Outcome reporting bias in publishing of clinical trials : A report of basic data collection from Helsinki area in 2000s

Outcome reporting bias (ORB) and publication bias are prevalent problems in medical research and cause a threat to reliability of evidence based medicine. In this work I will 1) present the basic data collection conducted for an ORB and publication bias study, 2) illustrate the usefulness and difficulties in using REC submissions for research, and 3) review the preliminary results of the study by Chan et al. My data collection included all trial protocols in HUS area in 2002 and 2007. There were in total 265 (2002: 139, 2007: 126) trial protocols. Protocols had a lot of variation in their manner and completeness of reporting. The data collection was somewhat cumbersome and included a lot of bureaucracy. However, these kind of studies are important in order to accurately determine ORB and publication bias. Moreover, the forthcoming publication by Chan et al. is, to my knowledge, the first to compare all three sources: protocols, trial registries and publications

Therapeutic targeting of LCK tyrosine kinase and mTOR signaling in T-cell acute lymphoblastic leukemia

Relapse and refractory T-cell acute lymphoblastic leukemia (T-ALL) has a poor prognosis, and new combination therapies are sorely needed. Here, we used an ex vivo high-throughput screening platform to identify drug combinations that kill zebrafish T-ALL and then validated top drug combinations for preclinical efficacy in human disease. This work uncovered potent drug synergies between AKT/mTORC1 (mammalian target of rapamycin complex 1) inhibitors and the general tyrosine kinase inhibitor dasatinib. Importantly, these same drug combinations effectively killed a subset of relapse and dexamethasone-resistant zebrafish T-ALL. Clinical trials are currently underway using the combination of mTORC1 inhibitor temsirolimus and dasatinib in other pediatric cancer indications, leading us to prioritize this therapy for preclinical testing. This combination effectively curbed T-ALL growth in human cell lines and primary human T-ALL and was well tolerated and effective in suppressing leukemia growth in patient-derived xenografts (PDX) grown in mice. Mechanistically, dasatinib inhibited phosphorylation and activation of the lymphocyte-specific protein tyrosine kinase (LCK) to blunt the T-cell receptor (TCR) signaling pathway, and when complexed with mTORC1 inhibition, induced potent T-ALL cell killing through reducing MCL-1 protein expression. In total, our work uncovered unexpected roles for the LCK kinase and its regulation of downstream TCR signaling in suppressing apoptosis and driving continued leukemia growth. Analysis of a wide array of primary human T-ALLs and PDXs grown in mice suggest that combination of temsirolimus and dasatinib treatment will be efficacious for a large fraction of human T-ALLs.Peer reviewe