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Mapuskar K, Vasquez Martinez G, Pulliam C, Petronek M, Steinbach E, Monga V, Furqan M, Jetton J, Saunders D, Pearce A, Davidson S, Pitre L, Dunlap N, Fairbanks R, Lee C, Mott S, Bodeker K, Cl H, Buatti J, Anderson C, Beardsley R, Holmlund J, Zepeda-Orozco D, Spitz D, Allen B. Avasopasem manganese ( GC4419) protects against cisplatin-induced chronic kidney disease: An exploratory analysis of renal metrics from a randomized phase 2b clinical trial in head and neck cancer patients. Redox Biol 2023; 60:102599. [PMID: 36640725 PMCID: PMC9852651 DOI: 10.1016/j.redox.2022.102599] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) patients treated with high-dose cisplatin concurrently with radiotherapy (hdCis-RT) commonly suffer kidney injury leading to acute and chronic kidney disease (AKD and CKD, respectively). We conducted a retrospective analysis of renal function and kidney injury-related plasma biomarkers in a subset of HNSCC subjects receiving hdCis-RT in a double-blinded, placebo-controlled clinical trial (NCT02508389) evaluating the superoxide dismutase mimetic, avasopasem manganese (AVA), an investigational new drug. We found that 90 mg AVA treatment prevented a significant reduction in estimated glomerular filtration rate (eGFR) three months as well as six and twelve months after treatment compared to 30 mg AVA and placebo. Moreover, AVA treatment may have allowed renal repair in the first 22 days following cisplatin treatment as evidenced by an increase in epithelial growth factor (EGF), known to aid in renal recovery. An upward trend was also observed in plasma iron homeostasis proteins including total iron (Fe-blood) and iron saturation (Fe-saturation) in the 90 mg AVA group versus placebo. These data support the hypothesis that treatment with 90 mg AVA mitigates cisplatin-induced CKD by inhibiting hdCis-induced renal changes and promoting renal recovery.
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Affiliation(s)
- K.A. Mapuskar
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | - G. Vasquez Martinez
- Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - C.F. Pulliam
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | - M.S. Petronek
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | - E.J. Steinbach
- The University of Iowa Stead Family Department of Pediatrics, Iowa City, IA, USA
| | - V. Monga
- University of Iowa Hospitals and Clinics, Department of Internal Medicine, Iowa City, IA, USA
| | - M. Furqan
- University of Iowa Hospitals and Clinics, Department of Internal Medicine, Iowa City, IA, USA
| | - J.G. Jetton
- Medical College of Wisconsin, Department of Pediatrics, Milwaukee, WI, USA
| | - D.P. Saunders
- Northeast Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada
| | - A. Pearce
- Northeast Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada
| | - S. Davidson
- Northeast Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada
| | - L. Pitre
- Northeast Cancer Centre, Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada
| | - N.E. Dunlap
- University of Louisville, School of Medicine, Louisville, KY, 40202, USA
| | | | - C.M. Lee
- Cancer Care Northwest, Spokane, WA, USA
| | - S.L. Mott
- University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, USA
| | - K.L. Bodeker
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | - Huang Cl
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, IA, USA
| | - J.M. Buatti
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | - C.M. Anderson
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA
| | | | | | - D. Zepeda-Orozco
- Kidney and Urinary Tract Center, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - D.R. Spitz
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA,Corresponding author. Division of Free Radical and Radiation Biology Department of Radiation Oncology The University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
| | - B.G. Allen
- University of Iowa Hospitals and Clinics, Free Radical and Radiation Biology Program, Department of Radiation Oncology, Iowa City, IA, USA,Corresponding author. Division of Free Radical and Radiation Biology Department of Radiation Oncology The University of Iowa Hospitals and Clinics, Iowa City, IA, 52242-1181, USA.
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Heer CD, Davis AB, Riffe DB, Wagner BA, Falls KC, Allen BG, Buettner GR, Beardsley RA, Riley DP, Spitz DR. Superoxide Dismutase Mimetic GC4419 Enhances the Oxidation of Pharmacological Ascorbate and Its Anticancer Effects in an H₂O₂-Dependent Manner. Antioxidants (Basel) 2018; 7:antiox7010018. [PMID: 29351198 PMCID: PMC5789328 DOI: 10.3390/antiox7010018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 01/17/2023] Open
Abstract
Lung cancer, together with head and neck cancer, accounts for more than one-fourth of cancer deaths worldwide. New, non-toxic therapeutic approaches are needed. High-dose IV vitamin C (aka, pharmacological ascorbate; P-AscH−) represents a promising adjuvant to radiochemotherapy that exerts its anti-cancer effects via metal-catalyzed oxidation to form H2O2. Mn(III)-porphyrins possessing superoxide dismutase (SOD) mimetic activity have been shown to increase the rate of oxidation of AscH−, enhancing the anti-tumor effects of AscH− in several cancer types. The current study demonstrates that the Mn(II)-containing pentaazamacrocyclic selective SOD mimetic GC4419 may serve as an AscH−/O2•− oxidoreductase as evidenced by the increased rate of oxygen consumption, steady-state concentrations of ascorbate radical, and H2O2 production in complete cell culture media. GC4419, but not CuZnSOD, was shown to significantly enhance the toxicity of AscH− in H1299, SCC25, SQ20B, and Cal27 cancer cell lines. This enhanced cancer cell killing was dependent upon the catalytic activity of the SOD mimetic and the generation of H2O2, as determined using conditional overexpression of catalase in H1299T cells. GC4419 combined with AscH− was also capable of enhancing radiation-induced cancer cell killing. Currently, AscH− and GC4419 are each being tested separately in clinical trials in combination with radiation therapy. Data presented here support the hypothesis that the combination of GC4419 and AscH− may provide an effective means by which to further enhance radiation therapy responses.
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Affiliation(s)
- Collin D Heer
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - Andrew B Davis
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - David B Riffe
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - Brett A Wagner
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - Kelly C Falls
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - Bryan G Allen
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | - Garry R Buettner
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | | | | | - Douglas R Spitz
- Free Radical and Radiation Biology Program, Department of Radiation Oncology, Holden Comprehensive Cancer Center, The University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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