Bladder cancer therapy using a conformationally fluid tumoricidal peptide complex
Alpha‑1‑oleate demonstrates tumoricidal activity against non‑muscle invasive bladder cancer with safety and efficacy in a Phase I/II clinical trial.
Partially unfolded alpha‑lactalbumin forms the oleic acid complex HAMLET, with potent tumoricidal activity. Here we define a peptide‑based molecular approach for targeting and killing tumor cells, and evidence of its clinical potential (ClinicalTrials.gov NCT03560479). A 39‑residue alpha‑helical peptide from alpha‑lactalbumin is shown to gain lethality for tumor cells by forming oleic acid complexes (alpha1‑oleate). Nuclear magnetic resonance measurements and computational simulations reveal a lipid core surrounded by conformationally fluid, alpha‑helical peptide motifs. In a single‑center, placebo‑controlled, double‑blinded Phase I/II interventional clinical trial of non‑muscle invasive bladder cancer, all primary end points of safety and efficacy of alpha1‑oleate treatment are reached, as evaluated in an interim analysis. Intra‑vesical instillations of alpha1‑oleate triggers massive shedding of tumor cells and the tumor size is reduced but no drug‑related side effects are detected (primary endpoints). Shed cells contain alpha1‑oleate, treated tumors show evidence of apoptosis and the expression of cancer‑related genes is inhibited (secondary endpoints). The results are especially encouraging for bladder cancer, where therapeutic failures and high recurrence rates create a great, unmet medical need.
The results are especially encouraging for bladder cancer, where therapeutic failures and high recurrence rates create a great, unmet medical need.
Evidence level: Állatkísérletes. Állatmodellben vizsgálták.