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Ixazomib Improves Bone Remodeling and Counteracts sonic Hedgehog signaling Inhibition Mediated by Myeloma Cells. Cancers (Basel) 2020; 12:cancers12020323. [PMID: 32019102 PMCID: PMC7073172 DOI: 10.3390/cancers12020323] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/18/2022] Open
Abstract
Multiple myeloma (MM) is a clonal B-cell malignancy characterized by an accumulation of plasma cells (PC) in the bone marrow (BM), leading to bone loss and BM failure. Osteolytic bone disease is a common manifestation observed in MM patients and represents the most severe cause of morbidity, leading to progressive skeletal damage and disabilities. Pathogenetic mechanisms of MM bone disease are closely linked to PCs and osteoclast (OCs) hyperactivity, coupled with defective osteoblasts (OBs) function that is unable to counteract bone resorption. The aim of the present study was to investigate the effects of Ixazomib, a third-generation proteasome inhibitor, on osteoclastogenesis and osteogenic differentiation. We found that Ixazomib was able to reduce differentiation of human monocytes into OCs and to inhibit the expression of OC markers when added to the OC medium. Concurrently, Ixazomib was able to stimulate osteogenic differentiation of human mesenchymal stromal cells (MSCs), increasing osteogenic markers, either alone or in combination with the osteogenic medium. Given the key role of Sonic Hedgehog (SHH) signaling in bone homeostasis, we further investigated Ixazomib-induced SHH pathway activation. This set of experiments showed that Ixazomib, but not Bortezomib, was able to bind the Smoothened (SMO) receptor leading to nuclear translocation of GLI1 in human MSCs. Moreover, we demonstrated that PCs act as GLI1 suppressors on MSCs, thus reducing the potential of MSCs to differentiate in OBs. In conclusion, our data demonstrated that Ixazomib regulates bone remodeling by decreasing osteoclastogenesis and prompting osteoblast differentiation via the canonical SHH signaling pathway activation, thus, representing a promising therapeutic option to improve the complex pathological condition of MM patients.
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Conticello C, Romano A, Del Fabro V, Martino EA, Calafiore V, Sapienza G, Leotta V, Parisi MS, Markovic U, Garibaldi B, Leotta S, Cotzia E, Innao V, Mannina D, Neri S, Musso M, Scalone R, Cangialosi C, Acquaviva F, Cardinale G, Merenda A, Maugeri C, Uccello G, Poidomani M, Longo G, Carlisi M, Tibullo D, Di Raimondo F. Feasibility, Tolerability and Efficacy of Carfilzomib in Combination with Lenalidomide and Dexamethasone in Relapsed Refractory Myeloma Patients: A Retrospective Real-Life Survey of the Sicilian Myeloma Network. J Clin Med 2019; 8:E877. [PMID: 31248142 PMCID: PMC6617295 DOI: 10.3390/jcm8060877] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/03/2019] [Accepted: 06/12/2019] [Indexed: 11/17/2022] Open
Abstract
Background: The ASPIRE (NCT01080391) phase 3 trial showed the efficacy of carfilzomib, lenalidomide and dexamethasone (KRd) triplet for relapse and refractory multiple myeloma (RRMM). However, little is known about safety and efficacy of KRd outside a clinical trial context. Methods: Herein we report real life results of KRd given to 130 RRMM patients from 12 Sicilian Centers. Results: Median age was 62 years; patients had received a median of two previous lines of treatment (range 1-10) and 52% were refractory to previous treatment. Median number of KRd cycles was 12 (2-29), with a mean duration of treatment of 12 months; 21 patients had received at least 18 cycles. Overall response rate was 61%, including 18% complete response. Median PFS was 22.9 months, median OS was not reached. Creatinine clearance >30 mL/min, quality of the best achieved response and standard Fluorescence In Situ Hybridization (FISH) risk were independent predictors of favorable outcome. Patients who received the full-dosage of carfilzomib in the first two cycles had a better outcome. Conclusions: KRd was effective and well tolerated and in a considerable proportion of patients, therapy continued beyond the 18th cycle. The finding of a better outcome in patients with the higher cumulative dose of carfilzomib in the first two cycle encourages to maintain the maximum tolerated dose.
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Affiliation(s)
- Concetta Conticello
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Alessandra Romano
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Vittorio Del Fabro
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Enrica Antonia Martino
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Valeria Calafiore
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Giuseppe Sapienza
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Valerio Leotta
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Marina Silvia Parisi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Uros Markovic
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | - Salvatore Leotta
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
| | | | - Vanessa Innao
- Division of Hematology, Dipartimento di Patologia Umana dell'Adulto e dell'Età Evolutiva, Policlinico G. Martino, University of Messina, 98122 Messina, Italy.
| | - Donato Mannina
- U.O.C. Ematologia, Azienda Ospedaliera Papardo, 98158 Messina, Italy.
| | - Santo Neri
- U.O.C. Ematologia, Azienda Ospedaliera Papardo, 98158 Messina, Italy.
| | - Maurizio Musso
- U.O.C. OncoEmatologia e TMO, Dipartimento Oncologico, La Maddalena, 90146 Palermo, Italy.
| | - Renato Scalone
- U.O.C. OncoEmatologia e TMO, Dipartimento Oncologico, La Maddalena, 90146 Palermo, Italy.
| | - Clotilde Cangialosi
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy.
| | - Francesco Acquaviva
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy.
| | - Giovanni Cardinale
- U.O.C. Ematologia, ARNAS-Civico-Di Cristina-Benfratelli, 90147 Palermo, Italy.
| | - Anxur Merenda
- U.O.C. Ematologia, ARNAS-Civico-Di Cristina-Benfratelli, 90147 Palermo, Italy.
| | - Cinzia Maugeri
- Division of Hematology, Sant'Elia Hospital, 93100 Caltanissetta, Italy.
| | | | | | - Giuseppe Longo
- U.O.C. Ematologia, Ospedale San Vincenzo, 98039 Taormina (ME), Italy.
| | - Melania Carlisi
- U.O.C. Ematologia, Policlinico P. Giaccone, 90127 Palermo, Italy.
| | - Daniele Tibullo
- Department of Biomedical and Biotechnological Science, University of Catania, 95125 Catania, Italy.
| | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, 95125 Catania, Italy.
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Romano A, Parrinello NL, La Cava P, Tibullo D, Giallongo C, Camiolo G, Puglisi F, Parisi M, Pirosa MC, Martino E, Conticello C, Palumbo GA, Di Raimondo F. PMN-MDSC and arginase are increased in myeloma and may contribute to resistance to therapy. Expert Rev Mol Diagn 2018; 18:675-683. [PMID: 29707981 DOI: 10.1080/14737159.2018.1470929] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Despite improvement in overall response due to the introduction of the first-in-class proteasome inhibitor bortezomib (btz), multiple myeloma (MM) is still an incurable disease due to the immune-suppressive bone marrow (BM) environment. Thus, the authors aimed to identify the role of CD11b+CD15+CD14-HLA-DR- granulocytic-like myeloid-derived suppressor cells (PMN-MDSC) in MM patients treated up-front with novel agents. METHODS In MM cell lines and primary cells derived by patients affected by MGUS and MM, we investigated sensitivity to bortezomib and lenalidomide in presence of Arg-1 and PMN-MDSC. RESULTS The authors found that PMN-MDSC and their function through increased arginase-1 (Arg-1) are associated with MM progression. When the authors assessed cell viability of the human myeloma cell lines MM1.s, OPM2 and U266 treated with 5-20 nM btz for 24 h in PMN-MDSC conditioned media, they disclosed that amount of Arg-1 and Arg-1 inhibition could affect btz sensitivity in-vitro. PMN-MDSC and Arg-1 were increased in peripheral blood of newly diagnosed MM patients compared to healthy subjects. PMN-MDSC and arginase were reduced after exposure to lenalidomide-based regimen but increased after btz-based treatment. CONCLUSION In MM, Arg-1 is mainly expressed by PMN-MDSC. PMN-MDSC and Arg-1 are reduced in vivo after lenalidomide but not bortezomib treatment.
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Affiliation(s)
- Alessandra Romano
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Nunziatina Laura Parrinello
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Piera La Cava
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Daniele Tibullo
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Cesarina Giallongo
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Giuseppina Camiolo
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Fabrizio Puglisi
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Marina Parisi
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Maria Cristina Pirosa
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Enrica Martino
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Concetta Conticello
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Giuseppe Alberto Palumbo
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
| | - Francesco Di Raimondo
- a Department of medical and surgical specialties, Hematology Section , University of Catania , Catania , Italy
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Cerchione C, Nappi D, Pareto AE, Di Perna M, Zacheo I, Picardi M, Pane F, Catalano L. Safety and comfort of domestic bortezomib injection in real-life experience. Support Care Cancer 2018; 26:3111-3116. [PMID: 29574618 DOI: 10.1007/s00520-018-4155-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 03/12/2018] [Indexed: 11/24/2022]
Abstract
Despite novel agents, multiple myeloma is still an incurable disease, especially for elderly and frail patients, who are difficult to manage for concomitant comorbidities as the therapeutic options are limited and the response to chemotherapy is often short. We report our evaluations upon safety and efficacy of domestic subcutaneous bortezomib in elderly and frail patients candidate to bortezomib-melphalan-prednisone (VMP) regimen. We confirmed that overall incidence of adverse events, including peripheral neuropathy, was low, and in no case required admission to emergency service, contributing to reduce the rate of therapy discontinuation. These results confirm the effectiveness and safety of subcutaneous bortezomib, in a real-life-experience, and define a new possibility of safe auto-administration in a comfortable domestic setting. We suggest that domestic treatment can significantly improve the quality of life of the patients, avoiding unnecessary transfer to the hospital without reducing treatment efficacy.
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Affiliation(s)
- Claudio Cerchione
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Davide Nappi
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Anna Emanuele Pareto
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Maria Di Perna
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Irene Zacheo
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Marco Picardi
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Fabrizio Pane
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Lucio Catalano
- Hematology, Department of Clinical Medicine and Surgery, University Federico II, Via Pansini 5, 80131, Naples, Italy
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Kong XB, Tang QY, Chen XY, Tu Y, Sun SZ, Sun ZL. Polyethylene glycol as a promising synthetic material for repair of spinal cord injury. Neural Regen Res 2017; 12:1003-1008. [PMID: 28761436 PMCID: PMC5514851 DOI: 10.4103/1673-5374.208597] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Polyethylene glycol is a synthetic, biodegradable, and water-soluble polyether. Owing to its good biological and material properties, polyethylene glycol shows promise in spinal cord tissue engineering applications. Although studies have examined repairing spinal cord injury with polyethylene glycol, these compelling findings have not been recently reviewed or evaluated as a whole. Thus, we herein review and summarize the findings of studies conducted both within and beyond China that have examined the repair of spinal cord injury using polyethylene glycol. The following summarizes the results of studies using polyethylene glycol alone as well as coupled with polymers or hydrogels: (1) polyethylene glycol as an adjustable biomolecule carrier resists nerve fiber degeneration, reduces the inflammatory response, inhibits vacuole and scar formation, and protects nerve membranes in the acute stage of spinal cord injury. (2) Polyethylene glycol-coupled polymers not only promote angiogenesis but also carry drugs or bioactive molecules to the injury site. Because such polymers cross both the blood-spinal cord and blood-brain barriers, they have been widely used as drug carriers. (3) Polyethylene glycol hydrogels have been used as supporting substrates for the growth of stem cells after injury, inducing cell migration, proliferation, and differentiation. Simultaneously, polyethylene glycol hydrogels isolate or reduce local glial scar invasion, promote and guide axonal regeneration, cross the transplanted area, and re-establish synaptic connections with target tissue, thereby promoting spinal cord repair. On the basis of the reviewed studies, we conclude that polyethylene glycol is a promising synthetic material for use in the repair of spinal cord injury.
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Affiliation(s)
- Xian-Bin Kong
- Department of Brain, Affiliated Hospital of China Logistics College of People's Armed Police Forces, Tianjin, China.,Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiu-Yan Tang
- Tianjin Key Laboratory of Neurological Trauma Repair, Tianjin, China
| | - Xu-Yi Chen
- Tianjin Key Laboratory of Neurological Trauma Repair, Tianjin, China
| | - Yue Tu
- Tianjin Key Laboratory of Neurological Trauma Repair, Tianjin, China
| | - Shi-Zhong Sun
- Tianjin Key Laboratory of Neurological Trauma Repair, Tianjin, China
| | - Zhong-Lei Sun
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
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6
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Lesovaya E, Yemelyanov A, Swart AC, Swart P, Haegeman G, Budunova I. Discovery of Compound A--a selective activator of the glucocorticoid receptor with anti-inflammatory and anti-cancer activity. Oncotarget 2016; 6:30730-44. [PMID: 26436695 PMCID: PMC4741564 DOI: 10.18632/oncotarget.5078] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/19/2015] [Indexed: 12/19/2022] Open
Abstract
Glucocorticoids are among the most effective anti-inflammatory drugs, and are widely used for cancer therapy. Unfortunately, chronic treatment with glucocorticoids results in multiple side effects. Thus, there was an intensive search for selective glucocorticoid receptor (GR) activators (SEGRA), which retain therapeutic potential of glucocorticoids, but with fewer adverse effects. GR regulates gene expression by transactivation (TA), by binding as homodimer to gene promoters, or transrepression (TR), via diverse mechanisms including negative interaction between monomeric GR and other transcription factors. It is well accepted that metabolic and atrophogenic effects of glucocorticoids are mediated by GR TA. Here we summarized the results of extensive international collaboration that led to discovery and characterization of Compound A (CpdA), a unique SEGRA with a proven “dissociating” GR ligand profile, preventing GR dimerization and shifting GR activity towards TR both in vitro and in vivo. We outlined here the unusual story of compound's discovery, and presented a comprehensive overview of CpdA ligand properties, its anti-inflammatory effects in numerous animal models of inflammation and autoimmune diseases, as well as its anti-cancer effects. Finally, we presented mechanistic analysis of CpdA and glucocorticoid effects in skin, muscle, bone, and regulation of glucose and fat metabolism to explain decreased CpdA side effects compared to glucocorticoids. Overall, the results obtained by our and other laboratories underline translational potential of CpdA and its derivatives for treatment of inflammation, autoimmune diseases and cancer.
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Affiliation(s)
- Ekaterina Lesovaya
- Department of Chemical Carcinogenesis, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Alexander Yemelyanov
- Pulmonary Division, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amanda C Swart
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | - Pieter Swart
- Department of Biochemistry, Stellenbosch University, Stellenbosch, South Africa
| | | | - Irina Budunova
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Sundahl N, Clarisse D, Bracke M, Offner F, Berghe WV, Beck IM. Selective glucocorticoid receptor-activating adjuvant therapy in cancer treatments. Oncoscience 2016; 3:188-202. [PMID: 27713909 PMCID: PMC5043069 DOI: 10.18632/oncoscience.315] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/08/2016] [Indexed: 02/07/2023] Open
Abstract
Although adverse effects and glucocorticoid resistance cripple their chronic use, glucocorticoids form the mainstay therapy for acute and chronic inflammatory disorders, and play an important role in treatment protocols of both lymphoid malignancies and as adjuvant to stimulate therapy tolerability in various solid tumors. Glucocorticoid binding to their designate glucocorticoid receptor (GR), sets off a plethora of cell-specific events including therapeutically desirable effects, such as cell death, as well as undesirable effects, including chemotherapy resistance, systemic side effects and glucocorticoid resistance. In this context, selective GR agonists and modulators (SEGRAMs) with a more restricted GR activity profile have been developed, holding promise for further clinical development in anti-inflammatory and potentially in cancer therapies. Thus far, the research into the prospective benefits of selective GR modulators in cancer therapy limped behind. Our review discusses how selective GR agonists and modulators could improve the therapy regimens for lymphoid malignancies, prostate or breast cancer. We summarize our current knowledge and look forward to where the field should move to in the future. Altogether, our review clarifies novel therapeutic perspectives in cancer modulation via selective GR targeting.
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Affiliation(s)
- Nora Sundahl
- Laboratory of Experimental Cancer Research (LECR), Department of Radiation Oncology & Experimental Cancer Research, Ghent University, Gent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Dorien Clarisse
- Laboratory of Experimental Cancer Research (LECR), Department of Radiation Oncology & Experimental Cancer Research, Ghent University, Gent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium; Receptor Research Laboratories, Nuclear Receptor Lab (NRL), VIB Medical Biotechnology Center, Ghent University, Ghent, Belgium
| | - Marc Bracke
- Laboratory of Experimental Cancer Research (LECR), Department of Radiation Oncology & Experimental Cancer Research, Ghent University, Gent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Fritz Offner
- Hematology, Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Wim Vanden Berghe
- Laboratory of Protein Chemistry, Proteomics and Epigenetic Signaling, Department of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Ilse M Beck
- Laboratory of Experimental Cancer Research (LECR), Department of Radiation Oncology & Experimental Cancer Research, Ghent University, Gent, Belgium; Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Nishihori T, Baz R, Shain K, Kim J, Ochoa-Bayona JL, Yue B, Sullivan D, Dalton W, Alsina M. An open-label phase I/II study of cyclophosphamide, bortezomib, pegylated liposomal doxorubicin, and dexamethasone in newly diagnosed myeloma. Eur J Haematol 2015; 95:426-35. [PMID: 25600676 DOI: 10.1111/ejh.12509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 01/09/2023]
Abstract
We conducted a phase 1/2 trial evaluating the combination of cyclophosphamide, bortezomib, pegylated liposomal doxorubicin, and dexamethasone (CVDD) for newly diagnosed multiple myeloma (MM). The primary objective of the phase 1 was to evaluate the safety and tolerability of maximum planned dose (MPD) and the phase 2 was to assess the overall response rate. Patients received 6-8 cycles of CVDD at four dose levels. There were no dose-limiting toxicities. The MPD was cyclophosphamide 750 mg/m(2) IV on day 1, bortezomib 1.3 mg/m(2) IV on days 1, 4, 8, 11, pegylated liposomal doxorubicin 30 mg/m(2) IV on day 4, and dexamethasone 20 mg orally on the day of and after bortezomib (21-d cycle). Forty-nine patients were treated at the MPD of which 22% had high-risk myeloma. The most common grade ≥3 toxicities included myelosuppression, infection, and fatigue. Overall response and complete response rates were 91% and 26% in standard-risk, and 100% and 58% in high-risk cohort, respectively. After a median follow-up of 34 months, the median progression-free survival was 31.3 months. The 2-yr overall survival was 91.1% in the standard-risk and 88.9% in the high-risk cohort, respectively. CVDD regimen was well tolerated and was highly active in newly diagnosed MM.
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Affiliation(s)
- Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Rachid Baz
- Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kenneth Shain
- Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jongphil Kim
- Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Biostatistics core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jose L Ochoa-Bayona
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Binglin Yue
- Biostatistics core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Daniel Sullivan
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - William Dalton
- Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Melissa Alsina
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Chemical Biology and Molecular Medicine Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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9
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Niewerth D, Jansen G, Assaraf YG, Zweegman S, Kaspers GJ, Cloos J. Molecular basis of resistance to proteasome inhibitors in hematological malignancies. Drug Resist Updat 2015; 18:18-35. [DOI: 10.1016/j.drup.2014.12.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 12/25/2022]
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10
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Zhang R, Liu Y, Yang Z, Li Y, Rong X, Wang L, Guo C, Li S, Liu J, Li M, Wu Y. Construction of nanoparticles based on amphiphilic PEI–PA polymers for bortezomib and paclitaxel co-delivery. RSC Adv 2015. [DOI: 10.1039/c4ra16544f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Polymer nanoparticles based on branched polyethyleneimine and palmitic acid conjugates were fabricated for bortezomib and paclitaxel co-delivery.
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11
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Clinical use of proteasome inhibitors in the treatment of multiple myeloma. Pharmaceuticals (Basel) 2014; 8:1-20. [PMID: 25545164 PMCID: PMC4381198 DOI: 10.3390/ph8010001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/04/2014] [Indexed: 01/08/2023] Open
Abstract
Multiple myeloma (MM) is an incurable hematological malignancy characterized by the clonal proliferation of neoplastic plasma cells. The use of proteasome inhibitors in the treatment of MM has led to significant improvements in outcomes. This article reviews data on the use of the two approved proteasome inhibitors (bortezomib and carlfilzomib), as well as newer agents under development. Emphasis is placed on the clinical use of proteasome inhibitors, including management of side effects and combination with other agents.
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