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Spotlight on Oncology: Pushing the tumor boundaries

A roundup of very recent novel research in the field of oncology
Written byJeffrey Bouley
| 19 min read

Things are always busy in the field of cancer research, but perhaps they’re especially hectic right now, given that news of four interesting and very novel oncology-related items showed up in the DDNews email in a span of less than 36 hours, just as the June 2018 issue was nearing the layout stage.

We don’t doubt that other uncharted (or barely charted) waters exist in the sea of oncology R&D and are currently being reported on as well, but since this quartet arrived so conveniently clumped together and right on our electronic doorstep, let’s give them the spotlight for right now.

Two-pronged antibodies draw immune killers directly to cancer cells

JUPITER, Fla.—In the lab of biochemist and immunologist Dr. Christoph Rader, an associate professor at The Scripps Research Institute (TSRI), scientists have engineered a new type of anticancer antibody that is intended to enhance nature’s cancer-fighting strategies by attracting killer T cells directly to cancer cells covered with a distinctive protein.

Referred to as “T-cell engaging bi-specific antibodies,” these novel weapons in the fight against cancer are designed to attack malignant cells but leave healthy cells untouched—all thanks to their selective targeting system. That targeting system homes in on ROR1 specifically, a protein found on the surface of several types of cancer cells.

“Once the T cells are recruited and activated, they release cytotoxic molecules that penetrate the target cells and kill them,” Rader said. “Natural antibodies can’t do this. You have to engineer them in a bispecific fashion to do this.”

Granted, bispecific antibodies themselves aren’t a new area of research, but this particular antibody and potential therapeutic may be more versatile than most.

As Rader explained, ROR1 is an excellent target for a “smart” cancer-fighting system because it is seen only in mature cells that are malignant. Rader first discovered ROR1’s activity in leukemia a decade ago while working at the National Cancer Institute.

“ROR1 is expressed during embryogenesis, and then it is tightly down-regulated after birth. It later reappears in both blood cancers and solid malignancies,” Rader said, adding that it has been found on malignant cells, including lung, breast, ovarian and blood-based cancers. “One of the most unique aspects of this bi-specific antibody is that it can work in so many different cancer indications.”

Also on the more novel side of bispecific antibody R&D is the duration of activity for this particular antibody. Rader credits Dr. Junpeng Qi, first author of the study on their bispecific ROR1 work and a postdoctoral associate at TSRI, with engineering a group of bispecific antibodies that stay active in animal models for about five days—which he points out is a feat compared with current approaches. The one U.S.-approved bispecific antibody therapeutic for cancer right now—against B cell acute lymphoblastic leukemia—stays active for a couple of hours, Rader said.

“Junpeng used a component of natural antibodies for this bispecific antibody that gives it not only a larger size, but also the ability to be recycled and stay in the blood longer,” Rader explained. “They are not there eternally, though. You get rid of them eventually, which is important for avoiding systemic toxicity.”

The scientists’ work is described in the article “Potent and Selective Antitumor Activity of a T-Cell Engaging Bispecific Antibody Targeting a Membrane-Proximal Epitope of ROR1,” which appeared online May 29 in the journal Proceedings of the National Academy of Sciences.

Also worth noting is that Rader is particularly interested in applying his bispecific antibodies to HER2-negative breast cancer, a type of breast cancer with fewer treatment options than many other cancers. “If you look at ROR1 expression in breast cancer, you see that the patients who are HER2-negative are often ROR1-positive,” he noted. “These breast cancer patients might benefit.”

Block a protein, block the bladder cancer

DUARTE, Calif.—In what is said to be the first published report on an FGFR3 inhibitor in patients with advanced bladder cancer, we have news out of the kidney cancer research team at City of Hope about a novel drug called BGJ398. As noted in research led by Dr. Sumanta Kumar Pal, an associate clinical professor at City of Hope and the co-director of the Kidney Cancer Program there, BGJ398 blocks a key protein—FGFR3—that drives bladder cancer, successfully treating a specific population of patients with advanced bladder cancer.

The research was published in Cancer Discovery under the title “Efficacy of BGJ398, a fibroblast growth factor receptor 1–3 inhibitor, in patients with previously treated advanced urothelial carcinoma with FGFR3 alterations.”

Advanced bladder cancer is usually fatal, and the five-year survival rate for stage IV bladder cancer is only about 15 percent. However, in a hopeful sign, the City of Hope investigators saw substantial tumor shrinkage and delays in tumor growth with abnormalities in the FGFR3 protein in patients who were treated with BGJ398. Among 67 patients treated, an overall response rate of 25.4 percent was observed, and an additional 38.8 percent of patients had disease stabilization, translating to a disease control rate of 64.2 percent.

According to Pal, “The activity suggests a new possible paradigm for treatment—specifically, screening for relevant mutations in bladder cancer and treating accordingly. With further investigation, agents like BGJ398 could fit a huge unmet need in this disease.”

And, as noted by the authors in the paper, “Although the treatment landscape of metastatic urothelial carcinoma is evolving, there is still a need for novel therapies in this domain. Following platinum-based chemotherapy, cytotoxic therapy has been associated with limited responses. While there is much excitement surrounding immunotherapy, a Phase 3 trial demonstrating superiority over checkpoint blockade inhibitor therapy over chemotherapy reported a response rate of just 21 percent. Current preliminary data suggest that tumors that harbor FGFR3 alterations are more likely to be resistant to immune checkpoint blockade, indicating a role for molecularly targeted therapies.”

Antifungal drug eliminates sleeping bowel cancer cells

LONDON—From a novel therapeutic we move on to a novel use for a drug intended for something very non-oncological. Specifically, an antifungal medication commonly prescribed for toenail infections could help eliminate dormant cells within bowel tumors, according to new research funded by Cancer Research UK and published in the Journal of Experimental Medicine.

Researchers at the Cancer Research UK Cambridge Institute say they have shown in laboratory studies of mice that itraconazole effectively halts the growth and progression of certain types of bowel cancer. The next step will be to see if this holds true in patients with the disease.

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Volume 14 - Issue 6 | June 2018

June 2018

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