Evelyn Kono

Monoclonal antibody targeting of N-cadherin inhibits prostate cancer growth, metastasis and castration resistance

The transition from androgen-dependent to castration-resistant prostate cancer (CRPC) is a lethal event of uncertain molecular etiology. Comparing gene expression in isogenic androgen-dependent and CRPC xenografts, we found a reproducible increase in N-cadherin expression, which was also elevated in primary and metastatic tumors of individuals with CRPC. Ectopic expression of N-cadherin in nonmetastatic, androgen-dependent prostate cancer models caused castration resistance, invasion and metastasis. Monoclonal antibodies against the ectodomain of N-cadherin reduced proliferation, adhesion and invasion of prostate cancer cells in vitro. In vivo, these antibodies slowed the growth of multiple established CRPC xenografts, blocked local invasion and metastasis and, at higher doses, led to complete regression. N-cadherin–specific antibodies markedly delayed the time to emergence of castration resistance, markedly affected tumor histology and angiogenesis, and reduced both AKT serine-threonine kinase activity and serum interleukin-8 (IL-8) secretion. These data indicate that N-cadherin is a major cause of both prostate cancer metastasis and castration resistance. Therapeutic targeting of this factor with monoclonal antibodies may have considerable clinical benefit.

Prostate stem cell antigen is a putative target for immunotherapy in pancreatic cancer.

The prostate stem cell antigen (PSCA) is a glycosylphosphatidyl-inositol (GPI)-linked cell surface antigen expressed in normal prostate and overexpressed in the majority of prostate cancers and correlates with tumor grade and disease stage. Because PSCA has been described to be up-regulated in pancreatic cancer, the purpose was to evaluate the expression of PSCA in human pancreatic cancer. Furthermore, the therapeutic efficacy of a monoclonal anti-PSCA antibody in an in vivo pancreatic cancer model was determined. Methods: The expression of PSCA in human pancreatic cancer tissues was determined and compared with chronic pancreatitis and normal pancreas by quantitative reverse transcriptase-polymerase chain reaction. Therapeutic efficacy of the monoclonal anti-PSCA antibody 1G8 was examined in Capan-1 pancreatic tumors grown as subcutaneous grafts in athymic nude mice. Results: PSCA was strongly up-regulated in human pancreatic cancer compared with chronic pancreatitis and normal pancreas. In addition, the PSCA protein was expressed on the cell surface of pancreatic cancer cells. Treatment with 1G8 significantly reduced tumor growth initiation in an in vivo pancreatic cancer xenograft model. In addition, antibody treatment of established tumors reduced tumor progression. Conclusions: These results show a potential therapeutic role for anti-PSCA antibodies in the treatment of pancreatic cancer. Furthermore, PSCA might serve as a novel marker in the diagnosis of pancreatic cancer.

Abstract A52: Efficacy of new developed N-cadherin monoclonal antibodies in combination with enzalutamide against castration-resistant prostate cancer

Introduction: Recent advances improved survival in men with metastatic castration-resistant prostate cancer (CRPC) after chemotherapy when treated with androgen ablation therapies, including the well-known androgen receptor (AR) antagonist enzalutamide. However, emergence of potential AR-independent mechanisms of castration resistance and resistance to these next-generation AR inhibitors has proven to be a challenge. Previously, we reported an association of N-cadherin, a mesenchymal cadherin expressed on the cell surface, with tumor progression and castration resistance. Targeting N-cadherin positive cells with specific monoclonal antibodies (mAb) affect tumor growth in both AR-positive and -negative prostate cancers. Here we report the further development of effective N-cadherin specific monoclonal antibodies against CRPC and their value in combination therapies. Method: Endogenously expressing N-cadherin prostate cancer cell lines (PC3, LAPC9) and androgen-dependent prostate cancer cells ectopically expressing N-cadherin (LNCaP, MDA-PCa-2b, VCaP) were evaluated in vitro for invasion, growth, and self-renewal in the presence of monoclonal antibodies raised against various extracellular domains of N-cadherin and their effects in combination with enzalutamide. Further, enzalutamide-resistant cell lines were also generated and evaluated. In vivo studies were performed using castration-resistant N-cadherin and AR positive, as well as androgen-dependent tumors implanted subcutaneously in mice as xenografts. The tumors were analyzed for response to enzalutamide or mAb alone or in combination. When the tumors reached 100-200 mm3 in volume the mice were castrated and treated with 5-10 mg/kg enzalutamide and/or 5-10 mg/kg mAb candidates. Tumors were monitored for growth, local invasion, and metastasis. At endpoint, tumors were harvested and further analyzed. Promising mAb candidates, as well as new epitope targets, were then selected and reformatted into full humanized N-cadherin monoclonal antibodies and further analyzed. Results: Ectopic expression of N-cadherin in N-cadherin negative cells enhanced cell growth and invasion in androgen-deprived conditions. In vitro studies showed that combination treatment of N-cadherin positive and AR-positive cells reduced invasion and cell proliferation than either treatment alone. Certain enzalutamide-resistant cell lines generated showed an increase in N-cadherin expression. Such cells responded to N-cadherin antibodies in androgen-deprived conditions, suggesting a role for N-cadherin in a subset of enzalutamide resistance. In vivo studies using CRPC xenograft models expressing N-cadherin and AR showed inhibition of tumor growth when the animals were castrated and treated with a combination of enzalutamide and N-cadherin mAb than either treatment alone. Androgen-dependent xenograft models in castrated mice also significantly delayed castration-resistant tumor growth when treated in combination than either treatment alone. The newly generated humanized mAbs showed similar outcomes. Conclusion: Previous studies suggested that therapeutic targeting of N-cadherin with monoclonal antibodies have significant effect in inhibiting tumor progression. We have verified that humanized N-cadherin mAb exhibit significant efficacy, fostering our search for increasingly effective immunotherapy in the clinic. Further, the antibodies showed synergy in combination with enzalutamide, suggesting promise in potential combination therapies for CRPC. Other androgen receptor antagonists and other drugs targeting those potentially involved in downstream pathways may prove to have additional clinical benefit. Citation Format: Evelyn A. Kono, Naoko Kobayashi, Kirstin Zettlitz, Joyce Yamashiro, Wang Chun, Della Z. Hu, Anna M. Wu, Robert E. Reiter. Efficacy of new developed N-cadherin monoclonal antibodies in combination with enzalutamide against castration-resistant prostate cancer [abstract]. In: Proceedings of the AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; Sao Paulo, Brazil. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(1_Suppl):Abstract nr A52.

Abstract LB-279: N-cadherin promotes castration-resistant prostate cancer progression by enhancing stem cell properties of prostate cancer cells

New generation of anti-androgen treatments such as enzalutamide and abiraterone are improving survival of men with advanced and metastatic prostate cancers, but resistance to these inevitably arises. The molecular mechanisms governing the emergence of treatment resistance in castration resistant prostate cancer (CRPC) patients are not well understood. Recent experience suggests that tumor regeneration from castration-resistant stem-like cells induce resistance to hormonal therapy. Therefore, elucidating novel targets essential for driving stem-like activity is critical to prevent and defeat CRPC. It has been shown that normal and cancer stem cells exploit normal development process of epithelial-mesenchymal transition (EMT) to survive and metastasize, and that EMT confer stem cell properties to more differentiated cancer cell progeny in breast and other cancers. However, it is unclear if EMT is linked with stem cells in normal and malignant prostate. We previously showed that N-cadherin, a marker of EMT, promotes CRPC progression and that there was a correlation between N-cadherin expression and the expression of stem cell associated markers. This leads to hypothesis that N-cadherin may promote CRPC by enhancing tumorige esis/tumor initiating properties of cancer cells in a castrate environment. N-cadherin may confer tumor initiating or stem-like properties to prostate cancer cells perhaps uniquely or specific to in a castrate environment. Here, we verified that EMT is linked to stem cells in both normal prostate and CRPC. We further demonstrate that N-cadherin is involved in increased stem cell properties in normal mouse and human prostates from clinical samples in an androgen-deprived environment. Castration elevates the expression of N-cadherin and stem cell marker Trop2, accompanied with enhanced stem cell properties of luminal population in normal mouse prostates. N-cadherin upregulates stem cell properties in prostate cancer cells in the absence of androgen and CRPC tumors. N-cadherin-positive cells from CRPC tumors behave as stem cells. Overexpression of N-cadherin enhances ALDH activity in a panel of prostate cancer cell lines. Our findings reveal an important role of N-cadherin in prostate cancer and stem cells, and provide useful information of EMT-related biomarkers for preventing and developing efficient therapeutics to combat the treatment resistance to next-generation AR antagonists. Citation Format: Shu Lin, Tanya Stonyanova, Evelyn Kono, Jaclyn Matsuura, Naoko Kobayashi, Joyce Yamashiro, Dai Hong, Owen N. Witte, Andrew S. Goldstein, Robert E. Reiter. N-cadherin promotes castration-resistant prostate cancer progression by enhancing stem cell properties of prostate cancer cells. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-279.

Abstract 677: Co-targeting of AR and N-cadherin with Enzalutamide and 2A9 monoclonal antibody to treat castration resistant prostate cancer

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Introduction: Enzalutamide (MDV3100) is an androgen receptor (AR) antagonist that targets various stages of the AR signaling pathway, and has been approved for the treatment of castration resistant prostate cancer (CRPC). Studies show improved survival in men with metastatic CRPC after chemotherapy when treated with Enzalutamide. However, emergence of potential AR-independent mechanisms of castration resistance and resistance to these next generation AR inhibitors has proven to be a challenge. Previously, we reported an association of N-cadherin, a mesenchymal cadherin expressed on the cell surface, with tumor progression and castration resistance. Targeting N-cadherin positive cells with specific monoclonal antibodies affect tumor growth in both AR positive and negative prostate cancers. Here we investigate the effects of co-targeting AR with Enzalutamide and N-cadherin with the N-cadherin specific monoclonal antibody 2A9 in CRPC. Method: N-cadherin was ectopically expressed in androgen dependent prostate cancer cells (LNCaP, MDA-PCa-2b, VCaP) and evaluated in vitro for invasion, growth, and self-renewal in the presence of Enzalutamide and 2A9 monoclonal antibody, raised against extracellular domain 4 of N-cadherin. Enzalutamide-resistant cell lines were generated and characterized. For in vivo studies, castration resistant N-cadherin and AR positive, as well as androgen-dependent tumors were implanted in mice as xenografts. When the tumors reached 100mm^3 in volume, mice were castrated and treated with 5-10mg/kg Enzalutamide and/or 5-10mg/kg 2A9 and monitored for tumor growth, local invasion, and metastasis. The tumors were harvested and analyzed for cell proliferation, apoptosis, and other markers. Results: Ectopic expression of N-cadherin in N-cadherin negative cells showed increase in cell growth and invasion in androgen-deprived conditions. In vitro studies show single or combination treatment of N-cadherin positive and AR positive cells reduce invasion and cell proliferation. Enzalutamide-resistant cell lines show response to 2A9 in androgen-deprived conditions. In vivo studies using CRPC xenograft models expressing N-cadherin and AR show inhibition of tumor growth when the animals are castrated and treated with a combination of Enzalutamide and 2A9 than either treatment alone. Androgen dependent xenograft models in castrated mice also showed significant delay in progression to castration resistance when treated in combination than either treatment alone. Conclusion: Previous studies suggested that therapeutic targeting of N-cadherin with monoclonal antibodies have significant effect in inhibiting tumor progression. The antibody in combination with Enzalutamide showed synergy. Other androgen receptor antagonists and other drugs targeting those potentially involved in downstream pathways may prove to have additional clinical benefit. Citation Format: Evelyn A. Kono, Sean Hyung-Kwon Lee, Tatsuya Shimomura, Shu Lin, Joyce Yamashiro, Robert E. Reiter. Co-targeting of AR and N-cadherin with Enzalutamide and 2A9 monoclonal antibody to treat castration resistant prostate cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 677. doi:10.1158/1538-7445.AM2014-677

Abstract 3021: Roles of EMT on stem cell properties of prostate stem and cancer cells during castration-resistant prostate cancer progression

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Androgen ablation remains the mainstay of treatment for men with advanced and metastatic prostate cancer. However, despite the introduction of new generation anti-androgens, a majority of men succumb to castration resistant prostate cancer (CRPC). The molecular mechanisms governing the emergence of treatment resistance in CRPC patients are not well understood. Recent experience suggests that tumor regeneration from castration-resistant stem-like cells induce resistance to hormonal therapy. Therefore, elucidating novel targets essential for driving stem-like activity is critical to prevent and defeat CRPC. It has been shown that normal and cancer stem cells exploit normal development process of epithelial-mesenchymal transition (EMT) to survive and metastasize, and that EMT confer stem cell properties to more differentiated cancer cell progeny in breast and other cancers. However, it is unclear if EMT is linked with stem cells in normal and malignant prostate. Our lab has reported that N-cadherin, a marker of EMT, is upregulated after neoadjuvant hormone ablation and in CRPC and is sufficient to cause metastasis and CRPC. Therapeutic targeting of N-cadherin by novel N-cadherin antibody inhibited metastatic and CRPC progression. The cell population displaying N-cadherin co-expressed a number of stem cell-associated genes in CRPC models. Here, we verified EMT linked to stem cells in both normal prostate and CRPC. We found in LAPC-9 CRPC tumors, the cell population expressing N-cadherin behaved like stem cells with enhanced sphere-forming ability, which could be specifically inhibited by novel N-cadherin antibody 2A9. We isolated stem-like CD49fhi/Trop2hi cells from prostatectomy specimens and found that forced N-cadherin expression promoted sphere formation of those cells. Our evaluation of gene expression in N-cadherin-positive prostate cancer cell lines and CRPC tumors demonstrated that N-cadherin expression activated common EMT transcriptional regulators including Zeb1. We asked if Zeb1 regulated stem cell properties in normal and malignant prostate. We found that forced Zeb1 expression induced EMT with enhanced cell invasiveness in LNCaP human prostate cancer cells. However, Zeb1 overexpression inhibited cell proliferation and CRPC tumor growth of LNCaP. Zeb1 overexpression also surprisingly inhibited sphere formation of normal stem/progenitor cells from prostatectomy specimens. Our data suggest that Zeb1-regulated EMT promotes both quiescence and invasiveness in normal and malignant prostate in which the quiescent cells may survive and play a role in treatment resistance, while N-cadherin mediates stem cell proliferation and self-renewal. Our research will likely provide useful information of EMT-related biomarkers for preventing and developing efficient therapeutics to combat the treatment resistance to new generation anti-androgens. Citation Format: Shu Lin, Evelyn Kono, Joyce Yamashiro, Sean Lee, Owen Witte, Andrew Goldstein, Robert E. Reiter. Roles of EMT on stem cell properties of prostate stem and cancer cells during castration-resistant prostate cancer progression. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3021. doi:10.1158/1538-7445.AM2014-3021

Abstract 3623: Monoclonal antibody against the 4th extracellular domain of N-cadherin affects FGF2 mediated pathways in prostate cancer

Proceedings: AACR 102nd Annual Meeting 2011‐‐ Apr 2‐6, 2011; Orlando, FL Introduction: Fibroblast growth factor 2 (FGF2) has been reported to synergize with N-cadherin, a cell surface marker of epithelial mesenchymal transition (EMT), to enhance migration and invasion in breast cancer and other cancers. Recent studies from our group suggested that N-cadherin promotes castration resistance and metastasis in prostate cancer. In addition, our studies showed that antibodies against N-cadherin ectodomains blocked prostate cancer invasion and castration resistant growth. To investigate the mechanism of action of N-cadherin antibodies in prostate cancer cells, we seek to determine the contribution of the different N-cadherin domains in promoting invasion and growth in prostate cancer cells, with particular focus on interaction with FGF2. Methods: Chimeric constructs, in which a N-cadherin domain was swapped with an E-cadherin domain, were generated and ectopically expressed in androgen dependent prostate cancer cell line LNCaP. The following combinations were made: 1/ NE: N-cadherin ectodomains linked to E-cadherin cytoplasmic domain (NE), 2/ EN: the reverse of NE, 3/ NEN: swapping N-cadherin ectodomain 4 for that of E-cadherin. Full length N-cadherin and empty vector sublines served as positive and negative controls. All cell lines were assayed for invasion and growth in androgen depleted media in combination with recombinant FGF2, FGF2 neutralizing antibody and N-cadherin antibodies. Results: Ectopic expression of N-cadherin in N-cadherin negative cells result in a 5-fold increase of FGF2 secreted in the media. In vitro studies have shown that the addition of recombinant FGF2 enhanced invasion by 56%± 0.04 in N-cadherin positive cells while treatment with FGF2 neutralizing antibody resulted in a 65%± 0.03 reduction in invasion. Chimeric cell lines which harbor extracellular domain 4 of N-cadherin, N and NE cell lines, showed >56%± 0.11 enhanced invasion to the addition of recombinant FGF2 while EN, NEN, and control cell lines did not. Monoclonal antibodies developed against regions in the extracellular domain of N-cadherin block the response to recombinant FGF2 with 2A9 (antibody raised against extracellular domain 4) being the least responsive. Conclusions: These studies suggest that the relationship between N-cadherin and FGF2 is involved in prostate cancer progression. Therapeutic targeting of N-cadherin with monoclonal antibodies, alone or in combination with other drugs targeting those potentially involved in downstream pathways may have significant clinical benefit. Future experiments include in vivo models where chimeric cell lines will be implanted in mice as xenografts, and will be monitored for tumor growth, local invasion, and metastasis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3623. doi:10.1158/1538-7445.AM2011-3623