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The Onco-Nephrology Field: The Role of Personalized Chemotherapy to Prevent Kidney Damage.

In recent years, the onco-nephrology field has acquired a relevant role in internal medicine due to the growing number of cases of renal dysfunction that have been observed in cancer patients. This clinical complication can be induced by the tumor itself (for example, due to obstructive phenomena affecting the excretory tract or by neoplastic dissemination) or by chemotherapy, as it is potentially nephrotoxic. Kidney damage can manifest as acute kidney injury or represent a worsening of pre-existing chronic kidney disease. In cancer patients, physicians should try to set preventive strategies

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… The novel chemotherapeutic agents, namely vascular endothelial grow factor (VEGF) inhibitors (such as bevacizumab and sunitinib) or antimetabolites (such as gemcitabine) might cause kidney injury due to the development of TMA. In particular, VEGF-target treatment can induce proteinuria and AH. …

Therapeutic drug monitoring for cytotoxic anticancer drugs: Principles and evidence-based practices.

Cytotoxic drugs are highly efficacious and also have low therapeutic index. A great degree of caution needs to be exercised in their usage. To optimize the efficacy these drugs need to be given at maximum tolerated dose which leads to significant amount of toxicity to the patient. The fine balance between efficacy and safety is the key to the success of cytotoxic chemotherapeutics. However, it is possibly more rewarding to obtain that balance for this class drugs as the frequency of drug related toxicities are higher compared to the other therapeutic class and are potentially life threatening

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… Imatinib, sunitinib and pazopanib: From flat-fixed dosing towards a pharmacokinetically guided personalized dose . Br J Clin Pharmacol ( 2020 ) 86 ( 2 ): 258–73 . doi: 10.1111/bcp.14185 PMC7015742 31782166 5 Bleyzac N Souillet G Magron P Janoly A Martin P Bertrand Y . …

Learn from antibody-drug conjugates: consideration in the future construction of peptide-drug conjugates for cancer therapy.

Cancer is one of the leading causes of death worldwide due to high heterogeneity. Although chemotherapy remains the mainstay of cancer therapy, non-selective toxicity and drug resistance of mono-chemotherapy incur broad criticisms. Subsequently, various combination strategies have been developed to improve clinical efficacy, also known as cocktail therapy. However, conventional "cocktail administration" is just passable, due to the potential toxicities to normal tissues and unsatisfactory synergistic effects, especially for the combined drugs with different pharmacokinetic properties. The drug

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… Park KY Kim J Cyclic pentapeptide cRGDfK enhances the inhibitory effect of sunitinib on TGF-β1-induced epithelial-to-mesenchymal transition in human non-small cell lung cancer cells PLoS ONE 2020 15 8 e0232917 32810161 10.1371/journal.pone.0232917 PMC7433881 79. …

Application of Artificial Intelligence Methods for Imaging of Spinal Metastasis.

Spinal metastasis is the most common malignant disease of the spine. Recently, major advances in machine learning and artificial intelligence technology have led to their increased use in oncological imaging. The purpose of this study is to review and summarise the present evidence for artificial intelligence applications in the detection, classification and management of spinal metastasis, along with their potential integration into clinical practice. A systematic, detailed search of the main electronic medical databases was undertaken in concordance with the PRISMA guidelines. A total of 30

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… Metastatic Tumor Burden and Loci as Predictors of First Line Sunitinib Treatment Efficacy in Patients with Renal Cell Carcinoma Sci. Rep. 2019 9 7754 10.1038/s41598-019-44226-y 31123336 PMC6533291 131. Saxena S. Jena B. Gupta N. Das S. Sarmah D. Bhattacharya P. Nath T. Paul S. Fouda M.M. Kalra M. …

The Ups and Downs of STAT Inhibition in Acute Myeloid Leukemia.

Aberrant Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling is implicated in the pathogenesis of acute myeloid leukemia (AML), a highly heterogeneous hematopoietic malignancy. The management of AML is complex and despite impressive efforts into better understanding its underlying molecular mechanisms, survival rates in the elderly have not shown a substantial improvement over the past decades. This is particularly due to the heterogeneity of AML and the need for personalized approaches. Due to the crucial role of the deregulated JAK-STAT signaling in AML, select

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… Pacritinib not only effectively inhibits the growth of many FLT3 -ITD+ AML cell lines, but combined inhibition of JAK2 and FLT3 also overcomes the resistance towards FLT3 inhibitors (e.g., Sunitinib), which is often associated with overactivation of the JAK-STAT pathway [ 137 ]. …

New Progress in Improving the Delivery Methods of Bisphosphonates in the Treatment of Bone Tumors.

Bone tumors are tumors that occur in the bone or its accessory tissues, including primary tumors and metastatic tumors. The main mechanism of bisphosphonate is to inhibit the resorption of destructive bone, inhibit the activity of osteoclasts and reduce the concentration of blood calcium. Therefore, bisphosphonates can be used for malignant hypercalcaemia, pain caused by osteolytic bone metastasis, prevention of osteolytic bone metastasis, multiple myeloma osteopathy, improving radiosensitivity and so on. However, the traditional administration of bisphosphonates can cause a series of adverse

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… Bisphosphonates combined with sunitinib may improve the response rate, progression free survival and overall survival of patients with bone metastases from renal cell carcinoma. Eur J Cancer . 2012;48(7):1031–1037. doi: 10.1016/j.ejca.2012.02.050 9. Menshawy A, Mattar O, Abdulkarim A, et al. …

A Comprehensive Biological and Clinical Perspective Can Drive a Patient-Tailored Approach to Multiple Myeloma: Bridging the Gaps between the Plasma Cell and the Neoplastic Niche.

There is a broad spectrum of diseases labeled as multiple myeloma (MM). This is due not only to the composite prognostic risk factors leading to different clinical outcomes and responses to treatments but also to the composite tumor microenvironment that is involved in a vicious cycle with the MM plasma cells. New therapeutic strategies have improved MM patients' chances of survival. Nevertheless, certain patients' subgroups have a particularly unfavorable prognosis. Biological stratification can be subdivided into patient, disease, or therapy-related factors. Alternatively, the biological sig

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… Targets | Therapeutic agents Angiogenesis | (1) IMiDs (thalidomide ∗ , lenalidomide ∗ ) (2) Anti-VEGF Ab (bevacizumab) (3) Tyrosine kinase inhibitor against VEGF (sunitinib) Hypoxia | (1) Evofosfamide investigational hypoxia-activated prodrug Stromal cells | (1) CXCR4 inhibitors (plerixafor) (2) Anti-CXCR4 …

Metastatic bone disease: Pathogenesis and therapeutic options: Up-date on bone metastasis management.

Bone metastases (BM) are a common complication of cancer, whose management often requires a multidisciplinary approach. Despite the recent therapeutic advances, patients with BM may still experience skeletal-related events and symptomatic skeletal events, with detrimental impact on quality of life and survival. A deeper knowledge of the mechanisms underlying the onset of lytic and sclerotic BM has been acquired in the last decades, leading to the development of bone-targeting agents (BTA), mainly represented by anti-resorptive drugs and bone-seeking radiopharmaceuticals. Recent pre-clinical an

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… Thus, VEGFR targeting by TKIs has been attempted, although preliminary studies with sunitinib and sorafenib were unsatisfactory [2] . …

ESMO / ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2016.

The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) thanks to contribution of 64 ESMO-appointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to p

Analysis of medical malpractice liability disputes related to novel antineoplastic drugs and research on risk prevention and control strategies.

OBJECTIVE: To investigate the general characteristics of litigation cases of medical malpractice liability disputes (MMLDs) related to novel antineoplastic drugs (NADs), the drugs involved, as well as the common types of medical errors related to NADs and their damages in the process of diagnosis and treatment, with the aims of improving the level of rational medication use in the clinical application of NADs and actively prevent medical disputes. METHODS: The China Judgments Online was searched for the cause of action using the key word "MMLDs" along with the name of 77 kinds of NADs. A tota

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… VEGFR/FGFR/PDGFR/KIT); Apatinib * (VEGFR2/STAT3/PD-L1 /ROS/Nrf2/p62); Avapritinib (PDGFRA/KIT); Axitinib (VEGFR/PDGFR/KIT); Donafenib; Fruquintinib (VEGFR); Lapatinib (EGFR/ErbB2/HER2); Lenvatinib (VEGFR/FGFR/PDGFR/KIT/RET); Pezopanib * (VEGFR/PDGFR/FGDR/KIT); Sorafenib * (VEGFR/PDGFR/C-RAF/B-RAF); Sunitinib …

The "Magic Bullet" Is Here? Cell-Based Immunotherapies for Hematological Malignancies in the Twilight of the Chemotherapy Era.

Despite the introduction of a plethora of different anti-neoplastic approaches including standard chemotherapy, molecularly targeted small-molecule inhibitors, monoclonal antibodies, and finally hematopoietic stem cell transplantation (HSCT), there is still a need for novel therapeutic options with the potential to cure hematological malignancies. Although nowadays HSCT already offers a curative effect, its implementation is largely limited by the age and frailty of the patient. Moreover, its efficacy in combating the malignancy with graft-versus-tumor effect frequently coexists with undesirab

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… Such a phenomenon has been observed for lenalidomide, bortezomib, GSK3 inhibitors, and tyrosine kinase inhibitors (e.g., imatinib, sunitinib, sorafenib) [ 175 , 176 ]. For instance, lenalidomide lowers the NK cell activation threshold and enhances IFN-γ production [ 177 ]. 3.2. …

Primary Thromboprophylaxis in Patients with Malignancies: Daily Practice Recommendations by the Hemostasis Working Party of the German Society of Hematology and Medical Oncology (DGHO), the Society of Thrombosis and Hemostasis Research (GTH), and the Austrian Society of Hematology and Oncology (ÖGHO).

Patients with cancer, both hematologic and solid malignancies, are at increased risk for thrombosis and thromboembolism. In addition to general risk factors such as immobility and major surgery, shared by non-cancer patients, cancer patients are exposed to specific thrombotic risk factors. These include, among other factors, cancer-induced hypercoagulation, and chemotherapy-mediated endothelial dysfunction as well as tumor-cell-derived microparticles. After an episode of thrombosis in a cancer patient, secondary thromboprophylaxis to prevent recurrent thromboembolism has long been established

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… Drug-specific risk factors for bleeding: tumor-specific treatment (i.e., BTK inhibitor—ibrutinib or inhibitors of VEGFR-associated tyrosine kinases i.e., axitinib, cabozantinib, lenvatinib, nintedanib, pazopanib, regorafenib, sorafenib, sunitinib, tivozanib or vandetanib) and/or concomitant pain medication …

Natural Products as Anticancer Agents: Current Status and Future Perspectives.

Natural products have been an invaluable and useful source of anticancer agents over the years. Several compounds have been synthesized from natural products by modifying their structures or by using naturally occurring compounds as building blocks in the synthesis of these compounds for various purposes in different fields, such as biology, medicine, and engineering. Multiple modern and costly treatments have been applied to combat cancer and limit its lethality, but the results are not significantly refreshing. Natural products, which are a significant source of new therapeutic drugs, are cu

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… Angiogenesis is inhibited by bevacizumab, sunitinib, and sorafenib [ 16 ]. The treatment of cancer has been greatly improved by the development of many drugs, but the disease is still an evolutionary process. Cancer cells are capable of adapting to a given drug treatment. … Over the decades, the Food and Drug Administration (FDA) has approved about 300 chemotherapeutic drugs for the treatment of cancer, including taxol, vinca and its derivatives, Platinium analogues, 5-fluorouracil, bevacizumab, erlotinib, nivolumab, ipilimumab, sunitinib, and olaparib, with other different …

When Cancer Clots: An Extensive Radiologic Analysis of Cancer-Associated Thromboembolism.

Cancer-associated thrombosis (CAT) is a leading cause of morbidity and mortality in patients with malignancy, yet its imaging manifestations extend far beyond the conventional diagnosis of deep vein thrombosis and pulmonary embolism. This comprehensive review examines the full spectrum of CAT as encountered by radiologists, from routine venous thromboembolism to unusual-site thromboses, arterial thromboembolic events, catheter-related complications, and endovascular management strategies. Patients with cancer face a four- to seven-fold increased risk of venous thromboembolism compared with the

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… VEGF pathway inhibitors, including bevacizumab, sunitinib, and lenvatinib, are associated with posterior reversible encephalopathy syndrome (PRES) in addition to arterial thrombotic events. …

Primary hyperhidrosis: an updated review.

BACKGROUND: Hyperhidrosis (HH) is a condition characterized by excessive sweating beyond the physiological needs of thermoregulation. HH can be classified as primary (idiopathic) hyperhidrosis (PHH) or secondary hyperhidrosis (SHH), which is associated with underlying medical conditions, medications or systemic disorders. This narrative review provides an updated overview of PHH, with a focus on epidemiology, aetiopathogenesis, clinical manifestations, diagnostic approaches and current management strategies, particularly highlighting pharmacological and procedural treatment options. METHODS:

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… selective serotonin reuptake inhibitors, tricyclic antidepressants, antiglaucoma eye drops, bladder stimulants, sialogogues, β-adrenergic receptor agonists, calcineurin inhibitors, TNF inhibitors, antiandrogens, gonadotropin-releasing hormone agonists, aromatase inhibitors, oral contraceptives, ixekizumab, sunitinib …

In vitro models of breast cancer bone metastasis: analyzing drug resistance through the lens of the microenvironment.

Even though breast cancers usually have a good outcome compared to other tumors, the cancer can progress and create metastases in different parts of the organism, the bone being a predilection locus. These metastases are usually the cause of death, as they are mostly resistant to treatments. This resistance can be caused by intrinsic properties of the tumor, such as its heterogeneity, but it can also be due to the protective role of the microenvironment. By activating signaling pathways protecting cancer cells when exposed to chemotherapy, contributing to their ability to reach dormancy, or ev

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… Osteoblasts | Decreased sensitivity to endocrine therapy due to loss of ER expression | IL-6/STAT3 direct cell-cell contact: gap junctions and Ca2+ signalling FGF2 & PDGF-DD induces EZH2-mediated reprogramming impacting Wnt and Notch TNFα/TNR1 MCP1/CCR2 (PI3K/Akt/mTor cascade) | Tocilizumab (anti-IL-R6 Ab) Sunitinib …

Intracellular Pathways and Mechanisms of Colored Secondary Metabolites in Cancer Therapy.

Despite the great advancements made in cancer treatment, there are still many unsatisfied aspects, such as the wide palette of side effects and the drug resistance. There is an obvious increasing scientific attention towards nature and what it can offer the human race. Natural products can be used to treat many diseases, of which some plant products are currently used to treat cancer. Plants produce secondary metabolites for their signaling mechanisms and natural defense. A variety of plant-derived products have shown promising anticancer properties in vitro and in vivo. Rather than recreating

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… A Phase I/II trial is ongoing regarding isoquercetin as an adjunct therapy in combination with Sunitinib in kidney cancer patients [ 171 ]. …

Osteoporosis in Childhood Cancer Survivors: Physiopathology, Prevention, Therapy and Future Perspectives.

The improvement of chemotherapy, radiotherapy, and surgical interventions, together with hematopoietic stem cell transplantation, increased childhood cancer survival rate in the last decades, reaching 80% in Europe. Nevertheless, anti-cancer treatments are mainly responsible for the onset of long-term side effects in childhood cancer survivors (CCS), including alterations of the endocrine system function and activity. In particular, the most frequent dysfunction in CCS is a metabolic bone disorder characterized by low bone mineral density (BMD) with increased skeletal fragility. BMD loss is al

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… Chemotherapeutic Drugs and Mitochondrial Dysfunction: Focus on Doxorubicin, Trastuzumab, and Sunitinib Oxid. Med. Cell. Longev. 2018 2018 7582730 10.1155/2018/7582730 29743983 PMC5878876 11. Varricchi G. Ameri P. Cadeddu C. Ghigo A. Madonna R. Marone G. Mercurio V. Monte I. Novo G. Parrella P. …

Inequity in Cardio-Oncology: Identifying Disparities in Cardiotoxicity and Links to Cardiac and Cancer Outcomes.

Minority and underresourced communities experience disproportionately high rates of fatal cancer and cardiovascular disease. The intersection of these disparities within the multidisciplinary field of cardio-oncology is in critical need of examination, given the risk of perpetuating health inequities in the growing vulnerable population of patients with cancer and cardiovascular disease. This review identifies 13 cohort studies and 2 meta-analyses investigating disparate outcomes in treatment-associated cardiotoxicity and situates these data within the context of oncologic disparities, preexis

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… common), ventricular dysfunction † (common) Axicabtagene ciloleucel Tyrosine kinase inhibitors Imatinib | Heart failure (rare), arrhythmias (rare) Dasatinib | Heart failure (common), pulmonary hypertension (rare) Nilotinib | Heart failure, myocardial ischemia (common), QT prolongation (intermediate) Sunitinib …

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis.

BACKGROUND: Chemoradiotherapy-associated mucositis can manifest as pain, inflammation, dysphagia, diarrhea, weight loss, rectal bleeding, and infection. Mucositis is a major dose-limiting side effect of chemotherapy, affecting nutritional intake and oral and intestinal function. Despite several interventions being available, there is a need for safe and effective preventative and treatment options for treatment-induced mucositis. The goals of this review are to discuss interventions based on foods and natural products and present the research to date. METHODS: A narrative literature review id

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… treatment-induced gastrointestinal toxicity in CRC has been posited to likely increase with the introduction of novel drugs and the use of more intense combination regimens of polychemotherapy combined with monoclonal antibodies. 6 , 10 Targeted therapies, including erlotinib, gefitinib, lapatinib, sorafenib, and sunitinib …