ANTI-TISSUE FACTOR ANTIBODY-DRUG CONJUGATES AND THEIR USE IN THE TREATMENT OF CANCER
The invention provides methods and compositions for treating cancer, such as advanced cervical cancer, in a subject, such as by the administration of antibody-drug conjugates that bind to tissue factor (TF). The invention also provides articles of manufacture and compositions comprising said antibody drug-conjugates that bind to TF for use in treating cancer (e.g., advanced cervical cancer).
1 . A method of treating cervical cancer in a subject, the method comprising administering to the subject an antibody-drug conjugate that binds to tissue factor (TF), wherein the antibody-drug conjugate comprises an anti-TF antibody or an antigen-binding fragment thereof conjugated to a monomethyl auristatin or a functional analog thereof or a functional derivative thereof, and wherein the antibody-drug conjugate is administered at a dose ranging from about 1.5 mg/kg to about 2.1 mg/kg.
2 . The method of claim 1 , wherein the dose is about 2.0 mg/kg.
3 . The method of claim 1 or claim 2 , wherein the antibody-drug conjugate is administered once about every 1 week, 2 weeks, 3 weeks or 4 weeks.
4 . The method of any one of claims 1 - 3 , wherein the antibody-drug conjugate is administered once about every 3 weeks.
5 . The method of any one of claims 1 - 4 , wherein the subject has been previously treated with one or more therapeutic agents and did not respond to the treatment, wherein the one or more therapeutic agents is not the antibody-drug conjugate.
6 . The method of any one of claims 1 - 4 , wherein the subject has been previously treated with one or more therapeutic agents and relapsed after the treatment, wherein the one or more therapeutic agents is not the antibody-drug conjugate.
7 . The method of any one of claims 1 - 4 , wherein the subject has been previously treated with one or more therapeutic agents and has experienced disease progression during treatment the, wherein the one or more therapeutic agents is not the antibody-drug conjugate.
8 . The method of any one of claims 5 - 7 , wherein the one or more therapeutic agents is a platinum-based therapeutic agent.
9 . The method of any one of claims 5 - 7 , wherein the one or more therapeutic agents is selected from the group consisting of: paclitaxel, cisplatin, carboplatin, topotecan, gemcitabine, fluorouracil, ixabepilone, imatinib mesylate, docetaxel, gefitinib, paclitaxel, pemetrexed, vinorelbine, doxil, cetuximab, pembrolizumab, nivolumab and bevacizumab.
10 . The method of any one of claims 1 - 9 , wherein the subject has experienced disease progression during or after treatment with:
a) paclitaxel and cisplatin,
b) paclitaxel and carboplatin, or
c) paclitaxel and topotecan.
11 . The method of any one of claims 1 - 10 , wherein the subject has received treatment with bevacizumab.
12 . The method of any one of claims 1 - 10 , wherein the subject is ineligible for treatment with bevacizumab.
13 . The method of any one of claims 1 - 12 , wherein the subject is not a candidate for curative therapy.
14 . The method of claim 13 , wherein the curative therapy comprises radiotherapy and/or exenterative surgery.
15 . The method of any one of claims 1 - 14 , wherein the subject did not respond to treatment with no more than two prior systemic treatment regimens.
16 . The method of any one of claims 1 - 14 , wherein the subject relapsed after treatment with no more than two prior systemic treatment regimens.
17 . The method of any one of claims 1 - 16 , wherein the cervical cancer is an adenocarcinoma, an adenosquamous carcinoma or a squamous cell carcinoma.
18 . The method of any one of claims 1 - 17 , wherein the cervical cancer is an advanced stage cervical cancer, such as a stage 3 or stage 4 cervical cancer, such as metastatic cervical cancer.
19 . The method of any one of claims 1 - 18 , wherein the cervical cancer is recurrent cervical cancer.
20 . The method of any one of claims 1 - 19 , wherein the monomethyl auristatin is monomethyl auristatin E (MMAE).
21 . The method of any one of claims 1 - 20 , wherein the anti-TF antibody or antigen-binding fragment thereof of the antibody-drug conjugate is a monoclonal antibody or a monoclonal antigen-binding fragment thereof.
22 . The method of any one of claims 1 - 21 , wherein the anti-TF antibody or antigen-binding fragment thereof of the antibody-drug conjugate comprises a heavy chain variable region and a light chain variable region, wherein the heavy chain variable region comprises:
(i) a CDR-H1 comprising the amino acid sequence of SEQ ID NO:1;
(ii) a CDR-H2 comprising the amino acid sequence of SEQ ID NO:2; and
(iii) a CDR-H3 comprising the amino acid sequence of SEQ ID NO:3; and
wherein the light chain variable region comprises:
(i) a CDR-L1 comprising the amino acid sequence of SEQ ID NO:4;
(ii) a CDR-L2 comprising the amino acid sequence of SEQ ID NO:5; and
(iii) a CDR-L3 comprising the amino acid sequence of SEQ ID NO:6, wherein the CDRs of the anti-TF antibody or antigen-binding fragment thereof of the antibody-drug conjugate are defined by the IMGT numbering scheme.
23 . The method of any one of claims 1 - 22 , wherein the anti-TF antibody or antigen-binding fragment thereof of the antibody-drug conjugate comprises a heavy chain variable region comprising an amino acid sequence at least 85% identical to the amino acid sequence of SEQ ID NO:7 and a light chain variable region comprising an amino acid sequence at least 85% identical to the amino acid sequence of SEQ ID NO:8.
24 . The method of any one of claims 1 - 23 , wherein the anti-TF antibody or antigen-binding fragment thereof of the antibody-drug conjugate comprises a heavy chain variable region comprising the amino acid sequence of SEQ ID NO:7 and a light chain variable region comprising the amino acid sequence of SEQ ID NO:8.
25 . The method of any one of claims 1 - 24 , wherein the anti-TF antibody of the antibody-drug conjugate is tisotumab.
26 . The method of any one of claims 1 - 25 , wherein the antibody-drug conjugate further comprises a linker between the anti-TF antibody or antigen-binding fragment thereof and the monomethyl auristatin.
27 . The method of claim 26 , wherein the linker is a cleavable peptide linker.
28 . The method of claim 27 , wherein the cleavable peptide linker has a formula: -MC-vc-PAB-, wherein:
a) MC is:
b) vc is the dipeptide valine-citrulline, and
c) PAB is:
29 . The method of any one of claims 26 - 28 , wherein the linker is attached to sulphydryl residues of the anti-TF antibody obtained by partial reduction or full reduction of the anti-TF antibody or antigen-binding fragment thereof.
30 . The method of claim 29 , wherein the linker is attached to MMAE, wherein the antibody-drug conjugate has the following-structure:
wherein p denotes a number from 1 to 8, S represents a sulphydryl residue of the anti-TF antibody, and Ab designates the anti-TF antibody or antigen-binding fragment thereof.
31 . The method of claim 30 , wherein the average value of p in a population of the antibody-drug conjugates is about 4.
32 . The method of any one of claims 1 - 31 , wherein the antibody-drug conjugate is tisotumab vedotin.
33 . The method of any one of claims 1 - 32 , wherein the route of administration for the antibody-drug conjugate is intravenous.
34 . The method of any one of claims 1 - 33 , wherein at least about 0.1%, at least about 1%, at least about 2%, at least about 3%, at least about 4%, at least about 5%, at least about 6%, at least about 7%, at least about 8%, at least about 9%, at least about 10%, at least about 15%, at least about 20%, at least about 25%, at least about 30%, at least about 35%, at least about 40%, at least about 45%, at least about 50%, at least about 60%, at least about 70%, or at least about 80% of the cervical cancer cells express TF.
35 . The method of any one of claims 1 - 34 , wherein one or more therapeutic effects in the subject is improved after administration of the antibody-drug conjugate relative to a baseline.
36 . The method of claim 35 , wherein the one or more therapeutic effects is selected from the group consisting of: size of a tumor derived from the cervical cancer, objective response rate, duration of response, time to response, progression free survival, and overall survival.
37 . The method of any one of claims 1 - 36 , wherein the size of a tumor derived from the cervical cancer is reduced by at least about 10%, at least about 15%, at least about 20%, at least about 25%, at least about 30%, at least about 35%, at least about 40%, at least about 45%, at least about 50%, at least about 60%, at least about 70%, or at least about 80% relative to the size of the tumor derived from the cervical cancer before administration of the antibody-drug conjugate.
38 . The method of any one of claims 1 - 37 , wherein the objective response rate is at least about 20%, at least about 25%, at least about 30%, at least about 35%, at least about 40%, at least about 45%, at least about 50%, at least about 60%, at least about 70%, or at least about 80%.
39 . The method of any one of claims 1 - 38 , wherein the subject exhibits progression-free survival of at least about 1 month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about 11 months, at least about 12 months, at least about eighteen months, at least about two years, at least about three years, at least about four years, or at least about five years after administration of the antibody-drug conjugate.
40 . The method of any one of claims 1 - 39 , wherein the subject exhibits overall survival of at least about 1 month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about 11 months, at least about 12 months, at least about eighteen months, at least about two years, at least about three years, at least about four years, or at least about five years after administration of the antibody-drug conjugate.
41 . The method of any one of claims 1 - 40 , wherein the duration of response to the antibody-drug conjugate is at least about 1 month, at least about 2 months, at least about 3 months, at least about 4 months, at least about 5 months, at least about 6 months, at least about 7 months, at least about 8 months, at least about 9 months, at least about 10 months, at least about 11 months, at least about 12 months, at least about eighteen months, at least about two years, at least about three years, at least about four years, or at least about five years after administration of the antibody-drug conjugate.
42 . The method of any one of claims 1 - 41 , wherein the subject has one or more adverse events and is further administered an additional therapeutic agent to eliminate or reduce the severity of the one or more adverse events.
43 . The method of any one of claims 1 - 41 , wherein the subject is at risk of developing one or more adverse events and is further administered an additional therapeutic agent to prevent or reduce the severity of the one or more adverse events.
44 . The method of claim 42 or claim 43 , wherein the one or more adverse events is anemia, abdominal pain, hypokalemia, hyponatremia, epistaxis, fatigue, nausea, alopecia, conjunctivitis, constipation, decreased appetite, diarrhea, vomiting, peripheral neuropathy, or general physical health deterioration.
45 . The method of claim 42 or claim 43 , wherein the one or more adverse events is a grade 3 or greater adverse event.
46 . The method of claim 42 or claim 43 , wherein the one or more adverse events is a serious adverse event.
47 . The method of claim 42 or claim 43 , wherein the one or more adverse events is conjunctivitis and/or keratitis and the additional agent is a preservative-free lubricating eye drop, an ocular vasoconstrictor and/or a steroid eye drop.
48 . The method of any one of claims 1 - 47 , wherein the antibody-drug conjugate is administered as a monotherapy.
49 . The method of any one of claims 1 - 48 , wherein the subject is a human.
50 . The method of any one of claims 1 - 49 , wherein the antibody-drug conjugate is in a pharmaceutical composition comprising the antibody-drug conjugate and a pharmaceutical acceptable carrier.