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Chu T, Pu T, Chen C. Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report. Clin Case Rep 2024; 12:e8774. [PMID: 38634096 PMCID: PMC11021600 DOI: 10.1002/ccr3.8774] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Key Clinical Message Anorectal gastrointestinal stromal tumors are extremely rare, constituting less than 0.1% of rectal tumors. Surgical resection using a transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors can be a successful treatment combination to remove the mass and prevent recurrence while preserving the integrity of the anal sphincter. Abstract Gastrointestinal stromal tumors (GISTs) are a rare subset of neoplasms, accounting for about 1%-2% of primary gastrointestinal malignancies. The stomach is the most common site for GISTs, with anorectal GISTs being exceptionally rare, representing only 0.1% of all rectal tumors. The standard approach for managing localized GIST involves complete surgical excision to achieve negative microscopic margins (R0) while preserving the tumor capsule and maintaining anal sphincter function. Surgical resection with transanal wide excision followed by adjuvant therapy using tyrosine kinase inhibitors can successfully remove the mass, prevent recurrence, and preserve the anal sphincter's integrity. Adjuvant therapy with imatinib is the recommended treatment for all localized GISTs assessed to have an intermediate or high risk of relapse. Here, we report a case of a 63-year-old male with a rectal GIST who underwent transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors.
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Affiliation(s)
- Ting‐Yi Chu
- Department of Surgery, School of MedicineTri‐Service General Hospital, National Defense Medical CenterTaipeiChina
| | - Ta‐Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, School of Medicine, Songshan BranchTri‐Service General Hospital, National Defense Medical CenterTaipeiChina
| | - Chao‐Yang Chen
- Division of Colon and Rectal Surgery, Department of Surgery, School of MedicineTri‐Service General Hospital, National Defense Medical CenterTaipeiChina
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2
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Nevejan L, Labarque V, Boeckx N. Chronic myeloid leukemia (CML) in children and adolescents-Clinicopathological findings. Eur J Haematol 2024; 112:458-465. [PMID: 37985225 DOI: 10.1111/ejh.14137] [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] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Barely two per million Belgian children/adolescents are diagnosed with chronic myeloid leukemia (CML) annually. In this retrospective study, we aimed to investigate the diagnostic features, clinical and laboratory characteristics, and treatment outcome of this rare entity. METHODS Medical records of all pediatric CML patients (age ≤ 17 years) diagnosed at the University Hospitals Leuven between 1986 and 2021 were reviewed. RESULTS Fourteen patients (median age at diagnosis 12.5 years) were included, all presenting in chronic phase. Five patients were diagnosed before 2003; main therapy included hydroxyurea (n = 5/5), interferon-alfa (n = 3/5) and allogeneic hematopoietic stem cell transplantation (allo-Tx) (n = 3/5). Complete hematologic response (CHR), complete cytogenetic response (CCyR) and major molecular response (MMR) was reached in resp. 4/5, 4/5 and in 2/3 of evaluable patients. Three patients progressed to accelerated/blast phase (median time 19 months) and 1/5 is alive and disease-free at last follow-up. Nine patients were diagnosed after 2003 and were treated with first generation (1°G) tyrosine kinase inhibitors (TKI): 3/9 subsequently underwent an allo-Tx, 4/9 were switched to 2°G TKI, one patient was additionally switched to 3°G TKI. CHR, CCyR and MMR was reached in 9/9, 9/9 and 8/9 of these patients. No progression to accelerated/blast phase was observed and none of these patients deceased. At last follow-up, 7/9 patients were in MMR or disease free, the two remaining patients did not reach or lost MMR, both related to compliance issues. CONCLUSION Our study confirmed that TKI significantly improved the prognosis of pediatric CML. However, drug compliance poses a considerable challenge.
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Affiliation(s)
- Louis Nevejan
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Veerle Labarque
- Department of Paediatrics, Paediatric Haematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium
| | - Nancy Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Laboratory of Experimental Hematology, University of Leuven, Leuven, Belgium
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3
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Huang J, Chen J. Pharmacokinetics and pharmacodynamic evaluation of hyaluronic acid-modified imatinib-loaded PEGylated liposomes in CD44-positive Gist882 tumor-bearing mice. J Liposome Res 2024; 34:97-112. [PMID: 37401372 DOI: 10.1080/08982104.2023.2228888] [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] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
To develop a PEGylated and CD44-targeted liposomes, enabled by surface coating with hyaluronic acid (HA) via amide bond to improve the efficacy of imatinib mesylate (IM), for tumor-targeted cytoplasmic drug delivery. HA was covalently grafted on DSPE-PEG2000-NH2 polymer. HA-modified or unmodified PEGylated liposomes were prepared with ethanol injection method, and the stability, drug release, and cytotoxicity of these liposomes were studied. Meanwhile, intracellular drug delivery efficiency, antitumor efficacy, and pharmacokinetics were also investigated. Ex vivo fluorescence biodistribution was also detected by small animal imaging. In addition, endocytosis mechanism was also explored HA-coated PEGylated liposomes (137.5 nm ± 10.24) had a negative zeta potential (-29.3 mV ± 5.44) and high drug loading (27.8%, w/w). The liposomes were stable with cumulative drug leakage (<60%) under physiological conditions. Blank liposomes were nontoxic to Gist882 cells, and IM-loaded liposomes had higher cytotoxicity to Gist882 cells. HA-modified PEGylated liposomes were internalized more effectively than non-HA coating via CD44-mediated endocytosis. Besides, the cellular uptake of HA-modified liposomes also partly depends on caveolin-medicated endocytosis and micropinocytosis. In rats, both liposomes produced a prolonged half-life of IM (HA/Lp/IM: 14.97h; Lp/IM: 11.15h) by 3- to 4.5-folds compared with the IM solution (3.61h). HA-decorated PEGylated liposomes encapsulated IM exhibited strong inhibitory effect on tumor growth in Gist882 cell-bearing nude mice and formation of 2D/3D tumor spheroids. The Ki67 immunohistochemistry result was consistent with the above results. IM-loaded PEGylated liposomes modified with HA exerted the excellent anti-tumor effect on tumor-bearing mice and more drugs accumulated into the tumor site.
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Affiliation(s)
- Ju Huang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing, China
| | - Jian Chen
- Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
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Jayant D, Goyal M, Thakur V, Sahu S, Babu B, Subbiah Nagaraj S, Tandup C, Behera A. Advanced and Metastatic Gastrointestinal Stromal Tumors Presenting With Surgical Emergencies Managed With Surgical Resection: A Case Series. Cureus 2024; 16:e53851. [PMID: 38465042 PMCID: PMC10924631 DOI: 10.7759/cureus.53851] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 03/12/2024] Open
Abstract
Advanced and metastatic gastrointestinal stromal tumors (GISTs) presenting with surgical emergencies are rare. Neoadjuvant imatinib being the treatment of choice for non-metastatic advanced disease with a proven role in downstaging the disease may not be feasible in patients presenting with bleeding and obstruction. We present a case series with retrospective analysis of a prospectively maintained database of patients with advanced and metastatic GISTs presenting with surgical emergencies. Clinical characteristics, imaging and endoscopic findings, surgical procedures, histological findings, and outcomes in these patients were studied. Four patients were included in this case series, with three males and one female (age range: 24-60 years). Two patients presented with melena; one with hemodynamic instability despite multiple blood transfusions underwent urgent exploratory laparotomy for bleeding gastric GIST, while the other underwent surgical exploration after careful evaluation given the recurrent, metastatic disease with a stable metabolic response on six months of imatinib. One patient with metastatic jejunal GIST who presented with an umbilical nodule and intestinal obstruction was given a trial of non-operative management for 72 hours, but due to non-resolution of obstruction, segmental jejunal en bloc resection with the dome of the urinary bladder with reconstruction and metastasectomy was needed. The patient with advanced gastric GIST who presented with gastric outlet obstruction was resuscitated, and an attempt of endoscopic naso-jejunal tube placement was tried, which failed, and exploration was needed. The mean length of hospital stay was 7.5 days. Histopathological examination confirmed GIST in all four patients with microscopic negative resection margins. All patients were started on imatinib with dose escalation to 800 mg in the patient with recurrent and metastatic disease; however, the patient with bleeding gastric GIST experienced severe adverse effects of imatinib and discontinued the drug shortly. All four patients are disease-free on follow-ups of 15 months, 48 months for the patient with advanced non-metastatic disease, and six and 24 months for the patients with metastatic disease. In the era of tyrosine kinase inhibitor (TKI) therapy for advanced and metastatic disease, upfront surgery is usually reserved for surgical emergencies only. Surgical resection, the cornerstone for the treatment of resectable GIST, may also be clinically relevant in metastatic settings, although it requires a careful and individualized approach.
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Affiliation(s)
- Divij Jayant
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Mrinal Goyal
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Vipul Thakur
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Swapnesh Sahu
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Basil Babu
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Satish Subbiah Nagaraj
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Cherring Tandup
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Arunanshu Behera
- General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
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Karpuz M, Ozgenc E, Oner E, Atlihan-Gundogdu E, Burak Z. 68 Ga-labeled, imatinib encapsulated, theranostic liposomes: Formulation, characterization, and in vitro evaluation of anticancer activity. Drug Dev Res 2024; 85:e22136. [PMID: 38009423 DOI: 10.1002/ddr.22136] [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] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/28/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
Cancer is still a global health problem. Among cancer types, breast cancer is the most frequently diagnosed one, and it causes a high mortality rate if not diagnosed in the early stages. In our study, imatinib encapsulated, nanosized, neutral/cationic liposome formulations were prepared as theranostic agents for breast cancer. After the characterization studies in which all liposomes exhibited proper profile owing to their particle size between 133 and 250 nm, polydispersity index values lower than 0.4, neutral and cationic zeta potential values, and high drug encapsulation efficiency, controlled drug release behaviors with zero-order kinetic were obtained. The higher than 90% radiolabeling efficiency values were obtained thanks to the determination of optimum radiolabeling condition (80°C temperature, 5 mCi radioactivity, and 10 min incubation period). According to the resazurin assay evaluating the cytotoxic profile of liposomes on MCF7 cells, neutral empty liposome was found as biocompatible, while both cationic liposomes (empty and drug-loaded ones) exhibited high nonspecific cytotoxicity at even low drug concentration due to the existence of stearyl amine in the formulations. However, dose-dependent cytotoxic effect and the highest cellular binding capacity were obtained by imatinib loaded neutral liposomes. In conclusion, 68 Ga-radiolabeled, imatinib-loaded, neutral, nanosized liposome formulation is the most promising one as a theranostic agent among all formulations.
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Affiliation(s)
- Merve Karpuz
- Department of Radiopharmacy, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Turkey
| | - Emre Ozgenc
- Department of Radiopharmacy, Faculty of Pharmacy, Ege University, Izmir, Turkey
| | - Ezgi Oner
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Turkey
- Thoracic Oncology Research Group, Trinity Translational Medicine Institute, St James's Hospital, Dublin, Ireland
- Department of Clinical Medicine, Trinity School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Zeynep Burak
- Department of Nuclear Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
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Bochicchio MT, Marconi G, Baldazzi C, Bandini L, Ruggieri F, Lucchesi A, Agostinelli C, Sabattini E, Orsatti A, Ferrari A, Capirossi G, Servili C, Ghelli Luserna di Rorà A, Martinelli G, Simonetti G, Rosti G. ETV6::ABL1-Positive Myeloid Neoplasm: A Case of a Durable Response to Imatinib Mesylate without Additional or Previous Treatment. Int J Mol Sci 2023; 25:118. [PMID: 38203288 PMCID: PMC10779409 DOI: 10.3390/ijms25010118] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/08/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
ETV6::ABL1 rearranged neoplasms are rare hematological diseases. To date, about 80 cases have been reported, including myeloid and lymphoid leukemias. The ETV6 gene codes for an ETS family transcription factor and several fusion partners have been described. When translocated, ETV6 causes the constitutive activation of the partner genes. Here, we report the case of a 54-year-old woman with a cryptic insertion of the 3' region of ABL1 in the ETV6 gene. The patient was first diagnosed with idiopathic hypereosinophilic syndrome, according to the clinical history, conventional cytogenetics, standard molecular analyses and pathologist description. Next generation sequencing of diagnosis samples unexpectedly detected both ETV6::ABL1 type A and B fusion transcripts, which were then confirmed by FISH. The diagnosis was Myeloid/Lymphoid neoplasm with ETV6::ABL1 fusion, and the patient received imatinib mesylate treatment. In a follow-up after more than one year, the patient still maintained the molecular and complete hematological responses. This case highlights the importance of timely and proper diagnostics and prompt tyrosine kinase inhibitor treatment.
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Affiliation(s)
- Maria Teresa Bochicchio
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
| | - Giovanni Marconi
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (G.M.); (A.L.)
| | - Carmen Baldazzi
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, BO, Italy; (C.B.); (L.B.)
| | - Lorenza Bandini
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, BO, Italy; (C.B.); (L.B.)
| | - Francesca Ruggieri
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40100 Bologna, BO, Italy;
| | - Alessandro Lucchesi
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (G.M.); (A.L.)
| | - Claudio Agostinelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40100 Bologna, BO, Italy;
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, BO, Italy; (E.S.); (A.O.)
| | - Elena Sabattini
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, BO, Italy; (E.S.); (A.O.)
| | - Agnese Orsatti
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, BO, Italy; (E.S.); (A.O.)
| | - Anna Ferrari
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
| | - Giorgia Capirossi
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
| | - Chiara Servili
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
| | | | - Giovanni Martinelli
- Scientific Directorate, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy;
| | - Giorgia Simonetti
- Biosciences Laboratory, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (F.R.); (A.F.); (G.C.); (C.S.); (G.S.)
| | - Gianantonio Rosti
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, FC, Italy; (G.M.); (A.L.)
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Liu WZ, Du YQ, Shen Q, Tao KX, Zhang P. Ripretinib for the treatment of advanced, imatinib-resistant gastrointestinal stromal tumors. J Dig Dis 2023. [PMID: 37706279 DOI: 10.1111/1751-2980.13229] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/12/2023] [Indexed: 09/15/2023]
Abstract
Discovery of constitutive activation of KIT/PDGFRA tyrosine kinases in gastrointestinal stromal tumors (GISTs) leads to the development of the targeted drug imatinib. However, the inevitable development of imatinib resistance remains a major issue. Ripretinib is a novel targeted drug that inhibits the activities of a broad spectrum of drug-resistant KIT/PDGFRA mutants. It was approved in 2020 and is currently recommended by major international guidelines as the fourth-line and beyond therapy for advanced GISTs. Emerging evidence shows that ripretinib is superior to sunitinib as a second-line treatment for KIT exon 11-mutated GISTs due to its activity against highly heterogeneous frequently occurring secondary mutations. This review summarizes current data on the use of ripretinib to treat advanced imatinib-resistant GISTs. We also propose future research directions to improve the targeted GIST treatment.
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Affiliation(s)
- Wei Zhen Liu
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yu Qiang Du
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qian Shen
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kai Xiong Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Peng Zhang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Jitrangsri K, Khaing EM, Intaraphairot T, Phaechamud T, Mahadlek J. Injectable Gamboge-Based In Situ Gel for Sustained Delivery of Imatinib Mesylate. Gels 2023; 9:737. [PMID: 37754418 PMCID: PMC10529659 DOI: 10.3390/gels9090737] [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: 08/31/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
The aim of this study was to prepare and characterize the imatinib mesylate (IM)-loaded gamboge-based ISG system for local administration of an anticancer agent against colorectal carcinoma. The ISG formulations were prepared in dimethyl sulfoxide (DMSO) and N-methyl-2-pyrrolidone (NMP). The physicochemical properties, drug release profile, and cytotoxicity of the developed formulations were assessed. The developed ISG demonstrated Newtonian flow behavior with acceptable rheological and mechanical properties. The viscosity of the developed ISG, measured at less than 80 cP, and the applied forces of less than 50 N·mm, indicated easy administration using clinical injection techniques. Upon contact with an aqueous phase, the ISG immediately formed a porous cross-sectional structure, enabling sustained release of IM over 14 days. The release profile of IM was fitted to the quasi-Fickian diffusion mechanism, and the release rate could be controlled by the types of solvent and the amount of IM content. The developed IM-loaded gamboge ISG effectively inhibited colorectal cancer cells, including HCT116 and HT29 cell lines, with less than 20% cell viability observed at a concentration of 1% w/w IM after 2 days of incubation. This suggests that the developed ISG may potentially serve as an injectable system for localized anticancer delivery against colorectal cells, potentially reducing the side effects of systemic chemotherapy and improving patient adherence.
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Affiliation(s)
- Kritamorn Jitrangsri
- Department of Chemical Engineering and Pharmaceutical Chemistry, School of Engineering and Technology, Walailak University, Nakhon Srithammarat 80160, Thailand;
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM Group), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (T.I.); (T.P.)
| | - Ei Mon Khaing
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM Group), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (T.I.); (T.P.)
- Program of Pharmaceutical Engineering, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
| | - Torsak Intaraphairot
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM Group), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (T.I.); (T.P.)
- Department of Biopharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
| | - Thawatchai Phaechamud
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM Group), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (T.I.); (T.P.)
- Program of Pharmaceutical Engineering, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
- Department of Industrial Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
| | - Jongjan Mahadlek
- Natural Bioactive and Material for Health Promotion and Drug Delivery System Group (NBM Group), Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand; (E.M.K.); (T.I.); (T.P.)
- Pharmaceutical Intellectual Center “Prachote Plengwittaya”, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom 73000, Thailand
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Kojima D, Fujikawa T, Kajitani R, Matsumoto Y, Hasegawa S. Trans-anal Minimally Invasive Surgery Combined With a Robotic Anterior Approach for Sleeve Resection of a Huge Rectal Gastrointestinal Stromal Tumor. Cureus 2023; 15:e46288. [PMID: 37915880 PMCID: PMC10617749 DOI: 10.7759/cureus.46288] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/03/2023] Open
Abstract
Due to anatomical complexity, large rectal gastrointestinal stromal tumors (GISTs) in the pelvis at the anterior aspect often require extended abdominal surgery to obtain clear surgical margins. Here, we show our trans-anal minimally invasive surgery combined with a robotic anterior approach for a huge low rectal GIST that was widely in contact with the prostate and urethra. By performing lateral dissection first, we can identify the orientation of critical organs such as the prostate, urethra, and neurovascular bundles, facilitating anterior anorectal dissection without urethral injury. Although the combination with a transabdominal robotic approach was required because of firm inflammatory adhesion between the tumor and prostate, the preceding trans-anal dissection plane facilitated the robotic anterior dissection and contributed to achieving complete dissection with negative resection margins.
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Affiliation(s)
- Daibo Kojima
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
- Surgery, Kokura Memorial Hospital, Kitakyushu, JPN
| | | | - Ryuji Kajitani
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | - Yoshiko Matsumoto
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | - Suguru Hasegawa
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
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Padhiyar J, Patel N, Lakum M, Shah H. Chronic Oro-Genital Ulcerations as a Presenting Feature of Chronic Eosinophilic Leukemia: A Case Report. Indian Dermatol Online J 2023; 14:524-526. [PMID: 37521217 PMCID: PMC10373812 DOI: 10.4103/idoj.idoj_477_22] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 08/01/2023] Open
Abstract
Hypereosinophilia can be primary, including idiopathic hypereosinophilic syndrome (HES) and chronic eosinophilic leukemia, or secondary/reactive to various infective and non-infective stimuli. Chronic oro-genital ulcerations can occur due to various dermatological and non-dermatological disorders, and many times it serves as a useful indicator of an underlying systemic disorder. Hence, a case presenting with chronic oro-genital ulcerations needs a thorough evaluation. We are reporting an interesting case of a middle-aged male who had chronic oro-genital ulcerations as a presenting feature of chronic eosinophilic leukemia with FIP1L1-PDGFRA fusion (FIP1-like 1/platelet-derived growth factor receptor alpha). The patient's oro-genital ulcerations responded excellently to imatinib.
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Affiliation(s)
- Jigna Padhiyar
- Department of Dermatology, Venereology and Leprosy, Gujarat Cancer Society Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
| | - Nayan Patel
- Department of Dermatology, Venereology and Leprosy, Gujarat Cancer Society Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
| | - Megha Lakum
- Department of Dermatology, Venereology and Leprosy, Gujarat Cancer Society Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
| | - Himal Shah
- QURE, Centre for Complete Care, Ahmedabad, Gujarat, India
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11
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Batra J, Ankireddypalli AR, Kanugula AK, Gorle S, Kaur J. Osteoporosis in a 60-Year-Old Male With a History of Chronic Myeloid Leukemia Treated With Imatinib Mesylate. Cureus 2023; 15:e40368. [PMID: 37325683 PMCID: PMC10263172 DOI: 10.7759/cureus.40368] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 06/17/2023] Open
Abstract
Secondary osteoporosis is defined as a decline in bone mineral density due to any underlying etiology, which usually results in accelerated bone loss than expected for the individual's age or gender. Almost 50-80% of men diagnosed with osteoporosis have secondary osteoporosis. We present a case of a 60-year-old male with secondary osteoporosis with a history of imatinib mesylate-treated chronic myeloid leukemia (CML). Imatinib mesylate has revolutionized the management of individuals with chronic myeloid leukemia, which is now managed as a chronic disease. Imatinib has been demonstrated to cause dysregulation of bone metabolism. The long-term effects of imatinib on bone metabolism are still unknown.
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Affiliation(s)
- Jaskaran Batra
- Internal Medicine, University of Pittsburgh Medical Center (UMPC) McKeesport, McKeesport, USA
| | | | | | - Swathi Gorle
- Internal Medicine, Wellstar Spalding Regional Medical Center, Griffin, USA
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12
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Hayakawa K, Maeda T, Egusa C, Okubo Y, Harada K. Topical application of imatinib mesylate ameliorated psoriasis-like skin lesions in imiquimod-induced murine model via angiogenesis inhibition. Exp Dermatol 2023; 32:878-888. [PMID: 36928929 DOI: 10.1111/exd.14790] [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] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
Psoriasis is a chronic skin disorder characterized by a skin rash with scaly patches. Microvascular abnormalities are a characteristic feature of psoriasis and play a crucial role in the pathogenesis of psoriatic lesions. Angiogenic factors are upregulated in psoriatic skin lesions and are thought to induce angiogenesis. Platelet-derived growth factor (PDGF) induces vascular endothelial growth factor (VEGF), and PDGF is upregulated in keratinocytes in psoriatic skin lesions. The present study aimed to investigate the effect of topical imatinib mesylate (IMT) in inhibiting the activation of PDGF signalling in the pathogenesis of psoriasis. When topically applied to the skin of mice with imiquimod (IMQ)-induced psoriasis, IMT ameliorated skin symptoms similar to those of human psoriasis. Hyperproliferation of keratinocytes, hyperkeratosis, inflammatory cell infiltration and hypervascularity were histologically suppressed by topical IMT. The expression of angiogenic factors including fibroblast growth factor (FGF) and VEGF was decreased. The expression of FGF and VEGF in a PDGF-stimulated fibroblast cell line was inhibited by IMT. PDGF is required for the signalling pathway producing angiogenic factors in fibroblast. Thus, topically applied IMT inhibits PDGFR activation in fibroblast and suppresses the production of angiogenic factors, thereby mitigating the symptoms of psoriasis. The inhibitory effect of IMT on angiogenesis suggests that topical application IMT may be a viable treatment option for psoriasis.
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Affiliation(s)
- Kazuma Hayakawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Maeda
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Chizu Egusa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Kazutoshi Harada
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
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13
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Saleh Mohammadnia M, Roghani-Mamaqani H, Ghalkhani M, Hemmati S. A Modified Electrochemical Sensor Based on N,S-Doped Carbon Dots/Carbon Nanotube-Poly(Amidoamine) Dendrimer Hybrids for Imatinib Mesylate Determination. Biosensors (Basel) 2023; 13:bios13050547. [PMID: 37232908 DOI: 10.3390/bios13050547] [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] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023]
Abstract
Imatinib mesylate, an anticancer drug, is prescribed to treat gastrointestinal stromal tumors and chronic myelogenous leukemia. A hybrid nanocomposite of N,S-doped carbon dots/carbon nanotube-poly(amidoamine) dendrimer (N,S-CDs/CNTD) was successfully synthesized and used as a significant modifier to design a new and highly selective electrochemical sensor for the determination of imatinib mesylate. A rigorous study with electrochemical techniques, such as cyclic voltammetry and differential pulse voltammetry, was performed to elucidate the electrocatalytic properties of the as-prepared nanocomposite and the preparation procedure of the modified glassy carbon electrode (GCE). A higher oxidation peak current was generated for the imatinib mesylate on a N,S-CDs/CNTD/GCE surface compared to the GCE and CNTD/GCE. The N,S-CDs/CNTD/GCE showed a linear relationship between the concentration and oxidation peak current of the imatinib mesylate in 0.01-100 μM, with a detection limit of 3 nM. Finally, the imatinib mesylate's quantification in blood-serum samples was successfully performed. The N,S-CDs/CNTD/GCE's reproducibility and stability were indeed excellent.
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Affiliation(s)
- Maryam Saleh Mohammadnia
- Faculty of Polymer Engineering, Sahand University of Technology, P.O. Box 51335-1996, Tabriz 533184-1133, Iran
| | - Hossein Roghani-Mamaqani
- Faculty of Polymer Engineering, Sahand University of Technology, P.O. Box 51335-1996, Tabriz 533184-1133, Iran
- Institute of Polymeric Materials, Sahand University of Technology, P.O. Box 51335-1996, Tabriz 533184-1133, Iran
| | - Masoumeh Ghalkhani
- Electrochemical Sensors Research Laboratory, Department of Chemistry, Faculty of Science, Shahid Rajaee Teacher Training University, Lavizan, P.O. Box 16785-163, Tehran 167881-5811, Iran
| | - Salar Hemmati
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz 516661-6471, Iran
- Biotechnology Research Center, Tabriz University of Medical Science, Tabriz 516661-6471, Iran
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14
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Yelisetti A, Chandrasekaran ND, Mavalavan VMD, Kumar J, Eswaran H. Imatinib-Induced Lichen Planus in Chronic Myeloid Leukemia: A Case Series. Cureus 2023; 15:e39064. [PMID: 37323347 PMCID: PMC10267534 DOI: 10.7759/cureus.39064] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder in which the Philadelphia chromosome is the cytogenetic hallmark. It is characterized by the t (9;22) translocation, which in turn creates the chimeric BCR-ABL oncogene coding for a constitutively activated tyrosine kinase. Imatinib mesylate is a tyrosine kinase inhibitor that targets the BCR-ABL protein, c-KIT, and platelet-derived growth factor (PDGF) receptors and is used to treat CML, gastrointestinal stromal tumors, and dermato-fibrosarcoma protuberant. The development of the specific inhibitor of BCR-ABL tyrosine kinase has been a notable success and approved as the first-line treatment for CML. Although adverse cutaneous reactions to imatinib mesylate are not infrequent, their clinical and histopathological features have generally been poorly characterized. Here we report three rare cases of cutaneous lichenoid eruptions that occurred during the treatment of CML with imatinib mesylate.
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Affiliation(s)
- Anuhya Yelisetti
- General Medicine, SRM Medical College Hospital and Research Centre, Chengalpattu, IND
| | | | - V M Durai Mavalavan
- Medical Oncology, SRM Medical College Hospital and Research Centre, Chennai, IND
| | - Janardhanan Kumar
- General Medicine, SRM Medical College Hospital and Research Centre, Chennai, IND
| | - Hariharan Eswaran
- Internal Medicine, SRM Medical College Hospital and Research Centre, Chennai, IND
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15
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Ferreira APS, Seguro FS, Abdo ARN, Santos FM, Maciel FVR, Nardinelli L, Giorgi RR, Ruiz ARL, Ferreira MPS, Rego EM, Rocha V, Bendit I. Real-world Imatinib Mesylate Treatment in Patients with Chronic Myeloid Leukemia: The Importance of Molecular Monitoring and the Early Molecular Response. Ann Hematol 2023:10.1007/s00277-023-05189-3. [PMID: 37052662 DOI: 10.1007/s00277-023-05189-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the Philadelphia (Ph) chromosome. After the introduction of imatinib mesylate (IM) in 2000, the natural history of the disease changed. Data on the treatment of CML with IM are from randomized clinical trials. Establishing whether these results can be reproduced or if caution is needed when extrapolating data to the general population with CML is essential. OBJECTIVES To evaluate the molecular response (MR) in patients with chronic-phase CML (CML-CP) not included in clinical studies and correlate them with the responses obtained in clinical trials. METHODS Between January 2007 and January 2017, 227 patients newly diagnosed with CML-CP treated with IM as first-line treatment were included. This study is an observational, retrospective, and single-center study. RESULTS At a median follow-up time of 7.3 years, 60.3% of the 227 patients who started IM were still on IM. Early molecular response (EMR) at 3 and 6 months was achieved by 74.2% and 65%, respectively. The median time to a MMR was nine months. The MR4.0 and MR4.5 were 67.2% and 51.1%, respectively. The overall survival (OS), progression-free survival (PFS), and event-free survival (EFS) of the patients who exclusively used IM were 91%, 91%, and 85.1%, respectively. CONCLUSION The results presented are similar to those described in prospective and randomized trials, demonstrating that the outcomes are reproducible in the real world. EMR at 3 and 6 months reflects better long-term responses, including higher rates of deeper molecular responses. Considering treatment costs, the absence of literature evidence of an impact on overall survival demonstrated by first-line second-generation tyrosine kinase inhibitors (TKIs), and the global OS of 85.8%, imatinib mesylate (IM) is still an excellent therapeutic option.
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Affiliation(s)
- Amanda Pifano Soares Ferreira
- Hematology Clinic Oncoclinicas, Sao Paulo, Brazil
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil
| | - Fernanda Salles Seguro
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
| | - Andre Ramires Neder Abdo
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
| | - Fernanda Maria Santos
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
| | - Felipe Vieira Rodrigues Maciel
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
- Hemato-Oncologia, DASA-Genômica, Sao Paulo, Brazil
| | - Luciana Nardinelli
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ricardo Rodrigues Giorgi
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Antonio Roberto Lancha Ruiz
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil
| | | | - Eduardo Magalhaes Rego
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Vanderson Rocha
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil
- Department of Hematology, Cancer Institute of Sao Paulo, University of Sao Paulo Medical School (ICESP), Sao Paulo, Brazil
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Israel Bendit
- Department of Hematology, Transfusion and Cell Therapy, University of Sao Paulo Medical School (HCFMUSP), Sao Paulo, Brazil.
- Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
- Hemato-Oncologia, DASA-Genômica, Sao Paulo, Brazil.
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Ling J, Shi L, Cheng X, Fu Y, Lin Z, Zhao Y, Li Z, Zhang J, Hu H, Cai Y, Deng Y. Neoadjuvant versus adjuvant imatinib in primary localized gastrointestinal stromal tumor. J Gastrointest Oncol 2023; 14:73-84. [PMID: 36915468 PMCID: PMC10007957 DOI: 10.21037/jgo-22-931] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background The effect of neoadjuvant therapy (NAT) with imatinib versus upfront resection (UR) followed by adjuvant therapy (AT) with imatinib on the outcomes of gastrointestinal stromal tumors (GIST) is unknown. Methods This is a retrospective study at a high-volume center. All the patients with primary localized GIST were identified in a hospital database from 2007 to 2021. The endpoints included local recurrence-free survival (LRFS), distance recurrence-free survival (DRFS), and overall survival (OS). Cox regression was used to perform multivariate survival analyses. The sensitivity analysis was conducted with the inverse probability of treatment weighting (IPTW) method. Results A total of 211 patients were included (Group A: UR + AT, n=140; Group B: NAT + resection + AT, n=71). In the entire cohort, 5-year DRFS, LRFS, and OS were 85.6%, 90.7%, and 92.5%, respectively. In the multivariate analysis, better DRFS was linked to NAT, tumor size of 5 cm, and AT. Sixteen patients (11.4%) in Group A and 1 (1.4%) in Group B had distant recurrences after AT discontinuation. The sensitivity analysis by IPTW provided approximately similar results. An interaction effect was observed between NAT and tumor location on DRFS. In non-gastric GISTs, NAT was associated with better DRFS [hazard ratio =0.131, 95% confidence interval (CI): 0.017-0.989, P=0.049], which was not the case in gastric GIST (P=0.08). NAT was not independently associated with LRFS or OS. Conclusions When compared to UR + AT, NAT + resection + AT may reduce the risk of distant recurrence in localized GIST and may be especially beneficial for patients with non-gastric GISTs.
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Affiliation(s)
- Jiayu Ling
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lishuo Shi
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Center for Clinical Research, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xingyu Cheng
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang Fu
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ziqin Lin
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yandong Zhao
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Pathology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheqing Li
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Data Management, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianwei Zhang
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Huabin Hu
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue Cai
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Dalle Fratte C, Polesel J, Gagno S, Posocco B, De Mattia E, Roncato R, Orleni M, Puglisi F, Guardascione M, Buonadonna A, Toffoli G, Cecchin E. Impact of ABCG2 and ABCB1 Polymorphisms on Imatinib Plasmatic Exposure: An Original Work and Meta-Analysis. Int J Mol Sci 2023; 24. [PMID: 36834713 DOI: 10.3390/ijms24043303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Adequate imatinib plasma levels are necessary to guarantee an efficacious and safe treatment in gastrointestinal stromal tumor (GIST) and chronic myeloid leukemia (CML) patients. Imatinib is a substrate of the drug transporters ATP-binding cassette subfamily B member 1 (ABCB1) and ATP-binding cassette subfamily G member 2 (ABCG2) that can affect its plasma concentration. In the present study, the association between three genetic polymorphisms in ABCB1 (rs1045642, rs2032582, rs1128503) and one in ABCG2 (rs2231142) and the imatinib plasma trough concentration (Ctrough) was investigated in 33 GIST patients enrolled in a prospective clinical trial. The results of the study were meta-analyzed with those of other seven studies (including a total of 649 patients) selected from the literature through a systematic review process. The ABCG2 c.421C>A genotype demonstrated, in our cohort of patients, a borderline association with imatinib plasma trough levels that became significant in the meta-analysis. Specifically, homozygous carriers of the ABCG2 c.421 A allele showed higher imatinib plasma Ctrough with respect to the CC/CA carriers (Ctrough, 1463.2 ng/mL AA, vs. 1196.6 ng/mL CC + AC, p = 0.04) in 293 patients eligible for the evaluation of this polymorphism in the meta-analysis. The results remained significant under the additive model. No significant association could be described between ABCB1 polymorphisms and imatinib Ctrough, neither in our cohort nor in the meta-analysis. In conclusion, our results and the available literature studies sustain an association between ABCG2 c.421C>A and imatinib plasma Ctrough in GIST and CML patients.
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Fajardoa CJ, Cálixb ES, Mojicac R, Duarted F. COVID-19 in patients with chronic myeloid leukaemia on tyrosine kinase inhibitor therapy: a Honduran observational study. Ecancermedicalscience 2022; 16:1481. [PMID: 36819815 PMCID: PMC9934964 DOI: 10.3332/ecancer.2022.1481] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction In the earliest cases of COVID-19, a higher percentage of severe and fatal cases was observed in patients with cancer, including those with haematological malignancies. However, patients with chronic myeloid leukaemia (CML) had better prognoses, suggesting that tyrosine kinase inhibitors (TKIs) may have a therapeutic effect against SARS-CoV-2. This study describes the clinical and epidemiological characteristics of patients with CML receiving the TKIs tested for SARS-CoV-2 in Tegucigalpa, Honduras. Methodology An Analytical cross-sectional study was conducted. The sample included patients with Philadelphia chromosome-positive (Ph+) CML, who had been tested at least once for COVID-19 at the Emma Romero de Callejas Cancer Centre (CCERC). Sociodemographic and clinical variables were both analysed. Epi Info 7.2.4.0 and Stata/MP 16.0 were used to collect and analyse data. The COVID-19 positivity percentage and the association between severity and the TKI used were determined using Fisher's exact test and odds ratio (OR). Data were gathered from clinical records with approval of CCERC institutional management. Results One hundred and forty-nine patients with Ph+ CML were included; 20.1% were COVID-19-positive; 56% were male; mean age was 46 years; 81% were receiving imatinib, with a mean treatment duration of 6 years; 55% achieved a BCR -ABL molecular response ≤ 0.1% (IS). Twenty-one percent had comorbidities. COVID-19 was asymptomatic in 38.7% of patients, mild in 35.5% and severe in 9.7%. One patient died, a fatality rate of 3.2%. No statistical association was found between disease severity and treatment with imatinib versus second-line TKI (OR: 0.833, p: 0.8493, 95% CI: 0.098-10.998). Conclusion Despite high COVID-19 positivity in CML when compared with the literature, this study found a lower fatality rate. The type of TKI used or molecular response at the time of infection was not associated with case severity. Determining the effectiveness of imatinib or other TKIs as a COVID-19 treatment requires randomised clinical trials.
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Gorajiya A, Lalwani A. Leveraging the Exploratory and Predictive Capabilities of Design of Experiments in Development of Intraarticular Injection of Imatinib Mesylate Containing Lipospheres. AAPS PharmSciTech 2022; 23:275. [PMID: 36207604 DOI: 10.1208/s12249-022-02431-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Abstract
An intraarticular, liposphere-based, formulation of Imatinib mesylate for weekly administration was developed. Lipospheres were prepared using double emulsion technique using dierucoyl phosphatidylcholine, 1,2-dipalmitoyl-sn-glycero-3-phospho-rac-(1-glycerol) sodium salt), cholesterol, and tricaprylin as lipid phase in dichloromethane in a four-step process. Primary emulsion, formed using a high-pressure homogenizer, was diluted using a secondary aqueous phase in an Inline mixer to form the liposomal dispersion. Nitrogen flushing was done to remove dichloromethane, and the dispersion was finally centrifuged and adjusted for potency. The amount of cholesterol and triglyceride was taken as formulation variables, and speed of homogenization was used as a process variable in the Box-Behnken design while particle size, % drug entrapment, and drug release at the end of 4 h and 5 days were taken as response variables. Multivariate data analysis grouped the variables in two latent variable sets, one based on the speed and the other on the composition of lipospheres. Multiple linear regression analysis was used to generate mathematical model for each response. Constraints were put on the values of responses, as per the requirements of the final product, and the "freedom to operate" design space was located using an overlay plot. The center point batch sufficed all the set criteria, and Monte Carlo simulations on the factor variables indicated a defect rate of 5%. The center point batch was characterized for viscosity, osmolality, pH, drug release, and lipocrit value. The dispersion was charged in a prefilled syringe and studied for stability. The product was found to be stable at 2-8°C over a period of 6 months.
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Affiliation(s)
- Amruta Gorajiya
- R and D - Injectables, Amneal Pharmaceuticals, Ahmedabad, India
| | - Anita Lalwani
- K. B. Institute of Pharmaceutical Education and Research, Gh 6 Road, Sector 23, Gandhinagar, 382023, Gujarat, India.
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20
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Alfagih A, AlJassim A, Alshamsan B, Alqahtani N, Asmis T. Gastrointestinal Stromal Tumors: 10-Year Experience in Cancer Center-The Ottawa Hospital (TOH). Curr Oncol 2022; 29:7148-57. [PMID: 36290839 DOI: 10.3390/curroncol29100562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 01/13/2023] Open
Abstract
(1) Background: The management of gastrointestinal stromal tumors (GIST) has significantly evolved over the last two decades, with the introduction of tyrosine kinase inhibitors (TKI). We aim to report 10 years of experience of GIST management at a regional cancer center in Canada. (2) Methods: We retrospectively analyzed the records of 248 consecutive patients diagnosed with GIST between 2011 and 2021. We describe the clinical and pathological data, management, and outcome, including survival. (3) Results: The most common GIST sites were the stomach 63% (156), followed by the small bowel 29% (73). At diagnosis, 83% (206) of patients had localized disease (stage I-III). According to the modified National Institutes of Health consensus criteria (NIH) for GIST, around 45% (90) had intermediate or high-risk disease. Most patients, 86% (213), underwent curative surgical resection. Forty-nine patients received adjuvant imatinib, while forty-three patients had advanced disease and received at least one line of TKI. With a median follow-up of 47 months, the 5-year recurrence-free survival (RFS) rates for very low and low risk were 100% and 94%, respectively, while those for intermediate and high risk were 84% and 51%, respectively. The 5-year overall survival (OS) rates for very low and low risk were 100% and 94%, while intermediate, high risk, and advanced were 91%, 88%, and 65%, respectively. Using the Kaplan-Meier method, there were statistically significant differences in RFS and OS between NIH risk groups, p < 0.0005. In univariate analysis, ECOG, site, mitosis, secondary malignancy, and size were predictors for OS. High mitosis and large size (>5 cm) were associated with worse RFS. (4) Conclusions: Curative surgical resection remains the gold standard management of GIST. Our results are comparable to the reported literature. Further research is needed to explore histology's role in risk stratification and initiating adjuvant TKI.
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21
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Kambayashi Y, Kasahara Y, Ohuchi K, Amagai R, Hashimoto A, Asano Y, Fujimura T. Successful treatment of metastatic fibrosarcomatous dermatofibrosarcoma protuberans with imatinib mesylate. Dermatol Ther 2022; 35:e15736. [PMID: 35898161 DOI: 10.1111/dth.15736] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/26/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a fibrohistiocytic tumor characterized by a high risk of local recurrence but a low risk of metastasis. A small subpopulation of DFSP undergoes fibrosarcomatous (FS) change, and approximately 15%-57% of cases of DFSP with FS change metastasizes, leading to a poor prognosis. In this report, a case of metastatic FS-DFSP that was successfully treated with imatinib mesylate in which the IHC staining pattern of recurrent DFSP was quantitatively analyzed in primary and metastatic DFSP areas, is described. Importantly, the recurrent area was composed of two IHC staining patterns (CD34 low PD-L1 high Ki67 high and CD34 high PD-L1 low Ki67 low pattern, while the metastatic area showed a clonal pattern (CD34 high PD-L1 low Ki67 intermediate ) in the present case. In this report, we described a case of metastatic fibrosarcomatous DFSP successfully treated with imatinib mesylate. This case suggests a subpopulation of DFSP with a favorable metastatic pattern.
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Affiliation(s)
- Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Kentaro Ohuchi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryo Amagai
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshihide Asano
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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22
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Perkins ME, Girard BM, Campbell SE, Vizzard MA. Imatinib Mesylate Reduces Voiding Frequency in Female Mice With Acute Cyclophosphamide-Induced Cystitis. Front Syst Neurosci 2022; 16:867875. [PMID: 35645740 PMCID: PMC9135974 DOI: 10.3389/fnsys.2022.867875] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/19/2022] [Indexed: 01/28/2023] Open
Abstract
Lamina propria interstitial cells that express the tyrosine kinase receptor, platelet-derived growth factor receptor alpha (PDGFRα) may play a role in urinary sensory signaling. Imatinib mesylate, also referred to as imatinib, is a tyrosine kinase inhibitor that can inhibit PDGFRα and has been widely used in urological research. We evaluated the functional effects of imatinib administration (via oral gavage or intravesical infusion) with two different experimental designs (prevention and treatment), in a cyclophosphamide (CYP)-induced cystitis (acute, intermediate, and chronic), male and female rodent model using conscious cystometry and somatic sensitivity testing. Imatinib significantly (0.0001 ≤ p ≤ 0.05) decreased voiding frequency and increased bladder capacity in acute CYP-induced cystitis, by the prevention (females) and treatment (females and males) designs. Imatinib was not effective in preventing or treating intermediate or chronic CYP-induced cystitis in either sex. Interestingly, in the prevention experiments, imatinib administration increased (0.0001 ≤ p ≤ 0.01) voiding frequency and decreased bladder capacity in control mice. However, in the treatment experiments, imatinib administration decreased (0.01 ≤ p ≤ 0.05) voiding frequency and increased bladder capacity in control mice. Bladder function improvements observed with imatinib treatment in acute CYP-induced cystitis mice remained and additionally improved with a second dose of imatinib 24 hours after CYP treatment. Imatinib administration did not affect pelvic somatic sensitivity in female mice with acute CYP-induced cystitis. Our studies suggest that (1) imatinib improves bladder function in mice with acute CYP-induced cystitis with a prevention and treatment design and (2) interstitial cells may be a useful target to improve bladder function in cystitis.
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23
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Castillo-Martínez MJ, Tuna-Aguilar EJ, Milke-García MDP, Camacho Zamora A, Villegas Cervantes V, Castillo-Martínez L. Nutritional Status of Patients with Chronic Myeloid Leukemia Treated with Imatinib Mesylate. Nutr Cancer 2022; 74:3211-3216. [PMID: 35510801 DOI: 10.1080/01635581.2022.2069275] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Imatinib mesylate (IM) is the treatment of choice in patients with chronic myeloid leukemia (CML). Among its nonhematological adverse events, water retention is the most common, together with weight gain. However, no thorough description of the body composition in these patients has been informed. Therefore, our purpose was to evaluate the nutritional status, body composition and handgrip-strength in patients with CML treated with IM. Methods: We conducted a cross-sectional study in 78 patients (n = 48 men, 30 women) with chronic myeloid leukemia in the chronic (82%) or accelerated (18%) phases. We assessed body mass index (BMI), body composition by bioelectrical impedance, performed vector analysis through Bioelectrical Impedance Vector Analysis, and handgrip-strength measurement in patients with at least 3 months of IM treatment. Hematocrit and hemoglobin values were collected from the medical charts. Results: BMI was within the normal range in 28.2%, indicated overweight in 39.7% and obesity in 30.8%. According to BIVA, 25.6% of the patients were muscle-depleted and were older (p = 0.006) and received lower doses of IM (p < 0.001). Conclusions: In patients with CML with ≥3 months of IM treatment muscular depletion is frequent and is related to lower doses of IM.
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Affiliation(s)
- María José Castillo-Martínez
- Department de Haematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | - Elena Juventina Tuna-Aguilar
- Department de Haematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
| | | | - Anaís Camacho Zamora
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Viviana Villegas Cervantes
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Lilia Castillo-Martínez
- Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México
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24
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Zhu X, Zhang J, Sun Y, Wang Y, Liu Q, Li P, Yu S, Liu N, Ye J, Ma D, Ji C. Restoration of miR-23a expression by chidamide sensitizes CML cells to imatinib treatment with concomitant downregulation of CRYAB. Bioengineered 2022; 13:8881-8892. [PMID: 35333695 PMCID: PMC9162009 DOI: 10.1080/21655979.2022.2056322] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
MicroRNAs (miRNAs) are involved in various processes from the initiation and development of cancers, including chronic myeloid leukemia (CML). In this report, we aimed to investigate the roles of miR-23a in the regulation of imatinib mesylate (IM) sensitivity in CML cells and the possible mechanisms involved in this process. We demonstrated that the expression of miR-23a was markedly low in bone marrow mononuclear cells from patients in whom IM treatment had failed and imatinib-resistant K562/G01 cells when compared to patients with optimal responses and imatinib-sensitive K562 cells, respectively. Overexpression of miR-23a was shown to induce apoptosis of K562/G01 cells and sensitize these cells to imatinib treatment. With the aid of bioinformatics analysis, we revealed that CRYAB could be a potential downstream effector of miR-23a, contributing to miR-23a-mediated IM resistance. We also observed that the expression of CRYAB was inversely correlated with miR-23a expression in CML cell lines and patient samples. Importantly, chidamide upregulated miR-23a expression and reversed the IM resistance of CML cells. Together, these findings strongly suggest that miR-23a acts as a tumor suppressor by downregulating CRYAB expression. Restoration of miR-23a by chidamide may therefore have a therapeutic effect in controlling the sensitivity of CML cells to imatinib.
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Affiliation(s)
- Xunxun Zhu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China.,Department of Hematology, Tengzhou Central People's Hospital, Tengzhou, Shandong, China
| | - Jingru Zhang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Yanping Sun
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Yan Wang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China.,Department of Hematology, Taian Central Hospital, Taian, Shandong, China
| | - Qian Liu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Peng Li
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Shuang Yu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Na Liu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Jingjing Ye
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Daoxin Ma
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
| | - Chunyan Ji
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, shandong, China
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25
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Macedo TR, de Queiroz GF, Casagrande TAC, Alexandre PA, Brandão PE, Fukumasu H, Melo SR, Dagli MLZ, Pinto ACBCF, Matera JM. Imatinib Mesylate for the Treatment of Canine Mast Cell Tumors: Assessment of the Response and Adverse Events in Comparison with the Conventional Therapy with Vinblastine and Prednisone. Cells 2022; 11:cells11030571. [PMID: 35159380 PMCID: PMC8834544 DOI: 10.3390/cells11030571] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Mast cell tumors (MCTs) are common neoplasms in dogs, and treatments for these diseases include surgery, polychemotherapy and targeted therapy with tyrosine kinase inhibitors. This study aimed to evaluate the response and the adverse events of treatment with imatinib mesylate (IM) compared to conventional therapy using vinblastine and prednisolone (VP) in canine cutaneous MCTs. Twenty-four dogs were included in the study; 13 animals were treated with IM and 11 with VP. Tumor tissue samples were submitted for histological diagnosis, grading and KIT immunostaining. The response to treatment was assessed by tomographic measurements according to VCOG criteria. Adverse events were classified according to VCOG-CTCAE criteria. The IM and VP groups had dogs with similar breeds, gender, ages, MCT localization, WHO stages and lymph node metastasis profiles. Most MCTs were grade 2/low and had KIT- patterns 2 and 3. The objective response rate (ORR) was significantly higher (30.79%) in the IM group then in VP group (9.09%). Adverse events (AE) in IM group were all grade 1, significantly different from VP. In conclusion, IM presented better ORR and less severe adverse events when compared to VP, representing a suitable option for the treatment of low-grade canine MCTs.
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Affiliation(s)
- Thais Rodrigues Macedo
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (T.R.M.); (S.R.M.); (A.C.B.C.F.P.); (J.M.M.)
| | - Genilson Fernandes de Queiroz
- Department of Animal Science, Federal Rural University of Semi-Arid, Mossoró 59625-900, Brazil
- Correspondence: ; Tel.: +55-1130917712
| | | | - Pâmela Almeida Alexandre
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (P.A.A.); (P.E.B.)
| | - Paulo Eduardo Brandão
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (P.A.A.); (P.E.B.)
| | - Heidge Fukumasu
- Laboratory of Comparative and Translational Oncology (LOCT), Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of Sao Paulo, Pirassununga 13635-900, Brazil;
| | - Samanta Rios Melo
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (T.R.M.); (S.R.M.); (A.C.B.C.F.P.); (J.M.M.)
| | - Maria Lucia Zaidan Dagli
- Laboratory of Experimental and Comparative Oncology, Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil;
| | - Ana Carolina B. C. Fonseca Pinto
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (T.R.M.); (S.R.M.); (A.C.B.C.F.P.); (J.M.M.)
| | - Julia Maria Matera
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo 05508-010, Brazil; (T.R.M.); (S.R.M.); (A.C.B.C.F.P.); (J.M.M.)
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26
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Hirata A, Sawai E, Henmi M, Shibasaki C, Mizoguchi Y, Narumi K, Aoki K. Imatinib Mesylate Exerted Antitumor Effect by Promoting Infiltration of Effector T Cells in Tumor. Biol Pharm Bull 2022; 45:34-41. [PMID: 34980779 DOI: 10.1248/bpb.b21-00493] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/22/2022]
Abstract
Imatinib mesylate is a potent tyrosine kinase inhibitor that may induce immunological effects, such as inhibition of immune suppressive cells; but, how it modulates the immune system remains to be completely elucidated. In this study, we showed that cell proliferation of CT26 colon cancer and Lewis lung carcinoma (3LL) lung cancer cells was not inhibited by imatinib in vitro, although its administration significantly suppressed the growth of CT26, but not 3LL, subcutaneous tumors, and prolonged survival in CT26 tumor-bearing mice. Further, we examined the expression of immune cell-related molecules in the tumors to elucidate the differences in imatinib-mediated antitumor effects between CT26 and 3LL tumors. The nCounter assay showed that the expression of CD8 and CD8+ T cell-recruiting chemokine genes was significantly elevated in imatinib-treated CT26 tumors than that in control tumors; however, the gene expression remained unchanged in imatinib-treated or control 3LL tumors. Furthermore, frequency of interferon-γ+ (IFN-γ+) CD8+ T cells was increased in imatinib-treated CT26 tumors than control tumors, indicating induction of antitumor immunity by imatinib. The analysis indicates that imatinib promotes infiltration of effector T cells in tumors by upregulating expression of cytokines that recruit CD8+ T cells in the tumor microenvironment, which may lead to a strong antitumor effect.
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Affiliation(s)
- Aya Hirata
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center.,Division of Respiratory Medicine, Kyorin University School of Medicine
| | - Eri Sawai
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
| | - Marina Henmi
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
| | - Chihiro Shibasaki
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
| | - Yukihiro Mizoguchi
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
| | - Kenta Narumi
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
| | - Kazunori Aoki
- Department of Immune Medicine, National Cancer Center Research Institute, National Cancer Center
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27
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Swain TR, Goutam S, Jena RK, Rout N. Analysis of adverse drug reactions of imatinib in chronic myeloid leukemia patients: An Eastern Indian experience. Indian J Pharmacol 2022; 54:349-352. [PMID: 36537404 PMCID: PMC9846910 DOI: 10.4103/ijp.ijp_844_21] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Imatinib mesylate is the cornerstone therapy in the management of chronic myeloid leukemia (CML). Monitoring of adverse drug reactions (ADRs) of imatinib in our patients is very important to ensure their safety. Aims and Objectives: The current study aims to monitor ADRs encountered in CML patients in the chronic phase with imatinib (400 mg/day). MATERIALS AND METHODS This prospective, observational study was conducted from November 2011 to May 2015 on 310 patients presented to the Departments of Clinical Hematology and Pharmacology of SCB MCH, Cuttack, diagnosed with CML at chronic phase. Collected ADRs were entered in the ADR reporting form (PvPI) and were analyzed for causality and severity. RESULTS Anemia was the most common hematological ADR, whereas hyperpigmentation and nausea were the most common nonhematological ADRs reported. Maximum ADRs were mild to moderate and required no change in the treatment course. CONCLUSION The study revealed that imatinib mesylate, a well tolerated drug, has very few cases of severe ADRs in Indian patients at the chronic stable phase of CML.
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Affiliation(s)
| | - Siddhartha Goutam
- Department of Pharmacology, SCB Medical College, Cuttack, Odisha, India
| | - Rabindra Kumar Jena
- Department of Clinical Haematology, SCB Medical College, Cuttack, Odisha, India
| | - Niranjan Rout
- Acharya Harihar Regional Cancer Centre, Cuttack, Odisha, India,Address for correspondence: Prof. Niranjan Rout, Acharya Harihar Regional Cancer Centre, Cuttack, Odisha, India. E-mail:
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28
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Hirai I, Tanese K, Fukuda K, Fusumae T, Nakamura Y, Sato Y, Amagai M, Funakoshi T. Imatinib mesylate in combination with pembrolizumab in patients with advanced KIT-mutant melanoma following progression on standard therapy: A phase I/II trial and study protocol. Medicine (Baltimore) 2021; 100:e27832. [PMID: 34889232 PMCID: PMC8663894 DOI: 10.1097/md.0000000000027832] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Genetic alterations of KIT gene are known to be one of the major causes of melanoma. Those are more common in the mucous and acral subtypes and KIT is regarded as major oncogene in Asian melanomas, where the prevalence of these subtypes is high. Up to date, several clinical trials have been conducted to target KIT gene alterations in melanoma with unsatisfied efficacies. Imatinib mesylate, a small-molecule inhibitor of the KIT tyrosine kinase, provides a rapid but not durable clinical response in KIT-mutant melanoma. Meanwhile, recent basic and clinical evidence have revealed another aspect of KIT-targeted therapy, namely the enhancement of antitumor activity of immune checkpoint inhibitors. Herein, we designed clinical trial of co-administrating imatinib mesylate and pembrolizumab (anti-PD-1 antibody) to evaluate its safety and efficacy. METHODS AND ANALYSIS This is an open-label, single-arm, phase I/II clinical trial involving Japanese patients with metastatic KIT-mutant melanoma that are refractory to standard therapy including anti-PD-1 therapy. Phase I study is a dose-escalation study comprising two dose levels of imatinib mesylate (200 and 400 mg/day, respectively) with fixed dose of pembrolizumab (200 mg every 3 weeks) to evaluate safety and tolerability and determine recommended phase II dose. The primary endpoint of the phase II study is the objective response rate after 4 cycles (3 weeks/cycle) of pembrolizumab and imatinib mesylate at the dose determined in phase I, based on RECIST version 1.1. A Simon's minimax two-stage design is employed to test the null hypothesis of a 5% response rate vs 30% alternative, which will be rejected when a lower confidence limit of two-sided 90% confidence interval of true response rate is over than threshold response rate. The secondary endpoints include progression free survival, overall survival, best overall response and incidence of adverse events. Totally, a target size of 22 patients will be expected. DISCUSSION If this study shows efficacy and acceptable safety profile, it will contribute to the development of novel treatment option for patients with KIT-mutant melanoma that are refractory to standard therapy. TRIAL REGISTRATION NCT04546074. Date of Registration: September 11, 2020 (https://clinicaltrials.gov/ct2/show/NCT04546074). Date of First Participant Enrollment: December 23, 2020.
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Affiliation(s)
- Ikuko Hirai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Keiji Tanese
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Keitaro Fukuda
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Fusumae
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshio Nakamura
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Takeru Funakoshi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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29
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Demirbolat GM, Altintas L, Yilmaz S, Arsoy T, Sözmen M, Degim IT. Nanodesigning of multifunctional quantum dots and nanoparticles for the treatment of fibrosarcoma. J Microencapsul 2021; 39:210-225. [PMID: 34796787 DOI: 10.1080/02652048.2021.1990423] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM An effective, dual drug(DD) loaded nanocarrier system (nano particle(NP), quantum dots(QDs)) having two active substances was aimed to develop for the treatment of fibrosarcoma. METHODS Zinc oxide(ZnO) QDs were produced using zinc acetate dehydrate as a precursor, were incorporated with chitosan(Ch), and finally decorated with PEG-linked folic acid and were found to be effective after imatinib mesylate(IM) and dexketoprofen trometamol(DT) were loaded. Characterizations, invitro drug releases, cell toxicities, penetrations through cell lines and in-vivo animal tests of the prepared nanosystems were performed. RESULTS The size of hybrid nanoparticles were 168.6 ± 48.8nm, surface charge was -35.8 ± 0.26mV. The encapsulation efficiency was 75% for IM and 99% for DT. DD-functionalized QDChNPs and lyophilized functionalized QDChNPs in capsules slowed down tumor growth by up to 76.5 % and 88.7 %. CONCLUSIONS Our results demonstrate that developed hybrid nanoparticles are highly effective. This hybrid system gathers many of the advantages of nanotechnology into one form.
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Affiliation(s)
- Gulen Melike Demirbolat
- Department of Pharmaceutical Technology, Biruni University Faculty of Pharmacy, 34010, Topkapi, Istanbul, Turkey.,Department of Pharmaceutical Technology, Gazi University Faculty of Pharmacy, 06330, Yenimahalle, Ankara, Turkey
| | - Levent Altintas
- Department of Pharmacology and Toxicology, Ankara University Faculty of Veterinary Medicine, 06110, Ankara, Turkey
| | - Sukran Yilmaz
- Food and Mouth Diseases Institute, 06520, Ankara, Turkey
| | - Taibe Arsoy
- Food and Mouth Diseases Institute, 06520, Ankara, Turkey
| | - Mahmut Sözmen
- Department of Preclinical Sciences, Ondokuz Mayıs University Faculty of Veterinary, Samsun, Turkey
| | - Ismail Tuncer Degim
- Department of Pharmaceutical Technology, Biruni University Faculty of Pharmacy, 34010, Topkapi, Istanbul, Turkey.,Department of Pharmaceutical Technology, Gazi University Faculty of Pharmacy, 06330, Yenimahalle, Ankara, Turkey
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30
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Eubanks BN, Tafti DA, House S, Logemann N. Dermatofibrosarcoma Protuberans Presenting in a Patient With Neurofibromatosis Type 1: Potential Implications on Treatment. Cureus 2021; 13:e17675. [PMID: 34650853 PMCID: PMC8489551 DOI: 10.7759/cureus.17675] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/05/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma. Neurofibromatosis type 1 (NF1) is a neurocutaneous syndrome that affects multiple organ systems. We present the case of a 47-year-old African American male with a two-year history of a slowly enlarging right lower back lesion. Upon workup, the 3 × 2 cm mass was biopsied confirming a diagnosis of DFSP. This was identified in concert with axillary freckling, café-au-lait spots, and pedunculated plaques evaluated with biopsy. The findings were consistent with neurofibromas, leading to a new diagnosis of NF1. The patient was definitively treated with wide local excision of the DFSP lesion without tumor recurrence over six years. DFSP has a favorable prognosis when treated with wide local excision and negative surgical margins. However, lesions may recur with inadequate margins. Although deferred in our patient, treatment with imatinib mesylate, a tyrosine kinase inhibitor, may be employed in the setting of advanced disease, metastasis, positive surgical margins, or irresectable locations. Imatinib has also been used to treat NF1. Hence, we posit that the concomitant presentation of these two disease entities in our patient highlights a potentially unique treatment with imatinib mesylate. To our knowledge, this is the second reported case of both entities in the same patient.
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Affiliation(s)
- Bianca N Eubanks
- Medicine, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Dawood A Tafti
- Department of Radiology, San Antonio Military Medical Center, San Antonio, USA
| | - Sabrina House
- Department of Dermatology, McDonald Army Health Center, Newport News, USA
| | - Nicholas Logemann
- Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, USA
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31
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Martins JRB, Moraes LN, Cury SS, Capannacci J, Carvalho RF, Nogueira CR, Hokama NK, Hokama POM. MiR-125a-3p and MiR-320b Differentially Expressed in Patients with Chronic Myeloid Leukemia Treated with Allogeneic Hematopoietic Stem Cell Transplantation and Imatinib Mesylate. Int J Mol Sci 2021; 22:ijms221910216. [PMID: 34638557 PMCID: PMC8508688 DOI: 10.3390/ijms221910216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
Chronic myeloid leukemia (CML), a hematopoietic neoplasm arising from the fusion of BCR (breakpoint cluster region) gene on chromosome 22 to the ABL (Abelson leukemia virus) gene on chromosome 9 (BCR-ABL1 oncogene), originates from a small population of leukemic stem cells with extensive capacity for self-renewal and an inflammatory microenvironment. Currently, CML treatment is based on tyrosine kinase inhibitors (TKIs). However, allogeneic hematopoietic stem cell transplantation (HSCT-allo) is currently the only effective treatment of CML. The difficulty of finding a compatible donor and high rates of morbidity and mortality limit transplantation treatment. Despite the safety and efficacy of TKIs, patients can develop resistance. Thus, microRNAs (miRNAs) play a prominent role as biomarkers and post-transcriptional regulators of gene expression. The aim of this study was to analyze the miRNA profile in CML patients who achieved cytogenetic remission after treatment with both HSCT-allo and TKI. Expression analyses of the 758 miRNAs were performed using reverse transcription quantitative polymerase chain reaction (RT-qPCR). Bioinformatics tools were used for data analysis. We detected miRNA profiles using their possible target genes and target pathways. MiR-125a-3p stood out among the downregulated miRNAs, showing an interaction network with 52 target genes. MiR-320b was the only upregulated miRNA, with an interaction network of 26 genes. The results are expected to aid future studies of miRNAs, residual leukemic cells, and prognosis in CML.
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Affiliation(s)
- Juliana R. B. Martins
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (FMB-UNESP), Botucatu 18618-687, Brazil; (J.R.B.M.); (J.C.); (C.R.N.); (N.K.H.)
| | - Leonardo N. Moraes
- Department of Bioprocesses and Biotechnology, School of Agriculture, São Paulo State University (FCA-UNESP), Botucatu 18610-034, Brazil;
| | - Sarah S. Cury
- Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (IBB-UNESP), Botucatu 18618-970, Brazil; (S.S.C.); (R.F.C.)
| | - Juliana Capannacci
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (FMB-UNESP), Botucatu 18618-687, Brazil; (J.R.B.M.); (J.C.); (C.R.N.); (N.K.H.)
| | - Robson Francisco Carvalho
- Department of Structural and Functional Biology, Institute of Biosciences, São Paulo State University (IBB-UNESP), Botucatu 18618-970, Brazil; (S.S.C.); (R.F.C.)
| | - Célia Regina Nogueira
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (FMB-UNESP), Botucatu 18618-687, Brazil; (J.R.B.M.); (J.C.); (C.R.N.); (N.K.H.)
| | - Newton Key Hokama
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (FMB-UNESP), Botucatu 18618-687, Brazil; (J.R.B.M.); (J.C.); (C.R.N.); (N.K.H.)
| | - Paula O. M. Hokama
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University (FMB-UNESP), Botucatu 18618-687, Brazil; (J.R.B.M.); (J.C.); (C.R.N.); (N.K.H.)
- Correspondence:
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Tennenbaum J, Groh M, Venditti L, Campos-Gazeau F, Chalayer E, De Broucker T, Hamidou M, Hunault M, Lyoubi A, Meunier R, Muron T, Sène D, Slama B, Guidoux C, Lefèvre G, Kahn JE, Denier C, Rohmer J. FIP1L1-PDGFRA-Associated Hypereosinophilic Syndrome as a Treatable Cause of Watershed Infarction. Stroke 2021; 52:e605-e609. [PMID: 34304603 DOI: 10.1161/strokeaha.121.034191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE Ischemic stroke has been reported in various conditions associated with eosinophilia. FIP1L1-PDGFRA fusion ([Fip1-like 1-platelet-derived growth factor receptor alpha]; F/P) leads to the proliferation of the eosinophilic lineage and thus to a clonal hypereosinophilic syndrome that is highly responsive to imatinib. METHODS We previously reported on a nationwide retrospective study of 151 patients with F/P-associated clonal hypereosinophilic syndrome. Patients from this cohort with a clinical history of ischemic stroke (as well as 2 additional cases) were further analyzed to better define their clinical picture and outcomes. RESULTS Sixteen male patients (median age, 51 [43-59] years) with low-to-intermediate cardiovascular risk were included. Median National Institutes of Health Stroke Scale was 4 (range, 1-6). Most cerebral imaging disclosed multiple bilateral infarctions of watershed distribution (69%). Despite frequent cardiac involvement (50%), cardiac thrombus was evidenced in a single patient and, according to the TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment), 62.5% of strokes were presumably of undetermined etiology. Among the 15 patients treated with imatinib, and after a median follow-up of 4.5 years, stroke recurred in only 3 patients (consisting of either cardio embolic or hemorrhagic events, unrelated to the first episode). CONCLUSIONS F/P+ clonal hypereosinophilic syndrome is a diagnosis to consider in patients with unexplained ischemic stroke and hypereosinophilia (especially in the setting of multiple cortical borderzone distribution) and warrants prompt initiation of imatinib.
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Affiliation(s)
- Juliette Tennenbaum
- National Reference Center for Hypereosinophilic syndromes (CEREO), France (J.T., M.G., M. Hamidou, G.L., J.-E.K., J.R.).,Department of Neurology, CHU du Kremlin-Bicêtre, France (J.T., L.V., C.D.)
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic syndromes (CEREO), France (J.T., M.G., M. Hamidou, G.L., J.-E.K., J.R.).,Department of Internal Medicine, Hôpital Foch, Suresnes, France (M.G., J.R.)
| | - Laura Venditti
- Department of Neurology, CHU du Kremlin-Bicêtre, France (J.T., L.V., C.D.)
| | | | - Emilie Chalayer
- Department of Hematology and Cell Therapy, Saint-Priest-en-Jarez, France. (E.C.)
| | - Thomas De Broucker
- Department of Neurology, Hôpital Delafontaire, Saint Denis, France (T.D.B., A.L.)
| | - Mohamed Hamidou
- Department of Internal Medicine, CHU de Nantes, France (M. Hamidou)
| | | | - Aicha Lyoubi
- Department of Neurology, Hôpital Delafontaire, Saint Denis, France (T.D.B., A.L.)
| | | | - Thierry Muron
- Department of Oncology, Saint-Priest-en-Jarez, France. (T.M.)
| | - Damien Sène
- Department of Internal Medicine, CHU Lariboisière, Paris, France (D.S.)
| | - Borhane Slama
- Department of Hematology, Hôpital d'Avignon, France (B.S.)
| | - Céline Guidoux
- Department of Neurology, CHU Bichat, Paris, France (C.G.)
| | - Guillaume Lefèvre
- National Reference Center for Hypereosinophilic syndromes (CEREO), France (J.T., M.G., M. Hamidou, G.L., J.-E.K., J.R.).,Department of Internal Medicine, CHU Lille, France (G.L.)
| | - Jean-Emmanuel Kahn
- National Reference Center for Hypereosinophilic syndromes (CEREO), France (J.T., M.G., M. Hamidou, G.L., J.-E.K., J.R.).,Department of Internal Medicine, CHU Ambroise Paré, Boulogne-Billancourt, France (J.-E.K.)
| | - Christian Denier
- Department of Neurology, CHU du Kremlin-Bicêtre, France (J.T., L.V., C.D.)
| | - Julien Rohmer
- National Reference Center for Hypereosinophilic syndromes (CEREO), France (J.T., M.G., M. Hamidou, G.L., J.-E.K., J.R.).,Department of Internal Medicine, Hôpital Foch, Suresnes, France (M.G., J.R.)
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Kozinova M, Joshi S, Ye S, Belinsky MG, Sharipova D, Farma JM, Reddy SS, Litwin S, Devarajan K, Campos AR, Yu Y, Schwartz B, von Mehren M, Rink L. Combined Inhibition of AKT and KIT Restores Expression of Programmed Cell Death 4 (PDCD4) in Gastrointestinal Stromal Tumor. Cancers (Basel) 2021; 13:cancers13153699. [PMID: 34359600 PMCID: PMC8345102 DOI: 10.3390/cancers13153699] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
The majority of gastrointestinal stromal tumor (GIST) patients develop resistance to the first-line KIT inhibitor, imatinib mesylate (IM), through acquisition of secondary mutations in KIT or bypass signaling pathway activation. In addition to KIT, AKT is a relevant target for inhibition, since the PI3K/AKT pathway is crucial for IM-resistant GIST survival. We evaluated the activity of a novel pan-AKT inhibitor, MK-4440 (formerly ARQ 751), as monotherapy and in combination with IM in GIST cell lines and preclinical models with varying IM sensitivities. Dual inhibition of KIT and AKT demonstrated synergistic effects in IM-sensitive and -resistant GIST cell lines. Proteomic analyses revealed upregulation of the tumor suppressor, PDCD4, in combination treated cells. Enhanced PDCD4 expression correlated to increased cell death. In vivo studies revealed superior efficacy of MK-4440/IM combination in an IM-sensitive preclinical model of GIST compared with either single agent. The combination demonstrated limited efficacy in two IM-resistant models, including a GIST patient-derived xenograft model possessing an exon 9 KIT mutation. These studies provide strong rationale for further use of AKT inhibition in combination with IM in primary GIST; however, alternative agents will need to be tested in combination with AKT inhibition in the resistant setting.
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Affiliation(s)
- Marya Kozinova
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
- Department of Molecular Pharmacology and Radiobiology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Shalina Joshi
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
| | - Shuai Ye
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
| | - Martin G. Belinsky
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
| | - Dinara Sharipova
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
| | - Jeffrey M. Farma
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (J.M.F.); (S.S.R.)
| | - Sanjay S. Reddy
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (J.M.F.); (S.S.R.)
| | - Samuel Litwin
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (S.L.); (K.D.)
| | - Karthik Devarajan
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (S.L.); (K.D.)
| | - Alex Rosa Campos
- Proteomics Core Facility, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA;
| | - Yi Yu
- ArQuIe Inc., A Wholly-Owned Subsidiary of Merck & Co., Inc. (Known as MSD Outside the United States and Canada), Kenilworth, NJ 07033, USA; (Y.Y.); (B.S.)
| | - Brian Schwartz
- ArQuIe Inc., A Wholly-Owned Subsidiary of Merck & Co., Inc. (Known as MSD Outside the United States and Canada), Kenilworth, NJ 07033, USA; (Y.Y.); (B.S.)
| | - Margaret von Mehren
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
- Department of Hematology and Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Lori Rink
- Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (M.K.); (S.J.); (S.Y.); (M.G.B.); (D.S.); (M.v.M.)
- Correspondence: ; Tel.: +1-(215)-214-1608
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Saka R, Chella N, Khan W. Development of Imatinib Mesylate-Loaded Liposomes for Nose to Brain Delivery: In Vitro and In Vivo Evaluation. AAPS PharmSciTech 2021; 22:192. [PMID: 34184160 DOI: 10.1208/s12249-021-02072-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/09/2021] [Indexed: 12/26/2022] Open
Abstract
Neurodegenerative diseases like Alzheimer's disease require treatment where it is essential for drug to reach brain. Nose to brain delivery of drugs enables direct transport to brain bypassing blood brain barrier. Imatinib mesylate, an anti-cancer agent, was found to have potential anti-Alzheimer's activity and thus repurposed for the same. However, the drug has severe side effects, poor brain bioavailability which may hinder effective treatment of Alzheimer's disease. In the current work, imatinib mesylate-loaded liposomes were prepared with particle size below 150 nm with sustained drug release up to 96 h. The liposomal drug formulation was compared with plain drug solution for cytotoxicity on N2a cells and did not show any kind of toxicity at concentrations up to 25 μg/mL. The nanocarrier formulation was then evaluated for brain deposition by nose to brain administration in comparison with drug solution in rats. The liposomes effectively improved the brain deposition of drug in brain from formulation compared to pure drug solution as indicated by AUC from in vivo experiments. These results indicate that the nose to brain delivery of liposomal imatinib mesylate improved the drug deposition and residence time in brain compared to drug solution administered through oral and intranasal routes.
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Mohammadi F, Rostami G, Assad D, Shafiei M, Hamid M, Jalaeikhoo H. Association of SLC22A1,SLCO1B3 Drug Transporter Polymorphisms and Smoking with Disease Risk and Cytogenetic Response to Imatinib in Patients with Chronic Myeloid Leukemia. Lab Med 2021; 52:584-596. [PMID: 34128532 DOI: 10.1093/labmed/lmab023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/16/2022] Open
Abstract
OBJECTIVE To determine whether polymorphisms of SLC22A1 and SLCO1B3 genes could predict imatinib (IM) response and chronic myeloid leukemia (CML) risk. METHODS We genotyped SLC22A1 (c.480G > C, c.1222A > G) and SLCO1B3 (c.334T > G, c.699G > A) polymorphisms in 132 patients with CML and 109 sex- and age-matched healthy subjects. The patients were evaluated for cytogenetic response by standard chromosome banding analysis (CBA). RESULTS Polymorphism analysis showed significant increased risk of IM resistance for SLC22A1c.1222AG (P = .03; OR = 2.2), SLCO1B3c.334TT/TG genotypes (P = .007; OR = 4.37) and 334T allele (P = .03; OR = 2.86). The double combinations of SLC22A1c.480CC and c.1222AG polymorphisms with SLCO1B3c.334TT/TG were significantly associated with complete cytogenetic response (CCyR) (P <.05; OR> 7). The interaction between all polymorphisms and smoking were associated with CML development and IM resistance (P ≤.04; OR> 3). CONCLUSIONS Our study results suggest the influence of SLC22A1 and SLCO1B3 polymorphisms and the interaction of smoking on CML development and IM response.
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Affiliation(s)
- Fatemeh Mohammadi
- Department of Biology, School of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Golale Rostami
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Dlnya Assad
- Department of Biology, College of Science, Sulaimani University, Sulaymanyah, Iraq
| | - Mohammad Shafiei
- Department of Biology, School of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran.,Biotechnology and Biological Science Research Center, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Hamid
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Hasan Jalaeikhoo
- AJA Cancer Epidemiology Research and Treatment Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran
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Abstract
Gastrointestinal stromal tumors (GISTs), even though rare, remain the most common mesenchymal tumors of the gastrointestinal (GI) tract. When GISTs occur outside of the GI tract, they are termed extragastrointestinal stromal tumors (EGISTs). Most GISTs arise from the stomach (50-70%) and small intestine (20-30%). A smaller percentage of these tumors also occurs in the large intestine (5%) and esophagus (2-5%). EGISTs have histopathological and molecular characteristics that are similar to GISTs. However, the precise incidence and tumor behavior of EGISTs are not fully understood. EGISTs have no specific symptoms or radiologic features, and in most cases, the presenting complaint is abdominal pain or discomfort. Yet, they tend to be more aggressive and have a worse prognosis than GISTs. Morphologic diagnosis based on microscopic examination of histological sections is the standard diagnostic procedure for GIST/EGIST. In this patient-centered study, we present a case of EGIST that originated in the anterior perirectal space, an extremely rare location; we also describe the endoscopic approach that was used to biopsy the tumor.
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Affiliation(s)
- Mohamed M Elagami
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Alman Khalid
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Vinod Kumar
- Hematology/Oncology, St. Joseph's University Medical Center, Paterson, USA
| | - Monisha Singhal
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Matthew A Grossman
- Interventional Gastroenterology, St. Joseph's University Medical Center, Paterson, USA
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Xu H, Ji H, Li Z, Qiao W, Wang C, Tang J. In vivo Pharmacokinetics and in vitro Release of Imatinib Mesylate-Loaded Liposomes for Pulmonary Delivery. Int J Nanomedicine 2021; 16:1221-1229. [PMID: 33628019 PMCID: PMC7898055 DOI: 10.2147/ijn.s294626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/29/2020] [Accepted: 01/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is characterized by abnormal proliferation of vascular endothelial and smooth muscle cells and causes occlusion of pulmonary arterioles that eventually results in right heart failure and death. The platelet-derived growth factor (PDGF) plays a prominent role in abnormal remodeling of pulmonary resistance vessels. Imatinib mesylate (IM), a PDGF-receptor tyrosine kinase inhibitor, was able to ameliorate PAH by reversing pulmonary vascular remodeling. METHODS In the present study, IM-loaded liposomes (IM-LPs) were developed and administered via the pulmonary route to delay the drug release and improve patient compliance for the treatment of PAH. The IM-LPs were prepared by the transmembrane gradient method with the spherical vesicles. The compatibility of the IM-LPs was studied by determining the viability of pulmonary arterial smooth muscle cells (PASMCs). Particle uptake by rat PASMCs was evaluated by incubating the particles with rat PASMCs. Pharmacokinetic studies were performed in male SD rats. RESULTS The IM-LPs showed an average size of 101.6 ± 50.80 nm with a zeta potential value of 19.66 ± 0.55 mV, a PDI of 0.250 and 81.96% ± 0.98% drug entrapment efficiency, meanwhile displayed a sustained release profile. Liposomes obviously increased intracellular accumulation of Rhodamine B by PASMCs using the fluorescence microscopic. Following intratracheal administration to rats, IM-LPs not only extended the half-life of IM, but also prolonged retention of IM compared with plain IM solution after intratracheal and intravenous administration. CONCLUSION The study show potential applications of the LPs for pulmonary delivery of IM and the method for the development of LPs in sustained release of IM for better therapeutic outcomes. Conclusively, the prepared IM-LPs were well designed in nanosized ranges and may be a promising formulation for pulmonary delivery of IM.
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Affiliation(s)
- Hongfei Xu
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
| | - Hongyu Ji
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
- Department of Pharmacy, The Second Affiliated Hospital, Harbin Medical University, Harbin, 150086, People's Republic of China
| | - Zerong Li
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
- Department of Pharmacy, The Second People’s Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518028, People’s Republic of China
| | - Wenmei Qiao
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
- Department of Pharmacy, Shenzhen Luohu Hospital Group-Shenzhen Luohu Traditional Chinese Medicine Hospital, Shanghai University of Traditional Chinese Medicine-Shenzhen Hospital, Shenzhen, 518001, People’s Republic of China
| | - Chenghao Wang
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
| | - Jingling Tang
- Department of Pharmaceutics, School of Pharmacy, Harbin Medical University, Harbin, 150086, People’s Republic of China
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Abstract
BACKGROUND Our study aimed to investigate the association between multidrug resistance (MDR1) C1236T, C3435T and G2677T/A polymorphisms and the response to imatinib (IM) in chronic myeloid leukemia (CML). MATERIALS AND METHODS An electronic databases in PubMed, Embase, Web of Knowledge, Scopus and Cochrane were searched using combinations of keywords relating to MDR1 polymorphisms and the response to IM in CML. Studies retrieved from database searches were screened using strict inclusion and exclusion criteria. RESULTS In total, 37 studies were initially identified, and 17 studies, involving 4494 CML patients, were eventually included in this meta-analysis.Results of our study revealed significant association between MDR1 G2677T/A and C3435T polymorphisms and response to IM in Caucasian population under recessive model (T or A vs G; OR = 1.43,95%CI [1;06-1.93]; T vs C;OR = 1.13; 95%IC [0.79; 1.63]), dominant (T or A vs G; OR = 0.94; 95%CI [0.74-1.21]; T vs C; OR = 1.49; 95%CI [1.02-2.17]) and heterozygous models (T or A vs G; OR = 0.83; 95%CI [0.64; 1.09]; T vs C; OR = 1.52; 95%CI [1.01-2.28]); respectively. However, never significative association was found between IM response and the MDR1 C1236T polymorphism (OR = 1.25; 95%CI [0.46; 3.33]). CONCLUSION The MDR1 G2677T/A and C3435T polymorphisms might be a risk factor for resistance to IM in Caucasian CML patients.
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Affiliation(s)
- N Louati
- Blood Bank, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - F Turki
- Department of Medical Genetic, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - H Mnif
- Blood Bank, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - R Frikha
- Department of Medical Genetic, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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Annuar AA, Ankathil R, Mohd Yunus N, Husin A, Ab Rajab NS, Abdul Aziz AA, Ibrahim MI, Sulong S. Impact of Fas/Fasl Gene Polymorphisms on Susceptibility Risk and Imatinib Mesylate Treatment Response in Chronic Myeloid Leukaemia Patients. Asian Pac J Cancer Prev 2021; 22:565-571. [PMID: 33639675 PMCID: PMC8190357 DOI: 10.31557/apjcp.2021.22.2.565] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Indexed: 12/03/2022] Open
Abstract
Background: The FAS mediated apoptosis pathway involving the FAS and FASL genes plays a crucial role in the regulation of apoptotic cell death and imatinib mesylate (IM) mechanism of action. Promoter polymorphisms FAS-670 A>G and FAS-844 T>C which alter the transcriptional activity of these genes may grant a risk to develop cancer and revamp the drug activities towards the cancer cell. We investigated the association of these two polymorphisms with the susceptibility risk and IM treatment response in Malaysian chronic myeloid leukaemia (CML) patients. Methods: This is a retrospective study, which included 93 CML patients and 98 controls. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method was used to genotype the FAS and FASL polymorphisms. Data nanlysis was done using SPSS Version 22. The associations of the genotypes with susceptibility risk and IM response in CML patients were assessed by means of logistic regression analysis and deriving odds ratio with 95% CI. Results: We observed a significant association between FASL-844T>C polymorphism and CML susceptibility risk and IM response. Variant C allele and FASL-844 CC variant genotype carriers had significantly higher risk for CML susceptibility (OR 1.756, CI 1.163-2.652, p=0.007 and OR 2.261, CI 1.013-5.047, p=0.047 respectively). Conversely, the heterozygous genotype FASL-844 TC conferred lower risk for CML susceptibility (OR 0.379, CI 0.176-0.816, p=0.013). The heterozygous and homozygous variant genotypes and variant C alleles were found to confer a lower risk for the development of IM resistance with OR 0.129 (95% CI: 0.034-0.489 p=0.003), OR 0.257 (95% CI: 0.081-0.818, p=0.021), and OR 0.486 (95% CI: 0.262-0.899, p=0.021) respectively. We also found that FAS-670 A>G polymorphism was not associated with CML susceptibility risk or IM response. Conclusion: The genetic polymorphism FASL-844 T>C may contribute to the CML susceptibility risk and also IM treatment response in CML patients. Accodringly, it may be useful as a biomarker for predicting CML susceptibility risk and IM resistance.
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Affiliation(s)
- Aziati Azwari Annuar
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Ravindran Ankathil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nazihah Mohd Yunus
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azlan Husin
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan Malaysia
| | - Nur Shafawati Ab Rajab
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Ahmad Aizat Abdul Aziz
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Sarina Sulong
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Butterfield JH. Successful Long-Term Control of the Syndrome of Episodic Angioedema With Eosinophilia (Gleich Syndrome) With Low-Dose Imatinib Mesylate and Prednisone. J Investig Med High Impact Case Rep 2021; 9:2324709620987691. [PMID: 33459036 PMCID: PMC7816523 DOI: 10.1177/2324709620987691] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 12/27/2022] Open
Abstract
The syndrome of episodic angioedema with eosinophilia, first reported over 40 years ago, is a hypereosinophilic disorder that, uniquely, is not associated with end-organ pathology. However, patients develop a constellation of symptoms that include angioedema, urticaria, fatigue, and fever. Episodes are accompanied by massive hypereosinophilia and weight gain. Type II serum cytokine levels (IL-5, IL-13, IL-9, and IL-10) show cyclic variations peaking at or just prior to the peak of eosinophilia and an abnormal Th2 cell phenotype has been reported. Attacks may occur with predictable regularity and have been described in both adults and children. Glucocorticoid therapy reliably reverses symptoms with accompanying diuresis, defervesce, and normalization of the eosinophil count. In this report, a patient who had the syndrome of episodic angioedema with eosinophilia exceeding 20 years is reported. He has had no end-organ damage to date. Testing for the CHIC2 deletion, a surrogate for the FIP1L1-PDGFRA fusion, was negative. Use of imatinib mesylate, initially as a steroid-sparing agent, and subsequently as a maintenance medication, plus low-dose prednisone has provided long-term control of hypereosinophilia and all clinical manifestations.
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Hrdinova T, Toman O, Dresler J, Klimentova J, Salovska B, Pajer P, Bartos O, Polivkova V, Linhartova J, Machova Polakova K, Kabickova H, Brodska B, Krijt M, Zivny J, Vyoral D, Petrak J. Exosomes released by imatinib‑resistant K562 cells contain specific membrane markers, IFITM3, CD146 and CD36 and increase the survival of imatinib‑sensitive cells in the presence of imatinib. Int J Oncol 2020; 58:238-250. [PMID: 33491750 DOI: 10.3892/ijo.2020.5163] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/27/2020] [Accepted: 10/08/2020] [Indexed: 11/06/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a malignant hematopoietic disorder distinguished by the presence of a BCR‑ABL1 fused oncogene with constitutive kinase activity. Targeted CML therapy by specific tyrosine kinase inhibitors (TKIs) leads to a marked improvement in the survival of the patients and their quality of life. However, the development of resistance to TKIs remains a critical issue for a subset of patients. The most common cause of resistance are numerous point mutations in the BCR‑ABL1 gene, followed by less common mutations and multiple mutation-independent mechanisms. Recently, exosomes, which are extracellular vesicles excreted from normal and tumor cells, have been associated with drug resistance and cancer progression. The aim of the present study was to characterize the exosomes released by imatinib‑resistant K562 (K562IR) cells. The K562IR‑derived exosomes were internalized by imatinib‑sensitive K562 cells, which thereby increased their survival in the presence of 2 µM imatinib. The exosomal cargo was subsequently analyzed to identify resistance‑associated markers using a deep label‑free quantification proteomic analysis. There were >3,000 exosomal proteins identified of which, 35 were found to be differentially expressed. From this, a total of 3, namely the membrane proteins, interferon‑induced transmembrane protein 3, CD146 and CD36, were markedly upregulated in the exosomes derived from the K562IR cells, and exhibited surface localization. The upregulation of these proteins was verified in the K562IR exosomes, and also in the K562IR cells. Using flow cytometric analysis, it was possible to further demonstrate the potential of CD146 as a cell surface marker associated with imatinib resistance in K562 cells. Taken together, these results suggested that exosomes and their respective candidate surface proteins could be potential diagnostic markers of TKI drug resistance in CML therapy.
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Affiliation(s)
- Tereza Hrdinova
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Ondrej Toman
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Jiri Dresler
- Military Health Institute, Military Medical Agency, 160 01 Prague 6, Czech Republic
| | - Jana Klimentova
- Faculty of Military Health Sciences, University of Defense in Brno, 500 02 Hradec Kralove, Czech Republic
| | - Barbora Salovska
- Department of Genome Integrity, Institute of Molecular Genetics of The Czech Academy of Sciences, 142 20 Prague 4, Czech Republic
| | - Petr Pajer
- Military Health Institute, Military Medical Agency, 160 01 Prague 6, Czech Republic
| | - Oldrich Bartos
- Department of Infectious Diseases, First Faculty of Medicine, Charles University and Military University Hospital Prague, 169 02 Prague 6, Czech Republic
| | - Vaclava Polivkova
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Jana Linhartova
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | | | - Hana Kabickova
- Military Health Institute, Military Medical Agency, 160 01 Prague 6, Czech Republic
| | - Barbora Brodska
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Matyas Krijt
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Jan Zivny
- Institute of Pathological Physiology, First Faculty of Medicine, Charles University, 128 20 Prague 2, Czech Republic
| | - Daniel Vyoral
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
| | - Jiri Petrak
- Institute of Hematology and Blood Transfusion, 128 20 Prague 2, Czech Republic
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Kimura T, Togawa T, Onishi K, Iida A, Sato Y, Goi T. Efficacy of Long-Term Adjuvant Therapy With Imatinib Mesylate After Extensive Surgical Treatment for Ruptured Gastrointestinal Stromal Tumors of the Small Intestine With Peritoneal Metastases: A Case Report. J Investig Med High Impact Case Rep 2020; 8:2324709620970736. [PMID: 33228387 PMCID: PMC7691891 DOI: 10.1177/2324709620970736] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal
neoplasms of the gastrointestinal tract. Although most patients with
advanced GISTs benefit from imatinib mesylate (IM) as standard
targeted therapy, the optimal duration of adjuvant IM for GIST
patients with high risk of recurrence who underwent surgical resection
remains unknown. In this article, we present a case of a ruptured GIST
of the small intestine accompanied by peritoneal metastases, which was
effectively treated by surgical procedure followed by long-term
adjuvant therapy with IM. Surgical resection was performed for the
ruptured small intestinal GIST, and multitude of peritoneal metastases
were cauterized. The patient received adjuvant therapy with IM (400
mg/day) for 12 years without an interruption or a dose change.
Peritoneal metastatic recurrence was observed by the follow-up
computed tomography scan obtained 12 years after surgery, and surgical
resection of the recurrent GIST was performed. The molecular
examination indicated a KIT exon 11 deletion mutation in both the
primary GIST and recurrent GIST. An additional point mutation was
observed in the recurrent GIST in exon 17 that caused resistance to
IM. The present case might indicate that extensive removal of the
tumor cells through surgery and long-term administration of IM without
an interruption or a dose change were important for achieving improved
recurrence-free survival in patients with ruptured GISTs of the small
intestine with peritoneal metastases.
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Affiliation(s)
- Toshihisa Kimura
- National Hospital Organization Tsuruga Medical Center, Tsuruga, Fukui, Japan
| | - Tamotsu Togawa
- National Hospital Organization Tsuruga Medical Center, Tsuruga, Fukui, Japan
| | - Kenji Onishi
- National Hospital Organization Tsuruga Medical Center, Tsuruga, Fukui, Japan
| | - Atsushi Iida
- National Hospital Organization Tsuruga Medical Center, Tsuruga, Fukui, Japan
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Yasuda K, Nobeyama Y, Ishiji T, Ota A, Asahina A. Effects of imatinib mesylate on cutaneous neurofibromas associated with neurofibromatosis type 1. Clin Case Rep 2020; 8:2125-2128. [PMID: 33235741 PMCID: PMC7669387 DOI: 10.1002/ccr3.3071] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/04/2020] [Indexed: 11/13/2022] Open
Abstract
Imatinib mesylate seemed to inhibit development of cutaneous neurofibromas (c-NFs) and promote growth of pre-existing c-NFs in our neurofibromatosis type 1 case. This report potentially provides new findings in the effects of imatinib mesylate.
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Affiliation(s)
- Ken‐ichi Yasuda
- Department of DermatologyThe Jikei University School of MedicineTokyoJapan
| | - Yoshimasa Nobeyama
- Department of DermatologyThe Jikei University School of MedicineTokyoJapan
| | - Takaoki Ishiji
- Department of DermatologyThe Jikei University School of MedicineTokyoJapan
| | - Arihito Ota
- Department of DermatologyThe Jikei University School of MedicineTokyoJapan
| | - Akihiko Asahina
- Department of DermatologyThe Jikei University School of MedicineTokyoJapan
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Wu TT, Goodarzi H, Wang J, Novoa R, Teng JMC. Imatinib as a potentially effective therapeutic alternative in corticosteroid-resistant eosinophilic fasciitis. Pediatr Dermatol 2020; 37:1171-1172. [PMID: 32970342 DOI: 10.1111/pde.14327] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/02/2020] [Indexed: 12/01/2022]
Abstract
Eosinophilic fasciitis (EF) is a rare condition in children that is typically treated with systemic corticosteroids. We present the case of a 9-year-old boy with biopsy-proven EF, refractory to systemic corticosteroids and methotrexate. The tyrosine kinase inhibitor imatinib was added as adjuvant therapy, leading to improvement in joint function and skin laxity. Our case is the first to suggest the anti-fibrotic properties of imatinib may benefit EF patients.
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Affiliation(s)
- Tiffany T Wu
- Department of Dermatology, Stanford University, Palo Alto, California, USA
| | - Heidi Goodarzi
- Department of Dermatology, Stanford University, Palo Alto, California, USA
| | - Jennifer Wang
- Department of Dermatology, Stanford University, Palo Alto, California, USA
| | - Roberto Novoa
- Department of Dermatology, Stanford University, Palo Alto, California, USA
| | - Joyce M C Teng
- Department of Dermatology, Stanford University, Palo Alto, California, USA
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Gambacorti-Passerini C, Chen C, Davis C, Sen GP, Guyan C, Hehlmann R, Michallet M, Paquette R, Goldberg SL. Treatment patterns and clinical outcomes of tyrosine kinase inhibitors in chronic-phase CML in clinical practice: 3-year European SIMPLICITY data. Eur J Haematol 2020; 106:82-89. [PMID: 32989776 PMCID: PMC7756290 DOI: 10.1111/ejh.13524] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
Objectives SIMPLICITY (NCT01244750) is an observational study of patients with chronic‐phase chronic myeloid leukemia (CP‐CML) in routine clinical practice receiving first‐line tyrosine kinase inhibitors (TKIs). We evaluated TKI treatment changes and how switching affects clinical response in patients recruited in Europe with ≥3 years of follow‐up. Methods The SIMPLICITY European cohort (France, Germany, Italy, the Netherlands, Russia, and Spain) included 431 patients. 370 (86%) were followed for ≥3 years. Results Proportions of patients experiencing treatment interruptions, TKI switching, and discontinuations decreased over 3 years’ follow‐up. Intolerance was a key driver for treatment changes. Complete cytogenetic response (CCyR) was achieved in 87.5% of patients switching TKI within 3 years of initiation vs 91.7% of non‐switchers. Major molecular response (MMR) was achieved in 82.4% of switchers vs 92.9% of non‐switchers. Over 3 years, not switching TKI was a strong predictor for achieving CCyR or MMR (both P < .05). Three‐year survival remained high, irrespective of treatment changes (95.3% switchers, 96.4% non‐switchers). Conclusions European patients with CP‐CML who do not switch TKI are more likely to achieve clinical response, while intolerance is a key driver for switching. Successful CML management may require careful selection of initial TKI, with early monitoring of response and intolerance.
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Affiliation(s)
| | - Clara Chen
- Bristol-Myers Squibb, Princeton, NJ, USA
| | | | | | | | | | | | | | - Stuart L Goldberg
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
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Abstract
RATIONALE Gastrointestinal stromal tumors that present outside the gastrointestinal tract are known for extra-gastrointestinal stromal tumors (EGISTs) and they share the same morphological and immunohistochemical characteristics with gastrointestinal stromal tumors. Here we report a rare case of diffuse primary EGIST arising at peritoneum. PATIENT CONCERNS A 57-year-old male presented to the hospital with abdominal pain and right lower abdominal tenderness. DIAGNOSIS The core needle puncture biopsy showed epithelial-like cells and the nuclei were ovoid and focally elongated. Immunohistochemical examination was consistent with a primary EGIST of the peritoneum. INTERVENTIONS The patient was treated with Imatinib mesylate. OUTCOMES Five months later, there is no complication resulting from treatment. The follow-up abdominal contrast-enhanced CT showed the lesion was significantly decreased in size, and was evaluated as partial response. The patient continued the treatment with Imatinib as prescribed by the oncologist. LESSONS EGISTs are rare and should be considered in the differential diagnosis of the peritoneal tumors and immunohistochemistry helps to confirm the diagnosis. Further study with longer follow-up is desired to characterize these uncommon tumors.
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Affiliation(s)
- Liang-ji Lu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Xiao-pei Xu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Fei Dong
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Jie Min
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, Zhejiang Province, China
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Armstrong AE, Rhodes SD, Smith A, Chen S, Bessler W, Ferguson MJ, Jiang L, Li X, Yuan J, Yang X, Yang FC, Robertson KA, Ingram DA, Blakeley JO, Clapp DW. Early administration of imatinib mesylate reduces plexiform neurofibroma tumor burden with durable results after drug discontinuation in a mouse model of neurofibromatosis type 1. Pediatr Blood Cancer 2020; 67:e28372. [PMID: 32459399 PMCID: PMC7516834 DOI: 10.1002/pbc.28372] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/26/2020] [Accepted: 04/13/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a common genetic disorder characterized by plexiform neurofibromas (pNF), which are thought to be congenital tumors that arise in utero and enlarge throughout life. Genetic studies in murine models delineated an indispensable role for the stem cell factor (SCF)/c-kit pathway in pNF initiation and progression. A subsequent phase 2 clinical trial using imatinib mesylate to inhibit SCF/c-kit demonstrated tumor shrinkage in a subset of preexisting pNF; however, imatinib's role on preventing pNF development has yet to be explored. PROCEDURE We evaluated the effect of imatinib dosed at 10-100 mg/kg/day for 12 weeks to one-month-old Nf1flox/flox ;PostnCre(+) mice, prior to onset of pNF formation. To determine durability of response, we then monitored for pNF growth at later time points, comparing imatinib- with vehicle-treated mice. We assessed gross and histopathological analysis of tumor burden. RESULTS Imatinib administered preventatively led to a significant decrease in pNF number, even at doses as low as 10 mg/kg/day. Tumor development continued to be significantly inhibited after cessation of imatinib dosed at 50 and 100 mg/kg/day. In the cohort of treated mice that underwent prolonged follow-up, the size of residual tumors was significantly reduced as compared with age-matched littermates that received vehicle control. CONCLUSIONS Early administration of imatinib inhibits pNF genesis in vivo, and effects are sustained after discontinuation of therapy. These findings may guide clinical use of imatinib in young NF1 patients prior to the substantial development of pNF.
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Affiliation(s)
- Amy E. Armstrong
- Division of Pediatric Hematology/Oncology, Riley Hospital for Children, Indianapolis, Indiana,Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Steven D. Rhodes
- Division of Pediatric Hematology/Oncology, Riley Hospital for Children, Indianapolis, Indiana,Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Abbi Smith
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Shi Chen
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Waylan Bessler
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Michael J. Ferguson
- Division of Pediatric Hematology/Oncology, Riley Hospital for Children, Indianapolis, Indiana,Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Li Jiang
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Xiaohong Li
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Jin Yuan
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Xianlin Yang
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Feng-Chun Yang
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana,Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kent A. Robertson
- Division of Pediatric Hematology/Oncology, Riley Hospital for Children, Indianapolis, Indiana,Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - David A. Ingram
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana
| | - Jaishri O. Blakeley
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - D. Wade Clapp
- Department of Pediatrics, Herman B. Wells Center for Pediatric Research, Indianapolis, Indiana,Correspondence should be addressed to: D. Wade Clapp, M.D., Richard L. Schreiner Professor and Chairman, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Dr., Room 5900, Indianapolis, IN 46202, Phone: (317) 944-7810 Office,
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Zhang Y, Wang Y, Zhang L, Xia L, Zheng M, Zeng Z, Liu Y, Yarovinsky T, Ostriker AC, Fan X, Weng K, Su M, Huang P, Martin KA, Hwa J, Tang WH. Reduced Platelet miR-223 Induction in Kawasaki Disease Leads to Severe Coronary Artery Pathology Through a miR-223/PDGFRβ Vascular Smooth Muscle Cell Axis. Circ Res 2020; 127:855-873. [PMID: 32597702 DOI: 10.1161/circresaha.120.316951] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
RATIONALE Kawasaki disease (KD) is an acute vasculitis of early childhood that can result in permanent coronary artery structural damage. The cause for this arterial vulnerability in up to 15% of patients with KD is unknown. Vascular smooth muscle cell dedifferentiation play a key role in the pathophysiology of medial damage and aneurysm formation, recognized arterial pathology in KD. Platelet hyperreactivity is also a hallmark of KD. We recently demonstrated that uptake of platelets and platelet-derived miRNAs influences vascular smooth muscle cell phenotype in vivo. OBJECTIVE We set out to explore whether platelet/vascular smooth muscle cell (VSMC) interactions contribute to coronary pathology in KD. METHODS AND RESULTS We prospectively recruited and studied 242 patients with KD, 75 of whom had documented coronary artery pathology. Genome-wide miRNA sequencing and droplet digital PCR demonstrated that patient with KD platelets have significant induction of miR-223 compared with healthy controls (HCs). Platelet-derived miR-223 has recently been shown to promote vascular smooth muscle quiescence and resolution of wound healing after vessel injury. Paradoxically, patients with KD with the most severe coronary pathology (giant coronary artery aneurysms) exhibited a lack of miR-223 induction. Hyperactive platelets isolated from patients with KD are readily taken up by VSMCs, delivering functional miR-223 into the VSMCs promoting VSMC differentiation via downregulation of PDGFRβ (platelet-derived growth factor receptor β). The lack of miR-223 induction in patients with severe coronary pathology leads to persistent VSMC dedifferentiation. In a mouse model of KD (Lactobacillus casei cell wall extract injection), miR-223 knockout mice exhibited increased medial thickening, loss of contractile VSMCs in the media, and fragmentation of medial elastic fibers compared with WT mice, which demonstrated significant miR-223 induction upon Lactobacillus casei cell wall extract challenge. The excessive arterial damage in the miR-223 knockout could be rescued by adoptive transfer of platelet, administration of miR-223 mimics, or the PDGFRβ inhibitor imatinib mesylate. Interestingly, miR-223 levels progressively increase with age, with the lowest levels found in <5-year-old. This provides a basis for coronary pathology susceptibility in this very young cohort. CONCLUSIONS Platelet-derived miR-223 (through PDGFRβ inhibition) promotes VSMC differentiation and resolution of KD induced vascular injury. Lack of miR-223 induction leads to severe coronary pathology characterized by VSMC dedifferentiation and medial damage. Detection of platelet-derived miR-223 in patients with KD (at the time of diagnosis) may identify patients at greatest risk of coronary artery pathology. Moreover, targeting platelet miR-223 or VSMC PDGFRβ represents potential therapeutic strategies to alleviate coronary pathology in KD. Graphic Abstract: A graphic abstract is available for this article.
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Affiliation(s)
- Yuan Zhang
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Yanfei Wang
- Department of Cardiology (Y.W., L.Z., P.H.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Li Zhang
- Department of Cardiology (Y.W., L.Z., P.H.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Luoxing Xia
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Minhui Zheng
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Zhi Zeng
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Yingying Liu
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Timur Yarovinsky
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (T.Y., A.C.O., K.A.M., J.H.)
| | - Allison C Ostriker
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (T.Y., A.C.O., K.A.M., J.H.)
| | - Xuejiao Fan
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Kai Weng
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Meiling Su
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Ping Huang
- Department of Cardiology (Y.W., L.Z., P.H.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
| | - Kathleen A Martin
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (T.Y., A.C.O., K.A.M., J.H.)
| | - John Hwa
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (T.Y., A.C.O., K.A.M., J.H.)
| | - Wai Ho Tang
- From the Institute of Pediatrics (Y.Z., L.X., M.Z., Z.Z., Y.L., X.F., K.W., M.S., W.H.T.), Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, China
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Huang W, Li J, Qiu F, Wu X, Zhang J, Li X, Yao G, Zhu S. Therapeutic drug monitoring-based dose optimization for imatinib-associated serious cutaneous reactions in a patient with gastrointestinal stromal tumours: A case report. J Clin Pharm Ther 2020; 45:856-862. [PMID: 32479700 DOI: 10.1111/jcpt.13201] [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: 12/23/2019] [Revised: 03/24/2020] [Accepted: 05/14/2020] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Imatinib mesylate (IM) is the first-line therapy for unresectable or metastatic gastrointestinal stromal tumours (GISTs). Here, we report a case of successful progressive dose optimization by therapeutic drug monitoring (TDM) for a patient with GISTs who developed IM-associated serious cutaneous reactions. CASE DESCRIPTION A 72-year-old female patient received IM at a dose of 400 mg/day for GISTs. The patient developed serious eczematoid drug eruptions and desquamation, following which IM was discontinued. One year later, the GISTs recurred with metastasis, and IM was re-administered at a dose of 100 mg/day, and the dose was gradually increased on the basis of TDM. The final dose of IM was 200 mg/day, and the trough concentration (Ctrough ) of IM was 1457.76 ng/mL. The images obtained from follow-up computed tomography (CT) showed a marked anti-tumour response. IM was well tolerated and the patient developed tolerable IM-associated cutaneous reactions. WHAT IS NEW AND CONCLUSION The strategy of TDM-guided dose optimization makes it possible to achieve optimal clinical efficacy for patients with GISTs who develop IM-associated serious cutaneous reactions.
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Affiliation(s)
- Wanting Huang
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Li
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Qiu
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingye Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Pharmacy, Chongqing Health Center for Women and Children, Chongqing, China
| | - Gaoqiong Yao
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shenyin Zhu
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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El-Sisi AE, Sokkar SS, Ibrahim HA, Hamed MF, Abu-Risha SE. Targeting MDR-1 gene expression, BAX/BCL2, caspase-3, and Ki-67 by nanoencapsulated imatinib and hesperidin to enhance anticancer activity and ameliorate cardiotoxicity. Fundam Clin Pharmacol 2020; 34:458-475. [PMID: 32080901 DOI: 10.1111/fcp.12549] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 08/02/2019] [Revised: 02/08/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022]
Abstract
There is a great demand to introduce new approaches into cancer treatment field due to incidence of increased breast cancer all over the world. The current study was designed to evaluate the role of imatinib mesylate (IM) and/or hesperidin (HES) nanoparticles alone or in combination in enhancing the anticancer activity and to investigate the ability of nanoencapsulation to reduce cardiotoxicity of IM in solid Ehrlich carcinoma (SEC)-bearing mice. IM and HES were loaded into PLGA (poly(lactic-co-glycolic acid) polymer. SEC was induced in female albino mice as a model for experimentally induced breast cancer. Mice were randomly divided into eight groups (n = 10). On day 28 from tumor inoculation, mice were sacrificed and blood samples were collected in heparinized tubes for hematological studies, biochemical determination of lactate dehydrogenase (LDH), and glutamic oxaloacetic transaminase (SGOT) levels. In addition, tumor and cardiac tissues were utilized for histopathological examination as well as determination of MDR-1 gene expression. Immunohistochemical staining of BAX and BCL-2 was done. Nano IM- and/or Nano HES-treated groups showed a significant reduction in tumor volume, weight, hematological, cardiac markers, and tumor MDR-1 gene downregulation compared to free conventional treated groups. In conclusion, the use of HES as an adjuvant therapy with IM could improve its cytotoxic effects and limit its cardiac toxicity. Furthermore, nanoencapsulation of IM and/or HES with PLGA polymer showed a remarkable anticancer activity.
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Affiliation(s)
- Alaa E El-Sisi
- Pharmacology and Toxicology department, College of Pharmacy, University of Tanta, Tanta, Egypt
| | - Samia S Sokkar
- Pharmacology and Toxicology department, College of Pharmacy, University of Tanta, Tanta, Egypt
| | - Hanaa A Ibrahim
- Pharmacology and Toxicology department, College of Pharmacy, University of Tanta, Tanta, Egypt
| | - Mohamed F Hamed
- Department of Pathology, College of Veterinary Medicine, University of El-Mansoura, Mansoura, Egypt
| | - Sally E Abu-Risha
- Pharmacology and Toxicology department, College of Pharmacy, University of Tanta, Tanta, Egypt
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