Combination immuno therapy and radiotherapy for the treatment of Her-2-positive cancers

1. A method of treating a Her-2/neu-expressing tumor growth or cancer in a subject comprising the step of administering a combination of radiation therapy and a recombinant attenuated Listeria strain comprising a nucleic acid comprising a first open reading frame encoding a fusion polypeptide comprising a Her-2/neu chimeric antigen fused to an additional polypeptide, said Her-2/neu chimeric antigen comprises amino acids as set forth in SEQ ID NO: 2, and a second open reading frame encoding a metabolic enzyme, wherein said metabolic enzyme complements an endogenous gene that is mutated in the chromosome of said recombinant attenuated Listeria strain, and wherein the administration of said radiation therapy comprises at least two administrations of said radiation therapy.

2. The method of claim 1 , wherein said subject is a human adult or child.

3. The method of claim 1 , wherein said subject is a canine.

4. The method of claim 1 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the mapped human MHC-class I epitopes.

5. The method of claim 1 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the canine MHC-class I epitopes.

6. The method of claim 1 , wherein said nucleic acid molecule is integrated into the Listeria genome.

7. The method of claim 1 , wherein said nucleic acid molecule is in a plasmid in said recombinant attenuated Listeria strain and wherein said plasmid is stably maintained in said recombinant attenuated Listeria strain in the absence of antibiotic selection.

8. The method of claim 1 , wherein said recombinant Listeria comprises a deletion in the actA virulence gene.

9. The method of claim 1 , wherein said additional polypeptide is selected from the group consisting of: a) non-hemolytic LLO protein or N-terminal fragment, b) a PEST sequence, or c) an ActA fragment.

10. The method of claim 1 , wherein said metabolic enzyme encoded by said second open reading frame is an alanine racemase enzyme or a D-amino acid transferaseenzyme.

11. The method of claim 1 , wherein said recombinant attenuated Listeria strain is ADXS31-164.

12. The method of claim 1 , wherein said recombinant attenuated Listeria strain is administered with an independent adjuvant, wherein said adjuvant comprises a granulocyte/macrophage colony-stimulating factor (GM-CSP) protein, a nucleotide molecule encoding a GM-CSP protein, saponin QS21, monophosphoryl lipid A, or an unmethylated CpG-containing oligonucleotide.

13. The method of claim 1 , wherein said radiation therapy is administered prior to administration of said recombinant attenuated Listeria strain.

14. The method of claim 1 , wherein said cancer is osteosarcoma.

15. A method of eliciting an enhanced immune response against a Her-2/neu-expressing tumor growth or cancer in a subject comprising the step of administering a combination of radiation therapy and a recombinant attenuated Listeria strain comprising a nucleic acid comprising a first open reading frame encoding a fusion polypeptide comprising a Her-2/neu chimeric antigen fused to an additional polypeptide, said Her-2/neu chimeric antigen comprises amino acids as set forth in SEQ ID NO: 2, and a second open reading frame encoding a metabolic enzyme, wherein said metabolic enzyme complements an endogenous gene that is mutated in the chromosome of said recombinant attenuated Listeria strain, and wherein the administration of said radiation therapy comprises at least two administrations of said radiation therapy.

16. The method of claim 15 , wherein said subject is a human adult or child.

17. The method of claim 15 , wherein said subject is a canine.

18. The method of claim 15 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the mapped human MHC-class I epitopes.

19. The method of claim 15 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the canine MHC-class I epitopes.

20. The method of claim 15 , wherein said nucleic acid molecule is integrated into the Listeria genome.

21. The method of claim 15 , wherein said nucleic acid molecule is in a plasmid in said recombinant attenuated Listeria strain and wherein said plasmid is stably maintained in said recombinant attenuated Listeria strain in the absence of antibiotic selection.

22. The method of claim 15 , wherein said recombinant Listeria comprises a deletion in the actA virulence gene.

23. The method of claim 15 , wherein said additional polypeptide is selected from the group consisting of: a) non-hemolytic LLO protein or N-terminal fragment, b) a PEST sequence, or c) an ActA fragment.

24. The method of claim 15 , wherein said metabolic enzyme encoded by said second open reading frame is an alanine racemase enzyme or a D-amino acid transferase enzyme.

25. The method of claim 15 , wherein said recombinant attenuated Listeria strain is ADXS31-164.

26. The method of claim 15 , wherein said recombinant attenuated Listeria strain is administered with an independent adjuvant, wherein said adjuvant comprises a granulocyte/macrophage colony-stimulating factor (GM-CSP) protein, a nucleotide molecule encoding a GM-CSP protein, saponin QS21, monophosphoryl lipid A, or an unmethylated CpG-containing oligonucleotide.

27. The method of claim 15 , wherein said radiation therapy is administered prior to administration of said recombinant attenuated Listeria strain.

28. The method of claim 15 , wherein said cancer is osteosarcoma.

29. The method of claim 15 , wherein said tumor growth or cancer is a relapse or metastasis.

30. The method of claim 29 , wherein said metastasis is pulmonary metastatic disease.

31. The method of claim 15 , wherein said eliciting an enhanced immune response results in an increased Her-2/neu specific T cell response.

32. A method of prolonging survival in a subject suffering from a Her-2/neu-expressing tumor growth or cancer comprising the step of administering a combination of radiation therapy and a recombinant attenuated Listeria strain comprising a nucleic acid comprising a first open reading frame encoding a fusion polypeptide comprising a Her-2/neu chimeric antigen fused to an additional polypeptide, said Her-2/neu chimeric antigen comprises amino acids as set forth in SEQ ID NO: 2, and a second open reading frame encoding a metabolic enzyme, wherein said metabolic enzyme complements an endogenous gene that is mutated in the chromosome of said recombinant attenuated Listeria strain, and wherein the administration of said radiation therapy comprises at least two administrations of said radiation therapy.

33. The method of claim 32 , wherein said subject is a human adult or child.

34. The method of claim 32 , wherein said subject is a canine.

35. The method of claim 32 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the mapped human MHC-class I epitopes.

36. The method of claim 32 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the canine MHC-class I epitopes.

37. The method of claim 32 , wherein said nucleic acid molecule is integrated into the Listeria genome.

38. The method of claim 32 , wherein said nucleic acid molecule is in a plasmid in said recombinant attenuated Listeria strain and wherein said plasmid is stably maintained in said recombinant attenuated Listeria strain in the absence of antibiotic selection.

39. The method of claim 32 , wherein said recombinant Listeria comprises a deletion in the actA virulence gene.

40. The method of claim 32 , wherein said additional polypeptide is selected from the group consisting of: a) non-hemolytic LLO protein or N-terminal fragment, b) a PEST sequence, or c) an ActA fragment.

41. The method of claim 32 , wherein said metabolic enzyme encoded by said second open reading frame is an alanine racemase enzyme or a D-amino acid transferase enzyme.

42. The method of claim 32 , wherein said recombinant attenuated Listeria strain is ADXS31-164.

43. The method of claim 32 , wherein said recombinant attenuated Listeria strain is administered with an independent adjuvant, wherein said adjuvant comprises a granulocyte/macrophage colony-stimulating factor (GM-CSP) protein, a nucleotide molecule encoding a GM-CSP protein, saponin QS21, monophosphoryl lipid A, or an unmethylated CpG-containing oligonucleotide.

44. The method of claim 32 , wherein said radiation therapy is administered prior to administration of said recombinant attenuated Listeria strain.

45. The method of claim 32 , wherein said cancer is osteosarcoma.

46. The method of claim 32 , wherein said tumor growth or cancer is a relapse or metastasis.

47. The method of claim 46 , wherein said metastasis is pulmonary metastatic disease.

48. A method of delaying metastatic disease in a subject suffering from a Her-2/neu-expressing tumor growth or cancer comprising the step of administering a combination of radiation therapy and a recombinant attenuated Listeria strain comprising a nucleic acid comprising a first open reading frame encoding a fusion polypeptide comprising a Her-2/neu chimeric antigen fused to an additional polypeptide, said Her-2/neu chimeric antigen comprises amino acids as set forth in SEQ ID NO: 2, and a second open reading frame encoding a metabolic enzyme, wherein said metabolic enzyme complements an endogenous gene that is mutated in the chromosome of said recombinant attenuated Listeria strain, and wherein the administration of said radiation therapy comprises at least two administrations of said radiation therapy.

49. The method of claim 48 , wherein said subject is a human adult or child.

50. The method of claim 48 , wherein said subject is a canine.

51. The method of claim 48 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the mapped human MHC-class I epitopes.

52. The method of claim 1 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the canine MHC-class I epitopes.

53. The method of claim 48 , wherein said nucleic acid molecule is integrated into the Listeria genome.

54. The method of claim 48 , wherein said nucleic acid molecule is in a plasmid in said recombinant attenuated Listeria strain and wherein said plasmid is stably maintained in said recombinant attenuated Listeria strain in the absence of antibiotic selection.

55. The method of claim 48 , wherein said recombinant Listeria comprises a deletion in the actA virulence gene.

56. The method of claim 48 , wherein said additional polypeptide is selected from the group consisting of: a) non-hemolytic LLO protein or N-terminal fragment, b) a PEST sequence, or c) an ActA fragment.

57. The method of claim 48 , wherein said metabolic enzyme encoded by said second open reading frame is an alanine racemase enzyme or a D-amino acid transferaseenzyme.

58. The method of claim 48 , wherein said recombinant attenuated Listeria strain is ADXS31-164.

59. The method of claim 48 , wherein said recombinant attenuated Listeria strain is administered with an independent adjuvant, wherein said adjuvant comprises a granulocyte/macrophage colony-stimulating factor (GM-CSP) protein, a nucleotide molecule encoding a GM-CSP protein, saponin QS21, monophosphoryl lipid A, or an unmethylated CpG-containing oligonucleotide.

60. The method of claim 48 , wherein said radiation therapy is administered prior to administration of said recombinant attenuated Listeria strain.

61. The method of claim 48 , wherein said cancer is osteosarcoma.

62. The method of claim 48 , wherein said tumor growth or cancer is a relapse or metastasis.

63. The method of claim 62 , wherein said metastasis is pulmonary metastatic disease.

64. A method of breaking tolerance to Her-2/neu in a subject suffering from a Her-2/neu-expressing tumor growth or cancer comprising the step of administering a combination of radiation therapy and a recombinant attenuated Listeria strain comprising a nucleic acid comprising a first open reading frame encoding a fusion polypeptide comprising a Her-2/neu chimeric antigen fused to an additional adjuvant, said Her-2/neu chimeric antigen comprises amino acids as set forth in SEQ ID NO: 2, and a second open reading frame encoding a metabolic enzyme, wherein said metabolic enzyme complements an endogenous gene that is mutated in the chromosome of said recombinant attenuated Listeria strain, and wherein the administration of said radiation therapy comprises at least two administrations of said radiation therapy.

65. The method of claim 64 , wherein said subject is a human adult or child.

66. The method of claim 64 , wherein said subject is a canine.

67. The method of claim 64 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the mapped human MHC-class I epitopes.

68. The method of claim 64 , wherein said Her-2/neu chimeric antigen comprises at least 5, 9, 13, 14, or 17 of the canine MHC-class I epitopes.

69. The method of claim 64 , wherein said nucleic acid molecule is integrated into the Listeria genome.

70. The method of claim 64 , wherein said nucleic acid molecule is in a plasmid in said recombinant attenuated Listeria strain and wherein said plasmid is stably maintained in said recombinant attenuated Listeria strain in the absence of antibiotic selection.

71. The method of claim 64 , wherein said recombinant Listeria comprises a deletion in the actA virulence gene.

72. The method of claim 64 , wherein said additional polypeptide is selected from the group consisting of: a) non-hemolytic LLO protein or N-terminal fragment, b) a PEST sequence, or c) an ActA fragment.

73. The method of claim 64 , wherein said metabolic enzyme encoded by said second open reading frame is an alanine racemase enzyme or a D-amino acid transferaseenzyme.

74. The method of claim 64 , wherein said recombinant attenuated Listeria strain is ADXS31-164.

75. The method of claim 64 , wherein said recombinant attenuated Listeria strain is administered with an independent adjuvant, wherein said adjuvant comprises a granulocyte/macrophage colony-stimulating factor (GM-CSP) protein, a nucleotide molecule encoding a GM-CSP protein, saponin QS21, monophosphoryl lipid A, or an unmethylated CpG-containing oligonucleotide.

76. The method of claim 64 , wherein said radiation therapy is administered prior to administration of said recombinant attenuated Listeria strain.

77. The method of claim 64 , wherein said cancer is osteosarcoma.

78. The method of claim 64 , wherein said tumor growth or cancer is a relapse or metastasis.

79. The method of claim 78 , wherein said metastasis is pulmonary metastatic disease.

80. The method of claim 1 , wherein said tumor growth or cancer is a relapse or metastasis.

81. The method of claim 80 , wherein said metastasis is pulmonary metastatic disease.