1
|
Laterza MM, Ciaramella V, Facchini BA, Franzese E, Liguori C, De Falco S, Coppola P, Pompella L, Tirino G, Berretta M, Montella L, Facchini G, Ciardiello F, de Vita F. Enhanced Antitumor Effect of Trastuzumab and Duligotuzumab or Ipatasertib Combination in HER-2 Positive Gastric Cancer Cells. Cancers (Basel) 2021; 13:cancers13102339. [PMID: 34066144 PMCID: PMC8150287 DOI: 10.3390/cancers13102339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 03/29/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/31/2022] Open
Abstract
Simple Summary The ToGA trial has demonstrated, in HER2-expressing patients, that unresectable and advanced gastric cancer, chemotherapy and trastuzumab in combination increase overall survival, even if it is still unclear why after one year the same patients are non-responsive to trastuzumab treatment. Here, we have demonstrated that in HER2-positive gastric cancer cell lines, the addition of duligotuzumab, targeting HER3 receptor, or ipatasertib, targeting AKT protein, enhances the antitumor effect of trastuzumab in vitro through a full inhibition of the membrane signals, on HER2 and HER3, and of downstream signaling, including AKT, and MAPK pathways. Hence, this study suggests a novel and biomarker-driven therapeutic strategy supporting further evaluation of the anti-tumor efficacy of these combinations in HER2 human gastric cancer patients. Abstract The anti-HER2 monoclonal antibody trastuzumab is a key drug for the treatment of HER2-positive gastric cancer (GC); however, its activity is often limited by the onset of resistance and mechanisms of resistance are still poorly understood. Several targeted agents showed synergistic activity by concomitant use with trastuzumab in vitro and are under clinical investigation. The aim of this study was to assess the antitumor activity of duligotuzumab, an anti HER3/EGFR antibody or ipatasertib, an AKT inhibitor, combined with trastuzumab in a panel of HER2-positive human gastric cancer cells (GCC), and the efficacy of such combinations in HER2-resistant cells. We have assessed the efficacy of duligotuzumab or ipatasertib and trastuzumab in combination, analyzing proliferation, migration and apoptosis and downstream intracellular signaling in vitro on human HER2-positive GCC (NCI-N87, OE33, OE19) and in negative HER2 GCC (MKN28). We observed a reduction of proliferation, migration and apoptotic rate in HER2-positive OE33, OE19 and N87 cell lines with the combination of duligotuzumab or ipatasertib plus trastuzumab. In particular, in OE33 and OE19 cell lines, the same combined treatment inhibited the activation of proteins downstream of HER2, HER3, AKT and MAPK pathways. Targeting both HER2 and HER3, or HER2 and AKT, results in an improved antitumor effect on HER2-positive GCC.
Collapse
Affiliation(s)
- Maria Maddalena Laterza
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
- Correspondence:
| | - Vincenza Ciaramella
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| | - Bianca Arianna Facchini
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| | - Elisena Franzese
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Carmela Liguori
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Stefano De Falco
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Paola Coppola
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Luca Pompella
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| | - Giuseppe Tirino
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
| | - Liliana Montella
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Gaetano Facchini
- UOC Oncologia, ASL Napoli 2 Nord, P.O. “S.M. delle Grazie”, Pozzuoli-Ischia, 80078 Napoli, Italy; (E.F.); (C.L.); (S.D.F.); (P.C.); (L.M.); (G.F.)
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| | - Ferdinando de Vita
- Department of Precision Medicine, University of Campania ‘Luigi Vanvitelli’, 81100 Napoli, Italy; (V.C.); (B.A.F.); (L.P.); (G.T.); (F.C.); (F.d.V.)
| |
Collapse
|
2
|
Fayette J, Wirth L, Oprean C, Udrea A, Jimeno A, Rischin D, Nutting C, Harari PM, Csoszi T, Cernea D, O'Brien P, Hanley WD, Kapp AV, Anderson M, Penuel E, McCall B, Pirzkall A, Vermorken JB. Randomized Phase II Study of Duligotuzumab (MEHD7945A) vs. Cetuximab in Squamous Cell Carcinoma of the Head and Neck (MEHGAN Study). Front Oncol 2016; 6:232. [PMID: 27843803 PMCID: PMC5086582 DOI: 10.3389/fonc.2016.00232] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/14/2016] [Indexed: 01/02/2023] Open
Abstract
Background Duligotuzumab, a novel dual-action humanized IgG1 antibody that blocks ligand binding to epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 3 (HER3), inhibits signaling from all ligand-dependent HER dimers, and can elicit antibody-dependent cell-mediated cytotoxicity. High tumor-expression of neuregulin 1 (NRG1), a ligand to HER3, may enhance sensitivity to duligotuzumab. Methods This multicenter, open-label, randomized phase II study (MEHGAN) evaluated drug efficacy in patients with recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) progressive on/after chemotherapy and among patients with NRG1-high tumors. Patients received duligotuzumab (1100 mg IV, q2w) or cetuximab (400 mg/m2 load, 250 mg/m2 IV, q1w) until progression or intolerable toxicity. Tumor samples were assayed for biomarkers [NRG1, ERBB3, and human papillomavirus (HPV) status]. Results Patients (N = 121) were randomized (duligotuzumab:cetuximab; 59:62), median age 62 years; ECOG 0–2. Both arms (duligotuzumab vs. cetuximab, respectively) showed comparable progression-free survival [4.2 vs. 4.0 months; HR: 1.23 (90% confidence interval (CI): 0.89–1.70)], overall survival [7.2 vs. 8.7 months; HR 1.15 (90% CI: 0.81–1.63)], and objective response rate (12 vs. 14.5%), with no difference between patients with NRG1-high tumors or ERBB3-low tumors. Responses in both arms were confined to HPV-negative patients. Grade ≥3 adverse events (AEs) (duligotuzumab vs. cetuximab, respectively) included infections (22 vs. 11.5%) and GI disorders (17 vs. 7%), contributing to higher rates of serious AEs (41 vs. 29.5%). Metabolic disorders were less frequent with duligotuzumab (10 vs. 16%); any grade rash-related events were less with duligotuzumab (49 vs. 67%). Conclusion While several lines of preclinical evidence had supported the premise that the blockade of HER3 in addition to that of EGFR may improve outcomes for patients with R/M SCCHN overall or specifically in those patients whose tumors express high levels of NRG1, this study provided definitive clinical evidence refuting this hypothesis. Duligotuzumab did not improve patient outcomes in comparison to cetuximab despite frequent expression of NRG1. These data indicate that inhibition of EGFR alone is sufficient to block EGFR–HER3 signaling, suggesting that HER2 plays a minimal role in this disease. Extensive biomarker analyses further show that HPV-negative SCCHN but not HPV-positive SCCHN are most likely to respond to EGFR blockage by cetuximab or duligotuzumab.
Collapse
Affiliation(s)
| | - Lori Wirth
- Massachusetts General Hospital , Boston, MA , USA
| | | | | | | | - Danny Rischin
- Peter MacCallum Cancer Centre, University of Melbourne , Melbourne, VIC , Australia
| | - Christopher Nutting
- Royal Marsden NHS Trust, The Institute of Cancer Research London , Sutton , UK
| | - Paul M Harari
- University of Wisconsin Hospital and Clinics , Madison, WI , USA
| | - Tibor Csoszi
- Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház , Szolnok , Hungary
| | - Dana Cernea
- Institutul Oncologic Prof. Dr. Ion Chiricuta Cluj-Napoca , Cluj-Napoca , Romania
| | - Paul O'Brien
- Medical University of South Carolina , Charleston, SC , USA
| | | | - Amy V Kapp
- Genentech , South San Francisco, CA , USA
| | | | | | | | | | | |
Collapse
|