Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system Philadelphia chromosome-positive leukemia

被引:325
作者
Porkka, Kimmo [1 ,2 ,3 ]
Koskenvesa, Perttu [1 ,2 ,3 ]
Lundan, Tuija [1 ,4 ]
Rimpilaeinen, Johanna [5 ]
Mustjoki, Satu [1 ,2 ,3 ]
Smykla, Richard [6 ]
Wild, Robert [7 ]
Luo, Roger [6 ]
Arnan, Montserrat [8 ]
Brethon, Benoit [9 ]
Eccersley, Lydia [10 ]
Hjorth-Hansen, Henrik [11 ,12 ]
Hoeglund, Martin [13 ]
Klamova, Hana [14 ]
Knutsen, Havar [15 ]
Parikh, Suhag [16 ]
Raffoux, Emmanuel [17 ]
Gruber, Franz [18 ]
Brito-Babapulle, Finella [10 ]
Dombret, Herve [17 ]
Duarte, Rafael F. [8 ]
Elonen, Erkki [2 ,3 ]
Paquette, Ron [19 ]
Zwaan, C. Michel [20 ,21 ]
Lee, Francis Y. F. [6 ]
机构
[1] Biomed Helsinki, Hematol Res Unit, FIN-00029 Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Dept Clin Chem, Helsinki, Finland
[3] Univ Helsinki, Cent Hosp, Dept Med Hematol, Helsinki, Finland
[4] Univ Helsinki, Cent Hosp, HUSLAB, Dept Mol Pathol, Helsinki, Finland
[5] N Karelia Cent Hosp, Joensuu, Finland
[6] Bristol Myers Squibb Res & Dev, Princeton, NJ USA
[7] OSI Pharmaceut, In Vivo Pharmacol, Boulder, CO USA
[8] ICO Hosp Duran & Reynals, Barcelona, Spain
[9] Hop St Louis, Paris, France
[10] Ealing Gen Hosp, Southall, Middx, England
[11] St Olavs Hosp, Dept Hematol, Trondheim, Norway
[12] Norwegian Univ Sci & Technol, Dept Mol Med & Canc Res, N-7034 Trondheim, Norway
[13] Univ Uppsala Hosp, Uppsala, Sweden
[14] Inst Hematol & Blood Transfus, CR-12820 Prague, Czech Republic
[15] Aker Univ Hosp, Lorenskog, Norway
[16] Duke Univ, Med Ctr, Pediat Blood & Marrow Transplant Program, Durham, NC USA
[17] Hosp St Louis, Paris, France
[18] Univ Tromso, Tromso, Norway
[19] Univ Calif Los Angeles, Los Angeles, CA USA
[20] Erasmus Med Ctr MC, Rotterdam, Netherlands
[21] Innovat Therapies Children Canc ITCC Consortium, Paris, France
关键词
D O I
10.1182/blood-2008-02-140665
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Although imatinib, a BCR-ABL tyrosine kinase inhibitor, is used to treat acute Philadelphia chromosome-positive (Ph+) leukemia, it does not prevent central nervous system (CNS) relapses resulting from poor drug penetration through the blood-brain barrier. Imatinib and dasatinib (a dual-specific SRC/BCR-ABL kinase inhibitor) were compared in a preclinical mouse model of intracranial Ph+ leukemia. Clinical dasatinib treatment in patients with CNS Ph+ leukemia was assessed. In preclinical studies, dasatinib increased survival, whereas imatinib failed to inhibit intracranial tumor growth. Stabilization and regression of CNS disease were achieved with continued dasatinib administration. The drug also demonstrated substantial activity in 11 adult and pediatric patients with CNS Ph+ leukemia. Eleven evaluable patients had clinically significant, long-lasting responses, which were complete in 7 patients. In 3 additional patients, isolated CNS relapse occurred during dasatinib therapy; and in 2 of them, it was caused by expansion of a BCR-ABL-mutated dasatinib-resistant clone, implying selection pressure exerted by the compound in the CNS. Dasatinib has promising therapeutic potential in managing intracranial leukemic disease and substantial clinical activity in patients who experience CNS relapse while ion imatinib therapy. This study is registered at ClinicalTrials. gov as CA180006 (#NCT00108719) and CA180015 (#NCT00110097).
引用
收藏
页码:1005 / 1012
页数:8
相关论文
共 36 条
[1]   Remission of Philadelphia chromosome-positive central nervous system leukemia after dasatinib therapy [J].
Abdelhalim, Ahmed ;
Barcos, Maurice ;
Block, Annemarie W. ;
Sait, Sheila N. J. ;
Starostik, Petr ;
Wetzler, Meir ;
Wang, Eunice S. .
LEUKEMIA & LYMPHOMA, 2007, 48 (05) :1053-1056
[2]   CNS blast crisis of chronic myelogenous leukemia in a patient with a major cytogenetic response in bone marrow associated with low levels of imatinib mesylate and its N-desmethylated metabolite in cerebral spinal fluid [J].
Bornhauser, M ;
Jenke, A ;
Freiberg-Richter, J ;
Radke, J ;
Schuler, US ;
Mohr, B ;
Ehninger, G ;
Schleyer, E .
ANNALS OF HEMATOLOGY, 2004, 83 (06) :401-402
[3]   High frequency of point mutations clustered within the adenosine triphosphate-binding region of BCR/ABL in patients with chronic myeloid leukemia or Ph-positive acute lymphoblastic leukemia who develop imatinib (STI571) resistance [J].
Branford, S ;
Rudzki, Z ;
Walsh, S ;
Grigg, A ;
Arthur, C ;
Taylor, K ;
Herrmann, R ;
Lynch, KP ;
Hughes, TP .
BLOOD, 2002, 99 (09) :3472-3475
[4]   Isolated central nervous system relapse in lymphoid blast crisis chronic myeloid leukemia and acute lymphoblastic leukemia in patients on imatinib therapy [J].
Bujassoum, S ;
Rifkind, J ;
Lipton, JH .
LEUKEMIA & LYMPHOMA, 2004, 45 (02) :401-403
[5]   The CXCR4 chemokine receptor in acute and chronic leukaemia:: a marrow homing receptor and potential therapeutic target [J].
Burger, Jan A. ;
Buerkle, Andrea .
BRITISH JOURNAL OF HAEMATOLOGY, 2007, 137 (04) :288-296
[6]   Distinct patterns of hematopoietic stem cell involvement in acute lymphoblastic leukemia [J].
Castor, A ;
Nilsson, L ;
Åstrand-Grundström, I ;
Buitenhuis, M ;
Ramirez, C ;
Anderson, K ;
Strömbeck, B ;
Garwicz, S ;
Békássy, AN ;
Schmiegelow, K ;
Lausen, B ;
Hokland, P ;
Lehmann, S ;
Juliusson, G ;
Johansson, B ;
Jacobsen, SEW .
NATURE MEDICINE, 2005, 11 (06) :630-637
[7]   Central nervous system involvement in adult acute lymphocytic leukemia [J].
Cortes, J .
HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA, 2001, 15 (01) :145-+
[8]   Dasatinib induces complete hematologic and cytogenetic responses in patients with imatinib-resistant or -intolerant chronic myeloid leukemia in blast crisis [J].
Cortes, Jorge ;
Rousselot, Philippe ;
Kim, Dong-Wook ;
Ritchie, Ellen ;
Hamerschlak, Nelson ;
Coutre, Steven ;
Hochhaus, Andreas ;
Guilhot, Francois ;
Saglio, Giuseppe ;
Apperley, Jane ;
Ottmann, Oliver ;
Shah, Neil ;
Erben, Philipp ;
Branford, Susan ;
Agarwal, Prasheen ;
Gollerkeri, Ashwin ;
Baccarani, Michele .
BLOOD, 2007, 109 (08) :3207-3213
[9]   Distribution of STI-571 to the brain is limited by P-glycoprotein-mediated efflux [J].
Dai, HQ ;
Marbach, P ;
Lemaire, M ;
Hayes, M ;
Elmquist, WF .
JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS, 2003, 304 (03) :1085-1092
[10]   A Bcr/Abl-independent, Lyn-dependent form of imatinib mesylate (STI-571) resistance is associated with altered expression of Bcl-2 [J].
Dai, Y ;
Rahmani, M ;
Corey, SJ ;
Dent, P ;
Grant, S .
JOURNAL OF BIOLOGICAL CHEMISTRY, 2004, 279 (33) :34227-34239