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Zhang Y, Kong L, Tan L. Effectiveness of nanoscale delivery systems on improving the bioavailability of lutein in rodent models: a systematic review. Crit Rev Food Sci Nutr 2022; 62:2375-2390. [PMID: 33249868 DOI: 10.1080/10408398.2020.1853035] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Lutein, a potent antioxidant and the main macular pigment that protects the macula from light-initiated oxidative damage, has low bioavailability. Various nanoscale delivery systems have been developed for improving its bioavailability. This systematic review aims to evaluate the effectiveness of nanoscale delivery systems on improving lutein bioavailability in rodent models. Using EBSCOhost and PubMed, a total of eleven peer-reviewed articles published from 2000 to 2020 were identified. Plasma lutein concentration, pharmacokinetic parameters, including maximum concentration (Cmax), area under curve (AUC), and time to reach the maximum concentration (Tmax), and lutein accumulation in organs were extracted to evaluate the bioavailability of lutein using nanoscale delivery methods as compared with unencapsulated or raw lutein. Various nanoscale delivery systems, including polymer nanoparticles, emulsions, and lutein nanoparticles, significantly improved the bioavailability of lutein, as evidenced by increased plasma lutein concentrations, Cmax, or AUC. Additionally, five out of seven studies observed enhanced accumulation of lutein in the liver and the eyes. Polymer nanoparticles and emulsions improve the dispersibility and stability of lutein, thus lutein might be more accessible in the small intestine. Lutein nanoparticles shortened the Tmax. Further studies are warranted to evaluate the effectiveness of nanoscale delivery systems on improving the functionalities of lutein.
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Affiliation(s)
- Yanqi Zhang
- Department of Human Nutrition, University of Alabama, Tuscaloosa, Alabama, USA
| | - Lingyan Kong
- Department of Human Nutrition, University of Alabama, Tuscaloosa, Alabama, USA
| | - Libo Tan
- Department of Human Nutrition, University of Alabama, Tuscaloosa, Alabama, USA
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2
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Cancer Clinical Trials: What Every Radiologist Wants to Know but Is Afraid to Ask. AJR Am J Roentgenol 2021; 216:1099-1111. [PMID: 33594911 DOI: 10.2214/ajr.20.22852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this article is to provide radiologists with a guide to the fundamental principles of oncology clinical trials. The review summarizes the evolution and structure of modern clinical trials with an emphasis on the relevance of clinical trials in the field of oncologic imaging. CONCLUSION. Understanding the structure and clinical relevance of modern clinical trials is beneficial for radiologists in the field of oncologic imaging.
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3
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Burt T, Young G, Lee W, Kusuhara H, Langer O, Rowland M, Sugiyama Y. Phase 0/microdosing approaches: time for mainstream application in drug development? Nat Rev Drug Discov 2020; 19:801-818. [PMID: 32901140 DOI: 10.1038/s41573-020-0080-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 12/13/2022]
Abstract
Phase 0 approaches - which include microdosing - evaluate subtherapeutic exposures of new drugs in first-in-human studies known as exploratory clinical trials. Recent progress extends phase 0 benefits beyond assessment of pharmacokinetics to include understanding of mechanism of action and pharmacodynamics. Phase 0 approaches have the potential to improve preclinical candidate selection and enable safer, cheaper, quicker and more informed developmental decisions. Here, we discuss phase 0 methods and applications, highlight their advantages over traditional strategies and address concerns related to extrapolation and developmental timelines. Although challenges remain, we propose that phase 0 approaches be at least considered for application in most drug development scenarios.
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Affiliation(s)
- Tal Burt
- Burt Consultancy LLC. talburtmd.com, New York, NY, USA. .,Phase-0/Microdosing Network. Phase-0Microdosing.org, New York, NY, USA.
| | - Graeme Young
- GlaxoSmithKline Research and Development Ltd, Ware, UK
| | - Wooin Lee
- Seoul National University, Seoul, Republic of Korea
| | | | - Oliver Langer
- Medical University of Vienna, Vienna, Austria.,AIT Austrian Institute of Technology GmbH, Vienna, Austria
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4
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Wang F, Zhang H, Ma AH, Yu W, Zimmermann M, Yang J, Hwang SH, Zhu D, Lin TY, Malfatti M, Turteltaub KW, Henderson PT, Airhart S, Hammock BD, Yuan J, de Vere White RW, Pan CX. COX-2/sEH Dual Inhibitor PTUPB Potentiates the Antitumor Efficacy of Cisplatin. Mol Cancer Ther 2017; 17:474-483. [PMID: 29284644 DOI: 10.1158/1535-7163.mct-16-0818] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 05/25/2017] [Accepted: 12/06/2017] [Indexed: 12/14/2022]
Abstract
Cisplatin-based therapy is highly toxic, but moderately effective in most cancers. Concurrent inhibition of cyclooxygenase-2 (COX-2) and soluble epoxide hydrolase (sEH) results in antitumor activity and has organ-protective effects. The goal of this study was to determine the antitumor activity of PTUPB, an orally bioavailable COX-2/sEH dual inhibitor, in combination with cisplatin and gemcitabine (GC) therapy. NSG mice bearing bladder cancer patient-derived xenografts were treated with vehicle, PTUPB, cisplatin, GC, or combinations thereof. Mouse experiments were performed with two different PDX models. PTUPB potentiated cisplatin and GC therapy, resulting in significantly reduced tumor growth and prolonged survival. PTUPB plus cisplatin was no more toxic than cisplatin single-agent treatment as assessed by body weight, histochemical staining of major organs, blood counts, and chemistry. The combination of PTUPB and cisplatin increased apoptosis and decreased phosphorylation in the MAPK/ERK and PI3K/AKT/mTOR pathways compared with controls. PTUPB treatment did not alter platinum-DNA adduct levels, which is the most critical step in platinum-induced cell death. The in vitro study using the combination index method showed modest synergy between PTUPB and platinum agents only in 5637 cell line among several cell lines examined. However, PTUPB is very active in vivo by inhibiting angiogenesis. In conclusion, PTUPB potentiated the antitumor activity of cisplatin-based treatment without increasing toxicity in vivo and has potential for further development as a combination chemotherapy partner. Mol Cancer Ther; 17(2); 474-83. ©2017 AACR.
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Affiliation(s)
- Fuli Wang
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California.,Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an City, Shanxi Province, China
| | - Hongyong Zhang
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California
| | - Ai-Hong Ma
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California Davis, Sacramento, California
| | - Weimin Yu
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California.,Department of Urology, Renmin Hospital, Wuhan University, Wuhan, Hubei Province, China
| | - Maike Zimmermann
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California
| | - Jun Yang
- Department of Entomology and Nematology, University of California, Davis, California
| | - Sung Hee Hwang
- Department of Entomology and Nematology, University of California, Davis, California
| | - Daniel Zhu
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California
| | - Tzu-Yin Lin
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California
| | | | | | - Paul T Henderson
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California
| | | | - Bruce D Hammock
- Department of Entomology and Nematology, University of California, Davis, California
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, Xi'an City, Shanxi Province, China
| | - Ralph W de Vere White
- Department of Urology, School of Medicine and Comprehensive Cancer Center, University of California Davis, Sacramento, California.
| | - Chong-Xian Pan
- Department of Internal Medicine, School of Medicine, University of California Davis, Sacramento, California. .,Department of Urology, School of Medicine and Comprehensive Cancer Center, University of California Davis, Sacramento, California.,VA Northern California Health Care System, Rancho Cordova, California
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5
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Malfatti MA, Enright HA, Be NA, Kuhn EA, Hok S, McNerney MW, Lao V, Nguyen TH, Lightstone FC, Carpenter TS, Bennion BJ, Valdez CA. The biodistribution and pharmacokinetics of the oxime acetylcholinesterase reactivator RS194B in guinea pigs. Chem Biol Interact 2017; 277:159-167. [PMID: 28941624 DOI: 10.1016/j.cbi.2017.09.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/13/2017] [Accepted: 09/19/2017] [Indexed: 01/09/2023]
Abstract
Organophosphorus-based (OP) nerve agents represent some of the most toxic substances known to mankind. The current standard of care for exposure has changed very little in the past decades, and relies on a combination of atropine to block receptor activity and oxime-type acetylcholinesterase (AChE) reactivators to reverse the OP binding to AChE. Although these oximes can block the effects of nerve agents, their overall efficacy is reduced by their limited capacity to cross the blood-brain barrier (BBB). RS194B, a new oxime developed by Radic et al. (J. Biol. Chem., 2012) has shown promise for enhanced ability to cross the BBB. To fully assess the potential of this compound as an effective treatment for nerve agent poisoning, a comprehensive evaluation of its pharmacokinetic (PK) and biodistribution profiles was performed using both intravenous and intramuscular exposure routes. The ultra-sensitive technique of accelerator mass spectrometry was used to quantify the compound's PK profile, tissue distribution, and brain/plasma ratio at four dose concentrations in guinea pigs. PK analysis revealed a rapid distribution of the oxime with a plasma t1/2 of ∼1 h. Kidney and liver had the highest concentrations per gram of tissue followed by lung, spleen, heart and brain for all dose concentrations tested. The Cmax in the brain ranged between 0.03 and 0.18% of the administered dose, and the brain-to-plasma ratio ranged from 0.04 at the 10 mg/kg dose to 0.18 at the 200 mg/kg dose demonstrating dose dependent differences in brain and plasma concentrations. In vitro studies show that both passive diffusion and active transport contribute little to RS194B traversal of the BBB. These results indicate that biodistribution is widespread, but very low quantities accumulate in the guinea pig brain, indicating this compound may not be suitable as a centrally active reactivator.
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Affiliation(s)
- Michael A Malfatti
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA.
| | - Heather A Enright
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Nicholas A Be
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Edward A Kuhn
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Saphon Hok
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Forensic Science Center, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - M Windy McNerney
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; War Related Illness and Injury Study Center, Veterans Affairs, Palo Alto, CA 94304, USA
| | - Victoria Lao
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Tuan H Nguyen
- Global Security Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Felice C Lightstone
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Timothy S Carpenter
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Brian J Bennion
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
| | - Carlos A Valdez
- Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA; Forensic Science Center, Lawrence Livermore National Laboratory, Livermore, CA 94550, USA
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6
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Enright HA, Malfatti MA, Zimmermann M, Ognibene T, Henderson P, Turteltaub KW. Use of Accelerator Mass Spectrometry in Human Health and Molecular Toxicology. Chem Res Toxicol 2016; 29:1976-1986. [PMID: 27726383 PMCID: PMC5203773 DOI: 10.1021/acs.chemrestox.6b00234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Accelerator mass spectrometry (AMS) has been adopted as a powerful bioanalytical method for human studies in the areas of pharmacology and toxicology. The exquisite sensitivity (10-18 mol) of AMS has facilitated studies of toxins and drugs at environmentally and physiologically relevant concentrations in humans. Such studies include risk assessment of environmental toxicants, drug candidate selection, absolute bioavailability determination, and more recently, assessment of drug-target binding as a biomarker of response to chemotherapy. Combining AMS with complementary capabilities such as high performance liquid chromatography (HPLC) can maximize data within a single experiment and provide additional insight when assessing drugs and toxins, such as metabolic profiling. Recent advances in the AMS technology at Lawrence Livermore National Laboratory have allowed for direct coupling of AMS with complementary capabilities such as HPLC via a liquid sample moving wire interface, offering greater sensitivity compared to that of graphite-based analysis, therefore enabling the use of lower 14C and chemical doses, which are imperative for clinical testing. The aim of this review is to highlight the recent efforts in human studies using AMS, including technological advancements and discussion of the continued promise of AMS for innovative clinical based research.
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Affiliation(s)
- Heather A. Enright
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA USA
| | - Michael A. Malfatti
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA USA
| | - Maike Zimmermann
- Department of Internal Medicine, Division of Hematology and Oncology, UC Davis Medical Center, Sacramento, CA USA
- Accelerated Medical Diagnostics Incorporated, Berkeley, CA USA
| | - Ted Ognibene
- Center for Accelerator Mass Spectrometry, Lawrence Livermore National Laboratory, Livermore, CA USA
| | - Paul Henderson
- Department of Internal Medicine, Division of Hematology and Oncology, UC Davis Medical Center, Sacramento, CA USA
- Accelerated Medical Diagnostics Incorporated, Berkeley, CA USA
| | - Kenneth W. Turteltaub
- Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA USA
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7
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Jiang S, Pan AW, Lin TY, Zhang H, Malfatti M, Turteltaub K, Henderson PT, Pan CX. Paclitaxel Enhances Carboplatin-DNA Adduct Formation and Cytotoxicity. Chem Res Toxicol 2015; 28:2250-2. [PMID: 26544157 DOI: 10.1021/acs.chemrestox.5b00422] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This rapid report focuses on the pharmacodynamic mechanism of the carboplatin/paclitaxel combination and correlates it with its cytotoxicity. Consistent with the synergistic to additive antitumor activity (the combination index ranging from 0.53 to 0.94), cells exposed to this combination had significantly increased carboplatin-DNA adduct formation when compared to that of carboplatin alone (450 ± 30 versus 320 ± 120 adducts per 10(8) nucleotides at 2 h, p = 0.004). Removal of paclitaxel increased the repair of carboplatin-DNA adducts: 39.4 versus 33.1 adducts per 10(8) nucleotides per hour in carboplatin alone (p = 0.021). This rapid report provides the first pharmacodynamics data to support the use of carboplatin/paclitaxel combination in the clinic.
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Affiliation(s)
- Shuai Jiang
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States
| | - Amy W Pan
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States
| | - Tzu-yin Lin
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States
| | - Hongyong Zhang
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States
| | - Michael Malfatti
- Lawrence Livermore National Laboratory , P.O. Box 808, Livermore, California 94551-0808, United States
| | - Kenneth Turteltaub
- Lawrence Livermore National Laboratory , P.O. Box 808, Livermore, California 94551-0808, United States
| | - Paul T Henderson
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States
| | - Chong-xian Pan
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States.,Department of Urology, University of California Davis , 4501 X Street, Room 3016, Sacramento, California 95817, United States.,Hematology and Oncology, VA Northern California Health Care System , 10535 Hospital Way, Mather, California 95655, United States
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8
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Vlaming MLH, van Duijn E, Dillingh MR, Brands R, Windhorst AD, Hendrikse NH, Bosgra S, Burggraaf J, de Koning MC, Fidder A, Mocking JAJ, Sandman H, de Ligt RAF, Fabriek BO, Pasman WJ, Seinen W, Alves T, Carrondo M, Peixoto C, Peeters PAM, Vaes WHJ. Microdosing of a Carbon-14 Labeled Protein in Healthy Volunteers Accurately Predicts Its Pharmacokinetics at Therapeutic Dosages. Clin Pharmacol Ther 2015; 98:196-204. [PMID: 25869840 DOI: 10.1002/cpt.131] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/30/2015] [Accepted: 04/06/2015] [Indexed: 11/12/2022]
Abstract
Preclinical development of new biological entities (NBEs), such as human protein therapeutics, requires considerable expenditure of time and costs. Poor prediction of pharmacokinetics in humans further reduces net efficiency. In this study, we show for the first time that pharmacokinetic data of NBEs in humans can be successfully obtained early in the drug development process by the use of microdosing in a small group of healthy subjects combined with ultrasensitive accelerator mass spectrometry (AMS). After only minimal preclinical testing, we performed a first-in-human phase 0/phase 1 trial with a human recombinant therapeutic protein (RESCuing Alkaline Phosphatase, human recombinant placental alkaline phosphatase [hRESCAP]) to assess its safety and kinetics. Pharmacokinetic analysis showed dose linearity from microdose (53 μg) [(14) C]-hRESCAP to therapeutic doses (up to 5.3 mg) of the protein in healthy volunteers. This study demonstrates the value of a microdosing approach in a very small cohort for accelerating the clinical development of NBEs.
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Affiliation(s)
| | | | - M R Dillingh
- Centre for Human Drug Research, Leiden, The Netherlands, UK
| | - R Brands
- AMRIF BV, Wageningen, The Netherlands, UK
| | - A D Windhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands, UK
| | - N H Hendrikse
- Department of Pharmacy and Clinical Pharmacology, VU University Medical Center, Amsterdam, The Netherlands, UK
| | | | - J Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands, UK
| | | | | | | | | | | | | | | | - W Seinen
- AMRIF BV, Wageningen, The Netherlands, UK.,Utrecht University, Utrecht, The Netherlands, UK
| | - T Alves
- GenIBET/IBET, Oeiras, Portugal
| | | | | | - P A M Peeters
- Centre for Human Drug Research, Leiden, The Netherlands, UK
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9
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Caoili SEC. Beyond new chemical entities: advancing drug development based on functional versatility of antibodies. Hum Vaccin Immunother 2014; 10:1639-44. [PMID: 24632567 PMCID: PMC4185958 DOI: 10.4161/hv.28192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Antibody-type agents (i.e., antibodies and derivatives thereof) may be produced as clinically valuable antidotes, which conceivably could be developed in tandem with prospective new pharmaceutical products so as to render the risks of clinical trials more acceptable from a regulatory standpoint. Yet, this is but a relatively narrow view of the full potential utility associated with antibody-type agents, the significance of which is appreciated upon reconsidering key aspects of early modern biomedical research (notably major contributions thereto by Nobel Laureate Paul Ehrlich) in light of much more recent advances (e.g., application of immunity-oriented approaches to diseases in general, epitope-specific targeting, abzyme-mediated catalysis, antibody-mediated sustained-release buffering of unbound-ligand concentrations, and enhanced thermal and metabolic stability of deuterated chemical species via the kinetic isotope effect), as conditioned by health-related concerns (e.g., current and anticipated epidemiologic transitions vis-a-vis environmental changes) especially with regard to sustainable development (e.g., emphasizing more efficient resource utilization toward increased global resilience based on greater independence from high-maintenance technological infrastructure). The broader view that thus emerges highlights the urgent need to rebalance the health-research agenda, which presently reflect an overemphasis on small-molecule candidate-drug discovery, in order to advance health based on a comprehensive fundamental synthesis of immunity and pharmacology.
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Affiliation(s)
- Salvador Eugenio C Caoili
- Department of Biochemistry and Molecular Biology; College of Medicine; University of the Philippines Manila; Manila, Philippines
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10
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Wurz GT, DeGregorio MW. Activating adaptive cellular mechanisms of resistance following sublethal cytotoxic chemotherapy: implications for diagnostic microdosing. Int J Cancer 2014; 136:1485-93. [PMID: 24510760 DOI: 10.1002/ijc.28773] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/30/2014] [Indexed: 11/07/2022]
Abstract
As Phase 0 studies have proven to be reasonably predictive of therapeutic dose pharmacokinetics, the application of microdosing has expanded into metabolism, drug-drug interactions and now diagnostics. One potentially serious issue with this application of microdosing that has not been previously discussed is the possibility of activating cellular mechanisms of drug resistance. Here, we provide an overview of Phase 0 microdosing and drug resistance, with an emphasis on cisplatin resistance, followed by a discussion of the potential for inducing acquired resistance to platinum-based or other types of chemotherapy in cancer patients participating in Phase 0 diagnostic microdosing studies. A number of alternative approaches to diagnostic microdosing, such as the human tumor cloning assay and the use of peripheral blood mononuclear cells as a surrogate for measuring DNA adducts, are discussed that would avoid exposing cancer patients to low doses of first-line chemotherapy and the possible risk of triggering cellular mechanisms of acquired resistance. Until it has been established that diagnostic microdosing in cancer patients poses no risk of acquired drug resistance, such studies should be approached with caution.
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Affiliation(s)
- Gregory T Wurz
- Division of Hematology and Oncology Department of Internal Medicine, University of California, Davis, Sacramento, CA
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11
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Cimino GD, Pan CX, Henderson PT. Personalized medicine for targeted and platinum-based chemotherapy of lung and bladder cancer. Bioanalysis 2013; 5:369-91. [PMID: 23394702 PMCID: PMC3644565 DOI: 10.4155/bio.12.325] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The personalized medicine revolution is occurring for cancer chemotherapy. Biomarkers are increasingly capable of distinguishing genotypic or phenotypic traits of individual tumors, and are being linked to the selection of treatment protocols. This review covers the molecular basis for biomarkers of response to targeted and cytotoxic lung and bladder cancer treatment with an emphasis on platinum-based chemotherapy. Platinum derivatives are a class of drugs commonly employed against solid tumors that kill cells by covalent attachment to DNA. Platinum-DNA adduct levels in patient tissues have been correlated to response and survival. The sensitivity and precision of adduct detection has increased to the point of enabling subtherapeutic dosing for diagnostics applications, termed diagnostic microdosing, prior to the initiation of full-dose therapy. The clinical status of this unique phenotypic marker for lung and bladder cancer applications is detailed along with discussion of future applications.
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Affiliation(s)
- George D Cimino
- Accelerated Medical Diagnostics, Inc., 2121 Second Street, B101, Davis, CA 95618, USA
| | - Chong-xian Pan
- University of California Davis, Department of Internal Medicine, Division of Hematology & Oncology & the UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 94568, USA
- Hematology/Oncology, VA Northern California Health Care System, 10535 Hospital Way, Mather, CA 95655, USA
| | - Paul T Henderson
- Accelerated Medical Diagnostics, Inc., 2121 Second Street, B101, Davis, CA 95618, USA
- University of California Davis, Department of Internal Medicine, Division of Hematology & Oncology & the UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 94568, USA
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12
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Dall'Era MA, Cheng L, Pan CX. Contemporary management of muscle-invasive bladder cancer. Expert Rev Anticancer Ther 2013; 12:941-50. [PMID: 22845409 DOI: 10.1586/era.12.60] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current standard treatment for muscle-invasive nonmetastatic bladder cancer is neoadjuvant platinum-based chemotherapy followed by radical cystectomy. However, neoadjuvant chemotherapy is not widely accepted even with level 1 evidence. Adjuvant chemotherapy should be discussed if patients have not received neoadjuvant chemotherapy before surgery and have high-risk pathologic features. Although not considered standard of care, bladder-sparing therapy can be considered for highly selected patients and for those medically unfit for surgery. Even though there are no level 1 data, the treatment outcomes for highly select patients given bladder-sparing therapy appear promising, with many patients retaining a functional bladder. Personalized chemotherapy is currently being actively pursued to target the underlying molecular changes and tailor to individual needs.
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Affiliation(s)
- Marc A Dall'Era
- Department of Urology, University of California Davis, 4860 Y Street, Suite 3500, Sacramento, CA 95817, USA.
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13
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Lei AQ, Cheng L, Pan CX. Current treatment of metastatic bladder cancer and future directions. Expert Rev Anticancer Ther 2012; 11:1851-62. [PMID: 22117153 DOI: 10.1586/era.11.181] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Metastatic urothelial carcinoma portends a very poor long-term prognosis, with 5-year survival at approximately 5%. The overall survival of metastatic bladder cancer has not improved over the last 20 years. The first-line therapy is cisplatin-based chemotherapy with the response rate approximately 50%. Approximately 30-50% of the patients are unsuitable for cisplatin, and there is no standard of care for this patient population. There is no standard second-line treatment. Several signaling pathways are activated in bladder urothelial carcinoma, but no targeted therapy, either alone or in combination with conventional cytotoxic chemotherapy, has been shown to significantly improve the treatment outcomes. The future of metastatic urothelial carcinoma treatment lies in the ability to deliver personalized therapy. This area remains an active research field today.
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Affiliation(s)
- Amy Q Lei
- Division of Hematology and Oncology, Department of Internal Medicine and Department of Urology, University of California Davis Cancer Center, Sacramento, CA 95817, USA
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14
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Progress in personalizing chemotherapy for bladder cancer. Adv Urol 2012; 2012:364919. [PMID: 22400017 PMCID: PMC3287014 DOI: 10.1155/2012/364919] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/16/2011] [Accepted: 11/25/2011] [Indexed: 02/06/2023] Open
Abstract
Platinum-based chemotherapy is commonly used for the treatment of locally advanced and metastatic bladder cancer. However, there are currently no methods to predict chemotherapy response in this disease setting. A better understanding of the biology of bladder cancer has led to developments of molecular biomarkers that may help guide clinical decision making. These biomarkers, while promising, have not yet been validated in prospective trials and are not ready for clinical applications. As alkylating agents, platinum drugs kill cancer cells mainly through induction of DNA damage. A microdosing approach is currently being tested to determine if chemoresistance can be identified by measuring platinum-induced DNA damage using highly sensitive accelerator mass spectrometry technology. The hope is that these emerging strategies will help pave the road towards personalized therapy in advanced bladder cancer.
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Dueker SR, Vuong LT, Lohstroh PN, Giacomo JA, Vogel JS. Quantifying exploratory low dose compounds in humans with AMS. Adv Drug Deliv Rev 2011; 63:518-31. [PMID: 21047543 PMCID: PMC3062634 DOI: 10.1016/j.addr.2010.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 10/08/2010] [Accepted: 10/18/2010] [Indexed: 11/20/2022]
Abstract
Accelerator Mass Spectrometry is an established technology whose essentiality extends beyond simply a better detector for radiolabeled molecules. Attomole sensitivity reduces radioisotope exposures in clinical subjects to the point that no population need be excluded from clinical study. Insights in human physiochemistry are enabled by the quantitative recovery of simplified AMS processes that provide biological concentrations of all labeled metabolites and total compound related material at non-saturating levels. In this paper, we review some of the exploratory applications of AMS (14)C in toxicological, nutritional, and pharmacological research. This body of research addresses the human physiochemistry of important compounds in their own right, but also serves as examples of the analytical methods and clinical practices that are available for studying low dose physiochemistry of candidate therapeutic compounds, helping to broaden the knowledge base of AMS application in pharmaceutical research.
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Wang S, Zhang H, Malfatti M, de Vere White R, Lara PN, Turteltaub K, Henderson P, Pan CX. Gemcitabine causes minimal modulation of carboplatin-DNA monoadduct formation and repair in bladder cancer cells. Chem Res Toxicol 2010; 23:1653-5. [PMID: 21028869 DOI: 10.1021/tx1003547] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We are developing a method to identify cellular resistance to carboplatin by using accelerator mass spectrometry to measure carboplatin-DNA adducts formed from drug microdoses (∼1/100th the therapeutic dose). Such an approach would be particularly useful if it is still valid in combination chemotherapy. We examined whether the addition of gemcitabine, another chemotherapeutic drug, could influence carboplatin-DNA adduct levels. There were no substantial differences in the levels of carboplatin-DNA adducts in cells upon exposure to the carboplatin/gemcitabine combination at various doses and schedules. These data demonstrate that microdosing is feasible for the characterization of carboplatin resistance when given in combination with gemcitabine.
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Affiliation(s)
- Sisi Wang
- Division of Hematology & Oncology, Department of Internal Medicine, UC Davis Cancer Center, Sacramento, California 95817, USA
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