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5-azacytidine enhances the anti-leukemic activity of lintuzumab (SGN-33) in preclinical models of acute myeloid leukemia.

Abstract
Despite therapeutic advances, the poor prognoses for acute myeloid leukemia (AML) and intermediate and high-risk myelodysplastic syndromes (MDS) point to the need for better treatment options. AML and MDS cells express the myeloid marker CD33, making it amenable to CD33-targeted therapy. Lintuzumab (SGN-33), a humanized monoclonal anti-CD33 antibody undergoing clinical evaluation, induced meaningful responses in a Phase 1 clinical trial and demonstrated anti-leukemic activity in preclinical models. Recently, it was reported that 5-azacytidine (Vidaza™) prolonged the overall survival of a group of high risk MDS and AML patients. To determine whether the combination of lintuzumab and 5-azacytidine would be beneficial, a mouse xenograft model of disseminated AML was used to evaluate the combination.  There was a significant reduction in tumor burden and an increase in overall survival in mice treated with lintuzumab and 5-azacytidine. The effects were greater than that obtained with either agent alone. As the in vivo anti-leukemic activity of lintuzumab was dependent upon the presence of mouse effector cells including macrophages and neutrophils, in vitro effector function assays were used to assess the impact of 5-azacytidine on lintuzumab activity. The results show that 5-azacytidine significantly enhanced the ability of lintuzumab to promote tumor cell killing through antibody-dependent cellular cytotoxicity (ADCC) and phagocytic (ADCP) activities. These results suggest that lintuzumab and 5-azacytidine act in concert to promote tumor cell killing. Additionally, these findings provide the rationale to evaluate this combination in the clinic.
AuthorsMay Kung Sutherland, Changpu Yu, Martha Anderson, Weiping Zeng, Nico van Rooijen, Eric L Sievers, Iqbal S Grewal, Che-Leung Law
JournalmAbs (MAbs) 2010 Jul-Aug Vol. 2 Issue 4 Pg. 440-8 ISSN: 1942-0870 [Electronic] United States
PMID20495353 (Publication Type: Journal Article)
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Azacitidine
  • lintuzumab
Topics
  • Animals
  • Antibodies, Monoclonal, Humanized (administration & dosage)
  • Antibody-Dependent Cell Cytotoxicity (drug effects)
  • Antineoplastic Agents (administration & dosage)
  • Azacitidine (administration & dosage)
  • Drug Evaluation, Preclinical
  • Drug Synergism
  • Drug Therapy, Combination
  • HL-60 Cells
  • Humans
  • Leukemia, Myeloid, Acute (immunology, therapy)
  • Macrophages (drug effects, immunology)
  • Mice
  • Mice, SCID
  • Neutrophils (drug effects, immunology)
  • Phagocytosis (drug effects)
  • Tumor Burden (drug effects)
  • Xenograft Model Antitumor Assays

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