`
`Field of the Invention
`
`The invention relates to an oncolytic immunotherapeutic agent andto the use of the
`
`oncolytic immunotherapeutic agent in treating cancer.
`
`Backgroundto the Invention
`
`Viruses have a uniqueability to enter cells at high efficiency. After entry into cells,
`
`viral genes are expressed andthe virus replicates. This usually results in the death ofthe
`
`10
`
`infected cell and the release of the antigenic components ofthe cell as the cell rupturesasit
`
`dies. As a result, virus mediated cell death tends to result in an immuneresponse to these
`
`cellular components, including both those derived from the host cell and those encoded by
`
`or incorporated into the virus itself and enhanced due to the recognition by the host of so
`
`called damage associated molecular patterns (DAMPs) whichaid in the activation of the
`
`15
`
`immuneresponse.
`
`Viruses also engage with various mediators of the innate immuneresponseaspart
`
`of the host responseto the recognition ofa viral infection through e.g.
`
`toll-like receptors
`
`and cGAS/STINGsignalling and the recognition of pathogen associated molecular patterns
`
`(PAMPs)resulting in the activation of interferon responses and inflammation which are
`
`20
`
`also immunogenic signals to the host. These immuneresponses mayresult in the
`
`immunogenicbenefit to cancer patients such that immune responses to tumorantigens
`
`provide a systemic overall benefit resulting in the treatment of tumors which have not been
`
`infected with the virus, including micro-metastatic disease, and providing vaccination
`
`against relapse.
`
`25
`
`The combined direct (‘oncolytic’) effects of the virus, and immune responses
`
`against tumorantigens (including non-self “neo-antigens’, i.e. derived from the particular
`
`mutated genesin individual tumors) is termed ‘oncolytic immunotherapy’.
`
`Viruses may also be used as delivery vehicles (‘vectors’) to express heterologous
`
`genes inserted into the viral genomein infected cells. These properties make viruses
`
`30
`
`useful for a variety of biotechnology and medical applications. For example, viruses
`
`expressing heterologous therapeutic genes may be used for gene therapy. In the context of
`
`oncolytic immunotherapy, delivered genes may include those encoding specific tumor
`
`antigens, genes intended to induce immuneresponsesor increase the immunogenicity of
`1
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`TRANSGENE/BIOINVENT
`EXHIBIT 1013
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`TRANSGENE/BIOINVENT
`EXHIBIT 1013
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`Page 1 of 85
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`
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`antigens released following virus replication and cell death, genes intended to shape the
`
`immuneresponse whichis generated, genes to increase the general immuneactivation
`
`status of the tumor, or genes to increase the direct oncolytic properties (1.e. cytotoxic
`
`effects) of the virus. Importantly, viruses have the ability to deliver encoded molecules
`
`whichare intended to help to initiate, enhance or shape the systemic anti-tumor immune
`
`responsedirectly and selectively to tumors, which may havebenefits of e.g. reduced
`
`toxicity or of focusing beneficial effects on tumors (including those not infected by the
`
`virus) rather than off-target effects on normal(i.e. non-cancerous) tissues as compared to
`
`the systemic administration of these same molecules or systemic administration of other
`
`10
`
`molecules targeting the same pathways.
`
`It has been demonstrated that a numberofviruses including, for example, herpes
`
`simplex virus (HSV) haveutility in the oncolytic treatment of cancer. HSV for use in the
`
`oncolytic treatment of cancer must be disabled such thatit is no longer pathogenic, but can
`
`still enter into and kill tumorcells. A numberof disabling mutations to HSV,including
`
`15
`
`disruption of the genes encoding ICP34.5, ICP6, and/or thymidine kinase, have been
`
`identified which do not preventthe virus from replicating in culture or in tumortissue in
`
`vivo, but which prevent significant replication in normal tissue. HSVs in which only the
`
`ICP34.5 genes have been disrupted replicate in many tumorcell types in vitro, and
`
`replicate selectively in tumortissue, but not in surrounding tissue, in mouse tumor models.
`
`20
`
`Clinical trials of ICP34.5 deleted, or ICP34.5 and ICP6 deleted, HSV have also shown
`
`safety and selective replication in tumortissue in humans.
`
`Asdiscussed above, an oncolytic virus, including HSV, mayalso be usedto deliver
`
`a therapeutic gene in the treatment of cancer. An ICP34.5 deleted virus of this type
`
`additionally deleted for ICP47 and encoding a heterologous gene for GM-CSFhasalso
`
`25
`
`beentested in clinicaltrials, including a phase 3 trial in melanoma in which safety and
`
`efficacy in man was shown. GM-CSFis a pro-inflammatory cytokine which has multiple
`
`functions including the stimulation of monocytes to exit the circulation and migrate into
`
`tissue where they proliferate and mature into macrophages and dendritic cells. GM-CSF is
`
`important for the proliferation and maturation of antigen presenting cells, the activity of
`
`30
`
`whichis needed for the activation of an anti-tumor immuneresponse. Thetrial data
`
`demonstrated that tumor responses could be seen in injected tumors, and to a lesser extent
`
`in uninjected tumors. Responses tended to be highly durable (months-years), and a
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`Page 2 of 85
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`
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`survival benefit appeared to be achieved in responding patients. Each of these indicated
`
`engagement of the immunesystem in the treatment of cancer in addition to the direct
`
`oncolytic effect. However, this and other data with oncolytic viruses generally showed
`
`that not all tumors respond to treatment and notall patients achieve a survival advantage.
`
`Thus, improvements to the art of oncolytic therapy are clearly needed.
`
`Recently it has been shownthat oncolytic immunotherapy canresult in additive or
`
`synergistic therapeutic effects in conjunction with immune checkpoint blockade(i.e.
`
`inhibition or ‘antagonism’ of immune checkpoint pathways, also termed immuneco-
`
`inhibitory pathways). Checkpoint (immune inhibitory pathway) blockade is intended to
`
`10
`
`block host immune inhibitory mechanisms which usually serve to prevent the occurrence
`
`of auto-immunity. However, in cancer patients these mechanismscanalso serveto inhibit
`
`the induction of or block the potentially beneficial effects of any immune responses
`
`induced to tumors.
`
`Systemic blockade of these pathways by agents targeting CTLA-4, PD-1 or PD-L1
`
`15
`
`have shownefficacy in a numberof tumor types, including melanomaandlungcancer.
`
`However, unsurprisingly, based on the mechanism ofaction, off target toxicity can occur
`
`due to the induction of auto-immunity. Even so, these agents are sufficiently tolerable to
`
`provide considerable clinical utility. Other immune co-inhibitory pathway and related
`
`targets for which agents (mainly antibodies) are in development include LAG-3, TIM-3,
`
`20
`
`VISTA, CSFIR, IDO, CEACAMI, CD47, Optimal clinical activity of these agents, for
`
`example PD, PDLI, LAG-3, PIM-3, VISTA, CSFIR, IDO, CD47, CEACAM], may
`
`require systemic administration or presence in all tumors due to the mechanism of action,
`
`i.e. inchiding targeting of the interface of tmmnine effector cells with tumors or other
`
`immune inhibitory mechanisms in/of tumors.
`
`fn some cases, more localised presence in
`
`25
`
`&.g. Just some tumors or in some byniph nodes may also be optimallyeffective, for example
`
`agents targeting CTLA-4,
`
`An alternative approachto increasing the anti-tumor immune response in cancer
`
`patients is to target (activate) immune co-stimulatory pathways, Le. in contrast to mbhibiting
`
`wrumune co-inhibitory pathways. These pathways send activating signals into T cells and
`
`30
`
`other immune cells, usually resulting from the interaction ofthe relevant ligands on antigen
`
`presenting cells (APCs) and the relevant receptors on the surface of T cells andother
`
`immune cells. These signals, depending on the figand/receptor, can result in the increased
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`Page 3 of 85
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`
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`activation of T cells and/or APCs and/or NK cells and/or B ceils, including particular gub-
`
`types, increased differentiation and proliferation of T cells and/or APCs and/or NK cells
`
`and/or B cells, inchiding particular subtypes, or suppression ofthe activity of immane
`
`inhibitory T cells such as regulatory T cells. Activation of these pathways would therefore
`
`be expected to result in enhanced anti-tumor immrnneresponses, but it might also be
`
`expected that systemic activation of these pathways, ic. activation of immune responses
`
`generally rather than anti-tumor immune responses specifically or selectively, would result
`
`in considerable off target toxicity im non-tumortissue, the degree of such off target toxicity
`
`depending on the particular immune co-stimulatory pathway being targeted. Nevertheless
`
`10
`
`agonts (mainly agonistic antibodies, or loss frequently the soluble ligand to the receptorin
`
`question} targeting immune co-stimulatory pathways, including agents targeting GITR, 4-
`
`1-BB, OX40, CD46or ICOS, and intended for systemic use G.e. intravenous delivery) are
`
`in or have been proposed for clinical development.
`
`For many of these approachestargeting immune co-inhibitory or co-inhibitory
`
`15
`
`pathwaysto be successful, pre-existing immune responses to tumors are needed,i.e. so that
`
`a pre-existing immuneresponse can be potentiated or a block to an anti-tumor immune
`
`response can be relieved. The presence of an inflamed tumor micro-environment, whichis
`
`indicative of such an ongoing response, is also needed. Pre-existing immuneresponses to
`
`tumor neo-antigens appearto be particularly importantfor the activity of immuneco-
`
`20
`
`inhibitory pathway blockade and related drugs. Only some patients may have an ongoing
`
`immuneresponse to tumorantigens including neoantigens and/or an inflamed tumor
`
`microenvironment, both of which are required for the optimal activity of these drugs.
`
`Therefore, oncolytic agents which can induce immuneresponses to tumorantigens,
`
`including neoantigens, and/or which can induce an inflamed tumor microenvironment are
`
`25
`
`attractive for use in combination with immune co-inhibitory pathway blockade and
`
`immunepotentiating drugs. This likely explains the promising combinedanti-tumor
`
`effects of oncolytic agents and immuneco-inhibitory pathway blockade in mice and
`
`humansthat have so far been observed.
`
`The above discussion demonstrates that there is still much scope for improving
`
`30
`
`oncolytic agents and cancertherapies utilising oncolytic agents, anti-tumor immune
`
`responses and drugs which target immune co-inhibitory or co-stimulatory pathways.
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`Page 4 of 85
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`Page 4 of 85
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`
`
`Summaryof the Invention
`
`The invention provides oncolytic viruses expressing GM-CSFandat least one
`
`molecule targeting an immuneco-stimulatory pathway. GM-CSFaidsin the induction of
`
`an inflammatory tumor micro-environment andstimulates the proliferation and maturation
`
`of antigen presenting cells, including dendritic cells, aiding the induction of an anti-tumor
`
`immuneresponses. These immuneresponses are amplified through activation of an
`
`immuneco-stimulatory pathway or pathways using an immuneco-stimulatory pathway
`
`activating molecule or molecules also delivered by the oncolytic virus.
`
`10
`
`The use of an oncolytic virus to deliver molecules targeting immuneco-stimulatory
`
`pathways to tumors focuses the amplification of immuneeffects on anti-tumor immune
`
`responses, and reduces the amplification of immuneresponses to non-tumorantigens.
`
`Thus, immunecells in tumors and tumordraining lymph nodesare selectively engaged by
`
`the molecules activating immune co-stimulatory pathways rather than immunecells in
`
`15
`
`general. This results in enhanced efficacy of immuneco-stimulatory pathway activation
`
`and anti-tumor immuneresponse amplification, and can also result in reduced off target
`
`toxicity. It is also important for focusing the effects of combined systemic immune co-
`
`inhibitory pathway blockade and immuneco-stimulatory pathway activation on tumors,1.e.
`
`such that the amplified immune responses from which co-inhibitory blocks are released are
`
`20
`
`antitumor immuneresponsesrather than responses to non-tumorantigens.
`
`The invention utilizes the fact that, when delivered by an oncolytic virus, the site of
`
`action of co-stimulatory pathway activation and of GM-CSFexpressionis in the tumor
`
`and/or tumordraining lymph node,but the results of such activation (an amplified systemic
`
`anti-tumor-immune response) are systemic. This targets tumors generally, and not only
`
`25
`
`tumors to which the oncolytic virus has delivered the molecule or molecules targeting an
`
`immuneco-stimulatory pathway or pathways and GM-CSF. Oncolytic viruses of the
`
`invention therefore provide improved treatment of cancer through the generation of
`
`improved tumor focused immune responses. The oncolytic virus of the invention also
`
`offers improved anti-tumor immunestimulating effects such that the immune-mediated
`
`30
`
`effects on tumors which are not destroyed by oncolysis, including micro-metastatic
`
`disease, are enhanced, resulting in more effective destruction of these tumors, and more
`
`Page 5 of 85
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`Page 5 of 85
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`
`
`effective long term anti-tumor vaccination to prevent future relapse and improve overall
`
`survival.
`
`Anti-tumor efficacy is improved when an oncolytic virus of the invention is used as
`
`a single agent and also whenthe virus is used in combination with other anti-cancer
`
`modalities, including chemotherapy, treatment with targeted agents, radiation and, in
`
`preferred embodiments, immune checkpoint blockade drugs(i.e. antagonists of an immune
`
`co-inhibitory pathway) and/or agonists of an immune co-stimulatory pathway.
`
`Accordingly, the present invention provides an oncolytic virus comprising: (4) 4
`
`GM-CSF-encading gene; and (ii) an mmmnime co-stimulatory pathway activating molecule
`
`10
`
`or immune co-stimulatory pathway activating moalecule-encoding gene. The virus may
`
`encode more than one immune co-stimulatory pathwayactivating molecule/gene,
`
`The immune co-stimulatory pathway activating molecule is preferably GITRL, 4-1-
`
`BBL, OX40L, ICOSL or CD40L or a modified version of any thereof or a protein capable
`
`of blocking signaling through CTLA-4, for example an antibody which binds CTLA-4.
`
`15
`
`Examples of modified versions include agonists of a co-stimulatory pathwaythat are
`
`secreted rather than being membrane bound, and/or agonists modified such that multimers
`
`of the protein are formed.
`
`The virus may be a modified clinical isolate, such as a modified clinical isolate ofa
`
`virus, wherein the clinical isolate kills two or more tumor cell lines more rapidly and/or at
`
`20
`
`a lower dose in vitro than one or more reference clinical isolates of the same species of
`
`VITUS.
`
`The virus is preferably a herpes simplex virus (HSV), such as HSVi. The HSV
`
`typically does not express functional ICP34.5 and/or functional ICP47 and/or expresses the
`
`UST gene as an immediate carly gene.
`
`25
`
`The inventionalso provides:
`
`-
`
`~
`
`-
`
`30
`
`a pharmaceutical composition comprising a virus of the invention and a
`
`pharmaceutically acceptable carrier or dilaent:
`
`the virus of the invention for use in a method of treating the human or animal body
`
`bytherapy;
`
`the virus of the invention for use in a methodoftreating cancer, wherein the
`
`method optionally comprises administering a further anti-cancer agent;
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`Page 6 of 85
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`Page 6 of 85
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`
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`~
`
`-
`
`aproduct of manufacture comprising a viras of the invention in a sterile vial,
`
`ampoule or syringe:
`
`amethod of treating cancer, which comprises administering a therapeutically
`
`effective amount of a virus or a pharmaceutical composition of the invention to a
`
`patient in need thereof, wherein the method optionally comprises administering a
`
`further anti-cancer agent which is optionally an antagonist of an immmine co-
`
`inhibitory pathway, or an agonist of an immuneco-sliroulatory pathway;
`
`-
`
`use ofa virus of the invention in the manufacture of a medicament for use ina
`
`method of treating cancer, wherein the method optionally comprises administering
`
`10
`
`a further anti-cancer agent which is optionally an antagonist of an immmine co-
`
`inhibitory pathway, or an agortist of an immrune co-stimulatory pathway;
`
`-
`
`amethodoftreating cancer, which comprises administering a therapeutically
`
`effective amountof an oncolytic virus, an inhibitor of the indoleamine 2,3-
`
`dioxygenase (IDO) pathway and a further antagonist of an immune co-inhibitory
`
`15
`
`pathway, or an agonist of an immuneco-stimulatory pathway to a patient in need
`
`thereof.
`
`Brief Description of the Figures
`
`Figure 1 depicts the structure of an exemplary virus of the invention that comprises
`
`20
`
`a gene encoding GM-CSFanda gene encoding CD40L.
`
`Figure 2 shows the differential abilities of the eight top ranking HSV1 clinical
`
`isolate strains as assessed bycrystal violet staining 24 hours or 48 hours after mfection
`
`with a MOT of 0.1, 6.01 or 0.001 as indicated in the Figure to kill Fadu, SK-mel-28, A549,
`
`HT1080, MIA-PA-CA-?, HT29 and MDA-MB-231 human tumor cell lines. The virus
`
`25
`
`strains ranked first and second on each cell line are indicated. The viras RHOISA was
`
`ranked first on cach of the Fadu, HTP1080, MIA-PA-CA-2? and HT29 cell lines and second
`
`on each of the SK-mel-28, 4549 and MDA-MB-231 cell lines. RHO04A was ranked joint
`
`first with RHOTSA and RHOISA on the HT29 cell line, first on the SK-mel-28 and AS49
`
`cell lines and second on the Fada cell line. RHOZ3A was ranked first on the MDA-MB-
`
`30
`
`231 cell line and second on the HT1O80 cell line. RHO3LA was ranked second on each of
`
`the MIA-PA-CA-2 and HT29 cell lines. RHO40A was ranked joint second on the HT29
`
`cell line.
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`Page 7 of 85
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`Page 7 of 85
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`
`
`Figure 3 shows a comparison between strain RHOISA,the strain ranked first of all
`
`the strains tested, with an ‘average’ strain from the screen (ic. stra RHOGSA).
`
`Approximately 10 fold less of strain RHOISA was needed to kill an equal proportion of
`
`cells than was needed of strain RHOGSA as shownbycrystal violet staining 24 or 48 hours
`
`post infection with MOls of 0.1, 0.01 and 0.001 in SK-mel-28, HT1080, MDA-MB-231,
`
`Fadu, MIA-PA-CA-2 and AS49 cell lines.
`
`Figures 4 and § depict structares of HSV1 viruses modified by the deletion of
`
`ICP34.5 and iCP47 such that the USI] gene is under control of the ICP457 immediate
`
`carly promoter and containing heterologous genes in the ICP34.5 locus, The viruses were
`
`10
`
`constructed using theRHGI8Astrain unless otherwise stated in the Figure.
`
`Figure 6 showsthe results of an ELISA to detect expression of human or mouse
`
`GM-CSFin supernatants from BHKcells infected with virus 16 (mGM-CSF and GALVR-
`
`), virus 17 (hGM-CSF and GALVR-) and virus 19 (mGM-CSF).
`
`Figure 7 is a comparison betweenthe cell-killing abilities of strain RHO18A in
`
`15
`
`which ICP34.5 is deleted and which expresses GALVR- and GFP(virus 10) with a virus
`
`that expresses only GFP (virus 12) as determined by crystal violet staining in three cell
`
`lines at low magnification.
`
`Figure 8 is a comparison betweenthe cell-killing abilities of strain RHO18A in
`
`which ICP34.5 and ICP47 are deleted and which expresses GALVR- and GM-CSF(virus
`
`20
`
`17) with a prior art strain with the same modifications as determined by crystal violet
`
`staining in four cell lines.
`
`Figure 9 showsthe effectiveness of Virus 16 (ICP34.5 and ICP47 deleted
`
`expressing GALVR- and mGM-CSF)in treating mice harbouring A20 lymphomatumors
`
`in both flanks. Tumors onthe right flanks were injected with the virus or vehicle and the
`
`25
`
`effects on tumorsize was observed for 30 days. The virus waseffective against both
`
`injected tumors and non-injected tumors.
`
`Figure 10 demonstrates the effects of Virus 15 (ICP34.5 and ICP47 deleted
`
`expressing GALVR- and GFP) and Virus 24 (ICP34.5 and ICP47 deleted expressing GFP)
`
`on rat 9L cells in vitro as assessed by crystal violet staining. The virus expressing GALV
`
`30
`
`(Virus 15) showed enhancedkilling of rat 9L cells in vitro as comparedto a virus which
`
`does not express GALV (Virus 24).
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`Page 8 of 85
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`Page 8 of 85
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`
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`Figure 11 showsthe antitumoreffects of Virus 16 in Balb/c mice harboring mouse
`
`CT26 tumorsin the left and right flanks. Groups of 10 mice were then treated with:
`
`Vehicle (3 injections into right flank tumors every other day); 5x10exp6 pfu of Virus 16
`
`(mRP1) injected in the right flank tumor every other day; anti-mouse PD1 alone (10mg/kg
`
`ip. every three days, BioXCell clone RMP1-14); anti-mouse CTLA-4 (3mg/kg i.p every
`
`three days, BioXCell clone 9D9); anti-mouse PD1 together with Virus 16; anti-mouse
`
`CTLA4together with Virus 16; 1-methyl trypotophan (I-MT; IDO inhibitor (Smg/mlin
`
`drinking water)); anti-mouse PD1 together with 1-methyl trypotophan;or anti-mouse PD1
`
`together with 1-methyl trypotophan and Virus 16. Effects on tumor size were observed for
`
`10
`
`a further 30 days. Greater tumor reduction was seen in animals treated with combinations
`
`of virus and checkpoint bockade than with the single treatment groups. Figure 11A shows
`
`that using Virus 16 and anti-PD1 in combination hasa better anti-tumoreffect than using
`
`either anti-PD1 or the virus alone. Figure 11B showsthat the anti-tumoreffect of Virus 16
`
`in combination with anti-CTLA-4 was better than the anti-tumoreffect of either Virus 16
`
`15
`
`or anti-CTLA-4 alone. Figure 11C showsthat enhanced tumor reduction was observed
`
`using Virus 16 together with both anti-PD1 and IDOinhibition as compared to anti-PD1
`
`and 1-MTinhibition in the absence of the virus.
`
`Figure 12 showsthe enhanced anti-tumoractivity of Virus 16 in combination with
`
`immunecheckpoint blockade in mouse A20 tumorsin both flanks of Balb/c mice as
`
`20
`
`comparedto either virus alone or checkpoint blockade alone (anti-PD1).
`
`Figure 13 showsthe structure of ICP34.5 and ICP47 deleted viruses expressing
`
`GALVR-, GM-CSFand codon optimized anti-mouse or anti-human CTLA-4 antibody
`
`constructs (secreted scFv molecules linked to human or mouse IgG1 Fe regions). The
`
`scFvs contain the linked ([G,S],) light and heavy variable chains from antibody 9D9
`
`25
`
`(US2011044953: mouse version) and from ipilimumab (US20150283234; humanversion).
`
`The resulting structure of the CTLA-4 inhibitor is also shown.
`
`Figure 14 showsanti-tumoreffects of Virus 16 and Virus 19 in a human xenograft
`
`model (A549). There were three injections of Virus 16, Virus 19 or of vehicle over one
`
`weekat three different dose levels (N=10/group). The doses of the viruses used is
`
`30
`
`indicated. The anti-tumoreffects of Virus 16 which expresses GALV were better than
`
`those of Virus 19 which does not express GALV.
`
`Page 9 of 85
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`Page 9 of 85
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`
`
`Figure 15 demonstrates the effects of viruses of the invention expressing GALVR-
`
`on 9L cells in the flanks of Fischer 344 rats. The following treatments were administered
`
`to groups of rats (ten per group), into one flank of each rat only three times per week for
`three weeks: 50ul of vehicle; SOul of 10’ pfu/ml of Virus 19 (expresses mGM-CSF but not
`GALVR-); or SOul of 107 pfu/ml of Virus 16 (expresses both mouse GM-CSF and GALV-
`
`R-). Effects on tumor growth were then observed for a further 30 days. Superior tumor
`
`control and shrinkage was observed with the virus expressing GM-CSF and GALV-R-as
`
`comparedto the virus expressing GM-CSFalone.
`
`Figure 16 showsthe anti-tumoreffects of viruses expressing anti-mCTLA-4(virus
`
`10
`
`27), mCD40L(virus 32), mOX4OL(virus 35), m4-2BBL(virus 33), , each also with
`
`mGM-CSF and GALV-R- compared to virus 16 (expresses GALV and mGM-CSF).
`
`Brief Description of the Sequence Listing
`
`SEQ ID NO: 1 is the nucleotide sequence of mouse GM-CSF.
`
`15
`
`SEQ ID NO: 2 is the nucleotide sequence of a codon optimized version of mouse
`
`GM-CSF.
`
`SEQ ID NO: 3 is the nucleotide sequence of human GM-CSF.
`
`SEQ ID NO: 4 is the nucleotide sequence of a codon optimized version of human
`
`GM-CSF.
`
`20
`
`SEQ ID NO: 5 is the amino acid sequence of mouse GM-CSF.
`
`SEQ ID NO: 6 is the amino acid sequence of human GM-CSF.
`
`SEQ ID NO: 7 is the nucleotide sequence of GALV-R-.
`
`SEQ ID NO: 8 is the nucleotide sequence of a codon optimized version of GALV-
`
`R-(the first three nucleotides are optional)
`
`25
`
`SEQ ID NO: 9 is the amino acid sequence of GALV-R-.
`
`SEQ ID NO: 10 is the nucleotide sequence of a codon optimized version of a
`
`human membrane boundversion of CD40L.
`
`SEQ ID NO: 11 is the amino acid sequence of a human membrane
`
`boundversion of CD40L.
`
`30
`
`SEQ ID NO: 12 is the nucleotide sequence of a codon optimized version of a
`
`multimeric secreted version of human CD40L.
`
`SEQ ID NO: 13 is the amino acid sequence of a multimeric secreted version of
`
`10
`
`Page 10 of 85
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`Page 10 of 85
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`
`
`human CD40L.
`
`SEQ ID NO: 14 is the nucleotide sequence of a codon optimized version of a
`
`multimeric secreted version of mouse CD40L.
`
`SEQ ID NO: 15 is the amino acid sequence of a multimeric secreted version of
`
`5
`
`mouse CD40L.
`
`SEQ ID NO: 16 is a codon optimized version of the nucleotide sequence of wild-
`
`type human CD40L.
`
`SEQ ID NO: 17 is the amino acid sequence of wild-type human CD40L.
`
`SEQ ID NO: 18 is a codon optimized version of the nucleotide sequence of wild-
`
`10
`
`type mouse CD40L.
`
`SEQ ID NO: 19 is the amino acid sequence of wild-type mouse CD40L.
`
`SEQ ID NO: 20 is the nucleotide sequence of a codon optimized version of murine
`
`4-1BBL.
`
`SEQ ID NO: 21 is the nucleotide sequence of a codon optimized version of human
`
`15
`
`4-1BBL.
`
`SEQ ID NO: 22is the nucleotide sequence of a codon optimized version of
`
`secreted mouse 4-1BBL.
`
`SEQ ID NO: 23 is the nucleotide sequence of a codon optimized version of human
`
`secreted 4-1BBL.
`
`20
`
`SEQ ID NO: 24is the nucleotide sequence of a codon optimized version of murine
`
`GITRL.
`
`SEQ ID NO: 25 is the nucleotide sequence of a codon optimized version of human
`
`GITRL.
`
`SEQ ID NO: 26 is the nucleotide sequence of a codon optimized version of
`
`25
`
`secreted murine GITRL.
`
`SEQ ID NO: 27 is the nucleotide sequence of a codon optimized version of
`
`secreted human GITRL.
`
`SEQ ID NO: 28 is the nucleotide sequence of a codon optimized version of murine
`
`OX40L.
`
`30
`
`SEQ ID NO: 29 is the nucleotide sequence of a codon optimized version of human
`
`OX40L.
`
`11
`
`Page 11 of 85
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`Page 11 of 85
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`
`
`SEQ ID NO: 30 is the nucleotide sequence of a codon optimized version of
`
`secreted murine OX40L.
`
`SEQ ID NO: 31 is the nucleotide sequence of a codon optimized version of
`
`secreted human OX40L.
`
`SEQ ID NO: 32 is the nucleotide sequence of a codon optimized version of murine
`
`ICOSL.
`
`ICOSL.
`
`SEQ ID NO: 33 is the nucleotide sequence of a codon optimized version of human
`
`SEQ ID NO: 34is the nucleotide sequence of a murine scFv CTLA-4antibody.
`
`10
`
`The first six and last cight nucleotides are restriction sites added for cloning purpases.
`
`SEQ ID NO: 35 is the nucleotide sequence of a murine scFv CTLA-4 antibody,
`
`The first six and last eight nacleotides are restriction sites added for cloning purposes.
`
`SEQ ID NO: 36 is the nucleotide sequence of the CMV promoter.
`
`SEQ ID NO: 37 is the nucleotide sequence of the RSV promoter.
`
`SEQ ID NO: 38 is the nucleotide sequence of BGH polyA.
`
`SEQ ID NO: 39 is the nucleotide sequence of SV40 late polyA.
`
`SEQ ID NO: 40 is the nucleotide sequence of the SV40 enhancer promoter.
`
`SEQ ID NO: 41 is the nucleotide sequence of rabbit beta-globulin (RBG) polyA.
`
`SEQ ID NO: 42 is the nucleotide sequence of GFP.
`
`SEQ ID NO: 43 is the nucleotide sequence of the MoMuLV LTRpromoter.
`
`
`
`15
`
`20
`
`SEQ ID NO: 44is the nucleotide sequence of the EFla promoter.
`
`SEQ ID NO: 45 is the nucleotide sequence of HGH polyA.
`
`Detailed Description of the Invention
`
`25
`
`Qneolytic Virus
`
`The virus of the invention is oncolytic. An oncolytic virus is a virus that infects
`
`and replicates in tumorcells, such that the tumorcells are killed. Therefore, the virus of
`
`the invention is replication competent. Preferably, the virus is selectively replication
`
`competent in tumortissue. A virusis selectively replication competent in tumortissueifit
`
`30
`
`replicates more effectively in tumortissue than in non-tumortissue. The ability of a virus
`
`to replicate in different tissue types can be determined using standard techniquesintheart.
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`12
`
`Page 12 of 85
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`Page 12 of 85
`
`
`
`The virus of the invention may be any virus which hasthese properties, including a
`
`herpes virus, pox virus, adenovirus, retrovirus, rhabdovirus, paramyxovirus or reovirus, or
`
`any species or strain within these larger groups. Viruses ofthe invention may be wild type
`
`G.e. unaltered from the parental virus species), or with gene disruptions or gene additions.
`
`Whichofthese is the case will depend onthe virus species to be used. Preferably the virus
`
`is a species of herpes virus, more preferablya strain of HSV, including strains of HSV1
`
`and HSV2, and is most preferablya strain of HSV1.
`
`In particularly preferred embodiments
`
`the virus of the invention is based on a clinical isolate of the virus species to be used. The
`
`clinical isolate may have been selected on the basis of it having particular advantageous
`
`10
`
`properties for the treatment of cancer.
`
`The clinical isolate may have surprisingly good anti-tumor effects comparedto
`
`other strains of the same virus isolated from other patients, wherein a patient is an
`
`individual harbouring the virus species to be tested. The virus strains used for comparison
`
`to identify viruses of the invention may be isolated from a patient or an otherwise healthy
`
`15
`
`(i.e. other than harboring the virus species to be tested) volunteer, preferably an otherwise
`
`healthy volunteer. HSV1 strains used to identify a virus of the invention are typically
`
`isolated from cold sores of individuals harboring HSV 1, typically by taking a swab using
`
`e.g. Virocult (Sigma) brand swab/container containing transport media followed by
`
`transport to the facility to be used for furthertesting.
`
`20
`
`After isolation of viruses to be compared from individuals, stocks of the viruses are
`
`typically prepared, for example by growingthe isolated viruses on BHKorverocells.
`
`Preferably, this is done following no more than 3 cycles of freeze thaw between taking the
`
`sample and it being grown on, for example, BHKorvero cells to prepare the virus stock
`
`for further use. More preferably the virus sample has undergone2 or less than 2 cycles of
`
`25
`
`freeze thaw prior to preparation of the stock for further use, more preferably one cycle of
`
`freeze thaw, most preferably no cycles of freeze thaw. Lysates from the cell lines infected
`
`with the viruses prepared in this way after isolation are compared, typically by testing for
`
`the ability of the virus to kill tumorcell lines in vitro. Alternatively, the viral stocks may
`
`be stored under suitable conditions, for example by freezing, prior to testing. Viruses of
`
`30
`
`the invention have surprisingly good anti-tumor effects compared to otherstrains of the
`
`samevirus isolated from other individuals, preferably when comparedto those isolated
`
`13
`
`Page 13 of 85
`
`Page 13 of 85
`
`
`
`from >5 individuals, more preferably >10 other individuals, most preferably >20 other
`
`individuals.
`
`Thestocksof the clinical isolates identified for modification to produce viruses of
`
`the invention (i.e. having surprisingly good properties for the killing of tumorcells as
`
`comparedto otherviral strains to which they were compared) may be stored undersuitable
`
`conditions, before or after modification, and used to generate further stocks as appropriate.
`
`A chnical isolate is astrain of a virus species which has beenisolated frorn its
`
`natural host. The clinical isolate has preferably been isolated for the purposes of testing
`
`and comparing the clinical isolate with other clinical isolates of that virus species for a
`
`10
`
`desired property, in the case of viruses of the invention that being the ability to kill human
`
`tumor cells. CHnical isolates which may be used for comparison also include those from
`
`clinical samples present in clinical repositories, Le. previously collected for clinical
`
`diagnostic or other purposes. In cither case the clinical isolates used for comparison and
`
`identification of viruses of the invention will preferably have undergone minimal culture ia
`
`15
`
`vitre prior to being tested for the desired property, preferably having only undergone
`
`sufficient culture to enable generation of sufficient stocks for comparative testing purposes.
`
`As such, the viruses used for comparisonto identify viruses of the invention may also
`
`include deposited strains, wherein the deposited strain has been isolated from a patient,
`
`preferably an HSV1 strain isolated from the cold sore ofa patient.
`
`20
`
`The virus may be a modified clinical isolate, wherein the clinical isolate kills two
`
`or more turnorcell fines more rapidly and/or at a lower dose in vitro than one or more
`
`reference clinical isolate of the sarn

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