Targeting the apoptotic pathway in chondrosarcoma using recombinant human Apo2L/TRAIL (dulanermin), a dual proapoptotic receptor (DR4/DR5) agonist. Mol Cancer Ther 2012 Nov;11(11):2541-6
Date
08/24/2012Pubmed ID
22914439Pubmed Central ID
PMC3496030DOI
10.1158/1535-7163.MCT-12-0358Scopus ID
2-s2.0-84869206991 (requires institutional sign-in at Scopus site) 51 CitationsAbstract
Recombinant human Apo2L/TRAIL (dulanermin) is based on the ligand for death receptors (DR4 and DR5), which promotes apoptosis. We report a patient with refractory chondrosarcoma who showed a prolonged response to dulanermin and explore mechanisms of response and resistance. This heavily pretreated patient had progressive metastatic chondrosarcoma to the lung. On dulanermin (8 mg/kg i.v. on days 1-5 in a 21-day cycle), the patient achieved a sustained partial response with only subcentimeter nodules remaining. After 62 months of dulanermin treatment, progressive disease in the lungs was noted, and the patient underwent a resection that confirmed chondrosarcoma. DR4 was detected (immunohistochemistry) in the patient's tumor, which may have enabled the response. However, upregulation of prosurvival proteins, namely, phosphorylated (p)-NF-κBp65 (Ser 536), p-STAT3 (Tyr 705), p-ERK 1/2 (Thr 202/Tyr 204), p-mTOR (Ser 2448), FASN, and Bcl-2, were also detected, which may have provided the underlying mechanisms for acquired dulanermin resistance. The patient was restarted on dulanermin and has continued on this treatment for an additional 16 months since surgery (78 months since initiation of treatment), with his most recent computed tomography (CT) scans showing no evidence of disease.
Author List
Subbiah V, Brown RE, Buryanek J, Trent J, Ashkenazi A, Herbst R, Kurzrock RAuthor
Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
ApoptosisBone Neoplasms
Cell Survival
Chondrosarcoma
DNA Mutational Analysis
Humans
Immunohistochemistry
Isocitrate Dehydrogenase
Lung Neoplasms
Male
Middle Aged
Proteomics
Proto-Oncogene Proteins c-bcl-2
Radiography, Thoracic
Receptors, Death Domain
Recombinant Proteins
Signal Transduction
TNF-Related Apoptosis-Inducing Ligand
Tomography, X-Ray Computed
Treatment Outcome
