Potentiation of a topoisomerase i inhibitor, karenitecin, by the histone deacetylase inhibitor valproic acid in melanoma

translational and phase l/ll clinical trial

Adil I. Daud, Jana Dawson, Ronald C. Deconti, Elona Bicaku, Douglas Marchion, Sem Bastien, Frederick A. Hausheer, Richard Lush, Anthony Neuger, Daniel M. Sullivan, Pamela N. Munster

Research output: Contribution to journalArticle

Abstract

Purpose: The novel topoisomerase I inhibitor karenitecin (KTN) shows activity against melanoma. We examined whether histone deacetylase inhibition could potentiate the DNA strand cleavage, cytotoxicity as well as the clinical toxicity, and efficacy of KTN in melanoma. Experimental Design: Apoptosis, COMET, and xenograft experiments were carried out as described previously. A phase I/II trial of valproic acid (VPA) and KTN was conducted in patients with stage IV melanoma, with any number of prior therapies, Eastern Cooperative Oncology Group performance status 0-2, and adequate organ function. Results: VPA pretreatment potentiated KTN-induced apoptosis in multiple melanoma cell lines and in mouse A375 xenografts. VPA increased KTN-induced DNA strand breaks. In the phase I/II trial, 39 patients were entered, with 37 evaluable for toxicity and 33 evaluable for response. Somnolence was the dose-limiting toxicity. The maximum tolerated dose for VP Awas 75 mg/kg/d; at maximum tolerated dose, serum VPA was ∼ 200 Ag/mL (1.28 mmol/L). At the dose expansion cohort, 47% (7 of 15) of patients had stable disease; median overall survival and time to progression were 32.8 and 10.2 weeks, respectively. Histone hyperacetylation was observed in peripheral blood mononuclear cells at maximum tolerated dose. Conclusion: VPA potentiates KTN-induced DNA strand breaks and cytotoxicity. VPA can be combined at 75 mg/kg/d for 5 days with full-dose KTN without overlapping toxicities. In metastatic poor prognosis melanoma, this combination is associated with disease stabilization in 47% of patients. Further testing of this combination appears warranted.

Original languageEnglish (US)
Pages (from-to)2479-2487
Number of pages9
JournalClinical Cancer Research
Volume15
Issue number7
DOIs
StatePublished - Apr 1 2009
Externally publishedYes

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Topoisomerase Inhibitors
Histone Deacetylase Inhibitors
Valproic Acid
Melanoma
Clinical Trials
Maximum Tolerated Dose
DNA Breaks
Heterografts
Topoisomerase I Inhibitors
Apoptosis
DNA Cleavage
Histone Deacetylases
cositecan
Histones
Blood Cells
Research Design
Cell Line
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Potentiation of a topoisomerase i inhibitor, karenitecin, by the histone deacetylase inhibitor valproic acid in melanoma : translational and phase l/ll clinical trial. / Daud, Adil I.; Dawson, Jana; Deconti, Ronald C.; Bicaku, Elona; Marchion, Douglas; Bastien, Sem; Hausheer, Frederick A.; Lush, Richard; Neuger, Anthony; Sullivan, Daniel M.; Munster, Pamela N.

In: Clinical Cancer Research, Vol. 15, No. 7, 01.04.2009, p. 2479-2487.

Research output: Contribution to journalArticle

Daud, AI, Dawson, J, Deconti, RC, Bicaku, E, Marchion, D, Bastien, S, Hausheer, FA, Lush, R, Neuger, A, Sullivan, DM & Munster, PN 2009, 'Potentiation of a topoisomerase i inhibitor, karenitecin, by the histone deacetylase inhibitor valproic acid in melanoma: translational and phase l/ll clinical trial', Clinical Cancer Research, vol. 15, no. 7, pp. 2479-2487. https://doi.org/10.1158/1078-0432.CCR-08-1931
Daud, Adil I. ; Dawson, Jana ; Deconti, Ronald C. ; Bicaku, Elona ; Marchion, Douglas ; Bastien, Sem ; Hausheer, Frederick A. ; Lush, Richard ; Neuger, Anthony ; Sullivan, Daniel M. ; Munster, Pamela N. / Potentiation of a topoisomerase i inhibitor, karenitecin, by the histone deacetylase inhibitor valproic acid in melanoma : translational and phase l/ll clinical trial. In: Clinical Cancer Research. 2009 ; Vol. 15, No. 7. pp. 2479-2487.
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abstract = "Purpose: The novel topoisomerase I inhibitor karenitecin (KTN) shows activity against melanoma. We examined whether histone deacetylase inhibition could potentiate the DNA strand cleavage, cytotoxicity as well as the clinical toxicity, and efficacy of KTN in melanoma. Experimental Design: Apoptosis, COMET, and xenograft experiments were carried out as described previously. A phase I/II trial of valproic acid (VPA) and KTN was conducted in patients with stage IV melanoma, with any number of prior therapies, Eastern Cooperative Oncology Group performance status 0-2, and adequate organ function. Results: VPA pretreatment potentiated KTN-induced apoptosis in multiple melanoma cell lines and in mouse A375 xenografts. VPA increased KTN-induced DNA strand breaks. In the phase I/II trial, 39 patients were entered, with 37 evaluable for toxicity and 33 evaluable for response. Somnolence was the dose-limiting toxicity. The maximum tolerated dose for VP Awas 75 mg/kg/d; at maximum tolerated dose, serum VPA was ∼ 200 Ag/mL (1.28 mmol/L). At the dose expansion cohort, 47{\%} (7 of 15) of patients had stable disease; median overall survival and time to progression were 32.8 and 10.2 weeks, respectively. Histone hyperacetylation was observed in peripheral blood mononuclear cells at maximum tolerated dose. Conclusion: VPA potentiates KTN-induced DNA strand breaks and cytotoxicity. VPA can be combined at 75 mg/kg/d for 5 days with full-dose KTN without overlapping toxicities. In metastatic poor prognosis melanoma, this combination is associated with disease stabilization in 47{\%} of patients. Further testing of this combination appears warranted.",
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T1 - Potentiation of a topoisomerase i inhibitor, karenitecin, by the histone deacetylase inhibitor valproic acid in melanoma

T2 - translational and phase l/ll clinical trial

AU - Daud, Adil I.

AU - Dawson, Jana

AU - Deconti, Ronald C.

AU - Bicaku, Elona

AU - Marchion, Douglas

AU - Bastien, Sem

AU - Hausheer, Frederick A.

AU - Lush, Richard

AU - Neuger, Anthony

AU - Sullivan, Daniel M.

AU - Munster, Pamela N.

PY - 2009/4/1

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N2 - Purpose: The novel topoisomerase I inhibitor karenitecin (KTN) shows activity against melanoma. We examined whether histone deacetylase inhibition could potentiate the DNA strand cleavage, cytotoxicity as well as the clinical toxicity, and efficacy of KTN in melanoma. Experimental Design: Apoptosis, COMET, and xenograft experiments were carried out as described previously. A phase I/II trial of valproic acid (VPA) and KTN was conducted in patients with stage IV melanoma, with any number of prior therapies, Eastern Cooperative Oncology Group performance status 0-2, and adequate organ function. Results: VPA pretreatment potentiated KTN-induced apoptosis in multiple melanoma cell lines and in mouse A375 xenografts. VPA increased KTN-induced DNA strand breaks. In the phase I/II trial, 39 patients were entered, with 37 evaluable for toxicity and 33 evaluable for response. Somnolence was the dose-limiting toxicity. The maximum tolerated dose for VP Awas 75 mg/kg/d; at maximum tolerated dose, serum VPA was ∼ 200 Ag/mL (1.28 mmol/L). At the dose expansion cohort, 47% (7 of 15) of patients had stable disease; median overall survival and time to progression were 32.8 and 10.2 weeks, respectively. Histone hyperacetylation was observed in peripheral blood mononuclear cells at maximum tolerated dose. Conclusion: VPA potentiates KTN-induced DNA strand breaks and cytotoxicity. VPA can be combined at 75 mg/kg/d for 5 days with full-dose KTN without overlapping toxicities. In metastatic poor prognosis melanoma, this combination is associated with disease stabilization in 47% of patients. Further testing of this combination appears warranted.

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