1
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Hermange G, Vainchenker W, Plo I, Cournède PH. Mathematical modelling, selection and hierarchical inference to determine the minimal dose in IFNα therapy against myeloproliferative neoplasms. MATHEMATICAL MEDICINE AND BIOLOGY : A JOURNAL OF THE IMA 2024; 41:110-134. [PMID: 38875109 DOI: 10.1093/imammb/dqae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/30/2024] [Accepted: 05/02/2024] [Indexed: 06/16/2024]
Abstract
Myeloproliferative neoplasms (MPN) are blood cancers that appear after acquiring a driver mutation in a hematopoietic stem cell. These hematological malignancies result in the overproduction of mature blood cells and, if not treated, induce a risk of cardiovascular events and thrombosis. Pegylated IFN$\alpha $ is commonly used to treat MPN, but no clear guidelines exist concerning the dose prescribed to patients. We applied a model selection procedure and ran a hierarchical Bayesian inference method to decipher how dose variations impact the response to the therapy. We inferred that IFN$\alpha $ acts on mutated stem cells by inducing their differentiation into progenitor cells; the higher the dose, the higher the effect. We found that the treatment can induce long-term remission when a sufficient (patient-dependent) dose is reached. We determined this minimal dose for individuals in a cohort of patients and estimated the most suitable starting dose to give to a new patient to increase the chances of being cured.
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Affiliation(s)
- Gurvan Hermange
- Université Paris-Saclay, CentraleSupélec, Laboratory of Mathematics and Informatics (MICS), Gif-sur-Yvette, France
| | - William Vainchenker
- INSERM U1287 (INSERM, Gustave Roussy, Université Paris-Saclay), Villejuif, France
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Isabelle Plo
- INSERM U1287 (INSERM, Gustave Roussy, Université Paris-Saclay), Villejuif, France
- Gustave Roussy, Villejuif, France
- Université Paris-Saclay, Villejuif, France
| | - Paul-Henry Cournède
- Université Paris-Saclay, CentraleSupélec, Laboratory of Mathematics and Informatics (MICS), Gif-sur-Yvette, France
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2
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Lai X, Jiao X, Zhang H, Lei J. Computational modeling reveals key factors driving treatment-free remission in chronic myeloid leukemia patients. NPJ Syst Biol Appl 2024; 10:45. [PMID: 38678088 PMCID: PMC11055880 DOI: 10.1038/s41540-024-00370-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 04/16/2024] [Indexed: 04/29/2024] Open
Abstract
Patients with chronic myeloid leukemia (CML) who receive tyrosine kinase inhibitors (TKIs) have been known to achieve treatment-free remission (TFR) upon discontinuing treatment. However, the underlying mechanisms of this phenomenon remain incompletely understood. This study aims to elucidate the mechanism of TFR in CML patients, focusing on the feedback interaction between leukemia stem cells and the bone marrow microenvironment. We have developed a mathematical model to explore the interplay between leukemia stem cells and the bone marrow microenvironment, allowing for the simulation of CML progression dynamics. Our proposed model reveals a dichotomous response following TKI discontinuation, with two distinct patient groups emerging: one prone to early molecular relapse and the other capable of achieving long-term TFR after treatment cessation. This finding aligns with clinical observations and underscores the essential role of feedback interaction between leukemic cells and the tumor microenvironment in sustaining TFR. Notably, we have shown that the ratio of leukemia cells in peripheral blood (PBLC) and the tumor microenvironment (TME) index can be a valuable predictive tool for identifying patients likely to achieve TFR after discontinuing treatment. This study provides fresh insights into the mechanism of TFR in CML patients and underscores the significance of microenvironmental control in achieving TFR.
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Affiliation(s)
- Xiulan Lai
- Institute for Mathematical Sciences, Renmin University of China, Beijing, China
| | - Xiaopei Jiao
- Department of Mathematics, Tsinghua University, Beijing, China
| | - Haojian Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Medical Research Institute, School of Medicine, Wuhan University, Wuhan, China.
- Frontier Science Center for Immunology and Metabolism, Medical Research Institute, School of Medicine, Wuhan University, Wuhan, China.
| | - Jinzhi Lei
- School of Mathematical Sciences, Center for Applied Mathematics, Tiangong University, Tianjin, China.
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3
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Lindström HJG, de Wijn AS, Friedman R. Interplay of mutations, alternate mechanisms, and treatment breaks in leukaemia: Understanding and implications studied with stochastic models. Comput Biol Med 2024; 169:107826. [PMID: 38101118 DOI: 10.1016/j.compbiomed.2023.107826] [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] [Received: 08/30/2023] [Revised: 11/08/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
Bcr-Abl1 kinase domain mutations are the most prevalent cause of treatment resistance in chronic myeloid leukaemia (CML). Alternate resistance pathways nevertheless exist, and cell line experiments show certain patterns in the gain, and loss, of some of these alternate adaptations. These adaptations have clinical consequences when the tumour develops mechanisms that are beneficial to its growth under treatment, but slow down its growth when not treated. The results of temporarily halting treatment in CML have not been widely discussed in the clinic and there is no robust theoretical model that could suggest when such a pause in therapy can be tolerated. We constructed a dynamic model of how mechanisms such as Bcr-Abl1 overexpression and drug transporter upregulation evolve to produce resistance in cell lines, and investigate its behaviour subject to different treatment schedules, in particular when the treatment is paused ('drug holiday'). Our study results suggest that the presence of additional resistance mechanisms creates an environment which favours mutations that are either preexisting or occur late during treatment. Importantly, the results suggest the existence of tumour drug addiction, where cancer cells become dependent on the drug for (optimal) survival, which could be exploited through a treatment holiday. All simulation code is available at https://github.com/Sandalmoth/dual-adaptation.
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MESH Headings
- Humans
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Fusion Proteins, bcr-abl/therapeutic use
- Protein Kinase Inhibitors/pharmacology
- Drug Resistance, Neoplasm
- Mutation
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
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Affiliation(s)
- H Jonathan G Lindström
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, SE-39182, Sweden
| | - Astrid S de Wijn
- Department of Mechanical and Industrial Engineering, , Norwegian University of Science and Technology, Trondheim, 7491, Norway
| | - Ran Friedman
- Department of Chemistry and Biomedical Sciences, Linnaeus University, Kalmar, SE-39182, Sweden.
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4
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Marcé S, Méndez A, Xicoy B, Estrada N, Cabezón M, Sturla AL, García MR, Angona A, Amat P, Escribano Serrat S, Scalzulli E, Morgades M, Senín A, Hernández-Boluda JC, Ferrer-Marín F, Anguita E, Cortés M, Plensa E, Breccia M, García-Gutierrez V, Zamora L. e14a2 Transcript Favors Treatment-Free Remission in Chronic Myeloid Leukemia When Associated with Longer Treatment with Tyrosine Kinase Inhibitors and Sustained Deep Molecular Response. J Clin Med 2024; 13:779. [PMID: 38337473 PMCID: PMC10856594 DOI: 10.3390/jcm13030779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
e13a2 and e14a2 are the most frequent transcript types of the BCR::ABL1 fusion gene in chronic myeloid leukemia (CML). The current goal with tyrosine kinase inhibitors (TKI) is to achieve sustained deep molecular response (DMR) in order to discontinue TKI treatment and remain in the so-called treatment-free remission (TFR) phase, but biological factors associated with these goals are not well established. This study aimed to determine the effect of transcript type on TFR in patients receiving frontline treatment with imatinib (IM) or second-generation TKI (2G-TKI). Patients treated at least 119 months with IM presented less post-discontinuation relapse than those that discontinued IM before 119 months (p = 0.005). In addition, cases with the e14a2 transcript type treated at least 119 months with IM presented a better TFR (p = 0.024). On the other hand, the type of transcript did not affect the cytogenetic or molecular response in 2G-TKI treated patients; however, the use of 2G-TKI may be associated with higher and earlier DMR in patients with the e14a2 transcript.
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Affiliation(s)
- Sílvia Marcé
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Aleix Méndez
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Blanca Xicoy
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Natalia Estrada
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Marta Cabezón
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Antonella Luciana Sturla
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Miriam Ratia García
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Anna Angona
- Hematology Department, ICO Girona-Hospital Josep Trueta, 17007 Girona, Spain;
| | - Paula Amat
- Hematology Department, Hospital Clínico Universitario-INCLIVA de Valencia, 46010 Valencia, Spain; (P.A.); (J.C.H.-B.)
| | - Silvia Escribano Serrat
- Hematology Department, Hospital Clínico San Carlos, IML, IdISSC, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (S.E.S.); (E.A.)
| | - Emilia Scalzulli
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, 00189 Rome, Italy; (E.S.); (M.B.)
| | - Mireia Morgades
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Alicia Senín
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Juan Carlos Hernández-Boluda
- Hematology Department, Hospital Clínico Universitario-INCLIVA de Valencia, 46010 Valencia, Spain; (P.A.); (J.C.H.-B.)
| | - Francisca Ferrer-Marín
- Hematology Department, Hospital General Universitario Morales Meseguer-CIBERER, IMIB, UCAM, 30008 Múrcia, Spain;
| | - Eduardo Anguita
- Hematology Department, Hospital Clínico San Carlos, IML, IdISSC, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (S.E.S.); (E.A.)
| | - Montserrat Cortés
- Hematology Department, Hospital General de Granollers, 08402 Granollers, Spain;
| | - Esther Plensa
- Hematology Department, Consorci Sanitari del Maresme, Hospital de Mataró, 08301 Mataró, Spain;
| | - Massimo Breccia
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, 00189 Rome, Italy; (E.S.); (M.B.)
| | - Valentín García-Gutierrez
- Hematology Department, Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalalá Madrid, 28801 Madrid, Spain;
| | - Lurdes Zamora
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
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5
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Irani YD, Hughes A, Kok CH, Clarson J, Yeung DT, Ross DM, Branford S, Hughes TP, Yong ASM. Immune modulation in chronic myeloid leukaemia patients treated with nilotinib and interferon-alpha. Br J Haematol 2023; 202:1127-1136. [PMID: 37482935 DOI: 10.1111/bjh.18984] [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] [Received: 04/22/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023]
Abstract
The addition of interferon to tyrosine kinase inhibitors (TKIs), to improve deep molecular response (DMR) and potentially treatment-free remission (TFR) rates in chronic-phase chronic myeloid leukaemia (CP-CML) patients is under active investigation. However, the immunobiology of this combination is poorly understood. We performed a comprehensive longitudinal assessment of immunological changes in CML patients treated with nilotinib and interferon-alpha (IFN-α) within the ALLG CML11 trial (n = 12) or nilotinib alone (n = 17). We demonstrate that nilotinib+IFN transiently reduced absolute counts of natural killer (NK) cells, compared with nilotinib alone. Furthermore, CD16+ -cytolytic and CD57+ CD62L- -mature NK cells were transiently reduced during IFN therapy, without affecting NK-cell function. IFN transiently increased cytotoxic T-lymphocyte (CTL) responses to leukaemia-associated antigens (LAAs) proteinase-3, BMI-1 and PRAME; and had no effect on regulatory T cells, or myeloid-derived suppressor cells. Patients on nilotinib+IFN who achieved MR4.5 by 12 months had a significantly higher proportion of NK cells expressing NKp46, NKp30 and NKG2D compared with patients not achieving this milestone. This difference was not observed in the nilotinib-alone group. The addition of IFN to nilotinib drives an increase in NK-activating receptors, CTLs responding to LAAs and results in transient immune modulation, which may influence earlier DMR, and its effect on long-term outcomes warrants further investigation.
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Affiliation(s)
- Yazad D Irani
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
| | - Amy Hughes
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Chung H Kok
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
| | - Jade Clarson
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - David T Yeung
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- The Australasian Leukaemia and Lymphoma Group, Melbourne, Victoria, Australia
| | - David M Ross
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- The Australasian Leukaemia and Lymphoma Group, Melbourne, Victoria, Australia
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, South Australia, Australia
- Department of Haematology, Flinders University and Medical Centre, Adelaide, South Australia, Australia
| | - Susan Branford
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, South Australia, Australia
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Timothy P Hughes
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- The Australasian Leukaemia and Lymphoma Group, Melbourne, Victoria, Australia
| | - Agnes S M Yong
- Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
- The University of Adelaide, School of Medicine, Adelaide, South Australia, Australia
- The Australasian Leukaemia and Lymphoma Group, Melbourne, Victoria, Australia
- Department of Haematology, Royal Perth Hospital, Perth, Western Australia, Australia
- The University of Western Australia Medical School, Perth, Western Australia, Australia
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6
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Del Core L, Pellin D, Wit EC, Grzegorczyk MA. A mixed-effects stochastic model reveals clonal dominance in gene therapy safety studies. BMC Bioinformatics 2023; 24:228. [PMID: 37268887 DOI: 10.1186/s12859-023-05269-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/04/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Mathematical models of haematopoiesis can provide insights on abnormal cell expansions (clonal dominance), and in turn can guide safety monitoring in gene therapy clinical applications. Clonal tracking is a recent high-throughput technology that can be used to quantify cells arising from a single haematopoietic stem cell ancestor after a gene therapy treatment. Thus, clonal tracking data can be used to calibrate the stochastic differential equations describing clonal population dynamics and hierarchical relationships in vivo. RESULTS In this work we propose a random-effects stochastic framework that allows to investigate the presence of events of clonal dominance from high-dimensional clonal tracking data. Our framework is based on the combination between stochastic reaction networks and mixed-effects generalized linear models. Starting from the Kramers-Moyal approximated Master equation, the dynamics of cells duplication, death and differentiation at clonal level, can be described by a local linear approximation. The parameters of this formulation, which are inferred using a maximum likelihood approach, are assumed to be shared across the clones and are not sufficient to describe situation in which clones exhibit heterogeneity in their fitness that can lead to clonal dominance. In order to overcome this limitation, we extend the base model by introducing random-effects for the clonal parameters. This extended formulation is calibrated to the clonal data using a tailor-made expectation-maximization algorithm. We also provide the companion package RestoreNet, publicly available for download at https://cran.r-project.org/package=RestoreNet . CONCLUSIONS Simulation studies show that our proposed method outperforms the state-of-the-art. The application of our method in two in-vivo studies unveils the dynamics of clonal dominance. Our tool can provide statistical support to biologists in gene therapy safety analyses.
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Affiliation(s)
- Luca Del Core
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, The Netherlands.
- School of Mathematical Sciences, University of Nottingham, Nottingham, UK.
| | - Danilo Pellin
- Harvard Medical School, Harvard University, Boston, MA, USA.
| | - Ernst C Wit
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, The Netherlands.
- Institute of Computing, Università della Svizzera italiana, Lugano, Switzerland.
| | - Marco A Grzegorczyk
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, The Netherlands.
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7
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Rodriguez J, Iniguez A, Jena N, Tata P, Liu ZY, Lander AD, Lowengrub J, Van Etten RA. Predictive nonlinear modeling of malignant myelopoiesis and tyrosine kinase inhibitor therapy. eLife 2023; 12:e84149. [PMID: 37115622 PMCID: PMC10212564 DOI: 10.7554/elife.84149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/26/2023] [Indexed: 04/29/2023] Open
Abstract
Chronic myeloid leukemia (CML) is a blood cancer characterized by dysregulated production of maturing myeloid cells driven by the product of the Philadelphia chromosome, the BCR-ABL1 tyrosine kinase. Tyrosine kinase inhibitors (TKIs) have proved effective in treating CML, but there is still a cohort of patients who do not respond to TKI therapy even in the absence of mutations in the BCR-ABL1 kinase domain that mediate drug resistance. To discover novel strategies to improve TKI therapy in CML, we developed a nonlinear mathematical model of CML hematopoiesis that incorporates feedback control and lineage branching. Cell-cell interactions were constrained using an automated model selection method together with previous observations and new in vivo data from a chimeric BCR-ABL1 transgenic mouse model of CML. The resulting quantitative model captures the dynamics of normal and CML cells at various stages of the disease and exhibits variable responses to TKI treatment, consistent with those of CML patients. The model predicts that an increase in the proportion of CML stem cells in the bone marrow would decrease the tendency of the disease to respond to TKI therapy, in concordance with clinical data and confirmed experimentally in mice. The model further suggests that, under our assumed similarities between normal and leukemic cells, a key predictor of refractory response to TKI treatment is an increased maximum probability of self-renewal of normal hematopoietic stem cells. We use these insights to develop a clinical prognostic criterion to predict the efficacy of TKI treatment and design strategies to improve treatment response. The model predicts that stimulating the differentiation of leukemic stem cells while applying TKI therapy can significantly improve treatment outcomes.
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MESH Headings
- Mice
- Animals
- Tyrosine Kinase Inhibitors
- Protein Kinase Inhibitors/pharmacology
- Protein Kinase Inhibitors/therapeutic use
- Drug Resistance, Neoplasm
- Myelopoiesis
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/pharmacology
- Mice, Transgenic
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
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Affiliation(s)
- Jonathan Rodriguez
- Graduate Program in Mathematical, Computational and Systems Biology, University of California, IrvineIrvineUnited States
- Center for Complex Biological Systems, University of California, IrvineIrvineUnited States
| | - Abdon Iniguez
- Graduate Program in Mathematical, Computational and Systems Biology, University of California, IrvineIrvineUnited States
- Center for Complex Biological Systems, University of California, IrvineIrvineUnited States
| | - Nilamani Jena
- Department of Medicine, University of California, IrvineIrvineUnited States
| | - Prasanthi Tata
- Department of Medicine, University of California, IrvineIrvineUnited States
| | - Zhong-Ying Liu
- Department of Medicine, University of California, IrvineIrvineUnited States
| | - Arthur D Lander
- Center for Complex Biological Systems, University of California, IrvineIrvineUnited States
- Department of Developmental and Cell Biology, University of California, IrvineIrvineUnited States
- Chao Family Comprehensive Cancer Center, University of California, IrvineIrvineUnited States
- Department of Biomedical Engineering, University of California, IrvineIrvineUnited States
| | - John Lowengrub
- Center for Complex Biological Systems, University of California, IrvineIrvineUnited States
- Chao Family Comprehensive Cancer Center, University of California, IrvineIrvineUnited States
- Department of Biomedical Engineering, University of California, IrvineIrvineUnited States
- Department of Mathematics, University of California, IrvineIrvineUnited States
| | - Richard A Van Etten
- Center for Complex Biological Systems, University of California, IrvineIrvineUnited States
- Department of Medicine, University of California, IrvineIrvineUnited States
- Chao Family Comprehensive Cancer Center, University of California, IrvineIrvineUnited States
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8
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Pérez-Jiménez M, Derényi I, Szöllősi GJ. The structure of the hematopoietic system can explain chronic myeloid leukemia progression. Sci Rep 2023; 13:5411. [PMID: 37012292 PMCID: PMC10070397 DOI: 10.1038/s41598-023-32400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Almost all cancer types share the hallmarks of cancer and a similar tumor formation: fueled by stochastic mutations in somatic cells. In case of chronic myeloid leukemia (CML), this evolutionary process can be tracked from an asymptomatic long-lasting chronic phase to a final rapidly evolving blast phase. Somatic evolution in CML occurs in the context of healthy blood production, a hierarchical process of cell division; initiated by stem cells that self-renew and differentiate to produce mature blood cells. Here we introduce a general model of hierarchical cell division explaining the particular progression of CML as resulting from the structure of the hematopoietic system. Driver mutations confer a growth advantage to the cells carrying them, for instance, the BCR::ABL1 gene, which also acts as a marker for CML. We investigated the relation of the BCR::ABL1 mutation strength to the hematopoietic stem cell division rate by employing computer simulations and fitting the model parameters to the reported median duration for the chronic and accelerated phases. Our results demonstrate that driver mutations (additional to the BCR::ABL1 mutation) are necessary to explain CML progression if stem cells divide sufficiently slowly. We observed that the number of mutations accumulated by cells at the more differentiated levels of the hierarchy is not affected by driver mutations present in the stem cells. Our results shed light on somatic evolution in a hierarchical tissue and show that the clinical hallmarks of CML progression result from the structural characteristics of blood production.
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Affiliation(s)
- Mario Pérez-Jiménez
- Department of Biological Physics, Eötvös Loránd University, Budapest , Hungary.
| | - Imre Derényi
- Department of Biological Physics, Eötvös Loránd University, Budapest , Hungary
- Department of Biological Physics, ELTE-MTA 'Lendület' Biophysics Research Group, Budapest , Hungary
| | - Gergely J Szöllősi
- Department of Biological Physics, Eötvös Loránd University, Budapest , Hungary
- Department of Biological Physics, ELTE-MTA 'Lendület' Evolutionary Genomics Research Group, Budapest , Hungary
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9
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Understanding Hematopoietic Stem Cell Dynamics—Insights from Mathematical Modelling. CURRENT STEM CELL REPORTS 2023. [DOI: 10.1007/s40778-023-00224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Abstract
Purpose of review
Hematopoietic stem cells (HSCs) drive blood-cell production (hematopoiesis). Out-competition of HSCs by malignant cells occurs in many hematologic malignancies like acute myeloid leukemia (AML). Through mathematical modelling, HSC dynamics and their impact on healthy blood cell formation can be studied, using mathematical analysis and computer simulations. We review important work within this field and discuss mathematical modelling as a tool for attaining biological insight.
Recent findings
Various mechanism-based models of HSC dynamics have been proposed in recent years. Key properties of such models agree with observations and medical knowledge and suggest relations between stem cell properties, e.g., rates of division and the temporal evolution of the HSC population. This has made it possible to study how HSC properties shape clinically relevant processes, including engraftment following an HSC transplantation and the response to different treatment.
Summary
Understanding how properties of HSCs affect hematopoiesis is important for efficient treatment of diseases. Mathematical modelling can contribute significantly to these efforts.
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10
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Karg E, Baldow C, Zerjatke T, Clark RE, Roeder I, Fassoni AC, Glauche I. Modelling of immune response in chronic myeloid leukemia patients suggests potential for treatment reduction prior to cessation. Front Oncol 2022; 12:1028871. [PMID: 36568156 PMCID: PMC9769401 DOI: 10.3389/fonc.2022.1028871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Discontinuation of tyrosine kinase inhibitor (TKI) treatment is emerging as the main therapy goal for Chronic Myeloid Leukemia (CML) patients. The DESTINY trial showed that TKI dose reduction prior to cessation can lead to an increased number of patients achieving sustained treatment free remission (TFR). However, there has been no systematic investigation to evaluate how dose reduction regimens can further improve the success of TKI stop trials. Methods Here, we apply an established mathematical model of CML therapy to investigate different TKI dose reduction schemes prior to therapy cessation and evaluate them with respect to the total amount of drug used and the expected TFR success. Results Our systematic analysis confirms clinical findings that the overall time of TKI treatment is a major determinant of TFR success, while highlighting that lower dose TKI treatment for the same duration is equally sufficient for many patients. Our results further suggest that a stepwise dose reduction prior to TKI cessation can increase the success rate of TFR, while substantially reducing the amount of administered TKI. Discussion Our findings illustrate the potential of dose reduction schemes prior to treatment cessation and suggest corresponding and clinically testable strategies that are applicable to many CML patients.
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Affiliation(s)
- Elena Karg
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christoph Baldow
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Thomas Zerjatke
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Richard E. Clark
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Ingo Roeder
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany,National Center for Tumor Diseases (NCT), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden–Rossendorf (HZDR), Dresden, Germany
| | - Artur C. Fassoni
- Instituto de Matemática e Computação, Universidade Federal de Itajubá (UNIFEI), Itajubá, Brazil
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany,*Correspondence: Ingmar Glauche,
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11
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Feliciangeli F, Dreiwi H, López-García M, Castro Ponce M, Molina-París C, Lythe G. Why are cell populations maintained via multiple compartments? J R Soc Interface 2022; 19:20220629. [PMID: 36349449 PMCID: PMC9653237 DOI: 10.1098/rsif.2022.0629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/12/2022] [Indexed: 10/02/2023] Open
Abstract
We consider the maintenance of 'product' cell populations from 'progenitor' cells via a sequence of one or more cell types, or compartments, where each cell's fate is chosen stochastically. If there is only one compartment then large amplification, that is, a large ratio of product cells to progenitors comes with disadvantages. The product cell population is dominated by large families (cells descended from the same progenitor) and many generations separate, on average, product cells from progenitors. These disadvantages are avoided using suitably constructed sequences of compartments: the amplification factor of a sequence is the product of the amplification factors of each compartment, while the average number of generations is a sum over contributions from each compartment. Passing through multiple compartments is, in fact, an efficient way to maintain a product cell population from a small flux of progenitors, avoiding excessive clonality and minimizing the number of rounds of division en route. We use division, exit and death rates, estimated from measurements of single-positive thymocytes, to choose illustrative parameter values in the single-compartment case. We also consider a five-compartment model of thymocyte differentiation, from double-negative precursors to single-positive product cells.
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Affiliation(s)
- Flavia Feliciangeli
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
- Systems Pharmacology and Medicine, Bayer AG, Leverkusen 51368, Germany
| | - Hanan Dreiwi
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
| | | | - Mario Castro Ponce
- Instituto de Investigación Tecnológica (ITT), Universidad Pontificia Comillas, Madrid, Spain
| | - Carmen Molina-París
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
- T-6, Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM 87545, USA
| | - Grant Lythe
- School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
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12
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Okamoto Y, Hirano M, Morino K, Kajita MK, Nakaoka S, Tsuda M, Sugimoto KJ, Tamaki S, Hisatake J, Yokoyama H, Igarashi T, Shinagawa A, Sugawara T, Hara S, Fujikawa K, Shimizu S, Yujiri T, Wakita H, Nishiwaki K, Tojo A, Aihara K. Early dynamics of chronic myeloid leukemia on nilotinib predicts deep molecular response. NPJ Syst Biol Appl 2022; 8:39. [PMID: 36229495 PMCID: PMC9561725 DOI: 10.1038/s41540-022-00248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder caused by the BCR-ABL1 tyrosine kinase. Although ABL1-specific tyrosine kinase inhibitors (TKIs) including nilotinib have dramatically improved the prognosis of patients with CML, the TKI efficacy depends on the individual patient. In this work, we found that the patients with different nilotinib responses can be classified by using the estimated parameters of our simple dynamical model with two common laboratory findings. Furthermore, our proposed method identified patients who failed to achieve a treatment goal with high fidelity according to the data collected only at three initial time points during nilotinib therapy. Since our model relies on the general properties of TKI response, our framework would be applicable to CML patients who receive frontline nilotinib or other TKIs.
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Affiliation(s)
- Yuji Okamoto
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan.,Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan.,Department of Biomedical Data Intelligence, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Mitsuhito Hirano
- Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan
| | - Kai Morino
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan.,Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Fukuoka, 816-8580, Japan
| | - Masashi K Kajita
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan. .,Department of Applied Chemistry and Biotechnology, Faculty of Engineering, University of Fukui, Fukui, 910-8507, Japan. .,Life Science Innovation Center, University of Fukui, Fukui, 910-8507, Japan.
| | - Shinji Nakaoka
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan.,Faculty of Advanced Life Science, Hokkaido University, Hokkaido, 060-0810, Japan.,PRESTO, Japan Science and Technology Agency, Tokyo, 102-0076, Japan
| | - Mayuko Tsuda
- Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan
| | - Kei-Ji Sugimoto
- Division of Hematology, Juntendo University Urayasu Hospital, Chiba, 279-0021, Japan
| | - Shigehisa Tamaki
- Department of Hematology, Japanese Red Cross Ise Hospital, Mie, 516-8512, Japan
| | - Junichi Hisatake
- Department of Hematology, Japanese Red Cross Omori Hospital, Tokyo, 143-8527, Japan
| | - Hisayuki Yokoyama
- Department of Hematology, National Hospital Organization, Sendai Medical Center, Miyagi, 983-8520, Japan
| | - Tadahiko Igarashi
- Divison of Hematology and Oncology, Gunma Cancer Center, Gunma, 373-8550, Japan
| | - Atsushi Shinagawa
- Department of Internal Medicine, Hitachi General Hospital, Ibaraki, 317-0077, Japan
| | - Takeaki Sugawara
- Division of Hematology-Oncology, Chiba Cancer Center, Chiba, 260-8717, Japan
| | - Satoru Hara
- Department of Hematology, Chiba Rosai Hospital, Chiba, 290-0003, Japan
| | - Kazuhisa Fujikawa
- Department of Hematology, Chibaken Saiseikai Narashino Hospital, Chiba, 275-8580, Japan
| | - Seiichi Shimizu
- Department of Hematology, Tsuchiura Kyodo General Hospital, Ibaraki, 300-0028, Japan
| | - Toshiaki Yujiri
- Third Department of Internal Medicine, Yamaguchi University, Yamaguchi, 755-0046, Japan
| | - Hisashi Wakita
- Division of Hematology and Oncology, Japanese Red Cross Narita Hospital, Chiba, 286-8523, Japan
| | - Kaichi Nishiwaki
- Division of Oncology and Hematology, Jikei University Kashiwa Hospital, Chiba, 277-8567, Japan
| | - Arinobu Tojo
- Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan.,Institute of Innovation Advancement, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
| | - Kazuyuki Aihara
- Institute of Industrial Science, The University of Tokyo, Tokyo, 153-8505, Japan. .,International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo, Tokyo, 113-0033, Japan.
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13
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Kim E, Hwang EJ, Lee J, Kim DY, Kim JY, Kim DW. Patient-specific molecular response dynamics can predict the possibility of relapse during the second treatment-free remission attempt in chronic myelogenous leukemia. Neoplasia 2022; 32:100817. [PMID: 35878453 PMCID: PMC9309666 DOI: 10.1016/j.neo.2022.100817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/26/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
In chronic myelogenous leukemia (CML), treatment-free remission (TFR) is defined as maintaining a major molecular response (MMR) without a tyrosine kinase inhibitor (TKI), such as imatinib (IM). Several studies have investigated the safety of the first TFR (TFR1) attempt and suggested recommendation guidelines for such an attempt. However, the plausibility and predictive factors for a second TFR (TFR2) have yet to be reported. The present study included 21 patients in chronic myeloid leukemia who participated in twice repeated treatment stop attempts. We develop a mathematical model to analyze and explain the outcomes of TFR2. Our mathematical model framework can explain patient-specific molecular response dynamics. Fitting the model to longitudinal BCR-ABL1 transcripts from the patients generated patient-specific parameters. Binary tree decision analyses of the model parameters suggested a model based predictive binary classification factor that separated patients into low- and high-risk groups of TFR2 attempts with an overall accuracy of 76.2% (sensitivity of 81.1% and specificity of 69.9%). The low-risk group maintained a median TFR2 of 28.2 months, while the high-risk group relapsed at a median time of 3.25 months. Further, our model predicted a patient-specific optimal IM treatment duration before the second IM stop that could achieve the desired TFR2 (e.g., 5 years).
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Affiliation(s)
- Eunjung Kim
- Natural Product Informatics Research Center, Korea Institute of Science and Technology, Gangneung, South Korea.
| | - Eo-Jin Hwang
- Leukemia Omics Research Institute, Eulji University Uijeongbu Campus, Uijeongbu, South Korea
| | - Junghye Lee
- Department of Industrial Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Dae-Young Kim
- Department of Hematology, Hematology center, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, South Korea
| | - Jae-Young Kim
- Graduate School of Analytical Science and Technology (GRAST), Chungnam National University, Daejeon, South Korea.
| | - Dong-Wook Kim
- Department of Hematology, Hematology center, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, South Korea; Leukemia Omics Research Institute, Eulji University Uijeongbu Campus, Uijeongbu, South Korea.
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14
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Combes FP, Li YF, Hoch M, Lorenzo S, Ho YY, Sy SKB. Exposure-Efficacy Analysis of Asciminib in Philadelphia Chromosome-Positive Chronic Myeloid Leukemia in Chronic Phase. Clin Pharmacol Ther 2022; 112:1040-1050. [PMID: 35776072 DOI: 10.1002/cpt.2699] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/14/2022] [Indexed: 11/07/2022]
Abstract
Asciminib is a first-in-class BCR::ABL1 inhibitor that works by specifically targeting the ABL myristoyl pocket (STAMP) and has potent activity against the T315I mutation. This study aimed to characterize the effect of asciminib exposure on disease progression and to elucidate factors influencing efficacy. Our analysis included 303 patients with chronic myeloid leukemia in chronic phase (CML-CP) recruited in a Phase 1 study with dose ranging from 10 to 200 mg twice a day (bid) or 40 to 200 mg once a day (qd) (NCT02081378) and in the Phase 3 ASCEMBL study receiving asciminib 40 mg bid (NCT03106779). A total of 67 patients harbored the T315I mutation. A longitudinal PK/PD model was developed to characterize the exposure-efficacy relationship, in which the efficacy was assessed through BCR::ABL1 transcript levels over time. Specifically, a three-compartment model representing quiescent leukemic stem cells, proliferating bone marrow cells, and resistant cells was developed. Drug killing of the proliferating cells by asciminib was characterized by a power model. A subgroup analysis was performed on the patients with T315I mutation using Emax model to characterize the drug effect. The model demonstrated the appropriateness of a total daily dose of asciminib 80 mg in patients without the T315I mutation and 200 mg bid in patients with the T315I mutation with further validation in light of safety data. This model captured key characteristics of patients' response to asciminib and helped inform dosing rationale for resistant and difficult-to-treat populations.
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Affiliation(s)
| | - Ying Fei Li
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Matthias Hoch
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Yu-Yun Ho
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Sherwin K B Sy
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
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15
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Pedersen RK, Andersen M, Knudsen TA, Skov V, Kjær L, Hasselbalch HC, Ottesen JT. Dose‐dependent mathematical modeling of interferon‐α‐treatment for personalized treatment of myeloproliferative neoplasms. COMPUTATIONAL AND SYSTEMS ONCOLOGY 2021. [DOI: 10.1002/cso2.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Rasmus K. Pedersen
- Centre for Mathematical Modeling ‐ Human Health and Disease (COMMAND) IMFUFA Department of Science and Environment Roskilde University Roskilde Denmark
| | - Morten Andersen
- Centre for Mathematical Modeling ‐ Human Health and Disease (COMMAND) IMFUFA Department of Science and Environment Roskilde University Roskilde Denmark
| | - Trine A. Knudsen
- Department of Hematology Zealand University Hospital Roskilde Denmark
| | - Vibe Skov
- Department of Hematology Zealand University Hospital Roskilde Denmark
| | - Lasse Kjær
- Department of Hematology Zealand University Hospital Roskilde Denmark
| | | | - Johnny T. Ottesen
- Centre for Mathematical Modeling ‐ Human Health and Disease (COMMAND) IMFUFA Department of Science and Environment Roskilde University Roskilde Denmark
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16
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Kiwumulo HF, Muwonge H, Ibingira C, Kirabira JB, Ssekitoleko RT. A systematic review of modeling and simulation approaches in designing targeted treatment technologies for Leukemia Cancer in low and middle income countries. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2021; 18:8149-8173. [PMID: 34814293 DOI: 10.3934/mbe.2021404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Virtual experimentation is a widely used approach for predicting systems behaviour especially in situations where resources for physical experiments are very limited. For example, targeted treatment inside the human body is particularly challenging, and as such, modeling and simulation is utilised to aid planning before a specific treatment is administered. In such approaches, precise treatment, as it is the case in radiotherapy, is used to administer a maximum dose to the infected regions while minimizing the effect on normal tissue. Complicated cancers such as leukemia present even greater challenges due to their presentation in liquid form and not being localised in one area. As such, science has led to the development of targeted drug delivery, where the infected cells can be specifically targeted anywhere in the body. Despite the great prospects and advances of these modeling and simulation tools in the design and delivery of targeted drugs, their use by Low and Middle Income Countries (LMICs) researchers and clinicians is still very limited. This paper therefore reviews the modeling and simulation approaches for leukemia treatment using nanoparticles as an example for virtual experimentation. A systematic review from various databases was carried out for studies that involved cancer treatment approaches through modeling and simulation with emphasis to data collected from LMICs. Results indicated that whereas there is an increasing trend in the use of modeling and simulation approaches, their uptake in LMICs is still limited. According to the review data collected, there is a clear need to employ these tools as key approaches for the planning of targeted drug treatment approaches.
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Affiliation(s)
| | - Haruna Muwonge
- Department of Medical Physiology, Makerere University, Kampala, Uganda
| | - Charles Ibingira
- Department of Human Anatomy, Makerere University, Kampala, Uganda
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17
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Saifullah HH, Lucas CM. Treatment-Free Remission in Chronic Myeloid Leukemia: Can We Identify Prognostic Factors? Cancers (Basel) 2021; 13:cancers13164175. [PMID: 34439327 PMCID: PMC8392063 DOI: 10.3390/cancers13164175] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Chronic myeloid leukemia (CML) is a blood cancer. Unlike other cancers CML treatment is lifelong and many patients experience side effects. For those patients who respond well to treatment and achieve deep molecular remission, quality of life is impacted because of continuous treatment. In this review, we look at emerging clinical trials which aim to investigate which patients can safely stop treatment. Treatment-free remission is the ultimate goal for CML patients, but there is still a gap in our knowledge as to why some patients can achieve treatment-free remission, while others relapse when treatment is stopped. Here we discuss if there are any prognostic factors that can predict the best candidates who qualify for treatment discontinuation, with a view to keeping them in remission. Abstract Following the development of tyrosine kinase inhibitors (TKI), the survival of patients with chronic myeloid leukaemia (CML) drastically improved. With the introduction of these agents, CML is now considered a chronic disease for some patients. Taking into consideration the side effects, toxicity, and high cost, discontinuing TKI became a goal for patients with chronic phase CML. Patients who achieved deep molecular response (DMR) and discontinued TKI, remained in treatment-free remission (TFR). Currently, the data from the published literature demonstrate that 40–60% of patients achieve TFR, with relapses occurring within the first six months. In addition, almost all patients who relapsed regained a molecular response upon retreatment, indicating TKI discontinuation is safe. However, there is still a gap in understanding the mechanisms behind TFR, and whether there are prognostic factors that can predict the best candidates who qualify for TKI discontinuation with a view to keeping them in TFR. Furthermore, the information about a second TFR attempt and the role of gradual de-escalation of TKI before complete cessation is limited. This review highlights the factors predicting success or failure of TFR. In addition, it examines the feasibility of a second TFR attempt after the failure of the first one, and the current guidelines concerning TFR in clinical practice.
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Affiliation(s)
- Hilbeen Hisham Saifullah
- Chester Medical School, University of Chester, Bache Hall, Chester CH2 1BR, UK
- Correspondence: (H.H.S.); (C.M.L.)
| | - Claire Marie Lucas
- Chester Medical School, University of Chester, Bache Hall, Chester CH2 1BR, UK
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool L69 3GA, UK
- Correspondence: (H.H.S.); (C.M.L.)
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18
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Cancer cells population control in a delayed-model of a leukemic patient using the combination of the eligibility traces algorithm and neural networks. INT J MACH LEARN CYB 2021. [DOI: 10.1007/s13042-021-01287-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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BUNIMOVICH-MENDRAZITSKY SVETLANA, SHAIKHET LEONID. STABILITY ANALYSIS OF A MATHEMATICAL MODEL FOR CHRONIC MYELOID LEUKEMIA ERADICATION. J BIOL SYST 2021. [DOI: 10.1142/s0218339021500078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We analyze a mathematical model for the treatment of chronic myeloid leukemia (CML). The model is designed for complete recovery of CML patients after treatment. The model developed in the paper [Bunimovich-Mendrazitsky S, Kronik N, Vainstein V, Optimization of interferon-alpha and imatinib combination therapy for CML: A modeling approach, Adv Theory Simul 2(1):1800081, 2018] introduced a combined treatment of CML based on imatinib therapy and immunotherapy. Immunotherapy based on Interferon alpha-2a (IFN-[Formula: see text]) affects stem and mature cancer cell mortality, and leads to outcome improvements in the combined therapy. The qualitative character of our results shows that additional therapy for the complete cure of CML patients is required. This additional treatment is tumor infiltrating lymphocytes (TIL) along with a combination imatinib and IFN-[Formula: see text] treatment. The model examines the interaction between CML cancer cells and effector cells, using an ODE system. Stability analysis of the model defines conditions when imatinib treatment might lead to the eradication of CML with IFN-[Formula: see text] and TIL. Three equilibria are investigated for the proposed model. Stability conditions for equilibria are formulated in terms of the linear matrix inequalities (LMIs).
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Affiliation(s)
| | - LEONID SHAIKHET
- Department of Mathematics, Ariel University, Ariel 40700, Israel
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20
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Scott JG, Maini PK, Anderson ARA, Fletcher AG. Inferring Tumor Proliferative Organization from Phylogenetic Tree Measures in a Computational Model. Syst Biol 2021; 69:623-637. [PMID: 31665523 DOI: 10.1093/sysbio/syz070] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 09/23/2019] [Accepted: 10/02/2019] [Indexed: 01/15/2023] Open
Abstract
We use a computational modeling approach to explore whether it is possible to infer a solid tumor's cellular proliferative hierarchy under the assumptions of the cancer stem cell hypothesis and neutral evolution. We work towards inferring the symmetric division probability for cancer stem cells, since this is believed to be a key driver of progression and therapeutic response. Motivated by the advent of multiregion sampling and resulting opportunities to infer tumor evolutionary history, we focus on a suite of statistical measures of the phylogenetic trees resulting from the tumor's evolution in different regions of parameter space and through time. We find strikingly different patterns in these measures for changing symmetric division probability which hinge on the inclusion of spatial constraints. These results give us a starting point to begin stratifying tumors by this biological parameter and also generate a number of actionable clinical and biological hypotheses regarding changes during therapy, and through tumor evolutionary time. [Cancer; evolution; phylogenetics.].
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Affiliation(s)
- Jacob G Scott
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Oxford, UK.,Departments of Translational Hematology and Oncology Research and Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Philip K Maini
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Oxford, UK
| | - Alexander R A Anderson
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Alexander G Fletcher
- School of Mathematics and Statistics, University of Sheffield, Sheffield, UK.,Bateson Centre, University of Sheffield, Sheffield, UK
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21
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Ottesen JT, Stiehl T, Andersen M. Blood Cancer and Immune Surveillance. SYSTEMS MEDICINE 2021. [DOI: 10.1016/b978-0-12-801238-3.11510-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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22
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Sasi S, Mohamed M, P C, Yassin MA. Myasthenia Gravis and Myeloproliferative Neoplasms - Mere Association or Paraneoplastic Neurologic Syndrome: A Mini-Review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021437. [PMID: 35075066 PMCID: PMC8823564 DOI: 10.23750/abm.v92i6.12180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 01/17/2023]
Abstract
Myasthenia Gravis (MG) is a rare neurological condition characterized by muscle weakness that worsens after use. Myeloproliferative Neoplasms (MPNs) are disorders due to stem-cell hyperplasia characterized by an increased peripheral blood cell count, overactive bone marrow, and proliferation of mature hematopoietic cells. MPNs may be Philadelphia (Ph) chromosome-positive or Negative .A systematic review of case reports was conducted by searching PubMed, Scopus, and Google scholar to identify case reports in which there is an association between MG and MPN and know whether MG can be considered a possible neurological paraneoplastic syndrome in patients with MPNs. A total of 13 cases of MPNs associated with MG were identified. The most common type of MPN associated with MG was chronic myeloid leukemia (CML) (10 out of 13 patients). In most of the patients, MG symptoms appeared after a diagnosis of MPN was made. Considering that 10 out of the 13 patients in our cohort had positive auto-antibodies though only 4 of them had thymic hyperplasia, we hypothesize that bone marrow proliferation was responsible for the production of autoantibodies in these patients.As the clonal cell population cannot be eliminated entirely in the bone marrow even after treatment with tyrosine kinase inhibitors (TKI) in Ph +ve MPNs and JAK2 inhibitors in Ph -ve MPNS, MG can occur even in patients who are treated with these agents. A high index of suspicion is needed to diagnose it early, and treatment should be initiated immediately with steroids and anticholinergic agents.
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Affiliation(s)
- Sreethish Sasi
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mouhand Mohamed
- Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Chitrambika P
- Department of Anaesthesiology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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23
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Roeder I, Glauche I. Overlooking the obvious? On the potential of treatment alterations to predict patient-specific therapy response. Exp Hematol 2020; 94:26-30. [PMID: 33246016 DOI: 10.1016/j.exphem.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/08/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022]
Abstract
Prognostic or therapeutic classification of diseases is often based on clinical or genetic characteristics at diagnosis or response landmarks determined at a certain time point of treatment. On the other hand, there are more and more means, such as molecular markers and sensor data, that allow for quantification of disease or therapeutic parameters over time. Although a general value of time-resolved disease monitoring is widely accepted, the full potential of using the available information on disease and treatment dynamics in the context of outcome prediction or individualized treatment optimization still seems to be, at least partially, overlooked. Within this Perspective, we summarize the conceptual idea of using dynamic information to obtain a better understanding of complex pathophysiological processes within their particular "host environment," which also allows us to intrinsically map patient-specific heterogeneity. Specifically, we discuss to which extent treatment alterations can provide additional information to understand a patient's individual condition and use this information to further adapt the therapeutic strategy. This conceptual discussion is illustrated by using examples from myeloid leukemias to which we recently applied this concept using statistical and mathematical modeling.
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Affiliation(s)
- Ingo Roeder
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Institute for Medical Informatics and Biometry, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Core Unit: Data Management and Analytics, Dresden, Germany.
| | - Ingmar Glauche
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Institute for Medical Informatics and Biometry, Dresden, Germany
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24
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Hoffmann H, Thiede C, Glauche I, Bornhaeuser M, Roeder I. Differential response to cytotoxic therapy explains treatment dynamics of acute myeloid leukaemia patients: insights from a mathematical modelling approach. J R Soc Interface 2020; 17:20200091. [PMID: 32900301 DOI: 10.1098/rsif.2020.0091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Disease response and durability of remission are very heterogeneous in patients with acute myeloid leukaemia (AML). There is increasing evidence that the individual risk of early relapse can be predicted based on the initial treatment response. However, it is unclear how such a correlation is linked to functional aspects of AML progression and treatment. We suggest a mathematical model in which leukaemia-initiating cells and normal/healthy haematopoietic stem and progenitor cells reversibly change between an active state characterized by proliferation and chemosensitivity and a quiescent state, in which the cells do not divide, but are also insensitive to chemotherapy. Applying this model to 275 molecular time courses of nucleophosmin 1-mutated patients, we conclude that the differential chemosensitivity of the leukaemia-initiating cells together with the cells' intrinsic proliferative capacity is sufficient to reproduce both, early relapse as well as long-lasting remission. We can, furthermore, show that the model parameters associated with individual chemosensitivity and proliferative advantage of the leukaemic cells are closely linked to the patients' time to relapse, while a reliable prediction based on early response only is not possible based on the currently available data. Although we demonstrate with our approach, that the complete response data is sufficient to quantify the aggressiveness of the disease, further investigations are necessary to study how an intensive early sampling strategy may prospectively improve risk assessment and help to optimize individual treatments.
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Affiliation(s)
- H Hoffmann
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - C Thiede
- Medical Clinic and Polyclinic I, University Hospital Dresden Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - I Glauche
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - M Bornhaeuser
- Medical Clinic and Polyclinic I, University Hospital Dresden Carl Gustav Carus, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - I Roeder
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
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25
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Machova Polakova K, Zizkova H, Zuna J, Motlova E, Hovorkova L, Gottschalk A, Glauche I, Koblihova J, Pecherkova P, Klamova H, Stastna Markova M, Srbova D, Benesova A, Polivkova V, Jurcek T, Zackova D, Mayer J, Ernst T, Mahon FX, Saussele S, Roeder I, Cross NCP, Hochhaus A. Analysis of chronic myeloid leukaemia during deep molecular response by genomic PCR: a traffic light stratification model with impact on treatment-free remission. Leukemia 2020; 34:2113-2124. [PMID: 32472084 DOI: 10.1038/s41375-020-0882-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
This work investigated patient-specific genomic BCR-ABL1 fusions as markers of measurable residual disease (MRD) in chronic myeloid leukaemia, with a focus on relevance to treatment-free remission (TFR) after achievement of deep molecular response (DMR) on tyrosine kinase inhibitor (TKI) therapy. DNA and mRNA BCR-ABL1 measurements by qPCR were compared in 2189 samples (129 patients) and by digital PCR in 1279 sample (62 patients). A high correlation was found at levels of disease above MR4, but there was a poor correlation for samples during DMR. A combination of DNA and RNA MRD measurements resulted in a better prediction of molecular relapse-free survival (MRFS) after TKI stop (n = 17) or scheduled interruption (n = 25). At 18 months after treatment cessation, patients with stopped or interrupted TKI therapy who were DNA negative/RNA negative during DMR maintenance (green group) had an MRFS of 80% and 100%, respectively, compared with those who were DNA positive/RNA negative (MRFS = 57% and 67%, respectively; yellow group) or DNA positive/RNA positive (MRFS = 20% for both cohorts; red group). Thus, we propose a "traffic light" stratification as a TFR predictor based on DNA and mRNA BCR-ABL1 measurements during DMR maintenance before TKI cessation.
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MESH Headings
- Adult
- Aged
- Female
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Male
- Middle Aged
- Neoplasm, Residual
- Polymerase Chain Reaction/methods
- Protein Kinase Inhibitors/therapeutic use
- Protein-Tyrosine Kinases/antagonists & inhibitors
- RNA, Messenger/analysis
- Remission Induction
- Withholding Treatment
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Affiliation(s)
- Katerina Machova Polakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Hana Zizkova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Jan Zuna
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Eliska Motlova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Lenka Hovorkova
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Andrea Gottschalk
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jitka Koblihova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Pavla Pecherkova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Hana Klamova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Stastna Markova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dana Srbova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Adela Benesova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Vaclava Polivkova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Tomas Jurcek
- Center of Molecular Biology and Gene Therapy, Internal Hematology and Oncology Clinic, Faculty Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Daniela Zackova
- Internal Hematology and Oncology Clinic, Faculty Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Mayer
- Internal Hematology and Oncology Clinic, Faculty Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Thomas Ernst
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, University of Jena, Jena, Germany
| | - Francois X Mahon
- BERGONIE Institute BORDEAUX, INSERM U1218 University of Bordeaux, Bordeaux, France
| | - Susanne Saussele
- Department of Haematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Ingo Roeder
- Institute for Medical Informatics and Biometry (IMB), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - Nicholas C P Cross
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury and Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, University of Jena, Jena, Germany
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26
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Andersen M, Hasselbalch HC, Kjær L, Skov V, Ottesen JT. Global dynamics of healthy and cancer cells competing in the hematopoietic system. Math Biosci 2020; 326:108372. [PMID: 32442449 DOI: 10.1016/j.mbs.2020.108372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 01/08/2023]
Abstract
Stem cells in the bone marrow differentiate to ultimately become mature, functioning blood cells through a tightly regulated process (hematopoiesis) including a stem cell niche interaction and feedback through the immune system. Mutations in a hematopoietic stem cell can create a cancer stem cell leading to a less controlled production of malfunctioning cells in the hematopoietic system. This was mathematically modelled by Andersen et al. (2017) including the dynamic variables: healthy and cancer stem cells and mature cells, dead cells and an immune system response. Here, we apply a quasi steady state approximation to this model to construct a two dimensional model with four algebraic equations denoted the simple cancitis model. The two dynamic variables are the clinically available quantities JAK2V617F allele burden and the number of white blood cells. The simple cancitis model represents the original model very well. Complete phase space analysis of the simple cancitis model is performed, including proving the existence and location of globally attracting steady states. Hence, parameter values from compartments of stem cells, mature cells and immune cells are directly linked to disease and treatment prognosis, showing the crucial importance of early intervention. The simple cancitis model allows for a complete analysis of the long term evolution of trajectories. In particular, the value of the self renewal of the hematopoietic stem cells divided by the self renewal of the cancer stem cells is found to be an important diagnostic marker and perturbing this parameter value at intervention allows the model to reproduce clinical data. Treatment at low cancer cell numbers allows returning to healthy blood production while the same intervention at a later disease stage can lead to eradication of healthy blood producing cells. Assuming the total number of white blood cells is constant in the early cancer phase while the allele burden increases, a one dimensional model is suggested and explicitly solved, including parameters from all original compartments. The solution explicitly shows that exogenous inflammation promotes blood cancer when cancer stem cells reproduce more efficiently than hematopoietic stem cells.
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Affiliation(s)
- Morten Andersen
- IMFUFA, Department of Science and Environment, Roskilde University, Denmark.
| | - Hans C Hasselbalch
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | - Lasse Kjær
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | - Vibe Skov
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | - Johnny T Ottesen
- IMFUFA, Department of Science and Environment, Roskilde University, Denmark
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27
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Vetrie D, Helgason GV, Copland M. The leukaemia stem cell: similarities, differences and clinical prospects in CML and AML. Nat Rev Cancer 2020; 20:158-173. [PMID: 31907378 DOI: 10.1038/s41568-019-0230-9] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 01/21/2023]
Abstract
For two decades, leukaemia stem cells (LSCs) in chronic myeloid leukaemia (CML) and acute myeloid leukaemia (AML) have been advanced paradigms for the cancer stem cell field. In CML, the acquisition of the fusion tyrosine kinase BCR-ABL1 in a haematopoietic stem cell drives its transformation to become a LSC. In AML, LSCs can arise from multiple cell types through the activity of a number of oncogenic drivers and pre-leukaemic events, adding further layers of context and genetic and cellular heterogeneity to AML LSCs not observed in most cases of CML. Furthermore, LSCs from both AML and CML can be refractory to standard-of-care therapies and persist in patients, diversify clonally and serve as reservoirs to drive relapse, recurrence or progression to more aggressive forms. Despite these complexities, LSCs in both diseases share biological features, making them distinct from other CML or AML progenitor cells and from normal haematopoietic stem cells. These features may represent Achilles' heels against which novel therapies can be developed. Here, we review many of the similarities and differences that exist between LSCs in CML and AML and examine the therapeutic strategies that could be used to eradicate them.
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MESH Headings
- Animals
- Biomarkers, Tumor
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/immunology
- Cell Transformation, Neoplastic/metabolism
- Disease Management
- Disease Susceptibility
- Drug Development
- History, 20th Century
- History, 21st Century
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/etiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/therapy
- Molecular Targeted Therapy
- Neoplastic Stem Cells/drug effects
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
- Research/history
- Research/trends
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Affiliation(s)
- David Vetrie
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
| | - G Vignir Helgason
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Mhairi Copland
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
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28
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Hoffmann K, Cazemier K, Baldow C, Schuster S, Kheifetz Y, Schirm S, Horn M, Ernst T, Volgmann C, Thiede C, Hochhaus A, Bornhäuser M, Suttorp M, Scholz M, Glauche I, Loeffler M, Roeder I. Integration of mathematical model predictions into routine workflows to support clinical decision making in haematology. BMC Med Inform Decis Mak 2020; 20:28. [PMID: 32041606 PMCID: PMC7011438 DOI: 10.1186/s12911-020-1039-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/29/2020] [Indexed: 02/05/2023] Open
Abstract
Background Individualization and patient-specific optimization of treatment is a major goal of modern health care. One way to achieve this goal is the application of high-resolution diagnostics together with the application of targeted therapies. However, the rising number of different treatment modalities also induces new challenges: Whereas randomized clinical trials focus on proving average treatment effects in specific groups of patients, direct conclusions at the individual patient level are problematic. Thus, the identification of the best patient-specific treatment options remains an open question. Systems medicine, specifically mechanistic mathematical models, can substantially support individual treatment optimization. In addition to providing a better general understanding of disease mechanisms and treatment effects, these models allow for an identification of patient-specific parameterizations and, therefore, provide individualized predictions for the effect of different treatment modalities. Results In the following we describe a software framework that facilitates the integration of mathematical models and computer simulations into routine clinical processes to support decision-making. This is achieved by combining standard data management and data exploration tools, with the generation and visualization of mathematical model predictions for treatment options at an individual patient level. Conclusions By integrating model results in an audit trail compatible manner into established clinical workflows, our framework has the potential to foster the use of systems-medical approaches in clinical practice. We illustrate the framework application by two use cases from the field of haematological oncology.
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Affiliation(s)
- Katja Hoffmann
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Katja Cazemier
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christoph Baldow
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Silvio Schuster
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yuri Kheifetz
- Institute for Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Sibylle Schirm
- Institute for Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Matthias Horn
- Institute for Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Thomas Ernst
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Constanze Volgmann
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Christian Thiede
- Department of Internal Medicine, Medical Clinic I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Martin Bornhäuser
- Department of Internal Medicine, Medical Clinic I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - Meinolf Suttorp
- Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Markus Scholz
- Institute for Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Ingo Roeder
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. .,National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.
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29
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Hähnel T, Baldow C, Guilhot J, Guilhot F, Saussele S, Mustjoki S, Jilg S, Jost PJ, Dulucq S, Mahon FX, Roeder I, Fassoni AC, Glauche I. Model-based inference and classification of immunological control mechanisms from TKI cessation and dose reduction in CML patients. Cancer Res 2020; 80:2394-2406. [DOI: 10.1158/0008-5472.can-19-2175] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/18/2019] [Accepted: 02/05/2020] [Indexed: 11/16/2022]
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30
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Harrington P, Radia D, de Lavallade H. What are the considerations for tyrosine kinase inhibitor discontinuation in chronic-phase chronic myeloid leukemia? Expert Rev Hematol 2020; 13:213-222. [PMID: 31952452 DOI: 10.1080/17474086.2020.1717944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Introduction: The outlook for patients with chronic myeloid leukemia (CML) has changed dramatically with the development of tyrosine kinase inhibitors (TKIs) with the current treatment goal for many patients being to obtain a durable deep molecular remission, discontinue TKI therapy, and remain treatment free.Areas covered: In this article, the authors review the data from the major TKI discontinuation studies, explore potential predictors of discontinuation outcome and look at possible mechanisms to explain the variable outcomes following TKI discontinuation including immune surveillance and leukemic stem cell (LSC) depletion following TKI treatment. Data from relevant articles published on the Pubmed database between January 2007 and January 2020 have been included.Expert opinion: The results from the majority of TKI discontinuation studies show a consistent picture with approximately half of eligible patients achieving treatment free remission (TFR). However, reliable clinical predictors or biomarkers for the outcome of TKI discontinuation remain elusive and the mechanisms to explain the diversity of discontinuation success are not completely understood. Future studies will need to focus on attempts to increase the number of patients eligible for treatment discontinuation and will likely involve drug combinations including novel agents aimed at targeting the residual LSC population and enhancement of immune surveillance mechanisms.
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Affiliation(s)
- Patrick Harrington
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK.,Department of Haematological Medicine, King's College London School of Medicine, London, UK
| | - Deepti Radia
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK
| | - Hugues de Lavallade
- Department of Haematological Medicine, King's College London School of Medicine, London, UK.,Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
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31
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Koschade SE, Brandts CH. Selective Autophagy in Normal and Malignant Hematopoiesis. J Mol Biol 2020; 432:261-282. [DOI: 10.1016/j.jmb.2019.06.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 12/16/2022]
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32
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Shah NP, García-Gutiérrez V, Jiménez-Velasco A, Larson S, Saussele S, Rea D, Mahon FX, Levy MY, Gómez-Casares MT, Pane F, Nicolini FE, Mauro MJ, Sy O, Martin-Regueira P, Lipton JH. Dasatinib discontinuation in patients with chronic-phase chronic myeloid leukemia and stable deep molecular response: the DASFREE study. Leuk Lymphoma 2019; 61:650-659. [PMID: 31647335 DOI: 10.1080/10428194.2019.1675879] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Treatment-free remission (TFR) in patients with chronic myeloid leukemia in chronic phase (CML-CP) is considered a feasible option, especially with the ability of second-generation tyrosine kinase inhibitors to induce higher rates of sustained deep molecular response (DMR). DASFREE is an open-label, single-arm, multicenter phase II trial assessing TFR after dasatinib discontinuation in patients with CML-CP (N = 84). At 2 years, TFR was 46% in all patients. Multivariate analyses revealed statistically significant associations between 2-year TFR and duration of prior dasatinib (≥median; p = .0051), line of therapy (first line; p = .0138), and age (>65 years; p = .0012). No disease transformation occurred, and the most common adverse events experienced off treatment were musculoskeletal (observed in 30 patients); however, dasatinib withdrawal events were reported in nine patients (11%) by the investigator. Overall, these findings support the feasibility of discontinuing dasatinib for patients with CML-CP in sustained DMR in the first line and beyond.
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Affiliation(s)
- Neil P Shah
- Department of Medicine/Hematology-Oncology, UCSF School of Medicine, San Francisco, CA, USA
| | | | | | - Sarah Larson
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Susanne Saussele
- III, Med. Clinic, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Delphine Rea
- Department of Hématologie, Hôpital Saint-Louis, Paris, France
| | - François-Xavier Mahon
- Department of Hématologie, Institut Bergonié, University of Bordeaux, Bordeaux, France
| | | | | | - Fabrizio Pane
- Dipartimento di Medicina clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - Michael J Mauro
- Myeloproliferative Neoplasms Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oumar Sy
- Bristol-Myers Squibb, Princeton, NJ, USA
| | | | - Jeffrey H Lipton
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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33
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Moisoiu V, Teodorescu P, Parajdi L, Pasca S, Zdrenghea M, Dima D, Precup R, Tomuleasa C, Soverini S. Assessing Measurable Residual Disease in Chronic Myeloid Leukemia. BCR-ABL1 IS in the Avant-Garde of Molecular Hematology. Front Oncol 2019; 9:863. [PMID: 31608223 PMCID: PMC6768007 DOI: 10.3389/fonc.2019.00863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/20/2019] [Indexed: 11/17/2022] Open
Abstract
Chronic myelogenous leukemia (CML) is a malignancy of the myeloid cell lineage characterized by a recurrent chromosomal abnormality: the Philadelphia chromosome, which results from the reciprocal translocation of the chromosomes 9 and 22. The Philadelphia chromosome contains a fusion gene called BCR-ABL1. The BCR-ABL1 codes for an aberrantly functioning tyrosine kinase that drives the malignant proliferation of the founding clone. The advent of tyrosine kinase inhibitors (TKI) represents a landmark in the treatment of CML, that has led to tremendous improvement in the remission and survival rates. Since the introduction of imatinib, the first TKI, several other TKI have been approved that further broadened the arsenal against CML. Patients treated with TKIs require sensitive monitoring of BCR-ABL1 transcripts with quantitative real-time polymerase chain reaction (qRT-PCT), which has become an essential part of managing patients with CML. In this review, we discuss the importance of the BCR-ABL1 assay, and we highlight the growing importance of BCR-ABL1 dynamics. We also introduce a mathematical correction for the BCR-ABL1 assay that could help homogenizing the use of the ABL1 as a control gene. Finally, we discuss the growing body of evidence concerning treatment-free remission. Along with the continuous improvement in the therapeutic arsenal against CML, the molecular monitoring of CML represents the avant-garde in the struggle to make CML a curable disease.
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Affiliation(s)
- Vlad Moisoiu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
- Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
| | - Lorand Parajdi
- Department of Mathematics, Babes Bolyai University, Cluj Napoca, Romania
| | - Sergiu Pasca
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Mihnea Zdrenghea
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Delia Dima
- Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
| | - Radu Precup
- Department of Mathematics, Babes Bolyai University, Cluj Napoca, Romania
| | - Ciprian Tomuleasa
- Department of Hematology, Ion Chiricuta Clinical Research Center, Cluj Napoca, Romania
- Department of Hematology, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Simona Soverini
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology L. and A. Seràgnoli, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
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César Fassoni A, Roeder I, Glauche I. To Cure or Not to Cure: Consequences of Immunological Interactions in CML Treatment. Bull Math Biol 2019; 81:2345-2395. [DOI: 10.1007/s11538-019-00608-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/21/2019] [Indexed: 10/26/2022]
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Detecting the stable point of therapeutic effect of chronic myeloid leukemia based on dynamic network biomarkers. BMC Bioinformatics 2019; 20:202. [PMID: 31074387 PMCID: PMC6509869 DOI: 10.1186/s12859-019-2738-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Most researches of chronic myeloid leukemia (CML) are currently focused on the treatment methods, while there are relatively few researches on the progress of patients’ condition after drug treatment. Traditional biomarkers of disease can only distinguish normal state from disease state, and cannot recognize the pre-stable state after drug treatment. Results A therapeutic effect recognition strategy based on dynamic network biomarkers (DNB) is provided for CML patients’ gene expression data. With the DNB criteria, the DNB with 250 genes is selected and the therapeutic effect index (TEI) is constructed for the detection of individual disease. The pre-stable state before the disease condition becomes stable is 1 month. Through functional analysis for the DNB, some genes are confirmed as key genes to affect the progress of CML patients’ condition. Conclusions The results provide a certain theoretical direction and theoretical basis for medical personnel in the treatment of CML patients, and find new therapeutic targets in the future. The biomarkers of CML can help patients to be treated promptly and minimize drug resistance, treatment failure and relapse, which reduce the mortality of CML significantly. Electronic supplementary material The online version of this article (10.1186/s12859-019-2738-0) contains supplementary material, which is available to authorized users.
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36
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A numerical approach for a discrete Markov model for progressing drug resistance of cancer. PLoS Comput Biol 2019; 15:e1006770. [PMID: 30779730 PMCID: PMC6396936 DOI: 10.1371/journal.pcbi.1006770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 03/01/2019] [Accepted: 01/08/2019] [Indexed: 11/19/2022] Open
Abstract
The presence of treatment-resistant cells is an important factor that limits the efficacy of cancer therapy, and the prospect of resistance is considered the major cause of the treatment strategy. Several recent studies have employed mathematical models to elucidate the dynamics of generating resistant cancer cells and attempted to predict the probability of emerging resistant cells. The purpose of this paper is to present numerical approach to compute the number of resistant cells and the emerging probability of resistance. Stochastic model was designed and developed a method to approximately but efficiently compute the number of resistant cells and the probability of resistance. To model the progression of cancer, a discrete-state, two-dimensional Markov process whose states are the total number of cells and the number of resistant cells was employed. Then exact analysis and approximate aggregation approaches were proposed to calculate the number of resistant cells and the probability of resistance when the cell population reaches detection size. To confirm the accuracy of computed results of approximation, relative errors between exact analysis and approximation were computed. The numerical values of our approximation method were very close to those of exact analysis calculated in the range of small detection size M = 500, 100, and 1500. Then computer simulation was performed to confirm the accuracy of computed results of approximation when the detection size was M = 10000,30000,50000,100000 and 1000000. All the numerical results of approximation fell between the upper level and the lower level of 95% confidential intervals and our method took less time to compute over a broad range of cell size. The effects of parameter change on emerging probabilities of resistance were also investigated by computed values using approximation method. The results showed that the number of divisions until the cell population reached the detection size is important for emerging the probability of resistance. The next step of numerical approach is to compute the emerging probabilities of resistance under drug administration and with multiple mutation. Another effective approximation would be necessary for the analysis of the latter case.
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37
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Ottesen JT, Pedersen RK, Sajid Z, Gudmand-Hoeyer J, Bangsgaard KO, Skov V, Kjær L, Knudsen TA, Pallisgaard N, Hasselbalch HC, Andersen M. Bridging blood cancers and inflammation: The reduced Cancitis model. J Theor Biol 2019; 465:90-108. [PMID: 30615883 DOI: 10.1016/j.jtbi.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 12/11/2018] [Accepted: 01/02/2019] [Indexed: 11/28/2022]
Abstract
A novel mechanism-based model - the Cancitis model - describing the interaction of blood cancer and the inflammatory system is proposed, analyzed and validated. The immune response is divided into two components, one where the elimination rate of malignant stem cells is independent of the level of the blood cancer and one where the elimination rate depends on the level of the blood cancer. A dimensional analysis shows that the full 6-dimensional system of nonlinear ordinary differential equations may be reduced to a 2-dimensional system - the reduced Cancitis model - using Fenichel theory. The original 18 parameters appear in the reduced model in 8 groups of parameters. The reduced model is analyzed. Especially the steady states and their dependence on the exogenous inflammatory stimuli are analyzed. A semi-analytic investigation reveals the stability properties of the steady states. Finally, positivity of the system and the existence of an attracting trapping region in the positive octahedron guaranteeing global existence and uniqueness of solutions are proved. The possible topologies of the dynamical system are completely determined as having a Janus structure, where two qualitatively different topologies appear for different sets of parameters. To classify this Janus structure we propose a novel concept in blood cancer - a reproduction ratio R. It determines the topological structure depending on whether it is larger or smaller than a threshold value. Furthermore, it follows that inflammation, affected by the exogenous inflammatory stimulation, may determine the onset and development of blood cancers. The body may manage initial blood cancer as long as the self-renewal rate is not too high, but fails to manage it if an inflammation appears. Thus, inflammation may trigger and drive blood cancers. Finally, the mathematical analysis suggests novel treatment strategies and it is used to discuss the in silico effect of existing treatment, e.g. interferon-α or T-cell therapy, and the impact of malignant cells becoming resistant.
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Affiliation(s)
- Johnny T Ottesen
- Department of Science and Environment, Roskilde University, Denmark.
| | | | - Zamra Sajid
- Department of Science and Environment, Roskilde University, Denmark
| | | | | | - Vibe Skov
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Denmark
| | - Lasse Kjær
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Denmark
| | - Trine A Knudsen
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Denmark
| | - Niels Pallisgaard
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Denmark
| | - Hans C Hasselbalch
- Department of Hematology, Zealand University Hospital, University of Copenhagen, Denmark
| | - Morten Andersen
- Department of Science and Environment, Roskilde University, Denmark
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38
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Chen KK, Du TF, Xiong PS, Fan GH, Yang W. Discontinuation of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia With Losing Major Molecular Response as a Definition for Molecular Relapse: A Systematic Review and Meta-Analysis. Front Oncol 2019; 9:372. [PMID: 31139566 PMCID: PMC6527744 DOI: 10.3389/fonc.2019.00372] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/23/2019] [Indexed: 02/05/2023] Open
Abstract
Background: A new goal in treatment of chronic myeloid leukemia (CML) in patients with stable deep molecular response (DMR) is maintaining durable treatment-free remission (TFR) after discontinuing tyrosine kinase inhibitor (TKI) treatment. Methods: We conducted a systematic review and meta-analysis focusing on the efficacy and safety of TKI discontinuation but also exploring the factors contributing to successful TFR. Results: The search yielded 10 trials including 1,601 patients. For patients who discontinued TKIs, the estimated weighted mean incidence of major molecular relapse was 16% (95%CI: 11-21), 34% (95%CI: 29-38), 39% (95%CI: 35-43) and 41% (95%CI: 36-47) at 3, 6, 12, and 24 months, respectively. Of these, 39, 82, and 95% of molecular losses occurred within the first 3, 6, and 12 months. In safety analysis, among patients without TFR, 98% (95% CI: 96-100) were sensitive to TKI retreatment. No new safety issues were identified except TKI withdrawal syndrome, which appeared during the early TFR phase, with a weighted mean incidence of 27% (95%CI: 19-35). Our subgroup analysis suggested better TFR associated with interferon therapy (P = 0.007), depth of molecular response (P = 0.018) and duration of DMR (P < 0.001). Conclusions: TFR as an extension of an approach to optimize management of CML is clinically feasible in approximately 59% of patients with sufficient TKI response. In the remaining 41% of patients with molecular relapse, discontinuing TKIs had no negative impact on clinical outcomes. Given the high heterogeneity among studies, the role of these predictors for successful TFR still requires further investigation.
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Affiliation(s)
- Kang-kang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Tai-feng Du
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Pei-sheng Xiong
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Guan-hua Fan
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
- *Correspondence: Guan-hua Fan
| | - Wei Yang
- Department of Thoracic Surgery, Administrative Office, Shantou University Medical College Cancer Hospital, Shantou, China
- Wei Yang
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39
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Abstract
Statistical and mathematical modeling are crucial to describe, interpret, compare, and predict the behavior of complex biological systems including the organization of hematopoietic stem and progenitor cells in the bone marrow environment. The current prominence of high-resolution and live-cell imaging data provides an unprecedented opportunity to study the spatiotemporal dynamics of these cells within their stem cell niche and learn more about aberrant, but also unperturbed, normal hematopoiesis. However, this requires careful quantitative statistical analysis of the spatial and temporal behavior of cells and the interaction with their microenvironment. Moreover, such quantification is a prerequisite for the construction of hypothesis-driven mathematical models that can provide mechanistic explanations by generating spatiotemporal dynamics that can be directly compared to experimental observations. Here, we provide a brief overview of statistical methods in analyzing spatial distribution of cells, cell motility, cell shapes, and cellular genealogies. We also describe cell-based modeling formalisms that allow researchers to simulate emergent behavior in a multicellular system based on a set of hypothesized mechanisms. Together, these methods provide a quantitative workflow for the analytic and synthetic study of the spatiotemporal behavior of hematopoietic stem and progenitor cells.
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40
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Bunimovich‐Mendrazitsky S, Kronik N, Vainstein V. Optimization of Interferon–Alpha and Imatinib Combination Therapy for Chronic Myeloid Leukemia: A Modeling Approach. ADVANCED THEORY AND SIMULATIONS 2018. [DOI: 10.1002/adts.201800081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Natalie Kronik
- Department of HaematologyHadassah Hospital Jerusalem 91120 Israel
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41
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Ross DM, Pagani IS, Shanmuganathan N, Kok CH, Seymour JF, Mills AK, Filshie RJ, Arthur CK, Dang P, Saunders VA, Braley J, Yong AS, Yeung DT, White DL, Grigg AP, Schwarer AP, Branford S, Hughes TP. Long-term treatment-free remission of chronic myeloid leukemia with falling levels of residual leukemic cells. Leukemia 2018; 32:2572-2579. [PMID: 30315232 DOI: 10.1038/s41375-018-0264-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/16/2018] [Accepted: 08/23/2018] [Indexed: 01/28/2023]
Abstract
Following the achievement of deep molecular response on tyrosine kinase inhibitors (TKIs), approximately half of patients with chronic myeloid leukemia (CML) can discontinue TKI and remain in treatment-free remission (TFR). The ALLG CML8 study enrolled 40 imatinib-treated patients with undetectable BCR-ABL1 mRNA (approximately MR4.5). Molecular relapse was defined as detectable BCR-ABL1 on two consecutive tests or any single value >0.1%. With a median follow-up of 8.6 years (range 5.7-11.2 years), 18 patients remain in continuous TFR (45.0%; 95% confidence interval 31.9-63.4%). The latest relapse detected was 27 months after stopping imatinib. No patient progressed to advanced phase. Twenty-two patients met criteria for imatinib re-treatment and all regained undetectable molecular response. Nine patients in long-term TFR were monitored by highly sensitive individualized BCR-ABL1 DNA PCR in a sufficient number of samples to enable more precise quantification of residual leukemia. BCR-ABL1 DNA decreased from a median of MR5.0 in the first year of TFR to MR6.1 in the sixth year of TFR. Our results support the long-term safety and remarkable stability of response after imatinib discontinuation in appropriately selected CML patients. Serial high sensitivity testing provides a new and unexpected finding of gradually reducing CML cells in patients in long-term TFR.
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Affiliation(s)
- David M Ross
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia. .,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide, Australia. .,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia. .,Flinders University and Medical Centre, Adelaide, Australia. .,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.
| | - Ilaria S Pagani
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia
| | - Naranie Shanmuganathan
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Genetic and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Chung H Kok
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | - John F Seymour
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, Royal Melbourne Hospital and Peter MacCallum Centre, and University of Melbourne, Melbourne, Australia
| | - Anthony K Mills
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Robin J Filshie
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, St Vincent's Hospital, Melbourne, Australia
| | - Christopher K Arthur
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, Australia
| | - Phuong Dang
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Verity A Saunders
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Jodi Braley
- Genetic and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - Agnes S Yong
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia
| | - David T Yeung
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia
| | - Deborah L White
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,School of Biological Sciences, Faculty of Sciences, University of Adelaide, Adelaide, Australia.,School of Paediatrics, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Health Sciences UniSA, Adelaide, Australia
| | - Andrew P Grigg
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Clinical Haematology, Austin Hospital and Olivia Newton John Cancer Research Institute, Melbourne, Australia
| | - Anthony P Schwarer
- Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, The Alfred Hospital and Box Hill Hospital, Melbourne, Australia
| | - Susan Branford
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Genetic and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia.,School of Biological Sciences, Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - Timothy P Hughes
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia
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42
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Inoue A, Kobayashi CI, Shinohara H, Miyamoto K, Yamauchi N, Yuda J, Akao Y, Minami Y. Chronic myeloid leukemia stem cells and molecular target therapies for overcoming resistance and disease persistence. Int J Hematol 2018; 108:365-370. [DOI: 10.1007/s12185-018-2519-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023]
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43
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Quantitative prediction of long-term molecular response in TKI-treated CML - Lessons from an imatinib versus dasatinib comparison. Sci Rep 2018; 8:12330. [PMID: 30120281 PMCID: PMC6098052 DOI: 10.1038/s41598-018-29923-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 07/12/2018] [Indexed: 01/07/2023] Open
Abstract
Longitudinal monitoring of BCR-ABL transcript levels in peripheral blood of CML patients treated with tyrosine kinase inhibitors (TKI) revealed a typical biphasic response. Although second generation TKIs like dasatinib proved more efficient in achieving molecular remission compared to first generation TKI imatinib, it is unclear how individual responses differ between the drugs and whether mechanisms of drug action can be deduced from the dynamic data. We use time courses from the DASISION trial to address statistical differences in the dynamic response between first line imatinib vs. dasatinib treatment cohorts and we analyze differences between the cohorts by fitting an established mathematical model of functional CML treatment to individual time courses. On average, dasatinib-treated patients show a steeper initial response, while the long-term response only marginally differed between the treatments. Supplementing each patient time course with a corresponding confidence region, we illustrate the consequences of the uncertainty estimate for the underlying mechanisms of CML remission. Our model suggests that the observed BCR-ABL dynamics may result from different, underlying stem cell dynamics. These results illustrate that the perception and description of CML treatment response as a dynamic process on the level of individual patients is a prerequisite for reliable patient-specific response predictions and treatment optimizations.
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44
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Pagani IS, Dang P, Kommers IO, Goyne JM, Nicola M, Saunders VA, Braley J, White DL, Yeung DT, Branford S, Hughes TP, Ross DM. BCR-ABL1 genomic DNA PCR response kinetics during first-line imatinib treatment of chronic myeloid leukemia. Haematologica 2018; 103:2026-2032. [PMID: 29976745 PMCID: PMC6269287 DOI: 10.3324/haematol.2018.189787] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/04/2018] [Indexed: 12/16/2022] Open
Abstract
Accurate quantification of minimal residual disease (MRD) during treatment of chronic myeloid leukemia (CML) guides clinical decisions. The conventional MRD method, RQ-PCR for BCR-ABL1 mRNA, reflects a composite of the number of circulating leukemic cells and the BCR-ABL1 transcripts per cell. BCR-ABL1 genomic DNA only reflects leukemic cell number. We used both methods in parallel to determine the relative contribution of the leukemic cell number to molecular response. BCR-ABL1 DNA PCR and RQ-PCR were monitored up to 24 months in 516 paired samples from 59 newly-diagnosed patients treated with first-line imatinib in the TIDEL-II study. In the first three months of treatment, BCR-ABL1 mRNA values declined more rapidly than DNA. By six months, the two measures aligned closely. The expression of BCR-ABL1 mRNA was normalized to cell number to generate an expression ratio. The expression of e13a2 BCR-ABL1 was lower than that of e14a2 transcripts at multiple time points during treatment. BCR-ABL1 DNA was quantifiable in 48% of samples with undetectable BCR-ABL1 mRNA, resulting in MRD being quantifiable for an additional 5-18 months (median 12 months). These parallel studies show for the first time that the rapid decline in BCR-ABL1 mRNA over the first three months of treatment is due to a reduction in both cell number and transcript level per cell, whereas beyond three months, falling levels of BCR-ABL1 mRNA are proportional to the depletion of leukemic cells.
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Affiliation(s)
- Ilaria S Pagani
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia
| | - Phuong Dang
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Ivar O Kommers
- VU University Medical Center, Amsterdam, the Netherlands
| | - Jarrad M Goyne
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Mario Nicola
- Genetic and Molecular Pathology, SA Pathology, Adelaide, Australia
| | - Verity A Saunders
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Jodi Braley
- Genetic and Molecular Pathology, SA Pathology, Adelaide, Australia
| | - Deborah L White
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia.,School of Biological Sciences, Faculty of Sciences, University of Adelaide, Australia.,School of Paediatrics, Faculty of Health Sciences, University of Adelaide, Australia.,Health Sciences UniSA, Adelaide, Australia
| | - David T Yeung
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Australia
| | - Susan Branford
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia.,Genetic and Molecular Pathology, SA Pathology, Adelaide, Australia.,School of Paediatrics, Faculty of Health Sciences, University of Adelaide, Australia.,Centre for Cancer Biology, School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Timothy P Hughes
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Australia.,Centre for Cancer Biology, School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - David M Ross
- Cancer Theme, South Australian Health & Medical Research Institute, Adelaide, Australia .,School of Medicine, Faculty of Health Sciences, University of Adelaide, Australia.,Australasian Leukaemia and Lymphoma Group, Melbourne, Australia.,Department of Haematology, Royal Adelaide Hospital and SA Pathology, Australia.,Centre for Cancer Biology, School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia.,Flinders University and Medical Centre, Adelaide, Australia
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45
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Fassoni AC, Baldow C, Roeder I, Glauche I. Reduced tyrosine kinase inhibitor dose is predicted to be as effective as standard dose in chronic myeloid leukemia: a simulation study based on phase III trial data. Haematologica 2018; 103:1825-1834. [PMID: 29954936 PMCID: PMC6278983 DOI: 10.3324/haematol.2018.194522] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/26/2018] [Indexed: 02/05/2023] Open
Abstract
Continuing tyrosine kinase inhibitor (TKI)-mediated targeting of the BCR-ABL1 oncoprotein is the standard therapy for chronic myeloid leukemia (CML) and allows for a sustained disease control in the majority of patients. While therapy cessation for patients appeared as a safe option for about half of those patients with optimal response, no systematic assessment of long-term TKI dose de-escalation has been made. We use a mathematical model to analyze and consistently describe biphasic treatment responses from TKI-treated patients from two independent clinical phase III trials. Scale estimates reveal that drug efficiency determines the initial response while the long-term behavior is limited by the rare activation of leukemic stem cells. We use this mathematical framework to investigate the influence of different dosing regimens on the treatment outcome. We provide strong evidence to suggest that TKI dose de-escalation (at least 50%) does not lead to a reduction of long-term treatment efficiency for most patients, who have already achieved sustained remission, and maintains the secondary decline of BCR-ABL1 levels. We demonstrate that continuous BCR-ABL1 monitoring provides patient-specific predictions of an optimal reduced dose without decreasing the anti-leukemic effect on residual leukemic stem cells. Our results are consistent with the interim results of the DESTINY trial and provide clinically testable predictions. Our results suggest that dose-halving should be considered as a long-term treatment option for CML patients with good response under continuing maintenance therapy with TKIs. We emphasize the clinical potential of this approach to reduce treatment-related side-effects and treatment costs.
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Affiliation(s)
- Artur C Fassoni
- Instituto de Matemática e Computação, Universidade Federal de Itajubá, Brazil.,Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Christoph Baldow
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Ingo Roeder
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany.,National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany
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46
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Lambert B, MacLean AL, Fletcher AG, Combes AN, Little MH, Byrne HM. Bayesian inference of agent-based models: a tool for studying kidney branching morphogenesis. J Math Biol 2018; 76:1673-1697. [PMID: 29392399 PMCID: PMC5906521 DOI: 10.1007/s00285-018-1208-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 01/02/2018] [Indexed: 12/11/2022]
Abstract
The adult mammalian kidney has a complex, highly-branched collecting duct epithelium that arises as a ureteric bud sidebranch from an epithelial tube known as the nephric duct. Subsequent branching of the ureteric bud to form the collecting duct tree is regulated by subcellular interactions between the epithelium and a population of mesenchymal cells that surround the tips of outgrowing branches. The mesenchymal cells produce glial cell-line derived neurotrophic factor (GDNF), that binds with RET receptors on the surface of the epithelial cells to stimulate several subcellular pathways in the epithelium. Such interactions are known to be a prerequisite for normal branching development, although competing theories exist for their role in morphogenesis. Here we introduce the first agent-based model of ex vivo kidney uretic branching. Through comparison with experimental data, we show that growth factor-regulated growth mechanisms can explain early epithelial cell branching, but only if epithelial cell division depends in a switch-like way on the local growth factor concentration; cell division occurring only if the driving growth factor level exceeds a threshold. We also show how a recently-developed method, "Approximate Approximate Bayesian Computation", can be used to infer key model parameters, and reveal the dependency between the parameters controlling a growth factor-dependent growth switch. These results are consistent with a requirement for signals controlling proliferation and chemotaxis, both of which are previously identified roles for GDNF.
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Affiliation(s)
- Ben Lambert
- Department of Zoology, University of Oxford, Oxford, UK.
| | - Adam L MacLean
- Mathematical Institute, University of Oxford, Andrew Wiles Building, Woodstock Road, Oxford, UK
- Department of Mathematics, University of California, Irvine, Irvine, CA, USA
| | - Alexander G Fletcher
- School of Mathematics and Statistics, University of Sheffield, Hicks Building, Hounsfield Road, Sheffield, S3 7RH, UK
- Bateson Centre, University of Sheffield, Firth Court, Western Bank, Sheffield, S10 2TN, UK
| | - Alexander N Combes
- Department of Anatomy and Neuroscience, University of Melbourne, Melbourne, VIC, 3010, Australia
- Murdoch Childrens Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
| | - Melissa H Little
- Murdoch Childrens Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Helen M Byrne
- Mathematical Institute, University of Oxford, Andrew Wiles Building, Woodstock Road, Oxford, UK
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47
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MacLean AL, Hong T, Nie Q. Exploring intermediate cell states through the lens of single cells. CURRENT OPINION IN SYSTEMS BIOLOGY 2018; 9:32-41. [PMID: 30450444 PMCID: PMC6238957 DOI: 10.1016/j.coisb.2018.02.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
As our catalog of cell states expands, appropriate characterization of these states and the transitions between them is crucial. Here we discuss the roles of intermediate cell states (ICSs) in this growing collection. We begin with definitions and discuss evidence for the existence of ICSs and their relevance in various tissues. We then provide a list of possible functions for ICSs with examples. Finally, we describe means by which ICSs and their functional roles can be identified from single-cell data or predicted from models.
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Affiliation(s)
- Adam L. MacLean
- Department of Mathematics and Center for Complex Biological Systems, University of California, Irvine, CA 92697, United States
| | - Tian Hong
- Department of Biochemistry & Cellular and Molecular Biology, University of Tennessee, Knoxville, TN 37966, United States
| | - Qing Nie
- Department of Mathematics and Center for Complex Biological Systems, University of California, Irvine, CA 92697, United States,Department of Developmental and Cell Biology, University of California, Irvine, CA 92697, United States
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48
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Ross DM. Chronic myeloid leukaemia: going off piste. Lancet Oncol 2018; 19:717-718. [PMID: 29735298 DOI: 10.1016/s1470-2045(18)30206-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 11/19/2022]
Affiliation(s)
- David M Ross
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia; Department of Haematology and Molecular Medicine, Flinders University and Medical Centre, Adelaide, SA, Australia.
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49
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Gale RP, Hochhaus A. Therapy-free remission in chronic myeloid leukemia: possible mechanism. Expert Rev Hematol 2018; 11:269-272. [PMID: 29448857 DOI: 10.1080/17474086.2018.1442213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Robert Peter Gale
- a Haematology Research Centre, Division of Experimental Medicine, Department of Medicine , Imperial College London , London , UK
| | - Andreas Hochhaus
- b Abteilung Hämatologie/Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena , Jena , Germany
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50
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Nishiyama Y, Saikawa Y, Nishiyama N. Interaction between the immune system and acute myeloid leukemia: A model incorporating promotion of regulatory T cell expansion by leukemic cells. Biosystems 2018; 165:99-105. [DOI: 10.1016/j.biosystems.2018.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 12/18/2017] [Accepted: 01/23/2018] [Indexed: 01/08/2023]
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