trabedersen and Neoplasms

Despite remarkable advances in cancer research, patients with malignant tumors such as high-grade glioma or advanced pancreatic carcinoma still face a poor prognosis. Because of the severe morbidity and mortality of such malignant tumor types, the identification of suitable molecular drug targets for causal treatment approaches is an important area of current research. Transforming growth factor-beta 2 (TGF-β2) is an attractive target because it regulates key mechanisms of carcinogenesis, in particular immunosuppression and metastasis, and is frequently overexpressed in malignant tumors. Here we describe the development of the antisense phosphorothioate oligodeoxynucleotide trabedersen (AP 12009) which was designed for the specific inhibition of TGF-β2 biosynthesis. In vitro and in vivo experiments confirmed the mode of action, efficacy and tolerability of trabedersen and paved the way for clinical studies. In patients with high-grade glioma, intratumoral treatment with trabedersen is currently evaluated in a pivotal, randomized and active-controlled phase III study. Intravenous application of trabedersen for the treatment of patients with advanced pancreatic carcinoma, metastasizing melanoma, or metastatic colorectal carcinoma is assessed in a currently ongoing phase I/II dose escalation study.

Topics: Animals; Antineoplastic Agents; Humans; Neoplasms; Oligodeoxyribonucleotides; Thionucleotides; Transforming Growth Factor beta2

Trabedersen (AP-12009), which is being developed by Antisense Pharma GmbH, is a synthetic antisense oligodeoxynucleotide designed to block the production of TGFbeta2, a secreted protein that can exert protumor effects. Trabedersen is indicated for the treatment of malignant brain tumors and other solid tumors overexpressing TGFbeta2, such as those of the skin, pancreas and colon. Preclinical studies demonstrated that trabedersen reduced the secretion of TGFbeta2 in cultured tumor cells and exhibited antitumor activity ex vivo. It was also demonstrated that chronic intracerebral or intravascular administration of trabedersen did not cause life-threatening side effects in animals. This observation was confirmed in early clinical trials in patients with advanced cancer. In a phase IIb trial, improved survival was observed in patients with brain tumors who were intratumorally administered trabedersen, compared with patients receiving standard chemotherapy. However, this observation requires validation by an ongoing large-scale, phase III, randomized, controlled trial. Meanwhile, continued research on trabedersen should help to determine the roles of TGFbeta2 in cancer and also further the development of antisense technology.

Topics: Animals; Antineoplastic Agents; Brain Neoplasms; Cell Line, Tumor; Clinical Trials as Topic; Drug Evaluation, Preclinical; Glioma; Humans; Neoplasms; Oligodeoxyribonucleotides; Oligonucleotides, Antisense; Thionucleotides; Transforming Growth Factor beta2

Overexpression of the cytokine transforming growth factor-beta 2 (TGF-beta2) is a hallmark of various malignant tumors including pancreatic carcinoma, malignant glioma, metastasizing melanoma, and metastatic colorectal carcinoma. This is due to the pivotal role of TGF-beta2 as it regulates key mechanisms of tumor development, namely immunosuppression, metastasis, angiogenesis, and proliferation. The antisense technology is an innovative technique offering a targeted approach for the treatment of different highly aggressive tumors and other diseases. Antisense oligonucleotides are being developed to inhibit the production of disease-causing proteins at the molecular level. The immunotherapeutic approach with the phosphorothioate oligodeoxynucleotide AP 12009 for the treatment of malignant tumors is based on the specific inhibition of TGF-beta2. After providing preclinical proof of concept, the safety and efficacy of AP 12009 were assessed in clinical phase I/II open-label dose-escalation studies in recurrent or refractory high-grade glioma patients. Median survival time after recurrence exceeded the current literature data for chemotherapy. Currently, phase I/II study in advanced pancreatic carcinoma, metastatic melanoma, and metastatic colorectal carcinoma and a phase IIb study in recurrent or refractory high-grade glioma are ongoing. The preclinical as well as the clinical results implicate targeted TGF-beta2 suppression as a promising therapeutic approach for malignant tumor therapy.

Topics: Antisense Elements (Genetics); Gene Targeting; Genetic Therapy; Humans; Male; Middle Aged; Neoplasms; Oligodeoxyribonucleotides; Thionucleotides; Transforming Growth Factor beta2