Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab

Switching of biologic agents in treatment of plaque psoriasis is a common strategy. Only a few studies are available on switching between IL17A-blockers. In a retrospective study, we identified 22 psoriasis patients who, after failing secukinumab as a first IL17A-blocker received ixekizumab with an observation period of at least 24 weeks. At last observation 10/22 patients had a good response (PASI75 or PASI<3) using ixekizumab therapy. None of five patients with primary non-response to secukinumab reached a good, durable response to ixekizumab. In conclusion, ixekizumab appears to be a therapeutic option as a second IL17A-blocker in psoriasis patients who did not show a primary non-response to secukinumab

NF-κB Inhibition through Proteasome Inhibition or IKKβ Blockade Increases the Susceptibility of Melanoma Cells to Cytostatic Treatment through Distinct Pathways

Metastasized melanoma is almost universally resistant to chemotherapy. Given that constitutive or drug-induced upregulation of NF-κB activity is associated with this chemoresistance, NF-κB inhibition may increase the susceptibility to antitumoral therapy. On the cellular level, two principles of NF-κB inhibition, proteasome inhibition by bortezomib and IκB kinase-β (IKKβ) inhibition by the kinase inhibitor of NF-κB-1 (KINK-1), significantly increased the antitumoral efficacy of camptothecin. When combined with camptothecin, either of the two NF-κB-inhibiting principles synergistically influenced progression-related in vitro functions, including cell growth, apoptosis, and invasion through an artificial basement membrane. In addition, when C57BL/6 mice were intravenously injected with B16F10 melanoma cells, the combination of cytostatic treatment with either of the NF-κB-inhibiting compounds revealed significantly reduced pulmonary metastasis compared to either treatment alone. However, on the molecular level, nuclear translocation of p65, cell cycle analysis, and expression of NF-κB-dependent gene products disclosed distinctly different molecular mechanisms, resulting in the same functional effect. That proteasome inhibition and IKKβ inhibition affect distinct molecular pathways downstream of NF-κB, both leading to increased chemosensitivity, is previously unreported. Thus, it is conceivable that switching the two principles of NF-κB inhibition, once resistance to one of the agents occurs, will improve future treatment regimens

Synthetic Lethal Screen Identifies NF-κB as a Target for Combination Therapy with Topotecan for patients with Neuroblastoma

<p>Abstract</p> <p>Background</p> <p>Despite aggressive multimodal treatments the overall survival of patients with high-risk neuroblastoma remains poor. The aim of this study was to identify novel combination chemotherapy to improve survival rate in patients with high-risk neuroblastoma.</p> <p>Methods</p> <p>We took a synthetic lethal approach using a siRNA library targeting 418 apoptosis-related genes and identified genes and pathways whose inhibition synergized with topotecan. Microarray analyses of cells treated with topotecan were performed to identify if the same genes or pathways were altered by the drug. An inhibitor of this pathway was used in combination with topotecan to confirm synergism by <it>in vitro </it>and <it>in vivo </it>studies.</p> <p>Results</p> <p>We found that there were nine genes whose suppression synergized with topotecan to enhance cell death, and the NF-κB signaling pathway was significantly enriched. Microarray analysis of cells treated with topotecan revealed a significant enrichment of NF-κB target genes among the differentially altered genes, suggesting that NF-κB pathway was activated in the treated cells. Combination of topotecan and known NF-κB inhibitors (NSC 676914 or bortezomib) significantly reduced cell growth and induced caspase 3 activity <it>in vitro</it>. Furthermore, in a neuroblastoma xenograft mouse model, combined treatment of topotecan and bortezomib significantly delayed tumor formation compared to single-drug treatments.</p> <p>Conclusions</p> <p>Synthetic lethal screening provides a rational approach for selecting drugs for use in combination therapy and warrants clinical evaluation of the efficacy of the combination of topotecan and bortezomib or other NF-κB inhibitors in patients with high risk neuroblastoma.</p

Integrative genomic analyses reveal an androgen-driven somatic alteration landscape in early-onset prostate cancer

Early-onset prostate cancer (EO-PCA) represents the earliest clinical manifestation of prostate cancer. To compare the genomic alteration landscapes of EO-PCA with "classical" (elderly-onset) PCA, we performed deep sequencing-based genomics analyses in 11 tumors diagnosed at young age, and pursued comparative assessments with seven elderly-onset PCA genomes. Remarkable age-related differences in structural rearrangement (SR) formation became evident, suggesting distinct disease pathomechanisms. Whereas EO-PCAs harbored a prevalence of balanced SRs, with a specific abundance of androgen-regulated ETS gene fusions including TMPRSS2:ERG, elderly-onset PCAs displayed primarily non-androgen-associated SRs. Data from a validation cohort of > 10,000 patients showed age-dependent androgen receptor levels and a prevalence of SRs affecting androgen-regulated genes, further substantiating the activity of a characteristic "androgen-type" pathomechanism in EO-PCA

The chemistry and biological activity of the Hyacinthaceae

Covering: 1914 to 2012The Hyacinthaceae (sensu APGII), with approximately 900 species in about 70 genera, can be divided into three main subfamilies, the Hyacinthoideae, the Urgineoideae and the Ornithogaloideae, with a small fourth subfamily the Oziroëoideae, restricted to South America. The plants included in this family have long been used in traditional medicine for a wide range of medicinal applications. This, together with some significant toxicity to livestock has led to the chemical composition of many of the species being investigated. The compounds found are, for the most part, subfamily-restricted, with homoisoflavanones and spirocyclic nortriterpenoids characterising the Hyacinthoideae, bufadienolides characterising the Urgineoideae, and cardenolides and steroidal glycosides characterising the Ornithogaloideae. The phytochemical profiles of 38 genera of the Hyacinthaceae will be discussed as well as any biological activity associated with both crude extracts and compounds isolated. The Hyacinthaceae of southern Africa were last reviewed in 2000 (T. S. Pohl, N. R. Crouch and D. A. Mulholland, Curr. Org. Chem., 2000, 4, 1287-1324; ); the current contribution considers the family at a global level

Susceptibility of melanoma cells to cytostatic treatment via distinct mechanisms of NF-kB-inhibition

Die vorliegende Arbeit zeigt eine Möglichkeit auf, die bisher meist erfolglose Chemotherapie des malignen Melanoms zu verbessern: Durch Inhibition des Transkriptionsfaktors NF-kB, der für die Regulation vieler tumorrelevanter Gene verantwortlich ist, konnten die Tumorzellen gegenüber der Wirkung von Zytostatika sensibilisiert werden. Zunächst wurden acht verschiedene Melanomzellen in Bezug auf ihre NF-kB-Aktivität und der Expression NF-kB-regulierter Proteine vergleichen. Es konnte gezeigt werden, dass die Mehrzahl der Melanomzellen über konstitutive Aktivität von NF-κB verfügt. Dabei bestand kein eindeutiger Zusammenhang zwischen der Expression NF-kB-regulierter Proteine und der Aktivität dieses Transkriptionsfaktors im Kern, was komplexe Regulationsmechanismen bei der Transkription und Translation vermuten lässt. Anhand einer ausgewählten Melanomzelllinie konnte gezeigt werden, dass zwei verschiedene NF-kB-Inhibitoren, der Proteasom-Inhibitor Bortezomib und der neue IKK-Inhibitor KINK-1 die Aktivität von NF-kB deutlich hemmen. Beim Vergleich beider NF-kB-Inhibitoren ließen sich unerwartet verschiedene molekulare Wirkungsmechanismen nachweisen: Während Bortezomib konzentrationsabhängig eine sehr starke Induktion von NOXA, eine Induktion von p53 sowie eine Abnahme von Cyclin D1 bewirkte, zeigte KINK-1 seine Effekte vor allem in der Reduktion von Chemokinen wie IL-8 und MCP-1. Passend zur Veränderung der Expression zellzyklus-relevanter Proteine hatte Bortezomib einen stärkeren Effekt auf den Zellzyklus als KINK-1. Beide Inhibitoren wurden mit verschiedenen Zytostatika kombiniert und konnten einerseits die Apoptoseinduktion durch Zytostatika verstärken und andererseits die durch Zytostatika reduzierte Invasion weiter reduzieren. Allerdings zeigte sich bei der Untersuchung tumorrelevanter Chemokine, dass KINK-1 im Gegensatz zu Bortezomib synergistische Effekte mit Camptothecin und Doxorubicin aufweist. Trotz molekularer Unterschiede bewirkten beide NF-kB-Inhibitoren vergleichbare funktionelle Effekte auf zellulärer Ebene. Dies galt auch für ein präklinisches in-vivo-Modell, in dem die experimentelle Lungenmetastasierung von B16F10-Melanomzellen in Mäusen ermittelt wurde: Hier wurden die Mäuse mit Camptothecin, KINK-1 und Bortezomib allein im Vergleich zu den jeweiligen Kombinationen aus Zytostatikum und NF-kB-Inhibitor behandelt. Beide Kombinationen zeigten eine signifikante Reduktion des Lungengewichts im Vergleich zu Camptothecin allein. Diese Arbeit konnte also den Nutzen aus NF-kB-Inhibition in Kombination mit Zytostatika für die hier verwendeten Substanzen bekräftigen und dabei einige molekulare Unterschiede aufdecken.Metastasized melanoma is almost resistant to chemotherapie. Constitutive or drug-induced upregulation of NF-kB is one reason for this chemoresistance. That's why inhibition of NF-kB may increase susceptibility to cytostatic drugs. Here, two different mechanisms of NF-kB-inhibition, proteasome inhibition by bortezomib and IkB kinase-beta (IKKbeta) inhibition by the kinase inhibitor of NF-kB-1 (KINK-1) are examined in their antitumoral efficacy and combined with camptothecin. When combined with camptothecin, either of the two NF-kB-inhibiting principles synergistically increased apoptosis and decreased invasion in vitro. In addition, when C57BL/6 mice were intravenously injected with B16F10 melanoma cells, the combination of camptothecin and either of the two compounds (bortezomib and KINK-1) significantly reduced pulmonary metastasis compared to either mono-treatment. However, molecular analysis revealed different mechanisms of the two NF-kB-inhibitors, resulting in the same functional effect. This study shows tow principles of NF-kB-inhibition that successfully augment susceptibility to cytostatic drugs in malignant melanoma