Purpose: The purpose of this study was to evaluate the antitumor efficacy of the reduced immunogenicity anti-
mesothelin immunotoxin RG7787 plus
nab-paclitaxel against primary
mesothelioma cell lines and
tumor xenografts and the utility of
mesothelin as a
biomarker of
tumor response.Experimental Design: Early-passage human
malignant mesothelioma cell lines NCI-Meso16, NCI-Meso19, NCI-Meso21, and NCI-Meso29 were evaluated for sensitivity to
RG7787 or
nab-paclitaxel alone or in combination. In addition, the antitumor activity of
RG7787 plus
nab-paclitaxel was evaluated using NCI-Meso16, NCI-Meso21, and NCI-Meso29
tumor xenografts in immunodeficient mice. Serum
mesothelin was measured at different time points to determine whether its levels correlated with
tumor response.Results: All four primary
mesothelioma cell lines highly expressed
mesothelin with 41 × 103 to 346 × 103
mesothelin sites per cell and were sensitive to
RG7787, with IC50 ranging from 0.3 to 10 ng/mL. Except for NCI-Meso19, these cells were also sensitive to
nab-paclitaxel, with IC50 of 10 to 25 ng/mL. In vitro,
RG7787 plus
nab-paclitaxel led to decreased cell viability compared with either agent alone. In NCI-Meso16
tumor xenografts, treatment with
RG7787 plus
nab-paclitaxel led to sustained complete
tumor regressions. Similar antitumor efficacy was observed against NCI-Meso21 and NCI-Meso29
tumor xenografts. In all three
tumor xenograft models, changes in human serum
mesothelin correlated with response to
therapy and were undetectable in mice with complete
tumor regression with
RG7787 and
nab-paclitaxel.Conclusions:
RG7787 plus
nab-paclitaxel is very active against primary human
mesothelioma cells in vitro as well as in vivo, with serum
mesothelin levels correlating with
tumor response. These results indicate that this combination could be useful for treating patients with
mesothelioma. Clin
Cancer Res; 23(6); 1564-74. ©2016 AACR.