1
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Guo Z, Zheng H, Ma J, Xu G, Jia Q. Design of pH-responsive molecularly imprinted polymer as a carrier for controlled and sustainable capecitabine release. Anal Chim Acta 2024; 1317:342881. [PMID: 39029999 DOI: 10.1016/j.aca.2024.342881] [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: 03/03/2024] [Revised: 04/30/2024] [Accepted: 06/16/2024] [Indexed: 07/21/2024]
Abstract
A molecularly imprinting polymer (MIP) carrier with pH-responsivity was designed to construct a drug delivery system (DDS) focusing on controlled and sustainable capecitabine (CAPE) release. The pH-responsive characteristic was achieved by the functionalization of SiO2 substrate with 4-formylphenylboronic acid, accompanied by the introduction of fluorescein isothiocyanate for the visualization of the intracellular localization of the nanocarrier. Experimental results indicated that CAPE was adsorbed onto the drug carrier with satisfactory encapsulation efficiency. The controlled release of CAPE was realized based on the break of borate ester bonds between -B(OH)2 and cis-diols in the weakly acidic environment. Density functional theory computations were conducted to investigate the adsorption/release mechanism. Moreover, in vitro experiments confirmed the good biocompatibility and ideal inhibition efficiency of the developed DDS. The MIP can act as an eligible carrier and exhibits the great potential in practical applications for tumor treatment.
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Affiliation(s)
- Zimeng Guo
- School of Pharmaceutical Sciences, Jilin University, Changchun, 130021, China
| | - Haijiao Zheng
- College of Chemistry, Jilin University, Changchun, 130012, China
| | - Jiutong Ma
- College of Chemistry, Jilin University, Changchun, 130012, China
| | - Guoxing Xu
- School of Pharmaceutical Sciences, Jilin University, Changchun, 130021, China.
| | - Qiong Jia
- College of Chemistry, Jilin University, Changchun, 130012, China.
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2
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Zhao M, Mi L, Ji Y, He X, Gao Y, Hu Y, Xu K. Advances of autoimmune rheumatic diseases related to malignant tumors. Inflamm Res 2023; 72:1965-1979. [PMID: 37768354 PMCID: PMC10611618 DOI: 10.1007/s00011-023-01780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Malignant neoplasms are a well-recognized global public health concern, with significant impacts on human health and quality of life. The interplay between tumors and autoimmune rheumatic diseases is complex, and the resulting tumor-associated rheumatic diseases represent a rare and intricate group of conditions that occur in the context of malignant tumors. In addition, various rheumatic diseases can arise as a consequence of oncology treatment. These diseases present with intricate clinical manifestations and pathological features, often rendering them challenging to diagnose and impacting patients' quality of life. Despite this, they have yet to be fully recognized. METHODS This article presents a literature review of published original articles and review articles concerning paraneoplastic rheumatic syndromes and rheumatic diseases associated with cancer treatment. We conducted a comprehensive literature search in PubMed, Web of Science and Google Scholar databases, excluding duplicated and irrelevant studies. In cases of duplicated research, we selected articles with higher impact factors for the review. RESULTS This review focuses on the clinical features, diagnosis, and treatment of paraneoplastic rheumatic diseases, as well as the pathogenesis of these diseases. Additionally, we summarize the autoimmune rheumatic diseases associated with cancer treatment. Ultimately, the goal of this review is to enhance recognition and improve the management of autoimmune rheumatic diseases related to tumors.
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Affiliation(s)
- Miaomiao Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Liangyu Mi
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Yuli Ji
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Xiaoyao He
- Department of Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yanan Gao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Yuting Hu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China
| | - Ke Xu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
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3
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Zhang Z, Zhang R, Li D. Molecular Biology Mechanisms and Emerging Therapeutics of Triple-Negative Breast Cancer. Biologics 2023; 17:113-128. [PMID: 37767463 PMCID: PMC10520847 DOI: 10.2147/btt.s426392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023]
Abstract
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that is conventionally characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2), accounting for approximately 15-20% of all breast cancers. Compared to other molecular phenotypes, TNBC is typically associated with high malignancy and poor prognosis. Cytotoxic agents have been the mainstay of treatment for the past few decades due to the lack of definitive targets and limited therapeutic interventions. However, recent developments have demonstrated that TNBC has peculiar molecular classifications and biomarkers, which provide the possibility of evolving treatment from basic cytotoxic chemotherapy to an expanding domain of targeted therapies. This review presents a framework for understanding the current clinical experience surrounding molecular biology mechanisms in TNBC (Figure 1). Including immunotherapy, polymerase (PARP) and PI3K/AKT pathway inhibitors, antibody-drug conjugates, and androgen receptor (AR) blockade. Additionally, the role of miRNA therapeutics targeting TNBC and potential strategies targeting cancer stem cells (CSCs) are discussed and highlighted. As more and more treatments arise on the horizon, we believe that patients with TNBC will have a new sense of hope.
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Affiliation(s)
- Zhiying Zhang
- Inner Mongolia Medical University, Department of Thyroid Breast Surgery, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, 010050, People’s Republic of China
| | - Rui Zhang
- Inner Mongolia Medical University, Department of Thyroid Breast Surgery, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, 010050, People’s Republic of China
| | - Donghai Li
- Inner Mongolia Medical University, Department of Thyroid Breast Surgery, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, 010050, People’s Republic of China
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4
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Bargakshatriya R, Pramanik SK. Stimuli-Responsive Prodrug Chemistries for Cancer Therapy. Chembiochem 2023; 24:e202300155. [PMID: 37341379 DOI: 10.1002/cbic.202300155] [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: 02/24/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 06/22/2023]
Abstract
Prodrugs are pharmacologically inactive, chemically modified derivatives of active drugs, which, following in vivo administration, are converted to the parent drugs through chemical or enzymatic cleavage. The prodrug approach holds tremendous potential to create the enhanced version of an existing pharmacological agent and leverage those improvements to augment the drug molecules' bioavailability, targeting ability, therapeutic efficacy, safety, and marketability. Especially in cancer therapy, prodrug application has received substantial attention. A prodrug can effectively broaden the therapeutic window of its parent drug by enhancing its release at targeted tumor sites while reducing its access to healthy cells. The spatiotemporally controlled release can be achieved by manipulating the chemical, physical, or biological stimuli present at the targeted tumor site. The critical strategy comprises drug-carrier linkages that respond to physiological or biochemical stimuli in the tumor milieu to yield the active drug form. This review will focus on the recent advancements in the development of various fluorophore-drug conjugates that are widely used for real-time monitoring of drug delivery. The use of different stimuli-cleavable linkers and the mechanisms of linker cleavage will be discussed. Finally, the review will conclude with a critical discussion of the prospects and challenges that might impede the future development of such prodrugs.
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Affiliation(s)
- Rupa Bargakshatriya
- CSIR-Central Salt and Marine Chemicals Research Institute, Gijubhai Badheka Marg, Bhavnagar, Gujarat, 364002, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Sumit Kumar Pramanik
- CSIR-Central Salt and Marine Chemicals Research Institute, Gijubhai Badheka Marg, Bhavnagar, Gujarat, 364002, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
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5
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Ma H, Zhao N, Luo S, Zhang Y, Yuan Z, Sun H, Gao S, Zhan X, Zhang L. Pharmacokinetic and bioequivalence study of two capecitabine tablets in Chinese patients with breast, colorectal or gastric cancer under fed condition: A multicentric, randomized, open-label, single-dose, two-period, two-way crossover clinical trial. Eur J Pharm Sci 2023; 182:106373. [PMID: 36623698 DOI: 10.1016/j.ejps.2023.106373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/25/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The aim of this study was to examine the pharmacokinetics, bioequivalence, and safety of two tablet formulations of capecitabine 500 mg in Chinese patients with breast, colorectal or gastric cancer under fed condition. METHODS A multicentric, randomized, open-label, single-dose, two-period, two-way crossover trial was conducted by randomizing a single oral dose of test (T) or reference (R, Xeloda®) capecitabine (500 mg) to patients of either sex with colon, colorectal or breast cancer under fed condition (high-fat and high-calorie diet). Pharmacokinetic parameters were calculated using non-compartmental methods. Patients were monitored for safety and tolerability throughout the study. RESULTS 74 subjects were randomly enrolled. The T/R geometric mean ratios (GMRs) and 90% confidence intervals (CIs) for Cmax, AUC0-t and AUC0-∞ of capecitabine were 96.60% (85.87-108.67%), 99.07% (95.40-102.89%), 99.17% (95.29-103.21%), respectively. All 90% CIs fell within the bioequivalence acceptance range of 80.00-125.00%. The common adverse events (AEs) included clinically significant laboratory abnormalities and gastrointestinal diseases. There were no serious adverse events (SAEs) or deaths during the study. No subject withdrew from the study due to AEs. CONCLUSION Single oral intake of test and the reference capecitabine tablets were bioequivalent under fed condition and had similar favourable safety profiles in Chinese patients with breast, colorectal or gastric cancer. TRIAL REGISTRATION chinadrugtrials.org.cn (CTR20182110).
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Affiliation(s)
- Haiping Ma
- Clinical Research Unit, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Naping Zhao
- Clinical Research Unit, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Suxia Luo
- Department of Gastroenterology, Henan Cancer Hospital, Zhengzhou, China
| | - Yanqiao Zhang
- Department of Gastroenterology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Zhijun Yuan
- Department of Oncology, Hunan Cancer Hospital, Changsha, China
| | - Hao Sun
- Department of Gastrointestinal Surgery, Chongqing University Cancer Hospital, Chongqing, China
| | - Shen Gao
- Clinical Research Unit, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
| | - Xianbao Zhan
- Department of Oncology, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
| | - Li Zhang
- Clinical Research Unit, The First Affiliated Hospital of Naval Medical University, Shanghai, China; Department of Pharmacy, The Second Hospital of Anhui Medical University, Hefei, China.
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6
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Strobel GB, Ponamgi SP, Roka A, Aboeata ASA. Exercise-induced Brugada pattern and ventricular tachycardia during Capecitabine treatment. CARDIO-ONCOLOGY 2022; 8:19. [PMCID: PMC9675155 DOI: 10.1186/s40959-022-00146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
We report the case of a 59-year-old female patient with no previous cardiovascular disease treated for Breast cancer with Capecitabine. Shortly after starting treatment, she developed recurrent angina. An exercise stress echocardiogram was performed, which induced a type 1 Brugada pattern 12 s of a non-sustained pleomorphic ventricular tachycardia ensued.
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Affiliation(s)
- George B. Strobel
- grid.254748.80000 0004 1936 8876Creighton University School of Medicine, Omaha, NE USA
| | - Shiva P. Ponamgi
- grid.254748.80000 0004 1936 8876Department of Cardiology, Creighton University School of Medicine, Omaha, NE USA
| | - Attila Roka
- grid.254748.80000 0004 1936 8876Department of Cardiology, Creighton University School of Medicine, Omaha, NE USA
| | - Ahmed S. A. Aboeata
- grid.254748.80000 0004 1936 8876Department of Cardiology, Creighton University School of Medicine, Omaha, NE USA
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7
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Wu Q, Qian W, Sun X, Jiang S. Small-molecule inhibitors, immune checkpoint inhibitors, and more: FDA-approved novel therapeutic drugs for solid tumors from 1991 to 2021. J Hematol Oncol 2022; 15:143. [PMID: 36209184 PMCID: PMC9548212 DOI: 10.1186/s13045-022-01362-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/02/2022] [Indexed: 11/10/2022] Open
Abstract
The United States Food and Drug Administration (US FDA) has always been a forerunner in drug evaluation and supervision. Over the past 31 years, 1050 drugs (excluding vaccines, cell-based therapies, and gene therapy products) have been approved as new molecular entities (NMEs) or biologics license applications (BLAs). A total of 228 of these 1050 drugs were identified as cancer therapeutics or cancer-related drugs, and 120 of them were classified as therapeutic drugs for solid tumors according to their initial indications. These drugs have evolved from small molecules with broad-spectrum antitumor properties in the early stage to monoclonal antibodies (mAbs) and antibody‒drug conjugates (ADCs) with a more precise targeting effect during the most recent decade. These drugs have extended indications for other malignancies, constituting a cancer treatment system for monotherapy or combined therapy. However, the available targets are still mainly limited to receptor tyrosine kinases (RTKs), restricting the development of antitumor drugs. In this review, these 120 drugs are summarized and classified according to the initial indications, characteristics, or functions. Additionally, RTK-targeted therapies and immune checkpoint-based immunotherapies are also discussed. Our analysis of existing challenges and potential opportunities in drug development may advance solid tumor treatment in the future.
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Affiliation(s)
- Qing Wu
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, 310053 Zhejiang China
| | - Wei Qian
- Department of Radiology, School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310009 Zhejiang China
| | - Xiaoli Sun
- Department of Radiation Oncology, School of Medicine, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003 Zhejiang China
| | - Shaojie Jiang
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, 310053 Zhejiang China
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8
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Bhattar K, Agrawal P. Clostridium difficile Infection During Palliative Capecitabine Chemotherapy: A Case Report. Cureus 2022; 14:e27102. [PMID: 36004012 PMCID: PMC9392427 DOI: 10.7759/cureus.27102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
Capecitabine has been used for triple-negative metastatic breast cancers both as monotherapy and in combination with other agents. However, its gastrointestinal side effects are one of the biggest challenges for its patient compliance, and often result in permanent drug withdrawal. There have been reports of it causing enterocolitis (mainly terminal ileitis) and even ischaemic colitis, but it has not frequently been directly associated with Clostridium difficile infection. We describe a case of a 65-year-old woman with triple-negative breast cancer on palliative capecitabine who presented with blood-streaked watery diarrhea and abdominal pain and was diagnosed with chemotherapy-induced severe colitis with superimposed Clostridium difficile infection.
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9
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Pham T, Plata PL, Zhang P, Vellara A, Bu W, Lin B, Cheng G, Liu Y. Knowledge-Based Design of 5-Fluororacil Prodrug Liposomal Formulation: Molecular Packing and Interaction Revealed by Interfacial Isotherms and X-ray Scattering Techniques. Mol Pharm 2021; 18:4331-4340. [PMID: 34739257 DOI: 10.1021/acs.molpharmaceut.1c00494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Prodrugs and nanoformulations are two effective strategies for sustained drug release and targeting drug delivery. In this study, we combined the two strategies to judiciously design the liposome formulation incorporating an amphiphilic prodrug of 5-fouroracil (5-FU), named 5-FCPal, for sustained drug release and enhanced bioavailability. 5-FCPal is an analogue of capecitabine (N4-pentyloxycarbonyl-5'-deoxy-5-fluorocytidine, Xeloda) by substituting the pentyl group at the N4 position with the palmityl. The amphiphilic molecule of 5-FCPal can self-assemble with the phospholipids to form stable vesicle structures with high drug loading. Although lipid vesicles have been widely studied and commercially used for clinical applications, because of the enormous options of the lipids and the equitable balance of hydrophobicity and bioavailability, it is essential to fundamentally understand the molecular interactions when designing and optimizing the liposomal prodrug formulations. We report the study of using X-ray liquid surface scattering techniques integrated with a Langmuir trough to explicitly reveal the interfacial behavior of the monolayer membrane of 5-FCPal with various saturated and unsaturated lipids with positively charged, neutral, and negatively charged head groups. More specifically, interfacial packing of the molecules was quantified using interfacial isotherms, X-ray reflectivity (XR), and grazing-incidence diffraction (GIXD). The results indicate that the interactions between the prodrug and the cationic lipids are most favorable. The highest drug loading is quantified by increasing the molar ratio of the prodrug until stable monolayer structures were disrupted by the multiple-layer domain of prodrug aggregates. Stable liposomes of 100 nm with 50% drug loading of 5-FCPal were generated based on the findings from the X-ray studies.
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Affiliation(s)
- Tiep Pham
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States
| | - Paola Leon Plata
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States
| | - Pin Zhang
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States
| | - Anand Vellara
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States
| | - Wei Bu
- NSF's ChemMatCARS and Pritzker School of Molecular Engineering, University of Chicago, Chicago, Illinois 60637, United States
| | - Binhua Lin
- NSF's ChemMatCARS and Pritzker School of Molecular Engineering, University of Chicago, Chicago, Illinois 60637, United States
| | - Gang Cheng
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States
| | - Ying Liu
- Department of Chemical Engineering, University of Illinois at Chicago, Chicago, Illinois 60608 United States.,Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois 60607, United States.,Department of Biopharmaceutical Sciences, University of Illinois at Chicago, Chicago, Illinois 60607, United States
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10
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Li P, He H, Xu L, Huang Y, Chen Z, Zhang Y, Yang R, Xiao G. Ortho-(1-phenylvinyl)benzyl glycosides: Ether-type glycosyl donors for the efficient synthesis of both O-glycosides and nucleosides. GREEN SYNTHESIS AND CATALYSIS 2020. [DOI: 10.1016/j.gresc.2020.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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11
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Hamzic S, Kummer D, Froehlich TK, Joerger M, Aebi S, Palles C, Thomlinson I, Meulendijks D, Schellens JH, García-González X, López-Fernández LA, Amstutz U, Largiadèr CR. Evaluating the role of ENOSF1 and TYMS variants as predictors in fluoropyrimidine-related toxicities: An IPD meta-analysis. Pharmacol Res 2020; 152:104594. [DOI: 10.1016/j.phrs.2019.104594] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/11/2019] [Accepted: 12/11/2019] [Indexed: 01/30/2023]
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12
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Li P, He H, Zhang Y, Yang R, Xu L, Chen Z, Huang Y, Bao L, Xiao G. Glycosyl ortho-(1-phenylvinyl)benzoates versatile glycosyl donors for highly efficient synthesis of both O-glycosides and nucleosides. Nat Commun 2020; 11:405. [PMID: 31964883 PMCID: PMC6972911 DOI: 10.1038/s41467-020-14295-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 12/19/2019] [Indexed: 12/11/2022] Open
Abstract
Both of O-glycosides and nucleosides are important biomolecules with crucial rules in numerous biological processes. Chemical synthesis is an efficient and scalable method to produce well-defined and pure carbohydrate-containing molecules for deciphering their functions and developing therapeutic agents. However, the development of glycosylation methods for efficient synthesis of both O-glycosides and nucleosides is one of the long-standing challenges in chemistry. Here, we report a highly efficient and versatile glycosylation method for efficient synthesis of both O-glycosides and nucleosides, which uses glycosyl ortho-(1-phenylvinyl)benzoates as donors. This glycosylation protocol enjoys the various features, including readily prepared and stable donors, cheap and readily available promoters, mild reaction conditions, good to excellent yields, and broad substrate scopes. In particular, the applications of the current glycosylation protocol are demonstrated by one-pot synthesis of several bioactive oligosaccharides and highly efficient synthesis of nucleosides drugs capecitabine, galocitabine and doxifluridine.
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Affiliation(s)
- Penghua Li
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
- School of Chemical Science and Technology, Yunnan University, Kunming, 650091, China
| | - Haiqing He
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Yunqin Zhang
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Rui Yang
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Lili Xu
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Zixi Chen
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Yingying Huang
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Limei Bao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China
| | - Guozhi Xiao
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Kunming, 650201, China.
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13
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Rashad N, Abdelhamid T, Shouman SA, Nassar H, Omran MA, El Desouky ED, Khaled H. Capecitabine-Based Chemoendocrine Combination as First-Line Treatment for Metastatic Hormone-Positive Metastatic Breast Cancer: Phase 2 Study. Clin Breast Cancer 2020; 20:228-237. [PMID: 32005499 DOI: 10.1016/j.clbc.2019.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/21/2019] [Accepted: 12/31/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preclinical studies have suggested a synergistic effect of tamoxifen and capecitabine in estrogen receptor-positive cell lines. We evaluated the safety and efficacy of first-line chemoendocrine treatment in patients with metastatic breast cancer. Biochemical assessment was performed of serum levels of thymidine phosphorylase enzyme (TP), serum tamoxifen, hydroxytamoxifen, and 5-fluorouracil in relationship to efficacy. PATIENTS AND METHODS This prospective phase 2 interventional study studied patients with estrogen receptor-positive, HER2- metastatic breast cancer who received either tamoxifen/capecitabine or letrozole/capecitabine as first-line treatment. The dose of capecitabine provided at 2000 mg per day continuously as a fixed dose. RESULTS Forty women with a median age of 49.3 years were enrolled. For the whole study group, median progression-free survival (PFS) was 10 months and median overall survival (OS) was 23.3 months. The overall response rate was 60% and the clinical benefit rate 82.5%. Progesterone receptor positivity was associated with significantly longer PFS (12 vs. 7 months, P = .021). The most frequent adverse events were palmar-plantar erythrodysesthesia (62.5%), fatigue (62.5%), diarrhea (30%), abdominal pain (12.5%), and constipation (10%). Changes in serum level of TP were not correlated to response to treatment, PFS, or OS. Higher serum levels of tamoxifen and hydroxytamoxifen were correlated with higher response rates and longer PFS but not OS. CONCLUSION Chemoendocrine treatment is well tolerated, with no evidence of contradictory effects between the combination components. However, the efficacy data need more validation.
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MESH Headings
- Abdominal Pain/chemically induced
- Abdominal Pain/epidemiology
- Adult
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Antineoplastic Agents, Hormonal/administration & dosage
- Antineoplastic Agents, Hormonal/adverse effects
- Antineoplastic Agents, Hormonal/pharmacokinetics
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/pharmacokinetics
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/blood
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Capecitabine/administration & dosage
- Capecitabine/adverse effects
- Capecitabine/pharmacokinetics
- Constipation/chemically induced
- Constipation/epidemiology
- Diarrhea/chemically induced
- Diarrhea/epidemiology
- Female
- Hand-Foot Syndrome/epidemiology
- Hand-Foot Syndrome/etiology
- Humans
- Letrozole/administration & dosage
- Letrozole/adverse effects
- Letrozole/pharmacokinetics
- Middle Aged
- Progression-Free Survival
- Prospective Studies
- Receptor, ErbB-2/analysis
- Receptors, Estrogen/analysis
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/analysis
- Receptors, Progesterone/metabolism
- Tamoxifen/administration & dosage
- Tamoxifen/adverse effects
- Tamoxifen/pharmacokinetics
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Affiliation(s)
- Noha Rashad
- Department of Medical Oncology, Maadi Armed Forces Hospital, Cairo, Egypt.
| | - Thoraya Abdelhamid
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Samia A Shouman
- Pharmacology Unit, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hanan Nassar
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mervat A Omran
- Pharmacology Unit, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Eman D El Desouky
- Department of Biostatistics and Epidemiology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hussein Khaled
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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14
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Mousavi SF, Fatemi MH. Probing the binding mechanism of capecitabine to human serum albumin using spectrometric methods, molecular modeling, and chemometrics approach. Bioorg Chem 2019; 90:103037. [PMID: 31212179 DOI: 10.1016/j.bioorg.2019.103037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/27/2019] [Accepted: 06/03/2019] [Indexed: 12/11/2022]
Abstract
Capecitabine as a prodrug of 5-Fluorouracil plays an important role in the treatment of breast and gastrointestinal cancers. Herein, in view of the importance of this drug in chemotherapy, interaction mechanism between Capecitabine (CAP) and human serum albumin (HSA) as a major transport protein in the blood circulatory system has been investigated by using a combination of spectroscopic and molecular modeling methods. The fluorescence spectroscopic results revealed that capecitabine could effectively quench the intrinsic fluorescence of HSA through a static quenching mechanism. Evaluation of the thermodynamic parameters suggested that the binding process was spontaneous while hydrogen bonds and van der Waals forces played a major role in this interaction. The value of the binding constant (Kb = 1.820 × 104) suggested a moderate binding affinity between CAP and HSA which implies its easy diffusion from the circulatory system to the target tissue. The efficiency of energy transfer and the binding distance between the donor (HSA) and acceptor (CAP) were determined according to forster theory of nonradiation energy transfer as 0.410 and 4.135 nm, respectively. Furthermore, UV-Vis spectroscopic results confirmed that the interaction was occurred between HSA and CAP and caused conformational and micro-environmental changes of HSA during the interaction. Multivariate curve resolution-alternating least square (MCR-ALS) methodology as an efficient chemometric tool was used to separate the overlapped spectra of the species. The MCR-ALS result was exploited to estimate the stoichiometry of interaction and to provide concentration and structural information about HSA-CAP interactions. Molecular docking studies suggested that CAP binds mainly to the subdomain IIA of HSA, which were compatible with those obtained by experimental data. Finally, molecular dynamics simulation (MD) was performed on the best docked complex by considering the permanence and flexibility of HSA-CAP complex in the binding site. MD result showed that CAP could steadily bind to HSA in the site I based on the formation of hydrogen bond and π-π stacking interaction in addition to hydrophobic force.
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Affiliation(s)
- S Fatemeh Mousavi
- Chemometrics Laboratory, Faculty of Chemistry, University of Mazandaran, Babolsar, Iran.
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15
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Rautio J, Meanwell NA, Di L, Hageman MJ. The expanding role of prodrugs in contemporary drug design and development. Nat Rev Drug Discov 2018; 17:559-587. [DOI: 10.1038/nrd.2018.46] [Citation(s) in RCA: 325] [Impact Index Per Article: 54.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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16
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Liu YL, Chin C, Catanese B, Lee SM, Zhan S, Kalinsky K, Connolly EP. Concurrent use of capecitabine with radiation therapy and survival in breast cancer (BC) after neoadjuvant chemotherapy. Clin Transl Oncol 2018; 20:1280-1288. [PMID: 29594944 DOI: 10.1007/s12094-018-1859-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Capecitabine has been studied as a radiosensitizer, and our study seeks to examine the association of concurrent capecitabine/radiation therapy (RT) on event-free- (EFS) and overall survival (OS) in women with breast cancer (BC) with residual disease after neoadjuvant chemotherapy (NAC). METHODS/PATIENTS In a retrospective study of women with BC who received adriamycin/taxane-based NAC from 2004-2016, we identified 21 women administered concurrent capecitabine/RT. To assess differences in survival, we selected a clinical control cohort (n = 57) based on criteria used to select patients for capecitabine/RT. We also created a matched cohort (2:1), matching on tumor subtype, pathological stage and age (< 50 or 50+ years). Differences in EFS, using STEEP criteria, and OS, using all-cause mortality, between those who received capecitabine/RT and controls were assessed. RESULTS Of the 21 women who received capecitabine/RT, median age was 52 years. The majority were pathologic stage III (n = 15) and hormone receptor-positive/HER2-negative BC (n = 20). In those receiving capecitabine/RT, there were 9 events, compared with 14 events in clinical and 10 events in matched controls. Capecitabine/RT was associated with worse OS in clinical (HR 3.83 95% CI 1.12-13.11, p = 0.03) and matched controls (HR 3.71 95% CI 1.04-13.18, p = 0.04), after adjusting for clinical size, pathological stage and lymphovascular invasion. Capecitabine/RT was also associated with a trend towards worse EFS in clinical (HR 2.41 95% CI 0.86-6.74, p = 0.09) and matched controls (HR 2.68 95% CI 0.91-7.90, p = 0.07) after adjustment. CONCLUSION Concurrent capecitabine/RT after NAC is associated with worse survival and should be carefully considered in BC.
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Affiliation(s)
- Y L Liu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C Chin
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - B Catanese
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - S M Lee
- Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA
| | - S Zhan
- Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA
| | - K Kalinsky
- Department of Medical Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | - E P Connolly
- Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.
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17
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Zhang XH, Hao S, Gao B, Tian WG, Jiang Y, Zhang S, Guo LJ, Luo DL. A network meta-analysis for toxicity of eight chemotherapy regimens in the treatment of metastatic/advanced breast cancer. Oncotarget 2018; 7:84533-84543. [PMID: 27811367 PMCID: PMC5356679 DOI: 10.18632/oncotarget.13023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/17/2016] [Indexed: 12/16/2022] Open
Abstract
Objective To compare the incidence of toxicity of 8 different chemotherapy regimens, including doxorubicin + paclitaxel, doxorubicin, capecitabine, CMF (cyclophosphamide + methotrexate + 5-fluorouracil), FAC (fluorouracil + doxorubicin + cyclophosphamide), doxorubicin + docetaxel, doxorubicin + cyclophosphamide and paclitaxel in the treatment of metastatic/advanced breast cancer. Results This network meta-analysis included 8 randomized controlled trials (RCTs). The findings revealed that, with regard to capecitabine alone regimen exhibited higher incidence of nausea/vomiting than doxorubicin + paclitaxel regimen, doxorubicin alone regimen and paclitaxel alone regimen in the treatment of patients with metastatic/advanced breast cancer (OR = 32.48, 95% CI = 1.65~2340.57; OR = 22.75, 95% CI = 1.03~1923.52; OR = 59.63, 95% CI = 2.22~5664.88, respectively). Furthermore, doxorubicin + cyclophosphamide regimen had lower incidence of febrile neutropenia than doxorubicin + docetaxel (OR = 0.17, 95% CI = 0.03~0.96). No significant difference in the incidence of stomatitis was observed among eight chemotherapy regimens. Materials and Methods We initially searched PubMed, Cochrane Library and Embase databases from the founding of these databases to January 2016. Eligible studies investigating the 8 different chemotherapy regimens for treatment of metastatic/advanced breast cancer were included for direct and indirect comparison. The odds ratio (OR) and surface under the cumulative ranking curves (SUCRA) value of the incidence of toxicity among eight chemotherapy regimens were analyzed. Conclusions Capecitabine alone regimen and doxorubicin + docetaxel regimen may have a more frequent toxicity in the treatment of metastatic/advanced breast cancer.
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Affiliation(s)
- Xiao-Hua Zhang
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Shuai Hao
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Bo Gao
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Wu-Guo Tian
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Yan Jiang
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Shu Zhang
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Ling-Ji Guo
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
| | - Dong-Lin Luo
- Department of Breast, Thyroid Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, P.R. China
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18
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Kast RE, Skuli N, Cos S, Karpel-Massler G, Shiozawa Y, Goshen R, Halatsch ME. The ABC7 regimen: a new approach to metastatic breast cancer using seven common drugs to inhibit epithelial-to-mesenchymal transition and augment capecitabine efficacy. BREAST CANCER-TARGETS AND THERAPY 2017; 9:495-514. [PMID: 28744157 PMCID: PMC5513700 DOI: 10.2147/bctt.s139963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Breast cancer metastatic to bone has a poor prognosis despite recent advances in our understanding of the biology of both bone and breast cancer. This article presents a new approach, the ABC7 regimen (Adjuvant for Breast Cancer treatment using seven repurposed drugs), to metastatic breast cancer. ABC7 aims to defeat aspects of epithelial-to-mesenchymal transition (EMT) that lead to dissemination of breast cancer to bone. As add-on to current standard treatment with capecitabine, ABC7 uses ancillary attributes of seven already-marketed noncancer treatment drugs to stop both the natural EMT process inherent to breast cancer and the added EMT occurring as a response to current treatment modalities. Chemotherapy, radiation, and surgery provoke EMT in cancer generally and in breast cancer specifically. ABC7 uses standard doses of capecitabine as used in treating breast cancer today. In addition, ABC7 uses 1) an older psychiatric drug, quetiapine, to block RANK signaling; 2) pirfenidone, an anti-fibrosis drug to block TGF-beta signaling; 3) rifabutin, an antibiotic to block beta-catenin signaling; 4) metformin, a first-line antidiabetic drug to stimulate AMPK and inhibit mammalian target of rapamycin, (mTOR); 5) propranolol, a beta-blocker to block beta-adrenergic signaling; 6) agomelatine, a melatonergic antidepressant to stimulate M1 and M2 melatonergic receptors; and 7) ribavirin, an antiviral drug to prevent eIF4E phosphorylation. All these block the signaling pathways - RANK, TGF-beta, mTOR, beta-adrenergic receptors, and phosphorylated eIF4E - that have been shown to trigger EMT and enhance breast cancer growth and so are worthwhile targets to inhibit. Agonism at MT1 and MT2 melatonergic receptors has been shown to inhibit both breast cancer EMT and growth. This ensemble was designed to be safe and augment capecitabine efficacy. Given the expected outcome of metastatic breast cancer as it stands today, ABC7 warrants a cautious trial.
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Affiliation(s)
| | - Nicolas Skuli
- INSERM, Centre de Recherches en Cancérologie de Toulouse - CRCT, UMR1037 Inserm/Université Toulouse III - Paul Sabatier, Toulouse, France
| | - Samuel Cos
- Department of Physiology and Pharmacology, School of Medicine, University of Cantabria and Valdecilla Research Institute (IDIVAL), Santander, Spain
| | | | - Yusuke Shiozawa
- Department of Cancer Biology, Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ran Goshen
- Eliaso Consulting Ltd., Tel Aviv-Yafo, Israel
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Hamzic S, Kummer D, Milesi S, Mueller D, Joerger M, Aebi S, Amstutz U, Largiader CR. Novel Genetic Variants in Carboxylesterase 1 Predict Severe Early-Onset Capecitabine-Related Toxicity. Clin Pharmacol Ther 2017; 102:796-804. [DOI: 10.1002/cpt.641] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 12/19/2022]
Affiliation(s)
- S Hamzic
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
- Graduate School for Cellular and Biomedical Sciences; University of Bern; Bern Switzerland
| | - D Kummer
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
- Graduate School for Cellular and Biomedical Sciences; University of Bern; Bern Switzerland
| | - S Milesi
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
| | - D Mueller
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
| | - M Joerger
- Department of Medical Oncology and Hematology; Cantonal Hospital St. Gallen; St. Gallen Switzerland
| | - S Aebi
- Division of Medical Oncology; Cantonal Hospital Lucerne; Lucerne Switzerland
| | - U Amstutz
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
| | - CR Largiader
- Institute of Clinical Chemistry; Inselspital, Bern University Hospital, University of Bern; Bern Switzerland
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Abstract
Capecitabine is an orally administered chemotherapeutic agent that is metabolized at the tumor site to 5-fluorouracil and thought to be without significant cardiac toxicity. We report a rare case of takotsubo cardiomyopathy that is thought to be related to capecitabine where the patient presented with chest pain, and ST elevation within 48 hours of capecitabine therapy. Workup included cardiac catheterization and coronary angiogram that showed nonobstructive coronary artery disease and anteroapical left ventricular wall motion abnormality with left ventricular ejection fraction of 35%. The drug was stopped, and the patient was treated with beta-blocker and angiotensin-converting enzymes inhibitor. Six weeks later, she had a repeat echocardiogram that was normal. Capecitabine-related cardiomyopathy seems to be very rare because only 5 cases have been reported in the literature (including our case). The condition has to be anticipated and treated to prevent the serious consequence of cardiac dysfunction. All reported cases have eventually recovered after stopping capecitabine.
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21
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Sawicki E, Schellens JHM, Beijnen JH, Nuijen B. Inventory of oral anticancer agents: Pharmaceutical formulation aspects with focus on the solid dispersion technique. Cancer Treat Rev 2016; 50:247-263. [PMID: 27776286 DOI: 10.1016/j.ctrv.2016.09.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 11/16/2022]
Abstract
Dissolution from the pharmaceutical formulation is a prerequisite for complete and consistent absorption of any orally administered drug, including anticancer agents (oncolytics). Poor dissolution of an oncolytic can result in low oral bioavailability, high variability in blood concentrations and with that suboptimal or even failing therapy. This review discusses pharmaceutical formulation aspects and absorption pharmacokinetics of currently licensed orally administered oncolytics. In nearly half of orally dosed oncolytics poor dissolution is likely to play a major role in low and unpredictable absorption. Dissolution-limited drug absorption can be improved with a solid dispersion which is a formulation method that induces super-saturated drug dissolution and with that it enhances in vivo absorption. This review discusses formulation principles with focus on the solid dispersion technology and how it works to enhance drug absorption. There are currently three licensed orally dosed oncolytics formulated as a solid dispersion (everolimus, vemurafenib and regorafenib) and these formulations result in remarkably improved dissolution and absorption compared to what can be achieved with conventional formulations of the respective oncolytics. Because of the successful implementation of these three solid dispersion formulations, we encourage the application of this formulation method for poorly soluble oral oncolytics.
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Affiliation(s)
- E Sawicki
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/MC Slotervaart, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
| | - J H M Schellens
- Department of Clinical Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Science Faculty, Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmaco-epidemiology & Clinical Pharmacology, Utrecht University, P.O. Box 80082, 3508 TB Utrecht, The Netherlands
| | - J H Beijnen
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/MC Slotervaart, Louwesweg 6, 1066 EC Amsterdam, The Netherlands; Department of Clinical Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Science Faculty, Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmaco-epidemiology & Clinical Pharmacology, Utrecht University, P.O. Box 80082, 3508 TB Utrecht, The Netherlands
| | - B Nuijen
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/MC Slotervaart, Louwesweg 6, 1066 EC Amsterdam, The Netherlands
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22
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Chang AYC, Foo KF, Koo WH, Ong S, So J, Tan D, Lim KH. Phase II study of neo-adjuvant chemotherapy for locally advanced gastric cancer. BMJ Open Gastroenterol 2016; 3:e000095. [PMID: 27648294 PMCID: PMC5013330 DOI: 10.1136/bmjgast-2016-000095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 05/19/2016] [Accepted: 05/24/2016] [Indexed: 01/26/2023] Open
Abstract
Background Neoadjuvant chemotherapy improves survival of locally advanced gastric cancer patients. However, benefit is limited and the best regimen remains controversial. Objectives Our primary objective of this prospective, multicenter phase 2 study was to evaluate the pathological complete response rate (PCR) with 2 cycles of docetaxel and capecitabine. Methods To be eligible, patients had to have histologically documented gastric cancer, a ECOG performance status 0 or 1, T3or4 Nany M0 staging after oesophagogastroduodenoscopy (OGD), endoscopic ultrasound (EUS), CT scan of thorax and abdomen, and negative laparoscopic examination and peritoneal washing. Eligible patients received two cycles of intravenous docetaxel 60 mg/m2 on day 1 and oral capecitabine 900 mg/m2 two times per day from day 1 to day 14 every 3 weeks. We evaluated the response by CT scan and EUS. The patients underwent curative resection with D2 lymphadenectomy subsequently. Results 18 patients were enrolled in the study: 66% were male and the median age was 60 years. 17 patients had T3 disease at diagnosis. There was no pCR noted. 4 patients had a partial response of 22% (95% CI: 7–42%), 8 patients had stable disease and 3 patients had disease progression. The median survival was 17.1 months with 3 long-term survivors after at least 3 years of follow-up. The treatment was well tolerated with neutropenia being the most common toxicity. We observed 22% grade III and 33% grade IV neutropenia, but no neutropenic fever or death was observed from chemotherapy. Conclusion Neo-adjuvant chemotherapy with docetaxel and capecitabine has limited activity against GC. More effective treatment regimens are needed urgently. Trial registration number NCT00414271.
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Affiliation(s)
| | - Kian Fong Foo
- Department of Medical Oncology , National Cancer Centre , Singapore
| | - Wen-Hsin Koo
- Department of Medical Oncology , National Cancer Centre , Singapore
| | - Simon Ong
- Department of Medical Oncology , National Cancer Centre , Singapore
| | - Jimmy So
- Department of Surgery , National University Hospital , Singapore
| | - Daniel Tan
- Department of Surgery , Alexandra Hospital , Singapore
| | - Khong Hee Lim
- Department of Surgery , Tan Tock Seng Hospital , Singapore
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23
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Segura-González M, Quintana-Quintana M. Systemic treatment with capecitabine as maintenance therapy in patients with recurring or metastatic breast cancer: experience in the Oncology Hospital, National Medical Center Siglo XXI, Mexican Social Security Institute. Med Oncol 2015; 32:93. [DOI: 10.1007/s12032-015-0533-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/13/2015] [Indexed: 11/30/2022]
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Law A, Dyson S, Anthony D. An exploratory study to identify risk factors for the development of capecitabine-induced Palmar Plantar Erythrodysesthesia (PPE). J Adv Nurs 2015; 71:1825-32. [DOI: 10.1111/jan.12639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Annie Law
- University Hospitals of Leicester NHS Trust; UK
| | | | - Denis Anthony
- University of Leeds; UK
- Harris Manchester College; University of Oxford; UK
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25
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Müller V, Fuxius S, Steffens CC, Lerchenmüller C, Luhn B, Vehling-Kaiser U, Hurst U, Hahn LJ, Soeling U, Wohlfarth T, Zaiss M. Quality of life under capecitabine (Xeloda®) in patients with metastatic breast cancer: data from a german non-interventional surveillance study. Oncol Res Treat 2014; 37:748-55. [PMID: 25531721 DOI: 10.1159/000369487] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022]
Abstract
AIM This non-interventional surveillance study (NIS) collected data on the quality of life (QoL) of patients treated with capecitabine as mono- or combination chemotherapy in an outpatient setting. METHODS Capecitabine was administered orally for 14 days of each 21-day cycle. The main parameters of interest were QoL, compliance, patient and physician satisfaction, handling of hand-foot syndrome (HFS), and efficacy. The statistics were descriptive; some differences were compared using confidence intervals (CIs). RESULTS 735 patients from 161 centers received at least 1 dose of capecitabine. The median duration of observation was 5.5 months overall. The QoL global score was 53% (mean from the entire study population at all times), without any correlation to HFS. The overall response rate (ORR) was 35.1%, and the disease control rate (DCR) 64.4%. The median progression-free survival (PFS) was overall 6.81 months (95% CI 6.32-7.63 months) and it was significantly higher in patients with HFS (8.4 months, 95% CI 7.5-9.2 months, hazard ratio (HR) 0.60; p < 0.0001). The safety and tolerability of capecitabine were considered acceptable. The HFS incidence (all grades) was 27.1%. CONCLUSIONS Capecitabine had a favorable risk-benefit relation in outpatient therapy. The QoL remained stable over the course of the investigation, indicating good compliance. HFS was a strong predictor of longer PFS and had no negative impact on the global QoL.
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Affiliation(s)
- Volkmar Müller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pei D, Zhu F, Chen X, Qian J, He S, Qian Y, Shen H, Liu Y, Xu J, Shu Y. Pre-adjuvant chemotherapy leukocyte count may predict the outcome for advanced gastric cancer after radical resection. Biomed Pharmacother 2014; 68:213-7. [DOI: 10.1016/j.biopha.2014.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 01/20/2014] [Indexed: 12/29/2022] Open
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Wang J, Sánchez-Roselló M, Aceña JL, del Pozo C, Sorochinsky AE, Fustero S, Soloshonok VA, Liu H. Fluorine in Pharmaceutical Industry: Fluorine-Containing Drugs Introduced to the Market in the Last Decade (2001–2011). Chem Rev 2013; 114:2432-506. [DOI: 10.1021/cr4002879] [Citation(s) in RCA: 3202] [Impact Index Per Article: 291.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Jiang Wang
- Key
Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, China
| | - María Sánchez-Roselló
- Department
of Organic Chemistry, Faculty of Pharmacy, University of Valencia, Av. Vicente Andrés Estellés, 46100 Burjassot, Valencia, Spain
- Laboratorio
de Moléculas Orgánicas, Centro de Investigación Príncipe Felipe, C/ Eduardo Primo Yúfera 3, 46012 Valencia, Spain
| | - José Luis Aceña
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel Lardizábal 3, 20018 San Sebastian, Spain
| | - Carlos del Pozo
- Department
of Organic Chemistry, Faculty of Pharmacy, University of Valencia, Av. Vicente Andrés Estellés, 46100 Burjassot, Valencia, Spain
| | - Alexander E. Sorochinsky
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel Lardizábal 3, 20018 San Sebastian, Spain
- IKERBASQUE, Basque Foundation for Science, Alameda Urquijo, 36-5 Plaza Bizkaia, 48011 Bilbao, Spain
- Institute
of Bioorganic Chemistry and Petrochemistry, National Academy of Sciences of Ukraine, Murmanska Street 1, 02660 Kyiv-94, Ukraine
| | - Santos Fustero
- Department
of Organic Chemistry, Faculty of Pharmacy, University of Valencia, Av. Vicente Andrés Estellés, 46100 Burjassot, Valencia, Spain
- Laboratorio
de Moléculas Orgánicas, Centro de Investigación Príncipe Felipe, C/ Eduardo Primo Yúfera 3, 46012 Valencia, Spain
| | - Vadim A. Soloshonok
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, Paseo Manuel Lardizábal 3, 20018 San Sebastian, Spain
- IKERBASQUE, Basque Foundation for Science, Alameda Urquijo, 36-5 Plaza Bizkaia, 48011 Bilbao, Spain
| | - Hong Liu
- Key
Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zu Chong Zhi Road, Shanghai 201203, China
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Purtscher-like retinopathy in association with metastatic pancreatic adenocarcinoma and capecitabine therapy. Retin Cases Brief Rep 2013; 7:196-7. [PMID: 25391104 DOI: 10.1097/icb.0b013e318280b034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report a case of Purtscher-like retinopathy in association with capecitabine chemotherapy for metastatic pancreatic adenocarcinoma. METHODS Case report. RESULTS Bilateral retinal hemorrhages and cotton-wool spots in a predominantly juxtapapillary distribution were observed coincident with decreased vision. There was gradual improvement of the retinopathy and patient's vision over several months until the time of death. CONCLUSION Metastatic pancreatic cancer and capecitabine, a fluoropyrimidine chemotherapeutic agent, are a rare cause of Purtscher-like retinopathy.
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Chu-Yuan H, Jing P, Yi-Sheng W, He-Ping P, Hui Y, Chu-Xiong Z, Guo-Jian L, Guo-Qiang W. The impact of chemotherapy-associated neutrophil/ lymphocyte counts on prognosis of adjuvant chemotherapy in colorectal cancer. BMC Cancer 2013; 13:177. [PMID: 23551939 PMCID: PMC3621660 DOI: 10.1186/1471-2407-13-177] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 02/06/2013] [Indexed: 01/17/2023] Open
Abstract
Background Leukocytes play an important role in cancer development. However, the impact of chemotherapy-associated neutropenia/lymphopenia on the prognosis of adjuvant chemotherapy is unknown. Here, we aimed to explore the impact of chemotherapy-associated neutrophil/lymphocyte counts on prognosis of adjuvant chemotherapy in colorectal cancer (CRC) and the risk factors for developing neutropenia/lymphopenia which showed impact on the prognosis of CRC receiving adjuvant chemotherapy. Methods From February 2003 to January 2011, 243 stage II and III CRC patients receiving adjuvant chemotherapy were enrolled in this retrospective study. The associations between neutrophil/ lymphocyte counts and disease free survival (DFS)/overall survival (OS) of CRC, and the risk factors for neutropenia/lymphopenia were investigated. Results No association of chemotherapy-associated neutrophil counts and CRC recurrence (AUC = 0.474, P = 0.534), death (AUC = 0.449, P = 0.249) was found by ROC analysis. However, the chemotherapy-associated lymphocyte counts could significantly affect CRC recurrence (AUC = 0.634, P = 0.001), or death(AUC = 0.607, P = 0.015), with a optimized cut-off of 0.66 × 109/L for recurrence, and 0.91 × 109/L for death, respectively. Kaplan–Meier method showed chemotherapy-associated lymphopenia <0.66 × 109/L was associated with shorter DFS (P < 0.0001), and chemotherapy-associated lymphopenia <0.91 × 109/L was associated with shorter OS (P = 0.003). Cox regression model showed chemotherapy-associated lymphopenia <0.66 × 109/L was the independent prognostic factor for DFS (HR, 3.521; 95%CI = 1.703-7.282), and chemotherapy-associated lymphopenia <0.91 × 109/L was the independent prognostic factor for OS (HR, 2.083; 95% CI = 1.103-3.936). Multivariate logistic regression showed the risk of developing chemotherapy-associated lymphopenia <0.66 × 109/L was found in those with pretreatment CEA ≥10 ng ml-1 (OR, 3.338; 95% CI = 1.523-7.315), and the risk of developing chemotherapy-associated lymphopenia <0.91 × 109/L was found in those with age >60 years (OR, 2.872; 95% CI = 1.344-6.136). Conclusions Chemotherapy-associated lymphopenia <0.66 × 109/L /0.91 × 109/L has a significant impact on the prognosis of CRC receiving adjuvant chemotherapy. Pretreatment CEA ≥10 ng ml-1 is the independent risk factor for developing lymphopenia <0.66 × 109/L, and age >60 years is the independent risk factor for developing lymphopenia <0.91 × 109/L during adjuvant chemotherapy of CRC.
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Affiliation(s)
- Hong Chu-Yuan
- Department of Gastrointestinal Surgery, Lab of Surgery, the Second Affiliated Hospital of Guangzhou Medical University, 250 Chang-gang-dong Road, Guangzhou 510260Guangdong Province, China
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Chachad S, Purandare S, Malhotra G, Naidu R. Comparison of pharmacokinetics and safety profiles of two capecitabine tablet formulations in patients with colon, colorectal or breast cancer. Cancer Chemother Pharmacol 2012; 71:287-92. [DOI: 10.1007/s00280-012-2007-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 10/10/2012] [Indexed: 01/06/2023]
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Shen B, Jamison TF. Rapid Continuous Synthesis of 5′-Deoxyribonucleosides in Flow via Brønsted Acid Catalyzed Glycosylation. Org Lett 2012; 14:3348-51. [DOI: 10.1021/ol301324g] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bo Shen
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Timothy F. Jamison
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
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Lashkov AA, Zhukhlistova NE, Seregina TA, Gabdulkhakov AG, Mikhailov AM. Uridine phosphorylase in biomedical, structural, and functional aspects: A review. CRYSTALLOGR REP+ 2011. [DOI: 10.1134/s1063774511040122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Sentürk T, Kanat O, Evrensel T, Aydinlar A. Capecitabine-induced cardiotoxicity mimicking myocardial infarction. Neth Heart J 2011; 17:277-80. [PMID: 19789694 DOI: 10.1007/bf03086265] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Capecitabine, a fluoropyrimidine derivative, is an orally administered drug that delivers 5-fluorouracil (5-FU) selectively to the tumour. The drug has demonstrated activity in metastatic colorectal cancer. We describe a male patient receiving capecitabine therapy with typical chest pain and electrocardiographic changes consistent with STsegment elevation myocardial infarction. Capecitabine-induced cardiotoxicity may develop in patients who have had a previous episode of 5-FU-induced cardiotoxicity. Capecitabine-induced cardiotoxicity is a rare condition that may lead to diagnostic and therapeutic dilemmas. (Neth Heart J 2009;17:277-80.).
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Affiliation(s)
- T Sentürk
- Department of Cardiology, Uludag University School of Medicine, Görükle, Bursa, Turkey
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Lee SJ, Choi YL, Park YH, Kim ST, Cho EY, Ahn JS, Im YH. Thymidylate synthase and thymidine phosphorylase as predictive markers of capecitabine monotherapy in patients with anthracycline- and taxane-pretreated metastatic breast cancer. Cancer Chemother Pharmacol 2010; 68:743-51. [PMID: 21170649 DOI: 10.1007/s00280-010-1545-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Accepted: 12/01/2010] [Indexed: 01/12/2023]
Abstract
PURPOSE The primary purpose of this study was to evaluate the role of thymidylate synthase (TS) and thymidine phosphorylase (TP) as biomarkers to predict clinical outcomes of capecitabine monotherapy in patients with anthracycline- and taxane-pretreated metastatic breast cancer (MBC). METHODS Of the patients who were previously treated with anthracycline and taxane regimens, 90 patients who had available tissue block for immunohistochemistry with measurable lesions were included. All patients received capecitabine (2,500 mg/m(2)/day) for 14 days every 3 weeks. RESULTS High TS expression was more common among patients with triple-negative (TN) subtype than among patients with other subtypes (33% for hormone receptor+, 8% for HER2+, and 58% for TN, P = 0.023). The median PFS was significantly lower in patients with high TS (6.6 vs. 3.0 months; P = 0.017) and low TP expressions (6.0 vs. 3.3 months; P = 0.013). A high TS and a low TP expressions were identified as unfavorable independent risk factors for PFS to capecitabine monotherapy in multivariate analysis (hazard ratio [HR], 1.7, P = 0.037 for high TS score; HR, 1.8, P = 0.014 for low TP score). CONCLUSIONS Our data suggest that high TS and low TP scores correlate with a shorter PFS for capecitabine monotherapy in patients with anthracycline- and taxane-pretreated MBC.
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Affiliation(s)
- Su Jin Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Švobaitė R, Solassol I, Pinguet F, Mazard T, Ivanauskas L, Ychou M, Bressolle FMM. A LIQUID CHROMATOGRAPHY-MASS SPECTROMETRY METHOD FOR THE SIMULTANEOUS DETERMINATION OF CAPECITABINE, 5′-DEOXY-5-FLUOROCYTIDINE, 5′-DEOXY-5-FLUOROURIDINE, 5-FLUOROURACIL, AND 5-FLUORODIHYDROURACIL IN HUMAN PLASMA. J LIQ CHROMATOGR R T 2010. [DOI: 10.1080/10826076.2010.503842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- R. Švobaitė
- a Pharmacokinetic Laboratory , Faculty of Pharmacy, University Montpellier I , Montpellier, France
- b Department of Analytical and Toxicological Chemistry , Kaunas University of Medicine , Kaunas, Lithuania
- c Oncopharmacology Department , Pharmacy Service, Val d'Aurelle Anticancer Centre , Montpellier, France
| | - I. Solassol
- c Oncopharmacology Department , Pharmacy Service, Val d'Aurelle Anticancer Centre , Montpellier, France
| | - F. Pinguet
- c Oncopharmacology Department , Pharmacy Service, Val d'Aurelle Anticancer Centre , Montpellier, France
| | - T. Mazard
- d Department of Medical Oncology , Val d'Aurelle Anticancer Centre , Montpellier, France
| | - L. Ivanauskas
- b Department of Analytical and Toxicological Chemistry , Kaunas University of Medicine , Kaunas, Lithuania
| | - M. Ychou
- d Department of Medical Oncology , Val d'Aurelle Anticancer Centre , Montpellier, France
| | - F. M. M. Bressolle
- a Pharmacokinetic Laboratory , Faculty of Pharmacy, University Montpellier I , Montpellier, France
- c Oncopharmacology Department , Pharmacy Service, Val d'Aurelle Anticancer Centre , Montpellier, France
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Polansky H, Dafni I. Gene-Eden, a broad range, natural antiviral supplement, may shrink tumors and strengthen the immune system. Acta Oncol 2010; 49:397-9. [PMID: 20059310 DOI: 10.3109/02841860903440296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Amarantidis K, Xenidis N, Chelis L, Chiotis A, Tentes A, Chatzaki E, Kortsaris A, Polychronidis A, Karakitsos P, Kakolyris S. A dose escalation study of docetaxel plus capecitabine in combination with oxaliplatin in patients with advanced solid tumors. Acta Oncol 2009; 49:245-51. [PMID: 19839918 DOI: 10.3109/02841860903253553] [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: 11/13/2022]
Abstract
OBJECTIVES Capecitabine (CAP), Oxaliplatin (OX) and Docetaxel (DOC) have shown considerable activity in a wide range of solid tumors. A phase I study was conducted in order to determine the maximum-tolerated dose (MTD) and dose-limiting toxicities (DLTs) of their combination in patients with advanced solid tumors. PATIENTS AND METHODS Twenty-one patients were enrolled. The patient's median age was 68 years, 15 were male, and 12 were chemo-naïve. DOC was administered on day 1 as an 1-hour (iv) infusion at a standard dose of 50 mg/m(2). OX was administered on day 1 as a 2-hour (iv) infusion at escalating doses ranging from 70-80 mg/m(2). CAP was administered orally on days 1 to 7 at escalating doses ranging from 2,000-2,750 mg/m(2) given as two daily divided doses. Treatment was repeated every two weeks. RESULTS Six different dose-levels were examined. At dose-level VI, two of three enrolled patients presented DLTs (one patient diarrhea and asthenia grade 3 and another grade 3 diarrhea), and thus, the recommended MTD for future phase II studies is CAP 2,750 mg/m(2) , DOC 50 mg/m(2) and OX 75 mg/m(2). A total of 121 treatment cycles were administered. Grade 3 neutropenia was observed in six (5%) treatment cycles and grade 3 thrombocytopenia in one (1%). There was no febrile episode. Grade 3 asthenia was observed in three (14%) patients, grade 3 diarrhea in four (19%), grade 3 neuropathy in one (5%), and grade 1/2 hand-foot syndrome in three (14%). Other toxicities were uncommon. There was no treatment related death. Four (29%) PRs and seven (50%) SD were observed among 14 evaluable patients. Responses were seen in patients with renal (n = 1), gastric (n = 2) and pancreatic (n = 1) cancer. CONCLUSIONS These results demonstrate that CAP, DOC and OX can be safely combined at clinically relevant doses and this regimen merits further evaluation.
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Affiliation(s)
- Kyriakos Amarantidis
- Department of Medical Oncology, University General Hospital of Alexandroupolis, Dragana 68100, Alexandroupolis, Greece
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Abstract
Breast cancer is the most common noncutaneous malignancy among every major ethnic group of women in the United States. Anthracyclines and taxanes are the most active and widely used chemotherapeutic agents for breast cancer, but the increased use of these agents at an early stage of disease often renders tumors resistant to these drugs by the time the disease recurs, thereby reducing the number of treatment options for metastatic disease. Moreover, even when these agents can be used in the metastatic setting, treatment failure occurs in most cases, and as a result the 5-year survival rates of patients with metastatic breast cancer are low. This outcome underscores the need for new, effective treatments of metastatic breast cancer and has led to investigation of novel ways to overcome the problem of drug resistance. This article reviews the current treatment options for breast cancer resistant to anthracycline and taxane and provides recommendations for disease management. Published sources for this review were found by searching PubMed (https://www.ncbi.nlm.nih.gov/pubmed) and congress Web sites.
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Affiliation(s)
- Alvaro Moreno-Aspitia
- Division of Hematology/Oncology/Cancer Center/Breast Clinic, Mayo Clinic, Jacksonville, FL 32224, USA
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Abstract
Breast cancer is the most common noncutaneous malignancy among every major ethnic group of women in the United States. Anthracyclines and taxanes are the most active and widely used chemotherapeutic agents for breast cancer, but the increased use of these agents at an early stage of disease often renders tumors resistant to these drugs by the time the disease recurs, thereby reducing the number of treatment options for metastatic disease. Moreover, even when these agents can be used in the metastatic setting, treatment failure occurs in most cases, and as a result the 5-year survival rates of patients with metastatic breast cancer are low. This outcome underscores the need for new, effective treatments of metastatic breast cancer and has led to investigation of novel ways to overcome the problem of drug resistance. This article reviews the current treatment options for breast cancer resistant to anthracycline and taxane and provides recommendations for disease management. Published sources for this review were found by searching PubMed (https://www.ncbi.nlm.nih.gov/pubmed) and congress Web sites.
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Affiliation(s)
- Alvaro Moreno-Aspitia
- Division of Hematology/Oncology/Cancer Center/Breast Clinic, Mayo Clinic, Jacksonville, FL 32224, USA
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Abstract
BACKGROUND Breast cancer is the most common cancer among women and comprises 26% of all cancers diagnosed in women in the United States. Among presenting patients, 3 - 6% already have metastatic disease, and 50 - 70% of the remaining patients develop systemic relapse. Recently many new drugs, particularly molecular targeted therapies, have been developed in the field. OBJECTIVE To review the current and emerging data on the treatment of metastatic breast cancer, with emphasis on novel therapies that show promise. METHODS PubMed and ASCO annual meeting abstracts were used for a literature search. RESULTS/CONCLUSIONS Despite improved response rates, conventional treatments still result only in transient remission in most cases. New therapeutic alternatives and new strategies to overcome drug resistance are needed to improve these results.
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Affiliation(s)
- Omer Dizdar
- Hacettepe University Institute of Oncology, Department of Medical Oncology, Ankara, Turkey
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Rohlicek J, Husak M, Gavenda A, Jegorov A, Kratochvil B, Fitch A. Capecitabine from X-ray powder synchrotron data. Acta Crystallogr Sect E Struct Rep Online 2009; 65:o1325-6. [PMID: 21583180 PMCID: PMC2969674 DOI: 10.1107/s1600536809017905] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Accepted: 05/12/2009] [Indexed: 11/24/2022]
Abstract
In the title compound [systematic name 5-deoxy-5-fluoro-N-(pentyloxycarbonyl)cytidine], C15H22FN3O6, the pentyl chain is disordered over two positions with refined occupancies of 0.53 (5) and 0.47 (5). The furan ring assumes an envelope conformation. In the crystal, intermolecular N—H⋯O hydrogen bonds link the molecules into chains propagating along the b axis. The crystal packing exhibits electrostatic interactions between the 5-fluoropyrimidin-2(1H)-one fragments of neighbouring molecules as indicated by short O⋯C [2.875 (3) and 2.961 (3) Å] and F⋯C [2.886 (3) Å] contacts.
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Lam MGEH, Bosma TB, van Rijk PP, Zonnenberg BA. (188)Re-HEDP combined with capecitabine in hormone-refractory prostate cancer patients with bone metastases: a phase I safety and toxicity study. Eur J Nucl Med Mol Imaging 2009; 36:1425-33. [PMID: 19319526 PMCID: PMC2724641 DOI: 10.1007/s00259-009-1119-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 03/02/2009] [Indexed: 11/12/2022]
Abstract
Purpose 188Re-HEDP is indicated for the treatment of pain in patients with painful osteoblastic bone metastases, including hormone-refractory prostate cancer patients. Efficacy may be improved by adding chemotherapy to the treatment regimen as a radiation sensitizer. The combination of 188Re-HEDP and capecitabine (Xeloda®) was tested in a clinical phase I study. Methods Patients with hormone-refractory prostate cancer were treated with capecitabine for 14 days (oral twice daily in a dose escalation regimen with steps of 1/3 of 2,500 mg/m2 per day in cohorts of three to six patients, depending on toxicity). Two days later patients were treated with 37 MBq/kg 188Re-HEDP as an intravenous injection. Six hours after treatment post-therapy scintigraphy was performed. Urine was collected for 8 h post-injection. Follow-up was at least 8 weeks. The primary end-point was to establish the maximum tolerable dose (MTD) of capecitabine when combined with 188Re-HEDP. Secondary end-points included the effect of capecitabine on the biodistribution and pharmacokinetics of 188Re-HEDP. Results Three patients were treated in the first and second cohorts, each without unacceptable toxicity. One of six patients in the highest cohort experienced unacceptable toxicity (grade 4 thrombopaenia). The MTD proved to be the maximum dose of 2,500 mg/m2 per day capecitabine. No unexpected toxicity occurred. Capecitabine had no effect on uptake or excretion of 188Re-HEDP. Conclusion Capecitabine may be safely used in combination with 188Re-HEDP in a dose of 2,500 mg/m2 per day and 37 MBq/kg, respectively. Efficacy will be further studied in a phase II study using these dosages.
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Affiliation(s)
- Marnix G E H Lam
- Department of Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
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Guichard SM, Macpherson JS, Mayer I, Reid E, Muir M, Dodds M, Alexander S, Jodrell DI. Gene expression predicts differential capecitabine metabolism, impacting on both pharmacokinetics and antitumour activity. Eur J Cancer 2008; 44:310-7. [DOI: 10.1016/j.ejca.2007.10.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Revised: 10/12/2007] [Accepted: 10/29/2007] [Indexed: 12/27/2022]
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Yamamoto D, Iwase S, Kitamura K, Odagiri H, Yamamoto C, Nagumo Y. A phase II study of trastuzumab and capecitabine for patients with HER2-overexpressing metastatic breast cancer: Japan Breast Cancer Research Network (JBCRN) 00 Trial. Cancer Chemother Pharmacol 2007; 61:509-14. [PMID: 17516068 DOI: 10.1007/s00280-007-0497-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Accepted: 04/08/2007] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the response rate and toxicity profile of trastuzumab and capecitabine in women with HER2-overexpressing advanced breast cancer. PATIENTS AND METHODS A total of 59 patients from 6 participating centers in Japan entered onto the study of trastuzumab and capecitabine. Eighty six percent of women had received prior chemotherapy as part of adjuvant (21.4%) or metastatic treatment (48.2%), or both (16.1%), including substantial portions of patients who had previously received either CMF (7.1%), anthracyclines (28.6%), taxanes (25.0%), or both types (25.0%) of chemotherapy. RESULTS Responses were observed in 28 of 56 patients (overall response rate, 50%). The response rate was 65.0% in patients treated with trastuzumab and capecitabine as first-line therapy for metastatic disease, and 62.5% among HER2 +3 positive patients, while high response rates were also seen in women treated with second- or third-line therapy. Patients receiving trastuzumab and capecitabine as first-line therapy had a longer TTP than did patients receiving this treatment as second- or third-line therapy (median TTP, 280 vs. 130 days, P < 0.05). Further, patients receiving trastuzumab and capecitabine as first-line therapy had longer OS than did patients receiving this treatment as second- or third-line therapy (median OS, 780 days vs. 480 weeks, P < 0.05). The treatment-related adverse events were hand-foot syndrome (30.4%), nausea (25%), diarrhea (10.7%), stomatitis (10.7%), fatigue (7.1%), and vomiting (5.4%). However, the majority were Grade 1-2 adverse events and only six patients experienced Grade 3 adverse events. Further Grade 1 cardiac toxicity was observed in one patient, while there were no cases of alopecia and treatment-related death. CONCLUSION Trastuzumab in combination with capecitabine is highly active in women with HER2-overexpressing metastatic breast cancer and is well tolerated.
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Affiliation(s)
- Daigo Yamamoto
- Department of Surgery, Kansai Medical University Hirakata Hospital, Hirakata, Osaka 573-1191, Japan.
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Eichbaum MHR, Gast AS, Schneeweiss A, Bruckner T, Sohn C. Activity and tolerability of a combined palliative chemotherapy with mitomycin C, folinate, and 5-Fluorouracil in patients with advanced breast cancer after intensive pretreatment: a retrospective analysis. Am J Clin Oncol 2007; 30:139-45. [PMID: 17414462 DOI: 10.1097/01.coc.0000251935.51345.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to evaluate the activity and toxicity of a combined chemotherapy containing mitomycin, folinate, and 5-fluorouracil (MiFoFU) in patients with advanced metastatic breast cancer and reduced performance status, ie, elderly patients or heavily pretreated patients. METHODS We studied the charts of 76 patients with progressive metastatic breast cancer who received MiFoFU chemotherapy at our institution between 1997 and 2003. Primary end points were response and time-to-progression (TTP); secondary end points were overall survival (OAS) and tolerability. RESULTS Median age was 57 years. Seventeen patients had > or =2 palliative cytostatic treatments before; 19 patients were older 65 years. Patients received a median of 6 cycles. Clinical benefit rate was 58%. After MiFoFU, median TTP and OAS were 8 months and 14 months, respectively. Main nonhematologic toxicity was stomatitis (grade I/II, 21%) and diarrhea (grade I/II, 37%). Grade III/IV hematotoxicity was seen in 18 patients (24%). CONCLUSIONS A combined MiFoFU chemotherapy is a well-tolerated treatment option in the palliative therapy for patients with metastatic breast cancer. In particular, the favorable efficacy/toxicity ratio in intensively pretreated or elderly patients makes this combination a reasonable alternative within these settings.
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Affiliation(s)
- Michael H R Eichbaum
- Department of Gynecology and Obstetrics, University of Heidelberg Medical School, Heidelberg, Germany.
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Braun M, Schlehe B, Faridi A, Heindrichs U, Rudlowski C. Treatment with Combinations of the Anti-HER2 Antibody Trastuzumab and Capecitabine in Advanced Metastatic Breast Cancer Patients – a Pilot Study. Breast Care (Basel) 2007. [DOI: 10.1159/000105492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Wijesinghe N, Thompson PI, McAlister H. Acute Coronary Syndrome Induced by Capecitabine Therapy. Heart Lung Circ 2006; 15:337-9. [PMID: 16697705 DOI: 10.1016/j.hlc.2006.03.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 03/24/2006] [Accepted: 03/28/2006] [Indexed: 11/25/2022]
Abstract
Capecitabine, a new member of the fluoropyrimidine family, is an orally administered drug that delivers fluorouracil (5-FU) selectively to the tumour. Although the cardiotoxicity of 5-FU is well documented, there is little published data about cardiovascular adverse effects of Capecitabine. This case highlights the possible development of acute coronary syndrome as a side effect of Capecitabine therapy.
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Affiliation(s)
- Namal Wijesinghe
- Waikato Hospital, Cardiology Department, Private Bag 3200, Hamilton 2001, New Zealand.
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Macpherson JS, Jodrell DI, Guichard SM. Validation of real-time reverse-transcription-polymerase chain reaction for quantification of capecitabine-metabolizing enzymes. Anal Biochem 2006; 350:71-80. [PMID: 16438929 DOI: 10.1016/j.ab.2005.11.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Revised: 11/22/2005] [Accepted: 11/28/2005] [Indexed: 12/27/2022]
Abstract
Capecitabine is an oral fluoropyrimidine carbamate activated sequentially in both liver and tumor tissues by carboxylesterases, cytidine deaminase, and thymidine phosphorylase. 5-Fluorouracil is inactivated by dihydropyrimidine dehydrogenase and targets thymidylate synthase. Here we report the validation of the real-time polymerase chain reaction assay for the quantification of the transcripts of the different enzymes involved in capecitabine activation. The method is specific, sensitive, and linear over 2-3 logs of RNA input. It is reproducible with less than 5% intraday variability and less than 10% interday variability. Five reference genes were tested for normalization. POLR2A was selected since it reduced variability between samples, demonstrated levels of expression similar to those of the genes of interest, and its expression was not modified by capecitabine treatment in samples from preclinical studies. The method was robust as the gene expression profiles from six colon cancer cell lines obtained by this method were similar to microarray data. Finally, the method was able to detect changes in gene expression in xenograft tumors treated with capecitabine. It could therefore constitute the method of choice for future correlative studies in patients receiving capecitabine.
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Affiliation(s)
- Janet S Macpherson
- Pharmacology and Drug Development Team, Cancer Research UK Centre, University of Edinburgh
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Pagani O, Sessa C, Nolè F, Munzone E, Crivellari D, Lombardi D, Thürlimann B, Hess D, Graffeo R, Ruggeri M, Longhi S, Goldhirsch A. Dose-finding study of weekly docetaxel, anthracyclines plus fluoropyrimidines as first-line treatment in advanced breast cancer. Ann Oncol 2005; 16:1609-17. [PMID: 15994176 DOI: 10.1093/annonc/mdi308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The efficacy and safety of prolonged fluoropyrimidines, either intravenously or orally, prompted their integration with taxanes and anthracyclines in the treatment of advanced breast cancer (ABC). We conducted three subsequent dose-finding studies on first-line chemotherapy in ABC with anthracyclines, either epirubicin (E) or doxorubicin (A), and docetaxel (T), both given on days 1 and 8 every 3 weeks, plus continuous infusion (CI) 5-fluorouracil (F) or capecitabine (X). PATIENTS AND METHODS Sixty-two patients (37% dominant visceral disease, 48% locally advanced disease, 45% two or more sites involved), received different doses of T (60--80 mg/m(2)), A (40--50 mg/m(2)) or E (60--90 mg/m(2)) and X (1,650 and 2,000 mg/m(2)), or CI F at a fixed daily dose of 200 mg/m(2). Cardiac function was monitored at baseline and then every four cycles by echocardiography. RESULTS The median number of cycles per patient with all regimens was four (range one to eight). Haematological and gastrointestinal toxicity defined the maximum tolerated doses, at T-80/E-90 mg/m(2) with TEF, T-70/A50/X-2,000 mg/m(2) with TAX and T-70/E-80/X-1,650 mg/m(2) with TEX. Two patients treated with TEF developed transient cardiac toxicity (dilatative cardiomyopathy and coronary subtotal stenosis requiring stenting) after cumulative E doses of 400 mg and 1,100 mg/m(2), respectively. Fifty-nine patients were evaluable for response; the overall response rates (ORR) were comparable between regimens (54% with TEF, 71% with TAX and 86% with TEX), with an 81% ORR in 31 patients with locally advanced disease. CONCLUSIONS The addition of fluoropyrimidines to weekly, intermittent ET is well tolerated and active in ABC.
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Affiliation(s)
- O Pagani
- Institute of Oncology of Southern Switzerland (IOSI), Ospedale S. Giovanni, Bellinzona, Switzerland.
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Pavlak M, Stojković R, Radacić-Aumiler M, Kasnar-Samprec J, Jercić J, Vlahović K, Zinić B, Radacić M. Antitumor activity of novel N-sulfonylpyrimidine derivatives on the growth of anaplastic mammary carcinoma in vivo. J Cancer Res Clin Oncol 2005; 131:829-36. [PMID: 16158306 DOI: 10.1007/s00432-005-0026-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2004] [Accepted: 07/04/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study was to investigate in vivo antitumor activity of newly synthesized N-sulfonylpyrimidine derivatives 1-(p-toluenesulfonyl)cytosine (4H), 1-(p-toluenesulfonyl)cytosine hydrochloride (4HxHCl) and zinc(II) complex of 1-(p-toluenesulfonyl)cytosine (4K). MATERIALS AND METHODS In order to do that we have used mouse anaplastic mammary carcinoma (AMCa). Tumor cells (10(6)) in a volume of 0.02 ml were transplanted into the thigh of the right hind leg of CBA mice. All compounds were dissolved in distilled water immediately before injecting to animals. RESULTS Antitumor effect of these compounds depends on drug doses and time interval between tumor transplantation and drug application. Further the efficacy of these compounds depends on number of drug injections, i. e. whether drug was given in single or in multiple doses. Multiple doses of 400 mg/kg of 1-(p-toluenesulfonyl)cytosine (4H) showed good antitumor effect when applied on day 1, 3, 5, 7 and 9 after tumor transplantation. Still good but slightly lower antitumor effect was also achieved when that compound was given in a single dose (1,200 mg/kg) on day 1 after tumor transplantation. The longest period of tumor growth time was obtained after application of 1-(p-toluenesulfonyl)cytosine hydrochloride (4HxHCl) given as a single dose (300 mg/kg) on day 1 or on day 6 after tumor implantation. However, antitumor effect of zinc(II) complex of 1-(p-toluenesulfonyl)cytosine (4K) was very strong when 300 mg/kg was given on day 1 or day 6, while this effect was slightly lower when drug (200 mg/kg/inj) was given on day 1, 3, 5, 7 and 9 or on day 6, 8, 10, 12 and 14. CONCLUSION In this work it has been found that N-1-sulfonylcytosine derivatives have strong antitumor activity against mouse mammary carcinoma which is a good reason for further research of these compounds both in experimental and preclinical studies.
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Affiliation(s)
- Marina Pavlak
- Department of Biology, Faculty of Veterinary Medicine, Zagreb University, Heinzelova 55, 10000, Zagreb, Croatia.
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