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Comparable efficacy of oral bendamustine versus intravenous administration in treating hematologic malignancies. 口服苯达莫司汀与静脉注射治疗血液恶性肿瘤的疗效相当。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-15 DOI: 10.1007/s00280-024-04688-y
Megan J Cracchiolo, Lisa Davis, Andrew P Matiatos, Dan W Davini, Muhammad Husnain, Richard J Simpson, Vasilios Voudouris, Emmanuel Katsanis

Purpose: The purpose of this study was to analyze potential differences in antitumor efficacy and pharmacokinetics between intravenous (IV) bendamustine and a novel orally administered (PO) bendamustine agent that is utilizing the beneficial properties of superstaturated solid dispersions formulated in nanoparticles.

Methods: Pharmacokinetics of IV versus PO bendamustine were determined by analysis of plasma samples collected from NSG mice treated with either IV or PO bendamustine. Plasma samples were analyzed using liquid chromatography-mass spectrometry following a liquid-liquid extraction to determine peak bendamustine concentration, area under the concentration-time curve, and the half-life in-vivo. In-vitro cytotoxicity of bendamustine against human non-Hodgkin Burkitt's Lymphoma (Raji), multiple myeloma (MM.1s), and B-cell acute lymphoblastic leukemia (RS4;11) cell lines was determined over time using MTS assays. Luciferase-tagged versions of the aforementioned cell lines were used to determine in-vivo bendamustine cytotoxicity of IV versus PO bendamustine at two different doses.

Results: Bendamustine at a high dose in-vitro causes cell death. There was no significant difference in antitumor activity between IV and novel PO bendamustine at a physiologically relevant concentration in all three xenograft models. In-vivo pharmacokinetics showed the oral bioavailability of bendamustine in mice to be 51.4%.

Conclusions: The novel oral bendamustine agent tested exhibits good oral bioavailability and systemic exposure for in-vivo antitumor efficacy comparable to IV bendamustine. An oral bendamustine formulation offers exciting clinical potential as an additional method of administration for bendamustine and warrants further evaluation in clinical studies.

目的:本研究旨在分析静脉注射(IV)苯达莫司汀与新型口服(PO)苯达莫司汀制剂在抗肿瘤疗效和药代动力学方面的潜在差异:通过分析从接受静脉注射或口服苯达莫司汀治疗的 NSG 小鼠身上采集的血浆样本,确定静脉注射与口服苯达莫司汀的药代动力学。血浆样本经液-液萃取后使用液相色谱-质谱法进行分析,以确定体内苯达莫司汀的峰值浓度、浓度-时间曲线下面积和半衰期。利用 MTS 检测法测定了苯达莫司汀对人类非霍奇金伯基特淋巴瘤(Raji)、多发性骨髓瘤(MM.1s)和 B 细胞急性淋巴细胞白血病(RS4;11)细胞株的体外细胞毒性。上述细胞系的荧光素酶标记版本被用来测定两种不同剂量的静脉注射与口服苯达莫司汀的体内细胞毒性:结果:高剂量苯达莫司汀在体外可导致细胞死亡。在所有三种异种移植模型中,生理相关浓度的静脉注射和新型口服苯达莫司汀的抗肿瘤活性没有明显差异。体内药代动力学显示,小鼠口服苯达莫司汀的生物利用度为 51.4%:结论:测试的新型口服苯达莫司汀制剂具有良好的口服生物利用度和全身暴露,体内抗肿瘤疗效与静脉注射苯达莫司汀相当。作为苯达莫司汀的另一种给药方法,口服苯达莫司汀制剂具有令人振奋的临床潜力,值得在临床研究中进一步评估。
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引用次数: 0
A sub-pharmacological test dose does not predict individual docetaxel exposure in prostate cancer patients. 亚药理试验剂量无法预测前列腺癌患者的多西他赛暴露量。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-29 DOI: 10.1007/s00280-024-04684-2
Marise R Heerma van Voss, Jessica Notohardjo, Joyce van Dodewaard-de Jong, Haiko J Bloemendal, Rob Ter Heine

Purpose: Docetaxel is a cytotoxic drug used for first-line treatment of various malignancies. It has a narrow therapeutic index and shows wide interpatient variability in clearance and toxicity. Tools for individual dose optimization are needed to maximize efficacy and avoid toxicity.

Methods: We performed a proof-of-concept study (EudraCT 2016-003785-77) to evaluate whether pharmacokinetics after a sub-pharmacological test dose of 1000 µg docetaxel (millidose) could be used to predict therapeutic dose exposure. Thirty prostate cancer patients eligible for treatment with docetaxel as part of routine clinical care were included. An intravenous docetaxel millidose was administered 1-7 days prior to therapeutic docetaxel. After both doses plasma docetaxel concentrations were measured by ultra- high performance liquid chromatography-tandem mass spectrometry. The docetaxel clearance was estimated with non-linear mixed effects modeling.

Results: Geometric mean docetaxel clearance was 57.9 L/h (GCV 78.6%) after admission of a millidose and 40.3 L/h (GCV 60.7%) after admission of a therapeutic dose. The millidose and therapeutic dose in a single patient were not significantly correlated (Spearman's rho R = 0.02, P = 0.92).

Conclusion: Docetaxel pharmacokinetics at milli- and therapeutic dose level showed insufficient correlation for individual dose optimization. However, the clearance of a docetaxel millidose and full dose are within the same order of magnitude. Therefore, docetaxel millidose pharmacokinetics could potentially facilitate prediction of docetaxel pharmacokinetics at a population level in situations where therapeutic dose levels are impractical, such as pharmacokinetic drug-drug interaction studies or pediatric studies.

目的:多西他赛是一种细胞毒性药物,用于各种恶性肿瘤的一线治疗。多西他赛的治疗指数较窄,患者间的清除率和毒性差异较大。为了最大限度地提高疗效和避免毒性,需要有个体剂量优化工具:我们进行了一项概念验证研究(EudraCT 2016-003785-77),以评估1000微克多西他赛(毫剂量)亚药理学试验剂量后的药代动力学是否可用于预测治疗剂量暴露。研究纳入了 30 名符合常规临床治疗条件的多西他赛前列腺癌患者。在多西他赛治疗前 1-7 天静脉注射多西他赛毫剂量。两次给药后,通过超高效液相色谱-串联质谱法测量血浆中多西他赛的浓度。采用非线性混合效应模型估算多西他赛清除率:几何平均多西他赛清除率在服用毫剂量后为 57.9 升/小时(GCV 78.6%),在服用治疗剂量后为 40.3 升/小时(GCV 60.7%)。单个患者的毫剂量和治疗剂量无明显相关性(Spearman's rho R = 0.02,P = 0.92):多西他赛的药代动力学在毫剂量和治疗剂量水平上显示出的相关性不足以优化个体剂量。然而,多西他赛毫剂量和全剂量的清除率在同一数量级。因此,多西他赛毫剂量药代动力学可能有助于在治疗剂量水平不切实际的情况下,如药代动力学药物相互作用研究或儿科研究中,预测多西他赛在群体水平的药代动力学。
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引用次数: 0
A joint model of longitudinal pharmacokinetic and time-to-event data to study exposure-response relationships: a proof-of-concept study with alectinib. 研究暴露-反应关系的纵向药代动力学和时间-事件数据联合模型:阿来替尼的概念验证研究。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI: 10.1007/s00280-024-04698-w
Lishi Lin, Vincent van der Noort, Neeltje Steeghs, Gerrina Ruiter, Jos H Beijnen, Alwin D R Huitema

Purpose: In exposure-response analyses of oral targeted anticancer agents, longitudinal plasma trough concentrations are often aggregated into a single value even though plasma trough concentrations can vary over time due to dose adaptations, for example. The aim of this study was to compare joint models to conventional exposure-response analyses methods with the application of alectinib as proof-of-concept.

Methods: Joint models combine longitudinal pharmacokinetic data and progression-free survival data to infer the dependency and association between the two datatypes. The results from the best joint model and the standard and time-dependent cox proportional hazards models were compared. To normalize the data, alectinib trough concentrations were normalized using a sigmoidal transformation to transformed trough concentrations (TTC) before entering the models.

Results: No statistically significant exposure-response relationship was observed in the different Cox models. In contrast, the joint model with the current value of TTC in combination with the average TTC over time did show an exposure-response relationship for alectinib. A one unit increase in the average TTC corresponded to an 11% reduction in progression (HR, 0.891; 95% confidence interval, 0.805-0.988).

Conclusion: Joint models are able to give insights in the association structure between plasma trough concentrations and survival outcomes that would otherwise not be possible using Cox models. Therefore, joint models should be used more often in exposure-response analyses of oral targeted anticancer agents.

目的:在口服靶向抗癌药物的暴露-反应分析中,纵向血浆谷浓度通常被汇总为一个单一值,即使血浆谷浓度会因剂量适应性等因素而随时间变化。本研究的目的是将联合模型与传统的暴露-反应分析方法进行比较,并应用阿来替尼作为概念验证:联合模型结合了纵向药代动力学数据和无进展生存期数据,以推断两种数据类型之间的依赖性和关联性。比较了最佳联合模型和标准与时间相关的 cox 比例危险度模型的结果。为了对数据进行归一化处理,阿来替尼的谷值浓度在进入模型前使用西格玛转换法归一化为转化谷值浓度(TTC):结果:在不同的Cox模型中均未观察到具有统计学意义的暴露-反应关系。相反,将 TTC 的当前值与一段时间内的平均 TTC 相结合的联合模型确实显示出阿来替尼的暴露-反应关系。平均TTC每增加一个单位,病情进展率就会降低11%(HR,0.891;95%置信区间,0.805-0.988):联合模型能够揭示血浆谷浓度与生存结果之间的关联结构,而使用 Cox 模型则无法做到这一点。因此,在口服靶向抗癌药的暴露-反应分析中应更多地使用联合模型。
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引用次数: 0
Regorafenib plus FOLFIRINOX as first-line treatment for patients with RAS-mutant metastatic colorectal cancer (FOLFIRINOX-R trial): a dose-escalation study. 瑞戈非尼加 FOLFIRINOX 作为 RAS 突变转移性结直肠癌患者的一线治疗(FOLFIRINOX-R 试验):一项剂量递增研究。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-07-10 DOI: 10.1007/s00280-024-04682-4
Antoine Adenis, François Ghiringhelli, Ludovic Gauthier, Thibault Mazard, Ludovic Evesque, Alexandre Evrard, Patrick Chalbos, Aurore Moussion, Sophie Gourgou, Marc Ychou

Purpose: The combination of bevacizumab and FOLFIRINOX is used in patients with RAS-mutant metastatic colorectal cancer (RASm-mCRC). Regorafenib, an oral multi-tyrosine kinase inhibitor, has antiangiogenic properties, cytostatic effects and also true cytotoxic effects, unlike bevacizumab. The aim of this study was to determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of the regorafenib-FOLFIRINOX combination in patients with RASm-mCRC.

Methods: The FOLFIRINOX-R trial was a phase 1/2 study where the dose-escalation part (3 + 3 design with three dose levels, DLs) was completed before its early termination. FOLFIRINOX (14-day cycle) included oxaliplatin (standard dose), folinic acid, fluorouracil and irinotecan (150 or 180 mg/m²). Regorafenib (120 or 160 mg daily) was given from day 4 to day 10 of each cycle. Dose-limiting toxicity (DLT) was studied in the first three cycles. Eligibility criteria included ECOG performance status ≤ 1 and not previously treated RASm-mCRC.

Results: Thirteen patients (median age: 65 years; min-max: 40-76) were enrolled. DLT could not be evaluated in one patient (DL3) due to poor observance. The median treatment duration and median follow-up were 6.2 (min-max: 2.3-10) and 13.4 (min-max: 3.8-18.0) months, respectively. Dose was modified in 12/13 (92%) patients. One grade 3 hypokalemia occurred at DL2. MTD was not reached at DL3. Grade 3 diarrhea was recorded in 7/13 patients (13 events) equally distributed in all DLs.

Conclusion: The RP2D for this regorafenib-FFX combination could not be determined due to a high prevalence of grade 3 diarrhea related to treatment as advised by our Independent Data Monitoring Committee.

Trial registration numbers: ClinicalTrials.gov : NCT03828799.

目的:贝伐珠单抗和 FOLFIRINOX 联合疗法适用于 RAS 突变转移性结直肠癌(RASm-mCRC)患者。瑞戈非尼是一种口服多酪氨酸激酶抑制剂,与贝伐珠单抗不同,它具有抗血管生成特性、细胞抑制作用和真正的细胞毒性作用。本研究旨在确定瑞戈非尼-FOLFIRINOX联合疗法在RASm-mCRC患者中的最大耐受剂量(MTD)和二期推荐剂量(RP2D):FOLFIRINOX-R试验是一项1/2期研究,其剂量递增部分(3+3设计,三个剂量水平,DLs)在提前终止前已经完成。FOLFIRINOX(14天周期)包括奥沙利铂(标准剂量)、亚叶酸、氟尿嘧啶和伊立替康(150或180毫克/平方米)。瑞戈非尼(每天120或160毫克)在每个周期的第4天至第10天服用。前三个周期研究剂量限制性毒性(DLT)。入选标准包括ECOG表现状态≤1和既往未接受过RASm-mCRC治疗:13名患者(中位年龄:65岁;最小-最大年龄:40-76岁)入组。一名患者(DL3)的DLT因观察不佳而无法评估。中位治疗时间和中位随访时间分别为 6.2 个月(最短:2.3-10 个月)和 13.4 个月(最短:3.8-18.0 个月)。12/13(92%)名患者的剂量有所调整。DL2时出现了1例3级低钾血症。DL3 时未达到 MTD。7/13例患者出现3级腹泻(13例),平均分布于所有DLs:结论:根据独立数据监控委员会的建议,由于与治疗相关的3级腹泻发生率较高,因此无法确定瑞戈非尼-FFX联合疗法的RP2D:ClinicalTrials.gov : NCT03828799。
{"title":"Regorafenib plus FOLFIRINOX as first-line treatment for patients with RAS-mutant metastatic colorectal cancer (FOLFIRINOX-R trial): a dose-escalation study.","authors":"Antoine Adenis, François Ghiringhelli, Ludovic Gauthier, Thibault Mazard, Ludovic Evesque, Alexandre Evrard, Patrick Chalbos, Aurore Moussion, Sophie Gourgou, Marc Ychou","doi":"10.1007/s00280-024-04682-4","DOIUrl":"10.1007/s00280-024-04682-4","url":null,"abstract":"<p><strong>Purpose: </strong>The combination of bevacizumab and FOLFIRINOX is used in patients with RAS-mutant metastatic colorectal cancer (RASm-mCRC). Regorafenib, an oral multi-tyrosine kinase inhibitor, has antiangiogenic properties, cytostatic effects and also true cytotoxic effects, unlike bevacizumab. The aim of this study was to determine the maximum tolerated dose (MTD) and the recommended phase 2 dose (RP2D) of the regorafenib-FOLFIRINOX combination in patients with RASm-mCRC.</p><p><strong>Methods: </strong>The FOLFIRINOX-R trial was a phase 1/2 study where the dose-escalation part (3 + 3 design with three dose levels, DLs) was completed before its early termination. FOLFIRINOX (14-day cycle) included oxaliplatin (standard dose), folinic acid, fluorouracil and irinotecan (150 or 180 mg/m²). Regorafenib (120 or 160 mg daily) was given from day 4 to day 10 of each cycle. Dose-limiting toxicity (DLT) was studied in the first three cycles. Eligibility criteria included ECOG performance status ≤ 1 and not previously treated RASm-mCRC.</p><p><strong>Results: </strong>Thirteen patients (median age: 65 years; min-max: 40-76) were enrolled. DLT could not be evaluated in one patient (DL3) due to poor observance. The median treatment duration and median follow-up were 6.2 (min-max: 2.3-10) and 13.4 (min-max: 3.8-18.0) months, respectively. Dose was modified in 12/13 (92%) patients. One grade 3 hypokalemia occurred at DL2. MTD was not reached at DL3. Grade 3 diarrhea was recorded in 7/13 patients (13 events) equally distributed in all DLs.</p><p><strong>Conclusion: </strong>The RP2D for this regorafenib-FFX combination could not be determined due to a high prevalence of grade 3 diarrhea related to treatment as advised by our Independent Data Monitoring Committee.</p><p><strong>Trial registration numbers: </strong>ClinicalTrials.gov : NCT03828799.</p>","PeriodicalId":9556,"journal":{"name":"Cancer Chemotherapy and Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a novel nomogram for predicting delayed methotrexate excretion following high-dose methotrexate in adult patients with hematologic malignancies. 为预测成年血液系统恶性肿瘤患者在使用大剂量甲氨蝶呤后的甲氨蝶呤延迟排泄量而开发的新型提名图。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-21 DOI: 10.1007/s00280-024-04687-z
Daisuke Ikeda, Tatsuya Isezaki, Kentaro Narita, Satoshi Yuyama, Mitsuaki Oura, Atsushi Uehara, Rikako Tabata, Masami Takeuchi, Kosei Matsue

Purpose: High-dose methotrexate (HDMTX) is integral in treating hematologic malignancies but carries risks of severe toxicities due to prolonged MTX exposure. However, knowledge of delayed MTX excretion is primarily derived from pediatric and adolescent cohorts, with the reported predictors being presented as rough dichotomous values. This study aimed to identify risk factors for delayed MTX excretion exclusively in adult patients with hematologic malignancies and develop a more applicable predictive nomogram based on continuous clinical and laboratory variables.

Methods: 517 HDMTX cycles in 194 patients were retrospectively analyzed. Delayed MTX excretion was defined as either MTX concentration ≥ 1.0 µmol/L at 48 h or ≥ 0.1 µmol/L at 72 h after HDMTX initiation. Multivariate logistic regression analysis was used to construct the nomogram internally validated with the bootstrap method.

Results: Delayed MTX excretion was observed in 24.0% of cycles. Six significant predictors were identified: relapsed/refractory disease (Odds ratio [OR] 2.03), fewer HDMTX cycles (OR 0.771), treatment intent (OR 2.13), lower albumin (OR 0.563) and creatinine clearance levels (OR 0.993), and increased γ-glutamyl transpeptidase levels (OR 1.004, all P < 0.05). These were incorporated into a web-based nomogram as continuous variables with good prediction accuracy (area under the curve, 0.73) and without significant overfitting. Delayed MTX excretion increased risks of developing acute kidney injury, even solely at the 72 h timepoint (OR 2.57, P = 0.025), without providing any benefit of clinical outcomes.

Conclusion: This study comprehensively characterized MTX elimination failure following HDMTX in adult patients and could pave the way for individualized risk prediction.

目的:大剂量甲氨蝶呤(HDMTX)是治疗血液系统恶性肿瘤不可或缺的药物,但由于MTX暴露时间过长,存在严重毒性的风险。然而,有关MTX排泄延迟的知识主要来自儿科和青少年队列,所报告的预测因素均为粗略的二分法值。本研究旨在确定血液恶性肿瘤成人患者MTX排泄延迟的风险因素,并根据连续的临床和实验室变量制定更适用的预测提名图。方法:对194名患者的517个HDMTX周期进行了回顾性分析。MTX延迟排泄的定义是:开始使用HDMTX后48小时内MTX浓度≥1.0 µmol/L或72小时内MTX浓度≥0.1 µmol/L。多变量逻辑回归分析用于构建提名图,并通过引导法进行了内部验证:24.0%的周期观察到MTX排泄延迟。结果:在 24.0% 的周期中观察到 MTX 排泄延迟,发现了六个重要的预测因素:复发/难治性疾病(Odds ratio [OR] 2.03)、较少的 HDMTX 周期(OR 0.771)、治疗意图(OR 2.13)、较低的白蛋白(OR 0.563)和肌酐清除率水平(OR 0.993)以及γ-谷氨酰转肽酶水平升高(OR 1.004,均为 P):本研究全面描述了成年患者在接受 HDMTX 治疗后 MTX 清除失败的特征,可为个体化风险预测铺平道路。
{"title":"Development of a novel nomogram for predicting delayed methotrexate excretion following high-dose methotrexate in adult patients with hematologic malignancies.","authors":"Daisuke Ikeda, Tatsuya Isezaki, Kentaro Narita, Satoshi Yuyama, Mitsuaki Oura, Atsushi Uehara, Rikako Tabata, Masami Takeuchi, Kosei Matsue","doi":"10.1007/s00280-024-04687-z","DOIUrl":"10.1007/s00280-024-04687-z","url":null,"abstract":"<p><strong>Purpose: </strong>High-dose methotrexate (HDMTX) is integral in treating hematologic malignancies but carries risks of severe toxicities due to prolonged MTX exposure. However, knowledge of delayed MTX excretion is primarily derived from pediatric and adolescent cohorts, with the reported predictors being presented as rough dichotomous values. This study aimed to identify risk factors for delayed MTX excretion exclusively in adult patients with hematologic malignancies and develop a more applicable predictive nomogram based on continuous clinical and laboratory variables.</p><p><strong>Methods: </strong>517 HDMTX cycles in 194 patients were retrospectively analyzed. Delayed MTX excretion was defined as either MTX concentration ≥ 1.0 µmol/L at 48 h or ≥ 0.1 µmol/L at 72 h after HDMTX initiation. Multivariate logistic regression analysis was used to construct the nomogram internally validated with the bootstrap method.</p><p><strong>Results: </strong>Delayed MTX excretion was observed in 24.0% of cycles. Six significant predictors were identified: relapsed/refractory disease (Odds ratio [OR] 2.03), fewer HDMTX cycles (OR 0.771), treatment intent (OR 2.13), lower albumin (OR 0.563) and creatinine clearance levels (OR 0.993), and increased γ-glutamyl transpeptidase levels (OR 1.004, all P < 0.05). These were incorporated into a web-based nomogram as continuous variables with good prediction accuracy (area under the curve, 0.73) and without significant overfitting. Delayed MTX excretion increased risks of developing acute kidney injury, even solely at the 72 h timepoint (OR 2.57, P = 0.025), without providing any benefit of clinical outcomes.</p><p><strong>Conclusion: </strong>This study comprehensively characterized MTX elimination failure following HDMTX in adult patients and could pave the way for individualized risk prediction.</p>","PeriodicalId":9556,"journal":{"name":"Cancer Chemotherapy and Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: An IQ consortium analysis of starting dose selection for oncology small molecule first‑in‑patient trials suggests an alternative NOAEL‑based method can be safe while reducing time to the recommended phase 2 dose. 更正:IQ联盟对肿瘤学小分子首次患者试验起始剂量选择的分析表明,一种基于NOAEL的替代方法是安全的,同时可以将时间缩短到推荐的2期剂量。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1007/s00280-023-04595-8
Bart A Jessen, Paul Cornwell, Sean Redmond, Thomas Visalli, Marie Lemper, Todd Bunch, Timothy Hart
{"title":"Correction to: An IQ consortium analysis of starting dose selection for oncology small molecule first‑in‑patient trials suggests an alternative NOAEL‑based method can be safe while reducing time to the recommended phase 2 dose.","authors":"Bart A Jessen, Paul Cornwell, Sean Redmond, Thomas Visalli, Marie Lemper, Todd Bunch, Timothy Hart","doi":"10.1007/s00280-023-04595-8","DOIUrl":"10.1007/s00280-023-04595-8","url":null,"abstract":"","PeriodicalId":9556,"journal":{"name":"Cancer Chemotherapy and Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41112227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantitative characterization of the effects of fulvestrant alone or in combination with taselisib (PI3Kinase inhibitor) on longitudinal tumor growth in patients with estrogen receptor-positive, HER2-negative, PIK3CA-mutant, advanced or metastatic breast cancer. 对雌激素受体阳性、HER2阴性、PIK3CA突变的晚期或转移性乳腺癌患者单独使用氟维司群或与他赛利西布(PI3Kinase抑制剂)联合使用对纵向肿瘤生长的影响进行定量分析。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-27 DOI: 10.1007/s00280-024-04690-4
Anita Moein, Jin Y Jin, Matthew R Wright, Harvey Wong

Purpose: Among cases of breast cancer, estrogen receptor-positive (ER +), PIK3CA-mutant, HER2- advanced breast cancer stands as a particularly complex clinical indication where approximately 40% of ER + /HER2- breast carcinomas present mutations in the PIK3CA gene. A significant hurdle in treating ER + breast cancer lies in surmounting the challenges of endocrine resistance. In the clinical setting, a multifaceted approach is essential for this indication, one that not only explores the effectiveness of individual treatments but also delves into the potential gains in therapeutic outcome from combination therapies.

Methods: In the current study, longitudinal tumor growth inhibition (TGI) models were developed to characterize tumor response over time in postmenopausal women with ER + /HER2- advanced or metastatic breast cancer undergoing treatment with fulvestrant alone or in combination with the PI3K inhibitor, taselisib. Impact of clinically relevant covariates on TGI metrics was assessed to identify patient subsets most likely to benefit from treatment with fulvestrant monotherapy or combination with taselisib.

Results: Tumor growth rate constant (Kg) was found to increase with increasing baseline tumor size and in the absence of baseline endocrine sensitivity. Further, Kg decreased in the absence of baseline liver metastases both in fulvestrant monotherapy and combination therapy with taselisib. Overall, additive/potentially synergistic anti-tumor effects were observed in patients treated with the taselisib-fulvestrant combination.

Conclusion: These results have important implications for understanding the therapeutic impact of combination treatment approaches and individualized responses to these treatments. Finally, this work, emphasizes the importance of model informed drug development for targeted cancer therapy.

Clinical trial registration: NCT02340221 Registered January 16, 2015, NCT01296555 Registered February 14, 2011.

目的:在乳腺癌病例中,雌激素受体阳性(ER +)、PIK3CA 基因突变、HER2-晚期乳腺癌是一种特别复杂的临床指征,约 40% 的 ER + /HER2- 乳腺癌存在 PIK3CA 基因突变。治疗 ER + 乳腺癌的一个重要障碍在于克服内分泌耐药性的挑战。在临床环境中,对这一适应症采取多方面的方法至关重要,不仅要探索单个疗法的有效性,还要深入研究联合疗法可能带来的治疗效果:在目前的研究中,我们建立了纵向肿瘤生长抑制(TGI)模型,以描述ER+/HER2-晚期或转移性乳腺癌绝经后女性患者在接受氟维司群单独治疗或与PI3K抑制剂他赛利西联合治疗后随着时间推移的肿瘤反应。评估了临床相关协变量对TGI指标的影响,以确定最有可能从氟维司群单药治疗或与他赛利西布联合治疗中获益的患者亚群:结果发现,肿瘤生长速率常数(Kg)会随着基线肿瘤大小的增加而增加,并且在没有基线内分泌敏感性的情况下也是如此。此外,无论是氟维司群单药治疗还是与他赛利西联合治疗,在没有基线肝转移的情况下,Kg都会降低。总之,在接受他赛利西布-氟维司群联合治疗的患者中观察到了相加/潜在的协同抗肿瘤效应:这些结果对于理解联合治疗方法的治疗效果以及对这些治疗方法的个体化反应具有重要意义。最后,这项工作强调了针对癌症靶向治疗的模型药物开发的重要性:NCT02340221 注册日期:2015年1月16日;NCT01296555 注册日期:2011年2月14日。
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引用次数: 0
Immunoregulatory cyclophilin a improves low-dose chemotherapy with a modulation of the immune tumor microenvironment in experimental models of melanoma B16 and lymphoma EL4 in vivo. 在体内黑色素瘤 B16 和淋巴瘤 EL4 的实验模型中,免疫调节环嗜蛋白 a 可通过调节免疫肿瘤微环境来改善低剂量化疗。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.1007/s00280-024-04691-3
Anastasiia A Kalinina, Leila R Tilova, Dmitry B Kazansky, Ludmila M Khromykh

Purpose: Different regimens of low-dose chemotherapy (LDC) are currently being actively developed and introduced into clinical practice. Along with its obvious advantages compared to conventional chemotherapy (low toxicity, prevention of drug resistance), LDC could also stimulate anti-tumor immune responses in a patient by activating effectors of innate and adaptive immunity and diminishing tumor-associated immunosuppression. As non-myeloablative, LDC could be successfully combined with different anti-cancer immunotherapeutic strategies, including immunoregulatory cytokines. Secreted cyclophilin A (CypA) is of particular interest in this respect. Previously, we showed that recombinant human CypA (rhCypA) had pleiotropic immunostimulatory activity and anti-tumor effects. Thus, rhCypA could be potentially proposed as a perspective component of combined therapy with LDC.

Methods: In this work, we evaluated the anti-tumor effects of rhCypA combined with low doses of cyclophosphamide, doxorubicin, dacarbazine, and paclitaxel in the experimental mouse tumor models of melanoma B16 and lymphoma EL4 in vivo.

Results: Synergic and potentiating effects of rhCypA combined with LDC were shown in these studies. Furthermore, as a monotherapeutic agent and a component of combined chemoimmunotherapy, rhCypA was shown to modulate the immune tumor microenvironment by enhancing tumor infiltration with macrophages, NK cells, and T cells. It was also found that rhCypA stimulated both systemic and local anti-tumor immune responses.

Conclusion: RhCypA could be potentially proposed as a perspective component of the combined cancer chemoimmunotherapy.

目的:目前正在积极开发不同的低剂量化疗(LDC)方案,并将其引入临床实践。与传统化疗相比,低剂量化疗具有明显的优势(低毒性、防止耐药性),还能通过激活先天性免疫和适应性免疫的效应因子,减轻肿瘤相关的免疫抑制,从而激发患者的抗肿瘤免疫反应。由于不产生瘤细胞,LDC 可以成功地与不同的抗癌免疫治疗策略(包括免疫调节细胞因子)相结合。在这方面,分泌型环嗜蛋白 A(CypA)尤其值得关注。此前,我们曾发现重组人 CypA(rhCypA)具有多向性免疫刺激活性和抗肿瘤作用。因此,rhCypA 有可能成为 LDC 联合疗法的一个重要组成部分:在这项工作中,我们评估了 rhCypA 与低剂量环磷酰胺、多柔比星、达卡巴嗪和紫杉醇联合使用对小鼠黑色素瘤 B16 和淋巴瘤 EL4 模型的抗肿瘤作用:结果:在这些研究中,rhCypA 与 LDC 联用产生了协同和增效作用。此外,rhCypA 作为单一治疗剂和联合化疗免疫疗法的组成部分,可通过增强巨噬细胞、NK 细胞和 T 细胞对肿瘤的浸润来调节免疫肿瘤微环境。研究还发现,rhCypA 可刺激全身和局部的抗肿瘤免疫反应:结论:RhCypA 有可能成为癌症化疗免疫疗法的一个重要组成部分。
{"title":"Immunoregulatory cyclophilin a improves low-dose chemotherapy with a modulation of the immune tumor microenvironment in experimental models of melanoma B16 and lymphoma EL4 in vivo.","authors":"Anastasiia A Kalinina, Leila R Tilova, Dmitry B Kazansky, Ludmila M Khromykh","doi":"10.1007/s00280-024-04691-3","DOIUrl":"10.1007/s00280-024-04691-3","url":null,"abstract":"<p><strong>Purpose: </strong>Different regimens of low-dose chemotherapy (LDC) are currently being actively developed and introduced into clinical practice. Along with its obvious advantages compared to conventional chemotherapy (low toxicity, prevention of drug resistance), LDC could also stimulate anti-tumor immune responses in a patient by activating effectors of innate and adaptive immunity and diminishing tumor-associated immunosuppression. As non-myeloablative, LDC could be successfully combined with different anti-cancer immunotherapeutic strategies, including immunoregulatory cytokines. Secreted cyclophilin A (CypA) is of particular interest in this respect. Previously, we showed that recombinant human CypA (rhCypA) had pleiotropic immunostimulatory activity and anti-tumor effects. Thus, rhCypA could be potentially proposed as a perspective component of combined therapy with LDC.</p><p><strong>Methods: </strong>In this work, we evaluated the anti-tumor effects of rhCypA combined with low doses of cyclophosphamide, doxorubicin, dacarbazine, and paclitaxel in the experimental mouse tumor models of melanoma B16 and lymphoma EL4 in vivo.</p><p><strong>Results: </strong>Synergic and potentiating effects of rhCypA combined with LDC were shown in these studies. Furthermore, as a monotherapeutic agent and a component of combined chemoimmunotherapy, rhCypA was shown to modulate the immune tumor microenvironment by enhancing tumor infiltration with macrophages, NK cells, and T cells. It was also found that rhCypA stimulated both systemic and local anti-tumor immune responses.</p><p><strong>Conclusion: </strong>RhCypA could be potentially proposed as a perspective component of the combined cancer chemoimmunotherapy.</p>","PeriodicalId":9556,"journal":{"name":"Cancer Chemotherapy and Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Phase I study of the anti‑TIGIT antibody tiragolumab in combination with atezolizumab in Japanese patients with advanced or metastatic solid tumors. 更正:日本晚期或转移性实体瘤患者抗 TIGIT 抗体 tiragolumab 联合 atezolizumab 的 I 期研究。
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 DOI: 10.1007/s00280-024-04645-9
Noboru Yamamoto, Takafumi Koyama, Jun Sato, Tatsuya Yoshida, Kazuki Sudo, Satoru Iwasa, Shunsuke Kondo, Kan Yonemori, Atsuko Kawasaki, Kyoko Satake, Shoyo Shibata, Toshio Shimizu
{"title":"Correction to: Phase I study of the anti‑TIGIT antibody tiragolumab in combination with atezolizumab in Japanese patients with advanced or metastatic solid tumors.","authors":"Noboru Yamamoto, Takafumi Koyama, Jun Sato, Tatsuya Yoshida, Kazuki Sudo, Satoru Iwasa, Shunsuke Kondo, Kan Yonemori, Atsuko Kawasaki, Kyoko Satake, Shoyo Shibata, Toshio Shimizu","doi":"10.1007/s00280-024-04645-9","DOIUrl":"10.1007/s00280-024-04645-9","url":null,"abstract":"","PeriodicalId":9556,"journal":{"name":"Cancer Chemotherapy and Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
AKR1C4 regulates the sensitivity of colorectal cancer cells to chemotherapy through ferroptosis modulation. AKR1C4 通过调节铁突变调节结直肠癌细胞对化疗的敏感性
IF 2.7 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-01 Epub Date: 2024-06-18 DOI: 10.1007/s00280-024-04685-1
Li Wang, Cuiling Lv, Xiaoxia Liu

Purpose: Colorectal cancer (CRC) remains a major global health concern, necessitating innovative therapeutic strategies to enhance treatment efficacy. In this study, we investigated the role of AKR1C4 in CRC and its impact on chemotherapy response.

Methods: AKR1C4 stable knockout CRC cell lines were generated using CRISPR/Cas9 technology. The impact of AKR1C4 depletion on chemotherapy sensitivity was assessed using Sulforhodamine B assay. Long-term, low-dose drug induction with increasing concentrations of 5FU, irinotecan, and oxaliplatin were employed to establish acquired chemoresistant CRC cell lines. Ferroptosis induction and inhibition were examined through total iron content and lipid peroxidation measurements.

Results: We found that AKR1C4 knockout enhances CRC cell sensitivity to chemotherapy, specifically by inducing ferroptosis. The enzymatic activity of AKR1C4 is crucial for regulating chemotherapy sensitivity in CRC cells, as evidenced by the inability of a Y55A mutant to reverse the sensitizing effect. Additionally, AKR1C4 inhibitors enhance chemotherapy sensitivity by inducing ferroptosis. Notably, AKR1C4 depletion resensitizes the acquired chemoresistant CRC cells to chemotherapy, suggesting its potential as a therapeutic target for overcoming acquired chemoresistance. Clinical analysis reveals that high AKR1C4 expression is associated with poor prognosis in CRC patients undergoing chemotherapy, highlighting its significance as a prognostic marker and a potential target for therapeutic intervention.

Conclusion: This study illuminates the multifaceted role of AKR1C4 in CRC, demonstrating its significance in regulating chemotherapy sensitivity, overcoming acquired resistance, and impacting clinical outcomes. The insights provided may pave the way for novel therapeutic strategies in CRC management.

目的:结直肠癌(CRC)仍然是全球关注的主要健康问题,需要创新的治疗策略来提高疗效。本研究探讨了 AKR1C4 在 CRC 中的作用及其对化疗反应的影响:方法:利用CRISPR/Cas9技术生成AKR1C4稳定敲除的CRC细胞系。方法:利用CRISPR/Cas9技术生成了AKR1C4稳定敲除的CRC细胞系,并利用磺基罗丹明B检测法评估了AKR1C4缺失对化疗敏感性的影响。利用浓度不断增加的 5FU、伊立替康和奥沙利铂进行长期低剂量药物诱导,建立获得性化疗耐药的 CRC 细胞系。通过测量总铁含量和脂质过氧化物来检验铁变态反应的诱导和抑制作用:结果:我们发现 AKR1C4 基因敲除能增强 CRC 细胞对化疗的敏感性,特别是通过诱导铁变态反应。AKR1C4的酶活性对调节CRC细胞的化疗敏感性至关重要,Y55A突变体无法逆转化疗敏感性就证明了这一点。此外,AKR1C4抑制剂还能通过诱导铁变态反应提高化疗敏感性。值得注意的是,抑制 AKR1C4 可使获得性化疗耐药的 CRC 细胞对化疗重新敏感,这表明 AKR1C4 有可能成为克服获得性化疗耐药的治疗靶点。临床分析表明,AKR1C4的高表达与接受化疗的CRC患者的不良预后有关,突出了其作为预后标志物和潜在治疗干预靶点的重要性:本研究揭示了 AKR1C4 在 CRC 中的多方面作用,证明了它在调节化疗敏感性、克服获得性耐药和影响临床结果方面的重要性。所提供的见解可能会为治疗 CRC 的新型治疗策略铺平道路。
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Cancer Chemotherapy and Pharmacology
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