1
|
Canaud G, Lopez Gutierrez JC, Irvine AD, Vabres P, Hansford JR, Ankrah N, Branle F, Papadimitriou A, Ridolfi A, O'Connell P, Turner S, Adams DM. Alpelisib for treatment of patients with PIK3CA-related overgrowth spectrum (PROS). Genet Med 2023; 25:100969. [PMID: 37634128 DOI: 10.1016/j.gim.2023.100969] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE PIK3CA-related overgrowth spectrum (PROS) encompasses several rare conditions resulting from activating variants in PIK3CA. Alpelisib, a PI3Kα-selective inhibitor, targets the underlying etiology of PROS, offering a novel therapeutic approach to current management strategies. This study evaluated the safety and efficacy of alpelisib in pediatric and adult patients with PROS. METHODS EPIK-P1 (NCT04285723) was a non-interventional, retrospective chart review of 57 patients with PROS (≥2 years) treated with alpelisib through compassionate use. Patients had severe/life-threatening PROS-related conditions and confirmed PIK3CA pathogenic variant. The primary end point assessed patient response to treatment at Week 24 (6 months). RESULTS Twenty-four weeks (6 months) after treatment initiation, 12 of 32 (37.5%) patients with complete case records included in the analysis of the primary end point experienced a ≥20% reduction in target lesion(s) volume. Additional clinical benefit independent from lesion volume reduction was observed across the full study population. Adverse events (AEs) and treatment-related AEs were experienced by 82.5% (47/57) and 38.6% (22/57) of patients, respectively; the most common treatment-related AEs were hyperglycemia (12.3%) and aphthous ulcer (10.5%). No deaths occurred. CONCLUSION EPIK-P1 provides real-world evidence of alpelisib effectiveness and safety in patients with PROS and confirms PI3Kα as a valid therapeutic target for PROS symptom management.
Collapse
Affiliation(s)
- Guillaume Canaud
- Translational Research Unit, Hôpital Necker Enfants Malades, Université Paris Cité, INSERM U1151, Paris, France.
| | | | - Alan D Irvine
- Clinical Medicine, Trinity College Dublin and Children's Health Ireland, Dublin, Ireland
| | - Pierre Vabres
- Reference Center for Rare Genetic Skin Diseases (MAGEC)-Mosaic, Department of Pediatrics, University Hospital Dijon-Bourgogne, and INSERM UMR1231, Genetics of Development Anomalies, Bourgogne-Franche-Comté University, Dijon, France
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital; Murdoch Children's Research Institute; Department of Pediatrics, University of Melbourne; Melbourne, Australia; Michael Rice Cancer Centre, South Australia Health and Medical Research Institute, South Australia ImmunoGENomics Cancer Institute, Adelaide, Australia
| | - Nii Ankrah
- Global Medical Affairs, Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Fabrice Branle
- Clinical Development, Novartis Pharma AG, Basel, Switzerland
| | | | - Antonia Ridolfi
- Global Medical Affairs Biostatistics, Novartis Pharma S.A.S., Rueil-Malmaison, France
| | | | - Stuart Turner
- Global Real World Evidence and Data Science, Novartis Pharmaceuticals Corporation, East Hanover, NJ
| | - Denise M Adams
- Division of Oncology, Comprehensive Vascular Anomalies Program, Children's Hospital of Philadelphia, Philadelphia, PA
| |
Collapse
|
2
|
Le MN, Wuertz BR, Biel MA, Thompson RL, Ondrey FG. Effects of methylene blue photodynamic therapy on oral carcinoma and leukoplakia cells. Laryngoscope Investig Otolaryngol 2022; 7:982-987. [PMID: 36000031 PMCID: PMC9392394 DOI: 10.1002/lio2.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/31/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Methylene blue (MB) is a readily available and affordable substrate that can be used as a photosensitizer for photodynamic therapy (PDT). The objective of this study was to determine if PDT with MB can downregulate matrix metalloproteinases (MMPs) related to oral carcinoma. Methods Cell cultures of oral squamous cell carcinoma (CA‐9‐22), oral leukoplakia (MSK‐Leuk1), and immortalized keratinocytes (Rhek‐1A) were photosensitized with MB and treated with PDT. MMP‐9 gene expression was interrogated via qRT‐PCR. The 3‐(4,5‐dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide (MTT) assay was used to confirm the efficacy of MB PDT. Results MMP‐9 gene expression was found to be significantly decreased in oral carcinoma, leukoplakia, and immortalized keratinocytes with use of MB PDT. Conclusion This work demonstrates that MB‐mediated PDT can downregulate MMPs which are critical to the invasion and metastasis of oral cancer. These results suggest that MB PDT could be a clinically significant and cost‐effective treatment for oral leukoplakia and carcinoma. Level of Evidence NA
Collapse
Affiliation(s)
- Mina N. Le
- Department of Otolaryngology – Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Beverly R. Wuertz
- Department of Otolaryngology – Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Merrill A. Biel
- Department of Otolaryngology – Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Rachel L. Thompson
- Department of Otolaryngology – Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Frank G. Ondrey
- Department of Otolaryngology – Head and Neck Surgery University of Minnesota Minneapolis Minnesota USA
| |
Collapse
|
3
|
Rinaldi G, Creissen A, Mahon C, Syed SB. Triple pass laser therapy for recalcitrant facial port wine stains. Lasers Med Sci 2021; 37:1643-1650. [PMID: 34536181 DOI: 10.1007/s10103-021-03414-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/05/2021] [Indexed: 12/01/2022]
Abstract
Patients with recalcitrant facial port wine stains (rfPWS) can be challenging to manage, often leaving the clinician with difficult decisions for treatment options. 'Triple therapy' consists of using three different laser wavelengths at each treatment setting. The evidence on outcomes is limited as this treatment approach has not been previously reported to the best of our knowledge. Children who received triple therapy at least once for rfPWS, and for whom SIAscopy readings had been taken, were retrospectively identified. SIAscope readings were compared before the first triple therapy treatment and at final the most recent clinical follow-up. The clinical appearance was also assessed using a Visual Analogue Scale comparing clinical photographs taken before triple therapy to those taken at the most recent clinical follow-up. A total of 47 children were identified and included in our review. The SIAscope readings showed an overall significant (p < 0.001) lightening with 39 (83%) showing lightening and 8 (17%) patients showing a darkening. Scores using the VAS also showed improvement with 55% experiencing an improvement in their clinical appearance, 38% showing no visible change and 6% appearing to have worsened. Triple therapy can offer improvement of rfPWS which have failed to respond to single wavelength laser therapy. SIAscopy and VAS scores correlate well in assessing clinical response; however, the added clinical benefit of SIAscopy in vascular laser clinics remains uncertain.
Collapse
Affiliation(s)
- Giulia Rinaldi
- Department of Medicine, Guy's and St Thomas' Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH, UK.
| | | | - Caroline Mahon
- Christchurch Hospital, Christchurch, Canterbury, New Zealand
| | | |
Collapse
|