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Í Dali C, Groeschel S, Moldovan M, Farah MH, Krägeloh-Mann I, Wasilewski M, Li J, Barton N, Krarup C. Intravenous arylsulfatase A in metachromatic leukodystrophy: a phase 1/2 study. Ann Clin Transl Neurol 2020; 8:66-80. [PMID: 33332761 PMCID: PMC7818087 DOI: 10.1002/acn3.51254] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/16/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Metachromatic leukodystrophy (MLD) is an autosomal recessive lysosomal storage disease caused by deficient activity of arylsulfatase A (ASA), resulting in severe motor and cognitive dysfunction. This phase 1/2 study evaluated the safety and efficacy of intravenous (IV) recombinant human ASA (rhASA; HGT-1111, previously known as Metazym) in children with MLD. METHODS Thirteen children with MLD (symptom onset < 4 years of age) were enrolled in an open-label, nonrandomized, dose-escalation trial and received IV rhASA at 50, 100, or 200 U/kg body weight every 14 (± 4) days for 52 weeks (NCT00418561; NCT00633139). Eleven children continued to receive rhASA at 100 or 200 U/kg during a 24-month extension period (NCT00681811). Outcome measures included safety observations, changes in motor and cognitive function, and changes in nerve conduction and morphometry. RESULTS There were no serious adverse events considered related to IV rhASA. Motor function and developmental testing scores declined during the study in all dose groups; no significant differences were observed between groups. Nerve conduction studies and morphometric analysis indicated that peripheral nerve pathology did not worsen during the study in any dose group. INTERPRETATION IV rhASA was generally well tolerated. There was no evidence of efficacy in preventing motor and cognitive deterioration, suggesting that IV rhASA may not cross the blood-brain barrier in therapeutic quantities. The relative stability of peripheral nerve function during the study indicates that rhASA may be beneficial if delivered to the appropriate target site and supports the development of rhASA for intrathecal administration in MLD.
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Affiliation(s)
- Christine Í Dali
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - Samuel Groeschel
- Department of Neuropediatrics, University Children's Hospital Tübingen, Tübingen, Germany
| | - Mihai Moldovan
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.,Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
| | - Mohamed H Farah
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ingeborg Krägeloh-Mann
- Department of Neuropediatrics, University Children's Hospital Tübingen, Tübingen, Germany
| | - Margaret Wasilewski
- Shire (a member of the Takeda group of companies), Lexington, Massachusetts, USA
| | - Jing Li
- Shire (a member of the Takeda group of companies), Lexington, Massachusetts, USA
| | - Norman Barton
- Shire (a member of the Takeda group of companies), Lexington, Massachusetts, USA
| | - Christian Krarup
- Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark.,Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
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Í Dali C, Sevin C, Krägeloh-Mann I, Giugliani R, Sakai N, Wu J, Wasilewski M. Safety of intrathecal delivery of recombinant human arylsulfatase A in children with metachromatic leukodystrophy: Results from a phase 1/2 clinical trial. Mol Genet Metab 2020; 131:235-244. [PMID: 32792226 DOI: 10.1016/j.ymgme.2020.07.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Metachromatic leukodystrophy (MLD) is an autosomal recessive disorder caused by deficient arylsulfatase A (ASA) activity and characterized by neurological involvement that results in severe disability and premature death. We examined the safety and tolerability of intrathecally delivered recombinant human ASA (rhASA; SHP611, now TAK-611) in children with MLD (NCT01510028). Secondary endpoints included change in cerebrospinal fluid (CSF) sulfatide and lysosulfatide levels, and motor function (assessed by Gross Motor Function Measure-88 total score). METHODS Twenty-four children with MLD who experienced symptom onset aged ≤ 30 months were enrolled. Patients received rhASA every other week (EOW) for 38 weeks at 10, 30, or 100 mg (cohorts 1-3; n = 6 per cohort), or 100 mg manufactured using a revised process (cohort 4; n = 6). RESULTS No rhASA-related serious adverse events (SAEs) were observed; 25% of patients experienced an SAE related to the intrathecal device or drug delivery method. Mean CSF sulfatide and lysosulfatide levels fell to within normal ranges in both 100 mg cohorts following treatment. Although there was a general decline in motor function over time, there was a tendency towards a less pronounced decline in patients receiving 100 mg. CONCLUSION Intrathecal rhASA was generally well tolerated at doses up to 100 mg EOW. These preliminary data support further development of rhASA as a therapy for patients with MLD.
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Affiliation(s)
- Christine Í Dali
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | | | - Ingeborg Krägeloh-Mann
- Department of Neuropediatrics, University Children's Hospital Tübingen, Tübingen, Germany.
| | - Roberto Giugliani
- Medical Genetics Service, HCPA, Department of Genetics, UFRGS, and INAGEMP, Porto Alegre, Brazil.
| | | | - James Wu
- Shire, a member of the Takeda group of companies, Lexington, MA, USA.
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Troy S, Wasilewski M, Beusmans J, Godfrey CJ. Pharmacokinetic Modeling of Intrathecally Administered Recombinant Human Arylsulfatase A (TAK-611) in Children With Metachromatic Leukodystrophy. Clin Pharmacol Ther 2020; 107:1394-1404. [PMID: 31868225 PMCID: PMC7325319 DOI: 10.1002/cpt.1752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 07/19/2019] [Accepted: 12/04/2019] [Indexed: 12/11/2022]
Abstract
Metachromatic leukodystrophy (MLD) is a lysosomal storage disease caused by deficient arylsulfatase A (ASA) activity, which leads to neuronal sulfatide accumulation and motor and cognitive deterioration. Intrathecal delivery of a recombinant human ASA (TAK-611, formerly SHP611) is under development as a potential therapy for MLD. We used serum and cerebrospinal fluid (CSF) TAK-611 concentrations measured during the phase I/II trial of intrathecal TAK-611 to develop a pharmacokinetic (PK) model describing drug disposition. CSF data were well characterized by a two-compartment model in the central nervous system (CNS); a single central compartment described the serum data. Estimated parameters suggested rapid distribution of TAK-611 from CSF into the putative brain tissue compartment, with persistence in the brain between doses (median distributive and terminal half-lives in the CNS: 1.02 and 477 hours, respectively). This model provides a valuable basis for understanding the PK distribution of TAK-611 and for PK/pharmacodynamic analyses of functional outcomes.
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Affiliation(s)
- Steven Troy
- Shire (a member of the Takeda group of companies), Lexington, Massachusetts, USA.,Radius Health, Waltham, Massachusetts, USA
| | - Margaret Wasilewski
- Shire (a member of the Takeda group of companies), Lexington, Massachusetts, USA.,ID Remedies LLC, Medford, Massachusetts, USA
| | - Jack Beusmans
- Metrum Research Group, Tariffville, Connecticut, USA
| | - C J Godfrey
- Metrum Research Group, Tariffville, Connecticut, USA
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Laskus Z, Wasilewski M, Michalski W, Frenkiel Z. [The results of treatment of middle ear carcinoma with radiotherapy]. Otolaryngol Pol 2000; 54:321-5. [PMID: 10917060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We have described results of treatment patients with an extremely rare disease--a middle ear carcinoma. Through 25 years we have treated 37 patients. We recommend surgical treatment immediately supplemented by radiotherapy--because of anatomical difficulties in gaining enough histological margins. The median of survival time was 7 months in the group of palliatively treated patients and 14 months in the group of radically treated patients. Three patients had following complications: a necrosis of retromandibular space and mandibular joint, a purulent otitis media and an osteoporosis of the temporal bone.
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Mascher H, Wasilewski M. Simple and Fast HPLC Method for the Determination of Triamterene and Hydroxytriamterenesulphate in Plasma and Urine. ACTA ACUST UNITED AC 1994. [DOI: 10.1080/10826079408013180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sagaster P, Essl R, Teich G, Fritz E, Wasilewski M, Umek H, Dünser E, Mascher H, Micksche M. Treatment of advanced colorectal cancer with folinic acid and 5-fluorouracil in combination with cisplatinum. Eur J Cancer 1994; 30A:1250-4. [PMID: 7999407 DOI: 10.1016/0959-8049(94)90167-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
51 patients with metastatic colorectal cancer (stage Dukes D) were treated with intravenous (i.v.) infusion on days 1, 3, 5, 8 and 16 with folinic acid (200 mg/m2) and 5-fluorouracil (600 mg/m2), and on days 1, 8 and 16 with cisplatinum (25 mg/m2 i.v.); cycles were repeated every 4 weeks. All 51 patients were evaluable for toxicity and response criteria. 26 patients had objective responses (3 complete responses, 5.9%; 23 partial responses, 45.1%), relative risk 51% (95% confidence intervals 36.7-65.0%). Response duration ranged from 4 to 28.0 months (median 16.8). Overall median survival of all patients included was 14.7 months (range 3.0-33.0). Toxicity of WHO grade III, requiring dose reduction, occurred in 9 (18%) patients. The regimen described here appears to be active, safe and well tolerated for treatment of patients with advanced colorectal cancer.
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Affiliation(s)
- P Sagaster
- Department of Internal Medicine and Medical Oncology, Wilhelminenspital, Vienna, Austria
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Bujko K, Skoczylas JZ, Bentzen SM, Hliniak A, Wasilewski M, Szutkowski ZJ, Osmólski A. A feasibility study of concomitant boost radiotherapy for patients with cancer of the supraglottic larynx. Acta Oncol 1993; 32:637-40. [PMID: 8260182 DOI: 10.3109/02841869309092444] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Between February 1988 and December 1989, 65 patients with supraglottic cancer completed a course of concomitant boost radiotherapy. Cases with N3 disease, a Karnovsky performance score less than 70, age above 70 years, or a second primary cancer were not eligible for the study. Distribution of the patients was: Stage T1-T2 30%, T3-T4 70%, N0 68%, N+ 32%. The total dose ranged from 60 Gy to 76 Gy (median 66 Gy); overall treatment time ranged from 36 to 56 days with a median of 42 days. The daily dose during the first 4 weeks was 1.8 Gy, and during the last 2 weeks it was 1.6 Gy b.i.d. with a 4- or (after September 1988) 6-h interval. The clinical impression was that the early mucosal reactions were acceptable but more severe than after conventional treatment, with confluent membranous mucosal reaction being observed in 54% of the patients. Also, this reaction was significantly more frequent in patients treated with a 4-h interval (68%) than with a 6-h interval (41%) between the daily fractions. To relieve severe dysphagia, narcotics were required in 22% of the patients. The follow-up time ranged from 22 to 50 months, median 34 months. Treatment-requiring late complications were observed in 8 patients, and the 3-year actuarial risk was 17% with 95% confidence limits (6%, 27%). Two of these patients had severe complications: one of them required a temporary tracheostomy due to arytenoid edema and the other developed a laryngo-cutaneous fistula which healed after pharmacological treatment. Actuarial 3-year local-regional control was 59% (46%, 71%) and 3-year actuarial crude survival 55% (42%, 67%). There was no significant difference in the incidence of late complications or tumor control between the two groups of patients treated with a 4- or 6-h interval between the daily fractions. This study shows that the concomitant boost regimen tried here is feasible, but also stresses that the interval between dose fractions should be 6 h or more.
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Affiliation(s)
- K Bujko
- Danish Cancer Society, Dept. of Experimental Clinical Oncology, Aarhus
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Szutkowski Z, Krzakowski M, Hliniak A, Wasilewski M. [Early results of combined treatment (induction chemotherapy and radiotherapy) of patients with squamous cell carcinoma of the oropharynx]. Nowotwory 1990; 40:125-30. [PMID: 2125719] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The results of combined treatment (induction chemotherapy followed by irradiation) in 23 patients with locally advanced squamous cell carcinoma of the oropharynx were presented. Chemotherapy program included Cisplatin 100 mg/m2 i.v. in day 1 and 5-fluorouracil 750 mg/m2 i.v. on day 1-5. The chemotherapy was administered every 3 weeks for maximum 3 cycles. Complete response in 15 patients (65%), stabilization in 4 patients (17%) and progressive disease was found in 3 patients (14%). 20 patients were irradiated with radical intention. Complete response was found in 9 patients (45%) after radiotherapy. Treatment was relatively well-tolerated. Out of 17 patients with at least 6 months' follow-up (range 6-24) 6 patients are alive with no evidence of disease. We estimate the postirradiation reaction as slightly more severe than after radiotherapy alone. The reaction did not influence the prescribed way of fractionation.
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Affiliation(s)
- Z Szutkowski
- Zakładu Teleradioterapii II Centrum Onkologii, Instytutu im. Marii Skłodowskiej-Curie w Warszawie
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Hliniak A, Bielec M, Osiadacz W, Szmigielski S, Wasilewski M. [Preliminary clinical studies on the use of local microwave (434 MHz) hyperthermia in advanced, superficially located neoplasms]. Nowotwory 1983; 33:299-304. [PMID: 6369256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Szmigielski S, Hliniak A, Bielec M, Wasilewski M. [Local hyperthermia in the treatment of malignant neoplasms]. Nowotwory 1983; 33:281-98. [PMID: 6369255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Jaziri M, Jilani SB, Wasilewski M, Gherab A. [Radiotherapy of highly developed breast cancers. Percentage of sterilized lesions]. Tunis Med 1979; 57:155-9. [PMID: 553347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Gherab A, Wasilewski M, Ben Attia RB, Jaziri M, Jilani SB, Jaafar MB. [Diagnosis and radiotherapy of cancer of the esophagus. Apropos of 58 cases]. Tunis Med 1979; 57:6-10. [PMID: 547466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Wasilewski M. [The action of poisons in human environment and retrobalbular neuritis (author's transl)]. Klin Oczna 1977; 47:229-31. [PMID: 559218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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15
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Wasilewski M. [A case of involuntary facial movements caused by unilateral refraction error (author's transl)]. Klin Oczna 1977; 47:189. [PMID: 853679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Wasilewski M. [Appearance of blood vessels in palpebral aperture in aging]. Klin Oczna 1975; 45:927-32. [PMID: 1160315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Wasilewski M. [Color vision in persons over 70]. Klin Oczna 1975; 45:355-9. [PMID: 1121153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Wasilewski M. [Studies of blood circulation in bulbar conjunctival vessels]. Klin Oczna 1974; 44:783-8. [PMID: 4410996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Wasilewski M. [Analysis of 100 cases of epiphora in the presence of patent lacrimal passages]. Klin Oczna 1974; 44:483-8. [PMID: 4830903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Dańczak Z, Wasilewski M. [Results of radiation therapy of carcinoma of the mouth floor]. Nowotwory 1973; 23:353-8. [PMID: 4769946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wasilewski M, Stawarz B. [Bathing of patients in the early postoperative period]. Wiad Lek 1973; 26:1219-21. [PMID: 4728836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wasilewski M, Gołebiowska D. [Telecobalt-60 gammagraphy in the planning of treatment of bladder neoplasms]. Pol Przegl Radiol Med Nukl 1972; 36:657-62. [PMID: 4645467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Wasilewski M, Nowak G. [Cobalt teletherapy of laryngeal cancer]. Nowotwory 1972; 22:219-24. [PMID: 5087206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Wasilewski M, Golebiowska D. [Telecobalt-60 gammagraphy in oncological practice]. Nowotwory 1972; 22:153-8. [PMID: 5038536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Wasilewski M, Nickie M. [Treatment of carcinoma of the tongue with telecobalt-60]. Nowotwory 1970; 20:135-40. [PMID: 5479169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Wasilewski M, Kielbińska S, Zomer J. [Radiotherapy of the cancer of the middle ear]. Nowotwory 1970; 20:141-7. [PMID: 5479170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Wasilewski M, Lukawska K, Krześniak J. [Irradiation of urethral carcinoma in women]. Nowotwory 1969; 19:301-9. [PMID: 5370348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Wasilewski M, Pieńkowska F. [Evaluation of x-ray treatment of sarcomas of the lymphoreticular system of the pharynx in the 1st and 2d stage of clinical advancement]. Nowotwory 1967; 17:127-34. [PMID: 4865243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wasilewski M, Gajl D. [Early results of telecobalt-60 therapy of cancer of the oral cavity]. Nowotwory 1966; 16:291-7. [PMID: 5956069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Wasilewski M, Malinowski Z. The cobalt 60 teletherapy treatment in advanced stages of cancer of the bladder. Cesk Radiol 1966; 20:28-32. [PMID: 5902789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Gajl D, Gwiazdowski B, Wasilewski M. [Application of isodose distribution in the planning of treatment]. Nowotwory 1965; 15:193-6. [PMID: 5835736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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