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EC4-ETA is a recombinant fusion toxin composed of an EpCAM-specific designed ankyrin repeat protein (DARPin Ec4) genetically fused to a truncated variant of Pseudomonas aeruginosa exotoxin A (ETA″). The drug was developed as an experimental antineoplastic agent to target and destroy EpCAM-positive tumor cells. The DARPin Ec4 domain confers high affinity (low nanomolar) binding to the epithelial cell adhesion molecule (EpCAM), a surface antigen overexpressed in many carcinomas, enabling specific tumor targeting. ETA″ acts as a cytotoxic payload: once internalized, it inhibits protein synthesis within the targeted cell, leading to cell death. Preclinical studies demonstrated highly potent and selective cytotoxicity toward EpCAM-positive tumor cell lines and strong antitumor activity in mouse xenograft models, including tumor regression[1][3].
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