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Abstract
Since the discovery of immune checkpoint proteins, there has been a special interest in developing antibodies that block programmed cell death 1 receptor (PD-1) and programmed cell death receptor ligand 1 (PD-L1) for a subset of cancer patients. PD-1 signaling negatively regulates T cell-mediated immune responses and serves as a mechanism for tumors to evade an antigen-specific T cell immunologic response. It plays a role in promoting cancer development and progression by enhancing tumor cell survival. With this background, PD-1 signaling represents a valuable therapeutic target for novel and effective cancer immunotherapy. Clinical data shows that blockade of this PD-1 signaling significantly enhance antitumor immunity, produce durable clinical responses, and prolong survival. Currently, there are three FDA-approved PD-L1 inhibitors for various malignancies ranging from non-small cell lung cancer to Merkel cell carcinoma. This review is to summarize many ongoing phase II/III trials of atezolizumab, durvalumab, avelumab, and new PD-L1 inhibitors in clinical developments. In particular, we focus on key trials that paved the pathway to FDA-approved indications for atezolizumab, durvalumab, and avelumab. Despite the popularity and accelerated FDA approval of PD-L1 inhibitors, further considerations into predictive biomarkers, mechanisms of resistance, treatment duration, immune-related toxicities, and PD-L1 expression threshold are needed to optimize anticancer potential in this class of immunotherapy.
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Affiliation(s)
- Akintunde Akinleye
- Department of Internal Medicine, Sovah Health, Danville, VA, 24541, USA.
| | - Zoaib Rasool
- Department of Internal Medicine, Sovah Health, Danville, VA, 24541, USA
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2
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Abstract
Pancreatic cancer is relatively insensitive to conventional chemotherapy. Therefore, novel agents targeting dysregulated pathways (MAPK/ERK, EGFR, TGF-β, HEDGEHOG, NOTCH, IGF, PARP, PI3K/AKT, RAS, and Src) are being explored in clinical trials as monotherapy or in combination with cytotoxic chemotherapy. This review summarizes the most recent advances with the targeted therapies in the treatment of patients with advanced pancreatic cancer.
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Affiliation(s)
- Akintunde Akinleye
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York, United States
| | - Chaitanya Iragavarapu
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York, United States
| | - Muhammad Furqan
- Division of Hematology/Oncology, Department of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Shundong Cang
- Department of Oncology, Henan Province People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Delong Liu
- Department of Oncology, Henan Cancer Hospital and the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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3
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Akinleye A, Nelson J, Islam H, Saeed F, Liu D. Franklin's disease: immunoglobulin heavy chain disease. Stem Cell Investig 2015; 2:1. [PMID: 27358869 DOI: 10.3978/j.issn.2306-9759.2015.01.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 01/05/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Akintunde Akinleye
- 1 Division of Hematology/Oncology, Department of Medicine, 2 Department of Pathology, New York Medical College, Valhalla, NY 10595, USA
| | - John Nelson
- 1 Division of Hematology/Oncology, Department of Medicine, 2 Department of Pathology, New York Medical College, Valhalla, NY 10595, USA
| | - Humayun Islam
- 1 Division of Hematology/Oncology, Department of Medicine, 2 Department of Pathology, New York Medical College, Valhalla, NY 10595, USA
| | - Faisal Saeed
- 1 Division of Hematology/Oncology, Department of Medicine, 2 Department of Pathology, New York Medical College, Valhalla, NY 10595, USA
| | - Delong Liu
- 1 Division of Hematology/Oncology, Department of Medicine, 2 Department of Pathology, New York Medical College, Valhalla, NY 10595, USA
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4
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Furqan M, Chen Y, Akinleye A, Sarungbam J, Gass A, Seiter K, Liu D. Management of mantle cell leukemia with cardiac involvement leading to cardiogenic shock. Front Med 2014; 8:254-8. [PMID: 24627286 DOI: 10.1007/s11684-014-0319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 12/26/2013] [Indexed: 10/25/2022]
Abstract
Mantle cell lymphoma is an aggressive subtype of B cell non-Hodgkin lymphoma. It can progress to leukemic phase but frank leukemic picture at initial presentation is not common. Leukemic phase indicates advance stage of the disease and generally associated with extensive extra-nodal involvement. Pericardial invasion has been reported, however we could not find a report of myocardial infiltration by this disease since the appraisal of the term "mantle cell lymphoma" in 1992. Here we report a case of cardiac involvement by mantle cell leukemia leading to cardiogenic shock which complicates the treatment decisions.
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Affiliation(s)
- Muhammad Furqan
- Division of Hematology and Oncology, Department of Medicine, Westchester Medical Center, 100 Woods Rd, Valhalla, NY, 10595, USA
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5
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Abstract
Signal Transducer and Activator of Transcription (STAT) proteins are a family of cytoplasmic transcription factors consisting of 7 members, STAT1 to STAT6, including STAT5a and STAT5b. STAT proteins are thought to be ideal targets for anti-cancer therapy since cancer cells are more dependent on the STAT activity than their normal counterparts. Inhibitors targeting STAT3 and STAT5 have been developed. These included peptidomimetics, small molecule inhibitors and oligonucleotides. This review summarized advances in preclinical and clinical development of these compounds.
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Affiliation(s)
- Muhammad Furqan
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
| | - Akintunde Akinleye
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
| | - Nikhil Mukhi
- Department of Medicine, SUNY Downstate Medical Center Brooklyn, Brooklyn, NY 11203, USA
| | - Varun Mittal
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
| | - Yamei Chen
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
- Department of Hematology, Xiamen Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Delong Liu
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
- Division of Hematology and Oncology, Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA
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6
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Akinleye A, Avvaru P, Furqan M, Song Y, Liu D. Phosphatidylinositol 3-kinase (PI3K) inhibitors as cancer therapeutics. J Hematol Oncol 2013; 6:88. [PMID: 24261963 PMCID: PMC3843585 DOI: 10.1186/1756-8722-6-88] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 11/12/2013] [Indexed: 02/08/2023] Open
Abstract
Phosphatidylinositol 3-kinases (PI3Ks) are lipid kinases that regulate diverse cellular processes including proliferation, adhesion, survival, and motility. Dysregulated PI3K pathway signaling occurs in one-third of human tumors. Aberrantly activated PI3K signaling also confers sensitivity and resistance to conventional therapies. PI3K has been recognized as an attractive molecular target for novel anti-cancer molecules. In the last few years, several classes of potent and selective small molecule PI3K inhibitors have been developed, and at least fifteen compounds have progressed into clinical trials as new anticancer drugs. Among these, idelalisib has advanced to phase III trials in patients with advanced indolent non-Hodgkin's lymphoma and mantle cell lymphoma. In this review, we summarized the major molecules of PI3K signaling pathway, and discussed the preclinical models and clinical trials of potent small-molecule PI3K inhibitors.
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Affiliation(s)
| | | | | | | | - Delong Liu
- Division of Hematology/Oncology, Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA.
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7
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Akinleye A, Furqan M, Adekunle O. Ibrutinib and indolent B-cell lymphomas. Clin Lymphoma Myeloma Leuk 2013; 14:253-60. [PMID: 24445187 DOI: 10.1016/j.clml.2013.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/21/2013] [Accepted: 08/28/2013] [Indexed: 12/22/2022]
Abstract
Most patients with indolent B-cell lymphomas fail to achieve complete remission with current treatment approaches and invariably relapse. During the past decade, innovative immunochemotherapy strategies have substantially improved disease control rates but not survival, thus providing the rationale for development of novel agents targeting dysregulated pathways that are operable in these hematological malignancies. Ibrutinib, a novel first-in-human Bruton's tyrosine kinase (BTK) inhibitor, has progressed into phase III trials after early-phase clinical studies demonstrated effective target inhibition, increased tumor response rates, and significant improvement in survival, particularly in patients with indolent B-cell lymphomas. Recently, the compound was designated a "breakthrough therapy" by the United States Food and Drug Administration for the treatment of patients with relapsed or refractory mantle cell lymphoma and Waldenström macroglobulinemia. This review summarizes recent achievements of ibrutinib, with a focus on its emerging role in the treatment of patients with indolent B-cell lymphoid malignancies.
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Affiliation(s)
- Akintunde Akinleye
- Division of Hematology and Oncology, Department of Medicine, New York Medical College, Valhalla, NY; Department of Medicine, Richmond University Medical Center, Staten Island, NY.
| | - Muhammad Furqan
- Division of Hematology and Oncology, Department of Medicine, New York Medical College, Valhalla, NY
| | - Oluwaseyi Adekunle
- Department of Medicine, Richmond University Medical Center, Staten Island, NY
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8
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Abstract
Small molecule inhibitors targeting dysregulated pathways (RAS/RAF/MEK, PI3K/AKT/mTOR, JAK/STAT) have significantly improved clinical outcomes in cancer patients. Recently Bruton's tyrosine kinase (BTK), a crucial terminal kinase enzyme in the B-cell antigen receptor (BCR) signaling pathway, has emerged as an attractive target for therapeutic intervention in human malignancies and autoimmune disorders. Ibrutinib, a novel first-in-human BTK-inhibitor, has demonstrated clinical effectiveness and tolerability in early clinical trials and has progressed into phase III trials. However, additional research is necessary to identify the optimal dosing schedule, as well as patients most likely to benefit from BTK inhibition. This review summarizes preclinical and clinical development of ibrutinib and other novel BTK inhibitors (GDC-0834, CGI-560, CGI-1746, HM-71224, CC-292, and ONO-4059, CNX-774, LFM-A13) in the treatment of B-cell malignancies and autoimmune disorders.
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Affiliation(s)
- Akintunde Akinleye
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA
| | - Yamei Chen
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA
- Department of Hematology, Xiamen Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Nikhil Mukhi
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA
| | - Yongping Song
- Institute of Hematology, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou, China
| | - Delong Liu
- Division of Hematology/Oncology, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA
- Institute of Hematology, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou, China
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9
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Abstract
Chronic lymphocytic leukemia (CLL) is a heterogeneous group of B-cell neoplasm. CLL is typically sensitive to a variety of cytotoxic agents, but relapse frequently occurs with conventional approaches. The treatment of CLL is evolving rapidly with the introduction of novel drugs, such as bendamustine, ofatumumab, lenalidomide, ibrutinib, idelalisib, veltuzumab, XmAb5574, navitoclax, dasatinib, alvespimycin, and TRU-016. This review summarizes the most current clinical experiences with these agents in the treatment of CLL.
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Affiliation(s)
- Mei Wu
- Department of Hematology, First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, 362000, China
| | - Akintunde Akinleye
- Division of Hematology/Oncology, New York Medical College and Westchester Medical Center, Valhalla, NY, 10595, USA
| | - Xiongpeng Zhu
- Department of Hematology, First Hospital of Quanzhou affiliated to Fujian Medical University, Quanzhou, 362000, China
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10
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Abstract
Four distinct MAP kinase signaling pathways involving 7 MEK enzymes have been identified. MEK1 and MEK2 are the prototype members of MEK family proteins. Several MEK inhibitors are in clinical trials. Trametinib is being evaluated by FDA for the treatment of metastatic melanoma with BRAF V600 mutation. Selumetinib has been studied in combination with docetaxel in phase II randomized trial in previously treated patients with advanced lung cancer. Selumetinib group had better response rate and progression-free survival. This review also summarized new MEK inhibitors in clinical development, including pimasertib, refametinib, PD-0325901, TAK733, MEK162 (ARRY 438162), RO5126766, WX-554, RO4987655 (CH4987655), GDC-0973 (XL518), and AZD8330.
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Affiliation(s)
- Akintunde Akinleye
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, 10595, USA
| | - Muhammad Furqan
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, 10595, USA
| | - Nikhil Mukhi
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, 10595, USA
| | - Pavan Ravella
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, 10595, USA
| | - Delong Liu
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, 10595, USA
- Division of Hematology and Oncology, New York Medical College and Westchester Medical Center, Valhalla, NY, USA
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11
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Affiliation(s)
- A A Ajayi
- Department of Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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