scholarly journals Current and Emerging Therapeutics for Cutaneous T-Cell Lymphoma: Histone Deacetylase Inhibitors

Lymphoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Annabelle L. Rodd ◽  
Katherine Ververis ◽  
Tom C. Karagiannis

Cutaneous T-cell lymphoma is a term that encompasses a spectrum of non-Hodgkin’s T-cell lymphomas with primary manifestations in the skin. It describes a heterogeneous group of neoplasms that are characterised by an accumulation of malignant T cells of the CD4 phenotype that have the propensity to home and accumulate in the skin, lymph nodes, and peripheral blood. The two most common variants of cutaneous T-cell lymphoma include mycosis fungoides and the leukemic variant, the Sézary syndrome. While numerous treatments are available for cutaneous T-cell lymphoma and have shown to have success in those with patch and plaque lesions, for those patients with tumour stage or lymph node involvement there is a significant decline in response. The relatively new therapeutic option with the use of histone deacetylase inhibitors is being advanced in the hope of decreasing morbidity and mortality associated with the disease. Histone deacetylase inhibitors have been shown to induce changes in gene expression, affecting cell cycle regulation, differentiation, and apoptosis. The aim of this paper is to discuss CTCL in the context of advances in CTCL treatment, specifically with HDAC inhibitors.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 800-800 ◽  
Author(s):  
James Bradner ◽  
Edward Greenberg ◽  
Sridevi Ponduru ◽  
Vishal Patel ◽  
Stuart Schreiber ◽  
...  

Abstract Cutaneous T-Cell Lymphoma (CTCL) comprises a group of related lymphoproliferative disorders characterized by the presence of malignant lymphocytes in the skin. Most patients with CTCL enjoy a normal life expectancy, though all experience chronic morbidity due to the symptomatic and cosmetic manifestations of epidermotropism. There is no curative therapeutic option for patients with CTCL and consequently topical approaches have become a core component of standard care. Recently, activity against advanced CTCL has been demonstrated by a new class of targeted agents: histone deacetylase inhibitors (HDACi). One HDACi has been approved by the FDA for use in advanced disease (vorinostat; SAHA; Merck Research Laboratories, Rahway, NJ). Dose-limiting toxicities with parenteral HDAC inhibitors include fatigue, diarrhea, nausea and myelosuppression. The poor tolerability of the currently available, nonselective small molecules render most patients with this indolent disease unlikely to benefit from this pharmacologic class. We therefore conceived of reverse pro-drug HDAC inhibitors to allow high dose-intensity at the site of disease and presystemic metabolism to mitigate side effects and reduce exposure to genotoxic agents. Suberohydroxamic acid phenyl ester (SHAPE) is a first-in-class soft-drug HDACi. SHAPE is a soluble, scalable analog of SAHA possessing an isosteric, isoelectronic ester bond at a site predicted by molecular modeling not to impact target recognition features. Serum metabolism was confirmed using a real-time absorbance assay capable of monitoring SHAPE degradation to suberic acid hydroxamate and phenol. We have determined that the rapid hydrolysis of SHAPE in serum is due to the catalytic activities of butyrylcholinesterase and paraoxonase. Cellular inhibition of Class I and II HDACs was confirmed using high content imaging; effects on histone and tubulin acetylation comparable to SAHA are witnessed at concentrations above 20 micromolar. Active site binding to HDAC isoforms was determined using purified protein and a novel, miniaturized fluorescence polarization assay we designed to permit instantaneous kinetic measurements of labile compounds. Tolerability studies of topical SHAPE were performed on shaved immunocompetent mice and on immunodeficient animals bearing human skin xenografts. Histologic evidence of inflammation or damage was not visualized. We next performed experiments testing efficacy against CTCL in vivo. Using cell lines established from neoplastic, skin-homing lymphocytes arising from an interleukin-7 transgenic murine model of CTCL, we developed a transplantation model in syngeneic animals with rapid, homogeneous disease onset compatible with studies of investigational agents. Daily administration of SHAPE (50 mg/mL) for two weeks resulted in clearance of skin-homing lymphocytes, compared to vehicle treated controls. For use in murine model studies and anticipating human clinical trials, we identified acetylation response biomarkers using mass spectrometry and developed immunohistochemical protocols with acetylation state-specific antibodies. In sum, we report the design, characterization and translational studies supporting the clinical development of a novel, soft-drug HDAC inhibitor in CTCL.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3973-3973
Author(s):  
Chunlei Zhang ◽  
Xiang Zhang ◽  
Madeleine Duvic

Abstract Abstract 3973 Histone deacetylase inhibitors (HDACi), including vorinostat (SAHA), depsipeptide (FK228), panobinostat (LBH589), belinostat (PXD101), and entinostat (SNDX275), show in-vitro and clinical activity against cutaneous T-cell lymphoma (CTCL) cell lines and patients' skin lesions [Zhang & Duvic, Expert Rev Dermatol 5: 393–401, 2010]. Vorinostat and depsipeptide were recently approved [Duvic et al, Blood 109: 31-9, 2007; Olsen et al, J Clin Oncol 25: 3109-15, 2007; Piekarz et al, J Clin Oncol 27: 5410-7, 2009], at response rates of 29% and 42%, respectively, but development of resistance remains an important clinical problem. Because we have shown that curcumin, the active ingredient of turmeric, exhibits anti-cancer activity through selective induction of tumor T-cell apoptosis and inhibition of NF-κB signaling in CTCL [Zhang et al, J Invest Dermatol 130: 2110-9, 2010], we now investigated whether curcumin combined with HDACi has synergistic anti-tumor effects in CTCL. HDACi-resistant MJ, HDACi-sensitive HH and HDACi cross-resistant HH/VOR CTCL cells were treated with HDACi (panobinostat, vorinostat, or enlinostat) plus or minus curcumin for up to 48 hrs. Cell viability was examined by the MTS assay and apoptosis by FACS analysis of annexin V/PI binding populations and/or cell cycle distribution. The NF-κB signaling pathway was analyzed by electrophoretic mobility gel shift assay and Western blotting. In MJ and HH cell lines, 5 nM panobinostat induced 1.4% and 11.4% apoptosis and 10 μM curcumin induced 24.5% and 29% apoptosis compared to vehicle controls. Panobinostat combined with curcumin induced 46.9% and 83.4% apoptosis in MJ and HH cell lines, respectively. Of interest, the HDACi cross-resistant HH/VOR CTCL cells were sensitive to curcumin alone and curcumin further enhanced panobinostat-induced apoptosis by 30% in the HH/VOR CTCL cells. Moreover, panobinostat combined with curcumin synergistically suppressed the DNA binding of NF-κB and decreased protein expression of the NF-κB activator RANK and NF-κBp65. Synergism was associated with down-regulation of NF-κB-regulated anti-apoptotic proteins (bcl-2, bcl-xL, and survivin), anti-proliferative proteins (c-myc and cyclooxygenase-2), and pro-invasive protein matrix metalloproteinase-9. Similar synergism was also seen when vorinostat or entinostat was combined with curcumin. These results suggest that HDACi could be combined with curcumin to enhance apoptosis of malignant T-cells through inhibition of NF-κB signaling in CTCL. Curcumin alone and in combination with HDACi may be an attractive strategy for the treatment of HDACi-refractory CTCL patients. Disclosures: Zhang: Novartis: Research Funding. Duvic:Novartis: Research Funding.


2018 ◽  
Vol 28 (17) ◽  
pp. 2985-2992 ◽  
Author(s):  
Jean-François Fournier ◽  
Yushma Bhurruth-Alcor ◽  
Branislav Musicki ◽  
Jérome Aubert ◽  
Michèle Aurelly ◽  
...  

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