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Angre T, Kumar A, Singh AK, Thareja S, Kumar P. Role of collagen regulators in cancer treatment: A comprehensive review. Anticancer Agents Med Chem 2022; 22:2956-2984. [DOI: 10.2174/1871520622666220501162351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/13/2022] [Accepted: 03/25/2022] [Indexed: 12/24/2022]
Abstract
Abstract:
Collagen is the most important structural protein and also a main component of extra-cellular matrix (ECM). It plays a role in tumor progression. Collagen can be regulated by altering it’s biosynthesis pathway through various signaling pathways, receptors and genes. Activity of cancer cells can also be regulated by other ECM components like metalloproteinases, hyaluronic acid, fibronectin and so on. Hypoxia is also one of the condition which leads to cancer progression by stimulating the expression of procollagen lysine as a collagen crosslinker, which increases the size of collagen fibres promoting cancer spread. The collagen content in cancerous cells leads to resistance in chemotherapy. So, to reduce this resistance, some of the collagen regulating therapies are introduced, which include inhibiting its biosynthesis, disturbing cancer cell signaling pathway, mediating ECM components and directly utilizing collagenase. This study is an effort to compile the strategies reported to control the collagen level and different collagen inhibitors reported so far. More research is needed in this area, growing understandings of collagen’s structural features and its role in cancer progression will aid in the advancement of newer chemotherapies.
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Affiliation(s)
- Tanuja Angre
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda, India
| | - Adarsh Kumar
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda, India
| | - Ankit Kumar Singh
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda, India
| | - Suresh Thareja
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda, India
| | - Pradeep Kumar
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda, India
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Santoleri F, Ranucci E, La Barba G, Colasanto I, Scaldaferri M, Cattel F, Federici F, Rossi C, Di Biagio K, Scortechini AR, Musicco F, Torquati G, Frazzetto A, Vozza A, de Rosa C, Lanzillo R, Monteverde M, Luciano L, Pane F, Pasquazi A, Celeste MG, Cantonetti M, Franceschini L, Rizzo M, Costantini A. Adherence, persistence and efficacy of dasatinib and nilotinib in the treatment of patients resistant or intolerant to imatinib with chronic myeloid leukemia in chronic phase: an Italian multicenter study over two years in real life. Curr Med Res Opin 2021; 37:477-481. [PMID: 33459083 DOI: 10.1080/03007995.2021.1876006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The use of dasatinib and nilotinib in the treatment of patients with chronic myeloid leukemia represents a valid therapeutic option for patients resistant or intolerant to imatinib. In this multicentre study, adherence, persistence and efficacy in real life over two years of treatment were evaluated. MATERIALS AND METHODS Adherence to treatment was calculated as the ratio between the dose received and the prescribed dose. The dose received was calculated using pharmacy refill data. The persistence with treatment was calculated as the difference between the end and the beginning of the treatment. Efficacy was assigned as Progression-Free Survival (PFS) and Events-Free Survival (EFS) and represented through the Kaplan-Meier curve. RESULTS The number of patients analysed was 117, 70 treated with dasatinib and 47 with nilotinib. Adherence to treatment for dasatinib and nilotinib at two years was 0.91 and 0.82 respectively. Persistence at two years was 77% while the PFS was 92% for both drugs in the study. CONCLUSION Adherence to the treatment calculated over two years showed a superiority of dasatinib over nilotinib. Nevertheless, the efficacy in terms of PFS and EFS is superimposable between the two drugs in the study.
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Affiliation(s)
| | - Elena Ranucci
- Department Pharmacist, Hematological Oncology Department, Pescara General Hospital, Pescara, Italy
| | - Gaetano La Barba
- Hematologist, Hematological Oncology Department, Pescara General Hospital, Pescara, Italy
| | - Irene Colasanto
- Hospital pharmacist, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Matilde Scaldaferri
- Hospital pharmacist, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesco Cattel
- Hospital pharmacist, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | | | | | - Katiuscia Di Biagio
- Environmental Epidemiology Unit - Regional Environmental Protection Agency of Marche, Ancona, Italy
| | - Anna Rita Scortechini
- Hematologist, Hematology Unit, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
| | - Felice Musicco
- Hospital Pharmacist at Regina Elena - San Gallicano cancer and dermatological Institute, Rome, Italy
| | - Giancarlo Torquati
- Hospital Pharmacist at Regina Elena - San Gallicano cancer and dermatological Institute, Rome, Italy
| | - Angela Frazzetto
- Hospital Pharmacist at Regina Elena - San Gallicano cancer and dermatological Institute, Rome, Italy
| | - Antonietta Vozza
- Hospital pharmacist, Azienda Ospedaliera Universitaria "Federico II", Napoli, Italy
| | - Caterina de Rosa
- Hospital pharmacist, Azienda Ospedaliera Universitaria "Federico II", Napoli, Italy
| | - Rosaria Lanzillo
- Hospital pharmacist, Azienda Ospedaliera Universitaria "Federico II", Napoli, Italy
| | - Maria Monteverde
- Biologist, Department of Clinical Medicine and Surgery, Federico II University Medical School, Napoli, Italy
| | - Luigia Luciano
- Hematologist, Department of Clinical Medicine and Surgery, Federico II University Medical School, Napoli, Italy
| | - Fabrizio Pane
- Hematologist, Department of Clinical Medicine and Surgery, Federico II University Medical School, Napoli, Italy
| | - Arianna Pasquazi
- Hospital pharmacist, Policlinico Tor Vergata PTV Foundation, Roma, Italy
| | | | - Maria Cantonetti
- Hematologist, Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata PTV Foundation, Roma, Italy
| | - Luca Franceschini
- Hematologist, Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata PTV Foundation, Roma, Italy
| | - Manuela Rizzo
- Hematologist, Unit of Lymphoproliferative Disorders, Policlinico Tor Vergata PTV Foundation, Roma, Italy
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Cytopenia among CML Patients on Imatinib in Kenya: Types, Grades, and Time Course. Adv Hematol 2020; 2020:7696204. [PMID: 32454829 PMCID: PMC7240645 DOI: 10.1155/2020/7696204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 03/31/2020] [Accepted: 04/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Imatinib mesylate is the gold standard for the treatment of all phases of Philadelphia-positive chronic myeloid leukemia. Patients on imatinib treatment may develop cytopenia due to drug toxicity. This study aimed to determine the types, grades, and time course of cytopenia in CML patients on imatinib at a Nairobi hospital. Methods This was a cross-sectional descriptive study of adult patients aged ≥18 years followed up at the Glivec International Patient Access Program (GIPAP) clinic from 2007 to 2015. Patients who developed cytopenia within 12 months of initiating imatinib were eligible. Clinical and hematologic data were retrieved from the patients' charts and entered into a study proforma. Measures of central tendency such as mean, median, mode, standard deviation, and variance were used for analysis. Results Sixty three percent (63.6%) of the 94 patients developed a monocytopenia, with anemia seen in 34%, neutropenia in 27.6%, and thrombocytopenia in 8% of the 94 patients. Anemia plus neutropenia was the most common bicytopenia at 12.7%. Pancytopenia was seen in only 5 of the 94 patients. Most of the cytopenia was grades 2 and 3. Anemia was present at baseline while neutropenia and thrombocytopenia developed within 12 months of imatinib initiation. Anemia resolved during the first 12 months of therapy while neutropenia and thrombocytopenia resolved within 24–36 months of treatment. Conclusion Monocytopenia, especially anemia, was the most common type of cytopenia. The cytopenia was predominantly grade 2, developed in majority of the patients within 6 months after imatinib initiation, and had resolved by 24–36 months after imatinib initiation.
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Epigenetic mechanisms underlying the therapeutic effects of HDAC inhibitors in chronic myeloid leukemia. Biochem Pharmacol 2019; 173:113698. [PMID: 31706847 DOI: 10.1016/j.bcp.2019.113698] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/05/2019] [Indexed: 12/20/2022]
Abstract
Chronic myeloid leukemia (CML) is a hematological disorder caused by the oncogenic BCR-ABL fusion protein in more than 90% of patients. Despite the striking improvements in the management of CML patients since the introduction of tyrosine kinase inhibitors (TKis), the appearance of TKi resistance and side effects lead to treatment failure, justifying the need of novel therapeutic approaches. Histone deacetylase inhibitors (HDACis), able to modulate gene expression patterns and important cellular signaling pathways through the regulation of the acetylation status of both histone and non-histone protein targets, have been reported to display promising anti-leukemic properties alone or in combination with TKis. This review summarizes pre-clinical and clinical studies that investigated the mechanisms underlying the anticancer potential of HDACis and discusses the rationale for a combination of HDACis with TKis as a therapeutic option in CML.
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Lack of association between functional polymorphism of DNA repair genes (XRCC1, XPD) and clinical response in Indian chronic myeloid leukemia patients. Mol Biol Rep 2019; 46:4997-5003. [PMID: 31286393 DOI: 10.1007/s11033-019-04950-0] [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: 02/18/2019] [Accepted: 06/27/2019] [Indexed: 02/07/2023]
Abstract
The resistance for the tyrosine kinase inhibitors in chronic myeloid leukemia (CML) occurs mainly due to BCR/ABL1 dependent and independent mechanisms. The defective DNA repair due to functional polymorphisms in DNA repair genes, might act as an etiological factor for leukemia progression. The study was carried out to understand the role of DNA repair genes (XRCC1, XPD) polymorphisms in Imatinib mesylate (IM) resistant CML patients. The study was carried out in total 87 CML patients (43 nonresponders-cases and 44 responders) who were treated with Imatinib. The treatment and follow-up was done according to European LeukemiaNet guidelines. The genotyping of selected SNPs were studied using RFLP and confirmed with Sanger sequencing (20%). The statistical analysis was performed using online tools (Socscistatistics and GraphPad InStat software). In our study no significant association was inferred between genotypes of DNA repair genes (XRCC1; rs1799782, rs25487, and XPD; rs13181) and complete cytogenetic response as well as molecular response. However there might be a possibility of association between XRCC1 Arg399Gln genotype AA/GA and cytogenetic response though it is statistically insignificant (p > 0.05). Though none of the genotypes of the DNA repair genes showed association with IM response, near association between XRCC1Arg399Gln genotype and cytogenetic response observed in our study. Hence, large sample size should be studied to establish the association of SNPs of DNA repair genes and IM response. Our study is a novel and important to explain the role of DNA repair genes polymorphisms in IM resistance.
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Liu Q, Zhang Y, Wang P, Liu J, Li B, Yu Y, Wu H, Kang R, Zhang X, Wang Z. Deciphering the scalene association among type-2 diabetes mellitus, prostate cancer, and chronic myeloid leukemia via enrichment analysis of disease-gene network. Cancer Med 2019; 8:2268-2277. [PMID: 30938105 PMCID: PMC6536925 DOI: 10.1002/cam4.1845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/25/2018] [Accepted: 10/06/2018] [Indexed: 12/12/2022] Open
Abstract
The potential biological relationship between type‐2 diabetes mellitus (T2DM) has been focused in numerous studies. To investigate the molecular associations among T2DM, prostate cancer (PCa), and chronic myeloid leukemia (CML), using a biomolecular network enrichment analysis. We obtained a list of disease‐related genes and constructed disease networks. Then, GO enrichment analysis was performed to identify the significant functions and pathways of overlapping modules in the Database for Annotation, Visualization and Integrated Discovery (DAVID) database. More than 75% of these overlapping genes were found to be consistent with the findings of previous studies. In the three diseases, we found that Sarcoglycan delta (SGCD) and Rho family GTPase 3 (RND3) were the overlapping genes and identified negative regulation of apoptotic process and negative regulation of transcription from RNA polymerase II promoter RNA as the two overlapping biological functions. CML and PCa were the most closely related, with 34 overlapping genes, five overlapping modules, 27 overlapping biological functions, and nine overlapping pathways. There were 13 overlapping genes, one overlapping modules, four overlapping biological functions and one overlapping pathway (FoxO signaling pathway) were found in T2DM and CML.And T2DM and PCa were the least related pair in our study, with only six overlapping genes, five overlapping modules, and one overlapping biological function. SGCD and RND3 were the main gene‐to‐gene relationship among T2DM, CML, and PCa; apoptosis, development, and transcription from RNA polymerase II promote processes were the main functional connections among T2DM, CML, and PCa by network enrichment analysis. There is a “scalene” relationship among T2DM, CML, and PCa at gene, pathway, biological process, and module levels: CML and PCa were the most closely related, the second were T2DM and PCa, and T2DM and PCa were the least related pair in our study. Our study provides a new avenue for further studies on T2DM and cancers, which may promote the discovery and development of novel therapeutic and can be used to treat multiple diseases.
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Affiliation(s)
- Qiong Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yingying Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Pengqian Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bing Li
- Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanan Yu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongli Wu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruixia Kang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoxu Zhang
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhong Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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Ma J, Wu D, Yi J, Yi Y, Zhu X, Qiu H, Kong R, Lin J, Qian J, Deng Z. MiR-378 promoted cell proliferation and inhibited apoptosis by enhanced stem cell properties in chronic myeloid leukemia K562 cells. Biomed Pharmacother 2019; 112:108623. [PMID: 30797151 DOI: 10.1016/j.biopha.2019.108623] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/24/2019] [Accepted: 01/24/2019] [Indexed: 02/07/2023] Open
Abstract
Dysregulation of miR-378 has been found in diverse types of tumors as well as in leukemia. The role of miR-378 in chronic myeloid leukemia (CML) remains unclear. The aim of the study was to reveal the potential effects of miR-378 in the pathological process and progress in CML. Our results showed general level of miR-378 was significant higher in CML patients compared to controls. Overexpression of miR-378 dramatically promoted cell proliferation and drug-resistance. Additionally, apoptosis was inhibited in cells transfected with miR-378. More and bigger stem cell sphere formation was observed in miR-378 transfected cells. Furthermore, enhanced expression of miR-378 was associated with upregulation of stem-cell makers OCT4 and c-Myc. Further study validated that miR-378 inhibited the expression of FUS1. Our research demonstrated the oncogenic nature of miR-378 in CML, and might contribute to the progress of CML.
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Affiliation(s)
- Jichun Ma
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China
| | - Dehong Wu
- Department of Hematology, Kunshan Third People's Hospital, KunShan, Jiangsu, China
| | - Jing Yi
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China
| | - Yunyun Yi
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China
| | - Xin Zhu
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China
| | - Hongchun Qiu
- Department of Hematology, Kunshan Third People's Hospital, KunShan, Jiangsu, China
| | - Rong Kong
- Department of Hematology, Kunshan Third People's Hospital, KunShan, Jiangsu, China
| | - Jiang Lin
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China
| | - Jun Qian
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China.
| | - Zhaoqun Deng
- Department of Central Lab, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China; The Key Lab of Precision Diagnosis and Treatment in Hematologic Malignancies of Zhenjiang City, China.
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Lee A, Hong S, Kim D. KRDS: a web server for evaluating drug resistance mutations in kinases by molecular docking. J Cheminform 2018; 10:20. [PMID: 29633047 PMCID: PMC5891443 DOI: 10.1186/s13321-018-0274-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 04/02/2018] [Indexed: 11/23/2022] Open
Abstract
Kinases are major targets of anti-cancer therapies owing to their importance in signaling processes that regulate cell growth and proliferation. However, drug resistance has emerged as a major obstacle to cancer therapy. Resistance to drugs has various underlying mechanisms, including the acquisition of mutations at drug binding sites and the resulting reduction in drug binding affinity. Therefore, the identification of mutations that are relevant to drug resistance may be useful to overcome this issue. We hypothesized that these mutations can be identified by combining recent advances in computational methods for protein structure modeling and ligand docking simulation. Hence, we developed a web-based tool named the Kinase Resistance Docking System (KRDS) that enables the assessment of the effects of mutations on kinase-ligand interactions. KRDS receives a list of mutations in kinases, generates structural models of the mutants, performs docking simulations, and reports the results to users. The changes in docking scores and docking conformations can be analyzed to infer the effects of mutations on drug binding and drug resistance. We expect our tool to improve our understanding of drug binding mechanisms and facilitate the development of effective new drugs to overcome resistance related to kinases; it may be particularly useful for biomedical researchers who are not familiar with computational environments. Our tool is available at http://bcbl.kaist.ac.kr/KRDS/.
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Affiliation(s)
- Aeri Lee
- Department of Bio and Brain Engineering, KAIST, Daejeon, 34141, Republic of Korea
| | - Seungpyo Hong
- Division of Nutrition and Metabolism Research, Korea Food Research Institute, Wanju-gun, Jeollabuk-do, Republic of Korea
| | - Dongsup Kim
- Department of Bio and Brain Engineering, KAIST, Daejeon, 34141, Republic of Korea.
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Felicetti F, Nervo A, Piovesan A, Berardelli R, Marchisio F, Gallo M, Arvat E. Tyrosine kinase inhibitors rechallenge in solid tumors: a review of literature and a case description with lenvatinib in thyroid cancer. Expert Rev Anticancer Ther 2017; 17:1093-1098. [PMID: 28988510 DOI: 10.1080/14737140.2017.1390432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In the last decade tyrosine kinase inhibitors (TKIs) have been employed for a wide range of hematological and solid tumors and today they represent a valid therapeutic option for different neoplasms. Among them, both sorafenib and lenvatinib were approved for the treatment of radioactive iodine (RAI) refractory differentiated thyroid carcinoma (DTC). Unfortunately, in some cases the efficacy of TKIs is limited by the onset of drug resistance after the initial response. Areas covered: We report the case of a patient with a RAI refractory advanced DTC, treated with lenvatinib after surgery, multiple RAI administrations, traditional chemotherapy, and sorafenib. During treatment with lenvatinib, a noticeable response was detected by sequential computed tomography scans but, after 27 months, tumor progression became evident and led to lenvatinib interruption. In absence of any active treatment, a further disease progression was documented, and lenvatinib was re-administered obtaining a new objective response. Starting from this case report, we review available reports about the rechallenge with TKIs in solid tumors, discussing the possible mechanisms underlying the efficacy of this approach. Expert commentary: Rechallenge with TKIs in solid tumors could be a therapeutic option in subjects with advanced and metastatic DTC who experience a progressive disease after initial response to lenvatinib.
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Affiliation(s)
| | - Alice Nervo
- a Department of Medical Sciences , University of Turin , Turin , Italy.,b Oncological Endocrinology Unit , Città della Salute e della Scienza Hospital , Turin , Italy
| | - Alessandro Piovesan
- b Oncological Endocrinology Unit , Città della Salute e della Scienza Hospital , Turin , Italy
| | - Rita Berardelli
- b Oncological Endocrinology Unit , Città della Salute e della Scienza Hospital , Turin , Italy
| | - Filippo Marchisio
- c Diagnostic and Interventional Radiology Unit , Città della Salute e della Scienza Hospital, University of Turin , Turin , Italy
| | - Marco Gallo
- b Oncological Endocrinology Unit , Città della Salute e della Scienza Hospital , Turin , Italy
| | - Emanuela Arvat
- a Department of Medical Sciences , University of Turin , Turin , Italy.,b Oncological Endocrinology Unit , Città della Salute e della Scienza Hospital , Turin , Italy
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Shanmuganathan N, Hiwase DK, Ross DM. Treatment of chronic myeloid leukemia: assessing risk, monitoring response, and optimizing outcome. Leuk Lymphoma 2017; 58:2799-2810. [DOI: 10.1080/10428194.2017.1312377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Naranie Shanmuganathan
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Haematology, SA Pathology, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Devendra Keshaorao Hiwase
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Haematology, SA Pathology, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - David Morrall Ross
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Haematology, SA Pathology, Adelaide, South Australia, Australia
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Department of Haematology, Flinders University and Medical Centre, Bedford Park, South Australia, Australia
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Freire JM, Rego de Figueiredo I, Valle J, Veiga AS, Andreu D, Enguita FJ, Castanho MARB. siRNA-cell-penetrating peptides complexes as a combinatorial therapy against chronic myeloid leukemia using BV173 cell line as model. J Control Release 2016; 245:127-136. [PMID: 27890856 DOI: 10.1016/j.jconrel.2016.11.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 12/31/2022]
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder caused by a single gene mutation, a reciprocal translocation that originates the Bcr-Abl gene with constitutive tyrosine kinase activity. As a monogenic disease, it is an optimum target for RNA silencing therapy. We developed a siRNA-based therapeutic approach in which the siRNA is delivered by pepM or pepR, two cell-penetrating peptides (CPPs) derived from the dengue virus capsid protein. These peptides have a dual role: siRNA delivery into cells and direct action as bioportides, i.e. intracellularly bioactive CPPs, targetting cancer-related signaling processes. Both pepM and pepR penetrate the positive Bcr-Abl+ Cell Line (BV173). Five in silico designed anti-Bcr-Abl siRNA were selected for in vitro analysis after thorough screening. The Bcr-Abl downregulation kinetics (48h to 168h) was followed by quantitative PCR. The bioportide action of the peptide vectors was evaluated by genome-wide microarray analysis and further validated by testing BV173 cell cycle and cell proliferation monitoring different genes involved in housekeeping/cell stress (RPL13A, HPRT1), cell proliferation (ki67), cell apoptosis (Caspase 3 and Caspase 9) and cell cycle steps (CDK2, CCDN2, CDKN1A). Assays with a commercial transfection agent were carried out for comparison purposes. Maximal Bcr-Abl gene knockdown was observed for one of the siRNA when delivered by pepM at 120h. Both pepM and pepR showed downregulation effects on proliferative CML-related signaling pathways having direct impact on BV173 cell cycle and proliferation, thus reinforcing the siRNA effect by acting as anticancer molecules. With this work we show the therapeutic potential of a CPP shuttle that combines intrinsic anticancer properties with the ability to deliver functional siRNA into CML cell models. By such combination, the pepM-siRNA conjugates lowered Bcr-Abl gene expression levels more extensively than conventional siRNA delivery technologies and perturbed leukemogenic cell homeostasis, hence revealing their potential as novel alternative scaffolds for CML therapy.
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Affiliation(s)
- João Miguel Freire
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Inês Rego de Figueiredo
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - Javier Valle
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona Biomedical Research Park, E-08003 Barcelona, Spain
| | - Ana Salomé Veiga
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
| | - David Andreu
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona Biomedical Research Park, E-08003 Barcelona, Spain
| | - Francisco J Enguita
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
| | - Miguel A R B Castanho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
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Keskin D, Sadri S, Eskazan AE. Dasatinib for the treatment of chronic myeloid leukemia: patient selection and special considerations. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:3355-3361. [PMID: 27784993 PMCID: PMC5066856 DOI: 10.2147/dddt.s85050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Dasatinib is one of the second-generation tyrosine kinase inhibitors used in imatinib resistance and/or intolerance, as well as in the frontline setting in patients with chronic myeloid leukemia-chronic phase, and also in patients with advanced disease. It is also utilized in Philadelphia chromosome-positive acute lymphocytic leukemia. While choosing the appropriate tyrosine kinase inhibitor (ie, dasatinib) for each individual patient, comorbidities and BCR-ABL1 kinase domain mutations should always be taken into consideration, among other things. This review mainly focuses on patient selection prior to dasatinib administration in the treatment of chronic myeloid leukemia.
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Affiliation(s)
- Dilek Keskin
- Department of Internal Medicine, Division of Hematology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevil Sadri
- Department of Internal Medicine, Division of Hematology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Emre Eskazan
- Department of Internal Medicine, Division of Hematology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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13
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Li L, Zhou D, Zheng Y, Xie W. Expression and functions of the STAT3-SCLIP pathway in chronic myeloid leukemia cells. Exp Ther Med 2016; 12:3381-3386. [PMID: 27882167 DOI: 10.3892/etm.2016.3768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/09/2016] [Indexed: 12/23/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a blood cell cancer with increased proliferation of granulocytes. Signal transducers and activators of transcription 3 (STAT3) is an important regulator of CML. To investigate the possible downstream factors of STAT3 and gain more insight into CML-related pathways, this study focused on the superior cervical ganglia protein 10-like protein (SCLIP, or SCG 10-like protein) and analyzed the functions of the STAT3-SCLIP pathway. The effects of STAT3 phosphorylation on SCLIP expression were examined by western blotting. Specific small interfering RNA (siRNA) was then used to knockdown SCLIP in the CML cell line K562 and the expression changes of STAT3 and factors further downstream, namely Bcl-2 and cyclin E1, were detected by RT-qPCR. Cell viability and apoptosis were also analyzed following the knockdown of SCLIP. Results showed a positive association between the phosphorylation of STAT3 and the expression of SCLIP. Knockdown of SCLIP inhibited the viability and induced the apoptosis of K562 cells. Knockdown of SCLIP did not affect the expression of STAT3 mRNA but downregulated the mRNA levels of Bcl-2 and cyclin E1. In conclusion, the results indicate that SCLIP is a direct downstream factor of STAT3, regulates Bcl-2 and cyclin E1 and mediates the viability and apoptosis of CML cells. Consisting of at least these four factors, the STAT3-SCLIP pathway might play critical roles in the regulation of CML. These data provided a more profound understanding of CML-related pathways.
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Affiliation(s)
- Li Li
- The Senior Department of Hematology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | - De Zhou
- The Senior Department of Hematology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | - Yanlong Zheng
- The Senior Department of Hematology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
| | - Wanzhuo Xie
- The Senior Department of Hematology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang 310006, P.R. China
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14
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Viola D, Valerio L, Molinaro E, Agate L, Bottici V, Biagini A, Lorusso L, Cappagli V, Pieruzzi L, Giani C, Sabini E, Passannati P, Puleo L, Matrone A, Pontillo-Contillo B, Battaglia V, Mazzeo S, Vitti P, Elisei R. Treatment of advanced thyroid cancer with targeted therapies: ten years of experience. Endocr Relat Cancer 2016; 23:R185-205. [PMID: 27207700 DOI: 10.1530/erc-15-0555] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/27/2016] [Indexed: 12/13/2022]
Abstract
Thyroid cancer is rare, but it is the most frequent endocrine malignancy. Its prognosis is generally favorable, especially in cases of well-differentiated thyroid cancers (DTCs), such as papillary and follicular cancers, which have survival rates of approximately 95% at 40 years. However, 15-20% of cases became radioiodine refractory (RAI-R), and until now, no other treatments have been effective. The same problems are found in cases of poorly differentiated (PDTC) and anaplastic (ATC) thyroid cancers and in at least 30% of medullary thyroid cancer (MTC) cases, which are very aggressive and not sensitive to radioiodine. Tyrosine kinase inhibitors (TKIs) represent a new approach to the treatment of advanced cases of RAI-R DTC, MTC, PDTC, and, possibly, ATC. In the past 10 years, several TKIs have been tested for the treatment of advanced, progressive, and RAI-R thyroid tumors, and some of them have been recently approved for use in clinical practice: sorafenib and lenvatinib for DTC and PDTC and vandetanib and cabozantinib for MTC. The objective of this review is to present the current status of the treatment of advanced thyroid cancer with the use of innovative targeted therapies by describing both the benefits and the limits of their use based on the experiences reported so far. A comprehensive analysis and description of the molecular basis of these therapies, as well as new therapeutic perspectives, are reported. Some practical suggestions are given for both the choice of patients to be treated and their management, with particular regard to the potential side effects.
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Affiliation(s)
- David Viola
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Laura Valerio
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Eleonora Molinaro
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Laura Agate
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Valeria Bottici
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Agnese Biagini
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Loredana Lorusso
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Virginia Cappagli
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Letizia Pieruzzi
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Carlotta Giani
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Elena Sabini
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Paolo Passannati
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Luciana Puleo
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Antonio Matrone
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Benedetta Pontillo-Contillo
- Diagnostic and Interventional RadiologyDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Valentina Battaglia
- Diagnostic and Interventional RadiologyDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Salvatore Mazzeo
- Diagnostic and Interventional RadiologyDepartment of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paolo Vitti
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy
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Shah E, Upadhyay P, Singh M, Mansuri MS, Begum R, Sheth N, Soni HP. EDTA capped iron oxide nanoparticles magnetic micelles: drug delivery vehicle for treatment of chronic myeloid leukemia and T1–T2 dual contrast agent for magnetic resonance imaging. NEW J CHEM 2016. [DOI: 10.1039/c6nj00655h] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study shows that multiple functionalities like drug delivery and T1–T2 dual modalities can be achieved by a proper surface architecture.
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Affiliation(s)
- Ekta Shah
- Department of Chemistry
- Faculty of Science
- The Maharaja Sayajirao University of Baroda
- Vadodara – 390 002
- India
| | - Pratik Upadhyay
- Department of Pharmaceutical Technology
- L. J. Institute of Pharmacy
- Ahmedabad
- India
| | - Mala Singh
- Department of Biochemistry
- Faculty of Science
- The Maharaja Sayajirao University of Baroda
- Vadodara – 390 002
- India
| | - Mohmmad Shoab Mansuri
- Department of Biochemistry
- Faculty of Science
- The Maharaja Sayajirao University of Baroda
- Vadodara – 390 002
- India
| | - Rasheedunnisa Begum
- Department of Biochemistry
- Faculty of Science
- The Maharaja Sayajirao University of Baroda
- Vadodara – 390 002
- India
| | - Navin Sheth
- Department of Pharmaceutical Sciences
- Saurashtra University
- Rajkot
- India
| | - Hemant P. Soni
- Department of Chemistry
- Faculty of Science
- The Maharaja Sayajirao University of Baroda
- Vadodara – 390 002
- India
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Di Stefano C, Mirone G, Perna S, Marfe G. The roles of microRNAs in the pathogenesis and drug resistance of chronic myelogenous leukemia (Review). Oncol Rep 2015; 35:614-24. [PMID: 26718125 DOI: 10.3892/or.2015.4456] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/23/2015] [Indexed: 11/06/2022] Open
Abstract
Chronic myeloid leukemia (CML) is characterized by the accumulation of Philadelphia chromosome-positive (Ph+) myeloid cells. Ph+ cells occur via a reciprocal translocation between the long arms of chromosomes 9 and 22 resulting in constitutively active BCR-ABL fusion protein. Tyrosine kinase inhibitors (TKIs) are used against the kinase activity of BCR-ABL protein for the effective treatment of CML. However, the development of drug resistance, caused by different genetic mechanisms, is the major issue in the clinical application of TKIs. These mechanisms include changes in expression levels of microRNAs (miRNAs). miRNAs are short non-coding regulatory RNAs that control gene expression and play an important role in cancer development and progression. In the present review, we highlight the roles of miRNAs both in the progression and chemotherapy-resistance of CML. Our understanding of these mechanisms may lead to the use of this knowledge not only in the treatment of patients with CML, but also in other type of cancers.
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Affiliation(s)
- Carla Di Stefano
- Department of Hematology, 'Tor Vergata' University, I-00133 Rome, Italy
| | - Giovanna Mirone
- Department of Medical Oncology B, Regina Elena National Cancer Institute, I-00144 Rome, Italy
| | - Stefania Perna
- Department of Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche, Seconda Università di Napoli, I-81100 Caserta, Italy
| | - Gabriella Marfe
- Department of Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche, Seconda Università di Napoli, I-81100 Caserta, Italy
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17
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Wells SA, Santoro M. Update: the status of clinical trials with kinase inhibitors in thyroid cancer. J Clin Endocrinol Metab 2014; 99:1543-55. [PMID: 24423326 PMCID: PMC5393476 DOI: 10.1210/jc.2013-2622] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT Thyroid cancer is usually cured by timely thyroidectomy; however, the treatment of patients with advanced disease is challenging because their tumors are mostly unresponsive to conventional therapies. Recently, the malignancy has attracted much interest for two reasons: the dramatic increase in its incidence over the last three decades, and the discovery of the genetic mutations or chromosomal rearrangements causing most histological types of thyroid cancer. OBJECTIVE This update reviews the molecular genetics of thyroid cancer and the clinical trials evaluating kinase inhibitors (KIs) in patients with locally advanced or metastatic disease. The update also reviews studies in other malignancies, which have identified mechanisms of efficacy, and also resistance, to specific KIs. This information has been critical both to the development of effective second-generation drugs and to the design of combinatorial therapeutic regimens. Finally, the update addresses the major challenges facing clinicians who seek to develop more effective therapy for patients with thyroid cancer. RESULTS PubMed was searched from January 2000 to November 2013 using the following terms: thyroid cancer, treatment of thyroid cancer, clinical trials in thyroid cancer, small molecule therapeutics, kinase inhibitors, and next generation sequencing. CONCLUSIONS A new era in cancer therapy has emerged based on the introduction of KIs for the treatment of patients with liquid and solid organ malignancies. Patients with thyroid cancer have benefited from this advance and will continue to do so with the development of drugs having greater specificity and with the implementation of clinical trials of combined therapeutics to overcome drug resistance.
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Affiliation(s)
- Samuel A Wells
- Cancer Genetics Branch (S.A.W.), National Cancer Institute, Bethesda, Maryland 20892; and Dipartimento di Medicina Molecolare e Biotecnologie Mediche (M.S.), Universita' di Napoli "Federico II," 80131 Napoli, Italy
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18
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Mughal A, Aslam HM, Khan AMH, Saleem S, Umah R, Saleem M. Bcr-Abl tyrosine kinase inhibitors- current status. Infect Agent Cancer 2013; 8:23. [PMID: 23787070 PMCID: PMC3706229 DOI: 10.1186/1750-9378-8-23] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 06/18/2013] [Indexed: 11/10/2022] Open
Abstract
Bcr-Abl plays a central role in the development of chromosome positive leukaemia. Chronic Myeloid leukaemia occurs due to increase proliferation and resistance to apoptosis by Bcr-Abl positive cells. Imatinib (STI571) is the first drug in the family of Bcr-Abl tyrosine kinase inhibitors while Nilotinib (AMN107) and Dasatinib (BMS-345825) are second generation drugs that are intended to have less resistance and intolerance than imatinib. Ponatinib (AP24534) an orally active Bcr-Abl Tyrosine Kinase Inhibitor and Bafetinib (INNO-406) have efficacy against various point mutations in the Bcr-Abl kinase. 1, 3, 4 thiadiazole derivatives has also displayed moderate inhibitory action on both Abl and Src kinase family. However there are varieties of Bcr-Abl inhibitors but Nilotinib is still the frontline tyrosine kinase inhibitors.
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Affiliation(s)
- Anum Mughal
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Shafaq Saleem
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Ribak Umah
- Final Year Student Of Dinajpur Medical College, Dakshin Dinajpur District, West Bengal, Bangladesh
| | - Maria Saleem
- First Year Student of Karachi Medical And Dental College, Karachi University, Karachi, Pakistan
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19
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Arginine homozygosity in codon 72 of p53 correlates with failure to imatinib response in chronic myeloid leukemia. Biomed Pharmacother 2013; 67:103-7. [DOI: 10.1016/j.biopha.2012.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 11/04/2012] [Indexed: 11/24/2022] Open
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20
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[Successive cutaneous adverse reactions to nilotinib and imatinib in a single patient]. Ann Dermatol Venereol 2012; 139:828-31. [PMID: 23237282 DOI: 10.1016/j.annder.2012.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 07/15/2012] [Accepted: 09/06/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Since the advent of targeted molecules, the treatment and prognosis of many cancers, especially chronic myeloid leukemia (CML), have been substantially modified through the introduction of first- and second-generation tyrosine kinase inhibitors. Skin effects constitute the most common adverse effects of these new substances. Although such skin changes are not life-threatening, they can have extensive clinical impact, in some cases leading to discontinuation of treatment. PATIENTS AND METHODS A 47-year-old woman with no past medical history was followed for chronic phase CML since 26/11/2010 with the presence of the t(9; 22) karyotype. Imatinib (IM) was started at a dose of 400mg/day and haematological response was good. After 4 months of treatment with IM the patient presented with erythematous plaques on both upper limbs and on the oral and vaginal mucosa. These lesions disappeared after discontinuation of IM. The patient was then put on nilotinib 400mg/d and skin lesions reappeared after 3 weeks in the more serious form of erythema multiform with acral distribution, but with no involvement of the mucosa, resulting in immediate cessation of nilotinib. Skin biopsy was consistent with a drug-induced eruption. The lesions disappeared after discontinuation of nilotinib. DISCUSSION In case of intolerance to IM, a second-generation ITK (dasatinib or nilotinib) may be substituted, and while cross-sensitivities seem infrequent, therapy is problematic in these patients presenting potentially curable blood dyscrasias.
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21
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Gadó K, Matolcsy A, Csomor J, Kicsi D, Bödör C, Domján G. Long lasting complete molecular remission after suspending dasatinib treatment in chronic myeloid leukemia. Exp Hematol Oncol 2012; 1:17. [PMID: 23210842 PMCID: PMC3514089 DOI: 10.1186/2162-3619-1-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 04/27/2012] [Indexed: 12/02/2022] Open
Abstract
Tyrosine kinase inhibitors specific for BCR-ABL, were a major breakthrough in CML therapy. Second generation tyrosine kinase inhibitors (dasatinib, nilotinib) are indicated for imatinib resistant and intolerant patients. Present guidelines recommend continuous drug dosing for maintaining remission. There is no available data concerning the optimal duration of dasatinib therapy. We report the case of an imatinib intolerant patient who succeeded a complete molecular remission with dasatinib. Dasatinib was stopped bacause of intolerance, but complete molecular remission was sustained for one year and minor molecular remission for 27 months after discontinuation of dasatinib.
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Affiliation(s)
- Klára Gadó
- 1st Department of Internal Medicine, Semmelweis University, Korányi S, Street 2, 1083, Budapest, Hungary.
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22
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Garay JP, Gray JW. Omics and therapy - a basis for precision medicine. Mol Oncol 2012; 6:128-39. [PMID: 22445068 PMCID: PMC3779147 DOI: 10.1016/j.molonc.2012.02.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 02/27/2012] [Indexed: 12/19/2022] Open
Abstract
A founding premise of the human genome project was that knowledge of the spectrum of abnormalities that comprise cancers and other human diseases would lead to improved disease management by identifying molecular abnormalities that could guide disease detection and diagnosis, suggest new therapeutic strategies and be developed as markers to predict response to therapy. This project led to elucidation of a reference normal human genome sequence and normal polymorphisms therein against which sequences from diseased tissues can be compared to enable identification of causal abnormalities. It also stimulated development of an array of computational tools for genomic analysis and catalyzed public and private sector development of revolutionary tools for genome analysis that transformed analysis of whole genomes from an enterprise that required international teams and hundreds of millions of dollars to a process that can be carried out in core facilities for only a few thousand dollars per sample. Indeed, the $1000 genome is nearly upon us. Applications of these technologies to human cancers in international cancer genome projects are now revealing the spectra of abnormalities that comprise thousands of individual cancers. Analyses of these data are leading to the promised improvements in disease management. We review several aspects of cancer genomics with emphasis on aspects that are relevant to improving cancer therapy.
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Affiliation(s)
- Joseph P Garay
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA.
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23
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Furlong MT, Agrawal S, Hawthorne D, Lago M, Unger S, Krueger L, Stouffer B. A validated LC–MS/MS assay for the simultaneous determination of the anti-leukemic agent dasatinib and two pharmacologically active metabolites in human plasma: Application to a clinical pharmacokinetic study. J Pharm Biomed Anal 2012; 58:130-5. [DOI: 10.1016/j.jpba.2011.09.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 09/08/2011] [Accepted: 09/12/2011] [Indexed: 11/28/2022]
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Src inhibitors, PP2 and dasatinib, increase retinoic acid-induced association of Lyn and c-Raf (S259) and enhance MAPK-dependent differentiation of myeloid leukemia cells. Leukemia 2011; 26:1180-8. [PMID: 22182854 PMCID: PMC3310950 DOI: 10.1038/leu.2011.390] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
All-trans-retinoic-acid (ATRA)-induced differentiation of human myeloid leukemia cells is characterized by persistent MAPK signaling. Fragmentary data suggests Src family kinase (SFK) inhibitors enhance differentiation and thus have potential therapeutic value. The present study shows that SFK inhibitors PP2 and dasatinib enhance aspects of MAPK signaling and regulate a panel of differentiation markers including CD11b and p47phox. HL-60 and NB4 myeloid leukemia cells show accelerated ATRA-induced G1/0 arrest/differentiation with inhibitor co-treatment. We also identified components of a Lyn- and c-Raf-containing MAPK signaling complex augmented by the inhibitors. PP2 and dasatinib increased ATRA-induced expression of Lyn and c-Raf (total and c-RafpS259) and their interaction. The Lyn-associated serine/threonine kinase CK2 also complexed with c-Raf and c-RafpS259, and the KSR1 scaffold protein bound c-Raf, Lyn, and ERK. c-Raf/ERK association was increased by the inhibitors, which is significant since ERK may cause c-Raf C-terminal domain (CTD) phosphorylation in a putative feedback mechanism. Consistent with this, inhibitor treatment caused more CTD phosphorylation. Lyn knockdown decreased c-Raf CTD and S259 phosphorylation. This is the first evidence suggesting SFK inhibitors enhance ATRA-induced differentiation through a possible feedback loop involving KSR1-scaffolded c-Raf and ERK complexed with Lyn and CK2.
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Barak AF, Bonstein L, Lauterbach R, Naparstek E, Tavor S. Tyrosine kinase inhibitors induced immune thrombocytopenia in chronic myeloid leukemia? Hematol Rep 2011; 3:e29. [PMID: 22593820 PMCID: PMC3269798 DOI: 10.4081/hr.2011.e29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 11/22/2011] [Indexed: 12/26/2022] Open
Abstract
The outcome and quality of life of chronic myeloid leukemia (CML) patients has remarkably changed with the treatment of tyrosine kinase inhibitors (TKIs). Currently, hematopoietic stem cell transplantation (HSCT) is considered mainly as a third line salvage therapy in cases of TKIs resistance or intolerance. Here we describe a patient with chronic phase CML who developed both resistance and late occurrence of s severe thrombo-cytopenia on first and second generation TKIs and eventually underwent HSCT. Although the mechanism of the myelosuppression is not fully understood, we showed for the first time the development of dose dependent platelet antibodies in the presence of TKIs, suggesting the possibility of TKIs induced thrombocytopenia. Our case emphasizes that late development of severe myelosuppression during imatinib treatment is probably an important indication for consideration of early HSCT.
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Affiliation(s)
- Avital F Barak
- Internal Medicine Department D, Tel-Aviv Sourasky Medical Center
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26
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Reed SD. When evaluating parameter uncertainty is not enough: the case of dasatinib and nilotinib for imatinib-resistant chronic myeloid leukemia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2011; 14:1055-1056. [PMID: 22152174 DOI: 10.1016/j.jval.2011.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 10/03/2011] [Indexed: 05/31/2023]
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Valent P, Gastl G, Geissler K, Greil R, Hantschel O, Lang A, Linkesch W, Lion T, Petzer AL, Pittermann E, Pleyer L, Thaler J, Wolf D. Nilotinib as frontline and second-line therapy in chronic myeloid leukemia: open questions. Crit Rev Oncol Hematol 2011; 82:370-7. [PMID: 21903413 DOI: 10.1016/j.critrevonc.2011.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 07/15/2011] [Accepted: 08/11/2011] [Indexed: 01/13/2023] Open
Abstract
Nilotinib is a second generation ABL tyrosine kinase inhibitor (TKI) that exerts major anti-leukemic effects in newly diagnosed patients with chronic myeloid leukemia (CML) as well as in most patients with imatinib-resistant CML. In freshly diagnosed patients, the anti-leukemic activity of nilotinib exceeds the efficacy of imatinib, and although long-term data for nilotinib are not available yet, the drug has recently been approved for firstline treatment of chronic phase CML in various countries. Still however, several questions concerning the optimal dose, follow-up parameters, long-term safety, and patient selection remain open. Likewise, it remains uncertain whether both Sokal low-risk and high-risk patients should receive nilotinib as frontline therapy in the future. Another question is whether nilotinib can completely eradicate CML in a subset of patients. Furthermore, it remains unclear whether and what comorbidity must be regarded as relative or absolute contra-indication for this TKI. To discuss these issues, the Austrian CML Working Group organized a series of meetings in 2010. In the current article, the outcomes from these discussions are summarized and presented together with recommendations for frontline use of TKIs in various groups of patients with CML. These recommendations should assist in daily practice as well as in the preparation and conduct of clinical trials.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Haematology & Haemostaseology, Medical University of Vienna, Austria.
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Gild ML, Bullock M, Robinson BG, Clifton-Bligh R. Multikinase inhibitors: a new option for the treatment of thyroid cancer. Nat Rev Endocrinol 2011; 7:617-24. [PMID: 21862995 DOI: 10.1038/nrendo.2011.141] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Thyroid cancer typically has a good outcome following standard treatments, which include surgery, radioactive iodine ablation and treatment with TSH-suppressive levothyroxine. Thyroid cancers that persist or recur following these therapies have a poorer prognosis. Activation of mitogenic and angiogenic signaling pathways occurs in these cancers, and preclinical models have shown that inhibition of key kinase steps in these pathways can have antitumoral effects. Several of these kinase inhibitors have now been tested in phase II and phase III trials, with modestly encouraging results. Some promising data exist for the use of vandetanib (also known as ZD6474), motesanib, axitinib, cabozantinib (also known as XL184), sorafenib, sunitinib, pazopanib and lenvatinib (also known as E7080) in progressive thyroid cancer of medullary, papillary and follicular subtypes. These drugs are generally well-tolerated, although dose-limiting toxicities are common, and a few (probable) treatment-related deaths have been reported. Additional phase III trials will be needed to conclusively show that treatment benefit exceeds risk. Drug resistance can occur via activation of alternate mitogenic signals (pathway switching), as has been reported for the use of kinase inhibitors in other malignancies, such as melanoma. The hypothesis that combinations of kinase inhibitors targeting different pathways might produce better results is currently being tested in several clinical trials.
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Affiliation(s)
- Matti L Gild
- Cancer Genetics Unit, Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
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Wu EQ, Guerin A, Yu AP, Bollu VK, Guo A, Griffin JD. Retrospective real-world comparison of medical visits, costs, and adherence between nilotinib and dasatinib in chronic myeloid leukemia. Curr Med Res Opin 2010; 26:2861-9. [PMID: 21062136 DOI: 10.1185/03007995.2010.533648] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare healthcare resource utilization, costs, and treatment adherence associated with dasatinib versus nilotinib treatment as second-line therapies in chronic myeloid leukemia (CML) patients. METHODS Two large retrospective claims databases (01/1999-06/2009) were combined to identify CML patients (ICD-9 code 205.1x) who received one or more prescriptions of dasatinib or nilotinib. Studied patients had continuous enrollment ≥ 1 month prior to and after the index date, defined as the first prescription for dasatinib or nilotinib. Patients were followed for up to 6 months from the index date to the earliest of the termination of healthcare plan enrollment or end of data availability. Patients with bone marrow or stem cell transplant during the study period were excluded. Poisson regression models were used to compare healthcare resource utilization between the two groups. Results were reported as incidence rate ratios (IRR). Healthcare cost differences were estimated for each cost component using generalized linear models or two-part models. Treatment adherence was measured by the proportion of days covered (PDC) and compared using generalized linear models. Multivariate regressions were used to control for potential confounding factors. RESULTS A total of 521 CML patients receiving second-line tyrosine kinase inhibitors (TKI) (452 dasatinib and 69 nilotinib) were studied. During the study period, dasatinib patients were estimated to have more than twice as many inpatient days (IRR = 2.44; p < 0.001) and nearly double the number of inpatient admissions (IRR = 1.99; p = 0.047) compared to nilotinib patients. Over the follow-up period, dasatinib patients incurred $8828 more in total medical service costs (p < 0.001); cost differences were mainly driven by an adjusted inpatient cost difference of $8520 (p = 0.003). Dasatinib patients were less adherent, with a PDC value approximately 13% lower compared to nilotinib patients (p = 0.009). CONCLUSIONS Among CML patients treated with second-line TKIs, nilotinib patients were more adherent and experienced lower healthcare resource utilization, resulting in medical service cost savings compared to dasatinib patients.
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MESH Headings
- Adult
- Aged
- Algorithms
- Ambulatory Care/economics
- Ambulatory Care/statistics & numerical data
- Antineoplastic Agents/economics
- Antineoplastic Agents/therapeutic use
- Cohort Studies
- Comorbidity
- Dasatinib
- Databases, Factual
- Female
- Health Care Costs
- Health Resources/economics
- Health Resources/statistics & numerical data
- Humans
- Insurance Claim Review/statistics & numerical data
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/economics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Male
- Medication Adherence/statistics & numerical data
- Middle Aged
- Pyrimidines/adverse effects
- Pyrimidines/economics
- Pyrimidines/therapeutic use
- Retrospective Studies
- Thiazoles/adverse effects
- Thiazoles/economics
- Thiazoles/therapeutic use
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Affiliation(s)
- Eric Q Wu
- Analysis Group, Inc., Boston, Massachusetts, USA.
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