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Bademci R, Erdoğan MA, Eroğlu E, Meral A, Erdoğan A, Atasoy Ö, Erbaş O. Demonstration of the protective effect of ghrelin in the livers of rats with cisplatin toxicity. Hum Exp Toxicol 2021; 40:2178-2187. [PMID: 34151639 DOI: 10.1177/09603271211026722] [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] [Indexed: 11/16/2022]
Abstract
Despite the various and newly developed chemotherapeutic agents in recent years, cisplatin is still used very frequently as a chemotherapeutic agent, even though cisplatin has toxic effects on many organs. The aim of our study is to show whether ghrelin reduces the liver toxicity of cisplatin in the rat model. Twenty-eight male Sprague Dawley albino mature rats were chosen to be utilized in the study. Group 1 rats (n = 7) were taken as the control group, and no medication was given to them. Group 2 rats (n = 7) received 5 mg/kg/day cisplatin and 1 ml/kg/day of 0.9% NaCl, Group 3 rats (n = 7) received 5 mg/kg/day cisplatin and 10 ng/kg/day ghrelin, Group 4 rats (n = 7) received 5 mg/kg/day cisplatin and 20 ng/kg/day ghrelin for 3 days. Glutathione, malondialdehyde (MDA), superoxide dismutase (SOD), plasma alanine aminotransferase (ALT) levels, and liver biopsy results were measured in rats. It was determined that, especially in the high-dose group, the MDA, plasma ALT, and SOD levels increased less in the ghrelin group as compared to the cisplatin group, and the glutathione level decreased slightly with a low dose of ghrelin, while it increased with a higher dose. In histopathological examination, it was determined that the toxic effect of cisplatin on the liver was reduced with a low dose of ghrelin, and its histopathological appearance was similar to normal liver tissue when given a high dose of ghrelin. These findings show that ghrelin, especially in high doses, can be used to reduce the toxic effect of cisplatin.
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Affiliation(s)
- R Bademci
- Department of General Surgery, 218502Istanbul Medipol University, Istanbul, Turkey
| | - M A Erdoğan
- Faculty of Medicine, Department of Physiology, 485550Izmir Katip Çelebi University, Izmir, Turkey
| | - E Eroğlu
- Department of General Surgery, 64117Memorial Hospital, Istanbul, Turkey
| | - A Meral
- Medical Faculty, Department of Biochemistry, 64162Yuzuncü Yıl University, Van, Turkey
| | - A Erdoğan
- Department of Emergency Medicine, Izmir Cigli Regional Training Hospital, Izmir, Turkey
| | - Ö Atasoy
- Department of Radiation Oncology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - O Erbaş
- Department of Physiology, Istanbul Bilim University, Istanbul, Turkey
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Chen CH, Huang CY, Lin HYH, Wang MC, Chang CY, Cheng YF. Association of Sodium Thiosulfate With Risk of Ototoxic Effects From Platinum-Based Chemotherapy: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2118895. [PMID: 34338793 PMCID: PMC8329743 DOI: 10.1001/jamanetworkopen.2021.18895] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Platinum-induced ototoxic effects are a significant issue because platinum-based chemotherapy is one of the most commonly used therapeutic medications. Sodium thiosulfate (STS) is considered a potential otoprotectant for the prevention of platinum-induced ototoxic effects that functions by binding the platinum-based agent, but its administration raises concerns regarding the substantial attenuation of the antineoplastic outcome associated with platinum. OBJECTIVE To evaluate the association between concurrent STS and reduced risk of ototoxic effects among patients undergoing platinum-based chemotherapy and to evaluate outcomes, including event-free survival, overall survival, and adverse outcomes. DATA SOURCES From inception through November 7, 2020, databases, including the Cochrane Library, PubMed, Embase, Web of Science, and Scopus, were searched. STUDY SELECTION Studies enrolling patients with cancer who were undergoing platinum-based chemotherapy that compared ototoxic effects development between patients who received STS and patients who did not and provided adequate information for meta-analysis were regarded as eligible. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. DATA EXTRACTION AND SYNTHESIS The data were extracted by 2 reviewers independently. A random-effects model was used to explore objectives. MAIN OUTCOMES AND MEASURES Relative risks (RRs) for ototoxic effects development and hemopoietic event development comparing the experimental group and the control group were estimated. Secondary outcomes were hazard ratios (HRs) for event-free survival and overall survival. Sensitivity analysis and trial sequential analysis were conducted to further consolidate pooled results. RESULTS Among 4 eligible studies that were included, there were 3 randomized clinical trials and 1 controlled study. A total of 278 patients were allocated to the experimental group (ie, platinum-based chemotherapy plus STS; 158 patients, including 13 patients using contralatral ears of the control group as samples) or the control group (ie, chemotherapy; 133 patients, including 13 patients using contralateral ears of the experimental group as samples). Overall, patients who received STS had a statistically significantly decreased risk of ototoxic effects during the course of platinum-based chemotherapy (RR, 0.61; 95% CI, 0.49-0.77; P < .001; I2 = 5.0%) without a statistically significant increase in the risk of poor event-free survival (HR, 1.13; 95% CI, 0.70-1.82; P = .61; I2 = 0%) or overall survival (HR, 1.90; 95% CI, 0.90-4.03; P = .09; I2 = 0%). In the trial sequential analysis of event-free survival (z = -0.52) and overall survival (z = -1.68), although the cumulative z curves did not surpass the traditional significance boundary (-1.96 to 1.96 for both) or sequential monitoring boundary (event-free survival: -8.0 to 8.0; overall survival boundary not renderable in the analysis because the information size was too small) of the adjusted CI, they did not reach the required information size. CONCLUSIONS AND RELEVANCE This meta-analysis found that concurrent STS delivery was associated with a decreased risk of platinum-induced ototoxic effects among patients treated with platinum-induced chemotherapy. These findings suggest that concurrent STS for protection against ototoxic effects should be considered for patients indicated for platinum-based chemotherapy.
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Affiliation(s)
- Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Heng-Yu Haley Lin
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mao-Che Wang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Yu Chang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Cortés Fuentes IA, Burotto M, Retamal MA, Frelinghuysen M, Caglevic C, Gormaz JG. Potential use of n-3 PUFAs to prevent oxidative stress-derived ototoxicity caused by platinum-based chemotherapy. Free Radic Biol Med 2020; 160:263-276. [PMID: 32827639 DOI: 10.1016/j.freeradbiomed.2020.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Platinum-based compounds are widely used for the treatment of different malignancies due to their high effectiveness. Unfortunately, platinum-based treatment may lead to ototoxicity, an often-irreversible side effect without a known effective treatment and prevention plan. Platinum-based compound-related ototoxicity results mainly from the production of toxic levels of reactive oxygen species (ROS) rather than DNA-adduct formation, which has led to test strategies based on direct ROS scavengers to ameliorate hearing loss. However, favorable clinical results have been associated with several complications, including potential interactions with chemotherapy efficacy. To understand the contribution of the different cytotoxic mechanisms of platinum analogues on malignant cells and auditory cells, the particular susceptibility and response of both kinds of cells to molecules that potentially interfere with these mechanisms, is fundamental to develop innovative strategies to prevent ototoxicity without affecting antineoplastic effects. The n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) have been tried in different clinical settings, including with cancer patients. Nevertheless, their use to decrease cisplatin-induced ototoxicity has not been explored to date. In this hypothesis paper, we address the mechanisms of platinum compounds-derived ototoxicity, focusing on the differences between the effects of these compounds in neoplastic versus auditory cells. We discuss the basis for a strategic use of n-3 PUFAs to potentially protect auditory cells from platinum-derived injury without affecting neoplastic cells and chemotherapy efficacy.
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Affiliation(s)
- Ignacio A Cortés Fuentes
- Otorhinolaryngology Service, Hospital Barros Luco-Trudeau, San Miguel, Santiago, Chile; Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Mauricio Burotto
- Oncology Department, Clínica Universidad de Los Andes, Santiago, Chile; Bradford Hill, Clinical Research Center, Santiago, Chile
| | - Mauricio A Retamal
- Universidad Del Desarrollo, Centro de Fisiología Celular e Integrativa, Facultad de Medicina Clínica Alemana, Santiago, Chile.
| | | | - Christian Caglevic
- Cancer Research Department, Fundación Arturo López Pérez, Santiago, Chile
| | - Juan G Gormaz
- Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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Molecular mechanisms of Cisplatin- induced placental toxicity and teratogenicity in rats and the ameliorating role of N-acetyl-cysteine. Int J Biochem Cell Biol 2019; 115:105579. [DOI: 10.1016/j.biocel.2019.105579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/23/2019] [Accepted: 07/31/2019] [Indexed: 11/23/2022]
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Rolland V, Meyer F, Guitton MJ, Bussières R, Philippon D, Bairati I, Leclerc M, Côté M. A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer. J Otolaryngol Head Neck Surg 2019; 48:4. [PMID: 30651130 PMCID: PMC6335693 DOI: 10.1186/s40463-019-0327-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity. Methods Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m2 at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE. On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment. For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables. Results Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically (p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz. Conclusions Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes. Trial registration ClinicalTrials.gov, NTC02281006, Registered 3 November 2014.
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Affiliation(s)
- Viannique Rolland
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - François Meyer
- Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Laval University Cancer Research Center, Quebec City, Canada
| | - Matthieu J Guitton
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,CERVO Brain Research Center, Quebec City, QC, Canada
| | - Richard Bussières
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - Daniel Philippon
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada
| | - Isabelle Bairati
- Laval University Cancer Research Center, Quebec City, Canada.,Department of Surgery, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Mathieu Leclerc
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada.,Department of Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Mathieu Côté
- Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Laval University, Pavillon Ferdinand-Vandry, Bureau 4889, 1050, avenue de la Médecine, Québec City, QC, G1V A06, Canada. .,Centre Hospitalier Universitaire de Québec, Hôtel-Dieu de Québec, Quebec City, QC, Canada.
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6
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Brock PR, Maibach R, Childs M, Rajput K, Roebuck D, Sullivan MJ, Laithier V, Ronghe M, Dall'Igna P, Hiyama E, Brichard B, Skeen J, Mateos ME, Capra M, Rangaswami AA, Ansari M, Rechnitzer C, Veal GJ, Covezzoli A, Brugières L, Perilongo G, Czauderna P, Morland B, Neuwelt EA. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med 2018; 378:2376-2385. [PMID: 29924955 PMCID: PMC6117111 DOI: 10.1056/nejmoa1801109] [Citation(s) in RCA: 211] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cisplatin chemotherapy and surgery are effective treatments for children with standard-risk hepatoblastoma but may cause considerable and irreversible hearing loss. This trial compared cisplatin with cisplatin plus delayed administration of sodium thiosulfate, aiming to reduce the incidence and severity of cisplatin-related ototoxic effects without jeopardizing overall and event-free survival. METHODS We randomly assigned children older than 1 month and younger than 18 years of age who had standard-risk hepatoblastoma (≤3 involved liver sectors, no metastatic disease, and an alpha-fetoprotein level of >100 ng per milliliter) to receive cisplatin alone (at a dose of 80 mg per square meter of body-surface area, administered over a period of 6 hours) or cisplatin plus sodium thiosulfate (at a dose of 20 g per square meter, administered intravenously over a 15-minute period, 6 hours after the discontinuation of cisplatin) for four preoperative and two postoperative courses. The primary end point was the absolute hearing threshold, as measured by pure-tone audiometry, at a minimum age of 3.5 years. Hearing loss was assessed according to the Brock grade (on a scale from 0 to 4, with higher grades indicating greater hearing loss). The main secondary end points were overall survival and event-free survival at 3 years. RESULTS A total of 109 children were randomly assigned to receive cisplatin plus sodium thiosulfate (57 children) or cisplatin alone (52) and could be evaluated. Sodium thiosulfate was associated with few high-grade toxic effects. The absolute hearing threshold was assessed in 101 children. Hearing loss of grade 1 or higher occurred in 18 of 55 children (33%) in the cisplatin-sodium thiosulfate group, as compared with 29 of 46 (63%) in the cisplatin-alone group, indicating a 48% lower incidence of hearing loss in the cisplatin-sodium thiosulfate group (relative risk, 0.52; 95% confidence interval [CI], 0.33 to 0.81; P=0.002). At a median of 52 months of follow-up, the 3-year rates of event-free survival were 82% (95% CI, 69 to 90) in the cisplatin-sodium thiosulfate group and 79% (95% CI, 65 to 88) in the cisplatin-alone group, and the 3-year rates of overall survival were 98% (95% CI, 88 to 100) and 92% (95% CI, 81 to 97), respectively. CONCLUSIONS The addition of sodium thiosulfate, administered 6 hours after cisplatin chemotherapy, resulted in a lower incidence of cisplatin-induced hearing loss among children with standard-risk hepatoblastoma, without jeopardizing overall or event-free survival. (Funded by Cancer Research UK and others; SIOPEL 6 ClinicalTrials.gov number, NCT00652132 ; EudraCT number, 2007-002402-21 .).
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Affiliation(s)
- Penelope R Brock
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Rudolf Maibach
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Margaret Childs
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Kaukab Rajput
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Derek Roebuck
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Michael J Sullivan
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Véronique Laithier
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Milind Ronghe
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Patrizia Dall'Igna
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Eiso Hiyama
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Bénédicte Brichard
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Jane Skeen
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - M Elena Mateos
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Michael Capra
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Arun A Rangaswami
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Marc Ansari
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Catherine Rechnitzer
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Gareth J Veal
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Anna Covezzoli
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Laurence Brugières
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Giorgio Perilongo
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Piotr Czauderna
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Bruce Morland
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
| | - Edward A Neuwelt
- From Great Ormond Street Hospital, London (P.R.B., K.R., D.R.), Nottingham Clinical Trials Unit, Nottingham (M. Childs), Royal Hospital for Sick Children, Glasgow (M.R.), Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne (G.J.V.), and University of Birmingham, Birmingham (B.M.) - all in the United Kingdom; International Breast Cancer Study Group, Bern (R.M.), and Hôpital Universitaire de Genève, Geneva (M.A.) - both in Switzerland; University of Melbourne, Melbourne, VIC, Australia (M.J.S.); University of Otago, Christchurch (M.J.S.), and Starship Children's Hospital, Auckland (J.S.) - both in New Zealand; Centre Hospitalier Universitaire, Besançon (V.L.), and Institut de Cancerologie Gustave Roussy, Villejuif (L.B.) - both in France; University of Padua, Padua (P.D., G.P.), and Consorzio Interuniversitario (CINECA), Bologna (A.C.) - both in Italy; Hiroshima University, Hiroshima, Japan (E.H.); Cliniques Universitaires Saint Luc, Brussels (B.B.); University Hospital Reina Sofia, Cordoba, Spain (M.E.M.); Our Lady's Children's Hospital, Dublin (M. Capra); Stanford University Medical Center, Palo Alto, CA (A.A.R.); University Hospital Rigshospitalet, Copenhagen (C.R.); Medical University of Gdansk, Gdansk, Poland (P.C.); and Oregon Health and Science University, Portland (E.A.N.)
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Sooriyaarachchi M, Gailer J, Dolgova NV, Pickering IJ, George GN. Chemical basis for the detoxification of cisplatin-derived hydrolysis products by sodium thiosulfate. J Inorg Biochem 2016; 162:96-101. [DOI: 10.1016/j.jinorgbio.2016.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/06/2016] [Accepted: 06/03/2016] [Indexed: 11/29/2022]
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Roldán-Fidalgo A, Martín Saldaña S, Trinidad A, Olmedilla-Alonso B, Rodríguez-Valiente A, García-Berrocal JR, Ramírez-Camacho R. In vitro and in vivo effects of lutein against cisplatin-induced ototoxicity. ACTA ACUST UNITED AC 2016; 68:197-204. [PMID: 26850526 DOI: 10.1016/j.etp.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/05/2016] [Accepted: 01/14/2016] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Cisplatin is a commonly prescribed drug that produces ototoxicity as a side effect. Lutein is a carotenoid with antioxidant and anti-inflammatory properties previously tested for eye, heart and skin diseases but not evaluated to date in ear diseases. AIM To evaluate the protective effects of lutein on HEI-OC1 auditory cell line and in a Wistar rat model of cisplatin ototoxicity. MATERIALS AND METHODS In vitro study: Culture HEI-OC1 cells were exposed to lutein (2.5-100 μM) and to 25 μM cisplatin for 24h. In vivo study: Twenty eight female Wistar rats were randomized into three groups. Group A (n=8) received intratympanic lutein (0.03 mL) (1mg/mL) in the right ear and saline solution in the left one to determine the toxicity of lutein. Group B (n=8) received also intraperitoneal cisplatin (10mg/kg) to test the efficacy of lutein against cisplatin ototoxicity. Group C (n=12) received intratympanic lutein (0.03 mL) (1mg/mL) to quantify lutein in cochlear fluids (30 min, 1h and 5 days after treatment). Hearing function was evaluated by means of Auditory Steady-State Responses before the procedure and 5 days after (groups A and B). Morphological changes were studied by confocal laser scanning microscopy. RESULTS In vitro study: Lutein significantly reduced the cisplatin-induced cytotoxicity in the HEI-OC1 cells when they were pre-treated with lutein concentrations of 60 and 80 μM. In vivo study: Intratympanic lutein (1mg/mL) application showed no ototoxic effects. However it did not achieve protective effect against cisplatin-induced ototoxicity in Wistar rats. CONCLUSIONS Although lutein has shown beneficial effects in other pathologies, the present study only obtained protection against cisplatin ototoxicity in culture cells, but not in the in vivo model. The large molecule size, the low dose administered, and restriction to diffusion in the inner ear could account for this negative result.
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Affiliation(s)
- A Roldán-Fidalgo
- Department of Otorhinolaryngology, Hospital Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain.
| | - S Martín Saldaña
- Foundation for Biomedical Research, Puerta de Hierro Hospital, Madrid, Spain
| | - A Trinidad
- Department of Otorhinolaryngology, Hospital Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - B Olmedilla-Alonso
- Institute of Food Science, Technology and Nutrition, CSIC, Madrid, Spain
| | - A Rodríguez-Valiente
- Department of Otorhinolaryngology, Hospital Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - J R García-Berrocal
- Department of Otorhinolaryngology, Hospital Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - R Ramírez-Camacho
- Department of Otorhinolaryngology, Hospital Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
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Anderson JM, Campbell K. Assessment of Interventions to Prevent Drug-Induced Hearing Loss. FREE RADICALS IN ENT PATHOLOGY 2015. [DOI: 10.1007/978-3-319-13473-4_12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Gurney JG, Bass JK, Onar-Thomas A, Huang J, Chintagumpala M, Bouffet E, Hassall T, Gururangan S, Heath JA, Kellie S, Cohn R, Fisher MJ, Panandiker AP, Merchant TE, Srinivasan A, Wetmore C, Qaddoumi I, Stewart CF, Armstrong GT, Broniscer A, Gajjar A. Evaluation of amifostine for protection against cisplatin-induced serious hearing loss in children treated for average-risk or high-risk medulloblastoma. Neuro Oncol 2014; 16:848-55. [PMID: 24414535 PMCID: PMC4022215 DOI: 10.1093/neuonc/not241] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 11/14/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate amifostine for protection from cisplatin-induced serious hearing loss in patients with average-risk medulloblastoma by extending a previous analysis to a much larger sample size. In addition, this study aimed to assess amifostine with serious hearing loss in patients with high-risk medulloblastoma treated with cisplatin. METHODS Newly diagnosed medulloblastoma patients (n = 379; ages 3-21 years), enrolled on one of 2 sequential St. Jude clinical protocols that included 4 courses of 75 mg/m(2) cisplatin, were compared for hearing loss by whether or not they received 600 mg/m(2) of amifostine immediately before and 3 hours into each cisplatin infusion. Amifostine administration was not randomized. The last audiological evaluation between 5.5 and 24.5 months following protocol treatment initiation was graded using the Chang Ototoxicity Scale. A grade of ≥ 2b (loss requiring a hearing aid or deafness) was considered a serious event. RESULTS Among average-risk patients (n = 263), amifostine was associated with protection from serious hearing loss (adjusted OR, 0.30; 95% CI, 0.14-0.64). For high-risk patients (n = 116), however, there was not sufficient evidence to conclude that amifostine prevented serious hearing loss (OR, 0.89; 95% CI, 0.31-2.54). CONCLUSIONS Although patients in this study were not randomly assigned to amifostine treatment, we found evidence in favor of amifostine administration for protection against cisplatin-induced serious hearing loss in average-risk but not in high-risk, medulloblastoma patients.
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Affiliation(s)
- James G Gurney
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Johnnie K Bass
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Arzu Onar-Thomas
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Jie Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Murali Chintagumpala
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Eric Bouffet
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Tim Hassall
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Sridharan Gururangan
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - John A Heath
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Stewart Kellie
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Richard Cohn
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Michael J Fisher
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Atmaram Pai Panandiker
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Thomas E Merchant
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Ashok Srinivasan
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Cynthia Wetmore
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Ibrahim Qaddoumi
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Clinton F Stewart
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Alberto Broniscer
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
| | - Amar Gajjar
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis Tenneessee (J.G.G., G.T.A.); Department of Rehabilitation Service, St. Jude Children's Research Hospital, Memphis Tenneessee (J.K.B.); Department of Biostatistics, St. Jude Children's Research Hospital, Memphis Tenneessee (A.O.-T., J.H.); Department of Oncology, St. Jude Children's Research Hospital, Memphis Tenneessee (C.W., I.Q., G.T.A., A.B., A.G.); Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee, (A.P.P., T.E.M.); Department of Bone Marrow Transplantation, St. Jude Children's Research Hospital, Memphis, Tenneessee (A.S.); Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis Tenneessee (C.F.S.); Department of Pediatrics, Texas Children's Cancer Center, Houston, Texas (M.C.); Hospital for Sick Children, Toronto, Ontario, Canada (E.B.); Royal Children's Hospital Brisbane, Herston, Australia (T.H.); The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina (S.G.); The Royal Children's Hospital Melbourne, Victoria, Australia (J.A.H.); Children's Hospital at Westmead, Sydney, Australia (S.K.); Sydney Children's Hospital, Sydney, Australia (R.C.); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (M.J.F.); School of Public Health, University of Memphis, Memphis, Tenneessee (J.G.G.)
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Wu C, Gopal KV, Moore EJ, Gross GW. Antioxidants L-carnitine and D-methionine modulate neuronal activity through GABAergic inhibition. J Neural Transm (Vienna) 2014; 121:683-93. [PMID: 24532255 DOI: 10.1007/s00702-014-1170-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 01/30/2014] [Indexed: 12/11/2022]
Abstract
Antioxidants are well known for their neuroprotective properties against reactive oxygen species in cortical neurons and auditory cells. We recently identified L-carnitine and D-methionine to be among agents that provide such protection. Here, we investigated their neuronal modulatory actions. We used cultured neuronal networks grown on microelectrode arrays to assess the effects of L-carnitine and D-methionine on network function. Spike production and burst properties of neuronal networks were used as parameters to monitor pharmacological responses. L-Carnitine and D-methionine reduced spike activity with 100% efficacy with EC50 values of 0.22 (± 0.01) mM and 1.06 (± 0.05) mM, respectively. In the presence of 1.0-40 μM of the GABAA antagonist bicuculline, the sigmoidal concentration-response curves of both compounds exhibited stepwise shifts, without a change in efficacy. Under a maximal bicuculline concentration of 40 μM, the EC50 increased to 3.57 (± 0.26) mM for L-carnitine and to 10.52 (± 0.97) mM for D-methionine, more than a tenfold increase. The agonist-antagonist interactions with bicuculline were estimated by Lineweaver-Burk plot analyses to be competitive, corroborated by the computed dissociation constants of bicuculline. For both compounds, the effects on the network burst pattern, activity reversibility, and bicuculline antagonism resembled that elicited by the GABAA agonist muscimol. We showed that the antioxidants L-carnitine and D-methionine modulate cortical electrical spike activity primarily through GABAA receptor activation. Our findings suggest the involvement of GABAergic mechanisms that perhaps contribute to the protective actions of these compounds.
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Affiliation(s)
- Calvin Wu
- Department of Biological Sciences, University of North Texas, Denton, TX, 76203, USA,
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A combination of cilostazol and Ginkgo biloba extract protects against cisplatin-induced Cochleo-vestibular dysfunction by inhibiting the mitochondrial apoptotic and ERK pathways. Cell Death Dis 2013; 4:e509. [PMID: 23429295 PMCID: PMC3734837 DOI: 10.1038/cddis.2013.33] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cisplatin (cis-diammine-dichloroplatinum; CDDP) is an anticancer drug that induces significant hearing loss and balance dysfunction as side effects. Cilostazol (CS, 6-[4-(1-cyclohexyl-1H-tetrazol-5-yl) butoxy]-3, 4-dihydro-2-(1H)-quinolinone) has neuroprotective and antioxidant effects, whereas Ginkgo biloba extract (GbE) has preventive effects on CDDP-induced hearing loss in rats, and GbE enhances the antiatherogenic effect of CS by inhibiting the generation of reactive oxygen species (ROS). The purpose of this study was to investigate the effects of renexin (RXN), which contains GbE and CS, against CDDP-induced cochleo-vestibular dysfunction in rats and to elucidate the mechanism underlying the protective effects of RXN on auditory cells. Rats intraperitoneally injected with CDDP exhibited an increase in hearing threshold and vestibular dysfunction, which agreed with hair cell damage in the Organ of Corti and otoliths. However, these impairments were significantly prevented in a dose-dependent manner by pre- and co-treatment with RXN, and these preventive effects in RXN-treated rats were more prominent than those in GbE-treated rats. In a CDDP pharmacokinetic study, platinum concentration was very similar between CDDP-only treated and RXN+CDDP cotreated rats. RXN markedly attenuated CDDP-induced intracellular ROS and significantly reduced CDDP-activated expression of p-extracellular regulated kinase (ERK), BAX, cytochrome c, cleaved caspase-3 and cleaved poly (ADP-ribose) polymerase, but increased BCL-XL expression. These results show that RXN may have a synergistic effect by strongly protecting hearing and vestibular dysfunction induced by CDDP by inhibiting ROS production, mitochondrial pathways and the ERK pathway, without interfering with CDDP pharmacokinetics. Therefore, RXN could potentially be used to reduce CDDP-related hearing loss and dizziness.
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13
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Ameliorative effect of the crude oil of the Nigella sativa on oxidative stress induced in rat testes by cisplatin treatment. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.bionut.2012.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Gurney JG, Bass JK. New International Society of Pediatric Oncology Boston Ototoxicity Grading Scale for pediatric oncology: still room for improvement. J Clin Oncol 2012; 30:2303-6. [PMID: 22547588 DOI: 10.1200/jco.2011.41.3187] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Protective effects of vitamins E, B and C and l-carnitine in the prevention of cisplatin-induced ototoxicity in rats. The Journal of Laryngology & Otology 2012; 126:464-9. [DOI: 10.1017/s0022215112000382] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:This experimental study aimed to investigate the effects of vitamins E, B and C and l-carnitine in preventing cisplatin-induced ototoxicity.Methods:Twenty-five adult, male, Wistar albino rats were randomly allocated to receive intraperitoneal cisplatin either alone or preceded by vitamins B, E or C or l-carnitine. Auditory brainstem response (i.e. hearing thresholds and wave I–IV intervals) and distortion product otoacoustic emissions (i.e. signal-to-noise ratios) were recorded before and 72 hours after cisplatin administration.Results:The following statistically significant differences were seen: control group pre- vs post-treatment wave I–IV interval values (p < 0.05); control vs vitamin E and B groups' I–IV interval values (p < 0.05); control vs other groups' hearing thresholds; vitamin E vs vitamin B and C and l-carnitine groups' hearing thresholds (p < 0.05); and vitamin B vs vitamin C and l-carnitine groups' hearing thresholds (p < 0.05). Statistically significant decreases were seen when comparing the initial and final signal-to-noise ratios in the control, vitamin B and l-carnitine groups (2000 and 3000 Hz; p < 0.01), and the initial and final signal-to-noise ratios in the control group (at 4000 Hz; p < 0.01).Conclusion:Vitamins B, E and C and l-carnitine appear to reduce cisplatin-induced ototoxicity in rats. The use of such additional treatments to decrease cisplatin-induced ototoxicity in humans is still under discussion.
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Abstract
OBJECTIVES/HYPOTHESIS To design a grading scale and audiologic protocols to better reflect clinical impact than the currently widely used classifications. STUDY DESIGN Retrospective. METHODS Audiologic studies from 130 patients receiving cisplatin chemotherapy were analyzed. Pure-tone audiograms were evaluated using the newly proposed grading criteria, Brock criteria, and Common Terminology Criteria for Adverse Events (CTCAE). The resulting grades were then compared to recommended audiologic interventions. Auditory brainstem response (ABR) data and data on incidences of conductive hearing loss from other multi-institutional studies that the author participated in were compared to data from this cohort. RESULTS Although the newly proposed, Brock, and CTCAE ototoxicity grades were significantly related to audiologist recommendations for assistive devices (P < .0001), the newly proposed criteria were more specific and allowed better delineation of different patients into distinct subgroups requiring either FM system (grade 2a) or hearing aid (grade 2b or higher). Multi-institutional data review indicated significant problems with ABR evaluations and separating out conductive hearing losses from ototoxicity. CONCLUSIONS The newly proposed grading system needs to be paired with specific recommendations regarding audiologic monitoring protocols as well as active participation by the audiologists implementing the protocol to provide clinically accurate assessment and grading of ototoxicity.
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Affiliation(s)
- Kay W Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California 94305, USA.
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Naqshbandi A, Khan W, Rizwan S, Khan F. Studies on the protective effect of flaxseed oil on cisplatin-induced hepatotoxicity. Hum Exp Toxicol 2012; 31:364-75. [DOI: 10.1177/0960327111432502] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cisplatin (CP) is known as one of the most potent chemotherapeutic antitumor drugs. The tissue-specific toxicity of CP in the kidneys is well documented. However, at higher doses less common toxic effects such as hepatotoxicity may arise. Since CP remains one of the most effective antineoplastic drug used in chemotherapy, strategies to protect tissues against CP toxicity are of clinical interest. Recently, ω-3 polyunsaturated fatty acids (PUFAs) from certain plants/seeds notably flaxseed have shown numerous health benefits. In view of this, the present study investigates the protective effect of flaxseed oil (FXO) on CP-induced damage in liver. Rats were pre-fed normal diet and the diet rich in FXO for 10 days and then a single dose of CP (6 mg/kg body weight) was administered intraperitoneally while still on diet. Serum/urine parameters, enzymes of carbohydrate metabolism and oxidative stress were analyzed. CP caused perturbation of the antioxidant defense as reflected by the decrease in the activities of catalase, superoxide dismutase and glutathione peroxidase. Further the activities of various enzymes involved in glycolysis, tricarboxylic acid cycle, gluconeogenesis and hexose monophosphate shunt pathways were determined and were found to be differentially altered by CP treatment. However, these alterations were ameliorated in CP-treated rats fed on FXO. Present results show that dietary supplementation of FXO in CP-treated rats ameliorated CP-induced hepatotoxic and other deleterious effects due to its intrinsic biochemical/antioxidant properties.
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Affiliation(s)
- A Naqshbandi
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - W Khan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - S Rizwan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - F Khan
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Saliba I, El Fata F. Is Intratympanic Injection of Erdosteine Protective Against Cisplatin-Induced Ototoxicity? Neurotox Res 2011; 21:302-8. [DOI: 10.1007/s12640-011-9282-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 09/28/2011] [Accepted: 09/29/2011] [Indexed: 10/17/2022]
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Park YH, Park CH, Kim HJ. The effect of topical sodium thiosulfate in experimentally induced myringosclerosis. Laryngoscope 2010; 120:1405-10. [PMID: 20583241 DOI: 10.1002/lary.20947] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS The purpose of this study was to investigate the effect of topical sodium thiosulfate (STS) in experimentally induced myringosclerosis (MS). STUDY DESIGN A prospective experimental animal study. METHODS Thirty Wistar albino rats were bilaterally myringotomized. The right ears were treated with STS or saline daily, and the left ears were left untreated and used as controls. The tympanic membranes were observed by otoendoscopy weekly, and tympanometric measurements were performed. All animals were histopathologically examined for myringosclerotic plaques. RESULTS Under otoendoscopy, myringosclerosis were observed around the handle of the malleus and near the annular region. The numbers of myringosclerotic ears were significantly more frequent in control and saline groups compared with the STS group (P < .05), and the formation of MS was more severe in control and saline groups compared with STS group (P < .05). Using tympanometric measurement, significantly reduced magnitudes of maximum admittance were observed in control and saline groups compared to normal and STS groups (P < .05). Under histopathologic examination, the tympanic membrane of the STS group appeared thinner than the control group (P < .05), with reduced calcium deposition than control and saline groups. CONCLUSIONS Our results show that sodium thiosulfate has a preventive role in the development of myringosclerosis in the experimental animal model.
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Affiliation(s)
- Yong Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, South Korea.
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Vlajkovic SM, Housley GD, Thorne PR. Adenosine and the auditory system. Curr Neuropharmacol 2010; 7:246-56. [PMID: 20190966 PMCID: PMC2769008 DOI: 10.2174/157015909789152155] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 03/03/2009] [Accepted: 03/20/2009] [Indexed: 02/06/2023] Open
Abstract
Adenosine is a signalling molecule that modulates cellular activity in the central nervous system and peripheral organs via four G protein-coupled receptors designated A1, A2A, A2B, and A3. This review surveys the literature on the role of adenosine in auditory function, particularly cochlear function and its protection from oxidative stress. The specific tissue distribution of adenosine receptors in the mammalian cochlea implicates adenosine signalling in sensory transduction and auditory neurotransmission although functional studies have demonstrated that adenosine stimulates cochlear blood flow, but does not alter the resting and sound-evoked auditory potentials. An interest in a potential otoprotective role for adenosine has recently evolved, fuelled by the capacity of A1 adenosine receptors to prevent cochlear injury caused by acoustic trauma and ototoxic drugs. The balance between A1 and A2A receptors is conceived as critical for cochlear response to oxidative stress, which is an underlying mechanism of the most common inner ear pathologies (e.g. noise-induced and age-related hearing loss, drug ototoxicity). Enzymes involved in adenosine metabolism, adenosine kinase and adenosine deaminase, are also emerging as attractive targets for controlling oxidative stress in the cochlea. Other possible targets include ectonucleotidases that generate adenosine from extracellular ATP, and nucleoside transporters, which regulate adenosine concentrations on both sides of the plasma membrane. Developments of selective adenosine receptor agonists and antagonists that can cross the blood-cochlea barrier are bolstering efforts to develop therapeutic interventions aimed at ameliorating cochlear injury. Manipulations of the adenosine signalling system thus hold significant promise in the therapeutic management of oxidative stress in the cochlea.
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Affiliation(s)
- Srdjan M Vlajkovic
- Department of Physiology, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
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Meen E, Blakley B, Quddusi T. Brain-derived nerve growth factor in the treatment of sensorineural hearing loss. Laryngoscope 2009; 119:1590-3. [PMID: 19479743 DOI: 10.1002/lary.20515] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS A possible medical treatment for sensorineural hearing loss using brain-derived nerve growth factor (BDNF) was explored. The hypothesis is that direct intracochlear application of BDNF will result in improved hearing. STUDY DESIGN Animal research study. METHODS Significant hearing loss was created using cisplatin in 11 guinea pigs. One month later, bilateral cochleostomies were performed placing 0.05 microg of BDNF in one cochlea of each animal prior to plugging with connective tissue. The other cochlea served as a control. Auditory brain-stem response (ABR) testing was then carried out for three months at 6,000, 8,000, 12,000, and 24,000 Hz. RESULTS ABR thresholds were better in the treated ear for all frequencies. Threshold differences were statistically significantly better two months after treatment (general linear model, repeated measures P = .045). CONCLUSIONS Intracochlear application of BDNF may prevent hearing loss.
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Affiliation(s)
- Eric Meen
- Department of Otolaryngology, University of Manitoba, Winnipeg, Canada.
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Fouladi M, Gajjar A. In Reply. J Clin Oncol 2009. [DOI: 10.1200/jco.2008.20.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Maryam Fouladi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
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Squalene selectively protects mouse bone marrow progenitors against cisplatin and carboplatin-induced cytotoxicity in vivo without protecting tumor growth. Neoplasia 2008; 10:1105-19. [PMID: 18813359 DOI: 10.1593/neo.08466] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 07/08/2008] [Accepted: 07/10/2008] [Indexed: 11/18/2022] Open
Abstract
Squalene, an isoprenoid antioxidant is a potential cytoprotective agent against chemotherapy-induced toxicity. We have previously published that squalene protects light-density bone marrow cells against cis-diamminedichloroplatinum( II) (cisplatin)-induced toxicity without protecting tumor cells in vitro. Here, we developed an in vivo mouse model of cisplatin and cis-diammine (cyclobutane-1,1-dicarboxylato) platinum(II) (carboplatin)-induced toxicity to further investigate squalene-mediated LD-BM cytoprotection including the molecular mechanism behind selective cytoprotection. We found that squalene significantly reduced the body weight loss of cisplatin and carboplatin-treated mice. Light-density bone marrow cells from squalene-treated mice exhibited improved formation of hematopoietic colonies (colony-forming unit-granulocyte macrophage). Furthermore, squalene also protected mesenchymal stem cell colonies (colony-forming unit-fibroblast) from cisplatin and carboplatin-induced toxicity. Squalene-induced protection was associated with decreased reactive oxygen species and increased levels of glutathione and glutathione peroxidase/glutathione-S-transferase. Importantly, squalene did not protect neuroblastoma, small cell carcinoma, or medulloblastoma xenografts against cisplatin-induced toxicity. These results suggest that squalene is a potential candidate for future development as a cytoprotective agent against chemotherapeutic toxicity.
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A. Abdin A, I. Draz E, I. Sarhan N. Evaluation of the Chemoprotective Role of N-Acetylcysteine on Cisplatin-Induced Nephrotoxicity: New Aspect of an Old Drug. INT J PHARMACOL 2008. [DOI: 10.3923/ijp.2008.339.351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ramírez-Camacho R, Esteban Fernández D, Verdaguer J, Gómez Gómez M, Trinidad A, García-Berrocal J, Palacios Corvillo M. Cisplatin-induced hearing loss does not correlate with intracellular platinum concentration. Acta Otolaryngol 2008; 128:505-9. [PMID: 18421602 DOI: 10.1080/00016480701635167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION Inductively coupled plasma mass spectrometry (ICP-MS) can be applied to organic tissues obtained from experimental animals. Hearing loss does not correlate with the platinum (Pt) concentration found in the inner ear. Drug structure and affinity to inner ear proteins could explain ototoxicity caused by cisplatin. OBJECTIVES To analyse Pt affinity for brain and ear tissues (of similar embryologic origin) in the Wistar rat and clearance gradient after a single dose, and to correlate these findings with hearing changes. MATERIALS AND METHODS Thirty-two Wistar rats were intraperitoneally injected with cisplatin at a dose of 5 mg/kg. Animals were sacrificed after obtaining auditory brain responses (ABRs) at 3, 7, 30 and 90 days (nine, seven, seven and nine animals, respectively). Brain and both temporal bones were extracted from each animal and analysed by ICP-MS to determine the absolute concentrations of the metal. Eight non-treated animals were employed as a control group. RESULTS The ABR thresholds were significantly elevated in animals from all groups after cisplatin treatment. A maximum accumulation of Pt for inner ear and brain was revealed around the first week: 3.175 (57%) and 0.342 (72%), respectively. Pt significantly accumulated in greater quantities in ear than in brain (p<0.01) and was cleared at a higher rate in brain than in ear (p<0.01) following cochlea/brain ratio analysis. No statistically significant correlation was found between amounts of Pt and hearing loss in the study animals.
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Harned TM, Kalous O, Neuwelt A, Loera J, Ji L, Iovine P, Sposto R, Neuwelt EA, Reynolds CP. Sodium thiosulfate administered six hours after cisplatin does not compromise antineuroblastoma activity. Clin Cancer Res 2008; 14:533-40. [PMID: 18223229 DOI: 10.1158/1078-0432.ccr-06-2289] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We determined if the potentially otoprotective agent sodium thiosulfate (STS) could be given 6 h after cisplatin without diminishing the antineuroblastoma activity of cisplatin in human neuroblastoma cell lines in vitro (including cisplatin-resistant cell lines) and in neuroblastoma xenografts in vivo. EXPERIMENTAL DESIGN We determined the antineuroblastoma activity of cisplatin with or without the addition of STS at 0 or 6 h after cisplatin in six neuroblastoma cell lines, both in standard cell culture conditions (20% O(2)) and in physiologic hypoxia (2% O(2)). Drug cytotoxicity was measured using the DIMSCAN fluorescence/digital imaging microscopy assay. In vivo studies of cisplatin combined with STS used a human neuroblastoma subcutaneous xenograft model (SMS-SAN) in athymic nu/nu mice. RESULTS A significant protection against cisplatin cytotoxicity was seen when the neuroblastoma cells were exposed to cisplatin directly combined with STS. However, when cisplatin was given first and STS exposure occurred 6 h later, no effect on cisplatin cytotoxicity was observed. In a subcutaneous neuroblastoma xenograft model in nu/nu mice, mice receiving cisplatin alone or cisplatin + STS at 6 h had significantly better progression-free survival rates (P < 0.03) compared with controls or mice treated with cisplatin + STS concurrently. There was no statistically significant difference in outcomes between mice treated with cisplatin alone and the group treated with cisplatin followed by STS 6 h later (P = 0.9). CONCLUSION These preclinical data suggest that the use of STS 6 h after cisplatin for otoprotection is unlikely to compromise the antineuroblastoma activity of cisplatin.
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Affiliation(s)
- Theresa M Harned
- Developmental Therapeutics Program, USC-CHLA Institute for Pediatric Clinical Research, Keck School of Medicine, University of Southern California and Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
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Kovacic P, Somanathan R. Ototoxicity and noise trauma: electron transfer, reactive oxygen species, cell signaling, electrical effects, and protection by antioxidants: practical medical aspects. Med Hypotheses 2007; 70:914-23. [PMID: 17977665 DOI: 10.1016/j.mehy.2007.06.045] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 06/18/2007] [Indexed: 12/01/2022]
Abstract
Ototoxins are substances of various structures and classes. This review provides extensive evidence for involvement of electron transfer (ET), reactive oxygen species (ROS) and oxidative stress (OS) as a unifying theme. Successful application is made to the large majority of ototoxins, as well as noise trauma. We believe it is not coincidental that these toxins generally incorporate ET functionalities (quinone, metal complex, ArNO(2), or conjugated iminium) either per se or in metabolites, potentially giving rise to ROS by redox cycling. Some categories, e.g., peroxides and noise, appear to operate via non-ET routes in generating OS. These highly reactive entities can then inflict injury via OS upon various constituents of the ear apparatus. The theoretical framework is supported by the extensive literature on beneficial effects of antioxidants, both for toxins and noise. Involvement of cell signaling and electrical effects are discussed. This review is the first comprehensive one based on a unified mechanistic approach. Various practical medical aspects are also addressed. There is extensive documentation for beneficial effects of antioxidants whose use might be recommended clinically for prevention of ototoxicity and noise trauma. Recent research indicates that catalytic antioxidants may be more effective. In addition to ototoxicity, a widespread problem consists of ear infections by bacteria which are demonstrating increasing resistance to conventional therapies. A recent, novel approach to improved drugs involves use of agents which inhibit quorum sensors that play important roles in bacterial functioning. Prevention of ear injury by noise trauma is also discussed, along with ear therapeutics.
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Affiliation(s)
- Peter Kovacic
- Department of Chemistry, San Diego State University, San Diego, CA 92182-1030, USA.
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Dickey DT, Muldoon LL, Doolittle ND, Peterson DR, Kraemer DF, Neuwelt EA. Effect of N-acetylcysteine route of administration on chemoprotection against cisplatin-induced toxicity in rat models. Cancer Chemother Pharmacol 2007; 62:235-41. [PMID: 17909806 PMCID: PMC2776068 DOI: 10.1007/s00280-007-0597-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2007] [Accepted: 09/06/2007] [Indexed: 10/22/2022]
Abstract
Dosing and route of administration of N-acetylcysteine (NAC) for protection against cisplatin (CDDP) nephrotoxicity was investigated in rats. Two models of toxicity were tested: a single high dose of CDDP (10 mg/kg intraperitoneally (IP)), and multiple low dose treatments (1 mg/kg IP twice a day for 4 days, 10 days rest, then repeated). NAC (50-1,200 mg/kg) was given to the rats by IP, oral (PO), intravenous (IV) and intra-arterial (IA) routes. Renal toxicity was determined by blood urea nitrogen (BUN) and creatinine (CR) levels 3 days after treatment. Blood collected 15 min after NAC was analyzed for total NAC. Both models of CDDP administration produced renal toxicity. In the single dose CDDP model, NAC 400 mg/kg given IP and PO produced no renal protection as measured by BUN (131.8 +/- 8.2 and 123.3 +/- 8.2, respectively) or CR (2.3 +/- 0.38 and 1.77 +/- 0.21, respectively). IV NAC reduced nephrotoxicity, (BUN 26.3 +/- 6.8, CR 0.47 +/- 0.15). NAC 50 mg/kg IA gave better protection than IV. In the repeated-dose CDDP model, nephrotoxicity was blocked by 800 mg/kg NAC given IV but not IP. Blood concentrations of total NAC showed a dose response after IV NAC, but high dose NAC (1,200 mg/kg) by the PO route gave very low levels of NAC. Thus the protective properties of NAC are affected by the dose and route of administration.
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Affiliation(s)
- D Thomas Dickey
- Department of Neurology and Blood Brain Barrier Program, Oregon Health & Science University, 3181 SW Sam Jackson Parkway, L603, Portland, OR, 97239, USA
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Pan Q, Liu B, Liu J, Cai R, Wang Y, Qian C. Synergistic induction of tumor cell death by combining cisplatin with an oncolytic adenovirus carrying TRAIL. Mol Cell Biochem 2007; 304:315-23. [PMID: 17577631 DOI: 10.1007/s11010-007-9514-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 05/16/2007] [Indexed: 11/24/2022]
Abstract
Chemoresistance and side effects are considered as the major obstacles in cisplatin-based chemotherapy of various human malignant tumors. Conjugation with cancer-specific apoptotic stimuli TRAIL or typical viro-agent ONYX-015 has been extensively investigated to enhance the antitumor activity of cisplatin. In this study, we presented a novel chemo-gene-virotherapeutic strategy to further improve the toxic effects in cancer cells and reduce the damage in normal cells. Here, an oncolytic adenoviral vector (ZD55), with a deletion of E1B 55-kDa gene, was employed to express the therapeutic TRAIL gene by constructing a recombinant virus ZD55-TRAIL. Exogenous gene delivery efficacy was determined by both in vitro and in vivo experiments and enhanced cytotoxicity of combined treatment of ZD55-TRAIL with cisplatin was evaluated in several cancer cell lines. Moreover, negative effects on normal cells have been tested in both L-02 and MRC-5 cell lines by MTT assay and apoptotic cell staining. According to our observation, combination of ZD55-TRAIL with cisplatin exhibited an apparent synergistic cytotoxicity in cancer cells, yet significantly abolished the negative toxicity in normal cells by reducing the dosage. Thus, a novel chemo-gene-virotherapeutic strategy for cancer therapy was proposed.
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Affiliation(s)
- Qiuwei Pan
- Xin Yuan Institute of Medicine and Biotechnology, Life Science College, Zhejiang Sci-Tech University, Hangzhou 310018, China
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Knight KR, Kraemer DF, Winter C, Neuwelt EA. Early Changes in Auditory Function As a Result of Platinum Chemotherapy: Use of Extended High-Frequency Audiometry and Evoked Distortion Product Otoacoustic Emissions. J Clin Oncol 2007; 25:1190-5. [PMID: 17401008 DOI: 10.1200/jco.2006.07.9723] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose The objective is to describe progressive changes in hearing and cochlear function in children and adolescents treated with platinum-based chemotherapy and to begin preliminary evaluation of the feasibility of extended high-frequency audiometry and distortion product otoacoustic emissions for ototoxicity monitoring in children. Patients and Methods Baseline and serial measurement of conventional pure-tone audiometry (0.5 to 8 kHz) and evoked distortion product otoacoustic emissions (DPOAEs) were conducted for 32 patients age 8 months to 20 years who were treated with cisplatin and/or carboplatin chemotherapy. Seventeen children also had baseline and serial measurement of extended high-frequency (EHF) audiometry (9 to 16 kHz). Audiologic data were analyzed to determine the incidence of ototoxicity using the American Speech-Language-Hearing Association criteria, and the relationships between the different measures of ototoxicity. Results Of the 32 children, 20 (62.5%) acquired bilateral ototoxicity in the conventional frequency range during chemotherapy treatment, and 26 (81.3%) had bilateral decreases in DPOAE amplitudes and dynamic range. Of the 17 children with EHF audiometry results, 16 (94.1%) had bilateral ototoxicity in the EHF range. Pilot data suggest that EHF thresholds and DPOAEs show ototoxic changes before hearing loss is detected by conventional audiometry. Conclusion EHF audiometry and DPOAEs have the potential to reveal earlier changes in auditory function than conventional frequency audiometry during platinum chemotherapy in children.
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Affiliation(s)
- Kristin R Knight
- Department of Pediatric Audiology, Child Development and Rehabilitation Center, Portland, Oregon, USA
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Abstract
Underlying the pathogenesis of chronic disease is the state of oxidative stress. Oxidative stress is an imbalance in oxidant and antioxidant levels. If an overproduction of oxidants overwhelms the antioxidant defenses, oxidative damage of cells, tissues, and organs ensues. In some cases, oxidative stress is assigned a causal role in disease pathogenesis, whereas in others the link is less certain. Along with underlying oxidative stress, chronic disease is often accompanied by muscle wasting. It has been hypothesized that catabolic programs leading to muscle wasting are mediated by oxidative stress. In cases where disease is localized to the muscle, this concept is easy to appreciate. Transmission of oxidative stress from diseased remote organs to skeletal muscle is thought to be mediated by humoral factors such as inflammatory cytokines. This review examines the relationship between oxidative stress, chronic disease, and muscle wasting, and the mechanisms by which oxidative stress acts as a catabolic signal.
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Affiliation(s)
- Jennifer S Moylan
- Department of Physiology, University of Kentucky, 800 Rose Street, Room MS-509, Lexington, Kentucky 40536-0298, USA
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Rybak LP, Whitworth CA, Mukherjea D, Ramkumar V. Mechanisms of cisplatin-induced ototoxicity and prevention. Hear Res 2006; 226:157-67. [PMID: 17113254 DOI: 10.1016/j.heares.2006.09.015] [Citation(s) in RCA: 379] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Revised: 09/09/2006] [Accepted: 09/24/2006] [Indexed: 11/27/2022]
Abstract
Cisplatin is a widely used chemotherapeutic agent to treat malignant disease. Unfortunately, ototoxicity occurs in a large percentage of patients treated with higher dose regimens. In animal studies and in human temporal bone investigations, several areas of the cochlea are damaged, including outer hair cells in the basal turn, spiral ganglion cells and the stria vascularis, resulting in hearing impairment. The mechanisms appear to involve the production of reactive oxygen species (ROS), which can trigger cell death. Approaches to chemoprevention include the administration of antioxidants to protect against ROS at an early stage in the ototoxic pathways and the application of agents that act further downstream in the cell death cascade to prevent apoptosis and hearing loss. This review summarizes recent data that shed new light on the mechanisms of cisplatin ototoxicity and its prevention.
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Affiliation(s)
- Leonard P Rybak
- Department of Surgery, Division of Otolaryngology, Southern Illinois University, School of Medicine, P.O. Box 19653, Springfield, IL 62794-9653, USA.
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Hyppolito MA, de Oliveira JAA, Rossato M. Cisplatin ototoxicity and otoprotection with sodium salicylate. Eur Arch Otorhinolaryngol 2006; 263:798-803. [PMID: 16758221 DOI: 10.1007/s00405-006-0070-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Accepted: 04/10/2006] [Indexed: 10/24/2022]
Abstract
Cisplatin is a potent antineoplastic drug widely used for the treatment of cancer in both adults and children. One of its most important side effects is ototoxicity, which leads to irreversible bilateral hearing loss for high frequencies (4-8 kHz). Several studies have tried to identify drugs that, when combined with cisplatin, may act as otoprotectors. The mechanism of ototoxicity of cisplatin is known to be related to changes in the antioxidant mechanisms of hair cells, especially the outer hair cells of the cochlea. Our proposal was to assess the action of sodium salicylate, which has a known antioxidant property, as a possible otoprotector of outer hair cells against the action of cisplatin, using distortion product otoacoustic emissions (DPOAEs) and scanning electron microscopy. The study was conducted on albino guinea pigs divided into two groups: group 1 (n = 9, 18 cochleae) receiving a cisplatin dose of 8.0 mg/kg/day by the intraperitoneal (ip) route for 3 days, group 2 (n = 10, 20 cochleae) receiving 100 mg/kg sodium salicylate by the subcutaneous route followed 90 min later by cisplatin, 8.0 mg/kg/day ip for 3 days, and group 3 (n = 3, six cochleae) treated with 100 mg/kg day sodium salicylate for 3 days. In group 1, there was damage with the absence of cilia in all three rows of outer hair cells in the basal turn, followed by turns 2 and 3. In group 2, hair cells were present in all cochlear turns, but exhibited disarrangement of the ciliary structure, especially in row 1, and the DPOAEs were absent after 3 days of treatment. We conclude that drugs such as sodium salicylate, because of their antioxidant properties, may protect, at least partially, the outer hair cells against cisplatin ototoxicity.
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MESH Headings
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Antineoplastic Agents/therapeutic use
- Antineoplastic Agents/toxicity
- Auditory Threshold/drug effects
- Cisplatin/therapeutic use
- Cisplatin/toxicity
- Cochlea/drug effects
- Cochlea/ultrastructure
- Guinea Pigs
- Hair Cells, Auditory/drug effects
- Hair Cells, Auditory/pathology
- Hair Cells, Auditory/ultrastructure
- Hearing Loss, Sensorineural/chemically induced
- Hearing Loss, Sensorineural/prevention & control
- Injections, Intraperitoneal
- Microscopy, Electron, Scanning
- Otoacoustic Emissions, Spontaneous/physiology
- Sodium Salicylate/therapeutic use
- Treatment Outcome
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Affiliation(s)
- Miguel Angelo Hyppolito
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, 14049-900 Ribeirão Preto, SP, Brazil.
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Hofmann G, Bauernhofer T, Krippl P, Lang-Loidolt D, Horn S, Goessler W, Schippinger W, Ploner F, Stoeger H, Samonigg H. Plasmapheresis reverses all side-effects of a cisplatin overdose--a case report and treatment recommendation. BMC Cancer 2006; 6:1. [PMID: 16390557 PMCID: PMC1334209 DOI: 10.1186/1471-2407-6-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Accepted: 01/04/2006] [Indexed: 11/28/2022] Open
Abstract
Background Cisplatin is widely used as an antineoplastic agent since it is effective against a broad spectrum of different tumours. Nevertheless, it has several potential side effects affecting different organ systems and an overdose may lead to life-threatening complications and even death. Case presentation We report on a 46-year old woman with non-small cell lung cancer who accidentally received 225 mg/m2 of cisplatin, which was threefold the dose as scheduled, within a 3-day period. Two days later, the patient presented with hearing loss, severe nausea and vomiting, acute renal failure as well as elevated liver enzymes. In addition, she developed a severe myelodepression. After plasmapheresis on two consecutive days and vigorous supportive treatment, the toxicity-related symptoms improved and the patient recovered without any sequelae. Conclusion To date, no general accepted guidelines for the treatment of cisplatin overdoses are available. Along with the experience from other published cases, our report shows that plasmapheresis is capable of lowering cisplatin plasma and serum levels efficiently. Therefore, plasma exchange performed as soon as possible can ameliorate all side effects of a cisplatin overdose and be a potential tool for clinicians for treatment. However, additional intensive supportive treatment-modalities are necessary to control all occurring side effects.
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Affiliation(s)
- Guenter Hofmann
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Thomas Bauernhofer
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Peter Krippl
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Doris Lang-Loidolt
- Ear, Nose and Throat University Hospital, Medical University of Graz, Auenbruggerplatz 26-28, 8036 Graz, Austria
| | - Sabine Horn
- Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Walter Goessler
- Institute of Chemistry, Analytical Chemistry, Karl-Franzens-University of Graz, Universitätsplatz 1, 8010 Graz, Austria
| | - Walter Schippinger
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Ferdinand Ploner
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Herbert Stoeger
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Hellmut Samonigg
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Dickey DT, Wu YJ, Muldoon LL, Neuwelt EA. Protection against Cisplatin-Induced Toxicities byN-Acetylcysteine and Sodium Thiosulfate as Assessed at the Molecular, Cellular, and in Vivo Levels. J Pharmacol Exp Ther 2005; 314:1052-8. [PMID: 15951398 DOI: 10.1124/jpet.105.087601] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cisplatin (CDDP) is a common, highly toxic chemotherapeutic agent. This study investigates chemoprotective effects of N-acetylcysteine (NAC) and sodium thiosulfate (STS) on in vitro and in vivo CDDP toxicities. For ototoxicity studies, CDDP (6 mg/kg) was administered to rats via a retrograde carotid artery infusion. Auditory brainstem response thresholds at 4 to 20 kHz were tested before and 7 days post-treatment. STS (8 g/m(2) i.v.) was administered at 4, 8, or 12 h after CDDP. For nephrotoxicity studies, rats were treated with CDDP intraperitoneally (10 mg/kg) before or after NAC (400 mg/kg) or STS (8 g/m(2)), and blood urea nitrogen (BUN) and creatinine concentrations were measured after 3 days. In vitro cytotoxicity and chemoprotection in human tumor cell lines were assessed by cell viability and immunoblotting assays. Rats treated with STS 4 h after CDDP exhibited no hearing change. The STS 8-h group had less otoprotection, whereas 12-h rats had ototoxicity. CDDP induced high BUN and creatinine, corresponding to renal tubule toxicities. All NAC-treated animals showed normal BUN and reduced creatinine levels compared with CDDP alone and no histopathological evidence of nephrotoxicity. Delayed STS treatment was not consistently protective against nephrotoxicity. STS administration fully protected against the in vitro cytotoxic and apoptotic effects of CDDP if added within 2 h of CDDP, but chemoprotection decreased if STS administration was 4 h, and was minimal by 6 h, after CDDP. Thus, the chemoprotection route and timing of administration can be manipulated to maintain CDDP antitumor efficacy while protecting against toxicities.
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Affiliation(s)
- D Thomas Dickey
- Oregon Health & Science University, Department of Neurology, Portland, 97239, USA
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El-Kareh AW, Secomb TW. A theoretical model for intraperitoneal delivery of cisplatin and the effect of hyperthermia on drug penetration distance. Neoplasia 2004; 6:117-27. [PMID: 15140400 PMCID: PMC1502091 DOI: 10.1593/neo.03205] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A theoretical model for the intraperitoneal (i.p.) delivery of cisplatin and heat to tumor metastases in tissues adjacent to the peritoneal cavity is presented. The penetration distance (the depth to which drug diffuses directly from the cavity into tissues) is predicted to be on the order of 0.5 mm. The model shows that exchange with the microvasculature has more effect than cellular uptake in limiting the penetration distance. Possible effects of hyperthermia are simulated, including increased cell uptake of drug, increased cell kill at a given level of intracellular drug, and decreased microvascular density. The model suggests that the experimental finding of elevated intracellular platinum levels up to a depth of 3 to 5 mm when drug is delivered i.p. by a heated infusion solution is due to penetration of heat to this distance, causing increased cell uptake of drug. Beyond a depth of about 0.5 mm, the drug is delivered mainly through the circulation. Use of sodium thiosulfate to deactivate systemic cisplatin may therefore be counterproductive when heat is delivered locally. The model suggests that i.p. delivery of heat, combined with systemic delivery of drug, may be as effective as i.p. delivery of heat and drug.
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Affiliation(s)
- Ardith W El-Kareh
- ARL-Microcirculation Division, University of Arizona, PO Box 245051, Tucson, AZ 85724-5051, USA.
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Thomas Dickey D, Muldoon LL, Kraemer DF, Neuwelt EA. Protection against cisplatin-induced ototoxicity by N-acetylcysteine in a rat model. Hear Res 2004; 193:25-30. [PMID: 15219317 DOI: 10.1016/j.heares.2004.02.007] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2003] [Accepted: 02/27/2004] [Indexed: 11/19/2022]
Abstract
Cisplatin (CDDP) is a widely used chemotherapeutic agent that is highly ototoxic. Animal studies and clinical trials have shown that thiosulfates can protect against platinum-induced ototoxicity. This study investigated a new model for CDDP ototoxicity in the rat, and tested the potential chemoprotective effect of administering N-acetylcysteine (NAC) before giving CDDP. Long Evans rats were treated with CDDP 6 mg/kg delivered to the aorta via a retrograde right external carotid artery infusion, 15 min after intravenous (IV) infusion of saline (n=8) or NAC 400 mg/kg (n=8), such that the vertebral arteries were perfused. Subsequent groups were similarly treated with NAC 30 min before (n=7) and 4 h after (n=7) CDDP. Auditory brainstem response (ABR) thresholds were tested at 4-20 kHz, 7 days after treatment and compared to baseline ABR values. The NAC-treated rats exhibited no significant change from baseline values at all time intervals, while the saline-treated rats showed marked ototoxicity, especially at higher frequencies. Furthermore, the rats treated with NAC 15 min before CDDP exhibited less overall toxicity to CDDP, as evidenced in weight loss 7 days post-treatment (mean for saline=-39.63 g; mean for NAC=-21.13 g; p=0.0084). These data show that treatment with NAC can prevent CDDP-induced ototoxicity in rats.
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Affiliation(s)
- D Thomas Dickey
- Department of Neurology, Oregon Health and Science University, Portland, OR 97201-3098, USA
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Wang J, Lloyd Faulconbridge RV, Fetoni A, Guitton MJ, Pujol R, Puel JL. Local application of sodium thiosulfate prevents cisplatin-induced hearing loss in the guinea pig. Neuropharmacology 2003; 45:380-93. [PMID: 12871655 DOI: 10.1016/s0028-3908(03)00194-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cisplatin (CDDP), an anticancer drug used extensively to treat a broad range of neoplasms, has strong ototoxic side effects. Sodium thiosulfate (STS) has been described as a protective agent against CDDP toxicity, but it also reduces CDDP's antitumoral cytotoxicity. To maintain the antitumoral effectiveness of systemic administration of CDDP, a strategy has been developed to apply STS directly into the cochlea. Perfusion of STS into the cochleae of guinea pigs completely prevented CDDP-induced hearing loss, with no change in either compound action potential (CAP) or distortion product otoacoustic emission (DPOAE) audiograms during the time course of the treatment. Histological analysis revealed a minimal loss of outer hair cells (OHCs) in the organ of Corti and no damage to the marginal cells of the stria vascularis as seen in animals exposed to CDDP. Cytocochleograms prepared 6 days after CDDP exposure showed that STS treatment protected more than 92.8% of OHCs and IHCs destined to die. Furthermore, it prevented CDDP-induced mitochondrial damage and subsequent translocation of cytochrome c, DNA fragmentation, and suppressed the apoptotic and necrotic hair cell degeneration. These results suggest that local application of STS may be an interesting strategy to prevent CDDP ototoxicity in patients undergoing CDDP chemotherapy.
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Affiliation(s)
- J Wang
- INSERM-U583, 71, rue de Navacelles, 34090, Montpellier, France
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Amar AP, Zlokovic BV, Apuzzo MLJ. Endovascular restorative neurosurgery: a novel concept for molecular and cellular therapy of the nervous system. Neurosurgery 2003; 52:402-12; discussion 412-3. [PMID: 12535371 DOI: 10.1227/01.neu.0000043698.86548.a0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2002] [Accepted: 10/14/2002] [Indexed: 11/19/2022] Open
Abstract
The amalgam of molecular biology and neurosurgery offers immense promise for neurorestoration and the management of neurodegenerative deficiencies, developmental disorders, neoplasms, stroke, and trauma. This article summarizes present strategies for and impediments to gene therapy and stem cell therapy of the central nervous system and advances the concept of a potential new approach, namely endovascular restorative neurosurgery. The objectives of gene transfer to the central nervous system are efficient transfection of host cells, selective sustained expression of the transgene, and lack of toxicity or immune excitation. The requisite elements of this process are the identification of candidate diseases, the construction of vehicles for gene transfer, regulated expression, and physical delivery. In the selection of target disorders, the underlying genetic events to be overcome, as well as their spatial and temporal distributions, must be considered. These factors determine the requirements for the physical dispersal of the transgene, the duration of transgene expression, and the quantity of transgene product needed to abrogate the disease phenotype. Vehicles for conveying the transgene to the central nervous system include viral vectors (retroviruses, lentiviruses, adenoviruses, adeno-associated viruses, and herpes simplex virus), liposomes, and genetically engineered cells, including neural stem cells. Delivery of the transgene into the brain presents several challenges, including limited and potentially risky access through the cranium, sensitivity to volumetric changes, restricted diffusion, and the blood-brain barrier. Genetic or cellular therapeutic agents may be injected directly into the brain parenchyma (via stereotaxy or craniotomy), into the cerebrospinal fluid (in the ventricles or cisterns), or into the bloodstream (intravenously or intra-arterially). The advantages of the endovascular route include the potential for widespread distribution, the ability to deliver large volumes, limited perturbation of neural tissue, and the feasibility of repeated administration.
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Affiliation(s)
- Arun Paul Amar
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
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