Treatment of Melanoma with wild-type P53 and detectable S100B using pentamidine:

使用喷他脒用野生型 P53 和可检测的 S100B 治疗黑色素瘤：

• 批准号: 7642487
• 负责人: EDWARD A. SAUSVILLE
• 金额: $ 31.13万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7642487
• 关键词: Age; Apoptosis; Apoptotic; Basic Science; Binding; Binding Proteins; Biochemical; Biological Assay; Calcium-Binding Proteins; Carboplatin; Clinical; Clinical Research; Computer Assisted; Cutaneous; Dacarbazine; Diagnostic; Disease; Documentation; Down-Regulation; Drug usage; Excision; FDA approved; Family; Goals; Induction of Apoptosis; Infection; Interferons; Interleukin-2; Laboratories; Leishmania; Melanoma Cell; Mutation; Nodal; Outpatients; Pathway interactions; Patients; Pentamidine; Pharmaceutical Preparations; Phase II Clinical Trials; Pneumocystis; Principal Investigator; Protein Isoforms; Proteins; Protozoan Infections; Recovery; Refractory; Relapse; Research Personnel; Science; Serum; Site; Skin; Small Interfering RNA; Structure; System; TP53 gene; Therapeutic; Trans-Activators; Transactivation; Treatment Protocols; Visceral; anticancer activity; base; chemotherapy; drug discovery; exhaust; experience; in vivo Model; melanoma; neoplastic cell; oncology; public health relevance; research clinical testing; response; small molecule; tissue culture; tumor

DESCRIPTION (provided by applicant): Basic science observations in the laboratory of Co-Investigator David Weber have demonstrated that S100B is a Ca2+binding protein that also binds to wild type (wt) p53 in primary melanoma cells. When targeted downregulation of S100B is accomplished by siRNA, recovery of p53 function ensues, with induction of apoptosis. This suggests the hypothesis that small molecules directed at the interaction of S100B and p53 might have clinical value in melanoma patients with wt p53 and expression of S100B. Co- Investigator Weber engaged collaborators to conduct a computer assisted drug discovery screen based on the known structure of S100B which defined that pentamidine, a clinically available FDA approved agent for treatment of protozoal infections could potently disrupt the p53-S100B interaction. The current Quick Trials application therefore seeks to partner the laboratory expertise of Co-Investigator Weber with the clinical experience of Principal Investigator Edward Sausville to conduct a phase II clinical trial in which patients with metastatic and/ or refractory malignant melanoma who are shown to express wtp53 and detectable S100B in their tumor cells will be treated with a well tolerated, outpatient regimen of pentamidine (days 1-5 for two of four weeks) for two cycles, followed by clinical reassessment. The primary endpoint will be to determine the response rate of relapsed and/or refractory melanoma that has previously been defined to express detectable S100B and to have wtp53, using RECIST criteria. The second goal of the application is to follow the effect of pentamidine on p21 expression in tumors, as a marker of p53 transactivator function, and S100B levels in tumor (also reflecting transactivation by p53) and in serum, as correlative indicators of drug effect on this pro-apoptotic pathway. Correlative science will benefit from the enormous expertise and established background of the Weber laboratory in S100B assays and expression systems. PUBLIC HEALTH RELEVANCE: The result of this clinical study will be important scientifically, as it will allow a clinical test with a readily available drug of an important therapeutic goal in oncology, namely "re- awakening" of p53 function with a readily available drug molecule. From a clinical and patient perspective, patients with advanced melanoma have essentially no consistently useful chemotherapeutic approaches, and so the documentation of clinical utility would provide options heretofore not available to these patients.

描述（由申请人提供）：合作研究者David Weber实验室的基础科学观察表明，S100B是一种Ca2+结合蛋白，也与原发性黑色素瘤细胞中的野生型（wt） p53结合。当siRNA完成S100B的靶向下调后，p53功能恢复，并诱导细胞凋亡。这表明，针对S100B和p53相互作用的小分子可能在具有wt p53和S100B表达的黑色素瘤患者中具有临床价值。共同研究者Weber与合作者进行了基于S100B已知结构的计算机辅助药物发现筛选，该筛选确定了喷他脒（一种经FDA批准用于治疗原虫感染的临床可用药物）可能会潜在地破坏p53-S100B的相互作用。因此，目前的快速试验申请寻求合作伙伴Weber的实验室专业知识与首席研究员Edward Sausville的临床经验进行II期临床试验，其中转移性和/或难治性恶性黑色素瘤患者在其肿瘤细胞中表达wtp53和可检测的S100B，将接受耐受性良好的门诊治疗，pentamidine方案（4周中的2周，1-5天），为期两个周期。然后进行临床再评估。主要终点将是确定复发和/或难治性黑色素瘤的缓解率，这些黑色素瘤以前被定义为表达可检测的S100B和wtp53，使用RECIST标准。申请的第二个目标是跟踪喷他脒对肿瘤中p21表达的影响，p21是p53反激活因子功能的标志，而肿瘤中S100B水平（也反映p53的反激活）和血清中S100B水平是药物对这一促凋亡途径作用的相关指标。相关科学将受益于韦伯实验室在S100B分析和表达系统方面的巨大专业知识和既定背景。公共卫生相关性：这项临床研究的结果将具有重要的科学意义，因为它将允许一种现成的药物进行临床试验，以实现肿瘤的一个重要治疗目标，即用现成的药物分子“重新唤醒”p53功能。从临床和患者的角度来看，晚期黑色素瘤患者基本上没有持续有效的化疗方法，因此临床效用的记录将为这些患者提供迄今为止无法获得的选择。