Combination therapy involving antibodies against Claudin 18.2 for treatment of cancer
The present invention provides a combination therapy for effectively treating and/or preventing diseases associated with cells expressing CLDN18.2, including cancer diseases such as gastric cancer, esophageal cancer, pancreatic cancer, lung cancer, ovarian cancer, colon cancer, hepatic cancer, head-neck cancer, and cancer of the gallbladder and metastases thereof.
1. A method of treating a cancer disease characterized by cells expressing claudin 18 splice variant 2, comprising administering to a patient an antibody having the ability of binding to claudin 18 splice variant 2 (CLDN18.2) in combination with an agent stabilizing or increasing expression of CLDN18.2, wherein the agent stabilizing or increasing expression of CLDN18.2 is selected from the group consisting of anthracyclines, platinum compounds, nucleoside analogs, taxanes, camptothecin analogs, prodrugs thereof, and combinations thereof,
wherein the antibody comprises a heavy chain variable region (VH) having a CDR1 of positions 45-52 of SEQ ID NO: 17, a CDR2 of positions 70-77 of SEQ ID NO: 17, and a CDR3 of positions 116-126 of SEQ ID NO: 17, and a light chain variable region (VL) having a CDR1 of positions 47-58 of SEQ ID NO: 24, a CDR2 of positions 76-78 of SEQ ID NO: 24, and a CDR3 of positions 115-123 of SEQ ID NO: 24.
2. The method of claim 1 , comprising administering an agent stimulating γδ T cells, wherein the agent stimulating γδ T cells is a bisphosphonate.
3. The method of claim 1 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises at least one anthracycline, at least one platinum compound and at least one of 5-fluorouracil and prodrugs thereof.
4. The method of claim 1 , wherein the taxane is selected from docetaxel and paclitaxel.
5. The method of claim 1 , wherein the camptothecin analog is selected from the group consisting of irinotecan and topotecan.
6. The method of claim 1 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises (i) epirubicin, oxaliplatin and 5-fluorouracil, (ii) epirubicin, oxaliplatin and capecitabine, (iii) epirubicin, cisplatin and 5-fluorouracil, (iv) epirubicin, cisplatin and capecitabine, or (v) folinic acid, oxaliplatin and 5-fluorouracil.
7. The method of claim 2 , wherein the bisphosponate is selected from the group consisting of zoledronic acid, clodronic acid, ibandronic acid, pamidronic acid, risedronic acid, minodronic acid, olpadronic acid, alendronic acid, incadronic acid and salts thereof.
8. The method of claim 1 , comprising administering to the patient interleukin-2.
9. The method of claim 2 , comprising administering to the patient interleukin-2.
10. The method of claim 1 , wherein the antibody having the ability of binding to CLDN18.2 mediates cell killing by one or more of complement dependent cytotoxicity (CDC) mediated lysis, antibody dependent cellular cytotoxicity (ADCC) mediated lysis, induction of apoptosis and inhibition of proliferation.
11. The method of claim 1 , wherein the antibody having the ability of binding to CLDN18.2 is an antibody selected from the group consisting of (i) an antibody produced by and/or obtainable from a clone deposited under the accession no. DSM ACC2810, (ii) an antibody which is a chimerized or humanized form of the antibody under (i), and (iii) an antibody comprising the antigen binding portion or antigen binding site, in particular the variable region, of the antibody under (i) and preferably having the specificity of the antibody under (i).
12. The method of claim 1 , wherein the cancer disease is selected from the group consisting of esophageal adenocarcinoma, pancreatic adenocarcinoma, lung adenocarcinoma, cancer of the stomach, cancer of the esophagus, in particular the lower esophagus, gastric cancer, cancer of the eso-gastric junction and gastroesophageal cancer.
13. The method of claim 3 , wherein the at least one anthracycline is epirubicin.
14. The method of claim 3 , wherein the at least one platinum compound is selected from the group consisting of oxaliplatin and cisplatin.
15. The method of claim 3 , wherein the at least one anthracycline is epirubicin, the at least one platinum compound is oxaliplatin, and the at least one of 5-fluorouracil and prodrugs thereof is 5-fluorouracil or capecitabine.
16. The method of claim 1 , wherein the antibody has a heavy chain variable region comprising an amino acid sequence represented by SEQ ID NO: 32.
17. The method of claim 1 , wherein the antibody has a light chain variable region comprising an amino acid sequence represented by SEQ ID NO: 39.
18. The method of claim 1 , wherein the antibody has a heavy chain variable region comprising an amino acid sequence represented by SEQ ID NO: 32 and a light chain variable region comprising an amino acid sequence represented by SEQ ID NO: 39.
19. A method of treating a cancer disease characterized by cells expressing claudin 18 splice variant 2, comprising administering to a patient an antibody having the ability of binding to claudin 18 splice variant 2 (CLDN18.2) in combination with an agent stabilizing or increasing expression of CLDN18.2, wherein the agent stabilizing or increasing expression of CLDN18.2 comprises at least one platinum compound and at least one of 5-fluorouracil and prodrugs thereof,
wherein the antibody comprises a heavy chain variable region (VH) having a CDR1 of positions 45-52 of SEQ ID NO: 17, a CDR2 of positions 70-77 of SEQ ID NO: 17, and a CDR3 of positions 116-126 of SEQ ID NO: 17, and a light chain variable region (VL) having a CDR1 of positions 47-58 of SEQ ID NO: 24, a CDR2 of positions 76-78 of SEQ ID NO: 24, and a CDR3 of positions 115-123 of SEQ ID NO: 24.
20. The method of claim 1 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises (i) oxaliplatin and 5-fluorouracil, (ii) oxaliplatin and capecitabine, (iii) cisplatin and 5-fluorouracil, (iv) cisplatin and capecitabine, or (v) folinic acid, oxaliplatin, and 5-fluorouracil.
21. The method of claim 19 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises (i) oxaliplatin and 5-fluorouracil, (ii) oxaliplatin and capecitabine, (iii) cisplatin and 5-fluorouracil, (iv) cisplatin and capecitabine, or (v) folinic acid, oxaliplatin, and 5-fluorouracil.
22. The method of claim 19 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises folinic acid, oxaliplatin, and 5-fluorouracil.
23. The method of claim 19 , wherein the antibody having the ability of binding to CLDN18.2 mediates cell killing by one or more of complement dependent cytotoxicity (CDC) mediated lysis, antibody dependent cellular cytotoxicity (ADCC) mediated lysis, induction of apoptosis and inhibition of proliferation.
24. The method of claim 19 , wherein the antibody having the ability of binding to CLDN18.2 is an antibody selected from the group consisting of (i) an antibody produced by and/or obtainable from a clone deposited under the accession no. DSM ACC2810, (ii) an antibody which is a chimerized or humanized form of the antibody under (i), and (iii) an antibody comprising the antigen binding portion or antigen binding site, in particular the variable region, of the antibody under (i) and preferably having the specificity of the antibody under (i).
25. The method of claim 19 , wherein the cancer disease is selected from the group consisting of esophageal adenocarcinoma, pancreatic adenocarcinoma, lung adenocarcinoma, cancer of the stomach, cancer of the esophagus, in particular the lower esophagus, gastric cancer, cancer of the eso-gastric junction and gastroesophageal cancer.
26. The method of claim 19 , wherein the antibody has a heavy chain variable region comprising an amino acid sequence represented by SEQ ID NO: 32.
27. The method of claim 19 , wherein the antibody has a light chain variable region comprising an amino acid sequence represented by SEQ ID NO: 39.
28. The method of claim 19 , wherein the antibody has a heavy chain variable region comprising an amino acid sequence represented by SEQ ID NO: 32 and a light chain variable region comprising an amino acid sequence represented by SEQ ID NO: 39.
29. The method of claim 28 , wherein the agent stabilizing or increasing expression of CLDN18.2 comprises folinic acid, oxaliplatin, and 5-fluorouracil.
30. The method of claim 28 , wherein the antibody is a chimeric antibody comprising a human kappa light chain constant region and a human IgG1 heavy chain constant region.
31. The method of claim 28 , wherein the human kappa light chain constant region is allotype Km(3) and/or the human IgG1 heavy chain constant region is allotype G1m(3).
32. The method of claim 28 , wherein the human kappa light chain constant region comprises an amino acid sequence represented by SEQ ID NO: 12 and the human IgG1 heavy chain constant region comprises an amino acid sequence represented by SEQ ID NO: 13.