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Can we unlock the potential of IGF-1R inhibition in cancer therapy?

ABSTRACT: IGF-1R inhibitors arrived in the clinic accompanied by optimism based on preclinical activity of IGF-1R targeting, and recognition that low IGF bioactivity protects from cancer. This was tempered by concerns about toxicity to normal tissue IGF-1R and cross-reactivity with insulin receptor (InsR). In fact, toxicity is not a show-stopper; the key issue is efficacy. While IGF-1R inhibition induces responses as monotherapy in sarcomas and with chemotherapy or targeted agents in common cancers, negative Phase 2/3 trials in unselected patients prompted the cessation of several Pharma programs. Here, we review completed and on-going trials of IGF-1R antibodies, kinase inhibitors and ligand antibodies. We assess candidate biomarkers for patient selection, highlighting the potential predictive value of circulating IGFs/IGFBPs, the need for standardized assays for IGF-1R, and preclinical evidence that variant InsRs mediate resistance to IGF-1R antibodies. We review hypothesis-led and unbiased approaches to evaluate IGF-1R inhibitors with other agents, and stress the need to consider sequencing with chemotherapy. The last few years were a tough time for IGF-1R therapeutics, but also brought progress in understanding IGF biology. Even failed studies include patients who derived benefit; they should be investigated to identify features distinguishing the tumors and host environment of responders from non-responders. We emphasize the importance of incorporating biospecimen collection into trial design, and wording patient consents to allow post hoc analysis of trial material as new data become available. Such information represents the key to unlocking the potential of this approach, to inform the next generation of trials of IGF signalling inhibitors.

SUBMITTER: King H

PROVIDER: S-EPMC4196677 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Can we unlock the potential of IGF-1R inhibition in cancer therapy?

King Helen H Aleksic Tamara T Haluska Paul P Macaulay Valentine M VM

Cancer treatment reviews 20140804 9

IGF-1R inhibitors arrived in the clinic accompanied by optimism based on preclinical activity of IGF-1R targeting, and recognition that low IGF bioactivity protects from cancer. This was tempered by concerns about toxicity to normal tissue IGF-1R and cross-reactivity with insulin receptor (InsR). In fact, toxicity is not a show-stopper; the key issue is efficacy. While IGF-1R inhibition induces responses as monotherapy in sarcomas and with chemotherapy or targeted agents in common cancers, negat ...[more]

PMID: 25123819

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Project description:AimInsulin-like growth factor-1 receptor (IGF-1R) is one of the main members of the tyrosine protein kinase receptor family. This receptor binds insulin-like growth factor-1 (IGF-1) with a high affinity. IGF-1 is a member of a family of proteins involved in mediating growth and development. However, the correlations of IGF-1 and IGF-1R to prognosis and tumor-infiltrating lymphocytes in different cancers remain unclear.MethodThis research comprehensively analyzed the expression pattern of IGF-1 and IGF-1R and the influence of IGF-1 and IGF-1R on clinical significance in prognosis prediction among 33 types of malignancies using The Cancer Genome Atlas (TCGA) and the Cancer Cell Line Encyclopedia (CCLE) databases. The correlation between IGF-1, IGF-1R, and cancer immunity was explored.ResultsIGF-1 and IGF-1R displayed inconsistent gene expression levels among diverse cancer cell lines. Typically, high expression level of IGF-1 and IGF-1R was detected in most malignant tumors. High expression of IGF-1 was closely bound up with the unfavorable overall survival (OS) for patients in BLCA, CHOL, and LAML upon Cox and Kaplan-Meier analyses. While high expression of IGF-1R was closely bound up with the unfavorable overall survival (OS) for patients in BLCA, LIHC, and LUAD. Furthermore, high expression level of IGF-1 and IGF-1R were closely connected with high degrees of tumor infiltrates, including CD4+ T cell, dendritic cells, and macrophages. In addition, we found that IGF-1 was commonly positively correlated with the expression of gene markers including LAIR1, ICOS, CD40LG, CTLA4, CD48, CD28, CD200R1, HAVCR2, and CD86. Whereas, IGF-1R was commonly positively correlated with the expression of gene markers including NRP1 and CD276. More importantly, IGF-1 and IGF-1R expression were correlated with tumor mutation burden (TMB), microsatellite instability (MSI), mismatch repair (MMR), and DNA methyltransferase (DNMT) of different types of cancers.ConclusionsThe impact of high IGF-1 and IGF-1R on prognosis and immune infiltrates differs across cancer types. Anti-IGF-1R therapy may inhibit tumor growth and contribute to immunotherapy in LIHC and KIRC.

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Can we unlock the potential of IGF-1R inhibition in cancer therapy?

Publications

Can we unlock the potential of IGF-1R inhibition in cancer therapy?

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