776
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Yao Z, Guo Z, Yang C, Tian Q, Gong CX, Liu G, Wang JZ. Phenylbutyric acid prevents rats from electroconvulsion-induced memory deficit with alterations of memory-related proteins and tau hyperphosphorylation. Neuroscience 2010; 168:405-15. [PMID: 20371270 DOI: 10.1016/j.neuroscience.2010.03.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 03/23/2010] [Accepted: 03/27/2010] [Indexed: 11/30/2022]
Abstract
Electroconvulsive therapy has been commonly applied in the treatment of refractory depression, but its cognitive side effects are noticed and restrict its application. The molecular mechanisms underlying the side effects remain elusive, and there is no efficient prevention. By employing a recognized electroconvulsive shock (ECS) rat model, we found in the present study that ECS induced spatial memory deficits with simultaneous decreases in synaptic proteins of N-methyl-D-aspartate receptor 2A/B (NR2A/B) and postsynaptic density 95 (PSD95), the immediate early gene c-Fos and cAMP response element binding (CREB) proteins, all of which are memory-related proteins. ECS also caused tau hyperphosphorylation at multiple Alzheimer-related phosphorylation sites with activation of glycogen synthase kinase-3beta (GSK-3beta), Akt and phospho-PKR-like endoreticulum (PERK), and inhibition of protein phosphatase-2A (PP)-2A. Intraperitoneal injection of phenylbutyric acid (PBA), an aromatic short chain fatty acid with the functions of molecule chaperon, prevented rats from the ECS-induced memory deficits, alterations of the memory-associated proteins, and tau hyperphosphorylation. Our data suggest that PBA may be potentially used for attenuating the side effects caused by electroconvulsive therapy.
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777
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Zhang Y, Gu ZY, Tian Z, Yang C, Cai XY. Oral metastasis from primary transitional cell carcinoma of the renal pelvis: report of a case. Int J Oral Maxillofac Surg 2010; 39:737-9. [PMID: 20236801 DOI: 10.1016/j.ijom.2010.02.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 12/02/2009] [Accepted: 02/15/2010] [Indexed: 11/27/2022]
Abstract
Transitional cell carcinoma of the renal pelvis is initially a slow growing tumor arising from the transitional epithelium of the mucous membrane of the renal pelvis. Recurrences occur in two forms: superficial bladder cancer and distant metastases. The common metastasis is in the lung, liver, brain and bone. Oral metastasis is seldom reported. The authors report an unusual case of transitional cell carcinoma of the renal pelvis metastasized to the oral cavity and lung simultaneously in a 74-year-old man, which occurred 1 year after a left nephroureterectomy. The patient underwent six courses of chemotherapy (gemcitabine, oxaliplatin, fluorouracil and nedaplatin), and received radiotherapy for the oral lesion. The symptoms were alleviated, but the tumor recurred in the oral cavity 2 years later. Brain and liver metastases were confirmed by CT. Repeated radiotherapy for oral metastasis was performed, but the patient died 4 years after the initial nephroureterectomy due to multiple metastases.
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778
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Zhou JY, Zhong HJ, Yang C, Yan J, Wang HY, Jiang JX. Corticosterone exerts immunostimulatory effects on macrophages via endoplasmic reticulum stress. Br J Surg 2010; 97:281-93. [PMID: 20069608 DOI: 10.1002/bjs.6820] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND : Glucocorticoids are the central effector hormones for the hypothalamic-pituitary-adrenal axis. However, the effects of endogenous glucocorticoids on the immune system are not understood completely. METHODS : Macrophage function (adherence, chemotaxis and cytokine production) was assessed in the presence of increasing concentrations of corticosterone. The role of endoplasmic reticulum (ER) stress in corticosterone immunoregulation was determined with thapsigargin and plasmid pGCL-GFP-siXBP1. Mifepristone was used to determine the role of glucocorticoid receptor in the corticosterone-induced ER stress response. RESULTS : Corticosterone exerted immunostimulatory effects on macrophage function at low concentrations. No effects were observed at high concentrations in the absence of immunological stimulation. Low-dose corticosterone induced ER stress, which was correlated to the corticosterone immunostimulatory activities. Expression of X box-binding protein (XBP) 1, but not activating transcription factor 6, was significantly increased at both mRNA and protein levels only in the presence of low-dose corticosterone. Inhibition of XBP1 expression with small interfering RNA significantly inhibited the corticosterone immunostimulatory effects. In addition, pretreatment of macrophages with mifepristone significantly inhibited the expression of glucose response protein 78 and XBP1 in macrophages by low-dose corticosterone. CONCLUSION : At low concentrations, endogenous glucocorticoids exert immunostimulatory actions on macrophages. The underlying mechanisms may be correlated to ER stress via the glucocorticoid receptor, in which XBP1 plays an important role.
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779
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Yang M, Yang C, Mine Y. Multiple T cell epitope peptides suppress allergic responses in an egg allergy mouse model by the elicitation of forkhead box transcription factor 3- and transforming growth factor-beta-associated mechanisms. Clin Exp Allergy 2010; 40:668-78. [PMID: 20082619 DOI: 10.1111/j.1365-2222.2009.03442.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peptide-based immunotherapy (PIT) represents an attractive approach for targeted interventions in immunological disorders, but has not been widely explored in the context of food allergy. OBJECTIVE In this study, we built on the information obtained from the recent identification of three immunodominant T cell epitopes of hen ovalbumin (OVA), a major egg allergen, to assess the therapeutic potential of PIT for food allergy, using the BALB/c mouse model. METHODS Groups of mice were sensitized to OVA by repeated oral gavages, and subsequently administered with single or multiple synthetic peptides containing OVA T cell epitopes. Following the peptide administration period, all mice were orally challenged with high doses of OVA to elicit active anaphylaxis. Serum, spleen, and intestinal tissues were collected for the determination of immunoglobulin levels, cytokine secretions, and intestinal gene expression. RESULTS Significantly lower anaphylactic scores were exhibited by mice that received multiple epitope-containing peptides, accompanied by lower serum histamine and OVA-specific IgE levels, compared with placebo-treated mice. Mechanistically, the quantification of cytokine secretions in splenocyte cultures revealed a T helper type 1-biased response (IFN-gamma) in all peptide-treated mice to the detriment of a T helper type 2-response (IL-4). Interestingly, a similar cytokine expression profile was determined in intestinal tissues, accompanied by a pronounced mRNA expression of regulatory molecules TGF-beta and forkhead box transcription factor 3 (FOXP3). These data suggest the activation of local repressive mechanisms mediated by subsets of regulatory T cells. CONCLUSION We demonstrated the therapeutic potential of PIT in a mouse model of food allergy model and provided evidence that mechanistic pathways entailing regulatory molecules TGF-beta and FOXP3, stand as promising trails for the further understanding of peptide-based strategies for food allergy.
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780
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Song Y, Wang Z, Tang Q, Xu H, Xing C, Miao Z, Yang C. Partial cancerous changes eventually developing into superficial spreading cancer over 18 months. Curr Oncol 2009; 16:57-60. [PMID: 20016747 PMCID: PMC2794672 DOI: 10.3747/co.v16i6.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In this report, we describe a patient presenting with the superficial spreading type of early gastric cancer (egc) accompanied by cancerous ulcers. Disease progression and treatment outcome are discussed. After symptoms persisted for more than 1 year, the patient underwent total gastrectomy with D2 lymph node dissection. The patient was diagnosed with superficial spreading cancer (ssc), accompanied by an extensive iic lesions. The progression of this patient suggests that the co-occurrence of cancerous ulcers may contribute to egc development to some extent. As is known, egc often develops into advanced gastric cancer with time. However, in our case, we observed a process during which partial cancerous changes developed into ssc over 18 months. Superficial spreading cancer should be considered an egc variant, which may have the ability to spread superficially along the stomach wall without invading the muscularis propria. But we speculate that, if gene expression changes for some reason, the malignant ssc cells may acquire the ability to grow deeply into the stomach wall. Eventually, Borrmann type iv gastric cancer may develop.
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781
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Liu Y, Xu F, Zhang Z, Yang C, Song R, Tian Y. Analysis of Synephrine in Da-cheng-qi Decoction by HPLC Employing Precolumn Derivatization With 9-Fluorenylmethyl Chloroformate. J Chromatogr Sci 2009; 47:925-30. [DOI: 10.1093/chromsci/47.10.925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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782
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Liu T, Yang C, Chen A, Stern R, Perks J, Gupta V, Jennelle R, Do L, Valicenti R, Purdy J. Mathematical Modeling of Dose Volume Histograms (DVHs) among Patients undergoing Radiation Therapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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783
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Yang C, He YL, Zhang L, Xu L, Yi Z, Wang Y, Li N, Zhu D. GLS/IL-12-modified Mycobacterium smegmatis as a novel anti-tuberculosis immunotherapeutic vaccine. Int J Tuberc Lung Dis 2009; 13:1360-1366. [PMID: 19861007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To study the effects and mechanisms of recombinant Mycobacterium smegmatis (rMS) carrying pZM03 (a co-expression plasmid encoding human granulysin [GLS] and murine interleukin 12 [IL-12]) on murine M. tuberculosis infection. DESIGN BALB/c mice infected with M. tuberculosis were treated with normal saline, M. smegmatis, pZM03 or rMS. The number of viable bacteria in the lungs and spleens were counted to observe the therapeutic effects. The levels of IL-12 and interferon-gamma (IFN-gamma) in serum, and IFN-gamma and tumour necrosis factor-alpha (TNF-alpha) released from spleen lymphocytes were detected to observe the T-helper 1 (Th1) response. Secretory IgA (SIgA) in bronchoalveolar lavage fluid was measured to observe the mucosal immunity. The lungs and spleens were prepared for pathological analysis. RESULTS The rMS group showed a significantly reduced number of colony-forming units compared to the other groups. The expression of GLS in the tissue, and increased levels of IL-12, IFN-gamma, TNF-alpha and SIgA, were found in the rMS group. The pathological changes in the lungs of the rMS group were localised, while those in the control group were extensive. CONCLUSION rMS had immunotherapeutic effects associated with a switch to the Th1 response and the antibacterial activity of GLS.
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MESH Headings
- Animals
- Antigens, Differentiation, T-Lymphocyte/genetics
- Antigens, Differentiation, T-Lymphocyte/immunology
- Bronchoalveolar Lavage Fluid/immunology
- Cells, Cultured
- Disease Models, Animal
- Female
- Humans
- Immunoglobulin A, Secretory/metabolism
- Interferon-gamma/blood
- Interleukin-12/blood
- Interleukin-12/genetics
- Interleukin-12/immunology
- Lung/immunology
- Lung/microbiology
- Mice
- Mice, Inbred BALB C
- Mycobacterium smegmatis/genetics
- Mycobacterium smegmatis/immunology
- Mycobacterium tuberculosis/pathogenicity
- Spleen/immunology
- Spleen/microbiology
- Th1 Cells/immunology
- Tuberculosis Vaccines/genetics
- Tuberculosis Vaccines/immunology
- Tuberculosis, Pulmonary/immunology
- Tuberculosis, Pulmonary/microbiology
- Tuberculosis, Pulmonary/pathology
- Tuberculosis, Pulmonary/therapy
- Tuberculosis, Splenic/immunology
- Tuberculosis, Splenic/microbiology
- Tuberculosis, Splenic/pathology
- Tuberculosis, Splenic/therapy
- Tumor Necrosis Factor-alpha/metabolism
- Vaccines, Synthetic/immunology
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784
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Yang C, Zhu Q, Han Y, Zhu J, Wang H, Cong R, Zhang D. Minimally-invasive total hip arthroplasty will improve early postoperative outcomes: a prospective, randomized, controlled trial. Ir J Med Sci 2009; 179:285-90. [DOI: 10.1007/s11845-009-0437-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Accepted: 09/16/2009] [Indexed: 10/20/2022]
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785
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Yang C, Tong Y, Ni W, Liu J, Xu W, Li L, Liu X, Meng H, Qian W. Inhibition of autophagy induced by overexpression of mda-7/interleukin-24 strongly augments the antileukemia activity in vitro and in vivo. Cancer Gene Ther 2009; 17:109-19. [PMID: 19730452 DOI: 10.1038/cgt.2009.57] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Melanoma differentiation-associated gene-7/interleukin-24 (mda-7/IL-24) is a novel candidate of tumor suppressor that can selectively induce apoptosis experimentally in a spectrum of human cancer cells including leukemia cells. However, a recent study suggests that mda-7/IL-24 promotes the survival of chronic lymphocytic leukemia B-cells. In this study, we showed that mda-7/IL-24 was constitutively expressed in leukemia cell lines and primary acute myeloid leukemia samples. Using a conditionally replicating adenovirus expressing mda-7/IL-24 (ZD55-IL-24), we showed that enforced expression of mda-7/IL-24 in leukemia cells induced autophagy, which was triggered by the upregulation of Beclin-1. Immunofluorescence and coimmunoprecipitation studies suggested that mda-7/IL-24 protein interacts with Beclin-1. Class III PI3K/Beclin-1 complex was shown involved in the mda-7/IL-24-induced autophagy. Moreover, autophagy inhibition by phosphatidylinositol 3-kinase inhibitor, wortmannin, resulted in a reduced Beclin-1 expression and autophagosome formation associated with significantly enhanced cell death. Importantly, the combination of ZD55-IL-24 with wortmannin elicited a strongly enhanced antileukemia efficacy in established leukemia xenografts. These results suggest that mda-7/IL-24-induced autophagy in leukemia cells may provide survival advantage and mda-7/IL-24 combined with agents that disrupt autophagy is a promising new strategy for the treatment of leukemia.
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786
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Wilder‐Smith C, Yang C, Graham S. 656 ABNORMAL POSTERIOR INSULA CORTEX ACTIVATION AND ENDOGENOUS PAIN MODULATION IN IRRITABLE BOWEL SYNDROME. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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787
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Zhang YH, Yong YM, Mao ZS, Yang C, Sun HY, Wang HL. Numerical Simulation of Gas-Liquid Flow in a Stirred Tank with Swirl Modification. Chem Eng Technol 2009. [DOI: 10.1002/ceat.200900067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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788
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Fang B, Shen GF, Yang C, Wu Y, Feng YM, Mao LX, Xia YH. Changes in condylar and joint disc positions after bilateral sagittal split ramus osteotomy for correction of mandibular prognathism. Int J Oral Maxillofac Surg 2009; 38:726-30. [PMID: 19375280 DOI: 10.1016/j.ijom.2009.03.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 07/19/2008] [Accepted: 03/02/2009] [Indexed: 11/26/2022]
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789
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Lu P, Yang C, Guasparri I, Harrington W, Wang YL, Cesarman E. Early events of B-cell receptor signaling are not essential for the proliferation and viability of AIDS-related lymphoma. Infect Agent Cancer 2009. [PMCID: PMC4261762 DOI: 10.1186/1750-9378-4-s2-p13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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790
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Yang C, Liu W, Nakayama A. Forced Convective Heat Transfer Enhancement in a Tube with its Core Partially Filled with a Porous Medium. ACTA ACUST UNITED AC 2009. [DOI: 10.2174/1877729500901010001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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791
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Sheth N, Yang C, Murphy S, Weiss M, Sim S. SU-FF-T-87: Dose Reconstruction of Intracranial Hypofractionated Helical Tomotherapy Treatments for Adaptive Planning. Med Phys 2009. [DOI: 10.1118/1.3181560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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792
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Chang TJ, Chen WP, Yang C, Lu PH, Liang YC, Su MJ, Lee SC, Chuang LM. Serine-385 phosphorylation of inwardly rectifying K+ channel subunit (Kir6.2) by AMP-dependent protein kinase plays a key role in rosiglitazone-induced closure of the K(ATP) channel and insulin secretion in rats. Diabetologia 2009; 52:1112-21. [PMID: 19357830 DOI: 10.1007/s00125-009-1337-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 02/26/2009] [Indexed: 11/27/2022]
Abstract
AIMS/HYPOTHESIS Rosiglitazone, an insulin sensitiser, not only improves insulin sensitivity but also enhances insulin secretory capacity by ameliorating gluco- and lipotoxicity in beta cells. Rosiglitazone can stimulate insulin secretion at basal and high glucose levels via a phosphatidylinositol 3-kinase (PI3K)-dependent pathway. We hypothesised that regulation of phosphorylation of the ATP-sensitive potassium (K(ATP)) channel might serve as a key step in the regulation of insulin secretion. METHODS Insulin secretory responses were studied in an isolated pancreas perfusion system, cultured rat islets and MIN6 and RINm5F beta cells. Signal transduction pathways downstream of PI3K were explored to link rosiglitazone to K(ATP) channel conductance with patch clamp techniques and insulin secretion measured by ELISA. RESULTS Rosiglitazone stimulated AMP-activated protein kinase (AMPK) activity and induced inhibition of the K(ATP) channel conductance in islet beta cells; both effects were blocked by the PI3K inhibitor LY294002. Following stimulation of AMPK by 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR), a pharmacological activator, both AICAR-stimulated insulin secretion and inhibition of K(ATP) channel conductance were unaffected by LY294002, indicating that AMPK activation occurs at a site downstream of PI3K activity. The serine residue at amino acid position 385 of Kir6.2 was found to be the substrate phosphorylation site of AMPK when activated by rosiglitazone or AICAR. CONCLUSIONS/INTERPRETATION Our data indicate that PI3K-dependent activation of AMPK is required for rosiglitazone-stimulated insulin secretion in pancreatic beta cells. Phosphorylation of the Ser(385) residue of the Kir6.2 subunit of the K(ATP) channel by AMPK may play a role in insulin secretion.
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793
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Liu T, Stern R, Yang C, Kahilainen J, Purdy J. SU-FF-T-366: Temporal Methods for the Elimination of the Cerenkov and Fluorescence Interference in Optical Fiber Dosimeters for External Beam Radiation Therapy. Med Phys 2009. [DOI: 10.1118/1.3181847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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794
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He R, Yang C. SU-FF-T-359: MapPhan with MapCHECK and Im'RT MatriXX for Real Gantry Angle IMRT QA. Med Phys 2009. [DOI: 10.1118/1.3181840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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795
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He R, Yang C. SU-FF-T-326: A Systematic Methodology in Dosimetric Verification of Anisotropic Analytical Algorithm in Eclipse Treatment Planning System. Med Phys 2009. [DOI: 10.1118/1.3181806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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796
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Yang J, Liu T, Yang C, Jennelle R, Chen A, Do L, Valicenti R, Purdy J. SU-FF-T-176: Rectal and Bladder Dose in Relationship to PTV Percentage Coverage in Prostate IMRT. Med Phys 2009. [DOI: 10.1118/1.3181651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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797
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Yang C, Sheth N, Murphy S, Sim S, Chen Y. SU-FF-T-664: Dose Grid Effects in Adaptive Planning of Helical TomoTherapy for Hypofractionated Treatments. Med Phys 2009. [DOI: 10.1118/1.3182162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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798
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Cui J, Stern R, Yang C, Purdy J. SU-FF-T-641: Testing the Sc, Sp, Scp Formulism for Elekta Beam Modulator. Med Phys 2009. [DOI: 10.1118/1.3182139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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799
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Yang C, Liu T, Zhou H, Cui J, Perks J, Stern R, Purdy J. SU-FF-T-245: Improvement of QA Pass-Rate in IMRT Patient Specific QA Using MapCHECK. Med Phys 2009. [DOI: 10.1118/1.3181721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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800
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Yang C, Hirsh V, Cadranel J, Chen Y, Park K, Kim S, Chao T, Oberdick M, Shahidi M, Miller V. Phase IIb/III double-blind randomized trial of BIBW 2992, an irreversible, dual inhibitor of EGFR and HER2 plus best supportive care (BSC) versus placebo plus BSC in patients with NSCLC failing 1–2 lines of chemotherapy (CT) and erlotinib or gefitinib (LUX- Lung1): A preliminary report. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8062 Background: No approved therapy exists for NSCLC patients (pts) who have failed chemotherapy (CT) and the reversible epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), erlotinib (E) or gefitinib (G). The efficacy of BIBW 2992 (Tovok), a potent, irreversible inhibitor of EGFR and human epidermal growth factor receptor 2 (HER2) with preclinical activity against the secondary resistance mutation T790M, in pts progressing after initial clinical benefit on E/G is being assessed in this randomized trial. Methods: Pts with advanced adenocarcinoma of the lung (Stage IIIB/IV; ECOG 0–2), who have failed one or two lines of CT (including platinum) and progressed following at least 12 weeks of E or G are randomized in a 2:1 ratio to receive BSC plus either oral BIBW 2992 50 mg qd or placebo until disease progression or unacceptable toxicity. Primary endpoint is overall survival, with progression-free survival, objective response and clinical benefit rate and duration, safety and quality of life being secondary endpoints. Enrollment of 400 pts is planned (HR=0.70, 85% power). An unblinded interim analysis of tumor response and safety by the independent Data Monitoring Committee (DMC) after the first 40 evaluable pts treated with BIBW 2992 will determine continuation to full accrual. Results: From May to November 2008, 145 pts have been randomized and 76 are still on treatment. Demographics (n=145): median age 59 (range: 30–82); female 68%, current/ex-smokers 38%; metastatic disease 91%, ECOG 0–1 92%; Asian origin 68%. 50% had one prior line of CT. Main prior EGFR-TKI was G in Asians (70%) and E in non-Asians (85%). 40% of pts had achieved a PR or CR on previous treatment with E/G. Duration of prior E/G treatment was >24 weeks and >48 weeks in 80% and 40% of pts, respectively. As expected, diarrhea, rash, anorexia, stomatitis, paronychia, nausea and vomiting were the most frequently observed adverse events. Conclusions: The trial is continuing recruitment after DMC review of efficacy and safety and updated demographics and blinded safety data will be reported. [Table: see text]
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