Abstract 408: Novel growth hormone receptor antagonist with discrete PEGylations markedly improve response to therapy in human pancreatic and bile duct cancers in mice

Abstract

Abstract Here we present a new and improved GHR antagonist candidate (compound G) with novel discrete PEGylations exhibiting marked efficacy in synergizing anti-cancer therapies. The American Cancer Society estimates the 5-year survival rates of pancreatic adenocarcinoma (PAAD) and bile duct cancer/cholangiocarcinoma (CHOL) to be a dismal 10% in 2022, indicating an urgent need for new therapeutic approaches for both of these devastating diseases. Several human cancers, including PAAD and CHOL express two validated oncological targets - the growth hormone receptor (GHR) and the insulin-like growth factor 1 receptor (IGF1R), as well as their cognate ligands growth hormone (GH) and insulin-like growth factor 1 (IGF1), respectively. Our laboratory had pioneered the discovery of pharmacologic antagonists for the growth hormone receptor (GHR), including the only approved and prescribed GHR antagonist, pegvisomant (Pfizer), prescribed for acromegaly (a condition of excess GH due to a hypersecreting pituitary adenoma). GHR antagonists not only inhibit the effects of GH but also robustly suppress the production of IGF1. The novel GHR antagonist compound G, that we present here, has a greater binding affinity than Pegvisomant to the GHR. And unlike Pegvisomant, compound G binds to the prolactin receptor as well as the GHR. A large body of research by us and others have earlier shown that the covert actions of tumoral GHR and IGF1R activation collectively drive mechanisms of therapy resistance including, but not limited to, active multidrug efflux, activation of epithelial-to-mesenchymal transition (EMT), resistance to apoptosis, increased fibrosis, increase of cancer stem cells, tumor angiogenesis and senescence. Our novel discrete PEGylated GHR antagonist, compound G, alone exhibits significant suppression of cancer cell viability, invasive potential, and drug efflux rate in PAAD and CHOL cell cultures. In Nude mice with human PAAD or CHOL xenografts, GHR inhibition by compound-G markedly sensitized the tumors towards both low and high doses of gemcitabine (for PAAD) or gemcitabine-cisplatin (for CHOL) treatments. Compound-G in combination with chemotherapy resulted in markedly reduced tumor sizes in all CHOL and PAAD mice and almost complete tumor clearance in 40% of the mice with PAAD. In the GHR antagonist treated tumors, significantly lower expression of ABC transporters (Abcb1, Abcg5, Abcc2, Abcg2), EMT mediators (Cdh2, Zeb1, Snai2, Epas1) and apoptosis marker (Bcl2) genes compared to control were observed - accounting for the molecular mechanisms underlying the observed effects. Collectively, our data provide a robust pre-clinical validation for treatment regimens combining GHR antagonist and chemotherapy leading to highly efficacious tumor clearance. Citation Format: Reetobrata Basu, John J. Kopchick. Novel growth hormone receptor antagonist with discrete PEGylations markedly improve response to therapy in human pancreatic and bile duct cancers in mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 408.