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Berning P, Hennemann C, Tulotta C, Schaefer C, Lechtape B, Hotfilder M, El Gourari Y, Jürgens H, Snaar-Jagalska E, Hempel G, Dirksen U, Potratz J. The Receptor Tyrosine Kinase RON and Its Isoforms as Therapeutic Targets in Ewing Sarcoma. Cancers (Basel) 2020; 12:cancers12040904. [PMID: 32272784 PMCID: PMC7226494 DOI: 10.3390/cancers12040904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 03/29/2020] [Accepted: 04/04/2020] [Indexed: 11/16/2022] Open
Abstract
The receptor tyrosine kinase (RTK) RON is linked to an aggressive metastatic phenotype of carcinomas. While gaining interest as a therapeutic target, RON remains unstudied in sarcomas. In Ewing sarcoma, we identified RON among RTKs conferring resistance to insulin-like growth factor-1 receptor (IGF1R) targeting. Therefore, we explored RON in pediatric sarcoma cell lines and an embryonic Tg(kdrl:mCherry) zebrafish model, using an shRNA-based approach. To examine RON–IGF1R crosstalk, we employed the clinical-grade monoclonal antibody IMC-RON8, alone and together with the IGF1R-antibody IMC-A12. RON silencing demonstrated functions in vitro and in vivo, particularly within micrometastatic cellular capacities. Signaling studies revealed a unidirectional IGF1-mediated cross-activation of RON. Yet, IMC-A12 failed to sensitize cells to IMC-RON8, suggesting additional mechanisms of RON activation. Here, RT-PCR revealed that childhood sarcomas express short-form RON, an isoform resistant to antibody-mediated targeting. Interestingly, in contrast to carcinomas, treatment with DNA methyltransferase inhibitor did not diminish but increased short-form RON expression. Thus, this first report supports a role for RON in the metastatic progression of Ewing sarcoma. While principal molecular functions appear transferrable between carcinomas, Ewing sarcoma and possibly more common sarcoma subtypes, RON highlights that specific regulations of cellular networks and isoforms require better understanding to successfully transfer targeting strategies.
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Affiliation(s)
- Philipp Berning
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Carolin Hennemann
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
- Department of General Pediatrics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Claudia Tulotta
- Institute of Biology, Leiden University, Gorlaeus Laboratories, Einsteinweg 55, 2333 CC Leiden, The Netherlands
| | - Christiane Schaefer
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Birgit Lechtape
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Marc Hotfilder
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Yassmine El Gourari
- Department of General Pediatrics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Heribert Jürgens
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Ewa Snaar-Jagalska
- Institute of Biology, Leiden University, Gorlaeus Laboratories, Einsteinweg 55, 2333 CC Leiden, The Netherlands
| | - Georg Hempel
- Institute of Pharmaceutical and Medical Chemistry, Westfälische Wilhelms-Universität Münster, Corrensstraße 48, 48149 Münster, Germany
| | - Uta Dirksen
- Division of Hematology and Oncology, Department of Pediatrics III, West German Cancer Centre, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
| | - Jenny Potratz
- Department of Pediatric Hematology and Oncology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
- Department of General Pediatrics, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
- Correspondence:
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El-Khoueiry AB, O'Donnell R, Semrad TJ, Mack P, Blanchard S, Bahary N, Jiang Y, Yen Y, Wright J, Chen H, Lenz HJ, Gandara DR. A phase I trial of escalating doses of cixutumumab ( IMC-A12) and sorafenib in the treatment of advanced hepatocellular carcinoma. Cancer Chemother Pharmacol 2018; 81:957-63. [PMID: 29520435 DOI: 10.1007/s00280-018-3553-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE The insulin-like growth factor (IGF) pathway is activated in hepatocarcinogenesis. Cixutumumab is a monoclonal antibody against human insulin-like growth factor-1 receptor (IGF-1R). Given the cross-talk between the IGF and VEGF pathways, we performed a phase I study of the combination of cixutumumab and sorafenib in hepatocellular cancer (HCC). METHODS Eligible patients with no prior systemic therapy for advanced HCC and Child-Pugh A to B7 were treated with sorafenib 400 mg BID and escalating doses of cixutumumab (2, 4, or 6 mg/kg IV weekly) in a 3 + 3 design. Dose limiting toxicity (DLT) was defined as treatment-related grade 3 or 4 non-hematologic toxicity (except for a subset of manageable toxicities) or any grade 4 hematologic toxicities. RESULTS In 21 patients enrolled, there were 3 DLTs; grade 3 hyperglycemia, grade 3 hypophosphatemia, and grade 5 peritonitis. The maximum tolerated dose of cixutumumab was 4 mg/kg IV weekly with standard dose sorafenib. Eighteen of 21 (86%) patients had grade 3 or above toxicities attributed to treatment. One patient also experienced grade 4 colonic perforation and grade 5 peritonitis. The median number of cycles completed was 4 (0-26). Of 16 patients evaluable for response, 81% achieved stable disease. The median progression free survival was 6.0 months (95% CI 3.6-undefined) and the median overall survival was 10.5 months (95% CI 7.1-undefined). CONCLUSIONS While the combination of cixutumumab and sorafenib had a toxicity profile similar to that of sorafenib monotherapy, it manifested limited clinical efficacy in unselected patients with HCC.
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Novello S, Scagliotti G, de Castro G, Kiyik M, Kowalyszyn R, Deppermann KM, Arriola E, Bosquee L, Novosiadly RD, Nguyen TS, Forest A, Tang S, Kambhampati SRP, Cosaert J, Reck M. An Open-Label, Multicenter, Randomized, Phase II Study of Cisplatin and Pemetrexed With or Without Cixutumumab ( IMC-A12) as a First-Line Therapy in Patients With Advanced Nonsquamous Non-Small Cell Lung Cancer. J Thorac Oncol 2016; 12:383-389. [PMID: 27464970 DOI: 10.1016/j.jtho.2016.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/31/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Type 1 insulin-like growth factor receptor is deregulated in solid tumors. Cixutumumab, a monoclonal antibody that inhibits the activity of type 1 insulin-like growth factor receptor, was investigated in combination with pemetrexed/cisplatin in the frontline setting. METHODS In this open-label, phase II study, patients with stage IV nonsquamous NSCLC and a performance status of 0 to 1 were randomized (1:1) to receive 20 mg/kg cixutumumab, 500 mg/m2 pemetrexed, and 75 mg/m2 cisplatin (cixutumumab [n = 87]) or pemetrexed and cisplatin (control [n = 85]). Eligible patients received pemetrexed-based maintenance therapy with cixutumumab (cixutumumab arm) or without it (control arm). The primary end point was progression-free survival. Secondary end points assessed overall survival, objective response rate, and safety. Survival was analyzed by the Kaplan-Meier method and Cox proportional hazard model. Exploratory correlative analyses were also performed. RESULTS The mean age of the intent-to-treat population (n = 172) was 59 years (range 32-83). Median progression-free survival was 5.45 months with cixutumumab versus 5.22 months in the control (hazard ratio = 1.15, 95% confidence interval: 0.81-1.61; p = 0.44). Median overall survival was 11.33 months with cixutumumab versus 10.38 months in the control (hazard ratio = 0.93, 95% confidence interval: 0.64-1.36). Objective response rate did not differ between treatments (p = 0.338). Grade 3 or 4 hyperglycemia occurred at a higher rate with cixutumumab than in the control (9.4% versus 1.2%). One death possibly related to cixutumumab occurred. CONCLUSIONS Efficacy was not improved in patients with nonsquamous NSCLC when cixutumumab was added to pemetrexed/cisplatin. Combination therapy was well tolerated and no new safety concerns were reported.
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Affiliation(s)
- Silvia Novello
- Department of Oncology, University of Turin, San Luigi Hospital, Turin, Italy.
| | - Giorgio Scagliotti
- Department of Oncology, University of Turin, San Luigi Hospital, Turin, Italy
| | - Gilberto de Castro
- Clinical Oncology Service, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Murat Kiyik
- Pulmonary Department, Yedikule Chest Disease Hospital, Istanbul, Turkey
| | | | | | | | | | - Ruslan D Novosiadly
- Department of Cancer Immunobiology, Eli Lilly and Company, New York, New York
| | - Tuan S Nguyen
- Statistics-Oncology Department, Eli Lilly and Company, Indianapolis, Indiana
| | - Amelie Forest
- Department of Cancer Immunobiology, Eli Lilly and Company, New York, New York
| | - Shande Tang
- Statistics-Oncology Department, Eli Lilly and Company, Bridgewater, New Jersey
| | | | - Jan Cosaert
- Clinical Sciences, Early Phase, Eli Lilly and Company, Bridgewater, New Jersey
| | - Martin Reck
- Department of Thoracic Oncology, Lung Clinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany
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