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Ab O, Whiteman KR, Bartle LM, Sun X, Singh R, Tavares D, LaBelle A, Payne G, Lutz RJ, Pinkas J, Goldmacher VS, Chittenden T, Lambert JM. IMGN853, a Folate Receptor-α (FRα)-Targeting Antibody-Drug Conjugate, Exhibits Potent Targeted Antitumor Activity against FRα-Expressing Tumors. Mol Cancer Ther 2015; 14:1605-13. [PMID: 25904506 DOI: 10.1158/1535-7163.mct-14-1095] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 04/10/2015] [Indexed: 11/16/2022]
Abstract
A majority of ovarian and non-small cell lung adenocarcinoma cancers overexpress folate receptor α (FRα). Here, we report the development of an anti-FRα antibody-drug conjugate (ADC), consisting of a FRα-binding antibody attached to a highly potent maytansinoid that induces cell-cycle arrest and cell death by targeting microtubules. From screening a large panel of anti-FRα monoclonal antibodies, we selected the humanized antibody M9346A as the best antibody for targeted delivery of a maytansinoid payload into FRα-positive cells. We compared M9346A conjugates with various linker/maytansinoid combinations, and found that a conjugate, now denoted as IMGN853, with the N-succinimidyl 4-(2-pyridyldithio)-2-sulfobutanoate (sulfo-SPDB) linker and N(2')-deacetyl-N(2')-(4-mercapto-4-methyl-1-oxopentyl)-maytansine (DM4) exhibited the most potent antitumor activity in several FRα-expressing xenograft tumor models. The level of expression of FRα on the surface of cells was a major determinant in the sensitivity of tumor cells to the cytotoxic effect of the conjugate. Efficacy studies of IMGN853 in xenografts of ovarian cancer and non-small cell lung cancer cell lines and of a patient tumor-derived xenograft model demonstrated that the ADC was highly active against tumors that expressed FRα at levels similar to those found on a large fraction of ovarian and non-small cell lung cancer patient tumors, as assessed by immunohistochemistry. IMGN853 displayed cytotoxic activity against FRα-negative cells situated near FRα-positive cells (bystander cytotoxic activity), indicating its ability to eradicate tumors with heterogeneous expression of FRα. Together, these findings support the clinical development of IMGN853 as a novel targeted therapy for patients with FRα-expressing tumors.
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Affiliation(s)
- Olga Ab
- Department of Cell Biology, ImmunoGen, Inc., Waltham, Massachusetts.
| | - Kathleen R Whiteman
- Department of Pharmacology Toxicology, ImmunoGen, Inc., Waltham, Massachusetts
| | - Laura M Bartle
- Department of Cell Biology, ImmunoGen, Inc., Waltham, Massachusetts
| | - Xiuxia Sun
- Department of Biochemistry, ImmunoGen, Inc., Waltham, Massachusetts
| | - Rajeeva Singh
- Department of Biochemistry, ImmunoGen, Inc., Waltham, Massachusetts
| | - Daniel Tavares
- Department of Antibody Engineering, ImmunoGen, Inc., Waltham, Massachusetts
| | - Alyssa LaBelle
- Department of Biomarkers, ImmunoGen, Inc., Waltham, Massachusetts
| | - Gillian Payne
- Department of Bioanalytical Science, ImmunoGen, Inc., Waltham, Massachusetts
| | - Robert J Lutz
- Department of Translational Research and Development, ImmunoGen, Inc., Waltham, Massachusetts
| | - Jan Pinkas
- Department of Pharmacology Toxicology, ImmunoGen, Inc., Waltham, Massachusetts
| | | | | | - John M Lambert
- Research and Development, ImmunoGen, Inc., Waltham, Massachusetts
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Necela BM, Crozier JA, Andorfer CA, Lewis-Tuffin L, Kachergus JM, Geiger XJ, Kalari KR, Serie DJ, Sun Z, Aspita AM, O’Shannessy DJ, Maltzman JD, McCullough AE, Pockaj BA, Cunliffe HE, Ballman KV, Thompson EA, Perez EA. Folate receptor-α (FOLR1) expression and function in triple negative tumors. PLoS One 2015; 10:e0122209. [PMID: 25816016 PMCID: PMC4376802 DOI: 10.1371/journal.pone.0122209] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/10/2015] [Indexed: 12/23/2022] Open
Abstract
Folate receptor alpha (FOLR1) has been identified as a potential prognostic and therapeutic target in a number of cancers. A correlation has been shown between intense overexpression of FOLR1 in breast tumors and poor prognosis, yet there is limited examination of the distribution of FOLR1 across clinically relevant breast cancer subtypes. To explore this further, we used RNA-seq data from multiple patient cohorts to analyze the distribution of FOLR1 mRNA across breast cancer subtypes comprised of estrogen receptor positive (ER+), human epidermal growth factor receptor positive (HER2+), and triple negative (TNBC) tumors. FOLR1 expression varied within breast tumor subtypes; triple negative/basal tumors were significantly associated with increased expression of FOLR1 mRNA, compared to ER+ and HER2+ tumors. However, subsets of high level FOLR1 expressing tumors were observed in all clinical subtypes. These observations were supported by immunohistochemical analysis of tissue microarrays, with the largest number of 3+ positive tumors and highest H-scores of any subtype represented by triple negatives, and lowest by ER+ tumors. FOLR1 expression did not correlate to common clinicopathological parameters such as tumor stage and nodal status. To delineate the importance of FOLR1 overexpression in triple negative cancers, RNA-interference was used to deplete FOLR1 in overexpressing triple negative cell breast lines. Loss of FOLR1 resulted in growth inhibition, whereas FOLR1 overexpression promoted folate uptake and growth advantage in low folate conditions. Taken together, our data suggests patients with triple negative cancers expressing high FOLR1 expression represent an important population of patients that may benefit from targeted anti-FOLR1 therapy. This may prove particularly helpful for a large number of patients who would typically be classified as triple negative and who to this point have been left without any targeted treatment options.
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Affiliation(s)
- Brian M. Necela
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
| | - Jennifer A. Crozier
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Cathy A. Andorfer
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
| | - Laura Lewis-Tuffin
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
| | - Jennifer M. Kachergus
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
| | - Xochiquetzal J. Geiger
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Krishna R. Kalari
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Daniel J. Serie
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida United States of America
| | - Zhifu Sun
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Alvaro Moreno Aspita
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Daniel J. O’Shannessy
- Department of Translational Medicine and Diagnostics, Morphotek, Exton, Pennsylvania, United States of America
| | - Julia D. Maltzman
- Department of Clinical Development, Morphotek, Exton, Pennsylvania, United States of America
| | - Ann E. McCullough
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Barbara A. Pockaj
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Arizona, United States of America
| | - Heather E. Cunliffe
- Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Karla V. Ballman
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - E. Aubrey Thompson
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
- * E-mail:
| | - Edith A. Perez
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United Sates of America
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103
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Srinivasarao M, Galliford CV, Low PS. Principles in the design of ligand-targeted cancer therapeutics and imaging agents. Nat Rev Drug Discov 2015; 14:203-19. [DOI: 10.1038/nrd4519] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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104
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Assessment of Folate Receptor-α and Epidermal Growth Factor Receptor Expression in Pemetrexed-Treated Non–Small-Cell Lung Cancer Patients. Clin Lung Cancer 2014; 15:320-30.e1-3. [DOI: 10.1016/j.cllc.2014.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/08/2014] [Accepted: 05/19/2014] [Indexed: 11/21/2022]
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105
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Bai LX, Ding L, Jiang SW, Kang HJ, Gao CF, Chen C, Zhou Q, Wang JT. Down-regulation of FRα Inhibits Proliferation and Promotes Apoptosis of Cervical Cancer Cells in Vitro. Asian Pac J Cancer Prev 2014; 15:5667-72. [DOI: 10.7314/apjcp.2014.15.14.5667] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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106
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Zhang Z, Wang J, Tacha DE, Li P, Bremer RE, Chen H, Wei B, Xiao X, Da J, Skinner K, Hicks DG, Bu H, Tang P. Folate receptor α associated with triple-negative breast cancer and poor prognosis. Arch Pathol Lab Med 2013; 138:890-5. [PMID: 24028341 DOI: 10.5858/arpa.2013-0309-oa] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Folate receptor α (FRA) has been shown to be selectively expressed in several types of human cancer, including breast cancer. Currently, several FRA target therapies are under intensive study. OBJECTIVE To investigate the expression pattern of FRA in a large cohort of patients with breast cancer and analyze its relationship with different clinicopathologic features, with expression of several key biomarkers, and with clinical outcome. DESIGN Four hundred forty-seven cases of infiltrating ductal carcinoma diagnosed between 1997 and 2008 at the University of Rochester Medical Center were identified and reviewed, and 25 blocks of tissue microassays were constructed. The association between expression of FRA and clinicopathologic features; expression of estrogen receptor (ER), progesterone receptor (PR), HER2/neu, and Ki-67; and clinical outcome of these tumors were evaluated. RESULTS The expression of FRA was significantly associated with tumors with high histologic grade, higher nodal stages, ER/PR negativity, and high proliferative activity (Ki-67 ≥ 15%), and was independent of HER2/neu overexpression. In all, 74% of ER/PR-negative and 80% of triple-negative breast cancers expressed FRA. The expression of FRA was significantly associated with a worse disease-free survival. CONCLUSIONS Our data demonstrate that a significant subgroup of ER/PR-negative and triple-negative breast cancers express FRA, and its expression is associated with worse clinical outcome.
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Affiliation(s)
- Zhang Zhang
- From the Department of Pathology, West China Hospital, Sichuan University, Chengdu, China (Drs Zhang, Chen, Wei, and Bu); RTI Health Solution, Research Triangle Park, North Carolina (Dr Wang); Biocare, Inc, Concord, California (Drs Tacha and Bremer); the Departments of Surgical Oncology (Drs Li and Skinner) and Pathology (Drs Hicks and Tang), University of Rochester Medical Center, Rochester, New York; the Department of Pathology, Luzhou Medical College, Luzhou, China (Dr Xiao); and the Department of Pathology, Japan-China Friendship Hospital, Beijing, China (Dr Da)
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Gamage DG, Hendrickson TL. GPI Transamidase and GPI anchored proteins: Oncogenes and biomarkers for cancer. Crit Rev Biochem Mol Biol 2013; 48:446-64. [DOI: 10.3109/10409238.2013.831024] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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108
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O'Shannessy DJ, Somers EB, Palmer LM, Thiel RP, Oberoi P, Heath R, Marcucci L. Serum folate receptor alpha, mesothelin and megakaryocyte potentiating factor in ovarian cancer: association to disease stage and grade and comparison to CA125 and HE4. J Ovarian Res 2013; 6:29. [PMID: 23590973 PMCID: PMC3640997 DOI: 10.1186/1757-2215-6-29] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/09/2013] [Indexed: 12/24/2022] Open
Abstract
Background Evaluate and compare the utility of serum folate receptor alpha (FRA) and megakaryocyte potentiating factor (MPF) determinations relative to serum CA125, mesothelin (MSLN) and HE4 for the diagnosis of epithelial ovarian cancer (EOC). Methods Electrochemiluminescent assays were developed for FRA, MSLN and MPF and used to assess the levels of these biomarkers in 258 serum samples from ovarian cancer patients. Commercial assays for CA125 and HE4 were run on a subset of 176 of these samples representing the serous histology. Data was analyzed by histotype, stage and grade of disease. A comparison of the levels of the FRA, MSLN and MPF biomarkers in serum, plasma and urine was also performed in a subset of 57 patients. Results Serum and plasma levels of FRA, MSLN and MPF were shown to be highly correlated between the two matrices. Correlations between all pairs of markers in 318 serum samples were calculated and demonstrated the highest correlation between HE4 and MPF, and the lowest between FRA and MPF. Serum levels of all markers showed a dependence on both stage and grade of disease. A multi-marker logistic regression model was developed resulting in an AUC=0.91 for diagnosis of serous ovarian cancer, a significant improvement over the AUC for any of the individual markers, including CA125 (AUC=0.84). Conclusions FRA has significant potential as a biomarker for ovarian cancer, both as a stand-alone marker and in combination with other known markers for EOC. The lack of correlation between the various markers analyzed in the present study suggests that a panel of markers can aid in the detection and/or monitoring of this disease.
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Affiliation(s)
- Daniel J O'Shannessy
- Department of Diagnostics Development, Morphotek, Inc,, 210 Welsh Pool Road, Exton, PA, USA.
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Bremer RE, Scoggin TS, Somers EB, O'Shannessy DJ, Tacha DE. Interobserver Agreement and Assay Reproducibility of Folate Receptor α Expression in Lung Adenocarcinoma: A Prognostic Marker and Potential Therapeutic Target. Arch Pathol Lab Med 2013; 137:1747-52. [DOI: 10.5858/arpa.2013-0039-oa] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Lung cancer is the leading cause of cancer deaths in the United States and globally. Folate-targeted drugs are among the promising new targeted therapies for lung cancer, provided predictive biomarkers can be identified for optimal patient selection.
Objective.—To evaluate the interobserver agreement and reproducibility of an immunohistochemistry assay for folate receptor α as a potential predictive marker for folate-targeted therapies.
Design.—Immunohistochemistry using anti–folate receptor α antibody 26B3 was performed on formalin-fixed, paraffin-embedded tissues. The M-score, a semiquantitative measure of staining intensity and proportion of tumor cells staining, was determined for each specimen. Interobserver agreement was assessed using lung adenocarcinoma specimens stained at a single site and evaluated by 3 independent pathologists. Interinstrument reproducibility assessed 20 specimens stained by 3 different automated stainers. Interlaboratory agreement was determined on 5 specimens, repeatedly stained on each of 5 days, at 3 different study sites.
Results.—Folate receptor α expression was identified in 39 of 54 cases of lung adenocarcinoma (72%) and 4 of 37 cases of lung squamous cell carcinoma (11%). Agreement among 3 pathologists was found in 24 of 26 cases (92%). Interinstrument reproducibility was observed in 19 of 20 cases (95%). Agreement among 3 laboratories was found for 49 of 50 specimens (98%).
Conclusions.—Immunostaining of folate receptor α in lung adenocarcinomas is reproducible across staining platforms and among laboratories. Agreement among pathologists is achieved using a semiquantitative scoring method. An accurate and convenient method for determining folate receptor α expression offers a potentially invaluable tool for selecting patients for folate-targeted therapies.
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Affiliation(s)
- Ryan E. Bremer
- From the Department of Research & Development, Biocare Medical LLC, Concord, California (Drs Bremer and Tacha and Ms Scoggin); and the Department of Diagnostic Development, Morphotek Inc, Exton, Pennsylvania (Ms Somers and Dr O'Shannessy)
| | - Tatiana S. Scoggin
- From the Department of Research & Development, Biocare Medical LLC, Concord, California (Drs Bremer and Tacha and Ms Scoggin); and the Department of Diagnostic Development, Morphotek Inc, Exton, Pennsylvania (Ms Somers and Dr O'Shannessy)
| | - Elizabeth B. Somers
- From the Department of Research & Development, Biocare Medical LLC, Concord, California (Drs Bremer and Tacha and Ms Scoggin); and the Department of Diagnostic Development, Morphotek Inc, Exton, Pennsylvania (Ms Somers and Dr O'Shannessy)
| | - Daniel J. O'Shannessy
- From the Department of Research & Development, Biocare Medical LLC, Concord, California (Drs Bremer and Tacha and Ms Scoggin); and the Department of Diagnostic Development, Morphotek Inc, Exton, Pennsylvania (Ms Somers and Dr O'Shannessy)
| | - David E. Tacha
- From the Department of Research & Development, Biocare Medical LLC, Concord, California (Drs Bremer and Tacha and Ms Scoggin); and the Department of Diagnostic Development, Morphotek Inc, Exton, Pennsylvania (Ms Somers and Dr O'Shannessy)
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Folate receptor alpha (FRA) expression remains unchanged in epithelial ovarian and endometrial cancer after chemotherapy. Gynecol Oncol 2013; 130:192-9. [PMID: 23558051 DOI: 10.1016/j.ygyno.2013.03.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/21/2013] [Accepted: 03/23/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Based on its expression profile, folate receptor alpha (FRA) is an attractive candidate for targeted diagnostics and therapeutics. However, applicability of these agents in residual or recurrent disease could be influenced by chemotherapy. We evaluated whether chemotherapy modified FRA expression in non-mucinous epithelial ovarian (EOC) and endometrial carcinoma (EC). METHODS FRA staining was evaluated by immunohistochemistry, using MAb 26B3, in 81 patients (41 EOCs and 40 ECs) and 17 control tissues (5 benign ovarian cysts, 5 normal ovarian, and 7 normal endometrial tissues). Chemotherapy effect was evaluated in 42 patients (30 paired samples at primary and interval debulking surgery and 12 from primary and recurrent disease). FRA expression was assessed using a semi-quantitative staining algorithm, the M-score (range 0-50). RESULTS Median difference in M-score between tumor and control samples was 27.5 for EOC (95% CI 10.0 to 45.0) and 6.7 for EC (95% CI -6.7 to 21.7). Paired samples from both primary and interval debulking surgery did not differ in FRA expression in EOC (median difference of M-score between paired samples of 0.0 [95% CI -2.6 to 2.6]). Recurrent EOC tumors reflected FRA status at diagnosis (median difference of M-score between paired samples of 3.3 [95% CI -7.0 to 13.6]). CONCLUSIONS This study shows no significant difference in FRA expression after chemotherapy, strengthening the rationale for FRA targeted diagnostics and therapeutics in FRA expressing tumors, whether newly diagnosed or at recurrence.
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