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Combining Anti-hla-dr or Anti-trop-2 antibodies with microtubule inhibitors, parp inhibitors, bruton kinase inhibitors or phosphoinositide 3-kinase inhibitors significantly improves therapeutic outcome in cancer

a technology of anti-trop-2 and anti-hla-dr, which is applied in the field of therapeutic use of antitaa antibodies or immunoconjugates, can solve the problems of mixed success in the treatment of human cancer, virtually no application in other diseases, and insolubility of most cpt derivatives in aqueous buffers

Inactive Publication Date: 2017-09-28
IMMUNOMEDICS INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0017]In certain embodiments involving treatment of cancer, the antibodies or immunoconjugates may be used in combination with surgery, radiation therapy, chemotherapy, immunotherapy with naked antibodies, including checkpoint-inhibiting antibodies, radioimmunotherapy, immunomodulators, vaccines, and the like. Most preferably, the antibody or immunoconjugate is used in combination with a PARP inhibitor, microtubule inhibitor, Bruton kinase inhibitor and / or PI3K inhibitor. These combination therapies can allow lower doses of each therapeutic to be given in such combinations, thus reducing certain severe side effects, and potentially reducing the courses of therapy required. When there is no or minimal overlapping toxicity, full doses of each can also be given.
[0018]Preferred optimal dosing of immunoconjugates may include a dosage of between 1 mg / kg and 20 mg / kg, more preferably 4 to 16 mg / kg, most preferably 8 to 10 mg / kg, preferably given either weekly, twice weekly, every other week, or every third week. The optimal dosing schedule may include treatment cycles of two consecutive weeks of therapy followed by one, two, three or four weeks of rest, or alternating weeks of therapy and rest, or one week of therapy followed by two, three or four weeks of rest, or three weeks of therapy followed by one, two, three or four weeks of rest, or four weeks of therapy followed by one, two, three or four weeks of rest, or five weeks of therapy followed by one, two, three, four or five weeks of rest, or administration once every two weeks, once every three weeks or once a month. Treatment may be extended for any number of cycles, preferably at least 2, at least 4, at least 6, at least 8, at least 10, at least 12, at least 14, or at least 16 cycles. Exemplary dosages of use may include 1 mg / kg, 2 mg / kg, 3 mg / kg, 4 mg / kg, 5 mg / kg, 6 mg / kg, 7 mg / kg, 8 mg / kg, 9 mg / kg, 10 mg / kg, 11 mg / kg, 12 mg / kg, 13 mg / kg, 14 mg / kg, 15 mg / kg, 16 mg / kg, 17 mg / kg, and 18 mg / kg. The person of ordinary skill will realize that a variety of factors, such as age, general health, specific organ function or weight, as well as effects of prior therapy on specific organ systems (e.g., bone marrow) may be considered in selecting an optimal dosage of immunoconjugate, and that the dosage and / or frequency of administration may be increased or decreased during the course of therapy. The dosage may be repeated as needed, with evidence of tumor shrinkage observed after as few as 4 to 8 doses. The optimized dosages and schedules of administration disclosed herein show unexpected superior efficacy and reduced toxicity in human subjects, which could not have been predicted from animal model studies. Surprisingly, the superior efficacy allows treatment of tumors that were previously found to be resistant to one or more standard anti-cancer therapies, including the parental compound, CPT-11, from which SN-38 is derived in vivo.

Problems solved by technology

Conjugates of MAbs that target tumor-associated antigens (TAA) and suitable toxic agents have been developed, but have had mixed success in the therapy of cancer in humans, and virtually no application in other diseases, such as infectious and autoimmune diseases.
CPTs present specific issues in the preparation of conjugates.
One issue is the insolubility of most CPT derivatives in aqueous buffers.
Second, CPTs provide specific challenges for structural modification for conjugating to macromolecules.
Third, the lability under physiological conditions of the δ-lactone moiety of the E-ring of camptothecins results in greatly reduced antitumor potency.

Method used

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  • Combining Anti-hla-dr or Anti-trop-2 antibodies with microtubule inhibitors, parp inhibitors, bruton kinase inhibitors or phosphoinositide 3-kinase inhibitors significantly improves therapeutic outcome in cancer
  • Combining Anti-hla-dr or Anti-trop-2 antibodies with microtubule inhibitors, parp inhibitors, bruton kinase inhibitors or phosphoinositide 3-kinase inhibitors significantly improves therapeutic outcome in cancer
  • Combining Anti-hla-dr or Anti-trop-2 antibodies with microtubule inhibitors, parp inhibitors, bruton kinase inhibitors or phosphoinositide 3-kinase inhibitors significantly improves therapeutic outcome in cancer

Examples

Experimental program
Comparison scheme
Effect test

example 1

Combination Therapy with ADC IMMU-132 and Microtubule Inhibitors or PARP Inhibitors

[0220]In current clinical trials (ClinicalTrials.gov, NCT01631552), triple-negative breast cancer (TNBC) patients treated with IMMU-132, which is composed of the active metabolite of irinotecan, SN-38, conjugated to an anti-Trop-2 antibody, shows manageable toxicity and very encouraging responses in relapsed / refractory cases.

[0221]Synthetic lethality is a concept in which a cell harboring one out of two possible gene or protein defects is viable, while a cell containing both defects is nonviable. BRCA1 / 2 mutations are linked to deficiencies in DNA repair and are associated with TNBC. Other repair mechanisms involve poly(adenosine diphosphoribose) polymerase (PARP), which can be used by cancer cells to overcome loss of BRACA1 / 2. Treatment of TNBC cells with either IMMU-132 or paclitaxel results in cleavage and deactivation of PARP, whereas the small molecule olaparib directly inhibits PARP. Therefore, ...

example 2

Combination Therapy with IMMU-114 (anti-HLA-DR) plus Bruton Kinase Inhibitor in Chronic Lymphocytic Leukemia (CLL)

[0246]Experimental Design.

[0247]Human chronic B cell leukemia cells (JVM-3) were plated in a 96-well plate. Cells were then incubated with various doses of the Bruton kinase inhibitor ibrutinib (1×10−5 to 3.9×10−9M) plus a constant amount of IMMU-114 (0.25, 0.5, 0.75, or 1 nM) for 96 h. Cell viability was assessed by MTS assay and dose / response curves were generated based on percent growth inhibition relative to untreated control cells. IC50-values were determined using Prism Graph-Pad. Data were normalized and isobolograms generated to demonstrate the effect of IMMU-114 on ibrutinib in JVM-3 cells.

[0248]Results

[0249]An example of how IMMU-114 shifted the IC50 of ibrutinib is shown in FIG. 5A. Cells incubated with ibrutinib alone resulted in an IC50 of 2.2×10−6M. However, when 0.5 nM of IMMU-114 is combined with ibrutinib, the IC50-value drops 2-fold to 1.08×10−6M. It sh...

example 3

Combination Therapy with IMMU-114 (anti-HLA-DR) Plus Phosphatidylinositide 3-Kinase (PI3K) Inhibitor in Chronic Lymphocytic Leukemia (CLL)

[0251]Experimental Design.

[0252]Human chronic leukemia B cells (JVM-3) were plated in a 96-well plate. Cells were then incubated with various doses of a PI3K inhibitor idelalisib (1×10−5 to 3.9×10−9M) plus a constant amount of IMMU-114 (0.25, 0.5, 0.75, or 1 nM) for 96 h. Cell viability was assessed by MTS assay and dose / response curves were generated based on percent growth inhibition relative to untreated control cells. IC50-values were determined using Prism Graph-Pad. Data were normalized and isobolograms generated to demonstrate the effect of IMMU-114 on ibrutinib in JVM-3 cells.

[0253]Results

[0254]As with ibrutinib, IMMU-114 shifted the IC50 of idelalisib in JVM-3 cells (FIG. 5B). Cells incubated with idelalisib alone resulted in an IC50 of 1.51×10−6M. However, when 0.5 nM of IMMU-114 is combined with idelalisib, the IC50-value drops 2-fold t...

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PUM

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Abstract

The present invention relates to combination therapy with drugs, such as microtubule inhibitors, PARP inhibitors, Bruton kinase inhibitors or PI3K inhibitors, with antibodies or immunoconjugates against HLA-DR or Trop-2. Where immunoconjugates are used, they preferably incorporate SN-38 or pro-2PDOX. The immunoconjugate may be administered at a dosage of between 1 mg / kg and 18 mg / kg, preferably 4, 6, 8, 9, 10, 12, 16 or 18 mg / kg, more preferably 8 or 10 mg / kg. The combination therapy can reduce solid tumors in size, reduce or eliminate metastases and is effective to treat cancers resistant to standard therapies, such as radiation therapy, chemotherapy or immunotherapy. Preferably, the combination therapy has an additive effect on inhibiting tumor growth. Most preferably, the combination therapy has a synergistic effect on inhibiting tumor growth.

Description

RELATED APPLICATIONS[0001]This application is a divisional of U.S. patent application Ser. No. 15 / 190,805, filed Jun. 23, 2016, which was a continuation-in-part of U.S. patent application Ser. No. 15 / 069,208, filed Mar. 14, 2016, which was a continuation-in-part of U.S. patent application Ser. No. 14 / 667,982 (now issued U.S. Pat. No. 9,493,573), filed Mar. 25, 2015, which was a divisional of U.S. patent application Ser. No. 13 / 948,732 (now issued U.S. Pat. No. 9,028,833), filed Jul. 23, 2013. This application claims the benefit under 35 U.S.C. 119(e) of U.S. Provisional Patent Application 62 / 184,331, filed Jun. 25, 2015, 62 / 201,361, filed Aug. 5, 2015, 62 / 250,715, filed Nov. 4, 2015, and 62 / 263,134, filed Dec. 4, 2015. The entire text of each priority application is incorporated herein by reference.SEQUENCE LISTING[0002]The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Sai...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61K31/337A61K31/4184A61K31/4375A61K31/454A61K31/4745A61K31/502A61K31/513A61K31/519A61K31/675A61K31/7088A61K31/713A61K33/24A61K39/395A61K45/06C07K16/28C07K16/30A61K33/243
CPCC07K16/30A61K31/519A61K31/513A61K31/502C07K16/3007A61K31/7088C07K16/2803A61K31/4745A61K47/48576A61K31/4375A61K47/48561A61K47/48384A61K31/337C07K2317/92A61K31/4184A61K39/39558C07K16/2887C07K2317/94A61K45/06A61K47/48569C07K16/2833A61K31/454A61K47/48407A61K31/675A61K33/24A61K31/713A61K31/357A61K47/6809A61K47/6849A61K47/6851A61K47/6853A61K47/6803A61K2300/00A61K33/243
Inventor GOLDENBERG, DAVID M.CARDILLO, THOMAS M.
Owner IMMUNOMEDICS INC
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