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Sakhdari A, Ok CY, Patel KP, Kanagal-Shamanna R, Yin CC, Zuo Z, Hu S, Routbort MJ, Luthra R, Medeiros LJ, Khoury JD, Loghavi S. TP53 mutations are common in mantle cell lymphoma, including the indolent leukemic non-nodal variant. Ann Diagn Pathol 2019; 41:38-42. [PMID: 31132650 DOI: 10.1016/j.anndiagpath.2019.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Mantle cell lymphoma (MCL) is an aggressive B-cell neoplasm, but clinically indolent subtypes are also recognized. Data on the utility of mutation profiling in the context of routine workup and its role in risk-stratification of MCL patients are limited. In this study, we describe the mutational landscape and clinicopathologic correlates of a series of MCL cases at a single-institution setting. METHODS Samples from 26 patients with MCL were evaluated by NGS using DNA extracted from peripheral blood (PB) or bone marrow (BM). Evaluation of extent of PB or BM involvement was performed using flow cytometry immunophenotyping. RESULTS The study group included 17 (65%) men and 9 (35%) women with a median age of 65 years (range, 50-94). Twenty-one (81%) patients had nodal MCL (N-MCL) and 5 (19%) had the "leukemic variant" (L-MCL). Mutated genesincluded TP53 (35%), ATM (27%), CARD11 (10%); and FBXW7, NOTCH1, SPEN, BIRC3 (~5% each). Most mutations were clonal in nature. Ten unique TP53 mutations were identified in 9 samples, including 3 L-MCL cases. There was no difference in the frequency of TP53 mutations between L-MCL and N-MCL groups (p = 0.3), but TP53 mutations were subclonal in 2/3 L-MCL cases. Identification of clonal TP53 alterations in L-MCL patients prompted initiation of therapy despite low tumor burden. CONCLUSIONS TP53 is commonly mutated in MCL. TP53 mutations may be clonal or subclonal. Seemingly indolent L-MCL may harbor subclonal TP53 mutations which may serve as a useful biomarker for prognostication, therapeutic planning, follow-up monitoring, and early detection of clonal expansion.
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Affiliation(s)
- Ali Sakhdari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Chi Young Ok
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Keyur P Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Rashmi Kanagal-Shamanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Zhuang Zuo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Mark J Routbort
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
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Jurczak W, Gruszka AM, Sowa Staszczak A, Dlugosz-Danecka M, Szostek M, Zimowska-Curylo D, Giza A, Krawczyk K, Jakobczyk M, Hubalewska-Dydejczyk A, Szymczyk M, Wróbel T, Knopińska-Posłuszny W, Kisiel E, Skotnicki A, Zinzani PL. Consolidation with 90Y ibritumomab tiuxetan radioimmunotherapy in mantle cell lymphoma patients ineligible for high dose therapy: results of the phase II multicentre Polish Lymphoma Research Group trial, after 8-year long follow-up. Leuk Lymphoma 2019; 60:2689-2696. [PMID: 30961415 DOI: 10.1080/10428194.2019.1602261] [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] [Indexed: 12/14/2022]
Abstract
Polish Lymphoma Research Group performed a phase-II trial to test whether 90Y ibritumomab tiuxetan radioimmunotherapy (Y90) may constitute an alternative consolidation for mantle cell lymphoma patients unfit for high-dose therapy. Forty-six patients were consolidated with Y90 following response to the 1st (n = 34) or 2nd line (n = 12) (immuno)chemotherapy. Majority of the patients had advanced disease (stage IV and presence of B-symptoms in 85% and 70%, respectively) and high MIPI (5.8, range 4-7). Consolidation with Y90 increased the complete remission (CR) rate obtained by the 1st line therapy from 41% to 91% and allowed for median PFS of 3.3 and OS of 6.5 years. In the first relapse, CR rate increased from 16% to 75%, while median PFS and OS totaled 2.2 and 6.5 years, respectively. At 8 years, 30% of patients, consolidated in the 1st line CR were alive, without relapse. Toxicity associated with Y90 is manageable, more severe after fludarabine-based regimens.
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Affiliation(s)
- Wojciech Jurczak
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Alicja M Gruszka
- Department of Experimental Oncology, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Anna Sowa Staszczak
- Department of Endocrinology, Nuclear Medicine Unit, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Monika Dlugosz-Danecka
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Marta Szostek
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Dagmara Zimowska-Curylo
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Agnieszka Giza
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Katarzyna Krawczyk
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Malgorzata Jakobczyk
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Alicja Hubalewska-Dydejczyk
- Department of Endocrinology, Nuclear Medicine Unit, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Michal Szymczyk
- Department of Lymphoid Malignancies, Centrum Onkologii-Instytut im Marii Sklodowskiej-Curie w Warszawie, Warszawa, Poland
| | - Tomasz Wróbel
- Department of Haematology, Uniwersytet Medyczny im Piastow Slaskich we Wroclawiu, Wroclaw, Poland
| | - Wanda Knopińska-Posłuszny
- Department of Hematology, Independent Public Health Care of the Ministry of the Internal Affairs with the Oncology Centre, Olsztyn, Poland
| | | | - Aleksander Skotnicki
- Department of Haematology, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Poland
| | - Pier Luigi Zinzani
- Policlinico "Sant'Orsola-Malpighi" - University of Bologna Institute of Hematology "Seràgnoli", Bologna, Italy
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Zaja F, Federico M, Vitolo U, Zinzani PL. Management of relapsed/refractory mantle cell lymphoma: a review of current therapeutic strategies. Leuk Lymphoma 2013; 55:988-98. [PMID: 23865835 DOI: 10.3109/10428194.2013.825903] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Abstract Despite recent advances in therapeutic strategies, a large proportion of patients with mantle cell lymphoma (MCL) experience progression after first-line treatment. Several attempts have been made to assess the role of different therapies for the treatment of patients with relapsed/refractory mantle cell lymphoma; however, a consensus on the optimal therapeutic strategy for each individual patient has not been reached. Overall, clinical evidence from phase II studies shows that high-dose cytarabine containing regimens, stem cell transplant and different biological agents all have promising activity with acceptable safety profiles. Therefore, these therapies can represent suitable treatment options for patients with relapsed/refractory MCL. Among different biological agents, at present only temsirolimus has been tested in a phase III study. This review considers available evidence on the management of relapsed/refractory MCL as discussed during a consensus meeting on the current treatment strategies for MCL.
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Affiliation(s)
- Francesco Zaja
- Clinica Ematologica, Centro Trapianti e Terapie Cellulari "Carlo Melzi", DISM, Azienda Ospedaliero Universitaria S. M. Misericordia , Udine , Italy
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Humala K, Younes A. Current and emerging new treatment strategies for mantle cell lymphoma. Leuk Lymphoma 2013; 54:912-21. [DOI: 10.3109/10428194.2012.726719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Vogt N, Klapper W. Variability in morphology and cell proliferation in sequential biopsies of mantle cell lymphoma at diagnosis and relapse: clinical correlation and insights into disease progression. Histopathology 2012; 62:334-42. [DOI: 10.1111/his.12009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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McKay P, Leach M, Jackson R, Cook G, Rule S. Guidelines for the investigation and management of mantle cell lymphoma. Br J Haematol 2012; 159:405-26. [PMID: 22994971 DOI: 10.1111/bjh.12046] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- P McKay
- Department of Haematology, Beatson West of Scotland Cancer Centre, Gartnavel Hospital, Glasgow, UK
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8
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Role of Histone Deacetylase Inhibitors in the Treatment of Lymphomas and Multiple Myeloma. Hematol Oncol Clin North Am 2012; 26:671-704, ix. [DOI: 10.1016/j.hoc.2012.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gimenez E, Chauvet M, Rabin L, Puteaud I, Duley S, Hamaidia S, Bruder J, Rolland-Neyret V, Le Gouill S, Tournilhac O, Voog E, Maisonneuve H, Jacob MC, Leroux D, Béné MC, Formisano-Tréziny C, Gabert J, Gressin R, Callanan MB. Cloned IGH VDJ
targets as tools for personalized minimal residual disease monitoring in mature lymphoid malignancies; a feasibility study in mantle cell lymphoma by the Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang. Br J Haematol 2012; 158:186-197. [DOI: 10.1111/j.1365-2141.2012.09161.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 03/14/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Estelle Gimenez
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Martine Chauvet
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Laetitia Rabin
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Isabelle Puteaud
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Samuel Duley
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
| | - Sieme Hamaidia
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Pôle recherche; CHU de Grenoble; Grenoble France
| | - Juliana Bruder
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
| | - Valérie Rolland-Neyret
- Pôle recherche; CHU de Grenoble; Grenoble France
- Pôle de Cancérologie et d'Hématologie; CHU de Grenoble; Grenoble France
| | | | - Olivier Tournilhac
- Hématologie; Hôtel Dieu; CHU de Clermont Ferrand, Boulevard Leon Malfreyt; Clermont Ferrand France
| | - Eric Voog
- Service d'Hématologie; Clinique Victor Hugo, 1 rue Victor Hugo; Le Mans France
| | | | - Marie C. Jacob
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Laboratoire d'immunologie cellulaire; CHU de Grenoble; Grenoble France
| | - Dominique Leroux
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
| | - Marie C. Béné
- Immunologie; CHU de Nancy & Nancy Université; Vandoeuvre les Nancy France
| | | | - Jean Gabert
- Faculté de Médecine; Université de la Méditerranée; Marseille France
- Laboratoire de Biologie Moléculaire, Hôpital Nord; Marseille France
| | - Rémy Gressin
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Pôle de Cancérologie et d'Hématologie; CHU de Grenoble; Grenoble France
| | - Mary B. Callanan
- INSERM U823, Institut Albert Bonniot; Grenoble France
- Université Joseph Fourier-Grenoble I; Institut Albert Bonniot; Grenoble France
- Plateforme de génétique moléculaire des cancers, Pôle de Biologie; CHU de Grenoble; Grenoble France
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Dawar R, Hernandez-Ilizaliturri F. The emerging role of lenalidomide in the management of mantle cell lymphoma (MCL). Best Pract Res Clin Haematol 2012; 25:185-90. [PMID: 22687454 DOI: 10.1016/j.beha.2012.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Mantle cell lymphoma (MCL) is considered an aggressive and incurable B-cell malignancy despite current available treatments that include the incorporation of rituximab, bortezomib, high-dose cytarabine, and for those eligible, high dose chemotherapy and autologous bone marrow transplant (HDC-ASCT). Patients with relapsed/refractory MCL represent a challenge for the treating physician stressing the need to develop therapeutic agents. Lenalidomide, a novel inmmunomodulatory drug (IMiD), is a promising therapeutic strategy for patients with relapsed/refractory B-cell lymphoma. Biologically, the mechanisms responsible for lenalidomide activity are yet to be clearly defined. Based on pre-clinical models and early correlative studies conducted parallel to clinical trials, lenalidomide has been found to enhance NK-cell and T-cell activity against tumor cells, alter the balance of pro- and anti-inflammatory cytokines in the tumor bed, inhibit angiogenesis, and to a lesser degree, induce cell cycle arrest and apoptosis in cancer cells. Together, all these biological effects appear to play a role in the activity observed in lymphoma patients treated with lenalidomide. Given the effect in NK- and T-cell function, lenalidomide is an alternative strategy to enhance the anti-tumor activity of monoclonal antibodies (mAbs). Clinical responses have been observed in patients with relapsed/refractory chronic lymphocytic leukemia (CLL), follicular lymphoma, small lymphocytic lymphoma, diffuse large B-cell lymphoma (DLBCL), and MCL. The favorable toxicity profile and route of administration made the use of lenalidomide an attractive therapy for certain types of patients (i.e. elderly, chemotherapy unfit, etc.). The erratic but serious incidence of tumor lysis syndrome and/or tumor flare reactions provides challenges in the incorporation of lenalidomide in the management of previously untreated lymphoma patients with bulky adenopathy. Early studies evaluating the efficacy and toxicity of lenalidomide in combination with steroids or rituximab/bendamustine in MCL are promising and warrant further study. In addition, the evaluation of lenalidomide in the maintenance setting (i.e. post HDC-ASCT) or in combination with other target specific agents (i.e. proteasome inhibitors) in MCL is being addressed in ongoing clinical trials. We provide a general overview of the clinical development of lenalidomide in MCL. Future translational and clinical studies will further define the role of lenalidomide in the management of de novo or relapsed/refractory MCL and may assist in the identification of subset of MCL patients most likely to gain clinical benefit from this exiting agent.
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Affiliation(s)
- Richa Dawar
- Medical Oncology and Immunology, Roswell Park Cancer Institute (RPCI), Elm and Carlton Streets, Buffalo, NY 14263, USA
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Seok Y, Kim J, Choi JR, Kim YR, Park SJ, Kim SJ, Song J, Lee KA. CD5-negative blastoid variant mantle cell lymphoma with complex CCND1/IGH and MYC aberrations. Ann Lab Med 2011; 32:95-8. [PMID: 22259787 PMCID: PMC3255497 DOI: 10.3343/alm.2012.32.1.95] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 02/07/2023] Open
Abstract
The coexistence of CCND1/IGH and MYC rearrangements in mantle cell lymphoma (MCL) is a rare finding associated with a very poor prognosis. In this study, a patient with blastoid variant (MCL) is reported. The disease was clinically aggressive and refractory to chemotherapy, and the patient only survived for 1 month following diagnosis. Conventional cytogenetic study, FISH, and multicolor FISH (mFISH) demonstrated the involvement of the BCL1/CCND1 locus in a complex translocation, t(3;11)(q25;p15)t(11;14)(q13;q32). In addition, subclonal abnormalities in the 8q24 region, manifested as a t(8;14)(q24;q32)/MYC rearrangement, were identified. To the best of our knowledge, this is the first MCL case in Korea bearing these complex genomic aberrations.
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Affiliation(s)
- Yoonmi Seok
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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Dreyling M, Kluin-Nelemans HC, Beà S, Hartmann E, Salaverria I, Hutter G, Perez-Galan P, Roue G, Pott C, Gouill SL, Cortelazzo S, Rule S, Hess G, Zaja F, Vitolo U, Szymczyk M, Walewski J, Ribrag V, Unterhalt M, Hermine O, Hoster E. Update on the molecular pathogenesis and clinical treatment of mantle cell lymphoma: report of the 10th annual conference of the European Mantle Cell Lymphoma Network. Leuk Lymphoma 2011; 52:2226-36. [DOI: 10.3109/10428194.2011.600488] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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HDM-2 inhibition suppresses expression of ribonucleotide reductase subunit M2, and synergistically enhances gemcitabine-induced cytotoxicity in mantle cell lymphoma. Blood 2011; 118:4140-9. [PMID: 21844567 DOI: 10.1182/blood-2011-03-340323] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Mantle cell lymphoma (MCL) usually responds well to initial therapy but is prone to relapses with chemoresistant disease, indicating the need for novel therapeutic approaches. Inhibition of the p53 E3 ligase human homolog of the murine double minute protein-2 (HDM-2) with MI-63 has been validated as one such strategy in wild-type (wt) p53 models, and our genomic and proteomic analyses demonstrated that MI-63 suppressed the expression of the ribonucleotide reductase (RNR) subunit M2 (RRM2). This effect occurred in association with induction of p21 and cell-cycle arrest at G(1)/S and prompted us to examine combinations with the RNR inhibitor 2',2'-difluoro-2'-deoxycytidine (gemcitabine). The regimen of MI-63-gemcitabine induced enhanced, synergistic antiproliferative, and proapoptotic effects in wtp53 MCL cell lines. Addition of exogenous dNTPs reversed this effect, whereas shRNA-mediated inhibition of RRM2 was sufficient to induce synergy with gemcitabine. Combination therapy of MCL murine xenografts with gemcitabine and MI-219, the in vivo analog of MI-63, resulted in enhanced antitumor activity. Finally, synergy was seen with MI-63-gemcitabine in primary patient samples that were found to express high levels of RRM2 compared with MCL cell lines. These findings provide a framework for translation of the rational combination of an HDM-2 and RNR inhibitor to the clinic for patients with relapsed wtp53 MCL.
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Harel S, Delarue R, Ribrag V, Dreyling M, Hermine O. Treatment of Younger Patients With Mantle Cell Lymphoma. Semin Hematol 2011; 48:194-207. [DOI: 10.1053/j.seminhematol.2011.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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