Harnessing Androgen Receptor Pathway Activation for Targeted Alpha Particle Radioimmunotherapy of Breast Cancer

Clin Cancer Res. 2019 Jan 15;25(2):881-891. doi: 10.1158/1078-0432.CCR-18-1521. Epub 2018 Sep 25.

Abstract

Purpose: The impact of androgen receptor (AR) activity in breast cancer biology is unclear. We characterized and tested a novel therapy to an AR-governed target in breast cancer.Experimental Design: We evaluated the expression of prototypical AR gene products human kallikrein 2 (hK2) and PSA in breast cancer models. We screened 13 well-characterized breast cancer cell lines for hK2 and PSA production upon in vitro hormone stimulation by testosterone [dihydrotestosterone (DHT)]. AR-positive lines were further evaluated by exposure to estrogen (17β-Estradiol) and the synthetic progestin D-Norgestrel. We then evaluated an anti-hK2-targeted radiotherapy platform (hu11B6), labeled with alpha (α)-particle emitting Actinium-225, to specifically treat AR-expressing breast cancer xenografts under hormone stimulation.

Results: D-Norgestrel and DHT activated the AR pathway, while 17β-Estradiol did not. Competitive binding for AR protein showed similar affinity between DHT and D-Norgestrel, indicating direct AR-ligand interaction. In vivo production of hK2 was sufficient to achieve site-specific delivery of therapeutic radionuclide to tumor tissue at >20-fold over background muscle uptake; effecting long-term local tumor control.

Conclusions: [225Ac]hu11B6 targeted radiotherapy was potentiated by DHT and by D-Norgestrel in murine xenograft models of breast cancer. AR activity in breast cancer correlates with kallikrein-related peptidase-2 and can be activated by D-Norgestrel, a common contraceptive, and AR induction can be harnessed for hK2-targeted breast cancer α-emitter radiotherapy.

MeSH terms

  • Alpha Particles / therapeutic use*
  • Animals
  • Biomarkers, Tumor
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Cell Line, Tumor
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Dose-Response Relationship, Radiation
  • Female
  • Hexokinase / antagonists & inhibitors
  • Humans
  • Immunoconjugates / administration & dosage*
  • Immunoconjugates / pharmacokinetics
  • Mice
  • Molecular Targeted Therapy
  • Radioimmunotherapy
  • Radiometry
  • Receptors, Androgen / metabolism*
  • Signal Transduction* / drug effects
  • Signal Transduction* / radiation effects
  • Tissue Distribution
  • Xenograft Model Antitumor Assays

Substances

  • Biomarkers, Tumor
  • Immunoconjugates
  • Receptors, Androgen
  • HK2 protein, human
  • Hexokinase