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赫赛汀-曲妥珠单抗情况说明书 - ...
根据 FDA 批准的赫赛汀检测结果选择患者进行治疗。Murthy, RK, Loi, S., Okines, A., Paplomata, E., Hamilton, E., Hurvitz, SA, Lin, NU, Borges, V., Abramson, V., Anders, C., Bedard, PL, Oliveira, M., Jakobsen, E., Bachelot, T., Shachar, SS, Müller, V., Braga, S., Duhoux, FP, Greil, R., Cameron, D., Carey, LA, Curigliano, G., Gelmon, K., Hortobagyi, G., Krop, I., Loibl, S., Pegram, M., Slamon, D., Palanca-Wessels, MC, Walker, L., Feng, W. & Winer, EP 2020. 背景：患有人类表皮生长因子受体 2 (HER2) 阳性转移性乳腺癌患者在接受多种 HER2 靶向药物治疗后病情进展，治疗选择有限。图卡替尼是一种在研的口服高选择性 HER2 酪氨酸激酶抑制剂。方法：我们随机分配了先前用曲妥珠单抗、帕妥珠单抗和曲妥珠单抗美坦新治疗过的 HER2 阳性转移性乳腺癌患者，这些患者有或没有脑转移，接受图卡替尼或安慰剂联合曲妥珠单抗和卡培他滨治疗。主要终点是前 480 名随机患者的无进展生存期。在总人群（612 名患者）中评估的次要终点包括总生存期、脑转移患者的无进展生存期、证实的客观缓解率和安全性。结果：图卡替尼联合治疗组 1 年无进展生存率为 33.1%，安慰剂联合治疗组 1 年无进展生存率为 12.3%（疾病进展或死亡风险比为 0.54；95% 置信区间 [CI]，0.42 至 0.71；P<0.001），中位无进展生存期分别为 7.8 个月和 5.6 个月。图卡替尼联合治疗组 2 年总生存率为 44.9%，安慰剂联合治疗组 26.6%（死亡风险比为 0.66；95% CI，0.50 至 0.88；P = 0.005），中位总生存期分别为 21.9 个月和 17.4 个月。在脑转移患者中，图卡替尼联合治疗组 1 年无进展生存率为 24.9%，安慰剂联合治疗组为 0%（风险比为 0.48；95% CI，0.34 至 0.69；P<0.001），中位无进展生存期分别为 7.6 个月和 5.4 个月。图卡替尼组常见不良事件包括腹泻、手掌足底红肿感觉异常综合征、恶心、疲劳和呕吐。与安慰剂联合治疗组相比，图卡替尼联合治疗组腹泻和 3 级或以上转氨酶升高的发生率更高。结论：对于接受过大量治疗的 HER2 阳性转移性乳腺癌患者（包括患有脑转移的患者），在曲妥珠单抗和卡培他滨中添加图卡替尼比添加安慰剂可获得更好的无进展生存期和总生存期结果；使用图卡替尼的患者腹泻和氨基转移酶水平升高的风险更高。（由 Seattle Genetics 资助；HER2CLIMB ClinicalTrials.gov 编号为 NCT02614794。）胃癌 - 赫赛汀与化疗（顺铂和卡培他滨或 5-氟尿嘧啶）联合使用获批用于治疗 HER2 阳性转移性胃癌或胃食管交界处（食管与胃的交界处）患者，这些患者之前未接受过转移性疾病治疗。Oh, DY。& Bang, YJ。2020。“HER2 是很大一部分乳腺癌女性的既定治疗靶点；多种药物包括曲妥珠单抗、帕妥珠单抗、拉帕替尼、来那替尼和曲妥珠单抗 emtansine (T-DM1) 已被批准用于治疗 HER2 阳性乳腺癌。HER2 在其他实体瘤患者中也过度表达。值得注意的是，在一线化疗中添加曲妥珠单抗提高了 HER2 阳性胃癌患者的总体生存率
Septins 破坏可控制肿瘤生长并增强赫赛汀的疗效
Septins disruption controls tumor growth and enhances efficacy of Herceptin 1 2 Rakesh K Singh* 1 , Kyu Kwang Kim 1 , Negar Khazan 1 , Rachael B. Rowswell-Turner 1 , Christian 3 Laggner 3 , Aaron Jones 1 , Priyanka Srivastava 1 , Virginia Hovanesian 4 , Liz Lamere 1 , Thomas 4 Conley 1 , Ravina Pandita 1 , Cameron Baker 5 , Jason R Myers 5 , Elizabeth Pritchett 5 , Awada Ahmad 1 , 5 Luis Ruffolo 2 , Katherine Jackson 2 , Scott A. Gerber 2 , John Ashton 5 , Michael T. Milano 6 , David 6 Linehan 2 , Richard G Moore 1 7 8 1 Wilmot Cancer Institute, Division of Gynecologic Oncology, Department of Obstetrics and 9 Gynecology, University of Rochester Medical Center, Rochester, NY, USA. 10 2 Department of Surgery, Microbiology and Immunology; Department of Radiation Oncology and 11 Center for Tumor Immunology Research, University of Rochester Medical Center, Rochester, NY, 12 USA. 13 3 Atomwise Inc, San Francisco, CA, USA. 14 4 Rhode Island Hospital, Providence, RI, USA. 15 5 Genomics Research Center, Wilmot Cancer Center, University of Rochester Medical Center, NY, 16 USA. 17 6 Department of Radiation Oncology, University of Rochester, NY, USA. 18 19 20 * Corresponding author: 21 Rakesh_Singh@URMC.Rochester.Edu 22 Telephone (office): 585-276-6281. Fax: 585-276-2576 23 24 Abstract 25 Septin expressions are altered in cancer cells and exhibit poor prognoses in malignancies. As the 26 first approach to develop a septin filament targeting agent, we optimized the structure of 27 Forchlorfenuron (FCF), a known plant cytokinin to generate UR214-9, which contrary to FCF, 28 causes septin-2/9 filamental structural catastrophe in cancer cells without altering cellular septin 29 protein levels. In-silico docking using septin-2/septin-2 dimer complex showed that UR214-9 30 displaced the guanine carbonyl oxygen from the GDP binding domain and showed increased 31 binding energy than FCF(-8.59vs-7.21). UR214-9 reduced cancer cell growth, downregulated 32 HER2/STAT-3 axis and controlled growth of HER2+ pancreatic, breast and ovarian cancer 33 xenografts in NSG mice and enhanced response of Herceptin against HER2+breast cancer 34 xenograft. Transcriptome analysis of UR214-9 exposed cells demonstrated significant 35 perturbation of <20 genes compared to afatinib which impacted >1200 genes in JIMT-1 breast 36 cancer cells indicating target specificity and non-transcriptional functions of UR214-9. In summary, 37 disrupting septins via UR214-9 is a new approach to control the growth of HER2+ malignancies. 38 39 Introduction 40 41 Septins are a family of GTP-binding cytoskeletal proteins that participate in cytokinesis, 42 cell migration, chromosomal dynamics and protein secretion. Septins hetero-oligomerize to 43 generate scaffolding filaments, bundles, and rings within cells 1-11 . Additionally, septins are a 44 critical cytoskeletal component that regulate the function of tubulin and actin. Altered septin 45