(a) administering a first vaccine to the mammal, wherein the first vaccine comprises an antibody component that binds with the TAA or with an antigen associated with the infectious agent, and wherein the antibody component is conjugated with a soluble immunogenic carrier protein; and

(b) administering a second vaccine to the mammal, wherein the second vaccine comprises an anti-idiotype antibody component that mimics an epitope of the TAA or the infectious agent antigen, and wherein the anti-idiotype antibody component is conjugated with a soluble immunogenic carrier protein. The antibody component of step (a) may be selected from the group consisting of: (a) a murine monoclonal antibody; (b) a humanized antibody derived from a murine monoclonal antibody; (c) a human monoclonal antibody; and (d) an antibody fragment derived from (a), (b) or (c), wherein the antibody fragment may be selected from the group consisting of F(ab′)2, F(ab)2, Fab′, Fab, Fv, sFv and minimal recognition unit.

Moreover, the anti-idiotype antibody component of step (b) may be selected from the group consisting of: (a) a polyclonal antibody; (b) a murine monoclonal antibody; (c) a humanized antibody derived from (b); (d) a human monoclonal antibody; (e) a subhuman primate antibody; and (f) an antibody fragment derived from (a), (b), (c), (d) or (e), in which the antibody fragment may be selected from the group consisting of F(ab′)₂, F(ab)₂, Fab′, Fab, Fv, sFv and minimal recognition unit.

The present invention also is directed to a method further comprising the step of (c) administering interferon-γ or interleukin-2 prior to and during the administration of the second vaccine. Alternatively, interleukin-2 and interferon-γ may be given prior to and during the administration of the vaccine.

The present invention also contemplates a method for inducing humoral and cellular immune responses in a mammal against a tumor that expresses a TAA or against a disease caused by an infectious agent, comprising the steps of:
 

	(a) administering a vaccine to the mammal, wherein the vaccine comprises an antibody component that binds with the TAA or with an antigen associated with the infectious agent, and wherein the antibody component is conjugated with a soluble immunogenic carrier protein; and
	(b) administering an antibody or antigen-binding fragment thereof, wherein the antibody or fragment is not conjugated with a soluble immunogenic carrier protein, and wherein the antibody or fragment binds with the TAA or with an antigen associated with the infectious agent.

The present invention also is directed to such a method in which the antibody or antibody fragment of step (b) is conjugated with biotin, and wherein the method further comprises the step of (c) administering avidin to decrease circulating levels of the biotinylated antibody or the biotinylated antibody fragment.

The present invention also contemplates a method, further comprising the step of (d) administering the vaccine of step (a) a second time.

Moreover, the present invention is directed to a method, further comprising the step of: (e) administering interferon-γ or interleukin-2 prior to and during the second administration of the vaccine. As an alternative, interleukin-2 and interferon-γ may be given prior to and during the administration of the vaccine.

The present invention also contemplates a method for inducing humoral and cellular immune responses in a patient against a tumor that expresses a TAA or against a disease caused by an infectious agent, comprising the steps of:
 

	(a) obtaining T cells from the patient;
	(b) introducing an expression vector into the T cells to obtain transfected T cells, wherein the expression vector comprises a DNA molecule encoding either a chimeric immunoglobulin/T cell receptor or a chimeric immunoglobulin/CD3 protein, and wherein the immunoglobulin-encoding portion of the DNA molecule encodes the variable region of an antibody that binds with the TAA or with an antigen associated with the infectious agent;
	(c) stimulating the proliferation of the transfected T cells to obtain an increased mass of transfected T cells; and
	(d) returning the increased mass of transfected T cells to the patient.

The present invention also is directed to a method which further comprises the step of: (e) administering a vaccine to the patient, wherein the vaccine comprises an anti-idiotype antibody component that binds with the immunoglobulin moiety of the chimeric immunoglobulin/T cell receptor or the chimeric immunoglobulin/CD3 protein, and wherein the anti-idiotype antibody component is conjugated with a soluble immunogenic carrier protein. As an alternative, at least one cytokine selected from the group consisting of interferon-γ and interleukin-2, may be administered to the patient after returning the transfected T cells and before performing step (e).

The present invention also contemplates a method for inducing humoral and cellular immune responses in a patient against a tumor that expresses a TAA or against a disease caused by an infectious agent, comprising the steps of:
 

	(a) obtaining T cells from the patient;
	(b) introducing an expression vector into the T cells to obtain transfected T cells, wherein the expression vector comprises a DNA molecule encoding either a chimeric immunoglobulin/T cell receptor or a chimeric immunoglobulin/CD3 protein, and wherein the immunoglobulin-encoding portion of the DNA molecule encodes the variable region of an antibody that mimics an epitope of the TAA or an epitope of an antigen associated with the infectious agent;
	(c) stimulating the proliferation of the transfected T cells to obtain an increased mass of transfected T cells; and
	(d) returning the increased mass of transfected T cells to the patient.

Moreover, the present invention contemplates a method which further comprises the step of: (e) administering a vaccine to the patient, wherein the vaccine comprises an antibody component that binds with the immunoglobulin moiety of the chimeric immunoglobulin/T cell receptor or the chimeric immunoglobulin/CD3 protein, and wherein the antibody component is conjugated with a soluble immunogenic carrier protein. As an alternative, at least one cytokine selected from the group consisting of interferon-γ and interleukin-2, may be administered to the patient after returning the transfected T cells and before performing step (e).

The present invention also is directed to a vaccine for treating a patient having a tumor that expresses carcinoembryonic antigen (CEA), comprising a pharmaceutically acceptable carrier and therapeutically effective amount of an anti-CEA antibody component which is conjugated with a soluble immunogenic carrier protein. The anti-CEA antibody component may be selected from the group consisting of: (a) a murine monoclonal Class III anti-CEA antibody; (b) a humanized antibody derived from a murine monoclonal Class III anti-CEA antibody; (c) a human monoclonal anti-CEA antibody; and (d) an antibody fragment derived from (a), (b) or (c).

The present invention also contemplates a vaccine for treating a patient having a tumor that expresses CEA, comprising a pharmaceutically acceptable carrier and therapeutically effective amount of ah anti-idiotype antibody component which is conjugated with a soluble immunogenic carrier protein, wherein the anti-idiotype antibody component mimics an epitope of CEA. The anti-idiotype antibody component may be selected from the group consisting of: (a) a polyclonal antibody that binds with the variable region of a Class III anti-CEA antibody; (b) a monoclonal antibody that binds with the variable region of a Class III anti-CEA antibody; (c) a humanized antibody derived from (b); (d) a subhuman primate antibody that binds with the variable region of a Class III anti-CEA antibody; (e) a human monoclonal anti-CEA antibody that binds with the variable region of a Class III anti-CEA antibody; and (f) an antibody fragment derived from (a), (b), (c), (d) or (e).

The present invention also contemplates a method for inducing humoral and cellular immune responses in a mammal against a tumor that expresses a TAA or against a disease caused by an infectious agent, comprising the steps of:
 

	(a) administering a first vaccine to the mammal, wherein the first vaccine comprises an antibody that binds with the TAA or with an antigen associated with the infectious agent, and wherein the antibody component is conjugated with a soluble immunogenic carrier protein;
	(b) administering an antibody or antigen-binding fragment thereof, wherein the antibody or fragment is not conjugated with a soluble immunogenic carrier protein, and wherein the antibody or fragment binds with the TAA or with an antigen associated with the infectious agent; and
	(c) administering a second vaccine to the mammal, wherein the second vaccine comprises an anti-idiotype antibody that mimics an epitope of the TAA or the infectious agent antigen, and wherein the anti-idiotype antibody component is conjugated with a soluble immunogenic carrier protein.

Preferably, such a method is performed wherein the first vaccine comprises a Class III anti-CEA antibody, wherein the antibody of step (b) is a Class III anti-CEA antibody, and wherein the second vaccine comprises an antibody that binds with the variable region of a Class III anti-CEA antibody.

The present invention also is directed to a method for treating a patient having a tumor that expresses CEA, comprising the step of administering bispecific antibody to the patient, wherein the bispecific antibody comprises a moiety that binds with CD3 protein and a moiety that binds with CEA, and wherein the CEA-binding moiety is derived from a Class III anti-CEA antibody.

DETAILED DESCRIPTION OF THE INVENTION

Production of Monoclonal Antibodies, Humanized Antibodies, Primat Antibodies and Human Antibodies

Rodent monoclonal antibodies to specific antigens may be obtained by methods known to those skilled in the art. See, for example, Kohler and Milstein, Nature 256: 495 (1975), and Coligan et al. (eds.), CURRENT PROTOCOLS IN IMMUNOLOGY, VOL. 1, pages 2.5.1-2.6.7 (John Wiley & Sons 1991) [hereinafter "Coligan"]. Briefly, monoclonal antibodies can be obtained by injecting mice with a composition comprising an antigen, verifying the presence of antibody production by removing a serum sample, removing the spleen to obtain B-lymphocytes, fusing the B-lymphocytes with myeloma cells to produce hybridomas, cloning the hybridomas, selecting positive clones which produce antibodies to the antigen, culturing the clones that produce antibodies to the antigen, and isolating the antibodies from the hybridoma cultures.

A wide variety of monoclonal antibodies against tumor associated antigens or infectious agents have been developed. See, for example, Goldenberg et al. international application publication No. WO 91/11465 (1991), and Goldenberg, international application publication No. WO 94/04702 (1994), each of which is incorporated by reference in its entirety.

An example of a suitable Mab is a Class III anti-CEA Mab. Conventional antisera raised against CEA usually contain antibodies that react with a group of substances closely related to CEA. The major members of this family of CEA-related antigens are (1) the normal cross-reactive antigen (NCA), which shares a similar tissue distribution with CEA, and (2) meconium antigen (MA), which shares almost identical physiochemical properties with CEA. The first panel of monoclonal antibodies (MAb) that defined NCA-cross-reactive, MA-cross-reactive, and CEA-specific epitopes on the CEA molecule were described by Primus et al., Cancer Research 43: 686 (1983). In particular, three classes of anti-CEA antibody were identified: 1) Class I antibodies, which react with CEA, NCA and MA; 2) Class II antibodies, which react with CEA and MA, but not with NCA; and 3) Class III antibodies, which are specific for CEA and do not bind with NCA or MA. Methods for obtaining Class III anti-CEA MAbs are disclosed by Primus et al., Cancer Research 43: 686 (1983), and Primus et al., U.S. Pat. No. 4,818,709. Moreover, the production of second generation Class III anti-CEA MAbs is disclosed by Hansen et al., Cancer 71: 3478 (1993), and U.S. Pat. No. 5,874,540, which are incorporated by reference.

MAbs can be isolated and purified from hybridoma cultures by a variety of well-established techniques. Such isolation techniques include affinity chromatography with Protein-A Sepharose, size-exclusion chromatography, and ion-exchange chromatography. See, for example, Coligan at pages 2.7.1-2.7.12 and pages 2.9.1-2.9.3. Also, see Baines et al., "Purification of Immunoglobulin G (IgG)," in METHODS IN MOLECULAR BIOLOGY, VOL. 10, pages 79-104 (The Humana Press, Inc. 1992).

In another embodiment, an antibody of the present invention is a subhuman primate antibody. General techniques for raising therapeutically useful antibodies in baboons may be found, for example, in Goldenberg et al., international patent publication No. WO 91/11465 (1991), and in Losman et al., Int. J. Cancer 46: 310 (1990), which is incorporated by reference.

In yet another embodiment, an antibody of the present invention is a "humanized" monoclonal antibody. That is, mouse complementarity determining regions are transferred from heavy and light variable chains of the mouse immunoglobulin into a human variable domain, followed by the replacement of some human residues in the framework regions of their murine counterparts. Humanized monoclonal antibodies in accordance with this invention are suitable for use in therapeutic methods. General techniques for cloning murine immunoglobulin variable domains are described, for example, by the publication of (1989), which is incorporated by reference in its entirety. Techniques for producing humanized MAbs are described, for example, by Jones et al., Nature 321: 522 (1986), Riechmann et al., Nature 332: 323 (1988), Verhoeyen et al., Science 239: 1534 (1988), Carter et al., Proc. Nat'l Acad. Sci. USA 89: 4285 (1992), Sandhu, Crit. Rev. Biotech. 12: 437 (1992), and Singer et al., J. Immun. 150: 2844 (1993), each of which is hereby incorporated by reference.

In another embodiment, an antibody of the present invention is a human monoclonal antibody. Such antibodies are obtained from transgenic mice that have been "engineered" to produce specific human antibodies in response to antigenic challenge. In this technique, elements of the human heavy and light chain locus are introduced into strains of mice derived from embryonic stem cell lines that contain targeted disruptions of the endogenous heavy chain and light chain loci. The transgenic mice can synthesize human antibodies specific for human antigens, and the mice can be used to produce human antibody-secreting hybridomas. Methods for obtaining human antibodies from transgenic mice are described by Green et al., Nature Genet. 7: 13 (1994), Lonberg et al., Nature 368: 856 (1994), and Taylor et al., Int. Immun. 6: 579 (1994), which are incorporated by reference.

3. Production of Antibody Fragments

The present invention contemplates the use of fragments of Ab1 or Ab2. Antibody fragments can be prepared by proteolytic hydrolysis of the antibody or by expression in E. coli of the DNA coding for the fragment.

Antibody fragments can be obtained by pepsin or papain digestion of whole antibodies by conventional methods. For example, antibody fragments can be produced by enzymatic cleavage of antibodies with pepsin to provide a 5S fragment denoted F(ab′)₂. This fragment can be further cleaved using a thiol reducing agent, and optionally a blocking group for th sulfhydryl groups resulting from cleavage of disulfide linkages, to produce 3.5S Fab′ monovalent fragments. Alternatively, an enzymatic cleavage using pepsin produces two monovalent Fab fragments and an Fc fragment directly. These methods are described, for example, by Goldenberg, U.S. Pat. Nos. 4,036,945 and 4,331,647 and references contained therein, which patents are incorporated herein in their entireties by reference. Also, see Nisonoff et al., Arch Biochem. Biophys. 89: 230 (1960); Porter, Biochem. J. 73: 119 (1959), Edelman et al., in METHODS IN ENZYMOLOGY VOL. 1, page 422 (Academic Press 1967), and Coligan at pages 2.8.1-2.8.10 and 2.10.-2.10.4.

Other methods of cleaving antibodies, such as separation of heavy chains to form monovalent light-heavy chain fragments, further cleavage of fragments, or other enzymatic, chemical or genetic techniques may also be used, so long as the fragments bind to the antigen that is recognized by the intact antibody.

For example, Fv fragments comprise an association of V_H and V_L chains. This association can be noncovalent, as described in Inbar et al., Proc. Nat'l Acad. Sci. USA 69: 2659 (1972). Alternatively, the variable chains can be linked by an intermolecular disulfide bond or cross-linked by chemicals such as glutaraldehyde. See, for example, Sandhu, supra.

Preferably, the Fv fragments comprise V_H and V_L chains which are connected by a peptide linker. These single-chain antigen binding proteins (sFv) are prepared by constructing a structural gene comprising DNA sequences encoding the V_H and V_L domains which are connected by an oligonucleotide. The structural gene is inserted into an expression vector which is subsequently introduced into a host cell, such as E. coli. The recombinant host cells synthesize a single polypeptide chain with a linker peptide bridging the two V domains. Methods for producing sFvs are described, for example, by Whitlow et al., Methods: A Companion to Methods in Enzymology 2: 97 (1991). Also see Bird et al., Science 242:423-426 (1988), Ladner et al., U.S. Pat. No. 4,946,778, Pack et al., Bio/Technology 11:1271-1277 (1993), and Sandhu, supra.

Another form of an antibody fragment is a peptide coding for a single complementarity-determining region (CDR). CDR peptides ("minimal recognition units") can be obtained by constructing genes encoding the CDR of an antibody of interest. Such genes are prepared, for example, by using the polymerase chain reaction to synthesize the variable region from RNA of antibody-producing cells. See, for example, Larrick et al., Methods: A Companion to Methods in Enzymology 2: 106 (1991).

4. Production of Anti-Idiotype Antibodies (Ab2)

Polyclonal Ab2 can be prepared by immunizing animals with Ab1 or fragments, using standard techniques. See, for example, Green et al., "Production of Polyclonal Antisera," in METHODS IN MOLECULAR BIOLOGY: IMMUNOCHEMICAL PROTOCOLS, Manson (ed.), pages 1-12 (Humana Press 1992). Also, see Coligan at pages 2.4.1-2.4.7.

Alternatively, monoclonal Ab2 can be prepared using Ab1 or fragments as immunogens with the techniques, described above. The preparation of a rat monoclonal Ab2 is illustrated in Example 3.

As another alternative, humanized Ab2 or subhuman primate Ab2 can be prepared using the above-described techniques.

5. Production of Bispecific Antibodies

Bispecific antibodies can be used to recruit and target T cells to a tumor cell. A bispecific antibody is a hybrid molecule that consists of nonidentical light and heavy chain pairs, providing two distinct antibody specificities. For example, bispecific antibodies have been produced with one binding site recognizing the CD3 signal transducing protein on T cells and a second binding site for a tumor-associated antigen. See, for example, Canevari et al., Int. J. Cancer 42: 18 (1988); Lanzaveccia et al., Eur. J. Immunl. 17: 105 (1987); Van Dijk et al., Int. J. Cancer 43: 344 (1989); and Renner et al., Science 264: 833 (1994).

Bispecific antibodies can be made by a variety of conventional methods, e.g., disulfide cleavage and reformation of mixtures of whole antibody or, preferably F(ab′)₂ fragments, fusions of more than one hybridoma to form polyomas that produce antibodies having more than one specificity, and by genetic engineering. Bispecific antibodies have been prepared by oxidative cleavage of Fab′ fragments resulting from reductive cleavage of different antibodies. See, for example, Winter et al., Nature 349: 293 (1991). This is advantageously carried out by mixing two different F(ab′)₂ fragments produced by pepsin digestion of two different antibodies, reductive cleavage to form a mixture of Fab′ fragments, followed by oxidative reformation of the disulfide linkages to produce a mixture of F(ab′)₂ fragments including bispecific antibodies containing a Fab′ portion specific to each of the original epitopes. General techniques for the preparation of such antibody composites may be found, for example, in Nisonhoff et al., Arch Biochem. Biophys. 93: 470 (1961), Hammerling et al., J. Exp. Med. 128: 1461 (i968), and U.S. Pat. No. 4,331,647.

More selective linkage can be achieved by using a heterobifunctional linker such as maleimide-hydroxysuccinimide ester. Reaction of the ester with an antibody or fragment will derivatize amine groups on the antibody or fragment, and the derivative can then be reacted with, e.g., an antibody Fab fragment having free sulfhydryl groups (or, a larger fragment or intact antibody with sulfhydryl groups appended thereto by, e.g., Traut's Reagent). Such a linker is less likely to crosslink groups in the same antibody and improves the selectivity of the linkage.

It is advantageous to link the antibodies or fragments at sites remote from the antigen binding sites. This can be accomplished by, e.g., linkage to cleaved interchain sulfydryl groups, as noted above. Another method involves reacting an antibody having an oxidized carbohydrate portion with another antibody which has at lease one free amine function. This results in an initial Schiff base (imine) linkage, which is preferably stabilized by reduction to a secondary amine, e.g., by borohydride reduction, to form the final composite. Such site-specific linkages are disclosed, for small molecules, in U.S. Pat. No. 4,671,958, and for larger addends in U.S. Pat. No. 4,699,784.

In the present context, a bispecific antibody comprises binding moieties for T cells and an antigen that is associated with a tumor cell or infectious agent. For example, a CEA binding moiety can be derived from a Class III Mab and the T cell-binding moiety can be derived from anti-CD3 Mab. Methods for preparing anti-CD3 antibodies are well-known to those of skill in the art. See, for example, Canevari et al., supra, Van Dijk et al., supra, Hansen et al., "Human T Lymphocyte Cell Surface Molecules Defined by the Workshop Monoclonal Antibodies (T Cell Protocol)," in LEUKOCYTE TYPING: HUMAN LEUKOCYTE MARKERS DETECTED BY MONOCLONAL ANTIBODIES, Bernard et al., (eds.) pages 195-212 (Springer-Verlag 1984); and U.S. Pat. No. 4,361,549. Alternatively, anti-CD3 antibodies can be obtained from commercial sources such as Boehringer Mannheim Corp. (Indianapolis, Ind.; Cat. No. 1273 485) and the American Type Culture Collection (Rockville, Md.; ATCC CRL 8001 [OKT-3]).

For example, a bispecific antibody can be prepared by obtaining an F(ab′)₂ fragment from an anti-CEA Class III Mab, as described above. The interchain disulfide bridges of the anti-CEA Class III F(ab′)₂ fragment are gently reduced with cysteine, taking care to avoid light-heavy chain linkage, to form Fab′-SH fragments. The SH group(s) is(are) activated with an excess of bis-maleimide linker (1,1′-(methylenedi-4,1-phenylene)bis-malemide). The anti-CD3 Mab is converted to Fab′-SH and then reacted with the activated anti-CEA Class III Fab′-SH fragment to obtain a bispecific antibody.

Alternatively, such bispecific antibodies can be produced by fusing two hybridoma cell lines that produce anti-CD3 Mab and anti-CEA Class III Mab. Techniques for producing tetradomas are described, for example, by Milstein et al., Nature 305: 537 (1983) and Pohl et al., Int. J. Cancer 54: 418 (1993).

Finally, bispecific antibodies can be produced by genetic engineering. For example, plasmids containing DNA coding for variable domains of an anti-CEA Class III Mab can be introduced into hybridomas that secrete anti-CD3 antibodies. The resulting "transfectomas" produce bispecific antibodies that bind CEA and CD3. Alternatively, chimeric genes can be designed that encode both anti-CD3 and anti-CEA binding domains. General techniques for producing bispecific antibodies by genetic engineering are described, for example, by Songsivilai et al., Biochem. Biophys. Res. Commun. 164: 271 (1989); Traunecker et al., EMBO J. 10: 3655 (1991); and Weiner et al., J. Immunol. 147: 4035 (1991).

6. The Use of Antibodies and Cytokines to Amplify the Humoral and Cellular Immune Response Against Tumor Cells and Infectious Agents

The present invention contemplates the therapeutic use of Ab1, Ab2 generated against Ab1, and fragments of either Ab1 or Ab2. These antibodies and fragments can be used as vaccines to induce both humoral and cellular immune responses in the recipient mammal. Moreover, the administration of Ab1 and/or bispecific antibodies can be used to amplify the integrated immune response.

According to one method of the present invention, a mammal is immunized with a vaccine comprising Ab1 or fragments thereof, to induce the production of Ab2 and T cells (T2 cells). After the mammal begins to produce T2 cells, the mammal may be given Ab1, or fragments thereof, by intravenous administration to expand the T2 cell mass. An additional advantage of this second administration is that the antibodies or fragments bind with cognate antigen on cancer cells or infectious organisms and thus, serve as targets for T2 cells. Methods for detecting the production of T cells that react with specific antibodies are well-known to those of ordinary skill in the art. See, for example, Fagerberg et al., Cancer Immunol. Immunother. 37: 264 (1993), which is incorporated by reference.

According to a preferred method, a mammal is subsequently immunized with a vaccine comprising Ab2, or fragments thereof, to induce the formation of Ab3 and T cells that recognize Ab2 (T3 cells). An advantage of this subsequent Ab2 vaccination is that cells expressing a tumor associated antigen or infectious agent antigen are destroyed by T3 cells directed to the antigen, and by T2 cells directed to Ab3, which also is bound by the antigen. Example 4 illustrates a method of treatment comprising the administration of an Ab1 vaccine, Ab1 (or fragments), and an Ab2 vaccine.

In addition, the T2 response may be further amplified by the intravenous administration of Ab1 antibodies or fragments after Ab2 vaccination.

It is possible that the efficacy of the Ab2 vaccine may be decreased by the presence of circulating Ab1 antibodies, which have been administered intravenously. Therefore, it is advantageous to clear circulating Ab1 prior to the administration of Ab2 vaccine. One method that can be used to achieve Ab1 clearance is to use Ab1 antibodies that have been conjugated with biotin. In this way, circulating biotinylated Ab1 can be cleared prior to Ab2 vaccination by the intravenous administration of avidin. Preferably, clearance with avidin is performed one to two days after the intravenous administration of Ab1 (or fragments thereof). This antibody clearance technique is described by Goldenberg, international application publication No. WO 94/04702 (1994).

In an alternative method of immunotherapy, a mammal is immunized with an Ab1 vaccine, treated with Ab1 (or fragments) to saturate a high percentage of tumor or infectious agent antigen sites and then, hyperimmunized with Ab1 vaccine to generate large numbers of cytotoxic lymphocytes directed against cells coated with Ab1 (or fragments thereof).

According to preferred methods of immunotherapy, the immune response is further amplified by the administration of cytokines. Examples of cytokines include the interferons (INFs), interleukins (ILs) and tumor necrosis factors. INF-γ induces macrophages, as well as cell-surface class II histocompatibility antigens on lymphoid cells and monocytes. See, for example, Klegerman et al., "Lymphokines and Monokines," in BIOTECHNOLOGY AND PHARMACY, Pezzuto et al. (eds.), pages 53-70 (Chapman & Hall 1993), and Roitt et al., IMMUNOLOGY, 3rd Edition, pages 7.8-7.14. (Mosby 1993). IL-2 is a T cell growth factor and a stimulator of natural killer cells and tumor-reactive T cells. Id. Thus, INF-γ and IL-2 are preferred cytokines for the augmentation of the immune response.

The antibodies and fragments of the present invention can be used as vaccines by conjugating the antibodies or fragments to a soluble immunogenic carrier protein. Suitable carrier proteins include keyhole lympet hemocyanin, which is the preferred carrier protein. The antibodies and fragments can be conjugated to the carrier protein using standard methods. See, for example, Hancock et al, "Synthesis of Peptides for Use as Immunogens," in METHODS IN MOLECULAR BIOLOGY: IMMUNOCHEMICAL PROTOCOLS, Manson (ed.), pages 23-32 (Humana Press 1992).

A preferred vaccination composition comprises an antibody conjugate or fragment conjugate, and an adjuvant. Examples of suitable adjuvants include aluminum hydroxide and lipid. Methods of formulating vaccine compositions are well-known to those of ordinary skill in the art. See, for example, Rola, "Immunizing Agents and Diagnostic Skin Antigens," in REMINGTON'S PHARMACEUTICAL SCIENCES, 18th Edition, Gennaro (ed.), pages 1389-1404 (Mack Publishing Company 1990).

Additional pharmaceutical methods may be employed to control the duration of action of a vaccine in a therapeutic application. Control release preparations can be prepared through the use of polymers to complex or adsorb the antibodies or fragments. For example, biocompatible polymers include matrices of poly(ethylene-co-vinyl acetate) and matrices of a polyanhydride copolymer of a stearic acid dimer and sebacic acid. Sherwood et al., Bio/Technology 10: 1446 (1992). The rate of release of an antibody or antibody fragment from such a matrix depends upon the molecular weight of the antibody or fragment, the amount of antibody or fragment within the matrix, and the size of dispersed particles. Saltzman et al., Biophys. J. 55: 163 (1989); Sherwood et al., supra. Other solid dosage forms are described in Ansel et al., PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERY SYSTEMS, 5th Edition (Lea & Febiger 1990), and Gennaro (ed.), REMINGTON'S PHARMACEUTICAL SCIENCES, 18th Edition (Mack Publishing Company 1990).

The antibody preparations of the present invention can be formulated according to known methods to prepare pharmaceutically useful compositions, whereby antibodies or antibody fragments are combined in a mixture with a pharmaceutically acceptable carrier. A composition is said to be a "pharmaceutically acceptable carrier" if its administration can be tolerated by a recipient mammal. Sterile phosphate-buffered saline is one example of a pharmaceutically acceptable carrier. Other suitable carriers are well-known to those in the art. See, for example, Ansel et al., PHARMACEUTICAL DOSAGE FORMS AND DRUG DELIVERY SYSTEMS, 5th Edition (Lea & Febiger 1990), and Gennaro (ed.), REMINGTON'S PHARMACEUTICAL SCIENCES, 18th Edition (Mack Publishing Company 1990).

The antibodies or fragments may be administered to a mammal intravenously or subcutaneously. Moreover, the administration may be by continuous infusion or by single or multiple boluses. Preferably, an antibody vaccine is administered subcutaneously, while an antibody preparation that is not a vaccine is administered intravenously. In general, the dosage of administered antibodies or fragments for humans will vary depending upon such factors as the patient's age, weight, height, sex, general medical condition and previous medical history. Typically, it is desirable to provide the recipient with a dosage of antibodies or fragments which is in the range of from about 1 pg/kg to 10 mg/kg (amount of agent/body weight of patient), although a lower or higher dosage also may be administered as circumstances dictate.

For purposes of therapy, antibodies or fragments are administered to a mammal in a therapeutically effective amount. An antibody preparation is said to be administered in a "therapeutically effective amount" if the amount administered is physiologically significant. An agent is physiologically significant if its presence results in a detectable change in the physiology of a recipient mammal. In particular, an antibody preparation of the present invention is physiologically significant if its presence invokes a humoral and/or cellular immune response in the recipient mammal.

A cytokine, such as INF-γ or IL-2, may be administered before and during the administration of an Ab1 vaccine or an Ab2 vaccine. Alternatively, INF-γ and IL-2, may be administered together before and during the administration of an antibody vaccine. Cytokines are administered to the mammal intravenously, intramuscularly or subcutaneously. For example, recombinant IL-2 may be administered intravenously as a bolus at 6×10⁵ IU/kg or as a continuous infusion at a dose of 18×10⁶ IU/m²/d. Weiss et al., J. Clin. Oncol. 10: 275 (1992). Alternatively, recombinant IL-2 may be administered subcutaneously at a dose of 12×10⁶ IU. Vogelzang et al., J. Clin. Oncol. 11: 1809 (1993). Moreover, INF-γ may be administered subcutaneously at a dose of 1.5×10⁶ U. Lienard et al., J. Clin. Oncol. 10: 52 (1992). Suitable IL-2 formulations include PROLEUKIN (Chiron Corp./Cetus Oncology Corp.; Emeryville, -CA) and TECELEUKIN (Hoffman-La Roche, Inc.; Nutley, N.J.), while ACTIMMUNE (Genentech, Inc.; South San Francisco, Calif.) is a suitable INF-γ preparation.

In addition, bispecific antibodies may be administered after the initial Ab1 treatment. The function of the bispecific antibodies is to bridge lymphocytes with CEA-bearing tumor cells and to trigger the lymphocyte-mediated cytolysis. Bispecific antibodies can be administered according to above-described general guidelines. However, bispecific antibodies, unlike antibody vaccines, are not conjugated with immunogens.

Those of ordinary skill in the art will appreciate that the above-described methods can be used to provide prophylaxis against infectious agents. Thus, the present invention contemplates the use of methods described herein to provide protection to a mammal before exposure to an infectious agent.

7. The Production and Therapeutic Use of T Cells that Express Chimeric Immunoglobulin/T Cell Receptors or Chimeric Immunoglobulin/CD3 Proteins

T cells can be divided into two mutually exclusive populations: T cells that express α and β T cell receptor (TCR) polypeptides, and T cells that express γ and δ TCR polypeptides. See, generally, Roitt et al., IMMUNOLOGY, 3rd Edition (Mosby 1993), and Bolhuis et al., Cancer Immunol. Immunother. 34: 1 (1991). The αβ polypeptide set is expressed by more than 95% of peripheral T cells and the vast majority of TCR-expressing thymocytes. In contrast, the γ^δ polypeptide set is expressed by a minor proportion of T cells in the thymus and secondary lymphatic organs, while the δ^δ T cells are abundant in various epithelia.

Each polypeptide chain of a TCR heterodimer comprises two external variable and constant immunoglobulin-like domains that are anchored into the plasma membrane by a transmembrane peptide and a short cytoplasmic tail. The N-terminal domains of the TCR polypeptides contain variable regions that are homologous with the variable domains of immunoglobulins. Moreover, analysis of these TCR variable domains has revealed areas of relatively greater variability which correspond to immunoglobulin hypervariable regions (CDRs). The variable domains of the αβ and γ^δ polypeptides are thought to associate in a manner that is similar to the association of V_H/V_L domains of immunoglobulin molecules, bringing six TCR hypervariable regions together to form an antigen binding site.

The TCR αβ and γ^δ polypeptides are both noncovalently associated with a series of polypeptides (γ, δ, ε, ζ, and η) collectively designated CD3 to form the complete TCR complex. In contrast to the TCR polypeptides, the amino acid sequences of CD3 components show no variability on different T cells and thus, the CD3-components cannot generate the diversity associated with TCR polypeptides. Instead, the CD3 component of the TCR complex is required for the transduction of signals generated by TCR-antigen interaction.

In general, T cells recognize cell-bound antigen in association with major histocompatibility complex (MHC) molecules on the surface of the antigen-presenting cell. However, methods are available to produce T cells that are targeted to particular tumors and that are not MHC-restricted. Bispecific antibodies, described above, provide one approach to targeting T cells. Another approach is to genetically engineer T cells having chimeric immunoglobulin/T cell receptors. To be effective, the chimeric immunoglobulin/TCRs must be expressed by T cells in a stable manner, and the chimeric immunoglobulin/TCRs must form a functional association with CD3 signal-transducing polypeptides.

Functional chimeric immunoglobulin/TCRs have been produced in which the variable gene segments of the TCR α and β chains were replaced by variable gene-segments of the heavy and light chain of an immunoglobulin. See, for example, Becker et al., Cell 58: 911 (1989), Eshhar et al., Br. J. Cancer 62 (Suppl. 10): 27 (1990), Goverman et al., Cell 60: 929 (1990), Gross et al., Transplant Proc. 21: 127 (1989a), and Gross et al., Proc. Nat'l Acad. Sci. USA 86: 10024 (1989b), which are incorporated by reference. The present invention contemplates construction of chimeric immunoglobulin/TCRs in which variable regions of the TCR α and β chains are replaced by variable gene segments of the heavy and light chain of either an Ab1 or an Ab2.

In addition, functional chimeric immunoglobulin/CD3 proteins have been produced in which DNA fragments encoding immunoglobulin variable segments were fused with DNA fragments encoding γ, ζ or η CD3 polypeptides. See, for example, Seed et al., international application publication No. WO 92/15322 (1992), and Eshhar et al., Proc. Nat'l Acad. Sci. USA 90: 720 (1993), which are incorporated by reference. Thus, the present invention also contemplates the construction of chimeric immunoglobulin/CD3 proteins comprising variable gene segments of the heavy and light chain of either an Ab1 or an Ab2.

Chimeric immunoglobulin/TCRs and chimeric immunoglobulin/CD3 proteins can be constructed using standard techniques. Typical techniques are illustrated by the following methods that can be used to construct an anti-CEA (or Ab2)/TCR.

DNA molecules encoding the variable regions of anti-CEA Mab or anti-idiotype Mab can be synthesized using the polymerase chain reaction with RNA from hybridomas that produce such antibodies. General techniques for the synthesis of murine variable regions and suitable primers are described, for example, by Orlandi et al., supra, Larrick et al., Methods: A Companion to Methods in Enzymology 2: 106 (1991), and by Kang et al., Id. at 111.

Methods for obtaining DNA molecules encoding human T cell receptor polypeptides are well-known to those of ordinary skill in the art. See, for example, Bougueleret et al., Immunogenetics 26: 304 (1987), and Luria et al., EMBO J. 6: 3307 (1987). Moreover, techniques for constructing chimeric immunoglobulin/TCRs and inserting the chimeric genes into expression vectors have been described, for example, by Becker et al., supra, Eshhar et al., supra, Goverman et al., supra, Gross et al. (1989a), supra, and Gross et al. (1989b), supra. Furthermore, standard protocols for constructing immunoglobulin fusion proteins are described by Coligan at pages 10.19.1-10.19.11. Preferred expression vectors contain a dominant selectable marker for the production of stably-transfected cells.

Expression vectors comprising chimeric immunoglobulin/TCR genes are introduced into human T cells. Human peripheral blood cells can be obtained by simple venipuncture and fractionated by Ficoll-Hypaque gradient separation to obtain a mononuclear cell fraction. See, for example, Coligan at pages 7.1.1-7.1.2. T cells are then separated from other mononuclear cells using a rosetting procedure. Id. at pages 7.2.1-7.2.4. Expression vectors are introduced into the human T cell fraction by electroporation or other well-known techniques. See, for example, Co et al., J. Immunol. 148: 1149 (1992), and Coligan at pages 10.13.2-10.17.7.

Alternatively, chimeric immunoglobulin/TCRs can be introduced into T cells by retrovirus-mediated gene transfer. An advantage of this approach is that all proviral copies become stably integrated into the chromosomes of the T cells and this ensures constitutive expression of chimeric immunoglobulin/TCRs. Methods for transfecting human T cells by retrovirus-mediated gene transfer are described by Kasid et al., Proc. Nat'l Acad. Sci. USA 87: 473 (1990), Rosenberg et al., N. Engl. J. Med. 323: 570 (1990), and Morecki et al., Cancer Immunol. Immunother. 32: 342 (1991).

Transfected cells that carry the expression vector are selected using a dominant selectable marker. For example, G418 can be used to select transfected T cells carrying an expression vector having the aminoglycoside phosphotransferase gene. Southern et al., J. Mol. Appi. Gen. 1: 327 (1982). A method for G4.18 selection of transfected human T cells is described by Morecki et al., supra. Alternatively, hygromycin-B can be used to select transfected cells carrying an expression vector having the hygromycin-B-phosphotransferase gene. Palmer et al., Proc. Nat'l Acad. Sci. USA 84: 1055 (1987). Moreover, aminopterin and mycophenolic acid can be used to select transfected cells carrying an expression vector having the xanthine-guanine phosphoribosyltransferase gene. Mulligan et al., Proc. Nat'l. Acad. Sci. USA 78: 2072 (1981).

Stably transfected T cells must be expanded in culture before the cells are administered to a patient. The proliferation of T cells can be induced by incubating the cells with the appropriate antigen. For example, a purified preparation of CEA can be used to induce proliferation of T cells expressing chimeric anti-CEA/TCR polypeptides, whereas a purified preparation of anti-CEA antibody (or fragments thereof) can be used to stimulate T cells expressing the chimeric anti-idiotype/TCR polypeptides. A standard technique for antigen-induced T cell proliferation is described by Coligan at page 7.10.4. In the present context, another important function of antigen-induced T cell proliferation is the verification of the presence of functional immunoglobulin/TCR or functional immunoglobulin/CD3 protein.

After culture expansion, the T cells are returned to the patient by intravenous infusion or by intraperitoneal administration. See, for example, Rosenberg et al., Science 233: 1318 (1986), Rosenberg et al., N. Engl. J. Med. 319: 1676 (1988), Hercend et al., J. Biol. Response Modif. 9: 546 (1990), Rosenberg et al., N. Engl. J. Med. 323: 570 (1990), and Bartholeyns et al., Anticancer Res. 11: 1201 (1991).

In summary, genetic engineering can be used to produce transformed human T cells that express chimeric immunoglobulin/TCRs or chimeric immunoglobulin/CD3 proteins. T cells that express Ab1/TCRs or Ab1/CD3 proteins correspond to T3 cells, while T cells expressing anti-idiotype (Ab2)/TCRs or Ab2/CD3 proteins correspond to T2 cells.

Several methods can be used to enhance the efficacy of adoptive immunotherapy. After administration of T cells that express Ab1/TCRs or Ab1/CD3 proteins, an Ab2 vaccine may be administered to expand the infused T cells in vivo. Similarly, the administration of T cells that express Ab2/TCRs or Ab2/CD3 proteins may be followed by Ab1 vaccination. In either case, the immune response may be amplified further by administering INF-γ, IL-2, or INF-γ and IL-2 after the administration of transformed T cells. Thus, antibody vaccination and cytokine treatment can be used to complement and augment the efficacy of adoptive immunotherapy with transformed T cells.
 

Claim 1 of 6 Claims

1. A method for inducing a cellular immune response in a patient against a tumor that expresses carcinoembryonic antigen (CEA), said method comprising:

administering an effective immunostimulatory amount of transfected T cells to a patient; and

subsequently administering at least one cytokine to said patient;

wherein said transfected T cells are produced by obtaining T cells from the patient and transfecting said T cells with an expression vector to obtain said transfected T cells;

wherein said expression vector comprises a DNA molecule encoding either a chimeric immunoglobulin/T cell receptor or a chimeric immunoglobulin/CD3 protein, and wherein said immunoglobulin-encoding portion of said DNA molecule encodes the variable regions of a Class III anti-CEA antibody, wherein the Class III anti-CEA antibody is MN-14 or humanized MN-14, and further wherein the variable regions of the α and β polypeptide chains of said T cell receptor are replaced by said variable regions of the antibody.

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