La apoptosis: un tema de interés para el laboratorio clínico / Apoptosis: a topic of interest for the clinical laboratory

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Actualización del manejo de extravasaciones de agentes citostáticos / Update in the management of extravasations of cytocytostatic agent

Objetivo Presentar las novedades descritas hasta la actualidad del manejo específico de las extravasaciones de los agentes citostáticos una vez extravasados. MétodoSe realizó una búsqueda en PubMed, Medline e IDIS-Iowa para identificar los trabajos redactados en inglés y/o español que describieron novedades de las medidas específicas para el manejo de sus extravasaciones. Se revisaron también las referencias incluidas en estos trabajos, así como fuentes terciarias recientes relacionadas con oncología o citostáticos. La búsqueda abarcó el periodo comprendido entre 1997 y 2010.ResultadosÚnicamente 22 agentes citostáticos cuentan con algún tipo de medida específica como tratamiento de su extravasación. Se presentan esta medidas en función del citostático de interés, clasificado según su grupo farmacológico. Conclusiones A pesar de que hasta ahora no hay un consenso general en el tratamiento específico de los agentes citostáticos al extravasarse, esta revisión recopila y esquematiza la información publicada actualmente para que pueda servir a cualquier centro sanitario nacional donde se prescriban, manipulen o administren fármacos citostáticos (AU)

Objective To present current developments in the specific management of extravasations of antineoplastic agents after the extravasation. Method We conducted a search in PubMed, Medline and IDIS-Iowa to identify papers written in English or Spanish that described new specific measures for the management of extravasations. We also reviewed the references given in these papers and recent tertiary sources related to oncology or cytostatic agents. The search covered the period between 1997 and 2010.ResultsThere are only specific measures for the treatment of extravasations of 22 cytostatic agents. These measures are presented for each cytostatic agent, according their drug group. Conclusions Although currently there is no general consensus on the specific management of antineoplastic agents after extravasation, this review outlines the information collected and published so far, so that it may be of use to any national health centre where cytostatic drugs are prescribed, handled or administered(AU)

Aurora kinase inhibitors: a new class of drugs targeting the regulatory mitotic system

The present review gives a perspective on the Aurora kinase family members, their function in normal cells, their role in cancer progression as well as their potential as target for anticancer treatment. Mitosis has been an important target for anticancer therapy development, leading to some specific drugs mainly addressing Tubulines, as a key structure of the mitotic spindle. Vinca alkaloids, taxanes or epotilones are good examples of conventionally developed antimitotic agents. However, novel classes of antineoplastic drugs are being studied, targeting the regulatory system that controls functional aspects of mitosis, such as Aurora or Polo-like kinases or Kinespondin inhibitors. The specific role of the different Aurora kinase proteins as regulator enzymes of the mitotic process in normal cells is discussed. Some of the mechanisms that link Aurora overexpression with cancer are also considered. Thereafter, the clinical and preclinical development of the different Aurora kinase inhibitors is presented. This is nowadays a very active area of therapeutic research and at least, sixteen new compounds are being studied as potential antineoplastic drugs. Most of them are in a very early phase of clinical development. However, we summarized the most recently published findings related with these drugs: main characteristics, way of administration, dose limiting toxicities and recommended doses for further studies. Another important aspect in Aurora kinase inhibition is the study and validation of potential biomarkers to optimize the clinical development. Several studies included pharmacodynamic assessments in normal blood cells, skin or/and tumor biopsies. Several proposals included a higher mitotic index, a decreased number of mitosis with bipolar spindles or normal alignment of chromosomes and inhibition of histone H3 phosphorylation. Future strategies and challenges for trials with Aurora kinase inhibitors are also discussed (AU)

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