Evidence map›Paper›PMID 30203445›Full record

ArticleJournal of cellular physiology2019

Neratinib augments the lethality of [regorafenib + sildenafil].

Laurence Booth, Jane L Roberts, Rumeesa Rais, Richard E Cutler, Irmina Diala, Alshad S Lalani, John F Hancock, Andrew Poklepovic, Paul Dent

Registry-linked trialAbstract read
In one paragraph

Article in Journal of cellular physiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02466802 (Phase I Study of Regorafenib and Sildenafil for Advanced Solid Tumors), which is not on this map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
2.4field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02466802 phase1completednot on this map

Phase I Study of Regorafenib and Sildenafil for Advanced Solid Tumors

TypeinterventionalSponsorVirginia Commonwealth UniversityRan2015 to 2019Enrolled32ConditionsSolid TumorArmsRegorafenib, Sildenafil Citrate
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 33 citations in OpenAlex.

  1. Review
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  14. Prevalence and role of HER2 mutations in cancer.Pharmacology & therapeutics · 2019
    Review
  15. Review
  16. Article
  17. Kinase inhibitors: look beyond the label on the bottle.Cancer drug resistance (Alhambra, Calif.) · 2019
    Review
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Laurence BoothDepartments of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
Jane L RobertsDepartments of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
Rumeesa RaisDepartments of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
Richard E CutlerPuma Biotechnology Inc., Los Angeles, California, University of Texas Health Science Center, Houston, Texas.
Irmina DialaPuma Biotechnology Inc., Los Angeles, California, University of Texas Health Science Center, Houston, Texas.
Alshad S LalaniPuma Biotechnology Inc., Los Angeles, California, University of Texas Health Science Center, Houston, Texas.
John F HancockDepartment of Integrative Biology and Pharmacology, University of Texas Health Science Center, Houston, Texas.
Andrew PoklepovicMedicine, Virginia Commonwealth University, Richmond, Virginia.
Paul DentDepartments of Biochemistry and Molecular Biology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.ORCID 0000-0001-6948-1875
Virginia Commonwealth University · USPuma Biotechnology (United States) · USThe University of Texas Health Science Center at Houston · US

Funding

Pemetrexed and sildenafil for lung cancerR01CA192613 · NCI · VIRGINIA COMMONWEALTH UNIVERSITY · PI DENT, PAUL · 2015 to 2019
$1.6M
NCI NIH HHS R01 CA192613
6 · The paper itself

Abstract

Regorafenib is approved for the treatment of colorectal cancer and hepatocellular carcinoma. In the trial NCT02466802, we have discovered that regorafenib can be safely combined with the phosphodiesterase 5 inhibitor sildenafil in advanced solid tumor patients. The present studies determined whether the approved ERBB1/2/4 and RAS downregulating drug neratinib, could enhance the lethality of [regorafenib + sildenafil]. Neratinib enhanced [regorafenib + sildenafil] lethality in a greater than additive fashion in colon cancer cells. The drug combination reduced the expression of mutant K-RAS and of multiple histone deacetylase (HDAC) proteins that required autophagosome formation. It caused green fluorescent protein or red fluorescent protein-tagged forms of K-RAS V12 to localize into large intracellular vesicles. Compared with [regorafenib + sildenafil], the three-drug combination caused greater and more prolonged activation of the ATM-AMPK-ULK-1 pathway and caused a greater suppression and prolonged inactivation of mammalian target of rapamycin, AKT, and p70 S6K. Approximately 70% of enhanced lethality caused by neratinib required ataxia-telangiectasia-mutated (ATM)-AMP-dependent protein kinase (AMPK) signaling whereas knockdown of Beclin1, ATG5, FADD, and CD95 completely prevented the elevated killing effect. Exposure of cells to [regorafenib + sildenafil] reduced the expression of the checkpoint immunotherapy biomarkers programmed death-ligand 1, ornithine decarboxylase, and indoleamine 2,3-dioxygenase-1 and increased the expression of major histocompatibility complex A (MHCA), which also required autophagosome formation. Knockdown of specific HDAC proteins recapitulated the effects observed using chemical agents. In vivo, using mouse cancer models, neratinib significantly enhanced the antitumor efficacy of [regorafenib + sildenafil]. Our data support performing a new three drug Phase I trial combining regorafenib, sildenafil, and neratinib.

Indexed as

AMP-Activated Protein KinasesAnimalsAntineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCell Line, TumorColorectal NeoplasmsDrug SynergismFemaleMaleMiceMice, Inbred BALB CMice, Inbred C57BLPhenylurea CompoundsPhosphodiesterase 5 InhibitorsPyridinesQuinolinesAMP-Activated Protein KinasesAntineoplastic AgentsneratinibPhenylurea CompoundsPhosphodiesterase 5 InhibitorsPyridinesQuinolinesregorafenibSildenafil CitrateautophagyDNA damageHDAC

Identifiers

PMID30203445
PMCPMC6322207
OpenAlexW2891563533

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.