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Rose TL, Weir WH, Mayhew GM, Shibata Y, Eulitt P, Uronis JM, Zhou M, Nielsen M, Smith AB, Woods M, Hayward MC, Salazar AH, Milowsky MI, Wobker SE, McGinty K, Millburn MV, Eisner JR, Kim WY. Correction to: Fibroblast growth factor receptor 3 alterations and response to immune checkpoint inhibition in metastatic urothelial cancer: a real world experience. Br J Cancer 2022; 126:1237. [PMID: 35277660 PMCID: PMC9023585 DOI: 10.1038/s41416-022-01781-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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2
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Rose TL, Weir WH, Mayhew GM, Shibata Y, Eulitt P, Uronis JM, Zhou M, Nielsen M, Smith AB, Woods M, Hayward MC, Salazar AH, Milowsky MI, Wobker SE, McGinty K, Millburn MV, Eisner JR, Kim WY. Fibroblast growth factor receptor 3 alterations and response to immune checkpoint inhibition in metastatic urothelial cancer: a real world experience. Br J Cancer 2021; 125:1251-1260. [PMID: 34294892 DOI: 10.1038/s41416-021-01488-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/07/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND FGFR3-altered urothelial cancer (UC) correlates with a non-T cell-inflamed phenotype and has therefore been postulated to be less responsive to immune checkpoint blockade (ICB). Preclinical work suggests FGFR3 signalling may suppress pathways such as interferon signalling that alter immune microenvironment composition. However, correlative studies examining clinical trials have been conflicting as to whether FGFR altered tumours have equivalent response and survival to ICB in patients with metastatic UC. These findings have yet to be validated in real world data, therefore we evaluated clinical outcomes of patients with FGFR3-altered metastatic UC treated with ICB and investigate the underlying immunogenomic mechanisms of response and resistance. METHODS 103 patients with metastatic UC treated with ICB at a single academic medical center from 2014 to 2018 were identified. Clinical annotation for demographics and cancer outcomes, as well as somatic DNA and RNA sequencing, were performed. Objective response rate to ICB, progression-free survival, and overall survival was compared between patients with FGFR3-alterations and those without. RNA expression, including molecular subtyping and T cell receptor clonality, was also compared between FGFR3-altered and non-altered patients. RESULTS Our findings from this dataset confirm that FGFR3-altered (n = 17) and wild type (n = 86) bladder cancers are equally responsive to ICB (12 vs 19%, p = 0.73). Moreover, we demonstrate that despite being less inflamed, FGFR3-altered tumours have equivalent T cell receptor (TCR) diversity and that the balance of a CD8 T cell gene expression signature to immune suppressive features is an important determinant of ICB response. CONCLUSIONS Our work in a real world dataset validates prior observations from clinical trials but also extends this prior work to demonstrate that FGFR3-altered and wild type tumours have equivalent TCR diversity and that the balance of effector T cell to immune suppression signals are an important determinant of ICB response.
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Affiliation(s)
- Tracy L Rose
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - William H Weir
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Patrick Eulitt
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Mi Zhou
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew Nielsen
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angela B Smith
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Woods
- Department of Urology, Loyola University, Chicago, IL, USA
| | - Michele C Hayward
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ashley H Salazar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew I Milowsky
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sara E Wobker
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katrina McGinty
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - William Y Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Trennepohl C, Sorah J, Eulitt P, Galeotti J, Zeidner JF, Montgomery ND, Coombs CC. Myeloid sarcoma manifesting as generalized lymphadenopathy in a patient with myelofibrosis. Clin Case Rep 2019; 7:2274-2276. [PMID: 31788302 PMCID: PMC6878033 DOI: 10.1002/ccr3.2473] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/17/2019] [Accepted: 08/12/2019] [Indexed: 11/15/2022] Open
Abstract
Immunophenotyping is critical to the diagnosis of MS, as it can be difficult to differentiate from other diagnoses including lymphoma using conventional light microscopy.
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Affiliation(s)
| | - Jonathan Sorah
- Department of MedicineUniversity of North CarolinaChapel HillNCUSA
| | - Patrick Eulitt
- Division of Hematology/OncologyDepartment of MedicineUniversity of North CarolinaChapel HillNCUSA
| | | | - Joshua F. Zeidner
- Division of Hematology/OncologyDepartment of MedicineUniversity of North CarolinaChapel HillNCUSA
| | | | - Catherine C. Coombs
- Division of Hematology/OncologyDepartment of MedicineUniversity of North CarolinaChapel HillNCUSA
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Eulitt P, Altun E, Sheikh A, Wong TZ, Woods M, Rose TL, Wallen E, Pruthi R, Smith A, Nielsen ME, Whang YE, Kim WY, Godley PA, Basch EM, David G, Ramirez J, Deal AM, Lee J, Milowsky MI. Pilot study of [ 18F] fluorodexoyglucose positron emission tomography-magnetic resonance imaging (FDG-PET-MRI) for staging of muscle-invasive bladder cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
e16002 Background: Standard of care imaging for staging MIBC is computed tomography (CT) abdomen and pelvis despite poor diagnostic accuracy. The addition of FDG-PET to evaluate biologic activity has been shown to improve detection of metastatic bladder cancer. Better soft tissue characterization with MRI may improve detection of local disease. We hypothesized that simultaneous acquisition of FDG-PET and MRI images (PET-MRI) would allow for more accurate preoperative staging in patients with MIBC. Methods: 21 patients with MIBC and planned radical cystectomy with lymph node dissection were enrolled. Four radiologists (2 senior, 2 junior) with expertise in MRI and PET independently reviewed MRI and FDG-PET scans, respectively, to determine: 1) extent of the primary bladder tumor; and 2) involvement of local lymph nodes and distant sites of disease. Combined radiologist reads were performed (senior MRI and junior PET and vice versa). Imaging results were compared to surgical pathology. Results: 18 patients were included in the final analysis (3 PET-MRI scans excluded due to technical pitfalls with image acquisition). Final pathology revealed 10 patients (56%) with muscle invasion and only 2 patients (11%) with lymph node involvement. Combined analyses of PET-MRI accurately detected the extent of the primary tumor (sensitivity 0.84, specificity 0.50, PPV 0.70, NPV 0.70), but was less accurate for the detection of lymph node involvement (sensitivity 0.00, specificity 1.00, no calculable PPV, NPV 0.91). Senior MRI radiologist had improved PPV and NPV for extent of primary tumor compared to junior MRI radiologist (PPV 0.71 vs 0.56, NPV 0.83 vs. 0.50), and senior PET radiologist had improved PPV with similar NPV for extent of primary tumor (PPV 1.00 vs 0.78, NPV 0.50 vs 0.55). No patient was determined to have distant metastatic disease. Conclusions: To our knowledge, this is the first study exploring the use of PET-MRI for staging MIBC. This novel imaging modality demonstrated promise in detecting the extent of the primary tumor. Further investigation of FDG-PET-MRI is needed to better determine its potential utility in staging MIBC.
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Affiliation(s)
| | - Ersan Altun
- University of North Carolina, Chapel Hill, NC
| | | | | | - Michael Woods
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Tracy L Rose
- University of North Carolina Hospital, Chapel Hill, NC
| | - Eric Wallen
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Raj Pruthi
- The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Angela Smith
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Young E. Whang
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - William Y. Kim
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | - Ethan M. Basch
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Grace David
- University of North Carolina, Chapel Hill, NC
| | - Juanita Ramirez
- Office of Clinical and Translational Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Allison Mary Deal
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | - Matthew I. Milowsky
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
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Rose TL, Hayward MC, Salazar AH, Eulitt P, McGinty K, Drier A, Wobker SE, Whang YE, Brower BY, Dunn M, Crona DJ, Shibata Y, Uronis JM, Mayhew G, Milowsky MI, Kim WY. Fibroblast growth factor receptor status and response to immune checkpoint inhibition in metastatic urothelial cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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
458 Background: Fibroblast growth factor receptor (FGFR) inhibitors are a promising new targeted therapy for patients with metastatic urothelial cancer (UC) and FGFR alterations. FGFR-altered tumors are more likely to be of the luminal molecular subtype, which is less immune infiltrated and may be less likely to respond to immune checkpoint inhibitors (ICP). Methods: Metastatic UC patients at the University of North Carolina who underwent targeted exon sequencing (any CLIA-certified platform) and were treated with ICP since 2014 were identified. Patients with any FGFR alteration were compared to patients without alterations (including mutations, fusions, and amplifications in FGFR1-4). Overall response rates (ORR) to ICP were assessed by a radiologist (K.M.) per RECIST 1.1 and compared between FGFR-altered and unaltered tumors using Fisher’s exact tests. Patients who died prior to radiologic assessment were considered non-responders. Results: 66 patients (median age 70, 65% male, 76% white, 21% black) were identified. Most patients (74%) had received prior platinum-based chemotherapy, and 13% had received 2 or more prior lines of therapy. At the time of initiation of ICP, 32% of patients had a hemoglobin < 10, 33% had liver metastases, and 72% had a performance status > 0. Fifteen (22%) patients had FGFR alterations. The ORR for all patients was 15%, with ORR of 13% in FGFR-altered patients compared with 16% in unaltered patients (p = 1.0). No patients (0/9, 0%) with known pathogenic mutations in FGFR3 responded to ICP compared to 10/57 (18%) of patients without these alterations (p = 0.33). 46% of FGFR-altered patients who stopped ICP due to progression received subsequent therapy. Conclusions: Response rates to ICP are low and there was no difference in ORR between FGFR-altered and unaltered patients. While no patient with pathogenic FGFR3 mutations responded to ICP in our cohort, this difference did not reach statistical significance. Given low response rates overall, some FGFR-altered patients may benefit from treatment with FGFR inhibitors prior to ICP. Analysis of larger cohorts of patients as well as patients from clinical trials and more in-depth molecular profiling may add further clarity.
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Affiliation(s)
- Tracy L Rose
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | - Anthony Drier
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Young E. Whang
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Mary Dunn
- Department of Medicine, Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | | | - William Y. Kim
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
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Eulitt P, Fabian D, Kelly C, Hemminger J, William BM. Waldenström's macroglobulinemia masquerading as ovarian cancer with peritoneal carcinomatosis, ascites, and elevated CA-125. Hematol Oncol Stem Cell Ther 2017; 12:54-59. [PMID: 28390215 DOI: 10.1016/j.hemonc.2017.02.004] [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] [Received: 08/14/2016] [Revised: 01/24/2017] [Accepted: 02/17/2017] [Indexed: 12/26/2022] Open
Abstract
Waldenström's macroglobulinemia is a rare hematology malignancy which often presents with "B symptoms," anemia, and thrombocytopenia. A 46-year-old woman presented with 2 months of abdominal distension accompanied by an unintentional 20-lb weight loss. Her abdominal CT scan demonstrated diffuse carcinomatosis with bilateral ovarian lesions and screening labs revealed a markedly elevated CA-125, suggesting a diagnosis of ovarian cancer. Upon admission for workup, patient was found to have a significant protein gap, later attributed to a markedly elevated IgM. Omental and bone marrow biopsy confirmed the diagnosis of Waldenström's macroglobulinemia, with elevation in CA-125 thought to be secondary to peritoneal irritation. This patient has since been successfully treated with six cycles of bendamusine and rituximab with no evidence of disease on staging scans and normalization of both CA-125 and IgM. To our knowledge, this is the first documented case of Waldenström's macroglobulinemia presenting with symptoms classically associated with ovarian cancer and demonstrates the importance of maintaining a broad differential when evaluating patients with abdominal carcinomatosis.
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Affiliation(s)
- Patrick Eulitt
- Ohio State University, Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA.
| | - Denise Fabian
- Ohio State University, Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Crystal Kelly
- Ohio State University, Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Jessica Hemminger
- Ohio State University, Wexner Medical Center, 460 West 10th Avenue, Columbus, OH 43210, USA
| | - Basem M William
- Ohio State University Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, A352 Starling Loving Hall, 320 W. 10th Avenue, Columbus, OH 43210, USA
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7
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Eulitt P, Zhao Q, Ruppert AS, Abruzzo L, Coombes C, Gordon A, Jones JA, Awan FT, Blachly JS, Andritsos LA, Byrd JC, Heerema NA, Woyach JA. The significance of BCL6 abnormalities on fluorescence in situ hybridization (FISH) in chronic lymphocytic leukemia (CLL). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e19005] [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)
- Patrick Eulitt
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Qiuhong Zhao
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Amy S. Ruppert
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Lynne Abruzzo
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Caitlin Coombes
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Amber Gordon
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | | | | | | | - John C. Byrd
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Nyla A. Heerema
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
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8
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Bareford MD, Park MA, Yacoub A, Hamed HA, Tang Y, Cruickshanks N, Eulitt P, Hubbard N, Tye G, Burow ME, Fisher PB, Moran RG, Nephew KP, Grant S, Dent P. Sorafenib enhances pemetrexed cytotoxicity through an autophagy-dependent mechanism in cancer cells. Cancer Res 2011; 71:4955-67. [PMID: 21622715 PMCID: PMC3139015 DOI: 10.1158/0008-5472.can-11-0898] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [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: 12/26/2022]
Abstract
Pemetrexed (ALIMTA, Lilly) is a folate antimetabolite that has been approved by the U.S. Food and Drug Administration for the treatment of non-small cell lung cancer and has been shown to stimulate autophagy. In the present study, we sought to further understand the role of autophagy in response to pemetrexed and to test if combination therapy could enhance the level of toxicity through altered autophagy in tumor cells. The multikinase inhibitor sorafenib (Nexavar, Bayer), used in the treatment of renal and hepatocellular carcinoma, suppresses tumor angiogenesis and promotes autophagy in tumor cells. We found that sorafenib interacted in a greater than additive fashion with pemetrexed to increase autophagy and to kill a diverse array of tumor cell types. Tumor cell types that displayed high levels of cell killing after combination treatment showed elevated levels of AKT, p70 S6K, and/or phosphorylated mTOR, in addition to class III receptor tyrosine kinases such as platelet-derived growth factor receptor beta and VEGF receptors, known in vivo targets of sorafenib. In xenograft and in syngeneic animal models of mammary carcinoma and glioblastoma, the combination of sorafenib and pemetrexed suppressed tumor growth without deleterious effects on normal tissues or animal body mass. Taken together, the data suggest that premexetred and sorafenib act synergistically to enhance tumor killing via the promotion of a toxic form of autophagy that leads to activation of the intrinsic apoptosis pathway, and predict that combination treatment represents a future therapeutic option in the treatment of solid tumors.
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Affiliation(s)
- M. Danielle Bareford
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Margaret A. Park
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Adly Yacoub
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Hossein A. Hamed
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Yong Tang
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Nichola Cruickshanks
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Patrick Eulitt
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Nisan Hubbard
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Gary Tye
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Matthew E. Burow
- Section of Hematology & Oncology, Tulane University School of Medicine, New Orleans LA 70112
| | - Paul B. Fisher
- Department of Human and Molecular Genetics, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
- Virginia Institute of Molecular Medicine, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Richard G. Moran
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Kenneth P. Nephew
- Department of Medical Sciences, Indiana University, School of Medicine, Bloomington, IN 47405
| | - Steven Grant
- Department of Medicine, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
- Virginia Institute of Molecular Medicine, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
| | - Paul Dent
- Department of Neurosurgery, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
- Virginia Institute of Molecular Medicine, Virginia Commonwealth University, 401 College St., Richmond, VA 23298
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Liang HY, Cheng A, Chang KC, Berger RD, Agarwal K, Eulitt P, Corretti M, Tomaselli G, Calkins H, Kass DA, Abraham TP. Influence of Atrial Function and Mechanical Synchrony on LV Hemodynamic Status in Heart Failure Patients on Resynchronization Therapy. JACC Cardiovasc Imaging 2011; 4:691-8. [DOI: 10.1016/j.jcmg.2011.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 02/16/2011] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
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Mitchell C, Yacoub A, Hossein H, Martin AP, Bareford MD, Eulitt P, Yang C, Nephew KP, Dent P. Inhibition of MCL-1 in breast cancer cells promotes cell death in vitro and in vivo. Cancer Biol Ther 2010; 10:903-17. [PMID: 20855960 DOI: 10.4161/cbt.10.9.13273] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The present studies have examined approaches to suppress MCL-1 function in breast cancer cells, as a means to promote tumor cell death. Treatment of breast cancer cells with CDK inhibitors (flavopiridol; roscovitine) enhanced the lethality of the ERBB1 inhibitor lapatinib in a synergistic fashion. CDK inhibitors interacted with lapatinib to reduce MCL-1 expression and over-expression of MCL-1 or knock down of BAX and BAK suppressed drug combination lethality. Lapatinib-mediated inhibition of ERK1/2 and to a lesser extent AKT facilitated CDK inhibitor -induced suppression of MCL-1 levels. Treatment of cells with the BH3 domain / MCL-1 inhibitor obatoclax enhanced the lethality of lapatinib in a synergistic fashion. Knock out of MCL-1 and BCL-XL enhanced lapatinib toxicity to a similar extent as obatoclax and suppressed the ability of obatoclax to promote lapatinib lethality. Pre-treatment of cells with lapatinib or with obatoclax enhanced basal levels of BAX and BAK activity and further enhanced drug combination toxicity. In vivo tumor growth data in xenograft and syngeneic model systems confirmed our in vitro findings. Treatment of cells with CDK inhibitors enhanced the lethality of obatoclax in a synergistic fashion. Over-expression of MCL-1 or knock down of BAX and BAK suppressed the toxic interaction between CDK inhibitors and obatoclax. Obatoclax and lapatinib treatment or obatoclax and CDK inhibitor treatment or lapatinib and CDK inhibitor treatment radiosensitized breast cancer cells. Lapatinib and obatoclax interacted to suppress mammary tumor growth in vivo. Collectively our data demonstrate that manipulation of MCL-1 protein expression by CDK inhibition or inhibition of sequestering function MCL-1 by Obatoclax renders breast cancer cells more susceptible to BAX/BAK-dependent mitochondrial dysfunction and tumor cell death.
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Affiliation(s)
- Clint Mitchell
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
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11
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Mitchell C, Park M, Eulitt P, Yang C, Yacoub A, Dent P. Poly(ADP-ribose) polymerase 1 modulates the lethality of CHK1 inhibitors in carcinoma cells. Mol Pharmacol 2010; 78:909-17. [PMID: 20696794 DOI: 10.1124/mol.110.067199] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Prior studies have demonstrated that inhibition of CHK1 can promote the activation of extracellular signal-regulated kinases 1 and 2 (ERK1/2) and phosphorylation of histone H2AX and that inhibition of poly(ADP-ribose) polymerase 1 (PARP1) can affect growth factor-induced ERK1/2 activation. The present studies were initiated to determine whether CHK1 inhibitors interacted with PARP1 inhibition to facilitate apoptosis. Transient expression of dominant-negative CHK1 raised basal ERK1/2 activity and prevented CHK1 inhibitors from activating ERK1/2. CHK1 inhibitors modestly increased the levels of PARP1 ADP ribosylation and molecular or small-molecule inhibition of PARP1 blocked CHK1 inhibitor-stimulated histone H2AX phosphorylation and activation of ERK1/2. Stimulated histone H2AX phosphorylation was ataxia telangiectasia-mutated protein-dependent. Multiple CHK1 inhibitors interacted in a greater than additive fashion with multiple PARP1 inhibitors to cause transformed cell-killing in short-term viability assays and synergistically killed tumor cells in colony-formation assays. Overexpression of BCL-xL or loss of BAX/BAK function, but not the function of BID, suppressed CHK1 inhibitor + PARP1 inhibitor lethality. Inhibition of BCL-2 family protein function enhanced CHK1 inhibitor + PARP1 inhibitor lethality and restored drug-induced cell-killing in cells overexpressing BCL-xL. Thus, PARP1 plays an important role in regulating the ability of CHK1 inhibitors to activate ERK1/2 and the DNA damage response. An inability of PARP1 to modulate this response results in transformed cell death mediated through the intrinsic apoptosis pathway.
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Affiliation(s)
- Clint Mitchell
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA 23298-0035, USA
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Hamed HA, Yacoub A, Park MA, Eulitt P, Sarkar D, Dimitrie IP, Chen CS, Grant S, Curiel DT, Fisher PB, Dent P. OSU-03012 enhances Ad.7-induced GBM cell killing via ER stress and autophagy and by decreasing expression of mitochondrial protective proteins. Cancer Biol Ther 2010; 9:526-36. [PMID: 20107314 DOI: 10.4161/cbt.9.7.11116] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The present studies focused on determining whether the autophagy-inducing drug OSU-03012 (AR-12) could enhance the toxicity of recombinant adenoviral delivery of melanoma differentiation associated gene-7/interleukin-24 (mda-7/IL-24) in glioblastoma multiforme (GBM) cells. The toxicity of a recombinant adenovirus to express MDA-7/IL-24 (Ad.mda-7) was enhanced by OSU-03012 in a diverse panel of primary human GBM cells. The enhanced toxicity correlated with reduced ERK1/2 phosphorylation and expression of MCL-1 and BCL-XL, and was blocked by molecular activation of ERK1/2 and by inhibition of the intrinsic, but not the extrinsic, apoptosis pathway. Both OSU-03012 and expression of MDA-7/IL-24 increased phosphorylation of PKR-like endoplasmic reticulum kinase (PERK) that correlated with increased levels of autophagy and expression of dominant negative PERK blocked autophagy induction and tumor cell death. Knockdown of ATG5 or Beclin1 suppressed OSU-03012 enhanced MDA-7/IL-24-induced autophagy and blocked the lethal interaction between the two agents. Ad.mda-7-infected GBM cells secreted MDA-7/IL-24 into the growth media and this conditioned media induced expression of MDA-7/IL-24 in uninfected GBM cells. OSU-03012 interacted with conditioned media to kill GBM cells and knockdown of MDA-7/IL-24 in these cells suppressed tumor cell killing. Collectively, our data demonstrate that the induction of autophagy and mitochondrial dysfunction by a combinatorial treatment approach represents a potentially viable strategy to kill primary human GBM cells.
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Affiliation(s)
- Hossein A Hamed
- Departments of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, 401 College St., Richmond, VA 23298, USA
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Abstract
Ultrasound is emerging as a useful tool for evaluation of neuromuscular conditions, because it can provide high-resolution anatomic information to complement electrodiagnostic data. There have been few studies in which ultrasound was used to assess the peripheral nerves of individuals with Charcot-Marie-Tooth (CMT) disease and none involving CMT type 1B. In this study we compared nerve cross-sectional area in individuals from a single large family with CMT 1B with normal, healthy controls. We also assessed for cranial nerve enlargement in those with CMT 1B with cranial neuropathies compared to those with CMT 1B without cranial neuropathies. Individuals with CMT 1B have significantly larger median and vagus nerves than healthy controls, but no difference was seen in cranial nerve size between those with versus those without cranial neuropathies. This is the first study to characterize the ultrasonographic findings in the peripheral nerves of individuals with CMT 1B.
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Affiliation(s)
- Michael S Cartwright
- Department of Neurology, Wake Forest University School of Medicine, Medical Center Boulevard, Meads Hall, Winston-Salem, North Carolina 27157, USA.
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