Anti-interleukin-6

Anti-interleukin-6 agents are a class of therapeutics. Interleukin 6 is a cytokine relevant to many inflammatory diseases and many cancers.[1] Hence, anti-IL6 agents have been sought.[2][3][4][5][6] In rheumatoid arthritis they can help patients unresponsive to TNF inhibitors.[7]

The first approved medication in this class, tocilizumab (Actemra), is an antibody directed against the IL6-receptor.[8] The second, siltuximab (Sylvant), is directed against IL-6 itself.[1][9] Siltuximab is approved for treatment of human immunodeficiency virus-negative and HHV-8-negative patients with multicentric Castleman's disease. Siltuximab was also tested in the phase I/II study for therapy of patients with metastatic castration-associated prostate cancer in combination with docetaxel and in renal cell carcinoma; phase II trials in ovarian cancer resulted in 39% of patients showed disease stabilization via IL-6-regulated downregulation of CCL2, CXCL12 and VEGF.

Tocilizumab was first used in large-cell lung carcinoma. In phase I/II trial of tocilizumab in ovarian cancer EGFR pathway upregulation was observed and after inhibition of this pathway by gefitinib tumor growth was decreased both in vitro and in vivo.[10]

Sarilumab was approved by US FDA in 2017 for rheumatoid arthritis.[11]

Several agents are in clinical trials: olokizumab (CDP6038)[12][13] elsilimomab, clazakizumab (BMS-945429, ALD518), sirukumab (CNTO 136), levilimab (BCD-089), and CPSI-2364 an apparent macrophage-specific inhibitor of the p38 mitogen-activated protein kinase pathway.[14] ALX-0061.[7]: Table1 

e.g. for rheumatoid arthritis : clazakizumab, olokizumab, sarilumab and sirukumab have all reported encouraging phase 2 results.[7] Sirukumab is in multiple phase 3 trials.[7]: Table1 

Agents in pre-clinical development include ARGX-109,[15][16] FE301,[1] and FM101.[17]

  1. ^ a b c Jones SA, Scheller J, Rose-John S (2011). "Therapeutic strategies for the clinical blockade of IL-6/gp130 signaling". The Journal of Clinical Investigation. 121 (9): 3375–83. doi:10.1172/JCI57158. PMC 3163962. PMID 21881215.
  2. ^ Barton BE (2005). "Interleukin-6 and new strategies for the treatment of cancer, hyperproliferative diseases and paraneoplastic syndromes". Expert Opinion on Therapeutic Targets. 9 (4): 737–52. doi:10.1517/14728222.9.4.737. PMID 16083340. S2CID 45421426.
  3. ^ Smolen JS, Maini RN (2006). "Interleukin-6: a new therapeutic target". Arthritis Research & Therapy. 8 (Suppl 2): S5. doi:10.1186/ar1969. PMC 3226077. PMID 16899109.
  4. ^ Stein and Sutherland (1998). "IL-6 as a drug discovery target". Drug Discovery Today. 3 (5): 202–213. doi:10.1016/S1359-6446(97)01164-1.
  5. ^ "Interleukin-6 – new target in the battle against Ras-induced cancers". 2007.
  6. ^ Yokota S (2003). "Interleukin 6 as a therapeutic target in systemic-onset juvenile idiopathic arthritis". Current Opinion in Rheumatology. 15 (5): 581–6. doi:10.1097/00002281-200309000-00010. PMID 12960484. S2CID 24296997.
  7. ^ a b c d Tanaka Y, Martin Mola E (2014). "IL-6 targeting compared to TNF targeting in rheumatoid arthritis: studies of olokizumab, sarilumab and sirukumab". Annals of the Rheumatic Diseases. 73 (9): 1595–7. doi:10.1136/annrheumdis-2013-205002. PMID 24833786.
  8. ^ Schoels MM, van der Heijde D, Breedveld FC, et al. (2013). "Blocking the effects of interleukin-6 in rheumatoid arthritis and other inflammatory rheumatic diseases: systematic literature review and meta-analysis informing a consensus statement". Ann. Rheum. Dis. 72 (4): 583–9. doi:10.1136/annrheumdis-2012-202470. PMC 3595140. PMID 23144446.
  9. ^ fda.gov
  10. ^ Korneev, KV; Atretkhany, KN; Drutskaya, MS; Grivennikov, SI; Kuprash, DV; Nedospasov, SA (January 2017). "TLR-signaling and proinflammatory cytokines as drivers of tumorigenesis". Cytokine. 89: 127–135. doi:10.1016/j.cyto.2016.01.021. PMID 26854213.
  11. ^ FDA Gives Nod to Sarilumab for Rheumatoid Arthritis. 2017
  12. ^ "UCB Announces Start Of Phase I Study For Antibody Drug Candidate CDP6038". 2 Dec 2008.
  13. ^ "Article > UCB's RA drug does not overly impress in Phase II". Archived from the original on 2015-12-22. Retrieved 2015-07-26.
  14. ^ Websky Mv FJ, Ohsawa I, Praktiknjo M, Wehner S, Abu-Elmagd K, Kitamura K, Kalff JC, Schaefer N, Pech T (2013). "The novel guanylhydrazone CPSI-2364 ameliorates ischemia reperfusion injury after experimental small bowel transplantation". Transplantation. 95 (11): 1315–23. doi:10.1097/TP.0b013e31828e72fa. PMID 23598944. S2CID 45761175.
  15. ^ "ArGEN-X Wins €1.5M IWT Grant to Progress Camelid-Derived Human Antibody Pipeline". 27 Sep 2010.
  16. ^ "RuiYi (Formerly Anaphore) and arGEN-X Announce Exclusive Worldwide License Agreement for ARGX-109, a Novel anti-IL-6 Antibody" (Press release).
  17. ^ "Formatech to Donate Services to Formulate and Fill Femta Pharmaceuticals' FM101 Monoclonal Antibody under Its "Fillanthrop". 30 July 2010.