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Mun JS, Parry MW, Tang A, Manikowski JJ, Crinella C, Mercuri JJ. Patient "No-Show" Increases the Risk of 90-Day Complications Following Primary Total Knee Arthroplasty: A Retrospective Cohort Study of 6,776 Patients. J Arthroplasty 2023; 38:2587-2591.e2. [PMID: 37295624 DOI: 10.1016/j.arth.2023.05.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Patients who "no-show" (NS) clinical appointments are at a high risk of adverse health outcomes. The objective of this study was to evaluate and characterize the relationship between NS visits prior to primary total knee arthroplasty (TKA) and 90-day complications after TKA. METHODS We retrospectively reviewed 6,776 consecutive patients undergoing primary TKA. Study groups were separated based on whether patients who NS versus always attended their appointment. A NS was defined as an intended appointment that was not canceled or rescheduled ≤2 hours before the appointment in which the patient did not show. Data collected included total number of follow-up appointments prior to surgery, patient demographics, comorbidities, and 90-day postoperative complications. RESULTS Patients who have ≥3 NS appointments had 1.5 times increased odds of a surgical site infection (odds ratio (OR) 1.54, P = .002) compared to always attended patients. Patients who were ≤65 years old (OR: 1.41, P < .001), smokers (OR: 2.01, P < .001), and had a Charlson comorbidity index ≥3 (OR: 4.48, P < .001) were more likely to miss clinical appointments. CONCLUSION Patients who have ≥3 NS appointments prior to TKA had an increased risk for surgical site infection. Sociodemographic factors were associated with higher odds of missing a scheduled clinical appointment. These data suggest that orthopaedic surgeons should consider NS data as an important clinical decision-making tool to assess risk for postoperative complications to minimize complications following TKA.
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Affiliation(s)
- Jeffrey S Mun
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Matthew W Parry
- Geisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, Pennsylvania
| | - Alex Tang
- Geisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, Pennsylvania
| | - Jesse J Manikowski
- Geisinger Cancer Institute - Center for Oncology Research and Innovation, Danville, Pennsylvania
| | - Cory Crinella
- Geisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, Pennsylvania
| | - John J Mercuri
- Geisinger Musculoskeletal Institute, Division of Adult Reconstruction, Scranton, Pennsylvania
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2
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Rudd MT, Manley PJ, Hanney B, Meng Z, Shu Y, de Leon P, Frie JL, Han Y, Wai JMC, Yang ZQ, Perkins JJ, Hurzy DM, Manikowski JJ, Zhu H, Bungard CJ, Converso A, Meissner RS, Cosden ML, Hayashi I, Ma L, O’Brien J, Uebele VN, Schachter JB, Bhandari N, Ward GJ, Fillgrove KL, Lu B, Liang Y, Dubost DC, Puri V, Eddins DM, Vardigan JD, Drolet RE, Kern JT, Uslaner JM. Discovery of MK-8768, a Potent and Selective mGluR2 Negative Allosteric Modulator. ACS Med Chem Lett 2023; 14:1088-1094. [PMID: 37583812 PMCID: PMC10424309 DOI: 10.1021/acsmedchemlett.3c00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/29/2023] [Indexed: 08/17/2023] Open
Abstract
Glutamate plays a key role in cognition and mood, and it has been shown that inhibiting ionotropic glutamate receptors disrupts cognition, while enhancing ionotropic receptor activity is pro-cognitive. One approach to elevating glutamatergic tone has been to antagonize presynaptic metabotropic glutamate receptor 2 (mGluR2). A desire for selectivity over the largely homologous mGluR3 motivated a strategy to achieve selectivity through the identification of mGluR2 negative allosteric modulators (NAMs). Extensive screening and optimization efforts led to the identification of a novel series of 4-arylquinoline-2-carboxamides. This series was optimized for mGluR2 NAM potency, clean off-target activity, and desirable physical properties, which resulted in the identification of improved C4 and C7 substituents. The initial lead compound from this series was Ames-positive in a single strain with metabolic activation, indicating that a reactive metabolite was likely responsible for the genetic toxicity. Metabolic profiling and Ames assessment across multiple analogs identified key structure-activity relationships associated with Ames positivity. Further optimization led to the Ames-negative mGluR2 negative allosteric modulator MK-8768.
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Affiliation(s)
- Michael T. Rudd
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Peter J. Manley
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Barbara Hanney
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Zhaoyang Meng
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Youheng Shu
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Pablo de Leon
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Jessica L. Frie
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Yongxin Han
- External
Discovery Chemistry, Merck & Co., Inc, Boston, Massachusetts 02115, United States
| | - Jenny Miu-Chun Wai
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Zhi-Qiang Yang
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - James J. Perkins
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Danielle M. Hurzy
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Jesse J. Manikowski
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Hong Zhu
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Christopher J. Bungard
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Antonella Converso
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Robert S. Meissner
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Mali L. Cosden
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Ikuo Hayashi
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Lei Ma
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Julie O’Brien
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Victor N. Uebele
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Joel B. Schachter
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Neetesh Bhandari
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Gwendolyn J. Ward
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Kerry L. Fillgrove
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Bing Lu
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Yuexia Liang
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - David C. Dubost
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Vanita Puri
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Donnie M. Eddins
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Joshua D. Vardigan
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Robert E. Drolet
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Jonathan T. Kern
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
| | - Jason M. Uslaner
- Departments
of Discovery Chemistry, Neuroscience Biology Discovery, Pharmacology, Nonclinical Dug
Safety, Pharmacokinetics, Discovery Pharmaceutical Sciences, and In Vivo Pharmacology, Merck & Co., Inc, West Point, Pennsylvania 19486, United States
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3
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Perkins JJ, McQuade P, Bungard CJ, Diamond TL, Gantert LT, Gotter AL, Hanney B, Hills ID, Hurzy DM, Joshi A, Kern JT, Schlegel KAS, Manikowski JJ, Meng Z, O’Brien JA, Roecker AJ, Smith SM, Uslaner JM, Hostetler E, Meissner RS. Discovery of [ 11C]MK-8056: A Selective PET Imaging Agent for the Study of mGluR 2 Negative Allosteric Modulators. ACS Med Chem Lett 2023; 14:986-992. [PMID: 37465306 PMCID: PMC10351059 DOI: 10.1021/acsmedchemlett.3c00175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/09/2023] [Indexed: 07/20/2023] Open
Abstract
Modification of potent, selective metabotropic glutamate receptor 2 negative allosteric modulator (mGluR2 NAM) led to a series of analogues with excellent binding affinity, lipophilicity, and suitable physicochemical properties for a PET tracer with convenient chemical handles for incorporation of a 11C or 18F radiolabel. [11C]MK-8056 was synthesized and evaluated in vivo and demonstrated appropriate affinity, selectivity, and physicochemical properties to be used as a positron emission tomography tracer for mGluR2.
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Affiliation(s)
- James J. Perkins
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Paul McQuade
- Translational
Imaging, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Christopher J. Bungard
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Tracy L. Diamond
- Pharmacology, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Liza T. Gantert
- Translational
Imaging, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Anthony L. Gotter
- Neuroscience
Biology Discovery, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Barbara Hanney
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Ivory D. Hills
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Danielle M. Hurzy
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Aniket Joshi
- Translational
Imaging, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Jonathan T. Kern
- Neuroscience
Biology Discovery, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Kelly-Ann S. Schlegel
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Jesse J. Manikowski
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Zhaoyang Meng
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Julie A. O’Brien
- Pharmacology, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Anthony J. Roecker
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Sean M. Smith
- Neuroscience
Biology Discovery, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Jason M. Uslaner
- Neuroscience
Biology Discovery, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Eric Hostetler
- Translational
Imaging, Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
| | - Robert S. Meissner
- Departments
of Discovery Chemistry, Merck & Co.,
Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, USA
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4
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Bakouny Z, Labaki C, Grover P, Awosika J, Gulati S, Hsu CY, Alimohamed SI, Bashir B, Berg S, Bilen MA, Bowles D, Castellano C, Desai A, Elkrief A, Eton OE, Fecher LA, Flora D, Galsky MD, Gatti-Mays ME, Gesenhues A, Glover MJ, Gopalakrishnan D, Gupta S, Halfdanarson TR, Hayes-Lattin B, Hendawi M, Hsu E, Hwang C, Jandarov R, Jani C, Johnson DB, Joshi M, Khan H, Khan SA, Knox N, Koshkin VS, Kulkarni AA, Kwon DH, Matar S, McKay RR, Mishra S, Moria FA, Nizam A, Nock NL, Nonato TK, Panasci J, Pomerantz L, Portuguese AJ, Provenzano D, Puc M, Rao YJ, Rhodes TD, Riely GJ, Ripp JJ, Rivera AV, Ruiz-Garcia E, Schmidt AL, Schoenfeld AJ, Schwartz GK, Shah SA, Shaya J, Subbiah S, Tachiki LM, Tucker MD, Valdez-Reyes M, Weissmann LB, Wotman MT, Wulff-Burchfield EM, Xie Z, Yang YJ, Thompson MA, Shah DP, Warner JL, Shyr Y, Choueiri TK, Wise-Draper TM, Gandhi R, Gartrell BA, Goel S, Halmos B, Makower DF, O' Sullivan D, Ohri N, Portes M, Shapiro LC, Shastri A, Sica RA, Verma AK, Butt O, Campian JL, Fiala MA, Henderson JP, Monahan RS, Stockerl-Goldstein KE, Zhou AY, Bitran JD, Hallmeyer S, Mundt D, Pandravada S, Papaioannou PV, Patel M, Streckfuss M, Tadesse E, Gatson NTN, Kundranda MN, Lammers PE, Loree JM, Yu IS, Bindal P, Lam B, Peters MLB, Piper-Vallillo AJ, Egan PC, Farmakiotis D, Arvanitis P, Klein EJ, Olszewski AJ, Vieira K, Angevine AH, Bar MH, Del Prete SA, Fiebach MZ, Gulati AP, Hatton E, Houston K, Rose SJ, Steve Lo KM, Stratton J, Weinstein PL, Garcia JA, Routy B, Hoyo-Ulloa I, Dawsey SJ, Lemmon CA, Pennell NA, Sharifi N, Painter CA, Granada C, Hoppenot C, Li A, Bitterman DS, Connors JM, Demetri GD, Florez (Duma) N, Freeman DA, Giordano A, Morgans AK, Nohria A, Saliby RM, Tolaney SM, Van Allen EM, Xu WV, Zon RL, Halabi S, Zhang T, Dzimitrowicz H, Leighton JC, Graber JJ, Grivas P, Hawley JE, Loggers ET, Lyman GH, Lynch RC, Nakasone ES, Schweizer MT, Vinayak S, Wagner MJ, Yeh A, Dansoa Y, Makary M, Manikowski JJ, Vadakara J, Yossef K, Beckerman J, Goyal S, Messing I, Rosenstein LJ, Steffes DR, Alsamarai S, Clement JM, Cosin JA, Daher A, Dailey ME, Elias R, Fein JA, Hosmer W, Jayaraj A, Mather J, Menendez AG, Nadkarni R, Serrano OK, Yu PP, Balanchivadze N, Gadgeel SM, Accordino MK, Bhutani D, Bodin BE, Hershman DL, Masson C, Alexander M, Mushtaq S, Reuben DY, Bernicker EH, Deeken JF, Jeffords KJ, Shafer D, Cárdenas AI, Cuervo Campos R, De-la-Rosa-Martinez D, Ramirez A, Vilar-Compte D, Gill DM, Lewis MA, Low CA, Jones MM, Mansoor AH, Mashru SH, Werner MA, Cohen AM, McWeeney S, Nemecek ER, Williamson SP, Peters S, Smith SJ, Lewis GC, Zaren HA, Akhtari M, Castillo DR, Cortez K, Lau E, Nagaraj G, Park K, Reeves ME, O'Connor TE, Altman J, Gurley M, Mulcahy MF, Wehbe FH, Durbin EB, Nelson HH, Ramesh V, Sachs Z, Wilson G, Bardia A, Boland G, Gainor JF, Peppercorn J, Reynolds KL, Rosovsky RP, Zubiri L, Bekaii-Saab TS, Joyner MJ, Riaz IB, Senefeld JW, Shah S, Ayre SK, Bonnen M, Mahadevan D, McKeown C, Mesa RA, Ramirez AG, Salazar M, Shah PK, Wang CP, Bouganim N, Papenburg J, Sabbah A, Tagalakis V, Vinh DC, Nanchal R, Singh H, Bahadur N, Bao T, Belenkaya R, Nambiar PH, O’Cearbhaill RE, Papadopoulos EB, Philip J, Robson M, Rosenberg JE, Wilkins CR, Tamimi R, Cerrone K, Dill J, Faller BA, Alomar ME, Chandrasekhar SA, Hume EC, Islam JY, Ajmera A, Brouha SS, Cabal A, Choi S, Hsiao A, Jiang JY, Kligerman S, Park J, Razavi P, Reid EG, Bhatt PS, Mariano MG, Thomson CC, Glace M(G, Knoble JL, Rink C, Zacks R, Blau SH, Brown C, Cantrell AS, Namburi S, Polimera HV, Rovito MA, Edwin N, Herz K, Kennecke HF, Monfared A, Sautter RR, Cronin T, Elshoury A, Fleissner B, Griffiths EA, Hernandez-Ilizaliturri F, Jain P, Kariapper A, Levine E, Moffitt M, O'Connor TL, Smith LJ, Wicher CP, Zsiros E, Jabbour SK, Misdary CF, Shah MR, Batist G, Cook E, Ferrario C, Lau S, Miller WH, Rudski L, Santos Dutra M, Wilchesky M, Mahmood SZ, McNair C, Mico V, Dixon B, Kloecker G, Logan BB, Mandapakala C, Cabebe EC, Jha A, Khaki AR, Nagpal S, Schapira L, Wu JTY, Whaley D, Lopes GDL, de Cardenas K, Russell K, Stith B, Taylor S, Klamerus JF, Revankar SG, Addison D, Chen JL, Haynam M, Jhawar SR, Karivedu V, Palmer JD, Pillainayagam C, Stover DG, Wall S, Williams NO, Abbasi SH, Annis S, Balmaceda NB, Greenland S, Kasi A, Rock CD, Luders M, Smits M, Weiss M, Chism DD, Owenby S, Ang C, Doroshow DB, Metzger M, Berenberg J, Uyehara C, Fazio A, Huber KE, Lashley LN, Sueyoshi MH, Patel KG, Riess J, Borno HT, Small EJ, Zhang S, Andermann TM, Jensen CE, Rubinstein SM, Wood WA, Ahmad SA, Brownfield L, Heilman H, Kharofa J, Latif T, Marcum M, Shaikh HG, Sohal DPS, Abidi M, Geiger CL, Markham MJ, Russ AD, Saker H, Acoba JD, Choi H, Rho YS, Feldman LE, Gantt G, Hoskins KF, Khan M, Liu LC, Nguyen RH, Pasquinelli MM, Schwartz C, Venepalli NK, Vikas P, Zakharia Y, Friese CR, Boldt A, Gonzalez CJ, Su C, Su CT, Yoon JJ, Bijjula R, Mavromatis BH, Seletyn ME, Wood BR, Zaman QU, Kaklamani V, Beeghly A, Brown AJ, Charles LJ, Cheng A, Crispens MA, Croessmann S, Davis EJ, Ding T, Duda SN, Enriquez KT, French B, Gillaspie EA, Hausrath DJ, Hennessy C, Lewis JT, Li X(L, Prescott LS, Reid SA, Saif S, Slosky DA, Solorzano CC, Sun T, Vega-Luna K, Wang LL, Aboulafia DM, Carducci TM, Goldsmith KJ, Van Loon S, Topaloglu U, Moore J, Rice RL, Cabalona WD, Cyr S, Barrow McCollough B, Peddi P, Rosen LR, Ravindranathan D, Hafez N, Herbst RS, LoRusso P, Lustberg MB, Masters T, Stratton C. Interplay of Immunosuppression and Immunotherapy Among Patients With Cancer and COVID-19. JAMA Oncol 2023; 9:128-134. [PMID: 36326731 PMCID: PMC9634600 DOI: 10.1001/jamaoncol.2022.5357] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/11/2022] [Indexed: 11/06/2022]
Abstract
Importance Cytokine storm due to COVID-19 can cause high morbidity and mortality and may be more common in patients with cancer treated with immunotherapy (IO) due to immune system activation. Objective To determine the association of baseline immunosuppression and/or IO-based therapies with COVID-19 severity and cytokine storm in patients with cancer. Design, Setting, and Participants This registry-based retrospective cohort study included 12 046 patients reported to the COVID-19 and Cancer Consortium (CCC19) registry from March 2020 to May 2022. The CCC19 registry is a centralized international multi-institutional registry of patients with COVID-19 with a current or past diagnosis of cancer. Records analyzed included patients with active or previous cancer who had a laboratory-confirmed infection with SARS-CoV-2 by polymerase chain reaction and/or serologic findings. Exposures Immunosuppression due to therapy; systemic anticancer therapy (IO or non-IO). Main Outcomes and Measures The primary outcome was a 5-level ordinal scale of COVID-19 severity: no complications; hospitalized without requiring oxygen; hospitalized and required oxygen; intensive care unit admission and/or mechanical ventilation; death. The secondary outcome was the occurrence of cytokine storm. Results The median age of the entire cohort was 65 years (interquartile range [IQR], 54-74) years and 6359 patients were female (52.8%) and 6598 (54.8%) were non-Hispanic White. A total of 599 (5.0%) patients received IO, whereas 4327 (35.9%) received non-IO systemic anticancer therapies, and 7120 (59.1%) did not receive any antineoplastic regimen within 3 months prior to COVID-19 diagnosis. Although no difference in COVID-19 severity and cytokine storm was found in the IO group compared with the untreated group in the total cohort (adjusted odds ratio [aOR], 0.80; 95% CI, 0.56-1.13, and aOR, 0.89; 95% CI, 0.41-1.93, respectively), patients with baseline immunosuppression treated with IO (vs untreated) had worse COVID-19 severity and cytokine storm (aOR, 3.33; 95% CI, 1.38-8.01, and aOR, 4.41; 95% CI, 1.71-11.38, respectively). Patients with immunosuppression receiving non-IO therapies (vs untreated) also had worse COVID-19 severity (aOR, 1.79; 95% CI, 1.36-2.35) and cytokine storm (aOR, 2.32; 95% CI, 1.42-3.79). Conclusions and Relevance This cohort study found that in patients with cancer and COVID-19, administration of systemic anticancer therapies, especially IO, in the context of baseline immunosuppression was associated with severe clinical outcomes and the development of cytokine storm. Trial Registration ClinicalTrials.gov Identifier: NCT04354701.
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Affiliation(s)
- Ziad Bakouny
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Chris Labaki
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Punita Grover
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio
| | - Joy Awosika
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio
| | - Shuchi Gulati
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio
| | - Chih-Yuan Hsu
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Saif I Alimohamed
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Babar Bashir
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Mehmet A Bilen
- Winship Cancer Institute, Emory University, Atlanta, Georgia
| | | | | | - Aakash Desai
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Arielle Elkrief
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Omar E Eton
- Hartford Healthcare Cancer Institute, Hartford, Connecticut
| | | | | | | | | | | | | | | | | | | | | | - Mohamed Hendawi
- Aurora Cancer Center, Advocate Aurora Health, Milwaukee, Wisconsin
| | - Emily Hsu
- Hartford Healthcare Cancer Institute, Hartford, Connecticut
| | - Clara Hwang
- Henry Ford Cancer Institute, Detroit, Michigan
| | - Roman Jandarov
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio
| | | | | | - Monika Joshi
- Penn State Cancer Institute, Hershey, Pennsylvania
| | - Hina Khan
- Brown University and Lifespan Cancer Institute, Providence, Rhode Island
| | - Shaheer A Khan
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York
| | - Natalie Knox
- Loyola University Medical Center, Maywood, Illinois
| | - Vadim S Koshkin
- UCSF, Helen Diller Comprehensive Cancer Center, San Francisco
| | | | - Daniel H Kwon
- UCSF, Helen Diller Comprehensive Cancer Center, San Francisco
| | - Sara Matar
- Hollings Cancer Center, MUSC, Charleston
| | - Rana R McKay
- Moores Cancer Center, UCSD, San Diego, California
| | - Sanjay Mishra
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Feras A Moria
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Nora L Nock
- Case Comprehensive Cancer Center, Department of Population and Quantitative Health Sciences, Cleveland, Ohio
| | | | - Justin Panasci
- Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | | | | | | | | | - Yuan J Rao
- George Washington University, Washington, DC
| | | | | | - Jacob J Ripp
- University of Kansas Medical Center, Kansas City
| | - Andrea V Rivera
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Andrew L Schmidt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Gary K Schwartz
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York
| | | | - Justin Shaya
- Moores Cancer Center, UCSD, San Diego, California
| | - Suki Subbiah
- Stanley S. Scott Cancer Center, LSU, New Orleans, Louisiana
| | - Lisa M Tachiki
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | | | | | | | - Zhuoer Xie
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Michael A Thompson
- Aurora Cancer Center, Advocate Aurora Health, Milwaukee, Wisconsin.,Tempus Labs, Chicago, Illinois
| | - Dimpy P Shah
- Mays Cancer Center, UT Health, San Antonio, Texas
| | | | - Yu Shyr
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Trisha M Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati Cancer Center, Cincinnati, Ohio
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Omar Butt
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ang Li
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eric Lau
- for the COVID-19 and Cancer Consortium
| | | | - Kyu Park
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ting Bao
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ji Park
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Erin Cook
- for the COVID-19 and Cancer Consortium
| | | | - Susie Lau
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anup Kasi
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Li C Liu
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | - Chris Su
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tan Ding
- for the COVID-19 and Cancer Consortium
| | | | | | | | | | | | | | | | | | | | | | - Sara Saif
- for the COVID-19 and Cancer Consortium
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5
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Leese EN, Weeder JL, Manikowski JJ, DeLaRue AM, Conger AR, Mahadevan A, Vogel VG, Mongelluzzo GJ, Gatson NTN. PA- and NP-led Ommaya clinics to manage leptomeningeal carcinomatosis. JAAPA 2021; 34:35-41. [PMID: 34772854 DOI: 10.1097/01.jaa.0000800264.81721.3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Physician assistants (PAs) and NPs are essential to quality care delivery. The need to demonstrate value and optimize PA and NP roles in neurology subspecialty clinics is unmet. We outline the development of a PA- and NP-led neuro-oncology procedural clinic and provide metrics to support the institutional and clinician value added. METHODS We designed a PA- and NP-led Geisinger Ommaya Clinic (GOC) to manage leptomeningeal carcinomatosis (LMC) with defined clinician roles and the GOC treatment protocol. A retrospective review of 135 patients (2012-2019) compared survival outcomes for patients treated on the protocol compared with those treated off the protocol. RESULTS Centralized care in the GOCs minimized shared physician encounters and improved PA and NP autonomy and utility. LMC therapy as part of the GOC protocol improved care continuity and survival outcomes. CONCLUSIONS PA- and NP-led procedural clinics optimize use of these clinicians and open physician availability for nonprocedural duties. This research highlights the institutional patient and financial benefit while demonstrating the operational and leadership growth potential for PAs and NPs.
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Affiliation(s)
- Erika N Leese
- At Geisinger Medical Center in Danville, Pa., Erika N. Leese is lead neuro-oncology advanced practice provider in the Neuroscience Institute, Jamie L. Weeder is chief advanced practice provider of hematology/oncology for the central and western regions, Jesse J. Manikowski is a data scientist in the Geisinger Cancer Institute, Angela M. DeLaRue is lead LPN for the neuro-oncology division, Andrew R. Conger is a lead neurosurgeon in neurosurgical oncology, Anand Mahadevan is chair of the department of radiation oncology, Victor G. Vogel is director of breast medical oncology/radiology, Gino J. Mongelluzzo is chair of the department of neuroradiology, and Na Tosha N. Gatson is director of the neuro-oncology division. The authors have disclosed no potential conflicts of interest, financial or otherwise
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6
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Gatson NTN, Bross SP, Odia Y, Mongelluzzo GJ, Hu Y, Lockard L, Manikowski JJ, Mahadevan A, Kazmi SAJ, Lacroix M, Conger AR, Vadakara J, Nayak L, Chi TL, Mehta MP, Puduvalli VK. Early imaging marker of progressing glioblastoma: a window of opportunity. J Neurooncol 2020; 148:629-640. [PMID: 32602020 DOI: 10.1007/s11060-020-03565-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/17/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Therapeutic intervention at glioblastoma (GBM) progression, as defined by current assessment criteria, is arguably too late as second-line therapies fail to extend survival. Still, most GBM trials target recurrent disease. We propose integration of a novel imaging biomarker to more confidently and promptly define progression and propose a critical timepoint for earlier intervention to extend therapeutic exposure. METHODS A retrospective review of 609 GBM patients between 2006 and 2019 yielded 135 meeting resection, clinical, and imaging inclusion criteria. We qualitatively and quantitatively analyzed 2000+ sequential brain MRIs (initial diagnosis to first progression) for development of T2 FLAIR signal intensity (SI) within the resection cavity (RC) compared to the ventricles (V) for quantitative inter-image normalization. PFS and OS were evaluated using Kaplan-Meier curves stratified by SI. Specificity and sensitivity were determined using a 2 × 2 table and pathology confirmation at progression. Multivariate analysis evaluated SI effect on the hazard rate for death after adjusting for established prognostic covariates. Recursive partitioning determined successive quantifiers and cutoffs associated with outcomes. Neurological deficits correlated with SI. RESULTS Seventy-five percent of patients developed SI on average 3.4 months before RANO-assessed progression with 84% sensitivity. SI-positivity portended neurological decline and significantly poorer outcomes for PFS (median, 10 vs. 15 months) and OS (median, 20 vs. 29 months) compared to SI-negative. RC/V ratio ≥ 4 was the most significant prognostic indicator of death. CONCLUSION Implications of these data are far-reaching, potentially shifting paradigms for glioma treatment response assessment, altering timepoints for salvage therapeutic intervention, and reshaping glioma clinical trial design.
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Affiliation(s)
- Na Tosha N Gatson
- Neuroscience Institute, Geisinger Health, Danville, PA, 17822, USA. .,Cancer Institute, Geisinger Health, Danville, PA, 17822, USA. .,Geisinger Commonwealth School of Medicine, Scranton, PA, 18509, USA. .,Geisinger Medical Center, Neuroscience Institute MC 14-03, 100 N. Academy Ave, Danville, PA, 17822, USA.
| | - Shane P Bross
- Neuroscience Institute, Geisinger Health, Danville, PA, 17822, USA
| | - Yazmin Odia
- Department of Neuro-Oncology, Miami Cancer Institute/Baptist Health South Florida, Miami, FL, 33176, USA
| | | | - Yirui Hu
- Department of Population Health Sciences, Geisinger Health, Danville, PA, 17822, USA
| | - Laura Lockard
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18509, USA
| | | | - Anand Mahadevan
- Cancer Institute, Geisinger Health, Danville, PA, 17822, USA
| | - Syed A J Kazmi
- Department of Pathology, Geisinger Health, Danville, PA, 17822, USA
| | - Michel Lacroix
- Neuroscience Institute, Geisinger Health, Danville, PA, 17822, USA
| | - Andrew R Conger
- Neuroscience Institute, Geisinger Health, Danville, PA, 17822, USA.,Geisinger Commonwealth School of Medicine, Scranton, PA, 18509, USA
| | - Joseph Vadakara
- Cancer Institute, Geisinger Health, Danville, PA, 17822, USA
| | - Lakshmi Nayak
- Harvard Medical School, Center for Neuro-Oncology,, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - T Linda Chi
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Minesh P Mehta
- Department of Radiation Oncology, Miami Cancer Institute/Baptist Health South Florida, Miami, FL, 33176, USA
| | - Vinay K Puduvalli
- Division of Neuro-Oncology, The OH State University Comprehensive Cancer Center - James and OSU Neurological Institute, Columbus, OH, 43210, USA.,Department of Neuro-Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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7
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Bungard CJ, Williams PD, Schulz J, Wiscount CM, Holloway MK, Loughran HM, Manikowski JJ, Su HP, Bennett DJ, Chang L, Chu XJ, Crespo A, Dwyer MP, Keertikar K, Morriello GJ, Stamford AW, Waddell ST, Zhong B, Hu B, Ji T, Diamond TL, Bahnck-Teets C, Carroll SS, Fay JF, Min X, Morris W, Ballard JE, Miller MD, McCauley JA. Design and Synthesis of Piperazine Sulfonamide Cores Leading to Highly Potent HIV-1 Protease Inhibitors. ACS Med Chem Lett 2017; 8:1292-1297. [PMID: 29259750 DOI: 10.1021/acsmedchemlett.7b00386] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/13/2017] [Indexed: 12/19/2022] Open
Abstract
Using the HIV-1 protease binding mode of MK-8718 and PL-100 as inspiration, a novel aspartate binding bicyclic piperazine sulfonamide core was designed and synthesized. The resulting HIV-1 protease inhibitor containing this core showed an 60-fold increase in enzyme binding affinity and a 10-fold increase in antiviral activity relative to MK-8718.
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Affiliation(s)
- Christopher J. Bungard
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Peter D. Williams
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Jurgen Schulz
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Catherine M. Wiscount
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - M. Katharine Holloway
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - H. Marie Loughran
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Jesse J. Manikowski
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Hua-Poo Su
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - David J. Bennett
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Lehua Chang
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Xin-Jie Chu
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Alejandro Crespo
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Michael P. Dwyer
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Kartik Keertikar
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Gregori J. Morriello
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Andrew W. Stamford
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Sherman T. Waddell
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Bin Zhong
- WuXi AppTec, 288 Fute Zhong Road, Shanghai 200131, China
| | - Bin Hu
- WuXi AppTec, 288 Fute Zhong Road, Shanghai 200131, China
| | - Tao Ji
- WuXi AppTec, 288 Fute Zhong Road, Shanghai 200131, China
| | - Tracy L. Diamond
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Carolyn Bahnck-Teets
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Steven S. Carroll
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - John F. Fay
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Xu Min
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - William Morris
- Merck & Co., Inc., 126 East Lincoln Avenue, Rahway, New Jersey 07065, United States
| | - Jeanine E. Ballard
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Michael D. Miller
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - John A. McCauley
- Merck & Co., Inc., 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
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8
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Bungard CJ, Williams PD, Ballard JE, Bennett DJ, Beaulieu C, Bahnck-Teets C, Carroll SS, Chang RK, Dubost DC, Fay JF, Diamond TL, Greshock TJ, Hao L, Holloway MK, Felock PJ, Gesell JJ, Su HP, Manikowski JJ, McKay DJ, Miller M, Min X, Molinaro C, Moradei OM, Nantermet PG, Nadeau C, Sanchez RI, Satyanarayana T, Shipe WD, Singh SK, Truong VL, Vijayasaradhi S, Wiscount CM, Vacca JP, Crane SN, McCauley JA. Discovery of MK-8718, an HIV Protease Inhibitor Containing a Novel Morpholine Aspartate Binding Group. ACS Med Chem Lett 2016; 7:702-7. [PMID: 27437081 DOI: 10.1021/acsmedchemlett.6b00135] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/09/2016] [Indexed: 12/18/2022] Open
Abstract
A novel HIV protease inhibitor was designed using a morpholine core as the aspartate binding group. Analysis of the crystal structure of the initial lead bound to HIV protease enabled optimization of enzyme potency and antiviral activity. This afforded a series of potent orally bioavailable inhibitors of which MK-8718 was identified as a compound with a favorable overall profile.
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Affiliation(s)
- Christopher J. Bungard
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Peter D. Williams
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Jeanine E. Ballard
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - David J. Bennett
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Christian Beaulieu
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Carolyn Bahnck-Teets
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Steve S. Carroll
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Ronald K. Chang
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - David C. Dubost
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - John F. Fay
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Tracy L. Diamond
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Thomas J. Greshock
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Li Hao
- Albany Molecular Research Singapore Research Center, 61 Science Park Road #05-01, The Galen Singapore
Science Park II, Singapore 117525
| | - M. Katharine Holloway
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | | | - Jennifer J. Gesell
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Hua-Poo Su
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Jesse J. Manikowski
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Daniel J. McKay
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Mike Miller
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Xu Min
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Carmela Molinaro
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Oscar M. Moradei
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Philippe G. Nantermet
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Christian Nadeau
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Rosa I. Sanchez
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Tummanapalli Satyanarayana
- Albany Molecular Research Singapore Research Center, 61 Science Park Road #05-01, The Galen Singapore
Science Park II, Singapore 117525
| | - William D. Shipe
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Sanjay K. Singh
- Albany Molecular Research Singapore Research Center, 61 Science Park Road #05-01, The Galen Singapore
Science Park II, Singapore 117525
| | - Vouy Linh Truong
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Sivalenka Vijayasaradhi
- Albany Molecular Research Singapore Research Center, 61 Science Park Road #05-01, The Galen Singapore
Science Park II, Singapore 117525
| | - Catherine M. Wiscount
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
| | - Joseph P. Vacca
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - Sheldon N. Crane
- Merck Frosst Centre for Therapeutic Research, 16711 TransCanada Highway, Kirkland, Quebec H9H 3L1, Canada
| | - John A. McCauley
- Merck Research Laboratories, 770 Sumneytown Pike, PO Box 4, West Point, Pennsylvania 19486, United States
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