Abstract

First line treatment for pancreatic cancer consists of surgical resection, if possible, and a subsequent course of chemotherapy using the nucleoside analogue gemcitabine. In some patients, an active transport mechanism allows gemcitabine to enter efficiently into the tumor cells, resulting in a significant clinical benefit. However, in most patients, low expression of gemcitabine transporters limits the efficacy of the drug to marginal levels, and patients need frequent administration of the drug at high doses, significantly increasing systemic drug toxicity. In this article we focus on a novel targeted delivery approach for gemcitabine consisting of conjugating the drug with an EphA2 targeting agent. We show that the EphA2 receptor is highly expressed in pancreatic cancers, and accordingly, the drug-conjugate is more effective than gemcitabine alone in targeting pancreatic tumors. Our preliminary observations suggest that this approach may provide a general benefit to pancreatic cancer patients and offers a comprehensive strategy for enhancing delivery of diverse therapeutic agents to a wide range of cancers overexpressing EphA2, thereby potentially reducing toxicity while enhancing therapeutic efficacy.

Highlights

  • Pancreatic cancer is an extremely aggressive and deadly disease, with a 5-year survival rate of less than 5%

  • Our experiments clearly suggest that conjugation of Gemcitabine with our EphA2 targeting agents increase its efficacy in animal models

  • Design and synthesis of EphA2-targeting agents conjugated with gemcitabine

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Summary

Introduction

Pancreatic cancer is an extremely aggressive and deadly disease, with a 5-year survival rate of less than 5%. Most tumors are either locally advanced or have metastasized at the time of diagnosis and, intrinsically, this cancer is extremely resistant to chemotherapy and radiation. First line treatment for pancreatic cancer consists of surgical resection, if possible, and a subsequent course of chemotherapy [1]. This chemotherapy usually consists of treatment with Gemcitabine [2]. In 1997, Burris, et al published a clinical study comparing Gemcitabine to 5-Fluoruracil (5-FU) for the treatment of pancreatic cancer [3]. 126 patients were enrolled with 63 per treatment group. 126 patients were enrolled with 63 per treatment group. 23.8%

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