Browsing by Author "Wang, H."

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    6820 Assessing The Efficacy And Safety Of Setrusumab For Osteogenesis Imperfecta: Updated Phase 2 Data From The Phase 2/3 Orbit Study
    (Oxford University Press, 2024-10-05) Gottesman, G. S.; Carpenter, T. O.; Wallace, M.; Smith, P.; Imel, E. A.; Wang, H.; Byers, H. M.; Krolczyk, S.; Lewiecki, E. M.; Medicine, School of Medicine
    Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and low bone mass with no universally accepted treatment. Setrusumab is a fully human anti-sclerostin monoclonal antibody that improved bone mineral density (BMD), bone strength, and bone turnover markers in adults with OI (ASTEROID; NCT03118570). In the ongoing Phase 2/3 Orbit study (NCT05125809), Phase 2 evaluated the efficacy and safety of setrusumab in pediatric and young-adult cohorts with OI based on PK/PD, safety, and BMD data, to determine the dosing strategy for the Phase 3 portion. Subjects with OI Types I, III, or IV, ages 5 to <26 years, were randomized 1:1 to receive 20 or 40 mg/kg setrusumab intravenously monthly. Six-month data as of August 2023 are presented. Twenty-four subjects (50% female, 75% <18 years of age) with OI Type I (n=17/24, 71%) or III/IV (n=7/24, 29%) were enrolled and randomized to receive 20 mg/kg (n=14/24) or 40 mg/kg (n=10/24) of setrusumab. The mean (SD) baseline-corrected area under the effect curve (AUEC) for serum P1NP in the 20 mg/kg setrusumab group was 4153 (4407) µg/(L*day) over month one of treatment, and 5256 (5521) µg/(L*day) in the 40 mg/kg group. Mean (SE) change from baseline in lumbar spine BMD in the 20 mg/kg group was 9.1% (1.8%) and 12.8% (2.5%) at M3 and M6, respectively (all p<0.05 vs baseline) and 9.3% (2.4%) and 16.1% (3.9%) in the 40 mg/kg group (M6 p<0.05 vs baseline). Mean (SE) baseline BMD Z-score in the 20 mg/kg group of 2.1 (0.8) improved by 0.6 (0.8) at M3 and 0.9 (0.8) at M6, and improved from 1.1 (0.4) at baseline by 0.5 (0.4) and 0.9 (0.4) at M3 and M6, respectively, in the 40 mg/kg group (all p<0.05 vs baseline). The median annualized fracture rate (excluding fingers, toes, face, and skull) was reduced significantly from 0.7 to 0 (p=0.042) after setrusumab initiation (calculated reduction of 67%). No new radiographically confirmed fractures excluding fingers, toes, face, and skull were reported in 20/24 (83%) subjects after starting setrusumab, while only 4/24 (17%) reported fractures (precipitating events: one subject: slipped on ice, stubbed toe, one subject each: fell off of tricycle, bending over in bed, tripped and fell). Setrusumab treatment resulted in no unexpected adverse events. Treatment-related adverse events included infusion-related reaction (7/24, 29%), headache (3/24, 13%) infusion site pain, bone pain, and upper respiratory tract infection (each 1/24, 4%). In Orbit Phase 2, we observed significant improvements from baseline in lumbar spine BMD at M3 and M6 at both 20 and 40 mg/kg doses, with no marked differences between dose groups. Fracture rates significantly decreased with setrusumab initiation, with 83% of subjects reporting no new fractures.
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    Dynamic Bioluminescence Imaging: Development of a Physiological Pharmacokinetic Model of Tumor Metabolism
    (Office of the Vice Chancellor for Research, 2013-04-05) Territo, P. R.; Shannon, H. E.; Freise, K. J.; Riley, A. A.; McCarthy, B. P.; Bailey, B. J.; Cai, S.; Cai, W.; Sinn, T. L.; Wang, H.; Wiek, C.; Hanenberg, H.; Pollok, Karen E.; Hutchins, Gary D.
    Bioluminescent imaging (BLI) has proven to be a valuable tool for the study of cellular biology and therapeutic response in a wide array of tumor types. Several BLI analytical approaches have been developed to assess tumor function and growth, all with the primary assumption that substrate concentrations saturate the luciferase enzyme. Recent work suggests that when D-luciferin is administered over the range from 75-600mg/kg, target tissue concentrations of D-luciferin are well below the Km of luciferase for the reaction, and, that the pharmacokinetics of D-luciferin significantly impact observed emission rates. To address the concentration and PK concerns, we developed a three compartment physiologically based pharmacokinetic (PhPK) model for D-luciferin including oxidation by luciferase via Michaelis-Menten kinetics. The model was applied to dynamically acquired BLI in NOD/SCID mice with ectopic luciferase-transfected SF767 tumors. The current PhPK model estimates tumor volume, tumor substrate metabolism (M ̅), tumor blood flow (Vb) and substrate extraction from the blood (Er). Studies were conducted using intraperitoneal, subcutaneous and intravenous routes of administration of 150 mg/kg of D-luciferin, where dynamic BLI was conducted weekly for four weeks. The D-luciferin concentration in tumor tissue, determined immediately after the last imaging session, was found to be approximately 8-fold below the reported Km for the reaction across all routes of administration, supporting the need for a PhPK modeling approach for analyzing BLI data. The model-predicted tumor volumes increased over time and were highly correlated with caliper-measured tumor volumes (y=1.984x, R2=0.980, p<0.0001). Tumor D-luciferin metabolism was found to increase exponentially over the 4 weeks, while blood flow decreased over this same interval, a finding which is consistent with the interpretation of a Warburg effect. When tumor M ̅ was compared with the traditional measures of peak emission (Cmax) and area under the curve (AUC), it was found that metabolism increased exponentially with increases in either Cmax (y=92.7exp(8E-11x), R2= 0.997) or AUC ( y=86.4exp(5E-14x), R2= 0.989), suggesting that Cmax and AUC may substantially underestimate the magnitude of tumor metabolism. The present PhPK model of D-luciferin distribution and metabolism overcomes limitations in the Cmax and AUC approaches caused by incorrect substrate: enzyme concentration assumptions, and thus provides a more reliable estimate of tumor burden, growth, and therapeutic response.
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    Dynamic Bioluminescence Imaging: Development of a Physiological Pharmacokinetic Model of Tumor Metabolism
    (Office of the Vice Chancellor for Research, 2012-04-13) Territo, P.R.; Shannon, H.E.; Freise, K.J.; Riley, A.A.; McCarthy, B.P.; Bailey, B.J.; Cai, S.; Cai, W.; Sinn, T.L.; Wang, H.; Hanenberg, H.; Pollok, K.E.; Hutchins, G.D.
    Bioluminescence (BLI) is a technology which has been studied extensively across multiple genera for more than 90 years. Over this period, BLI has emerged as a powerful noninvasive tool to study tumor localization, growth, and response to therapy due to the relatively recent technological advancements in instrumentation and molecular biology. This technology takes advantage of molecular transfection of the luciferase (LUC) gene from the North American firefly, Photinus pyralis, into human cancer cells, which are then implanted (ectopic or orthotopic) in mice. Oxidation of the exogenously administered substrate D-luciferin by the LUC gene product results in emission of green-yellow photons which are then evaluated in the context of tumor growth and development. Despite the more than 30 years of characterization, there exists a fundamental gap in our knowledge of the underlying PK/PD processes which are at the heart of nearly all BLI interpretation, and has lead to a dogmatic adherence in the literature to numerical methods which are at best simple corollaries of tumor metabolic rate. In an attempt to fill this void, this paper will present a new PK/PD model which takes advantage of the temporal nature of both substrate transport and light evolution. In addition, we will compare these results to traditional non-model based analyses and show how they differ. Lastly we will present OATS (One at A Time) Parameter Sensitivity and Monte Carlo Noise Analysis to characterize the numerical stability and sensitivity of this new model.
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    Mutations in CRBN and other cereblon pathway genes are infrequently associated with acquired resistance to immunomodulatory drugs
    (Springer Nature, 2021) Jones, J. R.; Barber, A.; Le Bihan, Y-V; Weinhold, N.; Ashby, C.; Walker, B. A.; Wardell, C. P.; Wang, H.; Kaiser, M. F.; Jackson, G. H.; Davies, F. E.; Chopra, R.; Morgan, G. J.; Pawlyn, C.; Graduate Medical Education, School of Medicine