Taregted therapy and companion diagnostic: the AEZS-108 story

Here’s a clear signal that prostate cancer is entering the world of targeted therapeutics associated with specific companion diagnostics: the Canadian company Aeterna Zentaris has announced a partnership to develop a companion diagnostic to identify patients likely to respond to their targeted therapy AEZS-108.

AEZS-108 is a molecule made up of two components: a synthetic peptide carrier and doxorubicin –a well-known form of chemotherapy. In clinical trials, AEZS-108 has already been shown to target the chemotherapy agent specifically to LHRH receptor-expressing tumors. The company claims that this results in “more targeted treatment with less damage to healthy tissue.” To date, AEZS-108 has completed Phase II trials in the treatment of endometrial and ovarian cancer, and is currently in Phase II trials in prostate and bladder cancer.

Aeterna Zentaris announced earlier today that it will be collaborating with Ventana Medical Systems to develop a companion diagnostic that can measure expression of LHRH receptors. By being able to clearly identify patients who express LHRH receptors, physicians will then be able to restrict use of AEZS-108 only to such patients, thereby increasing the probability of giving AEZS-108 only to patients in whom there is a high probability of effective delivery of doxorubicin chemotherapy to the tumor site.

From a prostate cancer point of view, there is not yet a lot of evidence that targeting doxorubicin in this way will actually have significant therapeutic benefit in men with advanced forms of prostate cancer. Doxorubicin has never shown significant therapeutic benefit in prostate cancer when used as a standard intravenous form of chemotherapy. However, if Aeterna Zentaris can show that they can target the drug using this type of delivery system, then maybe they can link the synthetic peptide carrier to a drug like docetaxel (Taxotere) which is known to work in men with advanced prostate cancer.

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