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Rai T, Kaushik N, Malviya R, Sharma PK. A review on marine source as anticancer agents. JOURNAL OF ASIAN NATURAL PRODUCTS RESEARCH 2024; 26:415-451. [PMID: 37675579 DOI: 10.1080/10286020.2023.2249825] [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: 01/13/2023] [Accepted: 08/15/2023] [Indexed: 09/08/2023]
Abstract
This review investigates the potential of natural compounds obtained from marine sources for the treatment of cancer. The oceans are believed to contain physiologically active compounds, such as alkaloids, nucleosides, macrolides, and polyketides, which have shown promising effects in slowing human tumor cells both in vivo and in vitro. Various marine species, including algae, mollusks, actinomycetes, fungi, sponges, and soft corals, have been studied for their bioactive metabolites with diverse chemical structures. The review explores the therapeutic potential of various marine-derived substances and discusses their possible applications in cancer treatment.
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Affiliation(s)
- Tamanna Rai
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Gautam Budh Nagar, Greater Noida, Uttar Pradesh 201306, India
| | - Niranjan Kaushik
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Gautam Budh Nagar, Greater Noida, Uttar Pradesh 201306, India
| | - Rishabha Malviya
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Gautam Budh Nagar, Greater Noida, Uttar Pradesh 201306, India
| | - Pramod Kumar Sharma
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Gautam Budh Nagar, Greater Noida, Uttar Pradesh 201306, India
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Barreca M, Spanò V, Montalbano A, Cueto M, Díaz Marrero AR, Deniz I, Erdoğan A, Lukić Bilela L, Moulin C, Taffin-de-Givenchy E, Spriano F, Perale G, Mehiri M, Rotter A, P. Thomas O, Barraja P, Gaudêncio SP, Bertoni F. Marine Anticancer Agents: An Overview with a Particular Focus on Their Chemical Classes. Mar Drugs 2020; 18:md18120619. [PMID: 33291602 PMCID: PMC7761941 DOI: 10.3390/md18120619] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
The marine environment is a rich source of biologically active molecules for the treatment of human diseases, especially cancer. The adaptation to unique environmental conditions led marine organisms to evolve different pathways than their terrestrial counterparts, thus producing unique chemicals with a broad diversity and complexity. So far, more than 36,000 compounds have been isolated from marine micro- and macro-organisms including but not limited to fungi, bacteria, microalgae, macroalgae, sponges, corals, mollusks and tunicates, with hundreds of new marine natural products (MNPs) being discovered every year. Marine-based pharmaceuticals have started to impact modern pharmacology and different anti-cancer drugs derived from marine compounds have been approved for clinical use, such as: cytarabine, vidarabine, nelarabine (prodrug of ara-G), fludarabine phosphate (pro-drug of ara-A), trabectedin, eribulin mesylate, brentuximab vedotin, polatuzumab vedotin, enfortumab vedotin, belantamab mafodotin, plitidepsin, and lurbinectedin. This review focuses on the bioactive molecules derived from the marine environment with anticancer activity, discussing their families, origin, structural features and therapeutic use.
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Affiliation(s)
- Marilia Barreca
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90123 Palermo, Italy; (M.B.); (V.S.); (A.M.); (P.B.)
- Faculty of Biomedical Sciences, Institute of Oncology Research, USI, 6500 Bellinzona, Switzerland;
| | - Virginia Spanò
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90123 Palermo, Italy; (M.B.); (V.S.); (A.M.); (P.B.)
| | - Alessandra Montalbano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90123 Palermo, Italy; (M.B.); (V.S.); (A.M.); (P.B.)
| | - Mercedes Cueto
- Instituto de Productos Naturales y Agrobiología (IPNA-CSIC), La Laguna, 38206 Tenerife, Spain;
| | - Ana R. Díaz Marrero
- Instituto Universitario de Bio-Orgánica Antonio González (IUBO AG), Universidad de La Laguna (ULL), La Laguna, 38200 Tenerife, Spain;
| | - Irem Deniz
- Department of Bioengineering, Faculty of Engineering, Manisa Celal Bayar University, 45119 Manisa, Turkey;
| | - Ayşegül Erdoğan
- Research Center for Testing and Analysis (EGE MATAL), Ege University Application, 35100 İzmir, Turkey;
| | - Lada Lukić Bilela
- Department of Biology, Faculty of Science, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Corentin Moulin
- Marine Natural Products Team, UMR 7272, Institut de Chimie de Nice, Université Côte d’Azur, CNRS, 06108 Nice, France; (C.M.); (E.T.-d.-G.); (M.M.)
| | - Elisabeth Taffin-de-Givenchy
- Marine Natural Products Team, UMR 7272, Institut de Chimie de Nice, Université Côte d’Azur, CNRS, 06108 Nice, France; (C.M.); (E.T.-d.-G.); (M.M.)
| | - Filippo Spriano
- Faculty of Biomedical Sciences, Institute of Oncology Research, USI, 6500 Bellinzona, Switzerland;
| | - Giuseppe Perale
- Faculty of Biomedical Sciences, USI, 6900 Lugano, Switzerland;
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, 1200 Vienna, Austria
| | - Mohamed Mehiri
- Marine Natural Products Team, UMR 7272, Institut de Chimie de Nice, Université Côte d’Azur, CNRS, 06108 Nice, France; (C.M.); (E.T.-d.-G.); (M.M.)
| | - Ana Rotter
- Marine Biology Station Piran, National Institute of Biology, 1000 Ljubljana, Slovenia;
| | - Olivier P. Thomas
- Marine Biodiscovery Laboratory, School of Chemistry and Ryan Institute, National University of Ireland, Galway (NUI Galway), H91TK33 Galway, Ireland;
| | - Paola Barraja
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90123 Palermo, Italy; (M.B.); (V.S.); (A.M.); (P.B.)
| | - Susana P. Gaudêncio
- UCIBIO—Applied Biomolecular Sciences Unit, Department of Chemistry, Blue Biotechnology & Biomedicine Lab, Faculty of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
- Correspondence: (S.P.G.); (F.B.); Tel.: +351-21-2948300 (S.P.G.); +41-91-8200367 (F.B.)
| | - Francesco Bertoni
- Faculty of Biomedical Sciences, Institute of Oncology Research, USI, 6500 Bellinzona, Switzerland;
- Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland
- Correspondence: (S.P.G.); (F.B.); Tel.: +351-21-2948300 (S.P.G.); +41-91-8200367 (F.B.)
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Abstract
INTRODUCTION 1,2,3,4-Tetrahydroisoquinoline (THIQ) is one of the 'privileged scaffolds', commonly found in nature. Initially, this class of compounds was known for its neurotoxicity. Later on, 1-methyl-1,2,3,4-tetrahydroisoquinoline was proved as an endogeneous Parkinsonism-preventing agent in mammals. The fused THIQs have been studied for their role as anticancer antibiotics. The US FDA approval of the trabectedin for the treatment of soft tissue sarcomas, is a milestone in the anticancer drug discovery. Areas covered: This review covers the patents on various therapeutic activities of the THIQ derivatives in the years between 2010 and 2015. Patents were collected using a thorough search of Espacenet and WIPO databases. The therapeutic areas covered include cancer, malaria, central nervous system (CNS), cardiovascular, metabolic disorders, and so on. This also includes several patents on specific THIQs of clinical importance. Expert opinion: A large number of the THIQ derivatives have been synthesised for various therapeutic activities, with noticeable success in the area of drug discovery for cancer and CNS. They may also prove to be promising candidates for various infectious diseases, such as malaria, tuberculosis, HIV-infection, HSV-infection, leishmaniasis, etc. They can also be developed as novel class of drugs for various therapeutic activities with unique mechanism of action.
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Affiliation(s)
- Inder Pal Singh
- a Department of Natural Products , National Institute of Pharmaceutical Education and Research (NIPER) , Punjab , India
| | - Purvi Shah
- a Department of Natural Products , National Institute of Pharmaceutical Education and Research (NIPER) , Punjab , India
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LEE WONSUP, YUN JEONGWON, NAGAPPAN ARULKUMAR, LU JINGNAN, KIM MINJEONG, LEE JEONGHEE, KIM DONGHOON, CHOI YUNGHYUN, KIM HYEJUNG, CHANG KICHURL, JUNG JINMYUNG. Synthesized tetrahydroisoquinoline alkaloid exerts anticancer effects at least in part by suppressing NF-κB-regulated proteins in A549 human lung cancer cells. Oncol Rep 2014; 33:1141-6. [DOI: 10.3892/or.2014.3658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/20/2014] [Indexed: 11/06/2022] Open
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PM00104 (Zalypsis®): a marine derived alkylating agent. Molecules 2014; 19:12328-35. [PMID: 25153860 PMCID: PMC6270769 DOI: 10.3390/molecules190812328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 08/11/2014] [Accepted: 08/11/2014] [Indexed: 01/20/2023] Open
Abstract
PM00104 (Zalypsis®) is a synthethic tetrahydroisoquinolone alkaloid, which is structurally similar to many marine organisms. The compound has been proposed as a potential chemotherapeutic agent in the treatment of solid human tumors and hematological malignancies. PM00104 is a DNA binding agent, causing inhibition of the cell cycle and transcription, which can lead to double stranded DNA breaks. After rigorous pre-clinical testing, the drug has been evaluated in a number of phase II clinical trials. This manuscript provides a review of current trials and appraises the efficacy of PM00104 as a future cancer treatment.
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Castellano DE, Bellmunt J, Maroto JP, Font-Pous A, Morales-Barrera R, Ghanem I, Suarez C, Martín Lorente C, Etxaniz O, Capdevila L, Coronado C, Alfaro V, Siguero M, Fernández-Teruel C, Carles J. Phase II clinical trial of PM00104 (Zalypsis®) in urothelial carcinoma patients progressing after first-line platinum-based regimen. Cancer Chemother Pharmacol 2014; 73:857-67. [DOI: 10.1007/s00280-014-2419-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/16/2014] [Indexed: 11/29/2022]
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Salazar R, Calles A, Gil M, Durán I, García M, Hidalgo M, Coronado C, Alfaro V, Siguero M, Fernández-Teruel C, Prados R, Calvo E. Phase I study of carboplatin in combination with PM00104 (Zalypsis®) in patients with advanced solid tumors. Invest New Drugs 2014; 32:644-52. [PMID: 24535315 DOI: 10.1007/s10637-014-0072-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/05/2014] [Indexed: 10/25/2022]
Abstract
This phase I trial determined the recommended dose for phase II trials (RD) of carboplatin 1-h intravenous (i.v.) infusion followed by PM00104 1-h i.v. infusion on Day 1 every 3 weeks (q3wk) in adult patients with advanced solid tumors. A toxicity-guided, dose-escalation design was used. Patients were stratified and divided into heavily (n = 6) or mildly pretreated (n = 14) groups. Transient grade 4 thrombocytopenia (in one heavily and three mildly pretreated patients) was the only dose-limiting toxicity (DLT) observed. Carboplatin AUC3-PM00104 2.0 mg/m(2) was the RD in both groups. At this RD, the carboplatin AUC was equal to ~60 % the target AUC used in other combinations, and the PM00104 dose intensity was 56-67 % of the value achieved at the RD for single-agent PM00104 given as 1-h infusion q3wk. Most treatment-related adverse events were grade 1/2. They mainly consisted of gastrointestinal and general symptoms, such as fatigue, anorexia, mucosal inflammation or nausea. Transient neutropenia (50 % of patients) and thrombocytopenia (33-38 %) were the most common severe hematological abnormalities; their incidence was higher than with single-agent PM00104. No pharmacokinetic drug-drug alterations occurred. Partial response was found in one patient with triple negative breast cancer pretreated with paclitaxel/bevacizumab. Three patients with colorectal cancer, head and neck cancer, and tumor of unknown origin had disease stabilization for ≥3 months. In conclusion, no optimal dose was reached due to overlapping myelosuppression despite stratification according to prior treatment. Therefore, this carboplatin plus PM00104 combination was not selected for further clinical research.
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Affiliation(s)
- Ramón Salazar
- Instituto Catalán de Oncología, L'Hospitalet de Llobregat, Barcelona, Spain
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Marine-sourced anti-cancer and cancer pain control agents in clinical and late preclinical development. Mar Drugs 2014; 12:255-78. [PMID: 24424355 PMCID: PMC3917273 DOI: 10.3390/md12010255] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 12/17/2013] [Accepted: 01/07/2014] [Indexed: 01/08/2023] Open
Abstract
The marine habitat has produced a significant number of very potent marine-derived agents that have the potential to inhibit the growth of human tumor cells in vitro and, in a number of cases, in both in vivo murine models and in humans. Although many agents have entered clinical trials in cancer, to date, only Cytarabine, Yondelis® (ET743), Eribulin (a synthetic derivative based on the structure of halichondrin B), and the dolastatin 10 derivative, monomethylauristatin E (MMAE or vedotin) as a warhead, have been approved for use in humans (Adcetris®). In this review, we show the compounds derived from marine sources that are currently in clinical trials against cancer. We have included brief discussions of the approved agents, where they are in trials to extend their initial approved activity (a common practice once an agent is approved), and have also included an extensive discussion of the use of auristatin derivatives as warheads, plus an area that has rarely been covered, the use of marine-derived agents to ameliorate the pain from cancers in humans, and to act as an adjuvant in immunological therapies.
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Butler MS, Robertson AAB, Cooper MA. Natural product and natural product derived drugs in clinical trials. Nat Prod Rep 2014; 31:1612-61. [DOI: 10.1039/c4np00064a] [Citation(s) in RCA: 383] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The 25 Natural Product (NP)-derived drugs launched since 2008 and the 100 NP-derived compounds and 33 Antibody Drug Conjugates (ADCs) in clinical trials or in registration at the end of 2013 are reviewed.
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Affiliation(s)
- Mark S. Butler
- Division of Chemistry and Structural Biology
- Institute for Molecular Bioscience
- The University of Queensland
- Brisbane, Australia
| | - Avril A. B. Robertson
- Division of Chemistry and Structural Biology
- Institute for Molecular Bioscience
- The University of Queensland
- Brisbane, Australia
| | - Matthew A. Cooper
- Division of Chemistry and Structural Biology
- Institute for Molecular Bioscience
- The University of Queensland
- Brisbane, Australia
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Indumathy S, Dass CR. Finding chemo: the search for marine-based pharmaceutical drugs active against cancer. ACTA ACUST UNITED AC 2013; 65:1280-301. [PMID: 23927467 DOI: 10.1111/jphp.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 05/29/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Cancer affects the health of many people globally. The most common treatment that is used for cancer is chemotherapy, which has shown promising results but not without side effects. Some of these side effects jeopardise further treatment, and this eventually leads to advanced stages of malignancy and mortality. As a result, there is a need for better and safer anticancer compounds such as those found naturally. One of the most abundant natural environments to find such compounds is the sea, and this vast resource has been biomined since the 1950s. KEY FINDINGS There are currently three marine anticancer agents marketed (Yondelis, Cytosar-U and Halaven), with several others undergoing clinical trials. This review discusses marine-derived products in clinical use and in clinical trials, and discusses available literature on the growth suppression or pro-apoptotic properties of these compounds, and the molecular mechanisms underpinning these cell biological phenomena. SUMMARY The marine environment may hold promising anticancer compounds within its depths, warranting further research to be performed in this area, albeit with respect for the natural ecosystems that are being explored for drug discover and subsequently used for drug development.
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Affiliation(s)
- Sivanjah Indumathy
- College of Biomedicine and Health, Victoria University, St Albans, Vic, Australia
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Martin LP, Krasner C, Rutledge T, Ibañes ML, Fernández-García EM, Kahatt C, Gómez MS, McMeekin S. Phase II study of weekly PM00104 (ZALYPSIS(®)) in patients with pretreated advanced/metastatic endometrial or cervical cancer. Med Oncol 2013; 30:627. [PMID: 23771800 DOI: 10.1007/s12032-013-0627-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 06/05/2013] [Indexed: 11/29/2022]
Abstract
This open-label, two-arm, phase II clinical trial evaluated the antitumor activity and safety profile of PM00104 (Zalypsis(®)) administered as a 1-h, weekly, intravenous infusion (days 1, 8 and 15; every 4 weeks) at a dose of 2 mg/m(2) to patients with advanced and/or metastatic endometrial (EC) or cervical cancer (CC) after one previous line of systemic chemotherapy. Twelve patients (median age, 61.5 years) with pretreated EC received a median of 2 treatment cycles (range 1-5) and seven patients (median age, 38 years) with pretreated CC received 2 treatment cycles. None achieved objective tumor response. Median progression-free survival (PFS) was 1.8 months, and median overall survival (OS) was 5.5 months in EC (median follow-up = 20.1 months); median PFS was 1.5 months, and median OS was 5.6 months in CC (median follow-up = 17.1 months). The most common toxicities reported were mild to moderate asthenia, nausea, vomiting and diarrhea. Despite PM00104 showing mostly mild, predictable, manageable and reversible toxicity, protocol criteria for further recruitment were not met in EC, a futility analysis was done and recruitment was stopped; a low patient recruitment rate together with no evidence of activity in CC resulted in early study closure.
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Affiliation(s)
- Lainie P Martin
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
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Romano M, Frapolli R, Zangarini M, Bello E, Porcu L, Galmarini CM, García-Fernández LF, Cuevas C, Allavena P, Erba E, D'Incalci M. Comparison of in vitro and in vivo biological effects of trabectedin, lurbinectedin (PM01183) and Zalypsis® (PM00104). Int J Cancer 2013; 133:2024-33. [PMID: 23588839 DOI: 10.1002/ijc.28213] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/03/2013] [Indexed: 01/29/2023]
Abstract
This study: (i) investigated the in vitro cytotoxicity and mode of action of lurbinectedin (PM01183) and Zalypsis® (PM00104) compared with trabectedin in cell lines deficient in specific mechanisms of repair, (ii) evaluated their in vivo antitumor activity against a series of murine tumors and human xenografts. The antiproliferative activity, the DNA damage and the cell cycle perturbations induced by the three compounds on tumor lines were very similar. Nucleotide Excision Repair (NER) deficient cells were approximately fourfold more resistant to trabectedin, lurbinectedin and Zalypsis®. Cells deficient in non-homologous end joining (NHEJ), MRN complex and translesion synthesis (TLS) were slightly more sensitive to the three compounds (approximately fivefold) while cells deficient in homologous recombination (HR) were markedly more sensitive (150-200-fold). All three compounds showed a good antitumor activity in several in vivo models. Lurbinectedin and trabectedin had a similar pattern of antitumor activity in murine tumors and in xenografts, whereas Zalypsis® appeared to have a distinct spectrum of activity. The fact that no relationship whatsoever was found between the in vitro cytotoxic potency and the in vivo antitumor activity, suggests that in addition to direct cytotoxic mechanisms other host-mediated effects are involved in the in vivo pharmacological effects.
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Affiliation(s)
- Michela Romano
- Department of Oncology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa, Milan, Italy
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A survey of marine natural compounds and their derivatives with anti-cancer activity reported in 2011. Molecules 2013; 18:3641-73. [PMID: 23529027 PMCID: PMC6270579 DOI: 10.3390/molecules18043641] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 03/07/2013] [Accepted: 03/11/2013] [Indexed: 12/13/2022] Open
Abstract
Cancer continues to be a major public health problem despite the efforts that have been made in the search for novel drugs and treatments. The current sources sought for the discovery of new molecules are plants, animals and minerals. During the past decade, the search for anticancer agents of marine origin to fight chemo-resistance has increased greatly. Each year, several novel anticancer molecules are isolated from marine organisms and represent a renewed hope for cancer therapy. The study of structure-function relationships has allowed synthesis of analogues with increased efficacy and less toxicity. In this report, we aim to review 42 compounds of marine origin and their derivatives that were published in 2011 as promising anticancer compounds.
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A phase I pharmacokinetic study of PM00104 (Zalypsis) administered as a 24-h intravenous infusion every 3 weeks in patients with advanced solid tumors. Cancer Chemother Pharmacol 2013; 71:1247-54. [PMID: 23455428 DOI: 10.1007/s00280-013-2119-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 02/01/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE PM00104 (Zalypsis) is a synthetic tetrahydroisoquinoline alkaloid with potent antiproliferative activity against tumor cell lines. This phase I study evaluated the safety, dose-limiting toxicities (DLTs), recommended dose for phase II trials (RD), pharmacokinetics (PK) and preliminary antitumor activity of PM00104 as a 24-h intravenous (i.v.) infusion every 3 weeks (q3wk). METHODS Thirty-seven patients with refractory advanced solid tumors received PM00104 in a toxicity-guided dose escalation study design (3 + 3 patients per cohort). Plasma samples were collected for PK analysis. RESULTS DLTs comprised severe neutropenia lasting >5 days (n = 4 patients), vomiting, thrombocytopenia, transaminase increases (n = 2 each), fatigue, tumor pain, myalgia, muscle stiffness, creatine phosphokinase increase and dosing delay >2 weeks due to moderate fatigue (n = 1 each). The RD was 4.0 mg/m(2). Most PM00104-related adverse events at the RD were mild or moderate; the most common were nausea, vomiting and fatigue. Myelosuppression and transaminase increases were transient and manageable. PK parameters increased linearly with dose. Higher PM00104 PK exposure was related to a decrease in hemoglobin, neutrophils, platelets and white blood cells. Area under the curve was directly correlated with both incidence and severity of nausea and vomiting. Three patients with hepatocellular carcinoma, esophageal adenocarcinoma and prostate adenocarcinoma had response evaluation criteria in solid tumors stable disease ≥3 months. CONCLUSIONS PM00104 given as 24-h i.v. infusion q3wk has predictable and manageable toxicity, but resulted in more myelotoxicity (because of the higher dose level achieved as the RD) and a similar drug clearance compared to 1-h infusion schedules. Preliminary evidence of antitumor activity was observed.
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González-Sales M, Valenzuela B, Pérez-Ruixo C, Fernández Teruel C, Miguel-Lillo B, Soto-Matos A, Pérez-Ruixo JJ. Population Pharmacokinetic–Pharmacodynamic Analysis of Neutropenia in Cancer Patients Receiving PM00104 (Zalypsis®). Clin Pharmacokinet 2012; 51:751-64. [DOI: 10.1007/s40262-012-0011-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Massard C, Margetts J, Amellal N, Drew Y, Bahleda R, Stephens P, Stevens P, Armand JP, Calvert H, Soria JC, Coronado C, Kahatt C, Alfaro V, Siguero M, Fernández-Teruel C, Plummer R. Phase I study of PM00104 (Zalypsis®) administered as a 1-hour weekly infusion resting every fourth week in patients with advanced solid tumors. Invest New Drugs 2012; 31:623-30. [PMID: 22688291 DOI: 10.1007/s10637-012-9843-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 05/28/2012] [Indexed: 10/28/2022]
Abstract
PM00104 (Zalypsis®) is a new synthetic alkaloid with potent cytotoxic activity against tumor cell lines. This phase I clinical trial determined the maximal tolerated dose (MTD) and recommended dose (RD) for phase II trials of PM00104 administered as a 1-hour intravenous (i.v.) infusion weekly for three consecutive weeks resting every fourth week (d1,8,15 q4wk). Forty-nine patients with advanced solid malignancies received PM00104 following a toxicity-guided, accelerated, dose-escalation design. Doses evaluated ranged from 0.07 to 3.0 mg/m(2). Dose-limiting toxicities (DLTs) appeared at the highest doses tested and comprised grade 3 diarrhea and grade 4 lipase increase at 2.0 mg/m(2); grade 1 thrombocytopenia and grade 2 neutropenia with two infusion omissions, grade 3 fatigue and grade 4 febrile neutropenia at 2.5 mg/m(2); and grade 3/4 fatigue, grade 4 neutropenia lasting >5 days and grade 4 thrombocytopenia at 3.0 mg/m(2). RD was established at 2.0 mg/m(2). PM00104-related adverse events at the RD were mostly grade 1/2, with fatigue, nausea and vomiting as the most common. Transient and manageable myelosuppression and transaminase increases were also reported. Main pharmacokinetic parameters increased linearly with dose. Disease stabilization lasting ≥ 3 months was found in 4 patients with cervical carcinoma, colorectal adenocarcinoma, lachrymal adenoid carcinoma, and bladder carcinoma (n=1 each). In conclusion, PM00104 2.0 mg/m(2) 1-hour, d1,8,15 q4wk showed a positive risk-benefit ratio, which has supported its further evaluation in three ongoing phase II clinical trials.
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Affiliation(s)
- Christophe Massard
- SITEP (Service des Innovations Thérapeutiques Précoces), Institute Gustave Roussy, 114, rue Edouard Vaillant, 94800, Villejuif, France.
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