IL-15 and IL-15Rα heterodimer dose escalation regimens for treating conditions
Described herein are dose escalation regimens for the administration of complexes comprising interleukin-15 (“IL-15”) covalently or noncovalently bound to IL-15 receptor alpha (“IL-15Rα”) to patients in order to enhance IL-15-mediated immune function. In a specific aspect, the dose escalation regimens are useful in the prevention, treatment, and/or management of disorders in which enhancing IL-15-mediated function is beneficial, such as cancer, infectious diseases, immunodeficiencies and lymphopenia. In another specific aspect, the dose escalation regimens are useful for eradicating or reducing HIV in HIV-infected patients.
1. A method for treating lymphocytopenia, cancer or an infectious disease in a human subject, comprising:
(a) administering an initial low dose of a human IL-15/IL-15Rα complex to the human subject, wherein the initial low dose is between 0.1 μg/kg and 1 μg/kg as determined based on the mass of single chain IL-15;
(b) obtaining a plasma sample taken from a human subject; and
(c) detecting a concentration of free IL-15 of 1 pg/ml to 50 pg/ml in the sample obtained from the subject after the administration of the initial low dose of the human IL-15/IL-15Rα complex and administration of successively higher doses of the human IL-15/IL-15Rα complex, wherein each successively higher dose is from two to three times higher than the previous dose.
2. The method of claim 1 , wherein the initial low dose is administered one to six times over a 7 to 14 day period.
3. The method of claim 1 or 2 , wherein each dose is administered at least once, twice or thrice over a 7 to 14 day period.
4. The method of claim 1 , wherein the detecting is done 24 hours, to 48 hours, or 72 hours after the administration of a dose of the IL-15/IL-15Rα complex and before the administration of another dose of the IL-15/IL-15Rα complex.
5. The method of claim 1 , wherein the dose is not increased if the levels of free IL-15 is above 50 pg/ml in a sample from the subject.
6. The method of claim 1 further comprising (d) administering a maintenance dose of the IL-15/IL-15Rα complex to the subject, wherein the maintenance dose reaches levels of free IL-15 of approximately 1 pg/ml to 50 pg/ml in the sample from the subject.
7. The method of claim 1 , wherein the cancer is melanoma, colon cancer, lung cancer, prostate cancer or renal cell carcinoma.
8. The method of claim 7 , wherein the cancer has metastasized.
9. The method of claim 1 , wherein the infectious disease is HIV.
10. The method of claim 1 , wherein the infectious disease is pneumonia or tuberculosis.
11. The method of claim 1 , wherein the lymphocytopenia is due to the administration of an anti-cancer agent.
12. The method of claim 1 , wherein the IL-15/IL-15Rα complex is administered subcutaneously, intravenously, intramuscularly, or intratumorally to the subject.
13. The method of claim 1 , wherein: (a) the human IL-15 comprises amino acid residues 49 to 162 of the amino acid sequence of SEQ ID NO: 1; and (b) the human IL-15Rα comprises the amino acid sequence of SEQ ID NO: 33.
14. The method of claim 1 , further comprising administering to the human subject one or more other therapies.
15. The method of claim 14 , wherein the one or more other therapies is an antibody.
16. The method of claim 15 , wherein the antibody immunospecifically binds to Her2, PD-1, a ligand of PD-1 or CD19.
17. The method of claim 15 , wherein the antibody is administered after the IL-15/IL-15Rα complex is administered or is administered before the IL-15/IL-15Ra complex is administered.
18. The method of claim 14 , wherein the one or more other therapies is a histone deacetylase (HDAC) inhibitor, TLR7 agonist, or a cytokine.
19. The method of claim 18 , wherein the cytokine is IL-7.