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Shi C, Ju H, Zhou R, Xu S, Wu Y, Gu Z, Wang Y, Chen W, Huang X, Han Y, Sun S, Li C, Wang M, Zhou G, Zhang Z, Li J, Ren G. The efficacy and safety of dalpiciclib, a cyclin-dependent kinase 4/6 inhibitor, in patients with advanced head and neck mucosal melanoma harboring CDK4 amplification. BMC Med 2024; 22:215. [PMID: 38807144 PMCID: PMC11134887 DOI: 10.1186/s12916-024-03431-x] [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] [Received: 07/01/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Mucosal melanoma (MM) is a rare but devastating subtype of melanoma. Our previous studies have demonstrated robust anti-tumor effects of cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors in head and neck MM (HNMM) patient-derived xenograft models with CDK4 amplification. Herein, we aimed to investigate the efficacy and safety of dalpiciclib (SHR6390), a CDK4/6 inhibitor, in HNMM patients harboring CDK4 amplification. METHODS The anti-tumor efficacy of dalpiciclib was assessed by HNMM patient-derived xenograft (PDX) models and patient-derived tumor cells (PDC) in vivo and in vitro. Immunohistochemical analyses and western blot were then performed to assess the markers of cell proliferation and CDK4/6 signaling pathway. For the clinical trial, advanced recurrent and/or metastatic HNMM patients with CDK4 amplification were treated with dalpiciclib 125 mg once daily for 21 consecutive days in 28-day cycles. The primary endpoint was disease control rate (DCR). Secondary endpoints included safety, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). RESULTS Dalpiciclib profoundly suppressed growth of HNMM-PDX and PDC with CDK4 amplification, whereas it showed relatively weak suppression in those with CDK4 wild type compared with vehicle. And dalpiciclib resulted in a remarkable reduction in the expression levels of Ki-67 and phosphorylated Rb compared with control group. In the clinical trial, a total of 17 patients were enrolled, and 16 patients were evaluable. The ORR was 6.3%, and the DCR was 81.3%. The estimated median PFS was 9.9 months (95% CI, 4.8-NA), and the median OS was not reached. The rate of OS at 12 months and 24 months was 68.8% (95% CI, 0.494-0.957) and 51.6% (95% CI, 0.307-0.866), respectively. The most frequent adverse events were neutrophil count decrease, white blood cell count decrease, and fatigue. CONCLUSIONS Dalpiciclib was well-tolerated and displayed a durable benefit for HNMM patients with CDK4 amplification in this study. Further studies on CDK4 inhibitors and its combination strategy for MM are worth further exploration. TRIAL REGISTRATION ChiCTR2000031608.
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Affiliation(s)
- Chaoji Shi
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, 200011, People's Republic of China
| | - Houyu Ju
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Rong Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Shengming Xu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Yunteng Wu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Ziyue Gu
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Ying Wang
- Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, 200011, People's Republic of China
| | - Wanling Chen
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Xinyi Huang
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Yong Han
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Shuyang Sun
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Chuwen Li
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Min Wang
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
- Department of Oral Pathology, School of Medicine, Ninth People's Hospital, Shanghai Jiao Tong University, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
| | - Guoyu Zhou
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China
| | - Zhiyuan Zhang
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, 200011, People's Republic of China.
| | - Jiang Li
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
- Department of Oral Pathology, School of Medicine, Ninth People's Hospital, Shanghai Jiao Tong University, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
| | - Guoxin Ren
- Department of Oral and Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Number 639, Zhi-Zao-Ju Road, Shanghai, 200011, People's Republic of China.
- National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai, 200011, People's Republic of China.
- Shanghai Key Laboratory of Stomatology &, Shanghai Research Institute of Stomatology, Shanghai, 200011, People's Republic of China.
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Ma J, Teng Y, Youming H, Tao X, Fan Y. The Value of Cell-Free Circulating DNA Profiling in Patients with Skin Diseases. Methods Mol Biol 2023; 2695:247-262. [PMID: 37450124 DOI: 10.1007/978-1-0716-3346-5_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Liquid biopsy, also known as fluid biopsy or fluid-phase biopsy, is the sampling and analysis of the blood, cerebrospinal fluid, saliva, pleural fluid, ascites, and urine. Compared with tissue biopsy, liquid biopsy technology has the advantages of being noninvasive, having strong repeatability, enabling early diagnosis, dynamic monitoring, and overcoming tumor heterogeneity. However, interest in cfDNA and skin diseases has not expanded until recently. In this review, we present an overview of the literature related to the basic biology of cfDNA in the field of dermatology as a biomarker for early diagnosis, monitoring disease activity, predicting progression, and treatment response.
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Affiliation(s)
- Jingwen Ma
- Medical Cosmetic Center, Shanghai Skin Disease Hospital, Tongji University, Shanghai, People's Republic of China
| | - Yan Teng
- Health Management Center, Department of Dermatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China
| | - Huang Youming
- Health Management Center, Department of Dermatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China
| | - Xiaohua Tao
- Health Management Center, Department of Dermatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China
| | - Yibin Fan
- Health Management Center, Department of Dermatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, People's Republic of China.
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Kiniwa Y, Nakamura K, Mikoshiba A, Ashida A, Akiyama Y, Morimoto A, Okuyama R. Usefulness of monitoring circulating tumor cells as a therapeutic biomarker in melanoma with BRAF mutation. BMC Cancer 2021; 21:287. [PMID: 33731038 PMCID: PMC7968258 DOI: 10.1186/s12885-021-08016-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While molecularly targeted therapies and immune checkpoint inhibitors have improved the prognosis of advanced melanoma, biomarkers are required to monitor drug responses. Circulating tumor cells (CTCs) are released from primary and/or metastatic tumors into the peripheral blood. We examined whether CTCs have potential as biomarkers by checking the number of CTCs, as well as the BRAF genotype of individual CTCs, in melanoma patients undergoing BRAF/MEK inhibitor treatment. METHODS CTCs were isolated from peripheral blood using a high-density dielectrophoretic microwell array, followed by labeling with melanoma-specific markers (MART-1 and/or gp100) and a leukocyte marker (CD45). The numbers of CTCs were analyzed in fifteen patients with stage 0-III melanoma. Furthermore, changes in CTC numbers were assessed in five patients with stage IV melanoma at four time points during BRAF/MEK inhibitor treatment, and the BRAF genotype was analyzed in CTCs isolated from one patient. RESULTS We examined CTCs in patients with stage 0-III (five samples per stage: stage 0-I, stage II, and stage III), and detected CTCs even in patients with early disease (stage 0 and I). Interestingly, recurrence occurred in the lymph nodes of one stage I patient 2 years after the detection of a high number of CTCs in the patient's blood. The total number of CTCs in four of five patients with stage IV melanoma fluctuated in response to BRAF/MEK inhibitor treatment, suggesting that CTC number has potential for use as a drug response marker in advanced disease patients. Interestingly, one of those patients had CTCs harboring seven different BRAF genotypes, and the mutated CTCs disappeared upon BRAF/MEK inhibitor treatment, except for those harboring BRAFA598V. CONCLUSIONS CTCs are present even in the early stage of melanoma, and the number of CTCs seems to reflect patients' responses to BRAF/MEK inhibitor treatment. Furthermore, genetic heterogeneity of BRAF may contribute to resistance to BRAF/MEK inhibitors. Our findings demonstrate the usefulness of CTC analysis for monitoring responses to targeted therapies in melanoma patients, and for understanding the mechanism of drug resistance.
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Affiliation(s)
- Yukiko Kiniwa
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Kenta Nakamura
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Asuka Mikoshiba
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Atsuko Ashida
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - Yasuyuki Akiyama
- Life Science Research Laboratory, Tosoh Corporation, Ayase, Kanagawa, Japan
| | - Atsushi Morimoto
- Life Science Research Laboratory, Tosoh Corporation, Ayase, Kanagawa, Japan
| | - Ryuhei Okuyama
- Department of Dermatology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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