CALRETICULIN NANOBODIES

Abstract

Provided are nanobodies that bind human calreticulin, fusion proteins including the nanobodies, pharmaceutical compositions including the nanobodies or fusion proteins, and radioconjugates of the nanobodies or fusion proteins.

Claims

1. A protein comprising a human-calreticulin binding nanobody amino acid sequence comprising the CDR1, CDR2, and CDR3 amino acid sequences of any one of the nanobody amino acid sequences set forth in SEQ ID NOS:72-134.

2. The protein of claim 1, comprising a human-calreticulin binding nanobody amino acid sequence comprising the CDR1, CDR2, and CDR3 sequences: (i) SEQ ID NO:18, SEQ ID NO: 41, and SEQ ID NO:60, respectively; (ii) SEQ ID NO:21, SEQ ID NO: 44, and SEQ ID NO:63, respectively; (iii) SEQ ID NO:26, SEQ ID NO:49, and SEQ ID NO:68, respectively; (iv) SEQ ID NO:22, SEQ ID NO:45, and SEQ ID NO:64, respectively; (v) SEQ ID NO:14, SEQ ID NO:39, and SEQ ID NO:58, respectively; (vi) SEQ ID NO:11, SEQ ID NO:35, and SEQ ID NO:57, respectively; (vii) SEQ ID NO:20, SEQ ID NO:43, and SEQ ID NO:62, respectively; or (viii) SEQ ID NO:19, SEQ ID NO: 42, and SEQ ID NO:61, respectively.

3. The protein of claim 1, comprising one or more of the human-calreticulin binding nanobody amino acid sequences set forth in SEQ ID NOS:72-134.

4. The protein of claim 3, comprising one or more of the human-calreticulin binding nanobody amino acid sequences set forth in SEQ ID NOS:120, 126, 131, 127, 115, 111, 125 or 123.

5. The protein of claim 2, consisting of a single VHH domain.

6. The protein of claim 2, wherein the protein is a nanobody Fc fusion protein.

7. A pharmaceutical composition comprising the protein of claim 2 and at least pharmaceutically acceptable excipient.

8. A radiopharmaceutical composition comprising the protein of claim 2 linked to a radionuclide.

9. The radiopharmaceutical composition of claim 8, further comprising at least one pharmaceutically acceptable excipient.

10. The radiopharmaceutical composition of claim 9, wherein the radionuclide is an alpha particle emitter.

11. The radiopharmaceutical composition of claim 9, wherein the radionuclide is a beta particle emitter.

12. The radiopharmaceutical composition of claim 9, wherein the radionuclide comprises .sup.131I.

13. The radiopharmaceutical composition of claim 9, wherein the radionuclide comprises .sup.225Ac, .sup.177Lu or .sup.90Y.

14. A composition comprising the protein of claim 2, chemically conjugated to a chelator.

15. The composition of claim 14, wherein the chelator comprises DOTA or a DOTA derivative.

16. The composition of claim 14, further comprising a radionuclide chelated by the chelator.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0012] FIG. 1A identifies the full amino acid sequence, the CDR3 group, and the CDR amino acid sequences for each of twenty-four (24) human calreticulin binding nanobody clones.

[0013] FIG. 1B identifies the full amino acid sequence, the CDR3 group, and the CDR amino acid sequences for each of twenty-four (24) human calreticulin binding nanobody clones.

[0014] FIG. 1C identifies the full amino acid sequence, the CDR3 group, and the CDR amino acid sequences for each of fifteen (15) human calreticulin binding nanobody clones.

[0015] FIG. 2A sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data, and bio-layer interferometry (BLI) hCRT off-rate data for twenty-three (23) of the anti-hCRT nanobody clones.

[0016] FIG. 2B sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data, and bio-layer interferometry (BLI) hCRT off-rate data for twenty-three (23) of the anti-hCRT nanobody clones.

[0017] FIG. 2C sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data, and bio-layer interferometry (BLI) hCRT off-rate data for seventeen (17) of the anti-hCRT nanobody clones.

[0018] FIG. 3 shows the flow cytometric cell binding data for eight (8) of the anti-hCRT nanobody clones, non-stained (cells only) control, secondary antibody only (no primary nanobody/antibody) control denoted SA only and non-specific primary nanobody BCII10 control.

DETAILED DESCRIPTION

[0019] A nanobody (Nb) or VHH domain antibody is the variable region of a camelid heavy chain-only antibody. The present invention provides nanobodies and nanobody fusion proteins that specifically bind human calreticulin (hCalreticulin, hCRT) and related compositions and methods of use thereof.

[0020] One aspect of the invention provides an anti-hCalreticulin nanobody or a fusion protein including an anti-hCalreticulin nanobody amino acid sequence, the nanobody or fusion protein including: [0021] (i) a nanobody amino acid sequence including the CDRs (CDR1, CDR2 and CDR3) of any of the nanobodies disclosed herein, i.e., of any of SEQ ID NOS:72-134; [0022] (ii) a nanobody amino acid sequence including the framework regions and the CDRs of any of the nanobodies disclosed herein i.e., of any of SEQ ID NOS:72-134; or [0023] (iii) a nanobody amino acid sequence including the full nanobody amino acid sequence of any of the nanobody sequences disclosed herein, i.e., of any of SEQ ID NOS:72-134.

[0024] FIG. 1A identifies the full amino acid sequence (SEQ ID NOS:72-95, respectively), the CDR3 group, and the CDR amino acid sequences for each of the human calreticulin binding nanobody clones designated 2SPC3, 2SPC16, 2SPC17, 2SPC28, 2SPC36, 2SPC70, 2SPC76, 3SPC35, 3SPC44, 2SPC100, 2SPC101, 2SPC104, 2SPC117, 2SPC118, 2SPC127, 2SPC131, 2SPC136, 2SPC142, 2SPC148, 2SPC169, 3SPC106, 3SPC139, 3SPC142, and 2TIC1.

[0025] FIG. 1B identifies the full amino acid sequence (SEQ ID NOS:96-119, respectively), the CDR3 group, and the CDR amino acid sequences for each of the human calreticulin binding nanobody clones designated 2TIC18, 3TIC33, 3TIC47, 3TIC74, 3TIC90, 3TIC91, 2TIC108, 2TIC113, 2TIC122, 2TIC131, 2TIC137, 2TIC165, 2TIC169, 2TIC185, 3TIC103, 3TIC157, 3TIC180, 2SPC10, 3SPC54, 2SPC186, 3SPC145, 3SPC159, 3SPC186, and 2SPC19.

[0026] FIG. 1C identifies the full amino acid sequence (SEQ ID NOS:120-134, respectively), the CDR3 group, and the CDR amino acid sequences for each of the human calreticulin binding nanobody clones designated 3SPC11, 2SPC154, 3SPC37, 3SPC45, 2TIC69, 3TIC109, 2TIC105, 2SPC50, 3SPC26, 3SPC27, 3SPC57, 3TIC34, 2SPC81, 2SPC31, and 2SPC135.

[0027] The CDR sequences of the nanobody clones are delineated according to the IMGT numbering convention. The CDRs are surrounded by VHH domain framework regions (FRs) in the following manner: FR1 is the amino acid sequence preceding (N-terminal to) CDR1, FR2 is the amino acid sequence between CDR1 and CDR2, FR3 is the amino acid sequence between CDR2 and CDR3, and FR4 is the amino acid sequence following (C-terminal to) CDR3 to the end of the nanobody (VHH domain) sequence.

[0028] FIG. 2A sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data (control is not coated with hCRT), and bio-layer interferometry (BLI) hCRT off-rate data for twenty-three (23) of the anti-hCRT nanobody clones.

[0029] FIG. 2B sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data (control is not coated with hCRT), and bio-layer interferometry (BLI) hCRT off-rate data for twenty-three (23) of the anti-hCRT nanobody clones.

[0030] FIG. 2C sets forth the clone name, VHH sequence, CDR3 group, ELISA hCRT binding data (control is not coated with hCRT), and bio-layer interferometry (BLI) hCRT off-rate data for seventeen (17) of the anti-hCRT nanobody clones.

[0031] The hCRT off rates for the 63 anti-hCRT nanobody clones (presented in FIGS. 2A-C) were determined by bio-layer interferometry (BLI) using an Octet Red instrument (ForteBio, Fremont, California, USA) and Fortebio Data Analysis Software, using a 1:1 binding model. A total absence of binding signal was observed for the negative (non-hCRT-specific) control nanobody BCII10. The majority of the nanobodies tested showed reliable binding responses higher than 0.1 nm. Where data was available, with the exception of one clone, all the nanobodies showed a very strong k-off which was always below about 510.sup.3 1/s.

[0032] FIG. 3 shows the flow cytometric cell binding data for eight (8) of the anti-hCRT nanobody clones, non-stained (cells only) control, secondary antibody only (no primary nanobody/antibody) control denoted SA only and non-specific primary nanobody BCII10 control. In brief, in vitro cell binding properties of eight anti-hCRT nanobody clones were evaluated by incubating 400 ug/ml (100 uL) unmodified nanobodies with acute promyelocytic leukemia cells (HL-60 cell line; ATCC CCL-240) for 1 h at 4 C. A fluorescently labeled secondary antibody (Goat Anti-Alpaca-AF647 [Jackson ImmunoResearch Laboratories, Inc., West Grove, Pennsylvania, USA] (1:500 dilution)) was added and incubated for 1 h at 4 C. The samples were then analyzed using a flow cytometer and the data was analyzed using BD Accuri C6 Plus Software. Clones 3SPC11 (SEQ ID NO:120), 2TIC105 (SEQ ID NO:126), 3TIC109 (SEQ ID NO:125), 3TIC157 (SEQ ID NO:111), and 3TIC34 (SEQ ID NO:131) specifically bound HL60 cells in the assay.

[0033] Another aspect of the invention provides a protein that includes one or more of the human Calreticulin binding nanobody amino acid sequences set forth in SEQ ID NOS:72-134. Such a protein may, for example, consist of one nanobody amino acid sequence alone, include multiple nanobody sequences that are the same or different, or include the one or more of the nanobody sequences and an affinity tag, such as an epitope tag and/or metal-binding tag, or include an Fc constant region, such as a human Fc constant region.

[0034] A related aspect of the invention provides a protein, such as a nanobody or a fusion protein including a nanobody amino acid sequence, that includes a nanobody (VHH) amino acid sequence including the CDR combination (of CDR1, CDR2, and CDR3) found in any one of the anti-hCRT nanobody sequences set forth in SEQ ID NOS:72-134 as shown in FIGS. 1A-1C, and in Table 1 below (indicating exemplary human Calreticulin binding nanobody sequences and, to the right of each in the table, its respective CDR1, CDR2, and CDR3 amino acid sequences).

TABLE-US-00001 TABLE 1 Nb CDR1 CDR2 CDR3 SEQ SEQ SEQ SEQ Nb Clone ID NO: ID NO: ID NO: ID NO: 2SPC3 72 1 30 53 2SPC16 73 2 31 54 2SPC17 74 1 32 53 2SPC28 75 3 33 53 2SPC70 77 4 32 55 3SPC35 79 5 33 53 3SPC44 80 6 32 53 2SPC100 81 4 32 53 2SPC104 83 7 31 54 2SPC127 86 8 33 56 2SPC131 87 9 30 53 2SPC142 89 3 34 53 2SPC148 90 4 33 53 3SPC139 93 8 33 53 3SPC142 94 10 33 53 2TIC1 95 11 35 57 3TIC90 100 11 36 57 2TIC113 103 12 35 57 2TIC122 104 11 37 57 3TIC180 112 13 38 57 2SPC10 113 14 39 58 3SPC54 114 15 39 58 3SPC145 116 16 40 59 3SPC159 117 17 40 59 2SPC19 119 18 41 60 3SPC37 122 19 42 61 2TIC69 124 20 43 62 2TIC105 126 21 44 63 2SPC50 127 22 45 64 3SPC26 128 23 46 65 3SPC27 129 24 47 66 3SPC57 130 25 48 67 3TIC34 131 26 49 68 2SPC81 132 27 50 69 2SPC31 133 28 51 70 2SPC135 134 29 52 71

[0035] Any of the nanobodies disclosed herein may further include an affinity tag such as an epitope tag and/or a metal-binding tag. For example, any of the nanobodies disclosed herein may further include an amino terminal combination hemagglutinin (HA) epitope and polyhistidine tag having the sequence AAAYPYDVPDYGSHHHHHH (SEQ ID NO: 135).

[0036] The invention also provides fusion proteins that include any of the CRT-binding nanobodies disclosed herein and an N-terminal, camelid or non-camelid immunoglobulin Fc region, such as the human IgG1 Fc region set forth in SEQ ID NO:136. The Fc sequence may, for example, begin immediately after the N-terminal SS of the nanobody (VHH) sequence in the fusion protein or may be preceded by a linker sequence which may, for example, be derived from an immunoglobulin hinge region. For example, the Fc portion may be connected to the nanobody (VHH) portion via a linker peptide disposed as the N-terminal end of the nanobody sequence, so that the amino-to-carboxyl arrangement of elements is nanobodylinkerFc.

[0037] The linker peptide may, for example, include the sequence STMVRS (SEQ ID NO: 137), EPKSCDKTHTCPPCP (SEQ ID NO:139; derived from human IgG1 hinge region), or VPRDCGCKPCICT (SEQ ID NO:141; derived from mouse IgG1 hinge region).

[0038] The Fc region may, for example, include the sequence:

TABLE-US-00002 DKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHE DPEVKFNWYVDGVEVHNAKTICPREEQYNSTYRVVSVLTVLHQDWLNGI CEYKCKVSNICALPAPIEKTISICAKGOPREPOVYTLPPSREEMTICNO VSLTCLVKGFYPSDIAVEWESNGOPENNYKTITTVLDSDGSFFLYSICL TVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK(SEQIDNO: 138;humanFcgamma1typewithN-terminalhinge region); APELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYV DGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKAL PAPIEKTISKAKGQPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDI AVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCS VMHEALHNHYTQKSLSLSPGK(SEQIDNO:140;humanFc gamma1type); or VPEVSSVFIFPPKPKDVLTITLTPKVTCVVVDISKDDPEVQFSWFVDDV EVHTAQTQPREEQFNSTFRSVSELPIMHQDWLNGKEFKCRVNSAAFPAP IEKTISKTKGRPKAPQVYTIPPPKEQMAKDKVSLTCMITDFFPEDITVE WQWNGQPAENYKNTQPIMNTNGSYFVYSKLNVQKSNWEAGNTFTCSVLH EGLHNHHTEKSLSHSPGK(SEQIDNO:142;mouseFc gamma1type).

[0039] Suitable pairings of linker sequences and Fc region sequences that may be used in a nanobody Fc fusion protein include, for example, SEQ ID NO:137 with SEQ ID NO:138, SEQ ID NO:139 with SEQ ID NO:140, and SEQ ID NO:141 with SEQ ID NO:142.

[0040] Cell surface expression of Calreticulin is upregulated in cells undergoing stress and in malignant cells. The nanobodies or nanobody fusion proteins disclosed herein may, for example, be linked directly or indirectly via a chemically conjugated chelator, to a radionuclide, for example, to target cytotoxic radiation to Calreticulin-expressing cells in mammalian subject such as a human patient, and/or to non-cytotoxically image Calreticulin-expression in a mammalian subject such as a human patient. For example, the nanobody or nanobody fusion protein may be directly labeled with .sup.131I according to the methods disclosed in U.S. Pat. No. 10,420,851 or the nanobody or nanobody fusion protein may be chemically conjugated to a chelator, such as p-SCN-DOTA and labeled with a radionuclide such as .sup.225Ac, according to the procedures described in U.S. Pat. No. 9,603,954. More generally, for radiolabeling, suitable radionuclides include but are not limited to .sup.134Ce, .sup.43Sc, .sup.44Sc, .sup.47Sc, .sup.55Co, .sup.60Cu, .sup.61Cu, .sup.62Cu, .sup.64Cu, .sup.67Cu, .sup.66Ga, .sup.67Ga, .sup.68Ga, .sup.131I, .sup.125I, .sup.82Rb, .sup.86Y, .sup.87Y, .sup.90Y, .sup.89Zr, .sup.97Ru, .sup.105Rh, .sup.109Pd, .sup.111In, .sup.117mSn, .sup.149Pm, .sup.149Tb, .sup.153Sm, .sup.177Lu, .sup.186Re, .sup.188Re, .sup.199Au, .sup.201Tl, .sup.203Pb .sup.212Pb, .sup.212Bi, .sup.213Bi, .sup.225Ac, and .sup.227Th.

[0041] The chelator group in the various aspects of the invention may, for example, include: 1,4,7,10-tetraazacyclododecane-1,4,7-triacetic acid (DO3A) or a derivative thereof, 1,4,7-triazacyclononane-1,4-diacetic acid (NODA) or a derivative thereof, 1,4,7-triazacyclononane-1,4,7-triacetic acid (NOTA) or a derivative thereof; 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) or a derivative thereof, 1,4,7-triazacyclononane, 1-glutaric acid-4,7-diacetic acid (NODAGA) or a derivative thereof; 1,4,7,10-tetraazacyclodecane, 1-glutaric acid-4,7,10-triacetic acid (DOTAGA) or a derivative thereof; 1,4,8,11-tetraazacyclotetradecane-1,4,8,11-tetraacetic acid (TETA) or a derivative thereof, 1,4,8,11-tetraazabicyclo[6.6.2]hexadecane-4,11-diacetic acid (CB-TE2A) or a derivative thereof; diethylene triamine pentaacetic acid (DTPA), its diester, or a derivative thereof; 2-cyclohexyl diethylene triamine pentaacetic acid (CHX-A-DTPA) or a derivative thereof, deforoxamine (DFO) or a derivative thereof, 1,2-[[6-carboxypyridin-2-yl]methylamino]ethane (H.sub.2dedpa) or a derivative thereof, DADA or a derivative thereof; 1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetra(methylene phosphonic acid) (DOTP) or a derivative thereof; 4-amino-6-[[16-[(6-carboxypyridin-2-yl)methyl]-1,4,10,13-tetraoxa-7,16-diazacyclooctadec-7-yl]methyl]pyridine-2-carboxylic acid (MACROPA-NH.sub.2) or a derivative thereof, MACROPA or a derivative thereof, 1,4,7,10-tetrakis(carbamoylmethyl)-1,4,7,10-tetraazacyclododecane (TCMC) or a derivative thereof; {4-[2-(bis-carboxymethylamino)-ethyl]-7-carboxymethyl-[1,4,7]triazonan-1-yl}-acetic acid (NETA) or a derivative thereof, Diamsar or a derivative thereof; 1,4,7-triazacyclononane-1,4,7-tris[methyl(2-carboxyethyl)phosphinic acid (TRAP, PRP9, TRAP-Pr) or a derivative thereof; N,N-bis(6-carboxy-2-pyridylmethyl)ethylenediamine-N,N-diacetic acid (H4octapa) or a derivative thereof; N,N-[1-benzyl-1,2,3-triazole-4-yl]methyl-N,N-[6-(carboxy)pyridin-2-yl]-1,2-diaminoethane (H2azapa) or a derivative thereof; N,N-[[6-(carboxy)pyridin-2-yl]methyl]diethylenetriamine-N,N,N-triacetic acid (H5decapa) or a derivative thereof, N,N-bis(2-hydroxy-5-sulfobenzyl)ethylenediamine-N,N-diacetic acid (SHBED) or a derivative thereof; N,N-bis(2-hydroxybenzyl)ethylenediamine-N,N-diacetic acid (HBED) or a derivative thereof; 3,6,9,15-tetraazabicyclo[9.3.1]pentadeca-1(15),11,13-triene-3,6,9,-triacetic acid (PCTA) or a derivative thereof; desferrioxamine B (DFO) or a derivative thereof; N,N-(methylenephosphonate)-N,N-[6-(methoxycarbonyl)pyridin-2-yl]methyl-1,2-diaminoethane (H6phospa) or a derivative thereof; 1,4,7,10,13,16-hexaazacyclohexadecane-N,N,N,N,N,N-hexaacetic acid (HEHA) or a derivative thereof, 1,4,7,10,13-pentaazacyclopentadecane-N,N,N,N,N-pentaacetic acid (PEPA) or a derivative thereof, or 3,4,3-LI(1,2-HOPO) or a derivative thereof.

[0042] The nanobodies or nanobody fusion proteins may, for example, also be linked to one or more cytotoxic drugs to target and deplete Calreticulin-expressing cells in a mammalian subject such as a human patient. Thus, one aspect of the invention provides an antibody-drug-conjugate (ADC) that includes a nanobody amino acid sequence as disclosed herein as a component.

[0043] The words comprising and forms of the word comprising as well as the word including and forms of the word including, as used in this description and in the claims, do not limit the inclusion of elements beyond what is referred to. Additionally, although throughout the present disclosure various aspects or elements thereof are described in terms of including or comprising, corresponding aspects or elements thereof described in terms of consisting essentially of or consisting of are similarly disclosed. For example, while certain aspects of the invention have been described in terms of a method including or comprising administering a radiolabeled targeting agent, corresponding methods instead reciting consisting essentially of or consisting of administering the radiolabeled target are also within the scope of said aspects and disclosed by this disclosure.

[0044] In addition, compositions including a radiolabeled anti-Calreticulin nanobody or nanobody fusion protein may include one or more pharmaceutically acceptable carriers or pharmaceutically acceptable excipients. Such carriers are well known to those skilled in the art. For example, injectable drug delivery systems include solutions, suspensions, gels, microspheres and polymeric injectables, and can include excipients such as solubility-altering agents (e.g., ethanol, propylene glycol and sucrose) and polymers (e.g., polycaprylactones and PLGA's). An exemplary formulation may be as substantially described in U.S. Pat. No. 10,420,851 or International Pub. No. WO 2017/155937, incorporated by reference herein. For example, according to certain aspects, the formulation may include 0.5% to 5.0% (w/v) of an excipient selected from the group consisting of ascorbic acid, polyvinylpyrrolidone (PVP), human serum albumin (HSA), a water-soluble salt of HSA, and mixtures thereof. Certain formulations may include 0.5-5% ascorbic acid; 0.54% polyvinylpyrrolidone (PVP); and the monoclonal antibody in 50 mM PBS buffer, pH 7.

[0045] The anti-hCalreticulin nanobodies and nanobody fusion proteins disclosed herein may, for example, be labeled with radionuclide, such as .sup.131I, .sup.177Lu, or .sup.225Ac, or conjugated to a cytotoxic drug, for use in the treatment of a Calreticulin-expressing cancer such as a breast cancer.

[0046] Cancers, including precancerous conditions that may be treated or imaged using proteins or conjugates thereof that include one or more of the anti-hCRT nanobodies disclosed herein include hematological (liquid) cancers and precancerous disorders and solid tumor cancer and precancerous disorders.

[0047] The hematological cancer or precancer may, for example, include a leukemia (such as acute myeloid leukemia (AML), acute promyelocytic leukemia, acute lymphoblastic leukemia (ALL), acute mixed lineage leukemia, chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), hairy cell leukemia, or large granular lymphocytic leukemia), myelodysplastic syndrome (MDS), a myeloproliferative disorders (polycythemia vera, essential thrombocytosis, primary myelofibrosis and chronic myeloid leukemia), multiple myeloma, MGUS and similar disorders, a lymphoma, Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), primary mediastinal large B-cell lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, transformed follicular lymphoma, splenic marginal zone lymphoma, lymphocytic lymphoma, T-cell lymphoma, and other B-cell malignancies.

[0048] The solid cancer or solid precancerous conditions may, for example, include a bone cancer, pancreatic cancer, skin cancer, cutaneous or intraocular malignant melanoma, uterine cancer, ovarian cancer, cancer of the anal region, stomach cancer, gastric cancer, testicular cancer, uterine cancer, carcinoma of the fallopian tubes, endometrial cancer, carcinoma of the endometrium, cervical cancer, carcinoma of the cervix, cervical epidermoid cancer, carcinoma of the vagina, carcinoma of the vulva, esophageal cancer, bronchioloalveolar cancer, cancer of the small intestine, cancer of the endocrine system, cancer of the thyroid gland, cancer of the parathyroid gland, cancer of the adrenal gland, sarcoma of soft tissue, cancer of the urethra, cancer of the penis, pediatric tumors, cancer of the bladder, cancer of the kidney or ureter, cancer of lung such as non-small cell lung carcinoma (NSCLC) or small cell lung carcinoma (SCLC), carcinoma of the renal pelvis, neoplasm of the central nervous system (CNS), primary CNS lymphoma, tumor angiogenesis, spinal axis tumor, brain stem glioma, pituitary adenoma, Kaposi's sarcoma, epidermoid cancer, squamous cell cancer, environmentally-induced cancers including those induced by asbestos such as mesothelioma, a breast cancer such as metastatic breast cancer, tamoxifen-sensitive breast cancer, tamoxifen-resistant breast cancer or triple negative breast cancer (TNBC), bladder cancer, prostate cancer such as castration resistant prostate cancer (CRPC), metastatic prostate cancer or metastatic CRPC (mCRPC), colorectal cancer, liver cancer such as hepatocellular carcinoma (HCC) or cholangiocarcinoma, renal cell carcinoma, head and neck cancer such as head and neck squamous cell cancer, a carcinoma, a sarcoma, or any combination thereof.

[0049] In general, the various aspects of the invention may be employed in the treatment and/or imaging of non-metastatic, premetastatic, and metastatic forms of cancers such as any of the aforementioned cancers.

[0050] Without limitation, the following aspects of the invention are also provided. [0051] Aspect 1. A protein including a human-calreticulin binding nanobody amino acid sequence including the CDR1, CDR2, and CDR3 amino acid sequences of any one of the nanobody amino acid sequences set forth in SEQ ID NOS:72-134. [0052] Aspect 2. The protein of aspect 1, including a human-calreticulin binding nanobody amino acid sequence including the CDR1, CDR2, and CDR3 sequences: [0053] (i) SEQ ID NO:18, SEQ ID NO: 41, and SEQ ID NO:60, respectively; [0054] (ii) SEQ ID NO:21, SEQ ID NO: 44, and SEQ ID NO:63, respectively; [0055] (iii) SEQ ID NO:26, SEQ ID NO:49, and SEQ ID NO:68, respectively; [0056] (iv) SEQ ID NO:22, SEQ ID NO:45, and SEQ ID NO:64, respectively; [0057] (v) SEQ ID NO:14, SEQ ID NO:39, and SEQ ID NO:58, respectively; [0058] (vi) SEQ ID NO:11, SEQ ID NO:35, and SEQ ID NO:57, respectively; [0059] (vii) SEQ ID NO:20, SEQ ID NO:43, and SEQ ID NO:62, respectively; or [0060] (viii) SEQ ID NO:19, SEQ ID NO: 42, and SEQ ID NO:61, respectively. [0061] Aspect 3. The protein of aspect 1, including one or more of the human-calreticulin binding nanobody amino acid sequences set forth in SEQ ID NOS:72-134. [0062] Aspect 4. The protein of aspect 3, including one or more of the human-calreticulin binding nanobody amino acid sequences set forth in SEQ ID NOS:120, 126, 131, 127, 115, 111, 125 or 123. [0063] Aspect 5. The protein of any one of aspects 1-4, consisting of a single VHH domain. [0064] Aspect 6. The protein of any one of aspects 1-4, wherein the protein is a nanobody Fc fusion protein. [0065] Aspect 7. A pharmaceutical composition including the protein of any one of aspects 1-6 and at least pharmaceutically acceptable excipient. [0066] Aspect 8. A radiopharmaceutical composition including the protein of any one of aspects 1-6 linked to a radionuclide. [0067] Aspect 9. The radiopharmaceutical composition of aspect 8, further including at least one pharmaceutically acceptable excipient. [0068] Aspect 10. The radiopharmaceutical composition of aspect 9 or 10, wherein the radionuclide is an alpha particle emitter. [0069] Aspect 11. The radiopharmaceutical composition of aspect 9 or 10, wherein the radionuclide is a beta particle emitter. [0070] Aspect 12. The radiopharmaceutical composition of aspect 9 or 10, wherein the radionuclide includes 131I. [0071] Aspect 13. The radiopharmaceutical composition of aspect 9 or 10, wherein the radionuclide includes .sup.225Ac, .sup.177Lu or .sup.90Y. [0072] Aspect 14 A composition including the protein of any one of aspects 1-6, chemically conjugated to a chelator. [0073] Aspect 15. The composition of aspect 14, wherein the chelator includes DOTA or a DOTA derivative. [0074] Aspect 16. The composition of aspect io 14 or 15, further including a radionuclide chelated by the chelator.

Example 1: Production of a Radiolabeled Anti-hCalreticulin Nanobody

[0075] The following exemplary procedures may be used to conjugate an anti-hCRT nanobody as disclosed herein to the chelator DOTA and label the conjugate with .sup.225Ac.

[0076] Conjugation to a chelator: 23 l of p-SCN-Bn-DOTA 20 mg/ml solution (in deionized water) is added to a 1.5 ml Eppendorf tube containing 1 mg anti-hCRT nanobody in 0.2 ml 0.1M NaHCO.sub.3 solution, and the total volume brought to 0.3 ml with 0.1M NaHCO.sub.3. The reaction mixture is then incubated at 37 C. for 2 hours with agitation. HPLC analysis of the reaction mixture can then performed; 10 l sample is mixed with 50 l water, and 50 l is injected into the HPLC apparatus. The resulting conjugate may be purified using a 10K Pierce protein concentrator (Thermo Scientific) with 0.25M NaOAc at 8000 G at 4 C.

[0077] Radiolabeling: Once the nanobody (or nanobody fusion protein) has been conjugated to a chelator, such as DOTA as described above, it may be labeled with a radionuclide such as .sup.177Lu, .sup.90Y, or .sup.225Ac.

[0078] An exemplary labeling reaction for .sup.225Ac is as follows: a reaction including 15 l 0.15M NH.sub.4OAc buffer, pH=6.5 and 2 L (10 g) DOTA-anti-hCRT nanobody (5 mg/ml) may be mixed in an Eppendorf reaction tube, and 4 L .sup.225Ac (10 Ci) in 0.05 M HCl subsequently added. The contents of the tube may be mixed with a pipette tip and the reaction mixture incubated at 37 C. for 90 min with shaking at 100 rpm. At the end of the incubation period, 3 L of a 1 mM DTPA solution may be added to the reaction mixture and incubated at room temperature for 20 min to bind the unreacted .sup.225Ac into the .sup.225Ac-DTPA complex. Instant thin layer chromatography with 10 cm silica gel strip and 10 mM EDTA/normal saline mobile phase may be used to determine the radiochemical purity of .sup.225Ac-DOTA-anti-hCRT-nanobody through separating .sup.225Ac-labeled DOTA-conjugated nanobody from free .sup.225Ac (.sup.225Ac-DTPA). In this system, the radiolabeled antibody stays at the point of application and .sup.225Ac-DTPA moves with the solvent front. The strips may be cut in halves and counted in the gamma counter equipped with the multichannel analyzer using channels 72-110 for .sup.225Ac to exclude its daughters.

[0079] Purification: Radiolabeled nanobody may, for example, be purified using Pierce protein concentrators PES, 3K MWCO volume 0.5 mL (Thermo Scientific) and 2-6 mL buffer solution. An exemplary radiolabeled targeting agent, such as .sup.225Ac-DOTA-nanobody Fc fusion protein, may be purified either on PD10 columns pre-blocked with 1% HSA or on Vivaspin centrifugal concentrators with a 50 kDa MW cut-off with 21.5 mL washes, 3 min per spin. HPLC analyses of the .sup.225Ac-DOTA-antibody after purification may be conducted using a Waters HPLC system equipped with flow-through Waters UV and Bioscan Radiation detectors, using a TSK3000SW XL column eluted with PBS at pH=7.4 and a flow rate of 1 ml/min. Appropriate molecular weight cutoff filters are readily selectable and available for the purification of subject radiolabeled proteins of different molecular weights.

Example 2: Generation of the Anti-hCRT Nanobodies

[0080] The methods used to generate the anti-hCRT nanobodies of this disclosure are described below.

[0081] Immunizations with Recombinant Human Calreticulin

[0082] Two llamas were subcutaneously injected on days 0, 14, 28, 42, 70 and 84, each time & per animal with about 100 to 150 g of recombinant human Calreticulin (amino acids 18-417; Cat. No. NBP1-44499, Novus Biologicals, LLC, Centennial, Colorado, USA). A His.sub.6 tag is present at the N-terminus of this protein. The adjuvant used was Gerbu adjuvant P. On day 87 (3 d.p.i) and on day 91 (7 d.p.i), about 100 ml anticoagulated blood was collected from each llama for lymphocyte preparation. Animal health was regularly monitored. None of the animals showed any sign of discomfort during the whole immunization period.

[0083] Construction of Two Independent VHH Libraries

[0084] Individual VHH libraries were constructed from each llama's lymphocytes to screen for the presence of antigen-specific Nanobodies (Nbs). To this end, a mix (ratio of 1:1) of total RNA from peripheral blood lymphocytes from 3 d.p.i. & 7 d.p.i. was used as template for first strand cDNA synthesis with an oligo(dT) primer. Using this cDNA, the VHH encoding sequences were amplified by PCR. For each llama, PCR fragments were digested with SapI, and cloned into the SapI site of the phagemid vector pMECS-GG. The VHH library obtained from the first animal was called Core 178B. The Core 178B library consists of about 510.sup.8 independent transformants, with about 92% of transformants harboring the vector with the right insert size of VHH-encoding sequences. The library obtained from the second animal, Core 179B, also consists of about 510.sup.8 independent transformants, with about 92% of transformants harboring the vector with the right insert size.

[0085] Isolation of Human Calreticulin-Specific Nanobodies

[0086] Both libraries were separately panned on solid-phase coated recombinant human Calreticulin with an N-terminal His.sub.6 tag (100 g/ml in 100 mM NaHCO.sub.3 pH 8.2) for 3 rounds. The enrichment for antigen-specific phages was assessed after each round of panning by comparing the number of phagemid particles eluted from antigen-coated wells with the number of phagemid particles eluted from negative control (uncoated blocked) wells.

[0087] For Core 178B, these experiments suggested that the phage population was enriched for antigen-specific phages about 1.5-fold, 15-fold and 40-fold after the 1.sup.st, 2.sup.nd and 3.sup.rd round, respectively. In total, 380 colonies (190 from round 2, 190 from round 3) were randomly selected and analyzed by ELISA for the presence of antigen-specific nanobodies in their periplasmic extracts (ELISA using crude periplasmic extracts including soluble Nanobodies). The antigen used for panning & ELISA screening was the same one as used for immunization, using uncoated blocked wells as negative controls (blank). Out of the 380 colonies tested by ELISA, 264 colonies scored positive for human Calreticulin. Based on sequence data of the 264 positive colonies, 22 different Nanobodies were identified, belonging to 4 different CDR3 groups (B-cell lineages) (see Excel file). Nanobodies belonging to the same CDR3 group (same B-cell lineage) are very similar and their amino acid sequences suggest that they are from clonally-related B-cells resulting from somatic hypermutation or from the same B-cell but diversified due to RT and/or PCR error during library construction. Nanobodies belonging to the same CDR3 group recognize the same epitope but their other characteristics (e.g. affinity, potency, stability, expression yield, etc.) can be different. Nanobodies resulting from the panning/ELISA screening of the Core 178B library bear TIC in their names.

[0088] When panning the Core 179B library on human Calreticulin, the enrichment experiments suggested that the phage population was enriched for antigen-specific phages about 25-fold and 60-fold after the 2.sup.nd and 3.sup.rd round, respectively. No enrichment was observed during the 1.sup.st round. Here also, in total 380 colonies (190 from round 2, 190 from round 3) were randomly selected and analyzed by ELISA for the presence of antigen-specific nanobodies in their periplasmic extracts, as described above. Out of the 380 colonies tested by ELISA, 245 colonies scored positive for human Calreticulin. Based on sequence data of the 245 positive colonies, 41 different nanobodies were identified, belonging to 11 different CDR3 groups (B-cell lineages). Nanobodies resulting from the panning/ELISA screening of the Core 179B library bear SPC in their names.

[0089] In summary, sixty-three (63) unique human Calreticulin-specific nanobodies (SEQ ID NOS:72-134) belonging to 15 different CDR3 groups were identified. The VHH and CDR sequences for these nanobody clones are presented in FIGS. 1A-1C.

[0090] While various specific embodiments have been illustrated and described herein, it will be appreciated that various changes can be made without departing from the spirit and scope of the invention(s). Moreover, features described in connection with one aspect of the invention may be used in conjunction with other aspects of the invention, even if not explicitly exemplified in combination within.