Jacob Joan, Anami Yasuaki, High Peyton C, Liang Zhengdong, Subramanian Shraddha, Ghosh Sukhen C, AghaAmiri Solmaz, Guernsey-Biddle Cara, Tran Ha, Rowe Julie, Azhdarinia Ali, Tsuchikama Kyoji, Carmon Kendra S
Center for Translational Cancer Research, The Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
UTHealth Houston Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Res. 2025 Mar 3;85(5):973-986. doi: 10.1158/0008-5472.CAN-24-0798.
As colorectal cancer remains a leading cause of cancer-related death, identifying therapeutic targets and approaches is essential to improve patient outcomes. The EGFR ligand epiregulin (EREG) is highly expressed in RAS wild-type (WT) and mutant colorectal cancer, with minimal expression in normal tissues, making it an attractive target for antibody-drug conjugate (ADC) development. In this study, we produced and purified an EREG mAb, H231, which had high specificity and affinity for human and mouse EREG. H231 also internalized to lysosomes, which is important for ADC payload release. ImmunoPET and ex vivo biodistribution studies showed significant tumor uptake of zirconium-89-labeled H231, with minimal uptake in normal tissues. H231 was conjugated to either cleavable dipeptide or tripeptide chemical linkers attached to the DNA-alkylating payload duocarmycin DM, and the cytotoxicity of EREG ADCs was assessed in a panel of colorectal cancer cell lines. EREG ADCs incorporating tripeptide linkers demonstrated the highest potency in EREG-expressing colorectal cancer cells irrespective of RAS mutations. Preclinical safety and efficacy studies showed that EREG ADCs were well tolerated, neutralized EGFR pathway activity, caused significant tumor growth inhibition or regression, and increased survival in colorectal cancer cell line and patient-derived xenograft models. These data suggest that EREG is a promising target for the development of ADCs for treating colorectal cancer and other cancer types that express high levels of EREG. Although the efficacy of clinically approved anti-EGFR mAbs is largely limited by RAS mutational status, EREG ADCs may show promise for both RAS mutant and WT patients, thus improving existing treatment options. Significance: EREG-targeting antibody-drug conjugates demonstrate acceptable safety and robust therapeutic efficacy in RAS mutant and wild-type colorectal cancer, suggesting their potential as an alternative to EGFR-targeted therapy to benefit a broader patient population.
由于结直肠癌仍然是癌症相关死亡的主要原因,确定治疗靶点和方法对于改善患者预后至关重要。表皮生长因子受体(EGFR)配体表皮调节素(EREG)在RAS野生型(WT)和突变型结直肠癌中高表达,在正常组织中表达极少,这使其成为抗体药物偶联物(ADC)开发的一个有吸引力的靶点。在本研究中,我们制备并纯化了一种EREG单克隆抗体H231,它对人和小鼠EREG具有高特异性和亲和力。H231还能内化至溶酶体,这对ADC有效载荷的释放很重要。免疫正电子发射断层扫描(ImmunoPET)和离体生物分布研究显示,89锆标记的H231在肿瘤中有显著摄取,在正常组织中摄取极少。H231与连接到DNA烷化有效载荷多卡霉素DM上的可裂解二肽或三肽化学接头偶联,并在一组结直肠癌细胞系中评估EREG ADC的细胞毒性。无论RAS突变情况如何,包含三肽接头的EREG ADC在表达EREG的结直肠癌细胞中显示出最高效力。临床前安全性和疗效研究表明,EREG ADC耐受性良好,可中和EGFR通路活性,导致显著的肿瘤生长抑制或消退,并提高结直肠癌细胞系和患者来源异种移植模型的生存率。这些数据表明,EREG是开发用于治疗结直肠癌和其他高表达EREG的癌症类型的ADC的一个有前景的靶点。尽管临床批准的抗EGFR单克隆抗体的疗效在很大程度上受RAS突变状态限制,但EREG ADC可能对RAS突变和野生型患者都有前景,从而改善现有治疗选择。意义:靶向EREG的抗体药物偶联物在RAS突变和野生型结直肠癌中显示出可接受的安全性和强大的治疗效果,表明它们有潜力作为EGFR靶向治疗的替代方案,使更广泛的患者受益。
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