VEGFR-2 TARGETING DNA VACCINE FOR COMBINATION THERAPY

Abstract

The present invention relates to an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, for use in the treatment of cancer, wherein the treatment further comprises the administration of at least one further anti-cancer agent. The present invention further relates to a pharmaceutical composition comprising an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, wherein the pharmaceutical composition further comprises at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation of U.S. Ser. No. 15/737,659, filed Dec. 18, 2017, which is a 371 National Stage application of International Application No. PCT/EP2016/001004, filed Jun. 16, 2016, which claims the benefit of European Application No. 15001803.4, filed Jun. 18, 2015, all of which are herein incorporated by reference in their entirety.

INCORPORATION OF SEQUENCE LISTING BY REFERENCE

[0002] The sequence listing contained in the file named "WRST004US-revised_ST25.txt", which is 67,042 kilobytes (size as measured in Microsoft Windows.RTM.) and was created on Aug. 24, 2020, is filed herewith by electronic submission and is incorporated by reference herein.

FIELD OF THE INVENTION

[0003] The present invention relates to an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, for use in the treatment of cancer, wherein the treatment further comprises the administration of at least one further anti-cancer agent. The present invention further relates to a pharmaceutical composition comprising an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, wherein the pharmaceutical composition further comprises at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

BACKGROUND OF THE INVENTION

[0004] The finding that tumors can be immunogenic has led to the development of a number of cancer immunotherapies designed to employ the immune system to selectively eliminate malignant cells while sparing normal tissue. However, survival benefits from vaccination against tumor antigens alone remain modest. Anti-cancer vaccines face numerous challenges, one of them being the immunosuppressive microenvironment. The abnormal tumor vasculature creates a hypoxic microenvironment that polarizes inflammatory cells toward immune suppression. Moreover, tumors systemically alter immune cells' proliferation, differentiation, and function via secretion of growth factors and cytokines.

[0005] For cure of cancer, complete eradication of cancer stem cells is of crucial importance. The numerous immune escape mechanisms of human tumors remain a major challenge in cancer immunotherapy. Thus, there exists a great need for improved cancer therapy approaches, which has not been met so far.

[0006] WO 2014/005683 discloses an attenuated mutant strain of Salmonella comprising a recombinant DNA molecule encoding a VEGF receptor protein for use in cancer immunotherapy, particularly for use in the treatment of pancreatic cancer.

[0007] WO 2014/173542 discloses an attenuated strain of Salmonella comprising a recombinant DNA molecule encoding Wilms' Tumor Protein (WT1) for use in cancer immunotherapy.

[0008] WO 2013/09189 discloses a method for growing attenuated mutant Salmonella typhi strains lacking galactose epimerase activity and harboring a recombinant DNA molecule.

OBJECTS OF THE INVENTION

[0009] In view of the prior art, it is an object of the present invention to provide novel cancer therapies. Such novel therapies would offer major advantages for improving the treatment options for cancer patients.

SUMMARY OF THE INVENTION

[0010] In one aspect the present invention relates to an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, for use in the treatment of cancer, wherein the treatment further comprises the administration of a further anti-cancer agent.

[0011] The attenuated strain of Salmonella encoding a VEGF receptor protein was surprisingly found to strongly increase the efficacy of cancer therapies which are based on the employment of the patient's immune system, such as treatment with cancer vaccines encoding tumor antigens or tumor stroma antigens, treatment with engineered T-cells that are designed to target tumor cells, treatment with bispecific antibodies designed to mediate the attachment of immune cells to tumor cells, and treatment with checkpoint inhibitors which aim at preventing the tumor induced inhibition of T-cell proliferation.

[0012] Surprisingly, it was observed that the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein leads to a significantly increased infiltration of the tumor by CD8.sup.+ and CD4.sup.+ T-cells. Furthermore, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein may lead to an increase in the number of activated CD8.sup.+ and CD4.sup.+ T-cells and/or to a reduction in the number of immunosuppressive lymphoid cells such as Treg cells. Without wishing to be bound by theory, it is believed that the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein improves the efficacy of cancer immunotherapies by enhancing the engagement of T-cells in the eradication of the tumor. The combination of the attenuated strain of Salmonella encoding a VEGF receptor protein with other anti-cancer agents, such as engineered T-cells, checkpoint inhibitors, bispecific antibodies and DNA vaccines encoding tumor antigens or tumor stroma antigens was shown to have synergistic effects on tumor specific T-cell responses and overall survival.

[0013] In particular embodiments, the treatment further comprises the administration of at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, of at least one checkpoint inhibitor, of at least one engineered T-cell, of at least one bispecific antibody exhibiting binding specificity for one T-cell surface protein and for a tumor antigen or a tumor stroma antigen, or of any combination thereof.

[0014] In particular embodiments, the at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen is selected from at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

[0015] In particular embodiments the at least one checkpoint inhibitor is selected from an antibody against PD-1, PD-L1 and CTLA4.

[0016] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are of the species Salmonella enterica.

[0017] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are Salmonella typhi Ty21a.

[0018] In particular embodiments, the expression cassette and the further expression cassette are a eukaryotic expression cassette, particularly comprising a CMV promoter.

[0019] In particular embodiments, the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith.

[0020] In particular embodiments, human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

[0021] In particular embodiments, the DNA molecule and the further DNA molecule comprise the kanamycin antibiotic resistance gene, the pMB1 ori, and a CMV promoter.

[0022] In particular embodiments, the DNA molecule and the further DNA molecule comprise the DNA sequence as found in SEQ ID NO 2.

[0023] In particular embodiments, the tumor antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human Wilms' Tumor Protein (WT1) having the amino acid sequence as found in SEQ ID NO 3 and a protein that shares at least about 80% sequence identity therewith, human Mesothelin (MSLN) having the amino acid sequence as found in SEQ ID NO 4 and a protein that shares at least about 80% sequence identity therewith, human CEA having the amino acid sequence as found in SEQ ID NO 5 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 6 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 7 and a protein that shares at least about 80% sequence identity therewith and CMV pp65 having the amino acid sequence as found in SEQ ID NO 8 and a protein that shares at least about 80% sequence identity therewith, and the tumor stroma antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human fibroblast activation protein (FAP).

[0024] In particular embodiments, human Wilms' Tumor Protein (WT1) has the amino acid sequence as found in SEQ ID NO 3, human Mesothelin (MSLN) has the amino acid sequence as found in SEQ ID NO 4, human CEA has the amino acid sequence as found in SEQ ID NO 5, and CMV pp65 has the amino acid sequence as found in SEQ ID NO 6, SEQ ID NO 7 or SEQ ID NO 8.

[0025] In particular embodiments, the attenuated strain of Salmonella is administered simultaneously with or prior to said further anti-cancer agent, i.e. simultaneously with or prior to said at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, said at least one checkpoint inhibitor, said at least one engineered T-cell and/or said at least one bispecific antibody.

[0026] In particular embodiments, the treatment is accompanied by chemotherapy, radiotherapy or biological cancer therapy. Particularly, the attenuated strain of Salmonella is administered before or during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy. In other particular embodiments, the attenuated strain of Salmonella is administered before and during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy.

[0027] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are administered orally.

[0028] In particular embodiments, the cancer is selected from colorectal cancer, pancreatic cancer, lung cancer, ovarian cancer, mesothelioma, acute myeloid leukemia, chronic myeloid leukemia, glioblastoma, gastric cancer, hepatocellular cancer, renal cell cancer, prostate cancer, and cervical cancer.

[0029] In particular embodiments, the single dose of the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella comprises from about 10.sup.5 to about 10.sup.11, particularly from about 10.sup.6 to about 10.sup.10, more particularly from about 10.sup.6 to about 10.sup.9, more particularly from about 10.sup.6 to about 10.sup.8, most particularly from about 10.sup.6 to about 10.sup.7 colony forming units (CFU).

[0030] In particular embodiments, the treatment is individualized cancer immunotherapy comprising the step of assessing the expression pattern of and/or the pre-immune response against said tumor antigen in a patient.

[0031] In a further aspect, the present invention relates to a pharmaceutical composition comprising an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, wherein the pharmaceutical composition further comprises at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

[0032] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella is Salmonella typhi Ty21a.

[0033] In particular embodiments, the expression cassette and the further expression cassette are a eukaryotic expression cassette, particularly comprising a CMV promoter.

[0034] In particular embodiments, the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith.

[0035] In particular embodiments, human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

[0036] In particular embodiments, the pharmaceutical composition is for use as a medicament, particularly for use in the treatment of cancer.

DETAILED DESCRIPTION OF THE INVENTION

[0037] The present invention may be understood more readily by reference to the following detailed description of the invention and the examples included therein.

[0038] In one aspect the present invention relates to an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, for use in the treatment of cancer, wherein the treatment further comprises the administration of a further anti-cancer agent.

[0039] VEGF receptor proteins are endothelial cell-specific receptor-tyrosine kinases that can be bound by the ligand vascular endothelial growth factor (VEGF) which causes them to dimerize and become activated through transphosphorylation. The VEGF family of growth factors (Kd 75-760 pM) encompasses 6 family members, VEGF-A (also known as VEGF) through E and PLGF (placental growth factor, also known as PGF or PIGF-2). VEGF growth factors regulate growth and differentiation of multiple components of the vascular system, especially blood and lymph vessels. There are three main subtypes of VEGFR, VEGFR-1 (or FLT1), VEGFR-2 (or KDR, FLK1) and VEGFR-3 (or FLT4). Membrane-bound VEGF receptors have an extracellular portion consisting of 7 immunoglobulin-like domains, a single transmembrane spanning region and an intracellular portion containing a split tyrosine-kinase domain. VEGFR transcripts give also rise to alternative splice variants that encode soluble VEGF receptor proteins.

[0040] According to the invention, the attenuated Salmonella strain functions as the bacterial carrier of the recombinant DNA molecule comprising an expression cassette encoding a VEGF receptor protein for the delivery of said recombinant DNA molecule into a target cell. Such a delivery vector comprising a DNA molecule encoding a heterologous antigen, such as a VEGF receptor protein--a tumor stroma antigen, is termed DNA vaccine.

[0041] In the context of the present invention, the term "vaccine" refers to an agent which is able to induce an immune response in a subject upon administration. A vaccine can preferably prevent, ameliorate or treat a disease.

[0042] The live attenuated Salmonella strain according to the present invention stably carries a recombinant DNA molecule encoding a VEGF receptor protein. It can be used as a vehicle for the oral delivery of this recombinant DNA molecule.

[0043] Genetic immunization might be advantageous over conventional vaccination. The target DNA can be detected for a considerable period of time thus acting as a depot of the antigen. Sequence motifs in some plasmids, like GpC islands, are immunostimulatory and can function as adjuvants furthered by the immunostimulation due to LPS and other bacterial components.

[0044] Live attenuated Salmonella vectors produce their own immunomodulatory factors such as lipopolysaccharides (LPS) in situ which may constitute an advantage over other forms of administration such as microencapsulation. Moreover, the mucosal vaccine according to the present invention has an intra-lymphatic mode of action, which proves to be of benefit. After ingestion of the attenuated vaccine according to the present invention, macrophages and other cells in Peyer's patches of the gut are invaded by the modified bacteria. The bacteria are taken up by these phagocytic cells. Due to their attenuating mutations, bacteria of the S. typhi Ty21 strain are not able to persist in these phagocytic cells but die at this time point. The recombinant DNA molecules are released and subsequently transferred into the cytosol of the phagocytic immune cells, either via a specific transport system or by endosomal leakage. Finally, the recombinant DNA molecules enter the nucleus, where they are transcribed, leading to massive VEGF receptor protein expression in the cytosol of the phagocytic cells. The infected cells undergo apoptosis, loaded with the VEGF receptor antigen, and are taken up and processed by the gut's immune system. The danger signals of the bacterial infection serve as a strong adjuvant in this process, leading to a strong target antigen specific CD8+ T-cell and antibody response at the level of both systemic and mucosal compartments. The immune response peaks around ten days after vaccination. The lack of anti-carrier response allows boosting with the same vaccine over many times.

[0045] In the context of the present invention, the term "attenuated" refers to a bacterial strain of reduced virulence compared to the parental bacterial strain, not harboring the attenuating mutation. Attenuated bacterial strains have preferably lost their virulence but retained their ability to induce protective immunity. Attenuation can be accomplished by deletion of various genes, including virulence, regulatory, and metabolic genes. Attenuated bacteria may be found naturally or they may be produced artificially in the laboratory, for example by adaptation to a new medium or cell culture or they may be produced by recombinant DNA technology. Administration of about 10.sup.11 CFU of the attenuated strain of Salmonella according to the present invention preferably causes Salmonellosis in less than 5%, more preferably less than 1%, most preferably less than 1% of subjects.

[0046] In the context of the present invention, the term "comprises" or "comprising" means "including, but not limited to". The term is intended to be open-ended, to specify the presence of any stated features, elements, integers, steps or components, but not to preclude the presence or addition of one or more other features, elements, integers, steps, components or groups thereof. The term "comprising" thus includes the more restrictive terms "consisting of" and "essentially consisting of". In one embodiment the term "comprising" as used throughout the application and in particular within the claims may be replaced by the term "consisting of".

[0047] The DNA molecule comprising an expression cassette encoding a VEGF receptor protein is suitably a recombinant DNA molecule, i.e. an engineered DNA construct, preferably composed of DNA pieces of different origin. The DNA molecule can be a linear nucleic acid, or preferably, a circular DNA plasmid generated by introducing an open reading frame encoding a VEGF receptor protein into an expression vector plasmid.

[0048] In the context of the present invention, the term "expression cassette" refers to a nucleic acid unit comprising at least one open reading frame (ORF) under the control of regulatory sequences controlling its expression. Expression cassettes can preferably mediate transcription of the included open reading frame encoding a tumor antigen or a tumor stroma antigen, such as the VEGF receptor protein, in a target cell. Expression cassettes typically comprise a promoter, at least one open reading frame and a transcription termination signal.

[0049] In particular embodiments, the treatment further comprises the administration of at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, of at least one checkpoint inhibitor, of at least one engineered T-cell, of at least one bispecific antibody exhibiting binding specificity for one T-cell surface protein and for a tumor antigen or for a tumor stroma antigen, or of any combination thereof.

[0050] In particular embodiments, the at least one bispecific antibody exhibits binding specificity for a tumor antigen selected from CD19, EpCAM, HER2, EGFR, CEA, CD33, EphA2 and MCSP.

[0051] In particular embodiments, the at least one engineered T-cell comprises at least one tumor antigen binding protein on its cell surface, wherein the tumor antigen is selected from CEA, FBP, GD2, GD3, Her2-neu, MAGE-A1, MSLN, PSCA, PSMA.

[0052] In particular embodiments, the treatment further comprises the administration of one further DNA vaccines encoding a tumor antigen or a tumor stroma antigen, in particular of one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

[0053] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of two further attenuated strains of Salmonella each encoding a tumor antigen.

[0054] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one checkpoint inhibitor.

[0055] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one further attenuated strains of Salmonella encoding a tumor antigen and one checkpoint inhibitor.

[0056] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one engineered T-cell.

[0057] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one engineered T-cell and one checkpoint inhibitor.

[0058] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one bispecific antibody.

[0059] In particular embodiments, the administration of the attenuated strain of Salmonella encoding a VEGF receptor protein is combined with the administration of one bispecific antibody and one checkpoint inhibitor.

[0060] In particular embodiments, the at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen is selected from at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

[0061] In particular embodiments the at least one checkpoint inhibitor is selected from an antibody against PD-1, PD-L1 and CTLA4.

[0062] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are of the species Salmonella enterica. Attenuated derivatives of Salmonella enterica are attractive vehicles for the delivery of heterologous antigens to the mammalian immune system, since S. enterica strains can potentially be delivered via mucosal routes of immunization, i.e. orally or nasally, which offers advantages of simplicity and safety compared to parenteral administration. Furthermore, Salmonella strains elicit strong humoral and cellular immune responses at the level of both systemic and mucosal compartments. Batch preparation costs are low and formulations of live bacterial vaccines are highly stable. Attenuation can be accomplished by deletion of various genes, including virulence, regulatory, and metabolic genes.

[0063] Several Salmonella typhimurium strains attenuated by aro mutations have been shown to be safe and effective delivery vehicles for heterologous antigens in animal models.

[0064] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are Salmonella typhi Ty21a. The live, attenuated S. typhi Ty21a strain is the active component of Typhoral L.RTM., also known as Vivotif.RTM. (manufactured by Berna Biotech Ltd., a Crucell Company, Switzerland). It is currently the only licensed live oral vaccine against typhoid fever. This vaccine has been extensively tested and has proved to be safe regarding patient toxicity as well as transmission to third parties (Wandan et al., J. Infectious Diseases 1982, 145:292-295). The vaccine is licensed in more than 40 countries and has been used in millions of individuals including thousands of children for prophylactic vaccination against typhoid fever. It has an unparalleled safety track record. There is no data available indicating that S. typhi Ty21a is able to enter the bloodstream systemically. The live attenuated Salmonella typhi Ty21a vaccine strain thus allows specific targeting of the immune system in the gut, while being safe and well-tolerated. The Marketing Authorization number of Typhoral L.RTM. is PL 15747/0001 dated 16 Dec. 1996. One dose of vaccine contains at least 2.times.10.sup.9 viable S. typhi Ty21a colony forming units and at least 5.times.10.sup.9 non-viable S. typhi Ty21a cells.

[0065] This well-tolerated, live oral vaccine against typhoid fever was derived by chemical mutagenesis of the wild-type virulent bacterial isolate S. typhi Ty2 and harbors a loss-of-function mutation in the galE gene resulting in its inability to metabolize galactose. The attenuated bacterial strain is also not able to reduce sulfate to sulfide which differentiates it from the wild-type Salmonella typhi Ty2 strain. With regard to its serological characteristics, the Salmonella typhi Ty21a strain contains the 09-antigen which is a polysaccharide of the outer membrane of the bacteria and lacks the 05-antigen which is in turn a characteristic component of Salmonella typhimurium. This serological characteristic supports the rationale for including the respective test in a panel of identity tests for batch release.

[0066] In particular embodiments, the expression cassette and the further expression cassette are a eukaryotic expression cassette, particularly comprising a CMV promoter. In the context of the present invention, the term "eukaryotic expression cassette" refers to an expression cassette which allows for expression of the open reading frame in a eukaryotic cell. It has been shown that the amount of heterologous antigen required to induce an adequate immune response may be toxic for the bacterium and may result in cell death, over-attenuation or loss of expression of the heterologous antigen. Using a eukaryotic expression cassette that is not expressed in the bacterial vector but only in the target cell may overcome this toxicity problem and the protein expressed typically exhibits a eukaryotic glycosylation pattern.

[0067] A eukaryotic expression cassette comprises regulatory sequences that are able to control the expression of an open reading frame in a eukaryotic cell, preferably a promoter and a polyadenylation signal. Promoters and polyadenylation signals included in the recombinant DNA molecules comprised by the attenuated strain of Salmonella of the present invention are preferably selected to be functional within the cells of the subject to be immunized. Examples of suitable promoters, especially for the production of a DNA vaccine for humans, include but are not limited to promoters from Cytomegalovirus (CMV), such as the strong CMV immediate early promoter, Simian Virus 40 (SV40), Mouse Mammary Tumor Virus (MMTV), Human Immunodeficiency Virus (HIV), such as the HIV Long Terminal Repeat (LTR) promoter, Moloney virus, Epstein Barr Virus (EBV), and from Rous Sarcoma Virus (RSV), the synthetic CAG promoter composed of the CMV early enhancer element, the promoter, the first exon and the first intron of chicken beta-actin gene and the splice acceptor of the rabbit beta globin gene, as well as promoters from human genes such as human actin, human myosin, human hemoglobin, human muscle creatine, and human metallothionein. In a particular embodiment, the eukaryotic expression cassette contains the CMV promoter. In the context of the present invention, the term "CMV promoter" refers to the strong immediate-early cytomegalovirus promoter.

[0068] Examples of suitable polyadenylation signals, especially for the production of a DNA vaccine for humans, include but are not limited to the bovine growth hormone (BGH) polyadenylation site, SV40 polyadenylation signals and LTR polyadenylation signals. In a particular embodiment, the eukaryotic expression cassette included in the recombinant DNA molecule comprised by the attenuated strain of Salmonella of the present invention comprises the BGH polyadenylation site.

[0069] In addition to the regulatory elements required for expression of the heterologous tumor antigen or tumor stroma antigen gene, like a promoter and a polyadenylation signal, other elements can also be included in the recombinant DNA molecule. Such additional elements include enhancers. The enhancer can be, for example, the enhancer of human actin, human myosin, human hemoglobin, human muscle creatine and viral enhancers such as those from CMV, RSV and EBV.

[0070] Regulatory sequences and codons are generally species dependent, so in order to maximize protein production, the regulatory sequences and codons are preferably selected to be effective in the species to be immunized. The person skilled in the art can produce recombinant DNA molecules that are functional in a given subject species.

[0071] In particular embodiments, the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith.

[0072] VEGFR-2, also known as kinase-insert-domain-containing receptor (KDR), appears to mediate almost all of the known cellular responses to VEGF. For example, the role of VEGF in angiogenesis appears to be mediated through the interaction of this protein with VEGFR-2. VEGFR-2 is a 1356 amino acid long, 200-230 kDa molecular weight high-affinity receptor for VEGF, as well as for VEGF-C and VEGF-D. Identified in humans through the screening of endothelial cDNA for tyrosine kinase receptors, VEGFR-2 shares 85% sequence identity with the previously discovered mouse fetal liver kinase 1 (Flk-1). VEGFR-2 is normally expressed in endothelial and hematopoietic precursors, as well as in endothelial cells, nascent hematopoietic stem cells and the umbilical cord stroma. However, in quiescent adult vasculature, VEGFR-2 mRNA appears to be down regulated.

[0073] The extracellular domain of VEGFR-2 contains 18 potential N-linked glycosylation sites. VEGFR-2 is initially synthesized as a 150 kDa protein and rapidly glycosylated to a 200 kDa intermediate form, and then further glycosylated at a slower rate to a mature 230 kDa protein which is expressed on the cell surface.

[0074] In this context, the term "about" or "approximately" means within 80% to 120%, alternatively within 90% to 110%, including within 95% to 105% of a given value or range.

[0075] In the context of the present invention, the term "protein that shares at least about 80% sequence identity with a given protein (the reference protein) refers to a protein that may differ in the amino acid sequence and/or the nucleic acid sequence encoding the amino acid sequence of the reference protein. The protein may be of natural origin, e.g. a mutant version of a wild-type protein, e.g. a mutant version of a wild type VEGF receptor protein, or a homolog of a different species, or an engineered protein, e.g. an engineered VEGF receptor protein. It is known that the usage of codons is different between species. Thus, when expressing a heterologous protein in a target cell, it may be necessary, or at least helpful, to adapt the nucleic acid sequence to the codon usage of the target cell. Methods for designing and constructing derivatives of a given protein are well known to anyone of ordinary skill in the art.

[0076] The protein that shares at least about 80% sequence identity with a given protein may contain one or more mutations comprising an addition, a deletion and/or a substitution of one or more amino acids in comparison to the given reference protein. According to the teaching of the present invention, said deleted, added and/or substituted amino acids may be consecutive amino acids or may be interspersed over the length of the amino acid sequence of the protein that shares at least about 80% sequence identity with a given reference protein. According to the teaching of the present invention, any number of amino acids may be added, deleted, and/or substitutes, as long as the amino acid sequence identity with the reference protein is at least about 80% and the mutated protein is immunogenic. Preferably, the immunogenicity of the protein which shares at least about 80% sequence identity with a reference protein of a given amino acid sequence is reduced by less than 50%, less than 40%, less than 30%, less than 20%, less than 10%, less than 5% or less than 1% compared to the reference protein of the given amino acid sequence, as measured by ELISA. Methods for designing and constructing protein homologues and for testing such homologues for their immunogenic potential are well known to anyone of ordinary skill in the art. In particular embodiments, the sequence identity with the reference protein is at least about 80%, at least about 85%, at least about 90%, or most particularly at least about 95%. Methods and algorithms for determining sequence identity including the comparison of a parental protein and its derivative having deletions, additions and/or substitutions relative to a parental sequence, are well known to the practitioner of ordinary skill in the art. On the DNA level, the nucleic acid sequences encoding the protein that shares at least about 80% sequence identity with the VEGF receptor protein may differ to a larger extent due to the degeneracy of the genetic code.

[0077] In particular embodiments, human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

[0078] In particular embodiments, the DNA molecule and the further DNA molecule comprise the kanamycin antibiotic resistance gene, the pMB1 ori, and a CMV promoter. In particular embodiments, the recombinant DNA molecule is derived from commercially available pVAX1.TM. expression plasmid (Invitrogen, San Diego, Calif.). This expression vector was modified by replacing the high copy pUC origin of replication by the low copy pMB1 origin of replication of pBR322. The low copy modification was made in order to reduce the metabolic burden and to render the construct more stable. The generated expression vector backbone was designated pVAX10.

[0079] In particular embodiments, the DNA molecule and the further DNA molecule comprise the DNA sequence as found in SEQ ID NO 2 (vector backbone pVAX10).

[0080] Inserting the VEGF receptor protein encoding ORF with the nucleic acid sequence as found in SEQ ID NO 9 into this expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.VR2-1 (WO 2013/091898). The expression plasmid pVAX10.VR2-1 is schematically depicted in FIG. 16. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.VR2-1 is designated VXM01 (WO 2013/091898).

[0081] Inserting human, truncated WT1 encoding ORF with the nucleic acid sequence as found in SEQ ID NO 10 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.hWT1. The expression plasmid pVAX10.hWT1 is schematically depicted in FIG. 17. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.hWT1 is designated VXM06 (WO 2014/173542).

[0082] Inserting human MSLN encoding ORF with the nucleic acid sequence as found in SEQ ID NO 11 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.hMSLN. The expression plasmid pVAX10.hMSLN is schematically depicted in FIG. 18. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.hMSLN is designated VXM04.

[0083] Inserting human CEA encoding ORF with the nucleic acid sequence as found in SEQ ID NO 12 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.hCEA. The expression plasmid pVAX10.hCEA is schematically depicted in FIG. 19. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.hCEA is designated VXM08.

[0084] Inserting CMV pp65 encoding ORF with the nucleic acid sequence as found in SEQ ID NO 13 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.CMVpp65_1. The expression plasmid pVAX10.CMVpp65_1 is schematically depicted in FIG. 20. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.CMVpp65_1 is designated VXM65_1.

[0085] Inserting CMV pp65 encoding ORF with the nucleic acid sequence as found in SEQ ID NO 14 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.CMVpp65_2. The expression plasmid pVAX10.CMVpp65_2 is schematically depicted in FIG. 21. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.CMVpp65_2 is designated VXM65_2.

[0086] Inserting CMV pp65 encoding ORF with the nucleic acid sequence as found in SEQ ID NO 15 into the expression vector backbone via NheI/XhoI yielded the expression plasmid pVAX10.CMVpp65_3. The expression plasmid pVAX10.CMVpp65_3 is schematically depicted in FIG. 22. The DNA vaccine comprising the attenuated Salmonella strain Ty21a harboring the expression plasmid pVAX10.CMVpp65_3 is designated VXM65_3.

[0087] In particular embodiments, the tumor antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human Wilms' Tumor Protein (WT1) having the amino acid sequence as found in SEQ ID NO 3 and a protein that shares at least about 80% sequence identity therewith, human Mesothelin (MSLN) having the amino acid sequence as found in SEQ ID NO 4 and a protein that shares at least about 80% sequence identity therewith, human CEA having the amino acid sequence as found in SEQ ID NO 5 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 6 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 7 and a protein that shares at least about 80% sequence identity therewith and CMV pp65 having the amino acid sequence as found in SEQ ID NO 8 and a protein that shares at least about 80% sequence identity therewith, and the tumor stroma antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human fibroblast activation protein (FAP).

[0088] In particular embodiments, human Wilms' Tumor Protein (WT1) has the amino acid sequence as found in SEQ ID NO 3, human Mesothelin (MSLN) has the amino acid sequence as found in SEQ ID NO 4, human CEA has the amino acid sequence as found in SEQ ID NO 5, and CMV pp65 has the amino acid sequence as found in SEQ ID NO 6, or SEQ ID NO 7, or SEQ ID NO 8.

[0089] Mesothelin is a 40-kDa cell surface glycoprotein present on normal mesothelial cells and overexpressed in several human tumors, including mesothelioma and ovarian and pancreatic adenocarcinoma. The mesothelin gene encodes a precursor protein of 71-kDa that is processed to yield a 31-kDa shed protein named megakaryocyte-potentiating factor (MPF) and the 40-kDa cell bound fragment mesothelin. Mesothelin was shown to exhibit megakaryocyte-colony-forming activity in the presence of interleukin-3. Mesothelin is a tumor differentiation antigen present at low levels on a restricted set of normal adult tissues, such as mesothelium, but aberrantly overexpressed in a wide variety of human tumors including mesotheliomas, ovarian and pancreatic cancers, squamous cell carcinomas of the cervix, head and neck, vulva, lung and esophagus, lung adenocarcinomas, endometrial carcinomas, biphasic synovial sarcomas, desmoplastic small round cell tumors and gastric adenocarcinomas. The normal biological function of Mesothelin is unknown. Studies in mesothelin knock-out mice revealed no detectable phenotype, and both male and female mice produced healthy off-spring. Studies in pancreatic cancer suggest that mesothelin plays a role in tumorigenesis by increasing cellular proliferation, migration, and S-phase cell populations. Furthermore, there is evidence that mesothelin is an immunogenic protein. Due to its expression profile, its oncogenic functions and its immunogenic potential, the tumor antigen mesothelin is a promising candidate for the development of cancer vaccines.

[0090] Wilms' tumor gene 1 (WT1) encodes a zinc finger transcription factor involved in cell proliferation and differentiation. The WT1 protein contains four zinc finger motifs at the C-terminus and a proline/glutamine-rich DNA-binding domain at the N-terminus. Multiple transcript variants, resulting from alternative splicing at two coding exons, have been well characterized. WT1 plays an essential role in the development of the urogenital system and is involved in cell proliferation and differentiation. The WT1 gene was isolated as the gene responsible for a childhood renal neoplasm, Wilms' tumor. It is highly expressed in a wide variety of malignancies including several types of hematological malignancies and various solid tumors. In contrast, normal tissue expression of WT1 in adults is restricted to gonads, uterus, kidney, mesothelium and progenitor cells in various types of tissues. WT-1 negatively affects differentiation and promotes proliferation of progenitor cells. Furthermore, overexpressed WT1 is immunogenic; WT1 specific T-cells as well as IgG anti-WT1 antibodies have been observed in cancer patients. Due to its expression profile, its oncogenic functions and its immunogenic potential, the tumor antigen WT1 is a promising candidate for the development of cancer vaccines.

[0091] In particular embodiments, WT1 is truncated. In particular embodiments, the zinc finger domain of WT1 is deleted. In particular embodiments, the truncated WT1 has the amino acid sequence as found in SEQ ID NO 3.

[0092] The zinc finger domain at the C-terminus of WT1 comprises four zinc finger motifs. Truncated WT1 of the amino acid sequence as found in SEQ ID NO 3 represents amino acids 1 to 371 of UniProt ref P19544-7. Deletion of the zinc finger domain minimizes the risk of immunological cross reactivity with other zinc finger containing transcription factors. Furthermore, truncated WT1 lacking the zinc finger domain has greater immunogenic potential than full-length WT1. In addition, deletion of the zinc finger motifs, which are essential for DNA binding, abrogates the oncogenic potential of WT1, thus minimizing the risk of oncogenesis.

[0093] The tegument protein CMV pp65 is a major immunodominant protein of human cytomegalovirus (CMV). The biologic function of CMV pp65 is unclear, but it is believed to be involved in cell cycle regulation. CMV pp65 is a nucleotropic protein exhibiting protein kinase activity, which is able to bind polo-like kinase 1 (PLK-1).

[0094] HCMV pp65 is expressed in more than 90% of glioblastoma specimens but not in surrounding normal brain. This viral protein is thus a promising candidate as tumor-specific target for the development novel of cancer immunotherapies.

[0095] The CMV pp65 protein contains two bipartite nuclear localization signals (NLSs) at amino acids 415 to 438 and amino acids 537 to 561 near the carboxy terminus and a phosphate binding site related to its kinase activity at lysine-436. Mutating the lysine at position 436 to asparagine and deletion of amino acids 537 to 561 results in a protein without kinase activity and markedly reduced nuclear localization. This mutant protein exhibits unaltered immunogenicity.

[0096] In particular embodiments, the CMV pp65 has the amino acid sequence as found in SEQ ID NO 6. SEQ ID NO 6 represents the amino acid sequence of wild type human CMV pp65.

[0097] In particular other embodiments, the CMV pp65 has the amino acid sequence as found in SEQ ID NO 7. SEQ ID NO 7 represents the amino acid sequence of human CMV pp65, which harbors the mutation K436N relative to the wild type human CMV pp65 of SEQ ID NO 6.

[0098] In particular other embodiments, the CMV pp65 has the amino acid sequence as found in SEQ ID NO 8. SEQ ID NO 8 represents the amino acid sequence of a truncated version of CMV pp65 of SEQ ID NO 7, which lacks the second, more C-terminal NLS (nuclear localization sequence) (i.e. amino acids 537 to 561 of CMV pp65 of SEQ ID NO 7).

[0099] Carcinoembryonic antigen (CEA) (also known as CEACAM5 and CD66e) is a member of a family of highly related glycosyl phosphatidyl inositol (GPI) cell surface anchored glycoproteins involved in cell adhesion. CEA is normally produced in gastrointestinal tissue during fetal development; protein expression ends before birth. Therefore CEA is usually present only at very low levels in the blood of healthy adults. However, the serum levels are raised in some types of cancer, in particular colorectal carcinoma, thus serving as tumor marker. CEA levels may also be raised in gastric carcinoma, pancreatic carcinoma, lung carcinoma, breast carcinoma, and medullary thyroid carcinoma, as well as some non-neoplastic conditions like ulcerative colitis, pancreatitis, cirrhosis, COPD, Crohn's disease and hypothyroidism.

[0100] In particular embodiments, the attenuated strain of Salmonella is administered simultaneously with or prior to said further anti-cancer agent, i.e. simultaneously with or prior to said at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, said at least one checkpoint inhibitor, said at least one engineered T-cell and/or said at least one bispecific antibody.

[0101] In the context of the present invention, the term "simultaneously with" means administration of the attenuated strain of Salmonella encoding a VEGF receptor protein and the at least one further anti-cancer agent on the same day, more particularly within 12 hours, more particularly within 2 hours.

[0102] In particular embodiments, administration of the attenuated Salmonella strain encoding a VEGF receptor protein and the at least one further anti-cancer agent occurs within eight consecutive weeks, more particularly within three to six consecutive weeks. The attenuated Salmonella strain according to the present invention and the at least one further anti-cancer agent may be administered via the same route or via different routes.

[0103] In particular embodiments, the treatment is accompanied by chemotherapy, radiotherapy or biological cancer therapy. For cure of cancer, complete eradication of cancer stem cells may be essential. For maximal efficacy, a combination of different therapy approaches may be beneficial.

[0104] In the context of the present invention, the term "biological cancer therapy" refers to cancer therapy involving the use of substances derived from living organisms or laboratory-produced versions of such substances. Biological cancer therapy approaches include the administration of immunostimulatory cytokines.

[0105] Chemotherapeutic agents that may be used in combination with the attenuated mutant strain of Salmonella of the present invention may be, for example: gemcitabine, amifostine (ethyol), cabazitaxel, cisplatin, dacarbazine (DTIC), dactinomycin, docetaxel, mechlorethamine, streptozocin, cyclophosphamide, carrnustine (BCNU), lomustine (CCNU), doxorubicin (adriamycin), doxorubicin lipo (doxil), folinic acid, gemcitabine (gemzar), daunorubicin, daunorubicin lipo (daunoxome), procarbazine, ketokonazole, mitomycin, cytarabine, etoposide, methotrexate, 5-fluorouracil (5-FU), vinblastine, vincristine, bleomycin, paclitaxel (taxol), docetaxel (taxotere), aldesleukin, asparaginase, busulfan, carboplatin, cladribine, camptothecin, CPT-11, 10-hydroxy-7-ethyl-camptothecin (SN38), dacarbazine, floxuridine, fludarabine, hydroxyurea, ifosfamide, idarubicin, mesna, interferon alpha, interferon beta, irinotecan, mitoxantrone, topotecan, leuprolide, megestrol, melphalan, mercaptopurine, oxaliplatin, plicamycin, mitotane, pegaspargase, pentostatin, pipobroman, plicamycin, streptozocin, tamoxifen, teniposide, testolactone, thioguanine, thiotepa, uracil mustard, vinorelbine, chlorambucil and combinations thereof.

[0106] Most preferred chemotherapeutic agents according to the invention are cabazitaxel, carboplatin, oxaliplatin, cisplatin, cyclophosphamide, docetaxel, gemcitabine, doxorubicin, paclitaxel (taxol), irinotecan, vincristine, vinblastine, vinorelbin, folinic acid, 5-fluorouracil and bleomycin, especially gemcitabine.

[0107] Particularly, the attenuated strain of Salmonella is administered before or during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy. In other particular embodiments, the attenuated strain of Salmonella is administered before and during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy.

[0108] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are administered orally. Oral administration is simpler, safer and more comfortable than parenteral administration. However, it has to be noted that the attenuated strain of Salmonella of the present invention may also be administered by any other suitable route. Preferably, a therapeutically effective dose is administered to the subject, and this dose depends on the particular application, the type of malignancy, the subject's weight, age, sex and state of health, the manner of administration and the formulation, etc. Administration may be single or multiple, as required.

[0109] The attenuated strain of Salmonella encoding a VEGF receptor protein and the at least one further attenuated strain of Salmonella encoding a tumor antigen or a tumor stroma antigen may be provided in the form of a solution, a suspension, a lyophilisate, an enteric coated capsule, or any other suitable form. Typically, the attenuated strain of Salmonella is formulated as drinking solution. This embodiment offers the advantage of improved patient compliance. Preferably, the drinking solution comprises means to neutralize gastric acids at least to a certain degree, i.e. to bring the pH of the gastric juice closer to a pH of 7. Preferably, the drinking solution is a buffered suspension comprising the attenuated strain of Salmonella according to the present invention. In a particular embodiment, the buffered suspension is obtained by suspending the attenuated strain of Salmonella in a suitable buffer, preferably containing 2.6 g sodium hydrogen carbonate, 1.7 g L-ascorbic acid, 0.2 g lactose monohydrate and 100 ml of drinking water.

[0110] The at least one further anti-cancer agent selected from at least one checkpoint inhibitor, at least one engineered T-cell, and at least one bispecific antibody exhibiting binding specificity for one T-cell surface protein and for a tumor antigen or for a tumor stroma antigen is preferably administered in the approved galenic formulation of the commercial product.

[0111] In particular embodiments, the cancer is selected from colorectal cancer, pancreatic cancer, lung cancer, ovarian cancer, mesothelioma, acute myeloid leukemia, chronic myeloid leukemia, glioblastoma, gastric cancer, hepatocellular cancer, renal cell cancer, prostate cancer, and cervical cancer.

[0112] The attenuated strain of Salmonella encoding a VEGF receptor protein together with another anti-cancer agent such as at least one checkpoint inhibitor, bispecific antibody, engineered T-cell and DNA vaccine encoding a tumor antigen or a tumor stroma antigen surprisingly show synergistic effects on T-cell responses and/or overall survival at relatively low doses of the attenuated strain of Salmonella encoding a VEGF receptor protein. Similarly, DNA vaccines comprising an attenuated strain of Salmonella encoding a tumor antigen or a tumor stroma antigen are surprisingly effective at relatively low doses. Administration of low doses of live bacterial vaccines minimizes the risk of excretion and thus of transmission to third parties.

[0113] In particular embodiments, the single dose of the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella comprises from about 10.sup.5 to about 10.sup.11, particularly from about 10.sup.6 to about 10.sup.10, more particularly from about 10.sup.6 to about 10.sup.9, more particularly from about 10.sup.6 to about 10.sup.8, most particularly from about 10.sup.6 to about 10.sup.7 colony forming units (CFU).

[0114] In particular embodiments, the single dose of both the attenuated strain of Salmonella encoding a VEGF receptor protein and the at least one further attenuated strain of Salmonella encoding a tumor antigen or a tumor stroma antigen are essentially the same, both single doses comprising from about 10.sup.5 to about 10.sup.11, particularly from about 10.sup.6 to about 10.sup.10, more particularly from about 10.sup.6 to about 10.sup.9, more particularly from about 10.sup.6 to about 10.sup.8, most particularly from about 10.sup.6 to about 10.sup.7 colony forming units (CFU). In particular embodiments, the single dose of the attenuated strain of Salmonella encoding a VEGF receptor protein is from about 10 to about 100 times lower than the single dose of the at least one further attenuated strain of Salmonella encoding a tumor antigen or a tumor stroma antigen. In particular other embodiments, the single dose of the attenuated strain of Salmonella encoding a VEGF receptor protein is from about 10 to about 100 times higher than the single dose of the at least one further attenuated strain of Salmonella encoding a tumor antigen or a tumor stroma antigen.

[0115] In this context, the term "about" or "approximately" means within a factor of 3, alternatively within a factor of 2, including within a factor of 1.5 of a given value or range.

[0116] In particular embodiments, the treatment is individualized cancer immunotherapy comprising the step of assessing the expression pattern of and/or the pre-immune response against said tumor antigen in a patient. The patient's tumor and/or stromal antigen expression pattern and/or the patient's pre-immune responses against tumor and/or stromal antigens may be assessed in a first step for example by companion diagnostics targeting the patient's specific tumor and/or stromal antigen pattern. Depending on the patient's tumor and/or stromal antigen expression pattern or the patient's pre-immune responses against tumor and/or stromal antigens, the attenuated strain of Salmonella encoding a VEGF receptor protein may be administered in combination with one or more suitable further Salmonella typhi Ty21a based cancer vaccine(s) comprising eukaryotic expression systems.

[0117] It may be favorable dependent on the occurrence of possible side effects, to include treatment with antibiotics or anti-inflammatory agents.

[0118] Should adverse events occur that resemble hypersensitivity reactions mediated by histamine, leukotrienes, or cytokines, treatment options for fever, anaphylaxis, blood pressure instability, bronchospasm, and dyspnoea are available. Treatment options in case of unwanted T-cell derived auto-aggression are derived from standard treatment schemes in acute and chronic graft vs. host disease applied after stem cell transplantation. Cyclosporin and glucocorticoids are proposed as treatment options.

[0119] In the unlikely case of systemic Salmonella typhi Ty21a type infection, appropriate antibiotic therapy is recommended, for example with fluoroquinolones including ciprofloxacin or ofloxacin. Bacterial infections of the gastrointestinal tract are to be treated with respective agents, such as rifaximin.

[0120] In a further aspect, the present invention relates to a pharmaceutical composition comprising an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, wherein the pharmaceutical composition further comprises at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

[0121] In particular embodiments, the pharmaceutical composition comprises the DNA vaccines VXM01 and VXM06.

[0122] In particular embodiments, the pharmaceutical composition comprises the DNA vaccines VXM01 and VXM04.

[0123] In particular embodiments, the pharmaceutical composition comprises the DNA vaccines VXM01 and VXM08.

[0124] In particular embodiments, the pharmaceutical composition comprises the DNA vaccines VXM01 and VXM65.

[0125] In particular embodiments, the least one further attenuated strain of Salmonella comprises at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen selected from the group consisting of human Wilms' Tumor Protein (WT1) having the amino acid sequence as found in SEQ ID NO 3 and a protein that shares at least about 80% sequence identity therewith, human Mesothelin (MSLN) having the amino acid sequence as found in SEQ ID NO 4 and a protein that shares at least about 80% sequence identity therewith, human CEA having the amino acid sequence as found in SEQ ID NO 5 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 6 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 7 and a protein that shares at least about 80% sequence identity therewith and CMV pp65 having the amino acid sequence as found in SEQ ID NO 8 and a protein that shares at least about 80% sequence identity therewith, particularly wherein human Wilms' Tumor Protein (WT1) has the amino acid sequence as found in SEQ ID NO 3, human Mesothelin (MSLN) has the amino acid sequence as found in SEQ ID NO 4, human CEA has the amino acid sequence as found in SEQ ID NO 5, and CMV pp65 has the amino acid sequence as found in SEQ ID NO 6, SEQ ID NO 7 or SEQ ID NO 8, and wherein the tumor stroma antigen is selected from fibroblast activation protein (FAP).

[0126] The pharmaceutical composition of the present invention may be in the form of a solution, a suspension, an enteric coated capsule, a lyophilized powder or any other form suitable for the intended use.

[0127] The pharmaceutical composition of the present invention may further comprises one or more pharmaceutically acceptable excipients.

[0128] In the context of the present invention, the term "excipient" refers to a natural or synthetic substance formulated alongside the active ingredient of a medication. Suitable excipients include antiadherents, binders, coatings, disintegrants, flavors, colors, lubricants, glidants, sorbents, preservatives and sweeteners.

[0129] In the context of the present invention, the term "pharmaceutically acceptable" refers to molecular entities and other ingredients of pharmaceutical compositions that are physiologically tolerable and do not typically produce untoward reactions when administered to a mammal (e.g., human). The term "pharmaceutically acceptable" may also mean approved by a regulatory agency of a Federal or a state government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in mammals, and, more particularly, in humans.

[0130] In particular embodiments, wherein the anti-cancer agent is selected from at least one further attenuated strain of Salmonella comprising harboring a tumor antigen or a tumor stroma antigen, the pharmaceutical composition according to the present invention may suitably be provided as drinking solution. This embodiment offers the advantage of improved patient compliance and allows for rapid, feasible and affordable mass vaccination programs, especially in poor geographies.

[0131] In particular, suitable drinking solutions comprise means to neutralize gastric acids to at least to a certain degree, i.e. to bring the pH of the gastric juice closer to a pH of 7. In a particular embodiment, the drinking solution is a buffered suspension obtained by suspending the attenuated strain of Salmonella according to the present invention in a suitable buffer, preferably in a buffer that neutralizes gastric acids to at least a certain degree, preferably in a buffer containing 2.6 g sodium hydrogen carbonate, 1.7 g L-ascorbic acid, 0.2 g lactose monohydrate and 100 ml of drinking water.

[0132] In particular embodiments, the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella is Salmonella typhi Ty21a.

[0133] In particular embodiments, the expression cassette and the further expression cassette are a eukaryotic expression cassette, particularly comprising a CMV promoter.

[0134] In particular embodiments, the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith.

[0135] In particular embodiments, human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

[0136] In particular embodiments, the pharmaceutical composition is for use as a medicament, particularly for use in the treatment of cancer.

[0137] In particular embodiments, the treatment comprises a single or multiple administrations of the attenuated strain of Salmonella encoding a VEGF receptor protein or the pharmaceutical composition according to the present invention. The single dose of the administrations may be the same or different. In particular, the treatment comprises 1, 2, 3, 4, 5 or 6 administrations of the attenuated strain of Salmonella encoding a VEGF receptor protein or the pharmaceutical composition according to the present invention, preferably wherein the multiple administrations occur within three to six consecutive months.

SHORT DESCRIPTION OF FIGURES AND TABLES

[0138] FIG. 1: Amino acid sequence of human VEGFR-2 encoded by VEGFR-2 cDNA contained in plasmid pVAX10.VR2-1 (corresponding to SEQ ID NO 1)

[0139] FIG. 2: Nucleic acid sequence comprised in empty expression vector pVAX10 (sequence of expression vector pVAX10 without the portion of the multiple cloning site which is located between the restriction sites NheI and XhoI (SEQ ID NO 2).

[0140] FIG. 3: Amino acid sequence of truncated human WT-1 encoded by WT-1 cDNA contained in plasmid pVAX10.hWT1 (SEQ ID NO 3)

[0141] FIG. 4: Amino acid sequence of human MSLN encoded by MSLN cDNA contained in plasmid pVAX10.hMSLN (SEQ ID NO 4)

[0142] FIG. 5: Amino acid sequence of human CEA encoded by CEA cDNA contained in plasmid pVAX10.hCEA (SEQ ID NO 5)

[0143] FIG. 6: Amino acid sequence of CMV pp65 encoded by CMV pp65 cDNA contained in plasmid pVAX10.CMVpp65_1 (SEQ ID NO 6)

[0144] FIG. 7: Amino acid sequence of CMV pp65 encoded by CMV pp65 cDNA contained in plasmid pVAX10.CMVpp65_2 (SEQ ID NO 7)

[0145] FIG. 8: Amino acid sequence of CMV pp65 encoded by CMV pp65 cDNA contained in plasmid pVAX10.CMVpp65_3 (SEQ ID NO 8)

[0146] FIG. 9: Nucleic acid sequence contained in plasmid pVAX10.VR2-1 and encoding human VEGFR-2 of SEQ ID NO 1

[0147] FIG. 10: Nucleic acid sequence contained in plasmid pVAX10.hWT1 and encoding human WT-1 of SEQ ID NO 3

[0148] FIG. 11: Nucleic acid sequence contained in plasmid pVAX10.hMSLN and encoding human MSLN of SEQ ID NO 4

[0149] FIG. 12: Nucleic acid sequence contained in plasmid pVAX10.hCEA and encoding human CEA of SEQ ID NO 5

[0150] FIG. 13: Nucleic acid sequence contained in plasmid pVAX10.CMVpp65_1 and encoding CMV pp65 of SEQ ID NO 6

[0151] FIG. 14: Nucleic acid sequence contained in plasmid pVAX10.CMVpp65_2 and encoding CMV pp65 of SEQ ID NO 7

[0152] FIG. 15: Nucleic acid sequence contained in plasmid pVAX10.CMVpp65_3 and encoding CMV pp65 of SEQ ID NO 8

[0153] FIG. 16: Plasmid map of pVAX10.VR2-1

[0154] FIG. 17: Plasmid map of pVAX10.hWT1

[0155] FIG. 18: Plasmid map of pVAX10.hMSLN

[0156] FIG. 19: Plasmid map of pVAX10.hCEA

[0157] FIG. 20: Plasmid map of pVAX10.CMVpp65_1

[0158] FIG. 21: Plasmid map of pVAX10.CMVpp65_2

[0159] FIG. 22: Plasmid map of pVAX10.CMVpp65_3

[0160] FIG. 23: Effects of the combined administration of VXM01 and anti-CTLA4 in a MC38 mouse tumor model--tumor growth

[0161] FIG. 24: Effects of the combined administration of VXM01 and anti-CTLA4 in a MC38 mouse tumor model--survival

[0162] FIG. 25: Effects of the combined administration of VXM01 and anti-CTLA4 in B16 mouse tumor model--survival

[0163] FIG. 26: Treatment schedule Example 3

[0164] FIG. 27: Effect of VXM01 treatment either with or without cyclophosphamide on tumor size [mm.sup.3] on day 30. Each dot represents the result of the tumor of one animal.

[0165] FIG. 28: Percentages of VEGFR-2-specific CD8.sup.+ cells in spleens of BALB/C mice bearing subcutaneous CT26 colon tumor cells. Each dot represents the results of one spleen. The results are given in total % of 3 pooled VEGFR2 pentamers.

[0166] FIG. 29: Anti-CD3 immunohistochemistry staining of tumor samples from animals treated with the empty vector and VXM01, respectively. CD3 positive cells appear in brown color (see arrow for example); .times.200 magnification.

[0167] FIG. 30: Quantification of immune cell infiltrates and PD-L1 mean fold induction in tumor samples from animals treated with VXM01 or VXM01 plus cyclophosphamide as compared to animals treated with the empty vector control. Data are derived from absolute cell count/tissue area [mm.sup.2]; .times.200 magnification.

[0168] FIG. 31: Percentages of VEGFR-2- and CEA-specific CD8.sup.+ cells in spleens of healthy mice treated with mice bearing subcutaneous CT26 colon tumor cells. Each dot represents the results of one spleen. The results are given in total % of 2 pooled VEGFR2 pentamers.

EXAMPLES

Example 1: MC38 Colon Carcinoma Anti-CTLA4 Combination Study

[0169] Four groups of C57/B16/6J mice (n=6 each) were challenged with a subcutaneous administration of 5.times.10.sup.5 MC38 tumor cells on Day 0 of the study.

[0170] The animals were treated with VXM01mlow (Salmonella typhimurium carrying a murine VEGFR-2-encoding eukaryotic expression cassette, manufactured by Richter-Helm BioLogics, Hannover, Germany) alone at a dose of 10.sup.8 CFU via oral gavage on Day -1, Day 1, Day 4, and Day 6 (n=6), or with VXM01mlow at the same dose, route of administration, and administration scheme plus the murine anti-CTLA4 antibody on Day 12, 14, 16, and 18 (n=6), or with the murine antiCTLA4-antibody on Day 12, 14, 16, and 18 alone (n=6), or without treatment (n=6, control).

[0171] Tumor growth was measured using a micro-caliper. Animals were sacrificed as soon as tumor volume reached 1500 mm.sup.3 for animal welfare reasons.

[0172] Survival of test animals was recorded once daily.

[0173] Tumor growth is graphically depicted in FIG. 23.

[0174] Survival of test animals is displayed in a Kaplan-Meier plot in FIG. 24.

Example 2: B16-F10 Melanoma Anti-CTLA4 Combination Study

[0175] Four groups of C57/B16/6J mice (n=6 each) were challenged with an intravenous administration of 2.times.10.sup.5 B16-F10 tumor cells on Day 0 of the study.

[0176] The animals were treated with VXM01mlow (Salmonella typhimurium carrying a murine VEGFR-2-encoding eukaryotic expression cassette, manufactured by Richter-Helm BioLogics, Hannover, Germany) alone at a dose of 10.sup.8 CFU via oral gavage on Day -5, Day -3, Day 0, and Day 2 (n=6), or with VXM01mlow at the same dose, route of administration, and administration scheme plus the murine anti-CTLA4 antibody on Day 8, 10, 12, and 14 (n=6), or with the murine antiCTLA4-antibody on Day 8, 10, 12, and 14 alone (n=6), or without treatment (n=6, control).

[0177] Survival of test animals was recorded once daily.

[0178] Survival of test animals is displayed in a Kaplan-Meier plot in FIG. 25.

Example 3: Antitumor Activity of VMX01 Vaccine in CT26 Murine Tumor Model

[0179] The aim of this study was to evaluate the antitumor activity of VXM01 with or without cyclophosphamide in BALB/C mice bearing subcutaneous CT26 colon tumors, and to characterize the immune responses elicited by the treatments in spleen and tumor.

[0180] Control VXM0m-empty (S. typhimurium vector control with no expression plasmid) and VXM01mlow (Salmonella typhimurium carrying a murine VEGFR-2-encoding eukaryotic expression cassette) were administered at 10.sup.8 CFU/adm by oral gavage (per os, PO) via a gavage tube. Regardless of animal groups, each animal received pre-dose application buffer PO to neutralize acid in the stomach prior dosing (100 .mu.l/animal/application). This buffer was composed by dissolution of 2.6 g sodium hydrogen carbonate, 1.7 g L-ascorbic acid and 0.2 g lactose monohydrate in 100 ml of drinking water and was applied within 30 min prior application of VXM0m-empty or VXM01mlow.

[0181] Cyclophosphamide was injected at 100 mg/kg/adm into the peritoneal cavity of mice (intraperitoneally, IP). The IP injection volume did not exceed 10 ml/kg and was calculated according to the most recent body weight of mice.

[0182] The treatment started at day 0 (D0), one day after randomization that was considered as day -1 (D-1). 33 healthy female BALB/C (BALB/CByJ) mice, 6 weeks old, were randomized according to their body weight into 4 groups of 11 animals each using Vivo Manager.RTM. software (Biosystemes, Couternon, France). A statistical test (analysis of variance) was performed to test for homogeneity between groups.

[0183] The treatment schedule was as follows:

[0184] Group 1: The animals from group 1 received a total of 6 PO administrations of VXM0m-empty on D1, D3, D5, D7, D14 and D21.

[0185] Group 2: The animals of group 2 received a total of 6 PO administrations of VXM01mlow on D1, D3, D5, D7, D14 and D21.

[0186] Group 3: The animals of group 3 received one single IP injection of cyclophosphamide on D0 and a total of 6 PO administrations of VXM01mlow on D1, D3, D5, D7, D14 and D21.

[0187] The treatment schedule is summarized in Table 1 and FIG. 26.

TABLE-US-00001 TABLE 1 Treatment Schedule No. Treatment Group Animals Treatment Dose Route Schedule 1* 11 Empty vector 10.sup.8 CFU/adm PO D1, D3, D5, D7, D14 and D21 2* 11 VXM01mlow 10.sup.8 CFU/adm PO D1, D3, D5, D7, D14 and D21 3* 11 VXM01mlow 10.sup.8 CFU/adm PO D1, D3, D5, D7, D14 and D21 Cyclo- 100 IP D0 phosphamide mg/kg/adm TOTAL 33 *Each animal received pre-dose application buffer per os (PO) to neutralize acid in the stomach prior dosing

[0188] Tumors were induced by subcutaneous injection of 1.times.10.sup.6 of CT26 cells in 200 .mu.l of RPMI 1640 into the right flank of the test animals on day 8 (D8).

[0189] On the day of termination (D30, i.e. 22 days after tumor inoculation), tumors from all mice were collected and tumor size was measured.

[0190] The results are graphically depicted in FIG. 27. Tumor size was significantly decreased in animals treated with either VXM01 alone or VXM01 plus cyclophosphamide as compared to the empty vector control. Tumor size reduction was most pronounced in the animals treated with both cyclophosphamide and the VXM01 vaccine.

[0191] On the day of termination, spleens were collected from all mice (11 samples per group) and placed individually into tubes containing chilled PBS (2-8.degree. C.). Immunomonitoring of VEGFR-2 specific T-cell responses using flow cytometry with pentamers was performed.

[0192] For this purpose, the spleen samples were washed with PBS and subsequently homogenized by plunging them through a 100 .mu.m nylon cell strainer. During homogenization, the strainer was rinsed several times with cool sterile PBS. The samples were centrifuged at 1500 rpm for 10 minutes at 2-8.degree. C., the supernatant was discarded and the cell pellet was resuspended in 2 ml ACK red blood cell lysis buffer (1 ml buffer per spleen). The cells were incubated in the lysis buffer for 1 min at RT. Then, PBS was added to 40 ml to stop the lysis and the cell suspension was sieved through a fresh strainer (40 .mu.m) and the flow through was collected in a new 50 ml tube. After centrifugation at 1500 rpm for 10 min at 2-8.degree. C. the supernatant was discarded and the pellet was resuspended in 5 ml 11-2 supplemented DMEM medium. The cells were incubated overnight at 37.degree. C. and 5% CO.sub.2.

[0193] Prior to pentamer staining, a live/dead (L/D) staining using the Live Dead (L/D) Fixable Yellow Dead Cell Stain Kit by Invitrogen was performed according to the manufacturer's instructions, in order to exclude dead cells by gating on negative population.

[0194] Pentamer staining was performed using Pro5.RTM. Recombinant MHC Pentamers by Proimmune, Oxford, UK, according to the manufacturer's instructions.

[0195] The following KDR (VEGFR-2) pentamers were used:

TABLE-US-00002 (SEQ ID NO: 16) H-2Kd-SYQYGTMQTL KDR-STL (SEQ ID NO: 17) H-2Kd-KYLSYPAPDI KDR-KDI (SEQ ID NO: 18) H-2Kd-RFVPDGNRI KDR-RRI (SEQ ID NO: 19) H-2Kd-TYQSIMYIV KDR-TIV (SEQ ID NO: 20) H-2Kd-DFLTLEHLI KDR-DLI

[0196] The results of the pentamer staining are shown in FIG. 28.

[0197] The number of VEGFR-2 specific CD8.sup.+ cytotoxic T-cells was significantly increased in animals treated with either VXM01 alone or VXM01 plus cyclophosphamide as compared to the empty vector control. The cyclophosphamide treatment together with VXM01 significantly increased the KDR pentamer response as compared to the response obtained with the vaccine VXM01 alone.

[0198] Tumors from 5 mice in each group were analyzed by immunohistochemistry (IHC).

[0199] For that purpose, the tumors were fixed in 10% neutral buffered formalin for 24 h to 48 h, transferred into ethanol and then embedded in paraffin. The embedded samples were subjected to immunohistochemical staining. The results are graphically depicted in FIGS. 29 and 30.

[0200] The mean number of T-cells per unit of tissue are was found to be increased in the tumors of mice treated with either VXM01 alone or VXM01 plus cyclophosphamide as compared to the empty vector control. CD3.sup.+ and CD8.sup.+ cell populations were found to be increased approximately three-fold in the tumor samples of mice treated with VXM01 plus cyclophosphamide and approximately two-fold in tumor samples of mice treated with VXM01 alone. Also the CD4.sup.+ T-cell population was increased in VXM01 vaccine treated animals with and without cyclophosphamide pretreatment, with a 1.7 fold increase in the mean number of CD4.sup.+ cells/tissue area in both vaccine groups as compared to the empty vector control.

[0201] Furthermore, the number of PD-1 positive immune cells was increased by a factor of 2.0 and 2.1 and the tumor was enriched in PD-L1-expressing cells upon treatment with VXM01 either as single agent or in combination with cyclophosphamide, clearly indicating that VXM01 treatment might increase the susceptibility of tumors towards the treatment with anti-PD-1 and anti-PD-L1 checkpoint inhibitors.

Example 4: VXM01/VXM08 Combination Study in Healthy C56BL/6J Mice

[0202] The aim of this study was to evaluate the capability of VXM01mlow and VXM08hm to trigger an immune response in healthy mice.

[0203] Control VXM0m-empty (S. typhimurium vector control with no expression plasmid), vaccine VXM01 mlow (Salmonella typhimurium harboring a murine VEGFR-2-encoding eukaryotic expression cassette) and vaccine VXM08hm (Salmonella typhimurium harboring a human CEA encoding eukaryotic expression cassette) were administered at 10.sup.8 CFU/adm in 50 .mu.l per application by oral gavage (per os, PO) via a gavage tube. Regardless of animal groups, each animal received pre-dose application buffer PO to neutralize acid in the stomach prior dosing (50 .mu.l/animal/application prior to single vaccine administration; 100 .mu.l/animal/application prior to combined administration of VXM01 and VXM08). This buffer was composed by dissolution of 2.6 g sodium hydrogen carbonate, 1.7 g L-ascorbic acid and 0.2 g lactose monohydrate in 100 ml of drinking water and was applied within 30 min prior application of VXM0m-empty, VXM01mlow and/or VXM08hm.

[0204] 40 healthy female C57BL/6J mice, 6-7 weeks old, were randomized on day 0 (D0) according to their body weight into 5 groups of 8 animals each using Vivo Manager.RTM. software (Biosystemes, Couternon, France). A statistical test (analysis of variance) was performed to test for homogeneity between groups.

[0205] The treatment schedule was as follows:

[0206] Group 1: The animals from group 1 received a total of 6 PO administrations of VXM0m-empty on D1, D3, D5, D7, D14 and D21.

[0207] Group 2: The animals of group 2 received a total of 6 PO administrations of VXM01mlow on D1, D3, D5, D7, D14 and D21.

[0208] Group 3: The animals of group 3 received a total of 6 PO administrations of VXM08hm on D2, D4, D6, D8, D15 and D22.

[0209] Group 4: The animals of group 4 received a total of 6 PO administrations of VXM01mlow on D2, D4, D6, D8, D15 and D22 and a total of 6 PO administrations of VXM08hm on D2, D4, D6, D8, D15 and D22.

[0210] Group 5: The animals of group 5 received a total of 6 PO administrations of VXM01mlow on D1, D3, D5, D7, D14 and D21 and a total of 6 PO administrations of VXM08hm on D2, D4, D6, D8, D15 and D22.

[0211] The treatment schedule is summarized in Table 2.

TABLE-US-00003 No. Dose Volume Group Mice Treatment (CFU/adm) (.mu.l) Route Treatment Schedule 1 8 Empty vector 50 PO Prime: D1, D3, D5, D7 Boost: D14, D21 2 8 VXM01mlow 10.sup.8 50 PO Prime: D1, D3, D5, D7 Boost: D14, D21 3 8 VXM08hm 10.sup.8 50 PO Prime: D2, D4, D6, D8 Boost: D15, D22 4 8 VXM01mlow 10.sup.8 50 PO Prime: D2, D4, D6, D8 Boost: D15 and D22 VXM08hm* 10.sup.8 50 PO Prime: D2, D4, D6, D8 (concomitant) Boost: D15, D22 5 8 VXM01mlow 10.sup.8 50 PO Prime: D1, D3, D5, D7 Boost: D14, D21 VXM08hm 10.sup.8 50 PO Prime: D2, D4, D6, D8 (alternate Boost: D15, D22 days) *VXM08 was administered just after VMX01, at the same day of application

[0212] On the day of termination (i.e. D29), spleens were collected from all mice (8 samples per group) and placed individually into tubes containing chilled PBS (2-8.degree. C.). Immunomonitoring of VEGFR-2 and CEA specific T-cell responses using flow cytometry with pentamers was performed. Pentamer analysis including preceding live/dead staining was performed as described in Example 3.

[0213] The following KDR (VEGFR-2) pentamers were used as a pool mix at same ratio:

TABLE-US-00004 (SEQ ID NO: 21) H-2Db-VILTNPISM KDR2 (SEQ ID NO: 22) H-2Db-FSNSTNDILI KDR3

[0214] The following CEA pentamers were used as a pool mix at same ratio:

TABLE-US-00005 (SEQ ID NO: 23) H-2Db-CGIQNSVSA CEA-CSA-Penta (SEQ ID NO: 24) H-2Db-LQLSNGNRTL CEA-LTL-Penta (SEQ ID NO: 25) H-2Db-CGIQNKLSV CEA-CSV-Penta

[0215] The results of the pentamer staining are shown in FIG. 31. The mean frequency of VEGFR-2 (KDR) specific CD8.sup.+ T-cells was 1.71, 4.36 and 2.76-fold higher in mice treated with VXM01mlow, VXM01mlow/VXM08hm (concomitant) and VXM01mlow/VXM08hm (alternate days) respectively than in the control group. Mice treated with VXM01mlow/VXM08hm either concomitantly or on alternate days showed a higher frequency of VEGFR-2 specific CD8.sup.+ T-cells as compared to mice treated with VXM01mlow alone. Although not statistically significant, the synergy was slightly higher when VXM01mlow and VXM08hm vaccine had been applied concomitantly, i.e. the same day as compared to the alternate day regimen.

[0216] The mean frequency of CEA-specific CD8.sup.+ T-cells was 1.29, 2.23 and 1.95-fold higher in mice treated with VXM08hm, VXM01mlow/VXM08hm (concomitant) and VXM01mlow/VXM08hm (alternate days) respectively than in the control group. Mice treated with VXM01mlow/VXM08hm either concomitantly or on alternate days showed a higher frequency of CEA specific CD8.sup.+ T-cells as compared to mice treated with VXM08hm alone. Although not statistically significant, the synergy was slightly higher when VXM01mlow and VXM08hm vaccine had been applied concomitantly, i.e. the same day as compared to the alternate day regimen.

Sequence CWU 1

1

2511356PRThuman 1Met Gln Ser Lys Val Leu Leu Ala Val Ala Leu Trp Leu Cys Val Glu1 5 10 15Thr Arg Ala Ala Ser Val Gly Leu Pro Ser Val Ser Leu Asp Leu Pro 20 25 30Arg Leu Ser Ile Gln Lys Asp Ile Leu Thr Ile Lys Ala Asn Thr Thr 35 40 45Leu Gln Ile Thr Cys Arg Gly Gln Arg Asp Leu Asp Trp Leu Trp Pro 50 55 60Asn Asn Gln Ser Gly Ser Glu Gln Arg Val Glu Val Thr Glu Cys Ser65 70 75 80Asp Gly Leu Phe Cys Lys Thr Leu Thr Ile Pro Lys Val Ile Gly Asn 85 90 95Asp Thr Gly Ala Tyr Lys Cys Phe Tyr Arg Glu Thr Asp Leu Ala Ser 100 105 110Val Ile Tyr Val Tyr Val Gln Asp Tyr Arg Ser Pro Phe Ile Ala Ser 115 120 125Val Ser Asp Gln His Gly Val Val Tyr Ile Thr Glu Asn Lys Asn Lys 130 135 140Thr Val Val Ile Pro Cys Leu Gly Ser Ile Ser Asn Leu Asn Val Ser145 150 155 160Leu Cys Ala Arg Tyr Pro Glu Lys Arg Phe Val Pro Asp Gly Asn Arg 165 170 175Ile Ser Trp Asp Ser Lys Lys Gly Phe Thr Ile Pro Ser Tyr Met Ile 180 185 190Ser Tyr Ala Gly Met Val Phe Cys Glu Ala Lys Ile Asn Asp Glu Ser 195 200 205Tyr Gln Ser Ile Met Tyr Ile Val Val Val Val Gly Tyr Arg Ile Tyr 210 215 220Asp Val Val Leu Ser Pro Ser His Gly Ile Glu Leu Ser Val Gly Glu225 230 235 240Lys Leu Val Leu Asn Cys Thr Ala Arg Thr Glu Leu Asn Val Gly Ile 245 250 255Asp Phe Asn Trp Glu Tyr Pro Ser Ser Lys His Gln His Lys Lys Leu 260 265 270Val Asn Arg Asp Leu Lys Thr Gln Ser Gly Ser Glu Met Lys Lys Phe 275 280 285Leu Ser Thr Leu Thr Ile Asp Gly Val Thr Arg Ser Asp Gln Gly Leu 290 295 300Tyr Thr Cys Ala Ala Ser Ser Gly Leu Met Thr Lys Lys Asn Ser Thr305 310 315 320Phe Val Arg Val His Glu Lys Pro Phe Val Ala Phe Gly Ser Gly Met 325 330 335Glu Ser Leu Val Glu Ala Thr Val Gly Glu Arg Val Arg Ile Pro Ala 340 345 350Lys Tyr Leu Gly Tyr Pro Pro Pro Glu Ile Lys Trp Tyr Lys Asn Gly 355 360 365Ile Pro Leu Glu Ser Asn His Thr Ile Lys Ala Gly His Val Leu Thr 370 375 380Ile Met Glu Val Ser Glu Arg Asp Thr Gly Asn Tyr Thr Val Ile Leu385 390 395 400Thr Asn Pro Ile Ser Lys Glu Lys Gln Ser His Val Val Ser Leu Val 405 410 415Val Tyr Val Pro Pro Gln Ile Gly Glu Lys Ser Leu Ile Ser Pro Val 420 425 430Asp Ser Tyr Gln Tyr Gly Thr Thr Gln Thr Leu Thr Cys Thr Val Tyr 435 440 445Ala Ile Pro Pro Pro His His Ile His Trp Tyr Trp Gln Leu Glu Glu 450 455 460Glu Cys Ala Asn Glu Pro Ser Gln Ala Val Ser Val Thr Asn Pro Tyr465 470 475 480Pro Cys Glu Glu Trp Arg Ser Val Glu Asp Phe Gln Gly Gly Asn Lys 485 490 495Ile Glu Val Asn Lys Asn Gln Phe Ala Leu Ile Glu Gly Lys Asn Lys 500 505 510Thr Val Ser Thr Leu Val Ile Gln Ala Ala Asn Val Ser Ala Leu Tyr 515 520 525Lys Cys Glu Ala Val Asn Lys Val Gly Arg Gly Glu Arg Val Ile Ser 530 535 540Phe His Val Thr Arg Gly Pro Glu Ile Thr Leu Gln Pro Asp Met Gln545 550 555 560Pro Thr Glu Gln Glu Ser Val Ser Leu Trp Cys Thr Ala Asp Arg Ser 565 570 575Thr Phe Glu Asn Leu Thr Trp Tyr Lys Leu Gly Pro Gln Pro Leu Pro 580 585 590Ile His Val Gly Glu Leu Pro Thr Pro Val Cys Lys Asn Leu Asp Thr 595 600 605Leu Trp Lys Leu Asn Ala Thr Met Phe Ser Asn Ser Thr Asn Asp Ile 610 615 620Leu Ile Met Glu Leu Lys Asn Ala Ser Leu Gln Asp Gln Gly Asp Tyr625 630 635 640Val Cys Leu Ala Gln Asp Arg Lys Thr Lys Lys Arg His Cys Val Val 645 650 655Arg Gln Leu Thr Val Leu Glu Arg Val Ala Pro Thr Ile Thr Gly Asn 660 665 670Leu Glu Asn Gln Thr Thr Ser Ile Gly Glu Ser Ile Glu Val Ser Cys 675 680 685Thr Ala Ser Gly Asn Pro Pro Pro Gln Ile Met Trp Phe Lys Asp Asn 690 695 700Glu Thr Leu Val Glu Asp Ser Gly Ile Val Leu Lys Asp Gly Asn Arg705 710 715 720Asn Leu Thr Ile Arg Arg Val Arg Lys Glu Asp Glu Gly Leu Tyr Thr 725 730 735Cys Gln Ala Cys Ser Val Leu Gly Cys Ala Lys Val Glu Ala Phe Phe 740 745 750Ile Ile Glu Gly Ala Gln Glu Lys Thr Asn Leu Glu Ile Ile Ile Leu 755 760 765Val Gly Thr Ala Val Ile Ala Met Phe Phe Trp Leu Leu Leu Val Ile 770 775 780Ile Leu Arg Thr Val Lys Arg Ala Asn Gly Gly Glu Leu Lys Thr Gly785 790 795 800Tyr Leu Ser Ile Val Met Asp Pro Asp Glu Leu Pro Leu Asp Glu His 805 810 815Cys Glu Arg Leu Pro Tyr Asp Ala Ser Lys Trp Glu Phe Pro Arg Asp 820 825 830Arg Leu Lys Leu Gly Lys Pro Leu Gly Arg Gly Ala Phe Gly Gln Val 835 840 845Ile Glu Ala Asp Ala Phe Gly Ile Asp Lys Thr Ala Thr Cys Arg Thr 850 855 860Val Ala Val Lys Met Leu Lys Glu Gly Ala Thr His Ser Glu His Arg865 870 875 880Ala Leu Met Ser Glu Leu Lys Ile Leu Ile His Ile Gly His His Leu 885 890 895Asn Val Val Asn Leu Leu Gly Ala Cys Thr Lys Pro Gly Gly Pro Leu 900 905 910Met Val Ile Val Glu Phe Cys Lys Phe Gly Asn Leu Ser Thr Tyr Leu 915 920 925Arg Ser Lys Arg Asn Glu Phe Val Pro Tyr Lys Thr Lys Gly Ala Arg 930 935 940Phe Arg Gln Gly Lys Asp Tyr Val Gly Ala Ile Pro Val Asp Leu Lys945 950 955 960Arg Arg Leu Asp Ser Ile Thr Ser Ser Gln Ser Ser Ala Ser Ser Gly 965 970 975Phe Val Glu Glu Lys Ser Leu Ser Asp Val Glu Glu Glu Glu Ala Pro 980 985 990Glu Asp Leu Tyr Lys Asp Phe Leu Thr Leu Glu His Leu Ile Cys Tyr 995 1000 1005Ser Phe Gln Val Ala Lys Gly Met Glu Phe Leu Ala Ser Arg Lys 1010 1015 1020Cys Ile His Arg Asp Leu Ala Ala Arg Asn Ile Leu Leu Ser Glu 1025 1030 1035Lys Asn Val Val Lys Ile Cys Asp Phe Gly Leu Ala Arg Asp Ile 1040 1045 1050Tyr Lys Asp Pro Asp Tyr Val Arg Lys Gly Asp Ala Arg Leu Pro 1055 1060 1065Leu Lys Trp Met Ala Pro Glu Thr Ile Phe Asp Arg Val Tyr Thr 1070 1075 1080Ile Gln Ser Asp Val Trp Ser Phe Gly Val Leu Leu Trp Glu Ile 1085 1090 1095Phe Ser Leu Gly Ala Ser Pro Tyr Pro Gly Val Lys Ile Asp Glu 1100 1105 1110Glu Phe Cys Arg Arg Leu Lys Glu Gly Thr Arg Met Arg Ala Pro 1115 1120 1125Asp Tyr Thr Thr Pro Glu Met Tyr Gln Thr Met Leu Asp Cys Trp 1130 1135 1140His Gly Glu Pro Ser Gln Arg Pro Thr Phe Ser Glu Leu Val Glu 1145 1150 1155His Leu Gly Asn Leu Leu Gln Ala Asn Ala Gln Gln Asp Gly Lys 1160 1165 1170Asp Tyr Ile Val Leu Pro Ile Ser Glu Thr Leu Ser Met Glu Glu 1175 1180 1185Asp Ser Gly Leu Ser Leu Pro Thr Ser Pro Val Ser Cys Met Glu 1190 1195 1200Glu Glu Glu Val Cys Asp Pro Lys Phe His Tyr Asp Asn Thr Ala 1205 1210 1215Gly Ile Ser Gln Tyr Leu Gln Asn Ser Lys Arg Lys Ser Arg Pro 1220 1225 1230Val Ser Val Lys Thr Phe Glu Asp Ile Pro Leu Glu Glu Pro Glu 1235 1240 1245Val Lys Val Ile Pro Asp Asp Asn Gln Thr Asp Ser Gly Met Val 1250 1255 1260Leu Ala Ser Glu Glu Leu Lys Thr Leu Glu Asp Arg Thr Lys Leu 1265 1270 1275Ser Pro Ser Phe Gly Gly Met Val Pro Ser Lys Ser Arg Glu Ser 1280 1285 1290Val Ala Ser Glu Gly Ser Asn Gln Thr Ser Gly Tyr Gln Ser Gly 1295 1300 1305Tyr His Ser Asp Asp Thr Asp Thr Thr Val Tyr Ser Ser Glu Glu 1310 1315 1320Ala Glu Leu Leu Lys Leu Ile Glu Ile Gly Val Gln Thr Gly Ser 1325 1330 1335Thr Ala Gln Ile Leu Gln Pro Asp Ser Gly Thr Thr Leu Ser Ser 1340 1345 1350Pro Pro Val 135523500DNAartificialexpression plasmid 2tgggcttttg ctggcctttt gctcacatgt tcttgactct tcgcgatgta cgggccagat 60atacgcgttg acattgatta ttgactagtt attaatagta atcaattacg gggtcattag 120ttcatagccc atatatggag ttccgcgtta cataacttac ggtaaatggc ccgcctggct 180gaccgcccaa cgacccccgc ccattgacgt caataatgac gtatgttccc atagtaacgc 240caatagggac tttccattga cgtcaatggg tggactattt acggtaaact gcccacttgg 300cagtacatca agtgtatcat atgccaagta cgccccctat tgacgtcaat gacggtaaat 360ggcccgcctg gcattatgcc cagtacatga ccttatggga ctttcctact tggcagtaca 420tctacgtatt agtcatcgct attaccatgg tgatgcggtt ttggcagtac atcaatgggc 480gtggatagcg gtttgactca cggggatttc caagtctcca ccccattgac gtcaatggga 540gtttgttttg gcaccaaaat caacgggact ttccaaaatg tcgtaacaac tccgccccat 600tgacgcaaat gggcggtagg cgtgtacggt gggaggtcta tataagcaga gctctctggc 660taactagaga acccactgct tactggctta tcgaaattaa tacgactcac tatagggaga 720cccaagctgg ctagcctcga gtctagaggg cccgtttaaa cccgctgatc agcctcgact 780gtgccttcta gttgccagcc atctgttgtt tgcccctccc ccgtgccttc cttgaccctg 840gaaggtgcca ctcccactgt cctttcctaa taaaatgagg aaattgcatc gcattgtctg 900agtaggtgtc attctattct ggggggtggg gtggggcagg acagcaaggg ggaggattgg 960gaagacaata gcaggcatgc tggggatgcg gtgggctcta tggcttctac tgggcggttt 1020tatggacagc aagcgaaccg gaattgccag ctggggcgcc ctctggtaag gttgggaagc 1080cctgcaaagt aaactggatg gctttctcgc cgccaaggat ctgatggcgc aggggatcaa 1140gctctgatca agagacagga tgaggatcgt ttcgcatgat tgaacaagat ggattgcacg 1200caggttctcc ggccgcttgg gtggagaggc tattcggcta tgactgggca caacagacaa 1260tcggctgctc tgatgccgcc gtgttccggc tgtcagcgca ggggcgcccg gttctttttg 1320tcaagaccga cctgtccggt gccctgaatg aactgcaaga cgaggcagcg cggctatcgt 1380ggctggccac gacgggcgtt ccttgcgcag ctgtgctcga cgttgtcact gaagcgggaa 1440gggactggct gctattgggc gaagtgccgg ggcaggatct cctgtcatct caccttgctc 1500ctgccgagaa agtatccatc atggctgatg caatgcggcg gctgcatacg cttgatccgg 1560ctacctgccc attcgaccac caagcgaaac atcgcatcga gcgagcacgt actcggatgg 1620aagccggtct tgtcgatcag gatgatctgg acgaagagca tcaggggctc gcgccagccg 1680aactgttcgc caggctcaag gcgagcatgc ccgacggcga ggatctcgtc gtgacccatg 1740gcgatgcctg cttgccgaat atcatggtgg aaaatggccg cttttctgga ttcatcgact 1800gtggccggct gggtgtggcg gaccgctatc aggacatagc gttggctacc cgtgatattg 1860ctgaagagct tggcggcgaa tgggctgacc gcttcctcgt gctttacggt atcgccgctc 1920ccgattcgca gcgcatcgcc ttctatcgcc ttcttgacga gttcttctga attattaacg 1980cttacaattt cctgatgcgg tattttctcc ttacgcatct gtgcggtatt tcacaccgca 2040tacaggtggc acttttcggg gaaatgtgcg cggaacccct atttgtttat ttttctaaat 2100acattcaaat atgtatccgc tcatgagaca ataaccctga taaatgcttc aataatagca 2160cgtgctaaaa cttcattttt aatttaaaag gatctaggtg aagatccttt ttgataatct 2220catgaccaaa atcccttaac gtgagttttc gttccactga gcgtcagacc cccatcagtg 2280accaaacagg aaaaaaccgc ccttaacatg gcccgcttta tcagaagcca gacattaacg 2340cttctggaga aactcaacga gctggacgcg gatgaacagg cagacatctg tgaatcgctt 2400cacgaccacg ctgatgagct ttaccgcagc tgcctcgcgc gtttcggtga tgacggtgaa 2460aacctctgac acatgcagct cccggagacg gtcacagctt gtctgtaagc ggatgccggg 2520agcagacaag cccgtcaggg cgcgtcagcg ggtgttggcg ggtgtcgggg cgcagccatg 2580acccagtcac gtagcgatag cggagtgtat actggcttaa ctatgcggca tcagagcaga 2640ttgtactgag agtgcaccat atgcggtgtg aaataccgca cagatgcgta aggagaaaat 2700accgcatcag gcgctcttcc gcttcctcgc tcactgactc gctgcgctcg gtcgttcggc 2760tgcggcgagc ggtatcagct cactcaaagg cggtaatacg gttatccaca gaatcagggg 2820ataacgcagg aaagaacatg tgagcaaaag gccagcaaaa ggccaggaac cgtaaaaagg 2880ccgcgttgct ggcgtttttc cataggctcc gcccccctga cgagcatcac aaaaatcgac 2940gctcaagtca gaggtggcga aacccgacag gactataaag ataccaggcg tttccccctg 3000gaagctccct cgtgcgctct cctgttccga ccctgccgct taccggatac ctgtccgcct 3060ttctcccttc gggaagcgtg gcgctttctc atagctcacg ctgtaggtat ctcagttcgg 3120tgtaggtcgt tcgctccaag ctgggctgtg tgcacgaacc ccccgttcag cccgaccgct 3180gcgccttatc cggtaactat cgtcttgagt ccaacccggt aagacacgac ttatcgccac 3240tggcagcagc cactggtaac aggattagca gagcgaggta tgtaggcggt gctacagagt 3300tcttgaagtg gtggcctaac tacggctaca ctagaaggac agtatttggt atctgcgctc 3360tgctgaagcc agttaccttc ggaaaaagag ttggtagctc ttgatccggc aaacaaacca 3420ccgctggtag cggtggtttt tttgtttgca agcagcagat tacgcgcaga aaaaaaggat 3480ctcaagaaga tcctttgatc 35003371PRThuman 3Met Gly Ser Asp Val Arg Asp Leu Asn Ala Leu Leu Pro Ala Val Pro1 5 10 15Ser Leu Gly Gly Gly Gly Gly Cys Ala Leu Pro Val Ser Gly Ala Ala 20 25 30Gln Trp Ala Pro Val Leu Asp Phe Ala Pro Pro Gly Ala Ser Ala Tyr 35 40 45Gly Ser Leu Gly Gly Pro Ala Pro Pro Pro Ala Pro Pro Pro Pro Pro 50 55 60Pro Pro Pro Pro His Ser Phe Ile Lys Gln Glu Pro Ser Trp Gly Gly65 70 75 80Ala Glu Pro His Glu Glu Gln Cys Leu Ser Ala Phe Thr Val His Phe 85 90 95Ser Gly Gln Phe Thr Gly Thr Ala Gly Ala Cys Arg Tyr Gly Pro Phe 100 105 110Gly Pro Pro Pro Pro Ser Gln Ala Ser Ser Gly Gln Ala Arg Met Phe 115 120 125Pro Asn Ala Pro Tyr Leu Pro Ser Cys Leu Glu Ser Gln Pro Ala Ile 130 135 140Arg Asn Gln Gly Tyr Ser Thr Val Thr Phe Asp Gly Thr Pro Ser Tyr145 150 155 160Gly His Thr Pro Ser His His Ala Ala Gln Phe Pro Asn His Ser Phe 165 170 175Lys His Glu Asp Pro Met Gly Gln Gln Gly Ser Leu Gly Glu Gln Gln 180 185 190Tyr Ser Val Pro Pro Pro Val Tyr Gly Cys His Thr Pro Thr Asp Ser 195 200 205Cys Thr Gly Ser Gln Ala Leu Leu Leu Arg Thr Pro Tyr Ser Ser Asp 210 215 220Asn Leu Tyr Gln Met Thr Ser Gln Leu Glu Cys Met Thr Trp Asn Gln225 230 235 240Met Asn Leu Gly Ala Thr Leu Lys Gly Val Ala Ala Gly Ser Ser Ser 245 250 255Ser Val Lys Trp Thr Glu Gly Gln Ser Asn His Ser Thr Gly Tyr Glu 260 265 270Ser Asp Asn His Thr Thr Pro Ile Leu Cys Gly Ala Gln Tyr Arg Ile 275 280 285His Thr His Gly Val Phe Arg Gly Ile Gln Asp Val Arg Arg Val Pro 290 295 300Gly Val Ala Pro Thr Leu Val Arg Ser Ala Ser Glu Thr Ser Glu Lys305 310 315 320Arg Pro Phe Met Cys Ala Tyr Pro Gly Cys Asn Lys Arg Tyr Phe Lys 325 330 335Leu Ser His Leu Gln Met His Ser Arg Lys His Thr Gly Glu Lys Pro 340 345 350Tyr Gln Cys Asp Phe Lys Asp Cys Glu Arg Arg Phe Ser Arg Ser Asp 355 360 365Gln Leu Lys 3704630PRThuman 4Met Ala Leu Pro Thr Ala Arg Pro Leu Leu Gly Ser Cys Gly Thr Pro1 5 10 15Ala Leu Gly Ser Leu Leu Phe Leu Leu Phe Ser Leu Gly Trp Val Gln 20 25 30Pro Ser Arg Thr Leu Ala Gly Glu Thr Gly Gln Glu Ala Ala Pro Leu 35 40 45Asp Gly Val Leu Ala Asn Pro Pro Asn Ile Ser Ser Leu Ser Pro Arg 50 55 60Gln Leu Leu Gly Phe Pro Cys Ala Glu Val Ser Gly Leu Ser Thr Glu65 70 75 80Arg Val Arg Glu Leu Ala Val Ala Leu Ala Gln Lys Asn Val Lys Leu 85 90 95Ser Thr Glu Gln Leu Arg Cys Leu Ala His Arg Leu Ser Glu Pro Pro 100 105 110Glu Asp Leu Asp Ala Leu Pro Leu Asp Leu Leu Leu Phe Leu Asn Pro 115 120 125Asp Ala Phe Ser Gly Pro Gln Ala Cys Thr Arg Phe Phe Ser Arg Ile 130 135 140Thr Lys Ala Asn Val Asp Leu Leu Pro Arg Gly Ala Pro Glu Arg

Gln145 150 155 160Arg Leu Leu Pro Ala Ala Leu Ala Cys Trp Gly Val Arg Gly Ser Leu 165 170 175Leu Ser Glu Ala Asp Val Arg Ala Leu Gly Gly Leu Ala Cys Asp Leu 180 185 190Pro Gly Arg Phe Val Ala Glu Ser Ala Glu Val Leu Leu Pro Arg Leu 195 200 205Val Ser Cys Pro Gly Pro Leu Asp Gln Asp Gln Gln Glu Ala Ala Arg 210 215 220Ala Ala Leu Gln Gly Gly Gly Pro Pro Tyr Gly Pro Pro Ser Thr Trp225 230 235 240Ser Val Ser Thr Met Asp Ala Leu Arg Gly Leu Leu Pro Val Leu Gly 245 250 255Gln Pro Ile Ile Arg Ser Ile Pro Gln Gly Ile Val Ala Ala Trp Arg 260 265 270Gln Arg Ser Ser Arg Asp Pro Ser Trp Arg Gln Pro Glu Arg Thr Ile 275 280 285Leu Arg Pro Arg Phe Arg Arg Glu Val Glu Lys Thr Ala Cys Pro Ser 290 295 300Gly Lys Lys Ala Arg Glu Ile Asp Glu Ser Leu Ile Phe Tyr Lys Lys305 310 315 320Trp Glu Leu Glu Ala Cys Val Asp Ala Ala Leu Leu Ala Thr Gln Met 325 330 335Asp Arg Val Asn Ala Ile Pro Phe Thr Tyr Glu Gln Leu Asp Val Leu 340 345 350Lys His Lys Leu Asp Glu Leu Tyr Pro Gln Gly Tyr Pro Glu Ser Val 355 360 365Ile Gln His Leu Gly Tyr Leu Phe Leu Lys Met Ser Pro Glu Asp Ile 370 375 380Arg Lys Trp Asn Val Thr Ser Leu Glu Thr Leu Lys Ala Leu Leu Glu385 390 395 400Val Asn Lys Gly His Glu Met Ser Pro Gln Ala Pro Arg Arg Pro Leu 405 410 415Pro Gln Val Ala Thr Leu Ile Asp Arg Phe Val Lys Gly Arg Gly Gln 420 425 430Leu Asp Lys Asp Thr Leu Asp Thr Leu Thr Ala Phe Tyr Pro Gly Tyr 435 440 445Leu Cys Ser Leu Ser Pro Glu Glu Leu Ser Ser Val Pro Pro Ser Ser 450 455 460Ile Trp Ala Val Arg Pro Gln Asp Leu Asp Thr Cys Asp Pro Arg Gln465 470 475 480Leu Asp Val Leu Tyr Pro Lys Ala Arg Leu Ala Phe Gln Asn Met Asn 485 490 495Gly Ser Glu Tyr Phe Val Lys Ile Gln Ser Phe Leu Gly Gly Ala Pro 500 505 510Thr Glu Asp Leu Lys Ala Leu Ser Gln Gln Asn Val Ser Met Asp Leu 515 520 525Ala Thr Phe Met Lys Leu Arg Thr Asp Ala Val Leu Pro Leu Thr Val 530 535 540Ala Glu Val Gln Lys Leu Leu Gly Pro His Val Glu Gly Leu Lys Ala545 550 555 560Glu Glu Arg His Arg Pro Val Arg Asp Trp Ile Leu Arg Gln Arg Gln 565 570 575Asp Asp Leu Asp Thr Leu Gly Leu Gly Leu Gln Gly Gly Ile Pro Asn 580 585 590Gly Tyr Leu Val Leu Asp Leu Ser Met Gln Glu Ala Leu Ser Gly Thr 595 600 605Pro Cys Leu Leu Gly Pro Gly Pro Val Leu Thr Val Leu Ala Leu Leu 610 615 620Leu Ala Ser Thr Leu Ala625 6305702PRThuman 5Met Glu Ser Pro Ser Ala Pro Pro His Arg Trp Cys Ile Pro Trp Gln1 5 10 15Arg Leu Leu Leu Thr Ala Ser Leu Leu Thr Phe Trp Asn Pro Pro Thr 20 25 30Thr Ala Lys Leu Thr Ile Glu Ser Thr Pro Phe Asn Val Ala Glu Gly 35 40 45Lys Glu Val Leu Leu Leu Val His Asn Leu Pro Gln His Leu Phe Gly 50 55 60Tyr Ser Trp Tyr Lys Gly Glu Arg Val Asp Gly Asn Arg Gln Ile Ile65 70 75 80Gly Tyr Val Ile Gly Thr Gln Gln Ala Thr Pro Gly Pro Ala Tyr Ser 85 90 95Gly Arg Glu Ile Ile Tyr Pro Asn Ala Ser Leu Leu Ile Gln Asn Ile 100 105 110Ile Gln Asn Asp Thr Gly Phe Tyr Thr Leu His Val Ile Lys Ser Asp 115 120 125Leu Val Asn Glu Glu Ala Thr Gly Gln Phe Arg Val Tyr Pro Glu Leu 130 135 140Pro Lys Pro Ser Ile Ser Ser Asn Asn Ser Lys Pro Val Glu Asp Lys145 150 155 160Asp Ala Val Ala Phe Thr Cys Glu Pro Glu Thr Gln Asp Ala Thr Tyr 165 170 175Leu Trp Trp Val Asn Asn Gln Ser Leu Pro Val Ser Pro Arg Leu Gln 180 185 190Leu Ser Asn Gly Asn Arg Thr Leu Thr Leu Phe Asn Val Thr Arg Asn 195 200 205Asp Thr Ala Ser Tyr Lys Cys Glu Thr Gln Asn Pro Val Ser Ala Arg 210 215 220Arg Ser Asp Ser Val Ile Leu Asn Val Leu Tyr Gly Pro Asp Ala Pro225 230 235 240Thr Ile Ser Pro Leu Asn Thr Ser Tyr Arg Ser Gly Glu Asn Leu Asn 245 250 255Leu Ser Cys His Ala Ala Ser Asn Pro Pro Ala Gln Tyr Ser Trp Phe 260 265 270Val Asn Gly Thr Phe Gln Gln Ser Thr Gln Glu Leu Phe Ile Pro Asn 275 280 285Ile Thr Val Asn Asn Ser Gly Ser Tyr Thr Cys Gln Ala His Asn Ser 290 295 300Asp Thr Gly Leu Asn Arg Thr Thr Val Thr Thr Ile Thr Val Tyr Ala305 310 315 320Glu Pro Pro Lys Pro Phe Ile Thr Ser Asn Asn Ser Asn Pro Val Glu 325 330 335Asp Glu Asp Ala Val Ala Leu Thr Cys Glu Pro Glu Ile Gln Asn Thr 340 345 350Thr Tyr Leu Trp Trp Val Asn Asn Gln Ser Leu Pro Val Ser Pro Arg 355 360 365Leu Gln Leu Ser Asn Asp Asn Arg Thr Leu Thr Leu Leu Ser Val Thr 370 375 380Arg Asn Asp Val Gly Pro Tyr Glu Cys Gly Ile Gln Asn Lys Leu Ser385 390 395 400Val Asp His Ser Asp Pro Val Ile Leu Asn Val Leu Tyr Gly Pro Asp 405 410 415Asp Pro Thr Ile Ser Pro Ser Tyr Thr Tyr Tyr Arg Pro Gly Val Asn 420 425 430Leu Ser Leu Ser Cys His Ala Ala Ser Asn Pro Pro Ala Gln Tyr Ser 435 440 445Trp Leu Ile Asp Gly Asn Ile Gln Gln His Thr Gln Glu Leu Phe Ile 450 455 460Ser Asn Ile Thr Glu Lys Asn Ser Gly Leu Tyr Thr Cys Gln Ala Asn465 470 475 480Asn Ser Ala Ser Gly His Ser Arg Thr Thr Val Lys Thr Ile Thr Val 485 490 495Ser Ala Glu Leu Pro Lys Pro Ser Ile Ser Ser Asn Asn Ser Lys Pro 500 505 510Val Glu Asp Lys Asp Ala Val Ala Phe Thr Cys Glu Pro Glu Ala Gln 515 520 525Asn Thr Thr Tyr Leu Trp Trp Val Asn Gly Gln Ser Leu Pro Val Ser 530 535 540Pro Arg Leu Gln Leu Ser Asn Gly Asn Arg Thr Leu Thr Leu Phe Asn545 550 555 560Val Thr Arg Asn Asp Ala Arg Ala Tyr Val Cys Gly Ile Gln Asn Ser 565 570 575Val Ser Ala Asn Arg Ser Asp Pro Val Thr Leu Asp Val Leu Tyr Gly 580 585 590Pro Asp Thr Pro Ile Ile Ser Pro Pro Asp Ser Ser Tyr Leu Ser Gly 595 600 605Ala Asn Leu Asn Leu Ser Cys His Ser Ala Ser Asn Pro Ser Pro Gln 610 615 620Tyr Ser Trp Arg Ile Asn Gly Ile Pro Gln Gln His Thr Gln Val Leu625 630 635 640Phe Ile Ala Lys Ile Thr Pro Asn Asn Asn Gly Thr Tyr Ala Cys Phe 645 650 655Val Ser Asn Leu Ala Thr Gly Arg Asn Asn Ser Ile Val Lys Ser Ile 660 665 670Thr Val Ser Ala Ser Gly Thr Ser Pro Gly Leu Ser Ala Gly Ala Thr 675 680 685Val Gly Ile Met Ile Gly Val Leu Val Gly Val Ala Leu Ile 690 695 7006561PRTCMV 6Met Glu Ser Arg Gly Arg Arg Cys Pro Glu Met Ile Ser Val Leu Gly1 5 10 15Pro Ile Ser Gly His Val Leu Lys Ala Val Phe Ser Arg Gly Asp Thr 20 25 30Pro Val Leu Pro His Glu Thr Arg Leu Leu Gln Thr Gly Ile His Val 35 40 45Arg Val Ser Gln Pro Ser Leu Ile Leu Val Ser Gln Tyr Thr Pro Asp 50 55 60Ser Thr Pro Cys His Arg Gly Asp Asn Gln Leu Gln Val Gln His Thr65 70 75 80Tyr Phe Thr Gly Ser Glu Val Glu Asn Val Ser Val Asn Val His Asn 85 90 95Pro Thr Gly Arg Ser Ile Cys Pro Ser Gln Glu Pro Met Ser Ile Tyr 100 105 110Val Tyr Ala Leu Pro Leu Lys Met Leu Asn Ile Pro Ser Ile Asn Val 115 120 125His His Tyr Pro Ser Ala Ala Glu Arg Lys His Arg His Leu Pro Val 130 135 140Ala Asp Ala Val Ile His Ala Ser Gly Lys Gln Met Trp Gln Ala Arg145 150 155 160Leu Thr Val Ser Gly Leu Ala Trp Thr Arg Gln Gln Asn Gln Trp Lys 165 170 175Glu Pro Asp Val Tyr Tyr Thr Ser Ala Phe Val Phe Pro Thr Lys Asp 180 185 190Val Ala Leu Arg His Val Val Cys Ala His Glu Leu Val Cys Ser Met 195 200 205Glu Asn Thr Arg Ala Thr Lys Met Gln Val Ile Gly Asp Gln Tyr Val 210 215 220Lys Val Tyr Leu Glu Ser Phe Cys Glu Asp Val Pro Ser Gly Lys Leu225 230 235 240Phe Met His Val Thr Leu Gly Ser Asp Val Glu Glu Asp Leu Thr Met 245 250 255Thr Arg Asn Pro Gln Pro Phe Met Arg Pro His Glu Arg Asn Gly Phe 260 265 270Thr Val Leu Cys Pro Lys Asn Met Ile Ile Lys Pro Gly Lys Ile Ser 275 280 285His Ile Met Leu Asp Val Ala Phe Thr Ser His Glu His Phe Gly Leu 290 295 300Leu Cys Pro Lys Ser Ile Pro Gly Leu Ser Ile Ser Gly Asn Leu Leu305 310 315 320Met Asn Gly Gln Gln Ile Phe Leu Glu Val Gln Ala Ile Arg Glu Thr 325 330 335Val Glu Leu Arg Gln Tyr Asp Pro Val Ala Ala Leu Phe Phe Phe Asp 340 345 350Ile Asp Leu Leu Leu Gln Arg Gly Pro Gln Tyr Ser Glu His Pro Thr 355 360 365Phe Thr Ser Gln Tyr Arg Ile Gln Gly Lys Leu Glu Tyr Arg His Thr 370 375 380Trp Asp Arg His Asp Glu Gly Ala Ala Gln Gly Asp Asp Asp Val Trp385 390 395 400Thr Ser Gly Ser Asp Ser Asp Glu Glu Leu Val Thr Thr Glu Arg Lys 405 410 415Thr Pro Arg Val Thr Gly Gly Gly Ala Met Ala Gly Ala Ser Thr Ser 420 425 430Ala Gly Arg Lys Arg Lys Ser Ala Ser Ser Ala Thr Ala Cys Thr Ala 435 440 445Gly Val Met Thr Arg Gly Arg Leu Lys Ala Glu Ser Thr Val Ala Pro 450 455 460Glu Glu Asp Thr Asp Glu Asp Ser Asp Asn Glu Ile His Asn Pro Ala465 470 475 480Val Phe Thr Trp Pro Pro Trp Gln Ala Gly Ile Leu Ala Arg Asn Leu 485 490 495Val Pro Met Val Ala Thr Val Gln Gly Gln Asn Leu Lys Tyr Gln Glu 500 505 510Phe Phe Trp Asp Ala Asn Asp Ile Tyr Arg Ile Phe Ala Glu Leu Glu 515 520 525Gly Val Trp Gln Pro Ala Ala Gln Pro Lys Arg Arg Arg His Arg Gln 530 535 540Asp Ala Leu Pro Gly Pro Cys Ile Ala Ser Thr Pro Lys Lys His Arg545 550 555 560Gly7561PRTartificialmutated CMV pp65 7Met Glu Ser Arg Gly Arg Arg Cys Pro Glu Met Ile Ser Val Leu Gly1 5 10 15Pro Ile Ser Gly His Val Leu Lys Ala Val Phe Ser Arg Gly Asp Thr 20 25 30Pro Val Leu Pro His Glu Thr Arg Leu Leu Gln Thr Gly Ile His Val 35 40 45Arg Val Ser Gln Pro Ser Leu Ile Leu Val Ser Gln Tyr Thr Pro Asp 50 55 60Ser Thr Pro Cys His Arg Gly Asp Asn Gln Leu Gln Val Gln His Thr65 70 75 80Tyr Phe Thr Gly Ser Glu Val Glu Asn Val Ser Val Asn Val His Asn 85 90 95Pro Thr Gly Arg Ser Ile Cys Pro Ser Gln Glu Pro Met Ser Ile Tyr 100 105 110Val Tyr Ala Leu Pro Leu Lys Met Leu Asn Ile Pro Ser Ile Asn Val 115 120 125His His Tyr Pro Ser Ala Ala Glu Arg Lys His Arg His Leu Pro Val 130 135 140Ala Asp Ala Val Ile His Ala Ser Gly Lys Gln Met Trp Gln Ala Arg145 150 155 160Leu Thr Val Ser Gly Leu Ala Trp Thr Arg Gln Gln Asn Gln Trp Lys 165 170 175Glu Pro Asp Val Tyr Tyr Thr Ser Ala Phe Val Phe Pro Thr Lys Asp 180 185 190Val Ala Leu Arg His Val Val Cys Ala His Glu Leu Val Cys Ser Met 195 200 205Glu Asn Thr Arg Ala Thr Lys Met Gln Val Ile Gly Asp Gln Tyr Val 210 215 220Lys Val Tyr Leu Glu Ser Phe Cys Glu Asp Val Pro Ser Gly Lys Leu225 230 235 240Phe Met His Val Thr Leu Gly Ser Asp Val Glu Glu Asp Leu Thr Met 245 250 255Thr Arg Asn Pro Gln Pro Phe Met Arg Pro His Glu Arg Asn Gly Phe 260 265 270Thr Val Leu Cys Pro Lys Asn Met Ile Ile Lys Pro Gly Lys Ile Ser 275 280 285His Ile Met Leu Asp Val Ala Phe Thr Ser His Glu His Phe Gly Leu 290 295 300Leu Cys Pro Lys Ser Ile Pro Gly Leu Ser Ile Ser Gly Asn Leu Leu305 310 315 320Met Asn Gly Gln Gln Ile Phe Leu Glu Val Gln Ala Ile Arg Glu Thr 325 330 335Val Glu Leu Arg Gln Tyr Asp Pro Val Ala Ala Leu Phe Phe Phe Asp 340 345 350Ile Asp Leu Leu Leu Gln Arg Gly Pro Gln Tyr Ser Glu His Pro Thr 355 360 365Phe Thr Ser Gln Tyr Arg Ile Gln Gly Lys Leu Glu Tyr Arg His Thr 370 375 380Trp Asp Arg His Asp Glu Gly Ala Ala Gln Gly Asp Asp Asp Val Trp385 390 395 400Thr Ser Gly Ser Asp Ser Asp Glu Glu Leu Val Thr Thr Glu Arg Lys 405 410 415Thr Pro Arg Val Thr Gly Gly Gly Ala Met Ala Gly Ala Ser Thr Ser 420 425 430Ala Gly Arg Asn Arg Lys Ser Ala Ser Ser Ala Thr Ala Cys Thr Ala 435 440 445Gly Val Met Thr Arg Gly Arg Leu Lys Ala Glu Ser Thr Val Ala Pro 450 455 460Glu Glu Asp Thr Asp Glu Asp Ser Asp Asn Glu Ile His Asn Pro Ala465 470 475 480Val Phe Thr Trp Pro Pro Trp Gln Ala Gly Ile Leu Ala Arg Asn Leu 485 490 495Val Pro Met Val Ala Thr Val Gln Gly Gln Asn Leu Lys Tyr Gln Glu 500 505 510Phe Phe Trp Asp Ala Asn Asp Ile Tyr Arg Ile Phe Ala Glu Leu Glu 515 520 525Gly Val Trp Gln Pro Ala Ala Gln Pro Lys Arg Arg Arg His Arg Gln 530 535 540Asp Ala Leu Pro Gly Pro Cys Ile Ala Ser Thr Pro Lys Lys His Arg545 550 555 560Gly8536PRTartificialmutated CMV pp65 8Met Glu Ser Arg Gly Arg Arg Cys Pro Glu Met Ile Ser Val Leu Gly1 5 10 15Pro Ile Ser Gly His Val Leu Lys Ala Val Phe Ser Arg Gly Asp Thr 20 25 30Pro Val Leu Pro His Glu Thr Arg Leu Leu Gln Thr Gly Ile His Val 35 40 45Arg Val Ser Gln Pro Ser Leu Ile Leu Val Ser Gln Tyr Thr Pro Asp 50 55 60Ser Thr Pro Cys His Arg Gly Asp Asn Gln Leu Gln Val Gln His Thr65 70 75 80Tyr Phe Thr Gly Ser Glu Val Glu Asn Val Ser Val Asn Val His Asn 85 90 95Pro Thr Gly Arg Ser Ile Cys Pro Ser Gln Glu Pro Met Ser Ile Tyr 100 105 110Val Tyr Ala Leu Pro Leu Lys Met Leu Asn Ile Pro Ser Ile Asn Val 115 120 125His His Tyr Pro Ser Ala Ala Glu Arg Lys His Arg His Leu Pro Val 130 135 140Ala Asp Ala Val Ile His Ala Ser Gly Lys Gln Met Trp Gln Ala Arg145 150 155 160Leu Thr

Val Ser Gly Leu Ala Trp Thr Arg Gln Gln Asn Gln Trp Lys 165 170 175Glu Pro Asp Val Tyr Tyr Thr Ser Ala Phe Val Phe Pro Thr Lys Asp 180 185 190Val Ala Leu Arg His Val Val Cys Ala His Glu Leu Val Cys Ser Met 195 200 205Glu Asn Thr Arg Ala Thr Lys Met Gln Val Ile Gly Asp Gln Tyr Val 210 215 220Lys Val Tyr Leu Glu Ser Phe Cys Glu Asp Val Pro Ser Gly Lys Leu225 230 235 240Phe Met His Val Thr Leu Gly Ser Asp Val Glu Glu Asp Leu Thr Met 245 250 255Thr Arg Asn Pro Gln Pro Phe Met Arg Pro His Glu Arg Asn Gly Phe 260 265 270Thr Val Leu Cys Pro Lys Asn Met Ile Ile Lys Pro Gly Lys Ile Ser 275 280 285His Ile Met Leu Asp Val Ala Phe Thr Ser His Glu His Phe Gly Leu 290 295 300Leu Cys Pro Lys Ser Ile Pro Gly Leu Ser Ile Ser Gly Asn Leu Leu305 310 315 320Met Asn Gly Gln Gln Ile Phe Leu Glu Val Gln Ala Ile Arg Glu Thr 325 330 335Val Glu Leu Arg Gln Tyr Asp Pro Val Ala Ala Leu Phe Phe Phe Asp 340 345 350Ile Asp Leu Leu Leu Gln Arg Gly Pro Gln Tyr Ser Glu His Pro Thr 355 360 365Phe Thr Ser Gln Tyr Arg Ile Gln Gly Lys Leu Glu Tyr Arg His Thr 370 375 380Trp Asp Arg His Asp Glu Gly Ala Ala Gln Gly Asp Asp Asp Val Trp385 390 395 400Thr Ser Gly Ser Asp Ser Asp Glu Glu Leu Val Thr Thr Glu Arg Lys 405 410 415Thr Pro Arg Val Thr Gly Gly Gly Ala Met Ala Gly Ala Ser Thr Ser 420 425 430Ala Gly Arg Asn Arg Lys Ser Ala Ser Ser Ala Thr Ala Cys Thr Ala 435 440 445Gly Val Met Thr Arg Gly Arg Leu Lys Ala Glu Ser Thr Val Ala Pro 450 455 460Glu Glu Asp Thr Asp Glu Asp Ser Asp Asn Glu Ile His Asn Pro Ala465 470 475 480Val Phe Thr Trp Pro Pro Trp Gln Ala Gly Ile Leu Ala Arg Asn Leu 485 490 495Val Pro Met Val Ala Thr Val Gln Gly Gln Asn Leu Lys Tyr Gln Glu 500 505 510Phe Phe Trp Asp Ala Asn Asp Ile Tyr Arg Ile Phe Ala Glu Leu Glu 515 520 525Gly Val Trp Gln Pro Ala Ala Gln 530 53594071DNAhuman 9atgcagagca aggtgctgct ggccgtcgcc ctgtggctct gcgtggagac ccgggccgcc 60tctgtgggtt tgcctagtgt ttctcttgat ctgcccaggc tcagcataca aaaagacata 120cttacaatta aggctaatac aactcttcaa attacttgca ggggacagag ggacttggac 180tggctttggc ccaataatca gagtggcagt gagcaaaggg tggaggtgac tgagtgcagc 240gatggcctct tctgtaagac actcacaatt ccaaaagtga tcggaaatga cactggagcc 300tacaagtgct tctaccggga aactgacttg gcctcggtca tttatgtcta tgttcaagat 360tacagatctc catttattgc ttctgttagt gaccaacatg gagtcgtgta cattactgag 420aacaaaaaca aaactgtggt gattccatgt ctcgggtcca tttcaaatct caacgtgtca 480ctttgtgcaa gatacccaga aaagagattt gttcctgatg gtaacagaat ttcctgggac 540agcaagaagg gctttactat tcccagctac atgatcagct atgctggcat ggtcttctgt 600gaagcaaaaa ttaatgatga aagttaccag tctattatgt acatagttgt cgttgtaggg 660tataggattt atgatgtggt tctgagtccg tctcatggaa ttgaactatc tgttggagaa 720aagcttgtct taaattgtac agcaagaact gaactaaatg tggggattga cttcaactgg 780gaataccctt cttcgaagca tcagcataag aaacttgtaa accgagacct aaaaacccag 840tctgggagtg agatgaagaa atttttgagc accttaacta tagatggtgt aacccggagt 900gaccaaggat tgtacacctg tgcagcatcc agtgggctga tgaccaagaa gaacagcaca 960tttgtcaggg tccatgaaaa accttttgtt gcttttggaa gtggcatgga atctctggtg 1020gaagccacgg tgggggagcg tgtcagaatc cctgcgaagt accttggtta cccaccccca 1080gaaataaaat ggtataaaaa tggaataccc cttgagtcca atcacacaat taaagcgggg 1140catgtactga cgattatgga agtgagtgaa agagacacag gaaattacac tgtcatcctt 1200accaatccca tttcaaagga gaagcagagc catgtggtct ctctggttgt gtatgtccca 1260ccccagattg gtgagaaatc tctaatctct cctgtggatt cctaccagta cggcaccact 1320caaacgctga catgtacggt ctatgccatt cctcccccgc atcacatcca ctggtattgg 1380cagttggagg aagagtgcgc caacgagccc agccaagctg tctcagtgac aaacccatac 1440ccttgtgaag aatggagaag tgtggaggac ttccagggag gaaataaaat tgaagttaat 1500aaaaatcaat ttgctctaat tgaaggaaaa aacaaaactg taagtaccct tgttatccaa 1560gcggcaaatg tgtcagcttt gtacaaatgt gaagcggtca acaaagtcgg gagaggagag 1620agggtgatct ccttccacgt gaccaggggt cctgaaatta ctttgcaacc tgacatgcag 1680cccactgagc aggagagcgt gtctttgtgg tgcactgcag acagatctac gtttgagaac 1740ctcacatggt acaagcttgg cccacagcct ctgccaatcc atgtgggaga gttgcccaca 1800cctgtttgca agaacttgga tactctttgg aaattgaatg ccaccatgtt ctctaatagc 1860acaaatgaca ttttgatcat ggagcttaag aatgcatcct tgcaggacca aggagactat 1920gtctgccttg ctcaagacag gaagaccaag aaaagacatt gcgtggtcag gcagctcaca 1980gtcctagagc gtgtggcacc cacgatcaca ggaaacctgg agaatcagac gacaagtatt 2040ggggaaagca tcgaagtctc atgcacggca tctgggaatc cccctccaca gatcatgtgg 2100tttaaagata atgagaccct tgtagaagac tcaggcattg tattgaagga tgggaaccgg 2160aacctcacta tccgcagagt gaggaaggag gacgaaggcc tctacacctg ccaggcatgc 2220agtgttcttg gctgtgcaaa agtggaggca tttttcataa tagaaggtgc ccaggaaaag 2280acgaacttgg aaatcattat tctagtaggc acggcggtga ttgccatgtt cttctggcta 2340cttcttgtca tcatcctacg gaccgttaag cgggccaatg gaggggaact gaagacaggc 2400tacttgtcca tcgtcatgga tccagatgaa ctcccattgg atgaacattg tgaacgactg 2460ccttatgatg ccagcaaatg ggaattcccc agagaccggc tgaagctagg taagcctctt 2520ggccgtggtg cctttggcca agtgattgaa gcagatgcct ttggaattga caagacagca 2580acttgcagga cagtagcagt caaaatgttg aaagaaggag caacacacag tgagcatcga 2640gctctcatgt ctgaactcaa gatcctcatt catattggtc accatctcaa tgtggtcaac 2700cttctaggtg cctgtaccaa gccaggaggg ccactcatgg tgattgtgga attctgcaaa 2760tttggaaacc tgtccactta cctgaggagc aagagaaatg aatttgtccc ctacaagacc 2820aaaggggcac gattccgtca agggaaagac tacgttggag caatccctgt ggatctgaaa 2880cggcgcttgg acagcatcac cagtagccag agctcagcca gctctggatt tgtggaggag 2940aagtccctca gtgatgtaga agaagaggaa gctcctgaag atctgtataa ggacttcctg 3000accttggagc atctcatctg ttacagcttc caagtggcta agggcatgga gttcttggca 3060tcgcgaaagt gtatccacag ggacctggcg gcacgaaata tcctcttatc ggagaagaac 3120gtggttaaaa tctgtgactt tggcttggcc cgggatattt ataaagatcc agattatgtc 3180agaaaaggag atgctcgcct ccctttgaaa tggatggccc cagaaacaat ttttgacaga 3240gtgtacacaa tccagagtga cgtctggtct tttggtgttt tgctgtggga aatattttcc 3300ttaggtgctt ctccatatcc tggggtaaag attgatgaag aattttgtag gcgattgaaa 3360gaaggaacta gaatgagggc ccctgattat actacaccag aaatgtacca gaccatgctg 3420gactgctggc acggggagcc cagtcagaga cccacgtttt cagagttggt ggaacatttg 3480ggaaatctct tgcaagctaa tgctcagcag gatggcaaag actacattgt tcttccgata 3540tcagagactt tgagcatgga agaggattct ggactctctc tgcctacctc acctgtttcc 3600tgtatggagg aggaggaagt atgtgacccc aaattccatt atgacaacac agcaggaatc 3660agtcagtatc tgcagaacag taagcgaaag agccggcctg tgagtgtaaa aacatttgaa 3720gatatcccgt tagaagaacc agaagtaaaa gtaatcccag atgacaacca gacggacagt 3780ggtatggttc ttgcctcaga agagctgaaa actttggaag acagaaccaa attatctcca 3840tcttttggtg gaatggtgcc cagcaaaagc agggagtctg tggcatctga aggctcaaac 3900cagacaagcg gctaccagtc cggatatcac tccgatgaca cagacaccac cgtgtactcc 3960agtgaggaag cagaactttt aaagctgata gagattggag tgcaaaccgg tagcacagcc 4020cagattctcc agcctgactc ggggaccaca ctgagctctc ctcctgttta a 4071101116DNAhuman 10atggacttcc tcttgctgca ggacccggct tccacgtgtg tcccggagcc ggcgtctcag 60cacacgctcc gctccgggcc tgggtgccta cagcagccag agcagcaggg agtccgggac 120ccgggcggca tctgggccaa gttaggcgcc gccgaggcca gcgctgaacg tctccagggc 180cggaggagcc gcggggcgtc cgggtctgag ccgcagcaaa tgggctccga cgtgcgggac 240ctgaacgcgc tgctgcccgc cgtcccctcc ctgggtggcg gcggcggctg tgccctgcct 300gtgagcggcg cggcgcagtg ggcgccggtg ctggactttg cgcccccggg cgcttcggct 360tacgggtcgt tgggcggccc cgcgccgcca ccggctccgc cgccaccccc gccgccgccg 420cctcactcct tcatcaaaca ggagccgagc tggggcggcg cggagccgca cgaggagcag 480tgcctgagcg ccttcactgt ccacttttcc ggccagttca ctggcacagc cggagcctgt 540cgctacgggc ccttcggtcc tcctccgccc agccaggcgt catccggcca ggccaggatg 600tttcctaacg cgccctacct gcccagctgc ctggagagcc agcccgctat tcgcaatcag 660ggttacagca cggtcacctt cgacgggacg cccagctacg gtcacacgcc ctcgcaccat 720gcggcgcagt tccccaacca ctcattcaag catgaggatc ccatgggcca gcagggctcg 780ctgggtgagc agcagtactc ggtgccgccc ccggtctatg gctgccacac ccccaccgac 840agctgcaccg gcagccaggc tttgctgctg aggacgccct acagcagtga caatttatac 900caaatgacat cccagcttga atgcatgacc tggaatcaga tgaacttagg agccacctta 960aagggagttg ctgctgggag ctccagctca gtgaaatgga cagaagggca gagcaaccac 1020agcacagggt acgagagcga taaccacaca acgcccatcc tctgcggagc ccaatacaga 1080atacacacgc acggtgtctt cagaggcatt cagtga 1116111893DNAhuman 11atggccttgc caacggctcg acccctgttg gggtcctgtg ggacccccgc cctcggcagc 60ctcctgttcc tgctcttcag cctcggatgg gtgcagccct ccaggaccct ggctggagag 120acagggcagg aggctgcgcc cctggacgga gtcctggcca acccacctaa catttccagc 180ctctcccctc gccaactcct tggcttcccg tgtgcggagg tgtccggcct gagcacggag 240cgtgtccggg agctggctgt ggccttggca cagaagaatg tcaagctctc aacagagcag 300ctgcgctgtc tggctcaccg gctctctgag ccccccgagg acctggacgc cctcccattg 360gacctgctgc tattcctcaa cccagatgcg ttctcggggc cccaggcctg cacccgtttc 420ttctcccgca tcacgaaggc caatgtggac ctgctcccga ggggggctcc cgagcgacag 480cggctgctgc ctgcggctct ggcctgctgg ggtgtgcggg ggtctctgct gagcgaggct 540gatgtgcggg ctctgggagg cctggcttgc gacctgcctg ggcgctttgt ggccgagtcg 600gccgaagtgc tgctaccccg gctggtgagc tgcccgggac ccctggacca ggaccaacag 660gaggcagcca gggcggctct gcagggcggg ggacccccct acggcccccc gtcgacatgg 720tctgtctcca cgatggacgc tctgcggggc ctgctgcccg tgctgggcca gcccatcatc 780cgcagcatcc cgcagggcat cgtggccgcg tggcggcaac gctcctctcg ggacccatcc 840tggcggcagc ctgaacggac catcctccgg ccgcggttcc ggcgggaagt ggagaagaca 900gcctgtcctt caggcaagaa ggcccgcgag atagacgaga gcctcatctt ctacaagaag 960tgggagctgg aagcctgcgt ggatgcggcc ctgctggcca cccagatgga ccgcgtgaac 1020gccatcccct tcacctacga gcagctggac gtcctaaagc ataaactgga tgagctctac 1080ccacaaggtt accccgagtc tgtgatccag cacctgggct acctcttcct caagatgagc 1140cctgaggaca ttcgcaagtg gaatgtgacg tccctggaga ccctgaaggc tttgcttgaa 1200gtcaacaaag ggcacgaaat gagtcctcag gctcctcggc ggcccctccc acaggtggcc 1260accctgatcg accgctttgt gaagggaagg ggccagctag acaaagacac cctagacacc 1320ctgaccgcct tctaccctgg gtacctgtgc tccctcagcc ccgaggagct gagctccgtg 1380ccccccagca gcatctgggc ggtcaggccc caggacctgg acacgtgtga cccaaggcag 1440ctggacgtcc tctatcccaa ggcccgcctt gctttccaga acatgaacgg gtccgaatac 1500ttcgtgaaga tccagtcctt cctgggtggg gcccccacgg aggatttgaa ggcgctcagt 1560cagcagaatg tgagcatgga cttggccacg ttcatgaagc tgcggacgga tgcggtgctg 1620ccgttgactg tggctgaggt gcagaaactt ctgggacccc acgtggaggg cctgaaggcg 1680gaggagcggc accgcccggt gcgggactgg atcctacggc agcggcagga cgacctggac 1740acgctggggc tggggctaca gggcggcatc cccaacggct acctggtcct agacctcagc 1800atgcaagagg ccctctcggg gacgccctgc ctcctaggac ctggacctgt tctcaccgtc 1860ctggcactgc tcctagcctc caccctggcc tga 1893122109DNAhuman 12atggagtctc cctcggcccc tccccacaga tggtgcatcc cctggcagag gctcctgctc 60acagcctcac ttctaacctt ctggaacccg cccaccactg ccaagctcac tattgaatcc 120acgccgttca atgtcgcaga ggggaaggag gtgcttctac ttgtccacaa tctgccccag 180catctttttg gctacagctg gtacaaaggt gaaagagtgg atggcaaccg tcaaattata 240ggatatgtaa taggaactca acaagctacc ccagggcccg catacagtgg tcgagagata 300atatacccca atgcatccct gctgatccag aacatcatcc agaatgacac aggattctac 360accctacacg tcataaagtc agatcttgtg aatgaagaag caactggcca gttccgggta 420tacccggagc tgcccaagcc ctccatctcc agcaacaact ccaaacccgt ggaggacaag 480gatgctgtgg ccttcacctg tgaacctgag actcaggacg caacctacct gtggtgggta 540aacaatcaga gcctcccggt cagtcccagg ctgcagctgt ccaatggcaa caggaccctc 600actctattca atgtcacaag aaatgacaca gcaagctaca aatgtgaaac ccagaaccca 660gtgagtgcca ggcgcagtga ttcagtcatc ctgaatgtcc tctatggccc ggatgccccc 720accatttccc ctctaaacac atcttacaga tcaggggaaa atctgaacct ctcctgccac 780gcagcctcta acccacctgc acagtactct tggtttgtca atgggacttt ccagcaatcc 840acccaagagc tctttatccc caacatcact gtgaataata gtggatccta tacgtgccaa 900gcccataact cagacactgg cctcaatagg accacagtca cgacgatcac agtctatgca 960gagccaccca aacccttcat caccagcaac aactccaacc ccgtggagga tgaggatgct 1020gtagccttaa cctgtgaacc tgagattcag aacacaacct acctgtggtg ggtaaataat 1080cagagcctcc cggtcagtcc caggctgcag ctgtccaatg acaacaggac cctcactcta 1140ctcagtgtca caaggaatga tgtaggaccc tatgagtgtg gaatccagaa caaattaagt 1200gttgaccaca gcgacccagt catcctgaat gtcctctatg gcccagacga ccccaccatt 1260tccccctcat acacctatta ccgtccaggg gtgaacctca gcctctcctg ccatgcagcc 1320tctaacccac ctgcacagta ttcttggctg attgatggga acatccagca acacacacaa 1380gagctcttta tctccaacat cactgagaag aacagcggac tctatacctg ccaggccaat 1440aactcagcca gtggccacag caggactaca gtcaagacaa tcacagtctc tgcggagctg 1500cccaagccct ccatctccag caacaactcc aaacccgtgg aggacaagga tgctgtggcc 1560ttcacctgtg aacctgaggc tcagaacaca acctacctgt ggtgggtaaa tggtcagagc 1620ctcccagtca gtcccaggct gcagctgtcc aatggcaaca ggaccctcac tctattcaat 1680gtcacaagaa atgacgcaag agcctatgta tgtggaatcc agaactcagt gagtgcaaac 1740cgcagtgacc cagtcaccct ggatgtcctc tatgggccgg acacccccat catttccccc 1800ccagactcgt cttacctttc gggagcgaac ctcaacctct cctgccactc ggcctctaac 1860ccatccccgc agtattcttg gcgtatcaat gggataccgc agcaacacac acaagttctc 1920tttatcgcca aaatcacgcc aaataataac gggacctatg cctgttttgt ctctaacttg 1980gctactggcc gcaataattc catagtcaag agcatcacag tctctgcatc tggaacttct 2040cctggtctct cagctggggc cactgtcggc atcatgattg gagtgctggt tggggttgct 2100ctgatatag 2109131683DNACMV 13atggaatcca gggggaggag gtgtccggag atgatctcag tcctcggacc gattagcggt 60cacgtgctca aagcggtctt cagcagagga gacactccgg tgctgccgca cgaaacaagg 120ctccttcaga cggggataca cgtgcgtgtg agtcagccca gcctgatcct cgtgtctcaa 180tacacccctg acagcactcc ctgtcacaga ggggacaacc aactccaggt ccagcacacc 240tacttcactg ggagcgaggt cgagaacgtc agcgtgaacg tgcacaaccc cacgggaaga 300tcaatctgcc ctagccagga gcccatgagc atctacgtgt acgccctccc gctcaagatg 360ctcaacatcc cctccatcaa cgtccaccac tatccctccg ctgccgaacg taaacaccga 420cacttgccag ttgcggacgc cgtgatacac gcttcaggga agcagatgtg gcaagccagg 480cttactgtga gtggactcgc ctggactagg caacagaacc agtggaagga gcccgacgtg 540tactacacca gcgccttcgt gttccccaca aaagacgtcg cgctgcgaca tgtggtgtgc 600gctcacgaac tggtgtgcag catggagaac acgcgagcga ccaagatgca ggtgatcggt 660gaccagtacg tcaaggtgta cctggagagc ttctgcgagg atgtcccgtc cggaaagctg 720ttcatgcacg tgaccctggg cagtgacgtt gaggaagacc tgaccatgac gcgtaacccg 780cagcctttca tgagaccgca cgagaggaac ggattcaccg tcctgtgccc gaagaacatg 840atcatcaagc ccggcaagat cagccacatc atgctcgacg tcgccttcac ctctcacgaa 900cacttcgggc tgctgtgtcc gaagagcatt ccgggtctga gcatctcagg caacctgctg 960atgaacgggc agcagatctt cctggaagtg caggccataa gggagaccgt ggaactgagg 1020cagtacgatc ctgtggctgc cctgttcttc ttcgacatcg acctcttgct gcaaaggggt 1080ccacagtata gcgaacaccc caccttcacc tcccagtacc gtatccaggg caagctggag 1140taccgacaca cttgggatag gcacgacgag ggtgccgctc aaggtgacga cgatgtttgg 1200actagcggct ctgatagcga cgaagagctg gtgaccactg agcgcaaaac tccaagagtt 1260acgggcggcg gcgcaatggc tggcgcctct acttccgcgg gaaggaaaag gaaaagcgcg 1320tctagcgcaa ctgcatgcac tgccggtgtg atgacaaggg ggagactgaa ggccgagagt 1380acagtggctc cggaagagga taccgacgag gactctgaca acgagatcca caaccccgca 1440gtgtttacgt ggccaccttg gcaagccggc atccttgcta gaaacctggt gcccatggtg 1500gccacagtcc aaggccagaa cctgaagtac caggagttct tctgggacgc caacgacatc 1560taccgtatct tcgccgaact tgaaggcgtc tggcagccgg cggctcaacc caaaaggaga 1620cgtcacagac aggacgcgct tcccggaccc tgtattgcct ctacccccaa gaaacaccgg 1680ggc 1683141683DNAartificialmutated CMV pp65 cDNA 14atggaatcca gggggaggag gtgtccggag atgatctcag tcctcggacc gattagcggt 60cacgtgctca aagcggtctt cagcagagga gacactccgg tgctgccgca cgaaacaagg 120ctccttcaga cggggataca cgtgcgtgtg agtcagccca gcctgatcct cgtgtctcaa 180tacacccctg acagcactcc ctgtcacaga ggggacaacc aactccaggt ccagcacacc 240tacttcactg ggagcgaggt cgagaacgtc agcgtgaacg tgcacaaccc cacgggaaga 300tcaatctgcc ctagccagga gcccatgagc atctacgtgt acgccctccc gctcaagatg 360ctcaacatcc cctccatcaa cgtccaccac tatccctccg ctgccgaacg taaacaccga 420cacttgccag ttgcggacgc cgtgatacac gcttcaggga agcagatgtg gcaagccagg 480cttactgtga gtggactcgc ctggactagg caacagaacc agtggaagga gcccgacgtg 540tactacacca gcgccttcgt gttccccaca aaagacgtcg cgctgcgaca tgtggtgtgc 600gctcacgaac tggtgtgcag catggagaac acgcgagcga ccaagatgca ggtgatcggt 660gaccagtacg tcaaggtgta cctggagagc ttctgcgagg atgtcccgtc cggaaagctg 720ttcatgcacg tgaccctggg cagtgacgtt gaggaagacc tgaccatgac gcgtaacccg 780cagcctttca tgagaccgca cgagaggaac ggattcaccg tcctgtgccc gaagaacatg 840atcatcaagc ccggcaagat cagccacatc atgctcgacg tcgccttcac ctctcacgaa 900cacttcgggc tgctgtgtcc gaagagcatt ccgggtctga gcatctcagg caacctgctg 960atgaacgggc agcagatctt cctggaagtg caggccataa gggagaccgt ggaactgagg 1020cagtacgatc ctgtggctgc cctgttcttc ttcgacatcg acctcttgct gcaaaggggt 1080ccacagtata gcgaacaccc caccttcacc tcccagtacc gtatccaggg caagctggag 1140taccgacaca cttgggatag gcacgacgag ggtgccgctc aaggtgacga cgatgtttgg 1200actagcggct ctgatagcga cgaagagctg gtgaccactg agcgcaaaac tccaagagtt 1260acgggcggcg gcgcaatggc tggcgcctct acttccgcgg gaaggaacag gaaaagcgcg 1320tctagcgcaa ctgcatgcac tgccggtgtg atgacaaggg ggagactgaa ggccgagagt 1380acagtggctc cggaagagga taccgacgag gactctgaca acgagatcca caaccccgca 1440gtgtttacgt ggccaccttg gcaagccggc atccttgcta gaaacctggt gcccatggtg 1500gccacagtcc aaggccagaa cctgaagtac caggagttct tctgggacgc caacgacatc 1560taccgtatct tcgccgaact tgaaggcgtc tggcagccgg cggctcaacc caaaaggaga

1620cgtcacagac aggacgcgct tcccggaccc tgtattgcct ctacccccaa gaaacaccgg 1680ggc 1683151608DNAartificialmutated CMV pp65 cDNA 15atggaatcca gggggaggag gtgtccggag atgatctcag tcctcggacc gattagcggt 60cacgtgctca aagcggtctt cagcagagga gacactccgg tgctgccgca cgaaacaagg 120ctccttcaga cggggataca cgtgcgtgtg agtcagccca gcctgatcct cgtgtctcaa 180tacacccctg acagcactcc ctgtcacaga ggggacaacc aactccaggt ccagcacacc 240tacttcactg ggagcgaggt cgagaacgtc agcgtgaacg tgcacaaccc cacgggaaga 300tcaatctgcc ctagccagga gcccatgagc atctacgtgt acgccctccc gctcaagatg 360ctcaacatcc cctccatcaa cgtccaccac tatccctccg ctgccgaacg taaacaccga 420cacttgccag ttgcggacgc cgtgatacac gcttcaggga agcagatgtg gcaagccagg 480cttactgtga gtggactcgc ctggactagg caacagaacc agtggaagga gcccgacgtg 540tactacacca gcgccttcgt gttccccaca aaagacgtcg cgctgcgaca tgtggtgtgc 600gctcacgaac tggtgtgcag catggagaac acgcgagcga ccaagatgca ggtgatcggt 660gaccagtacg tcaaggtgta cctggagagc ttctgcgagg atgtcccgtc cggaaagctg 720ttcatgcacg tgaccctggg cagtgacgtt gaggaagacc tgaccatgac gcgtaacccg 780cagcctttca tgagaccgca cgagaggaac ggattcaccg tcctgtgccc gaagaacatg 840atcatcaagc ccggcaagat cagccacatc atgctcgacg tcgccttcac ctctcacgaa 900cacttcgggc tgctgtgtcc gaagagcatt ccgggtctga gcatctcagg caacctgctg 960atgaacgggc agcagatctt cctggaagtg caggccataa gggagaccgt ggaactgagg 1020cagtacgatc ctgtggctgc cctgttcttc ttcgacatcg acctcttgct gcaaaggggt 1080ccacagtata gcgaacaccc caccttcacc tcccagtacc gtatccaggg caagctggag 1140taccgacaca cttgggatag gcacgacgag ggtgccgctc aaggtgacga cgatgtttgg 1200actagcggct ctgatagcga cgaagagctg gtgaccactg agcgcaaaac tccaagagtt 1260acgggcggcg gcgcaatggc tggcgcctct acttccgcgg gaaggaacag gaaaagcgcg 1320tctagcgcaa ctgcatgcac tgccggtgtg atgacaaggg ggagactgaa ggccgagagt 1380acagtggctc cggaagagga taccgacgag gactctgaca acgagatcca caaccccgca 1440gtgtttacgt ggccaccttg gcaagccggc atccttgcta gaaacctggt gcccatggtg 1500gccacagtcc aaggccagaa cctgaagtac caggagttct tctgggacgc caacgacatc 1560taccgtatct tcgccgaact tgaaggcgtc tggcagccgg cggctcaa 16081610PRTArtificial sequenceSynthetic peptide 16Ser Tyr Gln Tyr Gly Thr Met Gln Thr Leu1 5 101710PRTArtificial sequenceSynthetic peptide 17Lys Tyr Leu Ser Tyr Pro Ala Pro Asp Ile1 5 10189PRTArtificial sequenceSynthetic peptide 18Arg Phe Val Pro Asp Gly Asn Arg Ile1 5199PRTArtificial sequenceSynthetic peptide 19Thr Tyr Gln Ser Ile Met Tyr Ile Val1 5209PRTArtificial sequenceSynthetic peptide 20Asp Phe Leu Thr Leu Glu His Leu Ile1 5219PRTArtificial sequenceSynthetic peptide 21Val Ile Leu Thr Asn Pro Ile Ser Met1 52210PRTArtificial sequenceSynthetic peptide 22Phe Ser Asn Ser Thr Asn Asp Ile Leu Ile1 5 10239PRTArtificial sequenceSynthetic peptide 23Cys Gly Ile Gln Asn Ser Val Ser Ala1 52410PRTArtificial sequenceSynthetic peptide 24Leu Gln Leu Ser Asn Gly Asn Arg Thr Leu1 5 10259PRTArtificial sequenceSynthetic peptide 25Cys Gly Ile Gln Asn Lys Leu Ser Val1 5

Claims

1. An attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, for use in the treatment of cancer, wherein the treatment further comprises the administration of i) at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, particularly selected from at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen, or ii) at least one checkpoint inhibitor, particularly selected from an antibody against PD-1, PD-L1 and CTLA4, or iii) at least one engineered T-cell, comprising at least one tumor antigen binding protein and/or at least one tumor stroma antigen binding protein on its cell surface; or iv) at least one bispecific antibody exhibiting binding specificity for one T-cell surface protein and for a tumor antigen or for a tumor stroma antigen; or v) or any combination thereof.

2. The attenuated strain of Salmonella for use according to claim 1, wherein the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are of the species Salmonella enterica, particularly wherein the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are Salmonella typhi Ty21a.

3. The attenuated strain of Salmonella for use according to claim 1 or 2, wherein the expression cassette and the further expression cassette are a eukaryotic expression cassette, particularly wherein the expression cassette and the further expression cassette comprise a CMV promoter.

4. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith, particularly wherein human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

5. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the DNA molecule and the further DNA molecule comprise the kanamycin antibiotic resistance gene, the pMB1 ori, and a CMV promoter, particularly wherein the DNA molecule and the further DNA molecule comprise the DNA sequence as found in SEQ ID NO 2.

6. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein said tumor antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human Wilms' Tumor Protein (WT1) having the amino acid sequence as found in SEQ ID NO 3 and a protein that shares at least about 80% sequence identity therewith, human Mesothelin (MSLN) having the amino acid sequence as found in SEQ ID NO 4 and a protein that shares at least about 80% sequence identity therewith, human CEA having the amino acid sequence as found in SEQ ID NO 5 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 6 and a protein that shares at least about 80% sequence identity therewith, CMV pp65 having the amino acid sequence as found in SEQ ID NO 7 and a protein that shares at least about 80% sequence identity therewith, and CMV pp65 having the amino acid sequence as found in SEQ ID NO 8 and a protein that shares at least about 80% sequence identity therewith, particularly wherein human Wilms' Tumor Protein (WT1) has the amino acid sequence as found in SEQ ID NO 3, human Mesothelin (MSLN) has the amino acid sequence as found in SEQ ID NO 4, human CEA has the amino acid sequence as found in SEQ ID NO 5, and CMV pp65 has the amino acid sequence as found in SEQ ID NO 6, SEQ ID NO 7 or SEQ ID NO 8, and wherein said tumor stroma antigen encoded by said further attenuated strain of Salmonella is selected from the group consisting of human fibroblast activation protein (FAP).

7. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the attenuated strain of Salmonella is administered simultaneously with or prior to said at least one DNA vaccine encoding a tumor antigen or a tumor stroma antigen, said at least one checkpoint inhibitor, said at least one engineered T-cell and/or said at least one bispecific antibody.

8. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the treatment is accompanied by chemotherapy, radiotherapy or biological cancer therapy, particularly wherein the attenuated strain of Salmonella is administered before or during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy, or before and during the chemotherapy or the radiotherapy treatment cycle or the biological cancer therapy.

9. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella are administered orally.

10. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the cancer is selected from colorectal cancer, pancreatic cancer, lung cancer, ovarian cancer, mesothelioma, acute myeloid leukemia, chronic myeloid leukemia, glioblastoma, gastric cancer, hepatocellular cancer, renal cell cancer, prostate cancer, and cervical cancer.

11. The attenuated strain of Salmonella for use according to of any one of the preceding claims, wherein the single dose of the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella comprises from about 10.sup.5 to about 10.sup.11, particularly from about 10.sup.6 to about 10.sup.10, more particularly from about 10.sup.6 to about 10.sup.9, more particularly from about 10.sup.6 to about 10.sup.8, most particularly from about 10.sup.6 to about 10.sup.7 colony forming units (CFU).

12. The attenuated strain of Salmonella for use according to any one of the preceding claims, wherein the treatment is individualized cancer immunotherapy comprising the step of assessing the expression pattern of and/or the pre-immune response against said tumor antigen in a patient.

13. A pharmaceutical composition comprising an attenuated strain of Salmonella comprising at least one copy of a DNA molecule comprising an expression cassette encoding a VEGF receptor protein, wherein the pharmaceutical composition further comprises at least one further attenuated strain of Salmonella comprising at least one copy of a further DNA molecule comprising a further expression cassette encoding a tumor antigen or a tumor stroma antigen.

14. The pharmaceutical composition according to claim 13, wherein the attenuated strain of Salmonella and the at least one further attenuated strain of Salmonella is Salmonella typhi Ty21a, wherein the expression cassette and the further expression cassette is a eukaryotic expression cassette, particularly comprising a CMV promoter, and wherein the VEGF receptor protein is selected from the group consisting of human VEGFR-2 having the amino acid sequence as found in SEQ ID NO 1 and a protein that shares at least about 80% sequence identity therewith, particularly wherein human VEGFR-2 has the amino acid sequence as found in SEQ ID NO 1.

15. The pharmaceutical composition according to claim 13 or 14, for use as a medicament, particularly for use in the treatment of cancer.