A phase I/IIA study of AGS-PSCA for castration-resistant prostate cancer.

BACKGROUND: This first-in-human phase I/IIA study was designed to evaluate the safety and pharmacokinetics (PKs) of AGS-PSCA a fully human monoclonal antibody directed to prostate stem cell antigen (PSCA) in progressive castration-resistant prostate cancer. PATIENTS AND METHODS: Twenty-nine patients were administered infusions of AGS-PSCA (1-40 mg/kg) every 3 weeks for 12 weeks; 18 final patients received a 40-mg/kg loading dose followed by 20-mg/kg repeat doses. Primary end points were safety and PK. Immunogenicity, antitumor activity and circulating tumor cells were also evaluated. RESULTS: No drug-related serious adverse events were noted. Dose escalation stopped before reaching the maximum tolerated dose as target concentrations were achieved. Drug levels accumulated linearly with dose and the mean terminal half-life was 2-3 weeks across dose levels. The 40-mg/kg loading dose followed by repeated 20-mg/kg doses yielded serum drug concentrations above the projected minimum therapeutic threshold after two to three doses without excessive drug accumulation or toxicity. Significant antitumor effects were not seen. CONCLUSIONS: A 40-mg/kg loading dose followed by 20-mg/kg infusions every 3 weeks is the recommended phase II dose of AGS-PSCA. PSCA is a promising drug target and studies in prostate and other relevant solid tumors are planned.

Canine gastrointestinal stromal tumors: immunohistochemical expression of CD34 and examination of prognostic indicators including proliferation markers Ki67 and AgNOR.

Gastrointestinal stromal tumors (GISTs), leiomyomas, and leiomyosarcomas are common mesenchymal neoplasms in the gastrointestinal (GI) tract of dogs. As previously diagnosed smooth muscle tumors of the canine GI tract are increasingly reclassified as GISTs, it becomes important to identify additional criteria that may assist in the diagnosis of these neoplasms, provide prognostic information, and offer targets for therapy. Examination of cluster of differentiation (CD), molecule expression (such as KIT [CD117] and CD34) as well as gross, histologic, and immunohistochemical features (such as tumor size, tumor location, mitotic index, AgNOR, and Ki67 labeling) in human GISTs has revealed new and valuable prognostic, diagnostic, and therapeutic information. In this study, GISTs were examined for the gross, histologic, and immunohistochemical features listed above. Forty-nine cases of canine gastrointestinal mesenchymal neoplasms from the Animal Medical Center (New York, NY) were categorized as GISTs (KIT positive), leiomyosarcoma/leiomyoma (KIT negative, smooth muscle actin [SMA], and/or desmin positive), or other (KIT, SMA, and desmin negative). A proportion (55%) of canine cases previously diagnosed as smooth muscle tumors were reclassified as GISTs according to KIT immunoreactivity. Statistical correlations with survival data were not possible because of insufficient follow-up data. However, there was a significant difference between mitotic index, AgNOR, and Ki67 scores depending on the location of the tumor (small vs large intestine). This study represents the first time CD34 immunoreactivity has been demonstrated in canine GISTs.

Recurrence rates and clinical outcome for dogs with grade II mast cell tumours with a low AgNOR count and Ki67 index treated with surgery alone.

Grade II mast cell tumours (MCT) are tumours with variable biologic behaviour. Multiple factors have been associated with outcome, including proliferation markers. The purpose of this study was to determine if extent of surgical excision affects recurrence rate in dogs with grade II MCT with low proliferation activity, determined by Ki67 and argyrophilic nucleolar organising regions (AgNOR). Eighty-six dogs with cutaneous MCT were evaluated. All dogs had surgical excision of their MCT with a low Ki67 index and combined AgNORxKi67 (Ag67) values. Twenty-three (27%) dogs developed local or distant recurrence during the median follow-up time. Of these dogs, six (7%) had local recurrence, one had complete and five had incomplete histologic margins. This difference in recurrence rates between dogs with complete and incomplete histologic margins was not significant. On the basis of this study, ancillary therapy may not be necessary for patients with incompletely excised grade II MCT with low proliferation activity.

A new assay for the microsomal metabolism of nitrosamines.

This report describes a new general assay for the microsomal oxidative dealkylation of nitrosamines. After precipitation of the microsomal proteins, aldehydes formed from nitrosamines are quantitated by high-pressure liquid chromatography as their 2,4-dinitrophenylhydrazones. This novel assay method offers some distinct advantages over the commonly used Nash reagent assay. Dimethylnitrosamine, diethylnitrosamine, and methylethylnitrosamine were metabolized by microsomes from noninduced male Fischer rat liver, and the aldehydes produced by these reactions were examined. Two distinct kinetic lines were observed for reactions containing dimethylnitrosamine or diethylnitrosamine. Similarly, two Km's were observed for the production of both formaldehyde and acetaldehyde produced by the metabolism of methylethylnitrosamine.

Metabolism of three cyclic nitrosamines in Sprague-Dawley rats.

The metabolism of three cyclic nitrosamines has been studied in Sprague-Dawley rats. The compounds were nitrosopyrrolidine, nitrosohexamethyleneimine, and nitrosohepatamethyleneimine and were labeled at the alpha carbon with 14C. At low doses (2 to 4 mg/animal) the compounds were metabolized to 14CO2 to the extent of 77, 43, and 27%, respectively, after 24 hr. At doses closer to the 50% lethal dose of the compounds (70 to 160 mg/animal) the metabolism values were only 14, 4, and 8%, respectively, after 24 hr. The significance of these results is discussed.

Effect of glucocorticoids on activation of leukemia virus in AKR mouse embryo cells.

The effect of glucocorticoids on activation and replication of leukemia virus in AKR mouse embryo cells was analyzed. The number of cells detected as positive by fluorescent antibody techniques as well as the virus production in cells chronically producing virus was doubled at optimal concentrations of glucocorticoids. The effect of the hormones in activated cells was found to be not on the process of activation per se but rather on synthesis of the viral components after activation has occurred. Intracellular reverse transcriptase levels were not changed by hormone treatment. The stimulation of virus synthesis by glucocorticoids requires binding of the steroid to a cytoplasmic receptor protein.

Relationship between carcinogenicity and in vitro metabolism of nitrosomethylethylamine, nitrosomethyl-N-butylamine, and nitrosomethyl-(2-phenylethyl)amine labeled with deuterium in the methyl and alpha-methylene positions.

With the use of rat liver preparations, the in vitro microsomal metabolism of methylethylnitrosamine, methyl-n-butylnitrosamine, and methyl(2-phenylethyl)nitrosamine labeled with deuterium in the methyl and alpha-methylene positions has been compared with that of the parent (unlabeled) compounds. All three forms of the liver carcinogen methylethylnitrosamine are metabolized with two sets of kinetic constants. Examination of these kinetic constants suggests that both methylation and ethylation of cellular nucleophiles might be important in the carcinogenic action of these nitrosamines. The esophageal carcinogen, methyl(2-phenylethyl)nitrosamine, gave only one set of kinetic constants during metabolism. The metabolism of the three methylbutylnitrosamines gave results similar to that of the three methylethyl nitrosamines. Except for metabolism of d2-methylbutylnitrosamine to butyraldehyde, two sets of kinetic constants were found. Approximately equivalent amounts of methylating species were produced from d3-methylbutylnitrosamine and d0-methylbutylnitrosamine.

Mutagenicity of potassium alkanediazotates and their use as model compounds for activated nitrosamines.

The mutagenicity of a series of potassium alkanediazotates in the Ames assay was studied. These compounds were isolated as solids and are soluble in dimethyl sulfoxide. Upon addition to water, they form diazohydroxides (which are postulated intermediates in the decomposition of alpha-hydroxylated nitrosamines). The diazohydroxides decompose to electrophilic intermediates which may react with macromolecules or water. In the Ames assay, potassium diazotates produced his+ revertants in Salmonella typhimurium strains TA 100 and TA 1535 but not in strains TA 98, TA 1537, or TA 1538. Methane, methane-d3, ethane, propane, and phenylmethanediazotates were mutagenic in strain TA 100, and all diazotates with the exception of phenylmethanediazotate, produced revertants in TA 1535. The order of mutagenic potency of these compounds was: methane approximately equal to methane-d3 greater than ethane, greater than phenylmethane (TA 100) greater than propane greater than phenylmethane (TA 1535) = 0. All diazotates were direct-acting mutagens and produced revertants even when no liver 9000 X g supernatant (S9) fractions were present. S9 fractions inhibited the mutagenicity of potassium diazotates, and equivalent concentrations of S9 fractions (3 mg protein per plate) from either rat or hamster liver, whether induced or not, were equally effective. Bovine serum albumin was not as effective as S9 fractions in inhibiting diazotate mutagenesis, but heat-inactivated (70 degrees for 20 min) S9 fractions were as inhibitory of methanediazotate mutagenicity as native S9 fractions were at low protein concentrations. The half-lives of mutagenicity of methane- and ethanediazotates in aqueous solutions were identical (less than or equal to 15 sec); after less than 2 min in solution, these diazotates were rendered completely inactive. The implications of these studies for mechanisms of nitrosamine action and the use of potassium alkanediazotates as model compounds for activated nitrosamines are discussed.

Metabolism of the Z and E isomers of N-nitroso-N-methyl-(2-oxopropyl)amine by rat hepatocytes.

The metabolism of N-nitroso-N-methyl-N-(2-oxopropyl)amine was examined using freshly isolated hepatocytes from Fischer 344 rats. As determined by high performance liquid chromatography, it was found that the E isomer was preferentially metabolized when the parent mixture was used. When the two isomers were studied separately, the E isomer was efficiently metabolized in the hepatocytic system, whereas the Z isomer was not. The kinetics of disappearance of the Z isomer during metabolism was identical to that for the reequilibration of the Z isomer to the mixture of isomers in the absence of a metabolizing system.

Metabolism of the liver carcinogen N-nitrosopyrrolidine by rat liver microsomes.

This report represents a study of the total metabolism of the hepatocellular carcinogen, N-nitrosopyrrolidine (NO-PYR), by rat liver microsomes and postmicrosomal supernatant. [2,5-14C]NO-PYR, which is totally extractable from aqueous solution with methylene chloride, is converted to radioactive nonmethylene chloride-extractable products by these fractions. The initial rate of conversion to nonmethylene chloride-extractable products follows simple Michaelis-Menten kinetics with an apparent Km of 3.6 x 10(-4) M NO-PYR. The major products of NO-PYR metabolism by rat liver microsomes and postmicrosomal supernatant have been isolated and identified. One product of metabolism of NO-PYR is 2-hydroxytetrahydrofuran formed by alpha-hydroxylation by the microsomes. In the presence of postmicrosomal supernatant enzymes, this compound exists only as a transient intermediate which is rapidly converted to 1,4-butanediol or gamma-hydroxybutyrate. These compounds may be cycled into general cellular metabolism resulting in the production of CO2. Two minor pathways of metabolism have also been found.

Three-dimensional conformal radiation therapy alone or in combination with surgery for treatment of canine intracranial meningiomas.

Treatment protocols, treatment planning methods and tumour types in studies evaluating radiotherapy for canine brain tumours have been varied. This case series retrospectively evaluated the outcome of definitive, three-dimensional conformal radiation therapy (3D-CRT) as either a sole modality or as an adjuvant to surgery in 31 dogs diagnosed with meningioma by histopathology (n = 10) or cross-sectional imaging of the head (n = 21, assessed independently by two board certified radiologists). Prescribed dose ranged from 45 to 54 Gy in 2.5 to 3 Gy fractions. Median overall survival was 577 days (interquartile range = 272-829 days; range = 30-1942 days) when all deaths were considered and 906 days (interquartile range = 336-912 days; range = 10 -1942 days) when only dogs dying due to meningioma were considered. No significant difference in survival time was detected for the defined clinical or imaging findings or between treatment with radiotherapy alone versus adjuvant radiotherapy, suggesting that 3D-CRT may be a viable alternative to surgery.

Microsomal metabolism of the Z and E isomers of N-nitroso-N-methyl-N-n-pentylamine.

N-Nitrosomethyl-N-n-pentylamine was separated into its E and Z isomers by HPLC. When the metabolism was examined using microsomes isolated from uninduced Fischer 344 rats, it was found that, at a constant final concentration of 0.5 mM, the yield of formaldehyde produced increased as the proportion of the Z isomer rose. The yield of valeraldehyde, on the other hand, decreased with an increasing proportion of the Z isomer. Kinetic constants were determined for the metabolism of the two isomers. During the metabolism of the Z isomer, the Vmax was 2.2-fold higher for the formation of formaldehyde than that for the E. The Vmax for valeraldehyde was 2.0-fold lower during the metabolism of the Z isomer. The results indicate that the relative position of the nitroso group can have a profound effect on the metabolism of each side of this type of molecule.

Lack of metabolism of 2,6-dimethyldinitrosopiperazine by microsomes and postmicrosomal supernatant prepared from the rat esophagus and non-glandular stomach.

Microsomes and postmicrosomal supernatant were prepared from the esophagus and non-grandular stomach of rats. Using these fractions, we could not demonstrate in vitro metabolism of 2,6-dimethyldinitrosopiperazine (DMDNP), a potent esophageal and non-grandular stomach carcinogen in rats. The esophageal and non-grandular stomach fractions did metabolize N-nitrosopyrrolidine (NPYR) to a small extent, and liver microsomes and postmicrosomal supernatant metabolized both nitrosamines to a similar extent. Therefore, we advise caution in the interpretation of metabolic studies using 'target' and 'non-target' organs as indicative of activation of compounds to proximate carcinogens.

Metabolic studies of 15N-labeled N-nitrosoproline in isolated rat hepatocytes and subcellular fractions.

The metabolism of the non-carcinogenic N-nitrosoproline (NPRO) was investigated in vitro using both S9 preparations and isolated hepatocytes from F344 rats. The studies were performed using 15N-labeled nitrosamine and the reaction mixtures were examined mass spectrometrically for the presence of 15N2 or other 15N-labeled gaseous products. In addition, the metabolism of NPRO was monitored by capillary gas chromatography. The results indicated no 15N2 production from either the hepatocyte or S9 preparations, as well as no detectable loss of substrate from the reaction mixtures. Mass spectrometric analysis failed to reveal any metabolites of NPRO. The results suggest that NPRO may be refractory to the normal nitrosamine activating enzymes, confirming its suitability for use in human epidemiological studies of endogenous nitrosation.

Metabolism of 15N-labelled N-nitrosodimethylamine and N-nitroso-N-methylaniline by isolated rat hepatocytes.

The N-demethylation of 15N-labeled N-nitrosodimethylamine (DMN) and N-nitroso-N-methylaniline (NMA) by isolated rat hepatic cells has been investigated. The values obtained in this system for molecular nitrogen formed during metabolism, compared with substrate consumed, were DMN 47%, NMA 23%, and N-nitroso-N-methylurea (NMU) 105%. The results for DMN are roughly halfway between those previously determined with rat liver S-9 fraction in vitro (33%) and in vivo (67%). For NMA, the hepatocyte data are closer to those obtained from S-9 in vitro (19%), rather than the in vivo (52%). No mixed nitrogen ( 15N14N ) or labeled nitrogen oxides were found.

Formation of epsilon-hydroxycaproate and epsilon-aminocaproate from N-nitrosohexamethyleneimine: evidence that microsomal alpha-hydroxylation of cyclic nitrosamines may not always involve the insertion of molecular oxygen into the substrate.

The formation of the products of microsomal metabolism of the cyclic nitrosamine, nitrosohexamethyleneimine (NO-HEX) were studied. Information on the origins of the oxygen atoms in four major metabolites of NO-HEX was obtained by metabolizing this compound in an 18O2 atmosphere using microsomes and cytosol, beta- and gamma-Hydroxy-NO-HEX are formed as a result of the insertion of a hydroxyl group derived from molecular oxygen into NO-HEX. All of the oxygen atoms in epsilon-aminocaproate (EAC) were derived from water. Approximately half of the molecules of epsilon- hydroxycaproate ( EHC ) contain an 18O atom; thus, half of the alpha-hydroxy-NO-HEX formed incorporates a hydroxyl group derived from molecular oxygen with the remainder of the hydroxyls being from water. To account for the above data and the related metabolic origins of EAC and EHC ( Hecker and McClusky , Cancer Res., 42 (1982) 59; Hecker et al., Teratogen. Carcinogen. Mutagen (1982) in press), we have proposed a mechanism for the formation of these compounds from cyclic nitrosamines catalyzed by microsomal and cytosolic enzymes.

The metabolism of nitrosopyrrolidine by hepatocytes from Fischer rats.

Nitrosopyrrolidine (NO-PYR), an hepatocellular carcinogen, is rapidly metabolized to CO2 by hepatocytes freshly isolated from the livers of male Fischer rats. Using CO2 evolution as a measure of NO-PYR metabolism, we observed two kinetic constants; a high affinity component (Km = 0.11 mM), and a lower affinity component (K m = 3.2 mM). The high affinity component has similar kinetic constants to those observed for in vitro reactions with microsomes plus cytosol (Km = 0.36 mM). Therefore, it is probable that the microsomal reaction is the limiting factor in the metabolism of NO-PYR in hepatocytes. NO-PYR may be metabolized to CO2 through normal anaplerotic sequences. Some metabolites of NO-PYR which have been tentatively identified are gamma-hydroxybutyrate, succinic semialdehyde, 3,4-dihydroxybutyric acid lactone, lactate, acetate, pyruvate, glyoxylate, gamma-aminobutyrate and alanine. 2-Hydroxytetrahydrofuran (2-hydroxy-THF). a product of alpha-hydroxylation was detected at low levels in only one of four reactions. 3-Hydroxy-NO-PYR is present but represents only a small percentage of the total metabolism and is probably of little significance in the overall catabolism of NO-PYR in hepatocytes.

Regulatory science: a special update from the United States Food and Drug Administration: Preclinical issues and status of investigation of botanical drug products in the United States.

A recent survey was conducted across the therapeutic divisions within the CDER, U.S. FDA regarding the number of submissions related to botanical drug products over the past ten years. The overall number of botanical submissions as expressed in the parenthesis are as follows: 1990 (1), 1991 (4), 1992 (4), 1993 (5), 1994 (6), 1995 (5), 1996 (13), 1997 (16), 1998 (10). In the total of 64 counted, 50 of them are submitted in original IND and the rest (14) in pre-IND format. The therapeutic categories are focused on dermatological and topical (19), anti AIDS/antiviral (12), oncologic (13), neuropharmacologic (8), endocrine and metabolic (3), urologic (2), tobacco (2), and cardio-renal products (1). The regulatory actions taken on these submissions showed that 68% of them are evaluated as safe to proceed for the human trials, while the rest (32%) of submissions required agency's regulatory guidance. Among the submissions that required further guidance, 81% were deficient in preclinical pharmacology/toxicology information and the rest (19%) lacks information in other areas (chemistry, clinical protocols). Following agency's guidance, 93% of the submissions that were put on hold were allowed to proceed. In summary, a total of 94% of all the botanical INDs submitted to the agency were allowed to proceed without additional animal toxicity studies conducted. In conclusion, this survey indicates that the growing public interest in botanical supplements has prompted more formal evaluation of the efficacy/safety claims of these products.