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  • 1
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2018
    In:  Experimental & Molecular Medicine Vol. 50, No. 11 ( 2018-11), p. 1-12
    In: Experimental & Molecular Medicine, Springer Science and Business Media LLC, Vol. 50, No. 11 ( 2018-11), p. 1-12
    Type of Medium: Online Resource
    ISSN: 1226-3613 , 2092-6413
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
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  • 2
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 956-956
    Abstract: Background: Promising results are seen from several early phase clinical trials on the cellular immunotherapy based on chimeric antigen receptor (CAR)-engineered T (CAR-T) targeting B cell maturation antigen (BCMA) for the treatment of relapsed/refractory (RR) multiple myeloma (MM). We developed an anti-BCMA CAR-T cell product manufactured via gamma-retrovirus-mediated transduction of activated T cells to express a second-generation CAR with the 4-1BB costimulatory domain along with a truncated epidermal growth factor receptor (tEGFR) as a safety switch. The preclinical study confirmed its high reactivity against MM cells. Methods: We initiated a phase 1 clinical trial (NCT03093168) to evaluate the safety and feasibility of this BCMA CAR-T autologous cellular therapy for treating RRMM. The enrolled RRMM patients either had received at least 3 prior treatment regimens, including a proteasome inhibitor and an immunomodulatory agent, or were double-refractory, and have over 5% BCMA expression on plasma cells (One patient with extramedullary plasmacytoma does not express BCMA). Patients were subjected to a lymphodepleting regimen with Cy (300 mg/m2, d-5 to d-3) and Flu daily for 3 days (25 mg/m2, d-5 to d-3) prior to the CAR-T infusion (d0) at a dose of 9´106 CAR+ cells/kg. The efficacy was assessed by the International Uniform Response Criteria for Multiple Myeloma, and the toxicity was graded by CTCAE 4.03. Results: As of July 6th, 2018, 17patients had been infused with this intended dose of the autologous BCMA CAR-T cells, and 14 patients had reached at least 1 month of follow-up. As of this data cut-off, the most common non-haematologicalgrade 3 adverse events were pneumonia, hypophosphatemiaand hypocalcemia(two[14%] of 14patients), and fever, cytokine release syndrome,and neurotoxicities (one[7%] of 14patients).All toxicities were fully reversible. The overall response rate (ORR) for the 14 evaluable patients was 79%, including 3 sCRs, 4 CRs and 2 MRD-negative responses (2 VGPR). The CAR-T cell expansion and persistence were consistently observed throughout these patients.The durable remission was observed for two early enrolled patients, with the ongoing objective response (1 sCR and 1 VGPR) lasting more than 15 months. Conclusions: Our result demonstrates the high potential of this single CAR-T infusion therapy for RRMM, including 3 sCRs and ongoing durable clinical responses, with only mild and manageable CRS to date. These initial data provide strong evidence to support the further development of this anti-myeloma cellular immunotherapy. Disclosures Liu: HRAIN Biotechnology: Employment. Fang:HRAIN Biotechnology: Employment. He:HRAIN Biotechnology: Employment. Xie:HRAIN Biotechnology: Employment. Chen:HRAIN Biotechnology: Employment. Wei:HRAIN Biotechnology: Employment. Tao:HRAIN Biotechnology: Employment. Wang:Immune Design: Equity Ownership; HRAIN Biotechnology: Consultancy, Equity Ownership.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
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  • 3
    Online Resource
    Online Resource
    American Society of Hematology ; 2015
    In:  Blood Vol. 126, No. 23 ( 2015-12-03), p. 1855-1855
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 1855-1855
    Abstract: Some young multiple myeloma (MM) patients, coined macrofocal MM, have been reported to present with multiple lytic bone lesions and less than 10% bone marrow plasma cells (BMPCs). They usually have low tumor burden and favorable outcome. To further understand the clinical and laboratory features of macrofocal MM, we retrospectively analyzed about 1000 symptomatic MM patients of two centers and found that 49 (4.9%) patients fulfilled the criteria of macrofocal MM. Median age was 54 years; 39 (80%) were male. The immunoglobulin subtype included IgG (13), IgA (5), IgD (4), light chain only (4) and non-secretory type (23). International Staging System (ISS) stage 1 in 45 (92%), and no stage 3 patient. Durie-Salmon (DS) Staging System stage 3A in 48 (98%), and 2A in 1. Extramedullary plasmacytomas (EMPs) in 39 (80%) patients. The mean percentage of BMPCs was 2.1%, and 44 (90%) patients had less than 5% BMPCs. No patients had hypercalcemia and renal impairment. FISH cytogenetics, available in 11 patients, showed IgH translocation in 7, 13q del in 2, t(4;14) in 1, 1q21 amp in 6 and p53 del in 2 patients. Serum free light chain (sFLC), available in 14 patients, showed abnormal sFLC in 7 of 14 patients and 4 in 7 non-secretory type patients. Thirty eight (77.6%) patients received new drug-based induction therapies and 14 patients received autologous stem cell transplantation (ASCT) as consolidation therapy. After a median follow-up of 36 months,the estimated median progression-free survival (PFS) was 41 months and the median overall survival time (OS) had not been reached. Forty four macrofocal MM with ISS stage 1 and DS stage 3A were compared to all (93) typical symptomatic MM patients who were diagnosed at the same period with the same stages according to both ISS and DS Staging System. For macrofocal MM, there were significantly more male patients and EMPs, higher hemoglobin levels and lowerb2-microglobulin (b2M) levels than that of typical MM. There were no significant differences in the proportions of patients received novel agents-based chemotherapy and ASCT between two groups, however, the estimated median PFS of macrofocal MM was significant superior to typical MM (41 vs 23 months, respectively; P= 0.001) (Figure 1), and the estimated median OS was also better in macrofocal MM than typical MM (not reached vs 61 months; P= 0.004) (Figure 2). Multivariate analysis showed that only the type of disease was the independent prognostic factor of both PFS and OS. In summary, Macrofocal MM is a particular subgroup of MM with multiple bone lesions and lower tumor burden, higher frequency of EMPs, and better survival than typical symptomatic MM. Figure 1. Figure 1. Figure 2. Figure 2. Disclosures Fan: The National Natural Science Foundation of China: Research Funding. Hou:Novartis: Membership on an entity's Board of Directors or advisory committees.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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  • 4
    In: Blood, American Society of Hematology, Vol. 120, No. 21 ( 2012-11-16), p. 721-721
    Abstract: Abstract 721 Novel agents and stem cell transplantation have dramatically improved the remission and survival rates of multiple myeloma (MM). However, almost all patients would experience a relapse, which indicates the existence of tumor-initiating population and/or cancer stem cells (CSCs). Side population (SP) cells are an enriched source of cancer-initiating cells with stem cell properties, which has be acted as a unique hallmark for no specific marker of MM CSC study. The emerging role of microRNAs (miRNAs) in numerous types of human cancer led us to hypothesize that this group of non-coding genes might serve as key regulators of the cell signaling pathways in myeloma SP cells. Firstly, we successfully isolated and identified SP cells in MM cell lines and primary cells by a MoFlo cytometer, which represented a small fraction of the total cell population ranged from 0.04% to 2.0%. SP cells showed trend significantly high proliferation ability in formation 1392 ± 257 colonies in medium compared with 550 ±15 colonies for the MP cells after 14 days culture. We also have observed that SP cells contain majority percentage of quiescent population (G0/G1 stage) with 95.47% compared to major population (MP) cells with 49.36% in cell cycle assay, which may be one of the reasons for the drug resistance in SP cells besides to the overexpression of the ABC transporters. Indeed, ABCG2 were significantly enhanced in SP cells in comparison with MP cells both in mRNA and protein levels in our study. We next aimed to investigate the contribution of miRNA expression profiling on myeloma SP cells. Therefore, miRCURY™ LNA array analysis of sorted SP and MP cells from two primary myeloma patients was performed. Among the miRNAs exhibiting at least 2-fold and statistically significant difference in expression, 43 miRNAs were identified in total, with 12 upregulated and 31 down-regulated in SP cells compared with MP cells. Five interesting miRNAs, which may be involved in cancer stem cell pathology, were confirmed by qRT-PCR. We subsequently identified the high-probability interesting predicted target genes and signaling pathways of these dysregulated miRNAs by bioinformatic analysis. The majority of the affected pathways are preferentially related to SP cell presented in PI3K/AKT/mTOR, MAPK/ERK, ErbB/EGF, Wnt/b-catenin, Ubiquitin mediated proteolysis, TGF-β pathways and so on. Previous recently studies have addressed that mTOR signaling in the maintenance of CSCs have played a vital role. We further identified several activated signaling pathway proteins of PI3K/AKT/mTOR pathway in MM SP cells using phosphor-specific antibodies by immunofluorescence staining and western blot, including the PI3K/AKT/mTOR protein CAB39, TSC1, p-S6 and p-P70S6K. And then, a specific inhibitor of mTOR, rapamycin, was found to reduce remarkably the SP fraction within NCI-H929 cells, which contained 1.3% 3.57% SP cells and 0.05% SP after treatment. We next focus on to assess the miR-451 function analysis, a PI3K/mTOR signaling target, which was overexpressed in MM SP cells. Inhibition expression of miR-451 did not change the proliferation, apoptosis, and cell cycle in NCI-H929 cells. However, after MM cells treatment with As2O3, bortezomib, and lenalidomide, knockdown of miR-451 showed a dramatically increases in apoptosis (24%, 15%, and 8% elevation of apoptosis compared to control, respectively), S-phase cell cycle (10%, 8%, 5% elevation compared to control cells, respectively), and CAB39 expression. In summary, we have identified the MM SP cell and its microRNAs differentially expressed pattern. We further identify that mTOR signaling in the maintenance of CSCs have played an important role, and inhibition of miR-451 contributes to enhance anti-myeloma novel agents' effectiveness, through increased cells apoptosis, differentiation, and CAB39 expression. Our findings might give more insights into the mechanisms regulating MM SP cells and provide a novel strategy to overcome resistance to existing therapies against myeloma. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2012
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  • 5
    In: BioMed Research International, Hindawi Limited, Vol. 2015 ( 2015), p. 1-7
    Abstract: The International Staging System (ISS) is the most important prognostic system for multiple myeloma (MM). It was identified in the era of conventional agents. The outcome of MM has significantly changed by novel agents. Thus the applicability of ISS system in the era of novel agents in Chinese patients needs to be demonstrated. We retrospectively analyzed the clinical outcomes and prognostic significance of ISS system in 1016 patients with newly diagnosed multiple myeloma in Chinese patients between 2008 and 2012, who received bortezomib- or thalidomide-based regimens as first-line therapy. The median overall survival (OS) of patients for ISS stages I/II/III was not reached/55.4 months/41.7 months ( p 〈 0.001 ), and the median progression-free survival (PFS) was 30/29.5/25 months ( p = 0.072 ), respectively. Statistically significant difference in survival was confirmed among three ISS stages in thalidomide-based group, but not between ISS stages I and II in bortezomib-based group. These findings suggest that ISS system can predict the survival in the era of novel agents in Chinese MM patients, and bortezomib may have the potential to partially overcome adverse effect of risk factors on survival, especially in higher stage of ISS system.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2015
    detail.hit.zdb_id: 2698540-8
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  • 6
    In: Clinical Lymphoma Myeloma and Leukemia, Elsevier BV, Vol. 19, No. 10 ( 2019-10), p. e205-e206
    Type of Medium: Online Resource
    ISSN: 2152-2650
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2540998-0
    detail.hit.zdb_id: 2193618-3
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2014
    In:  Metabolic Brain Disease Vol. 29, No. 1 ( 2014-3), p. 87-92
    In: Metabolic Brain Disease, Springer Science and Business Media LLC, Vol. 29, No. 1 ( 2014-3), p. 87-92
    Type of Medium: Online Resource
    ISSN: 0885-7490 , 1573-7365
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 2018067-6
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  • 8
    In: British Journal of Haematology, Wiley, Vol. 166, No. 5 ( 2014-09), p. 690-701
    Type of Medium: Online Resource
    ISSN: 0007-1048
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 1475751-5
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  • 9
    In: Annals of Hematology, Springer Science and Business Media LLC, Vol. 99, No. 8 ( 2020-08), p. 1779-1791
    Type of Medium: Online Resource
    ISSN: 0939-5555 , 1432-0584
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1458429-3
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  • 10
    Online Resource
    Online Resource
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 15_suppl ( 2019-05-20), p. 8036-8036
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 15_suppl ( 2019-05-20), p. 8036-8036
    Abstract: 8036 Background: Multiple myeloma (MM) is a plasma cell malignancy characterized by chromosomal instabilities (CIN). Here we investigate the potential of cell-free DNA CIN as non-invasive biomarker to predict early response for MM treatments. Methods: In this prospective study, we recruited 11 relapsed/refractory (RRMM) and 19 newly diagnosed (NDMM) patients at Changzheng Hospital. Plasma samples were collected after finished two cycles or one month (RRMM) of therapy, with matched ones before the current regimen. cfDNA was extracted, followed by CIN analyses by using a customized bioinformatics workflow, ultrasensitive chromosomal aneuploidy detector (UCAD). Criteria for response and progression were according to the IMWG (Durie BG et al. 2006). Results: 7 (23%) patients (5 RRMM and 2 NDMM) showed high cfDNA CIN regard as strong positive after two cycles of treatment. Plasma cfDNA CIN profiling found complex clonal evolution compared two cycles to baseline. Multiple genomic regions, including chr7, 17p (TP53), 12q and 3p, were involved in clonal evolution. The degree of cfDNA CIN correlated with myeloma stage and overall survival. Remarkably, of the 5 heavily treated RRMM patients and 1 primary refractory newly diagnosed patient, 3 died within 60 days after the last time of cfDNA detection. Nine patients (30%) of patients showed positive cfDNA CIN after two cycles of treatment, which response rate was 11% (n=1) with SD, 33% (n=3) with MR, and 56% with PR, respectively. Fourteen patients with 5 RRMM and 9 NDMM were detected marginal or negative cfDNA CIN after two cycle’s treatment. The overall response rate in 14 patients was 100%, including 14.3% with a complete response, 14.3% with a very good partial response (VGPR), 57.1% with a PR, and 14.3% with a MR. Of these patients, 3 RRMM who received with more than six lines of therapy, showed positive cfDNA CIN. Subsequently, these three heavily treated RRMM patients have chance to enroll the chimeric antigen receptor T-Cell immunotherapy (CAR-T) therapy (enrolled NCT03093168). Surprisedly, all of them benefit from the CAR-T therapy to improve responses dramatically, meanwhile, the dynamics of total cfDNA concentration correlated with tumor burden to negative. Conclusions: We provide evidence that cfDNA level correlates with tumor burden and response rate in MM. For heavily pre-treated advanced RRMM patients with cfDNA CIN positive were benefit from the CAR-T therapy. Therefore, serial plasma cfDNA analysis is a robust and sensitive tool for monitoring response to therapy.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
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