Comparison of the efficacy of strontium-89 chloride in treating bone metastasis of lung, breast, and prostate cancers

Anticancer potential of Marina Crystal Minerals (MCM) against the growth of murine mammary adenocarcinoma cells in vivo

In vitro studies have shown that Marina Crystal Minerals (MCM), a crystallized mixture of minerals and trace elements from sea water, possesses apoptotic and immune modulatory effects in human breast cancer cells MDA-MB-231. The current study aimed to evaluate MCM's anticancer effect in vivo against murine mammary adenocarcinoma cells and to explore its underlying mechanisms. Mice were inoculated intramuscularly with Ehrlich ascites carcinoma (EAC) cells, a breast adenocarcinoma. Tumors became palpable within 9 days. Tumor-bearing mice were injected with MCM intraperitoneally (IP) or intratumorally (IT) at a dose of 40 mg/kg BW for 6 days/week until day 28 post-inoculation. Tumor growth, cell cycle progression, cell cycle regulatory proteins, apoptosis, apoptotic regulatory markers, mitochondrial membrane potential (MMP), natural killer (NK) cell activity, and histopathological effects were investigated. Treatment with MCM reduced tumor volume by 49.4% for IP and 59.5% for IT injection. MCM induced cancer cell apoptosis, as indicated by a sub-G1 peak and confirmed by Annexin V/PI assay and histopathological examination. This was mediated by increased Bax expression, caspase-3 activation, decreased Bcl-2 expression, and MMP disruption. Furthermore, MCM treatment induced G1 cell cycle arrest, mediated through significantly increased expression of p53, p21, and p27 and decreased expression of cyclin D1 and PCNA in cancer cells. Finally, MCM treatment markedly enhanced NK cell cytotoxicity. MCM possesses chemopreventive potential to reduce tumor growth by suppressing cell proliferation, inducing apoptosis in EAC cells via a mitochondrial dependent pathway, and activating the immune system. Our results suggest MCM's beneficial potential for treating breast adenocarcinoma.

The Correlation Between Potential "Anti- Cancer" Trace Elements and the Risk of Breast Cancer: A Case-Control Study in a Chinese Population

Backgrounds

Breast cancer is a heterogeneous disease without clear pathogenesis and effective primary prevention. The “anti-cancer” effects of several trace elements have received increasing attention in recent years. The main purpose of current study is to explore the differences of three potential “anti-cancer” trace elements selenium (Se), molybdenum (Mo), and strontium (Sr) between patients with malignant breast tumors and healthy controls.

Methods

We conducted a case–control study in 45 patients with malignant breast tumors as cases and 95 healthy volunteers as controls from Peking University Third Hospital, Beijing, China. The serum concentrations of trace elements were evaluated by using inductively coupled plasma mass spectrometry (ICP-MS).

Results

The cases may have a lower Se levels when compared with controls (cases: 106.22 ng/ml, SD: 20.95 ng/ml; controls: 117.02 ng/ml, IQR: 22.79 ng/ml, p = 0.014). High levels of Se were a protective factor from breast cancer after adjusting the potential confounders of age, BMI, smoking, drinking, and menopause status (OR = 0.395, 95% CI, 0.178, 0.877, p = 0.023). The levels of Sr were lower in cases with high histologic grade when compared to low histologic grade (low histologic grade: 49.83 ng/ml, IQR: 41.35–62.60 ng/ml; high histologic grade: 40.19 ng/ml, IQR: 39.24–47.16 ng/ml, p < 0.05).

Conclusions

Our findings herein supported that Se has protective effects to avoid malignant breast tumors and Sr has protective effects to avoid poorly differentiated malignant breast tumors. Exploring “anti-cancer” related trace elements and their associations with breast cancer will assist for the early prevention and intervention for the disease.

[177Lu]Lu-DOTA-ZOL bone pain palliation in patients with skeletal metastases from various cancers: efficacy and safety results

Background

[¹⁷⁷Lu]Lu-DOTA-ZOL has shown promising results from the dosimetry and preclinical aspects, but data on its role in the clinical efficacy are limited. The objective of this study is to evaluate the efficacy and safety of [¹⁷⁷Lu]Lu-DOTA-ZOL as a bone pain palliation agent in patients experiencing pain due to skeletal metastases from various cancers.

Methods

In total, 40 patients experiencing bone pain due to skeletal metastases were enrolled in this study. The patients were treated with a mean cumulative dose of 2.1 ± 0.6 GBq (1.3–2.7 GBq) [¹⁷⁷Lu]Lu-DOTA-ZOL in a median follow-up duration of 10 months (IQR 8–14 months). The primary outcome endpoint was response assessment according to the visual analogue score (VAS). Secondary endpoints included analgesic score (AS), global pain assessment score, Eastern Cooperative Oncology Group Assessment performance status (ECOG), Karnofsky performance status, overall survival, and safety assessment by the National Cancer Institute’s Common Toxicity Criteria V5.0.

Results

In total, 40 patients (15 males and 25 females) with a mean age of 46.6 ± 15.08 years (range 24–78 years) were treated with either 1 (N = 15) or 2 (N = 25) cycles of [¹⁷⁷Lu]Lu-DOTA-ZOL. According to the VAS response assessment criteria, complete, partial, and minimal responses were observed in 11 (27.5%), 20 (50%), and 5 patients (12.5%), respectively with an overall response rate of 90%. Global pain assessment criteria revealed complete, partial, minimal, and no response in 2 (5%), 25 (62.5%), 9 (22.5%), and 4 (10%) patients, respectively. Twenty-eight patients died and the estimated median overall survival was 13 months (95% CI 10–14 months). A significant improvement was observed in the VAS, AS, and ECOG status when compared to baseline. None of the patients experienced grade III/IV haematological, kidney, or hepatotoxicity due to [¹⁷⁷Lu]Lu-DOTA-ZOL therapy.

Conclusion

[¹⁷⁷Lu]Lu-DOTA-ZOL shows promising results and is an effective radiopharmaceutical in the treatment of bone pain due to skeletal metastases from various cancers.

Leveraging the power of non-radium radionuclide treatments in bone metastases

This review overviews the current status and clinical results of unsealed radionuclide therapies in skeletal metastasis. The other modes of treatment such as external bean radiotherapy and the newer receptor targeted radiopharmaceuticals tagged to alpha and beta particle emitting radionuclides have also been touched upon. With the advent of the latter in recent years, the intravenously administered radiopharmaceuticals that can be employed in the setting of skeletal metastases can be broadly categorized into (i) bone-seeking and (ii) receptor targeted specific tumor-seeking radiopharmaceuticals. The second category conceptualizes the "radionuclide based theranostics" and "precision oncology" and has the additional advantage of targeting both skeletal and non-skeletal disease and being the preferred therapy befitting the contemporary paradigm of clinical oncology.