Moorse UCSD Cancer Center

What is going on in the BCRF?

New Biomarker May Predict Leukemia Aggressiveness

Scientists at the University of California, San Diego and the Moores UCSD Cancer Center have evidence of a potential new biomarker to predict the aggressiveness of an often difficult-to-treat form of leukemia. They found that high levels of a particular enzyme in the blood are an indicator that chronic lymphocytic leukemia (CLL) – the most common form of adult leukemia – will be aggressive and in need of immediate treatment.

The researchers, led by Paul A. Insel, MD, professor of pharmacology and medicine at the UC San Diego School of Medicine, say that the enzyme, PDE7B, is also critical to the development of CLL and a potential target for drugs against the disease. They presented their results April 19, 2009 at the AACR 100th Annual Meeting 2009 in Denver.

One of the problems in deciding on the right therapy for CLL is that it is difficult to know which type of leukemia a patient has. One form progresses slowly, with few symptoms for years while the other form is more aggressive and dangerous. While tests exist and are commonly used to help doctors predict which form a patient may have, their availability and usefulness are limited.

In previous work, Insel's group had discovered that among a group of enzymes, cyclic nucleotide phosphodiesterases, one of the phosphodiesterases, PDE7B, was 10 times higher in CLL patients than in healthy individuals. PDE7B controls the levels of cyclic AMP (cAMP), a molecule that can promote programmed cell death, a process that is defective in CLL. Whereas most cancers have out-of-control cell growth, CLL is characterized by an overabundance of white blood cells that do not die when they should. High levels of PDE7B mean less cAMP and as a result, less cell death.

“The question was, could the level of PDE7B expression provide evidence for the clinical stage and diagnosis for individual patients?” Insel said. To find out if changes in PDE7B levels might reflect disease progression, Insel, postodoctoral fellow Linghzi Zhang, PhD, and their co-workers compared the amount of PDE7B in white blood cells in 85 untreated patients with CLL to those of 30 healthy adults, and watched for changes over time. They then divided the results into patients who had high levels of PDE7B and those who had low amounts.

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Studying Novel Leukemia Vaccine for High-Risk Patients

Researchers at the Moores Cancer Center at the University of California, San Diego (UCSD) are conducting clinical trials of a novel therapy aimed at revving up the immune system to combat a particularly difficult-to-treat form of leukemia. The experimental therapy is being offered to patients with chronic lymphocytic leukemia (CLL) whose cancer did not respond or was resistant to initial treatment or harbors a particular chromosomal abnormality called a 17p deletion. In most of these cases, the cancer has failed to respond to further conventional therapy.

In this clinical trial, patients will receive a vaccine of an immune-boosting molecule, ISF35 (Immune Stimulatory Factor 35) followed by three courses of rituximab, a monoclonal antibody, and the chemotherapy drugs fludarabine and cyclophosphamide (FCR). The trial is termed Phase I, meaning that it is aimed at testing the safety of the combination of repeat infusions of ISF35 and FCR, the latter being considered the standard and best possible CLL treatment. “This approach – activating immune cells followed by chemotherapy – may lead to new strategies that could be applied to other cancers,” said Januario E. Castro, M.D., assistant clinical professor of medicine at the UC San Diego School of Medicine and the Moores UCSD Cancer Center, who leads the work. The vaccine therapy approach makes it possible to target the cancer cells and activate the immune system by making the cancerous leukemia B cells more visible. The activated immune system can then find and eliminate the cancer cells.

CLL can be especially hard to treat. Though chemotherapy can beat back the disease initially, and patients may do well for years, the disease invariably returns, frequently resistant to further treatment. The American Cancer Society estimates that about 15,100 new cases of CLL will occur this year in the United States, with about 4,390 deaths from the disease.

“Standard strategies for CLL involve drugs and drug combinations that result in serious toxicities, little or no improvement in survival, and poor tolerance by the elderly,” Castro said. “Almost all patients eventually experience disease relapse and become less responsive to therapy. Clearly we need novel therapeutic approaches for CLL, and ISF35 therapy represents such an innovation.”

According to Castro, the latest study builds on previous trials completed at UCSD and M.D. Anderson Cancer Center in Houston. “Those trials showed remarkable results for ISF35 in patients with high-risk and treatment-resistant CLL,” he said, particularly when combined with chemotherapy.

Castro said that ISF35 also has the “potential to treat a range of blood cancers including lymphomas and even certain types of breast and lung cancers and melanoma,” adding that future clinical trials are being planned.

This trial is sponsored by Memgen, LLC, which is headquartered in Dallas, TX, and is funded by Memgen and the Leukemia & Lymphoma Society Therapy Acceleration Program. ISF35 is based on technology discovered by Thomas J. Kipps, M.D., Ph.D., professor of medicine and Deputy Director for Research at the Moores UCSD Cancer Center. This technology has been patented by the University of California and licensed to Memgen for the treatment of CLL and other cancers.

Contact Sheila Hoff, RN, <shoff@ucsd.edu>, 858-822-5360 for more infomation.

The Future of Personalized Cancer Treatment: An Entirely New Direction for RNAi Delivery

In technology that promises to one day allow drug delivery to be tailored to an individual patient and a particular cancer tumor, researchers at the University of California, San Diego School of Medicine, have developed an efficient system for delivering siRNA, which interferes with gene expression, into primary cells. The work will be published in the May 17 in the advance on-line edition of Nature Biotechnology.

“RNAi has an unbelievable potential to manage cancer and treat it,” said Steven Dowdy, PhD, Howard Hughes Medical Institute Investigator and professor of cellular and molecular medicine at UC San Diego School of Medicine. “While there's still a long way to go, we have successfully developed a technology that allows for siRNA drug delivery into the entire population of cells, both primary and tumor-causing, without being toxic to the cells.”

Article is coninued CLICK HERE

 

How to Activate YOUR Immune System: Gene Therapy Research (Part 2)

To deliver the ISF35 molecule to target malignant B lymphocytes, we use a replication defective type 5 adenovirus. The adenovirus infects the leukemic cells, resulting in the stable expression of the ISF35 molecule on the cell surface. The adenoviral proteins trigger the immune system to attack infected malignant cells, and ISF35 augments this response, resulting in a localized full-force reaction against the treated cells
(Continued) MORE INFORMATION

Fellowship Researchers at the BCRF

Current Researchers:

Yoshinori Nonomura, M.D., Ph.D.-Tokyo Medical and Dental University:
Arrived on April 1st 2008!

Jessie-Farah Fecteau, Ph.D.-Universite Laval-Quebec, Canada:
Arrives July 7th 2008.

Christoph Steininger, M.D.-Medical University of Vienna:
Arrives August 1st 2008.

Past Researchers

Emanuela Ghia, Ph.D. - University La Sapienza of Rome
2006-2009

Arnon Kater, M.D. Ph.D. - Academic Medical Center, University of Amsterdam
2008-2009


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