Anticancer carrier-linked prodrugs in clinical trials

Abstract

Coupling of low molecular weight anticancer drugs to antibodies, serum proteins or polymers through a cleavable linker has been an effective method for improving the therapeutic index of cytotoxic established agents. Modern drug–antibody conjugates that have recently entered clinical trials have primarily used highly potent drugs such as calicheamicin or maytansins. Gemtuzumab ozogamicin, a conjugate of calicheamicin and an anti-CD33 humanized antibody, is the first drug–antibody conjugate to receive market approval. Drug conjugates that have undergone clinical assessment include N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer conjugates with doxorubicin, camptothecin, paclitaxel and Pt(II) complexes, poly(ethylene glycol) conjugates with camptothecin and paclitaxel, polyglutamate conjugates with paclitaxel and camptothecin, a methotrexate–albumin conjugate and an albumin-binding doxorubicin prodrug. This review summarizes the Phase I – III studies that have been performed with these macromolecular prodrugs.

Keywords::

• antibodies
• anticancer prodrugs
• cancer chemotherapy
• drug targeting
• polymer therapeutics

Acknowledgements

The preclinical development of DOXO-EMCH was supported by the German Cancer Aid, Germany.

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