pci-32765 and bosutinib

Topics: Adenine; Aniline Compounds; COVID-19 Drug Treatment; Drug Repositioning; Hematologic Neoplasms; Humans; Imatinib Mesylate; Janus Kinases; Nitriles; Oligopeptides; Piperidines; Protein Kinase Inhibitors; Pyrazoles; Pyrimidines; Quinolines

Recent studies have shown that therapeutic drug monitoring of tyrosine kinase inhibitors (TKIs) could improve treatment efficacy and safety. A simple analytical method using high-performance LC/electrospray ionization-tandem mass spectrometry has been developed and validated for simultaneous quantification of BCR-ABL and Bruton's TKIs used for chronic leukemia (imatinib, dasatinib, bosutinib, nilotinib, and ibrutinib) in human plasma. Although these structures and physical properties are similar, owing to their different linear ranges, simultaneously determining the plasma levels of these five TKIs by applying optimal MS parameters remains difficult. A quantitative range exceeding 60,000-fold was required, and the linear dynamic ranges of imatinib, bosutinib, and nilotinib were limited because of the presence of a saturated detection signal. In this study, we applied the in-source collision-induced dissociation technique to control the ion amounts in mass spectrometry. This new method allowed rapid determination within 5 min with simple pretreatment. The method was validated according to the US Food and Drug Administration guidelines. Moreover, all samples of patients with chronic leukemia were successfully measured and their values were within the linear range of measurement. Therefore, our high-throughput analytical system is useful to measure the plasma concentrations of imatinib, dasatinib, bosutinib, nilotinib, and ibrutinib in clinical practice.

Topics: Adenine; Aniline Compounds; Chromatography, Liquid; Dasatinib; Drug Monitoring; Female; High-Throughput Screening Assays; Humans; Imatinib Mesylate; Leukemia; Male; Middle Aged; Nitriles; Piperidines; Protein Kinase Inhibitors; Pyrimidines; Quinolines; Spectrometry, Mass, Electrospray Ionization; Tandem Mass Spectrometry

Monotherapy clinical trials with mutation-targeted kinase inhibitors, despite some success in other cancers, have yet to impact glioblastoma (GBM). Besides insufficient blood-brain barrier penetration, combinations are key to overcoming obstacles such as intratumoral heterogeneity, adaptive resistance, and the epistatic nature of tumor genomics that cause mutation-targeted therapies to fail. With now hundreds of potential drugs, exploring the combination space clinically and preclinically is daunting. We are building a simulation-based approach that integrates patient-specific data with a mechanistic computational model of pan-cancer driver pathways (receptor tyrosine kinases, RAS/RAF/ERK, PI3K/AKT/mTOR, cell cycle, apoptosis, and DNA damage) to prioritize drug combinations by their simulated effects on tumor cell proliferation and death. Here we illustrate a first step, tailoring the model to 14 GBM patients from The Cancer Genome Atlas defined by an mRNA-seq transcriptome, and then simulating responses to three promiscuous FDA-approved kinase inhibitors (bosutinib, ibrutinib, and cabozantinib) with evidence for blood-brain barrier penetration. The model captures binding of the drug to primary targets and off-targets based on published affinity data and simulates responses of 100 heterogeneous tumor cells within a patient. Single drugs are marginally effective or even counterproductive. Common copy number alterations (PTEN loss, EGFR amplification, and NF1 loss) have a negligible correlation with single-drug or combination efficacy, reinforcing the importance of postgenetic approaches that account for kinase inhibitor promiscuity to match drugs to patients. Drug combinations tend to be either cytostatic or cytotoxic, but seldom both, highlighting the need for considering targeted and nontargeted therapy. Although we focus on GBM, the approach is generally applicable.

Topics: Adenine; Anilides; Aniline Compounds; Antineoplastic Agents; Apoptosis; Blood-Brain Barrier; Cell Cycle; Cell Proliferation; Central Nervous System Neoplasms; Clinical Trials as Topic; Computer Simulation; Drug Discovery; Drug Therapy, Combination; Genomics; Glioblastoma; Humans; Models, Theoretical; Nitriles; Piperidines; Protein-Tyrosine Kinases; Pyrazoles; Pyridines; Pyrimidines; Quinolines; RNA, Messenger; Stochastic Processes; Transcriptome

Topics: Adenine; Aniline Compounds; Antineoplastic Agents; Bevacizumab; Brentuximab Vedotin; Cost-Benefit Analysis; Drug Industry; Humans; Immunoconjugates; Neoplasms; Nitriles; Piperidines; Pyrazoles; Pyrimidines; Quinolines; State Medicine; Trastuzumab; United Kingdom