Preclinical activity of melflufen (J1) in ovarian cancer

// Charlotte Carlier 1, * , Sara Strese 2, * , Kristina Viktorsson 3 , Ebba Velander 4 , Peter Nygren 4 , Maria Uustalu 5 , Therese Juntti 3, 5 , Rolf Lewensohn 3 , Rolf Larsson 2 , Jack Spira 6 , Elly De Vlieghere 7 , Wim P. Ceelen 1, # , Joachim Gullbo 2, 4, # 1 Department of Surgery, Laboratory of Experimental Surgery, Ghent University, Ghent, Belgium 2 Department of Medical Sciences, Division of Cancer Pharmacology and Computational Medicine, Uppsala University, Uppsala, Sweden 3 Department of Oncology and Pathology, Karolinska Biomics Center, Karolinska Institutet, Stockholm, Sweden 4 Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden 5 Oncopeptides AB, Stockholm, Sweden 6 Present address: InSpira Medical AB, Tyresö, Sweden 7 Radiation Oncology and Experimental Cancer Research, Laboratory of Experimental Cancer Research, Ghent University, Ghent, Belgium * These authors contributed equally to this work # Shared senior authorship Correspondence to: Charlotte Carlier, email: Charlotte.carlier@ugent.be Sara Strese, email: sara.strese@medsci.uu.se Keywords: ovarian cancer, melflufen, preclinical, in vivo, intraperitoneal treatment Received: April 01, 2016 Accepted: July 19, 2016 Published: August 09, 2016 ABSTRACT Ovarian cancer carries a significant mortality. Since symptoms tend to be minimal, the disease is often diagnosed when peritoneal metastases are already present. The standard of care in advanced ovarian cancer consists of platinum-based chemotherapy combined with cytoreductive surgery. Unfortunately, even after optimal cytoreduction and adjuvant chemotherapy, most patients with stage III disease will develop a recurrence. Intraperitoneal administration of chemotherapy is an alternative treatment for patients with localized disease. The pharmacological and physiochemical properties of melflufen, a peptidase potentiated alkylator, raised the hypothesis that this drug could be useful in ovarian cancer and particularily against peritoneal carcinomatosis. In this study the preclinical effects of melflufen were investigated in different ovarian cancer models. Melflufen was active against ovarian cancer cell lines, primary cultures of patient-derived ovarian cancer cells, and inhibited the growth of subcutaneous A2780 ovarian cancer xenografts alone and when combined with gemcitabine or liposomal doxorubicin when administered intravenously. In addition, an intra- and subperitoneal xenograft model showed activity of intraperitoneal administered melflufen for peritoneal carcinomatosis, with minimal side effects and modest systemic exposure. In conclusion, results from this study support further investigations of melflufen for the treatment of peritoneal carcinomatosis from ovarian cancer, both for intravenous and intraperitoneal administration.