Binding domain

Abstract

The present invention provides variant antigen-binding domains that contain at least one mutation in the VH domain compared to a reference antibody and exhibit increased affinity for TRBC2 compared to the reference antibody. It also provides antibodies, chimeric antigen receptors (CARs), bispecific T cell engagers (BiTEs), cells containing the CARs, and conjugates containing the variant antigen-binding domains or the antibodies. It also provides medical uses, diagnostic methods, and personalized medicine methods utilizing the products of the present invention.

Description

[Technical Field]

[0001] FIELD OF THE INVENTION The present invention relates to variant antigen-binding domains that specifically bind to TRBC2, as well as cells and agents useful in the treatment and diagnosis of T-cell malignancies. [Background technology]

[0002] Background of the Invention Lymphoid malignancies can be broadly divided into those derived from either T cells or B cells. T-cell malignancies are a clinically and biologically heterogeneous group of disorders, collectively accounting for 10-20% of non-Hodgkin lymphomas and 20% of acute leukemias. The most commonly identified histologic subtypes are peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), and anaplastic large cell lymphoma (ALCL). Approximately 20% of all acute lymphoblastic leukemias (ALL) are of the T-cell phenotype.

[0003] These conditions generally behave aggressively compared to, for example, B-cell malignancies, with an estimated 5-year survival rate of only 30%. In the case of T-cell lymphoma, a high proportion of patients exhibit disseminated disease, unfavorable International Prognostic Indicator (IPI) scores, and extranodal disease. Chemotherapy alone is usually ineffective, with fewer than 30% of patients being cured with current treatments.

[0004] Furthermore, unlike B-cell malignancies, where immunotherapies such as the anti-CD20 monoclonal antibody rituximab have dramatically improved outcomes, there are currently no equally effective and minimally toxic immunotherapeutic agents available to treat T-cell malignancies. A key difficulty in developing immunotherapies for T-cell disorders is the considerable overlap in marker expression between clonal and normal T cells, and the lack of a single antigen that can unambiguously identify clonal (malignant) cells.

[0005] Chimeric antigen receptor (CAR) T cells have shown promise in treating refractory B-cell malignancies. While targeting T-cell malignancies appears equally effective, the application of CARs in diseases such as T-cell lymphomas has been hampered by the lack of suitable target antigens. Unlike B-cell lymphomas, where ablation of the B-cell compartment is a manageable toxicity and can be treated with intravenous immunoglobulin administration, ablation of the T-cell compartment is less well tolerated and leads to complications associated with suppression of cell-mediated immunity.

[0006] A method for treating T-cell lymphoma and leukemia that involves targeting the constant region of the TCR beta chain (TRBC) has previously been described in WO2015 / 132598. This approach is based on the unique feature of T-cell receptors, namely, that each TCR encodes either TRBC1 or TRBC2 in an exclusive manner. Because T-cell lymphomas and leukemias are clonal populations of cells, each lymphoma expresses one TCR with either TRBC1 or TRBC2 on its surface.

[0007] The monoclonal antibody Jovi-1 specifically binds to TRBC1 and has been used as a CAR binding domain for therapy to treat T-cell lymphoma (Maciocia et al., 2017, Nat Med 23:1416-23; WO2015 / 132598). This proposed therapy allows treatment of a subset of patients expressing TCRs bearing the TRBC1 constant region.

[0008] To treat the entire patient population, binding agents / CARs targeting TRBC2 are needed. One method for obtaining antibodies specific to TRBC2 is by phage selection on a human phage display library. Another method involves immunizing animals with peptides derived from TRBC2 and then selecting specific antibodies. Both approaches have been successfully implemented, and various TRBC2-specific binding agents have been generated, as disclosed in WO2015 / 132598.

[0009] The present invention provides alternative binding agents that are specific for TRBC2 and are potential therapeutic agents for the treatment of TRBC2+ lymphoma or leukemia. [Prior art documents] [Patent documents]

[0010] [Patent Document 1] International Publication No. 2015 / 132598 [Non-patent literature]

[0011] [Non-Patent Document 1] Maciocia et al., 2017, Nat Med 23:1416-23 Summary of the Invention [Means for solving the problem]

[0012] Summary of Aspects of the Invention The inventors have solved the crystal structure of the TRBC1-specific monoclonal antibody JOVI-1 in complex with the TRBC1-TCR to 2.4 Å (Viney et al., 1992, Hybridoma 11:701-13) (Figure 3). From the crystal structure, it was possible to engineer the original Jovi-1 antibody to bind to TRBC2. This approach is particularly attractive because several amino acids in the antibody form a paratope that provides shape complementarity to enable TCR engagement, and only a small number are required for specificity for TRBC1. Through computational biology and protein engineering, the inventors rationally designed mutated versions of the TRBC1 binder that are specific for TRBC2 and have reduced affinity for TRBC1.

[0013] Thus, in a first aspect, the present invention provides a variant antigen-binding domain comprising at least one mutation in the VH domain compared to a reference antibody having a VH domain having the sequence set forth in SEQ ID NO: 1 and a VL domain having the sequence set forth in SEQ ID NO: 2, wherein the at least one mutation in the VH domain is selected from T28K, Y32K and A100N, and wherein the variant antigen-binding domain exhibits increased affinity for TRBC2 compared to the reference antibody.

[0014] The variant antigen-binding domain may comprise at least two mutations in the VH domain selected from T28K, Y32K, and A100N. For example, it may comprise the mutations Y32K and A100N. The variant antigen-binding domain may comprise the mutation T28R in the VH domain or the mutation G31K in the VH domain.

[0015] The variant antigen-binding domain can comprise T28K, Y32K and A100N mutations.

[0016] The variant antigen-binding domain may further comprise at least one mutation at a position selected from the group consisting of V2, Y27, G31, R98, Y102, N103 and A107 in the VH domain, N35 in the VL domain and R55 in the VL domain. The at least one further mutation may be selected from the following: a) in the VH domain - V2K, V2R, - Y27F, Y27M, Y27N, Y27W, - G31K, G31R, G31S, - R98K, - Y102F, Y102L, - N103A, N103E, N103F, N103H, N103L, N103M, N103Q, N103S, N103W, N103Y, - A107S, and b) in the VL domain - N35M, N35F, N35Y, N35K, N35R, and - R55K.

[0017] The variant antigen-binding domain may be selected from variant antigen-binding domains comprising the following combinations of mutations: - T28K, Y32F, A100N in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N in the VH domain, - T28K, Y32F, A100N, Y27N in the VH domain - T28K, Y32F, A100N, G31K in the VH domain - T28K, Y32F, A100N, Y27M in the VH domain - T28K, Y32F, A100N, Y27W in the VH domain - T28K, Y32F, A100N in the VH domain and R55K in the VL domain, - T28K, Y32F, A100N, N103H in the VH domain - T28K, Y32F, A100N, N103A in the VH domain - T28K, Y32F, A100N, N103Y in the VH domain - T28K, Y32F, A100N in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, R98K in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103W in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain, - T28K, Y32F, A100N, N103L in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103W in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, Y27F in the VH domain, - T28K, Y32F, A100N, N103Q in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain, - T28K, Y32F, A100N, N103M in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, G31R in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, V2R in the VH domain, - T28K, Y32F, A100N, G31S in the VH domain, - T28K, Y32F, A100N, A107S in the VH domain, - T28K, Y32F, A100N, N103E in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, V2K in the VH domain, - T28K, Y32F, A100N, N103E in the VH domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, Y102F in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102L, N103W in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, Y102L, N103W in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102F in the VH domain, and - T28K, Y32F, A100N, Y102L, N103M in the VH domain and N35R in the VL domain.

[0018] The variant antigen-binding domain may comprise T28K, Y32F, A100N mutations in the VH domain and N35K mutation in the VL domain.

[0019] The variant antigen-binding domain may comprise T28K, Y32F and A100N mutations in the VH domain.

[0020] The variant antigen-binding domain may further exhibit reduced affinity for TRBC1 compared to the reference antibody.

[0021] The ratio of the affinities of the variant antigen-binding domains to TRBC2 and TRBC1 may be at least 2.

[0022] The ratio of the affinities of the variant antigen-binding domains to TRBC2 and TRBC1 may be at least 5.

[0023] The ratio of the affinities of the variant antigen-binding domains to TRBC2 and TRBC1 may be at least 10.

[0024] The variant antigen-binding domain may further comprise an oligomerization domain.

[0025] In a second aspect, the present invention provides an antibody comprising a variant antigen-binding domain according to the first aspect of the invention.

[0026] In a third aspect, the present invention provides a chimeric antigen receptor (CAR) comprising a variant antigen-binding domain according to the first aspect of the invention, a spacer, a transmembrane domain and an endodomain.

[0027] The spacer can be selected from the human CD8 stalk shown in SEQ ID NO:7 and the COMP spacer shown in SEQ ID NO:19.

[0028] In a fourth aspect, the present invention provides a bispecific T cell engager (BiTE) comprising a variant antigen-binding domain according to the first aspect of the invention and a T cell activation domain.

[0029] In a fifth aspect, the present invention provides a nucleic acid sequence encoding a variant antigen-binding domain according to the first aspect of the invention, an antibody according to the second aspect of the invention, a CAR according to the third aspect of the invention, or a BiTE according to the fourth aspect of the invention.

[0030] In a sixth aspect, the present invention provides a vector comprising a nucleic acid sequence according to the fifth aspect of the invention.

[0031] In a seventh aspect, the present invention provides a cell comprising a CAR according to the third aspect of the invention.

[0032] In an eighth aspect, the present invention provides a method for producing a cell according to the seventh aspect of the invention, the method comprising transducing or transfecting the cell with a vector according to the sixth aspect of the invention comprising a nucleic acid sequence encoding a CAR.

[0033] In a ninth aspect, the present invention provides a conjugate comprising a variant antigen-binding domain according to the first aspect of the invention or an antibody according to the second aspect of the invention and a detectable or chemotherapeutic entity.

[0034] The conjugate can include a chemotherapeutic entity.

[0035] In a tenth aspect, the present invention provides a method for treating T-cell lymphoma or leukemia in a subject, the method comprising administering to the subject a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, wherein the malignant T cells express TRBC2.

[0036] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0037] In an eleventh aspect, the present invention provides a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, for use in medicine.

[0038] In a twelfth aspect, the present invention provides a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, for use in treating T-cell lymphoma or leukemia, wherein the malignant T cells express TRBC2.

[0039] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0040] In a thirteenth aspect, the present invention provides the use of a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, in the manufacture of a medicament for treating T-cell lymphoma or leukemia, wherein the malignant T cells express TRBC2.

[0041] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0042] In a fourteenth aspect, the present invention provides a diagnostic agent comprising a variant antigen-binding domain according to the first aspect of the invention or an antibody according to the second aspect of the invention.

[0043] The diagnostic agent may be for diagnosing T-cell lymphoma or leukemia.

[0044] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0045] In a fifteenth aspect, the present invention provides a method for diagnosing T-cell lymphoma or leukemia in a subject, the method comprising contacting a variant antigen-binding domain according to the first aspect of the invention or an antibody according to the second aspect of the invention with a sample comprising T cells from the subject.

[0046] The method for diagnosing T-cell lymphoma or leukemia in a subject can further include determining the percentage of TRBC2-positive T cells in the sample.

[0047] A percentage of TRBC2-positive T cells in a sample of 70% or higher can indicate the presence of T-cell lymphoma or leukemia.

[0048] The sample may be or may be derived from a blood sample.

[0049] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0050] In a sixteenth aspect, the present invention provides a method for identifying a subject with T-cell lymphoma or leukemia who is eligible for treatment with a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, the method comprising the step of determining the percentage of TRBC2-positive T cells in a sample comprising T cells from the subject.

[0051] A subject may be eligible for said treatment with cells according to the seventh aspect of the invention, or antibodies according to the second aspect of the invention, or BiTEs according to the fourth aspect of the invention, or conjugates according to the ninth aspect of the invention, if the percentage of TRBC2-positive T cells in the sample is 70% or higher.

[0052] The sample may be or may be derived from a blood sample.

[0053] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0054] In a seventeenth aspect, the present invention provides a method for selecting a therapy comprising a cell according to the seventh aspect of the invention, or an antibody according to the second aspect of the invention, or a BiTE according to the fourth aspect of the invention, or a conjugate according to the ninth aspect of the invention, for treatment of a subject, the method comprising the step of determining the percentage of TRBC2-positive T cells in a sample comprising T cells from the subject.

[0055] The therapy can be selected to treat the subject if the percentage of TRBC2-positive T cells in the sample is 70% or higher.

[0056] The sample may be or may be derived from a blood sample.

[0057] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia. [Brief explanation of the drawings]

[0058] [Figure 1]Figure 1 is a diagram of the αβ T cell receptor / CD3 complex. The T cell receptor is formed from six distinct protein chains that must be assembled in the endoplasmic reticulum to be expressed on the cell surface. Four proteins of the CD3 complex (CD3ζ, CD3γ, CD3ε, and CD3δ) encase the T cell receptor (TCR). This TCR imbues the complex with specificity for a particular antigen and is composed of two chains: TCRα and TCRβ. Each TCR chain has a membrane-distal variable component and a membrane-proximal constant component. Nearly all T cell lymphomas and many T cell leukemias express the TCR / CD3 complex. [Figure 2] Figure 2 shows the separation of T cell receptor β-constant region (TRBC)-1 and TRBC2 during T cell receptor rearrangement. Each TCR beta chain is formed from the genomic recombination of specific beta variable (V), diversity (D), joining (J), and constant (TRBC) regions. The human genome contains two highly similar, functionally equivalent TRBC loci, known as TRBC1 and TRBC2. During TCR gene rearrangement, the J region recombines with either TRBC1 or TRBC2. This rearrangement is permanent. Because T cells express many copies of a single TCR on their surface, each T cell expresses a TCR whose β chain constant region is encoded by either TRBC1 or TRBC2. [Figure 3] FIG. 3 shows the structural interface between TCR beta and the Fab fragment of the TRBC1-specific antibody Jovi-1. [Figure 4] Figure 4 shows a diagram of the structure of TRBC1 and TRBC2-specific chimeric antigen receptors (CARs). [Figure 5] Figure 5 shows functional characterization of anti-TRBC2 CARs. IFN-γ production by (A) anti-TRBC2 triple mutant CAR and (B) anti-TRBC1 CAR incubated in the presence of TRBC1 or TRBC2. [Figure 6]Figure 6 shows the cytotoxic activity of (A) anti-TRBC2 triple mutant CAR-T cells and (B) anti-TRBC1 CAR-T cells co-incubated with Raji WT, Raji TRBC1+, or Raji TRBC2+ cells. [Figure 7] Figure 7 shows antigen-specific activation of anti-TRBC2 CAR-transduced Jurkat cells co-incubated with HPB TRBC1 and HPB TRBC2 cells. Jurkat cells (TRBC1+) were transduced with a second-generation anti-TRBC2 CAR construct and co-incubated with HPB TRBC1 and HPB TRBC2 cells at a 1:1 E:T ratio. Controls included non-transduced Jurkat cells (NT), HPB-ALL cells with a knockout TCR (referred to as HPB KO), and transduced Jurkat cells plated alone as a negative control or with αCD3 / αCD28 antibodies as a positive assay control. N35K: a binder with the T28K, Y32F, and A100N mutations in the VH domain of hJovi-1 and N35K in the VL domain; N103L: a binder with the T28K, Y32F, A100N, and N103L mutations in the VH domain of hJovi-1; N103M-N35Y: a binder with the T28K, Y32F, A100N, and N103M mutations in the VH domain of hJovi-1 and N35Y in the VL domain Y102F-N103M-N35R: a binder with T28K, Y32F, A100N, Y102F, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain; and Y102L-N103M-N35R: a binder with T28K, Y32F, A100N, Y102L, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain. [Figure 8]Figure 8 shows the cytotoxic activity of anti-TRBC2 CAR-T cells co-incubated with TRBC1+ HPB-ALL and TRBC2+ HPB-ALL cells. Peripheral blood mononuclear cells (PBMCs) were transduced with a second-generation anti-TRBC2 CAR construct. Transduced PBMCs were co-incubated with TRBC1+ HPB-ALL and TRBC2+ HPB-ALL cells at an E:T ratio of 1:2. Controls included non-transduced cells (NT), cells transduced with anti-TRBC1hJovi-1 CAR (JOVI), and HPB-ALL cells with a knockout TCR (HPB-KO). N35K: a binder with the T28K, Y32F, and A100N mutations in the VH domain of hJovi-1 and N35K in the VL domain; N103L: a binder with the T28K, Y32F, A100N, and N103L mutations in the VH domain of hJovi-1; N103M-N35Y: a binder with the T28K, Y32F, A100N, and N103M mutations in the VH domain of hJovi-1 and N35Y in the VL domain Y102F-N103M-N35R: a binder with T28K, Y32F, A100N, Y102F, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain; and Y102L-N103M-N35R: a binder with T28K, Y32F, A100N, Y102L, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain. [Figure 9A] FIG. 9 shows an analysis of the effect of different antibody formats on the binding of anti-TRBC2 antibodies by surface plasmon resonance (SPR). [Figure 9B] FIG. 9 shows an analysis of the effect of different antibody formats on the binding of anti-TRBC2 antibodies by surface plasmon resonance (SPR). [Figure 9C] FIG. 9 shows an analysis of the effect of different antibody formats on the binding of anti-TRBC2 antibodies by surface plasmon resonance (SPR). DETAILED DESCRIPTION OF THE INVENTION

[0059] Detailed Description of the Invention The inventors solved the crystal structure of Jovi-1, which helped identify two key residues essential for TRBC1 specificity (Figure 1). Interestingly, these residues are located in CDR1, as opposed to CDR3, which typically promotes antibody specificity. Furthermore, other residues located in close proximity to the TRBC1 epitope are likely essential for engineering specificity from TRBC1 to TRBC2. Residues in Jovi-1 that are involved in TRBC1 binding or important for generating TRBC2 specificity are described herein.

[0060] The present invention provides variants of the antigen-binding domain of JOVI-1 that have higher affinity for TCR beta constant region 2 (TRBC2) than JOVI-1.

[0061] 1. TCRβ constant region (TRBC) T cell receptors (TCRs) are expressed on the surface of T lymphocytes and are responsible for recognizing antigens bound to major histocompatibility complex (MHC) molecules. When the TCR engages an antigenic peptide and MHC (peptide / MHC), the T lymphocyte becomes activated through a series of biochemical events mediated by associated enzymes, coreceptors, specialized adaptor molecules, and activated or released transcription factors.

[0062] The TCR is a disulfide-linked, membrane-anchored heterodimer consisting of highly variable alpha (α) and beta (β) chains that are usually expressed as part of a complex with an invariant CD3 chain molecule. T cells that express this receptor are called α:β (or αβ) T cells (about 95% of all T cells). A small number of T cells express an alternative receptor formed by variable gamma (γ) and delta (δ) chains; these are called γδ T cells (about 5% of all T cells).

[0063] Each α and β chain consists of two extracellular domains: a variable (V) region and a constant (C) region, both of which are immunoglobulin superfamily (IgSF) domains that form an antiparallel β-sheet. The constant region is proximal to the cell membrane and is followed by a transmembrane region and a short cytoplasmic tail, while the variable region binds to the peptide / MHC complex. The constant region of the TCR consists of a short connective sequence in which cysteine ​​residues form disulfide bonds, thereby forming the link between the two chains.

[0064] The variable domains of both the TCR α and β chains have three hypervariable or complementarity determining regions (CDRs). The variable region of the β chain also has an additional region of hypervariability (HV4), which does not normally contact the antigen and is therefore not considered a CDR.

[0065] The TCR also contains up to five invariant chains: γ, δ, ε (collectively referred to as CD3), and ζ. The CD3 and ζ subunits mediate TCR signaling through specific cytoplasmic domains that interact with second messenger and adapter molecules after antigen recognition by αβ or γδ. Prior to cell surface expression of the TCR complex, the subunits assemble in pairs, in which both the transmembrane and extracellular domains of TCR α and β and CD3 γ and δ play a role.

[0066] Thus, the TCR generally consists of the CD3 complex and the TCR α and β chains, which in turn consist of variable and constant regions (Figure 1).

[0067] The locus (Chr7:q34) supplying the TCRβ constant region (TRBC) has doubled over evolutionary history, generating two nearly identical and functionally equivalent genes: TRBC1 and TRBC2 (Figure 2). Each TCR contains either TRBC1 or TRBC2 exclusively, and thus, each αβ T cell expresses either TRBC1 or TRBC2 exclusively.

[0068] The present inventors have previously determined that TRBC1 and TRBC2 can be distinguished from each other despite their similarity in sequence. The inventors have also previously determined that the amino acid sequences of TRBC1 and TRBC2 can be distinguished in situ on the surface of cells, such as T cells (WO2015 / 132598).

[0069] 2. Variant antigen-binding domains In a first aspect, the present invention provides a variant antigen-binding domain comprising at least one mutation in the VH domain compared to a reference antibody having a VH domain having the sequence set forth in SEQ ID NO: 1 and a VL domain having the sequence set forth in SEQ ID NO: 2, hereinafter "the variant antigen-binding domain of the invention", wherein the at least one mutation in the VH domain is selected from T28K, Y32F and A100N, and wherein the variant antigen-binding domain displays increased affinity for TRBC2 compared to the reference antibody.

[0070] As used herein, the term "variant" or "mutant" refers to a polypeptide that differs from a specifically recited polypeptide, i.e., a reference or parent polypeptide, by amino acid insertion, deletion, and / or substitution, for example, created using recombinant DNA technology or by de novo synthesis. Variant and mutant are used interchangeably in the context of the present invention. Variant antigen-binding domains of the present invention include antigen-binding molecules in which one or more amino acid residues have been altered by substitution, addition, and / or deletion in a manner that substantially affects the antigen-binding affinity of the reference or parent antigen-binding domain.

[0071] The term "antigen-binding domain" as used herein refers to the variable regions of each pair of antibody light and heavy chains, i.e., the VL and VH domains, respectively, that form the binding site. They are characterized by the same general structure, which is composed of relatively conserved regions called frameworks (FRs) that connect three hypervariable regions called complementarity-determining regions (CDRs) (Kabat et al., 1991, Sequences of Proteins of Immunological Interest, 5 th Ed., NIH Publication No. 91-3242, Bethesda, MD.; Chothia & Lesk, 1987, J Mol Biol 196:901-17). As used herein, the term "complementarity-determining region" or "CDR" refers to the region in an antibody that complements the shape of an antigen. Thus, CDRs determine the affinity (roughly speaking, binding strength) and specificity of the protein for a specific antigen. The CDRs of the two chains of each pair are aligned by the framework regions and achieve the function of binding to a specific epitope.

[0072] The variant antigen-binding domain of the present invention comprises at least one mutation in the VH domain compared to a reference antibody. As used herein, the term "reference antibody" refers to the humanized JOVI-1 antibody, i.e., hJOVI-1, which comprises a VH domain having the sequence set forth in SEQ ID NO: 1 and a VL domain having the sequence set forth in SEQ ID NO: 2. Murine JOVI-1 was previously disclosed by Viney et al. (1992; supra) and is commercially available (Abcam, ab5465). It has previously been determined that JOVI-1 can distinguish cells based on the specific expression of TRBC1 or TRBC2 by specifically binding only to TRBC1 (WO2015 / 132598). [ka]

[0073] Hereinafter, unless otherwise specified, any reference to a VH domain means the VH domain of hJOVI-1 shown in SEQ ID NO: 1, and unless otherwise specified, any reference to a VL domain means the VL domain of hJOVI-1 shown in SEQ ID NO: 2.

[0074] The inventors have determined that the presence of at least one mutation selected from T28K, Y32F and A100N in the VH domain of a reference antibody induces an increased affinity of the variant antigen-binding domain of the present invention for TRBC2 compared to the reference antibody (Example 1).

[0075] The term "affinity" as used herein refers to the strength of the interaction between the antigen-binding site of an antibody and an epitope. A high affinity antibody binds to a greater amount of antigen in a shorter time than a low affinity antibody. Affinity is the k off / k on The equilibrium dissociation constant (K D The affinity of an antigen-binding domain for any given antigen can be quantified using any conventional method, including, but not limited to, label-dependent methods, such as direct and indirect ELISA and radioimmunoassay methods, as well as label-free methods that allow for direct detection and measurement of interactions in real time, such as surface plasmon resonance and biolayer interference.

[0076] The affinity of the variant antigen-binding domain of the present invention to TRBC2 is increased relative to that of a reference antibody. The affinity of the variant antigen-binding domain to TRBC2 can be increased by at least 1%, at least 5%, at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 100%, at least 150%, at least 200%, at least 300%, at least 400%, at least 500%, at least 600%, at least 700%, at least 800%, at least 900%, at least 1,000%, at least 5,000%, or at least 10,000% relative to the affinity of the reference antibody to TRBC2.

[0077] The variant antigen-binding domain of the present invention may comprise a T28K mutation in the VH domain. The variant antigen-binding domain of the present invention may comprise a Y32F mutation in the VH domain. The variant antigen-binding domain of the present invention may comprise an A100N mutation in the VH domain.

[0078] The variant antigen-binding domain of the present invention may comprise at least two mutations in the VH domain selected from T28K, Y32F, and A100N. The at least two mutations may be Y32F and A100N. In one embodiment, the variant antigen-binding domain of the present invention may further comprise the mutations Y32F and A100N and the mutation T28R in the VH domain. In another embodiment, the variant antigen-binding domain of the present invention may further comprise the mutations Y32F and A100N and the mutation G31R in the VH domain.

[0079] The variant antigen binding domain of the present invention may comprise the mutations T28K, Y32F and A100N in the VH domain.

[0080] In another embodiment, the variant antigen-binding domain of the invention comprises the mutations T28K, Y32F and A100N in the VH domain and further comprises at least one mutation at a position selected from the group consisting of V2, Y27, G31, R98, Y102, N103 and A107 in the VH domain, and N35 and R55 in the VL domain. The variant antigen-binding domain of the invention may comprise one, two, three, four, five, six or seven mutations at positions selected from the group consisting of V2, Y27, G31, R98, Y102, N103 and A107 in the VH domain, and N35 and R55 in the VL domain.

[0081] A variant antigen-binding domain of the invention may comprise the mutations T28K, Y32F and A100N in the VH domain and may further comprise a mutation at position V2 in the VH domain, a mutation at position Y27 in the VH domain, a mutation at position G31 in the VH domain, a mutation at position R98 in the VH domain, a mutation at position Y102 in the VH domain, a mutation at position N103 in the VH domain, a mutation at position A107 in the VH domain, a mutation at position N35 in the VL domain and a mutation at position R55 in the VL domain.

[0082] The variant antigen binding domain of the invention may comprise the mutations T28K, Y32F and A100N in the VH domain and further comprises at least one mutation selected from: a) in the VH domain - V2K, V2R, - Y27F, Y27M, Y27N, Y27W, - G31K, G31R, G31S, - R98K, - Y102F, Y102L, - N103A, N103E, N103F, N103H, N103L, N103M, N103Q, N103S, N103W, N103Y, and - A107S, and b) in the VL domain - N35M, N35F, N35Y, N35K, N35R, and - R55K.

[0083] The variant antigen-binding domain of the present invention may be selected from variant antigen-binding domains comprising the following combinations of mutations: - T28K, Y32F, A100N, Y27N in the VH domain, - T28K, Y32F, A100N, G31K in the VH domain, - T28K, Y32F, A100N, Y27M in the VH domain, - T28K, Y32F, A100N, Y27W in the VH domain, - T28K, Y32F, A100N in the VH domain, - T28K, Y32F, A100N in the VH domain and R55K in the VL domain, - T28K, Y32F, A100N in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, N103H in the VH domain, - T28K, Y32F, A100N, N103A in the VH domain, - T28K, Y32F, A100N, N103Y in the VH domain, - T28K, Y32F, A100N in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, R98K in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103S in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103W in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain, - T28K, Y32F, A100N, N103L in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, N103L in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103W in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, Y27F in the VH domain, - T28K, Y32F, A100N, N103Q in the VH domain, - T28K, Y32F, A100N, N103S in the VH domain, - T28K, Y32F, A100N, N103M in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, G31R in the VH domain, - T28K, Y32F, A100N, N103W in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, V2R in the VH domain, - T28K, Y32F, A100N, G31S in the VH domain, - T28K, Y32F, A100N, A107S in the VH domain, - T28K, Y32F, A100N, N103E in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, V2K in the VH domain, - T28K, Y32F, A100N, N103E in the VH domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35F in the VL domain, - T28K, Y32F, A100N, Y102F, N103M in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, Y102F in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35M in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35Y in the VL domain, - T28K, Y32F, A100N, N103M in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, N103F in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102L, N103W in the VH domain and N35R in the VL domain, - T28K, Y32F, A100N, Y102L, N103W in the VH domain and N35K in the VL domain, - T28K, Y32F, A100N, Y102F in the VH domain, and - T28K, Y32F, A100N, Y102L, N103M in the VH domain and N35R in the VL domain.

[0084] These specific combinatorial mutations have been shown to alter binding to TRBC2 and TRBC1 in a manner that is beneficial for TRBC2 targeting (see Table 1). [Table 1-1] [Table 1-2] [Table 1-3]

[0085] In a specific embodiment, the variant antigen binding domain of the invention comprises the following mutations in the VH domain: T28K, Y32F, A100N.

[0086] In another specific embodiment, the variant antigen binding domain of the invention comprises the following mutations in the VH domain: T28K, Y32F, A100N and Y27N.

[0087] In another specific embodiment, the variant antigen binding domain of the invention comprises the following mutations in the VH domain: T28K, Y32F, A100N and N103M.

[0088] In another specific embodiment, the variant antigen binding domain of the invention comprises the mutations T28K, Y32F, A100N in the VH domain and N35K in the VL domain.

[0089] In another specific embodiment, the variant antigen binding domain of the invention comprises the following mutations in the VH domain: T28K, Y32F, A100N, N103L.

[0090] In another specific embodiment, the variant antigen binding domain of the invention comprises the mutations T28K, Y32F, A100N, N103M in the VH domain and the mutation N35Y in the VL domain.

[0091] In another specific embodiment, the variant antigen binding domain of the invention comprises the mutations T28K, Y32F, A100N, Y102F, N103M in the VH domain and the mutation N35R in the VL domain.

[0092] In another specific embodiment, the variant antigen binding domain of the invention comprises the mutations T28K, Y32F, A100N, Y102L, N103M in the VH domain and the mutation N35R in the VL domain.

[0093] It would be particularly advantageous if the variant antigen-binding domain of the present invention not only exhibits increased affinity for TRBC2 compared to the reference antibody, but also has decreased affinity for TRBC1 compared to that of the reference antibody. This change in antigen specificity would enable the variant antigen-binding domain to distinguish between TRBC2 and TRBC1 by exhibiting preferential binding to TRBC2. Thus, in another embodiment, the variant antigen-binding domain further exhibits reduced affinity for TRBC1 compared to the reference antibody.

[0094] The affinity of the variant antigen-binding domain of the present invention to TRBC2 is reduced relative to that of the reference antibody. The affinity of the variant antigen-binding domain to TRBC2 can be increased by at least 1%, at least 5%, at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 100%, at least 150%, at least 200%, at least 300%, at least 400%, at least 500%, at least 600%, at least 700%, at least 800%, at least 900%, at least 1,000%, at least 5,000%, or at least 10,000% relative to the affinity of the reference antibody to TRBC2.

[0095] The ratio of the affinities of the variant antigen binding domains of the present invention for TRBC2 and TRBC1 may be at least 2, or at least 3, or at least 4, or at least 5, or at least 6, or at least 7, or at least 8, or at least 9, or at least 10, or at least 15, or at least 20, or at least 25, or at least 50, or at least 100, or at least 500, or at least 1,000, or greater.

[0096] By increasing the binding affinity of the variant antigen-binding domain of the present invention in Example 6, the inventors unexpectedly discovered that not only is the binding affinity of the variant antigen-binding domain of the present invention to TRBC2 increased, but its low affinity to TRBC1 is maintained, resulting in a dramatic improvement in the specificity of the variant antigen-binding domain of the present invention to TRBC2.

[0097] The binding affinity of the variant antigen-binding domain of the present invention to TRBC2 can be increased by using a domain capable of forming oligomers or multimers. Thus, the variant antigen-binding domain of the present invention can further comprise an oligomerization domain. As used herein, the term "oligomerization domain" refers to a domain that self-associates to form oligomers, such as dimers, trimers, or multimers. Thus, as used herein, the term oligomerization domain also refers to a multimerization domain. Oligomerization domains are well known to those skilled in the art, and any oligomerization domain can be used with the variant antigen-binding domain of the present invention, provided that the resulting oligomers maintain or improve the affinity of the monomeric variant antigen-binding domain to TRBC2. Examples of oligomerization domains include, but are not limited to, an Fc region, a COMP spacer of SEQ ID NO: 18, or a truncated COMP, as described below in connection with the chimeric antigen receptor (CAR) of the present invention.

[0098] The present invention also contemplates different formats for the variant antigen-binding domains of the invention, including but not limited to scFv, diabodies, trimeric bodies, minibodies, F(ab) and F(ab')2 fragments, and complete antibodies, i.e., IgG, IgM, IgA, IgD, IgE.

[0099] Thus, another aspect of the present invention relates to antibodies comprising a variant antigen-binding domain of the invention, hereinafter "antibodies of the invention".

[0100] 3. Chimeric Antigen Receptor In another aspect, the present invention provides a chimeric antigen receptor (CAR), hereinafter "the CAR of the invention", comprising a variant antigen binding domain, a transmembrane domain and an endodomain of the invention.

[0101] The term "variant antigen-binding domain of the invention" has been described in detail in relation to the first aspect of the invention, and its features and embodiments apply equally to this aspect of the invention.

[0102] As used herein, the term "chimeric antigen receptor" or "CAR" or "chimeric T cell receptor" or "artificial T cell receptor" or "chimeric immunoreceptor" refers to a chimeric type I transmembrane protein that links an extracellular antigen-recognition domain (binder) to an intracellular signaling domain (endodomain). The binder is typically a single-chain variable fragment (scFv) derived from a monoclonal antibody (mAb), but can be based on other formats that contain an antigen-binding site. A spacer domain is usually required to separate the binder from the membrane and allow it to have a suitable orientation. A common spacer domain used is the Fc of IgG1. More compact spacers, such as the stalk from CD8α, and even just the IgG1 hinge, are sufficient depending on the antigen. The transmembrane domain anchors the protein in the cell membrane and links the spacer to the endodomain.

[0103] Early CAR designs had endodomains derived from the intracellular portion of the γ chain of FcεR1 or CD3ζ. As a result, these first-generation receptors transduced immune signal 1, which was sufficient to induce T cell killing of cognate target cells, but were unable to fully activate T cells to proliferate and survive. To overcome this limitation, composite endodomains were constructed: fusion of the intracellular portion of a T cell costimulatory molecule to that of CD3ζ resulted in second-generation receptors that could simultaneously transduce activation and costimulatory signals after antigen recognition. The most commonly used costimulatory domain is that of CD28, which delivers the most potent costimulatory signal—i.e., immune signal 2, which induces T cell proliferation. Several receptors have also been described that contain TNF receptor family endodomains, including the closely related OX40 and 4-1BB, which transduce survival signals. Even more potent third-generation CARs have now been described, with endodomains capable of transducing activation, proliferation, and survival signals.

[0104] When a CAR binds to a target antigen, it transmits an activation signal to the T cell in which it is expressed. Thus, the CAR directs the specificity and cytotoxicity of the T cell to tumor cells expressing the target antigen.

[0105] Thus, a CAR generally comprises: (i) an antigen-binding domain; (ii) a spacer; (iii) a transmembrane domain; and (iii) an intracellular domain that comprises or is associated with a signaling domain (see Figure 4).

[0106] A CAR can have the following general structure: Antigen-binding domain - spacer domain - transmembrane domain - intracellular signaling domain (endodomain).

[0107] 3.1.Signal Peptide The CAR of the invention can include a signal peptide so that when the CAR is expressed in a cell, such as a T cell, the nascent protein is directed to the endoplasmic reticulum and then to the cell surface where it is expressed.

[0108] The core of a signal peptide can contain a long stretch of hydrophobic amino acids that tend to form a single alpha helix. The signal peptide can begin with a short stretch of positively charged amino acids, which helps enforce the proper topology of the polypeptide during translocation. At the end of the signal peptide, there is typically a stretch of amino acids that is recognized and cleaved by a signal peptidase. The signal peptidase can cleave during or after translocation to generate the free signal peptide and mature protein. The free signal peptide is then digested by a specific protease.

[0109] The signal peptide can be at the amino terminus of the molecule.

[0110] The signal peptide can include SEQ ID NOs: 3-5, or variants thereof having 5, 4, 3, 2 or 1 amino acid mutations (insertions, substitutions or additions), provided that the signal peptide still functions to cause cell surface expression of the protein. SEQ ID NO: 3: MGTSLCCWMALCLLGADHADG

[0111] The signal peptide of SEQ ID NO: 3 is compact and highly efficient: it is predicted to give approximately 95% cleavage after the terminal glycine, allowing efficient removal by signal peptidases. SEQ ID NO: 4: MSLPVTALLLPLALLLHAARP

[0112] The signal peptide of SEQ ID NO: 4 is derived from IgG1. SEQ ID NO: 5: MAVPTQVLGLLLLWLTDARC

[0113] The signal peptide of SEQ ID NO: 5 is derived from CD8.

[0114] 3.2.Spacer Domain CARs contain a spacer sequence that links the antigen-binding domain to the transmembrane domain and spatially separates the antigen-binding domain from the endodomain. The flexible spacer allows the antigen-binding domain to orient in different directions to facilitate binding.

[0115] In the CAR of the present invention, the spacer sequence can comprise, for example, an IgG1 Fc region, an IgG1 hinge, or a human or mouse CD8 stalk. The spacer can alternatively comprise an alternative linker sequence, an IgG1 hinge, or a CD8 stalk, having a length and / or domain spacing characteristics similar to that of the IgG1 Fc region. The human IgG1 spacer can be modified to remove the Fc binding motif. The spacer can comprise a coiled-coil domain, for example, as described in WO2016 / 151315.

[0116] The CAR of the present invention may comprise a sequence selected from the sequences shown in SEQ ID NOs: 6 to 10 or variants thereof having at least 80% sequence identity. [ka] [ka]

[0117] The COMP coiled-coil domain can be truncated at the N-terminus and retain surface expression. Thus, the coiled-coil COMP spacer can comprise or consist of a truncated version of SEQ ID NO: 19, truncated at the N-terminus. Truncated COMP can comprise the five C-terminal amino acids of SEQ ID NO: 19, i.e., the sequence CDACG (SEQ ID NO: 20). Truncated COMP can comprise 5 to 44 amino acids, e.g., at least 5, 10, 15, 20, 25, 30, 35, or 40 amino acids. Truncated COMP can correspond to the C-terminus of SEQ ID NO: 19. For example, a truncated COMP containing 20 amino acids can comprise the sequence QQVREITFLKNTVMECDACG (SEQ ID NO: 21). Truncated COMP can retain the cysteine ​​residue(s) involved in multimerization. Truncated COMP can retain the ability to form multimers.

[0118] 3.3.Transmembrane domain The transmembrane domain is the sequence of the CAR that spans the membrane.

[0119] A transmembrane domain can be any protein structure that is thermodynamically stable in a membrane. It is generally an alpha helix containing several hydrophobic residues. The transmembrane domain of any transmembrane protein can be used to provide the transmembrane moiety of the present invention. The presence and span of a transmembrane domain of a protein can be determined by those skilled in the art using the TMHMM algorithm (http: / / www.cbs.dtu.dk / services / TMHMM-2.0 / ). Furthermore, given that a transmembrane domain of a protein has a relatively simple structure, i.e., a polypeptide sequence predicted to form a hydrophobic alpha helix of sufficient length to span the membrane, an artificially designed TM domain can also be used (U.S. Patent No. 7,052,906 B1 describes a synthetic transmembrane component).

[0120] The transmembrane domain can be derived from CD28, CD8a or TYRP-1, which confer superior receptor stability.

[0121] In one embodiment, the transmembrane domain is derived from CD8a. SEQ ID NO: 11: CD8a transmembrane domain IYIWAPLAGTCGVLLLSLVIT

[0122] In another embodiment, the transmembrane domain is derived from TYRP-1. SEQ ID NO: 12: TYRP-1 transmembrane domain IIAIAVVGALLLVALIFGTASYLI

[0123] 3.4. End Domain The endodomain is the signaling portion of the CAR. After antigen recognition, the receptor cluster, native CD45 and CD148, are excluded from the synapse, and the signal is transmitted to the cell. The most commonly used endodomain component is that of CD3ζ, which contains three ITAMs. This transmits an activation signal to T cells after binding to antigen. Because CD3ζ cannot provide a fully competent activation signal, additional costimulatory signaling may be required. Examples of costimulatory domains include the endodomains from CD28, OX40, 4-1BB, CD27, and ICOS, which can be used with CD3ζ to transmit proliferation / survival signals.

[0124] In one embodiment, at least one costimulatory endodomain is used with CD3ζ. In a specific embodiment, the costimulatory endodomain is selected from the group consisting of endodomains from CD28, OX40, 4-1BB, CD27, and ICOS.

[0125] In another embodiment, at least two costimulatory endodomains are used with CD3ζ. In a specific embodiment, the two costimulatory endodomains are selected from the group consisting of endodomains from CD28, OX40, 4-1BB, CD27, and ICOS, in any combination and order. Particularly preferred combinations include endodomains from CD28 and CD3ζ, endodomains from OX40 and CD3ζ, endodomains from 4-1BB and CD3ζ, endodomains from CD28, OX40, and CD3ζ, and endodomains from CD28, 4-1BB, and CD3ζ.

[0126] The transmembrane and intracellular T cell signaling domains (endodomains) of a CAR having an activating endodomain can comprise the sequences set forth in SEQ ID NOs: 13-18 or variants thereof having at least 80% sequence identity.

[0127] [ka]

[0128] [ka]

[0129] [ka] [ka]

[0130] [ka]

[0131] [ka]

[0132] [ka]

[0133] A variant sequence can have at least 80%, 85%, 90%, 95%, 98% or 99% sequence identity to SEQ ID NOs: 13-18, provided that the sequence provides an effective transmembrane domain and an effective intracellular T cell signaling domain.

[0134] The CAR of the present invention may comprise a sequence from the group of sequences shown in SEQ ID NOs: 25-36.

[0135] [ka]

[0136] [ka]

[0137] [ka]

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[0147] 4. Bispecific T Cell Engagers A wide variety of molecules have been developed based on the basic concept of having two antibody-like binding domains.

[0148] Bispecific T-cell-engaging molecules are a class of bispecific antibody-type molecules developed primarily for use as anticancer drugs. They direct the host's immune system, more specifically the cytotoxic activity of T cells, against target cells, such as cancer cells. In these molecules, one binding domain binds to T cells via the CD3 receptor, while the other binds to target cells, such as tumor cells, via a tumor-specific molecule. Because the bispecific molecule binds to both the target cell and the T cell, it brings the target cell into close proximity with the T cell, allowing the T cell to exert its effects, such as cytotoxicity against cancer cells. Formation of the T cell:bispecific antibody:cancer cell complex induces signaling in the T cell, leading to, for example, the release of cytotoxic mediators. Ideally, the agent would only induce the desired signaling in the presence of target cells, leading to selective killing.

[0149] Bispecific T cell engaging molecules have been developed in several different formats, but one of the most common is a fusion consisting of two tandem single-chain variable fragments (scFv) of different antibodies, sometimes known as BiTEs (bispecific T cell engagers).

[0150] The present invention also contemplates bispecific molecules that selectively recognize TRBC2 and are capable of activating T cells. For example, the molecule may be a BiTE.

[0151] Thus, in another aspect, the invention provides a bispecific T cell engager (BiTE) comprising a variant antigen-binding domain of the invention and a T cell activation domain, hereinafter a "BiTE of the invention."

[0152] The term "variant antigen-binding domain of the present invention" is described in detail in connection with the first aspect of the present invention, and its features and embodiments are equally applicable to this aspect of the present invention.

[0153] As used herein, the term "T cell activation domain" refers to a second domain capable of activating T cells. The T cell activation domain may be a scFv that specifically binds to CD3. Examples of anti-CD3 scFvs suitable for the present invention are well known in the art and include, without limitation, scFvs derived from OKT3.

[0154] The bispecific molecule can include a signal peptide that aids in its production. The signal peptide can cause secretion of the bispecific molecule by the host cell, so that the bispecific molecule can be harvested from the supernatant of the host cell.

[0155] The signal peptide can be at the amino terminus of the molecule. The bispecific molecule can have the following general formula: signal peptide - variant antigen-binding domain of the present invention - T cell activation domain.

[0156] To link the variant antigen-binding domain and the T cell activation domain of the present invention and spatially separate the two domains, the bispecific molecule can include a spacer sequence.

[0157] The spacer sequence can include, for example, an IgG1 hinge or a CD8 stalk. The linker can alternatively include an alternative linker sequence having a length and / or domain spacing characteristic similar to that of an IgG1 hinge or a CD8 stalk.

[0158] 5. Nucleic Acids In another aspect, the present invention also provides a nucleic acid sequence encoding the variant antigen-binding domain of the present invention, hereinafter "the first nucleic acid of the present invention".

[0159] In another aspect, the present invention also provides a nucleic acid sequence encoding an antibody of the invention, hereinafter a "second nucleic acid of the invention".

[0160] In another aspect, the present invention also provides a nucleic acid sequence encoding a CAR of the present invention, hereinafter the "third nucleic acid of the present invention."

[0161] In another aspect, the invention also provides a nucleic acid sequence encoding a BiTE of the invention, hereinafter the "fourth nucleic acid of the invention."

[0162] The terms "variant antigen-binding domain of the invention," "antibody of the invention," and "BiTE of the invention" have been described in detail in the context of the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0163] As used herein, the terms "polynucleotide," "nucleotide," and "nucleic acid" are intended to be synonymous with each other.

[0164] It will be understood by those skilled in the art that, as a result of the degeneracy of the genetic code, many different polynucleotides and nucleic acids can encode the same polypeptide. Furthermore, it should be understood that those skilled in the art can use routine techniques to make nucleotide substitutions that do not affect the polypeptide sequence encoded by the polynucleotides described herein to reflect the codon usage of any particular host organism in which the polypeptide will be expressed.

[0165] The nucleic acid sequences and constructs of the present invention may contain alternative codons in regions of the sequence that encode the same or similar amino acid sequences to avoid homologous recombination.

[0166] Nucleic acids according to the present invention may comprise DNA or RNA. Nucleic acids may be single-stranded or double-stranded. They may also be polynucleotides containing synthetic or modified nucleotides. Several different types of modifications to oligonucleotides are known in the art. These include methylphosphonate and phosphorothioate backbones, and the addition of acridine or polylysine chains to the 3' and / or 5' ends of the molecule. It should be understood that polynucleotides can be modified by any method available in the art for use as described herein. Such modifications can be made to enhance the in vivo activity or lifespan of the desired polynucleotide.

[0167] The terms "variant," "homologue," or "derivative" in relation to a nucleotide sequence include any substitution, variation, modification, replacement, deletion, or addition of one or more nucleic acid(s) from or to the sequence.

[0168] 6. Vector The present invention also provides vectors or kits of vectors comprising one or more nucleic acid sequences of the present invention. Such vectors can be used to introduce the nucleic acid sequences into host cells so that they express the variant antigen-binding molecules, or antibodies, or CARs, or BiTEs of the present invention.

[0169] The terms "variant antigen-binding domain of the invention," "antibody of the invention," and "BiTE of the invention" have been described in detail in the context of the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0170] The vector may be, for example, a plasmid or a viral vector, such as a retroviral or lentiviral vector, or a transposon-based vector or synthetic mRNA.

[0171] The vector may be one that is capable of transfecting or transducing a cytolytic immune cell, such as a T cell or an NK cell.

[0172] 7.Cells Another aspect of the present invention relates to a cell comprising a CAR of the present invention, hereinafter "the cell of the present invention."

[0173] The cell can contain a nucleic acid or vector of the invention.

[0174] The terms "CAR of the invention", "nucleic acid of the invention", "vector of the invention" have been described in detail in connection with the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0175] The cell may be a cytolytic immune cell, such as a T cell or an NK cell.

[0176] T cells or T lymphocytes are a type of lymphocyte that plays a central role in cell-mediated immunity. They can be distinguished from other lymphocytes, such as B cells and natural killer cells (NK cells), by the presence of a T cell receptor (TCR) on the cell surface. There are various types of T cells, as summarized below.

[0177] Helper T cells (TH cells) assist other white blood cells in immunological processes, including the maturation of B cells into plasma cells and memory B cells, and the activation of cytotoxic T cells and macrophages. TH cells express CD4 on their surface. TH cells are activated when peptide antigens are presented by MHC class II molecules on the surface of antigen-presenting cells (APCs). These cells can differentiate into one of several subtypes, including TH1, TH2, TH3, TH17, Th9, or THF, which secrete different cytokines to promote different types of immune responses.

[0178] Cytolytic T cells (TC cells, or CTLs) destroy virus-infected and tumor cells and are also implicated in transplant rejection. CTLs express CD8 on their surface. These cells recognize their targets by binding to antigens associated with MHC class I, which are present on the surface of all nucleated cells. Through IL-10, adenosine, and other molecules secreted by regulatory T cells, CD8+ cells can be inactivated and rendered anergic, thereby preventing autoimmune diseases such as experimental autoimmune encephalomyelitis.

[0179] Memory T cells are a subset of antigen-specific T cells that persist for a long time after an infection has resolved. They rapidly expand into large numbers of effector T cells upon re-exposure to cognate antigen, thereby providing the immune system with a "memory" for past infections. Memory T cells include three subtypes: central memory T cells (TCM cells) and two types of effector memory T cells (TEM cells and TEMRA cells). Memory cells can be either CD4+ or CD8+. Memory T cells generally express the cell surface protein CD45RO.

[0180] Regulatory T cells (Treg cells), formerly known as suppressor T cells, are crucial for maintaining immune tolerance. Their primary role is to shut down T cell-mediated immunity, directing the end of an immune response, and to suppress autoreactive T cells that have escaped the process of negative selection in the thymus.

[0181] Two major classes of CD4+ Treg cells have been described - naturally occurring Treg cells and adaptive Treg cells.

[0182] Naturally occurring Treg cells (also known as CD4+CD25+FoxP3+Treg cells) arise in the thymus and are associated with interactions between developing T cells and TSLP-activated myeloid dendritic cells (CD11c+) and plasmacytoid dendritic cells (CD123+). Naturally occurring Treg cells can be distinguished from other T cells by the presence of an intracellular molecule called FoxP3. Mutations in the FOXP3 gene can prevent the development of regulatory T cells, potentially causing the fatal autoimmune disease IPEX.

[0183] Adaptive Treg cells (also known as Tr1 or Th3 cells) can arise during a normal immune response.

[0184] The cells may be natural killer cells (or NK cells). NK cells form part of the innate immune system and provide a rapid, MHC-independent response to innate signals from virus-infected cells.

[0185] NK cells (belonging to the group of innate lymphoid cells) are defined as large granular lymphocytes (LGLs) and constitute a third type of cell that differentiates from a common lymphoid progenitor that generates B and T lymphocytes. NK cells are known to differentiate and mature in the bone marrow, lymph nodes, spleen, tonsils and thymus, from where they then enter the circulation.

[0186] The cells of the present invention may be any of the cell types noted above. In one embodiment, the cells of the present invention are T cells. In another embodiment, the cells of the present invention are NK cells.

[0187] Cells according to this aspect of the invention can be produced ex vivo from the patient's own peripheral blood (first party), or from donor peripheral blood (second party) in the context of hematopoietic stem cell transplantation, or from peripheral blood from an unrelated donor (third party).

[0188] Alternatively, cells according to this aspect of the invention may be derived from the ex vivo differentiation of inducible or embryonic precursor cells into cytolytic cells. Alternatively, immortalized cytolytic cell lines, such as T or NK cells, which retain their lytic function and can act as therapeutic agents can be used.

[0189] In all these embodiments, the CAR-expressing cells are generated by introducing DNA or RNA encoding the chimeric polypeptide by one of many means, including viral vector transduction, DNA or RNA transfection.

[0190] The cells of the present invention can be ex vivo cells from a subject. The cells can be from a peripheral blood mononuclear cell (PBMC) sample. Cells, particularly cytolytic cells such as T or NK cells, can be activated and / or expanded, for example, by treatment with an anti-CD3 monoclonal antibody, before being transduced with a nucleic acid encoding a molecule that provides a CAR of the present invention.

[0191] The cells of the invention can be produced by a method comprising transducing or transfecting a cell with a vector of the invention comprising a nucleic acid sequence encoding a CAR.

[0192] The method for producing the cells of the present invention can further comprise the step of isolating the cells from a cell-containing sample from a subject or other source as described above prior to the transduction or transfection step. If the cells are cytolytic cells, the sample is a cytolytic cell-containing sample from the subject.

[0193] The term "subject" or "individual" as used in the context of the present invention refers to a member of a mammalian species, preferably a human being, male or female, of any age or race.

[0194] The cells of the invention can then be purified, for example, by selection based on expression of the antigen-binding domain of the CAR.

[0195] 8. Conjugates The variant antigen binding domain or antibody of the invention may be a conjugate of the variant antigen binding domain or antibody, for example the conjugate may be a detectable entity or a chemotherapeutic entity.

[0196] The terms "variant antigen-binding domain of the invention" and "antibody of the invention" have been described in detail in relation to the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0197] The detectable entity may be a fluorescent moiety, such as a fluorescent peptide. As used herein, the term "fluorescent peptide" refers to a polypeptide that emits light of a detectable wavelength after excitation. Examples of fluorescent proteins include, but are not limited to, fluorescein isothiocyanate (FITC), phycoerythrin (PE), allophycocyanin (APC), green fluorescent protein (GFP), enhanced GFP, red fluorescent protein (RFP), blue fluorescent protein (BFP) and mCherry.

[0198] The variant antigen binding domains or antibodies of the invention conjugated to a detectable entity can be used to determine the TRBC of malignant T cells.

[0199] As used herein, the term "chemotherapeutic entity" refers to an entity that is destructive to cells, i.e., the entity reduces the viability of the cell. The resulting conjugate is hereinafter referred to as the "chemotherapeutic conjugate of the invention." The chemotherapeutic entity may be a cytotoxic drug. Contemplated chemotherapeutic agents include alkylating agents, nitrosoureas, ethyleneimine / methylmelamine, alkyl sulfonates, antimetabolites, pyrimidine analogs, epipodophyllotoxins, enzymes such as L-asparaginase; biological response modifiers, e.g., IFNα, IL-2, G-CSF, and GM-CSF; platinum coordination complexes, e.g., cisplatin and carboplatin, anthracenediones, substituted ureas such as hydroxyurea, methylhydrazine derivatives including N-methylhydrazine (MIH) and procarbazine, adrenocortical suppressants, e.g., mitotane (o,p'-DDD) and aminoglutethimide; and corticosteroid antagonists, e.g., prednisolone. These include, but are not limited to, hormones and antagonists, including donisone and equivalents, dexamethasone, and aminoglutethimide; progestins, such as hydroxyprogesterone caproate, medroxyprogesterone acetate, and megestrol acetate; estrogens, such as diethylstilbestrol and ethinyl estradiol equivalents; antiestrogens, such as tamoxifen; androgens, such as testosterone propionate and fluoxymesterone / equivalents; antiandrogens, such as flutamide, gonadotropin-releasing hormone analogs, and leuprolide; and nonsteroidal antiandrogens, such as flutamide.

[0200] The variant antigen binding domain or antibody of the invention conjugated to a chemotherapeutic entity allows for targeted delivery of the chemotherapeutic entity to cells expressing TRBC2.

[0201] 9. Pharmaceutical Compositions The present invention also relates to a pharmaceutical composition comprising a cell or a plurality of cells, or an antibody, or a BiTE, or a chemotherapeutic conjugate of the invention, hereinafter "pharmaceutical composition of the invention".

[0202] Pharmaceutical compositions can further comprise pharmaceutically acceptable carriers, diluents or excipients.Pharmaceutical compositions can optionally comprise one or more additional pharmaceutically active polypeptides and / or compounds.Such preparations can be, for example, suitable for intravenous injection.

[0203] The terms "cells of the invention," "antibodies of the invention," "BiTEs of the invention," and "chemotherapeutic conjugates of the invention" have been described in detail in connection with the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0204] Administration Administration of the cell or cells, or antibody, or BiTE, or chemotherapeutic conjugate of the invention can be achieved using any of a variety of routes that make the active ingredient bioavailable. For example, the agent can be administered by oral and parenteral routes, intraperitoneally, intravenously, subcutaneously, transdermally, intramuscularly, through local delivery, e.g., by catheter or stent.

[0205] Generally, a physician will determine the actual dosage that is most suitable for an individual subject, which will vary depending on the age, weight, and response of the particular patient. The dosage is sufficient to reduce or decrease the number of clonal T cells that express TRBC1 or TRBC2.

[0206] 10. Treatment Method In another aspect, the invention provides a cell, or antibody, or BiTE, or chemotherapeutic conjugate of the invention for use in medicine.

[0207] In another aspect, the present invention provides a method for treating T-cell lymphoma or leukemia in a subject, hereinafter "the treatment method of the present invention," comprising administering to the subject a cell, antibody, BiTE, or chemotherapeutic conjugate of the present invention, wherein the malignant T cells express TRBC2. The administration may be in the form of a pharmaceutical composition, as described above.

[0208] This embodiment of the invention can alternatively be formulated as a cell, or antibody, or BiTE, or chemotherapeutic conjugate of the invention for use in treating T-cell lymphoma or leukemia, hereafter "a cell, antibody, BiTE or chemotherapeutic conjugate for use of the invention," wherein the malignant T cells express TRBC2.

[0209] This aspect of the invention can alternatively be formulated as the use of a cell, or antibody, or BiTE, or chemotherapeutic conjugate of the invention in the manufacture of a medicament for treating T-cell lymphoma or leukemia, wherein the malignant T cells express TRBC2.

[0210] The terms "cells of the invention," "antibodies of the invention," "BiTEs of the invention," "subjects," and "chemotherapeutic conjugates of the invention" have been described in detail in connection with the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0211] Methods for treating T-cell lymphoma and / or leukemia relate to therapeutic uses of the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the invention. As used herein, the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the invention can be administered to a subject with an existing T-cell lymphoma and / or leukemia to alleviate, reduce, or ameliorate at least one symptom associated with the disease and / or to slow, reduce, or block the progression of the disease.

[0212] Methods for preventing T-cell lymphoma and / or leukemia involve the prophylactic use of the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the invention. As used herein, such cells, antibodies, BiTEs, or chemotherapeutic conjugates can be administered to subjects who do not already have T-cell lymphoma and / or leukemia and / or who do not exhibit any symptoms of T-cell lymphoma and / or leukemia to prevent or attenuate the cause of the disease or to reduce or prevent the occurrence of at least one symptom associated with the disease. The subject may be predisposed to or considered at risk for developing T-cell lymphoma and / or leukemia.

[0213] The method may include the following steps: (i) isolating a cytotoxic cell-containing sample; (ii) transducing or transfecting such cells with a nucleic acid sequence or vector provided by the present invention; and (iii) administering the cells from (ii) to a subject.

[0214] The cytotoxic cell-containing sample can be isolated from the subject or from other sources, e.g., as described above. Cytotoxic cells, such as T or NK, can be isolated from the subject's own peripheral blood (first party), or in the context of hematopoietic stem cell transplantation, from donor peripheral blood (second party), or from peripheral blood from an unrelated donor (third party).

[0215] The method for treating T-cell lymphoma and / or leukemia relates to the therapeutic use of a drug, which can be administered to a subject with an existing disease of T-cell lymphoma and / or leukemia to alleviate, reduce, or ameliorate at least one symptom associated with the disease, and / or to slow, reduce, or block the progression of the disease.

[0216] These therapeutic applications involve the administration of a therapeutically effective amount of the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the invention.

[0217] As used herein, the term "therapeutically effective amount" refers to the amount of the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the invention required to achieve appreciable prevention, cure, delay, reduction in the severity of, or amelioration of one or more symptoms of TRBC2-positive T-cell lymphoma and / or leukemia.

[0218] The methods of the present invention can be used for the treatment of any lymphoma and / or leukemia associated with clonal expansion of cells expressing a T cell receptor (TCR) comprising TRBC2. Thus, the present invention relates to methods for treating diseases involving malignant T cells expressing a TCR comprising TRBC2.

[0219] The method of the present invention can be used to treat T cell lymphoma in which malignant T cells express a TCR containing TRBC2. "Lymphoma" is used herein by its standard meaning to refer to cancer that typically develops in lymph nodes but can also invade the spleen, bone marrow, blood, and other organs. Lymphoma typically manifests as a solid tumor of lymphocytes. The primary symptom associated with lymphoma is lymphadenopathy, while secondary (B) symptoms can include fever, night sweats, weight loss, loss of appetite, fatigue, shortness of breath, and itching.

[0220] The methods of the present invention can be used to treat T-cell leukemia in which malignant T cells express a TCR that includes TRBC2. "Leukemia" is used herein by its standard meaning to refer to a cancer of the blood or bone marrow.

[0221] The following is an exemplary, non-exhaustive list of diseases that can be treated by the methods of the present invention.

[0222] Peripheral T-cell lymphoma Peripheral T-cell lymphomas are relatively rare lymphomas, accounting for less than 10% of all non-Hodgkin's lymphomas (NHLs). However, they are associated with an aggressive clinical course, and the cause and exact cellular origin of the majority of T-cell lymphomas remain poorly defined.

[0223] Lymphoma usually first presents as swelling in the neck, armpits, or groin. Additional swelling may occur where other lymph nodes are located, for example, in the spleen. Enlarged lymph nodes typically encroach on blood vessels, nerves, or stomach spaces, which can result in swelling of the arms and legs, tingling and numbness, or a feeling of fullness, respectively. Lymphoma symptoms also include nonspecific symptoms such as fever, chills, unexplained weight loss, night sweats, lethargy, and itching.

[0224] The WHO classification utilizes morphological and immunophenotypic features, combined with clinical features and, in some cases, genetics, to delineate prognostic and therapeutically meaningful categorizations of peripheral T-cell lymphomas (Swerdlow et al., WHO classification of tumors of hematopoietic and lymphoid tissues. 4th ed., Lyon: IARC Press, 2008). The anatomical localization of neoplastic T cells parallels, in part, their proposed normal cellular counterparts and functions, and thus T-cell lymphomas are associated with lymph nodes and peripheral blood. This approach allows for a better understanding of some of the manifestations of T-cell lymphomas, including cellular distribution, some aspects of morphology, and associated clinical findings.

[0225] The most common T-cell lymphoma is peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), which accounts for 25% of cases, followed by angioimmunoblastic T-cell lymphoma (AITL) (18.5%).

[0226] Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) PTCL-NOS accounts for more than 25% of all peripheral T-cell and NK / T-cell lymphomas and is the most common subtype. It is determined by a diagnosis of exclusion and does not correspond to any of the specific mature T-cell lymphoma entities listed in the current WHO 2008. As such, it resembles diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS).

[0227] The majority of patients are adults, with a median age of 60 years, and a male to female ratio of 2:1. The majority of cases are of nodal origin, but approximately 13% of patients experience extranodal manifestations, most commonly involving the skin and gastrointestinal tract.

[0228] The cytological spectrum is very broad, ranging from pleomorphic to monomorphic. Three morphologically defined variants have been described, including lymphoepithelioid (Lennert) variant, T-zone variant, and follicular variant. The lymphoepithelioid variant of PTCL contains abundant background epithelioid histiocytes and is generally CD8 positive. It is associated with a better prognosis. The follicular variant of PTCL-NOS is beginning to emerge as a potentially distinct clinicopathological entity.

[0229] The majority of PTCL-NOS have a mature T-cell phenotype, and the majority of cases are CD4 positive. 75% of cases show variable loss of at least one pan-T-cell marker (CD3, CD2, CD5, or CD7), with CD7 and CD5 being most frequently downregulated. CD30 and, rarely, CD15 may be expressed, with CD15 being an adverse prognostic feature. CD56 expression, although rare, also has a negative prognostic impact. Additional adverse pathologic prognostic factors include a proliferation rate of greater than 25% based on KI-67 expression and the presence of greater than 70% transformed cells. Immunophenotypic analysis of these lymphomas provides limited insight into their biology.

[0230] Angioimmunoblastic T-cell lymphoma (AITL) AITL is a systemic disease characterized by polymorphic infiltrates involving lymph nodes, prominent high endothelial venules (HEVs), and perivascular expansion of follicular dendritic cell (FDC) meshwork. AITL is considered a de novo T-cell lymphoma derived from follicular helper-type αβ T cells (TFH), which are usually found in germinal centers.

[0231] AITL is the second most common entity among peripheral T-cell lymphoma and NK / T-cell lymphoma, accounting for approximately 18.5% of cases. It occurs in middle-aged to older adults, with a median age of 65 years, and incidence rates are roughly equal in men and women. Clinically, patients usually have advanced-stage disease with generalized lymphadenopathy, hepatosplenomegaly, and prominent constitutional symptoms. A pruritic skin rash is commonly present. Polyclonal hypergammaglobulinemia, associated with autoimmune phenomena, is often present.

[0232] Three distinct morphological patterns have been described for AITL. The early lesions (pattern I) of AITL usually show a preserved architecture with characteristic hyperplastic follicles. The neoplastic proliferation is localized to the periphery of the follicles. In pattern II, the nodular architecture is partially obliterated, with few regressed follicles preserved. The subcapsular sinuses are preserved and even enlarged. The paracortex contains branched HEVs, and FDCs proliferate beyond the B-cell follicles. The neoplastic cells are small to medium in size, with minimal cytologic atypicality. They often have clear to hazy cytoplasm and may show distinct cell membranes. A polymorphic inflammatory background is usually evident.

[0233] Although AITL is a T-cell malignancy, there is a characteristic expansion of B cells and plasma cells, which may reflect the function of the neoplastic cells as TNF-cells. Both EBV-positive and EBV-negative B cells are present. In some cases, atypical B cells may morphologically and immunophenotypically resemble Hodgkin / Reed-Sternberg-like cells, sometimes resulting in diagnostic confusion. B-cell proliferation in AITL can be widespread, and some patients develop secondary EBV-positive diffuse large B-cell lymphoma (DLBCL) or, more rarely, EBV-negative B-cell neoplasms, often with plasmacytic differentiation.

[0234] Neoplastic CD4+ T cells in AITL show strong expression of CD10 and CD279 (PD-1) and are positive for CXCL13. CXCL13 leads to increased B cell recruitment to lymph nodes via adhesion to HEV, B cell activation, plasmacytic differentiation, and expansion of FDC meshworks, all of which contribute to the morphological and clinical characteristics of AITL. Strong PD-1 expression on perifollicular tumor cells is particularly helpful in distinguishing AITL pattern I from reactive follicular and paracortical hyperplasia.

[0235] The follicular variant of PTCL-NOS is a separate entity with a TFH phenotype. In contrast to AITL, it does not have prominent HEV or FDC extrafollicular expansion. Neoplastic cells may form intrafollicular aggregates mimicking B-cell follicular lymphoma, but they may also have an interfollicular growth pattern or involve mantle expansion. Clinically, the follicular variant of PTCL-NOS is distinct from AITL, as patients more frequently present with early disease with partial lymph node involvement and may lack the constitutional symptoms associated with AITL.

[0236] Anaplastic large cell lymphoma (ALCL) ALCL can be subdivided into ALCL-"anaplastic lymphoma kinase" (ALK)+ or ALCL-ALK-.

[0237] ALCL-ALK+ is one of the best-defined entities of peripheral T-cell lymphoma, possessing characteristic "hallmark cells" with horseshoe-shaped nuclei and expressing ALK and CD30. It accounts for approximately 7% of all peripheral T-cell and NK-cell lymphomas and is most common in the first 30 years of life. Patients often present with lymphadenopathy, but involvement of extranodal sites (skin, bone, soft tissue, lung, liver) and B symptoms are common.

[0238] ALCL, ALK+, exhibits a wide morphological spectrum, with five distinct patterns described, but all variants contain some hallmark cells. Hallmark cells have eccentric horseshoe- or kidney-shaped nuclei and prominent perinuclear eosinophilic Golgi regions. Tumor cells grow in a cohesive pattern with a predilection for sinus involvement. Smaller tumor cells predominate in the small cell variant, while in the lymphohistiocytic variant, the presence of tumor cells, many of which are small, is masked by abundant histiocytes.

[0239] By definition, all cases are ALK and CD30 positive, with expression usually weaker in smaller tumor cells. Pan-T cell markers are often absent, and surface expression of CD3 is absent in 75% of cases.

[0240] ALK expression is the result of a characteristic recurrent genetic alteration consisting of rearrangement of the ALK gene on chromosome 2 p23 to one of many partner genes, resulting in the expression of a chimeric protein. The most common partner gene, occurring in 75% of cases, is nucleophosmin (NPM1) on chromosome 5 q35, resulting in t(2;5)(p23;q35). The cellular distribution of ALK in different translocation variants can vary depending on the partner gene.

[0241] ALCL-ALK- was included as a provisional category in the 2008 WHO classification. It is defined as a CD30-positive T-cell lymphoma with a cohesive growth pattern and the presence of hallmark cells, morphologically indistinguishable from ALCL-ALK+, but lacking expression of the ALK protein.

[0242] Patients are usually adults between the ages of 40 and 65, in contrast to ALCL-ALK+, which is more common in children and young adults. In ALCL-ALK-, both lymph node and extranodal tissue involvement is possible, although the latter is less common than in ALCL-ALK+. The majority of ALCL-ALK- cases demonstrate obliteration of lymph node architecture by sheets of cohesive neoplastic cells with typical "hallmark" features. In contrast to ALCL-ALK+, a small cell morphologic variant has not been recognized.

[0243] ALCL-ALK-, unlike its ALK+ counterpart, shows greater conservation of surface T-cell marker expression, but less likely expression of cytotoxicity markers and epithelial membrane antigen (EMA). Gene expression signatures and recurrent chromosomal imbalances differ between ALCL-ALK- and ALCL-ALK+, confirming that they are distinct entities at the molecular and genetic levels.

[0244] ALCL-ALK- is clinically distinct from both ALCL-ALK+ and PTCL-NOS, and there are marked differences in prognosis between these three distinct entities. The 5-year overall survival rate for ALCL-ALK- has been reported to be 49%, which is not as good as that for ALCL-ALK+ (70%), but is also significantly better than that for PTCL-NOS (32%).

[0245] Enteropathy-associated T-cell lymphoma (EATL) EATL is an aggressive neoplasm thought to originate from intraepithelial T cells in the intestine. The 2008 WHO classification recognizes two morphologically, immunohistochemically, and genetically distinct types of EATL: type I (representing the majority of EATL) and type II (accounting for 10–20% of cases).

[0246] Type I EATL is usually associated with overt or clinically asymptomatic gluten-sensitive enteropathy and is more commonly seen in patients of Northern European descent due to the high prevalence of celiac disease in this population.

[0247] EATL lesions are most commonly found in the jejunum or ileum (90% of cases), and rarely in the duodenum, colon, stomach, or areas outside the gastrointestinal tract. Intestinal lesions are usually multifocal and associated with mucosal ulceration. The clinical course of EATL is aggressive, with the majority of patients dying from the disease or its complications within one year.

[0248] The cytological spectrum of EATL type I is broad, and some cases may contain undifferentiated cells. In some cases, a polymorphic inflammatory background is present, which may obscure the neoplastic component. The intestinal mucosa in the area adjacent to the tumor often exhibits features of celiac disease, with smoothing of the villi and an increased number of intraepithelial lymphocytes (IELs), which may represent pathological precursor cells.

[0249] By immunohistochemistry, neoplastic cells are often CD3+CD4-CD8-CD7+CD5-CD56-βF1+ and contain cytotoxic granule-associated proteins (TIA-1, granzyme B, perforin). CD30 is partially expressed in almost all cases. CD103, a mucosal homing receptor, may be expressed in EATL.

[0250] Type II EATL, also known as monomorphic CD56+ intestinal T-cell lymphoma, is defined as an intestinal tumor composed of small to medium-sized monomorphic T cells expressing both CD8 and CD56. Lateral spread of the tumor is often observed within the mucosa, without an inflammatory background. The majority of cases express the gamma delta TCR, although some cases also involve the alpha beta TCR.

[0251] Type II EATL has a more global distribution than type I EATL and is often seen in Asian or Latin American populations, where celiac disease is rare. In individuals of European descent, EATL II represents approximately 20% of intestinal T-cell lymphomas, with a history of celiac disease in at least a subset of cases. The clinical course is aggressive.

[0252] Hepatosplenic T-cell lymphoma (HSTL) HSTL is an aggressive systemic neoplasm that generally originates from gamma-delta cytotoxic T cells of the innate immune system, but in rare cases can originate from alpha-beta T cells. It is one of the rarest T-cell lymphomas and typically affects adolescents and young adults (median age, 35 years) with a strong male predominance.

[0253] Extranodal NK / T cell lymphoma nasal type Extranodal NK / T-cell lymphoma, nasal type, is an aggressive disease often associated with destructive midline lesions and necrosis. The majority of cases are derived from NK cells, but some cases are derived from cytotoxic T cells. It is commonly associated with Epstein-Barr virus (EBV).

[0254] Cutaneous T-cell lymphoma The methods of the invention can also be used to treat cutaneous T-cell lymphoma.

[0255] Cutaneous T-cell lymphoma (CTCL) is characterized by the migration of malignant T cells to the skin, resulting in the appearance of various lesions that change shape as the disease progresses, typically beginning as what appears to be a rash and eventually forming plaques and tumors that then metastasize to other parts of the body.

[0256] Cutaneous T-cell lymphomas include those described in the following illustrative, but not comprehensive, list: mycosis fungoides, Pagetoid reticulosis, Sezary syndrome, granulomatous lax cutis, lymphomatoid papulosis, pityriasis lichenoides chronica, CD30+ cutaneous T-cell lymphoma, secondary cutaneous CD30+ large cell lymphoma, non-mycosis fungoides CD30- cutaneous large T-cell lymphoma, pleomorphic T-cell lymphoma, Lennert lymphoma, subcutaneous T-cell lymphoma, and angiocentric lymphoma.

[0257] Signs and symptoms of CTCL vary depending on the specific disease, the two most common types of which are mycosis fungoides and Sézary syndrome. Classic mycosis fungoides has three stages: -Plaques (atrophic or nonatrophic): nonspecific dermatitis, plaques on lower trunk and buttocks; minimal / absent pruritus; -Plaques: intensely itchy plaques, lymphadenopathy; and -Tumor: ulcer-prone It can be divided into:

[0258] Sézary syndrome is defined by erythroderma and leukemia. Signs and symptoms include edematous skin, lymphadenopathy, palmar and / or plantar hyperkeratosis, alopecia, nail dystrophy, ectropion, and hepatosplenomegaly.

[0259] Of all primary cutaneous lymphomas, 65% are of the T-cell type. The most common immunophenotype is CD4-positive. The term cutaneous T-cell lymphoma encompasses a wide variety of disorders, and these diseases do not share a common pathophysiology.

[0260] The primary pathogenic mechanism for the development of cutaneous T-cell lymphoma (i.e., mycosis fungoides) is unknown. Mycosis fungoides may be preceded by a T-cell-mediated chronic inflammatory skin disease, which can occasionally progress to a fatal lymphoma.

[0261] Primary cutaneous ALCL (C-ALCL) C-ALCL is often morphologically indistinguishable from ALC-ALK-. It is defined as a large-cell cutaneous tumor of anaplastic, pleomorphic, or immunoblastic morphology in which more than 75% of cells express CD30. Together with lymphomatoid papulosis (LyP), C-ALCL belongs to the spectrum of primary cutaneous CD30-positive T-cell lymphoproliferative disorders, which as a group comprise the second most common cutaneous T-cell lymphoproliferative disorder after mycosis fungoides.

[0262] The immunohistochemical staining profile is quite similar to ALCL-ALK-, with a greater percentage of cases staining positive for cytotoxic markers. At least 75% of tumor cells should be positive for CD30. CD15 is also expressed, and when lymph node involvement occurs, differentiation from classic Hodgkin lymphoma can be difficult. Rare cases of ALCL-ALK+ may present with localized cutaneous involvement and may resemble C-ALCL.

[0263] T-cell acute lymphoblastic leukemia T-cell acute lymphoblastic leukemia (T-ALL) accounts for approximately 15% of ALL in pediatric cohorts and approximately 25% of ALL in adult cohorts. Patients usually have high white blood cell counts and may present with organomegaly, particularly mediastinal hypertrophy and CNS involvement.

[0264] The methods of the present invention can be used to treat T-ALL associated with malignant T cells expressing TCRs, including TRBCs.

[0265] T-cell prolymphocytic leukemia T-cell prolymphocytic leukemia (T-PLL) is a mature T-cell leukemia with aggressive behavior and a predilection for involvement of the blood, bone marrow, lymph nodes, liver, spleen, and skin. T-PLL primarily affects adults over the age of 30. Other names include T-cell chronic lymphocytic leukemia, "knotty" T-cell leukemia, and T-prolymphocytic leukemia / T-cell lymphocytic leukemia.

[0266] In peripheral blood, T-PLL consists of medium-sized lymphocytes with a single nucleolus and basophilic cytoplasm, occasionally with blebs or projections. The nuclei are usually round to ovoid, and patients occasionally have cells with more irregular nuclear contours, similar to the cerebriform nuclear shape seen in Sézary syndrome. The small cell variant accounts for 20% of all T-PLL cases, and the Sézary cell-like (cerebriform) variant is seen in 5% of cases.

[0267] T-PLL has the immunophenotype of mature (postthymic) T lymphocytes, and the neoplastic cells are generally positive for the pan-T antigens CD2, CD3, and CD7, and negative for TdT and CD1a. The immunophenotype CD4+ / CD8- is present in 60% of cases, the CD4+ / CD8+ immunophenotype is present in 25%, and the CD4- / CD8+ immunophenotype is present in 15% of cases.

[0268] The T-cell lymphoma or leukemia to be treated or prevented can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0269] The treatment method can include administering a therapeutic amount of a cell or cells, or antibody, or BiTE, or chemotherapeutic conjugate of the invention. Those skilled in the art can determine the amount of a cell or cells, or antibody, or BiTE, or chemotherapeutic conjugate of the invention that can exert a therapeutic effect on a patient by conventional methods.

[0270] 11. Diagnostic Agents TRBC2 + TRBC1 +It has previously been determined that the proportion of T cells from healthy donors expressing TRBC1 is 35% versus 65%, i.e., the median percentage of overall T cells expressing TRBC1 was 35% (range, 25-47%) (Maciocia et al., 2017, Nat Med 23:1416-23). ​​Because T-cell lymphoma or leukemia is a clonal cancer (Maciocia et al., 2017; supra), the uncontrolled proliferation of malignant T cells, which is a hallmark of T-cell lymphoma or leukemia, is associated with the expression of TRBC1. + or TRBC2 + T cells (i.e., TRBC2 - or TRBC1 - Therefore, by specifically binding to TRBC2 and thus being able to distinguish between TRBC1 and TRBC2, the variant antigen-binding domains and antibodies of the present invention are valuable agents for the diagnosis of T-cell lymphoma or leukemia.

[0271] Thus, in another aspect, the present invention provides a diagnostic agent comprising a variant antigen-binding domain of the invention, hereinafter the "first diagnostic agent of the invention".

[0272] In another aspect, the present invention provides a diagnostic agent comprising an antibody of the invention, hereinafter "second diagnostic agent of the invention". The terms "variant antigen-binding domain of the invention" and "antibody of the invention" have been described in detail in relation to the previous aspects of the invention, and the features and embodiments thereof apply equally to these aspects of the invention.

[0273] The variant antigen-binding domains or antibodies of the present invention used in these assays may be labeled or unlabeled. As used herein, the term "detectable label" or "labeling agent" refers to a molecular label that allows for the detection, localization, and / or identification of the molecule to which it is attached, using appropriate procedures and equipment for detection, for example, by spectroscopic, photochemical, biochemical, immunochemical, or chemical means. Labeling agents suitable for labeling antibodies include radionuclides, enzymes, fluorophores, chemiluminescent reagents, enzyme substrates or cofactors, enzyme inhibitors, particles, dyes, and derivatives. As those skilled in the art will understand, unlabeled variant antigen-binding domains and antibodies must be detected with additional reagents, such as labeled secondary antibodies. This is particularly beneficial for increasing the sensitivity of the detection method, as it allows for signal amplification. There are a variety of conventional assays that can be used in the present invention using unlabeled antibodies of the present invention (primary antibodies) and labeled antibodies of the present invention (secondary antibodies); these techniques include Western blots or immunoblots, ELISAs (enzyme-linked immunosorbent assays), RIAs (radioimmunoassays), competitive EIAs (competitive enzyme-linked immunosorbent assays), DAS-ELISAs (double antibody sandwich-ELISAs), immunocytochemical and immunohistochemical techniques, flow cytometry, or multiplexed detection techniques based on the use of protein microspheres, biochips, or microarrays containing the antibodies of the present invention. Other methods for detecting and quantifying TRBC2 using the variant antigen-binding domains or antibodies of the present invention include affinity chromatography techniques or ligand binding assays.

[0274] The diagnostic agent can be used to diagnose T-cell lymphoma or leukemia.

[0275] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0276] 12. Diagnostic Methods In another aspect, the present invention provides a method for diagnosing T-cell lymphoma or leukemia in a subject, hereinafter "diagnostic method of the invention", which method comprises contacting a variant antigen binding domain or antibody of the invention with a sample comprising T cells from the subject.

[0277] The terms "variant antigen-binding domain of the invention", "antibody of the invention" and "subject" have been described in detail in relation to the previous aspect of the invention, and the features and embodiments thereof apply equally to this aspect of the invention.

[0278] The diagnostic method of the present invention may further comprise the step of determining the percentage of TRBC2-positive T cells in the sample.

[0279] To carry out the first method of the present invention, a sample containing T cells, such as a biological sample, is obtained from a research subject. The term "sample" or "biological sample" as used herein includes different types of biological fluids or tissue sections of affected organs containing T cells. Illustrative, non-limiting examples of samples useful in the diagnostic method of the present invention include different types of biological fluids containing T cells, such as blood, lymph, and cerebrospinal fluid. These biological fluid samples can be obtained by any conventional method known to those skilled in the art. Alternatively, the sample can be a section of affected organ tissue sample, such as from lymph nodes, spleen, tonsils, or thymus, obtained by any conventional method, such as by biopsy or surgical resection, as well as from frozen sections taken for histological purposes.

[0280] According to the first step of the diagnostic method of the invention, a variant antigen-binding domain or antibody of the invention is contacted with a sample from a subject under suitable conditions known to those skilled in the art.

[0281] Those skilled in the art can use several conventional methods to detect TRBC2 in a sample, which are suitable for carrying out the second step of the diagnostic method of the present invention. Immunological methods are particularly useful. Therefore, the use of the first or second diagnostic agent of the present invention may be particularly useful for carrying out the diagnostic method of the present invention. The features and specific embodiments of the diagnostic agent of the present invention have been defined above and apply equally to the diagnostic method of the present invention.

[0282] In the diagnostic methods of the present invention, a percentage of TRBC2-positive T cells in a sample of 70%, or 75%, or 80%, or 85%, or 90%, or 95%, or 96%, or 97%, or 98%, or 99%, or higher, can indicate the presence of T-cell lymphoma or leukemia.

[0283] As will be understood by those skilled in the art, prediction is preferably, but not necessarily, correct for 100% of the subjects to be diagnosed or evaluated. However, this term requires that a statistically significant portion of subjects can be identified as having an increased probability of having a given result. Whether the data obtained from a subject is statistically significant can be easily determined by those skilled in the art using various well-known statistical evaluation tools, such as determining confidence intervals, determining p-values, cross-validation classification evaluation, etc. Details can be found in Dowdy and Wearden, Statistics for Research, John Wiley & Sons, New York 1983. Preferred confidence intervals are at least 50%, at least 60%, at least 70%, at least 80%, at least 90% or at least 95%. The p-value is preferably 0.01 or 0.005 or less.

[0284] Furthermore, given their ability to specifically bind to TRBC2-positive T cells, the variant antigen-binding domains or antibodies of the present invention can also be used in the in vivo diagnosis of T-cell lymphoma or leukemia, for example, they can be used in medical imaging, i.e., a set of techniques and processes used to generate images of the body (or its parts and functions), e.g., the human body, for clinical purposes, e.g., medical procedures that seek to reveal, diagnose, or examine disease.

[0285] For this purpose, the variant antigen-binding domains or antibodies of the invention can be labeled by suitable methods known in the art, for example, by conjugation and / or incorporation of a suitable molecule, such as a radioisotope or fluorescent dye, to provide them as agents for diagnostic imaging methods, such as radioimmunodiagnosis, positron emission tomography (PET), endoscopic immunofluorescence, etc. The variant antigen-binding domains and antibodies of the invention can be conjugated to a gamma-emitting isotope and used in radioimmunoscintigraphy using a gamma camera or single-photon tomography. The variant antigen-binding domains and antibodies of the invention can be conjugated to a positron emitter and used in PET. The variant antigen-binding domains and antibodies of the invention can be conjugated to a fluorescent dye, such as Cy3, Cy2, Cy5, or FITC, and used in endoscopic immunofluorescence. The variant antigen-binding domains and antibodies of the invention, modified as described, can be administered to an individual at an appropriate dose by any suitable route, for example, intravenously, and the location of TRBC2-positive T cells can be detected, determined, or measured by processes well known in the art. The methods and techniques used herein, including diagnostic imaging, will be known to those skilled in the art, who will also be able to provide suitable dosage formulations.

[0286] The T-cell lymphoma or leukemia to be diagnosed can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0287] The sample may be or may be derived from a blood sample.

[0288] 13. Personalized Medicine Methods In another aspect, the invention provides a method for identifying a subject with T-cell lymphoma or leukemia who is eligible for treatment with a cell, antibody, BiTE, or chemotherapeutic conjugate of the invention, hereinafter the "first personalized medicine method of the invention," comprising determining the percentage of TRBC2-positive T cells in a sample comprising T cells from the subject.

[0289] The terms "cells of the invention," "antibodies of the invention," "BiTEs of the invention," "chemotherapeutic agents of the invention," "subjects," and "samples comprising T cells" have been described in detail in connection with the previous aspect of the invention, and the features and embodiments thereof apply equally to this aspect of the invention.

[0290] In a first personalized medicine method of the present invention, if the percentage of TRBC2-positive T cells in the sample is 70%, or 75%, or 80%, or 85%, or 90%, or 95%, or 96%, or 97%, or 98%, or 99%, or higher, the subject is eligible for said treatment with the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the present invention.

[0291] In another aspect, the invention provides a method for selecting a therapy comprising a cell, antibody, BiTE, or chemotherapeutic conjugate of the invention for treatment of a subject, hereinafter the "second personalized medicine method of the invention," the method comprising determining the percentage of TRBC2-positive T cells in a sample comprising T cells from the subject.

[0292] The terms "cells of the invention," "antibodies of the invention," "BiTEs of the invention," "chemotherapeutic agents of the invention," "subjects," and "samples comprising T cells" have been described in detail in connection with the previous aspect of the invention, and the features and embodiments thereof apply equally to this aspect of the invention.

[0293] In a second personalized medicine method of the present invention, if the percentage of TRBC2-positive T cells in the sample is 70%, or 75%, or 80%, or 85%, or 90%, or 95%, or 96%, or 97%, or 98%, or 99%, or higher, a therapy comprising the cells, antibodies, BiTEs, or chemotherapeutic conjugates of the present invention is selected to treat the subject.

[0294] The sample may be or may be derived from a blood sample.

[0295] The T-cell lymphoma or leukemia can be selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

[0296] The present invention will now be further described by way of examples, which serve to aid those skilled in the art in carrying out the present invention and are not intended to limit the scope of the invention in any way. [Example]

[0297] Example 1 Analysis of anti-TRBC2 antibody binding by surface plasmon resonance (SPR) The crystal structure of the TRBC1-specific monoclonal antibody hJovi-1 was solved to 2.4 Å in complex with TRBC1-TCR (Figure 3). Through computational biology and protein engineering, several mutant versions of the anti-TRBC1 binder were rationally designed to switch specificity from TRBC1 to TRBC2. Several anti-TRBC2 binders were generated in IgG format. Table 1 details the mutations contained in the VH and VL domains of hJovi-1.

[0298] Using a Biacore T200 instrument, a series S CM5 sensor chip was immobilized by amine coupling, and anti-human Fc capture antibodies were immobilized to a density of 9,000–10,000 RU. HBS-P+ buffer was used as the running buffer for all experimental conditions. Test anti-TRBC2 antibodies (Table 1) were captured onto flow cells 2, 3, and 4 to a density of 100–300 RU. Known concentrations of recombinant purified TRBC1 or TRBC2 were used as the "analyte" and injected onto each flow cell at a flow rate of 30 μl / min with a contact time of 150 s and a dissociation time of 300 s. In each experiment, flow cell 1 was unmodified and used for reference subtraction. To account for drift, a "zero concentration" sensorgram containing only buffer was used for double reference subtraction. Data were fitted to a 1:1 Langmuir binding model. Because a capture system was used, a local R was used for data fitting in each case. max parameters were used.

[0299] The affinity results for TRBC1 and TRBC2 obtained with each anti-TRBC2 antibody are shown in Table 1. The anti-TRBC2 antibodies tested generally showed preferential binding to TRBC2 in the nM range, with varying k and k kinetic properties. In most cases, binding to TRBC1 was determined to be >1 μM, values ​​approaching the sensitivity limit of the instrument.

[0300] Example 2 Generation of KFN binder-based anti-TRBC2 CAR Second-generation CAR constructs were generated based on the anti-TRBC2 triple mutant (T28K, Y32F, A100N mutations in the VH domain of hJovi-1, SEQ ID NO: 26) and humanized Jovi-1 (hJovi-1) (Figure 4). These CAR constructs were cloned into retroviral vectors and used to transduce activated PBMCs obtained from healthy donors.

[0301] Example 3 Functional characterization of anti-TRBC2 CAR: Cytokine production To investigate the functional capacity of anti-TRBC2 triple mutant CAR-T cells against TRBC2, a plate-binding assay was used in which TRBC1 or TRBC2 was immobilized before the addition of CAR-T cells. After 72 hours, culture supernatants were collected, and IFN-γ production was measured by ELISA. In Figure 5A, anti-TRBC2 triple mutant CAR-T cells showed greater IFN-γ release in the presence of TRBC2 ligand compared to TRBC1. In contrast, hJovi-1 CAR-T cells showed higher IFN-γ production only when cultured with TRBC1 ligand (Figure 5B). These results demonstrate that anti-TRBC2 triple mutant-transduced CAR-T cells have greater activation and cytokine release in response to TRBC2 but not when exposed to TRBC1.

[0302] Example 4 Functional characterization of anti-TRBC2 CAR: cytotoxicity assay To determine the ability of the anti-TRBC2 triple mutant to target TRBC2, we set up a cytotoxicity assay using Raji cells transduced to express TRBC1 or TRBC2 and co-cultured with CAR-T cells. hJovi-1 CAR-T cells or the anti-TRBC2 triple mutant CAR-T cells were co-cultured with Raji WT, Raji TRBC1, or Raji TRBC2. + or Raji TRBC2 +The anti-TRBC2 triple mutant CAR-T cells were cultured at a 1:1 (E:T) ratio with either Raji or Raji TRBC2. Target cell recovery was measured after 72 hours of culture by flow cytometry and used to establish the cytotoxic potential of the CAR-T cells. Cultures containing the anti-TRBC2 triple mutant CAR-T cells were cultured at a 1:1 (E:T) ratio with either Raji or Raji TRBC2. + The anti-TRBC2 triple mutant CAR-T cells showed limited survival of target cells (Figure 6). In contrast, the anti-TRBC2 triple mutant CAR-T cells inhibited Raji TRBC1 + Does not eliminate target cells, TRBC2 + This demonstrates their increased ability to target cells.

[0303] We used an engineered monoclonal antibody to generate a second-generation anti-TRBC2 CAR. We demonstrated that our anti-TRBC2 CAR exhibited specificity, cytokine release, and cytotoxicity against TRBC2+ cell lines in 72-hour cocultures, but not against TRBC1+ cell lines or cell lines that did not express a TCR on their surface. Anti-TRBC2 CAR T cells also demonstrated proliferation capacity in long-term coculture assays.

[0304] Example 5 Functional characterization of anti-TRBC2 CAR: killing assay Additional second-generation CAR constructs were generated based on the anti-TRBC2 binders from Table 1 with the following mutations: - T28K, Y32F, A100N mutations in the VH domain of hJovi-1 and N35K in the VL domain (referred to as N35K, SEQ ID NO: 25), - T28K, Y32F, A100N, N103L mutations in the VH domain of hJovi-1 (referred to as N103L, SEQ ID NO: 27), - T28K, Y32F, A100N, N103M mutations in the VH domain of hJovi-1 and N35Y in the VL domain (referred to as N103M-N35Y, SEQ ID NO: 28); - T28K, Y32F, A100N, Y102F, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain (referred to as Y102F-N103M-N35R, SEQ ID NO: 29), - T28K, Y32F, A100N, Y102L, N103M mutations in the VH domain of hJovi-1 and N35R in the VL domain (referred to as Y102L-N103M-N35R, SEQ ID NO: 30).

[0305] These CAR constructs and the anti-TRBC2 triple mutant (T28K, Y32F, A100N mutation in the VH domain of hJovi-1, referred to as KFN, SEQ ID NO: 26) were cloned into retroviral vectors and used to transduce (a) Jurkat cells or (b) activated PBMCs obtained from healthy donors. An anti-TRBC1 control CAR, i.e., the hJovi-1 CAR construct, was used as a control in killing assays using activated PBMCs.

[0306] a) Jurkat cells To assess whether the resulting binders were specific for the TRBC2 antigen, TRBC1+ Jurkat cells were transduced with the anti-TRBC2 CAR construct described above. HPB-ALL cells transduced to express only TRBC1 or TRBC2 (referred to as HPB TRBC1 and HPB TRBC2, respectively) were used as target cells, and transduced Jurkat cells were co-cultured at a 1:1 effector-to-target (E:T) ratio with HPB-ALL cells carrying a knockout TCR (referred to as HPB KO) as a negative control. Transduced Jurkat cells were plated alone or with αCD3 / αCD28 antibodies to serve as negative or positive assay controls, respectively. Antigen-specific activation was examined by flow cytometry after 24 hours via CD69 staining.

[0307] The results, shown in Figure 7, revealed that all transduced Jurkat cells were selectively activated after co-incubation with HPB TRBC2 cells. Since no CD69 upregulation was observed when Jurkat cells were co-cultured with TRBC1 or HPB KO targets, these results demonstrate that all tested CARs displayed specificity for the TRBC2 target.

[0308] b) PBMCs First, after staining with 10 μg / ml of biotinylated mouse JOVI-1 antibody, which binds only to TRBC1, PBMCs were separated into TRBC1+ and TRBC2+ cells using magnetic anti-biotin-coated beads. The TRBC2+ population was transduced with the hJovi-1 CAR (JOVI), and the TRBC1+ population was transduced with the anti-TRBC2 CAR described above. This differential transduction ensured that antigen activation and target killing were only induced when targets were added under controlled culture conditions (e.g., effector-to-target ratio and time point), rather than in mixed populations where conditions varied for each PBMC donor.

[0309] Second, we set up a killing assay using HPB-ALL cells transduced to express only TRBC1 or TRBC2 (referred to as TRBC1+HPB-ALL and TRBC2+HPB-ALL, respectively) as target cells and HPB-ALL cells with a knockout TCR (referred to as HPB-KO) as a negative control. Ten days after transduction, the cells were co-cultured at an E:T ratio of 1:2. Cell killing was examined by flow cytometry 72 hours after assay setup.

[0310] The results demonstrated that hJovi-1 CAR-T cells killed only TRBC1+ HPB-ALL cells, and all anti-TRBC2 CAR-T cells killed only TRBC2+ HPB-ALL cells (Figure 8). Similar levels of background killing were observed for all TRBC1- and TRBC2-specific CAR-T cells in HPB-KO control cells, indicating that all CARs tested were specific for their cognate antigens.

[0311] Example 6 Analysis of the effect of different antibody formats on the binding of anti-TRBC2 antibodies by surface plasmon resonance (SPR) The effect of multimerization on anti-TRBC2 binders was analyzed by SPR. For this purpose, anti-TRBC2 antibodies with the T28K, Y32F, A100N, Y102L, and N103M mutations in the VH domain and the N35R mutation in the VL domain of hJovi-1 antibody were used in three different formats: scFv (SEQ ID NO: 22), scFv-Fc (SEQ ID NO: 23), and scFv-COMP (SEQ ID NO: 24). [ka] [ka]

[0312] To test the 1:1 binding interaction of anti-TRBC2 scFv, a Biacore T200 instrument was used to immobilize a series S CM5 sensor chip via amine coupling with an anti-human Fc capture antibody at a density of 9,000–10,000 RU. HBS-P+ buffer was used as the running buffer for all experimental conditions. The test anti-TRBC2 antibody was captured on flow cell 4 to a density of 200–250 RU. Known concentrations of recombinant purified TRBC1 or TRBC2 were used as the "analyte" and injected over each flow cell at a flow rate of 30 μl / min with a 150-second contact time and a 300-second dissociation time. Flow cell 1 was unmodified and used for reference subtraction. To account for drift, a "zero concentration" sensorgram containing only buffer was used for double reference subtraction. Data were fitted to a 1:1 Langmuir binding model. Because a capture system was used, a local R was used for data fitting in each case. max The parameters were used to determine the dissociation rate value and the half-life as t 1 / 2 = ln2 / kd.

[0313] The results, shown in Figure 9A, revealed that this anti-TRBC2 scFv binder had a half-life of 8 seconds. The binding affinity of this binder is shown in Table 1.

[0314] To test the multivalent interactions of the scFv-Fc and scFv-COMP antibody formats, a Series S CAP chip was immobilized with biotin capture reagent to 2500–5000 RU. Soluble recombinant biotinylated TRBC1 and TRBC2 were captured onto flow cell 3 to densities of 90–110 RU in independent experimental cycles. Purified anti-TRBC2 scFv-Fc or scFv-COMP antibodies were injected onto the flow cell at a flow rate of 30 μl / min with a 150-second contact time and a 300-second dissociation time. Flow cell 1, in which the biotinylated protein was omitted, was used for reference subtraction. To account for drift, a "zero concentration" sensorgram of buffer alone was used as a double reference subtraction. Data were fitted to a 1:1 Langmuir binding model. Because a capture system was used, the local Rmax parameter was used for data fitting in each case. Dissociation rate values ​​were determined, and half-lives were calculated as t. 1 / 2 = ln2 / kd.

[0315] The results, shown in Figures 9B and 9C, revealed half-lives of the scFv-Fc and scFv-COMP antibody formats to be 16.2 seconds and 7.3 minutes, respectively.

[0316] Thus, these results demonstrate that multimerization improves binding of low affinity / high specificity TRBC2 antibodies.

[0317] This application claims the benefit of UK Patent Application No. 1817822.8 filed on October 31, 2018, which is incorporated herein by reference in its entirety.

[0318] All publications mentioned in the above specification are incorporated herein by reference. Various modifications and variations of the described methods and systems of the present invention will be apparent to those skilled in the art without departing from the scope and spirit of the invention. Although the present invention has been described in connection with specific preferred embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the invention that are obvious to those skilled in molecular biology or related fields are intended to be within the scope of the following claims.

Claims

1. A variant antigen-binding domain comprising a VH domain having a sequence as set forth in SEQ ID NO: 1 with three, four or five mutations in the VH domain of the sequence as set forth in SEQ ID NO: 1, and a VL domain having a sequence as set forth in SEQ ID NO: 2, or a VL domain having a sequence as set forth in SEQ ID NO: 2 with one mutation in the VL domain of the sequence as set forth in SEQ ID NO: 2, wherein the mutations in the variant antigen-binding domain are any of the following combinations of mutations: - T28K, Y32F, A100N, N103E in the VH domain; - G31R, Y32F, A100N in the VH domain; - T28R, Y32F, A100N in the VH domain; - V2K, T28K, Y32F, A100N in the VH domain; - N103E, T28K, Y32F, A100N in the VH domain, and N35M in the VL domain; - T28K, Y32F, A100N, N103F in the VH domain, and N35K in the VL domain; - T28K, Y32F, A100N, A107S in the VH domain; - G31S, T28K, Y32F, A100N in the VH domain; - V2R, T28K, Y32F, A100N in the VH domain; - T28K, Y32F, A100N, N103M in the VH domain, and N35R in the VL domain; - N103W, T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - T28K, G31R, Y32F, A100N in the VH domain; - N103F, T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - N103F, T28K, Y32F, A100N in the VH domain, and N35M in the VL domain; - N103M, T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - T28K, Y32F, A100N, N103S in the VH domain; - T28K, Y32F, A100N, N103Q in the VH domain; - Y27F, T28K, Y32F, A100N in the VH domain; - N103F, T28K, Y32F, A100N in the VH domain, and N35Y in the VL domain; - N103W, T28K, Y32F, A100N in the VH domain, and N35M in the VL domain; - N103L, T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - N103L, T28K, Y32F, A100N in the VH domain, and N35K in the VL domain; - T28K, Y32F, A100N, N103W in the VH domain; - T28K, Y32F, A100N, N103F in the VH domain; - N103L, T28K, Y32F, A100N in the VH domain, and N35Y in the VL domain; - N103W, T28K, Y32F, A100N in the VH domain, and N35K in the VL domain; - N103L, T28K, Y32F, A100N in the VH domain, and N35R in the VL domain; - N103L, T28K, Y32F, A100N in the VH domain, and N35M in the VL domain; - N103S, T28K, Y32F, A100N in the VH domain, and N35Y in the VL domain; - N103S, T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - T28K, Y32F, A100N, N103L in the VH domain; - T28K, Y32F, A100N, N103M in the VH domain, and N35Y in the VL domain; - N103S, T28K, Y32F, A100N in the VH domain, and N35R in the VL domain; - T28K, Y32F, R98K, A100N in the VH domain; - N103S, T28K, Y32F, A100N in the VH domain, and N35K in the VL domain; - T28K, Y32F, A100N in the VH domain, and N35F in the VL domain; - N103W, T28K, Y32F, A100N in the VH domain, and N35R in the VL domain; - T28K, Y32F, A100N, N103M in the VH domain; - N103S, T28K, Y32F, A100N in the VH domain, and N35M in the VL domain; - T28K, Y32F, A100N in the VH domain, and N35R in the VL domain; - T28K, Y32F, A100N, N103Y in the VH domain; - T28K, Y32F, A100N, N103A in the VH domain; - T28K, Y32F, A100N, N103H in the VH domain; - T28K, Y32F, A100N, N103M in the VH domain, and N35M in the VL domain; - T28K, Y32F, A100N in the VH domain and N35K in the VL domain; - T28K, Y32F, A100N in the VH domain and R55K in the VL domain; - T28K, Y32F, A100N in the VH domain; - Y27W, T28K, Y32F, A100N in the VH domain; - T28K, Y32F, A100N, Y102F in the VH domain, and N35R in the VL domain; - T28K, Y32F, A100N, Y102F, N103M in the VH domain, and N35R in the VL domain; - T28K, Y32F, A100N, Y102F, N103M in the VH domain, and N35F in the VL domain; - Y27M, T28K, Y32F, A100N in the VH domain; - T28K, G31K, Y32F, A100N in the VH domain; - T28K, Y32F, A100N, Y102F, N103M in the VH domain, and N35K in the VL domain; or - Y27N, T28K, V32F, A100N in the VH domain; wherein said variant antigen-binding domain displays increased affinity for TRBC2 compared to a reference antibody, said reference antibody comprising a VH domain having the sequence set forth in SEQ ID NO: 1 and a VL domain having the sequence set forth in SEQ ID NO:

2.

2. 2. The variant antigen-binding domain of claim 1, wherein the mutations in the VH domain consist of T28K, Y32F and A100N, and the mutation in the VL domain consists of N35K.

3. 2. The variant antigen-binding domain of claim 1, wherein the mutations in the VH domain consist of T28K, Y32F and A100N.

4. 4. The variant antigen-binding domain of any of claims 1 to 3, further exhibiting reduced affinity for TRBC1 compared to said reference antibody.

5. 5. The variant antigen-binding domain of claim 1 , further comprising an oligomerization domain.

6. An antibody comprising a variant antigen-binding domain according to any one of claims 1 to 4.

7. A chimeric antigen receptor (CAR) comprising the variant antigen-binding domain of any one of claims 1 to 4, a spacer, a transmembrane domain, and an endodomain.

8. The CAR of claim 7, wherein the spacer is selected from the human CD8 stalk shown in SEQ ID NO: 7 and the COMP spacer shown in SEQ ID NO:

19.

9. 5. A bispecific T cell engager (BiTE®) comprising a variant antigen-binding domain of any one of claims 1 to 4 and a T cell activation domain.

10. A nucleic acid encoding a variant antigen-binding domain of any one of claims 1 to 5, an antibody of claim 6, a CAR of claim 7 or 8, or a BiTE® of claim 9.

11. A vector comprising the nucleic acid of claim 10.

12. A cell comprising the CAR of claim 7 or 8.

13. 13. A method for producing the cell of claim 12, comprising transducing or transfecting a cell ex vivo with the vector of claim 11, comprising a nucleic acid encoding a CAR.

14. A conjugate comprising a variant antigen-binding domain according to any one of claims 1 to 5 or an antibody according to claim 6 and a detectable or chemotherapeutic entity.

15. 15. The conjugate of claim 14, comprising a chemotherapeutic entity.

16. 16. A composition for treating T-cell lymphoma or leukemia in a subject, comprising a cell according to claim 12 or an antibody according to claim 6, or a BiTE® according to claim 9, or a conjugate according to claim 14 or 15, wherein T cells of the T-cell lymphoma or leukemia express TRBC2.

17. A composition comprising a cell according to claim 12, or an antibody according to claim 6, or a BiTE (registered trademark) according to claim 9, or a conjugate according to claim 14 or 15, for use in medicine.

18. 16. A composition comprising a cell according to claim 12, or an antibody according to claim 6, or a BiTE® according to claim 9, or a conjugate according to claim 14 or 15, for use in the treatment of T-cell lymphoma or leukemia, wherein T cells of the T-cell lymphoma or leukemia express TRBC2.

19. 16. Use of a cell according to claim 12, or an antibody according to claim 6, or a BiTE® according to claim 9, or a conjugate according to claim 14 or 15, in the manufacture of a medicament for treating a T-cell lymphoma or leukemia, wherein the T cells of the T-cell lymphoma or leukemia express TRBC2.

20. A diagnostic agent comprising a variant antigen-binding domain according to any one of claims 1 to 5 or an antibody according to claim 6.

21. The diagnostic agent according to claim 20 for diagnosing T-cell lymphoma or leukemia.

22. 10. A composition comprising a variant antigen-binding domain according to any one of claims 1 to 5 or an antibody according to claim 6 for use in a method for diagnosing T-cell lymphoma or leukemia in a subject, the method comprising contacting the variant antigen-binding domain or the antibody with a sample comprising T cells from the subject.

23. 23. The composition of claim 22, wherein the method further comprises determining the percentage of TRBC2 positive T cells in the sample.

24. 24. The composition of claim 23, wherein a percentage of TRBC2 positive T cells in said sample of 70% or higher indicates the presence of T cell lymphoma or leukemia.

25. 25. The composition of any of claims 22 to 24, wherein the sample is or is derived from a blood sample.

26. 20. The use of claim 19, wherein the T-cell lymphoma or leukemia is selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

27. 26. The composition of any one of claims 16, 18, 22 to 24, and 25, or the diagnostic agent of claim 21, wherein the T-cell lymphoma or leukemia is selected from peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma (ALCL), enteropathy-associated T-cell lymphoma (EATL), hepatosplenic T-cell lymphoma (HSTL), extranodal NK / T-cell lymphoma, nasal type, cutaneous T-cell lymphoma, primary cutaneous ALCL, T-cell prolymphocytic leukemia, and T-cell acute lymphoblastic leukemia.

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