Skip to main content

Advertisement

Log in

Adnectin-Targeted Inhibitors: Rationale and Results

  • Evolving Therapies (R Bukowski, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Adnectins are a family of binding proteins derived from the 10th type III domain of human fibronectin (10Fn3), which is part of the immunoglobulin superfamily and normally binds integrin. The 10Fn3 has the potential for broad therapeutic applications given its structural stability, ability to be manipulated, and its abundance in the human body. The most commonly studied adnectin is CT-322, which is an inhibitor of vascular endothelial growth factor receptor-2. A bispecific adnectin, El-Tandem, has also been developed and binds to epidermal growth factor receptor and insulin-like growth factor-1 receptor simultaneously. Pre-clinical studies have shown promising results in relation to reducing tumor growth, decreasing microvessel density, and promoting normalization of tumor architecture. The phase I trial with CT-322 demonstrates relatively low toxicities. However, the phase II study done with CT-322 in recurrent glioblastoma does not reveal as promising results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •Of importance ••Of major importance

  1. Lipovsek D. Adnectins: engineered target-binding protein therapeutics. Protein Eng Des Sel PEDS. 2011;24:3–9.

    Article  CAS  PubMed  Google Scholar 

  2. Ramamurthy V, Krystek Jr SR, Bush A, Wei A, Emanuel SL, Das Gupta R, et al. Structures of adnectin/protein complexes reveal an expanded binding footprint. Structure. 2012;20:259–69.

    Article  CAS  PubMed  Google Scholar 

  3. Mamluk R, Carvajal IM, Morse BA, Wong H, Abramowitz J, Aslanian S, et al. Anti-tumor effect of CT-322 as an adnectin inhibitor of vascular endothelial growth factor receptor-2. mAbs. 2010;2:199–208. This is one of the earlier papers summarizing the development of CT-322 and its function as a VEGFR-2 inhibitor. Also shows promising results of CT-322 for tumor reduction in orthotopic breast carcinoma in athymic mice and a COLO-205 xenograft model.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Iacob RE, Chen G, Ahn J, Houel S, Wei H, Mo J, et al. The influence of adnectin binding on the extracellular domain of epidermal growth factor receptor. J Am Soc Mass Spectrom. 2014;25:2093–102.

    Article  CAS  PubMed  Google Scholar 

  5. Waters JD, Sanchez C, Sahin A, Futalan D, Gonda DD, Scheer JK, et al. CT322, a VEGFR-2 antagonist, demonstrates anti-glioma efficacy in orthotopic brain tumor model as a single agent or in combination with temozolomide and radiation therapy. J Neuro-Oncol. 2012;110:37–48. This was a preclinical model to observe the efficacy of CT-322 in glioblastoma as single agent or with standard therapy. This study demonstrated promising results, especially when used in combination with temozolomide and radiation therapy. Demonstrated decreased CD31 staining when treated with CT-322, which indicates angiogenesis inhibition.

    Article  CAS  Google Scholar 

  6. Emanuel SL, Engle LJ, Chao G, Zhu RR, Cao C, Lin Z, et al. A fibronectin scaffold approach to bispecific inhibitors of epidermal growth factor receptor and insulin-like growth factor-I receptor. mAbs. 2011;3:38–48. This paper summarized the development and efficacy of El-Tandem Adnectin, which is a bispecific adnectin that binds to EGFR and IGF-1R simultaneously. El Tandem binds with greater affinity to both receptors than other adnectins that bind to either alone.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Dineen SP, Sullivan LA, Beck AW, Miller AF, Carbon JG, Mamluk R, et al. The adnectin CT-322 is a novel VEGF receptor 2 inhibitor that decreases tumor burden in an orthotopic mouse model of pancreatic cancer. BMC Cancer. 2008;8:352.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Ackermann M, Carvajal IM, Morse BA, Moreta M, O'Neil S, Kossodo S, et al. Adnectin CT-322 inhibits tumor growth and affects microvascular architecture and function in COLO205 tumor xenografts. Int J Oncol. 2011;38:71–80.

    CAS  PubMed  Google Scholar 

  9. Ackermann M, Morse BA, Delventhal V, Carvajal IM, Konerding MA. Anti-VEGFR2 and anti-IGF-1R-adnectins inhibit Ewing’s sarcoma A673-xenograft growth and normalize tumor vascular architecture. Angiogenesis. 2012;15:685–95.

    Article  CAS  PubMed  Google Scholar 

  10. Tolcher AW, Sweeney CJ, Papadopoulos K, Patnaik A, Chiorean EG, Mita AC, et al. Phase I and pharmacokinetic study of CT-322 (BMS-844203), a targeted adnectin inhibitor of VEGFR-2 based on a domain of human fibronectin. Clin Cancer Res Off J Am Assoc Cancer Res. 2011;17:363–71. This is the only phase I trial involving adnectins that has been published. It demonstrates what the maximum tolerated dose is as well as the more common adverse effects of CT-322. The results from this trial demonstrate that CT-322 is well tolerated and secondarily demonstrate promising results regarding tumor regression.

    Article  CAS  Google Scholar 

  11. Schiff D, Kesari S, de Groot J, Mikkelsen T, Drappatz J, Coyle T, et al. Phase 2 study of CT-322, a targeted biologic inhibitor of VEGFR-2 based on a domain of human fibronectin, in recurrent glioblastoma. Investig New Drugs. 2015;33:247–53. This is the only phase II trial published involving adnectins, specifically CT-322. This study was also just published win 2015. From this study, the null hypothesis could not be rejected since adequate enrollment was not achieved and so CT-322 was said to be ineffective for the treatment of recurrent glioblastoma.

    Article  CAS  Google Scholar 

  12. Ranpura V, Pulipati B, Chu D, Zhu X, Wu S. Increased risk of high-grade hypertension with bevacizumab in cancer patients: a meta-analysis. Am J Hypertens. 2010;23:460–8.

    Article  CAS  PubMed  Google Scholar 

  13. Kamba T, McDonald DM. Mechanisms of adverse effects of anti-VEGF therapy for cancer. Br J Cancer. 2007;96:1788–95.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Hayman SR, Leung N, Grande JP, Garovic VD. VEGF inhibition, hypertension, and renal toxicity. Curr Oncol Rep. 2012;14:285–94.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Wu S, Kim C, Baer L, Zhu X. Bevacizumab increases risk for severe proteinuria in cancer patients. J Am Soc Nephrol JASN. 2010;21:1381–9.

    Article  CAS  PubMed  Google Scholar 

  16. Chinot OL, de La Motte RT, Moore N, Zeaiter A, Das A, Phillips H, et al. AVAglio: phase 3 trial of bevacizumab plus temozolomide and radiotherapy in newly diagnosed glioblastoma multiforme. Adv Ther. 2011;28:334–40.

    Article  CAS  PubMed  Google Scholar 

  17. Eskens FA, Verweij J. The clinical toxicity profile of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR) targeting angiogenesis inhibitors; a review. Eur J Cancer. 2006;42:3127–39.

    Article  CAS  PubMed  Google Scholar 

  18. Higa GM, Abraham J. Biological mechanisms of bevacizumab-associated adverse events. Expert Rev Anticancer Ther. 2009;9:999–1007.

    Article  CAS  PubMed  Google Scholar 

  19. Liu JF, Barry WT, Birrer M, Lee JM, Buckanovich RJ, Fleming GF, et al. Combination cediranib and olaparib versus olaparib alone for women with recurrent platinum-sensitive ovarian cancer: a randomised phase 2 study. Lancet Oncol. 2014;15:1207–14.

    Article  CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

All authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Monica Mita.

Additional information

This article is part of the Topical Collection on Evolving Therapies

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sachdev, E., Gong, J., Rimel, B. et al. Adnectin-Targeted Inhibitors: Rationale and Results. Curr Oncol Rep 17, 35 (2015). https://doi.org/10.1007/s11912-015-0459-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11912-015-0459-8

Keywords

Navigation