Metabolism and Pharmacokinetics of the Cyclin-Dependent Kinase Inhibitor R-Roscovitine in the Mouse

Total Page:16

File Type:pdf, Size:1020Kb

Metabolism and Pharmacokinetics of the Cyclin-Dependent Kinase Inhibitor R-Roscovitine in the Mouse Molecular Cancer Therapeutics 125 Metabolism and pharmacokinetics of the cyclin-dependent kinase inhibitor R-roscovitine in the mouse Bernard P. Nutley,1 Florence I. Raynaud,1 COOH-R-roscovitine could be inhibited by replacement Stuart C. Wilson,1 Peter M. Fischer,2 of metabolically labile protons with deuterium. After 1 1 Angela Hayes, Phyllis M. Goddard, 60 minutes of incubation of R -roscovitine-d9 or Steven J. McClue,2 Michael Jarman,1 R-roscovitine with mouse liver microsomes, formation of 2 1 f David P. Lane, and Paul Workman COOH-R-roscovitine-d9 was decreased by 24% com- pared with the production of COOH-R-roscovitine. In 1 Cancer Research UK Centre for Cancer Therapeutics, Institute of addition, the levels of R-roscovitine-d remaining were Cancer Research, Surrey, United Kingdom and 2Cyclacel Ltd., 9 Dundee, United Kingdom 33% higher than those of R-roscovitine. However, formation of several minor R-roscovitine metabolites was enhanced with R-roscovitine-d9, suggesting that metabolic Abstract switching from the major carbinol oxidation pathway had occurred. Synthetic COOH-R-roscovitine and C8-oxo- R-roscovitine (seliciclib, CYC202) is a cyclin-dependent R-roscovitine were tested in functional cyclin-dependent kinase inhibitor currently in phase II clinical trials in patients kinase assays and shown to be less active than with cancer. Here, we describe its mouse metabolism and R-roscovitine, confirming that these metabolic reactions pharmacokinetics as well as the identification of the are deactivation pathways. [Mol Cancer Ther 2005; principal metabolites in hepatic microsomes, plasma, and 4(1):125–39] urine. Following microsomal incubation of R-roscovitine at 10 Ag/mL (28 Amol/L) for 60 minutes, 86.7% of the parent drug was metabolized and 60% of this loss was due to Introduction formation of one particular metabolite. This was identified Mammalian cell division is tightly regulated by the as the carboxylic acid resulting from oxidation of the activation of the cyclin-dependent kinase (CDK) family of hydroxymethyl group of the amino alcohol substituent at cell cycle regulatory proteins (1). This regulation is required C2 of the purine core present in R-roscovitine. Identifica- for the processes that govern cell proliferation and to allow tion was confirmed by chemical synthesis and comparison DNA replication and mitosis to occur in proper sequence of an authentic sample of the R-roscovitine-derived and at the correct time. Activation of the CDKs is controlled carboxylate metabolite (COOH-R-roscovitine). Other minor by various signal transduction pathways and requires metabolites were identified as C8-oxo-R-roscovitine and 9 formation of a complex consisting of the catalytic CDK unit N -desisopropyl-R-roscovitine; these accounted for 4.9% and the appropriate regulatory cyclin subunit (2). Once and 2.6% of the parent, respectively. The same metabolic activated, these cyclin-CDK complexes in turn regulate pattern was observed in vivo, with a 4.5-fold lower AUC11 other factors (e.g., phosphorylation of the retinoblastoma for R-roscovitine (38 Amol/L/h) than for COOH-R-roscovi- protein) leading to an orderly progression through the cell tine (174 Amol/L/h). Excretion of R-roscovitine in the urine cycle. Several such cyclin-CDK complexes have been up to 24 hours post-dosing accounted for an average of identified and these were shown to regulate various points only 0.02% of the administered dose of 50 mg/kg, of the cell cycle (1). Control of the cell cycle is commonly whereas COOH-R-roscovitine represented 65% to 68% deregulated in human cancers, for example, by mutation or of the dose irrespective of the route of administration (i.v., altered expression of CDKs, cyclins, and their regulatory i.p., or p.o.). A partially deuterated derivative (R-roscovi- molecules (2). Because of this, synthetic inhibitors of CDKs tine-d9) was synthesized to investigate if formation of may provide important new cancer treatments that are more selective than many of the cytotoxic drugs currently in use (2–4). Previous reports have described the discovery of 2,6,9- trisubstituted purines that were effective at inhibiting the Received 7/29/04; revised 11/3/04; accepted 11/10/04. activity of several protein kinase classes, including the CDK Grant support: Cancer Research UK and Cyclacel Ltd. D. Lane is a Gibb family and especially CDK2 (5–8). Since the first report (5) Fellow and P. Workman is a Life Fellow of Cancer Research UK. of the selective inhibition of CDK2 by the 2,6,9-trisubsti- The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked tuted purine olomoucine (Fig. 1), there has been substantial advertisement in accordance with 18 U.S.C. Section 1734 solely to progress in the development of more potent analogues. indicate this fact. Among these, CYC202 (seliciclib), a pure and chirally Requests for reprints: Florence I. Raynaud, Cancer Research UK Centre for defined form (9) of R-roscovitine (refs. 8, 10; Fig. 1), was Cancer Therapeutics, Institute of Cancer Research, Cotswold Road, Sutton, Surrey SM2 5NG, United Kingdom. Phone: 44-20-8722-4212; chosen for development from a large set of 2,6,9-trisubsti- Fax: 44-20-8770-7899. E-mail: [email protected] tuted purine analogues (11) and is currently undergoing Copyright C 2005 American Association for Cancer Research. phase II clinical trials (12, 13). Mol Cancer Ther 2005;4(1). January 2005 Downloaded from mct.aacrjournals.org on September 28, 2021. © 2005 American Association for Cancer Research. 126 Metabolism and Pharmacokinetics of R-Roscovitine (CYC202) atmosphere cooled to 0jC was added diisopropylethyl- amine (4.0 mL, 2.64 eq, 22.96 mmol) followed by benzyl- amine (1.15 mL, 1.21 eq, 10.53 mmol). The reaction mixture was stirred at 0jC for 3 hours, allowed to return to room temperature over 30 minutes, and stirred at this tempera- ture for 16 hours, when thin-layer chromatography with CH2Cl2/Et2O/MeOH (55:43:2) indicated that the reaction had gone to completion. The solvent was evaporated in vacuo, and the residue was purified by gradient column chromatography on silica gel eluted with CH2Cl2/Et2O/ MeOH (55:45:0–55:43:2) to afford 2 as a white solid (1.36 g, 64%). Melting point 240-241jC. 1Hnuclearmagnetic y resonance (NMR) (d6-DMSO, 250 MHz): 4.62 (d, 2H, J = 5.60 Hz, -HNCH2-Bz), 7.25-7.33 (m, 5H, Bz), 8.10 (s, 1H, -N = CH-NH-), 8.81 (brs, 1H, -HNCH2-Bz), 13.06 (brs, 1H, -N = CH-NH-). Fast atom bombardment mass spectroscopy (FABMS) m/z: 244 ([M + H]+, 100), 180 (15), 166 (9), 136 (5), 91 (10). Accurate mass (M + H): actual: 244.0998, measured: 244.1002. Microanalysis (expected/measured): C12H10N5F: C: 59.25:59.12, H: 4.14:4.06, N: 28.79:28.47. Benzyl-(2-fluoro-9-isopropyl-9H-purin-6-yl)amine (3a). To a stirred solution of 2 (0.83 g, 1 eq, 3.41 mmol) in Figure 1. Chemical structures of olomoucine (OLO), R-roscovitine dimethylacetamide (10 mL) at room temperature under an (ROS), COOH-R-roscovitine (COOH-ROS), and bohemine (BOH). argon atmosphere was added powdered, anhydrous K2CO3 (2.35 g, 5 eq, 17.00 mmol) followed by 2-bromopro- pane (3.2 mL, 10 eq, 34.08 mmol). The reaction mixture was stirred at room temperature for 48 hours, when thin- Identification of the biotransformation pathways is an essential component of the rational development and use of molecular therapeutics. In this article, we present the results of our in vitro and in vivo studies of the metabolism of R-roscovitine in the mouse. Our findings are supported by the synthesis of putative metabolites and of selectively deuterated derivatives. We identified the major metabolite of R-roscovitine as a carboxylic acid formed by oxidation of the hydroxymethyl moiety of the purine C2 substituent and show that the formation of this metabolite is a deactivation reaction. The results presented here contributed to the initiation of clinical trials with R- roscovitine and the basic murine pharmacokinetics and metabolism variables have been observed recently to be similar in humans (14). Materials and Methods General SKF-525A, NADPH, and formic acid (96% ACS grade) were purchased from Sigma-Aldrich (Gillingham, Dorset, United Kingdom). High-performance liquid chromatogra- phy–grade methanol was purchased from Laserchrom (Rochester, Kent, United Kingdom). Olomoucine and R-roscovitine were prepared as described previously (8, 9). Schemes for the synthesis of other compounds used in this study are given in Fig. 2. Protein kinase assays were Figure 2. Scheme for synthesis of compounds used in this study. a, j done as described previously (12). BnNH2,iPr2NEt, n-butanol, 95 C, 4 h. b, iPr-Br (for 3a)oriso-C3D7Br (for 3b), K2CO3, DMA, room temperature, 24 h. c, 8 (for 4a)or Syntheses NH2CH(CH2CH3)COOH (for 4b), DBU, NMP, 160jC, 1 h (racemiza- Benzyl-(2-fluoro-9H-purin-6-yl)amine (2). To a stirred tion during reaction). d, DIEA, n-butanol, DMSO, CH3CH2C(NH2)CH2OH, 140jC, 48 h. DMA, -bromosuccinimide, room temperature, 16 h. solution of 6-chloro-2-fluoro-9H-purine 1 (1.5 g, 1 eq, 8.69 e, N f, DMSO, NaOH aqueous, 140jC, 32 h. g, LiAlD4, monoglyme, 95jC, 16 mmol; ref. 15) in n-butanol (100 mL) under an argon h. h, 9, DIEA, n-butanol, DMSO, 140jC, 48 h. Mol Cancer Ther 2005;4(1). January 2005 Downloaded from mct.aacrjournals.org on September 28, 2021. © 2005 American Association for Cancer Research. Molecular Cancer Therapeutics 127 layer chromatography with CH2Cl2/Et2O/MeOH (55:40:5) (R)-2-(6-Benzylamino-9-isopropyl-9H-purin-2-ylami- indicated that the reaction had gone to completion.
Recommended publications
  • Australian Public Assessment Report for Aminolevulinic Acid Hcl
    Australian Public Assessment Report for Aminolevulinic acid HCl Proprietary Product Name: Gliolan Sponsor: Specialised Therapeutics Australia Pty Ltd March 2014 Therapeutic Goods Administration About the Therapeutic Goods Administration (TGA) · The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health, and is responsible for regulating medicines and medical devices. · The TGA administers the Therapeutic Goods Act 1989 (the Act), applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance), when necessary. · The work of the TGA is based on applying scientific and clinical expertise to decision- making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and medical devices. · The TGA relies on the public, healthcare professionals and industry to report problems with medicines or medical devices. TGA investigates reports received by it to determine any necessary regulatory action. · To report a problem with a medicine or medical device, please see the information on the TGA website < http://www.tga.gov.au>. About AusPARs · An Australian Public Assessment Record (AusPAR) provides information about the evaluation of a prescription medicine and the considerations that led the TGA to approve or not approve a prescription medicine submission. · AusPARs are prepared and published by the TGA. · An AusPAR is prepared for submissions that relate to new chemical entities, generic medicines, major variations, and extensions of indications. · An AusPAR is a static document, in that it will provide information that relates to a submission at a particular point in time. · A new AusPAR will be developed to reflect changes to indications and/or major variations to a prescription medicine subject to evaluation by the TGA.
    [Show full text]
  • Other Alkylating Agents
    Anticancer agents The Alkylating agents The alkylating agents are the oldest group of cytostatic drugs. The first of them – mechlorethamine was introduced into therapy in 1949. The alkylating agents can contain one or two alkylating groups. In the body the alkylating agents may react with DNA, RNA and proteins, although their reaction with DNA is believed to be the most important. 1 • The primary target of DNA coross-linking agents is the actively dividing DNA molecule. • The DNA cross-linkers are all extremly reactive nucleophilic structures (+). • When encountered, the nucleophilic groups on various DNA bases (particularly, but not exclusively, the N7 of guaninę) readily attack the electrophilic drud, resulting in irreversible alkylation or complexation of the DNA base. • Some DNA alkylating agents, such as the nitrogen mustards and nitrosoureas, are bifunctional, meaning that one molecule of the drug can bind two distinct DNA bases. 2 • Most commonly, the alkylated bases are on different DNA molecules, and intrastrand DNA cross-linking through two guaninę N7 atoms results. • The DNA alkylating antineoplastics are not cel cycle specific, but they are more toxic to cells in the late G1 or S phases of the cycle. • This is a time when DNA unwinding and exposing its nucleotides, increasing the Chance that vulnerable DNA functional groups will encounter the nucleophilic antineoplastic drug and launch the nucleophilic attack that leads to its own destruction. • The DNA alkylators have a great capacity for inducing toth mutagenesis and carcinogenesis, they can promote caner in addition to treating it. 3 • Organometallic antineoplastics – Platinum coordination complexes, also cross-link DNA, and many do so by binding to adjacent guanine nucleotides, called disguanosine dinucleotides, on the single strand of DNA.
    [Show full text]
  • Nonpredictable Pharmacokinetic Behavior of High-Dose Cyclophosphamide in Combination with Cisplatin and 1,3-Bis(2-Chloroethyl)-1-Nitrosourea1
    Vol. 5, 747–751, April 1999 Clinical Cancer Research 747 Nonpredictable Pharmacokinetic Behavior of High-Dose Cyclophosphamide in Combination with Cisplatin and 1,3-Bis(2-chloroethyl)-1-nitrosourea1 Yago Nieto,2 Xuesheng Xu, Pablo J. Cagnoni, of the drug unpredictable from an initial measurement on Steve Matthes, Elizabeth J. Shpall, day 1. Thus, in this combination, measurement of levels of Scott I. Bearman, James Murphy, and parent CPA, with the objective of real-time therapeutic monitoring of this drug, is not informative. Roy B. Jones University of Colorado Bone Marrow Transplant Program [Y. N., P. J. C., S. M., E. J. S., S. I. B., R. B. J.] and Department of INTRODUCTION Biostatistics [X. X., J. M.], University of Colorado, Denver, Colorado HDC3 with stem cell support attempts to overcome cell 80262 resistance to standard-dose chemotherapy by exploiting the dose-response effects of combinations of antineoplastic drugs. ABSTRACT Considering the high potential for toxicity with HDC, ongoing research is pursuing the application of TDM to HDC. TDM Our objective was to assess whether the total area prospectively adjusts for interindividual variability of concen- under the curve (AUC) of high-dose cyclophosphamide trations achieved after the first dose of a drug to a final target PK (CPA), combined with cisplatin and 1,3-bis(2-chloroethyl)- parameter. This strategy is based on two requirements: (a) the 1-nitrosourea, could be predicted from its AUC on the first knowledge that, for a particular drug, a certain PK parameter is day of treatment. We reviewed the AUC of CPA in 470 associated with either a toxic or a therapeutic pharmacodynamic patients who underwent pharmacokinetic monitoring of the effect; and (b) the demonstration that the drug’s PK behavior is drug.
    [Show full text]
  • Gene Therapy with Drug Resistance Genes
    Cancer Gene Therapy (2006) 13, 335–345 r 2006 Nature Publishing Group All rights reserved 0929-1903/06 $30.00 www.nature.com/cgt REVIEW Gene therapy with drug resistance genes M Zaboikin1, N Srinivasakumar1 and F Schuening Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, USA A major side effect of cancer chemotherapy is myelosuppression. Expression of drug-resistance genes in hematopoietic stem cells (HSC) using gene transfer methodologies holds the promise of overcoming marrow toxicity in cancer chemotherapy. Adequate protection of marrow cells in cancer patients from myelotoxicity in this way would permit the use of escalating doses of chemotherapy for eradicating residual disease. A second use of drug-resistance genes is for coexpression with a therapeutic gene in HSCs to provide a selection advantage to gene-modified cells. In this review, we discuss several drug resistance genes, which are well suited for in vivo selection as well as other newer candidate genes with potential for use in this manner. Cancer Gene Therapy (2006) 13, 335–345. doi:10.1038/sj.cgt.7700912; published online 7 October 2005 Keywords: hematopoietic stem cell; chemoprotection; drug resistance; gene transfer Introduction increasing interest due to their demonstrated superiority to g-retroviral vectors for gene delivery into HSCs.4–7 Hematopoietic stem cells (HSCs) are defined by their Retroviral vectors have been shown to be effective in properties of self-renewal, pluripotency, and life-long correcting genetic disorders in small animal models such persistence following transplantation in the host. HSCs as mice. However, success has been meager in large are easily accessible and deliverable back to recipients by animals including humans.
    [Show full text]
  • Microsomal Metabolism of Nitrosoureas'
    [CANCER RESEARCH 35, 296-301, February 1975] Microsomal Metabolism of Nitrosoureas' Donald L. Hill, Marion C. Kirk, and Robert F. Struck Kettering-Meyer Laboratory. Southern Research Institute, Birmingham. Alabama 35205 SUMMARY nate formed from BCNU can also give rise to 2-chloro ethyiamine, an alkylating agent (29). MNU has activity N,N'-Bis(2-chloroethyl)-N-nitrosourea (BCNU) is a sub against experimental tumors ( I3) and also has carcinogenic strate for a microsomal enzyme of mouse liver. The reaction (6) and mutagenic (7) effects. This reactive compound requires NADPH, and the product is 1,3-bis(2-chloro decomposes to give a methylcarbonium ion and isocyanic ethyl)urea. This activity is also found in mouse lungs but not acid (19). in several other tissues. With reaction conditions under Although the pharmacological distribution and urinary which BCNU is not chemically degraded, the Km for excretion of nitrosoureas and their products have been BCNU with liver microsomes is 1.7 mM; nicotine is a studied (5, 16, 17, 20, 23, 24, 26, 28) and evidence for their competitive inhibitor with a K1 of 0.6 [email protected] biotransformation has been presented (20), only 1 report of nitrosourea is denitrosated in a similar reaction. their enzymatic metabolism has appeared. May el a!. (18) N-(2-Chloroethyl)-N'-cyclohexyl-N-nitrosourea and N- have found that CCNU is enzymatically hydroxylated on (2- chloroethyl)-N'-(trans-4-methylcyclohexyl)- N-nitroso the cyclohexyl ring by an enzyme of rat liver microsomes. urea are also substrates for microsomal enzymes, but the This report concerns the characterization from mouse products of these reactions are ring-hydroxylated deriva liver of microsomal enzymes that metabolize BCNU, tives.
    [Show full text]
  • Mycosis Fungoides and Sézary Syndrome: Focus on The
    Anais Brasileiros de Dermatologia 2021;96(4):458---471 Anais Brasileiros de Dermatologia www.anaisdedermatologia.org.br REVIEW Mycosis fungoides and Sézary syndrome: focus on the ଝ,ଝଝ current treatment scenario a,∗ a b José Antonio Sanches , Jade Cury-Martins , Rodrigo Martins Abreu , a c Denis Miyashiro , Juliana Pereira a Dermatology Clinic Division, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil b Medical Department, Private Institution, São Paulo, SP, Brazil c Hematology Clinic Division, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil Received 2 October 2020; accepted 6 December 2020 Available online 28 May 2021 Abstract Cutaneous T-cell lymphomas are a heterogeneous group of lymphoproliferative dis- KEYWORDS orders, characterized by infiltration of the skin by mature malignant T cells. Mycosis fungoides Lymphoma, T-cell, is the most common form of cutaneous T-cell lymphoma, accounting for more than 60% of cases. cutaneous; Mycosis fungoides in the early-stage is generally an indolent disease, progressing slowly from Mycosis fungoides; some patches or plaques to more widespread skin involvement. However, 20% to 25% of patients Sezary syndrome; progress to advanced stages, with the development of skin tumors, extracutaneous spread and Therapeutics poor prognosis. Treatment modalities can be divided into two groups: skin-directed therapies and systemic therapies. Therapies targeting the skin include topical agents, phototherapy and radiotherapy. Systemic therapies include biological response modifiers, immunotherapies and chemotherapeutic agents. For early-stage mycosis fungoides, skin-directed therapies are pre- ferred, to control the disease, improve symptoms and quality of life. When refractory or in advanced-stage disease, systemic treatment is necessary.
    [Show full text]
  • The Effect of 5-Aminolevulinic Acid Based Photodynamic Therapy and Photochemical Internalization of Bleomycin on the F98 Rat Glioma Cell Line
    UNLV Retrospective Theses & Dissertations 1-1-2008 The effect of 5-aminolevulinic acid based photodynamic therapy and photochemical internalization of bleomycin on the F98 rat glioma cell line Khishigzaya Kharkhuu University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/rtds Repository Citation Kharkhuu, Khishigzaya, "The effect of 5-aminolevulinic acid based photodynamic therapy and photochemical internalization of bleomycin on the F98 rat glioma cell line" (2008). UNLV Retrospective Theses & Dissertations. 2296. http://dx.doi.org/10.25669/7km5-6xyc This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Retrospective Theses & Dissertations by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. THE EFFECT OF 5-AMlNOLEVULlNlC ACID BASED PHOTODYNAMIC THERAPY AND PHOTOCHEMICAL INTERNALIZATION OF BLEOMYCIN ON THE F98 RAT GLIOMA CELL LINE by Khishigzaya Kharkhuu Bachelor of Science Moscow Power Engineering Institute 2003 A thesis submitted in partial fulfillment of the requirement for the Master of Science Degree in Health Physics Department of Health Physics School of Allied Health Sciences Division of Health Sciences Graduate College University of Nevada, Las Vegas May 2008 UMI Number: 1456345 INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted.
    [Show full text]
  • EANO Guidelines on the Diagnosis and Treatment of Diffuse Gliomas of Adulthood
    EVIDENCE-BASED GUIDELINES OPEN EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood Michael Weller1 ✉ , Martin van den Bent 2, Matthias Preusser 3, Emilie Le Rhun4,5,6,7, Jörg C. Tonn8, Giuseppe Minniti 9, Martin Bendszus10, Carmen Balana 11, Olivier Chinot12, Linda Dirven13,14, Pim French 15, Monika E. Hegi 16, Asgeir S. Jakola 17,18, Michael Platten19,20, Patrick Roth1, Roberta Rudà21, Susan Short 22, Marion Smits 23, Martin J. B. Taphoorn13,14, Andreas von Deimling24,25, Manfred Westphal26, Riccardo Soffietti 21, Guido Reifenberger27,28 and Wolfgang Wick 29,30 Abstract | In response to major changes in diagnostic algorithms and the publication of mature results from various large clinical trials, the European Association of Neuro-Oncology (EANO) recognized the need to provide updated guidelines for the diagnosis and management of adult patients with diffuse gliomas. Through these evidence-based guidelines, a task force of EANO provides recommendations for the diagnosis, treatment and follow- up of adult patients with diffuse gliomas. The diagnostic component is based on the 2016 update of the WHO Classification of Tumors of the Central Nervous System and the subsequent recommendations of the Consortium to Inform Molecular and Practical Approaches to CNS Tumour Taxonomy — Not Officially WHO (cIMPACT- NOW). With regard to therapy, we formulated recommendations based on the results from the latest practice-changing clinical trials and also provide guidance for neuropathological and neuroradiological assessment. In these guidelines, we define the role of the major treatment modalities of surgery, radiotherapy and systemic pharmacotherapy, covering current advances and cognizant that unnecessary interventions and expenses should be avoided.
    [Show full text]
  • A First-In-Human, Phase 1, Dose-Escalation Study of Dinaciclib
    Nemunaitis et al. Journal of Translational Medicine 2013, 11:259 http://www.translational-medicine.com/content/11/1/259 RESEARCH Open Access A first-in-human, phase 1, dose-escalation study of dinaciclib, a novel cyclin-dependent kinase inhibitor, administered weekly in subjects with advanced malignancies John J Nemunaitis1*, Karen A Small2, Paul Kirschmeier2, Da Zhang2, Yali Zhu2, Ying-Ming Jou2, Paul Statkevich2, Siu-Long Yao2 and Rajat Bannerji2,3 Abstract Background: Dinaciclib, a small-molecule, cyclin-dependent kinase inhibitor, inhibits cell cycle progression and proliferation in various tumor cell lines in vitro. We conducted an open-label, dose-escalation study to determine the safety, tolerability, and bioactivity of dinaciclib in adults with advanced malignancies. Methods: Dinaciclib was administered starting at a dose of 0.33 mg/m2, as a 2-hour intravenous infusion once weekly for 3 weeks (on days 1, 8, and 15 of a 28-day cycle), to determine the maximum administered dose (MAD), dose-limiting toxicities (DLTs), recommended phase 2 dose (RP2D), and safety and tolerability. Pharmacodynamics of dinaciclib were assessed using an ex vivo phytohemagglutinin lymphocyte stimulation assay and immunohistochemistry staining for retinoblastoma protein phosphorylation in skin biopsies. Evidence of antitumor activity was assessed by sequential computed tomography imaging after every 2 treatment cycles. Results: Forty-eight subjects with solid tumors were treated. The MAD was found to be 14 mg/m2 and the RP2D was determined to be 12 mg/m2; DLTs at the MAD included orthostatic hypotension and elevated uric acid. Forty-seven (98%) subjects reported adverse events (AEs) across all dose levels; the most common AEs were nausea, anemia, decreased appetite, and fatigue.
    [Show full text]
  • Extract from the Clinical Evaluation Report for Aminolevulinic Acid Hcl
    AusPAR Attachment 2 Extract from the Clinical Evaluation Report for Aminolevulinic acid HCl Proprietary Product Name: Gliolan Sponsor: Specialised Therapeutics Australia Pty Ltd Date of CER: December 2012–February 2013 Therapeutic Goods Administration About the Therapeutic Goods Administration (TGA) · The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health, and is responsible for regulating medicines and medical devices. · The TGA administers the Therapeutic Goods Act 1989 (the Act), applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance), when necessary. · The work of the TGA is based on applying scientific and clinical expertise to decision- making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and medical devices. · The TGA relies on the public, healthcare professionals and industry to report problems with medicines or medical devices. TGA investigates reports received by it to determine any necessary regulatory action. · To report a problem with a medicine or medical device, please see the information on the TGA website <http://www.tga.gov.au>. About the Extract from the Clinical Evaluation Report · This document provides a more detailed evaluation of the clinical findings, extracted from the Clinical Evaluation Report (CER) prepared by the TGA. This extract does not include sections from the CER regarding product documentation or post market activities. · The words [Information redacted], where they appear in this document, indicate that confidential information has been deleted. · For the most recent Product Information (PI), please refer to the TGA website <http://www.tga.gov.au/hp/information-medicines-pi.htm>.
    [Show full text]
  • Shiga Toxin 1, As DNA Repair Inhibitor, Synergistically Potentiates the Activity of the Anticancer Drug, Mafosfamide, on Raji Cells
    Toxins 2013, 5, 431-444; doi:10.3390/toxins5020431 OPEN ACCESS toxins ISSN 2072-6651 www.mdpi.com/journal/toxins Article Shiga Toxin 1, as DNA Repair Inhibitor, Synergistically Potentiates the Activity of the Anticancer Drug, Mafosfamide, on Raji Cells Maurizio Brigotti 1,*, Valentina Arfilli 1, Domenica Carnicelli 1, Laura Rocchi 1, Cinzia Calcabrini 2, Francesca Ricci 3, Pasqualepaolo Pagliaro 3, Pier Luigi Tazzari 3, Roberta R. Alfieri 4, Pier Giorgio Petronini 4 and Piero Sestili 2 1 Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, Bologna 40126, Italy; E-Mails: [email protected] (V.A.); [email protected] (D.C.); [email protected] (L.R.) 2 Department of Biomolecular Sciences, University of Urbino “Carlo Bo”,Via Saffi 2, Urbino 61029, Italy; E-Mails: [email protected] (C.C.); [email protected] (P.S.) 3 Immunohematology and Transfusion Center, S. Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy; E-Mails: [email protected] (F.R.); [email protected] (P.P.); [email protected] (P.L.T.) 4 Department of Clinical and Experimental Medicine, University of Parma, Via Volturno 39, Parma 43126, Italy; E-mails: [email protected] (R.R.A.); [email protected] (P.G.P.) * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel.: +39-51-209-4716; Fax: +39-51-209-4746. Received: 17 January 2013; in revised form: 7 February 2013 / Accepted: 7 February 2013 / Published: 21 February 2013 Abstract: Shiga toxin 1 (Stx1), produced by pathogenic Escherichia coli, targets a restricted subset of human cells, which possess the receptor globotriaosylceramide (Gb3Cer/CD77), causing hemolytic uremic syndrome.
    [Show full text]
  • Apoptotic Tumor Cell Death Induced by Estramustine in Patients with Malignant Glioma1
    Vol. 4, 87-91, January 1998 Clinical Cancer Research 87 Apoptotic Tumor Cell Death Induced by Estramustine in Patients with Malignant Glioma1 Christina Valibo, A. Tommy Bergenheim, effects in human glioma cells in vitro (1, 2) and in a rat glioma Per Bergstrom, Per-Olof Gunnarsson, and model (3). The effects seem to involve the microtubuli system, resulting in an arrest of glioma cells in G2-M phase of the cell Roger Henriksson2 cycle (1, 4, 5). In addition, other cytotoxic effects involving cell Departments of Oncology [C. V., P. B., R. H.] and Neurosurgery [A. T. B.], UmeA University, 5-901 85 Ume#{225},Sweden, and Pharmacia membrane-coupled events (6-8) and DNA (2, 8) are involved. Upjohn, Lund, Sweden [P-O. G.] The phenomena of apoptosis, programmed cell death, has gained increased interest in experimental tumor research, and recently, it was suggested that EaM causes programmed cell ABSTRACT death in an experimental glioma model (9). In the present study, Estramustine phosphate (EMP), a cytotoxic drug used we have been able to demonstrate that EaM induces apoptosis in in the treatment of prostatic carcinoma, is metabolized and malignant glioma in the clinical situation. exerts specific cytotoxic effects in malignant glioma in vitro and in vivo. In the present study, we have evaluated the cytotoxic effect of EMP in the clinical situation with regard MATERIALS AND METHODS to appearance of DNA damage and its correlation to the Patients. Eighteen patients with supratentorial astrocy- uptake of estramustine (EaM) in human malignant astrocy- toma grade III-IV operated on at the Department of Neurosur- toma tissue.
    [Show full text]