Antibody-drug conjugates and uses thereof
Patent Information
- Application Number
- JP2025130431
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2025-08-05
- Publication Date
- 2026-03-04
AI Technical Summary
Existing treatments have limited effectiveness for patients with HER2-negative gastric cancer, and immunotherapy is only suitable for 40% of patients, necessitating the development of new treatments for gastric cancer.
An anti-clavini N 18.2 antibody-drug conjugate was developed. The anti-clavini N 18.2 antibody was conjugated with the dolastin derivative MMAE via an MC-vc-PAB linker to form an antibody-drug conjugate. The conjugate enters tumor cells via endocytosis and is degraded in lysosomes to release MMAE, thereby blocking microtubule polymerization and inhibiting tumor cell proliferation.
This antibody-drug conjugate exhibits good tumor cell growth inhibitory activity and demonstrates significant anti-tumor effects in vitro and in vivo, particularly showing potential therapeutic prospects for gastric cancer, gastroesophageal junction adenocarcinoma, and pancreatic cancer.
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Abstract
Description
[Technical Field]
[0001] The present invention relates to the field of medicinal chemistry, in particular to antibody-drug conjugates and their uses. [Background technology]
[0002] Gastric cancer is one of the most common cancers worldwide, with incidence rates relatively high in East Asia, Eastern Europe, and South America, and relatively low in North America and Africa. Chemotherapy is the standard initial treatment for advanced or recurrent gastric cancer. Although the prognosis for gastric cancer patients has improved significantly with advances in surgical techniques and perioperative care, the 5-year overall survival rate remains low at 10–15%. Targeted therapy has offered new hope for the treatment of recurrent / advanced gastric cancer. While the combination of trastuzumab and chemotherapy has shown some benefit in HER2-positive patients, only 15% of patients are HER2-positive, limiting the benefit to a limited number of patients. In recent years, immunotherapy has offered new hope for the treatment of recurrent / advanced gastric cancer. However, according to the results of the KEYNOTE-12 study, only 40% of patients with recurrent / advanced gastric cancer or GEJ adenocarcinoma are suitable for this treatment. Therefore, the development of new gastric cancer treatments remains necessary. Summary of the Invention [Means for solving the problem]
[0003] The inventors of the present application conducted numerous experiments and original research to prepare an anti-claudin 18.2 antibody-drug conjugate and confirmed that it had good biological activity, thereby arriving at the present invention.
[0004] To this end, in a first aspect of the invention, the present invention provides an antibody-drug conjugate, a pharmaceutically acceptable salt, solvate, or solvate of said salt, wherein the antibody-drug conjugate has the structure shown in Formula I: Ab-(LD) p Formula I During the ceremony, The Ab is an anti-claudin 18.2 antibody comprising a heavy chain and a light chain, wherein the heavy chain variable region CDR1 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 2, 10, 18, 26, 34, 42, 68, 76, 84, 92, 100, 108, or 116, or a variant thereof; the heavy chain variable region CDR2 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 3, 11, 19, 27, 35, 43, 69, 77, 85, 93, 101, 109, or 117, or a variant thereof; and the heavy chain variable region CDR3 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 4, 12, 20, 28, 36, 4 the light chain variable region CDR1 comprises a sequence selected from the sequence shown in SEQ ID NO: 50, 58, 124, or 132, or a variant thereof; the light chain variable region CDR2 comprises a sequence selected from the sequence shown in SEQ ID NO: 51, 59, 125, or 133, or a variant thereof; and the light chain variable region CDR3 comprises a sequence selected from the sequence shown in SEQ ID NO: 52, 60, 126, or 134, or a variant thereof; D is a cytotoxic agent; L is a linker for conjugating the anti-claudin 18.2 antibody to the cytotoxic agent, p is between 2.0 and 8.0 (e.g., between 2.0 and 7.0, between 2.0 and 6.0, between 2.0 and 5.0, between 2.0 and 4.0, between 3.0 and 7.0, between 3.0 and 6.0, between 3.0 and 5.0, or between 3.0 and 4.0, or, for example, between 3.0, 4.0, 5.0, 6.0, or 7.0).
[0005] The antibody-drug conjugate of the present invention exhibits good tumor cell growth inhibitory activity in vivo and in vitro and has good prospects for application. The antibody-drug conjugate of the present invention is formed by linking an anti-claudin 18.2 antibody with the dolastatin derivative MMAE via an MC-vc-PAB linker, and its antitumor mechanism of action is as follows: After binding to claudin 18.2 on the surface of tumor cells, the antibody-drug conjugate enters the tumor cells via endocytosis and is transported to lysosomes, where it is then degraded by proteases to release MMAE. After entering the cytoplasm, MMAE binds to tubulin and inhibits its polymerization, thereby blocking various cellular physiological functions, including tubulin-related mitosis, resulting in the inhibition of tumor cell proliferation and tumor cell death.
[0006] Of note, an "antibody-drug conjugate" is a composition containing ADC molecules with the same or different DAR values. Specifically, the present invention provides a composition comprising multiple ADC molecules. In certain cases, the multiple ADCs each comprise the same number of drug molecules in the composition. In other cases, the multiple ADCs each comprise a different number of drug molecules in the composition.
[0007] The drug-antibody ratio (DAR) described above refers to the number of drug molecules bound to an antibody (e.g., p in Formula I). The number of drug molecules contained in an antibody-drug conjugate of the present invention (e.g., p in Formula I) is usually an integer. When the number of drug molecules contained in an antibody-drug conjugate of the present invention (e.g., p in Formula I) is a decimal number, this refers to the average number of drug molecules bound per antibody in a composition comprising multiple ADC molecules.
[0008] The above-described drug-antibody ratio (DAR) can be verified by conventional means such as mass spectrometry, ELISA assay, HIC, and HPLC. The quantitative distribution of the ADC with respect to p can also be determined. In some cases, a homogeneous ADC with a particular p value from ADCs loaded with other drugs can be separated, purified, and verified by means such as reverse-phase HPLC or electrophoresis.
[0009] In some embodiments, the heavy chain variable region CDR1 of the anti-claudin 18.2 antibody comprises a sequence selected from the sequence set forth in SEQ ID NO: 2, 10, 18, 26, 34, or 42, or a variant thereof; the heavy chain variable region CDR2 comprises a sequence selected from the sequence set forth in SEQ ID NO: 3, 11, 19, 27, 35, or 43, or a variant thereof; the heavy chain variable region CDR3 comprises a sequence selected from the sequence set forth in SEQ ID NO: 4, 12, 20, 28, 36, or 44, or a variant thereof; the light chain variable region CDR1 comprises a sequence selected from the sequence set forth in SEQ ID NO: 50 or 58, or a variant thereof; the light chain variable region CDR2 comprises a sequence selected from the sequence set forth in SEQ ID NO: 51 or 59, or a variant thereof; and the light chain variable region CDR3 comprises a sequence selected from the sequence set forth in SEQ ID NO: 52 or 60, or a variant thereof.
[0010] In some embodiments, the heavy chain variable region CDR1 of the anti-claudin 18.2 antibody comprises a sequence selected from the sequence set forth in SEQ ID NO: 68, 76, 84, 92, 100, 108, or 116, or a variant thereof; the heavy chain variable region CDR2 comprises a sequence selected from the sequence set forth in SEQ ID NO: 69, 77, 85, 93, 101, 109, or 117, or a variant thereof; the heavy chain variable region CDR3 comprises a sequence selected from the sequence set forth in SEQ ID NO: 70, 78, 86, 94, 102, 110, or 118, or a variant thereof; the light chain variable region CDR1 comprises a sequence selected from the sequence set forth in SEQ ID NO: 124 or 132, or a variant thereof; the light chain variable region CDR2 comprises a sequence selected from the sequence set forth in SEQ ID NO: 125 or 133, or a variant thereof; and the light chain variable region CDR3 comprises a sequence selected from the sequence set forth in SEQ ID NO: 126 or 134, or a variant thereof.
[0011] In some embodiments, the heavy chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody comprise a combination of the following sequences: (1) SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, (2) SEQ ID NO: 10, SEQ ID NO: 11, SEQ ID NO: 12, (3) SEQ ID NO: 18, SEQ ID NO: 19, SEQ ID NO: 20, (4) SEQ ID NO: 26, SEQ ID NO: 27, SEQ ID NO: 28, (5) SEQ ID NO: 34, SEQ ID NO: 35, SEQ ID NO: 36, (6) SEQ ID NO: 42, SEQ ID NO: 43, SEQ ID NO: 44, (7) SEQ ID NO: 68, SEQ ID NO: 69, SEQ ID NO: 70, (8) SEQ ID NO: 76, SEQ ID NO: 77, SEQ ID NO: 78, (9) SEQ ID NO: 84, SEQ ID NO: 85, SEQ ID NO: 86, (10) SEQ ID NO: 92, SEQ ID NO: 93, SEQ ID NO: 94, (11) SEQ ID NO: 100, SEQ ID NO: 101, SEQ ID NO: 102, (12) SEQ ID NO: 108, SEQ ID NO: 109, SEQ ID NO: 110, (13) SEQ ID NO: 116, SEQ ID NO: 117, SEQ ID NO: 118; The light chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 50, SEQ ID NO: 51, SEQ ID NO: 52, (2) SEQ ID NO: 58, SEQ ID NO: 59, SEQ ID NO: 60, (3) SEQ ID NO: 124, SEQ ID NO: 125, SEQ ID NO: 126, (4) Selected from SEQ ID NO: 132, SEQ ID NO: 133, and SEQ ID NO: 134.
[0012] In some embodiments, the heavy chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody comprise a combination of the following sequences: (1) SEQ ID NO: 2, SEQ ID NO: 3, SEQ ID NO: 4, (2) SEQ ID NO: 10, SEQ ID NO: 11, SEQ ID NO: 12, (3) SEQ ID NO: 18, SEQ ID NO: 19, SEQ ID NO: 20, (4) SEQ ID NO: 26, SEQ ID NO: 27, SEQ ID NO: 28, (5) SEQ ID NO: 34, SEQ ID NO: 35, SEQ ID NO: 36, (6) SEQ ID NO: 42, SEQ ID NO: 43, SEQ ID NO: 44; The light chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 50, SEQ ID NO: 51, SEQ ID NO: 52, (2) Selected from SEQ ID NO: 58, SEQ ID NO: 59, and SEQ ID NO: 60.
[0013] In some embodiments, the heavy chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody comprise a combination of the following sequences: (1) SEQ ID NO: 68, SEQ ID NO: 69, SEQ ID NO: 70, (2) SEQ ID NO: 76, SEQ ID NO: 77, SEQ ID NO: 78, (9) SEQ ID NO: 84, SEQ ID NO: 85, SEQ ID NO: 86, (4) SEQ ID NO: 92, SEQ ID NO: 93, SEQ ID NO: 94, (5) SEQ ID NO: 100, SEQ ID NO: 101, SEQ ID NO: 102, (6) SEQ ID NO: 108, SEQ ID NO: 109, SEQ ID NO: 110, (7) SEQ ID NO: 116, SEQ ID NO: 117, SEQ ID NO: 118; The light chain variable regions CDR1, CDR2, and CDR3 of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 124, SEQ ID NO: 125, SEQ ID NO: 126, (2) Selected from SEQ ID NO: 132, SEQ ID NO: 133, and SEQ ID NO: 134.
[0014] In some embodiments, the heavy chain variable region FR1 of the anti-claudin 18.2 antibody comprises a sequence selected from the sequences set forth in SEQ ID NOs: 5, 13, 21, 29, 37, 45, 71, 79, 87, 95, 103, 111, or 119, or a variant thereof; the heavy chain variable region FR2 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 6, 14, 22, 30, 38, 46, 72, 80, 88, 96, 104, 112, or 120, or a variant thereof; the heavy chain variable region FR3 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 7, 15, 23, 31, 39, 47, 73, 81, 89, 97, 105, 113, or 121, or a variant thereof; and the heavy chain variable region FR4 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 8, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 42, 43, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 80, 88, 96, 104, 112, or 12 , 24, 32, 40, 48, 74, 82, 90, 98, 106, 114, or 122, or a variant thereof; the light chain variable region FR1 comprises a sequence selected from the sequence set forth in SEQ ID NO: 53, 61, 127, or 135, or a variant thereof; the light chain variable region FR2 comprises a sequence selected from the sequence set forth in SEQ ID NO: 54, 62, 128, or 136, or a variant thereof; the light chain variable region FR3 comprises a sequence selected from the sequence set forth in SEQ ID NO: 55, 63, 129, or 137, or a variant thereof; and the light chain variable region FR4 comprises a sequence selected from the sequence set forth in SEQ ID NO: 56, 64, 130, or 138, or a variant thereof.
[0015] In some embodiments, the heavy chain variable region FR1 of the anti-claudin 18.2 antibody has a sequence selected from the sequences set forth in SEQ ID NOs: 5, 13, 21, 29, 37, or 45 or a variant thereof; the heavy chain variable region FR2 has a sequence selected from the sequences set forth in SEQ ID NOs: 6, 14, 22, 30, 38, or 46 or a variant thereof; the heavy chain variable region FR3 has a sequence selected from the sequences set forth in SEQ ID NOs: 7, 15, 23, 31, 39, or 47 or a variant thereof; and the heavy chain variable region FR4 has a sequence selected from the sequences set forth in SEQ ID NOs: 8, 16, 24, 32, 33, 34, 35, 36, 37, 38, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, , 40, or 48, or a variant thereof; the light chain variable region FR1 has a sequence selected from the sequence shown in SEQ ID NO: 53 or 61, or a variant thereof; the light chain variable region FR2 has a sequence selected from the sequence shown in SEQ ID NO: 54 or 62, or a variant thereof; the light chain variable region FR3 has a sequence selected from the sequence shown in SEQ ID NO: 55 or 63, or a variant thereof; and the light chain variable region FR4 has a sequence selected from the sequence shown in SEQ ID NO: 56 or 64, or a variant thereof.
[0016] In some embodiments, the heavy chain variable region FR1 of the anti-claudin 18.2 antibody comprises a sequence selected from the sequences set forth in SEQ ID NOs: 71, 79, 87, 95, 103, 111, or 119, or a variant thereof; the heavy chain variable region FR2 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 72, 80, 88, 96, 104, 112, or 120, or a variant thereof; the heavy chain variable region FR3 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 73, 81, 89, 97, 105, 113, or 121, or a variant thereof; and the heavy chain variable region FR 4 comprises a sequence selected from the sequences set forth in SEQ ID NOs: 74, 82, 90, 98, 106, 114, or 122, or a variant thereof; the light chain variable region FR1 comprises a sequence selected from SEQ ID NOs: 127 or 135, or a variant thereof; the light chain variable region FR2 comprises a sequence selected from SEQ ID NOs: 128 or 136, or a variant thereof; the light chain variable region FR3 comprises a sequence selected from SEQ ID NOs: 129 or 137, or a variant thereof; and the light chain variable region FR4 comprises a sequence selected from SEQ ID NOs: 130 or 138, or a variant thereof.
[0017] In some embodiments, the variable regions FR1, FR2, FR3, and FR4 of the heavy chain of the anti-claudin 18.2 antibody are a combination of the following sequences: (1) SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7, SEQ ID NO: 8, (2) SEQ ID NO: 13, SEQ ID NO: 14, SEQ ID NO: 15, SEQ ID NO: 16, (3) SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 23, SEQ ID NO: 24, (4) SEQ ID NO: 29, SEQ ID NO: 30, SEQ ID NO: 31, SEQ ID NO: 32, (5) SEQ ID NO: 37, SEQ ID NO: 38, SEQ ID NO: 39, SEQ ID NO: 40, (6) SEQ ID NO: 45, SEQ ID NO: 46, SEQ ID NO: 47, SEQ ID NO: 48, (7) SEQ ID NO: 71, SEQ ID NO: 72, SEQ ID NO: 73, SEQ ID NO: 74, (8) SEQ ID NO: 79, SEQ ID NO: 80, SEQ ID NO: 81, SEQ ID NO: 82, (9) SEQ ID NO: 87, SEQ ID NO: 88, SEQ ID NO: 89, SEQ ID NO: 90, (10) SEQ ID NO: 95, SEQ ID NO: 96, SEQ ID NO: 97, SEQ ID NO: 98, (11) SEQ ID NO: 103, SEQ ID NO: 104, SEQ ID NO: 105, SEQ ID NO: 106, (12) SEQ ID NO: 111, SEQ ID NO: 112, SEQ ID NO: 113, SEQ ID NO: 114, (13) SEQ ID NO: 119, SEQ ID NO: 120, SEQ ID NO: 121, SEQ ID NO: 122; The variable regions FR1, FR2, FR3, and FR4 of the light chain of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 53, SEQ ID NO: 54, SEQ ID NO: 55, SEQ ID NO: 56, (2) SEQ ID NO: 61, SEQ ID NO: 62, SEQ ID NO: 63, SEQ ID NO: 64, (3) SEQ ID NO: 127, SEQ ID NO: 128, SEQ ID NO: 129, SEQ ID NO: 130, (4) Selected from SEQ ID NO: 135, SEQ ID NO: 136, SEQ ID NO: 137, and SEQ ID NO: 138.
[0018] In some embodiments, the variable regions FR1, FR2, FR3, and FR4 of the heavy chain of the anti-claudin 18.2 antibody are a combination of the following sequences: (1) SEQ ID NO: 5, SEQ ID NO: 6, SEQ ID NO: 7, SEQ ID NO: 8, (2) SEQ ID NO: 13, SEQ ID NO: 14, SEQ ID NO: 15, SEQ ID NO: 16, (3) SEQ ID NO: 21, SEQ ID NO: 22, SEQ ID NO: 23, SEQ ID NO: 24, (4) SEQ ID NO: 29, SEQ ID NO: 30, SEQ ID NO: 31, SEQ ID NO: 32, (5) SEQ ID NO: 37, SEQ ID NO: 38, SEQ ID NO: 39, SEQ ID NO: 40, (6) SEQ ID NO: 45, SEQ ID NO: 46, SEQ ID NO: 47, SEQ ID NO: 48; The variable regions FR1, FR2, FR3, and FR4 of the light chain of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 53, SEQ ID NO: 54, SEQ ID NO: 55, SEQ ID NO: 56, (2) Selected from SEQ ID NO: 61, SEQ ID NO: 62, SEQ ID NO: 63, and SEQ ID NO: 64.
[0019] In some embodiments, the variable regions FR1, FR2, FR3, and FR4 of the heavy chain of the anti-claudin 18.2 antibody are a combination of the following sequences: (1) SEQ ID NO: 71, SEQ ID NO: 72, SEQ ID NO: 73, SEQ ID NO: 74, (2) SEQ ID NO: 79, SEQ ID NO: 80, SEQ ID NO: 81, SEQ ID NO: 82, (3) SEQ ID NO: 87, SEQ ID NO: 88, SEQ ID NO: 89, SEQ ID NO: 90, (4) SEQ ID NO: 95, SEQ ID NO: 96, SEQ ID NO: 97, SEQ ID NO: 98, (5) SEQ ID NO: 103, SEQ ID NO: 104, SEQ ID NO: 105, SEQ ID NO: 106, (6) SEQ ID NO: 111, SEQ ID NO: 112, SEQ ID NO: 113, SEQ ID NO: 114, (7) SEQ ID NO: 119, SEQ ID NO: 120, SEQ ID NO: 121, SEQ ID NO: 122; The variable regions FR1, FR2, FR3, and FR4 of the light chain of the anti-claudin 18.2 antibody have the following combination of sequences: (1) SEQ ID NO: 127, SEQ ID NO: 128, SEQ ID NO: 129, SEQ ID NO: 130, (2) Selected from SEQ ID NO: 135, SEQ ID NO: 136, SEQ ID NO: 137, and SEQ ID NO: 138.
[0020] In some embodiments, the variable region of the heavy chain of the anti-claudin 18.2 antibody is selected from the sequence set forth in SEQ ID NO: 1, 9, 17, 25, 33, 41, 67, 75, 83, 91, 99, 107, or 115; The variable region of the light chain of the anti-claudin 18.2 antibody is selected from the sequences set forth in SEQ ID NO: 49, 57, 123, or 131.
[0021] In some embodiments, the variable region of the heavy chain of the anti-claudin 18.2 antibody is selected from the sequence set forth in SEQ ID NO: 1, 9, 17, 25, 33, or 41; The variable region of the light chain of the anti-claudin 18.2 antibody is selected from the sequences set forth in SEQ ID NO: 49 or 57.
[0022] In some embodiments, the variable region of the heavy chain of the anti-claudin 18.2 antibody is selected from the sequence set forth in SEQ ID NO: 67, 75, 83, 91, 99, 107, or 115; The variable region of the light chain of the anti-claudin 18.2 antibody is selected from the sequences set forth in SEQ ID NO: 123 or 131.
[0023] In some embodiments, the heavy chain variable region and the light chain variable region of the anti-claudin 18.2 antibody have a combination of the following sequences: (1) SEQ ID NO: 17 and SEQ ID NO: 57, (2) SEQ ID NO: 41 and SEQ ID NO: 49; (3) SEQ ID NO: 41 and SEQ ID NO: 57, (4) Selected from SEQ ID NO: 115 and SEQ ID NO: 131.
[0024] In some embodiments, the sequences of the heavy chain variable region and light chain variable region of the anti-claudin 18.2 antibody are SEQ ID NO: 41 and SEQ ID NO: 49, respectively.
[0025] In some embodiments, the heavy chain constant region of the anti-claudin 18.2 antibody is selected from the constant region of human IgG (e.g., IgG1, IgG2, IgG3, or IgG4), IgM, IgA, IgD, IgA, or a variant of said constant region, preferably human IgG1; The constant region of the light chain of the anti-claudin 18.2 antibody is selected from a human lambda constant region, a kappa constant region, or a variant of said constant region, preferably a human kappa constant region.
[0026] In some embodiments, the amino acid sequence of the heavy chain of the anti-claudin 18.2 antibody comprises the sequence set forth in SEQ ID NO: 65, or a sequence having greater than 70% identity to SEQ ID NO: 65, e.g., greater than 75%, 80%, 85%, 90%, 95%, 99% identity; The amino acid sequence of the light chain of the anti-claudin 18.2 antibody comprises the sequence set forth in SEQ ID NO: 66, or a sequence having greater than 70% identity to SEQ ID NO: 66, for example, greater than 75%, 80%, 85%, 90%, 95%, or 99% identity.
[0027] In some embodiments, p is 3.0 to 4.0. In some embodiments, p is 3.0 to 3.8.
[0028] In some embodiments, p is 3.0, 3.4, 3.5, or 3.8. In some embodiments, p is 3.8.
[0029] In some embodiments, the cytotoxic agent is selected from the group consisting of SN-38, gemcitabine, monomethyl auristatin E (MMAE), monomethyl auristatin F (MMAF), maytansinoids (e.g., maytansine DM1, maytansine DM4), calicheamicin, MGBA (e.g., duocarmycin), doxorubicin, ricin, diphtheria toxin and other toxins, I131, interleukins, tumor necrosis factors, chemokines, and nanoparticles.
[0030] In some embodiments, the cytotoxic agent is MMAE. The structure of MMAE is:
[0031] [ka]
[0032] In some embodiments, the linker is selected from the group consisting of 6-maleimidohexanoyl (MC), maleimidopropionyl (MP), N-succinimidyl 4-(2-pyridylthio)valerate (SPP), 4-(N-maleimidomethyl)-cyclohexane-1-formyl (MCC), N-succinimidyl (4-iodo-acetyl)aminobenzoate (SIAB), and 6-maleimidocaproyl-valine-citrulline-p-aminobenzyloxycarbonyl (MC-vc-PAB).
[0033] In some embodiments, the linker is 6-maleimidocaproyl-valine-citrulline-p-aminobenzyloxycarbonyl (MC-vc-PAB).
[0034] In some embodiments, LD described in formula I is MC-vc-PAB-MMAE, the structure of which is shown in the following formula:
[0035] [ka]
[0036] In some embodiments, Ab is (a) heavy chain variable regions CDR1, CDR2, CDR3 and light chain variable regions CDR1, CDR2, CDR3, wherein the sequence of the heavy chain variable region CDR1 is set forth in SEQ ID NO: 42, the sequence of the heavy chain variable region CDR2 is set forth in SEQ ID NO: 43, the sequence of the heavy chain variable region CDR3 is set forth in SEQ ID NO: 44, the sequence of the light chain variable region CDR1 is set forth in SEQ ID NO: 50, the sequence of the light chain variable region CDR2 is set forth in SEQ ID NO: 51, and the sequence of the light chain variable region CDR3 is set forth in SEQ ID NO: 52; (b) a heavy chain variable region and a light chain variable region, wherein the sequence of the heavy chain variable region is set forth in SEQ ID NO: 41 and the sequence of the light chain variable region is set forth in SEQ ID NO: 49, and / or (c) a heavy chain and a light chain, wherein the sequence of the heavy chain is set forth in SEQ ID NO: 65 and the sequence of the light chain is set forth in SEQ ID NO: 66; L is MC-vc-PAB, D is MMAE.
[0037] In a second aspect, the present invention provides a composition comprising the antibody-drug conjugate described above, a pharmaceutically acceptable salt, solvate, or solvate of said salt.
[0038] In some embodiments, the composition further comprises a chemotherapy drug known for treating tumors, such as doxorubicin (Adriamycin), cyclophosphamide, a taxane [such as paclitaxel (Taxol), docetaxel (Taxotere)], capecitabine (Xeloda), gemcitabine (Gemzar), vinorelbine (Navelbine), tamoxifen, aromatase inhibitors (Arimidex, Furlong, Arnold New), 5-FU plus leucovorin, irinotecan (Camptosar), oxaliplatin, cisplatin, carboplatin, estramustine, mitoxantrone (Novantrone), prednisone, vincristine (Oncovin), doxorubicin, prednisone, or the like, or a combination thereof.
[0039] In some embodiments, the composition further comprises an immunotherapeutic drug known for treating tumors, such as, for example, a PD-1 monoclonal antibody (such as pembrolizumab or nivolumab), a PD-L1 monoclonal antibody (such as atezolizumab), a TIGIT monoclonal antibody, a 4-1BB monoclonal antibody, a VEGFR2 monoclonal antibody (such as ramucirumab or apatinib), a HER2 monoclonal antibody (such as trastuzumab, a trastuzumab biosimilar, or a trastuzumab-dkst), or the like, or a combination thereof.
[0040] In some embodiments, the composition further comprises an immunosuppressant selected from the following: (1) glucocorticoids such as cortisone and prednisone, (2) microbial metabolites such as cyclosporine and tacrolimus, (3) antimetabolites such as azathioprine and 6-mercaptopurine, (4) polyclonal and monoclonal antilymphocyte antibodies such as antilymphocyte globulin and OKT3, and (5) alkylating agents such as cyclophosphamide. Specific immunosuppressants include, for example, methylprednisolone, prednisone, azathioprine, prograf, xenipra, sule, cyclosporine, tacrolimus, rapamycin, mycophenolate mofetil, mizoribine, cyclophosphamide, and fingolimod.
[0041] In some embodiments, the composition further comprises a pharmaceutically acceptable carrier, diluent, or excipient.
[0042] In a third aspect of the present invention, the present invention provides use of the above-described antibody-drug conjugate, a pharmaceutically acceptable salt, solvate, or solvate of the salt thereof, or the above-described composition in the preparation of a medicament, wherein the medicament is used for the prevention and / or treatment of a disease associated with claudin 18.2.
[0043] In some embodiments, the disease associated with claudin 18.2 is gastric cancer, adenocarcinoma of the gastroesophageal junction, or pancreatic cancer.
[0044] In some embodiments, the claudin 18.2-associated disease is gastric cancer.
[0045] In a fourth aspect of the present invention, the present invention provides a method for preventing and / or treating a disease associated with claudin 18.2, the method comprising the step of administering to a subject in need thereof a prophylactically and / or therapeutically effective amount of the above-described antibody-drug conjugate compound, a pharmaceutically acceptable salt, solvate, or solvate of the salt thereof, or the above-described composition.
[0046] In some embodiments, the disease associated with claudin 18.2 is gastric cancer, adenocarcinoma of the gastroesophageal junction, or pancreatic cancer.
[0047] In some embodiments, the claudin 18.2-associated disease is gastric cancer.
[0048] In a fifth aspect of the present invention, the present invention provides the above-described antibody-drug conjugate, a pharmaceutically acceptable salt, solvate, or solvate of the salt thereof, or the above-described composition, for use in preventing and / or treating a disease associated with claudin18.2.
[0049] In some embodiments, the disease associated with claudin 18.2 is gastric cancer, adenocarcinoma of the gastroesophageal junction, or pancreatic cancer.
[0050] In some embodiments, the claudin 18.2-associated disease is gastric cancer. [Brief explanation of the drawings]
[0051] [Figure 1] 1 shows RT-PCR results of an example of the present invention, showing that stably transfected HEK293 cell lines express claudin 18.1 and claudin 18.2, respectively, and that both the stably transfected HEK293 cell line expressing claudin 18.2 and the control KATO III cells can amplify the characteristic 780 bp band specific to claudin 18.2, while HEK293 expressing claudin 18.1 can only amplify the common 504 bp fragment. [Figure 2] In an example of the present invention, the results of screening stably transfected HEK293 cell lines expressing claudin 18.2 at high levels by FACS are shown. The black dots represent negative controls, and the gray dots represent stably transfected HEK293 cell lines expressing claudin 18.2 at high levels. [Figure 3] In an example of the present invention, the results of screening stably transfected NIH3T3 cell lines expressing high levels of claudin 18.2 by FACS are shown. The black line represents the negative control, the gray shading represents stably transfected 3T3 cell lines expressing claudin 18.2, NO.32-H represents a stably transfected 3T3 cell line expressing high levels of claudin 18.2, NO.18-M represents a stably transfected 3T3 cell line expressing medium levels of claudin 18.2, and NO.6-L represents a stably transfected 3T3 cell line expressing low levels of claudin 18.2. [Figure 4] 1 is a graph showing the results of the ADCC effect of an anti-claudin 18.2 antibody according to an example of the present invention. [Figure 5] 1 is a graph showing the results of the CDC effect of an anti-claudin 18.2 antibody according to an example of the present invention. [Figure 6] 1 is a hydrophobic interaction chromatogram (HIC) of an antibody-drug conjugate according to an example of the present invention. [Figure 7] 1 is a graph showing the results of the cell-killing effect of different CM311 ADCs on the LT-M11 cell line according to an example of the present invention. [Figure 8] 1 is a graph showing the results of the inhibitory activity of CM311-ADC-1 according to an example of the present invention and the control CM311-ADC-2 on tumor growth in a nude mouse PDX model of human gastric cancer, STO#025. [Figure 9] 1 is a graph showing the effect of CM311-ADC-1 according to an example of the present invention and the control CM311-ADC-2 on the body weight of animals in a PDX model of human stomach cancer nude mice STO#025. [Figure 10] 1 is a graph showing the results of the inhibitory activity of CM311-ADC-1 according to an example of the present invention and the control CM311-ADC-2 on tumor growth in a nude mouse PDX model of human gastric cancer, STO#523. [Figure 11]1 is a graph showing the effect of CM311-ADC-1 according to an example of the present invention and the control CM311-ADC-2 on the body weight of animals in a PDX model of human stomach cancer nude mice STO#523. [Figure 12] 1 is a graph showing the results of a comparison of the in vitro cellular activity of an antibody-drug conjugate according to an example of the present invention with an antibody (QC logarithmic transformation independent fitting graph). DETAILED DESCRIPTION OF THE INVENTION
[0052] Specific Embodiments The embodiments of the present invention will be described in detail with reference to the following examples, and those skilled in the art will understand that the following examples are intended to illustrate the present invention and do not limit the scope of the present invention. If no specific conditions are specified in the examples, they are carried out according to conventional conditions or conditions suggested by the manufacturer. If the manufacturer is not specified, the reagents or equipment used are conventional products available on the market.
[0053] In the present invention, unless otherwise specified, the scientific and technical terms used herein have the meanings commonly understood by those skilled in the art.In addition, the terms used herein relating to protein and nucleic acid chemistry, molecular biology, cell and tissue culture, microbiology, immunology, and experimental procedures are terms and conventional procedures widely used in the corresponding fields.Meanwhile, in order to better understand the present invention, the definitions and explanations of relevant terms are provided below.
[0054] Claudin proteins are scaffolding proteins that make up the tight junction structure. They are located on the upper side of the gap between adjacent cells. Their distribution is tissue- and organ-specific. Their main functions are cell-cell adhesion, maintenance of cell polarity, regulation of paracellular permeability, and participation in the regulation of cell proliferation and differentiation. In tumors, the tight junctions between cells are disrupted, and claudins are unable to perform their normal functions.
[0055] Claudin 18 is a member of the claudin family and has two different first exons, which can result in two isoforms, claudin 18.1 and claudin 18.2, due to alternative splicing. These two isoforms are transcribed and amplified in different tissues, with claudin 18.1 primarily expressed in lung tissue and claudin 18.2 specifically expressed in stomach tissue. Claudin 18.2 (GenBank accession number: NM_001002026.3) is not expressed in normal tissues other than gastric mucosa, but is significantly upregulated in various tumors, including 80% of gastrointestinal adenomas, 60% of pancreatic tumors, and some tumors of the bile duct, ovary, and lung.
[0056] The term "claudin 18.2-related disease (or claudin 18.2-associated disease)" refers to a disease in which the expression of claudin 18.2 in tissue cells is different from (e.g., greater than) normal levels. For example, if the expression level of claudin 18.2 in certain tissue cells is higher than the expression level of claudin 18.2 in a reference or control (i.e., normal tissue cells), this indicates the presence of a claudin 18.2-associated disease in the subject (particularly a human) from which the tissue cells were obtained.
[0057] For purposes of the present invention, unless otherwise specified, any numerical range should be understood to include any value or any sub-range contained within that range.
[0058] In the present invention, the term "antibody" generally refers to an immunoglobulin molecule composed of two identical pairs of polypeptide chains, each pair having one "light" (L) chain and one "heavy" (H) chain. Antibody light chains can be divided into two categories: kappa and lambda. Heavy chains can be divided into five types: μ, δ, γ, α, or ε, and antibodies can be divided into five types based on their heavy chains: IgM, IgD, IgG, IgA, and IgE. Within the light and heavy chains, the variable and constant regions are connected by a "J" region of about 12 or more amino acids, and heavy chains also contain a "D" region of about 3 or more amino acids. Each heavy chain contains a heavy chain variable region (V H ) and heavy chain constant region (C H The heavy chain constant region is composed of three domains (C H 1. C H 2, and C H Each light chain consists of a light chain variable region (V L ) and the light chain constant region (C L The light chain constant region consists of one domain, C L The constant regions of the antibody may mediate the binding of the immunoglobulin to host tissues or factors, including various cells of the immune system (e.g., effector cells) and the C1q component of the complement system. H Area and V L The region can be divided into more highly variable regions called complementarity determining regions (CDRs), which are interspersed with more highly conserved regions called framework regions (FRs). H and V L Each of the variable regions (V) of each heavy-light chain pair consists of three CDRs and four FRs, which are arranged in the following order from the amino terminus to the carboxy terminus: FR1, CDR1, FR2, CDR2, FR3, CDR3, FR4. H and V L) form the antibody binding site. The assignment of amino acids to each region or structural domain is according to Kabat's Sequences of Proteins of Immunological Interest (National Institutes of Health, Bethesda, Md. (1987 and 1991)), or Chothia & Lesk (1987) J. Mol. Biol. 196:901-917, Chothia et al. (1989) Nature 342:878-883.
[0059] In the present invention, algorithms for determining sequence identity (homology) and sequence similarity include, for example, the BLAST algorithm and the BLAST 2.0 algorithm, which are described in Altschul et al. (1977) Nucl. Acid. Res. 25:3389-3402 and Altschul et al. (1990) J. Mol. Biol. 215:403-410, respectively. BLAST and BLAST 2.0 can be used to determine the percent identity of the amino acid sequences of the present invention, for example, by using the parameters described in the literature or the default parameters. Software for performing BLAST analysis is publicly available from the National Center for Biotechnology Information.
[0060] In the present invention, an amino acid sequence that has at least 70% sequence identity to a given amino acid sequence includes polypeptide sequences that are substantially identical to the amino acid sequence, for example, those that have at least 70% sequence identity, preferably at least 75%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99% or more sequence identity to a polypeptide sequence of the present invention when measured using methods described herein (e.g., BLAST analysis using standard parameters).
[0061] In the present invention, a variant of an amino acid sequence refers to a sequence that has more than 70% identity with the amino acid sequence, for example, more than 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99%, for example, a sequence in which three, two, or one amino acid has been substituted, deleted, or added. Preferably, no more than three amino acids have been substituted, added, or deleted. More preferably, no more than two amino acids have been substituted, added, or deleted. Most preferably, no more than one amino acid has been substituted, added, or deleted.
[0062] "Substitutional" variants are those in which at least one amino acid residue in a native sequence has been deleted and a different amino acid inserted in its place. The substitutions may be single, where only one amino acid is substituted in the molecule, or multiple, where two or more amino acids are substituted in the same molecule. Multiple substitutions may be made at contiguous positions. Similarly, an amino acid may be replaced by multiple residues, in which case the variant includes both substitutions and insertions. "Insertion" (or "addition") variants are those in which one or more amino acids are inserted at a particular position immediately adjacent to the native sequence. "Immediately adjacent to an amino acid" refers to addition to the alpha-carboxyl or alpha-amino functionality of that amino acid. "Deletional" variants are those in which one or more amino acids in the native amino acid sequence have been removed. Typically, deletion variants have one or two amino acids deleted in a specific region of the molecule.
[0063] In certain embodiments, in the conjugation reaction, fewer drug moieties than the theoretical maximum are bound to the antibody.Generally, antibodies do not contain many free and reactive cysteine thiol groups that can be bound to drug moieties, and in fact, most of the cysteine thiol groups in antibodies exist as disulfide bridges.In certain embodiments, antibodies can be reduced with a reducing agent such as dithiothreitol (DTT) or tris(2-carboxyethyl)phosphine (TCEP) under partial or complete reducing conditions to generate reactive cysteine thiol groups.
[0064] In some embodiments, the pharmaceutically acceptable salt is an inorganic or organic acid salt, wherein the inorganic acid salt is hydrochloride, hydrobromide, hydroiodide, nitrate, bicarbonate, carbonate, sulfate, or phosphate, and the organic acid salt is formate, acetate, propionate, benzoate, maleate, fumarate, succinate, tartrate, citrate, ascorbate, α-ketoglutarate, α-glycerophosphate, alkylsulfonate, or arylsulfonate, preferably, the alkylsulfonate is methanesulfonate or ethanesulfonate, and the arylsulfonate is benzenesulfonate or p-toluenesulfonate.
[0065] Pharmaceutically acceptable salts can be obtained using standard procedures well known in the art, for example, by reacting a sufficient amount of a basic compound with an appropriate acid to provide a pharmaceutically acceptable anion.
[0066] As used herein, unless otherwise specified, the term "prodrug" refers to a compound that may be hydrolyzed, oxidized, or otherwise reacted under biological conditions. "Prodrugs" refers to derivatives that are capable of reacting (in vitro or in vivo) with the compounds of the present invention to provide the compounds of the present invention. Prodrugs become active compounds only when they undergo this reaction under biological conditions and are inactive in their unreacted form. Prodrugs can generally be prepared using well-known methods, such as those described in Burger's Medicinal Chemistry and Drug Discovery (1995) 172-178, 949-982 (Manfred E. Wolff, ed., 5th ed.).
[0067] In the present invention, the term "solvate" refers to the following form of the antibody-drug conjugate according to the present invention: a solid or liquid complex formed by coordination of the antibody-drug conjugate with solvent molecules. A hydrate is a specific form of a solvate having coordinated water molecules. In the present invention, the preferred solvate is a hydrate.
[0068] Methods for preparing various pharmaceutical compositions containing a certain amount of active ingredient are known to those skilled in the art, or will become apparent in light of this disclosure. As described in REMINGTON'S PHARMACEUTICAL SCIENCES (Martin, EW, ed., Mack Publishing Company, 19th ed. (1995)), methods for preparing such pharmaceutical compositions include incorporating suitable pharmaceutical excipients, carriers, diluents, etc. that are not toxic to cells or mammals when exposed at the dosages and concentrations used.
[0069] Pharmaceutical compositions of the present invention may comprise aqueous pH buffered solutions, or alternatively may comprise: buffers such as phosphate, citrate, and other organic acids; antioxidants including ascorbic acid; 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, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates, including glucose, mannose, sucrose, trehalose, or dextrins; chelating agents such as EDTA; sugar alcohols such as mannitol or sorbitol; salt-forming counterions, such as sodium; and / or nonionic surfactants such as TWEN™, polyethylene glycol (PEG), and PLURONICS™.
[0070] The pharmaceutical preparations of the present invention are prepared by known methods, including conventional mixing, dissolving, or lyophilizing techniques. The compounds of the present invention can be prepared in the form of pharmaceutical compositions and administered to patients by various routes appropriate for the chosen mode of administration, for example, orally or parenterally (intravenously, intramuscularly, topically, or subcutaneously).
[0071] Thus, the combination of the compounds of the present invention with a pharmaceutically acceptable carrier (e.g., an inert diluent or an assimilable edible carrier) can be administered systemically, for example, orally. These can be enclosed in hard or soft shell gelatin capsules, which can be compressed into tablets. For oral therapeutic administration, the active compound can be formulated with one or more excipients and taken in the form of swallowable tablets, buccal tablets, lozenges, capsules, elixirs, suspensions, syrups, wafers, and the like. Such compositions and preparations should contain at least 0.1% of the active compound. The percentage of such compositions and preparations can, of course, vary and may range from about 1% to about 99% by weight of a given unit dosage form. In such therapeutically useful compositions, the active compound is in an amount such that an effective dosage level can be obtained.
[0072] Tablets, troches, pills, capsules, and the like may also contain the following: binders such as tragacanth gum, gum arabic, cornstarch, or gelatin; excipients such as dicalcium hydrogen phosphate; disintegrating agents such as cornstarch, potato starch, or alginic acid; lubricants such as magnesium stearate; and sweeteners such as sucrose, fructose, lactose, or aspartame; or flavoring agents such as peppermint, oil of wintergreen, or cherry flavor. When the unit dosage form is a capsule, it may contain, in addition to materials of the type described above, a liquid carrier such as vegetable oil or polyethylene glycol. Various other materials may be present, which may serve as coatings or otherwise modify the physical form of the solid unit dosage form. For example, tablets, pills, or capsules may be coated with gelatin, wax, shellac, and / or sugar. Syrup or elixir may contain active compound, sucrose or fructose as sweetener, methylparaben or propylparaben as preservative, dye, and flavoring (cherry flavor or orange flavor, etc.). Needless to say, any material used in preparing any unit dosage form should be pharmaceutically acceptable and should be substantially non-toxic in the amount used.In addition, active compound may be incorporated into sustained-release preparations and sustained-release devices.
[0073] The active compound may also be administered intravenously or intraperitoneally by infusion or injection.An aqueous solution of the active compound or its salt may be prepared by optionally mixing with a non-toxic surfactant.Also, a dispersion may be prepared in glycerin, liquid polyethylene glycol, triacetin, and mixtures thereof, and in oil.Under normal storage and use conditions, these preparations contain preservatives to prevent the growth of microorganisms.
[0074] Pharmaceutical dosage forms suitable for injection or infusion may include sterile aqueous solutions or dispersions or sterile powders containing the active ingredient (optionally encapsulated in liposomes) that are sterile and suitable for extemporaneous preparation in an injectable or infusible solution or dispersion. In all cases, the ultimate dosage form must be sterile, liquid, and stable under the conditions of manufacture and storage. Liquid carriers can be solvents or liquid dispersion media containing, for example, water, ethanol, polyols (e.g., glycerin, propylene glycol, and liquid polyethylene glycol), vegetable oils, non-toxic glycerides, and suitable mixtures thereof. Proper fluidity can be maintained, for example, by the formation of liposomes, by maintaining the desired particle size in the case of dispersions, or by the use of surfactants. Prevention of microorganisms can be achieved by various antibacterial and antifungal agents, such as parabens, chlorobutanol, phenol, sorbic acid, and thimerosal. In many cases, it is preferable to include isotonic agents, such as sugars, buffers, or sodium chloride. Prolonged absorption of the injectable compositions can be brought about by the use of agents delaying absorption, for example, aluminum monostearate and gelatin.
[0075] Sterile injectable solutions are prepared by incorporating the active compound in the required amount in an appropriate solvent with various other ingredients as described above, as needed, followed by filtration and sterilization. In the case of sterile powders for preparing sterile injectable solutions, the preferred preparation methods are vacuum drying and freeze-drying techniques, which yield a powder of the active ingredient, which was originally in sterile-filtered solution, plus any additional required ingredient.
[0076] Useful solid carriers include pulverized solids (e.g., talc, clay, microcrystalline cellulose, silica, and alumina). Useful liquid carriers include water, ethanol, or ethylene glycol, or water-ethanol / ethylene glycol mixtures, in which the compounds of the present invention can be dissolved or dispersed at effective levels, optionally with the aid of non-toxic surfactants. Properties for a given application can be optimized by adding adjuvants (e.g., fragrances) and additional antimicrobial agents.
[0077] Thickeners (such as synthetic polymers, fatty acids, salts and esters of fatty acids, fatty alcohols, modified cellulose, or modified inorganic materials) can also be used with liquid carriers to form spreadable pastes, gels, ointments, soaps, and the like that can be applied directly to the user's skin.
[0078] The above-described preparations may be in unit dosage form (physically separated units containing a single dosage form suitable for administration to the human and other mammalian body). The unit dosage form may be one capsule or tablet, or multiple capsules or tablets. Depending on the specific treatment involved, the amount of active ingredient in the unit dose may vary or may be adjusted to about 0.1 to about 1000 mg or more.
[0079] Additionally, it includes the application of various novel drug dosage forms such as lacto-liposomes, microspheres, and nanospheres, including the use of particulate dispersion systems including polymeric micelles, nanoemulsions, submicroemulsions, microcapsules, microspheres, liposomes, and niosomes (also known as nonionic surfactant vesicles).
[0080] As used herein, the term "treating" generally refers to obtaining a desired pharmacological and / or physiological effect. The effect may be prophylactic, in terms of complete or partial prevention of a disease or its symptoms, and / or therapeutic, in terms of partial or complete stabilization or cure of the disease and / or disease side effects. As used herein, "treatment" encompasses any treatment for a disease in a patient, including (a) prevention of a disease or condition in a patient who is susceptible to, but has not yet been diagnosed with, the disease or condition, (b) suppression of symptoms of the disease, i.e., prevention of its occurrence, or (c) alleviation of symptoms of the disease, i.e., regression of the disease or condition.
[0081] In the present invention, "subject" refers to a vertebrate. In certain embodiments, a vertebrate refers to a mammal. Mammals include, but are not limited to, livestock (such as cows), pets (such as cats, dogs, and horses), primates, mice, and rats. In certain embodiments, a mammal refers to a human.
[0082] In the present invention, an "effective amount" refers to an amount effective to achieve a desired therapeutic or preventive effect at the necessary dosage and frequency. The "therapeutically effective amount" of a substance / molecule according to the present invention may vary depending on factors such as the disease state, age, sex, and weight of the individual, as well as the ability of the substance / molecule to induce a desired response in the individual. A therapeutically effective amount also encompasses an amount in which any toxic or adverse consequences of the substance / molecule are outweighed by the therapeutically beneficial effects. A "prophylactically effective amount" refers to an amount effective to achieve a desired preventive effect at the necessary dosage and frequency. Usually, but not always, a prophylactically effective amount is less than a therapeutically effective amount because a prophylactic dose is administered to a subject prior to the onset of disease or at an early stage of disease. In the case of cancer, a therapeutically effective amount of a drug reduces the number of cancer cells, reduces the size of a tumor, inhibits (i.e., somewhat slows, preferably stops) the infiltration of cancer cells into surrounding organs, inhibits (i.e., somewhat slows, preferably stops) the metastasis of tumors, somewhat inhibits the growth of tumors, and / or somewhat alleviates one or more symptoms associated with cancer.
[0083] For purposes of the present invention, the twenty conventional amino acids and their abbreviations follow conventional usage. See Immunology—A Synthesis (2nd Edition, E.S. Golub and D.R. Gren, Eds., Sinauer Associates, Sunderland, Mass. (1991)), incorporated herein by reference.
[0084] The term "chimeric antibody" refers to an antibody whose variable region sequences are derived from one species and whose constant region sequences are derived from another species, such as an antibody whose variable region sequences are derived from a murine antibody and whose constant region sequences are derived from a human antibody.
[0085] "Humanized" antibodies refer to non-human (e.g., murine) forms of antibodies, which are chimeric immunoglobulins, immunoglobulin chains, or fragments thereof (e.g., 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 derived from a human immunoglobulin (recipient antibody) in which residues from the complementarity-determining regions (CDRs) of the recipient antibody are substituted by CDR residues from a non-human species (donor antibody) such as mouse, rat, or rabbit having the desired specificity, affinity, and capacity.
[0086] Furthermore, during humanization, amino acid residues within the CDR1, CDR2, and / or CDR3 regions of VH and / or VL may be mutated, thereby improving one or more binding characteristics (e.g., affinity) of the antibody. For example, mutations can be introduced by PCR-mediated mutagenesis, and their effect on antibody binding or other functional properties can be assessed using the in vitro or in vivo assays described herein. Typically, conservative mutations are introduced. Such mutations can be amino acid substitutions, additions, or deletions. Furthermore, typically, no more than one or two mutations are made within one CDR. Thus, the humanized antibodies of the present invention also encompass antibodies with one or two amino acid mutations within one CDR.
[0087] The present invention will be further described below using specific examples, but these examples are not intended to limit the scope of the present invention.
[0088] Example 1 Preparation of humanized antibodies 1. Preparation of Anti-claudin-18.2 Monoclonal Antibody As shown below, multiple strategies were applied simultaneously to immunize Balb / c mice, and screening yielded monoclonal antibodies that specifically bind only to claudin-18.2 but not to claudin-18.1 (an alternative splice variant of claudin-18).
[0089] 1) Construction of a stably transfected cell line expressing claudin 18.2 Claudin18.1-puc57-Amp (SynbioTech), a plasmid containing the full-length gene sequence of human claudin18.1 (UniProtKB-P56856), was synthesized. Using this plasmid as a template, the full-length human claudin18.1 fragment (Met1-Val261) was amplified by PCR using the upstream primer 5'-ttggcaaagaattgctagatgtccaccaccacatgcc-3' (SEQ ID NO: 171) and the downstream primer 5'-tgttcgggccctcctcgattacacatagtcgtgcttgg-3' (SEQ ID NO: 172). The amplified product was enzymatically purified using the NEBuilder HiFi DNA Assembly Kit. The fragments were ligated using Master Mix (NEB, Cat: M0530L) and then cloned into a eukaryotic expression plasmid system. Similarly, a plasmid containing the full-length gene sequence of human claudin18.2 (UniProtKB-P56856-2), claudin18.2-puc57-Amp (SynbioTech), was synthesized. Using this plasmid as a template, the full-length human claudin18.2 fragment (Met1-Val261) was amplified by PCR using the upstream primer 5'-ttggcaaagaattgctagatggccgtgactgcctgtc-3' (SEQ ID NO: 173) and the downstream primer 5'-tgttcgggccctcctcgattacacatagtcgtgcttgg-3' (SEQ ID NO: 174). The amplified product was enzymatically ligated using NEBuilder HiFi DNA Assembly Master Mix (NEB, Cat. No.: M0530L) and then cloned into a eukaryotic expression plasmid system. The plasmid was electroporated into NIH3T3 cells and HEK293 cells, respectively, and stable expression cell lines were obtained by stepwise pressure screening using 1-10 μg / mL puromycin (Gibco, Cat. No.: A1113803).
[0090] The stably transfected HEK293 cell lines expressing claudin 18.1 and claudin 18.2 were first verified by RT-PCR. Total RNA was extracted from positive cell clones using a Trizol RNA extraction kit, and a cDNA library was obtained by reverse transcription with an oligo(dT) primer using a SuperScript™ First-Strand Synthesis System reverse transcription kit (Cat. No. 18080051). Because the two splice fragments of claudins, claudin 18.1 and claudin 18.2, differ in the region from the N-terminus to the first extracellular domain (loop 1), primers KNB14 (5'-tgtgcgccaccatggccgtg-3' (SEQ ID NO: 175)) and KNB15 (5'-tggaaggataagattgtacc-3' (SEQ ID NO: 176)) were designed to amplify the region from loop 1 to the C-terminus (504 bp) of claudin 18.1 and claudin 18.2 (excluding loop 1). Primer KNB16 (5'-tgggtgccattggcctcctg-3' (SEQ ID NO: 177)) was designed to specifically and complementarily bind to the N-terminus of claudin 18.2 but not to the N-terminus of claudin 18.1. These primers were used to amplify only the full-length fragment (780 bp) from the N-terminus to the C-terminus of claudin 18.2. III cells (ATCC HTB-103) was used as a positive control. As shown in Figure 1, RT-PCR demonstrated that the stably transfected HEK293 cell lines expressed claudin 18.1 and claudin 18.2, respectively. Both the stably transfected HEK293 cell line expressing claudin 18.2 and the control KATO III cells were able to amplify the characteristic band at 780 bp specific to claudin 18.2, while the HEK293 expressing claudin 18.1 was able to amplify only the common fragment at 504 bp.
[0091] Stably transfected cell lines, HEK293 cells expressing claudin 18.2 and NIH3T3 cells expressing claudin 18.2, were digested, collected, washed twice with PBS, and incubated with 100 μL of 1:200 diluted rabbit anti-claudin 18.2 primary antibody (Abcam, EPR19202, Cat: ab222512) at 4°C for 60 minutes. Excess primary antibody solution was removed by washing with 0.5% BSA / PBS, and 50 μL of goat anti-rabbit IgGFc-AF647 secondary antibody (Jackson ImmunoResearch, Cat: 111-606-046) was added and incubated at 4°C for 45 minutes. Excess secondary antibody was removed by washing with 0.5% BSA / PBS, and finally, the cells were resuspended in 100 μL of PBS solution and immediately detected by flow cytometry. The results are shown in Figures 2 and 3.
[0092] Figure 2 shows the results of FACS analysis of the stably transfected cell line HEK293-claudin18.2, which was transfected with the full-length claudin18.2 gene. Black dots represent untransfected HEK293 cells, and gray dots represent stably transfected HEK293 cells expressing claudin18.2. HEK293 cells do not express claudin18.2, while the stably transfected HEK293-claudin18.2 cells highly express claudin18.2 on the cell surface.
[0093] Figure 3 shows the results of FACS detection of claudin 18.2 in stably transfected NIH3T3 cell lines expressing high levels of claudin 18.2. The black line represents the negative control, and the gray shading represents stably transfected 3T3 cell lines expressing claudin 18.2. NO.32-H represents a stably transfected 3T3 cell line expressing high levels of claudin 18.2, NO.18-M represents a stably transfected 3T3 cell line expressing intermediate levels of claudin 18.2, and NO.6-L represents a stably transfected 3T3 cell line expressing low levels of claudin 18.2.
[0094] Positive stably transfected cell line outgrowths were collected and frozen, and animals were immunized with a stably transfected NIH3T3 cell line expressing claudin-18.2.
[0095] 2) Preparation of anti-claudin 18.2 monoclonal antibodies from hybridomas Six- to eight-week-old female Balb / c mice were immunized with stably transfected 3T3 cells expressing claudin 18.2 or a plasmid encoding claudin 18.2, or alternately with 1 × 10 3T3 cells stably transfected with claudin 18.2. 6 Each time, 100 μg of plasmid was mixed with Freund's adjuvant or non-Freund's adjuvant and then injected into the base of the thigh and footpad, and immunization was performed again at a different site two weeks later. When DNA was used for immunization, 20 μg of plasmid was mixed with 1 μg of CpG and then injected directly into the abdomen of the mouse using a gene gun (Biorad) at 40 psi. Immunization was performed once a week. Three days before fusion, 1 × 10 cells per mouse were transfected using a stably transfected HEK293 cell line that expresses high levels of claudin 18.2. 6Pulse immunization was performed by injecting 50 μL of each antibody into the tail vein. Three days later, the mice were sacrificed, and popliteal, inguinal, and iliac lymph nodes were harvested and crushed in DMEM to obtain a B cell-enriched suspension. The spleens were excised, crushed in DMEM, and centrifuged to obtain a spleen cell suspension. An appropriate volume of the lymph node and spleen cell suspension mixture was mixed with SP2 / 0, and the cells were fused using an electrofusion device.
[0096] 3) Construction of an anti-claudin 18.2 phage antibody library Total RNA was extracted from a portion of the mouse spleen and peripheral lymph node cell suspension using a Trizol RNA extraction kit. Reverse transcription was performed using a reverse transcription kit (SuperScript First-Strand Synthesis System, Cat. No. 18080051) with light- and heavy-chain-specific primers to generate antibody light and heavy chain cDNA libraries. Using this cDNA library as a template, antibody light and heavy chain variable region fragments were amplified by PCR using light and heavy chain variable region primers. After enzymatic digestion, the PCR products were cloned into phage plasmid vectors containing the human antibody light chain constant region C kappa or the human IgG1 heavy chain constant region CH1 to form chimeric light and heavy chain libraries, respectively. The antibody fragments in the light chain library were double-digested with BspQI and SfiI and then ligated into the heavy chain library to generate a library with a capacity of 1.2 x 10 , based on the filamentous phage M13. 10 A mouse chimeric Fab phage display library was constructed. The phage (titer: approximately 1 × 10 13 0.8 mL of the solution (1 × 10 / mL) was mixed with 200 μL of 5% BSA / PBS and transfected with 1 × 10 HEK293 cells expressing claudin 18.1. 7 The mixture was placed in an ice bath for 1 hour, centrifuged at 1,000 rpm for 10 minutes, and the collected supernatant was incubated with 1 x 10 cells expressing claudin 18.2 in a 2000 ml tube. 6The cells were mixed with 1000 mM TEA, incubated in an ice bath for 1 hour, and centrifuged at 1000 rpm for 3 minutes. The supernatant was discarded, and the mixture was washed 5 to 10 times with 1 mL of 1% BSA / PBS. The cells were lysed with 1 mL of 100 mM TEA and incubated at room temperature for 10 minutes. After neutralization with 0.5 mL of 1 M Tris-HCl (pH 7.5), the phage was infected with 10 mL of logarithmic-phase TG1 E. coli at 37°C for 30 minutes. The phage was recovered and titered according to conventional molecular biology procedures, and the next round of panning was performed.
[0097] 2. Screening and Sequence Acquisition of Anti-Claudin-18.2 Specific Antibodies Claudin 18.1-expressing HEK293 cells, claudin 18.2-expressing HEK293 cells, and HEK293 cells were pre-stained with Cell Tracker Green CMFDA Dye (Thermo, Cat. No.: C2925) at 5 μM, 0.5 μM, and 0 μM, respectively, according to the manufacturer's instructions for live cell staining. After removing the dye by washing, the cells were mixed at a 1:1:1 ratio and added to a 96-well plate (2 × 10 cells). 5The cells were incubated in an ice bath for 1 hour with hybridoma supernatant or supernatant from bacterial induction (100 cells / well). AlexaFluro647-labeled anti-mouse IgG Fc or anti-human IgG F(ab)'2 secondary antibodies (Jackson ImmunoResearch) were added and incubated on ice for 45 minutes. After washing, 100 μL of PBS was added to each well to resuspend the cells. The cells were analyzed using a flow cytometer (iQue Screener). Three distinct cell populations were circled according to the difference in fluorescence intensity in the FL2 channel, and the binding of the tested antibodies to each cell population was then detected in the FL4 channel. The selected antibodies bound with high affinity and specificity to stably transfected HEK293 cells expressing claudin-18.2, but not to stably transfected HEK293 cells expressing claudin-18.1 or HEK293 cells. A total of 320 clones were selected from the hybridoma cells by FACS, and these 320 clones were able to bind to claudin 18.2 but not to claudin 18.1. After three rounds of panning, 62 clones were selected from the phage Fab library, and these 62 clones bound to claudin 18.2 with high affinity but not to claudin 18.1.
[0098] Plasmids were extracted from positive clones selected from the phage library and sequenced. The variable region sequences were then cloned into heavy and light chain constant region vectors, respectively, to express full-length IgG. Positive cells from hybridomas were lysed by adding 1 mL of TRNzol, and total RNA was extracted using the guanidine thiocyanate method. First-strand cDNA was synthesized using this as a template, and the DNA sequences of the variable regions corresponding to the hybridoma cells were then amplified using this first-strand cDNA as a template. After sequencing the amplification products, the heavy and light chain variable region sequences of the candidate hybridomas were obtained, as shown below.
[0099] Clone 18D10: heavy chain
[0100] [ka]
[0101] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 140), CDR2 (SEQ ID NO: 141), and CDR3 (SEQ ID NO: 142), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 143), FR2 (SEQ ID NO: 144), FR3 (SEQ ID NO: 145), and FR4 (SEQ ID NO: 146), respectively.
[0102] Nucleic acid sequence
[0103] [ka]
[0104] Light chain
[0105] [ka]
[0106] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 148), CDR2 (SEQ ID NO: 149), and CDR3 (SEQ ID NO: 150), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 151), FR2 (SEQ ID NO: 152), FR3 (SEQ ID NO: 153), and FR4 (SEQ ID NO: 154), respectively.
[0107] Nucleic acid sequence
[0108] [ka]
[0109] Clone 18A9: heavy chain
[0110] [ka]
[0111] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 156), CDR2 (SEQ ID NO: 157), and CDR3 (SEQ ID NO: 158), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 159), FR2 (SEQ ID NO: 160), FR3 (SEQ ID NO: 161), and FR4 (SEQ ID NO: 162), respectively.
[0112] Nucleic acid sequence
[0113] [ka]
[0114] Light chain
[0115] [ka]
[0116] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 164), CDR2 (SEQ ID NO: 165), and CDR3 (SEQ ID NO: 166), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 167), FR2 (SEQ ID NO: 168), FR3 (SEQ ID NO: 169), and FR4 (SEQ ID NO: 170), respectively.
[0117] Nucleic acid sequence
[0118] [ka]
[0119] The heavy and light chain variable region sequence fragments described above were amplified by PCR, and the heavy chain variable region was cloned into a vector containing a human heavy chain constant region to express a complete IgG1 heavy chain in mammalian cells. Similarly, the light chain variable region was cloned into a vector containing a human light chain constant region to express a complete kappa light chain in mammalian cells. After sequence verification, these were transfected into HEK293-6E mammalian cells to express and secrete IgG1 into the culture medium. The supernatant was collected, filtered, and then purified. IgG was purified by protein A chromatography. The culture supernatant was loaded onto an appropriately sized protein A column, washed with 50 mM Tris-HCl (pH 8.0), 250 mM NaCl, and the bound IgG was eluted with 0.1 M glycine-HCl (pH 3.0). The protein was concentrated by ultrafiltration using a concentration tube (Millipore), and the IgG concentration was determined by spectrophotometric detection of OD280. The purity of the IgG was analyzed by SDS-PAGE.
[0120] Claudin 18.1-expressing HEK293 cells, claudin 18.2-expressing HEK293 cells, and HEK293 cells were collected in the logarithmic growth phase, digested, and then cultured at 5 × 10 cells. 4100 μL of each antibody was added to a U-shaped 96-well plate and centrifuged at 1100 rpm for 3 minutes, after which the supernatant was discarded. Cells were gently tapped, and 50 μL of serially diluted antibody was added to each well (antibody concentration starting from 100 nM, 5-fold dilutions, 8 gradients) and incubated for 1 hour at 4°C. After incubation, 140 μL of 0.5% BSA was added to each well and washed three times. AlexaFluro647 anti-human IgG secondary antibody (Jackson ImmunoResearch, Cat: 109-606-170) was added at 30 μL / well and incubated for 40 minutes at 4°C. After incubation, 140 μL of 0.5% BSA was added to each well and washed three times. Finally, each well was resuspended in 50 μL of PBS and detected by flow cytometry (iQue Screener). As shown in Table 1, the results indicate that the obtained chimeric claudin 18.2 IgG1 antibody recognizes only HEK293 cells expressing claudin 18.2 transfected with the claudin 18.2 gene, but does not bind to HEK293 or HEK293 cells expressing claudin 18.1.
[0121] [Table 1]
[0122] 3. Humanization of anti-claudin-18.2 antibodies The variable region sequences of selected monoclonal antibodies were aligned with human germline antibody sequences to find sequences with high homology for CDR grafting. Subsequently, in silico homology modeling was performed to analyze the amino acid sequences of the CDR regions and their surrounding frameworks to examine their spatial and three-dimensional binding patterns. Electrostatic, van der Waals, hydrophobic, and entropy values were calculated to identify key amino acid residues in each positive monoclonal antibody gene sequence that could interact with the target and maintain the spatial framework. Backmutation sites were designed accordingly. HLA-DR affinity was analyzed to select human germline framework sequences with relatively low immunogenicity. Amino acid residues that could undergo denaturation during fermentation were analyzed, and mutations to reduce the likelihood of denaturation were designed.
[0123] Different heavy and light chain derivatives were designed. The full sequences of the light and heavy chain derivatives were synthesized and then cloned into vectors containing the antibody kappa chain constant region Ckappa or the human IgG1 constant regions CH1-CH3. Plasmids containing the light and heavy chain derivatives from the same parent were paired, transfected into HEK293.6E cells, and the antibodies were expressed for 5-6 days. The supernatants were collected and purified on a protein A column.
[0124] The sequence of the humanized antibody is as follows: 18D10: Heavy chain variable region: 18D10VHv1:
[0125] [ka]
[0126] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 2), CDR2 (SEQ ID NO: 3), and CDR3 (SEQ ID NO: 4), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO:5), FR2 (SEQ ID NO:6), FR3 (SEQ ID NO:7), and FR4 (SEQ ID NO:8), respectively.
[0127] Nucleic acid sequence
[0128] [ka]
[0129] 18D10VHv2:
[0130] [ka]
[0131] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 10), CDR2 (SEQ ID NO: 11), and CDR3 (SEQ ID NO: 12), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 13), FR2 (SEQ ID NO: 14), FR3 (SEQ ID NO: 15), and FR4 (SEQ ID NO: 16), respectively.
[0132] Nucleic acid sequence
[0133] [ka]
[0134] 18D10VHv3:
[0135] [ka]
[0136] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 18), CDR2 (SEQ ID NO: 19), and CDR3 (SEQ ID NO: 20), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 21), FR2 (SEQ ID NO: 22), FR3 (SEQ ID NO: 23), and FR4 (SEQ ID NO: 24), respectively.
[0137] Nucleic acid sequence
[0138] [ka]
[0139] 18D10VHv4:
[0140] [ka]
[0141] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 26), CDR2 (SEQ ID NO: 27), and CDR3 (SEQ ID NO: 28), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 29), FR2 (SEQ ID NO: 30), FR3 (SEQ ID NO: 31), and FR4 (SEQ ID NO: 32), respectively.
[0142] Nucleic acid sequence
[0143] [ka]
[0144] 18D10VHv5:
[0145] [ka]
[0146] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 34), CDR2 (SEQ ID NO: 35), and CDR3 (SEQ ID NO: 36), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 37), FR2 (SEQ ID NO: 38), FR3 (SEQ ID NO: 39), and FR4 (SEQ ID NO: 40), respectively.
[0147] Nucleic acid sequence
[0148] [ka]
[0149] 18D10VHv6:
[0150] [ka]
[0151] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 42), CDR2 (SEQ ID NO: 43), and CDR3 (SEQ ID NO: 44), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 45), FR2 (SEQ ID NO: 46), FR3 (SEQ ID NO: 47), and FR4 (SEQ ID NO: 48), respectively.
[0152] Nucleic acid sequence
[0153] [ka]
[0154] Light chain variable region: 18D10VLv1:
[0155] [ka]
[0156] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 50), CDR2 (SEQ ID NO: 51), and CDR3 (SEQ ID NO: 52), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 53), FR2 (SEQ ID NO: 54), FR3 (SEQ ID NO: 55), and FR4 (SEQ ID NO: 56), respectively.
[0157] Nucleic acid sequence
[0158] [ka]
[0159] 18D10VLv2:
[0160] [ka]
[0161] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 58), CDR2 (SEQ ID NO: 59), and CDR3 (SEQ ID NO: 60), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 61), FR2 (SEQ ID NO: 62), FR3 (SEQ ID NO: 63), and FR4 (SEQ ID NO: 64), respectively.
[0162] Nucleic acid sequence
[0163] [ka]
[0164] The sequence of a preferred humanized antibody is as follows: Heavy chain amino acid sequence:
[0165] [ka]
[0166] Heavy chain nucleic acid sequence
[0167] [ka]
[0168] Light chain amino acid sequence:
[0169] [ka]
[0170] Light chain nucleic acid sequence
[0171] [ka]
[0172] 18A9: Heavy chain variable region: 18A9VHv1:
[0173] [ka]
[0174] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 68), CDR2 (SEQ ID NO: 69), and CDR3 (SEQ ID NO: 70), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 71), FR2 (SEQ ID NO: 72), FR3 (SEQ ID NO: 73), and FR4 (SEQ ID NO: 74), respectively.
[0175] Nucleic acid sequence
[0176] [ka]
[0177] 18A9VHv2:
[0178] [ka]
[0179] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 76), CDR2 (SEQ ID NO: 77), and CDR3 (SEQ ID NO: 78), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 79), FR2 (SEQ ID NO: 80), FR3 (SEQ ID NO: 81), and FR4 (SEQ ID NO: 82), respectively.
[0180] Nucleic acid sequence
[0181] [ka]
[0182] 18A9VHv3:
[0183] [ka]
[0184] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 84), CDR2 (SEQ ID NO: 85), and CDR3 (SEQ ID NO: 86), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 87), FR2 (SEQ ID NO: 88), FR3 (SEQ ID NO: 89), and FR4 (SEQ ID NO: 90), respectively.
[0185] Nucleic acid sequence
[0186] [ka]
[0187] 18A9VHv4:
[0188] [ka]
[0189] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 92), CDR2 (SEQ ID NO: 93), and CDR3 (SEQ ID NO: 94), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 95), FR2 (SEQ ID NO: 96), FR3 (SEQ ID NO: 97), and FR4 (SEQ ID NO: 98), respectively.
[0190] Nucleic acid sequence
[0191] [ka]
[0192] 18A9VHv5:
[0193] [ka]
[0194] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 100), CDR2 (SEQ ID NO: 101), and CDR3 (SEQ ID NO: 102), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 103), FR2 (SEQ ID NO: 104), FR3 (SEQ ID NO: 105), and FR4 (SEQ ID NO: 106).
[0195] Nucleic acid sequence
[0196] [ka]
[0197] 18A9VHv6:
[0198] [ka]
[0199] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 108), CDR2 (SEQ ID NO: 109), and CDR3 (SEQ ID NO: 110), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 111), FR2 (SEQ ID NO: 112), FR3 (SEQ ID NO: 113), and FR4 (SEQ ID NO: 114), respectively.
[0200] Nucleic acid sequence
[0201] [ka]
[0202] 18A9VHv7:
[0203] [ka]
[0204] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 116), CDR2 (SEQ ID NO: 117), and CDR3 (SEQ ID NO: 118), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 119), FR2 (SEQ ID NO: 120), FR3 (SEQ ID NO: 121), and FR4 (SEQ ID NO: 122), respectively.
[0205] Nucleic acid sequence
[0206] [ka]
[0207] Light chain variable region: 18A9VLv1:
[0208] [ka]
[0209] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 124), CDR2 (SEQ ID NO: 125), and CDR3 (SEQ ID NO: 126), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 127), FR2 (SEQ ID NO: 128), FR3 (SEQ ID NO: 129), and FR4 (SEQ ID NO: 130), respectively.
[0210] Nucleic acid sequence
[0211] [ka]
[0212] 18A9VLv2:
[0213] [ka]
[0214] In this, the underlined portions are, from left to right, CDR1 (SEQ ID NO: 132), CDR2 (SEQ ID NO: 133), and CDR3 (SEQ ID NO: 134), respectively. The non-underlined portions are, from left to right, FR1 (SEQ ID NO: 135), FR2 (SEQ ID NO: 136), FR3 (SEQ ID NO: 137), and FR4 (SEQ ID NO: 138), respectively.
[0215] Nucleic acid sequence
[0216] [ka]
[0217] Example 2 Pharmacological studies on humanized antibodies 1. Humanized antibody affinity (EC 50 ) determination Logarithmically growing cells were collected, blocked with 3% BSA for 30 min, and plated in a U-shaped 96-well plate with 5 × 10 cells. 4The cells were seeded at a density of 100 μL per well. The plate was centrifuged at 1100 rpm for 3 minutes, and the supernatant was discarded. The plate was gently tapped to dissociate the cells, and 50 μL of serially diluted antibody (antibody concentration starting from 100 nM, 8 5-fold dilutions) was added to each well and incubated at 4°C for 1 hour. After incubation, 140 μL of 0.5% BSA was added to each well, and the wells were washed three times. AF 647 / APC anti-human secondary antibody was added at 30 μL / well and incubated for 40 minutes at 4° C. After incubation, 140 μL of 0.5% BSA was added to each well and washed three times. Finally, the cells in each well were resuspended in 50 μL of PBS and subjected to FACS analysis using iQue (Intellicyt, USA) (see Table 2).
[0218] [Table 2]
[0219] 2. ADCC killing activity of CM311 antibody against tumor cells Thirty milliliters of fresh blood was taken into a 50-mL centrifuge tube, 15 mL of 1x PBS was added, and the mixture was mixed well. This mixture was then slowly added to a centrifuge tube containing 20 mL of Ficoll-Paque Plus, allowing the blood to spread over the surface of the Ficoll-Paque Plus. The tubes were centrifuged at 2000 rpm for 30 minutes at 20°C, the top serum was discarded, and the buffy coat (i.e., PBMCs) was absorbed and divided into 50-mL centrifuge tubes, 10 mL per tube. At least 30 mL of 1x PBS was added to each tube and mixed well. The tubes were centrifuged at 1300 rpm for 10 minutes at 4°C, the supernatant was discarded, and the tubes were rinsed with 10 mL of 1x PBS and counted.
[0220] The cells were resuspended in FBS / RPMI 1640 medium and cultured for 2 hours at 37°C and 5% CO. The medium was centrifuged at 1300 rpm for 10 minutes, the supernatant was discarded, and the cells were resuspended in FBS / RPMI 1640 medium and plated at 4 x 10 cells per well in a U-shaped 96-well plate. 5 The plates were seeded with 50 μL of cells / well. The 18D10 chimera, 18A9 chimera, anti-claudin 18.2 humanized antibodies 18D10 and 18A9 (i.e., CM311; CM311 is a collective term for the humanized antibodies 18D10 and 18A9), and a control anti-KLH antibody were diluted (40, 20, 10, 5, 2.5, and 1.25 μg / mL) and added at 25 μL / well. The plates were incubated at 37°C and 5% CO for 30 minutes. The plates were then removed and KATO III cells were added at a density of 8 × 10 cells. 3 25 μL / well of target cells were added. The plate was incubated at 37°C with 5% CO2 for 3.5 hours. 2 μL of 10x lysis buffer was added to wells with maximum target cell release, and incubation was continued for 30 minutes at 37°C with 5% CO2. The plate was removed and centrifuged at 1000 rpm for 3 minutes, and the supernatant was transferred to a black ELISA plate at 50 μL / well. 50 μL / well of LDH detection substrate was added and incubated at room temperature for 10 minutes. 25 μL / well of stop solution was added to stop the reaction. OD (optical density) was measured using a microplate reader (Biotek).
[0221] The results are calculated as follows: % Cell Killed = (OD 実験 -OD コントロール放出 ) / (OD 最大放出 -OD コントロー ル放出 )×100% As shown in Figure 4, the anti-claudin 18.2 humanized antibodies 18D10 and 18A9 have strong ADCC activity.
[0222] 3.CDC cell-killing activity of CM311 antibody against tumor cells KATO III cells in the logarithmic growth phase were cultured at 1 × 10 cells. 7 The cells were resuspended at 1 × 10 cells / mL. CFSE (Sigma, 87444-5MG-F) was added to a final concentration of 1 μM. The reaction was stopped by adding 3 volumes of medium after incubation at room temperature for 10 minutes. The cells were centrifuged at 1000 rpm at 4°C for 5 minutes, the supernatant was discarded, and the cells were resuspended in medium. The cells were plated at 1 × 10 cells / mL in a 96-well plate. 5 Cells were seeded at 50 μL per well. Dilutions of the 18D10 chimera, 18A9 chimera, anti-claudin 18.2 humanized antibodies 18D10 and 18A9 (CM311), and a control anti-KLH antibody (dilutions of 30, 10, 3.33, 1.11, and 0.37 μg / mL) were added at 50 μL per well. Complement was diluted to 30% with medium and added to the plate at 50 μL per well. The plate was incubated at 37°C and 5% CO2 for 2 hours, centrifuged at 1000 rpm for 3 minutes, and the supernatant was discarded. PI staining solution (1:200 dilution) was mixed with sulfate latex (Invitrogen, S37227) and then added to the 96-well plate at 100 μL per well. After incubation on ice for 10 minutes, the cells were analyzed by FACS. As shown in Figure 5, the anti-claudin 18.2 humanized antibodies 18D10 and 18A9 have strong CDC activity.
[0223] Example 3 Preparation and Analysis of Antibody-Drug Conjugates 1. Preparation of Antibody-drug Conjugates For 10 mg of CM311 antibody, the buffer was exchanged into reducing buffer (25 mM sodium borate, pH 8.0, 25 mM NaCl, 5 mM EDTA) using a 15 mL 30 KD ultrafiltration device three times to a final volume of approximately 1 mL. The solution was transferred to a new pre-weighed Eppendorf centrifuge tube, weighed, and the protein concentration was measured to calculate the total protein content. A 2.5-fold molar amount of DTT was added to the antibody and incubated at room temperature for 2 hours with constant mixing. The mixture was then buffer exchanged into binding buffer (50 mM Tris, pH 7.2, 150 mM NaCl, 5 mM EDTA) using a 15 mL 30 KD ultrafiltration device three times. The solution was aliquoted, measured at A280 to determine the protein concentration, weighed, and the total protein content was calculated. A 10 μL sample was then aliquoted and analyzed by Ellman's method to determine the number of free thiol groups.
[0224] Furthermore, the molar concentration of the free thiol groups was calculated using the following formula.
[0225]
number
[0226] b: Cuvette path length (typically 1 cm). The number of moles of free thiol groups was calculated from the molar concentration of free thiol groups and the volume of the total protein solution.
[0227] To the reduced antibody, vc-MMAE (i.e., MC-vc-PAB-MMAE) (dissolved in DMSO) was added in an amount equivalent to 1.1 times the molar number of free thiol groups, and the mixture was allowed to react for 2 hours at room temperature with occasional mixing. N-acetylcysteine was added in an amount equivalent to 20 times the molar number of vc-MMAE (i.e., MC-vc-PAB-MMAE) in the reaction solution, and the mixture was allowed to stand for 5 minutes. The mixture's buffer was exchanged three times with a conjugate storage solution (20 mM histidine, 3% sucrose, 0.03% Tween-80, pH 5.5) using a 15 ml 30 kD ultrafiltration device. The resulting antibody-drug conjugate product, anti-claudin-18.2-ADC (a term used to refer collectively to antibody-drug conjugates prepared from humanized antibodies 18D10 or 18A9), was stored at 4°C.
[0228] 2. Determining the DAR of antibody-drug conjugates The drug content (drug-antibody ratio, DAR) of this antibody-drug conjugate was determined by hydrophobic interaction chromatography (HIC-HPLC).
[0229] The HIC profile of a typical antibody-drug conjugate, CM311-18D10-VH6 / VL1-ADC, is shown in Figure 6. Based on the peak areas of this profile, the average DAR was 3.8.
[0230] Similarly, the antibody-drug conjugate CM311-18D10-VH3 / VL2-ADC had a mean DAR of 3.5.
[0231] The mean DAR for the antibody-drug conjugate CM311-18D10-VH6 / VL2-ADC was 3.4.
[0232] The mean DAR for the antibody-drug conjugate CM311-18A9-VH7 / VL2-ADC was 3.0.
[0233] It is worth noting that the name of the antibody-drug conjugate described above, CM311-18D10-VH6 / VL1-ADC, indicates that the antibody used in preparing the antibody-drug conjugate is CM311-18D10-VH6 / VL1. Furthermore, the antibody name, CM311-18D10-VH6 / VL1, indicates that the antibody used in preparing the antibody-drug conjugate described above is of the 18D10 antibody class, with a heavy chain variable region of VHv6 and a light chain variable region of VLv1. As can be seen from Table 2 above, the specific antibody used in preparing the antibody-drug conjugate described above is h18D10.v16. The names of the remaining three antibody-drug conjugates, CM311-18D10-VH3 / VL2-ADC, CM311-18D10-VH6 / VL2-ADC, and CM311-18A9-VH7 / VL2-ADC, can also be understood in accordance with the above description. Specifically, the specific antibody used in the preparation of antibody-drug conjugate CM311-18D10-VH3 / VL2-ADC is h18D10.v23 in Table 2, the specific antibody used in the preparation of antibody-drug conjugate CM311-18D10-VH6 / VL2-ADC is h18D10.v26 in Table 2, and the specific antibody used in the preparation of antibody-drug conjugate CM311-18A9-VH7 / VL2-ADC is h18A9.v27 in Table 2.
[0234] Example 4 Pharmacodynamic studies of antibody drug conjugates in vitro After passage 1-2 times, the recovered cell lines were first pipetted into a 15 mL centrifuge tube, centrifuged, and discarded. The cell culture flask was then rinsed with 5 mL of PBS and digested with 2 mL of trypsin-EDTA. The cells were then resuspended in medium in the same 15 mL centrifuge tube, centrifuged, discarded, and resuspended in medium. 0.5 mL of the suspension was then counted using a cell counter. Cells were seeded onto 96-well cell culture plates (LT-1C8 cells at 5,000 or 10,000 cells / well, LT-M11 cells at 5,000 cells / well, and BxPC-3 at 3,000 cells / well) and cultured for 24 hours. After incubation, serially diluted CM311 ADC antibody-drug conjugates (conjugated to different CM311 monoclonal antibodies) were added and incubated for 96 hours. CCK-8 or Presto-Blue detection reagent was then added to each well, and the cells were detected using a microplate reader with four-parameter fitting.
[0235] Experimental reagents and suppliers: Goods
[0236] [Table 3]
[0237] cell line
[0238] [Table 4]
[0239] Test Results: Each CM311 ADC IC 50 The mean values are shown in Table 3. Figure 7 is a representative graph of the cell killing effect of different CM311 ADCs on LT-M11 cells.
[0240] [Table 5]
[0241] Note: In Figure 7, Sample 1: CM311-18D10-VH3 / VL2-ADC Sample 2: CM311-18D10-VH6 / VL1-ADC Sample 3: CM311-18D10-VH6 / VL2-ADC Sample 4: CM311-18A9-VH7 / VL2-ADC As can be seen from the results in Table 3 and Figure 7, different CM311 ADCs exhibited significant cell killing activity in moderately and highly expressing claudin-18.2 cell lines, but did not exhibit significant cell killing activity in the claudin-18.2-negative BxPC-3 cell line.
[0242] Example 5 Pharmacodynamic studies of antibody drug conjugates in vivo The antitumor activity of CM311ADC was tested in two gastric cancer PDX models (STO#025 and STO#523), both of which had relatively high levels of claudin-18 mRNA.
[0243] The process of establishing a PDX model of human gastric cancer in nude mice was as follows: a volume of approximately 15–30 mm 3 The tumor tissue was subcutaneously transplanted into the back of BALB / c nude mice. 3Once tumor size reached 100 mg / kg, mice were randomly divided into groups with five mice per group to ensure uniform tumor volume and body weight across the different groups. There were four groups in total: vehicle, 1 mg / kg CM311-ADC-1, 3 mg / kg CM311-ADC-1, and 3 mg / kg CM311-ADC-2 (non-conjugated, control ADC). CM311-ADC-1 refers to the antibody-drug conjugate CM311-18D10-VH6 / VL1-ADC. In comparison to CM311-ADC-1, the antibody in CM311-ADC-2 is a human IgG1 isotype control, which does not bind to tumor cell surface targets.
[0244] Data analysis: Tumor volumes were measured twice a week during the experiment. The formula for calculating tumor volume (TV) was TV = l × w 2 / 2, where l and w represent the measured length and width of the tumor, respectively. The relative tumor volume (RTV) was calculated according to the measurement results as RTV = V f / V0, where V0 is the tumor volume measured during administration to the group (i.e., day 0), and V f is the tumor volume measured on the last day. Relative tumor growth rate T / C (%) = (RTV in the treatment group / RTV in the vehicle group) × 100%. Tumor growth inhibition rate TGI% = (mean tumor volume in the vehicle group - mean tumor volume in the treatment group) / mean tumor volume in the vehicle group × 100%. If T / C (%) ≦ 40% and P < 0.05, the tested ADC is considered to have a significant inhibitory effect on tumor growth.
[0245] Test Results: 1) Study on the efficacy of CM311 ADC in the human gastric cancer PDX model STO#025, which has high expression of claudin-18 mRNA The experimental results are shown in Figures 8 and 9. After administration of CM311-ADC-1 at 1 and 3 mg / kg, the relative tumor growth rates (T / C%) on day 28 were 29.86% and 0%, respectively, and the tumor growth inhibition rates (TGI%) were 70.13% and 100%, respectively. Tumors completely regressed in 0 / 5 and 5 / 5, and partially regressed in 2 / 5 and 0 / 5, respectively. The T / C% and TGI% in the CM311-ADC-2 (3 mg / kg) group were 67.24% and 32.76%, respectively. The experimental results showed that both CM311-ADC-1 (3 mg / kg) and CM311-ADC-1 (1 mg / kg) had significant inhibitory activity against tumor growth, but CM311-ADC-2 (3 mg / kg) did not have significant antitumor activity. The tumor-bearing mice tolerated CM311-ADC-1 and CM311-ADC-2 very well.
[0246] 2) Study of the efficacy of CM311ADC in the human gastric cancer PDX model STO#523, which highly expresses claudin-18 mRNA The experimental results are shown in Figures 10 and 11. After administration of CM311-ADC-1 at 1 and 3 mg / kg, the relative tumor growth rates (T / C%) on day 28 were 35.60% and 6.79%, respectively, and the tumor growth inhibition rates (TGI%) were 64.40% and 93.21%, respectively. The T / C% and TGI% for the CM311-ADC-2 (3 mg / kg) group were 114.81% and -14.81%, respectively. The experimental results showed that both CM311-ADC-1 (3 mg / kg) and CM311-ADC-1 (1 mg / kg) had significant tumor growth inhibitory activity, whereas CM311-ADC-2 (3 mg / kg) did not have significant antitumor activity. The tumor-bearing mice tolerated CM311-ADC-1 and CM311-ADC-2 very well.
[0247] Example 6 Comparison of Cellular Activity for Antibodies and Antibody Drug Conjugates in Vitro Test Method: KATO III cell line was seeded at 5000 cells / well, and 24 hours later, test samples were added. All test samples were diluted 2.4-fold starting from a final concentration of 1000 ng / mL, incubated for 96 hours, and developed with PrestoBlue for 60 minutes before fluorescence intensity was read using a microplate reader.
[0248] The samples tested were as follows: Sample 1: CM311, specifically CM311-18D10-VH6 / VL1; Sample 2: Anti-Claudin-18.2-ADC, specifically CM311-18D10-VH6 / VL1-ADC; Sample 3: Non-binding control ADC, specifically IgG-L1D1 (IgG-L1D1 is an ADC conjugated to an IgG antibody and an L1D1 small molecule (i.e., vcMMAE, i.e., MC-vc-PAB-MMAE)).
[0249] The test results are shown in Figure 12 and Table 4. As can be seen from Figure 12, anti-claudin-18.2-ADC (e.g., CM311-18D10-VH6 / VL1-ADC) showed EC 50 The value was 16.37 ng / mL, indicating strong cell killing, whereas CM311 (eg, CM311-18D10-VH6 / VL1) and IgG-L1D1 did not show significant cell killing activity.
[0250] [Table 6]
Claims
1. An antibody-drug conjugate, a pharmaceutically acceptable salt thereof, a solvate, or a solvate of said salt, wherein said antibody-drug conjugate has the structure shown in Formula I: Ab-(LD)p Formula I During the ceremony, Ab is an anti-claudin 18.2 antibody, said anti-claudin 18.2 antibody comprising a heavy chain and a light chain; The sequence of the heavy chain variable region CDR1 is as set forth in SEQ ID NO: 42, The sequence of the heavy chain variable region CDR2 is as set forth in SEQ ID NO: 43, The sequence of the heavy chain variable region CDR3 is as set forth in SEQ ID NO: 44; the sequence of the light chain variable region CDR1 is as set forth in SEQ ID NO: 50; the sequence of the light chain variable region CDR2 is as set forth in SEQ ID NO:51; and the sequence of the light chain variable region CDR3 is as set forth in SEQ ID NO:52; D is a cytotoxic agent; L is a linker for linking the anti-claudin 18.2 antibody to the cytotoxic agent, p is 2.0 to 8.0; An antibody-drug conjugate, a pharmaceutically acceptable salt thereof, a solvate thereof, or a solvate of said salt.
2. The antibody-drug conjugate of claim 1, wherein the sequence of the heavy chain variable region is as set forth in SEQ ID NO: 41 and the sequence of the light chain variable region is as set forth in SEQ ID NO: 49, or a pharmaceutically acceptable salt, solvate, or solvate of said salt.
3. The antibody-drug conjugate of claim 2, wherein the heavy chain sequence is as set forth in SEQ ID NO: 65 and the light chain sequence is as set forth in SEQ ID NO: 66, or a pharmaceutically acceptable salt, solvate, or solvate of said salt.
4. The antibody-drug conjugate, its pharmaceutically acceptable salt, solvate, or solvate of said salt according to any one of claims 1 to 3, wherein p is 2.0 to 7.0, 2.0 to 6.0, 2.0 to 5.0, 2.0 to 4.0, 3.0 to 7.0, 3.0 to 6.0, 3.0 to 5.0, or 3.0 to 4.
0.
5. The antibody-drug conjugate, its pharmaceutically acceptable salt, solvate, or solvate of said salt according to claim 4, wherein p is 3.0 to 4.0 or 3.0 to 3.
8.
6. The antibody-drug conjugate, its pharmaceutically acceptable salt, solvate, or solvate of said salt, of claim 5, wherein p is 3.0, 3.4, 3.5, or 3.
8.
7. 2. The antibody-drug conjugate of claim 1, or a pharmaceutically acceptable salt, solvate, or solvate of said salt, wherein the cytotoxic agent is selected from the group consisting of SN-38, gemcitabine, monomethyl auristatin E (MMAE), monomethyl auristatin F (MMAF), maytansinoids (e.g., maytansine DM1, maytansine DM4), calicheamicin, MGBA (e.g., duocarmycin), doxorubicin, ricin, diphtheria toxin and other toxins, IL-31, interleukins, tumor necrosis factors, chemokines, and nanoparticles.
8. 2. The antibody-drug conjugate of claim 1, or a pharmaceutically acceptable salt, solvate, or solvate of said salt thereof, wherein the linker is selected from the group consisting of 6-maleimidohexanoyl (MC), maleimidopropionyl (MP), N-succinimidyl 4-(2-pyridylthio)valerate (SPP), 4-(N-maleimidomethyl)-cyclohexane-1-formyl (MCC), N-succinimidyl(4-iodo-acetyl)aminobenzoate (SIAB), and 6-maleimidocaproyl-valine-citrulline-p-aminobenzyloxycarbonyl (MC-vc-PAB).
9. A composition comprising the antibody-drug conjugate according to any one of claims 1 to 8, a pharmaceutically acceptable salt thereof, a solvate thereof, or a solvate of said salt.
10. 10. The composition of claim 9, comprising at least one of a chemotherapeutic drug, an immunotherapeutic drug, and an immunosuppressant known for treating tumors and / or at least one pharmaceutically acceptable carrier, diluent, or excipient.
11. A pharmaceutical composition for preventing and / or treating a disease associated with claudin 18.2, comprising the antibody-drug conjugate of any one of claims 1 to 8, a pharmaceutically acceptable salt, solvate, or solvate of said salt thereof, or the composition of claim 9 or 10.
12. The pharmaceutical composition of claim 11, wherein the disease associated with claudin 18.2 is gastric cancer, adenocarcinoma of the gastroesophageal junction, or pancreatic cancer.