Phase 2 study of imexon, a prooxidant molecule, in relapsed and refractory B-cell non-Hodgkin lymphoma

Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular redox balance. We therefore designed a phase 2 study of imexon (Amplimexon/NSC-714597), a prooxidant molecule, in patients with relapsed/refr...

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Veröffentlicht in:Blood Jg. 124; H. 8; S. 1259
Hauptverfasser: Barr, Paul M, Miller, Thomas P, Friedberg, Jonathan W, Peterson, Derick R, Baran, Andrea M, Herr, Megan, Spier, Catherine M, Cui, Haiyan, Roe, Denise J, Persky, Daniel O, Casulo, Carla, Littleton, Jamie, Schwartz, Mark, Puvvada, Soham, Landowski, Terry H, Rimsza, Lisa M, Dorr, Robert T, Fisher, Richard I, Bernstein, Steven H, Briehl, Margaret M
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 21.08.2014
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ISSN:1528-0020, 1528-0020
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Abstract Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular redox balance. We therefore designed a phase 2 study of imexon (Amplimexon/NSC-714597), a prooxidant molecule, in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). Imexon was administered at 1000 mg/m(2) IV daily for 5 days in 21-day cycles. Gene expression analysis performed on pretreatment tumor specimens included 13 transcripts used to generate a redox signature score, previously demonstrated to correlate with lymphoma prognosis. Twenty-two patients were enrolled having follicular (n = 9), diffuse large B-cell (DLBCL) (n = 5), mantle cell (n = 3), transformed follicular (n = 2), small lymphocytic (n = 2), and Burkitt (n = 1) lymphoma. The most common grade 3/4 adverse events were anemia (14%) and neutropenia (9%). The overall response rate was 30%, including responses in follicular lymphoma (4 of 9) and DLBCL (2 of 5). Gene expression analyses revealed CD68 and the redox-related genes, GPX1 and SOD2, as well as a higher redox score to correlate with clinical responses. Therefore, pretreatment markers of oxidative stress may identify patients likely to respond to this therapeutic approach. This trial was registered at www.clinicaltrials.gov as #NCT01314014.
AbstractList Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular redox balance. We therefore designed a phase 2 study of imexon (Amplimexon/NSC-714597), a prooxidant molecule, in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). Imexon was administered at 1000 mg/m(2) IV daily for 5 days in 21-day cycles. Gene expression analysis performed on pretreatment tumor specimens included 13 transcripts used to generate a redox signature score, previously demonstrated to correlate with lymphoma prognosis. Twenty-two patients were enrolled having follicular (n = 9), diffuse large B-cell (DLBCL) (n = 5), mantle cell (n = 3), transformed follicular (n = 2), small lymphocytic (n = 2), and Burkitt (n = 1) lymphoma. The most common grade 3/4 adverse events were anemia (14%) and neutropenia (9%). The overall response rate was 30%, including responses in follicular lymphoma (4 of 9) and DLBCL (2 of 5). Gene expression analyses revealed CD68 and the redox-related genes, GPX1 and SOD2, as well as a higher redox score to correlate with clinical responses. Therefore, pretreatment markers of oxidative stress may identify patients likely to respond to this therapeutic approach. This trial was registered at www.clinicaltrials.gov as #NCT01314014.Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular redox balance. We therefore designed a phase 2 study of imexon (Amplimexon/NSC-714597), a prooxidant molecule, in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). Imexon was administered at 1000 mg/m(2) IV daily for 5 days in 21-day cycles. Gene expression analysis performed on pretreatment tumor specimens included 13 transcripts used to generate a redox signature score, previously demonstrated to correlate with lymphoma prognosis. Twenty-two patients were enrolled having follicular (n = 9), diffuse large B-cell (DLBCL) (n = 5), mantle cell (n = 3), transformed follicular (n = 2), small lymphocytic (n = 2), and Burkitt (n = 1) lymphoma. The most common grade 3/4 adverse events were anemia (14%) and neutropenia (9%). The overall response rate was 30%, including responses in follicular lymphoma (4 of 9) and DLBCL (2 of 5). Gene expression analyses revealed CD68 and the redox-related genes, GPX1 and SOD2, as well as a higher redox score to correlate with clinical responses. Therefore, pretreatment markers of oxidative stress may identify patients likely to respond to this therapeutic approach. This trial was registered at www.clinicaltrials.gov as #NCT01314014.
Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular redox balance. We therefore designed a phase 2 study of imexon (Amplimexon/NSC-714597), a prooxidant molecule, in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL). Imexon was administered at 1000 mg/m(2) IV daily for 5 days in 21-day cycles. Gene expression analysis performed on pretreatment tumor specimens included 13 transcripts used to generate a redox signature score, previously demonstrated to correlate with lymphoma prognosis. Twenty-two patients were enrolled having follicular (n = 9), diffuse large B-cell (DLBCL) (n = 5), mantle cell (n = 3), transformed follicular (n = 2), small lymphocytic (n = 2), and Burkitt (n = 1) lymphoma. The most common grade 3/4 adverse events were anemia (14%) and neutropenia (9%). The overall response rate was 30%, including responses in follicular lymphoma (4 of 9) and DLBCL (2 of 5). Gene expression analyses revealed CD68 and the redox-related genes, GPX1 and SOD2, as well as a higher redox score to correlate with clinical responses. Therefore, pretreatment markers of oxidative stress may identify patients likely to respond to this therapeutic approach. This trial was registered at www.clinicaltrials.gov as #NCT01314014.
Author Casulo, Carla
Miller, Thomas P
Persky, Daniel O
Spier, Catherine M
Barr, Paul M
Fisher, Richard I
Roe, Denise J
Peterson, Derick R
Herr, Megan
Rimsza, Lisa M
Schwartz, Mark
Landowski, Terry H
Baran, Andrea M
Briehl, Margaret M
Friedberg, Jonathan W
Littleton, Jamie
Dorr, Robert T
Puvvada, Soham
Bernstein, Steven H
Cui, Haiyan
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  organization: University of Rochester, Wilmot Cancer Center, Rochester, NY
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  organization: University of Arizona Cancer Center, Tucson, AZ
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  organization: University of Rochester, Wilmot Cancer Center, Rochester, NY
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  organization: University of Rochester, Wilmot Cancer Center, Rochester, NY
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  organization: University of Rochester, Wilmot Cancer Center, Rochester, NY
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  organization: University of Rochester, Wilmot Cancer Center, Rochester, NY
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  organization: University of Arizona Cancer Center, Tucson, AZ
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  organization: University of Arizona Cancer Center, Tucson, AZ
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  organization: Department of Pathology, University of Arizona, Tucson, AZ
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Snippet Lymphoma cells are subject to higher levels of oxidative stress compared with their normal counterparts and may be vulnerable to manipulations of the cellular...
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StartPage 1259
SubjectTerms Adult
Aged
Aged, 80 and over
Biomarkers, Tumor - biosynthesis
Disease-Free Survival
Female
Gene Expression Regulation, Neoplastic - drug effects
Glutathione Peroxidase - biosynthesis
Glutathione Peroxidase GPX1
Hexanones - administration & dosage
Hexanones - adverse effects
Humans
Lymphoma, B-Cell - drug therapy
Lymphoma, B-Cell - metabolism
Lymphoma, B-Cell - mortality
Lymphoma, B-Cell - pathology
Male
Middle Aged
Neoplasm Proteins - biosynthesis
Oxidants - administration & dosage
Oxidants - adverse effects
Oxidative Stress - drug effects
Recurrence
Superoxide Dismutase - biosynthesis
Survival Rate
Title Phase 2 study of imexon, a prooxidant molecule, in relapsed and refractory B-cell non-Hodgkin lymphoma
URI https://www.ncbi.nlm.nih.gov/pubmed/25016003
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