COMBINATION THERAPY WITH AN ANTI-AXL ANTIBODY-PBD CONJUGATE AND NANOCUPS
This disclosure relates to therapies in which an antibody drug conjugate is administered together with a composition comprising nanoscale cavitation initiators. Application of ultrasound following administration provides effective, targeted delivery of antibody drug conjugate to the diseased site. The therapies are useful in the treatment of solid tumour.
1 . An antibody drug conjugate for use in a method of treating a solid tumour in a subject, which method comprises administering to the subject:
(i) a pharmaceutical composition comprising a plurality of nanoparticles, each nanoparticle comprising:
a cup having a cavity, wherein the cavity has an opening of at least 50 nm in size, and
a gas pocket present in the cavity,
wherein the gas pocket is partially encapsulated by the cup, wherein the nanoparticle comprises a single nanocup having a single cavity, and wherein the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or diluent, which is a liquid medium; and
(ii) the antibody drug conjugate, wherein the antibody drug conjugate comprises an anti-AXL antibody conjugated to a pyrrolobenzodiazepine dimer;
and exposing the subject to ultrasound.
2 . The antibody drug conjugate for use according to claim 1 wherein the antibody comprises (i) an immunoglobulin heavy chain variable region having a CDR1 region with the amino acid sequence shown in SEQ ID NO: 3, a CDR2 region with the amino acid sequence shown in SEQ ID NO: 4, and a CDR3 region with the amino acid sequence shown in SEQ ID NO: 5; and (ii) an immunoglobulin light chain variable region having a CDR1 region with the amino acid sequence shown in SEQ ID NO: 6, a CDR2 region with the amino acid sequence shown in SEQ ID NO: 7, and a CDR3 region with the amino acid sequence shown in SEQ ID NO: 8.
3 . The antibody drug conjugate for use according to claim 2 wherein the antibody comprises an immunoglobulin heavy chain variable region having the amino acid sequence shown in SEQ ID NO: 1.
4 . The antibody drug conjugate for use according to claim 2 or claim 3 wherein the antibody comprises an immunoglobulin light chain variable region having the amino acid sequence shown in SEQ ID NO: 2.
5 . The antibody drug conjugate for use according to any one of the preceding claims where the antibody drug conjugate is of formula (I):
Ab-L-D (I)
wherein:
Ab is an antibody that binds to AXL; and
L-D is a drug linker of formula (II):
wherein:
(a) R LL is a linker for connection to Ab;
(b) (i) R 10 and R 11 together form a double bond between the nitrogen and carbon atoms to which they are attached; or (ii) R 10 is R-LA which is a linker for connection to Ab, and R 11 is OH; or (iii) R 10 is a capping group R C , and R 11 is OH;
(c) m is 0 or 1; and
(d) when there is a double bond between C2 and C3, R 2 is methyl;
when there is a single bond between C2 and C3, R 2 is either H or ;
when there is a double bond between C2′ and C3′, R 12 is methyl;
when there is a single bond between C2′ and C3′, R 12 is H or .
6 . The antibody drug conjugate for use according to claim 5 , wherein R LL is of formula (IIa):
wherein:
Q is:
where Q X is such that Q is an amino-acid residue, a dipeptide residue, a tripeptide residue or a tetrapeptide residue;
X is:
where a=0 to 5, b1=0 to 16, b2=0 to 16, c1=0 or 1, c2=0 or 1, d=0 to 5, wherein at least b1 or b2=0 and at least c1 or c2=0, and
G LL is a linker group connected to the antibody.
7 . The antibody drug conjugate for use according to any one of the preceding claims wherein the linker is a cleavable linker, such as a linker comprising a cathepsin cleavable sequence e.g. Val-Ala or Val-Cit.
8 . The antibody drug conjugate for use according to any one of the preceding claims where the cytotoxin is conjugated to the antibody at an endogenous and/or engineered N-linked glycosylation site.
9 . The antibody drug conjugate for use according to any one of claims 5 to 8 where L-D is compound B2.
10 . The antibody drug conjugate for use according to any one of the preceding claims , wherein at least a part of the cavity of each nanoparticle is substantially part-spherical, preferably wherein the cavity of each nanoparticle is substantially part-spherical.
11 . The antibody drug conjugate for use according to any one of the preceding claims , wherein the gas pocket is a bubble having a diameter of at least 50 nm, preferably from 150 to 250 nm.
12 . The antibody drug conjugate for use according to any one of the preceding claims , wherein each nanoparticle is from 300 to 600 nm in size.
13 . The antibody drug conjugate for use according to any one of the preceding claims , wherein the nanoparticles are polymeric nanoparticles, preferably the nanoparticles comprise cross-linked polymer.
14 . The antibody drug conjugate for use according to any one of the preceding claims , wherein the ultrasound has a pressure amplitude of from 1 MPa to 4 MPa.
15 . A method of treating a solid tumour in a subject, which method comprises administering to the subject:
(i) a pharmaceutical composition comprising a plurality of nanoparticles, each nanoparticle comprising:
a cup having a cavity, wherein the cavity has an opening of at least 50 nm in size, and
a gas pocket present in the cavity,
wherein the gas pocket is partially encapsulated by the cup, wherein the nanoparticle comprises a single nanocup having a single cavity, and wherein the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or diluent, which is a liquid medium; and
(ii) an antibody drug conjugate comprising an anti-AXL antibody conjugated to a pyrrolobenzodiazepine dimer;
and exposing the subject to ultrasound.