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Amitay-Laish I, Reiter O, Prag-Naveh H, Kershenovich R, Hodak E. Retinoic acid receptor agonist as monotherapy for early-stage mycosis fungoides: does it work? J DERMATOL TREAT 2018; 30:258-263. [PMID: 29889596 DOI: 10.1080/09546634.2018.1487525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Retinoids exert their biologic effects by binding to intracellular retinoic-acid receptors (RARs) and/or retinoid X receptors (RXRs). Early-stage mycosis fungoides (MF) has been effectively treated with bexarotene, an RXR-agonist, with overall response (OR) rates 54-67% and complete response (CR) rates 7-27%. Data on RAR-agonist monotherapy are limited. OBJECTIVE To analyze the effectiveness of RAR-agonist monotherapy for early-stage MF. METHODS Data on patients with early-stage MF treated with acitretin/isotretinoin monotherapy at a tertiary cutaneous lymphoma clinic in 2010-2017 were collected retrospectively from the medical files. RESULTS Thirty-five patients (26 males) of median age 50 years (range 8-83) with early-stage MF (IA 9, IB 26) underwent 37 treatment events: 25 acitretin and 12 isotretinoin at a median dosages of 0.3 mg/kg (range 0.2-0.9) and 0.2 mg/kg (range 0.1-0.7), respectively. Median time to maximal response was 6 months for both (range 1-10 for acitretin, 3-16 for isotretinoin); median treatment duration was 10 months (range 3-46) for acitretin, and 9 months (range 3-55) for isotretinoin. OR was 64% for acitretin and 80% for isotretinoin, and CR, 4% and 8%, respectively. Side-effect profiles were as previously reported for retinoids. CONCLUSIONS Early-stage MF patients may benefit from low dose RAR-agonist monotherapy, although the CR rate is low.
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Affiliation(s)
- Iris Amitay-Laish
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Ofer Reiter
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Hadas Prag-Naveh
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel
| | - Ruben Kershenovich
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel
| | - Emmilia Hodak
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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Ivanova D, Gronemeyer H, de Lera AR. Design and Stereoselective Synthesis of Retinoids with Ferrocene or N-Butylcarbazole Pharmacophores that Induce Post-Differentiation Apoptosis in Acute Promyelocytic Leukemia Cells. ChemMedChem 2011; 6:1518-29. [DOI: 10.1002/cmdc.201100065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 03/04/2011] [Indexed: 11/10/2022]
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Magoulas GE, Bariamis SE, Athanassopoulos CM, Haskopoulos A, Dedes PG, Krokidis MG, Karamanos NK, Kletsas D, Papaioannou D, Maroulis G. Syntheses, antiproliferative activity and theoretical characterization of acitretin-type retinoids with changes in the lipophilic part. Eur J Med Chem 2010; 46:721-37. [PMID: 21208698 DOI: 10.1016/j.ejmech.2010.12.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 11/22/2010] [Accepted: 12/07/2010] [Indexed: 11/19/2022]
Abstract
Acitretin analogs, incorporating changes in the lipophilic part, were efficiently synthesized from commercially available aromatic aldehydes or methyl ketones using the Wittig or Horner-Wadsworth-Emmons reaction. Their antiproliferative activity was evaluated against human breast MCF-7 epithelial cells. Analogs 3, 4, 8 and 11 exhibited strong, dose-dependent, antiproliferative activity on the tested cell line. Analog 3, incorporating three methoxy groups in the aromatic ring, exhibited the strongest inhibitory effect at 10 μM. High-level all electron conventional ab initio and density functional theory quantum chemical calculations were performed to obtain the molecular structure, electron charge distribution and polarization properties of all compounds of interest in this work. The most active analogs were planar and were characterized by larger dipole moments than the other synthesized molecules. Another factor of importance to the analysis of the activity of these molecules is the dipole polarizability.
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Affiliation(s)
- George E Magoulas
- Laboratory of Synthetic Organic Chemistry, Department of Chemistry, University of Patras, GR-265 04 Patras, Greece
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Caselli E, Galvan M, Santoni F, Alvarez S, de Lera AR, Ivanova D, Gronemeyer H, Caruso A, Guidoboni M, Cassai E, Dolcetti R, Di Luca D. Retinoic Acid Analogues Inhibit Human Herpesvirus 8 Replication. Antivir Ther 2008. [DOI: 10.1177/135965350801300205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Retinoids have a pronounced antiviral effect against several viruses. In this study we aimed to investigate the effect of retinoids on human herpesvirus 8 (HHV-8). Methods A panel of retinoic acid compounds were tested for their antiviral activity against HHV-8 in human umbilical vascular endothelial cells (HUVECs) and in a human epithelial cell line. The presence, transcription and antigen expression of HHV-8 in infected cells – in the presence or absence of retinoic acid compounds – were evaluated by PCR, reverse transcriptase PCR and immunofluorescence assays; HHV-8 viral load was determined by real-time quantitative PCR. Angiogenesis induced by HHV-8 was also assessed using Cultrex® basement membrane extract. Results The compounds tested specifically inhibited viral promoters, during the early and late phases of infection in both cell systems tested, and resulted in up to 100fold reduction of viral titre and release of progeny virus. The inhibition of viral replication induced by retinoids in endothelial cells, the primary target of HHV-8-driven transformation in Kaposi's Sarcoma, prevented endothelial cells from developing spindle morphology and in vitro tube formation, characteristic changes associated with HHV-8 infection and transformation. Conclusions We show that retinoids inhibit HHV-8 replication and identify new retinoid compounds with a strong antiviral effect. Selective retinoids, particularly those with retinoic acid receptor agonist activity, may be good candidates for the development of antiviral drugs.
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Affiliation(s)
- Elisabetta Caselli
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Italy
| | - Monica Galvan
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Italy
| | - Fabio Santoni
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Italy
| | - Susana Alvarez
- Departamento de Química Orgànica, Universidade de Vigo, Spain
| | - Angel R de Lera
- Departamento de Química Orgànica, Universidade de Vigo, Spain
| | - Diana Ivanova
- Departamento de Química Orgànica, Universidade de Vigo, Spain
- Department of Cancer Biology, IGBMC, Strasbourg, France
| | | | - Arnaldo Caruso
- Section of Microbiology, Department of Experimental and Applied Medicine, University of Brescia, Italy
| | - Massimo Guidoboni
- Immunovirology and Biotherapy Unit, CRO – IRCCS, National Cancer Institute, Aviano, Italy
- Present address: Division of Medical Oncology and Immunotherapy, Department of Oncology, University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy
| | - Enzo Cassai
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Italy
| | - Riccardo Dolcetti
- Immunovirology and Biotherapy Unit, CRO – IRCCS, National Cancer Institute, Aviano, Italy
| | - Dario Di Luca
- Section of Microbiology, Department of Experimental and Diagnostic Medicine, University of Ferrara, Italy
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Querfeld C, Nagelli LV, Rosen ST, Kuzel TM, Guitart J. Bexarotene in the treatment of cutaneous T-cell lymphoma. Expert Opin Pharmacother 2006; 7:907-15. [PMID: 16634713 DOI: 10.1517/14656566.7.7.907] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Primary cutaneous T-cell lymphomas encompass a spectrum of non-Hodgkin's lymphomas that are characterised by clonal proliferation of skin-homing malignant T lymphocytes. Mycosis fungoides and the leukaemic variant Sézary syndrome, collectively referred to as cutaneous T-cell lymphomas, are the most common entities. No curative therapy exists and patients ultimately develop advanced or relapsed disease that is refractory to standard treatment options. Therefore, there is a great need for the development of novel emerging therapies. Bexarotene is the first synthetic nuclear retinoid X receptor-selective retinoid approved by the FDA for the treatment of refractory cutaneous T-cell lymphoma in all stages, as both an oral capsule and a topical gel formulation. Bexarotene was found to induce apoptosis in a variety of preclinical in vitro and in vivo models including cutaneous T-cell lymphoma cells, and has shown efficacy in two multi-centre, open-label Phase II - III clinical trials for early and advanced stages of cutaneous T-cell lymphoma in patients who have failed or were refractory to standard therapies. New insights into the immunomodulatory function of bexarotene have indicated opportunities for combined treatment with IFN-alpha, denileukin diftitox or phototherapy. This article reviews the biological properties, pharmacokinetics, clinical efficacy, safety and role of bexarotene in the treatment of cutaneous T-cell lymphoma.
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Affiliation(s)
- Christiane Querfeld
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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Torque C, Sueur B, Cabou J, Bricout H, Hapiot F, Monflier E. Substrate-selective aqueous organometallic catalysis. How small water-soluble organic molecules enhance the supramolecular discrimination. Tetrahedron 2005. [DOI: 10.1016/j.tet.2005.03.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ivanova D, Rossin A, Gronemeyer H, Valla A, Cartier D, Le Guillou R, Labia R. Structure–activity relationships of methylene or terminal side chain modified retinoids on the differentiation and cell death signaling in NB4 promyelocytic leukemia cells. Bioorg Med Chem Lett 2004; 14:4257-61. [PMID: 15261282 DOI: 10.1016/j.bmcl.2004.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Revised: 05/12/2004] [Accepted: 06/03/2004] [Indexed: 11/17/2022]
Abstract
New structure-activity relationships of a series of methylene or side chain modified retinoids on NB4 acute promyelocytic leukemia cells are investigated. The differentiation- and apoptosis-inducing potential of these compounds is analyzed on the basis of their selective retinoic acid receptor binding profile.
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Affiliation(s)
- Diana Ivanova
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, 1 rue Laurent Fries, BP 10142, 67404 Illkirch, France
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Querfeld C, Rosen ST, Guitart J, Rademaker A, Fung BB, Posten W, Kuzel TM. Comparison of selective retinoic acid receptor– and retinoic X receptor–mediated efficacy, tolerance, and survival in cutaneous t-cell lymphoma. J Am Acad Dermatol 2004; 51:25-32. [PMID: 15243520 DOI: 10.1016/j.jaad.2003.11.058] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Primary cutaneous T-cell lymphomas are non-Hodgkin's lymphomas with varied clinical presentation and prognosis. The most common subtypes of cutaneous T-cell lymphomas are the epidermotropic variants mycosis fungoides and Sézary syndrome. Treatment of mycosis fungoides has encompassed a variety of modalities including the use of retinoids with several studies evaluating their efficacy. The reported benefits and duration of response have varied in published data. The biological effect of retinoids is mediated by specific receptor families, retinoic acid receptor (RAR) and retinoic X receptor (RXR), with subsequently altered gene expression. There are no data available on cutaneous T-cell lymphomas that compare RAR and RXR retinoids. The objective of our retrospective, nonrandomized, single-center study was to compare the response, survival outcomes, and toxic effects in our phase II trial of the RAR-specific retinoid, all-trans retinoic acid, with clinical use of the RXR-specific retinoid, bexarotene, in patients with mycosis fungoides/Sézary syndrome who have relapsed. There was no statistical difference in response rates (12% vs 21%), response duration (20.5 vs 7.3 months), event-free survival time (4 vs 5 months), or median survival when corrected for length of follow-up. Both have favorable toxicity profiles that can be managed with medications. The toxicity profile caused by bexarotene seems to be more limited to laboratory values and better tolerated, although generally associated with more severe grades of toxicity. In conclusion, both retinoids have modest objective response rates and, therefore, most likely will have limited impact as monotherapeutic agents. However, the immunomodulatory effects of RAR and RXR retinoids provide a rational basis for using retinoids in combination with other biologic immune response modifiers, phototherapy, or cytotoxic chemotherapy.
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Affiliation(s)
- Christiane Querfeld
- Department of Dermatology, Division of Hematology/Oncology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chihcago, IL 60611, USA
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