A phase II study of vorolanib (CM082) in combination with toripalimab (JS001) in patients with advanced mucosal melanoma

10040

Background: Vorolanib (CM082) is a multi-target tyrosine kinase inhibitor including VEGF, PDGF, c-kit, and Flt-3. Toripalimab (JS001) is a humanized IgG4 mAb against programmed death-1 (PD-1) with clinical activity in metastasis melanoma but not in its mucosal subtype. In this phase II study (NCT03602547), we investigated the safety and efficacy of CM082 in combination with JS001 in patients (pts) with advanced mucosal melanoma. Methods: The study enrolled pts from 18 to 75 years-old with histologically confirmed metastatic mucosal melanoma, ECOG PS 0-1, no prior systemic anti-cancer treatment. Eligible pts were treated with CM082 tablet (150 or 200 mg once daily) combined with JS001 (240mg every 2 weeks, IV, Q2W) until confirmed disease progression or unacceptable toxicity. Clinical response was evaluated every 8 week. The primary endpoint was overall response rate (ORR) using RECIST v1.1. Secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), duration of remission (DOR), and time to first remission (TTR) according to RECIST v1.1 and iRECIST. The safety was also assessed. Results: Between July 2018 and April 12, 2019, 40 pts (19 pts in 150mg group; 21 pts in 200mg group) were enrolled and 38 pts were evaluable for tumor response (150mg n = 18, 200mg n = 20), with 4 (22.2%) confirmed partial response (PR), 6 (33.3%) stable disease (SD) and 8 (44.4%) progression disease (PD) in the 150mg CM082 group; 3 (15%) PRs (including 2 unconfirmed), 10 (50%) SD, and 7 (35%) PD were reported in the 200mg CM082 group. Tumors shrank in 10 pts (56%) in the 150mg group and 10 pts (50%) in the 200mg group. At data cut-off (November 28, 2019), 29 pts had PFS events (150mg n = 12; 200mg n = 17). The median PFS was 5.7 (95% CI 2.0, NE) months and 5.6 (1.9, 7.7) months in the two groups, respectively. The most common treatment-related adverse events (AEs) were grade 1 or 2, including leukopenia, elevated LDH, increased ALT, neutropenia, increased AST, and elevated GGT. Common grade 3 or higher adverse events ( > 10%) were increased ALT (12 pts, 30%), increased AST (11 pts, 27.5%), neutropenia (6 pts, 15%) and elevated GGT (6 pts, 15%). Eight pts had 9 serious AEs (SAEs). The study is still ongoing and more data will be presented in the future. Conclusions: PFS benefit was observed in both 150mg and 200mg subgroups. This study demonstrated potentially improved efficacy with predictable toxicities of CM082 in combination with JS001 therapy, which may be an effective treatment option for pts with advanced mucosal melanoma. Clinical trial information: NCT03602547.

Palbociclib (P) in advanced acral lentiginous melanoma (ALM) with CDK4 pathway gene aberrations

9528

Background: Genetic Aberrations in the CDK4 Pathway occur in 82% of the ALM pts (Clin Cancer Res,2017, 23(22):6946-6957), which is predominant subtype in China. This study is to evaluate the anti-tumor activity of palbociclib, a CDK4/6 inhibitor, in advanced ALM pts with CDK pathway gene aberrations. Methods: In this phase II trial, patients with advanced ALM with CDK pathway gene aberrations (CDK4 or/and CCND1 amplification or/and CDKN2A loss) were treated with palbociclib 125 mg po, d1-21 of 28 day cycles. According to the study design, this trial will be closed if less than 2 patients yield objective response (OR) or stable disease (SD) at a preset 8-week landmark analysis. Secondary endpoints are progression-free survival (PFS), overall survival (OS) and safety. Results: Fifteen pts were enrolled from April to Nov 2018. All pts are included in the data analysis for demographics, safety, ORR, PFS and OS. Median age was 54 y (range, 25-74y), 6(40%) were males,5( 33.3%) had the primary sites of subungual, 4(26.7%) were of stage III. Median numbers of prior therapies: 2 (range: 0-5). Three (20.0%) pts achieved tumor shrinkage at 8 wks, including 1 confirmed partial responses (PR). Two pts had treatment ongoing at the data cutoff (January 2019). Median PFS was 2.5m (range, 1.5-8.8m), estimated mean OS was 8.1m (range, 6.7-9.4m). Four pts deceased due to disease progression. The most common treatment related adverse events (TRAEs) were leukopenia/neutropenia (87%; G3, 33%), thrombocytopenia (27%; G3, 7%), anemia (40%; G3, 7%). Conclusions: Monotherapy with palbociclib demonstrated preliminary activities in advanced melanoma pts with CDK pathway gene aberrations. Therefore, the study met its primary endpoint. Palbociclib had an acceptable safety profile as previous studies. Combination of CDK4/6 inhibitor with other agents is under consideration. Clinical trial information: NCT03454919.

Characterization of mechano-microenvironment of acral melanoma and its potential impact on tumor cell invasion

e21062

Background: Acral melanoma is the main subtype in Asia, and tends to be insensitive to conventional and novel therapies compared with cutaneous melanomas. It has been proved that biomechanical alterations inside the tumor microenvironment significantly affect tumor progression in breast, pancreatic and other cancers(Hepatology. 2016 July ; 64(1): 261–275; Cold Spring Harbor Symposia on Quantitative Biology, Volume LXXXI) . Hence, we hypothesized that the biomechanical microenvironment plays critical roles in proliferation and invasion in acral melanoma. In this study, the main purpose is to observe whether melanoma cells have the same ability called “durotaxis” as other tumors, which to respond to a gradient of extracellular stiffness and migrate in a directed fashion. Methods: In this study, the stiffness was compared between the acral melanoma tissue and the normal tissue by using the atomic force microscope (AFM) with fresh samples and the freezing microtome sectioning specimen (J. Matthew Barnes et al., Nature Cell Biology 2018.) . A stiffness gradient polyacrylamide hydrogel system was constructed to observe how the acral melanoma cells response. Using automated tracking (Curr Protoc Cell Biol. ; 76: 12.12.1–12.12.16.) of positional data for large sample size of single migrating cells to systematically analyze polarized melanoma cell migration in response to stiffness gradient. Results: The results showed that 1) all the acral melanoma cell lines tested displayed strong anti-durotactic migratory response, which was in accordance with the AFM measurement that the melanoma microenvironment gradually softened; 2) Acral melanoma cells tend to move toward softer areas on gradient gels, which is contrary to the migration behavior of most other tumor cells. Conclusions: In this study, we presented the different migratory pattern of acral melanoma cells. It may illustrate the invasion mechanism for aral melanoma cells. It could also herald that extracellular matrix may be a potential therapeutic target in acral melanomas.

[Study on the differentiation and apoptosis of HL-60 cell line induced by Puerarin]

OBJECTIVE

To investigate the differentiation of HL-60 cells induced by different doses of Purerarin(PR) comparing with all-trans retinoic acid(ATRA) and to see if PR can induce apoptosis of HL-60 cells.

METHODS

Cell differentiation was analyzed by NBT reduction, the ratio of NBT/MTT and CD11b, apoptosis by morphology, DNA electrophoresis, and flow cytometry(FCM).

RESULTS

80 micrograms.ml-1, 160 micrograms.ml-1, 320 micrograms.ml-1 PR could induce differentiation of HL-60 cells, no significant difference was observed between the cells treated with 1 mumol.L-1 ATRA and 320 micrograms.ml-1 PR. Treated with 320 micrograms.ml-1, 640 micrograms.ml-1 PR, HL-60 cells exhibited a morphological characteristic of apoptosis and typical DNA ladder on gel electrophoresis. FCM analysis showed that PR could interfere with cell cycle in HL-60 cells, with a increased ratio of sub-G1 in HL-60 cells.

CONCLUSION

PR exerts effect on differentiation and induces apoptosis in HL-60 cells.

[The relationship between clinical prognosis and classification of the isoforms of fuse gene in acute promyelocytic leukemia]

To check the anti-apoptosis gene bcl-2 protein/mRNA expression in 28 acute promyelocytic leukemia (APL), by immunohistochemistry and in situ hybridization, and to analyse the relationship among the bcl-2 gene expressions, clinical prognosis and classification of the isoforms of fuse gene in APL. The result shows the two types of isoforms of PML-RAR alpha have no significance in bcl-2 protein/mRNA expression, indexes of clinical prognosis. This shows that the classification of PML-RAR alpha isoform has no influence on clinical prognosis.

Neural representation of sound duration in the inferior colliculus of the mouse

In this study we examined the neuronal responses of single units to different sound durations in the inferior colliculus (IC) of the mouse. One hundred and one recorded units were classified into onset (58%), sustained (9%) on-sustained (22%), pauser (9%) and chopper (2%) response patterns. Thirty-four percent of the recorded units showing stronger responses to long stimulus durations were defined as long-duration-selective neurons. Twenty-five percent of the units preferred a narrow range of sound durations and were classified as band-pass neurons. Ten percent of the units responded preferentially to short stimulus durations and thus displayed short-duration selectivity. Twelve percent of the units that responded with nearly constant spike counts to stimuli of varying duration were classified as all-pass neurons. In contrast to the result of no short-duration-selective neurons found in chinchilla IC, we observed that some of the onset units in the IC of the mouse displayed a short duration preference. The best duration range of the duration-selective neurons in the present study corresponds to the duration range of mouse calls. We suggest that an inhibitory mechanism contributes to the duration selectivity observed in the present study.

[Relationship between the expression of bcl-2 apoptosis and acute myelogenous leukemia prognosis]

In order to check the anti-apoptosis gene bcl-2 protein expression in 58 AML patients we used the immunohistochemical method, and analyse the relationship between bcl-2 protein and prognosis of AML. The result showed that the high expression of bcl-2 protein was related to poor clinical prognosis of AML. This shows that the expression of bcl-2 gene can serve as an index for the prognosis of AML.

[Experimental study on Jurkat cell apoptosis induced by Boswellia carterii Birdw extractive]

OBJECTIVE

To study the influence of Boswellia carterii Birdw(BCB) extractive of different concentrations on human Jurkat cell apoptosis at different time points.

METHODS

Agarose gel electrophoresis, transmission electron microscope(TEM) and flow cytometry(FCM) were used for observing DNA ladders, morphology of Jurkat cells and cell cycle, respectively.

RESULTS

BCB induced apoptosis of Jurkat cells and typical DNA ladders; TEM demonstrated the presence of apoptosis Jurkat cells, condensation of cytoplasm, numerous vaculoes in cytoplasm, compaction of the nuclear chromatin and formation of apoptosis dody. The sub-G1 peak was detected by cell cycle analysis. It revealed that G1 phage cells increased and S phage cells decreased.

CONCLUSION

The data indicate that BCB extractive induces time- and concentration-dependent apoptosis in Jurkat cell line.

Determination of aspartame by ion chromatography with electrochemical integrated amperometric detection

In this paper, the separation and determination of the sweetener aspartame by ion chromatography coupled with electrochemical amperometric detection is reported. Sodium saccharin, acesulfame-K and aspartame were separated using 27.5 mmol/l NaOH isocratic elution on a Dionex IonPac AS4A-SC separation column. Aspartame can be determined by integrated amperometric detection without interference from the other two sweeteners. The method can be applied to the determination of aspartame in powered tabletop, fruit juice and carbonated beverage samples, and the results obtained by integrated amperometry were in agreement with those obtained using a UV detection method. A method for determining analytes with an NH2 group by ion chromatography with integrated amperometry was developed.

Ion chromatographic determination of taurine in medicine, nutrient capsule and human urine with electrochemical detection

A very simple and sensitive method for the determination of taurine by ion chromatography with electrochemical integrated pulsed amperometry is firstly described. Taurine was determined using 160 mmol/l NaOH as eluent and a Dionex CarboPac PA1 separation column (250x4 mm I.D.) without the interference with ten kinds of common amino acids. The peak area response of taurine was linear in the range 0.1-20 microg/ml, the detection limit was 0.034 microg/ml. The method has been applied successfully in the determination of taurine in medicinal granule, nutrient capsule and human urine. The content determined in medicinal granule is consistent with that marked by the manufacturer.

[The mechanism of renal hyperperfusion induced by hyperglycemia]

Using whole body clearance technique as well as isolated perfused rat kidney (IPRK). We studied the effect of hyperglycemia on renal hemodynamics and the possible mechanism involved. Hyperglycemia increased renal plasma flow (RPF) and glomerular filtration rate (GFR). In nonfiltering isolated perfused rat kidney or after adding furosemide to the perfusate, both techniques were believed to abolish the tubuloglomerular feedback, the renal hemodynamic changes induced by hyperglycemia disappeared, but adding sodium nitroprusside increased RPF and decreased renal vascular resistance (RVR). D-alpha-methyl-glucoside, a glucose derivative, increased RPF and GFR in IPRK, but had no influence on renal hemodynamics in whole body clearance study. Hemoglobin, which could block the action of endothelium--derived relaxing factor (EDRF), did not change the effects of hyperglycemia on renal hemodynamics in IPRK. These results indicated that hyperglycemia could directly induce hyperperfusion and hyperfiltration, which is mainly mediated by suppression of tubuloglomerular feedback. EDRF do not play the major role in the changes of hemodynamics induced by hyperglycemia.

Studies on the structure of HBV DNA

The structure of HBV adr NC-1 DNA is analyzed and compared with another five strains of HBV DNAs. Some of the prokaryotic promoter-like sequences, palindrom sequences and ATAA are found. An enhancer core sequence and some other characteristics are also shown. In considering the frame and its regulatory sequence as a transcriptional unit some of the possible new frames are discussed.

Determination of the complete nucleotide sequence of HBV adr NC-1 DNA

On the basis of sequencing the large DNA-fragments which have been inserted into M13mp8, we design a simple strategy to determine the complete nucleotide sequence of HBV adr NC-1 DNA with chain termination method. The whole genome is 3195 nucleotides long. Five reading frames are observed. The gene location and organization are shown.