Vascular endothelial growth factor C (
VEGF-C) is a key mediator of lymphangiogenesis, acting via its receptors VEGF-R2 and VEGF-R3. High expression of
VEGF-C in
tumors correlates with increased lymphatic vessel density, lymphatic vessel invasion, sentinel lymph node
metastasis and poor prognosis. Recently, we found that in a chemically induced skin
carcinoma model, increased
VEGF-C drainage from the
tumor enhanced lymphangiogenesis in the sentinel lymph node and facilitated metastatic spread of
cancer cells via the lymphatics. Hence, interference with the
VEGF-C/
VEGF-R3 axis holds promise to block metastatic spread, as recently shown by use of a neutralizing anti-VEGF-R3 antibody and a soluble VEGF-R3 (
VEGF-C/D trap). By antibody phage-display, we have developed a human
monoclonal antibody fragment (single-chain Fragment variable, scFv) that binds with high specificity and affinity to the fully processed mature form of human
VEGF-C. The scFv binds to an
epitope on
VEGF-C that is important for receptor binding, since binding of the scFv to
VEGF-C dose-dependently inhibits the binding of
VEGF-C to VEGF-R2 and VEGF-R3 as shown by BIAcore and ELISA analyses. Interestingly, the variable heavy domain (V(H)) of the anti-
VEGF-C scFv, which contains a mutation typical for camelid heavy chain-only
antibodies, is sufficient for binding
VEGF-C. This reduced the size of the potentially
VEGF-C-blocking
antibody fragment to only 14.6 kDa. Anti-
VEGF-C V(H)-based
immunoproteins hold promise to block the lymphangiogenic activity of
VEGF-C, which would present a significant advance in inhibiting lymphatic-based metastatic spread of certain
cancer types.