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Calsina-Berna A, González-Barboteo J, Llorens-Torromé S, Julià-Torras J. Antitumoral Agent-Induced Constipation: A Systematic Review. Cancers (Basel) 2023; 16:99. [PMID: 38201526 PMCID: PMC10778329 DOI: 10.3390/cancers16010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Constipation is a common symptom in patients receiving antitumoral treatment. The mechanisms underlying antitumoral agent-induced constipation (ATAIC) are poorly defined. This systematic review aimed to analyze and synthesize the available information related to the prevalence, etiology, and treatment of ATAIC. METHODS A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted. The review included human studies written in English, French, or Spanish involving patients with cancer and containing information about the prevalence, etiology, and treatment of ATAIC. RESULTS A total of 73 articles were included. The reported prevalence ranged from 0.8% to 86.6%. Six studies reported an ATAIC prevalence of over 50%. The prevalence rates of constipation of grades 3 and 4 ranged between 0 and 11%. The importance of enteric neuronal integrity in gastrointestinal function was reported. The articles with the highest levels of evidence in relation to ATAIC treatment obtained in this systematic review studied treatments with acupuncture, sweet potato, osteopath, probiotics, and moxibustion. CONCLUSIONS The prevalence of constipation in patients undergoing antitumoral treatment is very diverse. Studies specifically designed to report the prevalence of antineoplastic treatment-induced constipation are needed. The importance of enteric neuronal integrity in gastrointestinal function was described. Thus, neuroprotection could be an area of research for the treatment of chemotherapy-induced gastrointestinal disorders.
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Affiliation(s)
- Agnès Calsina-Berna
- Palliative Care Department, School of Medicine, The University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
- Palliative Care Department, Institut Català d'Oncologia, 08908 Badalona, Spain
- Research and Knowledge Group in Palliative Care of Catalan Institute of Oncology (GRICOPAL), 08916 Badalona, Spain
| | - Jesús González-Barboteo
- Research and Knowledge Group in Palliative Care of Catalan Institute of Oncology (GRICOPAL), 08916 Badalona, Spain
- Palliative Care Department, Institut Català d'Oncologia-L'Hospitalet, 08916 Badalona, Spain
| | - Silvia Llorens-Torromé
- Research and Knowledge Group in Palliative Care of Catalan Institute of Oncology (GRICOPAL), 08916 Badalona, Spain
- Palliative Care Department, Institut Català d'Oncologia-L'Hospitalet, 08916 Badalona, Spain
| | - Joaquim Julià-Torras
- Palliative Care Department, Institut Català d'Oncologia, 08908 Badalona, Spain
- School of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
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Malacrida A, Cavalloro V, Martino E, Costa G, Ambrosio FA, Alcaro S, Rigolio R, Cassetti A, Miloso M, Collina S. Anti-Multiple Myeloma Potential of Secondary Metabolites from Hibiscus sabdariffa-Part 2. Molecules 2021; 26:molecules26216596. [PMID: 34771006 PMCID: PMC8588054 DOI: 10.3390/molecules26216596] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
Multiple Myeloma (MM) is an aggressive tumor causing millions of deaths every year and currently available therapies are often unsuccessful or correlated with severe side effects. In our previous work we demonstrated that the Hibiscus sabdariffa hydroalcoholic extract inhibits the growth of the MM cell line and we isolated two metabolites responsible for the activity: Hib-ester and Hib-carbaldehyde. Herein we report their interaction with proteasome, one of the main targets in the fight against MM. The molecular modelling study outlined a good interaction of both compounds with the target and these results prompted us to investigate their potential to inhibit proteasome. Metabolites were then isolated from the calyces and an extract with a high content of Hib-ester and Hib-carbaldehyde was prepared. An anticancer profile was drawn, evaluating apoptosis, autophagy and proteasome inhibition, with the anticancer properties being mainly attributed to the Hib-ester and Hib-carbaldehyde, while the proteasome inhibition of the extract could also be ascribed to the presence of anthocyanins, a class of secondary metabolites already known for their proteasome inhibitory activity.
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Affiliation(s)
- Alessio Malacrida
- School of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy; (A.M.); (R.R.)
- Experimental Neurology Unit, University of Milano-Bicocca, 20900 Monza, Italy
| | - Valeria Cavalloro
- Department of Earth and Environmental Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Emanuela Martino
- Department of Earth and Environmental Sciences, University of Pavia, 27100 Pavia, Italy;
- Correspondence: (E.M.); (M.M.)
| | - Giosuè Costa
- Department of Health Sciences, Campus “S. Venuta”, “Magna Græcia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (G.C.); (F.A.A.); (S.A.)
- Net4Science Academic Spin-Off, Campus “S. Venuta”, “Magna Græcia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
- Associazione CRISEA-Centro di Ricerca e Servizi Avanzati per l’Innovazione Rurale, Località Condoleo di Belcastro (CZ), 88050 Belcastro, Italy
| | - Francesca Alessandra Ambrosio
- Department of Health Sciences, Campus “S. Venuta”, “Magna Græcia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (G.C.); (F.A.A.); (S.A.)
| | - Stefano Alcaro
- Department of Health Sciences, Campus “S. Venuta”, “Magna Græcia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (G.C.); (F.A.A.); (S.A.)
- Net4Science Academic Spin-Off, Campus “S. Venuta”, “Magna Græcia” University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
- Associazione CRISEA-Centro di Ricerca e Servizi Avanzati per l’Innovazione Rurale, Località Condoleo di Belcastro (CZ), 88050 Belcastro, Italy
| | - Roberta Rigolio
- School of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy; (A.M.); (R.R.)
- Experimental Neurology Unit, University of Milano-Bicocca, 20900 Monza, Italy
| | - Arianna Cassetti
- CREA, Research Centre for Vegetable and Ornamental Crops, 18038 Sanremo, Italy;
| | - Mariarosaria Miloso
- School of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy; (A.M.); (R.R.)
- Experimental Neurology Unit, University of Milano-Bicocca, 20900 Monza, Italy
- Correspondence: (E.M.); (M.M.)
| | - Simona Collina
- Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy;
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Nabulsi NA, Alobaidi A, Talon B, Asfaw AA, Zhou J, Sharp LK, Sweiss K, Patel PR, Ko NY, Chiu BCH, Calip GS. Self-reported health and survival in older patients diagnosed with multiple myeloma. Cancer Causes Control 2020; 31:641-650. [PMID: 32356139 DOI: 10.1007/s10552-020-01305-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 04/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Patient-reported outcomes such as self-reported health (SRH) are important in understanding quality cancer care, yet little is known about links between SRH and outcomes in older patients with multiple myeloma (MM). We evaluated associations between SRH and mortality among older patients with MM. METHODS We analyzed a retrospective cohort of patients ages ≥ 65 years diagnosed with first primary MM using the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) data resource. Pre-diagnosis SRH was grouped as high (excellent/very good/good) or low (fair/poor). We used Cox proportional hazards models to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between SRH and all-cause and MM-specific mortality. RESULTS Of 521 MM patients with mean (SD) age at diagnosis of 76.8 (6.1) years, 32% reported low SRH. In multivariable analyses, low SRH was suggestive of modest increased risks of all-cause mortality (HR 1.32, 95% CI 1.02-1.71) and MM-specific mortality (HR 1.22, 95% CI 0.87-1.70) compared to high SRH. CONCLUSION Findings suggest that low pre-diagnosis SRH is highly prevalent among older patients with MM and is associated with modestly increased all-cause mortality. Additional research is needed to address quality of life and modifiable factors that may accompany poor SRH in older patients with MM.
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Affiliation(s)
- Nadia A Nabulsi
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Ali Alobaidi
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Brian Talon
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Alemseged A Asfaw
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Jifang Zhou
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA
| | - Karen Sweiss
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
| | - Pritesh R Patel
- Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Naomi Y Ko
- Section of Hematology Oncology, Boston University School of Medicine, Boston, MA, USA
| | - Brian C-H Chiu
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Gregory S Calip
- Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA. .,Division of Public Health Sciences, Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Anti-Multiple Myeloma Potential of Secondary Metabolites from Hibiscus sabdariffa. Molecules 2019; 24:molecules24132500. [PMID: 31323932 PMCID: PMC6651714 DOI: 10.3390/molecules24132500] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/04/2019] [Accepted: 07/06/2019] [Indexed: 12/15/2022] Open
Abstract
Multiple myeloma (MM) belongs to hematological cancers and its incidence is increasing worldwide. Despite recent advances in its therapy, MM still causes many deaths every year. In fact, current therapies sometimes fail and are associated with severe adverse effects, including neurotoxicity. As a part of our ongoing efforts to discover new potential therapies against MM, we prepared Hibiscus sabdariffa extracts obtained by a microwave-assisted solvent extraction and investigate their activity by in vitro assays on the RPMI-8226 cell line. The bioguided fractionation of the crude ethanolic extract allowed the identification of HsFC as the most effective extract. We assessed cell viability (MTT and Tripan blue test), cell migration (Boyden chamber assay), and neurotoxicity (DRG neurotoxicity assay). The promising results prompted us to further fractionate HsFC and we obtained two molecules effective against RPMI-8226 cells without neurotoxic effects at their active concentrations. Moreover, both compounds are able to significantly reduce cell migration.
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Mlak R, Szudy‐Szczyrek A, Mazurek M, Szczyrek M, Homa‐Mlak I, Mielnik M, Chocholska S, Jankowska‐Łęcka O, Małecka‐Massalska T, Hus M. Polymorphisms in the promotor region of theCRBNgene as a predictive factor for peripheral neuropathy in the course of thalidomide‐based chemotherapy in multiple myeloma patients. Br J Haematol 2019; 186:695-705. [DOI: 10.1111/bjh.15972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/19/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Radosław Mlak
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Aneta Szudy‐Szczyrek
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Marcin Mazurek
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Michał Szczyrek
- Department of Pneumonology, Oncology and Allergology Medical University of Lublin Lublin Poland
| | - Iwona Homa‐Mlak
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Michał Mielnik
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Sylwia Chocholska
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Olga Jankowska‐Łęcka
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | | | - Marek Hus
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
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Gay F, Larocca A. Special problems in the management of elderly patients with multiple myeloma. Eur J Intern Med 2018; 58:64-69. [PMID: 30527921 DOI: 10.1016/j.ejim.2018.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/08/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022]
Abstract
Multiple myeloma (MM) is a neoplastic disease typical of the elderly. Many steps forward have been made in the characterization of patients, and new treatment strategies are available today. Clinical trials represent a major point in the definition of standard treatment, although they usually include fit patients, while frail patients are commonly excluded. Therefore, frail patients may receive treatments that may be too toxic, thus jeopardizing the beneficial effects of therapy. A careful patient assessment is crucial to better characterize patients and consequently to appropriately select treatment. Future trials testing novel agent-based therapies in different subsets of patients will shed light on this important issue and will allow patients to receive appropriate, tailored treatments.
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Affiliation(s)
- Francesca Gay
- Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
| | - Alessandra Larocca
- Division of Hematology, University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
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7
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Kiely F, Cran A, Finnerty D, O'Brien T. Self-Reported Quality of Life and Symptom Burden in Ambulatory Patients With Multiple Myeloma on Disease-Modifying Treatment. Am J Hosp Palliat Care 2016; 34:671-676. [PMID: 27141015 DOI: 10.1177/1049909116646337] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Knowledge of health-related quality of life (QoL) of patients with multiple myeloma on disease-modifying treatments is limited. AIM (1) Determine symptom prevalence in patients with multiple myeloma on disease-modifying treatment. Identify the range and nature of these symptoms within the dimensions of physical, psychological, social, and financial well-being. (2) Measure self-reported QoL. (3) Compare the above-mentioned parameters to the general population and patients with advanced cancer. METHOD Adults with multiple myeloma on disease-modifying treatment, attending the hematology day unit in a tertiary referral center from November 2012 to January 2013, were eligible for inclusion in a cross-sectional quantitative survey. Consenting patients completed 2 validated questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented by the myeloma-specific module (EORTC QLQ-MY20) and the Hospital Anxiety Depression Score (HADS). RESULTS Forty-one patients were included for analysis: 59% were male and 41% were female. Mean age was 63.7 years (range 46-86, standard deviation 11.24). The QoL scores were significantly lower than the general population and comparable to those with advanced cancer. The most commonly reported physical symptoms were pain (66%), fatigue (63%), and dyspnea (51%). About 54% of the patients were burdened by financial worries. Anxiety (30%) and depression (37%) were prevalent. CONCLUSION Patients with myeloma on disease-modifying treatment have a lower QoL than the general population and are symptomatic across physical, psychological, financial, and social domains. A holistic approach to patient care is warranted, and patients may benefit from specialist palliative care input.
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Affiliation(s)
- Fiona Kiely
- 1 Department of Palliative Medicine, Marymount University Hospital & Hospice, Curraheen, Cork, Ireland.,2 Department of Haematology, Dunmanway Day Unit, Cork University Hospital, Cork, Ireland
| | - Alison Cran
- 1 Department of Palliative Medicine, Marymount University Hospital & Hospice, Curraheen, Cork, Ireland.,2 Department of Haematology, Dunmanway Day Unit, Cork University Hospital, Cork, Ireland
| | - Deirdre Finnerty
- 1 Department of Palliative Medicine, Marymount University Hospital & Hospice, Curraheen, Cork, Ireland.,2 Department of Haematology, Dunmanway Day Unit, Cork University Hospital, Cork, Ireland
| | - Tony O'Brien
- 1 Department of Palliative Medicine, Marymount University Hospital & Hospice, Curraheen, Cork, Ireland.,2 Department of Haematology, Dunmanway Day Unit, Cork University Hospital, Cork, Ireland
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8
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Terpos E, Kleber M, Engelhardt M, Zweegman S, Gay F, Kastritis E, van de Donk NWCJ, Bruno B, Sezer O, Broijl A, Bringhen S, Beksac M, Larocca A, Hajek R, Musto P, Johnsen HE, Morabito F, Ludwig H, Cavo M, Einsele H, Sonneveld P, Dimopoulos MA, Palumbo A. European Myeloma Network guidelines for the management of multiple myeloma-related complications. Haematologica 2016; 100:1254-66. [PMID: 26432383 DOI: 10.3324/haematol.2014.117176] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The European Myeloma Network provides recommendations for the management of the most common complications of multiple myeloma. Whole body low-dose computed tomography is more sensitive than conventional radiography in depicting osteolytic disease and thus we recommend it as the novel standard for the detection of lytic lesions in myeloma (grade 1A). Myeloma patients with adequate renal function and bone disease at diagnosis should be treated with zoledronic acid or pamidronate (grade 1A). Symptomatic patients without lytic lesions on conventional radiography can be treated with zoledronic acid (grade 1B), but its advantage is not clear for patients with no bone involvement on computed tomography or magnetic resonance imaging. In asymptomatic myeloma, bisphosphonates are not recommended (grade 1A). Zoledronic acid should be given continuously, but it is not clear if patients who achieve at least a very good partial response benefit from its continuous use (grade 1B). Treatment with erythropoietic-stimulating agents may be initiated in patients with persistent symptomatic anemia (hemoglobin <10g/dL) in whom other causes of anemia have been excluded (grade 1B). Erythropoietic agents should be stopped after 6-8 weeks if no adequate hemoglobin response is achieved. For renal impairment, bortezomib-based regimens are the current standard of care (grade 1A). For the management of treatment-induced peripheral neuropathy, drug modification is needed (grade 1C). Vaccination against influenza is recommended; vaccination against streptococcus pneumonia and hemophilus influenza is appropriate, but efficacy is not guaranteed due to suboptimal immune response (grade 1C). Prophylactic aciclovir (or valacyclovir) is recommended for patients receiving proteasome inhibitors, autologous or allogeneic transplantation (grade 1A).
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Affiliation(s)
- Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Greece
| | - Martina Kleber
- Department of Hematology and Oncology, University of Freiburg Medical Center, Germany Clinic for Internal Medicine, University Hospital Basel, Switzerland
| | - Monika Engelhardt
- Department of Hematology and Oncology, University of Freiburg Medical Center, Germany
| | - Sonja Zweegman
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Francesca Gay
- Division of Hematology, S. Giovanni Battista Hospital, University of Turin, Italy
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Greece
| | | | - Benedetto Bruno
- Division of Hematology, S. Giovanni Battista Hospital, University of Turin, Italy
| | - Orhan Sezer
- Department of Hematology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Annemiek Broijl
- Department of Hematology, Erasmus University Medical Center Rotterdam, the Netherlands
| | - Sara Bringhen
- Division of Hematology, S. Giovanni Battista Hospital, University of Turin, Italy
| | - Meral Beksac
- Department of Hematology, Ankara University, Turkey
| | - Alessandra Larocca
- Division of Hematology, S. Giovanni Battista Hospital, University of Turin, Italy
| | - Roman Hajek
- Department of Hemato-Oncology, University Hospital Ostrava and Faculty of Medicine OU, Ostrava, Czech Republic
| | - Pellegrino Musto
- Centro di Riferimento Oncologico della Basilicata, Istituto di Ricovero e Cura a Carattere Scientifico, Rionero in Vulture, Italy
| | | | - Fortunato Morabito
- Department of Hematology, Azienda Ospedaliera dell'Annunziata, Cosenza, Italy
| | - Heinz Ludwig
- Department of Medicine I, Center of Oncology, Hematology and Palliative Care, Wilhelminenspital, Vienna, Austria
| | - Michele Cavo
- "Seràgnoli" Institute of Hematology and Medical Oncology, University of Bologna, Italy
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würburg, Würzburg, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus University Medical Center Rotterdam, the Netherlands
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Greece
| | - Antonio Palumbo
- Division of Hematology, S. Giovanni Battista Hospital, University of Turin, Italy
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9
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[Lenalidomide nephrotoxicity]. Bull Cancer 2016; 103:499-506. [PMID: 26927826 DOI: 10.1016/j.bulcan.2016.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 01/23/2016] [Accepted: 01/25/2016] [Indexed: 12/22/2022]
Abstract
The introduction of lenalidomide into the therapeutic arsenal of hematologic malignancies has represented an important step forward in the management of multiple myeloma. However, its use is associated with several toxicities including kidney injury. The present review examines the drug's pharmacokinetics, discusses the main adverse renal effects that are associated with lenalidomide treatment, and makes recommendations for dosage adjustment in patients with underlying renal impairment.
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10
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Olivier-Abbal P, Teisseyre AC, Montastruc JL. Comparison of serious adverse reactions between thalidomide and lenalidomide: analysis in the French Pharmacovigilance database. Med Oncol 2013; 30:733. [DOI: 10.1007/s12032-013-0733-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/21/2013] [Indexed: 01/18/2023]
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Seki JT, Banglawala S, Lentz EM, Reece DE. Desensitization to Lenalidomide in a Patient With Relapsed Multiple Myeloma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:162-5. [DOI: 10.1016/j.clml.2012.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/05/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
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12
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Jakubowiak A. Management strategies for relapsed/refractory multiple myeloma: current clinical perspectives. Semin Hematol 2012; 49 Suppl 1:S16-32. [PMID: 22727389 DOI: 10.1053/j.seminhematol.2012.05.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In the last decade, the introduction of novel agents including the immunomodulatory drugs thalidomide and lenalidomide, and the first-in-class proteasome inhibitor bortezomib, has dramatically improved clinical outcome in patients with relapsed/refractory multiple myeloma (MM) compared to conventional chemotherapy alone. Although combination treatment approaches with traditional cytotoxic agents and novel agents have led to response rates as high as 85% in patients with relapsed/refractory disease, not all patients will respond to established novel agents, and even those who do respond will ultimately relapse or become refractory to currently available regimens. There is no generally accepted standard treatment for patients with relapsed/refractory disease; however, both disease-related (eg, quality and duration of response to previous therapies and the aggressiveness of the relapse) and patient-related (eg, preexisting toxicities, comorbid conditions, quality of life, age, and performance status) factors should be considered when selecting the best treatment option. This article will review up-to-date approaches for managing patients with relapsed/refractory MM, including the efficacy and safety of established novel agents, the use of adjunctive/supportive care, and strategies for tailored treatment.
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13
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Rushworth GF, Leslie SJ, Forsyth P, Vincent C. Evidence-based case report: multiple thrombotic episodes associated with lenalidomide and dexamethasone therapy for multiple myeloma. Ther Adv Drug Saf 2012; 3:115-22. [PMID: 25083230 DOI: 10.1177/2042098611433773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Lenalidomide in combination with dexamethasone is a treatment for patients with relapsed or refractory myeloma. Although this combination demonstrates a high level of efficacy, it further exacerbates the hypercoaguable state that exists within myeloma. Thromboprophylactic regimen require careful selection and if warfarin is chosen, assiduous monitoring is required to ensure it will be clinically effective. We report the case of one patient who experienced multiple thrombotic events despite anticoagulant or antiplatelet thromboprophylaxis and review the contributing factors.
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Affiliation(s)
- Gordon F Rushworth
- Advanced Pharmacist Clinical Research, Highland Clinical Research Facility, Centre for Health Science, Old Perth Road, Inverness IV2 3JH, UK
| | - Stephen J Leslie
- NHS Highland, Raigmore Hospital, and University of Stirling, Inverness, UK
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Berenson JR, Yellin O, Kazamel T, Hilger JD, Chen CS, Cartmell A, Woliver T, Flam M, Bravin E, Nassir Y, Vescio R, Swift RA. A phase 2 study of pegylated liposomal doxorubicin, bortezomib, dexamethasone and lenalidomide for patients with relapsed/refractory multiple myeloma. Leukemia 2012; 26:1675-80. [DOI: 10.1038/leu.2012.51] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Berenson JR, Yellin O, Chen CS, Patel R, Bessudo A, Boccia RV, Yang HH, Vescio R, Yung E, Mapes R, Eades B, Hilger JD, Wirtschafter E, Hilger J, Nassir Y, Swift RA. A modified regimen of pegylated liposomal doxorubicin, bortezomib and dexamethasone (DVD) is effective and well tolerated for previously untreated multiple myeloma patients. Br J Haematol 2011; 155:580-7. [DOI: 10.1111/j.1365-2141.2011.08884.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lee JC, Ahn KS, Jeong SJ, Jung JH, Kwon TR, Rhee YH, Kim SH, Kim SY, Yoon HJ, Zhu S, Chen CY, Kim SH. Signal transducer and activator of transcription 3 pathway mediates genipin-induced apoptosis in U266 multiple myeloma cells. J Cell Biochem 2011; 112:1552-62. [PMID: 21344490 DOI: 10.1002/jcb.23077] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
It has drawn a lot of attention to target signal transducer and activator of transcription 3 (STAT3) as a potential strategy for cancer therapeutics. Using several myelogenous cell lines, the effect of genipin (an active compound of Gardenia fruit) on the STAT3 pathway and apoptosis was investigated. Genipin suppressed the constitutive STAT3 activation in U266 and U937 cells and stimulated Src homology 2 domain-containing phosphatase 1 (SHP-1), which dephosphorylates and inactivates STAT3. Specifically, genipin blocked STAT3 activation via repressing the activation of c-Src, but not Janus kinase 1 (JAK1). Genipin also downregulated the expression of STAT3 target genes including Bcl-2, Bcl-x(L) , Survivin, Cyclin D1, and VEGF. Conversely, protein tyrosine phosphatase inhibitor pervanadate blocked genipin induced STAT3 inactivation. Using DNA fragmentation or TUNEL assays, we demonstrated the apoptotic effect of genipin on U266, MM.1S, and U937 cells. Furthermore, genipin effectively potentiated the cytotoxic effect of chemotherapeutic agents, such as bortezomib, thalidomide, and paclitaxel in U266 cells. Our data suggest that through regulation of Src and SHP-1, genipin antagonizes STAT3 for the induction of apoptosis in myeloma cells.
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Affiliation(s)
- Jang Choon Lee
- College of Oriental Medicine, Kyung Hee University, Seoul 130-701, Republic of Korea
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Management of the adverse effects of lenalidomide in multiple myeloma. Adv Ther 2011; 28 Suppl 1:1-10. [PMID: 21431626 DOI: 10.1007/s12325-010-0104-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Indexed: 10/18/2022]
Abstract
The introduction of new agents in the treatment of multiple myeloma, such as thalidomide, bortezomib, or lenalidomide, has represented an important step forward in the management of this disease, with improvement in both treatment response and patient survival. On the other hand, when new drugs are used it is very important to know their associated toxicity, since adequate management of the adverse effects can help to avoid unnecessary treatment interruptions - thereby undoubtedly contributing to improvement in the efficacy of therapy. The present study reviews the main hematological and nonhematological adverse effects potentially associated with the use of lenalidomide in its most common combinations used for the treatment of multiple myeloma, and the recommendations for dealing with such effects.
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