1
|
Gaspar N, Marshall LV, Binner D, Herold R, Rousseau R, Blanc P, Capdeville R, Carleer J, Copland C, Kerloeguen Y, Norga K, Pacaud L, Sevaux MA, Spadoni C, Sterba J, Ligas F, Taube T, Uttenreuther-Fischer M, Chioato S, O'Connell MA, Geoerger B, Blay JY, Soria JC, Kaye S, Wulff B, Brugières L, Vassal G, Pearson ADJ. Joint adolescent-adult early phase clinical trials to improve access to new drugs for adolescents with cancer: proposals from the multi-stakeholder platform-ACCELERATE. Ann Oncol 2018; 29:766-771. [PMID: 29351570 PMCID: PMC5889024 DOI: 10.1093/annonc/mdy002] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- N Gaspar
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France.
| | - L V Marshall
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| | - D Binner
- Create for Chloe and UK Representative for aPODD, European Medicines Agency, London, UK
| | - R Herold
- Product Development Scientific Support Department, European Medicines Agency, London, UK
| | - R Rousseau
- Gritstone Oncology, Inc., Emeryville, USA
| | - P Blanc
- Imagine for Margo, Fourqueux, France
| | | | - J Carleer
- Belgium Federal Agency for Medicines and Health Products, EUROSTATION, Brussels, Belgium
| | - C Copland
- Centre for English Language Teaching, University of York, York, UK
| | - Y Kerloeguen
- Pharmaceuticals Division, PDOA, Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - K Norga
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK; Universitair Ziekenhuis Antwerpen, Edegem, Belgium
| | | | | | - C Spadoni
- aPODD Foundation, City Point, London, UK
| | - J Sterba
- Pediatric Oncology Department, University Hospital Brno, School of Medicine Masaryk University Brno, Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, ICRC Brno, St. Anna University Hospital Brno, Czech Republic
| | - F Ligas
- Product Development Scientific Support Department, European Medicines Agency, London, UK
| | - T Taube
- Boehringer Ingelheim, Pharma GmbH&Co KG, TA Oncology, Biberach, Germany
| | | | - S Chioato
- Regulatory Strategy Oncology, Pfizer Italia, Milano, Italy
| | - M A O'Connell
- Regulatory Strategy Oncology, Pfizer Italia, Milano, Italy
| | - B Geoerger
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France
| | - J-Y Blay
- Centre Léon Bérard and University Claude Bernard Lyon 1, Lyon
| | - J C Soria
- Drug Development Department (DITEP), Gustave Roussy, Villejuif and University Paris-Sud, Orsay, France
| | - S Kaye
- Adult Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, London, UK
| | - B Wulff
- Paediatric Haematology/Oncology, Clinical Research/Paediatric Drug Development, University Childreńs Hospital III Hufelandstraße, Essen, Germany
| | - L Brugières
- Department of Oncology for Children and Adolescents, Gustave Roussy Cancer Campus, Villejuif, France
| | - G Vassal
- Department of Clinical Research, Gustave Roussy, Villejuif and Paris-Sud University, Le Kremlin-Bicêtre, France
| | - A D J Pearson
- Paediatric and Adolescent Drug Development Team, Oak Centre for Children & Young People, The Royal Marsden Hospital & The Institute of Cancer Research, London, UK
| |
Collapse
|
2
|
Moore AS, Kearns PR, Knapper S, Pearson ADJ, Zwaan CM. Novel therapies for children with acute myeloid leukaemia. Leukemia 2013; 27:1451-60. [PMID: 23563239 DOI: 10.1038/leu.2013.106] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [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: 03/06/2013] [Revised: 03/24/2013] [Accepted: 04/04/2013] [Indexed: 12/22/2022]
Abstract
Significant improvements in survival for children with acute myeloid leukaemia (AML) have been made over the past three decades, with overall survival rates now approximately 60-70%. However, these gains can be largely attributed to more intensive use of conventional cytotoxics made possible by advances in supportive care, and although over 90% of children achieve remission with frontline therapy, approximately one third in current protocols relapse. Furthermore, late effects of therapy cause significant morbidity for many survivors. Novel therapies are therefore desperately needed. Early-phase paediatric trials of several new agents such as clofarabine, sorafenib and gemtuzumab ozogamicin have shown encouraging results in recent years. Due to the relatively low incidence of AML in childhood, the success of paediatric early-phase clinical trials is largely dependent upon collaborative clinical trial design by international cooperative study groups. Successfully incorporating novel therapies into frontline therapy remains a challenge, but the potential for significant improvement in the duration and quality of survival for children with AML is high.
Collapse
Affiliation(s)
- A S Moore
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia.
| | | | | | | | | |
Collapse
|
3
|
Schleiermacher G, Mosseri V, London WB, Maris JM, Brodeur GM, Attiyeh E, Haber M, Khan J, Nakagawara A, Speleman F, Noguera R, Tonini GP, Fischer M, Ambros I, Monclair T, Matthay KK, Ambros P, Cohn SL, Pearson ADJ. Segmental chromosomal alterations have prognostic impact in neuroblastoma: a report from the INRG project. Br J Cancer 2012; 107:1418-22. [PMID: 22976801 PMCID: PMC3494425 DOI: 10.1038/bjc.2012.375] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [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: 01/09/2023] Open
Abstract
Background: In the INRG dataset, the hypothesis that any segmental chromosomal alteration might be of prognostic impact in neuroblastoma without MYCN amplification (MNA) was tested. Methods: The presence of any segmental chromosomal alteration (chromosome 1p deletion, 11q deletion and/or chromosome 17q gain) defined a segmental genomic profile. Only tumours with a confirmed unaltered status for all three chromosome arms were considered as having no segmental chromosomal alterations. Results: Among the 8800 patients in the INRG database, a genomic type could be attributed for 505 patients without MNA: 397 cases had a segmental genomic type, whereas 108 cases had an absence of any segmental alteration. A segmental genomic type was more frequent in patients >18 months and in stage 4 disease (P<0.0001). In univariate analysis, 11q deletion, 17q gain and a segmental genomic type were associated with a poorer event-free survival (EFS) (P<0.0001, P=0.0002 and P<0.0001, respectively). In multivariate analysis modelling EFS, the parameters age, stage and a segmental genomic type were retained in the model, whereas the individual genetic markers were not (P<0.0001 and RR=2.56; P=0.0002 and RR=1.8; P=0.01 and RR=1.7, respectively). Conclusion: A segmental genomic profile, rather than the single genetic markers, adds prognostic information to the clinical markers age and stage in neuroblastoma patients without MNA, underlining the importance of pangenomic studies.
Collapse
Affiliation(s)
- G Schleiermacher
- INSERM U, Laboratoire de Génétique et Biologie des Cancers, Institut Curie, Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Moore AS, Faisal A, Gonzalez de Castro D, Bavetsias V, Sun C, Atrash B, Valenti M, de Haven Brandon A, Avery S, Mair D, Mirabella F, Swansbury J, Pearson ADJ, Workman P, Blagg J, Raynaud FI, Eccles SA, Linardopoulos S. Selective FLT3 inhibition of FLT3-ITD+ acute myeloid leukaemia resulting in secondary D835Y mutation: a model for emerging clinical resistance patterns. Leukemia 2012; 26:1462-70. [PMID: 22354205 PMCID: PMC3523391 DOI: 10.1038/leu.2012.52] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [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: 01/08/2023]
Abstract
Acquired resistance to selective FLT3 inhibitors, is an emerging clinical problem in the treatment of FLT3-ITD+ acute myeloid leukaemia (AML). The paucity of valid pre-clinical models has limited investigations to determine the mechanism of acquired therapeutic resistance, thereby limiting the development of effective treatments. We generated selective FLT3 inhibitor-resistant cells by treating the FLT3-ITD+ human AML cell line MOLM-13 in vitro with the FLT3-selective inhibitor MLN518, and validated the resistant phenotype in vivo and in vitro. The resistant cells, MOLM-13-RES, harboured a new D835Y tyrosine kinase domain (TKD) mutation on the FLT3-ITD+ allele. Acquired TKD mutations, including D835Y, have recently been identified in FLT3-ITD+ patients relapsing after treatment with the novel FLT3 inhibitor, AC220. Consistent with this clinical pattern of resistance, MOLM-13- RES cells displayed high relative resistance to AC220 and Sorafenib. Furthermore, treatment of MOLM-13-RES cells with AC220 lead to loss of the FLT3 wild type allele and duplication of the FLT3-ITD-D835Y allele. Our FLT3-Aurora kinase inhibitor, CCT137690, successfully inhibited growth of FLT3-ITD-D835Y cells in vitro and in vivo, suggesting that dual FLT3-Aurora inhibition may overcome selective FLT3 inhibitor resistance, in part due to inhibition of Aurora kinase, and may benefit patients with FLT3-mutated AML.
Collapse
Affiliation(s)
- A S Moore
- Cancer Research UK Cancer Therapeutics Unit, Division of Cancer Therapeutics, The Institute of Cancer Research, Sutton, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Matthay KK, Shulkin B, Ladenstein R, Michon J, Giammarile F, Lewington V, Pearson ADJ, Cohn SL. Criteria for evaluation of disease extent by (123)I-metaiodobenzylguanidine scans in neuroblastoma: a report for the International Neuroblastoma Risk Group (INRG) Task Force. Br J Cancer 2010; 102:1319-26. [PMID: 20424613 PMCID: PMC2865749 DOI: 10.1038/sj.bjc.6605621] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [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: 09/29/2009] [Revised: 02/22/2010] [Accepted: 03/03/2010] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Neuroblastoma is an embryonic tumour of the sympathetic nervous system, metastatic in half of the patients at diagnosis, with a high preponderance of osteomedullary disease, making accurate evaluation of metastatic sites and response to therapy challenging. Metaiodobenzylguanidine (mIBG), taken into cells via the norepinephrine transporter, provides a sensitive and specific method of assessing tumour in both soft tissue and bone sites. The goal of this report was to develop consensus guidelines for the use of mIBG scans in staging, response assessment and surveillance in neuroblastoma. METHODS The International Neuroblastoma Risk Group (INRG) Task Force, including a multidisciplinary group in paediatric oncology of North and South America, Europe, Oceania and Asia, formed a subcommittee on metastatic disease evaluation, including expert nuclear medicine physicians and oncologists, who developed these guidelines based on their experience and the medical literature, with approval by the larger INRG Task Force. RESULTS Guidelines for patient preparation, radiotracer administration, techniques of scanning including timing, energy, specific views, and use of single photon emission computed tomography are included. Optimal timing of scans in relation to therapy and for surveillance is reviewed. Validated semi-quantitative scoring methods in current use are reviewed, with recommendations for use in prognosis and response evaluation. CONCLUSIONS Metaiodobenzylguanidine scans are the most sensitive and specific method of staging and response evaluation in neuroblastoma, particularly when used with a semi-quantitative scoring method. Use of the optimal techniques for mIBG in staging and response, including a semi-quantitative score, is essential for evaluation of the efficacy of new therapy.
Collapse
Affiliation(s)
- K K Matthay
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, CA 94143-0106, USA.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Moore AS, Blagg J, Linardopoulos S, Pearson ADJ. Aurora kinase inhibitors: novel small molecules with promising activity in acute myeloid and Philadelphia-positive leukemias. Leukemia 2010; 24:671-8. [DOI: 10.1038/leu.2010.15] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
7
|
Beiske K, Burchill SA, Cheung IY, Hiyama E, Seeger RC, Cohn SL, Pearson ADJ, Matthay KK. Consensus criteria for sensitive detection of minimal neuroblastoma cells in bone marrow, blood and stem cell preparations by immunocytology and QRT-PCR: recommendations by the International Neuroblastoma Risk Group Task Force. Br J Cancer 2009; 100:1627-37. [PMID: 19401690 PMCID: PMC2696761 DOI: 10.1038/sj.bjc.6605029] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 02/16/2009] [Accepted: 03/17/2009] [Indexed: 01/23/2023] Open
Abstract
Disseminating disease is a predictive and prognostic indicator of poor outcome in children with neuroblastoma. Its accurate and sensitive assessment can facilitate optimal treatment decisions. The International Neuroblastoma Risk Group (INRG) Task Force has defined standardised methods for the determination of minimal disease (MD) by immunocytology (IC) and quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) using disialoganglioside G(D2) and tyrosine hydroxylase mRNA respectively. The INRG standard operating procedures (SOPs) define methods for collecting, processing and evaluating bone marrow (BM), peripheral blood (PB) and peripheral blood stem cell harvest by IC and QRT-PCR. Sampling PB and BM is recommended at diagnosis, before and after myeloablative therapy and at the end of treatment. Peripheral blood stem cell products should be analysed at the time of harvest. Performing MD detection according to INRG SOPs will enable laboratories throughout the world to compare their results and thus facilitate quality-controlled multi-centre prospective trials to assess the clinical significance of MD and minimal residual disease in heterogeneous patient groups.
Collapse
Affiliation(s)
- K Beiske
- Department of Pathology, Oslo University Hospital, Oslo, Norway.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Ambros PF, Ambros IM, Brodeur GM, Haber M, Khan J, Nakagawara A, Schleiermacher G, Speleman F, Spitz R, London WB, Cohn SL, Pearson ADJ, Maris JM. International consensus for neuroblastoma molecular diagnostics: Report from the international neuroblastoma risk grouping (INRG) Biology committee. Klin Padiatr 2009. [DOI: 10.1055/s-0029-1222622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
9
|
Cole M, Price L, Parry A, Picton S, Waters F, Marshall S, Goran C, Parnham A, Wastell H, Reid MM, Pearson ADJ, Boddy AV, Veal GJ. A study to determine the minimum volume of blood necessary to be discarded from a central venous catheter before a valid sample is obtained in children with cancer. Pediatr Blood Cancer 2007; 48:687-95. [PMID: 16676305 DOI: 10.1002/pbc.20873] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The objective of this study was to determine the minimum volume of blood that should be discarded from a range of different types of central venous catheter (CVC), such that the subsequent blood sample was not diluted or contaminated by the residual intra-luminal fluid. PROCEDURE Seventy children aged 1-19 years with central venous access inserted as part of their standard clinical treatment were recruited to this prospective study. Statistical comparison of the extent of variation in biochemical and haematological parameters observed between two blood samples taken following routine 5 ml discard blood volumes, as compared to the extent of variation between samples drawn following a 5 ml discard volume and <5 ml volumes, was carried out. RESULTS Data indicate that the measurement error in a clinical sample obtained following a 3 ml discard volume is no different to the measurement error obtained when using a standard 5 ml discard volume. Comparable results were obtained from patients with various different types of CVC or portacath access. CONCLUSIONS The withdrawal of a 3 ml discard volume is sufficient to ensure that the subsequent blood sample is not diluted or contaminated by residual intra-luminal fluid. This may have a significant clinical impact in paediatric oncology, where patients frequently require blood transfusions due to the haematological toxicities associated with chemotherapy. It is hoped that these results will impact on hospital policies concerning specified discard volumes taken from CVCs prior to the withdrawal of blood samples for research purposes and routine clinical analysis.
Collapse
Affiliation(s)
- M Cole
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Łastowska M, Viprey V, Santibanez-Koref M, Wappler I, Peters H, Cullinane C, Roberts P, Hall AG, Tweddle DA, Pearson ADJ, Lewis I, Burchill SA, Jackson MS. Identification of candidate genes involved in neuroblastoma progression by combining genomic and expression microarrays with survival data. Oncogene 2007; 26:7432-44. [PMID: 17533364 DOI: 10.1038/sj.onc.1210552] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [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: 02/03/2023]
Abstract
Identifying genes, whose expression is consistently altered by chromosomal gains or losses, is an important step in defining genes of biological relevance in a wide variety of tumour types. However, additional criteria are needed to discriminate further among the large number of candidate genes identified. This is particularly true for neuroblastoma, where multiple genomic copy number changes of proven prognostic value exist. We have used Affymetrix microarrays and a combination of fluorescent in situ hybridization and single nucleotide polymorphism (SNP) microarrays to establish expression profiles and delineate copy number alterations in 30 primary neuroblastomas. Correlation of microarray data with patient survival and analysis of expression within rodent neuroblastoma cell lines were then used to define further genes likely to be involved in the disease process. Using this approach, we identify >1000 genes within eight recurrent genomic alterations (loss of 1p, 3p, 4p, 10q and 11q, 2p gain, 17q gain, and the MYCN amplicon) whose expression is consistently altered by copy number change. Of these, 84 correlate with patient survival, with the minimal regions of 17q gain and 4p loss being enriched significantly for such genes. These include genes involved in RNA and DNA metabolism, and apoptosis. Orthologues of all but one of these genes on 17q are overexpressed in rodent neuroblastoma cell lines. A significant excess of SNPs whose copy number correlates with survival is also observed on proximal 4p in stage 4 tumours, and we find that deletion of 4p is associated with improved outcome in an extended cohort of tumours. These results define the major impact of genomic copy number alterations upon transcription within neuroblastoma, and highlight genes on distal 17q and proximal 4p for downstream analyses. They also suggest that integration of discriminators, such as survival and comparative gene expression, with microarray data may be useful in the identification of critical genes within regions of loss or gain in many human cancers.
Collapse
Affiliation(s)
- M Łastowska
- Institute of Human Genetics, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Veal GJ, Errington J, Tilby MJ, Pearson ADJ, Foot ABM, McDowell H, Ellershaw C, Pizer B, Nowell GM, Pearson DG, Boddy AV. Adaptive dosing and platinum-DNA adduct formation in children receiving high-dose carboplatin for the treatment of solid tumours. Br J Cancer 2007; 96:725-31. [PMID: 17299395 PMCID: PMC2360071 DOI: 10.1038/sj.bjc.6603607] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A pharmacokinetic-pharmacodynamic study was carried out to investigate the feasibility and potential importance of therapeutic monitoring following high-dose carboplatin treatment in children. High-dose carboplatin was administered over 3 or 5 days, with the initial dose based on renal function, to achieve target area under the plasma concentration-time curve (AUC) values of 21 or 20 mg ml(-1).min, respectively. Dose adjustment was carried out based on observed individual daily AUC values, to obtain the defined target exposures. Platinum-DNA adduct levels were determined in peripheral blood leucocytes and toxicity data were obtained. Twenty-eight children were studied. Based on observed AUC values, carboplatin dose adjustment was performed in 75% (21 out of 28) patients. Therapeutic monitoring resulted in the achievement of carboplatin exposures within 80-126% of target AUC values, as compared to estimated exposures of 65-213% of target values without dose adjustment. The carboplatin AUC predicted with no dose modification was positively correlated with pretreatment glomerular filtration rate (GFR) values. Higher GFR values were observed in those patients who would have experienced AUC values >25% above the target AUC than those patients attaining AUC values >25% below the target AUC, following renal function-based dosing. Platinum-DNA adduct levels correlated with observed AUC values on day 1 of carboplatin and increased over a 5-day course of treatment. Real-time monitoring of carboplatin pharmacokinetics with adaptive dosing is both feasible and necessary for the attainment of consistent AUC values in children receiving high-dose carboplatin treatment. Pharmacodynamic data suggest a strong correlation between carboplatin pharmacokinetics and the drug-target interaction.
Collapse
Affiliation(s)
- G J Veal
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, UK
| | - J Errington
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, UK
| | - M J Tilby
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, UK
| | | | - A B M Foot
- Bristol Royal Hospital for Children, Bristol, BS2 8BJ, UK
| | - H McDowell
- Alder Hey Children's Hospital, Liverpool, L12 2AP, UK
| | - C Ellershaw
- United Kingdom Children's Cancer Study Group, Leicester, LE1 6TP, UK
| | - B Pizer
- Alder Hey Children's Hospital, Liverpool, L12 2AP, UK
| | - G M Nowell
- Department of Earth Sciences, Durham University, Durham, DH1 3LE, UK
| | - D G Pearson
- Department of Earth Sciences, Durham University, Durham, DH1 3LE, UK
| | - A V Boddy
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, UK
- Northern Institute for Cancer Research, Medical School, Framlington Place, University of Newcastle upon Tyne, Newcastle upon Tyne, NE2 4HH, UK. E-mail:
| |
Collapse
|
12
|
Veal GJ, Cole M, Errington J, Pearson ADJ, Foot ABM, Whyman G, Boddy AV. Pharmacokinetics and metabolism of 13-cis-retinoic acid (isotretinoin) in children with high-risk neuroblastoma - a study of the United Kingdom Children's Cancer Study Group. Br J Cancer 2007; 96:424-31. [PMID: 17224928 PMCID: PMC2360017 DOI: 10.1038/sj.bjc.6603554] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The administration of 13-cis-retinoic acid (13-cisRA), following myeloablative therapy improves 3-year event-free survival rates in children with high-risk neuroblastoma. This study aimed to determine the degree of inter-patient pharmacokinetic variation and extent of metabolism in children treated with 13-cisRA. 13-cis-retinoic acid (80 mg m−2 b.d.) was administered orally and plasma concentrations of parent drug and metabolites determined on days 1 and 14 of courses 2, 4 and 6 of treatment. Twenty-eight children were studied. The pharmacokinetics of 13-cisRA were best described by a modified one-compartment, zero-order absorption model combined with lag time. Mean population pharmacokinetic parameters included an apparent clearance of 15.9 l h−1, apparent volume of distribution of 85 l and absorption lag time of 40 min with a large inter-individual variability associated with all parameters (coefficients of variation greater than 50%). Day 1 peak 13-cisRA levels and exposure (AUC) were correlated with method of administration (P<0.02), with 2.44- and 1.95-fold higher parameter values respectively, when 13-cisRA capsules were swallowed as opposed to being opened and the contents mixed with food before administration. Extensive accumulation of 4-oxo-13-cisRA occurred during each course of treatment with plasma concentrations (mean±s.d. 4.67±3.17 μM) higher than those of 13-cisRA (2.83±1.44 μM) in 16 out of 23 patients on day 14 of course 2. Extensive metabolism to 4-oxo-13-cisRA may influence pharmacological activity of 13-cisRA.
Collapse
Affiliation(s)
- G J Veal
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK
| | - M Cole
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK
| | - J Errington
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK
| | | | - A B M Foot
- Bristol Royal Hospital for Children, Bristol BS2 8BJ, UK
| | - G Whyman
- UKCCSG, University of Leicester, Leicester LE1 6TH, UK
| | - A V Boddy
- Northern Institute for Cancer Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, UK
- E-mail:
| |
Collapse
|
13
|
Goranov BB, Campbell Hewson QD, Pearson ADJ, Redfern CPF. Overexpression of RARgamma increases death of SH-SY5Y neuroblastoma cells in response to retinoic acid but not fenretinide. Cell Death Differ 2006; 13:676-9. [PMID: 16341128 DOI: 10.1038/sj.cdd.4401824] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
14
|
Willits I, Price L, Parry A, Tilby MJ, Ford D, Cholerton S, Pearson ADJ, Boddy AV. Pharmacokinetics and metabolism of ifosfamide in relation to DNA damage assessed by the COMET assay in children with cancer. Br J Cancer 2005; 92:1626-35. [PMID: 15827549 PMCID: PMC2362048 DOI: 10.1038/sj.bjc.6602554] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The degree of damage to DNA following ifosfamide (IFO) treatment may be linked to the therapeutic efficacy. The pharmacokinetics and metabolism of IFO were studied in 19 paediatric patients, mostly with rhabdomyosarcoma or Ewings sarcoma. Ifosfamide was dosed either as a continuous infusion or as fractionated doses over 2 or 3 days. Samples of peripheral blood lymphocytes were obtained during and up to 96 h after treatment, and again prior to the next cycle of chemotherapy. DNA damage was measured using the alkaline COMET assay, and quantified as the percentage of highly damaged cells per sample. Samples were also taken for the determination of IFO and metabolites. Pharmacokinetics and metabolism of IFO were comparable with previous studies. Elevations in DNA damage could be determined in all patients after IFO administration. The degree of damage increased to a peak at 72 h, but had returned to pretreatment values prior to the next dose of chemotherapy. There was a good correlation between area under the curve of IFO and the cumulative percentage of cells with DNA damage (r2=0.554, P=0.004), but only in those patients receiving fractionated dosing. The latter patients had more DNA damage (mean±s.d., 2736±597) than those patients in whom IFO was administered by continuous infusion (1453±730). The COMET assay can be used to quantify DNA damage following IFO therapy. Fractionated dosing causes a greater degree of DNA damage, which may suggest a greater degree of efficacy, with a good correlation between pharmacokinetic and pharmacodynamic data.
Collapse
Affiliation(s)
- I Willits
- Northern Institute for Cancer Research, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - L Price
- School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - A Parry
- School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - M J Tilby
- Northern Institute for Cancer Research, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - D Ford
- School of Biomedical Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - S Cholerton
- School of Medical Education Development, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - A D J Pearson
- School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
- Paediatric Oncology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - A V Boddy
- Northern Institute for Cancer Research, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
- Northern Institute for Cancer Research, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK. E-mail:
| |
Collapse
|
15
|
Armstrong JL, Ruiz M, Boddy AV, Redfern CPF, Pearson ADJ, Veal GJ. Increasing the intracellular availability of all-trans retinoic acid in neuroblastoma cells. Br J Cancer 2005; 92:696-704. [PMID: 15714209 PMCID: PMC2361877 DOI: 10.1038/sj.bjc.6602398] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Recent data indicate that isomerisation to all-trans retinoic acid (ATRA) is the key mechanism underlying the favourable clinical properties of 13-cis retinoic acid (13cisRA) in the treatment of neuroblastoma. Retinoic acid (RA) metabolism is thought to contribute to resistance, and strategies to modulate this may increase the clinical efficacy of 13cisRA. The aim of this study was to test the hypothesis that retinoids, such as acitretin, which bind preferentially to cellular retinoic acid binding proteins (CRABPs), or specific inhibitors of the RA hydroxylase CYP26, such as R116010, can increase the intracellular availability of ATRA. Incubation of SH-SY5Y cells with acitretin (50 μM) or R116010 (1 or 10 μM) in combination with either 10 μM ATRA or 13cisRA induced a selective increase in intracellular levels of ATRA, while 13cisRA levels were unaffected. CRABP was induced in SH-SY5Y cells in response to RA. In contrast, acitretin had no significant effect on intracellular retinoid concentrations in those neuroblastoma cell lines that showed little or no induction of CRABP after RA treatment. Both ATRA and 13cisRA dramatically induced the expression of CYP26A1 in SH-SY5Y cells, and treatment with R116010, but not acitretin, potentiated the RA-induced expression of a reporter gene and CYP26A1. The response of neuroblastoma cells to R116010 was consistent with inhibition of CYP26, indicating that inhibition of RA metabolism may further optimise retinoid treatment in neuroblastoma.
Collapse
Affiliation(s)
- J L Armstrong
- Northern Institute for Cancer Research, Paul O'Gorman Building, Medical School, Framlington Place, University of Newcastle Upon Tyne, Newcastle Upon Tyne NE2 4HH, UK.
| | | | | | | | | | | |
Collapse
|
16
|
Cole M, Price L, Parry A, Keir MJ, Pearson ADJ, Boddy AV, Veal GJ. Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics. Br J Cancer 2004; 90:60-4. [PMID: 14710207 PMCID: PMC2395308 DOI: 10.1038/sj.bjc.6601484] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Estimation of glomerular filtration rate (GFR) using the clearance of chromium 51 EDTA ((51)Cr-EDTA) (or other radiolabelled isotopes) is reliable, but invasive and not always practicable. Mathematical models have been devised for estimating GFR using readily obtainable patient characteristics. Unfortunately, these models were developed using various patient populations and may not provide the optimal prediction of GFR in children with cancer. The current study uses population pharmacokinetics to determine the relationship between (51)Cr-EDTA clearance, and patient covariates in 50 paediatric cancer patients. These models were validated using a separate group of 43 children and were compared with previously published models of renal function. Body size was the major determinant of (51)Cr-EDTA clearance and inclusion of weight or surface area reduced the residual variability between individuals (coefficient of variation) from 61 to 32%. Serum creatinine was the only other parameter that significantly improved the model. Mean percentage error values of -5.0 and -1.1% were observed for models including weight alone or weight and creatinine, respectively, with precision estimates of 21.7 and 20.0%. These simple additive models provide a more rationale approach than the use of complex formulae, involving additional parameters, to predict renal function.
Collapse
Affiliation(s)
- M Cole
- Northern Institute for Cancer Research, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
- School of Mathematics and Statistics, University of Newcastle, Newcastle upon Tyne NEI 7RU, UK
| | - L Price
- School of Clinical Medical Sciences (Child Health), University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - A Parry
- School of Clinical Medical Sciences (Child Health), University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - M J Keir
- Department of Medical Physics, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - A D J Pearson
- School of Clinical Medical Sciences (Child Health), University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - A V Boddy
- Northern Institute for Cancer Research, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
| | - G J Veal
- Northern Institute for Cancer Research, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
- Northern Institute for Cancer Research, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK. E-mail:
| |
Collapse
|
17
|
Ambros IM, Benard J, Boavida M, Bown N, Caron H, Combaret V, Couturier J, Darnfors C, Delattre O, Freeman-Edward J, Gambini C, Gross N, Hattinger CM, Luegmayr A, Lunec J, Martinsson T, Mazzocco K, Navarro S, Noguera R, O'Neill S, Potschger U, Rumpler S, Speleman F, Tonini GP, Valent A, Van Roy N, Amann G, De Bernardi B, Kogner P, Ladenstein R, Michon J, Pearson ADJ, Ambros PF. Quality assessment of genetic markers used for therapy stratification. J Clin Oncol 2003; 21:2077-84. [PMID: 12775732 DOI: 10.1200/jco.2003.03.025] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [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: 11/20/2022] Open
Abstract
PURPOSE Therapy stratification based on genetic markers is becoming increasingly important, which makes commitment to the highest possible reliability of the involved markers mandatory. In neuroblastic tumors, amplification of the MYCN gene is an unequivocal marker that indicates aggressive tumor behavior and is consequently used for therapy stratification. To guarantee reliable and standardized quality of genetic features, a quality-assessment study was initiated by the European Neuroblastoma Quality Assessment (ENQUA; connected to International Society of Pediatric Oncology) Group. MATERIALS AND METHODS One hundred thirty-seven coded specimens from 17 tumors were analyzed in 11 European national/regional reference laboratories using molecular techniques, in situ hybridization, and flow and image cytometry. Tumor samples with divergent results were re-evaluated. RESULTS Three hundred fifty-two investigations were performed, which resulted in 23 divergent findings, 17 of which were judged as errors after re-evaluation. MYCN analyses determined by Southern blot and in situ hybridization led to 3.7% and 4% of errors, respectively. Tumor cell content was not indicated in 32% of the samples, and 11% of seemingly correct MYCN results were based on the investigation of normal cells (eg, Schwann cells). Thirty-eight investigations were considered nonassessable. CONCLUSION This study demonstrated the importance of revealing the difficulties and limitations for each technique and problems in interpreting results, which are crucial for therapeutic decisions. Moreover, it led to the formulation of guidelines that are applicable to all kinds of tumors and that contain the standardization of techniques, including the exact determination of the tumor cell content. Finally, the group has developed a common terminology for molecular-genetic results.
Collapse
Affiliation(s)
- I M Ambros
- Children's Cancer Research Institute, Kinderspitalgasse 6, A-1090 Vienna, Austria.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Scott DK, Board JR, Lu X, Pearson ADJ, Kenyon RM, Lunec J. The neuroblastoma amplified gene, NAG: genomic structure and characterisation of the 7.3 kb transcript predominantly expressed in neuroblastoma. Gene 2003; 307:1-11. [PMID: 12706883 DOI: 10.1016/s0378-1119(03)00459-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [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: 11/30/2022]
Abstract
Amplification of the MYCN oncogene in neuroblastoma is associated with poor prognosis. The amplified unit of DNA can be up to 1 Mb in size and so could contain additional genes which affect tumour phenotype. The neuroblastoma amplified gene (NAG) gene was initially located 400 kb telomeric to MYCN at 2p24 and reported to be co-amplified in 5/8 (63%) cell lines and 9/13 (70%) tumours. The sequence of a 4.5 kb transcript was proposed from the analysis of overlapping cDNA clones. However, our Northern blot hybridisation experiments indicate that the main RNA species expressed in neuroblastoma is 7-8 kb in size. We describe for the first time the cloning and sequencing of the 7.3 kb transcript of the NAG gene together with its precise genomic location and full exon structure. The 5' end of the gene is located 30 kb telomeric to DDX1, with the two genes lying in opposite orientations. The 52 exons of the 7.3 kb transcript cover 420 kb of genomic DNA. In vitro translation studies confirmed the protein coding potential of the transcript. Co-amplification of the entire NAG gene with MYCN was found in 1/6 (17%) neuroblastoma cell lines and 10/50 (20%) primary tumours. Previous studies had measured co-amplification of only the 5' end of the gene, nearest to MYCN. In this study, co-amplification of the NAG gene was found to be significantly associated with low disease stage in MYCN-amplified tumours (P=0.0063).
Collapse
MESH Headings
- Base Sequence
- Blotting, Northern
- Cloning, Molecular
- Conserved Sequence/genetics
- DNA, Complementary/chemistry
- DNA, Complementary/genetics
- Exons
- Gene Amplification
- Gene Expression Regulation, Neoplastic
- Genes/genetics
- Humans
- Introns
- Molecular Sequence Data
- N-Myc Proto-Oncogene Protein
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Neoplasm Staging
- Neuroblastoma/genetics
- Neuroblastoma/pathology
- Nuclear Proteins/genetics
- Oncogene Proteins/genetics
- Promoter Regions, Genetic/genetics
- RNA, Neoplasm/genetics
- RNA, Neoplasm/metabolism
- Sequence Analysis, DNA
- Sequence Homology, Nucleic Acid
- Transcription, Genetic
- Tumor Cells, Cultured
Collapse
Affiliation(s)
- D K Scott
- Cancer Research Unit, Northern Institute of Cancer Research, University of Newcastle Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | | | | | | | | | | |
Collapse
|
19
|
Lashford LS, Thiesse P, Jouvet A, Jaspan T, Couanet D, Griffiths PD, Doz F, Ironside J, Robson K, Hobson R, Dugan M, Pearson ADJ, Vassal G, Frappaz D. Temozolomide in malignant gliomas of childhood: a United Kingdom Children's Cancer Study Group and French Society for Pediatric Oncology Intergroup Study. J Clin Oncol 2002; 20:4684-91. [PMID: 12488414 DOI: 10.1200/jco.2002.08.141] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.7] [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: 11/20/2022] Open
Abstract
PURPOSE To determine the response rate of the malignant gliomas of childhood to an oral, daily schedule of temozolomide. PATIENTS AND METHODS A multicenter, phase II evaluation of an oral, daily schedule of temozolomide (200 mg/m(2) on 5 consecutive days) was undertaken in children with relapsed or progressive, biopsy-proven, high-grade glioma (arm A) and progressive, diffuse, intrinsic brainstem glioma (arm B). Evidence of activity was defined by radiologic evidence of a sustained reduction in tumor size on serial magnetic resonance imaging scans. RESULTS Fifty-five patients were recruited (34 to arm A and 21 to arm B) and received 215 cycles of chemotherapy. Grade 3/4 thrombocytopenia was the most frequent toxic event (7% of cycles). Prolonged myelosuppression resulted in significant treatment delays and dose reductions (17% and 22% of cycles, respectively). Two toxic deaths were documented and were related to myelosuppression and sepsis in one patient and pneumonia in a second. The overall (best) response rate was 12% for arm A (95% confidence interval [CI], 3 to 28 in the study cohort, and 2 to 31 for eligible patients) and 5% and 6%, respectively, for arm B (95% CI, 0 to 26 in the study cohort, and 0 to 27 for eligible patients). Stabilization of disease was also documented and was most noteworthy for brainstem gliomas, where two patients achieved both radiologic static disease and discontinued steroid medication. CONCLUSION Despite moderate toxicity, objective response rates to temozolomide have been low, indicating that temozolomide has minimal activity in the high-grade gliomas of childhood.
Collapse
Affiliation(s)
- L S Lashford
- Christie National Health Service Trust, Manchester.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Meczes EL, Pearson ADJ, Austin CA, Tilby MJ. Schedule-dependent response of neuroblastoma cell lines to combinations of etoposide and cisplatin. Br J Cancer 2002; 86:485-9. [PMID: 11875719 PMCID: PMC2375204 DOI: 10.1038/sj.bjc.6600060] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2001] [Revised: 10/26/2001] [Accepted: 11/01/2001] [Indexed: 12/20/2022] Open
Abstract
The growth inhibitory effects of cisplatin and etoposide on neuroblastoma cell lines were investigated in several scheduled combinations. Results were analyzed using median effect and combination index analyses. In all schedules in which cisplatin was administered prior to etoposide a synergistic effect was observed. Conversely, an antagonistic effect was seen in all schedules where etoposide was administered before cisplatin.
Collapse
Affiliation(s)
- E L Meczes
- Paediatric Oncology Laboratory, Cancer Research Unit, Catherine Cookson Building, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH UK
| | | | | | | |
Collapse
|
21
|
Pearson ADJ. Response to the letter from Dr Cosolo and Colleagues. Br J Cancer 1992. [DOI: 10.1038/bjc.1992.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|