Treatment of cancer using a CD123 chimeric antigen receptor
The invention provides compositions and methods for treating diseases associated with expression of CD123. The invention also relates to chimeric antigen receptor (CAR) specific to CD123, vectors encoding the same, and recombinant cells comprising the CD123 CAR. The invention also includes methods of administering a genetically modified cell expressing a CAR that comprises a CD123 binding domain.
1. A method of providing an anti-tumor immunity in a mammal, comprising administering to the mammal an effective amount of an immune effector cell comprising:
(a) an isolated nucleic acid molecule encoding a chimeric antigen receptor (CAR), wherein the CAR comprises a CD123 binding domain, a transmembrane domain, and an intracellular signaling domain, and wherein the encoded CD123 binding domain comprises:
(i) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 487, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 492, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 497; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 502, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 507, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 512; or
(ii) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 517, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 522, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 527; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 532, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 537, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 542; or
(iii) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 335, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 363, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 391; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 419, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 447, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 475, or
(b) an isolated CAR polypeptide molecule encoded by the nucleic acid molecule of (a).
2. A method of treating a mammal having a disease associated with a cell which expresses CD123, comprising administering to the mammal an effective amount of an immune effector cell comprising:
(a) an isolated nucleic acid molecule encoding a CAR, wherein the CAR comprises a CD123 binding domain, a transmembrane domain, and an intracellular signaling domain, and wherein the encoded CD123 binding domain comprises:
(i) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 487, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 492, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 497; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 502, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 507, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 512; or
(ii) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 517, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 522, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 527; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 532, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 537, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 542; or
(iii) a heavy chain variable domain comprising three complementary determining regions of heavy chain complementary determining region 1 (HC CDR1), heavy chain complementary determining region 2 (HC CDR2), and heavy chain complementary determining region 3 (HC CDR3) present in order of HC CDR1, HC CDR2, and HC CDR3, wherein HC CDR1 comprises the amino acid sequence of SEQ ID NO: 335, HC CDR2 comprises the amino acid sequence of SEQ ID NO: 363, and HC CDR3 comprises the amino acid sequence of SEQ ID NO: 391; and
a light chain variable domain comprising three complementary determining regions of light chain complementary determining region 1 (LC CDR1), light chain complementary determining region 2 (LC CDR2), and light chain complementary determining region 3 (LC CDR3) present in order of LC CDR1, LC CDR2, and LC CDR3, wherein LC CDR1 comprises the amino acid sequence of SEQ ID NO: 419, LC CDR2 comprises the amino acid sequence of SEQ ID NO: 447, and LC CDR3 comprises the amino acid sequence of SEQ ID NO: 475, or
(b) an isolated CAR polypeptide molecule encoded by the nucleic acid molecule of (a).
3. The method of claim 2 , wherein the disease associated with a cell which expresses CD123 is:
(i) a cancer or malignancy,
(ii) a precancerous condition, or
(ii) a non-cancer related indication associated with expression of CD123.
4. The method of claim 2 , wherein the disease is a hematologic cancer, a leukemia, or a pre-leukemia.
5. The method of claim 2 , wherein the disease is chosen from one or more of acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), acute lymphoblastic B-cell leukemia (B-cell acute lymphoid leukemia, BALL), acute lymphoblastic T-cell leukemia (T-cell acute lymphoid leukemia, TALL), B-cell prolymphocytic leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia (CML), hairy cell leukemia, Hodgkin lymphoma, a histiocytic disorder, a mast cell disorder, a myelodysplasia, a myelodysplastic syndrome, a myeloproliferative neoplasm, a plasma cell myeloma, a plasmacytoid dendritic cell neoplasm, or a combination thereof.
6. The method of claim 1 , wherein the immune effector cell comprises:
(i) an mRNA encoding the CAR polypeptide; or
(ii) a lentiviral vector comprising the nucleic acid molecule, or encoding the CAR polypeptide.
7. The method of claim 1 , wherein the immune effector cell is administered in combination with second therapeutic agent or procedure chosen from one or more of chemotherapy, a targeted anti-cancer therapy, an oncolytic drug, a cytotoxic agent, a cytokine, surgical procedure, a radiation procedure, an agonist of a costimulatory molecule, an inhibitor of an immune checkpoint molecule, a vaccine, or a second CAR-based immunotherapy.
8. The method of claim 7 , wherein the immune effector cell is administered in combination with:
(i) an agonist of a costimulatory molecule chosen from one or more of OX40, CD2, CD27, CDS, ICAM-1, LFA-1 (CD11a/CD18), ICOS (CD278), 4-1BB (CD137), GITR, CD30, CD40, BAFFR, HVEM, CD7, LIGHT, NKG2C, SLAMF7, NKp80, CD160, B7-H3 or CD83 ligand; or
(ii) an inhibitor of an immune checkpoint molecule chosen from one or more of PD1, PD-L1, PD-L2, CTLA4, TIM3, CEACAM-1, CEACAM-3, CEACAM-5, LAG3, VISTA, BTLA, TIGIT, LAIR1, CD160, 2B4, CD80, CD86, B7-H3 (CD276), B7-H4 (VTCN1), HVEM (TNFRSF14 or CD270), KIR, A2aR, MHC class I, MHC class II, GALS, adenosine, or TGFR.
9. The method of claim 7 , wherein the immune effector cell is administered in combination with a PD-1 inhibitor, a TIM-3 inhibitor, a CEACAM-1 inhibitor, or a combination thereof.
10. The method of claim 9 , wherein:
(i) the PD-1 inhibitor and the TIM-3 inhibitor are administered in combination; or
(ii) the TIM-3 inhibitor and the CEACAM-1 inhibitor are administered in combination.
11. The method of claim 7 , wherein:
(i) the agonist or the inhibitor is an antibody molecule; and/or
(ii) the inhibitor is administered subsequent to the administration of the immune effector cell.
12. The method of claim 1 , wherein the immune effector cell is administered in combination with a CD19 inhibitor.
13. The method of claim 12 , wherein the CD19 inhibitor is a CD19 CAR-expressing cell or an anti-CD19 antibody molecule.
14. The method of any of claim 2 , wherein the disease is a CD19-negative cancer.
15. The method of claim 2 , wherein the disease is relapsing and refractory ALL.
16. The method of claim 12 , wherein:
(i) the immune effector cell is administered after administration of the CD19 inhibitor; or
(ii) the immune effector cell is administered concurrently with the CD19 inhibitor.
17. The method of claim 1 , wherein the immune effector cell expresses a CD19 CAR and the CD123 CAR.
18. The method of claim 1 , further comprising transplanting a cell or a bone marrow, into the mammal.
19. The method of claim 1 , wherein the nucleic acid molecule of (a) encodes a CAR comprising:
(A) (i) the amino acid sequence of the light chain variable region of SEQ ID NO: 276;
or
(ii) an amino acid sequence with 95-99% identity to the amino acid sequence of the light chain variable regions of SEQ ID NO: 276;
(B) (i) the amino acid sequence of the heavy chain variable region of SEQ ID NO: 217;
or
(ii) an amino acid sequence with 95-99% identity to the amino acid sequence of of the heavy chain variable regions of SEQ ID NO: 217; and/or
(C) the amino acid sequence of the light chain variable region of SEQ ID NO: 276, and the amino acid sequence of the heavy chain variable region of SEQ ID NO: 217.
20. The method of claim 1 , wherein:
(i) the encoded CD123 binding domain of (a) comprises the amino acid sequence selected of SEQ ID NO:480;
(ii) the encoded CD123 binding domain of (a) comprises an amino acid sequence with 95-99% identity to SEQ ID NO: 480; and/or
(iv) the CD123 binding domain of (a) comprises a nucleotide sequence selected from a group consisting of SEQ ID NO: 479 and 481, or a nucleotide sequence with 95-99% identity thereof.
21. The method of claim 1 , wherein:
(a) the encoded CAR of (a) includes a transmembrane domain that comprises a transmembrane domain of a protein selected from the group consisting of the alpha, beta or zeta chain of the T-cell receptor, CD28, CD3 epsilon, CD45, CD4, CDS, CD8, CD9, CD16, CD22, CD33, CD37, CD64, CD80, CD86, CD134, CD137 and CD154; or
(b) the encoded transmembrane domain of (a) comprises the amino acid sequence of SEQ ID NO: 6, or an amino acid sequence with 95-99% identity to the amino acid sequence of SEQ ID NO:6; or
(c) the nucleic acid sequence encoding the transmembrane domain of (a) comprises the nucleotide sequence of SEQ ID NO:17, or a nucleotide sequence with 95-99% identity thereof.
22. The method of claim 1 , wherein the encoded CD123 binding domain of (a) is connected to the transmembrane domain by a hinge region, and wherein
(i) the encoded hinge region comprises the amino acid sequence of SEQ ID NO:2, or an amino acid sequence with 95-99% identity thereof; or
(ii) the nucleic acid sequence encoding the hinge region comprises the nucleotide sequence of SEQ ID NO: 13, or a nucleotide sequence with 95-99% identity thereof.
23. The method of claim 1 , wherein the encoded costimulatory domain of (a) is a functional signaling domain obtained from a protein selected from the group consisting of a MHC class I molecule, a TNF receptor protein, an Immunoglobulin-like protein, a cytokine receptor, an integrin, a signaling lymphocytic activation molecule (SLAM protein), an activating NK cell receptor, BTLA, a Toll ligand receptor, OX40, CD2, CD7, CD27, CD28, CD30, CD40, ICAM-1, LFA-1 (CD11a/CD18), 4-1BB (CD137), B7-H3, ICAM-1, ICOS (CD278), GITR, BAFFR, LIGHT, HVEM (LIGHTR), KIRDS2, SLAMF7, NKp80 (KLRF1), NKp44, NKp30, NKp46, CD19, CD4, CD8alpha, CD8beta, IL2R beta, IL2R gamma, IL7R alpha, ITGA4, 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, NKG2D, NKG2C, TNFR2, TRANCE/RANKL, DNAM1 (CD226), SLAMF4 (CD244, 2B4), CD84, CD96 (Tactile), CEACAM1, CRTAM, Ly9 (CD229), CD160 (BY55), PSGL1, CD100 (SEMA4D), CD69, SLAMF6 (NTB-A, Ly108), SLAM (SLAMF1, CD150, IPO-3), BLAME (SLAMF8), SELPLG (CD162), LTBR, LAT, GADS, SLP-76, and PAG/Cbp.
24. The method of claim 23 , wherein:
(i) the encoded costimulatory domain of (a) comprises the amino acid sequence of SEQ ID NO:7, or an amino acid sequence with 95-99% identity to the amino acid sequence of SEQ ID NO:7; or
(ii) the nucleic acid sequence encoding the costimulatory domain comprises the nucleotide sequence of SEQ ID NO:18, or a nucleotide sequence with 95-99% identity thereof.
25. The method of claim 1 , wherein:
(i) the encoded intracellular signaling domain of (a) comprises a functional signaling domain of 4-1BB and/or a functional signaling domain of CD3 zeta;
(ii) the encoded intracellular signaling domain of (a) comprises the amino acid sequence of SEQ ID NO: 7 and/or the amino acid sequence of SEQ ID NO:9 or SEQ ID NO:10; or an amino acid sequence with 95-99% identity to the amino acid sequence of SEQ ID NO:7 and/or the amino acid sequence of SEQ ID NO:9 or SEQ ID NO:10; or
(iii) the encoded intracellular signaling domain of (a) comprises the amino acid sequence of SEQ ID NO:7 and the amino acid sequence of SEQ ID NO:9 or SEQ ID NO:10, wherein the sequences comprising the intracellular signaling domain are expressed in the same frame and as a single polypeptide chain; and/or
(iv) the nucleic acid sequence encoding the intracellular signaling domain of (a) comprises the nucleotide sequence of SEQ ID NO:18, or a nucleotide sequence with 95-99% identity thereof, and/or the nucleotide sequence of SEQ ID NO:20 or SEQ ID NO:21, or a nucleotide sequence with 95-99% identity thereof.
26. The method of claim 1 , wherein the nucleic acid molecule of (a) further comprises a leader sequence which encodes the amino acid sequence of SEQ ID NO:1.
27. The method of claim 1 , wherein the nucleic acid molecule of (a) encodes a CAR comprising:
(i) the amino acid sequence of SEQ ID NO: 99;
or
(ii) an amino acid sequence with 95-99% identity to SEQ ID NO: 99.
28. The method of claim 1 , wherein the nucleic acid molecule of (a) comprises the nucleotide sequence of SEQ ID NO: 40, or a nucleotide sequence with 95-99% identity to SEQ ID NO: 40.
29. The method of claim 1 , wherein the administering to the mammal comprises an effective amount of a population of immune effector cells.
30. The method of claim 1 , wherein the immune effector cell is a T cell or an NK cell.
31. The method of claim 2 , wherein the immune effector cell is a T cell or an NK cell.
32. The method of claim 1 , wherein the encoded CD123 binding domain of (a) further comprises a linker, and wherein the encoded linker comprises the amino acid sequence of SEQ ID NO: 38.
33. The method of claim 2 , wherein the encoded CD123 binding domain of (a) further comprises a linker, and wherein the encoded linker comprises the amino acid sequence of SEQ ID NO: 38.