1
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Synthesis and biological evaluation of aminobenzamides containing purine moiety as class I histone deacetylases inhibitors. Bioorg Med Chem 2021; 56:116599. [DOI: 10.1016/j.bmc.2021.116599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 01/26/2023]
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2
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Li Q, Persoons L, Daelemans D, Herdewijn P. Iron/Copper Co-Catalyzed Cross-Coupling Reaction for the Synthesis of 6-Substituted 7-Deazapurines and the Corresponding Nucleosides. J Org Chem 2019; 85:403-418. [DOI: 10.1021/acs.joc.9b02414] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Qingfeng Li
- KU Leuven, Rega Institute for Medical Research, Medicinal Chemistry, Herestraat 49-bus 1041, 3000 Leuven, Belgium
| | - Leentje Persoons
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Herestraat 49-bus 1043, 3000 Leuven, Belgium
| | - Dirk Daelemans
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Herestraat 49-bus 1043, 3000 Leuven, Belgium
| | - Piet Herdewijn
- KU Leuven, Rega Institute for Medical Research, Medicinal Chemistry, Herestraat 49-bus 1041, 3000 Leuven, Belgium
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3
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Xu Z, Yang Y, Mai X, Liu B, Xiong Y, Feng L, Liao Y, Zhang Y, Wang H, Ouyang L, Liu S. Syntheses and Biological Evaluation of Novel Hydroxamic Acid Derivatives Containing Purine Moiety as Histone Deacetylase Inhibitors. Chem Pharm Bull (Tokyo) 2018; 66:439-451. [PMID: 29607910 DOI: 10.1248/cpb.c17-00997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The novel hydroxamates containing purine scaffold were designed, synthesized and screened for their biological activities as histone deacetylase (HDAC) inhibitors. Some of them exhibited excellent acti-HDACs activities and antiproliferative activities, the most promising compound was 7m'. Western blot analysis indicated the compounds 7f', 7l', 7m', 7o' could increase histone H3 acetylation levels in HCT116 and K562 cell lines, and 7m' increased the level of acetyl histone H3 in a dose-dependent manner, which is similar to the behavior of suberoylanilide hydroxamic acid (SAHA). Molecular docking study revealed that the conformation of 7m' in the active site of HDAC2 was similar to positive drug SAHA, which were oriented with the hydroxamic acid towards the catalytic center and formed metal binding with zinc ion.
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Affiliation(s)
- Zhaoxing Xu
- School of Pharmaceutical Sciences, Nanchang University
| | - Yongchao Yang
- School of Pharmaceutical Sciences, Nanchang University
| | - Xi Mai
- School of Pharmaceutical Sciences, Nanchang University
| | - Bin Liu
- School of Pharmaceutical Sciences, Nanchang University
| | | | - Lihuang Feng
- School of Pharmaceutical Sciences, Nanchang University
| | - Yijing Liao
- School of Pharmaceutical Sciences, Nanchang University
| | - Yu Zhang
- School of Pharmaceutical Sciences, Nanchang University
| | - Huanlu Wang
- School of Pharmaceutical Sciences, Nanchang University
| | | | - Shuhao Liu
- School of Pharmaceutical Sciences, Nanchang University
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4
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Ren H, An H, Hatala PJ, Stevens WC, Tao J, He B. Versatile synthesis and biological evaluation of novel 3'-fluorinated purine nucleosides. Beilstein J Org Chem 2015; 11:2509-20. [PMID: 26734098 PMCID: PMC4685831 DOI: 10.3762/bjoc.11.272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/26/2015] [Indexed: 01/03/2023] Open
Abstract
A unified synthetic strategy accessing novel 3'-fluorinated purine nucleoside derivatives and their biological evaluation were achieved. Novel 3'-fluorinated analogues were constructed from a common 3'-deoxy-3'-fluororibofuranose intermediate. Employing Suzuki and Stille cross-coupling reactions, fifteen 3'-fluororibose purine nucleosides 1-15 and eight 3'-fluororibose 2-chloro/2-aminopurine nucleosides 16-23 with various substituents at position 6 of the purine ring were efficiently synthesized. Furthermore, 3'-fluorine analogs of natural products nebularine and 6-methylpurine riboside were constructed via our convergent synthetic strategy. Synthesized nucleosides were tested against HT116 (colon cancer) and 143B (osteosarcoma cancer) tumor cell lines. We have demonstrated 3'-fluorine purine nucleoside analogues display potent tumor cell growth inhibition activity at sub- or low micromolar concentration.
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Affiliation(s)
- Hang Ren
- College of Chemistry and Molecular Engineering, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
- Granlen, Inc., 7864 Paseo Tulipero, Carlsbad, CA 92009, USA
| | - Haoyun An
- Granlen, Inc., 7864 Paseo Tulipero, Carlsbad, CA 92009, USA
| | - Paul J Hatala
- Granlen, Inc., 7864 Paseo Tulipero, Carlsbad, CA 92009, USA
| | | | - Jingchao Tao
- College of Chemistry and Molecular Engineering, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, China
| | - Baicheng He
- Molecular Oncology Laboratory, The University of Chicago Medical Center, Chicago, Illinois 60637, USA
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5
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Nauš P, Caletková O, Konečný P, Džubák P, Bogdanová K, Kolář M, Vrbková J, Slavětínská L, Tloušt'ová E, Perlíková P, Hajdúch M, Hocek M. Synthesis, cytostatic, antimicrobial, and anti-HCV activity of 6-substituted 7-(het)aryl-7-deazapurine ribonucleosides. J Med Chem 2014; 57:1097-110. [PMID: 24397620 DOI: 10.1021/jm4018948] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A series of 80 7-(het)aryl- and 7-ethynyl-7-deazapurine ribonucleosides bearing a methoxy, methylsulfanyl, methylamino, dimethylamino, methyl, or oxo group at position 6, or 2,6-disubstituted derivatives bearing a methyl or amino group at position 2, were prepared, and the biological activity of the compounds was studied and compared with that of the parent 7-(het)aryl-7-deazaadenosine series. Several of the compounds, in particular 6-substituted 7-deazapurine derivatives bearing a furyl or ethynyl group at position 7, were significantly cytotoxic at low nanomolar concentrations whereas most were much less potent or inactive. Promising activity was observed with some compounds against Mycobacterium bovis and also against hepatitis C virus in a replicon assay.
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Affiliation(s)
- Petr Nauš
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center , Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
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6
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Nauš P, Perlíková P, Bourderioux A, Pohl R, Slavětínská L, Votruba I, Bahador G, Birkuš G, Cihlář T, Hocek M. Sugar-modified derivatives of cytostatic 7-(het)aryl-7-deazaadenosines: 2'-C-methylribonucleosides, 2'-deoxy-2'-fluoroarabinonucleosides, arabinonucleosides and 2'-deoxyribonucleosides. Bioorg Med Chem 2012; 20:5202-14. [PMID: 22877872 DOI: 10.1016/j.bmc.2012.07.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/02/2012] [Accepted: 07/02/2012] [Indexed: 01/20/2023]
Abstract
A series of novel sugar-modified derivatives of cytostatic 7-hetaryl-7-deazaadenosines (2'-C-methylribonucleosides, 2'-deoxy-2'-fluoroarabinonucleosides, arabinonucleosides and 2'-deoxyribonucleosides) was prepared and screened for biological activity. The synthesis consisted of preparation of the corresponding sugar-modified 7-iodo-7-deazaadenine nucleosides and their aqueous-phase Suzuki-Miyaura cross-coupling reactions with (het)arylboronic acids or Stille couplings with hetarylstannanes in DMF. The synthesis of 7-iodo-7-deazaadenine nucleosides was based on a glycosidation of 6-chloro-7-iodo-7-deazapurine with a suitable sugar synthon or on an interconversion of 2'-OH stereocenter (for arabinonucleosides). Several examples of 2'-C-Me-ribonucleosides showed moderate anti-HCV activities in a replicon assay accompanied by cytotoxicity. Several 7-hetaryl-7-deazaadenine fluoroarabino- and arabinonucleosides exerted moderate micromolar cytostatic effects. The most active was 7-ethynyl-7-deazaadenine fluoroarabinonucleoside which showed submicromolar antiproliferative activity. However, all the sugar-modified derivatives were less active than the parent ribonucleosides.
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Affiliation(s)
- Petr Nauš
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
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7
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Karskela T, Klika KD, Lönnberg H. Synthesis of 7-substituted 3-β-D-ribofuranosyl-3H-imidazo[2,1-i]purines. ACTA ACUST UNITED AC 2011. [DOI: 10.1135/cccc2011069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A method for the synthesis of 7-substituted 3-β-D-ribofuranosyl-3H-imidazo[2,1-i]purines has been devised whereby compounds were prepared in a few steps from a common intermediate, 3-(2′,3′-O-isopropylidene-β-D-ribofuranosyl)-3H-imidazo[2,1-i]purine-7-carbaldehyde, obtained from the reaction of 2′,3′-O-isopropylideneadenosine with bromomalonaldehyde. The formyl group of the carbaldehyde was subsequently reductively aminated and the resulting secondary amines were then further derivatized either by acylation, lactamization or reductive alkylation.
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8
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Bourderioux A, Nauš P, Perlíková P, Pohl R, Pichová I, Votruba I, Džubák P, Konečný P, Hajdúch M, Stray KM, Wang T, Ray AS, Feng JY, Birkus G, Cihlar T, Hocek M. Synthesis and Significant Cytostatic Activity of 7-Hetaryl-7-deazaadenosines. J Med Chem 2011; 54:5498-507. [DOI: 10.1021/jm2005173] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aurelie Bourderioux
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Petr Nauš
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Pavla Perlíková
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Radek Pohl
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Iva Pichová
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Ivan Votruba
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
| | - Petr Džubák
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Puškinova 6, Olomouc 77520, Czech Republic
| | - Petr Konečný
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Puškinova 6, Olomouc 77520, Czech Republic
| | - Marián Hajdúch
- Laboratory of Experimental Medicine, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Puškinova 6, Olomouc 77520, Czech Republic
| | - Kirsten M. Stray
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Ting Wang
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Adrian S. Ray
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Joy Y. Feng
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Gabriel Birkus
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Tomas Cihlar
- Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, California 94404, United States
| | - Michal Hocek
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
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9
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Naus P, Pohl R, Votruba I, Dzubák P, Hajdúch M, Ameral R, Birkus G, Wang T, Ray AS, Mackman R, Cihlar T, Hocek M. 6-(Het)aryl-7-deazapurine ribonucleosides as novel potent cytostatic agents. J Med Chem 2010; 53:460-70. [PMID: 19929004 DOI: 10.1021/jm901428k] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A series of novel 7-deazapurine ribonucleosides bearing an alkyl, aryl, or hetaryl group in position 6 and H, F, or Cl atom in position 7 has been prepared either by Pd-catalyzed cross-coupling reactions of the corresponding protected 6-chloro-(7-halogenated-)7-deazapurine ribonucleosides with alkyl- or (het)arylorganometallics followed by deprotection, or by single-step aqueous phase cross-coupling reactions of unprotected 6-chloro-(7-halogenated-)7-deazapurine ribonucleosides with (het)arylboronic acids. Significant cytostatic effect was detected with a substantial proportion of the prepared compounds. The most potent were 7-H or 7-F derivatives of 6-furyl- or 6-thienyl-7-deazapurines displaying cytostatic activity in multiple cancer cell lines with a geometric mean of 50% growth inhibition concentration ranging from 16 to 96 nM, a potency comparable to or better than that of the nucleoside analogue clofarabine. Intracellular phosphorylation to mono- and triphosphates and the inhibition of total RNA synthesis was demonstrated in preliminary study of metabolism and mechanism of action studies.
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Affiliation(s)
- Petr Naus
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, Gilead Sciences & IOCB Research Center, Flemingovo nam. 2, CZ-16610 Prague 6, Czech Republic
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10
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Hui CK, Cheung WWW, Zhang HY, Au WY, Yueng YH, Leung AYH, Leung N, Luk JM, Lie AKW, Kwong YL, Liang R, Lau GKK. Kinetics and risk of de novo hepatitis B infection in HBsAg-negative patients undergoing cytotoxic chemotherapy. Gastroenterology 2006; 131:59-68. [PMID: 16831590 DOI: 10.1053/j.gastro.2006.04.015] [Citation(s) in RCA: 389] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Accepted: 03/23/2006] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS De novo hepatitis B virus (HBV)-related hepatitis after chemotherapy results in high morbidity and mortality. We evaluate the clinical course of de novo HBV-related hepatitis after chemotherapy. METHODS Two hundred forty-four consecutive hepatitis B surface antigen (HBsAg)-negative lymphoma patients treated with chemotherapy were followed up for a median of 12.4 (range, 0.1-65.0) months. Serially collected serum samples were analyzed for hepatitis, serum HBV DNA, and HBsAg seroreversion. RESULTS Eight of the 244 patients (3.3%) developed de novo HBV-related hepatitis. A 100-fold increase in serum HBV DNA preceded de novo HBV-related hepatitis by a median of 18.5 (range, 12-28) weeks. All 8 patients had normal serum alanine aminotransaminase level when the 100-fold increase in serum HBV DNA occurred. Patients with de novo HBV-related hepatitis were more likely to have occult HBV infection before chemotherapy. Direct sequencing results showed that these 8 patients had de novo HBV-related hepatitis from reactivation of occult HBV infection. Three of the 8 patients with de novo HBV-related hepatitis compared with 6 of the 236 patients without de novo HBV-related hepatitis developed fulminant hepatic failure (37.5% vs 2.5%, respectively, P < .001). On multivariate Cox analysis, de novo HBV-related hepatitis was independently associated with a higher risk of fulminant hepatic failure (relative risk, 29.854; 95% confidence interval: 4.844-183.980; P < .001). CONCLUSIONS Close surveillance for a 100-fold increase in HBV DNA is recommended for HBsAg-negative patients treated with chemotherapy so that early commencement of antiviral therapy can be initiated before the occurrence of de novo HBV-related hepatitis.
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Affiliation(s)
- Chee-Kin Hui
- Centre For The Study of Liver Diseases, The University of Hong Kong, Hong Kong SAR, China.
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11
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Kay NE. Purine Analogue-Based Chemotherapy Regimens for Patients With Previously Untreated B-Chronic Lymphocytic Leukemia. Semin Hematol 2006; 43:S50-4. [PMID: 16549115 DOI: 10.1053/j.seminhematol.2005.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
B-cell chronic lymphocytic leukemia (B-CLL) is a clonal malignancy characterized by the expansion of small B lymphocytes and accumulation of CLL cells. This disease is the most common form of leukemia in the Western hemisphere and is currently not considered to be curable using currently available therapies. Published reports have suggested that purine analogues have activity in B-CLL and superior to alkylating agents. Even though responses have been observed with purine analogues that are used as single agents, these responses were not durable. The use of combination purine analogue therapy with alkylating agents and/or monoclonal antibodies was then explored in order to take advantage of synergistic actions of these agents to improve the quality of clinical responses. Both fludarabine and pentostatin have shown improved responses when combined with alkylating agents and even higher overall and complete responses (CRs) when combined with monoclonal antibodies.
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Affiliation(s)
- Neil E Kay
- Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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12
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Lamanna N, Weiss MA. Purine Analogue-Based Chemotherapy Regimens for Second-Line Therapy in Patients With Chronic Lymphocytic Leukemia. Semin Hematol 2006; 43:S44-9. [PMID: 16549114 DOI: 10.1053/j.seminhematol.2005.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A dramatic change has occurred in the management of chronic lymphocytic leukemia (CLL) over the past 20 years. The use of newer therapies, including the purine analogues, has resulted in higher frequencies of response. Combination therapy with purine analogues, alkylators, and/or monoclonal antibodies represents a promising new approach to the treatment of patients with CLL. The most commonly studied regimens have utilized fludarabine, but severe myelosuppression and immunosuppression of these combinations require close attention to dosing and schedule. Of the purine analogues that show activity in CLL, pentostatin appears to be the least myelosuppressive. These combination strategies are associated with high-quality responses in the majority of patients and may one day lead to improved survival or possibly even a cure for patients with CLL.
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Affiliation(s)
- Nicole Lamanna
- Department of Medicine, Leukemia Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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13
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Legraverend M, Grierson DS. The purines: potent and versatile small molecule inhibitors and modulators of key biological targets. Bioorg Med Chem 2006; 14:3987-4006. [PMID: 16503144 DOI: 10.1016/j.bmc.2005.12.060] [Citation(s) in RCA: 258] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Revised: 12/29/2005] [Accepted: 12/29/2005] [Indexed: 11/24/2022]
Abstract
The goal of this review is to highlight the wide range of biological activities displayed by purines, with particular emphasis on new purine-based agents which find potential application as chemical-biology tools and/or therapeutic agents. The expanding interest in the biological properties of polyfunctionalized purine derivatives issues, in large part, from the development of rapid high-throughput screening essays for new protein targets, and the corresponding development of efficient synthetic methodology adapted to the construction of highly diverse purine libraries. Purine-based compounds have found new applications as inducers of interferon and lineage-committed cell dedifferentiation, agonists and antagonists of adenosine receptors, ligands of corticotropin-releasing hormone receptors, and as inhibitors of HSP90, Src kinase, p38alpha MAP kinase, sulfotransferases, phosphodiesterases, and Cdks. The scope of application of purines in biology is most certainly far from being exhausted. Testing purine derivatives against the multitude of biological targets for which small molecule probes have not yet been found should thus be a natural reflex.
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Affiliation(s)
- Michel Legraverend
- UMR 176 CNRS-Institut Curie, Laboratoire de Pharmacochimie, Bât. 110, Centre Universitaire, 91405 Orsay, France.
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14
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Robak T, Szmigielska-Kapłon A, Błoński JZ, Kasznicki M, Chojnowski K. Activity of Cladribine Combined with Etoposide in Heavily Pretreated Patients with Indolent Lymphoid Malignancies. Chemotherapy 2005; 51:247-51. [PMID: 16088121 DOI: 10.1159/000087251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2004] [Accepted: 03/10/2005] [Indexed: 11/19/2022]
Abstract
We determined the effectiveness and toxicity of combined chemotherapy consisting of etoposide 100 mg/m(2)/day i.v. and cladribine (2-CdA) 0.12 mg/kg/day i.v. each for 5 days (EC regimen) in the treatment of refractory or relapsed low-grade non-Hodgkin's lymphoma and chronic lymphocytic leukemia. The cycles were repeated every 28 days, reaching a maximum of six courses. Twenty patients entered the study. All patients had received three or more cycles of chemotherapy before the EC regimen (median 8, range 3-19). Thirteen patients received 2-CdA before the EC regimen. Seven out of 20 patients (35%) responded, including one complete response. Median overall survival time of responding patients was 22 months (range 3-30). Myelosuppression and infections were the major toxicity of the EC regimen.
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Affiliation(s)
- T Robak
- Department of Hematology, Medical University of Lodz and Copernicus Memorial Hospital, Poland.
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15
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Dillman RO. Pentostatin (Nipent) in the treatment of chronic lymphocyte leukemia and hairy cell leukemia. Expert Rev Anticancer Ther 2004; 4:27-36. [PMID: 14748654 DOI: 10.1586/14737140.4.1.27] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pentostatin (Nipent), formerly known as deoxycoformycin, is a profound inhibitor of the enzyme adenosine deaminase, resulting in the accumulation of metabolites that inhibit ribonucleotide reductase, which in turn inhibits DNA synthesis. Pentostatin was the first of the purine analogs to undergo extensive testing as an anticancer agent and the first to receive US Food and Drug Administration approval for a treatment indication. It is highly effective as first-line monotherapy in hairy cell leukemia, with a complete response rate of 80% and a 10-year survival rate of around 80%. Pentostatin is also active in chronic lymphocyte leukemia as a single agent, but appears even more promising in combination approaches with the alkylating agents chlorambucil or cyclophosphamide. Due to the increasing recognition of delayed severe stem cell and immune suppression following therapy with other purine analogs, there has been renewed interest in pentostatin, especially in combination with chemotherapy and/or the monoclonal antibody rituximab (Rituxan) in chronic lymphocyte leukemia.
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Affiliation(s)
- Robert O Dillman
- Hoag Cancer Center, 1 Hoag Drive, Building 41, Newport Beach, CA 92660, USA.
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16
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Petrella M, Montaner J, Batist G, Wainberg MA. The role of surrogate markers in the clinical development of antiretroviral therapy: a model for early evaluation of targeted cancer drugs. Cancer Invest 2004; 22:149-60. [PMID: 15069773 DOI: 10.1081/cnv-120027590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Both CD4 cell counts and measurements of plasma HIV-1 RNA (i.e. viral load) have become established surrogate markers for predicting treatment and disease outcome in HIV infection, and are instrumental for the evaluation of new antiretroviral drugs in clinical trials. Recently, HIV drug-resistance testing has also become available and has been shown to have prognostic value in providing guidance with antiretroviral therapy. The identification of robust surrogate markers is also an essential requirement for the clinical development of targeted anticancer agents, which unlike their cytotoxic counterparts, are often devoid of the toxicities that have been traditionally used to monitor the efficacy of chemotherapy. In particular, biological or molecular markers that are predictive of a drug effect need to be integrated into early efficacy trials of targeted therapies in order to confirm that the drug is in fact "hitting" the intended target. The full clinical significance of many of the altered cell types or polymorphisms, which are selected by cytostatic agents, remains to be elucidated. However, molecular genotyping of these targets, akin to drug resistance testing for HIV infection, may constitute an important strategy to assist with the selection and monitoring of targeted chemotherapy in cancer patients. Thus, lessons from HIV/AIDS on the value of surrogate makers may assist with the development and optimization of targeted cancer therapy.
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Affiliation(s)
- Marco Petrella
- McGill University AIDS Centre, Lady Davis Institute, Montréal, Québec, Canada
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17
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Delgado J, Bustos JG, Jimenez MC, Quevedo E, Hernandez-Navarro F. Are activation markers (CD25, CD38 and CD103) predictive of sensitivity to purine analogues in patients with T-cell prolymphocytic leukemia and other lymphoproliferative disorders? Leuk Lymphoma 2002; 43:2331-4. [PMID: 12613520 DOI: 10.1080/1042819021000040035] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
T-cell prolymphocytic leukemia (T-PLL) is a rare lymphoproliferative disorder with distinctive clinical and laboratory features. It is often resistant to conventional chemotherapy, but complete or partial responses have been documented with the use of purine analogues. We report on two cases of T-PLL with a slightly different immunophenotype but a remarkably different response to pentostatin. We discuss the possible therapeutic implications of this finding and establish a comparison between immunophenotype and sensitivity to purine analogues in patients with T-PLL and other chronic lymphoproliferative disorders.
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Affiliation(s)
- Julio Delgado
- Department of Hematology, Hospital Universitario La Paz, Planta 6a Diagonal, Paseo Castellana 261, 28046 Madrid, Spain.
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Robak T, Kasznicki M. Alkylating agents and nucleoside analogues in the treatment of B cell chronic lymphocytic leukemia. Leukemia 2002; 16:1015-27. [PMID: 12040433 DOI: 10.1038/sj.leu.2402531] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2001] [Accepted: 02/19/2002] [Indexed: 11/09/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the Western world. The natural clinical course is highly variable and chemotherapy is usually not indicated in early and stable disease. Treatment is needed in the progressive form of this leukemia. Chlorambucil, with or without steroids, has been for many years the drug of choice in the treatment of CLL. More recently, treatment approaches have included nucleoside analogues, (NA) fludarabine (FAMP) and cladribine (2-CdA, 2-chlorodeoxyadenosine), which seem to be the treatment of choice for patients failing standard therapies. Their role as first line therapy is being investigated in randomized trials and the results have recently been published. These studies have shown a higher overall response and complete remission (CR) rate and longer response duration in patients treated initially with NA than with chlorambucil or cyclophosphamide-based combination regimens. In contrast, overall survival is similar in patients treated with NA and alkylating agents. However, the randomized trials were designed as crossover studies which may influence survival. Combined use of NA with other cytotoxic drugs, cytokines, monoclonal antibodies and other agents may increase the CR and prolong survival time. However, the results of randomized trials comparing combination treatment with NA alone are not yet available. In conclusion, alkylating agents still have an important place in the routine management of the majority of CLL patients. NA should be routinely used as second line treatment and possibly as first line therapy in younger patients, who are candidates for potentially curative treatment such as stem cell transplantation and/or monoclonal antibodies.
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Affiliation(s)
- T Robak
- Department of Hematology, Medical University of Lódź, Copernicus Memorial Hospital, Lódź, Poland
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