments, a VEGF Trap sequence of the present disclosure can be as shown in Table 1C. In some embodiments, the sequence is at least 80% identical to that shown in Table 1C, e.g., at least 80, 85, 90, 95, 96, 97, 98, 99% identical to that shown in 1C. In some embodiments, any of the VEGF Trap molecules in U.S. Pub. No. 20150376271 can be employed herein. In some embodiments, the VEGF Trap sequence is fused to IL-6 in one of the following manners: to an N-terminal end of a heavy chain comprising IL-6 VH (
In some embodiments, the VEGF Trap includes VEGF binding domains fused to an Fc region, e.g., a human Fc region. In some embodiments, a VEGF trap includes a VEGFR-Fc fusion sequence. In some embodiments, the VEGF Trap includes a VEGFR-Fc sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID NOs 85-88. In some embodiments, the VEGF Trap is Aflibercept or Conbercept.
In some embodiments, a therapeutic agent that targets VEGF is an antibody (including an antigen binding fragment thereof) that specifically binds VEGF. A anti-VEGF antibody can be used as a therapeutic agent that targets VEGF in addition to and/or instead of a VEGF Trap in any method disclosed herein. In some embodiments, the anti-VEGF antibody is, without limitation, Ranibizumab or Bevacizumab.
In some embodiments, the IL-6 Ab VEGF Trap construct can have any of the sequences provided in TABLE 1D. In some embodiments, the construct can be at least 80% identical to the sequences in Table 1D, e.g., 80, 85, 90, 95, 96, 97, 98, 99% identical or higher. In some embodiments, the fusion protein can be in line with those percentages, with the exception that the antibody IL-6 domain does not contain one or more of the CDRs in Table 1E. In some embodiments, the fusion protein is one that contains one or more of the identified sequences in
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGSEVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
GYYALDIWGQGTLVTVSSASTKGPSVFPLAPSSKS
EMYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKK
FPLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLT
CEATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGI
ELSVGEKLVLNCTARTELNVGIDENWEYPSSKH
QHKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRS
DQGLYTCAASSGLMTKKNSTFVRVHEKDKTHT
GYYALDIWGQGTLVTVSSASTKGPSVFPLAPSSKS
EMYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKK
FPLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLT
CEATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGI
ELSVGEKLVLNCTARTELNVGIDENWEYPSSKH
QHKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRS
DQGLYTCAASSGLMTKKNSTFVRVHEKDKTHT
GYYALDIWGQGTLVTVSSASTKGPSVFPLAPSSKS
EMYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKK
FPLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLT
CEATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGI
ELSVGEKLVLNCTARTELNVGIDENWEYPSSKH
QHKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRS
DQGLYTCAASSGLMTKKNSTFVRVHEKDKTHT
To express the anti-IL-6 antibodies and/or IL-6 VEGF Traps provided herein, DNA fragments encoding VH and VL regions described can first be obtained. Various modifications, e.g. mutations, deletions, and/or additions can also be introduced into the DNA sequences using standard methods known to those of skill in the art. For example, mutagenesis can be carried out using standard methods, such as PCR-mediated mutagenesis, in which the mutated nucleotides are incorporated into the PCR primers such that the PCR product contains the desired mutations or site-directed mutagenesis.
The present disclosure encompasses modifications to the variable regions shown herein. For example, the present disclosure includes antibodies comprising functionally equivalent variable regions and CDRs which do not significantly affect their properties as well as variants which have enhanced or decreased activity and/or affinity. For example, the amino acid sequence may be mutated to obtain an antibody with the desired binding affinity to IL-6. Modification of polypeptides is routine practice in the art and need not be described in detail herein. Examples of modified polypeptides include polypeptides with conservative substitutions of amino acid residues, one or more deletions or additions of amino acids which do not significantly deleteriously change the functional activity, or which mature (enhance) the affinity of the polypeptide for its ligand, or use of chemical analogs.
Amino acid sequence insertions include amino- and/or carboxyl-terminal fusions ranging in length from one residue to polypeptides containing a hundred or more residues, as well as intra-sequence insertions of single or multiple amino acid residues. Examples of terminal insertions include an antibody with an N-terminal methionyl residue or the antibody fused to an epitope tag. Other insertional variants of the antibody molecule include the fusion to the N- or C-terminus of the antibody of an enzyme or a polypeptide which increases the half-life of the antibody in the blood circulation.
Substitution variants have at least one amino acid residue in the antibody molecule removed and a different residue inserted in its place. The sites of greatest interest for substitutional mutagenesis include the hypervariable regions, but framework alterations are also contemplated. Conservative substitutions are shown in Table 0.4 under the heading of “conservative substitutions.” If such substitutions result in a change in biological activity, then more substantial changes, denominated “exemplary substitutions” in Table 0.4, or as further described below in reference to amino acid classes, may be introduced and the products screened.
Substantial modifications in the biological properties of the antibody are accomplished by selecting substitutions that differ significantly in their effect on maintaining (a) the structure of the polypeptide backbone in the area of the substitution, for example, as a ß-sheet or helical conformation, (b) the charge or hydrophobicity of the molecule at the target site, or (c) the bulk of the side chain. Naturally occurring residues are divided into groups based on common side-chain properties:
Non-conservative substitutions are made by exchanging a member of one of these classes for another class.
One type of substitution, for example, that may be made is to change one or more cysteines in the antibody, which may be chemically reactive, to another residue, such as, without limitation, alanine or serine. For example, there can be a substitution of a non-canonical cysteine. The substitution can be made in a CDR or framework region of a variable domain or in the constant region of an antibody. In some embodiments, the cysteine is canonical. Any cysteine residue not involved in maintaining the proper conformation of the antibody also may be substituted, generally with serine, to improve the oxidative stability of the molecule and prevent aberrant cross-linking. Conversely, cysteine bond(s) may be added to the antibody to improve its stability, particularly where the antibody is an antibody fragment such as an Fv fragment.
The antibodies may also be modified, e.g. in the variable domains of the heavy and/or light chains, e.g., to alter a binding property of the antibody. Changes in the variable region can alter binding affinity and/or specificity. In some embodiments, no more than one to five conservative amino acid substitutions are made within a CDR domain. In other embodiments, no more than one to three conservative amino acid substitutions are made within a CDR domain. For example, a mutation may be made in one or more of the CDR regions to increase or decrease the KD of the antibody for IL-6, to increase or decrease koff, or to alter the binding specificity of the antibody. Techniques in site-directed mutagenesis are well-known in the art. See, e.g., Sambrook et al. and Ausubel et al., supra.
According to an aspect, the IgG domain of an IL-6 antagonist antibody can be IgG1, IgG2, IgG3 or IgG4. According to another aspect, the IgG domain can be a composite in which a constant regions is formed from more than one of the above isotypes (e.g., CH1 region from IgG2 or IgG4, hinge, CH2 and CH3 regions from IgG1). In choosing an isotype, it is known in the art that human isotopes IgG1 and IgG3 have complement-mediated cytotoxicity whereas human isotypes IgG2 and IgG4 have poor or no complement-mediated cytotoxicity. In some embodiments the IL-6 antagonist antibody isotype is IgG1.
The light chain constant region can be either human lambda or kappa. In some embodiments, the IL-6 antagonist antibody has a human kappa light chain constant region.
Human constant regions show allotypic variation and isoallotypic variation between different individuals, that is, the constant regions can differ in different individuals at one or more polymorphic positions. Isoallotypes differ from allotypes in that sera recognizing an isoallotype binds to a non-polymorphic region of one or more other isotypes. Reference to a human constant region includes a constant region with any natural allotype or any permutation of residues occupying polymorphic positions in natural allotypes or up to 3, 5 or 10 substitutions for reducing or increasing effector function as described below.
One or several amino acids at the amino or carboxy terminus of the light and/or heavy chains such as the C-terminal lysine of the heavy chain, may be missing or derivatized in a proportion or all of the molecules.
Substitutions can be made in the constant regions to reduce or increase effector function such as complement-mediated cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC) (see, e.g., Winter et al., U.S. Pat. No. 5,624,821; Tso et al., U.S. Pat. No. 5,834,597; and Lazar et al., Proc. Natl. Acad. Sci. USA 103:4005, 2006), or to prolong half-life in humans (see, e.g., Hinton et al., J. Biol. Chem. 279:6213, 2004).
In some embodiments, the IL-6 antagonist antibodies provided herein include one more substitutions that reduce complement mediated cytotoxicity. Reduction in complement mediated cytotoxicity can be accomplished with or without reduction in Fc receptor binding depending on the nature of the mutation(s). Antibodies with reduced complement mediated cytotoxicity but little or no reduction in Fc receptor allow a desired effect of Fc-mediated phagocytosis of iC3b without activating complement, which may contribute to side effects. Exemplary mutations known to reduce complement-mediated cytotoxicity in human constant regions include mutations at positions 241, 264, 265, 270, 296, 297, 322, 329 and 331 by EU numbering. Mutations in positions 318, 320, and 322 have been reported to reduce complement activation in mouse antibodies. Alanine is a preferred residue to occupy these positions in a mutated constant region. Some exemplary human mutations that have been used include F241A, V264A, D265A, V296A, N297A, K322A, and P331S in human IgG3 and D270A or E, N297Q, K322A, P329A, and P331S in human IgG1 (EU numbering).
Here, as elsewhere, the EU numbering scheme is used for numbering amino acids in the constant region of an antibody. When a residue in a variable region is referenced herein (unless designated otherwise) the residue numbering is according to the variable domain (or, if designated, the SEQ ID NO). Substitution at any or all of positions 234, 235, 236 and/or 237 reduce affinity for Fcγ receptors, particularly FcγRI receptor and also reduces complement binding and activation (see, e.g., U.S. Pat. No. 6,624,821 WO/2009/052439). An alanine substitution at positions 234, 235 and 237 reduces effector functions, particularly in the context of human IgG1. Optionally, positions 234, 236 and/or 237 in human IgG2 are substituted with alanine and position 235 with glutamine. (See, e.g., U.S. Pat. No. 5,624,821) to reduce Fc receptor binding. Exemplary substitutions for increasing half-life include a Gln at position 250 and/or a Leu at position 428. In accordance with an aspect of the present disclosure, where the anti-IL-6 antibody presented has a human IgG1 isotype, it is preferred that the antibody has at least one mutation in the constant region. Preferably, the mutation reduces complement fixation or activation by the constant region. In particularly preferred aspects of the present disclosure, the antibody has one or more mutations at positions E233, L234, L235, G236, G237, A327, A330 and P331 by EU numbering. Still more preferably, the mutations constitute one or more of the following E233P, L234V, L234A, L235A, G237A, A327G, A330S and P331S by EU numbering. In the most preferred embodiments the human IgG1 has the following mutations L234A, L235A and G237A by EU numbering.
The half-life of IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps can be extended by attachment of a “half-life extending moieties” or “half-life extending groups,” which terms are herein used interchangeably to refer to one or more chemical groups attached to one or more amino acid site chain functionalities such as —SH, —OH, —COOH, —CONH2, —NH2, or one or more N- and/or O-glycan structures and that can increase in vivo circulatory half-life of proteins/peptides when conjugated to these proteins/peptides. Examples of half-life extending moieties include polymers described herein, particularly those of zwitterionic monomers, such as HEMA-phosphorylcholine, PEG, biocompatible fatty acids and derivatives thereof, Hydroxy Alkyl Starch (HAS) e.g. Hydroxy Ethyl Starch (HES), Poly Ethylene Glycol (PEG), Poly (Glyx-Sery) (HAP), Hyaluronic acid (HA), Heparosan polymers (HEP), Fleximers, Dextran, Poly-sialic acids (PSA), Fc domains, Transferrin, 25 Albumin, Elastin like (ELP) peptides, XTEN polymers, PAS polymers, PA polymers, Albumin binding peptides, CTP peptides, FcRn binding peptides and any combination thereof.
In some embodiments, the antibody is conjugated with a phosphorylcholine containing polymer. In some embodiments, the antibody is conjugated with a poly(acryloyloxyethyl phosphorylcholine) containing polymer, such as a polymer of acrylic acid containing at least one acryloyloxyethyl phosphorylcholine monomer such as 2-methacryloyloxyethyl phosphorylcholine (i.e., 2-methacryloyl-2′-trimethylammonium ethyl phosphate).
In some embodiments, the antibody and/or antibody VEGF Trap fusion is conjugated with a water-soluble polymer, which refers to a polymer that is soluble in water. A solution of a water-soluble polymer may transmit at least about 75%, more preferably at least about 95% of light, transmitted by the same solution after filtering. On a weight basis, a water-soluble polymer or segment thereof may be at least about 35%, at least about 50%, about 70%, about 85%, about 95% or 100% (by weight of dry polymer) soluble in water.
In one embodiment a half-life extending moiety can be conjugated to an IL-6 antagonist antibodies and/or IL-6 Ab VEGF Trap via free amino groups of the protein using N-hydroxysuccinimide (NHS) esters. Reagents targeting conjugation to amine groups can randomly react to ϵ-amine group of lysines, α-amine group of N-terminal amino acids, and δ-amine group of histidines.
However, IL-6 antagonist antibodies of the present disclosure have many amine groups available for polymer conjugation. Conjugation of polymers to free amino groups, thus, might negatively impact the ability of the antibody to bind to the epitope.
In another embodiment, a half-life extending moiety is coupled to one or more free SH groups using any appropriate thiol-reactive chemistry including, without limitation, maleimide chemistry, or the coupling of polymer hydrazides or polymer amines to carbohydrate moieties of the IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps after prior oxidation. The use of maleimide coupling is a particularly preferred embodiment of the present disclosure. Coupling preferably occurs at cysteines naturally present or introduced via genetic engineering.
In some embodiments, polymers are covalently attached to cysteine residues introduced into IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps by site directed mutagenesis. In some embodiments, the cysteine residues in the Fc portion of the IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap can be used. In some embodiments, sites to introduce cysteine residues into an Fc region are provided in WO 2013/093809, U.S. Pat. No. 7,521,541, WO 2008/020827, U.S. Pat. Nos. 8,008,453, 8,455,622 and US2012/0213705, incorporated herein by reference for all purposes. In some embodiments, cysteine mutations are Q347C and L443C referring to the human IgG heavy chain by the EU index of Kabat. In some embodiments, the cysteine added by directed mutagenesis for subsequent polymer attachment is L443C. In some embodiments, the stoichiometry of IL-6 antagonist antibody to polymer is 1:1; in other words, a conjugate consists essentially of molecules each comprising one molecule of IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap conjugated to one molecule of polymer. In some embodiments, coupling can occur at one or more lysines.
In some embodiments, a conjugate comprises an isolated antagonist antibody that specifically binds to IL-6 or IL-6 Ab VEGF Trap is conjugated to a polymer. In some embodiments, the polymer comprises a zwitterionic monomer. In some embodiments, the zwitterionic monomer, without limitations, is HEMA-phosphorylcholine, PEG, biocompatible fatty acids and derivatives thereof, Hydroxy Alkyl Starch (HAS) e.g. Hydroxy Ethyl Starch (HES), Poly Ethylene Glycol (PEG), Poly (Glyx-Sery) (HAP), Hyaluronic acid (HA), Heparosan polymers (HEP), Fleximers, Dextran, Poly-sialic acids (PSA), Fc domains, Transferrin, 25 Albumin, Elastin like (ELP) peptides, XTEN polymers, PAS polymers, PA polymers, Albumin binding peptides, CTP peptides, or FcRn binding peptides. In some embodiments, the polymer comprising a zwitterionic monomer is a half-life extending moiety.
In some embodiments, the IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap can have a half-life extending moiety attached. In some embodiments, the half-life extending moiety is a zwitterionic polymer but PEG or other half-life extenders discussed below can alternatively be used. In some embodiments, the zwitterionic polymer is formed of monomers having a phosphorylcholine group. In some embodiments, the monomer is 2-(acryloyloxyethyl)-2′-(trimethylammoniumethyl) phosphate. In some embodiments, the monomer is 2-(methacryloyloxyethyl)-2′-(trimethylammoniumethyl) phosphate (HEMA-PC).
In some embodiments, the polymer conjugated to the IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap has at least 2 or 3 or more arms. Some polymers have 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 arms. In some embodiments, the polymer has 3, 6 or 9 arms. In some embodiments, the polymer has 9 arms. In some embodiments, the polymer peak molecular weight is between 300,000 and 1,750,000 Da. In some embodiments, the polymer has a peak molecular weight between 500,000 and 1,000,000 Da. In some embodiments, the polymer has a peak molecular weight between 600,000 to 800,000 Da.
In some embodiments, a conjugate of antagonistic anti-IL-6 antibody and/or IL-6 Ab VEGF Trap and a polymer is provided. In some embodiments, the polymer has a peak molecular weight between 300,000 and 1,750,000 Daltons as measured by size exclusion chromatography—multi angle light scattering (hereinafter “SEC-MALS”). In some embodiments, the polymer has a peak molecular weight between 500,000 and 1,000,000 Daltons as measured by SEC-MALS. In some embodiments, the polymer has a peak molecular weight between 600,000 to 800,000 Daltons as measured by SEC-MALS.
In some embodiments, a half-life extending moiety may be conjugated to a naturally occurring cysteine residue of an IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap provided herein. In some embodiments, the half-life extending moiety is conjugated added to a cysteine that is added via site directed mutagenesis. In some embodiments, the cysteine is added by using recombinant DNA technology to add the peptide SGGGC or CAA to the C-terminus of either the light or heavy chain. In some embodiments, the peptide is added to the heavy chain. In some embodiments, the cysteine residue introduced via recombinant DNA technology is selected from the group consisting of (EU numbering) Q347C and L443C.
In accordance with another aspect of the present disclosure, a pharmaceutical composition is presented having an IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap and a pharmaceutically acceptable excipient.
IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps (or other constructs provided herein) can be produced by recombinant expression including (i) the production of recombinant DNA by genetic engineering, (ii) introducing recombinant DNA into prokaryotic or eukaryotic cells by, for example and without limitation, transfection, electroporation or microinjection, (iii) cultivating the transformed cells, (iv) expressing anti-IL-6 antibodies, e.g. constitutively or on induction, and (v) isolating the anti-IL-6 antibody, e.g. from the culture medium or by harvesting the transformed cells, in order to (vi) obtain purified anti-IL-6 antibody.
In some embodiments, a conjugate comprising an anti-IL-6 antibody and/or IL-6 Ab VEGF Trap and a polymer is provided (as well as the other constructs provided herein, such as a bioconjugate). The antibody and/or Ab-Trap is any one of the antibodies and/or Traps disclosed herein. In some embodiments, the antibody is an IgG. In some embodiments, the antibody is IgA, IgE, IgD or IgM. In some embodiments, the polymer is covalently bonded to a sulfhydryl group. In some embodiments, the polymer is covalently bonded to a sulfhydryl group from a cysteine residue. In some embodiments, the polymer is covalently bonded to a sulfhydryl group from a cysteine residue on the heavy chain. In some embodiments, the polymer is covalently bonded to a sulfhydryl group from a cysteine residue on the heavy chain of the IgG. In some embodiments, the antibody comprises a cysteine residue at position 347 or 443 (EU numbering). In some embodiments, the polymer is covalently bonded to a sulfhydryl group from a cysteine residue at position 347 or 443 (EU numbering).
IL-6 antagonist antibodies and/or IL-6 Ab VEGF Trap can be produced by expression in a suitable prokaryotic or eukaryotic host system characterized by producing a pharmacologically acceptable anti-IL-6 antibody molecule. Examples of eukaryotic cells are mammalian cells, such as CHO, COS, HEK 293, BHK, SK-Hip, and HepG2. Other suitable expression systems are prokaryotic (e.g., E. coli with pET/BL21 expression system), yeast (Saccharomyces cerevisiae and/or Pichia pastoris systems), and insect cells. In some embodiments, an isolated cell line that produces any of the antibodies and/or Ab-Traps disclosed herein is provided. In some embodiments, the isolated cell line is selected, without limitations, from one or more of CHO, k1SV, XCeed, CHOK1SV, GS-KO.
In some embodiments, an isolated nucleic acid encoding any of the antibodies and/or Ab-Traps disclosed herein is provided. In some embodiments, a recombinant expression vector comprising the isolated nucleic acid is provided. In some embodiments, a host cell comprises the expression vector.
A wide variety of vectors can be used for the preparation of the IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps and may be selected from eukaryotic and prokaryotic expression vectors. Examples of vectors for prokaryotic expression include plasmids such as, and without limitation, preset, pet, and pad, wherein the promoters used in prokaryotic expression vectors include one or more of, and without limitation, lac, trc, trp, recA, or araBAD. Examples of vectors for eukaryotic expression include, without limitation: (i) for expression in yeast, vectors such as, and without limitation, pAO, pPIC, pYES, or pMET, using promoters such as, and without limitation, AOX1, GAP, GAL1, or AUG1; (ii) for expression in insect cells, vectors such as and without limitation, pMT, pAc5, pIB, pMIB, or pBAC, using promoters such as and without limitation PH, p10, MT, Ac5, OpIE2, gp64, or polh, and (iii) for expression in mammalian cells, vectors such as, and without limitation, pSVL, pCMV, pRc/RSV, pcDNA3, or pBPV, and vectors derived from, in one aspect, viral systems such as and without limitation vaccinia virus, adeno-associated viruses, herpes viruses, or retroviruses, using promoters such as and without limitation CMV, SV40, EF-1, UbC, RSV, ADV, BPV, and beta-actin.
In some embodiments, a method of producing an IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap is provided. In some embodiments, the method comprises culturing a cell line that recombinantly produces any of the antibodies and/or Ab-Traps disclosed herein under conditions wherein the antibody is produced and recovered. In some embodiments, a method of producing an IL-6 antagonist antibody and/or IL-6 Ab VEGF Trap is provided. In some embodiments, the method comprises culturing a cell line comprising nucleic acid encoding an antibody and/or Ab-Trap comprising a heavy chain comprising the amino acid sequence shown in Table 1A and a light chain comprising the amino acid sequence shown in Table 1B under conditions wherein the antibody and/or IL-6 Ab VEGF Trap is produced and recovered. In some embodiments, the heavy and light chains of the antibody and/or IL-6 Ab VEGF Trap are encoded on separate vectors. In some embodiments, the heavy and light chains of the antibody and/or IL-6 Ab VEGF Trap are encoded on the same vector.
In some embodiments, a conjugate comprising an isolated antagonist antibody and/or IL-6 Ab VEGF Trap that specifically binds to IL-6 and a phosphorylcholine-containing polymer is provided. In some embodiments, the polymer is covalently bonded to the antibody and/or Ab-Trap. In some embodiments, the polymer is non-covalently bonded to the antibody and/or Ab-Trap. The conjugate can be made using any suitable option. Suitable options are described, e.g., in U.S. Pat. App. No. 2019/0270806, the disclosure of which is incorporated herein by reference in its entirety. With reference to
In some embodiments, a conjugate comprising an anti-IL-6 antibody and/or IL-6 Ab VEGF Trap and a phosphorylcholine containing polymer is provided. In some embodiments, the polymer is covalently bonded to the antibody outside a variable region of the antibody. In some embodiments, a conjugate comprising an anti-IL-6 antibody and/or IL-6 Ab VEGF Trap and a phosphorylcholine containing polymer is provided. The polymer is covalently bonded to the antibody at a cysteine outside a variable region of the antibody. In some embodiments, a conjugate comprising an anti-IL-6 antibody and/or IL-6 Ab VEGF Trap and a phosphorylcholine containing polymer is provided, wherein the polymer is covalently bonded to the antibody at a cysteine outside a variable region of the antibody wherein said cysteine has been added via recombinant DNA technology. In some embodiments of the conjugate, the polymer comprises 2(methacryloyloxy)ethyl (2-(trimethylammonio)ethyl) phosphate (MPC) monomers.
In accordance with another aspect of the present disclosure, a method is provided where the conjugation group (e.g. maleimide) is added after polymer synthesis. This is sometimes referred to as a “snap-on strategy” or “universal polymer strategy”. See, e.g., U.S. patent application Ser. No. 14/916,180 (published as U.S. Patent Application Publication No. 20160199501), hereby incorporated by reference in its entirety. In some embodiments, a single initiator moiety can be used for large scale polymer synthesis. Thus, conditions can be developed for scaled up optimal polymer synthesis. Such polymers can then be adapted to various types of functional agents by “snapping-on” various types of linkers. For example, if it is desired to conjugate a larger functional agent to a polymer of the instant disclosure such as an antibody of even a Fab fragment, a longer linker sequence can be snapped on to the polymer. In contrast, smaller functional agents may call for relatively shorter linker sequences.
In some embodiments of the methods, the initiator has about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 sites for polymer initiation. In some embodiments, the initiator has about 3, about 6, or about 9 sites for polymer initiation.
In accordance with another aspect of the present disclosure, a second linker has second, third, fourth, fifth, and sixth reactive groups. More preferably, a second linker has just second and third reactive groups.
In accordance with an aspect of the present disclosure, each polymer arm has from about 20 to about 2000 monomer units. Preferably, each arm has from about 100 to 500 monomer units or from about 500 to 1000 monomer units or from about 1000 to 1500 monomer units or from about 1500 to 2000 monomer units.
In accordance with an aspect of the present disclosure, the peak molecular weight of the polymer-functional agent conjugate is about 100,000 to 1,500,000 Da. Preferably, the peak molecular weight of the polymer-functional agent conjugate is about 200,000 to about 300,000 Da, about 400,000 to about 600,000 Da or about 650,000 to about 850,000 Da.
In some embodiments, the polymer has three or more arms, or is synthesized with an initiator comprising 3 or more polymer initiation sites. In some embodiments, the polymer has 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 arms, or is synthesized with an initiator comprising 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 polymer initiation sites. More preferably, the polymer has 3, 6, or 9 arms, or is synthesized with an initiator comprising 3, 6, or 9 polymer initiation sites. In some embodiments, the polymer has 9 arms, or is synthesized with an initiator comprising 9 polymer initiation sites.
In some embodiments, the polymer that is added has a molecular weight between about 300,000 and about 1,750,000 Da (SEC-MALs). In some embodiments, the polymer has a molecular weight between about 500,000 and about 1,000,000 Da. In some embodiments, the polymer has a molecular weight of between about 600,000 to about 900,000 Da. In some embodiments, the polymer has a molecular weight of between about 750,000 to about 850,000 Da. In some embodiments, the polymer has a molecular weight of between about 800,000 to about 850,000 Da. In some embodiments, the polymer has a molecular weight of between about 750,000 to about 800,000 Da.
In some embodiments, any of the antibodies and/or Ab-Traps described herein can be further conjugated to a polymer to form a bioconjugate. The molecular weight of the bioconjugate (in total, SEC-MALs) can be between about 350,000 and 2,000,000 Daltons, for example, between about 450,000 and 1,900,000 Daltons, between about 550,000 and 1,800,000 Daltons, between about 650,000 and 1,700,000 Daltons, between about 750,000 and 1,600,000 Daltons, between about 850,000 and 1,500,000 Daltons, between about 900,000 and 1,400,000 Daltons, between about 950,000 and 1,300,000 Daltons, between about 900,000 and 1,000,000 Daltons, between about 1,000,000 and 1,300,000 Daltons, between about 850,000 and 1,300,000 Daltons, between about 850,000 and 1,000,000 Daltons, and between about 1,000,000 and 1,200,000 Daltons. In some embodiments, the bioconjugate has a molecular weight between about 350,000 and 1,900,000 Daltons.
In some embodiments, the antibody and/or Ab-Trap conjugate is purified. In some embodiments, the polymer in aspect of the antibody and/or Ab-Trap conjugate is polydisperse, i.e. the polymer PDI is not 1.0. In some embodiments, the PDI is less than 1.5. In some embodiments, the PDI is less than 1.4. In some embodiments, the PDI is less than 1.3. In some embodiments the PDI is less than 1.2. In some embodiments the PDI is less than 1.1. In some embodiments, the conjugate PDI is equal to or less than 1.5.
In some embodiments, the antibody and/or Ab-Trap conjugate has an anti-IL-6 immunoglobulin G (IgG) bonded to a polymer, which polymer comprises MPC monomers, wherein the sequence of the anti-IL-6 heavy chain is in Table 1A, and the sequence of the anti-IL-6 light chain is in Table 1B, and wherein the antibody and/or Ab-Trap is bonded only at C442 to the polymer. In some embodiments, the polymer has 9 arms and has a molecular weight of between about 600,000 to about 1,000,000 Da.
In some embodiments, the antibody and/or Ab-Trap conjugate has an anti-IL-6 immunoglobulin G (IgG) bonded to a polymer, which polymer comprises MPC monomers, wherein the sequence of the anti-IL-6 heavy chain comprises in Table 1A, and the sequence of the anti-IL-6 light chain comprises in Table 1B, and wherein the antibody is bonded only at C443 (EU numbering to the polymer. In some embodiments, the polymer has 9 arms and has a molecular weight of between about 600,000 to about 1,000,000 Da. In some embodiments, the conjugate comprises a polymer that has 9 arms and the polymer has a molecular weight of between about 600,000 to about 900,000 Da.
In some embodiments, the antibody conjugate has the following structure:
In some embodiments, the antibody conjugate has the following structure:
In some embodiments, the antibody and/or Ab-Trap conjugate is present in a liquid formulation. In some embodiments, the antibody and/or Ab-Trap conjugate is combined with a pharmaceutically acceptable carrier.
In some embodiments, the isotype of the anti-IL-6 antibody (and/or IL-6 Ab-VEGF Trap) heavy chain, is IgG1 and has a CH1, hinge, CH2 and CH3 domains. In some embodiments the light chain isotype is kappa.
In some embodiments, the IgG1 domain of the anti-IL-6 antibody (and/or IL-6 Ab-VEGF Trap) has one or more mutations to modulate effector function, such as ADCC, ADCP, and CDC. In some embodiments, the IgG1 mutations reduce effector function. In some embodiments the amino acids to use for effector function mutations include (EU numbering) E233X, L234X, L235X, G236X, G237X, G236X, D270X, K322X, A327X, P329X, A330X, A330X, P331X, and P331X, in which X is any natural or non-natural amino acid. In some embodiments, the mutations include one or more of the following: E233P, L234V, L234A, L235A, G237A, A327G, A330S and P331S (EU numbering). In some embodiments, the anti-IL-6 heavy chain has the following mutations (EU numbering): L234A, L235A and G237A. In some embodiments, the number of effector function mutations relative to a natural human IgG1 sequence is no more than 10. In some embodiments the number of effector function mutations relative to a natural human IgG1 sequence is no more than 5, 4, 3, 2 or 1. In some embodiments, the antibody (and/or IL-6 Ab-VEGF Trap) has decreased Fc gamma binding and/or complement C1q binding, such that the antibody's ability to result in an effector function is decreased. This can be especially advantageous for ophthalmic indications/disorders.
In some embodiments, the anti-IL-6 antibody (and/or IL-6 Ab-VEGF Trap) comprises one or more of the following amino acid mutations: L234A, L235A, G237A, and L443C (EU numbering, or 451A, 452A, and 454A, and 660C in SEQ ID NO: 170, as shown in double underlining in
In some embodiments, the anti-IL-6 antibody (and/or IL-6 Ab VEGFTrap) is or is part of a human immunoglobulin G (IgG1).
In some embodiments, the IL-6 antibody (and/or IL-6 Ab-VEGF Trap) comprises a heavy chain constant domain that comprises one or more mutations that reduce an immune-mediated effector function.
In some embodiments, the anti-IL-6 heavy chain has a cysteine residue added as a mutation by recombinant DNA technology which can be used to conjugate a half-life extending moiety. In some embodiments, the mutation is Q347C (EU numbering) and/or L443C (EU numbering). In some embodiments, the mutation is L443C (EU numbering). In some embodiments, the stoichiometry of antibody to polymer is 1:1; in other words, a conjugate has one molecule of antibody conjugated to one molecule of polymer.
The half-life of the anti-IL-6 antibodies can be extended by attachment of a “half-life (“half life”) extending moieties” or “half-life (“half life”) extending groups”. Half-life extending moieties include peptides and proteins which can be expressed in frame with the biological drug of issue (or conjugated chemically depending on the situation) and various polymers which can be attached or conjugated to one or more amino acid side chain or end functionalities such as —SH, —OH, —COOH, —CONH2, —NH2, or one or more N- and/or O-glycan structures. Half-life extending moieties generally act to increase the in vivo circulatory half-life of biologic drugs.
Examples of peptide/protein half-life extending moieties include Fc fusion (Capon D J, Chamow S M, Mordenti J, et al. Designing CD4 immunoadhesions for AIDS therapy. Nature. 1989. 337:525-31), human serum albumin (HAS) fusion (Yeh P, Landais D, Lemaitre M, et al. Design of yeast-secreted albumin derivatives for human therapy: biological and antiviral properties of a serum albumin-CD4 genetic conjugate. Proc Natl Acad Sci USA. 1992. 89:1904-08), carboxy terminal peptide (CTP) fusion (Fares F A, Suganuma N. Nishimori K, et al. Design of a long-acting follitropin agonist by fusing the C-terminal sequence of the chorionic gonadotropin beta subunit to the follitropin beta subunit. Proc Natl Acad Sci USA. 1992. 89:4304-08), genetic fusion of non-exact repeat peptide sequence (XTEN) fusion (Schellenberger V, Wang C W, Geething N C, et al. A recombinant polypeptide extends the in vivo half-life of peptides and proteins in a tunable manner. Nat Biotechnol. 2009. 27:1186-90), elastin like peptide (ELPylation) (MCpherson D T, Morrow C, Minehan D S, et al. Production and purification of a recombinant elastomeric polypeptide, G(VPGVG19-VPGV, from Escherichia coli. Biotechnol Prog. 1992. 8:347-52), human transferrin fusion (Prior C P, Lai C-H, Sadehghi H et al. Modified transferrin fusion proteins. Patent WO2004/020405. 2004), proline-alanine-serine (PASylation) (Skerra A, Theobald I, Schlapsky M. Biological active proteins having increased in vivo and/or vitro stability. Patent WO2008/155134 A1. 2008), homo-amino acid polymer (HAPylation) (Schlapschy M, Theobald I, Mack H, et al. Fusion of a recombinant antibody fragment with a homo-amino acid polymer: effects on biophysical properties and prolonged plasma half-life. Protein Eng Des Sel. 2007. 20:273-84) and gelatin like protein (GLK) fusion (Huang Y-S, Wen X-F, Zaro J L, et al. Engineering a pharmacologically superior form of granulocyte-colony-stimulating-factor by fusion with gelatin-like protein polymer. Eur J. Pharm Biopharm. 2010. 72:435-41).
Examples of polymer half-life extending moieties include polyethylene glycol (PEG), branched PEG, PolyPEG® (Warwick Effect Polymers; Coventry, UK), polysialic acid (PSA), starch, hydroxylethyl starch (HES), hydroxyalkyl starch (HAS), carbohydrate, polysaccharides, pullulane, chitosan, hyaluronic acid, chondroitin sulfate, dermatan sulfate, dextran, carboxymethyl-dextran, polyalkylene oxide (PAO), polyalkylene glycol (PAG), polypropylene glycol (PPG), polyoxazoline, polyacryloylmorpholine, polyvinyl alcohol (PVA), polycarboxylate, polyvinylpyrrolidone, polyphosphazene, polyoxazoline, polyethylene-co-maleic acid anyhydride, polystyrene-co-maleic acid anhydride, poly(l-hydroxymethyethylene hydroxymethylformal) (PHF), a zwitterionic polymer, a phosphorylcholine containing polymer and a polymer comprising MPC, Poly (Glyx-Sery), Hyaluronic acid (HA), Heparosan polymers (HEP), Fleximers, Dextran, and Poly-sialic acids (PSA).
In one embodiment a half-life extending moiety can be conjugated to an antibody via free amino groups of the protein using N-hydroxysuccinimide (NHS) esters. Reagents targeting conjugation to amine groups can randomly react to ϵ-amine group of lysines, α-amine group of N-terminal amino acids, and δ-amine group of histidines.
However, the anti-IL-6 antibodies (and/or IL-6 Ab-VEGF Trap) disclosed herein can have many amine groups available for polymer conjugation. Conjugation of polymers to free amino groups, thus, might negatively impact the ability of the antibody proteins to bind to IL-6 (and/or IL-6 Ab-VEGF Trap).
In some embodiments, a half-life extending moiety is coupled to one or more free SH groups using any appropriate thiol-reactive chemistry including, without limitation, maleimide chemistry, or the coupling of polymer hydrazides or polymer amines to carbohydrate moieties of the antibody after prior oxidation. In some embodiments maleimide coupling is used In some embodiments, coupling occurs at cysteines naturally present or introduced via genetic engineering.
In some embodiments, conjugates of antibody and high MW polymers serving as half-life extenders are provided. In some embodiments, a conjugate comprises an antibody (and/or IL-6 Ab-VEGF Trap) that is coupled to a zwitterionic polymer wherein the polymer is formed from one or more monomer units and wherein at least one monomer unit has a zwitterionic group is provided. In some embodiments, the zwitterionic group is phosphorylcholine.
In some embodiments, one of the monomer units is HEMA-PC. In some embodiments, a polymer is synthesized from a single monomer which is HEMA-PC.
In some embodiments, some antibody (and/or IL-6 Ab VEGFTrap) conjugates have 2, 3, or more polymer arms wherein the monomer is HEMA-PC. In some embodiments, the conjugates have 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12 polymer arms wherein the monomer is HEMA-PC. In some embodiments, the conjugates have 3, 6 or 9 arms. In some embodiments, the conjugate has 9 arms.
In some embodiments, polymer-antibody (and/or polymer-IL-6 Ab-VEGFTrap) conjugates have a polymer portion with a molecular weight of between 100,000 and 1,500,000 Da. In some embodiments, the conjugate has a polymer portion with a molecular weight between 500,000 and 1,000,000 Da. In some embodiments, the conjugate has a polymer portion with a molecular weight between 600,000 to 800,000 Da. In some embodiments, the conjugate has a polymer portion with a molecular weight between 600,000 and 850,000 Da and has 9 arms. When a molecular weight is given for an antibody conjugated to a polymer, the molecular weight will be the addition of the molecular weight of the protein, including any carbohydrate moieties associated therewith, and the molecular weight of the polymer.
In some embodiments, an anti-IL-6 antibody (and/or IL-6 Ab VEGF Trap) has a HEMA-PC polymer which has a molecular weight measured by Mw of between about 100 kDa and 1650 kDa is provided. In some embodiments, the molecular weight of the polymer as measured by Mw is between about 500 kDa and 1000 kDa. In some embodiments, the molecular weight of the polymer as measured by Mw is between about 600 kDa to about 900 kDa. In some embodiments, the polymer molecular weight as measured by Mw is 750 or 800 kDa plus or minus 15%.
In some embodiments, the polymer is made from an initiator suitable for ATRP having one or more polymer initiation sites. In some embodiments, the polymer initiation site has a 2-bromoisobutyrate site. In some embodiments, the initiator has 3 or more polymer initiation sites. In some embodiments, the initiator has 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 polymer initiation sites. In some embodiments, the initiator has 3, 6 or 9 polymer initiation sites. In some embodiments, the initiator has 9 polymer initiation sites. In some embodiments, the initiator is OG1786.
The anti-IL-6 antibodies (and/or IL-6 Ab-VEGFTrap) can be produced by recombinant expression including (i) the production of recombinant DNA by genetic engineering, (ii) introducing recombinant DNA into prokaryotic or eukaryotic cells by, for example and without limitation, transfection, electroporation or microinjection, (iii) cultivating the transformed cells, (iv) expressing antibody, e.g. constitutively or on induction, and (v) isolating the antibody, e.g. from the culture medium or by harvesting the transformed cells, in order to (vi) obtain purified antibody.
The anti-IL-6 antibodies (and/or IL-6 Ab-VEGF Trap) can be produced by expression in a suitable prokaryotic or eukaryotic host system characterized by producing a pharmacologically acceptable antibody molecule. Examples of eukaryotic cells are mammalian cells, such as CHO, COS, HEK 293, BHK, SK-Hip, and HepG2. Other suitable expression systems are prokaryotic (e.g., E. coli with pET/BL21 expression system), yeast (Saccharomyces cerevisiae and/or Pichia pastoris systems), and insect cells.
A wide variety of vectors can be used for the preparation of the antibodies (and/or IL-6 Ab-VEGF Trap) disclosed herein and are selected from eukaryotic and prokaryotic expression vectors. Examples of vectors for prokaryotic expression include plasmids such as, and without limitation, preset, pet, and pad, wherein the promoters used in prokaryotic expression vectors include one or more of, and without limitation, lac, trc, trp, recA, or araBAD. Examples of vectors for eukaryotic expression include: (i) for expression in yeast, vectors such as, and without limitation, pAO, pPIC, pYES, or pMET, using promoters such as, and without limitation, AOX1, GAP, GAL1, or AUG1; (ii) for expression in insect cells, vectors such as and without limitation, pMT, pAc5, pIB, pMIB, or pBAC, using promoters such as and without limitation PH, p10, MT, Ac5, OpIE2, gp64, or polh, and (iii) for expression in mammalian cells, vectors such as, and without limitation, pSVL, pCMV, pRc/RSV, pcDNA3, or pBPV, and vectors derived from, in one aspect, viral systems such as and without limitation vaccinia virus, adeno-associated viruses, herpes viruses, or retroviruses, using promoters such as and without limitation CMV, SV40, EF-1, UbC, RSV, ADV, BPV, and beta-actin.
In some embodiments, there is at least one polymer per protein. In some embodiments, the ratio of protein to polymer is 1:4 to 1:6. In some embodiments, the ratio of protein (Ab) to polymer is 1:5 molar ratio. In some embodiments, the amount of protein is 5, 4, 3, 2, or about 2.4 mg/ml.
In some embodiments, the purification following the combination of the polymer and the antibody further comprises a cation exchange column.
In some embodiments, the presence of the polymer attached to the IL-6 antagonist antibodies and/or IL-6 Ab VEGF Traps can provide a deeper potency due to the presence of the polymer itself. In some embodiments, the presence of the polymer, when used in combination with a heparin binding domain, (such as in VEGF) results in a conjugated molecule with deeper potency. In some embodiments, as shown in the HUVECs data provided in the examples below, the molecule is superior in angiogenesis. In some embodiments, this is a difference in nature of the conjugate molecule, not simply a difference in degree (e.g., comparing the conjugate to the unconjugated molecules). Furthermore, as shown in the HUVEC proliferation assays in the examples below, in some embodiments, the presence of the polymer provides for synergistic inhibition.
In addition, in some embodiments, as cell densities are increased (e.g., from 4,000 to 6,000), the potency of the conjugate may also improve.
In some embodiments, the amount (by weight of protein) of the conjugate used is more than 50 mg/ml. It can be, for example, 55, 60, 65, 70 or greater mg/ml (by weight of pre-conjugation protein).
A modification or mutation may also be made in a framework region or constant region to increase the half-life of an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap). See, e.g., PCT Publication No. WO 00/09560. A mutation in a framework region or constant region can also be made to alter the immunogenicity of the antibody, to provide a site for covalent or non-covalent binding to another molecule, or to alter such properties as complement fixation, FcR binding and antibody-dependent cell-mediated cytotoxicity. In some embodiments, no more than one to five conservative amino acid substitutions are made within the framework region or constant region. In other embodiments, no more than one to three conservative amino acid substitutions are made within the framework region or constant region. According to the present disclosure, a single antibody may have mutations in any one or more of the CDRs or framework regions of the variable domain or in the constant region.
Modifications also include glycosylated and nonglycosylated polypeptides, as well as polypeptides with other post-translational modifications, such as, for example, glycosylation with different sugars, acetylation, and phosphorylation. Antibodies are glycosylated at conserved positions in their constant regions (Jefferis and Lund, 1997, Chem. Immunol. 65:111-128; Wright and Morrison, 1997, TibTECH 15:26-32). The oligosaccharide side chains of the immunoglobulins affect the protein's function (Boyd et al., 1996, Mol. Immunol. 32:1311-1318; Wittwe and Howard, 1990, Biochem. 29:4175-4180) and the intramolecular interaction between portions of the glycoprotein, which can affect the conformation and presented three-dimensional surface of the glycoprotein (Jefferis and Lund, supra; Wyss and Wagner, 1996, Current Opin. Biotech. 7:409-416). Oligosaccharides may also serve to target a given glycoprotein to certain molecules based upon specific recognition structures. Glycosylation of antibodies has also been reported to affect antibody-dependent cellular cytotoxicity (ADCC). In particular, antibodies produced by CHO cells with tetracycline-regulated expression of β(1,4)-N-acetylglucosaminyltransferase III (GnTIII), a glycosyltransferase catalyzing formation of bisecting GlcNAc, was reported to have improved ADCC activity (Umana et al., 1999, Nature Biotech. 17:176-180).
Glycosylation of antibodies is typically either N-linked or O-linked. N-linked refers to the attachment of the carbohydrate moiety to the side chain of an asparagine residue. The tripeptide sequences asparagine-X-serine, asparagine-X-threonine, and asparagine-X-cysteine, where X is any amino acid except proline, are the recognition sequences for enzymatic attachment of the carbohydrate moiety to the asparagine side chain. Thus, the presence of either of these tripeptide sequences in a polypeptide creates a potential glycosylation site. O-linked glycosylation refers to the attachment of one of the sugars N-acetylgalactosamine, galactose, or xylose to a hydroxyamino acid, most commonly serine or threonine, although 5-hydroxyproline or 5-hydroxylysine may also be used.
Addition of glycosylation sites to the antibody (and/or Ab-Trap) is conveniently accomplished by altering the amino acid sequence such that it contains one or more of the above-described tripeptide sequences (for N-linked glycosylation sites). The alteration may also be made by the addition of, or substitution by, one or more serine or threonine residues to the sequence of the original antibody (for O-linked glycosylation sites).
The glycosylation pattern of antibodies (and/or Ab-Trap) may also be altered without altering the underlying nucleotide sequence. Glycosylation largely depends on the host cell used to express the antibody. Since the cell type used for expression of recombinant glycoproteins, e.g. antibodies, as potential therapeutics is rarely the native cell, variations in the glycosylation pattern of the antibodies can be expected (see, e.g. Hse et al., 1997, J. Biol. Chem. 272:9062-9070).
In addition to the choice of host cells, factors that affect glycosylation during recombinant production of antibodies (and/or Ab-Trap) include growth mode, media formulation, culture density, oxygenation, pH, purification schemes and the like. Various methods have been proposed to alter the glycosylation pattern achieved in a particular host organism including introducing or overexpressing certain enzymes involved in oligosaccharide production (U.S. Pat. Nos. 5,047,335; 5,510,261 and 5,278,299). Glycosylation, or certain types of glycosylation, can be enzymatically removed from the glycoprotein, for example, using endoglycosidase H (Endo H), N-glycosidase F, endoglycosidase F1, endoglycosidase F2, endoglycosidase F3. In addition, the recombinant host cell can be genetically engineered to be defective in processing certain types of polysaccharides. These and similar techniques are well known in the art.
Some embodiments provided herein can be employed as a therapeutic for inflammatory retinal diseases and/or retinal vesicular diseases with a component of inflammation. In addition to angiogenesis, inflammation has been implicated in the pathogenesis of these retinal diseases. Anti-inflammatory therapies such as steroids have been effective in treating both uveitis (a spectrum of diseases with intraocular inflammation as a defining characteristic) and diabetic macular edema (DME). Similarly, genetically inherited polymorphisms in IL-6 have been associated with higher PDR incidence in patients with type 2 diabetes. Moreover, disease progression in AMD, DR and RVO have been reported to be associated with increased serum and/or ocular levels of IL-6. Additionally, chronic inflammatory cells have been seen on the surface of the Bruch's membrane in eyes with neovascular AMD. IL-6 has been implicated in resistance to anti-VEGF treatments in DME patients. This in part is believed to be an indirect result of IL-6 mediated upregulation of VEGF expression [reference] as well as more direct VEGF-independent angiogenic functions mediated by IL-6 signaling that occur in the presence of VEGF inhibitors. In some embodiments, any one or more of these conditions can be treated and/or prevented by one or more of the compositions provided herein.
Various sequence arrangements of the Anti-IL-6 antibody/VEGF trap (VEGFR1/2) can be employed or provided in different arrangements.
Based on the results with the VEGF trap variants and improved Anti-IL-6 paratopes, 216 molecules in two different configurations were designed and prepared that comprised combinations of sequences as displayed in
In some embodiments, any of the VEGF trap variants provided herein can be paired with any of: the heavy and light chain sequences of IL-6 antibodies provided herein, and can be further modified by any of the polymers provided herein. In some embodiments, any of the VEGF trap variants provided herein can be paired with any of: the heavy and light chain variable sequences of IL-6 antibodies provided herein, and can be further modified by any of the polymers provided herein. In some embodiments, any of the VEGF trap variants provided herein can be paired with any of: the heavy and light chain 3 CDRs (HCDR1, HCDR2, HCDR3, LCDR1, LCDR2, and LCDR3) of IL-6 antibodies provided herein, and can be further modified by any of the polymers provided herein. In some embodiments, the IL-6-VEGF trap fusion comprises the components in
In some embodiments, the sequence of the anti-IL-6-VEGF trap (or dual inhibitor, fusion protein, or conjugate thereof) includes SEQ ID NO: 169 as the light chain, SEQ ID NO: 170 as the heavy chain fused to the VEGFR trap, via a linker. In some embodiments, the sequence of the anti-IL-6-VEGF trap (or dual inhibitor, or fusion protein or conjugate thereof) is at least 80% identical to a molecule comprising SEQ ID NO: 169 and 170, including, for example, at least 85, 90, 95, 96, 97, 98, 99, or greater percent identity to the combination of SEQ ID NO: 170 and 169. In some embodiments, the sequence of the anti-IL-6-VEGF trap (or conjugate thereof) is at least 80% identical to a molecule comprising SEQ ID NO: 169 and at least 80% identical to the molecule comprising SEQ ID NO: 170, including, for example, at least 85, 90, 95, 96, 97, 98, 99%, or greater identity to SEQ ID NO: 170 and at least 85, 90, 95, 96, 97, 98, 99%, or greater identity to 169. In some embodiments, the CDRs remain as depicted in any of the CDRs provided herein for an anti-IL-6 antibody (including those in SEQ ID NO: 170 and 169), while the remainder of the sequences (heavy and light chain, heavy and light variable regions, and/or full fusion sequences (such as SEQ ID NO 169 and 170) are allowed to be vary such that the full sequence is at least 80, 85, 90, 95, 96, 97, 98, 99, or greater percent identity to the original sequence. In some embodiments, the CDRs can vary by 1, 2, or 3 conservative alterations, while the remainder of the sequences (heavy and light chain, heavy and light variable regions, and/or full fusion sequences (such as SEQ ID NO 169 and 170) are allowed to be vary such that the full sequence is at least 80, 85, 90, 95, 96, 97, 98, 99, or greater percent identity to the original sequence. In some embodiments, the trap sequence (that shown in gray in
In some embodiments, the fusion protein (or dual inhibitor) or conjugate thereof comprises 1, 2, 3, 4, 5, or all 6 of the CDRs provided herein. In some embodiments, the fusion protein or conjugate thereof includes at least SEQ ID NOs: 49, 50, and 51 (or a variant with 1, 2, or 3 conservative substitutions). In some embodiments, the fusion protein (or dual inhibitor) or conjugate thereof includes at least SEQ ID NOs: 172, 173, and 174 (or a variant with 1, 2, or 3 conservative substitutions). In some embodiments, the fusion protein or conjugate thereof includes at least SEQ ID NOs: 49, 50, and 51 (or a variant with 1, 2, or 3 conservative substitutions) and at least SEQ ID NOs: 172, 173, and 174 (or a variant with 1, 2, or 3 conservative substitutions). In some embodiments, these 6 CDRs (or variants thereof) are contained within a human antibody framework region. In some embodiments, the CDRs are within the framework region of any of the antibodies provided herein, or variants thereof that are at least 80, 85, 90, 95, 96, 97, 98, 99, or greater percent identity to the heavy and/or light chain variable regions provided herein, including, without limitation, those in tables 1A for the heavy chain and 1B for the light chain. In some embodiments, the fusion protein (or dual inhibitor) or conjugate thereof includes at least SEQ ID NOs: 49, 50, and 51 (or a variant with 1, 2, or 3 conservative substitutions) and at least SEQ ID NOs: 172, 173, and 174 (or a variant with 1, 2, or 3 conservative substitutions) and these CDRs (including the variants) are substituted for the CDRs within one or more of the sequences in Table 1D, or within a variant within table 1D (where, disregarding the CDRs in Table 1D, the remaining sequence is at least 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 99.5 or greater percent identity to the heavy chain containing section and the light chain section in Table 1D). Thus, in some embodiments, these 6 CDRs (and the variants thereof) can be substituted not only for the CDRs of the sequences noted in Table 1, but also for variants thereof. In some embodiments, the CDRs provided in table 1E (including 1A1, 1E2, and 1E3) are excluded as options within the variants of possible CDRs. In some embodiment, the antibody (including fragments thereof) is one that is at least 80% identical to an antibody having the heavy and light chain variable regions depicted in
In some embodiments, an isolated antagonistic IL-6 antibody is provided. It can comprise a heavy chain amino acid variable region that comprises a heavy chain that has a sequence of at least one of SEQ ID NOs: 7-13, 19-27, 89, 90, 256-262; and a light chain amino acid variable region that comprises the light chain that has a sequences of at least one of SEQ ID NOs: 91-93, 28-30. In some embodiments, the isolated antagonistic IL-6 antibody includes a heavy chain amino acid variable region that comprises a heavy chain that has a sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID NOs: 7-13, 19-27, 89, 90, 256-262; and a light chain amino acid variable region that comprises the light chain that has a sequences of at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID NOs: 91-93, 28-30.
In some embodiments, an isolated antagonist IL-6 antibody is provided that comprises a heavy chain variable region (VH) comprising 3 complementarity determining regions: VH (CDR1), VH CDR2, and VH CDR3 having an amino acid sequence from the CDRs listed in SEQ ID NO: 256; and a light chain variable region (VL) comprising a VL CDR1, VL CDR2, and VL CDR3 having an amino acid sequence selected from the group of CDRs listed in SEQ ID NO: 91-93.
In some embodiments, an isolated antagonist antibody that binds to IL-6 is provide. The antibody comprises at least one of the following mutations based on EU numbering: L234A, L235A, and G237A.
In some embodiments, an isolated antagonistic antibody that binds to IL-6, the antibody comprising: a CDRH1 that is a CDRH1 in SEQ ID NO: 172; a CDRH2 that is a CDRH2 in SEQ ID NO: 173; a CDRH3 that is a CDRH3 in SEQ ID NO: 174: a CDRL1 that is a CDRL1 in SEQ ID NO: 199; a CDR12 that is a CDRL2 in SEQ ID NO: 200; a CDRL3 that is a CDRL3 in SEQ ID NO: 201; at least one of the following mutations (EU numbering): L234A, L235A, and G237A; and at least one of the following mutations (EU numbering): Q347C or L443C.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises an anti-IL-6 heavy chain variable region sequences selected from SEQ ID NO: 7-13, 89, 90, and/or 256-262. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises an anti-IL-6 heavy chain variable region sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID NO: 7-13, 89, 90, and/or 256-262.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor has a VEGF trap sequences selected from at least one of SEQ ID Nos: 145, 15, 16, or 17. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor has a VEGF trap sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID Nos: 145, 15, 16, or 17.
In some embodiments, the linker sequence is SEQ ID NO: 18.
In some embodiments, the heavy chain sequence for the Anti-IL-6 molecules is selected from at least one of SEQ ID NOs 19-27 or includes at least the sequence in one of SEQ ID NOs: 89, 90, 256-262.
In some embodiments, the light chain sequence for the anti-IL-6 molecule comprises at least 1, 2, or 3 light chain CDRs from at least one of SEQ ID NOs 76-84.
In some embodiments, the heavy chain sequence for the Anti-IL-6 molecule comprises at least 1, 2, or 3 heavy chain CDRs from at least one of SEQ ID NOs 49-75.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a VEGFR-Fc sequence from at least one of SEQ ID NOs 85-88. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a VEGFR-Fc sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to any one of SEQ ID NOs 85-88.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises one or more of the sequences in any one or more of SEQ ID Nos 7-13, 145, 15-17, 18-84. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises one or more sequences that are each independently at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to one of SEQ ID Nos 7-13, 145, 15-17, 18-84.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises an IL-6 VH; an IL-6 VL; an IL-6 Fc; a VEGF Trap; and a linker. In some embodiments, the IL-6 VH comprises a sequence from an IL6 VH sequence in any one of SEQ ID NOs: 19-27, 31-39, 89, 90, or 256-262. In some embodiments, the IL-6 VH comprises a sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to one of SEQ ID NOs 19-27, 31-39, 89, 90, or 256-262. In some embodiments, the IL-6 VL comprises a sequence from an IL6 VL sequence in any one of SEQ ID NOs: 28-30 or 91-93. In some embodiments, the IL-6 VL comprises a sequence from an IL6 VL sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to one of SEQ ID NOs: 28-30 or 91-93. In some embodiments, the Fc comprises a sequence from a Fc sequence in any one of SEQ ID NOs: 40-48. In some embodiments, the Fc comprises a sequence from a Fc sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to one of SEQ ID NOs: 40-48. In some embodiments, the VEGF Trap comprises a sequence from a VEGF trap sequence in any one of SEQ ID NOs: 145, 15, 16, or 17. In some embodiments, the VEGF Trap comprises a sequence from a VEGF trap sequence at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 97%, at least about 98%, at least about 99% or about 100%, or any percentage in a range defined by any two of the preceding values, identical to one of SEQ ID NOs: 145, 15, 16, or 17.
In some embodiments, a fusion protein is provided that comprises an IL-6 VH; an IL-6 VL; an IL-6 Fc; and a VEGF Trap, wherein the fusion protein alters HUVEC proliferation. In some embodiments, altering HUVEC proliferation is inhibiting VEGF/IL6 mediated proliferation.
In some embodiments, a fusion protein comprising a sequence that is at least 80% identical to SEQ ID NO: 263 and at least 80% identical to SEQ ID NO: 117 is provided. The fusion protein is further conjugated to a polymer. In some embodiments, the fusion protein is at least 95% identical to SEQ ID NO: 263 and at least 95% identical to SEQ ID NO: 117. In some embodiments, the protein comprises at least a) SEQ ID NO: 172, 173, 174, 199, 200, and 201, or b) a substitutions of 1, 2, or 3 amino acids within SEQ ID NO: 172, 173, 174, 199, 200, and/or 201, wherein the substitution is a conservative substitution.
In some embodiments, any of the constructs provided herein can include one or more mutation at positions 94 and/or 95 of the VEGFR sequence. In some embodiments, the mutation(s) can be T94I and H95I. In some embodiments this reduces any cleavage of the VEGFR protein (as detailed in the examples below).
In some embodiments, (where Anti-IL-6-VEGFR is the orientation), the variable and constant domains of the heavy chain, illustrated by Heavy chain—Fab, sequences 5A-5I of
In some embodiments, the VEGFR-Fc trap fusion is part of an engineered IgG1 framework. In addition to the VEGFR-Anti-IL-6 and Anti-IL-6-VEGFR constructs, an anti-VEGF (VEGFR-Fc) molecule comprising the VEGF trap with cleavage resistant variants, as described above, and an engineered IgG1 Fc domain, as illustrated by sequences 6A-6D of
As shown in
In some embodiments, any one or more of the sequences for the specified amino acid sequence in any one or more of
In some embodiments, the dual inhibitor provides one or more synergistic result. In some embodiments, the dual inhibitor is synergistically better than each section administered as a monotherapy (e.g. an IL-6 therapy and a VEGF therapy combined). In some embodiments, the combined VEGFR-IL-6 construct provides a synergistic result, as shown in the proliferation assay results (e.g., where the dual inhibitor has a clear effect on HUVEC proliferation, an important component of angiogenesis, while neither Eylea nor Anti-IL-6 achieve any change). Thus, in some embodiments, a method for controlling HUVEC proliferation is provided, whereby one employs a VEGFR-Anti-IL-6 construct as provided herein.
In other embodiments, the fusion construct simply provides an additive benefit by achieving both VEGF trap results and anti-IL-6 results.
In some embodiments, any one or more of the components in any one of more of tables provided herein can be combined together such that a VEGFR-anti-IL-6 construct is produced or such that an anti-IL-6-VEGFR construct is produced. In some embodiments, the construct will also include an Fc region. In some embodiments, the Fc region can be a human Fc region.
In some embodiments, the CDRs alone (with or without any particular framework section) can be employed as the antibody section. Thus, any one or more (e.g., 3 or 6) of the CDRs within each chain or pair of chains (heavy and light) can be used from any of the tables or figures provided herein, in combination with any of the other components (VEGFR and/or linkers). CDRs and/or 1, 2, or 3 heavy chain CDRs) from any of the IL-6 constructs provided herein can be combined with any one or more of the VEGFR sequences provided herein. In some embodiments, any heavy and/or light chain variable region from any of the IL-6 constructs provided herein can be combined with any one or more of the VEGFR sequences provided herein. In some embodiments, any of the linkers can be provided within the final construct as well.
In some embodiments, any nucleic acid sequence encoding any one of more of the amino acid sequences provided herein can be provided as well (e.g., in isolation, within a vector, or in a cell, etc.)
In some embodiments, any one or more of the polymers for conjugation to form the bioconjugate can be combined with any of the VEGFR-IL6 constructs provided herein.
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1A-1D (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1A (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1B (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1C (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1D (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1A (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1B (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1C (
In some embodiments, the VEGFR-anti-IL-6 combination is sequence 1D (
In some embodiments, any of the IL-6 antibody sequences can be employed with any of the VEGFR sequences provided herein. In some embodiments, any 1, 2, 3, 4, 5, or 6 CDRS (1, 2, or 3 light chain and 1, 2, or 3 heavy chain) anti-IL-6 sequences can be employed with any of the VEGFR arrangements.
In some embodiments, any anti-IL-6 antibody light and/or heavy chain can be employed, with any one or more of the point mutations provided in any one of more of Tables 18.1-18.4. In some embodiments, the fusion construct employs an anti-IL-6 construct that has a point mutation at any one or more of the positions identified in any one or more of Tables 18.1-18.4. In some embodiments, the positions altered are those underlined and bolded in the relevant figures as showing changed residues. In some embodiments, the construct is one that includes changes in heavy chain include one or more of S35H, G66D, L100A, or L100S and the changes in light chain include one or more of M32L, M50D, N52S or M88Q. CDR positions follow their order of appearance in the variable domain when described (e.g. S35H, G66D . . . ). Fc positions follow EU numbering when described (e.g. L234A, L235A . . . ) In some embodiments, the construct (e.g., antibody to Il-6, and/or IL-6 VEGF Trap, and/or IL-6 VEGF Trap bioconjugate (to one or more of the biopolymers provided herein)), includes 1, 2, 3, 4, 5, 6, 7, or 8 of the following in the heavy and light chains: S35H, G66D, L100A, and/or L100S in the heavy and M32L, M50D, N52S and/or M88Q in the light chain. In some embodiments, these point mutations can be used in any one of the Il-antibodies or constructs containing Il-6 antibodies provided herein.
As will be appreciated by one of skill in the art, there are a variety of constructs provided herein. Generally, these constructs can be grouped into: antibodies to Il-6, and/or Anti-IL-6 VEGF Trap (fusions of the antibody and VEGF Trap), and/or IL-6 VEGF Trap bioconjugate (the fusions with one or more of the biopolymers provided herein), and/or VEGF Trap constructs, and/or VEGF Trap biopolymers. Thus, any of the separate components provided herein (and variants thereof) can be used separately or in combination with one another. In some embodiments, the constructs of any of these groupings (antibodies to Il-6, and/or anti-IL-6 VEGF Trap (fusions of the antibody and VEGF Trap), and/or IL-6 VEGF Trap bioconjugate (the fusions with one or more of the biopolymers provided herein), and/or VEGF Trap constructs, and/or VEGF Trap biopolymers) can be used for any of the methods or other compositions provided herein. For example, any of these options can be used for any of the methods of treatment that are described in regard to IL-6 VEGF Trap therapies, and/or IL-6 therapies, and/or IL-6 VEGF Trap bioconjugates. As will be appreciated, the characteristics and properties of each of the construct can be different for each of the treatments, in line with the properties of the components detailed herein. Thus, the description provided herein with regard to, for example, cell lines, nucleic acids, therapies, and other embodiments, are not only specifically contemplated for anti-IL-6-VEGF Trap and/or bioconjugates thereof, but also for antibodies (and, for example, fragments thereof), antibody-bioconjugates, and VEGF Trap constructs separate from the anti-IL-VEGF Trap and/or bioconjugates. For example, in some embodiments, any of the point mutations (or combinations thereof) for IL-6 can be used in an antibody (or binding fragment thereof) for a treatment that is simply antibody based, instead of antibody and VEGF trap based arrangement. Thus, the point mutations for VEGF Trap and IL-6 antibodies is not limited to the context of fusion arrangements (although it does provide that), as it also describes such constructs (and uses thereof and method of making) separate from a fusion arrangement. Rather than repeat all such embodiments separately, it is noted that any such description for one of the arrangements (antibodies to Il-6, and/or Anti-IL-6 VEGF Trap (fusions of the antibody and VEGF Trap), and/or IL-6 VEGF Trap bioconjugate (the fusions with one or more of the biopolymers provided herein), and/or VEGF Trap constructs, and/or VEGF Trap biopolymers) applies and identifies the options for all of the other such arrangements (antibodies to Il-6, and/or Anti-IL-6 VEGF Trap (fusions of the antibody and VEGF Trap), and/or IL-6 VEGF Trap bioconjugate (the fusions with one or more of the biopolymers provided herein), and/or VEGF Trap constructs, and/or VEGF Trap biopolymers).
In some embodiments, any of the VEGF Trap constructs are contemplated for use as compositions, components, or therapies, including for example, those in
In some embodiments, any of the anti-IL-6 antibody constructs are contemplated for use as compositions, components, or therapies, including for example, those in tables 1A and 1E and
In some embodiments, the fusion protein comprises a mutation at position 94 in the VEGF Trap sequence, at position 95 in the VEGF Trap sequence, or at T94I and H95I in the VEGF Trap sequence.
In some embodiments, a VEGFR-Anti-IL-6 dual inhibitor is provided. The VEGFR-Anti-IL-6 dual inhibitor comprises a trap antibody fusion of Anti-IL 6 antibody and a VEGF (VEGFR1/2) trap, wherein the dual inhibitor includes at least one point mutation within a VEGFR sequence to reduce cleavage of the VEGFR sequence. In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor has a molecular weight of 1.0 MDa.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor provides therapy for inflammatory retinal diseases.
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a constant heavy, constant light, a fragment antigen binding, a fragment crystallizable (Fc), vascular endothelial growth factor receptor (VEGFR), a variable heavy, a variable light and CDR regions.
In some embodiments, the Anti-IL-6 heavy chain variable region sequences can be selected from options VI, VII, VIII, IX, X, XI, or XII of
In some embodiments, the VEGF trap sequence can be selected from at least one of options 1A, 1B, 1C or 1D of
In some embodiments for the VEGFR-anti-IL-6 dual inhibitor, the heavy chain sequence for anti-IL-6 molecules can be selected from at least one of options 3A, 3B, 3C, 3D, 3E, 3F, 3G, 3H, or 3I of
In some embodiments for the VEGFR-anti-IL-6 dual inhibitor the light chain sequence for Anti-IL-6 molecules comprises at least 1, 2, or 3 light chain CDRs from at least one of option 4A, 4B, or 4C of
In some embodiments for the VEGFR-anti-IL-6 dual inhibitor the heavy chain sequence for the anti-IL-6 molecule comprises at least 1, 2, or 3 heavy chain CDRs from at least one of option 5A, 5B, 5C, 5D, 5E, 5F, 5G, 5H, or 5I of
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises a VEGFR-Fc sequence from at least one of option 6A, 6B, 6C or 6D of
In some embodiments, the VEGFR-anti-IL-6 dual inhibitor comprises one or more of the sequences in
In some embodiments, the VEGFR-Anti-IL-6 dual inhibitor comprises an IL-6 VH, an IL-6 VL, an IL-6 Fc, a VEGF Trap, and a linker. In some embodiments, the IL-6 VH comprises a sequence from an IL6 VH sequence in
In some embodiments, a protein construct is provided that comprises: at least 3 heavy chain CDRs; at least 3 light chain CDRs; a VEGF trap sequence; and a linker sequence, wherein each of the sequences is selected from a sequence within
In some embodiments, a fusion protein is provided that comprises: an IL-6 VH, an IL-6 VL, an IL-6 Fc, a VEGF Trap, and wherein the fusion protein alters HUVEC proliferation. In some embodiments, each sequence is selected from a sequence within
The present disclosure also provides polynucleotides encoding any of the antibodies (and/or IL-6 Ab-VEGF Trap), including antibody fragments and modified antibodies described herein. In another aspect, the present disclosure provides a method of making any of the polynucleotides described herein. Polynucleotides can be made and expressed by procedures known in the art. Accordingly, the present disclosure provides polynucleotides or compositions, including pharmaceutical compositions, comprising polynucleotides, encoding any of the IL-6 antagonists antibodies (and/or IL-6 Ab-VEGF Traps) provided herein.
Polynucleotides complementary to any such sequences are also encompassed by the present disclosure. Polynucleotides may be single-stranded (coding or antisense) or double-stranded, and may be DNA (genomic, cDNA or synthetic) or RNA molecules. RNA molecules include HnRNA molecules, which contain introns and correspond to a DNA molecule in a one-to-one manner, and mRNA molecules, which do not contain introns. Additional coding or non-coding sequences may, but need not, be present within a polynucleotide of the present disclosure, and a polynucleotide may, but need not, be linked to other molecules and/or support materials.
Polynucleotides may comprise a native sequence (i.e., an endogenous sequence that encodes an antibody or a fragment thereof) or may comprise a variant of such a sequence. Polynucleotide variants contain one or more substitutions, additions, deletions and/or insertions such that the immunoreactivity of the encoded polypeptide is not diminished, relative to a native immunoreactive molecule. The effect on the immunoreactivity of the encoded polypeptide may generally be assessed as described herein. Variants preferably exhibit at least about 70% identity, more preferably, at least about 80% identity, yet more preferably, at least about 90% identity, and most preferably, at least about 95% identity to a polynucleotide sequence that encodes a native antibody or a fragment thereof.
Two polynucleotide or polypeptide sequences are said to be “identical” if the sequence of nucleotides or amino acids in the two sequences is the same when aligned for maximum correspondence as described below. Comparisons between two sequences are typically performed by comparing the sequences over a comparison window to identify and compare local regions of sequence similarity. A “comparison window” as used herein, refers to a segment of at least about 20 contiguous positions, usually 30 to about 75, or 40 to about 50, in which a sequence may be compared to a reference sequence of the same number of contiguous positions after the two sequences are optimally aligned.
Optimal alignment of sequences for comparison may be conducted using the MegAlign® program in the Lasergene® suite of bioinformatics software (DNASTAR®, Inc., Madison, WI), using default parameters. This program embodies several alignment schemes described in the following references: Dayhoff, M. O., 1978, A model of evolutionary change in proteins—Matrices for detecting distant relationships. In Dayhoff, M. O. (ed.) Atlas of Protein Sequence and Structure, National Biomedical Research Foundation, Washington DC Vol. 5, Suppl. 3, pp. 345-358; Hein J., 1990, Unified Approach to Alignment and Phylogenes pp. 626-645 Methods in Enzymology vol. 183, Academic Press, Inc., San Diego, CA; Higgins, D. G. and Sharp, P. M., 1989, CABIOS 5: 151-153; Myers, E. W. and Muller W., 1988, CABIOS 4:11-17; Robinson, E. D., 1971, Comb. Theor. 11:105; Santou, N., Nes, M., 1987, Mol. Biol. Evol. 4:406-425; Sneath, P. H. A. and Sokal, R. R., 1973, Numerical Taxonomy the Principles and Practice of Numerical Taxonomy, Freeman Press, San Francisco, CA; Wilbur, W. J. and Lipman, D. J., 1983, Proc. Natl. Acad. Sci. USA 80:726-730.
Preferably, the “percentage of sequence identity” is determined by comparing two optimally aligned sequences over a window of comparison of at least 20 positions, wherein the portion of the polynucleotide or polypeptide sequence in the comparison window may comprise additions or deletions (i.e., gaps) of 20 percent or less, usually 5 to 15 percent, or 10 to 12 percent, as compared to the reference sequences (which does not comprise additions or deletions) for optimal alignment of the two sequences. The percentage is calculated by determining the number of positions at which the identical nucleic acid bases or amino acid residue occurs in both sequences to yield the number of matched positions, dividing the number of matched positions by the total number of positions in the reference sequence (i.e. the window size) and multiplying the results by 100 to yield the percentage of sequence identity.
Variants may also, or alternatively, be substantially homologous to a native gene, or a portion or complement thereof. Such polynucleotide variants are capable of hybridizing under moderately stringent conditions to a naturally occurring DNA sequence encoding a native antibody (or a complementary sequence).
Suitable “moderately stringent conditions” include prewashing in a solution of 5×SSC, 0.5% SDS, 1.0 mM EDTA (pH 8.0); hybridizing at 50° C.-65° C., 5×SSC, overnight; followed by washing twice at 65° C. for 20 minutes with each of 2×, 0.5× and 0.2×SSC containing 0.1% SDS.
As used herein, “highly stringent conditions” or “high stringency conditions” are those that: (1) employ low ionic strength and high temperature for washing, for example 0.015 M sodium chloride/0.0015 M sodium citrate/0.1% sodium dodecyl sulfate at 50° C.; (2) employ during hybridization a denaturing agent, such as formamide, for example, 50% (v/v) formamide with 0.1% bovine serum albumin/0.1% Ficoll/0.1% polyvinylpyrrolidone/50 mM sodium phosphate buffer at pH 6.5 with 750 mM sodium chloride, 75 mM sodium citrate at 42° C.; or (3) employ 50% formamide, 5×SSC (0.75 M NaCl, 0.075 M sodium citrate), 50 mM sodium phosphate (pH 6.8), 0.1% sodium pyrophosphate, 5×Denhardt's solution, sonicated salmon sperm DNA (50 μg/ml), 0.1% SDS, and 10% dextran sulfate at 42° C., with washes at 42° C. in 0.2×SSC (sodium chloride/sodium citrate) and 50% formamide at 55° C., followed by a high-stringency wash consisting of 0.1×SSC containing EDTA at 55° C. The skilled artisan will recognize how to adjust the temperature, ionic strength, etc. as necessary to accommodate factors such as probe length and the like.
It will be appreciated by those of ordinary skill in the art that, as a result of the degeneracy of the genetic code, there are many nucleotide sequences that encode a polypeptide as described herein. Some of these polynucleotides bear minimal homology to the nucleotide sequence of any native gene. Nonetheless, polynucleotides that vary due to differences in codon usage are specifically contemplated by the present disclosure. Further, alleles of the genes comprising the polynucleotide sequences provided herein are within the scope of the present disclosure. Alleles are endogenous genes that are altered as a result of one or more mutations, such as deletions, additions and/or substitutions of nucleotides. The resulting mRNA and protein may, but need not, have an altered structure or function. Alleles may be identified using standard techniques (such as hybridization, amplification and/or database sequence comparison).
The polynucleotides of this disclosure can be obtained using chemical synthesis, recombinant methods, or PCR. Methods of chemical polynucleotide synthesis are well known in the art and need not be described in detail herein. One of skill in the art can use the sequences provided herein and a commercial DNA synthesizer to produce a desired DNA sequence.
For preparing polynucleotides using recombinant methods, a polynucleotide comprising a desired sequence can be inserted into a suitable vector, and the vector in turn can be introduced into a suitable host cell for replication and amplification, as further discussed herein. Polynucleotides may be inserted into host cells by any means known in the art. Cells are transformed by introducing an exogenous polynucleotide by direct uptake, endocytosis, transfection, F-mating or electroporation. Once introduced, the exogenous polynucleotide can be maintained within the cell as a non-integrated vector (such as a plasmid) or integrated into the host cell genome. The polynucleotide so amplified can be isolated from the host cell by methods well known within the art. See, e.g., Sambrook et al., 1989.
Alternatively, PCR allows reproduction of DNA sequences. PCR technology is well known in the art and is described in U.S. Pat. Nos. 4,683,195, 4,800,159, 4,754,065 and 4,683,202, as well as PCR: The Polymerase Chain Reaction, Mullis et al. eds., Birkauswer Press, Boston, 1994.
RNA can be obtained by using the isolated DNA in an appropriate vector and inserting it into a suitable host cell. When the cell replicates and the DNA is transcribed into RNA, the RNA can then be isolated using methods well known to those of skill in the art, as set forth in Sambrook et al., 1989, supra, for example.
Suitable cloning vectors may be constructed according to standard techniques, or may be selected from a large number of cloning vectors available in the art. While the cloning vector selected may vary according to the host cell intended to be used, useful cloning vectors will generally have the ability to self-replicate, may possess a single target for a particular restriction endonuclease, and/or may carry genes for a marker that can be used in selecting clones containing the vector. Suitable examples include plasmids and bacterial viruses, e.g., pUC18, pUC19, Bluescript (e.g., pBS SK+) and its derivatives, mp18, mp19, pBR322, pMB9, ColE1, pCR1, RP4, phage DNAs, and shuttle vectors such as pSA3 and pAT28. These and many other cloning vectors are available from commercial vendors such as BioRad, Strategene, and Invitrogen.
Expression vectors are further provided. Expression vectors generally are replicable polynucleotide constructs that contain a polynucleotide according to the present disclosure. It is implied that an expression vector must be replicable in the host cells either as episomes or as an integral part of the chromosomal DNA. Suitable expression vectors include but are not limited to plasmids, viral vectors, including adenoviruses, adeno-associated viruses, retroviruses, cosmids, and expression vector(s) disclosed in PCT Publication No. WO 87/04462. Vector components may generally include, but are not limited to, one or more of the following: a signal sequence; an origin of replication; one or more marker genes; suitable transcriptional controlling elements (such as promoters, enhancers and terminator). For expression (i.e., translation), one or more translational controlling elements are also usually required, such as ribosome binding sites, translation initiation sites, and stop codons.
The vectors containing the polynucleotides of interest can be introduced into the host cell by any of a number of appropriate means, including electroporation, transfection employing calcium chloride, rubidium chloride, calcium phosphate, DEAE-dextran, or other substances; microprojectile bombardment; lipofection; and infection (e.g., where the vector is an infectious agent such as vaccinia virus). The choice of introducing vectors or polynucleotides will often depend on features of the host cell.
The present disclosure also provides host cells comprising any of the polynucleotides described herein. Any host cells capable of over-expressing heterologous DNAs can be used for the purpose of isolating the genes encoding the antibody, polypeptide or protein of interest. Non-limiting examples of mammalian host cells include but not limited to COS, HeLa, and CHO cells. See also PCT Publication No. WO 87/04462. Suitable non-mammalian host cells include prokaryotes (such as E. coli or B. subtillis) and yeast (such as S. cerevisae, S. pombe; or K. lactis). Preferably, the host cells express the cDNAs at a level of about 5 fold higher, more preferably, 10 fold higher, even more preferably, 20 fold higher than that of the corresponding endogenous antibody or protein of interest, if present, in the host cells. Screening the host cells for a specific binding to IL-6 is effected by an immunoassay or FACS. A cell overexpressing the antibody or protein of interest can be identified.
An expression vector can be used to direct expression of an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap). One skilled in the art is familiar with administration of expression vectors to obtain expression of an exogenous protein in vivo. See, e.g., U.S. Pat. Nos. 6,436,908; 6,413,942; and 6,376,471. Administration of expression vectors includes local or systemic administration, including injection, oral administration, particle gun or catheterized administration, and topical administration. In another embodiment, the expression vector is administered directly to the sympathetic trunk or ganglion, or into a coronary artery, atrium, ventricle, or pericardium.
Targeted delivery of therapeutic compositions containing an expression vector, or subgenomic polynucleotides can also be used. Receptor-mediated DNA delivery techniques are described in, for example, Findeis et al., Trends Biotechnol., 1993, 11:202; Chiou et al., Gene Therapeutics: Methods And Applications Of Direct Gene Transfer, J. A. Wolff, ed., 1994; Wu et al., J. Biol. Chem., 1988, 263:621; Wu et al., J. Biol. Chem., 1994, 269:542; Zenke et al., Proc. Natl. Acad. Sci. USA, 1990, 87:3655; Wu et al., J. Biol. Chem., 1991, 266:338. Therapeutic compositions containing a polynucleotide are administered in a range of about 100 ng to about 200 mg of DNA for local administration in a gene therapy protocol. Concentration ranges of about 500 ng to about 50 mg, about 1 μg to about 2 mg, about 5 μg to about 500 μg, and about 20 μg to about 100 μg of DNA can also be used during a gene therapy protocol. The therapeutic polynucleotides and polypeptides can be delivered using gene delivery vehicles. The gene delivery vehicle can be of viral or non-viral origin (see generally, Jolly, Cancer Gene Therapy, 1994, 1:51; Kimura, Human Gene Therapy, 1994, 5:845; Connelly, Human Gene Therapy, 1995, 1:185; and Kaplitt, Nature Genetics, 1994, 6:148). Expression of such coding sequences can be induced using endogenous mammalian or heterologous promoters. Expression of the coding sequence can be either constitutive or regulated.
Viral-based vectors for delivery of a desired polynucleotide and expression in a desired cell are well known in the art. Exemplary viral-based vehicles include, but are not limited to, recombinant retroviruses (see, e.g., PCT Publication Nos. WO 90/07936; WO 94/03622; WO 93/25698; WO 93/25234; WO 93/11230; WO 93/10218; WO 91/02805; U.S. Pat. Nos. 5,219,740 and 4,777,127; GB Patent No. 2,200,651; and EP Patent No. 0 345 242), alphavirus-based vectors (e.g., Sindbis virus vectors, Semliki forest virus (ATCC VR-67; ATCC VR-1247), Ross River virus (ATCC VR-373; ATCC VR-1246) and Venezuelan equine encephalitis virus (ATCC VR-923; ATCC VR-1250; ATCC VR 1249; ATCC VR-532)), and adeno-associated virus (AAV) vectors (see, e.g., PCT Publication Nos. WO 94/12649, WO 93/03769; WO 93/19191; WO 94/28938; WO 95/11984 and WO 95/00655). Administration of DNA linked to killed adenovirus as described in Curiel, Hum. Gene Ther., 1992, 3:147 can also be employed.
Non-viral delivery vehicles and methods can also be employed, including, but not limited to, polycationic condensed DNA linked or unlinked to killed adenovirus alone (see, e.g., Curiel, Hum. Gene Ther., 1992, 3:147); ligand-linked DNA (see, e.g., Wu, J. Biol. Chem., 1989, 264:16985); eukaryotic cell delivery vehicles cells (see, e.g., U.S. Pat. No. 5,814,482; PCT Publication Nos. WO 95/07994; WO 96/17072; WO 95/30763; and WO 97/42338) and nucleic charge neutralization or fusion with cell membranes. Naked DNA can also be employed. Exemplary naked DNA introduction methods are described in PCT Publication No. WO 90/11092 and U.S. Pat. No. 5,580,859. Liposomes that can act as gene delivery vehicles are described in U.S. Pat. No. 5,422,120; PCT Publication Nos. WO 95/13796; WO 94/23697; WO 91/14445; and EP 0524968. Additional approaches are described in Philip, Mol. Cell Biol., 1994, 14:2411, and in Woffendin, Proc. Natl. Acad. Sci., 1994, 91:1581.
The present disclosure also provides pharmaceutical compositions comprising an effective amount of an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) conjugate described herein. Examples of such compositions, as well as how to formulate, are also described herein. In some embodiments, the composition comprises one or more IL-6 antagonist antibodies (and/or IL-6 Ab-VEGF Trap) and/or antibody (and/or Ab-Trap) conjugates. In other embodiments, the IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) recognizes human IL-6. In other embodiments, the IL-6 antagonist antibody is a human antibody. In other embodiments, the IL-6 antagonist antibody is a humanized antibody. In some embodiments, the IL-6 antagonist antibody comprises a constant region that does not trigger an unwanted or undesirable immune response, such as antibody-mediated lysis or ADCC. In other embodiments, the IL-6 antagonist (and/or IL-6 Ab-VEGF Trap) comprises one or more CDR(s) of the antibody (such as one, two, three, four, five, or, in some embodiments, all six CDRs).
It is understood that the compositions can comprise more than one IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) (e.g., a mixture of IL-6 antibodies that recognize different epitopes of IL-6). Other exemplary compositions comprise more than one IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) that recognize the same epitope(s), or different species of IL-6 antagonist antibodies (and/or IL-6 Ab-VEGF Trap) that bind to different epitopes of IL-6. In some embodiments, the compositions comprise a mixture of IL-6 antagonist antibodies (and/or IL-6 Ab-VEGF Trap) that recognize different variants of IL-6. In addition, in some embodiments, the composition can also, or instead, comprise more than one VEGF Trap. These alternative VEGF Trap sections can include different sequences for the VEGF Trap section, as long as the sections at least have the same or similar functionality as noted herein.
The composition used in the present disclosure can further comprise pharmaceutically acceptable carriers, excipients, or stabilizers (Remington: The Science and practice of Pharmacy 20th Ed., 2000, Lippincott Williams and Wilkins, Ed. K. E. Hoover), in the form of lyophilized formulations or aqueous solutions. Acceptable carriers, excipients, or stabilizers are nontoxic to recipients at the dosages and concentrations, and may comprise buffers such as phosphate, citrate, and other organic acids; antioxidants including ascorbic acid and methionine; preservatives (such as octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride, benzethonium chloride; phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propyl paraben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol); low molecular weight (less than about 10 residues) polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, histidine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrans; chelating agents such as EDTA; sugars such as sucrose, mannitol, trehalose or sorbitol; salt-forming counter-ions such as sodium; metal complexes (e.g. Zn-protein complexes); and/or non-ionic surfactants such as Polysorbate, PLURONICS™ or polyethylene glycol (PEG). Pharmaceutically acceptable excipients are further described herein.
Pharmaceutical compositions adapted for parenteral administration include aqueous and non-aqueous sterile injection solution which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formulation substantially isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents. Excipients which may be used for injectable solutions include water, alcohols, polyols, glycerin and vegetable oils, for example. The compositions may be presented in unit-dose or multi-dose containers, for example sealed ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carried, for example water for injections, immediately prior to use. Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets. Pharmaceutical compositions can be substantially isotonic, implying an osmolality of about 250-350 mOsm/kg water.
The pharmaceutical compositions may contain preserving agents, solubilizing agents, stabilizing agents, wetting agents, emulsifiers, sweeteners, colorants, odorants, salts (substances of the present disclosure may themselves be provided in the form of a pharmaceutically acceptable salt), buffers, coating agents or antioxidants. They may also contain therapeutically active agents in addition to the substance of the present disclosure. The pharmaceutical compositions of the present disclosure may be employed in combination with one or more pharmaceutically acceptable excipients. Such excipients may include, but are not limited to, saline, buffered saline (such as phosphate buffered saline), dextrose, liposomes, water, glycerol, ethanol and combinations thereof.
The IL-6 antagonist antibodies (and/or IL-6 Ab-VEGF Trap), IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) conjugates, and pharmaceutical compositions of the present disclosure can be employed alone or in conjunction with other compounds, such as therapeutic compounds or molecules, e.g. anti-inflammatory drugs, analgesics or antibiotics. Such administration with other compounds may be simultaneous, separate or sequential. The components may be prepared in the form of a kit which may comprise instructions as appropriate.
These molecules could also be used to treat cytokine release syndrome following CAR-T or similar immune-oncology therapeutics.
The present disclosure also provides kits comprising any or all of the antibodies, VEGF Traps and fusion proteins described herein. Kits of the present disclosure include one or more containers comprising an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) or conjugate described herein and instructions for use in accordance with any of the methods of the present disclosure described herein. Generally, these instructions comprise a description of administration of the IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) or conjugate for the above described therapeutic treatments. In some embodiments, kits are provided for producing a single-dose administration unit. In certain embodiments, the kit can contain both a first container having a dried protein and a second container having an aqueous formulation. In certain embodiments, kits containing single and multi-chambered pre-filled syringes (e.g., liquid syringes and lyosyringes) are included.
In some embodiments, the antibody is a human antibody. In some embodiments, the antibody is a humanized antibody. In some embodiments, the antibody is a monoclonal antibody. The instructions relating to the use of an IL-6 antagonist antibody (and/or IL-6 Ab-VEGF Trap) or conjugate generally include information as to dosage, dosing schedule, and route of administration for the intended treatment. The containers may be unit doses, bulk packages (e.g., multi-dose packages) or sub-unit doses. Instructions supplied in the kits of the present disclosure are typically written instructions on a label or package insert (e.g., a paper sheet included in the kit), but machine-readable instructions (e.g., instructions carried on a magnetic or optical storage disk) are also acceptable.
The kits of the present disclosure are in suitable packaging. Suitable packaging includes, but is not limited to, vials, bottles, jars, flexible packaging (e.g., sealed Mylar or plastic bags), and the like. Also contemplated are packages for use in combination with a specific device, such as prefilled syringe, an inhaler, nasal administration device (e.g., an atomizer) or an infusion device such as a minipump. A kit may have a sterile access port (for example the container may be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle). The container may also have a sterile access port (for example the container may be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle). At least one active agent in the composition is an IL-6 antagonist antibody or conjugate. The container may further comprise a second pharmaceutically active agent.
Kits may optionally provide additional components such as buffers and interpretive information. In some embodiments, the kits can include an additional syringe and needle used for back fill of the dosing syringe. Normally, the kit comprises a container and a label or package insert(s) on or associated with the container.
Some embodiments of the present disclosure are provided as any one of the following numbered alternatives.
The following examples are offered for illustrative purposes only, and are not intended to limit the scope of the present disclosure in any way. Indeed, various modifications of the present disclosure in addition to those shown and described herein will become apparent to those skilled in the art from the foregoing description and fall within the scope of the appended claims.
Despite the therapeutic success of anti-vascular endothelial growth factor (VEGF) biologic drugs for the treatment of neovascular retinal diseases, unmet need still exists due to (i) VEGF therapy-resistant patients, (ii) patients who lose efficacy to anti-VEGF agents due to the progression of additional underlying pathologies such as fibrosis, wound-healing, and atrophy (iii) undertreatment due to the requirement for frequent intravitreal injections. Below are results regarding novel bi-specific biologic agents designed to inhibit both VEGF and IL-6.
Methods Dual inhibitors were designed and characterized for their binding affinities to their respective targets by surface plasmon resonance (SPR). Functional aspects of the molecules were tested by (1) ELISA assays targeting the competitive blocking of each target to its respective receptor (2) VEGF and/or IL-6 stimulated primary human retinal microvascular endothelial cell (HRMVEC) proliferation assays can be performed, and (3) three-dimensional primary cell co-culture assays to assess the inhibition of angiogenic sprouting can be performed.
IL-6 Ab-VEGF Trap constructs bound with pM affinity to VEGF and IL-6. Binding kinetics of each target were independent of the presence of the other, indicating that both targets can bind simultaneously without interference. Binding of these molecules to each of their targets inhibits interactions with their respective cognate receptors.
When combined within a biopolymer conjugate platform, these dual inhibitor molecules provide a further therapeutic agent for the next generation of treatment and prevention of retinal diseases.
The present examples outline the construction of an anti-IL-6 and anti-VEGF dual inhibitor molecule containing an IL-6 antibody in an engineered human IgG1 framework and IgG1 Fc domain fused to an anti-VEGF trap. The Fc domain for these molecules contains L234A, L235A and G237A substitutions that minimize effector function, and L443C that allows site specific conjugation with a half-life extending phosphorylcholine based biopolymer (residue positions follow EU numbering).
An anti-IL-6 paratope in the engineered human IgG1 framework was affinity maturated using a combination of library scanning mutagenesis in E. coli followed by site-directed mutagenesis in a mammalian system. The construction of a dual expression plasmid system containing a heavy and light chain Fab with anti-IL-6 CDR sequences was achieved in E. coli.
Fab libraries were constructed containing random single point mutations for all 71 CDR positions, excluding substitutions for Cys, Met and Asn due to the chemical liabilities associated with these amino acids. Small-scale expression in 96 well plates format was utilized for screening the Fab libraries. E. coli colonies (TG1 cells, Zymo Research) containing randomized single point mutations were picked into 96 well plates (1.5 mL) and grown overnight at 30° C. in LB Amp+2% glucose. A separate 96 well plate was created on the following day by removing 100 μL of culture and adding 100 μL of 30% glycerol, then stored at −80° C. The remaining culture was spun down for 20 min and later resuspended in 1.5 mL of LB Amp containing 1 mM IPTG for induction of protein expression at 30° C. After 5 hours, cells were spun down, resuspended in 500 μL of HBS-EP+ buffer and lysed by one freeze/thaw cycle. Lysates were centrifuged for 30 minutes and vacuum filtered (200 μL) into round bottom 96 well plates for Biacore analysis.
Affinities of anti-IL-6 Fabs were determined using a Biacore T200 (GE Healthcare) at 25° C. CM5 chips were activated with EDC and NHS, recombinant human IL-6 (R&D Systems) was diluted into 10 mM sodium acetate pH 5 to a concentration of 0.1 mg/mL and injected over the activated chip. Three ranges of antigen density (100-150 RU, 300-400 RU, 400-600 RU) were obtained by using variable flow times for each chip channel, later blocked with ethanolamine. Supernatants of the 96-well filtered culture lysates were injected at 50 μL/min for 120 seconds. Fitting of dissociation curves (300 seconds) to single exponential decay curve was used for the determination of dissociation rates (koff). Chip surfaces were regenerated with 10 mM Glycine pH 1.7 solution injected at 50 μL/min during 60 seconds after every cycle of sample binding and dissociation. Clones that showed similar or improved koff values in comparison to the wild-type were submitted for DNA sequencing for mutation identification.
From the total of 71 CDR residue positions, screening data showed 15 residues were critical for IL-6 binding and could not be replaced by any other amino acid. Substitutions in tolerable positions resulted in similar koff values to the parent molecule (Table 1.1). Most of these single replacements were later introduced into the genes of the full heavy and light chains cloned in mammalian expression vectors, which were co-transfected into 3 ml cultures of Expi293 cells for protein production. On the fifth day, these cultures were centrifuged and the supernatants containing secreted antibodies were harvested and diluted in HBS-EP+ running buffer (1:20 ratio). Point mutants are in tables 1.1-1.6
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated as ‘crit’.
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated s ‘crit’.
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated as ‘crit’.
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated as ‘crit’.
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated as ‘crit’.
Table displays koff values (s-1) for every tolerable substitution within define CDR. In overall mutants present similar koff to parental molecule (4.94E−03±7.67E−04). Residues critical for IL-6 binding and did not tolerate replacements are indicated as ‘crit’.
Binding kinetics of these single mutant molecules to IL-6 were measured at 25° C. using a Biacore T200. Antibodies were captured on a Protein A chip (GE) by injecting 1:20 dilution of cell supernatant at 10 μL/min for 60 seconds. Five concentrations (0.56, 1.67, 5, 15 and 45 nM) of IL-6 were flowed over captured antibodies for 60 seconds at a flow rate of 30 μL/min and dissociated for 180 seconds in a single cycle kinetics Biacore assay format. The sensor chip was regenerated by a 60 seconds injection of 10 mM Glycine pH 1.7 at flow rate of 50 μL/min. A similar assay setup was used to monitor interactions between purified antibody samples and IL-6 at 37° C., when applicable. For this setup, 1 μg/mL of purified antibody was injected over a Protein A chip at 10 μL/min for 25-28 seconds. Data analysis for supernatant and purified samples were performed using BIAevaluation software (GE). All sensorgrams were double reference subtracted and fit using a 1:1 Langmuir binding model.
From all single point mutations tested (Table 1.7), the G66D mutation at the heavy chain CDR2 (sequential numbering of the antibody variable domain) resulted in a marked affinity boost (˜2 fold decrease in KD relative to wild-type: 6.95×10−11 M vs 1.58×10−10 M respectively). G66D was retained, and the remaining heavy chain and light chain CDR residues that could have manufacturing related chemical liabilities (Cys, Met, Asn) were mutagenized. Based on this premise, two heavy chain variants were generated including triple mutations (Table 1.9): I) M34I/G66D/I108V, II) M34W/G66D/I108V and three light chain variants including triple and quadruple mutations (Table 1.10): III) M32L/M50D/N52S/M88Q, IV) M32L/M50A/N52S/M88Q, V) M32L/M50D/M88Q (residue positions follow sequential numbering of the antibody variable heavy chain). We evaluated the IL-6 binding to all the possible combinations among these variants using the same Biacore assay setup described for the single point mutations. Our findings demonstrated these mutations countered the effect of the single point G66D mutation while keeping the affinity to IL-6 closer to the parent CDR sequence (Table 1.8). Based on these results, these modified CDRs were incorporated into the design of the anti-IL-6 and IL-6 Ab-VEGF Trap.
Biacore kinetics for anti-IL-6 single point mutations. Data were obtained for samples prior (sup) at 25° C. and after purification at 37° C. Mutations selected to be at final CDR combinations (Table 4) are italicized. CDR positions that did not tolerate mutations in the bacterial screening are indicated as critical.
Biacore kinetics data for anti-IL-6 CDR variants. Kinetic data were obtained from cell culture supernatants (sup) at 25° C. and purified samples at 37° C. Heavy and light chain CDR mutations are indicated on the left and right side, respectively (heavy/light). Capture, kon (ka), koff (kd) rates and dissociation constants are listed in the table.
The VEGF binding moiety of the IL-6Ab-VEGF Trap consisted of a fusion between VEGFR1 domain 2 and VEGFR2 domain 3 (Table 2.0). This fusion works as a VEGF trap, preventing VEGF from binding to cellular VEGF receptors.
12 constructs were tested containing the VEGF trap in two distinct configurations (Table 2.1). In the first configuration, the VEGF trap was positioned at the beginning of the protein, followed by a duplicate series of a Gly-Gly-Gly-Gly-Ser linker (GS), which connects the VEGF trap to the N-terminus of the anti-IL-6 heavy chain (VEGF Trap-AntiIL-6; Table 2.1, molecules A-F). In the second configuration, the variable and constant domains of the heavy chain (Fab region) are connected to the VEGF Trap via the GS linker, and then the Fc domain is fused to the C-terminal end of the VEGF trap. Thus, in this configuration, the VEGF trap is sandwiched between the antibody Fab and Fc regions (AntiIL-6-VEGF Trap; Table 2.1, molecules G-L).
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
WTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAED
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
SDTGRPFVEMYSEIPEIIHMTEGRELVIPCRVTSP
NITVTLKKFPLDTLIPDGKRIIWDSRKGFIISNAT
YKEIGLLTCEATVNGHLYKTNYLTHRQTNTIID
VVLSPSHGIELSVGEKLVLNCTARTELNVGIDEN
WEYPSSKHQHKKLVNRDLKTQSGSEMKKFLST
LTIDGVTRSDQGLYTCAASSGLMTKKNSTFVRV
HEK
GGGGSGGGGS
EVQLVESGGGLVQPGGSLRLS
SWTYYSDTVTDRFTFSLDTSKSTAYLQMNSLRAE
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDFNWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
YYALDVWGQGTLVTVSSASTKGPSVFPLAPSSKST
MYSEIPEIIHMTEGRELVIPCRVTSPNITVTLKKF
PLDTLIPDGKRIIWDSRKGFIISNATYKEIGLLTC
EATVNGHLYKTNYLTHRQTNTIIDVVLSPSHGIE
LSVGEKLVLNCTARTELNVGIDENWEYPSSKHQ
HKKLVNRDLKTQSGSEMKKFLSTLTIDGVTRSD
QGLYTCAASSGLMTKKNSTFVRVHEKDKTHTC
Biacore (setup as described in the previous session) kinetic data showed that although the KD values among all variants are comparable, there is a variation in the capture values for the supernatant samples (Table 2.2). This parameter is sensitive to the amount of antibody present in solution, which suggested a variation on the level protein expression among these molecules due to the different CDR compositions. On the other hand, the two VEGF Trap positions tested did not show marked influence on the kinetic data. Experiments monitoring expression levels (data not shown) showed the IL-6-VEGF Trap configuration has about 20% higher yield of expression in comparison to VEGF Trap-AntiIL-6 configuration. Preliminary Biacore data also indicates AntiIL-6-VEGF Trap configuration binds tighter to a VEGF homologue, the placental growth factor (PLGF) (data not shown).
To evaluate the binding kinetics of the different dual inhibitors configurations to VEGF, a series of Biacore assays were performed to measure the affinity between these molecules. Binding kinetics were measured at 37° C. in buffer HBS-EP+ containing 1 mg/mL BSA. Anti-VEGF agents (VEGF Trap-AntiIL-6 (5 μg/mL), AntiIL-6-VEGF Trap (5 μg/mL), OG1950 (1 μg/mL) and Eylea (0.5 μg/mL)) were captured on a Protein A chip (GE) at 10 μL/min for 25 seconds, five concentrations of VEGF-A165 (0.19, 0.56, 1.67, 5, 15 nM) were flowed over captured antibodies for 120 seconds at 30 μL/min and dissociated for 30 min. The sensor chip surface was regenerated by 60 seconds injection of 10 mM Glycine, pH 1.7 at a flow rate of 50 μl/min. All sensorgrams were double reference subtracted and fit using a 1:1 Langmuir binding model.
Data show VEGF trap component in the dual inhibitor molecule binds tightly to VEGF-A independent of configuration. The anti-IL-6 molecule component did not seem to influence VEGF-A binding to the VEGF trap, since the dual inhibitor molecules show similar affinity to VEGF affinity as another VEGF trap-based molecule (Eylea). (
A Biacore assay was implemented to directly monitor the dual binding of IL-6 and VEGF-A. Dual inhibitor molecules (2 μg/mL) were captured on a Protein A chip (GE) at 10 μL/min for 25 seconds, five concentrations of IL-6 and/or VEGF-A165 (0.19, 0.56, 1.67, 5, 15 nM) were flowed individually or mixed over captured antibodies for 120 seconds at 30 μL/min and dissociated for 30 min. The sensor chip surface was regenerated by 60 seconds injection of 10 mM Glycine, pH 1.7 at a flow rate of 50 μl/min. All data were double reference subtracted, and the sum of individual IL-6 and VEGF-A sensorgrams were used to create a theoretical curve, which was compared to the sensorgrams of mixed samples.
Results demonstrated that theoretical and experimental curves are nearly superimposed, which strongly supports a model where both targets bind to the dual inhibitor molecules without affecting their respective interactions. (
IL-6/IL-6R complexes can bind to the membrane bound receptor, gp130, and this trimeric complex stimulates IL-6 signaling, such as proliferation and upregulation of VEGF. Inhibition of either IL-6 binding to IL-6R or IL-6/IL-6R binding to gp130 blocks IL-6 mediated downstream signaling pathways. To determine whether the anti-IL-6 antibodies block either of these binding events, an ELISA was first established to assess whether they can bind to IL-6 while it is complexed with IL-6 receptor.
A Nunc MaxiSorp ELISA was coated with 100 μl of 1 μg/ml of recombinant human IL-6R (R&D Systems) overnight. 10 nM IL-6 (R&D Systems) was mixed with a 3-fold dilution series of anti-IL-6 (final concentrations of 30 nM down to 10 pM). After blocking and washing, the mixture was added to the IL-6R coated plates. This assay was also performed by first incubating the IL-6R coated plate with 10 nM IL-6, washing, and then adding the anti-IL-6 antibody. For both methods, bound antibody/IL-6 complexes were detected with an anti-Human IgG HRP antibody and developed with TMB (KPL) for 10 minutes. Absorbance at 450 nM was measured on a SpectraMax Plus plate reader (Molecular Devices) and plotted against the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve.
A Nunc MaxiSorp ELISA was coated with 100 μl of 1 μg/ml of recombinant human IL-6 (R&D systems) overnight. A 3-fold dilution series of anti-IL-6 (R&D Systems; final concentrations of 30 nM down to 10 pM) was performed and solutions were added to the blocked IL-6 coated plates. Antibody/IL-6 complexes were detected with an anti-Human IgG HRP antibody and developed with TMB (KPL) for 10 minutes. Absorbance at 450 nM was measured on a SpectraMax Plus plate reader (Molecular Devices) and plotted against the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve.
Under the conditions tested, the anti-IL-6 antibody described here binds specifically to IL-6, but not when it is complexed with IL-6 receptor, suggesting that the antibody and IL-6R share a common epitope on IL-6. The results are shown in
An ELISA to determine whether the anti-IL-6 antibody and dual IL-6/VEGF inhibitors blocked IL-6 from binding to IL-6R was then performed
A Nunc MaxiSorp ELISA was coated with 100 μl of 1 μg/ml of anti-IL-6/IL-6R complex antibody (R&D Systems; IL-6/IL-6R DuoSet) overnight. The plate was blocked in 2% bovine serum albumin (BSA) in PBS-Tween (PBST) for 2 hours. During blocking, 6 nM of IL-6 (R&D Systems), 1 nM of IL-6R (R&D Systems), and an 8-point, 3-fold dilution series of dual inhibitors or single arm controls (starting with 30 nM) were incubated at room temperature. This mixture was then added to the ELISA plate following a wash step. After 1 hour, the plate was washed and incubated with biotinylated anti-IL-6/IL-6R antibody (R&D Duoset). IL-6/IL-6R complexes were detected with streptavidin-HRP (1:2000 dilution; R&D Systems) and developed using TMB reagent (KPL) for 10 minutes. Absorbance at 450 nM was measured on a SpectraMax Plus plate reader (Molecular Devices) and plotted against the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve.
Under these conditions, the anti-IL-6 antibody and dual IL-6/VEGF inhibitors effectively compete with IL-6R for binding to IL-6, and therefore inhibit the IL-6/IL-6R interaction. The IC50 values for dual inhibitor molecules are comparable (anti-IL-6=0.36 nM, VEGF Trap-anti-IL-6=0.47 nM, and anti-IL-6-VEGF Trap=0.32 nM), indicating that the configuration of the molecule does not influence IL-6 binding or inhibition. Eylea served as a negative control. (
To assess the function of the VEGF trap, the ability of the dual IL-6/VEGF inhibitors to block VEGF binding to its receptor (VEGFR) was tested by a competitive ELISA.
A Nunc MaxiSorp ELISA was coated with 100 μl of 1 μg/ml of recombinant, human VEGFR-Fc (R&D Systems) overnight. The plate was blocked in 2% bovine serum albumin (BSA) in PBS-Tween (PBST) for 2 hours. During blocking, 100 pM biotinylated VEGF (btVEGF; R&D Systems), was incubated with increasing concentrations of anti-IL-6-VEGF Trap, VEGF Trap-anti-IL-6, or the bivalent anti-VEGF antibody OG1950. Bound bt-VEGF was detected with streptavidin-HRP (1:2000 dilution; R&D Systems) and developed using TMB reagent (KPL) for 10 minutes. Absorbance at 450 nM was measured on a SpectraMax Plus plate reader (Molecular Devices) and plotted against the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve.
Under these conditions, the dual IL-6/VEGF inhibitors bind to VEGF and inhibits it from binding to its receptor. When the VEGF trap is situated at the N-terminal end of the anti-IL-6 antibody, VEGF inhibition is roughly 2.5-fold more potent than the molecule whose VEGF trap is positioned between the Fab and Fc domains of the anti-IL-6 antibody (IC50 1.74 nM vs. 4.53 nM, respectively), likely due to a change in valency from 2 binding sites to 1 binding site. The results are shown in
To ensure that the dual inhibitors can simultaneously bind to both IL-6 and VEGF, they were subjected to a bridging ELISA where they first interact with plate-bound IL-6, and then are incubated with biotinylated VEGF (btVEGF). Detection of btVEGF by streptavidin HRP indicates that IL-6 bound molecules are also able to bind btVEGF.
A Nunc MaxiSorp ELISA was coated with 100 μl of 1 μg/ml of recombinant, human IL-6 (Tonbo Sciences) overnight. The plate was blocked in 2% bovine serum albumin (BSA) in PBS-Tween (PBST) for 2 hours. During blocking, 100 pM btVEGF) was incubated with increasing concentrations of anti-IL-6-VEGF Trap, VEGF Trap-anti-IL-6, or the bivalent antiVEGF antibody OG1950 as a negative control. Bound btVEGF was detected with streptavidin-HRP (1:2000 dilution; R&D systems) and developed using TMB reagent (KPL) for 10 minutes. Absorbance at 450 nM was measured on a SpectraMax Plus plate reader (Molecular Devices) and plotted against the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve.
This assay confirmed that the dual IL-6/VEGF inhibitors simultaneously bind IL-6 and btVEGF. The orientation of the anti-IL-6 and VEGF Trap has slightly variable binding, with the anti-IL-6-VEGF Trap orientation being more favorable under these conditions (EC50 VEGF Trap-antiIL-6=0.079 nM and antiIL-6-VEGF Trap=0.026 nM). Eylea and anti-IL-6 served as negative controls. The results are shown in
A first route for the synthesis of OG1802 is as follows. First, TFA/amine salt initiator (Compound L) having the structure shown in
First, Compound K, having the structure shown in
and Compound E (0.525 g, 0.81 mmol, 1.0 equiv) (see
The reaction was warmed to room temperature and stirred for 15 minutes. The reaction was quenched by adding water (20 mL), saturated aqueous sodium bicarbonate (20 mL) and ethyl acetate (100 mL). The organic layer was separated and the aqueous layer extracted with ethyl acetate (75 mL). The combined organic layers were washed with saturated aqueous sodium bicarbonate (30 mL), 0.5 M aqueous citric acid (40 mL), water (25 mL), and saturated aqueous sodium chloride (40 mL), then dried (sodium sulfate), filtered and concentrated under vacuum. The residue which was used without further purification resulted in 2.0 g (0.80 mmol, 99%) of Compound K.
1H NMR (400 MHZ DMSO-d6): δ=1.36 (s, 9H, OCCH3), 1.90 (s, 54H, CC(CH3)2Br), 2.31 (t, J=7.2 Hz, 6H, CCH2CH2NH), 2.98 (d, J=5.6 Hz, 6H, CCH2NH), 3.04 (q, J=6.0 Hz, 2H, OCH2CH2NH), 3.18 (s, 2H, OCH2C), 3.3-3.37 (m, 8H, CH2), 3.47-3.55 (m, 12H, CH2), 3.58 (s, 6H, OCH2C), 3.87 (s, 6H, O—CCH2O), 4.27 (s, 18H, CCH2OC═O), 6.74 (brt, 1H, CH2NHC═O), 7.69 (t, J=6.8 Hz, 3H, CH2NHC═O), 7.84 (t, J=6.0 Hz, 3H, CH2NHC═O).
LC-MS (ES, m/z): [(M+2H-boc)/2]+ Calcd for (C84H136Br9N7O33+2H-Boc)/2=1196.6. Found 1196.6.
Next Compound L (
1H NMR (400 MHZ DMSO-d6): δ=1.90 (s, 54H, CC(CH3)2Br), 2.31 (t, J=7.2 Hz, 6H, CCH2CH2NH), 2.97-3.0 (m, 8H, CCH2NH and OCH2CH2NH), 3.17 (s, 2H, OCH2C), 3.3 (q, 6H, CH2CH2NHC═O), 3.4-3.59 (m, 20H, CH2), 3.87 (s, 6H, O═CCH2O), 4.27 (s, 18H, CCH2OC═O), 7.69-7.84 (m, 9H, both CH2NHC═O and NH3+).
LC-MS (ES, m/z): [(M+2H)/2]+ Calcd for (C84H136Br9N7O33+2H)/2=1196.6. Found 1197.4.
Next, Compound L (
Next, the maleimide Mal-PEG4-PFP ester was snapped on (as set forth in
OG1786 is the nine-arm initiator for polymer synthesis used as a precursor in the synthesis of OG1802. Each arm is terminated with a 2-bromoisobutyrate which is capable of initiating polymerization under ATRP. OG1786 is a salt of trifluoro acetic acid (TFA) as shown in
In a 1 L round bottom flask equipped with a magnetic stir bar and an addition funnel was added OG1550 (14.8 g), methyl tert-butyl ether (MTBE) (350 ml) and water (30 ml). The mixture was stirred to dissolve the OG1550, then cooled in an ice bath. To this mixture was added a solution of trifluoroacetic acid (4.9 ml) in water (90 ml) dropwise over 90 minutes. After addition is complete the mixture was stirred an additional 15 minutes then removed from the ice bath and allowed to warm to room temperature. The mixture was stirred (after removal from the ice bath) for a further 4-5 hours, until tlc showed ˜5% starting material remaining, and the pH of the aqueous was between 3 and 4 (pH paper).
The mixture was partitioned. The MTBE layer was washed with water (30 ml). Combine aqueous layers then the aqueous extracted with MTBE (150 ml). This second MTBE phase was washed with water (30 ml). The combined aqueous layers were washed with a third portion of MTBE (100 ml). The third MBTE phase was washed with water (25 ml). The aqueous layers were again combined (˜250 ml, pH˜4, by pH paper).
The product was collected by lyophilization. 11.5 g white solid was obtained. This material is extremely hygroscopic, so best handled under nitrogen. The product was confirmed by LCMS.
The prepared OG1546 was then reacted with OG1563 to yield OG1784 (as depicted in
In a 250 ml flask under nitrogen equipped with a stir bar was added OG1546 (hygroscopic, 9.0 g), followed by N,N-dimethylformamide (110 ml). The mixture was stirred at room temperature until all OG1546 dissolved (about 15 minutes), then OG1563 (29.9 g) was added, and the mixture stirred a further 3 minutes until the OG1563 had also been dissolved. The resulting solution was cooled in an ice bath, and N,N-diisopropylethylamine (37.6 ml) was added over 3 minutes, followed by propylphosphonic anhydride (T3P), 50% in ethyl acetate (34.5 ml) dropwise over 5 minutes (T3P addition is exothermic). After T3P addition was complete, the flask was removed from the cooling bath and allowed to reach room temperature. Samples were then taken at 5 minute intervals for LCMS analysis. The reaction showed very light yellow/tan color.
After 20 minutes the reaction was cooled again in an ice bath and 5 ml water added. The mixture was then removed from the cooling bath and a further 50 ml water portion added, followed by 50 ml 0.5 M citric acid then isopropylacetate (300 ml). The mixture was partitioned. The aqueous phase (˜300 ml) was extracted with additional isopropyl acetate (150 ml). The aqueous phase was AQ1 for HPLC test. The combined organics were washed with aqueous citric acid (115 ml, 65 mM, which was the mixture of 15 ml of 0.5 M citric acid plus 100 ml water), and the aqueous phase was AQ2 (pH˜3). The organic phase was washed with water/saturated sodium chloride (100 ml/25 ml), and the aqueous phase was AQ3 (pH˜3). The organic phase was finally washed with saturated sodium chloride (100 ml), and the aqueous phase was AQ4. None of the AQ fractions contained any significant product (data not provided). The organic phase confirmed the product via LCMS. The product was dried over sodium sulfate (80 g), filtered and rinsed with isopropyl acetate (75 ml), and concentrated on a rotary evaporator to a tan oil (33.2 g). The crude was stored overnight under nitrogen.
The next day the crude was allowed to come to room temperature, then dissolved in acetonitrile/water (46 ml/12 ml) and filtered using an HPLC filter disk (Cole-Parmer PTFE 0.2 μm, product number 02915-20). The filtrate was split into three equal portions and purified in three runs.
The filtrate was loaded onto a RediSep Rf Gold C18 column (275 g, SN 69-2203-339, Lot #24126-611Y) equilibrated with 50% acetonitrile/water. The material was eluted at 100 ml/min using the following gradient (solvent A: water, solvent B: acetonitrile). All the relevant fractions were checked by HPLC. The fractions adjudged to be pure enough were pooled (from all three runs) and concentrated (bath temperature kept at about 20° C.) on rotovap, then partitioned between dichloromethane (100 ml) and water (5 ml)/saturated sodium chloride (25 ml). The aqueous was extracted twice more with dichloromethane (2×30 ml). The combined organics were dried over sodium sulfate (35 g), filtered, rinsed with DCM (30 ml), and concentrated. The product and purity were confirmed by LCMS methods. The isolated yield and the purity of the R5172 and R5228 lots are shown in Table 6.0.
53%
Next OG1405 was prepared from OG1784 as depicted in
Next, OG1405 was reacted with OG1402 to prepare OG1785 as set forth in
More water (50 ml), followed by 0.5 M citric acid (75 ml) and isopropyl acetate (175 ml) was added. The mixture was partitioned in 5 minutes. The aqueous was extracted with additional isopropyl acetate (50 mL). The combined organics were washed with aqueous citric acid (0.13 M, 30 ml, consist of 10 ml of 0.5 M citric acid and 20 ml water). The organics were then washed with the mixture of saturated sodium chloride (25 ml) and water (25 ml), then finally washed with the saturated sodium chloride (25 ml). They were then dried over sodium sulfate (124 g), filtered and rinsed with isopropyl acetate (30 ml), and concentrated under rotary evaporator to a tan oil (27.3 g). Samples were taken for LCMS analysis.
The oil was dissolved in acetonitrile/water (3:1, 15 ml/5 ml), filtered through an HPLC filter disk (Cole-Parmer PTFE membrane 0.2 μm, product number 02915-20) and split into three equal portions, each of which were individually purified as follows.
Portions were loaded onto Redi-Sep Gold C18 column (275 g, SN—69-2203-339, Lot 241234-611W) equilibrated at 50% solvent B (acetonitrile)/50% solvent A (water). The material was then purified by reverse phase HPLC with a solvent A: water/solvent B: acetonitrile gradient. Appropriate fractions were pooled and partitioned between dichloromethane (150 ml) and water (5 ml)/saturated sodium chloride (25 ml). The aqueous was extracted twice with dichloromethane (2×50 ml). Combined organics were dried over sodium sulfate (60 g), filtered and rinsed with dichloromethane (40 ml) and concentrated. Structure and purity were confirmed by various analytics including LCMS: OG1785 was isolated as a foamy solid (R5329, 19.0 g, 83% yield, 95.1% purity (a/a 210 nm), stored under nitrogen at 4° C.
Next, the tert-butyloxycarbonyl protecting group on OG1785 was removed using trifluoroacetic acid (TFA) to produce OG1786 as depicted in
Polymer OG1801 is made first from the initiator OG1786. OG1801 has an amine functionality, which is more stable (than maleimide) during polymer synthesis. To synthesize polymer OG1801, a modified version of ATRP is used wherein the copper species (Cu(I)) is generated in situ by adding metallic copper to Cu (II). Starting materials and reagents needed in the reaction are calculated based on batch input of the monomer (HEMA-PC) OG47, as well as the targeted molecular weight (MW).
Weighed 50 g monomer OG47 in glove box and added 200 mL of degassed EtOH to dissolve the monomer at room temperature; sampled for monomer concentration test. Weighed Cu (II), Bpy, Cu(0) in a 500 mL flask; purged with Argon, while adding monomer solution to the flask; sealed the flask with stopper and vacuumed for 25 min until no bubbles. The reaction changed color gradually from light green to dark green, then to light brown; weighed ˜200 mg of initiator OG1786 in glove box, and dissolved in ˜2000 uL of DMF under room temperature to make 100 mg/mL stock solution; sampled for initiator concentration and purity test; added the initiator solution to the flask under Argon. The reaction solution became dark brown and started thickening over time; sealed the system and let the reaction occur over 2 days.
OG1801 was then prepared for addition of the maleimide and catalyst (copper) was removed as follows: A prepacked RediSep® Rf normal phase silica column is used to remove the catalyst. The size of the column is chosen based on the copper amount in the reaction mixture. For instance, a 330 g column (Cat. #69-2203-330, Column size 330 g, CV=443 mL) was used for a 50 g batch of OG1801. Teflon tubing is used for all the connection as EtOH is the elute solvent.
After copper removal, all the fractions were transferred to a round bottom flask in batches, and evaporated the EtOH by rotary evaporator at 45-50° C. at reduced pressure to dryness. In this step, EtOH volume collected from condensation was monitored to make sure EtOH removal was >90%. The polymer was dissolved in 250 mL of WFI and filtered using a 0.2 um filter. It resulted in a clear to light yellow polymer solution at ˜150 mg/mL. The solution could be stored at 2-8° C. up to 3 month before use.
Starting materials and reagents needed in the reaction are calculated based on batch input of OG1801. The linker is 3-maleimidopropionic acid, NHS ester. Added 30 ml of 0.5 M sodium phosphate (in WFI, pH 8) to 50 g polymer solution (˜150 mg/mL). Let stir for 1 min; pH was 8.0 by pH paper. Weighed 204.8 mg of linker and dissolved in DMF 4.1 mL to make 50 mg/mL stock sln. Added linker solution dropwise 815 uL per minute to the polymer sln with strong stirring. Took 5 min to added 4095 uL of linker solution. Reacted at room temperature for 30 min. Quenched reaction with 20 mL of 5% acetic acid to achieve a final pH of 5. Filtered the solution using 1 L vacuum filter (0.2 um).
OG1802 (shown in
A HEA-PC polymer was synthesized as described below. HEA-PC (2-(acryloyloxy)ethyl-2-(trimethylammonium)ethyl phosphate), which is an acrylate as opposed to the methacrylate HEMA-PC described above, has the following structure:
HEA-PC was polymerized to the initiator shown in Example 5 as compound L.
Prepared a stock solution of initiator at 200 mg/mL by dissolving 2.2 mg of initiator in 11 μl of dry DMF and a 200 mg/ml solution of ligand by dissolving 4.6 mg of Me6TREN in 23 μL of dry DMF. Dispense 8.25 μl of the stock solution of initiator and 13.6 μl of the ligand into a tube. Degas at −78ºC for 5 mn then refill with Argon and add 1.2 mg of CuBr. Degas and refill with Argon. Add a stock solution of HEA-PC in methanol (weigh out 0.461 g of HEA-PC and dissolve it in 0.5 mL of methanol) to the solution inside the reactor at −78° C. Rinse the vial with 200 μl of methanol and add it inside the reactor at −78° C. and then 0.5 mL of distilled water then another 200 μl of water. Degas thoroughly until no bubbling is seen and all heterogeneity disappears (solid particulates dissolve or disappear). Refill with 4 psi of Argon and let the reaction to proceed at RT for an hour. The reaction was already viscous. The reaction was allowed to proceed for about one hour. A solution of bipyridine in methanol (5 mg in 0.5 uL) was added. Another 2-3 ml of methanol was added and the catalyst was allowed to oxidize overnight at 4ºC. Conversion determined by 1H NMR was estimated to be 94%.
The next day the polymer was dialyzed and subjected to SEC/MALS analysis using Shodex SB806M_HQ column (7.8×300 mm) in 1×PBS pH 7.4 at 1 ml/min, giving a PDI of 1.157, Mn of 723.5 kDa, Mp of 820.4 kDa and Mw of 837.2 kDa (before dialysis PDI is 1.12, Mn=695 kDa, Mp=778 kDa). Next a maleimide functionality was added to the polymer so that it could be conjugate to a protein.
Next, the maleimide Mal-PEG4-PFP (see Example 20 above) ester was snapped on to the HEA-PC polymer as shown in Example 20. The resulting maleimide functionalized HEA-PC polymer can then be conjugated to sulfhydryl groups as discussed herein for HEMA-PC polymers.
An acrylamide PC polymer was also made using the monomer 2-(acrylamyl)ethyl-2-(trimethylammonium)ethyl phosphate (Am-PC), having the following structure:
The Am-PC was used for polymerization employing a 3 arm initiator (a TFA salt) having the structure:
The synthesis of the Am-PC polymer was conducted as follows:
A stock solution of ligand at 200 mg/mL was prepared by dissolving 9 mg of Me6TREN in 45 uL of dry DMF. Add 19.7 uL of the stock solution to a reaction vessel. Prepare a stock solution of initiator at 200 mg/mL by dissolving 6.5 mg of material in 32.5 uL of DMF. Add 11 uL of the initiator stock solution to the ligand from above. Degas for 5 min. Add 1 mg of CuBr. Prepared a stock solution of CuBr2 at 200 mg/mL by dissolving 4 mg CuBr2 in 20 μL of DMF. Add 0.5 g of monomer (AmPC) to 1 mL of methanol (slow dissolution/viscous solution), followed by 1 uL of the stock solution of CuBr2. Add the monomer solution dropwise to the reaction mixture above. Rinse with 1 mL of water. Degas the reaction mixture thoroughly (freeze-thaw). Let the reaction proceed for 24 hours.
Afterwards the Am-PC polymer may be dialyzed. The molecular weight of the above polymer was determined by SEC/MALS: Mn is 215 kDa, Mp: 250 kDa, PDI is 1.17. Conversion was estimated by 1H NMR to be 94%. A maleimide functionality can be added to the Am-PC polymer as discussed above for HEMA-PC and HEA-PC. Maleimide functionalized Am-PC polymer can be conjugated to a protein as described above.
After addition of the maleimide functionality to polymer OG1801 to form OG1802 (see above), an Ellman's assay was used to determine the amount of functional maleimide expressed as percent function (i.e. conjugatable) in a sample. Thiol converted Ellman's reagent (DTNB) to TNB- then to TNB2—in water at neutral and alkaline pH, which gave off a yellow color (measured at 412 nm). A standard curve was established with cysteine. Since the maleimide reacts with thiol, this assay actually measured the thiol (cysteine) left. The inhibition was calculated as the molarity ratios of (original thiol−thiol left after maleimide polymer addition)/(original thiol) and is expressed as a percentage where the higher the percent the higher the maleimide functionalization.
Reagents Employed in Assay: A standard curve was prepared using the cysteine from 62.5 μM to 2 μM. Polymer stock solutions were prepared by dissolving the powder in 1×PBS pH7.4 (reaction buffer) and mixing thoroughly. An equal molar of polymer and cysteine solutions were mixed and allowed to react at 27° C. for 30 minutes. The 150 μM of DTNB solution was added into the cysteine standards and polymer/cysteine reactions and the color was developed at 27° C. for 5 minutes. OD at 412 nm was read on the Spectramax plate reader and percent inhibition was calculated with the Softmax Pro software and the cysteine standard curve.
The heavy and light chains may be cloned into expression plasmids and transfected into CHO cells. Cells can be grown up in appropriate media and harvested. The antibody (or in the alternative the Ab-Trap) may be purified using Protein A affinity column capture and elution. The antibody (or in the alternative the Ab-Trap) cysteine at position 443 (L443C (EU numbering)) residue is typically “capped” or oxidized by chemicals in the cell culture media and is not available for conjugation. In this regard, purified antibody (or in the alternative the Ab-Trap) may be subjected to a decapping (i.e. reducing) procedure to remove the cap and enable the free (i.e. those not involved in Cys-Cys disulfide bonds) cysteine residue to be conjugated to the maleimide functionality of a polymer. Decapping may be done by mixing purified antibody (or in the alternative the Ab-Trap) protein with a 30× molar excess for 1 hour at ambient temperature of a reducing agent such as TCEP (3,3′,3″-Phosphanetriyltripropanoic acid), Trisodium 3,3′,3″-phosphinetriyltris(benzene-1-sulphonate) (TPPTS), or something similar. The reduction reaction may be monitored by SDS-PAGE. Following reduction, the antibody (or in the alternative the Ab-Trap) protein may be buffer exchanged using a Pellicon XL Ultrafiltration Cassette with 20 mM Tris pH7.5, 100 mM NaCl, 0.5 mM TCEP buffer to remove the cap. The TCEP reagent may then be removed in the same buffer exchange setup with 20 mM Tris pH7.5, 100 mM NaCl. Reduced antibody (or in the alternative the Ab-Trap) may then be allowed to reoxidized using 15× molar excess of the oxidation agent DHAA (DeHydroxy Ascorbic Acid) for 1 hr at ambient temperature which again is monitored by SDS-PAGE assay. The DHAA reagent may then be removed in the same buffer exchange setup with 20 mM Tris pH7.5, 100 mM NaCl.
Decapped antibody (or in the alternative the Ab-Trap) may be conjugated to polymer OG1802 to yield the bioconjugate. An excess of OG1802 is used (3-20 fold molar excess). Conjugation can be monitored by cation-exchanger HPLC chromatography and driven to near completion. Antibody (or in the alternative the Ab-Trap) conjugate may be purified via cation exchanger chromatography and buffer exchanged into the formulation buffer by ultrafiltration/diafiltration (UF/DF). Antibody (or in the alternative the Ab-Trap) conjugate may be purified chromatographically as described above.
VEGFR-AntiIL6 conjugation process with OG1802 involved two steps: an initial reduction reaction to remove the cysteine S protecting groups (decapping), which was followed by conjugation to the biopolymer OG1802 via maleimide-cysteine chemistry. The decapping was done by first reducing (30-60 min) VEGFR-AntiIL6 with 30× molar excess of 3,3′,3″-Phosphanetriyltripropanoic acid (TCEP) followed by buffer exchange into 20 mM Tris-HCl pH 7.5, 100 mM NaCl to remove the cysteine cap and TCEP (
Then, reduced VEGFR-AntiIL6 was oxidized (30-60 min) with 15× molar excess of dehydro-ascorbic acid (dHAA) followed by buffer exchange into 20 mM Tris pH 7.5, 100 mM NaCl to remove the oxidizing reagent (
The conjugation process was done by mixing VEGFR-AntiIL6 at a final concentration of 2.4 mg/mL (or 12.5 μM) with 5× molar excess of the biopolymer OG1802 at pH 8.0. The conjugation process took place at 2-8° C. for a period of 2 to 3 days. Conjugated VEGFR-Anti-IL6 was purified from unconjugated material by cation exchange chromatography (CEX) with Poros XS resin using a step gradient of increasing salt concentrations (0-500 mM NaCl) in buffer containing 20 mM sodium acetate pH 5.5 (
SDS-PAGE (
As shown in
As illustrated in
The results of a cell-based VEGF stimulated VEGFR reporter assay are provided in
For the experiments, Promega KDR/VEGF HEK293 thaw-and-use cells (CS181405; Promega) were thawed and added to 4.6 mL of assay medium (10% FBS in DMEM). 25 μL of cells were transferred to each well of a 96-well plate. VEGF (500 pM final concentration) was mixed with a 10-point, 1:3 dilution series of inhibitors, starting at 100 nM (final concentration), and incubated for 30 minutes before adding 50 μL to the plated cells. After 6 hours, 75 μL of prepared Bio-Glo reagent (Promega) was added to the cells and incubated for 3-10 minutes at room temperature. Luminescence was measured on an iD3 plate reader (Molecular Devices). Relative luminescence units were normalized to the lowest inhibitor concentration for each curve and plotted as the average of replicates with standard error against the log of the concentration of antibody using GraphPad Prism software and fit with a non-linear regression curve. In this example, VEGFR-AntiIL6 corresponds to a heavy chain molecule comprising of sequences 1A-2A-3H paired with a light chain containing sequence 4A.
Passage 2 or 3 HUVEC cells were cultured in Vascular Basal Media supplemented with 1× Bovine Brain Extract endothelial cell growth kit (ATCC; growth media) in 5% CO2 at 37° C. Once cells reached 70% confluency, cells were lifted from the plate using trypsin (0.05%; ATCC) and 0.75×10{circumflex over ( )}6 cells plated in a T25 flask in growth media. Media was swapped for Assay Media (2% FBS in Vascular Basal Medium) the following day. After 6 hours, 5 μg/ml of Calcein AM was directly added to the media and incubated for 30 minutes at 37° C. At the same time, 200 μL of pre-thawed Matrigel (growth factor reduced; Corning) were added to each well of an 8-well glass chamber slide and incubate at 37° C. for 30 minutes. During incubations, 25 nM of each inhibitor (final concentrations) was mixed with 3 nM VEGF (R&D), 12.5 nM IL6 (Tonbo), and 25 nM IL6R (Tonbo) (all final concentrations). Following the 30 minute Calcein AM incubation, the cells were washed 3× with PBS and then trypsinized. Harvested cells were centrifuged for 3 minutes at 1,500×g and resuspended in assay medium at a density of 500,000 cells/mL. 100 μL of cells were then mixed with 100 μL of prepared inhibitor/complex solutions, and then transferred to the Matrigel coated chamber slides and incubated overnight. The next day, tubules were imaged using a 10× objective lens and the GFP filter on a EVOS fluorescence microscope (Life Technologies). At least 2 representative images were taken for each condition and then analyzed using the Angiogenesis Analyzer Plugin for ImageJ (NIH), which evaluates and quantifies 20 tubule network formation parameters.
In some embodiments, the VEGFR-Anti-IL6 construct allows for synergistic mechanisms to improve efficacy and durability in specific at-risk populations. At-risk populations include those with at-risk for or diagnosed with diabetic retinopathy or one or more inflammatory retinal disease.
As shown in
As can be seen in
The generation of improved Anti-IL-6 paratopes is described in the present example. Biacore kinetics results are shown in Tables 18.1, 18.2, 18.3, and 18.4
To provide a superior anti-IL-6 paratope on the engineered human IgG1 framework, the G66D (CDR2) heavy chain mutant was affinity matured. Initially, G66D full heavy chain libraries containing random single point mutations at positions S35, I51, T63 and T65 were constructed, excluding substitutions for Cys, Met and Asn due to the chemical liabilities associated with these amino acids. Those four positions were selected based on their tolerance for mutations as observed in bacterial and mammalian screens. The mammalian expression vectors containing heavy chain mutations were co-transfected with light chain wild-type and variant M32L/M50D/N52S/M88Q into 3 mL cultures of Expi293 cells and incubated for five days. These cultures were centrifuged and supernatants containing secreted antibodies were harvested and diluted in HBS-EP+ running buffer (1:20 ratio).
The various constructs and resulting kinetic properties are provided below in Tables 18.1-18.4.
Binding kinetics of these mutant molecules to IL-6 were measured at 37° C. using a Biacore T200. Antibodies were captured on a Protein A chip (GE) by injecting 1:20 cell supernatant dilutions at 10 μL/min for 60 seconds. Five concentrations (0.56, 1.67, 5, 15 and 45 nM) of IL-6 were flowed over captured antibodies for 60 seconds at a flow rate of 30 μL/min and dissociated for 180 seconds in a single cycle kinetics Biacore assay format. The sensor chip was regenerated by a 60 seconds injection of 10 mM Glycine pH 1.7 at the flow rate of 50 μL/min. A similar assay setup was used to monitor interactions between purified antibody samples and IL-6 at 37° C., when applicable. For this setup, 1 μg/mL of purified antibody was injected over a Protein A chip at 10 μL/min for 25 seconds. Five concentrations (0.56, 1.67, 5, 15 and 45 nM) of IL-6 were flowed over captured antibodies for 60 seconds at the flow rate of 30 μL/min and dissociated for 1800 seconds in a single cycle kinetics Biacore assay format. The sensor chip was regenerated by a 60 seconds injection of 10 mM Glycine pH 1.7 at flow rate of 50 μL/min. Data analysis for supernatant and purified samples were performed using BIAevaluation software (GE). All sensorgrams were double reference subtracted and fit using a 1:1 Langmuir binding model.
As shown by Tables 18.1 and 18.2, S35H G66D double mutant heavy chain presented a boost on protein expression, as indicated by the approximate two-fold increase in the capture level relative to the wild-type heavy chain. This mutant also presented a small increase in affinity depending on the paired light chain (wild-type: ˜2 fold, M32L/M50D/N52S/M88Q:˜1.3 fold). Table 18.1 illustrates G66D optimization of LC wild type Biacore kinetics for Anti-IL-6 heavy chain double mutants. Data were obtained for samples prior (sup) and after purification, both at 37° C. Table 18.2 illustrates G66D optimization of LC mutant Biacore kinetics for Anti-IL-6 heavy chain double mutants paired with mutagenized light chain. Data were obtained for samples prior (sup) and after purification both at 37° C.
Therefore, this double mutant was selected as a starting point for another round where substitution-tolerant positions Q99 and L100 at CDR3 were randomly mutagenized, expressed, and evaluated for IL-6 binding as described for the G66D screening round. As shown in Tables 18.3 and 18.4, L100 substitutions for Ala, Ser, Gly, Thr, Gln, Lys presented superior expression when compared to wild-type as indicated by the capture levels. These mutants were therefore selected for purification and IL-6 binding evaluation. Affinity measurements with the purified material also showed superior IL-6 binding, as illustrated in Tables 18.3 and 18.4. Based on these results, these additional modified CDRs, as illustrated in
Table 18.3 illustrates G66D/S35H heavy chain modification paired with LC wild-type Biacore kinetics for Anti-IL-6 heavy chain triple mutants. Data were obtained for samples prior (sup) and after purification, both at 37° C. Table 18.4 illustrates G66D/S35H heavy chain modification paired with LC mutant Biacore kinetics for Anti-IL-6 heavy chain triple mutants paired with mutagenized light chain. Data were obtained for samples prior (sup) and after purification, both at 37° C.
Based on the results with the VEGF trap variants and superior anti-IL-6 paratopes, 216 molecules in two different configurations were designed that were comprised of combinations of sequences as displayed in
In some embodiments, any of the options of the VEGF trap, wherein it is sandwiched between the antibody Fab and Fc regions, can be paired with light chains listed on sequences 4A-4C of
Anti-IL-6Anti-IL-6
As discussed in Example 13, VEGFR-AntiIL6 presents a minor degree of cleavage at the VEGFR1 domain 2 at the VEGF trap region. We developed two orthogonal chromatography methods to separate intact protein from cleaved material after the protein A purification step: i) cation exchange (CEX) and ii) hydrophobic interaction (HIC).
For the CEX method, VEGFR-AntiIL6 protein A eluate pH solution is adjusted to 6, which is then injected into a Porous XS column pre-equilibrated with 20 mM sodium phosphate pH 6. Intact protein eluted at lower ionic strength than cleaved material and is almost entirely separated within a linear gradient of increasing ionic strength (0-1 M sodium chloride) (
For the HIC method, a mixture of VEGFR-AntiIL6 intact protein enriched with cleaved material was injected into a Butyl HP column pre-equilibrated with 20 mM sodium phosphate pH 6, 500 mM-1 M ammonium sulfate. Intact and cleaved proteins were separated within a linear gradient of decreasing ionic strength (1-0 M ammonium sulfate), where intact protein eluted at lower ionic strength than cleaved material and could be partially or completely separated depending on the fractions pooled (
The Kinetic Exclusion Assay (KinExA®) 3200 system (Sapidyne Instruments Inc., Boise, ID) was used to measure the equilibrium binding affinity and kinetics between VEGFR-AntiIL6 or VEGFR-AntiIL6-OG1802 (the protein component of which is shown in
Affinity between dual inhibitor molecules and VEGF were determined from 2-3 titration curves at increasing dual inhibitor concentrations and their corresponding VEGF titrating serial dilutions (indicated in parenthesis) listed as follow: I) VEGFR-AntiIL6: 1 nM (20 nM, 2-fold dilution, 12 dilutions) 3.5 hours incubation; 50 pM (500 pM, 2-fold dilution, 14 dilutions) 2.5 hours incubation; 10 pM (1 nM, 2-fold dilution, 13 dilutions) 23 hours incubation; II) VEGFR-AntiIL6-OG1802: 2 nM (30 nM, 2-fold dilution, 12 dilutions) 45 min incubation; 100 pM (15 nM, 2-fold dilution, 14 dilutions) 6 hours incubation; 7.5 pM (1 nM, 2-fold dilution, 14 dilutions) 48 hours incubation. Similar measurements were performed with IL6 under the following conditions: III) VEGFR-AntiIL6: 1 nM (20 nM, 2-fold dilution, 13 dilutions) 7 hours incubation; 10 pM (1 nM, 2-fold dilution, 13 dilutions) 42 hours incubation; 100 pM (1 nM, 2-fold dilution, 13 dilutions) 2.5 hours incubation; IV) VEGFR-AntiIL6-OG1802: 1 nM (22.5 nM, 2-fold dilution, 13 dilutions) 5.5 hours incubation; 100 pM (22.5 nM, 2-fold dilution, 14 dilutions) 12 hours incubation.
On rates (kon, M−1s−1) between dual inhibitor molecules and VEGF or IL6 were directly determined from kinetic measurement experiments (1-2 curves for each analyzed pair), while off rates (koff, s−1) were calculated based on the following equation: koff=Kd×kon. Measurements were conducted on four preparations containing i) 100 pM VEGFR-AntiIL6 and 86.4 pM VEGF, ii) 217 pM VEGFR-AntiIL6-OG1802 and 200 pM VEGF, iii) 100 pM VEGFR-AntiIL6 and 84.3 pM IL6, iv) 1000 pM VEGFR-AntiIL6 and 900 pM IL6.
All measurements were done at 37° C. using 1×PBS running buffer (pH 7.4) and samples prepared in 1×PBS (pH 7.4) with 1 mg/mL BSA. Data analyses were done using KinExA Pro software 4.3.11.
Under the conditions tested, VEGFR-AntiIL6-OG1802 binds to VEGF and IL6 in a comparable manner to VEGFR-AntiIL6 with Kd values of 2.10 pM to VEGFR-AntiIL6 and VEGF, 1.02 pM to VEGFR-AntiIL6-OG1802 and VEGF, 21.10 pM to VEGFR-AntiIL6 and IL6, 12.10 pM to VEGFR-AntiIL6-OG1802 and IL6 (see table 22.1 and 22.2).
The measured affinities of VEGFR-AntiIL6 and VEGFR-AntiIL6-OG1802 were within error for both IL6 and VEGF, thus these results demonstrate that the biopolymer does not affect binding of dual inhibitors to its targets.
This assay was performed as described in example 3. In this assay, VEGFR-AntiIL6, VEGFR-AntiIL6-OG1802 (as shown in
This assay was performed as described in example 3.
Under these conditions, the VEGFR-AntiIL6-OG1802 effectively blocked the IL-6/IL-6R interaction in a manner comparable to VEGFR-AntiIL6 with IC50 values of 0.26 nM for VEGFR-AntiIL6 and 0.23 nM for VEGFR-AntiIL6-OG1802 (
This assay was performed as described in example 15.
Under the conditions tested, VEGFR-AntiIL6-OG1802 inhibited VEGF stimulated VEGFR reporter cells in a comparable manner to VEGFR-AntiIL6 and Eylea with average IC50 values of 0.35±0.10 nM, 0.51±0.07 nM, and 0.35±0.03 nM, respectively (
Passage 2 HUVEC cells were cultured in Vascular Basal Media supplemented with 1× Bovine Brain Extract endothelial cell growth kit (ATCC; growth media) in 5% CO2 at 37 degrees. Once cells reached 70% confluency, cells were lifted from the plate using trypsin (0.05%; ATCC) and 0.75×10{circumflex over ( )}6 cells plated in a T25 flask in growth media.
The next day, media was swapped for Assay Media (2% FBS in Vascular Basal Medium). After 6 hours, 5 μg/ml of Calcein AM was added directly to the media and incubated for 30 minutes at 37 degrees.
At the same time, 200 μls of prethawed Matrigel (growth factor reduced; Corning) was added to each well of a 8-well glass chamber slide and incubated at 37 degrees for 30 minutes.
During incubations, inhibitors (37.5 nM final concentration) were mixed with lipopolysaccharide (LPS; Sigma; 1 ug/ml final concentration).
Following the 30 minute Calcein AM incubation, the cells were washed 3× with PBS and then trypsinized. Harvested cells were centrifuged for 3 minutes at 1,500×g and resuspended in assay medium at a density of 500,000 cells/ml. 150 μls of cells were then mixed with 100 μls of prepared inhibitor/complex solutions, and then transferred to the Matrigel coated chamber slides and incubated overnight.
The next day, tubules were imaged using a 10× objective lens and the GFP filter on a EVOS fluorescence microscope (Life Technologies). At least 2 representative images were taken for each condition and then analyzed using the Angiogenesis Analyzer Plugin for ImageJ (NIH), which evaluates and quantifies 20 tubule network formation parameters.
Statistical significance was determined from all replicates from independent experiments using a unpaired, two-tailed Students t-test.
Under these conditions, VEGFR-AntiIL6 showed statistically significant inhibition of 15/20 measured angiogenic parameters over control, while Eylea significantly inhibited 5/20 and anti-IL6 inhibited 3/20 relative to control treated cells. Altogether, all but one of the parameters that trended or were significantly affected by Eylea or anti-IL6 were significantly inhibited by VEGFR-AntiIL6. Additionally, there were several parameters where VEGFR-AntiIL6 displayed significantly better inhibition over Eylea (7/20) and anti-IL6 (10/20), 3 of which VEGFR-AntiIL6 was significantly better than both Eylea and anti-IL6. (
VEGFR-AntiIL6-OG1802 effectively inhibited HUVEC tubule formation, and interestingly, VEGFR-AntiIL6-OG1802 showed a trend of increased inhibition in 9/20 parameters over VEGFR-AntiIL6. (
This assay was performed as described in example 17.
Under the conditions tested, VEGFR-AntiIL6-OG1802 (the protein component as shown in
Interestingly, VEGFR-AntiIL6-OG1802 showed increased efficacy relative to VEGFR-AntiIL6 when different densities of cells were seeded per well at the beginning of the experiment. As shown in
As shown in the examples above, without intending to be limited by theory, it appears that the biopolymer helps deliver its protein counterpart to the surface of the plate and cells. This allows the drug to primarily inhibit the pools of VEGF and IL6 that are most likely to activate cell signaling and avoid being saturated by VEGF and IL6 suspended higher in the fluid phase and less likely to affect cell signaling. As cell numbers increase, this effect would be more pronounced as more drug is needed to act on more cells. Thus, in some embodiments, the conjugate provides a superior product in that it can assist in distribution of the molecule.
A patient having a COVID-19 infection is suffering from cytokine release syndrome (CRS). An effective amount of VEGFR-AntiIL6-OG1802 is administered intravenously to the patient to treat the CSR.
A patient having a COVID-19 infection is suffering from pulmonary edema. An effective amount of VEGFR-AntiIL6-OG1802 is administered to the patient by nebulization to treat the pulmonary edema.
A patient having a COVID-19 infection is suffering from acute respiratory distress syndrome (ARDS). An effective amount of VEGFR-AntiIL6-OG1802 is administered to the patient by nebulization to treat the ARDS.
A patient having a COVID-19 infection is intubated. An effective amount of VEGFR-AntiIL6-OG1802 is administered to the patient by nebulization to treat intubation-induced inflammation and tissue damage.
A patient with cancer receives a CAR-T therapy to treat the cancer. An effective amount of VEGFR-AntiIL6-OG1802 is administered to the patient intravenously to reduce the risk of systemic inflammation induced by the CAR-T therapy.
All patent filings, websites, other publications, accession numbers and the like cited above or below are incorporated by reference in their entirety for all purposes to the same extent as if each individual item were specifically and individually indicated to be so incorporated by reference. If different versions of a sequence are associated with an accession number at different times, the version associated with the accession number at the effective filing date of this application is meant. The effective filing date means the earlier of the actual filing date or filing date of a priority application referring to the accession number if applicable. Likewise if different versions of a publication, website or the like are published at different times, the version most recently published at the effective filing date of the application is meant unless otherwise indicated. Any feature, step, element, embodiment, or aspect of the present disclosure can be used in combination with any other unless specifically indicated otherwise. Although the present disclosure has been described in some detail by way of illustration and example for purposes of clarity and understanding, it will be apparent that certain changes and modifications may be practiced within the scope of the appended claims.
This application is the U.S. National Stage Application under 35 U.S.C. § 371 of International Application No. PCT/US2021/031194, filed May 6, 2021, which claims priority to U.S. Provisional Application No. 63/022,370, filed May 8, 2020. The entirety of each of these related applications is incorporated herein by reference.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2021/031194 | 5/6/2021 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63022370 | May 2020 | US |
