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ANG1005, a Brain-Penetrating Peptide–Drug Conjugate, Shows Activity in Patients with Breast Cancer with Leptomeningeal Carcinomatosis and Recurrent Brain Metastases
Abstract
Purpose: ANG1005, a novel taxane derivative, consists of three paclitaxel molecules covalently linked to Angiopep-2, designed to cross the blood–brain and blood–cerebrospinal barriers and to penetrate malignant cells via LRP1 transport system. Preclinical and clinical evidence of efficacy with ANG1005 has been previously shown. Patients and Methods: A multicenter, open-label phase II study in adult patients with measurable recurrent brain metastases from breast cancer (BCBM), with or without leptomeningeal carcinomatosis was conducted (n = 72 BCBM; n = 28 leptomeningeal carcinomatosis subset). ANG1005 was administered intravenously at 600 mg/m2 every 3 weeks. Tumor assessment was based on central nervous system (CNS) RECIST 1.1 for intracranial, and RECIST 1.1 for extracranial response. The primary endpoint was determination of intracranial objective response rate (iORR). Results: Median age was 47.5 years. Safety profile was similar to that of paclitaxel with myelosuppression as the predominating toxicity. Average number of prior CNS-directed therapies was 2.8 and 94% of the patients had prior taxane treatment. Patient benefit (stable disease or better) was seen in 77% (intracranial) and 86% (extracranial) of the evaluable patients, with iORR of 15% (investigator) or 8% (independent radiology facility [IRF] review). In the leptomeningeal carcinomatosis subset, 79% of the patients had intracranial disease control and estimated median overall survival of 8.0 months (95% CI, 5.4–9.4). Conclusions: Even though the study preset rule for iORR per IRF was not met in this heavily pretreated population, a notable CNS and systemic treatment effect was seen in all patients including symptom improvement and prolonged overall survival compared to historical control for the subset of patients with leptomeningeal carcinomatosis (n = 28).
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ANG1005 has shown clinical activity for treatment of leptomeningeal carcinomatosis and recurrent brain metastases in breast cancer patients.
“ANG1005, a brain-penetrant Angiopep–paclitaxel bioconjugate, has recently shown clinical activity for the treatment of leptomeningeal carcinomatosis and recurrent brain metastases in breast cancer patients [22].”
From MT1-MMP Expression Levels and Catalytic Functions Dictate LDL Receptor-Related Protein-1 Ligand Internalization Capacity in U87 Glioblastoma Cells (2022) · cites this paper as [22]
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Sorted by citations
Challenges and opportunities to penetrate the blood-brain barrier for brain cancer therapy
Upton, D. H., Ung, C., George, S. M., Tsoli, M., Kavallaris, M., & Ziegler, D. S. (2022) · Theranostics · doi:10.7150/thno.69682 · Cited by 182
Pratt, J., Haidara, K., & Annabi, B. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232214214 · Cited by 8
Metadata
- Authors
- Kumthekar, P., Tang, S.-C., Brenner, A. J., Kesari, S., Piccioni, D. E., Anders, C., Carrillo, J., Chalasani, P., Kabos, P., Puhalla, S., Tkaczuk, K., Garcia, A. A., Ahluwalia, M. S., Wefel, J. S., Lakhani, N., & Ibrahim, N.
- Affiliations
- 1Northwestern University Feinberg School of Medicine, Chicago, Illinois.
- 2Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, Mississippi.
- 3Mays Cancer Center, UT Health San Antonio, San Antonio, Texas.
- 4John Wayne Cancer Institute and Pacific Neuroscience Institute, Santa Monica, California.
- 5Department of Neurosciences, UC San Diego Moores Cancer Center, La Jolla, California.
- 6Duke Cancer Institute, Durham, North Carolina.
- 7John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, California.
- 8University of Arizona Cancer Center, Tucson, Arizona.
- 9University of Colorado, Anschutz Medical Campus, Greenwood Village, Colorado.
- 10University of Pittsburgh Magee Women's Cancer Program, Pittsburgh, Pennsylvania.
- 11University Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland.
- 12Louisiana State University, New Orleans, Louisiana.
- 13Miller Family Endowed Chair in NeuroOncology; Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio.
- 14Departments of Neuro-Oncology and Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
- 15Cancer and Hematology Centers of Western Michigan, Grand Rapids, Michigan.
- 16Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas.
- Venue
- Clinical Cancer Research
- Published
- 2020-06-15
- Volume
- 26
- Issue
- 12
- Pages
- 2789-2799
- ISSN
- 1078-0432
- 1557-3265
- Cited by
- 250
- References
- 3
- Language
- en
- Funders
- Laval University (ANG1005)
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