Effects of survivin on FVADT chemotherapy for refractory multiple myeloma

Abstract

Abstract. The present study aimed to investigate the effects of survivin, an apoptosis inhibitor protein, on the efficacy of the fludarabine, vincristine, epirubicin, dexamethasone and thalidomide (FVADT) chemotherapy regime for the treatment of refractory multiple myeloma (MM). A total of 82 patients with MM were selected from the Hematology Inpatient Department at The Second Affiliated Hospital of Zhengzhou University (Zhengzhou, China). The initial treatment group consisted of 40 patients with MM, who received the vincristine, epirubicin and dexamethasone (VAD) chemotherapy regime. The refractory group consisted of 42 patients with refractory MM, who received the FVADT chemotherapy regime. Bone marrow biopsies were collected via marrow aspirations, and the protein expression of survivin was analyzed by immunohistochemistry. In addition, the Kaplan-Meier method was used for survival analyses. Intergroup differences in the protein expression levels of survivin were compared, and the association between survivin expression and the short-and long-term effects of FVADT chemotherapy were analyzed. The positive expression rate of survivin was significantly higher in the refractory group, as compared with the initial treatment group (P<0.05). Furthermore, the complete remission rate and the effective rate were significantly lower in the survivin-positive group, as compared with the survivin-negative group (P<0.05). The overall survival, progression free survival and 1 and 3 year survival rates of the survivin-positive group were significantly higher, as compared with the survivin-negative group (P<0.05). The results of the present study suggested that the protein expression of survivin was upregulated in refractory MM tissues, which was indicative of a poor short-and long-term efficacy for FVADT chemotherapy.

Remodeling the tumor immune microenvironment via siRNA therapy for precision cancer treatment

“…Besides, Yang et al. [21] represented that the positive expression rate of survivin was significantly increased in patients with multiple refractory myelomas (MRM), and the patients with high expression of survivin had increased drug resistance and harsher chemotherapeutic effects. Using siRNA- survivin drugs would completely reverse vincristine resistance, which suggested that the siRNA- survivin drug was the potentially proper treatment of vincristine-resistant MRM [22] .…”

Proinflammatory cytokines (IL-6, IL-18) and apoptotic factors (HP 53, survivin) in patients with alcoholic liver cirrhosis

“…An assessment of the level of survivin may have significance in the prognosis of oncological treatment, e.g. multiple myeloma [7], adenoid cystic carcinoma of the lacrimal gland [8], ovarian cancer [9] and osteosarcoma [10]. Peroukides et al studied the protein expression of survivin in 69 cases of HCC and adjacent liver cirrhosis, and demonstrated increased protein levels and distinct sub cellular localization of survivin in HCC and liver cirrhosis [11].…”

Drug targets and resistance mechanisms in multiple myeloma

“…Survivin has been reported to inhibit apoptosis and regulate mitosis as well as cytokinesis. Studies indicate that survivin expression correlates with proliferation and poor overall survival of patients, as well as treatment failure [181,182] . XIAP (inhibitor of apoptosis protein) expression appears elevated in many cancer cells often conferring resistance to chemotherapy-induced cell death [183] .…”