- Klíčová slova
- ivosidenib,
- MeSH
- cholangiokarcinom * farmakoterapie MeSH
- glycin * terapeutické užití MeSH
- isocitrátdehydrogenasa genetika MeSH
- klinická studie jako téma metody MeSH
- lidé MeSH
- pyridiny * terapeutické užití MeSH
- Check Tag
- lidé MeSH
PURPOSE: This phase 1/2 study aimed to evaluate the safety and preliminary efficacy of combining disulfiram and copper (DSF/Cu) with radiation therapy (RT) and temozolomide (TMZ) in patients with newly diagnosed glioblastoma (GBM). METHODS AND MATERIALS: Patients received standard RT and TMZ with DSF (250-375 mg/d) and Cu, followed by adjuvant TMZ plus DSF (500 mg/d) and Cu. Pharmacokinetic analyses determined drug concentrations in plasma and tumors using high-performance liquid chromatography-mass spectrometry. RESULTS: Thirty-three patients, with a median follow-up of 26.0 months, were treated, including 12 IDH-mutant, 9 NF1-mutant, 3 BRAF-mutant, and 9 other IDH-wild-type cases. In the phase 1 arm, 18 patients were treated; dose-limiting toxicity probabilities were 10% (95% CI, 3%-29%) at 250 mg/d and 21% (95% CI, 7%-42%) at 375 mg/d. The phase 2 arm treated 15 additional patients at 250 mg/d. No significant difference in overall survival or progression-free survival was noted between IDH- and NF1-mutant cohorts compared with institutional counterparts treated without DSF/Cu. However, extended remission occurred in 3 BRAF-mutant patients. Diethyl-dithiocarbamate-copper, the proposed active metabolite of DSF/Cu, was detected in plasma but not in tumors. CONCLUSIONS: The maximum tolerated dose of DSF with RT and TMZ is 375 mg/d. DSF/Cu showed limited clinical efficacy for most patients. However, promising efficacy was observed in BRAF-mutant GBM, warranting further investigation.
- MeSH
- alkylační protinádorové látky terapeutické užití farmakokinetika MeSH
- chemoradioterapie * metody MeSH
- disulfiram * terapeutické užití farmakokinetika aplikace a dávkování MeSH
- doba přežití bez progrese choroby MeSH
- dospělí MeSH
- glioblastom * radioterapie genetika mortalita terapie farmakoterapie MeSH
- isocitrátdehydrogenasa genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- měď * krev terapeutické užití MeSH
- nádory mozku * radioterapie mortalita genetika terapie MeSH
- protoonkogenní proteiny B-Raf genetika MeSH
- senioři MeSH
- temozolomid * terapeutické užití farmakokinetika aplikace a dávkování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze I MeSH
- klinické zkoušky, fáze II MeSH
- Klíčová slova
- Ivosidenib, tipiracil,
- MeSH
- analýza přežití MeSH
- bevacizumab terapeutické užití MeSH
- cholangiokarcinom * farmakoterapie prevence a kontrola MeSH
- isocitrátdehydrogenasa antagonisté a inhibitory fyziologie genetika MeSH
- klinické zkoušky, fáze III jako téma MeSH
- kolorektální nádory * farmakoterapie prevence a kontrola MeSH
- lidé MeSH
- metastázy nádorů MeSH
- multicentrické studie jako téma MeSH
- trifluridin terapeutické užití MeSH
- výchova a vzdělávání MeSH
- vysoce účinné nukleotidové sekvenování metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
Cholangiokarcinom patří mezi zhoubná nádorová onemocnění s velmi nepříznivou prognózou, pětileté přežití se týká méně než 10 % pacientů. Pokrok v oblasti molekulárních analýz těchto nádorů však velmi rozšířil možnosti cílené léčby. K nejčastěji identifikovaným změnám cholangiokarcinomu patří mutace isocitrátdehydrogenázy 1 (IDH1). Ivosidenib (Tibsovo®) jako cílený inhibitor této enzymatické varianty může nyní uplatnit svoji účinnost.
Patients suffering from cholangiocarcinoma have very unfavorable prognosis, 5 years survival is usually less than 10 %. Progress in molecular testing of this tumors revealed better possibilities of targeted therapy. One of the most represented changes is isocitrate dehydrogenase-1 (IDH-1) mutation. Selective inhibitor of mutated IDH-1 enzyme ivosidenib (Tibsovo®) is effective choice of treatment of this disease.
- Klíčová slova
- ivosidenib,
- MeSH
- cholangiokarcinom * diagnóza farmakoterapie genetika MeSH
- cílená molekulární terapie * klasifikace metody MeSH
- isocitrátdehydrogenasa antagonisté a inhibitory genetika MeSH
- lidé MeSH
- míra přežití MeSH
- mutace účinky léků MeSH
- nežádoucí účinky léčiv klasifikace MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Klíčová slova
- Ivosidenib,
- MeSH
- cholangiokarcinom * diagnóza farmakoterapie MeSH
- glycin analogy a deriváty MeSH
- inhibitory enzymů terapeutické užití MeSH
- isocitrátdehydrogenasa genetika MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- mutace MeSH
- protinádorové látky aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- pyridiny terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- souhrny MeSH
Targeting mutations that trigger acute myeloid leukaemia (AML) has emerged as a refined therapeutic approach in recent years. Enasidenib (Idhifa) is the first selective inhibitor of mutated forms of isocitrate dehydrogenase 2 (IDH2) approved against relapsed/refractory AML. In addition to its use as monotherapy, a combination trial of enasidenib with standard intensive induction therapy (daunorubicin + cytarabine) is being evaluated. This study aimed to decipher enasidenib off-target molecular mechanisms involved in anthracycline resistance, such as reduction by carbonyl reducing enzymes (CREs) and drug efflux by ATP-binding cassette (ABC) transporters. We analysed the effect of enasidenib on daunorubicin (Daun) reduction by several recombinant CREs and different human cell lines expressing aldo-keto reductase 1C3 (AKR1C3) exogenously (HCT116) or endogenously (A549 and KG1a). Additionally, A431 cell models overexpressing ABCB1, ABCG2, or ABCC1 were employed to evaluate enasidenib modulation of Daun efflux. Furthermore, the potential synergism of enasidenib over Daun cytotoxicity was quantified amongst all the cell models. Enasidenib selectively inhibited AKR1C3-mediated inactivation of Daun in vitro and in cell lines expressing AKR1C3, as well as its extrusion by ABCB1, ABCG2, and ABCC1 transporters, thus synergizing Daun cytotoxicity to overcome resistance. This work provides in vitro evidence on enasidenib-mediated targeting of the anthracycline resistance actors AKR1C3 and ABC transporters under clinically achievable concentrations. Our findings may encourage its combination with intensive chemotherapy and even suggest that the effectiveness of enasidenib as monotherapy against AML could lie beyond the targeting of mIDH2.
- MeSH
- ABC transportéry metabolismus MeSH
- adenosintrifosfát MeSH
- akutní myeloidní leukemie * farmakoterapie genetika MeSH
- antracykliny MeSH
- cytarabin terapeutické užití MeSH
- daunomycin * farmakologie MeSH
- isocitrátdehydrogenasa genetika metabolismus terapeutické užití MeSH
- lidé MeSH
- protinádorová antibiotika terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Patients below 55 years were genetically studied because the prevalence of isocitrate dehydrogenase 1 (IDH1) decreases in older patients and on grounds of cost-effectiveness, as suggested by the World Health Organization (WHO) in 2016. The aim of our study was to use novel massively parallel sequencing (MPS) approaches to examine rare variants of IDH1/2 in Czech diffuse astrocytic and oligodendroglial tumors (gliomas) patients below 55 years of age who had been immunohistochemically (IHC) diagnosed as IDH1 R132H negative. The IHC IDH1 status (wild type or mutant) of 275 tissue samples was analyzed using antibodies against the IDH1 R132H protein. Sixty-three samples of 55 years old patients with IHC IDH1 WT status were genotyped using two different MPS technologies to detect rare IDH1 and IDH2 variants. The tiered IHC (60 positive) and molecular (10 positive) approach thus revealed that 70 of the 275 samples (25%) bore IDH1/IDH2 mutations. The combined molecular and IHC approach thus revealed that 70 of the 275 samples (25%) considered in the study bore IDH1/IDH2 mutations. IHC detection of the IDH1 R132H variant should be routinely complemented with MPS to detect rare IDH1/2 variants in glioma patients below 55 years of age with negative IHC result of IDH R132H variant.
- MeSH
- gliom * patologie MeSH
- isocitrátdehydrogenasa genetika metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- mutace MeSH
- nádory mozku * diagnóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- vysoce účinné nukleotidové sekvenování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Mitochondrial retrograde signaling is a mitochondria-to-nucleus communication pathway, conserved from yeast to humans, by which dysfunctional mitochondria relay signals that lead to cell stress adaptation in physiopathological conditions via changes in nuclear gene expression. The most comprehensive picture of components and regulation of retrograde signaling has been obtained in Saccharomyces cerevisiae, where retrograde-target gene expression is regulated by RTG genes. In this chapter, we describe methods to measure mitochondrial retrograde pathway activation at the level of mRNA and protein products in yeast model systems, including cell suspensions and microcolonies. In particular, we will focus on three major procedures: mRNA levels of RTG-target genes, such as those encoding for peroxisomal citrate synthase (CIT2), aconitase, and NAD+-specific isocitrate dehydrogenase subunit 1 by real-time PCR; expression analysis of CIT2-gene protein product (Cit2p-GFP) by Western blot and fluorescence microscopy; the phosphorylation status of transcriptional factor Rtg1/3p which controls RTG-target gene transcription.
- MeSH
- akonitáthydratasa genetika metabolismus MeSH
- buněčné jádro genetika metabolismus MeSH
- citrátsynthasa genetika metabolismus MeSH
- fosforylace MeSH
- intracelulární signální peptidy a proteiny metabolismus MeSH
- isocitrátdehydrogenasa genetika metabolismus MeSH
- mitochondrie metabolismus patologie MeSH
- Saccharomyces cerevisiae - proteiny genetika metabolismus MeSH
- Saccharomyces cerevisiae genetika metabolismus MeSH
- signální transdukce MeSH
- transkripční faktory BHLH-Zip metabolismus MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
This prospective population-based study on a group of 132 resected IDH-wildtype (IDH-wt) glioblastoma (GBM) patients assesses the prognostic and predictive value of selected genetic biomarkers and clinical factors for GBM as well as the dependence of these values on the applied therapeutic modalities. The patients were treated in our hospital between June 2006 and June 2015. Clinical data and tumor samples were analyzed to determine the frequencies of TP53, MDM2, EGFR, RB1, BCR, and CCND1 gene aberrations and the duplication/deletion statuses of the 9p21.3, 1p36.3, 19q13.32, and 10p11.1 chromosome regions. Cut-off values distinguishing low (LCN) and high (HCN) copy number status for each marker were defined. Additionally, MGMT promoter methylation and IDH1/2 mutation status were investigated retrospectively. Young age, female gender, Karnofsky scores (KS) above 80, chemoradiotherapy, TP53 HCN, and CCND1 HCN were identified as positive prognostic factors, and smoking was identified as a negative prognostic factor. Cox proportional regression models of the chemoradiotherapy patient group revealed TP53 HCN and CCND1 HCN to be positive prognostic factors for both progression-free survival and overall survival. These results confirmed the influence of key clinical factors (age, KS, adjuvant oncotherapy, and smoking) on survival in GBM IDH-wt patients and demonstrated the prognostic and/or predictive importance of CCND1, MDM2, and 22q12.2 aberrations.
- MeSH
- DNA modifikační methylasy genetika MeSH
- glioblastom * genetika terapie MeSH
- isocitrátdehydrogenasa genetika MeSH
- lidé MeSH
- metylace DNA MeSH
- mutace MeSH
- nádory mozku * genetika terapie MeSH
- prospektivní studie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
