This application is based on provisional U.S. application No. 60/434,267, filed Dec. 17, 2002.
1. Field of the Invention
The present invention relates generally to the field of cancer therapy.
2. Description of Related Art
In the past, p53 gene transfer to tumors (p53 gene therapy) has been attempted by incorporating the gene for p53, usually coupled to an appropriate transcriptional promoter DNA sequence, into a viral or non-viral vectors. The vector promotes the entry of the p53 gene into the cancer cell, where it is transcribed and translated into p53 protein. A preferred embodiment of p53 gene therapy has used replication-impaired adenoviral vectors derived from Type V human adenovirus, in which the early region E1A/B genes of the viral genome required for viral replication are replaced by the wild-type p53 gene and appropriate promoter sequence. Adenoviral vectors have advantages for industrial production, as they are relatively stable and easy to prepare in high titer. Adenoviruses are able to enter most cell types, and therefore can be used as delivery vehicles for DNA. These vectors have shown efficacy against tumors in several animal models and have been used in clinical trials in humans for various cancers. Saadatmandi N, Wilson D R, Gjerset R A. p53 Gene Therapy. Encyclopedia of Cancer: Academic Press, 2002;425-432.
Often, treatment with the Adenoviral p53 vectors fails to achieve complete eradication of the tumor and must be used in combination with a conventional DNA damaging chemotherapy to enhance p53 activity. There are reports that the combination approach in patients with tumors that had previously failed conventional therapy can result in improved responses compared with single agent treatment (i.e., either conventional therapy alone, or p53 adenovirus alone) Saadatmandi, N., Wilson, D. R., and Gjerset, R. A. p53 Gene Therapy. In: J. R. Bertino (ed.) Encyclopedia of Cancer, second edition, Vol. 3. San Diego: Academic Press, 2002. Nevertheless, the p53 plus chemotherapy combined approach again requires that patients receive conventional chemotherapy, and be exposed to the toxic side effects encountered with this form of therapy.
The p14ARF tumor suppressor is known to act at least in part by stabilizing p53 and increasing its activity (Zhang, Y., Xiong, Y., and Yarbrough, W. G. ARF promotes MDM2 degradation and stabilizes p53: ARF-INK4a locus deletion impairs both the Rb and p53 tumor suppression pathways, Cell. 92: 725-34., 1998; Kamijo, T., Weber, J. D., Zambetti, G., Zindy, F., Roussel, M. F., and Sherr, C. J. Functional and physical interactions of the ARF tumor suppressor with p53 and Mdm2, Proc Natl Acad Sci USA. 95: 8292-7., 1998.) In one study, p14ARF was found to be suppressive of tumor cells that retained expression of wild-type p53 and lost expression of p14ARF and were refractory to p53 gene transfer (Lu, W., Lin, J., and Chen, J. Expression of p14ARF overcomes tumor resistance to p53, Cancer Res. 62: 1305-10., 2002) In another study, co-expression of p53 and p14ARF, delivered separately in independent vectors was better than either vector alone in tumors cells that had lost either wild-type p53 or p14ARF expression (Tango, Y., Fujiwara, T., Itoshima, T., Takata, Y., Katsuda, K., Uno, F., Ohtani, S., Tani, T., Roth, J. A., and Tanaka, N. Adenovirus-Mediated p14ARF Gene Transfer Cooperates with Ad5CMV-p53 to Induce Apoptosis in Human Cancer Cells, Hum Gene Ther. 13: 1373-82., 2002)
Nearly all cancer cells survive by losing the p53 pathway, either through loss or mutation of the p53 gene or through deregulation of the pathway in another way. Restoration of the pathway through p53 gene transfer is generally suppressive of cancer cells. Gjerset R A, Turla S T, Sobol R E, et al. Use of wild-type p53 to achieve complete treatment sensitization of tumor cells expressing endogenous mutant p53. Mol Carcinog 1995;14:275-85; Gjerset R A, Mercola D. Sensitization of tumors to chemotherapy through gene therapy. Adv Exp Med Biol 2000;465 :273-91. The pathway is latent in normal cells because the signals that trigger its activation, including activation of oncogenes, are absent, and gene transfer of p53 is much less suppressive of normal cells (Katayose, et al., Cytotoxic effects of adenovirus-mediated p53 protein expression in normal and tumor mammary epithelial cells., Clin. Cancer Res. 1(8): 889-897, 1995.). P53-based therapies, including p53 gene therapy have therefore attracted interest as a potentially highly efficacious tumor-specific therapy with reduced toxicity.
Conventional treatments are presently unable to achieve cures for most cancers. Cancer, Principles and Practice of Oncology. DeVita, V. T., Hellman, S., Rosenberg, S. A., eds., J.B. Lippincott Comp., Philadelphia. Sixth edition (2001). Furthermore, because these treatments often target cellular pathways shared by normal cells, they can be extremely toxic to normal tissue. A potentially more effective approach to cancer treatment would target cellular processes, such as the p53 pathway, to which cancer cells might be uniquely or preferentially susceptible. A single gene p53 replacement strategy to tumor suppression is often ineffective (Gjerset, R. A., Turla, S. T., Sobol, R. E., Scalise, J. J., Mercola, D., Collins, H., Hopkins, P. Use of wild-type p53 to achieve complete treatment sensitization of tumor cells expressing endogenous mutant p53, Molecular Carcinogenesis, 14:275-285, 1995.) and a p53 plus chemotherapy combination approach again requires that patients receive conventional chemotherapy, and be exposed to the toxic side effects encountered with this form of therapy. There is therefore a need for new therapeutic approaches to cancer the exploit tumor suppressor genes or suppressor gene combinations more effectively and that have reduced toxicity as well as increased efficacy, compared to conventional treatments.
The invention is directed to a method of inducing killing, or apoptosis, or growth arrest of malignant or metastatic cancer cells. The method involves contacting cancer cells with a bicistronic construct of p53 and p14ARF genes (or gene variants thereof), which express protein having tumor suppressor activity. The method may be used in combination with one or modes of therapy, such as radiation therapy and chemotherapy.
Another aspect of the invention is a bicistronic construct comprising p53 and p14ARF genes or gene variants thereof. An embodiment includes the bicistronic construct disposed in a viral vector selected from the group of vectors consisting of retro viral, adeno-associated viral, herpes simplex viral, cytomegaloviral vectors. The bicistronic construct may be disposed in a non-viral delivery vehicle selected from the group consisting of liposomes, polylysine carrier complexes, or naked DNA. Viral vectors and non-viral delivery vehicles which comprise the bicistronic construct are subjects of the invention. Another composition of the invention includes a pharmaceutical carrier which contains either a bicistronic construct comprising p53 and p14ARF genes, or a vector comprising a bicistronic construct comprising p53 and p14ARF genes, or a non-viral delivery vehicle comprising a bicistronic construct comprising p53 and p14ARF genes.
Our approach was to focus on a cellular pathway regulated by the p53 tumor suppressor that leads to cell death or cell growth arrest in response to certain cellular abnormalities commonly encountered in cancer cells, such as DNA damage and oncogene expression.
We found that a bicistronic construct of p53/p14ARF was superior to either of two single gene vectors (for either p53 or p14ARF, respectively) to enhance p53 activity, and was surprisingly better than a combination of two single gene vectors for p53 and p14ARF. In cells expressing endogenous p14ARF, or expressing both endogenous ARF and wild-type p53, there was a striking improvement in tumor suppression by supplying exogenous p14ARF together with p53 as a bicistronic construct expressing the two proteins. The method of the invention, in comparison with other approaches in the art, is illustrated in
The vector is structurally different than prior vectors in that it incorporates both the p53 and p14ARF genes in a single expression cassette under the control of a single promoter. In our invention, the two genes are co-delivered as one vector, rather than as single gene vectors. Functionally, the bicistronic vector is superior either to p53 alone, or to a combination of single gene vectors for p53 and p14ARF.
Our vector would be used to deliver the p53 and p14ARF genes to human malignant or metastatic cancer cells so as to induce killing or apoptosis or growth arrest in these cells. While a preferred embodiment of the present invention involves delivery of a p14ARF and p53 to the tumor via an adenoviral vector, we also anticipate that other delivery mechanisms, including retro viral, adeno-associated viral, herpes simplex viral, cytomegaloviral, could also be used. Methods for formulating pharmaceutical compositions or carriers for the bicistronic constructs or vectors disclosed herein are well known in the art (e.g. U.S. Pat. Nos. 6,054,467, and 5,747,469) incorporated herein by reference). Non-viral delivery vehicles could be used as well, including approaches that utilize liposomes, polylysine carrier complexes, or naked DNA (1992, Proc. Natl. Acad. Sci. USA 89:6099-6103; Zhu et al., Systemic gene expressino after intravenous DNA delivery into adult mice, (1993) Science 261:209-211; Yoshimura et al., (1992) Nucleic Acids Research 20: 3233-3240). Methods for combination therapy involving chemotherapy and gene therapy are well known (e.g. U.S. Pat. Nos. 6,054,467; 5,747,469)
We have used the cytomegalovirus promoter to achieve expression of p53 and p14ARF, but other promoters could be used as well, including the Rous Sarcoma Virus promoter, and SV40 promoter. In some embodiments, the vector could be used in combination with radiation, and/or with conventional chemotherapy of all types such as cisplatin, etoposide, camptothecin, doxorubicin, 5-fluorouracil. Our invention would also include variants of p53 or p 14ARF (such as mutated or truncated forms of these tumor suppressors) that retain the tumor suppressor activity of the protein, or that display enhanced tumor suppressor activity.
We anticipate that all types of human tumors, irrespective of their endogenous p53 and ARF status, would be amenable to this approach. Preferred embodiments would be head and neck cancer, breast cancer, and lung cancer.
We constructed a bicistronic adenovirus encoding ARF and p53 (denoted Adp14/p53 or AdBi-cis), using the AdEasy kit of Quantum Biotechnologies. The p14ARF and p53 coding sequences were obtained from normal human fibroblast RNA by RT-PCR amplification. The bicistronic cassette containing an internal ribosome entry site (IRES) flanked by multicloning sites was obtained from the pIRES vector of Clontech.
To obtain the full length adenoviral genome, the pSHUTTLE-CMV construct containing the ARF-IRES-p53 insert was recombined in bacteria with the AdEasy vector (which encodes the remainder of the adenoviral genome minus E1 and E3, followed by packaging in 293 kidney cells.
We constructed the bicistronic vector for p14ARF and p53 as described above (see
The vectors were expanded, purified and titered. We demonstrated that each vector was able to induce expression of its respective transgene following treatment of tumor cells. We then carried out viability assays with several tumor cell lines to determine the relative tumor suppressor activity of the various vectors. Tumor cells growing as monolayer cultures in vitro were exposed for 4 hours to various doses of the bicistronic adenoviral vector Adp14/p53 described above, replated at low density in 96 well plates (triplicate wells for each vector treatment) and viability was scored 3 days later by a standard MTS assay, which measures the bioconversion of a formazan compound to a colored derivative that absorbs at 490 nm. Absorbance is proportional to the number of viable cells. We express viability as a percentage of the viability of untreated cells.
The cell lines tested were DLD-1 human colon cancer cells, that express endogenous mutant p53 and endogenous ARF, and murine N202 cells that express endogenous wild-type p53 and endogenous ARF.
We found that the growth and viability of tumor cells was completely suppressed by treatment with a bicistronic adenoviral vector encoding p53 and p14ARF (denoted “ARF”) and that the doses of vector needed to achieve complete suppression were 20 times lower than doses needed to achieve suppression with single gene vectors for p53 or ARF (
Also surprising was our ability to completely abolish the viabilty of several tumor cell lines of different origins in vitro using very low vector to cell ratios (less than 20). Suppression of growth and viability was associated with the induction of cell death, as evidenced by a dye exclusion assay (Trypan Blue), where dead cells appear Trypan Blue positive (
In the experiment shown in
By ensuring that the p53 pathway was maximally induced, the bicistronic vector provided a highly improved biological approach to cancer therapy, compared to single gene treatments, and was far better even than a combination of single gene treatments. The high degree of anti-tumor efficacy achieved with the bicistronic vector may obviate the need to combine this highly targeted biological treatment with conventional chemotherapy or radiation, as has been necessary in the past to optimize the single gene approach for p53 (see overview article Saadatmandi, N., Wilson, D. R., and Gjerset, R. A. p53 Gene Therapy. In: J. R. Bertino (ed.) Encyclopedia of Cancer, second edition, Vol. 3. San Diego: Academic Press, 2002). In some cases, however, a combination with conventional treatments may further enhance the anti tumor benefits of this therapy. The bicistronic vector or an alternative delivery vector for a bicistronic expression cassette encoding p53 and p14ARF is anticipated to be broadly applicable to the treatment of a wide range of cancers.
The references cited herein, to the extent that they provide exemplary procedural or other details supplementary to those set forth herein, are specifically incorporated by reference.
Number | Date | Country | |
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60434267 | Dec 2002 | US |