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      A chemically modified antibody mediates complete eradication of tumours by selective disruption of tumour blood vessels

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          Abstract

          Background:

          The possibility of eradicating cancer by selective destruction of tumour blood vessels may represent an attractive therapeutic avenue, but most pharmaceutical agents investigated so far did not achieve complete cures and are not completely specific. Antibody conjugates now allow us to evaluate the impact of selective vascular shutdown on tumour viability and to study mechanisms of action.

          Methods:

          We synthesised a novel porphyrin-based photosensitiser suitable for conjugation to antibodies and assessed anticancer properties of its conjugate with L19, a clinical-stage human monoclonal antibody specific to the alternatively spliced EDB domain of fibronectin, a marker of tumour angiogenesis.

          Results:

          Here we show in two mouse model of cancer (F9 and A431) that L19 is capable of highly selective in vivo localisation around tumour blood vessels and that its conjugate with a photosensitiser allows selective disruption of tumour vasculature upon irradiation, leading to complete and long-lasting cancer eradication. Furthermore, depletion experiments revealed that natural killer cells are essential for the induction of long-lasting complete responses.

          Conclusions:

          These results reinforce the concept that vascular shutdown can induce a curative avalanche of tumour cell death. Immuno-photodynamic therapy may be particularly indicated for squamous cell carcinoma of the skin, which we show to be strongly positive for markers of angiogenesis.

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          Most cited references40

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          Photodynamic therapy and anti-tumour immunity.

          Photodynamic therapy (PDT) uses non-toxic photosensitizers and harmless visible light in combination with oxygen to produce cytotoxic reactive oxygen species that kill malignant cells by apoptosis and/or necrosis, shut down the tumour microvasculature and stimulate the host immune system. In contrast to surgery, radiotherapy and chemotherapy that are mostly immunosuppressive, PDT causes acute inflammation, expression of heat-shock proteins, invasion and infiltration of the tumour by leukocytes, and might increase the presentation of tumour-derived antigens to T cells.
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            Divergent immunoglobulin g subclass activity through selective Fc receptor binding.

            Subclasses of immunoglobulin G (IgG) display substantial differences in their ability to mediate effector responses, contributing to variable activity of antibodies against microbes and tumors. We demonstrate that the mechanism underlying this long-standing observation of subclass dominance in function is provided by the differential affinities of IgG subclasses for specific activating IgG Fc receptors compared with their affinities for the inhibitory IgG Fc receptor. The significant differences in the ratios of activating-to-inhibitory receptor binding predicted the in vivo activity. We suggest that these highly predictable functions assigned by Fc binding will be an important consideration in the design of therapeutic antibodies and vaccines.
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              Photodynamic Therapy and the Development of Metal-Based Photosensitisers

              Photodynamic therapy (PDT) is a treatment modality that has been used in the successful treatment of a number of diseases and disorders, including age-related macular degeneration (AMD), psoriasis, and certain cancers. PDT uses a combination of a selectively localised light-sensitive drug (known as a photosensitiser) and light of an appropriate wavelength. The light-activated form of the drug reacts with molecular oxygen to produce reactive oxygen species (ROS) and radicals; in a biological environment these toxic species can interact with cellular constituents causing biochemical disruption to the cell. If the homeostasis of the cell is altered significantly then the cell enters the process of cell death. The first photosensitiser to gain regulatory approval for clinical PDT was Photofrin. Unfortunately, Photofrin has a number of associated disadvantages, particularly pro-longed patient photosensitivity. To try and overcome these disadvantages second and third generation photosensitisers have been developed and investigated. This Review highlights the key photosensitisers investigated, with particular attention paid to the metallated and non-metallated cyclic tetrapyrrolic derivatives that have been studied in vitro and in vivo; those which have entered clinical trials; and those that are currently in use in the clinic for PDT.
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                Author and article information

                Journal
                Br J Cancer
                British Journal of Cancer
                Nature Publishing Group
                0007-0920
                1532-1827
                29 March 2011
                08 March 2011
                : 104
                : 7
                : 1106-1115
                Affiliations
                [1 ]simpleDepartment of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology Zürich , Wolfgang-Pauli-Strasse 10, Zürich 8093, Switzerland
                [2 ]simpleDepartment of Dermatology, University Hospital Zurich , Gloriastrasse 31, Zurich 8091, Switzerland
                [3 ]simplePhilochem AG, c/o ETH Zürich, Institute of Pharmaceutical Sciences, Wolfgang-Pauli-Strasse 10 , HCI E520, Zürich 8093, Switzerland
                [4 ]simpleInstitute of Surgical Pathology, University Hospital Zurich , Schmelzbergstrasse 12, Zurich 8091, Switzerland
                [5 ]simpleDepartment of Chemistry, University of Hull , Cottingham Road, Kingston-upon-Hull HU6 7RX, UK
                Author notes
                Article
                bjc201178
                10.1038/bjc.2011.78
                3068510
                21386847
                187e7354-9083-43ac-9bc1-22bc698bd55a
                Copyright © 2011 Cancer Research UK
                History
                : 22 December 2010
                : 14 February 2011
                Categories
                Translational Therapeutics

                Oncology & Radiotherapy
                immunotherapy,monoclonal antibody,squamous cell carcinoma,tumour neovasculature,natural killer cells,photodynamic therapy

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