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Murad AM, Brognaro H, Falke S, Lindner J, Perbandt M, Mudogo C, Schubert R, Wrenger C, Betzel C. Structure and activity of the DHNA Coenzyme-A Thioesterase from Staphylococcus aureus providing insights for innovative drug development. Sci Rep 2022; 12:4313. [PMID: 35279696 PMCID: PMC8918352 DOI: 10.1038/s41598-022-08281-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/01/2022] [Indexed: 12/04/2022] Open
Abstract
Humanity is facing an increasing health threat caused by a variety of multidrug resistant bacteria. Within this scenario, Staphylococcus aureus, in particular methicillin resistant S. aureus (MRSA), is responsible for a number of hospital-acquired bacterial infections. The emergence of microbial antibiotic resistance urgently requires the identification of new and innovative strategies to treat antibiotic resistant microorganisms. In this context, structure and function analysis of potential drug targets in metabolic pathways vital for bacteria endurance, such as the vitamin K2 synthesis pathway, becomes interesting. We have solved and refined the crystal structure of the S. aureus DHNA thioesterase (SaDHNA), a key enzyme in the vitamin K2 pathway. The crystallographic structure in combination with small angle X-ray solution scattering data revealed a functional tetramer of SaDHNA. Complementary activity assays of SaDHNA indicated a preference for hydrolysing long acyl chains. Site-directed mutagenesis of SaDHNA confirmed the functional importance of Asp16 and Glu31 for thioesterase activity and substrate binding at the putative active site, respectively. Docking studies were performed and rational designed peptides were synthesized and tested for SaDHNA inhibition activity. The high-resolution structure of SaDHNA and complementary information about substrate binding will support future drug discovery and design investigations to inhibit the vitamin K2 synthesis pathway.
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de Medeiros AF, de Souza BBP, Coutinho LP, Murad AM, dos Santos PIM, Monteiro NDKV, dos Santos EA, Maciel BLL, de Araújo Morais AH. Structural insights and molecular dynamics into the inhibitory mechanism of a Kunitz-type trypsin inhibitor from Tamarindus indica L. J Enzyme Inhib Med Chem 2021; 36:480-490. [PMID: 33491503 PMCID: PMC7875565 DOI: 10.1080/14756366.2021.1876686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/23/2020] [Accepted: 01/11/2021] [Indexed: 11/08/2022] Open
Abstract
Trypsin inhibitors from tamarind seed have been studied in vitro and in preclinical studies for the treatment of obesity, its complications and associated comorbidities. It is still necessary to fully understand the structure and behaviour of these molecules. We purifed this inhibitor, sequenced de novo by MALDI-TOF/TOF, performed its homology modelling, and assessed the interaction with the trypsin enzyme through molecular dynamics (MD) simulation under physiological conditions. We identified additional 75 amino acid residues, reaching approximately 72% of total coverage. The four best conformations of the best homology modelling were submitted to the MD. The conformation n°287 was selected considering the RMSD analysis and interaction energy (-301.0128 kcal.mol-1). Residues Ile (54), Pro (57), Arg (59), Arg (63), and Glu (78) of pTTI presented the highest interactions with trypsin, and arginine residues were mainly involved in its binding mechanism. The results favour bioprospecting of this protein for pharmaceutical health applications.
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Affiliation(s)
| | - Beatriz Blenda Pinheiro de Souza
- Postgraduate Biological Molecular, Institute of Biological Sciences, University of Brasília, Brasília, Brazil
- Laboratory of Mass Spectometry-LEM, Embrapa Genetic Resources and Biotechnology, Brasília, Brazil
| | | | - Aline Melro Murad
- Laboratory of Mass Spectometry-LEM, Embrapa Genetic Resources and Biotechnology, Brasília, Brazil
| | | | | | - Elizeu Antunes dos Santos
- Postgraduate Biochemistry Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande, Natal, Brazil
- Tropical Medicine Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Bruna Leal Lima Maciel
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana Heloneida de Araújo Morais
- Postgraduate Biochemistry Program, Biosciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
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Murad AM, Wrenger C, Betzel C. Structure-function analysis of proteins involved in the metabolic pathway of vitamin K acting as major pathogenic factors in Staphylococcus aureusinfection. Acta Crystallogr A Found Adv 2015. [DOI: 10.1107/s2053273315096023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Murad AM, Molinari HBC, Magalhães BS, Franco AC, Takahashi FSC, de Oliveira- NG, Franco OL, Quirino BF. Physiological and proteomic analyses of Saccharum spp. grown under salt stress. PLoS One 2014; 9:e98463. [PMID: 24893295 PMCID: PMC4043529 DOI: 10.1371/journal.pone.0098463] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 05/04/2014] [Indexed: 11/18/2022] Open
Abstract
Sugarcane (Saccharum spp.) is the world most productive sugar producing crop, making an understanding of its stress physiology key to increasing both sugar and ethanol production. To understand the behavior and salt tolerance mechanisms of sugarcane, two cultivars commonly used in Brazilian agriculture, RB867515 and RB855536, were submitted to salt stress for 48 days. Physiological parameters including net photosynthesis, water potential, dry root and shoot mass and malondialdehyde (MDA) content of leaves were determined. Control plants of the two cultivars showed similar values for most traits apart from higher root dry mass in RB867515. Both cultivars behaved similarly during salt stress, except for MDA levels for which there was a delay in the response for cultivar RB867515. Analysis of leaf macro- and micronutrients concentrations was performed and the concentration of Mn(2+) increased on day 48 for both cultivars. In parallel, to observe the effects of salt stress on protein levels in leaves of the RB867515 cultivar, two-dimensional gel electrophoresis followed by MS analysis was performed. Four proteins were differentially expressed between control and salt-treated plants. Fructose 1,6-bisphosphate aldolase was down-regulated, a germin-like protein and glyceraldehyde 3-phosphate dehydrogenase showed increased expression levels under salt stress, and heat-shock protein 70 was expressed only in salt-treated plants. These proteins are involved in energy metabolism and defense-related responses and we suggest that they may be involved in protection mechanisms against salt stress in sugarcane.
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Affiliation(s)
- Aline Melro Murad
- Genome Sciences and Biotechnology Program, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
- Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
| | | | - Beatriz Simas Magalhães
- Genome Sciences and Biotechnology Program, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
| | - Augusto Cesar Franco
- Department of Botany, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | | | - Nelson Gomes de Oliveira-
- Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
| | - Octávio Luiz Franco
- Genome Sciences and Biotechnology Program, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
- Centro de Análises Proteômicas e Bioquímicas, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
- * E-mail: (OLF); (BFQ)
| | - Betania Ferraz Quirino
- Genome Sciences and Biotechnology Program, Universidade Católica de Brasília, Brasília, Distrito Federal, Brazil
- Embrapa-Agroenergy, Brasília, Distrito Federal, Brazil
- * E-mail: (OLF); (BFQ)
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Abstract
Plants present various advantages for the production of biomolecules, including low risk of contamination with prions, viruses and other pathogens, scalability, low production costs, and available agronomical systems. Plants are also versatile vehicles for the production of recombinant molecules because they allow protein expression in various organs, such as tubers and seeds, which naturally accumulate large amounts of protein. Among crop plants, soybean is an excellent protein producer. Soybean plants are also a good source of abundant and cheap biomass and can be cultivated under controlled greenhouse conditions. Under containment, the plant cycle can be manipulated and the final seed yield can be maximized for large-scale protein production within a small and controlled area. Exploitation of specific regulatory sequences capable of directing and accumulating recombinant proteins in protein storage vacuoles in soybean seeds, associated with recently developed biological research tools and purification systems, has great potential to accelerate preliminary characterization of plant-derived biopharmaceuticals and industrial macromolecules. This is an important step in the development of genetically engineered products that are inexpensive and safe for medicinal, food and other uses.
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Affiliation(s)
- G R Vianna
- Laboratório de Transferência e Expressão de Genes, Embrapa Recursos Genéticos e Biotecnologia, Parque Estação Biológica, Brasília, DF, Brasil
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Cunha NB, Araújo ACG, Leite A, Murad AM, Vianna GR, Rech EL. Correct targeting of proinsulin in protein storage vacuoles of transgenic soybean seeds. Genet Mol Res 2010; 9:1163-70. [PMID: 20589613 DOI: 10.4238/vol9-2gmr849] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Soybean plants are promising bioreactors for the expression of biochemically complex proteins that cannot be produced in a safe and/or economically viable way in microorganisms, eukaryotic culture cells or secreted by transgenic animal glands. Soybeans present many desirable agronomic characteristics for high scale protein production, such as high productivity, short reproductive cycle, photoperiod sensitivity, and natural organs destined for protein accumulation in the seeds. The significant similarities between plant and human cells in terms of protein synthesis processes, folding, assembly, and post-translational processing are important for efficient accumulation of recombinant proteins. We obtained two transgenic lines using biolystics, incorporating the human proinsulin gene under control of the monocot tissue-specific promoter from sorghum gamma-kafirin seed storage protein gene and the alpha-coixin cotyledonary vacuolar signal peptide from Coix lacryma-jobi (Poaceae). Transgenic plants expressed the proinsulin gene and accumulated the polypeptide in mature seeds. Protein targeting to cotyledonary protein storage vacuoles was successfully achieved and confirmed with immunocytochemistry assays. The combination of different regulatory sequences was apparently responsible for high stability in protein accumulation, since human proinsulin was detected after seven years under room temperature storage conditions.
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Affiliation(s)
- N B Cunha
- Embrapa Recursos Genéticos e Biotecnologia, Parque Estação Biológica, Brasília, DF, Brasil
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Sivakumar S, Franco OL, Thayumanavan B, Murad AM, Manickam A, Mohan M, Mridula M. Cloning and structural analysis of an Indian little millet (Panicum sumatrense) zein-like storage protein: implications for molecular assembly. Biochemistry (Mosc) 2007; 71:1183-91. [PMID: 17140379 DOI: 10.1134/s0006297906110034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Zeins are prolamin storage proteins that accumulate in kernel endosperm of several cereals. For cloning of genes coding for zein-like proteins that accumulate in enhanced quantities in the filling stages of little millet (Panicum sumatrense Roth.) developing grains, RT-PCR was performed using specific primers. A 750-bp cDNA was directly sequenced and in silico analysis showed high identity degree to alpha-prolamins. This family is composed of zeins from Zea mays, coixins from Coix lachryma-jobi, and alpha-kafirins from Sorghum bicolor. The putative conserved domain of zein-like proteins was identified by primary structure comparisons. Furthermore, threading analyses indicated that the millet zein-like protein forms an anti-parallel alpha-helical hairpin with two opposite surfaces: one hydrophobic and the other hydrophilic that probably could be involved in protein storage assembly. Knowledge about zein-like alpha-prolamins in little millet will lead to cloning and transfer of this gene to other major food crops, such as cereals and legumes, with inferior nutritional quality for monogastric animals.
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Affiliation(s)
- S Sivakumar
- Center for Plant Molecular Biology, Tamil Nadu Agricultural University, Coimbatore-641 003, India.
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Murad AM, d'Enfert C, Gaillardin C, Tournu H, Tekaia F, Talibi D, Marechal D, Marchais V, Cottin J, Brown AJ. Transcript profiling in Candida albicans reveals new cellular functions for the transcriptional repressors CaTup1, CaMig1 and CaNrg1. Mol Microbiol 2001; 42:981-93. [PMID: 11737641 DOI: 10.1046/j.1365-2958.2001.02713.x] [Citation(s) in RCA: 179] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The pathogenic fungus, Candida albicans contains homologues of the transcriptional repressors ScTup1, ScMig1 and ScNrg1 found in budding yeast. In Saccharomyces cerevisiae, ScMig1 targets the ScTup1/ScSsn6 complex to the promoters of glucose repressed genes to repress their transcription. ScNrg1 is thought to act in a similar manner at other promoters. We have examined the roles of their homologues in C. albicans by transcript profiling with an array containing 2002 genes, representing about one quarter of the predicted number of open reading frames (ORFs) in C. albicans. The data revealed that CaNrg1 and CaTup1 regulate a different set of C. albicans genes from CaMig1 and CaTup1. This is consistent with the idea that CaMig1 and CaNrg1 target the CaTup1 repressor to specific subsets of C. albicans genes. However, CaMig1 and CaNrg1 repress other C. albicans genes in a CaTup1-independent fashion. The targets of CaMig1 and CaNrg1 repression, and phenotypic analyses of nrg1/nrg1 and mig1/mig1 mutants, indicate that these factors play differential roles in the regulation of metabolism, cellular morphogenesis and stress responses. Hence, the data provide important information both about the modes of action of these transcriptional regulators and their cellular roles. The transcript profiling data are available at http://www.pasteur.fr/recherche/unites/RIF/transcriptdata/.
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Affiliation(s)
- A M Murad
- Molecular and Cell Biology, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
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Murad AM, Guimarães RC, Aragão BC, Scalabrini-Neto AO, Rodrigues VH, Garcia R. Phase II trial of the use of paclitaxel and gemcitabine as a salvage treatment in metastatic breast cancer. Am J Clin Oncol 2001; 24:264-8. [PMID: 11404498 DOI: 10.1097/00000421-200106000-00011] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate gemcitabine plus paclitaxel in heavily pretreated patients with metastatic breast cancer (MBC). Patients with MBC with second or third relapse to anthracycline-containing regimens received a 3-hour infusion of paclitaxel 175 mg/m2 on day 1, and gemcitabine 1.0 g/m2 on days 1, 8, and 15, every 28 days. Because of unacceptable thrombocytopenia seen in the first 5 patients, the gemcitabine schedule was changed to days 1 and 8 (G-1,8) for the remainder of the study, every 21 days. Twenty-nine patients (median age, 46 years; range, 32-68 years) received 137 cycles (median: 4 per patient). The regimen was well tolerated. World Health Organization grades III and IV thrombocytopenia were observed in 5 (18.5%) of the first 27 cycles (G-1,8,15), and in 6 (5.4%) of the 110 subsequent cycles (G-1,8)--p = 0.04 for the difference between schedules. Five patients had grade I and two had grade III neuropathy. Eight patients had grade III neutropenia, two had grade IV neutropenia associated with fever (G-1,8,15), and eight had grades I and II myalgia and fatigue. There were 16 (55%) objective responses (95% CI 36-73%); 5 (17%) complete responses, 11 (38%) partial responses (95% CI 3-30% and 19-56%, respectively), and 6 (20.5%) patients with stable disease. Median response duration was 8 months (range, 4-26 months). Median overall survival was 12 months (range, 4-28+ months), and 1-year and 2-year survival rates were 45% and 30%, respectively. This phase II study demonstrated a manageable toxicity profile with the gemcitabine day 1, 8 schedule in combination with paclitaxel and significant and promising activity in heavily pretreated patients with MBC. A confirmatory phase III trial is warranted.
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Affiliation(s)
- A M Murad
- Oncology Section, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Murad AM, Guimarães RC, Aragão BC, Scalabrini'Neto AO, Rodrigues VH, Garcia R. Gemcitabine and paclitaxel as salvage therapy in metastatic breast cancer. Oncology (Williston Park) 2001; 15:25-7. [PMID: 11252885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In a phase II trial, 29 patients with anthracycline-pretreated or anthracycline-resistant metastatic breast cancer in whom anthracycline-containing first- or second-line chemotherapy failed received combination paclitaxel (Taxol)/gemcitabine (Gemzar). The initial regimen of paclitaxel at 175 mg/m2 on day 1 and gemcitabine at 1,000 mg/m2 on days 1, 8, and 15 of a 28-day cycle was given to five patients for a total of 27 cycles. The regimen resulted in excessive thrombocytopenia and was subsequently changed to gemcitabine at the same dose on days 1 and 8 of a 21-day cycle, with study treatment being given for a maximum of eight cycles. This regimen was well tolerated. Further evaluation of this regimen in minimally and heavily pretreated patients with advanced breast cancer is warranted.
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Affiliation(s)
- A M Murad
- Hospital Das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Affiliation(s)
- A M Murad
- Department of Molecular and Cell Biology, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen AB25 2ZD, UK
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Murad AM, Petroianu A, Guimaraes RC, Aragao BC, Cabral LO, Scalabrini-Neto AO. Phase II trial of the combination of paclitaxel and 5-fluorouracil in the treatment of advanced gastric cancer: a novel, safe, and effective regimen. Am J Clin Oncol 1999; 22:580-6. [PMID: 10597742 DOI: 10.1097/00000421-199912000-00008] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This prospective phase II clinical trial was performed to explore the activity and efficacy of the combination of paclitaxel and 5-fluorouracil in the treatment of advanced gastric adenocarcinoma. Thirty-one patients ages 18 to 70 years, with Karnofsky performance status (KPS) >50, adequate cardiac, renal, and hepatic functions, measurable metastatic or locally unresectable disease, life expectancy > or =3 months, signed written informed consent, and without any previous chemotherapy were assigned to receive on an outpatient basis: paclitaxel--175 mg/m2, in a 3-hour infusion on day 1 and 5-fluorouracil--1.5 g/m2, also in a 3-hour infusion on day 2 every 21 days, for a maximum of seven cycles. A system to assess clinical benefit based on KPS, analgesic consumption, and weight gain was also used in this trial. Median age was 61 years (range, 31-70 years). The 29 patients eligible for response and toxicity evaluation underwent 147 cycles of chemotherapy. There were 19 (65.5%) objective responses (95% confidence interval: 48%-83%), including 7 (24.1%) complete responses and 12 (41.4%) partial responses. Three patients had the complete response pathologically confirmed. In three of six patients who went to second-look laparotomy, a potentially curative esophagogastrectomy was possible. The toxicity of this combination was considered low, predictable, and manageable and was characterized mainly by reversible alopecia, peripheral neuropathy, myalgia, and mild neutropenia. Fifteen (51.7%) patients attained a clinical benefit response. The median overall survival was 12 months (range, 2-30+ months) and the 30-month overall survival was 20%. This novel regimen appears to be very effective in advanced gastric cancer. The projected 2-year survival of 20% is higher than that achieved with other first-line regimens. These encouraging results indicate the need for further studies to confirm the merit of this regimen.
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Affiliation(s)
- A M Murad
- Division of Oncology, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG-Brazil
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Abstract
BACKGROUND: Although many treatments for advanced gastric cancer have been developed, systemic therapy remains elusive. METHODS: The author reviewed data on recent phase II and III trials of the main new agents and combinations. RESULTS: Chemotherapy appears to improve survival of patients with advanced disease, albeit slightly. New drugs that might improve response rates and survival include the taxanes. CONCLUSIONS: New combinations, including the taxanes, must be designed and evaluated to further improve the outcome for patients with advanced gastric cancer.
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Affiliation(s)
- AM Murad
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Murad AM, Guimaraes RC, Amorim WC, Morici AC, Ferreira-Filho AF, Schwartsmann G. Phase II trial of paclitaxel and ifosfamide as a salvage treatment in metastatic breast cancer. Breast Cancer Res Treat 1997; 45:47-53. [PMID: 9285116 DOI: 10.1023/a:1005882314735] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Treatment results in patients failing first-line chemotherapy in metastatic breast cancer (MBC) are still unsatisfactory, with patients exhibiting poor responses to salvage therapy and a short overall survival. Both paclitaxel and ifosfamide are able to produce objective tumor responses in this disease. Therefore, the antitumor effects and toxicity of their combined use could be worthwhile studying in patients progressing after doxorubicin-containing combinations. PATIENTS AND METHODS This Phase II trial of paclitaxel/ifosfamide included patients with bi-dimensionally measurable metastatic breast cancer in second or third relapse, following anthracycline-containing regimens; ECOG PS < 2, and adequate hepatic, cardiac, renal, and hematological functions. Paclitaxel 175 mg/m2 was given on day 1, in a 3-hour infusion with appropriate antiallergic pre-medication; while ifosfamide 1.8 g/m2 was given on days 2, 3, 4 with mesna 360 mg/m2 i.v., 15 minutes before and 4 hours after ifosfamide administration, and 720 mg/m2 P.O. 8 hours later at home, also on days 2, 3, 4. The cycles were repeated every 21 days, on an outpatient basis. RESULTS Twenty-four patients were accrued for the study and 23 were considered eligible for the evaluation of toxicity and response. Previous chemotherapy included: CMF/FAC (16 cases); CMF plus mitoxantrone/FAC/cisplatin, vinblastine, mitomycin C (2 cases): and FAC/mitomycin C, vinblastine, and etoposide (5 cases). There were 11 (48%) objective responses (95% C.I.:27-69%), including 2 (9%) CR and 9 (39%) PR (95% C.I.:0-21% and 19-61%, respectively). Five (22%) patients attained disease stabilization. Median response duration was 7+ months (range 4 to 20+), and the median overall survival was 12 months (range 4-23+). The regimen was well tolerated. WHO nausea/ vomiting grades 1-2, alopecia grade 3, and neutropenia grades 1-2 were seen in most patients. Four patients experienced mild neuropathy, while it was grade 3 in 1 case. Seven patients had grade 3 neutropenia. In addition, grade 4 neutropenia associated with fever was documented in other 4 cases. No hypersensitivity reactions were seen. One case of reversible tachycardia after drug administration was seen. Myalgia grades 1-2 was also reported in some patients. CONCLUSION These results suggest that the present regimen has significant activity in heavily pretreated patients with a MBC, with a manageable toxicity profile. Further trials exploiting the above mentioned drug combination are warranted.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Abstract
PURPOSE A bleomycin, carboplatin, and ifosfamide (BIC) chemotherapy protocol was designed to evaluate tumor response and palliation in patients with advanced cervical cancer. PATIENTS AND METHODS Forty patients with stage IV primary or recurrent squamous cell carcinoma of the cervix (19 previously irradiated and 21 nonirradiated) were assigned to treatment with six cycles of BIC: bleomycin, 30 mg bolus on day 1; carboplatin, 200 mg/m2 bolus on day 1; and ifosfamide, 2g/m2 for 3 consecutive days, infused over 2 hours. Mesna was administered as a bolus 15 minutes, and 4 and 8 hours after ifosfamide at 20% (intravenous [IV]), and 40% (orally, at home) of the ifosfamide dose, respectively. RESULTS Thirty-five patients (27 stage IVA and eight stage IVB) were considered eligible for response and toxicity evaluation. After a median of four cycles (maximum of six in responders), we observed objective responses in 21 patients (60%), with eight complete responses (CRs; 23%), including two histologically documented by laparotomy, and 13 (37%) partial responses (PRs) (95% confidence limits, 44% to 76%, 9% to 37%, and 21% to 53%, respectively). Median overall survival duration was 11 months (range, 3 to 24+). Median overall survival duration in the nonirradiated group was 17 months versus 4 months in the previously irradiated group (P = .005). The median progression-free survival duration of the responders was 12 months, and the median disease-free survival duration of the complete responders was 14 months. Toxicity was acceptable and included manageable alopecia, vomiting, and neutropenia. There was one toxic death due to febrile neutropenia and sepsis. CONCLUSION BIC can be administered on an outpatient basis and seems to be effective in inducing tumor response and palliation in patients with disseminated squamous cell carcinoma of cervix, with a possible survival benefit for previously nonirradiated patients, with an acceptable toxicity profile.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clinicas Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Murad AM, Santiago FF, Petroianu A, Rocha PR, Rodrigues MA, Rausch M. Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 1993. [PMID: 8508427 DOI: 10.1002/1097-0142(19930701)72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In an attempt to decrease the toxic effects of fluorouracil, doxorubicin, and methotrexate (FAMTX) by reducing the dose of methotrexate from 1500 mg/m2, according to the original regimen, to 1000 mg/m2, the authors designed the modified FAMTX treatment that was evaluated in a prospective Phase II-III randomized trial. METHODS Patients with advanced gastric cancer were randomized to receive modified FAMTX treatment or supportive measures only (control group). In the middle of the study, the randomization was interrupted because of strong evidence of benefit in terms of tumor reduction and projected survival in the treatment arm receiving chemotherapy. By the end of the study, 30 assessable patients had received chemotherapy and 10 had received supportive treatment. RESULTS The overall response rate was 50% (15 patients); 12 patients (40%) had partial responses and 3 (10%) had complete responses (CR). One patient with extensive peritoneal carcinomatosis attained a CR pathologically documented by laparoscopic examination and peritoneal biopsy. The median overall survival time of the treated group was 9 months, whereas that of the control group was only 3 months (P = 0.001). The median overall survival time of the responders was 16 months, and their median remission duration was 8 months. The regimen was well tolerated, with a very acceptable toxicity profile. There was one toxic death resulting from neutropenia and sepsis in a patient who did not receive adequate leucovorin rescue. CONCLUSIONS This regimen appears to prolong survival in patients with advanced gastric cancer, and the reduction of the methotrexate dose does not seem to compromise its efficacy.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Abstract
BACKGROUND In an attempt to decrease the toxic effects of fluorouracil, doxorubicin, and methotrexate (FAMTX) by reducing the dose of methotrexate from 1500 mg/m2, according to the original regimen, to 1000 mg/m2, the authors designed the modified FAMTX treatment that was evaluated in a prospective Phase II-III randomized trial. METHODS Patients with advanced gastric cancer were randomized to receive modified FAMTX treatment or supportive measures only (control group). In the middle of the study, the randomization was interrupted because of strong evidence of benefit in terms of tumor reduction and projected survival in the treatment arm receiving chemotherapy. By the end of the study, 30 assessable patients had received chemotherapy and 10 had received supportive treatment. RESULTS The overall response rate was 50% (15 patients); 12 patients (40%) had partial responses and 3 (10%) had complete responses (CR). One patient with extensive peritoneal carcinomatosis attained a CR pathologically documented by laparoscopic examination and peritoneal biopsy. The median overall survival time of the treated group was 9 months, whereas that of the control group was only 3 months (P = 0.001). The median overall survival time of the responders was 16 months, and their median remission duration was 8 months. The regimen was well tolerated, with a very acceptable toxicity profile. There was one toxic death resulting from neutropenia and sepsis in a patient who did not receive adequate leucovorin rescue. CONCLUSIONS This regimen appears to prolong survival in patients with advanced gastric cancer, and the reduction of the methotrexate dose does not seem to compromise its efficacy.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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18
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Abstract
BACKGROUND In an attempt to decrease the toxic effects of fluorouracil, doxorubicin, and methotrexate (FAMTX) by reducing the dose of methotrexate from 1500 mg/m2, according to the original regimen, to 1000 mg/m2, the authors designed the modified FAMTX treatment that was evaluated in a prospective Phase II-III randomized trial. METHODS Patients with advanced gastric cancer were randomized to receive modified FAMTX treatment or supportive measures only (control group). In the middle of the study, the randomization was interrupted because of strong evidence of benefit in terms of tumor reduction and projected survival in the treatment arm receiving chemotherapy. By the end of the study, 30 assessable patients had received chemotherapy and 10 had received supportive treatment. RESULTS The overall response rate was 50% (15 patients); 12 patients (40%) had partial responses and 3 (10%) had complete responses (CR). One patient with extensive peritoneal carcinomatosis attained a CR pathologically documented by laparoscopic examination and peritoneal biopsy. The median overall survival time of the treated group was 9 months, whereas that of the control group was only 3 months (P = 0.001). The median overall survival time of the responders was 16 months, and their median remission duration was 8 months. The regimen was well tolerated, with a very acceptable toxicity profile. There was one toxic death resulting from neutropenia and sepsis in a patient who did not receive adequate leucovorin rescue. CONCLUSIONS This regimen appears to prolong survival in patients with advanced gastric cancer, and the reduction of the methotrexate dose does not seem to compromise its efficacy.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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19
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Abstract
BACKGROUND In an attempt to decrease the toxic effects of fluorouracil, doxorubicin, and methotrexate (FAMTX) by reducing the dose of methotrexate from 1500 mg/m2, according to the original regimen, to 1000 mg/m2, the authors designed the modified FAMTX treatment that was evaluated in a prospective Phase II-III randomized trial. METHODS Patients with advanced gastric cancer were randomized to receive modified FAMTX treatment or supportive measures only (control group). In the middle of the study, the randomization was interrupted because of strong evidence of benefit in terms of tumor reduction and projected survival in the treatment arm receiving chemotherapy. By the end of the study, 30 assessable patients had received chemotherapy and 10 had received supportive treatment. RESULTS The overall response rate was 50% (15 patients); 12 patients (40%) had partial responses and 3 (10%) had complete responses (CR). One patient with extensive peritoneal carcinomatosis attained a CR pathologically documented by laparoscopic examination and peritoneal biopsy. The median overall survival time of the treated group was 9 months, whereas that of the control group was only 3 months (P = 0.001). The median overall survival time of the responders was 16 months, and their median remission duration was 8 months. The regimen was well tolerated, with a very acceptable toxicity profile. There was one toxic death resulting from neutropenia and sepsis in a patient who did not receive adequate leucovorin rescue. CONCLUSIONS This regimen appears to prolong survival in patients with advanced gastric cancer, and the reduction of the methotrexate dose does not seem to compromise its efficacy.
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Affiliation(s)
- A M Murad
- Division of Hematology/Oncology, Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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20
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Abstract
The present study deals with the determination of the incidence of chromosome changes in workers at a factory making storage batteries in Baghdad city. Blood samples were collected from 19 workers and 9 employees of the Scientific Research Council as control individuals, and chromosomes prepared from lymphocyte cultures were analyzed by standardized methods. Statistical analysis of the results gave significantly higher frequencies of chromatid and chromosome aberrations, particularly gaps, among the workers. No significant differences were observed in the incidence of chromosome aberrations in cells of smokers and non-smokers in both lead-exposed workers and controls. Therefore the observed increase in these aberrations was found to be associated mainly with exposure to lead oxides during the manufacture of the lead alloy grids and lead smelting.
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