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Frigault MM, Mithal A, Wong H, Stelte-Ludwig B, Mandava V, Huang X, Birkett J, Johnson AJ, Izumi R, Hamdy A. Enitociclib, a Selective CDK9 Inhibitor, Induces Complete Regression of MYC+ Lymphoma by Downregulation of RNA Polymerase II Mediated Transcription. Cancer Res Commun 2023; 3:2268-2279. [PMID: 37882668 PMCID: PMC10634346 DOI: 10.1158/2767-9764.crc-23-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/24/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023]
Abstract
Double-hit diffuse large B-cell lymphoma (DH-DLBCL) is an aggressive, and often refractory, type of B-cell non-Hodgkin lymphoma (NHL) characterized by rearrangements in MYC and BCL2. Cyclin-dependent kinase 9 (CDK9) regulates transcriptional elongation and activation of transcription factors, including MYC, making it a potential targeted approach for the treatment of MYC+ lymphomas. Enitociclib is a well-tolerated and clinically active CDK9 inhibitor leading to complete metabolic remissions in 2 of 7 patients with DH-DLBCL treated with once weekly 30 mg intravenous administration. Herein, we investigate the pharmacodynamic effect of CDK9 inhibition in preclinical models and in blood samples from patients [DH-DLBCL (n = 10) and MYC+ NHL (n = 5)] treated with 30 mg i.v. once weekly enitociclib. Enitociclib shows significant regulation of RNA polymerase II Ser2 phosphorylation in a MYC-amplified SU-DHL-4 cell line and depletion of MYC and antiapoptosis protein MCL1 in SU-DHL-4 and MYC-overexpressing SU-DHL-10 cell lines in vitro. Tumor growth inhibition reaching 0.5% of control treated SU-DHL-10 xenografts is achieved in vivo and MYC and MCL1 depletion as well as evidence of apoptosis activation after enitociclib treatment is demonstrated. An unbiased analysis of the genes affected by CDK9 inhibition in both cell lines demonstrates that RNA polymerase II and transcription pathways are primarily affected and novel enitociclib targets such as PHF23 and TP53RK are discovered. These findings are recapitulated in blood samples from enitociclib-treated patients; while MYC downregulation is most robust with enitociclib treatment, other CDK9-regulated targets may be MYC independent delivering a transcriptional downregulation via RNA polymerase II. SIGNIFICANCE MYC+ lymphomas are refractory to standard of care and novel treatments that downregulate MYC are needed. The utility of enitociclib, a selective CDK9 inhibitor in this patient population, is demonstrated in preclinical models and patients. Enitociclib inhibits RNA polymerase II function conferring a transcriptional shift and depletion of MYC and MCL1. Enitociclib intermittent dosing downregulates transcription factors including MYC, providing a therapeutic window for durable responses in patients with MYC+ lymphoma.
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Affiliation(s)
| | | | | | | | | | - Xin Huang
- Vincerx Pharma, Inc., Palo Alto, California
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Plummer R, Verheul HM, De Vos FYFL, Leunen K, Molife LR, Rolfo C, Grundtvig-Sørensen P, De Grève J, Rottey S, Jerusalem G, Italiano A, Spicer J, Dirix L, Goessl C, Birkett J, Spencer S, Learoyd M, Bailey C, Dean E. Pharmacokinetic Effects and Safety of Olaparib Administered with Endocrine Therapy: A Phase I Study in Patients with Advanced Solid Tumours. Adv Ther 2018; 35:1945-1964. [PMID: 30324586 DOI: 10.1007/s12325-018-0804-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 08/13/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The PARP inhibitor olaparib is efficacious as monotherapy and has potential application in combination with endocrine therapy for the treatment of breast cancer. This phase I study assessed the safety and pharmacokinetic (PK) profiles of olaparib combined with tamoxifen, anastrozole or letrozole in patients with advanced solid tumours. METHODS During part A, PK profiles were assessed in three consecutive treatment periods: (1) olaparib (tablet) 300 mg bid, days 1-5 followed by a 4-day washout; (2) cohort 1, tamoxifen 60 mg loading dose qd days 10-13, 20 mg qd days 14-26; cohort 2, anastrozole 1 mg qd days 10-19; cohort 3, letrozole 2.5 mg qd days 10-38; (3) as for period 2, with concomitant olaparib 300 mg bid for 5 days. Patients could then enter part B and receive olaparib monotherapy (300 mg bid continuously). Safety was assessed in parts A and B until 12 months after the last patient entered part B. RESULTS Seventy-nine patients (20.3% with breast cancer) received treatment in part A; 72 completed part A and 69 entered part B. Anastrozole and letrozole had no effect on the PK profile of olaparib and vice versa. Co-administration with tamoxifen produced a modest decrease in exposure to olaparib [geometric least-squares mean (GLSmean) Cmax,ss and AUC0-τ decreased by 20% (90% CI 0.71-0.90) and 27% (0.63-0.84), respectively]. Exposure to tamoxifen was slightly increased when combined with olaparib [GLSmean Cmax,ss and AUC0-τ increased by 13% (1.06-1.22) and 16% (1.11-1.21), respectively]; however, the 90% CI fell within the 0.7-1.43 boundary and there were no changes in exposure to tamoxifen metabolites. The safety profile for olaparib alone and in combination with the antihormonal therapies was acceptable. CONCLUSIONS The combination of olaparib and either anastrozole, letrozole or tamoxifen was generally well tolerated, with no clinically relevant PK interactions identified. FUNDING AstraZeneca. CLINICAL TRIAL REGISTRATION NCT02093351.
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Affiliation(s)
- Ruth Plummer
- Northern Centre for Cancer Care, Newcastle University, Newcastle upon Tyne, UK.
| | - Henk M Verheul
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Filip Y F L De Vos
- University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | | | - L Rhoda Molife
- The Royal Marsden and Institute of Cancer Research, Sutton, UK
| | | | | | - Jacques De Grève
- Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Guy Jerusalem
- CHU Sart-Tilman Liege, Liege University, Liege, Belgium
| | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre Bordeaux, Bordeaux, France
| | - James Spicer
- King's College London, Guy's Hospital, London, UK
| | - Luc Dirix
- Campus Sint-Augustinus, GZA Ziekenhuizen, Antwerp, Belgium
| | | | | | | | | | | | - Emma Dean
- The Christie NHS Foundation Trust, University of Manchester, Manchester, UK
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Plummer R, Verheul HM, Langenberg MHG, Leunen K, Molife LR, Rolfo CD, Soerensen PG, De Greve J, Rottey S, Jerusalem GHM, Italiano A, Spicer JF, Dirix LY, Goessl CD, Birkett J, Spencer S, Learoyd M, Dean EJ. Pharmacokinetic (PK) effects and safety of olaparib in combination with tamoxifen, anastrozole, or letrozole: Phase I study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.2562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- Ruth Plummer
- Northern Centre for Cancer Care, Newcastle upon Tyne, United Kingdom
| | - Henk M.W. Verheul
- Department of Medical Oncology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Karin Leunen
- Universitair Ziekenhuizen Leuven, Leuven, Belgium
| | - L Rhoda Molife
- The Royal Marsden and Institute of Cancer Research, Sutton, United Kingdom
| | | | | | | | - Sylvie Rottey
- Ghent University Hospital, Heymans Institute of Pharmacology, Ghent, Belgium
| | | | - Antoine Italiano
- Institut Bergonié, Department of Medical Oncology, Bordeaux, France
| | - James F. Spicer
- King's College London at Guy's Hospital, London, United Kingdom
| | - Luc Yves Dirix
- GZA Ziekenhuizen campus Sint-Augustinus, Antwerp, Belgium
| | | | | | | | | | - Emma Jane Dean
- University of Manchester, The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
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Dyer M, Hutchinson C, Rule S, Shah N, Salles GA, Karlin L, Morschhauser F, Terriou L, Fegan C, Davison A, Cartron G, Saunders A, Honda H, Sharpe J, Yoshizawa T, Yasuhiro T, Kawabata K, Awata H, Birkett J. The Bruton’s tyrosine kinase (BTK) inhibitor ONO-4059: Single-agent activity in patients with relapsed and refractory non-GCB-DLBCL. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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)
- Martin Dyer
- Leicester Royal Infirmary, Leicester, United Kingdom
| | | | - Simon Rule
- Derriford Hospital, Plymouth, United Kingdom
| | - Nimish Shah
- Derriford Hospital, Plymouth, United Kingdom
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Arranz MJ, Munro J, Birkett J, Bolonna A, Mancama D, Sodhi M, Lesch KP, Meyer JF, Sham P, Collier DA, Murray RM, Kerwin RW. Pharmacogenetic prediction of clozapine response. Lancet 2000; 355:1615-6. [PMID: 10821369 DOI: 10.1016/s0140-6736(00)02221-2] [Citation(s) in RCA: 253] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We did association studies in multiple candidate genes to find the combination of polymorphisms that give the best predictive value of response to clozapine in schizophrenic patients. A combination of six polymorphisms in neurotransmitter-receptor-related genes resulted in 76.7% success in the prediction of clozapine response (p=0.0001) and a sensitivity of 95% (+/- 0.04) for satisfactory response. These results will form the basis for a simple test to enhance the usefulness of clozapine in psychiatric treatment.
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Li T, Holmes C, Sham PC, Vallada H, Birkett J, Kirov G, Lesch KP, Powell J, Lovestone S, Collier D. Allelic functional variation of serotonin transporter expression is a susceptibility factor for late onset Alzheimer's disease. Neuroreport 1997; 8:683-6. [PMID: 9106747 DOI: 10.1097/00001756-199702100-00021] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [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: 02/04/2023]
Abstract
We examined a deletion/insertion promoter polymorphism of the serotonin transporter gene, which confers an approximately 40% reduction in expression of the protein, in 196 subjects with late onset Alzheimer's disease (AD) and 271 controls. The frequency of the 484 bp low activity allele was elevated in the subjects with AD (p = 0.004), and an excess of the low activity genotype (30%) was also found in comparison with the controls (20%) (chi 2 = 7.16; p = 0.03). This association was unrelated to the age of the subjects or controls, or to epsilon 4 alleles of the ApoE gene. The odds ratio for the effect of the homozygous low activity genotype was 1.7 (95% CI 1.08-2.67), with a population attributable risk of 33% (95% CI 5-54%). These findings indicate that the low activity allele of the serotonin transporter is a risk factor for late onset AD.
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Affiliation(s)
- T Li
- Department of Psychological Medicine, Institute of Psychiatry, London, UK
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Abstract
I think I may have discovered the answer to the growing list of complaints about NI IS waiting lists under this Tory Government. Make sure you live in an area which has a Labour MP.
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Birkett J. A Case of Aneurism of the Femoral Artery, treated by long-continued Compression of the Common Iliac; with Remarks. J R Soc Med 1869; 52:317-25. [PMID: 20896342 DOI: 10.1177/095952876905200117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Birkett J. On the Mortality Arising from Abdominal Hernia: With Suggestions for its Diminution. West J Med 1868; 2:418-20. [DOI: 10.1136/bmj.2.407.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. A Contribution to the Surgical Pathology of Sero-Sanguineous Cysts in the Neck and Axilla. J R Soc Med 1868; 51:185-198.7. [PMID: 20896316 DOI: 10.1177/095952876805100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Birkett J. A Case of Aneurism of the Femoral Artery, the Sac of which burst, and its treatment; with observations. J R Soc Med 1867; 50:431-438.2. [PMID: 20896298 DOI: 10.1177/095952876705000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Birkett J. Reduction of Dislocations of the Joints by Manipulation. West J Med 1866. [DOI: 10.1136/bmj.2.305.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. The Results Attending the Removal of the First Growth of Cancer. West J Med 1866. [DOI: 10.1136/bmj.2.300.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Birkett J. Guy's Hospital. West J Med 1859; 1:323-5. [DOI: 10.1136/bmj.s4-1.121.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. Case of Excision of the Head of the Humerus (Decapitatiohumeri), with its results. J R Soc Med 1859; 42:1-6. [PMID: 20896112 DOI: 10.1177/095952875904200102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Birkett J. Inquiry into the Nature of those Cases of Strangulated Oblique Inguinal Hernia, termed "Reduction en bloc, ou en masse;" with special Relation to the Anatomy of the actual Lesion, and Practical Deductions derived from an Examination of the Cases. Med Chir Trans 1859; 42:247-87. [PMID: 20896123 DOI: 10.1177/095952875904200118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Birkett J. Hernia into the Vaginal Process of the Peritoneum: Its Varieties, Complications, and Treatment: Illustrated by Cases. West J Med 1858. [DOI: 10.1136/bmj.s4-1.99.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. Practical Illustrations of the Treatment of Some Cases of Injury to the Hands. West J Med 1857. [DOI: 10.1136/bmj.s4-1.50.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. CASE OF SUDDEN DEATH DURING THE INHALATION OF THE VAPOUR OF CHLOROFORM. West J Med 1854. [DOI: 10.1136/bmj.s3-2.102.1120-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Birkett J. PATHOLOGY AND TREATMENT OF CHRONIC INDURATION OF THE MAMMA. West J Med 1853; 1:561-3. [DOI: 10.1136/bmj.s3-1.26.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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