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Okayama M, Fujimori K, Sato M, Samata K, Kurita K, Sugiyama H, Suto Y, Iwasaki G, Yamada T, Kiuchi F, Ichikawa D, Matsushita M, Hirao M, Kunieda H, Yamazaki K, Hattori Y. GTN057, a komaroviquinone derivative, induced myeloma cells' death in vivo and inhibited c-MET tyrosine kinase. Cancer Med 2023; 12:9749-9759. [PMID: 36825580 PMCID: PMC10166914 DOI: 10.1002/cam4.5691] [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: 09/22/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Despite the development of newly developed drugs, most multiple myeloma (MM) patients with high-risk cytogenetic abnormalities such as t(4;14) or del17p relapse at anin early stage of their clinical course. We previously reported that a natural product,komaroviquinone (KQN), isolated from the perennial semi-shrub Dracocephalum komarovi, i.e., komaroviquinone (KQN) and its derivative GTN024 induced the apoptosis of MM cells by producing reactive oxygen species (ROS), but both exhibited significant hematological toxicity. Aim of this study is to clarify anti-tumor activity, safety and pharmacokinetics of GTN057, an optimization compound of KQN in vivo. METHODS ICR/SCID xenograft model of KMS11, a t(4;14) translocation-positive MM cell line, was used for in vivo study. Mice pharmacokinetics of GTN057 and the degradation products were analyzed by LC-MS/MS. RESULTS Herein, our in vitro experiments revealed that GTN057 is much less toxic to normal hematopoietic cells, induced the apoptosis of both MM cell lines andpatient samples, including those with high-risk cytogenetic changes. A xenograft model of a high-risk MM cell line demonstrated that GTN057 significantly delayed the tumor growth with no apparent hematological or systemic toxicities in vivo. The pathological examination of GTN057-treated tumors in vivoshowed revealed apoptosis of MM cells and anti-angiogenesis. In addition to the production of ROS, GTN057 inhibited the downstream signaling of c-MET, a receptor tyrosine kinase a receptor forand hepatocyte growth factor (HGF) receptor. Thus, GTN057 is less toxic and is able tomay be a candidate drug for treating MM patients, via multifunctional mechanisms. We have also extensively studied the pharmacologyical analysis of GTN057. The metabolites of GTN057, (e.g.,such as GTN054), may also have anti-tumorantitumor activity. CONCLUSION Natural products or and their derivatives can could be good sources of antineoplastic drugs even for high-risk cancer.
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Affiliation(s)
- Mikio Okayama
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan.,Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kota Fujimori
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Mariko Sato
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Koichi Samata
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Koki Kurita
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Hiromu Sugiyama
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Yutaka Suto
- Faculty of Pharmacy, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Genji Iwasaki
- Faculty of Pharmacy, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Taketo Yamada
- Department of Pathology, Saitama Medical University, Saitama, Japan
| | - Fumiyuki Kiuchi
- Division of Natural Medicines, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Daiju Ichikawa
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Maiko Matsushita
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Maki Hirao
- Department of Hematology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Hisako Kunieda
- Department of Hematology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kohei Yamazaki
- Department of Hematology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yutaka Hattori
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan.,Department of Hematology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
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Costa BA, Mouhieddine TH, Richter J. What's Old is New: The Past, Present and Future Role of Thalidomide in the Modern-Day Management of Multiple Myeloma. Target Oncol 2022; 17:383-405. [PMID: 35771402 DOI: 10.1007/s11523-022-00897-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
Immunomodulatory drugs (IMiDs) have become an integral part of therapy for both newly diagnosed and relapsed/refractory multiple myeloma (RRMM). IMiDs bind to cereblon, leading to the degradation of proteins involved in B-cell survival and proliferation. Thalidomide, a first-generation IMiD, has little to no myelosuppressive potential, negligible renal clearance, and long-proven anti-myeloma activity. However, thalidomide's adverse effects (e.g., somnolence, constipation, and peripheral neuropathy) and the advent of more potent therapeutic options has led to the drug being less frequently used in many countries, including the US and Canada. Newer-generation IMiDs, such as lenalidomide and pomalidomide, are utilized far more frequently. In numerous previous trials, salvage therapy with thalidomide (50-200 mg/day) plus corticosteroids (with or without selected cytotoxic or targeted agents) has been shown to be effective and well-tolerated in the RRMM setting. Hence, thalidomide-based regimens remain important alternatives for heavily pretreated patients, especially for those who have no access to novel therapies and/or are not eligible for their use (due to renal failure, high-grade myelosuppression, or significant comorbidities). Ongoing and future trials may provide further insights into the current role of thalidomide, especially by comparing thalidomide-containing regimens with protocols based on newer-generation IMiDs and by investigating thalidomide's association with novel therapies (e.g., antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptor T cells).
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Affiliation(s)
- Bruno Almeida Costa
- Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tarek H Mouhieddine
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1185, New York, NY, 10029, USA
| | - Joshua Richter
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1185, New York, NY, 10029, USA.
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Hattori Y, Ikeda Y, Suzuki Y, Ichikawa D, Matsushita M. Codon 72 polymorphism of TP53 gene is a novel prognostic marker for therapy in multiple myeloma. Br J Haematol 2014; 165:728-31. [PMID: 24611901 DOI: 10.1111/bjh.12784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yutaka Hattori
- Division of Clinical Physiology and Therapeutics, Keio University Faculty of Pharmacy, Tokyo, Japan.
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A myeloma cell line established from a patient refractory to thalidomide therapy revealed high-risk cytogenetic abnormalities and produced vascular endothelial growth factor. Blood Cancer J 2013; 3:e115. [PMID: 23686003 PMCID: PMC3674455 DOI: 10.1038/bcj.2013.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ueda T, Iino R, Yokoyama K, Okamoto S, Asakura K, Tsukada Y, Ishizawa J, Matsuki E, Ikeda Y, Hattori Y. Post-transplant consolidation therapy using thalidomide alone for the patients with multiple myeloma: a feasibility study in Japanese population. Int J Hematol 2012; 96:477-84. [DOI: 10.1007/s12185-012-1166-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/13/2012] [Accepted: 08/13/2012] [Indexed: 01/06/2023]
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Wells EM, Rao AAN, Scafidi J, Packer RJ. Neurotoxicity of biologically targeted agents in pediatric cancer trials. Pediatr Neurol 2012; 46:212-21. [PMID: 22490765 PMCID: PMC3626408 DOI: 10.1016/j.pediatrneurol.2012.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 02/10/2012] [Indexed: 02/07/2023]
Abstract
Biologically targeted agents offer the promise of delivering specific anticancer effects while limiting damage to healthy tissue, including the central and peripheral nervous systems. During the past 5-10 years, these agents were examined in preclinical and adult clinical trials, and are used with increasing frequency in children with cancer. This review evaluates current knowledge about neurotoxicity from biologically targeted anticancer agents, particularly those in pediatric clinical trials. For each drug, neurotoxicity data are reviewed in adult (particularly studies of brain tumors) and pediatric studies when available. Overall, these agents are well tolerated, with few serious neurotoxic effects. Data from younger patients are limited, and more neurotoxicity may occur in the pediatric population because these agents target pathways that control not only tumorigenesis but also neural maturation. Further investigation is needed into long-term neurologic effects, particularly in children.
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Affiliation(s)
- Elizabeth M. Wells
- Brain Tumor Institute, Children's National Medical Center, Washington, DC
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
- Department of Neurology and Pediatrics, George Washington University, Washington, DC
| | - Amulya A. Nageswara Rao
- Brain Tumor Institute, Children's National Medical Center, Washington, DC
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
- Department of Neurology and Pediatrics, George Washington University, Washington, DC
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Joseph Scafidi
- Brain Tumor Institute, Children's National Medical Center, Washington, DC
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
- Department of Neurology and Pediatrics, George Washington University, Washington, DC
| | - Roger J. Packer
- Brain Tumor Institute, Children's National Medical Center, Washington, DC
- Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
- Department of Neurology and Pediatrics, George Washington University, Washington, DC
- Communications should be addressed to: Dr. Packer; Department of Neurology; Children's National Medical Center; 111 Michigan Avenue NW; Washington, DC 20010.
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Incidence and risk factors for developing venous thromboembolism in Japanese with diffuse large b-cell lymphoma. Thromb Res 2011; 130:7-11. [PMID: 22000981 DOI: 10.1016/j.thromres.2011.09.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 08/30/2011] [Accepted: 09/20/2011] [Indexed: 12/21/2022]
Abstract
The reported incidence of venous thromboembolism (VTE) in lymphoma patients is 5% to 17% in Western countries. The incidence and risk factors for developing VTE, however, are not well elucidated in Asian lymphoma patients. The incidence and clinical presentations of VTE were retrospectively assessed in 142 patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL) from April 2006 to November 2010 at Keio University Hospital. Clinical data were collected and all episodes of symptomatic VTE confirmed by imaging were included. Patients with primary central nervous system lymphoma or DLBCL transformed from prior low-grade lymphoma were excluded. Fifteen (11%) patients had at least one episode of VTE. Five patients developed VTE before beginning chemotherapy and 8 episodes of VTE occurred during the first three cycles of chemotherapy. By univariate analysis, age 60 or over (odds ratio [OR] 4.81, confidence interval [CI] 1.04-22.20, p=0.04), Eastern Cooperative Oncology Group performance status 2, 3, or 4 (OR 39.90, CI 5.05-315.20, p=0.0005), and International Prognostic Index high or high-intermediate (OR 9.40, CI 1.20-73.69, p=0.03) were identified as risk factors for developing VTE. By multivariate analysis, performance status 2, 3, or 4 remained a significant risk factor for developing VTE (OR 31.14, CI 3.79-255.62, p=0.001). The incidence of VTE in Japanese with DLBCL was comparable with that in the Western population. Patients with DLBCL and poor performance status at diagnosis were at high risk for developing VTE especially early in the course of treatment.
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Iida S. [Molecular-targeted therapy of multiple myeloma]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2010; 99:132-139. [PMID: 20376958 DOI: 10.2169/naika.99.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Koh Y, Bang SM, Lee JH, Yoon HJ, Do YR, Ryoo HM, Lee N, Kim SJ, Kim K, Yoon SS, Won JH, Mun YC, Lee MH, Rhee KH, Kim HJ, Eom H, Kim MK, Shin HC. Low incidence of clinically apparent thromboembolism in Korean patients with multiple myeloma treated with thalidomide. Ann Hematol 2009; 89:201-6. [PMID: 19705118 DOI: 10.1007/s00277-009-0807-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 07/31/2009] [Indexed: 12/31/2022]
Abstract
The frequency of thromboembolic events (TE) in Caucasian patients with multiple myeloma (MM) receiving thalidomide as the initial treatment has been reported to be 10~58% without prophylactic anticoagulation. Korean MM patients treated with thalidomide were studied to determine the frequency of TE and associated risk factors. A retrospective medical record review of the Korean MM registry from 25 centers in Korea between 2003 and 2007 was performed. We assessed the incidence of arterial and venous TE and the associated clinical parameters. Three hundred and sixty MM patients (median age 61 years, range 32-88 years) received thalidomide treatment. Fourteen patients (3.9%) developed TE: 12 had venous and two had arterial locations. The sites for the venous TE included lungs (seven), lower extremities (four), upper extremities (one), and neck (one). Arterial TE developed in cerebral and peripheral arteries each. No single clinical parameter such as prerequisite for the metabolic syndrome, disease status, and treatment regimen were predictive for the development of TE. The frequency of TE in patients who received thalidomide as initial therapy (7/155) was not different from those who received thalidomide for progressive or relapsed disease (7/205, p = 0.592). The frequency of TE during thalidomide treatment in Korean patients with MM was low. No significant clinical factor was found to be a risk factor. The subgroup requiring thromboprophylaxis among the Korean patients with MM, receiving thalidomide, needs to be clarified.
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Affiliation(s)
- Youngil Koh
- Department of Internal medicine, Seoul National University Hospital, Seoul, South Korea
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Phase II and pharmacokinetic study of thalidomide in Japanese patients with relapsed/refractory multiple myeloma. Int J Hematol 2009; 89:636-41. [PMID: 19399582 DOI: 10.1007/s12185-009-0314-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 03/25/2009] [Accepted: 03/31/2009] [Indexed: 10/20/2022]
Abstract
To obtain approval from the Ministry of Health, Labor and Welfare of Japan, a phase II study was conducted to assess the pharmacokinetics and pharmacodynamics of thalidomide along with its efficacy and safety in Japanese patients with multiple myeloma. Between 2005 and 2006, 42 patients were enrolled, and 37 patients met eligibility criteria. Of the 37 patients, 3 were excluded from efficacy analysis because of short duration of thalidomide administration (<4 weeks). The overall response rate was 35.3% (12/34), including partial response of 14.7% (5/34) and minimal response of 20.6% (7/34). The adverse events observed in high frequency (>40%) were leukopenia, neutropenia, drowsiness, dry mouth, and constipation. Grade 3 neutropenia was observed in nine cases. Peripheral neuropathy and eruption were observed in about one-quarter of the patients. Deep vein thrombosis was not observed. At a single oral dose of thalidomide (100 mg), the C (max) was 1.68 +/- 0.41 microg/ml, T (max) was 4.54 +/- 1.71 h, T (1/2) was 4.86 +/- 0.44 h, and AUC was 15.87 +/- 3.05 microg h/ml. Low-dose thalidomide was an effective and tolerable treatment for Japanese patients with relapsed/refractory myeloma. Leukopenia and neutropenia were the most serious adverse events. The pharmacokinetics was similar to those observed in Caucasian patients.
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Current Awareness in Hematological Oncology. Hematol Oncol 2008. [DOI: 10.1002/hon.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Abstract
PURPOSE OF REVIEW To conduct a critical review of recent data pertaining to the clinical and therapeutic aspects of peripheral neuropathies in the setting of malignancies, with the exception of paraproteinemic neuropathies. Our search extended to the past 2 years, using a PubMed search strategy. RECENT FINDINGS In the field of neuropathies linked with the development of the cancer, recent works have focused on lymphoma and cancer-associated vasculitides. In paraneoplastic syndromes, the major fact of the past 2 years is the issue of guidelines for diagnosis and treatment of these disorders, under the aegis of the paraneoplastic syndromes Euronetwork and of the European Federation of Neurological Sciences. When considering chemotherapy, neurotoxicity is becoming increasingly better known. Finally, the spectrum of late-delayed complications of irradiation further increases with a better clinical characterization of radiotherapy-induced dropped head syndrome. SUMMARY This article successively reviews the results of the recent studies in these various fields. In the field of chemotherapy, we will particularly focus on some new data concerning oxaliplatin, bortezomib, the albumin-bound form of paclitaxel and lenalidomide.
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