TY - JOUR
T1 - Evaluation of plitidepsin in patients with primary myelofibrosis and post polycythemia vera/essential thrombocythemia myelofibrosis
T2 - Results of preclinical studies and a phase II clinical trial
AU - Pardanani, A.
AU - Tefferi, A.
AU - Guglielmelli, P.
AU - Bogani, C.
AU - Bartalucci, N.
AU - Rodríguez, J.
AU - Extremera, S.
AU - Pérez, I.
AU - Alfaro, V.
AU - Vannucchi, A. M.
N1 - Funding Information:
Financial support for this study was provided by PharmaMar, Colmenar Viejo, Madrid, Spain. The preclinical studies were supported by Fondazione Toscana Life Science and a grant from Associazione Italiana per la Ricerca sul Cancro (AIRC, progetto 5 per Mille to AGIMM group, project number #1005).
PY - 2015/3/13
Y1 - 2015/3/13
N2 - Previous data established that plitidepsin, a cyclic depsipeptide, exerted activity in a mouse model of myelofibrosis (MF). New preclinical experiments reported herein found that low nanomolar plitidepsin concentrations potently inhibited the proliferation of JAK2V617F-mutated cell lines and reduced colony formation by CD34+ cells of individuals with MF, at least in part through modulation of p27 levels. Cells of MF patients had significantly reduced p27 content, that were modestly increased upon plitidepsin exposure. On these premise, an exploratory phase II trial evaluated plitidepsin 5 mg/m2 3-h intravenous infusion administered on days 1 and 15 every 4 weeks (q4wk). Response rate (RR) according to the International Working Group for Myelofibrosis Research and Treatment consensus criteria was 9.1% (95% CI, 0.241.3%) in 11 evaluable patients during the first trial stage. The single responder achieved a red cell transfusion independence and stable disease was reported in nine additional patients (81.8%). Eight patients underwent a short-lasting improvement of splenomegaly. In conclusion, plitidepsin 5 mg/m2 3-h infusion q4wk was well tolerated but had a modest activity in patients with primary, post-polycythaemia vera or post-essential thrombocythaemia MF. Therefore, this trial was prematurely terminated and we concluded that further clinical trials with plitidepsin as single agent in MF are not warranted.
AB - Previous data established that plitidepsin, a cyclic depsipeptide, exerted activity in a mouse model of myelofibrosis (MF). New preclinical experiments reported herein found that low nanomolar plitidepsin concentrations potently inhibited the proliferation of JAK2V617F-mutated cell lines and reduced colony formation by CD34+ cells of individuals with MF, at least in part through modulation of p27 levels. Cells of MF patients had significantly reduced p27 content, that were modestly increased upon plitidepsin exposure. On these premise, an exploratory phase II trial evaluated plitidepsin 5 mg/m2 3-h intravenous infusion administered on days 1 and 15 every 4 weeks (q4wk). Response rate (RR) according to the International Working Group for Myelofibrosis Research and Treatment consensus criteria was 9.1% (95% CI, 0.241.3%) in 11 evaluable patients during the first trial stage. The single responder achieved a red cell transfusion independence and stable disease was reported in nine additional patients (81.8%). Eight patients underwent a short-lasting improvement of splenomegaly. In conclusion, plitidepsin 5 mg/m2 3-h infusion q4wk was well tolerated but had a modest activity in patients with primary, post-polycythaemia vera or post-essential thrombocythaemia MF. Therefore, this trial was prematurely terminated and we concluded that further clinical trials with plitidepsin as single agent in MF are not warranted.
UR - http://www.scopus.com/inward/record.url?scp=84989282773&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84989282773&partnerID=8YFLogxK
U2 - 10.1038/bcj.2015.5
DO - 10.1038/bcj.2015.5
M3 - Article
C2 - 25768401
AN - SCOPUS:84989282773
SN - 2044-5385
VL - 5
JO - Blood cancer journal
JF - Blood cancer journal
IS - 3
M1 - e286
ER -