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Lubben B, Alhallak K, Sun J, Muz B, Bash H, Park C, Adebayo O, Achilefu S, DiPersio JF, Azab AK. Targeted Cancer Immunotherapy by Nanoparticle T Cell Engagers. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r2489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Berit Lubben
- Washington University in Saint LouisSaint LouisMO
- Saint Louis UniversitySaint LouisMO
| | | | - Jennifer Sun
- Washington University in Saint LouisSaint LouisMO
| | - Barbara Muz
- Washington University in Saint LouisSaint LouisMO
| | - Hannah Bash
- Washington University in Saint LouisSaint LouisMO
| | - Chaelee Park
- Washington University in Saint LouisSaint LouisMO
| | - Ola Adebayo
- Washington University in Saint LouisSaint LouisMO
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Ghobrial IM, Liu C, Zavidij O, Azab AK, Baz R, Laubach JP, Mishima Y, Armand P, Munshi NC, Basile F, Constantine M, Vredenburgh J, Boruchov A, Crilley P, Henrick PM, Hornburg KTV, Leblebjian H, Chuma S, Reyes K, Noonan K, Warren D, Schlossman R, Paba‐Prada C, Anderson KC, Weller E, Trippa L, Shain K, Richardson PG. Phase I/II trial of the CXCR4 inhibitor plerixafor in combination with bortezomib as a chemosensitization strategy in relapsed/refractory multiple myeloma. Am J Hematol 2019; 94:1244-1253. [PMID: 31456261 DOI: 10.1002/ajh.25627] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/11/2022]
Abstract
We tested the hypothesis that using CXCR4 inhibition to target the interaction between the tumor cells and the microenvironment leads to sensitization of the tumor cells to apoptosis. Eligibility criteria included multiple myeloma (MM) patients with 1-5 prior lines of therapy. The purposes of the phase I study were to evaluate the safety and maximal-tolerated dose (MTD) of the combination. The treatment-related adverse events and response rate of the combination were assessed in the phase II study. A total of 58 patients were enrolled in the study. The median age of the patients was 63 years (range, 43-85), and 78% of them received prior bortezomib. In the phase I study, the MTD was plerixafor 0.32 mg/kg, and bortezomib 1.3 mg/m2 . The overall response rate for the phase II study was 48.5%, and the clinical benefit rate 60.6%. The median disease-free survival was 12.6 months. The CyTOF analysis demonstrated significant mobilization of plasma cells, CD34+ stem cells, and immune T cells in response to plerixafor. This is an unprecedented study that examines therapeutic targeting of the bone marrow microenvironment and its interaction with the tumor clone to overcome resistance to therapy. Our results indicate that this novel combination is safe and that the objective response rate is high even in patients with relapsed/refractory MM. ClinicalTrials.gov, NCT00903968.
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Affiliation(s)
- Irene M. Ghobrial
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Chia‐Jen Liu
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Oksana Zavidij
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Abdel K. Azab
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
- Department of Radiation OncologyCancer Biology Division, Washington University School of Medicine St. Louis, Missouri
| | - Rachid Baz
- Department of Malignant HaematologyH. Lee Moffitt Cancer Center and Research Institute Tampa, Florida
| | - Jacob P. Laubach
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Yuji Mishima
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Philippe Armand
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Nikhil C. Munshi
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Frank Basile
- Department of Medical OncologyDavenport‐Mugar Cancer Center, Cape Cod Hospital Hyannis Massachusetts
| | - Michael Constantine
- Department of Medical OncologyDana‐Farber/Brigham and Women's Cancer Center, Milford Regional Medical Center Milford Massachusetts
| | - James Vredenburgh
- Department of Medical OncologySaint Francis Hospital and Medical Center Hartford Connecticut
| | - Adam Boruchov
- Department of Medical OncologySaint Francis Hospital and Medical Center Hartford Connecticut
| | - Pamela Crilley
- Department of Medical OncologyCancer Treatment Centers of America, Eastern Regional Medical Center Philadelphia Pennsylvania
| | - Patrick M. Henrick
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Kalvis T. V. Hornburg
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Houry Leblebjian
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Stacey Chuma
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Kaitlen Reyes
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Kimberly Noonan
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Diane Warren
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Robert Schlossman
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Claudia Paba‐Prada
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Kenneth C. Anderson
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
| | - Edie Weller
- Department of Biostatistics and Computational BiologyDana‐Farber Cancer Institute Boston Massachusetts
| | - Lorenzo Trippa
- Department of Biostatistics and Computational BiologyDana‐Farber Cancer Institute Boston Massachusetts
| | - Kenneth Shain
- Department of Malignant HaematologyH. Lee Moffitt Cancer Center and Research Institute Tampa, Florida
| | - Paul G. Richardson
- Medical Oncology, Dana‐Farber Cancer InstituteHarvard Medical School Boston Massachusetts
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Waldschmidt JM, Simon A, Wider D, Müller SJ, Follo M, Ihorst G, Decker S, Lorenz J, Chatterjee M, Azab AK, Duyster J, Wäsch R, Engelhardt M. CXCL12 and CXCR7 are relevant targets to reverse cell adhesion-mediated drug resistance in multiple myeloma. Br J Haematol 2017; 179:36-49. [PMID: 28670693 DOI: 10.1111/bjh.14807] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 04/01/2017] [Indexed: 12/14/2022]
Abstract
Cell adhesion-mediated drug resistance (CAM-DR) by the bone marrow (BM) is fundamental to multiple myeloma (MM) propagation and survival. Targeting BM protection to increase the efficacy of current anti-myeloma treatment has not been extensively pursued. To extend the understanding of CAM-DR, we hypothesized that the cytotoxic effects of novel anti-myeloma agents may be abrogated by the presence of BM stroma cells (BMSCs) and restored by addition of the CXCL12 antagonist NOX-A12 or the CXCR4 inhibitor plerixafor. Following this hypothesis, we evaluated different anti-myeloma agents alone, with BMSCs and when combined with plerixafor or NOX-A12. We verified CXCR4, CD49d (also termed ITGA4) and CD44 as essential mediators of BM adhesion on MM cells. Additionally, we show that CXCR7, the second receptor of stromal-derived-factor-1 (CXCL12), is highly expressed in active MM. Co-culture proved that co-treatment with plerixafor or NOX-A12, the latter inhibiting CXCR4 and CXCR7, functionally interfered with MM chemotaxis to the BM. This led to the resensitization of MM cells to the anti-myeloma agents vorinostat and pomalidomide and both proteasome inhibitors bortezomib and carfilzomib. Within a multicentre phase I/II study, NOX-A12 was tested in combination with bortezomib-dexamethasone, underlining the feasibility of NOX-A12 as an active add-on agent to antagonize myeloma CAM-DR.
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Affiliation(s)
- Johannes M Waldschmidt
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Simon
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dagmar Wider
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stefan J Müller
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marie Follo
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sarah Decker
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joschka Lorenz
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Manik Chatterjee
- Department of Internal Medicine II, Translational Oncology/CCC Mainfranken, University Hospital Würzburg, Würzburg, Germany
| | - Abdel K Azab
- Cancer Biology Division, Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Justus Duyster
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Wäsch
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Department of Haematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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de la Puente P, Muz B, Jin A, Azab F, Luderer M, Salama NN, Azab AK. MEK inhibitor, TAK-733 reduces proliferation, affects cell cycle and apoptosis, and synergizes with other targeted therapies in multiple myeloma. Blood Cancer J 2016; 6:e399. [PMID: 26918363 PMCID: PMC4771970 DOI: 10.1038/bcj.2016.7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P de la Puente
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - B Muz
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - A Jin
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA.,Department of Pharmaceutical and Administrative Sciences, St Louis College of Pharmacy, St Louis, MO, USA
| | - F Azab
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - M Luderer
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - N N Salama
- Department of Pharmaceutical and Administrative Sciences, St Louis College of Pharmacy, St Louis, MO, USA.,Department of Pharmaceutics and Industrial Pharmacy, Cairo University Faculty of Pharmacy, Cairo, MO, Egypt
| | - A K Azab
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
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Affiliation(s)
- B Muz
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - P de la Puente
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - F Azab
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - M Luderer
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - A K Azab
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
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Abstract
Multiple myeloma (MM) is an incurable disease characterized by the proliferation of plasma cells. The survival in MM patients has improved significantly in the past decade due to the introduction of novel agents. In this review, we focus on novel agents used in MM, including immunomodulatory drugs (thalidomide, lenalidomide and pomalidomide), proteasome inhibitors (bortezomib, carfilzomib, marizomib and ixazomib citrate), monoclonal antibodies (elotuzumab, siltuximab, daratumumab and BT-062), and drugs affecting an interaction with the tumor microenvironment (anti-VLA4 monoclonal antibody, chemokine CXCR4 inhibitor AMD-3100 and selectin inhibitor GMI-1070). We discuss their mechanism of action, preclinical and clinical outcome in the treatment of MM. Although the development of novel agents has improved the outcomes of MM treatment, most of the patients will still relapse and become refractory to therapy due to development of drug resistance. A better understanding of the biological mechanisms of MM progression, including cellular and molecular events in the MM cells and in their bone marrow microenvironment, is warranted to provide new therapeutic targets and develop new drugs and therapeutic strategies to treat MM.
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Affiliation(s)
- P de la Puente
- Department of Radiation Oncology, Cancer Biology Division, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.
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