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Megías-Vericat JE, Martínez-Cuadrón D, Sanz MÁ, Montesinos P. Salvage regimens using conventional chemotherapy agents for relapsed/refractory adult AML patients: a systematic literature review. Ann Hematol 2018; 97:1115-1153. [DOI: 10.1007/s00277-018-3304-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/12/2018] [Indexed: 12/26/2022]
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Hinrichs MJM, Ryan PM, Zheng B, Afif-Rider S, Yu XQ, Gunsior M, Zhong H, Harper J, Bezabeh B, Vashisht K, Rebelatto M, Reed M, Ryan PC, Breen S, Patel N, Chen C, Masterson L, Tiberghien A, Howard PW, Dimasi N, Dixit R. Fractionated Dosing Improves Preclinical Therapeutic Index of Pyrrolobenzodiazepine-Containing Antibody Drug Conjugates. Clin Cancer Res 2017. [PMID: 28630216 DOI: 10.1158/1078-0432.ccr-17-0219] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To use preclinical models to identify a dosing schedule that improves tolerability of highly potent pyrrolobenzodiazepine dimers (PBDs) antibody drug conjugates (ADCs) without compromising antitumor activity.Experimental Design: A series of dose-fractionation studies were conducted to investigate the pharmacokinetic drivers of safety and efficacy of PBD ADCs in animal models. The exposure-activity relationship was investigated in mouse xenograft models of human prostate cancer, breast cancer, and gastric cancer by comparing antitumor activity after single and fractionated dosing with tumor-targeting ADCs conjugated to SG3249, a potent PBD dimer. The exposure-tolerability relationship was similarly investigated in rat and monkey toxicology studies by comparing tolerability, as assessed by survival, body weight, and organ-specific toxicities, after single and fractionated dosing with ADCs conjugated to SG3249 (rats) or SG3400, a structurally related PBD (monkeys).Results: Observations of similar antitumor activity in mice treated with single or fractionated dosing suggests that antitumor activity of PBD ADCs is more closely related to total exposure (AUC) than peak drug concentrations (Cmax). In contrast, improved survival and reduced toxicity in rats and monkeys treated with a fractionated dosing schedule suggests that tolerability of PBD ADCs is more closely associated with Cmax than AUC.Conclusions: We provide the first evidence that fractionated dosing can improve preclinical tolerability of at least some PBD ADCs without compromising efficacy. These findings suggest that preclinical exploration of dosing schedule could be an important clinical strategy to improve the therapeutic window of highly potent ADCs and should be investigated further. Clin Cancer Res; 23(19); 5858-68. ©2017 AACR.
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Affiliation(s)
| | - Pauline M Ryan
- Biologics Safety Assessment, MedImmune, Gaithersburg, Maryland
| | - Bo Zheng
- Clinical Pharmacology and DMPK, MedImmune, Gaithersburg, Maryland
| | | | - Xiang Qing Yu
- Clinical Pharmacology and DMPK, MedImmune, Gaithersburg, Maryland
| | - Michele Gunsior
- Clinical Pharmacology and DMPK, MedImmune, Gaithersburg, Maryland
| | - Haihong Zhong
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Jay Harper
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Binyam Bezabeh
- Antibody Discovery and Protein Engineering, MedImmune, Gaithersburg, Maryland
| | - Kapil Vashisht
- Biologics Safety Assessment, MedImmune, Gaithersburg, Maryland
| | | | - Molly Reed
- Biologics Safety Assessment, MedImmune, Gaithersburg, Maryland
| | - Patricia C Ryan
- Biologics Safety Assessment, MedImmune, Gaithersburg, Maryland
| | - Shannon Breen
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Neki Patel
- Spirogen Ltd., QMB Innovation Centre, London, United Kingdom
| | - Cui Chen
- Oncology Research, MedImmune, Gaithersburg, Maryland
| | - Luke Masterson
- Spirogen Ltd., QMB Innovation Centre, London, United Kingdom
| | | | | | - Nazzareno Dimasi
- Antibody Discovery and Protein Engineering, MedImmune, Gaithersburg, Maryland
| | - Rakesh Dixit
- Biologics Safety Assessment, MedImmune, Gaithersburg, Maryland
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Li Z, Yin S, Zhang L, Liu W, Chen B, Xing H. Clinicopathological characteristics and prognostic value of cancer stem cell marker CD133 in breast cancer: a meta-analysis. Onco Targets Ther 2017; 10:859-870. [PMID: 28243121 PMCID: PMC5317305 DOI: 10.2147/ott.s124733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The association of CD133 overexpression with clinicopathological significance and prognosis in patients with breast cancer remains controversial. We thus performed a meta-analysis to evaluate the role of CD133 expression in the development and prognosis of breast cancer. Methods The databases PubMed, Embase, and Cochrane Library (updated to August 1, 2016) were searched. Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (95% CI) were used to evaluate the impact of CD133 expression on clinicopathological features, overall survival, and disease-free survival. Results A total of 1,734 patients from 13 studies were subject to final analysis. The results showed a significant association between overexpression of CD133 and estrogen receptor status (OR 0.35, 95% CI 0.18–0.70), progesterone receptor status (OR 0.56, 95% CI 0.43–0.74), human epidermal growth factor-2 status (OR 1.81, 95% CI 1.33–2.45), lymph node metastasis (OR 1.98, 95% CI 1.34–2.92), and tumor histological grade (OR 1.79, 95% CI 1.26–2.54) in breast cancer. However, no significant correlation was found between upregulation of CD133 expression and onset age (OR 1.03, 95% CI 0.70–1.53) or tumor size (OR 1.29, 95% CI 0.80–2.09). Moreover, CD133-positive breast cancer patients had a higher risk of mortality (HR 1.91, 95% CI 1.21–3.03) and disease progression (HR 2.70, 95% CI 1.05–6.95). Conclusion This meta-analysis suggested that CD133 might be a predictor of clinical outcomes as well as prognosis and could be a potentially new gene therapy target for breast cancer patients.
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Affiliation(s)
- Zhan Li
- Department of Breast Surgery
| | - Songcheng Yin
- Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning
| | | | | | - Bo Chen
- Department of Breast Surgery
| | - Hua Xing
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People's Republic of China
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