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Ma C, Zhao J, Zheng G, Wu S, Wu R, Yu D, Liao J, Zhang H, Liu L, Jiang L, Qian F, Zeng H, Wu G, Lu Z, Ye J, Zhang W. Qijiao Shengbai Capsule alleviated leukopenia by interfering leukotriene pathway: Integrated network study of multi-omics. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 128:155424. [PMID: 38537441 DOI: 10.1016/j.phymed.2024.155424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Leukopenia could be induced by chemotherapy, which leads to bone marrow suppression and even affects the therapeutic progression of cancer. Qijiao Shengbai Capsule (QSC) has been used for the treatment of leukopenia in clinic, but its bioactive components and mechanisms have not yet been elucidated clearly. PURPOSE This study aimed to elucidate the molecular mechanisms of QSC in treating leukopenia. STUDY DESIGN Serum pharmacochemistry, multi-omics, network pharmacology, and validation experiment were combined to study the effect of QSC in murine leukopenia model. METHODS First, UPLC-QTOF-MS was used to clarify the absorbed components of QSC. Then, cyclophosphamide (CTX) was used to induce mice model with leukopenia, and the therapeutic efficacy of QSC was assessed by an integrative approach of multi-omics and network pharmacology strategy. Finally, molecular mechanisms and potential therapeutic targets were identified by validated experiments. RESULTS 121 compounds absorbed in vivo were identified. QSC significantly increase the count of white blood cells (WBCs) in peripheral blood of leukopenia mice with 15 days treatment. Multi-omics and network pharmacology revealed that leukotriene pathway and MAPK signaling pathway played crucial roles during the treatment of leukopenia with QSC. Six targets (ALOX5, LTB4R, CYSLTR1, FOS, JUN, IL-1β) and 13 prototype compounds were supposed to be the key targets and potential active components, respectively. The validation experiment further confirmed that QSC could effectively inhibit the inflammatory response induced by leukopenia. The inhibitors of ALOX5 activity can significantly increase the number of WBCs in leukopenia mice. Molecular docking of ALOX5 suggested that calycosin, daidzein, and medicarpin were the potentially active compounds of QSC. CONCLUSION Leukotriene pathway was found for the first time to be a key role in the development of leukopenia, and ALOX5 was conformed as the potential target. QSC may inhibit the inflammatory response and interfere the leukotriene pathway, it is able to improve hematopoiesis and achieve therapeutic effects in the mice with leukopenia.
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Affiliation(s)
- Chi Ma
- Institute of Respiratory Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jing Zhao
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Guangyong Zheng
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Shiyu Wu
- School of Pharmacy, Fujian University of Traditional Chinese Medicine, Fujian, 350122, China
| | - Ruijun Wu
- School of Pharmacy, Naval Medical University, Shanghai 200433, China
| | - Dianping Yu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jingyu Liao
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Hongwei Zhang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Li Liu
- Guizhou Hanfang Pharmaceutical Co., Ltd., Guizhou, 550014, China
| | - Lu Jiang
- Guizhou Hanfang Pharmaceutical Co., Ltd., Guizhou, 550014, China
| | - Fei Qian
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Huawu Zeng
- School of Pharmacy, Naval Medical University, Shanghai 200433, China
| | - Gaosong Wu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Zhenhui Lu
- Institute of Respiratory Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Ji Ye
- School of Pharmacy, Naval Medical University, Shanghai 200433, China.
| | - Weidong Zhang
- School of Pharmacy, Naval Medical University, Shanghai 200433, China; Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China; School of Pharmacy, Fujian University of Traditional Chinese Medicine, Fujian, 350122, China.
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Crawford J, Herndon D, Gmitter K, Weiss J. The impact of myelosuppression on quality of life of patients treated with chemotherapy. Future Oncol 2024:1-16. [PMID: 38587388 DOI: 10.2217/fon-2023-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/21/2024] [Indexed: 04/09/2024] Open
Abstract
Side effects from chemotherapy-induced myelosuppression can negatively affect patients' quality of life (QoL). Neutropenia increases infection risk, and anemia frequently results in debilitating fatigue. Additionally, the bleeding risk associated with thrombocytopenia can lead to fear and anxiety. However, traditional interventions for myelosuppression fall short of the ideal. Granulocyte colony-stimulating factors reduce the risk of severe neutropenia but commonly lead to bone pain. Erythropoiesis-stimulating agents are not always effective and may cause thromboembolic events, while transfusions to correct anemia/thrombocytopenia are associated with transfusion reactions and volume overload. Trilaciclib, which is approved for reducing myelosuppression in patients with extensive-stage small cell lung cancer, together with several investigational agents in development for managing myelosuppression have the potential to improve QoL for patients on chemotherapy.
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Affiliation(s)
| | - Dana Herndon
- Cone Health Cancer Center, Greensboro, NC 27403, USA
| | | | - Jared Weiss
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
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Suprien C, Guimarães LH, de Carvalho LP, Machado PRL. Pentavalent Antimony Associated with G-CSF in the Treatment of Cutaneous Leishmaniasis Caused by Leishmania (Viannia) braziliensis. Pathogens 2024; 13:301. [PMID: 38668256 PMCID: PMC11054058 DOI: 10.3390/pathogens13040301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/29/2024] Open
Abstract
Cutaneous leishmaniasis (CL), caused by Leishmania braziliensis, in recent decades has shown decreasing cure rates after treatment with meglumine antimoniate (MA). Granulocyte colony-stimulating factor (G-CSF) is a cytokine associated with epithelialization and healing processes. METHODS This study compares the effectiveness of G-CSF associated with MA in the treatment of CL. A total of 32 patients aged between 18 and 50 years with CL confirmed for L. braziliensis were included in this study. G-CSF or placebo (0.9% saline) was applied by intralesional infiltration at four equidistant points on the edges of the largest ulcer on days 0 and 15 of treatment associated with intravenous MA. RESULTS Males predominated in the G-CSF group (59%), while females predominated in the control group (53%). Injuries to the lower limbs predominated in both study groups. The cure rate in the G-CSF group was 65% and in the control group it was 47%, 90 days after initiation of therapy. CONCLUSIONS Our data indicate that the association of G-CSF with MA is not superior to MA monotherapy. Although not significant, the potential benefit of this combination deserves further investigation. The use of higher doses or other routes of application of G-CSF in a greater number of patients should contribute to a definitive response.
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Affiliation(s)
- Carvel Suprien
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Bahia, Salvador 40026-010, Bahia, Brazil; (C.S.); (L.P.d.C.)
| | - Luiz H. Guimarães
- National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Bahia, Brazil;
- Medicine School, Federal University of Recôncavo Bahia, Santo Antônio de Jesus 44380-000, Bahia, Brazil
| | - Lucas P. de Carvalho
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Bahia, Salvador 40026-010, Bahia, Brazil; (C.S.); (L.P.d.C.)
- National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Bahia, Brazil;
- Immunology Service of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
- Gonçalo Moniz Institute, Fiocruz, Salvador 40296-710, Bahia, Brazil
| | - Paulo R. L. Machado
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Bahia, Salvador 40026-010, Bahia, Brazil; (C.S.); (L.P.d.C.)
- National Institutes of Science and Technology in Tropical Diseases, Ministry of Science and Technology, Salvador, Bahia, Brazil;
- Immunology Service of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
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Rehlinghaus M, Rehker P, Che Y, Grunewald CM, Niegisch G. [Neutropenia - when is GCSF support indicated?]. Aktuelle Urol 2024; 55:38-43. [PMID: 37607583 DOI: 10.1055/a-2128-4965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Many systemic treatments used in genitourinary oncology negatively affect haematopoiesis, thus leading to neutropenia. Neutropenic patients are vulnerable to bacterial, and other infections. Often fever is the only symptom in these patients. Neutropenic fever is a major threat for these patients, as it may lead to life-threatening therapy complications that significantly impair the patient's quality of life, Moreover, it may also worsen the prognosis due to therapy delays or necessary dose modifications. Granulocyte colony stimulating factors (GCSF), which can improve neutrophil granulocyte formation, are used both for supportive treatment in febrile neutropenia and for its prophylaxis. The correct indication for such GCSF support depends on the general risk of febrile neutropenia of the therapy used, as well as on individual patient factors and the treatment intent (palliative vs. curative). Based on the current recommendations both of the German and international guidelines, this article aims to provide an up-to-date and practice-oriented overview of the use of GCSF in uro-oncology.
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Affiliation(s)
- Marc Rehlinghaus
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Philipp Rehker
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Yue Che
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Camilla Marisa Grunewald
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
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Russler-Germain DA, Cliff ERS, Bartlett NL. Cell-of-origin effect of polatuzumab vedotin in diffuse large B-cell lymphoma: no ordinary subgroup analysis. Blood 2023; 142:2216-2219. [PMID: 37797275 DOI: 10.1182/blood.2023022048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023] Open
Abstract
ABSTRACT Subgroup analysis from the POLARIX trial of polatuzumab vedotin plus chemotherapy for untreated large B-cell lymphoma suggests greater efficacy among patients with activated B-cell subtype disease. Both preclinical and additional clinical evidence support this interaction between cell-of-origin and polatuzumab efficacy.
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Affiliation(s)
- David A Russler-Germain
- Division of Oncology, Washington University School of Medicine, St. Louis, MO
- Siteman Cancer Center, St. Louis, MO
| | - Edward R Scheffer Cliff
- Program on Regulation, Therapeutics and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Nancy L Bartlett
- Division of Oncology, Washington University School of Medicine, St. Louis, MO
- Siteman Cancer Center, St. Louis, MO
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Aapro MS, Chaplin S, Cornes P, Howe S, Link H, Koptelova N, Mehl A, Di Palma M, Schroader BK, Terkola R. Cost-effectiveness of granulocyte colony-stimulating factors (G-CSFs) for the prevention of febrile neutropenia (FN) in patients with cancer. Support Care Cancer 2023; 31:581. [PMID: 37728795 PMCID: PMC10511548 DOI: 10.1007/s00520-023-08043-4] [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: 01/30/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Clinical practice guidelines recommend the use of all approved granulocyte colony-stimulating factors (G-CSFs), including filgrastim and pegfilgrastim, as primary febrile neutropenia (FN) prophylaxis in patients receiving high- or intermediate-risk regimens (in those with additional patient risk factors). Previous studies have examined G-CSF cost-effectiveness by cancer type in patients with a high baseline risk of FN. This study evaluated patients with breast cancer (BC), non-small cell lung cancer (NSCLC), or non-Hodgkin's lymphoma (NHL) receiving therapy who were at intermediate risk for FN and compared primary prophylaxis (PP) and secondary prophylaxis (SP) using biosimilar filgrastim or biosimilar pegfilgrastim in Austria, France, and Germany. METHODS A Markov cycle tree-based model was constructed to evaluate PP versus SP in patients with BC, NSCLC, or NHL receiving therapy over a lifetime horizon. Cost-effectiveness was evaluated over a range of willingness-to-pay (WTP) thresholds for incremental cost per quality-adjusted life year (QALY) gained. Sensitivity analyses evaluated uncertainty. RESULTS Results demonstrated that using biosimilar filgrastim as PP compared to SP resulted in incremental cost-effectiveness ratios (ICERs) well below the most commonly accepted WTP threshold of €30,000. Across all three countries, PP in NSCLC had the lowest cost per QALY, and in France, PP was both cheaper and more effective than SP. Similar results were found using biosimilar pegfilgrastim, with ICERs generally higher than those for filgrastim. CONCLUSIONS Biosimilar filgrastim and pegfilgrastim as primary prophylaxis are cost-effective approaches to avoid FN events in patients with BC, NSCLC, or NHL at intermediate risk for FN in Austria, France, and Germany.
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Affiliation(s)
| | | | | | - Sebastian Howe
- Sandoz International GmbH, Industriestr. 18, D-83607, Holzkirchen, Germany.
| | - Hartmut Link
- Private Practice Hematology Oncology Kaiserslautern, Kaiserslautern, Germany
| | - Natalia Koptelova
- Sandoz International GmbH, Industriestr. 18, D-83607, Holzkirchen, Germany
| | - Andrea Mehl
- Sandoz International GmbH, Industriestr. 18, D-83607, Holzkirchen, Germany
| | - Mario Di Palma
- Gustave Roussy, Paris-Saclay University, Villejuif, France
| | | | - Robert Terkola
- University Medical Center, Groningen, The Netherlands
- Paracelsus Medical University, Salzburg, Austria
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Aix SP, Ciuleanu TE, Navarro A, Cousin S, Bonanno L, Smit EF, Chiappori A, Olmedo ME, Horvath I, Grohé C, Farago AF, López-Vilariño JA, Cullell-Young M, Nieto A, Vasco N, Gómez J, Kahatt C, Zeaiter A, Carcereny E, Roubec J, Syrigos K, Lo G, Barneto I, Pope A, Sánchez A, Kattan J, Zarogoulidis K, Waller CF, Bischoff H, Juan-Vidal O, Reinmuth N, Dómine M, Paz-Ares L. Combination lurbinectedin and doxorubicin versus physician's choice of chemotherapy in patients with relapsed small-cell lung cancer (ATLANTIS): a multicentre, randomised, open-label, phase 3 trial. THE LANCET. RESPIRATORY MEDICINE 2023; 11:74-86. [PMID: 36252599 DOI: 10.1016/s2213-2600(22)00309-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lurbinectedin is a synthetic marine-derived anticancer agent that acts as a selective inhibitor of oncogenic transcription. Lurbinectedin monotherapy (3·2 mg/m2 every 3 weeks) received accelerated approval from the US Food and Drug Administration on the basis of efficacy in patients with small-cell lung cancer (SCLC) who relapsed after first-line platinum-based chemotherapy. The ATLANTIS trial assessed the efficacy and safety of combination lurbinectedin and the anthracycline doxorubicin as second-line treatment for SCLC. METHODS In this phase 3, open-label, randomised study, adult patients aged 18 years or older with SCLC who relapsed after platinum-based chemotherapy were recruited from 135 hospitals across North America, South America, Europe, and the Middle East. Patients were randomly assigned (1:1) centrally by dynamic allocation to intravenous lurbinectedin 2·0 mg/m2 plus doxorubicin 40·0 mg/m2 administered on day 1 of 21-day cycles or physician's choice of control therapy (intravenous topotecan 1·5 mg/m2 on days 1-5 of 21-day cycles; or intravenous cyclophosphamide 1000 mg/m2, doxorubicin 45·0 mg/m2, and vincristine 2·0 mg on day 1 of 21-day cycles [CAV]) administered until disease progression or unacceptable toxicity. Primary granulocyte-colony stimulating factor prophylaxis was mandatory in both treatment groups. Neither patients nor clinicians were masked to treatment allocation, but the independent review committee, which assessed outcomes, was masked to patients' treatment allocation. The primary endpoint was overall survival in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02566993, and with EudraCT, 2015-001641-89, and is complete. FINDINGS Between Aug 30, 2016, and Aug 20, 2018, 613 patients were randomly assigned to lurbinectedin plus doxorubicin (n=307) or control (topotecan, n=127; CAV, n=179) and comprised the intention-to-treat population; safety endpoints were assessed in patients who had received any partial or complete study treatment infusions (lurbinectedin plus doxorubicin, n=303; control, n=289). After a median follow-up of 24·1 months (95% CI 21·7-26·3), 303 patients in the lurbinectedin plus doxorubicin group and 289 patients in the control group had discontinued study treatment; progressive disease was the most common reason for discontinuation (213 [70%] patients in the lurbinectedin plus doxorubicin group vs 152 [53%] in the control group). Median overall survival was 8·6 months (95% CI 7·1-9·4) in the lurbinectedin plus doxorubicin group versus 7·6 months (6·6-8·2) in the control group (stratified log-rank p=0·90; hazard ratio 0·97 [95% CI 0·82-1·15], p=0·70). 12 patients died because of treatment-related adverse events: two (<1%) of 303 in the lurbinectedin plus doxorubicin group and ten (3%) of 289 in the control group. 296 (98%) of 303 patients in the lurbinectedin plus doxorubicin group had treatment-emergent adverse events compared with 284 (98%) of 289 patients in the control group; treatment-related adverse events occurred in 268 (88%) patients in the lurbinectedin plus doxorubicin group and 266 (92%) patients in the control group. Grade 3 or worse haematological adverse events were less frequent in the lurbinectedin plus doxorubicin group than the control group (anaemia, 57 [19%] of 302 patients in the lurbinectedin plus doxorubicin group vs 110 [38%] of 288 in the control group; neutropenia, 112 [37%] vs 200 [69%]; thrombocytopenia, 42 [14%] vs 90 [31%]). The frequency of treatment-related adverse events leading to treatment discontinuation was lower in the lurbinectedin plus doxorubicin group than in the control group (26 [9%] of 303 patients in the lurbinectedin plus doxorubicin group vs 47 [16%] of 289 in the control group). INTERPRETATION Combination therapy with lurbinectedin plus doxorubicin did not improve overall survival versus control in patients with relapsed SCLC. However, lurbinectedin plus doxorubicin showed a favourable haematological safety profile compared with control. FUNDING PharmaMar.
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Affiliation(s)
- Santiago Ponce Aix
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Tudor Eliade Ciuleanu
- Department of Oncology, Institutul Oncologic Prof Dr Ion Chiricuta, Cluj-Napoca, Romania
| | - Alejandro Navarro
- Medical Oncology Department, Vall d'Hebron University Hospital & Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Sophie Cousin
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Laura Bonanno
- Medical Oncology 2, Istituto Oncologico Veneto, Padova, Italy
| | - Egbert F Smit
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Alberto Chiappori
- Department of Thoracic Oncology, H Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | | | - Ildiko Horvath
- National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - Christian Grohé
- Department of Respiratory Diseases, Evangelische Lungenklinik Berlin, Berlin, Germany
| | - Anna F Farago
- Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | | | | | | | | | | | | | | | - Enric Carcereny
- Badalona-Applied Research Group in Oncology (B-ARGO) and Medical Oncology Department, Catalan Institute of Oncology Badalona, Germans Trias i Pujol Hospital, Barcelona, Spain
| | - Jaromir Roubec
- Nemocnice AGEL Ostrava-Vítkovice, Ostrava-Vítkovice, Czech Republic
| | | | - Gregory Lo
- R S McLaughlin Durham Regional Cancer Centre, Lakeridge Health, Oshawa, ON, Canada
| | | | - Anthony Pope
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | | | - Joseph Kattan
- Hotel-Dieu de France University Hospital, Saint Joseph University, Beirut, Lebanon
| | | | | | - Helge Bischoff
- Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Oscar Juan-Vidal
- Department of Medical Oncology, Hospital Universitario La Fe, Valencia, Spain
| | | | - Manuel Dómine
- Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Luis Paz-Ares
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain; CNIO-H12o Lung Cancer Clinical Research Unit, Madrid, Spain; Ciberonc, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
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9
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Blayney DW, Schwartzberg L. Chemotherapy-Induced Neutropenia and Emerging Agents for Prevention and Treatment: A Review. Cancer Treat Rev 2022; 109:102427. [DOI: 10.1016/j.ctrv.2022.102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 11/02/2022]
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Sun X, Guo S. Effectiveness of cell- and colony stimulating factor-based therapy for liver cirrhosis: a network meta-analysis of randomized controlled trials. Cytotherapy 2022; 24:516-525. [PMID: 35227600 DOI: 10.1016/j.jcyt.2021.11.006] [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: 07/16/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AIMS Cirrhosis is the 11th leading cause of death worldwide. Because of the limitations of liver transplantation, cell- and granulocyte colony-stimulating factor (G-CSF)-based therapies are considered potential treatment methods. This work analyzes the effectiveness of cell- and G-CSF-based therapies by network meta-analysis. METHODS A literature search was performed in four databases from inception to September 10, 2021. Registered randomized controlled trials (RCTs) evaluating cell-based therapies and/or G-CSF-based therapies for cirrhosis patients were included. Traditional and network meta-analyses were analyzed in terms of survival, model for end-stage liver disease (MELD) score, Child-Turcotte-Pugh (CTP) score, alanine aminotransferase levels and aspartate aminotransferase levels. RESULTS Twenty-four studies were included in this analysis. The results showed that G-CSF-based therapies (odds ratio [OR], 2.38, 95% confidence interval [CI], 1.49-3.79, P < 0.01) and cell-based therapies (OR, 1.54, 95% CI, 1.00-2.40, P = 0.048) improved the transplantation-free survival rate compared with standard medical treatment. Network analysis results showed that G-CSF combined with erythropoietin (EPO) and growth hormone (GH) had a therapeutic advantage, and cell-based therapy with mononuclear cell (MNC) hepatic artery injection and intravenous mesenchymal stem cells (MSCs) combined with G-CSF also had a relative advantage in terms of survival outcome. For the MELD score, G-CSF plus GH and MSC portal vein injection had relative advantages. G-CSF plus GH and G-CSF plus EPO had advantages in terms of CTP scores. The included strategies demonstrated no obvious improvement in liver injury indicators. CONCLUSIONS Cell-based therapy has potential therapeutic effects for liver cirrhosis. Among cell-based therapies, intravenous MSCs and hepatic artery injection of MNCs have advantageous therapeutic effects. The use of G-CSF was also noted in regimens that improved survival outcomes. However, more well-designed, large-scale RCTs are needed to confirm this conclusion.
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Affiliation(s)
- Xiaojun Sun
- Inpatients Department, Nanjing Qi-xia Xi-gang Community Health Service Centers, Nanjing, China
| | - Shilei Guo
- Research and Development Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, China.
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Cho KS, Jang WY, Park JE. Treatment Experience for a Child with Ewing Sarcoma who Refused to Receive Blood Transfusions for Religious Reasons as a Jehovah’s Witness. CLINICAL PEDIATRIC HEMATOLOGY-ONCOLOGY 2022. [DOI: 10.15264/cpho.2022.29.1.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kyu Sik Cho
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Woo Young Jang
- Department of Orthopedic Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jun Eun Park
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
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van Laar SA, Gombert-Handoko KB, Wassenaar S, Kroep JR, Guchelaar HJ, Zwaveling J. Real-world evaluation of supportive care using an electronic health record text-mining tool: G-CSF use in breast cancer patients. Support Care Cancer 2022; 30:9181-9189. [PMID: 36044088 PMCID: PMC9633501 DOI: 10.1007/s00520-022-07343-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/24/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Chemotherapy-induced febrile neutropenia (FN) is a life-threatening and chemotherapy dose-limiting adverse event. FN can be prevented with granulocyte-colony stimulating factors (G-CSFs). Guidelines recommend primary G-CSF use for patients receiving either high (> 20%) FN risk (HR) chemotherapy, or intermediate (10-20%) FN risk (IR) chemotherapy if the overall risk with additional patient-related risk factors exceeds 20%. In this study, we applied an EHR text-mining tool for real-world G-CSF treatment evaluation in breast cancer patients. METHODS Breast cancer patients receiving IR or HR chemotherapy treatments between January 2015 and February 2021 at LUMC, the Netherlands, were included. We retrospectively collected data from EHR with a text-mining tool and assessed G-CSF use, risk factors, and the FN and neutropenia (grades 3-4) and incidence. RESULTS A total of 190 female patients were included, who received 77 HR and 113 IR treatments. In 88.3% of the HR regimens, G-CSF was administered; 7.3% of these patients developed FN vs. 33.3% without G-CSF. Although most IR regimen patients had ≥ 2 risk factors, only 4% received G-CSF, of which none developed neutropenia. However, without G-CSF, 11.9% developed FN and 31.2% severe neutropenia. CONCLUSIONS Our text-mining study shows high G-CSF use among HR regimen patients, and low use among IR regimen patients, although most had ≥ 2 risk factors. Therefore, current practice is not completely in accordance with the guidelines. This shows the need for increased awareness and clarity regarding risk factors. Also, text-mining can effectively be implemented for the evaluation of patient care.
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Affiliation(s)
- Sylvia A. van Laar
- grid.10419.3d0000000089452978Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Kim B. Gombert-Handoko
- grid.10419.3d0000000089452978Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Sophie Wassenaar
- grid.10419.3d0000000089452978Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Judith R. Kroep
- grid.10419.3d0000000089452978Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- grid.10419.3d0000000089452978Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Juliette Zwaveling
- grid.10419.3d0000000089452978Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
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13
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Lapidari P, Gbenou A, Havas J, Martin E, Pistilli B, Martin AL, Everhard S, Coutant C, Cottu P, Lesur A, Lerebours F, Tredan O, Vanlemmens L, Jouannaud C, Levy C, Rigal O, Fournier M, Andre F, Vaz-Luis I, Di Meglio A. Long-term patient reported outcomes and hematologic toxicity among patients who received Granulocyte-Colony Stimulating Factors during chemotherapy for early breast cancer. Breast 2021; 57:43-48. [PMID: 33711699 PMCID: PMC7970125 DOI: 10.1016/j.breast.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 11/12/2022] Open
Abstract
We assessed long-term associations of Granulocyte-Colony Stimulating Factors (G-CSF) use with patient-reported outcomes (PROs) and hematologic toxicity among chemotherapy-treated, early-stage breast cancer patients in CANTO (NCT01993498). Among 2920 patients longitudinally followed-up until year-4 after diagnosis, 49% used G-CSF. In multivariable-adjusted mixed-models, EORTC QLQ-C30 pain and summary score were not substantially different between groups (overall adjusted mean difference, use vs no-use [95%CI]: +1.27 [-0.33 to +2.87] and -1.01 [-1.98 to -0.04], respectively). PROs were slightly worse at year-4 among patients receiving G-CSF, although differences were of trivial clinical significance. No major differences were observed in leukocyte or platelet count over time.
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Affiliation(s)
- Pietro Lapidari
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France; Univesità Degli Studi di Pavia, Pavia, Italy
| | - Arnauld Gbenou
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | - Julie Havas
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | - Elise Martin
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | - Barbara Pistilli
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | | | | | | | | | - Anne Lesur
- Centre Alexis Vautrin, Vandoeuvre Les Nancy, France
| | | | | | | | | | | | | | | | - Fabrice Andre
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France
| | - Antonio Di Meglio
- INSERM Unit 981 - Molecular predictors and new targets in oncology, Gustave Roussy, Villejuif, France.
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