Abstract

Gastrointestinal cancers (GI) account for 26% of cancer incidences globally and 35% of all cancer-related deaths. The main challenge is to target cancer specific antigens. Mucins are heavily O-glycosylated proteins overexpressed in different cancers. The transmembrane glycoprotein MUC1 is the most likeable target for antibodies, owing to its specific overexpression and aberrant glycosylation in many types of cancers. For the past 30 years, MUC1 has remained a possible diagnostic marker and therapeutic target. Despite initiation of numerous clinical trials, a comprehensively effective therapy with clinical benefit is yet to be achieved. However, the interest in MUC1 as a therapeutic target remains unaltered. For all translational studies, it is important to incorporate updated relevant research findings into therapeutic strategies. In this review we present an overview of the antibodies targeting MUC1 in GI cancers, their potential role in immunotherapy (i.e., antibody-drug and radioimmunoconjugates, CAR-T cells), and other novel therapeutic strategies. We also present our perspectives on how the mechanisms of action of different anti-MUC1 antibodies can target specific hallmarks of cancer and therefore be utilized as a combination therapy for better clinical outcomes.

Highlights

  • Gastrointestinal cancers (GI) account for 26% of cancer incidences globally and 35% of all cancer-related deaths

  • The anti-MUC1 antibody-based therapeutics developed against GI cancers that are in pre-clinical and clinical trials have been summarized in Tables 1 and 2 respectively

  • Krebs von den Lugen-6 (KL-6) is a mouse IgG1 Monoclonal antibodies (mAbs) that recognizes a sialylated sugar of Krebs von den

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Summary

Global Burden of GI Cancers

Gastrointestinal (GI) cancers collectively refer to cancers of the esophagus and stomach (gastroesophageal cancers), the colon and rectum (colorectal cancers), pancreas, liver, gallbladder, small intestine, appendix, and anus. Esophageal cancer is the seventh most commonly diagnosed cancer and the 6th leading cause of cancer-related deaths worldwide [1]. It is often detected late and there are usually no early symptoms. The overall five-year survival rate for advanced esophageal cancer in the United States is about 15% [2]. Most of the pancreatic tumors are detected at a very advanced stage making it a lethal disease It has a dismal 5% 5-year survival rate globally, a mean life expectancy of

Structure of MUC1
Role in GI Tumors
Anti-MUC1 Antibodies in Preclinical and Clinical Trials
Antibodies Recognizing Non-Glycopeptide Epitope
Antibodies Recognizing Glycopeptide Epitopes
Bispecific Antibodies for MUC1
CAR-T Cells Targeting MUC1
Molecular Interactions between MUC1 and Its Antibodies
Concluding Remarks and Future Perspectives
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