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J Clin Invest. 2018 Jul 2;128(7):2927-2943. doi: 10.1172/JCI120481. Epub 2018 Jun 4.

Tumor stroma-targeted antibody-drug conjugate triggers localized anticancer drug release.

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Tumor Angiogenesis Unit, Mouse Cancer Genetics Program (MCGP), National Cancer Institute (NCI), NIH, Frederick, Maryland, USA.
BioMed Valley Discoveries Inc., Kansas City, Missouri, USA.
Protein Interactions Section, Cancer and Inflammation Program, NCI, NIH, Frederick, Maryland, USA.
Basic Research Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research (FNLCR), Frederick, Maryland, USA.
Transgenic Core Facility, MCGP, NCI, Frederick, Maryland, USA.
Veterinary Pathology Section, Pathology/Histotechnology Laboratory, Leidos Biomedical Research Inc., FNLCR, Frederick, Maryland, USA.


Although nonmalignant stromal cells facilitate tumor growth and can occupy up to 90% of a solid tumor mass, better strategies to exploit these cells for improved cancer therapy are needed. Here, we describe a potent MMAE-linked antibody-drug conjugate (ADC) targeting tumor endothelial marker 8 (TEM8, also known as ANTXR1), a highly conserved transmembrane receptor broadly overexpressed on cancer-associated fibroblasts, endothelium, and pericytes. Anti-TEM8 ADC elicited potent anticancer activity through an unexpected killing mechanism we term DAaRTS (drug activation and release through stroma), whereby the tumor microenvironment localizes active drug at the tumor site. Following capture of ADC prodrug from the circulation, tumor-associated stromal cells release active MMAE free drug, killing nearby proliferating tumor cells in a target-independent manner. In preclinical studies, ADC treatment was well tolerated and induced regression and often eradication of multiple solid tumor types, blocked metastatic growth, and prolonged overall survival. By exploiting TEM8+ tumor stroma for targeted drug activation, these studies reveal a drug delivery strategy with potential to augment therapies against multiple cancer types.


Angiogenesis; Cancer; Therapeutics

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