BMS-754807, a Small-Molecule Inhibitor of Insulin-like Growth Factor-1 Receptor/Insulin Receptor, Enhances Gemcitabine Response in Pancreatic Cancer

Gemcitabine has limited clinical benefits in pancreatic ductal adenocarcinoma (PDAC). Insulin-like growth factor (IGF) signaling proteins are frequently overexpressed in PDAC. The therapeutic potential of BMS-754807, a small-molecule inhibitor of IGF-type 1 receptor (IGF-1R) and insulin receptor (IR), and gemcitabine was evaluated in experimental PDAC. Cell proliferation and protein expression were measured by WST-1 assay and immunoblotting. Tumor growth and survival studies were conducted in murine xenografts. PDAC cells expressed phospho-IGF-1R protein. BMS-754807 and gemcitabine inhibited cell proliferation of PDAC cells; the combination of BMS-754807 with gemcitabine had additive effects. Addition of BMS-754807 decreased gemcitabine IC50 from 9.7 μmol/L to 75 nmol/L for AsPC-1, from 3 μmol/L to 70 nmol/L for Panc-1, from 72 to 16 nmol/L for MIA PaCa-2, and from 28 to 16 nmol/L for BxPC-3 cells. BMS-754807 caused a decrease in phospho-IGF-1R and phospho-AKT proteins in AsPC-1 and Panc-1 cells. BMS-754807 and gemcitabine caused an increase in PARP-1 and caspase-3 cleavage. Net tumor growth inhibition in BMS-754807, gemcitabine, and BMS-754807+gemcitabine groups was 59%, 35%, and 94% as compared with controls. Effects of therapy on intratumoral proliferation and apoptosis corresponded with tumor growth inhibition data. BMS-754807 also caused a decrease in phospho-IGF-1R and phospho-AKT in tumor tissue lysates. Median animal survival (controls: 21 days) with BMS-754807 was 27 days (P = 0.03), with gemcitabine 28 days (P = 0.05), and in the BMS-754807+gemcitabine combination group, 41 days (P = 0.007). The strong antitumor activity of BMS-754807 in experimental PDAC supports the potential of BMS-754807-induced mechanisms for clinical PDAC therapy. Mol Cancer Ther; 11(12); 2644–53. ©2012 AACR.

[1]  L. Kuo,et al.  Structure of apo, unactivated insulin-like growth factor-1 receptor kinase at 1.5 A resolution. , 2003, Acta crystallographica. Section D, Biological crystallography.

[2]  A. Belfiore,et al.  Insulin/Insulin-like Growth Factor I Hybrid Receptors Have Different Biological Characteristics Depending on the Insulin Receptor Isoform Involved* , 2002, The Journal of Biological Chemistry.

[3]  T. Shows,et al.  Enhanced levels of insulin-like growth factor messenger RNA in human colon carcinomas and liposarcomas. , 1986, Cancer research.

[4]  R. Schwarz,et al.  An orthotopic in vivo model of human pancreatic cancer. , 1999, Surgery.

[5]  D. Yee,et al.  Disrupting insulin-like growth factor signaling as a potential cancer therapy , 2007, Molecular Cancer Therapeutics.

[6]  J. Fargnoli,et al.  Differential mechanisms of acquired resistance to insulin-like growth factor-i receptor antibody therapy or to a small-molecule inhibitor, BMS-754807, in a human rhabdomyosarcoma model. , 2010, Cancer research.

[7]  Y. Kido,et al.  Clinical review 125: The insulin receptor and its cellular targets. , 2001, The Journal of clinical endocrinology and metabolism.

[8]  Richard Gorlick,et al.  Initial testing (stage 1) of the IGF‐1 receptor inhibitor BMS‐754807 by the pediatric preclinical testing program , 2011, Pediatric blood & cancer.

[9]  H. Friess,et al.  Growth factors and their receptors in pancreatic cancer. , 2001, Teratogenesis, carcinogenesis, and mutagenesis.

[10]  W. Miller,et al.  Irinotecan plus gemcitabine results in no survival advantage compared with gemcitabine monotherapy in patients with locally advanced or metastatic pancreatic cancer despite increased tumor response rate. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  D. Carbone,et al.  The Efficacy of IGF-I Receptor Monoclonal Antibody against Human Gastrointestinal Carcinomas is Independent of k-ras Mutation Status , 2011, Clinical Cancer Research.

[12]  R. Radinsky,et al.  AMG 479, a fully human anti–insulin-like growth factor receptor type I monoclonal antibody, inhibits the growth and survival of pancreatic carcinoma cells , 2009, Molecular Cancer Therapeutics Molecular Cancer Therapeutics.

[13]  N. Awasthi,et al.  Antitumour activity of sunitinib in combination with gemcitabine in experimental pancreatic cancer. , 2011, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[14]  N. Awasthi,et al.  Endothelial monocyte activating polypeptide II interferes with VEGF-induced proangiogenic signaling , 2009, Laboratory Investigation.

[15]  A. Gualberto,et al.  Emerging role of insulin-like growth factor receptor inhibitors in oncology: early clinical trial results and future directions , 2009, Oncogene.

[16]  Edward S. Kim,et al.  Implication of the Insulin-like Growth Factor-IR Pathway in the Resistance of Non–small Cell Lung Cancer Cells to Treatment with Gefitinib , 2007, Clinical Cancer Research.

[17]  A. Maitra,et al.  Gemcitabine plus nab-paclitaxel is an active regimen in patients with advanced pancreatic cancer: a phase I/II trial. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  C. Conover,et al.  In vitro and in vivo antitumor effects of the dual insulin-like growth factor-I/insulin receptor inhibitor, BMS-554417. , 2006, Cancer research.

[19]  A. Tolcher,et al.  Phase I pharmacokinetic and biologic correlative study of mapatumumab, a fully human monoclonal antibody with agonist activity to tumor necrosis factor-related apoptosis-inducing ligand receptor-1. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  M. Korc,et al.  Insulin-like growth factor I overexpression in human pancreatic cancer: evidence for autocrine and paracrine roles. , 1995, Cancer research.

[21]  D. Carbone,et al.  Genetic blockade of the insulin-like growth factor-I receptor: a promising strategy for human pancreatic cancer. , 2003, Cancer research.

[22]  Y. Kido,et al.  The Insulin Receptor and Its Cellular Targets , 2001 .

[23]  Zheng Yang,et al.  BMS-754807, a small molecule inhibitor of insulin-like growth factor-1R/IR , 2009, Molecular Cancer Therapeutics.

[24]  R. Baserga Targeting the IGF-1 receptor: from rags to riches. , 2004, European journal of cancer.

[25]  M. Schwarz,et al.  In vivo therapy of local tumor progression by targeting vascular endothelium with EMAP-II. , 2004, The Journal of surgical research.

[26]  M. Reni,et al.  Gemcitabine versus cisplatin, epirubicin, fluorouracil, and gemcitabine in advanced pancreatic cancer: a randomised controlled multicentre phase III trial. , 2005, The Lancet. Oncology.

[27]  P. Murawa,et al.  Erlotinib Plus Gemcitabine Compared With Gemcitabine Alone in Patients With Advanced Pancreatic Cancer: A Phase III Trial of the National Cancer Institute of Canada Clinical Trials Group , 2023, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[28]  A. Adjei,et al.  Phase I Dose Escalation Study of the Anti–Insulin-Like Growth Factor-I Receptor Monoclonal Antibody CP-751,871 in Patients with Refractory Solid Tumors , 2007, Clinical Cancer Research.

[29]  R. Labianca,et al.  Gemcitabine in combination with oxaliplatin compared with gemcitabine alone in locally advanced or metastatic pancreatic cancer: results of a GERCOR and GISCAD phase III trial. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[30]  J. Stock,et al.  Severe diabetes, age-dependent loss of adipose tissue, and mild growth deficiency in mice lacking Akt2/PKB beta. , 2003, The Journal of clinical investigation.

[31]  E. Bohula,et al.  Targeting the type 1 insulin-like growth factor receptor as anti-cancer treatment , 2003, Anti-Cancer Drugs.

[32]  K. Siddle,et al.  Insulin and insulin-like growth factor-I (IGF-I) receptor overexpression in breast cancers leads to insulin/IGF-I hybrid receptor overexpression: evidence for a second mechanism of IGF-I signaling. , 1999, Clinical cancer research : an official journal of the American Association for Cancer Research.

[33]  C. Osborne,et al.  Hormone responsive human breast cancer in long-term tissue culture: effect of insulin. , 1976, Proceedings of the National Academy of Sciences of the United States of America.

[34]  P. L. Yen,et al.  The efficacy of a novel, dual PI3K/mTOR inhibitor NVP‐BEZ235 to enhance chemotherapy and antiangiogenic response in pancreatic cancer , 2012, Journal of cellular biochemistry.

[35]  D. V. Von Hoff,et al.  Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[36]  N. Awasthi,et al.  EMAP II-Based Antiangiogenic-Antiendothelial In Vivo Combination Therapy of Pancreatic Cancer , 2010, Annals of Surgical Oncology.

[37]  R. Baserga The insulin-like growth factor-I receptor as a target for cancer therapy , 2005, Expert opinion on therapeutic targets.

[38]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[39]  S. Hankinson,et al.  Insulin-like growth factors and neoplasia , 2004, Nature Reviews Cancer.

[40]  M. Rubini,et al.  The IGF-I receptor in cell growth, transformation and apoptosis. , 1997, Biochimica et biophysica acta.

[41]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[42]  M. Saif Pancreatic cancer: highlights from the 42nd annual meeting of the American Society of Clinical Oncology, 2006. , 2006, JOP : Journal of the pancreas.

[43]  A. Martins,et al.  Insulin-Like Growth Factor I Receptor Pathway Inhibition by ADW742, Alone or in Combination with Imatinib, Doxorubicin, or Vincristine, Is a Novel Therapeutic Approach in Ewing Tumor , 2006, Clinical Cancer Research.

[44]  D. Leroith,et al.  The role of the IGF system in cancer growth and metastasis: overview and recent insights. , 2007, Endocrine reviews.

[45]  A. Costantino,et al.  Insulin receptor activation by IGF-II in breast cancers: evidence for a new autocrine/paracrine mechanism , 1999, Oncogene.

[46]  F. Peruzzi,et al.  The IGF‐1 receptor in cancer biology , 2003, International journal of cancer.

[47]  R. Brekken,et al.  Smac mimetic-derived augmentation of chemotherapeutic response in experimental pancreatic cancer , 2011, BMC Cancer.

[48]  N. Webster,et al.  Elevated insulin-like growth factor I receptor autophosphorylation and kinase activity in human breast cancer. , 1998, Cancer research.

[49]  A. Costantino,et al.  Insulin Receptor Isoform A, a Newly Recognized, High-Affinity Insulin-Like Growth Factor II Receptor in Fetal and Cancer Cells , 1999, Molecular and Cellular Biology.

[50]  S. Weroha,et al.  IGF-1 Receptor Inhibitors in Clinical Trials—Early Lessons , 2008, Journal of Mammary Gland Biology and Neoplasia.

[51]  J. Baker,et al.  Mice carrying null mutations of the genes encoding insulin-like growth factor I (Igf-1) and type 1 IGF receptor (Igf1r) , 1993, Cell.