Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Oncogene. 2012 Nov 15;31(46):4859-67. doi: 10.1038/onc.2011.647. Epub 2012 Jan 23.
Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase aberrantly expressed in neuroblastoma, a devastating pediatric cancer of the sympathetic nervous system. Germline and somatically acquired ALK aberrations induce increased autophosphorylation, constitutive ALK activation and increased downstream signaling. Thus, ALK is a tractable therapeutic target in neuroblastoma, likely to be susceptible to both small-molecule tyrosine kinase inhibitors and therapeutic antibodies-as has been shown for other receptor tyrosine kinases in malignancies such as breast and lung cancer. Small-molecule inhibitors of ALK are currently being studied in the clinic, but common ALK mutations in neuroblastoma appear to show de novo insensitivity, arguing that complementary therapeutic approaches must be developed. We therefore hypothesized that antibody targeting of ALK may be a relevant strategy for the majority of neuroblastoma patients likely to have ALK-positive tumors. We show here that an antagonistic ALK antibody inhibits cell growth and induces in vitro antibody-dependent cellular cytotoxicity of human neuroblastoma-derived cell lines. Cytotoxicity was induced in cell lines harboring either wild type or mutated forms of ALK. Treatment of neuroblastoma cells with the dual Met/ALK inhibitor crizotinib sensitized cells to antibody-induced growth inhibition by promoting cell surface accumulation of ALK and thus increasing the accessibility of antigen for antibody binding. These data support the concept of ALK-targeted immunotherapy as a highly promising therapeutic strategy for neuroblastomas with mutated or wild-type ALK.
间变性淋巴瘤激酶(ALK)是一种在神经母细胞瘤中异常表达的受体酪氨酸激酶,神经母细胞瘤是一种毁灭性的儿童交感神经系统癌症。胚系和体细胞获得的 ALK 异常导致自身磷酸化增加、ALK 持续激活和下游信号转导增加。因此,ALK 是神经母细胞瘤中一个可行的治疗靶点,可能容易受到小分子酪氨酸激酶抑制剂和治疗性抗体的影响,正如其他受体酪氨酸激酶在乳腺癌和肺癌等恶性肿瘤中所表现出的那样。ALK 的小分子抑制剂目前正在临床研究中,但神经母细胞瘤中常见的 ALK 突变似乎表现出新出现的不敏感性,这表明必须开发互补的治疗方法。因此,我们假设针对 ALK 的抗体靶向可能是大多数可能具有 ALK 阳性肿瘤的神经母细胞瘤患者的相关策略。我们在这里表明,一种拮抗型 ALK 抗体可抑制人神经母细胞瘤衍生细胞系的细胞生长并诱导体外抗体依赖性细胞毒性。在携带野生型或突变型 ALK 的细胞系中均可诱导细胞毒性。用双重 Met/ALK 抑制剂克唑替尼处理神经母细胞瘤细胞可通过促进细胞表面 ALK 的积累从而增加抗原与抗体结合的可及性,使细胞对抗体诱导的生长抑制敏感。这些数据支持针对 ALK 的免疫疗法作为一种有前途的治疗策略,用于治疗具有突变型或野生型 ALK 的神经母细胞瘤。