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Old 08-17-2012, 06:35 AM   #1
Lani
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new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + low

dose taxane, apparently without same cardiotoxicty as herceptin

DOn't have time to read yet, but small size of molecule, fact much of the effect is via the immune system may allow it to be effective in CNS ie cross blood brain barrier. Got to run, but wanted to post



Combination Peptide Therapies Might Offer More Effective, Less Toxic Cancer Treatment


COLUMBUS, Ohio - Two studies suggest that two peptide agents used either together or individually with a low-dose of a standard chemotherapy drug might offer more effective cancer therapy than current standard single-drug treatments.

The studies used animal models of breast cancer to show that the peptide combinations dramatically delay tumor onset and progression by both inhibiting tumor growth and blocking the formation of new tumor blood vessels, say researchers at the Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James). In addition, the treatments caused few side effects.

The findings are described in two papers published online in the journal OncoImmunology. The first paper describes how vaccination with a HER2 peptide followed by treatment with a VEGF peptide inhibitor prevents tumor formation in a transplantable mammary tumor model. The second paper documents how either HER2 peptide or VEGF peptide treatment combined with low-dose paclitaxel effectively kills tumor cells in both the transplantable tumor model and a transgenic mammary tumor model.

"For treating cancer, combination therapies are much more effective than individual therapies, and peptides in combination, whether by vaccination or as therapy, appear to be safer, nontoxic, and taking us closer to a cure," says principle investigator Dr. Pravin Kaumaya, director of the division of vaccine development at the OSUCCC - James.

Kaumaya, who is a professor of obstetrics and gynecology, of molecular and cellular biochemistry, and of microbiology at Ohio State, led the research that developed the peptide agents. Peptides are short chains of amino acids, and the HER2 peptide and VEGF peptide are short amino-acid chains that mimic full-length HER2 and VEGF molecules.

The HER2 receptor molecule is important for controlling tumor growth in many cancers; the VEGF receptor molecule controls the formation of new blood vessels needed to feed tumors. Both molecules are overexpressed in many cancers.

In the new studies, the researchers investigated whether the peptide vaccine and the peptide inhibitor worked more effectively in combination, and also whether they could synergize with a standard chemotherapy agent, paclitaxel.

The HER2 peptide vaccine is injected into the body where it causes the immune system to generate antibodies to the HER2 receptor. These antibodies then bind to the overexpressed HER2 receptors on cancer cells, preventing them from stimulating tumor-cell proliferation. The VEGF therapeutic peptide binds directly to the VEGF receptor molecule, preventing it from directing the formation of new blood vessels.

In the first paper, the team shows that vaccinating mice with the HER2 peptide before aggressive mammary cancer cells are transplanted into the mice can delay the onset of the tumors. When this vaccination treatment was combined with weekly treatments of the VEGF peptide, tumor growth was significantly delayed. In animals given the VEGF peptide, which is engineered not to break down in the body, 40 percent of the animals did not develop tumors at all by the end of the experiment.

In theory, Kaumaya explains, such a peptide vaccine could prevent HER2-driven breast cancer from developing in a daughter who inherited the genetic risk for this cancer from her mother. "We could vaccinate a person who doesn't have the cancer and create a memory for HER2 overexpression in her immune system," he says. "Then, when a tumor starts growing and over-expressing HER2, it would crank up her immune system to produce antibodies to shut the cancer down." This study's results suggest that adding VEGF peptide therapy might halt tumor progression altogether.

The second paper lays groundwork for testing peptide therapies in clinical trials. These experiments tested whether the HER2 peptide vaccine or the VEGF peptide therapy would boost the effectiveness of paclitaxel, a standard chemotherapy drug, when the drug is used at low dose to reduce its toxicity.

"We know from other people's work that treating patients with a low-dose chemotherapy agent like paclitaxel primes the system to be more responsive to other targeted treatments," Kaumaya says. Indeed, the team showed that both peptide treatments used individually with paclitaxel delayed tumor growth and development and produced better response rates than either agent without the drug in both transplanted and transgenic mouse breast cancer models.

Importantly, the combined therapies showed no toxic side effects. In contrast, paclitaxel and the current standard anti-HER2 therapy, trastuzumab, both had toxic effects on the heart.

"Our goal is to find a cure by interfering with various cancer-cell pathways using medicines that are not toxic," Kaumaya says.

Funding from the NIH/National Cancer Institute (grant CA084356) supported this research.

Other Ohio State researchers involved in the two studies were Kevin Foy, Megan Miller, Nicanor Moldovan, Tatjana Bozanovic, and William E. Carson, III.

OPEN ACCESS: Combined vaccination with HER-2 peptide followed by therapy with VEGF peptide mimics exerts effective anti-tumor and anti-angiogenic effects in vitro and in vivo
[OncoImmunology]
Overexpression of HER-2 and VEGF plays a key role in the development and metastasis of several human cancers. Many FDA-approved therapies targeting both HER-2 (Trastuzumab, Herceptin) and VEGF (Bevacizumab, Avastin) are expensive, have unacceptable toxicities and are often associated with the development of resistance. Here, we evaluate the dual antitumor effects of combining designed particular HER-2 peptide vaccine with VEGF peptide mimics. In vitro, HER-2 phosphorylation and antibody-dependent cellular toxicity were used to validate whether combining HER-2- and VEGF-targeting therapies would be effective. Moreover, a two-pronged approach was tested in vivo: (1) active immunotherapy with conformational HER-2 B-cell epitope vaccines and (2) anti-angiogenic therapy with a peptide structured to mimic VEGF. A transplantable BALB/c mouse model challenged with TUBO cells was used to test the effects of the HER-2 peptide vaccine combined with VEGF peptide mimics. Tumor sections after treatment were stained for blood vessel density and actively dividing cells. Our results show that immunization with an HER-2 peptide epitope elicits high affinity HER-2 native antibodies that are effective in inhibiting tumor growth <em>in vivo</em>, an effect that is enhanced by VEGF peptide mimics. We demonstrate that the combination of HER-2 and VEGF peptides induces potent anti-tumor and anti-angiogenic responses.



OPEN ACCESS: Immunotherapy with HER-2 and VEGF peptide mimics plus metronomic paclitaxel causes superior antineoplastic effects in transplantable and transgenic mouse models of human breast cancer
[OncoImmunology]

HER-2 and the vascular endothelial factor receptor (VEGF) represent validated targets for the therapy of multiple tumor types and inhibitors of these receptors have gained increasing importance in the clinic. In this context, novel bioactive agents associated with better therapeutic outcomes and improved safety profile are urgently required. Specifically engineered HER-2- and VEGF-derived peptides in combination with low-dose chemotherapy might provide a substantial impact on tumor metastasis and cancer progression. We tested the antitumor effects of HER-2 and VEGF peptide mimics in combination with metronomic paclitaxel in both PyMT and Balb/c murine model challenged with TUBO cells. The combination of low-dose paclitaxel and HER-2 or VEGF peptide mimics had greater inhibitory effects than either agent alone. Peptide treatment caused virtually no cardiotoxic effects, while paclitaxel and the anti-HER-2 antibody trastuzumab (Herceptin), exerted consistent cardiotoxicity. The combination regimen also promoted significant reductions in tumor burden and prolonged survival rates in both transgenic and transplantable tumor models. Tumor weights were significantly reduced in mice treated with HER-2 peptides alone, and even more in animals that received HER-2 peptide with low-dose paclitaxel, which alone had no significant effects on tumor growth in the transgenic model. Specifically engineered native peptide sequences from HER-2 and VEGF used in combination with metronomic paclitaxel demonstrate enhanced anticancer efficacy and an encouraging safety profile. This novel approach to targeted therapy may offer new avenues for the treatment of breast cancer and other solid tumors that overexpress HER-2 and VEGF.
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Old 08-17-2012, 09:33 AM   #2
Ellie F
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

Thanks Lani
When you have time wondered if you could answer a question. I thought I remember Dr Slamon saying that her 2 bc wasn't inherited? This paper seems to say it can be.
Thanks
Ellie
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Old 08-19-2012, 11:13 AM   #3
Lani
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

I have posted before that in mice there is an inherited her2+ breast cancer that is related to Fox P3, an important marker on immune cells called Tregulatory cells. The gene is located on the X-chromosome.

It is felt this might happen in people, but would probably be very rare.

Noone knows how rare, as most families with breast cancer have not had all members her2 tested, as the mother's or grandmother's breast cancer occurred long before her2 testing was widespread. I have started several threads about this and asked her2support members to list any family members they know had breast cancer and whether it was tested for her2==in most cases it was not.

I think this would be better used for those who have already had her2+ dcis or her2+ breast cancer. Sometimes the new lesion ends up being her2- second bcs or "dcis"es or recurrences that have become her2- under the influence of the preceding treatment , but it would seem that this new combination vaccine would be most helpful trying prevent those recurrences/dcis'es, or new invasive tumors that are again her2+ (probably the majority)
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Old 08-19-2012, 06:18 PM   #4
Laurel
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

This is exciting stuff, Lani!
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Smile On!
Laurel


Dx'd w/multifocal DCIS/IDS 3/08
7mm invasive component
Partial mast. 5/08
Stage 1b, ER 80%, PR 90%, HER-2 6.9 on FISH
0/5 nodes
4 AC, 4 TH finished 9/08
Herceptin every 3 weeks. Finished 7/09
Tamoxifen 10/08. Switched to Femara 8/09
Bilat SPM w/reconstruction 10/08
Clinical Trial w/Clondronate 12/08
Stopped Clondronate--too hard on my gizzard!
Switched back to Tamoxifen due to tendon pain from Femara

15 Years NED
I think I just might hang around awhile....

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Old 08-20-2012, 05:24 AM   #5
Ellie F
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

Thank Lani
Remember posting on the inherited thread. Hopefully there will only be a few inherited her 2 breast cancers.
Ellie
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Old 08-20-2012, 07:45 AM   #6
cheery
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

Lani/Ellie

My mother was ER/PR+, HER2- while I am ER/PR-, HER+. My oncologist said I probably inherited the gene that causes BC but the nature of BC is individually unique, hence the different hormonal & HER2+ receptors.

It would be good to vaccinate all the high risk daughters.
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Old 08-20-2012, 12:28 PM   #7
Lani
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

I think that is an oversimplification

Breast cancer is not one disease but many diseases.

They have so far found a gene responsible for less than 5% of all kinds of breast cancer put together.

The real fallacy I think is assuming that what we know know is worth generalizing about--- it is such a tip on the iceberg.

I heard from someone that the answer to the boards examination that medical students take after finishing their medical school/residency change every 3 years (as new research disproves old) and I heard that over 30 years ago.

I don't think we know much-- we are learning that problems with telomeres increase genomic instability which can be the source of so much heterogeneity within tumors. The speed with which knowledge improves is going up asssymptotically (incredibly more than linearly) as computers do much of the numbers crunching and looking for patterns and as gene/protein/microRNA/mRNA analysis of tumors becomes subject to a faster and faster automated process.

So keep tuning in for new findings and hope doctors have enough time to keep reading the literature (even just in their own field) as it is voluminous and changing quickly. Doubt they have enough time to read it all AND treat patients AND/OR do research. Conferences help inform them of the major advances-- we hope the little ones (like the initial anecdotal evidence of trying IT herceptin for leptomeningeal metastasis) don't stay under the radar--this is a major motivator for keeping this site informed and hoping the word spreads.
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Old 08-20-2012, 05:27 PM   #8
cheery
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Re: new promising combination peptide immunotherapy w antiher2 +antiVEGF peptides + l

Lani

Thanks for the invaluable insight, as always.
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