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Banerji U, Ingles Garces AH, Michalarea V, Ruddle R, Raynaud FI, Riisnaes R, Nava Rodrigues D, Tunariu N, Porter JC, Ward SE, Parmar M, Turner AJ, Seeramreddi S, Hall E, Dean EJ, Basu B, George A, Kaye SB, Banerjee SN, De Bono JS. An investigator-initiated phase I study of ONX-0801, a first-in-class alpha folate receptor targeted, small molecule thymidylate synthase inhibitor in solid tumors. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.2503] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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
2503 Background: ONX-0801 is a first-in-class alpha folate receptor (AFR) targeted thymidylate synthase inhibitor, engineered to differentially accumulate 6000-fold in AFR overexpressing cancer cells. Methods: A 3+3 dose escalation design was used and two IV schedules were explored. Schedule A, weekly dosing (QW) and schedule B, once every 2 weeks dosing (Q2W). A cycle consisted of 4 weeks and treatment was stopped after 6 cycles in both schedules. An expansion cohort to evaluate clinical activity in patients with AFR overexpressing high grade serous ovarian cancer (HGSOC) was planned. Results: 21 patients each were treated in schedule A and B exploring doses ranging from 1-6 mg/m2 and 2-12 mg/m2, respectively. The dose limiting toxicity on schedule A was G3 cellulitis; no dose limiting toxicity was seen on schedule B. The most common toxicities were fatigue 15/42 (36%), nausea 9/42 (21%) and dysgeusia 5/42 (12%). Within schedule A at 4 mg/m2, 2 patients developed suspected drug-related changes on pulmonary function tests (drop in Dlco > 15%) at cycles 5 and 6, respectively. No cases of suspected drug-related drop in Dlco were noted in patients treated in schedule B. No grade 3-4 diarrhea, mucositis or neutropenia were seen in either cohort. The Cmax, AUC and half-life at 12 mg/m2 were 4952 ng/mL, 85170 h*ng/mL and 26 h, respectively. Pre-clinical PK-PD modelling aimed to achieve concentrations between 0.05-1 µM and this was achieved for periods of 48 h at doses of 4 mg/m2and above. Based on safety and PK, the recommended phase II dose (RP2D) of ONX-0801 was 12 mg/m2 Q2W and an expansion in patients with HGSOC is ongoing. 5 patients with HGSOC had partial responses (PRs) in the dose escalation cohort. In the current expansion cohort in patients with HGSOC, 5/11 patients had PRs. Archival samples have been analyzed from 8/11 patients in the expansion cohort. 4/4 AFR+ve and 4/4 AFR-ve patients did and did not have a PR following treatment with ONX-0801, respectively. Conclusions: The RP2D of ONX-0801 is 12 mg/m2 Q2W. At the RP2D, multiple patients with AFR overexpressing HGSOC have had PRs and further randomized biomarker prespecified phase II trials are warranted. Clinical trial information: NCT02360345.
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Affiliation(s)
- Udai Banerji
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | | | - Vasiliki Michalarea
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Ruth Ruddle
- The Institute of Cancer Research, London, United Kingdom
| | - Florence I. Raynaud
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Ruth Riisnaes
- The Institute of Cancer Research, London, United Kingdom
| | - Daniel Nava Rodrigues
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Nina Tunariu
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Joanna C Porter
- University College London and University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sarah Emily Ward
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Mona Parmar
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Alison Joanne Turner
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | | | - Emma Hall
- The Institute of Cancer Research, London, United Kingdom
| | - Emma Jane Dean
- The Christie NHS Foundation Trust and The University of Manchester, Manchester, United Kingdom
| | - Bristi Basu
- University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Angela George
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Stan B Kaye
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Susana N. Banerjee
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
| | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
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Hansen AR, Shapiro G, Do KT, Kumar R, Martin-Liberal J, Higano CS, Wisinski KB, Dean EJ, Heath EI, Rathkopf DE, Linch MD, Barry ST, Brugger W, De Bruin E, Colebrook S, Klinowska T, Mitchell PD, Moorthy G, De Bono JS, Siu LL. A first in human phase I study of AZD8186, a potent and selective inhibitor of PI3K in patients with advanced solid tumours as monotherapy and in combination with the dual mTORC1/2 inhibitor vistusertib (AZD2014) or abiraterone acetate. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.2570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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
2570 Background: Loss of PTEN function leads to increased PI3Kβ signalling. AZD8186 (AZD) exhibits significant anti-tumour activity in PTEN-deficient preclinical models, particularly when combined with anti-androgens or the dual mTORC1/2 inhibitor vistusertib (AZD2014). Here we report on the dose-finding part of this Phase 1 study. Methods: AZD single agent was administered twice daily (BD) in 3 different schedules (5 days on/ 2 days off, 2 days on/ 5 days off and continuous). Escalating doses of AZD were evaluated in cohorts of 3-6 patients treated until progression, unacceptable toxicity, or consent withdrawal. Accrual is ongoing in the combination arms with vistusertib or abiraterone acetate. Results: As of 16 Jan 2017, 87 patients have received AZD at doses of 30–360 mg BD, with 28 confirmed as PTEN deficient (IHC). The selected RP2D for the 5 days on/2 days off monotherapy schedule is 60 mg BD. PK parameters show that systemic exposures to AZD and its major active metabolite increase in a dose proportional manner. 69 serious adverse events (SAEs) were reported in 31 patients on AZD monotherapy with 23 SAEs considered possibly related to AZD. In the 5/2 schedule: 5 dose limiting toxicities (G3 rash with ≥G2 fever and/or chills) were observed in 5 patients at doses of 120-360mg. Adverse events ≥G1 in > 20% included diarrhoea, nausea, fatigue, LFT elevations and decreased appetite. 20 patients remained on study for > 100 days. Dose-dependent target inhibition has been demonstrated in surrogate tissue (platelets). Evaluation of direct tumour target engagement in paired biopsies is currently ongoing. Preliminary efficacy: Confirmed PRs seen in a CRPC patient (BRCA2 and androgen receptor mutant) treated in combination with vistusertib (on study for 411 days) and in one ongoing monotherapy PTEN-deficient colorectal cancer patient (on study > 329 days). Updated data will be presented. Conclusions: AZD has potential for treatment of PTEN-deficient tumours. Investigation of the safety/tolerability and preliminary efficacy in combination with vistusertib or abiraterone acetate is continuing. Clinical trial information: NCT01884285.
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Affiliation(s)
| | | | - Khanh T Do
- Dana-Farber Cancer Institute, Boston, MA
| | - Rajiv Kumar
- Royal Marsden Hospital, Surrey, United Kingdom
| | - Juan Martin-Liberal
- Medical Oncology Department, Vall d'Hebron University Hospital, Molecular Therapeutics Research Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | | | - Emma Jane Dean
- University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Elisabeth I. Heath
- Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | | | | | | | | | | | | | | | | | | | - Johann S. De Bono
- The Institute of Cancer Research and The Royal Marsden Hospital, London, United Kingdom
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3
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Potts SJ, Dean EJ, Polikoff J, Pacey S, Chiorean EG, Chee CE, Sigal D, Aslam M, Pauwels P, Christiansen JH, Multani PS, Lamoureux J, Murphy D. Detecting NTRK, ROS1, and ALK gene fusions in gastrointestinal tumor patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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
619 Background: The STARTRK-2 trial is a potentially registration-enabling Phase 2 global basket trial of the tyrosine kinase inhibitor entrectinib in patients with solid tumors harboring NTRK1, NTRK2, NTRK3, ROS1, or ALK gene fusions. Phase 1 studies of entrectinib reported a 79% ORR across multiple histologies in patients with gene fusions of these targets who were naïve to inhibitors of these targets, received an effective dose, and had extracranial disease. Patients harboring these fusions are typically rare in the cancer population ( < 3%); however, they have been seen across a wide variety of GI tumors. In this presentation we report on the occurrence of these fusions in GI tumors, based on Ignyta’s internal and partner testing. We discuss the development of an assay for GI samples and immunohistochemistry (IHC) screening efficiency rates in a clinical cohort of 157 GI samples. Methods: The occurrence of NTRK, ROS1, and ALK gene fusions in GI tumors was studied from Ignyta internal and partner collaborations. We developed a 2-step diagnostic test to identify fusions in FFPE clinical specimens. IHC screening using a pan-receptor tyrosine kinase cocktail of antibodies precedes an RNA-based anchored multiplex PCR next generation sequencing (NGS) assay. Results: IHC positivity rates ranged from 0 to 24 percent depending on histology and averaging 8% positivity rate across 15 tumor locations. The screen is particularly effective in cholangiocarcinoma, colon, esophagus, gastric, peritoneum, rectum and small bowel. It was highest in pancreas (24%). Out of 157 GI samples, no instances were detected where the IHC was screened negative and gene fusions were observed by NGS. The IHC cocktail enriches detection of the patient population for gene fusions over 11-fold and has a 100% negative predictive value. Conclusions: This 2-step assay is an efficient method for detection of gene rearrangements in both high-volume clinical testing and studies of archival formalin-fixed paraffin-embedded specimens. Depending on how it is implemented in clinical trials, the staged approach can substantially decrease the costs and tissue expended for NGS. Screening efficiency may be improved even further as additional diagnostic antibodies become available. Clinical trial information: NCT02568267.
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Affiliation(s)
| | - Emma Jane Dean
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Simon Pacey
- University of Cambridge, Cambridge, United Kingdom
| | | | - Cheng Ean Chee
- National University Cancer Institute Singapore, Singapore, Singapore
| | | | - Maria Aslam
- Newcastle Private Oncology Centre, New Lambton Heights, NSW, Australia
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Dean EJ, Falchook GS, Patel MR, Brenner AJ, Infante JR, Arkenau HT, Borazanci EH, Lopez JS, Pant S, Schmid P, Frankel AE, Jones SF, McCulloch W, Kemble G, O'Farrell M, Burris H. Preliminary activity in the first in human study of the first-in-class fatty acid synthase (FASN) inhibitor, TVB-2640. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2512] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | - Manish R. Patel
- Sarah Cannon Research Institute/Florida Cancer Specialists, Sarasota, FL
| | | | | | - Hendrik-Tobias Arkenau
- Sarah Cannon Research Institute UK, London and University College London Hospitals., London, United Kingdom
| | | | | | - Shubham Pant
- Oklahoma University Health Science Center, Edmond, OK
| | | | | | | | | | | | | | - Howard Burris
- Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, TN
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5
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Plummer ER, Dean EJ, Evans TJ, Greystoke A, Herbschleb K, Ranson M, Brown J, Zhang Y, Karan S, Pollard J, Penney MS, Asmal M, Fields SZ, Middleton MR. Phase I trial of first-in-class ATR inhibitor VX-970 in combination with gemcitabine (Gem) in advanced solid tumors (NCT02157792). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2513] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - T.R. Jeffry Evans
- Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, United Kingdom
| | | | | | - Malcolm Ranson
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Jennifer Brown
- University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | | | | | - John Pollard
- Vertex Pharmaceuticals Ltd., Milton Park, United Kingdom
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6
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Krebs M, Dive C, Dean EJ, Rothwell DG, Brognard J, Wallace A, Miller C, Cook N, Rafii S, Ayub M, Leong HS, Siswick C, Chapman P, Smith N, Jordan A, Hughes AM, Marais R, Brady G. TARGET trial: Molecular profiling of circulating tumour DNA to stratify patients to early phase clinical trials. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps11614] [Citation(s) in RCA: 7] [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] [Indexed: 11/20/2022] Open
Affiliation(s)
- Matthew Krebs
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Caroline Dive
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | | | - John Brognard
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Andrew Wallace
- Regional Molecular Genetics Service, St Mary's Hospital, Manchester, United Kingdom
| | - Crispin Miller
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Natalie Cook
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Saeed Rafii
- Sarah Cannon Research Institute, London, United Kingdom
| | - Mahmood Ayub
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Hui-Sun Leong
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Carla Siswick
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Phil Chapman
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Nigel Smith
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Allan Jordan
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Andrew M. Hughes
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Richard Marais
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Ged Brady
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
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7
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Dean EJ, Banerji U, Girotti R, Niculescu-Duvaz I, Lopes F, Davies L, Niculescu-Duvaz D, Dhomen N, Ellis S, Ali Z, O'Carrigan B, Carter L, Chisolm L, Dive C, Lane HA, Lorigan P, Gore ME, Larkin J, Marais R, Springer C. A Phase 1 first-in-human trial to evaluate the safety and tolerability of CCT3833, an oral panRAF inhibitor, in patients with advanced solid tumours, including metastatic melanoma. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps9597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Udai Banerji
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, United Kingdom
| | - Romina Girotti
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | | | - Filipa Lopes
- The Institute of Cancer Research, London, United Kingdom
| | | | | | - Natalie Dhomen
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Sally Ellis
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Zohra Ali
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | - Brent O'Carrigan
- The Royal Marsden/Institute of Cancer Research, London, United Kingdom
| | - Louise Carter
- Experimental Cancer Medicine Team, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Luke Chisolm
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Caroline Dive
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Heidi A Lane
- Basilea Pharmaceutica International Ltd, Basel, Switzerland
| | - Paul Lorigan
- University of Manchester and The Christie NHS FT, Manchester, United Kingdom
| | | | - James Larkin
- The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | - Richard Marais
- Cancer Research UK Manchester Institute, Manchester, United Kingdom
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8
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Zubairi IH, Dean EJ, Molife LR, Lopez JS, Ranson M, El-Khouly F, Savulsky CI, Reyderman L, Jia Y, Hutton E, Morrison R, Sweeting L, Greystoke A, Barriuso J, Kristeleit RS, Evans TJ. Phase 1 multicenter, open-label study to establish the maximum tolerated dose (MTD) of two administration schedules of E7389 (eribulin) liposomal formulation in patients (pts) with solid tumors. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Emma Jane Dean
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - L Rhoda Molife
- The Royal Marsden Hospital NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom
| | | | - Malcolm Ranson
- The Christie NHS Foundation Trust (retired), Manchester, United Kingdom
| | | | | | | | - Yan Jia
- Eisai Inc., Woodcliff Lake, NJ
| | | | - Rosemary Morrison
- Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, United Kingdom
| | - Lorna Sweeting
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Alastair Greystoke
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jorge Barriuso
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - T.R. Jeffry Evans
- Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, United Kingdom
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9
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Plummer R, Verheul HM, Langenberg MHG, Leunen K, Molife LR, Rolfo CD, Soerensen PG, De Greve J, Rottey S, Jerusalem GHM, Italiano A, Spicer JF, Dirix LY, Goessl CD, Birkett J, Spencer S, Learoyd M, Dean EJ. Pharmacokinetic (PK) effects and safety of olaparib in combination with tamoxifen, anastrozole, or letrozole: Phase I study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ruth Plummer
- Northern Centre for Cancer Care, Newcastle upon Tyne, United Kingdom
| | - Henk M.W. Verheul
- Department of Medical Oncology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Karin Leunen
- Universitair Ziekenhuizen Leuven, Leuven, Belgium
| | - L Rhoda Molife
- The Royal Marsden and Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | - Sylvie Rottey
- Ghent University Hospital, Heymans Institute of Pharmacology, Ghent, Belgium
| | | | - Antoine Italiano
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
| | - James F. Spicer
- King's College London at Guy's Hospital, London, United Kingdom
| | - Luc Yves Dirix
- GZA Ziekenhuizen campus Sint-Augustinus, Antwerp, Belgium
| | | | | | | | | | - Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
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10
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Banerji U, Dean EJ, Perez-Fidalgo JA, Batist G, Bedard PL, You B, Westin SN, Kabos P, Davies B, Elvin P, Lawrence P, Yates JWT, Ambrose H, Rugman P, Foxley A, Salim S, Casson E, Lindemann JPO, Schellens JHM. A pharmacokinetically (PK) and pharmacodynamically (PD) driven phase I trial of the pan-AKT inhibitor AZD5363 with expansion cohorts in PIK3CA mutant breast and gynecological cancers. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.2500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Udai Banerji
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Emma Jane Dean
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Philippe L. Bedard
- The Princess Margaret Cancer Centre, Division of Medical Oncology & Hematology, Toronto, ON, Canada
| | - Benoit You
- Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, Université Lyon 1, Lyon, France
| | | | - Peter Kabos
- University of Colorado Cancer Center, Aurora, CO
| | | | - Paul Elvin
- AstraZeneca, Macclesfield, United Kingdom
| | | | | | | | | | | | | | - Ed Casson
- AstraZeneca, Macclesfield, United Kingdom
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11
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Dean EJ, Banerji U, Schellens JHM, Krebs M, Jimenez B, van der Noll R, Foxley A, Yates JWT, Taylor N, Evans S, Guy T, Casson E, Rugman P, Salim S, Lindemann JPO, Lawrence P. Results of OAK: A phase 1, open-label, multicentre study to compare two dosage forms of AZD5363 and to explore the effect of food on the pharmacokinetic (PK) exposure, safety, and tolerability of AZD5363 in patients with advanced solid malignancies. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.2577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Emma Jane Dean
- The University of Manchester and The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Udai Banerji
- The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | | | - Matthew Krebs
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Begona Jimenez
- The Institute of Cancer Research and The Royal Marsden, London, United Kingdom
| | - Ruud van der Noll
- The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | | | | | | | | | | | - Ed Casson
- AstraZeneca, Macclesfield, United Kingdom
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12
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Molife LR, Dean EJ, Blanco-Codesido M, Krebs MG, Brunetto AT, Greystoke AP, Daniele G, Lee L, Kuznetsov G, Myint KT, Wood K, de las Heras B, Ranson MR. A Phase I, Dose-Escalation Study of the Multitargeted Receptor Tyrosine Kinase Inhibitor, Golvatinib, in Patients with Advanced Solid Tumors. Clin Cancer Res 2014; 20:6284-94. [DOI: 10.1158/1078-0432.ccr-14-0409] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Stovold R, Meredith SL, Bryant JL, Babur M, Williams KJ, Dean EJ, Dive C, Blackhall FH, White A. Neuroendocrine and epithelial phenotypes in small-cell lung cancer: implications for metastasis and survival in patients. Br J Cancer 2013; 108:1704-11. [PMID: 23519056 PMCID: PMC3668479 DOI: 10.1038/bjc.2013.112] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/12/2013] [Accepted: 02/20/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Small-cell lung cancer (SCLC) has a very aggressive clinical course with early metastasis. This study investigated how the distinctive neuroendocrine characteristics contribute to disease progression and invasion in human SCLC. METHODS The neuroendocrine phenotype (pro-opiomelanocortin (POMC)) was quantified by ELISA in blood samples from 43 SCLC patients. The neuroendocrine (POMC, chromogranin A, neuron-specific enolase, NCAM) and epithelial (cytokeratin and E-cadherin) phenotypes were investigated, using ELISA and immunocytochemistry/immunohistochemistry. RESULTS In SCLC patients, 16% had elevated circulating POMC, which was associated with significantly worse survival (P=0.02) and liver metastases (P=0.004). In addition, POMC correlated with epithelial-positive circulating tumour cells (P=0.0002). In a panel of SCLC cell lines, all POMC-secreting cell lines expressed cytokeratin (40% of total). Even after cloning, DMS 79 cells expressed both neuroendocrine and epithelial markers. DMS 79 xenografts secreted POMC into the blood, which mirrored the tumour volume. These xenografts expressed both neuroendocrine and epithelial phenotypes in all tumours, with both phenotypes prevalent in cells invading the surrounding tissue. CONCLUSION Both neuroendocrine and epithelial phenotypes coexist in human SCLC tumours in vitro and in vivo and this persists in invading tumour cells. In patients, POMC secretion predicts poor survival and liver metastases, suggesting a crucial role of the neuroendocrine phenotype.
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Affiliation(s)
- R Stovold
- Faculty of Life Sciences, Manchester Academic Health Sciences Centre, University of Manchester, 3.016 AV Hill Building, Manchester M13 9PT, UK
- Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK
| | - S L Meredith
- Faculty of Life Sciences, Manchester Academic Health Sciences Centre, University of Manchester, 3.016 AV Hill Building, Manchester M13 9PT, UK
| | - J L Bryant
- Faculty of Life Sciences, Manchester Academic Health Sciences Centre, University of Manchester, 3.016 AV Hill Building, Manchester M13 9PT, UK
| | - M Babur
- Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Stopford Building, Manchester M13 9PT, UK
| | - K J Williams
- Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Stopford Building, Manchester M13 9PT, UK
| | - E J Dean
- Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK
| | - C Dive
- Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK
| | - F H Blackhall
- The Christie NHS Foundation Trust, Manchester M20 4BX, UK
| | - A White
- Faculty of Life Sciences, Manchester Academic Health Sciences Centre, University of Manchester, 3.016 AV Hill Building, Manchester M13 9PT, UK
- Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Stopford Building, Manchester M13 9PT, UK
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Gupta A, Moreno V, Dean EJ, Drew Y, Nicum S, Ranson M, Plummer R, Swaisland H, Burke W, McCormack P, Tchakov I, Middleton MR, Kaye SB, Molife LR. Phase I study to determine the bioavailability and tolerability of a tablet formulation of the PARP inhibitor olaparib in patients with advanced solid tumors: Dose-escalation phase. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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
3051 Background: We previously reported the comparative bioavailability of the olaparib tablet (TAB) up to 200 mg BID, with the initial capsule formulation; gmean AUC0–T following 200 mg BID TAB was ~20% lower than 400 mg BID capsule (CAP; Molife et al ASCO 2010). Olaparib 200 mg BID TAB had an acceptable tolerability profile suggesting further dose escalation might be justified. Methods: Study NCT00777582 was amended to include a dose-escalation phase, to define the maximum tolerated dose (MTD) and safety profile of the TAB, and 2 expansion phases to compare safety and efficacy of TAB doses vs 400 mg BID CAP. Expansion phase data are reported separately. Here, we report preliminary data from the dose-escalation phase where patients (pts) with advanced solid tumors, ECOG PS 0–2 and adequate organ function were assigned to treatment with increasing olaparib BID TAB doses in 28-day continuous dosing cycles. Pharmacokinetic (PK) sampling was performed on days 1, 8, 15, 29, 57. Results: 30 pts (M:F, 3:27; median age 54 yrs [range 19–70]) were enrolled in the dose-escalation phase and received treatment at 5 dose levels: 250, 300, 350, 400 and 450 mg (each dose level, n=6). Overall, the most common AEs were nausea (80%), fatigue (73%) and diarrhea (36%). The majority of AEs were mild to moderate (CTC grade [G] 1/2). Hematologic toxicity in terms of, mostly mild, anemia, neutropenia and thrombocytopenia, appeared to increase at doses of 300 mg BID or higher. Two pts had dose-limiting toxicities at 450 mg (G3 thrombocytopenia and G3 anemia); the TAB MTD was 400 mg BID. Exposure increased proportionally with increasing dose: mean exposure after 400 mg BID was double that following the previously reported 200 mg BID dose. Following 300 and 400 mg doses, gmean Cmax ss, AUC0–T and Cmin ss matched or exceeded the 400 mg BID CAP dose. Conclusions: The MTD of olaparib TAB was 400 mg BID. Based on PK analysis, the 300 and 400 mg BID doses were selected for evaluation in the MTD expansion phase to further define safety and preliminary efficacy.
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Affiliation(s)
- Avinash Gupta
- Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Victor Moreno
- Royal Marsden Hospital and Institute of Cancer Research, Surrey, United Kingdom
| | - Emma Jane Dean
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Yvette Drew
- Northern Institute for Cancer Research, Newcastle upon Tyne, United Kingdom
| | - Shibani Nicum
- Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | - Malcolm Ranson
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Ruth Plummer
- Northern Institute for Cancer Research, Newcastle upon Tyne, United Kingdom
| | | | | | | | | | | | - Stanley B. Kaye
- Royal Marsden Hospital and Institute of Cancer Research, Surrey, United Kingdom
| | - L Rhoda Molife
- Royal Marsden Hospital and Institute of Cancer Research, Surrey, United Kingdom
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15
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Daniele G, Ranson M, Blanco-Codesido M, Dean EJ, Shah KJ, Krebs M, Brunetto A, Greystoke A, Johnston C, Kuznetsov G, Matijevic M, Mistry B, de las Heras B, Molife LR. Phase I dose-finding study of golvatinib (E7050), a c-Met and Eph receptor targeted multi-kinase inhibitor, administered orally QD to patients with advanced solid tumors. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
3030 Background: Golvatinib is a highly potent, small molecule ATP-competitive inhibitor of the c-Met receptor tyrosine kinase and multiple members of the Eph receptor family as well as c-Kit and Ron, based on isolated kinase assays. Golvatinib showed preclinical evidence of anti-tumor activity. This phase 1 study was performed to determine the MTD, safety, PK, PD and preliminary activity of golvatinib. Methods: Patients (pts) with advanced solid tumors, ECOG PS 0-1, ≥ 18 years (yrs) and adequate organ function were eligible. Golvatinib was administered orally, once daily (QD), continuously. Blood samples for PK and PD analysis were collected at multiple time-points. Mandatory tumor biopsies for PD analysis were taken pre and post Cycle 1 in an expanded MTD cohort. Results: 34 pts (M/F: 21/13; median age 63.5yrs [range 32-78]) were treated at 6 dose levels: 100, 200, 270, 360, 450 and 400 mg. Tumor types were colorectal (n=15), lung (n=4), renal (n=4), esophageal (n=2), melanoma (n=2) and others (n=7). Three DLTs were observed: Gr3 GGT and alkaline phosphatase (n=1; 200mg) and repeated Gr2 (n=1) and Gr3 (n=1) fatigue, both at 450mg. The MTD was determined to be 400 mg QD. Frequently occurring adverse events ([AEs]; all grades) were fatigue: 68% (Gr3: 15%), diarrhea: 65%, nausea: 62%, vomiting: 53%, decreased appetite: 47% (Gr3: 9%), ALT increase: 38% and AST increase: 23%. No Gr4 AEs were observed. Best response was stable disease in 6 pts lasting >84 days. PK showed high variability and plasma concentration increased with dose. The Cmax was reached within a median time of 4 hours. Plasma PD analysis showed an increase in soluble c-Met and Ang 2 levels after golvatinib treatment. Tumor PD analysis in 5 pts at 400 mg demonstrated a baseline elevated MET gene copy number, with c-Met overexpression and post treatment decline in phospho(p)-c-Met expression in 1 pt; post-treatment decline in p-c-Met in a 2nd pt, and post-treatment decline in p-ERK in a 3rd pt. Conclusions: Golvatinib at an MTD of 400 mg QD has manageable toxicity. Preliminary PD analysis demonstrated evidence of c-Met target modulation. Further evaluation will continue in phase 2 combination studies.
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Affiliation(s)
- Gennaro Daniele
- Royal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom
| | - Malcolm Ranson
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Emma Jane Dean
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | - Matthew Krebs
- Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Andre Brunetto
- Royal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | | | | | | | - L Rhoda Molife
- Royal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom
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16
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Banerji U, Dean EJ, Gonzalez M, Greystoke AP, Basu B, Krebs M, Puglisi M, Grinsted L, Oelmann E, Burke W, Harrington E, Green S, Ranson M. First-in-human phase I trial of the dual mTORC1 and mTORC2 inhibitor AZD2014 in solid tumors. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.3004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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
3004 Background: AZD2014 is a potent, dual mTORC1/mTORC2 inhibitor with clear activity in in vivo and in vitro experimental models. Methods: This 2-part study consisted of "rolling six" dose escalation (Part A) and expansion (Part B) phases. Part A: 3–6 pts per cohort received an oral solution of AZD2014 BD starting at 50 mg. A further 6 pts were treated in Part A below the MTD to study changes in pharmacodynamic (PD) biomarkers. Part B: additional pts were dosed at the MTD, including a group of ER+/PR+ or HER2+ patients with breast cancer. Primary endpoint: safety and tolerability; secondary endpoints: pharmacokinetics (PK), PD and efficacy. Biomarkers assessed: mTORC1: pS6 (S235/236) and p4EBP1 (T37/46); mTORC2: pAKT (S473). Results: 50 pts have been enroled in this ongoing study and interim data are reported: Part A, n=23 (25 mg, n=6; 50 mg, n=8; 70 mg, n=5; 100 mg, n=4; all BD); Part B, n=27. The MTD was 50 mg BD. DLTs were seen at both 100 mg (Gr 2 and 3 lethargy/fatigue, n=4/4) and 70 mg (Gr 3 mucositis, Gr 2 lethargy, n=2/4); no DLTs were seen at 25 mg or 50 mg. The most common AEs in order of incidence were fatigue, stomatitis, decreased appetite, nausea and diarrhea. Seven SAEs (nausea, vomiting, lethargy, abdominal pain, mucositis) reported by 3 pts were considered ‘possibly related’ to the study drug by investigators. AZD2014 is rapidly absorbed following single and BD multiple doses with a short t1/2 of ~3 h. At 50 mg (n=32), preliminary data show geometric mean AUCss=7.4 µg.h/ml and Cmax ss=1.7 µg/ml. One pt with acinar pancreatic cancer had a RECIST partial response. pAKT and p4EBP1 reductions were observed between 2–8 h in platelet-rich plasma and peripheral blood mononuclear cells respectively. Target modulation in paired tumor biopsies was seen at the MTD. Reduction in the phosphorylation of S6 and 4EBP1 was evident in 8/10 and 3/9 paired biopsies respectively. pAKT was reduced in 3/6 evaluable paired biopsies. As opposed to rapalogs, pAKT was not upregulated in any of the evaluable post-treatment biopsies. Conclusions: The MTD for AZD2014 is 50 mg BD. Further clinical evaluation of AZD2014 is now warranted based on the safety, PK and proof-of-mechanism PD data, as well as its preliminary clinical activity. Updated results will be presented.
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Affiliation(s)
- Udai Banerji
- Drug Development Unit, The Institute of Cancer Research/The Royal Marsden Hospital, Sutton, United Kingdom
| | - Emma Jane Dean
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Michael Gonzalez
- Drug Development Unit, The Institute of Cancer Research/The Royal Marsden Hospital, Sutton, United Kingdom
| | | | - Bristi Basu
- Drug Development Unit, The Institute of Cancer Research/The Royal Marsden Hospital, Sutton, United Kingdom
| | - Matthew Krebs
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Martina Puglisi
- Drug Development Unit, The Institute of Cancer Research/The Royal Marsden Hospital, Sutton, United Kingdom
| | | | | | | | | | | | - Malcolm Ranson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
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17
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Dean EJ, Ward T, Pinilla C, Houghten R, Welsh K, Makin G, Ranson M, Dive C. A small molecule inhibitor of XIAP induces apoptosis and synergises with vinorelbine and cisplatin in NSCLC. Br J Cancer 2009; 102:97-103. [PMID: 19904270 PMCID: PMC2813749 DOI: 10.1038/sj.bjc.6605418] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [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] [Indexed: 01/16/2023] Open
Abstract
Background: Evasion of apoptosis contributes to the pathogenesis of solid tumours including non-small cell lung cancer (NSCLC). Malignant cells resist apoptosis through over-expression of inhibitor of apoptosis proteins (IAPs), such as X-linked IAP (XIAP). Methods: A phenylurea-based small molecule inhibitor of XIAP, XIAP antagonist compound (XAC) 1396-11, was investigated preclincally to determine its ability to sensitise to clinically relevant cytotoxics, potentially allowing dose reduction while maintaining therapeutic efficacy. Results: XIAP protein expression was detected in six NSCLC cell lines examined. The cytotoxicity of XAC 1396-11 against cultured NSCLC cell lines in vitro was concentration- and time-dependent in both short-term and clonogenic assays. XAC 1396-11-induced apoptosis was confirmed by PARP cleavage and characteristic nuclear morphology. XAC 1396-11 synergised with vinorelbine±cisplatin in H460 and A549 NSCLC cells. The mechanism of synergy was enhanced apoptosis, shown by increased cleavage of caspase-3 and PARP and by the reversal of synergy by a pan-caspase inhibitor. Synergy between XAC 1396-11 and vinorelbine was augmented by optimising drug scheduling with superior effects when XAC 1396-11 was administered before vinorelbine. Conclusion: These preclinical data suggest that XIAP inhibition in combination with vinorelbine holds potential as a therapeutic strategy in NSCLC.
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Affiliation(s)
- E J Dean
- Department of Clinical and Experimental Pharmacology, Paterson Institute for Cancer Research, University of Manchester, Wilmslow Road, Manchester M20 4BX, England, UK
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Affiliation(s)
- E J Dean
- Department of Gastroenterology, University Hospitals Aintree NHS Trust, Lower Lane, Liverpool L9 7AL, UK
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Foster N, Dean EJ, Lee DL. The effect of homogenates and excretory/secretory products of Nippostrongylus brasiliensis and of acetylcholinesterase on the amplitude and frequency of contraction of uninfected rat intestine in vitro. Parasitology 1994; 108 ( Pt 4):453-9. [PMID: 8008459 DOI: 10.1017/s0031182000076010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Whole worm homogenates and excretory/secretory (E/S) products of adult Nippostrongylus brasiliensis significantly decreased the amplitude of contractions of segments of uninfected rat intestine maintained in an organ bath, with significantly larger volumes of E/S products being required to bring about a similar decrease to that caused by the whole worm homogenate. Boiled samples of homogenate and E/S products significantly decreased the amplitude of contractions of uninfected rat intestine, but larger volumes were needed than with unboiled samples. Frequency of contraction was unaltered by homogenates or E/S products. When electric eel AChE was injected into the lumen of segments of uninfected rat intestine maintained in an organ bath there was no significant decrease in the amplitude of contractions. These results suggest that substances present in the E/S products of N. brasiliensis significantly reduce the amplitude of contractions of uninfected rat intestine in vitro and that the biochemical holdfast responsible for this phenomenon may not be AChE.
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Affiliation(s)
- N Foster
- Department of Pure and Applied Biology, University of Leeds
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