1
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Qing Y, Chan R, Fu P, Cullen J, Miron A, Jacobson JM, Pink J, Gerson SL. Impact of age, antiretroviral therapy, and cancer on epigenetic aging in people living with HIV. Cancer Med 2023; 12:11010-11019. [PMID: 36951656 DOI: 10.1002/cam4.5809] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Premature aging has been identified as a global risk factor for cancer. Causes of premature aging are multifactorial, including inflammation, infection, chronic stress, and lifestyle factors. METHOD We evaluated whether premature aging in people living with HIV (PLWH) was associated with antiretroviral therapy (ART) or the diagnosis of cancer. We used well-established DNA methylation patterns to assess premature aging, using Horvath et al., in individuals with HIV located in Cleveland, Ohio and compared these to standardized datasets of US historical blood samples. Some of the PLWH developed cancer over time. RESULTS We found that DNA methylation analysis identified accelerated aging in PLWH whereas ART therapy mitigated the advancement of DNA methylation age. A variety of cancers were observed in this population, but a cancer diagnosis was not significantly associated with more advanced DNA methylation age. CONCLUSION We find that the age acceleration detected in PLWH is mitigated by ART therapy and is not further accelerated by a diagnosis of cancer.
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Affiliation(s)
- Yulan Qing
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Ricky Chan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pingfu Fu
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jennifer Cullen
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alexander Miron
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Genetics and Genomics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jeffrey M Jacobson
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - John Pink
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA
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2
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Ho WJ, Smith JNP, Park YS, Hadiono M, Christo K, Jogasuria A, Zhang Y, Broncano AV, Kasturi L, Dawson DM, Gerson SL, Markowitz SD, Desai AB. 15-PGDH regulates hematopoietic and gastrointestinal fitness during aging. PLoS One 2022; 17:e0268787. [PMID: 35587945 PMCID: PMC9119474 DOI: 10.1371/journal.pone.0268787] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/08/2022] [Indexed: 11/30/2022] Open
Abstract
Emerging evidence implicates the eicosanoid molecule prostaglandin E2 (PGE2) in conferring a regenerative phenotype to multiple organ systems following tissue injury. As aging is in part characterized by loss of tissue stem cells' regenerative capacity, we tested the hypothesis that the prostaglandin-degrading enzyme 15-hydroxyprostaglandin dehydrogenase (15-PGDH) contributes to the diminished organ fitness of aged mice. Here we demonstrate that genetic loss of 15-PGDH (Hpgd) confers a protective effect on aging of murine hematopoietic and gastrointestinal (GI) tissues. Aged mice lacking 15-PGDH display increased hematopoietic output as assessed by peripheral blood cell counts, bone marrow and splenic stem cell compartments, and accelerated post-transplantation recovery compared to their WT counterparts. Loss of Hpgd expression also resulted in enhanced GI fitness and reduced local inflammation in response to colitis. Together these results suggest that 15-PGDH negatively regulates aged tissue regeneration, and that 15-PGDH inhibition may be a viable therapeutic strategy to ameliorate age-associated loss of organ fitness.
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Affiliation(s)
- Won Jin Ho
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Julianne N. P. Smith
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Young Soo Park
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Matthew Hadiono
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Kelsey Christo
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Alvin Jogasuria
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Yongyou Zhang
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Alyssia V. Broncano
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Lakshmi Kasturi
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Dawn M. Dawson
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Stanton L. Gerson
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, United States of America
| | - Sanford D. Markowitz
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, United States of America
| | - Amar B. Desai
- Department of Medicine, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
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3
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Biswas T, Dowlati A, Kunos CA, Pink JJ, Oleinick NL, Malik S, Fu P, Cao S, Bruno DS, Bajor DL, Patel M, Gerson SL, Machtay M. Adding Base-Excision Repair Inhibitor TRC102 to Standard Pemetrexed-Platinum-Radiation in Patients with Advanced Nonsquamous Non-Small Cell Lung Cancer: Results of a Phase I Trial. Clin Cancer Res 2022; 28:646-652. [PMID: 34740922 PMCID: PMC8866206 DOI: 10.1158/1078-0432.ccr-21-2025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/04/2021] [Revised: 09/01/2021] [Accepted: 10/29/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE TRC102, a small-molecule base-excision repair inhibitor, potentiates the cytotoxicity of pemetrexed and reverses resistance by binding to chemotherapy-induced abasic sites in DNA. We conducted a phase I clinical trial combining pemetrexed and TRC102 with cisplatin-radiation in stage III nonsquamous non-small cell lung cancer (NS-NSCLC). PATIENTS AND METHODS Fifteen patients were enrolled from 2015 to 2019. The primary objective was to determine the dose-limiting toxicity and maximum tolerated dose of TRC102 in combination with pemetrexed, cisplatin, and radiotherapy. Secondary objectives were to assess toxicity, tumor response, and progression-free survival at 6 months. Based on our preclinical experiments, pemetrexed-TRC102 was given on day 1, and cisplatin/radiotherapy was initiated on day 3. This schedule was duplicated in the second cycle. After completion, two additional cycles of pemetrexed-cisplatin were given. Toxicities were assessed using NCI CTACAE versions 4/5. RESULTS The median age was 69 years (45-79) with the median follow-up of 25.7 months (range, 7.9-47.4). No dose-limiting toxicities and no grade 5 toxicity were seen. Hematologic and gastrointestinal toxicities were the most common side effects. No clinical radiation pneumonitis was seen. Of 15 evaluable patients, three had complete response (20%), and 12 had partial response (80%). The 6-month progression-free survival was 80%, and the 2-year overall survival was 83%. CONCLUSIONS Pemetrexed-TRC102 combined with cisplatin/radiotherapy in NS-NSCLC is safe and well tolerated. The recommended phase II dose is 200 mg TRC102 along with cisplatin-pemetrexed. No additional safety signal was seen beyond the expected CRT risks. A phase II trial, integrating post-CRT immunotherapy with this aggressive DNA-damaging regimen, is warranted.
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Affiliation(s)
- Tithi Biswas
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio.,Correspondence Author: Tithi Biswas, Department of Radiation Oncology, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106. Phone: 216-704-3088; E-mail:
| | - Afshin Dowlati
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | | | - John J. Pink
- Case Western Reserve University, Cleveland, Ohio.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | | | | | - Pingfu Fu
- Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Shufen Cao
- Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Debora S. Bruno
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | - David L. Bajor
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | - Monaliben Patel
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Case Western Reserve University, Cleveland, Ohio
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,School of Medicine, Case Western Reserve University, Cleveland, Ohio
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4
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Smith JN, Dawson DM, Christo KF, Jogasuria AP, Cameron MJ, Antczak MI, Ready JM, Gerson SL, Markowitz SD, Desai AB. 15-PGDH inhibition activates the splenic niche to promote hematopoietic regeneration. JCI Insight 2021; 6:143658. [PMID: 33600377 PMCID: PMC8026178 DOI: 10.1172/jci.insight.143658] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
The splenic microenvironment regulates hematopoietic stem and progenitor cell (HSPC) function, particularly during demand-adapted hematopoiesis; however, practical strategies to enhance splenic support of transplanted HSPCs have proved elusive. We have previously demonstrated that inhibiting 15-hydroxyprostaglandin dehydrogenase (15-PGDH), using the small molecule (+)SW033291 (PGDHi), increases BM prostaglandin E2 (PGE2) levels, expands HSPC numbers, and accelerates hematologic reconstitution after BM transplantation (BMT) in mice. Here we demonstrate that the splenic microenvironment, specifically 15-PGDH high-expressing macrophages, megakaryocytes (MKs), and mast cells (MCs), regulates steady-state hematopoiesis and potentiates recovery after BMT. Notably, PGDHi-induced neutrophil, platelet, and HSPC recovery were highly attenuated in splenectomized mice. PGDHi induced nonpathologic splenic extramedullary hematopoiesis at steady state, and pretransplant PGDHi enhanced the homing of transplanted cells to the spleen. 15-PGDH enzymatic activity localized specifically to macrophages, MK lineage cells, and MCs, identifying these cell types as likely coordinating the impact of PGDHi on splenic HSPCs. These findings suggest that 15-PGDH expression marks HSC niche cell types that regulate hematopoietic regeneration. Therefore, PGDHi provides a well-tolerated strategy to therapeutically target multiple HSC niches, promote hematopoietic regeneration, and improve clinical outcomes of BMT.
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Affiliation(s)
- Julianne Np Smith
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
| | - Dawn M Dawson
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
| | - Kelsey F Christo
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
| | - Alvin P Jogasuria
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
| | - Mark J Cameron
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
| | - Monika I Antczak
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Joseph M Ready
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Stanton L Gerson
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA.,University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Sanford D Markowitz
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA.,University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Amar B Desai
- Department of Medicine and Case Comprehensive Cancer Center Case Western Reserve University, Cleveland, Ohio, USA
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5
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Gerson SL, Shaw K, Harrison LB, Holcombe RF, Hutchins L, Lee CB, Loehrer PJ, Mulkerin D, Purcell WT, Teston L, Weiner LM, Weiner GJ. Status of Cancer Care at Network Sites of the Nation's Academic Cancer Centers. J Natl Compr Canc Netw 2021; 19:726-732. [PMID: 33706258 DOI: 10.6004/jnccn.2020.7656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cancer care coordination across major academic medical centers and their networks is evolving rapidly, but the spectrum of organizational efforts has not been described. We conducted a mixed-methods survey of leading cancer centers and their networks to document care coordination and identify opportunities to improve geographically dispersed care. METHODS A mixed-methods survey was sent to 91 cancer centers in the United States and Canada. We analyzed the number and locations of network sites; access to electronic medical records (EMRs); clinical research support and participation at networks; use of patient navigators, care paths, and quality measures; and physician workforce. Responses were collected via Qualtrics software between September 2017 and December 2018. RESULTS Of the 69 responding cancer centers, 74% were NCI-designated. Eighty-seven percent of respondents were part of a matrix health system, and 13% were freestanding. Fifty-six reported having network sites. Forty-three respondents use navigators for disease-specific populations, and 24 use them for all patients. Thirty-five respondents use ≥1 types of care path. Fifty-seven percent of networks had complete, integrated access to their main center's EMRs. Thirty-nine respondents said the main center provides funding for clinical research at networks, with 22 reporting the main center provides all funding. Thirty-five said the main center provided pharmacy support at the networks, with 15 indicating the main center provides 100% pharmacy support. Certification program participation varied extensively across networks. CONCLUSIONS The data show academic cancer centers have extensive involvement in network cancer care, often extending into rural communities. Coordinating care through improved clinical trial access and greater use of patient navigation, care paths, coordinated EMRs, and quality measures is likely to improve patient outcomes. Although it is premature to draw firm conclusions, the survey results are appropriate for mapping next steps and data queries.
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Affiliation(s)
- Stanton L Gerson
- 1Case Comprehensive Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Kate Shaw
- 2Association of American Cancer Institutes, Pittsburgh, Pennsylvania
| | | | - Randall F Holcombe
- 4University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Laura Hutchins
- 5UAMS Winthrop P. Rockefeller Cancer Institute, Little Rock, Arkansas
| | - Carrie B Lee
- 6UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Patrick J Loehrer
- 7Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana
| | - Daniel Mulkerin
- 8University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | | | - Lois Teston
- 10Seidman Cancer Center, University Hospitals Cleveland Medical Center and Case Comprehensive Cancer Center, Cleveland, Ohio
| | - Louis M Weiner
- 11Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; and
| | - George J Weiner
- 12Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
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6
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Nguyen MT, Moiani D, Ahmed Z, Arvai AS, Namjoshi S, Shin DS, Fedorov Y, Selvik EJ, Jones DE, Pink J, Yan Y, Laverty DJ, Nagel ZD, Tainer JA, Gerson SL. An effective human uracil-DNA glycosylase inhibitor targets the open pre-catalytic active site conformation. Prog Biophys Mol Biol 2021; 163:143-159. [PMID: 33675849 PMCID: PMC8722130 DOI: 10.1016/j.pbiomolbio.2021.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
Human uracil DNA-glycosylase (UDG) is the prototypic and first identified DNA glycosylase with a vital role in removing deaminated cytosine and incorporated uracil and 5-fluorouracil (5-FU) from DNA. UDG depletion sensitizes cells to high APOBEC3B deaminase and to pemetrexed (PEM) and floxuridine (5-FdU), which are toxic to tumor cells through incorporation of uracil and 5-FU into DNA. To identify small-molecule UDG inhibitors for pre-clinical evaluation, we optimized biochemical screening of a selected diversity collection of >3,000 small-molecules. We found aurintricarboxylic acid (ATA) as an inhibitor of purified UDG at an initial calculated IC50 < 100 nM. Subsequent enzymatic assays confirmed effective ATA inhibition but with an IC50 of 700 nM and showed direct binding to the human UDG with a KD of <700 nM. ATA displays preferential, dose-dependent binding to purified human UDG compared to human 8-oxoguanine DNA glycosylase. ATA did not bind uracil-containing DNA at these concentrations. Yet, combined crystal structure and in silico docking results unveil ATA interactions with the DNA binding channel and uracil-binding pocket in an open, destabilized UDG conformation. Biologically relevant ATA inhibition of UDG was measured in cell lysates from human DLD1 colon cancer cells and in MCF-7 breast cancer cells using a host cell reactivation assay. Collective findings provide proof-of-principle for development of an ATA-based chemotype and “door stopper” strategy targeting inhibitor binding to a destabilized, open pre-catalytic glycosylase conformation that prevents active site closing for functional DNA binding and nucleotide flipping needed to excise altered bases in DNA.
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Affiliation(s)
- My T Nguyen
- Case Western Reserve University, Department of Biochemistry, Cleveland, OH, 44106, USA
| | - Davide Moiani
- Departments of Cancer Biology and of Molecular & Cellular Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd, Houston, TX, 77030, USA
| | - Zamal Ahmed
- Departments of Cancer Biology and of Molecular & Cellular Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd, Houston, TX, 77030, USA
| | - Andrew S Arvai
- Integrative Structural & Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Sarita Namjoshi
- Departments of Cancer Biology and of Molecular & Cellular Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd, Houston, TX, 77030, USA
| | - Dave S Shin
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Yuriy Fedorov
- Case Small-Molecule Screening Core, School of Medicine, Case Western Reserve University, Cleveland, OH, 44016, USA
| | - Edward J Selvik
- Department of Pharmaceutical Sciences, The University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA
| | - Darin E Jones
- Department of Pharmaceutical Sciences, The University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR, 72205, USA
| | - John Pink
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Yan Yan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Daniel J Laverty
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA
| | - Zachary D Nagel
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA
| | - John A Tainer
- Departments of Cancer Biology and of Molecular & Cellular Oncology, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd, Houston, TX, 77030, USA; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA.
| | - Stanton L Gerson
- Case Western Reserve University, Department of Biochemistry, Cleveland, OH, 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA.
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7
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Sweet DR, Vasudevan NT, Fan L, Booth CE, Keerthy KS, Liao X, Vinayachandran V, Takami Y, Tugal D, Sharma N, Chan ER, Zhang L, Qing Y, Gerson SL, Fu C, Wynshaw-Boris A, Sangwung P, Nayak L, Holvoet P, Matoba K, Lu Y, Zhou G, Jain MK. Myeloid Krüppel-like factor 2 is a critical regulator of metabolic inflammation. Nat Commun 2020; 11:5872. [PMID: 33208733 PMCID: PMC7674440 DOI: 10.1038/s41467-020-19760-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/03/2019] [Accepted: 10/23/2020] [Indexed: 12/20/2022] Open
Abstract
Substantial evidence implicates crosstalk between metabolic tissues and the immune system in the inception and progression of obesity. However, molecular regulators that orchestrate metaflammation both centrally and peripherally remains incompletely understood. Here, we identify myeloid Krüppel-like factor 2 (KLF2) as an essential regulator of obesity and its sequelae. In mice and humans, consumption of a fatty diet downregulates myeloid KLF2 levels. Under basal conditions, myeloid-specific KLF2 knockout mice (K2KO) exhibit increased feeding and weight gain. High-fat diet (HFD) feeding further exacerbates the K2KO metabolic disease phenotype. Mechanistically, loss of myeloid KLF2 increases metaflammation in peripheral and central tissues. A combination of pair-feeding, bone marrow-transplant, and microglial ablation implicate central and peripheral contributions to K2KO-induced metabolic dysfunction observed. Finally, overexpression of myeloid KLF2 protects mice from HFD-induced obesity and insulin resistance. Together, these data establish myeloid KLF2 as a nodal regulator of central and peripheral metabolic inflammation in homeostasis and disease. Inflammation contributes to the development of metabolic disease through incompletely understood mechanisms. Here the authors report that deletion of the transcription factor KLF2 in myeloid cells leads to increased feeding and weight gain in mice with concomitant peripheral and central tissue inflammation, while overexpression protects against diet-induced metabolic disease.
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Affiliation(s)
- David R Sweet
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Neelakantan T Vasudevan
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Liyan Fan
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Chloe E Booth
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Komal S Keerthy
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Xudong Liao
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Vinesh Vinayachandran
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Yoichi Takami
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Derin Tugal
- Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Nikunj Sharma
- DBPAP/OVRR/CBER, Food and Drug Administration, Silver Spring, MD, USA
| | - E Ricky Chan
- Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Lilei Zhang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Yulan Qing
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.,National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, USA
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.,National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, USA
| | - Chen Fu
- Department of Genetics and Genome Sciences, Case Western Reserve University, and University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Anthony Wynshaw-Boris
- Department of Genetics and Genome Sciences, Case Western Reserve University, and University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Panjamaporn Sangwung
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH, USA
| | - Lalitha Nayak
- Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Paul Holvoet
- Experimental Cardiology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Keiichiro Matoba
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Yuan Lu
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Charles River Laboratories, Ashland, OH, USA
| | - Guangjin Zhou
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Mukesh K Jain
- Case Cardiovascular Research Institute, Case Western Reserve University, and Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
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8
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Patel R, Zhang L, Desai A, Hoenerhoff MJ, Kennedy LH, Radivoyevitch T, La Tessa C, Gerson SL, Welford SM. Protons and High-Linear Energy Transfer Radiation Induce Genetically Similar Lymphomas With High Penetrance in a Mouse Model of the Aging Human Hematopoietic System. Int J Radiat Oncol Biol Phys 2020; 108:1091-1102. [PMID: 32629081 DOI: 10.1016/j.ijrobp.2020.06.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Humans are exposed to charged particles in different scenarios. The use of protons and high-linear energy transfer (LET) in cancer treatment is steadily growing. In outer space, astronauts will be exposed to a mixed radiation field composed of both protons and heavy ions, in particularly the long-term space missions outside of earth's magnetosphere. Thus, understanding the radiobiology and transforming potential of these types of ionizing radiation are of paramount importance. METHODS AND MATERIALS We examined the effect of 10 or 100 cGy of whole-body doses of protons or 28Si ions on the hematopoietic system of a genetic model of aging based on recent studies that showed selective loss of the MLH1 protein in human hematopoietic stems with age. RESULTS We found that Mlh1 deficient animals are highly prone to develop lymphomas when exposed to either low doses of protons or 28Si ions. The lymphomas that develop are genetically indistinguishable, in spite of different types of damage elicited by low- and high-LET radiation. RNA sequencing analyses reveal similar gene expression patterns, similar numbers of altered genes, similar numbers of single nucleotide variants and insertions and deletions, and similar activation of known leukemogenic loci. CONCLUSIONS Although the incidence of malignancy is related to radiation quality, and increased due to loss of Mlh1, the phenotype of the tumors is independent of LET.
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Affiliation(s)
- Rutulkumar Patel
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Luchang Zhang
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Amar Desai
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Mark J Hoenerhoff
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Lucy H Kennedy
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Tomas Radivoyevitch
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Chiara La Tessa
- University of Trento, Trento, Italy; Trento Institute for Fundamental Physics and Applications TIFPA-INFN, Trento, Italy
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Scott M Welford
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida; Department of Radiation Oncology, University of Miami, Miami, Florida.
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9
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Eads JR, Krishnamurthi SS, Saltzman J, Bokar JA, Savvides P, Meropol NJ, Gibbons J, Koon H, Sharma N, Rogers L, Pink JJ, Xu Y, Beumer JH, Riendeau J, Fu P, Gerson SL, Dowlati A. Phase I clinical trial of temozolomide and methoxyamine (TRC-102), an inhibitor of base excision repair, in patients with advanced solid tumors. Invest New Drugs 2020; 39:142-151. [PMID: 32556884 DOI: 10.1007/s10637-020-00962-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 05/17/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022]
Abstract
Temozolomide (TMZ) generates DNA adducts that are repaired by direct DNA and base excision repair mechanisms. Methoxyamine (MX, TRC-102) potentiates TMZ activity by binding to apurinic and apyrimidinic (AP) sites after removal of N3-methyladenine and N7-methylguanine, inhibiting site recognition of AP endonuclease. We conducted a phase I trial to determine the maximum tolerated dose and dose-limiting toxicities (DLTs) of intravenous MX when given with oral TMZ. Patients with advanced solid tumors and progression on standard treatment were enrolled to a standard 3 + 3 dose escalation trial assessing escalating doses of TMZ and MX. Tumor response was assessed per RECIST and adverse events (AEs) by CTCAEv3. Pharmacokinetics (PK) of MX and COMET assays on peripheral blood mononuclear cells were performed. 38 patients were enrolled-median age 59.5 years (38-76), mean number of cycles 2.9 [1-13]. No DLTs were observed. Cycle 1 grade 3 AEs included fatigue, lymphopenia, anemia, INR, leukopenia, neutropenia, allergic reaction, constipation, psychosis and paranoia. Cycle 2-13 grade 4 AEs included thrombocytopenia and confusion. A partial response was seen in 1 patient with a pancreatic neuroendocrine tumor (PNET) and six additional patients, each with different tumor types, demonstrated prolonged stable disease. MX PK was linear with dose and was not affected by concomitant TMZ. TMZ 200 mg/m2 daily × 5 may be safely administered with MX 150 mg/m2 intravenously once on day 1 with minimal toxicity. Further studies assessing this drug combination in select tumor types where temozolomide has activity may be warranted.
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Affiliation(s)
- Jennifer R Eads
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Smitha S Krishnamurthi
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Joel Saltzman
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Joseph A Bokar
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Panos Savvides
- St. Joseph's Hospital and Medical Center, University of Arizona Comprehensive Cancer Center, University of Arizona, Phoenix, AZ, USA
| | - Neal J Meropol
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- Flatiron Health, New York, NY, USA
| | - Joseph Gibbons
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Henry Koon
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Neelesh Sharma
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Lisa Rogers
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - John J Pink
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Yan Xu
- Case Comprehensive Cancer Center, Cleveland State University, Cleveland, OH, USA
| | - Jan H Beumer
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Riendeau
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Pingfu Fu
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA
| | - Afshin Dowlati
- Case Comprehensive Cancer Center, Case Western Reserve University, University Hospitals Seidman Cancer Center, 11100 Euclid Avenue, Lakeside 1200, Cleveland, OH, 44106, USA.
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10
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Chamoun K, De Lima MJ, Caimi PF, Fu P, Cao S, Otegbeye F, Patel S, Ali N, Gerson SL, Boughan KM, Kyasaram RK, Malek E. Insurance status and survival of multiple myeloma (MM) patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.18_suppl.lba107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
LBA107 Background: MM is often treated with oral antineoplastic medications (OAM). OAM prices have been rapidly escalating and there are well-described issues with affordability (Shih et al. JCO 2017). We therefore hypothesized that insurance status influences MM patients (pts) survival and interrogated the National Cancer Database (NCDB) to test this hypothesis. Methods: NCDB houses data on 70% of cancer pts in the USA. Data from 117,926 MM pts diagnosed between year 2005 and 2014 was analyzed. Primary outcome was overall survival (OS) which was analyzed using Kaplan-Meier method and Cox model. Results: Median age at diagnosis was 67 years (19-90); 55% were males. 57% of pts lived in areas where the median income was < $46k/year (individual income data was not available); Primary insurance was Medicare (52%), private insurance (35%) or Medicaid (5%), and 3% were uninsured. 40% were treated in academic institutions. Median follow up was 30 months (0-145). By univariate analysis, better OS was observed in pts with primary MM, lower Charlson Comorbidity Index (CCI), treatment in academic institutions, higher median regional income, or private insurance ( p<0.0001 for all). Median age of pts on Medicare, private insurance, Medicaid, or those without insurance was 74, 57, 58, and 57 years, respectively. When restricting the analysis to pts ≥ 65 years old, pts with private insurance had longer OS compared to Medicare pts (p<0.0001). The table shows the results of MV analysis. Conclusions: Insurance type and regional income are associated with MM survival. This may be related to affordability of OAM and merits further investigation. [Table: see text]
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Affiliation(s)
- Kamal Chamoun
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Marcos J.G. De Lima
- University Hospitals Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH
| | - Paolo Fabrizio Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Pingfu Fu
- Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, OH
| | - Shufen Cao
- Department of Biostats and Epidemiology, Case Western Reserve University, Cleveland, OH
| | - Folashade Otegbeye
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Seema Patel
- Adult Malignant Hematology, Seidman Cancer Center, Cleveland, OH
| | - Naveed Ali
- Case Western Reserve University Seidman Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Kirsten M Boughan
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | | | - Ehsan Malek
- Division of Hematology and Oncology, University of Cincinnati, Cincinnati, OH
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11
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Malek E, Chamoun K, Caimi PF, Gerson SL, Tomlinson BK, Patel S, De Lima MJ, Fu P. Comparable survival of African-Americans and Caucasian patients with multiple myeloma: A hospital-based study including 117,926 patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e18170] [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
e18170 Background: Multiple Myeloma (MM) counts the most common hematologic malignance among African-Americans with twice the incidence of whites. The outcomes have greatly improved during the last 15 years, however with changing demographics there is an increasing focus on how various subgroups, based on race and ethnicity may be benefiting from survival improvement in MM. Previous studies showed that if access to care is assured, racial disparity-driven differences in outcome may be mitigated. Here, we conducted a study using the National Cancer Data Base (NCDB), which covers more than 70% of cancer pts in the USA, to evaluate survival patterns by race. Methods: MM patients (pts) diagnosed between years 2005 and 2014 and reported to the NCDB were analyzed (n = 117926). Pts were divided in three groups based on the year (y) of diagnosis (2005-07, 2008-10 and 2011-14). Kaplan-Meier method and log-rank test were used for overall survival analysis (OS). The effect size, hazard ratio (HR), of race on OS was estimated by Cox model adjusted by confounders. Results: Median age at diagnosis was 67 y (19 - 90); 55% were males. Median follow up was 30 months (m) (0 - 145). Median OS for white and black pts was 46 m (95% CI: 45.4 - 46.6) and 50.6 m (95% CI: 49.1 - 52.3), respectively (p < 0.0001). Black had longer OS compared to white pts by univariable analysis in all three study periods, noticeably with a trend toward higher survival benefit in most recent years. After adjusting for a variety of factors there was no statistically significant difference between the two racial groups (Table). Conclusions: This large study confirmed that after adjusting for confounding factors survival is similar for white and black MM pts. [Table: see text]
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Affiliation(s)
- Ehsan Malek
- Division of Hematology and Oncology, University of Cincinnati, Cincinnati, OH
| | - Kamal Chamoun
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Paolo Fabrizio Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Ben Kent Tomlinson
- Adult Hematologic Malignancies and Stem Cell Transplant Section, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH
| | - Seema Patel
- Adult Malignant Hematology, Seidman Cancer Center, Cleveland, OH
| | - Marcos J.G. De Lima
- University Hospitals Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH
| | - Pingfu Fu
- Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, OH
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12
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Sloan AE, Roger L, Murphy C, Reese J, Lazarus HM, Dropulic B, Gerson SL. A phase I study of MGMT-P140K transfected hematopoetic progenitor cells (HPC) combined with TMZ/O6BG dose escalation for newly diagnosed, MGMT unmethylated glioblastoma: Tolerance and evidence of survival benefit. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.2062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
2062 Background: GBM is the most common malignant brain tumor with a median survival of 15 months despite surgery and radio-chemotherapy. The most important mechanism of TMZ resistance is the O6-methylguanine-DNA methyltransferase (MGMT) gene which repairs temozolamide-induced DNA methylation. The MGMT inhibitor O6-benzylguanine (BG) demonstrated efficacy in depleting MGMT and maximizing tumor response in early phase clinical trials. However, MGMT expression is also low in hematopoietic cells, so this approach led to unacceptable bone marrow toxicity and thus has been abandoned. We hypothesized that chemoprotection of hematopoietic HPC with an MGMT mutant (MGMT-P140K) characterized by normal methyltransferase activity, coupled with low affinity for BG would maximize anti-tumor response while enabling patients to tolerate TMZ & BG dose escalation with minimal toxicity. A phase I trial was performed to test this hypothesis. Methods: 10 adults with newly diagnosed MGMT unmethylated, IDH-1 WT, GBM underwent standard surgery and radiation, followed by transplantation with autologous CD34+ HPC engineered to express MGMT-P140K using a lentiviral vector. We tested tolerance and efficacy of three different paradigms for conditioning bone marrow and re-infusion of HPC. To assess chemo-protection, patients’ blood counts and transgene marking were monitored during and after treatment, as was toxicity, response, and progression-free and overall survival. Results: Treatment was moderately toxic with 3/10 patients suffering grade 3-4 hematologic toxicity; no high grade non-hematologic toxicity was observed . Viral transduction rates ranged from 3-75% and were clearly improved in Arm III utilizing BCNU conditioning and intra-patient dose escalation of TMZ/O6GB. In patients tolerating 3 cycles or more, P140K-MGMT gene markings in peripheral blood and bone marrow cells increased 3-26-fold with only mild (Grade 2-3) mylosuppression consistent with chemo-protection as hypothesized. Median PFS and OS was 22 and 31 months respectfully, and three patients in Arm III are healthy and progression free at 36-39 months. OS exceeded RPA predicted survival by 3.3-fold suggesting clinical benefit. Viral insertion site analysis demonstrate lack of clonal dominance. Conclusions: P140K-MGMT transfected HPC enables TMZ/ BG dose escalation with acceptable toxicity and increased survival in a small cohort of selected patients. A phase II study is ongoing. Clinical trial information: NCT01269424.
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Affiliation(s)
| | | | | | - Jane Reese
- Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Boro Dropulic
- Lentigen Technology Inc., A Miltenyi Biotec Company, Gaithersburg, MD
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
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13
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Chamoun K, Kyasaram RK, Metheny LL, Gallogly M, Caimi PF, Gerson SL, De Lima MJ, Malek E. Demographic characteristics of smoldering multiple myeloma patients: A hospital-based study including 11,643 patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13064] [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
e13064 Background: SMM is the requisite asymptomatic phase that precedes Multiple Myeloma (MM). Observation until progression to MM has been the standard of care. However, the improvement in risk assessment and utility of chemoprevention strategies stemmed from large trials (e.g. QUIREDEX and E3A06) is beginning to shift the paradigm toward early detection of SMM by implementing screening strategies (e.g., PROMIS study). Lack of specific ICD code for SMM has been a major problem in epidemiologic studies aiming at characterizing the demographics and temporal dynamics of SMM. Here, we used the National Cancer Data Base (NCDB), which covers more than 70% of cancer pts in the USA, for this purpose. Methods: NCDB data from year 2010 to 2014 was analyzed. We defined SMM as pts with ICD-O 9732 that were placed on active surveillance or did not receive any therapy in the first 3 months (m) after diagnosis (Ravindran et al. Blood Cancer J. 2016). Institution size was categorized as small, medium and large if they reported < 10, 10-50, and > 50 cases per year, respectively. Results: Out of a total of 68234 MM pts, we identified 11643 (17%) with SMM. Median follow up was 32 m (0 - 85). Median age was 65 years (26 - 90), 52% were males, 71% were white and 24% were black. Median survival was 77.7 and 49.8 m for pts with SMM and MM, respectively ( p= 0.001). Median age at diagnosis of SMM was 62 and 66 years in blacks and whites, respectively ( p= 0.01). Over 87% of pts were diagnosed in small and medium size institutions (38% and 49%, respectively). Medicare was the main insurance payer (57%), followed by private insurance (32%) and Medicaid (5%), and 3% were not insured. The majority of pts (59.5%) lived in areas where the median income is less than $46K/year. Median distance traveled to treatment facility was 8.5 miles. During the first two years from diagnosis 18% needed treatment which is compatible with known estimated 10% per year risk of progression from SMM to MM. Conclusions: This large study of over 11,000 SMM pts highlights the national demographics of SMM diagnosed between years 2010 and 2014. Our results indicate that targeting small and medium size facilities should be an essential part of SMM screening strategies.
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Affiliation(s)
- Kamal Chamoun
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | | | - Leland L. Metheny
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Molly Gallogly
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Paolo Fabrizio Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Marcos J.G. De Lima
- University Hospitals Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH
| | - Ehsan Malek
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
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14
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Ye R, Kundrapu S, Gerson SL, Driscoll JJ, Beck R, Ali N, Landgren O, VanHeeckeren W, Luo G, Kroger N, Caimi P, De Lima M, Malek E. Immune Signatures Associated With Clonal Isotype Switch After Autologous Stem Cell Transplantation for Multiple Myeloma. Clin Lymphoma Myeloma Leuk 2019; 19:e213-e220. [PMID: 30878316 PMCID: PMC7444684 DOI: 10.1016/j.clml.2018.12.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/03/2018] [Revised: 11/19/2018] [Accepted: 12/28/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND High-dose chemotherapy and autologous stem cell transplantation (ASCT) are integral components of the overall treatment for patients with multiple myeloma (MM) aged ≤ 65 years. The emergence of oligoclonal immunoglobulin bands (ie, immunoglobulins differing from those originally identified at diagnosis [termed clonal isotype switch (CIS)]) has been reported in patients with MM after high-dose chemotherapy followed by autologous stem cell transplantation. However, the clinical relevance and the correlation with immune reconstitution remains unclear. PATIENTS AND METHODS Patients with MM who had undergone ASCT from 2007 to 2016 were included in the present study. The percentage of natural killer cells, B-cells, and T-cells was measured using flow cytometry in pre- and post-ASCT bone marrow samples. CIS was defined as the appearance of a new serum monoclonal spike on serum protein electrophoresis and immunofixation that differed from original heavy or light chain detected at diagnosis. RESULTS A retrospective analysis of 177 patients with MM who had undergone ASCT detected CIS in 39 (22%). CIS after ASCT correlated with improved progression-free survival (52.2 vs. 36.6 months; P = .21) and overall survival (75.1 vs. 65.4 months; P = .021). Patients with a relapse had an isotype that differed from a CIS, confirming the benign nature of this phenomenon. CIS was also associated with lower CD8 T-cell percentages and a greater CD4/CD8 ratio (2.8 vs. 0.2; P = .001) compared with patients who did not demonstrate a CIS, suggestive of more profound T-cell immune reconstitution in this group. CONCLUSION Taken together, our data have demonstrated that a CIS is a benign phenomenon and correlates with a reduced disease burden and enriched immune repertoire beyond the B-cell compartment.
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Affiliation(s)
- Rebecca Ye
- Department of Medicine, New York University School of Medicine, New York, NY
| | - Sirisha Kundrapu
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - James J Driscoll
- Division of Hematology and Oncology, The Vontz Center for Molecular Studies, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Rose Beck
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Naveed Ali
- Adult Hematologic Malignancies and Stem Cell Transplant Program, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ola Landgren
- Myeloma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Willem VanHeeckeren
- Division of Hematology and Oncology, University Hospital Cleveland Medical Center, Cleveland, OH
| | - George Luo
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Nicolaus Kroger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paolo Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Program, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Marcos De Lima
- Adult Hematologic Malignancies and Stem Cell Transplant Program, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH; Case Western Reserve University School of Medicine, Cleveland, OH
| | - Ehsan Malek
- Adult Hematologic Malignancies and Stem Cell Transplant Program, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH; Case Western Reserve University School of Medicine, Cleveland, OH.
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15
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Srinivasan SS, Seenivasan R, Condie A, Gerson SL, Wang Y, Burda C. Gold Nanoparticle-Based Fluorescent Theranostics for Real-Time Image-Guided Assessment of DNA Damage and Repair. Int J Mol Sci 2019; 20:ijms20030471. [PMID: 30678294 PMCID: PMC6387448 DOI: 10.3390/ijms20030471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/11/2022] Open
Abstract
Chemotherapeutic dosing, is largely based on the tolerance levels of toxicity today. Molecular imaging strategies can be leveraged to quantify DNA cytotoxicity and thereby serve as a theranostic tool to improve the efficacy of treatments. Methoxyamine-modified cyanine-7 (Cy7MX) is a molecular probe which binds to apurinic/apyrimidinic (AP)-sites, inhibiting DNA-repair mechanisms implicated by cytotoxic chemotherapies. Herein, we loaded (Cy7MX) onto polyethylene glycol-coated gold nanoparticles (AuNP) to selectively and stably deliver the molecular probe intravenously to tumors. We optimized the properties of Cy7MX-loaded AuNPs using optical spectroscopy and tested the delivery mechanism and binding affinity using the DLD1 colon cancer cell line in vitro. A 10:1 ratio of Cy7MX-AuNPs demonstrated a strong AP site-specific binding and the cumulative release profile demonstrated 97% release within 12 min from a polar to a nonpolar environment. We further demonstrated targeted delivery using imaging and biodistribution studies in vivo in an xenografted mouse model. This work lays a foundation for the development of real-time molecular imaging techniques that are poised to yield quantitative measures of the efficacy and temporal profile of cytotoxic chemotherapies.
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Affiliation(s)
- Shriya S Srinivasan
- Center for Chemical Dynamics and Nanomaterials Research, Department of Chemistry, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Rajesh Seenivasan
- Center for Chemical Dynamics and Nanomaterials Research, Department of Chemistry, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Allison Condie
- Department of Radiology, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Stanton L Gerson
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA.
| | - Yanming Wang
- Department of Radiology, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
| | - Clemens Burda
- Center for Chemical Dynamics and Nanomaterials Research, Department of Chemistry, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
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Abstract
Cancer stem cells (CSCs) are a subpopulation of cells within tumors that possess the stem cell characteristics of self-renewal, quiescence, differentiation, and the ability to recapitulate the parental tumor when transplanted into a host. CSCs are correlated with poor clinical outcome due to their contribution to chemotherapy resistance and metastasis. Multiple cell surface and enzymatic markers have been characterized to identify CSCs within a heterogeneous tumor, and here we summarize ongoing preclinical and clinical efforts to therapeutically target these cells and improve patient outcomes. Stem Cells Translational Medicine 2019;8:75-81.
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Affiliation(s)
- Amar Desai
- Department of MedicineCase Western Reserve UniversityClevelandOhioUSA
- Case Comprehensive Cancer CenterCase Western Reserve UniversityClevelandOhioUSA
| | - Yan Yan
- Department of MedicineCase Western Reserve UniversityClevelandOhioUSA
- Case Comprehensive Cancer CenterCase Western Reserve UniversityClevelandOhioUSA
| | - Stanton L. Gerson
- Department of MedicineCase Western Reserve UniversityClevelandOhioUSA
- Case Comprehensive Cancer CenterCase Western Reserve UniversityClevelandOhioUSA
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17
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Patel R, Gerson SL, Welford SM. Abstract 5053: Mlh1 deficiency increases the risk of hematopoietic malignancies post low- and high-LET radiation exposure. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5053] [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
Introduction/Aim: Natural sources of radiation in space include galactic cosmic rays (GCR), solar energetic particles and trapped energetic particles in a planetary magnetic field. These sources are difficult to shield, thus posing significant health risks to astronauts on long-term inter-planetary missions. During space travel, genomic instability is a major concern where astronauts are exposed to potent sources of ionizing radiation, namely GCR consisting of high energy and charged atomic nuclei. In particular, hematopoietic stem cells (HSCs) are susceptible to internal and external stresses that threaten the integrity of the cell, and accumulation of damage can lead to HSCs dysfunction and oncogenesis. Recent data has demonstrated that humans accumulate microsatellite instability with acquired loss of MLH1 protein in HSCs as a function of age. Therefore, we hypothesized that high-LET (linear energy transfer) radiation characteristic of the GCR that will confront astronauts on space missions will damage HSCs and contribute to induction and progression of hematopoietic malignancies. Methods: To study this hypothesis, we employed a DNA mismatch repair deficient mouse model (Mlh1+/-) to study the effects of low-LET γ-ray vs high-LET 56Fe ion radiation on HSCs of potential astronaut population. In vitro colony forming unit assays and in vivo complete blood count (CBC) plus competitive repopulation assays were carried out to understand harmful impact of radiation and Mlh1 deficiency on HSCs functions. In addition, mice were followed up to 18 months post irradiation to observe HSC malignancies in Mlh1+/+ and Mlh1+/- mice. Results: HSC short- and long-term functional assays showed defects in HSCs/HPCs function caused by irradiation, but not depending on Mlh1 status. CBC 5 and 9 months post irradiation demonstrated no impact of irradiation or Mlh1 status on HSC differentiation. However, 56Fe-ion irradiated Mlh1+/- mice showed a significant higher incidence of lymphomagenesis compared to γ-rays irradiated and sham-irradiated Mlh1+/- mice. In addition, immunohistochemistry analysis of lymphomas displayed significant higher incidence of T-cell rich B-cell lymphomas. Conclusion: Thus, the data show that MMR defects in HSCs leads to sensitization to radiation induced hematopoietic malignancy, and that radiation quality effects exacerbate the sensitivity. The findings could have profound effects on astronaut screening and designing better mitigators for space missions.
Citation Format: Rutulkumar Patel, Stanton L. Gerson, Scott M. Welford. Mlh1 deficiency increases the risk of hematopoietic malignancies post low- and high-LET radiation exposure [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5053.
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Abstract
The DNA damage response (DDR) is a series of pathways and processes required to repair lesions to DNA. These pathways range from repairing strand breaks to the double helix, damaged bases formed after oxidation or deamination, inaccurate DNA replication resulting in mispaired base alignment, intrastrand crosslinks that trigger cell death, and a plethora of other genomic insults. The DDR is believed to be a critical component of radio and chemoresistance in many cancers as well, with the tumor's ability to repair therapy induced damage being an important tool used to survive traditional chemotherapeutic agents. Here we summarize advances made in specifically targeting DDR proteins in cancer therapy and project on the potential breakthroughs and pitfalls to arise as the field progresses.
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Affiliation(s)
- Amar Desai
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Yan Yan
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Stanton L Gerson
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA.
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Desai A, Zhang Y, Park Y, Dawson DM, Larusch GA, Kasturi L, Wald D, Ready JM, Gerson SL, Markowitz SD. A second-generation 15-PGDH inhibitor promotes bone marrow transplant recovery independently of age, transplant dose and granulocyte colony-stimulating factor support. Haematologica 2018; 103:1054-1064. [PMID: 29472361 PMCID: PMC6058768 DOI: 10.3324/haematol.2017.178376] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 08/09/2017] [Accepted: 02/20/2018] [Indexed: 01/09/2023] Open
Abstract
Hematopoietic stem cell transplantation following myeloablative chemotherapy is a curative treatment for many hematopoietic malignancies. However, profound granulocytopenia during the interval between transplantation and marrow recovery exposes recipients to risks of fatal infection, a significant source of transplant-associated morbidity and mortality. We have previously described the discovery of a small molecule, SW033291, that potently inhibits the prostaglandin degrading enzyme 15-PGDH, increases bone marrow prostaglandin E2, and accelerates hematopoietic recovery following murine transplant. Here we describe the efficacy of (+)-SW209415, a second-generation 15-PGDH inhibitor, in an expanded range of models relevant to human transplantation. (+)-SW209415 is 10,000-fold more soluble, providing the potential for intravenous delivery, while maintaining potency in inhibiting 15-PGDH, increasing in vivo prostaglandin E2, and accelerating hematopoietic regeneration following transplantation. In additional models, (+)-SW209415: (i) demonstrated synergy with granulocyte colony-stimulating factor, the current standard of care; (ii) maintained efficacy as transplant cell dose was escalated; (iii) maintained efficacy when transplant donors and recipients were aged; and (iv) potentiated homing in xenotransplants using human hematopoietic stem cells. (+)-SW209415 showed no adverse effects, no potentiation of in vivo growth of human myeloma and leukemia xenografts, and, on chronic high-dose administration, no toxicity as assessed by weight, blood counts and serum chemistry. These studies provide independent chemical confirmation of the activity of 15-PGDH inhibitors in potentiating hematopoietic recovery, extend the range of models in which inhibiting 15-PGDH demonstrates activity, allay concerns regarding potential for adverse effects from increasing prostaglandin E2, and thereby, advance 15-PGDH as a therapeutic target for potentiating hematopoietic stem cell transplantation.
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Affiliation(s)
- Amar Desai
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Yongyou Zhang
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Youngsoo Park
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Pathology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Dawn M Dawson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Gretchen A Larusch
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Lakshmi Kasturi
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - David Wald
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
- Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Joseph M Ready
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Stanton L Gerson
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sanford D Markowitz
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
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Patel R, Qing Y, Kennedy L, Yan Y, Pink J, Aguila B, Desai A, Gerson SL, Welford SM. MMR Deficiency Does Not Sensitize or Compromise the Function of Hematopoietic Stem Cells to Low and High LET Radiation. Stem Cells Transl Med 2018; 7:513-520. [PMID: 29656536 PMCID: PMC6052615 DOI: 10.1002/sctm.17-0295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 12/15/2017] [Accepted: 03/20/2018] [Indexed: 12/12/2022] Open
Abstract
One of the major health concerns on long-duration space missions will be radiation exposure to the astronauts. Outside the earth's magnetosphere, astronauts will be exposed to galactic cosmic rays (GCR) and solar particle events that are principally composed of protons and He, Ca, O, Ne, Si, Ca, and Fe nuclei. Protons are by far the most common species, but the higher atomic number particles are thought to be more damaging to biological systems. Evaluation and amelioration of risks from GCR exposure will be important for deep space travel. The hematopoietic system is one of the most radiation-sensitive organ systems, and is highly dependent on functional DNA repair pathways for survival. Recent results from our group have demonstrated an acquired deficiency in mismatch repair (MMR) in human hematopoietic stem cells (HSCs) with age due to functional loss of the MLH1 protein, suggesting an additional risk to astronauts who may have significant numbers of MMR deficient HSCs at the time of space travel. In the present study, we investigated the effects gamma radiation, proton radiation, and 56 Fe radiation on HSC function in Mlh1+/+ and Mlh1-/- marrow from mice in a variety of assays and have determined that while cosmic radiation is a major risk to the hematopoietic system, there is no dependence on MMR capacity. Stem Cells Translational Medicine 2018;7:513-520.
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Affiliation(s)
| | - Yulan Qing
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Lucy Kennedy
- Unit for Laboratory and Animal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Yan Yan
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical center and Case Western Reserve University, Cleveland, Ohio, USA
| | - John Pink
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Brittany Aguila
- Department of Biochemistry, Case Western Reserve University, Cleveland, Ohio, USA
| | - Amar Desai
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Seidman Cancer Center, University Hospitals Cleveland Medical center and Case Western Reserve University, Cleveland, Ohio, USA
| | - Scott M Welford
- Department of Radiation Oncology, Sylvester Cancer Center, University of Miami, Miami, Florida, USA
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Cohen JA, Imrey PB, Planchon SM, Bermel RA, Fisher E, Fox RJ, Bar-Or A, Sharp SL, Skaramagas TT, Jagodnik P, Karafa M, Morrison S, Reese Koc J, Gerson SL, Lazarus HM. Pilot trial of intravenous autologous culture-expanded mesenchymal stem cell transplantation in multiple sclerosis. Mult Scler 2018; 24:501-511. [PMID: 28381130 PMCID: PMC5623598 DOI: 10.1177/1352458517703802] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [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: 12/14/2022]
Abstract
BACKGROUND Mesenchymal stem cells (MSCs) exhibit immunomodulatory, tissue-protective, and repair-promoting properties in vitro and in animals. Clinical trials in several human conditions support the safety and efficacy of MSC transplantation. Published experience in multiple sclerosis (MS) is modest. OBJECTIVE To assess feasibility, safety, and tolerability and explore efficacy of autologous MSC transplantation in MS. METHODS Participants with relapsing-remitting multiple sclerosis (RRMS) or secondary progressive multiple sclerosis (SPMS), Expanded Disability Status Scale score 3.0-6.5, disease activity or progression in the prior 2 years, and optic nerve involvement were enrolled. Bone-marrow-derived MSCs were culture-expanded and then cryopreserved. After confirming fulfillment of release criteria, 1-2 × 106 MSCs/kg were thawed and administered IV. RESULTS In all, 24 of 26 screened patients were infused: 16 women and 8 men, 10 RRMS and 14 SPMS, mean age 46.5, mean Expanded Disability Status Scale score 5.2, 25% with gadolinium-enhancing magnetic resonance imaging (MRI) lesions. Mean cell dosage (requiring 1-3 passages) was 1.9 × 106 MSCs/kg (range, 1.5-2.0) with post-thaw viability uniformly ⩾95%. Cell infusion was tolerated well without treatment-related severe or serious adverse events, or evidence of disease activation. CONCLUSION Autologous MSC transplantation in MS appears feasible, safe, and well tolerated. Future trials to assess efficacy more definitively are warranted.
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Affiliation(s)
- Jeffrey A Cohen
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Peter B Imrey
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA/Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah M Planchon
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Robert A Bermel
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Elizabeth Fisher
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA/Biogen, Cambridge, MA, USA
| | - Robert J Fox
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Amit Bar-Or
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada/Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan L Sharp
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Thomai T Skaramagas
- Mellen Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Patricia Jagodnik
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Matt Karafa
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shannon Morrison
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jane Reese Koc
- Case Comprehensive Cancer Center and National Center for Regenerative Medicine, Case Western Reserve University and Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Stanton L Gerson
- Case Comprehensive Cancer Center and National Center for Regenerative Medicine, Case Western Reserve University and Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Hillard M Lazarus
- Case Comprehensive Cancer Center and National Center for Regenerative Medicine, Case Western Reserve University and Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Yan Y, Qing Y, Pink JJ, Gerson SL. Loss of Uracil DNA Glycosylase Selectively Resensitizes p53-Mutant and -Deficient Cells to 5-FdU. Mol Cancer Res 2018; 16:212-221. [PMID: 29117941 DOI: 10.1158/1541-7786.mcr-17-0215] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 04/21/2017] [Revised: 08/02/2017] [Accepted: 10/26/2017] [Indexed: 11/16/2022]
Abstract
Thymidylate synthase (TS) inhibitors including fluoropyrimidines [e.g., 5-Fluorouracil (5-FU) and 5-Fluorodeoxyuridine (5-FdU, floxuridine)] and antifolates (e.g., pemetrexed) are widely used against solid tumors. Previously, we reported that shRNA-mediated knockdown (KD) of uracil DNA glycosylase (UDG) sensitized cancer cells to 5-FdU. Because p53 has also been shown as a critical determinant of the sensitivity to TS inhibitors, we further interrogated 5-FdU cytotoxicity after UDG depletion with regard to p53 status. By analyzing a panel of human cancer cells with known p53 status, it was determined that p53-mutated or -deficient cells are highly resistant to 5-FdU. UDG depletion resensitizes 5-FdU in p53-mutant and -deficient cells, whereas p53 wild-type (WT) cells are not affected under similar conditions. Utilizing paired HCT116 p53 WT and p53 knockout (KO) cells, it was shown that loss of p53 improves cell survival after 5-FdU, and UDG depletion only significantly sensitizes p53 KO cells. This sensitization can also be recapitulated by UDG depletion in cells with p53 KD by shRNAs. In addition, sensitization is also observed with pemetrexed in p53 KO cells, but not with 5-FU, most likely due to RNA incorporation. Importantly, in p53 WT cells, the apoptosis pathway induced by 5-FdU is activated independent of UDG status. However, in p53 KO cells, apoptosis is compromised in UDG-expressing cells, but dramatically elevated in UDG-depleted cells. Collectively, these results provide evidence that loss of UDG catalyzes significant cell death signals only in cancer cells mutant or deficient in p53.Implications: This study reveals that UDG depletion restores sensitivity to TS inhibitors and has chemotherapeutic potential in the context of mutant or deficient p53. Mol Cancer Res; 16(2); 212-21. ©2017 AACR.
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Affiliation(s)
- Yan Yan
- Department of Pharmacology, Case Western Reserve University, Cleveland, Ohio
| | - Yulan Qing
- Case Comprehensive Cancer Center, Division of General Medical Sciences-Oncology, Case Western Reserve University, Cleveland, Ohio
| | - John J Pink
- Case Comprehensive Cancer Center, Division of General Medical Sciences-Oncology, Case Western Reserve University, Cleveland, Ohio
| | - Stanton L Gerson
- Case Comprehensive Cancer Center, Division of General Medical Sciences-Oncology, Case Western Reserve University, Cleveland, Ohio.
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23
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Yan Y, Han X, Qing Y, Condie AG, Gorityala S, Yang S, Xu Y, Zhang Y, Gerson SL. Inhibition of uracil DNA glycosylase sensitizes cancer cells to 5-fluorodeoxyuridine through replication fork collapse-induced DNA damage. Oncotarget 2018; 7:59299-59313. [PMID: 27517750 PMCID: PMC5312313 DOI: 10.18632/oncotarget.11151] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 03/31/2016] [Accepted: 07/19/2016] [Indexed: 12/12/2022] Open
Abstract
5-fluorodeoxyuridine (5-FdU, floxuridine) is active against multiple cancers through the inhibition of thymidylate synthase, which consequently introduces uracil and 5-FU incorporation into the genome. Uracil DNA glycosylase (UDG) is one of the main enzymes responsible for the removal of uracil and 5-FU. However, how exactly UDG mediates cellular sensitivity to 5-FdU, and if so whether it is through its ability to remove uracil and 5-FU have not been well characterized. In this study, we report that UDG depletion led to incorporation of uracil and 5-FU in DNA following 5-FdU treatment and significantly enhanced 5-FdU's cytotoxicity in cancer cell lines. Co-treatment, but not post-treatment with thymidine prevented cell death of UDG depleted cells by 5-FdU, indicating that the enhanced cytotoxicity is due to the retention of uracil and 5-FU in genomic DNA in the absence of UDG. Furthermore, UDG depleted cells were arrested at late G1 and early S phase by 5-FdU, followed by accumulation of sub-G1 population indicating cell death. Mechanistically, 5-FdU dramatically reduced DNA replication speed in UDG depleted cells. UDG depletion also greatly enhanced DNA damage as shown by γH2AX foci formation. Notably, the increased γH2AX foci formation was not suppressed by caspase inhibitor treatment, suggesting that DNA damage precedes cell death induced by 5-FdU. Together, these data provide novel mechanistic insights into the roles of UDG in DNA replication, damage repair, and cell death in response to 5-FdU and suggest that UDG is a target for improving the anticancer effect of this agent.
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Affiliation(s)
- Yan Yan
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, USA
| | - Xiangzi Han
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, USA
| | - Yulan Qing
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Allison G Condie
- Division of Radiopharmaceutical Science, Case Center for Imaging Research, Department of Radiology, Chemistry, and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | | | - Shuming Yang
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Yan Xu
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.,Department of Chemistry, Cleveland State University, Cleveland, OH, USA
| | - Youwei Zhang
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, USA
| | - Stanton L Gerson
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
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Abdel-Wahab O, Abrahm JL, Adams S, Adewoye AH, Allen C, Ambinder RF, Anasetti C, Anastasi J, Anderson JA, Antin JH, Antony AC, Araten DJ, Armand P, Armstrong G, Armstrong SA, Arnold DM, Artz AS, Awan FT, Baglin TP, Benson DM, Benz EJ, Berliner N, Bhagat G, Bhardwaj N, Bhatia R, Bhatia S, Bhatt MD, Bhatt VR, Bitan M, Blinderman CD, Bollard CM, Braun BS, Brenner MK, Brittenham GM, Brodsky RA, Brown M, Broxmeyer HE, Brummel-Ziedins K, Brunner AM, Buadi FK, Burkhardt B, Burns M, Byrd JC, Caimi PF, Caligiuri MA, Canavan M, Cantor AB, Carcao M, Carroll MC, Carty SA, Castillo JJ, Chan AK, Chapin J, Chiu A, Chute JP, Clark DB, Coates TD, Cogle CR, Connell NT, Cooke E, Cooley S, Corradini P, Creager MA, Creger RJ, Cromwell C, Crowther MA, Cushing MM, Cutler C, Dang CV, Danial NN, Dave SS, DeCaprio JA, Dinauer MC, Dinner S, Diz-Küçükkaya R, Dodd RY, Donato ML, Dorshkind K, Dotti G, Dror Y, Dunleavy K, Dvorak CC, Ebert BL, Eck MJ, Eikelboom JW, Epperla N, Ershler WB, Evans WE, Faderl S, Ferrara JL, Filipovich AH, Fischer M, Fredenburgh JC, Friedman KD, Fuchs E, Fuller SJ, Gailani D, Galipeau J, Gallagher PG, Ganapathi KA, Gardner LB, Gee AP, Gerson SL, Gertz MA, Giardina PJ, Gibson CJ, Golan K, Golub TR, Gonzales MJ, Gotlib J, Gottschalk S, Grant MA, Graubert TA, Gregg XT, Gribben JG, Gross DM, Gruber TA, Guitart J, Gurbuxani S, Gur-Cohen S, Gutierrez A, Hamadani M, Hari PN, Hartwig JH, Hayman SR, Hayward CP, Hebbel RP, Heslop HE, Hillis C, Hillyer CD, Ho K, Hockenbery DM, Hoffman R, Hogg KE, Holtan SG, Horny HP, Hsu YMS, Hunter ZR, Huntington JA, Iancu-Rubin C, Iqbal A, Isenman DE, Israels SJ, Italiano JE, Jaffe ES, Jaffer IH, Jagannath S, Jäger U, Jain N, James P, Jeha S, Jordan MB, Josephson CD, Jung M, Kager L, Kambayashi T, Kanakry JA, Kantarjian HM, Kaplan J, Karafin MS, Karsan A, Kaufman RJ, Kaufman RM, Keller FG, Kelly KM, Kessler CM, Key NS, Keyzner A, Khandoga AG, Khanna-Gupta A, Khatib-Massalha E, Klein HG, Knoechel B, Kollet O, Konkle BA, Kontoyiannis DP, Koreth J, Koretzky GA, Kotecha D, Kremyanskaya M, Kumari A, Kuzel TM, Küppers R, Lacy MQ, Ladas E, Landier W, Lapid K, Lapidot T, Larson PJ, Levi M, Lewis RE, Liebman HA, Lillicrap D, Lim W, Lin JC, Lindblad R, Lip GY, Little JA, Lohr JG, López JA, Luscinskas FW, Maciejewski JP, Majhail NS, Manches O, Mandle RJ, Mann KG, Manno CS, Marcogliese AN, Mariani G, Marincola FM, Mascarenhas J, Massberg S, McEver RP, McGrath E, McKinney MS, Mehta RS, Mentzer WC, Merlini G, Merryman R, Michel M, Migliaccio AR, Miller JS, Mims MP, Mondoro TH, Moorehead P, Muniz LR, Munshi NC, Najfeld V, Nayak L, Nazy I, Neff AT, Ness PM, Notarangelo LD, O'Brien SH, O'Connor OA, O'Donnell M, Olson A, Orkin SH, Pai M, Pai SY, Paidas M, Panch SR, Pande RL, Papayannopoulou T, Parikh R, Petersdorf EW, Peterson SE, Pittaluga S, Ponce DM, Popolo L, Prchal JT, Pui CH, Puigserver P, Rak J, Ramos CA, Rand JH, Rand ML, Rao DS, Ravandi F, Rawlings DJ, Reddy P, Reding MT, Reiter A, Rice L, Riese MJ, Ritchey AK, Roberts DJ, Roman E, Rooney CM, Rosen ST, Rosenthal DS, Rossmann MP, Rot A, Rowley SD, Rubnitz JE, Rydz N, Salama ME, Sauk S, Saunthararajah Y, Savage W, Scadden D, Schaefer KG, Schiffman F, Schneidewend R, Schrier SL, Schuchman EH, Scullion BF, Selvaggi KJ, Senoo K, Shaheen M, Shaz BH, Shelburne SA, Shpall EJ, Shurin SB, Siegal D, Silberstein LE, Silberstein L, Silverstein RL, Sloan SR, Smith FO, Smith JW, Smith K, Steensma DP, Steinberg MH, Stock W, Storry JR, Stramer SL, Strauss RG, Stroncek DF, Taylor J, Thota S, Treon SP, Tulpule A, Valdes RF, Valent P, Vedantham S, Vercellotti GM, Verneris MR, Vichinsky EP, von Andrian UH, Vose JM, Wagner AJ, Wang E, Wang JH, Warkentin TE, Wasserstein MP, Webster A, Weisdorf DJ, Weitz JI, Westhoff CM, Wheeler AP, Widick P, Wiley JS, William BM, Williams DA, Wilson WH, Wolfe J, Wolgast LR, Wood D, Wu J, Yahalom J, Yee DL, Younes A, Young NS, Zeller MP. Contributors. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00168-2] [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: 10/18/2022] Open
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Ramos EK, Hoffmann AD, Gerson SL, Liu H. New Opportunities and Challenges to Defeat Cancer Stem Cells. Trends Cancer 2017; 3:780-796. [PMID: 29120754 PMCID: PMC5958547 DOI: 10.1016/j.trecan.2017.08.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Cancer stem cells (CSCs) are a subpopulation of cancer cells that are capable of self-renewal, proliferation, differentiation, plastic adaptation, and immune regulation, thereby mediating tumorigenesis, metastasis, and therapy resistance. CSCs are associated with cancer progression and clinical outcome in cancer patients. Successful targeting of CSCs will therefore be necessary to eradicate and cure cancer. Functional regulators of stem cell (stemness) signaling pathways in human cancers have brought new opportunities to target CSCs and reframe cancer-targeting strategies in clinical settings. However, challenges remain due to a lack of complete understanding of CSC plasticity/heterogeneity and the limited efficacy of individual stemness inhibitors in cancer treatment. In this article we review CSC signaling pathways and the current state of CSC-targeting therapeutics in combinatory treatments in clinical trials.
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Affiliation(s)
- Erika K Ramos
- Driskill Graduate Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department Pharmacology, Northwestern University, Chicago, IL, USA; These authors equally contributed to the manuscript preparation
| | - Andrew D Hoffmann
- Department Pharmacology, Northwestern University, Chicago, IL, USA; These authors equally contributed to the manuscript preparation
| | - Stanton L Gerson
- The Case Comprehensive Cancer Center, Cleveland, OH, USA; The National Center for Regenerative Medicine, Cleveland, OH, USA; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
| | - Huiping Liu
- Department Pharmacology, Northwestern University, Chicago, IL, USA; The Case Comprehensive Cancer Center, Cleveland, OH, USA; The National Center for Regenerative Medicine, Cleveland, OH, USA; Department of Medicine, Division of Hematology and Oncology, Northwestern University, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA; Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Nardi EA, Wolfson JA, Rosen ST, Diasio RB, Gerson SL, Parker BA, Alvarnas JC, Levine HA, Fong Y, Weisenburger DD, Fitzgerald CL, Egan M, Stranford S, Carlson RW, Benz EJ. Value, Access, and Cost of Cancer Care Delivery at Academic Cancer Centers. J Natl Compr Canc Netw 2017; 14:837-47. [PMID: 27407124 DOI: 10.6004/jnccn.2016.0088] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022]
Abstract
Key challenges facing the oncology community today include access to appropriate, high quality, patient-centered cancer care; defining and delivering high-value care; and rising costs. The National Comprehensive Cancer Network convened a Work Group composed of NCCN Member Institution cancer center directors and their delegates to examine the challenges of access, high costs, and defining and demonstrating value at the academic cancer centers. The group identified key challenges and possible solutions to addressing these issues. The findings and recommendations of the Work Group were then presented at the Value, Access, and Cost of Cancer Care Policy Summit in September 2015 and multi-stakeholder roundtable panel discussions explored these findings and recommendations along with additional items.
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Affiliation(s)
- Elizabeth A Nardi
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Julie A Wolfson
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Steven T Rosen
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Robert B Diasio
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Stanton L Gerson
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Barbara A Parker
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joseph C Alvarnas
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Harlan A Levine
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Yuman Fong
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Dennis D Weisenburger
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - C Lyn Fitzgerald
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Maggie Egan
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Sharon Stranford
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Robert W Carlson
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Edward J Benz
- From National Comprehensive Cancer Network, Fort Washington, Pennsylvania; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, Alabama; City of Hope Comprehensive Cancer Center, Los Angeles, California; Mayo Clinic Cancer Center, Rochester, Minnesota; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio; UC San Diego Moores Cancer Center, La Jolla, California; Patient, City of Hope Comprehensive Cancer Center, Los Angeles, California; and Dana-Farber Cancer Institute, Boston, Massachusetts
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Caimi PF, Cooper BW, William BM, Dowlati A, Barr PM, Fu P, Pink J, Xu Y, Lazarus HM, de Lima M, Gerson SL. Phase I clinical trial of the base excision repair inhibitor methoxyamine in combination with fludarabine for patients with advanced hematologic malignancies. Oncotarget 2017; 8:79864-79875. [PMID: 29108368 PMCID: PMC5668101 DOI: 10.18632/oncotarget.20094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/26/2017] [Indexed: 02/07/2023] Open
Abstract
PURPOSE We determined the safety, pharmacokinetics, pharmacodynamics and recommended phase II dose of the base excision repair blocker methoxyamine combined with fludarabine. MATERIALS AND METHODS This was a phase I study with intravenous fludarabine (25 mg/m2, days 1-5), and methoxyamine (15 mg/m2-120 mg/m2, once). A maximum of six cycles were given. Adult patients with relapsed/refractory hematologic malignancies, excluding acute myeloid leukemia, were eligible. RESULTS Twenty patients were treated; diagnoses included CLL/SLL (n = 10), follicular lymphoma (n = 3), DLBCL (n = 3), mantle cell lymphoma (n = 1), anaplastic large cell lymphoma (n = 1) and plasma cell myeloma (n = 2). No DLTs were observed and dose escalation reached the maximum planned dose. Hematologic toxicity was frequent; most common grade 3-4 toxicities were lymphopenia (70%), neutropenia (60%), leukopenia (50%) and anemia (40%). Four patients achieved a partial remission and 8 achieved stable disease. The drug combination resulted in increased DNA damage measured with the Comet assay. CONCLUSIONS Methoxyamine combined with fludarabine was safe and well tolerated. Hematologic toxicity was comparable to single agent fludarabine. Activity appears to correlate with increased levels of DNA damage. Further studies will examine use of this combination of as part conditioning regimens of stem cell transplant and use of methoxyamine as fludarabine dose-sparing agent.
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Affiliation(s)
- Paolo F. Caimi
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Brenda W. Cooper
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Basem M. William
- Division of Hematology. The Ohio State University Medical School, Columbus, Ohio, USA
| | - Afshin Dowlati
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Paul M. Barr
- Division of Hematology and Oncology, Department of Medicine, University of Rochester, Rochester, New York, USA
| | - Pingfu Fu
- Department of Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
| | - John Pink
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Yan Xu
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Hillard M. Lazarus
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Marcos de Lima
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, Cleveland, Ohio, USA
- Division of Hematology and Oncology, Department of Medicine, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
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Patel R, Arakawa H, Radivoyevitch T, Gerson SL, Welford SM. Long-Term Deficits in Behavior Performances Caused by Low- and High-Linear Energy Transfer Radiation. Radiat Res 2017; 188:672-680. [PMID: 28961076 DOI: 10.1667/rr14795.1] [Citation(s) in RCA: 8] [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] [Indexed: 11/03/2022]
Abstract
Efforts to protect astronauts from harmful galactic cosmic radiation (GCR) require a better understanding of the effects of GCR on human health. In particular, little is known about the lasting effects of GCR on the central nervous system (CNS), which may lead to behavior performance deficits. Previous studies have shown that high-linear energy transfer (LET) radiation in rodents leads to short-term declines in a variety of behavior tests. However, the lasting impact of low-, medium- and high-LET radiation on behavior are not fully defined. Therefore, in this study C57BL/6 male mice were irradiated with 100 or 250 cGy of γ rays (LET ∼0.3 KeV/μm), 10 or 100 cGy of 1H at 1,000 MeV/n (LET ∼0.2 KeV/μm), 28Si at 300 MeV/n (LET ∼69 KeV/μm) or 56Fe at 600 MeV/n (LET of ∼180 KeV/μm), and behavior metrics were collected at 5 and 9 months postirradiation to analyze differences among radiation qualities and doses. A significant dose effect was observed on recognition memory and activity levels measured 9 months postirradiation, regardless of radiation source. In contrast, we observed that each ion species had a distinct effect on anxiety, motor coordination and spatial memory at extended time points. Although 28Si and 56Fe are both regarded as high-LET particles, they were shown to have different detrimental effects on behavior. In summary, our findings suggest that GCR not only affects the CNS in the short term, but also has lasting damaging effects on the CNS that can cause sustained declines in behavior performance.
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Affiliation(s)
| | | | - Tomas Radivoyevitch
- f Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Stanton L Gerson
- d Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.,e Seidman Cancer Center, University Hospitals, Cleveland, Ohio; and
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Dashzeveg NK, Taftaf R, Ramos EK, Torre-Healy L, Chumakova A, Silver DJ, Alban TJ, Sinyuk M, Thiagarajan PS, Jarrar AM, Turaga SM, Saygin C, Mulkearns-Hubert E, Hitomi M, Rich JN, Gerson SL, Lathia JD, Liu H. New Advances and Challenges of Targeting Cancer Stem Cells. Cancer Res 2017; 77:5222-5227. [PMID: 28928129 DOI: 10.1158/0008-5472.can-17-0054] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/25/2017] [Accepted: 07/18/2017] [Indexed: 02/04/2023]
Abstract
The second International Cancer Stem Cell Conference in Cleveland, Ohio, on September 20-23, 2016, convened 330 attendees from academic, industrial, and clinical organizations. It featured a debate on the concepts and challenges of the cancer stem cells (CSC) as well as CSC-centered scientific sessions on clinical trials, genetics and epigenetics, tumor microenvironment, immune suppression, metastasis, therapeutic resistance, and emerging novel concepts. The conference hosted 35 renowned speakers, 100 posters, 20 short talks, and a preconference workshop. The reported advances of CSC research and therapies fostered new collaborations across national and international borders, and inspired the next generation's young scientists. Cancer Res; 77(19); 5222-7. ©2017 AACR.
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Affiliation(s)
- Nurmaa K Dashzeveg
- Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rokana Taftaf
- Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erika K Ramos
- Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Luke Torre-Healy
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Anastasia Chumakova
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Daniel J Silver
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Tyler J Alban
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Maksim Sinyuk
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Praveena S Thiagarajan
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Awad M Jarrar
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Soumya M Turaga
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Caner Saygin
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Erin Mulkearns-Hubert
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Masahiro Hitomi
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Jeremy N Rich
- Department of Stem Cell Biology and Regenerative Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio.,The Case Comprehensive Cancer Center, Cleveland, Ohio.,The National Center for Regenerative Medicine, Cleveland, Ohio
| | - Stanton L Gerson
- The Case Comprehensive Cancer Center, Cleveland, Ohio.,The National Center for Regenerative Medicine, Cleveland, Ohio.,The University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Justin D Lathia
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio.,The Case Comprehensive Cancer Center, Cleveland, Ohio.,The National Center for Regenerative Medicine, Cleveland, Ohio
| | - Huiping Liu
- Department of Pharmacology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. .,The Case Comprehensive Cancer Center, Cleveland, Ohio.,The National Center for Regenerative Medicine, Cleveland, Ohio.,Department of Medicine (Hematology and Oncology Division) and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Deparmtent of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Abstract
Whereas transformation events in hematopoietic malignancies may occur at different developmental stages, the initial mutation originates in hematopoietic stem cells (HSCs), creating a preleukemic stem cell (PLSC). Subsequent mutations at either stem cell or progenitor cell levels transform the PLSC into lymphoma/leukemia initiating cells (LIC). Thymic lymphomas have been thought to develop from developing thymocytes. T cell progenitors are generated from HSCs in the bone marrow (BM), but maturation and proliferation of T cells as well as T-lymphomagenesis depends on both regulatory mechanisms and microenvironment within the thymus. We studied PLSC linked to thymic lymphomas. In this study, we use MSH2-/- mice as a model to investigate the existence of PLSC and the evolution of PLSC to LIC. Following BM transplantation, we found that MSH2-/- BM cells from young mice are able to fully reconstitute multiple hematopoietic lineages of lethally irradiated wild-type recipients. However, all recipients developed thymic lymphomas within three and four months post transplantation. Transplantation of different fractions of BM cells or thymocytes from young health MSH2-/- mice showed that an HSC enriched fraction always reconstituted hematopoiesis followed by lymphoma development. In addition, lymphomas did not occur in thymectomized recipients of MSH2-/- BM. These results suggest that HSCs with DNA repair defects such as MSH2-/- are PLSCs because they retain hematopoietic function, but also carry an obligate lymphomagenic potential within their T-cell progeny that is dependent on the thymic microenvironment.
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Affiliation(s)
- Yulan Qing
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Stanton L. Gerson
- Case Comprehensive Cancer Center, National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail:
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Tacastacas JD, Chan DV, Carlson S, Gerson SL, Dowlati A, Fu P, Lu K, Groft S, Rosenjack J, Honda K, McCormick TS, Cooper KD. Evaluation of O6-Benzylguanine-Potentiated Topical Carmustine for Mycosis Fungoides: A Phase 1-2 Clinical Trial. JAMA Dermatol 2017; 153:413-420. [PMID: 28199478 DOI: 10.1001/jamadermatol.2016.5793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance In a phase 1 trial, single-dose O6-benzylguanine with topical carmustine for patients with early stage (stage IA through stage IIA) cutaneous T-cell lymphoma, mycosis fungoides (MF) type, resulted in clinical responses proportional to inhibition of O6-alkylguanine-DNA alkyltransferase activity, but a maximum tolerated dose (MTD) was not reached. Objective To determine whether dose escalation of carmustine in combination with dual-dose O6-benzylguanine to prolong alkyltransferase inhibition could reach an MTD. Design, Setting, and Participants A single-arm, phase 1-2 clinical trial conducted at a university teaching hospital enrolled 17 adults with stage IA through stage IIA cutaneous T-cell lymphoma, MF type, to evaluate treatment using topical carmustine plus 2 subsequent daily doses of intravenous O6-benzylguanine, administered every 2 weeks for up to 24 weeks (12 cycles). All patients who received treatment were included in an intent-to-treat analysis of the response rate. The study was conducted from February 17, 2010, to April 8, 2014. Data analysis was performed from May 1, 2014, to December 1, 2015. Interventions Topical carmustine and intravenous O6-benzylguanine. Main Outcomes and Measures Clinical disease response was assessed by the Severity-Weighted Assessment Tool (score range, 0-400; higher score indicates worse disease). Safety data were acquired by review of adverse events at study visits. Results Of the 17 patients enrolled, 12 (71%) were men; mean (SD) age was 45.2 (14.6) years. There were 7 complete responses and 8 partial responses to combination carmustine and O6-benzylguanine treatment. The overall clinical response rate was 88%, with a mean (SD) duration of complete response of 14.43 (6.6) months. The MTD was 20 mg of carmustine applied once in combination with 2 daily doses of 120 mg/m2 of O6-benzylguanine. Most adverse events (112 [67%]) were grade I. Of 15 patients with dermatitis, 5 individuals (33%) demonstrated grade II dermatitis that was unresponsive to topical corticosteroid therapy. The dermatitis was characterized by high levels of macrophage activation, and clearance was associated with vitamin D3 administration. Conclusions and Relevance Compared with single-dose O6-benzylguanine and carmustine, dual-dose O6-benzylguanine resulted in higher overall response rates and reduced total carmustine doses but was associated with more cutaneous adverse events. The MTD for dual-dose O6-benzylguanine plus carmustine was also ascertained. Trial Registration clinicaltrials.gov Identifier: NCT00961220.
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Affiliation(s)
- Joselin D Tacastacas
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Derek V Chan
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio2Advanced Dermatology, New Hyde Park, New York
| | - Sean Carlson
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio3Cleveland Clinic Imaging Institute, Cleveland, Ohio
| | - Stanton L Gerson
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Afshin Dowlati
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Pingfu Fu
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Kurt Lu
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Sarah Groft
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio7Pathology Department, Case Western Reserve University, Cleveland, Ohio
| | - Julie Rosenjack
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio8Pediatrics Department, Case Western Reserve University, Cleveland, Ohio
| | - Kord Honda
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Thomas S McCormick
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Kevin D Cooper
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio5Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Splenic marginal zone lymphoma: excellent outcomes in 64 patients treated in the rituximab era. Hematology 2017; 22:405-411. [DOI: 10.1080/10245332.2017.1279842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - PingFu Fu
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Howard Meyerson
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - David B. Mansur
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Sheen Cherian
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Marcos J.G. De Lima
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Robert M. Dean
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Brian T. Hill
- Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Basem M. William
- University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, OH, USA
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33
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Oleinick NL, Biswas T, Patel R, Tao M, Patel R, Weeks L, Sharma N, Dowlati A, Gerson SL, Fu P, Zhang J, Machtay M. Radiosensitization of non-small-cell lung cancer cells and xenografts by the interactive effects of pemetrexed and methoxyamine. Radiother Oncol 2016; 121:335-341. [PMID: 27838149 DOI: 10.1016/j.radonc.2016.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 12/15/2015] [Revised: 09/09/2016] [Accepted: 10/03/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE The anti-folate pemetrexed is a radiosensitizer. In pre-clinical models, pemetrexed is more effective along with the base-excision-repair inhibitor methoxyamine. We tested whether methoxyamine enhances pemetrexed-mediated radiosensitization of lung adenocarcinoma cells and xenografts. MATERIALS AND METHODS A549 and H1299 cells were evaluated for cell cycle distribution by flow cytometry, radiosensitization by clonogenic assay, and DNA repair by neutral comet assay and repair protein activation. H460 cells were included in some studies. Xenografts in nude mice received drug(s) and/or radiation, and tumor growth was monitored by caliper and in vivo toxicity by animal weight. RESULTS Exposure to pemetrexed/methoxyamine for 24 (H1299, H460) or 48 (A549)hours before irradiation resulted in accumulation of cells near the radiosensitive G1/S border; dose-enhancement factors of 1.62±0.19, 1.97±0.25, and 1.67±0.30, respectively; reduction of mean inactivation dose by 32%, 30%, and 46%, respectively; and significant reductions of SF2 and SF4 (p<0.05). Radiosensitization was associated with rapid DNA double-strand-break rejoining and increased levels of DNA-PKcs. Both tumor-growth rate and tumor-growth delay were significantly improved by adding methoxyamine to pemetrexed pre-irradiation (p<0.0001); no mice lost weight during treatment. CONCLUSIONS Addition of methoxyamine to pemetrexed and fractionated radiotherapy may improve outcome for patients with locally advanced non-squamous non-small-cell lung cancer.
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Affiliation(s)
- Nancy L Oleinick
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA.
| | - Tithi Biswas
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Rutulkumar Patel
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Department of Pharmacology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Mingfang Tao
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Ravi Patel
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Lachelle Weeks
- Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Neelesh Sharma
- Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Afshin Dowlati
- Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Stanton L Gerson
- Department of Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Pingfu Fu
- Department of Epidemiology and Biostatistics, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Junran Zhang
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
| | - Mitchell Machtay
- Department of Radiation Oncology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA; Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, USA
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34
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Cooper BW, De Lima MJG, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of nodal marginal zone lymphoma reveals excellent long-term outcomes in the rituximab era. Br J Haematol 2016; 175:275-280. [DOI: 10.1111/bjh.14228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/25/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Marcos J. G. De Lima
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center/Case Western Reserve University; Cleveland OH USA
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Kenyon J, Nickel-Meester G, Qing Y, Santos-Guasch G, Drake E, PingfuFu, Sun S, Bai X, Wald D, Arts E, Gerson SL. Epigenetic Loss of MLH1 Expression in Normal Human Hematopoietic Stem Cell Clones is Defined by the Promoter CpG Methylation Pattern Observed by High-Throughput Methylation Specific Sequencing. ACTA ACUST UNITED AC 2016; 3. [PMID: 27570841 PMCID: PMC4996274 DOI: 10.23937/2469-570x/1410031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Indexed: 02/07/2023]
Abstract
Normal human hematopoietic stem and progenitor cells (HPC) lose expression of MLH1, an important mismatch repair (MMR) pathway gene, with age. Loss of MMR leads to replication dependent mutational events and microsatellite instability observed in secondary acute myelogenous leukemia and other hematologic malignancies. Epigenetic CpG methylation upstream of the MLH1 promoter is a contributing factor to acquired loss of MLH1 expression in tumors of the epithelia and proximal mucosa. Using single molecule high-throughput bisulfite sequencing we have characterized the CpG methylation landscape from −938 to −337 bp upstream of the MLH1 transcriptional start site (position +0), from 30 hematopoietic colony forming cell clones (CFC) either expressing or not expressing MLH1. We identify a correlation between MLH1 promoter methylation and loss of MLH1 expression. Additionally, using the CpG site methylation frequencies obtained in this study we were able to generate a classification algorithm capable of sorting the expressing and non-expressing CFC. Thus, as has been previously described for many tumor cell types, we report for the first time a correlation between the loss of MLH1 expression and increased MLH1 promoter methylation in CFC derived from CD34+ selected hematopoietic stem and progenitor cells.
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Affiliation(s)
- Jonathan Kenyon
- Department of Pathology, Case Western Reserve University, Cleveland, OH, 44106, USA; Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Gabrielle Nickel-Meester
- Division of Infectious Disease, Department of Medicine, Case School of Medicine and the Center for AIDS Research, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Yulan Qing
- Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Gabriela Santos-Guasch
- Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Ellen Drake
- Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - PingfuFu
- Department of Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Shuying Sun
- Department of Mathematics, Texas State University, San Marcos, TX, 78666, USA
| | - Xiaodong Bai
- RNA Center, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - David Wald
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA; Center for Stem Cell and Regenerative Medicine, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, 44106, USA
| | - Eric Arts
- Division of Infectious Disease, Department of Medicine, Case School of Medicine and the Center for AIDS Research, Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Stanton L Gerson
- Department of Pathology, Case Western Reserve University, Cleveland, OH, 44106, USA; Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH, 44106, USA; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, 44106, USA; Center for Stem Cell and Regenerative Medicine, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, 44106, USA; Seidman Cancer Center, University Hospitals of Cleveland, Cleveland, OH, 44106, USA
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36
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Zhang C, van der Voort D, Shi H, Zhang R, Qing Y, Hiraoka S, Takemoto M, Yokote K, Moxon JV, Norman P, Rittié L, Kuivaniemi H, Atkins GB, Gerson SL, Shi GP, Golledge J, Dong N, Perbal B, Prosdocimo DA, Lin Z. Matricellular protein CCN3 mitigates abdominal aortic aneurysm. J Clin Invest 2016; 126:2012. [PMID: 27135882 DOI: 10.1172/jci87977] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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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37
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Zhang C, van der Voort D, Shi H, Zhang R, Qing Y, Hiraoka S, Takemoto M, Yokote K, Moxon JV, Norman P, Rittié L, Kuivaniemi H, Atkins GB, Gerson SL, Shi GP, Golledge J, Dong N, Perbal B, Prosdocimo DA, Lin Z. Matricellular protein CCN3 mitigates abdominal aortic aneurysm. J Clin Invest 2016; 126:1282-99. [PMID: 26974158 DOI: 10.1172/jci82337] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 01/28/2016] [Indexed: 12/19/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is a major cause of morbidity and mortality; however, the mechanisms that are involved in disease initiation and progression are incompletely understood. Extracellular matrix proteins play an integral role in modulating vascular homeostasis in health and disease. Here, we determined that the expression of the matricellular protein CCN3 is strongly reduced in rodent AAA models, including angiotensin II-induced AAA and elastase perfusion-stimulated AAA. CCN3 levels were also reduced in human AAA biopsies compared with those in controls. In murine models of induced AAA, germline deletion of Ccn3 resulted in severe phenotypes characterized by elastin fragmentation, vessel dilation, vascular inflammation, dissection, heightened ROS generation, and smooth muscle cell loss. Conversely, overexpression of CCN3 mitigated both elastase- and angiotensin II-induced AAA formation in mice. BM transplantation experiments suggested that the AAA phenotype of CCN3-deficient mice is intrinsic to the vasculature, as AAA was not exacerbated in WT animals that received CCN3-deficient BM and WT BM did not reduce AAA severity in CCN3-deficient mice. Genetic and pharmacological approaches implicated the ERK1/2 pathway as a critical regulator of CCN3-dependent AAA development. Together, these results demonstrate that CCN3 is a nodal regulator in AAA biology and identify CCN3 as a potential therapeutic target for vascular disease.
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38
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Starr AG, Caimi PF, Fu P, Massoud MR, Meyerson H, Hsi ED, Mansur DB, Cherian S, Singh AD, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Dual institution experience of extranodal marginal zone lymphoma reveals excellent long-term outcomes. Br J Haematol 2016; 173:404-12. [DOI: 10.1111/bjh.13975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 12/14/2022]
Affiliation(s)
- Adam G. Starr
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Paolo F. Caimi
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - PingFu Fu
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Mira R. Massoud
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Howard Meyerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Eric D. Hsi
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - David B. Mansur
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Sheen Cherian
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Arun D. Singh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brenda W. Cooper
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Marcos J.G. De Lima
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Hillard M. Lazarus
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Stanton L. Gerson
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
| | - Deepa Jagadeesh
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Mitchell R. Smith
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Robert M. Dean
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brad L. Pohlman
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Brian T. Hill
- Cleveland Clinic Foundation; Case Comprehensive Cancer Center; Cleveland OH USA
| | - Basem M. William
- University Hospitals Case Medical Center; Case Western Reserve University; Cleveland OH USA
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Chakrabarti G, Silvers MA, Ilcheva M, Liu Y, Moore ZR, Luo X, Gao J, Anderson G, Liu L, Sarode V, Gerber DE, Burma S, DeBerardinis RJ, Gerson SL, Boothman DA. Tumor-selective use of DNA base excision repair inhibition in pancreatic cancer using the NQO1 bioactivatable drug, β-lapachone. Sci Rep 2015; 5:17066. [PMID: 26602448 PMCID: PMC4658501 DOI: 10.1038/srep17066] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [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: 06/12/2015] [Accepted: 10/22/2015] [Indexed: 11/09/2022] Open
Abstract
UNLABELLED Base excision repair (BER) is an essential pathway for pancreatic ductal adenocarcinoma (PDA) survival. Attempts to target this repair pathway have failed due to lack of tumor-selectivity and very limited efficacy. The NAD(P)H Quinone Oxidoreductase 1 (NQO1) bioactivatable drug, ß-lapachone (ARQ761 in clinical form), can provide tumor-selective and enhanced synergy with BER inhibition. ß-Lapachone undergoes NQO1-dependent futile redox cycling, generating massive intracellular hydrogen peroxide levels and oxidative DNA lesions that stimulate poly(ADP-ribose) polymerase 1 (PARP1) hyperactivation. Rapid NAD(+)/ATP depletion and programmed necrosis results. To identify BER modulators essential for repair of ß-lapachone-induced DNA base damage, a focused synthetic lethal RNAi screen demonstrated that silencing the BER scaffolding protein, XRCC1, sensitized PDA cells. In contrast, depleting OGG1 N-glycosylase spared cells from ß-lap-induced lethality and blunted PARP1 hyperactivation. Combining ß-lapachone with XRCC1 knockdown or methoxyamine (MeOX), an apyrimidinic/apurinic (AP)-modifying agent, led to NQO1-dependent synergistic killing in PDA, NSCLC, breast and head and neck cancers. OGG1 knockdown, dicoumarol-treatment or NQO1- cancer cells were spared. MeOX + ß-lapachone exposure resulted in elevated DNA double-strand breaks, PARP1 hyperactivation and TUNEL+ programmed necrosis. Combination treatment caused dramatic antitumor activity, enhanced PARP1-hyperactivation in tumor tissue, and improved survival of mice bearing MiaPaca2-derived xenografts, with 33% apparent cures. SIGNIFICANCE Targeting base excision repair (BER) alone has limited therapeutic potential for pancreatic or other cancers due to a general lack of tumor-selectivity. Here, we present a treatment strategy that makes BER inhibition tumor-selective and NQO1-dependent for therapy of most solid neoplasms, particularly for pancreatic cancer.
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Affiliation(s)
- Gaurab Chakrabarti
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Molly A Silvers
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Mariya Ilcheva
- Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Yuliang Liu
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Zachary R Moore
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Xiuquan Luo
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Jinming Gao
- Departments of Pharmacology, Dallas, TX 75390-8807
| | | | - Lili Liu
- Department of Hematology and Oncology, Case Western Reserve Comprehensive Cancer Center, Cleveland, OH 44106
| | - Venetia Sarode
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX 75390-9234
| | - David E Gerber
- Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Sandeep Burma
- Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
| | - Ralph J DeBerardinis
- Children's Medical Center Research Institute, UT Southwestern Medical Center, Dallas, TX 75390-8502
| | - Stanton L Gerson
- Department of Hematology and Oncology, Case Western Reserve Comprehensive Cancer Center, Cleveland, OH 44106
| | - David A Boothman
- Departments of Pharmacology, Dallas, TX 75390-8807.,Radiation Oncology, Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75390-8807
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40
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Gao XH, Krokowski D, Guan BJ, Bederman I, Majumder M, Parisien M, Diatchenko L, Kabil O, Willard B, Banerjee R, Wang B, Bebek G, Evans CR, Fox PL, Gerson SL, Hoppel CL, Liu M, Arvan P, Hatzoglou M. Quantitative H2S-mediated protein sulfhydration reveals metabolic reprogramming during the integrated stress response. eLife 2015; 4:e10067. [PMID: 26595448 PMCID: PMC4733038 DOI: 10.7554/elife.10067] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [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: 07/14/2015] [Accepted: 11/16/2015] [Indexed: 12/26/2022] Open
Abstract
The sulfhydration of cysteine residues in proteins is an important mechanism involved in diverse biological processes. We have developed a proteomics approach to quantitatively profile the changes of sulfhydrated cysteines in biological systems. Bioinformatics analysis revealed that sulfhydrated cysteines are part of a wide range of biological functions. In pancreatic β cells exposed to endoplasmic reticulum (ER) stress, elevated H2S promotes the sulfhydration of enzymes in energy metabolism and stimulates glycolytic flux. We propose that transcriptional and translational reprogramming by the integrated stress response (ISR) in pancreatic β cells is coupled to metabolic alternations triggered by sulfhydration of key enzymes in intermediary metabolism.
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Affiliation(s)
- Xing-Huang Gao
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Dawid Krokowski
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Bo-Jhih Guan
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
| | - Ilya Bederman
- Department of Pediatrics, Case Western Reserve University, Cleveland, United States
| | - Mithu Majumder
- Department of Pharmacology, Case Western Reserve University, Cleveland, United States
| | - Marc Parisien
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Luda Diatchenko
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Omer Kabil
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, United States
| | - Belinda Willard
- Mass Spectrometry Laboratory for Protein Sequencing, Lerner Research Institute, Cleveland Clinic, Cleveland, United States
| | - Ruma Banerjee
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, United States
| | - Benlian Wang
- Center for Proteomics and Bioinformatics, School of Medicine, Case Western Reserve University, Cleveland, United States.,Center for Synchotron Biosciences, School of Medicine, Case Western Reserve University, Cleveland, United States
| | - Gurkan Bebek
- Center for Proteomics and Bioinformatics, School of Medicine, Case Western Reserve University, Cleveland, United States.,Center for Synchotron Biosciences, School of Medicine, Case Western Reserve University, Cleveland, United States
| | - Charles R Evans
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical School, Ann Arbor, United States
| | - Paul L Fox
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, United States
| | - Stanton L Gerson
- Department of Medicine, Division of Hematology/Oncology, School of Medicine, Case Western Reserve University, Cleveland, United States
| | - Charles L Hoppel
- Department of Pharmacology, Case Western Reserve University, Cleveland, United States
| | - Ming Liu
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical School, Ann Arbor, United States
| | - Peter Arvan
- Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical School, Ann Arbor, United States
| | - Maria Hatzoglou
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, United States
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41
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Abstract
DNA damage and repair is a fundamental process that plays an important role in cancer treatment. Base excision repair (BER) is a major repair pathway that often leads to drug resistance in DNA-targeted cancer chemotherapy. In order to measure BER, we have developed a near infrared (NIR) fluorescent probe. This probe binds to a key intermediate, termed apurinic/apyrimidinic (AP) site, in the BER pathway where DNA damage and repair occurs. We have developed an assay to show the efficacy of the probe binding to AP sites and have shown that it can distinguish AP sites in DNA extract from chemotherapy treated cells. This probe has potential application in monitoring patient response to chemotherapy and evaluating new drugs in development.
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Affiliation(s)
- Allison G Condie
- Department of Radiology, Chemistry, and Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Yan Yan
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH, United States of America
| | - Stanton L Gerson
- Department of Hematology and Oncology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, United States of America
| | - Yanming Wang
- Department of Radiology, Chemistry, and Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America
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42
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Abstract
Abstract
Many cancer chemotherapeutics target DNA, which makes them vulnerable to repair by innate mechanisms the cell has evolved to ward off endogenous and exogenous DNA damage. In the course of chemotherapy, these repair pathways lead to drug resistance and reduced efficacy of cancer treatment. To address these issues, our goal was to develop imaging agents to visualize and quantify DNA repair in cancer. Thus, we have developed small molecule, fluorescent probes that bind to the abasic (or AP for apurinic/apyrimidinic) site in DNA, a key intermediate in the base excision repair (BER) pathway.
Taking advantage of the biochemistry of BER, we have developed an assay based on a fluorescently tagged DNA oligomer to evaluate the ability of these probes to bind to AP sites and stall further repair. This assay relies on blocking the DNA single strand breaking activity of the enzyme, AP endonuclease (APE), when its natural substrate, the AP site, is obstructed by probe binding. Using this assay, we have screened our novel probes for their AP site binding potential. Our cyanine-(Cy7) based probe outperformed other, commercially available AP site binding probes including methoxyamine (MX) and aldehyde reactive probe (ARP).
In addition, we have developed a method for analyzing a genomic DNA sample that demonstrates the potential to evaluate physiologically relevant quantities of AP sites. 5-Fluoro-2′-deoxyuridine (FUDR) is indicated for treatment of many types of cancer; however, uracil DNA glycosylase (UDG) can repair the lesions in DNA introduced by FUDR. Therefore, we prepared a UDG knockdown of the DLD1 colon cancer cell line and treated both wild type and knockdown cells with FUDR for 24, 48, and 72 h. Following extraction of the DNA and in vitro treatment with purified UDG, we observed a nearly 9-fold increase in fluorescence in treated versus untreated cells. This confirmed that our probe could report of AP site quantity in cancer cells in vitro.
Our cyanine-based probes have several benefits over existing probes including red and NIR fluorescence for application in animal imaging. Our studies indicate that these probes bind to AP sites more efficiently than existing probes. Further, these fluorescent AP site-binding agents could have application in drug development and discovery or be used in assays to monitor patient response to therapy.
Citation Format: Allison G. Condie, Yan Yan, Stanton L. Gerson, Yanming Wang. Development of fluorescent probes for detection of DNA base excision repair in human cancer cells. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4754. doi:10.1158/1538-7445.AM2015-4754
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Affiliation(s)
| | - Yan Yan
- Case Western Reserve University, Cleveland, OH
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43
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Zhang Y, Desai A, Yang SY, Bae KB, Antczak MI, Fink SP, Tiwari S, Willis JE, Williams NS, Dawson DM, Wald D, Chen WD, Wang Z, Kasturi L, Larusch GA, He L, Cominelli F, Di Martino L, Djuric Z, Milne GL, Chance M, Sanabria J, Dealwis C, Mikkola D, Naidoo J, Wei S, Tai HH, Gerson SL, Ready JM, Posner B, Willson JKV, Markowitz SD. TISSUE REGENERATION. Inhibition of the prostaglandin-degrading enzyme 15-PGDH potentiates tissue regeneration. Science 2015; 348:aaa2340. [PMID: 26068857 DOI: 10.1126/science.aaa2340] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Agents that promote tissue regeneration could be beneficial in a variety of clinical settings, such as stimulating recovery of the hematopoietic system after bone marrow transplantation. Prostaglandin PGE2, a lipid signaling molecule that supports expansion of several types of tissue stem cells, is a candidate therapeutic target for promoting tissue regeneration in vivo. Here, we show that inhibition of 15-hydroxyprostaglandin dehydrogenase (15-PGDH), a prostaglandin-degrading enzyme, potentiates tissue regeneration in multiple organs in mice. In a chemical screen, we identify a small-molecule inhibitor of 15-PGDH (SW033291) that increases prostaglandin PGE2 levels in bone marrow and other tissues. SW033291 accelerates hematopoietic recovery in mice receiving a bone marrow transplant. The same compound also promotes tissue regeneration in mouse models of colon and liver injury. Tissues from 15-PGDH knockout mice demonstrate similar increased regenerative capacity. Thus, 15-PGDH inhibition may be a valuable therapeutic strategy for tissue regeneration in diverse clinical contexts.
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Affiliation(s)
- Yongyou Zhang
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Amar Desai
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Sung Yeun Yang
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Gastroenterology, Haeundae Paik Hospital, Inje University, Busan 612896, South Korea
| | - Ki Beom Bae
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Surgery, Busan Paik Hospital, and Paik Institute of Clinical Research and Ocular Neovascular Research Center, Inje University, Busan, South Korea
| | - Monika I Antczak
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Stephen P Fink
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Shruti Tiwari
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Joseph E Willis
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Noelle S Williams
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Dawn M Dawson
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - David Wald
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Wei-Dong Chen
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Zhenghe Wang
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Lakshmi Kasturi
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Gretchen A Larusch
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Lucy He
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Fabio Cominelli
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Luca Di Martino
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Zora Djuric
- Department of Family Medicine, University of Michigan, Ann Arbor MI 48109, USA
| | - Ginger L Milne
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
| | - Mark Chance
- Proteomics Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Juan Sanabria
- Department of Surgery, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA
| | - Chris Dealwis
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Debra Mikkola
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jacinth Naidoo
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Shuguang Wei
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Hsin-Hsiung Tai
- College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA
| | - Stanton L Gerson
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA.
| | - Joseph M Ready
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Bruce Posner
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - James K V Willson
- Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Sanford D Markowitz
- Department of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA. Case Medical Center, University Hospitals of Cleveland, Cleveland, OH 44106, USA.
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44
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Starr A, Fu P, Caimi PF, Campagnaro EL, Cooper BW, De Lima MJ, Lazarus HM, Gerson SL, Meyerson H, Jagadeesh D, Smith MR, Dean RM, Pohlman BL, Hill BT, William BM. Outcomes and prognostic factors in marginal zone lymphoma: Case comprehensive cancer center cumulative experience of 358 cases. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8554] [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)
- Adam Starr
- Case Western Reserve University, Cleveland, OH
| | - PingFu Fu
- Case Comprehensive Cancer Center, Cleveland, OH
| | - Paolo Fabrizio Caimi
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Erica Leigh Campagnaro
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brenda W. Cooper
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Marcos J.G. De Lima
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Hillard M. Lazarus
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
| | | | - Deepa Jagadeesh
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | | | - Robert M. Dean
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brad L. Pohlman
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Brian Thomas Hill
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Basem M. William
- University Hospitals Seidman Cancer Center, Case Western Reserve University, and Case Comprehensive Cancer Center, Cleveland, OH
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45
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Eads JR, Krishnamurthi SS, Saltzman JN, Meropol NJ, Bokar JA, Gibbons J, Koon HB, Sharma N, Savvides P, Pink J, Xu Y, Beumer JH, Fu P, Beatty K, Kane D, Rodal MB, Czalkiewicz J, Riendeau J, Gerson SL, Dowlati A. Phase I clinical trial of temozolomide and methoxyamine (TRC-102) in patients with advanced solid tumors. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.2558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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)
- Jennifer Rachel Eads
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Smitha S. Krishnamurthi
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Joel N. Saltzman
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Neal J. Meropol
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Joseph A. Bokar
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Joseph Gibbons
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Henry B. Koon
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Neelesh Sharma
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | | | - John Pink
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Yan Xu
- Case Comprehensive Cancer Center, Cleveland State University, Cleveland, OH
| | | | - Pingfu Fu
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Kristi Beatty
- University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Donna Kane
- University Hospitals Seidman Cancer Center, Cleveland, OH
| | | | | | - John Riendeau
- University Hospitals Seidman Cancer Center, Cleveland, OH
| | - Stanton L. Gerson
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Afshin Dowlati
- University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
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46
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Afable M, Caimi PF, Hosing C, de Lima M, Khouri I, William BM, Nieto Y, Cooper BW, Anderlini P, Gerson SL, Lazarus HM, Champlin R, Popat U. Hematopoietic Progenitor Cell Harvesting Is Feasible after Treatment with Brentuximab Vedotin in CD30(+) Lymphoma Patients Who Received Multiple Prior Lines of Treatment. Biol Blood Marrow Transplant 2015; 21:1529-1531. [PMID: 25937397 DOI: 10.1016/j.bbmt.2015.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 02/19/2015] [Accepted: 04/22/2015] [Indexed: 01/16/2023]
Abstract
Brentuximab vedotin (BV), an antibody-drug conjugate that targets CD30, induces high response rates in CD30(+) lymphoid malignancies. It is unknown if BV use affects procurement of autologous CD34(+) stem cells and hematopoietic engraftment after autologous stem cell transplantation (ASCT). We examined 42 patients treated with BV before mobilization. Median times from diagnosis to transplantation, from initial BV treatment to transplantation, and from last BV treatment to stem cell collection were 21 months (range, 10 to 210), 5 months (range, 1.5 to 16.8), and 30 days (range, 2 to 280), respectively. Mobilization was successful on the first attempt in 38 patients (90.4%). The median number of infused CD34(+) cells was 5.46 × 10(6)/kg (range, 1.65 to 54.78 × 10(6)/kg). The median times to neutrophil and platelet engraftment were 10 (range, 9 to 13), and 10.5 days (range, 7 to 35), respectively. BV before high-dose chemotherapy-ASCT did not adversely affect peripheral blood stem cell mobilization and subsequent engraftment in a cohort of heavily pretreated patients with CD30(+) lymphomas.
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Affiliation(s)
- Manuel Afable
- University Hospitals Seidman Cancer Center, Cleveland, Ohio
| | - Paolo F Caimi
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Chitra Hosing
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Marcos de Lima
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Issa Khouri
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Basem M William
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Yago Nieto
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Brenda W Cooper
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Paolo Anderlini
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Stanton L Gerson
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Hillard M Lazarus
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.,Division of Hematology and Oncology, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | - Richard Champlin
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Uday Popat
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
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47
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Adorno-Cruz V, Kibria G, Liu X, Doherty M, Junk DJ, Guan D, Hubert C, Venere M, Mulkearns-Hubert E, Sinyuk M, Alvarado A, Caplan AI, Rich J, Gerson SL, Lathia J, Liu H. Cancer stem cells: targeting the roots of cancer, seeds of metastasis, and sources of therapy resistance. Cancer Res 2015; 75:924-9. [PMID: 25604264 DOI: 10.1158/0008-5472.can-14-3225] [Citation(s) in RCA: 179] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With the goal to remove the roots of cancer, eliminate metastatic seeds, and overcome therapy resistance, the 2014 inaugural International Cancer Stem Cell (CSC) Conference at Cleveland, OH, convened together over 320 investigators, including 55 invited world-class speakers, 25 short oral presenters, and 100 poster presenters, to gain an in-depth understanding of CSCs and explore therapeutic opportunities targeting CSCs. The meeting enabled intriguing discussions on several topics including: genetics and epigenetics; cancer origin and evolution; microenvironment and exosomes; metabolism and inflammation; metastasis and therapy resistance; single cell and heterogeneity; plasticity and reprogramming; as well as other new concepts. Reports of clinical trials targeting CSCs emphasized the urgent need for strategically designing combinational CSC-targeting therapies against cancer.
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Affiliation(s)
- Valery Adorno-Cruz
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Golam Kibria
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Xia Liu
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Mary Doherty
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Damian J Junk
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Dongyin Guan
- Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Chris Hubert
- Department of Stem Cell Biology and Regenerative Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Monica Venere
- Department of Cancer Biology, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Erin Mulkearns-Hubert
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Maksim Sinyuk
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Alvaro Alvarado
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio
| | - Arnold I Caplan
- Department of Biology, Case Western Reserve University School of Medicine, Cleveland, Ohio. National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Jeremy Rich
- Department of Stem Cell Biology and Regenerative Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio. National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Stanton L Gerson
- National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Justin Lathia
- Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, Cleveland, Ohio. National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Huiping Liu
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio. National Center for Regenerative Medicine, Case Western Reserve University, Cleveland, Ohio. Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio.
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48
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Roth JC, Alberti MO, Ismail M, Lingas KT, Reese JS, Gerson SL. MGMT enrichment and second gene co-expression in hematopoietic progenitor cells using separate or dual-gene lentiviral vectors. Virus Res 2014; 196:170-80. [PMID: 25479595 DOI: 10.1016/j.virusres.2014.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 08/12/2014] [Revised: 11/20/2014] [Accepted: 11/25/2014] [Indexed: 12/21/2022]
Abstract
The DNA repair gene O(6)-methylguanine-DNA methyltransferase (MGMT) allows efficient in vivo enrichment of transduced hematopoietic stem cells (HSC). Thus, linking this selection strategy to therapeutic gene expression offers the potential to reconstitute diseased hematopoietic tissue with gene-corrected cells. However, different dual-gene expression vector strategies are limited by poor expression of one or both transgenes. To evaluate different co-expression strategies in the context of MGMT-mediated HSC enrichment, we compared selection and expression efficacies in cells cotransduced with separate single-gene MGMT and GFP lentivectors to those obtained with dual-gene vectors employing either encephalomyocarditis virus (EMCV) internal ribosome entry site (IRES) or foot and mouth disease virus (FMDV) 2A elements for co-expression strategies. Each strategy was evaluated in vitro and in vivo using equivalent multiplicities of infection (MOI) to transduce 5-fluorouracil (5-FU) or Lin(-)Sca-1(+)c-kit(+) (LSK)-enriched murine bone marrow cells (BMCs). The highest dual-gene expression (MGMT(+)GFP(+)) percentages were obtained with the FMDV-2A dual-gene vector, but half of the resulting gene products existed as fusion proteins. Following selection, dual-gene expression percentages in single-gene vector cotransduced and dual-gene vector transduced populations were similar. Equivalent MGMT expression levels were obtained with each strategy, but GFP expression levels derived from the IRES dual-gene vector were significantly lower. In mice, vector-insertion averages were similar among cells enriched after dual-gene vectors and those cotransduced with single-gene vectors. These data demonstrate the limitations and advantages of each strategy in the context of MGMT-mediated selection, and may provide insights into vector design with respect to a particular therapeutic gene or hematologic defect.
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Affiliation(s)
- Justin C Roth
- Molecular Virology Training Program, Case Western Reserve University, Cleveland, OH, USA; Division of Hematology and Oncology, Department of Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA; Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Michael O Alberti
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Mourad Ismail
- Division of Hematology and Oncology, Department of Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Karen T Lingas
- Division of Hematology and Oncology, Department of Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Jane S Reese
- Division of Hematology and Oncology, Department of Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA; Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
| | - Stanton L Gerson
- Division of Hematology and Oncology, Department of Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA; Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA; National Center for Regenerative Medicine, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA; The Center for Stem Cell and Regenerative Medicine, Cleveland, OH, USA.
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49
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Qing Y, Gerson SL. Abstract 1910: Evolution of preleukemia stem cells to lymphoma initiating cells requires thymus in msh2-/- mice. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-1910] [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
Thymic lymphomas have been thought to develop from disregulated differentiation and proliferation of developing thymocytes. T cell progenitors are generated from hematopoietic stem cells (HSCs) in the bone marrow (BM). Recent evidence strongly suggests that whereas transformation events may occur at different developmental stages, the initial mutation originates in the HSCs, and creates a preleukemic stem cell (PLSC). Subsequent mutations at either stem cell or progenitor cell levels would transform the PLSC into lymphoma/leukemia initiating cells (LIC). Maturation and proliferation of T cells depend on regulatory mechanisms in the thymus where the T-progenitors must interact with the microenvironment. Here we investigate the requirement of thymus environment for lymphoma development.
Defects in the mismatch repair system (MMR) underlie hereditary non-polyposis colorectal cancer (HNPCC)/Lynch syndrome. Individuals with no MMR function present with childhood onset of hematological and brain malignancies. Mice carrying a null allele for the MMR gene, Msh2, are preferentially prone to develop thymic lymphomas and to a lesser extent, gastrointestinal tumors. Consistent with these findings in mice, MMR defects have also been observed in sporadic and hereditary hematological malignancies. In this study, we use MSH2-/- mice as a model to investigate the existence of PLSC and the evolution of PLSC to LIC.
Using bone marrow transplantation, we found that limiting dilutions of MSH2-/- HSCs from young mice are able to reconstitute lethally irradiated wild-type recipients, and contribute to development of multiple hematopoietic lineages. However, all the recipients develop thymic lymphomas after a latency of 3-4 months post transplantation. Transplantation of different fractions of bone marrow cells or thymocytes from young MSH2-/- mice showed that only the HSC enriched fraction leads to lymphoma development. The lymphomas are transplantable, limiting dilution experiments showed that even 40 lymphoma cells could initiate T cell leukemia in sublethally irradiated secondary recipients within a month. In contrast, transplantation of the HSC enriched LSK fraction from the BM of lymphoma bearing mice into secondary recipients resulted in thymic lymphomas after a latency of 5 months. However, lymphoma development following transplant of HSC required an intact thymus and was not observed for more than 9 months if recipients were thymectomized, whereas this stromal requirement was not observed when transplanting T cell leukemicthymic lymphoma cells.
These results suggested that MSH2-/- HSCs are PLSCs. While they retain full hematopoietic potential, their T-cell progeny gain lymphomagenic potential in the thymic microenvironment and become LICs. In this model, the evolution from PLSC to LIC is stromal-dependent.
Citation Format: Yulan Qing, Stanton L. Gerson. Evolution of preleukemia stem cells to lymphoma initiating cells requires thymus in msh2-/- mice. [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 1910. doi:10.1158/1538-7445.AM2014-1910
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Affiliation(s)
- Yulan Qing
- Case Western Reserve University, Cleveland, OH
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50
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Desai A, Qing Y, Gerson SL. Exonuclease 1 is a critical mediator of survival during DNA double strand break repair in nonquiescent hematopoietic stem and progenitor cells. Stem Cells 2014; 32:582-93. [PMID: 24420907 DOI: 10.1002/stem.1596] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 08/07/2013] [Revised: 09/11/2013] [Accepted: 09/28/2013] [Indexed: 12/13/2022]
Abstract
Hematopoietic stem cell (HSC) populations require DNA repair pathways to maintain their long-term survival and reconstitution capabilities, but mediators of these processes are still being elucidated. Exonuclease 1 (Exo1) participates in homologous recombination (HR) and Exo1 loss results in impaired 5' HR end resection. We use cultured Exo1(mut) fibroblasts and bone marrow to demonstrate that loss of Exo1 function results in defective HR in cycling cells. Conversely, in Exo1(mut) mice HR is not required for maintenance of quiescent HSCs at steady state, confirming the steady state HSC reliance on nonhomologous end joining (NHEJ). Exo1(mut) mice sustained serial repopulation, displayed no defect in competitive repopulation or niche occupancy, and exhibited no increased sensitivity to whole body ionizing radiation. However, when Exo1(mut) HSCs were pushed into cell cycle in vivo with 5-fluorouracil or poly IC, the hematopoietic population became hypersensitive to IR, resulting in HSC defects and animal death. We propose Exo1-mediated HR is dispensable for stem cell function in quiescent HSC, whereas it is essential to HSC response to DNA damage processing after cell cycle entry, and its loss is not compensated by intact NHEJ. In HSCs, the maintenance of stem cell function after DNA damage is dependent on the DNA repair capacity, segregated by active versus quiescent points in cell cycle.
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Affiliation(s)
- Amar Desai
- Department of Pharmacology, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, USA; Division of Hematology/Oncology, National Center for Regenerative Medicine, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, USA; Case Comprehensive Cancer Center, Seidman Cancer Center, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, Ohio, USA
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