Development of Sapacitabine Therapy in Leukemias

沙帕西他滨治疗白血病的进展

基本信息

批准号：
7468680
负责人：
WILLIAM K PLUNKETT
金额：
$ 17.34万
依托单位：
UNIVERSITY OF TX MD ANDERSON CAN CTR
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-01 至 2013-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7468680
关键词：
Achievement Acute Myelocytic Leukemia Acute leukemia Address Advanced Development BAY 54-9085 Bioavailable Biological Markers Biological Models Blast Cell Cell Cycle Checkpoint Cells Chemicals Class Clinic Clinical Clinical Research Clinical Trials Complement Condition Cytosine DNA Repair Development Disease remission Dose Drug Kinetics Effectiveness FLT3 gene FLT3 inhibition FLT3 inhibitor Goals Human In Vitro Investigation Laboratories Lead Lesion Maintenance Therapy Malignant Neoplasms Molecular Abnormality Mutation Newly Diagnosed Nucleotides Numbers Outcome Pathway interactions Patient Selection Patients Peripheral Pharmaceutical Preparations Pharmacodynamics Phase Phase I Clinical Trials Phase III Clinical Trials Plasma Range Rate Receptor Protein-Tyrosine Kinases Refractory Relapse Reproduction spores Research Resistance Role Sampling Schedule Standards of Weights and Measures Stem cells Testing Therapeutic Agents Toxic effect Translations Tyrosine Kinase Inhibitor Work abstracting analog base bench to bedside cancer cell chemotherapeutic agent chemotherapy clinical effect concept cytosine nucleoside cytotoxic design improved in vitro Model inhibitor/antagonist killings leukemia leukemic stem cell mutant novel nucleoside analog phosphodiester prognostic receptor repaired response sensor small molecule stem success translational study tripolyphosphate

项目摘要

Effective therapies for acute leukemias have been developed incrementally, advanced by the development of agents with different mechanisms of action. Sapacitabine, the orally bioavailable form of CNDAC (2'-Ccyano- 2'-deoxy-1-/3-D-ara¿>/no-pentofuranosyl- cytosine), is a potent cytosine nucleoside analogue with a novel mechanism of action. The design of CNDAC was based on the concept that once its triphosphate is incorporated into DMA, the addition of a subsequent deoxynucleotide would initiate 3-elimination, resulting in cleavage of the 3'-5' phosphodiester linkage and conversion of incorporated analogue to a chain-terminating nucleotide, CNddC. Clinically active in phase I studies, the mechanisms of action of sapacitabine are unique among therapeutic agents, as it causes a single strand nick in DMA that is terminated by a nucleotide that cannot be extended and is resistant to repair. Our hypothesis is that sapacitabine will elicit novel pharmacodynamic responses for detecting DMA damage, for repair of the lesions, and for activation of cell cycle checkpoints that will serve as biomarkers to guide clinical development of sapacitabine alone and in combination with targeted inhibitors of these pathways. We will conduct translational studies in primary leukemia cells in vitro and during therapy that will complement and extend ongoing laboratory investigations. The specific aims for testing this hypothesis are: 1. Evaluate pharmacokinetics and pharmacodynamics of sapacitabine during phase l/ll clinical trials in patients with relapsed/refractory leukemias, 2. Characterize biomarkers for cellular responses to sapacitabine, 3. Formulate laboratory rationales for clinical translation of mechanism-based combinations of sapacitabine with small molecule inhibitors. The overall goal of our proposal is aimed at developing a thorough understanding of cellular responses to sapacitabine that will identify biomarkers that have prognostic value to optimize patient selection and schedules of administration in the clinic, and to provide rationales for combinations with agents targeted at inhibiting DMA damage sensors, DNA repair mechanisms, and dysregulating checkpoint controls. Lay abstract: We have identified a drug candidate that kills cancer cells in ways that are different from all other drugs. We have shown that it active treatment in humans with leukemia who have not responded to standard therapies, and propose laboratory and clinical studies that may increase its effectiveness at treating these and other cancers.

急性白血病的有效治疗方法已逐步开发出来，并随着发展而进步具有不同作用机制的药物，CNDAC（2'-Ccyano-）的口服生物利用形式。 2'-脱氧-1-/3-D-ara¿ >/no-pentofuranosyl- cytosine），是一种有效的胞嘧啶核苷类似物，具有 CNDAC 的新作用机制是基于这样的概念：一旦其三磷酸盐被掺入 DMA 后，添加随后的脱氧核苷酸将引发 3-消除，从而导致 3'-5' 磷酸二酯键的裂解以及将掺入的类似物转化为链终止核苷酸，CNddC 在 I 期研究中处于临床活跃状态，沙帕西他滨的作用机制是独特的。在治疗药物中，它会导致 DMA 中出现单链切口，该切口由核苷酸终止我们的假设是，沙帕西他滨会引发新的症状。用于检测 DMA 损伤、修复损伤和激活细胞的药效反应周期检查点将作为生物标志物指导沙帕西他滨单独和联合临床开发与这些途径的靶向抑制剂相结合，我们将在初级阶段进行转化研究。体外和治疗期间的白血病细胞将补充和扩展正在进行的实验室研究。检验该假设的具体目的是： 1. 评估药物的药代动力学和药效学沙帕西他滨在复发/难治性白血病患者的 l/ll 期临床试验中，2. 表征细胞对萨帕西他滨反应的生物标志物，3. 制定临床转化的实验室原理基于机制的沙帕西他滨与小分子抑制剂的组合我们的总体目标。该提案旨在全面了解细胞对萨帕西他滨的反应，这将识别具有预后价值的生物标志物，以优化患者选择和给药方案并为与抑制 DMA 损伤的药物联合使用提供依据传感器、DNA 修复机制和失调的检查点控制：我们已经确定了。一种以不同于所有其他药物的方式杀死癌细胞的候选药物。对标准疗法没有反应的白血病患者进行积极治疗，并提出实验室和临床研究可能会提高其治疗这些癌症和其他癌症的有效性。