Search

Background: RAS/RAF/mitogen-activated protein kinase activation is common in myeloid malignancies. Trametinib, a mitogen-activated protein kinase kinase 1 (MEK1)/MEK2 inhibitor with activity against multiple myeloid cell lines at low nanomolar concentrations, was evaluated for safety and clinical activity in patients with relapsed/refractory leukemias.Methods: This phase 1/2 study accrued patients with any relapsed/refractory leukemia in phase 1. In phase 2, this study accrued patients with relapsed/refractory acute myeloid leukemia (AML) or high-risk myelodysplastic syndromes (MDS) with NRAS or KRAS mutations (cohort 1); patients with AML, MDS, or chronic myelomonocytic leukemia (CMML) with a RAS wild-type mutation or an unknown mutation status (cohort 2); and patients with CMML with an NRAS or KRAS mutation (cohorts 3).Results: The most commonly reported treatment-related adverse events were diarrhea, rash, nausea, and increased alanine aminotransferase levels. The phase 2 recommended dose for Trametinib was 2 mg orally daily. The overall response rates were 20%, 3%, and 27% for cohorts 1, 2, and 3, respectively, and this indicated preferential activity among RAS-mutated myeloid malignancies. Repeated cycles of trametinib were well tolerated with manageable or reversible toxicities; these results were similar to those of other trametinib studies.Conclusions: The selective, single-agent activity of trametinib against RAS-mutated myeloid malignancies validates its therapeutic potential. Combination strategies based on a better understanding of the hierarchical role of mutations and signaling in myeloid malignancies are likely to improve the response rate and duration. Cancer 2016;122:1871-9. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

1. This study assessed the mass balance, metabolism and disposition of [14C]trametinib, a first-in-class mitogen-activated extracellular signal-related kinase (MEK) inhibitor, as an open-label, single solution dose (2 mg, 2.9 MBq [79 µCi]) in two male subjects with advanced cancer. 2. Trametinib absorption was rapid. Excretion was primarily via feces (∼81% of excreted dose); minor route was urinary (∼19% of excreted dose). The primary metabolic elimination route was deacetylation alone or in combination with hydroxylation. Circulating drug-related component profiles (composed of parent with metabolites) were similar to those found in elimination together with N-glucuronide of deacetylation product. Metabolite analysis was only possible from <50% of administered dose; therefore, percent of excreted dose (defined as fraction of percent of administered dose recovery over total dose recovered in excreta) was used to assess the relative importance of excretion and metabolite routes. The long elimination half-life (∼10 days) favoring sustained targeted activity was important in permitting trametinib to be the first MEK inhibitor with clinical activity in late stage clinical studies. 3. This study exemplifies the challenges and adaptability needed to understand the metabolism and disposition of an anticancer agent, like trametinib, with both low exposure and a long elimination half-life. [ABSTRACT FROM AUTHOR]

A program in gerontology consisting of a curriculum and a research phase has been organized as an elective course for medical students. The objective is to provide an opportunity for students of medicine to learn the medical characteristics of the older patient. The curriculum phase has a series of lectures on the medical and biological aspects of the aging process. The program recognizes, through student research awards, the paramount importance of laboratory investigations in generating a fund of knowledge that will enable the physician to deal more effectively with the medical needs of the aging and the aged. [ABSTRACT FROM PUBLISHER]

Acute stress, such as heat, and some metals, such as arsenite, will induce a specific group of stress proteins referred to as heat-shock proteins. The heat-shock proteins contribute to the survival of cells following a variety of stresses. Similarly, metals such as cadmium and zinc, will increase the levels of metallothionein (MT). The metal-binding protein, MT, has also been found to have a protective role in the cellular response to acute stresses like heavy metals. The purpose of the present study was to examine the production of these proteins in response to metals. Rat hepatocytes were maintained in monolayer culture for 22 hr, and subsequently treated with various concentrations of metals for 4 hr, or incubated at 43.5°C for 15–60 min. Following two washes with fresh media, the cells were labeled with [S]-methionine (25 μCi/ml) in methionine-free media for 4 hr for determination of heat-shock protein production, or reincubated in fresh media for 20 hr for MT determination. Heat-shock protein production was determined by SDS-polyacrylamide gel electrophoresis followed by autoradiography. The autoradiograms were quantified by densitometric scanning. MT was determined by the Cd/hemoglobin affinity assay. Three metals (arsenite, cadmium, and zinc) strongly increased the heat-shock proteins. Whereas arsenite was a much less effective inducer of MT than was cadmium or zinc, arsenite was as effective as the other metals in inducing heat-shock proteins. Nickel was a good inducer of MT; however, it resulted in only a slight increase in the levels of heat-shock proteins. Heat-shock treatment was found to cause a major elevation in heat-shock proteins levels while actually decreasing the levels of MT. In conclusion, while similarities exist between induction of heat-shock protein and MT, there is not always a good correlation between the various stresses that induce heat-shock proteins and those that induce MT. [ABSTRACT FROM PUBLISHER]

Metallothionein (MT) is a sulfhydryl-rich, metal-binding protein that provides protection against metal toxicity. MT is induced by acute stress, hormones, metals, and various organic compounds. Recently, arsenicals have also been shown to induce MT. However, the mechanism and character of MT induction by arsenicals is unknown. Therefore, the effect of various arsenic forms on the tissue concentration of MT was determined. Mice were injected sc with various doses of arsenite [As(III)], arsenate [As(V)], monomethylarsenate (MMAA), and dimethylarsenate (DMAA), and MT content in the liver was measured 24 hr later by the Cd-hemoglobin radioassay. As(III) is a potent hepatic MT inducer in that a 30-fold increase in MT was observed at the dose of 85 μmol/kg. In comparison, it took 3-, 50-, and 120-fold higher molar amounts of As(V), MMAA, and DMAA, respectively to produce a similar effect. MMAA produces the largest increase in hepatic MT (80-fold), followed by As(III) (30-fold), As(V) (25-fold), and DMAA (10-fold). However, none of the arsenicals induced MT in mouse primary hepatocyte cultures. Both MT-I and MT-II were coordinately induced by As(III), As(V), and MMAA. MT induction by As(III) was further characterized following sc administration of arsenite (85 μmol/kg). Hepatic MT induction peaked at 24 hr, and in addition to the liver, As(III) also increased MT in kidney, spleen, stomach, intestine, heart, and lung. MT-I mRNA increased 24-, 52-, and 11-fold at 3, 6, and 15 hr after As(III) administration. This induction profile is similar to that observed after Zn or Cd exposure. In conclusion, arsenicals are effective inducers of MT , and their potency and efficacy are dependent on the chemical form of arsenic. As(III) is a potent hepatic MT inducer for both MT-I and MT-II, and this effect is associated with an increase in MT mRNA. [ABSTRACT FROM PUBLISHER]