Document Detail


Functional activity of the OCT-1 protein is predictive of long-term outcome in patients with chronic-phase chronic myeloid leukemia treated with imatinib.
MedLine Citation:
PMID:  20421539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Organic cation transporter-1 (OCT-1) activity (OA), a measure of the OCT-1-mediated influx of imatinib into CML mononuclear cells (MNCs), is predictive of major molecular response (MMR) at 12 and 24 months in patients with untreated CML. We now report the impact of OA on loss of response, disease transformation, and survival after 5 years of imatinib. PATIENTS AND METHODS: OA is defined as the difference in intracellular concentration of carbon-14-imatinib with and without OCT-1 inhibition. OA was measured in blood from 56 patients with untreated chronic-phase CML. RESULTS: More patients who had high OA (ie, > median OA value) achieved MMR by 60 months compared with patients who had low OA (89% v 55%; P = .007). A low OA was associated with a significantly lower overall survival (87% v 96%; P = .028) and event-free survival (EFS; 48% v 74%; P = .03) as well as a higher kinase domain mutation rate (21% v 4%; P = .047). These differences were highly significant in patients who averaged less than 600 mg/d of imatinib in the first 12 months but were not significant in patients averaging >/= 600 mg/d. Patients with very low OA (ie, quartile 1) were the only group who developed leukemic transformation (21% in quartile 1 v 0% in all other quartiles; P = .002). CONCLUSION: Measurement of OA pretherapy is a predictor for the long-term risk of resistance and transformation in patients with imatinib-treated CML. Early dose-intensity may reduce the negative prognostic impact of low OA. We propose that OA could be used to individualize dosage strategies for patients with CML to maximize molecular response and optimize long-term outcome.
Authors:
Deborah L White; Phuong Dang; Jane Engler; Amity Frede; Stephanie Zrim; Michael Osborn; Verity A Saunders; Paul W Manley; Timothy P Hughes
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Publication Detail:
Type:  Clinical Trial, Phase II; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-26
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  28     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-28     Completed Date:  2010-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2761-7     Citation Subset:  IM    
Affiliation:
Haematology Department, Centre for Cancer Biology, SA Pathology (IMVS Campus), University of Adelaide, Frome Road, Adelaide, Australia. deb.white@imvs.sa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Antineoplastic Agents / administration & dosage,  adverse effects
Disease-Free Survival
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Gene Expression Regulation, Leukemic / drug effects*
Humans
Kaplan-Meiers Estimate
Leukemia, Myeloid, Chronic-Phase / drug therapy*,  genetics*,  mortality
Male
Maximum Tolerated Dose
Middle Aged
Organic Cation Transporter 1 / genetics*
Piperazines / administration & dosage*,  adverse effects
Predictive Value of Tests
Probability
Pyrimidines / administration & dosage*,  adverse effects
RNA, Messenger / analysis
Reverse Transcriptase Polymerase Chain Reaction
Risk Assessment
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Organic Cation Transporter 1; 0/Piperazines; 0/Pyrimidines; 0/RNA, Messenger; 152459-95-5/imatinib

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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