A Phase I Clinical Trial of AZD1775 in Combination with Neoadjuvant Weekly Docetaxel and Cisplatin before Definitive Therapy in Head and Neck Squamous Cell Carcinoma
CLINICAL CANCER RESEARCH
Authors: Mendez, Eduardo; Rodriguez, Cristina P.; Kao, Michael C.; Raju, Sharat; Diab, Ahmed; Harbison, R. Alex; Konnick, Eric Q.; Mugundu, Ganesh M.; Santana-Davila, Rafael; Martins, Renato; Futran, Neal D.; Chow, Laura Q. M.
Abstract
Purpose: The WEE1 tyrosine kinase regulates G(2)-M transition and maintains genomic stability, particularly in p53-deficient tumors which require DNA repair after genotoxic therapy. Thus, a need arises to exploit the role of WEE1 inhibition in head and neck squamous cell carcinoma (HNSCC) mostly driven by tumor-suppressor loss. This completed phase I clinical trial represents the first published clinical experience using the WEE1 inhibitor, AZD1775, with cisplatin and docetaxel. Patients and Methods: We implemented an open-label phase I clinical trial using a 3+3 dose-escalation design for patients with stage III/IVB HNSCC with borderline-resectable or -unresectable disease, but who were candidates for definitive chemoradiation. Escalating AZD1775 was administered orally twice a day over 2.5 days on the first week, then in combination with fixed cisplatin (25 mg/m(2)) and docetaxel (35 mg/m(2)) for 3 additional weeks. The primary outcome measure was adverse events to establish MTD. Secondary measures included response rates, pharmacokinetics (PK), pharmacodynamics, and genomic data. Results: The MTD for AZD1775 was established at 150 mg orally twice per day for 2.5 days. RECISTv1.1 responses were seen in 5 of 10 patients; histologic adjustment revealed three additional responders. The only drug-limiting toxicity was grade 3 diarrhea. The PK C8hr target of 240 nmol/L was achieved on day 4 at all three doses tested. Pharmacodynamic analysis revealed a reduction in pY15-Cdk, and increases in gamma H2AX, CC3, and RPA32/RPA2 were noted in responders versus nonresponders. Conclusions: The triplet combination of AZD1775, cisplatin, and docetaxel is safe and tolerable. Preliminary results show promising antitumor efficacy in advanced HNSCC, meriting further investigation at the recommended phase II dose. (C) 2018 AACR.
Specific Changes in c-fos Expression and Colocalization with DNA in Identified Neuronal Nuclei of Edible Snail Following Neurotransmitter Application
BULLETIN OF EXPERIMENTAL BIOLOGY AND MEDICINE
Authors: Shevelkin, A. V.; Efimova, O. I.; Nikitin, V. P.; Anokhin, K. V.; Sherstnev, V. V.
Abstract
The effects of serotonin and glutamate on c-fos expression and c-Fos colocalization with DNA were immunohistochemically studied in defense behavior command neurons R-LPa2-3 in snail Helix lucorum. Simultaneous neurotransmitter application resulted in increased c-Fosimmunoreactivity and colocalization with DNA-specific stain Hoechst 33342 in LPa2 and RPa2 neurons with specific dynamics for each identified cell. In the nuclei of LPa3 and RPa3 neurons, neurotransmitter application did not significant change the c-Fos level. These findings are indicative of specific spatiotemporal changes in c-fos expression and c-Fos colocalization with DNA in investigated neurons of edible snail under the influence of neurotransmitters.