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Kogiso M, Qi L, Du Y, Braun FK, Zhang H, Huang LF, Guo L, Huang Y, Teo WY, Lindsay H, Zhao S, Injac SG, Liu Z, Mehta V, Tran D, Li F, Baxter PA, Su JM, Perlaky L, Parsons DW, Chintagumpala M, Adesina A, Song Y, Li XN. Synergistic anti-tumor efficacy of mutant isocitrate dehydrogenase 1 inhibitor SYC-435 with standard therapy in patient-derived xenograft mouse models of glioma. Transl Oncol 2022; 18:101368. [PMID: 35182954 PMCID: PMC8857594 DOI: 10.1016/j.tranon.2022.101368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/23/2022] [Accepted: 02/08/2022] [Indexed: 11/05/2022] Open
Abstract
A novel pair of orthotopic PDX models of glioma bearing IDH1-R132H/R132C mutations. New mutant IDH1i (SY-435) with standard therapy led to strong therapeutic efficacy. H3K4/K9 methylation/mtDNA-encoded molecules mediate anti-tumor activity of SYC-435. Discovered MYO1F, CTC1 and BCL9 as novel genes that mediated SYC-435 resistance.
Clinical outcomes in patients with WHO grade II/III astrocytoma, oligodendroglioma or secondary glioblastoma remain poor. Isocitrate dehydrogenase 1 (IDH1) is mutated in > 70% of these tumors, making it an attractive therapeutic target. To determine the efficacy of our newly developed mutant IDH1 inhibitor, SYC-435 (1-hydroxypyridin-2-one), we treated orthotopic glioma xenograft model (IC-BT142AOA) carrying R132H mutation and our newly established orthotopic patient-derived xenograft (PDX) model of recurrent anaplastic oligoastrocytoma (IC-V0914AOA) bearing R132C mutation. In addition to suppressing IDH1 mutant cell proliferation in vitro, SYC-435 (15 mg/kg, daily x 28 days) synergistically prolonged animal survival times with standard therapies (Temozolomide + fractionated radiation) mediated by reduction of H3K4/H3K9 methylation and expression of mitochondrial DNA (mtDNA)-encoded molecules. Furthermore, RNA-seq of the remnant tumors identified genes (MYO1F, CTC1 and BCL9) and pathways (base excision repair, TCA cycle II, sirtuin signaling, protein kinase A, eukaryotic initiation factor 2 and α-adrenergic signaling) as mediators of therapy resistance. Our data demonstrated the efficacy SYC-435 in targeting IDH1 mutant gliomas when combined with standard therapy and identified a novel set of genes that should be prioritized for future studies to overcome SYC-435 resistance.
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Affiliation(s)
- Mari Kogiso
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Lin Qi
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pediatrics, Program of Precision Medicine PDOX Modeling of Pediatric Tumors, Simpson Querrey Biomedical Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Yuchen Du
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pediatrics, Program of Precision Medicine PDOX Modeling of Pediatric Tumors, Simpson Querrey Biomedical Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Frank K Braun
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Huiyuan Zhang
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - L Frank Huang
- Division of Experimental Hematology and Cancer Biology, Brain Tumor Center, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Lei Guo
- Texas A&M Health Science Center, Institute of Biosciences and Technology, Houston, TX 77030, USA
| | - Yulun Huang
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Neurosurgery, Brain and Nerve Research Laboratory, the First Affiliated Hospital, Soochow University Medical School, Suzhou, Jiangsu 215007, China
| | - Wan-Yee Teo
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Cancer and Stem Cell Biology Program, Duke-NUS Medical School, National Cancer Center, KK Women's and Children's Hospital, Humphrey Oei Institute of Cancer Research, Institute of Molecular and Cell Biology, A*STAR, 169610, Singapore
| | - Holly Lindsay
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Sibo Zhao
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Sarah G Injac
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Zhen Liu
- Department of Pharmacology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Vidya Mehta
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pathology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Diep Tran
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pathology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Feng Li
- Department of Pathology, Alkek Center for Drug Discovery, Advanced Technology Core, Baylor College of Medicine, Houston, TX 77030, USA
| | - Patricia A Baxter
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Jack M Su
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Laszlo Perlaky
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - D Williams Parsons
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Murali Chintagumpala
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA
| | - Adekunle Adesina
- Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pathology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Yongcheng Song
- Department of Pharmacology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xiao-Nan Li
- Laboratory of Molecular Neuro-Oncology, Department of Pediatrics, Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer Center, Texas Children's Hospital, Houston, TX 77030, USA; Department of Pediatrics, Program of Precision Medicine PDOX Modeling of Pediatric Tumors, Simpson Querrey Biomedical Research Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Yamaguchi M. [Current status and future prospects of diffuse large B-cell lymphoma treatment]. Rinsho Ketsueki 2022; 63:1126-1134. [PMID: 36198538 DOI: 10.11406/rinketsu.63.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) has been used as the standard treatment regimen for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), since the introduction of rituximab in the early 2000s. Recently, polatuzumab vedotin and anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy have been introduced as potential treatment options for relapsed or refractory DLBCL. The effectiveness of polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone for newly diagnosed CD20-positive DLBCL, except for the low-risk group of the international prognostic index, was reported in 2022. Bispecific antibodies such as epcoritamab, mosunetuzumab, and glofitamab, anti-CD19 antibody drug tafasitamab combined with lenalidomide, CD19 antibody drug conjugate loncastuximab tesirine, oral selective inhibitor of nuclear export selinexor, and several new agents have been investigated for DLBCL. For non-germinal center B-cell type DLBCL, R-CHOP combined with acalabrutinib is being evaluated. This review summarizes the current standard of care for DLBCL and outlines the recently introduced therapeutic agents or those that are under development in Japan.
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Affiliation(s)
- Motoko Yamaguchi
- Department of Hematological Malignancies, Mie University Graduate School of Medicine
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Wang W, Chang Y, Liu S. A commentary on "A systematic review and meta-analysis comparing the effectiveness of negative-pressure wound therapy to standard therapy in the prevention of complications after vascular surgery" (Int J Surg 2020; 76: 94-150). Int J Surg 2021; 91:105998. [PMID: 34133984 DOI: 10.1016/j.ijsu.2021.105998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Wenhui Wang
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, China.
| | - Yaowen Chang
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Shengye Liu
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, China
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Khavinson VK, Kuznik BI, Trofimova SV, Volchkov VA, Rukavishnikova SA, Titova ON, Akhmedov TA, Trofimov AV, Potemkin VV, Magen E. Results and Prospects of Using Activator of Hematopoietic Stem Cell Differentiation in Complex Therapy for Patients with COVID-19. Stem Cell Rev Rep 2021; 17:285-90. [PMID: 33575961 DOI: 10.1007/s12015-020-10087-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/29/2022]
Abstract
The paper presents the results of a standard and complex treatment method using the peptide drug thymus thymalin in patients with COVID-19. One of the mechanisms of the immunomodulatory effect of thymalin is considered to be the ability of this peptide drug to influence the differentiation of human hematopoietic stem cells (HSCs). It was found that, as a result of standard treatment, patients in the control group showed a decrease in the concentration of the pro-inflammatory cytokine IL-6, C-reactive protein, D-dimer. The addition of thymalin to standard therapy accelerated the decline in both these indicators and the indicators of the T cell system. This has helped reduce the risk of blood clots in COVID-19 patients. The revealed properties of the thymus peptide preparation are the rationale for its inclusion in the complex treatment of coronavirus infection.
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Mytinger JR, Albert DVF, Twanow JD, Vidaurre J, Tan Y, Brock GN, Ostendorf AP. Compliance With Standard Therapies and Remission Rates After Implementation of an Infantile Spasms Management Guideline. Pediatr Neurol 2020; 104:23-9. [PMID: 31911027 DOI: 10.1016/j.pediatrneurol.2019.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND We implemented an infantile spasms management guideline recommending standard therapies and, early start of next treatment. After six years, we determined (1) our compliance with standard therapies, (2) time to next treatment, and (3) rate of initial and three-month electroclinical remission with first, second, and third treatments. METHODS This is a retrospective record review of newly diagnosed spasms from September 2012 to September 2018, with the onset age of two months to two years. RESULTS Standard therapies (hormone or vigabatrin) were the first treatments in 114 of 115 consecutive patients. The second and third treatments were started within 14 days of failed treatment in only 21% and 24%, respectively. Remission with the first and second treatments was similar (41% and 40%). Remission was lower for the third treatment (15%), although higher if standard therapy was used (36%). Initial and three-month remission by the first treatment was significantly higher for adrenocorticotropic hormone (ACTH, 66% and 79%, respectively) and prednisolone (53% and 83%, respectively) than for vigabatrin (19% and 40%, respectively). There were no significant differences in patient characteristics or rates of remission between ACTH and prednisolone. CONCLUSIONS Although we achieved excellent compliance with standard therapies as initial treatment, a next treatment often started after two weeks. Given the superiority of hormone therapies over vigabatrin and standard therapies over nonstandard therapies, as well as the potentially negative impact of delays in effective treatment, future interventions need to focus on increasing the use of hormone over vigabatrin (for patients without tuberous sclerosis complex), use of standard therapies as second and third treatments, and reducing delays to next treatment.
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Bui MH, Son NT, Viet PT, Hiep NH, Dinh TC. Oral Rivaroxaban Versus Standard Therapy in Acute Venous Thromboembolism Treatment for Vietnamese Patients. Open Access Maced J Med Sci 2019; 7:4255-4259. [PMID: 32215073 PMCID: PMC7084024 DOI: 10.3889/oamjms.2019.370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND: Direct oral anticoagulant-rivaroxaban may provide a simple, fixed-dose therapy for the management of hospital-acquired, acute venous thromboembolism (VTE) and for extended treatment, its use could skip lab observation and/or parenteral treatment. AIM: Compare the efficacy and safety (EAS) of RIV vs. standard therapy (SDTD) in a cohort of Vietnamese patients diagnosed with symptomatic, acute VTE. METHODS: An open-label, case-control, prospective study was conducted to check the efficacy and safety (EAS) of oral rivaroxaban (RIV) alone (15 mg 2 times/day for 3 weeks, then 20 mg 1 time/day) in a comparison to the standard therapy (STDT) (enoxaparin 1.0 mg/kg 2 times/day combining with vitamin K antagonist). Patients were treated for 6 months and followed-up for suspect reoccurring VTE and bleeding. RESULTS: A total 187 patients were enrolled into study. 83 were provided rivaroxaban and 104 received enoxaparin overlapping with vitamin K antagonist (VKAs). Recurrent VTE occurred in 3 (3.6%) rivaroxaban-received patients compared with 5 (4.8%) standard-treatment received patients (OR: 0.74, 95% CI, 0.17 to 3.20, p > 0.05). Major bleeding events were found in 1 (1,8%) and 4 (3.9%) cases in the RIV treated and STDT cohort, respectively (OR: 0.30, 95% CI, 0.03 to 2.76, p > 0.05). CONCLUSION: The finding of this study in Vietnamese patients with acute VTE presented comparable EAS profile with RIV versus STDT, consistent with those found in global population.
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Affiliation(s)
- My Hanh Bui
- Tuberculosis and Lung Disease Department, Hanoi Medical University, Hanoi, Vietnam.,Scientific Research & International Cooperation Department, Hanoi Medical University Hospital, Hanoi, Vietnam
| | | | - Pham Thanh Viet
- Department of General Administration, Bach Mai Hospital, Hanoi, Cho Ray Hospital, Ho Chi Minh, Vietnam
| | - Nguyen Hoang Hiep
- Center for Development of Curriculum and Human Resource in Health, Hanoi Medical University, Hanoi, Vietnam
| | - Toi Chu Dinh
- Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
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Bun S, Yunokawa M, Ebata T, Kobayashi Kato M, Shimoi T, Kato T, Tamura K. Feasibility of initial treatment in elderly patients with ovarian cancer in Japan: a retrospective study. Int J Clin Oncol 2019; 24:1111-8. [PMID: 30993482 DOI: 10.1007/s10147-019-01449-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 04/07/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the real world situation and clarify the problem in initial treatment for elderly patients with ovarian cancer in Japan. METHODS We used the ovarian cancer database, containing all patients diagnosed and treated with International Federation of Gynecology and Obstetrics Stage I-IV ovarian cancer at the National Cancer Center Hospital in Japan from June 2008 to April 2013. Patients were stratified into two groups based on age: an elderly group, aged 70 years or older, and a younger group, aged below 70 years. We retrospectively assessed the rate of receiving standard therapy, and the feasibility and safety of chemotherapy compared with younger patients. RESULTS In total, 244 patients (elderly group, 36 patients; younger group, 208 patients) were analyzed. A significantly lower proportion of elderly patients than younger patients received standard therapy (15.7% vs. 32.5%, p = 0.026). Even for the elderly group, 95% patients underwent surgery in our institution. Conversely the rate of patients receiving nonstandard chemotherapy in the elderly group was significantly higher than in the younger group (30.5% vs. 9.6%, p = 0.01). CONCLUSIONS This study clarified the type of treatment being performed in the field, and the proportion of elderly ovarian cancer patients receiving standard therapy compared with younger patients in Japan. In addition, the actual situation of elderly patients in Japan might be different from that in Western countries. We need to evaluate the appropriate treatment for elderly patients in Japan.
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Huang P, Guo Y, Feng S, Zhao G, Li B, Liu Q. Efficacy and safety of Shenfu injection for septic shock: A systematic review and meta-analysis of randomized controlled trials. Am J Emerg Med 2019; 37:2197-2204. [PMID: 30981461 DOI: 10.1016/j.ajem.2019.03.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/13/2019] [Accepted: 03/22/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of Shenfu injection (SFI) combined with standard therapy versus standard therapy for septic shock, three groups of patients with septic shock were analyzed based on the level of mean arterial lactate. They were mean arterial lactate level < 4.5 mmol/L, 4.5 mmol/L ≤ mean arterial lactate level < 7 mmol/L and mean arterial lactate level ≥ 7 mmol/L. METHODS Randomized controlled trials (RCT) from PubMed, Cochrane library, Embase, CENTRAL, SinoMed, Wanfang, CNKI, and Weipu (VIP) databases from the inception to September 2018 were searched. Relative risks (RR), weighted mean difference (WMD), along with 95% confidence interval (95%CI) were used to analyze the main outcomes. Statistical analysis was performed using Rev.Man 5.3. The qualities of the involved studies were accessed by the ROB according to the Cochrane handbook. RESULTS 19 randomized controlled trials with 1505 participants were included. Compared with standard therapy, SFI plus standard therapy cannot decrease the 28-day mortality for all of the three groups. Compared with the other two subgroups (mean arterial lactate level < 4.5 mmol/L and mean arterial lactate level ≥ 7 mmol/L), the 4.5 mmol/L ≤ mean arterial lactate level < 7 mmol/L group has a trend to decrease 28-day mortality (RR: 0.67; 95% CI: 0.38-1.19; P = 0.17). In addition, adding SFI could have further increased mean arterial pressure (MAP) at 6-hours (RR: 7.05; 95% CI: 4.14-9.97) and further normalized heart rate (HR) when compared with standard therapy (RR: -17.48; 95% CI: [-19.39-(-15.57)]. CONCLUSION For septic shock patients with 4.5 mmol/L ≤ mean arterial lactate level < 7 mmol/L, when the Traditional Chinese Medicine syndrome meet Yang-Qi deficiency, clinicians could choose SFI as a supplementary drug. But further high-quality and large-scale RCT should be performed to verify it. PROSPERO REGISTRATION NUMBER CRD42018090320.
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Affiliation(s)
- Po Huang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Capital Medical University, Beijing 100010, China
| | - Yuhong Guo
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Shuo Feng
- Beijing institute of Traditional Chinese Medicine, Beijing 100010, China
| | - Guozhen Zhao
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Beijing University of Chinese Medicine, Beijing 100010, China
| | - Bo Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Beijing institute of Traditional Chinese Medicine, Beijing 100010, China.
| | - Qingquan Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Capital Medical University, Beijing 100010, China; Beijing institute of Traditional Chinese Medicine, Beijing 100010, China; Beijing Key Laboratory of Basic Research with Traditional Chinese Medicine on Infectious Diseases, Beijing 100010, China.
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Oppermann H, Matusova M, Glasow A, Dietterle J, Baran-Schmidt R, Neumann K, Meixensberger J, Gaunitz F. D,L-Methadone does not improve radio- and chemotherapy in glioblastoma in vitro. Cancer Chemother Pharmacol 2019; 83:1017-24. [PMID: 30888463 DOI: 10.1007/s00280-019-03816-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/13/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Glioblastoma (GBM) is the most common malignant tumor of the central nervous system. Median survival of glioblastoma patients under standard therapy including radiotherapy and chemotherapy using temozolomide (TMZ) is 14.6 months. As cell culture experiments combining D,L-methadone with doxorubicin demonstrated an increased reduction of cell viability of glioblastoma cells, the opioid has been discussed as a drug for the treatment of GBM. Despite lack of clinical and experimental evidence that D,L-methadone in combination with standard therapy will be beneficial, an increasing number of tumor patients medicating themselves with D,L-methadone present to the hospitals in Germany. METHODS As a first step towards understanding whether D,L-methadone may increase the efficacy of standard therapy, we used a cell culture model of primary GBM and fibroblast cell cultures derived from GBM patients. The cultures were treated with different concentrations of D,L-methadone in combination with X-irradiation, TMZ or both. Cell viability was determined by measuring ATP in cell lysates and dehydrogenase activity in living cells. RESULTS When only treated with D,L-methadone, 1 µM of the opioid was sufficient to reduce viability of fibroblasts, whereas 10 µM was needed to significantly reduce glioblastoma cell viability. In addition, D,L-methadone did not improve the anti-neoplastic effects of X-irradiation, temozolomide or both. CONCLUSIONS As D,L-methadone reduces glioblastoma cell viability only when concentrations are used that had been reported to be toxic to patients and as there were no interactions observable combining it with standard therapy, a recommendation for the use of D,L-methadone in glioblastoma therapy cannot be given.
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Laurent I, Astère M, Wang KR, Cheng QF, Li QF. Efficacy and Time Sensitivity of Amniotic Membrane treatment in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-analysis. Diabetes Ther 2017; 8:967-979. [PMID: 28895073 PMCID: PMC5630554 DOI: 10.1007/s13300-017-0298-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Diabetic foot ulcers (DFUs) are complex chronic wounds which have a major long-term impact on the morbidity, mortality and quality of patients. The objective of this study was to assess the efficacy and time sensitivity of human amnion/chorion membrane treatment in patients with chronic DFUs. METHODS The Cochrane Library, PubMed, Embase and Web of Science databases were systematically searched to identify relevant articles up to 10 April 2017. All randomized controlled trials (RCTs) comparing human amnion/chorion membrane + standard therapy and standard therapy alone in patients with DFUs were included in the analysis. Eligible studies were reviewed and data extracted into standard form. The Cochrane Collaboration's tool for assessing the risk of bias was used. Review manager version 5.3 software was used for statistical analysis. Data were analyzed using a random effect model. RESULTS Overall, the initial search of the four databases identified 352 published studies; of these, seven RCTS were ultimately included in the meta-analysis. The overall test effect in the group assessed at 4 weeks was Z = 4.14 [P < 0.0001; odds ratio (OR) 0.05; 95% confidence interval (CI) 0.01-0.21]. The overall test effect in the group assessed at 6 weeks was Z = 4.28 (P < 0.0001; OR 0.07; 95% CI 0.02-0.23). The overall effect in the group assessed at 12 weeks was Z = 4.96 (P < 0.00001; OR 0.10; 95% CI 0.04-0.24. The results showed that patients receiving amniotic membrane + standard therapy had far fewer incomplete healing wounds than those receiving standard of care alone. Assessment of the wound healing state at 4 and 6 weeks revealed that the wound healing state was almost the same, but there was a net difference of wound healing state at 12 weeks. CONCLUSION Human amnion/chorion membrane + standard of care treatment heals DFUs significantly faster than standard of care alone. When using the amnion in patients with DFUs, the optimal times to assess progress in wound healing should be 4 and 12 weeks.
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Affiliation(s)
- Irakoze Laurent
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Manirakiza Astère
- Department of Oncology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kan Ran Wang
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qing-Feng Cheng
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Qi Fu Li
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Abstract
Intra-articular injections with glucocorticoids are standard procedures according to therapy guidelines in many rheumatic conditions. There is increasing evidence from clinical trials on the treatment of rheumatoid arthritis that more patients will attain the target of remission using a combination of systemic medication and intra-articular injections with glucocorticoids compared to systemic medication alone. Intra-articular injections with glucocorticoids play an important role in the therapeutic management of pediatric rheumatic diseases. In many countries competency in performing intra-articular injections is among the important skills necessary for certification as a specialist in rheumatology.
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Affiliation(s)
- M Hammer
- Klinik für Rheumatologie, St. Josef-Stift, Westtor 7, 48324, Sendenhorst, Deutschland.
| | - T Schwarz
- Klinik für Rheumatologie, St. Josef-Stift, Westtor 7, 48324, Sendenhorst, Deutschland
| | - G Ganser
- Klinik für Rheumatologie, St. Josef-Stift, Westtor 7, 48324, Sendenhorst, Deutschland
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Rick O, Böckmann J, Dauelsberg T, Hoffmann W, Kämpfer W, Otto U, Rogge A, Zermann D. [Rehabilitation of prostate cancer patients : A multidisciplinary consensus]. Urologe A 2016; 55:933-9. [PMID: 27246473 DOI: 10.1007/s00120-016-0122-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Even though several specialist groups, including the German Pension Insurance (Deutsche Rentenversicherung) and health insurance funds, participate in the rehabilitation of patients with prostate carcinoma, there is no standardized rehabilitation program available for these patients. Consequently, there is no transparency regarding the services provided within the scope of rehabilitation for the referring physicians to uro-oncological rehabilitation, in particular, neither for physicians at urological acute-care clinics, nor for the patients concerned. Rehabilitation clinics are rather left to their own devices as to which services they provide in the treatment of the respective disease and in social situations, but also with regard to the consulting services offered. PROBLEM Development of a standard for the rehabilitation of patients with prostate carcinoma, taking into account both specialist circles and self-help groups relevant to this matter. METHODS Specialist groups, including self-help groups participating in the rehabilitation of patients with prostate cancer, have formed an expert group and developed the present standard. To this end, a thematic unsystematic literature review was carried out in advance to provide an evidence-based foundation. RESULTS Views were given with regard to rehabilitation diagnostics, the therapy of urinary incontinence and erectile dysfunction, sport and physical exercise therapy, psycho-oncology, and social- and disease-related consulting. In this context, the focus was set on classification as well as on the consensus strength of the respective recommendations. CONCLUSION All parties involved in the rehabilitation of prostate cancer patients, as well as the patients and the responsible cost bearers, can now use the standard as an orientation guide.
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Patel AA, Ogden K, Mody SH, Bookhart B. The economic implications of switching to rivaroxaban from enoxaparin plus vitamin K antagonist in the treatment of venous thromboembolism. J Med Econ 2015; 18:323-32. [PMID: 25557176 DOI: 10.3111/13696998.2014.1001850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Venous thromboembolism (VTE) impacts ∼900,000 individuals annually in the US, causing up to 100,000 deaths. Patients experiencing VTE have heightened risk of recurrence. Initial parenteral anti-coagulation is standard therapy for acute VTE followed by ≥3 months of warfarin, which introduces the risk of major bleeding. Balancing increased risks of bleeding and recurrent VTE remains challenging. Recent clinical trials suggest that rivaroxaban, an oral direct inhibitor of factor Xa, provides an effective, safe, simplified approach to treatment. This study considers the economic implications of these data. METHODS This study modeled inpatient, acute, and 1-year VTE costs for a hypothetical commercial plan with 1 million members. At baseline, all VTE patients receive standard therapy. Alternatively, 25% are instead treated with rivaroxaban. Model inputs are trial- and literature-based. RESULTS Standard therapy for VTE consumes 9474 inpatient days ($31.6 million). Added to that is treatment for 74 recurrences ($1.4 million); major and non-major bleed events ($1 million); and direct costs of anti-coagulation ($5.3 million). Alternatively, a 25% shift to oral anti-coagulation with rivaroxaban reduces inpatient days (by 5%); associated acute-care costs (by 2%); recurrences and costs (by 6%). Four major bleeding events are prevented, at the cost of one additional non-major bleeding event, which, taken together, reduce net utilization by 9%. Direct costs of anti-coagulation increase by 5%. CONCLUSION The reduction in inpatient utilization, recurrences, and major bleeding resulting from a 25% shift from standard therapy to rivaroxaban following acute VTE would conserve ∼$860,475 for every 1 million commercial health plan enrollees.
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Boglione L, Cusato J, Cariti G, Di Perri G, D'Avolio A. Treatment optimization of naïve HCV-1 patients using IL28B, RVR and fibrosis stage. Antiviral Res 2015; 116:45-7. [PMID: 25660111 DOI: 10.1016/j.antiviral.2015.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/26/2015] [Accepted: 01/29/2015] [Indexed: 01/30/2023]
Abstract
The treatment of patients with HCV genotype 1 is quickly changing. The clinician could optimize the selection of patients who may benefit from standard therapy with pegylated-interferon and ribavirin instead of more expensive new combinations with the directly acting antivirals. We retrospectively examined in our cohort of 232 patients with genotype 1 infection the role of interleukin 28B (both rs8099917 and rs12979860), fibrosis stage and rapid virological response. Global SVR in TT/CC patients was 88.3% (98% in F0-F1, 80% in F2-F3); in TT/TC was 68.2 (85% in F0-F1, 71.4% in F2-F3). Rapid virological response was related to rs12979860 CC genotype but is not useful to predict the virological response in TG/GG patients at rs8099917. The standard dual therapy may be successfully administered in all TT/CC and TT/TC patients without F4 fibrosis score. Conversely, patients with TG/CC or GG/CC genotypes should be treated with other therapeutic options.
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Affiliation(s)
- Lucio Boglione
- Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy.
| | - Jessica Cusato
- Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Giuseppe Cariti
- Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
| | - Antonio D'Avolio
- Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy
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Heo J, Jeon SW, Jung JT, Kwon JG, Kim EY, Lee DW, Seo HE, Ha CY, Kim HJ, Kim ES, Park KS, Cho KB, Lee SH, Jang BI. A randomised clinical trial of 10-day concomitant therapy and standard triple therapy for Helicobacter pylori eradication. Dig Liver Dis 2014; 46:980-4. [PMID: 25132282 DOI: 10.1016/j.dld.2014.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 07/07/2014] [Accepted: 07/20/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND As a result of increased resistance to antibiotics, Helicobacter pylori eradication rates using standard triple therapy have been declining. AIM To validate the efficacy and tolerability of a concomitant regimen as a first-line treatment for H. pylori infection. METHODS A total of 348 naïve H. pylori-infected patients from six hospitals in Korea were randomly assigned to concomitant therapy and standard triple therapy groups. The concomitant regimen consisted of 30 mg of lansoprazole, 1g of amoxicillin, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily for 10 days. The standard triple regimen consisted of 30 mg of lansoprazole, 1g of amoxicillin, and 500 mg of clarithromycin, twice daily for 10 days. RESULTS Concomitant and standard eradication rates were 78.7% (137/174) vs. 70.7% (123/174) by intention-to-treat (p=0.084) and 88.7% (133/150) vs. 78.4% (120/153) by per-protocol (p=0.016), respectively. The two groups were similar with regard to the incidence of adverse events. CONCLUSIONS Although 10-day concomitant therapy was validated as a suboptimal treatment option for the treatment of H. pylori infection, this regimen is expected to be a promising starting point in the development of an optimal treatment regimen for H. pylori infection.
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Affiliation(s)
- Jun Heo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Seong Woo Jeon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea.
| | - Jin Tae Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Joong Goo Kwon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Eun Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Dong Wook Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Hyang Eun Seo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Chang Yoon Ha
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Hyun Jin Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Eun Soo Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Kyung Sik Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Kwang Bum Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea
| | - Si Hyung Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | - Byung Ik Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
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Heo J, Jeon SW. Optimal treatment strategy for Helicobacter pylori: Era of antibiotic resistance. World J Gastroenterol 2014; 20:5654-5659. [PMID: 24914324 PMCID: PMC4024773 DOI: 10.3748/wjg.v20.i19.5654] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/29/2013] [Accepted: 02/20/2014] [Indexed: 02/06/2023] Open
Abstract
Standard triple therapy, consisting of a proton pump inhibitor, plus amoxicillin and clarithromycin, has been the most commonly used first-line treatment regimen for Helicobacter pylori (H. pylori) eradication for many years worldwide. However, as a result of increased resistance to antibiotics, H. pylori eradication rates with use of standard triple therapy have been declining and recently reached < 80% in many countries. Several new strategies to enhance the eradication rate of H. pylori have been studied. Currently, among the alternative first-line eradication regimens, concomitant and hybrid regimens have shown excellent results and could be the optimal treatment option. Although clinical usefulness of rescue therapy for patients in whom eradication of H. pylori with non-bismuth quadruple regimen has failed is unclear, levofloxacin-based quadruple therapy has shown promise as a rescue treatment. The choice of third-line therapy depends on factors such as the local pattern of antibiotic resistance, drug availability, and previous treatment. We hope that a simple method for detection of antibiotic susceptibility using polymerase chain reaction would be a possible alternative to administration of “tailored treatment” in the era of increasing prevalence of antimicrobial resistance.
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