Phase I dose escalation and expansion study of golidocitinib, a highly selective JAK1 inhibitor, in relapsed or refractory peripheral T-cell lymphomas

BACKGROUND

Relapsed or refractory peripheral T-cell lymphomas (r/r PTCLs) are a group of rare and aggressive diseases that lack effective therapies. Constitutive activation of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway is reported to be associated with PTCLs. Golidocitinib is an oral, potent JAK1 selective inhibitor evaluated in a phase I/II multinational study in patients with r/r PTCLs.

PATIENTS AND METHODS

Patients with r/r PTCLs were eligible. The primary objectives were to assess safety and tolerability of golidocitinib and to define its recommended phase II dose (RP2D). The secondary objectives were to evaluate its antitumor activity and pharmacokinetics (PK).

RESULTS

A total of 51 patients were enrolled and received golidocitinib treatment at 150 or 250 mg once daily (QD). The median prior lines of therapies were 2 (range: 1-8). Golidocitinib was tolerated at both doses tested, while a higher incidence of serious adverse events and dose modifications at 250 mg were observed. The most common grade ≥3 drug-related treatment-emergent adverse events were neutropenia (27.5%) and thrombocytopenia (11.8%). An objective response rate of 39.2% and a complete response rate of 21.6% were observed. With median follow-up time of 14.7 and 15.9 months, the median duration of response (DoR) and progression-free survival were 8.0 and 3.3 months, respectively. Based on these data, 150 mg QD was defined as the RP2D. Golidocitinib demonstrated a favorable PK profile as an oral agent. Biomarker analysis suggested a potential correlation between JAK/STAT pathway aberrations and clinical activity of golidocitinib.

CONCLUSIONS

In this phase I study, golidocitinib demonstrated an acceptable safety profile and encouraging antitumor efficacy in heavily pretreated patients with r/r PTCLs. These results support the initiation of the multinational pivotal study in patients with r/r PTCLs.

Evaluation of phytoplankton-stimulating potency of effluent nitrogen depending on its chemical forms: A comparison between inorganic and organic nitrogen

Wastewater-originated nitrogen (N) is considered a primary N source in urban waters. In order to mitigate eutrophication in such waters, decreasing N discharges from wastewater treatment plants (WWTPs) is necessary. Upgrading WWTPs from conventional activated sludge (CAS) to biological nutrient removal (BNR) is the most common measure to lower levels of effluent N. However, in spite of successful N reduction through such upgrades, eutrophication persists in numerous urban waters. In this study, we investigated why decreased N discharge resulting from upgrading CAS to BNR, particularly predenitrification BNR, cannot necessarily alleviate eutrophication. Our laboratory reactor study demonstrated that compared to CAS effluent N, predenitrification BNR effluent N contains less dissolved inorganic N (DIN) but more dissolved organic N (DON), especially low molecular weight DON (LMW-DON). Bioassay-based experimental and numerical analyses found that effluent N has dissimilar phytoplankton-stimulating potency depending on its chemical forms. In particular, effluent LMW-DON showed significantly greater potency than effluent DIN. This difference in potency makes predenitrification BNR effluent N more productive for causing primary production than CAS effluent N. These results indicate that the impact of effluent N on eutrophication should be evaluated based on not only the total quantity but also the qualitative aspect of N.

Development of an Improved Sulfur-Oxidizing Bacteria-Based Ecotoxicity Test for Simple and Rapid On-Site Application

Microbial toxicity tests are considered efficient screening tools for the assessment of water contamination. The objective of this study was to develop a sulfur-oxidizing bacteria (SOB)-based ecotoxicity test with high sensitivity and reproducibility for simple and rapid on-site application. To attain this goal, we developed a 25 mL vial-based toxicity kit and improved our earlier SOB toxicity test technique. The current study applied a suspended form of SOB and shortened the processing time to 30 min. Moreover, we optimized the test conditions of the SOB toxicity kit in terms of initial cell density, incubating temperature, and mixing intensity during incubation. We determined that 2 × 10⁵ cells/mL initial cell density, 32 °C incubating temperature, and 120 rpm mixing intensity are the optimal test conditions. Using these test conditions, we performed SOB toxicity tests for heavy metals and petrochemicals, and obtained better detection sensitivity and test reproducibility, compared to earlier SOB tests. Our SOB toxicity kit tests have numerous advantages, including a straightforward test protocol, no requirement of sophisticated laboratory equipment, and no distortion of test results from false readings of end-points and properties of test samples, making it suitable for simple and rapid on-site application.

Evaluation of joint toxicity of BTEX mixtures using sulfur-oxidizing bacteria

Benzene (B), toluene (T), ethylbenzene (E), and xylenes (X) are petrochemicals vital in various industrial and commercial processing but identified as priority pollutants due to their high toxicity. The objective of this study was to investigate the toxicological nature of BTEX mixtures under controlled laboratory aquatic conditions using sulfur-oxidizing bacteria (SOB). Results from individual BTEX tests demonstrated that the order of toxicity among BTEX was X ≥ E > T > B. Comparisons of dose-effect curves for BTEX suggest that the biochemical mode of action of B in SOB was different from those of T, E, and X. Toxicological interactions of BTEX in mixtures were studied using concentration addition (CA), independent action (IA), and combination index (CI)-isobologram models. The CI model approximated the actual toxicity of BTEX mixtures better than the CA and IA models. In most cases, BTEX induced synergistic interactions in mixtures. However, in some B-containing mixtures, antagonism was observed at low effective levels. The effective level (fa)-CI plots and polygonograms illustrate that synergistic interactions of BTEX became stronger with an increase in effective levels. In addition, ternary and quaternary mixtures were found to provoke stronger synergism than binary mixtures. The present study suggests that the CI-isobologram model is a suitable means to evaluate diverse toxicological interactions of contaminants in mixtures.

Investigation of characteristics of effluent DON derived from conventional activated sludge (CAS) and predenitrification biological removal (BNR): In terms of proteins and humic substances

Upgrading wastewater treatment plants (WWTPs) from conventional activated sludge (CAS) to predenitrification biological nutrient removal (BNR) results in improved removal of dissolved inorganic nitrogen (DIN) from wastewater. However, changes in dissolved organic nitrogen (DON) with these WWTP upgrades and their potential impacts on receiving waters have been little researched. In this study, we investigated characteristics of effluent DON derived from CAS and predenitrification BNR, paying special attention to proteins and humic substances. Through a lab-scale reactor study and analysis of full-scale WWTP effluents, we found that in predenitrification BNR effluent, proteins are much more dominant than humic substances, whereas in CAS effluent, proteins and humic substances are similarly abundant. In terms of molecular weight, the majority of proteins were present in the effluent's low molecular weight (LMW) fraction (<1 kDa), while humic substances were found mostly in the effluent's high molecular weight (HMW) fraction (0.45 μm-1 kDa). Determination of dissolved organic carbon (DOC)/DON ratios in effluents supports that proteins (and LMW-DON) were most likely microbial-derived organic N produced during treatment processing, whereas humic substances (and HMW-DON) more likely originated outside of treatment systems. Bioassay tests demonstrated that effluent DON derived from predenitrification BNR was more bioavailable than that derived from CAS. We also found that LMW-DON and proteins were highly bioavailable DON compared to HMW-DON and humic substances. The results of this study suggest that upgrading CAS to predenitrification BNR makes effluent DON to become more conducive to phytoplankton blooms in receiving waters.

A simple and rapid algal assay kit to assess toxicity of heavy metal-contaminated water

This study presents a novel algal-based toxicity test suitable for simple and rapid assessment of heavy metal (Hg2+, Cr6+, Cd2+, Pb2+, or As3+)-contaminated water. A closed-system kit-type algal assay was developed using Chlorella vulgaris. Toxicity was assessed by oxygen evolution in the gaseous phase of the assay kits, which was measured via a needle-type oxygen sensor. Initial cell density, light intensity, and exposure time that enabled favorable test performance for the algal assay kits were 103 cells/mL, 250 μmol m-2s-1, and 18 h, respectively. Results from the heavy metal toxicity tests demonstrate that Hg2+, Cr6+, Cd2+, and Pb2+ are more toxic in inhibiting algal photosynthetic activity than As3+. The 18 h half-maximum effective concentrations (EC50) for Hg2+, Cr6+, Cd2+, Pb2+, and As3+ were determined to be 31.3 ± 0.5, 179.6 ± 7.5, 301.3 ± 6.1, 476.1 ± 10.5, and 2184.1 ± 31.1 μg/L, respectively. A strong correlation between oxygen concentrations in the headspace of the assay kits and chlorophyll a production indicates that oxygen evolution in the gaseous phase is able to represent algal photosynthetic activity and serve as the end-point in algal toxicity tests. High test sensitivity and reproducibility as well as an easy test protocol and rapid processing time make the algal assay kit a suitable tool for simple and rapid toxicity testing of heavy metal-contaminated water.

Real-time biomonitoring of oxygen uptake rate and biochemical oxygen demand using a novel optical biogas respirometric system

In response to the ever-increasing need for monitoring-based process control of wastewater treatment plants, an online applicable respirometer shows great promise for real-time measurement of oxygen uptake rate (OUR) and biochemical oxygen demand (BOD) measurements as a surrogate of the biodegradability of wastewater. Here, we have developed a photosensor-assisted real-time respirometric system equipped with bubble counting sensors for accurate measurement of microbial oxygen consumption in a bottle. This system can measure OUR and BOD in a bottle equipped with a tube containing NaOH solution to absorb carbon dioxide and supplied with continuous atmospheric oxygen to the bottle, which reliably supplies non-limiting dissolved oxygen (DO) for aerobic biodegradation even at high organic loads. These technical improvements allow a sensitive and rapid analytical tool offering real-time profiles of oxygen uptake rate as well as BOD measurements with an extended measurable range (0-420 mg O₂/L), enabling significant reduction or elimination of dilution steps. The respirometric system was used to elucidate the biodegradable kinetics of domestic and swine wastewaters as a function of the type and concentration of organic matters, depending on source characteristics including rapidly or slowly oxidizable organic substances by bacteria. Compared with conventional and manometric BOD methods, our method is reliable and accurate.

Improved toxicity analysis of heavy metal-contaminated water via a novel fermentative bacteria-based test kit

The objective of this study was development of a simple and reliable microbial toxicity test based on fermentative bacteria to assess heavy metal (Hg²⁺, Cu²⁺, Cr⁶⁺, Ni²⁺, As⁵⁺, or Pb²⁺)-contaminated water. The dominant species of test organisms used in this study was a spore-forming fermentative bacterium, Clostridium guangxiense. Toxicity of water was assessed based on inhibition of fermentative gas production of the test organisms, which was analyzed via a syringe method. Overall, the fermentative bacteria-based test kits satisfactorily identified increased toxicity of water as water was contaminated with high amounts of heavy metals; however, levels of inhibition were dissimilar depending on the species of metals. Inhibitory effects of Hg²⁺, Cu²⁺, Cr⁶⁺, and Ni²⁺ were considerably greater than those of As⁵⁺ and Pb²⁺. The 24 h half-maximum effective concentrations (EC₅₀) for Hg²⁺, Cu²⁺, Cr⁶⁺, Ni²⁺, As⁵⁺, and Pb²⁺ were analyzed to be 0.10, 0.51, 1.09, 3.61, 101.33, and 243.45 mg/L, respectively, confirming that Hg²⁺, Cu²⁺, Cr⁶⁺, and Ni²⁺ are more toxic to fermentative gas production than As⁵⁺ and Pb²⁺. The fermentative bacteria-based toxicity test represents an improvement over other existing toxicity tests because of ease of end-point measurement, high reproducibility, and favorable on-site field applicability. These advantages make the fermentative bacteria-based test suitable for simple and reliable toxicity screening for heavy metal-contaminated water.

A Microbial Bioassay for Direct Contact Assessment of Soil Toxicity Based on Oxygen Consumption of Sulfur Oxidizing Bacteria

A new direct contact assessment of soil toxicity using sulfur oxidizing bacteria (SOB) is proposed for analyzing the toxicity of soils. The proposed method is based on the ability of SOB to oxidize elemental sulfur to sulfuric acid in the presence of oxygen. Since sulfate ions are produced from sulfur by SOB oxidation activity, changes in electrical conductivity (EC) serve as a proxy to assess toxicity in water. However, in soil medium, EC values are not reliable due to the adsorption of SO₄ ^2- ions by soils. Here, we suggest a new parameter which measures oxygen consumption by SOB for 6 hours to assess soil toxicity by using a lubricated glass syringe method. The proposed method is rapid, simple, cost- effective as well as sensitive and capable of assessing direct contact soil toxicity.

Role of TAF15b in transcriptional regulation of autonomous pathway for flowering

The autonomous pathway promotes flowering by repressing a major flowering repressor, FLOWERING LOCUS C (FLC). Approximately 30 genes are involved in this pathway, and several of them are related to RNA processing; however, the molecular basis of the transcriptional regulation of FLC is yet to be understood. Recently, we discovered a new autonomous pathway gene, TATA-binding protein-associated factor 15b (TAF15b), which has a RNA recognition motif (RRM) and represses the level of FLC transcripts. TAF15b regulates the expression of FLC by directly interacting with RNA polymerase II (Pol II) at the transcription start sites on both the sense and antisense strands of the FLC locus. In addition to the transcriptional regulation in the nucleus, TAF15b accumulates in processing bodies (p-bodies), which are cytoplasmic RNA granules involved in translational repression, during heat stress. Here we discuss the implications of our findings and suggest a dual role of TAF15b in both transcriptional and translational regulation.

Formation of Low-Molecular-Weight Dissolved Organic Nitrogen in Predenitrification Biological Nutrient Removal Systems and Its Impact on Eutrophication in Coastal Waters

To alleviate eutrophication in coastal waters, reducing nitrogen (N) discharge from wastewater treatment plants (WWTPs) by upgrading conventional activated sludge (CAS) to biological nutrient removal (BNR) processes is commonplace. However, despite numerous upgrades and successful reduction of N discharge from WWTPs, eutrophication problems persist. These unexpected observations raise the possibility that some aspects of BNR yield environmental responses as yet overlooked. Here, we report that one of the most common BNR processes, predenitrification, is prone to the production of low-molecular-weight dissolved organic N (LMW-DON), which is highly bioavailable and stimulates phytoplankton blooms. We found that in predenitrification BNR, LMW-DON is released during the post-aerobic step following the preanoxic step, which does not occur in CAS. Consequently, predenitrification systems produced larger amount of LMW-DON than CAS. In estuarine bioassays, predenitrification BNR effluents produced more phytoplankton biomass than CAS effluents despite lower N concentrations. This was also supported by stronger correlations found between phytoplankton biomass and LMW-DON than other N forms. These findings suggest that WWTPs upgraded to predenitrification BNR reduce inorganic N discharge but introduce larger quantities of potent LMW-DON into coastal systems. We suggest reassessing the N-removal strategy for WWTPs to minimize the eutrophication effects of effluents.

Development of a hybrid microbial fuel cell (MFC) and fuel cell (FC) system for improved cathodic efficiency and sustainability: the M2FC reactor

In an effort to improve the efficiency and sustainability of microbial fuel cell (MFC) technology, a novel MFC reactor, the M2FC, was constructed by combining a ferric-based MFC with a ferrous-based fuel cell (FC). In this M2FC reactor, ferric ion, the catholyte in the MFC component, is regenerated by the FC system with the generation of additional electricity. When the MFC component was operated separately, the electricity generation was maintained for only 98 h due to the depletion of ferric ion in the catholyte. In combination with the fuel cell, however, the production of power was sustained because ferric ion was continually replenished from ferrous ion in the FC component. Moreover, the regeneration process of ferric ion by the FC produced additional energy. The M2FC reactor yielded a power density of up to 2 W m(-2) (or time-averaged value of approximately 650 mW m(-2)), density up to 20 times (or approximately six times based on time-averaged value) higher than the corresponding MFC system.

A phase II trial of gemcitabine, ifosfamide, dexamethasone, and oxaliplatin (GIDOX) for patients with refractory or relapsed non-Hodgkin's lymphoma

8559

Background: Gemcitabine combined with cisplatin has been known as an effective regimen for lymphoma treatment in salvage setting. However, this regimen has the modest response with severe nephrotoxcity and neurotoxicity, especially to heavily treated patients. We investigated the response rate and toxicity of gemcitabine, ifosfamide, dexamethasone, and oxaliplatin (GIDOx) for recurrent or refractory aggressive B-cell non-Hodgkin lymphoma (NHL), looking for the more effective and less toxic therapy. Methods: Patients with recurrent or refractory diffuse large B-cell NHL or mantle cell lymphoma, measurable disease, and more than one previous chemotherapy regimen were eligible. Treatment consisted of gemcitabine 1000 mg/m2 intravenously (i.v.) on Days 1 and 8, ifosfamide 2000 mg/m2 i.v. on Day 1, dexamethasone 40 mg orally on Days 1–4, and oxaliplatin 130mg/m2 i.v. on Day 2, every 21 days. The primary end point was a response after three cycles. Patients could then proceed to stem cell transplantation (SCT) or receive up to six treatment cycles. Results: Twenty-seven eligible patients were evaluable for toxicity and response. The median age of the patients was 54 years (range, 18–75 years) and most had diffuse large-cell lymphoma. After 3 cycles, there were 4 complete responses (CR; 15%) and 10 partial responses (PR; 37%). There was an overall response rate (RR) of 52%. The RR after completion of all protocol chemotherapy including SCT was 44% (10 CR, 2 PR). In total 88 cycles of GIDOx, grade 3 and 4 neutropenia occurred in 33% and 16% of cycles, respectively. Grade 3 and 4 thrombocytopenia occurred in 14% and 16% of cycles, respectively. Tow patients (2%) experienced febrile neutropenia. Seven patients (26%) proceeded to SCT. Conclusions: GIDOx is an active salvage regimen in aggressive B-cell NHL and can be administered with acceptable toxicity.

No significant financial relationships to disclose.

Association of polymorphisms in myeloperoxidase and catalase genes with precancerous changes in the gastric mucosa of patients at inner-city hospitals in New York

Gastric carcinogenesis is a multistep process progressing from chronic gastritis, through glandular atrophy (GA), intestinal metaplasia (IM) and dysplasia. We have previously demonstrated that minority patients at New York City hospitals are infected with a relatively virulent strain of H. pylori (Hp) and that Hp infection is associated with an increased incidence of precancerous changes in the gastric mucosa. Nevertheless, precancerous changes are not observed in every Hp-infected individual, suggesting that environmental and genetic factors may also play a role in the formation and appearance of precancerous lesions. In the present study, the association between polymorphisms in the promoter regions of human myeloperoxidase (MPO -463G--> A) and catalase (CAT -262C-->T) genes and the appearance of precancerous changes in the gastric mucosa of our patient population were examined. Patients enrolled in this study were undergoing endoscopy for gastrointestinal complaints. Samples were collected from 126 patients at Kings County Hospital in Brooklyn and St. John's Episcopal Hospital in Queens. One antral biopsy was taken for genotyping, while additional biopsies were taken from the antrum and fundic region for histological analysis and were scored with respect to acute and chronic inflammation, GA, IM and Hp infestation according to the Sydney classification. MPO and CAT genotypes were determined by PCR and RFLP. CAT genotypes did not influence the incidence or severity of precancerous lesions in the fundic or antral regions of the stomach, whereas the MPO -463A allele was associated with an increase in intensity of gastric atrophy in the fundic mucosa. In Hp-infected individuals, the MPO -463G/G genotype was associated with an increase in the incidence of IM in the antrum, whereas the A allele was associated with an increase in IM in the fundic region. These paradoxical findings suggest that different MPO genotypes are associated with the appearance of IM in distinct anatomical regions of the stomach. However, since the majority of gastric cancer (GC) cases in our patient population occurred in the antrum, the MPO -463G/G genotype, which is associated with increased MPO expression and antral IM, may be considered a risk factor for GC.