Preclinical studies of 5-fluoro-2′-deoxycytidine and tetrahydrouridine in pediatric brain tumorsReportar como inadecuado

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Journal of Neuro-Oncology

, Volume 126, Issue 2, pp 225–234

First Online: 30 October 2015Received: 30 June 2015Accepted: 19 October 2015DOI: 10.1007-s11060-015-1965-0

Cite this article as: Morfouace, M., Nimmervoll, B., Boulos, N. et al. J Neurooncol 2016 126: 225. doi:10.1007-s11060-015-1965-0


Chemotherapies active in preclinical studies frequently fail in the clinic due to lack of efficacy, which limits progress for rare cancers since only small numbers of patients are available for clinical trials. Thus, a preclinical drug development pipeline was developed to prioritize potentially active regimens for pediatric brain tumors spanning from in vitro drug screening, through intracranial and intra-tumoral pharmacokinetics to in vivo efficacy studies. Here, as an example of the pipeline, data are presented for the combination of 5-fluoro-2′-deoxycytidine and tetrahydrouridine in three pediatric brain tumor models. The in vitro activity of nine novel therapies was tested against tumor spheres derived from faithful mouse models of Group 3 medulloblastoma, ependymoma, and choroid plexus carcinoma. Agents with the greatest in vitro potency were then subjected to a comprehensive series of in vivo pharmacokinetic PK and pharmacodynamic PD studies culminating in preclinical efficacy trials in mice harboring brain tumors. The nucleoside analog 5-fluoro-2′-deoxycytidine FdCyd markedly reduced the proliferation in vitro of all three brain tumor cell types at nanomolar concentrations. Detailed intracranial PK studies confirmed that systemically administered FdCyd exceeded concentrations in brain tumors necessary to inhibit tumor cell proliferation, but no tumor displayed a significant in vivo therapeutic response. Despite promising in vitro activity and in vivo PK properties, FdCyd is unlikely to be an effective treatment of pediatric brain tumors, and therefore was deprioritized for the clinic. Our comprehensive and integrated preclinical drug development pipeline should reduce the attrition of drugs in clinical trials.

KeywordsG3 medulloblastoma Ependymoma Choroid plexus carcinoma FdCyd THU Marie Morfouace, Birgit Nimmervoll, Nidal Boulos, and Yogesh T. Patel have contributed equally to this work.

Electronic supplementary materialThe online version of this article doi:10.1007-s11060-015-1965-0 contains supplementary material, which is available to authorized users.

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Autor: Marie Morfouace - Birgit Nimmervoll - Nidal Boulos - Yogesh T. Patel - Anang Shelat - Burgess B. FreemanIII - Giles W. R


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