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Krzysztof Jamroziak, Bartosz Puła, Jan Walewski
A number of new treatment options have recently emerged for chronic lymphocytic leukemia (CLL) patients, including the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib, phosphatidylinositol-3-kinase (PI3K) delta isoform inhibitor idelalisib combined with rituximab, the Bcl-2 antagonist venetoclax, and the new anti-CD20 antibodies obinutuzumab and ofatumumab. Most of these agents are already included into treatment algorithms defined by international practice guidelines, but more clinical investigations are needed to answer still remaining questions...
January 2017: Current Treatment Options in Oncology
Gillian L Dornan, Braden D Siempelkamp, Meredith L Jenkins, Oscar Vadas, Carrie L Lucas, John E Burke
Activated PI3K Delta Syndrome (APDS) is a primary immunodeficiency disease caused by activating mutations in either the leukocyte-restricted p110δ catalytic (PIK3CD) subunit or the ubiquitously expressed p85α regulatory (PIK3R1) subunit of class IA phosphoinositide 3-kinases (PI3Ks). There are two classes of APDS: APDS1 that arises from p110δ mutations that are analogous to oncogenic mutations found in the broadly expressed p110α subunit and APDS2 that occurs from a splice mutation resulting in p85α with a central deletion (Δ434-475)...
February 6, 2017: Proceedings of the National Academy of Sciences of the United States of America
Zohreh Nademi, Mary A Slatter, Christopher C Dvorak, Benedicte Neven, Alain Fischer, Felipe Suarez, Claire Booth, Kanchan Rao, Alexandra Laberko, Julia Rodina, Yves Bertrand, Sylwia Kołtan, Robert Dębski, Terence Flood, Mario Abinun, Andrew R Gennery, Sophie Hambleton, Stephan Ehl, Andrew J Cant
No abstract text is available yet for this article.
November 12, 2016: Journal of Allergy and Clinical Immunology
Klemens Hoegenauer, Nicolas Soldermann, Christina Hebach, Gregory J Hollingworth, Ian Lewis, Anette von Matt, Alexander B Smith, Romain M Wolf, Rainer Wilcken, Dorothea Haasen, Christoph Burkhart, Frédéric Zécri
In the recent years, PI3Kδ has emerged as a promising target for the treatment of B- and T-cell mediated inflammatory diseases. We present a cellular assay activity analysis for our previously reported 4,6-diaryl quinazoline PI3Kδ inhibitor series that suggests an optimal logP range between 2 and 3. We discovered novel analogues in this lipophilicity space that feature a chiral pyrrolidineoxy-group as a replacement for the position-4 aromatic ring of 4,6-diaryl quinazolines. These Fsp(3) enriched derivatives retain potency and selectivity towards PI3Kδ...
October 27, 2016: Bioorganic & Medicinal Chemistry Letters
Changchun Deng, Mark R Lipstein, Luigi Scotto, Xavier O Jirau Serrano, Michael A Mangone, Shirong Li, Jeremie Vendome, Yun Hao, Xiaoming Xu, Shi-Xian Deng, Ronald B Realubit, Nicholas P Tatonetti, Charles Karan, Suzanne Lentzsch, David A Fruman, Barry Honig, Donald W Landry, Owen A O'Connor
Phosphoinositide 3-kinase (PI3K) and the proteasome pathway are both involved in activating the mechanistic target of rapamycin (mTOR). Because mTOR signaling is required for initiation of messenger RNA translation, we hypothesized that cotargeting the PI3K and proteasome pathways might synergistically inhibit translation of c-Myc. We found that a novel PI3K δ isoform inhibitor TGR-1202, but not the approved PI3Kδ inhibitor idelalisib, was highly synergistic with the proteasome inhibitor carfilzomib in lymphoma, leukemia, and myeloma cell lines and primary lymphoma and leukemia cells...
January 5, 2017: Blood
Leena Patel, Jayaraman Chandrasekhar, Jerry Evarts, Kristen Forseth, Aaron C Haran, Carmen Ip, Adam Kashishian, Musong Kim, David Koditek, Sandy Koppenol, Latesh Lad, Eve-Irene Lepist, Mary E McGrath, Stephane Perreault, Kamal D Puri, Armando G Villaseñor, John R Somoza, Bart H Steiner, Joseph Therrien, Jennifer Treiberg, Gary Phillips
Aberrant signaling of phosphoinositide 3-kinase δ (PI3Kδ) has been implicated in numerous pathologies including hematological malignancies and rheumatoid arthritis. Described in this manuscript are the discovery, optimization, and in vivo evaluation of a novel series of pyridine-containing PI3Kδ inhibitors. This work led to the discovery of 35, a highly selective inhibitor of PI3Kδ which displays an excellent pharmacokinetic profile and is efficacious in a rodent model of rheumatoid arthritis.
October 3, 2016: Journal of Medicinal Chemistry
Klemens Hoegenauer, Nicolas Soldermann, Frédéric Stauffer, Pascal Furet, Nadege Graveleau, Alexander B Smith, Christina Hebach, Gregory J Hollingworth, Ian Lewis, Sascha Gutmann, Gabriele Rummel, Mark Knapp, Romain M Wolf, Joachim Blanz, Roland Feifel, Christoph Burkhart, Frédéric Zécri
Inhibition of the lipid kinase PI3Kδ is a promising principle to treat B and T cell driven inflammatory diseases. Using a scaffold deconstruction-reconstruction strategy, we identified 4-aryl quinazolines that were optimized into potent PI3Kδ isoform selective analogues with good pharmacokinetic properties. With compound 11, we illustrate that biochemical PI3Kδ inhibition translates into modulation of isoform-dependent immune cell function (human, rat, and mouse). After oral administration of compound 11 to rats, proximal PD markers are inhibited, and dose-dependent efficacy in a mechanistic plaque forming cell assay could be demonstrated...
August 11, 2016: ACS Medicinal Chemistry Letters
Jennifer R Brown
Constitutive or mutational activation of the phosphatidylinositol 3 kinase, or PI3K, has been implicated in many cancers, including chronic lymphocytic leukemia (CLL). The δ isoform of the p110 catalytic subunit of PI3K has its primary physiologic function in B cells and appears to be the predominant mediator of most PI3K signals in CLL cells. Idelalisib is a first-in-class inhibitor of the PI3K delta isoform that shows near complete inhibition of AKT phosphorylation in CLL cells in vitro and in vivo. Idelalisib shows the classic pattern of response to BCR inhibition in CLL, with rapid nodal response and transient increase in lymphocytosis...
April 2016: Seminars in Oncology
E Gaudio, C Tarantelli, I Kwee, C Barassi, E Bernasconi, A Rinaldi, M Ponzoni, L Cascione, A Targa, A Stathis, S Goodstal, E Zucca, F Bertoni
BACKGROUND: Lymphomas are among the most common human cancers and represent the cause of death for still too many patients. The B-cell receptor with its downstream signaling pathways represents an important therapeutic target for B-cell lymphomas. Here, we evaluated the activity of the MEK1/2 inhibitor pimasertib as single agent and in combination with other targeted drugs in lymphoma preclinical models. MATERIALS AND METHODS: Cell lines derived mature B-cell lymphomas were exposed to increasing doses of pimasertib alone...
June 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Kenneth Down, Augustin Amour, Ian R Baldwin, Anthony W J Cooper, Angela M Deakin, Leigh M Felton, Stephen B Guntrip, Charlotte Hardy, Zoë A Harrison, Katherine L Jones, Paul Jones, Suzanne E Keeling, Joelle Le, Stefano Livia, Fiona Lucas, Christopher J Lunniss, Nigel J Parr, Ed Robinson, Paul Rowland, Sarah Smith, Daniel A Thomas, Giovanni Vitulli, Yoshiaki Washio, J Nicole Hamblin
Optimization of lead compound 1, through extensive use of structure-based design and a focus on PI3Kδ potency, isoform selectivity, and inhaled PK properties, led to the discovery of clinical candidates 2 (GSK2269557) and 3 (GSK2292767) for the treatment of respiratory indications via inhalation. Compounds 2 and 3 are both highly selective for PI3Kδ over the closely related isoforms and are active in a disease relevant brown Norway rat acute OVA model of Th2-driven lung inflammation.
September 24, 2015: Journal of Medicinal Chemistry
Elisa Ten Hacken, Jan A Burger
Chronic Lymphocytic Leukemia (CLL) is a malignancy of mature B lymphocytes which are highly dependent on interactions with the tissue microenvironment for their survival and proliferation. Critical components of the microenvironment are monocyte-derived nurselike cells (NLCs), mesenchymal stromal cells, T cells and NK cells, which communicate with CLL cells through a complex network of adhesion molecules, chemokine receptors, tumor necrosis factor (TNF) family members, and soluble factors. (Auto-) antigens and/or autonomous mechanisms activate the B-cell receptor (BCR) and its downstream signaling cascade in secondary lymphatic tissues, playing a central pathogenetic role in CLL...
March 2016: Biochimica et Biophysica Acta
Stephan Stilgenbauer, Richard R Furman, Clive S Zent
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is usually diagnosed in asymptomatic patients with early-stage disease. The standard management approach is careful observation, irrespective of risk factors unless patients meet the International Workshop on CLL (IWCLL) criteria for "active disease," which requires treatment. The initial standard therapy for most patients combines an anti-CD20 antibody (such as rituximab, ofatumumab, or obinutuzumab) with chemotherapy (fludarabine/cyclophosphamide [FC], bendamustine, or chlorambucil) depending on multiple factors including the physical fitness of the patient...
2015: American Society of Clinical Oncology Educational Book
K Balakrishnan, M Peluso, M Fu, N Y Rosin, J A Burger, W G Wierda, M J Keating, K Faia, S O'Brien, J L Kutok, V Gandhi
The functional relevance of the B-cell receptor (BCR) and the evolution of protein kinases as therapeutic targets have recently shifted the paradigm for treatment of B-cell malignancies. Inhibition of p110δ with idelalisib has shown clinical activity in chronic lymphocytic leukemia (CLL). The dynamic interplay of isoforms p110δ and p110γ in leukocytes support the hypothesis that dual blockade may provide a therapeutic benefit. IPI-145, an oral inhibitor of p110δ and p110γ isoforms, sensitizes BCR-stimulated and/or stromal co-cultured primary CLL cells to apoptosis (median 20%, n=57; P<0...
September 2015: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Manuela Bergmann, Clemens-Martin Wendtner
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in the Western world. Median age at diagnosis is around 70 years. To confirm the diagnosis more than 5000 B-lymphocytes/µl need to be present. The expression of the typical surface markers CD5, CD19, CD20 and CD23 has to be confirmed by flow cytometry. A bone marrow biopsy is not mandatory for the diagnosis. Before start of treatment the assessment of 17 p deletion and/or TP53-mutational status is recommended. Treatment indications include stage Binet C or signs of an active disease as rapidly progressive lymphadenopathy or organomegaly together with physical limitation, B symptoms that cannot be tolerated, rapidly deteriorating blood values, or rapidly increasing leukocyte counts (Lymphocyte doubling time less than 6 months)...
April 2015: Deutsche Medizinische Wochenschrift
Feng Jin, Michelle Robeson, Huafeng Zhou, Grace Hisoire, Srini Ramanathan
Idelalisib, a phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor, is metabolized primarily by aldehyde oxidase to form GS-563117, an inactive metabolite, and is metabolized to a lesser extent by cytochrome P450 3A and uridine 5'-diphospho-glucuronosyltransferase 1A4. In a mass balance study, the orally administered idelalisib dose was recovered mainly in feces (∼78%). This study evaluated the pharmacokinetics and safety of a single 150-mg dose of idelalisib in subjects with moderate or severe hepatic impairment and in age-, sex-, and weight-matched, healthy controls...
August 2015: Journal of Clinical Pharmacology
Manman Wei, Xiang Wang, Zilan Song, Mingkun Jiao, Jian Ding, Ling-Hua Meng, Ao Zhang
Chronic lymphocytic leukemia (CLL) remains the most incurable leukemia. Early chemotherapeutic treatments, including alkylating agents, purine nucleoside derivatives, and immunotherapeutic antibodies, only show limited benefits for patients but severe off-target related side effects. Recent advances in understanding of the critical molecular pathways of regulating proliferation and survival of B-CLL cells have spurred a new therapeutical strategy by selectively targeting phosphoinositide 3-kinase delta (PI3Kδ)...
July 2015: Medicinal Research Reviews
Feng Jin, Michelle Robeson, Huafeng Zhou, Candra Moyer, Sibylle Wilbert, Bernard Murray, Srini Ramanathan
Idelalisib, a potent phosphatidylinositol-3-kinase delta (PI3Kδ) inhibitor, is metabolized primarily by aldehyde oxidase to form GS-563117 and to a lesser extent by cytochrome P450 (CYP) 3A and uridine 5'-diphospho-glucuronosyltransferase 1A4. In vitro, idelalisib inhibits P-glycoprotein (P-gp) and organic anion transporting polypeptides 1B1 and 1B3, and GS-563117 is a time-dependent CYP3A inhibitor. This study enrolled 24 healthy subjects and evaluated (1) the effect of idelalisib on the pharmacokinetics (PK) of digoxin, a P-gp probe substrate, rosuvastatin, a breast cancer resistance protein, and OATP1B1/OATP1B3 substrate, and midazolam, a CYP3A substrate; and (2) the effect of a strong inducer, rifampin, on idelalisib PK...
August 2015: Journal of Clinical Pharmacology
Steven E Coutré, Jacqueline C Barrientos, Jennifer R Brown, Sven de Vos, Richard R Furman, Michael J Keating, Daniel Li, Susan M O'Brien, John M Pagel, Martin H Poleski, Jeff P Sharman, Nai-Shun Yao, Andrew D Zelenetz
Idelalisib is a first-in-class selective, oral, phosphatidylinositol 3-kinase delta (PI3Kδ) inhibitor approved for the treatment of several types of blood cancer. Idelalisib has demonstrated significant efficacy and a tolerable safety profile in clinical trials. However, the US prescribing information contains a black box warning for fatal and/or severe diarrhea or colitis, hepatotoxicity, pneumonitis and intestinal perforation. An expert panel was convened to review the pathology of these treatment-emergent adverse events (TEAEs) to propose key management tools for patients receiving idelalisib therapy...
2015: Leukemia & Lymphoma
Yvonne G Hewett, Dipesh Uprety, Binay K Shah
Idelalisib, the first in-class phosphotidlyinositol 3-kinase delta (PI3Kδ) inhibitor, was approved by the US Food and Drug Administration in July 2014. It simultaneously received breakthrough therapy designation in combination with rituximab for the treatment of relapsed chronic lymphocytic leukemia (CLL) as well as accelerated approval as monotherapy for the treatment of relapsed follicular lymphoma and relapsed small lymphocytic lymphoma. In a pivotal phase III study of 220 patients with relapsed CLL, the overall response rate of patients who received rituximab plus idelalisib was 81%...
April 2016: Journal of Oncology Pharmacy Practice
Yuan Zhang, Hua Li, Yicheng Pu, Shan Gong, Chunfeng Liu, Xinghong Jiang, Jin Tao
Although melatonin receptors are widely expressed in the mammalian central nervous system and peripheral tissues, there are limited data regarding the functions of melatonin in cerebellar Purkinje cells. Here, we identified a novel functional role of melatonin in modulating P-type Ca(2+) channels and action-potential firing in rat Purkinje neurons. Melatonin at 0.1 μm reversibly decreased peak currents (I(Ba)) by 32.9%. This effect was melatonin receptor 1 (MT(R1)) dependent and was associated with a hyperpolarizing shift in the voltage dependence of inactivation...
April 2015: Journal of Pineal Research
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