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Dmukauskas M, Cioffi G, Waite KA, Mammoser AG, Sloan AE, Ma PC, Barnholtz-Sloan JS. Sex Difference in Disease-Related Adverse Events Post-Diagnosis of Lung Cancer Brain Metastases in Medicare Individuals ≥ 66 Years of Age. Cancers (Basel) 2024; 16:2986. [PMID: 39272844 PMCID: PMC11394199 DOI: 10.3390/cancers16172986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/21/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024] Open
Abstract
Sex differences are evident in adverse events (AEs) related to brain tumors, yet sex differences in AEs specific to brain metastases (BrMs) are underexplored. Lung cancer BrMs dominate among BrM, comprising over half of cases. This study examined sex differences in AEs associated with lung cancer BrMs in individuals aged 66 or older using the SEER-Medicare dataset. Multivariable logistic regression, adjusted for demographic factors and comorbidities, stratified by histological subtype, treatment, age, and year of diagnosis were used to analyze AEs among those with BrMs from primary lung tumors. Year of diagnosis was grouped into prior/post-2013, to account for shifts in treatment paradigms. The results showed nuanced sex-specific AEs. Females diagnosed post-2013 with small-cell, squamous-cell, or other non-small-cell carcinoma BrMs had a higher headache likelihood than males. Males with adenocarcinoma post-2013 were more likely to experience brain herniation. Females aged 76 and older with small-cell BrM exhibited increased vision difficulty risk compared to males of the same age, with no significant difference in other age groups. Males treated for adenocarcinoma faced heightened hemorrhagic stroke risk. This study reveals sex-specific disparities in AEs among older individuals with lung cancer BrMs, varying by histological subtype, age, diagnosis year, and treatment.
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Affiliation(s)
- Mantas Dmukauskas
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Gino Cioffi
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Kristin A Waite
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Aaron G Mammoser
- Neuroscience Service Line and Piedmont Brain Tumor Center, Piedmont Health, Atlanta, GA 30309, USA
| | - Andrew E Sloan
- Neuroscience Service Line and Piedmont Brain Tumor Center, Piedmont Health, Atlanta, GA 30309, USA
| | - Patrick C Ma
- Penn State Cancer Institute, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Penn State University, Hershey, PA 17033, USA
| | - Jill S Barnholtz-Sloan
- Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
- Center for Biomedical Informatics and Information Technology, National Cancer Institute, Rockville, MD 20892, USA
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2
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Mushtaq A, Wu P, Naseer MM. Recent drug design strategies and identification of key heterocyclic scaffolds for promising anticancer targets. Pharmacol Ther 2024; 254:108579. [PMID: 38160914 DOI: 10.1016/j.pharmthera.2023.108579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
Cancer, a noncommunicable disease, is the leading cause of mortality worldwide and is anticipated to rise by 75% in the next two decades, reaching approximately 25 million cases. Traditional cancer treatments, such as radiotherapy and surgery, have shown limited success in reducing cancer incidence. As a result, the focus of cancer chemotherapy has switched to the development of novel small molecule antitumor agents as an alternate strategy for combating and managing cancer rates. Heterocyclic compounds are such agents that bind to specific residues in target proteins, inhibiting their function and potentially providing cancer treatment. This review focuses on privileged heterocyclic pharmacophores with potent activity against carbonic anhydrases and kinases, which are important anticancer targets. Evaluation of ongoing pre-clinical and clinical research of heterocyclic compounds with potential therapeutic value against a variety of malignancies as well as the provision of a concise summary of the role of heterocyclic scaffolds in various chemotherapy protocols have also been discussed. The main objective of the article is to highlight key heterocyclic scaffolds involved in recent anticancer drug design that demands further attention from the drug development community to find more effective and safer targeted small-molecule anticancer agents.
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Affiliation(s)
- Alia Mushtaq
- Department of Chemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Peng Wu
- Chemical Genomics Centre, Max Planck Institute of Molecular Physiology, Otto-Hahn Str. 11, Dortmund 44227, Germany
| | - Muhammad Moazzam Naseer
- Department of Chemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan; Chemical Genomics Centre, Max Planck Institute of Molecular Physiology, Otto-Hahn Str. 11, Dortmund 44227, Germany.
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3
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Fischer M, Luck M, Werle M, Vogel A, Bashawat M, Ludwig K, Scheidt HA, Müller P. The small-molecule kinase inhibitor ceritinib, unlike imatinib, causes a significant disturbance of lipid membrane integrity: A combined experimental and MD study. Chem Phys Lipids 2023; 257:105351. [PMID: 37863350 DOI: 10.1016/j.chemphyslip.2023.105351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023]
Abstract
Ceritinib and imatinib are small-molecule protein kinase inhibitors which are applied as therapeutic agents against various diseases. The fundamentals of their clinical use, i.e. their pharmacokinetics as well as the mechanisms of the inhibition of the respective kinases, are relatively well studied. However, the interaction of the drugs with membranes, which can be a possible cause of side effects, has hardly been investigated so far. Therefore, we have characterized the interaction of both drugs with lipid membranes consisting of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) in the absence and in the presence of cholesterol. For determining the membrane impact of both drugs on a molecular level, different experimental (NMR, ESR, fluorescence) and theoretical (MD simulations) approaches were applied. The data show that ceritinib, in contrast to imatinib, interacts more effectively with membranes significantly affecting various physico-chemical membrane parameters like membrane order and transmembrane permeation of polar solutes. The pronounced membrane impact of ceritinib can be explained by a strong affinity of the drug towards POPC which competes with the POPC-cholesterol interaction by that attenuating the ordering effect of cholesterol. The data are relevant for understanding putative toxic and cytotoxic side effects of these drugs such as the triggering of cell lysis or apoptosis.
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Affiliation(s)
- Markus Fischer
- Leipzig University, Institute for Medical Physics and Biophysics, Härtelstr. 16-18, D-04107 Leipzig, Germany
| | - Meike Luck
- Humboldt University Berlin, Department of Biology, Invalidenstr. 42, D-10115 Berlin, Germany
| | - Max Werle
- Humboldt University Berlin, Department of Biology, Invalidenstr. 42, D-10115 Berlin, Germany
| | - Alexander Vogel
- Leipzig University, Institute for Medical Physics and Biophysics, Härtelstr. 16-18, D-04107 Leipzig, Germany
| | - Mohammad Bashawat
- Humboldt University Berlin, Department of Biology, Invalidenstr. 42, D-10115 Berlin, Germany
| | - Kai Ludwig
- Freie Universität Berlin, Research Center for Electron Microscopy and Core Facility BioSupraMol, Institute of Chemistry and Biochemistry, Fabeckstr. 36a, D-14195 Berlin, Germany
| | - Holger A Scheidt
- Leipzig University, Institute for Medical Physics and Biophysics, Härtelstr. 16-18, D-04107 Leipzig, Germany.
| | - Peter Müller
- Humboldt University Berlin, Department of Biology, Invalidenstr. 42, D-10115 Berlin, Germany.
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4
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Talay Pınar P, Uzun G, Şentürk Z. First electrochemical investigation of new generation antineoplastic agent ceritinib at a boron-doped diamond electrode based on the pre-enrichment effect of anionic surfactant. JOURNAL OF THE IRANIAN CHEMICAL SOCIETY 2023. [DOI: 10.1007/s13738-023-02792-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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5
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Gupta P, Makkar TK, Goel L, Pahuja M. Role of inflammation and oxidative stress in chemotherapy-induced neurotoxicity. Immunol Res 2022; 70:725-741. [PMID: 35859244 DOI: 10.1007/s12026-022-09307-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
Chemotherapeutic agents may adversely affect the nervous system, including the neural precursor cells as well as the white matter. Although the mechanisms are not completely understood, several hypotheses connecting inflammation and oxidative stress with neurotoxicity are now emerging. The proposed mechanisms differ depending on the class of drug. For example, toxicity due to cisplatin occurs due to activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), which alters hippocampal long-term potentiation. Free radical injury is also involved in the cisplatin-mediated neurotoxicity as dysregulation of nuclear factor erythroid 2-related factor 2 (Nrf2) has been seen which protects against the free radical injury by regulating glutathione S-transferases and hemeoxygenase-1 (HO-1). Thus, correcting the imbalance between NF-κB and Nrf2/HO-1 pathways may alleviate cisplatin-induced neurotoxicity. With newer agents like bortezomib, peripheral neuropathy occurs due to up-regulation of TNF-α and IL-6 in the sensory neurons. Superoxide dismutase dysregulation is also involved in bortezomib-induced neuropathy. This article reviews the available literature on inflammation and oxidative stress in neurotoxicity caused by various classes of chemotherapeutic agents. It covers the conventional medicines like platinum compounds, vinca alkaloids, and methotrexate, as well as the newer therapeutic agents like immunomodulators and immune checkpoint inhibitors. A better understanding of the pathophysiology will lead to further advancement in strategies for management of chemotherapy-induced neurotoxicity.
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Affiliation(s)
- Pooja Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, 110029, India. .,Coordinator, AIIMS Adverse Drug Reaction Monitoring Centre, Pharmacovigilance Program of India, New Delhi, India.
| | - Tavneet Kaur Makkar
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Lavisha Goel
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Monika Pahuja
- Division of Basic Medical Sciences, Indian Council of Medical Research, New Delhi, India
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6
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Miao R, Dong X, Liu XY, Lo SL, Mei XY, Dang Q, Cai J, Li S, Yang K, Xie SL, Liang Y. Dynamic Meta-data Network Sparse PCA for Cancer Subtype Biomarker Screening. Front Genet 2022; 13:869906. [PMID: 35711917 PMCID: PMC9197542 DOI: 10.3389/fgene.2022.869906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022] Open
Abstract
Previous research shows that each type of cancer can be divided into multiple subtypes, which is one of the key reasons that make cancer difficult to cure. Under these circumstances, finding a new target gene of cancer subtypes has great significance on developing new anti-cancer drugs and personalized treatment. Due to the fact that gene expression data sets of cancer are usually high-dimensional and with high noise and have multiple potential subtypes’ information, many sparse principal component analysis (sparse PCA) methods have been used to identify cancer subtype biomarkers and subtype clusters. However, the existing sparse PCA methods have not used the known cancer subtype information as prior knowledge, and their results are greatly affected by the quality of the samples. Therefore, we propose the Dynamic Metadata Edge-group Sparse PCA (DM-ESPCA) model, which combines the idea of meta-learning to solve the problem of sample quality and uses the known cancer subtype information as prior knowledge to capture some gene modules with better biological interpretations. The experiment results on the three biological data sets showed that the DM-ESPCA model can find potential target gene probes with richer biological information to the cancer subtypes. Moreover, the results of clustering and machine learning classification models based on the target genes screened by the DM-ESPCA model can be improved by up to 22–23% of accuracies compared with the existing sparse PCA methods. We also proved that the result of the DM-ESPCA model is better than those of the four classic supervised machine learning models in the task of classification of cancer subtypes.
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Affiliation(s)
- Rui Miao
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Xin Dong
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Xiao-Ying Liu
- Computer Engineering Technical College, Guangdong Polytechnic of Science and Technology, Zhuhai, China
| | - Sio-Long Lo
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Xin-Yue Mei
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Qi Dang
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Jie Cai
- Institute of Systems Engineering, Macau University of Science and Technology, Avenida Wai Long, Taipa, China
| | - Shao Li
- MOE Key Laboratory of Bioinformatics, TCM-X Center/Bioinformatics Division, BNRIST/Department of Automation, Tsinghua University, Beijing, China
| | - Kuo Yang
- MOE Key Laboratory of Bioinformatics, TCM-X Center/Bioinformatics Division, BNRIST/Department of Automation, Tsinghua University, Beijing, China
| | - Sheng-Li Xie
- Guangdong-HongKong-Macao Joint Laboratory for Smart Discrete Manufacturing, Guangzhou, China
| | - Yong Liang
- Peng Cheng Laboratory, Shenzhen, China
- *Correspondence: Yong Liang,
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7
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Yang X, Wu C, Su W, Yu J. Mechanochemical C−X/C−H Functionalization: An Alternative Strategy Access to Pharmaceuticals. European J Org Chem 2022. [DOI: 10.1002/ejoc.202101440] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Xinjie Yang
- Zhejiang University of Technology Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals Chaowang Road 18# 310014 Hangzhou CHINA
| | - Chongyang Wu
- Zhejiang University of Technology Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals Chaowang Road 18# 310014 Hangzhou CHINA
| | - Weike Su
- Zhejiang University of Technology Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals Chaowang Road 18# 310014 Hangzhou CHINA
| | - Jingbo Yu
- Zhejiang University of Technology Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals Chaowang Road 18# 310014 Hangzhou CHINA
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8
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Sofi FA, Bharatam PV. Synthesis of Drugs and Biorelevant N-heterocycles Employing Recent Advances in C-N Bond Formation. CURR ORG CHEM 2020. [DOI: 10.2174/1385272824999200909114144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
C-N bond formation is a particularly important step in the generation of many
biologically relevant heterocyclic molecules. Several methods have been reported for this
purpose over the past few decades. Well-known named reactions like Ullmann-Goldberg
coupling, Buchwald-Hartwig coupling and Chan-Lam coupling are associated with the C-N
bond formation reactions. Several reviews covering this topic have already been published.
However, no comprehensive review covering the synthesis of drugs/ lead compounds using
the C-N bond formation reactions was reported. In this review, we cover many modern
methods of the C-N bond formation reactions, with special emphasis on metal-free and
green chemistry methods. We also report specific strategies adopted for the synthesis of
drugs, which involve the C-N bond formation reactions. Examples include anti-cancer,
antidepressant, anti-inflammatory, anti-atherosclerotic, anti-histaminic, antibiotics, antibacterial, anti-rheumatic,
antiepileptic and anti-diabetic agents. Many recently developed lead compounds generated using the C-N bond
formation reactions are also covered in this review. Examples include MAP kinase inhibitors, TRKs inhibitors,
Polo-like Kinase inhibitors and MPS1 inhibitors.
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Affiliation(s)
- Firdoos Ahmad Sofi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S Nagar 160 062, Punjab, India
| | - Prasad V. Bharatam
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S Nagar 160 062, Punjab, India
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9
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Wang BL, Kou SB, Lin ZY, Shi JH. Insight into the binding behavior of ceritinib on human α-1 acid glycoprotein: Multi-spectroscopic and molecular modeling approaches. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2020; 232:118160. [PMID: 32113179 DOI: 10.1016/j.saa.2020.118160] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/03/2020] [Accepted: 02/16/2020] [Indexed: 06/10/2023]
Abstract
Ceritinib is a second-generation anaplastic lymphoma kinase (ALK) inhibitor for mainly treating non-small cell lung cancer (NSCLC). This investigation focused on to clarify in detail the binding behavior between human α-1 acid glycoprotein (HAG) and ceritinib by means of multi-spectroscopic and molecular modeling approaches. Fluorescence data obtained at four different temperatures indicated ceritinib quenched the endogenous fluorescence of HAG by a static quenching mechanism. Based on the Kb value at 105 M-1 level, it can be inferred that the binding affinity between both is strong. From findings of thermodynamic parameter analysis, the competitive experiments with ANS and sucrose as well as molecular dynamic (MD) simulation, it can be inferred that hydrophobicity, hydrogen bonding, van der Waals forces as well as electrostatic interactions exist in the binding interaction between ceritinib and HAG. The findings from UV absorption, circular dichroism, and synchronous fluorescence spectroscopy indicated that the change in the microenvironment around the protein structure, secondary structure and tryptophan residues occurred after interaction with ceritinib. The data from FRET analysis confirmed that the non-radiative energy transfer between the two existed and the binding distance between the acceptor (ceritinib) and donor (HAG) was 2.11 nm. Meantime, the influence of Ca2+, Cu2+, Ni2+, Co2+, and Zn2+ ions on the binding interaction of ceritinib with HAG were obvious, especially Zn2+ ion.
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Affiliation(s)
- Bao-Li Wang
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China
| | - Song-Bo Kou
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China
| | - Zhen-Yi Lin
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China
| | - Jie-Hua Shi
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310032, China.
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10
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Jamshed MB, Munir F, Shahid N, Sadiq U, Muhammad SA, Ghanem NB, Zhong H, Li X, Zhang Q. Antitumor activity and combined inhibitory effect of ceritinib with gemcitabine in pancreatic cancer. Am J Physiol Gastrointest Liver Physiol 2020; 318:G109-G119. [PMID: 31736340 DOI: 10.1152/ajpgi.00130.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Pancreatic cancer (PC) is predominantly incurable and is primarily treated with gemcitabine, but drug resistance commonly develops. Thus, new medicines are needed. Ceritinib (LDK378) is a second-generation tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) with antitumor activity in various cancers. However, studies involving ceritinib for the treatment of PC are inadequate. We analyzed the combined effects of ceritinib and gemcitabine on PC and their mechanism of action. Three PC cell lines were used to evaluate the antitumor effects of ceritinib combined with gemcitabine. We analyzed cell viability using CCK-8 assays, determined apoptosis levels through flow cytometry, and analyzed autophagy and cell signaling pathways by Western blotting and tissue array analysis with samples from xenograft models. Ceritinib strongly inhibited the proliferation of PC cells in a dose-dependent manner, induced apoptosis, and inhibited autophagy and cell migration by regulating relevant factors. Ceritinib in combination with gemcitabine exhibited significant growth inhibition and additive antitumor effects in vitro. In vivo, gemcitabine and ceritinib reduced tumor size by up to 30%. In our study, ALK was shown to be highly expressed in various PC cells and tissues. Ceritinib strongly inhibited the levels of activated ALK in PC cells with subsequent effects on the downstream mediators STAT3, AKT, and ERK. In addition, ceritinib inhibited tumor progression in xenograft models. Overall, our research shows that ceritinib inhibits the ALK signaling pathway, leading to cell growth/angiogenesis inhibition in PC and the induction of apoptosis. We recommend using ceritinib as a new treatment for PC.NEW & NOTEWORTHY These data proved that ceritinib inhibits the anaplastic lymphoma kinase signaling pathway, leading to cell growth/angiogenesis inhibition and the induction of apoptosis by inhibiting STAT3, AKT, and ERK pathway in pancreatic cancer (PC). We recommend using ceritinib as a new treatment for PC.
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Affiliation(s)
- Muhammad Babar Jamshed
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.,School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Fahad Munir
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Numan Shahid
- Department of General Surgery, The School of International Studies of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Ussama Sadiq
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Syed Aun Muhammad
- Institute of Molecular Biology and Biotechnology, Bahaudin Zakariya University, Multan, Pakistan
| | - Noor Bader Ghanem
- The School of International Studies of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Hong Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Xiaokun Li
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qiyu Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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11
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Ahmed NM, Youns M, Soltan MK, Said AM. Design, synthesis, molecular modelling, and biological evaluation of novel substituted pyrimidine derivatives as potential anticancer agents for hepatocellular carcinoma. J Enzyme Inhib Med Chem 2019; 34:1110-1120. [PMID: 31117890 PMCID: PMC6537702 DOI: 10.1080/14756366.2019.1612889] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
New anticancer agents are highly needed to overcome cancer cell resistance. A novel series of pyrimidine pyrazoline-anthracene derivatives (PPADs) (4a-t) were designed and synthesised. The anti-liver cancer activity of all compounds was screened in vitro against two hepatocellular carcinoma (HCC) cell lines (HepG2 and Huh-7) as well as normal fibroblast cells by resazurin assay. The designed compounds 4a-t showed a broad-spectrum anticancer activity against the two cell lines and their activity was more prominent on cancer compared to normal cells. Compound 4e showed high potency against HepG2 and Huh-7 cell lines ((IC50=5.34 and 6.13 μg/mL, respectively) comparable to that of doxorubicin (DOX) activities. A structure activity relationship (SAR) has been investigated and compounds 4e, 4i, 4m, and 4q were the most promising anticancer agents against tested cell lines. These compounds induced apoptosis in HepG2 and Huh-7 cells through significant activation of caspase 3/7 at all tested concentrations. In conclusion, 4e could be a potent anticancer drug.
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Affiliation(s)
- Naglaa Mohamed Ahmed
- a Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy , Helwan University , Cairo , Egypt
| | - Mahmoud Youns
- b Biochemistry Department, Faculty of Pharmacy , Helwan University , Cairo , Egypt.,c Department of Functional Genome Analysis , German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Moustafa Khames Soltan
- d Medicinal Chemistry Department, Faculty of Pharmacy , Zagazig University , Zagazig , Egypt.,e Oman College of Health Sciences , Muscat , Sultanate of Oman
| | - Ahmed Mohammed Said
- a Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy , Helwan University , Cairo , Egypt.,f Department of Chemistry , University at Buffalo, The State University of New York , Buffalo , NY , USA
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12
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Song P, Zhang L, Shang C. [Current Status for Anaplastic Lymphoma Kinase in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:703-711. [PMID: 30201071 PMCID: PMC6136995 DOI: 10.3779/j.issn.1009-3419.2018.09.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The incidence of ALK gene rearrangement in non-small cell lung cancer (NSCLC) was about 3% to 5%. ALK gene inhibitors have made great breakthrough in recent years, significantly extending the survival period of patients with ALK(+) advanced NSCLC. But the majority of patients will be acquired drug resistance after treatment. This article has been explained separately from the ALK genetic background, the detection method, the treatment of the three generations of ALK inhibitors and the strategy after drug resistance. It is desire to have reference value and reference meaning for clinical work.
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Affiliation(s)
- Peng Song
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - Li Zhang
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
| | - Congcong Shang
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
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13
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Ouyang X, Barling A, Lesch A, Tyner JW, Choonoo G, Zheng C, Jeng S, West TM, Clayburgh D, Courtneidge SA, McWeeney SK, Kulesz-Martin M. Induction of anaplastic lymphoma kinase (ALK) as a novel mechanism of EGFR inhibitor resistance in head and neck squamous cell carcinoma patient-derived models. Cancer Biol Ther 2018; 19:921-933. [PMID: 29856687 PMCID: PMC6300392 DOI: 10.1080/15384047.2018.1451285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/07/2018] [Indexed: 01/09/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) currently only has one FDA-approved cancer intrinsic targeted therapy, the epidermal growth factor receptor (EGFR) inhibitor cetuximab, to which only approximately 10% of tumors are sensitive. In order to extend therapy options, we subjected patient-derived HNSCC cells to small-molecule inhibitor and siRNA screens, first, to find effective combination therapies with an EGFR inhibitor, and second, to determine a potential mechanistic basis for repurposing the FDA approved agents for HNSCC. The combinations of EGFR inhibitor with anaplastic lymphoma kinase (ALK) inhibitors demonstrated synergy at the highest ratio in our cohort, 4/8 HNSCC patients' derived tumor cells, and this corresponded with an effectiveness of siRNA targeting ALK combined with the EGFR inhibitor gefitinib. Co-targeting EGFR and ALK decreased HNSCC cell number and colony formation ability and increased annexin V staining. Because ALK expression is low and ALK fusions are infrequent in HNSCC, we hypothesized that gefitinib treatment could induce ALK expression. We show that ALK expression was induced in HNSCC patient-derived cells both in 2D and 3D patient-derived cell culture models, and in patient-derived xenografts in mice. Four different ALK inhibitors, including two (ceritinib and brigatinib) FDA approved for lung cancer, were effective in combination with gefitinib. Together, we identified induction of ALK by EGFR inhibitor as a novel mechanism potentially relevant to resistance to EGFR inhibitor, a high ratio of response of HNSCC patient-derived tumor cells to a combination of ALK and EGFR inhibitors, and applicability of repurposing ALK inhibitors to HNSCC that lack ALK aberrations.
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Affiliation(s)
- Xiaoming Ouyang
- Department of Dermatology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Ashley Barling
- Department of Dermatology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Aletha Lesch
- Department of Dermatology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Jeffrey W. Tyner
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Division of Hematology and Medical Oncology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Gabrielle Choonoo
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Christina Zheng
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Sophia Jeng
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Toni M. West
- Department of Pharmacology, University of California at Davis, 451 Health Science Dr., Davis, California
| | - Daniel Clayburgh
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Operative Care Division, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd., Portland, Oregon
| | - Sara A. Courtneidge
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Shannon K. McWeeney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
| | - Molly Kulesz-Martin
- Department of Dermatology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, Oregon
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14
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Latif M, Ashraf Z, Basit S, Ghaffar A, Zafar MS, Saeed A, Meo SA. Latest perspectives of orally bioavailable 2,4-diarylaminopyrimidine analogues (DAAPalogues) as anaplastic lymphoma kinase inhibitors: discovery and clinical developments. RSC Adv 2018; 8:16470-16493. [PMID: 35540549 PMCID: PMC9080316 DOI: 10.1039/c8ra01934g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/19/2018] [Indexed: 01/06/2023] Open
Abstract
The course of anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) therapy has improved impressively. The Food and Drug Administration (FDA) has approved crizotinib (Xalkori, Pfizer) as a first-in-class tyrosine kinase inhibitor (TKI) that demonstrated a substantial objective response rate (ORR) and remarkable progression-free survival (PFS). However, acquired resistance to crizotinib is still a major concern especially as the central nervous system (CNS) remains the most common sites of relapse. To combat disease resistance, limited PFS and poor CNS exposure exhibited by crizotinib (Xalkori, Pfizer) led to the discovery of numerous next generation ALK-TKIs and surprisingly most of them are 2,4-Diarylaminopyrimidine Analogues (DAAPalogues). To date, DAAPalogues have been investigated extensively to display their superior potency against numerous kinase targets especially ALK/ROS1. This review describes hit-to-drug evolution strategies, activity spectra, milestones related to medicinal chemistry discovery efforts and scalable synthetic pathways of clinically emerging DAAPalouges which are either progressing as investigational or preclinical candidates. In addition, the significance of DAAPalogues to treat the patients with ALK+-NSCLC in clinical settings has been detailed. This review is beneficial for medicinal chemists and researchers contributing to discovering ALK-TKIs to overcome existing issues related to DAAPalouges in the drug discovery process.
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Affiliation(s)
- Muhammad Latif
- College of Medicine, Centre for Genetics and Inherited Diseases (CGID), Taibah University Al-Madinah Al-Munawwarah Kingdom of Saudi Arabia
| | - Zaman Ashraf
- Department of Chemistry, Allama Iqbal Open University Islamabad 44000 Pakistan
| | - Sulman Basit
- College of Medicine, Centre for Genetics and Inherited Diseases (CGID), Taibah University Al-Madinah Al-Munawwarah Kingdom of Saudi Arabia
| | - Abdul Ghaffar
- Department of Chemistry, University of Engineering and Technology Lahore Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University Al-Madinah Al-Munawwarah Kingdom of Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University Islamabad 44000 Pakistan
| | - Aamer Saeed
- Department of Chemistry, Quaid-e-Azam University Islamabad Pakistan
| | - Sultan Ayoub Meo
- Department of Physiology, College of Medicine, King Saud University Riyadh Kingdom of Saudi Arabia
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15
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Powell CE, Gao Y, Tan L, Donovan KA, Nowak RP, Loehr A, Bahcall M, Fischer ES, Jänne PA, George RE, Gray NS. Chemically Induced Degradation of Anaplastic Lymphoma Kinase (ALK). J Med Chem 2018; 61:4249-4255. [PMID: 29660984 DOI: 10.1021/acs.jmedchem.7b01655] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We present the development of the first small molecule degraders that can induce anaplastic lymphoma kinase (ALK) degradation, including in non-small-cell lung cancer (NSCLC), anaplastic large-cell lymphoma (ALCL), and neuroblastoma (NB) cell lines. These degraders were developed through conjugation of known pyrimidine-based ALK inhibitors, TAE684 or LDK378, and the cereblon ligand pomalidomide. We demonstrate that in some cell types degrader potency is compromised by expression of drug transporter ABCB1. In addition, proteomic profiling demonstrated that these compounds also promote the degradation of additional kinases including PTK2 (FAK), Aurora A, FER, and RPS6KA1 (RSK1).
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Affiliation(s)
- Chelsea E Powell
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
| | - Yang Gao
- Department of Pediatric Hematology and Oncology , Dana-Farber Cancer Institute and Children's Hospital Boston, Harvard Medical School , Boston , Massachusetts 02215 , United States
| | - Li Tan
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
| | - Katherine A Donovan
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
| | - Radosław P Nowak
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
| | - Amanda Loehr
- Department of Pediatric Hematology and Oncology , Dana-Farber Cancer Institute and Children's Hospital Boston, Harvard Medical School , Boston , Massachusetts 02215 , United States
| | | | - Eric S Fischer
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
| | | | - Rani E George
- Department of Pediatric Hematology and Oncology , Dana-Farber Cancer Institute and Children's Hospital Boston, Harvard Medical School , Boston , Massachusetts 02215 , United States
| | - Nathanael S Gray
- Department of Biological Chemistry & Molecular Pharmacology , Harvard Medical School , Boston , Massachusetts 02115 , United States
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16
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Abstract
This last decade has yielded more robust development of cancer treatments and first-in-class agents than ever before. Since 2006, nearly one hundred new drugs have received regulatory approval for the treatment of hematological and solid organ neoplasms. Moreover, older conventional therapies have received approval for new clinical indications and are being used in combination with these newer small-molecule targeted treatments. The nervous system is vulnerable to many of the traditional cancer therapies, manifesting both already well-described acute and chronic toxicities. However, newer agents may produce toxicities that may seem indistinguishable from the underlying cancer. Early recognition of neurotoxicities from new therapeutics is vital to avoid irreversible neurological injury. This review focuses on cancer therapies in use in the last 10 years and approved by the FDA from January 2006 through January 1, 2017.
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Affiliation(s)
- Alicia M Zukas
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia
| | - David Schiff
- Department of Neurology, University of Virginia, Charlottesville, Virginia
- Department of Neurological Surgery, and Medicine, University of Virginia, Charlottesville, Virginia
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17
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Chen Y, Guo W, Fan J, Chen Y, Zhang X, Chen X, Luo P. The applications of liquid biopsy in resistance surveillance of anaplastic lymphoma kinase inhibitor. Cancer Manag Res 2017; 9:801-811. [PMID: 29263703 PMCID: PMC5724713 DOI: 10.2147/cmar.s151235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
With the clinical promotion of precision medicine and individualized medical care, molecular targeted medicine has been used to treat non-small cell lung cancer (NSCLC) patients and proved to be significantly effective. Anaplastic lymphoma kinase (ALK) inhibitor is one of the most important specific therapeutic agents for patients with ALK-positive NSCLC. It can extend the survival of patients. However, resistance to the ALK inhibitor inevitably develops in the application process. So, the real-time resistance surveillance is particularly important, and liquid biopsy is one of the most potential inspection methods. Circulating tumor cells, circulating free tumor DNA and exosome in body fluid are used as the main detection biomarkers to reflect the occurrence of resistance in real time through sequencing or counting and then to guide the follow-up treatment.
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Affiliation(s)
- Yating Chen
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Wenjie Guo
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Junsheng Fan
- Department of Respiratory, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuqing Chen
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xiaoli Zhang
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xin Chen
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Peng Luo
- Department of Respiratory, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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18
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Management of ceritinib therapy and adverse events in patients with ALK-rearranged non-small cell lung cancer. Lung Cancer 2017; 111:51-58. [PMID: 28838397 DOI: 10.1016/j.lungcan.2017.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/05/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022]
Abstract
Anaplastic lymphoma kinase rearrangement (ALK+) occurs in approximately 2-7% of patients with non-small cell lung cancer (NSCLC), contributing to a considerable number of patients with ALK+ NSCLC worldwide. Ceritinib is a next generation ALK inhibitor (ALKi), approved by the European Medicines Agency in 2015. In the first-in-human, phase I study, ceritinib demonstrated rapid and durable responses in ALK patients previously treated with a different ALKi and in those who were ALKi-naive. As ceritinib is starting to be used routinely for the treatment of patients with ALK+ NSCLC, experience is growing with regard to ideal therapy management. In this review we provide a brief background to the development of ceritinib. The optimal treatment management and adverse events associated with ceritinib in clinical trials and in clinical practice are then discussed in detail, and where applicable, an expert consensus on specific recommendations are made. In clinical trials, the most common adverse events related to ceritinib are nausea, vomiting, and diarrhea. However, the majority of these are mild and, in the opinion of the authors, can be effectively managed with dose modifications. Based on clinical data, ceritinib has demonstrated efficacy as a first-line therapy and in patients who have relapsed on crizotinib, including those with brain metastases at baseline. Unfortunately, at some point, all patients experience progressive disease, with the central nervous system being a common site of metastases. Recommendations are made for continuing treatment beyond disease progression as long as a clinical benefit to patients is observed. Here, we review management of ceritinib treatment and adverse events and make recommendations on optimal management of patients.
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Ocular toxicities associated with targeted anticancer agents: an analysis of clinical data with management suggestions. Oncotarget 2017; 8:58709-58727. [PMID: 28938590 PMCID: PMC5601686 DOI: 10.18632/oncotarget.17634] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 03/16/2017] [Indexed: 11/25/2022] Open
Abstract
Ocular toxicities are among the most common adverse events resulting from targeted anticancer agents and are becoming increasingly relevant in the management of patients on these agents. The purpose of this study is to provide a framework for management of these challenging toxicities based on objective data from FDA labels and from analysis of the literature. All oncologic drugs approved by the FDA up to March 14, 2015, were screened for inclusion. A total of 16 drugs (12 small-molecule drugs and 4 monoclonal antibodies) were analyzed for ocular toxicity profiles based on evidence of ocular toxicity. Trials cited by FDA labels were retrieved, and a combination search in Medline, Google Scholar, the Cochrane database, and the NIH Clinical Trials Database was conducted. The majority of ocular toxicities reported were low severity, and the most common were conjunctivitis and "visual disturbances." However, severe events including incidents of blindness, retinal vascular occlusion, and corneal ulceration occurred. The frequency and severity at which ocular toxicities occur merits a more multidisciplinary approach to managing patients with agents that are known to cause ocular issues. We suggest a standardized methodology for referral and surveillance of patients who are potentially at risk of severe ocular toxicity.
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20
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Qian M, Zhu B, Wang X, Liebman M. Drug resistance in ALK-positiveNon-small cell lungcancer patients. Semin Cell Dev Biol 2017; 64:150-157. [DOI: 10.1016/j.semcdb.2016.09.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 09/28/2016] [Indexed: 02/07/2023]
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21
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Cui ZH, Zhang Y, Liang LL, Li ZH, Abramova I, Hao Q. Development of a new choroidal metastasis in resistance to crizotinib therapy in anaplastic lymphoma kinase-rearranged non-small cell lung cancer. Int J Ophthalmol 2017; 10:310-314. [PMID: 28251094 DOI: 10.18240/ijo.2017.02.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 05/29/2016] [Indexed: 11/23/2022] Open
Affiliation(s)
- Zhi-Hua Cui
- First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yan Zhang
- First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Ling-Ling Liang
- First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zhao-Hui Li
- People's Hospital of Changchun City, Changchun 130000, Jilin Province, China
| | - Inna Abramova
- Pharm. D. Candidate, 2016, Long Island University, Brooklyn NY 11201, USA
| | - Qian Hao
- First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Rossi A, Sacco PC, Santabarbara G, Sgambato A, Casaluce F, Palazzolo G, Maione P, Gridelli C. Developments in pharmacotherapy for treating metastatic non-small cell lung cancer. Expert Opin Pharmacother 2017; 18:151-163. [PMID: 28067062 DOI: 10.1080/14656566.2017.1280460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Most patients with non-small cell lung (NSCLC), including squamous cell carcinoma, adenocarcinoma and large cell carcinoma, have advanced disease at diagnosis and systemic therapy is the standard-of-care. About 20% of Caucasian patients are affected by an oncogene-addicted advanced NSCLC for which correspondent inhibitors are available. Areas covered: The main state-of-the-art synthetic anticancer drugs in the groups of chemotherapeutics, epidermal growth factor receptor and anaplastic lymphoma kinase tyrosine kinase inhibitors for NSCLC treatment, are reviewed and discussed from phase III randomized practice-changing trials onwards. A structured search of bibliographic databases for peer-reviewed research literature and of main meetings using a focused review question was undertaken. Expert opinion: The survival of NSCLC patients is increasing, regardless of the presence or not of a specific target, due to the availability of new generation drugs. The continuous deep knowledge of the mechanisms of NSCLC development and the constant research into new drugs should lead to the discovery of new potential targets and the synthesis of corresponding inhibitors to improve the outcomes of each subgroup of patients in order to control the disease in a constantly growing percentage of patients.
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Affiliation(s)
- Antonio Rossi
- a Division of Medical Oncology , 'S.G. Moscati' Hospital , Avellino , Italy
| | | | | | - Assunta Sgambato
- a Division of Medical Oncology , 'S.G. Moscati' Hospital , Avellino , Italy
| | - Francesca Casaluce
- a Division of Medical Oncology , 'S.G. Moscati' Hospital , Avellino , Italy
| | | | - Paolo Maione
- a Division of Medical Oncology , 'S.G. Moscati' Hospital , Avellino , Italy
| | - Cesare Gridelli
- a Division of Medical Oncology , 'S.G. Moscati' Hospital , Avellino , Italy
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Zaarour M, Nazha B, Weerasinghe C, Moussaly E, Terjanian T. Anaplastic lymphoma kinase inhibitors in elderly patients with advanced non-small cell lung cancer. Expert Rev Anticancer Ther 2016; 16:877-83. [PMID: 27328177 DOI: 10.1080/14737140.2016.1204235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths in the USA and worldwide. At diagnosis, half of the patients are over 70 years of age, and most present with advanced disease for which chemotherapy provides modest benefit with significant toxicity. Older patients often have more comorbidities than their younger counterparts and tend to be excluded from clinical trials. AREAS COVERED A small percentage (less than 7%) of patients with NSCLC have the anaplastic lymphoma kinase (ALK) rearrangement. Compared to the general NSCLC population, this clinically distinct group has a relatively younger median age of 51 years at diagnosis. As such, elderly patients with ALK-positive disease are both a minority within this group and are expected to be underrepresented in clinical trials. Expert commentary: Despite promising results in the general population, data about the efficacy and safety of ALK inhibitors in the elderly population remains scarce. In our review, we briefly discuss the current evidence of ALK inhibitors in the general population and we shed light on this subgroup of elderly patients with advanced ALK-positive disease.
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Affiliation(s)
- Mazen Zaarour
- a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA
| | - Bassel Nazha
- a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA
| | - Chanudi Weerasinghe
- a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA
| | - Elias Moussaly
- a Department of Medicine , Staten Island University Hospital Northwell Health , Staten Island , NY , USA
| | - Terenig Terjanian
- b Department of Medicine, Division of Hematology/Oncology , Staten Island University Hospital Northwell Health , Staten Island , NY , USA
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Abstract
INTRODUCTION Lung cancer is associated with poor prognosis and limited benefit from chemotherapy. The treatment of non-small cell lung cancer (NSCLC) has been revolutionized by the discovery of targetable genetic alterations, including the ALK fusion oncogene. AREAS COVERED Three drugs have been approved for clinical use in ALK-positive patients - crizotinib, ceritinib and alectinib. Unfortunately, treatment resistance inevitably develops. Several mechanisms of acquired resistance are reported. In this review, we will discuss emerging treatment options in ALK-positive advanced NSCLC and strategies to overcome resistance mechanisms, including newer generation of ALK inhibitors, Hsp90 inhibitors and immunotherapy. EXPERT OPINION Tremendous advances have been made in the treatment of ALK-positive lung cancers, but management hurdles still exist, including universal development of resistance to ALK inhibitors and limited CNS activity. Given that specific treatment strategies target distinct patterns of resistance, re-biopsy at the time of progression appears necessary to optimize management. However, there remain many issues in routine clinical application including the burden placed on the patients by serial biopsies and the risks of repeat invasive procedures. Future studies are needed to validate the usage of non- or minimally invasive tests and to determine the optimal orders of utilizing different ALK inhibitors.
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Affiliation(s)
- Janaki Sharma
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Vipul Pareek
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Huijie Liu
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Haiying Cheng
- a Division of Medical Oncology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA
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Rothschild SI. New treatment options for ALK+ advanced non-small-cell lung cancer: critical appraisal of ceritinib. Ther Clin Risk Manag 2016; 12:735-41. [PMID: 27217763 PMCID: PMC4863587 DOI: 10.2147/tcrm.s87876] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Rearrangements in ALK gene and EML4 gene were first described in 2007. This genomic aberration is found in about 2%–8% of non-small-cell lung cancer (NSCLC) patients. Crizotinib was the first ALK tyrosine kinase inhibitor licensed for the treatment of metastatic ALK-positive NSCLC based on a randomized Phase III trial. Despite the initial treatment response of crizotinib, disease progression inevitably develops after approximately 10 months of therapy. Different resistance mechanisms have recently been described. One relevant mechanism of resistance is the development of mutations in ALK. Novel ALK tyrosine kinase inhibitors have been developed to overcome these mutations. Ceritinib is an oral second-generation ALK inhibitor showing clinical activity not only in crizotinib-resistant ALK-positive NSCLC but also in treatment-naïve ALK-positive disease. In this paper, preclinical and clinical data of ceritinib are reviewed, and its role in the clinical setting is put into perspective.
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Affiliation(s)
- Sacha I Rothschild
- Department of Internal Medicine, Medical Oncology, University Hospital Basel, Basel, Switzerland
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26
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Cass Y, Connor TH, Tabachnik A. Safe handling of oral antineoplastic medications: Focus on targeted therapeutics in the home setting. J Oncol Pharm Pract 2016; 23:350-378. [PMID: 27009803 DOI: 10.1177/1078155216637217] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction With the growing number of oral targeted therapies being approved for use in cancer therapy, the potential for long-term administration of these drugs to cancer patients is expanding. The use of these drugs in the home setting has the potential to expose family members and caregivers to them either through direct contact with the drugs or indirectly by exposure to the parent compounds and/or their active metabolites in contaminated patients' waste. Methods A systematic literature review was performed and the known adverse health effect of 32 oral targeted therapeutics is summarized. In particular, the carcinogenicity, genotoxicity, and embryo-fetal toxicity, along with the route of excretion were evaluated. Results Carcinogenicity testing has not been performed on most of the oral targeted therapeutics and the genotoxicity data are mixed. However, the majority of these drugs exhibit adverse reproductive effects, some of which are severe. Currently, available data does not permit the possibility of a health hazard from inappropriate handling of drugs and contaminated patients waste to be ignored, especially in a long-term home setting. Further research is needed to understand these issues. Conclusions With the expanding use of targeted therapies in the home setting, family members and caregivers, especially those of reproductive risk age, are, potentially at risk. Overall basic education and related precautions should be taken to protect family members and caregivers from indirect or direct exposure from these drugs. Further investigations and discussion on this subject are warranted.
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Affiliation(s)
| | - Thomas H Connor
- 2 Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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El-Osta H, Shackelford R. Personalized treatment options for ALK-positive metastatic non-small-cell lung cancer: potential role for Ceritinib. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2015; 8:145-54. [PMID: 26622190 PMCID: PMC4638315 DOI: 10.2147/pgpm.s71100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The fusion of echinoderm microtubule-associated protein-like 4 with the anaplastic lymphoma kinase (EML4-ALK) is found in 3%–7% of non-small-cell lung cancer (NSCLC) cases and confers sensitivity to crizotinib, the first United States Food and Drug Administration (FDA)-approved ALK inhibitor drug. Although crizotinib has an excellent initial therapeutic effect, acquired resistance to this drug invariably develops within the first year of treatment. Resistance may involve secondary gatekeeper mutations within the ALK gene interfering with crizotinib–ALK interactions, or compensatory activation of aberrant bypass signaling pathways. New therapeutic strategies to overcome crizotinib resistance are needed. Ceritinib, a second-generation ALK inhibitor, overcomes several crizotinib-resistant ALK mutations and has demonstrated efficacy against tumor growth in several in vitro and in vivo preclinical models of crizotinib resistance. Notably, the dose-escalation Phase I ASCEND-1 trial has shown a marked activity of ceritinib in both crizotinib-naïve and crizotinib-resistant ALK-rearranged lung cancer. The overall response rate was 58% in a subgroup of patients with ALK-rearranged late-stage NSCLC. Drug discontinuation rate due to toxicity was 10%. The standard dose was established at 750 mg daily. This paper outlines the pathogenesis and treatment of ALK-positive lung cancer, focuses on the preclinical and clinical results surrounding the accelerated FDA approval of ceritinib for the treatment of ALK-positive metastatic NSCLC patients who have progressed on/or are crizotinib intolerant, and discusses the potential efforts seeking to maximize ceritinib efficacy and expand its usage to other indications in cancer therapy.
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Affiliation(s)
- Hazem El-Osta
- Department of Medicine, Feist-Weiller Cancer Center, Louisiana State University Health Science Center-Shreveport, Shreveport, LA, USA
| | - Rodney Shackelford
- Department of Pathology, Feist-Weiller Cancer Center, Louisiana State University Health Science Center-Shreveport, Shreveport, LA, USA
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28
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RESPONSE OF UVEAL METASTASES TO ALK INHIBITORS IN ALK-POSITIVE NON-SMALL-CELL LUNG CANCER. Retin Cases Brief Rep 2015; 10:37-40. [PMID: 26263240 DOI: 10.1097/icb.0000000000000190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To present a case of uveal metastases in a patient with anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer and the response to systemic ALK inhibitors. METHODS A retrospective case report. A 75-year-old nonsmoker who has ALK-positive left upper bronchus adenocarcinoma-developed uveal metastases during his course of treatment. RESULTS Initially, the patient's disseminated malignancy showed a significant response to crizotinib. However, because the bone metastases started progressing again and he developed bilateral ocular metastases, he was switched to ceritinib. After initiation of ceritinib therapy, the uveal melanomas have shown a significant decrease in thickness and no new lesions have developed. CONCLUSION ALK inhibitors are an effective first-line treatment in patients with ALK-positive uveal metastases secondary to ALK-positive non-small-cell lung cancer. Despite the fact that crizotinib, a first-generation ALK inhibitor, is initially effective in dealing with non-small-cell lung cancer and its metastases, resistance to it seems to develop on a regular basis. A second-generation ALK inhibitor, such as ceritinib, is also effective in overcoming this resistance in treating those with ALK-positive uveal metastases.
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29
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Crescenzo R, Inghirami G. Anaplastic lymphoma kinase inhibitors. Curr Opin Pharmacol 2015; 23:39-44. [PMID: 26051994 DOI: 10.1016/j.coph.2015.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/10/2015] [Accepted: 05/15/2015] [Indexed: 11/30/2022]
Abstract
The anaplastic lymphoma kinase (ALK) gene is a member of the insulin receptor superfamily and it has been associated with more than twenty distinct chimera, including established drivers of several human cancers. Multiple clinical trials have proven that the pharmacological inhibition of ALK signaling leads to remarkable clinical improvement and improves the quality of life of ALK+ cancer patients. Crizotinib was the first ALKi to achieve approval from the Food and Drug Administration, although additional compounds are now moving into diversified clinical trials.
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Affiliation(s)
- Ramona Crescenzo
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10021, USA; Department of Molecular Biotechnology and Health Science, Center for Experimental Research and Medical Studies (CeRMS), University of Torino, Torino 10126, Italy
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10021, USA; Department of Molecular Biotechnology and Health Science, Center for Experimental Research and Medical Studies (CeRMS), University of Torino, Torino 10126, Italy; Department of Pathology, NYU Cancer Center, New York University School of Medicine, New York, NY 10016, USA.
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