1
|
Abstract
MCL is a well-characterized generally aggressive lymphoma with a poor prognosis. However, patients with a more indolent disease have been reported in whom the initiation of therapy can be delayed without any consequence for the survival. In 2017 the World Health Organization updated the classification of MCL describing two main subtypes with specific molecular characteristics and clinical features, classical and indolent leukaemic nonnodal MCL. Recent research results suggested an improving outcome of this neoplasm. The addition of rituximab to conventional chemotherapy has increased overall response rates, but it did not improve overall survival compared to chemotherapy alone. The use of intensive frontline therapies including rituximab and consolidation with autologous stem cell transplantation ameliorated response rate and prolonged progression-free survival in young fit patients, but any impact on survival remains to be proven. Furthermore, the optimal timing, cytoreductive regimen and conditioning regimen, and the clinical implications of achieving a disease remission even at molecular level remain to be elucidated. The development of targeted therapies as the consequence of better understanding of pathogenetic pathways in MCL might improve the outcome of conventional chemotherapy and spare the toxicity of intense therapy in most patients. Cases not eligible for intensive regimens, may be considered for less demanding therapies, such as the combination of rituximab either with CHOP or with purine analogues, or bendamustine. Allogeneic SCT can be an effective option for relapsed disease in patients who are fit enough and have a compatible donor. Maintenance rituximab may be considered after response to immunochemotherapy as the first-line strategy in a wide range of patients. Finally, since the optimal approach to the management of MCL is still evolving, it is critical that these patients are enrolled in clinical trials to identify the better treatment options.
Collapse
Affiliation(s)
| | - Maurilio Ponzoni
- Pathology Unit, San Raffaele Scientific Institute, Milan, Italy; Unit of Lymphoid Malignancies, San Raffaele Scientific Institute, Milan, Italy
| | - Andrés J M Ferreri
- Unit of Lymphoid Malignancies, San Raffaele Scientific Institute, Milan, Italy; Medical Oncology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Martin Dreyling
- Medizinische Klinik III der Universität München-Grosshadern, München, Germany
| |
Collapse
|
2
|
Pokorna Z, Jirkovsky E, Hlavackova M, Jansova H, Jirkovska A, Lencova-Popelova O, Brazdova P, Kubes J, Sotakova-Kasparova D, Mazurova Y, Adamcova M, Vostatkova L, Holzerova K, Kolar F, Simunek T, Sterba M. In vitro and in vivo investigation of cardiotoxicity associated with anticancer proteasome inhibitors and their combination with anthracycline. Clin Sci (Lond) 2019; 133:1827-44. [PMID: 31409729 DOI: 10.1042/CS20190139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 07/26/2019] [Accepted: 08/12/2019] [Indexed: 01/07/2023]
Abstract
Although proteasome inhibitors (PIs) are modern targeted anticancer drugs, they have been associated with a certain risk of cardiotoxicity and heart failure (HF). Recently, PIs have been combined with anthracyclines (ANTs) to further boost their anticancer efficacy. However, this raised concerns regarding cardiac safety, which were further supported by several in vitro studies on immature cardiomyocytes. In the present study, we investigated the toxicity of clinically used PIs alone (bortezomib (BTZ), carfilzomib (CFZ)) as well as their combinations with an ANT (daunorubicin (DAU)) in both neonatal and adult ventricular cardiomyocytes (NVCMs and AVCMs) and in a chronic rabbit model of DAU-induced HF. Using NVCMs, we found significant cytotoxicity of both PIs around their maximum plasma concentration (cmax) as well as significant augmentation of DAU cytotoxicity. In AVCMs, BTZ did not induce significant cytotoxicity in therapeutic concentrations, whereas the toxicity of CFZ was significant and more profound. Importantly, neither PI significantly augmented the cardiotoxicity of DAU despite even more profound proteasome-inhibitory activity in AVCMs compared with NVCMs. Furthermore, in young adult rabbits, no significant augmentation of chronic ANT cardiotoxicity was noted with respect to any functional, morphological, biochemical or molecular parameter under study, despite significant inhibition of myocardial proteasome activity. Our experimental data show that combination of PIs with ANTs is not accompanied by an exaggerated risk of cardiotoxicity and HF in young adult animal cardiomyocytes and hearts.
Collapse
|
3
|
Affiliation(s)
- Toru Motokura
- Division of Clinical Laboratory Medicine, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| |
Collapse
|
4
|
Ye H, Desai A, Zeng D, Romaguera J, Wang ML. Frontline Treatment for Older Patients with Mantle Cell Lymphoma. Oncologist 2018; 23:1337-1348. [PMID: 29895632 PMCID: PMC6291324 DOI: 10.1634/theoncologist.2017-0470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
The natural history of mantle cell lymphoma (MCL) undergoing chemotherapy is a cyclical pattern of remission followed by recurrence of disease due to acquired chemotherapy resistance. The median age of the occurrence of MCL is 65 years, so half of the newly diagnosed MCL patients are considered "elderly." The tolerance to long-term chemotherapy in elderly patients is decreased; hence, the response to frontline therapy used is of paramount importance. We hope that our review may guide clinicians in treating such populations in a more personalized and evidence-based manner.In the older patients with risk variables, frontline treatment is determined according to different body status of fit, unfit or compromised, and frail. In the fit patients, the pursuit of remission and prolongation of survival might currently justify the use of more intense and toxic therapies. For unfit or compromised older patients, disease control needs to be prioritized, maintaining a balance between the benefits and toxicities of the treatment. For frail patients, tolerance of treatment and minimizing myelotoxicity should be the primary focus. "Chemotherapy-free" regimens are likely to be considered as the first-line strategy for this population. On the other hand, in the older MCL population without risk variables, observation or "watch and wait" can prevent overtreatment. Furthermore, more clinical trials and research studies on novel agents and targeted therapies need to be translated into the general population to provide optimal treatment and to guide personalized treatment. IMPLICATIONS FOR PRACTICE: This review emphasizes the importance of frontline therapies for older MCL patients. MCL patients commonly experience a cyclical pattern of remission followed by recurrence of disease due to acquired chemotherapy resistance. As a special population, elderly patients have various comorbidities and decreased organ function, which may reduce the chances of undergoing treatment for recurrent disease. Thus, this older population of patients with MCL should be treated separately and exceptionally. So far, systematic reviews with regard to frontline treatment for older patients with MCL have not been encountered, but the hope is that this review may guide clinicians in treating such populations in a more personalized and evidence-based manner.
Collapse
Affiliation(s)
- Haige Ye
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aakash Desai
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- The University of Texas Health Science Center, Houston, Texas, USA
| | - Dongfeng Zeng
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jorge Romaguera
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael L Wang
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
5
|
Gressin R, Daguindau N, Tempescul A, Moreau A, Carras S, Tchernonog E, Schmitt A, Houot R, Dartigeas C, Pignon JM, Corm S, Banos A, Mounier C, Dupuis J, Macro M, Fleury J, Jardin F, Sarkozy C, Damaj G, Feugier P, Fornecker LM, Chabrot C, Dorvaux V, Bouadallah K, Amorin S, Garidi R, Voillat L, Joly B, Celigny PS, Morineau N, Moles MP, Zerazhi H, Fontan J, Arkam Y, Alexis M, Delwail V, Vilque JP, Ysebaert L, Le Gouill S, Callanan MB. A phase 2 study of rituximab, bendamustine, bortezomib and dexamethasone for first-line treatment of older patients with mantle cell lymphoma. Haematologica 2018; 104:138-146. [PMID: 30171024 PMCID: PMC6312036 DOI: 10.3324/haematol.2018.191429] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 08/23/2018] [Indexed: 01/30/2023] Open
Abstract
We present results of a prospective, multicenter, phase II study evaluating rituximab, bendamustine, bortezomib and dexamethasone as first-line treatment for patients with mantle cell lymphoma aged 65 years or older. A total of 74 patients were enrolled (median age, 73 years). Patients received a maximum of six cycles of treatment at 28-day intervals. The primary objective was to achieve an 18-month progression-free survival rate of 65% or higher. Secondary objectives were to evaluate toxicity and the prognostic impact of mantle cell lymphoma prognostic index, Ki67 expression, [18F]fluorodeoxyglucose-positron emission tomography and molecular minimal residual disease, in peripheral blood or bone marrow. With a median follow-up of 52 months, the 24-month progression-free survival rate was 70%, hence the primary objective was reached. After six cycles of treatment, 91% (54/59) of responding patients were analyzed for peripheral blood residual disease and 87% of these (47/54) were negative. Four-year overall survival rates of the patients who did not have or had detectable molecular residual disease in the blood at completion of treatment were 86.6% and 28.6%, respectively (P<0.0001). Neither the mantle cell lymphoma index, nor fluorodeoxyglucose-positron emission tomography nor Ki67 positivity (cut off of ≥30%) showed a prognostic impact for survival. Hematologic grade 3-4 toxicities were mainly neutropenia (51%), thrombocytopenia (35%) and lymphopenia (65%). Grade 3-4 non-hematologic toxicities were mainly fatigue (18.5%), neuropathy (15%) and infections. In conclusion, the tested treatment regimen is active as frontline therapy in older patients with mantle cell lymphoma, with manageable toxicity. Minimal residual disease status after induction could serve as an early predictor of survival in mantle cell lymphoma. ClinicalTrials.gov: NCT 01457144.
Collapse
Affiliation(s)
- Rémy Gressin
- Onco-Hematology Department, Grenoble University Hospital .,INSERM 1209, CNRS UMR 5309, Faculté de Médecine, Université Grenoble-Alpes, Institute for Advanced Biosciences, Grenoble
| | | | | | - Anne Moreau
- Pathology Department, Nantes University Hospital
| | - Sylvain Carras
- Onco-Hematology Department, Grenoble University Hospital
| | | | - Anna Schmitt
- Hematology Department, Cancer Institute Bergonie Bordeaux
| | - Roch Houot
- Hematology Department, Rennes University Hospital
| | | | | | - Selim Corm
- Hematology Department, Chambery Hospital
| | | | | | - Jehan Dupuis
- Lymphoid Malignancies Unit, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil
| | | | - Joel Fleury
- Hematology Department, Clermont-Ferrand Cancer Institute
| | | | - Clementine Sarkozy
- Hematology Department, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud. INSERM 1052
| | - Ghandi Damaj
- Hematology Department, Amiens University Hospital
| | | | | | - Cecile Chabrot
- Hematology Department, University Clermont-Ferrand Hospital
| | | | | | - Sandy Amorin
- Hematology Department, University Hospital Paris Saint-Louis
| | - Reda Garidi
- Hematology Department, Saint Quentin Hospital
| | | | | | | | | | | | | | - Jean Fontan
- Hematology Department, Besançon University Hospital
| | | | | | - Vincent Delwail
- Onco-Hematology Department, University Hospital Poitiers and INSERM, CIC 1402, Poitiers University
| | | | | | | | - Mary B Callanan
- INSERM 1209, CNRS UMR 5309, Faculté de Médecine, Université Grenoble-Alpes, Institute for Advanced Biosciences, Grenoble .,Unit for Innovation in Genetics and Epigenetics in Oncology, Dijon University Hospital, France
| | | |
Collapse
|
6
|
Pease DF, Morrison VA. Treatment of mantle cell lymphoma in older adults. J Geriatr Oncol 2018; 9:308-314. [DOI: 10.1016/j.jgo.2017.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/27/2017] [Accepted: 12/13/2017] [Indexed: 10/18/2022]
|
7
|
Affiliation(s)
- Pamela McKay
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Mike Leach
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Bob Jackson
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Stephen Robinson
- Department of Haematology, University Hospitals Bristol, Bristol, UK
| | - Simon Rule
- Department of Haematology, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| |
Collapse
|
8
|
Kluin-Nelemans JC, Doorduijn JK. What is the optimal initial management of the older MCL patient? Best Pract Res Clin Haematol 2017; 31:99-104. [PMID: 29452672 DOI: 10.1016/j.beha.2017.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/09/2017] [Indexed: 02/04/2023]
Abstract
The current first line treatment of a patient with mantle cell lymphoma (MCL) is often considered as too toxic for elderly patients. The elderly, however, comprise the majority of the patients with MCL. The results of several recent studies have shown that the outcome of this patient group is not as dismal as in the past. Indeed, if patients are not considered frail, and can tolerate rituximab and moderate intensive chemotherapy such as R-CHOP followed by rituximab maintenance or R-bendamustine, a 4-year overall survival of >80% can be achieved. In this chapter the developments of the regimens, resulting in the standard treatment options for these patients, are discussed.
Collapse
Affiliation(s)
- Johanna C Kluin-Nelemans
- Dept of Haematology, University Medical Centre Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
| | - Jeanette K Doorduijn
- Dept of Haematology, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| |
Collapse
|
9
|
Zhu R, Lu D, Chu YW, Chai A, Green M, Zhang N, Jin JY. Assessment of Correlation Between Early and Late Efficacy Endpoints to Identify Potential Surrogacy Relationships in Non-Hodgkin Lymphoma: a Literature-Based Meta-analysis of 108 Phase II and Phase III Studies. AAPS J 2017; 19:669-681. [DOI: 10.1208/s12248-017-0056-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/07/2017] [Indexed: 12/18/2022]
|
10
|
Maynadier M, Basile I, Gallud A, Gary-Bobo M, Garcia M. Combination treatment with proteasome inhibitors and antiestrogens has a synergistic effect mediated by p21WAF1 in estrogen receptor-positive breast cancer. Oncol Rep 2016; 36:1127-34. [PMID: 27373750 DOI: 10.3892/or.2016.4873] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 05/11/2015] [Indexed: 11/06/2022] Open
Abstract
Although antiestrogens significantly improve the survival of patients with ER-positive breast cancer, therapeutic resistance remains a major limitation. The combinatorial use of antiestrogen with other therapies was proposed to increase their efficiency and more importantly, to prevent or delay the resistance phenomenon. In the present study, we addressed their combined effects with proteasome inhibitors (PIs). The effects of antiestrogens (hydroxyl-tamoxifen, raloxifen and fulvestrant) currently used in endocrine therapy were tested in combination with PIs, bortezomib or MG132, on the growth of three ER-positive breast cancer cell lines and in two cellular models of acquired antiestrogen resistance. When compared to single treatments, these combined treatments were significantly more effective in preventing the growth of the cell lines. The regulation of key cell cycle proteins, the cyclin-dependent kinase inhibitors, p21WAF1 and p27KIP1, were also studied. Bortezomib and MG132 drastically increased p21WAF1 expression through elevation of its mRNA concentration. Notably, p27KIP1 regulation was quite different from that of p21WAF1. Furthermore, the effect of bortezomib in combination with antiestrogen was evaluated on antiestrogen-resistant cell lines. The growth of two antiestrogen-resistant cell lines appeared responsive to proteasome inhibition and was strongly decreased by a combined therapy with an antiestrogen. Collectively, these findings provide new perspectives for the use of PIs in combination with endocrine therapies for breast cancer and possibly to overcome acquired hormonal resistance.
Collapse
Affiliation(s)
- Marie Maynadier
- Institut des Biomolécules Max Mousseron (IBMM), CNRS, Université Montpellier, ENSCM, Faculté de Montpellier, 34093 Montpellier Cedex 5, France
| | - Ilaria Basile
- Institut des Biomolécules Max Mousseron (IBMM), CNRS, Université Montpellier, ENSCM, Faculté de Montpellier, 34093 Montpellier Cedex 5, France
| | - Audrey Gallud
- Institut des Biomolécules Max Mousseron (IBMM), CNRS, Université Montpellier, ENSCM, Faculté de Montpellier, 34093 Montpellier Cedex 5, France
| | - Magali Gary-Bobo
- Institut des Biomolécules Max Mousseron (IBMM), CNRS, Université Montpellier, ENSCM, Faculté de Montpellier, 34093 Montpellier Cedex 5, France
| | - Marcel Garcia
- Institut des Biomolécules Max Mousseron (IBMM), CNRS, Université Montpellier, ENSCM, Faculté de Montpellier, 34093 Montpellier Cedex 5, France
| |
Collapse
|
11
|
Abstract
Bortezomib is a first in class proteasome inhibitor, initially approved by the US Food and Drug Administration for the treatment of plasma cell myeloma. Bortezomib has been approved for the treatment of relapsed and refractory mantle cell lymphoma (MCL) and, more recently, in the upfront setting as well. Treatment algorithms for MCL have rapidly evolved over the past two decades, and the optimal regimen remains to be defined. The choice of treatment regimen is based on disease risk stratification models, the expected toxicity of antineoplastic agents, the perceived patient ability to tolerate the planned treatments and the availability of novel agents. As new drugs with novel mechanisms of action and variable toxicity profiles come into use, treatment decisions for a given patient have become increasingly complex. This article provides an overview of the evolving use of bortezomib in the rapidly changing management landscape of MCL.
Collapse
Affiliation(s)
- Bryan Hambley
- Department of Medicine, University Hospitals Case Medical Center, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Paolo F Caimi
- Department of Medicine, University Hospitals Case Medical Center, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Basem M William
- Department of Internal Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, A352 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA
| |
Collapse
|
12
|
Abstract
Bortezomib (Velcade(®)) is a proteasome inhibitor that is approved for the treatment of multiple myeloma and mantle cell lymphoma (MCL). This article reviews the efficacy and tolerability of bortezomib in combination with rituximab, cyclophosphamide, doxorubicin and prednisone (VR-CAP) in the treatment of previously untreated MCL unsuitable for stem-cell transplantation, and overviews the pharmacology of bortezomib. In the large, randomized, assessor-blinded, multinational LYM-3002 trial, induction therapy with VR-CAP improved progression-free survival significantly more than R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) after a median follow-up of 40 months in patients with newly diagnosed MCL ineligible or not considered for stem-cell transplantation. Complete response and certain other secondary endpoints were improved significantly more with VR-CAP than R-CHOP. Overall survival data were not mature at the time of assessment. The improved efficacy with VR-CAP was accompanied by an increased incidence of grade 3 or higher adverse events, particularly haematological adverse events.
Collapse
Affiliation(s)
- Paul L McCormack
- Springer, Private Bag 65901, Mairangi Bay 0754, Auckland, New Zealand,
| |
Collapse
|
13
|
Abstract
OPINION STATEMENT Mantle cell lymphoma is a distinct subtype of non-Hodgkin's lymphoma, which has historically been associated with a poor prognosis. It is now recognized as a heterogeneous disease with variable biologic and clinical behavior. Treatment paradigms have evolved along two lines. Younger, fit mantle cell lymphoma (MCL) patients are generally treated with intensive strategies and older less fit patients with non-intensive strategies. Most of the published literature has focused on intensive strategies, which appear to result in more durable remissions, but with an unclear impact on overall survival. The literature is more sparse for the roughly 50% of patients who are not candidates for intensive strategies, and no "standard" approach has been established for this patient population. However, clues are emerging. Randomized clinical trials have (a) established that bendamustine-rituximab (BR) is more efficacious and less toxic than rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP); (b) established that bortezomib should replace vincristine if using an R-CHOP backbone; and (c) established that maintenance rituximab (MR) is beneficial after an R-CHOP induction. In our opinion, it is reasonable to extrapolate the data supporting MR after R-CHOP and apply MR after a BR induction. In our practice, we recommend BR followed by MR for 2 years to MCL patients not eligible for intensive therapy. An ongoing US intergroup trial is testing the addition of bortezomib to the BR backbone and the addition of lenalidomide to MR. This trial may establish a standard of care in the older MCL population. In addition, exciting options for relapsed MCL have emerged in the last few years, with the introduction of the Bruton tyrosine kinase (BTK) inhibitor ibrutinib and the development of the lenalidomide-rituximab combination. In this article, we will discuss the current available options for these older MCL patients and the evidence supporting those options.
Collapse
|
14
|
Abstract
Mantle cell lymphoma (MCL) is an uncommon subtype of non-Hodgkin lymphoma previously considered to have a poor prognosis. Large gains were made in the first decade of the new century when clinical trials established the importance of high-dose therapy and autologous stem-cell rescue and high-dose cytarabine in younger patients and the benefits of maintenance rituximab and bendamustine in older patients. In particular, greater depth of understanding of the molecular pathophysiology of MCL has resulted in an explosion of specifically targeted new efficacious agents. In particular, agents recently approved by the Food and Drug Administration include the proteasome inhibitor bortezomib, immunomodulator lenalidomide, and Bruton's tyrosine kinase inhibitor ibrutinib. We review recent advances in the understanding of MCL biology and outline our recommended approach to therapy, including choice of chemoimmunotherapy, the role of stem-cell transplantation, and mechanism-based targeted therapies, on the basis of a synthesis of the data from published clinical trials.
Collapse
Affiliation(s)
- Chan Yoon Cheah
- Chan Yoon Cheah, Sir Charles Gairdner Hospital and PathWest Laboratory Medicine WA, Nedlands; Chan Yoon Cheah, University of Western Australia, Crawley, Western Australia; John F. Seymour, Peter MacCallum Cancer Centre, East Melbourne; John F. Seymour, University of Melbourne, Parkville, Victoria, Australia; and Chan Yoon Cheah and Michael L. Wang, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - John F Seymour
- Chan Yoon Cheah, Sir Charles Gairdner Hospital and PathWest Laboratory Medicine WA, Nedlands; Chan Yoon Cheah, University of Western Australia, Crawley, Western Australia; John F. Seymour, Peter MacCallum Cancer Centre, East Melbourne; John F. Seymour, University of Melbourne, Parkville, Victoria, Australia; and Chan Yoon Cheah and Michael L. Wang, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael L Wang
- Chan Yoon Cheah, Sir Charles Gairdner Hospital and PathWest Laboratory Medicine WA, Nedlands; Chan Yoon Cheah, University of Western Australia, Crawley, Western Australia; John F. Seymour, Peter MacCallum Cancer Centre, East Melbourne; John F. Seymour, University of Melbourne, Parkville, Victoria, Australia; and Chan Yoon Cheah and Michael L. Wang, The University of Texas MD Anderson Cancer Center, Houston, TX.
| |
Collapse
|
15
|
Abstract
Mantle cell lymphoma (MCL) is an incurable, typically aggressive subtype of non-Hodgkin lymphoma, accounting for 4%–7% of newly diagnosed non-Hodgkin lymphoma cases. Chemoresistance commonly ensues in MCL, and patients with this heterogeneous disease invariably relapse, underscoring the unmet need for better therapies. Over the past few years, several novel agents with promising activity and unique mechanisms of action have been deemed effective in MCL. Bortezomib is a reversible proteasome inhibitor, approved as a single agent for patients with relapsed/refractory MCL who have received at least one prior line of therapy. Addition of bortezomib to chemoimmunotherapies has demonstrated good tolerability and superior efficacy, both in the upfront and salvage settings, and recently one such combination of bortezomib plus rituximab, cyclophosphamide, doxorubicin, and prednisone was approved as a frontline regimen in untreated patients with MCL. This review examines the role of bortezomib in a multitude of clinical settings and ongoing clinical trials designed to optimize its integration in the current treatment paradigms of MCL.
Collapse
Affiliation(s)
- Nishanth Vallumsetla
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jonas Paludo
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prashant Kapoor
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
16
|
Abstract
Mantle cell lymphoma is molecularly characterized by the chromosomal translocation t(11;14) (q13;q32) that results in a constitutional overexpression of the cell cycle regulator protein cyclin D1. Generally, the disease is characterized by rapid relapses and poor long-term outcome. However, a subset of patients with indolent disease has been identified. Randomized trials have demonstrated the superiority of dose intensified, cytarabine-containing induction with or without autologous stem cell transplantation in younger patients. In elderly patients, a rituximab-based maintenance has significantly prolonged progression-free and overall survival after treatment with rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP). Unfortunately, the vast majority of patients will eventually relapse. Numerous molecular targeting strategies (bortezomib, lenalidomide, temsirolimus, and especially inhibitors of the B-cell receptor pathway) have achieved high response rates in phase II studies and should be strongly considered in relapsed disease.
Collapse
Affiliation(s)
- Martin Dreyling
- From the Department of Medicine III, University Hospital Großhadern/LMU München, Munich, Germany
| | | |
Collapse
|
17
|
Abstract
Mantle cell lymphoma (MCL) is a hematological malignancy with unfavorable prognosis. Bortezomib, a potent, selective and reversible inhibitor of the 26S proteasome, was shown to be active in MCL and is currently implemented in therapeutic combinations. Single-agent bortezomib has demonstrated clinical efficacy in relapsed and refractory MCL with objective response in up to 47% of the patients. However, complete remission rates are low and duration of response is relatively short. In previously untreated patients, the addition of bortezomib to induction chemotherapy is also promising. Further evaluation of bortezomib alone or in combination with other drugs for the treatment of MCL is warranted to improve the quality of life and survival of patients. This review explores bortezomib as therapy in patients with MCL.
Collapse
Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 93-510 Lodz, ul. Ciołkowskiego 2, Poland
| |
Collapse
|
18
|
Abstract
Mantle cell lymphoma (MCL) is a rare and aggressive form of non-Hodgkin's lymphoma that generally affects older individuals and continues to have one of the worst outcomes of all the lymphomas. Over the last decade, there has been a widespread adoption of cytarabine-based therapy in younger patients, and the incorporation of rituximab into chemotherapeutic regimens has become an evidence-based standard of care. However MCL remains a largely incurable disease, and following relapse, it can be a challenge to manage. Although it is possible to define prognosis reliably, there are, as yet, no clear diagnostic or response-adjusted parameters that can help to guide therapeutic decisions. However, there are a number of highly active targeted therapies that are moving into the clinic that are set to transform the therapeutic paradigm for this disease in the very near future. This review will explore the molecular pathogenesis of MCL and the current and evolving therapeutic strategies for this disease.
Collapse
|
19
|
Abstract
INTRODUCTION Bortezomib , the first proteasome inhibitor (PI) to be evaluated in humans, is approved in the USA and Europe for the treatment of patients with multiple myeloma, and in the USA for patients with relapsed mantle cell lymphoma (MCL). AREAS COVERED This review examines the role of bortezomib in the therapy of non-Hodgkin's lymphoma (NHL). Bortezomib may be particularly effective against the NF-κB-dependent activated B-cell subtype of diffuse large B-cell lymphoma. The combination of bortezomib with rituximab and dexamethasone represents a standard approach for the treatment of Waldenström's macroglobulinemia, and that with bendamustine and rituximab has demonstrated excellent efficacy in follicular lymphoma. Combinations with other novel agents, such as inhibitors of cyclin-dependent kinases or histone deacetylases, also hold substantial promise in NHL. Unmet needs in NHL, competitor compounds, chemistry, pharmacokinetics, pharmacodynamics and safety and tolerability of bortezomib are also discussed. EXPERT OPINION The success of bortezomib in MCL has validated the proteasome as a therapeutic target in NHL. Rational combinations, for example, with Bruton's tyrosine kinase inhibitors or BH3-mimetics, may hold the key to optimizing the therapeutic potential of PIs in NHL. Future trials are likely to involve newer agents with improved pharmacodynamic (e.g., carfilzomib, marizomib) or pharmacokinetic (e.g., ixazomib, oprozomib) properties.
Collapse
Affiliation(s)
- Prithviraj Bose
- Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA
| | - Michael S. Batalo
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA
| | - Beata Holkova
- Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA
| | - Steven Grant
- Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA
- Virginia Commonwealth University, Department of Internal Medicine, Richmond, VA, USA
- Virginia Commonwealth University, Department of Microbiology and Immunology, Richmond, VA, USA
- Virginia Commonwealth University, Department of Biochemistry and Molecular Biology, Richmond, VA, USA
- Virginia Commonwealth University, Department of Human and Molecular Genetics, Richmond, VA, USA
- Virginia Commonwealth University, Institute for Molecular Medicine, 401 College Street, P.O. Box 980035, Richmond, VA 23298, USA Tel: +1 804 828 5211
| |
Collapse
|
20
|
Steinritz D, Schmidt A, Simons T, Ibrahim M, Morguet C, Balszuweit F, Thiermann H, Kehe K, Bloch W, Bölck B. Chlorambucil (nitrogen mustard) induced impairment of early vascular endothelial cell migration – Effects of α-linolenic acid and N-acetylcysteine. Chem Biol Interact 2014; 219:143-50. [DOI: 10.1016/j.cbi.2014.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/16/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
|
21
|
Abstract
Mantle cell lymphoma is a distinct subtype of B-cell non-Hodgkin lymphoma, accounting for 3-10 % of all non-Hodgkin lymphoma cases. The median age at diagnosis is nearly 70 years. The prognosis of patients is based on the Mantle Cell Lymphoma International Prognostic Index, which is calculated on the basis of four independent prognostic factors (age, performance status, serum lactate dehydrogenase and leukocyte count). Treatment of elderly patients with de novo untreated mantle cell lymphoma is based on rituximab combined with chemotherapy. The most commonly used regimen is the classical CHOP21 (cyclophosphamide, doxorubicin, vincristine and prednisone) regimen. Bendamustine is also an option, especially for patients with cardiac comorbidities. In elderly patients who are relatively young and fit, an approach based on treatment usually used for younger patients, with cytarabine-based induction followed by autologous stem cell transplantation, should be discussed. Treatment of relapsing patients is based on the use of newer effective drugs, including bortezomib, lenalidomide and thalidomide, and mammalian target of rapamycin (mTOR) inhibitors, such as temsirolimus. These drugs are often combined with rituximab and can be prescribed in combination with chemotherapy. Promising new drugs are Bruton tyrosine kinase inhibitors and other inhibitors of the phosphoinositide 3-kinase (PI3K)-mTOR-protein kinase B (AKT) pathway. Despite these new advances, mantle cell lymphoma remains an incurable disease, and further basic and clinical research is warranted.
Collapse
|
22
|
Dreyling M, Ferrero S, Hermine O. How to manage mantle cell lymphoma. Leukemia 2014; 28:2117-30. [DOI: 10.1038/leu.2014.171] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/28/2014] [Accepted: 05/19/2014] [Indexed: 12/30/2022]
|
23
|
Chang JE, Li H, Smith MR, Gascoyne RD, Paietta EM, Yang DT, Advani RH, Horning SJ, Kahl BS. Phase 2 study of VcR-CVAD with maintenance rituximab for untreated mantle cell lymphoma: an Eastern Cooperative Oncology Group study (E1405). Blood 2014; 123:1665-73. [PMID: 24458437 PMCID: PMC3954048 DOI: 10.1182/blood-2013-08-523845] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 01/17/2014] [Indexed: 11/20/2022] Open
Abstract
Rituximab, bortezomib, modified hyper-cyclophosphamide, doxorubicin, vincristine, dexamethasone (VcR-CVAD) induction chemoimmunotherapy and maintenance rituximab (MR) were evaluated for efficacy and safety in Eastern Cooperative Oncology Group protocol E1405. Patients with previously untreated mantle cell lymphoma received VcR-CVAD chemotherapy every 21 days for 6 cycles, followed by MR for 2 years. Transplant-eligible patients had the option of autologous stem cell transplantation (ASCT) consolidation instead of MR. The primary end point was the complete response (CR) rate to VcR-CVAD. The secondary end points were overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and toxicities. Seventy-five eligible patients with a median age of 62 (range 40-76) were enrolled. The ORR was 95% and a CR was achieved in 68% of patients. After a median follow-up of 4.5 years, 3-year PFS and OS were 72% and 88%, respectively. No substantial difference in PFS or OS was observed between patients treated with MR (n = 44) vs ASCT (n = 22). There were no unexpected toxicities. VcR-CVAD produced high ORR and CR rates in mantle cell lymphoma. MR after VcR-CVAD induction performed similarly to ASCT and may improve response duration. Randomized clinical trials comparing MR against ASCT should be considered and randomized clinical trials evaluating bortezomib's contribution to conventional therapy are under way. This study was registered at www.clinicaltrials.gov as #NCT00433537.
Collapse
|
24
|
Abstract
The identification of the ubiquitin–proteasome system as a new therapeutic target has been one of the most recent successes in cancer treatment. The development and clinical approval of the first-in-class proteasome inhibitor, bortezomib has revolutionized the treatment of multiple myeloma (MM) and mantle cell lymphoma (MCL). In MM, bortezomib is now integrated in induction, conditioning, consolidation, maintenance, and salvage treatment protocols. Bortezomib-based regimens provide high remission rates and confer significant survival advantage compared to conventional chemotherapy in both the bone marrow transplant and non-transplant setting. In MCL, overall response rates in patients who have received at least one prior therapy range from 30 to 45%, even in chemotherapy resistant patients. Clinical trials to further improve the sequencing of bortezomib-containing combination therapies are ongoing. Until recently, intravenous injection was the standard route of bortezomib administration. However, severe adverse side effects, peripheral neuropathy in particular, were observed in up to 16% of MM patients and up to 54% of MCL patients treated with intravenous bortezomib, with grade 3 and 4 in 11 and 12% of patients, respectively. Moreover, complete remission rates, if at all, are low and duration of response is short both in MM and MCL. These limitations may be overcome by changing the method of bortezomib administration as well as by rationally combining bortezomib with other therapeutic agents. Indeed, recent data demonstrate that subcutaneous bortezomib administration is non-inferior to intravenous administration, with an improved systemic safety profile, good local tolerance, and a more convenient route of administration. Based on these data, subcutaneous bortezomib injection was approved as a supplemental new drug application for all approved indications in MM and MCL after at least one prior therapy. More than 30 clinical trials in MM and MCL are currently ongoing to evaluate the efficacy and safety profile of subcutaneous bortezomib also in induction, maintenance, and salvage therapy.
Collapse
Affiliation(s)
- Klaus Podar
- Medical Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| |
Collapse
|
25
|
Xiao Y, Yin J, Wei J, Shang Z. Incidence and risk of cardiotoxicity associated with bortezomib in the treatment of cancer: a systematic review and meta-analysis. PLoS One 2014; 9:e87671. [PMID: 24489948 PMCID: PMC3906186 DOI: 10.1371/journal.pone.0087671] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 12/29/2013] [Indexed: 01/30/2023] Open
Abstract
Background We conducted a systematic review and meta-analysis to clarify the incidence and risk of cardiotoxicity associated with bortezomib in cancer patients. Methods Databases from PubMed, Web of Science and abstracts presented at ASCO meeting up to July 31, 2013 were searched to identify relevant studies. Eligible studies included prospective phase II and III trials evaluating bortezomib in cancer patients with adequate data on cardiotoxicity. Statistical analyses were conducted to calculate the summary incidence, odds ratio (OR) and 95% confidence intervals (CIs) by using either random effects or fixed effect models according to the heterogeneity of included studies. Results A total of 5718 patients with a variety of malignancies from 25 clinical trials were included in our analysis. The incidence of all-grade and high-grade cardiotoxicity associated with bortezomib was 3.8% (95%CI: 2.6–5.6%) and 2.3% (1.6–3.5%), with a mortality of 3.0% (1.4–6.5%). Patients treated with bortezomib did not significantly increase the risk of all-grade (OR 1.15, 95%CI: 0.82–1.62, p = 0.41) and high-grade (OR 1.13, 95%CI: 0.58–2.24, p = 0.72) cardiotoxicity compared with patients treated with control medication. Sub-group analysis showed that the incidence of cardiotoxicity varied with tumor types, treatment regimens and phases of trials. No evidence of publication bias was observed. Conclusions The use of bortezomib does not significantly increase the risk of cardiotoxicity compared to control patients. Further studies are recommended to investigate this association and risk differences among different tumor types, treatment regimens and phases of trials.
Collapse
Affiliation(s)
- Yi Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail:
| | - Jin Yin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jia Wei
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Shang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
26
|
Goy A. Mantle cell lymphoma: continuously improving the odds! Expert Opin Orphan Drugs 2013. [DOI: 10.1517/21678707.2013.854700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
27
|
|
28
|
Xia M, Huang R, Sakamuru S, Alcorta D, Cho MH, Lee DH, Park DM, Kelley MJ, Sommer J, Austin CP. Identification of repurposed small molecule drugs for chordoma therapy. Cancer Biol Ther 2013; 14:638-47. [PMID: 23792643 PMCID: PMC3742493 DOI: 10.4161/cbt.24596] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Chordoma is a rare, slow growing malignant tumor arising from remnants of the fetal notochord. Surgery is the first choice for chordoma treatment, followed by radiotherapy, although postoperative complications remain significant. Recurrence of the disease occurs frequently due to the anatomy of the tumor location and violation of the tumor margins at the initial surgery. Currently, there are no effective drugs available for patients with chordoma. Due to the rarity of the disease, there is limited opportunity to test agents in clinical trials and no concerted effort to develop agents for chordoma in the pharmaceutical industry. To rapidly and efficiently identify small molecules that inhibit chordoma cell growth, we screened the NCGC Pharmaceutical Collection (NPC) containing approximately 2800 clinically approved and investigational drugs at 15 different concentrations in chordoma cell lines, U-CH1 and U-CH2. We identified a group of drugs including bortezomib, 17-AAG, digitoxin, staurosporine, digoxin, rubitecan, and trimetrexate that inhibited chordoma cell growth, with potencies from 10 to 370 nM in U-CH1 cells, but less potently in U-CH2 cells. Most of these drugs also induced caspase 3/7 activity with a similar rank order as the cytotoxic effect on U-CH1 cells. Cantharidin, digoxin, digitoxin, staurosporine, and bortezomib showed similar inhibitory effect on cell lines and 3 primary chordoma cell cultures. The combination treatment of bortezomib with topoisomerase I and II inhibitors increased the therapeutic potency in U-CH2 and patient-derived primary cultures. Our results provide information useful for repurposing currently approved drugs for chordoma and potential approach of combination therapy.
Collapse
Affiliation(s)
- Menghang Xia
- NIH Chemical Genomics Center, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Visco C, Finotto S, Zambello R, Paolini R, Menin A, Zanotti R, Zaja F, Semenzato G, Pizzolo G, D'Amore ES, Rodeghiero F. Combination of Rituximab, Bendamustine, and Cytarabine for Patients With Mantle-Cell Non-Hodgkin Lymphoma Ineligible for Intensive Regimens or Autologous Transplantation. J Clin Oncol 2013; 31:1442-9. [DOI: 10.1200/jco.2012.45.9842] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The combination of bendamustine (B) and rituximab (R) is efficacious, with favorable toxicity in mantle-cell lymphoma (MCL). In this phase II study, we combined cytarabine with R and B (R-BAC) in patients with MCL age ≥ 65 years who were previously untreated or relapsed or refractory (R/R) after one prior immunochemotherapy treatment. Patients and Methods In stage one, we established the maximum-tolerated dose (MTD) of cytarabine in R-BAC. In stage two, patients received R (375 mg/m2 intravenously [IV] on day 1), B (70 mg/m2 IV on days 2 and 3), and cytarabine (MTD IV on days 2 to 4) every 28 days for four to six cycles. The primary end point (overall response rate [ORR]) was evaluated by positron emission tomography. Secondary end points included safety, progression-free survival (PFS), response duration, and overall survival. Results Forty patients (median age, 70 years; 20 previously untreated patients) were enrolled; 93% had Ann Arbor stage III/IV disease; 49% had high Mantle Cell International Prognostic Index scores, with 15% blastoid histology. All R/R patients (35% refractory) had previously received R-containing regimens. The cytarabine MTD used in stage two was 800 mg/m2, and R-BAC was well tolerated, with an 85% treatment completion rate. The major toxicity was transient grades 3 to 4 thrombocytopenia (87% of patients); febrile neutropenia occurred in 12%. The ORR was 100% (95% complete response [CR]) for previously untreated and 80% (70% CR) for R/R patients. The 2-year PFS rate (± standard deviation) was 95% ± 5% for untreated and 70% ± 10% for R/R patients. Conclusion R-BAC is well tolerated and active against MCL.
Collapse
Affiliation(s)
- Carlo Visco
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Silvia Finotto
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Renato Zambello
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Rossella Paolini
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Andrea Menin
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Roberta Zanotti
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Francesco Zaja
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Gianpietro Semenzato
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Giovanni Pizzolo
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Emanuele S.G. D'Amore
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| | - Francesco Rodeghiero
- Carlo Visco, Silvia Finotto, Andrea Menin, Emanuele S.G. D'Amore, and Francesco Rodeghiero, San Bortolo Hospital, Vicenza; Renato Zambello and Gianpietro Semenzato, Padua University School of Medicine, Padova; Rossella Paolini, Santa Maria della Misericordia Hospital, Rovigo; Roberta Zanotti and Giovanni Pizzolo, University of Verona, Verona; and Francesco Zaja, Azienda Ospedaliera Universitaria Santa Maria Misericordia, Udine, Italy
| |
Collapse
|
30
|
Boukhiar MA, Roger C, Tran J, Gressin R, Martin A, Ajchenbaum-Cymbalista F, Varin-Blank N, Ledoux D, Baran-Marszak F. Targeting early B-cell receptor signaling induces apoptosis in leukemic mantle cell lymphoma. Exp Hematol Oncol 2013; 2:4. [PMID: 23422267 PMCID: PMC3585857 DOI: 10.1186/2162-3619-2-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 02/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We previously showed that B-cell receptor (BCR) signaling pathways are important for in vitro survival of mantle cell lymphoma (MCL) cells. To further identify early BCR-activated signaling pathways involved in MCL cell survival, we focused our study on BCR-proximal kinases such as LYN whose dysregulations could contribute to the aggressive course of MCL. METHODS Primary MCL cells were isolated from 14 leukemic patients. Early BCR-induced genes were identified by qRT-PCR array. The basal and BCR-induced phosphorylation of LYN and JNK were evaluated by immunoblottting. Cell survival signals were evaluated by apoptosis using flow cytometry. RESULTS We showed that LYN was constitutively phosphorylated in MCL cell lines and in 9/10 leukemic MCL cases. Treatment with dasatinib or with a specific inhibitor of Src kinases such as PP2 suppressed constitutive LYN activation and increased in vitro spontaneous apoptosis of primary MCL cells. BCR engagement resulted in an increase of LYN phosphorylation leading to activation of c-JUN NH2-terminal kinase (JNK) and over-expression of the early growth response gene-1 (EGR-1). Inhibition of JNK with SP600125 induced apoptosis and reduced level of basal and BCR-induced expression of EGR-1. Furthermore, decreasing EGR1 expression by siRNA reduced BCR-induced cell survival. Treatment with PP2 or with dasatinib suppressed BCR-induced LYN and JNK phosphorylation as well as EGR-1 upregulation and is associated with a decrease of cell survival in all cases analysed. CONCLUSIONS This study highlights the importance of BCR signaling in MCL cell survival and points out to the efficiency of kinase inhibitors in suppressing proximal BCR signaling events and in inducing apoptosis.
Collapse
Affiliation(s)
- Mohand-Akli Boukhiar
- INSERM, UMR U978, Adaptateur de Signalisation en Hématologie, F-93000, Bobigny, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Li ZM, Zucca E, Ghielmini M. Open questions in the management of mantle cell lymphoma. Cancer Treat Rev 2013; 39:602-9. [PMID: 23415066 DOI: 10.1016/j.ctrv.2012.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 12/28/2012] [Accepted: 12/31/2012] [Indexed: 11/25/2022]
Abstract
Mantle cell lymphoma (MCL) is one of the lymphomas with the worse prognosis (median survival 3-5years) as it has an aggressive evolution and at the same time is incurable. Biologically it is characterized by the t(11;14)(q13;q32) translocation leading to overexpression of cyclin D1. This review focuses on a number of controversial issues in the management of this disease, as how to stage patients with a disease which often has extranodal localizations, how to recognize the small subgroup of cases with an indolent course, which treatment is suggested for the young and fit or for the elderly, the role of CNS prophylaxis, rituximab maintenance and radiotherapy, the indications to allogeneic transplantation and the place of new active anti-lymphoma drugs.
Collapse
Affiliation(s)
- Zhi-Ming Li
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | | | | |
Collapse
|
32
|
Gimenez E, Chauvet M, Rabin L, Puteaud I, Duley S, Hamaidia S, Bruder J, Rolland-Neyret V, Le Gouill S, Tournilhac O, Voog E, Maisonneuve H, Jacob MC, Leroux D, Béné MC, Formisano-Tréziny C, Gabert J, Gressin R, Callanan MB. Cloned IGH VDJ
targets as tools for personalized minimal residual disease monitoring in mature lymphoid malignancies; a feasibility study in mantle cell lymphoma by the Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang. Br J Haematol 2012; 158:186-197. [DOI: 10.1111/j.1365-2141.2012.09161.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 03/14/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Estelle Gimenez
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Martine Chauvet
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Laetitia Rabin
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Isabelle Puteaud
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Samuel Duley
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
| | - Sieme Hamaidia
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Pôle recherche; CHU de Grenoble; Grenoble France
| | - Juliana Bruder
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
| | - Valérie Rolland-Neyret
- Pôle recherche; CHU de Grenoble; Grenoble France
- Pôle de Cancérologie et d'Hématologie; CHU de Grenoble; Grenoble France
| | | | - Olivier Tournilhac
- Hématologie; Hôtel Dieu; CHU de Clermont Ferrand, Boulevard Leon Malfreyt; Clermont Ferrand France
| | - Eric Voog
- Service d'Hématologie; Clinique Victor Hugo, 1 rue Victor Hugo; Le Mans France
| | | | - Marie C. Jacob
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Laboratoire d'immunologie cellulaire; CHU de Grenoble; Grenoble France
| | - Dominique Leroux
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Marie C. Béné
- Immunologie; CHU de Nancy & Nancy Université; Vandoeuvre les Nancy France
| | | | - Jean Gabert
- Faculté de Médecine; Université de la Méditerranée; Marseille France
- Laboratoire de Biologie Moléculaire, Hôpital Nord; Marseille France
| | - Rémy Gressin
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Pôle de Cancérologie et d'Hématologie; CHU de Grenoble; Grenoble France
| | - Mary B. Callanan
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| |
Collapse
|