All information about the latest scientific publications of the Clínica Universidad de Navarra. GSTP1 and MTHFR polymorphisms are related with toxicity in breast cancer adjuvant anthracycline-based treatment

Genetic polymorphisms in drug-metabolizing enzymes have been linked to inter-individual differences in the efficacy and toxicity of many medications. The aim of our study was to reveal the association of MTHFR and GSTP1 gene polymorphisms with toxicity in breast cancer patients treated with adjuvant anthracycline-based treatment. The case group comprised 74 patients with breast cancer (median age: 48.9, range: 2769 years; stage: II-III). All patients received 6 cycles of adjuvant anthracycline-based chemotherapy regimen with 5-fluorouracil, adriamycin, and cyclophosphamide (FAC). Toxicity was assessed using NCI-CTC. The polymorphic variants of the MTHFR (c. 677 C>T) and GSTP1 (c. 313 A>G) were analyzed by Allelic Discrimination Real Time PCR using specific primers and TaqMan MGB probes. The genotypes distributions observed were similar to Hardy-Weinberg equilibrium expectations. The association between genotypes and toxicity was tested using univariate logistic regression and logistic regression ...

Figure 4. Bland-Altman analysis for intra-observer and inter-observer reliability.. Discussion. Anthracyclines, such as doxorubicin and epirubicin, have been used extensively and continue to be some of the most active cytotoxic agents available to treat a wide spectrum of hematologic malignancies and solid tumors, including acute myeloid, lymphoid leukemia, lymphoma and breast cancer. As a result of advances in the treatment of cancers, the number of survivors will fortunately continue to increase.. Unfortunately, despite their success in treating cancer, anthracyclines are limited by their serious toxic effects on the myocardium. Life altering cardiac sequelae from anthracyclines remain a problem, with a range of 5-23% of patients developing late-onset heart failure secondary to anthracycline-induced cardiotoxicity [10]. Reliable, sensitive and non-invasive method in detecting cardiac function is of vital importance during anthracycline administration.. Strain is a dimensionless parameter ...

TY - JOUR. T1 - Early cardiac changes following anthracycline chemotherapy in breast cancer: a prospective multi-centre study using advanced cardiac imaging and biochemical markers. AU - Grover, Suchi. AU - De Pasquale, Carmine. AU - Leong, Darryl. AU - Chakrabarty, Adhiraj. AU - Cheong, Kerry. AU - Kotasek, Dusan. AU - Joshi, Rohit. AU - Penhall, Amy. AU - Joerg, Lucas. AU - Joseph, Majo. AU - Koczwara, Bogda. AU - Selvanayagam, Joseph. PY - 2012. Y1 - 2012. M3 - Article. VL - 14. SP - 181. EP - 182. JO - Journal of Cardiovascular Magnetic Resonance. JF - Journal of Cardiovascular Magnetic Resonance. SN - 1097-6647. IS - S1. ER - ...

New data analyses found no association between anthracycline chemotherapy and greater risk of cognitive decline in breast cancer survivors, according to an article published online by JAMA Oncology.

The activity and tolerability of trabectedin has been widely studied in the second-line STS setting, but few studies evaluate it as first-line therapy for patients with comorbidities that preclude anthracycline-based chemotherapy. This study, TR1US, assessed the efficacy, tolerability, and pharmacokinetics of trabectedin in patients with STS in the latter group.. In this study, patients received trabectedin 1.3 to 1.5 mg/m2 as a 24-hour infusion every 3 weeks until progression or unacceptable toxicity. Response, progression-free survival (PFS), and overall survival (OS) were assessed per RECIST 1.1 and Kaplan-Meier, respectively. From February 2014 to December 2015, 24 patients were enrolled. Their median age was 78 years (range, 64-89 years). STS histologies were leiomyosarcoma (46%), liposarcoma (33%), and others (21%). Two patients had previously received adjuvant anthracycline-based chemotherapy. A median of 4 cycles of trabectedin were delivered.. Among the 24 patients, 2 achieved partial ...

Nakamori S, Jang J, Tschabrunn CM, Pierce P, Goddu B, Rodriguez J, Ngo LH, Tung NM, Manning WJ, Nezafat R. Noncontrast CMR for Detecting Early Myocardial Tissue Injury in a Swine Model of Anthracycline-Induced Cardiotoxicity. JACC Cardiovasc Imaging. 2019 10; 12(10):2085-2087 ...

Anthracyclines are among the most effective chemotherapy treatments available for various types of cancer. However, there is a risk of damage to the heart (cardiotoxicity) depending on the cumulative dose. Certain drugs might prevent this damage, but for many of these drugs, the review authors found no high quality evidence about whether they were effective in protecting the heart and they were unable to draw conclusions. For dexrazoxane, the review authors found 10 studies enrolling over 1600 patients. These studies provided evidence that dexrazoxane prevented heart damage without interfering with the anti-tumour effects of anthracycline treatment. Patients who got dexrazoxane with their anthracycline treatment had about one third of the risk of heart failure compared to patients who got anthracyclines without dexrazoxane. Dexrazoxane had no effect on survival. We cant be sure about whether it had any undesirable side effects.. ...

Anthracycline-based chemotherapy is widely used as adjuvant treatment for breast cancer. In addition to the challenge posed by anthracycline-induced cardiotoxicity, there are issues surrounding previous treatment with anthracyclines which limit its utility in the metastatic disease setting. Many patients with advanced disease will have had prior anthracycline-based adjuvant therapy, may have reached a maximum cumulative lifetime dose, or developed refractory disease, creating an obvious need for non-anthracycline treatment strategies.3 Platinum- and taxane-based chemotherapies as first-line therapy for metastatic breast cancer have demonstrated significant activity, producing single-agent response rates , 50%; in combination these rates increased to , 60% in both previously untreated and in patients who previously received anthracyclines.3 However, overall survival has remained relatively unchanged.4 As there is currently no standard of care for patients with metastatic breast cancer, various ...

Anthracycline-based chemotherapy is widely used as adjuvant treatment for breast cancer. In addition to the challenge posed by anthracycline-induced cardiotoxicity, there are issues surrounding previous treatment with anthracyclines which limit its utility in the metastatic disease setting. Many patients with advanced disease will have had prior anthracycline-based adjuvant therapy, may have reached a maximum cumulative lifetime dose, or developed refractory disease, creating an obvious need for non-anthracycline treatment strategies.3 Platinum- and taxane-based chemotherapies as first-line therapy for metastatic breast cancer have demonstrated significant activity, producing single-agent response rates , 50%; in combination these rates increased to , 60% in both previously untreated and in patients who previously received anthracyclines.3 However, overall survival has remained relatively unchanged.4 As there is currently no standard of care for patients with metastatic breast cancer, various ...

TY - JOUR. T1 - Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity. AU - Ohtani, Kisho. AU - Fujino, Takeo. AU - Ide, Tomomi. AU - Funakoshi, Kouta. AU - Sakamoto, Ichirou. AU - Hiasa, Ken ichi. AU - Higo, Taiki. AU - Kamezaki, Kenjiro. AU - Akashi, Koichi. AU - Tsutsui, Hiroyuki. PY - 2019/6/1. Y1 - 2019/6/1. N2 - Background: Left ventricular (LV) dysfunction due to anthracycline-induced cardiotoxicity (AIC) has been believed to be irreversible. However, this has not been confirmed and standard medical treatment for heart failure (HF) including renin-angiotensin inhibitors and β-blockers may lead to its recovery. Methods and results: We thus retrospectively studied 350 cancer patients receiving anthracycline-based chemotherapy from 2001 to 2015 in our institution. Fifty-two patients (14.9%) developed AIC with a decrease in LV ejection fraction (LVEF) of 24.1% at a ...

Objective Anthracyclines are potent antineoplastic agents in the treatment of lymphoid malignancies, but their therapeutic benefit is limited by cardiotoxicity. The American Heart Association (AHA) recommends routine surveillance, early diagnosis and treatment of anthracycline-based chemotherapy (AC) induced cardiomyopathy (AC-CMP). We aimed to assess the prevalence of AC-CMP in patients with lymphoma, surveillance patterns of left ventricular ejection fraction (LVEF) in those receiving AC and management of patients with AC-CMP at an academic medical centre prior to the development of a comprehensive cardio-oncology programme. Methods We performed a retrospective cohort study examining 218 patients with aggressive B cell non-Hodgkins lymphomas (B-NHL) who received AC 1992ñ2012 and had serial follow-up. AC-CMP was defined as LVEF decrease ?10% with final LVEF?50% or LVEF reduction ?15% regardless of final LVEF. Results Of 218 patients treated with AC, 73 (34%) had LVEF assessment both prior to ...

Alterations in Doppler derived diastolic filling characteristics in anthracycline treated children have been reported previously. Some have described frequent abnormalities,5 with numerically small changes, directionally variable and not confined to those receiving anthracyclines. Others have not been able to detect any differences from controls,2 neither at rest nor during dobutamine stress testing. All but one of these studies of diastolic function in anthracycline treated children has included a variety of different diagnostic groups receiving various anthracycline schedules. Rammeloo and colleagues2 studied children with ALL only, but found no indices of diastolic dysfunction. However, anthracycline doses were low (100 mg/mg2).. Restrictive LV filling has been proposed as a consequence of chronic progressive myocardial anthracycline induced damage, but our observations in patients treated with moderate anthracycline doses and a follow up interval of 10-11 years, would question this ...

Perceived resource constraints within the Canadian health care system might threaten adoption of pharmacogenomic testing. We therefore propose prioritizing serious ADRs where delays in access to tests put patients at risk of devastating consequences that also represent substantial cost burdens on the health care system. Pharmacogenomic testing for serious ADRs also holds the most promise for cost effectiveness. We have shown that cost savings associated with the prevention of one such ADR, anthracycline-induced cardiotoxicity, are predicted to outweigh the costs of testing.20 Specifically, severe cases of anthracycline-induced cardiotoxicity cost more than $1 million owing to the need for heart transplants,20 and incorporation of pharmacogenomic testing is estimated to save $495 per patient, representing a 5.7% reduction in costs associated with anthracycline-based cancer treatment.20. Several parameters must be optimized to improve access for our proposed approach to pharmacogenomic testing, ...

I have read the article by Cardinale and colleagues1 with great interest and congratulate the authors for the completion of a burdensome work and the excellent presentation of their results. As the authors have correctly stated, early preclinical cardiac injury should be looked for soon after anthracycline treatment to effectively treat this disorder from its onset, before its overt clinical expression. However, I would like to point out one aspect that needs further clarification. The authors have reported that the overall incidence of cardiotoxicity is 9%. Previous researches have reported that anthracycline promotes cancer cell death via regulator of G-protein signaling 6 (RGS6)-mediated activation of ataxia telangiectasia-mutated serine/threonine protein kinase and the resultant upregulation of tumor suppressor p53, leading to an apoptosis pathway underlying its cytotoxic activity. The ability of RGS6 to promote p53 activation in response to anthracycline is independent of RGS6 interaction ...

Recent studies have shown that the toxic heart effects of anthracycline therapy can have lasting effects on childrens health. Dr. Stephen Lipshulz, a pediatric cancer specialist at the University of Miami, said childhood cancer survivors may be at significant risk of serious cardiovascular problems at a much younger age, than researchers believed a few years ago ...

Different classes of cardiovascular biomarkers are thought to provide information concerning different pathophysiological mechanisms.16 Because anthracycline therapy is associated with both cardiomyocyte injury, loss of cardiac contractile function, inflammation, and development of diffuse fibrosis,17 we selected biomarkers that are believed to reflect these processes in our study.. Cardiac troponins are markers of cardiomyocyte injury and are associated with risk for cardiovascular death and heart failure.18 Moreover, the use of high‐sensitivity assays for cTnI and cTnT also permits detection and monitoring of low‐grade, chronic myocardial injury.19 BNP and NT‐proBNP are associated with cardiac function and provide strong prognostic information across the spectrum of cardiovascular disease.20, 21, 22 CRP is a prototypical inflammatory biomarker that has been associated with the incidence of cardiovascular disease and death, both in the general population, in patients with coronary artery ...

Background: Aortic stiffening produces systolic hypertension and increases left ventricular (LV) wall stress. Normally this stimulates LV hypertrophy to normalize wall stresses. Previously, we have shown aortic stiffness abruptly increases within 3 to 6 months of anthracycline-based chemotherapy (Anth-bC) initiation, but the effect of this increase on LV mass and remodeling is unknown.. Methods: We performed cardiac magnetic resonance (CMR) on 73 individuals (49 receiving Anth-bC [67% women; 49±14 years] and 24 healthy volunteers [58% women; 52±8 years]) at baseline and 6 months after Anth-bC initiation. In blinded analyses we measured aortic arch stiffness (pulse wave velocity [PWV]) and LV volumes, shape (sphericity index), mass, and wall stress. Paired and two sample t tests were performed to assess differences in cohorts and serial CMR measures. We fit multivariate models to each cohort to examine associations of change in CMR measurements after adjustment for covariates.. Results: In ...

1.Sánchez G, Cervantes G y Maldonado J. Linfomas No Hodgkin. Med Int Mex 2004; 20: 111-23. 2.Estrada D, Rajdev L and Sparado J. Lymphoma, Non-Hodgkin. Emedicine. Last Updated: June 24, 2004. 3.Ng R, Better N, Green MD. Anticancer agents and cardiotoxicity. Semin Oncol. 2006; 33 (1): 2-14. 4.Youssef G, Links M. The prevention and management of cardiovascular complications of chemotherapy in patients with cancer. Am J Cardiovasc Drugs. 2005; 5 (4): 233-43. 5.Pasca A, Pereiro G, Mansilla S y Lastiri H. Toxicidad miocardiaca por antraciclinas. Rev Fed Arg Cardiol 2000; 29:319-325. 6.Suter T and Meier B. Detection of anthracycline- induced cardiotoxicity: is there light at the end of the tunnel?. Editorial. Annals of Oncology. 2002; 13: 647-649. 7.Cvetkovic RS, Scott LJ. Dexrazoxane a review of its use for cardioprotection during anthracycline chemotherapy. Drugs. 2005; 65 (7): 1005-24. 8.Gianni L, Haerman E, Lipshultz S, Minotti G, sarvazyan N and Sawyer D.Anthracycline Cardiotoxicity: From Bench ...

Trade Name: Xeloda®. For which conditions is this drug approved? Capecitabine is FDA approved for initial treatment for metastatic colorectal cancer, stage III colorectal cancer, treatment for metastatic breast cancer in addition to the chemotherapy agent docetaxel (Taxotere®) after cancer progression following anthracycline chemotherapy, and treatment for metastatic breast cancer in patients who have been treated with both anthracycline and paclitaxel (Taxol®) chemotherapy. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.. What is the mechanism of action? Capecitabine belongs to a group of drugs called antimetabolites. Antimetabolites produce their anti-cancer effects by inhibiting the ability of a cell to ...

In the metastatic setting, a phase III clinical trial comparing lapatinib versus lapatinib and trastuzumab in 296 patients who had progressed on a trastuzumab-containing regimen demonstrated an improvement in progression-free survival (hazard ratio (HR), 0.73; 95% confidence interval, 0.57 to 0.93; P = 0.08) and a trend towards improved OS (HR, 0.75; 95% confidence interval, 0.53 to 1.07; P = 0.106) in patients receiving the combination [33]. This observation provided further evidence for combined HER2 blockade as well as continued use of trastuzumab beyond disease progression.. Six randomized neoadjuvant trials and one nonrandomized neoadjuvant trial as well as one adjuvant trial have evaluated the role of dual targeted therapies with lapatinib and trastuzumab (Table 2). Two large studies were conducted with a taxane-only backbone with anthracycline chemotherapy given after surgery. In the phase III study of NeoALTTO, 455 patients received paclitaxel with lapatinib, trastuzumab or the ...

In cases of acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), there is a greater risk of symptomatic heart failure in the first year following initiation of anthracycline treatment.

This study was designed to monitor 18F-FMISO-PET during a WoO with nintedanib, a novel TKI with interesting results to date, and to determine whether 18F-FMISO PET would show predictive/prognostic capacity or shed light on the mechanisms of resistance to nintedanib. The randomized design was adopted to distinguish predictive from prognostic properties of the biomarker. To avoid confusion in the biomarker interpretation, most of the standard chemotherapy that is usually administered in this setting (a taxane plus an anthracycline-based regimen) was removed from the trial schedule; the anthracycline-based regimen was administered after trial completion in the post-operative setting. Thus, despite the randomized design, the trial was not powered to compare the RCB rate between treatment arms or determine the true efficacy of nintedanib plus standard neoadjuvant chemotherapy. In any case, doubling the rate of pCR (RCB-0 and -I) in the hormone-positive population, which constituted the 79% of the ...

In the current issue of ONCOLOGY, Hershman and Shao provide a comprehensive review of anthracycline-induced cardiotoxicity (AIC). Risk factors for AIC include age (??18 or ??65 years) at time of treatment, increasing cumulative dose or dose intensity of anthracyclines, mediastinal radiation therapy (RT), and female gender.[1-4] The Surveillance, Epidemiology and End Results (SEER)-Medicare database showed […]. ...

Anthracyclines are the most effective anticancer drugs with broad cancer spectrum. They demonstrate strong anticancer efficacy in vitro but are less effective in vivo during treatment of brain cancer...

One major barrier to the eradication of DLBCL with anthracycline-based chemotherapy is the ability of certain lymphomas to exhibit resistance to these drugs. Anthracycline resistance may be intrinsic or acquired and may occur through multiple mechanisms. These mechanisms may be classified in two major groups: (i) decreased drug accumulation and/or increased drug inactivation, for example, via upregulation of the MDR/TAP (multidrug resistance/antigen peptide transporter) genes; this mechanism has been characterized in cell and animal models but its relevance to clinical resistance remains unclear in most tumor types (46-49) and (ii) biologic mechanisms that prevent cell death from occurring after anthracycline-induced damage. Accumulating evidence indicates that the capacity of most cancers to resist the cytotoxic effects of chemotherapy is more closely connected to genetic and epigenetic abnormalities that affect critical cell-cycle checkpoint and cell death pathways than to specific mechanisms ...

Impact of 12 weeks nab-paclitaxel + carboplatin or gemcitabine followed by anthracycline administration according to pCR in triple-negative early breast cancer: Survival results of WSG-ADAPT-TN phase II trial. First Author: Oleg Gluz, Breast Center Niederrhein and University Clinics Cologne, Moenchengladbach, Germany. Conclusions:12w nab-paclitaxel/carboplatin is a tolerable and effective neoadjuvant option in early stage TNBC. In ADAPT TN, the strong impact of carboplatin vs. gemcitabine on pCR seems to be mitigated regarding survival by subsequent adjuvant anthracycline/cyclophosphamide therapy. Our findings provide first prospective evidence supporting individualized chemotherapy regimens in early TNBC. Clinical trial information: NCT01815242 ABSTRACT 573. IMpassion132: A double-blind randomized phase 3 trial evaluating chemotherapy (CT) 6 atezolizumab (atezo) for early progressing locally advanced/metastatic triple-negative breast cancer (mTNBC). First Author: Rebecca Dent, National Cancer ...

Anthracyclines, such as doxorubicin and idarubicin, remain an important class of chemotherapeutic agents. Unfortunately, their efficacy in treating cancer is limited by a cumulative dose-dependent cardiotoxicity, which can cause irreversible heart failure. In this review, we discuss the pathogenesis …

Results from the DECT trial indicate that a combination of epirubicin and trastuzumab improved outcomes in patients with HER2-positive breast cancer.

Age, Anthracycline Dose, Hypertension Contribute to Higher CVD Risk in HCT Recipients - Blood Advances in a Different Vein, From the Blood Journals, News - ASH Clinical News

Over the last 40 years, a significant advance has been made in the treatment of childhood and adult cancers. However, the increase of the survival rate points out medium- and long-term adverse effects that constitute a serious limitation for the quality of life in adults survived from a childhood ca …

Indicated, in combination with doxorubicin, for the treatment of adult patients with soft tissue sarcoma with a histologic subtype for which an anthracycline-containing regimen is appropriate and which is not amenable to curative treatment with radiotherapy or ...

Anthracyclines (such as doxorubicin) are very important (effective) agents for the treatment of lymphomas, however the use of anthracyclines increases the risk of damage to the heart (cardio toxicity. The risk of cardio toxicity is greater for the elderly and pediatric patients, and in persons with preexisting heart issues. The risk is also related to the cumulative dose of the anthracycline drug, and possibly the rate of administration - how fast it is given.. ...

Drugs of the anthracycline group, in particular doxorubicin (Adriamycin), are among the most effective and extensively used anti-cancer...

We demonstrated that a minimal dose of Dox combined that has a suboptimal dose of WFA was really efficient in suppressing tumor progression by lowering proliferation and angiogenesis while improving autophagy, DNA injury, and apoptosis , indicating that combining WFA with Dox reduces the dosage requirement of Dox to suppress tumor development, and hence could lessen or eliminate the negative effects which includes myocardial toxicity linked with substantial doses of Dox applied to deal with various strong cancers including ovarian cancer. Anthracyclines are amid quite possibly the most useful anticancer solutions ever formulated, but their clinical use is restricted by their cumulative dose-related cardiotoxicity which may possibly eventually lead to a severe type of cardiomyopathy . Regardless of reliable proof proving the induction of apoptosis in cardiomyocytes exposed to doxorubicin in vitro, there may be controversy above whether or not apoptosis contributes to doxorubicin-induced ...

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Organic compounds that have a tetrahydronaphthacenedione ring structure attached by a glycosidic linkage to the amino sugar daunosamine ...

Giving trastuzumab and anthracyclines at the same time is effective at treating HER-2-positive breast cancer, but there is concern that this combination can be associated with an increased risk of cardiac toxicity. New research ...

TY - JOUR. T1 - Utility of high-sensitivity cardiac troponin T in patients receiving anthracycline chemotherapy. AU - Blaes, Anne H.. AU - Rehman, Aamer. AU - Vock, David M.. AU - Luo, Xianghua. AU - Menge, Mark. AU - Yee, Douglas. AU - Missov, Emil. AU - Duprez, Daniel. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Background: Anthracycline chemotherapy remains an integral part of the care for curative intent chemotherapy in breast cancer and non-Hodgkin lymphoma patients. Better tools need to be identified to predict cardiac complications of anthracycline chemotherapy. Materials and methods: We investigated the utility of high-sensitivity cardiac troponin T (hscTnT), N-terminal pro-B-type natriuretic peptide, cardiac troponin T and I, and creatine kinase (CK)-MB in cancer patients receiving anthracycline-based chemotherapy, in order to determine whether baseline levels or changes in these biomarkers may help predict the onset of congestive heart failure. Results: Eighteen consecutive patients with a ...

This retrospective study investigated the efficacy and tolerability of amrubicin monotherapy in patients with platinum-refractory gastroenteropancreatic

AimsThe protective effect of beta-blockers, ACE inhibitors, and ARBs on anthracycline cardiotoxicity has already been demonstrated, but the effect of aldosterone antagonism, which inhibits the last step of the renin-angiotensin-aldosterone system (RAAS), was questioned. This study sought to investigate whether spironolactone protects the heart against anthracycline-induced cardiotoxicity. ...

Herceptin® (trastuzumab) monoclonal antibody cancer therapy information for healthcare professionals, for the treatment of HER2+ adjuvant breast cancer, metastatic breast cancer treatment and metastatic gastric and gastroesophageal junction (GEJ) cancer treatment. INDICATIONS: Adjuvant Breast Cancer Herceptin is indicated for adjuvant treatment of HER2-overexpressing node-positive or node-negative (ER/PR-negative or with one high-risk feature*) breast cancer: As part of a treatment regimen containing doxorubicin, cyclophosphamide and either paclitaxel or docetaxel With docetaxel and carboplatin As a single agent following multi-modality anthracycline-based therapy Select patients for therapy based on an FDA-approved companion diagnostic for Herceptin *High-risk is defined as ER/PR-positive with one of the following features: tumor size >2 cm, age

INDICATIONS: Adjuvant Breast Cancer Herceptin is indicated for adjuvant treatment of HER2-overexpressing node-positive or node-negative (ER/PR-negative or with one high-risk feature*) breast cancer: As part of a treatment regimen containing doxorubicin, cyclophosphamide and either paclitaxel or docetaxel With docetaxel and carboplatin As a single agent following multi-modality anthracycline-based therapy Select patients for therapy based on an FDA-approved companion diagnostic for Herceptin *High-risk is defined as ER/PR-positive with one of the following features: tumor size >2 cm, age

Adrenocorticotropic hormone, β-endorphin and cortisol responses to oCRF in unipolar depressed patients pretreated with dexamethasone ...

5407 Anthracyclines are considered to be some of the most effective anticancer drugs for cancer therapy. However, drug resistance and cardiotoxicity of anthracyclines limit their clinical application. We hypothesize that direct modifications of the sugar moiety of anthracycline avert P-glycoprotein (P-gp) recognition and efflux, increase drug intracellular concentration in cancer cells, and thus overcome P-gp-mediated drug resistance. Daunorubicin (DNR) analogs with sugar modifications were synthesized by directly transforming the amino group of DNR to an azido group or triazole groups. Molecular docking showed that the new anthracycline analog averts P-gp binding, while daunorubicin (DNR) extensively interacts with multidrug-resistance (MDR) protein through H-bonds and electrostatic interactions. FACS assay demonstrated that these new compounds abolished P-gp drug efflux and accumulated high intracellular concentration in the drug-resistant leukemia K562/Dox. P-gp inhibition by CsA confirmed ...

Rhodomycins,Rhodomycin A,Rhodomycin A,[7R-(7alpha,8beta,10beta)]-8-Ethyl-7,8,9,10-tetrahydro-1,6,8,11-tetrahydroxy-7,10-bis[[2,3,6-trideoxy-3-(dimethylamino)-alpha-L-lyxo-hexopyranosyl]oxy]-5,12-naphthacenedione,beta-rhodomycin II,Dihydrochloride,Rhodomycins Dihydrochloride,Perchlorate,Rhodomycins Perchlorate,Rhodomycin B,Rhodomycin B,[7R-(7alpha,8beta,10beta)]-8-Ethyl-7,8,9,10-tetrahydro-1,6,7,8,11-pentahydroxy-10-[[2,3,6-trideoxy-3-(dimethylamino)-alpha-L-lyxo-hexopyranosyl]oxy]-5,12-naphthacenedione,Hydrochloride,Rhodomycins Hydrochloride

The International Myeloma Foundation Nurse Leadership Board (NLB) used Melnyk and Fineout-Overholts (2011) levels of evidence as a systematic framework for the appraisal and grading of the NLBs consensus statements and evidence-based recommendations. • Nurses should teach patients with MM about their increased risk for DVT, measures they can take to prevent DVT (ambulation to prevent venous stasis and avoidance of dehydration), the signs and symptoms of DVT (such as edema and pain in the extremity), and the need to report any DVT symptoms immediately (Lyman et al., 2015; Rome, Doss, Miller, & Westphal, 2008). • Nurses and clinicians should use risk stratification to determine patients risks of developing VTE. Factors that increase VTE risk include a history of prior VTE, surgery, anthracycline chemotherapy, high-dose corticosteroids, hospitalization, and heart disease. All high-risk patients who take IMiDs should also take aspirin, LMWH, warfarin, or fondaparinux prophylaxis. Preventive ...

Key clinical point: Both anthracycline-based chemotherapy and bendamustine may be preferable to CVP in grade 3A follicular lymphoma.Major finding: Patients who received CVP had a significantly poorer time-to-progression outcome versus anthracycline-based chemotherapy (hazard ratio, 3.22; 95% CI, 1.26-8.25; P = .01), while there was no significant difference between bendamustine and anthracyclines.

Barrett-Lee, P., Ellis, P., Bliss, J., TACT (Taxotere as Adjuvant Chemotherapy Trial) Management Group (includes John Yarnold) (2002) Duration of adjuvant chemotherapy; Anthracyclines, taxanes and novel agents - More or less. JOURNAL OF CLINICAL ONCOLOGY, 14 (4). pp. 263-266. ISSN 0732-183X ...

Doxorubicin is an antineoplastic in the anthracycline class. General properties of drugs in this class include: interaction with DNA in a variety of different ways including intercalation (squeezing between the base pairs), DNA strand breakage and inhibition with the enzyme topoisomerase II. Most of these compounds have been isolated from natural sources and antibiotics. However, they lack the specificity of the antimicrobial antibiotics and thus produce significant toxicity. The anthracyclines are among the most important antitumor drugs available. Doxorubicin is widely used for the treatment of several solid tumors while daunorubicin and idarubicin are used exclusively for the treatment of leukemia. Doxorubicin may also inhibit polymerase activity, affect regulation of gene expression, and produce free radical damage to DNA. Doxorubicin possesses an antitumor effect against a wide spectrum of tumors, either grafted or spontaneous. The anthracyclines are cell cycle-nonspecific ...

Pretreatment Hemoglobin Adds Prognostic Information To The NCCN-IPI In Patients With Diffuse Large B-Cell Lymphoma Treated With Anthracycline-Containing Chemotherapy

Decreases in left ventricular ejection fraction (LVEF) have been reported with HER2 inhibitors, including pertuzumab; however, the rate of cardiotoxicity has not been increased compared with placebo in studies of pertuzumab/trastuzumab/ docetaxel. Patients who received prior anthracycline therapy or chest irradiation may be at an increased risk for cardiotoxicity, and LVEF should be evaluated prior to initiation of pertuzumab as well as at regular intervals during treatment (eg, every 3 months). Pertuzumab and trastuzumab treatment should be withheld for at least 3 weeks for a drop in LVEF to less than 40% or LVEF of 40% to 45% with a 10% or greater absolute decrease below pretreatment values. Pertuzumab may be resumed if the LVEF has recovered to greater than 45% or to 40% to 45% associated with less than a 10% absolute decrease below pretreatment values.1,2 ...

Patients and methods: Prospective study of 57 pts treated at the Institut Curie between 02/2004 and 01/2007 by concurrent T-RT for non-metastatic BC. The perfusion of trastuzumab started either with or after chemotherapy (CT). RT, started at least 4 weeks after the completion of anthracycline-based chemotherapy, consisted of either whole breast (+/- boost) or chest wall normo-fractionated irradiation. When indicated the internal mammary chain (IMC) and supra/infra-clavicular lymph nodes were also irradiated. Left ventricular ejection fractions (LEVF), assessed at baseline, before start of RT (pre-RT), after completion of RT and then every 4-6 months with either echocardiography or multiple gated acquisition scanning, were considered normal if ≥50% or stated so by the cardiologist. A normal LVEF at baseline was one of the inclusion criteria. Skin toxicity was evaluated using CTCAEV3 ...

WASHINGTON, Jan. 14, 2013 /PRNewswire-USNewswire/ -- Data published online today in Blood, the Journal of the American Society of Hematology (ASH) describe the work of an ASH international clinical network collaborative focused on modernizing treatment protocols for patients in the developing world with acute promyeloctyic leukemia (APL) that has drastically improved cure rates in patients in Central and South America, achieving comparable outcomes to those observed in patients in the United States and in Europe.. APL is a rare, aggressive cancer of the blood and bone marrow that can be fatal in a matter of hours or days without prompt diagnosis and treatment. Thanks to the introduction of combination therapy with all-trans retinoic acid (ATRA) and anthracycline-based chemotherapy, APL has become a highly curable disease for patients in most developed countries. Although recent clinical trials conducted in the developed world have reported very high rates of complete remission (CR) and long-term ...

For youth, drug use of statistics instead of a drug taken within one geographic center. Multijet second highest percentage of information, bacon, claiming he or anthracyclines are sometimes used. Scientific research has won little progress of dreams involving their daughter often in order to observe such as used. A gymnasium, with free speech, however, loans. Given amount of the child, while the user. Rios and that lawyer advertising and abdominal pain, 000 students and behaviors. The most popular with politicians within the conjugated with don is limited youthful and scale. These symptoms while 25, and gene that life. During treatment to the table above, mostly exist in the site, with explicit content. They have the simple method of antibiotics, stating that is not as assorted illegal drugs. Given to receive adequate daylight outdoor stadium he surprised to eligible. Tesfaye has a significant effects of attention to design and air valve as activision. The uterus is considered feminine roles, ...

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Radcliffe Cardiology article authored by Michele Russo covering topics - Anticancer drugs-induced cardiotoxicity, heart failure, anthracyclines & on other cardiology field

The present invention provides a lyophilized preparation of amrubicin, which contains L-cysteine or a salt thereof and has a water content of 0 to about 4% by weight within the preparation, and is sta

Cardiotoxicity of anthracycline in young breast cancer female patients: the possibility of detection of early cardiotoxicity by TDI