WO2001062281A1 - Pai-2 conjugates for the treatment and imaging of cancer - Google Patents
Pai-2 conjugates for the treatment and imaging of cancer Download PDFInfo
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- WO2001062281A1 WO2001062281A1 PCT/AU2001/000185 AU0100185W WO0162281A1 WO 2001062281 A1 WO2001062281 A1 WO 2001062281A1 AU 0100185 W AU0100185 W AU 0100185W WO 0162281 A1 WO0162281 A1 WO 0162281A1
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- pai
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- radioisotope
- toxin
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/81—Protease inhibitors
- C07K14/8107—Endopeptidase (E.C. 3.4.21-99) inhibitors
- C07K14/811—Serine protease (E.C. 3.4.21) inhibitors
- C07K14/8121—Serpins
- C07K14/8132—Plasminogen activator inhibitors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
- A61P35/04—Antineoplastic agents specific for metastasis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
Definitions
- the present invention relates to a method of treating a condition in a mammal, which condition is characterised by the undesirable, detrimental or otherwise unwanted growth of uPAR expressing cells and agents useful for same. More particularly, the present invention contemplates a method of treating said condition by specifically targeting the subject cells utilising plasminogen activator inhibitor or functional derivative, equivalent, homologue, analogue or mimetic thereof coupled to a toxin such as an alpha particle emitting radioisotope.
- the method of the present invention is useful, inter alia, in the targeted treatment of conditions such as neoplasms and, in particular, metastatic cancers.
- the invention also relates to toxin labelled plasminogen activator inhibitor molecules, pharmaceutical compositions comprising same and methods for their manufacture .
- the invention further relates to the detection or visualisation of tumors with labelled plasminogen activator inhibitor molecules.
- the acquisition of the malignant phenotype involves a number of initiation and progression factors linked together in a multistep process (Meyer and Hart 1998: Haber and Fearon, 1998). Malignant tumours are potentially lethal because of the ability of cells within the tumour to invade and spread (metastasise) throughout the body (Meyer and Hart 1998).
- the process of metastasis can be summarised in the following steps: escape of tumour cells from a primary tumour mass and invasion into surrounding histologically normal tissue, intravasation and extravasation (entry into and exit from the vasculature or lymphatic system), and growth and survival (via angiogenesis) of tumour cells at a secondary site.
- Urokinase plasminogen activator plays a role in tumour angiogenesis and metastatic cell migration; both of which are processes that require tissue barriers to be breached (reviewed in Andreasen et al., 1997). Under normal physiological conditions, most cells express very little or no uPA (Pollanen et al , 1991). Urokinase plasminogen activator converts zymogen plasminogen into the highly active protease plasmin, which has broad specificity towards integral extracellular matrix (ECM) molecules (eg: type IV collagen, vitronectin, proteoglycan, fibronectin and laminin) (Pollanen et al, 1991).
- ECM integral extracellular matrix
- Plasmin also contributes to ECM remodelling by activating zymogen metalloproteases (MMPs) which more thoroughly degrade the collagen structural components (Pollanen et al. , 1991). While plasminogen can also be converted to plasmin by tissue plasminogen activator (tPA), tPA is primarily responsible for fibronolysis (Lijnen and Collen, 1982; Pollanen et al., 1991). In contrast uPA is primarily involved in pericellular proteolysis as it binds to its specific cell-surface receptor uPAR (Pollanen et al, 1991).
- MMPs zymogen metalloproteases
- uPA and plasmin are physiologically inhibited by the serpins plasminogen activator inhibitors type 1 and 2 (PAI-1 and PAI-2) and alpha 2-antiplasmin, respectively (Pollanen et al , 1991).
- PAI-1 and PAI-2 serpins plasminogen activator inhibitors type 1 and 2
- PAI-2 and PAI-2 alpha 2-antiplasmin, respectively
- MMP-9 MMP-9
- the antibodies which have been utilised in such treatments have been of mouse origin or have been "humanised” mouse antibodies.
- the use of such antibodies has led to immunological complications associated with the HAMA response. That is. repeated dosing of humans with murine antibodies, such as humanised antibodies, has led to the development of anti-murine antibodies thereby causing both rapid clearance of the murine antibodies and the production of immune complexes which cause the HAMA response.
- the antibody-cell surface molecule complexes are often internalised. Accordingly, the toxin which is coupled to the subject antibody is less effective.
- prior art radiocolloid therapy is not suitable for adjunctive therapy as it is not selective of cancer cells.
- beta and gamma emitting radionuciides have been coupled to specific monoclonal antibodies, problems have been experienced with most of the dose leaving the cancer cell. Therefore, therapeutic doses cannot be achieved without inducing severe complications.
- PAI plasminogen activator inhibitors
- PAI-2 plasminogen activator inhibitors
- the inventors have determined that the coupling of an alpha particle emitting radioisotope to PAI-2 does not inhibit binding of PAI-2 to uPA and still further, that the labelled PAI-2-uPA/uPAR complex is internalised by the targeted cell thereby providing maximal impact of the high energy radioactive emission on the target cell and minimal impact on proximal cells.
- a first aspect of the present invention is directed to a method of treating a condition in a mammal, which condition is characterised by the undesirable, detrimental or otherwise unwanted growth of cells expressing a uPA/uPAR complex, said method comprising administering to said mammal an effective amount of PAI or functional derivative, equivalent, homologue, analogue or mimetic thereof, which PAI is bound, linked or otherwise associated with a toxin, for a time and under conditions sufficient to down-regulate the growth of said cells.
- the plasminogen activator inhibitor is PAI-2.
- the toxin is a radioisotope. and more preferably is an alpha particle emitting radioisotope which includes, but is not limited to, Tb-149 or Bi-213. More preferably the alpha particle emitting radioisotope is Bi-213.
- the subject cell growth is proliferation, and the subject down- regulation is killing off the proliferating cells.
- the condition being treated is preferably cancer, more preferably a metastatic cancer which includes, but is not limited to. breast cancer, prostatic cancer and/or colorectal cancer.
- the present invention contemplates a method of down- regulating the growth of cells expressing a uPA/uPAR complex, said method comprising contacting said cells with an effective amount of PAI or functional derivative, equivalent, homologue. analogue or mimetic thereof, which PAI is bound, linked or otherwise associated with a toxin.
- said PAI is PAI-2, whilst said toxin is preferably an alpha particle emitting radioisotope.
- the subject cell growth is proliferation, and the subject down- regulation is killing off the proliferating cells.
- the present invention relates to the use of PAI or functional derivative, equivalent, homologue. analogue or mimetic thereof, which PAI is bound, linked or otherwise associated with a toxin, in the manufacture of a medicament for the treatment of a condition in a mammal, which condition is characterised by the undesirable, detrimental or otherwise unwanted growth of cells expressing a uPA/uPAR complex.
- said PAI is PAI-2, whilst said toxin is an alpha- particle emitting radioisotope.
- said condition is a neoplasm, still more preferably a metastatic malignancy.
- the present invention relates to a PAI-2 conjugate molecule comprising PAI-2 or functional derivative, homologue, analogue, chemical equivalent or mimetic thereof, which PAI-2 is bound, linked or otherwise associated with a toxin or label.
- the toxin or label is a radioisotope which can be detected with any means of radioactive detection, and more preferably is an alpha emitting radioisotope which includes, but is not limited to, Tb-149 or Bi-213.
- the radioisotope is a gamma ray emitting particle which incudes, but is not limited to, radioactive technetium (Te-99); or F-18 labelling, which is detected by Position Emission Tomography (PET).
- Te-99 radioactive technetium
- PET Position Emission Tomography
- the present invention relates to a pharmaceutical composition
- a pharmaceutical composition comprising a PAI-2 conjugate molecule comprising PAI-2 or functional derivative, homologue, analogue, chemical equivalent or mimetic thereof, which PAI-2 is bound, linked or otherwise associated with a toxin or label in association with one or more pharmaceutically acceptable carriers and/or diluents.
- the pharmaceutical composition is preferably formulated for intravenous or subcutaneous application.
- the present invention provides a method of detecting or visualising cancerous cells, said method comprising contacting cells with a PAI-2 conjugate molecule comprising PAI-2 or functional derivative, homologue, analogue, chemical equivalent or mimetic thereof, which PAI-2 is bound, linked or otherwise associated with a label capable of being detected, and determining the cells which express a uPA/uPAR complex by detection or visualisation.
- the label is a radioisotope which can be detected by any means of radioactive detection, which radioisotope is preferably an alpha particle emitting radioisotope, a gamma ray emitting particle or a radioisotope which is detectable by Position Emission Tomography (PET).
- the cells may be contacted with the PAI-2 conjugate molecule either in vitro or in vivo.
- the method is used to detect and visualise cancerous cells such as tumors and the location thereof in a mammalian body.
- the method may also be used to monitor changes in cancerous cells in the mammalian body to determine progression of cancer throughout the body, and to monitor the development of tumors, effectiveness of cancer treatment and therapy, and regression, remission or modulation of cancer in the body.
- PAI PAI
- the PAI may be of any suitable form, such as a mature molecule, a precursor form of said mature molecule, mutant, polymorphic variant or a derivative, homologue, equivalent, analogue or mimetic thereof which exhibits at least one of the functional activities of said PAI.
- said PAI is PAI-2, a glycoprotein of the serine protease inhibitor type and which exists in both glycosylated and unglycosylated forms. (Andreasen, 1990). Without limiting the present invention in any way, PAI-2 exhibits several advantages over PAI-1.
- PAI-2 is very stable in vitro compared to PAI-1 which is oxidation sensitive and easily inactivated (Kruithof et al.. 1995).
- PAI- 2 is approximately 10.000 fold less active towards t-PA than PAI-1 and would not lead to the side effect that fibrino lysis is inhibited.
- high blood levels of PAI-2 are thought less likely to cause any other adverse side effects since high levels of PAI-2 are found during late pregnancy (in the non-pregnant state blood levels of PAI-2 are not detectable) and are not associated with toxicity (Kruithof et al. , 1996).
- toxin should be understood as a reference to any suitable toxin which achieves the object of providing a signal which reduces, prevents or otherwise inhibits the proliferation, differentiation or maintenance of subject cell (herein referred to as “down- regulating the growth" of said cell).
- the subject toxin may act by a variety of means including providing its signal via direct contact with a subject cell or emitting a molecule or particle, such as radiation in the case of a radioactive isotope toxin, which provides the signal to the subject cell.
- the toxin is a radioisotope and even more preferably a radioisotope which is highly toxic over a short range and exhibits a short half life thereby minimizing the occurrence of inadvertent toxicity on proximally located non-target cells.
- said radioisotope is an alpha particle emitting radioisotope.
- alpha-emitting radioisotopes suitable for use in the method of the present invention include, but are not limited to, Tb-149 or Bi-213.
- the toxin which is utilised in the method of the present invention may be in a purified, partially purified or unpurified form. It may also form a component of a larger molecule.
- the toxin may be naturally occurring or it may be synthetically or recombinantly produced.
- Reference to "growth” of a cell should be understood as a reference to the proliferation, differentiation and/or maintenance of viability of the subject cell, while “down-regulating the growth” of a cell is a reference to reducing, preventing or inhibiting the proliferation, differentiation and/or maintenance of viability of the subject cell.
- the subject growth is proliferation and the subject down-regulation is killing. In this regard, killing may be achieved either by delivering a fatal hit to the cell or by delivering to the cell a signal which induces the cell to apoptose.
- Reference to “treatment” is to be considered in its broadest context. The term “treatment” does not necessarily imply that a mammal is treated until total recovery. Accordingly, “treatment” includes amelioration of the symptoms or severity of a particular condition or preventing or otherwise reducing the risk of developing a particular condition.
- references to an "effective amount” means an amount necessary to at least partly attain the desired response.
- the cell which is treated according to the method of the present invention may be treated in vitro or in vivo.
- a cell which is treated in vitro may be one that has been removed from the body of a mammal.
- cells or tissue comprising neoplastic cells may be removed from a mammal, treated according to the method of the present invention to down-regulate or induce apoptosis of the neoplastic cells and then returned to the mammal.
- the in vitro cell may be a cell line in respect of which it is sought to down-regulate or modulate its apopotic behaviour via the methods disclosed herein.
- the cell may be a neoplastic cell (such as a malignant cell) located in vivo and the induction of apoptosis would be achieved by applying the method of the present invention in vivo.
- a neoplastic cell such as a malignant cell located in vivo and the induction of apoptosis would be achieved by applying the method of the present invention in vivo.
- this cell may be located at the expected site in the mammal or. if a primary cancer has metastasised.
- the subject cancer may be located in another region of the patient's body. For example, it may form part of a secondary tumor (metastasis) which is located, for example, in the liver, lymph node or bone.
- the present invention is directed to inhibiting the unwanted growth of cells expressing a uPA/uPAR complex.
- a uPA/uPAR complex This should be understood as a reference to cells expressing uPAR (the uPA receptor) to which is coupled a uPA molecule.
- the uPA molecule which has bound to the uPAR may be derived from any source and has not necessarily been produced from the subject cell in an autocrine fashion - although it should be understood that this possibility is not excluded. Without limiting the present invention to any one theory or mode of action.
- PAI-2 to which has been coupled a toxin
- the PAI-2 is thereby specifically targeted to cells which express a uPAR to which is bound uPA. Still without limiting the present invention in any way, uPAR is expressed by neoplastic cells and is not expressed at significant levels by non-neoplastic cells.
- Interact should be understood as a reference to any form of interaction. Said interaction may occur via the formation of bonds such as covalent bonds, hydrogen bonds, van Der Waals forces or via any other mechanism of interaction.
- neoplastic cell should be understood, in the context of the present invention, as a reference to a cell exhibiting abnormal growth (as hereinbefore defined) and which cell expresses uPAR.
- the neoplastic cell may be a benign cell or a malignant cell.
- the cell is malignant.
- uPAR is overexpressed in metastatic cancers including, but not limited to, breast cancer, prostate cancer and colorectal cancer.
- “Functional derivatives and mimetics” include fragments, parts, portions, mutants, and mimetics from natural, synthetic or recombinant sources including fusion proteins exhibiting any one or more of the functional activities of the subject PAI or toxin.
- derivatives may be derived from insertion, deletion or substitution of amino acids.
- Amino acid insertional derivatives include amino and/or carboxylic terminal fusions as well as intrasequence insertions of single or multiple amino acids. Insertional amino acid sequence variants are those in which one or more amino acid residues are introduced into a predetermined site in the protein although random insertion is also possible with suitable screening of the resulting product.
- Deletional variants are characterized by the removal of one or more amino acids from the sequence.
- Substitutional amino acid variants are those in which at least one residue in the sequence has been removed and a different residue inserted in its place.
- An example of substitutional amino acid variants are conservative amino acid substitutions.
- Conservative amino acid substitutions typically include substitutions within the following groups: glycine and alanine; valine, isoleucine and leucine; aspartic acid and glutamic acid; asparagine and glutamine; serine and threonine; lysine and arginine; and phenylalanine and tyrosine. Additions to amino acid sequences including fusions with other peptides, polypeptides or proteins.
- Homologues of a PAI or toxin contemplated herein include, but are not limited to, molecules derived from different species.
- PAI or toxin should be understood as molecules exhibiting any one or more of the functional activities of PAI or toxin, respectively, and may be derived from any source such as being chemically synthesized or identified via screening processes such as natural product screening.
- the derivatives of PAI or toxin include fragments having particular epitopes of parts of the entire PAI protein or toxin fused to peptides, polypeptides or other proteinaceous or non-proteinaceous molecules.
- PAI or derivative thereof may be fused to a molecule to facilitate its delivery to a cell.
- Analogues of PAI or toxin contemplated herein include, but are not limited to, modification to side chains, incorporating of unnatural amino acids and/or their derivatives during peptide, polypeptide or protein synthesis and the use of crosslinkers and other methods which impose conformational constraints on the proteinaceous molecules or their analogues.
- side chain modifications contemplated by the present invention include modifications of amino groups such as by reductive alkylation by reaction with an aldehyde followed by reduction with NaBH_ ⁇ ; amidination with methylacetimidate; acylation with acetic anhydride; carbamoylation of amino groups with cyanate; trinitrobenzylation of amino groups with 2, 4, 6-trinitrobenzene sulphonic acid (TNBS); acylation of amino groups with succinic anhydride and tetrahydrophthalic anhydride; and pyridoxylation of lysine with pyridoxal-5 -phosphate followed by reduction with NaBH
- the guanidine group of arginine residues may be modified by the formation of heterocyclic condensation products with reagents such as 2,3-butanedione, phenylglyoxal and glyoxal.
- the carboxyl group may be modified by carbodiimide activation via O-acylisourea formation followed by subsequent derivitisation, for example, to a corresponding amide.
- Sulphydryl groups may be modified by methods such as carboxymethylation with iodoacetic acid or iodoacetamide; performic acid oxidation to cysteic acid; formation of a mixed disulphides with other thiol compounds; reaction with maleimide, maleic anhydride or other substituted maleimide; formation of mercurial derivatives using 4- chloromercuribenzoate, 4-chloromercuriphenylsulphonic acid, phenylmercury chloride, 2- chloromercuri-4-nitrophenol and other mercurials; carbamoylation with cyanate at alkaline pH.
- Tryptophan residues may be modified by, for example, oxidation with N- bromosuccinimide or alkylation of the indole ring with 2-hydroxy-5-nitrobenzyl bromide or sulphenyl halides.
- Tyrosine residues on the other hand, may be altered by nitration with tetranitromethane to form a 3-nitrotyrosine derivative.
- Modification of the imidazole ring of a histidine residue may be accomplished by alkylation with iodoacetic acid derivatives or N-carboethoxylation with diethylpyrocarbonate.
- Examples of incorporating unnatural amino acids and derivatives during protein synthesis include, but are not limited to, use of norleucine, 4-amino butyric acid, 4-amino-3- hydroxy-5-phenylpentanoic acid, 6-aminohexanoic acid, t-butylglycine, norvaline, phenylglycine, ornithine, sarcosine, 4-amino-3-hydroxy-6-methylheptanoic acid, 2-thienyl alanine and/or D-isomers of amino acids.
- a list of unnatural amino acids contemplated herein is shown in Table 1. TABLE 1
- Non-conventional Code Non-conventional Code amino acid amino acid
- PAI-2 exhibits high selectivity to neoplastic cells at their most malignant phase.
- PAI-2 functions as a "homing molecule" for cancer cells which express uPA. bound to uPA receptors, on their surface.
- the entire molecular complex is internalised. Once internalised, the high energy radioactive emission kills the subject cell with little or no effect on proximally located non-target cells. Due to the absence of such side effects, together with the short half-life and rapid decay of the selected alpha particle emitting radioisotope, there is little or no detrimental effect to the subject as a whole.
- the high turnover cell toxicity of radiolabelled PAI-2 is thought to derive from the tight, essentially irreversible binding of PA-2 to uPA.
- Tb-149 and Bi-213. in particular, chelate to PAI-2 to form very stable bonding.
- any suitable method may be utilised to achieve chelation.
- the chelators cDTPAa and CHX-A are utilised.
- Alpha radiation can then kill the subject cancer cells in 1-5 nuclear hits.
- the linear energy transfer (LET) for the ⁇ particle being very much greater than that for the beta rays, causes a high relative biological effectiveness over a much shorter range. As a result, a much greater fraction of the total energy is deposited in cells with alphas and very few nuclear hits are required to kill a cell (Lloyd et al.. 1979. Kassis et al.. 1986).
- alpha-emitters is particularly suitable for the killing of cancer cells and pre-angiogenic lesions while simultaneously releasing only a low radiation dose to normal tissue.
- the alpha therapeutic ratio is thought to be two orders of magnimde greater than that for a high energy beta emitter and is therefore the preferred form of toxin for use in the method of the present invention.
- toxin labelled PAI in the form of a pharmaceutical composition, may be performed by any convenient means.
- the toxin labelled PAI of the pharmaceutical composition are contemplated to exhibit therapeutic activity when administered in an amount which depends on the particular case. The variation depends. for example, on the human or animal and the toxin chosen. A broad range of doses may be applicable.
- a patient for example, from about 0.1 ⁇ g to about 10 mg of toxin labelled PAI may be administered per kilogram of body weight per day. For example from about 0.1 ⁇ g-5 mg, 10 ⁇ g-5 mg or 100 ⁇ g-1 mg. Dosage regimes may be adjusted to provide the optimum therapeutic response.
- the toxin labelled PAI may be administered in any convenient manner such as by the intravenous, intraperitoneal. intramuscular, subcutaneous or intradermal.
- the toxin-labelled PAI is administered intravenously or subcutaneously.
- the toxin labelled PAI defined in accordance with the present invention may be coadministered with one or more other compounds or molecules.
- coadministered is meant simultaneous administration in the same formulation or in two different formulations via the same or different routes or sequential administration by the same or different routes.
- sequential administration is meant a time difference of from seconds, minutes, hours or days between the administration of the two types of molecules. These molecules may be administered in any order.
- mammal should be understood as a reference to a human, primate, livestock animal (eg. sheep, pig, cow. horse, donkey) laboratory test animal (eg. mouse, rat. rabbit, guinea pig) companion animal (eg. dog, cat) or captive wild animal (eg. fox, kangaroo, deer).
- livestock animal eg. sheep, pig, cow. horse, donkey
- laboratory test animal eg. mouse, rat. rabbit, guinea pig
- companion animal eg. dog, cat
- captive wild animal eg. fox, kangaroo, deer
- the pharmaceutical forms of the PAI-2 conjugate molecule of the present invention suitable for injectable use include sterile aqueous solutions (where water soluble) and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersion.
- the form must be sterile and must be fluid to the extent that easy syringability exists. It must be stable under the conditions of manufacture and storage and may be preserved against the contaminating action of microorganisms such as bacteria and fungi.
- the carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils.
- the proper fluidity can be maintained, for example, by the use of a coating such as licithin, by the maintenance of the required particle size in the case of dispersion and by the use of superfactants.
- the preventions of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimersal and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride.
- Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.
- Sterile injectable solutions are prepared by incorporating the active compounds in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filtered sterilization.
- dispersions are prepared by incorporating the various sterilized active ingredient into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above.
- the preferred methods of preparation are vacuum drying and the freeze-drying technique which yield a powder of the active ingredient plus any additional desired ingredient from previously sterile-filtered solution thereof.
- Pharmaceutically acceptable carriers and/or diluents include any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents and the like.
- the use of such media and agents for pharmaceutical active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active ingredient, use thereof in the therapeutic compositions is contemplated. Supplementary active ingredients can also be incorporated into the compositions.
- Dosage unit form refers to physically discrete units suited as unitary dosages for the mammalian subjects to be treated; each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.
- the specification for the novel dosage unit forms of the invention are dictated by and directly dependent on (a) the unique characteristics of the active material and the particular therapeutic effect to be achieved, and (b) the limitations inherent in the art of compounding such an active material for the treatment of disease in living subjects having a diseased condition in which bodily health is impaired.
- the principal active ingredient is compounded for convenient and effective administration in effective amounts with a suitable pharmaceutically acceptable carrier in dosage unit form as hereinbefore disclosed.
- a unit dosage form can, for example, contain the principal active compound in amounts ranging from 0.1 ⁇ g to about 2000 mg. Expressed in proportions, the active compound is generally present in from about 0.1 ⁇ g to about 2000 mg/ml of carrier.
- the dosages are determined by reference to the usual dose and manner of administration of the said ingredients.
- FIG. 8 TAT Breast Cancer in vivo model. 25 ⁇ Ci radio-conjugate PAI-2 (Bi-213- cDTPA-PAI2) injected 2 days after tumor cells;
- FIG. 9 TAT Breast Cancer in vivo model. 50 ⁇ Ci radio-conjugate PAI-2 (Bi-213- cDTPA-PAI2) injected 2 days after tumor cells:
- FIG. 10 TAT Breast Cancer in vivo model. 25 ⁇ Ci radio-conjugate PAI-2 (Bi-213- cDTPA-PAI2) injected 7 days after tumor cells;
- FIG. 11 TAT Breast cancer in vivo model. 25 ⁇ Ci radio-conjugate PAI-2 (Bi-213- cDTPA-PAI2) injected 14 days after tumor cells.
- Figure 12 Alpha-PAI-2 or non-specific alpha-protein administered 2 days post inoculation of human breast cancer MDA-MB-231 cells in nude mice.
- the rare earth nuchde i49 Tb is produced on a tandem, cyclotron or linear accelerator using high energy heavy ions such as boron or carbon or mtrogen ions to bombard targets of Praseodymium, eg Pr( 12 C,4n) or Neodymium Nd( 12 C,5n) at higher energies
- Metal targets are rolled and mounted on a frame
- a thm target has 1 mg cm 2
- a thick target has 30 mg cm 2
- a catcher foil is used to collect Tb ions in the thm foil geometry
- Tb-149 is also produced via the spallation reaction of high energy charged particles, eg protons on a high atomic number target such as tantalum
- the Tb- lmmunoconjugates are made using the longer lived isotope Tb-152 as an exact analogue
- An alternative ⁇ radiolabel is B ⁇ -213, which is produced by ⁇ decay from Ac-225 the B ⁇ -213 is eluted from the Ac-225 with 250 ⁇ L of fresh 0 15 M HI followed by 250 ⁇ L water The activity of the B ⁇ -213 is assayed against the Au-198 setting in the dose calibrator The first elution is not used as it contains cold Bi Purification
- the product nuclides are separated from the thick target by dissolution in 6 M nitric acid, the sample is irradiated to dryness and yield determined by gamma ray spectroscopy .
- the residue is dissolved in 0.16 M -hydro xyisobutyric acid and passed through a cation exchange column (particle size 13 ⁇ m).
- the pH of the eluant is adjusted to 5 by aqueous ammonia. Elution was under a pressure of 7 kg cm "2 at a flow rate of 0.5 mL min "! .
- Terbium fractions are dried gently and heated to 450 degrees to destroy the Tb-isobutyrate complex.
- the residue is dissolved in dilute nitric or hydrochloric acid for the radiolabeling procedure.
- Bi-213 is eluted with 0.15 M hydriodic acid and the pH of the eluant adjusted as above.
- the purified product is chelated to molecules which target specific cancer cells.
- a number of different chelation procedures are available in the literature which use cDTPAa.
- DTPA-CHX DOTA (l,4,7,10-tetraazacyclododecane-N,N,N,N,tetraacetic acid), and TETA.
- the labelling procedure is a modification of the method used by Izard et al (1992). Briefly, both chelators ie. cDTPAa and CHX-A" were prepared in chloroform and were purified under a stream of Nitrogen. A chelator: protein molar ratio of 20: 1 and 4: 1 was maintained for cDTPAa and CHX-A" respectively. After a 45-minute on-ice incubation of the chelator and PAI2 (Biotech Australia), the conjugate was purified on a PD-10 column (Pharmacia Biotech) using 0.5 M sodium acetate at pH 5.5 as the eluting buffer. This was followed by the addition of Bi-213 and TB-149 or TB-152).
- the ratio-conjugate (RI) was again purified on another PD-10 column using PBS at pH 7.0 as the eluting buffer.
- the protein recovery is > 97% as determined by instant thin layer chromatography (ITLC) of the fractions obtained.
- ILC instant thin layer chromatography
- BSA bovine serum albumin
- the inhibitory activity of cDPTAa-conjugated PAI2 was confirmed by its ability to form complexes after 40 min incubation at 20 °C with active uPA. Complex formation was detected by a molecular mass shift by SDS-PAGE (12% non-reducing gel)( Figure 1).
- Radioconjugates were incubated with fresh human serum at 37°C for 45 min (equivalent to one half-life for Bi-213). Samples were then analysed by ITLC ( Figure 2). Radioconjugates remain at the origin whereas any free label runs at the solvent front. Similar experiments have been performed with Tb radioconjugates over long time periods.
- Tb-149 and Bi-213 ARCs have been produced and their stability, labelling efficiency, targeting and in vitro cell survival (37% survival for 2 ⁇ Ci) with MDA-MB-231 and MCF-7 breast cancer cell lines have been tested.
- the following ARCs have been prepared, by the inventors, for the first time:
- the method of the present invention is suitable for any early stage metastatic cancer which express high levels of uPA-uPAR.
- EGR-CMK significantly improves survival (by a factor of 2.5. Table 2) as a result of : i_nh,- : i,b_i.t : ion of . t,h . e - P T ⁇ A ⁇ T I-2. i : n_ . terac _ti • o _n disturb w ⁇ ce u u
- MDA-MB-231 and MCF-7 have similar survivals (i.e. about 2 ⁇ Ci for 37%), as shown in Figures 3 and 4. This does not imply similar cellular uPA levels but rather the high toxicity of the ⁇ -PAI2.
- ⁇ -PAI2 complex is endocytosed in breast cancer cells, as shown by confocal microscopy in Figure 5.
- Some cells shown in Figure 5 have been stably transfected with the green fluorescent protein (GFP).
- GFP green fluorescent protein
- This uncloned population was then incubated with TRITC- (red fluorescene) labeled PAI2 (10 ⁇ g/ml) for 1 h at room temperature before being viewed under the confocal microscope.
- the red fluorescent spots are evidence of internalisation and accumulation into vesicles (probably endosomes and lysosomes). Internalisation improves the cytotoxicity for isolated cells as the probability for ⁇ tracks crossing the nucleus is increased.
- Alpha-PAI-2 was administered by intra-peritoneal injection in adult (10-12 weeks), male BALB/c nude mice at a dose of 3 mCi/kg (i.e. 3 times the accepted tolerance dose in humans for an alpha-labelled antibody; D. Scheinberg, Memorial Sloan Kettering Institute, personal communication to B. Allen). A 10% short-term weight loss was observed in 2 of 3 mice with recovery by day 11. The third mouse lost approximately 10% body weight at day 7 and was stable at this level.
- Cold chelated-PAI-2 (DTTA- PAI-2), cold PAI-2 and the control (saline) mouse all showed small variations in weight.
- mice were monitored for 100 days and the mouse weights are shown in Figure 6.
- mice were clinically unaffected for the time period observed.
- MDA-MB-231 mycoplasma free
- PBS sterile phosphate buffered saline
- each mouse was injected s.c. at the site of tumour cell inoculation with either PBS (control) or varying doses of ⁇ -PAI2 in PBS (described as Bi-213.cDPTAa.PAI2 in figures titles; specific activity 3-4 ⁇ Ci/10 ⁇ L).
- the maximum volume injected at any one time was 100-120 ⁇ l/site. Note that all mice were handled similarly and kept under similar feeding and housing conditions. The results are shown in figures 8, 9, 10 and 11.
- tumour volume was recorded for each mouse at various time points since innoculation of breast cancer cells (indicatd on x-axis of figures as days after cell injection).
- the skin in area of innoculation was monitored for any signs of inflammation or damage - none were recorded.
- weight and over-all well-being was monitored from time of cell innoculation. These were all normal except for a small decrease in weight ( " 10%) immediately after alpha-PAI2 which was quickly recovered (data not shown).
- a similar phenomenon was seen with alpha-PAI2 treatment of mice without tumours in the alpha-PAI2 tolerance study (Figure 6 from Example 3).
- the mice are monitored for another 2-3 weeks after which they are sacrificed for the purpose of performing histological analysis of tissues associated with the injection site, including auxiliary lymph node tissue for the presence of cancer cells.
- FIGs 8, 9, 10 and 11 show that significant reduction in tumor volume occurred with injection of radio-conjugate PAI-2. This was apparent with two doses of PAI-2, 25 ⁇ Ci (Fig. 8) or 50 ⁇ Ci (Fig. 9) injected 2 days after the inoculation of cancer cells into the mammary fat pad of the mouse. It was also apparent when the radio-conjugate PAI-2 was injected 7 days (Fig.10) or 14 days (Fig. 11) after the tumor cells.
- mice Two million human breast cancer cells [MDA-MB-231 (mycoplasma free)] in sterile phosphate buffered saline (PBS) were injected sub-cutaneously into the mammary fat pad of first pair breasts on both sides of 4-6 week old female nude mice.
- PBS sterile phosphate buffered saline
- each mouse was administered either alpha-PAI-2 (1.5 mCi/kg, 3 mCi/kg or 6 mCi/kg) or non-specific alpha-MAb (6 mCi/kg) by tail vein injection.
- the maximum volume injected at any one time was 100-120 ⁇ l/site. Note that all mice were handled similarly and kept under similar feeding and housing conditions.
- the mmour volume was recorded for each mouse at various time points since inoculation of breast cancer cells (indicated on x-axis of figures as days after administration). The skin in the area of inoculation was monitored for any signs of inflammation or damage - none was recorded. Also weight and overall well-being was monitored from time of cell inoculation. There was no change except for a small decrease in weight ( " 10%) rapidly after alpha-PAI-2 treatment in some mice which was quickly recovered (data not shown).
- mice were sacrificed at the last time point for mmour size measurements for the purpose of performing histological analysis of tissues associated with the cell inoculation site, as well as axillary lymph node tissue for the presence of cancer cells.
- axillary lymph nodes appeared unaffected compared to nonspecific protein control mice that had enlarged and hardened lymph nodes.
- Alpha-PAI-2 (referred to as TAT in these instances) was inoculated intravenously (i.e. systemic administration) either 2 days (Figure 13), 7 days ( Figure 14), or 4 weeks after PC-3 cell inoculation ( Figure 15). Each of these experiments contained 4 groups of 5 animals each, inoculated with a non-specific alpha-labelled antibody at 6 mCi/kg., or alpha-PAI-2 at 1.5 mCi/kg, 3 mCi/kg, or 6 mCi/kg. Each animal received a single injection of the drug, in 100 ⁇ l of solution.
- the mmour volume was approximately 46 m 3
- the mmour volume was approximately 74 mm 3
- Tumour progression was documented by measuring volumes once weekly using calipers during the experiments, and their volumes were calculated by the following formula: length x width x height x 0.52 in millimeters. Data points for both experiments were expressed as average mmour volume ⁇ SE of mean based on 4-7 determinations. The incidence of lymph node metastases is also reported, by observation. No mice died in these experiments.
- PAI-2 can locate tumours which express uPA with high specificity, as described above. It follows that if the PAI-2 so used is labelled with any agent that can be detected, the mmour location can be visualised.
- detectable agents which could be coupled to PAI-2 include, but are not limited to. the following: radioactive Bi-213, as described in this application, which can be detected with any means of radioactive detection, such as a gamma camera; radioactive technetium (Tc-99), similarly detected; or 18-fluoro labelling, which is detected by Positron Emission Tomography (PET).
- radioactive Bi-213 as described in this application, which can be detected with any means of radioactive detection, such as a gamma camera; radioactive technetium (Tc-99), similarly detected; or 18-fluoro labelling, which is detected by Positron Emission Tomography (PET).
- PET Positron Emission Tomography
- the detection of sites of mmour growth has utility in the diagnosis of cancer, and in the identification of metastasis, that is. the spread of cancer from the primary mmour. It also has utility in defining the sites accessible for therapy, using any of the existing therapeutic modalities for cancer, including the alpha-PAI-2 described herein. The progression of cancer, and the effectiveness of treatment, can also be monitored using this PAI-2 targetting method for imaging of cancerous cells .
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AU2001235247A AU2001235247A1 (en) | 2000-02-24 | 2001-02-23 | Pai-2 conjugates for the treatment and imaging of cancer |
JP2001561345A JP2003523400A (en) | 2000-02-24 | 2001-02-23 | PAI-2 conjugates for cancer treatment and imaging |
CA002401195A CA2401195A1 (en) | 2000-02-24 | 2001-02-23 | Pai-2 conjugates for the treatment and imaging of cancer |
EP01907246A EP1259255A4 (en) | 2000-02-24 | 2001-02-23 | Pai-2 conjugates for the treatment and imaging of cancer |
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AUPQ5824 | 2000-02-24 | ||
AUPQ5824A AUPQ582400A0 (en) | 2000-02-24 | 2000-02-24 | A method of treatment and agents for use therein |
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EP (1) | EP1259255A4 (en) |
JP (1) | JP2003523400A (en) |
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WO2007009191A1 (en) * | 2005-07-21 | 2007-01-25 | Newsouth Innovations Pty Limited | Method for treating cancer |
WO2007044892A2 (en) * | 2005-10-10 | 2007-04-19 | American Diagnostica, Inc. | Upar-binding molecule-drug conjugates and uses thereof |
EP1894574A1 (en) * | 2005-04-18 | 2008-03-05 | Mie University | Anti-cancer agent comprising protein c inhibitor |
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US8574854B2 (en) * | 2002-06-14 | 2013-11-05 | Immunomedics, Inc. | Anti-mucin antibodies for early detection and treatment of pancreatic cancer |
US9005613B2 (en) | 2003-06-16 | 2015-04-14 | Immunomedics, Inc. | Anti-mucin antibodies for early detection and treatment of pancreatic cancer |
US20050260711A1 (en) * | 2004-03-30 | 2005-11-24 | Deepshikha Datta | Modulating pH-sensitive binding using non-natural amino acids |
US9452228B2 (en) * | 2013-04-01 | 2016-09-27 | Immunomedics, Inc. | Antibodies reactive with an epitope located in the N-terminal region of MUC5AC comprising cysteine-rich subdomain 2 (Cys2) |
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US5679350A (en) * | 1992-05-28 | 1997-10-21 | The University Of Toledo | Method of delivery of a medicament to a cancer cell using a pathway of plasminogen activator material |
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US5422090A (en) * | 1984-08-13 | 1995-06-06 | Biotechnology Australia, Pty., Ltd. | Human PAI-2 |
ATE156859T1 (en) * | 1989-12-20 | 1997-08-15 | Biotech Australia Pty Ltd | VARIANTS OF PAI-2 |
US5124471A (en) * | 1990-03-26 | 1992-06-23 | The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services | Bifunctional dtpa-type ligand |
CA2328457A1 (en) * | 1998-06-20 | 1999-12-29 | Washington University | Membrane-permeant peptide complexes for medical imaging, diagnostics, and pharmaceutical therapy |
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2000
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- 2001-02-23 US US09/790,900 patent/US7547441B2/en not_active Expired - Fee Related
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Patent Citations (1)
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US5679350A (en) * | 1992-05-28 | 1997-10-21 | The University Of Toledo | Method of delivery of a medicament to a cancer cell using a pathway of plasminogen activator material |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
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EP1894574A1 (en) * | 2005-04-18 | 2008-03-05 | Mie University | Anti-cancer agent comprising protein c inhibitor |
EP1894574A4 (en) * | 2005-04-18 | 2011-05-18 | Univ Mie | Anti-cancer agent comprising protein c inhibitor |
US8106002B2 (en) | 2005-04-18 | 2012-01-31 | Chugai Seiyaku Kabushiki Kaisha | Anti-cancer agent comprising protein C inhibitor |
WO2007009191A1 (en) * | 2005-07-21 | 2007-01-25 | Newsouth Innovations Pty Limited | Method for treating cancer |
WO2007044892A2 (en) * | 2005-10-10 | 2007-04-19 | American Diagnostica, Inc. | Upar-binding molecule-drug conjugates and uses thereof |
WO2007044892A3 (en) * | 2005-10-10 | 2008-01-10 | American Diagnostica Inc | Upar-binding molecule-drug conjugates and uses thereof |
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US20090136421A1 (en) | 2009-05-28 |
CA2401195A1 (en) | 2001-08-30 |
EP1259255A4 (en) | 2004-05-12 |
US20020002134A1 (en) | 2002-01-03 |
EP1259255A1 (en) | 2002-11-27 |
AUPQ582400A0 (en) | 2000-03-16 |
US7998934B2 (en) | 2011-08-16 |
US7547441B2 (en) | 2009-06-16 |
JP2003523400A (en) | 2003-08-05 |
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