[PMID]: | 28644774 |
[Au] Autor: | Lamba JK; Chauhan L; Shin M; Loken MR; Pollard JA; Wang YC; Ries RE; Aplenc R; Hirsch BA; Raimondi SC; Walter RB; Bernstein ID; Gamis AS; Alonzo TA; Meshinchi S |
[Ad] Endereço: | Jatinder K. Lamba, Lata Chauhan, and Miyoung Shin, University of Florida, Gainesville, FL; Michael R. Loken, Hematologics Inc; Rhonda E. Ries, Irwin D. Bernstein, and Soheil Meshinchi, Fred Hutchinson Cancer Research Center; Roland B. Walter and Soheil Meshinchi, University of Washington, Seattle, W |
[Ti] Título: | CD33 Splicing Polymorphism Determines Gemtuzumab Ozogamicin Response in De Novo Acute Myeloid Leukemia: Report From Randomized Phase III Children's Oncology Group Trial AAML0531. |
[So] Source: | J Clin Oncol;35(23):2674-2682, 2017 Aug 10. |
[Is] ISSN: | 1527-7755 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | Purpose Gemtuzumab ozogamicin (GO), a CD33-targeted immunoconjugate, is a re-emerging therapy for acute myeloid leukemia (AML). CD33 single nucleotide polymorphism rs12459419 C>T in the splice enhancer region regulates the expression of an alternatively spliced CD33 isoform lacking exon2 (D2-CD33), thus eliminating the CD33 IgV domain, which is the antibody-binding site for GO, as well as diagnostic immunophenotypic panels. We aimed to determine the impact of the genotype of this splicing polymorphism in patients with AML treated with GO-containing chemotherapy. Patients and Methods CD33 splicing single nucleotide polymorphism was evaluated in newly diagnosed patients with AML randomly assigned to receive standard five-course chemotherapy alone (No-GO arm, n = 408) or chemotherapy with the addition of two doses of GO once during induction and once during intensification (GO arm, n = 408) as per the Children's Oncology Group AAML0531 trial. Results The rs12459419 genotype was CC in 415 patients (51%), CT in 316 patients (39%), and TT in 85 patients (10%), with a minor allele frequency of 30%. The T allele was significantly associated with higher levels of D2-CD33 transcript ( P < 1.0E ) and with lower diagnostic leukemic cell surface CD33 intensity ( P < 1.0E ). Patients with the CC genotype had significantly lower relapse risk in the GO arm than in the No-GO arm (26% v 49%; P < .001). However, in patients with the CT or TT genotype, exposure to GO did not influence relapse risk (39% v 40%; P = .85). Disease-free survival was higher in patients with the CC genotype in the GO arm than in the No-GO arm (65% v 46%, respectively; P = .004), but this benefit of GO addition was not seen in patients with the CT or TT genotype. Conclusion Our results suggest that patients with the CC genotype for rs12459419 have a substantial response to GO, making this a potential biomarker for the selection of patients with a likelihood of significant response to GO. |
[Mh] Termos MeSH primário: |
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico Leucemia Mieloide Aguda/tratamento farmacológico Leucemia Mieloide Aguda/genética RNA Mensageiro/sangue Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/genética
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[Mh] Termos MeSH secundário: |
Adolescente Adulto Alelos Aminoglicosídeos/administração & dosagem Anticorpos Monoclonais Humanizados/administração & dosagem Criança Pré-Escolar Intervalo Livre de Doença Heterozigoto Homozigoto Seres Humanos Lactente Recém-Nascido Leucemia Mieloide Aguda/metabolismo Polimorfismo de Nucleotídeo Único Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/metabolismo Resultado do Tratamento Adulto Jovem
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[Pt] Tipo de publicação: | CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Nm] Nome de substância:
| 0 (Aminoglycosides); 0 (Antibodies, Monoclonal, Humanized); 0 (RNA, Messenger); 0 (Sialic Acid Binding Ig-like Lectin 3); 93NS566KF7 (gemtuzumab) |
[Em] Mês de entrada: | 1709 |
[Cu] Atualização por classe: | 170908 |
[Lr] Data última revisão:
| 170908 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 170624 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1200/JCO.2016.71.2513 |
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