학술논문

Targeting the Tumor Stroma: the Biology and Clinical Development of Pegylated Recombinant Human Hyaluronidase (PEGPH20)
Document Type
Review Paper
Source
Current Oncology Reports. July 2017 19(7):1-9
Subject
Pegylated recombinant human hyaluronidase
PEGPH20
Hyaluronic acid
Hyaluronan
Glycosaminoglycan
Pancreatic ductal adenocarcinoma
Interstitial fluid pressure
Stromal resistance
Tumor stroma
Tumor microenvironment
Extracellular matrix
Diffusion
Convection
Tumor perfusion
Gemcitabine
Nab-paclitaxel
Immunotherapy
Thromboembolic events
KPC mice
CD44
RHAMM
Language
English
ISSN
1523-3790
1534-6269
Abstract
The tumor stroma is increasingly recognized as a key player in tumorigenesis through its effects on cell signaling, immune responses, and access of therapeutic agents. A major component of the extracellular matrix is hyaluronic acid (HA), which raises the interstitial gel fluid pressure within tumors and reduces drug delivery to malignant cells, and has been most extensively studied in pancreatic ductal adenocarcinoma (PDA). Pegylated recombinant human hyaluronidase (PEGPH20) is a novel agent that degrades HA and normalizes IFP to enhance the delivery of cytotoxic agents. It has demonstrated promising preclinical results and early clinical evidence of efficacy in the first-line treatment of metastatic PDA with acceptable tolerability. Moreover, intratumoral HA content appears to be a predictive biomarker of response. Phase 2 and 3 trials of PEGPH20 plus chemotherapy are ongoing in metastatic PDA, and it is also being evaluated in other malignancies and in combination with radiation and immunotherapy.