RESUMO
Mast cells (MC) are present in the skin and mucous membranes, lymphoid organs, intestine wall and brain, where they are located close to the blood and lymphatic vessels and nerve terminals. As a source of a large number of biologically active substances, many of which are released quickly into the environment as a result of degranulation process, mast cells play an essential role in the regulation of physiological processes in the tissues where they are present. Changing the MC population and activity in the tissues during aging is associated with age-related changes of the skin and mucous membranes, the development of central nervous system disorders such as itching, headache, joint and muscle pain, memory loss, attention deficits, depression, anxiety and depressive disorders, autism, Alzheimer's disease and multiple sclerosis.
Assuntos
Envelhecimento/fisiologia , Senescência Celular/fisiologia , Mastócitos/fisiologia , Humanos , Comunicação Parácrina/fisiologiaRESUMO
BACKGROUND: This phase I-II trial compared plitidepsin 1-h infusion alone or combined with dacarbazine (DTIC) 1-h infusion as front-line therapy for advanced melanoma. METHODS: The recommended dose (RD) for plitidepsin/DTIC was defined in the first stage. In the second stage, patients were randomised to receive single-agent plitidepsin 3.2 mg m(-2) (n = 20) on days 1, 8 and 15 every 4 weeks (q4wk) or plitidepsin 2.4 mg m(-2) on days 1, 8 and 15 q4wk combined with DTIC 800 mg m(-2) q4wk (n = 38). RESULTS: The overall response rate with plitidepsin/DTIC was 21.4%; all responders had normal serum lactate dehydrogenase (LDH) levels and performance status ≤ 1 at baseline. Median progression-free survival (PFS) with plitidepsin/DTIC was 3.3 months in all patients, and 4.3 months in those with baseline normal LDH. No responses occurred with single-agent plitidepsin and median PFS was 1.5 months. Both regimens were well tolerated. Haematological abnormalities were more common and transaminase increases more severe with plitidepsin/DTIC. Treatment-related transaminase increases leading to infusion omission on day 8 were relatively common. No drug-drug pharmacokinetic interactions were found. CONCLUSION: This plitidepsin/DTIC schedule has antitumour activity and manageable toxicity in advanced melanoma. Further evaluation of plitidepsin 2.4 mg m(-2) fortnightly and DTIC 800 mg m(-2) q4wk is recommended.