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BackgroundPatients with HER2-positive metastatic breast cancer (MBC) are at high risk of developing central nervous system (CNS) metastases. A potent and selective HER2 inhibitor with good blood-brain barrier (BBB) penetration is highly desirable.MethodsThe design and structure-activity relationship of DZD1516 was described. The potency and selectivity of DZD1516 were determined by enzymatic and cellular assays. The antitumor activity of DZD1516 monotherapy or in combination with HER2 antibody-drug conjugate was assessed in CNS and subcutaneous xenograft mouse models. A phase 1 first-in-human study evaluated the safety, tolerability, pharmacokinetics, and preliminary antitumor activity of DZD1516 in patients with HER2+ MBC who relapsed from standard of care.ResultsDZD1516 showed good selectivity against HER2 over wild-type EGFR in vitro and potent antitumor activity in vivo. Twenty-three patients were enrolled and received DZD1516 monotherapy treatment across six dose levels (25-300 mg, twice daily). Dose-limiting toxicities were reported at 300 mg, and thus 250 mg was defined as the maximum tolerated dose. The most common adverse events included headache, vomiting, and hemoglobin decreased. No diarrhea or skin rash was observed at ≤ 250 mg. The mean Kp,uu,CSF was 2.1 for DZD1516 and 0.76 for its active metabolite DZ2678. With median seven lines of prior systemic therapy, the best antitumor efficacy in intracranial, extracranial and overall lesions was stable disease.ConclusionsDZD1516 provides positive proof of concept for an optimal HER2 inhibitor with high BBB penetration and HER2 selectivity. Further clinical evaluation of DZD1516 is warranted, with the RP2D being 250 mg BID.Clinicaltrialsgov identifier NCT04509596. Registered on August 12, 2020; Chinadrugtrial: CTR20202424 Registered on December 18, 2020.

DP303c is a HER2-targeted ADC with a cleavable linker-MMAE payload. Previous in vitro studies demonstrated that DP303c showed similar or better antitumor activity than T-DM1 in xenograft models. This was a multicenter, dose escalation and dose expansion phase 1 study in China. Eligible patients were 18-75 years old with HER2-positive advanced solid tumors who were unable to benefit from standard therapy. DP303c was administered intravenously every 3 weeks, with accelerated titration at lower dose of 0.5 mg/kg and 3 + 3 design with dose levels of 1.0, 2.0, 3.0 or 4.0 mg/kg at dose escalation part, followed by the selected dose level at dose expansion part. The primary endpoints were safety and tolerability, as well as identification of recommended phase 2 dose. As of Feb 28, 2023, 94 patients were enrolled and received DP303c (dose escalation: n = 22; dose expansion: n = 72), of whom 68 patients had breast cancer. One dose limiting toxicity (Grade 3 eye pain) was observed at 4.0 mg/kg dose, and the maximum tolerated dose was not reached. The most common treatment-related adverse events at grade 3 or higher were blurred vison (16.0%), dry eye (6.4%), and peripheral neuropathy (5.3%). No treatment-related death occurred. Overall, among 91 efficacy evaluable patients, 39 patients (42.9%) achieved an objective response. Disease control was observed in 62 patients (68.1%). In 66 efficacy evaluable patients with breast cancer, 34 patients achieved an objective response (51.5%). Disease control was achieved in 51 patients (77.3%). Median PFS was 6.4 months. On a molar basis, DP303c Cmax at 3.0 mg/kg doses was 132-folder higher than that for free MMAE. DP303c demonstrated promising anti-tumor activity with acceptable safety in patients with pre-treated advanced HER2 positive solid tumors, especially in breast cancer. Based on safety and efficacy results, 3.0 mg/kg Q3W was determined as recommended phase 2 dose for DP303c. (Trial registration: ClinicalTrials.gov Identifier: NCT04146610). [ABSTRACT FROM AUTHOR]

Abstract Background Both thermotherapy and arsenic have been shown to be active against a broad spectrum of cancers. To reduce the limitations of conventional thermotherapy, improve therapeutic anticancer activity, reduce the toxicity of arsenic on normal tissue, and increase tissue-specific delivery, we prepared a nanosized As2O3/Fe3O4 complex (Fe3O4 magnetic nanoparticles encapsulated in As2O3). We assessed the thermodynamic characteristics of this complex and validated the hyperthermia effect, when combined with magnetic fluid hyperthermia (MFH), on xenograft HeLa cells (human cervical cancer cell line) in nude mice. We also measured the effect on the expression of CD44v6, VEGF-C, and MMP-9 which were related to cancer and/or metastasis. Results The nanosized As2O3/Fe3O4 particles were approximately spherical, had good dispersibility as evidenced by TEM, and an average diameter of about 50 nm. With different concentrations of the nanosized As2O3/Fe3O4 complex, the correspondingsuspension of magnetic particles could attain a steady temperature ranging from 42°C to 65°C when placed in AMF for 40 min. Thermochemotherapy with the nanosized As2O3/Fe3O4 complex showed a significant inhibitory effect on the mass (88.21%) and volume (91.57%) of xenograft cervical tumors (p < 0.05 for each measurement, compared with control). In addition, thermochemotherapy with the nanosized As2O3/Fe3O4 complex significantly inhibited the expression of CD44v6, VEGF-C, and MMP-9 mRNA (p < 0.05 for each). Conclusion As2O3/Fe3O4 complex combined with MFH had is a promising technique for the minimally invasive elimination of solid tumors and may be have anticancerometastasic effect by inhibiting the expression of CD44v6, VEGF-C, and MMP-9.

Purpose: KN026 is a novel bispecific antibody that simultaneously binds to two distinct HER2 epitopes. This first-in-human phase I study evaluated the safety/tolerability, pharmacokinetics, preliminary efficacy, and potential predictive biomarker activity of KN026 administered as monotherapy to patients with HER2-positive metastatic breast cancer (MBC)., Patients and Methods: Female patients with HER2-positive MBC who had progressed on prior anti HER2 therapies received intravenous KN026 monotherapy at 5 mg/kg (once weekly), 10 mg/kg (once weekly), 20 mg/kg (once every 2 weeks), or 30 mg/kg (once every 3 weeks). Dose escalation was guided by a "3+3" dose escalation rule followed by dose expansion., Results: Sixty-three patients were enrolled. The most common treatment-related adverse events (TRAE) were pyrexia (23.8%), diarrhea (22.2%), aspartate aminotransferase increased (22.2%), alanine aminotransferase increased (22.2%). Only 4 patients reported grade 3 TRAEs. Results from exposure-response analysis supported the selection of the recommended phase II doses at 20 mg/kg once every 2 weeks or 30 mg/kg once every 3 weeks, which had objective response rates (ORR) of 28.1% and median progression-free survival (PFS) of 6.8 months (95% confidence interval: 4.2-8.3) in 57 patients. Translational research in 20 HER2-amplified patients further confirmed that co-amplification (vs. no co-amplification) of CDK12 was a promising biomarker in predicting better response to KN026 (ORR of 50% vs. 0% and median PFS of 8.2 vs. 2.7 months, P = 0.05 and 0.04, respectively)., Conclusions: KN026, a HER2 bispecific antibody, was well tolerated and achieved comparable efficacy as trastuzumab and pertuzumab doublet even in the more heavily pretreated patients. Co-amplification of HER2/CDK12 may define patients who benefit more from KN026., (©2021 American Association for Cancer Research.)

Purpose: This study was performed to investigate the effects of lanostane against human breast cancer cells with emphasis on its potential to inhibit cancer cell growth and metastasis along with understanding the underlying molecular mechanism mediating the effects., Methods: The SK-BR-3 normal breast line and the MB-157 breast cancer cell line were used in this study. MTT of cell growth was used to determine the viability of cells under lanostane treatment. Colony formation assay was used to analyze the clone forming capability of cancer cells when treated with lanostane. DAPI and acridine orange (AO)/ethidium bromide (EB) staining assays were performed for assessing the apoptic cell death. The level of cellular apoptosis was further examined using flow cytometry. Wound healing and transwell assays were performed to determine the migration and invasion of cancer cells. Western blotting was used for determining the concentration of proteins of interest., Results: The lanostane treatment of cancer cells resulted in loss of cell viability. The IC50 value was 15µM and the inhibitory effects were dose-dependent. However, the inhibition of cell proliferation in normal breast cells was comparatively lower. The antiproliferative effects of lanostane were modulated through Bax/Bcl-2 pathway inducing apoptosis of cancer cells. Furthermore, the lanostane rendered cancer cells less motile and reduced their metastasis remarkably. The inhibition of cell metastasis was modulated through Rho-associated kinases (ROCK) signaling pathway which is involved in metastasis of breast cancer to bone tissues. Hence, the results suggested that lanostane inhibited the breast cancer metastasis to bone., Conclusion: The results of the present study are suggestive of anticancer effects of lanostene triterpene which exerted its effects by inhibiting cell proliferation and metastasis of breast cancer cells mediated through inactivation of Rho-associated kinase signaling. The study holds promise to provide a lead for exploring the secondary metabolite-based anticancer approach against various human malignancies.

Purpose: Oridonin, a diterpenoid, has been reported to exhibit anticancer activity against a wide range of cancer types.In this study, the effect Oridonin was examined against human osteosarcoma cells., Methods: The human osteosarcoma cells U2OS were treated with various concentrations of Oridonin from 0-200 μM for 24 h. The anti-proliferative effects of Oridonin were measured by cell viability assay. DAPI and annexin V/propidium iodide (PI) assays were employed to examine the induction of apoptosis. Transwell assay was performed to examine the cell migration and invasion. Expression analysis was performed by western blot., Results: Oridonin inhibited the proliferation of U2OScells and exhibited an IC50 of 30 µM. The antiproliferative effects were mainly found to be due to induction of apoptosis as indicated by DAPI staining. Moreover, the annexin V/PI staining showed that the percentage of the apoptotic cells increased with increase in the concentration of Oridonin. The induction of apoptosis was also related with upregulation of Bax, Caspase 3 and 9 expression and downregulation of Bcl-2. Oridonin was also found to cause significant decrease in the expression of MMP-2, 3 and 9 concentration-dependently. Transwell assay showed that Oridonin inhibited the migration and invasion of the U2OS cells., Conclusion: It is concluded that Oridonin exhibits significant antiproliferative effects on the osteosarcoma cells and may prove essential in the development of systemic therapy for osteosarcoma.

Purpose: To study the anticancer effects of aloe emodin against the MIAPaCa-2 and PANC-1 human pancreatic adenocarcinoma cancer cell lines by evaluating its effect on autophagic cell death, mitochondrial membrane potential (ΛΨm) loss and cell cycle arrest., Methods: The MTT assay was employed to examine the anti-proliferative effect of aloe emodin on these cells, and inverted phase contrast and fluorescence microscopes were used to evaluate apoptotic induction. Flow cytometry was performed to examine the effects of aloe emodin on ΛΨm and cell cycle phase distribution., Results: The findings indicated that aloe emodin induced dose-dependent cytotoxicity in both pancreatic carcinoma cells with MIAPaCa-2 cells being more susceptible than PANC-1, along with inhibiting cancer cell colony formation. Aloe emodin-treated cells exhibited cell shrinkage along with distortion of the normal cell morphology. In addition, these cells showed chromatin condensation, membrane blebbing and predominantly emitted red fluorescence, which signified apoptosis. Following treatment with aloe emodin (10, 40 and 80 µM) the early apoptotic cell percentage increased to 17.5, 39.6 and 58.8%, respectively, while late apoptotic cells percentage increased to 22.3, 27.6 and 37.2% respectively. There was also a marked increase in the loss of ΛΨm in the aloe emodin-treated cells, as well as dose-dependent sub-G1 cell cycle arrest. Furthermore, aloe emodin treatment led to a substantial enhancement of the conversion of light chain 3 (LC3)-l to LC3-ll and this increase was shown to follow aloe emodin dose-dependent pattern, thus indicating that aloe emodin may induce autophagy in addition to apoptosis., Conclusion: To sum up, aloe emodin inhibits cancer cell growth in human pancreatic carcinoma cells and it was shown that these anticancer effects are mediated via both apoptotic and autophagic pathways, cell cycle arrest and loss of mitochondrial membrane potential.

Background: Both thermotherapy and arsenic have been shown to be active against a broad spectrum of cancers. To reduce the limitations of conventional thermotherapy, improve therapeutic anticancer activity, reduce the toxicity of arsenic on normal tissue, and increase tissue-specific delivery, we prepared a nanosized As2O3/Fe3O4 complex (Fe3O4 magnetic nanoparticles encapsulated in As2O3). We assessed the thermodynamic characteristics of this complex and validated the hyperthermia effect, when combined with magnetic fluid hyperthermia (MFH), on xenograft HeLa cells (human cervical cancer cell line) in nude mice. We also measured the effect on the expression of CD44v6, VEGF-C, and MMP-9 which were related to cancer and/or metastasis., Results: The nanosized As2O3/Fe3O4 particles were approximately spherical, had good dispersibility as evidenced by TEM, and an average diameter of about 50 nm. With different concentrations of the nanosized As2O3/Fe3O4 complex, the correspondingsuspension of magnetic particles could attain a steady temperature ranging from 42 degrees C to 65 degrees C when placed in AMF for 40 min. Thermochemotherapy with the nanosized As2O3/Fe3O4 complex showed a significant inhibitory effect on the mass (88.21%) and volume (91.57%) of xenograft cervical tumors (p < 0.05 for each measurement, compared with control). In addition, thermochemotherapy with the nanosized As2O3/Fe3O4 complex significantly inhibited the expression of CD44v6, VEGF-C, and MMP-9 mRNA (p < 0.05 for each)., Conclusion: As2O3/Fe3O4 complex combined with MFH had is a promising technique for the minimally invasive elimination of solid tumors and may be have anticancerometastasic effect by inhibiting the expression of CD44v6, VEGF-C, and MMP-9.