1
|
Zehra K, Banu A, Can E, Hülya C. Fisetin and/or capecitabine causes changes in apoptosis pathways in capecitabine-resistant colorectal cancer cell lines. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:7913-7926. [PMID: 38748229 PMCID: PMC11449987 DOI: 10.1007/s00210-024-03145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/03/2024] [Indexed: 10/04/2024]
Abstract
Capecitabine is recommended as one of the first-line chemotherapy treatments for advanced or metastatic colorectal cancer. Researches have been conducted on capecitabine's impact on the viability of human colon cancer cells and its potential to induce apoptosis. However, even in cases initially responsive to treatment, the development of acquired resistance significantly limits its efficacy. Challenges still exist in effectively treating patients with chemotherapy, and developing new cytotoxic drugs is hindered by drug resistance. Fisetin alters the cell cycle, inducing apoptosis, inhibiting cancer cell proliferation, and enhancing the therapeutic effectiveness of chemotherapy drugs. This work aims to create a plan for reversing capecitabine resistance. For this purpose, the role of capecitabine and/or fisetin combinations in cell proliferation and apoptosis has been determined in both wild-type and capecitabine-resistant HT29 cells (CR/HT29). We developed capecitabine-resistant cell line from wild-type HT29 cells. This study demonstrated the effects of capecitabine, fisetin, and their combinations on both resistant and wild-type cells through experiments including cell survival skills, cell proliferation, wound healing, colony formation, hoechst staining, and western blot analysis. We established capecitabine-resistant cell lines. P-gp expression increased in CR/HT29 cells. Capecitabine effects on a CR/HT29 cells less than wild-type HT29 cells. The combination of fisetin and capecitabine in cell proliferation caused greater reductions in wild-type HT29 cells than in capecitabine-resistant cells. Fisetin has also additive effects on the apoptotic pathway in CR/HT29 cells. This study provides new perspectives on the combination of capecitabine and/or flavonoid treatment in resistant cells.
Collapse
Affiliation(s)
- Kanli Zehra
- Institute of Health Sciences, Marmara University, Basibuyuk-Maltepe, Istanbul, 34854, Turkey
| | - Aydin Banu
- School of Medicine, Department of Biophysics, Marmara University, Basic Medical Sciences Building, Maltepe, Istanbul, 34854, Turkey
| | - Erzik Can
- School of Medicine, Department of Medical Biology, Marmara University, Basic Medical Sciences Building, Maltepe, Istanbul, 34854, Turkey
| | - Cabadak Hülya
- School of Medicine, Department of Biophysics, Marmara University, Basic Medical Sciences Building, Maltepe, Istanbul, 34854, Turkey.
| |
Collapse
|
2
|
Araki H, Takenaka T, Takahashi K, Yamashita F, Matsuoka K, Yoshisue K, Ieiri I. A semimechanistic population pharmacokinetic and pharmacodynamic model incorporating autoinduction for the dose justification of TAS-114. CPT Pharmacometrics Syst Pharmacol 2022; 11:604-615. [PMID: 34951129 PMCID: PMC9124359 DOI: 10.1002/psp4.12747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/17/2021] [Accepted: 11/09/2021] [Indexed: 12/20/2022] Open
Abstract
TAS-114 is a dual deoxyuridine triphosphatase (dUTPase) and dihydropyrimidine dehydrogenase (DPD) inhibitor expected to widen the therapeutic index of capecitabine. Its maximum tolerated dose (MTD) was determined from a safety perspective in a combination study with capecitabine; however, its inhibitory effects on DPD activity were not assessed in the study. The dose justification to select its MTD as the recommended dose in terms of DPD inhibition has been required, but the autoinduction profile of TAS-114 made it difficult. To this end, an approach using a population pharmacokinetic (PPK)/pharmacodynamic (PD) model incorporating autoinduction was planned; however, the utility of this approach in the dose justification has not been reported. Thus, the aim of this study was to demonstrate the utility of a PPK/PD model incorporating autoinduction in the dose justification via a case study of TAS-114. Plasma concentrations of TAS-114 from 185 subjects and those of the endogenous DPD substrate uracil from 24 subjects were used. A two-compartment model with first-order absorption with lag time and an enzyme turnover model were selected for the pharmacokinetic (PK) model. Moreover, an indirect response model was selected for the PD model to capture the changes in plasma uracil concentrations. Model-based simulations provided the dose justification that DPD inhibition by TAS-114 reached a plateau level at the MTD, whereas exposures of TAS-114 increased dose dependently. Thus, the utility of a PPK/PD model incorporating autoinduction in the dose justification was demonstrated via this case study of TAS-114.
Collapse
Affiliation(s)
- Hikari Araki
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Toru Takenaka
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Koichi Takahashi
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Fumiaki Yamashita
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Kazuaki Matsuoka
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Kunihiro Yoshisue
- Pharmacokinetics Research LaboratoriesTaiho Pharmaceutical Co. Ltd.TsukubaIbarakiJapan
| | - Ichiro Ieiri
- Department of Clinical Pharmacology and Biopharmaceutics, Graduate School of Pharmaceutical SciencesKyushu UniversityFukuokaJapan
- Department of PharmacyKyushu University HospitalFukuokaJapan
| |
Collapse
|
3
|
García-Alfonso P, Muñoz Martín AJ, Ortega Morán L, Soto Alsar J, Torres Pérez-Solero G, Blanco Codesido M, Calvo Ferrandiz PA, Grasso Cicala S. Oral drugs in the treatment of metastatic colorectal cancer. Ther Adv Med Oncol 2021; 13:17588359211009001. [PMID: 33995592 PMCID: PMC8111515 DOI: 10.1177/17588359211009001] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most common forms of cancer, with an estimated 1.36 million new cases and almost 700,000 deaths annually. Approximately 21% of patients with CRC have metastatic disease at diagnosis. The objective of this article is to review the literature on the efficacy and safety of oral drugs available for the treatment of metastatic colorectal cancer (mCRC). Several such drugs have been developed, and fluoropyrimidines are the backbone of chemotherapy in this indication. They exert their antitumour activity by disrupting the synthesis and function of DNA and RNA. Oral fluoropyrimidines include prodrugs capecitabine, tegafur, eniluracil/5-fluorouracil, tegafur/uracil, tegafur/gimeracil/oteracil and trifluridine/tipiracil (FTD/TPI). Oral drugs offer several advantages over injectable formulations, including convenience, flexibility, avoidance of injection-related adverse events (AEs) and, in some circumstances, lower costs. However, oral drugs may not be suitable for patients with gastrointestinal obstruction or malabsorption, they may result in reduced treatment adherence and should not be co-administered with drugs that interfere with absorption or hepatic metabolism. Oral fluoropyrimidines such as capecitabine, as monotherapy or in combination with oxaliplatin, irinotecan or bevacizumab, are as effective as intravenous 5-fluorouracil (5-FU) in first-line treatment of mCRC. Other oral fluoropyrimidines, such as FTD/TPI, are effective in patients with mCRC who are refractory, intolerant or ineligible for 5-FU. In addition, oral fluoropyrimidines are used in adjuvant treatment of mCRC. Regorafenib is an oral multikinase inhibitor used in patients in whom several previous lines of therapy have failed. Frequent AEs associated with oral drugs used in the treatment of CRC include hand-foot syndrome and gastrointestinal and haematological toxicities.
Collapse
Affiliation(s)
- Pilar García-Alfonso
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, Madrid, 28009, Spain
| | | | - Laura Ortega Morán
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Soto Alsar
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | |
Collapse
|
4
|
Wu J, Xu S, Han CC, Yuan G. Controlled drug release: On the evolution of physically entrapped drug inside the electrospun poly(lactic-co-glycolic acid) matrix. J Control Release 2021; 331:472-479. [PMID: 33549717 DOI: 10.1016/j.jconrel.2021.01.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
The drug loading and releasing properties of poly(lactic-co-glycolic acid) (PLGA) were approached with the application of neutron techniques. The neutron reflection (NR) study on the response of PLGA material to vapor and to bulk water revealed that the hydration of PLGA origins from the molecular compatibility between water and PLGA. Hydration is reversible with regard to the change in humidity and temperature. Capecitabine as drug was embedded in the electrospun PLGA fibers. Small angle neutron scattering (SANS) was able to disclose the domain of entrapped drug inside the fibers and trace its evolution over time when the electrospun membrane was incubated in D2O buffer solution. The evolution of drug domains is discussed in terms of the concentration dependence, the temperature dependence, and the relevance between the drug diffusion inside the polymer matrix and the drug release out to the medium. It was observed that, at 20 °C the drug-related domains are relatively small (~ 100 Å) and relax extremely slow while at 37 °C the drug-related domains are relatively larger (~ 200 Å) and relax faster. These behaviors can be related to the glassy property of structural material. The transportation of drug through the polymer matrix relies on the global relaxation of PLGA chains. The variation of fiber diameter vs. incubation time was followed by ultra-small angle neutron scattering (USANS). The bi-phasic or tri-phasic release kinetics from a series of fibers with different drug loading (2%, 5%, 10%, 20%, 30%, 40%, 50%) were discussed based on the SANS and USANS discovery.
Collapse
Affiliation(s)
- Jiaen Wu
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China
| | - Shanshan Xu
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China; Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA.
| | - Charles C Han
- Institute for Advanced Study, Shenzhen University, Shenzhen 518060, China; Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
| | - Guangcui Yuan
- Center for Neutron Research, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA; Department of Physics, Georgetown University, Washington, D. C., 20057, USA.
| |
Collapse
|
5
|
Feng Y, Mo S, Dai W, Li Q, Cai G, Cai S. Increasing age-related survival gap among patients with colorectal cancer: a population-based retrospective study. Int J Clin Oncol 2019; 25:100-109. [PMID: 31531787 DOI: 10.1007/s10147-019-01538-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/29/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Survival for patients with colorectal cancer (CRC) has improved over the past decades. However, it is unclear whether older patients have benefited to the same extent as younger patients. METHODS The Surveillance, Epidemiology, and End Results (SEER) 9 registries database was queried for CRC patients from 1975 to 2009. We presented yearly data for survival with overlying loess-smoothing lines across all age groups. Another cohort was created using the SEER 18 registries database for patients diagnosed with CRC from 1973 to 2014. Yearly data for surgery-performed rate, stage proportion, and multivariate hazard ratio were performed with overlying smoothing lines across all age groups. RESULTS In the analysis SEER 9, 5-year cause-specific survival (CSS) of patients aged ≤ 54, 55-64, and 65-74 years showed robust increase since 1975; however, the survival of patients aged 75-84 years remained low despite modest improvement, and patients aged 85 or older even showed no survival gains since 1990. In the analysis of SEER 18, there has been a steady increase in the survival of patients aged ≤ 54, 55-64, 65-74, and 75-84 years as time period advanced; however, of CRC patients aged ≥ 85 years, the survival curves of period 1990-1999 and 2000-2012 could not be distinguished from each other presented with negligibly a small gap from the curve of 1980-1989. CONCLUSIONS The strong interaction between age and year of diagnosis implies that older patients have benefited less over time than younger patients, especially for patients aged ≥ 85 years.
Collapse
Affiliation(s)
- Yang Feng
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Shaobo Mo
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Weixing Dai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qingguo Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Guoxiang Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
6
|
Yano W, Yokogawa T, Wakasa T, Yamamura K, Fujioka A, Yoshisue K, Matsushima E, Miyahara S, Miyakoshi H, Taguchi J, Chong KT, Takao Y, Fukuoka M, Matsuo K. TAS-114, a First-in-Class Dual dUTPase/DPD Inhibitor, Demonstrates Potential to Improve Therapeutic Efficacy of Fluoropyrimidine-Based Chemotherapy. Mol Cancer Ther 2018; 17:1683-1693. [PMID: 29748212 DOI: 10.1158/1535-7163.mct-17-0911] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 02/26/2018] [Accepted: 05/04/2018] [Indexed: 11/16/2022]
Abstract
5-Fluorouracil (5-FU) is an antimetabolite and exerts antitumor activity via intracellularly and physiologically complicated metabolic pathways. In this study, we designed a novel small molecule inhibitor, TAS-114, which targets the intercellular metabolism of 5-FU to enhance antitumor activity and modulates catabolic pathway to improve the systemic availability of 5-FU. TAS-114 strongly and competitively inhibited deoxyuridine 5'-triphosphate nucleotidohydrolase (dUTPase), a gatekeeper protein preventing aberrant base incorporation into DNA, and enhanced the cytotoxicity of fluoropyrimidines in cancer cells; however, it had little intrinsic activity. In addition, TAS-114 had moderate and reversible inhibitory activity on dihydropyrimidine dehydrogenase (DPD), a catabolizing enzyme of 5-FU. Thus, TAS-114 increased the bioavailability of 5-FU when coadministered with capecitabine in mice, and it significantly improved the therapeutic efficacy of capecitabine by reducing the required dose of the prodrug by dual enzyme inhibition. Enhancement of antitumor efficacy caused by the addition of TAS-114 was retained in the presence of a potent DPD inhibitor containing oral fluoropyrimidine (S-1), indicating that dUTPase inhibition plays a major role in enhancing the antitumor efficacy of fluoropyrimidine-based therapy. In conclusion, TAS-114, a dual dUTPase/DPD inhibitor, demonstrated the potential to improve the therapeutic efficacy of fluoropyrimidine. Dual inhibition of dUTPase and DPD is a novel strategy for the advancement of oral fluoropyrimidine-based chemotherapy for cancer treatment. Mol Cancer Ther; 17(8); 1683-93. ©2018 AACR.
Collapse
Affiliation(s)
- Wakako Yano
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Tatsushi Yokogawa
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan. .,Business Development Department, Taiho Pharmaceutical Co., Ltd., Kandanishiki-cho, Tokyo, Japan
| | - Takeshi Wakasa
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Keisuke Yamamura
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Akio Fujioka
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Kunihiro Yoshisue
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Eiji Matsushima
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Seiji Miyahara
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Hitoshi Miyakoshi
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Junko Taguchi
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Khoon Tee Chong
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Yayoi Takao
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Masayoshi Fukuoka
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan
| | - Kenichi Matsuo
- Discovery and Preclinical Research Division, Taiho Pharmaceutical Co., Ltd., Tsukuba, Ibaraki, Japan.
| |
Collapse
|
7
|
Immobilization of Neutral Protease from Bacillus subtilis for Regioselective Hydrolysis of Acetylated Nucleosides: Application to Capecitabine Synthesis. Molecules 2016; 21:molecules21121621. [PMID: 27898006 PMCID: PMC6273923 DOI: 10.3390/molecules21121621] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 12/05/2022] Open
Abstract
This paper describes the immobilization of the neutral protease from Bacillus subtilis and its application in the regioselective hydrolysis of acetylated nucleosides, including building blocks useful for the preparation of anticancer products. Regarding the immobilization study, different results have been obtained depending on the immobilization procedure. Epoxy hydrophobic carriers gave a poorly stable derivative that released almost 50% of the immobilized protein under the required reaction conditions. On the contrary, covalent immobilization on a differently activated hydrophilic carrier (agarose) resulted in very stable enzyme derivatives. In an attempt to explain the obtained enzyme immobilization results, the hypothetical localization of lysines on the enzyme surface was predicted in a 3D structure model of B. subtilis protease N built in silico by using the structure of Staphylococcus aureus metalloproteinase as the template. The immobilized enzyme shown a high regioselectivity in the hydrolysis of different peracetylated nucleosides. A stable enzyme derivative was obtained and successfully used in the development of efficient preparative bioprocesses for the hydrolysis of acetylated nucleosides, giving new intermediates for the synthesis of capecitabine in high yield.
Collapse
|
8
|
Abstract
INTRODUCTION Most anticancer drugs have poor aqueous solubility and low permeability across the gastrointestinal tract. Furthermore, extensive efflux by P-glycoproteins (P-gp) in the small intestine also limits the efficient delivery of anticancer drugs via oral route. Area covered: This review explores the prodrug strategy for oral delivery of anticancer drugs. Different categories of oral anticancer prodrugs along with recent clinical studies have been comprehensively reviewed here. Furthermore, novel anticancer prodrugs such as polymer-prodrugs and lipid-prodrugs have been discussed in detail. Finally, various nanocarrier-based approaches employed for oral delivery of anticancer prodrugs have also been discussed. Expert opinion: Premature degradation of anticancer prodrugs in the gastrointestinal tract could lead to variable pharmacokinetics and undesired toxicity. Despite their increased aqueous solubility, the oral bioavailability of several anticancer prodrugs are limited by their poor permeability across the gastrointestinal tract. These limitations can be overcome by the use of functional excipients (polymers, lipids, amino acids/dipeptides), which are specifically absorbed via transporters and receptor-mediated endocytosis. Oral delivery of anticancer prodrugs using nanocarrier-based drug delivery system is a recent development; however it should be justified based on the comparative advantages of encapsulating prodrug in a nanocarrier versus the use of anticancer prodrug molecule itself.
Collapse
Affiliation(s)
- Amit K Jain
- a Department of Chemical Engineering , Texas Tech University , Lubbock , TX , USA
| | - Sanyog Jain
- b Centre for Pharmaceutical Nanotechnology, Department of Pharmaceutics , National Institute of Pharmaceutical Education and Research (NIPER) , Mohali , Punjab , India
| |
Collapse
|
9
|
Interaction of 5-fluoro-5′-deoxyuridine with human serum albumin under physiological and non-physiological condition: A biophysical investigation. Colloids Surf B Biointerfaces 2014; 123:469-77. [DOI: 10.1016/j.colsurfb.2014.09.044] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 09/16/2014] [Accepted: 09/21/2014] [Indexed: 02/01/2023]
|
10
|
A phase II study of cetuximab, capecitabine and radiotherapy in neoadjuvant treatment of patients with locally advanced resectable rectal cancer. Eur J Surg Oncol 2009; 36:244-50. [PMID: 20042310 DOI: 10.1016/j.ejso.2009.12.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Revised: 11/29/2009] [Accepted: 12/07/2009] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Neoadjuvant chemoradiotherapy (CRT) reduces local tumor recurrence in locally advanced rectal cancer (LARC). This phase II study assessed neoadjuvant cetuximab with capecitabine-based CRT in LARC. METHODS Patients with stage II/III LARC received capecitabine 1250 mg/m(2) twice daily for 2 weeks followed by intravenous cetuximab 400 mg/m(2) at week 3, then weekly intravenous 250 mg/m(2) cetuximab plus CRT including capecitabine 825 mg/m(2) twice daily (including weekends during radiotherapy) with radiotherapy of 45 Gy (25 x 1.8 Gy), 5 days a week for 5 weeks. Total mesorectal excision was scheduled 4-6 weeks following completion of CRT. The primary endpoint was pathological complete response (pCR). RESULTS Thirty-seven patients were eligible for safety and efficacy. TMN staging at baseline was: T4N2, 11%; T3N2, 40%; T2N2, 3%; T3N1, 35%; T2N1, 3% and T3N0 8%. The most common adverse events included, grade 1/2 acneiform skin rash (86%), and grade 3 radiodermatitis, (16%), diarrhea (11%) and hypersensitivity (5%). pCR was achieved in 3 patients (8%). Overall-, T- and N-downstaging rates were 73%, 57% and 81% respectively. Total sphincter preservation rate was 76%, and 53% in 17 patients whose tumors were located within 5 cm from the anal verge. Non-fatal perioperative complications occurred in 13 patients (35%) with delayed wound healing occurring in 6 patients (16%). One death was recorded due to sepsis following colonic necrosis. CONCLUSION Neoadjuvant cetuximab with capecitabine-based CRT is tolerable in patients with resectable LARC. Whilst the pCR rate was similar to recent reports, a high pathological downstaging rate was achieved.
Collapse
|
11
|
Willett C, Czito B. Chemoradiotherapy in Gastrointestinal Malignancies. Clin Oncol (R Coll Radiol) 2009; 21:543-56. [DOI: 10.1016/j.clon.2009.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 05/13/2009] [Indexed: 01/08/2023]
|
12
|
Willett CG, Czito BG. Neoadjuvant Chemoradiation for Rectal Cancer. SEMINARS IN COLON AND RECTAL SURGERY 2008. [DOI: 10.1053/j.scrs.2008.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
13
|
Zobi F, Spingler B, Alberto R. Syntheses, Structures and Reactivities of [CpTc(CO)3X]+and [CpRe(CO)3X]+. Eur J Inorg Chem 2008. [DOI: 10.1002/ejic.200800258] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
14
|
Willett CG, Czito BG, Bendell JC. Radiation Therapy in Stage II and III Rectal Cancer. Clin Cancer Res 2007; 13:6903s-8s. [DOI: 10.1158/1078-0432.ccr-07-1158] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Zobi F, Mood BB, Wood PA, Fabbiani FPA, Parsons S, Sadler PJ. Tagging (Arene)ruthenium(II) Anticancer Complexes with Fluorescent Labels. Eur J Inorg Chem 2007. [DOI: 10.1002/ejic.200700144] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
16
|
Desmoulin F, Gilard V, Malet-Martino M, Martino R. Metabolism of capecitabine, an oral fluorouracil prodrug: (19)F NMR studies in animal models and human urine. Drug Metab Dispos 2002; 30:1221-9. [PMID: 12386128 DOI: 10.1124/dmd.30.11.1221] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Capecitabine (Xeloda; CAP) is a recently developed oral antineoplastic prodrug of 5-fluorouracil (5-FU) with enhanced tumor selectivity. Previous studies have shown that CAP activation follows a pathway with three enzymatic steps and two intermediary metabolites, 5'-deoxy-5-fluorocytidine (5'-DFCR) and 5'-deoxy-5-fluorouridine (5'-DFUR), to form 5-FU preferentially in tumor tissues. In the present work, we investigated all fluorinated compounds present in liver, bile, and perfusate medium of isolated perfused rat liver (IPRL) and in liver, plasma, kidneys, bile, and urine of healthy rats. Moreover, data obtained from rat urine were compared with those from mice and human urine. According to a low cytidine deaminase (3.5.4.5) activity in rats, 5'-DFCR was by far the main product in perfusate medium from IPRL and plasma and urine from rats. Liver and circulating 5'-DFCR in perfusate and plasma equilibrated at the same concentration value in the range 25 to 400 microM, which supports the involvement of es-type nucleoside transporter in the liver. 5'-DFUR and alpha-fluoro-beta-ureidopropionic acid (FUPA) + alpha-fluoro-beta-alanine (FBAL) were the main products in urine of mice, making up 23 to 30% of the administered dose versus 3 to 4% in rat. In human urine, FUPA + FBAL represented 50% of the administered dose, 5'-DFCR 10%, and 5'-DFUR 7%. Since fluorine-19 nuclear magnetic resonance spectroscopy gives an overview of all the fluorinated compounds present in a sample, we observed the following unreported metabolites of CAP: 1) 5-fluorocytosine and its hydroxylated metabolite, 5-fluoro-6-hydroxycytosine, 2) fluoride ion, 3) 2-fluoro-3-hydroxypropionic acid and fluoroacetate, and 4) a glucuroconjugate of 5'-DFCR.
Collapse
Affiliation(s)
- Franck Desmoulin
- Groupe de Résonance Magnétique Nucléaire Biomédicale, Unité Mixte Recherche Centre National de la Recherche Scientifique 5623, Université Paul Sabatier, Toulouse, France.
| | | | | | | |
Collapse
|
17
|
Goel S, Jhawer M, Rajdev L, Hopkins U, Fehn K, Baker C, Chun HG, Makower D, Landau L, Hoffman A, Wadler S, Mani S. Phase I clinical trial of irinotecan with oral capecitabine in patients with gastrointestinal and other solid malignancies. Am J Clin Oncol 2002; 25:528-34. [PMID: 12393999 DOI: 10.1097/00000421-200210000-00022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine the safety of irinotecan and capecitabine in patients with advanced solid tumors. Thirty-four patients received 122 courses of irinotecan 200 to 300 mg/m(2) as an intravenous infusion during 30 minutes on day 1 and capecitabine 1,500 to 3,000 mg/d orally 12 hours apart starting on day 2 for 14 days, repeated every 21 days (one course). Three to seven patients were treated in six dose-escalation cohorts. Three of 7 (43%) patients treated with irinotecan 300 mg/m(2) and capecitabine 2,300 mg/d had course 1 dose-limiting toxicity (DLT) defining maximum tolerated dosage (MTD). Fatigue and diarrhea were the major DLTs, and other events included neutropenia, anorexia, and hand-foot syndrome. At one dose level below the MTD, none of 7 patients treated with irinotecan 275 mg/m(2), and capecitabine 2,300 mg/d (36 courses) had course 1 DLT. Grade III to IV toxicities beyond course 1 included neutropenia (11% of all courses), fatigue (3.4%) and hand-foot syndrome (3.4%). There were only two episodes of febrile grade II neutropenia. There were no toxic deaths. Transient antitumor response was noted in one patient with irinotecan and 5-fluorouracil-refractory colon cancer. The combination of irinotecan 275 mg/m(2) and capecitabine 2,300 mg/d represents a safe, favorable, and convenient outpatient regimen warranting further phase II evaluation.
Collapse
Affiliation(s)
- Sanjay Goel
- Department of Hematology/Oncology, Montefiore Medical Center/Albert Einstein College of Medicine and Albert Einstein Comprehensive Cancer Center Bronx, NY 10461, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Twelves CJ, Cassidy J. Which endpoints should we use in evaluating the use of novel fluoropyrimidine regimens in colorectal cancer? Br J Cancer 2002; 86:1670-6. [PMID: 12087448 PMCID: PMC2375398 DOI: 10.1038/sj.bjc.6600341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2001] [Revised: 03/21/2002] [Accepted: 03/27/2002] [Indexed: 02/04/2023] Open
Abstract
Although significant advances have been made in the treatment of advanced/metastatic colorectal cancer, 5-fluorouracil (5-FU) still forms the basis of chemotherapy. Recently, new 5-FU schedules and novel fluoropyrimidines have been developed, but there are no trials directly comparing these regimens. The current review describes the mechanisms of action, pre-clinical and phase I/II studies of two oral fluoropyrimidine therapies, capecitabine and uracil with tegafur plus leucovorin. It also compares the phase III studies of these agents with those of the two most popular infusional 5-FU-based regimens: de Gramont and German AIO (The Association of Medical Oncology (AIO) of the German Cancer Society). Both oral and infusional regimens demonstrated similar survival to the Mayo Clinic regimen, a standard treatment for colorectal cancer. Therefore, other endpoints must be examined to decide optimum therapy, including response rates, time to disease progression, tolerability and patients' convenience. All four new therapies demonstrated superior safety profiles compared with the Mayo Clinic regimen. However the uracil with tegafur plus leucovorin regimen was associated with severe diarrhoea and capecitabine with hand-foot syndrome. Patients will not sacrifice efficacy for the convenience of oral therapy alone, therefore the fact that capecitabine achieved superior response rates and equivalent time to disease progression compared with the Mayo Clinic regimen, while uracil with tegafur plus leucovorin produced lower response rates and significantly inferior time to disease progression, is highly relevant in choosing treatment.
Collapse
Affiliation(s)
- C J Twelves
- Cancer Research UK Department of Medical Oncology, Alexander Stone Building, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, Scotland, UK.
| | | |
Collapse
|
19
|
JONES ADAM, FUJIYAMA CHISATO, TURNER KEVIN, CRANSTON DAVID, WILLIAMS KAYE, STRATFORD IAN, BICKNELL ROY, HARRIS ADRIANL. ROLE OF THYMIDINE PHOSPHORYLASE IN AN IN VITRO MODEL OF HUMAN BLADDER CANCER INVASION. J Urol 2002. [DOI: 10.1016/s0022-5347(05)65349-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- ADAM JONES
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - CHISATO FUJIYAMA
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - KEVIN TURNER
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - DAVID CRANSTON
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - KAYE WILLIAMS
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - IAN STRATFORD
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - ROY BICKNELL
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - ADRIAN L. HARRIS
- From the Imperial Cancer Research Fund, University of Oxford Institute of Molecular Medicine, John Radcliffe Hospital and Department of Urology, Churchill Hospital, Headington, Oxford and Department of Pharmacy, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
20
|
|
21
|
Lang TT, Selner M, Young JD, Cass CE. Acquisition of human concentrative nucleoside transporter 2 (hcnt2) activity by gene transfer confers sensitivity to fluoropyrimidine nucleosides in drug-resistant leukemia cells. Mol Pharmacol 2001; 60:1143-52. [PMID: 11641443 DOI: 10.1124/mol.60.5.1143] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CEM-ARAC leukemia cells with resistance to cytarabine were shown to lack equilibrative transporter (hENT1) expression and activity. Stable transfer of hCNT2 cDNA into CEM-ARAC enabled Na(+)-dependent transport of purine and pyrimidine nucleoside analogs and provided a unique in vitro model for studying hCNT2. Analysis of [(3)H]uridine inhibitory activity by test substances in hCNT2 transfectant ARAC/D2 revealed structural requirements for interaction with hCNT2: 1) ribosyl and 2'-deoxyribosyl nucleosides were better inhibitors than 3'-deoxyribosyl, 2',3'-dideoxyribosyl or arabinosyl nucleosides; 2) uridine analogs with halogens at position 5 were better inhibitors than 5-methyluridine or thymidine; 3) 2-chloroadenosine was a better inhibitor than 2-chloro-2'-deoxyadenosine (cladribine); and 4) cytosine-containing nucleosides, 7-deazaadenosine and nucleobases were not inhibitors. Quantification of inhibitory capacity yielded K(i) values of 34-50 microM (5-halogenated uridine analogs, 2'-deoxyuridine), 82 microM (5-fluoro-2'-deoxyuridine), 197-246 microM (5-methyluridine < 5-bromo-2'-deoxyuridine < 5-iodo-2'-deoxyuridine), and 411 microM (5-fluoro-5'-deoxyuridine, capecitabine metabolite). Comparisons of hCNT2-mediated transport rates indicated halogenated uridine analogs were transported more rapidly than halogenated adenosine analogs, even though hCNT2 exhibited preference for physiologic purine nucleosides over uridine. Kinetics of hCNT2-mediated transport of 5-fluorouridine and uridine were similar (K(m) values, 43-46 microM). The impact of hCNT2-mediated transport on chemosensitivity was assessed by comparing antiproliferative activity of nucleoside analogs against hCNT2-containing cells with transport-defective, drug-resistant cells. Chemosensitivity was restored partially for cladribine, completely for 5-fluorouridine and 5-fluoro-2'-deoxyuridine, whereas there was little effect on chemosensitivity for fludarabine, 7-deazaadenosine, or cytarabine. These studies, which demonstrated hCNT2 uptake of halogenated uridine analogs, suggested that hCNT2 is an important determinant of cytotoxicity of this class of compounds in vivo.
Collapse
Affiliation(s)
- T T Lang
- Canadian Institute of Health Research Membrane Protein Research Group, University of Alberta
| | | | | | | |
Collapse
|
22
|
Rougier P, Mitry E. Review of the role of CPT-11 in the treatment of colorectal cancer. Clin Colorectal Cancer 2001; 1:87-94. [PMID: 12445366 DOI: 10.3816/ccc.2001.n.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Colorectal cancer (CRC) is the second leading cause of cancer death in Western countries, and although the treatment of advanced CRC has progressed substantially, the improvements in response rates have not always been translated into a significant survival benefit. Until recently, the standard therapy for advanced CRC was a variety of biomodulated 5-fluorouracil (5-FU) regimens. 5-FU was used as first- or second-line therapy, and a different 5-FU regimen was used second line if first-line 5-FU therapy failed. Typically, the survival times for these patients were short and their quality of life poor. In recent years, a variety of new agents have emerged that have demonstrated activity in the treatment of advanced CRC. Of these, irinotecan (CPT-11) and oxaliplatin in combination with 5-FU and folinic acid (FA) have yielded the most promising results. However, only CPT-11 combined with either bolus or high-dose infusional 5-FU/FA, in randomized phase III studies, has demonstrated an increased response rate and median time to progression, producing a significant and clinically relevant survival advantage. In 2 randomized phase III studies, oxaliplatin/5-FU/FA demonstrated a clear increase in response rate over 5-FU/FA alone but failed to demonstrate a survival advantage. CPT-11 was approved by the Food and Drug Administration in April 2000 for the first-line treatment of advanced CRC in combination with 5-FU/FA.
Collapse
Affiliation(s)
- P Rougier
- Department of Hepato-Gastro-Enterology and Digestive Oncology, Hospital Ambroise Paré, 92100 Boulogne, France.
| | | |
Collapse
|