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Otani S, Sasaki J, Nakahara Y, Fukui T, Igawa S, Naoki K, Bessho A, Hosokawa S, Fukamatsu N, Nakamura Y, Kasai T, Sugiyama T, Tokito T, Seki N, Hamada A, Okamoto H, Masuda N. Phase II study of amrubicin plus erlotinib in previously treated, advanced non-small cell lung cancer with wild-type epidermal growth factor receptor (TORG1320). Invest New Drugs 2020; 39:530-536. [PMID: 33159674 DOI: 10.1007/s10637-020-01031-z] [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: 10/12/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
Background Amrubicin (AMR) is a completely synthetic 9-aminoanthracycline and clinically active against non-small cell lung cancer (NSCLC). We conducted a phase I study of AMR and erlotinib (ERL) combination therapy in previously treated patients with advanced NSCLC and have already reported the safety and effectiveness. Methods We conducted a multi-center, single-arm phase II trial to evaluate the efficacy of AMR and ERL combination therapy in patients with previously treated, advanced NSCLC harboring wild-type EGFR, PS 0-1 and < 75 years of age. Patients were treated at 3-week intervals with AMR plus ERL. The primary endpoint was the PFS, and the secondary endpoints were the response rate (RR), disease control rate (DCR), overall survival (OS) and toxicity. The trough ERL concentration (Ctrough) was measured as an exploratory study to analyze the relationship between the efficacy/safety and pharmacokinetics. Results From June 2013 to July 2016, 25 patients were enrolled in this trial. The PFS according to the central test was 3.6 months (95% confidence interval 2.1-5.1). The RR and DCR were 24.0% and 64.0%, respectively. We had no treatment-related deaths in this study. Conclusions The PFS of AMR and ERL combination therapy was superior to that of AMR monotherapy in the historical setting, but the primary endpoint was not met in this trial. In our study, the pharmacokinetic analysis showed that the Ctrough of ERL was elevated with combination therapy. This combination therapy might be a viable treatment for previously treated NSCLC patients without a driver oncogene mutation. Clinical trial information UMIN 000010582.
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Affiliation(s)
- Sakiko Otani
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan.
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
| | - Yoshiro Nakahara
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
| | - Tomoya Fukui
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
| | - Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
| | - Katsuhiko Naoki
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
| | - Akihiro Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, 2-1-1, aoe,Kita-ku, Okayama-city, 700-8607, Japan
| | - Shinobu Hosokawa
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, 2-1-1, aoe,Kita-ku, Okayama-city, 700-8607, Japan
| | - Nobuaki Fukamatsu
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, 2-1-1, aoe,Kita-ku, Okayama-city, 700-8607, Japan
| | - Yukiko Nakamura
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56, Okazawa-cho, Hodogaya-ku, Yokohama city, Kanagawa, 240-8555, Japan
| | - Takashi Kasai
- Division of Thoracic Oncology, Tochigi Cancer Center, 4-9-13, Yonan, Utsunomiya-city, Tochigi, 320-0834, Japan
| | - Tomohide Sugiyama
- Division of Thoracic Oncology, Tochigi Cancer Center, 4-9-13, Yonan, Utsunomiya-city, Tochigi, 320-0834, Japan
| | - Takaaki Tokito
- Division of Respirology, Neurology, and Rheumatology, Department ofInternal Medicine, Kurume University School of Medicine, 67, Asahimachi, Kurume-city, Fukuoka, 830-0011, Japan
| | - Nobuhiko Seki
- Division of Medical oncology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-0014, Japan
| | - Akinobu Hamada
- Division of Molecular Pharmacology, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, 56, Okazawa-cho, Hodogaya-ku, Yokohama city, Kanagawa, 240-8555, Japan
| | - Noriyuki Masuda
- Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara city, Kanagawa, 252-0375, Japan
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Jones K, Kentala K, Beck MW, An W, Lippert AR, Lewis JC, Dickinson BC. Development of a Split Esterase for Protein-Protein Interaction-Dependent Small-Molecule Activation. ACS CENTRAL SCIENCE 2019; 5:1768-1776. [PMID: 31807678 PMCID: PMC6891849 DOI: 10.1021/acscentsci.9b00567] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Indexed: 05/21/2023]
Abstract
Split reporters based on fluorescent proteins and luciferases have emerged as valuable tools for measuring interactions in biological systems. Relatedly, biosensors that transduce measured input signals into outputs that influence the host system are key components of engineered gene circuits for synthetic biology applications. While small-molecule-based imaging agents are widely used in biological studies, and small-molecule-based drugs and chemical probes can target a range of biological processes, a general method for generating a target small molecule in a biological system based on a measured input signal is lacking. Here, we develop a proximity-dependent split esterase that selectively unmasks ester-protected small molecules in an interaction-dependent manner. Exploiting the versatility of an ester-protected small-molecule output, we demonstrate fluorescent, chemiluminescent, and pharmacological probe generation, each created by masking key alcohol functional groups on a target small molecule. We show that the split esterase system can be used in combination with ester-masked fluorescent or luminescent probes to measure protein-protein interactions and protein-protein interaction inhibitor engagement. We demonstrate that the esterase-based reporter system is compatible with other commonly used split reporter imaging systems for the simultaneous detection of multiple protein-protein interactions. Finally, we develop a system for selective small-molecule-dependent cell killing by unmasking a cytotoxic molecule using an inducible split esterase. Presaging utility in future synthetic biology-based therapeutic applications, we also show that the system can be used for intercellular cell killing via a bystander effect, where one activated cell unmasks a cytotoxic molecule and kills cells physically adjacent to the activated cells. Collectively, this work illustrates that the split esterase system is a valuable new addition to the split protein toolbox, with particularly exciting potential in synthetic biology applications.
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Affiliation(s)
- Krysten
A. Jones
- Department
of Chemistry, The University of Chicago, Chicago, Illinois 60637, United States
| | - Kaitlin Kentala
- Department
of Chemistry, The University of Chicago, Chicago, Illinois 60637, United States
| | - Michael W. Beck
- Department
of Chemistry, The University of Chicago, Chicago, Illinois 60637, United States
| | - Weiwei An
- Department
of Chemistry, Center for Drug Discovery, Design, and Delivery (CD4),
Center for Global Health Impact (CGHI), Southern Methodist University, Dallas, Texas 75275-0314, United States
| | - Alexander R. Lippert
- Department
of Chemistry, Center for Drug Discovery, Design, and Delivery (CD4),
Center for Global Health Impact (CGHI), Southern Methodist University, Dallas, Texas 75275-0314, United States
| | - Jared C. Lewis
- Department
of Chemistry, Indiana University, Bloomington, Indiana 47405, United States
| | - Bryan C. Dickinson
- Department
of Chemistry, The University of Chicago, Chicago, Illinois 60637, United States
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Vogus DR, Krishnan V, Mitragotri S. A review on engineering polymer drug conjugates to improve combination chemotherapy. Curr Opin Colloid Interface Sci 2017. [DOI: 10.1016/j.cocis.2017.08.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Gutova M, Goldstein L, Metz M, Hovsepyan A, Tsurkan LG, Tirughana R, Tsaturyan L, Annala AJ, Synold TW, Wan Z, Seeger R, Anderson C, Moats RA, Potter PM, Aboody KS. Optimization of a Neural Stem-Cell-Mediated Carboxylesterase/Irinotecan Gene Therapy for Metastatic Neuroblastoma. MOLECULAR THERAPY-ONCOLYTICS 2016; 4:67-76. [PMID: 28345025 PMCID: PMC5363723 DOI: 10.1016/j.omto.2016.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 12/22/2022]
Abstract
Despite improved survival for children with newly diagnosed neuroblastoma (NB), recurrent disease is a significant problem, with treatment options limited by anti-tumor efficacy, patient drug tolerance, and cumulative toxicity. We previously demonstrated that neural stem cells (NSCs) expressing a modified rabbit carboxylesterase (rCE) can distribute to metastatic NB tumor foci in multiple organs in mice and convert the prodrug irinotecan (CPT-11) to the 1,000-fold more toxic topoisomerase-1 inhibitor SN-38, resulting in significant therapeutic efficacy. We sought to extend these studies by using a clinically relevant NSC line expressing a modified human CE (hCE1m6-NSCs) to establish proof of concept and identify an intravenous dose and treatment schedule that gave maximal efficacy. Human-derived NB cell lines were significantly more sensitive to treatment with hCE1m6-NSCs and irinotecan as compared with drug alone. This was supported by pharmacokinetic studies in subcutaneous NB mouse models demonstrating tumor-specific conversion of irinotecan to SN-38. Furthermore, NB-bearing mice that received repeat treatment with intravenous hCE1m6-NSCs and irinotecan showed significantly lower tumor burden (1.4-fold, p = 0.0093) and increased long-term survival compared with mice treated with drug alone. These studies support the continued development of NSC-mediated gene therapy for improved clinical outcome in NB patients.
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Affiliation(s)
- Margarita Gutova
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Leanne Goldstein
- Information Sciences, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Marianne Metz
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Anahit Hovsepyan
- Departments of Radiology and Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Lyudmila G Tsurkan
- Department of Chemical Biology & Therapeutics, St. Jude Children's Research Hospital, Memphis, TN 38101, USA
| | - Revathiswari Tirughana
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Lusine Tsaturyan
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Alexander J Annala
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Timothy W Synold
- Department of Cancer Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Zesheng Wan
- Children's Center for Cancer and Blood Diseases, CHLA/Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Robert Seeger
- Children's Center for Cancer and Blood Diseases, CHLA/Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Clarke Anderson
- Department of Pediatric Oncology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Rex A Moats
- Departments of Radiology and Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Philip M Potter
- Department of Chemical Biology & Therapeutics, St. Jude Children's Research Hospital, Memphis, TN 38101, USA
| | - Karen S Aboody
- Departments of Developmental and Stem Cell Biology, City of Hope National Medical Center and Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
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Kaira K, Sunaga N, Imai H, Kamide Y, Koga Y, Ono A, Kuwako T, Masuda T, Hisada T, Ishizuka T, Yamada M. Phase I dose escalation study of amrubicin plus paclitaxel in previously treated advanced non-small cell lung cancer. Int J Clin Oncol 2015; 21:240-247. [PMID: 26266640 DOI: 10.1007/s10147-015-0883-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/28/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND We conducted a phase I dose escalation study to determine the maximum tolerated dose (MTD), the recommended dose (RD) and the safety profile of amrubicin (AMR) plus paclitaxel (PTX) combination regimen for patients with previously treated non-small cell lung cancer (NSCLC). PATIENTS AND METHODS PTX was administered at a fixed dose of 150 mg/m(2)/day on day 1 and AMR was intravenously administered at a starting dose of 25 mg/m(2)/day on days 1-3, and this was repeated every 4 weeks. Doses of each drug were planned as follows-level 0, 20/150; level 1, 25/150; level 2, 30/150; level 3, 30/180 AMR mg/m(2) per day/PTX mg/m(2) per day. RESULTS Twelve patients were enrolled in this study. The dose-limiting toxicity (DLT) of the regimen was assessed during the first cycle. At level 1, all three patients developed a DLT due to grade 4 neutropenia lasting >4 days, grade 4 thrombocytopenia and grade 3 febrile neutropenia. Therefore, level 1 was considered the MTD and level 0 was selected as the RD. Objective responses were seen in two patients (response rate 16.7 %). Overall disease control rate was 91.7 %. CONCLUSIONS The combination of AMR and PTX is a feasible and well-tolerated regimen for the treatment of patients with previously treated advanced NSCLC. Although our study included a small number of patients, encouraging disease control and progression-free survival were achieved at the recommended doses. Further clinical trials are warranted.
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Affiliation(s)
- Kyoichi Kaira
- Department of Oncology Clinical Development, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan. .,Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan.
| | - Noriaki Sunaga
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Hisao Imai
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Yosuke Kamide
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Yasuhiko Koga
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Akihiro Ono
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Tomohito Kuwako
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Tomomi Masuda
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Takeshi Hisada
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
| | - Tamotsu Ishizuka
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan.,Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masanobu Yamada
- Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan
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Camacho KM, Kumar S, Menegatti S, Vogus DR, Anselmo AC, Mitragotri S. Synergistic antitumor activity of camptothecin-doxorubicin combinations and their conjugates with hyaluronic acid. J Control Release 2015; 210:198-207. [PMID: 25921087 DOI: 10.1016/j.jconrel.2015.04.031] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/21/2015] [Accepted: 04/24/2015] [Indexed: 11/19/2022]
Abstract
Combinations of topoisomerase inhibitors I and II have been found to synergistically inhibit cancer cell growth in vitro, yet clinical studies of these types of combinations have not progressed beyond phase II trials. The results of clinical combinations of topoisomerase (top) I and II inhibitors typically fall within one of two categories: little to no improvement in therapeutic efficacy, or augmented toxicity compared to the single drug counterparts. Hence, despite the promising activity of top I and II inhibitor combinations in vitro, their clinical applicability has not been realized. Here, we report the use of polymer-drug conjugates as a means to co-deliver synergistic doses of top I and II inhibitors camptothecin (CPT) and doxorubicin (DOX) to tumors in vivo in a 4T1 breast cancer model. At specific molar ratios, DOX and CPT were found to be among the most synergistic combinations reported to date, with combination indices between 0.01 and 0.1. The identified optimal ratios were controllably conjugated to hyaluronic acid, and elicited significant tumor reduction of murine 4T1 breast cancer model when administered intravenously. This study elucidates a method to identify synergistic drug combinations and translate them to in vivo by preserving the synergistic ratio via conjugation to a carrier polymer, thus opening a promising approach to translate drug combinations to clinically viable treatment regimens.
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Affiliation(s)
- Kathryn M Camacho
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States
| | - Sunny Kumar
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States
| | - Stefano Menegatti
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States
| | - Douglas R Vogus
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States
| | - Aaron C Anselmo
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States
| | - Samir Mitragotri
- Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, CA 93106, United States.
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Honda Y, Takigawa N, Fushimi S, Ochi N, Kubo T, Ozaki S, Tanimoto M, Kiura K. Disappearance of an activated EGFR mutation after treatment with EGFR tyrosine kinase inhibitors. Lung Cancer 2012; 78:121-4. [DOI: 10.1016/j.lungcan.2012.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 06/23/2012] [Accepted: 07/08/2012] [Indexed: 11/25/2022]
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