Epigenomics in respiratory epithelium carcinogenesis: prevention and therapeutic challenges

Variability of voriconazole concentrations in patients with hematopoietic stem cell transplantation and hematological malignancies: influence of loading dose, procalcitonin, and pregnane X receptor polymorphisms

AIMS

Voriconazole (VCZ) displays highly variable pharmacokinetics affecting treatment efficacy and safety. We aimed to identify the factors affecting VCZ steady-state trough concentration (Cssmin) to provide evidence for optimizing VCZ treatment regimens.

METHODS

A total of 510 Cssmin of 172 patients with hematopoietic stem cell transplantation and hematologic malignancies and their clinical characteristics and genotypes of FMO, POR, and PXR were included in this study.

RESULTS

In univariate analysis, the standard loading dose of VCZ significantly increased the Cssmin of VCZ (P < 0.001). The Cssmin of VCZ was significantly correlated with patients' total bilirubin (TB) (P < 0.001) and procalcitonin (PCT) (P < 0.001). FMO3 rs2266780 (P = 0.025), POR rs10954732 (P = 0.015), PXR rs2461817 (P = 0.010), PXR rs7643645 (P = 0.003), PXR rs3732359 (P = 0.014), PXR rs3814057 (P = 0.005), and PXR rs6785049 (P = 0.013) have a significant effect on Cssmin of VCZ. Loading dose, TB, PCT level, and PXRrs3814057 polymorphism were independent influencing factors of VCZ Cssmin in the analysis of multivariate linear regression. And loading dose, PCT, and PXR rs3814057 had significant effects on the probability of the therapeutic window of VCZ.

CONCLUSION

The high variability of VCZ Cssmin may be partially explained by loading dose, liver function, inflammation, and PXR polymorphisms. This study suggests the VCZ standard loading dose regimen significantly increased Cssmin and probability of the therapeutic window providing treatment benefits. Patients in the high PCT group may be more likely to exceed 5.5 μg/mL, thus suffering from VCZ toxicity.

Transcription factor networks as targets for therapeutic intervention of cancer: the breast cancer paradigm

It has long been shown that many of the presently used anticancer drugs exert their effects partly through modulating the activity of vital transcription factors. The intricacy of transcriptional regulation still represents the main obstacle for the design of transcription factor-directed agents. Systematic mapping of tumor-specific transcriptional networks and application of new molecular tools have reinforced research interest and efforts in this venue. The case of breast cancer is discussed as a representative example.

Cancer immunomics and application of 'omics' for cancer management

Several 'omics' sciences have been launched. The outstanding diversity of immune system components, together with the complexity of the regulatory pathways and network-type interactions, makes immunology a combinatorial science. Cancer immonomics is a branch of immunomics. The present cancer immunomics project aims at diagnostics and therapy. Comparative and structural genomics can be applied for understanding the underlying tumorogenesis process. For diagnostic purposes, in order to develop a new marker, gene expression analysis technologies, such as DNA microarray, differential display, cDNA subtraction, serial analysis of gene expression and serological proteome analysis, which enable investigators to obtain comprehensive data with respect to gene expression profiles, are progressing rapidly. For therapeutic purposes, vaccine candidate finding, gene therapy and drug-tumor interaction modeling can be clarified by the advance immunomics techniques. In this article, the author will present the basic concepts on cancer immunomics and application for basic study of the pathogenesis, diagnosis and treatment of cancer.