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Kopmar NE, Gooley T, Curley N, Russell K, Shaw C, Schonhoff K, Lim J, Halpern AB, Walter RB, Scott BL, Appelbaum J, Hendrie PC, Estey EH, Percival MEM. Results from a phase I study of continuous infusion cladribine, high-dose cytarabine, and mitoxantrone for relapsed/refractory high-grade myeloid neoplasms. Leuk Lymphoma 2023; 64:1057-1059. [PMID: 36896478 PMCID: PMC10330652 DOI: 10.1080/10428194.2023.2185087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Noam E Kopmar
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ted Gooley
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Niall Curley
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Kathryn Russell
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Carole Shaw
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kelda Schonhoff
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - John Lim
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anna B Halpern
- Department of Medicine, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Roland B Walter
- Department of Medicine, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Laboratory Medicine & Pathology, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Bart L Scott
- Department of Medicine, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jacob Appelbaum
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Paul C Hendrie
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Elihu H Estey
- Department of Medicine, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Mary-Elizabeth M Percival
- Department of Medicine, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
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Coffey DG, Cowan AJ, DeGraaff B, Martins TJ, Curley N, Green DJ, Libby EN, Silbermann R, Chien S, Dai J, Morales A, Gooley TA, Warren EH, Becker PS. High-Throughput Drug Screening and Multi-Omic Analysis to Guide Individualized Treatment for Multiple Myeloma. JCO Precis Oncol 2021; 5:PO.20.00442. [PMID: 34250400 PMCID: PMC8232547 DOI: 10.1200/po.20.00442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/14/2021] [Accepted: 02/24/2021] [Indexed: 11/20/2022] Open
Abstract
Multiple myeloma (MM) is a genetically heterogeneous malignancy characterized by variable treatment responses. Although numerous drugs have been approved in recent years, the ability to predict treatment response and tailor individual therapy is limited by the absence of robust predictive biomarkers. The goal of this clinical trial was to use ex vivo, high-throughput screening (HTS) of 170 compounds to predict response among patients with relapsed or refractory MM and inform the next treatment decisions. Additionally, we integrated HTS with multi-omic analysis to uncover novel associations between in vitro drug sensitivity and gene expression and mutation profiles. MATERIALS AND METHODS Twenty-five patients with relapsed or refractory MM underwent a screening bone marrow or soft tissue biopsy. Sixteen patients were found to have sufficient plasma cells for HTS. Targeted next-generation sequencing was performed on plasma cell-free DNA from all patients who underwent HTS. RNA and whole-exome sequencing of bone marrow plasma cells were performed on eight and seven patients, respectively. RESULTS Results of HTS testing were made available to treating physicians within a median of 5 days from the biopsy. An actionable treatment result was identified in all 16 patients examined. Among the 13 patients who received assay-guided therapy, 92% achieved stable disease or better. The expression of 105 genes and mutations in 12 genes correlated with in vitro cytotoxicity. CONCLUSION In patients with relapsed or refractory MM, we demonstrate the feasibility of ex vivo drug sensitivity testing on isolated plasma cells from patient bone marrow biopsies or extramedullary plasmacytomas to inform the next line of therapy.
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Affiliation(s)
- David G. Coffey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
- Brotman Baty Institute for Precision Medicine, Seattle, WA
| | - Andrew J. Cowan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Bret DeGraaff
- Department of Medicine, University of Washington, Seattle, WA
| | - Timothy J. Martins
- Quellos High Throughput Screening Core, Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA
| | - Niall Curley
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Damian J. Green
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Edward N. Libby
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
| | - Rebecca Silbermann
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR
| | - Sylvia Chien
- Department of Medicine, University of Washington, Seattle, WA
| | - Jin Dai
- Department of Medicine, University of Washington, Seattle, WA
| | - Alicia Morales
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ted A. Gooley
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Edus H. Warren
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
- Brotman Baty Institute for Precision Medicine, Seattle, WA
| | - Pamela S. Becker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
- Brotman Baty Institute for Precision Medicine, Seattle, WA
- Quellos High Throughput Screening Core, Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, CA
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