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Elgamal OA, Fobare S, Vibhute S, Mehmood A, Vroom DC, Johnson ML, Stearns B, Lerma JR, Truxall J, Stahl E, Carmichael B, Orwick SJ, Mims AS, Curran E, Santhanam R, Tridandapani S, Phelps MA, Xie Z, Coss CC, Baker SD, Patrick J, Ezzell JK, Rai J, Pan J, Rai SN, Stillwell C, Wunderlich M, Abdulrahim M, Goodwin TE, Hilinski G, Bennett CE, Hertlein E, Byrd JC. Pyrimidine depletion enhances targeted and immune therapy combinations in acute myeloid leukemia. JCI Insight 2024; 9:e173646. [PMID: 38646934 DOI: 10.1172/jci.insight.173646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/12/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
Acute myeloid leukemia (AML) is a fatal disease characterized by the accumulation of undifferentiated myeloblasts, and agents that promote differentiation have been effective in this disease but are not curative. Dihydroorotate dehydrogenase inhibitors (DHODHi) have the ability to promote AML differentiation and target aberrant malignant myelopoiesis. We introduce HOSU-53, a DHODHi with significant monotherapy activity, which is further enhanced when combined with other standard-of-care therapeutics. We further discovered that DHODHi modulated surface expression of CD38 and CD47, prompting the evaluation of HOSU-53 combined with anti-CD38 and anti-CD47 therapies, where we identified a compelling curative potential in an aggressive AML model with CD47 targeting. Finally, we explored using plasma dihydroorotate (DHO) levels to monitor HOSU-53 safety and found that the level of DHO accumulation could predict HOSU-53 intolerability, suggesting the clinical use of plasma DHO to determine safe DHODHi doses. Collectively, our data support the clinical translation of HOSU-53 in AML, particularly to augment immune therapies. Potent DHODHi to date have been limited by their therapeutic index; however, we introduce pharmacodynamic monitoring to predict tolerability while preserving antitumor activity. We additionally suggest that DHODHi is effective at lower doses with select immune therapies, widening the therapeutic index.
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Affiliation(s)
- Ola A Elgamal
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Sydney Fobare
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Sandip Vibhute
- Medicinal Chemistry Shared Resource, Comprehensive Cancer Center
| | - Abeera Mehmood
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Dennis C Vroom
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Mariah L Johnson
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Blaise Stearns
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - James R Lerma
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jean Truxall
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Emily Stahl
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Bridget Carmichael
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Shelley J Orwick
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Alice S Mims
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - Emily Curran
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ramasamy Santhanam
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | | | - Mitch A Phelps
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Zhiliang Xie
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Christopher C Coss
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Sharyn D Baker
- College of Pharmacy and Comprehensive Cancer Center; and
| | - Jeffrey Patrick
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Janel K Ezzell
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Jayesh Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jianmin Pan
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Shesh N Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine
- Cancer Data Science Center, College of Medicine; and
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Cody Stillwell
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mark Wunderlich
- Division of Experimental Hematology and Cancer Biology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | | | - Gerard Hilinski
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Chad E Bennett
- Medicinal Chemistry Shared Resource, Comprehensive Cancer Center
- Drug Development Institute, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Erin Hertlein
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
| | - John C Byrd
- Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Hematology, Department of Internal Medicine, College of Medicine
- College of Pharmacy and Comprehensive Cancer Center; and
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2
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Fobare S, Elgamal OA, Wunderlich M, Stahl E, Mehmood A, Furby C, Lerma JR, Sesterhenn TM, Pan J, Rai J, Johnstone ME, Abdul-Aziz A, Johnson ML, Rai SN, Byrd JC, Hertlein E. Inhibition of Enhancer of Zeste Homolog 2 Induces Blast Differentiation, Impairs Engraftment and Prolongs Survival in Murine Models of Acute Myeloid Leukemia. Cancers (Basel) 2024; 16:569. [PMID: 38339323 PMCID: PMC10854504 DOI: 10.3390/cancers16030569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is the malignant proliferation of immature myeloid cells characterized by a block in differentiation. As such, novel therapeutic strategies to promote the differentiation of immature myeloid cells have been successful in AML, although these agents are targeted to a specific mutation that is only present in a subset of AML patients. In the current study, we show that targeting the epigenetic modifier enhancer of zeste homolog 2 (EZH2) can induce the differentiation of immature blast cells into a more mature myeloid phenotype and promote survival in AML murine models. METHODS The EZH2 inhibitor EPZ011989 (EPZ) was studied in AML cell lines, primary in AML cells and normal CD34+ stem cells. A pharmacodynamic assessment of H3K27me3; studies of differentiation, cell growth, and colony formation; and in vivo therapeutic studies including the influence on primary AML cell engraftment were also conducted. RESULTS EPZ inhibited H3K27me3 in AML cell lines and primary AML samples in vitro. EZH2 inhibition reduced colony formation in multiple AML cell lines and primary AML samples, while exhibiting no effect on colony formation in normal CD34+ stem cells. In AML cells, EPZ promoted phenotypic evidence of differentiation. Finally, the pretreatment of primary AML cells with EPZ significantly delayed engraftment and prolonged the overall survival when engrafted into immunodeficient mice. CONCLUSIONS Despite evidence that EZH2 silencing in MDS/MPN can promote AML pathogenesis, our data demonstrate that the therapeutic inhibition of EZH2 in established AML has the potential to improve survival.
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Affiliation(s)
- Sydney Fobare
- Medical Scientist Training Program, The Ohio State University, Columbus, OH 43210, USA;
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Ola A. Elgamal
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Mark Wunderlich
- Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Emily Stahl
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Abeera Mehmood
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Casie Furby
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - James R. Lerma
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Thomas M. Sesterhenn
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Jianmin Pan
- Division of Biostatistics and Bioinformatics, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- The Cancer Data Science Center, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH 45267, USA
| | - Jayesh Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- The Cancer Data Science Center, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH 45267, USA
| | - Megan E. Johnstone
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Amina Abdul-Aziz
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Mariah L. Johnson
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Shesh N. Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- The Cancer Data Science Center, Department of Environmental Health and Public Health Sciences, University of Cincinnati, Cincinnati, OH 45267, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH 45267, USA
| | - John C. Byrd
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
| | - Erin Hertlein
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45229, USA (J.C.B.)
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3
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Abdul-Aziz A, Devine RD, Lyberger JM, Chang H, Kovacs A, Lerma JR, Rogers AM, Byrd JC, Hertlein E, Behbehani GK. Mass Cytometry as a Tool for Investigating Senescence in Multiple Model Systems. Cells 2023; 12:2045. [PMID: 37626855 PMCID: PMC10453346 DOI: 10.3390/cells12162045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 08/27/2023] Open
Abstract
Cellular senescence is a durable cell cycle arrest as a result of the finite proliferative capacity of cells. Senescence responds to both intrinsic and extrinsic cellular stresses, such as aging, mitochondrial dysfunction, irradiation, and chemotherapy. Here, we report on the use of mass cytometry (MC) to analyze multiple model systems and demonstrate MC as a platform for senescence analysis at the single-cell level. We demonstrate changes to p16 expression, cell cycling fraction, and histone tail modifications in several established senescent model systems and using isolated human T cells. In bone marrow mesenchymal stromal cells (BMSCs), we show increased p16 expression with subsequent passage as well as a reduction in cycling cells and open chromatin marks. In WI-38 cells, we demonstrate increased p16 expression with both culture-induced senescence and oxidative stress-induced senescence (OSIS). We also use Wanderlust, a trajectory analysis tool, to demonstrate how p16 expression changes with histone tail modifications and cell cycle proteins. Finally, we demonstrate that repetitive stimulation of human T cells with CD3/CD28 beads induces an exhausted phenotype with increased p16 expression. This p16-expressing population exhibited higher expression of exhaustion markers such as EOMES and TOX. This work demonstrates that MC is a useful platform for studying senescence at a single-cell protein level, and is capable of measuring multiple markers of senescence at once with high confidence, thereby improving our understanding of senescent pathways.
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Affiliation(s)
- Amina Abdul-Aziz
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (A.A.-A.)
| | - Raymond D. Devine
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Justin M. Lyberger
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Hsiaochi Chang
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Amy Kovacs
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - James R. Lerma
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (A.A.-A.)
| | - Andrew M. Rogers
- Maine Medical Center, Portland, ME 04102, USA
- Tufts University School of Medicine, Boston, MA 02111, USA
| | - John C. Byrd
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (A.A.-A.)
| | - Erin Hertlein
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (A.A.-A.)
| | - Gregory K. Behbehani
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
- Pelotonia Institute for Immuno-Oncology, The James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
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4
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Ayinde O, Sharpe C, Stahl E, Tokarski RJ, Lerma JR, Muthusamy N, Byrd JC, Fuchs JR. Examination of the Impact of Triazole Position within Linkers on Solubility and Lipophilicity of a CDK9 Degrader Series. ACS Med Chem Lett 2023; 14:936-942. [PMID: 37465296 PMCID: PMC10351057 DOI: 10.1021/acsmedchemlett.3c00082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/02/2023] [Indexed: 07/20/2023] Open
Abstract
Optimization of degrader properties is often a challenge due to their beyond-rule-of-5 nature. Given the paucity of known E3 ligases and the often-limited choice of ligands with varied chemical structures for a given protein target, degrader linkers represent the best position within the chimeric molecules to modify their overall physicochemical properties. In this work, a series of AT7519-based CDK9 degraders was assembled using click chemistry, facilitating the tuning of aqueous solubility and lipophilicity while retaining their linker type and molecular weight. Using chromatographic logD and kinetic solubility experiments, we show that degraders with similar chemical constitution but varied position of the embedded triazole demonstrate different lipophilicity and aqueous solubility properties. Overall, this work highlights the impact of triazole placement on linker composition through application of click chemistry for degrader synthesis and its ability to be used to promote the achievement of favorable physicochemical properties.
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Affiliation(s)
- Oluwatosin
R. Ayinde
- Division
of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, Ohio 43210, United States
| | - Chia Sharpe
- Department
of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati Ohio 45267, United States
| | - Emily Stahl
- Division
of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio 43210, United States
| | - Robert J. Tokarski
- Division
of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, Ohio 43210, United States
| | - James R. Lerma
- Department
of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati Ohio 45267, United States
| | - Natarajan Muthusamy
- Division
of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio 43210, United States
- The
Ohio State University Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus Ohio 43210, United States
| | - John C. Byrd
- Department
of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati Ohio 45267, United States
- University
of Cincinnati Cancer Center, College of Medicine, University of Cincinnati, Cincinnati Ohio 45267, United States
| | - James R. Fuchs
- Division
of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, Ohio 43210, United States
- The
Ohio State University Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus Ohio 43210, United States
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5
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Tokarski RJ, Sharpe CM, Huntsman AC, Mize BK, Ayinde OR, Stahl EH, Lerma JR, Reed A, Carmichael B, Muthusamy N, Byrd JC, Fuchs JR. Bifunctional degraders of cyclin dependent kinase 9 (CDK9): Probing the relationship between linker length, properties, and selective protein degradation. Eur J Med Chem 2023; 254:115342. [PMID: 37071962 DOI: 10.1016/j.ejmech.2023.115342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/02/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023]
Abstract
Cyclin-dependent kinase 9 (CDK9) is a promising therapeutic target in multiple cancer types, including acute myeloid leukemia (AML). Protein degraders, also known as proteolysis targeting chimeras (PROTACs), have emerged as tools for the selective degradation of cancer targets, including CDK9, complementing the activity of traditional small-molecule inhibitors. These compounds typically incorporate previously reported inhibitors and a known E3 ligase ligand to induce ubiquitination and subsequent degradation of the target protein. Although many protein degraders have been reported in the literature, the properties of the linker necessary for efficient degradation still require special attention. In this study, a series of protein degraders was developed, employing the clinically tested CDK inhibitor AT7519. The purpose of this study was to examine the effect that linker composition, specifically chain length, would have on potency. In addition to establishing a baseline of activity for various linker compositions, two distinct homologous series, a fully alkyl series and an amide-containing series, were prepared, demonstrating the dependence of degrader potency in these series on linker length and the correlation with predicted physicochemical properties.
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Affiliation(s)
- Robert J Tokarski
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, United States
| | - Chia M Sharpe
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, 45267, United States
| | - Andrew C Huntsman
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, United States
| | - Brittney K Mize
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, United States
| | - Oluwatosin R Ayinde
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, United States
| | - Emily H Stahl
- The Ohio State University Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH, 43210, United States
| | - James R Lerma
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, 45267, United States
| | - Andrew Reed
- CCIC Mass Spectrometry and Proteomics, The Ohio State University, Columbus, OH, 43210, United States
| | - Bridget Carmichael
- The Ohio State University Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH, 43210, United States
| | - Natarajan Muthusamy
- The Ohio State University Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH, 43210, United States
| | - John C Byrd
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, 45267, United States; University of Cincinnati Cancer Center, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267, United States
| | - James R Fuchs
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, United States.
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