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1. (WO2019063829) IMMUNOGENIC COMPOSITION FOR THE TREATMENT OF CANCER
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CLAIMS

1 ) Ex vivo method for obtaining a composition suitable for the treatment of cancer in a subject, comprising the steps of:

a) providing primary tumor cells derived from the subject, and

b) ex vivo contacting the tumor cells with an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor).

2) Method according to claim 1 wherein the cells are cultured in vitro in order to increase the number of cells before step b) is performed.

3) Method according to claim 1 or 2 wherein the tumor cells are contacted with an immunostimulatory compound, preferably interferon gamma, and the BET inhibitor either simultaneously or sequentially in step b).

4) Method according to claim 1 - 3 wherein the composition is treated so that it is not tumorigenic in vivo after step b).

5) Method according to any one of claims 1 - 4 wherein the method additionally comprises a step of ex vivo contacting the tumor cells with T-cells or dendritic cells obtained from the subject.

6) Method according to any one of claims 1 - 5, wherein the tumor cells are HLA- negative tumor cells and/or PD-L1 -negative tumor cells.

7) Method according to any one of claims 1 - 6, wherein the cancer is a solid tumor or a hematological cancer.

8) Method according to any one of claims 1 - 7, wherein the cancer is a melanoma.

9) Method according to any one of claims 1 - 8, wherein the BET inhibitor is

selected from the list consisting of JQ1 , MK-8628, BMS-986158, INCB54329, ABBV-075, CPI-0610, FT-1 101 , GS-5829, GSK525762, PLX51 107, Ten-010,

OTX-015, CPI-0610, 3-methyl-1 ,2,3,4-tetrahydroquinazolin-2-ones, 2- thiazolidinones, CPI-203, I-BET762 (GSK525762A), I-BET151 (GSK1210151A), and RVX208, preferably wherein the BET inhibitor is selected from the group consisting of JQ1 , I-BET151 (GSK1210151A), and I-BET762 (GSK525762A).

Method according to any one of claims 1 - 9, wherein the tumor cells in step

are in vitro grown to organoids.

1 1 ) Composition obtainable by a method according to any one of claims 1 - 10.

12) Composition obtained by a method according to any one of claims 1 - 10.

13) Pharmaceutical composition comprising the composition according to claim 1 1 or 12 and a pharmaceutically acceptable carrier or excipient.

14) A composition as defined in Claim 1 1 or 12, or a pharmaceutical composition as defined in Claim 13, for use in medicine.

15) Composition according to any one of claims 11 - 13 for use in the treatment of cancer wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal,

subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof.

16) Use of a composition as defined in Claim 1 1 or 12, or a pharmaceutical

composition as defined in Claim 13, in the manufacture of a medicament for the treatment of cancer, wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof.

17) A method for the treatment of cancer in a subject, the method comprising the step of administering to the subject a composition as defined in Claim 1 1 or 12, or a pharmaceutical composition as defined in Claim 13, and preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof.

18) Composition for use according to claim 15, or the use according to Claim 16, or the method for the treatment of cancer according to Claim 17, wherein the treatment is combined with the systemic or localized administration of a drug selected from the group consisting of immunomodulatory compound,

angiogenesis inhibitors, chemotherapeutics or c-Myc downregulation, preferably wherein the drug is an immunomodulatory compound selected from the group consisting of BET inhibitors, immunostimulatory cytokines, natural, endogenous or synthetic ligands of Toll like receptors, ligands of other immunostimulatory receptors, modulators of immune checkpoints, or agonistic modulators.

The use of an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) to increase the expression and presentation of tumor-specific neo-antigens in one or more tumor cells.

An inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) for use in the treatment of cancer in a subject, wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof; and characterised in that the cancer in the subject comprises tumor cells that exhibit no or low levels of expression and presentation of tumor-specific neo-antigens.

Use of an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) in the manufacture of a medicament for the treatment of cancer in a subject, wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof; and characterised in that the cancer in the subject comprises tumor cells that exhibit no or low levels of expression and presentation of tumor-specific neo-antigens.

A method for the treatment of cancer in a subject, the method comprising the step of administering to the subject an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor), characterised in that the cancer in the subject comprises tumor cells that exhibit no or low levels of expression and presentation of tumor-specific neo-antigens.

An inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) for use in the treatment of cancer in a subject, wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumoral administration or a combination thereof; and characterised in that the cancer in the subject comprises HLA-negative tumor cells and/or PD-L1 -negative tumor cells.

Use of an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) in the manufacture of a medicament for the treatment of cancer in a subject, wherein the treatment comprises administering of the composition to the subject, preferably wherein said administering comprises intradermal, subcutaneous, intramuscular, intravenous, or intratumorai administration or a combination thereof; and characterised in that the cancer in the subject comprises HLA-negative tumor cells and/or PD-L1 -negative tumor cells.

A method for the treatment of cancer in a subject, the method comprising the step of administering to the subject an inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor), characterised in that the cancer in the subject comprises HLA-negative tumor cells and/or PD-L1 -negative tumor cells.

An inhibitor for use according to Claim 20 or 23, or the use according to Claim 21 or 24, or the method according to Claim 22 or 25, wherein administration of the inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) increases the expression and presentation of tumor-specific neo-antigens in the tumor cells of the cancer in the subject.

An inhibitor for use according to Claim 20, 23 or 26, or the use according to Claim 21 , 24 or 26, or the method according to Claim 22, 25 or 26, wherein the inhibitor of a bromodomain and extra-terminal domain family member (BET inhibitor) is combined with the systemic or localized administration of a drug selected from the group consisting of immunomodulatory compound, angiogenesis inhibitors, chemotherapeutics or c-Myc downregulation, preferably wherein the drug is an immunomodulatory compound selected from the group consisting:

immunostimulatory cytokines, natural, endogenous or synthetic ligands of Toll like receptors, ligands of other immunostimulatory receptors, modulators of immune checkpoints, or agonistic modulators.