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Ajdari M, Ranjbar A, Karimian K, Karimi M, Heli H, Sattarahmady N. Characterization and Evaluation of Nano-niosomes Encapsulating Docetaxel against Human Breast, Pancreatic, and Pulmonary Adenocarcinoma Cancer Cell Lines. J Biomed Phys Eng 2024; 14:159-168. [PMID: 38628892 PMCID: PMC11016824 DOI: 10.31661/jbpe.v0i0.2401-1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/29/2024] [Indexed: 04/19/2024]
Abstract
Background Docetaxel (DXL) is an antineoplastic agent for cancer treatment, the therapeutic efficiency of which is limited due to low solubility, hydrophobicity, and tissue specificity. Objective In this study, nano-niosomes were introduced for improving therapeutic index of DXL. Material and Methods In this experimental study, two nano-niosomes were synthesized using Span 20® and Span 80® and a thin film hydration method with DXL loading (DXL-Span20 and DXL-Span80). Characterization, in-vitro cytotoxicity and bioavailability of the nano-niosomes was also evaluated via in-vivo experiments. Results DXL-Span20 and DXL-Span80 have vesicles size in a range of 84-90 nm and negative zeta potentials. DXL entrapment efficiencies were obtained as 69.6 and 74.0% for DXL-Span20 and DXL-Span80, respectively; with an in-vitro sustained release patterns. Cytotoxicity assays were performed against MDA-MB-231, Calu-6, and AsPC-1 cell lines, and the results indicated that DXL loading into nano-niosomes led to decrement in values of half-maximal inhibitory concentration (IC50) at least 2.5 times and at most 6.5 times, compared to free DXL. Moreover, the rat blood bioavailability of DXL after intraperitoneal administration and the pharmacokinetic parameters indicated higher DXL plasma level and the higher effectiveness of DXL-Span80 compared to DXL-Span20. Conclusion Carrying DXL by the nano-niosomes led to enhanced cytotoxicity (and lower IC50 values) and higher efficacy with enhanced pharmacokinetic parameters.
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Affiliation(s)
- Mohammadreza Ajdari
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aliyeh Ranjbar
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khashayar Karimian
- Arasto Pharmaceutical Chemicals Inc., Yousefabad, Jahanarar Avenue, Tehran, Iran
| | - Maryam Karimi
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Heli
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naghmeh Sattarahmady
- Nanomedicine and Nanobiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Medical Physics and Engineering, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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2
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Tarcha FV, Baccarin ALDC, Barros LADR, de Alencar EBA, del Giglio A, Cruz FJSM. Febrile neutropenia incidence and the variable toxicity profile between brand and generic docetaxel in the adjuvant treatment of breast cancer with docetaxel and cyclophosphamide regimen. EINSTEIN-SAO PAULO 2023; 21:eAO0486. [PMID: 38126660 PMCID: PMC10730260 DOI: 10.31744/einstein_journal/2023ao0486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/12/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To assess the incidence of febrile neutropenia without primary granulocyte colony-stimulating factor prophylaxis in patients undergoing chemotherapy with adjuvant docetaxel and cyclophosphamide, and to evaluate the toxicity profile of brand-name docetaxel (Taxotere ® ) and the generic formulation. METHODS This retrospective study was conducted using data obtained from electronic medical records of patients treated at a Brazilian cancer center. Patients with breast cancer who underwent adjuvant treatment between January 2016 and June 2019 were selected. Data were analyzed using chi-square and Fisher correlation of variables, and multivariate analyses were adjusted for propensity score. RESULTS A total of 231 patients with a mean age of 55.9 years at the time of treatment were included in the study. The majority (93.9%) had luminal histology, 84.8% were at clinical stage I, and 98.2% had a good performance status. The overall incidence of febrile neutropenia in the study population was 13.4% (31 cases). The use of brand-name docetaxel (Taxotere ® ) was the only factor associated with febrile neutropenia occurrence (OR= 3.55, 95%CI= 1.58-7.94, p=0.002). CONCLUSION In patients with breast cancer who require treatment with adjuvant docetaxel and cyclophosphamide regimen, the toxicity profile differs between brand-name and generic docetaxel. Regardless of the formulation used, the incidence of febrile neutropenia was less than 20%, which may allow for the omission of primary prophylactic granulocyte colony-stimulating factor use in this setting.
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Affiliation(s)
- Flávia Viécili Tarcha
- Instituto Brasileiro de Controle do CâncerSão PauloSPBrazil Instituto Brasileiro de Controle do Câncer
,
São Paulo
,
SP
,
Brazil
.
| | - Ana Luísa de Castro Baccarin
- Instituto Brasileiro de Controle do CâncerSão PauloSPBrazil Instituto Brasileiro de Controle do Câncer
,
São Paulo
,
SP
,
Brazil
.
| | - Lilian Arruda do Rêgo Barros
- Instituto Brasileiro de Controle do CâncerSão PauloSPBrazil Instituto Brasileiro de Controle do Câncer
,
São Paulo
,
SP
,
Brazil
.
| | | | - Auro del Giglio
- Centro Universitário FMABCSanto AndréSPBrazil Centro Universitário FMABC
,
Santo André
,
SP
,
Brazil
.
| | - Felipe José Silva Melo Cruz
- Instituto Brasileiro de Controle do CâncerSão PauloSPBrazil Instituto Brasileiro de Controle do Câncer
,
São Paulo
,
SP
,
Brazil
.
- Centro Universitário FMABCSanto AndréSPBrazil Centro Universitário FMABC
,
Santo André
,
SP
,
Brazil
.
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Yiding C, Zhongyi H. Differences between the quality aspects of various generic and branded docetaxel formulations. Curr Med Res Opin 2021; 37:1421-1433. [PMID: 33998944 DOI: 10.1080/03007995.2021.1929895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Docetaxel is a widely prescribed chemotherapy drug in oncology and post expiry of its patent, the drug has been marketed as a generic by multiple manufacturers. It is also classified as a narrow therapeutic window drug. Through enhanced permeability and retention effect, polymeric micelles can passively target agents to tumor tissue, thereby decreasing toxicity of the drug in normal tissue. However, various studies have raised concerns that generic docetaxel leads to greater incidences of toxicities among patients with cancer. Thus, we herein review the pharmaceutical challenges associated with different docetaxel formulations and provide insights into the dissimilarities in the quality and safety of branded and generic docetaxel formulations. Literature review reported that 90% of the generic formulations of docetaxel contain inadequate quantity of active drug and high levels of impurities. Higher amounts of solvents such as polysorbate 80 and ethanol in docetaxel formulation lead to severe toxicities such as febrile neutropenia, hematological, and cutaneous toxicities. In most of the studies, even minor changes in excipients, solvents, unbound fraction of docetaxel were associated with adverse events, while in few, the source of docetaxel remained unidentified. One study reported incidence of febrile neutropenia due to a switch in the formulation from branded to generic. The quality, safety, and efficacy of medicines will directly affect the life of patients, and therefore, use of docetaxel formulations that guarantee safety of patients are the necessity of the hour. Being an injectable anti-cancer drug, it is important to determine the consistency of the various formulations of docetaxel globally, conduct bioequivalence studies as per the regulatory standards, taking into account the permissible limits of the excipients or the presence of such unapproved excipients.
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Affiliation(s)
- Chen Yiding
- Department of Breast Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Huang Zhongyi
- The GCP Office, The Central Hospital of Jing'an District, Shanghai, China
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Docetaxel Skin Exposure and Micronucleation Contributes to Skin Toxicity Caused by CPC634. Cancers (Basel) 2021; 13:cancers13153741. [PMID: 34359641 PMCID: PMC8345028 DOI: 10.3390/cancers13153741] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary CPC634 is a nanoparticle entrapping docetaxel that is associated with skin toxicity that resembles conventional docetaxel-related skin toxicity. In this randomised cross-over study, the cutaneous pharmacokinetics and pharmacodynamics of docetaxel and CPC634 were compared to unravel the mechanisms behind the cutaneous toxicity. The total docetaxel concentration in the skin was almost four-fold higher after CPC634 administration compared to conventional docetaxel. Both CPC634 and conventional docetaxel administration resulted in anti-mitotic effects in the skin such as micronucleation. Micronucleation can induce an inflammatory reaction, which could lead to skin toxicity. Abstract Docetaxel entrapped nanoparticle CPC634 is associated with dose-related skin toxicity that resembles conventional docetaxel (Cd)-related skin toxicity. This study compared the cutaneous pharmacokinetics and pharmacodynamics of docetaxel and CPC634. In this randomised cross-over study, patients with solid tumours received one cycle of CPC634 and Cd (both at 75 mg/m2). Skin biopsies were taken at baseline and at day 8 of both cycles. Released and total docetaxel (released docetaxel plus entrapped docetaxel) concentrations and histopathological changes in the skin biopsies were evaluated. Twenty patients underwent paired skin biopsies for pharmacokinetic analysis and 10 patients had biopsies available for histopathological assessment. The total skin docetaxel concentration was 369% (95%CI: 229% to 569%, p < 0.001) higher after CPC634 administration compared to Cd while the released docetaxel concentrations were not statistically different (95%CI: −9% to 63%, p = 0.169). The CPC634 released docetaxel concentration in the skin was positively correlated with plasma concentrations (Pearson’s correlation 0.48, p = 0.03). Histopathological examination revealed increased apoptosis, mitotic cells with nuclear atypia, and micronucleation with an enhanced Ki-67 index for both compounds. In conclusion, both CPC634 and Cd treatment result in docetaxel exposure in the skin causing cutaneous anti-mitotic effects such as micronucleation, which could induce an inflammatory reaction leading to skin toxicity.
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Pétronille R, Bernard D, Guillaume LG, Victoire V, Thomas F, Jérôme C, Eloïse DC, Gérard P, Sylvie S, Audrey S, François L, Suzette D, Muriel P, Maxime A. Comparative analysis of docetaxel: physical and chemical characterisation of Taxotère® and generics. Eur J Cancer 2020; 135:183-191. [PMID: 32599408 DOI: 10.1016/j.ejca.2020.04.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/01/2020] [Indexed: 02/02/2023]
Abstract
Several cases of fatal enterocolitis have been described in association with the use of docetaxel (DTX), and this increase in adverse events has been concomitant with a change in formulation. Indeed in 2010, a new DTX-based presentation has been introduced in the form of a single ready-to-use vial by Sanofi-Aventis, presentation also used for generics. In this study, different available formulations were compared (Sanofi 2 vials, Sanofi 1 vial, Accord Healthcare, Kabi, Hospira) in terms of composition compliance with control specifications and simulated micelle behaviour to try to determine what could be the potential causes of this problem. This work had permitted to show that all the tested products complied with specifications in terms of dosage and purity. Variations in the composition of polysorbate 80 (PS80) have been observed but are probably too small to be responsible for the toxicity found in patients. However, we identified a difference in micelle size and release kinetics probably because of doubling concentration of ethanol in new formulation. As a result, we emphasised the importance in the case of DTX of conducting bioequivalence studies as expected in European Medicines Agency (EMA) guidance to ensure patient safety, even though these formulation changes might seem minor. Therefore, further studies are needed to explore the potential role of ethanol, PS80 and the unbound fraction of DTX in the development of enterocolitis in patients treated with DTX.
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Affiliation(s)
- Roy Pétronille
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France.
| | - Do Bernard
- Pharmacy Department, Hôpital Henri Mondor, Créteil, F-94010, France; University of Paris-Sud, Department of Pharmacy, Laboratory "Matériaux et Santé" EA 401, 5 Rue Jean Baptiste Clément, 92296 Châtenay-Malabry, France
| | | | | | - Fleury Thomas
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France
| | - Conq Jérôme
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France
| | - Da Costa Eloïse
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France
| | - Pierron Gérard
- Centre National de La Recherche Scientifique, UMR-8122, Institut Gustave Roussy, Villejuif 94805, France
| | - Souquere Sylvie
- Centre National de La Recherche Scientifique, UMR-8122, Institut Gustave Roussy, Villejuif 94805, France
| | - Solgadi Audrey
- University of Paris-Sud, Department of Pharmacy, Laboratory "Matériaux et Santé" EA 401, 5 Rue Jean Baptiste Clément, 92296 Châtenay-Malabry, France
| | - Lemare François
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France
| | - Delaloge Suzette
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Paul Muriel
- Pharmacy Department, Hôpital Henri Mondor, Créteil, F-94010, France
| | - Annereau Maxime
- Pharmacy Department, Gustave Roussy, Villejuif, F-94805, France
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Atrafi F, Dumez H, Mathijssen RHJ, Menke van der Houven van Oordt CW, Rijcken CJF, Hanssen R, Eskens FALM, Schöffski P. A phase I dose-escalation and pharmacokinetic study of a micellar nanoparticle with entrapped docetaxel (CPC634) in patients with advanced solid tumours. J Control Release 2020; 325:191-197. [PMID: 32590047 DOI: 10.1016/j.jconrel.2020.06.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/13/2020] [Accepted: 06/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND CPC634 is docetaxel entrapped in core-cross linked polymeric micelles. In preclinical studies, CPC634 demonstrated enhanced pharmacokinetics and improved therapeutic index. This phase I dose escalation study is the first-in-human study with CPC634. METHODS adult patients with advanced solid tumours received CPC634 intravenously either 3-weekly (Q3W) (part 1, dose range 15-100 mg/m2), 2-weekly (Q2W) (part 2, 45 mg/m2) or Q3W with dexamethasone premedication (part 3, 60 mg/m2). RESULTS thirty-three patients were enrolled. Skin toxicity was dose limiting (DLT) at ≥60 mg/m2 in part 1 and at 45 mg/m2 in part 2 and was the most common CPC634 related grade ≥ 3 adverse event (24%). With dexamethasone premedication no DLTs were observed at 60 mg/m2 Q3W. CPC634 exhibited a dose-proportional pharmacokinetic profile. At 60 mg/m2, the plasma area under the curve was 4067.5 ± 2974.0 ng/h/mL and the peak plasma level 217.3 ± 91.9 ng/mL with a half-life of 39.7 ± 9.4 h for released docetaxel. CONCLUSION CPC634 could be administered safely upon pretreatment with dexamethasone. Cumulative skin toxicity was the main DLT. The recommended phase 2 dose was determined at 60 mg/m2 Q3W with dexamethasone premedication.
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Affiliation(s)
- Florence Atrafi
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands.
| | - Herlinde Dumez
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Ron H J Mathijssen
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | | | | | - Rob Hanssen
- Cristal Therapeutics, Maastricht, the Netherlands
| | - Ferry A L M Eskens
- Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | - Patrick Schöffski
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
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Evaluation of intestinal permeation enhancement with carboxymethyl chitosan-rhein polymeric micelles for oral delivery of paclitaxel. Int J Pharm 2019; 573:118840. [PMID: 31715358 DOI: 10.1016/j.ijpharm.2019.118840] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 11/24/2022]
Abstract
Polymeric micelles (PMs) are currently under investigation as potential nanocarriers for oral administration of paclitaxel (PTX). Previously, we developed amphiphilic carboxymethyl chitosan-rhein (CR) conjugate for oral delivery of PTX. PTX-loaded CR PMs exhibited a homogeneous and small size (<200 nm) with a drug loading capacity (DL) of 35.46 ± 1.07%. However, The absorption parameters of PTX using CR PMs have not been studied before. Here, we evaluated the intestinal permeation of CR PMs by in situ intestinal absorption experiments. PTX-loaded CR PMs enhanced the absorption of PTX in the intestine without causing significant intestinal villi injury. Compared to the P-glycoprotein (P-gp) inhibition of verapamil, the transport mechanism of CR PMs across intestinal epithelial cells may bypass P-gp efflux. Caco-2 cell uptake assays also confirmed that CR PMs can be taken up into the enterocyte as whole and independent of P-gp. Local biodistribution evaluation showed that fluorescence-labeled CR PMs were absorbed into the intestinal villi. In vivo bioimaging of tumor-bearing mice verified a significant portion of CR PMs were intactly absorbed through the intestine, then distributed and accumulated at the tumor site. For their significant intestinal permeation enhancement, CR PMs might be considered as promising oral delivery carriers for PTX and other water-insoluble drugs.
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Gini Index-Based Maximum Concentration and Area Under the Curve Split Points for Analysing Adverse Event Occurrence in Bioequivalence Studies. Pharmaceut Med 2018. [DOI: 10.1007/s40290-017-0217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Barata-Silva C, Hauser-Davis RA, Silva ALOD, Moreira JC. Desafios ao controle da qualidade de medicamentos no Brasil. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1414-462x201700030075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Resumo Introdução O desenvolvimento científico e tecnológico, assim como a adoção de políticas públicas voltadas à redução do custo dos medicamentos, tem ampliado o acesso da população a alternativas terapêuticas, as quais incluem medicamentos genéricos, biossimilares, nanomedicamentos e complexos não biológicos. As categorias já comercializadas exigem procedimentos próprios para a garantia de sua qualidade, eficácia terapêutica e segurança. Nesse contexto, o presente estudo procura realizar uma avaliação do cenário atual no Brasil sobre esse tema, apontando para situações que certamente terão de ser enfrentadas em um futuro próximo. Metodologia Foi realizado um levantamento de dados nas bases eletrônicas MEDLINE, PubMed e SCIELO, buscando artigos originais, tanto em português quanto em inglês, indexados retrospectivamente até 1999. Foram utilizados termos de busca relevantes em língua portuguesa e inglesa. Mais de 50 artigos científicos foram encontrados. Resultados e Discussão A maioria dos artigos avaliados aponta problemas tanto na fabricação quanto no controle de medicamentos genéricos e biossimilares, seja no mercado internacional, seja no nacional. No entanto, novas formas medicamentosas estão sendo criadas e necessitam do desenvolvimento de legislação e de metodologias específicas para a garantia da qualidade desses produtos. Uma avaliação do atual sistema brasileiro de registro e controle da qualidade aponta falhas e, especialmente, falta de uma farmacovigilância mais bem estruturada e ativa no país. Conclusão O atual cenário demonstra que os órgãos responsáveis no país necessitam rever a atual sistemática utilizada na fabricação e controle de medicamentos e aprimorá-la, bem como se preparar para o enfrentamento de outras demandas, algumas ainda mais complexas, que já se encontram em desenvolvimento.
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Ratanajarusiri T, Sriuranpong V, Sitthideatphaiboon P, Poovoravan N, Vinayanuwat C, Parinyanitikul N, Angspatt P, Thawinwisan W, Tanasanvimon S. A Difference in the Incidences of Hypersensitivity Reactions to Original and Generic Taxanes. Chemotherapy 2016; 62:134-139. [DOI: 10.1159/000450748] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 09/09/2016] [Indexed: 11/19/2022]
Abstract
Purpose: To compare incidences of hypersensitivity reaction (HSR) between original and generic taxanes including paclitaxel and docetaxel. Methods: We conducted a prospective study enrolling all patients receiving taxanes at King Chulalongkorn Memorial Hospital. Taxanes were infused accordingly to the step-wise rate escalation protocol at this hospital. Active surveillance for HSRs was performed. During the study period, there was only 1 generic brand used for each taxane. We primarily compared the incidences of HSR between original and generic drugs for each taxane. Results: During the period from January 1 to December 31, 2013, a total of 258 consecutive patients receiving taxanes were enrolled; 128 received paclitaxel, i.e. 65 and 63 in the original (Taxol) and generic arms, respectively, and 130 received docetaxel, i.e. 66 and 64 in the original (Taxotere) and generic arms, respectively. Premedication, including antihistamines and dexamethasone, was administered to all patients 30 min before taxane infusion. There were 26 (10.0%) HSR events including 24 grade 2 and 2 grade 3 HSRs. In the paclitaxel group, there were 9 (13.8%) and 7 (11.1%) HSRs in the original and generic arms, respectively (p = 0.791). In the docetaxel group, there were 9 (13.6%) and 1 (1.6%) HSRs in the original and generic arms, respectively (p = 0.017). No life-threatening symptoms or permanent discontinuation of taxanes occurred. Conclusions: In this prospective study, the incidences of HSR were similar with generic and original paclitaxel but significantly different with generic and original docetaxel.
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11
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Generic oncology drugs: are they all safe? Lancet Oncol 2016; 17:e493-e501. [DOI: 10.1016/s1470-2045(16)30384-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/18/2016] [Accepted: 07/28/2016] [Indexed: 12/19/2022]
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Faqeer NA, Mashni O, Dawoud R, Rumman A, Hanoun E, Nazer L. Comparing the Incidence of Febrile Neutropenia Resulting in Hospital Admission Between the Branded Docetaxel and the Generic Formulations. J Clin Pharmacol 2016; 57:275-279. [PMID: 27479828 DOI: 10.1002/jcph.803] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/27/2016] [Accepted: 07/27/2016] [Indexed: 11/10/2022]
Abstract
Studies have raised concern about the safety of generic compared with branded drugs. Febrile neutropenia (FN) resulting in hospital admission was compared between the branded docetaxel (Taxotere®, Sanofi) and 2 generic formulations (docetaxel Ebewe and docetaxel Hospira) in patients with breast cancer. This was a retrospective study that included patients with breast cancer who received docetaxel between January 2012 and December 2014. Patients who had an admission diagnosis of FN and had received docetaxel within 14 days prior to admission were evaluated. The docetaxel brand and dose, patient characteristics, hospital length of stay, admission to the intensive care unit (ICU), and mortality were recorded. During the study period, 2904 cycles of docetaxel were given for 876 patients (1519 cycles of docetaxel Sanofi, 811 cycles of docetaxel Hospira, and 574 cycles of docetaxel Ebewe). Among the cycles given, 130 cycles were associated with FN that required hospital admission. The overall incidence of FN resulting in hospital admission was significantly higher in patients who had received docetaxel Hospira, compared with patients who had received docetaxel Sanofi (47[5.8%] cycles vs 53 [3.5%] cycles, P = .009), but there was no significant difference between docetaxel Ebewe and docetaxel Sanofi (30[5.2%] cycles vs 53 [3.5%] cycles, P = .069). All cases of FN resolved except for 1 patient who died in the ICU after receiving docetaxel Ebewe. There was a significant difference in the incidence of FN between docetaxel Sanofi and docetaxel Hospira, but all cases in both groups resolved completely.
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Affiliation(s)
- Nour Al Faqeer
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Ola Mashni
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Rawan Dawoud
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Asma Rumman
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Esraa Hanoun
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Lama Nazer
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
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Elm'hadi C, Tanz R, Khmamouche MR, Toreis M, Mahfoud T, Slimani KA, Errihani H, Ichou M. Toxicities of docetaxel: original drug versus generics-a comparative study about 81 cases. SPRINGERPLUS 2016; 5:732. [PMID: 27386229 PMCID: PMC4909666 DOI: 10.1186/s40064-016-2351-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Docetaxel is a chemotherapy drug widely prescribed in oncology that recognizes a variety of manufactured generics whose toxicity is increasingly reported. The aim of this study was to compare the toxicities between the original and a generics docetaxel in a Moroccan center. METHODS In a cross sectional study, we enrolled patients treated with docetaxel from the oncology department of the military hospital of Rabat over a period of 2 years (2013-2014). We compared the prevalence of hypersensitivity reactions, febrile neutropenia, peripheral neuropathy, gastrointestinal, cutaneous, and hematologic toxicities, between four different presentations of docetaxel including the original drug. Only grade II or worse adverse events related to chemotherapy were considered. Treatments discontinuations due to toxicity were also compared. Unusual skin toxicities were included. RESULTS 81 patients were eligible for analysis [43/generics arm vs. 38/original drug arm. Hematological toxicity was significantly more frequent in the generic arm than in the original drug (32.6 vs. 13.2 %; p = 0.04)]. Also, a signifying higher rate of treatment discontinuation was observed in the generic arm (39.5 vs. 7.9 %, p = 0.001). The use of specific generic increase numerically the skin toxicities (17.6 vs. 0 %, p = 0.026). CONCLUSION Our data suggest that generics of docetaxel are associated with an increase of hematological and cutaneous toxicities, an increase of treatment discontinuation rate and emphasize the need of a regulation of generics' manufacture.
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Affiliation(s)
- Choukri Elm'hadi
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco ; School of Medicine and Pharmacy, University Mohamed V, Souissi, Rabat, Morocco
| | - Rachid Tanz
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco
| | | | - Mehdi Toreis
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco
| | - Tarik Mahfoud
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco
| | - Khaoula Alaoui Slimani
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco
| | - Hassan Errihani
- Medical Oncology Department, National Institute of Oncology Sidi Mohamed Ben Abdellah, Rabat, Morocco
| | - Mohammed Ichou
- Medical Oncology Department, Mohammed V Military Teaching Hospital of Rabat, Rabat, Morocco
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14
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Letter to the editor. Support Care Cancer 2015; 23:2861. [DOI: 10.1007/s00520-015-2790-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022]
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15
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Fox CB, Kim J, Le LV, Nemeth CL, Chirra HD, Desai TA. Micro/nanofabricated platforms for oral drug delivery. J Control Release 2015; 219:431-444. [PMID: 26244713 DOI: 10.1016/j.jconrel.2015.07.033] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 12/18/2022]
Abstract
The oral route of drug administration is most preferred due to its ease of use, low cost, and high patient compliance. However, the oral uptake of many small molecule drugs and biotherapeutics is limited by various physiological barriers, and, as a result, drugs suffer from issues with low solubility, low permeability, and degradation following oral administration. The flexibility of micro- and nanofabrication techniques has been used to create drug delivery platforms designed to address these barriers to oral drug uptake. Specifically, micro/nanofabricated devices have been designed with planar, asymmetric geometries to promote device adhesion and unidirectional drug release toward epithelial tissue, thereby prolonging drug exposure and increasing drug permeation. Furthermore, surface functionalization, nanotopography, responsive drug release, motion-based responses, and permeation enhancers have been incorporated into such platforms to further enhance drug uptake. This review will outline the application of micro/nanotechnology to specifically address the physiological barriers to oral drug delivery and highlight technologies that may be incorporated into these oral drug delivery systems to further enhance drug uptake.
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Affiliation(s)
- Cade B Fox
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Jean Kim
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Long V Le
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Cameron L Nemeth
- UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA
| | - Hariharasudhan D Chirra
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA
| | - Tejal A Desai
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA; UC Berkeley & UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA 94158, USA.
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