(a) Field of the Invention
The invention relates to a novel cancer therapy based on the direct or indirect downregulation of endogenous CEA/NCA which plays an instrumental role in malignant progression through its differentiation-blocking activity on normal cells.
(b) Description of Prior Art
The long-term cure rates for cancers at many sites treated by present means, such as surgery, radiation and chemotherapy, are often unacceptably low. Due to the common presence of metastases derived from the primary tumor, it is impossible to treat most cancers effectively with surgery and radiation alone. Systemic chemotherapy is effective in some cases but is often too toxic to permit the use of the doses required for cure. Novel treatments based on molecular differences between cancer and normal cells are required. Such treatments would likely be non-toxic and, since they would be based on different principles from the commonly used treatments, would be expected to be synergistic with them, giving more effective combined treatment.
Tumor cells at many sites, including colon, breast, lung, cervix, ovary, stomach, bladder, pancreas and esophagus express large amounts of carcinoembryonic antigen (CEA) and/or the closely related family member, NCA, on their surfaces. The expression of these glycoproteins, especially CEA, in normal cells is very limited. This represents the basis for the wide clinical use of CEA as a blood tumor marker. Since the majority of human cancers show up-regulation of CEA/NCA, any therapy based on this fact has potential application to an immense number of cancer patients. This upregulation in so many types of cancer led us to suggest that CEA and NCA could actually contribute directly to tumorigenicity. We first showed that CEA (Benchimol et al, Cell 57:327-334, 1989) and NCA (Zhou et al, Cell Growth Differ. 1:209-215, 1990) function as intercellular adhesion molecules. Although CEA had been previously considered as an inert marker of tumorigenicity, we suggested that inappropriate CEA/NCA expression in cells still capable of proliferation could cause a distortion of tissue architecture (which is determined by adhesion molecules) and an inhibition of terminal differentiation that normally removes cells from the pool of cells with potential to proliferate, thus contributing directly to malignant progression.
In agreement with this hypothesis, we have shown that CEA and NCA expression in transfected myoblasts can inhibit terminal myogenic differentiation and promote tumorigenicity. Peptides representing the adhesion domains of CEA can release the myogenic differentiation block in CEA-transfected myoblasts, indicating the necessity of CEA-CEA interactions for the inhibition of terminal differentiation.
In the present invention, the inhibition of terminal differentiation by CEA/NCA over-expression has been demonstrated to apply to the adipogenic differentiation of mouse fibroblasts, to the neuronal differentiation of mouse embryonal carcinoma cells and to the differentiation and polarization of human colonocytes. CEA/NCA over-expression has also been shown to distort tissue architecture and to inhibit anoikis (apoptosis of anchorage-free cells). The inhibition of differentiation depends on both interactions between the external domains of CEA and on the presence of a CEA-determined glycophosphatidyl-inositol (GPI) membrane anchor. Novel treatments based on reversal of the carcinogenetic effects of CEA/NCA would be highly desirable since they would be precisely targeted to tumor cells expressing these molecules and should therefore be applicable to a large proportion of human cancers. Reversal can be achieved by interference with certain subdomains of CEA and NCA that are required for the differentiation-blocking activity, by downregulating the cellular production of these molecules and by three other means, as delineated below.
It would be highly desirable to provide a novel cancer therapy based on the direct or indirect downregulation of endogenous CEA/NCA which plays an instrumental role in malignant progression, through its differentiation-blocking activity on normal cells.
One aim of the present invention is to provide a novel cancer therapy based on interference with the differentiation-blocking activity of CEA/NCA or on downregulating the production of CEA/NCA, which we show plays an important role in malignant progression. This treatment based on this property of CEA/NCA is precisely targeted to tumor cells expressing these molecules and is therefore non-toxic and applicable to a large proportion of human cancers.
In accordance with the present invention, there exists five (5) different routes for interference with the tumorigenic effects of CEA/NCA:
All these routes lead to new useful clinical agents capable of removing tumor cells by inducing their terminal differentiation, thus effectively killing tumor cells by a mechanism distinct from that of cytotoxic drugs.
In accordance with the present invention there is provided an inhibiting CEA/NCA sequence, which comprises antisense mRNA sequences which hybridize to at least one domain of CEA/NCA selected from the group consisting of the cDNA sequences of CEA and NCA to reduce the expression of endogenous CEA/NCA when administered to a cancer patient.
In accordance with the present invention there is also provided inhibiting CEA/NCA nucleotide sequences, wherein the sequence is an antisense cDNA, an antisense oligonucleotide or an antisense ribozyme containing CEA/NCA antisense nucleotide sequences.
In accordance with the present invention there is also provided anti-CEA/NCA antibodies, which comprise antibodies raised against subdomains of CEA/NCA involved in the differentiation-blocking activity associated with tumorigenicity, wherein the subdomains are selected from the group consisting of the sequences G30YSWYK, N42RQII, Q80ND and other sequences in the N terminal 107 amino acid domain, and sequences in the internal A3B3 domain of CEA.
In accordance with the present invention there is also provided peptides and peptide-derived mimetics, which comprise peptide and peptide-derived mimetics interacting with subdomains of CEA/NCA involved in the differentiation-blocking activity associated with tumorigenicity, wherein the subdomains are selected from the group consisting of the sequences G30YSWYK, N42RQII, Q80ND and other sequences in the N-terminal 107 amino acid domain, and sequences in the internal A3B3 domain of CEA.
The present invention includes also combinations of peptides representing these subdomains in which the peptides are free or linked together with polyethylene glycol molecules.
In accordance with the present invention there is also provided a shankless anchor, which comprises a GPI anchor of CEA without the external peptide domains attached, wherein the GPI anchor interferes with downstream targets of endogenous CEA/NCA molecules to inhibit the differentiation-blocking activity of the endogenous CEA/NCA molecules.
In accordance with the present invention there is also provided a method to restore endogenous integrin function including integrins α5β1 and αvβ3, which comprises the steps of:
thereby inhibiting the differentiation-blocking activity of the endogenous CEA/NCA molecules.
In accordance with the present invention there is also provided a drug screen assay utilizing CEA/NCA-expressing transfectants of rat L6 myoblasts to determine pharmaceutical agents which are capable of inhibiting the signaling process required for differentiation-blocking activity of the endogenous CEA/NCA molecules, which comprises the steps of:
In accordance with the present invention there is also provided the use of the anti-CEA/NCA antibodies, the peptides and peptide-derived mimetics, the inhibiting CEA/NCA sequence, or the shankless anchor of the present invention, to enhance efficacy of other anti-cancer treatments by increasing the differentiation status of a tumor and by enhancing the bystander effect; whereby more differentiated tumor cells cause more adjacent autonomous tumor cells to behave more as non-malignant or normal cells. Other treatment modes will not be required to kill as many tumor cells in order to be efficacious.
In accordance with the present invention there is also provided anti-CEA/NCA antibodies, the peptides and peptide-derived mimetics, the inhibiting CEA/NCA sequence, or the shankless anchor of the present invention, to restore anoikis/apoptosis to levels of non-malignat or normal cells, thereby increasing the efficacy of all other cytotoxic chemotherapeutic drugs which depend on apoptosis for killing cells.
Although CEA had been previously considered as an inert marker of tumorigenicity, we suggested (Benchimol et al, 1989) that inappropriate CEA/NCA expression in cells still capable of proliferation could cause a distortion of tissue architecture and an inhibition of terminal differentiation which normally removes cells from the pool of cells with potential to proliferate, thus contributing directly to malignant progression.
The above hypothesis was tested in several model systems: CEA expression in rat myoblasts (by transfection with CEA cDNA) was shown to block terminal myogenic differentiation completely (Eidelman et al, J. Cell Biol. 123:467-475, 1993); NCA had the same effect whereas a CEA family member that is down-regulated in cancer (BGP) had no effect (Rojas et al, Cell Growth Differ. 7:655-662, 1996); CEA expression inhibits terminal adipogenic differentiation of mouse adipocytes; CEA and NCA, but not BGP, expression inhibits the neuronal differentiation of mouse embryonal carcinoma cells; finally, human colorectal carcinoma cell lines, SW-1222 and Caco-2, that retain differentiation and polarization capacity, when forced by transfection to over-express CEA and NCA, lose their ability to form colonic crypt-like glandular structures with central lumens in both monolayer and spheroid culture and lose their ability to polarize, closely resembling the more progressed human colorectal carcinomas removed from patients (
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In an assay, developed in our laboratory, that tests the ability of human colonocytes to conform to normal tissue architecture (Ilantzis & Stanners, In Vitro Cell. Dev. Biol.—Animal 33: 50-61, 1997), over-expression of NCA causes a marked deterioration of their capacity to form colonic crypts (
In fact, we have shown that the cell surface levels of CEA and NCA on purified colonocytes from freshly excised colon carcinomas and adjacent normal tissue from patients, measured by FACS analysis, are markedly higher on the tumor cells relative to the normal cells and inversely correlated with the degree of differentiation of the tumors (Ilantzis et al, Lab Invest. 76(5):703-716, 1997); this represents clinical evidence in support of our hypothesis. Even microadenomas, the early precursors of colonic carcinomas showed upregulation of CEA and NCA in direct relation to their degree of dysplasia (Ilantzis et al, 1997).
In agreement with the suggestion that these effects of CEA/NCA over-expression could drive malignant progression, both the rat myoblasts (Screaton et al, J. Cell Biol. 137:939-952, 1997) and human CaCo-2 colonocytes transfected with CEA/NCA, but not with the empty transfection vector, produced tumors in nude mice with a strikingly reduced latent period.
The above results support the contention that CEA and NCA are general inhibitors of terminal cellular differentiation. We have evidence that they achieve this by interference with the function of integrins responsible for cell/extracellular matrix interactions. The latter interactions are known to be required for many different types of cellular differentiation. Furthermore, we have direct evidence that these CEA/NCA-induced perturbations in integrin function inhibit anoikis, the apoptotic process that is employed to destroy cells that do not conform to normal tissue architecture (
The inhibition of apoptosis by the over-production of CEA/NCA is an alteration that will contribute to the development of cancer. It will also lead to resistance to cell killing by cytotoxic agents used in chemotherapy, which our results with certain such agents indicates. Thus, inhibition of these effects of CEA/NCA will lead to increased sensitivity to cytotoxic chemotherapeutic drugs.
The overall picture, then, is one of CEA/NCA-induced inhibition of terminal cellular differentiation, cellular polarization and anoikis, and an accompanying loss of tissue architecture. The net effect of these CEA/NCA-induced cellular changes is to promote malignancy and to produce resistance to cell killing chemotherapeutic agents.
1. Antibodies, Peptides and Mimetics:
The myogenic differentiation-blocking activity of CEA, at least, can be reversed by interference with the adhesion domains of CEA (the N and A3B3 domains—Zhou et al, J. Cell Biol. 122: 951-960, 1993) using domain-specific peptides made in bacteria or by a deletion in the N-terminal domain (Eidelman et al, J. Cell Biol. 123:467-475, 1993), indicating the necessity of CEA-CEA interaction for the effect. In fact, the ΔNCEA deletion mutant that is defective in its ability to effect a myogenic differentiation block can be potentiated by the application of cross-linking monoclonal antibodies. We therefore presume that it is CEA-CEA binding leading to clustering on the cell surface that is required for the differentiation block. Further work has shown that the glycophosphatidyl inositol (GPI) membrane anchor of CEA is also required for the myogenic differentiation block.
The precise subdomains in the N domain of the CEA molecule responsible for intercellular adhesion and for the myogenic differentiation block (and, by implication, other types of differentiation block) have been identified. These are NRQII, starting at amino acid #42 in the N domain of CEA (where the numbering begins at the first amino acid of the mature protein) which, when deleted or mutated to NRRIV (Q44R&I46V) or DRQII (N42D), abrogate both intercellular adhesion in transfected CHO-derived cells and the myogenic differentiation block; in addition, mutations giving amino acid substitutions at QND, starting at amino acid #80 in the N domain, giving QAD (N81A) or QNN (D82N) completely remove the ability of CEA to block myogenic differentiation without affecting its ability to mediate intercellular adhesion in CHO-derived cells (
Thus the adhesive and differentiation-blocking activities of CEA can be separated, allowing the possibility of precise interference with the differentiation-blocking activity.
In fact, cyclic peptides including the sequences GYSWYK, NRQII and QND of the three subdomains of the CEA N domain have been applied to L6 myoblasts producing CEA and have dramatically released the CEA-imposed block in myogenic differentiation (
We thus propose to use peptides or mimetics representing these subdomains or monoclonal antibodies that bind to them that block the necessary CEA-CEA or NCA-NCA intermolecular interactions for the tumorigenic effects of CEA/NCA as agents for clinical use.
2. Antisense Agents:
Importantly, human SW-1222 colon carcinoma cells transfected with a defective mutant of CEA and thereby actually producing less than normal levels of CEA, denoted SW-CEA↓, were more differentiated than the parental cells, in that they exhibited a more normal flat morphology in monolayer culture (
Such down regulation could be achieved by the application of CEA/NCA anti-sense oligonucleotides or anti-sense ribozymes to tumors or gene therapy with CEA/NCA antisense cDNA constructs.
3. Regulation of Integrin Function
We have recently shown that CEA/NCA over-expression inhibits terminal differentiation in so many different types of cells by perturbing a molecular process common to all, that of interaction with the extra-cellular matrix (ECM). The major class of cellular receptors responsible for ECM interactions are the integrins; integrin-ECM interactions are known to be involved in many types of differentiation, in the maintenance of tissue architecture and in anoikis (apoptosis). The particular integrin disturbed in its function by CEA/NCA expression (but not by BGP or other controls) is α5β1, as shown by reversal of the inhibitory effect of CEA/NCA on anoikis of suspended rat L6 myoblasts and human Caco-2 cells by a monoclonal antibody against this integrin. This mAb or peptides/mimetics that mimic its effects on α5β1 function could be administered to patients bearing CEA/NCA expressing tumors and would be expected to release the differentiation block imposed by CEA/NCA. In mouse P19 embryonal carcinoma cells, the integrin affected is αvβ3. The agents described above in routes 1, 2, 3, 4 and 5 of the present invention should cause CEA/NCA over-expressing tumor cells to differentiate terminally, thus removing them as potential colonizing cells in the body.
4. Shankless Anchors:
We have shown that the structural features of the CEA molecule required for the differentiation are as follows: first, external domains capable of self association and, second, attachment of these to the hydrophobic carboxy-terminal domain of CEA; the latter domain is normally cleaved during processing events resulting in the formation of a GPI membrane anchor. Thus the trans-membrane linked BGPa member of the CEA family, normally without effect on myogenic differentiation, can be converted to one that blocks differentiation by the addition of the CEA GPI domain (
Strategy 1. depends on interference with the binding domains of CEA which are the self-binding domains naturally associated with the CEA GPI anchor. The present strategy is targeted to the GPI domain itself. CEA molecules lacking binding domains, consisting of the GPI anchor alone, with little or no attached peptide (“shankless anchors”), can be generated by enzymatic cleavage or by the use of CEA cDNA constructs with deleted binding domains. These can be applied directly to cells blocked in differentiation by CEA/NCA and, as has been shown for other GPI-linked molecules, should successfully embed themselves from the external milieu into the membrane of the cells. Inhibition with the differentiation-blocking activity of the endogenous CEA/NCA molecules is anticipated via competition by the CEA shankless anchors for elements of the molecular pathway required for the CEA/NCA effect. Release of the CEA-mediated myogenic differentiation block has, in fact, been observed by co-transfection with CEA cDNA constructs producing CEA molecules with intact GPI anchors but defective external binding domains.
The above inhibitory effect of GPI anchors could be applied in principle to inhibit the activity of any GPI-linked molecule. This extends the potential utility of the present invention to include many types of GPI-linked molecules with a wide range of biomedical effects.
Development of the Present Invention Over the Next Year
The present invention will be more readily understood by referring to the following example which is given to illustrate the invention rather than to limit its scope.
L6 rat myoblasts transfected with CEA/NCA cDNA and thereby blocked in their differentiation provide the most sensitive assay for screening agents capable of releasing the differentiation block.
While the invention has been described in connection with specific embodiments thereof, it will be understood that it is capable of further modifications and this application is intended to cover any variations, uses, or adaptations of the invention following, in general, the principles of the invention and including such departures from the present disclosure as come within known or customary practice within the art to which the invention pertains and as may be applied to the essential features hereinbefore set forth, and as follows in the scope of the appended claims.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2,224,129 | Feb 1998 | CA | national |
This application is a continuation of U.S. patent application Ser. No. 09/637,530, filed Aug. 11, 2000, which is a continuation application of PCT/CA99/00119, filed Feb. 11, 1999, which is an international filing of Canadian Patent Application No. 2,224,129, filed Feb. 12, 1998, all of which are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 09637530 | Aug 2000 | US |
| Child | 11041199 | Jan 2005 | US |
| Parent | PCT/CA99/00119 | Feb 1999 | US |
| Child | 09637530 | Aug 2000 | US |