Understanding the Unique Attributes of MUC16 (CA125): Potential Implications in Targeted Therapy Srustidhar Das1 and Surinder K
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Published OnlineFirst November 2, 2015; DOI: 10.1158/0008-5472.CAN-15-1050 Cancer Review Research Understanding the Unique Attributes of MUC16 (CA125): Potential Implications in Targeted Therapy Srustidhar Das1 and Surinder K. Batra1,2,3 Abstract CA125, the most widely used ovarian cancer biomarker, was immunoadhesin HN125 to interfere MUC16 binding to mesothe- first identified approximately 35 years ago in an antibody screen lin. Since the identification of CA125 to be MUC16, it is hypoth- against ovarian cancer antigen. Two decades later, it was cloned esized to undergo proteolytic cleavage, a process that is considered and characterized to be a transmembrane mucin, MUC16. Since to be critical in determining the kinetics of MUC16 shedding as then, several studies have investigated its expression, functional, well as generation of a cell-associated carboxyl-terminal fragment and mechanistic involvement in multiple cancer types. Antibody- with potential oncogenic functions. In addition to our experi- based therapeutic approaches primarily using antibodies against mental demonstration of MUC16 cleavage, recent studies have the tandem repeat domains of MUC16 (e.g., oregovomab and demonstrated the functional importance of carboxyl terminal abagovomab) have been the modus operandi for MUC16-targeted fragments of MUC16 in multiple tumor types. Here, we provide therapy, but have met with very limited success. In addition, how our understanding of the basic biologic processes involving efforts have been also made to disrupt the functional cooperation MUC16 influences our approach toward MUC16-targeted thera- of MUC16 and its interacting partners; for example, use of a novel py. Cancer Res; 75(22); 1–6. Ó2015 AACR. Introduction of its cleavage (1, 6–8). Likewise, existence of splice forms without a transmembrane domain resulting in the secretory MUC16 is a type I transmembrane mucin that was cloned MUC16 has also been predicted (9). However, proper exper- and characterized independently by Lloyd and O'Brien in an imental validation is lacking to support these claims. Although effort toward biochemical characterization of CA125 (1–3). On 35 years have elapsed since the discovery of CA125 and 14 years the basis of the sequencing data, MUC16 is an extremely large since it was identified to be MUC16, our understanding of the glycoprotein (22,152 amino acids) with approximately 12,000 basic biologic processes involving MUC16 cleavage, promoter amino acids of the heavily O-glycosylated N-terminal region, a characterization, and therefore its regulation, existence of splice tandem repeat region comprising approximately 60 repeats of variants etc. is still rudimentary. Part of the problems in 156 amino acids each, a transmembrane domain and a cyto- addressing these issues lies with the enormous size and com- plasmic tail of 32 amino acids (Fig. 1A; ref. 4). MUC16 harbors plexity of this protein and lack of appropriate technical 56 SEA (sea urchin, enterokinase, and agrin) domains, the resources (such as antibodies for various regions of MUC16) highest among all mucins, and each SEA domain constitutes in addressing these problems. In this review, we focus on how a major portion (amino acids 1–128) of each tandem repeat our understanding of some of these basic processes (particu- (Fig. 1A, black outlined box at the bottom left; ref. 5). MUC16 larly cleavage) affects our outlook in exploiting the therapeutic is predicted to undergo cleavage in the penultimate and/or last potential of MUC16. SEA domain and phosphorylation event(s) in the cytoplasmic tail domain (CTD) is (are) believed to be critical determinants MUC16: A Historical Perspective In 1981, Bast and colleagues developed a monoclonal antibody 1 Department of Biochemistry and Molecular Biology, University of (i.e., OC125) that was reactive against epithelial ovarian cancer Nebraska Medical Center, Omaha, Nebraska. 2Department of Pathol- ogy, University of Nebraska Medical Center, Omaha, Nebraska. 3Buf- cells and cryopreserved tumor tissues from ovarian cancer fett Cancer Center, Eppley Institute for Research in Cancer and Allied patients, but not with the nonmalignant tissue samples (10). The Diseases, University of Nebraska Medical Center, Omaha, Nebraska. antigen that was reactive to this particular antibody was desig- Current address for S. Das: Department of Medicine, Karolinska Universitetss- nated as cancer antigen 125, hence the name CA125. Although jukhuset, Solna 171 76 Stockholm, Sweden. E-mail: [email protected] the antibody was developed with a therapeutic intent to treat the Corresponding Author: Surinder K. Batra, Department of Biochemistry and ovarian cancer patients, shedding of the antigen CA125 in to the Molecular Biology, Eppley Institute for Research in Cancer and Allied Diseases, circulation did not bode well for that purpose. Instead, detection University of Nebraska Medical Center, 985870 Nebraska Medical Center, of the antigen CA125 in the circulation was foreseen as an Omaha, NE 68198-5870. Phone: 402-559-5455; Fax: 402-559-6650; E-mail: interesting opportunity to monitor the recurrent ovarian cancer [email protected] and still is the current gold standard marker for recurrent ovarian doi: 10.1158/0008-5472.CAN-15-1050 cancer. Although the potential of using CA125 toward (i) mon- Ó2015 American Association for Cancer Research. itoring the response to ovarian cancer treatment, (ii) recurrence of www.aacrjournals.org OF1 Downloaded from cancerres.aacrjournals.org on September 28, 2021. © 2015 American Association for Cancer Research. Das and Batra Published OnlineFirst November 2, 2015; DOI: 10.1158/0008-5472.CAN-15-1050 A Schematics of full-length MUC16 and a prototype tandem repeat N ? SEA = N SEA SEA SEA SEA55th SEA56th TM CTD C TR ANK1 ANK2 SEA DSVLV PLARRVDR TM PLTGNSDLPFWA Site # 2 Site # 1 Novel cleavage area “GSVVV” 12000 aa Tandem repeat (TR) Possible additional C 60+ repeats of 156 aa analogue cleavage site(s) of MUC1 Prototype TR of MUC16 Location of CA125 epitope reactive to OC125-mAb Actin CC CC ERM c-Src SEAn n=~10SEAn+1 n=~10 VTTRRRKKEGEYNVQQQCPGYYQSHLDLEDLQ ub ub P ub ub TRn TRn+1 nnub ub = N-Glycosylation site = O-Glycosylation site BCProposed model of proteolytic MUC16 interactome and possible processing of MUC16 therapeutic intervention NK cell ? CD16 higG1-Fc SEA SEA HN125 SEA NKG2D Siglec-9 sMUC16 SEA SEA SEA Full-length Hetero-dimeric Hetero-dimeric a d SEA TM IAB SEA MUC16-Cter TM b cell Mesothelial TM c a ~ ~ pH 5.0 Gal-3 pH 6.0 SEA SEA Gal-1 b TM SEA TM SEA SEA SEA SEA SEA Steric-hindrance TM TM TM SEA SEA SEA SEA SEA SEA Mesothelin TM SEA c TM TM Endothelium SEA Post-Golgi SEA SEA SEA SEA p38 P pH-7.0 Breflate ? TM SEA E-selectin CSC SEA trans TM Proliferation phenotype SEA TM MMP7 SEA d SEA SEA SEA pH-7.1 SEA TM Cyclin D1 LMO2 Golgi medial L-selectin Metastasis SEA NANOG Lymphocyte TM ER Apoptosis PP cis DR 5 STAT3 JAK2 TR 3 PP Meso JAK2 C-JUN Nucleus TM STAT3 SEA SEA Meso-TR3 e © 2015 American Association for Cancer Research OF2 Cancer Res; 75(22) November 15, 2015 Cancer Research Downloaded from cancerres.aacrjournals.org on September 28, 2021. © 2015 American Association for Cancer Research. Published OnlineFirst November 2, 2015; DOI: 10.1158/0008-5472.CAN-15-1050 MUC16 and Cancer Therapeutics the disease (ovarian cancer) following treatment, and/or (iii) mucins are hypothesized to be critical in mediating their sig- early detection of the disease was soon realized, its molecular naling functions and MUC16 (CA125) being one the most characterization took an overwhelmingly long two decades time widely used serum biomarker for ovarian cancer (23) and one till 2001, when Lloyd and O'Brien's groups independently dem- of the top three frequently mutated gene across many tumor onstrated that CA125 is indeed a very large membrane bound types (24), it is imperative to understand the cleavage of MUC16 mucin MUC16 (1–3). Since then, several groups, including ours, if we are to understand its role in tumorigenesis. One of the have attempted to characterize MUC16 with respect to its cleav- major hurdles in addressing MUC16 cleavage has been lack of age (11), trafficking (12), regulation of expression (13, 14), and antibodies for the C-terminal region as most of the well-char- its functional involvement in health and disease (15–21). Recent- acterized antibodies bind to the repetitive epitopes (i.e., CA125) ly, Cheon and colleagues generated and characterized a whole in the tandem repeat region. To circumvent the lack of anti- body Muc16 knockout mouse model (22). These mice are viable bodies for the C-terminal MUC16, we used dual epitope tagging and fertile with lack of any apparent developmental defects (22) of various lengths of carboxyl-terminal MUC16 fragments to and therefore, can be used as an interesting tool to address the narrow down the potential site of cleavage. We observed that basic questions related to Muc16/MUC16. earlier predicted sites #1 and #2 are not essential for MUC16 cleavage, instead a novel stretch of 12 amino acids in the juxta- membrane ectodomain (PLTGNSDLPFWA) was found to be MUC16 Cleavage: A Long-Standing Question sufficient for MUC16 cleavage (Fig. 1A; ref. 11). Although this Because the molecular identity of CA125 was revealed to be a novel stretch of 12 amino acids was found to be sufficient for single pass transmembrane mucin MUC16 (2, 3), predictions MUC16 cleavage, it is not an absolute necessity, as deletion of have been made about its possible cleavage in the juxta-mem- this stretch did not result in complete abrogation of MUC16 brane SEA domains. Primarily, the PLARRVDR site (site #1) in cleavage (11). It can thus be speculated that MUC16 cleavage the last (56th; ref. 1) and DSVLV site (site #2, analogous to may not be entirely dependent on its primary amino acid GSVVV site on MUC1) on the penultimate (55th; ref.