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ImClone Systems Incorporated, New York, New York
| ABSTRACT |
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| INTRODUCTION |
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The principle pathways for transduction of the IGF signal are mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3'-kinase/Akt (1 , 19) . After ligand-dependent receptor autophosphorylation, the IGF-IR phosphorylates a series of adaptor proteins, including insulin receptor substrate-1 (IRS-1), to activate intracellular signaling cascades. The MAPK pathway is primarily responsible for the mitogenic signal elicited after IGF stimulation but may also play a role in cell survival in cells overexpressing the IGF-IR (20) . IGF-dependent signaling through phosphatidylinositol 3'-kinase elicits survival processes including the phosphorylation and activation of the antiapoptotic protein Akt and, as a result, has been shown to protect cells from damage-induced apoptosis (21) . IGF signaling through the IGF-IR has also been shown to protect tumor cells from the cytotoxic effects of chemotherapy and radiation and may be an important factor in tumor cell drug resistance (5 , 22) . Furthermore, recent evidence suggests that resistance to the anti-HER2 antibody trastuzumab (Herceptin) in some forms of breast cancer may be due to activation of IGF-IR signaling in those cancers (23) . Consequently, inhibition of IGF signaling has been shown to increase the susceptibility of tumor cells to chemotherapeutic agents, making it a logical target for therapeutic intervention (10 , 24) .
A variety of strategies have been developed to inhibit the IGF-IR signaling pathway in tumor cells. Approaches using antisense oligonucleotides, inhibitory peptide, soluble receptor, and dominant negative receptor mutants that target the IGF-IR have been effective at inhibiting the proliferation of tumor cell lines in vitro and in experimental mouse models (25, 26, 27, 28, 29) . Murine antibodies directed against the human IGF-IR, in particular anti-IR-3, have also been shown to inhibit the proliferation in vitro and tumorigenesis in vivo of a variety of human tumor cell types (30, 31, 32, 33, 34, 35) . These studies have established targeting the IGF-IR as an attractive anticancer therapeutic strategy and validated an antibody approach as an effective mechanism to inhibit IGF-IR signaling. However, murine antibodies as such are not ideal human therapeutics, due to the high probability of developing specific immunity or allergic reactions to the therapeutic. Fully human antibodies offer the greatest potential for success as human therapeutics because they would be less likely to elicit an immune response and should possess a longer half-life in vivo (36) . To this end, we have developed a fully human monoclonal antibody that specifically targets the human IGF-IR. We demonstrate that this antibody possesses high affinity for the receptor and acts as an antagonist of ligand binding and signaling. In addition, we show that this antibody is capable of facilitating the degradation of the IGF-IR after uptake and internalization, leading to a reduction in surface receptor density on treated tumor cells. As a result, this antibody exhibits strong antitumor cell activity in vitro and in vivo, demonstrating its potential as a candidate for antitumor therapy.
| MATERIALS AND METHODS |
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Phage Display Screening.
Recombinant extracellular human IGF-IR was used to screen a human naïve (nonimmunized) bacteriophage Fab library containing 3.7 x 1010 unique clones (37
, 38)
. Soluble IGF-IR (50 µg/ml) was coated onto tubes and blocked with 3% milk/PBS. Phage were prepared by growing library stock to log phase, rescuing with M13K07 helper phage, and amplifying overnight at 30°C in 2YT culture medium containing ampicillin and kanamycin selection. The resulting phage preparation was precipitated in 4% polyethylene glycol/0.5 M NaCl and resuspended in 3% milk/PBS. Immobilized IGF-IR was incubated with the phage preparation for 1 h at room temperature, and tubes were washed 10 times with PBST (PBS containing 0.1% Tween 20) and with PBS. The bound phage was eluted with 1 ml of 100 mM triethylamine and allowed to infect log phase TG1 Escherichia coli. Infected TG1 cells were pelleted, spread onto selection plates, and incubated overnight at 30°C. Resulting colonies were pooled and stored in 2YT (10% glycerol) at -70°C. For second-round selection, this phage stock was used for enrichment of IGF-IR selective Fab following the above procedure, but with a reduced concentration of immobilized IGF-IR (5 µg/ml) and increased numbers of washes. Individual Fab candidates were rescued from selected TG1 clones as described above. Amplified phage preparations were blocked with 3% milk/PBS at room temperature for 1 h and added to Maxi-sorb 96-well microtiter plates (Nunc) coated with IGF-IR (1 µg/ml x 100 µl). After incubation at room temperature for 1 h, the plates were washed three times with PBST and incubated with a mouse anti-M13 phage horseradish peroxidase-conjugated antibody (Amersham Pharmacia Biotech, Piscataway, NJ). The plates were washed five times, tetramethylbenzidine (TMB) peroxidase substrate (KPL, Gaithersburg, MD) was added, and the absorbance at 450 nm was read using a microplate reader (Molecular Devices, Sunnyvale, CA). The diversity of anti-IGF-IR Fab clones was assessed by restriction analysis. Fab purification was performed as described previously (38)
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Generation of Light Chain-Shuffled Phage Display Library.
The human phage display library, from which anti-IGF-IR Fab 2F8 was identified, was used as the source of the antibody light chain repertoire in the shuffled library. A phagemid preparation from the Fab library was first digested with SfiI and NotI, followed by electrophoresis on an agarose gel to delete the VH gene fragments from the antibody light chain-containing backbone vector. The gene encoding the VH domain of clone 2F8 was generated by digestion of 2F8-coding phagemid with the same restriction enzymes and gel purified. The 2F8 VH-coding gene was then ligated into the purified backbone vector to create the antibody light chain-shuffled Fab repertoire. TG1 cells were transformed with the ligation mixtures via electroporation with a BTX600 (BTX, Holliston, MA). The transformed TG1 cells were grown in 2YT media at 37°C for 60 min and plated onto 2YT agar plates containing 100 µg/ml ampicillin and 2% glucose (2YTAG). Resulting colonies were scraped into 5 ml of 2YTAG media, mixed with 50% glycerol to a final concentration of 10%, aliquoted, and stored at -70°C. Screening of the shuffled Fab library for IGF-IR binding was performed as described above, except that IGF-IR was coated at a concentration of 2 µg/ml.
BIAcore Analysis.
The binding kinetics of soluble Fab and antibody proteins to IGF-IR was determined by using a BIACORE 3000 (BIAcore, Piscataway, NJ). Recombinant IGF-IR was immobilized onto a sensor chip, and Fab or antibody was injected at various concentrations. Sensorgrams were obtained and evaluated using BIA Evaluation 2.0 software to determine rate constants. The affinity constant, KD, was calculated from the ratio of the rate constants Koff/Kon.
Solid Phase Receptor Binding Assays.
Recombinant human IGF-IR or IR (100 ng/well) was coated onto 96 strip-well plates and blocked with 5% milk/PBS. Antibody preparations were diluted onto IGF-IR plates and incubated for 0.51 h at room temperature. Bound antibody was detected with a goat antihuman Fc-horseradish peroxidase antibody (Sigma) and visualized with TMB reagents and microplate reader at A450 nm. For competitive blocking assay, 40 pM 125I-IGF-I or 125I-insulin was added after antibody pretreatment, and the plates were incubated for an additional 90 min. Wells were then washed three times with ice-cold PBS/0.1% BSA, dried, and counted in a gamma scintillation counter. Anti-insulin blocking antibody 47-9 was obtained from NeoMarkers/LabVision (Fremont, CA).
Cell-Based Blocking Assay.
Assays were performed as described previously (31)
, with minor modifications. MCF7 or ZR-75-1 human breast cancer cells were seeded into 24-well dishes and cultured overnight. Subconfluent monolayers were washed two to three times in binding buffer (Iscoves Medium/0.1% BSA), and antibody was added in binding buffer. After a short incubation with antibody or cold ligand on ice, 40 pM 125I-IGF-I or 125I-insulin (approximately 40,000 cpm) was added to each well and incubated for an additional 3 h with gentle agitation. The wells were then washed three times with ice-cold PBS/0.1%BSA. Monolayers were then lysed with 200 µl of 0.5N NaOH and counted in a gamma counter.
Antibody Engineering and Expression.
The DNA sequences encoding the heavy and light chain genes from Fab candidates were amplified by PCR for cloning into glutamine synthetase system expression vectors (Lonza Biologics plc, Slough, Berkshire, United Kingdom). Engineered immunoglobulin expression vectors were stably transfected in NS0 cells using glutamine synthetase selection, and clones were screened for antibody expression by anti-Fc ELISA. Full-length IgG1 antibody was purified by protein A affinity chromatography (Poros A; PerSeptive Biosystems Inc., Foster City, CA).
Cell Proliferation and Mitogenesis Assays.
For proliferation inhibition, 10,000 MCF7 cells were seeded into 24-well plates in complete medium. After 24 h, 50 nM antibody was added to plates in triplicate and allowed to culture for an additional 3 days. The mouse monoclonal antibody anti-IR-3 was obtained from Oncogene Science (Cambridge, MA). The total number of cells (bound and suspension) for each well was determined using a Coulter counter. Mitogenic assay was performed as described previously (39)
, with some modification. Human tumor cells were plated into 96-well tissue culture plates at 5,00010,000 cells/well and allowed to adhere. RPMI-8226 cells were cultured in round-bottomed dishes and sedimented by gentle centrifugation before medium changes. The medium was replaced with serum-free medium and incubated overnight at 37°C. Cells were incubated with IGF-I with or without antibody and incubated overnight at 37°C. [3H]Thymidine (0.25 µCi; ICN, Irvine, CA) was subsequently added to each well and incubated for 5 h at 37°C. The supernatant was aspirated, and the cells were suspended by trypsinization for 5 min. The cells were collected onto a filter and washed three times with water, using a cell harvester. After drying, the filter was processed for reading in a scintillation counter.
Western Blotting and Immunoprecipitation.
Cells were plated into 10-cm or 6-well culture dishes and grown to 7080% confluence. Monolayers were washed twice in PBS and cultured overnight in serum-free medium. Antibody was then added in fresh serum-free media and incubated at 37°C for 3060 min. Cells were incubated with ligand for 10 min and then placed on ice and washed with ice-cold PBS. The cells were lysed in 50 mM Tris-HCl (pH 7.4), 150 mM NaCl, 1% Triton X-100, 1 mM EDTA, 1 mM phenylmethylsulfonyl fluoride, 0.5 mM Na3VO4, 1 µg/ml leupeptin, 1 µg/ml pepstatin, and 1 µg/ml aprotinin on ice for 10 min. The lysate was clarified by centrifugation at 4°C. Solubilized IGF-IR was then immunoprecipitated from the lysate. Antibody IGF-IRß, clone C-20 (Santa Cruz Biotechnology, Santa Cruz, CA) or A12 at 4 µg/ml were incubated with 400 µl of lysate overnight at 4°C. Immune complexes were precipitated by the addition of protein A-agarose beads for 2 h at 4°C, pelleted, and washed three times with lysis buffer. For immunoprecipitation of pure IRs, IGF-IR-depleted supernatant from an IGF-IR immunoprecipitate was immunoprecipitated with anti-insulin antibody 18-44 (NeoMarkers/LabVision). Immunoprecipitates bound to the protein A-agarose beads were stripped into denaturing gel sample buffer. Lysates or immunoprecipitates were processed for denaturing gel electrophoresis and run on a 412% acrylamide gel and blotted to nitrocellulose membrane by Western blot. Tyrosine-phosphorylated protein was detected on the blot using an anti-phospho-tyrosine antibody (NeoMarkers/LabVision) and an antimouse-horseradish peroxidase secondary antibody. IGF-IR-ß was detected with monoclonal antibody C-20 (Santa Cruz Biotechnology), and IR-ß was detected using antibody CT-3 (Cell Signaling Technology, Beverly, MA). Phospho-Akt and total Akt antibodies were obtained from PharMingen (BD Biosciences, San Diego, CA). For MAPK phosphorylation, phospho-p44/42 and total p44/42 antibodies were purchased from Cell Signaling Technology). Phospho-IRS-1 and total IRS-1 were detected with 2381 and 2382, respectively, from Cell Signaling. Bands were visualized with the enhanced chemiluminescence reagent (Amersham Pharmacia Biotech) on X-ray film (Eastman Kodak, Rochester, NY).
Antibody Internalization Assay.
Antibody A12 was radioiodinated with 125I [Amersham Pharmacia Biotech using IODO beads (Pierce, Rockford, IL)] according to manufacturers instructions. MCF7 human breast cancer cells were plated into 6-well plates and cultured overnight to 70% confluence. One µg of 125I-A12 was added to each well and incubated at 37°C or kept on ice at 4°C. Plates were incubated for 30, 90, or 180 min, and each time point was performed in triplicate. The control was held at 4°C for 180 min. At each time point, wells were washed three times with PBS/0.2% BSA and then stripped for 5 min with 100 mM glycine-HCl, 2 M urea (pH 2.5). Cells were washed three times with PBS/0.2% BSA and solubilized with 1N NaOH/1% Triton X-100. Stripped and solubilized fractions were then read on a gamma counter.
Receptor Degradation Analysis.
MCF7 cells were plated in regular culture medium overnight followed by overnight incubation in serum-free medium. IGF-I (50 nM) or A12 was then added, and cells were incubated at 37°C for up to 24 h. Cells were washed in ice-cold PBS, lysed in radioimmunoprecipitation assay buffer, and quantitated by BCA kit (Pierce) for equivalent loading onto 412% Tris-glycine gels (Invitrogen). Proteins were electrophoresed and transferred to nitrocellulose membrane, and IGF-IR was detected using antibody C-20 against IGF-IRß (Santa Cruz Biotechnology), antirabbit horseradish peroxidase-conjugated secondary antibody, and enhanced chemiluminescence reagent (Amersham Biosciences). Experiments including inhibitors were performed as described above, except that cells were pretreated with either 40 mM methylamine (Sigma) for 4 h or 30 µM MG115 (Sigma) or DMSO (Sigma) vehicle control for 2 h before the addition of ligand or A12.
Fluorescence-Activated Cell-Sorting Scanning of IGF-I Surface Receptor Density.
Adherent MCF 7 cells were treated for 4 h with 50 nM of either IGF-I or A12 at 37°C. Cells were washed in ice-cold PBS/5% BSA twice, and 1 x 106 cells were aliquoted to staining tubes and placed on ice. Anti-IGF-IR antibody, Ab-1 (NeoMarkers, Fremont, CA), was then incubated with cells at 4°C for 2 h. After PBS/BSA washes, cells were incubated with antimouse IgG phycoerythrin-conjugated secondary antibody (PharMingen, BD Biosciences) for 1 h on ice. After PBS/BSA wash, cells were analyzed by fluorescence-activated cell-sorting assay using a FACSvantage SE flow cytometer (BD Bioscience).
Human Tumor Xenograft Models.
Tumor xenografts were established by s.c. injection of 5 x 106 MCF7, 2 x 106 BxPC-3, or 2 x 106 Colo205 cells mixed in Matrigel (Collaborative Research Biochemicals, Bedford, MA) into the left flank of 56-week-old female athymic (nu/nu) mice (Charles River Laboratories, Wilmington, MA). In the MCF7 xenograft model, a pellet containing 0.72 mg of 17ß-estradiol (Innovative Research of America) was implanted s.c. into the shoulder area of mice 3 days before tumor cell injection. Tumors were allowed to reach 150300 mm3 in size, and then mice were randomized into groups of 10 animals each. Mice were treated by i.p. injection every 3 days with vehicle control (saline) or monoclonal antibody A12 at a dose of 1 mg. Treatment of animals was continued for the duration of the study. Tumors were measured twice each week with calipers, and tumor volumes were calculated by the following formula: (
/6 (w1 x w2 x w2)), where w1 represents the largest tumor diameter, and w2 represents the smallest tumor diameter. Tumor volumes were analyzed using the Mann-Whitney U test and computed using the statistical package in SigmaStat (version 2.03; Jandel Scientific, San Rafeal, CA).
Immunohistochemistry of Tumor Sections.
MCF7 tumor samples from representative animals were fixed in 10% neutral buffered formalin, embedded in paraffin, and sectioned at 4 µm onto slides. After deparaffinization and rehydration, sections were processed for H&E, Ki-67 or terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) staining. H&E-stained sections were stained with Gills hematoxylin (VWR) and eosin (Richard Allen, Kalamazoo, MI). For Ki-67 staining, epitopes were unmasked at 95°C-99°C for 20 min in Target Retrieval Solution (DAKO, Carpinteria, CA). Endogenous peroxidases were blocked using Peroxidase Block (EnVision+ Rabbit System; DAKO) for 5 min at room temperature followed by a 1-h incubation at room temperature in nonspecific protein block (5% BSA, 10% normal goat serum, and 0.02% Tween 20). Ki67 was detected with antibody Ab-4 (LabVision, Fremont, CA) and 3,3'-diaminobenzidine+ per EnVision+ Rabbit System instructions. For detection of TUNEL-positive cells, the In Situ Cell Death Detection Kit (Roche Applied Science, Indianapolis, IN) was used per kit instructions with minor modifications. Briefly, sections were digested for 15 min at room temperature with proteinase K (20 µg/ml) and permeabilized with 0.1% sodium citrate buffer containing 0.1% Triton X-100 for 2 min at 4°C, followed by incubation with TUNEL labeling mix at 37°C for 1 h. After multiple washes, sections were counterstained with Hoechst 33342 (Molecular Probes, Eugene, OR) and coverslipped using an anti-fade reagent. Light and fluorescent images of immunostained tissue were viewed on a Zeiss Axioskop and digitized using a SONY camera and Scion CG-7 framegrabber. Proliferation index was determined by quantitation of Ki-67 immunostaining by calculating the number of 3,3'-diaminobenzidine-positive pixels/total number of nuclear pixels (hematoxylin-positive pixels plus 3,3'-diaminobenzidine-positive pixels) x 100 in 10 fields at x200. The apoptosis index, determined by TUNEL staining, is calculated from the number of TUNEL-positive pixels/total number of Hoechst-positive pixels x 100 in 10 fields at x200. The apoptosis/proliferation ratio equals the apoptosis index/proliferation index x 1000. For single-dose immunohistochemistry analysis, athymic nude mice received injection with 2 x 106 tumor cells mixed in an equal volume of Matrigel. When tumors reached approximately 300400 mm3, they received i.p. injection with a single dose of A12 (1 mg) or saline. Tumor samples from four animals were removed at time intervals after treatment, fixed in 10% neutral buffered formalin, embedded in paraffin, and sectioned at 4 µm onto slides for immunohistological analyses. Sections were stained with primary antibodies [polyclonal anti-IGF-IRß (1:100; Santa Cruz Biotechnology), polyclonal anti-phosphorylated IGF-IR (Tyr1131)/IR (Tyr1146; 1:50; Cell Signaling Technology), or polyclonal anti-phosphorylated p44/42 MAPK (Thr202/Tyr204; 1:150; Cell Signaling Technology)] and visualized as described above.
| RESULTS |
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Light and heavy chain variable regions from 2F8 Fab were amplified by PCR and cloned in-frame to human immunoglobulin constant region sequences for expression as full-length IgG1 in mammalian cells. Binding kinetic analysis (BIAcore) was performed on 2F8 IgG, and 2F8 was shown to bind to the IGF-IR with an affinity of 0.61 nM (KD = 0.61 x 10-9 M; Kon = 2.8 x 105 M-1s-1; Koff = 1.8 x 10-4 s-1). Because the binding affinity of native IGF-I for the IGF-IR has been determined to be as high as 0.1 nM (40
, 41)
, we sought to improve on the binding affinity of 2F8 to make it more competitive with ligand. A second-generation Fab phage library was generated in which the 2F8 heavy chain was conserved, and the light chain was varied to a diversity of >108 unique species. This method, termed light chain shuffling, has been used successfully to improve the affinity of selected antibodies for a given target antigen (42
, 43)
. This library was screened for binding to the human IGF-IR, and the panning process was performed for a total of three rounds. To select for higher affinity Fab candidates, the concentration of immobilized receptor was reduced, and the length of washes before elution were increased substantially. Seven clones were analyzed after isolation, and all seven contained the same DNA sequence and restriction digest profile. The single Fab species was designated A12. After conversion to IgG1, binding kinetic analysis was performed on A12. BIAcore analysis determined that the binding affinity of A12 for IGF-IR was 40 pM (0.04 x 10-9 M; Kon = 7.2 x 105 M-1s-1; Koff = 3.0 x 10-5 s-1) or approximately a 10-fold increase over 2F8. As a result of the increased affinity for receptor, A12 possessed greater binding activity in receptor-based ELISA (Fig. 1A)
. In turn, A12 also exhibited increased blocking activity of radiolabeled IGF-I ligand for immobilized IGF-IR (Fig. 1B.)
. A12 possessed similar blocking activity to cold IGF-I, with an IC50 of approximately 1 nM (0.15 µg/ml), but had significantly greater ligand blocking activity than 2F8 or IGF-II (IC50 = 6 nM).
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A12 Inhibits Ligand-Dependent IGF-IR Phosphorylation and Downstream Signaling.
Because it was demonstrated that anti-IGF-IR antibodies 2F8 and A12 possessed receptor antagonist activity on human tumor cells, as demonstrated by specific ligand blocking activity, we sought to determine the extent to which A12 inhibited receptor phosphorylation and activation of downstream effector molecules after ligand stimulation. Western blot analysis of receptor autophosphorylation and phosphorylation of Akt and MAPK (extracellular signal-regulated kinase 1/2) was performed in the presence or absence of antibody on the MCF7 human breast cancer cell line. As shown in Fig. 2A
, autophosphorylation of the IGF-IR was arrested after serum deprivation, and the addition of either 2F8 or A12 alone did not induce receptor phosphorylation, indicating the absence of detectable antibody agonist activity at a concentration of 100 nM. On the addition of 10 nM IGF-I, IGF-IR phosphorylation was strongly induced. 2F8 effected an approximately 50% reduction in ligand-mediated IGF-IR phosphorylation, whereas A12 almost completely blocked phosphorylation.
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A12 Does Not Block IR Signaling but Can Block Signaling of Atypical IGF-IR.
The IGF-IR shares considerable homology with the IR (47)
. To demonstrate the selectivity of A12 for the IGF-IR, the antibody was tested in an IR blocking assay. As shown in Fig. 3A
, A12 did not block the binding of radiolabeled insulin to the IR, even at 100 nM concentration. Cold insulin effectively competed with an IC50 of approximately 0.5 nM. A commercial anti-IR blocking antibody, 47-9, showed modest activity (50% maximal inhibition), and cold IGF-I competed only at high concentrations, consistent with previously published results (41)
. To further assess potential blocking of insulin binding on tumor cells, a blocking assay was performed on human breast cancer cell lines MCF7 and ZR-75-1. ZR-75-1 was included because it possesses a greater IR:IGF-IR ratio in comparison with MCF7 cells (44)
, and we reasoned that insulin binding to the cells would be more indicative of specific IR binding. MCF7 cells have been shown previously to possess atypical IGF-IR capable of high affinity binding of insulin (48)
. As shown in Fig. 3B
, although cold insulin was able to titrate the binding of radiolabeled insulin to cells, A12 did not block insulin binding to ZR-75-1 cells, even at an antibody concentration of 200 nM. As expected, A12 blocked insulin binding to MCF7 cells (Fig. 3C)
. To demonstrate selective blocking of IGF-IR and not IR by A12, we performed successive immunoprecipitation of IGF-IR and IR (44)
in these cell lines to obtain only classical IR homodimers. Immunoblot analysis (Fig. 3D)
showed no tyrosine phosphorylation of IRs in MCF7 cells by either IGF-I or insulin. To the contrary, tyrosine phosphorylation was induced by insulin but not IGF-I in ZR-75-1 and was not inhibited by A12. It could, however, be inhibited by the anti-IR blocking antibody 47-9. To assess further insulin signaling in MCF7 cells, we analyzed the IGF-IR/hybrid immunoprecipation for ligand-dependent signaling. As shown in the bottom panel of Fig. 3D
, tyrosine phosphorylation of these receptors was induced by both IGF-I and insulin and inhibited by A12 but not 47-9. These results demonstrate that A12 selectively blocks IGF-IR receptors, including atypical and hybrid receptors, and does not block IRs on tumor cells.
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A12 Inhibits IGF-Dependent Cell Mitogenesis and Proliferation.
To determine whether A12 was capable of inhibiting ligand-dependent cell proliferation as a result of receptor blocking and down-modulation activity, a mitogenic assay was performed on MCF7 cells (Fig. 5A)
. Ligand was titrated on cells to determine the dynamic range of ligand stimulation and the relative amount of ligand necessary to achieve maximal mitogenic response (510 nM). Concentrations of A12 from 100 nm were tested and shown to inhibit breast cancer cell mitogenesis in response to IGF-I ligand in a dose-dependent fashion, with an IC50 value of 5 nM. MCF7 cells treated with A12 in the absence of ligand failed to stimulate mitogenesis (Fig. 5B)
, demonstrating that this antibody lacks detectable receptor agonist activity. We then tested the effect of A12 on inhibiting tumor cell growth in culture. Proliferating cells in culture in serum-containing medium were treated with 50 nM A12, mouse anti-IGF-IR monoclonal antibody anti-IR-3, or a control antibody and incubated for 4 days. Total cell number was then determined, and the calculated number of cell doublings was determined. Anti-IR-3 was included in this proliferation assay for comparison of IGF-IR antagonist activity. As seen in Fig. 5C
, A12 effected a significant inhibition of MCF7 cell proliferation compared with control and anti-IR-3. In serum-containing medium, A12 inhibited proliferation of MCF7 cells by 90%, in comparison with 60% inhibition with anti-IR-3. To demonstrate broad inhibitory activity on multiple tumor types, we further tested A12 in mitogenic assays on several other diverse tumor types, including a second breast cancer line (T47D), a pancreatic cancer line (BxPC-3), and a multiple myeloma cell line (RPMI-8226). As shown in Fig. 5, DF
, A12 effected significant antimitogenic activity on each of these lines, with IC50s of 10 nM or less. The fold induction of these cells in response to IGF-I ligand stimulation ranged from 1.3-fold (T47D) to 4-fold (BxPC-3).
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| DISCUSSION |
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We determined that after binding to IGF-IR on the surface of human tumor cells, A12 is internalized into cells and leads to the rapid degradation of the receptor by a lysosome-dependent pathway. In doing so, A12 caused a significant reduction in the relative levels of surface-associated IGF-IR on MCF7 cells, as demonstrated by fluorescence-activated cell-sorting analysis. This effect was not observed after incubation with IGF-I. The precise mechanism by which antibodies can act to target the IGF-IR for degradation in a manner distinct from ligand is unclear. However, the ability of A12 to block ligand signaling by two processes, direct antagonism of ligand binding and receptor surface down-modulation, may greatly enhance its effectiveness in suppressing IGF-IR signaling in tumor cells.
Anticancer therapeutic strategies using antibodies to target growth factor receptors have emerged as a new class of effective clinical therapeutics, providing efficacy with low toxicity as an alternative or supplement to conventional cytotoxic therapy (51 , 52) . The IGF-IR signaling pathway has been extensively demonstrated to be a causative factor in the development of many types of cancer. We have shown that A12 was capable of inhibiting IGF ligand signaling, mitogenesis, and proliferation in a variety of human tumor cell lines in vitro. Using three distinct tumor xenograft models, A12 was shown to effect a >70% inhibition of tumor growth in vivo. In the MCF7 breast cancer model, A12 effected a dose-dependent inhibition of tumor growth. These results support the concept that targeting IGF-IR may be beneficial in treating diverse tumor types. No toxicity or weight loss was observed in any of the A12-treated animals. However, because A12 was selected for binding to the human form of the IGF-IR, it is possible that the weak cross-reactivity it possesses for the mouse receptor may be insufficient to effect toxicity in mice. In addition, because A12 is an IgG1 antibody, it is possible that some of the antitumor activity may be due to immune effector functions. However, we have recently determined that A12 failed to stimulate natural killer cell-mediated lysis of target tumor cells in an antibody-dependent cellular cytotoxicity chromium release assay,1 suggesting that the antitumor activity of A12 is due specifically to its function as an antagonist of the IGF-IR. In support of this, immunohistochemical analysis of tumor sections determined that a combination of both antiproliferative and proapoptotic processes was responsible for the reduction in tumor growth, and A12 could be demonstrated to effect a marked inhibition of total IGF-IR levels and phosphorylation after single-dose administration of the antibody.
Mechanistically, the fully human antibody A12 displays high affinity for the human IGF-IR and competes with its ligands, IGF-I and IGF-II, for binding. As a result, A12 inhibits ligand-mediated signal transduction of cell proliferation and survival pathways and dramatically inhibits tumor cell proliferation in vitro and in vivo. Because it is engineered as fully human monoclonal antibody, it is likely to exhibit low immunoreactivity in humans in vivo and therefore represents a good candidate molecule for therapeutic intervention in human diseases in which deregulated expression of the IGF-IR plays a critical role.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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Requests for reprints: Dale L. Ludwig, Department of Molecular Biology, ImClone Systems Incorporated, 180 Varick Street, New York, New York 10014. Phone: (646) 638-5187; Fax: (212) 645-2054; E-mail: Dale.Ludwig{at}imclone.com
1 D. L. Ludwig, unpublished results. ![]()
Received 6/10/03. Revised 10/ 1/03. Accepted 10/ 9/03.
| REFERENCES |
|---|
|
|
|---|
IR-3). J. Biol. Chem., 268: 2655-2661, 1993.This article has been cited by other articles:
![]() |
T. Iwasa, I. Okamoto, M. Suzuki, E. Hatashita, Y. Yamada, M. Fukuoka, K. Ono, and K. Nakagawa Inhibition of Insulin-Like Growth Factor 1 Receptor by CP-751,871 Radiosensitizes Non-Small Cell Lung Cancer Cells Clin. Cancer Res., August 15, 2009; 15(16): 5117 - 5125. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Adachi, R. Li, H. Yamamoto, Y. Min, W. Piao, Y. Wang, A. Imsumran, H. Li, Y. Arimura, C.-T. Lee, et al. Insulin-like growth factor-I receptor blockade reduces the invasiveness of gastrointestinal cancers via blocking production of matrilysin Carcinogenesis, August 1, 2009; 30(8): 1305 - 1313. [Abstract] [Full Text] [PDF] |
||||
![]() |
U. K. Misra, Y. Mowery, S. Kaczowka, and S. V. Pizzo Ligation of cancer cell surface GRP78 with antibodies directed against its COOH-terminal domain up-regulates p53 activity and promotes apoptosis Mol. Cancer Ther., May 1, 2009; 8(5): 1350 - 1362. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Doern, X. Cao, A. Sereno, C. L. Reyes, A. Altshuler, F. Huang, C. Hession, A. Flavier, M. Favis, H. Tran, et al. Characterization of Inhibitory Anti-insulin-like Growth Factor Receptor Antibodies with Different Epitope Specificity and Ligand-blocking Properties: IMPLICATIONS FOR MECHANISM OF ACTION IN VIVO J. Biol. Chem., April 10, 2009; 284(15): 10254 - 10267. [Abstract] [Full Text] [PDF] |
||||
![]() |
J.-E. Choi, S.-s. Lee, D. A. Sunde, I. Huizar, K. L. Haugk, V. J. Thannickal, R. Vittal, S. R. Plymate, and L. M. Schnapp Insulin-like Growth Factor-I Receptor Blockade Improves Outcome in Mouse Model of Lung Injury Am. J. Respir. Crit. Care Med., February 1, 2009; 179(3): 212 - 219. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. M. Barlaskar, A. C. Spalding, J. H. Heaton, R. Kuick, A. C. Kim, D. G. Thomas, T. J. Giordano, E. Ben-Josef, and G. D. Hammer Preclinical Targeting of the Type I Insulin-Like Growth Factor Receptor in Adrenocortical Carcinoma J. Clin. Endocrinol. Metab., January 1, 2009; 94(1): 204 - 212. [Abstract] [Full Text] [PDF] |
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B. C. Litzenburger, H.-J. Kim, I. Kuiatse, J. M. Carboni, R. M. Attar, M. M. Gottardis, C. R. Fairchild, and A. V. Lee BMS-536924 Reverses IGF-IR-Induced Transformation of Mammary Epithelial Cells and Causes Growth Inhibition and Polarization of MCF7 Cells Clin. Cancer Res., January 1, 2009; 15(1): 226 - 237. [Abstract] [Full Text] [PDF] |
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L. Cao, Y. Yu, I. Darko, D. Currier, L. H. Mayeenuddin, X. Wan, C. Khanna, and L. J. Helman Addiction to Elevated Insulin-like Growth Factor I Receptor and Initial Modulation of the AKT Pathway Define the Responsiveness of Rhabdomyosarcoma to the Targeting Antibody Cancer Res., October 1, 2008; 68(19): 8039 - 8048. [Abstract] [Full Text] [PDF] |
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J. Rodon, V. DeSantos, R. J. Ferry Jr., and R. Kurzrock Early drug development of inhibitors of the insulin-like growth factor-I receptor pathway: Lessons from the first clinical trials Mol. Cancer Ther., September 1, 2008; 7(9): 2575 - 2588. [Abstract] [Full Text] [PDF] |
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Y. Shang, Y. Mao, J. Batson, S. J. Scales, G. Phillips, M. R. Lackner, K. Totpal, S. Williams, J. Yang, Z. Tang, et al. Antixenograft tumor activity of a humanized anti-insulin-like growth factor-I receptor monoclonal antibody is associated with decreased AKT activation and glucose uptake Mol. Cancer Ther., September 1, 2008; 7(9): 2599 - 2608. [Abstract] [Full Text] [PDF] |
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M. Q. Lacy, M. Alsina, R. Fonseca, M. L. Paccagnella, C. L. Melvin, D. Yin, A. Sharma, M. Enriquez Sarano, M. Pollak, S. Jagannath, et al. Phase I, Pharmacokinetic and Pharmacodynamic Study of the Anti-Insulinlike Growth Factor Type 1 Receptor Monoclonal Antibody CP-751,871 in Patients With Multiple Myeloma J. Clin. Oncol., July 1, 2008; 26(19): 3196 - 3203. [Abstract] [Full Text] [PDF] |
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W. Piao, Y. Wang, Y. Adachi, H. Yamamoto, R. Li, A. Imsumran, H. Li, T. Maehata, M. Ii, Y. Arimura, et al. Insulin-like growth factor-I receptor blockade by a specific tyrosine kinase inhibitor for human gastrointestinal carcinomas Mol. Cancer Ther., June 1, 2008; 7(6): 1483 - 1493. [Abstract] [Full Text] [PDF] |
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D. Sachdev and D. Yee Disrupting Insulin-Like Growth Factor Signaling as a Potential Cancer Therapy Am. Assoc. Cancer Res. Educ. Book, April 12, 2008; 2008(1): 39 - 58. [Abstract] [Full Text] [PDF] |
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Y. Kusada, T. Morizono, A. Matsumoto-Takasaki, K. Sakai, S. Sato, H. Asanuma, A. Takayanagi, and Y. Fujita-Yamaguchi Construction and Characterization of Single-chain Antibodies Against Human Insulin-like Growth Factor-I Receptor from Hybridomas Producing 1H7 or 3B7 Monoclonal Antibody J. Biochem., January 1, 2008; 143(1): 9 - 19. [Abstract] [Full Text] [PDF] |
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P. D. Ryan and P. E. Goss The Emerging Role of the Insulin-Like Growth Factor Pathway as a Therapeutic Target in Cancer Oncologist, January 1, 2008; 13(1): 16 - 24. [Abstract] [Full Text] [PDF] |
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L. S. Quinn, B. G. Anderson, and S. R. Plymate Muscle-specific overexpression of the type 1 IGF receptor results in myoblast-independent muscle hypertrophy via PI3K, and not calcineurin, signaling Am J Physiol Endocrinol Metab, December 1, 2007; 293(6): E1538 - E1551. [Abstract] [Full Text] [PDF] |
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L. Wang, T. C. Schulz, E. S. Sherrer, D. S. Dauphin, S. Shin, A. M. Nelson, C. B. Ware, M. Zhan, C.-Z. Song, X. Chen, et al. Self-renewal of human embryonic stem cells requires insulin-like growth factor-1 receptor and ERBB2 receptor signaling Blood, December 1, 2007; 110(12): 4111 - 4119. [Abstract] [Full Text] [PDF] |
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S. R. Plymate, K. Haugk, I. Coleman, L. Woodke, R. Vessella, P. Nelson, R. B. Montgomery, D. L. Ludwig, and J. D. Wu An Antibody Targeting the Type I Insulin-like Growth Factor Receptor Enhances the Castration-Induced Response in Androgen-Dependent Prostate Cancer Clin. Cancer Res., November 1, 2007; 13(21): 6429 - 6439. [Abstract] [Full Text] [PDF] |
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E. K. Rowinsky, H. Youssoufian, J. R. Tonra, P. Solomon, D. Burtrum, and D. L. Ludwig IMC-A12, a Human IgG1 Monoclonal Antibody to the Insulin-Like Growth Factor I Receptor Clin. Cancer Res., September 15, 2007; 13(18): 5549s - 5555s. [Abstract] [Full Text] [PDF] |
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C. J. Barnes, K. Ohshiro, S. K. Rayala, A. K. El-Naggar, and R. Kumar Insulin-like Growth Factor Receptor as a Therapeutic Target in Head and Neck Cancer Clin. Cancer Res., July 15, 2007; 13(14): 4291 - 4299. [Abstract] [Full Text] [PDF] |
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L. Conti, G. Regis, A. Longo, P. Bernabei, R. Chiarle, M. Giovarelli, and F. Novelli In the absence of IGF-1 signaling, IFN-{gamma} suppresses human malignant T-cell growth Blood, March 15, 2007; 109(6): 2496 - 2504. [Abstract] [Full Text] [PDF] |
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H. D. Sun, M. Malabunga, J. R. Tonra, R. DiRenzo, F. E. Carrick, H. Zheng, H.-R. Berthoud, O. P. McGuinness, J. Shen, P. Bohlen, et al. Monoclonal antibody antagonists of hypothalamic FGFR1 cause potent but reversible hypophagia and weight loss in rodents and monkeys Am J Physiol Endocrinol Metab, March 1, 2007; 292(3): E964 - E976. [Abstract] [Full Text] [PDF] |
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G. W. Allen, C. Saba, E. A. Armstrong, S.-M. Huang, S. Benavente, D. L. Ludwig, D. J. Hicklin, and P. M. Harari Insulin-like Growth Factor-I Receptor Signaling Blockade Combined with Radiation Cancer Res., February 1, 2007; 67(3): 1155 - 1162. [Abstract] [Full Text] [PDF] |
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D. Sachdev and D. Yee Disrupting insulin-like growth factor signaling as a potential cancer therapy Mol. Cancer Ther., January 1, 2007; 6(1): 1 - 12. [Abstract] [Full Text] [PDF] |
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J. D. Wu, K. Haugk, I. Coleman, L. Woodke, R. Vessella, P. Nelson, R. B. Montgomery, D. L. Ludwig, and S. R. Plymate Combined In vivo Effect of A12, a Type 1 Insulin-Like Growth Factor Receptor Antibody, and Docetaxel against Prostate Cancer Tumors. Clin. Cancer Res., October 15, 2006; 12(20): 6153 - 6160. [Abstract] [Full Text] [PDF] |
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J. M. O'Toole, K. E. Rabenau, K. Burns, D. Lu, V. Mangalampalli, P. Balderes, N. Covino, R. Bassi, M. Prewett, K. J. Gottfredsen, et al. Therapeutic Implications of a Human Neutralizing Antibody to the Macrophage-Stimulating Protein Receptor Tyrosine Kinase (RON), a c-MET Family Member. Cancer Res., September 15, 2006; 66(18): 9162 - 9170. [Abstract] [Full Text] [PDF] |
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G. Descamps, S. Wuilleme-Toumi, V. Trichet, C. Venot, L. Debussche, T. Hercend, M. Collette, N. Robillard, R. Bataille, and M. Amiot CD45neg but Not CD45pos Human Myeloma Cells Are Sensitive to the Inhibition of IGF-1 Signaling by a Murine Anti-IGF-1R Monoclonal Antibody, mAVE1642 J. Immunol., September 15, 2006; 177(6): 4218 - 4223. [Abstract] [Full Text] [PDF] |
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V. L. T. Ballard, J. M. Holm, and J. M. Edelberg Quantitative PCR-based approach for rapid phage display analysis: a foundation for high throughput vascular proteomic profiling Physiol Genomics, September 14, 2006; 26(3): 202 - 208. [Abstract] [Full Text] [PDF] |
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Z. Wang, G. Chakravarty, S. Kim, Y. D. Yazici, M. N. Younes, S. A. Jasser, A. A. Santillan, C. D. Bucana, A. K. El-Naggar, and J. N. Myers Growth-Inhibitory Effects of Human Anti-Insulin-Like Growth Factor-I Receptor Antibody (A12) in an Orthotopic Nude Mouse Model of Anaplastic Thyroid Carcinoma Clin. Cancer Res., August 1, 2006; 12(15): 4755 - 4765. [Abstract] [Full Text] [PDF] |
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L. M. Schnapp, S. Donohoe, J. Chen, D. A. Sunde, P. M. Kelly, J. Ruzinski, T. Martin, and D. R. Goodlett Mining the Acute Respiratory Distress Syndrome Proteome: Identification of the Insulin-Like Growth Factor (IGF)/IGF-Binding Protein-3 Pathway in Acute Lung Injury Am. J. Pathol., July 1, 2006; 169(1): 86 - 95. [Abstract] [Full Text] [PDF] |
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S. L. Spence, A. L. Shaffer, L. M. Staudt, S. Amde, S. Manney, C. Terry, K. Weisz, and P. Nissley Transformation of Late Passage Insulin-Like Growth Factor-I Receptor Null Mouse Embryo Fibroblasts by SV40 T Antigen. Cancer Res., April 15, 2006; 66(8): 4233 - 4239. [Abstract] [Full Text] [PDF] |
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S. D. Oldroyd, Y. Miyamoto, A. Moir, T. S. Johnson, A. M. El Nahas, and J. L. Haylor An IGF-I antagonist does not inhibit renal fibrosis in the rat following subtotal nephrectomy Am J Physiol Renal Physiol, March 1, 2006; 290(3): F695 - F702. [Abstract] [Full Text] [PDF] |
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D. Sachdev, R. Singh, Y. Fujita-Yamaguchi, and D. Yee Down-regulation of Insulin Receptor by Antibodies against the Type I Insulin-Like Growth Factor Receptor: Implications for Anti-Insulin-Like Growth Factor Therapy in Breast Cancer Cancer Res., February 15, 2006; 66(4): 2391 - 2402. [Abstract] [Full Text] [PDF] |
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K. E. O'Reilly, F. Rojo, Q.-B. She, D. Solit, G. B. Mills, D. Smith, H. Lane, F. Hofmann, D. J. Hicklin, D. L. Ludwig, et al. mTOR Inhibition Induces Upstream Receptor Tyrosine Kinase Signaling and Activates Akt Cancer Res., February 1, 2006; 66(3): 1500 - 1508. [Abstract] [Full Text] [PDF] |
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E. Menu, H. Jernberg-Wiklund, T. Stromberg, H. De Raeve, L. Girnita, O. Larsson, M. Axelson, K. Asosingh, K. Nilsson, B. Van Camp, et al. Inhibiting the IGF-1 receptor tyrosine kinase with the cyclolignan PPP: an in vitro and in vivo study in the 5T33MM mouse model Blood, January 15, 2006; 107(2): 655 - 660. [Abstract] [Full Text] [PDF] |
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A. Al-Zahrani, M. S. Sandhu, R. N. Luben, D. Thompson, C. Baynes, K. A. Pooley, C. Luccarini, H. Munday, B. Perkins, P. Smith, et al. IGF1 and IGFBP3 tagging polymorphisms are associated with circulating levels of IGF1, IGFBP3 and risk of breast cancer Hum. Mol. Genet., January 1, 2006; 15(1): 1 - 10. [Abstract] [Full Text] [PDF] |
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Y. Feng, Z. Zhu, X. Xiao, V. Choudhry, J. C. Barrett, and D. S. Dimitrov Novel human monoclonal antibodies to insulin-like growth factor (IGF)-II that potently inhibit the IGF receptor type I signal transduction function Mol. Cancer Ther., January 1, 2006; 5(1): 114 - 120. [Abstract] [Full Text] [PDF] |
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B. S. Miller and D. Yee Type I Insulin-like Growth Factor Receptor as a Therapeutic Target in Cancer Cancer Res., November 15, 2005; 65(22): 10123 - 10127. [Abstract] [Full Text] [PDF] |
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Y. Wang, J. Hailey, D. Williams, Y. Wang, P. Lipari, M. Malkowski, X. Wang, L. Xie, G. Li, D. Saha, et al. Inhibition of insulin-like growth factor-I receptor (IGF-IR) signaling and tumor cell growth by a fully human neutralizing anti-IGF-IR antibody Mol. Cancer Ther., August 1, 2005; 4(8): 1214 - 1221. [Abstract] [Full Text] [PDF] |
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Z. T. Bloomgarden Second World Congress on the Insulin Resistance Syndrome: Mediators, pediatric insulin resistance, the polycystic ovary syndrome, and malignancy Diabetes Care, July 1, 2005; 28(7): 1821 - 1830. [Full Text] [PDF] |
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D. Lu, H. Zhang, H. Koo, J. Tonra, P. Balderes, M. Prewett, E. Corcoran, V. Mangalampalli, R. Bassi, D. Anselma, et al. A Fully Human Recombinant IgG-like Bispecific Antibody to Both the Epidermal Growth Factor Receptor and the Insulin-like Growth Factor Receptor for Enhanced Antitumor Activity J. Biol. Chem., May 20, 2005; 280(20): 19665 - 19672. [Abstract] [Full Text] [PDF] |
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S. Miyamoto, M. Nakamura, K. Shitara, K. Nakamura, Y. Ohki, G. Ishii, M. Goya, K. Kodama, T. Sangai, H. Maeda, et al. Blockade of Paracrine Supply of Insulin-Like Growth Factors Using Neutralizing Antibodies Suppresses the Liver Metastasis of Human Colorectal Cancers Clin. Cancer Res., May 1, 2005; 11(9): 3494 - 3502. [Abstract] [Full Text] [PDF] |
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J. D. Wu, A. Odman, L. M. Higgins, K. Haugk, R. Vessella, D. L. Ludwig, and S. R. Plymate In vivo Effects of the Human Type I Insulin-Like Growth Factor Receptor Antibody A12 on Androgen-Dependent and Androgen-Independent Xenograft Human Prostate Tumors Clin. Cancer Res., April 15, 2005; 11(8): 3065 - 3074. [Abstract] [Full Text] [PDF] |
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N. Loizos, Y. Xu, J. Huber, M. Liu, D. Lu, B. Finnerty, R. Rolser, A. Malikzay, A. Persaud, E. Corcoran, et al. Targeting the platelet-derived growth factor receptor {alpha} with a neutralizing human monoclonal antibody inhibits the growth of tumor xenografts: Implications as a potential therapeutic target Mol. Cancer Ther., March 1, 2005; 4(3): 369 - 379. [Abstract] [Full Text] [PDF] |
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B. D. Cohen, D. A. Baker, C. Soderstrom, G. Tkalcevic, A. M. Rossi, P. E. Miller, M. W. Tengowski, F. Wang, A. Gualberto, J. S. Beebe, et al. Combination Therapy Enhances the Inhibition of Tumor Growth with the Fully Human Anti-Type 1 Insulin-Like Growth Factor Receptor Monoclonal Antibody CP-751,871 Clin. Cancer Res., March 1, 2005; 11(5): 2063 - 2073. [Abstract] [Full Text] [PDF] |
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G. S. Warshamana-Greene, J. Litz, E. Buchdunger, C. Garcia-Echeverria, F. Hofmann, and G. W. Krystal The Insulin-Like Growth Factor-I Receptor Kinase Inhibitor, NVP-ADW742, Sensitizes Small Cell Lung Cancer Cell Lines to the Effects of Chemotherapy Clin. Cancer Res., February 15, 2005; 11(4): 1563 - 1571. [Abstract] [Full Text] [PDF] |
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Y. H. Ibrahim and D. Yee Insulin-Like Growth Factor-I and Breast Cancer Therapy Clin. Cancer Res., January 15, 2005; 11(2): 944s - 950s. [Abstract] [Full Text] [PDF] |
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R. Kooijman and A. Coppens Insulin-like growth factor-I stimulates IL-10 production in human T cells J. Leukoc. Biol., October 1, 2004; 76(4): 862 - 867. [Abstract] [Full Text] [PDF] |
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G. Bocci, S. Man, S. K. Green, G. Francia, J. M. L. Ebos, J. M. du Manoir, A. Weinerman, U. Emmenegger, L. Ma, P. Thorpe, et al. Increased Plasma Vascular Endothelial Growth Factor (VEGF) as a Surrogate Marker for Optimal Therapeutic Dosing of VEGF Receptor-2 Monoclonal Antibodies Cancer Res., September 15, 2004; 64(18): 6616 - 6625. [Abstract] [Full Text] [PDF] |
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