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Corticorelin acetate, a synthetic corticotropin-releasing factor with preclinical antitumor activity, alone and with bevacizumab, against human solid tumor models

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Abstract

Purpose

Corticorelin acetate (CrA) is a synthetic form of corticotropin-releasing factor undergoing clinical trials in the treatment of peritumoral brain edema (PBE). We sought to investigate preclinically its potential as an antitumor agent against human solid tumors and to assess its ability to enhance the therapeutic activity of bevacizumab (BEV) in these same models.

Methods

The in vivo efficacy of CrA as a single agent and in combination with the antiangiogenic agent, BEV, was examined in two preclinical human tumor models, the MX-1 breast and Colo-205 colon carcinomas. These models were selected based on their known sensitivity to BEV and were tumor types in which BEV has been approved for clinical use. The corneal micropocket assay was also performed to assess the antiangiogenic activity of CrA relative to BEV. The exposure level of CrA in the mouse using a typical preclinical regimen was measured so as to compare it to reported clinical exposure levels.

Results

CrA was active as a single agent in the MX-1 breast carcinoma, but did not exhibit statistically significant activity as a single agent in the Colo-205 colon carcinoma under the doses and schedules used in the study. When BEV, which was active or near active in both the MX-1 and Colo-205 models, was administered concomitantly with CrA, therapeutic outcomes were observed that were significantly better than those obtained using either monotherapy. These therapeutic potentiations using CrA plus BEV were obtained in the absence of any observable increase in toxicities. CrA was active in the corneal micropocket assay, producing a substantial (>70%) inhibition of neovascularization. A representative CrA regimen in mice produced an exposure within eightfold of human exposure determined at one-half the current clinical dose.

Conclusions

The application of CrA for the treatment of PBE likely involves its activity as an antiangiogenic agent, which may be one possible mechanism to explain its observed preclinical antitumor activity. That activity, as well as its ability to provide an enhanced therapeutic outcome when given in conjunction with BEV in the absence of increased toxicity, supports the use of CrA clinically as other than a replacement therapy for dexamethasone in PBE.

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References

  1. Stummer W (2007) Mechanisms of tumor-related brain edema. Neurosurg Focus 22:E8

    Article  PubMed  Google Scholar 

  2. Lee SW, Kim WJ, Park JA, Choi YK, Kwon YW, Kim KW (2006) Blood-brain barrier interfaces and brain tumors. Arch Pharm Res 29:265–275

    Article  PubMed  CAS  Google Scholar 

  3. Tjuvajev J, Uehara H, Desai R, Beattie B, Matei I, Zhou Y, Kreek MJ, Koutcher J, Blasberg R (1996) Corticotropin-releasing factor decreases vasogenic edema. Cancer Res 56:1352–1360

    PubMed  CAS  Google Scholar 

  4. Kaal EC, Vecht CJ (2004) The management of brain edema in brain tumors. Curr Opin Oncol 16:593–600

    Article  PubMed  CAS  Google Scholar 

  5. Grammatopoulos DK, Chrousos GP (2002) Functional characteristics of CRH receptors and potential clinical applications of CRH-receptor antagonists. Trends Endocrinol Metab 13:436–444

    Article  PubMed  CAS  Google Scholar 

  6. Hillhouse EW, Grammatopoulos OK (2006) The molecular mechanisms underlying the regulation of the biological activity of corticotropin releasing hormone receptors: implications for physiology and pathophysiology. Endocr Rev 27:260–286

    Article  PubMed  CAS  Google Scholar 

  7. Reubi JC, Waser W, Vale W, Rivier J (2003) Expression of CRF1 and CRF2 receptors in human cancers. J Clin Endocrinol Metab 88:3312–3320

    Article  PubMed  CAS  Google Scholar 

  8. Bale TL, Giordano FJ, Vale WW (2003) A new role for corticotrophin-releasing factor receptor-2: suppression of vascularization. Trends Cardiovasc Med 13:68–71

    Article  PubMed  CAS  Google Scholar 

  9. Wang J, Xu Y, Xu Y, Zhu H, Zhang R, Zhang G, Li S (2008) Urocortin’s inhibition of tumor growth and angiogenesis in hepatocellular carcinoma via corticotrophin-releasing factor receptor 2. Cancer Invest 26:359–368

    Article  PubMed  Google Scholar 

  10. Kenyon BM, Voest EE, Chen CC, Flynn E, Folkman J, D’Amato RJ (1996) A model of angiogenesis in the mouse cornea. Invest Ophtalmol Vis Sci 37:1625–1632

    CAS  Google Scholar 

  11. Recht LD, Mechtler L, Phuphanich S, Hormigo A, Hines V, Milsted R, O’Connor PC, Ryan RP, Wong ET (2009) A placebo-controlled study investigating the dexamethasone-sparing effects of corticorelin acetate in patients with primary or metastatic brain tumors and peritumoral edema. J Clin Oncol 27:abstr 2078

  12. Mechtler L, Wong ET, Hormigo A, Pannullo S, Hines V, Milsted R, O’Connor PO, Ryan RP, Recht L (2009) A long-term open-label extension study examining the steroid-sparing effects of corticorelin acetate in patients with cerebral tumors. J Clin Oncol 27:abstr 2079

  13. Shapiro WR, Mechtler L, Cher L, Wheeler H, Hines V, Milsted R, O’Connor PC, Ryan RP, L. Recht L (2009) A randomized, double-blind study comparing corticorelin acetate with dexamethasone in patients with primary malignant glioma who require increased dexamethasone doses to control symptoms of peritumoral brain edema. J Clin Oncol 27:abstr 2080

  14. Moliterno JA, Henry E, Pannullo SC (2009) Corticorelin acetate injections for the treatment of peritumoral brain edema. Expert Opin Investig Drugs 18:1413–1419

    Article  PubMed  CAS  Google Scholar 

  15. Ryan R, Moroz M, Berestein T, Evans-Freke S, Gamez I, Hines V, and Blasberg R (2009) Corticorelin acetate exhibits preclinical antitumor activity against the human glioma U87 xenograft. Proc Am Assoc Cancer Res, abstr 2326

  16. Gamez I, Ryan R, and Keir S (2010) Corticorelin acetate exhibits preclinical antitumor activity, alone and with bevacizumab, against human brain tumor models. Proc Am Assoc Cancer Res, abstr 1557

  17. Hsu JY, Wakelee HA (2009) Monoclonal antibodies targeting vascular endothelial growth factor: current status and future challenges in cancer therapy. BioDrugs 23(5):289–304

    Article  PubMed  CAS  Google Scholar 

  18. Kleinbaum DG, Klein M (2005) Survival analysis: a self-learning text, 2nd edn. Spring, Statistics for Biology and Health, New York

    Google Scholar 

  19. Zar JH (1999) Biostatistical analysis, 4th edn. Prentice-Hall, Upper Saddle River

    Google Scholar 

  20. Higgins B, Kolinsky K, Linn M, Adames V, Zhang YE, Moisa C, Dugan U, Heimbrook D, Packman K (2007) Antitumor activity of capecitabine and bevacizumab combination in a human estrogen receptor-negative breast adenocarcinoma xenograft model. Anticancer Res 27:2279–2287

    PubMed  CAS  Google Scholar 

  21. Yanagisawa M, Fujimoto-Ouchi K, Yorozu K, Yamashita Y, Mori K (2009) Antitumor activity of bevacizumab in combination with capecitabine and oxaliplatin in human colorectal cancer xenograft models. Oncol Rep 22:241–247

    PubMed  CAS  Google Scholar 

  22. Gerber HP, Ferrara N (2005) Pharmacology and pharmacodynamics of bevacizumab as monotherapy or in combination with cytotoxic therapy in preclinical studies. Cancer Res 65:671–680

    PubMed  CAS  Google Scholar 

  23. Warren RS, Yuan H, Matli MR, Gillett NA, Ferrara N (1995) Regulation by vascular endothelial growth factor of human colon cancer tumorigenesis in a mouse model of experimental liver metastasis. J Clin Invest 95:1789–1797

    Article  PubMed  CAS  Google Scholar 

  24. Kim KJ, Li B, Winer J, Armanini M, Gillett N, Phillips HS, Ferrara N (1993) Inhibition of vascular endothelial growth factor-induced angiogenesis suppresses tumour growth in vivo. Nature 362:841–844

    Article  PubMed  CAS  Google Scholar 

  25. Mordenti J, Thomsen K, Licko V, Chen H, Meng YG, Ferrara N (1999) Efficacy and concentration-response of murine anti-VEGF monoclonal antibody in tumor-bearing mice and extrapolation to humans. Toxicol Pathol 27:14–21

    Article  PubMed  CAS  Google Scholar 

  26. Lee SY, Kim DK, Cho JH, Koh JY, Yoon YH (2008) Inhibitory effect of bevacizumab on the angiogenesis and growth of retinoblastoma. Arch Ophthalmol 126:953–958

    Article  PubMed  CAS  Google Scholar 

  27. Hao Z, Huang Y, Cleman J, Jovin IS, Vale WW, Bale TL, Giordano FJ (2008) Urocortin 2 inhibits tumor growth via effects on vascularization and cell proliferation. Proc Natl Acad Sci USA 105:3939–3944

    Article  PubMed  CAS  Google Scholar 

  28. Tjuvajev J, Kolesnikov Y, Joshi R, Sherinski J, Koutcher L, Zhou Y, Matei C, Koutcher J, Kreek MJ, Blasberg R (1998) Anti-neoplastic properties of human corticotropin releasing factor: involvement of the nitric oxide pathway. In Vivo 12:1–10

    PubMed  CAS  Google Scholar 

  29. Investigator’s Brochure Xerecept® (Corticorelin acetate): Version 1.0 Celtic Pharma Development Services Inc., New York

  30. Schulte HM, Chrousos GP, Gold PW, Booth JD, Oldfield EH, Cutler GB Jr, Loriaux DL (1985) Continuous administration of synthetic ovine corticotropin-releasing factor in man. Physiological and pathophysiological implications. J Clin Invest 75:1781–1785

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The contributions of the research staffs from Piedmont Research Center and the Farmington Pharma Development Corporation in conjunction with the Hartford Hospital are duly recognized.

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Correspondence to Idoia Gamez.

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Gamez, I., Ryan, R.P., Reid, L.D. et al. Corticorelin acetate, a synthetic corticotropin-releasing factor with preclinical antitumor activity, alone and with bevacizumab, against human solid tumor models. Cancer Chemother Pharmacol 67, 1415–1422 (2011). https://doi.org/10.1007/s00280-010-1437-3

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  • DOI: https://doi.org/10.1007/s00280-010-1437-3

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