1
|
Dhar S, Gullbo J, Nilsson K, Nygren P, Larsson R. A Nonclonogenic Cytotoxicity Assay Using Primary Cultures of Patient Tumor Cells for Anticancer Drug Screening. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/108705719800300307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Primary cultures of cells from patients with chronic lymphocytic leukemia (CLL) and ovarian carcinoma (Ovca) were compared with the renal carcinoma ACHN and the lymphocytic CCRF-CEM human tumor cell lines in response to 63 toxic or nontoxic compounds. The experiments were conducted at 1, 10, and 100 μ/ml in 96-well microtiter plates for an assay time of 72 h. The plates were analyzed by the fully automated Dynatech Immuno Assay System (DIAS) using Alamar blue as a fluorometric/colorimetric indicator of metabolic activity. Drug response data were reported as the area under the tumor cell survival-concentration curve (AUC). Noncytotoxic compounds were classified as inactive by all cell systems. According to the AUC, CCRF-CEM and CLL cells were the most sensitive, followed by ACHN, and then Ovca. Many of the clinically active drugs were detected by all cell systems. However, the sensitivity pattern differed considerably between the cell types as judged from correlation analysis, and a higher proportion of clinically inactive drugs were scored as active by the cell lines compared with the primary cultures. Ovca showed the highest ratio of clinically solid tumor active/clinically inactive agents followed by CLL. The results indicate that primary cultures of human tumor cells may be a useful and valuable model for anticancer drug screening.
Collapse
Affiliation(s)
- Sumeer Dhar
- Division of Clinical Pharmacology, University Hospital, Uppsala University, Uppsala, Sweden
| | - Joachim Gullbo
- Division of Clinical Pharmacology, University Hospital, Uppsala University, Uppsala, Sweden
| | - Kenneth Nilsson
- Department of Pathology, University Hospital, Uppsala University, Uppsala, Sweden
| | - Peter Nygren
- Department of Oncology, University Hospital, Uppsala University, Uppsala, Sweden
| | - Rolf Larsson
- Division of Clinical Pharmacology, University Hospital, Uppsala University, Uppsala, Sweden
| |
Collapse
|
2
|
Friedman AA, Letai A, Fisher DE, Flaherty KT. Precision medicine for cancer with next-generation functional diagnostics. Nat Rev Cancer 2015; 15:747-56. [PMID: 26536825 PMCID: PMC4970460 DOI: 10.1038/nrc4015] [Citation(s) in RCA: 398] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Precision medicine is about matching the right drugs to the right patients. Although this approach is technology agnostic, in cancer there is a tendency to make precision medicine synonymous with genomics. However, genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This limitation can be addressed by functional testing of live patient tumour cells exposed to potential therapies. Recently, several 'next-generation' functional diagnostic technologies have been reported, including novel methods for tumour manipulation, molecularly precise assays of tumour responses and device-based in situ approaches; these address the limitations of the older generation of chemosensitivity tests. The promise of these new technologies suggests a future diagnostic strategy that integrates functional testing with next-generation sequencing and immunoprofiling to precisely match combination therapies to individual cancer patients.
Collapse
Affiliation(s)
- Adam A Friedman
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
| | - Anthony Letai
- Dana-Farber Cancer Institute, Harvard Medical School, 440 Brookline Avenue, Mayer 430, Boston, Massachusetts 02215, USA
| | - David E Fisher
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
- Dermatology and Cutaneous Biology Research Center, Massachusetts General Hospital, 149 East 13th Street, Charlestown, Massachusetts 02129, USA
| | - Keith T Flaherty
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
| |
Collapse
|
3
|
Rogalińska M, Błoński JZ, Góralski P, Wawrzyniak E, Hartman M, Rogalska A, Robak P, Koceva-Chyła A, Piekarski H, Robak T, Kiliańska ZM. Relationship between in vitro drug sensitivity and clinical response of patients to treatment in chronic lymphocytic leukemia. Int J Oncol 2015; 46:1259-67. [PMID: 25572009 DOI: 10.3892/ijo.2015.2823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/04/2014] [Indexed: 11/05/2022] Open
Abstract
To improve the efficacy of therapeutic options in chronic lymphocytic leukemia (CLL) an in vitro system to determine the response of mononuclear blood cells from blood of patients was elaborated. The study combines four approaches, i.e., cell viability, apoptosis rate, differential scanning calorimetry (DSC), and immunoblotting to develop personalized therapy protocols based on the cell sensitivity to drug exposure of individual CLL patients. The complementary analyses were performed on 28 peripheral blood samples from previously untreated CLL patients before therapy. The induction and progress of apoptosis in CLL cells exposed in vitro to purine analogs combined with mafosfamide, i.e., cladribine + mafosfamide (CM) and fludarabine + mafosfamide (FM) were assessed using the above approaches. The changes in thermal profiles (decrease/loss of transition at 95±5˚C) coincided with an accumulation of apoptotic cells, a decrease in the number of viable cells, and differences in the expression of the apoptosis‑related protein PARP‑1. No significant changes were observed in the thermal profiles of nuclei isolated from CLL cells resistant to the treatment. The complementary assays revealed a strong relationship between both the in vitro sensitivity of leukemia cells to drugs and the clinical response of the patients, determined usually after the sixth course of treatment (after ~6 months of therapy). As a summary of studies followed by complementary tests, our findings demonstrate the value of in vitro exposure of CLL cell samples to drugs intended to treat CLL patients, before their administration in order to recommend the most suitable and effective therapy for individual patients.
Collapse
Affiliation(s)
- Małgorzata Rogalińska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Jerzy Z Błoński
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Paweł Góralski
- Department of Physical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland
| | - Ewa Wawrzyniak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Mariusz Hartman
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Aneta Rogalska
- Department of Thermobiology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Paweł Robak
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
| | - Aneta Koceva-Chyła
- Department of Thermobiology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Henryk Piekarski
- Department of Physical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Zofia M Kiliańska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| |
Collapse
|
4
|
Cai B, Wang S, Huang J, Lee CK, Gao C, Liu B. Cladribine and bendamustine exhibit inhibitory activity in dexamethasone-sensitive and -resistant multiple myeloma cells. Am J Transl Res 2013; 5:36-46. [PMID: 23390564 PMCID: PMC3560475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/02/2013] [Indexed: 06/01/2023]
Abstract
Cladribine (2-CDA) is a well-known purine nucleoside analog with activities against lymphoproliferative disorders such as hairy cell leukemia (HCL). Bendamustine, a hybrid molecule of purine analog and alkylator, induces apoptosis via DNA damage response and inhibition of mitotic checkpoint. Their therapeutic potential in patients with multiple myeloma (MM), particularly those become resistant to traditional chemotherapeutic agents, remains unclear. Here we study the effects of cladribine or bendamustine on dexamethasone-sensitive (MM1.S) and -resistant (MM1.R) MM cells. MTS-based proliferation assays showed that cladribine and bendamustine exhibited similar anti-proliferation/anti-survival effects on MM1.S and MM1.R cells in a dose-dependent manner. The IC50s of cladribine were approximately 35.3 nmol/L and 58 nmol/L for MM1.S and MM1.R cells, respectively. The IC50s of bendamustine were approximately 119.8 μmol/L (MM1.S) and 138 μmol/L (MM1.R). An apoptotic-ELISA and western blot assays of PARP cleavage and activation of caspase-8 and caspase-3 indicated that cladribine or bendamustine induced apoptosis in both cell lines. Similar results were obtained with flow cytometric analysis showing that cladribine or bendamustine increased the sub-G1 population. Treatment with bendamustine but not cladribine also resulted in cell cycle S-phase arrest. Either cladribine or bendamustine led to a remarkable increase of the phosphorylated H2A.X, CHK1 and CHK2 in both MM1.S and MM1.R cells, suggesting an induction of DNA damage response. Collectively, we demonstrate that cladribine and bendamustine exert potent inhibitory effects on dexamethasone-sensitive and -resistant MM cells in vitro. Our data suggest that MM patients, including those with dexamethasone resistance, may particularly benefit from cladribine or bendamustine.
Collapse
Affiliation(s)
- Bo Cai
- Department of Hematology, Chinese PLA General HospitalBeijing, China
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical CampusAurora, CO, USA
| | - Shuiliang Wang
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical CampusAurora, CO, USA
| | - Jingcao Huang
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical CampusAurora, CO, USA
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeTianjin, China
| | - Choon-Kee Lee
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical CampusAurora, CO, USA
- Current address: San Juan Cancer Center, Montrose Memorial HospitalMontrose, CO, USA
| | - Chunji Gao
- Department of Hematology, Chinese PLA General HospitalBeijing, China
| | - Bolin Liu
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical CampusAurora, CO, USA
| |
Collapse
|
5
|
Ma J, Wang S, Zhao M, Deng XS, Lee CK, Yu XD, Liu B. Therapeutic potential of cladribine in combination with STAT3 inhibitor against multiple myeloma. BMC Cancer 2011; 11:255. [PMID: 21679466 PMCID: PMC3141773 DOI: 10.1186/1471-2407-11-255] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 06/16/2011] [Indexed: 12/14/2022] Open
Abstract
Background Cladribine or 2-chlorodeoxyadenosine (2-CDA) is a well-known purine nucleoside analog with particular activity against lymphoproliferative disorders, such as hairy cell leukemia (HCL). Its benefits in multiple myeloma (MM) remain unclear. Here we report the inhibitory effects of cladribine on MM cell lines (U266, RPMI8226, MM1.S), and its therapeutic potential in combination with a specific inhibitor of the signal transducer and activator of transcription 3 (STAT3). Methods MTS-based proliferation assays were used to determine cell viability in response to cladribine. Cell cycle progression was examined by flow cytometry analysis. Cells undergoing apoptosis were evaluated with Annexin V staining and a specific ELISA to quantitatively measure cytoplasmic histone-associated DNA fragments. Western blot analyses were performed to determine the protein expression levels and activation. Results Cladribine inhibited cell proliferation of MM cells in a dose-dependent manner, although the three MM cell lines exhibited a remarkably different responsiveness to cladribine. The IC50 of cladribine for U266, RPMI8226, or MM1.S cells was approximately 2.43, 0.75, or 0.18 μmol/L, respectively. Treatment with cladribine resulted in a significant G1 arrest in U266 and RPMI8226 cells, but only a minor increase in the G1 phase for MM1.S cells. Apoptosis assays with Annexin V-FITC/PI double staining indicated that cladribine induced apoptosis of U266 cells in a dose-dependent manner. Similar results were obtained with an apoptotic-ELISA showing that cladribine dramatically promoted MM1.S and RPMA8226 cells undergoing apoptosis. On the molecular level, cladribine induced PARP cleavage and activation of caspase-8 and caspase-3. Meanwhile, treatment with cladribine led to a remarkable reduction of the phosphorylated STAT3 (P-STAT3), but had little effect on STAT3 protein levels. The combinations of cladribine and a specific STAT3 inhibitor as compared to either agent alone significantly induced apoptosis in all three MM cell lines. Conclusions Cladribine exhibited inhibitory effects on MM cells in vitro. MM1.S is the only cell line showing significant response to the clinically achievable concentrations of cladribine-induced apoptosis and inactivation of STAT3. Our data suggest that MM patients with the features of MM1.S cells may particularly benefit from cladribine monotherapy, whereas cladribine in combination with STAT3 inhibitor exerts a broader therapeutic potential against MM.
Collapse
Affiliation(s)
- Jian Ma
- International Medical Centre of PLA General Hospital, Beijing, PR China
| | | | | | | | | | | | | |
Collapse
|
6
|
Nagourney RA. Ex vivo programmed cell death and the prediction of response to chemotherapy. Curr Treat Options Oncol 2006; 7:103-10. [PMID: 16455021 DOI: 10.1007/s11864-006-0045-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Since the earliest introduction of cytotoxic chemotherapy, investigators have pursued laboratory techniques designed to match patients to available drugs. Most of the work, published through the 1980s, reflected the prevailing view of cancer as a disease of dysregulated cell proliferation. Noteworthy, the description of apoptosis and programmed cell death, fundamental to our modern understanding of human tumor biology, did not occur until well after the heyday of in vitro chemosensitivity testing. By incorporating the modern tenets of carcinogenesis associated with perturbations in cell survival we can now re-examine laboratory assays of drug response in the context of drug-induced programmed cell death. Although there is interest in the use of genomic analyses for the prediction of chemotherapy response, the painful recognition that genotype does not equal phenotype will continue to limit broad application of these platforms. Biosystematics instructs that biological pathways rarely follow predicted routes. Efforts to force human biology to behave according to preconceived scientific dictates have proven costly and unsuccessful. Whole-cell experimental models with the capacity to evaluate all the operative mechanisms of cellular response to injury, acting in concert, provide valid tools for the study of human cancer. Educated by cellular behavior, we can expeditiously examine molecular processes of interest. This article briefly reviews the history of whole-cell experimental models of in vitro chemosensitivity testing then focuses on cell-death measures as the most robust predictors of clinical outcome in human cancer.
Collapse
|
7
|
Krett NL, Davies KM, Ayres M, Ma C, Nabhan C, Gandhi V, Rosen ST. 8-Amino-adenosine is a potential therapeutic agent for multiple myeloma. Mol Cancer Ther 2004. [DOI: 10.1158/1535-7163.1411.3.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Abstract
Multiple myeloma (MM) is a malignancy of clonal B-cells that accounts for 10% of all hematologic malignancies. We have shown previously that a novel purine analogue, 8-chloro-adenosine, has significant activity for MM in preclinical studies. Objective: Using MM cell lines, we investigated the molecular mechanism of related congener of adenosine, 8-amino-adenosine (8-NH2-Ado). Methods: We employed biological and biochemical assays in MM cell lines to evaluate the clinical potential of 8-NH2-Ado. Results: In MM cell lines both sensitive and resistant to conventional chemotherapies, 8-NH2-Ado is cytotoxic, with IC50 ranging from 300 nmol/L to 3 μmol/L. A mouse leukemic cell line lacking adenosine kinase activity was resistant to 8-NH2-Ado, indicating that phosphorylation of 8-NH2-Ado to its triphosphate form is required for cytotoxicity. A 4-hour incubation of MM cells with 10 μmol/L analogue resulted in an accumulation of >7 mmol/L 8-NH2-ATP with a parallel decline in the endogenous ATP levels. Accumulation of 8-NH2-ATP was dependent on both exogenous concentration of 8-NH2-Ado and incubation time. The accumulation of 8-NH2-ATP was accompanied by a decrease in both RNA and DNA synthesis. The mechanism of 8-NH2-Ado-mediated cytotoxicity was due to apoptosis as measured by an increase in Annexin V binding, a decrease in mitochondrial membrane potential, an increase in caspase activity, cleavage of caspase substrates, and an increase in cells with a sub-G1 DNA content. Conclusion: Based on these results, we conclude that 8-NH2-Ado may hold great potential as a therapeutic agent for the treatment of MM.
Collapse
Affiliation(s)
- Nancy L. Krett
- 1Division of Hematology Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois and
| | - Katharine M. Davies
- 1Division of Hematology Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois and
| | - Mary Ayres
- 2Department of Experimental Therapeutics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chunguang Ma
- 1Division of Hematology Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois and
| | - Chadi Nabhan
- 1Division of Hematology Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois and
| | - Varsha Gandhi
- 2Department of Experimental Therapeutics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Steven T. Rosen
- 1Division of Hematology Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University Medical School, Chicago, Illinois and
| |
Collapse
|
8
|
Abstract
The purine nucleoside analogues (PNA), fludarabine (FA), cladribine (2-chlorodeoxyadenosine, 2-CdA) and 2'-deoxycoformycin (DCF), represent a novel group of cytotoxic agents with high activity in low-grade lymphoid malignancies. However, several investigations have revealed that these agents are active also in acute myeloid leukemia (AML) and chronic myelogenous leukemia (CML). Synergistic interaction between FA or 2-CdA with cytarabine (Ara-C) have been demonstrated in both preclinical and clinical studies. PNA enhance the cell concentration of Ara-CTP, which is active metabolite of Ara-C. It is likely that the addition of granulocyte colony stimulating factor (G-CSF) may further improve the effects of FA (FLAG) or 2-CdA (CLAG). The addition of anthracyclines to induction therapy does not appear to result in a substantial advantage in terms of CR achievement and duration. An alternative approach to increase FLAG activity might be the addition of investigational drugs with novel mechanism of action, such as topoiromerase I inhibitors. The addition of anthracyclines to induction therapy does not appear to result in a substantial advantage in terms of CR achievement and duration. Clinical studies have confirmed the efficacy of PNA alone or in combination protocols in the treatment of AML. These regimens seem to produce superior results with acceptable toxicities in previously treated and relapsed, poor risk AML. However, early relapses remain a significant problem in a majority of refractory or relapsed patients in CR after treatment with PNA based regimens. To prolong remission duration or even cure AML, auto--or allo stem cell transplantation should be considered. However, FAMP or 2-CdA containing regimens may impair mobilization and collection of stem cells from peripheral blood for autotransplantation. Few studies have analyzed the role of PNA in CML. 2-CdA, FAMP and DCF can induce hematologic response in chronic phase of CML but cytogenetic responses have not been observed. Preliminary results suggest, that PNA used alone or in combination may be used as palliation in blast phase of the disease. However, currently, the role of these agents in CML is insignificant because of the high activity of Glivec in this disease. Finally, PNA, especially FA play an important role in non-myeloablative conditioning regimens for allogenic stem cell transplantation in high-risk patients, possibly also with myeloid malignancies.
Collapse
MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Antibiotics, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/pharmacology
- Antimetabolites, Antineoplastic/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Child, Preschool
- Cladribine/therapeutic use
- Clinical Trials as Topic
- Cytarabine/administration & dosage
- Drug Synergism
- Female
- Granulocyte Colony-Stimulating Factor/administration & dosage
- Hematopoietic Stem Cell Mobilization
- Humans
- Infant
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/therapy
- Male
- Middle Aged
- Pentostatin/pharmacology
- Pentostatin/therapeutic use
- Peripheral Blood Stem Cell Transplantation
- Remission Induction
- Salvage Therapy
- Transplantation Conditioning
- Transplantation, Autologous
- Transplantation, Homologous
- Treatment Outcome
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
- Vidarabine/pharmacology
- Vidarabine/therapeutic use
Collapse
Affiliation(s)
- Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 93-513 Lodz, Pabianicka 62 Poland.
| |
Collapse
|
9
|
Nagourney RA, Brewer CA, Radecki S, Kidder WA, Sommers BL, Evans SS, Minor DR, DiSaia PJ. Phase II trial of gemcitabine plus cisplatin repeating doublet therapy in previously treated, relapsed ovarian cancer patients. Gynecol Oncol 2003; 88:35-9. [PMID: 12504624 DOI: 10.1006/gyno.2002.6855] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim was to determine the safety and efficacy of gemcitabine plus cisplatin for patients with relapsed ovarian carcinoma and to compare ex vivo drug sensitivity profiles with clinical outcomes. PATIENTS AND METHODS Previously treated patients with ovarian carcinoma received cisplatin (30 mg/m(2)) plus gemcitabine (600-750 mg/m(2)) on Days 1 and 8 of each 21-day cycle. Seventeen of the 27 patients underwent ex vivo analyses for correlation with clinical response. RESULTS Of 27 patients, there were 7 (26%) complete and 12 (44%) partial responses, for an overall response rate of 70% (95% CI: 53-87%). Toxicities included neutropenia Grade III in 51.9%, Grade IV in 29.6%; anemia Grade III in 18.5 %; thrombocytopenia Grade III in 66.7 %, Grade IV in 29.6%; nausea and vomiting Grade III in 14.8 %; peripheral neuropathy Grade III in 3.7%; and alopecia Grade IV in 11.1% of patients. The median time to progression for objective responders was 7.9 months with a range of 2.1 to 13.2 months. There were no treatment-related deaths. Ex vivo results correlated with response, time to progression, and survival, remaining significant when adjusted for platin-resistance and number of prior therapies. Adjustment for platin-free interval decreased the significance but did not, in and of itself, predict significantly for progression-free survival. CONCLUSIONS Cisplatin plus gemcitabine is active for patients with relapsed ovarian cancer. Toxicities, primarily hematologic, are manageable with dose modifications. Responses observed in heavily pretreated and platin-resistant patients indicate activity in drug-refractory patients. The results of the ex vivo analyses correlate with clinical outcomes.
Collapse
|
10
|
Chun HH, Castellví-Bel S, Wang Z, Nagourney RA, Plaeger S, Becker-Catania SG, Naeim F, Sparkes RS, Gatti RA. TCL-1, MTCP-1 and TML-1 gene expression profile in non-leukemic clonal proliferations associated with ataxia-telangiectasia. Int J Cancer 2002; 97:726-31. [PMID: 11857346 DOI: 10.1002/ijc.10102] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We analyzed the role of 4 genes, TCL-1, MTCP-1, TML-1 and ATM, in the early pathogenesis of T cell leukemia, with particular interest in the characteristics of long-standing non-leukemic clonal proliferations in ataxia-telangiectasia (A-T) patients. Five patients were studied: 4 patients had A-T (2 of whom had non-leukemic clonal proliferations [ATCP]), 1 had B cell lymphoma and 1 had T-ALL; a fifth patient with T-PLL did not have A-T. We measured the levels of expression for TCL-1, MTCP-1 and TML-1. TCL-1, not expressed in unstimulated mature T cells, was upregulated in the peripheral blood leukocytes (PBL) of the 2 A-T patients with ATCP. It was also expressed in the malignant cells of the A-T patient with B cell lymphoma and the T-PLL cells of the patient without A-T. In the same cells, MTCP-1 type A was expressed equally in all 5 patients, as well as in the controls; MTCP-1 type B transcripts were not observed. TML-1, also not expressed in unstimulated T cells, was expressed in the PBL of one A-T patient with ATCP and in the leukemic cells of the non-A-T T-PLL patient. These expression patterns were compared to cellular immunophenotypes. The non-leukemic clonal T cell populations had the characteristics of immature T cells. We conclude that TCL-1 and TML-1 play a role in cell proliferation and survival but are not pivotal genes in the progression to malignancy, even when the ATM gene is mutated. Additional genetic alterations must occur to initiate tumorigenesis.
Collapse
Affiliation(s)
- Helen H Chun
- Department of Pathology, School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095-1732, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Szalay J, Bruno P, Bhati R, Adjodha J, Schueler D, Summerville V, Vazeos R. Associations of PKC isoforms with the cytoskeleton of B16F10 melanoma cells. J Histochem Cytochem 2001; 49:49-66. [PMID: 11118478 DOI: 10.1177/002215540104900106] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Although PKC plays a major role in regulating the morphology and function of the cytoskeleton, little is known about in situ associations of specific isoforms with the cytoskeleton. We demonstrate that seven PKC isoforms are expressed in B16F10 melanoma cells and show different levels of induction by serum. Using cell cytoskeleton preparations (CSKs), confocal microscopy, and immunocytochemistry, all isoforms show specific patterns of localization to focal contact-like structures (alpha, delta), very small cytoplasmic granules/vesicles (all isoforms), dense ordered arrays of small granules in the perinuclear region (alpha, delta), granules/vesicles associated with a homogeneous framework in the cytoplasm adjacent to the nucleus (gamma), or irregular-shaped patches of granules at or near the nuclear perimeter (eta, theta). In addition, several isoforms are present as cytoplasmic granules/ vesicles in linear or curvilinear arrays (alpha, delta, epsilon, theta). When isoform localization is examined using 3.7% formaldehyde or methanol:acetone, the patterns of localization in CSKs are often difficult or impossible to detect, and many are described here for the first time. Double-labeling experiments with CSK demonstrate that PKC actin co-localizes with punctate alpha-rich particles above the nucleus, granules of epsilon throughout the cytoplasm, and with theta in irregular-shaped aggregates associated with the nucleus. Vimentin co-localizes with perinuclear granules of delta and beta(2), and alpha-tubulin co-localizes with theta in structures at or near the nuclear surface and in microtubules associated with the microtubule organizing center (MTOC). In summary, the present study demonstrates that seven PKC isoforms are endogenously expressed in B16F10 melanoma cells. These isoforms show various levels of induction by serum and specific patterns of association with various components of the detergent-resistant cell cytoskeleton.
Collapse
Affiliation(s)
- J Szalay
- Queens College, Department of Biology, Flushing, New York 11367, USA.
| | | | | | | | | | | | | |
Collapse
|
12
|
Nagourney RA, Link JS, Blitzer JB, Forsthoff C, Evans SS. Gemcitabine plus cisplatin repeating doublet therapy in previously treated, relapsed breast cancer patients. J Clin Oncol 2000; 18:2245-9. [PMID: 10829044 DOI: 10.1200/jco.2000.18.11.2245] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To determine the safety and efficacy of gemcitabine plus cisplatin for patients with relapsed adenocarcinoma of the breast. PATIENTS AND METHODS Previously treated patients with adenocarcinoma of the breast received cisplatin (30 mg/m(2)) plus gemcitabine (1,000 mg/m(2)) on days 1, 8, and 15 of each 28-day cycle, which was changed after patient no. 12 to cisplatin (30 mg/m(2)) plus gemcitabine (750 mg/m(2)) days 1 and 8 of each 21-day cycle. RESULTS Of 30 patients, three (10%) had complete and 12 (40%) had partial responses, for an overall response rate of 50%. Two objective responses were observed among the four patients accrued after relapse that followed high-dose/stem-cell therapies. The median time to progression was 14 weeks. The median time to progression for objective responders was 23.5 weeks, with a range of 8 to 68 weeks. Toxicities included grades III and IV neutropenia in 13%, anemia in 6%, thrombocytopenia in 31%, grade III nausea in 4%, and grade II peripheral neuropathy in 2% of 151 treatment cycles. Moderate alopecia occurred in four patients. There were no treatment-related deaths. CONCLUSION Cisplatin plus gemcitabine is active and tolerable for patients with relapsed breast cancer. Responses observed in previously treated patients, including high-dose/stem-cell failures, indicate activity in otherwise drug-refractory patients.
Collapse
Affiliation(s)
- R A Nagourney
- Rational Therapeutics, Inc, Long Beach Memorial Medical Center, and Memorial Breast Center, Long Beach, CA, USA.
| | | | | | | | | |
Collapse
|
13
|
Laurencet FM, Zulian GB, Guetty-Alberto M, Iten PA, Betticher DC, Alberto P. Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies. Br J Cancer 1999; 79:1215-9. [PMID: 10098762 PMCID: PMC2362247 DOI: 10.1038/sj.bjc.6690195] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The feasibility of combining cladribine with cyclophosphamide and prednisone in the management of indolent lymphoid malignancies was determined. Nineteen patients [nine chronic lymphocytic leukaemia (CLL), seven non-Hodgkin's lymphoma (NHL) and three macroglobulinaemia (M))] received cladribine 0.1 mg kg(-1) per day as a subcutaneous bolus injection on days 1-3 (up to 5 injections) with intravenous cyclophosphamide 500 mg m(-2) on day 1 and oral prednisone 40 mg (m-2) on days 1-5 at 4-weekly intervals up to a maximum of six courses. A total of 80 courses were given. Overall response rate was 88%, with four patients achieving a complete clinical and haematological response and 12 achieving a partial response. Neutropenia WHO grade 4 in two patients and WHO grade 3 infection in one patient were the limiting toxicities on treatment. During the follow-up, WHO grade >3 haematological complications occurred in five patients and WHO grade >3 non-haematological complications in five patients. There were no treatment-related deaths. This study demonstrates the feasibility of the cladribine/cyclophosphamide/prednisone (CCP) combination that appears highly active and safe in the management of indolent lymphoid malignancies.
Collapse
Affiliation(s)
- F M Laurencet
- Division of Oncology, Geneva University Hospitals, Switzerland
| | | | | | | | | | | |
Collapse
|
14
|
Bosanquet AG, Burlton AR, Bell PB, Harris AL. Ex vivo cytotoxic drug evaluation by DiSC assay to expedite identification of clinical targets: results with 8-chloro-cAMP. Br J Cancer 1997; 76:511-8. [PMID: 9275029 PMCID: PMC2227987 DOI: 10.1038/bjc.1997.417] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
There is a pressing need to reduce the time and cost of developing new cytotoxic agents and to accurately identify clinically active agents at an early stage. In this study, the differential staining cytotoxicity (DiSC) assay was used to assess the efficacy of the novel antitumour cAMP analogue, 8-chloro-cAMP (8-Cl-cAMP) (and its metabolite 8-Cl-adenosine) against 107 fresh specimens of human neoplastic and normal cells. Diagnoses included chronic and acute leukaemias, myeloma, non-Hodgkin's lymphoma (NHL) and miscellaneous solid tumours. The aim was to identify targets for subsequent phase I, II and III trials. 8-Cl-cAMP was tested at 4-985 microM, along with standard chemotherapeutic drugs. 8-Cl-cAMP and its metabolite caused no morphologically observable cell differentiation but induced dose-dependent cytotoxicity. Compared with untreated patients, previously treated chronic lymphocytic leukaemia (CLL) patients showed no increase in ex vivo resistance to 8-Cl-cAMP (P = 0.878); minimal cross-resistance with other cytotoxic drugs was detected. Compared with normal cells (mean LC90 = 1803 microM), 8-Cl-cAMP showed significant ex vivo activity against CLL (117.0 microM; P < 0.0001) and NHL (140.0 microM; P < 0.0001), of which eight were mantle cell NHL (84.7 microM), and greatest activity against cells from patients with acute myeloid leukaemia (AML; mean LC90 = 24.3 microM; in vitro therapeutic index 74-fold, P < 0.0001). Solid tumour specimens were comparatively resistant to 8-Cl-cAMP. The results highlight the clinical potential of 8-Cl-cAMP, point to several new phase I, II and III trial possibilities and provide a rationale for the inclusion of ex vivo cytotoxic drug evaluation in the drug development process.
Collapse
Affiliation(s)
- A G Bosanquet
- Bath Cancer Research Unit, School of Postgraduate Medicine, University of Bath, Royal United Hospital, UK
| | | | | | | |
Collapse
|
15
|
Makower D, Venkatraj U, Dutcher JP, Wiernik PH. Occurrence of myeloma in a chronic lymphocytic leukemia patients after response to differentiation therapy with interleukin-4. Leuk Lymphoma 1996; 23:617-9. [PMID: 9031095 DOI: 10.3109/10428199609054873] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The occurrence of chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in a single individual is rare, and the clonal relationship between the two neoplasms is unclear. We describe here a patient with CLL who developed symptoms of MM while responding to experimental therapy with interleukin-4 (IL-4). This patient was treated with 2-chlorodeoxyadenosine (2-CDA), and had a response in both malignancies.
Collapse
Affiliation(s)
- D Makower
- Department of Oncology, Albert Einstein Cancer Center, Bronx, New York, USA
| | | | | | | |
Collapse
|
16
|
Dhar S, Nygren P, Csoka K, Botling J, Nilsson K, Larsson R. Anti-cancer drug characterisation using a human cell line panel representing defined types of drug resistance. Br J Cancer 1996; 74:888-96. [PMID: 8826854 PMCID: PMC2074735 DOI: 10.1038/bjc.1996.453] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Differential drug response in a human cell line panel representing defined types of cytotoxic drug resistance was measured using the non-clonogenic fluorometric microculture cytotoxicity assay (FMCA). In total 37 drugs were analysed; eight topoisomerase II inhibitors, eight anti-metabolites, eight alkylating agents, eight tubulin-active agents and five compounds with other or unknown mechanisms of action, including one topoisomerase I inhibitor. Correlation analysis of log IC50 values obtained from the panel showed a high degree of similarity among the drugs with a similar mechanism of action. The mean percentage of mechanistically similar drugs included among the ten highest correlations, when each drug was compared with the remaining data set, was 100%, 92%, 88% and 52% for the topoisomerase II inhibitors, alkylators, tubulinactive agents and anti-metabolites respectively. Classification of drugs into the four categories representing different mechanisms of action using a probabilistic neural network (PNN) analysis resulted in 29 (91%) correct predictions. The results indicate the feasibility of using a limited number of cell lines for prediction of mechanism of action of anti-cancer drugs. The present approach may be well suited for initial classification and evaluation of novel anti-cancer drugs and as a potential tool to guide lead compound optimisation.
Collapse
Affiliation(s)
- S Dhar
- Department of Oncology, University Hospital, Uppsala University, Sweden
| | | | | | | | | | | |
Collapse
|
17
|
Abstract
The anticancer drug 2-chloro-2'-deoxyadenosine (CdA) belongs to the family of purine nucleoside analogs. CdA is exquisitely cytotoxic both to the dividing and to the non-dividing lymphocyte, which supports its use in lymphoproliferative disorders of low-grade malignancy. Indeed, the best clinical results with CdA are achieved in hairy-cell leukemia, in chronic lymphocytic leukemia, in Waldenström's macroglobulinemia and in low-grade malignant lymphoma. Most patients with hairy-cell leukemia achieve a complete response with a single course of CdA. However, the disease is not eradicated and a fraction of complete responders will eventually relapse. In chronic lymphocytic leukemia and in malignant lymphoma, complete or partial responses can be achieved in approximately 40% of previously treated patients, even after classical chemotherapy has failed. However, few responses sustain beyond 1 to 2 years, while longer unmaintained responses may be obtained in Waldenström's macroglobulinemia. More responses (70-80%) are achieved in patients with chronic lymphoproliferative disorders treated de novo with CdA but their impact on survival remains to be established. More than 10 years after its first use in clinical practice, late adverse consequences of the severe and sustained immunosuppression induced by CdA have not been reported but should still be closely monitored.
Collapse
Affiliation(s)
- A Delannoy
- Department of Hematology, Saint-Luc University Hospital, Brussels, Belgium
| |
Collapse
|
18
|
Hjertner O, Börset M, Waage A. Comparison of the effects of 2-chlorodeoxyadenosine and melphalan myeloma cell lines. Leuk Res 1996; 20:155-60. [PMID: 8628014 DOI: 10.1016/0145-2126(95)00128-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We have studied the effects of 2-chlorodeoxyadenosine (2-CdA) and melphalan on DNA synthesis and cell proliferation of five myeloma cell lines and one primary culture of highly purified myeloma cells. The DNA synthesis was estimated by thymidine incorporation and cell death was estimated by a coluorimetric assay sensitive to mitochondrial activity. The concentrations of 2-CdA giving 50% inhibition of DNA synthesis (ID50) in four cell lines were 8, 100, 500 and 2500 nM, whereas the corresponding concentrations of melphalan were 600, 600, 1000 and 7500 nM, respectively. In one cell line, the ID50 for melphalan was 400 nM, whereas 2-CdA apparently was without inhibitory effect and the ID50 was not reached. The ID50 for 2-CdA in the primary culture was 250 nM. When compared on a molar basis, 2-CdA had a more potent inhibitory effect than melphalan on four out of five myeloma cell lines. This is in contrast to clinical experiments which have shown lack of effect of 2-CdA in myeloma patients. Our study shows that 2-CdA has a marked heterogeneous effect on myeloma cell lines and opens up the possibility that a similar variation in sensitivity may also exist among myeloma cell clones in vivo.
Collapse
Affiliation(s)
- O Hjertner
- Institute of Cancer Research and Molecular Biology, University of Trondheim, Norway
| | | | | |
Collapse
|
19
|
Delannoy A, Ferrant A, Martiat P, Bosly A, Michaux JL. 2-Chlorodeoxyadenosine and multiple myeloma. Eur J Haematol 1994; 53:181-2. [PMID: 7925863 DOI: 10.1111/j.1600-0609.1994.tb00669.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
|
20
|
Larsson R, Fridborg H, Liliemark J, Csoka K, Kristensen J, de la Torre M, Nygren P. In vitro activity of 2-chlorodeoxyadenosine (CdA) in primary cultures of human haematological and solid tumours. Eur J Cancer 1994; 30A:1022-6. [PMID: 7946567 DOI: 10.1016/0959-8049(94)90136-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
2-Chlorodeoxyadenosine (CdA) is a deaminase-resistant purine analogue which has shown clinical activity against various haematological tumours, and is currently undergoing phase II trials. In the present study, the semiautomated fluorometric microculture cytotoxicity assay (FMCA) was used for in vitro evaluation of CdA activity in cell suspensions from both haematological and solid tumours. A total of 133 samples from various diagnoses were successfully tested with continuous drug exposure. CdA showed high in vitro activity against samples from chronic and acute lymphocytic leukaemia and acute myelocytic leukaemia, but little or no response was observed in the solid tumour groups. Cross-resistance analysis with standard drugs revealed the following rank order of correlation coefficients: cytosine arabinoside (AraC) > daunorubicin > doxorubicin > vincristine > prednisolone > 4-hydroperoxycyclophosphamide > etoposide > cisplatin. The high correlation between CdA and AraC was maintained even if the analysis was based only on the haematological tumours. The results indicate that CdA is differentially active against haematological tumours with little or no activity against solid tumours. CdA also appears highly cross resistant with AraC. If this disease-specific information is substantiated in further clinical trials and extended to other phase I-II drugs, non-clonogenic drug resistance assays such as the FMCA may become useful in new drug evaluation, and in targeting specific diagnoses and patients for phase II trials.
Collapse
Affiliation(s)
- R Larsson
- Division of Clinical Pharmacology, University Hospital, Uppsala, Sweden
| | | | | | | | | | | | | |
Collapse
|
21
|
Bryson HM, Sorkin EM. Cladribine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in haematological malignancies. Drugs 1993; 46:872-94. [PMID: 7507037 DOI: 10.2165/00003495-199346050-00007] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cladribine (2-chloro-2'-deoxyadenosine) is an adenosine deaminase-resistant analogue of deoxyadenosine. In the treatment of hairy cell leukaemia, cladribine has demonstrated excellent efficacy (complete response in 33 to 92% of patients) in noncomparative studies. Cladribine appears to compare favourably with other systemic agents in this indication as it achieves a high degree of efficacy after a single 7-day course, with an acceptable tolerability profile. However, long term data and direct comparative studies with interferon-alpha and pentostatin (deoxycoformycin) are required to confirm the finite advantages offered by cladribine. Preliminary results obtained in other indications including chronic lymphocytic leukaemia, non-Hodgkin's lymphoma, cutaneous T cell lymphoma, Waldenström's macroglobinaemia and acute myeloid leukaemia in children have been sufficiently encouraging to warrant further study. Early pharmacokinetic data suggest that cladribine may be administered by oral and subcutaneous routes, both of which permit convenient outpatient therapy. Myelosuppression, the dose-limiting toxicity of cladribine, and culture-negative fever are the most common adverse effects associated with therapy. However, cladribine appears to be only rarely associated with many of the other adverse effects that characterise antineoplastic therapy. In the weeks post-treatment, there is a small but definite risk of serious infection; infections with a fatal outcome have been reported in a number of studies with cladribine. In conclusion, preliminary data concerning cladribine have been extremely encouraging. Should early response rates in patients with hairy cell leukaemia be sustained, the efficacy of the drug, together with a short treatment regimen, a favourable tolerability profile, and the possibility of oral therapy, suggest that cladribine is likely to supersede other agents available for this indication.
Collapse
Affiliation(s)
- H M Bryson
- Adis International Limited, Auckland, New Zealand
| | | |
Collapse
|