title: Reduction of HLA-DR+ lymphocytes after treatment with enzastaurin in patients with metastatic thyroid cancer.
abstract: BACKGROUND
  Cytotoxic anti-tumor agents like methotrexate or cyclophosphamide have been used in the treatment of autoimmune diseases although the exact mechanism of their immunomodulatory function is unclear. By contrast, molecularly targeted anti-tumor agents, such as the serine/threonine kinase inhibitor enzastaurin, have not been evaluated for treatments other than cancer.
  
  
  METHODS
  Blood was sampled from patients with metastatic thyroid cancer treated with enzastaurin followed by the combination treatment of enzastaurin and the anti-folate pemetrexed. During this sequential treatment, blood was drawn every 14 days to monitor changes in the lymphocyte population.
  
  
  RESULTS
  We observed that enzastaurin monotherapy reduced the number of HLA-DR-expressing lymphocytes. No signs of infection were observed in any patient.
  
  
  CONCLUSIONS
  Our findings suggest an immunomodulatory effect of enzastaurin in addition to the anti-tumor effect.
authors.affiliation: Klinikum Nurnberg Nord, Medizinische Klinik 5, Onkologie und Hämatologie, Nürnberg, Germany. smetak@klinikum-nuernberg.de
authors.forename: Manfred
authors.initials: M
authors.lastname: Smetak
authors.forename: Karin
authors.initials: K
authors.lastname: Weigang-Koehler
authors.forename: Axel
authors.initials: A
authors.lastname: Hanauske
authors.forename: Ute
authors.initials: U
authors.lastname: Ohnmacht
authors.forename: Michael
authors.initials: M
authors.lastname: Lahn
authors.forename: Martin
authors.initials: M
authors.lastname: Wilhelm
authors.forename: Josef
authors.initials: J
authors.lastname: Birkmann
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D007211:Indoles / Q000627:therapeutic use*; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000166:cytology / Q000187:drug effects* / Q000276:immunology*; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D006684:HLA-DR Antigens; D007211:Indoles; C504878:enzastaurin