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Mteremko D, Chilongola J, Paluch AS, Chacha M. Ensemble-based virtual screening of African natural products to target human thymidylate synthase. J Mol Graph Model 2023; 125:108568. [PMID: 37591123 DOI: 10.1016/j.jmgm.2023.108568] [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] [Received: 04/19/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023]
Abstract
Human thymidylate synthase (hTS) is a validated drug target for chemotherapy. A virtual screening experiment was used to prioritize a list of compounds from African Natural Products Databases docked against the orthosteric binding pocket of hTS. Consensus scores of binding affinities from ensemble-based virtual screening, hydrated docking and MM-PBSA calculations ranked compounds NEA4433 and NEA4434 as the best candidates owing to binding affinity scores in the picomolar order, their excellent ADMET profiles and the good stability of the protein-ligand complexes formed. The current study demonstrates the role of water in small molecule binding to hTS in mediating protein-ligand interactions. Similarly, the robust ensemble docking (relaxed scheme complex) ranked NEA4433 and NEA4434 as the best candidates. Furthermore, the best candidates prioritized were shown to strongly interact with the same residues that interacted with hTS substrate and cofactor.
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Affiliation(s)
- Denis Mteremko
- The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.
| | - Jaffu Chilongola
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Andrew S Paluch
- Department of Chemical, Paper, and Biomedical Engineering, Miami University, Oxford, OH, 45056, USA
| | - Musa Chacha
- The Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania; Arusha Technical College, Arusha, Tanzania
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2
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Paulsen NH, Pfeiffer P, Ewertz M, Fruekilde PBN, Feddersen S, Holm HS, Bergmann TK, Qvortrup C, Damkier P. Implementation and clinical benefit of DPYD genotyping in a Danish cancer population. ESMO Open 2023; 8:100782. [PMID: 36791638 PMCID: PMC10024141 DOI: 10.1016/j.esmoop.2023.100782] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND In 2020, the European Medicines Agency recommended testing patients for dihydropyrimidine dehydrogenase (DPD) deficiency before systemic treatment with fluoropyrimidines (FP). DPD activity testing identifies patients at elevated risk of severe FP-related toxicity (FP-TOX). The two most used methods for DPD testing are DPYD genotyping and DPD phenotyping (plasma uracil concentration). The primary objective of this study was to compare the overall frequency of overall grade ≥3 FP-TOX before and after the implementation of DPYD genotyping. PATIENTS AND METHODS Two hundred thirty Danish, primarily gastrointestinal cancer patients, were DPYD-genotyped before their first dose of FP, and blood was sampled for post hoc assessment of P-uracil. The initial dose was reduced for variant carriers. Grade ≥3 FP-TOX was registered after the first three treatment cycles of FP. The frequency of toxicity was compared to a historical cohort of 492 patients with post hoc determined DPYD genotype from a biobank. RESULTS The frequency of overall grade ≥3 FP-TOX was 27% in the DPYD genotype-guided group compared to 24% in the historical cohort. In DPYD variant carriers, DPYD genotyping reduced the frequency of FP-related hospitalization from 19% to 0%. In the control group, 4.8% of DPYD variant carriers died due to FP-TOX compared to 0% in the group receiving DPYD genotype-guided dosing of FP. In the intervention group, wild-type patients with uracil ≥16 ng/ml had a higher frequency of FP-TOX than wild-type patients with uracil <16 ng/ml (55% versus 28%). CONCLUSIONS We found no population-level benefit of DPYD genotyping when comparing the risk of grade ≥3 FP-TOX before and after clinical implementation. We observed no deaths or FP-related hospitalizations in patients whose FP treatment was guided by a variant DPYD genotype. The use of DPD phenotyping may add valuable information in DPYD wild-type patients.
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Affiliation(s)
- N H Paulsen
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - P Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - M Ewertz
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - P B N Fruekilde
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark
| | - S Feddersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark
| | - H S Holm
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - T K Bergmann
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - C Qvortrup
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - P Damkier
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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3
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García-Alfonso P, Muñoz Martín AJ, Ortega Morán L, Soto Alsar J, Torres Pérez-Solero G, Blanco Codesido M, Calvo Ferrandiz PA, Grasso Cicala S. Oral drugs in the treatment of metastatic colorectal cancer. Ther Adv Med Oncol 2021; 13:17588359211009001. [PMID: 33995592 PMCID: PMC8111515 DOI: 10.1177/17588359211009001] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most common forms of cancer, with an estimated 1.36 million new cases and almost 700,000 deaths annually. Approximately 21% of patients with CRC have metastatic disease at diagnosis. The objective of this article is to review the literature on the efficacy and safety of oral drugs available for the treatment of metastatic colorectal cancer (mCRC). Several such drugs have been developed, and fluoropyrimidines are the backbone of chemotherapy in this indication. They exert their antitumour activity by disrupting the synthesis and function of DNA and RNA. Oral fluoropyrimidines include prodrugs capecitabine, tegafur, eniluracil/5-fluorouracil, tegafur/uracil, tegafur/gimeracil/oteracil and trifluridine/tipiracil (FTD/TPI). Oral drugs offer several advantages over injectable formulations, including convenience, flexibility, avoidance of injection-related adverse events (AEs) and, in some circumstances, lower costs. However, oral drugs may not be suitable for patients with gastrointestinal obstruction or malabsorption, they may result in reduced treatment adherence and should not be co-administered with drugs that interfere with absorption or hepatic metabolism. Oral fluoropyrimidines such as capecitabine, as monotherapy or in combination with oxaliplatin, irinotecan or bevacizumab, are as effective as intravenous 5-fluorouracil (5-FU) in first-line treatment of mCRC. Other oral fluoropyrimidines, such as FTD/TPI, are effective in patients with mCRC who are refractory, intolerant or ineligible for 5-FU. In addition, oral fluoropyrimidines are used in adjuvant treatment of mCRC. Regorafenib is an oral multikinase inhibitor used in patients in whom several previous lines of therapy have failed. Frequent AEs associated with oral drugs used in the treatment of CRC include hand-foot syndrome and gastrointestinal and haematological toxicities.
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Affiliation(s)
- Pilar García-Alfonso
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, Madrid, 28009, Spain
| | | | - Laura Ortega Morán
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Soto Alsar
- Oncología Médica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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4
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King DA, Diasio RB, Saif MW. Association of Pharmacogenetics With Adverse Events of Fluorouracil/Capecitabine in Patients With Cancer. JCO Oncol Pract 2021; 17:453-454. [PMID: 33793308 DOI: 10.1200/op.20.01072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Daniel A King
- Daniel A. King, MD, PhD, Stanford University, Stanford, CA; Robert B. Diasio, MD, Mayo Clinic Cancer Center, Rochester, MN; and M. Wasif Saif, MD, MBBS, Northwell Health Cancer Institute and Feinstein Institute of Research, Lake Success, NY
| | - Robert B Diasio
- Daniel A. King, MD, PhD, Stanford University, Stanford, CA; Robert B. Diasio, MD, Mayo Clinic Cancer Center, Rochester, MN; and M. Wasif Saif, MD, MBBS, Northwell Health Cancer Institute and Feinstein Institute of Research, Lake Success, NY
| | - M Wasif Saif
- Daniel A. King, MD, PhD, Stanford University, Stanford, CA; Robert B. Diasio, MD, Mayo Clinic Cancer Center, Rochester, MN; and M. Wasif Saif, MD, MBBS, Northwell Health Cancer Institute and Feinstein Institute of Research, Lake Success, NY
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5
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Pant P, Pathak A, Jayaram B. Symmetric Nucleosides as Potent Purine Nucleoside Phosphorylase Inhibitors. J Phys Chem B 2021; 125:2856-2862. [PMID: 33715357 DOI: 10.1021/acs.jpcb.0c10553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nucleic acids are one of the most enigmatic biomolecules crucial to several biological processes. Nucleic acid-protein interactions are vital for the coordinated and controlled functioning of a cell, leading to the design of several nucleoside/nucleotide analogues capable of mimicking these interactions and hold paramount importance in the field of drug discovery. Purine nucleoside phosphorylase is a well-established drug target due to its association with numerous immunodeficiency diseases. Here, we study the binding of human purine nucleoside phosphorylase (PNP) to some bidirectional symmetric nucleosides, a class of nucleoside analogues that are more flexible due to the absence of sugar pucker restraints. We compared the binding energies of PNP-symmetric nucleosides to the binding energies of PNP-inosine/Imm-H (a transition-state analogue), by means of 200 ns long all-atom explicit-solvent Gaussian accelerated molecular dynamics simulations followed by energetics estimation using the MM-PBSA methodology. Quite interestingly, we observed that a few symmetric nucleosides, namely, ν3 and ν4, showed strong binding with PNP (-14.1 and -12.6 kcal/mol, respectively), higher than inosine (-6.3 kcal/mol) and Imm-H (-9.6 kcal/mol). This is rationalized by an enhanced hydrogen-bond network for symmetric nucleosides compared to inosine and Imm-H while maintaining similar van der Waals contacts. We note that the chemical structures of both ν3 and ν4, due to an additional unsaturation in them, resemble enzymatic transition states and fall in the category of transition-state analogues (TSAs), which are quite popular.
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Affiliation(s)
- Pradeep Pant
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.,Supercomputing Facility for Bioinformatics & Computational Biology, Hauz Khas, New Delhi 110016, India
| | - Amita Pathak
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.,Supercomputing Facility for Bioinformatics & Computational Biology, Hauz Khas, New Delhi 110016, India
| | - B Jayaram
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.,Supercomputing Facility for Bioinformatics & Computational Biology, Hauz Khas, New Delhi 110016, India.,Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
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6
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Vogel WH, Minhas A, Baumrucker S. Dihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen? J Adv Pract Oncol 2021; 11:68-73. [PMID: 33542850 PMCID: PMC7517765 DOI: 10.6004/jadpro.2020.11.1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
5-fluorouracil (5-FU) and its prodrug capecitabine are frequently prescribed in oncology. While usually well tolerated, toxicity can be severe, and even life-threatening. A dihydropyrimidine dehydrogenase (DPD) deficiency can cause severe toxicity. Current testing for DPD deficiency does not meet the criteria for a routine screening test prior to 5-FU therapy. A case study of a fatality secondary to capecitabine toxicity is reviewed and literature is examined regarding general screening for DPD deficiency.
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Affiliation(s)
| | - Ahmed Minhas
- East Tennessee State University, Johnson City, Tennessee
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Yang SJ, Tseng SY, Wang CH, Young TH, Chen KC, Shieh MJ. Magnetic nanomedicine for CD133-expressing cancer therapy using locoregional hyperthermia combined with chemotherapy. Nanomedicine (Lond) 2020; 15:2543-2561. [DOI: 10.2217/nnm-2020-0222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: Cells with CD133 overexpression, a theoretical cancer stem cells (CSCs) marker, have been shown to induce colorectal cancer (CRC) initiation and relapse. Therefore, the detection and treatment of CSCs are the most important factors in overcoming CRC. Materials & methods: Herein, we developed a magnetite-based nanomedicine (superparamagnetic iron oxide@poly(sodium styrene sulfonate)/irinotecan/human serum albumin-anti-CD133 nanoparticle) using loco-regional hyperthermia combined with chemotherapy for CRC- and CSC-specific targeting treatment. Results: The designed nanoparticles were highly biocompatible and exhibited a higher temperature increase rate under radiofrequency generator irradiation. The nanoparticles could be used as a T2-weighted magnetic resonance imaging contrast media, and also applied during hyperthermia and chemotherapy to display a synergistic anticancer effect. Conclusion: Therefore, the superparamagnetic iron oxide@poly(sodium styrene sulfonate)/irinotecan/human serum albumin-anti-CD133 nanoparticles are a powerful candidate for future antitumor strategies.
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Affiliation(s)
- Shu-Jyuan Yang
- Institute of Biomedical Engineering, College of Medicine & College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
| | - Shu-Yi Tseng
- Institute of Biomedical Engineering, College of Medicine & College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
| | - Chung-Hao Wang
- Gene'e Tech Co. Ltd. 2F., No.661, Bannan Rd., Zhonghe Dist., New Taipei City 235, Taiwan
| | - Tai-Horng Young
- Institute of Biomedical Engineering, College of Medicine & College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
| | - Ke-Cheng Chen
- Institute of Biomedical Engineering, College of Medicine & College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
- Department of Surgery, National Taiwan University Hospital & College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan
| | - Ming-Jium Shieh
- Institute of Biomedical Engineering, College of Medicine & College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan
- Department of Oncology, National Taiwan University Hospital & College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan
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Ramesh D, Vijayakumar BG, Kannan T. Therapeutic potential of uracil and its derivatives in countering pathogenic and physiological disorders. Eur J Med Chem 2020; 207:112801. [PMID: 32927231 DOI: 10.1016/j.ejmech.2020.112801] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/21/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023]
Abstract
Uracil is one of the most notable pharmacophores in medicinal chemistry as the pyrimidine nucleobase forms an integral part of many commercial drugs. Though the name uracil is usually associated with cancer drugs, there are many uracil-based compounds which can treat different diseases when they are employed. So far, there has been no in-depth review concerning uracil drugs in the market, or in the different stages of clinical trials, including those approved or discontinued. The current work focuses on the importance of uracil and its derivatives in treating different diseases. The use of uracil compounds in treating viral infections, cancer, diabetic, thyroid and autosomal recessive disorders are discussed in the review. The mechanism of action of each uracil drug with emphasis on their structure and properties are discussed in detail. The targeted action of these drugs on sites or on the different stages of a disorder/pathogenic life cycle are also discussed. This review encompasses uracil drugs approved as well as those in development from the 1950's onwards. The utility of uracil in drug discovery and its association with a wide range of diseases is brought forth within this review to demonstrate its potential to a wider audience.
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Affiliation(s)
- Deepthi Ramesh
- Department of Chemistry, Pondicherry University, Kalapet, Puducherry, 605014, India
| | | | - Tharanikkarasu Kannan
- Department of Chemistry, Pondicherry University, Kalapet, Puducherry, 605014, India.
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9
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Pant P, Jayaram B. C5' omitted DNA enhances bendability and protein binding. Biochem Biophys Res Commun 2019; 514:979-984. [PMID: 31092333 DOI: 10.1016/j.bbrc.2019.05.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/06/2019] [Indexed: 12/24/2022]
Abstract
Protein-DNA interactions are of great biological importance. The specificity and strength of these intimate contacts are crucial in the proper functioning of a cell, wherein the role of DNA dynamic bendability has been a matter of discussion. We relate DNA bendability to protein binding by introducing some simple modifications in the DNA structure. We removed C5' carbon in first modified structure and the second has an additional carbon between C3' and 3'-OH, hereby pronounced as C(-) and C(+) nucleic acids respectively. We observed that C(+) nucleic acid retains B-DNA duplex as seen by means of 500 ns long molecular dynamics (MD) simulations, structural and energetic calculations, while C(-) nucleic acid attains a highly bend structure. We transferred these observations to a protein-DNA system in order to monitor as to what extent the bendability enhances the protein binding. The energetics of binding is explored by performing 100 ns long MD simulations on control and modified DNA-protein complexes followed by running MM-PBSA/GBSA calculations on the resultant structures. It is observed that C(+) nucleic acid has protein binding in close correspondence to the control system (∼-14 kcal/mol) due to their relatable structure, while the C(-) nucleic acid displayed high binding to the protein (∼-18 kcal/mol). DelPhi based calculations reveal that the high binding could be the result of enhanced electrostatic interactions caused by exposed bases in the bend structure for protein recognition. Such modified oligonucleotides, due to their improved binding to protein and resistance to nuclease degradation, have a great therapeutic value.
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Affiliation(s)
- Pradeep Pant
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India; Supercomputing Facility for Bioinformatics & Computational Biology, Hauz Khas, New Delhi, 110016, India
| | - B Jayaram
- Department of Chemistry, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India; Supercomputing Facility for Bioinformatics & Computational Biology, Hauz Khas, New Delhi, 110016, India; Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
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10
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Prospective DPYD genotyping to reduce the risk of fluoropyrimidine-induced severe toxicity: Ready for prime time. Eur J Cancer 2016; 54:40-48. [DOI: 10.1016/j.ejca.2015.11.008] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 01/29/2023]
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Rastogi S, Sirohi B, Deodhar K, Shetty N, Shrikhande SV. Dilemma of dihydropyrimidine dehydrogenase deficiency in colorectal cancer patients: is Uftoral ® the right answer? COLORECTAL CANCER 2014. [DOI: 10.2217/crc.14.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
SUMMARY Fluoropyrimidines (5-fluorouracil, capecitabine, S-1, Uftoral® [UFT; Merck, Germany]) and their derivatives are effective in management of colorectal cancer. DPD deficiency is not routinely tested and is usually diagnosed after a patient has severe/grade IV toxicity secondary to the use of 5-fluorouracil or capecitabine. Once DPD deficiency is diagnosed, there are sparse data on the use of UFT or raltitrexed and there are no comparable outcome data with well-known regimens like infusional 5-fluorouracil, leucovorin oxaliplatin (FOLFOX) and infusional 5-fluorouracil, leucovorin, irinotecan (FOLFIRI). Here we report the first case series from India of DPD deficiency and the use of UFT.
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Affiliation(s)
- Sameer Rastogi
- Department of Medical Oncology–TMC, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Bhawna Sirohi
- Department of Medical Oncology–TMC, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Kedar Deodhar
- Department of Pathology–TMC, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Nitin Shetty
- Deaprtment of Radiology–TMC, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
| | - Shailesh V Shrikhande
- Department of GI & HPB Surgery–TMC, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
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Deenen MJ, Cats A, Beijnen JH, Schellens JHM. Standard-dose tegafur-uracil (UFT) is not a safe alternative in partial dihydropyrimidine dehydrogenase-deficient patients. Ther Adv Med Oncol 2013; 5:91-2. [PMID: 23323150 DOI: 10.1177/1758834012464806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Maarten J Deenen
- Division of Clinical Pharmacology, Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, and Department of Clinical Pharmacy, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands
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13
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Cubero DIG, Del Giglio A. Tegafur-uracil (UFT) in lower doses is safe for the treatment of colorectal cancer in patients with partial dihydropyrimidine dehydrogenase deficiency: a proof of principle. Ther Adv Med Oncol 2013; 5:93-4. [PMID: 23323151 DOI: 10.1177/1758834012469430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Daniel I G Cubero
- Department of Oncology and Haematology, ABC Foundation School of Medicine, Av. Principe de Gales, n.821, anexo 3, Santo André/SP, 09060-650, Brazil
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