Abstract 3582: Differentiation of niraparib and olaparib brain penetration in a mouse brain metastatic tumor model

Purpose: There remains an unmet need to provide effective treatment therapy for patients with primary and metastatic brain tumors; lack of drug penetration across the blood brain barrier (BBB) is a key factor. Synthetic lethality remains an attractive mechanism in treating brain tumors post radiotherapy. Here, we evaluated brain penetration and distribution of niraparib and olaparib in a mouse brain tumor model.

Experimental: Female mice (CrTac:NCr-Foxn1nu; 6 w/o) received 2.5E5 luciferase transfected human breast cancer line (MDA 231-BRM2-831) via intracardiac injection. Mice were imaged twice/week using bioluminescence imaging (BLI) to monitor tumor growth. On day 35, mice with brain metastases (BM) were treated via oral gavage once daily for 5 days with either niraparib (35 mg/kg, n=4 BM, n=3 control), olaparib (50 mg/kg, n=3 BM, n=3 control), or vehicle (n=3 control). Terminal blood samples and brains were collected 2 hr post final dose. Serial tissue sections were collected for MALDI-IMS, H&E and IHC staining from 5 distinct horizontal planes in the brain. Tissue collected between each imaging plane was homogenized for LC-MS bioanalysis.

Summary of Data: In vivo BLI imaging was used to identify mice with BM and tumor presence was confirmed ex vivo using IHC. Quantitative MALDI IMS of coronal brain sections collected from mice administered niraparib showed consistent concentrations distributed throughout the brain parenchyma with locally higher concentrations detected from tumor regions. Table 1 summarizes the LC-MS bioanalysis concentrations in plasma and bulk brain homogenates and brain section concentrations detected by MALDI IMS. The estimated mean unbound brain-to-plasma partition coefficient (Kp,uu,brain) was 3.0x and 5.6x higher for niraparib compared to olaparib in control and BM mice, respectively.

Conclusions: Herein, we demonstrated that niraparib has a higher brain penetration and distribution compared to olaparib in both control mice and mice with BM.

Summary of Quantification Results Displayed as Total Conc. with Adjusted Free Conc. in Parentheses Compound Group Terminal Plasma Mean (ng/mL) LC-MS Bulk Brain Homogenate Mean (ng/g) MALDI IMS Brain Section Mean (ng/g) Kp,uu Brain Niraparib Control 3847 (769) 658 (111) 532 (89) 0.18 Niraparib BM 2535 (507) 543 (91) 473 (80) 0.14 Niraparib Vehicle BLQ BLQ Olaparib Control 226 (68) 6 (2) BLQ 0.06 Olaparib BM 119 (36) 5 (2) BLQ 0.03 Olaparib Vehicle BLQ BLQ

Citation Format: Mark Reid Groseclose, Jeremy Barry, Tinamarie Skedzielewski, Gerald McDermott, Chakravarthi Balabhadrapatruni, Bill Benson, Yongle Pang, David K. Lim, Hoang Tran, Mike Ringenberg, Keyur Gada, Amine Aziez, Elaine Paul, Hasan Alsaid. Differentiation of niraparib and olaparib brain penetration in a mouse brain metastatic tumor model. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3582.

Detection of right atrial thrombus in a woman with pulmonary embolism and right heart compromise by bedside echocardiography

A 59-year-old female with a history of stage IV lung adenocarcinoma presented with worsening shortness of breath and cough over several weeks. She was tachycardic, hypotensive, and tachypneic. Portable chest x-ray suggested bilateral pleural effusions and computed tomography angiography (CTA) revealed bilateral pulmonary emboli (PE) with suspected right heart strain. Upon admission to the medical intensive care unit for treatment of PE, bedside echocardiography was performed to direct management. Indicators of cor pulmonale and right heart strain were apparent including right ventricle dilation, reduced tricuspid systolic excursion, and a deformed left ventricle with “D sign”. Most notably, a right atrial thrombus was detected, a finding not initially seen on CTA. Ultimately, prompt detection of the effects on the right ventricle by bedside echocardiography directed the next step in this patient's clinical course without delay.

Tissue distribution and brain penetration of niraparib in tumor bearing mouse models and its clinical relevance

e15066

Background: Cancer therapies that effectively cross the blood-brain barrier (BBB) to treat primary and metastatic brain tumors represent a critical unmet medical need. Brain metastasis are diagnosed in 10-40% of solid tumors and are associated with poor outcomes1. Preclinical data showed that niraparib has shown higher brain penetration as compared to other PARP inhibitors in an intact BBB setting2,3; however limited data is available to understand the penetration and residence of PARP inhibitors in a disrupted BBB setting. We conducted studies to assess the brain penetration of niraparib and olaparib in a disrupted BBB setting in an orthotopic animal tumor model. Additionally, we report tissue biodistribution of niraparib in a xenograft tumor mouse model. Methods: Brain penetration of niraparib and olaparib was assessed in GL261 orthotopic glioblastoma models. Niraparib and olaparib were dosed at 35 and 50 mg/kg once daily for 3-days, respectively. Brain tumor and contralateral normal brain region were excised following 3-day dosing. In a separate study niraparib tissue distribution in various organs was monitored in an ovarian (A2780) xenograft tumor mouse model. Several organs including tumors were excised following 5-day oral dosing of niraparib at 35mg/kg. Tissue samples were processed by homogenization followed by analysis using LC-MS/MS. Data were analyzed using non-compartmental analysis. Results: Mean drug concentrations at 2h post last dose in brain tumor region and normal contralateral brain region were 24µM and 2.15µM for niraparib compared with 0.7µM and 0.18µM for olaparib. Mean drug concentration at 24h post last dose in brain tumor region and normal contralateral region were 1.36µM and 0.53µM for niraparib compared with 0.17µM and 0.01µM for olaparib. In a A2780 xenograft tumor model tissue distribution study, niraparib demonstrated high levels of tissue penetration and retention in most perfused (lung, liver, kidney) and non-perfused tissues (tumor, ovary, pancreas). In most cases, tissues had at least 2-fold higher exposure than plasma at steady state following repeat oral dosing. Conclusions: Niraparib brain tumor tissue concentration was at least 25-fold greater than olaparib at 2h post dose. Data also suggests niraparib had better retention in brain tumor over olaparib with mean exposure as high as 1.4µM at 24h post dose (terminal phase) with just 3-days of dosing. These findings demonstrated that a favorable pharmacokinetic profile of niraparib was achieved in the disrupted BBB setting of the glioblastoma model. High penetration of niraparib in brain and other tissues along with a strong correlation with systemic exposures support the future investigation of niraparib in cancers with high incidence of brain metastasis. References: 1. Epidemiology, Biology, and Therapy; Chapter 1; 2015, Pages 3-29. 2. Oncotarget . 2018 Dec 14; 9(98): 37080–37096. 3. AACR 2019, Poster 3888.

Imaging doxorubicin and polymer-drug conjugates of doxorubicin-induced cardiotoxicity with bispecific anti-myosin-anti-DTPA antibody and Tc-99m-labeled polymers

BACKGROUND

Radiolabeled anti-myosin imaging is well-established for imaging doxorubicin-induced cardiotoxicity. However, to enable imaging of drug-induced cardiotoxicity in small experimental animals, pretargeting with bispecific anti-myosin-anti-DTPA-Fab-Fab' and targeting with high-specific radioactivity Tc-99m-DTPA-succinylated-polylysine (DSPL) was developed.

METHODS

Mice were injected biweekly with 10 mg/kg Dox or its equivalent as D-Dox-PGA. Tc-99m-DSPL myocardial activity after pretargeting with bsAb-Fab-Fab' was determined after gamma imaging performed at day 7 for Dox-treated mice and day 39 for all others.

RESULTS

Mice treated with 10 mg/kg Dox lost 10% total body weight in 1 week and 20% after a second dose. Pretargeted mice treated with 30 mg/kg cumulative D-Dox-PGA dose showed no loss of body weight for the duration of the study. Cardiotoxicity was confirmed by gamma imaging and scintillation counting (1.9 ± 0.25 [mean% ID/g ± SD]) after 1 dose of Dox. Mice injected with 3 × 10 mg/kg Dox equivalent as D-Dox-PGA (0.4 ± 0.04, P < .01) and untreated 2 control groups (0.20 ± 0.05 and 0.19 ± 0.04, P < .01) showed significantly lower myocardial anti-myosin radioactivity relative to the 10 mg/kg Dox group.

CONCLUSION

Pretargeting with bsAb-Fab-Fab' and targeting with Tc-99m labeled high-specific activity polymers enabled early visualization of doxorubicin induce cardiotoxicity in mice. Tolerated dose of D-Dox-PGA was greater than to 30 mg/kg Dox-equivalent dose with minimal cardiotoxicity.

Abstract 2952: Predicting concentration of PARP inhibitors in human tumor tissue using PBPK modeling

Poly (ADP-ribose) polymerase (PARP) inhibitors exert their effect intracellularly within tumor, thus sufficient tumor penetration is essential for a pharmacological response. Preclinical mouse xenograft data show a 3.3-fold higher tumor versus plasma exposure of niraparib, while for olaparib tumor exposure was less than plasma. This study aimed to build a physiologically-based pharmacokinetic (PBPK) model extended with a tissue composition-based permeability-limited tumor model to: (a) gain a mechanistic understanding of the differences in tumor exposure of niraparib and olaparib; and (b) to predict clinical tumor exposure in ovarian cancer patients at clinically relevant dosing regimens. A permeability-limited tumor model was developed that integrates data on tumor composition and drug physicochemical properties analogous to the established permeability-limited organ model available for the liver in the Simcyp Simulator [1,2]. The model assumes that unbound unionized drug is in equilibrium between the vascular and interstitial compartments and movement of the drug between the interstitial and intracellular space is via passive permeability. Total tumor concentration is dependent on passive permeability of the drug, drug binding to PARP and nonspecific binding to neutral lipids, neutral phospholipids, and acidic phospholipids in the intracellular space, albumin in the interstitial and pH of the tumor interstitial and intracellular spaces. Clinical and preclinical tumor physiological parameters such as volume, blood flow, and tissue composition are defined using published data. The model was developed using the Simcyp Simulator V17.1 and R [3]. Consistent with preclinical data, the model predicts a 5-7-fold higher tumor exposure relative to plasma, as measured by the AUC tumor to plasma ratio of niraparib compared with olaparib. Significant binding to acidic phospholipids contributes to the increased tumor exposure to niraparib, a basic drug, a mechanism that is not relevant to the neutral drug olaparib. Ongoing work aims to extrapolate the model to predict the clinical tumor concentration of olaparib and niraparib in ovarian cancer patients and to investigate the sensitivity of the model to key tumor attributes, including blood flow and interstitial pH that may contribute to variability in tumor drug exposure. A similar modeling approach may be used to predict the tumor exposure of other small molecule anticancer drugs from their plasma concentration and physicochemical properties in different types of solid tumor.

References

Jamei M et al, Clin Pharmacokinet. 2014;53:73-87

Poulin P et al, J Pharm Sci. 2015;104:1508-21

R Core Team (2018). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.

Citation Format: Rachel H. Rose, Kaiming Sun, Linzhong Li, Keyur Gada, Jing Yu Wang, Yongchang Qiu. Predicting concentration of PARP inhibitors in human tumor tissue using PBPK modeling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2952.

Abstract LB-069: In vivo delivery of asymmetric gene-silencing RNAs targeting CTNNB1 and PD-L1 show a broad spectrum of potent antitumor activities in preclinical cancer models

RNAi (RNA interference) technology has the potential to target any genes causing disease, including conventionally “undruggable” targets in cancer. We previously discovered aiRNA (asymmetric interfering RNA), a next generation of gene-silencing technology with improved gene silencing efficiency and reduced off-target effects in comparison with siRNA. We have recently developed a nanoscale formulation that encapsulates therapeutic aiRNAs targeting CTNNB1 and PD-L1, named BBI-801. Here we investigate the in vivo delivery and antitumor activity of BBI-801 encapsulating aiRNAs targeting CTNNB1 and PD-L1. CTNNB1 encodes undruggable β-catenin which is a cancer stemness gene that is broadly implicated in multiple cancer types PD-L1 gene encodes a key immune checkpoint factor that mediates cancer immune evasion. In our in vivo studies, we have achieved prolong silencing of β-Catenin/PD-L1 mRNA and protein in a dose-dependent manner in a wide variety of murine tumor models, including subcutaneous human tumor xenografts, orthotopic human liver and lung tumors, as well as syngeneic mouse colorectal, breast and lung tumors. Our biodistribution analysis of fluorescence-labeled aiRNA demonstrated that the delivery of BBI-801 to xenograft tumors happens within 5 minutes of aiRNA administration and lasts at least 8 hours. In all the models we examined, significant tumor growth inhibition by BBI-801 was achieved not only in β-Catenin over-expressed colorectal tumor models, SW480 and APCmin, but also in the rest of β-Catenin normal-expressed tumor models. Finally, BBI-801 is well tolerated and no signs of toxicity were observed after repeated dosing. These exciting data support further investigation of the anti-tumor potential of BBI-801 as an anticancer therapeutic in variety of tumor indications.

Citation Format: Youzhi Li, Yuan Gao, Yuxin Wang, Jie Su, Eric Hsu, Ewa Wybieralska, Janet Huang, Keyur Gada, Jun Oishi, Xiaoshu Dai, Erina Koga, Wei Li, Xiangao Sun, Emily Brooks, Chiang J. Li. In vivo delivery of asymmetric gene-silencing RNAs targeting CTNNB1 and PD-L1 show a broad spectrum of potent antitumor activities in preclinical cancer models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-069. doi:10.1158/1538-7445.AM2017-LB-069

Barriers and facilitators to dog walking in New England

Dog walking may increase physical activity among dogs and their owners. Understanding barriers and facilitators to walking the dog is critical to developing interventions to increase dog walking. This study aimed to confirm previously identified barriers and facilitators of dog walking, and to identify unique factors that may be relevant to dog walking in cities with variable weather. This mixed methods study used focus groups to identify barriers and facilitators associated with dog walking and a survey to examine which factors were associated with dog walking. Focus group participants described barriers, such as lack of time, weather, lack of places to walk and the dog's bad behaviour. Facilitators included enjoyment, dog walking norms (defined as the participant's perception of how much the veterinarian, other dog owners, and their family think they should walk the dog), and socialisation opportunities. A hierarchical regression analysis of survey data revealed that the participant's perception of dog walking norms was associated with increased frequency and duration of dog walking, while weather, work and family commitment barriers were associated with a reduced frequency and duration of dog walking. Family, community and veterinarian dog walking norms, inclement weather, and lack of time due to work obligations emerged as important correlates of dog walking. Interventions that aim to increase physical activity by encouraging dog walking may benefit from incorporating strategies that address facilitators (family support) and barriers (time and weather) to walking the dog.

Abstract LB-47: Specific and potent silencing of K-Ras by asymmetric RNA technology reveals addiction of gastric cancer stem cells

The protein K-Ras is a molecular switch that under normal conditions regulates cell growth and cell division. Mutations in this protein lead to the formation of tumors through continuous cell growth. About 30% of human cancers have a mutated Ras protein that is constitutively bound to GTP due to decreased GTPase activity and insensitivity to GAP action. Ras is also an important factor in many cancers in which it is not mutated but rather functionally activated through inappropriate activity of other signal transduction elements. Mutated K-Ras proteins are found in a large proportion of all tumour cells. K-Ras protein occupies a central position of interest. The identification of oncogenically mutated K-Ras in many human cancers led to major efforts to target this constitutively activated protein as a rational and selective treatment. Despite decades of active agent research, significant challenges still remain to develop therapeutic inhibitors of K-Ras.

To elucidate the function of K-Ras in the cancer development and maintenance, we developed asymmetric interfering RNAs (aiRNAs) which are able to silence target genes with high potency leading to long-lasting knockdown, and reducing off-target effects, and investigated the dependency of K-ras on cell survival in several types of human cancer cell lines. Much to our surprise, we found K-Ras plays a more significant role for gastric cancer maintenance compared to other types of cancer. Here we report aiRNA-induced silencing of K-Ras inhibited the cell proliferation of gastric cancer cells and the ability of gastric cancer cells to form colonies compared to other cancer types. Accumulating evidence has revealed that cancer stem cells (CSCs) are highly associated with prognosis, metastasis, and recurrence. To investigate the effect of K-Ras on CSCs, we tested the K-Ras gene silencing effects on an in vitro CSC culturing system. As a result, K-Ras inhibition decreased the colonies derived from gastric CSCs and altered the gene expression patterns of several genes involved in “stemness” compared to other cancer types. The results of these studies suggest that gastric cancer and gastric CSCs are affected by the K-Ras oncogene and that Kras aiRNAs are promising therapeutic candidates for the treatment of gastric cancer.

Citation Format: Xiangao Sun, Youzhi Li, Hiroki Umehara, Jun Oishi, Nithya Jesuraj, Jelena Barbulovic, Xiaoshu Dai, Keyur Gada, Chiang Li. Specific and potent silencing of K-Ras by asymmetric RNA technology reveals addiction of gastric cancer stem cells. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr LB-47. doi:10.1158/1538-7445.AM2014-LB-47

In vitro demonstration of enhanced prostate cancer toxicity: pretargeting with Bombesin bispecific complexes and targeting with polymer-drug-conjugates

BACKGROUND

Bombesin has been used to target Bombesin receptor, a growth receptor, which is over-expressed in many cancers, including prostate cancer. Polymer-anti-neoplastic-drug-conjugates (PDC) were also developed to reduce non-specific toxicity and increase tumor toxicity utilizing the enhanced permeability and retention effect, benefitting treatment of large tumors with well-established vasculature.

PURPOSE

If PDCs were delivered by targeted delivery to cancer cells, tumor toxicity would be enhanced and non-specific toxicity decreased.

METHODS

Cardiocyte toxicity was assessed in H9c2 cardiocytes with doxorubicin (Dox) or N-terminal DTPA-modified-Doxorubicin-loaded-polyglutamic acid polymers (D-Dox-PGA). Therapeutic efficacy of targeted D-Dox-PGA after pretargeting with Bombesin-conjugated anti-DTPA-antibody Bispecific Complexes (Bom-BiSpCx) was compared to that of Dox in PC3 cells. Bom-BiSpCx was generated by thioether bond between Bombesin to Anti-DTPA antibody.

RESULTS

D-Dox-PGA was demonstrated to have less cardiocyte toxicity (IC50 = 20 µg/ml) than free Dox (1.55 µg/ml, p < 0.001). However, after pre-targeting of human prostate cancer PC3 cells with Bom-BiSpCx and targeting with D-Dox-PGA, IC50 (13.2 µg/ml) was about two times less than that of Dox (28.5 µg/ml, p < 0.0001).

DISCUSSION

Targeted delivery of PDCs having lower cardiocyte toxicity enabled higher efficiency cancer cell therapy.

CONCLUSION

This study may allow development of very efficient targeted prostate cancer pro-drug therapy.

Imaging small human prostate cancer xenografts after pretargeting with bispecific bombesin-antibody complexes and targeting with high specific radioactivity labeled polymer-drug conjugates

PURPOSE

Pretargeting with bispecific monoclonal antibodies (bsMAb) for tumor imaging was developed to enhance target to background activity ratios. Visualization of tumors was achieved by the delivery of mono- and divalent radiolabeled haptens. To improve the ability to image tumors with bsMAb, we have combined the pretargeting approach with targeting of high specific activity radiotracer labeled negatively charged polymers. The tumor antigen-specific antibody was replaced with bombesin (Bom), a ligand that binds specifically to the growth receptors that are overexpressed by many tumors including prostate cancer. Bomanti- diethylenetriaminepentaacetic acid (DTPA) bispecific antibody complexes were used to demonstrate pretargeting and imaging of very small human prostate cancer xenografts targeted with high specific activity ¹¹¹In- or ⁹⁹mTc-labeled negatively charged polymers.

METHODS

Bispecific antibody complexes consisting of intact anti-DTPA antibody or Fab′ linked to Bom via thioether bonds (Bom-bsCx or Bom-bsFCx, respectively) were used to pretarget PC-3 human prostate cancer xenografts in SCID mice. Negative control mice were pretargeted with Bom or anti-DTPA Ab. 111In-Labeled DTPA-succinyl polylysine (DSPL) was injected intravenously at 24 h (7.03 ± 1.74 or 6.88 ± 1.89 MBq ¹¹¹In-DSPL) after Bom-bsCx or 50 ± 5.34 MBq of ⁹⁹mTc-DSPL after Bom-bsFCx pretargeting, respectively. Planar or single photon emission computed tomography (SPECT)/CT gamma images were obtained for up to 3 h and only planar images at 24 h. After imaging, all mice were killed and biodistribution of 111In or 99mTc activities were determined by scintillation counting.

RESULTS

Both planar and SPECT/CT imaging enabled detection of PC-3 prostate cancer lesions less than 1-2 mm in diameter in 1-3 h post 111In-DSPL injection. No lesions were visualized in Bom or anti-DTPA Ab pretargeted controls. 111In-DSPL activity in Bom-bsCx pretargeted tumors (1.21 ± 0.36 %ID/g) was 5.4 times that in tumors pretargeted with Bom or anti-DTPA alone (0.22 ± 0.08, p = 0.001). PC-3 xenografts pretargeted with Bom-bsFCx and targeted with ⁹⁹mTc-DSPL were visualizable by 1-3 h. Exquisite tumor uptake at 24 h (6.54 ± 1.58 %ID/g) was about 15 times greater than that of Bom pretargeted controls (0.44 ± 0.17, p = 0.002).

CONCLUSION

Pretargeting prostate cancer with Bom-bsCx or Bom-bsFCx enabled fast delivery of high specific radioactivity ¹¹¹In- or ⁹⁹mTc-labeled polymer-drug conjugates resulting in visualization of lesions smaller than 1- 2 mm in diameter within 3 h.