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Best of JACC: Case Reports From ACC.23.

This dedicated issue of JACC: Case Reports highlights the top ranked Complex Clinical Cases from the ACC 2023 Scientific Sessions. These cases were reviewed and selected by a committee of peers in the months leading up to the annual meeting. These reviewers were ACC members with no affiliation to the JACC: Case Reports Editorial Board. While the cases were presented at the meeting and included in the formal Abstract Book from ACC, they have not been published elsewhere. These cases illustrate how the ACC can be a place for cardiovascular professionals to come together to learn, grow, and share

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… Heart Failure and Cardiomyopathies INTENTIONAL TAXUS BACCATA INGESTION PRESENTING WITH CARDIOGENIC SHOCK AND VENTRICULAR TACHYCARDIA Ramy Mando, Olivia Allen, Matthew Hanna, Richard Bloomingdale, Ilana B. Kutinsky, Michael J. Gallagher, David E. … Ingestion of Taxus baccata (English Yew) may lead to cardiotoxicity and death. Intoxication is known to be resistant to standard treatments with no effective antidotes. …

Natural bioactive molecules and chemotherapeutics synergism for enhanced cancer therapy.

BACKGROUND: Chemotherapy remains a foundation of cancer care but is limited by multidrug resistance, systemic toxicities, and suboptimal selectivity, prompting interest in adjunctive strategies that improve efficacy and tolerability without adding significant burden to patients or healthcare systems. AIMS/OBJECTIVES: This review highlights evidence on natural bioactive compounds, including polyphenols, alkaloids, terpenoids, and fungal metabolites, as adjuvants to standard chemotherapeutics, with objectives to: first, delineate mechanisms by which these agents enhance cytotoxic efficacy and o

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… Research by Dai et al. demonstrated the anticancer potential of Taxus chinensis var. mairei (TC) against lung cancer through both laboratory and animal studies. Their findings showed that TC’s aqueous extract effectively fought cancer by degrading CD47 while maintaining low toxicity [ 57 ]. … Paclitaxel, a complex drug containing a diterpene taxane ring structure, is extracted from the Western yew tree ( Taxus brevifolia ) and exhibits cytotoxic effects through a unique mechanism [ 114 ]. …

Beyond Formulation: Contributions of Nanotechnology for Translation of Anticancer Natural Products into New Drugs.

Nature is the largest pharmacy in the world. Doxorubicin (DOX) and paclitaxel (PTX) are two examples of natural-product-derived drugs employed as first-line treatment of various cancer types due to their broad mechanisms of action. These drugs are marketed as conventional and nanotechnology-based formulations, which is quite curious since the research and development (R&D) course of nanoformulations are even more expensive and prone to failure than the conventional ones. Nonetheless, nanosystems are cost-effective and represent both novel and safer dosage forms with fewer side effects due to m

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… This substance was part of a screening program from the United States National Cancer Institution (NCI) in the early 1960s, in which they searched for new anticancer natural products and, as a result, described the activity of the crude extract from the bark of the western yew Taxus brevifolia [ 11 ] … The isolation and structure of taxol, a novel antileukemic and antitumor agent from Taxus brevifolia. J. Am. Chem Soc. 1971;93:2325–2327. doi: 10.1021/ja00738a045. 12. Donehower R.C. …

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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… Furthermore, the Taxus genus produces taxane-derived drugs. In 1971, paclitaxel, which is known commercially as Taxol ® , was first isolated from Taxus brevifolia Nutt (Pacific yew). … During the 1980s, another semi-synthetic taxane drug called docetaxel (Taxotere ® ) was isolated from Taxus baccata (European yew). Recent developments in chemical modification have focused on podophyllotoxin analogs, particularly teniposide and etoposide, two semi-synthetic antitumor agents. …

A Narrative Review on the Antitumoral Effects of Selected Mediterranean Plant Products from Southern Italy.

Natural products are a valuable source of bioactive compounds with established roles in oncology. Their structural diversity and ability to target multiple cancer-related pathways make them promising candidates for anticancer drug development. Increasing preclinical and clinical data highlight their potential not only to exert direct antitumor effects but also to enhance patient tolerance to conventional therapies by reducing side effects and improving treatment adherence. The Mediterranean region, known for its biodiversity and traditional dietary habits, provides a rich array of natural comp

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… Phytochemicals have long served as a foundation in oncology drug development, exemplified by compounds like vinblastine, vincristine (from Camptotheca acuminata ), paclitaxel ( Taxus brevifolia) , camptothecin ( Camptotheca acuminata ), and etoposide ( Podophyllum peltatum ), all of which have been successfully … Isolation and structure of taxol, a novel antileukemic and antitumor agent from Taxus brevifolia. J. Am. Chem. Soc. 1971;93:2325–2327. doi: 10.1021/ja00738a045. 20. Trajkovska-Broach A., Trajkovska Petkoska A. …

Long-Term Effects, Pathophysiological Mechanisms, and Risk Factors of Chemotherapy-Induced Peripheral Neuropathies: A Comprehensive Literature Review.

Neurotoxic anticancer drugs, such as platinum-based anticancer drugs, taxanes, vinca alkaloids, and proteasome/angiogenesis inhibitors are responsible for chemotherapy-induced peripheral neuropathy (CIPN). The health consequences of CIPN remain worrying as it is associated with several comorbidities and affects a specific population of patients already impacted by cancer, a strong driver for declines in older adults. The purpose of this review is to present a comprehensive overview of the long-term effects of CIPN in cancer patients and survivors. Pathophysiological mechanisms and risk factors

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… GSTM1 (deletion) | EPHA5 | CEP72 | | cyclin H | FZD3 | | | BCRP | CYP2C8 | | | Na V channels | CYP3A5 ∗ 3 | | | | CYP3A4 ∗ 22 | | | | ABCB1 | | Demographic variables | Age | Age | Age (children) | – Taxanes Taxane diterpenoids were isolated from the bark of the Pacific yew tree ( Taxus … brevifolia and Taxus baccata for paclitaxel and docetaxel, respectively) ( Saloustros et al., 2008 ; Wani and Horwitz, 2014 ). …

Plants as a Source of Anticancer Agents: From Bench to Bedside.

Cancer is the second leading cause of death after cardiovascular diseases. Conventional anticancer therapies are associated with lack of selectivity and serious side effects. Cancer hallmarks are biological capabilities acquired by cancer cells during neoplastic transformation. Targeting multiple cancer hallmarks is a promising strategy to treat cancer. The diversity in chemical structure and the relatively low toxicity make plant-derived natural products a promising source for the development of new and more effective anticancer therapies that have the capacity to target multiple hallmarks in

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… In addition, taxane-derived drugs are isolated from the Taxus genus. Paclitaxel, which is commercially identified as Taxol ® , was firstly obtained in 1971 from Taxus brevifolia (Pacific yew). … In the 1980s, another taxane semi-synthetic drug was isolated from Taxus baccata (European yew) known as docetaxel (Taxotere ® ) [ 33 ]. …

Anticancer natural products from the Middle East and North Africa: biodiversity, mechanisms, and translational challenges.

Cancer remains one of the leading causes of morbidity and mortality worldwide, imposing substantial clinical, societal, and economic burdens. Despite major advances in surgical oncology, systemic chemotherapy, radiation therapy, molecularly targeted therapeutics, and immune checkpoint inhibition, contemporary cancer treatment remains constrained by dose-limiting toxicities, intratumoral and intertumoral heterogeneity, and the inexorable emergence of multifaceted drug resistance mechanisms. These persistent therapeutic challenges have reinstated interest in natural products (NPs) as evolutionar

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… Remarkably, many anticancer drugs currently in clinical use, such as paclitaxel, vincristine, etoposide, and doxorubicin are derived from natural sources ( Taxus brevifolia , Catharanthus roseus , podophyllotoxin , and Streptomyces species, respectively) ( 2 , 37 , 49 – 52 ). … Class of NP | Examples of NPs | Source | Mechanism of action | Target cancers | References Plant-Derived Compounds | Paclitaxel, Vincristine, Camptothecin, Curcumin | Taxus brevifolia, Catharanthus roseus, Curcuma longa | Paclitaxel and vincristine disrupt microtubules; camptothecin inhibits topoisomerase …

Plumbagin, a Biomolecule with (Anti)Osteoclastic Properties.

Plumbagin is a plant-derived naphthoquinone that is widely used in traditional Asian medicine due to its anti-inflammatory and anti-microbial properties. Additionally, plumbagin is cytotoxic for cancer cells due to its ability to trigger reactive oxygen species (ROS) formation and subsequent apoptosis. Since it was reported that plumbagin may inhibit the differentiation of bone resorbing osteoclasts in cancer-related models, we wanted to elucidate whether plumbagin interferes with cytokine-induced osteoclastogenesis. Using C57BL/6 mice, we unexpectedly found that plumbagin treatment enhanced o

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… Several phytochemicals show cytotoxicity against cancer cells and are already used clinically, i.e., taxol/paclitaxel from Taxus brevifolia that kills tumour cells by inducing multipolar divisions when the cell enters mitosis [ 5 ] or vincristine from Cantharantus roseus that was approved as the first …

Evolution of Cancer Pharmacological Treatments at the Turn of the Third Millennium.

The medical history of cancer began millennia ago. Historical findings of patients with cancer date back to ancient Egyptian and Greek civilizations, where this disease was predominantly treated with radical surgery and cautery that were often ineffective, leading to the death of patients. Over the centuries, important discoveries allowed to identify the biological and pathological features of tumors, without however contributing to the development of effective therapeutic approaches until the end of the 1800s, when the discovery of X-rays and their use for the treatment of tumors provided the

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… Five years later, in 1971, the same research group of Wall and Wani described the molecular structure of taxol, a natural compound with antimitotic properties extracted from the tree Taxus brevifolia (Pacific yew or western yew, Wani et al., 1971 ). However, only in 1979, Susan B. …

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices

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… The use of a cardiovascular MDHT was first applied in the SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) trial, in which a cardiac surgeon and interventional cardiologist were required to document clinical equipoise between coronary artery bypass graft surgery (CABG) and percutaneous coronary …

Liposomal Drug Delivery Systems and Anticancer Drugs.

Cancer is a life-threatening disease contributing to ~3.4 million deaths worldwide. There are various causes of cancer, such as smoking, being overweight or obese, intake of processed meat, radiation, family history, stress, environmental factors, and chance. The first-line treatment of cancer is the surgical removal of solid tumours, radiation therapy, and chemotherapy. The systemic administration of the free drug is considered to be the main clinical failure of chemotherapy in cancer treatment, as limited drug concentration reaches the tumour site. Most of the active pharmaceutical ingredien

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… PCX is a naturally occurring compound extracted from Taxus brevifolia [ 30 ]. PCX has an anticancer activity against several cancers including refractory ovarian, breast, non-small cell lung cancer, gastric cancer [ 112 ], head and neck tumours, urologic malignancies, and Kaposi’s sarcoma [ 113 ]. …

Recent trends in specialty pharma business model.

The recent rise of specialty pharma is attributed to its flexible, versatile, and open business model while the traditional big pharma is facing a challenging time with patent cliff, generic threat, and low research and development (R&D) productivity. These multinational pharmaceutical companies, facing a difficult time, have been systematically externalizing R&D and some even establish their own corporate venture capital so as to diversify with more shots on goal, with the hope of achieving a higher success rate in their compound pipeline. Biologics and clinical Phase II proof-of-concept (POC

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… Paclitaxel was discovered in 1962 as a result of NCI screening program [ 48 ]; Monroe Wall and Mansukh Wani isolated the drug from the bark of the Pacific yew, Taxus brevifolia , and named it “Taxol”. In 1977, Dr. …

An overview of arsenic trioxide-involved combined treatment algorithms for leukemia: basic concepts and clinical implications.

Arsenic trioxide is a first-line treatment drug for acute promyelocytic leukemia, which is also effective for other kinds of leukemia. Its side effects, however, limit its clinical application, especially for patients with complex leukemia symptoms. Combination therapy can effectively alleviate these problems. This review summarizes the research progress on the combination of arsenic trioxide with anticancer drugs, vitamin and vitamin analogs, plant products, and other kinds of drugs in the treatment of leukemia. Additionally, the new progress in arsenic trioxide-induced cardiotoxicity was sum

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… Paclitaxel, an ingredient from taxus chinensis, is one of the most prominent anticancer drugs. However, paclitaxel was not effective in refractory or relapsed acute lymphocytic leukemia (ALL) patients [ 22 ]. …

Anti-Cancer Research Progress of Triptolide: Mechanisms of Action, Structural Modifications, Nanodelivery Systems and Clinical Challenges.

Triptolide is a bioactive diterpenoid lactone from traditional Chinese medicine with notable anti-tumor, immunosuppressive, and anti-inflammatory properties. However, its clinical utility is hampered by poor solubility, a narrow therapeutic index, and multi-organ toxicity. In response, extensive efforts have been made to improve its efficacy and safety profile. This review critically examines recent progress in Triptolide research, covering its mechanisms of action, derivative design, drug delivery systems, and cancer-specific applications. It also evaluates its clinical potential against panc

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… apoptosis, and even reverse drug resistance by intervening in multiple signaling pathways, demonstrating good therapeutic potential.2–4 In this context, a series of drugs derived from natural products have been successfully developed and applied in clinical practice, such as paclitaxel extracted from Taxus …

An overview of randomized phase III clinical trials of cancer nanomedicines.

BackgroundCancer therapy has undergone significant advances in recent decades attributed to personalized medicine and targeted drug delivery. Among the promising approaches, the use of nano-based delivery systems has become a relevant approach capable of improving treatment by releasing antineoplastic drugs at the target site, improving therapeutic efficacy, minimizing cytotoxicity in healthy tissues, and ultimately, reducing the intensity of adverse effects of chemotherapy. This study prospectively evaluated the impact of formulating anti-neoplastic drugs as nanomedicines on clinical response

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… Its precursor is isolated from Taxus brevifolia , i.e., the bark of the Pacific yew tree, which is used to treat several types of cancer. Its mechanism of action is based on the stabilization of microtubules, preventing cell proliferation in metaphase/anaphase. …

Targeting Autophagy with Natural Products as a Potential Therapeutic Approach for Cancer.

Macro-autophagy (autophagy) is a highly conserved eukaryotic intracellular process of self-digestion caused by lysosomes on demand, which is upregulated as a survival strategy upon exposure to various stressors, such as metabolic insults, cytotoxic drugs, and alcohol abuse. Paradoxically, autophagy dysfunction also contributes to cancer and aging. It is well known that regulating autophagy by targeting specific regulatory molecules in its machinery can modulate multiple disease processes. Therefore, autophagy represents a significant pharmacological target for drug development and therapeutic

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… Mallotus philippinensis | Inhibition of mTOR signaling and AMPK induction | Tapeworm, scabies and herpetic ringworm | A wide range of human cancers | Protein kinase C-δ inhibitor [ 137 , 138 , 139 ] Nucleation | Paclitaxel | | Polyoxygenated taxane class diterpenoid | Stem bark of the Pacific yew tree ( Taxus … brevifolia Nutt), bark of Pacific Taxus chinensis | Increase LC3-II, ATG5 and Beclin1 levels | FDA-approved for metastatic ovarian cancer | Lung-, ovarian- and breast cancers | Inhibition of autophagy in MCF-7 and SK-BR-3 breast cancer cells [ 60 , 140 , 141 ] Initiation, nucleation | γ -Tocotrienol …

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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… Vincristine and Vinblastine (vinca alkaloids extracted from Catharanthus roseus and Apocynaceae ), Paclitaxel (diterpenoid compound derived from Taxus brevifolia ), Etoposide (semisynthetic podophyllotoxin extracted from Podophyllum peltatum ), and Camptothecin (alkaloid derived from Camptotheca acuminata …

Curcumin Nanoparticles as Promising Therapeutic Agents for Drug Targets.

Curcuma longa is very well-known medicinal plant not only in the Asian hemisphere but also known across the globe for its therapeutic and medicinal benefits. The active moiety of Curcuma longa is curcumin and has gained importance in various treatments of various disorders such as antibacterial, antiprotozoal, cancer, obesity, diabetics and wound healing applications. Several techniques had been exploited as reported by researchers for increasing the therapeutic potential and its pharmacological activity. Here, the dictum is the new room for the development of physicochemical, as well as biolo

Efficacy of Polymer-Based Nanocarriers for Co-Delivery of Curcumin and Selected Anticancer Drugs.

Cancer remains a heavy health burden resulting in a high rate of mortality around the world. The presently used anticancer drugs suffer from several shortcomings, such as drug toxicity, poor biodegradability and bioavailability, and poor water solubility and drug resistance. Cancer is treated effectively by combination therapy whereby two or more anticancer drugs are employed. Most of the combination chemotherapies result in a synergistic effect and overcome drug resistance. Furthermore, the design of polymer-based nanocarriers for combination therapy has been reported by several researchers t

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… Curcumin in Cancer Therapy Numerous chemotherapeutics with various mechanisms of action have been extracted from plant sources, such as Catharanthus roseus , Taxus brevifolia, Betula alba , Curcuma longa , Erythroxylum previllei , and Cephalotaxus species, and Curcuma longa L , (where curcumin is isolated …