The cancer stem cell (CSC) concept has been proposed as an attractive theory to explain cancer development, and CSCs themselves have been considered as targets for the development of diagnostics and therapeutics. However, many unanswered questions concerning the existence of slow cycling/quiescent, drug-resistant CSCs remain. Here we report the establishment of colon cancer CSC lines, interconversion of the CSCs between a proliferating and a drug-resistant state, and reconstitution of tumor hierarchy from the CSCs. Stable cell lines having CSC properties were established from human colon cancer after serial passages in NOD/Shi-scid, IL-2Rc null (NOG) mice and subsequent adherent cell culture of these tumors. By generating specific antibodies against LGR5, we demonstrated that these cells expressed LGR5 and underwent self-renewal using symmetrical divisions. Upon exposure to irinotecan, the LGR5 1 cells transitioned into an LGR5 2 drug-resistant state. The LGR5 2 cells converted to an LGR5 1 state in the absence of the drug. DNA microarray analysis and immunohistochemistry demonstrated that HLA-DMA was specifically expressed in drug-resistant LGR5 2 cells, and epiregulin was expressed in both LGR5 1 and drug-resistant LGR5 2 cells. Both cells sustained tumor initiating activity in NOG mice, giving rise to a tumor tissue hierarchy. In addition, anti-epiregulin antibody was found to be efficacious in a metastatic model. Both LGR5 1 and LGR5 2 cells were detected in the tumor tissues of colon cancer patients. The results provide new biological insights into drug resistance of CSCs and new therapeutic options for cancer treatment.
Antibodies can swiftly provide therapeutics to target disease-related molecules
discovered in genomic research. Antibody engineering techniques have been actively
developed and these technological innovations have intensified the development of
therapeutic antibodies. From the mid-1990’s, a series of therapeutic antibodies were
launched that are now being used in clinic. The disease areas that therapeutic antibodies
can target have subsequently expanded, and antibodies are currently utilized as
pharmaceuticals for cancer, inflammatory disease, organ transplantation, cardiovascular
disease, infection, respiratory disease, ophthalmologic disease, and so on. This paper
briefly describes the modes of action of therapeutic antibodies. Several non-clinical
study results of the pathological changes induced by therapeutic antibodies are also
presented to aid the future assessment of the toxic potential of an antibody developed as
a therapeutic.
Agonistic antibodies targeting CD137 have been clinically unsuccessful due to systemic toxicity. Since conferring tumor selectivity through tumor-associated antigen limits its clinical use to cancers that highly express such antigen, we exploited extracellular adenosine triphosphate (exATP), which is a hallmark of the tumor microenvironment and highly elevated in solid tumors, as a broadly tumor selective switch. We generated a novel anti-CD137 switch antibody, STA551, which exerts agonistic activity only in the presence of exATP. STA551 demonstrated potent and broad anti-tumor efficacy against all mouse and human tumors tested and a wide therapeutic window without systemic immune activation in mice. STA551 was well tolerated even at 150 mg/kg/week in cynomolgus monkeys. These results provide a strong rationale for the clinical testing of STA551 against a broad variety of cancers regardless of antigen expression, and for the further application of this novel platform to other targets in cancer therapy.
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