1
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Bolland MJ, Gamble GD, Avenell A, Grey A. Identical summary statistics were uncommon in randomized trials and cohort studies. J Clin Epidemiol 2021; 136:180-188. [PMID: 34000386 DOI: 10.1016/j.jclinepi.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/15/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the proposition that identical summary statistics (mean and/or SD) in different randomized controlled trials (RCT) or clinical cohorts can be explained by common or homogeneous source populations. STUDY DESIGN We estimated the probability of identical summary data in studies with high proportions of identical summary statistics, in simulations, and in control datasets. RESULTS The probability of both an identical mean and an identical SD for a variable in separate RCT is low (<~3%), unless the variable is rounded to 1 significant figure. In two RCT with identical summary statistics for 16 of 39 shared variables, simulations indicated the probability of the observed matches was <1 in 100,000. In 34 clinical cohorts with publication integrity concerns, the proportion of summary statistics from variables reported in ≥10 studies that were identical in ≥2 cohorts were high (42% for means, 52% for SD, and 29% for both), and improbable based on simulations and comparisons to control datasets. CONCLUSIONS The likelihood of multiple identical summary statistics within an individual RCT or across a body of RCT or cohort studies by the same research group is low, especially when both the mean, and the SD are identical, unless the variables are rounded to 1 significant figure.
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Affiliation(s)
- Mark J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand; Department of Endocrinology, ADHB, Auckland, New Zealand.
| | - Greg D Gamble
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland
| | - Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand; Department of Endocrinology, ADHB, Auckland, New Zealand; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland
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2
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Johansson P, Kristjansdottir HL, Johansson H, Jakir A, Mellström D, Lewerin C. Highly increased risk of fracture in patients with myeloproliferative neoplasm. Leuk Lymphoma 2020; 62:211-217. [PMID: 32909485 DOI: 10.1080/10428194.2020.1817437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The risk for hip and vertebral fracture was determined in 10,752 patients diagnosed with myeloproliferative neoplasms (MPN) in Sweden 1995-2015. The mean follow-up time were 6.34 years. Five percent developed hip fracture and 1.3% a vertebral fracture. There was a significant increased risk for fracture among the MPN patients compared with the Swedish population. The ratio of observed (obs) and expected (exp) number of hip fracture in all MPN patients, polycythemia vera (PV), essential thrombocythemia and MPN undetermined (MPNu) was 1.20 (95% confidence interval (CI): 1.10-1.31), 1.37 (95% CI: 1.19-1.58), 1.02 (95% CI: 0.87-1.19), and 1.28 (95% CI: 1.07-1.52), respectively. Corresponding figures for vertebral fractures were 1.94 (95% CI: 1.64-2.29), 2.09 (95% CI: 1.56-2.75), 1.50 (95% CI: 1.06-2.07) and 2.47 (95% CI: 1.77-3.35), respectively. Patients with MPN had an increased risk of hip and vertebral fracture, especially patients with PV and MPNu in comparison with the entire Swedish population.
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Affiliation(s)
- Peter Johansson
- Section of Hematology and Coagulation, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | | | - Helena Johansson
- Department of Public Health, McKillop Health Institute, Australian Catholic University, Melbourne, Australia.,Community of Medicine, University of Gothenburg Faculty of Health Sciences, Goteborg, Sweden
| | - Ana Jakir
- Section of Hematology and Coagulation, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Dan Mellström
- Center of Bone and Arthritis Research, University of Gothenburg Faculty of Health Sciences, Goteborg, Sweden.,Department of Geriatric Medicine, University of Gothenburg Faculty of Health Sciences, Goteborg, Sweden
| | - Cataharina Lewerin
- Section of Hematology, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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3
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Particularities of Bone Regeneration in Rats after Implantation of Polycaprolactone Scaffold Mineralized with Vaterite with Adsorbed Tannic Acid. Bull Exp Biol Med 2019; 167:275-278. [PMID: 31243675 DOI: 10.1007/s10517-019-04508-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Indexed: 10/26/2022]
Abstract
We studied the particularities of osteo- and angiogenesis in albino rats after implantation of polycaprolactone scaffolds mineralized with vaterite with adsorbed tannic acid in the femoral bone defect. It was found that the processes of angio- and osteogenesis in the bone tissue after scaffolds implantation depend on their biocompatibility. Implantation of non-biocompatible scaffolds was followed by activation of angio- and osteogenesis aimed at separation of these scaffold from surrounding tissues. Implantation of polycaprolactone/vaterite scaffolds containing tannic acid stimulated angio- and osteogenesis leading to vascularization and bone tissue formation in the matrix. This demonstrate prospects of clinical approbation of these scaffolds for stimulation of bone regeneration in traumatological and orthopedic patients.
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4
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Kroschwald LM, Tauer JT, Kroschwald SI, Suttorp M, Wiedenfeld A, Beissert S, Bauer A, Rauner M. Imatinib mesylate and nilotinib decrease synthesis of bone matrix in vitro. Oncol Lett 2019; 18:2102-2108. [PMID: 31423283 DOI: 10.3892/ol.2019.10518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 05/13/2019] [Indexed: 11/06/2022] Open
Abstract
Tyrosine kinase inhibitors (TKIs), such as imatinib (IMA) and nilotinib (NIL), are the cornerstone of chronic myeloid leukemia (CML) treatment via the blockade of the oncogenic BCR-ABL1 fusion protein. However, skeletal side effects are commonly observed in pediatric patients receiving long-term treatment with IMA. Additionally, in vitro studies have shown that IMA and NIL alter vitamin D metabolism, which may further impair bone metabolism. To determine whether TKIs directly affect bone cell function, the present study treated the human osteoblastic cell line SaOS-2 with IMA or NIL and assessed effects on their mineralization capacity as well as mRNA expression of receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG), two cytokines that regulate osteoclastogenesis. Both TKIs significantly inhibited mineralization and downregulated osteoblast marker genes, including alkaline phosphatase, osteocalcin, osterix, as well as genes associated with the pro-osteogenic Wnt signaling pathway; NIL was more potent than IMA. In addition, both TKIs increased the RANKL/OPG ratio, which is known to stimulate osteoclastogenesis. The present results suggested that the TKIs IMA and NIL directly inhibited osteoblast differentiation and directly promoted a pro-osteoclastogenic environment through the RANKL-OPG signaling axis. Thus, we propose that future work is required to determine whether the bone health of CML patients undergoing TKI-treatment should be routinely monitored.
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Affiliation(s)
- Lysann Michaela Kroschwald
- Department of Dermatology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany.,Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
| | - Josephine Tabea Tauer
- Department of Pediatrics, Shriners Hospital for Children, McGill University, Montreal QC H4A 0A9, Canada
| | - Sonja Ingrid Kroschwald
- Simon Alberti Group, Max Planck Institute of Molecular Cell Biology and Genetics, D-01307 Dresden, Germany.,Institute for Biochemistry, ETH Zurich, CH-8093 Zurich, Switzerland
| | - Meinolf Suttorp
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
| | - Anne Wiedenfeld
- Department of Dermatology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
| | - Stefan Beissert
- Department of Dermatology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
| | - Andrea Bauer
- Department of Dermatology, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
| | - Martina Rauner
- Department of Medicine III and Center for Healthy Aging, Medical Faculty, Technical University Dresden, D-01307 Dresden, Germany
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5
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Kim B, Lee JH, Jin WJ, Kim HH, Ha H, Lee ZH. Trapidil induces osteogenesis by upregulating the signaling of bone morphogenetic proteins. Cell Signal 2018; 49:68-78. [DOI: 10.1016/j.cellsig.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/28/2018] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
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6
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Yu KJ, Li JK, Lee YC, Yu G, Lin SC, Pan T, Satcher RL, Titus MA, Yu-Lee LY, Weng WH, Gallick GE, Lin SH. Cabozantinib-induced osteoblast secretome promotes survival and migration of metastatic prostate cancer cells in bone. Oncotarget 2017; 8:74987-75006. [PMID: 29088840 PMCID: PMC5650395 DOI: 10.18632/oncotarget.20489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/14/2017] [Indexed: 12/25/2022] Open
Abstract
Therapies that target cancer cells may have unexpected effects on the tumor microenvironment that affects therapy outcomes or render therapy resistance. Prostate cancer (PCa) bone metastasis is uniquely associated with osteoblastic bone lesions and treatment with cabozantinib, a VEGFR-2 and MET inhibitor, leads to a reduction in number and/or intensity of lesions on bone scans. However, resistance to cabozantinib therapy inevitably occurs. We examined the effect of cabozantinib on osteoblast differentiation and secretion in the context of therapy resistance. We showed that primary mouse osteoblasts express VEGFR2 and MET and cabozantinib treatment decreased osteoblast proliferation but enhanced their differentiation. A genome-wide analysis of transcriptional responses of osteoblasts to cabozantinib identified a set of genes accounting for inhibition of proliferation and stimulation of differentiation, and a spectrum of secreted proteins induced by cabozantinib, including pappalysin, IGFBP2, WNT 16, and DKK1. We determined that these proteins were upregulated in the conditioned medium of cabozantinib-treated osteoblasts (CBZ-CM) compared to control CM. Treatment of C4-2B4 or PC3-mm2 PCa cells with CBZ-CM increased the anchorage-independent growth and migration of these PCa cells compared to cells treated with control CM. These results suggest that the effect of cabozantinib on the tumor microenvironment may increase tumor cell survival and cause therapy resistance.
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Affiliation(s)
- Kai-Jie Yu
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Jeffrey K Li
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Yu-Chen Lee
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Guoyu Yu
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Song-Chang Lin
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Tianhong Pan
- Department of Orthopedic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Robert L Satcher
- Department of Orthopedic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark A Titus
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Li-Yuan Yu-Lee
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Wen Hui Weng
- Department of Chemical Engineering and Biotechnology and Graduate Institute of Biochemical and Biomedical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Gary E Gallick
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas, USA
| | - Sue-Hwa Lin
- Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas, USA
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7
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O’Sullivan S, Tay ML, Lin JM, Bava U, Callon K, Cornish J, Naot D, Grey A. Tyrosine Kinase Inhibitors Regulate OPG through Inhibition of PDGFRβ. PLoS One 2016; 11:e0164727. [PMID: 27737004 PMCID: PMC5063333 DOI: 10.1371/journal.pone.0164727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 09/29/2016] [Indexed: 01/01/2023] Open
Abstract
Nilotinib and imatinib are tyrosine kinase inhibitors (TKIs) used in the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GIST). In vitro, imatinib and nilotinib inhibit osteoclastogenesis, and in patients they reduce levels of bone resorption. One of the mechanisms that might underlie these effects is an increase in the production of osteoprotegerin (OPG). In the current work we report that platelet-derived growth factor receptor beta (PDGFRβ) signaling regulates OPG production in vitro. In addition, we have shown that TKIs have effects on RANKL signaling through inhibition of the PDGFRβ and other target receptors. These findings have implications for our understanding of the mechanisms by which TKIs affect osteoclastogenesis, and the role of PDGFRβ signaling in regulating osteoclastogenesis. Further studies are indicated to confirm the clinical effects of PDGFRβ-inhibitors and to elaborate the intracellular pathways that underpin these effects.
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Affiliation(s)
- Susannah O’Sullivan
- Department of Pharmacology, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Mei Lin Tay
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Jian-Ming Lin
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Usha Bava
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Karen Callon
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Dorit Naot
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand
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8
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D'Oronzo S, Stucci S, Tucci M, Silvestris F. Cancer treatment-induced bone loss (CTIBL): pathogenesis and clinical implications. Cancer Treat Rev 2015; 41:798-808. [PMID: 26410578 DOI: 10.1016/j.ctrv.2015.09.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 12/20/2022]
Abstract
Osteopenia and osteoporosis are often long-term complications of anti-neoplastic treatments, defined as "cancer treatment-induced bone loss" (CTIBL). This pathological condition in oncologic patients results in a higher fracture risk than in the general population, and so has a significant negative impact on their quality of life. Hormone treatment is the main actor in this scenario, but not the only one. In fact, chemotherapies, radiotherapy and tyrosine kinase inhibitors may contribute to deregulate bone remodeling via different mechanisms. Thus, the identification of cancer patients at risk for CTIBL is essential for early diagnosis and appropriate intervention, that includes both lifestyle modifications and pharmacological approaches to prevent bone metabolism failure during anti-tumor treatments.
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Affiliation(s)
- S D'Oronzo
- University of Bari "Aldo Moro", Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
| | - S Stucci
- University of Bari "Aldo Moro", Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
| | - M Tucci
- University of Bari "Aldo Moro", Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
| | - F Silvestris
- University of Bari "Aldo Moro", Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, Piazza Giulio Cesare, 11, 70124 Bari, Italy.
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9
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Tauer JT, Hofbauer LC, Jung R, Gerdes S, Glauche I, Erben RG, Suttorp M. Impact of long-term exposure to the tyrosine kinase inhibitor imatinib on the skeleton of growing rats. PLoS One 2015; 10:e0131192. [PMID: 26107505 PMCID: PMC4479438 DOI: 10.1371/journal.pone.0131192] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/30/2015] [Indexed: 11/19/2022] Open
Abstract
The tyrosine kinase (TK) inhibitor imatinib provides a highly effective therapy for chronic myeloid leukemia (CML) via inhibition of the oncogenic TK BCR-ABL1. However, off-target TKs like platelet-derived growth factor receptors (PDGF-R) and colony-stimulating factor-1 receptor (c-fms), involved in bone remodeling, are also inhibited. Thus, pediatric patients with CML on imatinib exhibit altered bone metabolism, leading to linear growth failure. As TKI treatment might be necessary for a lifetime, long-term effects exerted on bone in children are of major concern. Therefore, we studied the skeletal long-term effects of continuous and intermittent imatinib exposure in a juvenile rat model. Four-weeks-old male Wistar rats were chronically exposed to imatinib via drinking water over a period of 10 weeks. Animals were exposed to a standard and high imatinib dosage continuously and to the high imatinib dose intermittently. Bone mass and strength were assessed using pQCT, micro-computed tomography (μCT), and biomechanical testing at the prepubertal, pubertal, and postpubertal age. Bone length and vertebral height as well as biochemical markers of bone turnover were analyzed. Femoral and tibial bone length were dose-dependently reduced by up to 24% (p<0.0001), femoral and tibial trabecular bone mass density (BMD) were reduced by up to 25% (p<0.01), and femoral breaking strength was lowered by up to 20% (p<0.05). Intermittent exposure mitigated these skeletal effects. Long-term exposure resulted in reduced vertebral height by 15% and lower trabecular BMD by 5%. Skeletal changes were associated with suppressed serum osteocalcin (p<0.01) and non-significantly elevated serum CTX-I and PINP levels. In conclusion, imatinib mainly impaired longitudinal growth of long bones rather than the vertebrae of growing rats. Interestingly, intermittent imatinib exposure has less skeletal side effects, which may be beneficial in pediatric patients taking imatinib.
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Affiliation(s)
- Josephine T. Tauer
- Department of Pediatrics, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- * E-mail:
| | - Lorenz C. Hofbauer
- Department of Internal Medicine III, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Roland Jung
- Experimental Center of the Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sebastian Gerdes
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Reinhold G. Erben
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Meinolf Suttorp
- Department of Pediatrics, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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10
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Keller DA, Brennan RJ, Leach KL. Clinical and Nonclinical Adverse Effects of Kinase Inhibitors. METHODS AND PRINCIPLES IN MEDICINAL CHEMISTRY 2015. [DOI: 10.1002/9783527673643.ch16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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11
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O'Sullivan S, Grey A. Adverse skeletal effects of drugs - beyond Glucocorticoids. Clin Endocrinol (Oxf) 2015; 82:12-22. [PMID: 25039381 DOI: 10.1111/cen.12549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 06/28/2014] [Accepted: 07/07/2014] [Indexed: 12/13/2022]
Abstract
Osteoporotic fractures are an important public health problem with significant individual and societal costs. In addition to the major risk factors for osteoporotic fracture, low bone mineral density (BMD), age, low body weight and history of fracture or falls, some drugs are now considered to be important secondary risk factor for bone loss and fracture, particularly amongst predisposed individuals. Currently available data are often generated from small observational clinical studies, making risk assessment and development of management guidelines difficult. In many cases, the exposed population has a low baseline risk for fracture and additional assessment and treatment may not be necessary. In this review, we focus on drugs other than glucocorticoids identified as potentially causing adverse skeletal effects, summarizing the existing evidence from preclinical and clinical studies, and suggest recommendations for patient management.
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12
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Alemán JO, Farooki A, Girotra M. Effects of tyrosine kinase inhibition on bone metabolism: untargeted consequences of targeted therapies. Endocr Relat Cancer 2014; 21:R247-59. [PMID: 24478055 DOI: 10.1530/erc-12-0400] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tyrosine kinase inhibitors (TKIs) are at the forefront of molecular-targeted therapies for cancer. With the advent of imatinib for the treatment of chronic myelogenous leukemia, a new wave of small-molecule therapeutics redefined the oncologic treatment to become chronically administered medications with tolerable side-effect profiles compared with cytotoxic agents. Effects on bone mineral metabolism were observed during early imatinib treatment, in the form of hypophosphatemia with increased urinary phosphorus excretion. This finding led to detailed investigations of off-target effects responsible for changes in bone cell maturation, activity, and impact on bone mass. Subsequently, another BCR-Abl inhibitor (dasatinib), vascular endothelial growth factor (VEGF) inhibitors (sorafenib and sunitinib) as well as rearranged during transfection (RET) inhibitors (vandetanib and cabozantinib) were developed. Inhibition of bone resorption appears to be a class effect and is likely contributed by TKI effects on the hematopoietic and mesenchymal stem cells. As long-term, prospective, clinical outcomes data accumulate on these targeted therapies, the full extent of off-target side effects on bone health will need to be considered along with the significant benefits of tyrosine kinase inhibition in oncologic treatment.
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Affiliation(s)
- José O Alemán
- Endocrine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Weill Cornell Medical College, New York, New York 10065, USA
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13
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Farmer S, Horváth-Puhó E, Vestergaard H, Hermann AP, Frederiksen H. Chronic myeloproliferative neoplasms and risk of osteoporotic fractures; a nationwide population-based cohort study. Br J Haematol 2013; 163:603-10. [DOI: 10.1111/bjh.12581] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/16/2013] [Accepted: 08/21/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Sarah Farmer
- Department of Haematology; Odense University Hospital; Odense Denmark
| | | | - Hanne Vestergaard
- Department of Haematology; Odense University Hospital; Odense Denmark
| | | | - Henrik Frederiksen
- Department of Haematology; Odense University Hospital; Odense Denmark
- Department of Clinical Epidemiology; Aarhus University Hospital; Aarhus Denmark
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14
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Terpos E, Apperley J, Milojkovic D. Imatinib and chronic myeloid leukemia: close to the bone. Leuk Lymphoma 2013; 54:1581-2. [DOI: 10.3109/10428194.2013.772608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Berman E, Girotra M, Cheng C, Chanel S, Maki R, Shelat M, Strauss HW, Fleisher M, Heller G, Farooki A. Effect of long term imatinib on bone in adults with chronic myelogenous leukemia and gastrointestinal stromal tumors. Leuk Res 2013; 37:790-4. [PMID: 23473999 DOI: 10.1016/j.leukres.2013.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/04/2013] [Accepted: 02/05/2013] [Indexed: 01/27/2023]
Abstract
Patients with chronic myelogenous leukemia (CML) or gastrointestinal stromal tumors (GIST) who take imatinib have abnormalities of bone metabolism. However, it is unclear what impact these changes have on bone mineral density (BMD). We prospectively analayzed levels of osteocalcin, a marker of bone formation secreted by osteoblasts, and serum N-telopeptide of type I collagen (NTX), a marker of bone resorption, as well as other minerals involved in bone metabolism in 19 patients with either CML or GIST We correlated these results with changes in bone mineral density as measured by serial dual energy X-ray absorptiometry (DEXA) scans over a two year period. Osteocalcin levels were low in 95% of patients and 37% had no measurable amount. Levels of NTX were less consistent. Nine patients (47%) had a decrease in BMD, four patients (2%) had an increase in BMD, and six patients (32%) had no change. There was no correlation between metabolic markers and change in BMD. We suggest that ongoing management of patients who take imatinib should include monitoring of bone health on a long term basis.
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Affiliation(s)
- Ellin Berman
- Leukemia Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY, USA.
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16
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O’Sullivan S, Horne A, Wattie D, Porteous F, Gamble G, Browett P, Grey A. Bone metabolism during long-term treatment with imatinib. Leuk Lymphoma 2013; 54:1783-5. [DOI: 10.3109/10428194.2012.760734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Borriello A, Caldarelli I, Basile MA, Bencivenga D, Tramontano A, Perrotta S, Ragione FD, Oliva A. The tyrosine kinase inhibitor dasatinib induces a marked adipogenic differentiation of human multipotent mesenchymal stromal cells. PLoS One 2011; 6:e28555. [PMID: 22164306 PMCID: PMC3229607 DOI: 10.1371/journal.pone.0028555] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/10/2011] [Indexed: 12/22/2022] Open
Abstract
Background The introduction of specific BCR-ABL inhibitors in chronic myelogenous leukemia therapy has entirely mutated the prognosis of this hematologic cancer from being a fatal disorder to becoming a chronic disease. Due to the probable long lasting treatment with tyrosine-kinase inhibitors (TKIs), the knowledge of their effects on normal cells is of pivotal importance. Design and Methods We investigated the effects of dasatinib treatment on human bone marrow-derived mesenchymal stromal cells (MSCs). Results Our findings demonstrate, for the first time, that dasatinib induces MSCs adipocytic differentiation. Particularly, when the TKI is added to the medium inducing osteogenic differentiation, a high MSCs percentage acquires adipocytic morphology and overexpresses adipocytic specific genes, including PPARγ, CEBPα, LPL and SREBP1c. Dasatinib also inhibits the activity of alkaline phosphatase, an osteogenic marker, and remarkably reduces matrix mineralization. The increase of PPARγ is also confirmed at protein level. The component of osteogenic medium required for dasatinib-induced adipogenesis is dexamethasone. Intriguingly, the increase of adipocytic markers is also observed in MSCs treated with dasatinib alone. The TKI effect is phenotype-specific, since fibroblasts do not undergo adipocytic differentiation or PPARγ increase. Conclusions Our data demonstrate that dasatinib treatment affects bone marrow MSCs commitment and suggest that TKIs therapy might modify normal phenotypes with potential significant negative consequences.
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Affiliation(s)
- Adriana Borriello
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
| | - Ilaria Caldarelli
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
| | - Maria Assunta Basile
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
| | - Debora Bencivenga
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
| | - Annunziata Tramontano
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
| | - Silverio Perrotta
- Department of Pediatrics, Second University of Naples, Naples, Italy
| | - Fulvio Della Ragione
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
- * E-mail:
| | - Adriana Oliva
- Department of Biochemistry and Biophysics, Second University of Naples, Naples, Italy
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Nurmio M, Joki H, Kallio J, Määttä JA, Väänänen HK, Toppari J, Jahnukainen K, Laitala-Leinonen T. Receptor tyrosine kinase inhibition causes simultaneous bone loss and excess bone formation within growing bone in rats. Toxicol Appl Pharmacol 2011; 254:267-79. [PMID: 21586300 DOI: 10.1016/j.taap.2011.04.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Revised: 04/08/2011] [Accepted: 04/26/2011] [Indexed: 01/24/2023]
Abstract
During postnatal skeletal growth, adaptation to mechanical loading leads to cellular activities at the growth plate. It has recently become evident that bone forming and bone resorbing cells are affected by the receptor tyrosine kinase (RTK) inhibitor imatinib mesylate (STI571, Gleevec®). Imatinib targets PDGF, ABL-related gene, c-Abl, c-Kit and c-Fms receptors, many of which have multiple functions in the bone microenvironment. We therefore studied the effects of imatinib in growing bone. Young rats were exposed to imatinib (150mg/kg on postnatal days 5-7, or 100mg/kg on postnatal days 5-13), and the effects of RTK inhibition on bone physiology were studied after 8 and 70days (3-day treatment), or after 14days (9-day treatment). X-ray imaging, computer tomography, histomorphometry, RNA analysis and immunohistochemistry were used to evaluate bone modeling and remodeling in vivo. Imatinib treatment eliminated osteoclasts from the metaphyseal osteochondral junction at 8 and 14days. This led to a resorption arrest at the growth plate, but also increased bone apposition by osteoblasts, thus resulting in local osteopetrosis at the osteochondral junction. The impaired bone remodelation observed on day 8 remained significant until adulthood. Within the same bone, increased osteoclast activity, leading to bone loss, was observed at distal bone trabeculae on days 8 and 14. Peripheral quantitative computer tomography (pQCT) and micro-CT analysis confirmed that, at the osteochondral junction, imatinib shifted the balance from bone resorption towards bone formation, thereby altering bone modeling. At distal trabecular bone, in turn, the balance was turned towards bone resorption, leading to bone loss.
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Affiliation(s)
- Mirja Nurmio
- Department of Physiology, University of Turku, Finland.
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