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Potent Immunity Achieved by Targeted, Sequential Administration of Recombinant DNA Vectors and Anchor-Modified Epitope Peptides

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Potent Immunity Achieved by

Potent Immunity Achieved by

Targeted, Sequential Administration

Targeted, Sequential Administration

of Recombinant DNA Vectors and

of Recombinant DNA Vectors and

Anchor

Anchor

-

-

Modified

Modified

Epitope

Epitope

Peptides

Peptides

Adrian Bot, M.D., Ph.D.

MannKind Corporation

(2)

MannKind Corporation, Valencia CA

¾

Diabetes



Late stage development

¾

Oncology

(3)

Plasmid Vectors: a Typical

Case of Yin & Yang

Features

Features

¾

¾

Co

Co

-

-

expression

expression

of

of

Tc

Tc

and

and

Th

Th

epitopes

epitopes

¾

¾

CpG

CpG

motifs

motifs

Response

Response

¾

¾

T1 immune

T1 immune

profile

profile

¾

¾

Limited

Limited

magnitude

pSEM

3315 bp

2: Melan A minigene

3:BGH polyadenylation region

7:Nuclear Import Sequence

1:CMV Enhancer/promoter

5:PMB Orign of Replication

4:kanamycin resistance gene

6:ISS

Reconfigured Panel of Epitopes

Epitope Cluster Region (Antigen Fragment)

Priming Vector

(Plasmid)

2: Coding sequence

(4)

Targeted Intra-Lymph Node

Delivery

Intralymphatic Injection

70mBq 99mTc Labelled

Human Immunoglobulin

Imaging the inguinal

lymph node

Insertion of a needle

into a superficial LN

Imaging of draining lymph nodes

subsequent to administration of

radio-labeled tracer

(5)

Immune Reactivity to a Tumor

Associated Antigen Correlates with the

Clinical Outlook

2w

0.5 – 1.5 mg of pSEM plasmid / infusion

Immune

patients

Non-immune

patients

Time to progression (days)

R

a

ti

o

o

f

S

D

p

a

ti

e

n

ts

/

t

o

ta

l

w

it

h

in

g

ro

u

p

P=0.0296

Time to progression versus immune reactivity analysis

(baseline and/or post-treatment)

(6)

Two Mutually Exclusive

Possibilities

¾

¾

TAA immunity is mechanistically

TAA immunity is mechanistically

relevant

relevant





The immunization methodology needs

The immunization methodology needs

improvement

improvement

¾

¾

TAA immunity is largely an

TAA immunity is largely an

epiphenomenon

(7)

Optimization of Active

Immunotherapeutic Strategies in

Development

Preclinical R&D

Proof of concept,

exploratory trials

Efficacy

trials

(8)

Building on the Immune Response Initiated

by Plasmid DNA: Preclinical Data

DNA only

Peptide only

DNA priming, Peptide boost

2w

naïve

Controls

N=5

Plasmid alone

N=20

Peptide alone

N=20

Melan A tetramer percent

Plasmid / Peptide

N=20

0

2

4

6

8

10

12

(9)

Robust Expansion of T Cell Immunity against Self

or Non-Self Epitopes by Targeted, Lymph Node

Delivery of Peptide Analogues

2w

Plasmid

Peptide

HHD1 transgenic mice

Melan A 26-35

SSX2 41-49

NYESO1 157-165

PRAME 425-433

PSMA 288-297

Tyrosinase 369-377

T

e

tr

a

m

e

r

CD8

0%

Naïve

50%

Immunized

0.2%

Naïve

18%

Immunized

0.1%

Naïve

10.5%

Immunized

0%

Naïve

49%

Immunized

Naïve

Naïve

0.1%

8.9%

Immunized

0.1%

Naïve

8%

Immunized

(10)

A Novel Immunotherapeutic

A Novel Immunotherapeutic

Approach: Features

Approach: Features

¾

¾

Multi

Multi

-

-

component

component





Plasmids and peptide analogues

Plasmids and peptide analogues





Peptides are anchor

Peptides are anchor

-

-

modified

modified

¾

¾

Multivalent

Multivalent





Co

Co

-

-

targets

targets

¾

¾

Cancer cells

Cancer cells

¾

¾

Neovasculature

Neovasculature

¾

¾

Targeted Approach

Targeted Approach





Lymph node delivery

Lymph node delivery



(11)

Prospective Immunization Protocol

Time

Amplification

Initiation

Diagnosis

Expression profiling

MHC

Antigens

Enrollment

Treatment cycles

… .

Induction

Phase

Maintenance

Phase

(12)

A Multivalent Immunotherapeutic Candidate for

A Multivalent Immunotherapeutic Candidate for

Melanoma

Melanoma

Plasmids (expressed portion)

Peptides

Targets

Melan A

Tyrosinase

NYESO-1

SSX2

MKC1207-D1

Melan A

Tyrosinase

N O O H N O N O N O S N O N N O N O O N O O N N O O NY-ESO-1 157-165 (L158(Nva), C165V)

MKC1207-P3

165V

N O N H N O N O O N O O O N O N N O N O N O O N O O SSX2 41-49 (A42V)

MKC1207-P4

MKC1207-D2

158Nva

42V

NYESO-1

SSX2

N O O O H N O N O N O N O N O N O N O N O O N O O melan-a 26-35 (A27Nva) N O O H N O S N O O O N O N O O N O S N O O N O O N N O O Tyrosinase 369-377 (V377(Nva))

27Nva

MKC1207-P1

377Nva

MKC1207-P2

(13)

A Multivalent Immunotherapeutic

Candidate for Melanoma

2w

Plasmids

Peptides

HHD1 transgenic mice

Melan A tetramer

Tyrosinase tetramer

SSX2 tetramer

NY-ESO tetramer

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Naïve controls

Pre boost

Post boost

Pre boost

Post boost

Pre boost

Post boost

Plasmid alone

Plasmid / Peptide

(N=50)

(14)

A Multivalent Immunotherapeutic Candidate for

A Multivalent Immunotherapeutic Candidate for

Ovarian Carcinoma

Ovarian Carcinoma

Plasmids (expressed portion)

Peptides

Targets

PSMA

PRAME

NYESO-1

SSX2

N O N H N O N O O N O O O N O N N O N O N O O N O O SSX2 41-49 (A42V)

MKC1106-P4

N O O H N O N O N O S N O N N O N O O N O O N N O O NY-ESO-1 157-165 (L158(Nva), C165V)

MKC1106-P3

N O O H N O N O N O O N N O N N N O N O N O N O O Prame 425-433 (L426(Nva),433(Nle))

MKC1106-P2

N O H N O N O N O O N O N O N O N O N N N O N O O psma 288-297 (I297V)

MKC1106-P1

MKC1106-D1

MKC1106-D2

297V

426Nva

433Nle

158Nva

165V

42V

PRAME

PSMA

NYESO-1

SSX2

(15)

A Multivalent Immunotherapeutic

Candidate for Ovarian Carcinoma

NYESO-1

PSMA

0

10

20

30

40

50

60

624.38

624.28

LNCap

Target cells

%

C

y

to

to

xi

c

ity

100:1

30:1

10:1

3:1

0

20

40

60

80

100

Control L158NvaC165V

Peptide boost

%

C

y

to

to

x

ic

it

y

E:T 10 E:T 30 E:T 100

624.38-NYESO

Target cells

PRAME

SSX2

0 10 20 30 40 50 60 70

624.28

624.38

IFN

treated

624.28

IFN

treated

624.38

Target cells

%

C

y

totox

ic

ity

E:T 10 E:T 30 E:T 100 0 20 40 60 80 100 T2 T2+SSX2 41-49 624.28 624.38

Target cells

% Cy

to

to

x

ic

it

y

E:T 10 E:T 30 E:T 100

(16)

Directions

¾

¾

Preclinical development

Preclinical development

¾

¾

Proof of principle in exploratory trials

Proof of principle in exploratory trials





Safety, immunity, relationship with clinical

Safety, immunity, relationship with clinical

outcome

outcome

¾

¾

Optimization

Optimization

¾

¾

Composition

Composition

¾

¾

Combinatorial approach

Combinatorial approach

Approved therapeutics

Approved therapeutics

Novel therapeutic candidates

Novel therapeutic candidates

¾

(17)

Acknowledgements

Thomas K

ű

ndig, U. Zurich

Rolf Zinkernagel, U. Zurich

Jeffrey Weber, USC

John Smith, Providence Portland Medical

Center

Evan Hersh, Arizona Cancer Center

Zhiyong Qiu

Ani-Der Sarkissian

Gene Girgis

Sayuri Yatsubo

Hong Tan

Chih-Sheng Chiang

Zheng Liu

Nathalie Kertesz

Anna Soloniona

Sutao Zhu

Liz Lantzy

Kent Smith

Brenna Meisenburg

Robb Pagarigan

Christiana Sanders

Victor Tam

Xiping Liu

Jian Gong

Lisa Do

Sean Hong

Ludmila Krymskaya

Liping Liu

Amy Bauland

Diljeet Joea

Kris Krishnan

Alfred Mann

Hakan Edstrom

References

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