WO2012004410A1 - Antagonistes de b7-h3 et taxanes - Google Patents

Antagonistes de b7-h3 et taxanes Download PDF

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WO2012004410A1
WO2012004410A1 PCT/EP2011/061750 EP2011061750W WO2012004410A1 WO 2012004410 A1 WO2012004410 A1 WO 2012004410A1 EP 2011061750 W EP2011061750 W EP 2011061750W WO 2012004410 A1 WO2012004410 A1 WO 2012004410A1
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antagonist
cancer
cells
cell
taxane
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Øystein FODSTAD
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Oslo Universitetssykehus Hf
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/337Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7088Compounds having three or more nucleosides or nucleotides
    • A61K31/7105Natural ribonucleic acids, i.e. containing only riboses attached to adenine, guanine, cytosine or uracil and having 3'-5' phosphodiester links
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
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    • C12N15/00Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09Recombinant DNA-technology
    • C12N15/11DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
    • C12N15/113Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing
    • C12N15/1138Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing against receptors or cell surface proteins
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    • C12N2310/00Structure or type of the nucleic acid
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    • C12N2310/14Type of nucleic acid interfering N.A.
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    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12N2310/00Structure or type of the nucleic acid
    • C12N2310/50Physical structure
    • C12N2310/53Physical structure partially self-complementary or closed
    • C12N2310/531Stem-loop; Hairpin

Definitions

  • the present invention relates to the use of a combination dosage comprising a B7- H3 antagonist and a taxane for the preparation of a medicament for preventing the progression of cancer in a human.
  • An aspect of the present invention relates to a B7-H3 antagonist for sensitizing a cancer cell to a taxane.
  • Another aspect of the present invention relates to a method for preventing the progression of cancer comprising providing an individual in need thereof, and administration to said individual a combination dosage comprising a B7-H3 antagonist and a taxane.
  • Breast cancer is an epithelial cancer and is the most common type of cancer as well as the most common cause of cancer-related death in women. Once breast cancer becomes metastatic, it is difficult to cure because it is often resistant to commonly used chemotherapeutics, such as a taxane-based regime, which is one of the most effective chemotherapeutic agents in the treatment of breast cancer. Hence, if the sensitivity to taxane-based chemotherapy could be increased, it would represent an important step in improving the clinical management of breast cancer.
  • B7-H3 a transmembrane protein with immunoglobulin-like structure, is known to have immunoregulatory properties with both inhibitory and stimulatory effects on the activation of T-cells. It has also been shown that B7-H3 expressed at the cell surface of neuroblastoma cells can inhibit natural killer-mediated lysis. The B7-H3 protein is found in many human tissues, and it is observed to be overexpressed in a wide range of human cancers.
  • B7-H3 structurally is a transmembrane protein, it is also found in the cytoplasm of tumor cells. Furthermore, a soluble form of the protein has been found in serum of patients with NSCLC, and elevated levels of circulating B7-H3 correlated with poor clinical outcome. The same group has reported the release of soluble B7-H3 from monocytes, dendritic cells, activated T-cells and some cancer cell lines.
  • Stat3 signal transducer and activator of transcription
  • Stat3 The activation of Stat3 is through phosphorylation by various tyrosine kinases, such as Janus activated kinases (Jak) and Src family kinases, which are associated with and activated by cytokine and growth factor receptors.
  • Jak Janus activated kinases
  • Src family kinases which are associated with and activated by cytokine and growth factor receptors.
  • the tyrosine phosphorylation leads to Stat dimerization, followed by nuclear translocation, and activation of the expression of several genes.
  • Stat3 constitutive activation of Stat3 occurs frequently in breast tumors and has been confirmed in a wide range of breast cancer cell lines, possibly through over-expression or constitutive activation of upstream receptors such as EGFR and HER2 or non- receptor tyrosine kinases. High levels of Stat3 activity have been shown to predict intrinsic chemotherapeutic drug resistance due to the upregulation of the antiapoptotic factors Bcl-xL, Bcl-2, cl-1 and Survivin.
  • An aspect of the present invention relates to the use of a combination dosage comprising a B7-H3 antagonist and a taxane for the preparation of a medicament for preventing the progression of cancer in a human.
  • Another aspect of the present invention relates to the use of a combination of a B7-H3 antagonist and a taxane for the manufacture of a medicament for the treatment of cancer in a subject, wherein the administration pattern of said medicament comprises:
  • the cancer an epithelial cancer. Substances
  • Another aspect of the present invention relates to a B7-H3 antagonist for use in a method of treatment comprising sensitizing a cancer cell to a taxane.
  • Another aspect of the present invention relates to a method for preventing the progression of cancer comprising providing an individual in need thereof, and administration to said individual a combination dosage comprising a B7-H3 antagonist and a taxane.
  • the B7-H3 antagonist selected from the group consisting of an siRNA directed to the mRNA encoding B7-H3, an shRNA directed to the mRNA encoding B7-H3, a miRNA directed to the mRNA encoding B7-H3, a polyclonal antibody, a monoclonal antibody, an aptamer, a soluble B7- H3 receptor that binds directly to B7-H3, an RNase H inducing antisense
  • oligonucleotide directed to the mRNA encoding B7-H3, and a ribozyme directed to the mRNA encoding B7-H3.
  • the taxane selected from the group consisting of paclitaxel and docetaxel.
  • cancer selected from the group consisting of breast cancer, ovarian cancer, clear cell renal cell carcinoma, urothelial cell carcinoma, prostate cancer, nonsmall-cell lung cancer (NSCLC), colorectal cancer and pancreatic cancer.
  • NSCLC nonsmall-cell lung cancer
  • A Stable cell transfectants of the parental MDA-MB-231 and MDA-MB-435 human breast cancer cell lines expressing either vector control TR33 or B7-H3shRNA were generated. Western blot results showed the protein level of B7-H3 of MDA-MB-231 (left) and MDAMB-435 cells (right), expressing either vector control TR33 or shB7- H3 and their corresponding parental cells, ⁇ -actin was probed as a loading control.
  • B Cell viability of 231, 231-TR33, 231-shB7-H3 (left), 435, 435-TR33, and 435- shB7-H3 (right) following treatment with paclitaxel at various concentrations for 72 h was assessed using MTS assay.
  • Annexin V-FITC stained cells was increased in B7-H3 knockdown cells.
  • 231-TR33 and 231-shB7-H3 were treated with 20 nmol/L paclitaxel for 0, 48, and 72 h, respectively, and apoptosis was examined by Annexin V-FITC staining and flow cytometry.
  • TUNEL-positive cells The percentage of TUNEL-positive cells was increased in B7-H3 knockdown cells.
  • Cells were treated with 0, 10 and 20 nmol/L paclitaxel for 72 h, and apoptosis was examined by TUNEL assay and flow cytometry.
  • B7-H3 overexpressing MDA-MB-231 cell varaiants were more resistance to pacilitaxelinduced apoptosis.
  • B7-H3 overexpressing 231-B7-H3 cells expressed higher level of B7-H3, compared to the 231-EGFP control cells as detected by Western blot.
  • Middle; B7-H3 overexpressing cells showed decreased level of cleaved-PARP compared to the control cells upon treatment with 20nmol/L paclitaxel for 72 h.
  • apoptosis-specific ELISA detection revealed that the level of cytoplasmic histoneassociated DNA fragments in paclitaxel treated 231- B7H3 cells was much lower than in control 231-EGFP cells.
  • FIG. 3 B7-H3 silencing suppressed Stat3 phosphorylation in breast cancer cells.
  • A Cells were treated with 20 nmol/L paclitaxel or left untreated. Whole cell lysates were made 72 h following treatment and probed for phospho- and total Stat3 with ⁇ -actin as a loading control.
  • B and C B7-H3 silencing downregulated Mcl-1 and Survivin expression. Paclitaxel treatment and Western blotting were performed as described above, and ⁇ - actin or a-tublin was used as loading controls.
  • Figure 4. B7-H3 regulated the phosphorylation of Stat3 at least partially through Jak2.
  • A The levels of phosphorylated Jak2 were decreased in B7-H3 knockdown cells. Cells as indicated were treated with 20 nmol/L paclitaxel or left untreated. Whole cell lysates were made 72 h following treatment and then probed for phospho- and total Jak2 with ⁇ -atefcin as a loading control. B, AG490 treatment almost abolished the phosphorylation level of Jak2 and lead to reduced levels of tyrosine phosphorylation of Stat3 in both B7-H3 knockdown cells and control cells.
  • MDA MB-231 and MDA-MB-435 cell variants 22 were treated with 50 pmol/L or 100 pmol/L AG490, respectively, for 24 h and Western blot analysis was performed to examine the protein levels of phospho- and total Jak2 and Stat3 with ⁇ -actin as a loading control.
  • FIG. 1 Growth curves of breast cancer xenografts in nude mice established by s.c injection of 5x106 MDA-MB-435-shB7-H3 or MDA-MB-435-TR33 cells in both flanks of nude mice with or without paclitaxel treatment. Each group consisted of 8 animals.
  • Paclitaxel (10 mg/kg) was injected i.v. into the tail vein at day 0 when the average tumor diameter was 5-6 mm. The tumor diameter was measured 1-2 times per week. The data is presented as mean of two independent experiments ⁇ standard error of the mean (SEM).
  • FIG. 6 Melanom cell line: FEMX-I TR33 treated with Docetaxel for 72 hours. Results shown as % Growth relative to untreated cells.
  • An aspect of the present invention relates to the use of a combination dosage comprising a B7-H3 antagonist and a taxane for the preparation of a medicament for preventing the progression of cancer in a subject.
  • Another aspect of the present invention relates to the combination of a B7-H3 antagonist and a taxane for the manufacture of a medicament for the treatment of cancer in a subject, wherein the administration patternsof said medicament comprises:
  • Another aspect of the present invention relates to a combination dosage comprising a B7-H3 antagonist and a taxane for use in preventing the progression of cancer in a human.
  • combination and combinational dosage use interchangeably and refers to the uses and methods of the present invention, wherein the B7-H3 antagonist and a taxane are administered in combination i.e. as a combinational dosage.
  • a B7-H3 antagonist and a taxane is administered separately.
  • the combination dosage of a B7-H3 antagonist and a taxane is administered simultaneously with the same release rates.
  • the combination dosage of a B7-H3 antagonist and a taxane is administered simultaneously with different release rates.
  • the B7-H3 antagonist is the B7-H3 antagonist and the taxane is administered separately at time points selected from the group selected from 1 hour, 2 hours, 4 rhcrars, 10 hours, 24 hours, 36 hours, 48 hours, 72 hours, 96 hours, 108 hours and 120 hours.
  • Another aspect of the present invention relates to a method for preventing the progression of cancer comprising providing an individual in need thereof, and administration to said individual a combination dosage comprising a B7-H3 antagonist and a taxane.
  • prevention of progression of cancer also to inhibition of progression, treatment of cancer and for prevention of relapse or treatment of relapse of cancer.
  • prevention of the progression of cancer is the prevention of the progression of cancer a treatment of said cancer.
  • In another embodiment of the present invention is the prevention of the progression of cancer a prevention of relapse and/or treatment of relapse of said cancer.
  • the cancer cell is selected from the group consisting of a breast cancer cell, an ovarian cancer cell, a prostate cancer cell, a nonsmall-cell lung cancer (NSCLC) cell, a colorectal cancer cell, a pancreatic cancer cell and a cell from all other types of carcinomas.
  • NSCLC nonsmall-cell lung cancer
  • the cancer cell a breast cancer cell.
  • the carreer is selected from the group consisting of breast cancer, ovarian cancer, clear cell renal cell carcinoma, urothelial cell carcinoma, prostate cancer, nonsmall-cell lung cancer (NSCLC), colorectal cancer, pancreatic cancer and all other types of carcinomas.
  • the cancer is a breast cancer.
  • a “carcinoma” is tumor tissue derived from putative epithelial cells whose genome has become altered or damaged to such an extent that the cells become transformed, and begin to exhibit abnormal malignant properties.
  • Epithelial cancers are therefore known as carcinomas.
  • the uses and methods of the B7-H3 antagonists described herein are efficient in the treatment of epithelial cancers.
  • the cancer type an epithelial cancer.
  • epithelial cancers/carcinomas Several types of epithelial cancers/carcinomas are known :
  • Adenocarcinoma refers to a carcinoma featuring microscopic glandular-related tissue cytology, tissue architecture, and/or gland-related molecular products, e.g., mucin.
  • Squamous cell carcinoma refers to a carcinoma with observable features and characteristics indicative of squamous differentiation (intercellular bridges, keratinization, squamous pearls).
  • Anaplastic carcinoma refers to a heterogeneous group of high-grade carcinomas that feature cells lacking distinct histological or cytological evidence of any of the more specifically differentiated neoplasms. These tumors are referred to as Anaplastic or Undifferentiated carcinomas. Large cell carcinomas composed of large, monotonous rounded or overtly polygonal-shaped cells with abundant cytoplasm.
  • Small cell carcinomas cells are usually round and are less than approximately 3 times the diameter of a resting lymphocyte and little evident cytoplasm.
  • epithelial cancers selected from the group consisting of adenocarcinomas, squamous cell carcinomas, adenosquamous carcinomas, anaplastic carcinomas, anaplastic carcinomas, large cell carcinomas and small cell carcinomas.
  • epithelial cancer selected from the group consisting of breast cancer, ovarian cancer, clear cell renal cell carcinoma, urothelial cell carcinoma, prostate cancer, nonsmall-cell lung cancer (NSCLC), colorectal cancer, pancreatic cancer and all other types of carcinomas.
  • NSCLC nonsmall-cell lung cancer
  • “Grading” of carcinomas refers to the employment of criteria intended to semi- quantify the degree of cellular and tissue maturity seen in the transformed cells relative to the appearance of the normal "parent" epithelial tissue from which the carcinoma derives.
  • Grade 1 or "Well Differentiated”: Indicates there is a close, or very close, resemblance to the normal parent tissue, and that the tumor cells are easily identified and classified as a particular malignant histological entity.
  • Grade 2 or “Moderately Differentiated”: Indicates there is considerable resemblance to the parent cells and tissues, but that abnormalities can commonly be seen and the more complex features are not particularly well-formed.
  • Grade 3 or "Poorly Differentiated”: Indicates that there is very little resemblance between the malignant tissue and the normal parent tissue, with abnormalities evident and the more complex architectural features are usually rudimentary or primitive.
  • Grade 4 Indicates that these carcinomas bear no significant resemblance to the corresponding parent cells and tissues, with no visible formation of glands, ducts, bridges, stratified layers, keratin pearls, or other notable characteristics consistent with a more highly differentiated neoplasm.
  • the "grading" of the carcinoma selected from the group consisting of grade 1, grade 2, grade 3 and grade 4.
  • Administration pattern is the "grading" of the carcinoma selected from the group consisting of grade 1, grade 2, grade 3 and grade 4.
  • the sensitizing periods will depend on the B7-H3 antagonists selected for sensitization and the type of cancer.
  • the first sensitizing period selected from the group consisting of 1 hour, 2 hours, 4 hours, 10 hours, 24 hours, 36 hours, 48 hours, 72 hours, 96 hours, 108 hours and 120 hours.
  • the subsequent sensitizing periods of different length as the first sensitizing period are the subsequent sensitizing periods of different length as the first sensitizing period.
  • the therapeutical periods will also depend on the taxane selected for the treatment of cancer and on the type of cancer.
  • the first therapeutical period selected from the group consisting of 1 hour, 2 hours, 4 hours, 10 hours, 24 hours, 36 hours, 48 hours, 72 hours, 96 hours, 108 hours and 120 hours.
  • the therapeutically effective amounts and the sensitizing effective amounts will also depend of the B7-H3 antagonist and taxane selected for sensitization and treatment.
  • An aspect of the present invention relates to a B7-H3 antagonist for use in a method of treatment comprising sensitizing a cancer cell to a taxane.
  • B7-H3 antagonists for use in a method of treatment comprising sensitizing a cancer cell to a taxane.
  • the B7-H3 antagonist of the present invention may function through several different mechanisms, but the hallmark of the B7-H3 antagonist of the present invention is the ability to minimize the function and/or expression of B7-H3 mRNA transcripts or protein.
  • Such mechanisms are known in the art and can be either direct antagonists that function directly on the B7-H3 gene, mRNA or protein or alternatively through an indirectly through an antagonistic or agonistic pathway where one or more proteins other than B7-H3 that interact directly or indirectly with B7-H3 is/are regulated by expression and/or function.
  • the antagonists of the present invention can be competitive antagonists (also known as surmountable antagonists) that reversibly bind to receptors at the same binding site (active site) as the endogenous ligand or agonist, but without activating the target.
  • competitive antagonists also known as surmountable antagonists
  • Agonists and antagonists "compete" for the same binding site on the target, and once bound, an antagonist will block agonist binding.
  • the level of activity of the target will be determined by the relative affinity of each molecule for the site and their relative concentrations. High concentrations of a competitive agonist will increase the proportion of receptors that the agonist occupies and higher concentrations of the antagonist will be required to obtain the same degree of binding site occupancy.
  • the antagonists of the present invention can also be non-competitive antagonists (sometimes called non-surmountable antagonists) which are allosteric
  • the antagonists of the present invention can also be uncompetitive antagonists which differ from non-competitive antagonists in that they require target activation by an agonist before they can bind to a separate allosteric binding site.
  • This type of antagonism produces a kinetic profile in which the same amount of antagonist blocks higher concentrations of agonist better than lower
  • the antagonists of the present invention can also be partial agonists which are defined as drugs that, at a given target, might differ in the amplitude of the functional response that they elicit after maximal target occupancy.
  • partial agonists can act as a competitive antagonist in the presence of a full agonist, as it competes with the full agonist for target occupancy, thereby producing a net decrease in the target activation as compared to that observed with the full agonist alone.
  • the antagonists of tha present invention also be an inverse agonist that can have effects similar to those of an antagonist, but causes a distinct set of downstream biological responses.
  • Constitutively active targets that exhibit intrinsic or basal activity can have inverse agonists, which not only block the effects of binding agonists like a classical antagonist but also inhibit the basal activity of the target.
  • the B7-H3 antagonist selected from the group consisting of a competitive antagonist, a non-competitive antagonist, an uncompetitive antagonist, a partial agonist and an inverse agonist.
  • the B7-H3 antagonist an RNAi antagonist mediated through an RNAi pathway.
  • the RNAi antagonist selected from the group consisting of an siRNA directed to the mRNA encoding B7-H3, an shRNA directed to the mRNA encoding B7-H3 and a miRNA directed to the mRNA encoding B7-H3.
  • the B7-H3 antagonist selected from the group consisting of an siRNA directed to the mRNA encoding B7-H3, an shRNA directed to the mRNA encoding B7-H3, a miRNA directed to the mRNA encoding B7-H3, a polyclonal antibody, a monoclonal antibody, an aptamer, a soluble B7-H3 receptor that binds directly to B7-H3, an RNase H inducing antisense oligonucleotide directed to the mRNA encoding B7-H3, and a ribozyme directed to the mRNA encoding B7-H3.
  • the B7-H3 antagonist of the present invention targeting an upstream and/or downstream event that has a direct and/or indirect effect on B7-H3.
  • tafee nucleic acid based B7-H3 antagonists may individual nucleic adds- optionally be substituted by the nucleic acid analogues selected from the group consisting of PNA, LIMA, TINA, and Morpholino (PMO). Taxanes
  • taxanes relate to diterpenes produced by the plants of the genus Taxus (yews). They were first derived from natural sources, but some have been synthesized artificially. Taxanes have been used to produce various chemotherapy drugs and the primary mechanism of the taxane class of drugs is the disruption of microtubule function. Thus, taxanes are essentially mitotic inhibitors.
  • paclitaxel which is better known under its trademark Taxol.
  • paclitaxel is dissolved in Cremophor EL and ethanol, as a delivery agent.
  • Cremophor EL Cremophor EL
  • ethanol a delivery agent.
  • paclitaxel sold under the trademark Abraxane.
  • Taxotere Another well known taxane is docetaxel which is better known under its trademark Taxotere.
  • the taxane selected from the group consisting of paclitaxel and docetaxel. Sensitizing
  • the B7-H3 antagonists of the present invention have the ability to sensitize cancer cells to taxanes.
  • the cancer types that the B7-H3 antagonists target can be divided into three groups.
  • cancer types where taxanes presently are used in treatment but where the B7-H3 antagonist causes a bonus effect.
  • the cancers types sensitize by the B7-H3 antagonists of the present invention selected from the group consisting of cancer types that until now are resistant to taxanes, cancer types where taxanes until now only have had limited success and cancer types where taxanes presently are used in treatment, but where the B7-H3 antagonist causes a bonus effect.
  • An important aspect of the present invention pertains to a composition comprising the taxane and/or the B7-H3 antagonist of the present invention.
  • composition in order to ensure optimum performance of such composition it is preferred that it comprises an immunologically and pharmacally acceptable carrier, excipient, vehicle and/or adjuvant.
  • an immunologically and pharmacally acceptable carrier, excipient, vehicle or adjuvant is usually classified by application location (or exposition). However, routes of administration can also basically be classified whether the effect is local (in topical administration) or systemic (in enteral or parenteral administration).
  • Topical administration refers to a local effect where the substance is applied directly where its action is desired. Sometimes, however, the term topical is defined as applied to a localized area of the body or to the surface of a body part, without necessarily involving target effect of the substance, making the
  • the classification rather a variant of the classification based on application location.
  • the route of administration is selected from the group consisting of intradermal application, epicutaneous application and nasal application.
  • Enteral administration refers to where a desired effect is systemic (non-local), and the substance is given via the digestive tract.
  • Parenteral administration refers to where a desired effect is systemic, and the substance is given by routes other than the digestive tract.
  • Example 1 - B7-H3 silencing increases paclitaxel sensitivity by abrogating
  • B7-H3 A correlation between high expression of the immunoregulatory protein B7-H3 and poor prognosis has been observed in many human cancers. However, the role and mechanism of B7-H3 in cancer cell chemoresistance is unknown. We hypothesized that B7-H3 might affect drug resistance in a non-immunological manner and studied paclitaxel activity in two breast cancer cell lines both in vitro and in vivo. The overall objective was to elucidate the function of B7-H3 in human cancer.
  • B7-H3 expression was silenced by shRNA, resulting in significantly increased sensitivity to paclitaxel, mediated via increased susceptibility to apoptosis. Furthermore, B7-H3 knock down cells had reduced levels of activated Stat3.
  • the sensitization to paclitaxel seen in vitro was confirmed in a xenograft model in nude mice. The results are translational as they demonstrate the role of B7-H3 in paclitaxel resistance, and suggest that manipulating the expression of B7-H3 and/or its signalling pathway partners may represent a novel approach to increase clinical sensitivity to paclitaxel, and potentially also to other chemotherapeutic drugs.
  • breast cancer is the most common type of cancer as well as the most common cause of cancer-related death in women. Once breast cancer becomes metastatic, it is difficult to cure because it is often resistant to commonly used
  • chemotherapeutics such as a taxane-based regime, which is one of the most effective chemotherapeutic agents in the treatment of breast cancer.
  • a taxane-based regime which is one of the most effective chemotherapeutic agents in the treatment of breast cancer.
  • B7-H3 a transmembrane protein with immunoglobulin-like structure , is known to have immunoregulatory properties with both inhibitory and stimulatory effects on the activation of T-cells. It has also been shown that B7-H3 expressed at the cell surface of neuroblastoma cells can inhibit natural killer-mediated lysis. The B7-H3 protein is found in many human tissues, and it is observed to be overexpressed in a wide range of human cancers. Notably, immunohistochemical reports have shown a correlation between high expression of B7-H3 and poor outcome in patients with clear cell renal cell carcinoma, urothelial cell carcinoma, prostate cancer, nonsmall-cell lung cancer (NSCLC), and pancreatic cancer.
  • NSCLC nonsmall-cell lung cancer
  • B7-H3 structurally is a transmembrane protein, it is also found in the cytoplasm of tumor cells. Furthermore, a soluble form of the protein has been found in serum of patients with NSCLC, and elevated levels of circulating B7-H3 correlated with poor clinical outcome. The same group has reported the release of soluble B7-H3 from monocytes, dendritic cells, activated T-cells and some cancer cell lines.
  • Stat3 signal transducer and activator of transcription
  • Stat3 The activation of Stat3 is through phosphorylation by various tyrosine kinases, such as Janus activated kinases (Jak) and Src family kinases, which are associated with and activated by cytokine and growth factor receptors.
  • Jak Janus activated kinases
  • Src family kinases which are associated with and activated by cytokine and growth factor receptors.
  • Constitutive activation of Stat3 occurs frequently in breast tumors and has been confirmed in a wide range of breast cancer cell lines, possibly through over-expression or constitutive activation of upstream receptors such as EGFR and HER2 or nonreceptor tyrosine kinases.
  • High levels of Stat3 activity have been shown to predict intrinsic cbeaiotherapeutic drug resistance due to the upregulation of the cteesr--- antiapoptotic factors Bcl-xL, Bcl-2, Mcl-1 and Survivin.
  • Anti-human B7-H3 antibody and anti-Survivin was purchased from R&D Systems, Inc.
  • Antibodies against Stat3, p-Stat3Tyr705, p-Stat3Ser727, Jak2, p-Jakl, p- Jak2, p-Src, Mcl-1 and PARP were from Cell Signaling Technology.
  • Antibody against ⁇ -actin and Tryphostins AG490 were from Sigma-Aldrich Chemical Co.
  • the horseradish peroxidise conjugated secondary anti-mouse, anti-rabbit, and anti- goat antibodies were from Bio-Rad Laboratories, Inc. Paclitaxel was from Mead Johnson Inc. (Princeton, NJ).
  • Cell lines MDA-MB-231 and MDA-MB-435 were purchased from the American Type Culture Collection (ATCC) (Manassas, VA). The cells were cultured in DMEM/F12 medium (Mediatech, Inc.) supplemented with a 10% fetal bovine serum (FBS, Atlanta Biologicals Inc., Lawrenceville, GA) and 1% penicillin-streptomycin (Gibco, Paisley, UK) at 37°C under an atmosphere of 5% C02.
  • ATCC American Type Culture Collection
  • HuSH 29mer shRNA constructs against B7-H3 (shB7-H3) and control plasmid pRS non effective TR30003 (TR33) were purchased from Origene Technologies, Inc.
  • shRNA construct or control vector were transfected into MDA-MB-231 and MDA- MB-435 cells using Lipofectamine 2000 (Invitrogen, Carlsbad, CA) according to the manufacturer's protocols, followed by selection with 1 pg/ml puromycin for 2 weeks. Antiboitic-resistant clones were isolated in medium with 0.5 pg/ml puromycin. RT-PCR and immunoblotting were performed to confirm the
  • NM_001024736 were amplified by PCR using the following primer sequences: Forward ( 5 '-TCACTCG AG CCCTG AGTCCCAG AGTCG G C- 3 ') (SEQ ID NO: 3); Reverse ( 5 '- ACTG AATTCGGTTGTG G GTG GTCTGTTC AT- 3 ') (SEQ ID NO:4); and then the full length cDNA was cloned into xho I and EcoR I linearized plasmid vector pIRES2- EGFP (Clonetech, USA).
  • the control vector pIRES2-EGFP and human B7-H3 expression vector pIRES2-B7-H3 were transfected in MDA-MB-231 cells respectively using Lipofectamine 2000. Stable clones were selected in medium containing 1.8 mg/mL Geneticin (Invitrogen, USA). The expression of B7-H3 was detected by Western blot. In vitro growth inhibition
  • Cells (1 x 104 cells) were initially plated in triplicate in 96-well culture plates. Twenty-four hours later, the medium was replaced with fresh medium with or without paclitaxel and incubated for indicated time. Cell viability was determined using cellTiter 96 Aqueous One Solution Cell Proliferation Assay Kit (Promega, USA).
  • 3 x 105 cells were grown in triplicate in 60 mm dishes with addition of 20 nmol/L paclitaxel for 0, 48 h, and 72 h respectively. And then cells were harvested and processed as described in the Annexin V-FITC Apoptosis Detection Kit I manual (BD Transduction Laboratories, BD Biosciences) and analyzed by flow cytometry (BD LSR II).
  • TUNEL assay s ⁇ " ⁇ ' ⁇ ' Terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick-end labeling (TUNEL) assay was performed using recombinant terminal transferase (TdT) and biotin-16-dUTP (Roche Diagnostics GmbH, Mannheim, Germany). After treated with with with 0, 10 and 20 nmol/L paclitaxel for 72 h, cells were processed following manufacturer's protocol and then analyzed by flow cytometer (BD Biosciences, San Jose, CA). Each experiment was repeated three times.
  • phenylmethylsulfonyl fluoride 1 mmol/L Na3V04, and protease inhibitor cocktail (Sigma-Aldrich ) for 20 min on ice.
  • the proteins were separated by SDS-PAGE and then electrotransferred onto nitrocellulose membrane (Bio-rad). Membranes were probed with indicated antibodies following the manufacturer's protocol.
  • mice Four groups of seven female Balb/c nude mice, bred at the nude rodent facility at the Norwegian Radium Hospital were used. The animals were maintained under specific pathogen-free conditions, and food and water were supplied ad libitum. Animal experiments were performed according to protocols approved by the animal care and use committee and were in compliance with the guidelines on animal welfare of the Norwegian National Committee for Animal Experiments. When the animals were 6-8 weeks of age, 5x106 cells (MDA-MB-435 shB7-H3 or MDA-MB-435 TR33 cells) in 0.2 ml PBS were injected s.c. in both flanks of nude mice. Animals bearing tumors with diameters ⁇ 4 mm or > 8 mm at 20 days after injection were excluded.
  • 5x106 cells MDA-MB-435 shB7-H3 or MDA-MB-435 TR33 cells
  • paclitaxel for therapy experiments, a stock solution of paclitaxel in ethanol (6 mg/ml) was dissolved in PBS and a single dose of 10 mg/kg of the drug was injected i.v. into the tail vein when the mean tumor diameter was 5-6 mm (day 0). The control mice received only the solvent. Tumor diameters were measured one to two times per week. Tumor volume was calculated by the formula 0.5 x length x width2 and growth curves constructed, and the data presented as mean of two independent experiments ⁇ standard error of the mean (SEM).
  • Paclitaxel is known to exert its cytotoxic effect through induction of apoptosis (25), and hence we investigated whether the
  • the extent of apoptosis was investigated by checking the amount of Annexin-5 stained cells, a marker for early stage apoptosis in MDA-MB-231 and MDA-MB-435 cells, and in MDA-MB-231 cells also for the amount of TUNEL positive cells, which reflects late stage apoptosis.
  • the response to 20 nmol/L paclitaxel was time dependent with an increase in the amount Annexin-V positive cells detected at 48 and 72 h (Fig. 2A).
  • MDA-MB-231 B7-H3 knockdown cells were more sensitive to paclitaxel-induced apoptosis, with the percentage of apoptotic cells in 231-shB7-H3 cells about two fold that in 231- TR33 cells at both 48 h and 72 h. Similar results were observed in MDA-MB-435 cell variants (Fig. S1A). The late stage apoptotic response was also dose
  • TUNEL positive cells were 11% versus 2% at 48 h and 18% versus 6% at 72 h, respectively. These results were confirmed by investigating the
  • paclitaxel had a marginal (not statistically significant) effect on tumor growth rate of MDA-MB-435 TR33 tumors, whereas the drug showed a relatively strong antitumor effect in mice carrying MDAMB-435 shB7-H3 xenografts.
  • the drug showed a relatively strong antitumor effect in mice carrying MDAMB-435 shB7-H3 xenografts.
  • the effect became significant from day 22 (all the p-values at each time point after day 22 were lower than 0.03).
  • the growth rate of MDA-MB-435 TR33 cells was faster than that of B7-H3 knockdown cells. This does not, however, explain the differences in paclitaxel response between the two groups.
  • the in vivo data strongly confirms the effects observed in the in vitro cellular cytotoxic assay that B7-H3 plays a critical role in paclitaxel responsiveness of breast cancer cells.
  • taxanes have significantly improved the overall and disease-free patient survival (28, 29).
  • the taxanes exert a response rate between 25% and 69% used as first-line treatment.
  • inherited and acquired resistance to taxanes represents a major obstacle in improving the overall response and survival. Therefore, the development of new therapeutic interventions to overcome taxane resistance becomes an important task in cancer research.
  • MDA-MB-435 The human MDA-MB-435 cell line was originally described as of breast cancer origin, whereas gene expression array studies indicated the cells to originate from malignant melanoma. However, subsequent evidence suggests that MDA-MB-435 is in fact a breast cancer cell line. In our study, the results obtained with MDA-MB- 435 cells were closely similar to those with MDA-MB-231 breast cancer cells. Importantly, our promising in vitro results demonstrating that B7-H3 seem to play a critical role in paclitaxel resistance, were confirmed in an animal model using the MDAMB-435 xenografts in which the growth rate of established B7-H3 knock down xenografts was significantly reduced whereas the growth of transfection control tumors were only marginally affected.
  • MDA-MB-435 vector control cells were faster than that of B7-H3 knockdown cells. This cannot, however, explain the differences in sensitivity to paclitaxel, as it is well known that fast-growing tumors generally respond better to chemotherapy than more slowly growing counterparts.
  • B7-H3 confers resistance to paclitaxel by reducing the sensitivity of the tumor cells to apoptosis, mediated via the Jak2/Stat3 pathway.
  • B7-H3 and its pathway partners are potential targets for developing novel therapeutic approaches.
  • our data demonstrates that B7-H3 plays an important role in determining the resistance to paclitaxel via non-immune mechanisms. Whether this effect of B7-H3 may extend to other drugs and tumor types is not yet determined, but preliminary results in our laboratory are promising and will be further explored.
  • Figures 6 and 7 shown experiments similar to the experiments shown in example 1 but with docetaxel as the active anti-cancer drug.

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Abstract

L'invention concerne l'utilisation d'une dose combinée contenant un antagoniste de B7-H3 et un taxane dans la préparation d'un médicament destiné à prévenir l'évolution d'un cancer chez un humain. Un aspect de l'invention concerne un antagoniste de B7-H3 destiné à sensibiliser une cellule cancéreuse à un taxane. Un autre aspect concerne une méthode de prévention de l'évolution d'un cancer, consistant à administrer à un individu nécessitant un tel traitement une dose combinée contenant un antagoniste de B7-H3 et un taxane.
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WO2018024849A1 (fr) * 2016-08-03 2018-02-08 Aalborg Universitet Oligonucléotides antisens (aso) conçus pour inhiber des protéines de points de contrôle immunitaires
CN108125976A (zh) * 2017-12-29 2018-06-08 唐山市人民医院 预测肺癌脑转移分子标记物miR-4270及在药物和诊断试剂盒中的应用
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