Niraparib in patients with metastatic castration-resistant prostate cancer and DNA repair gene defects (GALAHAD): a multicentre, open-label, phase 2 trial

Background Metastatic castration-resistant prostate cancers are enriched for DNA repair gene defects (DRDs) that can be susceptible to synthetic lethality through inhibition of PARP proteins. We evaluated the anti-tumour activity and safety of the PARP inhibitor niraparib in patients with metastatic castration-resistant prostate cancers and DRDs who progressed on previous treatment with an androgen signalling inhibitor and a taxane. Methods In this multicentre, open-label, single-arm, phase 2 study, patients aged at least 18 years with histologically confirmed metastatic castration-resistant prostate cancer (mixed histology accepted, with the exception of the small cell pure phenotype) and DRDs (assessed in blood, tumour tissue, or saliva), with progression on a previous next-generation androgen signalling inhibitor and a taxane per Response Evaluation Criteria in Solid Tumors 1.1 or Prostate Cancer Working Group 3 criteria and an Eastern Cooperative Oncology Group performance status of 0–2, were eligible. Enrolled patients received niraparib 300 mg orally once daily until treatment discontinuation, death, or study termination. For the final study analysis, all patients who received at least one dose of study drug were included in the safety analysis population; patients with germline pathogenic or somatic biallelic pathogenic alterations in BRCA1 or BRCA2 (BRCA cohort) or biallelic alterations in other prespecified DRDs (non-BRCA cohort) were included in the efficacy analysis population. The primary endpoint was objective response rate in patients with BRCA alterations and measurable disease (measurable BRCA cohort). This study is registered with ClinicalTrials.gov, NCT02854436. Findings Between Sept 28, 2016, and June 26, 2020, 289 patients were enrolled, of whom 182 (63%) had received three or more systemic therapies for prostate cancer. 223 (77%) of 289 patients were included in the overall efficacy analysis population, which included BRCA (n=142) and non-BRCA (n=81) cohorts. At final analysis, with a median follow-up of 10·0 months (IQR 6·6–13·3), the objective response rate in the measurable BRCA cohort (n=76) was 34·2% (95% CI 23·7–46·0). In the safety analysis population, the most common treatment-emergent adverse events of any grade were nausea (169 [58%] of 289), anaemia (156 [54%]), and vomiting (111 [38%]); the most common grade 3 or worse events were haematological (anaemia in 95 [33%] of 289; thrombocytopenia in 47 [16%]; and neutropenia in 28 [10%]). Of 134 (46%) of 289 patients with at least one serious treatment-emergent adverse event, the most common were also haematological (thrombocytopenia in 17 [6%] and anaemia in 13 [4%]). Two adverse events with fatal outcome (one patient with urosepsis in the BRCA cohort and one patient with sepsis in the non-BRCA cohort) were deemed possibly related to niraparib treatment. Interpretation Niraparib is tolerable and shows anti-tumour activity in heavily pretreated patients with metastatic castration-resistant prostate cancer and DRDs, particularly in those with BRCA alterations

Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population

Élaboration de matériaux nanofibreux biomimétiques à base de poly(sébaçate de glycérol) pour l’ingénierie tissulaire cardiaque

Cardiac tissue engineering aims to regenerate the heart. This technic relies on the use of a scaffold where the cells can proliferate. To be efficient, this scaffold should mimic mechanical and structural properties of the myocardium. In this thesis, poly(glycerol sebacate) (PGS) was chosen as building material. Its synthesis was studied, showing which parameters should be controlled in order to get the expected properties. In particular, mechanical properties fitting cardiac muscle’s ones can be obtained. Electrospinning was chosen as process method. This method allows the fabrication of nanofibrous mats mimicking biological tissues structure. As PGS processing is difficult because it is insoluble, it was electrospun at the prepolymer state, blended with another polymer. In this way, cardiac patches composed of poly(lactic acid) and PGS were fabricated. Furthermore, PGS was blended with polyvinylpyrrolidone and cyclodextrin to prepare elastomeric membranes with mechanical properties adapted to the heart. Finally, PGS was used in particles in order to organize PLA fibers deposits into structures able to improve cells and tissues development.L’ingénierie tissulaire cardiaque permet de promouvoir la régénération du cœur. Cette technique repose sur l’utilisation d’un substrat où se développent les cellules. Pour être performant, ce substrat doit mimer les propriétés mécaniques et structurelles du myocarde. Pour cette thèse, le poly(sébaçate de glycérol) (PGS), un élastomère biocompatible, a été choisi comme matériau de base. Sa synthèse a été étudiée, montrant quels sont les paramètres à contrôler pour obtenir les propriétés attendues. En particulier, des propriétés mécaniques adaptées au muscle cardiaque peuvent être obtenues. La méthode de mise œuvre choisie est l’élelectrofilage, qui permet la fabrication de mats nanofibreux imitant la structure des tissus biologiques. Comme la mise en forme du PGS est rendue difficile par son insolubilité, il a été électrofilé à l’état de prépolymère, mélangé à un autre polymère. Des patchs cardiaques à base d’acide polylactique et de PGS ont pu être fabriqués. Par ailleurs, en mélangeant le PGS à de la polyvinylpyrrolidone et de la cyclodextrine, des membranes élastomères aux propriétés mécaniques adaptées au cœur ont pu être préparées. Enfin, le PGS a été utilisé sous forme de particules afin d’organiser des dépôts de fibres de PLA en structures capables d’améliorer le développement des cellules et des tissus

Design of functional electrospun scaffolds based on poly(glycerol sebacate) elastomer and poly(lactic acid) for cardiac tissue engineering

International audienceMany works focus on the use of polyesters like poly(lactic acid) (PLA) to produce nanofibrous scaffolds for cardiac tissue engineering. However, such scaffolds are hydrophobic and difficult to functionalize. Here, we show that adding 30% of poly(glycerol sebacate) (PGS) elastomer within PLA leads to PLA:PGS scaffolds with improved biological properties, depending on the processing parameters. Two categories of fibers were produced by blend electrospinning, with diameters of 600 and 1300 nm. The resulting fibers were cured at 90°C or 120°C in order to achieve two different crosslinking densities. The designed scaffolds were considered for cytocompatibility, biocompatibility, biodegradability, chemical and mechanical properties. Our results demonstrated that the presence of PGS increases the hydrophilicity of the material and thus improves surface functionalization by Matrigel and laminin coating, a commonly used cell culture matrix. PLA:PGS scaffolds associated with Matrigel and laminin allow an increased material-cell interaction. Moreover, the cardiomyocytes seeded on such scaffolds acquire a morphology similar to that observed in native tissue, this result being more remarkable on fibers having the smallest diameter and the highest PGS crosslinking density. In addition, these scaffolds induce neovascularization without inflammatory response and foreign body giant cell response after grafting on mice’s heart. Hence, the improved biocompatibility and the ability to support cardiomyocytes development suggest that thin PLA:PGS scaffolds could be promising biomaterials for cardiac application

BIN1 recovers tauopathy-induced long-term memory deficits in mice and interacts with Tau through Thr348 phosphorylation

International audienc

ADAM30 Downregulates APP-Linked Defects Through Cathepsin D Activation in Alzheimer's Disease

Although several ADAMs (A disintegrin-like and metalloproteases) have been shown to contribute to the amyloid precursor protein (APP) metabolism, the full spectrum of metalloproteases involved in this metabolism remains to be established. Transcriptomic analyses centred on metalloprotease genes unraveled a 50% decrease in ADAM30 expression that inversely correlates with amyloid load in Alzheimer's disease brains. Accordingly, in vitro down- or up-regulation of ADAM30 expression triggered an increase/decrease in Aβ peptides levels whereas expression of a biologically inactive ADAM30 (ADAM30mut) did not affect Aβ secretion. Proteomics/cell-based experiments showed that ADAM30-dependent regulation of APP metabolism required both cathepsin D (CTSD) activation and APP sorting to lysosomes. Accordingly, in Alzheimer-like transgenic mice, neuronal ADAM30 over-expression lowered Aβ42 secretion in neuron primary cultures, soluble Aβ42 and amyloid plaque load levels in the brain and concomitantly enhanced CTSD activity and finally rescued long term potentiation alterations. Our data thus indicate that lowering ADAM30 expression may favor Aβ production, thereby contributing to Alzheimer's disease development

Genome-wide, high-content siRNA screening identifies the Alzheimer’s genetic risk factor FERMT2 as a major modulator of APP metabolism

Genome-wide association studies (GWASs) have identified 19 susceptibility loci for Alzheimer’s disease (AD). However, understanding how these genes are involved in the pathophysiology of AD is one of the main challenges of the “post-GWAS” era. At least 123 genes are located within the 19 susceptibility loci; hence, a conventional approach (studying the genes one by one) would not be time- and cost-effective. We therefore developed a genome-wide, high-content siRNA screening approach and used it to assess the functional impact of gene under-expression on APP metabolism. We found that 832 genes modulated APP metabolism. Eight of these genes were located within AD susceptibility loci. Only FERMT2 (a β3-integrin co-activator) was also significantly associated with a variation in cerebrospinal fluid Aβ peptide levels in 2886 AD cases. Lastly, we showed that the under-expression of FERMT2 increases Aβ peptide production by raising levels of mature APP at the cell surface and facilitating its recycling. Taken as a whole, our data suggest that FERMT2 modulates the AD risk by regulating APP metabolism and Aβ peptide production