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Shipunova VO, Komedchikova EN, Kotelnikova PA, Zelepukin IV, Schulga AA, Proshkina GM, Shramova EI, Kutscher HL, Telegin GB, Kabashin AV, Prasad PN, Deyev SM. Dual Regioselective Targeting the Same Receptor in Nanoparticle-Mediated Combination Immuno/Chemotherapy for Enhanced Image-Guided Cancer Treatment. ACS NANO 2020; 14:12781-12795. [PMID: 32935975 DOI: 10.1021/acsnano.0c03421] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When combined with immunotherapy, image-guided targeted delivery of chemotherapeutic agents is a promising direction for combination cancer theranostics, but this approach has so far produced only limited success due to a lack of molecular targets on the cell surface and low therapeutic index of conventional chemotherapy drugs. Here, we demonstrate a synergistic strategy of combination immuno/chemotherapy in conditions of dual regioselective targeting, implying vectoring of two distinct binding sites of a single oncomarker (here, HER2) with theranostic compounds having a different mechanism of action. We use: (i) PLGA nanoformulation, loaded with an imaging diagnostic fluorescent dye (Nile Red) and a chemotherapeutic drug (doxorubicin), and functionalized with affibody ZHER2:342 (8 kDa); (ii) bifunctional genetically engineered DARP-LoPE (42 kDa) immunotoxin comprising of a low-immunogenic modification of therapeutic Pseudomonas exotoxin A (LoPE) and a scaffold targeting protein, DARPin9.29 (14 kDa). According to the proposed strategy, the first chemotherapeutic nanoagent is targeted by the affibody to subdomain III and IV of HER2 with 60-fold specificity compared with nontargeted particles, while the second immunotoxin is effectively targeted by DARPin molecule to subdomain I of HER2. We demonstrate that this dual targeting strategy can enhance anticancer therapy of HER2-positive cells with a very strong synergy, which made possible 1000-fold decrease of effective drug concentration in vitro and a significant enhancement of HER2 cancer therapy compared to monotherapy in vivo. Moreover, this therapeutic combination prevented the appearance of secondary tumor nodes. Thus, the suggested synergistic strategy utilizing dual targeting of the same oncomarker could give rise to efficient methods for aggressive tumors treatment.
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Affiliation(s)
- Victoria O Shipunova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
- MEPhI (Moscow Engineering Physics Institute), Institute of Engineering Physics for Biomedicine (PhysBio), 31 Kashirskoe Shosse, Moscow 115409, Russia
| | - Elena N Komedchikova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Polina A Kotelnikova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Ivan V Zelepukin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
- MEPhI (Moscow Engineering Physics Institute), Institute of Engineering Physics for Biomedicine (PhysBio), 31 Kashirskoe Shosse, Moscow 115409, Russia
| | - Alexey A Schulga
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Galina M Proshkina
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Elena I Shramova
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Hilliard L Kutscher
- Institute for Lasers, Photonics and Biophotonics, University at Buffalo, 428 Natural Science Complex, Buffalo, New York 14260-3000, United States
- Department of Medicine, University at Buffalo, 875 Ellicott Street, Buffalo, New York 14203, United States
- Department of Anesthesiology, University at Buffalo, 77 Goodell Street, Suite 550, Buffalo, New York 14203, United States
| | - Georgij B Telegin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
| | - Andrei V Kabashin
- MEPhI (Moscow Engineering Physics Institute), Institute of Engineering Physics for Biomedicine (PhysBio), 31 Kashirskoe Shosse, Moscow 115409, Russia
- Aix Marseille University, CNRS, LP3, Campus de Luminy-case 917, 13288, Marseille Cedex 9, France
| | - Paras N Prasad
- MEPhI (Moscow Engineering Physics Institute), Institute of Engineering Physics for Biomedicine (PhysBio), 31 Kashirskoe Shosse, Moscow 115409, Russia
- Institute for Lasers, Photonics and Biophotonics, University at Buffalo, 428 Natural Science Complex, Buffalo, New York 14260-3000, United States
| | - Sergey M Deyev
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 16/10 Miklukho-Maklaya Street, Moscow 117997, Russia
- MEPhI (Moscow Engineering Physics Institute), Institute of Engineering Physics for Biomedicine (PhysBio), 31 Kashirskoe Shosse, Moscow 115409, Russia
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Pittman CT, Guido J, Hamelin EI, Blake TA, Johnson RC. Analysis of a ricin biomarker, ricinine, in 989 individual human urine samples. J Anal Toxicol 2013; 37:237-40. [PMID: 23471955 PMCID: PMC4547525 DOI: 10.1093/jat/bkt010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ricinine (3-cyano-4-methoxy-N-methyl-2-pyridone) is a urinary biomarker that can be measured to confirm human exposure to castor bean products such as ricin. Because many consumer products contain castor oil, another castor bean product, ricinine may be detectable in the general population. The following study characterized urinary ricinine concentrations from 989 individuals who were presumed to be unexposed to ricin. An automated diagnostic method was utilized to simplify the analysis of this large sample set. Sample preparation included a 96-well polystyrene divinylbenzene high throughput extraction and preconcentration step. Purified samples were analyzed by an efficient dual column, reversed-phase liquid chromatography separation and (13)C-isotope dilution tandem mass spectrometry. In this convenience sample set, only 1.2% of the urine specimens had detectable amounts of ricinine, randomly distributed between 0.186 and 4.15 ng/mL.
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Affiliation(s)
- Christopher T. Pittman
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341
| | - John Guido
- Oak Ridge Institute for Scientific Education, MC-100-44, P.O. Box 117, Oak Ridge, TN 37831
| | - Elizabeth I. Hamelin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341
| | - Thomas A. Blake
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341
| | - Rudolph C. Johnson
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341
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Loss-Morais G, Turchetto-Zolet AC, Etges M, Cagliari A, Körbes AP, Maraschin FDS, Margis-Pinheiro M, Margis R. Analysis of castor bean ribosome-inactivating proteins and their gene expression during seed development. Genet Mol Biol 2013; 36:74-86. [PMID: 23569411 PMCID: PMC3615529 DOI: 10.1590/s1415-47572013005000005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/21/2012] [Indexed: 01/26/2023] Open
Abstract
Ribosome-inactivating proteins (RIPs) are enzymes that inhibit protein synthesis after depurination of a specific adenine in rRNA. The RIP family members are classified as type I RIPs that contain an RNA-N-glycosidase domain and type II RIPs that contain a lectin domain (B chain) in addition to the glycosidase domain (A chain). In this work, we identified 30 new plant RIPs and characterized 18 Ricinus communis RIPs. Phylogenetic and functional divergence analyses indicated that the emergence of type I and II RIPs probably occurred before the monocot/eudicot split. We also report the expression profiles of 18 castor bean genes, including those for ricin and agglutinin, in five seed stages as assessed by quantitative PCR. Ricin and agglutinin were the most expressed RIPs in developing seeds although eight other RIPs were also expressed. All of the RIP genes were most highly expressed in the stages in which the endosperm was fully expanded. Although the reason for the large expansion of RIP genes in castor beans remains to be established, the differential expression patterns of the type I and type II members reinforce the existence of biological functions other than defense against predators and herbivory.
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Affiliation(s)
- Guilherme Loss-Morais
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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4
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Improving the Therapeutic Potential of Human Granzyme B for Targeted Cancer Therapy. Antibodies (Basel) 2013. [DOI: 10.3390/antib2010019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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5
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6
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Tsimberidou AM, Giles FJ, Kantarjian HM, Keating MJ, O'Brien SM. Anti-B4 Blocked Ricin Post Chemotherapy in Patients with Chronic Lymphocytic Leukemia--Long-term Follow-up of a Monoclonal Antibody-based Approach to Residual Disease. Leuk Lymphoma 2009; 44:1719-25. [PMID: 14692524 DOI: 10.1080/1042819031000116706] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Anti-B4-blocked ricin is an immunotoxin consisting of anti-B4 murine monoclonal antibody and "blocked ricin" toxin. The anti-B4 monoclonal antibody is directed against the CD19 antigen, which is expressed on B-lymphocytes. A phase II study of anti-B4 blocked ricin toxin in patients with B-cell chronic lymphocytic leukemia (CLL) with residual disease after chemotherapy was conducted. Eleven patients received anti-B4 blocked ricin at 30 microg/kg lean body mass (LBM) daily by continuous infusion for 7 days followed with repeat infusion administered at 14-day intervals. No patient achieved an objective response. The major reasons for failure to respond were the presence of adenopathy and residual marrow disease. Three patients achieved immunophenotypic response in marrow and peripheral blood. Three of 6 patients with rearranged IgH and/or Ig kappa were germline after anti-B4 blocked ricin. The median follow-up of surviving patients is 8.6 years. The median survival is 5.8 years (range, 0.0-8.8). All patients have progressed. The median time to progression was 0.8 years (range, 0.3-3.0). Infusion-related toxicities were all grade 1-2. The most common toxicity was transaminitis. Human antimouse antibody (HAMA) and/or human antiricin antibody (HARA) development was documented in 2 patients. Anti-B4 blocked ricin was well tolerated but had limited activity in patients with residual CLL after chemotherapy.
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MESH Headings
- Aged
- Antibodies, Monoclonal/immunology
- Antineoplastic Agents/adverse effects
- Drug Administration Schedule
- Female
- Follow-Up Studies
- Humans
- Immunoconjugates/immunology
- Immunoconjugates/therapeutic use
- Infusions, Intravenous
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
- Neoplasm, Residual/drug therapy
- Neoplasm, Residual/immunology
- Prognosis
- Remission Induction
- Ricin/immunology
- Ricin/therapeutic use
- Survival Rate
- Time Factors
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Affiliation(s)
- Apostolia M Tsimberidou
- Department of Leukemia, MD Anderson Cancer Center, University of Texas, 1515 Holcombe Boulevard, Unit 428, Houston, TX 77030, USA
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7
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Abstract
Immunotoxins are proteins used to treat cancer that are composed of an antibody fragment linked to a toxin. The immunotoxin binds to a surface antigen on a cancer cell, enters the cell by endocytosis, and kills it. The most potent immunotoxins are made from bacterial and plant toxins. Refinements over many years have produced recombinant immunotoxins; these therapeutic proteins are made using protein engineering. Individual immunotoxins are designed to treat specific cancers. To date, most success has been achieved treating hematologic tumors. Obstacles to successful treatment of solid tumors include poor penetration into tumor masses and the immune response to the toxin component of the immunotoxin, which limits the number of cycles that can be given. Strategies to overcome these limitations are being pursued.
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Affiliation(s)
- Ira Pastan
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
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8
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Abstract
Immunotoxins are proteins that contain a toxin along with an antibody or growth factor that binds specifically to target cells. Nearly all protein toxins work by enzymatically inhibiting protein synthesis. For the immunotoxin to work, it must bind to and be internalized by the target cells, and the enzymatic fragment of the toxin must translocate to the cytosol. Once in the cytosol, 1 molecule is capable of killing a cell, making immunotoxins some of the most potent killing agents. Various plant and bacterial toxins have been genetically fused or chemically conjugated to ligands that bind to cancer cells. Among the most active clinically are those that bind to hematologic tumors. At present, only 1 agent, which contains human interleukin-2 and truncated diphtheria toxin, is approved for use in cutaneous T-cell lymphoma. Another, containing an anti-CD22 Fv and truncated Pseudomonas exotoxin, has induced complete remissions in a high proportion of cases of hairy-cell leukemia. Refinement of existing immunotoxins and development of new immunotoxins are underway to improve the treatment of cancer.
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Affiliation(s)
- Robert J Kreitman
- Clinical Immunotherapy Section, Laboratory of Molecular Biology, Centers for Cancer Research, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 37, Room 5124B, Bethesda, MD 20892-4255, USA.
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9
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Shah MH, Porcu P, Mallery SR, Caligiuri MA. AIDS-associated malignancies. CANCER CHEMOTHERAPY AND BIOLOGICAL RESPONSE MODIFIERS 2003; 21:717-46. [PMID: 15338771 DOI: 10.1016/s0921-4410(03)21034-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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10
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Harvey ML, Illidge T, Johnson P. Antibodies in the treatment of lymphoma. Clin Oncol (R Coll Radiol) 2002; 13:251-61. [PMID: 11554621 DOI: 10.1053/clon.2001.9264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M L Harvey
- Cancer Research Campaign, University Medical Oncology, Southampton University Hospitals, UK
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11
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Tulpule A, Sherrod A, Dharmapala D, Young LL, Espina BM, Sanchez MN, Gill PS, Levine AM. Multidrug resistance (MDR-1) expression in AIDS-related lymphomas. Leuk Res 2002; 26:121-7. [PMID: 11755462 DOI: 10.1016/s0145-2126(01)00113-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
P-glycoprotein is a product of the multidrug resistance (MDR-1) gene. In non-Hodgkin's lymphoma, less than 20% of untreated de novo lymphomas express MDR-1 compared with approximately 50% after failure of chemotherapy. We wished to study the expression of MDR-1 in AIDS-related non-Hodgkin's lymphoma (AIDS-NHL). Tissue biopsies from 50 patients with newly diagnosed AIDS-NHL were studied by immunohistochemical analysis using C494, a monoclonal antibody specific for the MDR-1 isoform of P-gp. MDR-1 expression was correlated with patient demographics, lymphoma characteristics, response to chemotherapy, and survival. Forty-six males and four females with a median age of 38 years (range 26-63) were studied. A prior AIDS-defining opportunistic infection was reported in 35 patients (70%). The median CD4+ lymphocyte count was 69/mm(3) (range 0-920). Thirty-two patients (63%) had received prior anti-HIV therapy, including a protease inhibitor in five (10%). Pathologic types consisted of diffuse large cell in 13 (26%), immunoblastic in 13 (26%), small non-cleaved in 22 (44%), and high grade not otherwise specified in two (4%). The majority of patients (76%) had stage III/IV disease. Pre-treatment lymphoma tissues from 33 patients (66%) stained positively for MDR-1. MDR-1 positive patients had a significantly lower complete remission rate compared to MDR-1 negative patients (33 versus 65%, P=0.042). Duration of complete response was significantly longer in MDR-1 negative patients compared with MDR-1 positive patients (not reached versus 9.9 months, P=0.003). Strategies to overcome MDR-1 expression may be important for initial treatment in patients with AIDS-NHL.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/biosynthesis
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Acquired Immunodeficiency Syndrome/mortality
- Adult
- Anti-HIV Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/metabolism
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bleomycin/administration & dosage
- Bleomycin/metabolism
- Bleomycin/pharmacology
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/metabolism
- Cyclophosphamide/pharmacology
- Dexamethasone/administration & dosage
- Dexamethasone/metabolism
- Dexamethasone/pharmacology
- Disease-Free Survival
- Doxorubicin/administration & dosage
- Doxorubicin/metabolism
- Doxorubicin/pharmacology
- Drug Resistance, Multiple/genetics
- Drug Resistance, Neoplasm/genetics
- Female
- Gene Expression Regulation, Leukemic
- Humans
- Leucovorin/administration & dosage
- Leucovorin/metabolism
- Leucovorin/pharmacology
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/metabolism
- Lymphoma, AIDS-Related/mortality
- Male
- Methotrexate/administration & dosage
- Methotrexate/metabolism
- Methotrexate/pharmacology
- Middle Aged
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Prednisone/administration & dosage
- Prednisone/metabolism
- Prednisone/pharmacology
- Remission Induction
- Retrospective Studies
- Survival Analysis
- Vincristine/administration & dosage
- Vincristine/metabolism
- Vincristine/pharmacology
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Affiliation(s)
- Anil Tulpule
- Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
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12
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Sudhan Shaik M, Kanikkannan N, Singh M. Conjugation of anti-My9 antibody to stealth monensin liposomes and the effect of conjugated liposomes on the cytotoxicity of immunotoxin. J Control Release 2001; 76:285-95. [PMID: 11578743 DOI: 10.1016/s0168-3659(01)00450-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The carboxylic ionophore, monensin, was successfully entrapped in stealth liposomes by employing the pH-gradient method (interior pH of liposomes 9.5; exterior pH 5.0-5.9). A maximum of 14% of monensin could be entrapped in stealth liposomes by this method. The stealth liposomes could be successfully freeze-dried having mean particle size varying between 197 and 223 nm. The stealth liposomes were conjugated to anti-My9 monoclonal antibody (targeted against CD 33 antigen) by a disulfide linkage with almost full retention of immunoreactivity. The method of conjugation of liposomes with the antibody did not alter the particle size of liposomes and resulted in only 10% leakage of monensin. In-vitro cytotoxicity studies showed that antibody-conjugated monensin liposomes (3.5x10(-8) M monensin) potentiated the cytotoxicity of anti-My9 immunotoxin by a factor of 2070, in comparison to 360-fold potentiation observed with unconjugated monensin liposomes against human HL-60 promyelocytic leukemia cells. These results indicate that it is possible to enhance the in-vitro cytotoxicity of immunotoxin by several folds using antibody-conjugated monensin liposomes.
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Affiliation(s)
- M Sudhan Shaik
- Division of Pharmaceutics, College of Pharmacy, Florida A&M University, Tallahassee, FL 32307, USA
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13
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Seneviratne L, Espina BM, Nathwani BN, Chan JA, Brynes RK, Levine AM. Clinical, immunologic, and pathologic correlates of bone marrow involvement in 291 patients with acquired immunodeficiency syndrome-related lymphoma. Blood 2001; 98:2358-63. [PMID: 11588031 DOI: 10.1182/blood.v98.8.2358] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bone marrow involvement is reported in approximately 25% of patients with newly diagnosed acquired immunodeficiency syndrome-related lymphoma (ARL). Studied were 291 patients with ARL, diagnosed and treated at one medical center between 1984 and 1998. Clinical, immunologic, and pathologic characteristics of patients with bone marrow involvement were compared with those of patients without marrow involvement. Bone marrow involvement was present in 55 patients (19%). Small noncleaved lymphoma was diagnosed in 38% of the entire group and was the most common pathologic subtype in patients with bone marrow involvement (55% versus 34%; P =.008). Analysis of complete blood counts revealed a median hemoglobin level of 10.6 g/dL in both marrow-positive and marrow-negative groups. In contrast, a platelet count lower than 100 000/microL was more common in patients with bone marrow involvement (27% versus 11%; P =.02). Patients with marrow involvement were more likely to have leptomeningeal (cerebrospinal fluid [CSF]) lymphoma than patients whose marrows were uninvolved (24% versus 7%; P <.001) and were also more likely to have high lactate dehydrogenase (LDH) (P =.002), bone involvement (P <.001), and/or systemic B symptoms including fever, night sweats, and/or weight loss (P =.05). Median survival did not differ between marrow-positive and marrow-negative groups. On multivariate analysis, factors associated with decreased survival of marrow-positive patients included greater than 50% involvement (P =.002), systemic B symptoms (P =.008), and high-grade histologic type (P =.035). Marrow involvement in ARL correlates with small noncleaved pathology, thrombocytopenia lower than 100 000 mm(3), high LDH, and lymphomatous involvement of the CSF. Survival is statistically shorter in patients with greater than 50% marrow involvement, high-grade pathology, and/or systemic B symptoms.
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Affiliation(s)
- L Seneviratne
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA
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14
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Duong Van Huyen JP, Delignat S, Bloch MF, Kazatchkine MD, Kaveri SV. Variable sensitivity of lymphoblastoid cells to apoptosis induced by Viscum album Qu FrF, a therapeutic preparation of mistletoe lectin. Chemotherapy 2001; 47:366-76. [PMID: 11561140 DOI: 10.1159/000048545] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Viscum album (VA) Qu FrF preparation consists of an aqueous extract of Viscum album, the European mistletoe. It has cytotoxic and immunomodulatory properties that support its usefulness in cancer therapy. However, only little information is available on the interaction between mistletoe lectin (ML) and the humoral compartment of the immune system. METHODS Inhibition of proliferation of cells was performed by incorporation of (3)H-thymidine, and cell viability was assessed by the uptake of propidium iodide. Detection of Bcl-2 and related molecules was performed by SDS-PAGE followed by immunoblotting. RESULTS We demonstrated that B lymphocyte lines are insensitive to VA Qu FrF-induced apoptosis. We showed, using Fas-sensitive and Fas-resistant cell lines, that VA Qu FrF-induced apoptosis is Fas independent. In both B and T lymphocytes, treatment of the cells with VA Qu FrF was associated with decreased levels of Bcl-2 and Bcl-X. CONCLUSIONS Our results suggest that B lymphocyte depletion is not involved in the modulation of humoral immunity by ML. These observations should be of value in appropriate designing of cancer therapy using compounds containing mistletoe extracts.
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15
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Abstract
Three important issues have been the focus of much recent attention in the biology of AIDS-related lymphomas. The altered epidemiology in the era of highly active antiretroviral therapy, the role of herpesviruses including human herpesvirus 8 and the molecular genetics of HIV-associated T-cell lymphomas. These topics are covered in this article and their potential application to the clinical management of AIDS-related lymphomas are discussed.
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Affiliation(s)
- M Bower
- Department of Oncology, Chelsea and Westminster Hospital, London, UK.
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16
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Cohen K, Scadden DT. Non-Hodgkin's lymphoma: pathogenesis, clinical presentation, and treatment. Cancer Treat Res 2001; 104:201-30. [PMID: 11191128 DOI: 10.1007/978-1-4615-1601-9_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- Antiviral Agents/therapeutic use
- Bleomycin/therapeutic use
- California
- Clinical Trials as Topic
- Combined Modality Therapy
- Cyclophosphamide/therapeutic use
- Dexamethasone/therapeutic use
- Doxorubicin/therapeutic use
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 8, Human/isolation & purification
- Homosexuality, Male
- Humans
- Infusions, Intravenous
- Lymphoma, B-Cell/pathology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, T-Cell/pathology
- Male
- Prognosis
- Registries
- Vincristine/therapeutic use
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Affiliation(s)
- K Cohen
- Massachusetts General Hospital, Dana-Farber/Harvard Cancer Center, Partners AIDS Research Center, Harvard Medical School, USA
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17
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antiretroviral Therapy, Highly Active
- Antiviral Agents/therapeutic use
- Burkitt Lymphoma/epidemiology
- Burkitt Lymphoma/virology
- Epstein-Barr Virus Infections/complications
- Genes, myc
- Genes, p53
- Herpesviridae Infections/complications
- Herpesvirus 8, Human
- Humans
- Immunocompromised Host
- Immunotherapy
- Incidence
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/virology
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/virology
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, Non-Hodgkin/epidemiology
- Lymphoma, Non-Hodgkin/virology
- Male
- Prognosis
- Risk Factors
- Translocation, Genetic
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Affiliation(s)
- M Bower
- Department of Oncology, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
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18
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Abstract
Abstract
Over time, the epidemiologic and demographic characteristics of AIDS have changed in the United States, while the use of highly active antiretroviral therapy has changed the natural history of the disease. The goal of the study was to ascertain any changes in the epidemiologic, immunologic, pathologic, or clinical characteristics of AIDS-related lymphoma (ARL) over the course of the AIDS epidemic. Records of 369 patients with ARL diagnosed or treated at a single institution from 1982 through 1998 were reviewed. Single institutional data were compared to population-based data from the County of Los Angeles. Significant changes in the demographic profile of patients with newly diagnosed ARL have occurred, with the later time intervals associated with a higher prevalence in women (P = .25), in Latino/Hispanic individuals (P < .0001), and in those who acquired human immunodeficiency virus (HIV) heterosexually (P = .01). These changes were similar in both countywide, population-based analyses and in those from the single institution. The median CD4+ lymphocyte count at lymphoma diagnosis has decreased significantly over the years, from 177/dL in the earliest time period (1982-1986), to 53/dL in the last time period from 1995 to 1998 (P = .0006). The pathologic spectrum of disease has also changed, with a decrease in the prevalence of small noncleaved lymphoma (P = .0005) and an increase in diffuse large cell lymphoma (P < .0001). Despite changes in the use of antiretroviral or chemotherapy regimens, the median survival has not significantly changed.
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Abstract
Over time, the epidemiologic and demographic characteristics of AIDS have changed in the United States, while the use of highly active antiretroviral therapy has changed the natural history of the disease. The goal of the study was to ascertain any changes in the epidemiologic, immunologic, pathologic, or clinical characteristics of AIDS-related lymphoma (ARL) over the course of the AIDS epidemic. Records of 369 patients with ARL diagnosed or treated at a single institution from 1982 through 1998 were reviewed. Single institutional data were compared to population-based data from the County of Los Angeles. Significant changes in the demographic profile of patients with newly diagnosed ARL have occurred, with the later time intervals associated with a higher prevalence in women (P = .25), in Latino/Hispanic individuals (P < .0001), and in those who acquired human immunodeficiency virus (HIV) heterosexually (P = .01). These changes were similar in both countywide, population-based analyses and in those from the single institution. The median CD4+ lymphocyte count at lymphoma diagnosis has decreased significantly over the years, from 177/dL in the earliest time period (1982-1986), to 53/dL in the last time period from 1995 to 1998 (P = .0006). The pathologic spectrum of disease has also changed, with a decrease in the prevalence of small noncleaved lymphoma (P = .0005) and an increase in diffuse large cell lymphoma (P < .0001). Despite changes in the use of antiretroviral or chemotherapy regimens, the median survival has not significantly changed.
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LeMaistre CF. DAB389IL-2 (Denileukin Diftitox, ONTAK): Other Potential Applications. ACTA ACUST UNITED AC 2000. [DOI: 10.3816/clm.2000.s.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVE To review the current literature on HIV associated non-Hodgkin's lymphoma. METHODS A comprehensive Medline/Pubmed search of articles pertaining to HIV associated non-Hodgkin's lymphoma as well as personal experience from the treatment of over 200 patients at the Chelsea and Westminster Hospital, one of the largest centres for the management of HIV disease in Europe. CONCLUSION High grade B cell non-Hogdkin's lymphoma is the second commonest tumour affecting people with HIV. The incidence of this tumour is not declining following the introduction of highly active antiretroviral therapy. Chemotherapy has been employed with modest success in this group of patients; however, the prognosis remains worse than for immunocompetent patients. Advances in molecular genetics and virology have led to a greater understanding of the biology of these tumours. However, these advances have yet to be translated into improvements in the clinical management of patients with AIDS associated non-Hodgkin's lymphoma.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- Antiviral Agents/therapeutic use
- CD4 Lymphocyte Count
- Female
- Humans
- Lymphoma, AIDS-Related/classification
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/etiology
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/etiology
- Lymphoma, Non-Hodgkin/classification
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/etiology
- Male
- Prognosis
- Remission Induction
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Affiliation(s)
- T Powles
- Department Oncology, Chelsea and Westminster Hospital, London SW10 9NH, UK
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Molina A, Krishnan AY, Nademanee A, Zabner R, Sniecinski I, Zaia J, Forman SJ. High dose therapy and autologous stem cell transplantation for human immunodeficiency virus-associated non-Hodgkin lymphoma in the era of highly active antiretroviral therapy. Cancer 2000. [DOI: 10.1002/1097-0142(20000801)89:3<680::aid-cncr25>3.0.co;2-w] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Caraglia M, Budillon A, Vitale G, Lupoli G, Tagliaferri P, Abbruzzese A. Modulation of molecular mechanisms involved in protein synthesis machinery as a new tool for the control of cell proliferation. EUROPEAN JOURNAL OF BIOCHEMISTRY 2000; 267:3919-36. [PMID: 10866791 DOI: 10.1046/j.1432-1327.2000.01465.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the past years, the attention of scientists has focused mainly on the study of the genetic information and alterations that regulate eukaryotic cell proliferation and that lead to neoplastic transformation. All therapeutic strategies against cancer are, to date, directed at DNA either with cytotoxic drugs or gene therapy. Little or no interest has been aroused by protein synthesis mechanisms. However, an increasing body of data is emerging about the involvement of translational processes and factors in control of cell proliferation, indicating that protein synthesis can be an additional target for anticancer strategies. In this paper we review the novel insights on the biochemical and molecular events leading to protein biosynthesis and we describe their involvement in cell proliferation and tumorigenesis. A possible mechanistic explanation is given by the interactions that occur between protein synthesis machinery and the proliferative signal transduction pathways and that are therefore suitable targets for indirect modulation of protein synthesis. We briefly describe the molecular tools used to block protein synthesis and the attempts made at increasing their efficacy. Finally, we propose a new multimodal strategy against cancer based on the simultaneous intervention on protein synthesis and signal transduction.
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Affiliation(s)
- M Caraglia
- Dipartimento di Biochimica e Biofisica, Seconda Università di Napoli, Italy
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24
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Fraternale A, Casabianca A, Tonelli A, Vallanti G, Chiarantini L, Brandi G, Celeste AG, Magnani M. Inhibition of murine AIDS by alternate administration of azidothymidine and fludarabine monophosphate. J Acquir Immune Defic Syndr 2000; 23:209-20. [PMID: 10839656 DOI: 10.1097/00126334-200003010-00001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Anti-HIV-1 combination therapies, including protease and reverse transcriptase inhibitors, can reduce plasma viremia to undetectable levels within the first 2 weeks of treatment. This reduction is followed by a slower decline that primarily results from the presence of viral reservoirs such as CD4+ memory cells, dendritic cells, and macrophages. For this reason, we evaluated a new drug combination therapy that includes a lympholytic drug: (2-fluoro-ara-AMP, fludarabine) to eliminate cells already infected and an antiviral drug (azidothymidine [AZT]) to protect cells not yet infected. We used C57BL/6 mice infected with the retroviral complex LP-BM5, which developed severe immunodeficiency (i.e., murine AIDS), to select the most effective fludarabine regimen to inhibit disease progression, and then to evaluate the efficacy and toxicity of the fludarabine and AZT combinations. The results obtained show that intraperitoneal administration of fludarabine at 3 mg/mouse twice a day for 4 weeks is the most effective regimen in reducing splenomegaly, lymphadenopathy, hypergammaglobulinemia, and proviral DNA content in spleen and lymph nodes and in restoring the architecture of lymph nodes. Subsequently, we evaluated the combined or sequential administration of fludarabine and AZT. The data reported in this paper show that the sequential administration of the two drugs provides additive antiviral effects that reduce spleen and lymph node weights to normal values and proviral DNA content by approximately 95% in all infected organs; the phenotypes of blood T and B cells moved toward control values, although the number of B cells was significantly reduced by fludarabine treatment. Finally, we evaluated the outcome of the disease after suspension or continuation of different treatment regimens. In all treatment groups, the disease progressed and increased proviral DNA content was found in infected organs, but animals receiving the sequential administration of fludarabine and AZT were less affected than those receiving only fludarabine or the simultaneous administration of both. The results obtained suggest that fludarabine could be part of a new therapeutic approach aiming at eradicating HIV from those cells that have been already infected and that are not protected by highly active antiretroviral therapy (HAART).
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Affiliation(s)
- A Fraternale
- Giorgio Fornaini Institute of Biologic Chemistry, University of Urbino, Italy
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25
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Inhibition of Murine AIDS by Alternate Administration of Azidothymidine and Fludarabine Monophosphate. J Acquir Immune Defic Syndr 2000. [DOI: 10.1097/00042560-200003010-00001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Post J, Vooijs WC, Bast BJ, De Gast GC. Efficacy of an anti-CD138 immunotoxin and doxorubicin on drug-resistant and drug-sensitive myeloma cells. Int J Cancer 1999; 83:571-6. [PMID: 10508496 DOI: 10.1002/(sici)1097-0215(19991112)83:4<571::aid-ijc21>3.0.co;2-n] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multidrug resistance is an increasing problem in the treatment of cancer. We evaluated in vitro the effect of an anti-CD138 plasma-cell-specific immunotoxin (IT, B-B4-SO6) in combination with the chemotherapeutic drug doxorubicin on drug-sensitive and drug-resistant variants of the multiple-myeloma (MM)-derived cell line RPMI8226 and freshly isolated malignant-myeloma cells. Drug-resistant RPMI8226 cells were still sensitive to the IT, although to a lesser extent than drug-sensitive cells. In the clonogenic assay, using 10 nM B-B4-SO6, at least 5 logs kill was found for drug-sensitive RPMI8226 cells, vs. 2.5 logs kill for the drug-resistant RPMI8226 cells. When a sub-optimal dose of 1 nM IT was combined with 3 ng/ml doxorubicin, which was toxic for drug-sensitive but not for drug-resistant cells, an additive effect was found for drug-sensitive RPMI8226 cells. The IT did not influence the sensitivity of resistant cells for doxorubicin. We therefore speculate that this type of IT, may be of more value in combination with primary chemotherapy. The effect of B-B4-SO6 on malignant-myeloma cells of patients was investigated in a viability assay. Both drug-sensitive and drug-resistant cells from MM patients were sensitive to B-B4-SO6. After 2 days, a 50% kill of malignant cells was found when 10 nM IT were used. Doxorubicin was effective only on sensitive cells, and there was a tendency for an additive effect in the combination of these cells.
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Affiliation(s)
- J Post
- Division of Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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27
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Abstract
Immunotoxins are composed of a protein toxin connected to a binding ligand such as an antibody or growth factor. These molecules bind to surface antigens (which internalize) and kill cells by catalytic inhibition of protein synthesis within the cell cytosol. Immunotoxins have recently been tested clinically in hematologic malignancies and solid tumors and have demonstrated potent clinical efficacy in patients with malignant diseases that are refractory to surgery, radiation therapy and chemotherapy - the traditional modalities of cancer treatment. This therapy is thus evolving into a separate modality of cancer treatment, capable of rationally targeting cells on the basis of surface markers. Efforts are underway to obviate impediments to clinical efficacy, including immunogenicity and toxicity to normal tissues. Immunotoxins are now being developed to new antigens for the treatment of cancer.
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Affiliation(s)
- R J Kreitman
- Laboratory of Molecular Biology, Division of Cancer Biology, National Cancer Institute, National Institutes of Health, 37/4B27, 9000 Rockville Pike, 4255 Bethesda, MD 20892, USA.
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Abstract
Biologic approaches to lymphoma treatment are now a practical reality rather than a vaguely perceived hope for the future. Interferon alfa seems to have been established as a life-extending therapy for selected patients with follicular lymphoma. Humanized anti-CD20 monoclonal antibody (rituximab) has an authentic 50% response rate in patients with follicular lymphoma, frequently works when given a second time, and is demonstrating what seems to be synergistic activity when combined with chemotherapy. Radioimmunoconjugates using iodine-131 and yttrium-90 as payload are producing responses in refractory and aggressive lymphomas. Vaccines and adoptive cellular therapies are also showing promising results in early phase clinical testing.
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Affiliation(s)
- M Bendandi
- Institute of Hematology and Medical Oncology Seragnoli University of Bologna, Italy
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Maloney DG. Advances in the immunotherapy of hematologic malignancies: cellular and humoral approaches. Curr Opin Hematol 1999; 6:222-8. [PMID: 10400370 DOI: 10.1097/00062752-199907000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Therapy with unconjugated monoclonal antibodies (mAbs) and radiolabeled mAbs has shown activity in patients with B-cell non-Hodgkin's lymphoma and leukemia. Drug-conjugated mAbs are active in relapsed leukemia. Using these new agents with and after chemotherapy induces a high rate of remission, but this needs to be confirmed in randomized, clinical trials. The antitumor effect of allogeneic stem cell transplantation is being explored through the use of donor lymphocyte infusions for patients who have relapse after transplantation. Attempts to maintain antitumor activity without graft-versus-host disease include CD4 lymphocyte infusions, suicide gene-transfected cells, and the use of cloned T cells more specific for the tumor. Transplantation with nonmyeloablative conditioning regimens relying on the graft-versus-tumor effect of allogeneic lymphocytes has shown preliminary success in the treatment of many hematologic malignancies.
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Affiliation(s)
- D G Maloney
- Fred Hutchinson Cancer Research Center and the University of Washington, Seattle 98109-1024, USA.
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