Selective tumor sensitization to taxanes with the mAb-drug conjugate cBR96-doxorubicin

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Abstract
The chimeric monoclonal antibody cBR96 conjugated to doxorubicin (cBR96‐Dox) is selectively internalized by a wide variety of human carcinomas expressing an extended form of Lewis Y antigen (Ley). Endocytosis is followed by cleavage and release of free doxorubicin from the endocytic vesicles and subsequent cytotoxicity. Combination studies with standard anti‐cancer agents, undertaken to further increase the potency of this targeted therapy, identified significant synergistic anti‐tumor activity of cBR96‐Dox and either of the taxanes paclitaxel or docetaxel. Treatment with cBR96‐Dox 24 hr prior to paclitaxel resulted in a steady increase in the percentage of G2 tumor cells and corresponding increase in sensitivity to taxanes. Cell cycle analysis indicated the cBR96‐delivered doxorubicin was most effective against S‐phase cells, yet cells exposed to even subtoxic levels progressed to and arrested in G2, at a point of high sensitivity to the anti‐tubulin agent paclitaxel. The synergy obtained by staged combination of cBR96‐Dox and paclitaxel in vitro was reflected in significant anti‐tumor efficacy in vivo against xenograft models of human lung and breast tumors that could not be achieved by either agent alone. The staged combination elicited significant or complete regressions of established human Ley‐positive tumor xenografts using significantly reduced drug levels. Taken together, these data demonstrate a mechanistic approach to the selective elimination of Ley‐positive tumors by using targeted doxorubicin followed by taxane treatment.