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Ulusan AM, Rajendran P, Dashwood WM, Yavuz OF, Kapoor S, Gustafson TA, Savage MI, Brown PH, Sei S, Mohammed A, Vilar E, Dashwood RH. Optimization of Erlotinib Plus Sulindac Dosing Regimens for Intestinal Cancer Prevention in an Apc-Mutant Model of Familial Adenomatous Polyposis (FAP). Cancer Prev Res (Phila) 2021; 14:325-336. [PMID: 33277315 PMCID: PMC8137519 DOI: 10.1158/1940-6207.capr-20-0262] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/29/2020] [Accepted: 11/19/2020] [Indexed: 01/15/2023]
Abstract
A clinical trial in patients with familial adenomatous polyposis (FAP) demonstrated that sulindac plus erlotinib (SUL+ERL) had good efficacy in the duodenum and colon, but toxicity issues raised concerns for long-term prevention. We performed a biomarker study in the polyposis in rat colon (Pirc) model, observing phosphorylated Erk inhibition in colon polyps for up to 10 days after discontinuing ERL+SUL administration. In a follow-up study lasting 16 weeks, significant reduction of colon and small intestine (SI) tumor burden was detected, especially in rats given 250 ppm SUL in the diet plus once-a-week intragastric dosing of ERL at 21 or 42 mg/kg body weight (BW). A long-term study further demonstrated antitumor efficacy in the colon and SI at 52 weeks, when 250 ppm SUL was combined with once-a-week intragastric administration of ERL at 10, 21, or 42 mg/kg BW. Tumor-associated matrix metalloproteinase-7 (Mmp7), tumor necrosis factor (Tnf), and early growth response 1 (Egr1) were decreased at 16 weeks by ERL+SUL, and this was sustained in the long-term study for Mmp7 and Tnf. Based on the collective results, the optimal dose combination of ERL 10 mg/kg BW plus 250 ppm SUL lacked toxicity, inhibited molecular biomarkers, and exhibited effective antitumor activity. We conclude that switching from continuous to once-per-week ERL, given at one-quarter of the current therapeutic dose, will exert good efficacy with standard-of-care SUL against adenomatous polyps in the colon and SI, with clinical relevance for patients with FAP before or after colectomy. PREVENTION RELEVANCE: This investigation concludes that switching from continuous to once-per-week erlotinib, given at one-quarter of the current therapeutic dose, will exert good efficacy with standard-of-care sulindac against adenomatous polyps in the colon and small intestine, with clinical relevance for patients with FAP before or after colectomy.
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Affiliation(s)
- Ahmet M Ulusan
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas
- Internal Medicine, Hackensack University Medical Center, Hackensack, New Jersey
| | - Praveen Rajendran
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas.
| | - Wan Mohaiza Dashwood
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas
| | - Omer F Yavuz
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas
| | - Sabeeta Kapoor
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas
| | - Trace A Gustafson
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas
| | - Michelle I Savage
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Powel H Brown
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shizuko Sei
- Chemopreventive Agent Development Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Altaf Mohammed
- Chemopreventive Agent Development Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - Eduardo Vilar
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Roderick H Dashwood
- Center for Epigenetics and Disease Prevention, Texas A&M Health Science Center, Houston, Texas.
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas
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El-Refai AM, Elhabak DM, Khashaba RA. More is Not Always Better in Hair Growth Factors. Epidermal Growth Factor: Hair Growth Factor Involved in Alopecia Areata Pathogenesis. Int J Trichology 2020; 12:182-187. [PMID: 33376288 PMCID: PMC7759056 DOI: 10.4103/ijt.ijt_51_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/27/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Alopecia areata (AA) is the second most frequent nonscarring alopecia after androgenetic alopecia; the trigger factor induces changes in the growth plate of hair bulb and leads to premature termination of anagen phase. Epidermal growth factor (EGF) can be the key molecule that participates in initiation and suppression of normal hair growth cycle. The role of EGF in the pathogenesis of AA is still uncertain. Aim of the Work: This aim is to estimate the serum level of EGF in patients with AA trying to detect its role in AA pathogenesis and correlate it with the disease severity. Subjects and Methods: This case–control study included 60 clinically diagnosed patients with AA with different variants and severities and 25 age- and sex-matched healthy controls. EGF level was measured using ELISA. Results: The mean serum EGF was statistically significantly higher in patients than of controls (P < 0.0003). The EGF level was higher in patients with disease duration >1 month than patients with disease duration ≤ 1 month, and it was higher in patients with high recurrence than patients without recurrence (P > 0.05). The EGF in patients of severe AA was statistically significantly higher than moderate AA patients, and moderate cases were higher than mild AA patients (P = 0.0001). Furthermore, the level of EGF with scalp involvement was higher; the highest serum level of EGF marker in S4 (75%-99%) hair loss then S3 (50%-74% hair loss), illustrated in table (4) followed by different percentage of hair loss, difference statistically significant. Conclusions: Elevated hair-specific growth factor as EGF is not always a good sign for hair growth and functioning promotor inducing hair recovery, but it may be linked to the pathogenesis of hair disorders as AA.
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Affiliation(s)
- Asmaa M El-Refai
- Department of Dermatology, Venereology and Andrology, Benha University, Banha, Egypt
| | - Doaa Mohamed Elhabak
- Department of Dermatology, Venereology and Andrology, Benha University, Banha, Egypt
| | - Rana Atef Khashaba
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Banha, Egypt
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Yang JCH, Camidge DR, Yang CT, Zhou J, Guo R, Chiu CH, Chang GC, Shiah HS, Chen Y, Wang CC, Berz D, Su WC, Yang N, Wang Z, Fang J, Chen J, Nikolinakos P, Lu Y, Pan H, Maniam A, Bazhenova L, Shirai K, Jahanzeb M, Willis M, Masood N, Chowhan N, Hsia TC, Jian H, Lu S. Safety, Efficacy, and Pharmacokinetics of Almonertinib (HS-10296) in Pretreated Patients With EGFR-Mutated Advanced NSCLC: A Multicenter, Open-label, Phase 1 Trial. J Thorac Oncol 2020; 15:1907-1918. [PMID: 32916310 DOI: 10.1016/j.jtho.2020.09.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Almonertinib (HS-10296) is a novel, third-generation EGFR tyrosine kinase inhibitor (EGFR TKI) that targets both EGFR-sensitizing and T790M resistance mutations. This first-in-human trial aimed to evaluate the safety, efficacy, and pharmacokinetics of almonertinib in patients with locally advanced or metastatic EGFR mutation-positive NSCLC that had progressed after pevious EGFR TKI therapy. METHODS This phase 1, open-label, multicenter clinical trial (NCT0298110) included dose-escalation (55, 110, 220, and 260 mg) and dose-expansion cohorts (55, 110, and 220 mg) with once daily oral administration of almonertinib. In each expansion cohort, tumor biopsies were obtained for the determination of EGFR T790M status. The safety, tolerability, antitumor activity, and pharmacokinetics of almonertinib were evaluated. RESULTS A total of 120 patients (26 patients in the dose-escalation cohort and 94 patients in the dose-expansion cohort) were enrolled. The maximum tolerated dose was not defined in the dose-escalation phase; the 260 mg regimen was not further evaluated in the dose-expansion phase owing to safety concerns and saturation of exposure. The most common treatment-related grade greater than or equal to 3 adverse events were increased blood creatine phosphokinase (10%) and increased alanine aminotransferase (3%). Among 94 patients with the EGFR T790M mutation in the dose-expansion cohort, the investigator-assessed objective response rate and disease control rate were 52% (95% confidence interval [CI]: 42-63) and 92% (95% CI: 84-96), respectively. Median progression-free survival was 11.0 months (95% CI: 9.5-not reached) months. CONCLUSIONS Almonertinib is safe, tolerable and effective for patients with locally advanced or metastatic NSCLC harboring the EGFR T790M mutation who were pretreated with EGFR TKIs.
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Affiliation(s)
- James Chih-Hsin Yang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
| | - D Ross Camidge
- Department of Medicine Division of Medical Oncology, University of Colorado Health, Aurora, Colorado
| | - Cheng-Ta Yang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, Republic of China
| | - Jianying Zhou
- Department of Respiratory Medicine, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Renhua Guo
- Department of Medical Oncology, Jiangsu Province Hospital, Nanjing, Jiangsu, People's Republic of China
| | - Chao-Hua Chiu
- Division of Thoracic Oncology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Gee-Chen Chang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | - Her-Shyong Shiah
- Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Yuan Chen
- Department of Oncology, Tongji Medical College of HUST, Wuhan, Hubei, China
| | - Chin-Chou Wang
- Department of Occupational Medicine, Chang Gung Memorial Hospital- Kaohsiung, Kaohsiung, Taiwan, Republic of China
| | - David Berz
- Department of Cellular Therapeutics, Beverly Hills Cancer Center, Beverly Hills, California
| | - Wu-Chou Su
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Nong Yang
- Department of Medical Oncology, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Ziping Wang
- Department of Chest Medicine, Beijing Cancer Hospital, Beijing, China
| | - Jian Fang
- Department of Chest Medicine, Beijing Cancer Hospital, Beijing, China
| | - Jianhua Chen
- Department of Medical Oncology, Hunan Cancer Hospital, Changsha, Hunan, China
| | - Petros Nikolinakos
- Department of Research, University Cancer & Blood Center, LLC, Athens, Georgia
| | - You Lu
- Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ajit Maniam
- Division of Hematology and Oncology, Pacific Cancer Medical Center Inc., Anaheim, California
| | - Lyudmila Bazhenova
- Department of Medicine, Moores Cancer Center, University of California San Diego Health, La Jolla, California
| | - Keisuke Shirai
- Department of Hematology and Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Mohammad Jahanzeb
- Department of Clinical Medicine, Hematology-Oncology, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Maurice Willis
- Department of Oncology, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Nehal Masood
- Department of Medical Oncology, MultiCare Regional Cancer Center, MultiCare Institute for Research and Innovation, Tacoma, Washington
| | - Naveed Chowhan
- Department of Research, Baptist Healthcare Systems Inc., Baptist Health Floyd, New Albany, Indiana
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Hong Jian
- Department of Oncology, Shanghai Chest Hospital, Shanghai, People's Republic of China
| | - Shun Lu
- Department of Oncology, Shanghai Chest Hospital, Shanghai, People's Republic of China
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Chmielinska JJ, Kramer JH, Mak IT, Spurney CF, Weglicki WB. Substance P receptor blocker, aprepitant, inhibited cutaneous and other neurogenic inflammation side effects of the EGFR1-TKI, erlotinib. Mol Cell Biochem 2019; 465:175-185. [PMID: 31853800 DOI: 10.1007/s11010-019-03677-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/07/2019] [Indexed: 01/11/2023]
Abstract
Cutaneous changes like rash and hair loss, as well as other neurogenic inflammation side effects, occur frequently during anticancer treatment with the epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), erlotinib. These adverse events may be so severe that they impair the patient's compliance with the treatment or even cause its discontinuation. In the current preclinical study, rats (9.2 weeks) were treated with erlotinib (10 mg/kg/day) ± aprepitant (2 mg/kg/day) for 12 weeks. Visual changes in the development of facial skin lesions/hair loss and SP-receptor expression (immunohistochemically) in facial skin tissue were assessed; also changes in plasma magnesium, 8-isoprostane, substance P (SP), neutrophil superoxide production, and cardiac function (echocardiography) were measured. Erlotinib lowered plasma magnesium 14%, elevated SP 65%, caused 3.7-fold higher basal superoxide production, 2.5-fold higher 8-isoprostane levels, 11.6% lower cardiac systolic, and 10.9% lower diastolic function. Facial dermatological changes (alopecia, skin reddening, scabbing, nose crusting) occurred by 4 weeks (± + to ++) in erlotinib-treated rats, and progressively worsened (±++ to +++) by week 12. Facial skin SP-receptor upregulation (78% higher) occurred in epidermal and hair follicle cells. All adverse effects were substantially and significantly mitigated by aprepitant, including a 62% lowering of skin SP-receptors (p < 0.05). Elevated SP levels mediated the side effects of erlotinib treatment, but aprepitant's significant prevention of the systemic and cutaneous adverse events indicates a novel potential therapy against the side effects of this anticancer treatment.
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Affiliation(s)
- Joanna J Chmielinska
- Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, 439A Ross Hall, 2300 I St., N.W., Washington, DC, 20037, USA.
| | - Jay H Kramer
- Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, 442 Ross Hall, 2300 I St., N.W., Washington, DC, 20037, USA.
| | - I-Tong Mak
- Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, 441 Ross Hall, 2300 I St., N.W., Washington, DC, 20037, USA.
| | - Christopher F Spurney
- Department of Pediatrics, The Children's National Medical Center, Washington, DC, 20010, USA
| | - William B Weglicki
- Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, 20037, USA
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Tailor A, Waddington JC, Meng X, Park BK. Mass Spectrometric and Functional Aspects of Drug–Protein Conjugation. Chem Res Toxicol 2016; 29:1912-1935. [DOI: 10.1021/acs.chemrestox.6b00147] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Arun Tailor
- MRC Center
for Drug Safety
Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United Kingdom
| | - James C. Waddington
- MRC Center
for Drug Safety
Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United Kingdom
| | - Xiaoli Meng
- MRC Center
for Drug Safety
Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United Kingdom
| | - B. Kevin Park
- MRC Center
for Drug Safety
Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Sherrington Building, Ashton Street, Liverpool L69 3GE, United Kingdom
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Dambach DM, Simpson NE, Jones TW, Brennan RJ, Pazdur R, Palmby TR. Nonclinical Evaluations of Small-Molecule Oncology Drugs: Integration into Clinical Dose Optimization and Toxicity Management. Clin Cancer Res 2016; 22:2618-22. [DOI: 10.1158/1078-0432.ccr-15-2645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/11/2016] [Indexed: 11/16/2022]
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Chandra SA, Stokes AH, Hailey R, Merrill CL, Melich DH, DeSmet K, Furst SM, Peterson RA, Mellon-Kusibab K, Adler RR. Dermal toxicity studies: factors impacting study interpretation and outcome. Toxicol Pathol 2014; 43:474-81. [PMID: 25389277 DOI: 10.1177/0192623314548765] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The field of dermal toxicity continues to evolve in order to accurately predict dermal (and systemic) responses in humans to topically applied chemicals. Although the testing methods have undergone extensive refinements, idiosyncrasies and unexpected issues during the conduct of these studies are not unusual due to the plethora of new vehicles available for formulating test substances, changing regulatory requirements, and introducting new strain and/or species of laboratory animals as no single species or method seems to suffice for evaluating skin toxicity. The objective of this article is to illustrate some pragmatic issues that should be considered during the conduct as well as interpretation of dermal toxicity studies. Routine procedure-related issues such as hair clipping, tape stripping, and wrapping the animal's torso to prevent oral ingestion can influence the interpretation. Excipients used in dermal toxicity studies may be nontoxic when used alone but complex dermal formulations can result in unexpected irritation and toxicity. In conclusion, interpretation and risk assessment of dermal toxicity studies should be done in a comprehensive manner, taking into account procedure-related impact on study results, unique species susceptibility, limitation of gross visual (naked eye) observation for evidence of toxicity, and normal anatomical variation.
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Affiliation(s)
- Sundeep A Chandra
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Alan H Stokes
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Rick Hailey
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Christine L Merrill
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - David H Melich
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Kristina DeSmet
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Sylvia M Furst
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | - Richard A Peterson
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | | | - Rick R Adler
- Safety Assessment, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
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Park SR, Davis M, Doroshow JH, Kummar S. Safety and feasibility of targeted agent combinations in solid tumours. Nat Rev Clin Oncol 2013; 10:154-68. [PMID: 23358316 DOI: 10.1038/nrclinonc.2012.245] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The plethora of novel molecular-targeted agents (MTAs) has provided an opportunity to selectively target pathways involved in carcinogenesis and tumour progression. Combination strategies of MTAs are being used to inhibit multiple aberrant pathways in the hope of optimizing antitumour efficacy and to prevent development of resistance. While the selection of specific agents in a given combination has been based on biological considerations (including the role of the putative targets in cancer) and the interactions of the agents used in combination, there has been little exploration of the possible enhanced toxicity of combinations resulting from alterations in multiple signalling pathways in normal cell biology. Owing to the complex networks and crosstalk that govern normal and tumour cell proliferation, inhibiting multiple pathways with MTA combinations can result in unpredictable disturbances in normal physiology. This Review focuses on the main toxicities and the lack of tolerability of some common MTA combinations, particularly where evidence of enhanced toxicity compared to either agent alone is documented or there is development of unexpected toxicity. Toxicities caused by MTA combinations highlight the need to introduce new preclinical testing paradigms early in the drug development process for the assessment of chronic toxicities resulting from such combinations.
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Affiliation(s)
- Sook Ryun Park
- Division of Cancer Treatment and Diagnosis, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 31, Room 3A44, 31 Center Drive, Bethesda, MD 20892, USA
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Mecklenburg L, Kusewitt D, Kolly C, Treumann S, Adams ET, Diegel K, Yamate J, Kaufmann W, Müller S, Danilenko D, Bradley A. Proliferative and non-proliferative lesions of the rat and mouse integument. J Toxicol Pathol 2013; 26:27S-57S. [PMID: 25035577 PMCID: PMC4091526 DOI: 10.1293/tox.26.27s] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) project is a joint initiative of the societies of toxicological pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North America (STP). Its aim is to develop an internationally-accepted nomenclature for proliferative and non-proliferative lesions in laboratory rodents. A widely accepted international harmonization of nomenclature in laboratory animals will decrease confusion among regulatory and scientific research organizations in different countries and will provide a common language to increase and enrich international exchanges of information among toxicologists and pathologists. The purpose of this publication is to provide a standardized nomenclature for classifying microscopical lesions observed in the integument of laboratory rats and mice. Example colour images are provided for most lesions. The standardized nomenclature presented in this document and additional colour images are also available electronically at http://www.goreni.org. The nomenclature presented herein is based on histopathology databases from government, academia, and industrial laboratories throughout the world, and covers lesions that develop spontaneously as well as those induced by exposure to various test materials. (DOI: 10.1293/tox.26.27S; J Toxicol Pathol 2013; 26: 27S-57S).
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Affiliation(s)
| | | | | | | | - E. Terence Adams
- Experimental Pathology Laboratories, Inc, Research Triangle
Park, North Carolina, USA
| | - Kelly Diegel
- Hoffmann La-Roche Nonclinical Safety, Nutley, New Jersey,
USA
| | | | | | - Susanne Müller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach,
Germany
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Abstract
INTRODUCTION The design of target-specific covalent inhibitors is conceptually attractive because of increased biochemical efficiency through covalency and increased duration of action that outlasts the pharmacokinetics of the agent. Although many covalent inhibitors have been approved or are in advanced clinical trials to treat indications such as cancer and hepatitis C, there is a general tendency to avoid them as drug candidates because of concerns regarding immune-mediated toxicity that can arise from indiscriminate reactivity with off-target proteins. AREAS COVERED The review examines potential reason(s) for the excellent safety record of marketed covalent agents and advanced clinical candidates for emerging therapeutic targets. A significant emphasis is placed on proteomic techniques and chemical/biochemical reactivity assays that aim to provide a systematic rank ordering of pharmacologic selectivity relative to off-target protein reactivity of covalent inhibitors. EXPERT OPINION While tactics to examine selective covalent modification of the pharmacologic target are broadly applicable in drug discovery, it is unclear whether the output from such studies can prospectively predict idiosyncratic immune-mediated drug toxicity. Opinions regarding an acceptable threshold of protein reactivity/body burden for a toxic electrophile and a non-toxic electrophilic covalent drug have not been defined. Increasing confidence in proteomic and chemical/biochemical reactivity screens will require a retrospective side-by-side profiling of marketed covalent drugs and electrophiles known to cause deleterious toxic effects via non-selective covalent binding.
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Affiliation(s)
- Amit S Kalgutkar
- Pharmacokinetics, Dynamics, and Metabolism Department, Pfizer Worldwide Research and Development, Cambridge, MA 02139, USA.
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Perez-Soler R, Zou Y, Li T, Ling YH. The Phosphatase Inhibitor Menadione (Vitamin K3) Protects Cells from EGFR Inhibition by Erlotinib and Cetuximab. Clin Cancer Res 2011; 17:6766-77. [DOI: 10.1158/1078-0432.ccr-11-0545] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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