Abstract

Triple negative breast cancer (TNBC) is an aggressive breast cancer subtype with limited therapeutic options. Metastasis is the major cause of TNBC mortality. Angiogenesis facilitates TNBC metastases. Many TNBCs also form vascular channels lined by tumor cells rather than endothelial cells, known as ‘vasculogenic mimicry’ (VM). VM has been linked to metastatic TNBC behavior and resistance to anti-angiogenic agents. Epidermal growth factor receptor (EGFR) is frequently expressed on TNBC, but anti-EGFR antibodies have limited efficacy. We synthesized an anti-EGFR antibody–endostatin fusion protein, αEGFR IgG1-huEndo-P125A (αEGFR-E-P125A), designed to deliver a mutant endostatin, huEndo-P125A (E-P125A), to EGFR expressing tumors, and tested its effects on angiogenesis, TNBC VM, and motility in vitro, and on the growth and metastasis of two independent human TNBC xenograft models in vivo. αEGFR-E-P125A completely inhibited the ability of human umbilical vein endothelial cells to form capillary-like structures (CLS) and of TNBC cells to engage in VM and form tubes in vitro. αEGFR-E-P125A treatment reduced endothelial and TNBC motility in vitro more effectively than E-P125A or cetuximab, delivered alone or in combination. Treatment of TNBC with αEGFR-E-P125A was associated with a reduction in cytoplasmic and nuclear β-catenin and reduced phosphorylation of vimentin. αEGFR-E-P125A treatment of TNBC xenografts in vivo inhibited angiogenesis and VM, reduced primary tumor growth and lung metastasis of orthotopically implanted MDA-MB-468 TNBC cells, and markedly decreased lung metastases following intravenous injection of MDA-MB-231-4175 lung-tropic TNBC cells. Combined inhibition of angiogenesis, VM, and TNBC motility mediated by αEGFR-E-P125A is a promising strategy for the prevention of TNBC metastases.

Highlights

  • Angiogenesis, the development of new blood vessels by endothelial cells, is essential for neoplastic progression

  • We studied the ability of an anti-Epidermal growth factor receptor (EGFR) IgG1 antibody fused to a mutant form (E-P125A) of human endostatin, αEGFR-E-P125A, to inhibit angiogenesis, Triple negative breast cancer (TNBC) vasculogenic mimicry’ (VM), motility, and TNBC xenograft growth/metastasis in vivo and the investigated underlying mechanisms

  • Our prior studies using an anti-HER2 IgG3 antibody–endostatin fusion protein showed that replacement of native endostatin in the fusion with a human endostatin containing a proline to alanine mutation at position 125 (E-P125A) demonstrated enhanced anti-angiogenic and anti-tumor activity in both murine (EMT6-HER2) and human HER2 expressing SK-BR-3 xenograft models compared to fusions incorporating native endostatin [16]

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Summary

Introduction

Angiogenesis, the development of new blood vessels by endothelial cells, is essential for neoplastic progression. Tumor vasculature may be assembled through the formation of vascular channels lined by clonally related malignant tumor cells, a process known as ‘vasculogenic mimicry’ (VM) [1,2,3,4,5]. VM has been linked to metastatic potential and may contribute to resistance to anti-angiogenic agents, and many angiogenesis inhibitors have little/no effect on VM [3,4,5,7,8]. VM is frequently seen in TNBC and may play an important role in TNBC pathogenesis and resistance to anti-angiogenic agents [7,9]. We hypothesized that combined inhibition of both VM and angiogenesis would increase the efficacy of anti-TNBC therapy

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