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Randall J, Evans K, Watts B, Kosasih HJ, Smith CM, Earley EJ, Erickson SW, Jocoy EL, Bult CJ, Teicher BA, de Bock CE, Smith MA, Lock RB. In vivo activity of the second-generation proteasome inhibitor ixazomib against pediatric T-cell acute lymphoblastic leukemia xenografts. Exp Hematol 2024; 132:104176. [PMID: 38320689 PMCID: PMC10978271 DOI: 10.1016/j.exphem.2024.104176] [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: 10/25/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
The overall survival rate of patients with T-cell acute lymphoblastic leukemia (T-ALL) is now 90%, although patients with relapsed T-ALL face poor prognosis. The ubiquitin-proteasome system maintains normal protein homeostasis, and aberrations in this pathway are associated with T-ALL. Here we demonstrate the in vitro and in vivo activity of ixazomib, a second-generation orally available, reversible, and selective proteasome inhibitor against pediatric T-ALL cell lines and patient-derived xenografts (PDXs) grown orthotopically in immunodeficient NOD.Cg-PrkdcscidIL2rgtm1Wjl/SzJAusb (NSG) mice. Ixazomib was highly potent in vitro, with half-maximal inhibitory concentration (IC50) values in the low nanomolar range. As a monotherapy, ixazomib significantly extended mouse event-free survival of five out of eight T-ALL PDXs in vivo.
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Affiliation(s)
- Joanna Randall
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Kathryn Evans
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Ben Watts
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Hansen J Kosasih
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Christopher M Smith
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Eric J Earley
- RTI International, Research Triangle Park, Research Triangle, NC
| | | | | | | | | | - Charles E de Bock
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Richard B Lock
- Children's Cancer Institute, Lowy Cancer Research Centre, School of Clinical Medicine, University of New South Wales Medicine & Health, Centre for Childhood Cancer Research, University of New South Wales Sydney, Sydney, NSW, Australia.
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2
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Dakir EH, Gajate C, Mollinedo F. Antitumor activity of alkylphospholipid edelfosine in prostate cancer models and endoplasmic reticulum targeting. Biomed Pharmacother 2023; 167:115436. [PMID: 37683591 DOI: 10.1016/j.biopha.2023.115436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Prostate cancer is the second most frequent cancer and the fifth leading cause of cancer death among men worldwide. While the five-year survival in local and regional prostate cancer is higher than 99%, it falls to about 28% in advanced metastatic prostate cancer. The ether lipid edelfosine is considered the prototype of a family of promising antitumor drugs collectively named as alkylphospholipid analogs. Here, we found that edelfosine was the most potent alkylphospholipid analog in inducing apoptosis in three different human prostate cancer cell lines (LNCaP, PC3, and DU145) with distinct androgen dependency, and differing in tumor suppressor phosphatase and tensin homolog (PTEN) and p53 status. Edelfosine accumulated in the endoplasmic reticulum of prostate cancer cells, leading to endoplasmic reticulum stress and cell death in the three prostate cancer cells. Inhibition of autophagy potentiated the pro-apoptotic activity of edelfosine in LNCaP and PC3 cells, where autophagy was induced as a survival response. Edelfosine induced a slight and transient inhibition of AKT in PTEN-negative LNCaP and PC3 cells, but not in PTEN-positive DU145 cells. Daily oral administration of edelfosine in murine prostate restricted AKT kinase transgenic mice, expressing active AKT in a prostate-specific manner, and in a DU145 xenograft mouse model resulted in significant tumor regression and apoptosis in tumor cells. Taken together, these results show a significant in vitro and in vivo antitumor activity of edelfosine against prostate cancer, and highlight the endoplasmic reticulum as a novel and promising therapeutic target in prostate cancer.
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Affiliation(s)
- El-Habib Dakir
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; Faculty of Biology, University of Latvia, Riga, Latvia.
| | - Consuelo Gajate
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; Laboratory of Cell Death and Cancer Therapy, Department of Molecular Biomedicine, Centro de Investigaciones Biológicas - Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Ramiro de Maeztu 9, E-28040 Madrid, Spain.
| | - Faustino Mollinedo
- Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, CSIC-Universidad de Salamanca, Campus Miguel de Unamuno, E-37007 Salamanca, Spain; Laboratory of Cell Death and Cancer Therapy, Department of Molecular Biomedicine, Centro de Investigaciones Biológicas - Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Ramiro de Maeztu 9, E-28040 Madrid, Spain.
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3
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Bakırtaş M, Dal MS, Yiğenoğlu TN, Giden AO, Serin I, Başcı S, Kalpakci Y, Korkmaz S, Ekinci O, Albayrak M, Basturk A, Ozatli D, Dogu MH, Hacıbekiroglu T, Çakar MK, Ulas T, Miskioglu M, Gulturk E, Eser B, Altuntas F. Real-world data on the effectiveness and safety of Ixazomib-Lenalidomide-Dexamethasone therapy in relapsed/refractory multiple myeloma patients: a multicenter experience in Turkey. J Chemother 2023; 35:563-569. [PMID: 37211906 DOI: 10.1080/1120009x.2023.2208439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/03/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
A multicenter, retrospective, observational study was conducted to explore effectiveness and safety of ixazomib plus lenalidomide with dexamethasone (IRd) in relapsed/refractory multiple myeloma (RRMM) patients following at least ≥ two lines of therapy. Patients' treatment responses, overall response rate, progression-free survival rate, and adverse events were recorded. Mean age of 54 patients was 66.5 ± 9.1 years. There were 20 patients (37.0%) with progression. Median progression-free survival was 13 months in patients who received a median of three therapy lines in a 7.5-month follow-up period. Overall response rate was 38.5%. Of 54 patients, 19 (40.4%) had at least one adverse event, and nine (19.1%) had an adverse event of at least grade 3 or more. Of 72 adverse events observed in 47 patients, 68% were grade 1 or 2. Treatment was not stopped in any patient due to adverse events. IRd combination therapy was effective and safe in heavily treated RRMM patients.
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Affiliation(s)
- Mehmet Bakırtaş
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Mehmet Sinan Dal
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Tuğçe Nur Yiğenoğlu
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | | | - Istemi Serin
- Istanbul Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Semih Başcı
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Yasin Kalpakci
- Department of Hematology, Sakarya University, Sakarya, Turkey
| | - Serdal Korkmaz
- Kayseri City Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Kayseri, Turkey
| | - Omer Ekinci
- Gazi Yasargil Training and Research Hospital, Department of Hematology, University of Health Sciences, Diyarbakir, Turkey
| | - Murat Albayrak
- Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
| | | | - Duzgun Ozatli
- Department of Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Mehmet Hilmi Dogu
- Liv Hospital Ulus, Department of Hematology, Istinye University, Istanbul, Turkey
| | | | - Merih Kızıl Çakar
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
| | - Turgay Ulas
- School of Medicine, Department of Internal Medicine, Division of Hematology, Near East University, Nicosia, Cyprus
| | - Mine Miskioglu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Emine Gulturk
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Bulent Eser
- Department of Hematology, Medical Park Antalya Hospital, Antalya, Turkey
| | - Fevzi Altuntas
- Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, University of Health Sciences, Ankara, Turkey
- School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Chang HR. RNF126, 168 and CUL1: The Potential Utilization of Multi-Functional E3 Ubiquitin Ligases in Genome Maintenance for Cancer Therapy. Biomedicines 2023; 11:2527. [PMID: 37760968 PMCID: PMC10526535 DOI: 10.3390/biomedicines11092527] [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: 08/03/2023] [Revised: 08/27/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Ubiquitination is a post-translational modification (PTM) that is involved in proteolysis, protein-protein interaction, and signal transduction. Accumulation of mutations and genomic instability are characteristic of cancer cells, and dysfunction of the ubiquitin pathway can contribute to abnormal cell physiology. Because mutations can be critical for cells, DNA damage repair, cell cycle regulation, and apoptosis are pathways that are in close communication to maintain genomic integrity. Uncontrolled cell proliferation due to abnormal processes is a hallmark of cancer, and mutations, changes in expression levels, and other alterations of ubiquitination factors are often involved. Here, three E3 ubiquitin ligases will be reviewed in detail. RNF126, RNF168 and CUL1 are involved in DNA damage response (DDR), DNA double-strand break (DSB) repair, cell cycle regulation, and ultimately, cancer cell proliferation control. Their involvement in multiple cellular pathways makes them an attractive candidate for cancer-targeting therapy. Functional studies of these E3 ligases have increased over the years, and their significance in cancer is well reported. There are continuous efforts to develop drugs targeting the ubiquitin pathway for anticancer therapy, which opens up the possibility for these E3 ligases to be evaluated for their potential as a target protein for anticancer therapy.
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Affiliation(s)
- Hae Ryung Chang
- Department of Life Science, Handong Global University, Pohang 37554, Republic of Korea
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5
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Bhattacharyya S, Oblinger JL, Beauchamp RL, Yin Z, Erdin S, Koundinya P, Ware AD, Ferrer M, Jordan JT, Plotkin SR, Xu L, Chang LS, Ramesh V. Proteasomal pathway inhibition as a potential therapy for NF2-associated meningioma and schwannoma. Neuro Oncol 2023; 25:1617-1630. [PMID: 36806881 PMCID: PMC10479743 DOI: 10.1093/neuonc/noad037] [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: 09/14/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Neurofibromatosis 2 (NF2) is an inherited disorder caused by bi-allelic inactivation of the NF2 tumor suppressor gene. NF2-associated tumors, including schwannoma and meningioma, are resistant to chemotherapy, often recurring despite surgery and/or radiation, and have generally shown cytostatic response to signal transduction pathway inhibitors, highlighting the need for improved cytotoxic therapies. METHODS Leveraging data from our previous high-throughput drug screening in NF2 preclinical models, we identified a class of compounds targeting the ubiquitin-proteasome pathway (UPP), and undertook studies using candidate UPP inhibitors, ixazomib/MLN9708, pevonedistat/MLN4924, and TAK-243/MLN7243. Employing human primary and immortalized meningioma (MN) cell lines, CRISPR-modified Schwann cells (SCs), and mouse Nf2-/- SCs, we performed dose response testing, flow cytometry-based Annexin V and cell cycle analyses, and RNA-sequencing to identify potential underlying mechanisms of apoptosis. In vivo efficacy was also assessed in orthotopic NF2-deficient meningioma and schwannoma tumor models. RESULTS Testing of three UPP inhibitors demonstrated potent reduction in cell viability and induction of apoptosis for ixazomib or TAK-243, but not pevonedistat. In vitro analyses revealed that ixazomib or TAK-243 downregulates expression of c-KIT and PDGFRα, as well as the E3 ubiquitin ligase SKP2 while upregulating genes associated with endoplasmic reticulum stress-mediated activation of the unfolded protein response (UPR). In vivo treatment of mouse models revealed delayed tumor growth, suggesting a therapeutic potential. CONCLUSIONS This study demonstrates the efficacy of proteasomal pathway inhibitors in meningioma and schwannoma preclinical models and lays the groundwork for use of these drugs as a promising novel treatment strategy for NF2 patients.
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Affiliation(s)
- Srirupa Bhattacharyya
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Janet L Oblinger
- Center for Childhood Cancer & Blood Diseases, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Roberta L Beauchamp
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Zhenzhen Yin
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Serkan Erdin
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Priya Koundinya
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Anna D Ware
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Marc Ferrer
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Justin T Jordan
- Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Scott R Plotkin
- Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Lei Xu
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Long-Sheng Chang
- Center for Childhood Cancer & Blood Diseases, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Vijaya Ramesh
- Department of Neurology and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
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6
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Wilson N, Reese S, Ptak L, Aziz F, Parajuli S, Jucaud V, Denham S, Mishra A, Cascalho M, Platt JL, Hematti P, Djamali A. Ixazomib for Desensitization (IXADES) in Highly Sensitized Kidney Transplant Candidates: A Phase II Clinical Trial. KIDNEY360 2023; 4:e796-e808. [PMID: 36951387 PMCID: PMC10371382 DOI: 10.34067/kid.0000000000000113] [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: 07/22/2022] [Accepted: 01/30/2023] [Indexed: 03/24/2023]
Abstract
Key Points Ixazomib treatment resulted in decreases in B-cell subsets and bone marrow lymphocytes. Ixazomib treatment resulted in modest decreases in certain anti-HLA antibody specificities. Ixazomib treatment was tolerated, with modest adverse events. Background Ixazomib is a second-generation oral proteasome inhibitor approved for treatment of refractory multiple myeloma. We conducted an open-label phase II trial, IXAzomib for DESensitization (IXADES), testing the safety of ixazomib treatment as an approach to decreasing the level and diversity of specificities of anti-HLA antibodies in subjects awaiting kidney transplantation. The trial (NCT03213158 ) enrolled highly sensitized kidney transplant candidates, defined as subjects with calculated panel reactive antibodies (cPRA) >80%, awaiting kidney transplantation >24 months. The subjects were treated with 12 monthly cycles of ixazomib 3 mg+dexamethasone 20 mg. Efficacy was defined as a decrease of cPRA >20% or kidney transplantation. The safety end point was tolerability. Methods In ten enrolled subjects, no grade IV, five grade III, 11 grade II, and 43 grade I adverse events were noted. The adverse events included infection, transient paresthesia, nausea, vomiting, and diarrhea. The IXADES regimen was not associated with significant change in levels or diversity of anti-HLA antibodies (cPRA). Results Although the IXADES regimen did not exhibit a clear impact on levels and diversity of anti-HLA antibodies in this small cohort, the prolonged half-life of IgG could necessitate a longer duration of treatment for accurate evaluation of efficacy. Conclusions In conclusion, treatment with ixazomib/dexamethasone engendered mild-to-moderate toxicity. The impact on anti-HLA was modest and paradoxical in the case of anti-HLA-DR. Clinical trials combining ixazomib with other immunosuppressive agents may be more effective in addressing antibody-mediated processes in kidney transplantation.
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Affiliation(s)
- Nancy Wilson
- Department of Pathology and Laboratory Medicine, AVRL, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Shannon Reese
- Department of Medicine, Division of Hematology and Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Lucy Ptak
- Department of Administration, Division of Clinical Trials, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Fahad Aziz
- Department of Medicine, Division of Nephrology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Sandesh Parajuli
- Department of Medicine, Division of Nephrology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | | | | | - Ameet Mishra
- Department of Medicine, Division of Hematology and Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Marilia Cascalho
- Department of Surgery and Department of Microbiology & Immunology, University of Michigan, Ann Arbor, Michigan
| | - Jeffrey L. Platt
- Department of Surgery and Department of Microbiology & Immunology, University of Michigan, Ann Arbor, Michigan
| | - Peiman Hematti
- Department of Medicine, Division of Hematology and Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Arjang Djamali
- Department of Medicine, Maine Medical Center, Portland, Maine
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7
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Srimani JK, Diderichsen PM, Hanley MJ, Venkatakrishnan K, Labotka R, Gupta N. Population pharmacokinetic/pharmacodynamic joint modeling of ixazomib efficacy and safety using data from the pivotal phase III TOURMALINE‐MM1 study in multiple myeloma patients. CPT Pharmacometrics Syst Pharmacol 2022; 11:1085-1099. [PMID: 35598166 PMCID: PMC9381907 DOI: 10.1002/psp4.12815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 01/04/2023] Open
Abstract
Ixazomib is an oral proteasome inhibitor approved in combination with lenalidomide and dexamethasone for the treatment of relapsed/refractory multiple myeloma (MM). Approval in the United States, Europe, and additional countries was based on results from the phase III TOURMALINE‐MM1 (C16010) study. Here, joint population pharmacokinetic/pharmacodynamic time‐to‐event (TTE) and discrete time Markov models were developed to describe key safety (rash and diarrhea events, and platelet counts) and efficacy (myeloma protein [M‐protein] and progression‐free survival [PFS]) outcomes observed in TOURMALINE‐MM1. Models reliably described observed safety and efficacy results; prior immunomodulatory drug therapy and race were significant covariates for diarrhea and rash events, respectively, whereas M‐protein dynamics were sufficiently characterized using TTE models of relapse and dropout. Moreover, baseline M‐protein was identified as a significant covariate for observed PFS. The developed framework represents an integrated approach to describing safety and efficacy with MM therapy, enabling the simulation of prospective trials and potential alternate dosing regimens.
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Affiliation(s)
- Jaydeep K. Srimani
- Takeda Development Center Americas, Inc. (TDCA) Lexington Massachusetts USA
| | | | - Michael J. Hanley
- Takeda Development Center Americas, Inc. (TDCA) Lexington Massachusetts USA
| | | | - Richard Labotka
- Takeda Development Center Americas, Inc. (TDCA) Lexington Massachusetts USA
| | - Neeraj Gupta
- Takeda Development Center Americas, Inc. (TDCA) Lexington Massachusetts USA
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8
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Patel KK, Shah JJ, Feng L, Lee HC, Manasanch EM, Olsem J, Morphey A, Huo XJ, Thomas SK, Bashir Q, Qazilbash MH, Weber DM, Orlowski RZ. Safety and Efficacy of Combination Maintenance Therapy with Ixazomib and Lenalidomide in Patients with Posttransplant Myeloma. Clin Cancer Res 2022; 28:1277-1284. [PMID: 34992070 PMCID: PMC9365361 DOI: 10.1158/1078-0432.ccr-21-3420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/23/2021] [Accepted: 01/04/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE In this study, the addition of ixazomib to lenalidomide maintenance post-autologous stem cell transplant (ASCT) in 64 patients with newly diagnosed multiple myeloma was evaluated on the basis of the observed benefit of lenalidomide-only maintenance in prior studies. PATIENTS AND METHODS Patients were started on maintenance therapy with lenalidomide and ixazomib within 60-180 days of stem cell infusion. RESULTS Response rates deepened over time from baseline post-ASCT for 39 patients. The complete response (CR)/stringent CR rate was 43% and median overall survival was not reached with a median follow-up of 62 months (range, 25-82 months). Median PFS (mPFS) for all patients was 73 months and has not been reached for those with International Staging System (ISS) stage 1 disease. mPFS in 9 patients who had ISS stage 3 disease and 14 patients who had high-risk cytogenetics was 34 and 25 months, respectively. Twenty-two patients had progressive disease, while 19 patients continue to receive dual maintenance. The most common grade 3/4 adverse events included neutropenia, leukopenia, thrombocytopenia, lung infections, diarrhea, and maculopapular rash. Second primary malignancies occurred in 9 patients. Toxicity led to dose reductions in ixazomib and lenalidomide in 20 and 31 patients, respectively. Discontinuation of ixazomib due to toxicity occurred in 4 patients. Grade 1/2 neuropathy occurred in 22 patients and led to reduction or discontinuation of ixazomib in 2 patients. CONCLUSIONS The addition of ixazomib to lenalidomide maintenance demonstrated a better than expected PFS compared with historical data using lenalidomide alone and was safe and tolerable.
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Affiliation(s)
- Krina K. Patel
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas.,Corresponding Author: Krina K. Patel, Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston TX 77030. Phone: 713-792-6662; Fax: 713-792-1897; E-mail:
| | | | - Lei Feng
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Hans C. Lee
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Elisabet M. Manasanch
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Jasper Olsem
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Ashley Morphey
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Xiao Jiao Huo
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Sheeba K. Thomas
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Muzaffar H. Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Donna M. Weber
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas
| | - Robert Z. Orlowski
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston Texas.,Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston Texas
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9
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Voorhees PM, Suman VJ, Tuchman SA, Laubach JP, Hassoun H, Efebera YA, Mulkey F, Bova-Solem M, Santo K, Carlisle D, McCarthy PL, Richardson PG. A phase I/II study of ixazomib, pomalidomide, and dexamethasone for lenalidomide and proteasome inhibitor refractory multiple myeloma (Alliance A061202). Am J Hematol 2021; 96:1595-1603. [PMID: 34559902 PMCID: PMC8713771 DOI: 10.1002/ajh.26361] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/10/2021] [Accepted: 09/11/2021] [Indexed: 12/14/2022]
Abstract
Preclinical studies have demonstrated activity of the oral proteasome inhibitor (PI) ixazomib (IXA) in bortezomib-resistant multiple myeloma (MM) and synergy with immunomodulatory drugs. We therefore conducted a phase I/II study to establish the safety and preliminary efficacy of IXA with pomalidomide (POM) and dexamethasone (DEX) in lenalidomide (LEN)/PI-refractory MM. Dose escalation established a 4 mg dose of POM and IXA and 20/40 mg dose of DEX as the maximum tolerated dose. The phase II portion of the trial was redesigned and started anew after six patients had been randomized to IXA-POM-DEX due to a rapidly changing treatment landscape. Among the 29 evaluable LEN/PI-refractory patients treated with IXA-POM-DEX in phase I/II, the overall response rate (partial response or better) was 51.7% with a median duration of response of 16.8 months (range 56 days to 4.1 years), median progression-free survival of 4.4 months (95% confidence interval [CI]: 3.0-18.4), and median overall survival of 34.3 months (95% CI: 19.2 to not reached). Hematologic, gastrointestinal, and constitutional adverse events were common and consistent with the side-effect profiles of the individual agents. Our results support further evaluation of this all-oral regimen in relapsed/refractory MM.
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Affiliation(s)
- Peter M. Voorhees
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina, USA
| | - Vera J. Suman
- Alliance Statistics and Data Center, Rochester, Minnesota, USA
| | - Sascha A. Tuchman
- Division of Hematology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jacob P. Laubach
- Department of Hematology and Oncology, Dana-Farber/Partners Cancer Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Hani Hassoun
- Myeloma Service, Division of Hematologic Oncology, Department of Medicine, Memorial Sloan Cancer Center, New York, New York, USA
| | - Yvonne A. Efebera
- Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Flora Mulkey
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina, USA
| | - Misty Bova-Solem
- Alliance for Clinical Trials in Oncology, Protocol Operations Program, Chicago, Illinois, USA
| | - Katelyn Santo
- Alliance Statistics and Data Center, Rochester, Minnesota, USA
| | - Destin Carlisle
- Alliance for Clinical Trials in Oncology, Protocol Operations Program, Chicago, Illinois, USA
| | - Philip L. McCarthy
- Transplant and Cellular Therapy Program, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Paul G. Richardson
- Division of Hematology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA,Department of Hematology and Oncology, Dana-Farber/Partners Cancer Care, Harvard Medical School, Boston, Massachusetts, USA
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10
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LaPlante G, Zhang W. Targeting the Ubiquitin-Proteasome System for Cancer Therapeutics by Small-Molecule Inhibitors. Cancers (Basel) 2021; 13:3079. [PMID: 34203106 PMCID: PMC8235664 DOI: 10.3390/cancers13123079] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/14/2022] Open
Abstract
The ubiquitin-proteasome system (UPS) is a critical regulator of cellular protein levels and activity. It is, therefore, not surprising that its dysregulation is implicated in numerous human diseases, including many types of cancer. Moreover, since cancer cells exhibit increased rates of protein turnover, their heightened dependence on the UPS makes it an attractive target for inhibition via targeted therapeutics. Indeed, the clinical application of proteasome inhibitors in treatment of multiple myeloma has been very successful, stimulating the development of small-molecule inhibitors targeting other UPS components. On the other hand, while the discovery of potent and selective chemical compounds can be both challenging and time consuming, the area of targeted protein degradation through utilization of the UPS machinery has seen promising developments in recent years. The repertoire of proteolysis-targeting chimeras (PROTACs), which employ E3 ligases for the degradation of cancer-related proteins via the proteasome, continues to grow. In this review, we will provide a thorough overview of small-molecule UPS inhibitors and highlight advancements in the development of targeted protein degradation strategies for cancer therapeutics.
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Affiliation(s)
- Gabriel LaPlante
- Department of Molecular and Cellular Biology, College of Biological Science, University of Guelph, 50 Stone Rd E, Guelph, ON N1G2W1, Canada;
| | - Wei Zhang
- Department of Molecular and Cellular Biology, College of Biological Science, University of Guelph, 50 Stone Rd E, Guelph, ON N1G2W1, Canada;
- CIFAR Azrieli Global Scholars Program, Canadian Institute for Advanced Research, MaRS Centre West Tower, 661 University Avenue, Toronto, ON M5G1M1, Canada
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11
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Choi AY, Manook M, Olaso D, Ezekian B, Park J, Freischlag K, Jackson A, Knechtle S, Kwun J. Emerging New Approaches in Desensitization: Targeted Therapies for HLA Sensitization. Front Immunol 2021; 12:694763. [PMID: 34177960 PMCID: PMC8226120 DOI: 10.3389/fimmu.2021.694763] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/24/2021] [Indexed: 01/11/2023] Open
Abstract
There is an urgent need for therapeutic interventions for desensitization and antibody-mediated rejection (AMR) in sensitized patients with preformed or de novo donor-specific HLA antibodies (DSA). The risk of AMR and allograft loss in sensitized patients is increased due to preformed DSA detected at time of transplant or the reactivation of HLA memory after transplantation, causing acute and chronic AMR. Alternatively, de novo DSA that develops post-transplant due to inadequate immunosuppression and again may lead to acute and chronic AMR or even allograft loss. Circulating antibody, the final product of the humoral immune response, has been the primary target of desensitization and AMR treatment. However, in many cases these protocols fail to achieve efficient removal of all DSA and long-term outcomes of patients with persistent DSA are far worse when compared to non-sensitized patients. We believe that targeting multiple components of humoral immunity will lead to improved outcomes for such patients. In this review, we will briefly discuss conventional desensitization methods targeting antibody or B cell removal and then present a mechanistically designed desensitization regimen targeting plasma cells and the humoral response.
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Affiliation(s)
| | | | | | | | | | | | | | - Stuart Knechtle
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC, United States
| | - Jean Kwun
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC, United States
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12
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Discovery of novel candidates for anti-liposarcoma therapies by medium-scale high-throughput drug screening. PLoS One 2021; 16:e0248140. [PMID: 33690666 PMCID: PMC7946228 DOI: 10.1371/journal.pone.0248140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/21/2021] [Indexed: 12/16/2022] Open
Abstract
Sarcomas are a heterogeneous group of mesenchymal orphan cancers and new treatment alternatives beyond traditional chemotherapeutic regimes are much needed. So far, tumor mutation analysis has not led to significant treatment advances, and we have attempted to bypass this limitation by performing direct drug testing of a library of 353 anti-cancer compounds that are either FDA-approved, in clinical trial, or in advanced stages of preclinical development on a panel of 13 liposarcoma cell lines. We identified and validated six drugs, targeting different mechanisms and with good efficiency across the cell lines: MLN2238 –a proteasome inhibitor, GSK2126458 –a PI3K/mTOR inhibitor, JNJ-26481585 –a histone deacetylase inhibitor, triptolide–a multi-target drug, YM155 –a survivin inhibitor, and APO866 (FK866)–a nicotinamide phosphoribosyl transferase inhibitor. GR50s for those drugs were mostly in the nanomolar range, and in many cases below 10 nM. These drugs had long-lasting effect upon drug withdrawal, limited toxicity to normal cells and good efficacy also against tumor explants. Finally, we identified potential genomic biomarkers of their efficacy. Being approved or in clinical trials, these drugs are promising candidates for liposarcoma treatment.
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13
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Maples KT, Joseph NS, Harvey RD. Current developments in the combination therapy of relapsed/refractory multiple myeloma. Expert Rev Anticancer Ther 2020; 20:1021-1035. [PMID: 32969752 DOI: 10.1080/14737140.2020.1828071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Therapy for patients with multiple myeloma has improved dramatically over the past decade following the introduction of novel agents and combinations across the disease spectrum. When relapse or refractory disease develops, non-cross-resistant drugs, most often used in multidrug regimens, have provided significant improvements in patient outcomes. Despite these advances, myeloma remains incurable and additional therapeutic approaches, based on emerging molecular and cellular biology, are moving rapidly through development phases. Approaches new to myeloma, including antibody-drug conjugates, T-cell-directed therapies, and novel small molecules, are poised to bring in the next wave of treatment. AREAS COVERED This review addresses recent data for the management of relapsed/refractory disease, rationale for agent and regimen selection and combinations, and options showing early promise in trials. Literature and abstracts pertaining to trial data published or presented up to 2019 are included. EXPERT OPINION Therapeutic strategies continue to evolve in myeloma, with the application of existing platforms (e.g., antibody-drug conjugates) to target relevant biology (e.g., B cell maturation antigen). Within the next year, there will be additional agents approved for those with advanced disease, and combinations as well as placement in sequencing will deepen responses and improve outcomes for patients.
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Affiliation(s)
- Kathryn T Maples
- Department of Pharmaceutical Services, Emory University Hospitals and Winship Cancer Institute , Atlanta, GA, USA
| | - Nisha S Joseph
- Department of Hematology and Medical Oncology, Emory University School of Medicine; Winship Cancer Institute of Emory University , Atlanta, GA, USA
| | - R Donald Harvey
- Department of Hematology and Medical Oncology, Emory University School of Medicine; Winship Cancer Institute of Emory University , Atlanta, GA, USA.,Department of Pharmacology and Chemical Biology, Emory University School of Medicine , Atlanta, GA, USA
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14
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Tundo GR, Sbardella D, Santoro AM, Coletta A, Oddone F, Grasso G, Milardi D, Lacal PM, Marini S, Purrello R, Graziani G, Coletta M. The proteasome as a druggable target with multiple therapeutic potentialities: Cutting and non-cutting edges. Pharmacol Ther 2020; 213:107579. [PMID: 32442437 PMCID: PMC7236745 DOI: 10.1016/j.pharmthera.2020.107579] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 01/10/2023]
Abstract
Ubiquitin Proteasome System (UPS) is an adaptable and finely tuned system that sustains proteostasis network under a large variety of physiopathological conditions. Its dysregulation is often associated with the onset and progression of human diseases; hence, UPS modulation has emerged as a promising new avenue for the development of treatments of several relevant pathologies, such as cancer and neurodegeneration. The clinical interest in proteasome inhibition has considerably increased after the FDA approval in 2003 of bortezomib for relapsed/refractory multiple myeloma, which is now used in the front-line setting. Thereafter, two other proteasome inhibitors (carfilzomib and ixazomib), designed to overcome resistance to bortezomib, have been approved for treatment-experienced patients, and a variety of novel inhibitors are currently under preclinical and clinical investigation not only for haematological malignancies but also for solid tumours. However, since UPS collapse leads to toxic misfolded proteins accumulation, proteasome is attracting even more interest as a target for the care of neurodegenerative diseases, which are sustained by UPS impairment. Thus, conceptually, proteasome activation represents an innovative and largely unexplored target for drug development. According to a multidisciplinary approach, spanning from chemistry, biochemistry, molecular biology to pharmacology, this review will summarize the most recent available literature regarding different aspects of proteasome biology, focusing on structure, function and regulation of proteasome in physiological and pathological processes, mostly cancer and neurodegenerative diseases, connecting biochemical features and clinical studies of proteasome targeting drugs.
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Affiliation(s)
- G R Tundo
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
| | | | - A M Santoro
- CNR, Institute of Crystallography, Catania, Italy
| | - A Coletta
- Department of Chemistry, University of Aarhus, Aarhus, Denmark
| | - F Oddone
- IRCCS-Fondazione Bietti, Rome, Italy
| | - G Grasso
- Department of Chemical Sciences, University of Catania, Catania, Italy
| | - D Milardi
- CNR, Institute of Crystallography, Catania, Italy
| | - P M Lacal
- Laboratory of Molecular Oncology, IDI-IRCCS, Rome, Italy
| | - S Marini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - R Purrello
- Department of Chemical Sciences, University of Catania, Catania, Italy
| | - G Graziani
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - M Coletta
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
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15
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Listro R, Stotani S, Rossino G, Rui M, Malacrida A, Cavaletti G, Cortesi M, Arienti C, Tesei A, Rossi D, Giacomo MD, Miloso M, Collina S. Exploring the RC-106 Chemical Space: Design and Synthesis of Novel ( E)-1-(3-Arylbut-2-en-1-yl)-4-(Substituted) Piperazine Derivatives as Potential Anticancer Agents. Front Chem 2020; 8:495. [PMID: 32695745 PMCID: PMC7338850 DOI: 10.3389/fchem.2020.00495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/14/2020] [Indexed: 01/19/2023] Open
Abstract
Despite the fact that significant advances in treatment of common cancers have been achieved over the years, orphan tumors still represent an important unmet medical need. Due to their complex multifactorial origin and limited number of cases, such pathologies often have very limited treatment options and poor prognosis. In the search for new anticancer agents, our group recently identified RC-106, a Sigma receptor modulator endowed with proteasome inhibition activity. This compound showed antiproliferative activity toward different cancer cell lines, among them glioblastoma (GB) and multiple myeloma (MM), two currently unmet medical conditions. In this work, we directed our efforts toward the exploration of chemical space around RC-106 to identify new active compounds potentially useful in cancer treatment. Thanks to a combinatorial approach, we prepared 41 derivatives of the compound and evaluated their cytotoxic potential against MM and GB. Three novel potential anticancer agents have been identified.
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Affiliation(s)
- Roberta Listro
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Silvia Stotani
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy.,Medicinal Chemistry, Taros Chemicals GmbH and Co. KG, Dortmund, Germany
| | - Giacomo Rossino
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Marta Rui
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Alessio Malacrida
- Experimental Neurology Unit, School of Medicine and Surgery & Milan Center for Neuroscience, University of Milan Bicocca, Monza, Italy
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery & Milan Center for Neuroscience, University of Milan Bicocca, Monza, Italy
| | - Michela Cortesi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRCCS), Meldola, Italy
| | - Chiara Arienti
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRCCS), Meldola, Italy
| | - Anna Tesei
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRCCS), Meldola, Italy
| | - Daniela Rossi
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Marcello Di Giacomo
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Mariarosaria Miloso
- Experimental Neurology Unit, School of Medicine and Surgery & Milan Center for Neuroscience, University of Milan Bicocca, Monza, Italy
| | - Simona Collina
- Medicinal Chemistry and Pharmaceutical Technology Section, Department of Drug Sciences, University of Pavia, Pavia, Italy
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16
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Koh EY, You JE, Jung SH, Kim PH. Biological Functions and Identification of Novel Biomarker Expressed on the Surface of Breast Cancer-Derived Cancer Stem Cells via Proteomic Analysis. Mol Cells 2020; 43:384-396. [PMID: 32235022 PMCID: PMC7191048 DOI: 10.14348/molcells.2020.2230] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/09/2020] [Accepted: 01/28/2020] [Indexed: 02/08/2023] Open
Abstract
Breast cancer is one of the most common life-threatening malignancies and the top cause of cancer deaths in women. Although many conventional therapies exist for its treatment, breast cancer still has many handicaps to overcome. Cancer stem cells (CSCs) are a well-known cause of tumor recurrences due to the ability of CSCs for self-renewal and differentiation into cell subpopulations, similar to stem cells. To fully treat breast cancer, a strategy for the treatment of both cancer cells and CSCs is required. However, current strategies for the eradication of CSCs are non-specific and have low efficacy. Therefore, surface biomarkers to selectively treat CSCs need to be developed. Here, 34 out of 641 surface biomarkers on CSCs were identified by proteomic analysis between the human breast adenocarcinoma cell line MCF-7 and MCF-7-derived CSCs. Among them, carcinoembryonic antigen-related cell adhesion molecules 6 (CEACAM6 or CD66c), a member of the CEA family, was selected as a novel biomarker on the CSC surface. This biomarker was then experimentally validated and evaluated for use as a CSC-specific marker. Its biological effects were assessed by treating breast cancer stem cells (BCSCs) with short hairpin (sh)-RNA under oxidative cellular conditions. This study is the first to evaluate the biological function of CD66c as a novel biomarker on the surface of CSCs. This marker is available as a moiety for use in the development of targeted therapeutic agents against CSCs.
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Affiliation(s)
- Eun-Young Koh
- Department of Biomedical Laboratory Science, Konyang University, Daejeon 35365, Korea
| | - Ji-Eun You
- Department of Biomedical Laboratory Science, Konyang University, Daejeon 35365, Korea
| | - Se-Hwa Jung
- Department of Biomedical Laboratory Science, Konyang University, Daejeon 35365, Korea
| | - Pyung-Hwan Kim
- Department of Biomedical Laboratory Science, Konyang University, Daejeon 35365, Korea
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17
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Deng L, Meng T, Chen L, Wei W, Wang P. The role of ubiquitination in tumorigenesis and targeted drug discovery. Signal Transduct Target Ther 2020; 5:11. [PMID: 32296023 PMCID: PMC7048745 DOI: 10.1038/s41392-020-0107-0] [Citation(s) in RCA: 345] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 02/08/2023] Open
Abstract
Ubiquitination, an important type of protein posttranslational modification (PTM), plays a crucial role in controlling substrate degradation and subsequently mediates the "quantity" and "quality" of various proteins, serving to ensure cell homeostasis and guarantee life activities. The regulation of ubiquitination is multifaceted and works not only at the transcriptional and posttranslational levels (phosphorylation, acetylation, methylation, etc.) but also at the protein level (activators or repressors). When regulatory mechanisms are aberrant, the altered biological processes may subsequently induce serious human diseases, especially various types of cancer. In tumorigenesis, the altered biological processes involve tumor metabolism, the immunological tumor microenvironment (TME), cancer stem cell (CSC) stemness and so on. With regard to tumor metabolism, the ubiquitination of some key proteins such as RagA, mTOR, PTEN, AKT, c-Myc and P53 significantly regulates the activity of the mTORC1, AMPK and PTEN-AKT signaling pathways. In addition, ubiquitination in the TLR, RLR and STING-dependent signaling pathways also modulates the TME. Moreover, the ubiquitination of core stem cell regulator triplets (Nanog, Oct4 and Sox2) and members of the Wnt and Hippo-YAP signaling pathways participates in the maintenance of CSC stemness. Based on the altered components, including the proteasome, E3 ligases, E1, E2 and deubiquitinases (DUBs), many molecular targeted drugs have been developed to combat cancer. Among them, small molecule inhibitors targeting the proteasome, such as bortezomib, carfilzomib, oprozomib and ixazomib, have achieved tangible success. In addition, MLN7243 and MLN4924 (targeting the E1 enzyme), Leucettamol A and CC0651 (targeting the E2 enzyme), nutlin and MI-219 (targeting the E3 enzyme), and compounds G5 and F6 (targeting DUB activity) have also shown potential in preclinical cancer treatment. In this review, we summarize the latest progress in understanding the substrates for ubiquitination and their special functions in tumor metabolism regulation, TME modulation and CSC stemness maintenance. Moreover, potential therapeutic targets for cancer are reviewed, as are the therapeutic effects of targeted drugs.
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Affiliation(s)
- Lu Deng
- College of Animal Science and Technology, Northwest A&F University, Yangling Shaanxi, 712100, China.
| | - Tong Meng
- Division of Spine, Department of Orthopedics, Tongji Hospital Affiliated to Tongji University School of Medicine, 389 Xincun Road, Shanghai, China
| | - Lei Chen
- Division of Laboratory Safety and Services, Northwest A&F University, Yangling Shaanxi, 712100, China
| | - Wenyi Wei
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Ping Wang
- Tongji University Cancer Center, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200092, China.
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18
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Targeting the ubiquitin-proteasome pathway to overcome anti-cancer drug resistance. Drug Resist Updat 2020; 48:100663. [DOI: 10.1016/j.drup.2019.100663] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 02/07/2023]
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19
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Passero FC, Ravi D, McDonald JT, Beheshti A, David KA, Evens AM. Combinatorial ixazomib and belinostat therapy induces NFE2L2-dependent apoptosis in Hodgkin and T-cell lymphoma. Br J Haematol 2019; 188:295-308. [PMID: 31452195 DOI: 10.1111/bjh.16160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
Ixazomib activity and transcriptomic analyses previously established in T cell (TCL) and Hodgkin (HL) lymphoma models predicted synergistic activity for histone deacetylase (HDAC) inhibitory combination. In this present study, we determined the mechanistic basis for ixazomib combination with the HDAC inhibitor, belinostat, in HL and TCL cells lines (ixazomib-sensitive/resistant clones) and primary tumour cells. In ixazomib-treated TCL and HL cells, transient inhibition followed by full recovery of proteasomal activity observed was accompanied by induction of proteasomal gene expression with NFE2L2 (also termed NRF2) as a prominent upstream regulator. Downregulation of both NFE2L2 and proteasomal gene expression (validated by quantitative real time polymerase chain reaction) occurred with belinostat treatment in Jurkat and L428 cells. In addition, CRISPR/Cas9 mediated knockdown of NFE2L2 in Jurkat cells resulted in a significant decrease in cell viability with ixazomib compared with untreated control cells. Using transcriptomic and proteasomal activity evaluation of ixazomib, belinostat, or ixazomib + belinostat treated cells, we observed that NFE2L2, proteasome gene expression and functional recovery were abrogated by ixazomib + belinostat combination, resulting in synergistic drug activity in ixazomib-sensitive and -resistant cell lines and primary cells. Altogether, these results suggest that the synergistic activity of ixazomib + belinostat is mediated via inhibition NFE2L2-dependent proteasomal recovery and extended proteasomal inhibition culminating in increased cell death.
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Affiliation(s)
- Frank C Passero
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Dashnamoorthy Ravi
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Kevin A David
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Andrew M Evens
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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20
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Crisci S, Di Francia R, Mele S, Vitale P, Ronga G, De Filippi R, Berretta M, Rossi P, Pinto A. Overview of Targeted Drugs for Mature B-Cell Non-hodgkin Lymphomas. Front Oncol 2019; 9:443. [PMID: 31214498 PMCID: PMC6558009 DOI: 10.3389/fonc.2019.00443] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/09/2019] [Indexed: 12/15/2022] Open
Abstract
The improved knowledge of pathogenetic mechanisms underlying lymphomagenesis and the discovery of the critical role of tumor microenvironments have enabled the design of new drugs against cell targets and pathways. The Food and Drug Administration (FDA) has approved several monoclonal antibodies (mAbs) and small molecule inhibitors (SMIs) for targeted therapy in hematology. This review focuses on the efficacy results of the currently available targeted agents and recaps the main ongoing trials in the setting of mature B-Cell non-Hodgkin lymphomas. The objective is to summarize the different classes of novel agents approved for mature B-cell lymphomas, to describe in synoptic tables the results they achieved and, finally, to draw future scenarios as we glimpse through the ongoing clinical trials. Characteristics and therapeutic efficacy are summarized for the currently approved mAbs [i.e., anti-Cluster of differentiation (CD) mAbs, immune checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapy, and bispecific antibodies] as well as for SMIs i.e., inhibitors of B-cell receptor signaling, proteasome, mTOR BCL-2 HDAC pathways. The biological disease profiling of B-cell lymphoma subtypes may foster the discovery of innovative drug strategies for improving survival outcome in lymphoid neoplasms, as well as the trade-offs between efficacy and toxicity. The hope for clinical advantages should carefully be coupled with mindful awareness of the potential pitfalls and the occurrence of uneven, sometimes severe, toxicities.
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Affiliation(s)
- Stefania Crisci
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Raffaele Di Francia
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Sara Mele
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Pasquale Vitale
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Giuseppina Ronga
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Rosaria De Filippi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Paola Rossi
- Department of Biology and Biotechnology “L. Spallanzani,” University of Pavia, Pavia, Italy
| | - Antonio Pinto
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy
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21
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Romero-Aguilar KS, Arciniega-Martínez IM, Farfán-García ED, Campos-Rodríguez R, Reséndiz-Albor AA, Soriano-Ursúa MA. Effects of boron-containing compounds on immune responses: review and patenting trends. Expert Opin Ther Pat 2019; 29:339-351. [PMID: 31064237 DOI: 10.1080/13543776.2019.1612368] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Boron-containing compounds induce effects on immune responses. Such effects are interesting to the biomedical field for the development of therapeutic tools to modulate the immune system. AREAS COVERED The scope of BCC use to modify immune responses is expanding, mainly with regard to inflammatory diseases. The information was organized to demonstrate the breadth of reported effects. BCCs act as modulators of innate and adaptive immunity, with the former including regulation of cluster differentiation and cytokine production. In addition, BCCs exert effects on inflammation induced by infectious and noninfectious agents, and there are also reports regarding their effects on mechanisms involving hypersensitivity and transplants. Finally, the authors discuss the beneficial effects of BCCs on pathologies involving various targets and mechanisms. EXPERT OPINION Some BCCs are currently used as drugs in humans. The mechanisms by which these BCCs modulate immune responses, as well as the required structure-activity relationship for each observed mechanism of action, should be clarified. The former will allow for the development of improved immunomodulatory drugs with extensive applications in medicine. Patenting trends involve claims concerning the synthesis and actions of identified molecules with a defined profile regarding cytokines, cell differentiation, proliferation, and antibody production.
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Affiliation(s)
- Karla S Romero-Aguilar
- a Departamento de Fisiología, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
- b Departamento de Inmunología de Mucosas, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
| | - Ivonne M Arciniega-Martínez
- b Departamento de Inmunología de Mucosas, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
| | - Eunice D Farfán-García
- a Departamento de Fisiología, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
| | - Rafael Campos-Rodríguez
- b Departamento de Inmunología de Mucosas, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
| | - Aldo A Reséndiz-Albor
- b Departamento de Inmunología de Mucosas, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
| | - Marvin A Soriano-Ursúa
- a Departamento de Fisiología, Sección de Estudios de Posgrado e Investigación , Escuela Superior de Medicina del Instituto Politécnico Nacional , México City , México
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Smolewski P, Rydygier D. Ixazomib: an investigational drug for the treatment of lymphoproliferative disorders. Expert Opin Investig Drugs 2019; 28:421-433. [DOI: 10.1080/13543784.2019.1596258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Piotr Smolewski
- Department of Experimental Hematology, Medical University of Lodz, Lodz,
Poland
| | - Dominika Rydygier
- Department of Experimental Hematology, Medical University of Lodz, Lodz,
Poland
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23
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Aljoundi AK, Agoni C, Olotu FA, Soliman MES. Turning to Computer-aided Drug Design in the Treatment of Diffuse Large B-cell Lymphoma: Has it been Helpful? Anticancer Agents Med Chem 2019; 19:1325-1339. [PMID: 30950356 DOI: 10.2174/1871520619666190405111526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Amidst the numerous effective therapeutic options available for the treatment of Diffuse Large B-cell Lymphoma (DLBCL), about 30-40% of patients treated with first-line chemoimmunotherapy still experience a relapse or refractory DLBCL. This has necessitated a continuous search for new therapeutic agents to augment the existing therapeutic arsenal. METHODS The dawn of Computer-Aided Drug Design (CADD) in the drug discovery process has accounted for persistency in the application of computational approaches either alone or in combinatorial strategies with experimental methods towards the identification of potential hit compounds with high therapeutic efficacy in abrogating DLBCL. RESULTS This review showcases the interventions of structure-based and ligand-based computational approaches which have led to the identification of numerous small molecule inhibitors against implicated targets in DLBCL therapy, even though many of these potential inhibitors are piled-up awaiting further experimental validation and exploration. CONCLUSION We conclude that a successful and a conscious amalgamation of CADD and experimental approaches could pave the way for the discovery of the next generation potential leads in DLBCL therapy with improved activities and minimal toxicities.
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Affiliation(s)
- Aimen K Aljoundi
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa
| | - Clement Agoni
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa
| | - Fisayo A Olotu
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa
| | - Mahmoud E S Soliman
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4001, South Africa
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24
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The impact of NF-κB signaling on pathogenesis and current treatment strategies in multiple myeloma. Blood Rev 2019; 34:56-66. [DOI: 10.1016/j.blre.2018.11.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/14/2018] [Accepted: 11/22/2018] [Indexed: 12/13/2022]
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25
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Ip S, MacLaughlin CM, Joseph M, Mullaithilaga N, Yang G, Wang C, Walker GC. Dual-Mode Dark Field and Surface-Enhanced Raman Scattering Liposomes for Lymphoma and Leukemia Cell Imaging. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2019; 35:1534-1543. [PMID: 30350697 DOI: 10.1021/acs.langmuir.8b02313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Multifunctional probes are needed to characterize individual cells simultaneously by different techniques to provide complementary information. A preparative method and an in vitro demonstration of function are presented for a dual-function dark field microscopy/surface-enhanced Raman scattering (SERS) liposome probe for cancer. Liposomes composed of zwitterionic lipids are valuable both to limit biofouling and to serve as a modular matrix to incorporate a variety of functional molecules and hence are used here as vehicles for SERS-active materials. Dark field microscopy and SERS represent new combined functionalities for targeted liposomal probes. Two methods of antibody conjugation to SERS liposomes are demonstrated: (i) direct conjugation to functional groups on the SERS liposome surface and (ii) postinsertion of lipid-functionalized antibody fragments (Fabs) into preformed SERS liposomes. In vitro experiments targeting both lymphoma cell line LY10 and primary human chronic lymphocytic leukemia (CLL) cells demonstrate the usefulness of these probes as optical contrast agents in both dark field and Raman microscopy.
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Affiliation(s)
- Shell Ip
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario M5S3H6 , Canada
| | - Christina M MacLaughlin
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario M5S3H6 , Canada
| | - Michelle Joseph
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario M5S3H6 , Canada
| | - Nisa Mullaithilaga
- Department of Pathology and Laboratory Medicine , Mount Sinai Hospital and Faculty of Medicine, University of Toronto , 600 University Avenue , Toronto , Ontario M5G 1X5 , Canada
| | - Guisheng Yang
- Department of Pathology and Laboratory Medicine , Mount Sinai Hospital and Faculty of Medicine, University of Toronto , 600 University Avenue , Toronto , Ontario M5G 1X5 , Canada
| | - Chen Wang
- Department of Pathology and Laboratory Medicine , Mount Sinai Hospital and Faculty of Medicine, University of Toronto , 600 University Avenue , Toronto , Ontario M5G 1X5 , Canada
| | - Gilbert C Walker
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario M5S3H6 , Canada
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27
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Biotransformation of [ 14C]-ixazomib in patients with advanced solid tumors: characterization of metabolite profiles in plasma, urine, and feces. Cancer Chemother Pharmacol 2018; 82:803-814. [PMID: 30128949 DOI: 10.1007/s00280-018-3671-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/13/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE This metabolite profiling and identification analysis (part of a phase I absorption, distribution, metabolism, and excretion study) aimed to define biotransformation pathways and evaluate associated inter-individual variability in four patients with advanced solid tumors who received [14C]-ixazomib. METHODS After administration of a single 4.1-mg oral dose of [14C]-ixazomib (total radioactivity [TRA] ~ 500 nCi), plasma (at selected timepoints), urine, and fecal samples were collected before dosing and continuously over 0-168-h postdose, followed by intermittent collections on days 14, 21, 28, and 35. TRA analysis and metabolite profiling were performed using accelerator mass spectrometry. Radiolabeled metabolites were identified using liquid chromatography/tandem mass spectrometry. RESULTS Metabolite profiles were similar in plasma, urine, and feces samples across the four patients analyzed. All metabolites identified were de-boronated. In AUC0-816 h time-proportional pooled plasma, ixazomib (54.2% of plasma TRA) and metabolites M1 (18.9%), M3 (10.6%), and M2 (7.91%), were the primary components identified. M1 was the major metabolite, contributing to 31.1% of the 76.2% of the total dose excreted in urine and feces over 0-35-day postdose. As none of the identified metabolites had a boronic acid moiety, they are unlikely to be pharmacologically active. CONCLUSIONS Hydrolytic metabolism in conjunction with oxidative deboronation appears to be the principal process in the in vivo biotransformation pathways of ixazomib. The inference of formation-rate-limited clearance of ixazomib metabolites and the inferred lack of pharmacologic activity of identified circulating metabolites provides justification for use of parent drug concentrations/systemic exposure in clinical pharmacology analyses.
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28
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Rhodes J, Landsburg DJ. Small-Molecule Inhibitors for the Treatment of Diffuse Large B Cell Lymphoma. Curr Hematol Malig Rep 2018; 13:356-368. [DOI: 10.1007/s11899-018-0467-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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29
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Kumar SK, Buadi FK, LaPlant B, Halvorson A, Leung N, Kapoor P, Dingli D, Gertz MA, Go RS, Bergsagel PL, Lin Y, Dispenzieri A, Hwa YL, Fonder A, Hobbs M, Fonseca R, Hayman SR, Stewart AK, Lust JA, Mikhael J, Gonsalves W, Reeder C, Skacel T, Rajkumar SV, Lacy MQ. Phase 1/2 trial of ixazomib, cyclophosphamide and dexamethasone in patients with previously untreated symptomatic multiple myeloma. Blood Cancer J 2018; 8:70. [PMID: 30061664 PMCID: PMC6066484 DOI: 10.1038/s41408-018-0106-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/16/2018] [Accepted: 05/30/2018] [Indexed: 12/31/2022] Open
Abstract
Ixazomib is the first oral proteasome inhibitor to enter the clinic. Given the efficacy of bortezomib in combination with cyclophosphamide and dexamethasone, we studied the combination of ixazomib, cyclophosphamide and dexamethasone (ICd) in newly diagnosed multiple myeloma (NDMM) and patients with measurable disease, irrespective of transplant eligibility, were enrolled. The phase 1 was to determine the maximum tolerated dose (MTD) of cyclophosphamide in the combination. Patients received ixazomib 4 mg (days 1, 8, 15), dexamethasone 40 mg (days 1, 8, 15, 22), and cyclophosphamide 300 or 400 mg/m2 days 1, 8, 15, 22; cycles were 28 days. We enrolled 51 patients, 10 in phase 1 and 41 patients in phase 2. The median age was 64.5 years (range: 41–88); 29% had high or intermediate risk FISH. The MTD was 400 mg/m2 of cyclophosphamide weekly. The best confirmed response in all 48 patients included ≥ partial response in 77%, including ≥ VGPR in 35%; 3 patients had a sCR. The response rate for all 48 evaluable patients at 4-cycles was 71%; the median time to response was 1.9 months. Common adverse events included cytopenias, fatigue and GI intolerance. ICd is a convenient, all oral combination that is well tolerated and effective in NDMM.
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Affiliation(s)
- Shaji K Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
| | | | - Betsy LaPlant
- Department of Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Alese Halvorson
- Department of Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Nelson Leung
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - P Leif Bergsagel
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Yi Lisa Hwa
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Amie Fonder
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Miriam Hobbs
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Rafael Fonseca
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | | | - A Keith Stewart
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - John A Lust
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Joseph Mikhael
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | | | - Craig Reeder
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Tomas Skacel
- Takeda Pharmaceutical Company Limited, Osaka, Japan.,31st Medical Department Clinical Department of Haematology of the First Faculty of Medicine and General, Teaching Hospital Charles University, Praha, Czech Republic.,Clinical Department of Haematology of the First Faculty of Medicine and General Teaching Hospital, Charles University, Praha, Czech Republic
| | | | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
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30
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Ghobadi A, Rettig MP, Holt MS, Ritchey JK, Kennerly K, Chendamarai E, Eissenberg L, DiPersio JF. Ixazomib, an oral proteasome inhibitor, induces rapid mobilization of hematopoietic progenitor cells in mice. Blood 2018; 131:2594-2596. [PMID: 29695518 PMCID: PMC5992866 DOI: 10.1182/blood-2017-10-811620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Armin Ghobadi
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Michael P Rettig
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Matthew S Holt
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Julie K Ritchey
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Krista Kennerly
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Ezhilarasi Chendamarai
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Linda Eissenberg
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - John F DiPersio
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO
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31
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Abstract
Maintenance of protein homeostasis is a crucial process for the normal functioning of the cell. The regulated degradation of proteins is primarily facilitated by the ubiquitin proteasome system (UPS), a system of selective tagging of proteins with ubiquitin followed by proteasome-mediated proteolysis. The UPS is highly dynamic consisting of both ubiquitination and deubiquitination steps that modulate protein stabilization and degradation. Deregulation of protein stability is a common feature in the development and progression of numerous cancer types. Simultaneously, the elevated protein synthesis rate of cancer cells and consequential accumulation of misfolded proteins drives UPS addiction, thus sensitizing them to UPS inhibitors. This sensitivity along with the potential of stabilizing pro-apoptotic signaling pathways makes the proteasome an attractive clinical target for the development of novel therapies. Targeting of the catalytic 20S subunit of the proteasome is already a clinically validated strategy in multiple myeloma and other cancers. Spurred on by this success, promising novel inhibitors of the UPS have entered development, targeting the 20S as well as regulatory 19S subunit and inhibitors of deubiquitinating and ubiquitin ligase enzymes. In this review, we outline the manner in which deregulation of the UPS can cause cancer to develop, current clinical application of proteasome inhibitors, and the (pre-)clinical development of novel inhibitors of the UPS.
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Affiliation(s)
- Arjan Mofers
- Department of Medical and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden
| | - Paola Pellegrini
- Department of Medical and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden
| | - Stig Linder
- Department of Medical and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden. .,Cancer Center Karolinska, Department of Oncology and Pathology, Karolinska Institute, SE-171 76, Stockholm, Sweden.
| | - Pádraig D'Arcy
- Department of Medical and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
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32
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Accardi F, Toscani D, Costa F, Aversa F, Giuliani N. The Proteasome and Myeloma-Associated Bone Disease. Calcif Tissue Int 2018; 102:210-226. [PMID: 29080972 DOI: 10.1007/s00223-017-0349-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 10/19/2017] [Indexed: 12/21/2022]
Abstract
Bone disease is the hallmark of multiple myeloma (MM), a hematological malignancy characterized by osteolytic lesions due to a severe uncoupled and unbalanced bone remodeling with pronounced osteoblast suppression. Bone metastasis is also a frequent complication of solid tumors including advanced breast or prostate cancer. In the past years, the ubiquitin-proteasome pathway has been proved critical in regulating the balance between bone formation and bone resorption. Proteasome inhibitors (PIs) are a new class of drugs, currently used in the treatment of MM, that affect both tumor cells and bone microenvironment. Particularly, PIs stimulate osteoblast differentiation by human mesenchymal stromal cells and increase bone regeneration in mice. Interestingly, in vitro data indicate that PIs block MM-induced osteoblast and osteocyte cell death by targeting both apoptosis and autophagy. The preclinical data are supported by the following effects observed in MM patients treated with PIs: increase of bone alkaline phosphatase levels, normalization of the markers of bone turnover, and reduction of the skeletal-related events. Moreover, the histomorphometric data indicate that the treatment with bortezomib stimulates osteoblast formation and maintains osteocyte viability in MM patients. This review updates the evidence on the effects of PIs on bone remodeling and on cancer-induced bone disease while focusing on MM bone disease.
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Affiliation(s)
- Fabrizio Accardi
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
- Hematology and BMT Center, "Azienda Ospedaliero, Universitaria di Parma", Via Gramsci 14, 43126, Parma, Italy
| | - Denise Toscani
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Federica Costa
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Franco Aversa
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy
- Hematology and BMT Center, "Azienda Ospedaliero, Universitaria di Parma", Via Gramsci 14, 43126, Parma, Italy
| | - Nicola Giuliani
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
- Hematology and BMT Center, "Azienda Ospedaliero, Universitaria di Parma", Via Gramsci 14, 43126, Parma, Italy.
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33
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Boonstra PS, Avery P, Brown N, Hristov AC, Bailey NG, Kaminski MS, Phillips T, Devata S, Mayer T, Wilcox RA. A single center phase II study of ixazomib in patients with relapsed or refractory cutaneous or peripheral T-cell lymphomas. Am J Hematol 2017; 92:1287-1294. [PMID: 28842936 PMCID: PMC6116510 DOI: 10.1002/ajh.24895] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/09/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
The transcription factor GATA-3, highly expressed in many cutaneous T-cell lymphoma (CTCL) and peripheral T-cell lymphomas (PTCL), confers resistance to chemotherapy in a cell-autonomous manner. As GATA-3 is transcriptionally regulated by NF-κB, we sought to determine the extent to which proteasomal inhibition impairs NF-κB activation and GATA-3 expression and cell viability in malignant T cells. Proteasome inhibition, NF-κB activity, GATA-3 expression, and cell viability were examined in patient-derived cell lines and primary T-cell lymphoma specimens ex vivo treated with the oral proteasome inhibitor ixazomib. Significant reductions in cell viability, NF-κB activation, and GATA-3 expression were observed preclinically in ixazomib-treated cells. Therefore, an investigator-initiated, single-center, phase II study with this agent in patients with relapsed/refractory CTCL/PTCL was conducted. Concordant with our preclinical observations, a significant reduction in NF-κB activation and GATA-3 expression was observed in an exceptional responder following one month of treatment with ixazomib. While ixazomib had limited activity in this small and heterogeneous cohort of patients, inhibition of the NF-κB/GATA-3 axis in a single exceptional responder suggests that ixazomib may have utility in appropriately selected patients or in combination with other agents.
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Affiliation(s)
| | - Polk Avery
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Noah Brown
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | | | | | - Mark S. Kaminski
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Tycel Phillips
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Sumana Devata
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Tera Mayer
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
| | - Ryan A. Wilcox
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI
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Liu W, Chen J, Tamayo AT, Ruan C, Li L, Zhou S, Shen C, Young KH, Westin J, Davis RE, Hu S, Medeiros LJ, Ford RJ, Pham LV. Preclinical efficacy and biological effects of the oral proteasome inhibitor ixazomib in diffuse large B-cell lymphoma. Oncotarget 2017; 9:346-360. [PMID: 29416618 PMCID: PMC5787470 DOI: 10.18632/oncotarget.20378] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/08/2017] [Indexed: 01/01/2023] Open
Abstract
Despite advances in deciphering the molecular pathogenesis of diffuse large B-cell lymphoma (DLBCL), patients with relapsed/refractory disease, particularly those with adverse genetic features (e.g., mutated p53 or double hit lymphoma (DHL)) have very poor prognoses, and effective therapies are lacking. In this study we examined the preclinical efficacy and associated biological effects of the first oral proteasome inhibitor, ixazomib, in DLBCL in vitro and in vivo models. We demonstrated that ixazomib exhibited anti-tumor activities in 28 representative DLBCL cell lines, 10 primary DLBCL samples, and a DHL xenotransplant mouse model, at clinically achievable drug concentrations. Ixazomib sensitivity in DLBCL cells is correlated with immunoproteasomal activity; stimulating lymphoma cells with interferon gamma induced immunoproteasome activity and sensitized these cells to ixazomib. In addition, we showed that ixazomib induces apoptosis and the DNA damage response pathway, through activation of the checkpoint kinase 2 (CHK2). Hence, pharmacological inhibition of CHK2 enhances the anti-tumor activity of ixazomib in DLBCL cells. Our results indicate that ixazomib is an effective proteasome inhibitor active in DLBCL, including DHL, and its combination with a CHK2 inhibitor offers a potentially more robust therapeutic regimen for treatment-resistant DLBCL.
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Affiliation(s)
- Wei Liu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Pathology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Juan Chen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Archito T Tamayo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Changgeng Ruan
- Department of Pathology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Li Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shouhao Zhou
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Chan Shen
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jason Westin
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Richard E Davis
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Leonard J Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Richard J Ford
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lan V Pham
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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35
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Hanley MJ, Gupta N, Venkatakrishnan K, Bessudo A, Sharma S, O'Neil BH, Wang B, van de Velde H, Nemunaitis J. A Phase 1 Study to Assess the Relative Bioavailability of Two Capsule Formulations of Ixazomib, an Oral Proteasome Inhibitor, in Patients With Advanced Solid Tumors or Lymphoma. J Clin Pharmacol 2017; 58:114-121. [PMID: 28783865 DOI: 10.1002/jcph.987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 06/22/2017] [Indexed: 12/17/2022]
Abstract
The oral proteasome inhibitor ixazomib is approved in multiple countries in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least 1 prior therapy. Two oral capsule formulations of ixazomib have been used during clinical development. This randomized, 2-period, 2-sequence crossover study (Clinicaltrials.gov identifier NCT01454076) assessed the relative bioavailability of capsule B in reference to capsule A in adult patients with advanced solid tumors or lymphoma. The study was conducted in 2 parts. In cycle 1 (pharmacokinetic cycle), patients received a 4-mg dose of ixazomib as capsule A or capsule B on day 1, followed by a 4-mg dose of the alternate capsule formulation on day 15. Pharmacokinetic samples were collected over 216 hours postdose. After the pharmacokinetic cycle, patients could continue in the study and receive ixazomib (capsule B only) on days 1, 8, and 15 of each 28-day cycle. Twenty patients were enrolled; of these, 14 were included in the pharmacokinetic-evaluable population. Systemic exposures of ixazomib were similar after administration of capsule A or capsule B. The geometric least-squares mean ratios (capsule B versus capsule A) were 1.16 for Cmax (90% confidence interval [CI], 0.84-1.61) and 1.04 for AUC0-216 (90%CI, 0.91-1.18). The most frequently reported grade 3 drug-related adverse events were fatigue (15%) and nausea (10%); there were no grade 4 drug-related adverse events. These results support the combined analysis of data from studies that used either formulation of ixazomib during development.
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Affiliation(s)
- Michael J Hanley
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Neeraj Gupta
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Karthik Venkatakrishnan
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Alberto Bessudo
- California Cancer Associates for Research and Excellence, San Diego, CA, USA
| | - Sunil Sharma
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Bert H O'Neil
- Indiana University Simon Cancer Center, Indianapolis, IN, USA
| | - Bingxia Wang
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Helgi van de Velde
- Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
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Brayer J, Baz R. The potential of ixazomib, a second-generation proteasome inhibitor, in the treatment of multiple myeloma. Ther Adv Hematol 2017; 8:209-220. [PMID: 28694935 PMCID: PMC5495505 DOI: 10.1177/2040620717710171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 04/19/2017] [Indexed: 11/17/2022] Open
Abstract
The therapeutic armamentarium for multiple myeloma has recently benefited from the addition of several new agents (including second-generation proteasome inhibitors, monoclonal antibodies and histone deacetylase inhibitors). This review will focus on ixazomib, an orally bioavailable second-generation proteasome inhibitor. Specifically, we will review the preclinical data, clinical trial experience, potential indications as well as unanswered questions pertaining to this new agent in multiple myeloma.
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Affiliation(s)
- Jason Brayer
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Rachid Baz
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
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Thareja S, Zhu M, Ji X, Wang B. Boron-based small molecules in disease detection and treatment (2013–2016). HETEROCYCL COMMUN 2017. [DOI: 10.1515/hc-2017-0086] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AbstractRecent years have seen tremendous development in the design and synthesis of boron-based compounds as potential therapeutics and for detection applications. The present review highlights the most recent development of these boron-based small molecules, covering clinically used ixazomib, tavaborole, crisaborole and other molecules from 2013 to 2016.
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Affiliation(s)
- Suresh Thareja
- Department of Chemistry and Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, GA, USA
| | - Mengyuan Zhu
- Department of Chemistry and Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, GA, USA
| | - Xingyue Ji
- Department of Chemistry and Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, GA 30303, USA
| | - Binghe Wang
- Department of Chemistry and Center for Diagnostics and Therapeutics, Georgia State University, Atlanta, GA 30303, USA
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Sujobert P, Salles G, Bachy E. Molecular Classification of Diffuse Large B-cell Lymphoma: What Is Clinically Relevant? Hematol Oncol Clin North Am 2017; 30:1163-1177. [PMID: 27888873 DOI: 10.1016/j.hoc.2016.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Major progress in the understanding of diffuse large B-cell lymphoma (DLBCL) biology has been made in the last decade. Many specific compounds have now entered early phase clinical trials. However, further efforts are needed to find an accurate, fast, reproducible, and affordable technique to translate DLBCL subtype determination by gene expression profiles into clinical application. This article discusses the advantages and drawbacks of the currently available techniques of DLBCL subtype determination as well as important prognostic implications related to the cell of origin. Furthermore, the article provides a schematic description of how molecularly defined DLBCL subtypes could guide tailored therapy.
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Affiliation(s)
- Pierre Sujobert
- Laboratory of Hematology, Hospices Civils de Lyon, Hôpital Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite 69310, France; Université Claude Bernard Lyon1, Université de Lyon, Lyon, France; Centre de Recherche en Cancérologie de Lyon, INSERM 1052 CNRS 5286, Lyon, France
| | - Gilles Salles
- Université Claude Bernard Lyon1, Université de Lyon, Lyon, France; Centre de Recherche en Cancérologie de Lyon, INSERM 1052 CNRS 5286, Lyon, France; Department of Hematology, Hospices Civils de Lyon, Hôpital Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite 69310, France.
| | - Emmanuel Bachy
- Université Claude Bernard Lyon1, Université de Lyon, Lyon, France; Centre de Recherche en Cancérologie de Lyon, INSERM 1052 CNRS 5286, Lyon, France; Department of Hematology, Hospices Civils de Lyon, Hôpital Lyon Sud, 165 Chemin du Grand Revoyet, Pierre-Bénite 69310, France
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Posttransplant maintenance therapy in multiple myeloma: the changing landscape. Blood Cancer J 2017; 7:e545. [PMID: 28338672 PMCID: PMC5380907 DOI: 10.1038/bcj.2017.23] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/31/2017] [Indexed: 02/07/2023] Open
Abstract
Transplant-eligible patients with multiple myeloma (MM) now have extended survival after diagnosis owing to effective modern treatment strategies that include new agents in induction therapy, autologous stem cell transplant (ASCT), consolidation therapy and posttransplant maintenance therapy. Standard of care for newly diagnosed, fit patients includes ASCT and, often nowadays, posttransplant maintenance. Several large studies have shown the efficacy of maintenance with thalidomide, lenalidomide and bortezomib in the treatment scheme of MM with regards to prolonging progression-free survival and, to a lesser degree, overall survival. Herein we discuss the data currently available to support the use of maintenance therapy in patients after ASCT as well as the newer available agents that may be a part of its changing landscape in the years to come.
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40
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Zhang Z, Wang H, Yan M, Wang H, Zhang C. Novel copper complexes as potential proteasome inhibitors for cancer treatment (Review). Mol Med Rep 2016; 15:3-11. [PMID: 27959411 DOI: 10.3892/mmr.2016.6022] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/08/2016] [Indexed: 11/06/2022] Open
Abstract
The use of metal complexes in the pharmaceutical industry has recently increased and as a result, novel metal‑based complexes have initiated an interest as potential anticancer agents. Copper (Cu), which is an essential trace element in all living organisms, is important in maintaining the function of numerous proteins and enzymes. It has recently been demonstrated that Cu complexes may be used as tumor‑specific proteasome inhibitors and apoptosis inducers, by targeting the ubiquitin‑proteasome pathway (UPP). Cu complexes have demonstrated promising results in preclinical studies. The UPP is important in controlling the expression, activity and location of various proteins. Therefore, selective proteasome inhibition and apoptotic induction in cancer cells have been regarded as potential anticancer strategies. The present short review discusses recent progress in the development of Cu complexes, including clioquinol, dithiocarbamates and Schiff bases, as proteasome inhibitors for cancer treatment. A discussion of recent research regarding the understanding of metal inhibitors based on Cu and ligand platforms is presented.
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Affiliation(s)
- Zhen Zhang
- Institute of Antitumor Drug Research, School of Pharmacy, Jining Medical University, Rizhao, Shandong 276826, P.R. China
| | - Huiyun Wang
- Institute of Antitumor Drug Research, School of Pharmacy, Jining Medical University, Rizhao, Shandong 276826, P.R. China
| | - Maocai Yan
- Institute of Antitumor Drug Research, School of Pharmacy, Jining Medical University, Rizhao, Shandong 276826, P.R. China
| | - Huannan Wang
- Neurobiology Institute, Jining Medical University, Jining, Shandong 272100, P.R. China
| | - Chunyan Zhang
- Institute of Antitumor Drug Research, School of Pharmacy, Jining Medical University, Rizhao, Shandong 276826, P.R. China
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San-Miguel JF, Einsele H, Moreau P. The Role of Panobinostat Plus Bortezomib and Dexamethasone in Treating Relapsed or Relapsed and Refractory Multiple Myeloma: A European Perspective. Adv Ther 2016; 33:1896-1920. [PMID: 27677481 PMCID: PMC5083773 DOI: 10.1007/s12325-016-0413-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Indexed: 12/15/2022]
Abstract
Panobinostat is an oral pan-histone deacetylase inhibitor developed by Novartis. Panobinostat acts via epigenetic modification and inhibition of the aggresome pathway. In August 2015, the European Commission authorized panobinostat for use in combination with bortezomib and dexamethasone for the treatment of relapsed or relapsed and refractory multiple myeloma (MM) in patients who have received ≥2 prior regimens including bortezomib and an immunomodulatory drug. In January 2016, the National Institute for Health and Care Excellence recommended panobinostat for use in the same combination and patient population. The authorization and recommendation were based on results from the pivotal phase 3 PANORAMA 1 (NCT01023308) clinical trial, which demonstrated an improvement in median progression-free survival of 7.8 months for the three-drug combination compared with placebo plus bortezomib and dexamethasone in this patient population. This review will discuss the current treatment landscape for relapsed/refractory MM, the mechanism of action of panobinostat, clinical data supporting the European authorization, concerns about safety and strategies for mitigating toxicity, and how panobinostat fits into the current MM landscape in Europe. FUNDING Editorial support, funded by Novartis Pharmaceuticals.
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Affiliation(s)
| | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, University of Würzburg, Würzburg, Germany
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Randomized phase 2 trial of ixazomib and dexamethasone in relapsed multiple myeloma not refractory to bortezomib. Blood 2016; 128:2415-2422. [PMID: 27702799 DOI: 10.1182/blood-2016-05-717769] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/20/2016] [Indexed: 02/02/2023] Open
Abstract
Proteasome inhibitors have become an integral part of myeloma therapy. Considerable efforts have gone into optimizing this therapeutic approach to obtain maximal proteasome inhibition with least toxicity. Ixazomib is the first oral proteasome inhibitor to enter the clinic and has been studied as a single agent as well as in various combinations. The current trial was designed to examine the efficacy and toxicity of combining 2 different doses of ixazomib (4 mg and 5.5 mg given weekly for 3 of 4 weeks) with 40 mg weekly of dexamethasone, in relapsed myeloma. Seventy patients were enrolled, 35 patients randomly assigned to each ixazomib dose. Overall, 30 (43%; 95% confidence interval, 31-55) of the patients achieved a confirmed partial response or better, with 31% achieving a response with 4 mg and 54% with 5.5 mg of ixazomib. The median event-free survival (EFS) for the entire study population was 8.4 months; 1-year overall survival was 96%. The EFS was 5.7 months for patients with prior bortezomib exposure and 11.0 months for bortezomib-naïve patients. A grade 3 or 4 adverse event considered at least possibly related to treatment was seen in 11 (32%) patients at 4 mg and in 21 (60%) at 5.5 mg. Dose reductions were more frequent with 5.5 mg dose. Overall, the ixazomib with dexamethasone has good efficacy in relapsed myeloma, is well-tolerated and with higher response rate at 5.5 mg, albeit with more toxicity. This study was registered at www.clinicaltrials.gov as #NCT01415882.
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BH3 mimetic ABT-737 sensitizes colorectal cancer cells to ixazomib through MCL-1 downregulation and autophagy inhibition. Am J Cancer Res 2016; 6:1345-57. [PMID: 27429848 PMCID: PMC4937737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/19/2016] [Indexed: 01/07/2023] Open
Abstract
The proteasome inhibitor MLN9708 is an orally administered drug that is hydrolyzed into its active form, MLN2238 (ixazomib). Compared with Bortezomib, MLN2238 has a shorter proteasome dissociation half-life and a lower incidence and severity of peripheral neuropathy, which makes it an attractive candidate for colorectal cancer treatment. In the present study, we observed that MLN2238 induced autophagy, as evidenced by conversion of the autophagosomal marker LC3 from LC3I to LC3II, in colorectal cancer cell lines. Mcl-1, an anti-apoptotic Bcl-2 family protein, was markedly elevated after treating a colorectal cancer cell line with MLN2238. We proved that inhibiting Mcl-1 expression enhances MLN2238 induced apoptosis and negatively regulates autophagy. Co-administration of BH3 mimetic ABT-737 with MLN2238 synergistically kills colorectal cancer cells through MCL-1 neutralization and autophagy inhibition. Furthermore, the synergistic killing effect of the combination therapy is correlated with P53 status in colorectal cancer. These data highlight that the combination of ABT-737 with MLN9708 is a promising therapeutic strategy for human colorectal cancer.
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Zhang Z, Wang H, Wang Q, Yan M, Wang H, Bi C, Sun S, Fan Y. Anticancer activity and computational modeling of ternary copper (II) complexes with 3-indolecarboxylic acid and 1,10-phenanthroline. Int J Oncol 2016; 49:691-9. [DOI: 10.3892/ijo.2016.3542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/16/2016] [Indexed: 11/06/2022] Open
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Moreau P, Masszi T, Grzasko N, Bahlis NJ, Hansson M, Pour L, Sandhu I, Ganly P, Baker BW, Jackson SR, Stoppa AM, Simpson DR, Gimsing P, Palumbo A, Garderet L, Cavo M, Kumar S, Touzeau C, Buadi FK, Laubach JP, Berg DT, Lin J, Di Bacco A, Hui AM, van de Velde H, Richardson PG. Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med 2016; 374:1621-34. [PMID: 27119237 DOI: 10.1056/nejmoa1516282] [Citation(s) in RCA: 742] [Impact Index Per Article: 92.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Ixazomib is an oral proteasome inhibitor that is currently being studied for the treatment of multiple myeloma. METHODS In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 722 patients who had relapsed, refractory, or relapsed and refractory multiple myeloma to receive ixazomib plus lenalidomide-dexamethasone (ixazomib group) or placebo plus lenalidomide-dexamethasone (placebo group). The primary end point was progression-free survival. RESULTS Progression-free survival was significantly longer in the ixazomib group than in the placebo group at a median follow-up of 14.7 months (median progression-free survival, 20.6 months vs. 14.7 months; hazard ratio for disease progression or death in the ixazomib group, 0.74; P=0.01); a benefit with respect to progression-free survival was observed with the ixazomib regimen, as compared with the placebo regimen, in all prespecified patient subgroups, including in patients with high-risk cytogenetic abnormalities. The overall rates of response were 78% in the ixazomib group and 72% in the placebo group, and the corresponding rates of complete response plus very good partial response were 48% and 39%. The median time to response was 1.1 months in the ixazomib group and 1.9 months in the placebo group, and the corresponding median duration of response was 20.5 months and 15.0 months. At a median follow-up of approximately 23 months, the median overall survival has not been reached in either study group, and follow-up is ongoing. The rates of serious adverse events were similar in the two study groups (47% in the ixazomib group and 49% in the placebo group), as were the rates of death during the study period (4% and 6%, respectively); adverse events of at least grade 3 severity occurred in 74% and 69% of the patients, respectively. Thrombocytopenia of grade 3 and grade 4 severity occurred more frequently in the ixazomib group (12% and 7% of the patients, respectively) than in the placebo group (5% and 4% of the patients, respectively). Rash occurred more frequently in the ixazomib group than in the placebo group (36% vs. 23% of the patients), as did gastrointestinal adverse events, which were predominantly low grade. The incidence of peripheral neuropathy was 27% in the ixazomib group and 22% in the placebo group (grade 3 events occurred in 2% of the patients in each study group). Patient-reported quality of life was similar in the two study groups. CONCLUSIONS The addition of ixazomib to a regimen of lenalidomide and dexamethasone was associated with significantly longer progression-free survival; the additional toxic effects with this all-oral regimen were limited. (Funded by Millennium Pharmaceuticals; TOURMALINE-MM1 ClinicalTrials.gov number, NCT01564537.).
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Affiliation(s)
- Philippe Moreau
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Tamás Masszi
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Norbert Grzasko
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Nizar J Bahlis
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Markus Hansson
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Ludek Pour
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Irwindeep Sandhu
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Peter Ganly
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Bartrum W Baker
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Sharon R Jackson
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Anne-Marie Stoppa
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - David R Simpson
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Peter Gimsing
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Antonio Palumbo
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Laurent Garderet
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Michele Cavo
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Shaji Kumar
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Cyrille Touzeau
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Francis K Buadi
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Jacob P Laubach
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Deborah T Berg
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Jianchang Lin
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Alessandra Di Bacco
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Ai-Min Hui
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Helgi van de Velde
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
| | - Paul G Richardson
- From University Hospital Hôtel Dieu, Nantes (P.M., C.T.), the Department of Hematology, Institut Paoli-Calmettes, Marseille (A.-M.S.), and the Department of Hematology and Cell Therapy, Hospital Saint Antoine, Paris (L.G.) - all in France; the Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital, 3rd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (T.M.); the Department of Haemato-oncology and Bone Marrow Transplantation, Medical University of Lublin, and St. John's Cancer Center, Lublin, Poland (N.G.); Southern Alberta Cancer Research Institute, University of Calgary, Calgary (N.J.B.), and the Division of Hematology, Department of Medicine, University of Alberta, Edmonton (I.S.) - both in Canada; the Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden (M.H.); Hematology and Oncology, University Hospital Brno, Brno, Czech Republic (L.P.); the Department of Haematology, Christchurch Hospital, Christchurch (P. Ganly), the Department of Haematology, Palmerston North Hospital, Palmerston North, Manawatu (B.W.B.), the Department of Haematology, Middlemore Hospital, Auckland (S.R.J.), and the Department of Haematology, North Shore Hospital, Auckland (D.R.S.) - all in New Zealand; the Department of Hematology, University Hospital Rigshospitalet, Copenhagen (P. Gimsing); Myeloma Unit, Division of Hematology, University of Turin, Turin (A.P.), and Seràgnoli Institute of Haematology, Bologna University School of Medicine, St. Orsola-Malpighi University Hospital, Bologna (M.C.) - both in Italy; the Division of Hematology, Mayo Clinic, Rochester, MN (S.K., F.K.B.); and Dana-Farber Cancer Institute, Boston (J.P.L., P.G.R.), and Millennium Pharmaceuticals, Cambridge (D.T.B., J.L., A.D.B., A.-M.H., H.V.) - both in Massachusetts
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46
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Cornell RF, Kassim AA. Evolving paradigms in the treatment of relapsed/refractory multiple myeloma: increased options and increased complexity. Bone Marrow Transplant 2016; 51:479-91. [PMID: 26726946 PMCID: PMC4827007 DOI: 10.1038/bmt.2015.307] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 10/08/2015] [Accepted: 10/22/2015] [Indexed: 12/12/2022]
Abstract
The use of modern therapies such as thalidomide, bortezomib and lenalidomide coupled with upfront high-dose therapy and autologous stem cell transplant (ASCT) has resulted in improved survival in patients with newly diagnosed multiple myeloma (MM). However, patients with relapsed/refractory multiple myeloma (RRMM) often have poorer clinical outcomes and might benefit from novel therapeutic strategies. Emerging therapies, such as deacetylase inhibitors, monoclonal antibodies and new proteasome inhibitors, appear promising and may change the therapeutic landscape in RRMM. A limited number of studies has shown a benefit with salvage ASCT in patients with RRMM, although there remains ongoing debate about its timing and effectiveness. Improvement in transplant outcomes has re-ignited a debate on the timing and possible role for salvage ASCT and allogeneic stem cell transplant in RRMM. As the treatment options for management of patients with RRMM become increasingly complex, physicians must consider both disease- and patient-related factors in choosing the appropriate therapeutic approach, with the goal of improving efficacy while minimizing toxicity.
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Affiliation(s)
- R F Cornell
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - A A Kassim
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
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Gu C, Yang Y, Sompallae R, Xu H, Tompkins VS, Holman C, Hose D, Goldschmidt H, Tricot G, Zhan F, Janz S. FOXM1 is a therapeutic target for high-risk multiple myeloma. Leukemia 2016; 30:873-82. [PMID: 26648534 PMCID: PMC4826574 DOI: 10.1038/leu.2015.334] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/05/2015] [Accepted: 11/24/2015] [Indexed: 12/23/2022]
Abstract
The transcription factor forkhead box M1 (FOXM1) is a validated oncoprotein in solid cancers, but its role in malignant plasma cell tumors such as multiple myeloma (MM) is unknown. We analyzed publicly available MM data sets and found that overexpression of FOXM1 prognosticates inferior outcome in a subset (~15%) of newly diagnosed cases, particularly patients with high-risk disease based on global gene expression changes. Follow-up studies using human myeloma cell lines (HMCLs) as the principal experimental model system demonstrated that enforced expression of FOXM1 increased growth, survival and clonogenicity of myeloma cells, whereas knockdown of FOXM1 abolished these features. In agreement with that, constitutive upregulation of FOXM1 promoted HMCL xenografts in laboratory mice, whereas inducible knockdown of FOXM1 led to growth inhibition. Expression of cyclin-dependent kinase 6 (CDK6) and NIMA-related kinase 2 (NEK2) was coregulated with FOXM1 in both HMCLs and myeloma patient samples, suggesting interaction of these three genes in a genetic network that may lend itself to targeting with small-drug inhibitors for new approaches to myeloma therapy and prevention. These results establish FOXM1 as high-risk myeloma gene and provide support for the design and testing of FOXM1-targeted therapies specifically for the FOXM1(High) subset of myeloma.
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Affiliation(s)
- Chunyan Gu
- Basic Medical College, Nanjing University of Chinese Medicine, 210046 Nanjing, People’s Republic of China
- Department of Pathology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Ye Yang
- Basic Medical College, Nanjing University of Chinese Medicine, 210046 Nanjing, People’s Republic of China
- Department of Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Ramakrishna Sompallae
- Basic Medical College, Nanjing University of Chinese Medicine, 210046 Nanjing, People’s Republic of China
- Department of Bioinformatics Core Facility, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Hongwei Xu
- Department of Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Van S. Tompkins
- Department of Pathology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Carol Holman
- Department of Pathology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Dirk Hose
- Medizinische Klinik V, Universitätsklinikum Heidelberg
- Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Medizinische Klinik V, Universitätsklinikum Heidelberg
- Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany
| | - Guido Tricot
- Department of Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
- Holden Comprehensive Cancer Center, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Fenghuang Zhan
- Department of Internal Medicine, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
- Holden Comprehensive Cancer Center, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
| | - Siegfried Janz
- Department of Pathology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
- Holden Comprehensive Cancer Center, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, 52242 Iowa, USA
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48
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Gupta N, Hanley MJ, Venkatakrishnan K, Wang B, Sharma S, Bessudo A, Hui AM, Nemunaitis J. The Effect of a High-Fat Meal on the Pharmacokinetics of Ixazomib, an Oral Proteasome Inhibitor, in Patients With Advanced Solid Tumors or Lymphoma. J Clin Pharmacol 2016; 56:1288-95. [PMID: 26872892 PMCID: PMC5069578 DOI: 10.1002/jcph.719] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 11/22/2022]
Abstract
Ixazomib is the first oral proteasome inhibitor to be investigated in the clinic. This clinical study assessed whether the pharmacokinetics of ixazomib would be altered if administered after a high‐calorie, high‐fat meal. In a 2‐period, 2‐sequence, crossover study design, adult patients with advanced solid tumors or lymphoma received a 4‐mg oral dose of ixazomib as immediate‐release capsules on day 1 without food (fasted, administered following an overnight fast) or with food (fed, following consumption of a high‐calorie, high‐fat meal), followed by another dose on day 15 in the alternate food intake condition (fasted to fed or fed to fasted). Twenty‐four patients were enrolled; of these, 15 were included in the pharmacokinetic‐evaluable population. Administration of ixazomib after a high‐fat meal reduced both the rate and extent of absorption of ixazomib. Under fed conditions, the median time to peak plasma concentration (Tmax) of ixazomib was delayed by approximately 3 hours compared with administration in the fasted state (1.02 hours vs 4.0 hours), and there was a 28% reduction in total systemic exposure (area under the curve, AUC) and a 69% reduction in peak plasma concentration (Cmax). Together, the results support the administration of ixazomib on an empty stomach, at least 1 hour before or at least 2 hours after food. These recommendations are reflected in the United States Prescribing Information for ixazomib (clinicaltrials.gov identifier NCT01454076).
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Affiliation(s)
| | | | | | | | - Sunil Sharma
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Alberto Bessudo
- California Cancer Associates for Research and Excellence, San Diego, CA, USA
| | - Ai-Min Hui
- Millennium Pharmaceuticals, Cambridge, MA, USA
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Ravi D, Beheshti A, Abermil N, Passero F, Sharma J, Coyle M, Kritharis A, Kandela I, Hlatky L, Sitkovsky MV, Mazar A, Gartenhaus RB, Evens AM. Proteasomal Inhibition by Ixazomib Induces CHK1 and MYC-Dependent Cell Death in T-cell and Hodgkin Lymphoma. Cancer Res 2016; 76:3319-31. [PMID: 26988986 DOI: 10.1158/0008-5472.can-15-2477] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/29/2016] [Indexed: 12/19/2022]
Abstract
Proteasome-regulated NF-κB has been shown to be important for cell survival in T-cell lymphoma and Hodgkin lymphoma models. Several new small-molecule proteasome inhibitors are under various stages of active preclinical and clinical development. We completed a comprehensive preclinical examination of the efficacy and associated biologic effects of a second-generation proteasome inhibitor, ixazomib, in T-cell lymphoma and Hodgkin lymphoma cells and in vivo SCID mouse models. We demonstrated that ixazomib induced potent cell death in all cell lines at clinically achievable concentrations. In addition, it significantly inhibited tumor growth and improved survival in T-cell lymphoma and Hodgkin lymphoma human lymphoma xenograft models. Through global transcriptome analyses, proteasomal inhibition showed conserved overlap in downregulation of cell cycle, chromatin modification, and DNA repair processes in ixazomib-sensitive lymphoma cells. The predicted activity for tumor suppressors and oncogenes, the impact on "hallmarks of cancer," and the analysis of key significant genes from global transcriptome analysis for ixazomib strongly favored tumor inhibition via downregulation of MYC and CHK1, its target genes. Furthermore, in ixazomib-treated lymphoma cells, we identified that CHK1 was involved in the regulation of MYC expression through chromatin modification involving histone H3 acetylation via chromatin immunoprecipitation. Finally, using pharmacologic and RNA silencing of CHK1 or the associated MYC-related mechanism, we demonstrated synergistic cell death in combination with antiproteasome therapy. Altogether, ixazomib significantly downregulates MYC and induces potent cell death in T-cell lymphoma and Hodgkin lymphoma, and we identified that combinatorial therapy with anti-CHK1 treatment represents a rational and novel therapeutic approach. Cancer Res; 76(11); 3319-31. ©2016 AACR.
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Affiliation(s)
- Dashnamoorthy Ravi
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Afshin Beheshti
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Nasséra Abermil
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Frank Passero
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Jaya Sharma
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Michael Coyle
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Athena Kritharis
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Irawati Kandela
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois
| | - Lynn Hlatky
- Center of Cancer Systems Biology, Tufts University School of Medicine, Boston, Massachusetts
| | - Michail V Sitkovsky
- New England Inflammation and Tissue Protection Institute, Northeastern University, Boston, Massachusetts
| | - Andrew Mazar
- Chemistry of Life Processes Institute, Northwestern University, Evanston, Illinois
| | | | - Andrew M Evens
- Division of Hematology Oncology and Molecular Oncology Research Institute, Tufts Medical Center, Boston, Massachusetts.
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50
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Lub S, Maes K, Menu E, De Bruyne E, Vanderkerken K, Van Valckenborgh E. Novel strategies to target the ubiquitin proteasome system in multiple myeloma. Oncotarget 2016; 7:6521-37. [PMID: 26695547 PMCID: PMC4872730 DOI: 10.18632/oncotarget.6658] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/23/2015] [Indexed: 12/20/2022] Open
Abstract
Multiple myeloma (MM) is a hematological malignancy characterized by the accumulation of plasma cells in the bone marrow (BM). The success of the proteasome inhibitor bortezomib in the treatment of MM highlights the importance of the ubiquitin proteasome system (UPS) in this particular cancer. Despite the prolonged survival of MM patients, a significant amount of patients relapse or become resistant to therapy. This underlines the importance of the development and investigation of novel targets to improve MM therapy. The UPS plays an important role in different cellular processes by targeted destruction of proteins. The ubiquitination process consists of enzymes that transfer ubiquitin to proteins targeting them for proteasomal degradation. An emerging and promising approach is to target more disease specific components of the UPS to reduce side effects and overcome resistance. In this review, we will focus on different components of the UPS such as the ubiquitin activating enzyme E1, the ubiquitin conjugating enzyme E2, the E3 ubiquitin ligases, the deubiquitinating enzymes (DUBs) and the proteasome. We will discuss their role in MM and the implications in drug discovery for the treatment of MM.
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Affiliation(s)
- Susanne Lub
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ken Maes
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eline Menu
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke De Bruyne
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karin Vanderkerken
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Els Van Valckenborgh
- Laboratory of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
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