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Métivier C, Le Saëc P, Gaschet J, Chauvet C, Marionneau-Lambot S, Hofgaard PO, Bogen B, Pineau J, Le Bris N, Tripier R, Alliot C, Haddad F, Chérel M, Chouin N, Faivre-Chauvet A, Rbah-Vidal L. Preclinical Evaluation of a 64Cu-Based Theranostic Approach in a Murine Model of Multiple Myeloma. Pharmaceutics 2023; 15:1817. [PMID: 37514004 PMCID: PMC10385603 DOI: 10.3390/pharmaceutics15071817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023] Open
Abstract
Although the concept of theranostics is neither new nor exclusive to nuclear medicine, it is a particularly promising approach for the future of nuclear oncology. This approach is based on the use of molecules targeting specific biomarkers in the tumour or its microenvironment, associated with optimal radionuclides which, depending on their emission properties, allow the combination of diagnosis by molecular imaging and targeted radionuclide therapy (TRT). Copper-64 has suitable decay properties (both β+ and β- decays) for PET imaging and potentially for TRT, making it both an imaging and therapy agent. We developed and evaluated a theranostic approach using a copper-64 radiolabelled anti-CD138 antibody, [64Cu]Cu-TE1PA-9E7.4 in a MOPC315.BM mouse model of multiple myeloma. PET imaging using [64Cu]Cu-TE1PA-9E7.4 allows for high-resolution PET images. Dosimetric estimation from ex vivo biodistribution data revealed acceptable delivered doses to healthy organs and tissues, and a very encouraging tumour absorbed dose for TRT applications. Therapeutic efficacy resulting in delayed tumour growth and increased survival without inducing major or irreversible toxicity has been observed with 2 doses of 35 MBq administered at a 2-week interval. Repeated injections of [64Cu]Cu-TE1PA-9E7.4 are safe and can be effective for TRT application in this syngeneic preclinical model of MM.
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Affiliation(s)
- Cassandra Métivier
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
| | - Patricia Le Saëc
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
| | - Joëlle Gaschet
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
| | - Catherine Chauvet
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
| | | | - Peter O Hofgaard
- Department of Immunology, Oslo University Hospital, 04024 Oslo, Norway
| | - Bjarne Bogen
- Department of Immunology, Oslo University Hospital, 04024 Oslo, Norway
| | - Julie Pineau
- Univ. Brest, UMR CNRS 6521 CEMCA, 6 Avenue Victor le Gorgeu, 29200 Brest, France
| | - Nathalie Le Bris
- Univ. Brest, UMR CNRS 6521 CEMCA, 6 Avenue Victor le Gorgeu, 29200 Brest, France
| | - Raphaël Tripier
- Univ. Brest, UMR CNRS 6521 CEMCA, 6 Avenue Victor le Gorgeu, 29200 Brest, France
| | - Cyrille Alliot
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
- GIP ARRONAX, 44800 Saint-Herblain, France
| | - Férid Haddad
- IMT Atlantique, Nantes Université, Subatech, 44307 Nantes, France
- GIP ARRONAX, 44800 Saint-Herblain, France
| | - Michel Chérel
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
- Nuclear Medicine Department, ICO-René Gauducheau Cancer Center, 44800 Saint-Herblain, France
| | - Nicolas Chouin
- Nantes Université, Inserm, CNRS, Université d'Angers, Oniris, CRCI2NA, 44007 Nantes, France
| | - Alain Faivre-Chauvet
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, CHU Nantes, 44007 Nantes, France
| | - Latifa Rbah-Vidal
- Nantes Université, Inserm, CNRS, Université d'Angers, CRCI2NA, 44007 Nantes, France
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Ipek Y, Karademir N, Yilmazer O, Yilmaz G. The Effects of Second Primary Malignancies and Frailty on Overall Survival and Mortality in Geriatric Turkish Patients with Multiple Myeloma. Curr Oncol 2023; 30:5615-5630. [PMID: 37366906 DOI: 10.3390/curroncol30060423] [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: 05/03/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
The study aims to investigate second primary malignancy (SPM) development and frailty in Turkish geriatric patients with multiple myeloma (MM) and to assess the relationship between overall survival (OS) and various characteristics including SPM and frailty. Seventy-two patients diagnosed with and treated for MM were enrolled in the study. Frailty was determined by the IMWG Frailty Score. Fifty-three participants (73.6%) were found to have clinically-relevant frailty. Seven patients (9.7%) had SPM. Median follow-up was 36.5 (22-48.5) months, and 17 patients died during the follow-up period. Overall (OS) was 49.40 (45.01-53.80) months. Shorter OS was found in patients with SPM (35.29 (19.66-50.91) months) compared to those without (51.05 (46.7-55.4) months) (Kaplan-Meier; p = 0.018). The multivariate cox proportional hazards model revealed that patients with SPM had 4.420-fold higher risk of death than those without (HR: 4.420, 95% CI: 1.371-14.246, p = 0.013). Higher ALT levels were also independently associated with mortality (p = 0.038). The prevalence of SPM and frailty was high in elderly patients with MM in our study. The development of SPM independently reduces survival in MM; however, frailty was not found to be independently associated with survival. Our results suggest the importance of individualized approaches in the management of patients with MM, particularly with regard to SPM development.
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Affiliation(s)
- Yildiz Ipek
- Department of Hematology, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Nevra Karademir
- Department of Internal Diseases, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Onur Yilmazer
- Department of Internal Diseases, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Guven Yilmaz
- Department of Hematology, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
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Jin Y, Shang Y, Liu H, Ding L, Tong X, Tu H, Yuan G, Zhou F. A Retrospective Analysis: A Novel Index Predicts Survival and Risk-Stratification for Bone Destruction in 419 Newly Diagnosed Multiple Myelomas. Onco Targets Ther 2019; 12:10587-10596. [PMID: 31819538 PMCID: PMC6899072 DOI: 10.2147/ott.s229122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022] Open
Abstract
Objective Multiple myeloma (MM) patients with bone destruction are difficult to restore, so it is of great clinical significance to further explore the factors affecting MM bone destruction. Methods and results This study retrospectively analyzed 419 cases with MM. Multiple linear regression analysis showed that those MM patients with a higher concentration of Ca2+ in serum, higher positive rate of CD138 immuno-phenotype and advanced in stage with 13q34 deletion in cytogenetics would be more prone to bone destruction, while total bile acid (TBA) and kappa chain isotope negatively correlated with bone destruction in MM patients. The Kaplan-Meier analysis indicated that Ca2+, serum β2-microglobulin (β2-MG), hemoglobin (HGB), creatinine (CREA), uric acid (UA) and age correlated with the survival of bone destruction in MM patients. Cox regression analysis further showed that the independent prognostic factors of β2-MG and CREA had a higher risk for early mortality in bone destruction patients. Moreover, an index was calculated based on β2-MG and globulin (GLB) to white blood cell (WBC) ratio to predict the poor survival of bone destruction patients. Conclusion We provide a novel marker to predict the prognosis of myeloma patients using routine examination method instead of bone marrow aspiration, and provide a reference for clinical evaluation.
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Affiliation(s)
- Yanxia Jin
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China.,Hubei Key Laboratory of Edible Wild Plants Conservation and Utilization, Hubei Normal University, Huangshi, Hubei 435002, People's Republic of China
| | - Yufeng Shang
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China
| | - Hailing Liu
- Department of Clinical Hematology, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, People's Republic of China
| | - Lu Ding
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China
| | - Xiqin Tong
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China
| | - Honglei Tu
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China
| | - Guolin Yuan
- Department of Hematology, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441021, People's Republic of China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China.,Key Laboratory of Tumor Biological Behavior of Hubei Province, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, People's Republic of China
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Obstructive Jaundice as Initial Presentation of Multiple Myeloma: Case Presentation and Literature Review. Case Rep Med 2015. [PMID: 26221143 PMCID: PMC4480243 DOI: 10.1155/2015/686210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Multiple myeloma is a malignant plasma-cell disorder that primarily involves the bone marrow, but extramedullary involvement is becoming increasingly common (Bladé et al., 2012) both at initial presentation and follow-up. Most common initial presentations for multiple myeloma include generalized fatigue, renal insufficiency, bone pain, and recurrent bacterial infections. We present a case of a healthy 55-year-old man that presented to the emergency department with a three-week history of anorexia and jaundice without any past medical history. Patient's initial labs were significant for hyperbilirubinemia and elevated liver function enzymes (AST, ALT, ALP, and GGT). Additional laboratory workup was significant for mild hypercalcemia and increased protein gap. MRI and ERCP suggested primary sclerosing cholangitis but were not diagnostic. Liver biopsy illustrated plasma-cell infiltration and bone marrow biopsy diagnosed multiple myeloma with extramedullary disease. Patient was started on dexamethasone, bortezomib, and cyclophosphamide, but, despite this aggressive regimen, the patient continued to decline. We take this opportunity to present this atypical presentation of a common hematological malignancy and review the associated literature.
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Kiba T, Ito T, Nakashima T, Okikawa Y, Kido M, Kimura A, Kameda K, Miyamae F, Tanaka S, Atsumi M, Sumitani Y, Shitakubo Y, Niimi H. Bortezomib and dexamethasone for multiple myeloma: higher AST and LDH levels associated with a worse prognosis on overall survival. BMC Cancer 2014; 14:462. [PMID: 24952705 PMCID: PMC4078016 DOI: 10.1186/1471-2407-14-462] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/18/2014] [Indexed: 12/27/2022] Open
Abstract
Background Bortezomib offers a novel approach to the treatment of multiple myeloma producing rapid control. The aim of this study was to investigate the outcomes of bortezomib and dexamethasone-treated patients with multiple myeloma. Methods We conducted a retrospective study of 44 consecutively-treated multiple myeloma patients with bortezomib (1.3 mg/m2 on days 1, 4, 8, and 11 of a 21-day cycle or 1.3 mg/m2 intravenously 1, 8, 15, and 22 of every 35-day cycle) and dexamethasone. Results The median time to progression, progression free survival time, and overall survival time in the treatment groups was 14.9, 14.9, and 38.3 months, respectively. The present study also suggests the possibility that the prognosis of patients with high levels of AST and LDH might be worse. Conclusions Our results indicate that the treatment of multiple myeloma with bortezomib and dexamethasone is feasible.
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Affiliation(s)
- Takayoshi Kiba
- Division of Modern Medical Technology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure-shi, Hiroshima 737-0023, Japan.
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