Update Mammakarzinom 2020 Teil 5 – Einführung von Substanzen aus der metastasierten Therapiesituation in die frühe Therapiesituation

2021 ◽  
Vol 18 (03) ◽  
pp. 254-265
Author(s):  
Michael P. Lux ◽  
Andreas Schneeweiss ◽  
Andreas D. Hartkopf ◽  
Volkmar Müller ◽  
Wolfgang Janni ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Randomisierte Studie ◽  
Antibody Drug Conjugate ◽  
Akt Kinase ◽  
Drug Conjugate ◽  
Antibody Drug

ZusammenfassungBei neuen Therapieansätzen des Mammakarzinoms sind insbesondere bei Patientinnen mit HER2-positivem und HER2-negativem/hormonrezeptorpositivem (HR+) Mammakarzinom in den letzten Jahren deutliche Fortschritte gesehen worden. Bei HER2-positiven Tumoren müssen in dem Zusammenhang Pertuzumab, T‑DM1, Neratinib und bald auch Tucatinib und Trastuzumab-Deruxtecan (beide in Europa noch nicht zugelassen) genannt werden. Bei den Patientinnen mit HER2−/HR+-Mammakarzinom sind insbesondere die CDK4/6-Inhibitoren und der PIK3CA-Inhibitor Alpelisib zu nennen. Weitere, neue Therapien wie Akt-Kinase-Inhibitoren und orale SERDs (selective estrogen receptor down-regulators) werden bereits in laufenden klinischen Studien untersucht. Nicht nur bei den HER2-positiven Tumoren halten die Therapien Einzug in die kurative, (neo-) adjuvante Therapiesituation, sondern es wurde nun eine erste positive Studie mit Abemaciclib in der adjuvanten Situation vorgestellt. Bei Patientinnen mit einem triple-negativen Mammakarzinom ist nach vielen Jahren mit negativen Studienergebnissen mit dem Trop-2-Antikörper-Wirkstoff-Konjugat (antibody drug conjugate, ADC) Sacituzumab-Govitecan eine randomisierte Studie veröffentlicht worden, die einen deutlichen Therapiefortschritt bedeuten kann. Diese Übersichtsarbeit beschreibt die neuesten Entwicklungen beim Mammakarzinom nach dem ESMO-Kongress 2020.

Computational Approaches in Antibody-drug Conjugate Optimization for Targeted Cancer Therapy

2018 ◽  
Vol 18 (13) ◽  
pp. 1091-1109 ◽  
Author(s):  
Rita Melo ◽  
Agostinho Lemos ◽  
Antonio J. Preto ◽  
Jose G. Almeida ◽  
Joao D.G. Correia ◽  
...  
Keyword(s):  
Cancer Cells ◽  
Coarse Grained ◽  
Cytotoxic Agent ◽  
Target Cells ◽  
Antibody Drug Conjugate ◽  
Drug Conjugate ◽  
Cross Correlation Analysis ◽  
Traditional Therapies ◽  
Modular Structures ◽  
Antibody Drug

Cancer has become one of the main leading causes of morbidity and mortality worldwide. One of the critical drawbacks of current cancer therapeutics has been the lack of the target-selectivity, as these drugs should have an effect exclusively on cancer cells while not perturbing healthy ones. In addition, their mechanism of action should be sufficiently fast to avoid the invasion of neighbouring healthy tissues by cancer cells. The use of conventional chemotherapeutic agents and other traditional therapies, such as surgery and radiotherapy, leads to off-target interactions with serious side effects. In this respect, recently developed target-selective Antibody-Drug Conjugates (ADCs) are more effective than traditional therapies, presumably due to their modular structures that combine many chemical properties simultaneously. In particular, ADCs are made up of three different units: a highly selective Monoclonal antibody (Mab) which is developed against a tumour-associated antigen, the payload (cytotoxic agent), and the linker. The latter should be stable in circulation while allowing the release of the cytotoxic agent in target cells. The modular nature of these drugs provides a platform to manipulate and improve selectivity and the toxicity of these molecules independently from each other. This in turn leads to generation of second- and third-generation ADCs, which have been more effective than the previous ones in terms of either selectivity or toxicity or both. Development of ADCs with improved efficacy requires knowledge at the atomic level regarding the structure and dynamics of the molecule. As such, we reviewed all the most recent computational methods used to attain all-atom description of the structure, energetics and dynamics of these systems. In particular, this includes homology modelling, molecular docking and refinement, atomistic and coarse-grained molecular dynamics simulations, principal component and cross-correlation analysis. The full characterization of the structure-activity relationship devoted to ADCs is critical for antibody-drug conjugate research and development.

scholarly journals An antibody-drug conjugate with intracellular drug release properties showing specific cytotoxicity against CD7-positive cells

2021 ◽  
pp. 106626
Author(s):  
Jing Zhang ◽  
Arvind Jain ◽  
Sabine Milhas ◽  
Daniel J. Williamson ◽  
Justyna Mysliwy ◽  
...  
Keyword(s):  
Drug Release ◽  
Antibody Drug Conjugate ◽  
Drug Conjugate ◽  
Specific Cytotoxicity ◽  
Antibody Drug
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