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The Application of a Characterized Pre-Clinical
THE APPLICATION OF A CHARACTERIZED PRE-CLINICAL GLIOBLASTOMA ONCOSPHERE MODEL TO IN VITRO AND IN VIVO THERAPEUTIC TESTING by Kelli M. Wilson A dissertation submitted to Johns Hopkins University in conformity with the requirements for the degree of Doctor of Philosophy Baltimore, Maryland March, 2014 ABSTRACT Glioblastoma multiforme (GBM) is a lethal brain cancer with a median survival time (MST) of approximately 15 months following treatment. A serious challenge facing the development of new drugs for the treatment of GBM is that preclinical models fail to replicate the human GBM phenotype. Here we report the Johns Hopkins Oncosphere Panel (JHOP), a panel of GBM oncosphere cell lines. These cell lines were validated by their ability to form tumors intracranially with histological features of human GBM and GBM variant tumors. We then completed whole exome sequencing on JHOP and found that they contain genetic alterations in GBM driver genes such as PTEN, TP53 and CDKN2A. Two JHOP cell lines were utilized in a high throughput drug screen of 466 compounds that were selected to represent late stage clinical development and a wide range of mechanisms. Drugs that were inhibitory in both cell lines were EGFR inhibitors, NF-kB inhibitors and apoptosis activators. We also examined drugs that were inhibitory in a single cell line. Effective drugs in the PTEN null and NF1 wild type cell line showed a limited number of drug targets with EGFR inhibitors being the largest group of cytotoxic compounds. However, in the PTEN mutant, NF1 null cell line, VEGFR/PDGFR inhibitors and dual PIK3/mTOR inhibitors were the most common effective compounds. -
Clinical Policy: Baricitinib (Olumiant) Reference Number: ERX.SPA.291 Effective Date: 07.24.18 Last Review Date: 11.18 Revision Log
Clinical Policy: Baricitinib (Olumiant) Reference Number: ERX.SPA.291 Effective Date: 07.24.18 Last Review Date: 11.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Baricitinib (Olumiant®) is Janus kinase (JAK) inhibitor. FDA Approved Indication(s) Olumiant is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response to one or more tumor necrosis factor (TNF) antagonist therapies. Limitation(s) of use: Use of Olumiant in combination with other JAK inhibitors, biologic disease-modifying antirheumatic drugs (DMARDs), or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. Policy/Criteria Provider must submit documentation (such as office chart notes, lab results or other clinical information) supporting that member has met all approval criteria. It is the policy of health plans affiliated with Envolve Pharmacy Solutions™ that Olumiant is medically necessary when the following criteria are met: I. Initial Approval Criteria A. Rheumatoid Arthritis (must meet all): 1. Diagnosis of RA; 2. Prescribed by or in consultation with a rheumatologist; 3. Age ≥ 18 years; 4. Member meets one of the following (a or b): a. Failure of a ≥ 3 consecutive month trial of methotrexate (MTX) at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced; b. If intolerance or contraindication to MTX (see Appendix D), failure of a ≥ 3 consecutive month trial of at least ONE conventional DMARD (e.g., sulfasalazine, leflunomide, hydroxychloroquine) at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced; 5. -
Proteomics and Drug Repurposing in CLL Towards Precision Medicine
cancers Review Proteomics and Drug Repurposing in CLL towards Precision Medicine Dimitra Mavridou 1,2,3, Konstantina Psatha 1,2,3,4,* and Michalis Aivaliotis 1,2,3,4,* 1 Laboratory of Biochemistry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece; [email protected] 2 Functional Proteomics and Systems Biology (FunPATh)—Center for Interdisciplinary Research and Innovation (CIRI-AUTH), GR-57001 Thessaloniki, Greece 3 Basic and Translational Research Unit, Special Unit for Biomedical Research and Education, School of Medicine, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece 4 Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology, GR-70013 Heraklion, Greece * Correspondence: [email protected] (K.P.); [email protected] (M.A.) Simple Summary: Despite continued efforts, the current status of knowledge in CLL molecular pathobiology, diagnosis, prognosis and treatment remains elusive and imprecise. Proteomics ap- proaches combined with advanced bioinformatics and drug repurposing promise to shed light on the complex proteome heterogeneity of CLL patients and mitigate, improve, or even eliminate the knowledge stagnation. In relation to this concept, this review presents a brief overview of all the available proteomics and drug repurposing studies in CLL and suggests the way such studies can be exploited to find effective therapeutic options combined with drug repurposing strategies to adopt and accost a more “precision medicine” spectrum. Citation: Mavridou, D.; Psatha, K.; Abstract: CLL is a hematological malignancy considered as the most frequent lymphoproliferative Aivaliotis, M. Proteomics and Drug disease in the western world. It is characterized by high molecular heterogeneity and despite the Repurposing in CLL towards available therapeutic options, there are many patient subgroups showing the insufficient effectiveness Precision Medicine. -
Immunosuppressant Drugs Therapy with COVID-19
Immunosuppressant Drugs Therapy with COVID-19: Associated Risks, Drug-Drug Interactions & Contraindications Debjyoti Talukdar1, Diane Ignacio2, and Madan Mohan Gupta2 1Teerthanker Mahaveer University 2The University of the West Indies at St Augustine September 24, 2020 Abstract Immunosuppressant drugs like Etanercept, Mycophenolate mofetil, Sirolimus, Cyclosporine and Rituximab can weaken the immune system and make patients susceptible to SARS nCoV-2 virus. These drugs make immunocompromised persons more vulnerable to complications associated with COVID-19. Moreover, it can also increase the mortality and morbidity, as a weakened immune system can lead to longer duration of infection. This study discusses the guidelines on immunosuppressant drugs and its associated risk factors with COVID-19, issued by the U.S CDC (Centers for Disease Control and Prevention), WHO (World Health Organisation), U.S FDA (Food and Drug Administration) and other accredited global health organisa- tions. Moreover, it also includes information about pharmaceutical properties, mechanism of action, COVID-19 associated risk factors, adverse drug reactions, contraindications and drug-drug interactions. Our study will help government partners and international health organisations to better understand COVID-19 health risks associated with immunosuppressants. Increased public awareness about effective drug therapy for autoimmune diseases, cancer treatment, immunocompromised and organ transplant patients will help lower the mortality and morbidity associated with the disease amid COVID-19 pandemic. 1. INTRODUCTION As per the U.S Department of Health and Human Services and U.S FDA, immunosuppressant drugs can cause susceptibility to viruses leading to infection with increase in morbidity of the disease. It can cause severe risk of illness from COVID-19 due to a weakened immune system. -
Us 8530498 B1 3
USOO853 0498B1 (12) UnitedO States Patent (10) Patent No.: US 8,530,498 B1 Zeldis (45) Date of Patent: *Sep. 10, 2013 (54) METHODS FORTREATING MULTIPLE 5,639,476 A 6/1997 OShlack et al. MYELOMAWITH 5,674,533 A 10, 1997 Santus et al. 3-(4-AMINO-1-OXO-1,3-DIHYDROISOINDOL- 395 A 22 N. 2-YL)PIPERIDINE-2,6-DIONE 5,731,325 A 3/1998 Andrulis, Jr. et al. 5,733,566 A 3, 1998 Lewis (71) Applicant: Celgene Corporation, Summit, NJ (US) 5,798.368 A 8, 1998 Muller et al. 5,874.448 A 2f1999 Muller et al. (72) Inventor: Jerome B. Zeldis, Princeton, NJ (US) 5,877,200 A 3, 1999 Muller 5,929,117 A 7/1999 Muller et al. 5,955,476 A 9, 1999 Muller et al. (73) Assignee: Celgene Corporation, Summit, NJ (US) 6,020,358 A 2/2000 Muller et al. - 6,071,948 A 6/2000 D'Amato (*) Notice: Subject to any disclaimer, the term of this 6,114,355 A 9, 2000 D'Amato patent is extended or adjusted under 35 SS f 1939. All et al. U.S.C. 154(b) by 0 days. 6,235,756 B1 5/2001 D'Amatoreen et al. This patent is Subject to a terminal dis- 6,281.230 B1 8/2001 Muller et al. claimer 6,316,471 B1 1 1/2001 Muller et al. 6,326,388 B1 12/2001 Man et al. 6,335,349 B1 1/2002 Muller et al. (21) Appl. No.: 13/858,708 6,380.239 B1 4/2002 Muller et al. -
Leflunomide-Arava-Fact-Sheet
Leflunomide PATIENT FACT SHEET (Arava) Leflunomide (Arava) is a drug approved to treat combination with other DMARDs. Leflunomide blocks the adults with moderate to severe rheumatoid arthritis. formation of DNA, which is important for replicating cells, It belongs to a class of medications called disease such as those in the immune system. It suppresses the modifying antirheumatic drugs (DMARDs). Leflunomide immune system to reduce inflammation that causes pain is often used to treat rheumatoid arthritis alone or in and swelling in rheumatoid arthritis. WHAT IS IT? Leflunomide is usually given as a 20 mg tablet once a the first 3 days after starting leflunomide. It may take day. Doctors will often prescribe a “loading dose” to be several weeks after starting leflunomide to experience an taken when the medicine is first prescribed. The loading improvement in joint pain or swelling. Complete benefits dose of leflunomide is usually 100 mg (or five 20 mg may not be experienced until 6 to 12 weeks after starting HOW TO tablets) once weekly for 3 weeks or 100 mg a day for the medication. TAKE IT The most common side effect of leflunomide is stomach pain, indigestion, rash, and hair loss. In fewer diarrhea, which occurs in approximately 20 percent than 10 percent of patients, leflunomide can cause of patients. This symptom frequently improves with abnormal liver function tests or decreased blood cell time or by taking a medication to prevent diarrhea. If or platelet counts. Rarely, this drug may cause lung diarrhea persists, the dose of leflunomide may need to problems, such as cough, shortness of breath or be reduced. -
2017 American College of Rheumatology/American Association
Arthritis Care & Research Vol. 69, No. 8, August 2017, pp 1111–1124 DOI 10.1002/acr.23274 VC 2017, American College of Rheumatology SPECIAL ARTICLE 2017 American College of Rheumatology/ American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty SUSAN M. GOODMAN,1 BRYAN SPRINGER,2 GORDON GUYATT,3 MATTHEW P. ABDEL,4 VINOD DASA,5 MICHAEL GEORGE,6 ORA GEWURZ-SINGER,7 JON T. GILES,8 BEVERLY JOHNSON,9 STEVE LEE,10 LISA A. MANDL,1 MICHAEL A. MONT,11 PETER SCULCO,1 SCOTT SPORER,12 LOUIS STRYKER,13 MARAT TURGUNBAEV,14 BARRY BRAUSE,1 ANTONIA F. CHEN,15 JEREMY GILILLAND,16 MARK GOODMAN,17 ARLENE HURLEY-ROSENBLATT,18 KYRIAKOS KIROU,1 ELENA LOSINA,19 RONALD MacKENZIE,1 KALEB MICHAUD,20 TED MIKULS,21 LINDA RUSSELL,1 22 14 23 17 ALEXANDER SAH, AMY S. MILLER, JASVINDER A. SINGH, AND ADOLPH YATES Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be volun- tary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommendations are intended to promote benefi- cial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medi- cal knowledge, technology, and practice. -
Practice Guideline: Disease-Modifying Therapies for Adults with Multiple Sclerosis
Practice guideline: Disease-modifying therapies for adults with multiple sclerosis Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology Alexander Rae-Grant, MD1; Gregory S. Day, MD, MSc2; Ruth Ann Marrie, MD, PhD3; Alejandro Rabinstein, MD4; Bruce A.C. Cree, MD, PhD, MAS5; Gary S. Gronseth, MD6; Michael Haboubi, DO7; June Halper, MSN, APN-C, MSCN8; Jonathan P. Hosey, MD9; David E. Jones, MD10; Robert Lisak, MD11; Daniel Pelletier, MD12; Sonja Potrebic, MD, PhD13; Cynthia Sitcov14; Rick Sommers, LMSW15; Julie Stachowiak, PhD16; Thomas S.D. Getchius17; Shannon A. Merillat, MLIS18; Tamara Pringsheim, MD, MSc19 1. Department of Neurology, Cleveland Clinic, OH 2. Department of Neurology, Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St. Louis, MO 3. Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada 4. Department of Neurology, Mayo Clinic, Rochester, MN 5. UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco 6. Department of Neurology, Kansas University Medical Center, Kansas City 7. Department of Neurology, School of Medicine, University of Louisville, KY 8. Consortium of Multiple Sclerosis Centers, Hackensack, NJ 9. Department of Neuroscience, St. Luke’s University Health Network, Bethlehem, PA 10. Department of Neurology, School of Medicine, University of Virginia, Charlottesville 11. Consortium of Multiple Sclerosis Centers, Hackensack, NJ, and Department of Neurology, School of Medicine, Wayne State University, Detroit, MI 12. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles 13. Neurology Department, Southern California Permanente Medical Group, Kaiser, Los Angeles 14. -
Multinational Evaluation of Mycophenolic Acid, Tacrolimus
View metadata, citation and similar papers at core.ac.uk brought to you by CORE providedORIGINAL by University of QueenslandPAPER eSpace ISSN 1425-9524 © Ann Transplant, 2016; 21: 1-11 DOI: 10.12659/AOT.895664 Received: 2015.08.15 Accepted: 2015.09.01 Multinational Evaluation of Mycophenolic Published: 2016.01.05 Acid, Tacrolimus, Cyclosporin, Sirolimus, and Everolimus Utilization Authors’ Contribution: ABCDEF Kyle M. Gardiner School of Pharmacy, University of Queensland, Brisbane, QLD, Australia Study Design A ACDEF Susan E. Tett Data Collection B Statistical Analysis C ACDEF Christine E. Staatz Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G Corresponding Author: Christine E. Staatz, e-mail: [email protected] Source of support: Departmental funding only Background: Increasing immunosuppressant utilization and expenditure is a worldwide challenge as more people success- fully live with transplanted organs. Our aims were to characterize utilization of mycophenolate, tacrolimus, cy- closporin, sirolimus, and everolimus in Australian transplant recipients from 2007 to 2013; to identify specific patterns of usage; and to compare Australian utilization with Norwegian, Danish, Swedish, and the Netherlands use. Material/Methods: Australian utilization and expenditure data were captured through national Pharmaceutical Benefits Scheme and Highly Specialized Drug administrative databases. Norwegian, Danish, Swedish, and the Netherlands uti- lization were retrieved from their healthcare databases. Utilization was compared as defined daily dose per 1000 population per day (DDD/1000 population/day). Data on kidney transplant recipients, the predominant patient group prescribed these medicines, were obtained from international transplant registries. Results: From 2007–2013 Australian utilization of mycophenolic acid, tacrolimus and everolimus increased 2.7-fold, 2.2- fold, and 2.3-fold, respectively. -
Cereblon and Its Downstream Substrates As Molecular Targets of Immunomodulatory Drugs
Int J Hematol (2016) 104:293–299 DOI 10.1007/s12185-016-2073-4 PROGRESS IN HEMATOLOGY Mechanisms of action of novel drugs in multiple myeloma and those responsible for the acquired resistance Cereblon and its downstream substrates as molecular targets of immunomodulatory drugs Takumi Ito1,2 · Hiroshi Handa1 Received: 15 June 2016 / Revised: 19 July 2016 / Accepted: 19 July 2016 / Published online: 26 July 2016 © The Japanese Society of Hematology 2016 Abstract Thalidomide was first developed as a sedative History of immunomodulatory drugs (IMiDs) around 60 years ago, but exhibited teratogenicity, leading to serious defects such as limb deformities. Nevertheless, Immunomodulatory drugs (IMiDs) are a new class of anti- thalidomide is now recognized as a therapeutic drug for the cancer drugs for which the parent molecule is thalidomide. treatment of Hansen’s disease and myeloma. Immunomod- Thalidomide (Fig. 1) was developed as a sedative in 1950s ulatory drugs (IMiDs), a new class of anti-cancer drug by the German pharmaceutical company Grunenthal. derived from thalidomide, have also been developed and Experiments using rodents initially suggested it to be safe exert potent anti-cancer effects. Although the molecular for use in humans, and the drug was sold over 40 countries, mechanism of thalidomide and IMiDs remained unclear for including Japan. However, as is widely known, thalidomide a long time, cereblon, a substrate receptor of the CRL4 E3 was found to have serious teratogenic effects. Use during ubiquitin ligase was identified as a primary direct target by pregnancy is associated with developmental defects of the a new affinity technique. A growing body of evidence sug- limbs and ears. -
LEUSTATIN (Cladribine) Injection Should Be Administered Under the Supervision of a Qualified Physician Experienced in the Use of Antineoplastic Therapy
LEUSTATIN (cladribine) Injection For Intravenous Infusion Only WARNING LEUSTATIN (cladribine) Injection should be administered under the supervision of a qualified physician experienced in the use of antineoplastic therapy. Suppression of bone marrow function should be anticipated. This is usually reversible and appears to be dose dependent. Serious neurological toxicity (including irreversible paraparesis and quadraparesis) has been reported in patients who received LEUSTATIN Injection by continuous infusion at high doses (4 to 9 times the recommended dose for Hairy Cell Leukemia). Neurologic toxicity appears to demonstrate a dose relationship; however, severe neurological toxicity has been reported rarely following treatment with standard cladribine dosing regimens. Acute nephrotoxicity has been observed with high doses of LEUSTATIN (4 to 9 times the recommended dose for Hairy Cell Leukemia), especially when given concomitantly with other nephrotoxic agents/therapies. DESCRIPTION LEUSTATIN (cladribine) Injection (also commonly known as 2-chloro-2΄-deoxy- β -D-adenosine) is a synthetic antineoplastic agent for continuous intravenous infusion. It is a clear, colorless, sterile, preservative-free, isotonic solution. LEUSTATIN Injection is available in single-use vials containing 10 mg (1 mg/mL) of cladribine, a chlorinated purine nucleoside analog. Each milliliter of LEUSTATIN Injection contains 1 mg of the active ingredient and 9 mg (0.15 mEq) of sodium chloride as an inactive ingredient. The solution has a pH range of 5.5 to 8.0. Phosphoric -
Characterization of Ocular Adverse Events in Patients Receiving
Characterization of Ocular Adverse Events in Patients Receiving Belantamab Mafadotin for ≥12 Months: Post-Hoc Analysis of DREAMM-2 Study in Relapsed/Refractory Multiple Myeloma S. LONIAL1; A.K. NOOKA1; P. THULASI2; A.Z. BADROS3; B.H. JENG3; N.S. CALLANDER4; D. SBOROV5; B.E. ZAUGG6; R. POPAT7; S. DEGLI ESPOSTI8; J. BARON9; A. DOHERTY9; E. LEWIS10; J. OPALINSKA9; P. PAKA9; T. PIONTEK9; I. GUPTA9; A.V. FAROOQ11; A. JAKUBOWIAK11 | 1Emory University, Winship Cancer Institute, Atlanta, GA, USA; 2Emory Eye Center, Emory University, Atlanta, GA, USA; 3University of Maryland School of Medicine, Baltimore, MD, USA; 4University of Wisconsin, Carbone Cancer Center, Madison, WI, USA; 5Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; 6Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 7University College London Hospitals, NHS Foundation Trust, London, UK; 8NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 9GlaxoSmithKline, Collegeville, PA, USA; 10GlaxoSmithKline, Research Triangle Park, NC, USA; 11University of Chicago Medical Center, Chicago, IL, USA Dose delays and reductions related to ocular adverse events INTRODUCTION RESULTS All 14 patients required ≥2 dose delays, with dose reduction (to 1.92 mg/kg) in CONCLUSIONS Belantamab mafodotin (belamaf; GSK2857916) is a first-in-class, monomethyl auristatin F (MMAF)-containing 12 patients (86%). Demographics, efficacy, and overall safety information for patients treated with belamaf In this subset of 14 patients from the DREAMM-2 study, the median duration of response was antibody–drug conjugate (ADC) that binds to B-cell maturation antigen (BCMA) and eliminates multiple myeloma cells by for ≥12 months ● Patients experienced a mean of 3.6 dose delays over the ≥12 months of treatment a multimodal mechanism of action.1 (median: 3.5, range: 2–6).