Zalutumumab

Last updated
Zalutumumab
Monoclonal antibody
Type Whole antibody
Source Human
Target Epidermal growth factor receptor
Clinical data
ATC code
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CAS Number
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UNII
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Chemical and physical data
Formula C6512H10074N1734O2032S46
Molar mass 146643.09 g·mol−1
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Zalutumumab (proposed trade name HuMax-EGFR) is a fully human IgG1 monoclonal antibody (mAb) directed towards the epidermal growth factor receptor (EGFR). It is a product developed by Genmab in Utrecht, the Netherlands. Specifically, zalutumumab is designed for the treatment of squamous cell carcinoma of the head and neck (SCCHN), a type of cancer.

Contents

Mechanism of action

Zalutumumab works through inhibition of the EGFR signal. The EGFR is a receptor tyrosine kinase. Its structure includes an extracellular binding domain, a transmembrane lipophilic segment, and an intracellular tyrosine kinase domain.

Mechanism of EGFR

EGFR is over-expressed by many tumor cells. Upon binding by a ligand, such as the epidermal growth factor or TGF alpha, dimerization occurs, leading to autophosphorylation on the intracellular tyrosine residues. Following phosphorylation, the Grb2-SOS signaling complex is stimulated. This causes the activation of the G protein RAS through the exchange of guanosine diphosphate (GDP) for guanosine triphosphate (GTP). The exchange of GDP for GTP induces a conformational change of RAS to allow it to bind to Raf-1. Raf-1 is then activated through another multistep mechanism in which dephosphorylation of inhibitory sites by protein phosphatase 2A (PP2A), as well as the phosphorylation of activating sites by p21 activated kinase (PAK) occurs. After this, Raf-1 activates MAPK/ERK kinase (MEK), which then goes on to activate extracellular-signal-regulated kinase (ERK). ERK is then able to enter the cell nucleus and control gene expression by phosphorylating various transcription factors, such as Elk-1. It is from there that the specific gene transcription occurs to initiate the cell cycle. Through this mechanism, apoptosis is inhibited, angiogenesis, migration, adhesion, and invasion occur. Each of these is a functional element to the progression and development of cancer, which is defined as an abnormal growth of cells with a tendency to proliferate in an uncontrolled way and, in some cases, to metastasize. [1]

Mechanism of zalutumumab

In order to combat SCCHN, zalutumumab was designed to inhibit the EGFR signaling. Specifically, it binds to the EGFR Domain III on the cell surface. This locks the receptor in an inactive conformation, making the drug an inverse agonist. In doing this it is also acting as a competitive antagonist for the EGF ligand. In the inactive conformation, the distance between the intracellular tyrosine kinase residues is larger, which inhibits dimerization. Phosphorylation is consequently inhibited, so that no signal is released. Without a signal, cell cycle characteristics to enhance tumor growth are inhibited and the cancer progression is suppressed. [2]

This is not the only way in which zalutumumab works. It also is responsible for some antitumor affects through antibody-dependent cellular cytotoxicity (ADCC). The Fab, or fragment antigen binding region of the antibody, binds to the antigen on the EGFr expressing tumor cells. Through an immunological response, the body’s natural killer (NK) cells, which are a type of lymphocyte, recognize and bind to the Fc portion on the antibody through an Fc receptor, CD16. The NK cell is then activated through the cross linking of the Fc receptors which sends a signal to induce apoptosis and cell death. The target tumor cell is then destroyed. [2]

Developmental status

2009: Zalutumumab treatment was approved for Fast Track status by the U.S. Food and Drug Administration for patients suffering from SCCHN who have failed standard therapies and have no other options. The drug has undergone pre-clinical and Phase I and II studies and is also in Phases I and II for SCCHN front-line with chemo-radiation and SCCHN with radiation. Additionally, a Phase II is under way for SCCHN and Phase III studies are also being performed for SCCHN and SCCHN front-line with radio therapy. [3]

2010:A phase III study (of zalutumumab as an addition to 'best supportive care' in patients after failed standard platinum-based chemotherapy) reported a non-significant improvement in overall survival, and a significant 61% improvement in Progression-free survival [4]

2014:A study of zalutumumab as addition to chemoradiation for SCCHN showed no benefit, [5] and 94% developed a skin rash (11% severe enough to discontinue).

2015:Genmab not proceeding with zalutumumab. [6]

Related Research Articles

<span class="mw-page-title-main">Protein kinase</span> Enzyme that adds phosphate groups to other proteins

A protein kinase is a kinase which selectively modifies other proteins by covalently adding phosphates to them (phosphorylation) as opposed to kinases which modify lipids, carbohydrates, or other molecules. Phosphorylation usually results in a functional change of the target protein (substrate) by changing enzyme activity, cellular location, or association with other proteins. The human genome contains about 500 protein kinase genes and they constitute about 2% of all human genes. There are two main types of protein kinase. The great majority are serine/threonine kinases, which phosphorylate the hydroxyl groups of serines and threonines in their targets and most of the others are tyrosine kinases, although additional types exist. Protein kinases are also found in bacteria and plants. Up to 30% of all human proteins may be modified by kinase activity, and kinases are known to regulate the majority of cellular pathways, especially those involved in signal transduction.

<span class="mw-page-title-main">Tyrosine kinase</span> Class hi residues

A tyrosine kinase is an enzyme that can transfer a phosphate group from ATP to the tyrosine residues of specific proteins inside a cell. It functions as an "on" or "off" switch in many cellular functions.

Autocrine signaling is a form of cell signaling in which a cell secretes a hormone or chemical messenger that binds to autocrine receptors on that same cell, leading to changes in the cell. This can be contrasted with paracrine signaling, intracrine signaling, or classical endocrine signaling.

<span class="mw-page-title-main">Gefitinib</span> Drug used in fighting breast, lung, and other cancers

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<span class="mw-page-title-main">Epidermal growth factor receptor</span> Transmembrane protein

The epidermal growth factor receptor is a transmembrane protein that is a receptor for members of the epidermal growth factor family of extracellular protein ligands.

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c-Met, also called tyrosine-protein kinase Met or hepatocyte growth factor receptor (HGFR), is a protein that in humans is encoded by the MET gene. The protein possesses tyrosine kinase activity. The primary single chain precursor protein is post-translationally cleaved to produce the alpha and beta subunits, which are disulfide linked to form the mature receptor.

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<span class="mw-page-title-main">Platelet-derived growth factor receptor</span>

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<span class="mw-page-title-main">Proto-oncogene tyrosine-protein kinase Src</span> Mammalian protein found in Homo sapiens

Proto-oncogene tyrosine-protein kinase Src, also known as proto-oncogene c-Src, or simply c-Src, is a non-receptor tyrosine kinase protein that in humans is encoded by the SRC gene. It belongs to a family of Src family kinases and is similar to the v-Src gene of Rous sarcoma virus. It includes an SH2 domain, an SH3 domain and a tyrosine kinase domain. Two transcript variants encoding the same protein have been found for this gene.

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<span class="mw-page-title-main">Cell surface receptor</span> Class of ligand activated receptors localized in surface of plama cell membrane

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<span class="mw-page-title-main">AEE788</span> Chemical compound

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References

  1. What is Cancer, MedicineNet.com
  2. 1 2 Lammerts van Bueren JJ, Bleeker WK, Brännström A, von Euler A, Jansson M, Peipp M, Schneider-Merck T, Valerius T, van de Winkel JG, Parren PW (April 2008). "The antibody zalutumumab inhibits epidermal growth factor receptor signaling by limiting intra- and intermolecular flexibility". Proceedings of the National Academy of Sciences of the United States of America. 105 (16): 6109–14. Bibcode:2008PNAS..105.6109L. doi: 10.1073/pnas.0709477105 . PMC   2329681 . PMID   18427122.
  3. "Science and Research". Genmmab A/S. 2009.
  4. http://www.genengnews.com/news/bnitem.aspx?name=77261239 March 2010
  5. "OncoBriefs: Zalutumumab Misses Mark in H&N Cancer". medpagetoday.com. 22 February 2014.
  6. Design, inNottingham Web. "Welcome to UKMi National Medicines Information". www.ukmi.nhs.uk. Archived from the original on 2012-05-26. Retrieved 2015-10-31.