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1.
BMJ ; 374: n1959, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34497044

RESUMEN

OBJECTIVES: To investigate the regulatory handling of cancer drugs that were granted accelerated approval by the US Food and Drug Administration (FDA) but failed to improve the primary endpoint in post-approval trials and to evaluate the extent to which negative post-approval trials changed the recommendations in treatment guidelines. DESIGN: Retrospective observational study. SETTING: FDA and National Comprehensive Cancer Network (NCCN) reports. INCLUDED DRUGS: Cancer drugs that received accelerated approval from the FDA and had negative post-approval trials. MAIN OUTCOME MEASURES: Regulatory outcomes, including withdrawal, conversion to regular approval, and no action. RESULTS: 18 indications for 10 cancer drugs that received accelerated approval but failed to improve the primary endpoint in post-approval trials were identified. Of these, 11 (61%) were voluntarily withdrawn by the manufacturer and one (bevacizumab for breast cancer) was revoked by the FDA. Of the 11 withdrawals, six occurred in 2021 alone. The remaining six (33%) indications remain on the label. The NCCN guidelines provide a high level of endorsement (category 1 endorsement for one and category 2A endorsement for seven) for accelerated approval drugs that have failed post-approval trials, sometimes even after the approval has been withdrawn or revoked. CONCLUSION: Cancer drug indications that received accelerated approval often remained on formal FDA approved drug labelling and continued to be recommended in clinical guidelines several years after statutorily required post-approval trials showed no improvement in the primary efficacy endpoint. Clinical guidelines should better align with the results of post-approval trials of cancer drugs that received accelerated approval.


Asunto(s)
Antineoplásicos/efectos adversos , Aprobación de Drogas , Neoplasias/tratamiento farmacológico , Antineoplásicos/administración & dosificación , Bases de Datos Factuales , Supervivencia sin Enfermedad , Etiquetado de Medicamentos , Determinación de Punto Final , Humanos , Supervivencia sin Progresión , Estudios Retrospectivos , Retirada de Medicamento por Seguridad/estadística & datos numéricos , Factores de Tiempo , Incertidumbre , Estados Unidos , United States Food and Drug Administration
2.
Gan To Kagaku Ryoho ; 48(9): 1087-1092, 2021 Sep.
Artículo en Japonés | MEDLINE | ID: mdl-34521781

RESUMEN

Tumor lysis syndrome(TLS)is an oncologic emergency resulting from the lysis of large numbers of cancer cells leading to metabolic abnormalities when their contents are released into the bloodstream. TLS is sometimes fatal, and prevention is the cornerstone of TLS countermeasures. In 2010, Cairo et al reported the TLS development risk by cancer type after conventional chemotherapy. However, recently developed drug therapies are sufficiently different from earlier therapies to warrant reviewing the risk of TLS development. In this review, we will reassess the cancer-specific TLS risk based on new drug therapies and provide an overview of prevention and treatment methods.


Asunto(s)
Neoplasias , Síndrome de Lisis Tumoral , Humanos , Neoplasias/tratamiento farmacológico , Síndrome de Lisis Tumoral/diagnóstico , Síndrome de Lisis Tumoral/etiología , Síndrome de Lisis Tumoral/prevención & control
3.
Chimia (Aarau) ; 75(7): 605-613, 2021 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-34523401

RESUMEN

Ipatasertib is a potent small molecule Akt kinase inhibitor currently being tested in Phase III clinical trials for the treatment of metastatic castration-resistant prostate cancer and triple negative metastatic breast cancer. In this paper an overview of the development achievements towards the commercial manufacturing process is given. The convergent synthesis consists of ten steps with eight isolated intermediates and utilizes a wide range of chemical techniques and technologies to build-up this complex drug. All three stereocenters are introduced using enzyme or metal catalysis.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias , Humanos , Masculino , Neoplasias/tratamiento farmacológico , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico
4.
Pract Radiat Oncol ; 11(5): 310-312, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34479658

RESUMEN

I am a radiation oncologist with a busy clinical practice in Pennsylvania. I am credentialed to certify patients for medical marijuana and recommend that my patients try medical marijuana when symptom control with other options is suboptimal. This invited contribution is a brief summary of information that may help radiation oncologists understand their potential role in getting patients access to medical marijuana and my perspective on its potential value in the care of our patients.


Asunto(s)
Marihuana Medicinal , Neoplasias , Humanos , Marihuana Medicinal/uso terapéutico , Neoplasias/tratamiento farmacológico , Pennsylvania , Oncólogos de Radiación
5.
BMC Health Serv Res ; 21(1): 967, 2021 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-34521408

RESUMEN

BACKGROUND: New drugs including cancer drugs and orphan drugs are becoming increasingly more expensive. Risk sharing arrangements (RSAs) could manage the risk based on both financial impact and the health outcome of new drugs if reimbursed. To improve patients' access to new drugs under uncertainties, many developed countries have adopted RSAs. In this study, we aimed to understand the effects of RSAs in South Korea on patients' access. METHODS: We reviewed current status of RSA drugs in South Korea. The number of appraisals and time gap between market approval and reimbursement per RSA drug were considered to quantify improvement of patients' access as they showed how rapidly decisions on reimbursement of RSA drugs were derived. Then, we applied a comparative analysis to determine whether the RSA drugs in South Korea were reimbursed in the UK, Italy, and Australia. Most data for this study were obtained from websites of the governmental department/agencies responsible for appraisal of drug reimbursement in each country. And literatures related to RSAs were investigated as well. RESULTS: The eligibility for Korean RSAs had two key components - drugs for cancer and rare diseases and not having other alternative treatments. As of the first half of 2019, there were 39 RSA drugs reimbursed in South Korea, the majority of which were financial-based schemes. Refund and expenditure cap were the representative types (89.7%). After introduction of RSAs, the time gap and number of appraisals were decreased. Based on the indications of RSA drugs, the level of drug coverage in South Korea was found lower than Italy, similar to the UK, and higher than Australia. CONCLUSIONS: RSAs in South Korea significantly enhanced patients' access to new drugs and led to the alleviation of patients' out-of-pocket expenses. The drug coverage of South Korea had a level comparable to that of other countries. This study provides implications for countries that have a dual mission of containing pharmaceutical expenditure and improving access to new drugs.


Asunto(s)
Antineoplásicos , Neoplasias , Preparaciones Farmacéuticas , Humanos , Neoplasias/tratamiento farmacológico , Producción de Medicamentos sin Interés Comercial , República de Corea
6.
Front Immunol ; 12: 706186, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34484202

RESUMEN

Background: Sargramostim [recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF)] was approved by US FDA in 1991 to accelerate bone marrow recovery in diverse settings of bone marrow failure and is designated on the list of FDA Essential Medicines, Medical Countermeasures, and Critical Inputs. Other important biological activities including accelerating tissue repair and modulating host immunity to infection and cancer via the innate and adaptive immune systems are reported in pre-clinical models but incompletely studied in humans. Objective: Assess safety and efficacy of sargramostim in cancer and other diverse experimental and clinical settings. Methods and Results: We systematically reviewed PubMed, Cochrane and TRIP databases for clinical data on sargramostim in cancer. In a variety of settings, sargramostim after exposure to bone marrow-suppressing agents accelerated hematologic recovery resulting in fewer infections, less therapy-related toxicity and sometimes improved survival. As an immune modulator, sargramostim also enhanced anti-cancer responses in solid cancers when combined with conventional therapies, for example with immune checkpoint inhibitors and monoclonal antibodies. Conclusions: Sargramostim accelerates hematologic recovery in diverse clinical settings and enhances anti-cancer responses with a favorable safety profile. Uses other than in hematologic recovery are less-well studied; more data are needed on immune-enhancing benefits. We envision significantly expanded use of sargramostim in varied immune settings. Sargramostim has the potential to reverse the immune suppression associated with sepsis, trauma, acute respiratory distress syndrome (ARDS) and COVID-19. Further, sargramostim therapy has been promising in the adjuvant setting with vaccines and for anti-microbial-resistant infections and treating autoimmune pulmonary alveolar proteinosis and gastrointestinal, peripheral arterial and neuro-inflammatory diseases. It also may be useful as an adjuvant in anti-cancer immunotherapy.


Asunto(s)
COVID-19/inmunología , Factor Estimulante de Colonias de Granulocitos y Macrófagos/uso terapéutico , Factores Inmunológicos/uso terapéutico , Inmunoterapia , Neoplasias/tratamiento farmacológico , COVID-19/tratamiento farmacológico , Factor Estimulante de Colonias de Granulocitos y Macrófagos/inmunología , Humanos , Proteínas Recombinantes/inmunología , Proteínas Recombinantes/uso terapéutico , SARS-CoV-2/efectos de los fármacos
7.
Anticancer Res ; 41(9): 4543-4548, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34475081

RESUMEN

BACKGROUND/AIM: Adverse event (AE) frequencies observed in interventional clinical trials are difficult to interpret when the placebo control is missing. MATERIALS AND METHODS: Systematic literature review of AEs reported from the placebo arms of randomized cancer trials between 2008 and 2021. Imputation of missing values assuming normal distribution of hemoglobin values. RESULTS: Anemia grade 1 or higher was reported in 46 of 100 placebo monotherapy cohorts with a mean frequency of 23.4% (SD=27%) of the enrolled patients. The reported frequency depended on the type of cancer; other demographic variables had no significant influence on anemia frequency. CONCLUSION: External controls for anemia in clinical trials should be disease specific.


Asunto(s)
Anemia/epidemiología , Antineoplásicos/efectos adversos , Neoplasias/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anemia/inducido químicamente , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto Joven
8.
BMC Bioinformatics ; 22(1): 434, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34507532

RESUMEN

BACKGROUND: One of the major challenges in precision medicine is accurate prediction of individual patient's response to drugs. A great number of computational methods have been developed to predict compounds activity using genomic profiles or chemical structures, but more exploration is yet to be done to combine genetic mutation, gene expression, and cheminformatics in one machine learning model. RESULTS: We presented here a novel deep-learning model that integrates gene expression, genetic mutation, and chemical structure of compounds in a multi-task convolutional architecture. We applied our model to the Genomics of Drug Sensitivity in Cancer (GDSC) and Cancer Cell Line Encyclopedia (CCLE) datasets. We selected relevant cancer-related genes based on oncology genetics database and L1000 landmark genes, and used their expression and mutations as genomic features in model training. We obtain the cheminformatics features for compounds from PubChem or ChEMBL. Our finding is that combining gene expression, genetic mutation, and cheminformatics features greatly enhances the predictive performance. CONCLUSION: We implemented an extended Graph Neural Network for molecular graphs and Convolutional Neural Network for gene features. With the employment of multi-tasking and self-attention functions to monitor the similarity between compounds, our model outperforms recently published methods using the same training and testing datasets.


Asunto(s)
Antineoplásicos , Aprendizaje Profundo , Neoplasias , Preparaciones Farmacéuticas , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Genómica , Humanos , Neoplasias/tratamiento farmacológico , Neoplasias/genética
9.
Nat Commun ; 12(1): 5243, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34475406

RESUMEN

Peroxisome, a special cytoplasmic organelle, possesses one or more kinds of oxidases for hydrogen peroxide (H2O2) production and catalase for H2O2 degradation, which serves as an intracellular H2O2 regulator to degrade toxic peroxides to water. Inspired by this biochemical pathway, we demonstrate the reactive oxygen species (ROS) induced tumor therapy by integrating lactate oxidase (LOx) and catalase (CAT) into Fe3O4 nanoparticle/indocyanine green (ICG) co-loaded hybrid nanogels (designated as FIGs-LC). Based on the O2 redistribution and H2O2 activation by cascading LOx and CAT catalytic metabolic regulation, hydroxyl radical (·OH) and singlet oxygen (1O2) production can be modulated for glutathione (GSH)-activated chemodynamic therapy (CDT) and NIR-triggered photodynamic therapy (PDT), by manipulating the ratio of LOx and CAT to catalyze endogenous lactate to produce H2O2 and further cascade decomposing H2O2 into O2. The regulation reactions of FIGs-LC significantly elevate the intracellular ROS level and cause fatal damage to cancer cells inducing the effective inhibition of tumor growth. Such enzyme complex loaded hybrid nanogel present potential for biomedical ROS regulation, especially for the tumors with different redox state, size, and subcutaneous depth.


Asunto(s)
Antineoplásicos/farmacología , Nanogeles/química , Peroxisomas/enzimología , Fotoquimioterapia/métodos , Animales , Antineoplásicos/química , Catalasa/química , Catalasa/metabolismo , Catálisis , Línea Celular Tumoral , Óxido Ferrosoférrico/química , Glutatión/metabolismo , Humanos , Peróxido de Hidrógeno/metabolismo , Verde de Indocianina/química , Ratones , Oxigenasas de Función Mixta/química , Oxigenasas de Función Mixta/metabolismo , Nanopartículas/química , Neoplasias/tratamiento farmacológico , Neoplasias/metabolismo , Oxígeno/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Microambiente Tumoral/efectos de los fármacos
10.
Lakartidningen ; 1182021 Aug 10.
Artículo en Sueco | MEDLINE | ID: mdl-34498246

RESUMEN

5-fluorouracil (5-FU) is still a cornerstone in drug treatment for cancer. Some patients starting standard dosed 5-FU will experience severe adverse events (SAEs). One mechanism behind SAEs is impaired dihydropyrimidine dehydrogenase (DPD) activity, resulting in an accumulation of cytotoxic metabolites. Pre-emptive testing of DPD enzyme activity or genetic variation in its gene, DPYD,  is recommended since 2020 in Sweden. We report experience from DPYD testing in 368 patients planned for 5-FU treatment. DPYD variants associated with reduced DPD activity were observed in 28 patients (8%), which is close to the expected frequency. These patients tolerated 5-FU treatment when doses were reduced according to guidelines. However, 4 out of 5 variant allele carriers starting 5-FU at standard dose due to late arrival of test results experienced SAEs. Pre-emptive testing was calculated to be cost saving and thus beneficial from a healthcare economy perspective.


Asunto(s)
Fluorouracilo , Neoplasias , Antimetabolitos Antineoplásicos/efectos adversos , Ahorro de Costo , Atención a la Salud , Dihidrouracilo Deshidrogenasa (NADP)/genética , Detección Precoz del Cáncer , Fluorouracilo/efectos adversos , Costos de la Atención en Salud , Humanos , Neoplasias/tratamiento farmacológico , Neoplasias/genética , Pruebas de Farmacogenómica , Suecia
11.
Nihon Yakurigaku Zasshi ; 156(5): 282-287, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-34470932

RESUMEN

Basement membrane is a dense sheet-like extracellular matrix (ECM), which separates cells from surrounding interstitium. Type IV collagen is a major component of basement membrane and three of six α chains (namely α1-α6 chains) form a triple-helix structure. Recently, endogenous bioactive factors called "matricryptins" or "matrikines", which are produced by degrading and cleaving C-terminal domain of type IV collagen, attract attentions as a novel therapeutic target or a candidate for biomarkers. In all type IV collagens, matricryptins called arresten (α1 chain), canstatin (α2), tumstatin (α3), tetrastatin (α4), pentastatin (α5), and hexastatin (α6), have been identified. The type IV collagen-derived matricryptins have been previously studied as new therapeutic targets for neoplastic diseases since they exert anti-angiogenic and/or anti-tumor effects. On the other hand, we have recently demonstrated the cardioprotective effects of matricryptins in addition to the altered expression levels in cardiac diseases. In this review, we introduce the results of fundamental studies for the type IV collagen-derived matricryptins in various diseases, such as neoplastic diseases and cardiac diseases, and discuss the potential clinical application as novel therapeutic agents and biomarkers.


Asunto(s)
Colágeno Tipo IV , Neoplasias , Membrana Basal , Matriz Extracelular , Humanos , Neoplasias/tratamiento farmacológico
12.
Nanoscale ; 13(32): 13907, 2021 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-34477666

RESUMEN

Correction for 'Combining PD-L1 inhibitors with immunogenic cell death triggered by chemo-photothermal therapy via a thermosensitive liposome system to stimulate tumor-specific immunological response' by Jie Yu et al., Nanoscale, 2021, DOI: .


Asunto(s)
Liposomas , Neoplasias , Doxorrubicina , Humanos , Inhibidores de Puntos de Control Inmunológico , Muerte Celular Inmunogénica , Neoplasias/tratamiento farmacológico , Terapia Fototérmica
13.
Nanoscale ; 13(33): 13943-13961, 2021 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-34477676

RESUMEN

Drug-radiotherapy is a common and effective combinational treatment for cancer. This study aimed to explore the ionizing radiation-optimized drug treatment based on nanomaterials so as to improve the synergistic efficacy of drug-radiotherapy against cancer and limit the adverse effect on healthy organs. In this review, these emerging strategies were divided into four parts. First, the delivery of the drug-loaded nanoparticles was optimized owing to the strengthened passive targeting process, active targeting process, and cell targeting process of nanoparticles after ionizing radiation exposure. Second, nanomaterials were designed to respond to the ionizing radiation, thus leading to the release of the loading drugs controllably. Third, radiation-activated pro-drugs were loaded onto nanoparticles for radiation-triggered drug therapy. In particular, nontoxic nanoparticles with radiosensitization capability and innocuous radio-dynamic contrast agents can be considered as radiation-activated drugs, which were discussed in this review. Fourth, according to the various synergetic mechanisms, radiotherapy could improve the drug response of cancer, obtaining optimized drug-radiotherapy. Finally, relative suggestions were provided to further optimize these aforementioned strategies. Therefore, a novel topic was selected and the emerging strategies in this region were discussed, aiming to stimulate the inspiration for the development of ionizing radiation-optimized drug treatment based on nanomaterials.


Asunto(s)
Nanopartículas , Nanoestructuras , Neoplasias , Preparaciones Farmacéuticas , Humanos , Neoplasias/tratamiento farmacológico , Radiación Ionizante
14.
Nanoscale ; 13(31): 13231-13240, 2021 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-34477731

RESUMEN

Although artemisinin (ART) has shown initial promise in cancer therapy, its therapeutic efficacy is limited by its low tumor inhibitory efficacy and unfavorable distribution. Considering the important role of heme in the specific parasite-killing effect of ART, we designed a liposomal nanostructure self-assembled from hemin-lipid (Hemesome) to co-deliver ART and hemin for cancer therapy. The synergistic chemotherapeutic and immunotherapeutic effects of hemin and ART were demonstrated both in vitro and in vivo. The liposome-like structure was relatively stable in the blood circulation and gastrointestinal tract environment, but dissociated in the tumor cell environment. The folic acid (FA) modification not only increased their efficiency for transport across the epithelium, but also increased their tumor accumulation. In mouse models, following oral administration of FA-Hemesome-ART nanoparticles (5 mg kg-1 ART in total) every other day and intraperitoneal injection with a programmed death-ligand 1 antibody (aPD-L1, 70 µg per mouse in total), MC38 tumors were completely inhibited within 30 days. The cured mice remained tumor-free 30 days after rechallenging them with another inoculation of MC38 cells due to the strong immune memory effect.


Asunto(s)
Artemisininas , Nanopartículas , Neoplasias , Animales , Línea Celular Tumoral , Hemina , Inmunoterapia , Lípidos , Ratones , Neoplasias/tratamiento farmacológico
15.
Nanoscale ; 13(31): 13558, 2021 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-34477760

RESUMEN

Correction for 'Furin-instructed molecular self-assembly actuates endoplasmic reticulum stress-mediated apoptosis for cancer therapy' by Chenxing Fu et al., Nanoscale, 2020, 12, 12126-12132, DOI: .


Asunto(s)
Estrés del Retículo Endoplásmico , Neoplasias , Apoptosis , Furina , Humanos , Neoplasias/tratamiento farmacológico
16.
Nanoscale ; 13(30): 12966-12978, 2021 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-34477780

RESUMEN

Immune checkpoint blockade (ICB) therapy in combination with immunogenic death (ICD) triggered by photothermal therapy (PTT) and oxaliplatin (OXA) treatment was expected to elicit both innate and adaptive immune responses for tumor control and metastasis prevention. In this study, a photothermal agent (IR780), a folic acid (FA) linked oxaliplatin (OXA) prodrug, and PD-L1 inhibitors (BMS-1) were integrated into a liposomal system. The FA tumor-targeting and enhanced permeability and retention (EPR) effect of the liposomal system prolonged circulating times and increased accumulation in tumors, resulting in an enhanced photothermal effect and less systemic toxicity. In addition, PTT and OXA had a considerable synergistic effect in the induction of a combined ICD. The PD-1/PD-L1 checkpoint, which is a negative immune regulatory mechanism, could be blocked by the thermosensitive released BMS-1. Finally, ICD was harnessed to synergize with a small molecule PD-L1 inhibitor for activation of the immune system in the treatment of tumor relapse and metastasis.


Asunto(s)
Muerte Celular Inmunogénica , Neoplasias , Humanos , Inhibidores de Puntos de Control Inmunológico , Liposomas , Neoplasias/tratamiento farmacológico , Terapia Fototérmica
17.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(4): 620-627, 2021 Aug.
Artículo en Chino | MEDLINE | ID: mdl-34494535

RESUMEN

Multi-drug resistance(MDR)refers to the loss of sensitivity of tumor cells to traditional chemotherapeutics agents under the mediation of various mechanisms,resulting in the reduction of chemotherapy efficacy.Current studies suggest that a variety of factors,including cell membrane transporter-mediated efflux of anti-tumor drugs,special microenvironment in tumor tissue,DNA self-repair and anti-apoptotic process,and epithelial-mesenchymal cell transformation,may contribute to the formation of MDR.Cell membrane transporter-mediated drug efflux refers to an increase in the amount of anti-tumor drug pumped out of the cell through the up-regulation of the ATP-binding cassette transporter on tumor cell membrane,which reduces the concentration of the drug in the cell,thus forming MDR.An effective method to inhibit the efflux pump caused by overexpression of membrane transporters plays an important role in overcoming MDR.As a promising drug delivery system,multifunctional nanoparticles have demonstrated many advantages in antitumor therapy.Meanwhile,nanoparticles with tailored design are capable of overcoming MDR when combined with a variety of strategies.This paper described in detail the studies relevant to the use of multifunctional nano-sized drug delivery system combined with different strategies,such as co-delivery of agents,external responsiveness or target modification for intervention with efflux pump in order to reverse MDR.This paper provides reference for the development of nano-sized drug delivery system and the formulation of reversal strategy in the future.


Asunto(s)
Antineoplásicos , Nanopartículas Multifuncionales , Nanopartículas , Neoplasias , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Membrana Celular , Resistencia a Múltiples Medicamentos , Resistencia a Antineoplásicos , Humanos , Proteínas de Transporte de Membrana/farmacología , Proteínas de Transporte de Membrana/uso terapéutico , Neoplasias/tratamiento farmacológico , Microambiente Tumoral
18.
Ann Palliat Med ; 10(8): 9105-9113, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34488396

RESUMEN

BACKGROUND: To evaluate the effects and safety of peripherally inserted central catheters (PICCs) and venous access ports (PORTs) for cancer patients receiving chemotherapy. METHODS: We searched randomized controlled trials and retrospective cohort studies comparing PICCs to PORTs in cancer patients receiving chemotherapy. Data were extracted from relevant studies. We sought to evaluate procedure time, quality of life and thrombosis [risk ratio (RR) =4.37, 95% CI, 2.10, 9.07, P<0.0001, I2=22%]. Sensitivity analysis and the funnel plot showed that our study was robust and exhibited low publication bias. RESULTS: Ten previous studies were incorporated into this study for a total sample size of 2,585 patients. There was no difference between the PICC and PORT groups in QOL (MD =-1.12, 95% CI, -6.14, 3.91, P=0.66, fixed effect model, I2=32%). PORT required a longer procedure time than the PICC procedure (the overall MD was -5.55 with 95% CI, -6.96, -4.14, I2=0%), and PICCs had more associated complications than PORTs including occlusion (MD =5.42, 95% CI, 2.13, 13.75, P=0.0004, I2=40%) and thrombosis (risk ratio (RR) =4.37, 95% CI, 2.10, 9.07, P<0.0001, I2=22%). Sensitivity analysis and the funnel plot showed that our study was robust and exhibited low publication bias. DISCUSSION: Our study suggested that PORTs had similar clinical effects to PICCs in cancer patients receiving chemotherapy. However, PORTs were associated with fewer complications than PICCs.


Asunto(s)
Cateterismo Venoso Central , Catéteres Venosos Centrales , Neoplasias , Cateterismo Venoso Central/efectos adversos , Catéteres Venosos Centrales/efectos adversos , Humanos , Neoplasias/tratamiento farmacológico , Calidad de Vida , Estudios Retrospectivos , Factores de Riesgo
19.
Nanoscale ; 13(34): 14426-14434, 2021 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-34473179

RESUMEN

Since carbon dots (CDs) exhibit excellent biocompatibility, low cytotoxicity, near-infrared (NIR) absorbance, and superior photostability, many types of CDs are considered as powerful candidates for photothermal therapy (PTT) applications. However, the development of a desirable CD is still difficult due to insufficient photothermal conversion, thus resulting in the use of high laser power densities at a high dose of CDs for the PTT effect. Herein, bioinspired sulfur-doped CDs (S-CDs) with strong NIR absorbance were prepared from Camellia japonica flowers via a facile hydrothermal method for enhancing the photothermal conversion efficiency. The as-prepared S-CDs exhibited various advantages including cost-effective preparation, good water-solubility, high biocompatibility, intense NIR absorption, and excellent photothermal effect with robust photostability. Most importantly, the optimal low dose of S-CDs (45 µg mL-1) successfully led to efficient PTT performance with a high photothermal conversion efficiency (55.4%) under moderate laser power (808 nm, 1.1 W cm-2) for safe and effective cancer therapy.


Asunto(s)
Camellia , Neoplasias , Carbono , Humanos , Neoplasias/tratamiento farmacológico , Fototerapia , Terapia Fototérmica
20.
Mater Sci Eng C Mater Biol Appl ; 128: 112293, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34474844

RESUMEN

Due to increased requirements for precision cancer treatment, cancer chemotherapy and combination therapies have gradually developed in the direction of diagnosis and treatment integration. In this study, a non-toxic nano carrier that demonstrates integrated MRI signal enhancing performance, as well as better chemotherapy and photothermal conversion performance, was prepared and characterized. Furthermore, the carrier was used to construct an integrated system of tumor diagnosis and treatment. Our in vitro studies showed that this system has a considerable inhibition effect on tumor cells during the treatment of chemotherapy when combined with PTT, and in vivo studies showed that the system could improve the MRI signal of the tumor site with application of a safe dosage. Thus, this system based on NGO/USPIO has the potential to be a multi-functional nano drug delivery system integrating diagnosis and treatment benefits and applications that are worthy of further research.


Asunto(s)
Grafito , Nanopartículas de Magnetita , Neoplasias , Dextranos , Humanos , Neoplasias/diagnóstico por imagen , Neoplasias/tratamiento farmacológico , Óxidos
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