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Investigational New Drugs

, Volume 31, Issue 1, pp 14–19 | Cite as

A preclinical and clinical study of mycophenolate mofetil in pancreatic cancer

  • J. Rodríguez-Pascual
  • P. Sha
  • E. García-García
  • N. V. Rajeshkumar
  • E. De Vicente
  • Y. Quijano
  • A. Cubillo
  • B. Angulo
  • O. Hernando
  • M. HidalgoEmail author
PRECLINICAL STUDIES

Summary

A high throughput screening for anticancer activity of FDA approved drugs identified mycophenolic acid (MPA), an inhibitor of inositol monophosphate dehydrogenase (IMPDH) as an active agent with an antiangiogenesis mode of action. Exposure of pancreatic cancer cell lines to MPA resulted in growth inhibition and reduced the expression of VEGF that was reversed by supplementing the media with guanosine supporting and IMPDH-dependant mechanism. In preclinical in vivo study, MPA showed a moderate inhibition of tumor growth in a panel of 6 human derived pancreatic cancer xenografts but reduced the expression of VEGF. To investigate the effects of MPA in human pancreatic cancer, a total of 12 patients with resectable pancreatic cancer (PDA) received increasing doses of mycophenolate mofetil (MMF) in cohorts of 6 patients each from 5–15 days prior to surgical resection. Treatment was well tolerated with one episode of grade 1 muscle pain, one episode of grade 2 lymphopenia (2 gr/day dose) and one episode of grade 2 elevantion in LFT (all in the 2 gr./day dose). Patients recovered from surgery uneventfully with no increased post-operative complications. Assessment of CD31, VEGF, and TUNEL in resected specimens compared to a non treated control of 6 patients showed no significant variations in any of the study endpoints. In conclusion, this study shows the feasibility of translating a preclinical observation to the clinical setting and to explore a drug mechanism of action in patients. MPA, however, did not show any hints of antiangiogenesis of anticancer clinical activity questioning if this agent should be further developed in PDA.

Keywords

Pancreatic cancer Mycophenolic acid Angiogenesis 

Notes

Authors’ disclosures of potential conflicts of interest

None of the authors has any potential conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • J. Rodríguez-Pascual
    • 1
    • 2
  • P. Sha
    • 4
  • E. García-García
    • 1
    • 2
  • N. V. Rajeshkumar
    • 4
  • E. De Vicente
    • 1
    • 2
  • Y. Quijano
    • 1
    • 2
  • A. Cubillo
    • 1
    • 2
  • B. Angulo
    • 1
    • 2
  • O. Hernando
    • 1
    • 2
  • M. Hidalgo
    • 1
    • 2
    • 3
    Email author
  1. 1.Centro Integral Oncológico ¨Clara Campal¨ (CIOCC)MadridSpain
  2. 2.Facultad de Medicina CEU San PabloMadridSpain
  3. 3.Centro Nacional de Investigaciones OncologicasMadridSpain
  4. 4.Johns Hopkins UniversityBaltimoreUSA

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