Engineered immune cells and uses thereof
Engineered immune cells with GUCY2C-targeted CARs and co-expressed ICIs enhance cytotoxicity against MSS/pMMR mCRC by targeting GUCY2C, addressing the ineffectiveness of current immunotherapies and reducing treatment-related toxicities.
Patent Information
- Application Number
- PCT/CN2025/085085
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-03-27
- Filing Date
- 2025-03-26
- Publication Date
- 2025-10-02
AI Technical Summary
Current immunotherapy regimens for microsatellite stable/proficient mismatch repair (MSS/pMMR) metastatic colorectal cancer (mCRC) are ineffective, as patients have multiple innate resistance mechanisms, including low tumor lymphocyte infiltration and mutation burden, leading to poor prognosis and limited response to immune checkpoint inhibitors (ICIs).
Administering engineered immune cells, such as T cells, expressing a chimeric receptor (CAR) specific for GUCY2C and co-expressing an immune checkpoint inhibitor, such as an anti-PD-1 antibody, to target GUCY2C-positive cancers, allowing for localized delivery and enhanced cytotoxicity against tumor cells.
The combination therapy significantly increases cytotoxicity against GUCY2C-positive tumor cells, even in the absence of high antigen expression, while minimizing off-tumor toxicity and exhaustion, offering a safer and more effective treatment for MSS/pMMR cancers.
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Abstract
Description
ENGINEERED IMMUNE CELLS AND USES THEREOFCROSS REFERENCE TO RELATED APPLICATION
[0001] This application claims benefit of priority of International Patent Application No. PCT / CN2024 / 084174 filed on March 27, 2024, the content of which is incorporated herein by reference in its entirety. SEQUENCE STATEMENT
[0002] This application contains a Sequence Listing that has been submitted electronically as an XML file named “IEC250054PCT-seql. XML. ” The XML file, created on March 25, 2025, is 83, 123 bytes in size. The material in the XML file is hereby incorporated by reference in its entirety.FIELD OF INVENTION
[0003] The present disclosure relates to methods of treating a GUCY2C-positive cancer (e.g., metastatic colorectal cancer or metastatic gastric cancer) in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody) , wherein the engineered immune cell comprises a chimeric receptor (such as a chimeric antigen receptor (CAR) ) comprising: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain. Also provided are engineered immune cells co-expressing a chimeric receptor and an immune checkpoint inhibitor, and methods of making thereof.BACKGROUND
[0004] Guanylyl cyclase C, also known as Guanylate cyclase 2C (GCC, GUC2C or GUCY2C) , a member of the family of receptor guanylyl cyclases, is a transmembrane receptor for ligands guanylin, uroguanylin, lyphoguanylin and Escherichia coli (E. coli) heat-stable enterotoxin (STa) (see Proc. Natl. Acad. Sci. USA 93: 14827-14832 (1996) ; Eur J Cancer 41: 1618-1627 (2005) ) . GUCY2C is selectively expressed in intestine and colorectal tumors in humans and is a relatively specific marker for metastatic cancer cells in extraintestinal tissues (see Proc. Natl. Acad. Sci. USA 93: 14827-14832 (1996) ) . Thus, GUCY2C can serve as a highly sensitive and specific molecular marker for colorectal cancer (CRC) in detecting tumor cells in normal tissues and blood for staging and surveillance of CRC (see Gastroenterology 107: 1653-1661 (1994) ; Proc. Natl. Acad. Sci. USA 93: 14827-14832 (1996) ; Eur J Cancer 41: 1618-1627 (2005) ) . Recent studies have defined a new role as a tumor suppressor for GUCY2C, which together with its ligands have been implicated in the regulation of the balance of proliferation and differentiation along the crypt-to-villus axis in the intestine. Consequently, GUCY2C has emerged as a promising therapeutic target (see Proc. Natl. Acad. Sci. USA 100: 3018-3020 (2003) ; Expert Rev Clin Pharmacol, 10 (5) : 549-557 (2017) ) .
[0005] Immune checkpoint proteins include stimulatory and inhibitory molecules that play a critical role in regulating the immune system (see Br J Pharmacology 174 (22) : 3940-3955 (2017) ) . Immune checkpoint inhibitors (ICIs) have become a prominent tool in cancer immunotherapy as a strategy to block the interaction between immune checkpoint proteins and their ligand binding partners expressed on tumor cells (see Front Pharmacology 12: 731798 (2021) ; Clin Pract. 13 (1) : 22-40 (2022) ) . Programmed cell death protein 1 (PD-1, also known as CD279) is an inhibitory checkpoint protein expressed on a variety of immune cells including T cells, B cells, NK cells, monocytes and dendritic cells (see Annu Rev Immunol. 26: 677-704 (2008) ) . The binding of PD-1 to its ligand partner PD-L1 results in downstream signaling that inhibits T cell activation. Cancers have exploited this pathway by overexpressing PD-L1, resulting in an inhibitory signal that allows the tumor to avoid being targeted by the immune system (see Cell Insight. 3 (2) : 100146 (2024) ) . ICIs such as anti-PD-1 antibodies block this interaction, allowing T cells to kill the tumor cells. This therapeutic approach has been utilized in treating many cancer types, including gastrointestinal cancers such as colon cancer (see Biomedicines. 9 (9) : 1075 (2021) ) .
[0006] In the ICI therapy of colorectal cancer, the main beneficiaries are patients with highly immunogenic microsatellite instability-high (MSI-H) / deficient mismatch repair (dMMR) type. Approximately 5%of metastatic colorectal cancer (mCRC) are characterized by microsatellite instability (MSI) and / or deficiency in the mismatch repair pathway (dMMR) . These patients are insensitive to traditional chemotherapy and have a poor prognosis. However, ICIs have shown significant effects in treating these types of patients, both in first-line and later-line treatment, as well as neoadjuvant treatment of early-stage CRC.
[0007] Currently, the US-FDA has approved three immunotherapy regimens for the treatment of MSI-H / dMMR mCRC: pembrolizumab, nivolumab, and nivolumab in combination with ipilimumab. Results from the KEYNOTE-177 trial (NCT02563002) showed that in patients with untreated MSI-H / dMMR mCRC, first-line pembrolizumab significantly improved progression-free survival (PFS) (16.5 months vs 8.2 months, HR=0.6) and overall response rate (ORR) (45%vs 33%) and reduced overall toxicity (22%vs 66%) , compared with standard chemotherapy plus targeted therapy. Pembrolizumab is also the first-line standard therapy for patients with unresectable or metastatic MSI-H / dMMR mCRC in China. In the phase II CheckMate 142 study (NCT02060188) , patients with MSI-H / dMMR mCRC receiving first-line nivolumab and low-dose ipilimumab showed an ORR of 55%and good tolerability. Based on the results of the CheckMate 142 study, the 2023 version of the Chinese Society of Clinical Oncology (CSCO) guideline listed the nivolumab / ipilimumab dual-immunotherapy as a level III recommendation for palliative first-line treatment, and a level II recommendation for second-line and above treatment, in patients with MSI-H / dMMR mCRC.
[0008] Most mCRC patients have microsatellite stable (MSS) / proficient mismatch repair (pMMR) status. These patients have multiple innate resistance mechanisms to immunotherapy, such as low levels of tumor lymphocyte infiltration and tumor mutation burden. They usually cannot benefit from ICI treatment. Many studies have explored the efficacy of various treatment combinations in the MSS / pMMR mCRC patient population. (I) PD-1 inhibitor combined with small molecule anti-angiogenic drug tyrosine kinase inhibitor (TKI) : although the REGONIVO study showed that nivolumab combined with low-dose regorafenib showed good ORR (33.3%) and median progression-free survival (mPFS; 7.9 months) data in treating refractory MSS / pMMR mCRC, subsequent single-arm studies using different TKIs and PD-1 / PD-L1 monoclonal antibody combination regimens all showed limited efficacy data. (II) PD-L1 inhibitor combined with standard chemotherapy and anti-VEGF treatment: the BACCI study compared the efficacy of capecitabine and bevacizumab combined with atezolizumab or placebo in the third-line treatment of mCRC patients. The results showed that the ORR of the atezolizumab / capecitabine / bevacizumab triple combination group was slightly improved compared with the placebo / capecitabine / bevacizumab group, but mPFS and median overall survival (mOS) were not improved. In the AtezoTRIBE study, FOLFOXIRI and bevacizumab combined with atezolizumab showed longer PFS, but did not reach a significant difference compared to the FOLFOXIRI / bevacizumab control group (12.9 months vs 11.4 months, P=0.071) , and 2 cases were reported in the triple combination immunotherapy group (1%) with treatment-related deaths, while no death was reported in the control group. (III) PD-L1 inhibitor combined with anti-EGFR therapy: a phase II study of ipilimumab combined with nivolumab and panitumumab showed that triple therapy showed the primary endpoint ORR of 35%and mPFS of 5.7 months at Week 12 in RAS / BRAF wild-type and previously treated MSS / pMMR mCRC patients. Compared with the reported efficacy results of panitumumab monotherapy in late-line treatment, the triple combination therapy showed no significant difference in ORR or PFS. (IV) Dual-immunotherapy combination: The CCTG CO. 26 study evaluated the combination regimen of durvalumab and tremelimumab for the later-line treatment of patients with MSS / pMMR mCRC. The results showed that the combination therapy showed slightly prolonged OS compared to the best supportive therapy (6.6 months vs 4.1 months, p = 0.07, HR=0.72) , but there was no significant difference in PFS (1.8 months vs 1.9 months, p = 0.97, HR=1.01) . Currently, there is no approved or recommended immunotherapy regimens or combination regimens for the MSS / pMMR mCRC patient population.
[0009] The disclosure of all publications, patents, patent applications and published patent applications referred to herein are hereby incorporated by reference in their entirety. BRIEF SUMMARY OF THE INVENTION
[0010] The present application in one aspect provides methods of treating a GUCY2C-positive cancer (e.g., colorectal cancer) in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody) , wherein the engineered immune cell comprises a chimeric receptor (such as a CAR) comprising: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in separate compositions. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in a single composition. In some embodiments, the immune checkpoint inhibitor is secreted by the engineered immune cell. In some embodiments, the engineered immune cell comprises a first nucleic acid encoding the chimeric receptor, and a second nucleic acid encoding the immune checkpoint inhibitor. In some embodiments, the first nucleic acid further encodes a chimeric receptor signal peptide N-terminal to the chimeric receptor. In some embodiments, the second nucleic acid further encodes an immune checkpoint inhibitor signal peptide N-terminal to the immune checkpoint inhibitor.
[0011] In some embodiments according to any of the methods described above, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer.
[0012] In some embodiments according to any of the methods described above, the administration is independent of the microsatellite instability (MSI) or mismatch repair (MMR) status of the GUCY2C-positive cancer.
[0013] In some embodiments according to any of the methods described above, the GUCY2C-positive cancer is deficient mismatch repair (dMMR) or proficient mismatch repair (pMMR) cancer.
[0014] In some embodiments according to any of the methods described above, the GUCY2C-positive cancer has microsatellite instability (MSI) or is microsatellite stable (MSS) .
[0015] In some embodiments according to any of the methods described above, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer.
[0016] In some embodiments according to any of the methods described above, the GUCY2C-positive cancer expresses high level of GUCY2C. In some embodiments, the GUCY2C-positive cancer expresses moderate level of GUCY2C. In some embodiments, the GUCY2C-positive cancer expresses low level of GUCY2C.
[0017] In some embodiments according to any of the methods described above, the antigen binding domain of the chimeric receptor is selected from the group consisting of a Fab, a Fab’, a (Fab’) 2, an Fv, a single chain Fv (scFv) , a single domain antibody (sdAb) , and a peptide ligand specifically binding to GUCY2C.
[0018] In some embodiments according to any of the methods described above, the antigen binding domain of the chimeric receptor is an sdAb ( “anti-GUCY2C sdAb” ) . In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a CDR2 comprising the amino acid sequence of SEQ ID NO: 9, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 17; (ii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 2, a CDR2 comprising the amino acid sequence of SEQ ID NO: 10, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 18; (iii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 19; (iv) a CDR1 comprising the amino acid sequence of SEQ ID NO: 4, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 20; (v) a CDR1 comprising the amino acid sequence of SEQ ID NO: 5, a CDR2 comprising the amino acid sequence of SEQ ID NO: 12, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 21; (vi) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 22; (vii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 14, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 23; (viii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24; or (ix) a CDR1 comprising the amino acid sequence of SEQ ID NO: 8, a CDR2 comprising the amino acid sequence of SEQ ID NO: 16, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 25. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41.
[0019] In some embodiments according to any of the methods described above, the chimeric receptor is a chimeric antigen receptor (CAR) , and wherein the chimeric receptor further comprises an intracellular signaling domain. In some embodiments, the transmembrane domain is derived from the group consisting of CD8α, CD4, CD28, 4-1BB, CD80, CD86, CD152, and PD-1, such as derived from CD8α. In some embodiments, the intracellular signaling domain is derived from the group consisting of CD3ζ, FcRγ, FcRβ, CD3γ, CD3δ, CD3ε, CD5, CD22, CD79a, CD79b, and CD66d, such as derived from CD3ζ. In some embodiments, the chimeric receptor further comprises an intracellular co-stimulatory signaling domain. In some embodiments, the intracellular co-stimulatory signaling domain is derived from a co-stimulatory molecule selected from the group consisting of CD27, CD28, CD137, OX40, CD40, PD-1, LFA-1, ICOS, CD2, CD7, LIGHT, NKG2C, B7-H3, TNFRSF9, TNFRSF4, TNFRSF8, CD40LG, ITGB2, KLRC2, TNFRSF18, TNFRSF14, HAVCR1, LGALS9, DAP10, DAP12, CD83, ligands of CD83 and combinations thereof. In some embodiments, the intracellular co-stimulatory signaling domain is derived from a cytoplasmic domain of CD137. In some embodiments, the chimeric receptor further comprises a hinge domain located between the antigen binding domain and the transmembrane domain, such as derived from CD8α. In some embodiments, the chimeric receptor comprises the amino acid sequence of SEQ ID NO: 54.
[0020] In some embodiments according to any of the methods described above, the immune checkpoint inhibitor is an antibody or antigen-binding fragment thereof specifically recognizing an immune checkpoint protein. In some embodiments, the antibody or antigen-binding fragment thereof is selected from the group consisting of a full-length antibody, a Fab, a Fab’, a (Fab’) 2, an Fv, an scFv, and an sdAb, such as a full-length antibody or an scFv. In some embodiments, the immune checkpoint protein is selected from the group consisting of PD-1, PD-L1, TIGIT, LAG-3, CTLA-4, BTLA, and TIM-3. In some embodiments, the immune checkpoint protein is PD-1. In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 comprises an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is a full-length antibody ( “anti-PD-1 full-length antibody” ) . In some embodiments, the anti-PD-1 full-length antibody comprises a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is an scFv ( “anti-PD-1 scFv” ) . In some embodiments, the anti-PD-1 scFv comprises the amino acid sequence of SEQ ID NO: 50.
[0021] In some embodiments according to any of the methods described above, the first nucleic acid and the second nucleic acid are on different vectors. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector. In some embodiments, the first nucleic acid and the second nucleic acid are under the control of the same promoter. In some embodiments, the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker, such as a 2A peptide. In some embodiments, the vector encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56.
[0022] In some embodiments according to any of the methods described above, the engineered immune cell is selected from the group consisting of T cell, NK cell, B cell, monocyte, dendritic cell, and any combination thereof, such as a T cell.
[0023] The present application in another aspect provides engineered immune cells comprising: a) a first nucleic acid encoding a chimeric receptor (e.g., CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding an immune checkpoint inhibitor. In some embodiments, the engineered immune cell is any of the engineered immune cells co-expressing a chimeric receptor and an immune checkpoint inhibitor described in any of the methods described above. Also provided are pharmaceutical compositions comprising any of the engineered immune cells described herein, and a pharmaceutically acceptable excipient. Further provided are methods of making any of the engineered immune cells described herein, comprising: a) providing a population of immune cells (e.g., T cells) ; b) introducing into the population of immune cells a first nucleic acid encoding the chimeric receptor and a second nucleic acid encoding the immune checkpoint inhibitor.BRIEF DESCRIPTION OF THE DRAWINGS
[0024] FIGs. 1A-1C show the schematic construct structures. FIG. 1A shows a schematic construct structure of “C07” , encoding an anti-GUCY2C sdAb CAR. FIG. 1B shows a schematic construct structure of “C07-anti-PD-1-IgG” , encoding an anti-GUCY2C sdAb CAR and a full-length anti-PD-1 antibody. FIG. 1C shows a schematic structure of “C07-anti-PD-1-scFv” , encoding an anti-GUCY2C sdAb CAR and an anti-PD-1 scFv (e.g., VH- (G4S) 3 linker-VL) . The anti-PD-1 antibodies comprise a His6 tag at the C-terminus, and linked with a self-cleaving 2A (e.g., P2A) linker at the N-terminus for secretion of the anti-PD-1 antibodies.
[0025] FIGs. 2A-2D show the anti-GUCY2C sdAb CAR expression levels of the CAR-T cell groups or negative control group. FIG. 2A shows that 0.04%of negative control T cells that were not transduced with a sequence encoding anti-GUCY2C sdAb CAR or anti-PD-1 antibody (unT) were CAR-positive. FIG. 2B shows that 40.54%of T cells transduced with C07 construct were CAR-positive. FIG. 2C shows that 18.92%of T cells transduced with C07-anti-PD-1-IgG construct were CAR-positive. FIG. 2D shows that 48.85%of T cells transduced with C07-anti-PD-1-scFv construct are CAR-positive.
[0026] FIG. 3 shows the level of anti-PD-1 antibodies secreted in the supernatant of CAR-T cells or negative control. Both of C07-anti-PD-1-IgG CAR-T and C07-anti-PD-1-scFv CAR-T cell groups showed high secretion of anti-PD-1 antibodies. C07 CAR-T cells and negative control T cells (unT) did not secrete anti-PD-1 antibody.
[0027] FIG. 4 shows the PD-1 block rate by secreted anti-PD-1 antibodies in different volumes of supernatant from various CAR-T cell groups or negative control group. 100 μL, 50 μL, or 20 μL of supernatants (bars from left to right for each group) were collected from the indicated CAR-T cell group or negative control group (unT) , then incubated with unT cells, and PD-1 blockage on the cell surface was measured. C07-anti-PD-1-IgG and C07-anti-PD-1-scFv CAR-T cells secreted anti-PD-1 antibodies that bound to UnT cells and blocked cell surface PD-1 at different volumes of supernatant.
[0028] FIGs. 5A-5D show the in vitro cytotoxicity of GUCY2C CAR-T cells against GUCY2C-positive cell lines SW948. Luc (FIGs. 5A-5B) and SW948-PDL1. Luc (FIGs. 5C-5D) at an E: T ratio of 0.5: 1 or 0.25: 1. The SW948-PDL1. Luc cell line was constructed to overexpress the PD-L1 protein on the cell surface. Untransduced T cells (UnT) served as negative control in all tests. *p<0.05. **p<0.01.
[0029] FIGs. 6A-6D show continuous in vitro cytotoxicity against GUCY2C-positive cell lines SW948. Luc (FIGs. 6A-6B) and SW948-PDL1. Luc (FIGs. 6C-6D) by CAR-T cells at an E: T ratio of 2.5: 1 or 1.25: 1, which were stimulated by SW948 tumor cells beforehand. The SW948-PDL1. Luc cell line was constructed to overexpress the PD-L1 protein on the cell surface. As a control, SW948. Luc and SW948-PDL1. Luc cells were co-incubated with 10 μg / ml Keytruda (anti-PD-1 antibody) and the same amount of C07 CAR-T cells stimulated by SW948 tumor cell beforehand. The data demonstrate that after tumor cell stimulation, C07-anti-PD-1-IgG and C07-anti-PD-1-scFv CAR-T cells showed enhanced cytotoxicity compared to C07 CAR-T cells (either alone or in combination with Keytruda) . Untransduced T cells (UnT) served as a negative control in all tests. *p<0.05. **p<0.01. ***p<0.001.
[0030] FIGs. 7A and 7B show the concentration of IFN-γ released by the indicated CAR-T cells co-cultured with SW948-PDL1. Luc cells at an E: T ratio of 2.5: 1 (FIG. 7A) or 1.25: 1 (FIG. 7B) . The SW948-PDL1. Luc cell line was constructed to overexpress the PD-L1 protein on the cell surface. As a control, SW948-PDL1. Luc cells were co-incubated with 10 μg / mL Keytruda and the same amount of C07 CAR-T cells. Untransduced T cells (UnT) served as a negative control in all tests. After co-culturing with SW948-PDL1. Luc cells, IFN-γ release of all CAR-T cells were up-regulated. The IFN-γ release levels of C07-anti-PD-1-IgG and C07-anti-PD-1-scFv CAR-T cells were up-regulated higher than that of C07 CAR-T cells (either alone or in combination with Keytruda) . ***p<0.001. ****p<0.0001.DETAILED DESCRIPTION
[0031] The present application in one aspect provides methods of treating a GUCY2C-positive cancer (such as metastatic colorectal cancer or metastatic gastric cancer) in an individual (such as a human) , comprising administering to the individual an engineered immune cell and an immune checkpoint inhibitor ( “ICI” ; such as an anti-PD-1 antibody) , wherein the engineered immune cell comprises a chimeric receptor (e.g., “GUCY2C-targeted chimeric receptor” ; such as a CAR, hereinafter also referred to as “GUCY2C CAR” ) comprising: i) an antigen binding domain (e.g., sdAb) specifically recognizing GUCY2C; and ii) a transmembrane domain. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in separate compositions, such as simultaneously or sequentially. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in a single composition. In some embodiments, the immune checkpoint inhibitor is secreted by the engineered immune cell that expresses the chimeric receptor, for example, the engineered immune cell can comprise a first nucleic acid encoding the chimeric receptor and a second nucleic acid encoding the immune checkpoint inhibitor. In some embodiments, the administration is independent of the mismatch repair (MMR) status of the individual. In some embodiments, the MMR status is not tested before the administration. In some embodiments, the GUCY2C-positive cancer is deficient mismatch repair (dMMR) or proficient mismatch repair (pMMR) cancer. In some embodiments, the GUCY2C-positive cancer expresses high level, moderate level, or low level of GUCY2C.
[0032] The present application in another aspect provides engineered immune cells co-expressing a chimeric receptor (e.g., CAR, such as GUCY2C CAR) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody) . Hence in some embodiments, there is provided an engineered immune cell comprising: a) a first nucleic acid encoding a chimeric receptor, wherein the chimeric receptor comprises: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding an immune checkpoint inhibitor. Pharmaceutical compositions comprising thereof and methods of making thereof are also provided.
[0033] MSS and / or pMMR CRC are associated with poor prognosis, and almost all MSS / pMMR CRC are GUCY2C-positive cancer (see Cancer Immunol Immunother 71: 2765–2776 (2022) ; Am Soc Clin Oncol Educ Book 42: 242-253 (2022) ; Mod Pathol 34: 161–170 (2021) ) . For example, results of the phase II BACCI trial showed no significant difference in objective response rate (ORR) and progression-free survival (PFS) in mCRC patients treated with capecitabine chemotherapy, bevacizumab (an anti-VEGF-A antibody) and atezolizumab (an anti-PD-L1 antibody) as compared to patients receiving just capecitabine chemotherapy and bevacizumab, where the majority of patients in the study had pMMR status (see Cancer Treat Rev. 111: 102480 (2022) . Co-administration of CAR-T cells with ICIs has demonstrated to be a great challenge due to factors such as short half-life of anti-PD-1 antibodies, and immunotoxicity (see Life Sci. 338: 122387 (2024) ; Cancer cell Int. 22: 365 (2022) ; J Thorac Dis. 12 (8) : 4516-4521 (2020) ) . Currently there is no effective treatment for MSS / pMMR type GUCY2C-positive cancer, such as MSS / pMMR mCRC (see Front Immunol. 12: 762341 (2021) ; Cancer Treat Rev. 111: 102480 (2022) ) . The effectiveness and safety in cell therapy (e.g., CAR-T therapy) greatly depends on the identification of an ideal antigen, because most antigens in tumor cells are also present in normal cells. If the target tumor does not express high-level of the target antigen, on-target off-tumor toxicity can incur. The cytokine release syndrome (CRS) is the most common acute toxicity following CAR-T cell therapy (see J Exp Clin Cancer Res. 40 (1) : 367 (2021) ) .
[0034] Inventors of the present application identified effective and safe methods of treating GUCY2C-positive cancer, even for the hard to treat MSS / pMMR type. Particularly, when engineered immune cells expressing GUCY2C-targeted chimeric receptors (e.g., GUCY2C CAR) were used in combination with an immune checkpoint inhibitor (e.g., anti-PD-1 antibody) , the cytotoxicity against GUCY2C-positive tumor cells greatly increased compared to cell therapy alone, and the cytotoxicity difference was even more dramatic for tumor cells expressing the immune checkpoint molecule targeted by the ICI. The superior cytotoxicity against GUCY2C-positive tumor cells for the combination therapy compared to cell therapy alone was even more prominent when the engineered immune cells were pre-challenged with the GUCY2C-positive tumor cells, indicating that the ICIs could protect the engineered immune cells from exhaustion. Surprisingly, the superior cytotoxicity against GUCY2C-positive tumor cells was most prominent when the ICIs were expressed from the chimeric receptor-expressing engineered immune cells –the cytotoxicity as well as protection against exhaustion were both stronger than when ICIs were co-administered with same amount of engineered immune cells. Without being bound by the theory, targeted delivery of ICI to target cells, and bystander effect on other T cells, likely both contributed to the surprising effects observed. ICI-secreting CAR-T cells may act in both a paracrine and autocrine manner to improve the anti-tumor activity of CAR-T cells and bystander tumor-specific T cells. This co-expression approach may also improve safety, as the secreted ICIs remained localized to the tumor, protecting CAR-T cells from immune checkpoint protein (e.g., PD-1) inhibition, which could potentially avoid toxicities associated with systemic checkpoint inhibition. Moreover, all above mentioned superior effects were still observed when fewer engineered immune cells were used, suggesting that the methods provided herein may: i) employ lower cell therapy dosing to achieve desired therapeutic efficacy while minimizing side-effects of cell therapy; and ii) be used for GUCY2C-positive cancer with lower GUCY2C expression level. I. Definitions
[0035] Techniques and procedures described or referenced herein include those that are generally well understood and / or commonly employed using conventional methodology by those skilled in the art, such as, for example, the widely utilized methodologies described in Sambrook et al., Molecular Cloning: A Laboratory Manual (3d ed. 2001) ; Current Protocols in Molecular Biology (Ausubel et al. eds., 2003) ; Therapeutic Monoclonal Antibodies: From Bench to Clinic (An ed. 2009) ; Monoclonal Antibodies: Methods and Protocols (Albitar ed. 2010) ; and Antibody Engineering Vols 1 and 2 (Kontermann and Dübel eds., 2d ed. 2010) . Unless otherwise defined herein, technical and scientific terms used in the present description have the meanings that are commonly understood by those of ordinary skill in the art. For purposes of interpreting this specification, the following description of terms will apply and whenever appropriate, terms used in the singular will also include the plural and vice versa. In the event that any description of a term set forth conflicts with any document incorporated herein by reference, the description of the term set forth below shall control.
[0036] The term “antibody, ” “immunoglobulin, ” or “Ig” is used interchangeably herein, and is used in the broadest sense and specifically covers, for example, monoclonal antibodies (including agonist, antagonist, neutralizing antibodies, full length or intact monoclonal antibodies) , antibody compositions with polyepitopic or monoepitopic specificity, polyclonal or monovalent antibodies, multivalent antibodies, multispecific antibodies (e.g., bispecific antibodies so long as they exhibit the desired biological activity) , formed from at least two intact antibodies, single chain antibodies, and fragments thereof (e.g., domain antibodies) , as described below. An antibody can be human, humanized, chimeric and / or affinity matured, as well as an antibody from other species, for example, mouse, rabbit, llama, etc. The term “antibody” is intended to include a polypeptide product of B cells within the immunoglobulin class of polypeptides that is able to bind to a specific molecular antigen and is composed of two identical pairs of polypeptide chains, wherein each pair has one heavy chain (about 50-70 kDa) and one light chain (about 25 kDa) , each amino-terminal portion of each chain includes a variable region of about 100 to about 130 or more amino acids, and each carboxy-terminal portion of each chain includes a constant region. See, e.g., Antibody Engineering (Borrebaeck ed., 2d ed. 1995) ; and Kuby, Immunology (3d ed. 1997) . Antibodies also include, but are not limited to, synthetic antibodies, recombinantly produced antibodies, antibodies including from Camelidae species (e.g., llama or alpaca) or their humanized variants, intrabodies, anti-idiotypic (anti-Id) antibodies, and functional fragments (e.g., antigen binding fragments) of any of the above, which refers to a portion of an antibody heavy or light chain polypeptide that retains some or all of the binding activity of the antibody from which the fragment was derived. Non-limiting examples of functional fragments (e.g., antigen binding fragments) include single-chain Fvs (scFv) (e.g., including monospecific, bispecific, etc. ) , Fab fragments, F (ab’) fragments, F (ab) 2 fragments, F (ab’) 2 fragments, disulfide-linked Fvs (dsFv) , Fd fragments, Fv fragments, sdAb, diabody, triabody, tetrabody, and minibody. In particular, antibodies provided herein include immunoglobulin molecules and immunologically active portions of immunoglobulin molecules, for example, antigen-binding domains or molecules that contain an antigen-binding site that binds to an antigen (e.g., one or more CDRs of an antibody) . Such antibody fragments can be found in, for example, Harlow and Lane, Antibodies: A Laboratory Manual (1989) ; Mol. Biology and Biotechnology: A Comprehensive Desk Reference (Myers ed., 1995) ; Huston et al., 1993, Cell Biophysics 22: 189-224; Plückthun and Skerra, 1989, Meth. Enzymol. 178: 497-515; and Day, Advanced Immunochemistry (2d ed. 1990) . The antibodies provided herein can be of any class (e.g., IgG, IgE, IgM, IgD, and IgA) or any subclass (e.g., IgG1, IgG2, IgG3, IgG4, IgA1, and IgA2) of immunoglobulin molecule. Antibodies may be agonistic antibodies or antagonistic antibodies. Antibodies may be neither agonistic nor antagonistic.
[0037] An “antigen” is a structure to which an antibody can selectively bind. A target antigen may be a polypeptide, carbohydrate, nucleic acid, lipid, hapten, or other naturally occurring or synthetic compound. The target antigen can be a polypeptide. An antigen may be associated with a cell, for example, is present on or in a cell.
[0038] An “intact” antibody is one comprising an antigen-binding site as well as a CL and at least heavy chain constant regions, CH1, CH2 and CH3. The constant regions may include human constant regions or amino acid sequence variants thereof. An intact antibody may have one or more effector functions.
[0039] “Single-chain Fv” also abbreviated as “sFv” or “scFv” are antibody fragments that comprise the VH and VL antibody domains connected into a single polypeptide chain. The scFv polypeptide may further comprise a polypeptide linker between the VH and VL domains which enables the scFv to form the desired structure for antigen binding. For a review of the scFv, see Pluckthun in The Pharmacology of Monoclonal Antibodies, vol. 113, Rosenburg and Moore eds., Springer-Verlag, New York, pp. 269-315 (1994) .
[0040] The term “heavy chain-only antibody” or “HCAb” refers to a functional antibody, which comprises heavy chains, but lacks the light chains usually found in 4-chain antibodies. For example, camelid animals (such as camels, llamas, or alpacas) are known to produce HCAbs.
[0041] “Single domain antibody” or “sdAb” as used herein refers to a single monomeric variable antibody domain and which is capable of antigen binding. Single domain antibodies include VHH domains as described herein. Examples of single domain antibodies include, but are not limited to, antibodies naturally devoid of light chains such as those from Camelidae species (e.g., llama) , single domain antibodies derived from conventional 4-chain antibodies, engineered antibodies and single domain scaffolds other than those derived from antibodies. Single domain antibodies (e.g., VHH domains) may be derived from any species including, but not limited to mouse, human, camel, llama, goat, rabbit, and bovine. For example, a single domain antibody can be derived from antibodies raised in Camelidae species, for example in camel, llama, dromedary, alpaca and guanaco, as described herein. Other species besides Camelidae may produce heavy chain antibodies naturally devoid of light chain; VHHs derived from such other species are within the scope of the disclosure. The single domain antibody (e.g., VHH domain) provided herein has a structure of FR1-CDR1-FR2-CDR2-FR3-CDR3-FR4. Single domain antibodies may be genetically fused or chemically conjugated to another molecule (e.g., an agent) as described herein. Single domain antibodies may be part of a bigger binding molecule (e.g., a multispecific antibody or a chimeric antigen receptor) .
[0042] The terms “binds” or “binding” refer to an interaction between molecules including, for example, to form a complex. Interactions can be, for example, non-covalent interactions including hydrogen bonds, ionic bonds, hydrophobic interactions, and / or van der Waals interactions. A complex can also include the binding of two or more molecules held together by covalent or non-covalent bonds, interactions, or forces. The strength of the total non-covalent interactions between a single antigen-binding site on a binding molecule and a single epitope of a target molecule, such as an antigen, is the affinity of the binding molecule or functional fragment for that epitope. The ratio of dissociation rate (koff) to association rate (kon) of a binding molecule (e.g., an antibody) to a monovalent antigen (koff / kon) is the dissociation constant KD, which is inversely related to affinity. The lower the KD value, the higher the affinity of the molecule. The value of KD varies for different complexes of binding molecule and its target antigen and depends on both kon and koff. The dissociation constant KD for a binding molecule against its target provided herein can be determined using any method provided herein or any other method well known to those skilled in the art. The affinity at one binding site does not always reflect the true strength of the interaction between a binding molecule and a target antigen. When complex antigens containing multiple, repeating antigenic determinants, such as a polyvalent antigen, come in contact with antibodies containing multiple binding sites, the interaction of antibody with antigen at one site will increase the probability of a reaction at a second site. The strength of such multiple interactions between a multivalent antibody and antigen is called the avidity.
[0043] In connection with the binding molecules described herein terms such as “bind to, ” “that specifically bind to, ” and analogous terms are also used interchangeably herein and refer to binding molecules of antigen binding domains that specifically bind to an antigen, such as a polypeptide. A binding molecule or antigen binding domain that binds to or specifically binds to an antigen can be identified, for example, by immunoassays, or other techniques known to those of skill in the art. A binding molecule or antigen binding domain may bind to or specifically bind to an antigen when it binds to an antigen with higher affinity than to any cross-reactive antigen as determined using experimental techniques, such as radioimmunoassay (RIA) and enzyme linked immunosorbent assay (ELISA) . Typically, a specific or selective reaction will be at least twice background signal or noise and may be more than 10 times background. See, e.g., Fundamental Immunology 332-36 (Paul ed., 2d ed. 1989) for a discussion regarding binding specificity. The extent of binding of a binding molecule or antigen binding domain to a “non-target” protein may be less than about 10%of the binding of the binding molecule or antigen binding domain to its particular target antigen, for example, as determined by fluorescence activated cell sorting (FACS) analysis or RIA. A binding molecule or antigen binding domain that binds to an antigen includes one that is capable of binding the antigen with sufficient affinity such that the binding molecule is useful, for example, as a therapeutic and / or diagnostic agent in targeting the antigen. A binding molecule or antigen binding domain that binds to an antigen may have a dissociation constant (KD) of less than or equal to 1μM, 800 nM, 600 nM, 550 nM, 500 nM, 300 nM, 250 nM, 100 nM, 50 nM, 10 nM, 5 nM, 4 nM, 3 nM, 2 nM, 1 nM, 0.9 nM, 0.8 nM, 0.7 nM, 0.6 nM, 0.5 nM, 0.4 nM, 0.3 nM, 0.2 nM, or 0.1 nM. In certain embodiments, a binding molecule or antigen binding domain binds to an epitope of an antigen that is conserved among the antigen from different species.
[0044] The binding molecules or antigen binding domains can comprise “chimeric” sequences in which a portion of the heavy and / or light chain is identical with or homologous to corresponding sequences in antibodies derived from a particular species or belonging to a particular antibody class or subclass, while the remainder of the chain (s) is identical with or homologous to corresponding sequences in antibodies derived from another species or belonging to another antibody class or subclass, as well as fragments of such antibodies, so long as they exhibit the desired biological activity (see U.S. Pat. No. 4,816,567; and Morrison et al., 1984, Proc. Natl. Acad. Sci. USA 81: 6851-55) . Chimeric sequences may include humanized sequences.
[0045] In certain embodiments, the binding molecules or antigen binding domains can comprise portions of “humanized” forms of nonhuman (e.g., camelid, murine, non-human primate) antibodies that include sequences from human immunoglobulins (e.g., recipient antibody) in which the native CDR residues are replaced by residues from the corresponding CDR of a nonhuman species (e.g., donor antibody) such as camelid, mouse, rat, rabbit, or nonhuman primate having the desired specificity, affinity, and capacity. In some instances, one or more FR region residues of the human immunoglobulin sequences are replaced by corresponding nonhuman residues. Furthermore, humanized antibodies can comprise residues that are not found in the recipient antibody or in the donor antibody. These modifications are made to further refine antibody performance. A humanized antibody heavy or light chain can comprise substantially all of at least one or more variable regions, in which all or substantially all of the CDRs correspond to those of a nonhuman immunoglobulin and all or substantially all of the FRs are those of a human immunoglobulin sequence. The humanized antibody may comprise at least a portion of an immunoglobulin constant region (Fc) , typically that of a human immunoglobulin. For further details, see, Jones et al., Nature 321: 522-25 (1986) ; Riechmann et al., Nature 332: 323-29 (1988) ; Presta, Curr. Op. Struct. Biol. 2: 593-96 (1992) ; Carter et al., Proc. Natl. Acad. Sci. USA 89: 4285-89 (1992) ; U.S. Pat. Nos: 6,800,738; 6,719,971; 6,639,055; 6,407,213; and 6,054,297.
[0046] The binding molecules or antigen binding domains can comprise portions of a “fully human antibody” or “human antibody, ” wherein the terms are used interchangeably herein and refer to an antibody that comprises a human variable region and, for example, a human constant region. The binding molecules may comprise an antibody sequence. In specific embodiments, the terms refer to an antibody that comprises a variable region and constant region of human origin. “Fully human” antibodies, in certain embodiments, can also encompass antibodies which bind polypeptides and are encoded by nucleic acid sequences which are naturally occurring somatic variants of human germline immunoglobulin nucleic acid sequence. The term “fully human antibody” includes antibodies having variable and constant regions corresponding to human germline immunoglobulin sequences as described by Kabat et al. (See Kabat et al. (1991) Sequences of Proteins of Immunological Interest, Fifth Edition, U.S. Department of Health and Human Services, NIH Publication No. 91-3242) . A “human antibody” is one that possesses an amino acid sequence which corresponds to that of an antibody produced by a human and / or has been made using any of the techniques for making human antibodies. This definition of a human antibody specifically excludes a humanized antibody comprising non-human antigen-binding residues. Human antibodies can be produced using various techniques known in the art, including phage-display libraries (Hoogenboom and Winter, J. Mol. Biol. 227: 381 (1991) ; Marks et al., J. Mol. Biol. 222: 581 (1991) ) and yeast display libraries (Chao et al., Nature Protocols 1: 755-68 (2006) ) . Also available for the preparation of human monoclonal antibodies are methods described in Cole et al., Monoclonal Antibodies and Cancer Therapy 77 (1985) ; Boerner et al., J. Immunol. 147 (1) : 86-95 (1991) ; and van Dijk and van de Winkel, Curr. Opin. Pharmacol. 5: 368-74 (2001) . Human antibodies can be prepared by administering the antigen to a transgenic animal that has been modified to produce such antibodies in response to antigenic challenge, but whose endogenous loci have been disabled, e.g., mice (see, e.g., Jakobovits, Curr. Opin. Biotechnol. 6 (5) : 561-66 (1995) ; Brüggemann and Taussing, Curr. Opin. Biotechnol. 8 (4) : 455-58 (1997) ; and U.S. Pat. Nos. 6,075,181 and 6,150,584 regarding XENOMOUSETM technology) . See also, for example, Li et al., Proc. Natl. Acad. Sci. USA 103: 3557-62 (2006) regarding human antibodies generated via a human B-cell hybridoma technology.
[0047] The binding molecules or antigen binding domains can comprise portions of a “recombinant human antibody, ” wherein the phrase includes human antibodies that are prepared, expressed, created or isolated by recombinant means, such as antibodies expressed using a recombinant expression vector transfected into a host cell, antibodies isolated from a recombinant, combinatorial human antibody library, antibodies isolated from an animal (e.g., a mouse or cow) that is transgenic and / or transchromosomal for human immunoglobulin genes (see, e.g., Taylor, L. D. et al., Nucl. Acids Res. 20: 6287-6295 (1992) ) or antibodies prepared, expressed, created or isolated by any other means that involves splicing of human immunoglobulin gene sequences to other DNA sequences. Such recombinant human antibodies can have variable and constant regions derived from human germline immunoglobulin sequences (See Kabat, E. A. et al. (1991) Sequences of Proteins of Immunological Interest, Fifth Edition, U.S. Department of Health and Human Services, NIH Publication No. 91-3242) . In certain embodiments, however, such recombinant human antibodies are subjected to in vitro mutagenesis (or, when an animal transgenic for human Ig sequences is used, in vivo somatic mutagenesis) and thus the amino acid sequences of the VH and VL regions of the recombinant antibodies are sequences that, while derived from and related to human germline VH and VL sequences, may not naturally exist within the human antibody germline repertoire in vivo.
[0048] In certain embodiments, the binding molecules or antigen binding domains can comprise a portion of a “monoclonal antibody, ” wherein the term as used herein refers to an antibody obtained from a population of substantially homogeneous antibodies, e.g., the individual antibodies comprising the population are identical except for possible naturally occurring mutations that may be present in minor amounts or well-known post-translational modifications such as amino acid isomerization or deamidation, methionine oxidation or asparagine or glutamine deamidation, each monoclonal antibody will typically recognize a single epitope on the antigen. In specific embodiments, a “monoclonal antibody, ” as used herein, is an antibody produced by a single hybridoma or other cell. The term “monoclonal” is not limited to any particular method for making the antibody. For example, the monoclonal antibodies useful in the present disclosure may be prepared by the hybridoma methodology first described by Kohler et al., Nature 256: 495 (1975) , or may be made using recombinant DNA methods in bacterial or eukaryotic animal or plant cells (see, e.g., U.S. Pat. No. 4,816,567) . The “monoclonal antibodies” may also be isolated from phage antibody libraries using the techniques described in Clackson et al., Nature 352: 624-28 (1991) and Marks et al., J. Mol. Biol. 222: 581-97 (1991) , for example. Other methods for the preparation of clonal cell lines and of monoclonal antibodies expressed thereby are well known in the art. See, e.g., Short Protocols in Molecular Biology (Ausubel et al. eds., 5th ed. 2002) .
[0049] A typical 4-chain antibody unit is a heterotetrameric glycoprotein composed of two identical light (L) chains and two identical heavy (H) chains. In the case of IgGs, the 4-chain unit is generally about 150,000 daltons. Each L chain is linked to an H chain by one covalent disulfide bond, while the two H chains are linked to each other by one or more disulfide bonds depending on the H chain isotype. Each H and L chain also has regularly spaced intrachain disulfide bridges. Each H chain has at the N-terminus, a variable domain (VH) followed by three constant domains (CH) for each of the α and γ chains and four CH domains for μ and ε isotypes. Each L chain has at the N-terminus, a variable domain (VL) followed by a constant domain (CL) at its other end. The VL is aligned with the VH, and the CL is aligned with the first constant domain of the heavy chain (CH1) . Particular amino acid residues are believed to form an interface between the light chain and heavy chain variable domains. The pairing of a VH and VL together forms a single antigen-binding site. For the structure and properties of the different classes of antibodies, see, for example, Basic and Clinical Immunology 71 (Stites et al. eds., 8th ed. 1994) ; and Immunobiology (Janeway et al. eds., 5th ed. 2001) .
[0050] The term “Fab” or “Fab region” refers to an antibody region that binds to antigens. A conventional IgG usually comprises two Fab regions, each residing on one of the two arms of the Y-shaped IgG structure. Each Fab region is typically composed of one variable region and one constant region of each of the heavy and the light chain. More specifically, the variable region and the constant region of the heavy chain in a Fab region are VH and CH1 regions, and the variable region and the constant region of the light chain in a Fab region are VL and CL regions. The VH, CH1, VL, and CL in a Fab region can be arranged in various ways to confer an antigen binding capability according to the present disclosure. For example, VH and CH1 regions can be on one polypeptide, and VL and CL regions can be on a separate polypeptide, similarly to a Fab region of a conventional IgG. Alternatively, VH, CH1, VL and CL regions can all be on the same polypeptide and oriented in different orders as described in more detail the sections below.
[0051] The term “variable region, ” “variable domain, ” “V region, ” or “V domain” refers to a portion of the light or heavy chains of an antibody that is generally located at the amino-terminal of the light or heavy chain and has a length of about 120 to 130 amino acids in the heavy chain and about 100 to 110 amino acids in the light chain, and are used in the binding and specificity of each particular antibody for its particular antigen. The variable region of the heavy chain may be referred to as “VH” . The variable region of the light chain may be referred to as “VL” . The term “variable” refers to the fact that certain segments of the variable regions differ extensively in sequence among antibodies. The V region mediates antigen binding and defines specificity of a particular antibody for its particular antigen. However, the variability is not evenly distributed across the 110-amino acid span of the variable regions. Instead, the V regions consist of less variable (e.g., relatively invariant) stretches called framework regions (FRs) of about 15-30 amino acids separated by shorter regions of greater variability (e.g., extreme variability) called “hypervariable regions” that are each about 9-12 amino acids long. The variable regions of heavy and light chains each comprise four FRs, largely adopting a β sheet configuration, connected by three hypervariable regions, which form loops connecting, and in some cases form part of, the βsheet structure. The hypervariable regions in each chain are held together in close proximity by the FRs and, with the hypervariable regions from the other chain, contribute to the formation of the antigen-binding site of antibodies (see, e.g., Kabat et al., Sequences of Proteins of Immunological Interest (5th ed. 1991) ) . The constant regions are not involved directly in binding an antibody to an antigen, but exhibit various effector functions, such as participation of the antibody in antibody dependent cellular cytotoxicity (ADCC) and complement dependent cytotoxicity (CDC) . The variable regions differ extensively in sequence between different antibodies. The variable region may be a human variable region.
[0052] The term “variable region residue numbering according to Kabat” or “amino acid position numbering as in Kabat” , and variations thereof, refer to the numbering system used for heavy chain variable regions or light chain variable regions of the compilation of antibodies in Kabat et al., supra. Using this numbering system, the actual linear amino acid sequence may contain fewer or additional amino acids corresponding to a shortening of, or insertion into, an FR or CDR of the variable domain. For example, a heavy chain variable domain may include a single amino acid insert (residue 52a according to Kabat) after residue 52 and three inserted residues (e.g., residues 82a, 82b, and 82c, etc. according to Kabat) after residue 82. The Kabat numbering of residues may be determined for a given antibody by alignment at regions of homology of the sequence of the antibody with a “standard” Kabat numbered sequence. The Kabat numbering system is generally used when referring to a residue in the variable domain (approximately residues 1-107 of the light chain and residues 1-113 of the heavy chain) (e.g., Kabat et al., supra) . The “EU numbering system” or “EU index” is generally used when referring to a residue in an immunoglobulin heavy chain constant region (e.g., the EU index reported in Kabat et al., supra) . The “EU index as in Kabat” refers to the residue numbering of the human IgG 1 EU antibody. Other numbering systems have been described, for example, by AbM, Chothia, Contact, IMGT, and AHon.
[0053] The term “heavy chain” when used in reference to an antibody refers to a polypeptide chain of about 50-70 kDa, wherein the amino-terminal portion includes a variable region of about 120 to 130 or more amino acids, and a carboxy-terminal portion includes a constant region. The constant region can be one of five distinct types, (e.g., isotypes) referred to as alpha (α) , delta (δ) , epsilon (ε) , gamma (γ) , and mu (μ) , based on the amino acid sequence of the heavy chain constant region. The distinct heavy chains differ in size: α, δ, and γ contain approximately 450 amino acids, while μ and ε contain approximately 550 amino acids. When combined with a light chain, these distinct types of heavy chains give rise to five well known classes (e.g., isotypes) of antibodies, IgA, IgD, IgE, IgG, and IgM, respectively, including four subclasses of IgG, namely IgG1, IgG2, IgG3, and IgG4.
[0054] The term “light chain” when used in reference to an antibody refers to a polypeptide chain of about 25 kDa, wherein the amino-terminal portion includes a variable region of about 100 to about 110 or more amino acids, and a carboxy-terminal portion includes a constant region. The approximate length of a light chain is 211 to 217 amino acids. There are two distinct types, referred to as kappa (κ) or lambda (λ) based on the amino acid sequence of the constant domains.
[0055] As used herein, the terms “hypervariable region, ” “HVR, ” “Complementarity Determining Region, ” and “CDR” are used interchangeably. A “CDR” refers to one of three hypervariable regions (H1, H2 or H3) within the non-framework region of the immunoglobulin (Ig or antibody) VH β-sheet framework, or one of three hypervariable regions (L1, L2 or L3) within the non-framework region of the antibody VL β-sheet framework. CDR1, CDR2 and CDR3 in VH domain are also referred to as HCDR1, HCDR2 and HCDR3, respectively. CDR1, CDR2 and CDR3 in VL domain are also referred to as LCDR1, LCDR2 and LCDR3, respectively. Accordingly, CDRs are variable region sequences interspersed within the framework region sequences.
[0056] CDR regions are well known to those skilled in the art and have been defined by well-known numbering systems. For example, the Kabat Complementarity Determining Regions (CDRs) are based on sequence variability and are the most commonly used (see, e.g., Kabat et al., supra; Nick Deschacht et al., J Immunol 2010; 184: 5696-5704) . Chothia refers instead to the location of the structural loops (see, e.g., Chothia and Lesk, J. Mol. Biol. 196: 901-17 (1987) ) . The end of the Chothia CDR-H1 loop when numbered using the Kabat numbering convention varies between H32 and H34 depending on the length of the loop (this is because the Kabat numbering scheme places the insertions at H35A and H35B; if neither 35A nor 35B is present, the loop ends at 32; if only 35A is present, the loop ends at 33; if both 35A and 35B are present, the loop ends at 34) . The AbM hypervariable regions represent a compromise between the Kabat CDRs and Chothia structural loops, and are used by Oxford Molecular’s AbM antibody modeling software (see, e.g., Antibody Engineering Vol. 2 (Kontermann and Dübel eds., 2d ed. 2010) ) . The “contact” hypervariable regions are based on an analysis of the available complex crystal structures. Another universal numbering system that has been developed and widely adopted is ImMunoGeneTics (IMGT) Information (Lafranc et al., Dev. Comp. Immunol. 27 (1) : 55-77 (2003) ) . IMGT is an integrated information system specializing in immunoglobulins (IG) , T-cell receptors (TCR) , and major histocompatibility complex (MHC) of human and other vertebrates. Herein, the CDRs are referred to in terms of both the amino acid sequence and the location within the light or heavy chain. As the “location” of the CDRs within the structure of the immunoglobulin variable domain is conserved between species and present in structures called loops, by using numbering systems that align variable domain sequences according to structural features, CDR and framework residues are readily identified. This information can be used in grafting and replacement of CDR residues from immunoglobulins of one species into an acceptor framework from, typically, a human antibody. An additional numbering system (AHon) has been developed by Honegger and Plückthun, J. Mol. Biol. 309: 657-70 (2001) . Correspondence between the numbering system, including, for example, the Kabat numbering and the IMGT unique numbering system, is well known to one skilled in the art (see, e.g., Kabat, supra; Chothia and Lesk, supra; Martin, supra; Lefranc et al., supra) . The residues from each of these hypervariable regions or CDRs are exemplified in Table 1 below. Table 1. Exemplary CDRs According to Various Numbering Systems
[0057] The boundaries of a given CDR may vary depending on the scheme used for identification. Thus, unless otherwise specified, the terms “CDR” and “complementary determining region” of a given antibody or region thereof, such as a variable region, as well as individual CDRs (e.g., CDR-H1, CDR-H2) of the antibody or region thereof, should be understood to encompass the complementary determining region as defined by any of the known schemes described herein above. In some instances, the scheme for identification of a particular CDR or CDRs is specified, such as the CDR as defined by the IMGT, Kabat, Chothia, or Contact method. In other cases, the particular amino acid sequence of a CDR is given. It should be noted CDR regions may also be defined by any combination of various numbering systems, e.g., a combination of Kabat and Chothia numbering systems, a combination of Kabat and AbM numbering systems, or a combination of Kabat and IMGT numbering systems. Therefore, the term such as “a CDR1 as set forth in a specific VH” includes any CDR1 as defined by the exemplary CDR numbering systems described above, but is not limited thereby. Once a variable region (e.g., a VH or VL) is given, those skilled in the art would understand that CDRs within the region can be defined by different numbering systems or combinations thereof.
[0058] Hypervariable regions may comprise “extended hypervariable regions” as follows: 24-36 or 24-34 (L1) , 46-56 or 50-56 (L2) , and 89-97 or 89-96 (L3) in the VL, and 26-35 or 26-35A (H1) , 50-65 or 49-65 (H2) , and 93-102, 94-102, or 95-102 (H3) in the VH.
[0059] The term “constant region” or “constant domain” refers to a carboxy terminal portion of the light and heavy chain which is not directly involved in binding of the antibody to antigen but exhibits various effector function, such as interaction with the Fc receptor. The term refers to the portion of an immunoglobulin molecule having a more conserved amino acid sequence relative to the other portion of the immunoglobulin, the variable region, which contains the antigen binding site. The constant region may contain the CH1, CH2, and CH3 regions of the heavy chain and the CL region of the light chain.
[0060] The term “framework” or “FR” refers to those variable region residues flanking the CDRs. FR residues are present, for example, in chimeric, humanized, human, domain antibodies, diabodies, linear antibodies, and bispecific antibodies. FR residues are those variable domain residues other than the hypervariable region residues or CDR residues.
[0061] The term “Fc region” herein is used to define a C-terminal region of an immunoglobulin heavy chain, including, for example, native sequence Fc regions, recombinant Fc regions, and variant Fc regions. Although the boundaries of the Fc region of an immunoglobulin heavy chain might vary, the human IgG heavy chain Fc region is often defined to stretch from an amino acid residue at position Cys226, or from Pro230, to the carboxyl-terminus thereof. The C-terminal lysine (residue 447 according to the EU numbering system) of the Fc region may be removed, for example, during production or purification of the antibody, or by recombinantly engineering the nucleic acid encoding a heavy chain of the antibody. Accordingly, a composition of intact antibodies may comprise antibody populations with all K447 residues removed, antibody populations with no K447 residues removed, and antibody populations having a mixture of antibodies with and without the K447 residue. A “functional Fc region” possesses an “effector function” of a native sequence Fc region. Exemplary “effector functions” include C1q binding; CDC; Fc receptor binding; ADCC; phagocytosis; downregulation of cell surface receptors (e.g., B cell receptor) , etc. Such effector functions generally require the Fc region to be combined with a binding region or binding domain (e.g., an antibody variable region or domain) and can be assessed using various assays known to those skilled in the art. A “variant Fc region” comprises an amino acid sequence which differs from that of a native sequence Fc region by virtue of at least one amino acid modification (e.g., substituting, addition, or deletion) . In certain embodiments, the variant Fc region has at least one amino acid substitution compared to a native sequence Fc region or to the Fc region of a parent polypeptide, for example, from about one to about ten amino acid substitutions, or from about one to about five amino acid substitutions in a native sequence Fc region or in the Fc region of a parent polypeptide. The variant Fc region herein can possess at least about 80%homology with a native sequence Fc region and / or with an Fc region of a parent polypeptide, or at least about 90%homology therewith, for example, at least about 95%homology therewith.
[0062] As used herein, an “epitope” is a term in the art and refers to a localized region of an antigen to which a binding molecule (e.g., an antibody) can specifically bind. An epitope can be a linear epitope or a conformational, non-linear, or discontinuous epitope. In the case of a polypeptide antigen, for example, an epitope can be contiguous amino acids of the polypeptide (a“linear” epitope) or an epitope can comprise amino acids from two or more non-contiguous regions of the polypeptide (a “conformational, ” “non-linear” or “discontinuous” epitope) . It will be appreciated by one of skill in the art that, in general, a linear epitope may or may not be dependent on secondary, tertiary, or quaternary structure. For example, a binding molecule may bind to a group of amino acids regardless of whether they are folded in a natural three dimensional protein structure. A binding molecule may require amino acid residues making up the epitope to exhibit a particular conformation (e.g., bend, twist, turn or fold) in order to recognize and bind the epitope.
[0063] “Percent (%) amino acid sequence identity” and “homology” with respect to a peptide, polypeptide or antibody sequence are defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the specific peptide or polypeptide sequence, after aligning the sequences and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity. Alignment for purposes of determining percent amino acid sequence identity can be achieved in various ways that are within the skill in the art, for instance, using publicly available computer software such as BLAST, BLAST-2, ALIGN or MEGALIGNTM (DNASTAR) software. Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full length of the sequences being compared.
[0064] The term “specificity” refers to selective recognition of an antigen binding protein (such as a CAR or an antibody) for a particular epitope of an antigen. Natural antibodies, for example, are monospecific. The term "multispecific" as used herein denotes that an antigen binding protein has two or more antigen-binding sites of which at least two bind different epitopes. "Bispecific" as used herein denotes that an antigen binding protein has two different antigen-binding specificities. The term "monospecific" as used herein denotes an antigen binding protein that has one or more binding sites each of which bind the same epitope.
[0065] The term “valent” as used herein denotes the presence of a specified number of binding sites in an antigen binding protein (such as a CAR or an antibody) . A natural antibody for example or a full length antibody has two binding sites and is bivalent. As such, the terms "trivalent" , "tetravalent" , "pentavalent" and "hexavalent" denote the presence of two binding site, three binding sites, four binding sites, five binding sites, and six binding sites, respectively, in an antigen binding protein.
[0066] As used herein, a first antibody or fragment thereof “competes” for binding to a target antigen / epitope with a second antibody or fragment thereof when the first antibody or fragment thereof inhibits the target antigen / epitope binding of the second antibody of fragment thereof by at least about 50% (such as at least about any one of 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 98%or 99%) in the presence of an equimolar concentration of the first antibody or fragment thereof, or vice versa. A high throughput process for “binning” antibodies based upon their cross-competition is described in PCT Publication No. WO 03 / 48731.
[0067] “Chimeric antigen receptor” or "CAR" as used herein refers to genetically engineered receptors, which can be used to graft one or more antigen specificity onto immune effector cells, such as T cells. Some CARs are also known as “artificial T-cell receptors, ” “chimeric T cell receptors, ” or “chimeric immune receptors. ” The CAR may comprise an extracellular antigen binding domain specific for one or more antigens (such as tumor antigens) , a transmembrane domain, and an intracellular signaling domain of a T cell and / or other receptors. “CAR-T cell” refers to a T cell that expresses a CAR.
[0068] The terms “polypeptide” and “peptide” and “protein” are used interchangeably herein and refer to polymers of amino acids of any length. The polymer may be linear or branched, it may comprise modified amino acids, and it may be interrupted by non-amino acids. The terms also encompass an amino acid polymer that has been modified naturally or by intervention; for example, disulfide bond formation, glycosylation, lipidation, acetylation, phosphorylation, or any other manipulation or modification. Also included within the definition are, for example, polypeptides containing one or more analogs of an amino acid, including but not limited to, unnatural amino acids, as well as other modifications known in the art. It is understood that, because the polypeptides of this disclosure may be based upon antibodies or other members of the immunoglobulin superfamily, a “polypeptide” can occur as a single chain or as two or more associated chains.
[0069] “Polynucleotide” or “nucleic acid, ” as used interchangeably herein, refers to polymers of nucleotides of any length and includes DNA and RNA. The nucleotides can be deoxyribonucleotides, ribonucleotides, modified nucleotides or bases, and / or their analogs, or any substrate that can be incorporated into a polymer by DNA or RNA polymerase or by a synthetic reaction. A polynucleotide may comprise modified nucleotides, such as methylated nucleotides and their analogs. “Oligonucleotide, ” as used herein, refers to short, generally single-stranded, synthetic polynucleotides that are generally, but not necessarily, fewer than about 200 nucleotides in length. The terms “oligonucleotide” and “polynucleotide” are not mutually exclusive. The description above for polynucleotides is equally and fully applicable to oligonucleotides. A cell that produces a binding molecule of the present disclosure may include a parent hybridoma cell, as well as bacterial and eukaryotic host cells into which nucleic acids encoding the antibodies have been introduced. Unless specified otherwise, the left-hand end of any single-stranded polynucleotide sequence disclosed herein is the 5’ end; the left-hand direction of double-stranded polynucleotide sequences is referred to as the 5’ direction. The direction of 5’ to 3’ addition of nascent RNA transcripts is referred to as the transcription direction; sequence regions on the DNA strand having the same sequence as the RNA transcript that are 5’ to the 5’ end of the RNA transcript are referred to as “upstream sequences” ; sequence regions on the DNA strand having the same sequence as the RNA transcript that are 3’ to the 3’ end of the RNA transcript are referred to as “downstream sequences. ”
[0070] An “isolated nucleic acid” is a nucleic acid, for example, an RNA, DNA, or a mixed nucleic acids, which is substantially separated from other genome DNA sequences as well as proteins or complexes such as ribosomes and polymerases, which naturally accompany a native sequence. An “isolated” nucleic acid molecule is one which is separated from other nucleic acid molecules which are present in the natural source of the nucleic acid molecule. Moreover, an “isolated” nucleic acid molecule, such as a cDNA molecule, can be substantially free of other cellular material, or culture medium when produced by recombinant techniques, or substantially free of chemical precursors or other chemicals when chemically synthesized. In a specific embodiment, one or more nucleic acid molecules encoding an antibody as described herein are isolated or purified. The term embraces nucleic acid sequences that have been removed from their naturally occurring environment, and includes recombinant or cloned DNA isolates and chemically synthesized analogues or analogues biologically synthesized by heterologous systems. A substantially pure molecule may include isolated forms of the molecule. Specifically, an “isolated” nucleic acid molecule encoding a CAR or an antibody described herein is a nucleic acid molecule that is identified and separated from at least one contaminant nucleic acid molecule with which it is ordinarily associated in the environment in which it was produced.
[0071] Unless otherwise specified, a “nucleotide sequence encoding an amino acid sequence” includes all nucleotide sequences that are degenerate versions of each other and that encode the same amino acid sequence. The phrase nucleotide sequence that encodes a protein or an RNA may also include introns to the extent that the nucleotide sequence encoding the protein may in some versions contain an intron (s) .
[0072] The term “control sequences” refers to DNA sequences necessary for the expression of an operably linked coding sequence in a particular host organism. The control sequences that are suitable for prokaryotes, for example, include a promoter, optionally an operator sequence, and a ribosome binding site. Eukaryotic cells are known to utilize promoters, polyadenylation signals, and enhancers.
[0073] As used herein, the term “operatively linked, ” and similar phrases (e.g., genetically fused) , when used in reference to nucleic acids or amino acids, refer to the operational linkage of nucleic acid sequences or amino acid sequence, respectively, placed in functional relationships with each other. For example, an operatively linked promoter, enhancer elements, open reading frame, 5’ and 3’ UTR, and terminator sequences result in the accurate production of a nucleic acid molecule (e.g., RNA) . In some embodiments, operatively linked nucleic acid elements result in the transcription of an open reading frame and ultimately the production of a polypeptide (i.e., expression of the open reading frame) . As another example, an operatively linked peptide is one in which the functional domains are placed with appropriate distance from each other to impart the intended function of each domain.
[0074] The term “vector” refers to a substance that is used to carry or include a nucleic acid sequence, including for example, a nucleic acid sequence encoding a binding molecule (e.g., an antibody) as described herein, in order to introduce a nucleic acid sequence into a host cell. Vectors applicable for use include, for example, expression vectors, plasmids, phage vectors, viral vectors, episomes, and artificial chromosomes, which can include selection sequences or markers operable for stable integration into a host cell’s chromosome. Additionally, the vectors can include one or more selectable marker genes and appropriate expression control sequences. Selectable marker genes that can be included, for example, provide resistance to antibiotics or toxins, complement auxotrophic deficiencies, or supply critical nutrients not in the culture media. Expression control sequences can include constitutive and inducible promoters, transcription enhancers, transcription terminators, and the like, which are well known in the art. When two or more nucleic acid molecules are to be co-expressed (e.g., both an antibody heavy and light chain or an antibody VH and VL) , both nucleic acid molecules can be inserted, for example, into a single expression vector or in separate expression vectors. For single vector expression, the encoding nucleic acids can be operationally linked to one common expression control sequence or linked to different expression control sequences, such as one inducible promoter and one constitutive promoter. The introduction of nucleic acid molecules into a host cell can be confirmed using methods well known in the art. Such methods include, for example, nucleic acid analysis such as Northern blots or polymerase chain reaction (PCR) amplification of mRNA, immunoblotting for expression of gene products, or other suitable analytical methods to test the expression of an introduced nucleic acid sequence or its corresponding gene product. It is understood by those skilled in the art that the nucleic acid molecules are expressed in a sufficient amount to produce a desired product and it is further understood that expression levels can be optimized to obtain sufficient expression using methods well known in the art.
[0075] The term “host” as used herein refers to an animal, such as a mammal (e.g., a human) .
[0076] The term “host cell” as used herein refers to a particular subject cell that may be transfected with a nucleic acid molecule and the progeny or potential progeny of such a cell. Progeny of such a cell may not be identical to the parent cell transfected with the nucleic acid molecule due to mutations or environmental influences that may occur in succeeding generations or integration of the nucleic acid molecule into the host cell genome.
[0077] As used herein, the term “autologous” is meant to refer to any material derived from the same individual to whom it is later to be re-introduced into the individual.
[0078] “Allogeneic” refers to a graft derived from a different individual of the same species.
[0079] The term “transfected” or “transformed” or “transduced” as used herein refers to a process by which exogenous nucleic acid is transferred or introduced into the host cell. A “transfected” or “transformed” or “transduced” cell is one which has been transfected, transformed or transduced with exogenous nucleic acid. The cell includes the primary subject cell and its progeny.
[0080] The term “pharmaceutically acceptable” as used herein means being approved by a regulatory agency of the Federal or a state government, or listed in United States Pharmacopeia, European Pharmacopeia, or other generally recognized Pharmacopeia for use in animals, and more particularly in humans.
[0081] The term “effective amount” or “therapeutically effective amount” as used herein refers to the amount of an antibody or a therapeutic molecule comprising an agent and the antibody or pharmaceutical composition provided herein which is sufficient to result in the desired outcome.
[0082] The terms “subject, ” “individual, ” and “patient” may be used interchangeably. As used herein, in certain embodiments, a subject or an individual is a mammal, such as a non-primate or a primate (e.g., human) . In specific embodiments, the individual is a human. In one embodiment, the individual is a mammal, e.g., a human, diagnosed with a disease or disorder, or at risk of developing a disease or disorder.
[0083] As used herein, the terms “treat, ” “treatment” and “treating” refer to the reduction or amelioration of the progression, severity, and / or duration of a disease or condition resulting from the administration of one or more therapies. Treating may be determined by assessing whether there has been a decrease, alleviation and / or mitigation of one or more symptoms associated with the underlying disorder such that an improvement is observed with the patient, despite that the patient may still be afflicted with the underlying disorder. The term “treating” includes both managing and ameliorating the disease. The terms “manage, ” “managing, ” and “management” refer to the beneficial effects that a subject derives from a therapy which does not necessarily result in a cure of the disease.
[0084] The terms “prevent, ” “preventing, ” and “prevention” refer to reducing the likelihood of the onset (or recurrence) of a disease, disorder, condition, or associated symptom (s) (e.g., diabetes or a cancer) .
[0085] As used herein, “delaying” the development of cancer means to defer, hinder, slow, retard, stabilize, and / or postpone development of the disease. This delay can be of varying lengths of time, depending on the history of the disease and / or individual being treated. As is evident to one skilled in the art, a sufficient or significant delay can, in effect, encompass prevention, in that the individual does not develop the disease. A method that "delays" development of cancer is a method that reduces probability of disease development in a given time frame and / or reduces the extent of the disease in a given time frame, when compared to not using the method. Such comparisons are typically based on clinical studies, using a statistically significant number of individuals. Cancer development can be detectable using standard methods, including, but not limited to, computerized axial tomography (CAT Scan) , Magnetic Resonance Imaging (MRI) , abdominal ultrasound, clotting tests, arteriography, or biopsy. Development may also refer to cancer progression that may be initially undetectable and includes occurrence, recurrence, and onset.
[0086] The terms “about” and “approximately” mean within 20%, within 15%, within 10%, within 9%, within 8%, within 7%, within 6%, within 5%, within 4%, within 3%, within 2%, within 1%, or less of a given value or range.
[0087] As used in the present disclosure and claims, the singular forms “a” , “an” and “the” include plural forms unless the context clearly dictates otherwise.
[0088] It is understood that wherever embodiments are described herein with the term “comprising” otherwise analogous embodiments described in terms of “consisting of” and / or “consisting essentially of” are also provided. It is also understood that wherever embodiments are described herein with the phrase “consisting essentially of” otherwise analogous embodiments described in terms of “consisting of” are also provided.
[0089] The term “between” as used in a phrase as such “between A and B” or “between A-B” refers to a range including both A and B.
[0090] The term “and / or” as used in a phrase such as “A and / or B” herein is intended to include both A and B; A or B; A (alone) ; and B (alone) . Likewise, the term “and / or” as used in a phrase such as “A, B, and / or C” is intended to encompass each of the following embodiments: A, B, and C; A, B, or C; A or C; A or B; B or C; A and C; A and B; B and C; A (alone) ; B (alone) ; and C (alone) . II. Method of treating GUCY2C-positive cancer
[0091] The present application provides a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell expressing a GUCY2C-targeted chimeric receptor, such as GUCY2C CAR. In some embodiments, the method further comprises administering to the individual an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) . In some embodiments, the engineered immune cell co-expresses a GUCY2C-targeted chimeric receptor and an immune checkpoint inhibitor.
[0092] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises a chimeric receptor (e.g., engineered TCR, cTCR, or CAR) comprising: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain. In some embodiments, the chimeric receptor is a GUCY2C CAR. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in separate compositions. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered simultaneously. In some embodiments, the engineered immune cell is administered before the administration of the ICI. In some embodiments, the engineered immune cell is administered after the administration of the ICI. In some embodiments, the engineered immune cell and the immune checkpoint inhibitor are administered in a single composition. In some embodiments, the ICI is secreted by the engineered immune cell. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C.
[0093] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) comprising: (a) an antigen binding domain (e.g., scFv, sdAb, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . The intracellular co-stimulatory signaling domain can be at the N’ or the C’ of the intracellular signaling domain. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb, such as any of the anti-GUCY2C sdAbs provided herein. In some embodiments, the CAR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the transmembrane domain comprises the amino acid sequence of SEQ ID NO: 60. In some embodiments, the intracellular signaling domain comprises the amino acid sequence of SEQ ID NO: 62. In some embodiments, the intracellular co-stimulatory signaling domain comprises the amino acid sequence of SEQ ID NO: 61. In some embodiments, the hinge domain comprises the amino acid sequence of SEQ ID NO: 59. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 53 or 54. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprising an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the engineered immune cell expressing the GUCY2C CAR and the immune checkpoint inhibitor are administered in separate compositions, either simultaneously or sequentially. In some embodiments, the engineered immune cell expressing the GUCY2C CAR and the immune checkpoint inhibitor are administered in a single composition. In some embodiments, the ICI is secreted by the engineered immune cell. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C.
[0094] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an ICI (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) comprising: (a) an antigen binding domain (e.g., scFv, sdAb, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and wherein the ICI is not secreted by the engineered immune cell. The intracellular co-stimulatory signaling domain can be at the N’ or the C’ of the intracellular signaling domain. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb. In some embodiments, the engineered immune cell expressing the GUCY2C CAR and the ICI are administered in separate compositions, either simultaneously or sequentially. In some embodiments, the engineered immune cell expressing the GUCY2C CAR and the ICI are administered in a single composition. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb, such as any of the anti-GUCY2C sdAbs provided herein. In some embodiments, the CAR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprising an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C.
[0095] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises a) a first nucleic acid encoding a chimeric receptor (e.g., engineered TCR, cTCR, or CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding the ICI; and wherein the ICI is secreted by the engineered immune cell. In some embodiments, the chimeric receptor is a GUCY2C CAR. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C. In some embodiments, the first nucleic acid and the second nucleic acid are on different vectors. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector (e.g., under the control of the same promoter, or under the control of separate promoters) . In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, and wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker (e.g., 2A peptide, such as P2A or T2A) .
[0096] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises (1) a first nucleic acid encoding a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) , wherein the CAR comprises: (a) an antigen binding domain (e.g., scFv, sdAb, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and (2) a second nucleic acid encoding the ICI; and wherein the ICI is secreted by the engineered immune cell. The intracellular co-stimulatory signaling domain can be at the N’ or the C’ of the intracellular signaling domain. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb. In some embodiments, the CAR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the transmembrane domain comprises the amino acid sequence of SEQ ID NO: 60. In some embodiments, the intracellular signaling domain comprises the amino acid sequence of SEQ ID NO: 62. In some embodiments, the intracellular co-stimulatory signaling domain comprises the amino acid sequence of SEQ ID NO: 61. In some embodiments, the hinge domain comprises the amino acid sequence of SEQ ID NO: 59. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprising an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C. In some embodiments, the first nucleic acid and the second nucleic acid are on different vectors. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector (e.g., under the control of the same promoter, or under the control of separate promoters) . In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, and wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker (e.g., 2A peptide, such as P2A or T2A) .
[0097] In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises: (1) a first nucleic acid encoding a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) , wherein the CAR comprises: (a) an antigen binding domain (e.g., scFv, sdAb, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and (2) a second nucleic acid encoding the ICI; wherein the ICI is secreted by the engineered immune cell; wherein the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, and wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid (e.g., IRES, or encoding a cleavable linker such as 2A peptide) . In some embodiments, the first nucleic acid is upstream of the second nucleic acid. The intracellular co-stimulatory signaling domain can be at the N’ or the C’ of the intracellular signaling domain. In some embodiments, there is provided a method of treating a GUCY2C-positive cancer in an individual (e.g., human) , comprising administering to the individual an engineered immune cell (e.g., engineered T cell) and an immune checkpoint inhibitor (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) , wherein the engineered immune cell comprises a vector (e.g., viral vector, such as lentiviral vector) comprising from 5' to 3': a promoter (e.g., hEF1α promoter) -a first nucleic acid encoding a GUCY2C CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) -a linking nucleic acid (e.g., encoding P2A or T2A) -a second nucleic acid encoding the ICI; and wherein the ICI is secreted by the engineered immune cell. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb. In some embodiments, the CAR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the transmembrane domain comprises the amino acid sequence of SEQ ID NO: 60. In some embodiments, the intracellular signaling domain comprises the amino acid sequence of SEQ ID NO: 62. In some embodiments, the intracellular co-stimulatory signaling domain comprises the amino acid sequence of SEQ ID NO: 61. In some embodiments, the hinge domain comprises the amino acid sequence of SEQ ID NO: 59. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the first nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the CAR. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof comprising: an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the second nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI (e.g., N-terminal to the scFv, N-terminal to the heavy chain, and / or N-terminal to the light chain) . In some embodiments, the linking nucleic acid encodes a 2A peptide, e.g., a P2A or a T2A linker, such as comprising the amino acid sequence of SEQ ID NO: 64 or 65. In some embodiments, the vector comprising the first nucleic acid and the second nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56. In some embodiments, the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer. In some embodiments, the administration of the engineered immune cell and the immune checkpoint inhibitor is independent of the MMR status of the GUCY2C-positive cancer. In some embodiments, the MMR status is not tested before the administration of the engineered immune cell and the immune checkpoint inhibitor. In some embodiments, the GUCY2C-positive cancer is dMMR or pMMR cancer. In some embodiments, the GUCY2C-positive cancer has MSI or is MSS. In some embodiments, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer expresses moderate or low level of GUCY2C. A. GUCY2C-positive cancer
[0098] In some embodiments, the GUCY2C-positive cancer is a cancer that expresses, such as selectively expresses or abnormally expresses (e.g., overexpresses) GUCY2C. The expressed GUCY2C can either be a wild-type form or a mutant form (e.g., constitutively active, or with increased activity, or with reduced or absent activity) . In some embodiments, the GUCY2C-positive cancer is a solid tumor cancer. Examples of GUCY2C-positive cancers include but are not limited to gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer, and liver cancer. In some embodiments, the GUCY2C-positive cancer is a colorectal cancer (CRC) , such as metastatic colorectal cancer (mCRC) . In some embodiments, the GUCY2C-positive cancer is a gastric cancer, such as metastatic gastric cancer.
[0099] GUCY2C-positive cancers can be classified by the expression of Mismatch repair (MMR) proteins. Mismatch repair proteins function to correct DNA polymerase errors during replication and are critical in maintaining genome integrity (see Clin Adv Hematol Oncol. 16 (11) : 735-745 (2018) ) . A reduction in MMR expression results in increased DNA replication error, leading to a microsatellite instability (MSI) phenotype. Tumors with MSI phenotype can occur in the context of rare inherited syndromes such as Lynch syndrome or Constitutional Mismatch-Repair Deficiency (CMMR-D) , or can occur sporadically in as many as 10-15%of gastrointestinal (e.g., colorectal, gastric) cancers and endometrial cancers, and to a lesser extent in many other tumors (see Eur J Hum Genet 30: 996–997 (2022) ; Duval and Hamelin, Annates de genetique 45: 71 -75 (2002) ) . MSI phenotype can occur in around 5%of mCRCs. Sporadic MSI cancers are not restricted to colorectal, gastric or endometrial cancers, but may comprise bladder cancer, urinary tract cancer, ovary cancer, prostate cancer, lymphomas, leukemias, glioblastoma, astrocytoma and neuroblastoma.
[0100] MMR status can be classified as deficient MMR (dMMR) , wherein the tumors lack MMR proteins (e.g., MLH1, MSH2, MSH6, and PMS2) , or proficient MMR (pMMR) (see J Natl Cancer Inst. 103 (11) : 863-75 (2011) ) . A dMMR system results in the persistence of DNA mismatches in microsatellites that may then be incorporated into the genetic code as mutations. A dMMR system can be hereditary or sporadic in nature. Tumors that have a dMMR system can develop MSI, which is the expansion or reduction in the length of repetitive sequences in tumor DNA compared with normal DNA.
[0101] MMR status can be tested by any available methods known in the art. Two routes of tissue-based testing are widely in use to detect MMR status. The first is immunohistochemistry (IHC) , wherein proteins involved in the MMR pathway (MLH1, MSH2, MSH6 and PMS2) are stained, and the absence of detectable MMR protein is a readout for impaired MMR function (see JCO Precis Oncol 1: 1-15 (2017) ) . The second is MSI testing, which utilizes DNA amplification of five microsatellite markers (BAT25, BAT26, NR21, NR24 and NR27) , wherein a result showing variable marker lengths demonstrates instability and impaired MMR (see J Gastrointest Oncol. 4 (4) : 397-408 (2013) ; Mod Pathol 35: 1515–1528 (2022) ) . Next generation sequencing methods have also been developed, which can assess thousands of microsatellite loci as compared to PCR-based methods which only evaluate around five loci (see Methods Mol Biol. 2055: 119-132 (2020) ) .
[0102] In some embodiments, MSI status can be classified as MSI-high (MSI-H) , MSI-indeterminate (MSI-I) , MSI-low (MSI-L) , or microsatellite stable (MSS) . MSI status may be determined using the computational algorithm MSIsensor, wherein the percentage of unstable loci are disclosed as a cumulative score (see J Clin Oncol. 37 (4) : 286-295 (2019) ) . MSI-H may be defined as having an MSIsensor score greater than or equal to 10. MSI-I may be defined as having an MSIsensor score greater than or equal to 3 but less than 10. MSS may be defined as having an MSIsensor score less than 3 (see J Clin Oncol. 37 (4) : 286-295 (2019) ) . MSI-H may be defined as having two or more unstable loci, MSI-L may be defined as having one unstable locus, and MSS may be determined when all loci are stable (see Int J Cancer. 148 (5) : 1260-1275 (2021) ; Cancer Cell Int. 20: 16 (2020) ) . In some embodiments, the GUCY2C-positive cancer has microsatellite instability. In some embodiments, the GUCY2C-positive cancer is MSS.
[0103] MSI-H cancers have distinct clinicopathological features from MSI-L and MSS tumors, MSI-L and MSS tumors are considered to have the same clinical and molecular features, and the distinction between MSI-H and MSI-L / MSS tumors is important for their prognosis and treatment (Duval and Hamelin, Annates de genetique 45: 71 -75 (2002) ) .
[0104] ICI monotherapies are typically not effective for pMMR, MSS and MSI-L tumors, making them more challenging to treat and resulting in a poorer prognosis as compared to dMMR / MSI-H tumors (see Biochim Biophys Acta Rev Cancer. 1874 (2) : 188447 (2020) ; Front Immunol. 13: 961796 (2022) ) . For example, pembrolizumab, nivolumab, and nivolumab in combination with ipilimumab are FDA-approved ICI therapies for the treatment of MSI-H / dMMR mCRC. Factors such as tumor stage can be useful indicators in predicting prognosis for an individual. For example, dMMR is more frequent in earlier stage tumors, indicating treatments may be more effective at those earlier stages (see Curr Treat Options Oncol. 16 (7) : 30 (2015) ; J Hematol Oncol. 12 (1) : 54 (2019) ) .
[0105] GUCY2C has been shown to be expressed in up to 59%of esophageal tumors, 64%of pancreatic tumors, 68%of gastric tumors, and 98%in CRC tumors (see PLoS One. 12 (12) : e0189953 (2017) ) . To assess GUCY2C status, IHC can be used, and staining intensity can be categorized into four groups: 0 (no staining) , 1+ (weak positivity) , 2+ (moderate positivity) , and 3+ (strong positivity) . The percentage of GUCY2C-positive tumor cells with different staining intensities can be evaluated under a microscope (%cell 0, %cell 1+, %cell 2+ and %cell 3+) , and H-Score can be calculated according to the following formula: Score= 1×H-Score= 1× [%cells 1+ (weak positive) ] +2× [%cells 2+ (medium positive) ] +3× [%cells 3+ (strong positive) ] , H-score range: 0-300. A tumor sample with an H-score ≥ 10 can be considered GUCY2C-positive (see Cancer Chemother Pharmacol. 91 (4) : 291-300 (2023) ) . A tumor sample with an H-score less than 50 can be considered to express low levels of GUCY2C. A tumor sample with an H-score greater than or equal to 50 but less than 150 can be considered to express moderate levels of GUCY2C. A tumor sample with an H-score greater than or equal to 150 but less than or equal to 300 can be considered to express high levels of GUCY2C (see Lab Invest 98, 15–26 (2018) ) . Besides H-score, the expression level of GUCY2C can also be determined by flow cytometry.
[0106] In some embodiments, the GUCY2C-positive cancer is deficient mismatch repair (dMMR) type. In some embodiments, the GUCY2C-positive cancer is proficient mismatch repair (pMMR) type. In some embodiments, the GUCY2C-positive cancer is MSS type. In some embodiments, the GUCY2C-positive cancer is microsatellite instability (MSI) type, such as MSI-H, MSI-I, or MSI-L. In some embodiments, the GUCY2C-positive cancer has combinations of microsatellite and MMR status. In some embodiments, the GUCY2C-positive cancer is MSI / dMMR type, such as MSI-H / dMMR type or MSI-L / dMMR type. In some embodiments, the GUCY2C-positive cancer is MSS / dMMR type. In some embodiments, the GUCY2C-positive cancer is MSS / pMMR type. In some embodiments, the GUCY2C-positive cancer is MSI / pMMR type, such as MSI-H / pMMR type or MSI-L / pMMR type. See, e.g., Huang et al., J Gastrointest Oncol. 2021; 12 (6) : 2749-2762; Zwart et al., Cancer Med. 2023; 12 (15) : 15841-15853. In some embodiments, the GUCY2C-positive cancer is a metastatic colorectal cancer (mCRC) or a metastatic gastric cancer. In some embodiments, the GUCY2C-positive cancer is dMMR mCRC. In some embodiments, the GUCY2C-positive cancer is pMMR mCRC.
[0107] In some embodiments, the GUCY2C-positive cancer expresses high level GUCY2C (e.g., 150 ≤ H-score ≤ 300) . In some embodiments, the GUCY2C-positive cancer expresses moderate level GUCY2C (e.g., 50 ≤ H-score < 150) . In some embodiments, the GUCY2C-positive cancer expresses low level of GUCY2C (e.g., 10 ≤ H-score < 50) . In some embodiments, the administration of the immune checkpoint inhibitor and the engineered immune cell comprising the chimeric receptor is dependent of the GUCY2C expression level of the GUCY2C-positive cancer. In some embodiments, GUCY2C staining intensity is used to identify and / or select an individual for administration of the immune checkpoint inhibitor (e.g., an anti-PD-1 antibody) and the engineered immune cell comprising the chimeric receptor (e.g., a GUCY2C CAR) . In some embodiments, the treatment method further comprises selecting an individual for treatment based on the GUCY2C staining intensity of the GUCY2C-positive cancer. For example, in some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer expresses moderate or low level of GUCY2C. In some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer expresses high level of GUCY2C.
[0108] In some embodiments, the MMR status (e.g., pMMR or dMMR) and / or MSI status (e.g., MSI-H, MSI-L, or MSS) of the GUCY2C-positive cancer is not tested before administration of the immune checkpoint inhibitor and the engineered immune cell comprising the chimeric receptor. In some embodiments, the MMR status and / or MSI status is tested before administration of the immune checkpoint inhibitor and the engineered immune cell comprising the chimeric receptor. In some embodiments, the MMR status and / or MSI status is tested after administration of the immune checkpoint inhibitor and the engineered immune cell comprising the chimeric receptor. In some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is dependent of the MMR status and / or MSI status of the GUCY2C-positive cancer. For example, in some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is for individuals with pMMR GUCY2C-positive cancer. In some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is for individuals with dMMR GUCY2C-positive cancer. In some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is for individuals with MSI GUCY2C-positive cancer. In some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is for individuals with MSS GUCY2C-positive cancer. In some embodiments, the administration of the ICI and the engineered immune cell comprising the chimeric receptor is independent of the MMR status and / or MSI status of the GUCY2C-positive cancer. In some embodiments, the MMR status and / or MSI status of the GUCY2C-positive cancer is used to identify and / or select an individual for the treatment. In some embodiments, the treatment method further comprises selecting an individual for treatment based on the MMR status and / or MSI status of the GUCY2C-positive cancer. For example, in some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer is pMMR type and / or MSS type. In some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer is dMMR type and / or MSI type (e.g., MSI-H or MSI-L) .
[0109] In some embodiments, both GUCY2C staining intensity and MMR and / or MSI status are used to identify and / or select an individual for administration of the immune checkpoint inhibitor (e.g., an anti-PD-1 antibody) and the engineered immune cell comprising the chimeric receptor (e.g., a GUCY2C CAR) . In some embodiments, the treatment method further comprising selecting an individual for treatment based on the GUCY2C staining intensity and MMR and / or MSI status of the GUCY2C-positive cancer. For example, the treatment method may further comprise selecting an individual for treatment based on that the GUCY2C-positive cancer: i) expresses moderate or low level of GUCY2C, and ii) is of pMMR type and / or MSS type. In some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer: i) expresses moderate or low level of GUCY2C, and ii) is of dMMR type and / or MSI type. In some embodiments, the treatment method further comprises selecting an individual for treatment based on that the GUCY2C-positive cancer: i) expresses high level of GUCY2C, and ii) is of dMMR type and / or MSI type.
[0110] In some embodiments, the individual, to whom the engineered immune cells, cell populations, ICIs, or compositions thereof are administered is a primate, such as a human, monkey, gorilla, chimpanzee, etc. In some embodiments, the individual is a human. The individual can be male or female and can be any suitable age, including infant, juvenile, adolescent, adult, and geriatric individuals. In some embodiments, the individual is a mammal, including but are not limited to, mice, rats, hamsters, guinea pigs, rabbits, chinchillas, cats, dogs, horses, donkeys, cows, goats, sheep, deer, monkeys, apes, etc. In some embodiments, the individual is a livestock. In some embodiments, the individual is a companion animal. In some examples, the individual is a validated animal model for disease, adoptive cell therapy, and / or for assessing toxic outcomes. B. Chimeric receptors
[0111] The engineered immune cells described herein comprise a chimeric receptor, wherein the chimeric receptor comprises i) an antigen binding domain that specifically recognizes GUCY2C, and ii) a transmembrane domain. The GUCY2C-targeted chimeric receptor can be any chimeric receptor that specifically recognizes GUCY2C and is capable of activating the engineered immune cell (e.g., inducing cytokine secretion, and / or inducing GUCY2C-mediated immune cell cytotoxicity) . In some embodiments, the chimeric receptor is an engineered T cell receptor (TCR) , a chimeric TCR (cTCR) , or a chimeric antigen receptor (CAR) . In some embodiments, the chimeric receptor (e.g., cTCR or CAR) further comprises an intracellular signaling domain (ISD) .
[0112] In some embodiments, the chimeric receptor is a CAR (hereinafter also referred to as “GUCY2C CAR” ) . The CAR may comprise from N-terminus to C-terminus: (a) an antigen binding domain specifically recognizing GUCY2C (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . The CAR may comprise from N-terminus to C-terminus: (a) an antigen binding domain specifically recognizing GUCY2C (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular signaling domain (e.g., derived from CD3ζ) ; and (e) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) . The antigen binding domain of the GUCY2C CAR may be selected from the group consisting of a Fab, a Fab’, a (Fab’) 2, an Fv, a single chain Fv (scFv) , a single domain antibody (sdAb) , and a peptide ligand specifically binding to GUCY2C. In some embodiments, the antigen binding domain of the CAR is an anti-GUCY2C sdAb. In some embodiments, the antigen binding domain comprises two or more antigen-binding fragments (e.g., scFv or sdAb) specifically recognizing GUCY2C, such as connected in tandem. The two or more antigen-binding fragments can be the same or different. The two or more antigen-binding fragments can recognize the same epitope or different epitopes of GUCY2C. In some embodiments, the CAR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the transmembrane domain is derived from CD8α, such as comprising the amino acid sequence of SEQ ID NO: 60. In some embodiments, the intracellular signaling domain is derived from CD3ζ, such as comprising the amino acid sequence of SEQ ID NO: 62. In some embodiments, the intracellular co-stimulatory signaling domain is derived from a cytoplasmic domain of CD137, such as comprising the amino acid sequence of SEQ ID NO: 61. In some embodiments, the hinge domain is derived from CD8α, such as comprising the amino acid sequence of SEQ ID NO: 59. In some embodiments, the CAR further comprises a chimeric receptor signal peptide N-terminal to the antigen binding domain specifically recognizing GUCY2C. In some embodiments, the chimeric receptor signal peptide is derived from a CD8α propeptide, such as comprising the amino acid sequence of SEQ ID NO: 57.
[0113] In some embodiments, the GUCY2C CAR comprises from N’ to C’: (a) an anti-GUCY2C sdAb; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; and (d) an intracellular signaling domain (e.g., derived from CD3ζ) ; wherein the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a CDR2 comprising the amino acid sequence of SEQ ID NO: 9, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 17; (ii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 2, a CDR2 comprising the amino acid sequence of SEQ ID NO: 10, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 18; (iii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 19; (iv) a CDR1 comprising the amino acid sequence of SEQ ID NO: 4, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 20; (v) a CDR1 comprising the amino acid sequence of SEQ ID NO: 5, a CDR2 comprising the amino acid sequence of SEQ ID NO: 12, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 21; (vi) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 22; (vii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 14, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 23; (viii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24; or (ix) a CDR1 comprising the amino acid sequence of SEQ ID NO: 8, a CDR2 comprising the amino acid sequence of SEQ ID NO: 16, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 25. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. Hence in some embodiments, the GUCY2C CAR comprises from N’ to C’: (a) an anti-GUCY2C sdAb; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; and (d) an intracellular signaling domain (e.g., derived from CD3ζ) ; wherein the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the CAR further comprises an intracellular co-stimulatory signaling domain, such as an intracellular co-stimulatory signaling domain comprising a cytoplasmic domain of CD137. In some embodiments, the intracellular co-stimulatory signaling domain is at the C-terminus of the intracellular signaling domain. In some embodiments, the intracellular co-stimulatory signaling domain is at the N-terminus of the intracellular signaling domain. Hence in some embodiments, the GUCY2C CAR comprises from N’ to C’: (a) an anti-GUCY2C sdAb; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; wherein the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the transmembrane domain comprises the amino acid sequence of SEQ ID NO: 60. In some embodiments, the intracellular signaling domain comprises the amino acid sequence of SEQ ID NO: 62. In some embodiments, the hinge domain comprises the amino acid sequence of SEQ ID NO: 59. In some embodiments, the intracellular co-stimulatory signaling domain comprises the amino acid sequence of SEQ ID NO: 61. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54 (hereinafter also referred to as “C07 CAR” or “VHHC0708H2 CAR” ) . In some embodiments, the CAR further comprises a chimeric receptor signal peptide N-terminal to the anti-GUCY2C sdAb. In some embodiments, the chimeric receptor signal peptide comprises the amino acid sequence of SEQ ID NO: 57. In some embodiments, the CAR comprising the chimeric receptor signal peptide comprises the amino acid sequence of SEQ ID NO: 53 (hereinafter also referred to as “C07 CAR with SP” or “VHHC0708H2 CAR with SP” ) .
[0114] In some embodiments, the chimeric receptor is an engineered TCR (hereinafter also referred to as “GUCY2C engineered TCR” ) . The engineered TCR may comprise i) an antigen binding domain that comprises a Vα and a Vβ (or a Vδ and a Vγ) derived from a wildtype TCR together specifically recognizing GUCY2C, wherein the Vα, the Vβ, or both (or the Vδ, the Vγ, or both) , comprise one or more mutations (e.g., insertions, deletions, or substitutions, such as conservative substitutions) in one or more CDRs relative to the wild type TCR; and ii) a transmembrane domain (TM) derived from a TCR molecule (e.g., TCRα / TCRβ, or TCRδ / TCRγ) . The engineered TCR can be a single chain TCR (scTCR) or a dimeric TCR (dTCR) . For example, the engineered TCR may comprise: i) a first polypeptide chain comprising from N’ to C’: Vα (e.g., Vα variant) –Cα –TMα –optional TCRα cytoplasmic domain (cytoTCRα) , and ii) a second polypeptide chain comprising from N’ to C’: Vβ (e.g., Vβ variant) –Cβ –TMβ –optional cytoTCRβ; wherein the Vα and the Vβ form an antigen binding domain that specifically recognizes GUCY2C. The engineered TCR may comprise: i) a first polypeptide chain comprising from N’ to C’: Vγ (e.g., Vγ variant) –Cγ –TMγ –optional cytoTCRγ, and ii) a second polypeptide chain comprising from N’ to C’: Vδ (e.g., Vδ variant) –Cδ –TMδ –optional cytoTCRδ; wherein the Vγ and the Vδ form an antigen binding domain that specifically recognizes GUCY2C. The engineered TCR may bind to the same cognate peptide-MHC bound by the wildtype TCR. The engineered TCR may bind to the same cognate peptide-MHC with higher affinity compared to that bound by the wildtype TCR. The engineered TCR may bind to the same cognate peptide-MHC with lower affinity compared to that bound by the wildtype TCR. The engineered TCR may bind to a non-cognate peptide-MHC not bound by the wildtype TCR. The engineered TCR may not comprise an intracellular signaling domain. The engineered TCR may further comprise a hinge domain (or a connecting domain) between the TCR Ig-like constant domain and the TCR transmembrane domain, such as a hinge domain derived from TCRα / TCRβ or TCRδ / TCRγ.
[0115] In some embodiments, the chimeric receptor is a chimeric T cell receptor (cTCR; hereinafter also referred to as “GUCY2C-targeted cTCR” ) . The cTCR may comprise: i) an antigen binding domain comprising an antibody or antigen-binding fragment thereof (e.g., scFv, Fab, or sdAb) that specifically recognizes GUCY2C (e.g., any of the anti-GUCY2C sdAbs provided herein) , and ii) a full-length TCR subunit, wherein the TCR subunit is selected from the group consisting of TCRα, TCRβ, TCRγ, TCRδ, CD3γ, CD3ε, and CD3δ; wherein the antigen binding domain is fused (directly or indirectly) to the N-terminus of the full-length TCR subunit. For example, the cTCR may comprise from N’ to C’: i) an antigen binding domain comprising an antibody or antigen-binding fragment thereof (e.g., scFv, Fab, or sdAb) that specifically recognizes GUCY2C (e.g., any of the anti-GUCY2C sdAbs provided herein) , ii) an optional extracellular domain (ECD) or portion thereof derived from a first TCR subunit, and iii) a transmembrane domain derived from a second TCR subunit; wherein the first TCR subunit and the second TCR subunit are independently selected from the group consisting of TCRα, TCRβ, TCRγ, TCRδ, CD3γ, CD3ε, and CD3δ. The cTCR can be incorporated into a functional TCR complex along with other endogenous TCR subunits and confer antigen specificity to the TCR complex. The antigen binding domain of the anti-GUCY2C cTCR may be selected from the group consisting of a Fab, a Fab’, a (Fab’) 2, an Fv, an scFv, and an sdAb. The cTCR antigen binding domain may be fused to the N-terminus of the full-length or a portion thereof of CD3ε, CD3γ, or CD3δ. The cTCR antigen binding domain may be fused to the N-terminus of a TCRαmolecule (with or without the Vα domain) , and / or the N-terminus of a TCRβ molecule (with or without the Vβ domain) . The cTCR antigen binding domain may be fused to the N-terminus of a TCRγ molecule (with or without the Vγ domain) , and / or the N-terminus of a TCRδ molecule (with or without the Vδ domain) . The cTCR may not comprise an intracellular signaling domain. The cTCR may comprise an intracellular signaling domain, such as the intracellular signaling domain of CD3γ, CD3ε, or CD3δ. The cTCR intracellular signaling domain and the cTCR transmembrane domain can be derived from the same TCR subunit, e.g., both from CD3ε, both from CD3ε, or both from CD3δ. The cTCR antigen binding domain and the first TCR subunit (full-length or an ECD portion thereof) can be fused via a linker (such as a GS linker) . In some embodiments, the cTCR antigen binding domain is fused to the N-terminus of the transmembrane domain via an optional linker or hinge domain. The cTCR may further comprise a hinge domain between the ECD portion derived from the first TCR subunit and the transmembrane domain derived from the second TCR subunit. In some embodiments, the cTCR comprises from N-terminus to C-terminus: (a) an antigen binding domain comprising an antibody or antigen-binding fragment thereof (e.g., scFv, Fab, or sdAb) that specifically recognizes GUCY2C (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) an optional linker, (c) an optional extracellular domain of a first TCR subunit (e.g., CD3ε) or a portion thereof, (d) an optional hinge domain, (e) a transmembrane domain derived from a second TCR subunit (e.g., CD3ε) , and (f) an optional cytoplasmic domain (e.g., optional intracellular signaling domain) ; wherein the first and second TCR subunits are independently selected from the group consisting of TCRα, TCRβ, TCRγ, TCRδ, CD3ε, CD3γ, and CD3δ. The first and second TCR subunits can be the same or different. In some embodiments, the cTCR comprises from N-terminus to C-terminus: (a) an anti-GUCY2C scFv or sdAb (e.g., any of the anti-GUCY2C scFvs or sdAbs described herein) ; (b) an optional linker, and (c) a full-length CD3ε, CD3γ, or CD3δ.
[0116] Each component of chimeric receptors and optionally additional regions are described in more detail below.Antigen binding domain specifically recognizing GUCY2C
[0117] In some embodiments, the GUCY2C-targeted chimeric receptor or the antigen binding domain comprises a means for specifically recognizing GUCY2C. In some embodiments, the antigen binding domain of the chimeric receptor (e.g., cTCR or CAR) is selected from the group consisting of a Fab, a Fab’, a (Fab’) 2, an Fv, an scFv, an sdAb, and a peptide ligand specifically binding to GUCY2C. In some embodiments, the antigen binding domain is an anti-GUCY2C scFv or an anti-GUCY2C Fab. In some embodiments, the antigen binding domain is an anti-GUCY2C sdAb. In some embodiments, the antigen binding domain is a peptide ligand specifically binding to GUCY2C, such as any of guanylin, urogranylin, heat-stable enterotoxin (STs) , plecanatide, sildenafil and linaclotide. In some embodiments, the antigen binding domain is monospecific and monovalent. In some embodiments, the antigen binding domain is monospecific (e.g., specifically binding to the same GUCY2C epitope) and multivalent. In some embodiments, the antigen binding domain is multispecific (e.g., specifically binding to different GUCY2C epitopes) and multivalent.
[0118] The chimeric receptor antigen binding domain can specifically recognize GUCY2C of any source. In some embodiments, the GUCY2C is a human GUCY2C. In some embodiments, the GUCY2C is from any of mice, rats, hamsters, guinea pigs, rabbits, chinchillas, cats, dogs, horses, donkeys, cows, goats, sheep, deer, monkeys, apes, etc. In some embodiments, the chimeric receptor antigen binding domain specifically recognizes human GUCY2C. In some embodiments, the chimeric receptor antigen binding domain does not cross-react with GUCY2C from a non-human species. In some embodiments, the chimeric receptor antigen binding domain cross-reacts with GUCY2C from a non-human species, such as mouse, rat, or monkey (e.g., cynomolgus monkey) GUCY2C. Using chimeric receptor antigen binding domain that cross-reacts with GUCY2C from a non-human species can help extrapolate animal study data to human clinical trials. GUCY2C recognized by the chimeric receptor antigen binding domain can be wildtype GUCY2C or mutant GUCY2C.
[0119] Any antibodies or antigen-binding fragments specifically recognizing GUCY2C can be used in the chimeric receptor antigen binding domains described herein. Exemplary anti-GUCY2C antibodies or antigen-binding fragments include but are not limited to, 1F5F6 (e.g., Proteintech) , antibody moiety contained in TAK-164 (see AAPS J. 24 (6) : 107 (2022) ) , 2F3 (e.g., Abnova) , 1B11 (e.g., Abnova) , 3D5 (e.g., Abnova) , 2H8 (e.g., Abnova) , 1E1 (e.g., Abnova) , 3C2 (e.g., Abnova) , 3H6 (e.g., Abnova) , 3D2 (e.g., Abnova) , 2G7 (e.g., Abnova) , 1D11 (e.g., Abnova) , 1G5 (e.g., Abnova) , 3H1 (e.g., Abnova) , 3H3 (e.g., Abnova) , 2E5 (e.g., Invitrogen) , or 4G12 (e.g., Invitrogen) , or those described in US9000129, US8785600, US20230146072, US11525010, WO2021205325, or International Application No. PCT / CN2023 / 122401 filed on 28 September 2023, etc., the contents of each of which are incorporated herein by reference in their entirety. Anti-GUCY2C single domain antibody (sdAb)
[0120] In some embodiments, the antigen binding domain of the chimeric receptor (e.g., cTCR or CAR) comprises (or consists of, or consists essentially of) one or more anti-GUCY2C sdAbs, such as connected in tandem. In some embodiments, the antigen binding domain of the chimeric receptor (e.g., cTCR or CAR) comprises (or consists of, or consists essentially of) an anti-GUCY2C sdAb. Any anti-GUCY2C sdAbs described in the International Application No. PCT / CN2023 / 122401 filed on 28 September 2023 (the content of which is incorporated herein by reference in its entirety) can be used here in the chimeric receptor antigen binding domain.
[0121] In some embodiments, the anti-GUCY2C sdAb binds to human GUCY2C. GUCY2C (UniProtKB: P25092) is a surface receptor that functions in the maintenance of intestinal fluid, electrolyte homeostasis and cell proliferation (Expert Opin Ther Targets. 25 (5) : 335-346 (2021) ) . In healthy individuals, GUCY2C is primarily expressed on the luminal side of intestinal epithelium (see PLoS One. 12 (12) : e0189953 (2017) ) . In tumor samples, GUCY2C expression is largely associated with various gastrointestinal cancers. GUCY2C is expressed in the majority of esophageal, gastric and pancreatic cancers, and in nearly all primary and metastatic colorectal cancers (see PLoS One. 12 (12) : e0189953 (2017) ) .
[0122] In some embodiments, the anti-GUCY2C sdAb modulates one or more GUCY2C activities. In some embodiments, the anti-GUCY2C sdAb is an antagonist antibody.
[0123] In some embodiments, the anti-GUCY2C sdAb binds to GUCY2C (e.g., human GUCY2C) with a dissociation constant (KD) of ≤ 1μM, ≤ 100 nM, ≤ 10 nM, ≤ 1 nM, ≤ 0.1 nM, ≤ 0.01 nM, or ≤ 0.001 nM (e.g., about 10-8 M or less, such as any of from about 10-8 M to about 10-13 M, from about 10-9 M to about 10-13 M, from about 10-10 M to about 10-13 M, or from about 10-11 M to about 10-13 M) . A variety of methods of measuring binding affinity are known in the art, any of which can be used for purposes of the present disclosure, including by RIA, for example, performed with the an antibody of interest and its antigen (Chen et al., 1999, J. Mol Biol 293: 865-81) ; by biolayer interferometry (BLI) or surface plasmon resonance (SPR) assays by using, for example, an system, or by using, for example, a or a An “on-rate” or “rate of association” or “association rate” or “kon” may also be determined with the same BLI or SPR techniques described above using, for example, the the or the system.
[0124] In some embodiments, the anti-GUCY2C sdAb comprises a VNAR domain. In some embodiments, the anti-GUCY2C sdAb comprises a VHH domain. Exemplary anti-GUCY2C VHH domains that can be used herein include, but are not limited to, VHHA2322, VHHA2493, VHHC0464, VHHC0467, VHHC0494, VHHC0524, VHHC0694, VHHC0708, VHHC0806, VHHA2322H1, VHHA2322H2, VHHC0694H1, VHHC0694H2, VHHC0708H1, VHHC0708H2, and VHHC0708H3. In some embodiments, the anti-GUCY2C sdAb comprises from N’ to C’: FR1-CDR1-FR2-CDR2-FR3-CDR3-FR4.
[0125] In some embodiments, the anti-GUCY2C sdAb comprises one, two, or three CDR sequences of any one of VHHA2322, VHHA2493, VHHC0464, VHHC0467, VHHC0494, VHHC0524, VHHC0694, VHHC0708, VHHC0806, VHHA2322H1, VHHA2322H2, VHHC0694H1, VHHC0694H2, VHHC0708H1, VHHC0708H2, and VHHC0708H3. In some embodiments, the anti-GUCY2C sdAb comprises the following structure: FR1-CDR1-FR2-CDR2-FR3-CDR3-FR4, wherein the CDR sequences are selected from those in any of VHHA2322, VHHA2493, VHHC0464, VHHC0467, VHHC0494, VHHC0524, VHHC0694, VHHC0708, VHHC0806, VHHA2322H1, VHHA2322H2, VHHC0694H1, VHHC0694H2, VHHC0708H1, VHHC0708H2, and VHHC0708H3.
[0126] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-8, and / or (ii) a CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 9-16, and / or (iii) a CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 17-25. In some embodiments, the anti-GUCY2C sdAb comprises (i) a CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-8, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 9-16, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 17-25, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises (i) a CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-8, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 9-16, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 17-25. In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-8, a CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 9-16, and a CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 17-25. In some embodiments, the anti-GUCY2C sdAb comprises one, two, or all three CDRs of a VHH of any one of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb comprises CDR1, CDR2, and CDR3 of a VHH of any one of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises an acceptor human framework, e.g., a human immunoglobulin framework or a human consensus framework. CDR sequences can be determined according to well-known numbering systems / schemes, such as any of IMGT, Kabat, AbM, Chothia, and Contact numbering scheme, or a combination thereof. In some embodiments, the CDRs are determined according to Kabat numbering scheme. In some embodiments, the CDRs are determined according to AbM numbering scheme.
[0127] In some embodiments, the anti-GUCY2C sdAb comprises one, two, three, or all four framework regions of any of VHHA2322, VHHA2493, VHHC0464, VHHC0467, VHHC0494, VHHC0524, VHHC0694, VHHC0708, VHHC0806, VHHA2322H1, VHHA2322H2, VHHC0694H1, VHHC0694H2, VHHC0708H1, VHHC0708H2, and VHHC0708H3. In some embodiments, the anti-GUCY2C sdAb comprises one, two, three, or all four framework regions derived from a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb comprises all four framework regions derived from a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises an acceptor human framework, e.g., a human immunoglobulin framework or a human consensus framework.
[0128] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 1, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 17, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a CDR2 comprising the amino acid sequence of SEQ ID NO: 9, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 17. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26, 35, and 36, or a variant thereof having at least about 85%(e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to any one of SEQ ID NOs: 26, 35, and 36.
[0129] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 2, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 18, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 2, a CDR2 comprising the amino acid sequence of SEQ ID NO: 10, and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 18. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 27, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 27.
[0130] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 3, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 19, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 19. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 28, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 28.
[0131] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 4, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 4, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 20. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 29, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 29.
[0132] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 5, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 12, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 21, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 5, a CDR2 comprising the amino acid sequence of SEQ ID NO: 12, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 21. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 30, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 30.
[0133] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 13, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 22, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 22. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 31, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 31.
[0134] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 14, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 23, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 14, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 23. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 32, 37, and 38, or a variant thereof having at least about 85%(e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to any one of SEQ ID NOs: 32, 37, and 38.
[0135] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 24, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 33 and 39-41, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to any one of SEQ ID NOs: 33 and 39-41.
[0136] In some embodiments, the anti-GUCY2C sdAb comprises: (i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 8, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; (ii) a CDR2 comprising the amino acid sequence of SEQ ID NO: 16, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) ; and (iii) a CDR3 comprising the amino acid sequence of SEQ ID NO: 25, or a variant thereof comprising up to 5 (e.g., 5, 4, 3, 2, or 1) amino acid variations (e.g., insertion, deletion, or substitution, such as conservative substitution) . In some embodiments, the anti-GUCY2C sdAb comprises: a CDR1 comprising the amino acid sequence of SEQ ID NO: 8, a CDR2 comprising the amino acid sequence of SEQ ID NO: 16, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 25. In some embodiments, the anti-GUCY2C sdAb is camelid. In some embodiments, the anti-GUCY2C sdAb is humanized. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 34, or a variant thereof having at least about 85% (e.g., at least about any of 90%, 95%, 96%, 96%, 98%, 99%, or more) sequence identity to SEQ ID NO: 34.
[0137] In some embodiments, the anti-GUCY2C sdAb comprises a VHH having at least about any one of 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100%sequence identity to an amino acid sequence selected from SEQ ID NOs: 26-41. In some embodiments, the VHH with sequence variation contains substitutions (e.g., conservative substitutions) , insertions, and / or deletions relative to the reference sequence, but the anti-GUCY2C sdAb comprising that variant sequence retains the ability to bind to GUCY2C. In some embodiments, a total of 1 to 10 amino acids have been substituted, inserted and / or deleted in an amino acid sequence selected from any of SEQ ID NOs: 26-41. In some embodiments, substitutions, insertions, and / or deletions occur in regions outside the CDRs (i.e., in the FRs) . In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any of SEQ ID NOs: 26-41. In some embodiments, the anti-GUCY2C sdAb contains post-translational modifications of that sequence.
[0138] Functional epitopes can be mapped, e.g., by combinatorial alanine scanning, to identify amino acids in the GUCY2C protein that are necessary for interaction with anti-GUCY2C sdAbs provided herein. Conformational and crystal structure of anti-GUCY2C sdAb bound to GUCY2C may be employed to identify the epitopes. In some embodiments, the anti-GUCY2C sdAb specifically binds to the same GUCY2C epitope as any of the anti-GUCY2C sdAbs provided herein. In some embodiments, the anti-GUCY2C sdAb specifically binds to the same GUCY2C epitope as an anti-GUCY2C sdAb comprising a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41.
[0139] In some embodiments, the anti-GUCY2C sdAb specifically binds to GUCY2C competitively with any one of the anti-GUCY2C sdAbs described herein. In some embodiments, the anti-GUCY2C sdAb specifically binds to GUCY2C competitively with an anti-GUCY2C sdAb comprising a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41. In some embodiments, competitive binding may be determined using an ELISA assay.Transmembrane domain
[0140] The chimeric receptors of the present disclosure comprise a transmembrane domain that can be directly or indirectly fused to the extracellular antigen binding domain. Any protein structure that is thermodynamically stable in a cell membrane, such as a eukaryotic cell membrane, can be used as the transmembrane domain herein. The transmembrane domain may be derived either from a natural or from a synthetic source. For example, it can be a synthetic, non-naturally occurring protein segment, e.g., a hydrophobic protein segment that is thermodynamically stable in a cell membrane. The transmembrane domain can be derived from a wildtype protein, or contains one or more mutations (e.g., insertion, deletion, and / or substitution, such as conservative substitution) . A transmembrane domain containing one or more mutations can be employed to avoid mispairing with endogenous protein, e.g., endogenous TCR complex component (s) , in order to enhance correct chimeric receptor assembly and / or expression level.
[0141] Transmembrane domains are classified based on the three-dimensional structure of the transmembrane domain. For example, transmembrane domains may form an alpha helix, a complex of more than one alpha helix, a beta-barrel, or any other stable structure capable of spanning the phospholipid bilayer of a cell. Furthermore, transmembrane domains may also or alternatively be classified based on the transmembrane domain topology, including the number of passes that the transmembrane domain makes across the membrane and the orientation of the protein. For example, single-pass membrane proteins cross the cell membrane once, and multi-pass membrane proteins cross the cell membrane at least twice (e.g., 2, 3, 4, 5, 6, 7 or more times) . Membrane proteins may be defined as Type I, Type II or Type III depending upon the topology of their termini and membrane-passing segment (s) relative to the inside and outside of the cell. Type I membrane proteins have a single membrane-spanning region and are oriented such that the N-terminus of the protein is present on the extracellular side of the lipid bilayer of the cell and the C-terminus of the protein is present on the cytoplasmic side. Type II membrane proteins also have a single membrane-spanning region but are oriented such that the C-terminus of the protein is present on the extracellular side of the lipid bilayer of the cell and the N-terminus of the protein is present on the cytoplasmic side. Type III membrane proteins have multiple membrane-spanning segments and may be further sub-classified based on the number of transmembrane segments and the location of N-and C-termini.
[0142] In some embodiments, the chimeric receptor is a GUCY2C engineered TCR. In some embodiments, the transmembrane domain of the engineered TCR comprises a transmembrane domain of TCRα and a transmembrane domain of TCRβ. In some embodiments, the transmembrane domain of the engineered TCR comprises a transmembrane domain of TCRδ and a transmembrane domain of TCRγ. In some embodiments, a transmembrane domain containing one or more mutations is employed to avoid mispairing with endogenous TCR complex component (s) . For example, an engineered TCRα chain containing a mutation A in the transmembrane domain is paired with an engineered TCRβ chain containing a mutation B in the transmembrane domain, instead of pairing with the endogenous TCRβ chain.
[0143] In some embodiments, the chimeric receptor is a GUCY2C cTCR. In some embodiments, the transmembrane domain of the cTCR is derived from TCRα, TCRβ, TCRγ, TCRδ, CD3ε, CD3γ, or CD3δ. In some embodiments, a transmembrane domain containing one or more mutations is employed to avoid mispairing with endogenous TCR complex component (s) . For example, a first fusion polypeptide of VH-TCRα chain containing a mutation A in the TCRαtransmembrane domain is paired with a second fusion polypeptide of VL-TCRβ chain containing a mutation B in the TCRβ transmembrane domain, instead of pairing with the endogenous TCRβchain.
[0144] In some embodiments, the chimeric receptor is a GUCY2C CAR. In some embodiments, the transmembrane domain of the CAR is derived from a Type I single-pass membrane protein. In some embodiments, transmembrane domains from multi-pass membrane proteins may also be compatible for use in the CARs described herein. Multi-pass membrane proteins may comprise a complex of (at least 2, 3, 4, 5, 6, 7 or more) alpha helices or a beta sheet structure. In some embodiments, the N-terminus and the C-terminus of a multi-pass membrane protein are present on opposing sides of the lipid bilayer, e.g., the N-terminus of the protein is present on the cytoplasmic side of the lipid bilayer and the C-terminus of the protein is present on the extracellular side.
[0145] In some embodiments, the transmembrane domain of the CAR is derived from a molecule selected from the group consisting of: an α, β or ζ chain of a TCR, CD28, CD3ε, CD45, CD4, CD5, CD8, CD9, CD16, CD22, CD33, CD37, CD64, CD80, CD86, CD134, 4-1BB (CD137) , CD154, KIRDS2, OX40, CD2, CD27, LFA-1 (CD11a, CD18) , ICOS (CD278) , 4-1BB (CD137) , GITR, CD40, BAFFR, HVEM (LIGHTR) , SLAMF7, NKp80 (KLRF1) , CD160, Claudin-6, IL-2Rβ, IL-2Rγ, IL-7Ra, ITGA1, VLA1, CD49a, ITGA4, IA4, CD49D, ITGA6, VLA-6, CD49f, ITGAD, CD11d, ITGAE, CD103, ITGAL, CD11a, LFA-1, ITGAM, CD11b, ITGAX, CD11c, ITGB1, CD29, ITGB2, CD18, LFA-1, ITGB7, TNFR2, DNAM1 (CD226) , SLAMF4 (CD244, 2B4) , CD84, CD96 (Tactile) , CEACAM1, CRT AM, Ly9 (CD229) , CD160 (BY55) , PSGL1, CDIOO (SEMA4D) , SLAMF6 (NTB-A, Ly108) , SLAM (SLAMF1, CD150, IPO-3) , BLAME (SLAMF8) , SELPLG (CD162) , LTBR, PAG / Cbp, NKp44, NKp30, NKp46, NKG2D, and NKG2C. In some embodiments, the transmembrane domain is derived from a molecule selected from the group consisting of CD8α, CD4, CD28, CD137, CD80, CD86, CD152, and PD-1.
[0146] In some specific embodiments, the transmembrane domain of the CAR is derived from CD8α. In some embodiments, the transmembrane domain comprises the amino acid sequence of SEQ ID NO: 60.
[0147] Transmembrane domains for use in the chimeric receptors described herein (e.g., engineered TCR, cTCR, or CAR) can also comprise at least a portion of a synthetic, non-naturally occurring protein segment. The transmembrane domain may be a synthetic, non-naturally occurring alpha helix or beta sheet. The protein segment can be at least approximately 20 amino acids, e.g., at least 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, or more amino acids. Examples of synthetic transmembrane domains are known in the art, for example in U.S. Patent No. 7,052,906 and PCT Publication No. WO 2000 / 032776, the relevant disclosures of which are incorporated by reference herein.
[0148] The transmembrane domain provided herein may comprise a transmembrane region and a cytoplasmic region located at the C-terminal side of the transmembrane domain. The cytoplasmic region of the transmembrane domain may comprise three or more amino acids and, in some embodiments, helps to orient the transmembrane domain in the lipid bilayer. In some embodiments, one or more cysteine residues are present in the transmembrane region of the transmembrane domain. In some embodiments, one or more cysteine residues are present in the cytoplasmic region of the transmembrane domain. In some embodiments, the cytoplasmic region of the transmembrane domain comprises positively charged amino acids. In some embodiments, the cytoplasmic region of the transmembrane domain comprises the amino acids arginine, serine, and lysine.
[0149] In some embodiments, the transmembrane region of the transmembrane domain comprises hydrophobic amino acid residues. In some embodiments, the transmembrane domain of the chimeric receptors provided herein (e.g., engineered TCR, cTCR, or CAR) comprises an artificial hydrophobic sequence. For example, a triplet of phenylalanine, tryptophan and valine may be present at the C terminus of the transmembrane domain. In some embodiments, the transmembrane region comprises mostly hydrophobic amino acid residues, such as alanine, leucine, isoleucine, methionine, phenylalanine, tryptophan, or valine. In some embodiments, the transmembrane region is hydrophobic. In some embodiments, the transmembrane region comprises a poly-leucine-alanine sequence. The hydropathy, or hydrophobic or hydrophilic characteristics of a protein or protein segment, can be assessed by any method known in the art, for example the Kyte and Doolittle hydropathy analysis.Hinge domain
[0150] The chimeric receptors of the present disclosure (e.g., engineered TCR, cTCR, or CAR) may comprise a hinge domain that is located between the extracellular antigen binding domain and the transmembrane domain. A hinge domain is an amino acid segment that is generally found between two domains of a protein and may allow for flexibility of the protein and movement of one or both of the domains relative to one another. Any amino acid sequence that provides such flexibility and movement of the extracellular antigen binding domain relative to the transmembrane domain of the effector molecule can be used. A peptide linker (e.g., any of those described in the “Peptide Linker” subsection below) can be used as a hinge domain. The hinge domain may confer stability to a multi-chain chimeric receptor, such as by forming disulfide-bond between two polypeptide chains of a chimeric receptor (e.g., a CH1-CL pair hinge domain, or an antibody hinge region pair) .
[0151] The hinge domain may contain about 10-100 amino acids, e.g., about any one of 15-75 amino acids, 20-50 amino acids, or 30-60 amino acids. In some embodiments, the hinge domain may be at least about any one of 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, 55, 60, 65, 70, or 75 amino acids in length.
[0152] The hinge domain can be a hinge domain of a naturally occurring protein. Hinge domains of any protein known in the art to comprise a hinge domain are compatible for use in the chimeric receptors described herein. In some embodiments, the hinge domain is at least a portion of a hinge domain of a naturally occurring protein and confers flexibility to the chimeric receptor. In some embodiments, the hinge domain is derived from CD8α. In some embodiments, the hinge domain is a portion of the hinge domain of CD8α, e.g., a fragment containing at least 15 (e.g., 20, 25, 30, 35, or 40) consecutive amino acids of the hinge domain of CD8α. In some embodiments, the hinge domain derived from CD8α comprises the amino acid sequence of SEQ ID NO: 59.
[0153] Hinge domains of antibodies, such as an IgG, IgA, IgM, IgE, or IgD antibodies, are also compatible for use in the chimeric receptors described herein. In some embodiments, the chimeric receptor hinge domain is the hinge domain that joins the constant domains CH1 and CH2 of an antibody. In some embodiments, the chimeric receptor hinge domain comprises a CH1-CL pair (e.g., on two polypeptide chains for a multi-chain chimeric receptor) . The hinge domain may be of an antibody and comprise the hinge domain of the antibody and one or more constant regions of the antibody. The hinge domain may comprise the hinge domain of an antibody and the CH3 constant region of the antibody. The hinge domain may comprise the hinge domain of an antibody and the CH2 and CH3 constant regions of the antibody. In some embodiments, the antibody is an IgG, IgA, IgM, IgE, or IgD antibody. In some embodiments, the antibody is an IgG antibody. In some embodiments, the antibody is an IgG1, IgG2, IgG3, or IgG4 antibody. The hinge region may comprise the hinge region and the CH2 and CH3 constant regions of an IgG1 antibody. The hinge region may comprise the hinge region and the CH3 constant region of an IgG1 antibody. The hinge domain may comprise a constant domain or a fragment or a variant thereof from an immunoglobulin or a TCR subunit. The hinge domain may comprise a CH1, CH2, CH3, CH4, or CL antibody domain, or a fragment or a variant thereof. The hinge domain may comprise a Cα, Cβ, Cγ, or Cδ TCR domain, or a fragment or a variant thereof.
[0154] Non-naturally occurring peptides may also be used as hinge domains for the chimeric receptors described herein. In some embodiments, the hinge domain between the C-terminus of the extracellular antigen binding domain and the N-terminus of the transmembrane domain is a peptide linker, such as a (GGGGS) n linker (e.g., SEQ ID NO: 66) , wherein n can be an integer of at least 1, e.g., 1, 2, 3, 4, or more; or a (GxS) n linker, wherein x and n, independently can be an integer of at least 1, such as between 3 and 12, including 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12. In some embodiments, the peptide linker comprises the amino acid sequence of any one of SEQ ID NOs: 66, 67, and 74.Intracellular signaling domain
[0155] The intracellular signaling domain is responsible for activation of at least one of the normal effector functions of the immune effector cell expressing the chimeric receptors (e.g., CAR or cTCR) . The term “effector function” refers to a specialized function of a cell, such as in the killing of diseased cells such as tumor cells, or in the inhibition of tumor growth and / or inhibition of tumor development, including inhibition of tumor dissemination and metastasis. Effector function of a T cell, for example, may be cytolytic activity or helper activity including the secretion of cytokines. Thus the term “intracellular signaling domain” refers to the portion of a protein which transduces the effector function signal and directs the cell to perform a specialized function. While usually the entire intracellular signaling domain can be employed, in many cases it is not necessary to use the entire chain. To the extent that a truncated portion of the intracellular signaling domain is used, such truncated portion may be used in place of the intact chain as long as it transduces the effector function signal. The term intracellular signaling domain is thus meant to include any truncated portion of the intracellular signaling domain sufficient to transduce the effector function signal.
[0156] In some embodiments, the intracellular signaling domain comprises (or consists essentially of, or consists of) a primary intracellular signaling domain of an immune effector cell. In some embodiments, the chimeric receptor comprises an intracellular signaling domain consisting essentially of a primary intracellular signaling domain of an immune effector cell. “Primary intracellular signaling domain” refers to intracellular signaling sequence that acts in a stimulatory manner to induce immune effector functions. In some embodiments, the primary intracellular signaling domain contains a signaling motif known as immunoreceptor tyrosine-based activation motif, or ITAM. An “ITAM, ” as used herein, is a conserved protein motif that is generally present in the tail portion of signaling molecules expressed in many immune cells. The motif may comprise two repeats of the amino acid sequence YxxL / I (SEQ ID NO: 71) separated by 6-8 amino acids, wherein each x is independently any amino acid, producing the conserved motif YxxL / I-x6-8-YxxL / I (SEQ ID NO: 72) . In some embodiments, the ITAM contains a negatively charged amino acid (D / E) in the +2 position relative to the first ITAM tyrosine (Y) , resulting a consensus sequence of D / E-x0-2-YxxL / I-x6-8-YxxL / I (SEQ ID NO: 73) . ITAMs within signaling molecules are important for signal transduction within the cell, which is mediated at least in part by phosphorylation of tyrosine residues in the ITAM following activation of the signaling molecule. ITAMs may also function as docking sites for other proteins involved in signaling pathways. Exemplary ITAM-containing primary intracellular signaling sequences include those derived from CD3ζ, FcεRIβ, FcεRIγ, CD3γ, CD3δ, CD3ε, DAP12, CNAIP / NFAM1, STAM-1, STAM-2, Moesin, CD5, CD22, CD79a, CD79b, and CD66d (CEACAM3) .
[0157] A “functional” primary intracellular signaling domain is a sequence that is capable of transducing an immune cell activation signal when operably coupled to an appropriate receptor. “Non-functional” primary intracellular signaling domains, which may comprise fragments or variants of primary intracellular signaling domains, are unable to transduce an immune cell activation signal. For example, a non-functional primary intracellular signaling domain may have ITAM (s) truncated or mutated to possess no or less than about 5% (e.g., less than about any of 4%, 3%, 2%, 1%, or less) signal transduction / docking function (s) .
[0158] In some embodiments, the CAR of the present disclosure comprises an intracellular signaling domain, e.g., comprises an ITAM-containing primary intracellular signaling domain, or a functional primary intracellular signaling domain. In some embodiments, the CAR comprises (or consists essentially of, or consists of) an intracellular signaling domain (e.g., a primary intracellular signaling domain) derived from CD3ζ. In some embodiments, the intracellular signaling domain (e.g., the primary intracellular signaling domain) derived from CD3ζ comprises the amino acid sequence of SEQ ID NO: 62.
[0159] In some embodiments, the engineered TCR does not comprise an intracellular signaling domain. In some embodiments, the engineered TCR comprises the cytoplasmic domain of TCRα, TCRβ, TCRγ, or TCRδ.
[0160] In some embodiments, the cTCR does not comprise an intracellular signaling domain, e.g., when the TCR subunit is selected from TCRα, TCRβ, TCRγ, or TCRδ. In some embodiments, the cTCR comprises the cytoplasmic domain of TCRα, TCRβ, TCRγ, or TCRδ. In some embodiments, the cTCR comprises an intracellular signaling domain, e.g., when the TCR subunit is selected from CD3γ, CD3ε, or CD3δ.Intracellular co-stimulatory signaling domain
[0161] Many immune effector cells require co-stimulation, in addition to stimulation of an antigen-specific signal (e.g., the primary signal) , to promote cell proliferation, differentiation and survival, as well as to activate effector functions of the cell. In some embodiments, the chimeric receptor of the present disclosure (e.g., CAR) comprises at least one co-stimulatory signaling domain. The term “co-stimulatory signaling domain, ” as used herein, refers to at least a portion of a protein that mediates a secondary or co-stimulatory signal transduction within a cell to induce an immune response such as an effector function. The intracellular co-stimulatory signaling domain can act in an antigen-independent manner to provide a secondary or co-stimulatory signal to immune cells. The co-stimulatory signaling domain of the chimeric receptor described herein can be an intracellular signaling domain from a co-stimulatory protein, which transduces a secondary or co-stimulatory signal and modulates responses mediated by immune cells, such as T cells, NK cells, macrophages, neutrophils, or eosinophils. The term "co-stimulatory molecule" refers to a cognate binding partner on an immune cell (such as T cell) that specifically binds with a co-stimulatory ligand, thereby mediating a co-stimulatory response by the immune cell, such as, but not limited to, proliferation and survival. In some embodiments, the co-stimulatory molecule selected from the group consisting of CD27, CD28, CD137, OX40, CD40, PD-1, LFA-1, ICOS, CD2, CD7, LIGHT, NKG2C, B7-H3, TNFRSF9, TNFRSF4, TNFRSF8, CD40LG, ITGB2, KLRC2, TNFRSF18, TNFRSF14, HAVCR1, LGALS9, DAP10, DAP12, CD83, and ligands of CD83.
[0162] In some embodiments, the chimeric receptor comprises (or consists essentially of, or consists of) a single intracellular co-stimulatory signaling domain. In some embodiments, the chimeric receptor comprises (or consists essentially of, or consists of) two or more (such as about any of 2, 3, 4, or more) intracellular co-stimulatory signaling domains. In some embodiments, the chimeric receptor comprises two or more of the same co-stimulatory signaling domains. In some embodiments, the chimeric receptor comprises two or more co-stimulatory signaling domains from different co-stimulatory proteins, such as any two or more co-stimulatory proteins described herein. In some embodiments, the chimeric receptor (e.g., cTCR) lacks a functional primary intracellular signaling domain, but comprises one or more intracellular co-stimulatory signaling domains. In some embodiments, the chimeric receptor (e.g., cTCR) lacks any primary intracellular signaling domain, but comprises one or more intracellular co-stimulatory signaling domains. In some embodiments, the chimeric receptor (e.g., CAR) comprises an intracellular signaling domain (e.g., derived from CD3ζ) and one or more intracellular co-stimulatory signaling domains. In some embodiments, the one or more intracellular co-stimulatory signaling domains and the primary intracellular signaling domain (such as intracellular signaling domain of CD3ζ) are fused to each other via optional peptide linkers. The primary intracellular signaling domain and the one or more intracellular co-stimulatory signaling domains may be arranged in any suitable order. In some embodiments, the one or more intracellular co-stimulatory signaling domains are located between the transmembrane domain and the primary intracellular signaling domain (such as intracellular signaling domain of CD3ζ) . In some embodiments, the one or more intracellular co-stimulatory signaling domains are located at the C-terminus of the primary intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the primary intracellular signaling domain (e.g., derived from CD3ζ) is located in between two intracellular co-stimulatory signaling domains. Multiple co-stimulatory signaling domains may provide additive or synergistic stimulatory effects.
[0163] Activation of an intracellular co-stimulatory signaling domain in a host cell (e.g., an immune cell) may induce the cell to increase or decrease the production and secretion of cytokines, phagocytic properties, proliferation, differentiation, survival, and / or cytotoxicity. The intracellular co-stimulatory signaling domain of any co-stimulatory molecule may be compatible for use in the chimeric receptors described herein (e.g., CAR) . The type (s) of intracellular co-stimulatory signaling domain is selected based on factors such as the type of the immune effector cells in which the chimeric receptors would be expressed (e.g., T cells, NK cells, macrophages, neutrophils, or eosinophils) and the desired immune effector function (e.g., ADCC effect) . Examples of intracellular co-stimulatory signaling domains for use in the chimeric receptors (e.g., CARs) can be the cytoplasmic signaling domain of co-stimulatory proteins, including, without limitation, members of the B7 / CD28 family (e.g., B7-1 / CD80, B7-2 / CD86, B7-H1 / PD-L1, B7-H2, B7-H3, B7-H4, B7-H6, B7-H7, BTLA / CD272, CD28, CTLA-4, Gi24 / VISTA / B7-H5, ICOS / CD278, PD-1, PD-L2 / B7-DC, and PDCD6) ; members of the TNF superfamily (e.g., 4-1BB / TNFSF9 / CD137, 4-1BB Ligand / TNFSF9, BAFF / BLyS / TNFSF13B, BAFF R / TNFRSF13C, CD27 / TNFRSF7, CD27 Ligand / TNFSF7, CD30 / TNFRSF8, CD30 Ligand / TNFSF8, CD40 / TNFRSF5, CD40 / TNFSF5, CD40 Ligand / TNFSF5, DR3 / TNFRSF25, GITR / TNFRSF18, GITR Ligand / TNFSF18, HVEM / TNFRSF14, LIGHT / TNFSF14, Lymphotoxin-alpha / TNF-beta, OX40 / TNFRSF4, OX40 Ligand / TNFSF4, RELT / TNFRSF19L, TACI / TNFRSF13B, TL1A / TNFSF15, TNF-alpha, and TNF RII / TNFRSF1B) ; members of the SLAM family (e.g., 2B4 / CD244 / SLAMF4, BLAME / SLAMF8, CD2, CD2F-10 / SLAMF9, CD48 / SLAMF2, CD58 / LFA-3, CD84 / SLAMF5, CD229 / SLAMF3, CRACC / SLAMF7, NTB-A / SLAMF6, and SLAM / CD150) ; and any other co-stimulatory molecules, such as CD2, CD7, CD53, CD82 / Kai-1, CD90 / Thy1, CD96, CD160, CD200, CD300a / LMIR1, HLA Class I, HLA-DR, Ikaros, Integrin alpha 4 / CD49d, Integrin alpha 4 beta 1, Integrin alpha 4 beta 7 / LPAM-1, LAG-3, TCL1A, TCL1B, CRTAM, DAP12, Dectin-1 / CLEC7A, DPPIV / CD26, EphB6, TIM-1 / KIM-1 / HAVCR, TIM-4, TSLP, TSLP R, lymphocyte function associated antigen-1 (LFA-1) , and NKG2C.
[0164] In some embodiments, the one or more intracellular co-stimulatory signaling domains are derived from a co-stimulatory molecule selected from the group consisting of CD27, CD28, CD137, OX40, CD40, PD-1, LFA-1, ICOS, CD2, CD7, LIGHT, NKG2C, B7-H3, TNFRSF9, TNFRSF4, TNFRSF8, CD40LG, ITGB2, KLRC2, TNFRSF18, TNFRSF14, HAVCR1, LGALS9, DAP10, DAP12, CD83, ligands of CD83, and variants or combinations thereof.
[0165] In some embodiments, the chimeric receptor of the present disclosure (e.g., CAR) further comprises an intracellular co-stimulatory signaling domain derived from the cytoplasmic domain of CD137 (i.e., 4-1BB) . In some embodiments, the chimeric receptor (e.g., CAR) comprises an intracellular co-stimulatory signaling domain comprising the amino acid sequence of SEQ ID NO: 61. In some embodiments, the CAR comprises an intracellular signaling domain of CD3ζand an intracellular co-stimulatory signaling domain of CD137.
[0166] Also within the scope of the present disclosure are variants of any of the intracellular co-stimulatory signaling domains described herein, such that the variant intracellular co-stimulatory signaling domain is capable of modulating the immune response of the immune cell. The intracellular co-stimulatory signaling domain may comprise up to 10 amino acid residue variations (e.g., 1, 2, 3, 4, 5, or 8) as compared to a wild-type counterpart. Mutation of amino acid residues of the intracellular co-stimulatory signaling domain may result in i) an increase in signaling transduction and enhanced stimulation of immune responses relative to intracellular co-stimulatory signaling domains that do not comprise the mutation; or ii) a decrease in signaling transduction and reduced stimulation of immune responses relative to intracellular co-stimulatory signaling domains that do not comprise the mutation.Signal Peptide
[0167] The chimeric receptors of the present disclosure may comprise a signal peptide (also known as a signal sequence) at the N-terminus of the polypeptide. In general, signal peptides are peptide sequences that target a polypeptide to the desired site in a cell. In some embodiments, the signal peptide targets the chimeric receptor to the secretory pathway of the cell and will allow for integration and anchoring of the chimeric receptor into the lipid bilayer. Signal peptides including signal sequences of naturally occurring proteins or synthetic, non-naturally occurring signal sequences, which are compatible for use in the chimeric receptors described herein, will be evident to one of skill in the art. In some embodiments, the signal peptide is derived from a molecule selected from the group consisting of CD8α, GM-CSF receptor α, and IgG1 heavy chain. In some embodiments, the signal peptide is derived from a CD8α propeptide, e.g., human CD8α. In some embodiments, the signal peptide derived from CD8α comprises the amino acid sequence of SEQ ID NO: 57. In some embodiments, the signal peptide is derived from an immunoglobulin propeptide, such as mouse IgG heavy chain (mIgG) . In some embodiments, the signal peptide derived from immunoglobulin propeptide comprises the amino acid sequence of SEQ ID NO: 58.Peptide Linker
[0168] The chimeric receptor of the present disclosure may comprise one or more peptide linkers, such as between different components of the chimeric receptor (e.g., between two or more intracellular co-stimulatory signaling domains, between intracellular co-stimulatory signaling domain and primary intracellular signaling domain, or between the antigen binding domain and the transmembrane domain) , and / or within one chimeric receptor component (e.g., antigen binding domain, such as within an scFv, or for connecting two or more antibody moieties in tandem) .
[0169] Each peptide linker in a chimeric receptor may have the same or different length and / or sequence depending on the structural and / or functional features of the antibody moieties and / or the various domains. Each peptide linker may be selected and optimized independently. The length, the degree of flexibility and / or other properties of the peptide linker (s) used in the chimeric receptors may have some influence on properties, including but not limited to the affinity, specificity or avidity for one or more particular antigens or epitopes. For example, longer peptide linkers may be selected to ensure that two adjacent domains do not sterically interfere with one another. A short peptide linker may be disposed between the transmembrane domain and the primary intracellular signaling domain of a chimeric receptor (e.g., CAR) , or between the transmembrane domain and the intracellular co-stimulatory signaling domain of a chimeric receptor (e.g., CAR) . In some embodiment, the peptide linker comprises flexible residues (such as glycine and serine) so that the adjacent domains are free to move relative to each other. For example, a glycine-serine doublet can be a suitable peptide linker.
[0170] The peptide linker can be of any suitable length. The peptide linker may be at least about any of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 50, 75, 100 or more amino acids (aa) long. The peptide linker may be no more than about any of 100, 75, 50, 40, 35, 30, 25, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6, 5 or fewer aa long. In some embodiments, the length of the peptide linker is any of about 1 aa to about 10 aa, about 1 aa to about 20 aa, about 1 aa to about 30 aa, about 5 aa to about 15 aa, about 10 aa to about 25 aa, about 5 aa to about 30 aa, about 10 aa to about 30 aa, about 30 aa to about 50 aa, about 50 aa to about 100 aa, or about 1 aa to about 100 aa. In some embodiments, the peptide linker is about 10 aa to about 20 aa, such as about 15 aa.
[0171] The peptide linker may have a naturally occurring sequence, or a non-naturally occurring sequence. For example, a sequence derived from the hinge region of heavy chain only antibodies may be used as the linker. See, for example, WO1996 / 34103. In some embodiments, the peptide linker is a flexible linker. Exemplary flexible linkers include but not limited to glycine polymers (G) n, glycine-serine polymers, glycine-alanine polymers, alanine-serine polymers, threonine-serine, and other flexible linkers known in the art. Other linkers known in the art, for example, as described in WO2016014789, WO2015158671, WO2016102965, US20150299317, WO2018067992, US7741465, Colcher et al., J. Nat. Cancer Inst. 82: 1191-1197 (1990) , and Bird et al., Science 242: 423-426 (1988) may also be included in the chimeric receptors provided herein, the disclosure of each of which is incorporated herein by reference in their entirety.
[0172] In some embodiments, the peptide linker is (GGGGS) n (SEQ ID NO: 66) , wherein n is an integer of at least 1 (e.g., 1, 2, 3, 4, or more) . In some embodiments, the peptide linker is (GxS) n, wherein x and n independently can be an integer of at least 1, such as between 3 and 12 (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12) . In some embodiments, the (GxS) n linker comprises the amino acid sequence of SEQ ID NO: 67. In some specific embodiments, the peptide linker comprises the amino acid sequence of any one of SEQ ID NOs: 66, 67, and 74. C. Immune checkpoint inhibitors
[0173] Immune checkpoint proteins are stimulatory or inhibitory molecules that play an important role in the immune system regulation. Examples of inhibitory immune checkpoint proteins include, but are not limited to, PD-1, PD-L1, TIGIT, LAG-3, CTLA-4, BTLA, and TIM-3.
[0174] PD-1 is a 288-amino acid transmembrane protein in the CD28 gene family. PD-1 is expressed on immune cells such as T cells, B cells and NK cells. PD-1 comprises an N-terminal, extracellular IgV-like domain, a transmembrane domain, and an intracellular domain which includes an immunoreceptor tyrosine-based inhibitory motif and an immunoreceptor tyrosine-based switch motif. PD-1 can bind two ligands, PD-L1 and PD-L2. Ligand biding results in the inhibition of T-cell proliferation and cytotoxic activity (see Front Immunol. 11: 587460 (2020) ; Ann Transl Med. 8 (22) : 1526 (2020) ) . Overexpression of PD-L1 on tumor cells is associated with many types of cancers, promoting an immunosuppressive environment that is favorable for the cancer (see Onco Targets Ther. 9: 5023-39 (2016) ) . Immune checkpoint inhibitors are a useful immunotherapy strategy that act by blocking the interaction between the immune checkpoint protein and its ligand. For example, pembrolizumab is a monoclonal antibody that specifically binds the PD-1 receptor, which blocks the interaction with its ligands and promotes a T-cell-mediated immune response against tumor cells (see Am Health Drug Benefits. 8 (Spec Feature) : 96-100 (2015) ) .
[0175] An immune checkpoint inhibitor can be in the format of any protein format known in the art. In some embodiments, the immune checkpoint inhibitor is an antibody or an antigen-binding fragment thereof selected from the group consisting of a full-length antibody, a Fab, a Fab’, a (Fab’) 2, an Fv, an scFv, or an sdAb. In some embodiments, the immune checkpoint inhibitor is a full-length antibody or an scFv. The immune checkpoint inhibitor may be a ligand that blocks the immune checkpoint protein signaling, such as a decoy ligand that acts as an inhibitor and prevents a receptor from binding to its regular ligand. For example, in some embodiments, the immune checkpoint inhibitor is AMP-224, a recombinant fusion protein comprised of the extracellular domain of PD-L2 fused to Fc, which can inhibit PD-1 signaling. In some embodiments, the immune checkpoint inhibitor is AUNP12, which is a 29-mer peptide that can bind PD-L1 and inhibit the PD-1 / PD-L1 signaling pathway.
[0176] In some embodiments, the immune checkpoint inhibitor is an antibody or an antigen-binding fragment thereof that specifically recognizes an immune checkpoint protein selected from the group consisting of PD-1, PD-L1, TIGIT, LAG-3, CTLA-4, BTLA, and TIM-3.
[0177] In some embodiments, the immune checkpoint inhibitor is an antibody or antigen-binding fragment thereof specifically targets PD-L1 (e.g., derived from atezolizumab, avelumab, durvalumab, envafolimab, or cosibelimab) . In some embodiments, the antibody specifically targets TIGIT (e.g., derived from tiragolumab) . In some embodiments, the antibody specifically targets LAG-3 (e.g., derived from relatimab) . In some embodiments, the antibody specifically targets CTLA-4 (e.g., derived from ipilimumab) . In some embodiments, the antibody specifically targets PD-1 (e.g., derived from nivolumab, pembrolizumab, or cemiplimab) .Anti-PD-1 antibody or antigen-binding fragment thereof
[0178] In some embodiments, the immune checkpoint inhibitor is an anti-PD-1 antibody or antigen-binding fragment thereof. The anti-PD-1 antibody or antigen-binding fragment thereof can bind PD-1 derived from any organism, including but not limited to, dogs, cats, pigs, cows, sheep, goats, horses, rats, rabbits, hamsters, guinea pigs, monkeys, mice, and humans. In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof binds human PD-1. Any anti-PD-1 antibodies or antigen-binding fragments thereof available can be used here, including but are not limited to, nivolumab, pembrolizumab, cemiplimab, dostarlimab, retifanlimab, toripalimab, JTX-4014, spartalizumab, camrelizumab, sintilimab, tislelizumab, AMP-514 (MEDI0680) , or acrixolimab. In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof is derived from pembrolizumab (e.g., ) .
[0179] In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises a heavy chain variable domain (VH) and a light chain variable domain (VL) .
[0180] In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises H-CDR1, H-CDR2, and H-CDR3 of a VH comprising the amino acid sequence of SEQ ID NO: 48, and L-CDR1, L-CDR2, and L-CDR3 of a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the CDR positions are determined according to Kabat numbering scheme.
[0181] In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises: an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) ; an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) ; an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) ; an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) ; an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) ; and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47, or a variant thereof comprising up to 3 (e.g., 3, 2, or 1) amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) . In some embodiments, the affinity of such anti-PD-1 antibody or antigen-binding fragment for PD-1 (e.g., human PD-1) is comparable (e.g., within about 2-fold difference) to that of a reference antibody comprising a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the affinity of such anti-PD-1 antibody or antigen-binding fragment for PD-1 (e.g., human PD-1) is at least about 2-fold (e.g., at least about any of 5, 10, 50, 100, 1000, or more folds) of that of a reference antibody comprising a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49.
[0182] In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, or a variant thereof having at least about 80% (e.g., at least about any of 85%, 90%, 95%, 96%, 97%, 98%, 99%, or more) amino acid sequence homology to SEQ ID NO: 48; and a VL comprising the amino acid sequence of SEQ ID NO: 49, or a variant thereof having at least about 80% (e.g., at least about any of 85%, 90%, 95%, 96%, 97%, 98%, 99%or more) amino acid sequence homology to SEQ ID NO: 49. One or more amino acid variations (e.g., insertions, deletions, and / or substitutions, such as conserved substitutions) can be in one or more of the CDRs. One or more amino acid variations can be in one or more of the framework regions (FRs) . Two or more amino acid variations may be in both CDRs and FRs.
[0183] In some embodiments, the anti-PD-1 antibody or antigen-binding fragment thereof comprises an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49.
[0184] In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is a full-length antibody ( “anti-PD-1 full length antibody” ) . In some embodiments, the anti-PD-1 full-length antibody comprises an Fc region, such as a human Fc region. In some embodiments, the Fc region is derived from an IgG molecule, such as any one of the IgG1, IgG2, IgG3, or IgG4 subclass. In some embodiments, the anti-PD-1 full-length antibody comprises a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69.
[0185] In some embodiments, the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is an scFv ( “anti-PD-1 scFv” ) . In some embodiments, the VH and VL of the anti-PD-1 scFv are connected via a peptide linker, e.g., a peptide linker comprising the amino acid sequence of SEQ ID NO: 74. In some embodiments, the anti-PD-1 scFv comprises the amino acid sequence of SEQ ID NO: 50, or a variant thereof having at least about 80% (e.g., at least about any of 85%, 90%, 95%, 96%, 97%, 98%, 99%, or higher) sequence identity to the amino acid sequence of SEQ ID NO: 50. In some embodiments, the anti-PD-1 scFv comprises the amino acid sequence of SEQ ID NO: 50.
[0186] The immune checkpoint inhibitors (ICIs) of the present disclosure may comprise an ICI signal peptide N-terminal to the ICI. In some embodiments, the ICI signal peptide is derived from an immunoglobulin propeptide, such as mouse IgG heavy chain (mIgG) . In some embodiments, the signal peptide derived from immunoglobulin propeptide comprises the amino acid sequence of SEQ ID NO: 58. D. Nucleic acids and vectors encoding the chimeric receptor and / or immune checkpoint inhibitor
[0187] In one aspect, the present disclosure provides nucleic acids and vectors for cloning and expressing any one of the GUCY2C-targeted chimeric receptors (e.g., GUCY2C CAR) and / or immune checkpoint inhibitors (e.g., anti-PD-1 full length antibody or scFv) described herein. In some embodiments, the vector is suitable for replication and integration in eukaryotic cells, such as mammalian cells. In some embodiments, the vector is a viral vector. Examples of viral vectors include, but are not limited to, adenoviral vectors, adeno-associated virus (AAV) vectors, lentiviral vector, retroviral vectors, vaccinia vector, herpes simplex viral vector, and derivatives thereof. Viral vector technology is well known in the art and is described, for example, in Sambrook et al. (2001, Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, New York) , and in other virology and molecular biology manuals.
[0188] A number of viral based systems have been developed for gene transfer into mammalian cells. For example, retroviruses provide a convenient platform for gene delivery systems. The heterologous nucleic acid can be inserted into a vector and packaged in retroviral particles using techniques known in the art. The recombinant virus can then be isolated and delivered to the engineered mammalian cell in vitro or ex vivo. A number of retroviral systems are known in the art. In some embodiments, adenovirus vectors are used. A number of adenovirus vectors are known in the art. In some embodiments, lentivirus vectors are used. In some embodiments, self-inactivating lentiviral vectors are used. The lentiviral vectors can be used to transduce a mammalian cell (such as primary human T cells) using methods known in the art. Vectors derived from retroviruses such as lentivirus are suitable tools to achieve long-term gene transfer, because they allow long-term, stable integration of a transgene and its propagation in progeny cells. Lentiviral vectors also have low immunogenicity, and can transduce non-proliferating cells. In some embodiments, the vector encoding the chimeric receptor and / or the ICI is a lentiviral vector.
[0189] In some embodiments, there is provided a vector comprising any one of the nucleic acids encoding a GUCY2C-targeted chimeric receptor and / or an immune checkpoint inhibitor described herein. The nucleic acid can be cloned into the vector using any known molecular cloning methods in the art, including, for example, using restriction endonuclease sites and one or more selectable markers.
[0190] In some embodiments, the GUCY2C-targeted chimeric receptor (e.g., GUCY2C CAR) is encoded by a first nucleic acid and the immune checkpoint inhibitor is encoded by a second nucleic acid. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector. In some embodiments, the first nucleic acid and the second nucleic acid are each on a different vector. In some embodiments, the first nucleic acid further encodes a chimeric receptor signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the chimeric receptor. In some embodiments, the first nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 53 or 54. In some embodiments, the second nucleic acid further encodes an ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI. In some embodiments, the second nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 51 or 70. In some embodiments, the GUCY2C-targeted chimeric receptor (e.g., multi-chain chimeric receptor) is encoded by a first set of two or more nucleic acids. In some embodiments, the ICI (e.g., multi-chain ICI) is encoded by a second set of two or more nucleic acids. For example, in some embodiments, the ICI is a full-length antibody, and the heavy chain and the light chain are encoded by separate nucleic acids (e.g., either on the same vector or on different vectors, under the control of the same promoter or different promoters) . When the chimeric receptor or the ICI contains two or more polypeptide chains to be expressed, each polypeptide chain may comprise a signal peptide fused to the N-terminus. When the two or more polypeptide chains are to be expressed from the same vector and under the same promoter control, the nucleic acids encoding the two or more polypeptide chains may be connected via a linking nucleic acid encoding a cleavable linker (e.g., 2A peptide) or a linking nucleic acid of Internal Ribosome Entry Sites (IRES) sequence.
[0191] In some embodiments, the ICI is an anti-PD-1 full-length antibody, and the anti-PD-1 full-length antibody is encoded by a single nucleic acid under the control of one promoter. Hence in some embodiments, there is provided an isolated nucleic acid encoding an anti-PD-1 full-length antibody (e.g., derived from pembrolizumab) , wherein the nucleic acid encodes a heavy chain and a light chain of the anti-PD-1 full-length antibody, wherein the nucleic acid further encodes a first ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the heavy chain ( “first ICI SP-HC” ) and a second ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the light chain ( “second ICI SP-LC” ) , and wherein the nucleic acid further comprises a linking nucleic acid sequence (e.g., IRES, or encoding P2A or T2A) between the sequence encoding first ICI SP-HC and the sequence encoding second ICI SP-LC. In some embodiments, there is provided an isolated nucleic acid comprising from 5’ to 3’: a sequence encoding a second ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) -a sequence encoding a light chain of an anti-PD-1 full-length antibody (e.g., derived from pembrolizumab) -a linking nucleic acid sequence (e.g., IRES, or encoding P2A or T2A) -a sequence encoding a first ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) -a sequence encoding a heavy chain of the anti-PD-1 full-length antibody (e.g., derived from pembrolizumab) . In some embodiments, the anti-PD-1 full-length antibody comprises a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, there is provided an isolated nucleic acid encoding a polypeptide comprising the amino acid sequence of SEQ ID NO: 51.
[0192] In some embodiments, the nucleic acid encoding the GUCY2C-targeted chimeric receptor and / or the ICI is operably linked to a promoter. Varieties of promoters have been explored for gene expression in mammalian cells, and any of the promoters known in the art may be used in the present disclosure. Promoters may be roughly categorized as constitutive promoters or regulated promoters, such as inducible promoters.
[0193] In some embodiments, the nucleic acid encoding the GUCY2C-targeted chimeric receptor and / or the immune checkpoint inhibitor is operably linked to a constitutive promoter. Constitutive promoters allow heterologous genes (also referred to as transgenes) to be expressed constitutively in the host cells. Exemplary constitutive promoters contemplated herein include, but are not limited to, Cytomegalovirus (CMV) promoters, human elongation factors-1 alpha (hEF1α) , ubiquitin C promoter (UbiC) , phosphoglycerokinase promoter (PGK) , simian virus 40 early promoter (SV40) , and chicken β-Actin promoter coupled with CMV early enhancer (CAGG) . The efficiencies of such constitutive promoters on driving transgene expression have been widely compared in a huge number of studies. For example, Michael C. Milone et al compared the efficiencies of CMV, hEF1α, UbiC and PGK to drive CAR expression in primary human T cells, and concluded that hEF1α promoter not only induced the highest level of transgene expression, but was also optimally maintained in the CD4 and CD8 human T cells (Molecular Therapy, 17 (8) : 1453-1464 (2009) ) . In some embodiments, the nucleic acid encoding the GUCY2C-targeted chimeric receptor and / or the ICI is operably linked to an hEF1α promoter.
[0194] In some embodiments, the nucleic acid encoding the GUCY2C-targeted chimeric receptor and / or the immune checkpoint inhibitor is operably linked to an inducible promoter. The inducible promoter can be induced by one or more conditions, such as a physical condition, microenvironment of the engineered immune cell, the physiological state (e.g., activation state) of the engineered immune cell, an inducer (i.e., an inducing agent) , irradiation (such as ionizing radiation, light) , temperature (such as heat) , redox state, tumor environment, or any combination thereof.
[0195] In some embodiments, both the first nucleic acid encoding the chimeric receptor and the second nucleic acid encoding the ICI are under the control of an inducible promoter (e.g., can be the same or different, or can be both under the control of one inducible promoter) . In some embodiments, both the first nucleic acid encoding the chimeric receptor and the second nucleic acid encoding the ICI are under the control of a constitutive promoter (e.g., can be the same or different, or can be both under the control of one constitutive promoter) . In some embodiments, the first nucleic acid encoding the chimeric receptor is under the control of a constitutive promoter, and the second nucleic acid encoding the ICI is under the control of an inducible promoter. In some embodiments, the first nucleic acid encoding the chimeric receptor is under the control of an inducible promoter, and the second nucleic acid encoding the ICI is under the control of a constitutive promoter.
[0196] In some embodiments, the inducing condition does not induce the expression of endogenous genes in the engineered immune cell, and / or in the subject that receives the pharmaceutical composition.
[0197] In some embodiments, there is provide a vector (e.g., viral vector, such as lentiviral vector) comprising: a first nucleic acid encoding a GUCY2C-targeted chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) , and a second nucleic acid encoding an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) . In some embodiments, the first nucleic acid and the second nucleic acid are under the control of the same promoter. In some embodiments, the first nucleic acid and second nucleic acid are under the control of different promoters.
[0198] In some embodiments, there is provide a vector (e.g., viral vector, such as lentiviral vector) comprising: a first nucleic acid encoding a GUCY2C-targeted chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) , and a second nucleic acid encoding an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) , wherein the first nucleic acid and the second nucleic acid are under the control of the same promoter. In some embodiments, the first nucleic acid is upstream of the second nucleic acid. In some embodiments, the first nucleic acid is downstream of the second nucleic acid. In some embodiments, the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker, such as a 2A peptide. In some embodiments, the 2A peptide is P2A, T2A, E2A, or F2A. In some embodiments, the 2A peptide is P2A comprising the amino acid sequence of SEQ ID NO: 64. In some embodiments, the 2A peptide is T2A comprising the amino acid sequence of SEQ ID NO: 65. In some embodiments, the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid of IRES sequence. In some embodiments, the chimeric receptor comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the ICI is an anti-PD-1 scFv, e.g., comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the ICI is an anti-PD-1 full-length antibody (e.g., comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69) .
[0199] In some embodiments, there is provide a vector (e.g., viral vector, such as lentiviral vector) comprising from 5' to 3': a promoter (e.g., hEF1α promoter) -a first nucleic acid encoding a GUCY2C-targeted chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) -a linking nucleic acid (e.g., encoding P2A or T2A) -a second nucleic acid encoding an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) . In some embodiments, the chimeric receptor comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the ICI is an anti-PD-1 scFv, e.g., comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the ICI is an anti-PD-1 full-length antibody (e.g., comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69) . In some embodiments, the first nucleic acid further encodes a chimeric receptor signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the chimeric receptor. In some embodiments, the first nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 53. In some embodiments, the second nucleic acid further encodes an ICI signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI. In some embodiments, the second nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 51 or 70. In some embodiments, the vector encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56.
[0200] In some embodiments, the vector further contains a selectable marker gene or a reporter gene to select cells expressing the chimeric receptor and / or the immune checkpoint inhibitor from the population of host cells transfected with the nucleic acid (s) or the vector (s) (e.g., lentiviral vector) . Both selectable markers and reporter genes may be flanked by appropriate regulatory sequences to enable expression in the host cells. For example, the vector may contain transcription and translation terminators, initiation sequences, and promoters useful for regulation of the expression of the nucleic acid sequences.
[0201] In some embodiments, the vector further encodes a His-tag sequence. In some embodiments, the His-tag sequence is at the C-terminus of the chimeric receptor and / or the immune checkpoint inhibitor. In some embodiments, the His-tag sequence comprises the amino acid sequence of SEQ ID NO: 63. E. Engineered immune cells
[0202] Any immune cells can be used herein to make the engineered immune cells. See “IV. Methods of making engineered immune cells” section below for generation methods. The present application provides engineered immune cells that comprise any of the chimeric receptors, any of the nucleic acids and / or any of the vectors described herein.
[0203] One aspect of the present application provides an engineered immune cell comprising a) a first nucleic acid encoding a chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) .
[0204] The engineered immune cell may comprise (a) chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) ; and (b) an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) , wherein the chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) described herein and an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) are linked to each other via a 2A cleavable linker.
[0205] In some embodiments, the engineered immune cell comprises a polypeptide encoding a chimeric receptor (e.g., any of the chimeric receptors described herein, such as GUCY2C CAR) and / or a polypeptide encoding an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv) . In some embodiments, the chimeric receptor comprises the amino acid sequence of SEQ ID NO: 53 or 54. In some embodiments, the ICI is an anti-PD-1 scFv, e.g., comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the ICI is an anti-PD-1 full-length antibody (e.g., comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69) . In some embodiments, the engineered immune cell comprises a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56. The engineered immune cell may comprise a polypeptide comprising an amino acid sequence of SEQ ID NO: 55 or 56, or a functional variant having at least about 90%sequence identity thereto.
[0206] The engineered immune cells can also be further genetically modified to enhance their function. Examples include, but are not limited to, the transgenic expression of cytokines (e.g., IL2, IL7, IL15) , chemokines (e.g., CCL19, CCL21) , silencing of negative regulators (e.g., SHP-1, FAS, PD-L1) , chemokine receptors (e.g., CXCR2, CCR2b) , dominant negative receptors (e.g., dominant negative TGFβRII) , and / or so called 'signal converters' that convert a negative into a positive signal (e.g., IL4 / IL2 chimeric cytokine receptor, IL4 / IL9 chimeric cytokine receptor, or TGFβ / IL23 chimeric receptor) . The engineered immune cells may not be genetically modified to express IL-21, CCL19 and / or CCL21. In another aspect, the engineered immune cells may not be genetically modified to express cytokine and / or chemokine.
[0207] In some embodiments, the immune cell is selected from the group consisting of a monocyte, a dendritic cell, a macrophage, a B cell, a killer T cell (Tc, cytotoxic T lymphocyte, or CTL) , a helper T cell (Th) , a regulatory T cell (Treg) , an αβ T cell, a γδ T cell, a natural killer T (NKT) cell, a natural killer (NK) cell, and a combination thereof. In some embodiments, the immune cell is an immune effector cell that can exhibit immune effector functions. For example, immune effector cells comprise T cells (cytotoxic T cells, helper T cells, tumor infiltrating T cells) , B cells, NK cells, neutrophils, macrophages, and dendritic cells. The immune effector cell may express FcγRIII and perform ADCC effector function. Examples of immune effector cells which mediate ADCC include peripheral blood mononuclear cells (PBMC) , NK cells, monocytes, cytotoxic T cells, neutrophils, and eosinophils.
[0208] In some embodiments, the engineered immune cell is made from PBMC. In some embodiments, the engineered immune cell is a T cell. The engineered T cells may be αβ T cells, or γδ T cells. In some embodiments, the engineered T cells are CD4+ / CD8-, CD4- / CD8+, CD4+ / CD8+, CD4- / CD8-, or combinations thereof. In some embodiments, the engineered T cells produce IL-2, TFN, and / or TNF upon expressing the chimeric receptor and binding to the target cells, such as GUCY2C-positive tumor cells. In some embodiments, the CD8+ engineered T cells lyse antigen-specific target cells upon expressing the chimeric receptor and binding to the target cells.
[0209] In some embodiments, the engineered immune cell is an NK cell. In other embodiments, the engineered immune cell is made from established cell lines, for example, NK-92 cells.
[0210] In some embodiments, the engineered immune cell is derived from a stem cell. In some embodiments, the stem cell is a hematopoietic stem cell, pluripotent stem cell, induced pluripotent stem cell, or embryonic stem cell.
[0211] Immune cells for making the engineered immune cells described herein can be from any sources, such as derived from related (e.g., an individual having GUCY2C-positive cancer to be treated) or unrelated (e.g., healthy individual) humans, non-human animals, cell lines or cultures. In some embodiments, the engineered immune cell is allogeneic (e.g., derived from a healthy individual) . In some embodiments, the engineered immune cell is autologous (e.g., derived from the individual having GUCY2C-positive cancer to be treated) .
[0212] In some embodiments, the engineered immune cell is selected from the group consisting of T cell, NK cell, B cell, monocyte, dendritic cell, and any combination thereof. In some embodiments, the engineered immune cell is an engineered T cell. F. Administration methods
[0213] Any suitable methods for the administration of a protein construct (e.g., immune checkpoint inhibitor) and / or the administration of an engineered immune cell (e.g., GUCY2C CAR) can be used herein. In some embodiments, the engineered immune cell and the ICI are administered in separate compositions. The engineered immune cell can be administered before, after, or simultaneously with the ICI administration. In some embodiments, the engineered immune cell and the ICI are administered in a single composition. In some embodiments, the ICI is not secreted by the engineered immune cell (i.e., the ICI is added to the composition) . In some embodiments, the ICI is secreted by the engineered immune cell. “Administration” used herein encompasses all above administration situation, including direct administration and indirect administration. For example, when the engineered immune cell expresses both the GUCY2C-targeted chimeric receptor and the ICI, and only the engineered immune cell is actually administered to the individual to be treated, the ICI secreted by the engineered immune cell is still considered as being administered (i.e., indirectly) to the individual.
[0214] The route of administration is in accordance with any known and accepted methods, such as by single or multiple bolus or infusion over a long period of time in a suitable manner, e.g., injection or infusion by subcutaneous, intravenous, intraperitoneal, intramuscular, intratumoral, intraarterial, or intralesional routes, or by sustained release or extended-release means. The administration of the ICI and the engineered immune cell can use the same or different administration routes. In some embodiments, the ICI is administered intravenously, such as by infusion. In some embodiments, the engineered immune cell is administered intravenously, such as by infusion. In some embodiments, the engineered immune cell is administered intratumorally.
[0215] In some embodiments, the pharmaceutical composition provided herein contains the ICIs and / or engineered immune cells in amounts effective to treat or prevent the disease or disorder, such as a therapeutically effective or prophylactically effective amount. Therapeutic or prophylactic efficacy in some embodiments is monitored by periodic assessment of treated subjects. For repeated administrations over several days or longer, depending on the condition, the treatment is repeated until a desired suppression of disease symptoms occurs. However, other dosage regimens may be useful and can be determined.
[0216] In some embodiments, the ICI for administration is not secreted by the engineered immune cell. Depending on the type and severity of the disease, dosages of ICIs may include about 10 μg / kg to 100 mg / kg or more. Multiple doses may be administered intermittently. An initial higher loading dose, followed by one or more lower doses may be administered. The administration of the ICI not secreted by the engineered immune cell may be at a dosage of about 1 mg / kg / day to 10 mg / kg / day, depending upon the route of administration. Guidance as to particular dosages and methods of delivery is provided in the literature (see, e.g., U.S. Pat. Nos. 4,657,760; 5,206,344; and 5,225,212) . In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof derived from pembrolizumab (e.g., ) . In some embodiments, the dosing regimen of the ICI is the same as pembrolizumab or modified based on that of pembrolizumab.
[0217] In some embodiments, the ICI for administration is secreted by the engineered immune cell. In such situation, the dosage of administration (indirect administration) of the ICI follows the dosage of the administration (direct administration) of the engineered immune cell. In some embodiments, the engineered immune cell co-expressing the GUCY2C-targeted chimeric receptor (e.g., GUCY2C CAR, such as C07 CAR) and the ICI (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) is administered at the dose of about 1×104 cells / kg to about 1×108 cells / kg. In some embodiments, the ICI secreted by the engineered immune cell is at a dose less than that when ICI is not secreted by the engineered immune cell and needs to be externally provided. Dosages may vary depending on attributes particular to the disease or disorder and / or patient and / or other treatments.
[0218] In some embodiments, the engineered immune cell expresses a GUCY2C-targeted chimeric receptor (e.g., CAR) . In some embodiments, the engineered immune cell co-expresses a GUCY2C-targeted chimeric receptor (e.g., CAR) and an ICI (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, such as derived from pembrolizumab) . In some embodiments, a subject may be administered the range of about ten thousand to about 100 billion cells and / or that amount of cells per kilogram of body weight. In some embodiments, the engineered immune cells or pharmaceutical composition thereof is administered at a dosage of at least about any of 104, 105, 106, 107, 108, or 109 cells / kg of body weight of the individual. In some embodiments, the engineered immune cell co-expressing the chimeric receptor and the ICI is administered at a dose less than that when the engineered immune cell expresses the chimeric receptor only. Dosages may vary depending on attributes particular to the disease or disorder and / or patient and / or other treatments. The method may occur without or with the administration of one or more cytokines. The cytokine may be IL2, IL7, IL12, IL21, and / or IL15. The method may occur without or with one or more chemokines. The chemokine may be CCL19 and / or CCL21.
[0219] In some embodiments, the engineered immune cell (either expresses the chimeric receptor alone, or co-expresses the chimeric receptor and the ICI) or pharmaceutical composition thereof is administered for a single time. In some embodiments, the engineered immune cell (either expresses the chimeric receptor alone, or co-expresses the chimeric receptor and the ICI) or pharmaceutical composition thereof is administered for multiple times (such as any of 2, 3, 4, 5, 6, or more times) . In some embodiments, the ICI is not secreted by the engineered immune cell, and the administration of the ICI can be a single time or multiple times (such as any of 2, 3, 4, 5, 6, or more times) . In some embodiments, the engineered immune cell or pharmaceutical composition thereof is administered once or multiple times during a dosing cycle. In some embodiments, the ICI is not secreted by the engineered immune cell, and the ICI is administered once or multiple times during a dosing cycle. A dosing cycle can be, e.g., 1, 2, 3, 4, 5 or more week (s) , or 1, 2, 3, 4, 5, or more month (s) . The administration frequency and duration of the engineered immune cell expressing the chimeric receptor and an ICI not secreted by the engineered immune cell can be the same or different. The optimal dosage and treatment regime for a particular patient can be determined by one skilled in the art of medicine by monitoring the patient for signs of disease and adjusting the treatment accordingly. In certain embodiments, once the engineered immune cells (either express the chimeric receptor alone, or co-express the chimeric receptor and the ICI) are administered to a mammal (e.g., a human) , the biological activity of the engineered immune cell populations and / or ICIs is measured by any of a number of known methods. Parameters to assess include specific binding of an engineered immune cell or non-engineered immune cell (e.g., bystanders) to antigen, in vivo, e.g., by imaging, or ex vivo, e.g., by ELISA or flow cytometry. In certain embodiments, the ability of the engineered immune cells or non-engineered immune cells (e.g., bystanders) to destroy target cells can be measured using any suitable method known in the art, such as cytotoxicity assays described in, for example, Kochenderfer et al., J. Immunotherapy, 32 (7) : 689-702 (2009) , and Herman et al. J. Immunological Methods, 285 (1) : 25-40 (2004) . In certain embodiments, the biological activity of the engineered immune cells or non-engineered immune cells (e.g., bystanders) also can be measured by assaying expression and / or secretion of certain cytokines, such as CD107a, IFNγ, IL-2, and TNF. In some aspects, the biological activity is measured by assessing clinical outcome, such as reduction in tumor burden or load. In some embodiments, the biological activity of the ICI is assessed by blocking of immune checkpoint signaling pathway and / or exhaustion status of the engineered immune cells or non-engineered immune cells (e.g., bystanders) . Also see Examples 3 and 4 for methods of assessments. III. Engineered immune cells and pharmaceutical compositions thereof
[0220] In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing a chimeric receptor (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain. In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) comprising a nucleic acid encoding a chimeric receptor (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain. In some embodiments, the GUCY2C-targeted chimeric receptor is a GUCY2C engineered TCR. In some embodiments, the GUCY2C-targeted chimeric receptor is a GUCY2C-targeted cTCR. In some embodiments, the GUCY2C-targeted chimeric receptor is a GUCY2C CAR, such as any of the GUCY2C CARs described herein.
[0221] In some embodiments, the GUCY2C-targeted chimeric receptor is a GUCY2C CAR, such as an anti-GUCY2C sdAb CAR. Hence in some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing a CAR or comprising a nucleic acid encoding the CAR, wherein the CAR comprises: (a) an antigen binding domain (e.g., sdAb, scFv, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . The intracellular co-stimulatory signaling domain can be at the N-terminus or the C-terminus of the intracellular signaling domain. In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing a CAR or comprising a nucleic acid encoding the CAR, wherein the CAR comprises from N’ to C’: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the nucleic acid encoding the CAR further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the CAR.
[0222] In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing an immune checkpoint inhibitor (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) , or comprising a nucleic acid encoding the ICI. In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing an ICI or comprising a nucleic acid encoding the ICI, wherein the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprising an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the nucleic acid encoding the ICI further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI (e.g., N-terminal to the scFv, N-terminal to the heavy chain, and / or N-terminal to the light chain) . In some embodiments, the heavy chain and light chain of the anti-PD-1 full-length antibody are encoded on a same vector, such as connected by a cleavable 2A peptide (e.g., T2A or P2A) . Hence in some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) expressing an anti-PD-1 full-length antibody or comprising a nucleic acid encoding the anti-PD-1 full-length antibody, wherein the nucleic acid encodes a polypeptide sequence of SEQ ID NO: 51.
[0223] In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) comprising: a) a first nucleic acid encoding a chimeric receptor (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) . The GUCY2C-targeted chimeric receptor can be a GUCY2C engineered TCR, GUCY2C-targeted cTCR, or GUCY2C CAR. In some embodiments, the first nucleic acid and the second nucleic acid are on different vectors. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector, such as under the control of separate promoters, or under the control of the same promoter. In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) comprising: a) a first nucleic acid encoding a chimeric receptor (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain; and b) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) , wherein the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, and wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid (e.g., IRES, or encoding a cleavable linker such as 2A peptide) . In some embodiments, the first nucleic acid is upstream of the second nucleic acid. In some embodiments, the linking nucleic acid encodes a P2A comprising the amino acid sequence of SEQ ID NO: 64. In some embodiments, the first nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the chimeric receptor. In some embodiments, the second nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI (e.g., N-terminal to the scFv, N-terminal to the heavy chain, and / or N-terminal to the light chain) .
[0224] In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) comprising: a) a first nucleic acid encoding a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) , wherein the CAR comprises: (a) an antigen binding domain (e.g., sdAb, scFv, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and b) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) . In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) comprising: a) a first nucleic acid encoding a CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) , wherein the CAR comprises: (a) an antigen binding domain (e.g., sdAb, scFv, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and b) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) ; wherein the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, and wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid (e.g., IRES, or encoding a cleavable linker such as 2A peptide) . In some embodiments, the first nucleic acid is upstream of the second nucleic acid. In some embodiments, there is provide an engineered immune cell (e.g., engineered T cell) comprising a vector (e.g., viral vector, such as lentiviral vector) , wherein the vector comprises from 5' to 3': a promoter (e.g., hEF1αpromoter) -a first nucleic acid encoding a GUCY2C CAR (e.g., any of the GUCY2C CARs described herein, such as C07 CAR) -a linking nucleic acid (e.g., encoding P2A or T2A) -a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 full length antibody or scFv, e.g., derived from pembrolizumab) ; and wherein the GUCY2C CAR comprises: (a) an antigen binding domain (e.g., sdAb, scFv, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the linking nucleic acid encodes a P2A comprising the amino acid sequence of SEQ ID NO: 64. The intracellular co-stimulatory signaling domain can be at the N-terminus or the C-terminus of the intracellular signaling domain. In some embodiments, the CAR comprises from N’ to C’: (a) an anti-GUCY2C sdAb (e.g., any of the anti-GUCY2C sdAbs provided herein, such as VHHC0708H2 comprising SEQ ID NO: 40) ; (b) a hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) . In some embodiments, the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the first nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 57) N-terminal to the CAR. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof comprising: an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the second nucleic acid further encodes a signal peptide (e.g., comprising the amino acid sequence of SEQ ID NO: 58) N-terminal to the ICI (e.g., N-terminal to the scFv, N-terminal to the heavy chain, and / or N-terminal to the light chain) . In some embodiments, the heavy chain and light chain of the anti-PD-1 full-length antibody are encoded on a same vector, such as connected by a cleavable 2A peptide (e.g., T2A or P2A) . In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) co-expressing a GUCY2C CAR and an anti-PD-1 full-length antibody, or comprising a vector (e.g., viral vector, such as lentiviral vector) encoding the GUCY2C CAR and the anti-PD-1 full-length antibody, wherein the vector encodes a polypeptide sequence of SEQ ID NO: 55. In some embodiments, there is provided an engineered immune cell (e.g., engineered T cell) co-expressing a GUCY2C CAR and an anti-PD-1 scFv, or comprising a vector (e.g., viral vector, such as lentiviral vector) encoding the GUCY2C CAR and the anti-PD-1 scFv, wherein the nucleic acid encodes a polypeptide sequence of SEQ ID NO: 56.
[0225] Also provided are pharmaceutical compositions comprising any of the engineered immune cells described herein (e.g., engineered immune cell expressing a GUCY2C-targeted chimeric receptor, or engineered immune cell expressing an ICI, or engineered immune cell co-expressing a GUCY2C-targeted chimeric receptor and an ICI) , and optionally a pharmaceutically acceptable excipient. Also provided are pharmaceutical compositions comprising any of the ICIs described herein (e.g., anti-PD-1 antibody or antigen-binding fragment thereof) , and optionally a pharmaceutically acceptable excipient; wherein the ICI is not secreted by the engineered immune cell. Any excipient suitable for the storage and administration of engineered immune cells and / or protein constructs (e.g., ICIs) can be used herein. The excipient may not affect the viability, bioactivity, and / or secretion of the encoded ICIs of the engineered immune cells.
[0226] “Excipient” means a pharmaceutically acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, solvent, or encapsulating material. Excipients include, for example, encapsulating materials or additives such as absorption accelerators, antioxidants, binders, buffers, carriers, coating agents, coloring agents, diluents, disintegrating agents, emulsifiers, extenders, fillers, flavoring agents, humectants, lubricants, perfumes, preservatives, propellants, releasing agents, sterilizing agents, sweeteners, solubilizers, wetting agents and mixtures thereof. The term “excipient” can also refer to a diluent, adjuvant (e.g., Freunds’ adjuvant (complete or incomplete) or vehicle.
[0227] Excipients may be pharmaceutically acceptable excipients. Examples of pharmaceutically acceptable excipients include buffers, such as phosphate, citrate, and other organic acids; antioxidants, including ascorbic acid; low molecular weight (e.g., fewer than about 10 amino acid residues) polypeptide; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers, such as polyvinylpyrrolidone; amino acids, such as glycine, glutamine, asparagine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates, including glucose, mannose, or dextrins; chelating agents, such as EDTA; sugar alcohols, such as mannitol or sorbitol; salt-forming counterions, such as sodium; and / or nonionic surfactants, such as TWEENTM, polyethylene glycol (PEG) , and PLURONICSTM. Other examples of pharmaceutically acceptable excipients are described in Remington and Gennaro, Remington’s Pharmaceutical Sciences (18th ed. 1990) .
[0228] In one embodiment, each component is “pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit / risk ratio. See, e.g., Lippincott Williams &Wilkins: Philadelphia, PA, 2005; Handbook of Pharmaceutical Excipients, 6th ed.; Rowe et al., Eds.; The Pharmaceutical Press and the American Pharmaceutical Association: 2009; Handbook of Pharmaceutical Additives, 3rd ed.; Ash and Ash Eds.; Gower Publishing Company: 2007; Pharmaceutical Preformulation and Formulation, 2nd ed.; Gibson Ed.; CRC Press LLC: Boca Raton, FL, 2009. In some embodiments, pharmaceutically acceptable excipients are nontoxic to the cell or mammal being exposed thereto at the dosages and concentrations employed. In some embodiments, a pharmaceutically acceptable excipient is an aqueous pH buffered solution.
[0229] Excipients may be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable, or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil, and the like. Water is an exemplary excipient when a composition (e.g., a pharmaceutical composition) is administered intravenously. Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid excipients, particularly for injectable solutions. An excipient can also include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol, and the like. The composition, if desired, can also contain minor amounts of wetting or emulsifying agents, or pH buffering agents. Compositions can take the form of solutions, suspensions, emulsion, powders (e.g., freeze-dried) , sustained-release formulations, and the like. In some embodiments, the composition can be reconstituted.
[0230] Compositions, including pharmaceutical compositions, may contain a binding molecule (e.g., an antibody) , for example, in isolated or purified form, together with a suitable amount of excipients.
[0231] In some embodiments, there is provided a pharmaceutical composition comprising: i) an engineered immune cell (e.g., engineered T cell) expressing a GUCY2C-targeted chimeric receptor (e.g., GUCY2C CAR) , ii) an ICI (e.g., anti-PD-1 antibody or antigen-binding fragment thereof, e.g., derived from pembrolizumab) , and iii) optionally a pharmaceutically acceptable excipient.
[0232] In other embodiments, provided herein is a pharmaceutical composition comprising: i) an engineered immune cell comprising: (a) a first nucleic acid encoding a chimeric receptor (e.g., a GUCY2C CAR) comprising an antigen binding domain that specifically recognizes GUCY2C and a transmembrane domain, and (b) a second nucleic acid encoding an immune checkpoint inhibitor provided herein (e.g., an anti-PD-1 antibody or antigen binding fragment thereof, e.g., derived from pembrolizumab) , and ii) optionally a pharmaceutically acceptable excipient.
[0233] The choice of excipient may be determined in part by the particular cell, binding molecule, and / or antibody, and / or by the method of administration. Accordingly, there are a variety of suitable formulations.
[0234] Suitable pharmaceutically acceptable excipient for engineered immune cells may comprise buffers such as neutral buffered saline, phosphate buffered saline and the like; carbohydrates such as glucose, mannose, sucrose or dextrans, mannitol; proteins; polypeptides or amino acids such as glycine; antioxidants; chelating agents such as EDTA or glutathione; adjuvants (e.g., aluminum hydroxide) ; and preservatives. The pharmaceutically acceptable excipient may contain autologous serum, such as human serum. In some embodiments, the pharmaceutically acceptable excipient is non-toxic, biocompatible, non-immunogenic, biodegradable, and can avoid recognition by the host’s defense mechanism. The excipient may also contain adjuvants such as preserving stabilizing, wetting, emulsifying agents and the like. The pharmaceutically acceptable excipient may enhance the stability of the engineered immune cells or the ICIs secreted thereof. The pharmaceutically acceptable excipient may reduce aggregation of the ICIs secreted by the engineered mammalian cell. The final form may be sterile and may also be able to pass readily through an injection device such as a hollow needle. The proper viscosity may be achieved and maintained by the proper choice of excipients.
[0235] In some embodiments, the pharmaceutical composition is formulated to have a pH in the range of about 4.5 to about 9.0, including for example pH ranges of about any one of 5.0 to about 8.0, about 6.5 to about 7.5, or about 6.5 to about 7.0. The pharmaceutical composition can also be made to be isotonic with blood by the addition of a suitable tonicity modifier, such as glycerol.
[0236] Typically, acceptable carriers, excipients, or stabilizers are nontoxic to recipients at the dosages and concentrations employed, and include buffers, antioxidants including ascorbic acid, methionine, Vitamin E, sodium metabisulfite; preservatives, isotonicifiers, stabilizers, metal complexes (e.g., Zn-protein complexes) ; chelating agents such as EDTA and / or non-ionic surfactants.
[0237] Buffers may be used to control the pH in a range which optimizes the therapeutic effectiveness, especially if stability is pH dependent. Suitable buffering agents for use with the present disclosure include both organic and inorganic acids and salts thereof. For example, citrate, phosphate, succinate, tartrate, fumarate, gluconate, oxalate, lactate, acetate. Additionally, buffers may comprise histidine and trimethylamine salts such as Tris.
[0238] Preservatives may be added to retard microbial growth. Suitable preservatives for use with the present disclosure include octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium halides (e.g., chloride, bromide, iodide) , benzethonium chloride; thimerosal, phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propyl paraben; catechol; resorcinol; cyclohexanol, 3-pentanol, and m-cresol.
[0239] Tonicity agents, sometimes known as “stabilizers” can be present to adjust or maintain the tonicity of liquid in a composition. When used with large, charged biomolecules such as proteins and antibodies, they are often termed “stabilizers” because they can interact with the charged groups of the amino acid side chains, thereby lessening the potential for inter and intra-molecular interactions. Exemplary tonicity agents include polyhydric sugar alcohols, trihydric or higher sugar alcohols, such as glycerin, erythritol, arabitol, xylitol, sorbitol and mannitol.
[0240] Additional exemplary excipients include: (1) bulking agents, (2) solubility enhancers, (3) stabilizers and (4) agents preventing denaturation or adherence to the container wall. Such excipients include: polyhydric sugar alcohols (enumerated above) ; amino acids such as alanine, glycine, glutamine, asparagine, histidine, arginine, lysine, ornithine, leucine, 2-phenylalanine, glutamic acid, threonine, etc.; organic sugars or sugar alcohols such as sucrose, lactose, lactitol, trehalose, stachyose, mannose, sorbose, xylose, ribose, ribitol, myoinisitose, myoinisitol, galactose, galactitol, glycerol, cyclitols (e.g., inositol) , polyethylene glycol; sulfur containing reducing agents, such as urea, glutathione, thioctic acid, sodium thioglycolate, thioglycerol, α-monothioglycerol and sodium thio sulfate; low molecular weight proteins such as human serum albumin, bovine serum albumin, gelatin or other immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; monosaccharides (e.g., xylose, mannose, fructose, glucose; disaccharides (e.g., lactose, maltose, sucrose) ; trisaccharides such as raffinose; and polysaccharides such as dextrin or dextran.
[0241] Non-ionic surfactants or detergents (also known as “wetting agents” ) may be present to help solubilize the therapeutic agent as well as to protect the therapeutic protein against agitation-induced aggregation, which also permits the formulation to be exposed to shear surface stress without causing denaturation of the active therapeutic protein or antibody. Suitable non-ionic surfactants include, e.g., polysorbates (20, 40, 60, 65, 80, etc. ) , polyoxamers (184, 188, etc. ) , polyols, polyoxyethylene sorbitan monoethers ( etc. ) , lauromacrogol 400, polyoxyl 40 stearate, polyoxyethylene hydrogenated castor oil 10, 50 and 60, glycerol monostearate, sucrose fatty acid ester, methyl celluose and carboxymethyl cellulose. Anionic detergents that can be used include sodium lauryl sulfate, dioctyle sodium sulfosuccinate and dioctyl sodium sulfonate. Cationic detergents include benzalkonium chloride or benzethonium chloride.
[0242] In order for the pharmaceutical compositions to be used for in vivo administration, they are preferably sterile. The pharmaceutical composition may be rendered sterile by filtration through sterile filtration membranes. The pharmaceutical compositions herein generally can be placed into a container having a sterile access port, for example, an intravenous solution bag or vial having a stopper pierceable by a hypodermic injection needle.
[0243] A pharmaceutical composition can be provided as a controlled release or sustained release system. In one embodiment, a pump may be used to achieve controlled or sustained release (see, e.g., Sefton, Crit. Ref. Biomed. Eng. 14: 201-40 (1987) ; Buchwald et al., Surgery 88: 507-16 (1980) ; and Saudek et al., N. Engl. J. Med. 321: 569-74 (1989) ) . In another embodiment, polymeric materials can be used to achieve controlled or sustained release of a prophylactic or therapeutic agent (e.g., a fusion protein as described herein) or a composition provided herein (see, e.g., Medical Applications of Controlled Release (Langer and Wise eds., 1974) ; Controlled Drug Bioavailability, Drug Product Design and Performance (Smolen and Ball eds., 1984) ; Ranger and Peppas, J. Macromol. Sci. Rev. Macromol. Chem. 23: 61-126 (1983) ; Levy et al., Science 228: 190-92 (1985) ; During et al., Ann. Neurol. 25: 351-56 (1989) ; Howard et al., J. Neurosurg. 71: 105-12 (1989) ; U.S. Pat. Nos. 5,679,377; 5,916,597; 5,912,015; 5,989,463; and 5,128,326; PCT Publication Nos. WO 99 / 15154 and WO 99 / 20253) . Examples of polymers used in sustained release formulations include, but are not limited to, poly (2-hydroxy ethyl methacrylate) , poly (methyl methacrylate) , poly (acrylic acid) , poly (ethylene-co-vinyl acetate) , poly (methacrylic acid) , polyglycolides (PLG) , polyanhydrides, poly (N-vinyl pyrrolidone) , poly (vinyl alcohol) , polyacrylamide, poly (ethylene glycol) , polylactides (PLA) , poly (lactide-co-glycolides) (PLGA) , and polyorthoesters. In one embodiment, the polymer used in a sustained release formulation is inert, free of leachable impurities, stable on storage, sterile, and biodegradable. A controlled or sustained release system can be placed in proximity of a particular target tissue, for example, the nasal passages or lungs, thus requiring only a fraction of the systemic dose (see, e.g., Goodson, Medical Applications of Controlled Release Vol. 2, 115-38 (1984) ) . Controlled release systems are discussed, for example, by Langer, Science 249: 1527-33 (1990) . Any technique known to one of skill in the art can be used to produce sustained release formulations comprising one or more agents as described herein (see, e.g., U.S. Pat. No. 4,526,938, PCT publication Nos. WO 91 / 05548 and WO 96 / 20698, Ning et al., Radiotherapy &Oncology 39: 179-89 (1996) ; Song et al., PDA J. of Pharma. Sci. &Tech. 50: 372-97 (1995) ; Cleek et al., Pro. Int’l. Symp. Control. Rel. Bioact. Mater. 24: 853-54 (1997) ; and Lam et al., Proc. Int’l. Symp. Control Rel. Bioact. Mater. 24: 759-60 (1997) ) .
[0244] The active ingredients may also be entrapped in microcapsules prepared, for example, by coascervation techniques or by interfacial polymerization, for example, hydroxymethylcellulose or gelatin-microcapsules and poly- (methylmethacylate) microcapsules, respectively, in colloidal drug delivery systems (for example, liposomes, albumin microspheres, microemulsions, nanoparticles and nanocapsules) or in macroemulsions. Such techniques are disclosed in Remington's Pharmaceutical Sciences 18th edition.
[0245] Various compositions and delivery systems are known and can be used with the therapeutic agents provided herein, including, but not limited to, encapsulation in liposomes, microparticles, microcapsules, recombinant cells capable of expressing the chimeric receptor and / or ICI, construction of a nucleic acid as part of a retroviral or other vector, etc.
[0246] In some embodiments, the pharmaceutical composition is suitable for administration to a human. In some embodiments, the pharmaceutical composition is suitable for administration to a human by parenteral administration. Formulations suitable for parenteral administration include aqueous and non-aqueous, isotonic sterile injection solutions, which can contain antioxidants, buffers, bacteriostats, and solutes that render the formulation compatible with the blood of the intended recipient, and aqueous and non-aqueous sterile suspensions that can include suspending agents, solubilizers, thickening agents, stabilizing agents, and preservatives. The formulations can be presented in unit-dose or multi-dose sealed containers, such as ampules and vials, and can be stored in a condition requiring only the addition of the sterile liquid excipient methods of treatment, methods of administration, and dosage regimens described herein (i.e., water) for injection, immediately prior to use. In some embodiments, the pharmaceutical composition is contained in a single-use vial, such as a single-use sealed vial. In some embodiments, the pharmaceutical composition is contained in a multi-use vial. In some embodiments, the pharmaceutical composition is contained in bulk in a container. In some embodiments, the pharmaceutical composition is cryopreserved.
[0247] In some embodiments, the pharmaceutical composition is formulated for intravenous or subcutaneous administration. In some embodiments, the pharmaceutical composition is formulated for local administration to a tumor site, such as for intratumoral injection.
[0248] In some embodiments, the pharmaceutical composition must meet certain standards for administration to an individual. For example, the United States Food and Drug Administration has issued regulatory guidelines setting standards for cell-based immunotherapeutic products, including 21 CFR 610 and 21 CFR 610.13. Methods are known in the art to assess the appearance, identity, purity, safety, and / or potency of pharmaceutical compositions. In some embodiments, the pharmaceutical composition is substantially free of extraneous protein capable of producing allergenic effects, such as proteins of an animal source used in cell culture other than the engineered immune cells. In some embodiments, “substantially free” is less than about any of 10%, 5%, 1%, 0.1%, 0.01%, 0.001%, 1 ppm or less of total volume or weight of the pharmaceutical composition. In some embodiments, the pharmaceutical composition is prepared in a GMP-level workshop. In some embodiments, the pharmaceutical composition comprises less than about 5 EU / kg body weight / hr of endotoxin for parenteral administration. In some embodiments, at least about 70%of the engineered immune cells in the pharmaceutical composition are alive for intravenous administration. In some embodiments, the pharmaceutical composition has a “no growth” result when assessed using a 14-day direct inoculation test method as described in the United States Pharmacopoeia (USP) . In some embodiments, prior to administration of the pharmaceutical composition, a sample including both the engineered immune cells and the pharmaceutically acceptable excipient should be taken for sterility testing approximately about 48-72 hours prior to the final harvest (or coincident with the last re-feeding of the culture) . In some embodiments, the pharmaceutical composition is free of mycoplasma contamination. In some embodiments, the pharmaceutical composition is free of detectable microbial agents. In some embodiments, the pharmaceutical composition is free of communicable disease agents, such as HIV type I, HIV type II, HBV, HCV, Human T-lymphotropic virus, type I; and Human T-lymphotropic virus, type II. In some embodiments, the pharmaceutical composition is free of viral (e.g., lentivirus) components during manufacture. IV. Methods of making engineered immune cells and ICIs
[0249] Also provided are methods of making any of the engineered immune cells (e.g., an engineered T cell) described herein, such as engineered immune cell expressing a GUCY2C-targeted chimeric receptor (e.g., CAR) , engineered immune cell expressing an ICI (e.g., anti-PD-1 antibody or antigen-binding fragment thereof) , or engineered immune cell co-expressing a GUCY2C-targeted chimeric receptor and an ICI. Also provided are methods of making any of the ICIs described herein. Methods of cloning vector construction, protein expression and purification, cell preparation (e.g., enrichment and / or activation) and transfection, etc., are well-known in the art. Any of the isolated nucleic acids and vectors described under Section II “D. Nucleic acids and vectors encoding the chimeric receptor and / or immune checkpoint inhibitor” can be used herein to make the engineered immune cells and / or ICIs. Also see Examples 1 and 2 for exemplary making methods.
[0250] In some embodiments, there is provided a method of making an engineered immune cell (e.g., an engineered T cell) , wherein the engineered immune cell comprises a nucleic acid encoding a chimeric receptor (such as any of the GUCY2C-targeted chimeric receptors described herein, e.g., GUCY2C CAR, such as C07 CAR) comprising (a) an antigen binding domain that specifically recognizes GUCY2C and (b) a transmembrane domain; wherein the method comprises: introducing into a population of immune cells the nucleic acid encoding the chimeric receptor. In some embodiments, the method further comprises providing the population of immune cells before introducing the nucleic acid. In some embodiments, the method further comprises isolating and / or enriching a plurality of engineered immune cells that express the GUCY2C-targeted chimeric receptor.
[0251] In some embodiments, there is provided a method of making an engineered immune cell (e.g., an engineered T cell) , wherein the engineered immune cell comprises: (1) a first nucleic acid encoding a chimeric receptor (such as any of the GUCY2C-targeted chimeric receptors described herein, e.g., GUCY2C CAR, such as C07 CAR) comprising (a) an antigen binding domain that specifically recognizes GUCY2C and (b) a transmembrane domain; and (2) a second nucleic acid encoding an immune checkpoint inhibitor (e.g., an anti-PD-1 antibody or antigen-binding fragment thereof, e.g., derived from pembrolizumab) ; wherein the method comprises: introducing into a population of immune cells the first nucleic acid encoding the chimeric receptor and the second nucleic acid encoding the immune checkpoint inhibitor. In some embodiments, the method further comprises providing the population of immune cells before introducing the first nucleic acid and / or the second nucleic acid. Hence in some embodiments, the engineered immune cell is made from a method comprising providing a population of immune cells, and introducing into the population of immune cells a first nucleic acid encoding the chimeric receptor and a second nucleic acid encoding the immune checkpoint inhibitor. In some embodiments, the first nucleic acid and the second nucleic acid are on different vectors. In some embodiments, the first nucleic acid and the second nucleic acid are introduced into the population of immune cells simultaneously. In some embodiments, the first nucleic acid is introduced into the population of immune cells before introducing the second nucleic acid. In some embodiments, the method further comprises isolating and / or enriching a plurality of engineered immune cells expressing the GUCY2C-targeted chimeric receptor, then introducing into the plurality of engineered immune cells the second nucleic acid encoding the ICI. In some embodiments, the second nucleic acid is introduced into the population of immune cells before introducing the first nucleic acid. In some embodiments, the method further comprises isolating and / or enriching a plurality of engineered immune cells expressing the ICI, then introducing into the plurality of engineered immune cells the first nucleic acid encoding the GUCY2C-targeted chimeric receptor. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector (e.g., under the control of the same promoter or different promoters) . In some embodiments, the method further comprises isolating and / or enriching a plurality of engineered immune cells that express both the GUCY2C-targeted chimeric receptor and the ICI.
[0252] In some embodiments, the first nucleic acid and the second nucleic acid are introduced into the population of immune cells simultaneously. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector. In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector and under the control of separate promoters (can be the same or different) . In some embodiments, the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter, wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker, such as a self-cleaving peptide. In some embodiments, the self-cleaving peptide is selected from the group consisting of T2A, P2A, E2A, and F2A. In some embodiments, the cleavable linker is a P2A peptide comprising the amino acid sequence of SEQ ID NO: 64. In some embodiments, the cleavable linker is a T2A peptide comprising the amino acid sequence of SEQ ID NO: 65.
[0253] In some embodiments, there is provided a method of making an engineered immune cell (e.g., engineered T cell) , wherein the engineered immune cell comprises: (1) a first nucleic acid encoding a chimeric receptor (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the chimeric receptor comprises: i) an antigen binding domain (e.g., sdAb, Fab, or scFv) specifically recognizing GUCY2C; and ii) a transmembrane domain; and (2) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) ; wherein the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter; wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid (e.g., IRES, or encoding a cleavable linker such as 2A peptide) ; and wherein the method comprises: (a) providing a population of immune cells, and (b) introducing into the population of immune cells the vector comprising the first nucleic acid and the second nucleic acid. In some embodiments, there is provided a method of making an engineered immune cell (e.g., engineered T cell) , wherein the engineered immune cell comprises: (1) a first nucleic acid encoding a CAR (e.g., any of the GUCY2C-targeted chimeric receptors described herein, such as GUCY2C CAR, e.g., C07 CAR) , wherein the CAR comprises: (a) an antigen binding domain (e.g., sdAb, scFv, or Fab) specifically recognizing GUCY2C; (b) an optional hinge domain (e.g., derived from CD8α) ; (c) a transmembrane domain (e.g., derived from CD8α) ; (d) an optional intracellular co-stimulatory signaling domain (e.g., derived from CD137) ; and (e) an intracellular signaling domain (e.g., derived from CD3ζ) ; and (2) a second nucleic acid encoding an ICI (e.g., any of the ICIs described herein, such as anti-PD-1 scFv or anti-PD-1 full-length antibody, e.g., derived from pembrolizumab) ; wherein the first nucleic acid and the second nucleic acid are on the same vector and under the control of the same promoter; wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid (e.g., IRES, or encoding a cleavable linker such as 2A peptide) ; and wherein the method comprises: (i) providing a population of immune cells, and (ii) introducing into the population of immune cells the vector comprising the first nucleic acid and the second nucleic acid. In some embodiments, the first nucleic acid is upstream of the second nucleic acid. In some embodiments, the GUCY2C CAR comprises an anti-GUCY2C sdAb, wherein the anti-GUCY2C sdAb comprises a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24. In some embodiments, the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of SEQ ID NO: 40. In some embodiments, the CAR comprises the amino acid sequence of SEQ ID NO: 54. In some embodiments, the ICI is an anti-PD-1 antibody or antigen-binding fragment thereof comprising: an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47. In some embodiments, anti-PD-1 antibody or antigen-binding fragment thereof (e.g., scFv or Fab) comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49. In some embodiments, the ICI is an anti-PD-1 full-length antibody comprising a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69. In some embodiments, the ICI is an anti-PD-1 scFv comprising the amino acid sequence of SEQ ID NO: 50. In some embodiments, the vector comprising the first nucleic acid and the second nucleic acid encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56.
[0254] In some embodiments, the first nucleic acid and / or the second nucleic acid are introduced into the population of immune cells via a viral vector. Examples of viral vectors include, but are not limited to, adenoviral vectors, adeno-associated virus (AVV) vectors, lentiviral vector, retroviral vectors, herpes simplex viral vector, and derivatives thereof.
[0255] In some embodiments, the first nucleic acid and / or the second nucleic acid are under the control of a promoter. In some embodiments, the promoter is selected from the group consisting of a phosphoglycerate kinase (PGK) promoter (e.g., PGK-1 promoter) , a Rous Sarcoma Virus (RSV) promoter, an Simian Virus 40 (SV40) promoter, a cytomegalovirus (CMV) immediate early (IE) gene promoter, an elongation factor 1 alpha (EF1-α) promoter, a ubiquitin-C (UBQ-C) promoter, a cytomegalovirus CMV) enhancer / chicken beta-actin (CAG) promoter, polyoma enhancer / herpes simplex thymidine kinase (MC1) promoter, a beta actin (β-ACT) promoter, a myeloproliferative sarcoma virus enhancer, negative control region deleted, d1587rev primer-binding site substituted (MND) promoter, an NFAT promoter, a promoter, and an NFκB promoter. In some embodiments, the promoter is an hEF1α promoter.
[0256] In some embodiments, the engineered immune cell is prepared by introducing the chimeric receptors into the immune cell, such as a T cell. In some embodiments, the chimeric receptor is introduced to the immune cell by transfecting any one of the isolated nucleic acids or vectors described herein. In some embodiments, the immune cell (e.g., engineered immune cell expressing the chimeric receptor) is further engineered to express an ICI, by transfecting any one of the isolated nucleic acids or vectors described herein. In some embodiments, the chimeric receptor is introduced to the immune cell by inserting proteins into the cell membrane while passing cells through a microfluidic system, such as CELL (see, e.g., U.S. Patent Application Publication No. 20140287509) .
[0257] Methods of introducing vectors or isolated nucleic acids into a mammalian cell are known in the art. The vectors described can be transferred into an immune effector cell by physical, chemical, or biological methods.
[0258] Physical methods for introducing an isolated nucleic acid or vector into an immune cell include calcium phosphate precipitation, lipofection, particle bombardment, microinjection, electroporation, and the like. Methods for producing cells comprising vectors and / or exogenous nucleic acids are well-known in the art. See, e.g., Sambrook et al. (2001) Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory, New York. In some embodiments, the vector is introduced into the cell by electroporation.
[0259] Biological methods for introducing an isolated nucleic acid or vector into an immune cell include the use of DNA and RNA vectors. Viral vectors have become the most widely used method for inserting genes into mammalian, e.g., human cells.
[0260] Chemical means for introducing an isolated nucleic acid or vector into an immune cell include colloidal dispersion systems, such as macromolecule complexes, nanocapsules, microspheres, beads, and lipid-based systems including oil-in-water emulsions, micelles, mixed micelles, and liposomes. An exemplary colloidal system for use as a delivery vehicle in vitro is a liposome (e.g., an artificial membrane vesicle) .
[0261] RNA molecules encoding any of the chimeric receptors and / or immune checkpoint inhibitors described herein may be prepared by a conventional method (e.g., in vitro transcription) and then introduced into the immune cells via known methods such as mRNA electroporation. See, e.g., Rabinovich et al., Human Gene Therapy 17: 1027-1035 (2006) .
[0262] The transduced or transfected immune cell can be propagated ex vivo after introduction of the vector or isolated nucleic acid. For example, the transduced or transfected immune cell can be cultured to propagate for at least about any of 1 day, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 9 days, 10 days, 12 days, or 14 days. The transduced or transfected immune cells may be further evaluated or screened to select the engineered mammalian cell, e.g., expressing the chimeric receptor, or expressing both the chimeric receptor and the ICI.
[0263] Reporter genes may be used for identifying potentially transfected cells and for evaluating the functionality of regulatory sequences. In general, a reporter gene is a gene that is not present in or expressed by the recipient organism or tissue and that encodes a polypeptide whose expression is manifested by some easily detectable property, e.g., enzymatic activity. Expression of the reporter gene is assayed at a suitable time after the DNA has been introduced into the recipient cells. Suitable reporter genes may include genes encoding luciferase, beta-galactosidase, chloramphenicol acetyl transferase, secreted alkaline phosphatase, or the green fluorescent protein gene (e.g., Ui-Tei et al. FEBS Letters 479: 79-82 (2000) ) . Suitable expression systems are well known and may be prepared using known techniques or obtained commercially.
[0264] Other methods to confirm the presence of the nucleic acid encoding the chimeric receptors and / or immune checkpoint inhibitors in the engineered immune cell, include, for example, molecular biological assays well known to those of skill in the art, such as Southern and Northern blotting, RT-PCR and PCR; biochemical assays, such as detecting the presence or absence of a particular peptide, e.g., by immunological methods (such as ELISAs and Western blots) .
[0265] In some embodiments, the engineered immune cell is a T cell. T cells for use in expansion and genetic modification can be obtained from a number of sources, including peripheral blood mononuclear cells, bone marrow, lymph node tissue, cord blood, thymus tissue, tissue from a site of infection, ascites, pleural effusion, spleen tissue, and tumors. In some embodiments, any number of T cell lines available in the art, may be used. For example, T cells can be obtained from a unit of blood collected from a subject using any number of techniques known to the skilled artisan, such as FicollTM separation. In some embodiments, cells from the circulating blood of an individual are obtained by apheresis. The apheresis product typically contains lymphocytes, including T cells, monocytes, granulocytes, B cells, other nucleated white blood cells, red blood cells, and platelets. The cells collected by apheresis may be washed to remove the plasma fraction and to place the cells in an appropriate buffer or media for subsequent processing steps. In some embodiments, the cells are washed with phosphate buffered saline (PBS) . In some embodiments, the wash solution lacks calcium and may lack magnesium or may lack many if not all divalent cations. Initial activation steps in the absence of calcium may lead to magnified activation. As those of ordinary skill in the art would readily appreciate a washing step may be accomplished by methods known to those in the art, such as by using a semi-automated “flow-through” centrifuge (for example, the Cobe 2991 cell processor, the Baxter CytoMate, or the Haemonetics Cell Saver 5) according to the manufacturer's instructions. After washing, the cells may be resuspended in a variety of biocompatible buffers, such as, for example, Ca2+-free, Mg2+-free PBS, PlasmaLyte A, or other saline solution with or without buffer. Alternatively, the undesirable components of the apheresis sample may be removed and the cells directly resuspended in culture media.
[0266] T cells can be isolated from peripheral blood lymphocytes by lysing the red blood cells and depleting the monocytes, for example, by centrifugation through a PERCOLLTM gradient or by counterflow centrifugal elutriation. A specific subpopulation of T cells, such as CD3+, CD28+, CD4+, CD8+, CD45RA+, and CD45RO+ T cells, can be further isolated by positive or negative selection techniques. For example, in some embodiments, T cells are isolated by incubation with anti-CD3 / anti-CD28 (i.e., 3×28) -conjugated beads, such as M-450 CD3 / CD28 T, for a time period sufficient for positive selection of the desired T cells. In some embodiments, the time period is about 30 minutes. In a further embodiment, the time period ranges from about 30 minutes to about 36 hours or longer and all integer values there between, such as about 10 to about 24 hours. In a further embodiment, the time period is at least about 1, 2, 3, 4, 5, or 6 hours. For isolation of T cells from patients with leukemia, use of longer incubation times, such as 24 hours, can increase cell yield. Longer incubation times may be used to isolate T cells in any situation where there are few T cells as compared to other cell types, such in isolating T cells from tumor tissue or from immune-compromised individuals. Further, use of longer incubation times can increase the efficiency of capture of CD8+ T cells. For example, by simply shortening or lengthening the time T cells are allowed to bind to the CD3 / CD28 beads and / or by increasing or decreasing the ratio of beads to T cells, subpopulations of T cells can be preferentially selected for or against at culture initiation or at other time points during the process. Additionally, by increasing or decreasing the ratio of anti-CD3 and / or anti-CD28 antibodies on the beads or other surface, subpopulations of T cells can be preferentially selected for or against at culture initiation or at other desired time points. The skilled artisan would recognize that multiple rounds of selection can also be used. It may be desirable to perform the selection procedure and use the “unselected” cells in the activation and expansion process. “Unselected” cells can also be subjected to further rounds of selection.
[0267] Enrichment of a T cell population by negative selection can be accomplished with a combination of antibodies directed to surface markers unique to the negatively selected cells. One method is cell sorting and / or selection via negative magnetic immunoadherence or flow cytometry that uses a cocktail of monoclonal antibodies directed to cell surface markers present on the cells negatively selected. For example, to enrich for CD4+ cells by negative selection, a monoclonal antibody cocktail typically includes antibodies to CD14, CD20, CD11b, CD16, HLA-DR, and CD8. It may be desirable to enrich for or positively select for regulatory T cells which typically express CD4+, CD25+, CD62Lhi, GITR+, and FoxP3+. Alternatively, in certain embodiments, T regulatory cells are depleted by anti-C25 conjugated beads or other similar method of selection.
[0268] For isolation of a desired population of cells by positive or negative selection, the concentration of cells and surface (e.g., particles such as beads) can be varied. It may be desirable to significantly decrease the volume in which beads and cells are mixed together (i.e., increase the concentration of cells) , to ensure maximum contact of cells and beads. For example, in one embodiment, a concentration of 1 billion cells / ml or 2 billion cells / ml is used. In a further embodiment, greater than 100 million cells / ml is used. In a further embodiment, a concentration of cells of 10, 15, 20, 25, 30, 35, 40, 45, 50, 75, 80, 85, 90, 95, 100, 125, or 150 million cells / ml is used. Using high concentrations may result in increased cell yield, cell activation, and cell expansion. Further, use of high cell concentrations may allow more efficient capture of cells that may weakly express target antigens of interest, such as CD28-negative T cells, or from samples where there are many tumor cells present (i.e., leukemic blood, tumor tissue, etc. ) . Such populations of cells may have therapeutic value and would be desirable to obtain. In some embodiments, using high concentration of cells allows more efficient selection of CD8+ T cells that normally have weaker CD28 expression.
[0269] In some embodiments, it may be desirable to use lower concentrations of cells. By significantly diluting the mixture of T cells and surface (e.g., particles such as beads) , interactions between the particles and cells is minimized. This selects for cells that express high amounts of desired antigens to be bound to the particles. For example, CD4+ T cells express higher levels of CD28 and are more efficiently captured than CD8+ T cells in dilute concentrations. In some embodiments, the concentration of cells used can be from about 1×105 / mL to about 5×106 / mL, such as from about 1×105 / mL to about 1×106 / mL.
[0270] In some embodiments, the population of immune cells are enriched for CD4+ and / or CD8+ cells. In some embodiments, the population of immune cells are enriched for both CD4+and CD8+ cells, such as by using CD4 Nanobeads and CD8 Nanobeads. In some embodiments, the population of immune cells are activated before introducing the nucleic acid encoding the chimeric receptor and / or the ICI into the immune cells, such as by using anti-CD3 / CD28 particles. The enrichment of CD4+ and / or CD8+ cells may be performed before introducing the nucleic acid encoding the chimeric receptor and / or the ICI into the population of immune cells. The enrichment of CD4+ and / or CD8+ cells may be performed after introducing the nucleic acid encoding the chimeric receptor and / or the ICI into the population of immune cells (e.g., a mixture of PBMC) .
[0271] In some embodiments, the cells may be incubated on a rotator for varying lengths of time at varying speeds at either 2-10℃, or at room temperature.
[0272] T cells for stimulation can also be frozen after a washing step. Without being bound by theory, the freeze and subsequent thaw step may provide a more uniform product by removing granulocytes and to some extent monocytes in the cell population. After the washing step that removes plasma and platelets, the cells may be suspended in a freezing solution. While many freezing solutions and parameters are known in the art and will be useful in this context, one method involves using PBS containing 20%DMSO and 8%human serum albumin, or culture media containing 10%dextran 40 and 5%dextrose, 20%human serum albumin and 7.5%DMSO, or 31.25%plasmalyte-A, 31.25%dextrose 5%, 0.45%NaCl, 10%dextran 40 and 5%dextrose, 20%human serum albumin, and 7.5%DMSO or other suitable cell freezing media containing for example, Hespan and PlasmaLyte A. The cells then are frozen to -80℃ at a rate of 1° per minute and stored in the vapor phase of a liquid nitrogen storage tank. Other methods of controlled freezing may be used as well as uncontrolled freezing immediately at -20℃ or in liquid nitrogen.
[0273] In some embodiments, cryopreserved cells are thawed and washed as described herein and allowed to rest for one hour at room temperature prior to activation.
[0274] Also contemplated in the present disclosure is the collection of blood samples or apheresis product from a subject at a time period prior to when the expanded cells as described herein might be needed. As such, the source of the cells to be expanded can be collected at any time point necessary, and desired cells, such as T cells, isolated and frozen for later use in T cell therapy for any number of diseases or conditions that would benefit from T cell therapy, such as those described herein. In one embodiment, a blood sample or an apheresis is taken from a generally healthy subject. In certain embodiments, a blood sample or an apheresis is taken from a generally healthy subject who is at risk of developing a disease, but who has not yet developed a disease, and the cells of interest are isolated and frozen for later use. In certain embodiments, the T cells may be expanded, frozen, and used at a later time. In certain embodiments, samples are collected from a patient shortly after diagnosis of a particular disease as described herein but prior to any treatments. In a further embodiment, the cells are isolated from a blood sample or an apheresis from a subject prior to any number of relevant treatment modalities, including but not limited to treatment with agents such as natalizumab, efalizumab, antiviral agents, chemotherapy, radiation, immunosuppressive agents, such as cyclosporin, azathioprine, methotrexate, mycophenolate, and FK506, antibodies, or other immunoablative agents such as CAMPATH, anti-CD3 antibodies, cytoxan, fludarabine, cyclosporin, FK506, rapamycin, mycophenolic acid, steroids, FR901228, and irradiation. These drugs inhibit either the calcium dependent phosphatase calcineurin (cyclosporine and FK506) or inhibit the p70S6 kinase that is important for growth factor induced signaling (rapamycin) (Liu et al., Cell 66: 807-815 (1991) ; Henderson et al., Immun 73: 316-321 (1991) ; Bierer et al., Curr. Opin. Immun. 5: 763-773 (1993) ) . In a further embodiment, the cells are isolated for a patient and frozen for later use in conjunction with (e.g., before, simultaneously or following) bone marrow or stem cell transplantation, T cell ablative therapy using either chemotherapy agents such as, fludarabine, external-beam radiation therapy (XRT) , cyclophosphamide, or antibodies such as OKT3 or CAMPATH.
[0275] In some embodiments, T cells are obtained from a patient directly following treatment. In this regard, it has been observed that following certain cancer treatments, in particular treatments with drugs that damage the immune system, shortly after treatment during the period when patients would normally be recovering from the treatment, the quality of T cells obtained may be optimal or improved for their ability to expand ex vivo. Likewise, following ex vivo manipulation using the methods described herein, these cells may be in a preferred state for enhanced engraftment and in vivo expansion. Thus, it is contemplated within the context of the present disclosure to collect blood cells, including T cells, dendritic cells, or other cells of the hematopoietic lineage, during this recovery phase. Further, in certain embodiments, mobilization (for example, mobilization with GM-CSF) and conditioning regimens can be used to create a condition in a subject wherein repopulation, recirculation, regeneration, and / or expansion of particular cell types is favored, especially during a defined window of time following therapy. Illustrative cell types include T cells, B cells, dendritic cells, and other cells of the immune system.
[0276] In some embodiments, prior to or after genetic modification of the T cells expressing the chimeric receptors or co-expressing the chimeric receptors and the ICIs described herein, the T cells can be activated and expanded generally using methods as described, for example, in U.S. Pat. Nos. 6,352,694; 6,534,055; 6,905,680; 6,692,964; 5,858,358; 6,887,466; 6,905,681; 7,144,575; 7,067,318; 7,172,869; 7,232,566; 7,175,843; 5,883,223; 6,905,874; 6,797,514; 6,867,041; and U.S. Patent Application Publication No. 20060121005.
[0277] Generally, T cells can be expanded by contact with a surface having attached thereto an agent that stimulates a CD3 / TCR complex associated signal and a ligand that stimulates a co-stimulatory molecule on the surface of the T cells. In particular, T cell populations may be stimulated as described herein, such as by contact with an anti-CD3 antibody, or antigen binding fragment thereof, or an anti-CD2 antibody immobilized on a surface, or by contact with a protein kinase C activator (e.g., bryostatin) in conjunction with a calcium ionophore. For co-stimulation of an accessory molecule on the surface of the T cells, a ligand that binds the accessory molecule is used. For example, a population of T cells can be contacted with an anti-CD3 antibody and an anti-CD28 antibody, under conditions appropriate for stimulating proliferation of the T cells. To stimulate proliferation of either CD4+ T cells or CD8+ T cells, an anti-CD3 antibody and an anti-CD28 antibody can be used. Examples of an anti-CD3 antibody include UCHT1, OKT3, HIT3a (BioLegend, San Diego, US) can be used as can other methods commonly known in the art (Graves J, et al., J. Immunol. 146: 2102 (1991) ; Li B, et al., Immunology 116: 487 (2005) ; Rivollier A, et al., Blood 104: 4029 (2004) ) . Examples of an anti-CD28 antibody include 9.3, B-T3, XR-CD28 (Diaclone, Besancon, France) can be used as can other methods commonly known in the art (Berg et al., Transplant Proc. 30 (8) : 3975-3977 (1998) ; Haanen et al., J. Exp. Med. 190 (9) : 13191328 (1999) ; Garland et al., J. Immunol Meth. 227 (1-2) : 53-63 (1999) ) .
[0278] The primary stimulatory signal and the co-stimulatory signal for the T cell may be provided by different protocols. For example, the agents providing each signal may be in solution or coupled to a surface. When coupled to a surface, the agents may be coupled to the same surface (i.e., in “cis” formation) or to separate surfaces (i.e., in “trans” formation) . Alternatively, one agent may be coupled to a surface and the other agent in solution. In one embodiment, the agent providing the co-stimulatory signal is bound to a cell surface and the agent providing the primary activation signal is in solution or coupled to a surface. Both agents can be in solution. The agents may be in soluble form, and then cross-linked to a surface, such as a cell expressing Fc receptors or an antibody or other binding agent which will bind to the agents. In this regard, see for example, U.S. Patent Application Publication Nos. 20040101519 and 20060034810 for artificial antigen presenting cells (aAPCs) that are contemplated for use in activating and expanding T cells in certain embodiments in the present disclosure.
[0279] In some embodiments, the T cells, are combined with agent-coated beads, the beads and the cells are subsequently separated, and then the cells are cultured. In an alternative embodiment, prior to culture, the agent-coated beads and cells are not separated but are cultured together. In a further embodiment, the beads and cells are first concentrated by application of a force, such as a magnetic force, resulting in increased ligation of cell surface markers, thereby inducing cell stimulation.
[0280] By way of example, cell surface proteins may be ligated by allowing paramagnetic beads to which anti-CD3 and anti-CD28 are attached (3×28 beads) to contact the T cells. In one embodiment, the cells (for example, 104 to 108 T cells) and beads (for example, anti-CD3 / CD28 MACSiBead particlesa at a recommended titer of 1: 100) are combined in a buffer, preferably PBS (without divalent cations such as, calcium and magnesium) . Those of ordinary skill in the art can readily appreciate any cell concentration may be used. For example, the target cell may be very rare in the sample and comprise only 0.01%of the sample or the entire sample (i.e., 100%) may comprise the target cell of interest. Accordingly, any cell number is within the context of the present disclosure. The mixture m...
Claims
1.A method of treating a GUCY2C-positive cancer in an individual, comprising administering to the individual an engineered immune cell and an immune checkpoint inhibitor, wherein the engineered immune cell comprises a chimeric receptor comprising: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain.2.The method of claim 1, wherein the engineered immune cell and the immune checkpoint inhibitor are administered in a single composition.3.The method of claim 2, wherein the immune checkpoint inhibitor is secreted by the engineered immune cell.4.The method of claim 3, wherein the engineered immune cell comprises a first nucleic acid encoding the chimeric receptor, and a second nucleic acid encoding the immune checkpoint inhibitor.5.The method of claim 1, wherein the engineered immune cell and the immune checkpoint inhibitor are administered in separate compositions.6.The method of any one of claims 1-5, wherein the GUCY2C-positive cancer is gastrointestinal cancer, colorectal cancer, gastric cancer, esophageal cancer, esophagogastric junction cancer, small intestinal cancer, pancreatic cancer or liver cancer.7.The method any one of claims 1-6, wherein the administration is independent of the microsatellite instability (MSI) or mismatch repair (MMR) status of the GUCY2C-positive cancer.8.The method of any one of claims 1-7, wherein the GUCY2C-positive cancer is deficient mismatch repair (dMMR) or proficient mismatch repair (pMMR) cancer.9.The method of any one of claims 1-8, wherein the GUCY2C-positive cancer has microsatellite instability (MSI) or is microsatellite stable (MSS) .10.The method of any one of claims 1-9, the GUCY2C-positive cancer is metastatic colorectal cancer or metastatic gastric cancer.11.The method of any one of claims 1-10, wherein the GUCY2C-positive cancer expresses high level, moderate level, or low level of GUCY2C.12.The method of any one of claims 1-11, wherein the antigen binding domain of the chimeric receptor is selected from the group consisting of a Fab, a Fab’, a (Fab’) 2, an Fv, a single chain Fv (scFv) , a single domain antibody (sdAb) , and a peptide ligand specifically binding to GUCY2C.13.The method of claim 12, wherein the antigen binding domain of the chimeric receptor is an sdAb ( “anti-GUCY2C sdAb” ) .14.The method of claim 13, wherein the anti-GUCY2C sdAb comprises:(i) a CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a CDR2 comprising the amino acid sequence of SEQ ID NO: 9, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 17;(ii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 2, a CDR2 comprising the amino acid sequence of SEQ ID NO: 10, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 18;(iii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 19;(iv) a CDR1 comprising the amino acid sequence of SEQ ID NO: 4, a CDR2 comprising the amino acid sequence of SEQ ID NO: 11, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 20;(v) a CDR1 comprising the amino acid sequence of SEQ ID NO: 5, a CDR2 comprising the amino acid sequence of SEQ ID NO: 12, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 21;(vi) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 22;(vii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 6, a CDR2 comprising the amino acid sequence of SEQ ID NO: 14, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 23;(viii) a CDR1 comprising the amino acid sequence of SEQ ID NO: 7, a CDR2 comprising the amino acid sequence of SEQ ID NO: 15, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 24; or(ix) a CDR1 comprising the amino acid sequence of SEQ ID NO: 8, a CDR2 comprising the amino acid sequence of SEQ ID NO: 16, and a CDR3 comprising the amino acid sequence of SEQ ID NO: 25.15.The method of claim 14, wherein the anti-GUCY2C sdAb comprises a VHH comprising the amino acid sequence of any one of SEQ ID NOs: 26-41.16.The method of any one of claims 1-15, wherein the chimeric receptor is a chimeric antigen receptor (CAR) , and wherein the chimeric receptor further comprises an intracellular signaling domain.17.The method of claim 16, wherein the transmembrane domain is derived from the group consisting of CD8α, CD4, CD28, 4-1BB, CD80, CD86, CD152, and PD-1.18.The method of claim 17, wherein the transmembrane domain is derived from CD8α.19.The method of any one of claims 16-18, wherein the intracellular signaling domain is derived from the group consisting of CD3ζ, FcRγ, FcRβ, CD3γ, CD3δ, CD3ε, CD5, CD22, CD79a, CD79b, and CD66d.20.The method of claim 19, wherein the intracellular signaling domain is derived from CD3ζ.21.The method of any one of claims 16-20, wherein the chimeric receptor further comprises an intracellular co-stimulatory signaling domain.22.The method of claim 21, wherein the intracellular co-stimulatory signaling domain is derived from a co-stimulatory molecule selected from the group consisting of CD27, CD28, CD137, OX40, CD40, PD-1, LFA-1, ICOS, CD2, CD7, LIGHT, NKG2C, B7-H3, TNFRSF9, TNFRSF4, TNFRSF8, CD40LG, ITGB2, KLRC2, TNFRSF18, TNFRSF14, HAVCR1, LGALS9, DAP10, DAP12, CD83, ligands of CD83 and combinations thereof.23.The method of claim 22, wherein the intracellular co-stimulatory signaling domain is derived from a cytoplasmic domain of CD137.24.The method of any one of claims 16-23, wherein the chimeric receptor further comprises a hinge domain located between the antigen binding domain and the transmembrane domain.25.The method of claim 24, wherein the hinge domain is derived from CD8α.26.The method of any one of claims 4-25, wherein the first nucleic acid further encodes a chimeric receptor signal peptide N-terminal to the chimeric receptor.27.The method of any one of claims 16-26, wherein the chimeric receptor comprises the amino acid sequence of SEQ ID NO: 54.28.The method of any one of claims 1-27, wherein the immune checkpoint inhibitor is an antibody or antigen-binding fragment thereof specifically recognizing an immune checkpoint protein.29.The method of claim 28, wherein the antibody or antigen-binding fragment thereof is selected from the group consisting of a full-length antibody, a Fab, a Fab’, a (Fab’) 2, an Fv, an scFv, and an sdAb.30.The method of claim 29, wherein the antibody or antigen-binding fragment thereof is a full-length antibody or an scFv.31.The method of any one of claims 28-30, wherein the immune checkpoint protein is selected from the group consisting of PD-1, PD-L1, TIGIT, LAG-3, CTLA-4, BTLA, and TIM-3.32.The method of claim 31, wherein the immune checkpoint protein is PD-1.33.The method of claim 32, wherein the antibody or antigen-binding fragment thereof specifically recognizing PD-1 comprises an H-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, an H-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, an H-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, an L-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, an L-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and an L-CDR3 comprising the amino acid sequence of SEQ ID NO: 47.34.The method of claim 33, wherein the antibody or antigen-binding fragment thereof specifically recognizing PD-1 comprises a VH comprising the amino acid sequence of SEQ ID NO: 48, and a VL comprising the amino acid sequence of SEQ ID NO: 49.35.The method of any one of claims 32-34, wherein the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is a full-length antibody ( “anti-PD-1 full-length antibody” ) .36.The method of claim 35, wherein the anti-PD-1 full-length antibody comprises a heavy chain comprising the amino acid sequence of SEQ ID NO: 68, and a light chain comprising the amino acid sequence of SEQ ID NO: 69.37.The method of any one of claims 32-34, wherein the antibody or antigen-binding fragment thereof specifically recognizing PD-1 is an scFv ( “anti-PD-1 scFv” ) .38.The method of claim 37, wherein the anti-PD-1 scFv comprises the amino acid sequence of SEQ ID NO: 50.39.The method of any one of claims 4-38, wherein the second nucleic acid further encodes an immune checkpoint inhibitor signal peptide N-terminal to the immune checkpoint inhibitor.40.The method of any one of claims 4-39, wherein the first nucleic acid and the second nucleic acid are on the same vector.41.The method of claim 40, wherein the first nucleic acid and the second nucleic acid are under the control of the same promoter.42.The method of claim 41, wherein the first nucleic acid and the second nucleic acid are connected via a linking nucleic acid encoding a cleavable linker.43.The method of claim 42, wherein the cleavable linker is a 2A peptide.44.The method of any one of claims 40-43, wherein the vector encodes a polypeptide comprising the amino acid sequence of SEQ ID NO: 55 or 56.45.The method of any one of claims 4-39, wherein the first nucleic acid and the second nucleic acid are on different vectors.46.The method of any one of claims 1-45, wherein the engineered immune cell is selected from the group consisting of T cell, NK cell, B cell, monocyte, dendritic cell, and any combination thereof.47.The method of claim 46, wherein the engineered immune cell is a T cell.48.An engineered immune cell comprising:a) a first nucleic acid encoding a chimeric receptor, wherein the chimeric receptor comprises: i) an antigen binding domain specifically recognizing GUCY2C; and ii) a transmembrane domain; andb) a second nucleic acid encoding an immune checkpoint inhibitor.49.A pharmaceutical composition comprising the engineered immune cell of claim 48, and a pharmaceutically acceptable excipient.50.A method of making the engineered immune cell of claim 48, comprising:a) providing a population of immune cells;b) introducing into the population of immune cells a first nucleic acid encoding the chimeric receptor and a second nucleic acid encoding the immune checkpoint inhibitor.
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