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Benkova K, Mihalyova J, Hajek R, Jelinek T. Selinexor, selective inhibitor of nuclear export: Unselective bullet for blood cancers. Blood Rev 2021; 46:100758. [PMID: 32972802 DOI: 10.1016/j.blre.2020.100758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/26/2020] [Accepted: 08/13/2020] [Indexed: 11/25/2022]
Abstract
Exportin 1 (XPO1), also known as chromosome maintenance 1 protein (CRM1), is the main transporter for hundreds of proteins like tumor suppressors, growth regulatory factors, oncoprotein mRNAs and others. Its upregulation leads to the inactivation of the tumor suppressor anti-neoplastic function in many cancers and logically is associated with poor prognosis. Selective inhibitors of nuclear export (SINE) are a new generation of XPO1 inhibitors that are being investigated as a promising targeted anti-cancer therapy. Selinexor is the first generation of SINE compounds that is being evaluated in many clinical trials involving solid tumors and hematological malignancies with its two approved indications for relapsed multiple myeloma and relapsed diffuse large B-cell lymphoma. Here, we comprehensively review the current knowledge of selinexor and next generations of the SINE compounds in lymphoid and myeloid malignancies.
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Affiliation(s)
- Katerina Benkova
- Department of Hematooncology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava 708 52, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava 703 00, Czech Republic.
| | - Jana Mihalyova
- Department of Hematooncology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava 708 52, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava 703 00, Czech Republic.
| | - Roman Hajek
- Department of Hematooncology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava 708 52, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava 703 00, Czech Republic.
| | - Tomas Jelinek
- Department of Hematooncology, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava 708 52, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava 703 00, Czech Republic.
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Jelinek T, Popkova T, Duras J, Mihalyova J, Kascak M, Benkova K, Plonkova H, Cerna L, Koristek Z, Simicek M, Hajek R. Venetoclax plus bortezomib and dexamethasone in heavily pretreated end-stage myeloma patients without t(11;14): A real-world cohort. Hematol Oncol 2020; 38:412-414. [PMID: 32323881 DOI: 10.1002/hon.2736] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Tomas Jelinek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,Faculty of Science, University of Ostrava, Ostrava, Czech Republic
| | - Tereza Popkova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Juraj Duras
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Jana Mihalyova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Michal Kascak
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Katerina Benkova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Hana Plonkova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Lucie Cerna
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Zdenek Koristek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Michal Simicek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Roman Hajek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Jelinek T, Mihalyova J, Kascak M, Duras J, Popkova T, Benkova K, Richterova P, Plonkova H, Zuchnicka J, Broskevicova L, Huvarova L, Cerna L, Growkova K, Simicek M, Havel M, Gumulec J, Navratil M, Koristek Z, Paiva B, Hajek R. Single-agent venetoclax induces MRD-negative response in relapsed primary plasma cell leukemia with t(11;14). Am J Hematol 2019; 94:E35-E37. [PMID: 30370955 DOI: 10.1002/ajh.25331] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Tomas Jelinek
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
- Faculty of Science; University of Ostrava; Ostrava Czech Republic
- Centro de Investigación Médica Aplicada; Clínica Universidad de Navarra, IDISNA; Pamplona Spain
| | - Jana Mihalyova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Michal Kascak
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Juraj Duras
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Tereza Popkova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
| | - Katerina Benkova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Petra Richterova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Hana Plonkova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
| | - Jana Zuchnicka
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
| | - Lucie Broskevicova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
| | - Lucie Huvarova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Science; University of Ostrava; Ostrava Czech Republic
| | - Lucie Cerna
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
| | - Katerina Growkova
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Science; University of Ostrava; Ostrava Czech Republic
| | - Michal Simicek
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
- Faculty of Science; University of Ostrava; Ostrava Czech Republic
| | - Martin Havel
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
- Department of Imaging Methods; University Hospital Ostrava; Ostrava Czech Republic
| | - Jaromir Gumulec
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Milan Navratil
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Zdenek Koristek
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
| | - Bruno Paiva
- Centro de Investigación Médica Aplicada; Clínica Universidad de Navarra, IDISNA; Pamplona Spain
| | - Roman Hajek
- Department of Haematooncology; University Hospital Ostrava; Ostrava Czech Republic
- Faculty of Medicine; University of Ostrava; Ostrava Czech Republic
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Mihalyova J, Jelinek T, Growkova K, Hrdinka M, Simicek M, Hajek R. Venetoclax: A new wave in hematooncology. Exp Hematol 2018; 61:10-25. [PMID: 29477371 DOI: 10.1016/j.exphem.2018.02.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/31/2018] [Accepted: 02/05/2018] [Indexed: 12/22/2022]
Abstract
Inhibitors of antiapoptotic proteins of the BCL2 family can successfully restart the deregulated process of apoptosis in malignant cells. Whereas nonselective agents have been limited by their affinity to different BCL2 members, thus inducing excessive toxicity, the highly selective BCL2 inhibitor venetoclax (ABT-199, Venclexta™) has an acceptable safety profile. To date, it has been approved in monotherapy for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) with 17p deletion. Extension of indications can be expected in monotherapy and in combination regimens. Sensitivity to venetoclax is not common in lymphomas, but promising outcomes have been achieved in the mantle cell lymphoma group. Venetoclax is also active in multiple myeloma patients, especially in those with translocation t(11;14), even if high-risk features such as del17p are also present. Surprisingly, positive results are being obtained in elderly acute myeloid leukemia patients, in whom inhibition of BCL2 is able to substantially increase the efficacy of low-dose cytarabine or hypomethylating agents. Here, we provide a summary of available results from clinical trials and describe a specific mechanism of action that stands behind the efficacy of venetoclax in hematological malignancies.
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Affiliation(s)
- Jana Mihalyova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Tomas Jelinek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Faculty of Science, University of Ostrava, Ostrava, Czech Republic.
| | - Katerina Growkova
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Faculty of Science, University of Ostrava, Ostrava, Czech Republic
| | - Matous Hrdinka
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Faculty of Science, University of Ostrava, Ostrava, Czech Republic
| | - Michal Simicek
- Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; Faculty of Science, University of Ostrava, Ostrava, Czech Republic
| | - Roman Hajek
- Department of Haematooncology, University Hospital Ostrava, Ostrava, Czech Republic; Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Jelinek T, Mihalyova J, Kascak M, Duras J, Hajek R. PD-1/PD-L1 inhibitors in haematological malignancies: update 2017. Immunology 2017; 152:357-371. [PMID: 28685821 PMCID: PMC5629439 DOI: 10.1111/imm.12788] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/26/2017] [Accepted: 06/30/2017] [Indexed: 12/16/2022] Open
Abstract
The introduction of PD-1/PD-L1 pathway inhibitors is an important landmark in solid oncology with unprecedented practice-changing activity in various types of solid tumours. Among haematological malignancies, PD-1/PD-L1 inhibitors have been successful, so far, only in the treatment of classical Hodgkin lymphoma, which typically exhibits an over-expression of PD-1 ligands (PD-L1, PD-L2) due to alterations in chromosome 9p24.1. Such positive outcomes led to the US Food and Drug Administration approval of nivolumab use in relapsed Hodgkin lymphoma in 2016 as the first haematological indication. Although the results in other lymphoid malignancies have not been so striking, blockade of the PD-1/PD-L1 axis has led to meaningful responses in other lymphoma types such as diffuse large B-cell lymphoma, follicular lymphoma or several T-cell lymphomas. Monotherapy with PD-1/PD-L1 inhibitors in chronic lymphocytic leukaemia and multiple myeloma has been unsatisfactory, suggesting that a combinational approach with other synergistic drugs is needed. In the case of multiple myeloma, immunomodulatory agents together with corticosteroids represent the most promising combinations. Among myeloid malignancies, the anti-PD-1 monoclonal antibodies are examined dominantly in acute myeloid leukaemia and myelodysplastic syndromes in combination with potentially synergistic hypomethylating drugs such as 5-azacitidine, resulting in promising outcomes that warrant further investigation. We have described all available clinical results of PD-1/PD-L1 inhibitors in haematological malignancies and discussed related toxicities, as well as highlighted crucial preclinical studies in this review.
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Affiliation(s)
- Tomas Jelinek
- Department of Haemato‐oncologyUniversity Hospital OstravaOstravaCzech Republic
- Faculty of MedicineUniversity of OstravaOstravaCzech Republic
- Faculty of ScienceUniversity of OstravaOstravaCzech Republic
- Centro de Investigacion Medica Aplicada (CIMA)Clinica Universidad de NavarraIDISNAPamplonaSpain
| | - Jana Mihalyova
- Department of Haemato‐oncologyUniversity Hospital OstravaOstravaCzech Republic
| | - Michal Kascak
- Department of Haemato‐oncologyUniversity Hospital OstravaOstravaCzech Republic
| | - Juraj Duras
- Department of Haemato‐oncologyUniversity Hospital OstravaOstravaCzech Republic
| | - Roman Hajek
- Department of Haemato‐oncologyUniversity Hospital OstravaOstravaCzech Republic
- Faculty of MedicineUniversity of OstravaOstravaCzech Republic
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