Researchers at the Hanson Institute, Adelaide, South Australia, have identified and researched a protein that is a marker of dying and dead cancer cells. APOMAB® is a monoclonal antibody that has been developed to target this cancer cell marker.
APOMAB®may provide a reliable and accurate means of detecting the presence of dying and dead cancer cells in vivo – that is, in the body. This patented technology may permit the development of a range of products directed at diagnosing, monitoring and treating cancer.
APOMAB® technology represents a significant discovery because the specific detection of dying and dead cancer cells has proved to be a technically challenging task.
Proposed Applications of APOMAB®
APOMAB® products may include:
1. A diagnostic imaging product to locate cancer in the body.
APOMAB® can be combined with a radioisotope (radionuclide) that may enable detection of dying and dead cells in cancer tissue using the body scan techniques of nuclear medicine.
In making a diagnosis of cancer, considering options for treatment and assessing the effectiveness of treatment, clinicians need as much information as possible on the location, size and spread of disease. There are various imaging technologies that help clinicians see inside the body, and different techniques are used depending on the type of cancer and its location. Imaging modalities include computed tomography (CT), positron-emission tomography (PET), single photon emission tomography (SPECT), magnetic resonance imaging (MRI), X-ray, mammography and various nuclear medicine techniques that use radionuclides.
FDG-PET (fluorodeoxyglucose-PET) is an important diagnostic technique for imaging cancer, whereby glucose labelled with a radionuclide of fluorine (18F) serves as the marker. Glucose is an important energy source for living cells and FDG-PET images cells that are metabolically active. As cancer cells are metabolically active, dividing more rapidly than normal cells, “marked” areas are suggestive of cancer. Importantly, FDG-PET is not specific for cancer and it is not sufficiently sensitive to identify small lesions.
Generally, the equipment used for imaging cancer is used for imaging a wide variety of disorders. Current methods are inadequate for the routine detection of micrometastases and the search for effective, cancer-specific diagnostic technologies remains a major challenge.
2. A diagnostic product to assess the effectiveness of anticancer treatment.
APOMAB® may be able to identify whether a cancer treatment, such as chemotherapy or radiotherapy, is actually killing a patient’s cancer cells. At present, chemotherapy patients typically have three cycles of chemotherapy over about 12 weeks before the treating doctor makes an assessment of tumour response. During this time, the patient may face significant debilitating side effects such as nausea, hair loss, reduced white blood cell count (that increases the risk of infection) and mouth ulcers. Currently, tumour response is not assessed earlier because the available techniques are not sufficiently sensitive to identify small effects on tumours.
APOMAB® has the potential to provide an early indication of the effectiveness of chemotherapy, by being used after one or two doses of chemotherapy to assess whether the prescribed drugs are killing the cancer cells. If the drugs are not causing cell death, the doctor would have the opportunity to change the treatment. This should lead to improved survival for those patients who have chemotherapy-responsive cancers and, at the very least, improved quality-of-life for non-responsive patients because side effects can be avoided by discontinuing ineffective medicines. There is also an economic benefit from the better use of medicines and medical services.
3. A diagnostic product to assist anticancer drug development decisions.
In addition to the use of APOMAB® in clinical medicine to assess response to treatment, the APOMAB® diagnostic test may be of interest to pharmaceutical companies developing new anticancer drugs. Drug development is a very long and expensive process, and companies are looking to improve the ways they validate technologies and make decisions about continuing or discontinuing the development of a particular drug.
4. A product for the treatment of cancer.
APOMAB® products may also be used for the treatment of cancer using the process of radioimmunotherapy. This would involve joining APOMAB® to a radionuclide such as yttrium-90. The product may localise in areas of dying and dead cancer cells and deliver high levels of local radiation to destroy adjacent live cancer cells.
As chemotherapy aims to destroy cancer cells, a combination of an APOMAB® product and chemotherapy appears to offer a promising method of treating cancer. In addition to their cell killing capability, certain chemotherapeutic agents increase the sensitivity of cells to irradiation.
Importantly, this approach is potentially applicable to a wide range of cancer types including common cancers such as breast cancer and lung cancer.
5. An in vitro diagnostic test for cancer.
The APOMAB® technology may also be used for a blood-based in vitro (laboratory) diagnostic test. Cancer cells found in the blood and cancer cell components are released into the blood when cancer cells die. The marker identified by APOMAB® will be at very low concentrations so very sensitive screening technologies will need to be researched and developed to enable the marker to be reliably identified in a quantitative manner.
