A Human Monoclonal Anti-ANG2 Antibody Leads to Broad Antitumor Activity in Combination with VEGF Inhibitors and Chemotherapy Agents in Preclinical Models

Localized angiopoietin-2 (Ang2) expression has been shown to function as a key regulator of blood vessel remodeling and tumor angiogenesis, making it an attractive candidate for antiangiogenic therapy. A fully human monoclonal antibody (3.19.3) was developed, which may have significant pharmaceutical advantages over synthetic peptide-based approaches in terms of reduced immunogenicity and increased half-life to block Ang2 function. The 3.19.3 antibody potently binds Ang2 with an equilibrium dissociation constant of 86 pmol/L, leading to inhibition of Tie2 receptor phosphorylation in cell-based assays. In preclinical models, 3.19.3 treatment blocked blood vessel formation in Matrigel plug assays and in human tumor xenografts. In vivo studies with 3.19.3 consistently showed broad antitumor activity as a single agent across a panel of diverse subcutaneous and orthotopic xenograft models. Combination studies of 3.19.3 with cytotoxic drugs or anti–vascular endothelial growth factor agents showed significant improvements in antitumor activity over single-agent treatments alone with no apparent evidence of increased toxicity. Initial pharmacokinetic profiling studies in mice and nonhuman primates suggested that 3.19.3 has a predicted human half-life of 10 to 14 days. These studies provide preclinical data for 3.19.3 as a potential new antiangiogenic therapy as a single agent or in combination with chemotherapy or vascular endothelial growth factor inhibitors for the treatment of cancer. Mol Cancer Ther; 9(1); 145–56

[1]  D. Hanahan,et al.  VEGF-A has a critical, nonredundant role in angiogenic switching and pancreatic beta cell carcinogenesis. , 2002, Cancer cell.

[2]  Dai Fukumura,et al.  Tumor microvasculature and microenvironment: targets for anti-angiogenesis and normalization. , 2007, Microvascular research.

[3]  Thomas N. Sato,et al.  Angiopoietin-2, a natural antagonist for Tie2 that disrupts in vivo angiogenesis. , 1997, Science.

[4]  G. Yancopoulos,et al.  Vessel cooption, regression, and growth in tumors mediated by angiopoietins and VEGF. , 1999, Science.

[5]  Lauri Eklund,et al.  Angiopoietins assemble distinct Tie2 signalling complexes in endothelial cell–cell and cell–matrix contacts , 2008, Nature Cell Biology.

[6]  J. Marx Encouraging Results for Second-Generation Antiangiogenesis Drugs , 2005, Science.

[7]  S. Barry,et al.  AZD2171: a highly potent, orally bioavailable, vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor for the treatment of cancer. , 2005, Cancer research.

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

[9]  Gavin Thurston,et al.  Control of vascular morphogenesis and homeostasis through the angiopoietin–Tie system , 2009, Nature Reviews Molecular Cell Biology.

[10]  Siqing Shan,et al.  Inhibition of rat corneal angiogenesis by a nuclease-resistant RNA aptamer specific for angiopoietin-2 , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[11]  C. Tait,et al.  Angiopoietins in tumours: the angiogenic switch , 2004, The Journal of pathology.

[12]  Larry L. Green,et al.  Functional transplant of megabase human immunoglobulin loci recapitulates human antibody response in mice , 1997, Nature Genetics.

[13]  P. Campochiaro,et al.  Angiopoietin-2 is required for postnatal angiogenesis and lymphatic patterning, and only the latter role is rescued by Angiopoietin-1. , 2002, Developmental cell.

[14]  Mark W Dewhirst,et al.  Inhibition of in vivo tumor angiogenesis and growth via systemic delivery of an angiopoietin 2-specific RNA aptamer. , 2008, The Journal of surgical research.

[15]  J. Pollard,et al.  Distinct role of macrophages in different tumor microenvironments. , 2006, Cancer research.

[16]  G. Jayson,et al.  Antiangiogenic therapy for ovarian cancer , 2007, Current opinion in oncology.

[17]  J. Marx Cancer. Encouraging results for second-generation antiangiogenesis drugs. , 2005, Science.

[18]  Bing Li,et al.  Inhibition of vascular endothelial growth factor-induced angiogenesis suppresses tumour growth in vivo , 1993, Nature.

[19]  S. Gettinger Targeted therapy in advanced non-small-cell lung cancer. , 2008, Seminars in respiratory and critical care medicine.

[20]  T. Kodama,et al.  Differential function of Tie2 at cell–cell contacts and cell–substratum contacts regulated by angiopoietin-1 , 2008, Nature Cell Biology.

[21]  W. Shim,et al.  Angiopoietin: A TIE(d) Balance in Tumor Angiogenesis , 2007, Molecular Cancer Research.

[22]  M. Makuuchi,et al.  Biologic significance of angiopoietin-2 expression in human hepatocellular carcinoma. , 1999, The Journal of clinical investigation.

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

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

[25]  L. Ellis,et al.  Differential expression of angiopoietin‐1 and angiopoietin‐2 in colon carcinoma , 2001, Cancer.

[26]  G. Yancopoulos,et al.  Defective remodeling and maturation of the lymphatic vasculature in Angiopoietin-2 deficient mice. , 2008, Developmental biology.

[27]  D. Schadendorf,et al.  Host-derived angiopoietin-2 affects early stages of tumor development and vessel maturation but is dispensable for later stages of tumor growth. , 2009, Cancer research.

[28]  Thomas Hartmann,et al.  Suppression of angiogenesis and tumor growth by selective inhibition of angiopoietin-2. , 2004, Cancer cell.

[29]  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.

[30]  Luigi Naldini,et al.  Tie2 identifies a hematopoietic lineage of proangiogenic monocytes required for tumor vessel formation and a mesenchymal population of pericyte progenitors. , 2005, Cancer cell.

[31]  Claudio Campa,et al.  Targeting VEGF-A to treat cancer and age-related macular degeneration. , 2007, Annual review of medicine.

[32]  A. Griffioen,et al.  Quantitative assessment of angiogenesis and tumor vessel architecture by computer-assisted digital image analysis: effects of VEGF-toxin conjugate on tumor microvessel density. , 2000, Microvascular research.

[33]  M. Tabrizi,et al.  Elimination mechanisms of therapeutic monoclonal antibodies. , 2006, Drug discovery today.

[34]  R. Herbst Therapeutic options to target angiogenesis in human malignancies , 2006, Expert opinion on emerging drugs.

[35]  S. Wilhelm,et al.  Discovery and development of sorafenib: a multikinase inhibitor for treating cancer , 2006, Nature Reviews Drug Discovery.

[36]  G. Yancopoulos,et al.  In Situ Expression of Angiopoietins in Astrocytomas Identifies Angiopoietin-2 as an Early Marker of Tumor Angiogenesis , 1999, Experimental Neurology.

[37]  C. Szczylik,et al.  Targeted therapy of renal cell cancer. , 2008, Current opinion in investigational drugs.

[38]  H. Hurwitz Integrating the anti-VEGF-A humanized monoclonal antibody bevacizumab with chemotherapy in advanced colorectal cancer. , 2004, Clinical colorectal cancer.

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

[40]  Douglas Hanahan,et al.  Signaling Vascular Morphogenesis and Maintenance , 1997, Science.

[41]  L. Naldini,et al.  Tie2-expressing monocytes: regulation of tumor angiogenesis and therapeutic implications. , 2007, Trends in immunology.

[42]  J. Isner,et al.  Tie2 receptor ligands, angiopoietin-1 and angiopoietin-2, modulate VEGF-induced postnatal neovascularization. , 1998, Circulation research.

[43]  A. Eggert,et al.  High-level expression of angiogenic factors is associated with advanced tumor stage in human neuroblastomas. , 2000, Clinical cancer research : an official journal of the American Association for Cancer Research.