1
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Taskar KS, Yang X, Neuhoff S, Patel M, Yoshida K, Paine MF, Brouwer KL, Chu X, Sugiyama Y, Cook J, Polli JW, Hanna I, Lai Y, Zamek-Gliszczynski M. Clinical Relevance of Hepatic and Renal P-gp/BCRP Inhibition of Drugs: An International Transporter Consortium Perspective. Clin Pharmacol Ther 2022; 112:573-592. [PMID: 35612761 PMCID: PMC9436425 DOI: 10.1002/cpt.2670] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/16/2022] [Indexed: 12/11/2022]
Abstract
The role of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) in drug-drug interactions (DDIs) and limiting drug absorption as well as restricting the brain penetration of drugs with certain physicochemical properties is well known. P-gp/BCRP inhibition by drugs in the gut has been reported to increase the systemic exposure to substrate drugs. A previous International Transporter Consortium (ITC) perspective discussed the feasibility of P-gp/BCRP inhibition at the blood-brain barrier and its implications. This ITC perspective elaborates and discusses specifically the hepatic and renal P-gp/BCRP (referred as systemic) inhibition of drugs and whether there is any consequence for substrate drug disposition. This perspective summarizes the clinical evidence-based recommendations regarding systemic P-gp and BCRP inhibition of drugs with a focus on biliary and active renal excretion pathways. Approaches to assess the clinical relevance of systemic P-gp and BCRP inhibition in the liver and kidneys included (i) curation of DDIs involving intravenously administered substrates or inhibitors; (ii) in vitro-to-in vivo extrapolation of P-gp-mediated DDIs at the systemic level; and (iii) curation of drugs with information available about the contribution of biliary excretion and related DDIs. Based on the totality of evidence reported to date, this perspective supports limited clinical DDI risk upon P-gp or BCRP inhibition in the liver or kidneys.
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Affiliation(s)
- Kunal S. Taskar
- Drug Metabolism and Pharmacokinetics, IVIVT, GlaxoSmithKline, Stevenage, UK
| | - Xinning Yang
- Office of Clinical Pharmacology, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD
| | - Sibylle Neuhoff
- Certara UK Ltd, Simcyp Division, 1 Concourse Way, Level 2-Acero, Sheffield, S1 2BJ, UK
| | - Mitesh Patel
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Kenta Yoshida
- Clinical Pharmacology, Genentech Early Research and Development, South San Francisco, CA 94080, USA
| | - Mary F. Paine
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
| | - Kim L.R. Brouwer
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Xiaoyan Chu
- Department of ADME and Discovery Toxicology, Merck & Co., Inc., 2000 Galloping Hill Rd, Kenilworth, NJ 07033 USA
| | - Yuichi Sugiyama
- Laboratory of Quantitative System PK/Pharmacodynamics, School of Pharmacy, Kioicho campus, Josai International University, Tokyo 102-0093, Japan
| | - Jack Cook
- Clinical Pharmacology, Global Product Development, Pfizer Inc., Groton, Connecticut, USA
| | - Joseph W. Polli
- Global Medical Sciences, ViiV Healthcare, Research Triangle Park NC USA
| | - Imad Hanna
- Pharmacokinetic Sciences-Oncology, Novartis Institute for Biomedical Research, East Hanover, NJ
| | - Yurong Lai
- Drug Metabolism, Gilead Sciences Inc. Foster City, CA USA
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2
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Ashrafizaveh S, Ashrafizadeh M, Zarrabi A, Husmandi K, Zabolian A, Shahinozzaman M, Aref AR, Hamblin MR, Nabavi N, Crea F, Wang Y, Ahn KS. Long non-coding RNAs in the doxorubicin resistance of cancer cells. Cancer Lett 2021; 508:104-114. [PMID: 33766750 DOI: 10.1016/j.canlet.2021.03.018] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/01/2021] [Accepted: 03/17/2021] [Indexed: 12/24/2022]
Abstract
Chemotherapy is the main treatment used for cancer patients failing surgery. Doxorubicin (DOX) is a well-known chemotherapeutic agent capable of suppressing proliferation in cancer cells and triggering apoptosis via inhibiting topoisomerase II activity and producing DNA breaks. This activity of DOX restrains mitosis and cell cycle progression. However, frequent application of DOX results in the emergence of resistance in the cancer cells. It seems that genetic and epigenetic factors can provide DOX resistance of cancer cells. Long non-coding RNAs (lncRNAs) are a subcategory of non-coding RNAs with role in the regulation of several cellular processes such as proliferation, migration, differentiation and apoptosis. LncRNA dysregulation has been associated with chemoresistance, and this profile occurs upon DOX treatment of cancer. In the present review, we focus on the role of lncRNAs in mediating DOX resistance and discuss the molecular pathways and mechanisms. LncRNAs can drive DOX resistance via activating pathways such as NF-κB, PI3K/Akt, Wnt, and FOXC2. Some lncRNAs can activate protective autophagy in response to the stress caused by DOX, which mediates resistance. In contrast, there are other lncRNAs involved in the sensitivity of cancer cells to DOX, such as GAS5, PTCSC3 and FENDRR. Some anti-tumor agents such as polydatin can regulate the expression of lncRNAs, enhancing DOX sensitivity. Overall, lncRNAs are potential players in DOX resistance, and their identification and targeting are of importance in chemosensitivity. Furthermore, these findings can be translated into clinical for treatment of cancer patients.
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Affiliation(s)
| | - Milad Ashrafizadeh
- Faculty of Engineering and Natural Sciences, Sabanci University, Orta Mahalle, Üniversite Caddesi No. 27, Orhanlı, Tuzla, 34956 Istanbul, Turkey; Sabanci University Nanotechnology Research and Application Center (SUNUM), Tuzla, 34956, Istanbul, Turkey
| | - Ali Zarrabi
- Sabanci University Nanotechnology Research and Application Center (SUNUM), Tuzla, 34956, Istanbul, Turkey
| | - Kiavash Husmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology & Zoonoses, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Amirhossein Zabolian
- Young Researchers and Elite Club, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Md Shahinozzaman
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, 20742, USA
| | - Amir Reza Aref
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Department of Translational Sciences, Xsphera Biosciences Inc. Boston, MA, USA
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa
| | - Noushin Nabavi
- Department of Urological Sciences and Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, V6H3Z6, Canada
| | - Francesco Crea
- Cancer Research Group-School of Life Health and Chemical Sciences, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK.
| | - Yuzhuo Wang
- Department of Urological Sciences and Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, V6H3Z6, Canada.
| | - Kwang Seok Ahn
- Department of Science in Korean Medicine, Kyung Hee University, 24 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea; KHU-KIST Department of Converging Science and Technology, Kyung Hee University, Seoul 02447, Republic of Korea.
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3
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Ito D, Childress M, Mason N, Winter A, O'Brien T, Henson M, Borgatti A, Lewellen M, Krick E, Stewart J, Lahrman S, Rajwa B, Scott MC, Seelig D, Koopmeiners J, Ruetz S, Modiano J. A double blinded, placebo-controlled pilot study to examine reduction of CD34 +/CD117 +/CD133 + lymphoma progenitor cells and duration of remission induced by neoadjuvant valspodar in dogs with large B-cell lymphoma. F1000Res 2015; 4:42. [PMID: 28357033 PMCID: PMC5357040 DOI: 10.12688/f1000research.6055.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 01/15/2023] Open
Abstract
We previously described a population of lymphoid progenitor cells (LPCs) in canine B-cell lymphoma defined by retention of the early progenitor markers CD34 and CD117 and “slow proliferation” molecular signatures that persist in the xenotransplantation setting. We examined whether valspodar, a selective inhibitor of the ATP binding cassette B1 transporter (ABCB1, a.k.a., p-glycoprotein/multidrug resistance protein-1) used in the neoadjuvant setting would sensitize LPCs to doxorubicin and extend the length of remission in dogs with therapy naïve large B-cell lymphoma. Twenty dogs were enrolled into a double-blinded, placebo controlled study where experimental and control groups received oral valspodar (7.5 mg/kg) or placebo, respectively, twice daily for five days followed by five treatments with doxorubicin 21 days apart with a reduction in the first dose to mitigate the potential side effects of ABCB1 inhibition. Lymph node and blood LPCs were quantified at diagnosis, on the fourth day of neoadjuvant period, and 1-week after the first chemotherapy dose. Valspodar therapy was well tolerated. There were no differences between groups in total LPCs in lymph nodes or peripheral blood, nor in event-free survival or overall survival. Overall, we conclude that valspodar can be administered safely in the neoadjuvant setting for canine B-cell lymphoma; however, its use to attenuate ABCB1
+ cells does not alter the composition of lymph node or blood LPCs, and it does not appear to be sufficient to prolong doxorubicin-dependent remissions in this setting.
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Affiliation(s)
- Daisuke Ito
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Michael Childress
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Nicola Mason
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA.,Department of Pathology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA
| | - Amber Winter
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Clinical Investigation Center, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA
| | - Timothy O'Brien
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Michael Henson
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Antonella Borgatti
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Mitzi Lewellen
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Erika Krick
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA
| | - Jane Stewart
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Sarah Lahrman
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Bartek Rajwa
- Department of Basic Medical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Milcah C Scott
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Davis Seelig
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Joseph Koopmeiners
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | | | - Jaime Modiano
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, 55455, USA.,Center for Immunology, University of Minnesota, Minneapolis, MN, 55455, USA
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4
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Ito D, Childress M, Mason N, Winter A, O'Brien T, Henson M, Borgatti A, Lewellen M, Krick E, Stewart J, Lahrman S, Rajwa B, Scott MC, Seelig D, Koopmeiners J, Ruetz S, Modiano J. A double blinded, placebo-controlled pilot study to examine reduction of CD34 +/CD117 +/CD133 + lymphoma progenitor cells and duration of remission induced by neoadjuvant valspodar in dogs with large B-cell lymphoma. F1000Res 2015; 4:42. [PMID: 28357033 DOI: 10.12688/f1000research.6055.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 01/30/2023] Open
Abstract
We previously described a population of lymphoid progenitor cells (LPCs) in canine B-cell lymphoma defined by retention of the early progenitor markers CD34 and CD117 and "slow proliferation" molecular signatures that persist in the xenotransplantation setting. We examined whether valspodar, a selective inhibitor of the ATP binding cassette B1 transporter (ABCB1, a.k.a., p-glycoprotein/multidrug resistance protein-1) used in the neoadjuvant setting would sensitize LPCs to doxorubicin and extend the length of remission in dogs with therapy naïve large B-cell lymphoma. Twenty dogs were enrolled into a double-blinded, placebo controlled study where experimental and control groups received oral valspodar (7.5 mg/kg) or placebo, respectively, twice daily for five days followed by five treatments with doxorubicin 21 days apart with a reduction in the first dose to mitigate the potential side effects of ABCB1 inhibition. Lymph node and blood LPCs were quantified at diagnosis, on the fourth day of neoadjuvant period, and 1-week after the first chemotherapy dose. Valspodar therapy was well tolerated. There were no differences between groups in total LPCs in lymph nodes or peripheral blood, nor in event-free survival or overall survival. Overall, we conclude that valspodar can be administered safely in the neoadjuvant setting for canine B-cell lymphoma; however, its use to attenuate ABCB1 + cells does not alter the composition of lymph node or blood LPCs, and it does not appear to be sufficient to prolong doxorubicin-dependent remissions in this setting.
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Affiliation(s)
- Daisuke Ito
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Michael Childress
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Nicola Mason
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA.,Department of Pathology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA
| | - Amber Winter
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Clinical Investigation Center, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA
| | - Timothy O'Brien
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Michael Henson
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Antonella Borgatti
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Mitzi Lewellen
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Erika Krick
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104, USA
| | - Jane Stewart
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Sarah Lahrman
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Bartek Rajwa
- Department of Basic Medical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, 47907, USA
| | - Milcah C Scott
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Davis Seelig
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Joseph Koopmeiners
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | | | - Jaime Modiano
- Animal Cancer Care and Research Program, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, 55108, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, 55455, USA.,Center for Immunology, University of Minnesota, Minneapolis, MN, 55455, USA
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5
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Colabufo NA, Berardi F, Cantore M, Contino M, Inglese C, Niso M, Perrone R. Perspectives of P-Glycoprotein Modulating Agents in Oncology and Neurodegenerative Diseases: Pharmaceutical, Biological, and Diagnostic Potentials. J Med Chem 2009; 53:1883-97. [DOI: 10.1021/jm900743c] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Nicola Antonio Colabufo
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Francesco Berardi
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Mariangela Cantore
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Marialessandra Contino
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Carmela Inglese
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Mauro Niso
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Roberto Perrone
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
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6
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Holdsworth MT, Vo-Nguyen T. Employment of substandard antiemetic prophylaxis in recent trials of chemotherapy-induced nausea and vomiting. Ann Pharmacother 2005; 39:1903-10. [PMID: 16204394 DOI: 10.1345/aph.1g079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the prevalence of substandard antiemetic therapy among recently published trials conducted in patients with cancer who received emetogenic chemotherapy. DATA SOURCES A MEDLINE search was conducted (2000-July 2004) using the key words 5-HT(3) antagonists, ondansetron, granisetron, dolasetron, tropisetron, ramosetron, palonosetron, NK-1 antagonists, and aprepitant. STUDY SELECTION AND DATA EXTRACTION All antiemetic trials in patients receiving chemotherapy that were published from January 2000 to July 2004 were evaluated. Standard prophylactic antiemetic therapy was derived from contemporary antiemetic guidelines published by oncology professional organizations and expert panels. The number of patients and studies in which patients received standard and substandard antiemetic therapy was determined for both the acute and delayed phases of chemotherapy-induced nausea and vomiting (CINV). Separate determinations were made for severely and moderately emetogenic chemotherapy. The annual percentage of studies in which substandard antiemetic prophylaxis was given and the percentage of patients who received substandard prophylaxis also were determined. DATA SYNTHESIS Fifty-six studies were reviewed, which included a total of 10 274 patients and 125 study arms. The percentage of patients who received substandard antiemetic prophylaxis was 30% (n = 3063) for acute CINV and 33% (n = 3413) for delayed CINV. The average annual percentage of studies that employed substandard prophylaxis during this time period was 54%. CONCLUSIONS In recent antiemetic trials for CINV, the employment of substandard antiemetic therapy is common. These results raise important ethical questions regarding contemporary antiemetic trial design.
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Affiliation(s)
- Mark T Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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7
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Fracasso PM, Blum KA, Ma MK, Tan BR, Wright LP, Goodner SA, Fears CL, Hou W, Arquette MA, Picus J, Denes A, Mortimer JE, Ratner L, Ivy SP, McLeod HL. Phase I study of pegylated liposomal doxorubicin and the multidrug-resistance modulator, valspodar. Br J Cancer 2005; 93:46-53. [PMID: 15942626 PMCID: PMC2361488 DOI: 10.1038/sj.bjc.6602653] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Valspodar, a P-glycoprotein modulator, affects pharmacokinetics of doxorubicin when administered in combination, resulting in doxorubicin dose reduction. In animal models, valspodar has minimal interaction with pegylated liposomal doxorubicin (PEG-LD). To determine any pharmacokinetic interaction in humans, we designed a study to determine maximum tolerated dose, dose-limiting toxicity (DLT), and pharmacokinetics of total doxorubicin, in PEG-LD and valspodar combination therapy in patients with advanced malignancies. Patients received PEG-LD 20–25 mg m−2 intravenously over 1 h for cycle one. In subsequent 2-week cycles, valspodar was administered as 72 h continuous intravenous infusion with PEG-LD beginning at 8 mg m−2 and escalated in an accelerated titration design to 25 mg m−2. Pharmacokinetic data were collected with and without valspodar. A total of 14 patients completed at least two cycles of therapy. No DLTs were observed in six patients treated at the highest level of PEG-LD 25 mg m−2. The most common toxicities were fatigue, nausea, vomiting, mucositis, palmar plantar erythrodysesthesia, diarrhoea, and ataxia. Partial responses were observed in patients with breast and ovarian carcinoma. The mean (range) total doxorubicin clearance decreased from 27 (10–73) ml h−1 m−2 in cycle 1 to 18 (3–37) ml h−1 m−2 with the addition of valspodar in cycle 2 (P=0.009). Treatment with PEG-LD 25 mg m−2 in combination with valspodar results in a moderate prolongation of total doxorubicin clearance and half-life but did not increase the toxicity of this agent.
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Affiliation(s)
- P M Fracasso
- Alvin J Siteman Cancer Center and the Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
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8
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ten Tije AJ, Verweij J, Loos WJ, Sparreboom A. Pharmacological effects of formulation vehicles : implications for cancer chemotherapy. Clin Pharmacokinet 2003; 42:665-85. [PMID: 12844327 DOI: 10.2165/00003088-200342070-00005] [Citation(s) in RCA: 435] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The non-ionic surfactants Cremophor EL (CrEL; polyoxyethyleneglycerol triricinoleate 35) and polysorbate 80 (Tween) 80; polyoxyethylene-sorbitan-20-monooleate) are widely used as drug formulation vehicles, including for the taxane anticancer agents paclitaxel and docetaxel. A wealth of recent experimental data has indicated that both solubilisers are biologically and pharmacologically active compounds, and their use as drug formulation vehicles has been implicated in clinically important adverse effects, including acute hypersensitivity reactions and peripheral neuropathy.CrEL and Tween 80 have also been demonstrated to influence the disposition of solubilised drugs that are administered intravenously. The overall resulting effect is a highly increased systemic drug exposure and a simultaneously decreased clearance, leading to alteration in the pharmacodynamic characteristics of the solubilised drug. Kinetic experiments revealed that this effect is primarily caused by reduced cellular uptake of the drug from large spherical micellar-like structures with a highly hydrophobic interior, which act as the principal carrier of circulating drug. Within the central blood compartment, this results in a profound alteration of drug accumulation in erythrocytes, thereby reducing the free drug fraction available for cellular partitioning and influencing drug distribution as well as elimination routes. The existence of CrEL and Tween 80 in blood as large polar micelles has also raised additional complexities in the case of combination chemotherapy regimens with taxanes, such that the disposition of several coadministered drugs, including anthracyclines and epipodophyllotoxins, is significantly altered. In contrast to the enhancing effects of Tween 80, addition of CrEL to the formulation of oral drug preparations seems to result in significantly diminished drug uptake and reduced circulating concentrations. The drawbacks presented by the presence of CrEL or Tween 80 in drug formulations have instigated extensive research to develop alternative delivery forms. Currently, several strategies are in progress to develop Tween 80- and CrEL-free formulations of docetaxel and paclitaxel, which are based on pharmaceutical (e.g. albumin nanoparticles, emulsions and liposomes), chemical (e.g. polyglutamates, analogues and prodrugs), or biological (e.g. oral drug administration) strategies. These continued investigations should eventually lead to more rational and selective chemotherapeutic treatment.
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Affiliation(s)
- Albert J ten Tije
- Department of Medical Oncology, Erasmus MC - Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
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9
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Abstract
P-glycoprotein (P-gp), the most extensively studied ATP-binding cassette transporter, functions as a biological barrier by extruding toxic substances and xenobiotics out of cells. In vitro and in vivo studies have demonstrated that P-gp plays a significant role in drug absorption and disposition. Like cytochrome P450 enzymes, inhibition and induction of P-gp have been reported as the causes of drug-drug interactions. Because many prototypic inhibitors and inducers affect both CYP3A4 and P-gp, many drug interactions caused by these inhibitors and inducers involve these two systems. Clinically, it is very difficult to quantitatively differentiate P-gp-mediated drug interactions versus CYP3A4-mediated drug interactions, unless their relative contributions can be accurately estimated. Therefore, care should be exercised when interpreting drug interaction data and exploring the underlying mechanisms of drug interactions.
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Affiliation(s)
- Jiunn H Lin
- Department of Drug Metabolism, Merck Research Laboratories, WP75A-203, West Point, PA 19486, USA.
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Abstract
Chemotherapeutics are the most effective treatment for metastatic tumours. However, the ability of cancer cells to become simultaneously resistant to different drugs--a trait known as multidrug resistance--remains a significant impediment to successful chemotherapy. Three decades of multidrug-resistance research have identified a myriad of ways in which cancer cells can elude chemotherapy, and it has become apparent that resistance exists against every effective drug, even our newest agents. Therefore, the ability to predict and circumvent drug resistance is likely to improve chemotherapy.
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Affiliation(s)
- Michael M Gottesman
- Laboratory of Cell Biology and Cancer Therapeutics Branch, The Center for Cancer Research, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Kurosawa K, Takahashi K, Tsuda E, Tomida A, Tsuruo T. Reversal of multidrug resistance by novel nitrophenyl pyrones, SNF4435C and D. Jpn J Cancer Res 2001; 92:1235-41. [PMID: 11714449 PMCID: PMC5926656 DOI: 10.1111/j.1349-7006.2001.tb02145.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
SNF4435C and D, novel immunosuppressants produced by a strain of Streptomyces spectabilis, were examined for their reversing effects in vitro on various multidrug-resistant (MDR) tumor cells overexpressing P-glycoprotein. These two compounds in the range of 3-10 microM completely reversed the resistance of MDR variant cells, mouse leukemia P388 cells [vincristine (VCR)-resistant P388/VCR and adriamycin (ADM)-resistant P388/ADM], human myelogenous leukemia K562 cells (VCR-resistant K562/VCR and ADM-resistant K562/ADM) and human ovarian cancer A2780 cells (ADM-resistant AD(10)), against VCR. Both compounds moderately potentiated the sensitivity of the MDR cells to ADM but the reversal was not complete. SNF4435C and D significantly increased the intracellular accumulation of VCR in AD(10) cells as potently as verapamil, cyclosporin A (CysA) and FK506, whereas the compounds exerted no effect on the accumulation of VCR in the drug-sensitive parent cells. Moreover, SNF4435C improved the chemotherapeutic efficacy of VCR in the treatment of P388/VCR-bearing mice. When 10 mg/kg SNF4435C was administered intraperitoneally to the mice concurrently with 0.2 mg/kg VCR for every 5 days, a treated/control (T/C) value of 143% was obtained. These results suggest that the compounds are useful candidates or tools for MDR modification in cancer chemotherapy.
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Affiliation(s)
- K Kurosawa
- Research Institute of Life Science, Snow Brand Milk Products Co., Ltd., Ishibashi-machi, Shimotsuga-gun, Tochigi 329-0512.
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