888 resultados para PROTON PUMP INHIBITORS
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Because of its aberrant activation, the PI3K/AKT/mTOR signaling pathway represents a pharmacological target in blast cells from patients with acute myelogenous leukemia (AML). Using Reverse Phase Protein Microarrays (RPMA), we have analyzed 20 phosphorylated epitopes of the PI3K/Akt/mTor signal pathway of peripheral blood and bone marrow specimens of 84 patients with newly diagnosed AML. Fresh blast cells were grown for 2 h, 4 h or 20 h untreated or treated with a panel of phase I or phase II Akt allosteric inhibitors, either alone or in combination with the mTOR kinase inhibitor Torin1 or the broad RTK inhibitor Sunitinib. By unsupervised hierarchical clustering a strong phosphorylation/activity of most of the sampled members of the PI3K/Akt/mTOR pathway was observed in 70% of samples from AML patients. Remarkably, however, we observed that inhibition of Akt phosphorylation, as well as of its substrates, was transient, and recovered or even increased far above basal level after 20 h in 60% samples. We demonstrated that inhibition of Akt induces FOXO-dependent insulin receptor expression and IRS-1 activation, attenuating the effect of drug treatment by reactivation of PI3K/Akt. Consistent with this model we found that combined inhibition of Akt and RTKs is much more effective than either alone, revealing the adaptive capabilities of signaling networks in blast cells and highliting the limations of these drugs if used as monotherapy.
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The proton-nucleus elastic scattering at intermediate energies is a well-established method for the investigation of the nuclear matter distribution in stable nuclei and was recently applied also for the investigation of radioactive nuclei using the method of inverse kinematics. In the current experiment, the differential cross sections for proton elastic scattering on the isotopes $^{7,9,10,11,12,14}$Be and $^8$B were measured. The experiment was performed using the fragment separator at GSI, Darmstadt to produce the radioactive beams. The main part of the experimental setup was the time projection ionization chamber IKAR which was simultaneously used as hydrogen target and a detector for the recoil protons. Auxiliary detectors for projectile tracking and isotope identification were also installed. As results from the experiment, the absolute differential cross sections d$sigma$/d$t$ as a function of the four momentum transfer $t$ were obtained. In this work the differential cross sections for elastic p-$^{12}$Be, p-$^{14}$Be and p-$^{8}$B scattering at low $t$ ($t leq$~0.05~(GeV/c)$^2$) are presented. The measured cross sections were analyzed within the Glauber multiple-scattering theory using different density parameterizations, and the nuclear matter density distributions and radii of the investigated isotopes were determined. The analysis of the differential cross section for the isotope $^{14}$Be shows that a good description of the experimental data is obtained when density distributions consisting of separate core and halo components are used. The determined {it rms} matter radius is $3.11 pm 0.04 pm 0.13$~fm. In the case of the $^{12}$Be nucleus the results showed an extended matter distribution as well. For this nucleus a matter radius of $2.82 pm 0.03 pm 0.12$~fm was determined. An interesting result is that the free $^{12}$Be nucleus behaves differently from the core of $^{14}$Be and is much more extended than it. The data were also compared with theoretical densities calculated within the FMD and the few-body models. In the case of $^{14}$Be, the calculated cross sections describe the experimental data well while, in the case of $^{12}$Be there are discrepancies in the region of high momentum transfer. Preliminary experimental results for the isotope $^8$B are also presented. An extended matter distribution was obtained (though much more compact as compared to the neutron halos). A proton halo structure was observed for the first time with the proton elastic scattering method. The deduced matter radius is $2.60pm 0.02pm 0.26$~fm. The data were compared with microscopic calculations in the frame of the FMD model and reasonable agreement was observed. The results obtained in the present analysis are in most cases consistent with the previous experimental studies of the same isotopes with different experimental methods (total interaction and reaction cross section measurements, momentum distribution measurements). For future investigation of the structure of exotic nuclei a universal detector system EXL is being developed. It will be installed at the NESR at the future FAIR facility where higher intensity beams of radioactive ions are expected. The usage of storage ring techniques provides high luminosity and low background experimental conditions. Results from the feasibility studies of the EXL detector setup, performed at the present ESR storage ring, are presented.
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ABSTRACT: In this work, proton conducting copolymers, polymer blends and composites containing phosphonic acid groups have been prepared. Proton conduction mechanisms in these materials are discussed respectively in both, the anhydrous and humidified state. Atom transfer radical copolymerization (ATRCP) of diisopropyl-p-vinylbenzyl phosphonate (DIPVBP) and 4-vinyl pyridine (4VP) is studied for the first time in this work. The kinetic parameters are obtained by using the 1H-NMR online technique. Proton conduction in poly(vinylbenzyl phosphonic acid) (PVBPA) homopolymer and its statistical copolymers with 4-vinyl pyridine (poly(VBPA-stat-4VP)s) are comprehensively studied in both, the “dry” and “wet” state. Effects of temperature, water content and polymer composition on proton conductivities are studied and proton transport mechanisms under various conditions are discussed. The proton conductivity of the polymers is in the range of 10-6-10-8 S/cm in nominally dry state at 150 oC. However, proton conductivity of the polymers increases rapidly with water content in the polymers which can reach 10-2 S/cm at the water uptake of 25% in the polymers. The highest proton conductivity obtained from the polymers can even reach 0.3 S/cm which was measured at 85oC with 80% relative humidity in the measuring atmosphere. Poly(4-vinyl pyridine) was grafted from the surface of SiO2 nanoparticles using ATRP in this work for the first time. Following this approach, silica nanoparticles with a shell of polymeric layer are used as basic particles in a polymeric acidic matrix. The proton conductivities of the composites are studied under both, humidified and dry conditions. In dry state, the conductivity of the composites is in the range of 10-10~10-4 S/cm at 150 oC. While in humid state, the composites show much higher proton conductivity. The highest proton conductivity obtained with the composites is 0.5 S/cm measured at 85oC with 80% relative humidity in the measuring atmosphere. The miscibility of poly (vinyl phosphonic acid) and PEO is studied for the first time in this work and a phase diagram is plotted based on a DSC study and optical microscopy. With this knowledge, homogeneous PVPA/PEO mixtures are prepared as proton-conducting polymer blends. The mobility of phosphonic acid groups and PEO in the blends is determined by 1H-MAS-NMR in temperature dependent measurements. The effect of composition and the role of PEO on proton conduction are discussed.
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In Leukemias, recent developments have demonstrated that the Hedgehog pathway plays a key-role in the peculiar ability of self renewal of leukemia stem cells. The aim of this research activity was to investigate, through a first in man, Phase I, open label, clinical trial, the role and the impact, mainly in terms of safety profile, adverse events and pharmacokinetics, of a Sonic Hedgehog inhibitor compound on a population of heavely pretreated patients affected by AML, CML, MF, or MDS, resistant or refractory to standard chemotherapy. Thirty-five patients have been enrolled. The drug was administered orally, in 28 days cycles, without rest periods. The compound showed a good safety profile. The half life was of 17-35 hours, justifying the daily administration. Significant signs of activity, in terms of reduction of bone marrow blast cell amount were seen in most of the patients enrolled. Interestingly, correlative biological studies demonstrated that, comparing the gene expression profyiling signature of separated CD34+ cells before and after one cycle of treatment, the most variably expressed genes were involved in the Hh pathway. Moreover, we observed that many genes involved in MDR (multidrug resistance)were significantly down regulated after treatment. These data might lead to future clinical trials based on combinatory approaches, including, for instance, Hh inhibitors and conventional chemotherapy.
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In der vorgelegten Doktorarbeit werden Experimente vorgestellt, die an einem einzelnen Proton in einer Penningfalle durchgeführt worden sind. Die Eigenbewegung eines isoliert gespeicherten, freien Protons konnte elektronisch durch Kopplung an einen Resonanzschwingkreis nachgewiesen werden. Dies stellt eine nicht-destruktive Messung dar, d. h. das Teilchen geht während der Messung nicht verloren. Die freie Zyklotronfrequenz, die aus den drei gemessenen Eigenfrequenzen hervorgeht, ist eine von zwei zur Bestimmung des magnetischen Moments notwendigen Frequenzen. So wird im Gegensatz zu den existierenden Arbeiten eine direkte Bestimmung des g-Faktors ermöglicht. Planung, Entwicklung und Inbetriebnahme des experimentellen Aufbaus wurden im Rahmen dieser Arbeit durchgeführt, womit eine Messgenauigkeit von 10-7 erreicht wurde. Die dabei zu bewältigenden technischen Herausforderungen zur Bestimmung der zweiten Frequenz (der Larmorfrequenz) ergeben sich aus der Kleinheit des magnetischen Moments. Bei dem für diese Messung benötigten Spinzustand des Teilchens handelt es sich um einen internen Freiheitsgrad, der nur über eine Kopplung des magnetischen Moments an die Eigenbewegung bestimmt werden kann. Eine neuartige, hybride Penningfalle wird in dieser Arbeit vorgestellt, die als Quantensprung-Spektrometer die Spininformation auf die Eigenbewegung abbildet. Damit liegt der aus der magnetischen Kopplung resultierende Frequenzunterschied in den beiden Spinzuständen erstmalig in einem elektronisch detektierbaren Bereich.
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In this work, new promising proton conducting fuel cell membrane materials were characterized in terms of their structure and dynamic properties using solid-state nuclear magnetic resonance (NMR) spectroscopy and X-ray diffraction. Structurally different, phosphonic acid (PA) containing materials were systematically evaluated for possible high-temperature operation (e.g. at T>100°C). Notably, 1H, 2H and 31P magic angle spinning (MAS) NMR provided insight into local connectivities and dynamics of the hydrogen bonded network, while packing arrangements were identified by means of heteronuclear dipolar recoupling techniques.rnThe first part of this work introduced rather crystalline, low molecular weight ionomers for proton conducting membranes, where six different geometries such as line, triangle, screw, tetrahedron, square and hexagon, were investigated. The hexagon was identified as the most promising geometry with high-temperature bulk proton conductivities in the range of 10-3 Scm-1 at a relative humidity of 50%. However, 2H NMR and TGA-MS data suggest that the bulk proton transport is mainly due to the presence of crystal water. Single crystal X-ray data revealed that in the tetrahedron phosphonic acids form tetrameric clusters isolating the mobile protons while the phosphonic acids in the hexagon form zigzag-type pathways through the sample.rnThe second part of this work demonstrates how acid-base pairing and the choice of appropriate spacers may influence proton conduction. Different ratios of statistical copolymers of poly (vinylphosphonic acid) and poly (4-vinylpyridine) were measured to derive information about the local structure and chemical changes. Though anhydrous proton conductivities of all statistical copolymers are rather poor, the conductivity increases to 10-2 S cm-1 when exposing the sample to relative humidity of 80%. In contrast to PVPA, anhydride formation of phosphonic acids in the copolymer is not reversible even when exposing the sample to a relative humidity of 100%.rnIn addition, the influence of both spacers and degree of backbone crystallinity on bulk proton conductivity was investigated. Unlike in systems such as poly benzimidazole (PBI), spacers were inserted between the protogenic groups along the backbone. It was found that dilution of the protogenic groups decreases the conductivity, but compared to PVPA, similar apparent activation energies for local motions were obtained from both variable temperature 1H NMR and impedance spectroscopy data. These observations suggest the formation of phosphonic acid clusters with high degrees of local proton motion, where only a fraction of motions contribute to the observable bulk proton conductivity. Additionally, it was shown that gradual changes of the spacer length lead to different morphologies.rnIn summary, applying advanced solid-state NMR and X-ray analysis, structural and dynamic phenomena in proton conducting materials were identified on a molecular level. The results were discussed with respect to different proton conduction mechanisms and may contribute to a more rational design or improvement of proton conducting membranes.rn
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The electromagnetic form factors of the proton are fundamental quantities sensitive to the distribution of charge and magnetization inside the proton. Precise knowledge of the form factors, in particular of the charge and magnetization radii provide strong tests for theory in the non-perturbative regime of QCD. However, the existing data at Q^2 below 1 (GeV/c)^2 are not precise enough for a hard test of theoretical predictions.rnrnFor a more precise determination of the form factors, within this work more than 1400 cross sections of the reaction H(e,e′)p were measured at the Mainz Microtron MAMI using the 3-spectrometer-facility of the A1-collaboration. The data were taken in three periods in the years 2006 and 2007 using beam energies of 180, 315, 450, 585, 720 and 855 MeV. They cover the Q^2 region from 0.004 to 1 (GeV/c)^2 with counting rate uncertainties below 0.2% for most of the data points. The relative luminosity of the measurements was determined using one of the spectrometers as a luminosity monitor. The overlapping acceptances of the measurements maximize the internal redundancy of the data and allow, together with several additions to the standard experimental setup, for tight control of systematic uncertainties.rnTo account for the radiative processes, an event generator was developed and implemented in the simulation package of the analysis software which works without peaking approximation by explicitly calculating the Bethe-Heitler and Born Feynman diagrams for each event.rnTo separate the form factors and to determine the radii, the data were analyzed by fitting a wide selection of form factor models directly to the measured cross sections. These fits also determined the absolute normalization of the different data subsets. The validity of this method was tested with extensive simulations. The results were compared to an extraction via the standard Rosenbluth technique.rnrnThe dip structure in G_E that was seen in the analysis of the previous world data shows up in a modified form. When compared to the standard-dipole form factor as a smooth curve, the extracted G_E exhibits a strong change of the slope around 0.1 (GeV/c)^2, and in the magnetic form factor a dip around 0.2 (GeV/c)^2 is found. This may be taken as indications for a pion cloud. For higher Q^2, the fits yield larger values for G_M than previous measurements, in agreement with form factor ratios from recent precise polarized measurements in the Q2 region up to 0.6 (GeV/c)^2.rnrnThe charge and magnetic rms radii are determined as rn⟨r_e⟩=0.879 ± 0.005(stat.) ± 0.004(syst.) ± 0.002(model) ± 0.004(group) fm,rn⟨r_m⟩=0.777 ± 0.013(stat.) ± 0.009(syst.) ± 0.005(model) ± 0.002(group) fm.rnThis charge radius is significantly larger than theoretical predictions and than the radius of the standard dipole. However, it is in agreement with earlier results measured at the Mainz linear accelerator and with determinations from Hydrogen Lamb shift measurements. The extracted magnetic radius is smaller than previous determinations and than the standard-dipole value.
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In the race to obtain protons with higher energies, using more compact systems at the same time, laser-driven plasma accelerators are becoming an interesting possibility. But for now, only beams with extremely broad energy spectra and high divergence have been produced. The driving line of this PhD thesis was the study and design of a compact system to extract a high quality beam out of the initial bunch of protons produced by the interaction of a laser pulse with a thin solid target, using experimentally reliable technologies in order to be able to test such a system as soon as possible. In this thesis, different transport lines are analyzed. The first is based on a high field pulsed solenoid, some collimators and, for perfect filtering and post-acceleration, a high field high frequency compact linear accelerator, originally designed to accelerate a 30 MeV beam extracted from a cyclotron. The second one is based on a quadruplet of permanent magnetic quadrupoles: thanks to its greater simplicity and reliability, it has great interest for experiments, but the effectiveness is lower than the one based on the solenoid; in fact, the final beam intensity drops by an order of magnitude. An additional sensible decrease in intensity is verified in the third case, where the energy selection is achieved using a chicane, because of its very low efficiency for off-axis protons. The proposed schemes have all been analyzed with 3D simulations and all the significant results are presented. Future experimental work based on the outcome of this thesis can be planned and is being discussed now.
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The production of the Z boson in proton-proton collisions at the LHC serves as a standard candle at the ATLAS experiment during early data-taking. The decay of the Z into an electron-positron pair gives a clean signature in the detector that allows for calibration and performance studies. The cross-section of ~ 1 nb allows first LHC measurements of parton density functions. In this thesis, simulations of 10 TeV collisions at the ATLAS detector are studied. The challenges for an experimental measurement of the cross-section with an integrated luminositiy of 100 pb−1 are discussed. In preparation for the cross-section determination, the single-electron efficiencies are determined via a simulation based method and in a test of a data-driven ansatz. The two methods show a very good agreement and differ by ~ 3% at most. The ingredients of an inclusive and a differential Z production cross-section measurement at ATLAS are discussed and their possible contributions to systematic uncertainties are presented. For a combined sample of signal and background the expected uncertainty on the inclusive cross-section for an integrated luminosity of 100 pb−1 is determined to 1.5% (stat) +/- 4.2% (syst) +/- 10% (lumi). The possibilities for single-differential cross-section measurements in rapidity and transverse momentum of the Z boson, which are important quantities because of the impact on parton density functions and the capability to check for non-pertubative effects in pQCD, are outlined. The issues of an efficiency correction based on electron efficiencies as function of the electron’s transverse momentum and pseudorapidity are studied. A possible alternative is demonstrated by expanding the two-dimensional efficiencies with the additional dimension of the invariant mass of the two leptons of the Z decay.
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In dieser Arbeit werden zwei Arten von nicht-kovalent verknüpften Netzwerkstrukturen vorgestellt, die aus phosphonsäurehaltigen Molekülen aufgebaut sind. Einerseits sollen diese phosphonsäurehaltigen Moleküle als Protonenleiter in Brennstoffzellen eingesetzt werden. Dies ist durch die Möglichkeit des kooperativen Protonentransports in wasserstoffbrückenhaltigen Netzwerken begründet. Auf der anderen Seite sollen die phosphonsäurehaltigen Moleküle unter Einsatz von Metallkationen zur Darstellung ionischer Netzwerke verwendet werden. In diesem Fall fungieren die phosphonierten Moleküle als Linker in porösen organisch-anorganischen Hybridmaterialien, die sich beispielsweise zur Gasspeicherung eignen.rnEine Brennstoffzelle stellt Energie mit hoher Effizienz und geringer Umweltbelastung bereit. Das Herzstück der Brennstoffzelle ist die Elektrolytmembran, die auch als Separator oder Protonenaustauschmembran (PEM) bezeichnet wird. Es wird davon ausgegangen, daß der Schlüssel zur Weiterentwicklung der PEM-Brennstoffzellen in der Entwicklung von Elektrolyten liegt, die ausschließlich und effizient Protonen transportieren und darüber hinaus chemisch (oxidationsbeständig) und mechanisch stabil sind. Die mechanische Stabilität betrifft insbesondere den Betrieb der Brennstoffzelle bei hohen Temperaturen und niedriger relativer Feuchtigkeit. In dieser Arbeit wird ein neuartiger Ansatz zum Erreichen eines hohen Protonentransports im Festkörper vorgestellt, der auf dem Einsatz kleiner Moleküle beruht, die durch Selbstorganisation eine kontinuierliche protonenleitende Phase erzeugen. Bis jetzt stellt Hexakis(p-phosphonatophenyl)benzol das erste Beispiel eines kristallinen Protonenleiters dar, der im festen Zustand eine hohe und konstante Leistung zeigt. Die Modifizierung von Hexakis(p-phosphonatophenyl)benzol, entweder durch Änderung von para- zu meta-Substitution oder die Einführung von Alkylketten, führt zu Verbindungen geringerer Kristallinität und niedriger Protonenleitfähigkeit.rnIm zweiten Teil der Arbeit wurde 1,3,5-Tris(p-phosphonatophenyl)benzol als Linker in der Synthese von offenen Phosphonat-Netzwerken eingesetzt. Es bilden sich aufgrund der ionischen Wechselwirkung zwischen den positiv geladenen Metallkationen und den negativ geladenen Phosphonsäuregruppen hochstabile Feststoffe. Eines der wichtigsten Ergebnisse dieser Arbeit besteht darin, daß 1,3,5-Tris(p-phosphonatophenyl)benzol als Linker zum Aufbau poröser Hybridmaterialien eingesetzt werden kann. Zum ersten Mal wurde ein dreifach phosphoniertes organisches Molekül zum Aufbau mikroporöser offener Phosphonat-Netzwerke verwendet. Zudem konnte gezeigt werden, daß die Porosität mit dem Wachstumsmechanismus dieser Materialien zusammenhängt. Es ist nur dann möglich ein gleichfalls mikroporöses und kristallines ionisches Netzwerk auf der Grundlage phosphonierter Moleküle zu erhalten, wenn Linker und Konnektor die gleiche Geometrie und Funktionalität besitzen.rn
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This dissertation deals with two specific aspects of a potential hydrogen-based energy economy, namely the problems of energy storage and energy conversion. In order to contribute to the solution of these problems, the structural and dynamical properties of two promising materials for hydrogen storage (lithium imide/amide) and proton conduction (poly[vinyl phosphonic acid]) are modeled on an atomistic scale by means of first principles molecular dynamics simulation methods.rnrnrnIn the case of the hydrogen storage system lithium amide/imide (LiNH_2/Li_2NH), the focus was on the interplay of structural features and nuclear quantum effects. For these calculations, Path-Integral Molecular Dynamics (PIMD) simulations were used. The structures of these materials at room temperature were elucidated; in collaboration with an experimental group, a very good agreement between calculated and experimental solid-state 1H-NMR chemical shifts was observed. Specifically, the structure of Li_2NH features a disordered arrangement of the Li lattice, which was not reported in previous studies. In addition, a persistent precession of the NH bonds was observed in our simulations. We provide evidence that this precession is the consequence of a toroid-shaped effective potential, in which the protons in the material are immersed. This potential is essentially flat along the torus azimuthal angle, which might lead to important quantum delocalization effects of the protons over the torus.rnrnOn the energy conversion side, the dynamics of protons in a proton conducting polymer (poly[vinyl phosphonic acid], PVPA) was studied by means of a steered ab-initio Molecular Dynamics approach applied on a simplified polymer model. The focus was put on understanding the microscopic proton transport mechanism in polymer membranes, and on characterizing the relevance of the local environment. This covers particularly the effect of water molecules, which participate in the hydrogen bonding network in the material. The results indicate that these water molecules are essential for the effectiveness of proton conduction. A water-mediated Grotthuss mechanism is identified as the main contributor to proton conduction, which agrees with the experimentally observed decay on conductivity for the same material in the absence of water molecules.rnrnThe gain in understanding the microscopic processes and structures present in this materials can help the development of new materials with improved properties, thus contributing to the solution of problems in the implementation of fuel cells.
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The dominant process in hard proton-proton collisions is the production of hadronic jets.rnThese sprays of particles are produced by colored partons, which are struck out of their confinement within the proton.rnPrevious measurements of inclusive jet cross sections have provided valuable information for the determination of parton density functions and allow for stringent tests of perturbative QCD at the highest accessible energies.rnrnThis thesis will present a measurement of inclusive jet cross sections in proton-proton collisions using the ATLAS detector at the LHC at a center-of-mass energy of 7 TeV.rnJets are identified using the anti-kt algorithm and jet radii of R=0.6 and R=0.4.rnThey are calibrated using a dedicated pT and eta dependent jet calibration scheme.rnThe cross sections are measured for 40 GeV < pT <= 1 TeV and |y| < 2.8 in four bins of absolute rapidity, using data recorded in 2010 corresponding to an integrated luminosity of 3 pb^-1.rnThe data is fully corrected for detector effects and compared to theoretical predictions calculated at next-to-leading order including non-perturbative effects.rnThe theoretical predictions are found to agree with data within the experimental and theoretic uncertainties.rnrnThe ratio of cross sections for R=0.4 and R=0.6 is measured, exploiting the significant correlations of the systematic uncertainties, and is compared to recently developed theoretical predictions.rnThe underlying event can be characterized by the amount of transverse momentum per unit rapidity and azimuth, called rhoue.rnUsing analytical approaches to the calculation of non-perturbative corrections to jets, rhoue at the LHC is estimated using the ratio measurement.rnA feasibility study of a combined measurement of rhoue and the average strong coupling in the non-perturbative regime alpha_0 is presented and proposals for future jet measurements at the LHC are made.
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Precision measurements of observables in neutron beta decay address important open questions of particle physics and cosmology. In this thesis, a measurement of the proton recoil spectrum with the spectrometer aSPECT is described. From this spectrum the antineutrino-electron angular correlation coefficient a can be derived. In our first beam time at the FRM II in Munich, background instabilities prevented us from presenting a new value for a. In the latest beam time at the ILL in Grenoble, the background has been reduced sufficiently. As a result of the data analysis, we identified and fixed a problem in the detector electronics which caused a significant systematic error. The aim of the latest beam time was a new value for a with an error well below the present literature value of 4%. A statistical accuracy of about 1.4% was reached, but we could only set upper limits on the correction of the problem in the detector electronics, too high to determine a meaningful result. This thesis focused on the investigation of different systematic effects. With the knowledge of the systematics gained in this thesis, we are able to improve aSPECT to perform a 1% measurement of a in a further beam time.
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In chronic myeloid leukemia and Philadelphia-positive acute lymphoblastic leukemia patients resistant to tyrosine kinase inhibitors (TKIs), BCR-ABL kinase domain mutation status is an essential component of the therapeutic decision algorithm. The recent development of Ultra-Deep Sequencing approach (UDS) has opened the way to a more accurate characterization of the mutant clones surviving TKIs conjugating assay sensitivity and throughput. We decided to set-up and validated an UDS-based for BCR-ABL KD mutation screening in order to i) resolve qualitatively and quantitatively the complexity and the clonal structure of mutated populations surviving TKIs, ii) study the dynamic of expansion of mutated clones in relation to TKIs therapy, iii) assess whether UDS may allow more sensitive detection of emerging clones, harboring critical 2GTKIs-resistant mutations predicting for an impending relapse, earlier than SS. UDS was performed on a Roche GS Junior instrument, according to an amplicon sequencing design and protocol set up and validated in the framework of the IRON-II (Interlaboratory Robustness of Next-Generation Sequencing) International consortium.Samples from CML and Ph+ ALL patients who had developed resistance to one or multiple TKIs and collected at regular time-points during treatment were selected for this study. Our results indicate the technical feasibility, accuracy and robustness of our UDS-based BCR-ABL KD mutation screening approach. UDS was found to provide a more accurate picture of BCR-ABL KD mutation status, both in terms of presence/absence of mutations and in terms of clonal complexity and showed that BCR-ABL KD mutations detected by SS are only the “tip of iceberg”. In addition UDS may reliably pick 2GTKIs-resistant mutations earlier than SS in a significantly greater proportion of patients.The enhanced sensitivity as well as the possibility to identify low level mutations point the UDS-based approach as an ideal alternative to conventional sequencing for BCR-ABL KD mutation screening in TKIs-resistant Ph+ leukemia patients
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Backgrounds:Treatment of patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) not eligible to high dose therapy represents an unmet medical need. Panobinostat showed encouraging therapeutic activity in studies conducted in lymphoma cell lines and in vivo in patients with advanced hematologic malignancies.Purpose:FIL-PanAL10 (NCT01523834) is a phase II, prospective multicenter trial of the Fondazione Italiana Linfomi (FIL) to evaluate safety and efficacy of single agent Panobinostat as salvage therapy for R/R DLBCL patients and to evaluate a possible relationships between response and any biological features. Patients and Methods:Patients with R/R DLBCL were included. The treatment plan included 6 induction courses with Panobinostat monotherapy followed by other 6 courses of consolidation. The primary objective was to evaluate Panobinostat activity in terms of overall response (OR); secondary objectives were: CR rate, time to response (TTR), progression-free survival (PFS), safety and feasibility of Panobinostat. We included evaluation of the impact of pharmacogenetics, immunohistochemical patterns and patient’s specific gene expression and mutations as potential predictors of response to Panobinostat as explorative objectives. To this aim a pre-enrollment new tissue biopsy was mandatory. ResultsThirty-five patients, 21 males (60%), were enrolled between June 2011 and March 2014. At the end of induction phase, 7 responses (20%) were observed, including 4 CR (11%), while 28 patients (80%) discontinued treatment due to progressive disease (PD) in 21 (60%) or adverse events in 7 (20%). Median TTR in 9 responders was 2.6 months (range 1.8-12). With a median follow up of 6 months (range 1-34), the estimated 12 months PFS and OS were 27% and 30.5%, respectively. Grade 3-4 thrombocytopenia and neutropenia were the most common toxicities (in 29 (83%) and 12 (34%) patients, respectively. Conclusions The results of this study indicate that Panobinostat might be remarkably active in some patients with R/R DLBCL, showing durable CR