Aggressive cutaneous squamous cell carcinoma in a hydroxyurea- and ruxolitinib-pretreated patient with polycythaemia vera

Recent progress of JAK inhibitors for hematological disorders

JAK inhibitors are important therapeutic options for hematological disorders, especially myeloproliferative neoplasms. Ruxolitinib, the first JAK inhibitor approved for clinical use, improves splenomegaly and ameliorates constitutional symptoms in both myelofibrosis and polycythemia vera patients. Ruxolitinib is also useful for controlling hematocrit levels in polycythemia vera patients who were inadequately controlled by conventional therapies. Furthermore, pretransplantation use of ruxolitinib may improve the outcome of allo-hematopoietic stem cell transplantation in myelofibrosis. In contrast to these clinical merits, evidence of the disease-modifying action of ruxolitinib, i.e., reduction of malignant clones or improvement of bone marrow pathological findings, is limited, and many myelofibrosis patients discontinued ruxolitinib due to adverse events or disease progression. To overcome these limitations of ruxolitinib, several new types of JAK inhibitors have been developed. Among them, fedratinib was proven to provide clinical merits even in patients who were resistant or intolerant to ruxolitinib. Pacritinib and momelotinib have shown merits for myelofibrosis patients with thrombocytopenia or anemia, respectively. In addition to treatment for myeloproliferative neoplasms, recent studies have demonstrated that JAK inhibitors are novel and attractive therapeutic options for corticosteroid-refractory acute as well as chronic graft versus host disease.

Systematic exo-endo encapsulation of hydroxyurea (HU) by Cu, Ag, and Au-doped gallium nitride nanotubes (GaNNT) for smart therapeutic delivery

Similar to the more well-known carbon nanotubes, gallium nitride nanotubes (GaNNT) are among the materials that scientists have found to be extremely helpful in transporting drugs and to provide significant potential for multi-modal medical therapies. Here, the potential of Cu, Ag, and Au-doped GaNNT for smart delivery of the anticancer medication hydroxyurea (HU) was extensively investigated employing quantum chemical analysis and density functional theory (DFT) computation at the B3LYP-GD3BJ/def2-SVP level of theory. The systematic approach used in this study entails examining the exo (outside)-and endo (inside) loading of HU utilizing the investigated nanotubes in order to understand the adsorption, sensing processes, bonding types, and thermodynamic properties. Results of the HOMO-LUMO studies show that metal-doped GaNNTs with the hydroxyurea (HU) at the endo - interaction of the drug of the nanotube produced more reduced energy gaps (0.911-2.039 eV) compared with metal-doped GaNNTs complexes at the outside - interaction of the drug on the nanotube (2.25-3.22 eV) and as such reveal their suitability for use as drug delivery materials. As observed in the endo-interaction of HU adsorptions in the tubes, HU_endo_Au@GaNNT possessed the highest adsorption energy values of -118.716 kcal/mol which shows the most chemisorption between the surfaces and the adsorbate while for HU_exo_Ag@GaNNT is -97.431 kcal/mol for the highest exo-interactions. These results suggest that HU drug interacted inside the Ag, Au, and Cu doped GaNNT will be very proficient as a carrier of the HU drug into bio systems. These results are along with visual studies of weak interactions, thermodynamics, sensor, and drug release mechanisms suggest strongly the endo-encapsulation of HU as the best mode for smart drug delivery.