Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest forms of cancer. Poor survival rates are largelydue to the late stage at which PDAC is diagnosed and a lack of effective targeted therapies. While the field ofimmunotherapy has significantly increased overall survival in some malignancies, they have not translated toPDAC. The long-term goal of this research program is to develop a novel cancer vaccine for the treatment ofPDAC. Preliminary studies by our group and others have shown that the Anterior Gradient-2 (AGR2) protein, amember of the protein disulfide isomerase (PDI) family, is induced during PDAC oncogenesis and highlyexpressed in >90% of PDAC patients. AGR2 has intracellular oxidative folding function and is also released fromthe cell where it localizes to the surface of PDAC cells and is shed into the tumor microenvironment. Wehypothesize that AGR2 is an actionable target for the development of a PDAC targeted vaccine and will test thattheory using a new immunotherapy drug candidate. Streptococcal Mitogenic Exotoxin Z-2 (SMEZ-2) fromStreptococcus pyogenes is a bacterial superantigen (SAg) that binds to MHC II molecules on antigen presentingcells (APCs) with high affinity. In preliminary studies we generated a detoxified AGR2-SMEZ-2 conjugate thatwe hypothesize will stimulate a robust anti-PDAC immune response. We found in preliminary studies that AGR2-SMEZ-2 generates a robust anti-AGR2 response in mice and displays no overt toxicity. The objectives of Phase1 of this study are: (1) to demonstrate anti-PDAC efficacy of AGR2-SMEZ-2 in vivo, and (2) to measure B and Tcell biomarkers of an anti-AGR2 response in vaccinated mice. Upon success in Phase 1, the objectives of Phase2 of this study are: (1) to show synergy between AGR2-SMEZ-2 vaccination and checkpoint inhibition in vivo,(2) to compare the superior immunogenicity of SMEZ-2 mediated through MHC II-specific binding over existingvaccine carrier proteins, and (3) to determine the optimal dose, schedule, and toxicology profile of AGR2-SMEZ-2 in vivo. This work is innovative because we will investigate the anti-PDAC mechanism of our proprietary AGR2-SMEZ-2 vaccine and characterize the induced immune response in different mouse models. This work willsupport the development of a first-in-class vaccine for the treatment of PDAC, a cancer with few existingtherapies. In addition, we expect that this study will allow for other immunotherapies (namely checkpointinhibition) to become effective in providing a PDAC response in patients.
Public Health Relevance Statement: Narrative (Relevance)
Pancreatic cancer is one of the deadliest cancers and effective therapies are lacking. We have developed a
vaccine-based immunotherapy approach to target the Anterior Gradient-2 (AGR2) protein, which is highly
expressed in pancreatic tumors. Our strategy relies on utilizing AGR2 conjugated to the bacterial superantigen
(SAg) SMEZ-2 that activates a robust anti-AGR2 immune response. We anticipate that these studies will reveal
new ways of treating pancreatic cancer in preclinical models of cancer, setting the stage for clinical development
and the delivery of a new treatment regimen to patients in need.
Project Terms: <δ protein> | |