TREATMENT OF CANCER USING GFR ALPHA-4 CHIMERIC ANTIGEN RECEPTOR

1 . An isolated nucleic acid molecule encoding a chimeric antigen receptor (CAR) comprising an antigen binding domain, a transmembrane domain, and an intracellular signaling domain, wherein the antigen binding domain binds to isoform a or isoform b of human Glycosyl-phosphatidylinositol (GPI)-linked GDNF family α-receptor 4 (GFRα 4) cell-surface receptor and comprises:

(a) a heavy chain variable region comprising a heavy chain complementary determining region 1 (HC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 43, a heavy chain complementary determining region 2 (HC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 45, and a heavy chain complementary determining region 3 (HC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 47; and

(b) a light chain complementary determining region 1 (LC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 51, a light chain complementary determining region 2 (LC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 53, and a light chain complementary determining region 3 (LC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 55.

2 .- 7 . (canceled)

8 . The isolated nucleic acid molecule of claim 1 , wherein the CAR comprises:

(a) a light chain variable region comprising an amino acid sequence having at least one, two or three modifications but not more than 20 or 10 modifications of the amino acid sequence of SEQ ID NO: 49; or

(b) a light chain variable region comprising an amino acid sequence with 95-99% identity to the amino acid sequence of SEQ ID NO: 49; or

(c) a light chain variable region comprising an amino acid sequence of SEQ ID NO: 49; or

(d) a heavy chain variable region comprising the amino acid sequence of SEQ ID NO: 41; or

(e) a heavy chain variable region comprising an amino acid sequence having at least one, two or three modifications but not more than 20 or 10 modifications of the amino acid sequence of SEQ ID NO: 41; or

(f) a heavy chain variable region comprising an amino acid sequence with 95-99% identity to the amino acid sequence of SEQ ID NO: 41; or

(g) the amino acid sequence of SEQ ID NO: 41 and the amino acid sequence of SEQ ID NO: 49.

9 .- 10 . (canceled)

11 . The isolated nucleic acid molecule of claim 1 , wherein the antigen binding domain comprises:

(a) the amino acid sequence selected from SEQ ID NO: 59 or SEQ ID NO: 58;

(b) an amino acid sequence having at least one, two or three modifications but not more than 30, 20 or 10 modifications to SEQ ID NO: 59 or SEQ ID NO: 58; or

(c) an amino acid sequence with 95-99% identity to SEQ ID NO: 59 or SEQ ID NO: 58.

12 . The isolated nucleic acid molecule of claim 1 , wherein the nucleic acid sequence comprises:

a) a nucleotide sequence selected from SEQ ID NO: 56 or SEQ ID NO: 57, or

(b) a nucleotide sequence with 95-99% identity to a nucleotide sequence selected from SEQ ID NO: 56 or SEQ ID NO: 57.

13 - 24 . (canceled)

25 . The isolated nucleic acid molecule of claim 1 , wherein the CAR comprises

(a) the amino acid sequence of any of SEQ ID NOs: 85, 94, 98, or 102; or

(b) an amino acid sequence having at least one, two or three modifications but not more than 30, 20 or 10 modifications to any of SEQ ID NOs: 85, 94, 98, or 102; or

(c) an amino acid sequence with 95-99% identity to any of SEQ ID NOs: 85, 94, 98, or 102;

(d) a nucleotide sequence of SEQ ID NO: 89, 93, 97, or 101; or

(e) a nucleotide sequence with 95-99% identity to SEQ ID NO: 89, 93, 97, or 101.

26 .- 57 . (canceled)

58 . A method of treating a mammal having a disease associated with expression of a Glycosyl-phosphatidylinositol (GPI)-linked GDNF family α-receptor 4 (GFRα4) cell-surface receptor, the method comprising administering to the mammal an effective amount of a cell comprising a chimeric antigen receptor (CAR) that binds to isoform a or isoform b of the GFRα4 cell-surface receptor,

wherein the CAR comprises an antigen binding domain, a transmembrane domain, and an intracellular signaling domain, and wherein the antigen binding domain comprises:

(a) a heavy chain variable region and a light chain variable region comprising:

(i) a heavy chain complementary determining region 1 (HC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 63, a heavy chain complementary determining region 2 (HC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 65, and a heavy chain complementary determining region 3 (HC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 67; and

(ii) a light chain complementary determining region 1 (LC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 71, a light chain complementary determining region 2 (LC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 73, and a light chain complementary determining region 3 (LC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 75; or

(b) a heavy chain variable region and a light chain variable region comprising:

(i) a heavy chain variable region comprising a heavy chain complementary determining region 1 (HC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 43, a heavy chain complementary determining region 2 (HC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 45, and a heavy chain complementary determining region 3 (HC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 47; and

(ii) a light chain complementary determining region 1 (LC CDR1) comprising the amino acid sequence set forth in SEQ ID NO: 51, a light chain complementary determining region 2 (LC CDR2) comprising the amino acid sequence set forth in SEQ ID NO: 53, and a light chain complementary determining region 3 (LC CDR3) comprising the amino acid sequence set forth in SEQ ID NO: 55.

59 . The method of claim 58 , wherein the CAR binds to isoform a or isoform b of the GFRα4 cell-surface receptor.

60 . The method of claim 58 , wherein the cell is administered in combination with one or more of:

(a) an agent that increases the efficacy of the cell comprising the CAR nucleic acid or the CAR polypeptide;

(b) an agent that ameliorates one or more side effects associated with administration of the cell comprising the CAR nucleic acid or the CAR polypeptide; or

(c) an agent that treats the disease associated with a GFRα4 cell surface receptor.

61 . The method of claim 58 , further comprising administering an antitumor vaccine.

62 . The method of claim 60 , wherein the cell and the antitumor vaccine are co-administered to the mammal or are administered separately.

63 . The method of claim 58 , wherein the disease associated with expression of a GFRα4 cell-surface receptor is a cancer.

64 . The method of claim 63 , wherein the cancer is medullary thyroid carcinoma (MTC).

65 . The method of claim 58 , wherein the mammal is a human.

66 .- 67 . (canceled)

68 . The method of claim 58 , wherein the cell further comprises an inhibitory molecule, and wherein the inhibitory molecule comprises a first polypeptide that comprises at least a portion of an inhibitory molecule, associated with a second polypeptide that comprises a positive signal from an intracellular signaling domain.

69 . The method of claim 68 , wherein the first polypeptide comprises at least a portion of PD-1 and the second polypeptide comprising a costimulatory domain and a primary signaling domain.

70 . The method of claim 58 , wherein the CAR comprises:

(a) a light chain variable region comprising an amino acid sequence having at least one, two or three modifications but not more than 20 or 10 modifications of the amino acid sequence set forth in SEQ ID NO: 69 or SEQ ID NO: 49; or

(b) a light chain variable region comprising an amino acid sequence with about 95% up to about 99% identity to the amino acid sequence set forth in SEQ ID NO: 69 or SEQ ID NO: 49; and/or

(c) a heavy chain variable region comprising an amino acid sequence having at least one, two or three modifications but not more than 20 or 10 modifications of the amino acid sequence set forth in SEQ ID NO: 61 or SEQ ID NO: 41; or

(d) a heavy chain variable region comprising an amino acid sequence with about 95 up to about 99% identity to the amino acid sequence set forth in SEQ ID NO: 61 or SEQ ID NO: 41; or

(e) the amino acid sequences set forth in SEQ ID NO: 61 and SEQ ID NO: 69; or

(f) the amino acid sequences set forth in SEQ ID NO: 41 and SEQ ID NO: 49.

71 . The method of claim 58 , wherein the CAR comprises:

(a) the amino acid sequence selected from SEQ ID NO: 58, SEQ ID NO: 59, SEQ ID NO: 78, or SEQ ID NO: 79;

(b) an amino acid sequence having at least one, two or three modifications but not more than 30, 20, or 10 modifications of SEQ ID NO: 58, SEQ ID NO: 59, SEQ ID NO: 78, or SEQ ID NO: 79; or

(c) an amino acid sequence with about 95 up to about 99% identity to SEQ ID NO: 58, SEQ ID NO: 59, SEQ ID NO: 78, or SEQ ID NO: 79.

72 . The method of claim 58 , wherein the transmembrane domain comprises:

(a) a transmembrane domain from 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;

(b) the amino acid sequence of SEQ ID NO: 6;

(c) an amino acid sequence comprising at least one, two or three modifications but not more than 5 modifications of the amino acid sequence of SEQ ID NO: 6; or

(d) a sequence with about 95 up to about 99% identity to the amino acid sequence of SEQ ID NO: 6.

73 . The method of claim 58 , wherein the antigen binding domain is connected to the transmembrane domain by a hinge region; and wherein the hinge region comprises the amino acid sequence of SEQ ID NO: 2, or a sequence with about 95% up to about 99% identity to SEQ ID NO: 2.

74 . The method of claim 58 , wherein the intracellular signaling domain comprises:

(a) the amino acid sequence of SEQ ID NO: 7; or

(b) an amino acid sequence having at least one, two or three modifications but not more than 10 or 5 modifications of the amino acid sequence of SEQ ID NO: 7; or

(c) a sequence with about 95% up to about 99% identity to the amino acid sequence of SEQ ID NO: 7; or

(d) a functional signaling domain of 4-1BB and/or a functional signaling domain of CD3 zeta; or

(e) the amino acid sequence of SEQ ID NO: 7 and/or the sequence of SEQ ID NO: 9 or SEQ ID NO: 10; or

(f) an amino acid sequence having at least one, two or three modifications but not more than 10 or 5 modifications of 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

(g) a sequence with about 95% up to about 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

(h) the sequence of SEQ ID NO: 7 and the sequence of SEQ ID NO: 9 or SEQ ID NO: 10, wherein the sequences comprising the intracellular signaling domain are expressed as a single polypeptide chain.

75 . The method of claim 58 , wherein the CAR further comprises:

(a) a leader sequence comprising the amino acid sequence of SEQ ID NO: 1; or

(b) a hinge region comprising the amino acid sequence of SEQ ID NO: 2, or a sequence with about 95 up to about 99% identity to SEQ ID NO: 2.

76 . The method of claim 58 , wherein the CAR comprises:

(a) the amino acid sequence of any of SEQ ID NOs: 85, 86, 90, 92, 94, 96, 98, 100, 102, or 104;

(b) an amino acid sequence having at least one, two or three modifications but not more than 30, 20 or 10 modifications to any of SEQ ID NOs: 85, 86, 90, 92, 94, 96, 98, 100, 102, or 104; or

(c) an amino acid sequence with about 95 up to about 99% identity to any of SEQ ID NOs: 85, 86, 90, 92, 94, 96, 98, 100, 102, or 104.