Ang-2-VEGF-A CrossMab, a Novel Bispecific Human IgG1 Antibody Blocking VEGF-A and Ang-2 Functions Simultaneously, Mediates Potent Antitumor, Antiangiogenic, and Antimetastatic Efficacy

Purpose: VEGF-A blockade has been clinically validated as a treatment for human cancers. Angiopoietin-2 (Ang-2) expression has been shown to function as a key regulator of tumor angiogenesis and metastasis. Experimental Design: We have applied the recently developed CrossMab technology for the generation of a bispecific antibody recognizing VEGF-A with one arm based on bevacizumab (Avastin), and the other arm recognizing Ang-2 based on LC06, an Ang-2 selective human IgG1 antibody. The potency of Ang-2-VEGF CrossMab was evaluated alone and in combination with chemotherapy using orthotopic and subcutaneous xenotransplantations, along with metastasis analysis by quantitative real-time Alu-PCR and ex vivo evaluation of vessels, hypoxia, proliferation, and apoptosis. The mechanism of action was further elucidated using Western blotting and ELISA assays. Results: Ang-2-VEGF-A CrossMab showed potent tumor growth inhibition in a panel of orthotopic and subcutaneous syngeneic mouse tumors and patient or cell line-derived human tumor xenografts, especially at later stages of tumor development. Ang-2-VEGF-A CrossMab treatment led to a strong inhibition of angiogenesis and an enhanced vessel maturation phenotype. Neoadjuvant combination with chemotherapy resulted in complete tumor regression in primary tumor-bearing Ang-2-VEGF-A CrossMab-treated mice. In contrast to Ang-1 inhibition, anti-Ang-2-VEGF-A treatment did not aggravate the adverse effect of anti-VEGF treatment on physiologic vessels. Moreover, treatment with Ang-2-VEGF-A CrossMab resulted in inhibition of hematogenous spread of tumor cells to other organs and reduced micrometastatic growth in the adjuvant setting. Conclusion: These data establish Ang-2-VEGF-A CrossMab as a promising antitumor, antiangiogenic, and antimetastatic agent for the treatment of cancer. Clin Cancer Res; 19(24); 6730–40. ©2013 AACR.

[1]  Y. Kienast,et al.  A Novel Angiopoietin-2 Selective Fully Human Antibody with Potent Anti-Tumoral and Anti-Angiogenic Efficacy and Superior Side Effect Profile Compared to Pan-Angiopoietin-1/-2 Inhibitors , 2013, PloS one.

[2]  H. Dvorak,et al.  Heterogeneity of the tumor vasculature: the need for new tumor blood vessel type-specific targets , 2012, Clinical & Experimental Metastasis.

[3]  M. Felcht,et al.  Angiopoietin-2 differentially regulates angiogenesis through TIE2 and integrin signaling. , 2012, The Journal of clinical investigation.

[4]  B. Wiedenmann,et al.  Angiopoietin‐2 drives lymphatic metastasis of pancreatic cancer , 2011, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[5]  Guy Georges,et al.  Immunoglobulin domain crossover as a generic approach for the production of bispecific IgG antibodies , 2011, Proceedings of the National Academy of Sciences.

[6]  H. Wildiers,et al.  A randomized, placebo-controlled phase II study of AMG 386 plus bevacizumab (Bev) and paclitaxel (P) or AMG 386 plus P as first-line therapy in patients (pts) with HER2-negative, locally recurrent or metastatic breast cancer (LR/MBC). , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  P. Carmeliet,et al.  Molecular mechanisms and clinical applications of angiogenesis , 2011, Nature.

[8]  L. Naldini,et al.  Targeting the ANG2/TIE2 axis inhibits tumor growth and metastasis by impairing angiogenesis and disabling rebounds of proangiogenic myeloid cells. , 2011, Cancer cell.

[9]  H. Buhr,et al.  A novel antiangiogenic approach for adjuvant therapy of pancreatic carcinoma , 2011, Langenbeck's Archives of Surgery.

[10]  Baocun Sun,et al.  Antiangiogenic agents significantly improve survival in tumor-bearing mice by increasing tolerance to chemotherapy-induced toxicity , 2011, Proceedings of the National Academy of Sciences.

[11]  R. Lerner,et al.  Chemical generation of bispecific antibodies , 2010, Proceedings of the National Academy of Sciences.

[12]  H. Augustin,et al.  Identification of serum angiopoietin-2 as a biomarker for clinical outcome of colorectal cancer patients treated with bevacizumab-containing therapy , 2010, British Journal of Cancer.

[13]  D. Nam,et al.  Double antiangiogenic protein, DAAP, targeting VEGF-A and angiopoietins in tumor angiogenesis, metastasis, and vascular leakage. , 2010, Cancer cell.

[14]  M. Felcht,et al.  Angiopoietin-2 Stimulation of Endothelial Cells Induces αvβ3 Integrin Internalization and Degradation* , 2010, The Journal of Biological Chemistry.

[15]  R. Jain,et al.  Angiopoietin-2 Interferes with Anti-VEGFR2–Induced Vessel Normalization and Survival Benefit in Mice Bearing Gliomas , 2010, Clinical Cancer Research.

[16]  A. Gollerkeri,et al.  First-in-human dose-escalation safety and PK trial of a novel intravenous humanized monoclonal CovX body inhibiting angiopoietin 2. , 2010 .

[17]  M. Atkins,et al.  Plasma angiopoietin-2 (ANG2) as an angiogenic biomarker in renal cell carcinoma (RCC). , 2010 .

[18]  D. McDonald,et al.  Complementary actions of inhibitors of angiopoietin-2 and VEGF on tumor angiogenesis and growth. , 2010, Cancer research.

[19]  K. Leong,et al.  Use of anti-VEGF adjuvant therapy in cancer: challenges and rationale. , 2010, Trends in molecular medicine.

[20]  Mohammad Tabrizi,et al.  A Human Monoclonal Anti-ANG2 Antibody Leads to Broad Antitumor Activity in Combination with VEGF Inhibitors and Chemotherapy Agents in Preclinical Models , 2010, Molecular Cancer Therapeutics.

[21]  R. Herbst,et al.  Safety, pharmacokinetics, and antitumor activity of AMG 386, a selective angiopoietin inhibitor, in adult patients with advanced solid tumors. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  John M L Ebos,et al.  Accelerated metastasis after short-term treatment with a potent inhibitor of tumor angiogenesis. , 2009, Cancer cell.

[23]  Masahiro Inoue,et al.  Antiangiogenic therapy elicits malignant progression of tumors to increased local invasion and distant metastasis. , 2009, Cancer cell.

[24]  D. Schadendorf,et al.  Angiopoietin-2 Levels Are Associated with Disease Progression in Metastatic Malignant Melanoma , 2009, Clinical Cancer Research.

[25]  Gabriele Bergers,et al.  Modes of resistance to anti-angiogenic therapy , 2008, Nature Reviews Cancer.

[26]  M. Yao,et al.  Expression of angiopoietins and vascular endothelial growth factors and their clinical significance in acute myeloid leukemia. , 2008, Leukemia research.

[27]  M. J. Jarzynka,et al.  Angiopoietin-2 Stimulates Breast Cancer Metastasis through the α5β1 Integrin-Mediated Pathway , 2007 .

[28]  A. Dimitrakopoulou-Strauss,et al.  Angiopoietin-2 overexpression in morris hepatoma results in increased tumor perfusion and induction of critical angiogenesis-promoting genes. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  M. Mori,et al.  Angiopoietin 2 expression in invasive ductal carcinoma of the breast: its relationship to the VEGF expression and microvessel density , 2006, Breast Cancer Research and Treatment.

[30]  D. Schlaepfer,et al.  Angiopoietin 2 induces glioma cell invasion by stimulating matrix metalloprotease 2 expression through the alphavbeta1 integrin and focal adhesion kinase signaling pathway. , 2006, Cancer research.

[31]  F. Peale,et al.  Cross-species Vascular Endothelial Growth Factor (VEGF)-blocking Antibodies Completely Inhibit the Growth of Human Tumor Xenografts and Measure the Contribution of Stromal VEGF* , 2006, Journal of Biological Chemistry.

[32]  Napoleone Ferrara,et al.  Angiogenesis as a therapeutic target , 2005, Nature.

[33]  H. Yoshiji,et al.  Angiopoietin 2 displays a vascular endothelial growth factor dependent synergistic effect in hepatocellular carcinoma development in mice , 2005, Gut.

[34]  H. Augustin,et al.  The Tie-2 ligand Angiopoietin-2 destabilizes quiescent endothelium through an internal autocrine loop mechanism , 2005, Journal of Cell Science.

[35]  R. Jain Normalization of Tumor Vasculature: An Emerging Concept in Antiangiogenic Therapy , 2005, Science.

[36]  Lei Xu,et al.  Kinetics of vascular normalization by VEGFR2 blockade governs brain tumor response to radiation: role of oxygenation, angiopoietin-1, and matrix metalloproteinases. , 2004, Cancer cell.

[37]  J. Berlin,et al.  Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. , 2004, The New England journal of medicine.

[38]  K. Chayama,et al.  Clinical significance of angiopoietin-2 expression at the deepest invasive tumor site of advanced colorectal carcinoma. , 2004, International journal of oncology.

[39]  P. Sismondi,et al.  Angiopoietin‐2 expression in breast cancer correlates with lymph node invasion and short survival , 2003, International journal of cancer.

[40]  H. Wada,et al.  Expression of angiopoietins and its clinical significance in non-small cell lung cancer. , 2002, Cancer research.

[41]  Thomas N. Sato,et al.  Orchestration of angiogenesis and arteriovenous contribution by angiopoietins and vascular endothelial growth factor (VEGF) , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[42]  S. Kitano,et al.  Angiopoietin-2 is related to tumor angiogenesis in gastric carcinoma: possible in vivo regulation via induction of proteases. , 2001, Cancer research.

[43]  V. Dixit,et al.  Vascular Endothelial Growth Factor Induces Expression of the Antiapoptotic Proteins Bcl-2 and A1 in Vascular Endothelial Cells* , 1998, The Journal of Biological Chemistry.

[44]  L. Presta,et al.  'Knobs-into-holes' engineering of antibody CH3 domains for heavy chain heterodimerization. , 1996, Protein engineering.

[45]  P. Carmeliet,et al.  Lessons from the adjuvant bevacizumab trial on colon cancer: what next? , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[46]  N. Petrelli,et al.  Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: results of NSABP protocol C-08. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[47]  Jochen Herms,et al.  Real-time imaging reveals the single steps of brain metastasis formation , 2010, Nature Medicine.

[48]  M. J. Jarzynka,et al.  Angiopoietin-2 stimulates breast cancer metastasis through the alpha(5)beta(1) integrin-mediated pathway. , 2007, Cancer research.

[49]  Jeffrey W. Clark,et al.  Lessons from phase III clinical trials on anti-VEGF therapy for cancer , 2006, Nature Clinical Practice Oncology.

[50]  Ma Dong,et al.  Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer , 2006 .

[51]  W. Scheuer,et al.  Quantification of human Alu sequences by real-time PCR – an improved method to measure therapeutic efficacy of anti-metastatic drugs in human xenotransplants , 2004, Clinical & Experimental Metastasis.

[52]  V. Dixit,et al.  Vascular Endothelial Growth Factor Induces Expression of the Antiapoptotic Proteins Bcl-2 and A 1 in Vascular Endothelial Cells * , 1998 .