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CRM197 is used as a [[carrier protein]] in a number of approved conjugate vaccines. HibtiterTM, a vaccine to protect against Haemophius influenzae type b, approved by the FDA in 1990, was the first conjugate vaccine to use CRM197 (the vaccine was discontinued in 2007). Pfizer's Prevnar, which in 2000 became the first [[pneumococcal conjugate vaccine]] to gain FDA approval, comprises polysaccharides from pneumococcal [[serotype]]s conjugated to CRM197. A larger number of clinical and pre-clinical conjugate vaccines using CRM197 as the carrier protein are being evaluated. A further example of a vaccine currently in use that is a CRM197 conjugate is the meningitis ACWY vaccine, Menveo, produced by [[GlaxoSmithKline]].<ref>{{Cite web|url=https://www.medicines.org.uk/emc/medicine/27347#companyDetails|title=Menveo Group A, C, W135 and Y conjugate vaccine - Summary of Product Characteristics (SPC) - (eMC)|website=www.medicines.org.uk|access-date=2016-10-01}}</ref> In addition, CRM197 made in the Pelican Expression Technology™ platform is used in Merck's VAXNEUVANCE and Serum Institute's Pneumosil.
CRM197 possess a binding site for EGF receptor heparin-binding epidermal growth factor-like growth factor (HB-EGF), a member of the EGF family.<ref name="pmid7836353">{{cite journal | vauthors = Mitamura T, Higashiyama S, Taniguchi N, Klagsbrun M, Mekada E | title = Diphtheria toxin binds to the epidermal growth factor (EGF)-like domain of human heparin-binding EGF-like growth factor/diphtheria toxin receptor and inhibits specifically its mitogenic activity | journal = J Biol Chem | volume = 270 | issue = 3 | pages = 1015–9 | date = January 1995 | pmid = 7836353 | doi = 10.1074/jbc.270.3.1015 }}</ref> As this receptor is overexpressed on cancer cells, there have been efforts to use CRM197 as an anti-cancer therapy.<ref>{{cite journal | vauthors = Buzzi S, Rubboli D, Buzzi G, Buzzi AM, Morisi C, Pironi F | title = CRM197 (nontoxic diphtheria toxin): effects on advanced cancer patients | journal = Cancer Immunol Immunother | volume = 53 | issue = 11 | pages = 1041–8 | date = November 2004 | pmid = 15168087 | doi = 10.1007/s00262-004-0546-4 }}{{cite journal | vauthors = Dateoka S, Ohnishi Y, Kakudo K | title = Effects of CRM197, a specific inhibitor of HB-EGF, in oral cancer | journal = Med Mol Morphol | volume = 45 | issue = 2 | pages = 91–7 | date = June 2012 | pmid = 22718294 | doi = 10.1007/s00795-011-0543-6 }}</ref> The cancer immunotherapy company Imugene reported dramatic improvements in antibody titers from its B cell peptide cancer immunotherapy targeting HER2 when it used CRM197 as a carrier protein.[5]
CRM197 is being evaluated as a potential drug delivery [[fusion protein]]. The Swiss-based Turing Pharmaceuticals is working on CRM197 fusion constructs with therapeutic proteins of up to 1,000 amino acids in length.[6]
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