Treatment of cancer using humanized anti-CD19 chimeric antigen receptor
The invention provides compositions and methods for treating diseases associated with expression of CD19. The invention also relates to chimeric antigen receptor (CAR) specific to CD19, vectors encoding the same, and recombinant T cells comprising the CD19 CAR. The invention also includes methods of administering a genetically modified T cell expressing a CAR that comprises a CD19 binding domain.
1 . A method of providing an anti-tumor immunity in a mammal having a hematological cancer that is positive for CD19 comprising administering to the mammal an effective amount of a monotherapy comprising a cell expressing a chimeric antigen receptor (CAR) molecule, wherein the CAR molecule comprises a humanized anti-CD19 binding domain, a transmembrane domain, and an intracellular signaling domain, wherein the humanized anti-CD19 binding domain comprises a light chain complementarity determining region 1 (LC CDR1) of SEQ ID NO: 25, a light chain complementarity determining region 2 (LC CDR2) of SEQ ID NO: 26, a light chain complementarity determining region 3 (LC CDR3) of SEQ ID NO: 27, a heavy chain complementarity determining region 1 (HC CDR1) of SEQ ID NO: 19, a heavy chain complementarity determining region 2 (HC CDR2) of SEQ ID NO: 21, 22, or 23, and a heavy chain complementarity determining region 3 (HC CDR3) of SEQ ID NO: 24.
2 . The method of claim 1 , wherein the cell is an autologous T cell or an allogenic T cell.
3 . The method of claim 1 , wherein the mammal is a human.
4 . A method of treating a mammal having a hematological cancer that is positive for CD19 comprising administering to the mammal an effective amount of a monotherapy comprising a cell comprising a chimeric antigen receptor (CAR) molecule, wherein the CAR molecule comprises a humanized anti-CD19 binding domain, a transmembrane domain, and an intracellular signaling domain, wherein the humanized anti-CD19 binding domain comprises a light chain complementarity determining region 1 (LC CDR1) of SEQ ID NO: 25, a light chain complementarity determining region 2 (LC CDR2) of SEQ ID NO: 26, a light chain complementarity determining region 3 (LC CDR3) of SEQ ID NO: 27, a heavy chain complementarity determining region 1 (HC CDR1) of SEQ ID NO: 19, a heavy chain complementarity determining region 2 (HC CDR2) of SEQ ID NO: 21, 22, or 23, and a heavy chain complementarity determining region 3 (HC CDR3) of SEQ ID NO: 24.
5 . The method of claim 4 , wherein the hematological cancer that is positive for CD19 is selected from the group consisting of B-cell acute lymphoblastic leukemia (“BALL”), T-cell acute lymphoblastic leukemia (“TALL”), acute lymphoblastic leukemia (ALL); chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL); B cell prolymphocytic leukemia, Burkitt's lymphoma, diffuse large B cell lymphoma, follicular lymphoma, hairy cell leukemia, small cell- or a large cell-follicular lymphoma, MALT lymphoma, mantle cell lymphoma, Marginal zone lymphoma, myelodysplasia and myelodysplastic syndrome, non-Hodgkin's lymphoma, plasmablastic lymphoma, Waldenstrom macroglobulinemia, and combinations thereof.
6 . The method of claim 4 , wherein the cells expressing a CAR molecule are administered at a dose of 10 4 to 10 9 cells/kg body weight, 10 5 to 10 6 cells/kg body weight, 1.4 ×10 7 to 1.1×10 9 cells per dose, up to 5×10 7 , 1×10 7 -5×10 8 , or 1×10 8 -5×10 8 cells per dose.
7 . The method of claim 4 , wherein the humanized anti-CD19 binding domain is a scFv.
8 . The method of claim 4 , wherein the humanized anti-CD19 binding domain comprises:
(a) a light chain variable region listed in any of SEQ ID NOs: 1-12 and a heavy chain variable region listed in any of SEQ ID NOs: 1-12;
(b) a light chain variable region comprising an amino acid sequence having at least one, two, or three modifications but not more than 30, 20, or 10 modifications of an amino acid sequence of a light chain variable region listed in any of SEQ ID NOs: 1-12, or a sequence with at least 95% identity to an amino acid sequence of a light chain variable region listed in any of SEQ ID NOs: 1-12;
(c) a heavy chain variable region comprising an amino acid sequence having at least one, two, or three modifications but not more than 30, 20, or 10 modifications of an amino acid sequence of a heavy chain variable region listed in any of SEQ ID NOs: 1-12, or a sequence with at least 95% identity to an amino acid sequence of a heavy chain variable region listed in any of SEQ ID NOs: 1-12; or
(d) both (b) and (c).
9 . The method of claim 4 , wherein the humanized anti-CD19 binding domain comprises a sequence selected from the group consisting of SEQ ID NO:1, SEQ ID NO:2, SEQ ID NO:3, SEQ ID NO: 4, SEQ ID NO:5, SEQ ID NO:6, SEQ ID NO:7, SEQ ID NO:8, SEQ ID NO:9, SEQ ID NO:10, SEQ ID NO:11, and SEQ ID NO:12, or a sequence with at least 95% identity thereto.
10 . The method of claim 4 , wherein the CAR molecule further comprises:
(a) 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, CD5, CD8, CD9, CD16, CD22, CD33, CD37, CD64, CD80, CD86, CD134, CD137, and CD154; or
(b) a transmembrane domain comprising:
(i) the amino acid sequence of SEQ ID NO: 15; or
(ii) an amino acid sequence having at least one, two, or three modifications but not more than 20, 10, or 5 modifications of the amino acid sequence of SEQ ID NO: 15, or a sequence with at least 95% identity to the amino acid sequence of SEQ ID NO: 15.
11 . The method of claim 10 , wherein the humanized anti-CD19 binding domain is connected to the transmembrane domain by a hinge region.
12 . The method of claim 11 , wherein the hinge region comprises the amino acid sequence of SEQ ID NO:14 or SEQ ID NO:102, or a sequence with at least 95% identity thereto.
13 . The method of claim 4 wherein the CAR molecule further comprises a costimulatory domain.
14 . The method of claim 13 , wherein the costimulatory domain comprises a functional signaling domain of a protein selected from the group consisting of OX40, CD2, CD27, CD28, ICAM-1, LFA-1 (CD11a/CD18), and 4-1BB (CD137).
15 . The method of claim 14 , wherein the costimulatory domain comprises:
(i) the amino acid sequence of SEQ ID NO: 16; or
(ii) an amino acid sequence having at least one, two, or three modifications but not more than 20, 10, or 5 modifications of the amino acid sequence of SEQ ID NO: 16, or a sequence with at least 95% identity to the amino acid sequence of SEQ ID NO: 16.
16 . The method of claim 1 , wherein the CAR molecule further comprises an intracellular signaling domain.
17 . The method of claim 16 , wherein the intracellular signaling domain comprises a functional signaling domain of 4-1BB and/or a functional signaling domain of CD3 zeta.
18 . The method of claim 16 , wherein the intracellular signaling domain comprises:
(i) the amino acid sequence of SEQ ID NO: 16 and/or the amino acid sequence of SEQ ID NO:17;
(ii) the amino acid sequence of SEQ ID NO:16 and/or the amino acid sequence of SEQ ID NO:43;
(iii) an amino acid sequence having at least one, two, or three modifications but not more than 20, 10, or 5 modifications of the amino acid sequence of SEQ ID NO:16 and/or the amino acid sequence of SEQ ID NO:17 or SEQ ID NO:43, or a sequence with at least 95% identity to the amino acid sequence of SEQ ID NO:16 and/or the amino acid sequence of SEQ ID NO:17 or SEQ ID NO:43; or
(iv) the amino acid sequence of SEQ ID NO: 16 and the amino acid sequence of SEQ ID NO: 17 or SEQ ID NO:43, wherein the sequences comprising the intracellular signaling domain are expressed in the same frame and as a single polypeptide chain.
19 . The method of claim 4 , wherein the CAR molecule further comprises a leader sequence.
20 . The method of claim 19 , wherein the leader sequence comprises the amino acid sequence of SEQ ID NO: 13, or a sequence with at least 95% identity to the amino acid sequence of SEQ ID NO:13.
21 . The method of claim 4 , wherein the CAR molecule comprises, from N-terminus to C-terminus:
a humanized anti-CD19 binding domain comprising the amino acid sequence of SEQ ID NO: 2,
a transmembrane domain comprising the amino acid sequence of SEQ ID NO: 15,
a costimulatory domain comprising the amino acid sequence of SEQ ID NO: 16, and
a primary intracellular signaling domain comprising the amino acid sequence of SEQ ID NO: 17 or SEQ ID NO: 43.