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Combined Therapeutic Efficacy of the Thymidylate Synthase Inhibitor ZD1694 (TOMUDEX) and the Immunotoxin B43(Anti-CD19)-PAP in a SCID Mouse Model of Human B-Lineage Acute Lymphoblastic Leukemia

1998; Taylor & Francis; Volume: 28; Issue: 5-6 Linguagem: Inglês

10.3109/10428199809058358

1042-8194

Rauf Onur Ek, Gregory H. Reaman, Daune L. Crankshaw, Lisa M. Chelstrom, Dorothea E. Myers, Fatih M. Uckun,

Acute Lymphoblastic Leukemia research

The quinazoline antifolate N-(5-[N-(3,4-dihydro-2-methyl-4-oxoquinazolin-6-ylmethyl)-N- methylamino]-2-thenoyl)-L-glutamic acid (ZD1694; Tomudex) is a potent inhibitor of thymidylate synthase and causes cell death through disruption of DNA synthesis and repair by blocking the obligatory thymidine nucleotide synthesis. B43(anti-CD19)-PAP immunotoxin is a potent inhibitor of protein synthesis in CD19+ B-lineage acute lymphoblastic leukemia (ALL) cells and causes apoptosis. In this model, 100% of SCID mice challenged with 1 x 10(6) human NALM-6 B-lineage ALL cells develop overt and invariably fatal leukemia. All of the 22 control SCID mice treated with phosphate-buffered saline died of disseminated human leukemia between 31 and 61 days with a median survival of 41.2 days. Treatment with ZD 1694 resulted in improved leukemia-free survival with a median survival of 69.2 days (P < 0.001, log-rank test). B43-PAP treatment was more effective than ZD1694 (P=0.026) and resulted in 51.0% long-term leukemia-free survival with a median survival of 187.5 days (P < 0.0001. log-rank test). The combination of ZD1694 and B43-PAP was more effective than either agent alone and resulted in 100% long-term leukemia-free survival. To our knowledge, this preclinical study is the first to demonstrate the feasibility and therapeutic advantage of combining an anti-leukemia immunotoxin with a thymidylate synthase inhibitor.