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Published on: December 5, 2017
Using antibody directed phototherapy to target oesophageal adenocarcinoma with heterogeneous HER2 expression
Hayley Pye1, Mohammed Adil Butt1,2, Laura Funnell1
1Department for Tissue and Energy, Division of Surgery and Interventional Science, University College London, London, UK.
Abstract:
Early oesophageal adenocarcinoma (OA) and pre-neoplastic dysplasia may be treated with endoscopic resection and ablative techniques such as photodynamic therapy (PDT). Though effective, discrete areas of disease may be missed leading to recurrence. PDT further suffers from the side effects of off-target photosensitivity. A tumour specific and light targeted therapeutic agent with optimised pharmacokinetics could be used to destroy residual cancerous cells left behind after resection. A small molecule antibody-photosensitizer conjugate was developed targeting human epidermal growth factor receptor 2 (HER2). This was tested in an in vivo mouse model of human OA using a xenograft flank model with clinically relevant low level HER2 expression and heterogeneity. In vitro we demonstrate selective binding of the conjugate to tumour versus normal tissue. Light dependent cytotoxicity of the phototherapy agent in vitro was observed. In an in vivo OA mouse xenograft model the phototherapy agent had desirable pharmacokinetic properties for tumour uptake and blood clearance time. PDT treatment caused tumour growth arrest in all the tumours despite the tumours having a clinically defined low/negative HER2 expression level. This new phototherapy agent shows therapeutic potential for treatment of both HER2 positive and borderline/negative OA.
Insights
A new antibody-photosensitizer drug effectively targets and destroys residual esophageal adenocarcinoma cells after resection. This targeted phototherapy shows promise for treating both HER2-positive and HER2-negative esophageal cancers.
Area of Science:
- Oncology
- Biotechnology
- Photodynamic Therapy
Background:
- Early esophageal adenocarcinoma (OA) and dysplasia are treated with endoscopic resection and photodynamic therapy (PDT).
- Current treatments may miss discrete disease areas, leading to recurrence, and PDT can cause off-target photosensitivity.
- A need exists for a tumor-specific, light-activated therapeutic agent with optimized pharmacokinetics to eliminate residual cancer cells.
Purpose of the Study:
- To develop and evaluate a novel small molecule antibody-photosensitizer conjugate targeting human epidermal growth factor receptor 2 (HER2).
- To assess the efficacy of this conjugate as a targeted phototherapy for esophageal adenocarcinoma in a preclinical mouse model.
Main Methods:
- Developed a small molecule antibody-photosensitizer conjugate targeting HER2.
- Tested the conjugate *in vitro* for selective binding to tumor versus normal tissue and for light-dependent cytotoxicity.
- Evaluated the agent's pharmacokinetic properties and therapeutic effect in an *in vivo* mouse xenograft model of human OA with low/heterogeneous HER2 expression.
Main Results:
- The conjugate demonstrated selective binding to tumor cells *in vitro*.
- Light-activated phototherapy with the agent showed cytotoxicity *in vitro*.
- The phototherapy agent exhibited favorable pharmacokinetics in the *in vivo* OA mouse model, leading to tumor growth arrest in all treated xenografts, irrespective of HER2 expression levels.
Conclusions:
- The novel antibody-photosensitizer conjugate is a promising therapeutic agent for esophageal adenocarcinoma.
- This targeted phototherapy demonstrates potential for treating both HER2-positive and HER2-low/negative OA, addressing limitations of current treatments.
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