Antiplatelet drugs may increase the risk for checkpoint inhibitor-related pneumonitis in advanced cancer patients.

BACKGROUND: Immune checkpoint inhibitors (ICIs) are indicated for various cancers and are the mainstay of cancer immunotherapy. They are often associated with ICI-related pneumonitis (CIP), however, hindering a favorable clinical course. Recently, non-oncology concomitant drugs have been reported to affect the efficacy and toxicity of ICIs; however, the association between these drugs and the risk for CIP is uncertain. The aim of this study was to assess the impact of baseline concomitant drugs on CIP incidence in ICI-treated advanced cancer patients. PATIENTS AND METHODS: This was a single-center retrospective study that included a cohort of 511 patients with advanced cancer (melanoma and non-small-cell lung, head and neck, genitourinary, and other types of cancer) treated with ICIs. Univariable analysis was conducted to identify baseline co-medications associated with CIP incidence. A propensity score matching analysis was used to adjust for potential CIP risk factors, and multivariable analysis was carried out to assess the impact of the identified co-medications on CIP risk. RESULTS: Forty-seven (9.2%) patients developed CIP. In these patients, the organizing pneumonia pattern was the dominant radiological phenotype, and 42.6% had grade ≥3 CIP, including one patient with grade 5. Of the investigated baseline co-medications, the proportion of antiplatelet drugs (n = 50, 9.8%) was higher in patients with CIP (23.4% versus 8.4%). After propensity score matching, the CIP incidence was higher in patients with baseline antiplatelet drugs (22% versus 6%). Finally, baseline antiplatelet drug use was demonstrated to increase the risk for CIP incidence regardless of cancer type (hazard ratio, 3.46; 95% confidence interval 1.21-9.86). CONCLUSIONS: An association between concomitant antiplatelet drug use at baseline and an increased risk for CIP was seen in our database. This implies the importance of assessing concomitant medications for CIP risk management.

A white paper--consensus and recommendations of a global harmonization team on assessing the impact of immunogenicity on pharmacokinetic measurements.

The Global Bioanalysis Consortium (GBC) set up an international team to explore the impact of immunogenicity on pharmacokinetic (PK) assessments. The intent of this paper is to define the field and propose best practices when developing PK assays for biotherapeutics. We focus on the impact of anti-drug antibodies (ADA) on the performance of PK assay leading to the impact on the reported drug concentration and exposure. The manuscript describes strategies to assess whether the observed change in the drug concentration is due to the ADA impact on drug clearance rates or is a consequence of ADA interference in the bioanalytical method applied to measure drug concentration. This paper provides the bioanalytical scientist guidance for developing ADA-tolerant PK methods. It is essential that the data generated in the PK, ADA, pharmacodynamic and efficacy/toxicity evaluations are viewed together. Therefore, the extent for the investigation of the PK sensitivity to the presence of ADA should be driven by the project needs and risk based.

Pharmacological profile of MS-377, a novel antipsychotic agent with selective affinity for sigma receptors.

RATIONALE: MS-377 ((R)-(+)-1-(4-chlorophenyl)-3-[4-(2-methoxyethyl)piperazin-1-yl]me thyl-2- pyrrolidinone L-tartrate) was discovered as a new chemical entity with affinity for sigma receptors and without affinities for dopamine receptors. OBJECTIVE: In the present study, we examined the antipsychotic profile of MS-377 in several in vitro and in vivo experiments. METHODS: As in vitro assays, radioligand binding assays for sigma 1, sigma 2, D2 and 5-HT2 receptors were performed. As in vivo animal models, the effects of MS-377 on several behavioral models induced by phencyclidine (PCP), (+)-N-allylnormetazocine (NANM), apomorphine (Apo) and 5-hydroxytryptamine (5-HTP) were evaluated. All assay systems were conducted using the clinically active antipsychotic agents as reference standards. RESULTS: MS-377 displaced ligand bound to sigma 1 receptors in vitro. However, no such displacement was observed at sigma 2 or 5-HT2 receptors in vitro, or at D2 receptors either in vitro or in vivo. In behavioral studies, MS-377 inhibited both NANM- and PCP-induced head-weaving at low doses in mice and rats, whereas antipsychotic agents used in the present study were only effective against NANM-induced head-weaving behavior in mice. In addition, MS-377 antagonized Apo-induced climbing behavior and 5-HTP-induced head-twitching behavior in mice. MS-377 was inactive in models of extrapyramidal side effect (EPS) liability such as prevention of Apo-induced stereotypy and induction of catalepsy in rats. CONCLUSION: The present study demonstrated that MS-377 had not only anti-PCP activity but also anti-dopaminergic and anti-serotonergic activities in vivo, without acting directly through D2 or 5-HT2 receptors. Therefore, MS-377 could be a novel antipsychotic agent with clinical efficacy for overall symptoms of schizophrenia including its negative symptoms and without EPS liability.

Two short peptide sequences repeated three times in carrot beta-tubulin.

There are two repeated peptides, [S,T,Y]QQ[Y,M] and MFR[R,X][V,K], which appear three times each in the region corresponding to the third exon of carrot beta-tubulins. The former peptide is flanked on both sides by a pair of identically charged groups and the latter includes two or three basic amino acids in it. The sequences are generally conserved well among the eukaryotes except for fungi, in which one of the peptides, SQQY, does not exist.

Hexamer palindromic oligonucleotides with 5'-CG-3' motif(s) induce production of interferon.

We have shown previously that 30-mer oligonucleotides containing hexamer palindromic sequences with 5'-CG-3' motif(s) induce interferon (IFN), activate natural killer (NK) cells, and thus exhibit tumor-regressing activity. The present study showed that a hexamer palindromic oligonucleotide (5'-AACGTT-3') alone induced IFN from mouse spleen cells when added with cationic liposomes. Accordingly, 32 kinds of hexamer palindromic oligonucleotides were tested for their ability to induce IFN in the presence of cationic liposomes. The results show that oligonucleotides with NACGTN and NTCGAN sequences exhibited the strongest activity. ACGCGT and TCGCGA also possessed moderate but significant activity. In contrast, palindromes without CG motif(s) were devoid of the activity. No hexamer oligonucleotides showed the activity when liposomes were absent. A complete palindromic sequence was essential as any single base substitution resulted in diminished activity. Among variety of palindromic oligonucleotides of different sizes with an ACGT sequence at the center, the tetramer oligonucleotide was without activity, whereas the activity of hexamer and longer oligonucleotides was almost equally high. These results strongly suggest that the minimal essential structure required for IFN induction is the hexamer palindromic sequence with CG motif(s).

Binding of oligoguanylate to scavenger receptors is required for oligonucleotides to augment NK cell activity and induce IFN.

Specific palindromic sequences in synthetic oligonucleotides are required to induce IFN and augment IFN-mediated natural killer activity. To study the mechanism of IFN induction by oligonucleotides containing palindromic sequences, we investigated the possible target molecules of the oligonucleotides. Oligo-1, a 30mer single-stranded oligonucleotide with oligoG sequences next to the active palindromic sequence (AACGTT), had more activity than oligonucleotides with oligoA, oligoC, or oligoT sequences. The activity of oligo-1 was inhibited by a guanine homo-oligomer (G30), dextran sulfate, and polyvinyl sulfate. Oligo-1 bound to plastic-adherent mouse splenocytes, and the binding was inhibited by G30, dextran sulfate, and polyvinyl sulfate. Oligo-1 inhibited acetyl-LDL binding to the scavenger receptor on mouse splenocytes. These findings suggest that the binding of an extrapalindromic sequence to the scavenger receptor is required for the immunostimulatory activity of oligo-1.

The effect of temperature of fluorescence for liquid scintillators and their solvents.

The pulse-height distributions for 241Am and 131mXe in PPO solutions of the aromatic hydrocarbons, i.e. benzene, o-xylene, m-xylene, ethylbenzene and cumene are found to shift toward higher pulse-heights with decreasing temperature. Under u.v. excitation, the fluorescence intensity of these pure aromatic hydrocarbons increases markedly and the fluorescence maximum is found to shift to longer wavelengths with decreasing temperature. In conjunction with observations of the pulse-height shift in liquid scintillators and the fluorescence emission from the pure solvents, the pulse-height shifts observed are interpreted in terms of excimer formation in the aromatic hydrocarbons.