DOCSLIB.ORG

TITLE: Phase I/II Study of IRX5183 in Relapsed and Refractory Acute Myeloid Leukemia and High Risk Myelodysplastic Syndrome

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
TITLE: Phase I/II Study of IRX5183 in Relapsed and Refractory Acute Myeloid Leukemia and High Risk Myelodysplastic Syndrome Sponsor: Io Therapeutics, Inc. J15219 (IRB00083855) TITLE: Phase I/II study of IRX5183 in relapsed and refractory acute myeloid leukemia and high risk myelodysplastic syndrome Protocol designation: P_195183-201-2015 Principal Investigator: B Douglas Smith, M.D. 1650 Orleans Street, Room 246, CRB1 Baltimore, Maryland 21231 Telephone 410-614-5068; Fax 410-614-7437 [email protected] Co-Investigators: Kelly Norsworthy, M.D. 1650 Orleans Street, Room 2M48, CRB1 Baltimore, Maryland 21231 Telephone 443-694-0509; Fax 410-614-1005 [email protected] Gabriel Ghiaur, M.D./Ph.D. 1650 Orleans Street, Room 243, CRB1 Baltimore, Maryland 21231 Telephone 410-502-3183; Fax 410-614-7279 [email protected] Rick Jones, M.D. 1650 Orleans Street, Room 244, CRB1 Baltimore, Maryland 21231 Telephone 443-287-7104; Fax 410-614-7279 [email protected] Statistician: Ravi Varadhan, Ph.D., Ph.D. Study Sponsors: Io Therapeutics, Inc. 1805 East Garry Avenue, Suite 110 Santa Ana, CA 92705 Responsible Research Nurse: Seana Coffin Telephone 410-614-2023 [email protected] Responsible Data Manager: Colin Huck Telephone 410-614-3725 [email protected] Regulatory: Suzanne Bell Telephone 919-946-9901 [email protected] Version date: September 8, 2017 Io Page 1 of 66 Sponsor: Io Therapeutics, Inc. J15219 (IRB00083855) TABLE OF CONTENTS STUDY SCHEMA and SYNOPSIS......................................................................................................................................................... 4 1. OBJECTIVES ....................................................................................................................................................................................... 7 1.1. PRIMARY OBJECTIVES: .......................................................................................................................................................... 7 1.2. SECONDARY OBJECTIVES: .................................................................................................................................................... 7 2. BACKGROUND ................................................................................................................................................................................... 7 2.1. Acute myeloid leukemia: .............................................................................................................................................................. 7 2.2. Myelodysplastic syndrome: .......................................................................................................................................................... 9 2.3. Previous Cell Differentiation Therapies in Myeloid Malignancies: ........................................................................................ 11 2.4. Impact of bone marrow microenvironment on sensitivity to retinoids: ................................................................................. 12 2.5. IRX5183: ...................................................................................................................................................................................... 13 2.6. Rationale: ..................................................................................................................................................................................... 15 3. PATIENT SELECTION ................................................................................................................................................................... 16 3.1. Eligibility criteria: ....................................................................................................................................................................... 16 3.2. Exclusion criteria: ....................................................................................................................................................................... 17 3.3. Pregnancy: ................................................................................................................................................................................... 17 3.4. Inclusion of women and minorities:........................................................................................................................................... 18 3.5. Off-Study Criteria:...................................................................................................................................................................... 18 3.6. Informed Consent: ...................................................................................................................................................................... 18 4. PRETREATMENT PLAN ................................................................................................................................................................ 19 5. TREATMENT PLAN ........................................................................................................................................................................ 19 5.1. IRX5183 Administration: ........................................................................................................................................................... 19 5.2. Definition of dose-limiting toxicity: ........................................................................................................................................... 23 5.3. General concomitant medication and supportive care guidelines: ......................................................................................... 24 5.3.1. Differentiation syndrome....................................................................................................................................................... 24 5.3.2. Leukocytosis .......................................................................................................................................................................... 24 5.3.3. Hypertriglyceridemia……………………………………………………………………………………………………...…24 5.4. Duration of therapy: ................................................................................................................................................................... 25 5.5. Duration of follow-up: ................................................................................................................................................................ 26 5.6. Criteria for removal from study: ............................................................................................................................................... 26 6. DOSING DELAYS/DOSE MODIFICATIONS: ............................................................................................................................ 26 6.1. Dose Modifications for IRX5183: .............................................................................................................................................. 27 6.2. Discontinuation of IRX5183 for related adverse events: ......................................................................................................... 29 6.3. Exceptions to permanent discontinuation: ................................................................................................................................ 29 7. TREATMENT EVALUATION AND TOXICITY MONITORING ............................................................................................ 30 7.1. Clinical Responses:...................................................................................................................................................................... 30 7.2. Assessment of Response: ............................................................................................................................................................. 30 7.3. Measurement of Response / Response Criteria: ....................................................................................................................... 31 7.4. Adverse Events: ........................................................................................................................................................................... 31 7.5. Serious Adverse Event (SAE): ................................................................................................................................................... 32 7.6. Toxicity Reporting: ..................................................................................................................................................................... 32 7.7. Toxicity Monitoring: ................................................................................................................................................................... 32 7.8. Pharmacokinetics: ....................................................................................................................................................................... 33 8. CORRELATIVE STUDIES ............................................................................................................................................................. 34 8.1. Biologic activity: .......................................................................................................................................................................... 34 8.2. Cellular Collection and Processing: ........................................................................................................................................... 35 9. PHARMACEUTICAL INFORMATION ......................................................................................................................................
Load more

Recommended publications
  • WO 2017/177167 Al 12 October 2017 (12.10.2017) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2017/177167 Al 12 October 2017 (12.10.2017) P O P C T (51) International Patent Classification: (26) Publication Language: English Λ 61Κ 31/192 (2006.01) A61K 31/551 (2006.01) (30) Priority Data: A61K 31/167 (2006.01) A61K 31/553 (2006.01) 62/320,352 8 April 2016 (08.04.2016) US A61K 31/232 (2006.01) A61K 31/573 (2006.01) A61K 31/235 (2006.01) A61K 31/69 (2006.01) (71) Applicant: SYROS PHARMACEUTICALS, INC. A61K 31/25 (2006.01) A61K 31/695 (2006.01) [US/US]; 620 Memorial Drive, Suite 300, Cambridge, A61K 31/353 (2006.01) A61K 31/704 (2006.01) Massachusetts 02139 (US). A61K 31/40 (2006.01) A61K 31/706 (2006.01) A61K 31/4025 (2006.01) A61K 31/7068 (2006.01) (72) Inventors: MCKEOWN, Michael Robert; 74 Fenway, A61K 31/4155 (2006.01) A61K 33/24 (2006.01) #54, Boston, Massachusetts 021 15 (US). FIORE, Chris¬ A61K 31/426 (2006.01) A61K 33/36 (2006.01) topher; 620 Memorial Drive, Suite 300, Cambridge, Mas A61K 31/44 (2006.01) A61K 45/06 (2006.01) sachusetts 02 139 (US). EATON, Matthew Lucas; 90 Put A61K 31/4436 (2006.01) A61P 35/00 (2006.01) nam Avenue, #4, Cambridge, Massachusetts 02139 (US). A61K 31/498 (2006.01) A61P 35/02 (2006.01) LEE, Emily Payton; 1 Craigie Street, Apt. 35, Cambridge, A61K 31/519 (2006.01) A61P 35/04 (2006.01) Massachusetts 02138 (US).
    [Show full text]
  • Preparation and Antitumor Activity of a Tamibarotene-Furoxan Derivative
    DOI:http://dx.doi.org/10.7314/APJCP.2014.15.15.6343 Preparation and Anti-tumor Activity of a Tamibarotene-Furoxan Derivative RESEARCH ARTICLE Preparation and Antitumor Activity of a Tamibarotene- Furoxan Derivative Xue-Jian Wang1&*, Yu Duan1&, Zong-Tao Li2, Jin-Hong Feng3, Xiang-Po Pan4, Xiu-Rong Zhang1, Li-Hong Shi1, Tao Zhang2* Abstract Multi-target drug design, in which drugs are designed as single molecules to simultaneously modulate multiple physiological targets, is an important strategy in the field of drug discovery. QT-011, a tamibarotene-furoxan derivative, was here prepared and proposed to exert synergistic effects on antileukemia by releasing nitric oxide and tamibarotene. Compared with tamibarotene itself, QT-011 displayed stronger antiproliferative effects on U937 and HL-60 cells and was more effective evaluated in a nude mice U937 xenograft model in vivo. In addition, QT-011 could release nitric oxide which might contribute to the antiproliferative activity. Autodocking assays showed that QT-011 fits well with the hydrophobic pocket of retinoic acid receptors. Taken together, these results suggest that QT-011 might be a highly effective derivative of tamibarotene and a potential candidate compound as antileukemia agent. Keywords: Tamibarotene - NO donor - anti-tumor compound - retinoic acid receptors Asian Pac J Cancer Prev, 15 (15), 6343-6347 Introduction the combined treatment with RAR agonists (e.g., ATRA) and histone deacetylase inhibitors (e.g., butyrate, valproic Retinoids, which have been successfully used in the acid, SAHA, FK228, MS-275, and TSA) can remarkably control and treatment of cancer, can serve as in vivo ligands improve efficacy, reduce side effects, and decrease retinoid of retinoic acid receptors (RARs) or retinoid X receptors resistance against acute leukemia (e.g., APL) (Warrell, Jr.
    [Show full text]
  • Research in Your Backyard Developing Cures, Creating Jobs
    Research in Your Backyard Developing Cures, Creating Jobs PHARMACEUTICAL CLINICAL TRIALS IN ILLINOIS Dots show locations of clinical trials in the state. Executive Summary This report shows that biopharmaceutical research com- Quite often, biopharmaceutical companies hire local panies continue to be vitally important to the economy research institutions to conduct the tests and in Illinois, and patient health in Illinois, despite the recession. they help to bolster local economies in communities all over the state, including Chicago, Decatur, Joliet, Peoria, At a time when the state still faces significant economic Quincy, Rock Island, Rockford and Springfield. challenges, biopharmaceutical research companies are conducting or have conducted more than 4,300 clinical For patients, the trials offer another potential therapeutic trials of new medicines in collaboration with the state’s option. Clinical tests may provide a new avenue of care for clinical research centers, university medical schools and some chronic disease sufferers who are still searching for hospitals. Of the more than 4,300 clinical trials, 2,334 the medicines that are best for them. More than 470 of the target or have targeted the nation’s six most debilitating trials underway in Illinois are still recruiting patients. chronic diseases—asthma, cancer, diabetes, heart dis- ease, mental illnesses and stroke. Participants in clinical trials can: What are Clinical Trials? • Play an active role in their health care. • Gain access to new research treatments before they In the development of new medicines, clinical trials are are widely available. conducted to prove therapeutic safety and effectiveness and compile the evidence needed for the Food and Drug • Obtain expert medical care at leading health care Administration to approve treatments.
    [Show full text]
  • Incidence of Differentiation Syndrome Associated with Treatment
    Journal of Clinical Medicine Review Incidence of Differentiation Syndrome Associated with Treatment Regimens in Acute Myeloid Leukemia: A Systematic Review of the Literature Lucia Gasparovic 1, Stefan Weiler 1,2, Lukas Higi 1 and Andrea M. Burden 1,* 1 Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland; [email protected] (L.G.); [email protected] (S.W.); [email protected] (L.H.) 2 National Poisons Information Centre, Tox Info Suisse, Associated Institute of the University of Zurich, 8032 Zurich, Switzerland * Correspondence: [email protected]; Tel.: +41-76-685-22-56 Received: 30 August 2020; Accepted: 14 October 2020; Published: 18 October 2020 Abstract: Differentiation syndrome (DS) is a potentially fatal adverse drug reaction caused by the so-called differentiating agents such as all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), used for remission induction in the treatment of the M3 subtype of acute myeloid leukemia (AML), acute promyelocytic leukemia (APL). However, recent DS reports in trials of isocitrate dehydrogenase (IDH)-inhibitor drugs in patients with IDH-mutated AML have raised concerns. Given the limited knowledge of the incidence of DS with differentiating agents, we conducted a systematic literature review of clinical trials with reports of DS to provide a comprehensive overview of the medications associated with DS. In particular, we focused on the incidence of DS reported among the IDH-inhibitors, compared to existing ATRA and ATO therapies. We identified 44 published articles, encompassing 39 clinical trials, including 6949 patients. Overall, the cumulative incidence of DS across all treatment regimens was 17.7%.
    [Show full text]
  • WO 2013/061161 A2 2 May 2013 (02.05.2013) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2013/061161 A2 2 May 2013 (02.05.2013) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/337 (2006.01) A61K 31/48 (2006.01) kind of national protection available): AE, AG, AL, AM, A61K 31/395 (2006.01) A61K 31/51 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, A61K 31/4174 (2006.01) A61K 31/549 (2006.01) BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, A61K 31/428 (2006.01) A61K 31/663 (2006.01) DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (21) International Application Number: KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, PCT/IB20 12/002768 ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (22) International Filing Date: NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, 25 October 2012 (25.10.2012) RW, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, (25) Filing Language: English ZM, ZW. (26) Publication Language: English (84) Designated States (unless otherwise indicated, for every (30) Priority Data: kind of regional protection available): ARIPO (BW, GH, 61/552,922 28 October 201 1 (28.
    [Show full text]
  • Leukemia I N S I G H T S VOL
    Leukemia INSIGHTS VOL. 17 • NO. 1 SPRING 2012 Slow Motion Breakthroughs in Adult ALL Therapy With a recent wave of new, highly active monoclonal for ALL is poor, however, with complete response antibodies and of a new BCR-ABL tyrosine kinase rates of 20 percent to 30 percent, depending on inhibitor (ponatinib), we are at the brink of prior therapy and duration of first remission. therapeutic breakthroughs which will significantly Median disease-free survival ranges from 2 to improve survival of adult acute lymphocytic 7.5 months. Long-term survival after ALL salvage leukemia (ALL). therapy is less than 10 percent. In this issue of Adult ALL encompasses a heterogeneous group Leukemia Insights, we focus on newer investigational of lymphoid malignancies. The two predominant strategies in adult ALL. subtypes are B-ALL and T-ALL, based on expression of B-lineage or T-lineage markers. Prognosis is New Monoclonal Antibodies in Pre-B ALL related to age, karyotype, molecular profile, immu- nophenotype, and other disease features. Prognosis The targeting of CD20 in ALL with combinations for pediatric ALL has improved significantly in the of rituximab and chemotherapy has improved past several decades; the current long-term survival survival in Burkitt leukemia and in CD20+ ALL. rate is greater than 80 percent. Long-term survival In the same light, several conjugated and unconjugated in adult ALL is 35 percent to 40 percent. The most monoclonal antibodies targeting CD22 and CD19 common reason for failure is disease recurrence. are under study as almost all ALL leukemic cells The hyper-CVAD regimen (hyperfractionated also express these markers.
    [Show full text]
  • Patent Application Publication ( 10 ) Pub . No . : US 2019 / 0192440 A1
    US 20190192440A1 (19 ) United States (12 ) Patent Application Publication ( 10) Pub . No. : US 2019 /0192440 A1 LI (43 ) Pub . Date : Jun . 27 , 2019 ( 54 ) ORAL DRUG DOSAGE FORM COMPRISING Publication Classification DRUG IN THE FORM OF NANOPARTICLES (51 ) Int . CI. A61K 9 / 20 (2006 .01 ) ( 71 ) Applicant: Triastek , Inc. , Nanjing ( CN ) A61K 9 /00 ( 2006 . 01) A61K 31/ 192 ( 2006 .01 ) (72 ) Inventor : Xiaoling LI , Dublin , CA (US ) A61K 9 / 24 ( 2006 .01 ) ( 52 ) U . S . CI. ( 21 ) Appl. No. : 16 /289 ,499 CPC . .. .. A61K 9 /2031 (2013 . 01 ) ; A61K 9 /0065 ( 22 ) Filed : Feb . 28 , 2019 (2013 .01 ) ; A61K 9 / 209 ( 2013 .01 ) ; A61K 9 /2027 ( 2013 .01 ) ; A61K 31/ 192 ( 2013. 01 ) ; Related U . S . Application Data A61K 9 /2072 ( 2013 .01 ) (63 ) Continuation of application No. 16 /028 ,305 , filed on Jul. 5 , 2018 , now Pat . No . 10 , 258 ,575 , which is a (57 ) ABSTRACT continuation of application No . 15 / 173 ,596 , filed on The present disclosure provides a stable solid pharmaceuti Jun . 3 , 2016 . cal dosage form for oral administration . The dosage form (60 ) Provisional application No . 62 /313 ,092 , filed on Mar. includes a substrate that forms at least one compartment and 24 , 2016 , provisional application No . 62 / 296 , 087 , a drug content loaded into the compartment. The dosage filed on Feb . 17 , 2016 , provisional application No . form is so designed that the active pharmaceutical ingredient 62 / 170, 645 , filed on Jun . 3 , 2015 . of the drug content is released in a controlled manner. Patent Application Publication Jun . 27 , 2019 Sheet 1 of 20 US 2019 /0192440 A1 FIG .
    [Show full text]
  • Editorial Retinoids Induced Cancer Stem Cell Differentiation And
    Editorial Retinoids Induced Cancer Stem Cell Differentiation and Apoptosis for Cancer Therapies Xin Cao Project Leader of Targeted Drug Design and Validation, Zhongshan Hospital Institute of Clinical Science, Fudan University Shanghai Medical College, Shanghai, 200032, China E-mail: [email protected] Received 31 January 2019; Accepted 03 April 2019; Publication 19 April 2019 Abstract Retinoids show great potential in various kinds of cancer chemotherapy due to its ability to induce signals for cell differentiation or death, as well as inhibit cancer stem cell proliferation. This paper summarized the recent progress of retinoids induced cancer stem cell differentiation and apoptosis in cancer therapy field, with the highlighted novel retinoid named WYC-209 in our lab, which could inhibit the tumor stem cell and malignant melanoma tumors with high efficacy and little toxicity. Keywords: Retinoids, cancer stem cell, differentiation, apoptosis. The discovery of retinoic acid receptors (RARs) from early research elucidates how vitamin A (Figure 1(A)) regulates mammalian physiology including spermatogenesis, fertilization, pregnancy maintenance, morphogenesis and organogenesis. Then studies indicate the main metabolized active form of VitaminA, all-trans retinoic acid (ATRA, Figure 1(B)), played important roles in certain DNAactivation and protein expression regulations [1].Accordingly, Molecular and Cellular Therapies, Vol. 7 1, 1–8. doi: 10.13052/mct2052-8426.711 This is an Open Access publication. c 2019 the Author(s). All rights reserved. 2 Xin Cao Figure 1 Structures of several retinoids. retinoids firstly occurred as naturally low-molecular weight, fat-soluble unsaturated isoprenoids, including retinaldehyde, 9-cis retinoic acid and 13-cis retinoic acid et al., which also played essential roles as all-trans retinoic acid (ATRA) in various aspects of human vision, immunity, as well as fetal cell proliferations [2].
    [Show full text]
  • Tamibarotene in Patients with Acute Promyelocytic Leukaemia Relapsing After Treatment with All-Trans Retinoic Acid and Arsenic Trioxide D
    Donald and Barbara Zucker School of Medicine Journal Articles Academic Works 2015 Tamibarotene in patients with acute promyelocytic leukaemia relapsing after treatment with all-trans retinoic acid and arsenic trioxide D. Sanford F. Lo-Coco M. A. Sanz E. Di Bona S. Coutre See next page for additional authors Follow this and additional works at: https://academicworks.medicine.hofstra.edu/articles Part of the Hematology Commons, and the Oncology Commons Recommended Citation Sanford D, Lo-Coco F, Sanz M, Di Bona E, Coutre S, Altman J, Wetzler M, Allen SL, Ravandi F, Kantarjian H, Cortes J. Tamibarotene in patients with acute promyelocytic leukaemia relapsing after treatment with all-trans retinoic acid and arsenic trioxide. 2015 Jan 01; 171(4):Article 2062 [ p.]. Available from: https://academicworks.medicine.hofstra.edu/articles/2062. Free full text article. This Article is brought to you for free and open access by Donald and Barbara Zucker School of Medicine Academic Works. It has been accepted for inclusion in Journal Articles by an authorized administrator of Donald and Barbara Zucker School of Medicine Academic Works. For more information, please contact [email protected]. Authors D. Sanford, F. Lo-Coco, M. A. Sanz, E. Di Bona, S. Coutre, J. K. Altman, M. Wetzler, S. L. Allen, F. Ravandi, H. Kantarjian, and J. E. Cortes This article is available at Donald and Barbara Zucker School of Medicine Academic Works: https://academicworks.medicine.hofstra.edu/articles/2062 HHS Public Access Author manuscript Author Manuscript Author ManuscriptBr J Haematol Author Manuscript. Author manuscript; Author Manuscript available in PMC 2016 November 01.
    [Show full text]
  • Multiple Isolated Extramedullary Relapse of Acute Promyelocytic
    Kothari et al. SpringerPlus 2013, 2:49 http://www.springerplus.com/content/2/1/49 a SpringerOpen Journal REVIEW Open Access Multiple isolated extramedullary relapse of acute promyelocytic leukemia after allogeneic hematopoietic stem cell transplant: a case report and review of literature Shalin Kothari1*, Geoffrey Herzig1, Stephen Slone2 and Roger Herzig1 Abstract Isolated extramedullary disease (EMD) is uncommon, especially in acute promyelocytic leukemia (APL) after allogeneic hematopoietic stem cell transplantation (HSCT). We review the literature and present a 32 year old woman with APL who developed multiple EMDs after allogeneic HSCT within the calvarium, and later found to have various isolated lesions including femur, humerus and thoraco lumbar vertebrae. She was treated with local radiotherapy (XRT) to EMD lesions, all-trans retinoic acid, arsenic trioxide and donor lymphocyte infusion at different time points in her clinical course, without success. Out of reported cases in clinical setting as ours, average onset of isolated EMD is 25 months and median survival 14 months. Effective treatment of isolated EMD after HSCT is not yet clear, but ATO in combination with local XRT, tamibarotene and second HSCT have shown good results in some reported cases, but accumulation of more cases is needed to elucidate optimal therapy in such setting. Introduction after allogeneic hematopoietic stem cell transplant Among the more treatable subtypes of acute myeloid (HSCT). For the rest of this review, myeloid sarcomas leukemia (AML) is acute promyelocytic leukemia (APL). will be referred to as extramedullary disease (EMD). Nearly all patients with APL have a translocation of chromosomes 15 and 17, resulting in the fusion between RARα (retinoic acid receptor α), which encodes a retin- Case report oic acid receptor, and the promyelocytic leukemia (PML) The patient, a 32 year-old woman, was diagnosed with protein (Licht 2009).
    [Show full text]
  • Gene Signature of Children with Severe Respiratory Syncytial Virus Infection
    www.nature.com/pr BASIC SCIENCE ARTICLE OPEN Gene signature of children with severe respiratory syncytial virus infection Clyde Dapat 1, Satoru Kumaki2, Hiroki Sakurai3, Hidekazu Nishimura4, Hannah Karen Mina Labayo1, Michiko Okamoto1, Mayuko Saito1 and Hitoshi Oshitani1 BACKGROUND: The limited treatment options for children with severe respiratory syncytial virus (RSV) infection highlights the need for a comprehensive understanding of the host cellular response during infection. We aimed to identify host genes that are associated with severe RSV disease and to identify drugs that can be repurposed for the treatment of severe RSV infection. METHODS: We examined clinical data and blood samples from 37 hospitalized children (29 mild and 8 severe) with RSV infection. We tested RNA from blood samples using next-generation sequencing to profile global mRNA expression and identify cellular processes. RESULTS: Retractions, decreased breath sounds, and tachypnea were associated with disease severity. We observed upregulation of genes related to neutrophil, inflammatory response, blood coagulation, and downregulation of genes related to T cell response in children with severe RSV. Using network-based approach, 43 drugs were identified that are predicted to interact with the gene products of these differentially expressed genes. CONCLUSIONS: These results suggest that the changes in the expression pattern in the innate and adaptive immune responses may be associated with RSV clinical severity. Compounds that target these cellular processes can be repositioned as candidate 1234567890();,: drugs in the treatment of severe RSV. Pediatric Research (2021) 89:1664–1672; https://doi.org/10.1038/s41390-020-01347-9 IMPACT: ● Neutrophil, inflammation, and blood coagulation genes are upregulated in children with severe RSV infection.
    [Show full text]
  • Public Summary of Opinion on Orphan Designation Tamibarotene for the Treatment of Acute Promyelocytic Leukaemia
    EMA/COMP/361520/2009 Rev.2 Committee for Orphan Medicinal Products Public summary of opinion on orphan designation Tamibarotene for the treatment of acute promyelocytic leukaemia First publication 8 September 2009 Rev.1: sponsor’s change of address 13 March 2013 Rev.2: withdrawal from the Community Register 23 July 2013 Disclaimer Please note that revisions to the Public Summary of Opinion are purely administrative updates. Therefore, the scientific content of the document reflects the outcome of the Committee for Orphan Medicinal Products (COMP) at the time of designation and is not updated after first publication. Please note that this product was withdrawn from the Community Register of designated Orphan Medicinal Products in July 2013 on request of the Sponsor. On 24 July 2009, orphan designation (EU/3/09/658) was granted by the European Commission to Eudax S.R.L., Italy, for tamibarotene for the treatment of acute promyelocytic leukaemia. What is acute promyelocytic leukaemia? Acute promyelocytic leukaemia (APL) is a rare form of leukaemia, a cancer of the white blood cells (cells that fight against infections). APL is caused by a ‘chromosomal translocation’ (when there is a rearrangement of parts of genes between two chromosomes). The translocation affects the way the white blood cells grow. The cells also lack the ability to use retinoic acid (vitamin A). In patients with APL, large numbers of abnormal, immature white blood cells called ‘blasts’ quickly build up in the bone marrow (the spongy tissue inside the large bones) and are found in the blood. APL is a life-threatening disease because these immature cells take the place of the normal white blood cells, reducing the patient’s ability to fight infections.
    [Show full text]