Administration of teclistamab in four patients with multiple myeloma requiring hemodialysis.

OBJECTIVE: Relapsed/refractory multiple myeloma (MM) has poor outcomes, especially in heavily pretreated patients. Limited data exists on the use of novel therapies in MM patients with renal dysfunction. This case series describes the successful initiation of teclistamab in four patients with heavily pre-treated MM on hemodialysis (HD). DATA SOURCES: The medical records of four adult MM patients on HD who received teclistamab were retrospectively reviewed. DATA SUMMARY: All patients completed teclistamab step-up dosing and received at least one full dose. HD runs were administered irrespective of teclistamab initiation. Patients tolerated therapy well, with only one patient experiencing grade 1 CRS, which was managed with supportive care. CONCLUSIONS: Due to the complexity of this patient population, close monitoring and multidisciplinary care are crucial. This approach is essential for effectively managing MM patients with renal dysfunction and for exploring novel treatment options.

Collapse of Cancer Care Under the Current Conflict in Sudan.

Sudan has been under an armed conflict between the Sudanese Armed Forces and the Rapid Support Forces (RSF) militia since April 15, 2023. The conflict has turned the country into the largest internal displacement humanitarian crisis with 9.05 million internally displaced persons including 2.2 million children younger than 5 years and caused 1.47 million Sudanese to flee the country as refugees. The conflict has had a major destructive impact on the health system, which has incurred targeting with air raids, ground invasion, vandalization, looting of assets and supplies, and killing of doctors, nurses, and other health personnel. Khartoum Oncology Hospital, Sudan's main cancer hub for treatment, diagnostics, and research has become nonfunctional as a result of the conflict. The National Cancer Institute in Wad Medani, the second largest hub, faced a similar fate as the conflict spread to Al-Gezira State. Patients with cancer have been displaced multiple times in Sudan with grave consequences on the continuity of care, worsening of their disease outcomes and palpable negative impacts on children. The oncology workforce in Sudan have themselves been displaced yet are working hard to provide services and care for patients under impossible circumstances. Sudan's doctors in diaspora have rallied to provide support but they face multiple obstacles. As the conflict continues to spread, we call upon the WHO, the United Nations Children's Fund, St Jude Hospital, and all relevant partners to implement an immediate evacuation operation with urgent air lifts of the affected children to continue their cancer care in neighboring countries as was done in Ukraine and Gaza.

Pectin nanoparticles loaded with nitric oxide donor drug: A potential approach for tissue regeneration.

The process of wound healing and tissue regeneration involves several key mechanisms to ensure the production of new tissues with similar cellular functions. This study investigates the impact of pectin, a natural polysaccharide, and nebivolol hydrochloride (NBV), a nitric oxide (NO) donor drug, on wound healing. Utilizing ionotropic gelation, NBV-loaded pectin nanoparticles were developed following a 2231 full factorial design. The optimized formulation, determined using Design expert® software, exhibited an encapsulation efficiency percentage of 70.68%, zeta potential of -51.4 mV, and a particle size of 572 nm, characterized by a spherical, discrete morphology. An in vivo study was conducted to evaluate the effectiveness of the optimal formulation in wound healing compared to various controls. The results demonstrated the enhanced ability of the optimal formulation to accelerate wound healing. Moreover, histopathological examination further confirmed the formulation's benefits in tissue proliferation and collagen deposition at the wound site 15 days post-injury. This suggests that the developed formulation not only promotes faster healing but does so with minimal side effects, positioning it as a promising agent for effective wound healing and tissue regeneration.

Assessment of enhancing curcumin's solubility versus uptake on its anti-cancer efficacy.

Curcumin (CUR) exhibits anti-inflammatory and anti-cancer activities. However, its poor solubility and bioavailability limit its therapeutic applications. Several CUR nano-formulations have been developed to enhance its solubility and uptake, thereby improving its anti-cancer activity. Despite this, studies comparing the effect of enhanced CUR solubility versus cellular uptake on its anti-cancer efficacy are lacking. Therefore, CUR nanofibers (CUR NF) were synthesized by electrospinning using a water-soluble polymer to enhance CUR solubility. While CUR nanoparticles (CUR NP) were synthesized by nanoprecipitation method using a water-insoluble polymer to enhance CUR cellular uptake. Both nano-formulations aim to improve CUR cellular concentration and anti-cancer activity against various cancer cells. CUR NF and CUR NP were successfully synthesized at drug load (DL%) of 10 %, 20 %, and 40 % w/w. Both nano-formulations were characterized, and CUR dissolution, release, cytotoxicity, IC50, and cellular uptake were assessed. A gradual increase in NF diameter and NP size was observed as the drug load% increased compared to the placebo. NF showed a rapid CUR release and increased solubility by 16-38 fold. In contrast, NP sustained CUR release and resulted in only a 2-fold increase in solubility. Both formulations significantly reduced cell viability and IC50 compared to free CUR. However, CUR NP demonstrated higher cell toxicity (70-80 %) than CUR NF (60 %) and reduced IC50 up to 4 µM compared to 11 µM for NF. Enhancing CUR solubility or uptake can significantly increase its cellular concentration and anti-cancer activity. However, enhancing CUR cellular uptake by NP demonstrated superior anti-cancer effect compared to enhancing its solubility by NF.