Disialoganglioside GD2 Expression in Solid Tumors and Role as a Target for Cancer Therapy

• Type of Material: Article
• Authors: Taofeek Owonikoko, Emory University; Bassel Nazha, Emory University; Cengiz Inal, Salem Veterans Affairs Medical Center
• Language: English
• Date: 2020-07-07
• Publisher: FRONTIERS MEDIA SA
• Publication Version: Final Published Version
• Copyright Statement: Copyright © 2020 Nazha, Inal and Owonikoko.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fonc.2020.01000
• Title of Journal or Parent Work: FRONTIERS IN ONCOLOGY
• Volume: 10
• Start Page: 1000
• End Page: 1000
• Grant/Funding Information: The authors declare that editorial support provided by Omni Healthcare Communications was funded by United Therapeutics Corporation. The funder was not involved in the writing or editing of this review and did not influence its content. The funder was involved in the decision to submit for publication.
• Keywords: Science & Technology; COLONY-STIMULATING FACTOR; HIGH-AFFINITY; Life Sciences & Biomedicine; GANGLIOSIDE GD2; cancer therapy; OPEN-LABEL; neuroblastoma; ganglioside; MONOCLONAL-ANTIBODY 3F8; GD2; monoclonal antibody; PHASE-I; DEPENDENT CYTOTOXICITY; HUMAN-MELANOMA; NEUROBLASTOMA-CELLS; dinutuximab; Oncology; small cell lung cancer; clinical trials; ANTI-GD2 ANTIBODY
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Oncology

Abstract

Gangliosides are carbohydrate-containing sphingolipids that are widely expressed in normal tissues, making most subtypes unsuitable as targets for cancer therapy. However, the disialoganglioside GD2 subtype has limited expression in normal tissues but is overexpressed across a wide range of tumors. Disialoganglioside GD2 can be considered a tumor-associated antigen and well-suited as a target for cancer therapy. Disialoganglioside GD2 is implicated in tumor development and malignant phenotypes through enhanced cell proliferation, motility, migration, adhesion, and invasion, depending on the tumor type. This provides a rationale for targeting disialoganglioside GD2 in cancer therapy with the development of anti-GD2 monoclonal antibodies and other therapeutic approaches. Anti-GD2 monoclonal antibodies target GD2-expressing tumor cells, leading to phagocytosis and destruction by means of antibody-dependent cell-mediated cytotoxicity, lysis by complement-dependent cytotoxicity, and apoptosis and necrosis through direct induction of cell death. Anti-GD2 monoclonal antibodies may also prevent homing and adhesion of circulating malignant cells to the extracellular matrix. Disialoganglioside GD2 is highly expressed by almost all neuroblastomas, by most melanomas and retinoblastomas, and by many Ewing sarcomas and, to a more variable degree, by small cell lung cancer, gliomas, osteosarcomas, and soft tissue sarcomas. Successful treatment of disialoganglioside GD2-expressing tumors with anti-GD2 monoclonal antibodies is hindered by pharmacologic factors such as insufficient antibody affinity to mediate antibody-dependent cell-mediated cytotoxicity, inadequate penetration of antibody into the tumor microenvironment, and toxicity related to disialoganglioside GD2 expression by normal tissues such as peripheral sensory nerve fibers. Nonetheless, anti-GD2 monoclonal antibody dinutuximab (ch14.18) has been approved by the U.S. Food and Drug Administration and dinutuximab beta (ch14.18/CHO) has been approved by the European Medicines Agency for the treatment of high-risk neuroblastoma in pediatric patients. Clinical trials of anti-GD2 therapy are currently ongoing in patients with other types of disialoganglioside GD2-expressing tumors as well as neuroblastoma. In addition to anti-GD2 monoclonal antibodies, anti-GD2 therapeutic approaches include chimeric antigen receptor T-cell therapy, disialoganglioside GD2 vaccines, immunocytokines, immunotoxins, antibody–drug conjugates, radiolabeled antibodies, targeted nanoparticles, and T-cell engaging bispecific antibodies. Clinical trials should clarify further the potential of anti-GD2 therapy for disialoganglioside GD2-expressing malignant tumors.