Eliminating fibroblast activation protein-α expressing cells by photoimmunotheranostics

Photoimmunotherapy (PIT) using an antibody conjugated to a near infrared dye IR700 is achieving significant success in target-specific elimination of cells. Fibroblast activation protein alpha (FAP-) is an important target in cancer because of its expression by cancer associated fibroblasts (CAFs) as well as by some cancer cells. CAFs that express FAP- have protumorigenic and immune suppressive functions. Using immunohistochemistry of human breast cancer tissue microarrays, we identified an increase of FAP-+ CAFs in invasive breast cancer tissue compared to adjacent normal tissue. We found FAP- expression increased in fibroblasts co-cultured with cancer cells. In proof-of-principle studies, we engineered human FAP- overexpressing MDA-MB-231 and HT-1080 cancer cells and murine FAP- overexpressing NIH-3T3 fibroblasts to evaluate several anti-FAP- antibodies and selected AF3715 based on its high binding-affinity with both human and mouse FAP-. After conjugation of AF3715 with the phthalocyanine dye IR700, the resultant antibody conjugate, FAP--IR700, was evaluated in cells and tumors for its specificity and effectiveness in eliminating FAP- expressing cell populations with PIT. FAP--IR700-PIT resulted in effective FAP--specific cell killing in the engineered cancer cells and in two patient-derived CAFs in a dose-dependent manner. Following an intravenous injection, FAP--IR700 retention was three-fold higher than IgG-IR700 in FAP- overexpressing tumors, and two-fold higher compared to wild-type tumors. FAP--IR700-PIT resulted in significant growth inhibition of tumors derived from FAP- overexpressing human cancer cells. A reduction of endogenous FAP-+ murine CAFs was identified at 7 days after FAP--IR700-PIT. FAP--targeted NIR-PIT presents a promising strategy to eliminate FAP-+ CAFs.