throbber
Br. J. Cancer (1993), 67, 436-440
`
`Br. J. Cancer (1993), 67, 436-440
`
`'." Macmillan Press Ltd., 1993
`
`1993
`
`Characterisation of a humanised bispecific monoclonal antibody for
`cancer therapy
`
`A. Bruynck, G. Seemann & K. Bosslet
`
`Research Laboratories of Behringwerke AG, PO Box 11 40, W-3550 Marburg/Lahn, Germany.
`
`Summary A humanised bispecific monoclonal antibody (bsMAb) with binding specificity for carcinoem-
`bryonic antigen (CEA) on one arm and a radiolabelled chelate (DTPA-9Y) on the other arm was generated by
`consecutively transfecting the humanised genes of an anti-CEA MAb and the chimerised genes of an
`anti-chelate MAb into eucaryotic BHK cells using the calcium-phosphate coprecipitation technique. The
`antibodies secreted were of IgG3 isotype with a shortened hinge region (A gamma 3) and light chains. Double
`transfectomas were screened for the secretion of bsMAbs using a double determinant enzyme-linked immuno-
`sorbent assay (ELISA) based on solid phase attached HSA-benzyl-DTPA and an anti-idiotypic MAb selective
`for the CEA-specific arm. After purification on two immunoaffinity chromatography columns, the humanised
`bsMAbs were characterised by SDS-PAGE and a quantitative binding assay in antigen excess. The purification
`procedure resulted in 95% reactive bispecific MAb. This humanised bsMAb may be employed in two phase
`radioimmunotherapy, binding to the tumour via the anti-CEA arm and localising a radiolabelled chelate with
`the other arm, without inducing a strong immune response observed sometimes with murine MAbs.
`
`Besides the important role of murine monoclonal antibodies
`(MAbs) in basic research and in vitro diagnosis, they became
`important tools for in vivo diagnosis of tumours (Murray &
`Unger, 1988), inflammatory processes (Joseph et al., 1988)
`and thrombosis (Haber et al., 1990). Furthermore it was
`clinically proven that murine MAbs inhibit transplantation
`rejection (Goldstein, 1987; Kurrle et al., 1988) and interfere
`with gram negative sepsis (Greenman et al., 1991). No clear-
`cut clinical benefit, however, was shown so far in the therapy
`of solid tumours either with cytotoxic murine MAbs or
`MAb-drug conjugates (Dykes et al., 1987). This is mainly
`due to the unfavourable tumour tissue penetration charac-
`teristics and whole body distribution of macromolecules such
`as MAbs (Thomas et al., 1989), causing severe damages in
`normal tissue as well. This can be optimised using the
`recently described two phase immunotherapy approaches
`(Bosslet et al., 1991) based on bispecific MAbs. BsMAbs
`offer a unique possibility for the two phase immunotherapy
`consisting of a long-term binding phase of the nontoxic
`bsMAbs to tumour cells and, after the elimination of un-
`bound bsMAb, a short-term binding phase of an effector
`system. In our approach, we intend to use a bsMAb with
`binding specificity for a tumour associated antigen (carcino-
`embryonic antigen, CEA) on one arm and to a radiolabelled
`chelate (DTPA-9Y) on the other arm for a two phase radio-
`immunotherapy.
`BsMAbs have been generated either by chemical linking of
`the reduced monovalent parental Fab' fragments to form a
`bispecific F(ab')2 fragment (Brennan et al., 1985; Bagshawe et
`al., 1989), using the quadroma technique (Milstein & Cuello,
`1983), by double transfection of murine Ig genes (Lenz &
`Weidle, 1990) or by double transfection of chimeric DNA
`constructs (Songsivilai et al., 1989). A murine bsMAb with
`the above mentioned specificities, generated by double fusion
`has already been described (Bosslet et al., 1991).
`Unfortunately repetitive high dose injection of murine
`monoclonal antibodies in immunotherapy often induced the
`development of human anti-mouse-Ig antibodies (HAMA) in
`patients, which prevent prolonged treatment (Miller et al.,
`1983; Kroonenburgh, van & Pauwels, 1988). Consequently,
`the target was to produce a MAb capable of escaping surveil-
`lance by the human immune system while retaining the speci-
`ficity of the murine parental antibody. In a first approach,
`
`Correspondence: K. Bosslet.
`Received 12 December 1991; and in revised form 8 October 1992.
`
`the V-regions of murine antibodies were recombined with
`human constant region genes to form chimeric MAbs (Bouli-
`anne et al., 1984; Morrison et al., 1984). Lately, the antigen
`binding
`loops
`complementarity-determining
`regions
`or
`(CDRs) of the mouse VH and VL domains have successfully
`been transplanted to the VH and VL domains of human
`myeloma proteins without major impairment of the antigen
`binding capacity (Jones et al., 1986; Riechmann et al., 1988).
`One of these humanised MAb has already been applied in
`patients (Hale et al., 1988), without inducing a detectable
`immune response against the molecule.
`In this report, we describe the generation of a bifunctional
`MAb consisting of one humanised anti-CEA arm and a
`chimerised anti-DTPA-Y arm by double transfection of the
`corresponding genes into BHK cells, its purification using
`immunoaffinity chromatography and its characterisation.
`
`Materials and methods
`
`Production of CEA- and DTPA-specific murine MAbs
`The generation and screening of murine MAbs directed
`against CEA (BW 431) and DTPA-Y (BW 2050), respectively,
`was described previously (Bosslet et al., 1988 and 1991).
`
`Chimerisation of an anti-DTPA- Y MAb
`The murine variable (VH and VL) region genes of the heavy
`and light chain of MAb BW 2050 were recombined with the
`constant region genes of human IgGs (Ay3) according to the
`method of Boulianne et al. (1984) (Figure 1).
`
`Humanisation of an anti-CEA MAb
`The sequences of the heavy and light chain variable genes of
`MAb BW 431 (anti-CEA) were amplified and cloned as des-
`cribed by Orlandi et al. (1989) and the CDR regions were
`subsequently built into the framework of human VH and VL
`domains according to the methodology of Jones et al. (1986)
`and Riechmann et al. (1988) (Figure 1). The exact procedure
`for the humanisation of MAb BW 431 was described by
`Gussow and Seemann (1991).
`
`Expression of humanised bsMAb
`First, the expression vectors carrying the heavy and light
`chain genes of humanised MAb BW 431 were transfected
`
`Genzyme Ex. 1038, pg 917
`
`

`
`a
`
`Hindill
`
`P-
`
`Pvull
`
`Hindlill
`
`~~~~~~~~~~~Pvull
`
`/ iv
`
`f 8W~~SV*w__iHl
`~~~~~Prametur
`OK'hu
`
`E/
`/humUVH mu./
`2050/536 V). mu/
`
`pAM
`
`CH'I.
`
`Bl
`
`Hkp
`
`Tell~~~~~~~~ul
`
`Pati
`
`Poull
`
`~
`
`sotMal
`
`ftil
`
`Schematic diagrams of the expression plasmids pAb,
`Figure 1
`used for double transfection, containing the murine (black) CDRs
`of light a, and heavy b, chain of MAb BW 431 (anti-CEA) or the
`variable region of light c, and heavy d, chain of MAb BW 2050
`(anti-DTPA-Y) respectively, joined to the human (white) A
`gamma 3 and kappa constant regions. SV40 promoter and CMV
`enhancer are shown as well as the drug resistance marker ampi-
`cillin (amp).
`
`into eucaryotic BHK cells (ATCC CCL10, American Type
`Culture Collection, Rockville, Md., USA) using the Calcium-
`phosphate precipitation technique (Graham & van der Eb,
`1973). Two plasmids carrying resistance genes for methotrex-
`ate (Subramani et al., 1981) and G418 (Hudziak et al., 1982)
`as selection markers were cotransfected. A BHK cell line
`which had been selected for the production of humanised
`anti-CEA MAb and the binding of anti-idiotypic antibody
`(Gussow & Seemann, 1991) was transfected a second time
`with the chimeric genes coding for the heavy and light chains
`of MAb BW 2050. The resistance gene for hygromycin (Gritz
`& Davies, 1983) was cotransfected for the selection of double
`transfectomas.
`Cells were seeded out in a modified Dulbecco's medium
`containing human insulin and all three resistance markers
`(Mtx, G418, hygromycin). Clones grew out 2-3 weeks after
`transfection.
`
`Screening of the double transfectomas
`Transfectoma supernatants were screened for the presence of
`bispecific MAb using an ELISA system in which HSA-
`benzyl-DTPA (50 ng ml-') was attached to the solid phase of
`round bottom polystyrol plates (Nunc). Bound MAb was
`detected using a murine anti-idiotypic antibody (IgG2b)
`(Bosslet et al., 1990), selective for the murine as well as the
`humanised anti-CEA MAb BW 431, and an alkaline phos-
`phatase labelled goat anti-mouse-IgG2b antibody (Southern,
`Birmingham, USA) combined with the alcohol dehydrogen-
`ase-diaphorase amplification system (Stanley et al.,
`1985;
`system III). Optical density was measured at 493 nm using a
`Titertek multiscan type 3100 (Flow Laboratories).
`
`Double affinity chromatography
`Protein A-sepharose-purified anti-idiotypic MAb specific for
`BW 431 was coupled to cyanogen bromide-activated Sepha-
`
`HUMANISED BISPECIFIC MONOCLONAL ANTIBODY
`
`437
`
`rose at a concentration of 6.5 mg MAb ml - gel according to
`van Eijk and van Noort (1976). Supernatant of double trans-
`fectoma was loaded on the column. After extensive washing
`with phosphate-buffered saline (PBS), pH 7.2,
`specifically
`bound antibodies were eluted using PBS, pH 4.0. On a
`second column, antigen (HSA-benzyl-DTPA) was covalently
`coupled to CNbr-activated Sepharose at a concentration of
`8 mg ml-' gel. The MAb eluted from the anti-id column was
`loaded on the HSA-benzyl-DTPA column. After washing
`with PBS, pH 7.2, the bispecific MAbs were eluted with
`double distilled water containing 25% glycerine, and adjusted
`to pH 2.3
`The enrichment of bispecific MAb was monitored using
`three ELISA systems which allowed the determination of the
`functional anti DTPA arm (system 1), a functional anti CEA
`arm (system 2) or both arms (system 3). Technical details of
`the systems are identical to those described in screening of
`the double transfectomas.
`System I uses HSA benzyl-DTPA on the solid phase (coat-
`ing concentration: 50 ng ml-') combined with AP-labelled
`anti human K antibody (50 ng ml-', Southern Biotechnology
`h.c., Birmingham).
`In system II CEA at a concentration of 50ngml-' was
`attached to the solid phase instead of HSA-benzyl-DTPA.
`System III was described in chapter 'Screening of the
`double transfectomas'.
`
`Characterisation of bsMAbs in SDS-Polyacrylamide-gel
`electrophoresis
`Samples were analysed either unreduced or reduced with
`50 mM DTT by SDS-PAGE (Laemmli, 1970), carried out in
`a Mini Protean II Electrophoresis Cell (Bio-Rad, Richmond,
`Ca., USA) using a 10% stacking gel combined with a separa-
`tion gel of 4-15% (Bio-Rad). The gels were stained using
`Coomassie Blue according to the manufacturers' procedure
`(PhastGel'm Blue R, Pharmacia LKB, Sweden).
`
`Quantitative binding assay in antigen excess
`Four hundred ng ml-' of purified humanised bispecific MAb
`were incubated with increasing amounts of antigen. Antigen
`consisted of CEA-expressing HT 29 colon carcinoma xeno-
`grafts which were fixed using 5% formaldehyde for 5 days
`and squeezed after cutting in 1-3 mm3 cubes through a
`stainless steel sieve. This methodology generates single dead
`round cell bodies, defined as ACM (antigen containing
`material). After a 4 h incubation at room temperature the
`antigen was spun down and the amount of unbound MAb in
`the supernatant was determined using a quantitative ELISA
`specific for human IgG (anti-human-IgG attached to the
`solid-phase). The fraction of unbound MAb detectable in the
`supernatant in antigen excess represents the inactive fraction
`of the purified bsMAb preparation. Immunoreactivity (I.R.)
`was determined according to the formula
`
`I.R. = 100% -
`
`100% x IgG-concentration at point of determination
`Input IgG-concentration
`
`The point of determination was the highest amount of anti-
`gen at which there was no unspecific binding of the chimeric
`negative control MAb BW 554, selective for ganglioside GD2.
`
`Evaluation of the anti DTPA-arm
`One fg ml-' of HSA-Benzyl-DTPA-Y was used to coat
`microtitre plates. Constant amounts (1I00 tg ml-') of bsMAb
`purified by affinity chromatography were mixed with increas-
`ing amounts of DTPA-Y starting with 0.1 ng ml-' up to
`1 ttg ml-' in 1:4 fold dilution. After incubation of the mix-
`ture in the coated wells for 30' at RT, bound bsMAb was
`detected using an AP-labelled anti human K antibody as
`combined with the ADH-diaphorase amplification system.
`
`Genzyme Ex. 1038, pg 918
`
`

`
`Table I ELISA for the evalution of double immunoaffinity chromato-
`graphy
`
`III
`0.240
`
`I
`1.220
`
`II
`0.990
`
`Experimental procedure
`Concentrate before chromatography
`(1:20)
`Flow through a-id-column
`0.340
`1.200
`0.100
`Eluate (1:10)
`0.330
`0.340
`1.100
`Flow through antigen-column
`0.250
`0.170
`0.350
`Eluate (1: 10)
`0.440
`0.920
`0.350
`Optical density at 492 nm in detection system: (I) HSA-benzyl-DTPA
`solid phase + anti-K-AP; (II) CEA solid phase + anti-K-AP; (III) HSA-
`benzyl-DTPA solid phase + anti-id (IgG2b) + anti-IgG2b-AP.
`
`1
`
`2
`
`3
`
`4
`
`5
`
`6
`
`150 _
`
`110 _
`
`70-
`
`44-
`
`28-
`
`18-
`
`Figure 2
`SDS-Polyacrylamide gel electrophoresis (10% stacking
`gel) with unreduced (lanes 1-3) and reduced (lanes 4-6) samples
`of protein marker (lanes 1 and 4); monospecific humanised MAb
`BW 431 (lanes 2 and 5); bsMAb A 10 (lanes 3 and 6). Molecular
`weights in kDa.
`
`*
`
`-
`
`.+.
`
`| l X W | t t .......
`
`1500
`
`1000 _
`_
`
`-
`
`500
`
`w E
`
`C 0 C
`
`.)cJ
`
`xw
`
`33.3 +.+
`33.3
`100
`300
`
`0
`
`0
`
`0.4
`
`1.2
`
`3.6
`11.1
`mg ACM
`Figure 3 ELISA for the quantitative evaluation of unbound
`bispecific humanised MAb after double affinity chromatography.
`Individual
`wells contained
`the
`antigen
`containing
`material
`(ACM = CEA) (indicated on the abscissa) mixed with 400 ng of
`humanised bsMAb A 10 (
`), with 400 ng of humanised
`MAb BW 431 (. ), or with 400 ng of irrelevant chimeric MAb
`BW 554 (------). Optical density expressed in mE (492 nm) at the
`ordinate represents the amount of unbound MAb in the super-
`natant of each antigen concentration. The arrow indicates the
`point of determination.
`
`Table II
`
`hum. BW 431
`hum. bispecific
`A 10
`
`Immunoreactivity (I.R.), expressed as percentage, of human-
`ised bsMAb A 10 and humanised MAb BW 431
`IgG-concentration
`IgG-concentration
`(input)
`(p. of determination) % IR.
`400 ng ml-'
`15 ng ml-'
`96
`468 ng ml-'
`22 ng ml-'
`95
`
`438
`
`A. BRUYNCK et al.
`
`Results
`
`Generation of humanised anti-CEA x anti-DTPA- Y bsMAbs
`By double transfection of BHK cells we produced clones
`secreting bispecific IgG3 with one humanised anti-CEA arm
`and a chimerised anti-DTPA-Y arm. Arising clones were
`screened using a double determinant ELISA based on solid
`phase attached HSA-benzyl-DTPA and anti-idiotypic anti-
`body, selective for the CEA-specific arm (see Material and
`methods; system III). Out of 730 clones that were isolated
`2-3 weeks after transfection, three clones remained stable
`producers of bsMAbs after two rounds of cloning. The clone
`with the highest production rate was A 10/32/255, further
`named A 10 or humanised bsMAb. A 10 produced 4-8 pg
`MAb ml-' and was cultured in roller bottles in a modified
`Dulbecco's medium supplemented with human insulin and
`the resistance markers (G418, Mtx, hygromycin).
`
`Purification of humanised bsMAb
`Ten litres supernatant of clone A 10 were concentrated and
`purified using two consecutive affinity chromatography col-
`umns, first an anti-id column and second an antigen column.
`The effect of the individual purification steps was investigated
`using three different ELISAs, detecting the anti-DTPA-Y
`arm (system I), the anti CEA arm (system II), and both arms
`(system III). BsMAb could be separated from the non bi-
`specific molecules which appear by false recombinations of
`heavy and light chains. The data, presented in Table I, show
`a) the increase of activity in system II (specific for CEA) after
`anti-idiotypic affinity chromatography, and b) the increase of
`activity in system I (specific for DTPA-Y) after antigen
`affinity chromatography in the eluates in question. Coinci-
`dental there is a decrease of activity in the flow throughs of
`both columns.
`Out of 32 mg of IgG which could be detected via ELISA
`in 10 1 of supernatant of A 10, 3.1 mg were left over after
`double immunoaffinity purification. The yield of 10% was in
`the range suggested according to the theoretical considera-
`tions from Milstein and Cuello (1983).
`
`Characterisation of the humanised bsMAbs
`In order to characterise the immunoaffinity purified human-
`ised bsMAb and to investigate whether the bispecific mole-
`cule retains the characteristics of the humanised monospecific
`anti-CEA MAb 431, both molecules were compared using
`SDS-PAGE.
`In SDS-PAGE (Figure 2) both immunoglobulins showed a
`major band with an apparent molecular weight of approxi-
`mately 150 kDa and a minor band of approximately 125
`kDa. Under reducing conditions, the humanised anti CEA
`MAb showed a 50 kDa heavy chain and a 25 kDa light
`chain, whereas in the bsMAb preparation two light chains
`with an approximate molecular weight of 25 and 26.5 kDa
`were detected in addition to a 50 kDa heavy chain band.
`
`Quantitative binding capacity of humanised bsMAbs in antigen
`excess
`The immunoreactivity of the immunopurified bsMAb A 10
`was determined in comparison to the humanised monospecific
`anti-CEA MAb BW431 and an irrelevant chimeric antibody
`(BW 554) in an ELISA after incubation of constant amounts
`of antibody with increasing amounts of particle attached
`CEA as described in Materials and methods (Figure 3).
`Immunoreactivity was calculated, based on the IgG con-
`centrations determined by ELISA, according to the formula
`given in Materials and methods. Calculations indicated that
`95% of the preparation of bispecific MAb consisted of
`immunoreactive material, compared to 96% as determined
`for the monospecific humanised MAb BW 431 (see Table II).
`
`Genzyme Ex. 1038, pg 919
`
`

`
`Evaluation of the anti DTPA- Y arm
`The binding potential of the bsMAb to HSA-benzyl DTPA-
`Y was determined in a competitive ELISA system as des-
`cribed in Materials and methods. Increasing amounts of
`DTPA-Y as a competitor resulted in a decrease of the bind-
`ing signal in the ELISA down to background level (data not
`shown). These data indicate that free DTPA-Y is able to
`block the binding of the bsMAb to solid phase attached
`HSA-benzyl DTPA-Y, arguing for the functional integrity of
`the anti DTPA-Y arm.
`
`Discussion
`
`We have established a humanised bispecific monoclonal anti-
`body consisting of a humanised anti-CEA arm and a chime-
`rised anti-DTPA-Y arm. The bispecific molecule is of IgG3
`isotype and has a shortened hinge region: instead of normally
`four, the AIgG3 gene has only one exon, reducing the possi-
`ble disulfide bonds from 11 to 3. We were able to generate
`this bsMAb by two successive, calcium-phosphate mediated
`transfections of an eucaryotic BHK cell line. Out of several
`hundred clones, only three stably produced bsMAbs detect-
`able in a double determinant ELISA. For purification pur-
`poses we had to load the culture supernatant on two
`consecutive immunoaffinity chromatography columns, first
`presenting an anti-idiotypic antibody, selective for the CEA
`arm, and second the antigen for the anti-DTPA arm. Puri-
`fication was controlled by three ELISA systems (Table I),
`which proved that there was an increase of activity in the
`eluates and a coincidental decrease of activity in the flow
`through of the two columns. We were able to quantitatively
`separate 10% of bispecific monovalent antibodies from false-
`ly recombined molecules, a yield which correlates with the
`theoretical considerations of Milstein and Cuello (1983).
`Ninety-five per cent of the bispecific molecules were immuno-
`reactive as revealed by a quantitative binding assay in anti-
`gen excess (Table II). Compared to other methods (Doussal
`et al., 1989; Lenz & Weidle, 1990) this purification method
`leads to exceptionally high yields. Disadvantageous was the
`yield of the BHK cells secreting the immunoglobulins: from a
`cell line which had produced 4-8 g ml-' in the beginning,
`we only harvested about 30 mg immunoglobulin from 101
`supernatant instead of 40-80 mg expected. It has to be
`accepted that to some extent the cells lost the specificity of
`antibody production. In another case of antibody production
`in BHK cells in our laboratory it was revealed that the cells
`produced much more light chains than heavy chains (Bosslet,
`unpublished data), a fact which leads to reduced yields of
`intact molecules. Combined with the fact that two affinity
`chromatography columns are necessary for purification, these
`conditions are unfavourable for larger production scales.
`
`HUMANISED BISPECIFIC MONOCLONAL ANTIBODY
`
`439
`
`Comparison of the humanised bsMAb and the humanised
`monospecific anti-CEA antibody in SDS-PAGE proved that
`both molecules resemble each other to a large extent. The
`most obvious differences appear in the behaviour of the light
`chains of both antibodies which point to the presence of two
`different K-chains in the bsMAb (Figure 2, lanes 5 and 6).
`This may be due to the fact that one of the light chains still
`has a whole murine variable region. The integrity of the
`bispecific MAb was further proven by our immunoreactivity
`studies indicating that >95% of the bispecific humanised
`MAb were functionally active. This immunoreactivity is only
`marginally inferior to the value generated using the human-
`ised monospecific MAb (>96%-.
`The anti DTPA-Y could only be evaluated qualitatively.
`Data from the competitive ELISA system in which the bind-
`ing of the bsMAb to solid phase attached HSA-benzyl
`DTPA-Y was completely blocked by a > 100 fold excess of
`free DTPA-Y, argue for the functional integrity and speci-
`ficity of those bsMAb molecules which bound to the solid
`phase attached HSA-benzyl DTPA-Y. This type of analysis is
`less quantitative than the immunoreactivity assay performed
`for the anti CEA arm, but is nevertheless suited to support
`the usefulness of the hu bsMAb.
`The bispecific MAb generated is intended to be employed
`in two phase radioimmunotherapy, having dual specificity for
`carcino-embryonic antigen (CEA) and a radiolabelled chelate
`(DTPA-90Y). Concerning the specific tumour localisation,
`Bosslet et al. (1991) showed that it is possible to obtain a
`significant tissue penetration of solid human carcinoma xeno-
`grafts after long time application of the murine anti-CEA
`MAb BW 431. Since the two phase therapy concept is built
`up on repetitive long-term and high dose injections of
`bispecific antibodies, immunisation of patients is most prob-
`able. The humanised bsMAb is hoped to overcome the prob-
`lem of immunogenicity currently seen with murine and
`chimeric antibodies used in human therapy (Briiggemann et
`al., 1989).
`Considering the yields and the cumbersome purification
`procedure, attempts have been made to improve the yield of
`bispecific monovalent MAb using recombinant DNA techno-
`logy, e.g. the construction of an Ig heavy chain, consisting of
`VH of MAB 1 and a CHl domain, which is linked by a
`polypeptide spacer to the other heavy chain, consisting of VH
`of MAb 2 and a CH3 domain, to form a 'tandem heavy
`chain'. The association of such a 'tandem heavy chain' with
`the two corresponding light chains (VK of MAb 1 and a Cx
`domain or VK of MAb 2 and a CH3 domain) should lead
`predominantly to the formation of the desired bispecific
`molecule.
`
`The technical assistance of N. Doring, E. Herz, H. Lind and M.
`Matthai as well as the secretarial assistance of S. Lehnert are greatly
`appreciated.
`
`References
`
`BAGSHAWE, K.D., ROGERS, G.T. & SHARMA, S.K. (1989). Further
`improvements relating to drug delivery systems. WO 89/10140.
`BOSSLET, K., STEINSTRAESSER, A., SCHWARZ, A., HARTHUS, H.P.,
`LCJBEN, G., KUHLMANN, L. & SEDLACEK, H.H. (1988). Quanti-
`tative considerations supporting the irrelevance of circulating
`serum CEA for the immunoscintigraphic visualization of CEA
`expressing carcinomas. Eur. J. Nucl. Med., 14, 523-528.
`BOSSLET, K., KEWELOH, H.C., HERMENTIN, P., MUHRER, K.H.,
`SEDLACEK, H.H. & SCHULZ, G. (1990). Percolation and binding
`of monoclonal antibody BW 494 to pancreatic carcinoma tissues
`during high dose immunotherapy and consequences for future
`therapy modalities. Br. J. Cancer, 62, Suppl. X, 37-39.
`BOSSLET, K., STEINSTRAESSER, A., HERMENTIN, P., KUHLMANN,
`L., BRUYNCK, A., MAGERSTAEDT, M., SEEMANN, G., SCHWARZ,
`A. & SEDLACEK, H.H. (1991). Generation of bispecific mono-
`clonal antibodies for two phase radioimmunotherapy. Br. J.
`Cancer, 63, 681-686.
`
`BOULAINNE, G.L., HOZUMI, N. & SHULMAN, M.J. (1984). Produc-
`tion of functional chimeric mouse/human antibody. Nature, 312,
`643-646.
`BRENNAN, M., DAVISON, P.F. & PAULUS, H. (1985). Preparation of
`bispecific antibodies by chemical recombination of monoclonal
`immunoglobulin GI fragments. Science, 229, 81-83.
`BRJGGEMANN, M., WINTER, G., WALDMANN, H. & NEUBERGER,
`M.S. (1989). The immunogenicity of chimeric antibodies. J. Exp.
`Med., 170, 2153-2157.
`DYKES, P.W., BRADWELL, A.R., CHAPMAN, C.E. & VAUGHAN,
`A.T.M. (1987). Radioimmunotherapy of cancer: clinical studies
`and limiting factors. Cancer Treat. Rev., 14, 87-106.
`DOUSSAL, J.M., LE, MARTIN, M., GAUTHERAT, E., DELAAGE, M. &
`BARBET, M. (1989). In vitro and in vivo targeting of radiolabeled
`monovalent and divalent haptens with dual specificity mono-
`clonal antibody conjugates: enhanced divalent hapten affinity for
`cell bound antibody conjugates. J. Nucl. Med., 30, 1358-1366.
`
`Genzyme Ex. 1038, pg 920
`
`

`
`440
`
`A. BRUYNCK et al.
`
`EIJK, H.G. VAN & NOORT, W.L. VAN (1976). Isolation of rat transfer-
`rin using CNBr-activated sepharose 4B. J.
`Clin. Chem. Clin.
`Biochem., 14, 475-478.
`GOLDSTEIN, G. (1987). Overviews of the development of orthoclone
`OKT3: monoclonal antibody for therapeutic use in transplanta-
`tion. Transplant. Proc., XIX, 1-6.
`GRAHAM, F.L. & EB, A.J. VAN DER (1973). A new technique for the
`assay of infectivity of human adenovirus 5' DNA. Virology, 52,
`456-467.
`GREENMAN, R.L., SCHEIN, R.M.H., MARTIN, M.A., WENZEL, R.P.,
`MACINTYRE, N.R., CHMEL, E.H., KOHLER, R.B., MCCARTHY,
`M., PLOUFFE, J., RUSSELL, J.A. & THE XOMA SEPSIS STUDY
`GROUP (1991). A controlled clinical trial of ES murine mono-
`clonal 1gM antibody to endotoxin in the treatment of gram-
`negative sepsis. JAMA, 266, 1097-1102.
`GRITZ, L. & DAVES, J. (1983). Plasmid-encoded hygromycin-B resis-
`tance: the sequence of hygromycin-B-phosphotransferase gene
`and its expression in E. coli and S. cerevisia. Gene, 25, 179-188.
`GOSSOW, D.H. & SEEMANN, G. (1991). Humanization of monoclonal
`antibodies. Meth. Immunol., 203, 99-121.
`HABER, E., QUERTERMOUS, T., MATSUEDA, G.R., RUNGE, M.S. &
`BODE, C. (1990). Antibody-targeted thrombolytic agents. Jap.
`Circulation J., 54, 345-348.
`HALE, G., DYER, M.J.S., CLARK, M.R., PHILLIPS, J.M., MARCUS, R.,
`RIECHMANN, L., WINTER, G. & WALDMANN, H. (1988). Remis-
`sion induction in non-Hodgkin lymphoma with reshaped human
`monoclonal antibody CAMPATH-1H. Lancet, ii, 1394-1399.
`HUDZIAK, R.M., LASKI, F.A., RAJBHANDARY, U.L., SHARP, P.A. &
`CAPECCHI, M.R. (1982). Establishment of mammalian cell lines
`containing multiple nonsense mutations and functional suppres-
`sor tRNA genes. Cell,. 31, 137-146.
`JONES, P.T., DEAR, P.H., FOOTE, J., NEUBERGER, M.S. & WINTER,
`G. (1986). Replacing the complementarity-determining regions in
`a human antibody with those from a mouse. Nature, 321, 522.
`JOSEPH, K., HOFFKEN, H., BOSSLET, K. & SCHORLEMMER, H.U.
`(1988). In vivo labelling of granulocytes with 99"Tc anti-NCA
`monoclonal antibodies for imaging inflammation. Eur. J. Nucl.
`Med., 14, 367-373.
`KROONENBURGH, M.J.P.C. VAN & PAUWELLS, E.K.J. (1988). Human
`immunological response to mouse monoclonal antibodies in the
`treatment or diagnosis of malignant diseases. Nuclear Med. Com-
`mun., 9, 919-921.
`
`KURRLE, R., ENSSLE, K.H. & SEILER, F.R. (1988). Monoclonal anti-
`bodies directed to leukocyte differentiation antigens for thera-
`peutic use. Behring Inst. Mitt., 82, 154-173.
`LAEMMLI, U.K. (1970). Cleavage cultures of fused cells secreting
`antibody of predefined specificity. Nature, 227, 680-685.
`LENZ, H. & WEIDLE, U. (1990). Expression of heterobispecific anti-
`bodies by genes transfected into producer hybridoma cells. Gene,
`87, 213-218.
`MILLER, R.A., OSEROFF, A.R., STRATTE, P.T. & LEVY, R. (1983).
`Monoclonal antibody therapeutic trials in seven patients with
`T-cell lymphoma. Blood, 62, 988-995.
`MILSTEIN, C. & CUELLO, A.C. (1983). Hybrid hybridomas and their
`use in immunohistochemistry. Nature, 305, 537-540.
`MORRISON, S.L., JOHNSON, M.J., HERZENBERG, L.A. & 01, V.T.
`(1984). Chimeric human antibody molecules: mouse antigen-bind-
`ing domains with human constant region domains. Proc. Natl
`Acad. Sci. USA, 81, 6851-6855.
`MURRAY, J.L. & UNGER, M.W. (1988). Radioimmunodetection of
`cancer with monoclonal antibodies: current status, problems, and
`future directions. CRC Critical Rev. Oncol./Hematol., 8, 227-256.
`ORLANDI, R., GOSSOW, D.H., JONES, P.T. & WINTER, G. (1989).
`Cloning immunoglobulin variable domains for expression by the
`polymerase chain reaction. Proc. Natl Acad. Sci. USA, 86,
`3833-3837.
`RIECHMANN, L., CLARK, M., WALDMANN, H. & WINTER, G. (1988).
`Reshaping human antibodies for therapy. Nature, 332, 323-327.
`SONGSIVILAI, S., CLISSOLD, P.M. & LACHMANN, P. (1989). A novel
`strategy for producing chimeric bispecific antibodies by gene
`transfection. Biochem. Biophys. Res. Commun., 164, 271-276.
`STANLEY, C.J., PARIS, F., PLUMB, A., WEBB, A. & JOHANNSON, A.
`(1985). Enzyme amplification: a new techniqe for enhancing the
`speed and sensitivity of enzyme immunoassays. Int. Comm. Rad.
`Protect., 3, 44-47.
`SUBRAMANI, S., MULLIGAN, R. & BERG, P. (1981). Expression of
`the mouse dihydrofolate reductase complementary deoxyribo-
`nucleic acid in simian virus 40 vectors. Mol. Cell.
`Biol.,
`1,
`854-864.
`THOMAS, G.D., CHAPPELL, M.J., DYKES, P.W., RAMSDEN, D.B.,
`GODFREY, K., ELLIS, J.R.M. & BRADWELL, A.R. (1989). Effect of
`dose, molecular size,
`affinity, and protein binding on tumor
`uptake of antibody or ligand: a biomathematical model. Cancer
`Res., 49, 3290-3296.
`
`Genzyme Ex. 1038, pg 921

This document is available on Docket Alarm but you must sign up to view it.


Or .

Accessing this document will incur an additional charge of $.

After purchase, you can access this document again without charge.

Accept $ Charge
throbber

Still Working On It

This document is taking longer than usual to download. This can happen if we need to contact the court directly to obtain the document and their servers are running slowly.

Give it another minute or two to complete, and then try the refresh button.

throbber

A few More Minutes ... Still Working

It can take up to 5 minutes for us to download a document if the court servers are running slowly.

Thank you for your continued patience.

This document could not be displayed.

We could not find this document within its docket. Please go back to the docket page and check the link. If that does not work, go back to the docket and refresh it to pull the newest information.

Your account does not support viewing this document.

You need a Paid Account to view this document. Click here to change your account type.

Your account does not support viewing this document.

Set your membership status to view this document.

With a Docket Alarm membership, you'll get a whole lot more, including:

  • Up-to-date information for this case.
  • Email alerts whenever there is an update.
  • Full text search for other cases.
  • Get email alerts whenever a new case matches your search.

Become a Member

One Moment Please

The filing “” is large (MB) and is being downloaded.

Please refresh this page in a few minutes to see if the filing has been downloaded. The filing will also be emailed to you when the download completes.

Your document is on its way!

If you do not receive the document in five minutes, contact support at support@docketalarm.com.

Sealed Document

We are unable to display this document, it may be under a court ordered seal.

If you have proper credentials to access the file, you may proceed directly to the court's system using your government issued username and password.


Access Government Site

We are redirecting you
to a mobile optimized page.





Document Unreadable or Corrupt

Refresh this Document
Go to the Docket

We are unable to display this document.

Refresh this Document
Go to the Docket