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Malignant brain tumor, including the most common type glioblastoma, are histologically heterogeneous and invasive tumors known as the most devastating neoplasms with high morbidity and mortality. Despite multimodal treatment including surgery, radiotherapy, chemotherapy, and immunotherapy, the disease inevitably recurs and is fatal. This lack of curative options has motivated researchers to explore new treatment strategies and to develop new drug delivery systems (DDSs); however, the unique anatomical, physiological, and pathological features of brain tumors greatly limit the effectiveness of conventional chemotherapy. In this context, we review the recent progress in the development of nanoparticle‐basedDDSsaiming to address the key challenges in transporting sufficient amount of therapeutic agents into the brain tumor areas while minimizing the potential side effects. We first provide an overview of the standard treatments currently used in the clinic for the management of brain cancers, discussing the effectiveness and limitations of each therapy. We then provide an in‐depth review of nanotherapeutic systems that are intended to bypass the blood–brain barrier, overcome multidrug resistance, infiltrate larger tumorous tissue areas, and/or release therapeutic agents in a controlled manner.WIREs Nanomed Nanobiotechnol2018, 10:e1479. doi: 10.1002/wnan.1479This article is categorized under:Implantable Materials and Surgical Technologies > Nanomaterials and ImplantsTherapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

LBA4500 Background: Cisplatin-based chemo is a standard 1L treatment (tx) for mUC and the only tx that prolongs OS; however, age or comorbidities render many pts ineligible, and 30-50% receive no tx. Atezo (MPDL3280A) is active and well tolerated in platinum-treated mUC, justifying testing atezo as 1L tx in cisplatin-ineligible pts. Methods: Pts were chemo naive in the metastatic setting and cisplatin ineligible (renal [GFR > 30 but < 60 mL/min]/hearing impairment, ≥ G2 peripheral neuropathy [PN] or ≥ ECOG PS2). Atezo 1200 mg was given IV q3w until PD (RECIST v1.1). Centrally assessed PD-L1 on tumor infiltrating immune cells (IC; SP142 IHC assay) was scored IC2/3, 1 or 0. The primary efficacy endpoint was confirmed ORR assessed per RECIST v1.1 (central independent review facility) using a data cutoff of Sep 14, 2015. Results: 119 efficacy/safety-evaluable pts of any PD-L1 IC had a median age of 73 y: 21% ≥ 80 y. 18% had prior systemic tx (21% [neo]adjuvant); 10% had radiotherapy. 66% had visceral mets. 71% had CrCl < 60 mL/min; 13% had hearing loss ≥ 25 dB; 6% had prior PN ≥ G2; 20% had ECOG PS2. ORR was 19% (95% CI 13-28; 5% CR), and responses occurred in all IC subgroups (Table; includes DCR/PFS/OS) and in pts with poor prognostic factors. 22/23 responses were ongoing with mDOR not reached. Median follow-up was 8.5 mo (range 0.2-14.3); median tx duration was 15 wk. Atezo was generally well tolerated. Tx-related all-G and G3-4 AEs were seen in 64% and 12% of pts, respectively. Related all-G AEs ≥ 10% included fatigue, pruritus, diarrhea. 1 G5 related AE occurred (sepsis). 3% had a G3-4 immune-mediated AE. Conclusions: Atezo has clinically meaningful activity in 1L cisplatin-ineligible mUC pts, and preliminary OS is encouraging. The durable nature of response and favorable AE profile makes this an attractive alternative to chemo. NCT02108652. Clinical trial information: NCT02108652. [Table: see text]

ObjectiveDegeneration of oligodendroglial distal processes has been identified as an early event in multiple sclerosis (MS) lesion development. Our objective was to further define the development of the “dying‐back” oligodendrocyte lesion in situ and to model the development and potential reversibility of such responses using dissociated cultures of adult human brain‐derived oligodendrocytes.MethodsIn situ analyses were performed on glutaraldehyde‐fixed thin sections of clinically acute and pathologically active cases of MS. In vitro studies were conducted using adult human brain‐derived oligodendrocytes challenged by metabolic stress conditions (low nutrient/glucose).ResultsIn situ analyses indicated a spectrum of myelin changes in the presence of morphologically intact oligodendrocytes; these included degeneration of the inner cytoplasmic tongue with increasing sizes of intramyelinic bleb formation that could result in radial fractures of the myelin sheath. Macrophages with ingested myelin fragments were identified only once the fragmentation was established. In vitro studies indicated that oligodendrocyte process retraction, which was linked to reduced glycolytic respiratory activity, is reversible until a critical time point. Subsequent cell death was not linked to caspase‐3–dependent programs. Gene expression studies conducted at the latest reversible time point revealed reduced expression of pathways associated with cell process outgrowth and myelination, as well as with metabolic activity.InterpretationOur findings reveal the potential to protect and possibly restore myelin elaborated by existent oligodendrocytes in early and evolving MS lesions, and suggest the necessity of ongoing studies of the mechanisms underlying subsequent adult human oligodendrocyte cell death. Ann Neurol 2017;81:811–824

Key Points The expression level of ROR1 on CLL cells varies between patients. High-level CLL-cell expression of ROR1 associates with more aggressive disease.

SummaryAimsFibrillar aggregates of β‐amyloid protein (Aβ) are the main constituent of senile plaques and considered to be one of the causative events in the pathogenesis of Alzheimer's disease (AD). Compounds that could inhibit Aβ fibrils formation, disaggregate preformed Aβ fibrils as well as reduce their associated neurotoxicity might have therapeutic values for treating AD. In this study, the inhibitory effects of bis (heptyl)‐cognitin (B7C), a multifunctional dimer derived from tacrine, on aggregation and neurotoxicity of Aβ1‐40 were evaluated both in vitro and in vivo.MethodsThioflavin T fluorescence assay was carried out to evaluate Aβ aggregation, MTT and Hoechst‐staining assays were performed to investigate Aβ‐associated neurotoxicity. Fluorescent probe DCFH‐DA was used to estimate the accumulation of intracellular reactive oxygen stress (ROS). Morris water maze was applied to determine learning and memory deficits induced by intracerebroventricular infusion of Aβ in rats.ResultsB7C (0.1–10 μM), but not tacrine, effectively inhibited Aβ fibrils formation and disaggregated preformed Aβ fibrils following co‐incubation of B7C and Aβ monomers or preformed fibrils, respectively. In addition, B7C markedly reduced Aβ fibrils‐associated neurotoxicity in SH‐SY5Y cell line, as evidenced by the increase in cell survival, the decrease in Hoechst‐stained nuclei and in intracellular ROS. Most encouragingly, B7C (0.1 and 0.2 mg/kg), 10 times more potently than tacrine (1 and 2 mg/kg), inhibited memory impairments after intracerebroventricular infusion of Aβ in rats, as evidenced by the decrease in escape latency and the increase in the spatial bias in Morris water maze test along with upregulation of choline acetyltransferase activity and downregulation of acetylcholinesterase activity.ConclusionThese findings provide not only novel molecular insight into the potential application of B7C in treating AD, but also an effective approach for screening anti‐AD agents.

Abstract Methyl-lysine (Kme) recognition domains play a central role in epigenetic regulation during cellular differentiation, development, and gene transcription with more than 200 known “reader” domains in the human proteome. We describe our target-class approach to ligand design and discovery for three cancer relevant members of this large family: L3MBTL3 (a Malignant Brain Tumor (MBT) domain containing reader), 53BP1 (a tandem Tudor domain) and CBX7 (a chromo domain). The advantages of a small molecule driven approach to modulating chromatin biology are numerous: temporal resolution; mechanistic flexibility (targeting a specific activity of a protein as opposed to ablating them all with transgenic knock-outs or RNA-interference techniques); ease of delivery; and most significantly, when warranted, a small molecule tool has the potential to provide an immediate transition to a drug discovery effort, potentially cutting years off the time between target validation and therapeutic intervention. UNC1215 binds the MBT domains of L3MBTL3 with a Kd of 120 nM, competitively displacing mono- or dimethyl-lysine containing peptides. This probe is greater than 50-fold selective versus other members of the human MBT family and also demonstrates selectivity against more than 200 other Kme reader domains examined. UNC1215 increases the cellular mobility of GFP-L3MBTL3 fusion proteins and point mutants that disrupt the Kme binding function of GFP-L3MBTL3 phenocopy the effects of UNC1215. The potency, specificity, and cellular effects of UNC1215 establish it as the first cell-active antagonist of a Kme reader domain and a useful chemical probe for biological studies of the function of L3MBTL3 (James, L. I. et al. Nat Chem Biol 2013, 9, 184-191). 53BP1 is a Kme binding protein that plays a central biological role in DNA Damage Repair (DDR) pathway via its recruitment to sites of DNA double strand breaks (DSB). BRCA1 is a checkpoint and DNA damage repair gene that is required for maintenance of genomic integrity, and the inheritance of mutated BRCA1 is a major risk factor for breast and ovarian cancer. The BRCA1 knockout murine model is embryonic lethal and a conditional knockout in mammary glands results in low frequency and long latency of mammary tumor formation. It was recently reported that the BRCA1-null developmental phenotype is rescued when placed on a 53BP1-null background. Adult mice from this model, that are null for both the 53BP1 and BRCA1 genes, age normally and display a very low incidence of tumor formation. Genomic instability can be rescued in 53BP1 knockouts because the homologous recombination (HR) pathway is largely restored in cells lacking both BRCA1 and 53BP1 (Cao, L. et al. Molecular cell 2009, 35 (4), 534-41). Based on this data, small molecule antagonists of 53BP1's biological function could act as viable therapeutics to restore HR in the DDR response in humans with BRAC1 mutations. We will report the first small molecule, fragment-like ligands with selectivity for binding to 53BP1. CBX7 is a chromo domain containing Kme reader that, along with other CBX domains, recruits the PRC1 complex to histone 3, lysine 27 trimethylation sites (H3K27me3) and enables transcriptional silencing downstream of the PRC2 complex which ‘writes’ the H3K27me3 mark via the catalytic activity of EZH2. As EZH2 is a well validated drug target with inhibitors now entering the clinic for the treatment of various cancers, we hypothesize that antagonism of the PRC1 complex recognition of H3K27me3 will phenocopy and perhaps synergize with the activity of EZH2 inhibitors (Konze, K. D. et al. ACS Chemical Biology 2013, 8, 1324-1334). Progress towards a chemical probe to validate CBX7 as a therapeutic target will be presented. The pursuit of high quality chemical probes for KMe reader proteins represents an emerging area that will open new avenues of research in chromatin biology and may in time, translate to new therapeutic approaches. Antagonists of the readers of acetylated lysine (BRD4 bromo domains) derived from pioneering chemical probe efforts (Filippakopoulos, P. et al. Nature 468, 1067-73 (2010)) have recently entered the clinic for the treatment of various malignancies and we hope that our chemical probe work will help to validate Kme readers as novel and significant anti-tumor targets. Citation Format: Lindsey I. James, Jake I. Stuckey, Brandi M. Baughman, Michael T. Perfetti, Samantha G. Pattenden, Brad M. Dickson, Jacqueline L. Norris, Gaofeng Cui, Pavel Mader, Aiping Dong, Yunxiang Mu, Scott B. Rothbart, Brian D. Strahl, Jinrong Min, Peter J. Brown, Dmitri B. Kireev, William P. Janzen, Kevin M. McBride, Mark T. Bedford, Georges Mer, Cheryl H. Arrowsmith, Stephen V. Frye. Targeting chromatin regulation for cancer therapy: progress towards chemical probes for methyl-lysine readers. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr SY08-03. doi:10.1158/1538-7445.AM2015-SY08-03