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Rosenthal AC, Munoz JL, Villasboas JC. Clinical advances in epigenetic therapies for lymphoma. Clin Epigenetics 2023; 15:39. [PMID: 36871057 PMCID: PMC9985856 DOI: 10.1186/s13148-023-01452-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 02/19/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Advances in understanding of cancer biology, genomics, epigenomics, and immunology have resulted in development of several therapeutic options that expand cancer care beyond traditional chemotherapy or radiotherapy, including individualized treatment strategies, novel treatments based on monotherapies or combination therapy to reduce toxicities, and implementation of strategies for overcoming resistance to anticancer therapy. RESULTS This review covers the latest applications of epigenetic therapies for treatment of B cell, T cell, and Hodgkin lymphomas, highlighting key clinical trial results with monotherapies and combination therapies from the main classes of epigenetic therapies, including inhibitors of DNA methyltransferases, protein arginine methyltransferases, enhancer of zeste homolog 2, histone deacetylases, and the bromodomain and extraterminal domain. CONCLUSION Epigenetic therapies are emerging as an attractive add-on to traditional chemotherapy and immunotherapy regimens. New classes of epigenetic therapies promise low toxicity and may work synergistically with other cancer treatments to overcome drug resistance mechanisms.
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Affiliation(s)
- Allison C Rosenthal
- Division of Hematology, Medical Oncology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Javier L Munoz
- Division of Hematology, Medical Oncology, Mayo Clinic, 5777 E. Mayo Blvd, Phoenix, AZ, 85054, USA
| | - J C Villasboas
- Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA
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First-in-human Phase 1 open label study of the BET inhibitor ODM-207 in patients with selected solid tumours. Br J Cancer 2020; 123:1730-1736. [PMID: 32989226 PMCID: PMC7722752 DOI: 10.1038/s41416-020-01077-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 01/07/2023] Open
Abstract
Background Bromodomain and extra-terminal domain (BET) proteins are reported to be epigenetic anti-cancer drug targets. This first-in-human study evaluated the safety, pharmacokinetics and preliminary anti-tumour activity of the BET inhibitor ODM-207 in patients with selected solid tumours. Methods This was an open-label Phase 1 study comprised of a dose escalation part, and evaluation of the effect of food on pharmacokinetics. ODM-207 was administered orally once daily. The dose escalation part was initiated with a dose titration in the initial cohort, followed by a 3 + 3 design. Results Thirty-five patients were treated with ODM-207, of whom 12 (34%) had castrate-resistant prostate cancer. One dose-limiting toxicity of intolerable fatigue was observed. The highest studied dose achieved was 2 mg/kg due to cumulative toxicity observed beyond the dose-limiting toxicity (DLT) treatment window. Common AEs included thrombocytopenia, asthenia, nausea, anorexia, diarrhoea, fatigue, and vomiting. Platelet count decreased proportionally to exposure with rapid recovery upon treatment discontinuation. No partial or complete responses were observed. Conclusions ODM-207 shows increasing exposure in dose escalation and was safe at doses up to 2 mg/kg but had a narrow therapeutic window. Clinical trial registration The clinical trial registration number is NCT03035591.
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Liang D, Yu Y, Ma Z. Novel strategies targeting bromodomain-containing protein 4 (BRD4) for cancer drug discovery. Eur J Med Chem 2020; 200:112426. [DOI: 10.1016/j.ejmech.2020.112426] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 12/13/2022]
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Jia Q, Chen S, Tan Y, Li Y, Tang F. Oncogenic super-enhancer formation in tumorigenesis and its molecular mechanisms. Exp Mol Med 2020; 52:713-723. [PMID: 32382065 PMCID: PMC7272638 DOI: 10.1038/s12276-020-0428-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/08/2020] [Accepted: 03/23/2020] [Indexed: 12/11/2022] Open
Abstract
Super-enhancers (SEs) consist of a cluster of many enhancers bound to a great number of transcription factors. They are critical cis-regulatory elements that determine the identity of various human cell types. During tumorigenesis, DNA mutations and indels, chromosomal rearrangements, three-dimensional chromatin structural changes, and viral infections mediate oncogenic SE activation, and activated SEs have been found to regulate the expression of oncogenic genes. Inhibition specifically targeted to oncogenic SE assembly and activation provides a novel powerful therapeutic strategy for various cancers. In this paper, we first introduce the current understanding of oncogenic SE assembly and activation and then summarize the pathogenic factors and mechanism of oncogenic SE activation. Next, we elaborate on the oncogenic functions of SEs in cancers and the application of SEs as therapeutic targets. Finally, we turn our focus to the use of SEs in basic research and clinical trials. Drugs that block the assembly and activation of large DNA segments involved in enhancing gene expression could help in the treatment of cancer. Faqing Tang of Hunan Cancer Hospital in Changsha, China, and colleagues review the ways in which cancer cells hijack clusters of gene-regulating sequences known as super-enhancers, regulatory gene regions that normally help determine a cell’s unique identity, to drive the aberrant gene activity that fuels tumor growth. The researchers describe how numerous factors, ranging from internal DNA alterations, both large and small, to viral infections and other external assaults, can spur the formation of cancer-causing super-enhancers, leading to out-of-control gene expression. Therapies that selectively target these super-enhancers are now in early clinical testing. However, more studies of super-enhancers and their role in cancer development are needed to inform future drug development.
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Affiliation(s)
- Qunying Jia
- Hunan Key Laboratory of Oncotarget Gene and Clinical Laboratory, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Shuhua Chen
- Department of Otolaryngology, The Second People's Hospital of Foshan, Foshan, 528000, Guangdong, China
| | - Yuan Tan
- Hunan Key Laboratory of Oncotarget Gene and Clinical Laboratory, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Yuejin Li
- Hunan Key Laboratory of Oncotarget Gene and Clinical Laboratory, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Faqing Tang
- Hunan Key Laboratory of Oncotarget Gene and Clinical Laboratory, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China.
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Sermer D, Pasqualucci L, Wendel HG, Melnick A, Younes A. Emerging epigenetic-modulating therapies in lymphoma. Nat Rev Clin Oncol 2019; 16:494-507. [PMID: 30837715 DOI: 10.1038/s41571-019-0190-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite considerable advances in the treatment of lymphoma, the prognosis of patients with relapsed and/or refractory disease continues to be poor; thus, a continued need exists for the development of novel approaches and therapies. Epigenetic dysregulation might drive and/or promote tumorigenesis in various types of malignancies and is prevalent in both B cell and T cell lymphomas. Over the past decade, a large number of epigenetic-modifying agents have been developed and introduced into the clinical management of patients with haematological malignancies. In this Review, we provide a concise overview of the most promising epigenetic therapies for the treatment of lymphomas, including inhibitors of histone deacetylases (HDACs), DNA methyltransferases (DNMTs), enhancer of zeste homologue 2 (EZH2), bromodomain and extra-terminal domain proteins (BETs), protein arginine N-methyltransferases (PRMTs) and isocitrate dehydrogenases (IDHs), and highlight the most promising future directions of research in this area.
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Affiliation(s)
- David Sermer
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Laura Pasqualucci
- Institute for Cancer Genetics, Columbia University, New York, NY, USA
| | - Hans-Guido Wendel
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ari Melnick
- Weill-Cornell Medical College, New York, NY, USA
| | - Anas Younes
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Oliveira LJC, Gongora ABL, Latancia MT, Barbosa FG, Gregorio JVAM, Testagrossa LA, Amano MT, Feher O. The first report of molecular characterized BRD4-NUT carcinoma in Brazil: a case report. J Med Case Rep 2019; 13:279. [PMID: 31492174 PMCID: PMC6731562 DOI: 10.1186/s13256-019-2213-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022] Open
Abstract
Background NUT midline carcinoma is a rare and aggressive subset of squamous cell carcinoma, which is characterized by the translocation of nuclear protein in testis gene that is mostly fused with bromodomain and extraterminal family proteins. We describe here the first Brazilian case of NUT midline carcinoma with BRD4-NUT fusion detected in a next-generation sequencing panel and we present the clinical evolution of this patient. Case presentation A 42-year-old Caucasian man was diagnosed with poorly differentiated squamous cell carcinoma of the left maxillary sinus, with negative in situ hybridization for Epstein–Barr encoding region and human papillomavirus genotyping. He received induction therapy, chemoradiotherapy with weekly systemic chemotherapy, and, concurrently, weekly intra-arterial chemotherapy. New imaging evaluation, 1 month after the end of the last treatment, revealed a good partial response in the primary lesion. However, positron emission tomography-computed tomography showed multiple suspicious lesions in his bones and lungs, which were histologically confirmed. He died exactly 2 months after metastatic disease was diagnosed. Conclusions NUT midline carcinoma is usually very aggressive. Currently, there is no standard of care for treatment of NUT midline carcinoma. The definitive diagnosis must be by demonstration of NUTM1 rearrangement. Immunohistochemical staining of greater than 50% of tumor nuclei on formalin-fixed paraffin-embedded tissue using the monoclonal rabbit antibody to NUT (clone C52B1), has a specificity of 100%, and sensitivity of 87% for the diagnosis of NUT midline carcinoma. Our case is the first Brazilian case of NUT midline carcinoma with BRD4-NUT fusion.
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Affiliation(s)
- Leandro J C Oliveira
- Centro de Oncologia, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91. 2nd floor. Building A, São Paulo, 01308-050, Brazil.
| | - Aline B L Gongora
- Centro de Oncologia, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91. 2nd floor. Building A, São Paulo, 01308-050, Brazil
| | - Marcela T Latancia
- Instituto de Ensino e Pesquisa, Hospital Sírio Libanês, São Paulo, Brazil
| | - Felipe G Barbosa
- Serviço de Medicina Nuclear, Hospital Sírio Libanês, São Paulo, Brazil
| | - João Vitor A M Gregorio
- Centro de Oncologia, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91. 2nd floor. Building A, São Paulo, 01308-050, Brazil.,Serviço de Oncologia, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | | | - Mariane T Amano
- Instituto de Ensino e Pesquisa, Hospital Sírio Libanês, São Paulo, Brazil
| | - Olavo Feher
- Centro de Oncologia, Hospital Sírio Libanês, Rua Dona Adma Jafet, 91. 2nd floor. Building A, São Paulo, 01308-050, Brazil.,Serviço de Oncologia, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, São Paulo, Brazil
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Alqahtani A, Choucair K, Ashraf M, Hammouda DM, Alloghbi A, Khan T, Senzer N, Nemunaitis J. Bromodomain and extra-terminal motif inhibitors: a review of preclinical and clinical advances in cancer therapy. Future Sci OA 2019; 5:FSO372. [PMID: 30906568 PMCID: PMC6426170 DOI: 10.4155/fsoa-2018-0115] [Citation(s) in RCA: 186] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/04/2019] [Indexed: 01/18/2023] Open
Abstract
Histone lysine acetylation is critical in regulating transcription. Dysregulation of this process results in aberrant gene expression in various diseases, including cancer. The bromodomain, present in several proteins, recognizes promotor lysine acetylation and recruits other transcription factors. The bromodomain extra-terminal (BET) family of proteins consists of four conserved mammalian members that regulate transcription of oncogenes such as MYC and the NUT fusion oncoprotein. Targeting the acetyl-lysine-binding property of BET proteins is a potential therapeutic approach of cancer. Consequently, following the demonstration that thienotriazolodiazepine small molecules effectively inhibit BET, clinical trials were initiated. We thus discuss the mechanisms of action of various BET inhibitors and the prospects for their clinical use as cancer therapeutics.
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Affiliation(s)
- Ali Alqahtani
- Department of Internal Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Khalil Choucair
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Mushtaq Ashraf
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Danae M Hammouda
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Abduraham Alloghbi
- Department of Internal Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Talal Khan
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - Neil Senzer
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
| | - John Nemunaitis
- Division of Hematology & Medical Oncology, Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, 43614, USA
- ProMedica Health System, Toledo, OH, 43606, USA
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Pervaiz M, Mishra P, Günther S. Bromodomain Drug Discovery - the Past, the Present, and the Future. CHEM REC 2018; 18:1808-1817. [PMID: 30289209 DOI: 10.1002/tcr.201800074] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/12/2018] [Indexed: 12/26/2022]
Abstract
With the bromodomain (BRD) inhibitor JQ1, a remarkable success story of BRD4 as a novel drug target has been set off that yielded many anti-cancer drugs that are now in clinical trials. But not all of the great prospects of BRDs as drug targets may become true. First evaluations of ongoing clinical trials revealed that treatment with BET-inhibitors can be accompanied with significant toxic side effects and the validation of the therapeutic benefit of BET-inhibitors compared to existing therapies is still pending. New strategies that may overcome possible obstacles in BRD drug discovery include combination therapies with other agents, dual target inhibitors, and proteolysis targeting chimeras (PROTACs). Furthermore, non-BET proteins seem promising drug targets as well. Most recently, BRDs have been identified as putative targets to treat parasitic diseases such as malaria. Milestones in BRD drug discovery are reviewed and promising new developments are evaluated.
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Affiliation(s)
- Mehrosh Pervaiz
- Institute of Pharmaceutical Sciences, Albert-Ludwigs-Universität Freiburg, Hermann-Herder-Str. 9, 79104, Freiburg, Germany
| | - Pankaj Mishra
- Institute of Pharmaceutical Sciences, Albert-Ludwigs-Universität Freiburg, Hermann-Herder-Str. 9, 79104, Freiburg, Germany
| | - Stefan Günther
- Institute of Pharmaceutical Sciences, Albert-Ludwigs-Universität Freiburg, Hermann-Herder-Str. 9, 79104, Freiburg, Germany
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Zhao Y, Zhou B, Bai L, Liu L, Yang CY, Meagher JL, Stuckey JA, McEachern D, Przybranowski S, Wang M, Ran X, Aguilar A, Hu Y, Kampf JW, Li X, Zhao T, Li S, Wen B, Sun D, Wang S. Structure-Based Discovery of CF53 as a Potent and Orally Bioavailable Bromodomain and Extra-Terminal (BET) Bromodomain Inhibitor. J Med Chem 2018; 61:6110-6120. [PMID: 30015487 DOI: 10.1021/acs.jmedchem.8b00483] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We report the structure-based discovery of CF53 (28) as a highly potent and orally active inhibitor of bromodomain and extra-terminal (BET) proteins. By the incorporation of a NH-pyrazole group into the 9H-pyrimido[4,5- b]indole core, we identified a series of compounds that bind to BRD4 BD1 protein with Ki values of <1 nM and achieve low nanomolar potencies in the cell growth inhibition of leukemia and breast cancer cells. The most-promising compound, CF53, possesses excellent oral pharmacokinetic properties and achieves significant antitumor activity in both triple-negative breast cancer and acute leukemia xenograft models in mice. Determination of the co-crystal structure of CF53 with the BRD4 BD1 protein provides a structural basis for its high binding affinity to BET proteins. CF53 is very selective over non-BET bromodomain-containing proteins. These data establish CF53 as a potent, selective, and orally active BET inhibitor, which warrants further evaluation for advanced preclinical development.
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Doroshow DB, Eder JP, LoRusso PM. BET inhibitors: a novel epigenetic approach. Ann Oncol 2018; 28:1776-1787. [PMID: 28838216 DOI: 10.1093/annonc/mdx157] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Epigenetics has been defined as 'the structural adaptation of chromosomal regions so as to register, signal or perpetuate altered activity states.' Currently, several classes of anticancer drugs function at the epigenetic level, including inhibitors of DNA methyltransferase, histone deacetylase (HDAC), lysine-specific demethylase 1, zeste homolog 2, and bromodomain and extra-terminal motif (BET) proteins.BET proteins have multiple functions, including the initiation and elongation of transcription and cell cycle regulation. In recent years, inhibitors of BET proteins have been developed as anticancer agents. These inhibitors exhibit selectivity for tumor cells by preferentially binding to superenhancers, noncoding regions of DNA critical for the transcription of genes that determine a cell's identity. Preclinical research on BET inhibitors has identified them as a potential means of targeting MYC.Early clinical trials with BET inhibitors have had mixed results, with few responses in both hematologic and solid tumors that tend to be short-lived. Toxicities have included severe, thrombocytopenia, fatigue, nausea, vomiting, and diarrhea; GI side-effects, fatigue, and low-grade dysgeusia have limited compliance. However, preclinical data suggest that BET inhibitors may have a promising future in combination with other agents. They appear to be able to overcome resistance to targeted agents and have strong synergy with immune checkpoint inhibitors as well as with multiple epigenetic agents, particularly HDAC inhibitors. In many instances, BET and HDAC inhibitors were synergistic at reduced doses, suggesting a potential means of avoiding the overlapping toxicities of the two drug classes.BET inhibitors provide a novel approach to epigenetic anticancer therapy. However, to date they appear to have limited efficacy as single agents. A focus on BET inhibitors in combination with other drugs such as targeted and/or as other epigenetic agents is warranted, due to limited monotherapy activity, including pharmacodynamic correlatives differential activity amongst select drug combinations.
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Affiliation(s)
- D B Doroshow
- Section of Medical Oncology, Department of Medicine, Yale University and Yale Cancer Center, New Haven, USA
| | - J P Eder
- Section of Medical Oncology, Department of Medicine, Yale University and Yale Cancer Center, New Haven, USA
| | - P M LoRusso
- Section of Medical Oncology, Department of Medicine, Yale University and Yale Cancer Center, New Haven, USA
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Lewin J, Soria JC, Stathis A, Delord JP, Peters S, Awada A, Aftimos PG, Bekradda M, Rezai K, Zeng Z, Hussain A, Perez S, Siu LL, Massard C. Phase Ib Trial With Birabresib, a Small-Molecule Inhibitor of Bromodomain and Extraterminal Proteins, in Patients With Selected Advanced Solid Tumors. J Clin Oncol 2018; 36:3007-3014. [PMID: 29733771 DOI: 10.1200/jco.2018.78.2292] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Birabresib (MK-8628/OTX015) is a first-in-class bromodomain inhibitor with activity in select hematologic tumors. Safety, efficacy, and pharmacokinetics of birabresib were evaluated in patients with castrate-resistant prostate cancer, nuclear protein in testis midline carcinoma (NMC), and non-small-cell lung cancer in this phase Ib study. PATIENTS AND METHODS Forty-seven patients were enrolled to receive birabresib once daily at starting doses of 80 mg continuously (cohort A) or 100 mg for 7 consecutive days (cohort B) in 21-day cycles using a parallel dose escalation 3 + 3 design. The primary objective was occurrence of dose-limiting toxicities (DLTs) and determination of the recommended phase II dose. RESULTS Of 46 treated patients, 26 had castrate-resistant prostate cancer, 10 NMC, and 10 non-small-cell lung cancer. For cohort A, four of 19 (21%) evaluable patients had DLTs at 80 mg once daily (grade 3 thrombocytopenia [n = 3], ALT/hyperbilirubinemia [n = 1]) and two of three had DLTs at 100 mg once daily (grade 2 anorexia and nausea with treatment delay > 7 days [n = 1], grade 4 thrombocytopenia [n = 1]). No DLTs occurred in cohort B. Of 46 patients, 38 (83%) had treatment-related adverse events (diarrhea, 17 [37%]; nausea, 17 [37%]; anorexia, 14 [30%]; vomiting, 12 [26%]; thrombocytopenia 10 [22%]). Three patients with NMC (80 mg once daily) had a partial response (Response Evaluation Criteria in Solid Tumors [RECIST] version 1.1) with duration of 1.4 to 8.4 months. Pharmacokinetic analysis indicated a dose-proportional increase in birabresib exposure and rapid absorption. CONCLUSION The recommended phase II dose of birabresib in patients with select solid tumors is 80 mg once daily with continuous dosing. Birabresib has dose-proportional exposure and a favorable safety profile, with clinical activity observed in NMC. Future studies of birabresib must consider intermittent scheduling to possibly mitigate the toxicities of chronic dosing.
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Affiliation(s)
- Jeremy Lewin
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Jean-Charles Soria
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Anastasios Stathis
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Jean-Pierre Delord
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Solange Peters
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Ahmad Awada
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Philippe G Aftimos
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Mohamed Bekradda
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Keyvan Rezai
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Zhen Zeng
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Azher Hussain
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Susan Perez
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Lillian L Siu
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
| | - Christophe Massard
- Jeremy Lewin and Lillian L. Siu, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Jean-Charles Soria and Christophe Massard, Institut Gustave Roussy and University Paris-Sud, Villejuif; Jean-Pierre Delord, Institut Claudius Regaud Oncopole, Toulouse; Mohamed Bekradda, Oncology Therapeutic Development, Clichy; Keyvan Rezai, Hôpital René Huguenin, Saint-Cloud, France; Anastasios Stathis, Oncology Institute of Southern Switzerland, Bellinzona; Solange Peters, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Ahmad Awada and Philippe G. Aftimos, Université Libre de Bruxelles, Brussels, Belgium; and Zhen Zeng, Azher Hussain, and Susan Perez, Merck & Co, Kenilworth, NJ
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13
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Jauset T, Massó-Vallés D, Martínez-Martín S, Beaulieu ME, Foradada L, Fiorentino FP, Yokota J, Haendler B, Siegel S, Whitfield JR, Soucek L. BET inhibition is an effective approach against KRAS-driven PDAC and NSCLC. Oncotarget 2018; 9:18734-18746. [PMID: 29721157 PMCID: PMC5922351 DOI: 10.18632/oncotarget.24648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/25/2018] [Indexed: 12/12/2022] Open
Abstract
Effectively treating KRAS-driven tumors remains an unsolved challenge. The inhibition of downstream signaling effectors is a way of overcoming the issue of direct targeting of mutant KRAS, which has shown limited efficacy so far. Bromodomain and Extra-Terminal (BET) protein inhibition has displayed anti-tumor activity in a wide range of cancers, including KRAS-driven malignancies. Here, we preclinically evaluate the effect of BET inhibition making use of a new BET inhibitor, BAY 1238097, against Pancreatic Ductal Adenocarcinoma (PDAC) and Non-Small Cell Lung Cancer (NSCLC) models harboring RAS mutations both in vivo and in vitro. Our results demonstrate that BET inhibition displays significant therapeutic impact in genetic mouse models of KRAS-driven PDAC and NSCLC, reducing both tumor area and tumor grade. The same approach also causes a significant reduction in cell number of a panel of RAS-mutated human cancer cell lines (8 PDAC and 6 NSCLC). In this context, we demonstrate that while BET inhibition by BAY 1238097 decreases MYC expression in some cell lines, at least in PDAC cells its anti-tumorigenic effect is independent of MYC regulation. Together, these studies reinforce the use of BET inhibition and prompt the optimization of more efficient and less toxic BET inhibitors for the treatment of KRAS-driven malignancies, which are in urgent therapeutic need.
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Affiliation(s)
- Toni Jauset
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.,Peptomyc S.L., Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain
| | - Daniel Massó-Vallés
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Sandra Martínez-Martín
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Marie-Eve Beaulieu
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Peptomyc S.L., Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain
| | - Laia Foradada
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Peptomyc S.L., Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain
| | - Francesco Paolo Fiorentino
- Kitos Biotech srls, Porto Conte Ricerche, Alghero, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Jun Yokota
- Genomics and Epigenomics of Cancer Prediction Program, Institut d'Investigació Germans Trias I Pujol (IGTP), Campus Can Ruti, Barcelona, Spain
| | | | | | - Jonathan R Whitfield
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain
| | - Laura Soucek
- Vall d'Hebron Institute of Oncology (VHIO), Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.,Peptomyc S.L., Edifici Cellex, Hospital Vall d'Hebron, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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14
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Stathis A, Bertoni F. BET Proteins as Targets for Anticancer Treatment. Cancer Discov 2017; 8:24-36. [PMID: 29263030 DOI: 10.1158/2159-8290.cd-17-0605] [Citation(s) in RCA: 305] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/14/2017] [Accepted: 10/11/2017] [Indexed: 11/16/2022]
Affiliation(s)
| | - Francesco Bertoni
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Università della Svizzera italiana, Istituto Oncologico di Ricerca, Bellinzona, Switzerland
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15
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Bernasconi E, Gaudio E, Lejeune P, Tarantelli C, Cascione L, Kwee I, Spriano F, Rinaldi A, Mensah AA, Chung E, Stathis A, Siegel S, Schmees N, Ocker M, Zucca E, Haendler B, Bertoni F. Preclinical evaluation of the BET bromodomain inhibitor BAY 1238097 for the treatment of lymphoma. Br J Haematol 2017; 178:936-948. [PMID: 28653353 DOI: 10.1111/bjh.14803] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/29/2017] [Indexed: 12/21/2022]
Abstract
The epigenome is often deregulated in cancer and treatment with inhibitors of bromodomain and extra-terminal proteins, the readers of epigenetic acetylation marks, represents a novel therapeutic approach. Here, we have characterized the anti-tumour activity of the novel bromodomain and extra-terminal (BET) inhibitor BAY 1238097 in preclinical lymphoma models. BAY 1238097 showed anti-proliferative activity in a large panel of lymphoma-derived cell lines, with a median 50% inhibitory concentration between 70 and 208 nmol/l. The compound showed strong anti-tumour efficacy in vivo as a single agent in two diffuse large B cell lymphoma models. Gene expression profiling showed BAY 1238097 targeted the NFKB/TLR/JAK/STAT signalling pathways, MYC and E2F1-regulated genes, cell cycle regulation and chromatin structure. The gene expression profiling signatures also highly overlapped with the signatures obtained with other BET Bromodomain inhibitors and partially overlapped with HDAC-inhibitors, mTOR inhibitors and demethylating agents. Notably, BAY 1238097 presented in vitro synergism with EZH2, mTOR and BTK inhibitors. In conclusion, the BET inhibitor BAY 1238097 presented promising anti-lymphoma preclinical activity in vitro and in vivo, mediated by the interference with biological processes driving the lymphoma cells. Our data also indicate the use of combination schemes targeting EZH2, mTOR and BTK alongside BET bromodomains.
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Affiliation(s)
- Elena Bernasconi
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Eugenio Gaudio
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | | | - Chiara Tarantelli
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Luciano Cascione
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Ivo Kwee
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland.,IDSIA Dalle Molle Institute for Artificial Intelligence, Manno, Switzerland.,SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Filippo Spriano
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Andrea Rinaldi
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Afua A Mensah
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Elaine Chung
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland
| | - Anastasios Stathis
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | | | | | - Matthias Ocker
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | - Emanuele Zucca
- IDSIA Dalle Molle Institute for Artificial Intelligence, Manno, Switzerland
| | | | - Francesco Bertoni
- Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland
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