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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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LoRusso PM, Gounder M, Jalal SI, André V, Kambhampati SRP, Loizos N, Hall J, Holzer TR, Nasir A, Cosaert J, Kauh J, Chiorean EG. Phase 1 study of narnatumab, an anti-RON receptor monoclonal antibody, in patients with advanced solid tumors. Invest New Drugs 2017; 35:442-450. [PMID: 28161886 DOI: 10.1007/s10637-016-0413-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 09/08/2016] [Accepted: 11/22/2016] [Indexed: 01/21/2023]
Abstract
Purpose Macrophage-stimulating 1-receptor (RON) is expressed on macrophages, epithelial cells, and a variety of tumors. Narnatumab (IMC-RON8; LY3012219) is a neutralizing monoclonal antibody that blocks RON binding to its ligand, macrophage-stimulating protein (MSP). This study assessed safety, maximum tolerated dose (MTD), pharmacokinetics, pharmacodynamics, and efficacy of narnatumab in patients with advanced solid tumors. Methods Narnatumab was administered intravenously weekly at 5, 10, 15, or 20 mg/kg or every 2 weeks at 15, 20, 30, or 40 mg/kg in 4-week cycles. Results Thirty-nine patients were treated, and 1 dose-limiting toxicity (DLT) (grade 3 hyponatremia, 5 mg/kg) was reported. The most common narnatumab-related adverse events (AEs) were fatigue (20.5%) and decreased appetite, diarrhea, nausea, and vomiting (10.3% each). Except for 2 treatment-related grade 3 AEs (hyponatremia, hypokalemia), all treatment-related AEs were grade 1 or 2. Narnatumab had a short half-life (<7 days). After Cycle 2, no patients had concentrations above 140 μg/mL (concentration that demonstrated antitumor activity in animal models), except for 1 patient receiving 30 mg/kg biweekly. Eleven patients had a best response of stable disease, ranging from 6 weeks to 11 months. Despite only 1 DLT, due to suboptimal drug exposure, the dose was not escalated beyond 40 mg/kg biweekly. This decision was based on published data reporting that mRNA splice variants of RON are highly prevalent in tumors, accumulate in cytoplasm, and are not accessible by large-molecule monoclonal antibodies. Conclusions Narnatumab was well tolerated and showed limited antitumor activity with this dosing regimen.
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Affiliation(s)
- Patricia M LoRusso
- Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA. .,Yale Cancer Center, New Haven, CT, USA.
| | - Mrinal Gounder
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shadia I Jalal
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | | | | | - Nick Loizos
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Jennifer Hall
- Eli Lilly and Company, Indianapolis, IN, USA.,Boehringer Ingelheim, Ridgefield, CT, USA
| | | | - Aejaz Nasir
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Jan Cosaert
- Eli Lilly and Company, Indianapolis, IN, USA.,Merck KGaA, Darmstadt, Germany
| | - John Kauh
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Gabriela Chiorean
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
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Abstract
Introduction: Attrition in clinical development is widely recognised as a key factor negatively impacting overall R&D efficiency. Gaining an understanding of the reasons for candidate failure may lead to improvements in success rates and return on R&D investment. Areas covered: This report provides an analysis of reasons for discontinuation of development of 40 drugs dropped from the global oncology pipeline in 2013 - the largest number of terminations reported since this annual analysis began in 2005. The article also provides discussion on the observations in the context of contemporary views of anticancer drug development. Expert opinion: Twelve drugs (30% of the 2013 discontinuations) failed in Phase III development. None of the pivotal trials investigating these agents incorporated molecular biomarkers for patient stratification. The largest number of drug terminations (20 out of 40) occurred in Phase I development with reasons for termination commonly reported as strategic or undisclosed. Raising the bar in terms of requirements for progression from preclinical development, including the identification of robust pharmacodynamic biomarkers and biomarkers potentially predictive of clinical benefit may lead to an increase in success rates in clinical development and of overall R&D efficiency.
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Affiliation(s)
- Robert Williams
- Drug Development Office, Cancer Research UK , Angel Building, 407 St John Street, London EC1V 4AD , UK +44 203 469 6900 ;
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