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Apte A, Shrivastava R, Sanghavi S, Mitra M, Ramanan PV, Chhatwal J, Jain S, Chowdhury J, Premkumar S, Kumar R, Palani A, Kaur G, Javadekar N, Kulkarni P, Macina D, Bavdekar A. Multicentric Hospital-Based Surveillance of Pertussis Amongst Infants Admitted in Tertiary Care Facilities in India. Indian Pediatr 2021; 58:709-717. [PMID: 34465657] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To estimate the disease and economic burden of pertussis amongst hospitalised infants in India. DESIGN Multicentric hospital-based surveillance study. PARTICIPANTS Hospitalised infants with clinical suspicion of pertussis based on predefined criteria. OUTCOME MEASURES Proportion of infants with laboratory-confirmed pertussis, economic burden of pertussis amongst hospitalised infants. RESULTS 693 clinically suspected infants were recruited of which 32 (4.62%) infants had laboratory-confirmed pertussis. Progressive cough with post-tussive emesis (50%) and pneumonia (34%) were the common clinical presentations; apnea in young infants was significantly associated with pertussis. Infants with pertussis were more likely to be younger (median age 102.5 days vs.157 days) and born preterm (42.9% vs 24.5%). Almost 30% infants with pertussis had not received vaccine for pertussis with 50% of these infants aged less than 2 months. Pertussis was associated with higher costs of hospitalisation, pharmacy and loss of working days by caregivers as compared to non-pertussis cases. CONCLUSIONS Younger infants, those born preterm and those inadequately immunised against pertussis are at higher risk of pertussis infection. Timely childhood immunisation and introduction of maternal immunisation for pertussis can help in reducing the disease burden.
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Affiliation(s)
- A Apte
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | - R Shrivastava
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | - S Sanghavi
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | - M Mitra
- Department of Pediatrics, Institute of Child Heath, Kolkata, India
| | - P Venkat Ramanan
- Department of Pediatrics, Sri Ramachandra Medical Centre, Chennai, India
| | - J Chhatwal
- Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, India
| | - S Jain
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | - J Chowdhury
- Department of Pediatrics, Institute of Child Heath, Kolkata, India
| | - S Premkumar
- Department of Pediatrics, Sri Ramachandra Medical Centre, Chennai, India
| | - R Kumar
- Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, India
| | - A Palani
- Department of Pediatrics, Sri Ramachandra Medical Centre, Chennai, India
| | - G Kaur
- Department of Pediatrics, Christian Medical College and Hospital, Ludhiana, India
| | - N Javadekar
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | - P Kulkarni
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India
| | | | - A Bavdekar
- Department of Pediatrics, KEM Hospital Research Centre, Pune, India. Correspondence to: Dr Ashish Bavdekar, Associate Professor, Consultant Pediatric Gastroenterologist, Department of Pediatrics, KEM Hospital, Rasta Peth, Pune, Maharashtra 411 011.
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Apte A, Shrivastava R, Sanghavi S, Mitra M, Ramanan PV, Chhatwal J, Jain S, Chowdhury J, Premkumar S, Kumar R, Palani A, Kaur G, Javadekar N, Kulkarni P, Macina D, Bavdekar A. Multicentric Hospital-Based Surveillance of Pertussis Amongst Infants Admitted in Tertiary Care Facilities in India. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2276-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Tiran AL, Claperon A, Davidson J, Starck JB, Diguarher TL, Chanrion M, Mistry P, Wang Y, Monceau E, Bernhardt F, Rocchetti F, Lysiak-Auvity G, Chen I, Daniels Z, Pedder C, Fallowfield M, Henlin JM, Fejes I, Tatai J, Nyerges M, Durand D, Zarka M, Sanghavi S, Girard AM, Schoumacher M, Kraus-Berthier L, Newcombe R, Halilovic E, Banquet S, Rupin A, Maacke H, Murray J, Morris E, Hofmann F, Colland F, Geneste O. Abstract 1276: Identification of S65487/VOB560 as a potent and selective intravenous 2nd-generation BCL-2 inhibitor active in wild-type and clinical mutants resistant to Venetoclax. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1276] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The B-cell Lymphoma 2 (BCL-2) gene family encodes pro-apoptotic and anti-apoptotic proteins that are key regulators of the apoptotic process. Overexpression of the pro-survival member BCL-2 is a well-established mechanism contributing to oncogenesis and chemoresistance in several cancers, including lymphoma and leukemia. Venetoclax (Venclexta™), a selective BCL-2 inhibitor, is the first member of a new class of anti-cancer drugs, called BH3 mimetics, to be approved for CLL and AML. Here, we describe the identification of a novel potent and selective BCL-2 inhibitor named S65487/VOB560 that has a different binding mode on BCL-2 compared to Venetoclax. This inhibitor binds to the BH3 hydrophobic groove of BCL-2. Its selectivity profile demonstrates lack of significant binding to MCL-1, BFL-1 and poor affinity for BCL-XL. S65487/VOB560 induces apoptosis in a panel of hematological cancer cell lines and inhibits cell proliferation with IC50s in the low nM range. S65487/VOB560 induces complete regression in BCL-2-dependent RS4;11 tumors in vivo after a single IV (intravenous) administration. Strong and persistent tumor regression in xenograft models of lymphoid malignancies in mouse and rat were observed at well tolerated doses following weekly IV administration of S65487 in combination with the MCL-1-specific inhibitor, S64315/MIK665. These positive findings were further confirmed in a panel of AML PDX tumor models. Recently, acquired BCL-2 mutations (such as G101V and D103Y) were identified in patients with Chronic Lymphocytic Leukemia becoming resistant to Venetoclax. Interestingly, S65487/VOB560 is active on such BCL-2 mutants and induces apoptosis in preclinical resistance models. Altogether, these data demonstrate that S65487/VOB560 has significant therapeutic potential against human lymphoid and myeloid malignancies as well as in patients with Venetoclax resistant leukemias. Clinical studies are currently ongoing with S65487/VOB560 (NCT03755154).
Citation Format: Arnaud Le Tiran, Audrey Claperon, James Davidson, Jérôme-Benoit Starck, Thierry Le Diguarher, Maïa Chanrion, Prakash Mistry, Youzhen Wang, Elodie Monceau, Fabienne Bernhardt, Francesca Rocchetti, Gaelle Lysiak-Auvity, Ijen Chen, Zoe Daniels, Chris Pedder, Mandy Fallowfield, Jean-Michel Henlin, Imre Fejes, Janos Tatai, Miklos Nyerges, Didier Durand, Marion Zarka, Sneha Sanghavi, Anne-Marie Girard, Marie Schoumacher, Laurence Kraus-Berthier, Rick Newcombe, Ensar Halilovic, Sébastien Banquet, Alain Rupin, Heiko Maacke, James Murray, Erick Morris, Francesco Hofmann, Frédéric Colland, Olivier Geneste. Identification of S65487/VOB560 as a potent and selective intravenous 2nd-generation BCL-2 inhibitor active in wild-type and clinical mutants resistant to Venetoclax [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1276.
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Affiliation(s)
- Arnaud Le Tiran
- 1Institut de Recherches Servier Discovery Chemistry Unit, Croissy-sur-Seine, France
| | - Audrey Claperon
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | | | - Jérôme-Benoit Starck
- 1Institut de Recherches Servier Discovery Chemistry Unit, Croissy-sur-Seine, France
| | - Thierry Le Diguarher
- 1Institut de Recherches Servier Discovery Chemistry Unit, Croissy-sur-Seine, France
| | - Maïa Chanrion
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Prakash Mistry
- 4Novartis Institute of Biomedical Research, Oncology Drug Discovery, Basel, Switzerland
| | - Youzhen Wang
- 5Novartis Institute of Biomedical Research, Oncology Drug Discovery, Cambridge, MA
| | - Elodie Monceau
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Fabienne Bernhardt
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Francesca Rocchetti
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | | | - Ijen Chen
- 3Vernalis (R&D) Ltd, Cambridge, United Kingdom
| | - Zoe Daniels
- 3Vernalis (R&D) Ltd, Cambridge, United Kingdom
| | | | | | - Jean-Michel Henlin
- 1Institut de Recherches Servier Discovery Chemistry Unit, Croissy-sur-Seine, France
| | - Imre Fejes
- 6Servier Research Institute of Medicinal Chemistry, Budapest, Hungary
| | - Janos Tatai
- 6Servier Research Institute of Medicinal Chemistry, Budapest, Hungary
| | - Miklos Nyerges
- 6Servier Research Institute of Medicinal Chemistry, Budapest, Hungary
| | - Didier Durand
- 1Institut de Recherches Servier Discovery Chemistry Unit, Croissy-sur-Seine, France
| | - Marion Zarka
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Sneha Sanghavi
- 5Novartis Institute of Biomedical Research, Oncology Drug Discovery, Cambridge, MA
| | - Anne-Marie Girard
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Marie Schoumacher
- 7Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France
| | | | - Rick Newcombe
- 5Novartis Institute of Biomedical Research, Oncology Drug Discovery, Cambridge, MA
| | - Ensar Halilovic
- 5Novartis Institute of Biomedical Research, Oncology Drug Discovery, Cambridge, MA
| | - Sébastien Banquet
- 7Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France
| | - Alain Rupin
- 7Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France
| | - Heiko Maacke
- 4Novartis Institute of Biomedical Research, Oncology Drug Discovery, Basel, Switzerland
| | | | - Erick Morris
- 5Novartis Institute of Biomedical Research, Oncology Drug Discovery, Cambridge, MA
| | - Francesco Hofmann
- 4Novartis Institute of Biomedical Research, Oncology Drug Discovery, Basel, Switzerland
| | - Frédéric Colland
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Olivier Geneste
- 2Institut de Recherches Servier Oncology R&D Unit, Croissy-sur-Seine, France
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Bhatt S, Pioso MS, Olesinski EA, Yilma B, Ryan JA, Mashaka T, Leutz B, Adamia S, Zhu H, Kuang Y, Mogili A, Louissaint A, Bohl SR, Kim AS, Mehta AK, Sanghavi S, Wang Y, Morris E, Halilovic E, Paweletz CP, Weinstock DM, Garcia JS, Letai A. Reduced Mitochondrial Apoptotic Priming Drives Resistance to BH3 Mimetics in Acute Myeloid Leukemia. Cancer Cell 2020; 38:872-890.e6. [PMID: 33217342 PMCID: PMC7988687 DOI: 10.1016/j.ccell.2020.10.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 08/04/2020] [Accepted: 10/07/2020] [Indexed: 12/20/2022]
Abstract
Acquired resistance to BH3 mimetic antagonists of BCL-2 and MCL-1 is an important clinical problem. Using acute myelogenous leukemia (AML) patient-derived xenograft (PDX) models of acquired resistance to BCL-2 (venetoclax) and MCL-1 (S63845) antagonists, we identify common principles of resistance and persistent vulnerabilities to overcome resistance. BH3 mimetic resistance is characterized by decreased mitochondrial apoptotic priming as measured by BH3 profiling, both in PDX models and human clinical samples, due to alterations in BCL-2 family proteins that vary among cases, but not to acquired mutations in leukemia genes. BCL-2 inhibition drives sequestered pro-apoptotic proteins to MCL-1 and vice versa, explaining why in vivo combinations of BCL-2 and MCL-1 antagonists are more effective when concurrent rather than sequential. Finally, drug-induced mitochondrial priming measured by dynamic BH3 profiling (DBP) identifies drugs that are persistently active in BH3 mimetic-resistant myeloblasts, including FLT-3 inhibitors and SMAC mimetics.
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Affiliation(s)
- Shruti Bhatt
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA; Department of Pharmacy, National University of Singapore, Singapore
| | - Marissa S Pioso
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Elyse Anne Olesinski
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Binyam Yilma
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Jeremy A Ryan
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Thelma Mashaka
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Buon Leutz
- Department of Bioinformatics and Data Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Sophia Adamia
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA
| | - Haoling Zhu
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA
| | - Yanan Kuang
- Department of Bioinformatics and Data Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Abhishek Mogili
- Department of Bioinformatics and Data Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Abner Louissaint
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA
| | - Stephan R Bohl
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Annette S Kim
- Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA
| | - Anita K Mehta
- Breast Tumor Immunology Laboratory, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sneha Sanghavi
- Novartis Institutes for BioMedical Research, Inc., Cambridge, MA, USA
| | - Youzhen Wang
- Novartis Institutes for BioMedical Research, Inc., Cambridge, MA, USA
| | - Erick Morris
- Novartis Institutes for BioMedical Research, Inc., Cambridge, MA, USA
| | - Ensar Halilovic
- Novartis Institutes for BioMedical Research, Inc., Cambridge, MA, USA
| | - Cloud P Paweletz
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David M Weinstock
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA
| | - Jacqueline S Garcia
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, 440 Brookline Avenue, M430, Boston, MA 02215, USA; Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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Wang Y, Qui S, Sanghavi S, Mulford I, Lysiak G, Chanrion M, Mistry P, Pfaar U, Schoumacher M, Claperon A, Kraus-Berthier L, Banquet S, Derreal A, Fabre C, Maacke H, Colland F, Geneste O, Morris E, Halilovic E. Abstract 257: Targeting AML through apoptosis activation using Bcl-2/Mcl-1 or Bcl-2/Hdm2 inhibitor combination therapies. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Acute myeloid leukemia (AML) is an aggressive and heterogeneous hematologic malignancy, characterized by uncontrolled proliferation and impaired differentiation of myeloid cells. With the exception of certain subtypes, the average long-term survival rate remains low, thus underlining the need to further improve the outcome of AML patients. Since AML is one of the least mutated cancer types, the majority of AML patients may not carry targetable genetic alterations. However, the anti-apoptotic proteins of the Bcl-2 family, such as Bcl-2 and Mcl-1, are often overexpressed in AML, allowing deregulated survival; hence pro-apoptosis priming with small molecule inhibitors of Bcl-2 and Mcl-1 may provide a broader therapeutic benefit across the disease. In addition, a majority of AML patients carry wild-type p53, providing therapeutic opportunity for Hdm2 inhibitors to stabilize p53 and lead to expression of pro-apoptotic molecules (e.g., PUMA & BAX). Therefore, targeting the combined apoptosis mechanisms by inhibiting different anti-apoptotic Bcl-2 family of proteins and activating p53 concomitantly may synergistically enhance apoptotic cell death of AML tumor cells.
We tested the combination of Bcl-2 inhibitors (BCL201/S55746 or venetoclax) with either MIK665/S64315, a novel and selective inhibitor of Mcl-1 or HDM201, a selective small molecule inhibitor of p53:Hdm2 interaction, in a series of in vitro and in vivo studies in AML. In vitro, strong combination synergy was observed with a remarkable induction of cell death for both combinations. In vivo, the combination of Bcl-2 inhibitors with MIK665/S64315 or HDM201 lead to complete and durable antitumor responses in a variety of p53wt AML patient-derived xenograft models of heterogeneous genetic profiles. Notably, lowering the dose of HDM201 by 4 fold from its most efficacious dose, resulted in a high degree of tumor regressions while mitigating the toxicity effects on platelets. Taken together, these data demonstrate that a combination of Bcl-2 inhibitor (BCL201/S55746 or venetoclax) with MIK665/S64315 or HDM201 provide therapeutic benefit over the monotherapy, and support a rationale for testing these apoptosis enhancing combination approaches in AML patients.
Citation Format: Youzhen Wang, Shumei Qui, Sneha Sanghavi, Iain Mulford, Gaëlle Lysiak, Maïa Chanrion, Prakash Mistry, Ulrike Pfaar, Marie Schoumacher, Audrey Claperon, Laurence Kraus-Berthier, Sébastien Banquet, Alix Derreal, Claire Fabre, Heiko Maacke, Frédéric Colland, Olivier Geneste, Erick Morris, Ensar Halilovic. Targeting AML through apoptosis activation using Bcl-2/Mcl-1 or Bcl-2/Hdm2 inhibitor combination therapies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 257.
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Affiliation(s)
- Youzhen Wang
- 1Novartis Insts. for BioMedical Research, Cambridge, MA
| | - Shumei Qui
- 1Novartis Insts. for BioMedical Research, Cambridge, MA
| | | | - Iain Mulford
- 1Novartis Insts. for BioMedical Research, Cambridge, MA
| | - Gaëlle Lysiak
- 2Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Maïa Chanrion
- 2Servier Oncology R&D Unit, Croissy-sur-Seine, France
| | - Prakash Mistry
- 3Novartis Insts. for BioMedical Research, Basel, Switzerland
| | - Ulrike Pfaar
- 3Novartis Insts. for BioMedical Research, Basel, Switzerland
| | | | | | | | | | | | - Claire Fabre
- 3Novartis Insts. for BioMedical Research, Basel, Switzerland
| | - Heiko Maacke
- 3Novartis Insts. for BioMedical Research, Basel, Switzerland
| | | | | | - Erick Morris
- 1Novartis Insts. for BioMedical Research, Cambridge, MA
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Halilovic E, Chanrion M, Mistry P, Wartmann M, Qiu S, Sanghavi S, Chen Y, Lysiak G, Maragno AL, Pfaar U, Huth F, Schoumacher M, Claperon A, Kraus-Berthier L, Banquet S, Derreal A, Maacke H, Colland F, Geneste O, Morris E, Wang Y. Abstract 4477: MIK665/S64315, a novel Mcl-1 inhibitor, in combination with Bcl-2 inhibitors exhibits strong synergistic antitumor activity in a range of hematologic malignancies. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
One of the hallmarks of cancer is evasion of apoptosis. The B-cell lymphoma-2 (Bcl-2) family of proteins represents a crucial point of control of apoptosis. The Bcl-2 family comprises both pro- and anti-apoptotic members, the latter of which (Bcl-2, Bcl-xL, Bcl-w, Mcl-1 and Bcl-2A1) are often overexpressed in cancer cells, supporting their aberrant survival. Thus, these anti-apoptotic proteins have become an attractive target for cancer therapy. BH3 mimetics have been shown to bind to the BH3 binding groove of anti-apoptotic Bcl-2 family members and inhibit their function, resulting in apoptotic cell death, and one such BH3 mimetic, ABT-199 (venetoclax), has recently been approved for treatment of relapsed or refractory Chronic Lymphocytic Leukemia. We have developed two novel and potent BH3 mimetics: MIK665/S64315, a highly selective inhibitor of Mcl-1 and BCL201/S55746, a selective Bcl-2 inhibitor. Both compounds, individually induce apoptosis in hematological cancer cell lines, primary patient samples and demonstrate anti-tumor efficacy in xenograft models. MIK665/S64315 is currently in phase 1 clinical development in AML and MDS (NCT 02979366) and in MM and lymphoma (NCT02992483). Here, we describe the activity of the combination of MIK665/S64315 with BCL201/S55746 or venetoclax, both in vitro and in vivo, across a range of hematological indications (AML, MM and DLBCL). In vitro, a strong synergy was observed with these combinations, resulting in a remarkable induction of cell death in majority of cell lines tested. In vivo, MIK665/S64315 and BCL201/S55746 combinations lead to complete and durable antitumor responses in many different xenograft models in mice and rats. Taken together, these data demonstrate that a combination of MIK665/S64315 and BCL201/S55746 provide strong therapeutic benefit over either monotherapy, and support a rationale for testing Mcl-1 and Bcl-2 inhibitor combinations in patients with hematological malignancies.
Citation Format: Ensar Halilovic, Maïa Chanrion, Prakash Mistry, Markus Wartmann, Shumei Qiu, Sneha Sanghavi, Yan Chen, Gaëlle Lysiak, Ana Leticia Maragno, Ulrike Pfaar, Felix Huth, Marie Schoumacher, Audrey Claperon, Laurence Kraus-Berthier, Sébastien Banquet, Alix Derreal, Heiko Maacke, Frédéric Colland, Olivier Geneste, Erick Morris, Youzhen Wang. MIK665/S64315, a novel Mcl-1 inhibitor, in combination with Bcl-2 inhibitors exhibits strong synergistic antitumor activity in a range of hematologic malignancies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4477.
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Affiliation(s)
| | - Maïa Chanrion
- 2Servier Oncology R&D Unit, Croissy-sur-seine, France
| | - Prakash Mistry
- 3Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Markus Wartmann
- 3Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Shumei Qiu
- 1Novartis Institutes for BioMedical Research, Cambridge, MA
| | - Sneha Sanghavi
- 1Novartis Institutes for BioMedical Research, Cambridge, MA
| | - Yan Chen
- 1Novartis Institutes for BioMedical Research, Cambridge, MA
| | - Gaëlle Lysiak
- 2Servier Oncology R&D Unit, Croissy-sur-seine, France
| | | | - Ulrike Pfaar
- 3Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Felix Huth
- 3Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | | | | | | | | | - Heiko Maacke
- 3Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | | | - Erick Morris
- 1Novartis Institutes for BioMedical Research, Cambridge, MA
| | - Youzhen Wang
- 1Novartis Institutes for BioMedical Research, Cambridge, MA
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Drapkin BJ, Sanghavi S, Myers DT, Zhong J, Phat S, Wang Y, Halilovic E, Golji J, Farago A, Morris E, Dyson NJ. Abstract 381: Combined inhibition of Bcl-2 and MCL-1 in small cell lung cancer (SCLC) is most effective in tumors with low Bcl-xL expression. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: SCLC is an aggressive high-grade neuroendocrine malignancy in which targeting anti-apoptotic regulators such as Bcl-2 and Bcl-xL has shown efficacy in pre-clinical models but has not resulted in successful clinical trials (Rudin et al., Clin Cancer Res. 2012). Although SCLC cell-lines do not reflect the clinical impact of these inhibitors, patient-derived xenograft (PDX) models may more accurately recapitulate Bcl-2 family expression profiles and BH3 mimetic efficacy. One promising hypothesis is that the fellow anti-apoptotic protein MCL-1 rescues viability in the presence of Bcl-2/Bcl-xL antagonists. Here we evaluate the efficacy of the MCL-1 inhibitor S63845 in combination with a novel specific inhibitor of Bcl-2, BCL201/S55746, in SCLC patient-derived xenografts. Methods: BH3 mimetic compounds were tested for synergy in vitro in SCLC cell lines. A set of ten cell lines was chosen based on relative expression of BCL2, MCL1, and BCL2L1 (Bcl-xL) mRNA. Single agent and and pair-wise combinations of Bcl2 family inhibitors were compared in three-day growth inhibition assays. Loewe synergy scores were plotted versus Bcl2 family mRNA expression to identify the determinants of drug sensitivity. Based on the cell line synergy assays, a combination of BCL201/S55746 and S63845 was selected to test in PDX models of SCLC. Bcl-2 family expression was profiled across a panel of 37 SCLC PDX models generated at MGH by quantitative western blot, and standardized to the most sensitive SCLC cell line, NCI-H211. Ten models were selected based on absolute expression of Bcl-2, Bcl-xL and MCL-1. Mice were treated when subcutaneous tumors reached a volume of 400-800 cc, enabling precise measurement of tumor regression and time to tumor regrowth. Findings: Bcl-2 family dependency in SCLC cell lines was profiled with selective inhibitors as single agents or combinations. Maximum synergy was found between BCL201/S55746 and S63845 in cell lines with the highest Bcl-2:Bcl-xL expression ratio. Bcl-2 family expression was profiled across a panel of 37 PDX models of SCLC, and a representative set of 10 models was selected for in vivo testing. Consistent with cell line results, the two most sensitive models to BCL201/S55746+S63845 demonstrated the highest Bcl-2:Bcl-xL ratios, with moderate to high expression of MCL-1. In these models BCL201/S55746+S63845 resulted in a 44-70% tumor regression that was stable throughout 4 weeks of treatment. Efficacy was not dependent on MCL-1 expression, and was not strongly correlated with PDX sensitivity to platinum-etoposide. Conclusions: Combined inhibition of Bcl-2 with BCL201 and MCL-1 with S63845 is effective in SCLC tumors with relatively low Bcl-xL expression. This combination overcomes MCL-1 mediated resistance to Bcl-2 inhibitors, and represents a promising strategy to target anti-apoptotic dependency in SCLC.
Citation Format: Benjamin J. Drapkin, Sneha Sanghavi, David T. Myers, Jun Zhong, Sarah Phat, Youzhen Wang, Ensar Halilovic, Javad Golji, Anna Farago, Erick Morris, Nicholas J. Dyson. Combined inhibition of Bcl-2 and MCL-1 in small cell lung cancer (SCLC) is most effective in tumors with low Bcl-xL expression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 381.
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Affiliation(s)
| | | | | | - Jun Zhong
- 1Massachussetts General Hospital, Boston, MA
| | - Sarah Phat
- 1Massachussetts General Hospital, Boston, MA
| | | | | | | | - Anna Farago
- 1Massachussetts General Hospital, Boston, MA
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Kedves AT, Gleim S, Liang X, Bonal DM, Sigoillot F, Harbinski F, Sanghavi S, Benander C, George E, Gokhale PC, Nguyen QD, Kirschmeier PT, Distel RJ, Jenkins J, Goldberg MS, Forrester WC. Recurrent ubiquitin B silencing in gynecological cancers establishes dependence on ubiquitin C. J Clin Invest 2017; 127:4554-4568. [PMID: 29130934 DOI: 10.1172/jci92914] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 01/17/2017] [Accepted: 10/09/2017] [Indexed: 02/06/2023] Open
Abstract
Transcriptional repression of ubiquitin B (UBB) is a cancer-subtype-specific alteration that occurs in a substantial population of patients with cancers of the female reproductive tract. UBB is 1 of 2 genes encoding for ubiquitin as a polyprotein consisting of multiple copies of ubiquitin monomers. Silencing of UBB reduces cellular UBB levels and results in an exquisite dependence on ubiquitin C (UBC), the second polyubiquitin gene. UBB is repressed in approximately 30% of high-grade serous ovarian cancer (HGSOC) patients and is a recurrent lesion in uterine carcinosarcoma and endometrial carcinoma. We identified ovarian tumor cell lines that retain UBB in a repressed state, used these cell lines to establish orthotopic ovarian tumors, and found that inducible expression of a UBC-targeting shRNA led to tumor regression, and substantial long-term survival benefit. Thus, we describe a recurrent cancer-specific lesion at the level of ubiquitin production. Moreover, these observations reveal the prognostic value of UBB repression and establish UBC as a promising therapeutic target for ovarian cancer patients with recurrent UBB silencing.
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Affiliation(s)
- Alexia T Kedves
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Scott Gleim
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Xiaoyou Liang
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Dennis M Bonal
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Frederic Sigoillot
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Fred Harbinski
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Sneha Sanghavi
- Neurosciences, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Christina Benander
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | - Elizabeth George
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | | | | | | | | | - Jeremy Jenkins
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
| | | | - William C Forrester
- Chemical Biology and Therapeutics, Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA
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Tamhankar PM, Iyer S, Sanghavi S, Khopkar U. Chanarin-Dorfman syndrome: Clinical report and novel mutation in ABHD5 gene. J Postgrad Med 2014; 60:332-4. [DOI: 10.4103/0022-3859.138826] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Harbinski F, Craig VJ, Sanghavi S, Jeffery D, Liu L, Sheppard KA, Wagner S, Stamm C, Buness A, Chatenay-Rivauday C, Yao Y, He F, Lu CX, Guagnano V, Metz T, Finan PM, Hofmann F, Sellers WR, Porter JA, Myer VE, Graus-Porta D, Wilson CJ, Buckler A, Tiedt R. Rescue Screens with Secreted Proteins Reveal Compensatory Potential of Receptor Tyrosine Kinases in Driving Cancer Growth. Cancer Discov 2012; 2:948-59. [DOI: 10.1158/2159-8290.cd-12-0237] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gasser O, Bihl F, Sanghavi S, Rinaldo C, Rowe D, Hess C, Stablein D, Roland M, Stock P, Brander C. Treatment-dependent loss of polyfunctional CD8+ T-cell responses in HIV-infected kidney transplant recipients is associated with herpesvirus reactivation. Am J Transplant 2009; 9:794-803. [PMID: 19298451 PMCID: PMC2746278 DOI: 10.1111/j.1600-6143.2008.02539.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Antiretroviral-therapy has dramatically changed the course of HIV infection and HIV-infected (HIV(+)) individuals are becoming more frequently eligible for solid-organ transplantation. However, only scarce data are available on how immunosuppressive (IS) strategies relate to transplantation outcome and immune function. We determined the impact of transplantation and immune-depleting treatment on CD4+ T-cell counts, HIV-, EBV-, and Cytomegalovirus (CMV)-viral loads and virus-specific T-cell immunity in a 1-year prospective cohort of 27 HIV(+) kidney transplant recipients. While the results show an increasing breadth and magnitude of the herpesvirus-specific cytotoxic T-cell (CTL) response over-time, they also revealed a significant depletion of polyfunctional virus-specific CTL in individuals receiving thymoglobulin as a lymphocyte-depleting treatment. The disappearance of polyfunctional CTL was accompanied by virologic EBV-reactivation events, directly linking the absence of specific polyfunctional CTL to viral reactivation. The data provide first insights into the immune-reserve in HIV+ infected transplant recipients and highlight new immunological effects of thymoglobulin treatment. Long-term studies will be needed to assess the clinical risk associated with thymoglobulin treatment, in particular with regards to EBV-associated lymphoproliferative diseases.
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Affiliation(s)
- O Gasser
- Partners AIDS Research Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, United States, University Hospital Basel, Basel, Switzerland
| | - F Bihl
- University Hospital Geneva, Geneva, Switzerland
| | - S Sanghavi
- Infection Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - C Rinaldo
- Infection Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - D Rowe
- Infection Diseases and Microbiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - C Hess
- University Hospital Basel, Basel, Switzerland
| | - D Stablein
- Emmes Corporation, Maryland, United States
| | - M Roland
- University of California, San Francisco, California, United States
| | - P Stock
- University of California, San Francisco, California, United States
| | - C Brander
- Partners AIDS Research Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, United States, Irsicaixa Foundation, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain, Institucio Catalana de Recerca i Estudis Avancats (ICREA), Barcelona, Spain
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Gupta S, Hansen U, Sanghavi S, Emery R. The mechanism of failure in cemented glenoid components — an in vitro study. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83439-1] [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: 11/29/2022]
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Wagner T, Dix B, Friedeburg CV, Frieß U, Sanghavi S, Sinreich R, Platt U. MAX-DOAS O4measurements: A new technique to derive information on atmospheric aerosols-Principles and information content. ACTA ACUST UNITED AC 2004. [DOI: 10.1029/2004jd004904] [Citation(s) in RCA: 272] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T. Wagner
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - B. Dix
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - C. v. Friedeburg
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - U. Frieß
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - S. Sanghavi
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - R. Sinreich
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
| | - U. Platt
- Institut für Umweltphysik; University of Heidelberg; Heidelberg Germany
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Abstract
PURPOSE To investigate the hypothesis that percutaneous wire fixation of proximal humeral fractures is prone to regional neurovascular injury. MATERIALS AND METHODS 40 cadaveric shoulders had percutaneous wires inserted from anterior and lateral humeral shaft entry points into the humeral head. The shoulders were then dissected to identify the neurovascular structures in this area. RESULTS The axillary nerve trunk and posterior circumflex humeral artery were found to be within the field of dissection. The axillary nerve was damaged on three occasions by the lateral wires, two of which were direct nerve penetrations. The anterior wires caused a single perineural injury of a terminal branch. The main neurovascular leash was 57 mm (range 35-70 mm) from the acromion tip laterally and 51 mm (range 35-85 mm) anteriorly, with a width of 6 mm (range 4-13 mm) laterally, and 12 mm (range 7-15 mm) anteriorly. CONCLUSIONS Percutaneous wire stabilisation is an attractive fixation option but this study highlights the close proximity of the important neurovasculature. Such fixation should be performed utilising a limited open approach, with dissection to bone under direct vision, with the subsequent use of a drill-sleeve for soft-tissue protection.
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Affiliation(s)
- S Kamineni
- Department of Orthopaedic Surgery, Charing Cross Campus, Imperial College, London W6 8RF, UK
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Berson A, Emery R, Ng T, Rodriguez L, Sanghavi S. Clinical experience using respiratory gated radiation therapy for tumors in the chest, upper abdomen, and breast. Int J Radiat Oncol Biol Phys 2002. [DOI: 10.1016/s0360-3016(02)03395-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mehta MP, Sanghavi S. Management trends for lung cancer. WMJ 1999; 98:37-9, 42. [PMID: 10555475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- M P Mehta
- University of Wisconsin-Madison, USA
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Pau H, Johnston M, Sanghavi S. Dental prosthesis in the retropharyngeal space. J R Soc Med 1999; 92:250-1. [PMID: 10472264 PMCID: PMC1297179 DOI: 10.1177/014107689909200511] [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: 11/15/2022] Open
Affiliation(s)
- H Pau
- Department of Otolaryngology, Leicester Royal Infirmary NHS Trust, UK
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