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Hebron KE, Wan X, Roth JS, Liewehr DJ, Sealover NE, Frye WJ, Kim A, Stauffer S, Perkins OL, Sun W, Isanogle KA, Robinson CM, James A, Awasthi P, Shankarappa P, Luo X, Lei H, Butcher D, Smith R, Edmondson EF, Chen JQ, Kedei N, Peer CJ, Shern JF, Figg WD, Chen L, Hall MD, Difilippantonio S, Barr FG, Kortum RL, Robey RW, Vaseva AV, Khan J, Yohe ME. The Combination of Trametinib and Ganitumab is Effective in RAS-Mutated PAX-Fusion Negative Rhabdomyosarcoma Models. Clin Cancer Res 2023; 29:472-487. [PMID: 36322002 PMCID: PMC9852065 DOI: 10.1158/1078-0432.ccr-22-1646] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/22/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE PAX-fusion negative rhabdomyosarcoma (FN RMS) is driven by alterations in the RAS/MAP kinase pathway and is partially responsive to MEK inhibition. Overexpression of IGF1R and its ligands is also observed in FN RMS. Preclinical and clinical studies have suggested that IGF1R is itself an important target in FN RMS. Our previous studies revealed preclinical efficacy of the MEK1/2 inhibitor, trametinib, and an IGF1R inhibitor, BMS-754807, but this combination was not pursued clinically due to intolerability in preclinical murine models. Here, we sought to identify a combination of an MEK1/2 inhibitor and IGF1R inhibitor, which would be tolerated in murine models and effective in both cell line and patient-derived xenograft models of RAS-mutant FN RMS. EXPERIMENTAL DESIGN Using proliferation and apoptosis assays, we studied the factorial effects of trametinib and ganitumab (AMG 479), a mAb with specificity for human and murine IGF1R, in a panel of RAS-mutant FN RMS cell lines. The molecular mechanism of the observed synergy was determined using conventional and capillary immunoassays. The efficacy and tolerability of trametinib/ganitumab was assessed using a panel of RAS-mutated cell-line and patient-derived RMS xenograft models. RESULTS Treatment with trametinib and ganitumab resulted in synergistic cellular growth inhibition in all cell lines tested and inhibition of tumor growth in four of six models of RAS-mutant RMS. The combination had little effect on body weight and did not produce thrombocytopenia, neutropenia, or hyperinsulinemia in tumor-bearing SCID beige mice. Mechanistically, ganitumab treatment prevented the phosphorylation of AKT induced by MEK inhibition alone. Therapeutic response to the combination was observed in models without a mutation in the PI3K/PTEN axis. CONCLUSIONS We demonstrate that combined trametinib and ganitumab is effective in a genomically diverse panel of RAS-mutated FN RMS preclinical models. Our data also show that the trametinib/ganitumab combination likely has a favorable tolerability profile. These data support testing this combination in a phase I/II clinical trial for pediatric patients with relapsed or refractory RAS-mutated FN RMS.
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Affiliation(s)
- Katie E. Hebron
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892,Laboratory of Cell and Developmental Signaling, Center for Cancer Research, 8560 Progress Drive, Frederick, MD 21701
| | - Xiaolin Wan
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Jacob S. Roth
- Early Translation Branch, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, 9800 Medical Center Drive, Rockville, MD 20850
| | - David J. Liewehr
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Nancy E. Sealover
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Services, Bethesda, MD 20814
| | - William J.E. Frye
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892
| | - Angela Kim
- Laboratory of Cell and Developmental Signaling, Center for Cancer Research, 8560 Progress Drive, Frederick, MD 21701
| | - Stacey Stauffer
- Laboratory of Cell and Developmental Signaling, Center for Cancer Research, 8560 Progress Drive, Frederick, MD 21701
| | - Olivia L. Perkins
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Wenyue Sun
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892
| | - Kristine A. Isanogle
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Christina M. Robinson
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Amy James
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Parirokh Awasthi
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Priya Shankarappa
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Xiaoling Luo
- Collaborative Protein Technology Resource, National Cancer Institute, NIH, Bethesda, MD 20892
| | - Haiyan Lei
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Donna Butcher
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Roberta Smith
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Elijah F. Edmondson
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Jin-Qiu Chen
- Collaborative Protein Technology Resource, National Cancer Institute, NIH, Bethesda, MD 20892
| | - Noemi Kedei
- Collaborative Protein Technology Resource, National Cancer Institute, NIH, Bethesda, MD 20892
| | - Cody J. Peer
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Jack F. Shern
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - W. Douglas Figg
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892
| | - Lu Chen
- Early Translation Branch, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, 9800 Medical Center Drive, Rockville, MD 20850
| | - Matthew D. Hall
- Early Translation Branch, Division of Preclinical Innovation, National Center for Advancing Translational Sciences, 9800 Medical Center Drive, Rockville, MD 20850
| | - Simone Difilippantonio
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21701
| | - Frederic G. Barr
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892
| | - Robert L. Kortum
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Services, Bethesda, MD 20814
| | - Robert W. Robey
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892
| | - Angelina V. Vaseva
- Greehey Children’s Cancer Research Institute, UT Health San Antonio, San Antonio, Texas, USA
| | - Javed Khan
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892,Co-corresponding authors Correspondence: Marielle Yohe, M.D., Ph.D., Center for Cancer Research, National Cancer Institute, 8560 Progress Drive Room D3026, Frederick, MD 27101, Phone: (240) 760-7436,
| | - Marielle E. Yohe
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Bethesda, MD 20892,Laboratory of Cell and Developmental Signaling, Center for Cancer Research, 8560 Progress Drive, Frederick, MD 21701,Co-corresponding authors Correspondence: Marielle Yohe, M.D., Ph.D., Center for Cancer Research, National Cancer Institute, 8560 Progress Drive Room D3026, Frederick, MD 27101, Phone: (240) 760-7436,
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Yohe ME, Hebron KE, Wan X, Roth JS, Liewehr DJ, Sealover NE, Stauffer S, Feehan-Nelson O, Sun W, Isanogle KA, Robinson CM, James A, Awasthi P, Shankarappa P, Liu X, Lei H, Butcher D, Smith R, Edmonson EF, Chen JQ, Kedei N, Peer CS, Shern JF, Figg WD, Chen L, Hall MD, Difillipantonio S, Barr FG, Kortum RL, Vaseva AV, Khan J. Abstract IA023: Therapeutic efficacy of trametinib and ganitumab in RAS-mutated rhabdomyosarcoma. Clin Cancer Res 2022. [DOI: 10.1158/1557-3265.sarcomas22-ia023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: PAX-fusion negative rhabdomyosarcoma (FN RMS) is driven by alterations in the RAS/MAP kinase pathway and is partially responsive to MEK inhibition. Overexpression of IGF1R and its ligands is also observed in FN RMS. Preclinical and clinical studies have suggested that IGF1R is itself an important target in FN RMS. Our previous studies revealed preclinical efficacy of the MEK1/2 inhibitor, trametinib, and an IGF1R inhibitor, BMS75807, but this combination was not pursued clinically due to excessive toxicity in preclinical murine models. Here, we sought to identify a combination of an MEK1/2 inhibitor and IGF1R inhibitor that would be better tolerated in murine models and effective in both cell line and patient derived xenograft models of RAS-mutant FN RMS. Methods: Using proliferation and apoptosis assays, we studied the factorial effects of trametinib and ganitumab (AMG 479), a monoclonal antibody with specificity for human and murine IGF1R, in a panel of RAS-mutant FN RMS cell lines. The molecular mechanism of the observed synergy was determined using conventional and capillary immunoassays. The efficacy and tolerability of the combination was assessed using a panel of RAS-mutated cell-line and patient-derived RMS xenograft models. Results: Treatment with trametinib and ganitumab resulted in synergistic cellular growth inhibition in all cell lines tested and inhibition of tumor growth in five out of six models of RAS-mutant RMS. Evidence suggests that the combination had little effect on body weight loss, thrombocytopenia, neutropenia, or hyperinsulinemia in tumor-bearing SCID beige mice. Mechanistically, ganitumab treatment prevented the AKT phosphorylation that is induced by MEK inhibition alone. Therapeutic response to the combination was observed in models with an intact PI3K/PTEN axis. Conclusions: We demonstrate that combined trametinib and ganitumab is effective in a genomically diverse panel of RAS-mutated FN RMS preclinical models. The trametinib/ganitumab combination also likely has an improved tolerability profile compared to other IGF1R/MEK inhibitor combinations. These data support testing this combination in a phase I/II clinical trial for pediatric patients with relapsed or refractory RAS-mutated FN RMS.
Citation Format: Marielle E. Yohe, Katie E. Hebron, Xiaolin Wan, Jacob S. Roth, David J. Liewehr, Nancy E. Sealover, Stacey Stauffer, Olivia Feehan-Nelson, Wenyue Sun, Kristine A. Isanogle, Christina M. Robinson, Amy James, Parirokh Awasthi, Priya Shankarappa, Xiaoling Liu, Haiyan Lei, Donna Butcher, Roberta Smith, Elijah F. Edmonson, Jin-Qui Chen, Noemi Kedei, Cody S. Peer, Jack F. Shern, W. Douglas Figg, Lu Chen, Matthew D. Hall, Simone Difillipantonio, Frederic G. Barr, Robert L. Kortum, Angelina V. Vaseva, Javed Khan. Therapeutic efficacy of trametinib and ganitumab in RAS-mutated rhabdomyosarcoma [abstract]. In: Proceedings of the AACR Special Conference: Sarcomas; 2022 May 9-12; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2022;28(18_Suppl):Abstract nr IA023.
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Affiliation(s)
| | | | | | - Jacob S. Roth
- 3National Center for Advancing Translational Sciences, Rockville, MD,
| | | | | | | | | | - Wenyue Sun
- 2National Cancer Institute, Bethesda, MD,
| | | | | | - Amy James
- 1National Cancer Institute, Frederick, MD,
| | | | | | | | - Haiyan Lei
- 2National Cancer Institute, Bethesda, MD,
| | | | | | | | | | | | | | | | | | - Lu Chen
- 3National Center for Advancing Translational Sciences, Rockville, MD,
| | - Matthew D. Hall
- 3National Center for Advancing Translational Sciences, Rockville, MD,
| | | | | | | | - Angelina V. Vaseva
- 5University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Javed Khan
- 2National Cancer Institute, Bethesda, MD,
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Fuller SN, Shafiei A, Venzon DJ, Liewehr DJ, Mauda Havanuk M, Ilanchezhian MG, Edgerly M, Anderson VL, Levy EB, Hoang CD, Jones EC, Reilly KM, Widemann BC, Wood BJ, Bagheri H, Del Rivero J. Tumor Doubling Time Using CT Volumetric Segmentation in Metastatic Adrenocortical Carcinoma. Curr Oncol 2021; 28:4357-4366. [PMID: 34898541 PMCID: PMC8628706 DOI: 10.3390/curroncol28060370] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/17/2021] [Accepted: 10/27/2021] [Indexed: 12/03/2022] Open
Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy with an overall unfavorable prognosis. Clinicians treating patients with ACC have noted accelerated growth in metastatic liver lesions that requires rapid intervention compared to other metastatic locations. This study measured and compared the growth rates of metastatic ACC lesions in the lungs, liver, and lymph nodes using volumetric segmentation. A total of 12 patients with metastatic ACC (six male; six female) were selected based on their medical history. Computer tomography (CT) exams were retrospectively reviewed and a sampling of ≤5 metastatic lesions per organ were selected for evaluation. Lesions in the liver, lung, and lymph nodes were measured and evaluated by volumetric segmentation. Statistical analyses were performed to compare the volumetric growth rates of the lesions in each organ system. In this cohort, 5/12 had liver lesions, 7/12 had lung lesions, and 5/12 had lymph node lesions. A total of 92 lesions were evaluated and segmented for lesion volumetry. The volume doubling time per organ system was 27 days in the liver, 90 days in the lungs, and 95 days in the lymph nodes. In this series of 12 patients with metastatic ACC, liver lesions showed a faster growth rate than lung or lymph node lesions.
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Affiliation(s)
- Sarah N. Fuller
- Pediatric Oncology Branch, Rare Tumor Initiative, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.N.F.); (M.G.I.); (K.M.R.); (B.C.W.)
| | - Ahmad Shafiei
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA; (A.S.); (E.C.J.); (H.B.)
| | - David J. Venzon
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (D.J.V.); (D.J.L.)
| | - David J. Liewehr
- Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (D.J.V.); (D.J.L.)
| | - Michal Mauda Havanuk
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD 20892, USA; (M.M.H.); (V.L.A.); (E.B.L.); (B.J.W.)
| | - Maran G. Ilanchezhian
- Pediatric Oncology Branch, Rare Tumor Initiative, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.N.F.); (M.G.I.); (K.M.R.); (B.C.W.)
| | - Maureen Edgerly
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Victoria L. Anderson
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD 20892, USA; (M.M.H.); (V.L.A.); (E.B.L.); (B.J.W.)
| | - Elliot B. Levy
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD 20892, USA; (M.M.H.); (V.L.A.); (E.B.L.); (B.J.W.)
| | - Choung D. Hoang
- Thoracic Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Elizabeth C. Jones
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA; (A.S.); (E.C.J.); (H.B.)
| | - Karlyne M. Reilly
- Pediatric Oncology Branch, Rare Tumor Initiative, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.N.F.); (M.G.I.); (K.M.R.); (B.C.W.)
| | - Brigitte C. Widemann
- Pediatric Oncology Branch, Rare Tumor Initiative, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.N.F.); (M.G.I.); (K.M.R.); (B.C.W.)
| | - Bradford J. Wood
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD 20892, USA; (M.M.H.); (V.L.A.); (E.B.L.); (B.J.W.)
| | - Hadi Bagheri
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA; (A.S.); (E.C.J.); (H.B.)
| | - Jaydira Del Rivero
- Pediatric Oncology Branch, Rare Tumor Initiative, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.N.F.); (M.G.I.); (K.M.R.); (B.C.W.)
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
- Correspondence:
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Akshintala S, Baldwin A, Liewehr DJ, Goodwin A, Blakeley JO, Gross AM, Steinberg SM, Dombi E, Widemann BC. Longitudinal evaluation of peripheral nerve sheath tumors in neurofibromatosis type 1: growth analysis of plexiform neurofibromas and distinct nodular lesions. Neuro Oncol 2020; 22:1368-1378. [PMID: 32152628 PMCID: PMC7523449 DOI: 10.1093/neuonc/noaa053] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Understanding the natural history of non-malignant peripheral nerve sheath tumors (PNSTs) in neurofibromatosis type 1 (NF1) is critical to optimal clinical care and the development of meaningful clinical trials. METHODS We longitudinally analyzed growth of plexiform neurofibromas (PNs) and of PNSTs with distinct nodular appearance (distinct nodular lesions [DNLs]) using volumetric MRI analysis in patients enrolled on a natural history study (NCT00924196). RESULTS DNLs were observed in 58/122 (45.6%) patients (median 2 DNLs/patient). In DNLs that developed during follow-up, median age of development was 17 years. A moderate negative correlation was observed between the estimated PN growth rate and patients' age at initial MRI (Spearman's r [95% CI]: -0.60 [-0.73, -0.43], n = 70), whereas only a weak correlation was observed for DNLs (Spearman's r [95% CI]: -0.25 [-0.47, 0.004]; n = 61). We observed a moderate negative correlation between tumor growth rate and baseline tumor volume for PNs and DNLs (Spearman's r [95% CI]: -0.52 [-0.67, -0.32] and -0.61 [-0.75, -0.42], respectively). Spontaneous tumor volume reduction was observed in 10 PNs and 7 DNLs (median decrease per year, 3.6% and 7.3%, respectively). CONCLUSION We corroborate previously described findings that most rapidly growing PNs are observed in young children. DNLs tend to develop later in life and their growth is minimally age related. Distinct growth characteristics of PNs and DNLs suggest that these lesions have a different biology and may require different clinical management and clinical trial design. In a subset of PNs and DNLs, slow spontaneous regression in tumor volume was seen.
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Affiliation(s)
- Srivandana Akshintala
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Andrea Baldwin
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | | | - Anne Goodwin
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Jaishri O Blakeley
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrea M Gross
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | | | - Eva Dombi
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
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Boal LH, Glod J, Spencer M, Kasai M, Derdak J, Dombi E, Ahlman M, Beury DW, Merchant MS, Persenaire C, Liewehr DJ, Steinberg SM, Widemann BC, Kaplan RN. Pediatric PK/PD Phase I Trial of Pexidartinib in Relapsed and Refractory Leukemias and Solid Tumors Including Neurofibromatosis Type I-Related Plexiform Neurofibromas. Clin Cancer Res 2020; 26:6112-6121. [PMID: 32943455 DOI: 10.1158/1078-0432.ccr-20-1696] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/02/2020] [Accepted: 09/04/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE Simultaneously targeting the tumor and tumor microenvironment may hold promise in treating children with refractory solid tumors. Pexidartinib, an oral inhibitor of tyrosine kinases including colony stimulating factor 1 receptor (CSF-1R), KIT, and FLT3, is FDA approved in adults with tenosynovial giant cell tumor. A phase I trial was conducted in pediatric and young adult patients with refractory leukemias or solid tumors including neurofibromatosis type 1-related plexiform neurofibromas. PATIENTS AND METHODS A rolling six design with dose levels (DL) of 400 mg/m2, 600 mg/m2, and 800 mg/m2 once daily for 28-day cycles (C) was used. Response was assessed at regular intervals. Pharmacokinetics and population pharmacokinetics were analyzed during C1. RESULTS Twelve patients (4 per DL, 9 evaluable) enrolled on the dose-escalation phase and 4 patients enrolled in the expansion cohort: median (lower, upper quartile) age 16 (14, 16.5) years. No dose-limiting toxicities were observed. Pharmacokinetics appeared linear over three DLs. Pharmacokinetic modeling and simulation determined a weight-based recommended phase II dose (RP2D). Two patients had stable disease and 1 patient with peritoneal mesothelioma (C49+) had a sustained partial response (67% RECIST reduction). Pharmacodynamic markers included a rise in plasma macrophage CSF (MCSF) levels and a decrease in absolute monocyte count. CONCLUSIONS Pexidartinib in pediatric patients was well tolerated at all DL tested, achieved target inhibition, and resulted in a weight-based RPD2 dose.
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Affiliation(s)
- Lauren H Boal
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.,Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, D.C
| | - John Glod
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Melissa Spencer
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Miki Kasai
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Joanne Derdak
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Eva Dombi
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mark Ahlman
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Daniel W Beury
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Melinda S Merchant
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Christianne Persenaire
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - David J Liewehr
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Rosandra N Kaplan
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
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6
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Gross AM, Singh G, Akshintala S, Baldwin A, Dombi E, Ukwuani S, Goodwin A, Liewehr DJ, Steinberg SM, Widemann BC. Association of plexiform neurofibroma volume changes and development of clinical morbidities in neurofibromatosis 1. Neuro Oncol 2019; 20:1643-1651. [PMID: 29718344 DOI: 10.1093/neuonc/noy067] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Plexiform neurofibromas (PN) in neurofibromatosis 1 (NF1) can cause substantial morbidities. Clinical trials targeting PN have recently described decreases in PN volumes. However, no previous study has assessed the association between changes in PN volumes and PN-related morbidities. Our objective was to assess if increasing PN volume in NF1 is associated with increasing PN-related morbidity. Methods This is a retrospective review of patients enrolled on the NCI NF1 natural history study with ≥7 years of data available. Morbidities including pain, motor dysfunction, vision loss, and PN-related surgery were assessed at time of baseline PN MRI with volumetric analysis and time of MRI with maximum PN volume. Results Forty-one patients (median age at baseline 8 y) with 57 PN were included. At baseline, 40 PN had at least 1 PN-associated morbidity. During the observation period, 27 PN required increasing pain medication, and these PN grew faster per year (median difference 8.3%; 95% CI: 2.4, 13.8%) than those PN which did not. PN resulting in motor impairment at baseline (n = 11) had larger volumes compared with those that did not (median difference 461 mL; 95% CI: 66.9, 820). Conclusions Many NF1 PN were associated with clinically significant morbidity at baseline, highlighting the need for longitudinal morbidity evaluations starting at an early age to capture changes in PN-associated morbidities. Prospective evaluation of standardized patient reported and functional outcomes in clinical trials are ongoing and may allow further characterization of the association of PN volume increase or decrease and clinical changes.
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Affiliation(s)
- Andrea M Gross
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Gurbani Singh
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Srivandana Akshintala
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Andrea Baldwin
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Eva Dombi
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Somto Ukwuani
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - Anne Goodwin
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
| | - David J Liewehr
- Center for Cancer Research, National Cancer Institute (NCI) of the National Institutes of Health, Bethesda, Maryland
| | - Seth M Steinberg
- Center for Cancer Research, National Cancer Institute (NCI) of the National Institutes of Health, Bethesda, Maryland
| | - Brigitte C Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland
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7
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Komiya T, Memmott RM, Blumenthal GM, Bernstein W, Ballas MS, De Chowdhury R, Chun G, Peer CJ, Figg WD, Liewehr DJ, Steinberg SM, Giaccone G, Szabo E, Kawabata S, Tsurutani J, Rajan A, Dennis PA. A phase I/II study of pemetrexed with sirolimus in advanced, previously treated non-small cell lung cancer. Transl Lung Cancer Res 2019; 8:247-257. [PMID: 31367538 DOI: 10.21037/tlcr.2019.04.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Single-agent pemetrexed is a treatment for recurrent non-squamous non-small cell lung cancer (NSCLC) that provides limited benefit. Preclinical studies showed promising synergistic effects when the mammalian target of rapamycin (mTOR) inhibitor sirolimus was added to pemetrexed. Methods This was a single-institution phase I/II study of pemetrexed in combination with sirolimus. The primary endpoint for the phase I was to determine the maximum tolerated dose (MTD) and safety of the combination. The primary endpoint for the phase II portion was to determine the overall response rate at the MTD. Key eligibility criteria included recurrent, metastatic NSCLC, ECOG performance status of 0-2, and adequate organ function. Sirolimus was administered orally daily after an initial loading dose, and pemetrexed was given intravenously on day 1 of every 21-day cycle. Results Forty-two patients with recurrent, metastatic NSCLC were enrolled, 22 in phase I and 20 in phase II. The MTD was pemetrexed 500 mg/m2 every 3 weeks, and sirolimus 10 mg on day 1, and 3 mg daily thereafter. Treatment-related adverse events (AEs) occurred in 38 (90.5%) patients. The most common grade 3-4 treatment-related AEs were lymphopenia (31%) and hypophosphatemia (19%). Two treatment-related deaths occurred due to febrile neutropenia and infection, respectively. Among 27 total patients treated at the MTD, 6 (22.2%) had a partial response (PR), 12 (44.4%) had stable disease (SD) and 5 (18.5%) had progressive disease. Median progression-free survival (PFS) was 18.4 weeks (95% CI: 7.0-29.4). Conclusions The combination of pemetrexed and sirolimus is active in heavily-pretreated NSCLC (ClinicalTrials.gov Identifier: NCT00923273).
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Affiliation(s)
- Takefumi Komiya
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Regan M Memmott
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Gideon M Blumenthal
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Wendy Bernstein
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Marc S Ballas
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Roopa De Chowdhury
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Guinevere Chun
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Cody J Peer
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - William D Figg
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - David J Liewehr
- Biostatistics and Data Management Section, National Cancer Institute, Rockville, MD, USA
| | - Seth M Steinberg
- Biostatistics and Data Management Section, National Cancer Institute, Rockville, MD, USA
| | - Giuseppe Giaccone
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Eva Szabo
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.,Lung and Upper Aerodigestive Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Shigeru Kawabata
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Junji Tsurutani
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Arun Rajan
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Phillip A Dennis
- Medical Oncology Service, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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8
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Salem DA, Scott D, McCoy CS, Liewehr DJ, Venzon DJ, Arons E, Kreitman RJ, Stetler-Stevenson M, Yuan CM. Differential Expression of CD43, CD81, and CD200 in Classic Versus Variant Hairy Cell Leukemia. Cytometry B Clin Cytom 2019; 96:275-282. [PMID: 31077558 DOI: 10.1002/cyto.b.21785] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/05/2019] [Accepted: 04/19/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hairy cell leukemia (HCL) and hairy cell leukemia variant (HCLv) are rare diseases with overlapping clinicopathological features. Features distinguishing HCL from HCLv include expression of CD25, CD123, CD200, annexin-A1, and the presence of BRAF V600E mutation. HCLv typically lacks these markers, but they may occur in a subgroup of HCL patients with an aggressive clinical course. We examined CD43, CD81, CD79b, and CD200 expression in HCL and HCLv. METHODS Multiparametric flow cytometry (FCM) was performed on blood from 59 HCL and 15 HCLv patients for protocol entry. Mean fluorescent intensity (MFI) of CD43, CD79b, CD81, and CD200 was determined (for CD200, n = 17 and 7, respectively). RESULTS Median MFI of HCL vs HCLv was 545 vs 272 for CD43, 602 vs 2,450 for CD81, 4,962 vs 1,969 for CD79b, and 11,652 vs 1,405 for CD200, respectively. Analysis of the median differences, HCL minus HCLv (and their 95% confidence intervals and P-values) indicated that CD43 MFI (estimated median difference (95% CI): 212 [72-413; P = 0.0027) and CD200 MFI (9,883 [3,514-13,434]; P < 0.0001) were higher in HCL than in HCLv, while CD81 MFI (-1,858 [-2,604 to -1,365]; P < 0.0001) was lower in HCL than in HCLv. CD79b MFI HCL median was more than double that of HCLv, but the observed difference (1,571 [-739 to 4,417]) was consistent with the null hypothesis of no difference (P = 0.13). CONCLUSIONS CD200, CD43, and CD81 are likely differentially expressed between HCL and HCLv, reflecting their differing disease biology. Inclusion of these markers in FCM is potentially informative. © 2019 International Clinical Cytometry Society.
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Affiliation(s)
- Dalia A Salem
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland.,Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Drake Scott
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland
| | | | - David J Liewehr
- Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, Maryland
| | - David J Venzon
- Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, Maryland
| | - Evgeny Arons
- Laboratory of Molecular Biology, Clinical Immunotherapy Section, CCR, NCI, NIH, Bethesda, Maryland
| | - Robert J Kreitman
- Laboratory of Molecular Biology, Clinical Immunotherapy Section, CCR, NCI, NIH, Bethesda, Maryland
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9
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Sissung TM, Rajan A, Blumenthal GM, Liewehr DJ, Steinberg SM, Berman A, Giaccone G, Figg WD. Reproducibility of pharmacogenetics findings for paclitaxel in a heterogeneous population of patients with lung cancer. PLoS One 2019; 14:e0212097. [PMID: 30817750 PMCID: PMC6394902 DOI: 10.1371/journal.pone.0212097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/28/2019] [Indexed: 12/12/2022] Open
Abstract
Pharmacogenetics studies have identified several allelic variants with the potential to reduce toxicity and improve treatment outcome. The present study was designed to determine if such findings are reproducible in a heterogenous population of patients with lung cancer undergoing therapy with paclitaxel. We designed a prospective multi-institutional study that recruited n = 103 patients receiving paclitaxel therapy with a 5-year follow up. All patients were genotyped using the Drug Metabolizing Enzymes and Transporters (DMET) platform, which ascertains 1931 genotypes in 235 genes. Progression-free survival (PFS) of paclitaxel therapy and clinically-significant paclitaxel toxicities were classified and compared according to genotype. Initial screening revealed eleven variants that are associated with PFS. Of these, seven variants in ABCB11 (rs4148768), ABCC3 (rs1051640), ABCG1 (rs1541290), CYP8B1 (rs735320), NR3C1 (rs6169), FMO6P (rs7889839), and GSTM3 (rs7483) were associated with paclitaxel PFS in a multivariate analysis accounting for clinical covariates. Multivariate analysis revealed four SNPs in VKORC1 (rs2884737), SLC22A14 (rs4679028), GSTA2 (rs6577), and DCK (rs4643786) were associated with paclitaxel toxicities. With the exception of a variant in VKORC1, the present study did not find the same genetic outcome associations of other published research on pharmacogenetics variants that affect paclitaxel outcomes. This finding suggests that prior pharmacogenomics research findings may not be reproduced in the most frequently-diagnosed malignancy, lung cancer.
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Affiliation(s)
- Tristan M. Sissung
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Arun Rajan
- Thoracic and Gastrointestinal Oncology Branch, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Gideon M. Blumenthal
- Thoracic and Gastrointestinal Oncology Branch, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - David J. Liewehr
- Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Arlene Berman
- Office of Research Nursing in the Office of the Clinical Director, Office of the Clinical Director, National Cancer Institute, Bethesda, MD, United States of America
| | - Giuseppe Giaccone
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., United States of America
| | - William D. Figg
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, Bethesda, Maryland, United States of America
- * E-mail:
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10
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Salem DA, Maric I, Yuan CM, Liewehr DJ, Venzon DJ, Kochenderfer J, Stetler-Stevenson M. Quantification of B-cell maturation antigen, a target for novel chimeric antigen receptor T-cell therapy in Myeloma. Leuk Res 2018; 71:106-111. [PMID: 30053652 DOI: 10.1016/j.leukres.2018.07.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 01/17/2023]
Abstract
B-cell maturation antigen (BCMA) is expressed by normal and malignant plasma cells and is targeted via anti-BCMA chimeric antigen receptor T-cell therapy (BCMA CAR T-cell therapy) in plasma cell myeloma (PCM) patients. Surface BCMA expression is required for CAR T-cell binding and killing. We determined the incidence and intensity of expression of BCMA in bone marrow PCM cells using flow cytometry (FC) and immunohistochemistry (IHC). PCM BCMA expression was assessed by FC in 70 patients and in 43 concurrent specimens by IHC. BCMA expression was detected in 94% of patients. FC could assess BCMA expression in all specimens and expression was quantifiable (QuantiBRITE system, BD Biosciences, San Jose, CA) in 89% of cases. Expression was highly variable and could be numerically classified into dim, moderate or bright levels of expression. In the 43 specimens assessed successfully by both IHC and FC, FC showed higher positivity rate (97%) than IHC (72%), indicating that FC is more useful than IHC in detection of BCMA (p = 0.002; McNemar's test). We conclude that FC is more sensitive than IHC and can be used to objectively quantify BCMA expression by myeloma cells. IHC is primarily useful when there is significant infiltration of the bone marrow by myeloma and is less sensitive with low numbers of myeloma cells. Furthermore, the ability of FC to differentiate between normal and abnormal plasma cells and to quantify BCMA on these cells, makes it a useful and sensitive tool in screening patients for CAR T-cell therapy and for follow-up post therapy.
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Affiliation(s)
- Dalia A Salem
- Flow Cytometry, Laboratory of Pathology, CCR, NCI, NIH, USA; Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt.
| | | | | | - David J Liewehr
- Biostatistics and Data Management Section, CCR, NCI, NIH, USA
| | - David J Venzon
- Biostatistics and Data Management Section, CCR, NCI, NIH, USA
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11
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Gril B, Lyle LT, Lockman PR, Adkins CE, Mohammad AS, Sechrest E, Hua E, Palmieri D, Liewehr DJ, Steinberg SM, Kloc W, Izycka-Swieszewska E, Duchnowska R, Naema N, Brastianos PK, Steeg PS. Abstract 4933: Desmin+pericyte subpopulations correlated with blood-tumor barrier permeability in brain metastases of breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer brain metastases remain incurable. The blood-brain barrier (BBB) is a multicellular dynamic structure regulating exchanges between the blood and the central nervous system. As cancer cells colonize the brain, the BBB evolves into a blood-tumor barrier (BTB). The BTB limits compound penetration and therefore contributes to poor efficacy of chemotherapy. While the BBB has been well characterized in developmental and neurodegenerative disease studies, the BTB composition remains unknown.
We have characterized the BTB in three model systems of brain metastasis of breast cancer developed in the laboratory: a triple negative (231-BR6), and two HER2 overexpressing (SUM190-BR3, JIMT-1-BR3) subtypes. Using Texas Red dextran (TRD) as a marker of permeability and quantitative immunofluorescence staining, we analyzed the cellular and molecular composition of: 1) unaltered BBB vs. BTB, and 2) BTB in highly permeable metastases vs. BTB in poorly permeable metastases.
The BTB developed from the BBB in a series of alterations, including a neuroinflammatory reaction with astrogliosis, endothelial cell dilation, increased VEGF, reduced astrocyte endfoot polarity, and decrease in PDGFR+ pericytes. Only 10% of the metastatic lesions harbored a profound TRD exudation, which correlated with paclitaxel efficacy. We hypothesized that specific cellular and molecular changes account for the heterogeneity and increase in TRD diffusion. When metastases with relatively low- and high-TRD diffusion were compared, highly permeable metastases correlated with an increased expression of desmin+ pericytes in three models (231-BR6 p=0.0002; JIMT-1-BR3 p=0.004; SUM190-BR3 p=0.008) and a decrease in CD13+ pericytes in two model systems (231-BR6 p=0.014; JIMT-1-BR3 p=0.002). Decreased expression of laminin α2 in the parenchymal basement membrane (231-BR6 p=0.001; JIMT-1-BR3 p=0.049; SUM190-BR3 p=0.023) were associated with higher permeability. Desmin+ pericytes have been associated with pathological conditions such as fibrosis and spinal cord injury. Seven over nine human craniotomy specimens were positive for Desmin staining, validating clinically the relevance of our findings. We subsequently hypothesized that the desmin+ pericyte subpopulation functionally contributes to increased permeability. Desmin+ pericytes were produced in vitro by co-culturing primary mouse pericytes with astrocytes. When desmin+ or CD13+ pericytes were added to in vitro transendothelial electrical resistance (TEER) models of the BBB, the desmin+ pericytes exhibited less resistance, indicative of higher permeability. The data suggest that desmin+ pericytes may facilitate the permeability of the BTB. These studies show that the BTB in brain metastasis model systems involves consistent molecular changes. These data may identify new strategies to selectively permeabilize the BTB and enhance chemotherapeutic efficacy.
Citation Format: Brunilde Gril, L. Tiffany Lyle, Paul R. Lockman, Chris E. Adkins, Afroz Shareef Mohammad, Emily Sechrest, Emily Hua, Diane Palmieri, David J. Liewehr, Seth M. Steinberg, Wojciech Kloc, Ewa Izycka-Swieszewska, Renata Duchnowska, Nayyar Naema, Priscilla K. Brastianos, Patricia S. Steeg. Desmin+pericyte subpopulations correlated with blood-tumor barrier permeability in brain metastases of breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4933. doi:10.1158/1538-7445.AM2017-4933
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Affiliation(s)
| | - L. Tiffany Lyle
- 2 Purdue University College of Veterinary Medicine, West Lafayette, IN
| | - Paul R. Lockman
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | - Chris E. Adkins
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | | | - Emily Sechrest
- 3West Virginia University Health Sciences Center, Morgantown, WV
| | | | | | | | | | - Wojciech Kloc
- 5University of Varmia & Masuria University, Olsztyn, Poland
| | | | | | - Nayyar Naema
- 8Massachusetts General Hospital Cancer CenterHarvard Medical School, Boston, MA
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12
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Salem DAR, Korde N, Venzon DJ, Liewehr DJ, Maric I, Calvo KR, Braylan R, Tembhare PR, Yuan CM, Landgren CO, Stetler-Stevenson M. Expression of the IL-6 receptor alpha-chain (CD126) in normal and abnormal plasma cells in monoclonal gammopathy of undetermined significance and smoldering myeloma. Leuk Lymphoma 2017; 59:178-186. [PMID: 28540748 DOI: 10.1080/10428194.2017.1321746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IL-6 activity in normal plasma cells (nPCs) and abnormal plasma cells (aPCs) is CD126 (subunit of IL-6 receptor) dependent. We quantified CD126 expression on nPCs and aPCs in monoclonal gammopathy of undetermined significance (MGUS), smoldering myeloma (SMM), and multiple myeloma (MM). CD126 was detected on all nPCs and aPCs indicating that CD126 does not have diagnostic utility. CD126 expression was higher in aPCs than in nPCs in 85% SMM but only 41% MGUS and there was evidence that CD126 was higher in aPCs than nPCs in the SMM (p = .048) but not MGUS (p = .96) patients. There is also a greater association between nPC and aPC CD126 expression in low risk MGUS than observed in high risk MGUS and SMM, suggesting normal regulation of CD126 decreases with disease progression. Future studies need to elucidate the role of bone marrow milieu versus escape from normal CD126 regulation in malignant transformation of clonal plasma cells.
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Affiliation(s)
- Dalia Abdel-Raouf Salem
- a Laboratory of Pathology , CCR, NCI, NIH , Bethesda , MD , USA.,b Department of Clinical Pathology, Faculty of Medicine , Mansoura University , Mansoura , Egypt
| | - Neha Korde
- c Myeloma Service, Department of Medicine , Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - David J Venzon
- d Biostatistics and Data Management Section, CCR, NCI, NIH , Bethesda , MD , USA
| | - David J Liewehr
- d Biostatistics and Data Management Section, CCR, NCI, NIH , Bethesda , MD , USA
| | - Irina Maric
- e Hematology Service, Department of Laboratory Medicine , CC, NIH , Bethesda , MD , USA
| | - Katherine R Calvo
- e Hematology Service, Department of Laboratory Medicine , CC, NIH , Bethesda , MD , USA
| | - Raul Braylan
- e Hematology Service, Department of Laboratory Medicine , CC, NIH , Bethesda , MD , USA
| | | | | | - Carl Ola Landgren
- c Myeloma Service, Department of Medicine , Memorial Sloan-Kettering Cancer Center , New York , NY , USA
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13
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Shah NN, Watson TM, Yates B, Liewehr DJ, Steinberg SM, Jacobsohn D, Fry TJ. Procalcitonin and cytokine profiles in engraftment syndrome in pediatric stem cell transplantation. Pediatr Blood Cancer 2017; 64:10.1002/pbc.26273. [PMID: 27762068 PMCID: PMC7861473 DOI: 10.1002/pbc.26273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Diagnosis of engraftment syndrome (ES) following allogeneic hematopoietic stem cell transplantation (HSCT) can be a challenge due to the systemic presentation and alternative etiologies. With a goal of establishing biomarkers to more accurately distinguish ES, we prospectively analyzed levels of cytokines during HSCT. PROCEDURES We performed a prospective study of children ≤21 years who underwent allogeneic HSCT. Blood samples for interleukin (IL)-6, IL-8, IL-10, IL-1b, IL-12p70, interferon-γ, tumor necrosis factor alpha (TNF-α) and procalcitonin were obtained from each subject prior to conditioning, at day 0, and then biweekly through engraftment and at days 30, 60 and 100. Patients were evaluated for ES, infection and acute graft-versus-host disease. Cytokines were analyzed by values at engraftment, and also compared to pre-conditioning and day 0 values to evaluate for change from baseline. RESULTS A total of 30 subjects (median age: 7 years, min.-max.: 1-21 years) were enrolled of whom 5 had ES. Characterization of the cytokine profile revealed differences between day 0 from pre-HSCT, with a trend towards differences in IL-10, IL-12p70, interferon-γ and TNF-α at the time of ES. For IL8 and procalcitonin, there was evidence that the absolute difference (or fold change) between engraftment and pre-conditioning or day 0 differed according to ES. In particular, procalcitonin increased from baseline (15.1 median fold increase in ES+ versus 2.31 median fold increase in ES-, P = 0.0006, median difference: 13.8, 95% confidence interval: 6.33, 65.6). CONCLUSIONS Our data provide one of the first prospective studies evaluating cytokines in pediatric allogeneic HSCT and suggest that elevated procalcitonin may serve as a biomarker for ES. Further studies to evaluate this finding are warranted.
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Affiliation(s)
- Nirali N. Shah
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Theresa M. Watson
- Division of Blood and Marrow Transplantation,Center for Cancer and Blood Disorders, Children’s National Medical Center,Washington, DC
| | - Bonnie Yates
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - David J. Liewehr
- Biostatistics and Data Management Section, Office of the Clinical Director,CCR, NCI, NIH, Bethesda, Maryland
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director,CCR, NCI, NIH, Bethesda, Maryland
| | - David Jacobsohn
- Division of Blood and Marrow Transplantation,Center for Cancer and Blood Disorders, Children’s National Medical Center,Washington, DC
| | - Terry J. Fry
- Pediatric Oncology Branch, Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
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14
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Sissung TM, Deeken J, Leibrand CR, Price DK, Ehrlich S, Steinberg SM, Liewehr DJ, Dahut W, Figg WD. Identification of novel SNPs associated with risk and prognosis in patients with castration-resistant prostate cancer. Pharmacogenomics 2016; 17:1979-1986. [PMID: 27883295 DOI: 10.2217/pgs-2016-0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIM Metabolism and transport play major roles in life-long exposure to endogenous and exogenous carcinogens. We therefore explored associations between polymorphisms in absorption, distribution, metabolism and elimination genes and the risk and prognosis of castration-resistant prostate cancer (CRPC). MATERIALS & METHODS A total of 634 genotypes were tested in 74 patients using the Affymetrix DMETv1.0 platform. RESULTS No relation to risk was found. Three SNPs were associated with CRPC prognosis in Caucasians: ABCB11 rs7602171G>A (p = 0.003; n = 30; hazard ratio [HR]: 0.307), GSTP1 rs1799811C>T (p = 0.001; n = 38; HR: 0.254) and SLC5A6 rs1395 (p = 0.004; n = 35; HR: 3.15). Two other polymorphisms among Caucasians were associated with interesting trends: ABCB4 rs2302387C>T (p = 0.039) and ABCC5 rs939339A>G (p = 0.018). CONCLUSION This exploratory study is the first to show that polymorphisms in several absorption, distribution, metabolism and elimination genes may be associated with CRPC prognosis.
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Affiliation(s)
- Tristan M Sissung
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA
| | - John Deeken
- Inova Comprehensive Cancer & Research Institute, Falls Church, VA 22042, USA
| | - Crystal R Leibrand
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA
| | - Douglas K Price
- Molecular Pharmacology Program, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA
| | - Sheryl Ehrlich
- Molecular Pharmacology Program, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA
| | - Seth M Steinberg
- Biostatistics & Data Management Section, Office of the Clinical Director, National Cancer Institute, NIH, Shady Grove, MD 20850, USA
| | - David J Liewehr
- Biostatistics & Data Management Section, Office of the Clinical Director, National Cancer Institute, NIH, Shady Grove, MD 20850, USA
| | - William Dahut
- Prostate Cancer Clinical Research Section, Genitourinary Malignancies Branch, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - William D Figg
- Clinical Pharmacology Program, Office of the Clinical Director, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA.,Molecular Pharmacology Program, National Cancer Institute, 9000 Rockville Pike, Building 10, Room 5A01, Bethesda, MD 20892, USA
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15
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Thomas A, Chen Y, Berman A, Schrump DS, Giaccone G, Pastan I, Venzon DJ, Liewehr DJ, Steinberg SM, Miettinen M, Hassan R, Rajan A. Expression of mesothelin in thymic carcinoma and its potential therapeutic significance. Lung Cancer 2016; 101:104-110. [PMID: 27794397 DOI: 10.1016/j.lungcan.2016.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/29/2016] [Accepted: 09/27/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Advanced thymic epithelial tumors (TETs) lack adequate treatment options in part due to absence of well characterized tumor-specific antigens. Mesothelin, a cell surface antigen, has been used successfully as a target for tumor-directed therapy. We sought to determine tumor expression and serum levels of mesothelin in patients with TETs. PATIENTS AND METHODS Tissue samples were obtained from 71 patients with histologically confirmed, unresectable advanced TETs and evaluated for mesothelin expression by immunohistochemistry. The evaluation was blinded for clinical data and outcome. Mesothelin expression and its association with clinico-pathological parameters and survival were assessed. RESULTS Thymic carcinoma, thymoma, and thymic neuroendocrine tumors (NETs) accounted for 34 (48%), 29 (41%), and 8 (11%) cases respectively. Mesothelin expression was seen in a significantly larger proportion of thymic carcinoma (27/34, 79%) than thymoma (3/29, 10%) (P<0.0001) and was absent in thymic NETs. Among thymic carcinomas 13/34 (38%) showed expression in nearly all tumor cells. Immunoreactivity was membranous, strong, and homogenous. Patients with thymic carcinoma and high mesothelin expression (in >50% of tumor cells) had significantly improved overall survival (median not reached, n=19) compared to patients with no or low mesothelin expression (1.60 years; 95% CI: 1.24-4.94 years; n=15; HR=4.46, 95% CI: 1.55-12.80; p=0.0026). CONCLUSION Mesothelin expression is frequently observed in advanced thymic carcinomas, infrequently in thymomas and is absent in thymic NETs. Due to strong, membranous expression mesothelin is a potential therapeutic target in thymic carcinoma.
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Affiliation(s)
- Anish Thomas
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yuanbin Chen
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Arlene Berman
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - David S Schrump
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Giuseppe Giaccone
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA
| | - Ira Pastan
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - David J Venzon
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - David J Liewehr
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Markku Miettinen
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Raffit Hassan
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Arun Rajan
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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16
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Sissung TM, John D, Leibrand CR, Price DK, Ehrlich S, Steinberg SM, Liewehr DJ, Dahut WL, Figg WD. Abstract 1794: Identification of novel single nucleotide polymorphisms (SNPs) associated with risk and prognosis in patients with castration-resistant prostate cancer (CRPC). Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-1794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Liver metabolism plays a major role in life-long exposure to endogenous and exogenous carcinogens. We therefore explored associations between polymorphisms in genes involved in absorption, distribution, metabolism, and elimination (ADME) and the risk and prognosis of castration resistant prostate cancer (CRPC).
Methods: DNA samples from 47 patients (43 Caucasians) with CRPC were genotyped using the Drug Metabolizing Enzymes and Transporters platform v1.0, which tests 1,243 genetic variations in 169 ADME genes. First, the frequency of SNPs in genes previously reported to correlate with PCa risk (CYP17, CYP1A1, NAT2, and PPARgamma) were determined and compared to controls. Second, SNP variants in all tested genes were screened for an association with survival using a Cox regression model and subsequent Kaplan-Meier plot evaluations and comparisons between groups with the log-rank test.
Results: Overall 634 genotypes were ascertained. The rs743572 T>C in CYP17 was associated with decreased risk of CRPC (Fisher's exact test, P = 0.009, odds ratio 0.165, 95% confidence limits, 0.03-0.69), and we found no evidence that any other SNPs were strongly related to risk in this study. A combination of Cox model screening and graphical evaluation using Kaplan-Meier plots revealed that 5 were worthy of further consideration for survival. Of these, there was evidence that three SNPs were associated with CRPC prognosis in Caucasians (log-rank test p-values and hazard ratios): ABCB11 rs7602171 G>A (P = 0.003, adjusted P = 0.006, HR 0.307, 95% CI 0.149-0.714, n = 30), GSTP1 rs1799811 C>T (P = 0.001, HR 0.254, 95% CI 0.094-0.690, n = 38), and SLC5A6 rs1395 (P = 0.004, adjusted P = 0.008, HR 3.15, 95% CI 1.39-7.09, n = 35). Two other polymorphisms were considered interesting trends: ABCB4 rs2302387 C>T (P = 0.039), and ABCC5 rs939339 A>G (P = 0.036).
Conclusion: This exploratory pilot study is the first to show that polymorphisms in transporters involved in sterol disposition, ABCB11 and ABCB4, may be related to CRPC prognosis. Other potential associations were found in genes that regulate glutathione conjugation of carcinogens (GSTP1), vitamin uptake (SLC5A6), and nucleotide efflux (ABCC5). We also found evidence that CYP17 rs743572 is related to CRPC risk.
Citation Format: Tristan M. Sissung, Deeken John, Crystal R. Leibrand, Douglas K. Price, Sheryl Ehrlich, Seth M. Steinberg, David J. Liewehr, William L. Dahut, William D. Figg. Identification of novel single nucleotide polymorphisms (SNPs) associated with risk and prognosis in patients with castration-resistant prostate cancer (CRPC). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1794.
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Affiliation(s)
| | - Deeken John
- 2Inova Comprehensive Cancer and Research Institute, Falls Church, VA
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17
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Lyle LT, Lockman PR, Adkins CE, Mohammad AS, Sechrest E, Hua E, Palmieri D, Liewehr DJ, Steinberg SM, Kloc W, Izycka-Swieszewska E, Duchnowska R, Nayyar N, Brastianos PK, Steeg PS, Gril B. Alterations in Pericyte Subpopulations Are Associated with Elevated Blood-Tumor Barrier Permeability in Experimental Brain Metastasis of Breast Cancer. Clin Cancer Res 2016; 22:5287-5299. [PMID: 27245829 DOI: 10.1158/1078-0432.ccr-15-1836] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 05/19/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE The blood-brain barrier (BBB) is modified to a blood-tumor barrier (BTB) as a brain metastasis develops from breast or other cancers. We (i) quantified the permeability of experimental brain metastases, (ii) determined the composition of the BTB, and (iii) identified which elements of the BTB distinguished metastases of lower permeability from those with higher permeability. EXPERIMENTAL DESIGN A SUM190-BR3 experimental inflammatory breast cancer brain metastasis subline was established. Experimental brain metastases from this model system and two previously reported models (triple-negative MDA-231-BR6, HER2+ JIMT-1-BR3) were serially sectioned; low- and high-permeability lesions were identified with systemic 3-kDa Texas Red dextran dye. Adjoining sections were used for quantitative immunofluorescence to known BBB and neuroinflammatory components. One-sample comparisons against a hypothesized value of one were performed with the Wilcoxon signed-rank test. RESULTS When uninvolved brain was compared with any brain metastasis, alterations in endothelial, pericytic, astrocytic, and microglial components were observed. When metastases with relatively low and high permeability were compared, increased expression of a desmin+ subpopulation of pericytes was associated with higher permeability (231-BR6 P = 0.0002; JIMT-1-BR3 P = 0.004; SUM190-BR3 P = 0.008); desmin+ pericytes were also identified in human craniotomy specimens. Trends of reduced CD13+ pericytes (231-BR6 P = 0.014; JIMT-1-BR3 P = 0.002, SUM190-BR3, NS) and laminin α2 (231-BR6 P = 0.001; JIMT-1-BR3 P = 0.049; SUM190-BR3 P = 0.023) were also observed with increased permeability. CONCLUSIONS We provide the first account of the composition of the BTB in experimental brain metastasis. Desmin+ pericytes and laminin α2 are potential targets for the development of novel approaches to increase chemotherapeutic efficacy. Clin Cancer Res; 22(21); 5287-99. ©2016 AACR.
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Affiliation(s)
- L Tiffany Lyle
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Paul R Lockman
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Chris E Adkins
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Afroz Shareef Mohammad
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Emily Sechrest
- Department of Basic Pharmaceutical Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia
| | - Emily Hua
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Diane Palmieri
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - David J Liewehr
- Biostatistics and Data Management Section, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Wojciech Kloc
- Departments of Neurology & Neurosurgery, University of Varmia & Masuria University, Olsztyn, Poland.,Department of Neurosurgery, Copernicus Hospital Gdańsk, Poland
| | - Ewa Izycka-Swieszewska
- Departments of Pathology & Neuropathology, Medical University of Gdańsk, Poland.,Department of Pathomorphology, Copernicus Hospital, Gdańsk, Poland
| | - Renata Duchnowska
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
| | - Naema Nayyar
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Priscilla K Brastianos
- Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts
| | - Patricia S Steeg
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Brunilde Gril
- Women's Malignancies Branch, Center for Cancer Research, NCI, Bethesda, Maryland.
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18
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Keutgen XM, Nilubol N, Glanville J, Sadowski SM, Liewehr DJ, Venzon DJ, Steinberg SM, Kebebew E. Resection of primary tumor site is associated with prolonged survival in metastatic nonfunctioning pancreatic neuroendocrine tumors. Surgery 2015; 159:311-8. [PMID: 26453135 DOI: 10.1016/j.surg.2015.05.042] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [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: 02/27/2015] [Revised: 04/14/2015] [Accepted: 05/13/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Nonfunctioning pancreatic neuroendocrine tumors (NFpNET) present with distant metastases in up to 50% of patients. It is unknown whether removal of the primary tumor in patients with NFpNET and metastases is beneficial. METHODS We used the Surveillance, Epidemiology, and End Results database to identify patients with NFpNET and distant metastases. The primary outcome measure in this study was overall survival. RESULTS We identified 882 patients with metastatic NFpNET who had survival data; 303 (34%) patients had operative removal of their primary tumor of which 243 (80%) were grade I or II. Median survival of patients undergoing resection of the primary site was 65 (95% confidence interval 60-86) versus 10 (8-12) months for those without resection (P < .0001). Patients diagnosed after 2003 (n = 625, 71%) were more likely to undergo an operation than those diagnosed earlier (P = .001). Multivariable analysis showed that a lesser tumor grade (P < .0001), younger age (P < .0001), diagnosis during or after 2003 (P = .0003), tumor site in the body/tail (P = .009), and operative resection of the primary tumor site (P < .0001) were associated with prolonged survival of patients with NFpNET and distant metastases. CONCLUSION This study suggests that resection of the site of the primary NFpNET is associated with greater survival in patients with distant metastases and could therefore be considered as a additional treatment option in this patient population.
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Affiliation(s)
- Xavier M Keutgen
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Naris Nilubol
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Joanne Glanville
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Samira M Sadowski
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - David J Liewehr
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - David J Venzon
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Seth M Steinberg
- Biostatistics and Data Management Section, Office of the Clinical Director, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Electron Kebebew
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
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19
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Bates SE, Eisch R, Ling A, Rosing D, Turner M, Pittaluga S, Prince HM, Kirschbaum MH, Allen SL, Zain J, Geskin LJ, Joske D, Popplewell L, Cowen EW, Jaffe ES, Nichols J, Kennedy S, Steinberg SM, Liewehr DJ, Showe LC, Steakley C, Wright J, Fojo T, Litman T, Piekarz RL. Romidepsin in peripheral and cutaneous T-cell lymphoma: mechanistic implications from clinical and correlative data. Br J Haematol 2015; 170:96-109. [PMID: 25891346 PMCID: PMC4675455 DOI: 10.1111/bjh.13400] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 11/10/2014] [Accepted: 02/04/2015] [Indexed: 01/02/2023]
Abstract
Romidepsin is an epigenetic agent approved for the treatment of patients with cutaneous or peripheral T-cell lymphoma (CTCL and PTCL). Here we report data in all patients treated on the National Cancer Institute 1312 trial, demonstrating long-term disease control and the ability to retreat patients relapsing off-therapy. In all, 84 patients with CTCL and 47 with PTCL were enrolled. Responses occurred early, were clinically meaningful and of very long duration in some cases. Notably, patients with PTCL receiving romidepsin as third-line therapy or later had a comparable response rate (32%) of similar duration as the total population (38%). Eight patients had treatment breaks of 3.5 months to 10 years; in four of six patients, re-initiation of treatment led to clear benefit. Safety data show slightly greater haematological and constitutional toxicity in PTCL. cDNA microarray studies show unique individual gene expression profiles, minimal overlap between patients, and both induction and repression of gene expression that reversed within 24 h. These data argue against cell death occurring as a result of an epigenetics-mediated gene induction programme. Together this work supports the safety and activity of romidepsin in T-cell lymphoma, but suggests a complex mechanism of action.
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Affiliation(s)
- Susan E. Bates
- Developmental Therapeutics Branch, NCI, NIH, Bethesda, MD
| | - Robin Eisch
- Developmental Therapeutics Branch, NCI, NIH, Bethesda, MD
| | - Alex Ling
- Department of Radiology, Warren G Magnuson Clinical Center, NIH, Bethesda, MD
| | | | | | | | - H. Miles Prince
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Mark H. Kirschbaum
- Hematological Malignancies, Penn State Hershey Medical Center, Hershey, PA
| | - Steven L. Allen
- Hofstra North Shore-LIJ School of Medicine and Monter Cancer Center, Lake Success, NY
| | | | - Larisa J. Geskin
- Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - David Joske
- Sir Charles Gairdner Hospital, Nedlands, Western Australia
| | | | | | | | | | | | | | | | | | | | - John Wright
- Cancer Therapy Evaluation Program, DCTDC, NCI, Bethesda, MD
| | - Tito Fojo
- Center for Cancer Research, NCI, Bethesda, MD
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20
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Lopez-Chavez A, Thomas A, Rajan A, Raffeld M, Morrow B, Kelly R, Carter CA, Guha U, Killian K, Lau CC, Abdullaev Z, Xi L, Pack S, Meltzer PS, Corless CL, Sandler A, Beadling C, Warrick A, Liewehr DJ, Steinberg SM, Berman A, Doyle A, Szabo E, Wang Y, Giaccone G. Molecular profiling and targeted therapy for advanced thoracic malignancies: a biomarker-derived, multiarm, multihistology phase II basket trial. J Clin Oncol 2015; 33:1000-7. [PMID: 25667274 DOI: 10.1200/jco.2014.58.2007] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE We conducted a basket clinical trial to assess the feasibility of such a design strategy and to independently evaluate the effects of multiple targeted agents against specific molecular aberrations in multiple histologic subtypes concurrently. PATIENTS AND METHODS We enrolled patients with advanced non-small-cell lung cancer (NSCLC), small-cell lung cancer, and thymic malignancies who underwent genomic characterization of oncogenic drivers. Patients were enrolled onto a not-otherwise-specified arm and treated with standard-of-care therapies or one of the following five biomarker-matched treatment groups: erlotinib for EGFR mutations; selumetinib for KRAS, NRAS, HRAS, or BRAF mutations; MK2206 for PIK3CA, AKT, or PTEN mutations; lapatinib for ERBB2 mutations or amplifications; and sunitinib for KIT or PDGFRA mutations or amplification. RESULTS Six hundred forty-seven patients were enrolled, and 88% had their tumors tested for at least one gene. EGFR mutation frequency was 22.1% in NSCLC, and erlotinib achieved a response rate of 60% (95% CI, 32.3% to 83.7%). KRAS mutation frequency was 24.9% in NSCLC, and selumetinib failed to achieve its primary end point, with a response rate of 11% (95% CI, 0% to 48%). Completion of accrual to all other arms was not feasible. In NSCLC, patients with EGFR mutations had the longest median survival (3.51 years; 95% CI, 2.89 to 5.5 years), followed by those with ALK rearrangements (2.94 years; 95% CI, 1.66 to 4.61 years), those with KRAS mutations (2.3 years; 95% CI, 2.3 to 2.17 years), those with other genetic abnormalities (2.17 years; 95% CI, 1.3 to 2.74 years), and those without an actionable mutation (1.85 years; 95% CI, 1.61 to 2.13 years). CONCLUSION This basket trial design was not feasible for many of the arms with rare mutations, but it allowed the study of the genetics of less common malignancies.
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Affiliation(s)
- Ariel Lopez-Chavez
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Anish Thomas
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Arun Rajan
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Mark Raffeld
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Betsy Morrow
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Ronan Kelly
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Corey Allan Carter
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Udayan Guha
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Keith Killian
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Christopher C Lau
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Zied Abdullaev
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Liqiang Xi
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Svetlana Pack
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Paul S Meltzer
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Christopher L Corless
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Alan Sandler
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Carol Beadling
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Andrea Warrick
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - David J Liewehr
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Seth M Steinberg
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Arlene Berman
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Austin Doyle
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Eva Szabo
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Yisong Wang
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Giuseppe Giaccone
- Ariel Lopez-Chavez, Anish Thomas, Arun Rajan, Mark Raffeld, Betsy Morrow, Ronan Kelly, Corey Allan Carter, Udayan Guha, Keith Killian, Christopher C. Lau, Zied Abdullaev, Liqiang Xi, Svetlana Pack, Paul S. Meltzer, David J. Liewehr, Seth M. Steinberg, Arlene Berman, Eva Szabo, Yisong Wang, and Giuseppe Giaccone, National Cancer Institute; Austin Doyle, Cancer Therapy Evaluation Program, Bethesda, MD; Ariel Lopez-Chavez, Christopher L. Corless, Alan Sandler, Carol Beadling, and Andrea Warrick, Knight Cancer Institute, Oregon Health and Science University, Portland, OR; Ariel Lopez-Chavez, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; and Yisong Wang and Giuseppe Giaccone, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
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21
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Massimelli MJ, Majerciak V, Kang JG, Liewehr DJ, Steinberg SM, Zheng ZM. Multiple regions of Kaposi's sarcoma-associated herpesvirus ORF59 RNA are required for its expression mediated by viral ORF57 and cellular RBM15. Viruses 2015; 7:496-510. [PMID: 25690794 PMCID: PMC4353900 DOI: 10.3390/v7020496] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/15/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022] Open
Abstract
KSHV ORF57 (MTA) promotes RNA stability of ORF59, a viral DNA polymerase processivity factor. Here, we show that the integrity of both ORF59 RNA ends is necessary for ORF57-mediated ORF59 expression and deletion of both 5’ and 3’ regions, or one end region with a central region, of ORF59 RNA prevents ORF57-mediated translation of ORF59. The ORF59 sequence between nt 96633 and 96559 resembles other known MTA-responsive elements (MREs). ORF57 specifically binds to a stem-loop region from nt 96596–96572 of the MRE, which also binds cellular RBM15. Internal deletion of the MRE from ORF59 led to poor export, but accumulation of nuclear ORF59 RNA in the presence of ORF57 or RBM15. Despite of being translatable in the presence of ORF57, this deletion mutant exhibits translational defect in the presence of RBM15. Together, our results provide novel insight into the roles of ORF57 and RBM15 in ORF59 RNA accumulation and protein translation.
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Affiliation(s)
- Maria Julia Massimelli
- Tumor Virus RNA Biology Section, Gene Regulation and Chromosome Biology Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 1050 Boyles Street, Frederick, MD 21702, USA.
| | - Vladimir Majerciak
- Tumor Virus RNA Biology Section, Gene Regulation and Chromosome Biology Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 1050 Boyles Street, Frederick, MD 21702, USA.
| | - Jeong-Gu Kang
- Tumor Virus RNA Biology Section, Gene Regulation and Chromosome Biology Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 1050 Boyles Street, Frederick, MD 21702, USA.
| | - David J Liewehr
- Biostatistics & Data Management Section, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Seth M Steinberg
- Biostatistics & Data Management Section, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Zhi-Ming Zheng
- Tumor Virus RNA Biology Section, Gene Regulation and Chromosome Biology Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 1050 Boyles Street, Frederick, MD 21702, USA.
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22
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Ulahannan SV, Rahma OE, Duffy AG, Makarova-Rusher OV, Kurtoglu M, Liewehr DJ, Steinberg SM, Greten TF. Identification of active chemotherapy regimens in advanced biliary tract carcinoma: a review of chemotherapy trials in the past two decades. Hepat Oncol 2015; 2:39-50. [PMID: 25685318 PMCID: PMC4326054 DOI: 10.2217/hep.14.36] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 12/20/2022] Open
Abstract
Biliary tract carcinoma is a rare malignancy. We performed a comprehensive analysis of published prospective clinical trials in advanced biliary tract carcinoma in an attempt to identify active regimens in this setting. We searched PubMed and abstracts presented at the American Society of Clinical Oncology, Gastrointestinal Cancer Symposium, European Society of Medical Oncology and European Cancer Organization conferences for clinical trials in this disease. We found 83 trials. The effect of gemcitabine on overall survival benefit showed a strong trend (p = 0.014) and an improvement in progression-free survival (p = 0.003). Gemcitabine-based regimens containing 5-fluorouracil showed a trend toward an improved overall survival (p = 0.047) relative to platinum agents. Our findings support gemcitabine as the chemotherapy backbone for the treatment of patients with cholangiocarcinoma. Gemcitabine plus 5-fluorouracil combinations warrant further investigations.
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Affiliation(s)
- Susanna V Ulahannan
- Gastrointestinal Malignancies Section, Thoracic & GI-Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Osama E Rahma
- Division of Hematology/Oncology, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Austin G Duffy
- Gastrointestinal Malignancies Section, Thoracic & GI-Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Oxana V Makarova-Rusher
- Gastrointestinal Malignancies Section, Thoracic & GI-Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Metin Kurtoglu
- Gastrointestinal Malignancies Section, Thoracic & GI-Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - David J Liewehr
- Biostatistics & Data Management Section, National Cancer Institute, Rockville, MD, USA
| | - Seth M Steinberg
- Biostatistics & Data Management Section, National Cancer Institute, Rockville, MD, USA
| | - Tim F Greten
- Gastrointestinal Malignancies Section, Thoracic & GI-Oncology Branch, National Cancer Institute, Bethesda, MD, USA
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23
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Momot D, Nostrand TA, John K, Ward Y, Steinberg SM, Liewehr DJ, Poirier MC, Olivero OA. Role of nucleotide excision repair and p53 in zidovudine (AZT)-induced centrosomal deregulation. Environ Mol Mutagen 2014; 55:719-726. [PMID: 25073973 PMCID: PMC7675294 DOI: 10.1002/em.21889] [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] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 07/10/2014] [Indexed: 06/03/2023]
Abstract
The nucleoside reverse transcriptase inhibitor zidovudine (AZT) induces genotoxic damage that includes centrosomal amplification (CA > 2 centrosomes/cell) and micronucleus (MN) formation. Here we explored these end points in mice deficient in DNA repair and tumor suppressor function to evaluate their effect on AZT-induced DNA damage. We used mesenchymal-derived fibroblasts cultured from C57BL/6J mice that were null and wild type (WT) for Xpa, and WT, haploinsufficient and null for p53 (6 different genotypes). Dose-responses for CA formation, in cells exposed to 0, 10, and 100 μM AZT for 24 hr, were observed in all genotypes except the Xpa((+/+)) p53((+/-)) cells, which had very low levels of CA, and the Xpa((-/-)) p53((-/-)) cells, which had very high levels of CA. For CA there was a significant three-way interaction between Xpa, p53, and AZT concentration, and Xpa((-/-)) cells had significantly higher levels of CA than Xpa((+/+)) cells, only for p53((+/-)) cells. In contrast, the MN and MN + chromosomes (MN + C) data showed a lack of AZT dose response. The Xpa((-/-)) cells, with p53((+/+)) or ((+/-)) genotypes, had levels of MN and MN + C higher than the corresponding Xpa((+/+)) cells. The data show that CA is a major event induced by exposure to AZT in these cells, and that there is a complicated relationship between AZT and CA formation with respect to gene dosage of Xpa and p53. The loss of both genes resulted in high levels of damage, and p53 haploinsufficicency strongly protected Xpa((+/+)) cells from AZT-induced CA damage.
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Affiliation(s)
- Dariya Momot
- Carcinogen-DNA Interactions Section, LCBG, National Cancer Institute, NIH, Bethesda, Maryland
| | - Terri A. Nostrand
- Carcinogen-DNA Interactions Section, LCBG, National Cancer Institute, NIH, Bethesda, Maryland
| | - Kaarthik John
- Carcinogen-DNA Interactions Section, LCBG, National Cancer Institute, NIH, Bethesda, Maryland
| | - Yvona Ward
- Cell and Cancer Biology Branch, National Cancer Institute, NIH, Bethesda, Maryland
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, National Cancer Institute, NIH, Bethesda, Maryland
| | - David J. Liewehr
- Biostatistics and Data Management Section, National Cancer Institute, NIH, Bethesda, Maryland
| | - Miriam C. Poirier
- Carcinogen-DNA Interactions Section, LCBG, National Cancer Institute, NIH, Bethesda, Maryland
| | - Ofelia A. Olivero
- Carcinogen-DNA Interactions Section, LCBG, National Cancer Institute, NIH, Bethesda, Maryland
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24
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Jochems C, Boyerinas B, Madan RA, Poole DJ, Ning YM, Figg WD, Liewehr DJ, Steinberg SM, Gulley JL, Tsang KY, Schlom J. Abstract 2546: Analysis of immune cell subsets in a multidrug therapeutic regimen for patients with metastatic castration-resistant prostate cancer. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-2546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: To investigate the effects of docetaxel-based combination therapy with bevacizumab and dexamethasone premedication on the immune response in patients with metastatic castration-resistant prostate cancer (mCRPC).
Experimental Design: We studied immune responses in 13 patients enrolled in a phase II trial at the National Cancer Institute (NCI). The study was designed as a 13 patient expansion of a previously reported phase II study to evaluate the immunologic response after 2 cycles of treatment with a docetaxel-based chemotherapy regimen including docetaxel (75 mg/m2 every 3 weeks) and bevacizumab (15 mg/kg every 3 weeks). Dexamethasone pre-medication (4 mg) was given 12 h and 1 h prior to chemotherapy, and again after 12 h. Patients were evaluated before treatment and on day 40, 3 weeks after the second cycle. We compared PBMC and serum samples collected at baseline and after 40 days of treatment. We investigated CD4+ and CD8+ T-cells and regulatory T-cells (CD4+ CD25hi CD127- FoxP3+) by flow cytometry. T-cell proliferation, as well as NK-cell functional activity, was evaluated. Serum samples were analyzed for levels of cytokines, chemokines, sCD27, sCD40L and vascular endothelial growth factor (VEGF).
Results: The baseline characteristics were: median age 64 years, Gleason score 9, PSA 100 ng/ml, and Halabi Predicted Survival 10.6 months. Patients had a median PSA decline of 66% after 2 cycles. The median TTP was 14.1 months, and OS 18.7 months. At 3 weeks after the second cycle we found no significant changes in absolute lymphocyte count, CD4+ and CD8+ T-cell proliferation and NK-cell function. The number of CD4+ T-cells decreased. CTLA4+ regulatory T-cells did not change. There was no change in the serum levels of IL-6, IL-8, IL-10 and TNFα. As expected, the serum levels of VEGF decreased substantially after therapy. The serum levels of sCD40L did not change after treatment. Interestingly, an increase in the serum level of sCD27 correlated with longer OS (P= 0.037, R= 0.58).
Conclusions: Treatment of mCRPC patients with docetaxel-based combination therapy with bevacizumab and dexamethasone premedication for 40 days did not alter the immune response in a way that would decrease the likelihood of successful immunotherapy, either before or after this treatment.
Citation Format: Caroline Jochems, Benjamin Boyerinas, Ravi A. Madan, Diane J. Poole, Yang-Min Ning, William D. Figg, David J. Liewehr, Seth M. Steinberg, James L. Gulley, Kwong-Yok Tsang, Jeffrey Schlom. Analysis of immune cell subsets in a multidrug therapeutic regimen for patients with metastatic castration-resistant prostate cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2546. doi:10.1158/1538-7445.AM2014-2546
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Abstract
Despite major therapeutic advances in the management of patients with breast cancer, central nervous system (CNS) metastases remain an intractable problem, particularly in patients with metastatic HER2-positive and triple-negative breast cancer. As systemic therapies to treat extracranial disease improve, some patients are surviving longer, and the frequency of CNS involvement seems to be increasing. Furthermore, in the early-stage setting, the CNS remains a potential sanctuary site for relapse. This review highlights advances in the development of biologically relevant preclinical models, including the development of brain-tropic cell lines for testing of agents to prevent and treat brain metastases, and summarizes our current understanding of the biology of CNS relapse. From a clinical perspective, a variety of therapeutic approaches are discussed, including methods to improve drug delivery, novel cytotoxic agents, and targeted therapies. Challenges in current trial design and endpoints are reviewed. Finally, we discuss promising new directions, including novel trial designs, correlative imaging techniques, and enhanced translational opportunities.
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Affiliation(s)
- Nancy U Lin
- Authors' Affiliations: Dana-Farber Cancer Institute, Boston, Massachusetts; Medical Oncology Branch, Center for Cancer Research, National Cancer Institute; Women's Cancers Section, Laboratory of Molecular Pharmacology; and Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
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26
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Ulahannan SV, Rahma OE, Liewehr DJ, Steinberg SM, Duffy AG. Systemic chemotherapy for the treatment of advanced biliary tract carcinoma (BTC). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Osama E. Rahma
- National Institutes of Health/National Cancer Institute, Bethesda, MD
| | | | - Seth M. Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Austin G. Duffy
- National Cancer Institute at the National Institutes of Health, Bethesda, MD
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27
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Reece KM, Richardson ED, Cook KM, Campbell TJ, Pisle ST, Holly AJ, Venzon DJ, Liewehr DJ, Chau CH, Price DK, Figg WD. Epidithiodiketopiperazines (ETPs) exhibit in vitro antiangiogenic and in vivo antitumor activity by disrupting the HIF-1α/p300 complex in a preclinical model of prostate cancer. Mol Cancer 2014; 13:91. [PMID: 24775564 PMCID: PMC4113146 DOI: 10.1186/1476-4598-13-91] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [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] [Received: 08/01/2013] [Accepted: 04/02/2014] [Indexed: 01/08/2023] Open
Abstract
The downstream targets of hypoxia inducible factor-1 alpha (HIF-1α) play an important role in tumor progression and angiogenesis. Therefore, inhibition of HIF-mediated transcription has potential in the treatment of cancer. One attractive strategy for inhibiting HIF activity is the disruption of the HIF-1α/p300 complex, as p300 is a crucial coactivator of hypoxia-inducible transcription. Several members of the epidithiodiketopiperazine (ETP) family of natural products have been shown to disrupt the HIF-1α/p300 complex in vitro; namely, gliotoxin, chaetocin, and chetomin. Here, we further characterized the molecular mechanisms underlying the antiangiogenic and antitumor effects of these ETPs using a preclinical model of prostate cancer. In the rat aortic ring angiogenesis assay, gliotoxin, chaetocin, and chetomin significantly inhibited microvessel outgrowth at a GI50 of 151, 8, and 20 nM, respectively. In vitro co-immunoprecipitation studies in prostate cancer cell extracts demonstrated that these compounds disrupted the HIF-1α/p300 complex. The downstream effects of inhibiting the HIF-1α/p300 interaction were evaluated by determining HIF-1α target gene expression at the mRNA and protein levels. Dose-dependent decreases in levels of secreted VEGF were detected by ELISA in the culture media of treated cells, and the subsequent downregulation of VEGFA, LDHA, and ENO1 HIF-1α target genes were confirmed by semi-quantitative real-time PCR. Finally, treatment with ETPs in mice bearing prostate tumor xenografts resulted in significant inhibition of tumor growth. These results suggest that directly targeting the HIF-1α/p300 complex with ETPs may be an effective approach for inhibiting angiogenesis and tumor growth.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - William D Figg
- Molecular Pharmacology Section, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA.
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Palmieri D, Duchnowska R, Woditschka S, Hua E, Qian Y, Biernat W, Sosińska-Mielcarek K, Gril B, Stark AM, Hewitt SM, Liewehr DJ, Steinberg SM, Jassem J, Steeg PS. Profound prevention of experimental brain metastases of breast cancer by temozolomide in an MGMT-dependent manner. Clin Cancer Res 2014; 20:2727-39. [PMID: 24634373 DOI: 10.1158/1078-0432.ccr-13-2588] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Brain metastases of breast cancer cause neurocognitive damage and are incurable. We evaluated a role for temozolomide in the prevention of brain metastases of breast cancer in experimental brain metastasis models. EXPERIMENTAL DESIGN Temozolomide was administered in mice following earlier injection of brain-tropic HER2-positive JIMT-1-BR3 and triple-negative 231-BR-EGFP sublines, the latter with and without expression of O(6)-methylguanine-DNA methyltransferase (MGMT). In addition, the percentage of MGMT-positive tumor cells in 62 patient-matched sets of breast cancer primary tumors and resected brain metastases was determined immunohistochemically. RESULTS Temozolomide, when dosed at 50, 25, 10, or 5 mg/kg, 5 days per week, beginning 3 days after inoculation, completely prevented the formation of experimental brain metastases from MGMT-negative 231-BR-EGFP cells. At a 1 mg/kg dose, temozolomide prevented 68% of large brain metastases, and was ineffective at a dose of 0.5 mg/kg. When the 50 mg/kg dose was administered beginning on days 18 or 24, temozolomide efficacy was reduced or absent. Temozolomide was ineffective at preventing brain metastases in MGMT-transduced 231-BR-EGFP and MGMT-expressing JIMT-1-BR3 sublines. In 62 patient-matched sets of primary breast tumors and resected brain metastases, 43.5% of the specimens had concordant low MGMT expression, whereas in another 14.5% of sets high MGMT staining in the primary tumor corresponded with low staining in the brain metastasis. CONCLUSIONS Temozolomide profoundly prevented the outgrowth of experimental brain metastases of breast cancer in an MGMT-dependent manner. These data provide compelling rationale for investigating the preventive efficacy of temozolomide in a clinical setting.
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Affiliation(s)
- Diane Palmieri
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Renata Duchnowska
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Stephan Woditschka
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Emily Hua
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Yongzhen Qian
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Wojciech Biernat
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Katarzyna Sosińska-Mielcarek
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Brunilde Gril
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Andreas M Stark
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Stephen M Hewitt
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - David J Liewehr
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Seth M Steinberg
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Jacek Jassem
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, GermanyAuthors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
| | - Patricia S Steeg
- Authors' Affiliations: Women's Malignancies Branch; Laboratory of Pathology, Center for Cancer Research; Biostatistics and Data Management Section, NCI, NIH, Bethesda; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, Maryland; Department of Oncology, Military Institute of Medicine, Warsaw; Departments of Pathomorphology, and Oncology and Radiotherapy, Medical University; Regional Cancer Center, Gdańsk, Poland; and Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany
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Rahma OE, Hamilton JM, Wojtowicz M, Dakheel O, Bernstein S, Liewehr DJ, Steinberg SM, Khleif SN. The immunological and clinical effects of mutated ras peptide vaccine in combination with IL-2, GM-CSF, or both in patients with solid tumors. J Transl Med 2014; 12:55. [PMID: 24565030 PMCID: PMC3942063 DOI: 10.1186/1479-5876-12-55] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [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] [Received: 09/25/2013] [Accepted: 02/11/2014] [Indexed: 02/07/2023] Open
Abstract
Background Mutant Ras oncogenes produce proteins that are unique to cancer cells and represent attractive targets for vaccine therapy. We have shown previously that vaccinating cancer patients with mutant ras peptides is feasible and capable of inducing a specific immune response against the relevant mutant proteins. Here, we tested the mutant ras peptide vaccine administered in combination with low dose interleukin-2 (IL-2) or/and granulocyte-macrophage colony-stimulating factor (GM-CSF) in order to enhance the vaccine immune response. Methods 5000μg of the corresponding mutant ras peptide was given subcutaneously (SQ) along with IL-2 (Arm A), GM-CSF (Arm B) or both (Arm C). IL-2 was given SQ at 6.0 million IU/m2/day starting at day 5, 5 days/week for 2 weeks. GM-CSF was given SQ in a dose of 100μg/day one day prior to each ras peptide vaccination for 4 days. Vaccines were repeated every 5 weeks on arm A and C, and every 4 weeks on arm B, for a maximum of 15 cycles or until disease progression. Results We treated 53 advanced cancer patients (38 with colorectal, 11 with pancreatic, 1 with common bile duct and 3 with lung) on 3 different arms (16 on arm A, 18 on arm B, and 19 on arm C). The median progression free survival (PFS) and overall survival (OS) was 3.6 and 16.9 months, respectively, for all patients evaluable for clinical response (n = 48). There was no difference in PFS or OS between the three arms (P = 0.73 and 0.99, respectively). Most adverse events were grade 1-2 toxicities and resolved spontaneously. The vaccine induced an immune response to the relevant ras peptide in a total of 20 out of 37 evaluable patients (54%) by ELISPOT, proliferative assay, or both. While 92.3% of patients on arm B had a positive immune response, only 31% of patients on arm A and 36% of patients on arm C had positive immune responses (P = 0.003, Fisher’s exact test). Conclusions The reported data showed that IL-2 might have a negative effect on the specific immune response induced by the relevant mutant ras vaccine in patients with advanced cancer. This observation deserves further investigations. Trial registration NCI97C0141
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Affiliation(s)
| | | | | | | | | | | | | | - Samir N Khleif
- Cancer Vaccine Branch, CCR, NCI, 10 Center Drive, Bethesda, MD 20892, USA.
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Madan RA, Tsang KY, Jochems C, Marte JL, Tucker JA, Hodge JW, Singh H, Surolia I, O'Sullivan Coyne GH, Liewehr DJ, Steinberg SM, Heery CR, Schlom J, Gulley JL. Immune impact induced by PSA-tricom, a therapeutic vaccine for prostate cancer. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.4_suppl.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
245 Background: PSA-TRICOM is a vector-based therapeutic cancer vaccine designed to generate a targeted anti-tumor immune response against prostate-specific antigen (PSA)–expressing tumor cells. Early clinical trials have evaluated the immunologic impact of this vaccine and demonstrated promising clinical activity. PSA-TRICOM is being evaluated in a phase III trial in metastatic castration resistant prostate cancer (mCRPC). Methods: We recently conducted a broad overview of both published and new data which analyzed the immune responses to PSA-TRICOM. Immune responses included ELISPOT for antigen-specific immune response and flow-cytometry analysis of peripheral immune cells. Results: 104 patients (pts) with prostate cancer were tested for T-cell responses and 59 out of 104 (57%) demonstrated a greater than or equal to 2-fold increase in PSA-specific T cells 4 weeks after vaccine. The responders had a median 5-fold increase relative to pre-vaccine levels. For most pts PSA-specific immune responses (likely memory cells) seen 28 days following the most recent vaccine are quantitatively similar to levels of circulating influenza-specific T cells in the same pts. In addition, 19 out of 28 pts (68%) evaluated demonstrated immune responses to tumor-associated antigens not present in the vaccine (antigen spreading). Since PSA-TRICOM is designed to generate a cellular (TH1 immune response), it is not surprising that 2 out of 349 pts (<1.0%) demonstrated evidence of PSA antibody induction following vaccine. This suggests that post-vaccine PSA kinetics were not affected by PSA antibodies. Conclusions: PSA-TRICOM has demonstrated the ability to generate immune responses. Despite these findings, it is important to note that systemic immune response to PSA may underestimate the true therapeutic immune response since it does not measure cells that trafficked to tumor or antigen spreading. Furthermore, while the entire PSA gene is the vaccine, only one epitope of PSA is specifically evaluated in the T-cell responses. Further immune analysis continues in an ongoing phase III of PSA-TRICOM in mCRPC (NCT01322490), accruing worldwide, and two trials combining PSA-TRICOM with enzalutamide (biochemical recurrence/ NCT01875250 and mCRPC/ NCT01867333) currently accruing at NCI. Clinical trial information: multiple trials.
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Affiliation(s)
- Ravi Amrit Madan
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Kwong Yok Tsang
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Caroline Jochems
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Jennifer L. Marte
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Jo A Tucker
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - James W. Hodge
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | | | | | | | | | - Seth M. Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | | | - Jeffrey Schlom
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - James L. Gulley
- Laboratory of Tumor Immunology and Biology, National Cancer Institute at the National Institutes of Health, Bethesda, MD
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Weinberg BA, Lindenberg ML, Kurdziel KA, Steinberg SM, Liewehr DJ, Khadar K, McKinney Y, Choyke PL, Apolo AB. Assessment of bone metastases in patients (pts) with urothelial carcinoma using 18F-sodium fluoride PET/CT ( 18F-NaF) versus 18F-fluorodeoxyglucose PET/CT ( 18F-FDG). J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.4_suppl.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
329 Background: 18F-NaF has shown improved sensitivity for bone imaging when compared to conventional planar imaging or SPECT/CT using 99mTc-MDP. We compared the number of bone lesions detected on 18F-NaF versus 18F-FDG in urothelial cancer pts with known bone metastases undergoing treatment. Methods: Pts enrolled in a prospective single-arm phase II study of cabozantinib underwent 18F-NaF and 18F-FDG scans at baseline and at 8 weeks of therapy. In a lesion-based analysis independently confirmed by a nuclear medicine physician, abnormal foci of radiotracer uptake were categorized by location (skull, spine, pelvis, thorax, or long bones) and by disease state (benign, malignant, or indeterminate). A patient-based analysis was performed to determine if findings indicated disease progression, stable disease, or improvement of disease, based on the number of lesions and standardized uptake values (SUVs). Results: 294 total bone lesions were identified at baseline in 10 pts (8 male and 2 female, ages 44-73). 18F-NaF identified more lesions than 18F-FDG at baseline, 294 vs. 119. In a paired analysis, the median difference was 11.5 more lesions detected per patient on 18F-NaF vs. 18F-FDG (by Wilcoxon signed-rank test, p = 0.023). More total thoracic bone lesions at baseline, 100 vs. 23, were also detected on 18F-NaF vs. 18F-FDG, median 6.5 vs. 1.0 with a median difference of 6 more lesions per patient on 18F-NaF (p = 0.016). 18F-NaF also detected more skull lesions at baseline, 19 vs. 1, which was clinically but not statistically significant (p = 0.250). There was general concordance in the patient-based analysis; only 1 18F-NaF scan demonstrated progressive disease while its corresponding 18F-FDG scan showed stable disease. Conclusions:18F-NaF identified more lesions than 18F-FDG at baseline, making it a good staging exam. However, there was agreement between 18F-NaF and 18F-FDG in terms of tumor response in almost all the follow-up scans. Therefore, although a greater number of bone lesions are seen in 18F-NaF compared with 18F-FDG, the clinical significance in assessing treatment response remains to be determined. Clinical trial information: NCT01688999.
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Affiliation(s)
| | - Maria Liza Lindenberg
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Karen A. Kurdziel
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | | | - Kattie Khadar
- Medical Oncology Branch, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Yolanda McKinney
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute at the National Institutes of Health, Bethesda, MD
| | - Peter L. Choyke
- National Cancer Institute at the National Institutes of Health, Bethesda, MD
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Jassem J, Duchnowska R, Hua E, Qian Y, Biernat W, Sosinska-Mielcarek K, Gril B, Stark A, Hewitt S, Liewehr DJ, Steinberg SM, Palmieri D, Steeg PS. Abstract P6-11-04: Profound prevention of experimental brain metastases of breast cancer by temozolomide in a MGMT-dependent manner. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-11-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Brain metastases of breast cancer cause neurocognitive damage and are incurable. We evaluated in experimental brain metastasis model a role of temozolomide, an oral brain permeable alkylating agent characterized by significant uptake in the central nervous system, in the prevention of brain metastases of breast cancer.
Material and methods: To assess preventive role of temozolomide, mice were inoculated with 175,000 triple-negative 231-BR-EGFP cells in 0.1 mL PBS in the left ventricle of the heart. Three days after tumor cell inoculation, mice were randomized to temozolomide at the dose of 50 mg/kg delivered by oral gavage in saline, 5 days a week for 4 weeks, or vehicle. Subsequent experiments used temozolomide doses of 25, 10, 5, 1 and 0.5 mg/kg. To evaluate the efficacy of temozolomide in treating established BM, mice received temozolomide (50 mg/kg) beginning on either day 18 or day 24 post-injection of 231-BR-EGFR cells, 5 days a week for two and one week, respectively. To investigate the impact of temozolomide on survival, mice injected with 231-BR-EGFP cells were randomized to vehicle, temozolomide on days 3-14, or temozolomide on days 17-28 post-injection, per the schedule described above. To determine the functional contribution of MGMT expression in the BM preventive model, similar experiments were performed using 231-BR-EGFP cells with induced MGMT expression, and MGMT-positive Jimt-1 cells. Metastases were counted in step sections of one hemisphere of each brain. Additionally, the percentage of MGMT-positive tumor cells in 62 patient-matched sets of breast cancer primary tumors and resected brain metastases was determined immunohistochemically.
Results: Temozolomide, when dosed at 50, 25, 10 or 5 mg/kg, 5 days/week, beginning 3 days after inoculation, completely prevented the formation of experimental brain metastases from MGMT-negative 231-BR-EGFP cell line. At a 1 mg/kg dose, temozolomide prevented 68% of large brain metastases, and was ineffective at a dose of 0.5 mg/kg. When the 50 mg/kg dose was administered beginning on days 18 or 24, temozolomide efficacy was reduced or absent. Both schedules of temozolomide (days 3-14 and days 17-28) significantly increased survival (P = .0003 by long-rank test). Earlier administration of temozolomide resulted in long term survival of 6 and 2 out of 10 mice, respectively; a significant difference compared to vehicle (P < .0001 and .0003, respectively).Temozolomide was ineffective at preventing brain metastases in the MGMT-positive 231-BR-EGFP and Jimt-BR3 sublines. In 62 patient-matched sets of primary breast tumors and resected brain metastases 43.5% of the specimens had concordant low MGMT expression, while in another 14.5% sets high MGMT staining in the primary tumor corresponded with low staining in the brain metastasis.
Conclusions: Temozolomide profoundly prevents the outgrowth of experimental brain metastases of breast cancer in a MGMT-dependent manner. The majority of patients had low MGMT expressing brain metastases. These data provide a compelling rationale for investigating preventive efficacy of temozolomide in high-risk advanced breast cancer patients.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-11-04.
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Affiliation(s)
- J Jassem
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - R Duchnowska
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - E Hua
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - Y Qian
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - W Biernat
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - K Sosinska-Mielcarek
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - B Gril
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - A Stark
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - S Hewitt
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - DJ Liewehr
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - SM Steinberg
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - D Palmieri
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
| | - PS Steeg
- Medical University of Gdansk, Gdansk, Poland; Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, NCI, NIH, Bethesda, MD; National Heart, Lung and Blood Institute, NIH, Bthesda, MD; Military Institute of Medicine, Warsaw, Poland; Regional Cancer Center, Gdansk, Poland; Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick; Klinik fur Neurochirurgie UKSH Campus Kiel, Kiel, Germany; Laboratory of Pathology, Center for Cancer Research, NCI, NIH, Bethesda, MD; NCI, NIH, Bethesda, MD
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Calzone KA, Jenkins J, Yates J, Cusack G, Wallen GR, Liewehr DJ, Steinberg SM, McBride C. Survey of nursing integration of genomics into nursing practice. J Nurs Scholarsh 2013. [PMID: 23205780 DOI: 10.1111/j.1547-5069.2012.01475.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Translating clinically valid genomic discoveries into practice is hinged not only on technologic advances, but also on nurses-the largest global contingent of health providers-acquiring requisite competencies to apply these discoveries in clinical care. The study aim was to assess practicing nurse attitudes, practices, receptivity, confidence, and competency of integrating genomics into nursing practice. DESIGN A convenience sample of practicing nurses was recruited to complete an online survey that assessed domains from Roger's Diffusion of Innovations Theory and used family history utilization as the basis for competency assessment. METHODS Results were tabulated and analyzed using descriptive statistical techniques. FINDINGS Two-hundred-thirty-nine licensed registered nurses, 22 to 72 years of age, with a median of 20 years in practice, responded, for an overall response rate of 28%. Most were White (83%), female (92%), and held baccalaureate degrees (56%). Seventy-one percent considered genetics to be very important to nursing practice; however, 81% rated their understanding of the genetics of common diseases as poor or fair. Per-question response rates varied widely. Instrument assessment indicated that modifications were necessary to decrease respondent burden. CONCLUSIONS Respondents' perceived genomic competency was inadequate, family history was not routinely utilized in care delivery, and the extent of family history varied widely. However, most nurses indicated interest in pursuing continuing genomic education. CLINICAL RELEVANCE Findings from this study can lead to the development of targeted education that will facilitate optimal workforce preparation for the ongoing influx of genetics and genomics information, technologies, and targeted therapies into the healthcare arena. This pilot study provides a foundation on which to build the next step, which includes a national nursing workforce study.
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Affiliation(s)
- Kathleen A Calzone
- National Institutes of Health, National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD 20892, USA.
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Gulley JL, Madan RA, Tsang KY, Jochems C, Marté JL, Farsaci B, Tucker JA, Hodge JW, Liewehr DJ, Steinberg SM, Heery CR, Schlom J. Immune impact induced by PROSTVAC (PSA-TRICOM), a therapeutic vaccine for prostate cancer. Cancer Immunol Res 2013; 2:133-41. [PMID: 24778277 DOI: 10.1158/2326-6066.cir-13-0108] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PSA-TRICOM (PROSTVAC) is a novel vector-based vaccine designed to generate a robust immune response against prostate-specific antigen (PSA)-expressing tumor cells. The purpose of this report is to present an overview of both published studies and new data in the evaluation of immune responses to the PSA-TRICOM vaccine platform, currently in phase III testing. Of 104 patients tested for T-cell responses, 57% (59/104) demonstrated a ≥ 2-fold increase in PSA-specific T cells 4 weeks after vaccine (median 5-fold increase) compared with pre-vaccine, and 68% (19/28) of patients tested mounted post-vaccine immune responses to tumor-associated antigens not present in the vaccine (antigen spreading). The PSA-specific immune responses observed 28 days after vaccine (i.e., likely memory cells) are quantitatively similar to the levels of circulating T cells specific for influenza seen in the same patients. Measurements of systemic immune response to PSA may underestimate the true therapeutic immune response (as this does not account for cells that have trafficked to the tumor) and does not include antigen spreading. Furthermore, although the entire PSA gene is the vaccine, only one epitope of PSA is evaluated in the T-cell responses. Because this therapeutic vaccine is directed at generating a cellular/Th1 immune response (T-cell costimulatory molecules and use of a viral vector), it is not surprising that less than 0.6% of patients (2/349) tested have evidence of PSA antibody induction following vaccine. This suggests that post-vaccine PSA kinetics were not affected by PSA antibodies. An ongoing phase III study will evaluate the systemic immune responses and correlation with clinical outcomes.
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Affiliation(s)
- James L Gulley
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, NIH, 10 Center Drive, 13N208, MSC-1750, Bethesda, MD 20892, USA.
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35
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Shaffer BC, Modric M, Stetler-Stevenson M, Arthur DC, Steinberg SM, Liewehr DJ, Fowler DH, Gale RP, Bishop MR, Pavletic SZ. Rapid complete donor lymphoid chimerism and graft-versus-leukemia effect are important in early control of chronic lymphocytic leukemia. Exp Hematol 2013; 41:772-8. [PMID: 23689118 DOI: 10.1016/j.exphem.2013.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/12/2013] [Accepted: 04/18/2013] [Indexed: 01/29/2023]
Abstract
Eradication of minimal residual disease (MRD) after allotransplantation in persons with chronic lymphocytic leukemia (CLL) is associated with lower rates of relapse. Rapid engraftment of donor lymphocyte elements can contribute to MRD control, but it remains unclear whether this strategy will benefit patients. In this study, we report the incidence of MRD eradication and graft-versus-host disease (GvHD) in persons with rapid versus later donor T lymphocyte engraftment after lymphodepleting chemotherapy and reduced intensity conditioning (RIC) allotransplantation. Twenty-seven subjects received lymphodepleting chemotherapy to facilitate donor engraftment followed by fludarabine and cyclophosphamide RIC and a blood cell allograft. MRD was monitored by multicolor flow cytometry after transplantation. Complete donor T lymphoid chimerism (TLC) and myeloid chimerism (MC) were achieved in 25 subjects at a median of 28 days (range, 14-60 days) and 21 days (range, 14-180 days), respectively. Achieving complete donor TLC by day 14 versus day 28 or later correlated with occurrence of grade 2 or higher acute GvHD (90% [95% confidence interval {CI}, 78-100%] versus 35% [95% CI, 16-54%]; p = 0.014) and better control of MRD in the bone marrow at day 100, median 0% (range, 0-0.1%) versus 8.5% (range, 0-92%; p = 0.016). Among 11 persons with early donor TLC, none had progressive disease, and seven died of treatment -related mortality (TRM). In persons with later development of TLC, 8 of 16 had progressive disease and 2 died of TRM. Time to donor myeloid chimerism had no effect on outcomes. Rapid establishment of donor TLC resulted in more complete eradication of early MRD, but greater incidence of acute GvHD and TRM in persons with CLL undergoing RIC allotransplantation.
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Affiliation(s)
- Brian C Shaffer
- Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Huang J, Jochems C, Anderson AM, Talaie T, Jales A, Madan RA, Hodge JW, Tsang KY, Liewehr DJ, Steinberg SM, Gulley JL, Schlom J. Soluble CD27-pool in humans may contribute to T cell activation and tumor immunity. J Immunol 2013; 190:6250-8. [PMID: 23677477 DOI: 10.4049/jimmunol.1300022] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The interaction between CD27 and its ligand, CD70, has been implicated in regulating cellular immune responses to cancer. In this article, we report on the role of soluble CD27 (sCD27) in T cell activation and its elevation in the serum of cancer patients after immunotherapy. In vitro, sCD27 is preferentially derived from activated CD4(+) T cells. Adding sCD27 to stimulated PBMCs increases T cell activation and proliferation, and is associated with the immunologic synapse-related proteins myosin IIA, high mobility group box 1, and the TCR Vβ-chain. The pool of serum sCD27 is shown to be greater in healthy donors than in cancer patients. However, metastatic cancer patients treated with immunotherapy showed a significant increase in the serum sCD27-pool posttherapy (p < 0.0005); there was also an increased trend toward an association between enhanced sCD27-pool posttherapy and overall survival (p = 0.022). The identification of sCD27 as an immune modulator associated with enhanced human T cell activation in vitro and in vivo provides a rationale for developing new immunotherapeutic strategies aimed at enhancing sCD27 for treating cancer and potentially other diseases.
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Affiliation(s)
- Jianping Huang
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Gril BM, Palmieri D, Qian Y, Liewehr DJ, Steinberg SM, Anwar T, Andreu Z, Masana D, Steeg PS, Vidal-Vanaclocha F. Abstract 1442: PDGFRβ activation defines a subset of astrocytes in the neuroinflammatory microenvironment of breast cancer brain metastasis, inhibitable by pazopanib. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-1442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Brain metastases occur in approximately 35% of metastatic breast cancer patients whose tumors overexpress HER2. Brain colonization of cancer cells occurs in a unique environment, containing microglia, oligodendrocytes, astrocytes and neurons. While a neuroinflammatory response has been documented in brain metastasis, its contribution to cancer progression and therapy remains poorly understood. Using a model system to study experimental brain metastasis of breast cancer, we intensively characterized the brain metastatic microenvironment of a brain tropic, HER2-transfected MDA-MB-231 human breast carcinoma subline (231-BR-HER2). The 231-BR-HER2 cell line was injected into the left cardiac ventricle of immunocompromised mice; mice were treated with vehicle, 30mg/kg or 100mg/kg pazopanib twice a day beginning on day 3 post-injection, for 4 weeks. Pazopanib, a multispecific tyrosine kinase inhibitor targeting VEGFR-1, -2, and -3, PDGFR-α and β, and c-kit, directly targeted tumor cells through the disruption of B-Raf pathway, prevents the outgrowth of 231-BR-HER2 large brain metastases by 73% (p<0.0001). Here we evaluated the effect of pazopanib on the brain micro-environment microenvironment. A novel subpopulation of metastasis-associated astrocytes expressing phosphorylated (Y751) PDGFRβ was identified surrounding brain metastases. This subpopulation of p751-PDGFRβ + astrocytes was also identified in human brain metastases from five different craniotomy specimens. Expression of p751-PDGFRβ was studied in primary cultures of astrocyte-enriched glial cells. p751-PDGFRβ expression was increased in response to soluble factors from cultured breast cancer cells, and was inhibited by pazopanib treatment. In the mouse mode, pazopanib treatment resulted in a 70% (p=0.023) decrease of the p751-PDGFRβ+ astrocyte population, at the lowest dose of 30mg/kg, twice daily. In contrast, pazopanib did not have any effect on microglia expression. Collectively, the data identify a new subpopulation of activated astrocytes in the perivascular stage of subclinical brain metastases and demonstrate that they are inhibitable by pazopanib, suggesting its potential to prevent the development of brain metastases from breast cancer patients.
Citation Format: Brunilde M. Gril, Diane Palmieri, Yong Qian, David J. Liewehr, Seth M. Steinberg, Talha Anwar, Zoraida Andreu, Daniel Masana, Patricia S. Steeg, Fernando Vidal-Vanaclocha. PDGFRβ activation defines a subset of astrocytes in the neuroinflammatory microenvironment of breast cancer brain metastasis, inhibitable by pazopanib. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1442. doi:10.1158/1538-7445.AM2013-1442
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Affiliation(s)
| | | | - Yong Qian
- 1National Cancer Inst., Bethesda, MD
| | | | | | - Talha Anwar
- 2University of Michigan Medical Scientist Training Program, Ann Arbor, MI
| | - Zoraida Andreu
- 3CEU-San Pablo University School of Medicine and Hospital of Madrid Scientific Foundation, Madrid, Spain
| | - Daniel Masana
- 3CEU-San Pablo University School of Medicine and Hospital of Madrid Scientific Foundation, Madrid, Spain
| | | | - Fernando Vidal-Vanaclocha
- 3CEU-San Pablo University School of Medicine and Hospital of Madrid Scientific Foundation, Madrid, Spain
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Noonan AM, Eisch RA, Liewehr DJ, Sissung TM, Venzon DJ, Flagg TP, Haigney MC, Steinberg SM, Figg WD, Piekarz RL, Bates SE. Electrocardiographic studies of romidepsin demonstrate its safety and identify a potential role for K(ATP) channel. Clin Cancer Res 2013; 19:3095-104. [PMID: 23589175 DOI: 10.1158/1078-0432.ccr-13-0109] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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] [Indexed: 11/16/2022]
Abstract
PURPOSE Romidepsin is a histone deacetylase inhibitor (HDI) approved for the treatment of both cutaneous and peripheral T-cell lymphoma (CTCL and PTCL). During development, a thorough assessment of cardiac toxicity was conducted. EXPERIMENTAL DESIGN A phase II single-agent nonrandomized study of romidepsin was conducted in patients with CTCL or PTCL who had progressed after at least 1 prior systemic therapy. RESULTS Results for the first 42 patients enrolled on the NCI 1312 phase II study of romidepsin in CTCL or PTCL showed no cardiac toxicity based on serial electrocardiograms (ECG), troponins, and MUGA scans/echocardiograms. The cardiac assessments reported herein confirm the safety of romidepsin among 131 enrolled patients, while supporting a role for electrolyte replacement. Heart rate increased an average 11 bpm following romidepsin infusion; there was no evidence of increased arrhythmia. Criteria for potassium/magnesium replacement were met before 55% of 1365 romidepsin doses; an association with hypoalbuminemia was confirmed. We propose a mechanism for ST segment flattening and depression, the most common ECG abnormalities observed: HDI-induced alteration of the activity or expression of KATP channels. In addition, examination of the variants of the active transporter of romidepsin, ABCB1, showed a trend toward smaller heart rate changes in the peri-infusion period among wild-type than variant diplotypes. CONCLUSIONS We conclude that in the context of appropriate attention to electrolyte levels, the data support the cardiac safety of romidepsin.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Adult
- Aged
- Aged, 80 and over
- Antibiotics, Antineoplastic/adverse effects
- Depsipeptides/adverse effects
- Electrocardiography/drug effects
- Female
- Genotype
- Heart Rate/drug effects
- Histone Deacetylase Inhibitors/adverse effects
- Humans
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/metabolism
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/metabolism
- Magnesium/blood
- Male
- Middle Aged
- Potassium/blood
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Affiliation(s)
- Anne M Noonan
- Medical Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland 20892, USA
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39
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Gril B, Palmieri D, Qian Y, Anwar T, Liewehr DJ, Steinberg SM, Andreu Z, Masana D, Fernández P, Steeg PS, Vidal-Vanaclocha F. Pazopanib inhibits the activation of PDGFRβ-expressing astrocytes in the brain metastatic microenvironment of breast cancer cells. Am J Pathol 2013; 182:2368-79. [PMID: 23583652 DOI: 10.1016/j.ajpath.2013.02.043] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 01/03/2013] [Accepted: 02/25/2013] [Indexed: 12/31/2022]
Abstract
Brain metastases occur in more than one-third of metastatic breast cancer patients whose tumors overexpress HER2 or are triple negative. Brain colonization of cancer cells occurs in a unique environment, containing microglia, oligodendrocytes, astrocytes, and neurons. Although a neuroinflammatory response has been documented in brain metastasis, its contribution to cancer progression and therapy remains poorly understood. Using an experimental brain metastasis model, we characterized the brain metastatic microenvironment of brain tropic, HER2-transfected MDA-MB-231 human breast carcinoma cells (231-BR-HER2). A previously unidentified subpopulation of metastasis-associated astrocytes expressing phosphorylated platelet-derived growth factor receptor β (at tyrosine 751; p751-PDGFRβ) was identified around perivascular brain micrometastases. p751-PDGFRβ(+) astrocytes were also identified in human brain metastases from eight craniotomy specimens and in primary cultures of astrocyte-enriched glial cells. Previously, we reported that pazopanib, a multispecific tyrosine kinase inhibitor, prevented the outgrowth of 231-BR-HER2 large brain metastases by 73%. Here, we evaluated the effect of pazopanib on the brain neuroinflammatory microenvironment. Pazopanib treatment resulted in 70% (P = 0.023) decrease of the p751-PDGFRβ(+) astrocyte population, at the lowest dose of 30 mg/kg, twice daily. Collectively, the data identify a subpopulation of activated astrocytes in the subclinical perivascular stage of brain metastases and show that they are inhibitable by pazopanib, suggesting its potential to prevent the development of brain micrometastases in breast cancer patients.
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Affiliation(s)
- Brunilde Gril
- Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland 20892, USA.
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40
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Rahma OE, Liewehr DJ, Steinberg SM, Duffy AG, Greten TF. Effect of the addition of platinum to gemcitabine on outcome in patients with advanced pancreatic cancer who progress on gemcitabine: A comprehensive analysis of published trials. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.4_suppl.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
275 Background: Pancreatic cancer is one of the deadliest cancers with an estimated 5 years survival rate of 5%. Until recently gemcitabine had been considered the first line treatment for locally advanced or metastatic disease. Although many chemotherapy regimens have been used there is no standard of care for second line therapy. The aim of this analysis was to identify superior regimen in the second line setting. Methods: We conducted a general search on PubMed for “second line therapy in advanced pancreatic cancer”. We limited our search to trials published in English from 2000 through 2012. Studies presented as abstracts in major meetings were also included. Trials that used targeted therapy other than erlotinib were excluded. We compared in an exploratory fashion the RR, PFS and OS of BSC and each of the following regimens to the rest of the treatments: 5FU+platinum, gemcitabine+platinum, taxol, erlotinib. In addition, we compared the combinations of platinum with either 5FU or gemcitabine. Finally, we explored the trend of these treatments outcomes over time. Results: Forty-four trialswere identified, of which 34 trials (T) met the inclusion criteria treating 1503 patients (N). There was a trend toward an improved overall survival with treatments (T: 33; N: 1269) compared to BSC (T: 2; N: 234) only (P= 0.013). The combination of gemcitabine and platinum (T: 5; N: 154) was the only regimen that showed a trend toward superior outcomes compared to the other regimens (T: 28; N: 1115) in terms of RR and PFS (P= 0.006 and 0.059, respectively). However, there was no difference in overall survival (P= 0.10). When compared to 5FU+platinum (T: 12; N: 450) the regimen of gemcitabine+platinum (T: 5; N: 154) showed only a trend toward significance in terms of improved RR (P= 0.030) with no difference in PFS or OS (P= 0.60 and 0.22, respectively). Overall, there was a trend toward a worse RR and PFS with no change in OS over the past 13 years. Conclusions: The combination of gemcitabine and platinum may provide a valid second line option in patients with locally advanced or metastatic pancreatic cancer who progress on gemcitabine.
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Affiliation(s)
- Osama E. Rahma
- National Institutes of Health/National Cancer Institute, Bethesda, MD
| | | | - Seth M. Steinberg
- Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, MD
| | - Austin G. Duffy
- National Cancer Institute/National Institutes of Health, Bethesda, MD
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Fitzgerald DP, Emerson DL, Qian Y, Anwar T, Liewehr DJ, Steinberg SM, Silberman S, Palmieri D, Steeg PS. TPI-287, a new taxane family member, reduces the brain metastatic colonization of breast cancer cells. Mol Cancer Ther 2012; 11:1959-67. [PMID: 22622283 PMCID: PMC7489285 DOI: 10.1158/1535-7163.mct-12-0061] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [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] [Indexed: 11/16/2022]
Abstract
Brain metastases of breast and other cancers remain resistant to chemotherapeutic regimens that are effective systemically, in part due to the blood-brain barrier. We report that TPI-287, a new microtubule-stabilizing agent, displays in vitro cytotoxic activity similar to taxanes and epothilones. Unlike the taxanes, TPI-287 is permeable through the blood-brain barrier. Brain-to-plasma ratios of TPI-287 after a single injection typically exceeded one and were as high as 63.8 in the rat and 14.1 in the mouse. A brain-tropic derivative of the MDA-MB-231 triple-negative breast cancer cell line, 231-BR, was used to test whether TPI-287 may be efficacious at preventing or treating brain metastases. TPI-287 had growth inhibitory effects comparable with paclitaxel when 231-BR tumor cells were injected into the mammary fat pad. Brain metastatic colonization was determined by intracardiac injection of 231-BR cells, with treatment beginning on day 3 to 4 postinjection, culminating in a histologic count of brain metastases in brains necropsied days 25 to 28 postinjection. In this assay, paclitaxel, ixabepilone, and nab paclitaxel did not have significant inhibitory activity. TPI-287 was ineffective in the same assay using a 6 mg/kg every week schedule; however an 18 mg/kg dose delivered on days 3, 7, and 11 significantly reduced the outgrowth of brain metastases (55% reduction, P = 0.028) and reduced proliferation in brain metastases (16% reduction, P = 0.008). When TPI-287 treatment was delayed until days 18, 22, and 26 postinjection, efficacy was reduced (17% reduction, not significant). These data suggest that TPI-287 may have efficacy when administered early in the course of the disease.
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Affiliation(s)
- Daniel P. Fitzgerald
- Women's Cancers Section, Laboratory of Molecular Pharmacology, National Cancer Institute, Bethesda, Maryland
| | | | - Yongzhen Qian
- Laboratory Animal Sciences Program, Science Applications International Corporation, National Cancer Institute, Frederick, Maryland
| | - Talha Anwar
- Women's Cancers Section, Laboratory of Molecular Pharmacology, National Cancer Institute, Bethesda, Maryland
| | - David J. Liewehr
- Biostatistics and Data Management Section, National Cancer Institute, Bethesda, Maryland
| | - Seth M. Steinberg
- Biostatistics and Data Management Section, National Cancer Institute, Bethesda, Maryland
| | | | - Diane Palmieri
- Women's Cancers Section, Laboratory of Molecular Pharmacology, National Cancer Institute, Bethesda, Maryland
| | - Patricia S. Steeg
- Women's Cancers Section, Laboratory of Molecular Pharmacology, National Cancer Institute, Bethesda, Maryland
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42
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Marshall JCA, Collins JW, Nakayama J, Horak CE, Liewehr DJ, Steinberg SM, Albaugh M, Vidal-Vanaclocha F, Palmieri D, Barbier M, Murone M, Steeg PS. Effect of inhibition of the lysophosphatidic acid receptor 1 on metastasis and metastatic dormancy in breast cancer. J Natl Cancer Inst 2012; 104:1306-19. [PMID: 22911670 DOI: 10.1093/jnci/djs319] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Previous studies identified the human nonmetastatic gene 23 (NME1, hereafter Nm23-H1) as the first metastasis suppressor gene. An inverse relationship between Nm23-H1 and expression of lysophosphatidic acid receptor 1 gene (LPAR1, also known as EDG2 or hereafter LPA1) has also been reported. However, the effects of LPA1 inhibition on primary tumor size, metastasis, and metastatic dormancy have not been investigated. METHODS The LPA1 inhibitor Debio-0719 or LPA1 short hairpinned RNA (shRNA) was used. Primary tumor size and metastasis were investigated using the 4T1 spontaneous metastasis mouse model and the MDA-MB-231T experimental metastasis mouse model (n = 13 mice per group). Proliferation and p38 intracellular signaling in tumors and cell lines were determined by immunohistochemistry and western blot to investigate the effects of LPA1 inhibition on metastatic dormancy. An analysis of variance-based two-tailed t test was used to determine a statistically significant difference between treatment groups. RESULTS In the 4T1 spontaneous metastasis mouse model, Debio-0719 inhibited the metastasis of 4T1 cells to the liver (mean = 25.2 liver metastases per histologic section for vehicle-treated mice vs 6.8 for Debio-0719-treated mice, 73.0% reduction, P < .001) and lungs (mean = 6.37 lesions per histologic section for vehicle-treated mice vs 0.73 for Debio-0719-treated mice, 88.5% reduction, P < .001), with no effect on primary tumor size. Similar results were observed using the MDA-MB-231T experimental pulmonary metastasis mouse model. LPA1 shRNA also inhibited metastasis but did not affect primary tumor size. In 4T1 metastases, but not primary tumors, expression of the proliferative markers Ki67 and pErk was reduced by Debio-0719, and phosphorylation of the p38 stress kinase was increased, indicative of metastatic dormancy. CONCLUSION The data identify Debio-0719 as a drug candidate with metastasis suppressor activity, inducing dormancy at secondary tumor sites.
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Affiliation(s)
- Jean-Claude A Marshall
- The Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, National Institutes of Health, Bethesda, MD 20892, USA
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Fitzgerald DP, Subramanian P, Deshpande M, Graves C, Gordon I, Qian Y, Snitkovsky Y, Liewehr DJ, Steinberg SM, Paltán-Ortiz JD, Herman MM, Camphausen K, Palmieri D, Becerra SP, Steeg PS. Opposing effects of pigment epithelium-derived factor on breast cancer cell versus neuronal survival: implication for brain metastasis and metastasis-induced brain damage. Cancer Res 2012; 72:144-53. [PMID: 22215693 DOI: 10.1158/0008-5472.can-11-1904] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brain metastases are a significant cause of morbidity and mortality for patients with cancer, yet preventative and therapeutic options remain an unmet need. The cytokine pigment epithelium-derived factor (PEDF) is downregulated in resected human brain metastases of breast cancer compared with primary breast tumors, suggesting that restoring its expression might limit metastatic spread. Here, we show that outgrowth of large experimental brain metastases from human 231-BR or murine 4T1-BR breast cancer cells was suppressed by PEDF expression, as supported by in vitro analyses as well as direct intracranial implantation. Notably, the suppressive effects of PEDF were not only rapid but independent of the effects of this factor on angiogenesis. Paralleling its cytotoxic effects on breast cancer cells, PEDF also exerted a prosurvival effect on neurons that shielded the brain from tumor-induced damage, as indicated by a relative 3.5-fold reduction in the number of dying neurons adjacent to tumors expressing PEDF. Our findings establish PEDF as both a metastatic suppressor and a neuroprotectant in the brain, highlighting its role as a double agent in limiting brain metastasis and its local consequences.
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Affiliation(s)
- Daniel P Fitzgerald
- Women's Cancer's Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, National Institute of Mental Health, Bethesda, Maryland 20892, USA
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44
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Weisbrod AB, Liewehr DJ, Steinberg SM, Patterson EE, Libutti SK, Linehan WM, Nilubol N, Kebebew E. Association of type O blood with pancreatic neuroendocrine tumors in Von Hippel-Lindau syndrome. Ann Surg Oncol 2012; 19:2054-9. [PMID: 22350603 DOI: 10.1245/s10434-012-2276-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND ABO blood type antigens are expressed not only on human red blood cells, but also throughout the gastrointestinal tract and in normal pancreatic tissue. Previous studies have identified an association between ABO blood type and various malignancies. We analyzed the association of ABO blood type with pancreatic neuroendocrine tumors (PNETs) in a high-risk cohort of patients with Von Hippel-Lindau (VHL) syndrome. METHODS A retrospective review was performed of 798 patients with VHL syndrome. Blood type was confirmed for 181 patients. Fisher's exact test and Mehta's modification to Fisher's exact test were used to test for an association between ABO blood type and manifestations of VHL syndrome. RESULTS We found a strong trend for association between O blood type and pancreatic disease manifestation in patients with VHL syndrome (P = 0.047). More importantly, there was a significant association of O blood type with solid pancreatic lesions consistent with PNETs (P = 0.0084). Patients with solid pancreatic lesions who met criteria for surgical resection at the National Institutes of Health also had a higher rate of O blood type than those who did not require surgery (P = 0.051). CONCLUSIONS Our findings suggest an association between O blood type and pancreatic manifestation of disease in patients with VHL syndrome, especially for PNETs. Screening and surveillance approaches for pancreatic lesions in patients with VHL syndrome should also consider patient blood type. The possibility of A, B, H misexpression in PNETs should also be explored to determine whether the serologic association with disease translates into a relationship with tissue pathology.
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Affiliation(s)
- Allison B Weisbrod
- Endocrine Oncology Section, Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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45
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Stewart TJ, Greeneltch KM, Reid JE, Liewehr DJ, Steinberg SM, Liu K, Abrams SI. Interferon regulatory factor-8 modulates the development of tumour-induced CD11b+Gr-1+ myeloid cells. J Cell Mol Med 2011; 13:3939-50. [PMID: 20196788 PMCID: PMC3858838 DOI: 10.1111/j.1582-4934.2009.00685.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [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: 01/04/2023] Open
Abstract
Tumour-induced myeloid-derived suppressor cells (MDSC) promote immune suppression and mediate tumour progression. However, the molecular basis for the generation of MDSC, which in mice co-express the CD11b+ and Gr-1+ cell surface markers remains unclear. Because CD11b+Gr-1+ cells expand during progressive tumour growth, this suggests that tumour-induced events alter signalling pathways that affect normal myeloid cell development. Interferon regulatory factor-8 (IRF-8), a member of the IFN-γ regulatory factor family, is essential for normal myelopoiesis. We therefore examined whether IRF-8 modulated tumour-induced CD11b+Gr-1+ cell development or accumulation using both implantable (4T1) and transgenic (MMTV-PyMT) mouse models of mammary tumour growth. In the 4T1 model, both splenic and bone marrow-derived CD11b+Gr-1+ cells of tumour-bearing mice displayed a marked reduction in IRF-8 expression compared to control populations. A causal link between IRF-8 expression and the emergence of tumour-induced CD11b+Gr-1+ cells was explored in vivo using a double transgenic (dTg) mouse model designed to express transgenes for both IRF-8 and mammary carcinoma development. Despite the fact that tumour growth was unaffected, splenomegaly, as well as the frequencies and absolute numbers of CD11b+Gr-1+ cells were significantly lower in dTg mice when compared with single transgenic tumour-bearing mice. Overall, these data reveal that IRF-8 plays an important role in tumour-induced development and/or accumulation of CD11b+Gr-1+ cells, and establishes a molecular basis for the potential manipulation of these myeloid populations for cancer therapy.
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Affiliation(s)
- Trina J Stewart
- Laboratory of Tumor Immunology and Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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46
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Qian Y, Hua E, Bisht K, Woditschka S, Skordos KW, Liewehr DJ, Steinberg SM, Brogi E, Akram MM, Killian JK, Edelman DC, Pineda M, Scurci S, Degenhardt YY, Laquerre S, Lampkin TA, Meltzer PS, Camphausen K, Steeg PS, Palmieri D. Inhibition of Polo-like kinase 1 prevents the growth of metastatic breast cancer cells in the brain. Clin Exp Metastasis 2011; 28:899-908. [PMID: 21953073 PMCID: PMC7416514 DOI: 10.1007/s10585-011-9421-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [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: 04/15/2011] [Accepted: 08/25/2011] [Indexed: 01/10/2023]
Abstract
Few therapeutic strategies exist for the treatment of metastatic tumor cells in the brain because the blood-brain barrier (BBB) limits drug access. Thus the identification of molecular targets and accompanying BBB permeable drugs will significantly benefit brain metastasis patients. Polo-like kinase 1 (Plk1) is an attractive molecular target because it is only expressed in dividing cells and its expression is upregulated in many tumors. Analysis of a publicly available database of human breast cancer metastases revealed Plk1 mRNA expression was significantly increased in brain metastases compared to systemic metastases (P = 0.0018). The selective Plk1 inhibitor, GSK461364A, showed substantial uptake in normal rodent brain. Using a breast cancer brain metastatic xenograft model (231-BR), we tested the efficacy of GSK461364A to prevent brain metastatic colonization. When treatment was started 3 days post-injection, GSK461364A at 50 mg/kg inhibited the development of large brain metastases 62% (P = 0.0001) and prolonged survival by 17%. GSK461364A sensitized tumor cells to radiation induced cell death in vitro. Previously, it was reported that mutations in p53 might render tumor cells more sensitive to Plk1 inhibition; however, p53 mutations are uncommon in breast cancer. In a cohort of 41 primary breast tumors and matched brain metastases, p53 immunostaining was increased in 61% of metastases; 44% of which were associated with primary tumors with low p53. The data suggest that p53 overexpression occurs frequently in brain metastases and may facilitate sensitivity to Plk1 inhibition. These data indicate Plk1 may be a new druggable target for the prevention of breast cancer brain metastases.
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Affiliation(s)
- Yongzhen Qian
- Laboratory Animal Sciences Program, SAIC-Frederick, NCI, NIH, Frederick, MD, USA
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47
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Massimelli MJ, Kang JG, Majerciak V, Le SY, Liewehr DJ, Steinberg SM, Zheng ZM. Stability of a long noncoding viral RNA depends on a 9-nt core element at the RNA 5' end to interact with viral ORF57 and cellular PABPC1. Int J Biol Sci 2011; 7:1145-60. [PMID: 22043172 PMCID: PMC3204405 DOI: 10.7150/ijbs.7.1145] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 10/15/2011] [Indexed: 12/15/2022] Open
Abstract
Kaposi sarcoma-associated herpesvirus (KSHV) ORF57, also known as Mta (mRNA transcript accumulation), enhances viral intron-less transcript accumulation and promotes splicing of intron-containing viral RNA transcripts. In this study, we identified KSHV PAN, a long non-coding polyadenylated nuclear RNA as a main target of ORF57 by a genome-wide CLIP (cross-linking and immunoprecipitation) approach. KSHV genome lacking ORF57 expresses only a minimal amount of PAN. In cotransfection experiments, ORF57 alone increased PAN expression by 20-30-fold when compared to vector control. This accumulation function of ORF57 was dependent on a structured RNA element in the 5' PAN, named MRE (Mta responsive element), but not much so on an ENE (expression and nuclear retention element) in the 3' PAN previously reported by other studies. We showed that the major function of the 5' PAN MRE is increasing the RNA half-life of PAN in the presence of ORF57. Further mutational analyses revealed a core motif consisting of 9 nucleotides in the MRE-II , which is responsible for ORF57 interaction and function. The 9-nt core in the MRE-II also binds cellular PABPC1, but not the E1B-AP5 which binds another region of the MRE-II. In addition, we found that PAN RNA is partially exportable in the presence of ORF57. Together, our data provide compelling evidence as to how ORF57 functions to accumulate a non-coding viral RNA in the course of virus lytic infection.
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Affiliation(s)
- Maria J Massimelli
- Tumor Virus RNA Biology Laboratory, HIV and AIDS Malignancy Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1868, USA
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48
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Gril B, Palmieri D, Qian Y, Anwar T, Ileva L, Bernardo M, Choyke P, Liewehr DJ, Steinberg SM, Steeg PS. The B-Raf status of tumor cells may be a significant determinant of both antitumor and anti-angiogenic effects of pazopanib in xenograft tumor models. PLoS One 2011; 6:e25625. [PMID: 21998674 PMCID: PMC3187787 DOI: 10.1371/journal.pone.0025625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 09/08/2011] [Indexed: 12/12/2022] Open
Abstract
Pazopanib is an FDA approved Vascular Endothelial Growth Factor Receptor inhibitor. We previously reported that it also inhibits tumor cell B-Raf activity in an experimental brain metastatic setting. Here, we determine the effects of different B-Raf genotypes on pazopanib efficacy, in terms of primary tumor growth and anti-angiogenesis. A panel of seven human breast cancer and melanoma cell lines harboring different mutations in the Ras-Raf pathway was implanted orthotopically in mice, and tumor growth, ERK1/2, MEK1/2 and AKT activation, and blood vessel density and permeability were analyzed. Pazopanib was significantly inhibitory to xenografts expressing either exon 11 mutations of B-Raf, or HER2 activated wild type B-Raf; no significant inhibition of a xenograft expressing the common V600E B-Raf mutation was observed. Decreased pMEK staining in the responsive tumors confirmed that B-Raf was targeted by pazopanib. Interestingly, pazopanib inhibition of tumor cell B-Raf also correlated with its anti-angiogenic activity, as quantified by vessel density and area. In conclusion, using pazopanib, tumor B-Raf status was identified as a significant determinant of both tumor growth and angiogenesis.
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Affiliation(s)
- Brunilde Gril
- Women's Cancers Section, Laboratory of Molecular Pharmacology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America.
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49
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Wang L, Abbasi F, Jasper GA, Kreitman RJ, Liewehr DJ, Marti GE, Stetler-Stevenson M. Variables in the quantification of CD4 in normals and hairy cell leukemia patients. Cytometry B Clin Cytom 2011; 80:51-6. [PMID: 20687201 DOI: 10.1002/cyto.b.20541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Quantitative flow cytometry (QFCM) is being applied in the clinical flow cytometry laboratory. Quantitative normal T-cell CD4 expression represents a biologic standard and quality control agent. However, low levels of CD4 expression were detected in normal T-cells in Hairy Cell Leukemia (HCL) samples. METHODS The QuantiBrite System® was used to determine the level of CD4 expression (mean antibody bound per cell, ABC) in fresh and shipped HCL blood and fresh normal donor blood (NDB). The effects of shipping, lysing reagent, cell preparation method, and antibody lot were evaluated. RESULTS Shipped HCL specimens (n = 69) had a significantly lower mean CD4 ABC of 38,788 (CV = 9.1%) compared to fresh specimens (n = 105) CD4 value of 40,330 (CV = 8.4%) (P < 0.05). In NDB, significant differences were seen for fresh versus shipped specimens using the stain/lyse method but not for lyse/stain method. Consistent differences in CD4 ABC based upon antibody lot were observed in fresh HCL and NDB samples. Stain/lyse and lyse/stain methods using NH(4) Cl lyse were compared in NDB using identical samples and antibodies. The NDB CD4 ABC values obtained with the lyse (NH(4) Cl)/stain method (45,562, 3.7% CV) were lower than those obtained with the stain/lyse (NH(4) Cl) method (49,955, 3.3% CV) with P < 0.001. CONCLUSIONS CD4 expression in HCL patient samples is not inherently different from that observed in NDB and therefore may serve as a biological control in clinical QFCM. Technical variables impact significantly on QFCM of CD4.
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Affiliation(s)
- Lili Wang
- Chemical Science and Technology Laboratory, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-8312, USA
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50
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Gril B, Palmieri D, Qian Y, Smart D, Ileva L, Liewehr DJ, Steinberg SM, Steeg PS. Pazopanib reveals a role for tumor cell B-Raf in the prevention of HER2+ breast cancer brain metastasis. Clin Cancer Res 2010; 17:142-53. [PMID: 21081656 DOI: 10.1158/1078-0432.ccr-10-1603] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Brain metastases of breast cancer contribute significantly to patient morbidity and mortality. We have tested pazopanib, a recently approved antiangiogenic drug that targets VEGFR1, VEGFR2, VEGFR3, PDGFRβ, PDGFRα, and c-kit, for prevention of experimental brain metastases and mechanism of action. EXPERIMENTAL DESIGN In vitro assays included B-Raf enzymatic assays, Western blots, and angiogenesis assays. For in vivo assays, HER2 transfectants of the brain seeking sublines of MDA-MB-231 cells (231-BR-HER2) and MCF7 cells (MCF7-HER2-BR3, derived herein) were injected into the left cardiac ventricle of mice and treated with vehicle or pazopanib beginning on day 3 postinjection. Brain metastases were counted histologically, imaged, and immunostained. RESULTS Treatment with 100 mg/kg of pazopanib resulted in a 73% decline in large 231-BR-HER2 metastases (P < 0.0001) and a 39% decline in micrometastases (P = 0.004). In vitro, pazopanib was directly antiproliferative to 231-BR-HER2 breast cancer cells and inhibited MEK and ERK activation in vitro despite B-Raf and Ras mutations. Enzymatic assays demonstrated that pazopanib directly inhibited the wild type and exon 11 oncogenic mutant, but not the V600E mutant forms of B-Raf. Activation of the B-Raf targets pERK1/2 and pMEK1/2 was decreased in pazopanib-treated brain metastases whereas blood vessel density was unaltered. In the MCF7-HER2-BR3 experimental brain metastasis model, pazopanib reduced overall brain metastasis volume upon magnetic resonance imaging (MRI) by 55% (P = 0.067), without affecting brain metastasis vascular density. CONCLUSIONS The data identify a new activity for pazopanib directly on tumor cells as a pan-Raf inhibitor and suggest its potential for prevention of brain metastatic colonization of HER2(+) breast cancer.
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Affiliation(s)
- Brunilde Gril
- Women's Cancers Section, Laboratory of Molecular Pharmacology, Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland 20892, USA.
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