Toward Predicting Acute Myeloid Leukemia Patient Response to 7 + 3 Induction Chemotherapy via Diagnostic Microdosing

Strategic, feasibility, economic, and cultural aspects of Phase 0 approaches

Research conducted over the past 2 decades has enhanced the validity and expanded the applications of microdosing and other phase 0 approaches in drug development. Phase 0 approaches can accelerate drug development timelines and reduce attrition in clinical development by increasing the quality of candidates entering clinical development and by reducing the time to “go‐no‐go” decisions. This can be done by adding clinical trial data (both healthy volunteers and patients) to preclinical candidate selection, and by applying methodological and operational advantages that phase 0 have over traditional approaches. The main feature of phase 0 approaches is the limited, subtherapeutic exposure to the test article. This means a reduced risk to research volunteers, and reduced regulatory requirements, timelines, and costs of first‐in‐human (FIH) testing. Whereas many operational aspects of phase 0 approaches are similar to those of other early phase clinical development programs, they have some unique strategic, regulatory, ethical, feasibility, economic, and cultural aspects. Here, we provide a guidance to these operational aspects and include case studies to highlight their potential impact in a range of clinical development scenarios.

Molecular recognition-driven supramolecular nanoassembly of a hydrophobic uracil prodrug and hydrophilic cytarabine for precise combination treatment of solid and non-solid tumors

Combination chemotherapy has shown distinct therapeutic advantages over monotherapy in clinical cancer treatment, especially for two chemotherapeutic drugs with different mechanisms of action. However, how to achieve efficient co-delivery of two or more drugs with different physicochemical and pharmacokinetic properties for synergistic therapy is still a huge challenge. In particular, it is even more difficult to efficiently co-deliver a hydrophilic drug and a hydrophobic drug into one nanosystem. Herein, inspired by the natural Watson-Crick base pair molecular recognition in nucleic acids, a reduction-sensitive uracil prodrug of doxorubicin (U-SS-DOX) is synthesized and performs supramolecular co-assembly with cytarabine (Ara-C). Interestingly, the hydrophilic Ara-C molecules could readily co-assemble with U-SS-DOX, and multiple hydrogen bonds are found in the nanoassembly with an ultra-high drug loading rate. Moreover, 1,1'-dioctadecyl-3,3,3',3'-tetramethylindotricarbocyanine iodide (DiR) is used as a fluorescent probe to investigate the pharmacokinetics of U : C NPs. It turns out that the DiR-labeled U : C NPs significantly prolong the systemic circulation and promote the tumor-specific accumulation of DiR when compared with DiR solution. Furthermore, the supramolecular nanoassembly demonstrates potent satisfactory therapeutic effects in treating both solid and non-solid tumors in vivo. This study provides a novel molecular co-assembly nanoplatform for efficient co-delivery of hydrophilic and hydrophobic drugs.

Preclinical Models for Bladder Cancer Research

At diagnosis, more than 70% of bladder cancers (BCs) are at the non-muscle-invasive bladder cancer (NMIBC) stages, which are usually treated with transurethral resection followed by intravesical instillation. For the remaining advanced cancers, systemic therapy is the standard of care, with addition of radical cystectomy in cases of locally advanced cancer. Because of the difference in treatment modalities, different models are needed to advance the care of NMIBC and advanced BC. This article gives a comprehensive review of both in vitro and in vivo BC models and compares the advantages and drawbacks of these preclinical systems in BC research.

Radiocarbon Tracers in Toxicology and Medicine: Recent Advances in Technology and Science

This review summarizes recent developments in radiocarbon tracer technology and applications. Technologies covered include accelerator mass spectrometry (AMS), including conversion of samples to graphite, and rapid combustion to carbon dioxide to enable direct liquid sample analysis, coupling to HPLC for real-time AMS analysis, and combined molecular mass spectrometry and AMS for analyte identification and quantitation. Laser-based alternatives, such as cavity ring down spectrometry, are emerging to enable lower cost, higher throughput measurements of biological samples. Applications covered include radiocarbon dating, use of environmental atomic bomb pulse radiocarbon content for cell and protein age determination and turnover studies, and carbon source identification. Low dose toxicology applications reviewed include studies of naphthalene-DNA adduct formation, benzo[a]pyrene pharmacokinetics in humans, and triclocarban exposure and risk assessment. Cancer-related studies covered include the use of radiocarbon-labeled cells for better defining mechanisms of metastasis and the use of drug-DNA adducts as predictive biomarkers of response to chemotherapy.