BINDNG MOLECULES TO TUMOR ASSOCIATED MACROPHAGES AND METHODS OF USE

Abstract

Provided herein are binding molecules to tumor associated macrophages and associated methods for the treatment and detection of cancer.

Description

BACKGROUND OF THE INVENTION

Macrophages are distributed across all major organs, play central roles in normal immune homeostasis and disease progression, such as cancer, and are key regulators in the tumor microenvironment. In many tumors, anti-inflammatory macrophages (alternatively activated or M2 subtype), also known as tumor-associated macrophages (TAMs), are responsible for generating an immunosuppressive tumor microenvironment, which prevents the recognition and elimination of tumor cells by the immune system.

SUMMARY OF THE INVENTION

Described herein are molecules which preferentially bind to and target tumor associated macrophages (TAMs), pharmaceutical compositions thereof, and methods of treating and diagnosing the cancer and the immunosuppressive tumor microenvironment. Further provided, are pharmaceutical compositions comprising a tumor associated macrophage (TAM) binding molecule conjugated to a moiety, and a delivery agent and methods relating to the use of such pharmaceutical compositions for the treatment of cancer wherein the pharmaceutical composition is cytolytic to TAMs, removes, reduces and/or neutralizes TAMs, or repolarizes TAMs from an M2 phenotype to an M1 phenotype, methods relating to the use of such a pharmaceutical for the detection of cancer, and methods relating to the use of such a pharmaceutical for the detection of TAMs or a tumor microenvironment.

In one aspect, pharmaceutical compositions are provided. In some embodiments, the pharmaceutical compositions comprise a TAM binding molecule. In some embodiments, the pharmaceutical compositions comprise a TAM binding molecule conjugated to a moiety. In some embodiments, the pharmaceutical compositions comprise a TAM binding molecule conjugated to a moiety, and a binding agent. In some embodiments, the TAM binding molecule binds to retinoid X receptor beta on the TAM. In some embodiments, the TAM binding molecule is a peptide, ligand, antibody, non-IG domain, or small molecule entity. In some embodiments, the TAM binding molecule is an antibody or antigen-binding fragment thereof. In some embodiments, the antibody is an IgG, IgA, or IgM antibody. In some embodiments, the antibody is a single domain antibody. In some instances, the antibody is a chimeric, humanized, or human antibody. In other instances, the antigen binding fragment is a Fab, Fab′, Fab′-SH, Fv, scFv, F(ab′)2, or a diabody. In other embodiments, the TAM binding molecule is a peptide. In some instances, the TAM binding peptide is cyclic. In yet other instances, the cyclic TAM binding peptide comprises a) CRVLRSGSC, or b) CRVLRSGSC with at least one conservative amino acid substitution. In some embodiments, the moiety which is conjugated to the TAM binding molecule is a therapeutic agent or a diagnostic agent. In some instances, the moiety is a therapeutic agent wherein the therapeutic agent is a cytotoxic agent, a chemotherapeutic agent, a protein, a peptide, an antibody, a growth inhibitory agent, a nucleic acid, or an anti-hormonal agent. In other instances, the therapeutic is a cytotoxic agent wherein the cytotoxic agent is a ribosome inactivating protein, a histone deacetylase (HDAC) inhibitor, a tubulin inhibitor, an alkylating agent, an antibiotic, an antineoplastic agent, an antiproliferative agent, an antimetabolite, a topoisomerase I or II inhibitor, a hormonal agonist or antagonist, an immunomodulator, a DNA minor groove binder, or a radioactive agent. In other embodiments, the moiety is a diagnostic agent wherein the diagnostic agent is a label. In some instances, the diagnostic agent is a label wherein the label is a fluorescent label, a chromogenic label, or a radiolabel. In some embodiments, the pharmaceutical composition is comprised of the TAM binding molecule directly conjugated to the moiety. In other embodiments, the pharmaceutical composition is comprised of the TAM binding molecule indirectly conjugated to the moiety via a linker. In some instances, the delivery agent is a liposome, microsphere, nanoparticle, microemulsion, microcapsule, polymer matrix, hydrogel, or viral vector.

In another aspect, a method of treating cancer is provided. The method generally includes administering to a subject a pharmaceutical composition as described above. In some embodiments, the TAM binding molecule is cytolytic to tumor cells. In some embodiments, the TAM binding molecule inhibits tumor growth. In some embodiments, the method of treating cancer is provided wherein the cancer is selected from the group consisting of brain cancer, renal cancer, ovarian cancer, prostate cancer, lymphoma, breast cancer colon cancer, lung cancer, squamous cell carcinoma of the head and neck, and melanoma. In some embodiments, the method is performed wherein the pharmaceutical composition is administered topically, subcutaneously, intravenously, intradermally, intraperitoneally, orally, intramuscularly, or intracranially. In some embodiments, the method is performed wherein the pharmaceutical composition is administered in combination with a second therapeutic agent. In further embodiments, the method is performed in combination with a second therapeutic agent wherein the second therapeutic agent is a cancer chemotherapeutic agent, radiation therapy, a cytotoxic agent, another antibody, a NSAID, a corticosteroid, a dietary supplement (e.g. an antioxidant), or a combination thereof.

In another aspect, a method of reducing the number of TAMS in a tumor microenvironment in a subject having cancer is provided. This method generally includes a pharmaceutical composition described above wherein the pharmaceutical composition is cytolytic to TAMs.

In another aspect, a method of removing immunosuppression in a tumor microenvironment in a subject having cancer is provided. This method generally includes a pharmaceutical composition described above wherein the pharmaceutical composition removes, reduces, and/or neutralizes TAMs.

In another aspect, a method of repolarizing TAMS from an M2 phenotype to an M1 phenotype in a subject having cancer is provided. This method generally includes a pharmaceutical composition described above wherein the pharmaceutical composition repolarizes TAMs from an M2 phenotype to an M1 phenotype.

In another aspect, a method of detecting cancer in a subject is provided. This method generally includes administering to a subject thereof a pharmaceutical composition as described.

In another aspect, a method of detecting TAMS in a tumor microenvironment in a subject having cancer is provided. This method generally includes administering to a subject thereof a pharmaceutical composition as described above.

In another aspect, a method of detecting a tumor microenvironment in a subject is provided. This method generally includes administering to a subject thereof a pharmaceutical composition as described above.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.

BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:

TABLE 1 is a summary of tumors tested for CRV in vivo homing.

FIG. 1 is a depiction of FAM-peptide binding. A) In vitro binding of FAM-peptide to different cell lines. Cells were incubated with FAM-CRV or FAM-GGS (10 μM) at 4° C. for 1 h and washed with PBS. Fluorescence was measured by flow cytometry. High binding of FAM-CRV compared to FAM-GGS was found on J774, RAW, and THP-1 differentiated macrophages, but not on 4T1 tumor cells. B) Representative UV illumination image of FAM-CRV homing in different tissues in 4T1 breast cancer mice. 100 μg of FAM-CRV in 100 μL PBS was injected intravenously into 4T1 mice for 1-h circulation. Tissues were collected after transcardial perfusion with PBS.

FIG. 2 depicts immunofluorescence staining of tissues for FAM-peptide and CD31 with different homing time points (5, 15, and 60 min). Tissue sections of 4T1 orthotopic tumor-bearing mice injected with FAM-CRV or FAM-GGS peptide were stained with anti-FITC (green), anti-CD31 antibodies (red), and DAPI (blue). A) Homing results of FAM-CRV or FAM-GGS in tumors at different time points. Top row: whole tumor view. Bottom row: magnified view of regions marked by white squares in top row. B) Distribution of FAM-CRV in other organs. FAM-CRV signal washed out with time.

FIG. 3 depicts the association of FAM-CRV with tumor macrophages. A) Immunofluorescence staining of 4T1 mouse tissues for FAM-CRV and macrophage markers. Tissue sections were stained with anti-FITC (green), anti-CD11b, anti-F4/80 or anti-CD68 antibodies (red), and DAPI (blue). Scale bars: 100 μm. B-D) Ex vivo binding of FAM-CRV or FAM-GGS to cells isolated from different organs of 4T1 mice. Cells were incubated with FAM-CRV or FAM-GGS, CD11b, CD68, and F4/80 primary and secondary antibodies at 4° C. for 1 h. The cells were then washed and analyzed by flow cytometry. B: Preferential binding of FAM-CRV to tumor cells compared to blood and spleen cells. C: FAM-CRV or FAM-GGS binding to tumor cells. D: Population of CD11b and F4-80 positive cells in FAM-CRV positive cells. E) Flow cytometric analysis of cells isolated from 4T1 tumors after in vivo FAM-CRV homing. Tumors were obtained at 15 or 60 min post intravenous administration of FAM-CRV. Cells were incubated with CD11b, and F4/80 primary and secondary antibodies at 4° C. for 1 h, washed, and analyzed with flow cytometry.

FIG. 4 depicts the evaluation of FAM-CRV binding to macrophages in atherosclerotic plaques. A) In vivo homing of FAM-CRV, FAM-ARA (negative control), or FAM-LyP-1 (positive control) in ApoE −/− mice bearing atherosclerotic plaques in the aorta. 100 μg of the FAM-CRV, FAM-LyP1, or FAM-ARA was injected intravenously for 1-h circulation. The aorta (middle), kidney (right) and liver (left) were excised and imaged with UV illuminator. B) Ex vivo staining of isolated from aorta with plaques with FAM-CRV or FAM-GGS. Cells were incubated at 4° C. for 1 h, and then analyzed by flow cytometry.

FIG. 5 depicts the evaluation of RXRB as a CRV binding receptor. A) High binding of FAM-CRV compared to FAM-GGS to immobilized recombinant human RXRB protein. B) Silencing the expression of RXRB inhibited CRV binding to RAW at 4° C. for 1 h. C) Immunohistochemical staining of RXRB on 4T1 tumors with FAM-CRV or FAM-GGS in vivo homing. RXRB IHC staining colocalized with FAM-CRV and CD11b from immunofluorescence staining. D-F) Ex vivo binding of CRV to dissociated cells from 4T1 tumor. Cells were stained with FAM-CRV or FAM-GGS, CD11b, CD68, F4/80, and RXRB primary and secondary antibodies at 4° C. for 1 h. The cells were washed and analyzed with flow cytometry. G) Cell staining after in vivo FAM-CRV homing. Tumors were obtained at 60 min post intravenous administration of FAM-CRV. Cells were incubated with RXRB, CD11b, and F4/80 primary and secondary antibodies at 4° C. for 1 h. The cells were washed and analyzed with flow cytometry.

FIG. 6 depicts immunofluorescence staining of 4T1 mouse tissues with RXRB antibody and FAM-CRV in vivo homing. Tissue sections of 4T1 orthotopic tumor-bearing mice were stained with anti-FITC (fuchsia), anti-RXRB antibodies or control rabbit IgG (green), anti-CD11b, CD68, F4/80, or CD31 antibodies (red) and DAPI (blue). The last column shows a merged image from the control IgG-receiving animals.

FIG. 7 describes CRV-pSiNP homing. A) Fluorescence imaging of tissues from 4T1 mice after 1-h circulation of NPs. Top row: mouse injected with pSiNP. Bottom row: mouse injected with CRV-pSiNP. B) Flow cytometric analysis of cells isolated from 4T1 tumors after in vivo CRV-pSiNP or pSiNP homing. Tumors were obtained 60 min post intravenous administration. Cells were incubated with CD11b and CD68 primary and secondary antibodies at 4° C. for 1 h, washed, and analyzed with flow cytometry.

DETAILED DESCRIPTION OF THE INVENTION

Macrophages and the Tumor Microenvironment

In vivo, the tumor microenvironment is a complex milieu containing multiple cell types including tumor cells, vascular cells such as endothelial cells, and stromal cells, such as fibroblasts. In addition, in vivo, these cells are exposed to blood flow and various biological transport conditions. In vivo, microvascular cells in a tumor are affected by blood flow and communicate with tumor and non-tumor cells, both physically and through diffusible factors. In addition, the tumor vasculature is abnormal, characterized by chaotic branching, a low flow rate, and leaky vessels, and thus serves as a major transport barrier to anticancer therapies that target tumor cells. The interplay between tumor cells, endothelial cells, and stromal cells affects each cell type, leading to increased angiogenesis and tumor cell proliferation, and this crosstalk may be an important factor in determining the responsiveness of tumor cells to anticancer drugs.

In the tumor microenvironment cells experience oxygen and nutrient deprivation. Hypoxic stress alters the metabolism of tumor cells and macrophages within tumors with subsequent changes in the microenvironment. The change in microenvironment alters the phenotype and metabolism of macrophages to induce a tumor-promoting reprogramming. Nutrient stress also provokes autophagy to guarantee cell survival or to induce cell death. Death of tumor cells is communicative system attracting macrophages and directing their phenotype. Depending on the mode of tumor cell death macrophage polarization ranges from pro-inflammatory activation to anti-inflammatory/immuno-suppressive activation.

Chronic inflammation contributes to cancer development. The presence and activation of chronic innate immune cell types (e.g., neutrophils, macrophages, and mast cells) promote cancer development. Thus it is clear that some subsets of chronically activated innate cells promote the growth and/or facilitate the survival of neoplastic cells. Depending on their polarization status, immune cells can exert either antitumor (e.g. T-helper 1 (Th1) vs Th17 subsets of CD4(+) T cells, type I) or protumor (e.g. vs type II NKT cells, M1 vs M2 macrophages, and N1 vs N2 neutrophils) functions. Chronically activated and polarized immune cells (e.g. M2 macrophages and N2 neutrophils) produce or carry a myriad of chemokines, cytokines, growth factors, and proteases leading to tissue remodeling, angiogenesis, cell proliferation, genomic instability, and expansion of neoplastic cells into ectopic tissue.

Macrophages are a type of white blood cell, of the immune system, that engulfs and digests cellular debris, foreign substances, microbes, cancer cells, and anything else that does not have the type of proteins specific to healthy body cells on its surface in a process called phagocytosis. Macrophages increase inflammation and stimulate the immune system. Macrophages also play an important anti-inflammatory role and can decrease immune reactions through the release of cytokines. Macrophages that encourage inflammation are called M1 macrophages, whereas macrophages that decrease inflammation and encourage tissue repair are called M2 macrophages. Macrophages are a dominating immune cell population in most solid tumors. Tumor-associated macrophages (TAMs) are a type of macrophage. TAMs are thought to acquire an M2 phenotype, contributing to tumor growth and progression. TAMs can regulate tumor progression. Therapeutic strategies to reduce the number of TAMs or to manipulate the TAM phenotype are of interest to cancer therapy.

Retinoid X receptors (RXR) are members in the superfamily of nuclear receptor and have essential nuclear and cytoplasmic functions as transcription factors. RXR is a type of nuclear receptor that is activated by 9-cis retinoic acid, which is contemplated to be of endogenous relevance. RXR is also activated by 9-cis-13,14-dihydro-retinoic acid, may be the major endogenous mammalian RXR-selective agonist. There are three retinoic X receptors (RXR): RXR-alpha (RXRA), RXR-beta (RXRB), and RXR-gamma (RXRG), encoded by the RXRA, RXRB, RXRG genes, respectively. RXR is a hetero-dimerization partner for the members of the subfamily II nuclear receptors which regulate the transcription of numerous target genes, following chemical activation. RXR can heterodimerize with subfamily I nuclear receptors including CAR, FXR, LXR, PPAR, PXR, RAR, TR, and VDR. The RXR heterodimer in the absence of ligand is bound to hormone response elements complexed with corepressor protein. Binding of agonist ligands to RXR results in dissociation of corepressor and recruitment of coactivator protein. This promotes transcription of the downstream target gene into mRNA and eventually protein. RXR can regulate macrophages in inflammatory and metabolic disorders and there is potential for direct modulation of RXR signaling to treat macrophage-related pathologies. The cell surface expression of RXRB is specific to TAMs and RXRB is responsible for the preferential binding of CRV and other contemplated molecules to tumor macrophages.

Molecules that Target TAMs

The peptide CRV (CRVLRSGSC) is a cyclic macrophage-targeting peptide with a disulfide bond between the terminal cysteine residues. CRV selectively homes to tumors and binds with TAMs within said tumors. CRV recognizes and binds to RXRB on the surface of TAMs within tumors. CRV only recognizes TAMs, but not macrophages in atherosclerotic plaques.

CRV can be linked to a therapeutic agent. The therapeutic agent can comprise antibodies (e.g. IgG, IgA, or IgM).

CRV can be modified to produce a related peptide which is contemplated to also act as a TAM molecule. Examples of such a modification include one or more substitutions, deletions, or additions of amino acids. Conservative substitutions include amino acid substitutions that substitute a given amino acid with another amino acid of similar characteristics and further include, among the aliphatic amino acids interchange of alanine, valine, leucine, and isoleucine; interchange of the hydroxyl residues serine and threonine, exchange of the acidic residues aspartate and glutamate, substitution between the amide residues asparagine and glutamine, exchange of the basic residues lysine and arginine, and replacements among the aromatic residues phenylalanine and tyrosine. In some embodiments CRV is modified with one or more amino acid conservative substitutions. In other embodiments, CRV is modified with one amino acid conservative substitution.

Other TAM binding molecules which can act as a cell surface RXRB binding molecule to selectively bind TAMs comprise antibodies (e.g. IgG, IgA, or IgM), antigen binding fragments, peptides, ligands, non-IG domains, or small molecules. Said TAM binding molecules may bind RXRB at different locations on the RXRB molecule. If the TAM binding molecule is an antibody, it can be a single domain antibody, chimeric antibody, humanized antibody, human antibody, and/or monoclonal antibody. If the TAM binding molecule is an antigen binding fragment, it can be a Fab, Fab′, Fab′-SH, Fv, scFv, F(ab′)2, or a diabody. If the TAM binding molecule is a peptide, it can be cyclic. If the TAM binding molecule is cyclic, it can be CRV or another peptide.

Modifications to the TAM binding molecules are contemplated. These modifications include conjugation to an additional moiety. This moiety can be a therapeutic agent or a diagnostic agent to be used clinically or for research purposes.

These modifications can further constitute a delivery system, which can deliver the TAM binding molecules in a targeted fashion to the tumor or tumor microenvironment. Benefits of this delivery system can include reduction in the frequency of the dosages taken by a patient, a uniform effect of the drug, reduction of drug side-effects, and reduction of fluctuation in circulating drug levels.

Said moiety or TAM binding molecule or both can be held in a delivery agent. Said delivery agent can be a liposome, microsphere, nanoparticle, microemulsion, microcapsule, polymer matrix, hydrogel, or viral vector.

Liposomes are non-toxic, non-hemolytic, and non-immunogenic even upon repeated injections; they are biocompatible and biodegradable and can be designed to avoid clearance mechanisms (reticuloendothelial system (RES), renal clearance, chemical or enzymatic inactivation, or other undesirable effects. Lipid-based, ligand-coated nanocarriers can store their payload in a hydrophobic shell or a hydrophilic interior depending on the nature of the agent being carried.

Microspheres can encapsulate many types of drugs including small molecules, proteins, and nucleic acids and are easily administered through a syringe needle. Microspheres are generally biocompatible, can provide high bioavailability, and are capable of sustained release for long time periods. Disadvantages of microspheres include difficulty of large-scale manufacturing, inactivation of drug during fabrication, and poor control of drug release rates.

Nanoparticle-based drug delivery systems are contemplated to be a useful method for delivering agents. Some benefits of using nanoparticles include controllable release of the payload into the cytoplasm and circumvention of tumor drug resistance.

Microemulsions are isotropic, thermodynamically stable transparent (or translucent) systems of oil, water and surfactant, frequently in combination with a cosurfactant with a droplet size usually in the range of 20-200 nm. Said microemulsions can be classified as oil-in-water (o/w), water-in-oil (w/o) or bicontinuous systems depending on their structure and are characterized by ultra-low interfacial tension between oil and water phases. Said systems are currently of great technological and scientific interest to the researchers because of their potential to incorporate a wide range of drug molecules (hydrophilic and hydrophobic) due to the presence of both lipophilic and hydrophilic domains. These adaptable delivery systems provide protection against oxidation, enzymatic hydrolysis and improve the solubilization of lipophilic drugs and hence enhance their bioavailability. Microemulsions are suitable for oral and intravenous delivery systems and for sustained and targeted delivery (e.g. through ophthalmic, dental, pulmonary, vaginal and topical routes). Microemulsions have been used to improve the oral bioavailability of various poorly soluble drugs. In some instances, microemulsions are employed for challenging tasks such as carrying chemotherapeutic agents to neoplastic cells and oral delivery of insulin.

Microcapsules are particles with a diameter of 1-1000 μm, irrespective of the precise interior or exterior structure, which can be used for agent delivery. Microcapsules offer various significant advantages as drug delivery systems (e.g. an effective protection of the encapsulated active agent against (e.g. enzymatic) degradation, the possibility to accurately control the release rate of the incorporated drug over periods of hours to months, an easy administration (compared to alternative parenteral controlled release dosage forms, such as macro-sized implants), and desired, pre-programmed drug release profiles can be provided which match the therapeutic needs of the patient.

Agents can be embedded into a polymeric matric or co-crystallized with a polymeric template. Polymers are a drug delivery technology which provide controlled release of therapeutic agents in constant doses over long periods, cyclic dosage, and tunable release of both hydrophilic and hydrophobic drugs. Polymer Matrices may be tailored for specific cargo and engineered to exert distinct biological functions.

Hydrogels are three-dimensional, cross-linked networks of water-soluble polymers. Hydrogels can be made from virtually any water-soluble polymer, encompassing a wide range of chemical compositions and bulk physical properties. Furthermore, hydrogels can be formulated in a variety of physical forms, including slabs, microparticles, nanoparticles, coatings, and films. As a result, hydrogels are commonly used in clinical practice and experimental medicine for a wide range of applications, including tissue engineering and regenerative medicine, diagnostics, cellular immobilization, separation of biomolecules or cells, and barrier materials to regulate biological adhesions

Virus delivery vectors are a type of nanomaterial which can be a drug delivery material. A successful vector must be able to effectively carry and subsequently deliver a drug cargo to a specific target.

Said conjugation can be achieved directly or indirectly, and with or without a linker molecule. This linker molecule can be a pH sensitive linker, a disulfide linker, a peptide linker, a beta-glucoronide linker, a redox responsive linker, a hydrazone linker, a hydrophilic linker, an azo linker, or another type of linker. Said linker can respond to a stimulus to initiate drug release. Said stimulus can be internal or external. Said stimulus can be local. Said stimulus can be pH, enzyme, light, heat, or another stimulus.

If the TAM binding molecule is conjugated to a moiety which is a therapeutic agent, said therapeutic agent can be a cytotoxic agent (e.g. ribosome inactivating protein, histone deacetylase inhibitor, tubulin inhibitor, alkylating agent, antibiotic, antineoplastic agent, antiproliferative agent, antimetabolite, topoisomerase I or II inhibitor, hormonal agonist or antagonist, immunomodulator, DNA minor groove binder or radioactive agent), a chemotherapeutic agent (e.g. alkylating agent, anthracycline, taxane, epothilone, topoisomerase I or II inhibitor, histone deacetylase inhibitor, kinase inhibitor, nucleotide analog, peptide antibiotic, platinum based agent, retinoid, vinca alkaloid or derivative, or other chemotherapeutic agent), a protein, a peptide, an antibody, a growth inhibitory agent, a nucleic acid, or an anti-hormonal agent.

If the TAM binding molecule is conjugated to a moiety which is a diagnostic agent, said diagnostic agent can be a label, and said label can be a fluorescent label, a chromogenic label, or a radiolabel. Said label is contemplated to be used for diagnostic imaging (e.g. PET, or MRI imaging or an imaging protocol incorporating PET or MRI imaging).

EXAMPLES

Example 1: CRV Specifically Binds to Macrophages In Vitro

RAW (tumor-derived mouse macrophage cell line RAW264.7), J774 (tumor-derived mouse macrophage cell line J774A. 1), THP-1 differentiated macrophages (human macrophages differentiated from the human monocytic cell line THP-1) and 4T1 (mouse breast cancer cell line) cells were cultured in DMEM supplemented with 10% FCS. 1×10⁶ cells were incubated with FAM-CRV or the control peptide FAM-GGS (10 μM) in 300 μL of complete growth medium in an Eppendorf tube. After incubation at 4° C. for 1 h, the peptide-containing medium was removed by centrifugation and the cells were washed with PBS two times. 100 μL PFA (4% buffer) was then added to the cells for fixation and flow cytometry data were acquired on FACSCanto (BD Biosciences, San Jose). Experiment was repeated three times on different days.

FAM-CRV showed a much higher binding to RAW, J774, and THP-1 differentiated macrophages than did the control peptide FAM-GGS (FIG. 1A). Contrarily, there was very limited binding of FAM-CRV to the 4T1 breast cancer cell line. These results indicated that CRV specifically binds to macrophages in vitro.

Example 2: CRV Binding to Macrophages In Vivo

To investigate if CRV can bind to macrophages in vivo, FAM-CRV was intravenously injected into tumor bearing mice. To this end, 4T1 and MCF10CA1a human breast cancer cells and KRAS-Ink mouse PDAC cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin and 100 μg/mL streptomycin. Py8119 cells were cultured in Ham's F12K medium containing 5% FCS, 2.5 μg/mL amphotericin B, 50 μg/mL gentamycin, and MITO+. The human cell lines were authenticated by the DNA Analysis Core Facility at the Sanford Burnham Prebys Medical Discovery Institute (La Jolla, Calif.) and the KRAS-Ink cell line was authenticated by DDC Medical (Fairfield, Ohio). All cells were tested negative for mycoplasma contamination. To produce 4T1 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pad of normal BALB/c mice. To produce MCF10CA1a tumors, 2×10⁶ tumor cells (suspended in 100 μL of PBS) were injected into the mammary fat pads of female BALB/c athymic nude mice. To produce Py8119 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pads of C57BL6 mice. To produce KRAS-Ink PDAC tumors, 1×10⁶ cells (suspended in 100 μL of PBS) were injected into female BALB/c mice. To produce H1975 tumors, 1×10⁶ cells (suspended in 100 μL of PBS) were injected into (What kind of mouse? Where was the injection?) All animal experimentation received approval from the Animal Research Committee of Sanford Burnham Prebys Medical Discovery Institute.

Biodistribution of fluorescein-conjugated peptides (FAM-CRV, FAM-GGS, or FAM-ARA) was examined after intravenous injection of 100 μL peptide solution (1 mg/mL PBS) into the tail vein of a mouse. The peptide was allowed to circulate for 1 h and transcardial perfusion was performed with PBS. Tissues were collected, fixed with 4% formaldehyde buffer solution and then soaked in 30% sucrose in PBS overnight.

The tumor models tested in our study were summarized in Table 1. FAM-CRV homing was found positive in orthotopic 4T1 breast cancer, orthotopic MCF10CA1a breast cancer, subcutaneous kras-INK pancreatic cancer, subcutaneous KPC pancreatic cancer, and subcutaneous H1975 lung cancer. Compared to other organs, the tumors displayed a strong fluorescent signal under UV illumination.

TABLE 1
			In vivo
Cell line	Tumor type/origin	Model/tumor site	homing
4T1	Mouse mammary	Orthotopic	Positive
	carcinoma	mammary gland
MCF10CA1a	Mouse mammary	Orthotopic	Positive
	carcinoma	mammary gland
Py8119	Mouse mammary	Orthotopic	Negative
	carcinoma	mammary gland
INK	Mouse pancreatic	Subcutaneous	Positive
	cancer
KPC	Mouse pancreatic	Liver or	Positive
	ductal	Subcutaneous
	adenocarcinoma
H1975	Human lung	Subcutaneous	Positive
	adenocarcinoma

Representative images of FAM-CRV 1-h homing in the 4T1 breast cancer mouse model is shown in FIG. 1B. FAM-CRV was mainly observed in the tumors and the kidneys, and modest to low accumulation was observed liver and spleen, which have high monocyte/macrophage content. Similar biodistribution was observed in the other CRV-positive models. These results suggested that FAM-CRV preferentially homes to tumors rather than other macrophage rich organs.

Example 3: CRV Homing within Tumors

FAM-CRV was intravenously injected into tumor bearing mice. To this end, 4T1 human breast cancer cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin and 100 μg/mL streptomycin. The human cell line was authenticated by the DNA Analysis Core Facility at the Sanford Burnham Prebys Medical Discovery Institute (La Jolla, Calif.) and tested negative for mycoplasma contamination. To produce 4T1 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pad of normal BALB/c mice. All animal experimentation received approval from the Animal Research Committee of Sanford Burnham Prebys Medical Discovery Institute.

Biodistribution of fluorescein-conjugated peptides (FAM-CRV, FAM-GGS, or FAM-ARA) was examined after intravenous injection of 100 μL peptide solution (1 mg/mL PBS) into the tail vein of a mouse. The peptide was allowed to circulate for 1 h and transcardial perfusion was performed with PBS. Tissues were collected, fixed with 4% formaldehyde buffer solution and then soaked in 30% sucrose in PBS overnight. Tissues were finally frozen in OCT embedding medium (Tissue-Tek), and sliced for immunofluorescence staining.

Tissue sections were blocked in 1% bovine serum albumin with 0.1% Triton X-100 for 1 h, and incubated with appropriate primary antibodies and second antibodies. Blood vessels were visualized by staining tissue sections with monoclonal antibodies against CD-31. The primary antibody was rat anti-mouse CD31 (BD Biosciences). The secondary antibody was 594 donkey anti-rat IgG were from Invitrogen. After washing with PBS, sections were mounted in DAPI-containing mounting medium (Vector Laboratories, Burlingame, Calif.) and examined under a Zeiss LSM 710 NLO confocal microscope.

Immunofluorescence staining was performed for FAM-CRV and CD31 on all tissue sections. A representative image from 4T1 breast cancer model is shown in FIG. 2. CRV homed to and spread within the tumors. Inside the tumors, the peptide can quickly leave the blood vessel within 5 min post administration as very little FAM-CRV signals colocalized with CD31 staining (FIG. 2A). At different homing time points (5, 15, and 60 min), the signal of FAM-CRV gradually increased in the tumors. This indicated that the peptide penetrated across the blood vessels into the stroma. In comparison, the FAM-labeled control peptide, GGS (GGSGGSKG) yielded no fluorescence signals in the tumor at all time points. Interestingly it was found that FAM-CRV did accumulate in other organs, such as liver, spleen, and lymph nodes after 5 min circulation, but rapidly washed out after 1 h.

Example 4: CRV Targets Macrophages in the Tumor

To determine whether CRV targeted to macrophages or other cell types in the tumor, the tissue sections of 4T1 tumor-bearing mice were also stained for macrophages markers including CD11b, F4/80, and CD68 To this end, 4T1 human breast cancer cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin and 100 μg/mL streptomycin. The human cell line was authenticated by the DNA Analysis Core Facility at the Sanford Burnham Prebys Medical Discovery Institute (La Jolla, Calif.) and tested negative for mycoplasma contamination. To produce 4T1 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pad of normal BALB/c mice. All animal experimentation received approval from the Animal Research Committee of Sanford Burnham Prebys Medical Discovery Institute.

Biodistribution of fluorescein-conjugated peptides (FAM-CRV, FAM-GGS, or FAM-ARA) was examined after intravenous injection of 100 μL peptide solution (1 mg/mL PBS) into the tail vein of a mouse. The peptide was allowed to circulate for 1 h and transcardial perfusion was performed with PBS. Tissues were collected, fixed with 4% formaldehyde buffer solution and then soaked in 30% sucrose in PBS overnight. Tissues were finally frozen in OCT embedding medium (Tissue-Tek), and sliced for immunofluorescence staining.

Tissue sections were blocked in 1% bovine serum albumin with 0.1% Triton X-100 for 1 h, and incubated with appropriate primary antibodies and second antibodies. The primary antibodies were rat anti-mouse CD11b (BD Biosciences), rat anti-mouse F4/80 monoclonal (BD Biosciences), and rabbit anti-fluorescein/Oregon Green (Invitrogen) polyclonal antibodies. The secondary antibodies, Alexa Fluor 488 goat anti-rabbit IgG and 594 donkey anti-rat IgG were from Invitrogen. After washing with PBS, sections were mounted in DAPI-containing mounting medium (Vector Laboratories, Burlingame, Calif.) and examined under a Zeiss LSM 710 NLO confocal microscope.

Mice with tumor size about 8 mm were euthanized under deep anesthesia (Avertin, lack of response to a toe pinch) by cervical dislocation. Target (tumor) and control (e.g., liver, spleen) tissues were collected and further dissociated to single cells. Tumor cells were dissociated using MACS tumor dissociation kit. Cells were then incubated with fluorescent-labeled CRV or other cell markers (CD11b, CD68, F4/80, FAB, EpCAM, CD31) at 4° C. for 1 h. Positive cells were quantified on BD LSRFORTESSA and data were analyzed using FCS Express Version 3 (De Novo Software).

FAM-CRV signals strongly overlapped with those macrophages markers as shown in FIG. 3A. This suggested that the accumulation of FAM-CRV in the tumor was mainly due to its association with tumor macrophages. Immunofluorescence staining was also performed on other animal models and received the same results. To further validate, cells were also isolated from tumors, spleen, liver, and blood from the 4T1 tumor mice and incubated with FAM-CRV for ex vivo binding studies. In the 4T1 model, tumor cells demonstrated much higher FAM-CRV binding compared to the spleen and blood cells, confirming a preferential homing of FAM-CRV into the tumor (FIG. 3B). In comparison, the control FAM-GGS peptide could not specifically label macrophages in the tumor (FIG. 3C). There was about 15% of the single tumor cells that showed very high FAM-CRV signals compared to the rest tumor cells, which were designated as FAM-CRV positive. More than 50% of FAM-CRV-positive cells were stained positive for both CD11b and F4/80 (FIG. 3D). The low CRV-binding to the blood and splenic cells also suggested that FAM-CRV did not home to tumors by binding to circulating monocytes/macrophages, but recognized the tumor vasculatures, extravasated, and bound to macrophages in the tumor tissue.

Example 5: FAM-CRV Binds Preferentially to Tumor-Associated Macrophages

We further carried out flow cytometry analysis of dissociated 4T1 tumor cells after FAM-CRV in vivo homing (15, or 60 min post intravenous administration). To this end, FAM-CRV was intravenously injected into tumor bearing mice To this end, 4T1 human breast cancer cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin and 100 μg/mL streptomycin. The human cell line was authenticated by the DNA Analysis Core Facility at the Sanford Burnham Prebys Medical Discovery Institute (La Jolla, Calif.) and tested negative for mycoplasma contamination. To produce 4T1 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pad of normal BALB/c mice. All animal experimentation received approval from the Animal Research Committee of Sanford Burnham Prebys Medical Discovery Institute.

Fluorescein-conjugated peptides (100 μL, 1 mg/mL PBS) were intravenously injected into the tail vein of tumor-bearing mice. The peptide was allowed to circulate for 1 h. Mice were then euthanized under deep anesthesia (Avertin, lack of response to a toe pinch) by cervical dislocation. Tumors were collected and further dissociated to single cells, and incubated with different cell markers (CD11b, CD68, F4/80, FAB, EpCAM, CD31) at 4° C. for 1 h. Positive cells were quantified on BD LSRFORTESSA and data were analyzed using FCS Express Version 3 (De Novo Software).

The tumor cells from animals with both circulation lengths exhibited higher FAM-CRV signal compared to the non-injected control animals (FIG. 3E). About 20% of the FAM-CRV positive cells were identified as macrophages, which was much less than the percentage in the ex vivo binding studies. This was probably due to the massive staining and washing steps for primary and secondary antibodies that many weakly bound FAM-CRV dissociated. All these binding results indicated that FAM-CRV can preferentially bind to tumor-associated macrophages.

Example 6: FAM-CRV does not Bind Specifically to Macrophages in Atherosclerotic Plaques

As macrophages reside in other disease sites, such as atherosclerotic plaques, it is interesting to know whether CRV recognizes other pathological tissues containing macrophages. Therefore, in vivo homing of FAM-CRV was tested in ApoE −/− mice bearing atherosclerotic plaques in the aorta. Unlike LyP1, which homes to and bind to the macrophages both in tumors and plaques through the p32 receptor, FAM-CRV did not home to aortic plaques upon systemic administration (FIG. 4A), suggesting that CRV can distinguish TAMs from macrophages in the atherosclerotic plaques in vivo. Immunofluorescence staining of the aorta also observed no FAM-CRV accumulation in the plaques. Single cell suspension was also obtained from mouse aorta with atherosclerotic plaques and the ex vivo binding study confirmed that FAM-CRV does not bind specifically to the macrophages in the plaques compared to FAM-GGS (FIG. 4B). This feature makes CRV a desirable peptide to target macrophages for disease-specific applications.

Example 7: RXRB is Responsible for CRV Binding to Macrophages

The difference between CRV and LyP-1 suggests that CRV probably binds to a different receptor for TAM recognition. Therefore, the CRV receptor on macrophages was identified. To reduce the complexity, the membrane fraction of RAW cells was isolated, and performed affinity chromatography was performed to isolate putative CRV receptors. To this end, CRV was immobilized on a column. Lysates of 4T1 tumor tissue and membrane proteins of RAW cells (isolated with the Mem-PER Plus kit from Thermo Fisher) were utilized as two independent sources of putative receptors. After washing with buffer and the control peptide GGS, the putative receptor was eluted with an excess of free CRV peptide. Mass spectrometry analysis then identified the retinoid X receptor beta (RXRB) as a receptor candidate.

To confirm RXRB binds CRV, the binding of FAM-CRV to human recombinant RXRB protein immobilized on a plate was tested. Human RXRB recombinant protein (50 μL, 5 μg/mL) was immobilized in high binding 96-well plate at 4° C. overnight. Bovine serum albumin was used as the control protein. The protein solution was removed and washed one time with PBS. 1% BSA in PBS solution was then added to the wells and incubated at room temperature for 1 h to block the rest available binding sites. After one wash with PBS, RXRB and BSA were incubated with FAM-CRV (100 μL, 1 μM) at room temperature for 1 h. The wells were washed three times with PBS and the fluorescence was measured using a multiplate reader.

Compared to the control peptide FAM-GGS, there was significantly higher binding of CRV peptide to RXRB (FIG. 5A). On the other hand, neither peptide bound to the control protein BSA. Both J774 and RAW cells displayed high surface expression of RXRB, as well as high FAM-CRV binding, while tumor cell lines such as 4T1 and PPC1 have very limited RXRB surface expression and low FAM-CRV binding. CRISPR was employed to silence the expression of RXRB in RAW cells and evaluated the binding of CRV peptide to those engineered cells. As shown in FIG. 5B, silencing the expression of RXRB reduced about 70% of FAM-CRV binding to wild type RAW cells, which was quantified by flow cytometry after 1 h incubation. These in vitro results indicated that RXRB is responsible for the binding of CRV to macrophages.

Example 8: RXRB Surface Binding is Important for CRV Binding

In addition, RXRB immunohistochemical (TIC) staining on 4T1 tumor tissues was performed. To this end, 4T1 human breast cancer cells were cultured in Dulbecco's modified Eagle's medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin and 100 g/mL streptomycin. The human cell line was authenticated by the DNA Analysis Core Facility at the Sanford Burnham Prebys Medical Discovery Institute (La Jolla, Calif.) and tested negative for mycoplasma contamination. To produce 4T1 tumors, 1×10⁶ tumor cells (suspended in 100 μL of PBS) were orthotopically injected into the mammary fat pad of normal BALB/c mice. All animal experimentation received approval from the Animal Research Committee of Sanford Burnham Prebys Medical Discovery Institute.

Tissue sections were blocked in 1% bovine serum albumin with 0.1% Triton X-100 for 1 h, and incubated with appropriate primary antibodies and second antibodies. The primary antibodies were rat anti-mouse CD11b (BD Biosciences), rat anti-mouse F4/80 monoclonal (BD Biosciences), and rabbit anti-fluorescein/Oregon Green (Invitrogen) polyclonal antibodies. The secondary antibodies, Alexa Fluor 488 goat anti-rabbit IgG and 594 donkey anti-rat IgG were from Invitrogen. After washing with PBS, sections were mounted in DAPI-containing mounting medium (Vector Laboratories, Burlingame, Calif.) and examined under a Zeiss LSM 710 NLO confocal microscope.

This experiment showed that RXRB co-localized with FAM-CRV as well as the macrophage markers (CD11b, F4/80, and CD68) (FIG. 5C). It is also notable that the RXRB staining (brown) was presented on whole cells, not only on the nucleus, supporting that the RXRB surface expression was important for CRV binding.

Example 9: RXRB Positive Cells have Enhanced CRV Binding

To further investigate the correlation between CRV binding to macrophages and the surface expression of RXRB, ex vivo binding of CRV and RXRB antibody to dissociated tumor cells from 4T1 tumor models was performed. Mice with tumor size about 8 mm were euthanized under deep anesthesia (Avertin, lack of response to a toe pinch) by cervical dislocation. Target (tumor) and control (e.g., liver, spleen) tissues were collected and further dissociated to single cells. Tumor cells were dissociated using MACS tumor dissociation kit. Cells were then incubated with fluorescent-labeled CRV or other cell markers (CD11b, F4/80) at 4° C. for 1 h. Positive cells were quantified on BD LSRFORTESSA and data were analyzed using FCS Express Version 3 (De Novo Software).

Flow cytometry analyses showed that about 15% cells from the tumor were RXRB positive and FAM-CRV primarily bound to cells with high RXRB surface expression (FIG. 5D). The majority (about 73%) of the RXRB positive cells were CD11b and F4/80 positive (FIG. 5E), indicating they were mainly expressed by TAMs. 73% of the FAM-CRV positive tumor cells were CD11b and RXRB positive. Staining of tumor cells after FAM-CRV 1 h in vivo homing also demonstrated that the RXRB positive cells had higher CRV binding (FIG. 5G). However, the difference was reduced compared to the ex vivo binding result (FIG. 5D) due to FAM-CRV lost in the multiple washing steps.

Example 10: Major Organs have Different Levels of RXRB Expression

The good correlation of RXRB and CRV lead us to the interest to investigate the surface expression of RXRB in different tissues, which could potentially explain the biodistribution of CRV in vivo. RXRB antibody (or Rabbit IgG as control) and FAM-CRV was both intravenously injected (RXRB antibody: 4 h circulation; FAM-CRV: 1 h circulation) to the same mice, and the presentation of RXRB was assessed after transcardial perfusion. Tissue sections were blocked in 1% bovine serum albumin with 0.1% Triton X-100 for 1 h, and incubated with appropriate primary antibodies and second antibodies. Blood vessels were visualized by staining tissue sections with monoclonal antibodies against CD-31. The primary antibodies were rat anti-mouse CD31 (BD Biosciences), rat anti-mouse CD11b (BD Biosciences), rat anti-mouse F4/80 monoclonal (BD Biosciences), and rabbit anti-fluorescein/Oregon Green (Invitrogen) polyclonal antibodies. The secondary antibodies, Alexa Fluor 488 goat anti-rabbit IgG and 594 donkey anti-rat IgG were from Invitrogen. After washing with PBS, sections were mounted in DAPI-containing mounting medium (Vector Laboratories, Burlingame, Calif.) and examined under a Zeiss LSM 710 NLO confocal microscope.

Immunofluorescence staining of the tissue sections showed that major organs had different levels of RXRB expression. RXRB can be found in tumor, liver, spleen and kidney, but not in heart and lung, while the IgG control staining was not observable in any organs. FAM-CRV signal can only be identified in tumor and kidney after its 1 h circulation. In the tumor, where RXRB staining was the highest among all the organs, RXRB showed nice colocalization with FAM-CRV and macrophage markers, best with CD11b, followed by CD68, and then F4/80 (FIG. 6). In the liver, RXRB expression was much less and mainly colocalized with CD31 and little with CD68. As for the spleens, RXRB antibody was in part of red pulp area and did not have colocalization with CD31, and very little with CD68. The RXRB expression was very low and colocalized mainly with CD31 in the lymph nodes and kidneys. This could explain why FAM-CRV was quickly washed out in these two organs with time. Notably, the RXRB antibody staining results were similar with or without the Triton X-100 reagent for cell penetration

Example 11: RXRB is a Surface Marker with High Specific Expression on Tumor Macrophages

50 μg rabbit anti-mouse RXRB antibody (GeneTex, diluted in PBS, total volume was 100 μL) was intravenously injected to each mouse (n=3). 50 μg rabbit IgG per mouse was injected to the control group (n=3). Three hours later, FAM-CRV (100 μg in 100 μL) were injected to all animals. After 1 h circulation for FAM-CRV, animals were sacrificed with transcardial perfusion. Tissues were collected, fixed and sliced as described above.

When RXRB antibody was intravenously injected alone to 4T1 mice (also 4 h circulation), the apparent distribution of RXRB was the same as with FAM-CRV co-injection, indicating that the FAM-CRV presence did not affect the RXRB recognition by the antibody. In other words, RXRB antibody did not block CRV binding to RXRB in vivo, nor vice versa. This indicated that FAM-CRV bound to a different binding site as the RXRB antibody, which was in agreement as what was observed in the in vitro binding studies. These in vivo homing results demonstrated that RXRB is a good surface marker with its high specific expression on tumor macrophages. It also showed that RXRB antibody can preferentially home to tumors upon intravenous injection, penetrate the blood vessels and bind to macrophages in the extravascular regions, and function as a targeting agent.

Example 12: CRV-Mediated Tumor Homing of Nanoparticles

To investigate the translational potential of the CRV-targeting approach, CRV-mediated tumor homing of nanoparticles was evaluated. There has been extensive works showing porous silicon nanoparticles (pSiNP) as therapeutic carriers with controlled loading and release of various types of drugs (24, 25). Their high drug loading efficiency and time-gated imaging property make them particularly desirable as drug carriers.

As a proof of concept study, CRV-conjugated porous silicon nanoparticles (CRV-pSiNPs) were loaded with a red fluorescence probe, SR101 and the nanoparticles showed tumor homing effect in 4T1 tumor-bearing mice. 100-200 uL of a solution that contains CRV peptide, CRV-pSiNP, or control non-specific peptide was injected into the tail vein of tumor mice with a tumor size of about 8 mm. After 5 min, to up to 24 hours of circulation, the mice will be anesthetized and imaged with an imaging equipment (e.g., Xenogen IVIS, Lightools' light table, multiphoton LSM). When available as with Xenogen IVIS, the mice will be anesthetized with isoflurane during the imaging procedures (Induction: Flow rate 0.8-1.5 L/min, isoflurane vaporizer 2-3%, Maintenance: Flow rate 0.4-0.8 L/min, isoflurane vaporizer 2-3%). The mice will be then perfused with PBS. The tumors and control organs will be collected and used for histological characterization and immunohistochemical assessment.

The ex vivo IVIS imaging showed that there was higher SR101 intensity in the tumor of animals that received CRV-pSiNP compare to the control NP (FIG. 7A). The tumor dissociated cells with flow cytometry analysis was also analyzed. In the CRV-pSiNP group, 74% of CRV-pSiNP positive cells were CD11b and CD68 positive, while only 52.5% of control pSiNP positive cells were CD11b and CD68 positive macrophages. This suggested that CRV targeted NPs mimic the homing ability of the free peptide and that CRV-pSiNP system has the potential to deliver drugs to tumor-associated macrophages, thus improving the clinical outcome. Thus, CRV-pSiNP can be loaded with drugs to tune macrophage polarity and evaluate the therapeutic effect on tumor treatment.

While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims

1. A method of treating or diagnosing a cancer in a subject comprising administering to a subject thereof comprising a pharmaceutical composition comprising a tumor associated macrophage (TAM) binding molecule.

2. The method according to claim 1, wherein the TAM binding molecule binds to retinoid X receptor beta on the TAM.

3. The method according to claim 1, wherein the TAM binding molecule is a peptide, ligand, antibody, non-IG domain, or small molecule entity.

4. The method according to claim 1, wherein the TAM binding molecule is an antibody or antigen-binding fragment thereof.

5. The method according to claim 4, wherein the antibody is an IgG, IgA, or IgM antibody

6. The method according to claim 4, wherein the antibody is a single domain antibody

7. The method according to claim 4, wherein the antibody is a chimeric, humanized, or human antibody.

8. The method according to claim 4, wherein the antibody is a monoclonal antibody.

9. The method according to claim 4, wherein the antigen binding fragment is a Fab, Fab′, Fab′-SH, Fv, scFv, F(ab′)2, or a diabody.

10. The method according to claim 1, wherein the TAM binding molecule is a peptide.

11. The method according to claim 10, wherein the peptide is cyclic.

12. The method according to claim 10 or claim 11, wherein the peptide comprises a) CRVLRSGSC, or b) CRVLRSGSC with at least one conservative amino acid substitution.

13. The method according to claim 1, wherein the TAM binding molecule is further conjugated to a moiety.

14. The method according to claim 13, wherein the moiety is a therapeutic agent or a diagnostic agent.

15. The method according to claim 14, wherein the therapeutic agent is a cytotoxic agent, a chemotherapeutic agent, a protein, a peptide, an antibody, a growth inhibitory agent, a nucleic acid or an anti-hormonal agent.

16. The method according to claim 14, wherein the cytotoxic agent is a ribosome inactivating protein, a histone deacetylase (HDAC) inhibitor, a tubulin inhibitor, an alkylating agent, an antibiotic, an antineoplastic agent, an antiproliferative agent, an antimetabolite, a topoisomerase I or II inhibitor, a hormonal agonist or antagonist, an immunomodulator, a DNA minor groove binder, or a radioactive agent.

17. The method according to claim 14, wherein the diagnostic agent is a label.

18. The method according to claim 17, wherein the label is fluorescent label, a chromogenic label, or a radiolabel.

19. The method according to claim 13, wherein the TAM binding molecule is directly conjugated to the moiety.

20. The method according to claim 13, wherein the TAM binding molecule is indirectly conjugated to the moiety via linker.

21. The method according to claim 1, wherein the composition further comprises a delivery agent.

22. The method according to claim 21, wherein the delivery agent comprises liposomes, microspheres, nanoparticles, microemulsions, microcapsules, polymer matrices, hydrogels, or viral vectors.

23. The method according to claim 1, wherein the TAM binding molecule is cytolytic to tumor cells.

24. The method according to claim 1, wherein the TAM binding molecule inhibits tumor growth.

25. The method according to claim 1, wherein the cancer is selected from the group consisting of brain cancer, renal cancer, ovarian cancer, prostate cancer, colon cancer, lung cancer, squamous cell carcinoma of head and neck, and melanoma.

26. The method according to claim 1, wherein the pharmaceutical composition is administered subcutaneously, intravenously, intradermally, intraperitoneally, orally, intramuscularly or intracranially.

27. The method according to claim 1, wherein the pharmaceutical composition is administered in combination with a second therapeutic agent.

28. The method according to claim 27, wherein the second therapeutic agent is a cancer chemotherapeutic agent, radiation therapy, a cytotoxic agent, another antibody, a NSAID, a corticosteroid, a dietary supplement such as an antioxidant, or a combination thereof.

29. A pharmaceutical composition comprising a tumor associated macrophage (TAM) binding molecule conjugated to a moiety, and a delivery agent.

30. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule binds to retinoid X receptor beta on the TAM.

31. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule is a peptide, ligand, antibody, non-IG domain, or small molecule entity.

32. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule is an antibody or antigen-binding fragment thereof.

33. The pharmaceutical composition according to claim 32, wherein the antibody is an IgG, IgA, or IgM antibody.

34. The pharmaceutical composition according to claim 32, wherein the antibody is a single domain antibody.

35. The pharmaceutical composition according to claim 32, wherein the antibody is a chimeric, humanized, or human antibody.

36. The pharmaceutical composition according to claim 32, wherein the antibody is a monoclonal antibody.

37. The pharmaceutical composition according to claim 32, wherein the antigen binding fragment is a Fab, Fab′, Fab′-SH, Fv, scFv, F(ab′)2, or a diabody.

38. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule is a peptide.

39. The pharmaceutical composition according to claim 38, wherein the peptide is cyclic.

40. The pharmaceutical composition according to claim 38 or claim 39, wherein the peptide comprises a) CRVLRSGSC, or b) CRVLRSGSC with at least one conservative amino acid substitution.

41. The pharmaceutical composition according to claim 29, wherein the moiety is a therapeutic agent or a diagnostic agent.

42. The pharmaceutical composition according to claim 41, wherein the therapeutic agent is a cytotoxic agent, a chemotherapeutic agent, a protein, a peptide, an antibody, a growth inhibitory agent, a nucleic acid or an anti-hormonal agent.

43. The pharmaceutical composition according to claim 42, wherein the cytotoxic agent is a ribosome inactivating protein, a histone deacetylase (HDAC) inhibitor, a tubulin inhibitor, an alkylating agent, an antibiotic, an antineoplastic agent, an antiproliferative agent, an antimetabolite, a topoisomerase I or II inhibitor, a hormonal agonist or antagonist, an immunomodulator, a DNA minor groove binder, or a radioactive agent.

44. The pharmaceutical composition according to claim 41, wherein the diagnostic agent is a label.

45. The pharmaceutical composition according to claim 44, wherein the label is fluorescent label, a chromogenic label, or a radiolabel.

46. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule is directly conjugated to the moiety.

47. The pharmaceutical composition according to claim 29, wherein the TAM binding molecule is indirectly conjugated to the moiety via a linker.

48. The pharmaceutical composition according to claim 29, wherein the delivery agent comprises liposomes, microspheres, nanoparticles, microemulsions, microcapsules, polymer matrices, hydrogels, or viral vectors.

49. A method of reducing the number of TAMs in a tumor microenvironment in a subject having cancer comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48, wherein the pharmaceutical composition is cytolytic to TAMs.

50. A method of removing immunosuppression in a tumor microenvironment in a subject having cancer comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48, wherein the pharmaceutical composition removes, reduces and/or neutralizes TAMs.

51. A method of repolarizing TAMS from an M2 phenotype to M1 phenotype in a subject having cancer comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48, wherein the pharmaceutical composition repolarizes TAMS from an M2 phenotype to M1 phenotype.

52. A method of detecting a cancer in a subject comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48.

53. A method of detecting a tumor associated macrophages in a subject comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48.

54. A method of detecting a tumor microenvironment in a subject having cancer comprising administering to a subject thereof comprising a pharmaceutical composition according to claims 29-48.