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Hanna GJ, Stathis A, Lopez-Miranda E, Racca F, Quon D, Leyvraz S, Hess D, Keam B, Rodon J, Ahn MJ, Kim HR, Schneeweiss A, Ribera JM, DeAngelo D, Perez Garcia JM, Cortes J, Schönborn-Kellenberger O, Weber D, Pisa P, Bauer M, Beni L, Bobadilla M, Lehal R, Vigolo M, Vogl FD, Garralda E. A Phase I Study of the Pan-Notch Inhibitor CB-103 for Patients with Advanced Adenoid Cystic Carcinoma and Other Tumors. Cancer Res Commun 2023; 3:1853-1861. [PMID: 37712875 PMCID: PMC10501326 DOI: 10.1158/2767-9764.crc-23-0333] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE CB-103 selectively inhibits the CSL-NICD (Notch intracellular domain) interaction leading to transcriptional downregulation of oncogenic Notch pathway activation. This dose-escalation/expansion study aimed to determine safety, pharmacokinetics, and preliminary antitumor activity. EXPERIMENTAL DESIGN Patients ≥18 years of age with selected advanced solid tumors [namely, adenoid cystic carcinoma (ACC)] and hematologic malignancies were eligible. CB-103 was dosed orally in cycles of 28 days at escalating doses until disease progression. Notch-activating mutations were required in a dose confirmatory cohort. Endpoints included dose-limiting toxicities (DLT), safety, tumor response, pharmacokinetics, and pharmacodynamics. Exploratory analyses focused on correlates of Notch and target gene expression. RESULTS Seventy-nine patients (64, 12 dose-escalation cohorts; 15, confirmatory cohort) enrolled with 54% receiving two or more lines of prior therapy. ACC was the dominant tumor type (40, 51%). Two DLTs were observed [elevated gamma-glutamyl transferase (GGT), visual change]; recommended phase II dose was declared as 500 mg twice daily (5 days on, 2 days off weekly). Grade 3-4 treatment-related adverse events occurred in 15 patients (19%), including elevated liver function tests (LFTs), anemia, and visual changes. Five (6%) discontinued drug for toxicity; with no drug-related deaths. There were no objective responses, but 37 (49%) had stable disease; including 23 of 40 (58%) patients with ACC. In the ACC cohort, median progression-free survival was 2.5 months [95% confidence interval (CI), 1.5-3.7] and median overall survival was 18.4 months (95% CI, 6.3-not reached). CONCLUSIONS CB-103 had a manageable safety profile and biological activity but limited clinical antitumor activity as monotherapy in this first-in-human study. SIGNIFICANCE CB-103 is a novel oral pan-Notch inhibitor that selectively blocks the CSL-NICD interaction leading to transcriptional downregulation of oncogenic Notch pathway activation. This first-in-human dose-escalation and -confirmation study aimed to determine the safety, pharmacokinetics, and preliminary antitumor efficacy of CB-103. We observed a favorable safety profile with good tolerability and biological activity but limited clinical single-agent antitumor activity. Some disease stabilization was observed among an aggressive NOTCH-mutant ACC type-I subgroup where prognosis is poor and therapies are critically needed. Peripheral downregulation of select Notch target gene levels was observed with escalating doses. Future studies exploring CB-103 should enrich for patients with NOTCH-mutant ACC and investigate rational combinatorial approaches in tumors where there is limited success with investigational or approved drugs.
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Affiliation(s)
- Glenn J. Hanna
- Department of Medical Oncology, Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Anastasios Stathis
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | | | - Fabricio Racca
- IOB – Institute of Oncology Barcelona and Madrid, Hospital Quironsalud-Barcelona, Barcelona, Spain
| | - Doris Quon
- Sarcoma Oncology Research Center, Santa Monica, California
| | - Serge Leyvraz
- Charité Comprehensive Cancer Center, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Dagmar Hess
- Department of Medical Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of South Korea
| | - Jordi Rodon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Myung-Ju Ahn
- Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of South Korea
| | - Hye Ryun Kim
- Severance Hospital – Yonsei Cancer Center, Seoul, Republic of South Korea
| | - Andreas Schneeweiss
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg and German Cancer Research Center, Heidelberg, Germany
| | - Josep-Maria Ribera
- Institut Català d'Oncologia (Catalan Institute of Oncology [ICO]), Josep Carreras Research Institute, Barcelona, Spain
| | - Daniel DeAngelo
- Division of Leukemia, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Jose Manuel Perez Garcia
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Hospital, Barcelona, Spain
- Medica Scientia Innovation Research, Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, New Jersey
| | - Javier Cortes
- International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Hospital, Barcelona, Spain
- Medica Scientia Innovation Research, Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, New Jersey
| | | | - Dirk Weber
- Cellestia Biotech AG, Basel, Switzerland
| | - Pavel Pisa
- piMedConsulting Ltd, Gersau, Switzerland
| | | | - Laura Beni
- Cellestia Biotech AG, Basel, Switzerland
| | | | - Raj Lehal
- Cellestia Biotech AG, Basel, Switzerland
| | | | | | - Elena Garralda
- Early Drug Development Unit, Clinical Research Program, Vall d'Hebron University Hospital and Institute of Oncology (VHIO) and Medical Oncology, Vall d'Hebron University Hospital (HUVH), Barcelona, Spain
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Kremsner PG, Ahuad Guerrero RA, Arana-Arri E, Aroca Martinez GJ, Bonten M, Chandler R, Corral G, De Block EJL, Ecker L, Gabor JJ, Garcia Lopez CA, Gonzales L, Granados González MA, Gorini N, Grobusch MP, Hrabar AD, Junker H, Kimura A, Lanata CF, Lehmann C, Leroux-Roels I, Mann P, Martinez-Reséndez MF, Ochoa TJ, Poy CA, Reyes Fentanes MJ, Rivera Mejia LM, Ruiz Herrera VV, Sáez-Llorens X, Schönborn-Kellenberger O, Schunk M, Sierra Garcia A, Vergara I, Verstraeten T, Vico M, Oostvogels L, Lovesio L, Diez F, Grazziani F, Ganaha MC, Zalatnik VJ, Dittrich RJ, Espínola L, Lambert S, Longhi A, Vecchio C, Mastruzzo M, Fernandez A, Borchowiek S, Potito R, Ahuad Guerrero RA, Guardiani FM, Castella S, Foccoli M, Pedernera A, Braida A, Durigan V, Martella C, Bobat A, Boggia BE, Nemi SA, Tartaglione JG, Piedimonte FC, De Bie J, Reynales Londoño H, Rodríguez Ordoñez PA, García Cruz JM, Bautista Toloza L, Ladino González MC, Zambrano Ochoa AP, Prieto Pradera I, Torres Hernandez D, Mazo Elorza DP, Collazos Lennis MF, Vanegas Dominguez B, Solano Mosquera LM, Fendel R, Fleischmann WA, Koehne E, Kreidenweiss A, Köhler C, Esen M, Horn C, Eberts S, Kroidl A, Huber K, Thiel V, Mazara Rosario S, Reyes G, Rivera L, Donastorg Y, Lantigua F, Torres Almanzar D, Candelario R, Peña Mendez L, Rosario Gomez N, Portolés-Pérez A, Ascaso del Río A, Laredo Velasco L, Bustinduy Odriozola MJ, Larrea Arranz I, Martínez Alcorta LI, Durán Laviña MI, Imaz-Ayo N, Meijide S, García-de-Vicuña A, Santorcuato A, Gallego M, Aguirre-García GM, Olmos Vega J, González Limón P, Vázquez Villar A, Chávez Barón J, Arredondo Saldaña F, Luján Palacios JDD, Camacho Choza LJ, Vázquez Saldaña EG, Ortega Dominguez SJ, Vega Orozco KS, Torres Quiroz IA, Martinez Avendaño A, Herrera Sanchez J, Guzman E, Castro Castrezana L, Ruiz Palacios y Santos GM, de Winter RFJ, de Jonge HK, Schnyder JL, Boersma W, Hessels L, Djamin R, van der Sar S, DeAntonio R, Peña M, Rebollon G, Rojas M, Escobar J, Hammerschlag Icaza B, Wong T DY, Barrera Perigault P, Ruiz S, Chan M, Arias Hoo DJ, Gil AI, Celis CR, Balmaceda MP, Flores O, Ochoa M, Peña B, de la Flor C, Webb CM, Cornejo E, Sanes F, Mayorga V, Valdiviezo G, Ramírez Lamas SP, Grandez Castillo GA, Lama JR, Matta Aguirre ME, Arancibia Luna LA, Carbajal Paulet Ó, Zambrano Ortiz J, Camara A, Guzman Quintanilla F, Diaz-Parra C, Morales-Oliva J, Cornejo RE, Ricalde SA, Vidal J, Rios Nogales L, Cheatham-Seitz D, Gregoraci G, Brecx A, Walz L, Vahrenhorst D, Seibel T, Quintini G. Efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate in ten countries in Europe and Latin America (HERALD): a randomised, observer-blinded, placebo-controlled, phase 2b/3 trial. Lancet Infect Dis 2022; 22:329-340. [PMID: 34826381 PMCID: PMC8610426 DOI: 10.1016/s1473-3099(21)00677-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Additional safe and efficacious vaccines are needed to control the COVID-19 pandemic. We aimed to analyse the efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate. METHODS HERALD is a randomised, observer-blinded, placebo-controlled, phase 2b/3 clinical trial conducted in 47 centres in ten countries in Europe and Latin America. By use of an interactive web response system and stratification by country and age group (18-60 years and ≥61 years), adults with no history of virologically confirmed COVID-19 were randomly assigned (1:1) to receive intramuscularly either two 0·6 mL doses of CVnCoV containing 12 μg of mRNA or two 0·6 mL doses of 0·9% NaCl (placebo) on days 1 and 29. The primary efficacy endpoint was the occurrence of a first episode of virologically confirmed symptomatic COVID-19 of any severity and caused by any strain from 15 days after the second dose. For the primary endpoint, the trial was considered successful if the lower limit of the CI was greater than 30%. Key secondary endpoints were the occurrence of a first episode of virologically confirmed moderate-to-severe COVID-19, severe COVID-19, and COVID-19 of any severity by age group. Primary safety outcomes were solicited local and systemic adverse events within 7 days after each dose and unsolicited adverse events within 28 days after each dose in phase 2b participants, and serious adverse events and adverse events of special interest up to 1 year after the second dose in phase 2b and phase 3 participants. Here, we report data up to June 18, 2021. The study is registered at ClinicalTrials.gov, NCT04652102, and EudraCT, 2020-003998-22, and is ongoing. FINDINGS Between Dec 11, 2020, and April 12, 2021, 39 680 participants were enrolled and randomly assigned to receive either CVnCoV (n=19 846) or placebo (n=19 834), of whom 19 783 received at least one dose of CVnCoV and 19 746 received at least one dose of placebo. After a mean observation period of 48·2 days (SE 0·2), 83 cases of COVID-19 occurred in the CVnCoV group (n=12 851) in 1735·29 person-years and 145 cases occurred in the placebo group (n=12 211) in 1569·87 person-years, resulting in an overall vaccine efficacy against symptomatic COVID-19 of 48·2% (95·826% CI 31·0-61·4; p=0·016). Vaccine efficacy against moderate-to-severe COVID-19 was 70·7% (95% CI 42·5-86·1; CVnCoV 12 cases in 1735·29 person-years, placebo 37 cases in 1569·87 person-years). In participants aged 18-60 years, vaccine efficacy against symptomatic disease was 52·5% (95% CI 36·2-64·8; CVnCoV 71 cases in 1591·47 person-years, placebo, 136 cases in 1449·23 person-years). Too few cases occurred in participants aged 61 years or older (CVnCoV 12, placebo nine) to allow meaningful assessment of vaccine efficacy. Solicited adverse events, which were mostly systemic, were more common in CVnCoV recipients (1933 [96·5%] of 2003) than in placebo recipients (1344 [67·9%] of 1978), with 542 (27·1%) CVnCoV recipients and 61 (3·1%) placebo recipients reporting grade 3 solicited adverse events. The most frequently reported local reaction after any dose in the CVnCoV group was injection-site pain (1678 [83·6%] of 2007), with 22 grade 3 reactions, and the most frequently reported systematic reactions were fatigue (1603 [80·0%] of 2003) and headache (1541 [76·9%] of 2003). 82 (0·4%) of 19 783 CVnCoV recipients reported 100 serious adverse events and 66 (0·3%) of 19 746 placebo recipients reported 76 serious adverse events. Eight serious adverse events in five CVnCoV recipients and two serious adverse events in two placebo recipients were considered vaccination-related. None of the fatal serious adverse events reported (eight in the CVnCoV group and six in the placebo group) were considered to be related to study vaccination. Adverse events of special interest were reported for 38 (0·2%) participants in the CVnCoV group and 31 (0·2%) participants in the placebo group. These events were considered to be related to the trial vaccine for 14 (<0·1%) participants in the CVnCoV group and for five (<0·1%) participants in the placebo group. INTERPRETATION CVnCoV was efficacious in the prevention of COVID-19 of any severity and had an acceptable safety profile. Taking into account the changing environment, including the emergence of SARS-CoV-2 variants, and timelines for further development, the decision has been made to cease activities on the CVnCoV candidate and to focus efforts on the development of next-generation vaccine candidates. FUNDING German Federal Ministry of Education and Research and CureVac.
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Jeger S, Schönborn-Kellenberger O, De Winter H, Steeghs N, Gort E, Gomez-Roca C, Stavropoulou V, Kenefeck R, Fernandez E, Ji H, Marchand C, Legenne P, Cassier P. 170TiP A phase I study to characterize the safety and tolerability of MP0317, a tumor targeting FAP dependent CD40 agonist DARPin®, in patients with relapsed/refractory solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Kremsner PG, Mann P, Kroidl A, Leroux-Roels I, Schindler C, Gabor JJ, Schunk M, Leroux-Roels G, Bosch JJ, Fendel R, Kreidenweiss A, Velavan TP, Fotin-Mleczek M, Mueller SO, Quintini G, Schönborn-Kellenberger O, Vahrenhorst D, Verstraeten T, Alves de Mesquita M, Walz L, Wolz OO, Oostvogels L. Safety and immunogenicity of an mRNA-lipid nanoparticle vaccine candidate against SARS-CoV-2 : A phase 1 randomized clinical trial. Wien Klin Wochenschr 2021; 133:931-941. [PMID: 34378087 PMCID: PMC8354521 DOI: 10.1007/s00508-021-01922-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND We used the RNActive® technology platform (CureVac N.V., Tübingen, Germany) to prepare CVnCoV, a COVID-19 vaccine containing sequence-optimized mRNA coding for a stabilized form of SARS-CoV‑2 spike (S) protein encapsulated in lipid nanoparticles (LNP). METHODS This is an interim analysis of a dosage escalation phase 1 study in healthy 18-60-year-old volunteers in Hannover, Munich and Tübingen, Germany, and Ghent, Belgium. After giving 2 intramuscular doses of CVnCoV or placebo 28 days apart we assessed solicited local and systemic adverse events (AE) for 7 days and unsolicited AEs for 28 days after each vaccination. Immunogenicity was measured as enzyme-linked immunosorbent assay (ELISA) IgG antibodies to SARS-CoV‑2 S‑protein and receptor binding domain (RBD), and SARS-CoV‑2 neutralizing titers (MN50). RESULTS In 245 volunteers who received 2 CVnCoV vaccinations (2 μg, n = 47, 4 μg, n = 48, 6 μg, n = 46, 8 μg, n = 44, 12 μg, n = 28) or placebo (n = 32) there were no vaccine-related serious AEs. Dosage-dependent increases in frequency and severity of solicited systemic AEs, and to a lesser extent local AEs, were mainly mild or moderate and transient in duration. Dosage-dependent increases in IgG antibodies to S‑protein and RBD and MN50 were evident in all groups 2 weeks after the second dose when 100% (23/23) seroconverted to S‑protein or RBD, and 83% (19/23) seroconverted for MN50 in the 12 μg group. Responses to 12 μg were comparable to those observed in convalescent sera from known COVID-19 patients. CONCLUSION In this study 2 CVnCoV doses were safe, with acceptable reactogenicity and 12 μg dosages elicited levels of immune responses that overlapped those observed in convalescent sera.
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Affiliation(s)
- Peter G Kremsner
- Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
- Centre de Recherches Medicales de Lambarene, Lambarene, Gabon
| | - Philipp Mann
- CureVac AG, Schumannstraße 27, 60325, Frankfurt, Germany.
| | - Arne Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), partner site Munich, Munich, Germany
| | | | | | - Julian J Gabor
- Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), partner site Munich, Munich, Germany
| | | | | | - Rolf Fendel
- Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Andrea Kreidenweiss
- Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University Hospital Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Viet Nam
| | | | | | | | | | | | | | | | - Lisa Walz
- CureVac AG, Schumannstraße 27, 60325, Frankfurt, Germany
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Lopez Miranda E, Stathis A, Hess D, Racca F, Quon D, Rodon J, Saavedra Santa Gadea O, Perez Garcia JM, Nuciforo P, Vivancos A, Cortes J, Ferrarotto R, Schönborn-Kellenberger O, Vigolo M, Bobadilla M, Beni L, Lehal R, Bauer MP, Vogl FD, Garralda E. Phase 1 study of CB-103, a novel first-in-class inhibitor of the CSL-NICD gene transcription factor complex in human cancers. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.3020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3020 Background: CB-103 selectively inhibits the CSL-NICD interaction leading to down-regulation of CSL-NICD mediated oncogenic pathway activation downstream of NOTCH receptor/ligand signaling, and has shown potent anti-cancer activity as single agent and in combination with targeted/chemotherapies in preclinical models. The aim of this dose escalation/expansion phase 1/2a study is to assess safety, maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D), preliminary activity, pharmacokinetics and pharmacodynamics of CB-103. Methods: Eligible were adult patients (pts) with advanced or recurrent selected solid tumors. Tumor tissue, where available, was retrospectively tested for NOTCH pathway activating mutations and surrogate tissues were evaluated for gene expression of related target genes. CB-103 was given orally in 28 days cycles at escalating doses until disease progression or toxicity. In a dose confirmatory cohort, NOTCH activation will be prospectively assessed to determine eligibility. Results: Forty-one pts (19 adenoid cystic carcinoma (ACC), 16 colorectal and 4 breast cancer, 2 prostate cancer) were assigned to increasing dose levels starting from 15mg once daily (OD). Median age was 55 years (range 25-76). Median number of prior lines of therapy was 2 (range 0-7). Thirty-two pts in 8 escalation groups completed the 28-day DLT window. One DLT (asymptomatic grade (G) 3 GGT increase) was observed at the highest dose (600mg). Related treatment emergent adverse events (AE) occurring in >10% of pts were nausea (24%), diarrhea (20%), dyspepsia (15%), fatigue (12%) and vision blurred (12%), all G 1/2. No discontinuations occurred due to treatment-related AEs. The MTD has not been reached. Several pts reported vision changes that improved over time and were fully reversible after stopping the drug. Median time on treatment for all pts was 52 days (range 5-249). Best response was stable disease (SD). For ACC pts, preliminary median PFS was 21.7 weeks (95% confidence interval (CI) 13.7-22.4 weeks) and disease control rate (DCR) was 79% at week 8 and 58 % at week 20. Three pts with ACC harboring activating NOTCH alterations had radiologically confirmed stable disease (SD) > 6 months. Importantly, in 3 pts with NOTCH positive disease a temporary stop of tumor growth was observed. One pt showed a reduction in size of a liver lesion up to 25% before progression due to new lesions. Mechanistically, strong on-treatment downregulation of NOTCH target genes was observed. The dose of 600mg CB-103 OD was declared the RP2D. Conclusions: CB-103 is the first drug to effectively control the CSL-NICD transcription complex. CB-103 is well tolerated in pts with advanced tumors and, as expected on the basis of mechanistic studies, in the absence of the typical toxicities associated with Notch targeting GSIs or mABs. The RP2D has been established for advancing clinical development into phase 2. Clinical trial information: NCT03422679.
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Affiliation(s)
| | | | - Dagmar Hess
- Department of Medical Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Fabricio Racca
- IOB–Institute of Oncology Barcelona and Madrid, Hospital Quironsalud Barcelona, Barcelona, Spain
| | - Doris Quon
- Sarcoma Oncology Research Center, Santa Monica, CA
| | - Jordi Rodon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Paolo Nuciforo
- Molecular Oncology Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Cortes
- IOB Institute of Oncology, Quironsalud Group and Vall d´Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Renata Ferrarotto
- Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Laura Beni
- Cellestia Biotech AG, Basel, Switzerland
| | | | | | | | - Elena Garralda
- Early Drug Development Unit (UITM), Vall d'Hebron University Hospital and Institute of Oncology (VHIO) and Medical Oncology, Vall d’Hebron University Hospital (HUVH), Barcelona, Spain
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Umer A, Ługowska-Umer H, Schönborn-Kellenberger O, Korolkiewicz PK, Sein-Anand Ł, Kocic I, Korolkiewicz RP. Tachykinin antagonists ameliorate surgically induced impairment of gastrointestinal motility in rats. Fundam Clin Pharmacol 2020; 35:681-689. [PMID: 33058252 DOI: 10.1111/fcp.12616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/15/2020] [Revised: 09/15/2020] [Accepted: 10/09/2020] [Indexed: 01/23/2023]
Abstract
The protective effects of tachykinin receptor antagonists: SR140333 (NK1 receptor), SR48968 (NK2 receptor), and SB222200 (NK3 receptor) were tested in rats against a surgically induced postoperative inhibition of gut motility, a common complication of abdominal surgery. The small intestinal transit of Evans blue was measured 24-h post-surgery in untreated rats and animals subjected to skin incision, laparotomy, or laparotomy followed by gut evisceration and manipulation. Surgical procedures were conducted under diethyl ether anesthesia. In comparison to untreated and ether-anesthetized rats, animals undergoing skin incision, laparotomy, or laparotomy with gut evisceration and manipulation showed a significant decrease in the intestinal transit of Evans blue. The pretreatment with NK1 (3-100 µg/kg), NK2 (3-30 µg/kg), and NK3 (10-300 µg/kg) blockers before surgery ameliorated the inhibitory effects of gut manipulation in a dose-dependent manner. Moreover, the submaximal and maximal doses of NK3 antagonists showed a trend toward reversing not only the inhibition caused by gut manipulation but also laparotomy. An additive effect of combining submaximal doses of NK1-3 blockers was observed in animals pretreated with NK1 + NK2 compared to single-agent NK1 and NK2 . Additionally, doublets: NK1 + NK3 or NK2 + NK3 and a triplet: NK1 + NK2 + NK3 proved to be more effective than NK2 antagonist alone. In contrast, NK1-3 blockers have not markedly affected the intestinal propulsion in untreated rats or animals subjected to skin incision or laparotomy. NK1-3 blockers ameliorated the suppressed small-bowel gut motility 24 post-surgery. Combined pretreatment with NK1-3 antagonists provided selective, additive benefits compared to single agents.
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Affiliation(s)
- Artur Umer
- Department of Thoracic Surgery, Venerology, Allergology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venerology, Allergology, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | | | | | - Łukasz Sein-Anand
- Department of Clinical Toxicology Medical University of Gdańsk, Kartuska 4/6, Gdańsk, 80-104, Poland
| | - Ivan Kocic
- Department of Pharmacology, Medical University of Gdańsk, Dębowa 23, Gdańsk, 80-204, Poland
| | - Roman P Korolkiewicz
- Department of Pharmacology, Medical University of Gdańsk, Dębowa 23, Gdańsk, 80-204, Poland
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Umer A, Ługowska-Umer H, Schönborn-Kellenberger O, Korolkiewicz PK, Sein-Anand Ł, Kuziemski K, Korolkiewicz RP. Tachykinin Antagonists Reverse Ischemia/Reperfusion Gastrointestinal Motility Impairment in Rats. J Surg Res 2020; 255:510-516. [PMID: 32629333 DOI: 10.1016/j.jss.2020.05.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/29/2020] [Revised: 04/26/2020] [Accepted: 05/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Supraceliac aortic clamping and unclamping produces ischemia-reperfusion (I/R) injury of the splanchnic organs. The protective effects of tachykinin receptor antagonists, SR140333 (NK1 receptor), SR48968 (NK2 receptor), and SB222200 (NK3 receptor), against I/R-induced inhibition of intestinal motility were tested in rats. MATERIAL AND METHODS The intestinal transit of Evans blue was measured in untreated rats and animals subjected to skin incision, I/R (1 h superior mesenteric artery occlusion followed by 24 h reperfusion) or sham operation. Surgical procedures were conducted under diethyl ether anesthesia. RESULTS The gastrointestinal transit has not been markedly affected in rats, which were anesthetized or subjected to skin incision in comparison with untreated animals. In contrast, a sham operation and I/R have significantly reduced the intestinal motility. Pretreatment with NK1-3 blockers (SR140333 [3-30 μg/kg]; SR48968 [3-100 μg/kg]; and SB222200 [10-100 μg/kg]) reversed dose dependently the effects of I/R to the level observed after sham operation only. A combination of NK1+NK2+NK3 inhibitors exerted an additive effect compared with NK1 and NK2 antagonists used as single agents. Similarly, combined NK1+NK2 were more effective than NK2 alone. Sham operation and I/R have shifted the in vitro carbachol concentration-response curves to the right in comparison with untreated animals, a phenomenon partially reversed by NK1-NK3 pretreatment. CONCLUSIONS Single-agent and combined treatment with NK1-3 antagonists markedly attenuated the gastrointestinal dysmotility evoked by I/R injury. The pretreatment with NK3 blocker proved to be the most active in this experimental setting.
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Affiliation(s)
- Artur Umer
- Department of Thoracic Surgery, Medical University of Gdansk, Smoluchowskiego, Gdańsk, Poland
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venerology, Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Łukasz Sein-Anand
- Department of Clinical Toxicology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Kuziemski
- Department of Allergology and Pneumonology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Krauss J, Eigentler T, Schreiber J, Weishaupt C, Terheyden P, Heinzerling L, Mohr P, Weide B, Ochsenreither S, Gutzmer R, Becker J, Kiecker F, Funkner F, Heidenreich R, Kays SK, Klinkhardt U, Gnad-Vogt U, Scheel B, Schönborn-Kellenberger O, Seibel T. A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Terheyden P, Weishaupt C, Heinzerling L, Klinkhardt U, Krauss J, Mohr P, Kiecker F, Becker J, Dähling (Submitter A, Döner F, Heidenreich R, Scheel B, Schönborn-Kellenberger O, Seibel T, Gnad-Vogt U. Phase I dose-escalation and expansion study of intratumoral CV8102, a RNA-based TLR- and RIG-1 agonist in patients with advanced solid tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy289.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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Perez Garcia JM, Cortés J, Stathis A, Mous R, López-Miranda E, Azaro A, Genta S, Nuciforo P, Vivancos A, Ferrarotto R, Bertoni F, Rossi D, Spardy Burr N, Schönborn-Kellenberger O, Jorga K, Beni L, Lehal R, Bauer M, Weber D, Garralda E. First-in-human phase 1-2A study of CB-103, an oral Protein-Protein Interaction Inhibitor targeting pan-NOTCH signalling in advanced solid tumors and blood malignancies. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps2619] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Javier Cortés
- Ramon y Cajal University Hospital, Madrid, and Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Anastasios Stathis
- IOSI - Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Rogier Mous
- UMC Utrecht Cancer Center, Utrecht, Netherlands
| | | | - Analía Azaro
- Medical Oncology Department, Vall d’Hebron University Hospital; Molecular Therapeutics Research Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Sofia Genta
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Paolo Nuciforo
- Molecular Pathology Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Francesco Bertoni
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland
| | - Davide Rossi
- Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | | | | | - Karin Jorga
- Karin Jorga Life Science Consulting GmbH, Basel, Switzerland
| | - Laura Beni
- Cellestia Biotech AG, Basel, Switzerland
| | | | | | - Dirk Weber
- Cellestia Biotech AG, Basel, Switzerland
| | - Elena Garralda
- Medical Oncology Department, Vall d’Hebron University Hospital; Molecular Therapeutics Research Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Stenzl A, Feyerabend S, Syndikus I, Sarosiek T, Kübler H, Heidenreich A, Cathomas R, Grüllich C, Loriot Y, Perez Gracia S, Gillessen S, Klinkhardt U, Schröder A, Schönborn-Kellenberger O, Reus V, Koch S, Hong H, Seibel T, Fizazi K, Gnad-Vogt U. Results of the randomized, placebo-controlled phase I/IIB trial of CV9104, an mRNA based cancer immunotherapy, in patients with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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