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Repurposing nirogacestat, a gamma secretase enzyme inhibitor in desmoid tumors.

The gamma secretase (GS) enzyme controls cell-cell adhesion, neural stem cell proliferation, neo-angiogenesis, spinal maturation, and metabolism of amyloid precursor proteins (APP). Pathological production of abnormal amyloid-beta isoforms and senile plaques serves as the basis for pathogenesis of Alzheimer's disease (AD). GS enzyme inhibitors such as semagacestat and avagacestat were explored in AD but the studies were paused because of adverse events attributed to their influence on the Notch pathway.Crosstalk between Notch and Wnt signaling pathways created a potential role for GS inhibitor

Olanzapine versus aprepitant for the prophylaxis of chemotherapy-induced nausea and vomiting in breast cancer patients receiving doxorubicin-cyclophosphamide regimen: A prospective, nonrandomized, open-label study.

OBJECTIVE: Despite the guideline-directed therapy, complete absence of nausea was noted only in 33% of breast cancer patients on anthracycline-cyclophosphamide regimen. Hence, we sought to compare the efficacy of aprepitant (APT) versus olanzapine (OLP) in preventing chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients on doxorubicin-cyclophosphamide regimen. PATIENTS AND METHODS: A prospective, open-label, nonrandomized study was conducted at the Department of Oncology. Eighty-three patients completed the study with 43 in the APT group and 40 in OLP group. Data about nau

Antibodies to watch in 2020.

This 2020 installment of the annual 'Antibodies to Watch' series documents the antibody therapeutics approved in 2019 and in regulatory review in the United States or European Union, as well as those in late-stage clinical studies, as of November 2019*. At this time, a total of 5 novel antibody therapeutics (romosozumab, risankizumab, polatuzumab vedotin, brolucizumab, and crizanlizumab) had been granted a first approval in either the US or EU, and marketing applications for 13 novel antibody therapeutics (eptinezumab, teprotumumab, enfortumab vedotin, isatuximab, [fam-]trastuzumab deruxtecan,

Assessment and Treatment Outcomes of Pain in Cancer Patients Undergoing Chemotherapy - A Tertiary Care Centre Experience.

ObjectivesPain is a prevalent and debilitating symptom in cancer patients, significantly affecting their quality of life. This study aimed to evaluate pain severity, its management and associated factors in patients undergoing chemotherapy in a tertiary care centre.Materials and methodsA single-centre observational study was conducted at the Department of Medical Oncology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India, from January 2024 to June 2024. One hundred and four chemotherapy patients were assessed using the numerical rating scale to evaluate pain severity. D

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… This underscores the role of emotional, which includes breakthrough pain [ 20 ] and psychological support in enhancing treatment efficacy, as unmanaged pain can lead to increased distress, anxiety and reduced quality of life. …

Surgical techniques for patients with cancer-related neuropathic pain.

In this manuscript, we discuss the use of neuromodulatory techniques such as intrathecal therapy (IT) and spinal cord stimulation (SCS) for cancer pain in neuro-oncology patients. Currently, cancer pain management relies on oral opioids, which have a number of systemic side effects particularly in a chronic setting. An escalation of pain therapy for pain relief, such as neuromodulation, is necessary to improve neuro-oncology patients' quality of life. The paper highlights the need for more comprehensive pain management for patients during and after receiving cancer therapies. IT allows analges

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… IT systems are useful for patients with complicated analgesic regimens or progressive diseases that may require dose escalation over time. 3 , 7 The pumps can be programmed so that a bolus dose for breakthrough pain can be administered as needed. 11 IDDS implantation is an outpatient procedure. … pain more successfully than morphine. 25 Fentanyl and sufentanil use is more speculative. …

The Burden of Metastatic Cancer-Induced Bone Pain: A Narrative Review.

Bone pain is one of the most common forms of pain reported by cancer patients with metastatic disease. We conducted a review of oncology literature to further understand the epidemiology of and treatment approaches for metastatic cancer-induced bone pain and the effect of treatment of painful bone metastases on the patient's quality of life. Two-thirds of patients with advanced, metastatic, or terminal cancer worldwide experience pain. Cancer pain due to bone metastases is the most common form of pain in patients with advanced disease and has been shown to significantly reduce patients' qualit

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… Incident pain can be managed by increasing the opioid dose above that which is effective for controlling pain at rest. 11 Breakthrough pain is often unpredictable, sudden in onset (< 5 minutes from start of pain escalation until maximum pain), of short duration (often < 15 minutes), and particularly … A comprehensive review of rapid-onset opioids for breakthrough pain. CNS Drugs . 2012;26(6):509–535. doi: 10.2165/11630580-000000000-00000 15. Dómine Gómez M, Díaz Fernández N, Cantos Sánchez de Ibargüen B, et al. …

Palliative patients who may benefit from intranasal delivery of symptomatic drugs: a two-center observational study evaluated the administration of morphine and dexamethasone in Polish hospices.

IntroductionPatients receiving hospice care at the end of life often suffer from a variety of ailments. They may need medication to alleviate symptoms for the rest of their lives. The most common and recommended way to take opioids and steroids is orally. Less frequently, the subcutaneous or intravenous routes are used. The intranasal route is a relatively uncommon but interesting alternative for administering drugs.AimThe study aims to identify hospice patients who may benefit from changing the standard opioid and steroid administration route to intranasal delivery.Material and methodsThe ele

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… This drug, administered intranasally or transmucosal, has proven efficacy in relieving breakthrough pain associated with cancer. It continues to be researched for the treatment of dyspnea in palliative patients [ 27 ]. … Jamieson L, Harrop E, Johnson M et al (2021) Healthcare professionals’ views of the use of oral morphine and transmucosal diamorphine in the management of paediatric breakthrough pain and the feasibility of a randomised controlled trial: a focus group study (DIPPER). …

The burden of illness in patients with paroxysmal nocturnal hemoglobinuria receiving treatment with the C5-inhibitors eculizumab or ravulizumab: results from a US patient survey.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and life-threatening disease with symptoms of hemolysis and thrombosis. Current therapies for this complement-mediated disease rely predominantly on inhibition of the C5 complement protein. However, data on treatment responses and quality of life in C5-inhibitor (C5i)-treated PNH patients are scarce. The objective of this study was to determine C5i treatment effects on clinical parameters, PNH symptoms, quality of life, and resource use for PNH patients. This cross-sectional study surveyed 122 individuals in the USA receiving treatment for PN

Pain Experience in Oncology: A Targeted Literature Review and Development of a Novel Patient-Centric Conceptual Model.

Background and objectiveTypical endpoints in cancer clinical trials focus on standardized efficacy endpoints, such as overall survival. Pain is not always assessed, although it is a highly prevalent and distressing aspect of patients' cancer experience and plays a critical role in health-related quality of life. To inform future pain measurement strategies in oncology, this targeted literature review of pain-related qualitative publications in oncology aimed to characterize and explore the patient experience of pain, and its impact on how patients feel and function.MethodsA review of publicati

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… For some patients, pain impacted their physical ability and motivation to leave their bed [ 25 , 27 , 41 ], or caused significant restrictions on basic movement and left them immobile during episodes of severe or breakthrough pain [ 31 , 41 , 43 ]. … Breakthrough pain: A qualitative study of patients with advanced cancer in Northwest China Pain Manag. Nurs. 2018 19 506 515 10.1016/j.pmn.2017.11.006 29506898 31. Maly A. Singh N. Vallerand A.H. Experiences of urban African Americans with cancer pain Pain Manag. …

Acupuncture treatment for bortezomib-induced peripheral neuropathy: a case report.

Peripheral neuropathy is a common and severe dose-limiting side effect of the chemotherapy agent, bortezomib, in multiple myeloma patients. Treatment with narcotics, antidepressants, and anticonvulsants has limited response and potential significant side effects. Acupuncture has been reported to be effective in treating diabetic neuropathy and chemo-induced peripheral neuropathy. There has not been report on the effect of acupuncture in treating bortezomib-induced peripheral neuropathy specifically. Here, we report a successful case of using acupuncture to relieve bortezomib-induced peripheral

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… He was given morphine sulphate (MS) contin 15 mg PO twice daily with oxycodone 5 mg PO every 4 to 6 hours for breakthrough pain with no significant improvement. Pregabalin 75 mg PO twice daily was added without significant pain relief. … His use of breakthrough pain medication (oxycodone) decreased from 20 to 30 mg daily to 5 to 10 mg daily. He no longer had difficulty walking and standing. …

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling.

BackgroundCancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be prevented with improved prevention measures.ObjectivesTo evaluate the incidence and causes of ED visits by cancer patients and evaluate outcomes and disposition of ED visits.MethodsThis single-center, retrospective chart review was conducted in a tertiary medical hospital. We collected data using an electronic medical record and included oncology patients with activ

COVID-19 vaccination prevents a more severe course and treatment with complement inhibitors reduce worsening hemolysis during the Omicron pandemic in patients with PNH: a single-center study.

ObjectiveParoxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disease characterized by chronic complement-mediated hemolysis. The concentrated outbreak of coronavirus disease 2019 (COVID-19) in China after 6 December 2022, provided an opportunity to observe the disease course of PNH during an active Omicron infection epidemic.Patients and methodPatients diagnosed with PNH at Peking Union Medical College Hospital (PUMCH) before 6 December 2022, were followed up until 10 April 2023. Clinical data related to coronavirus infection and hemolysis were recorded. Factors influencing the infect

Navigating Trichosporon Asahii Infections in Pediatric Leukemia: First Reported Case in Central and Eastern Europe Case Report and Literature Review.

Invasive fungal infections pose significant challenges in the management of immunocompromised patients, particularly those undergoing treatment for hematologic malignancies. Trichosporon asahii is a rare but severe cause of invasive trichosporonosis, associated with mortality rates. Effective management is complicated by its resistance to echinocandins and reduced susceptibility to polyenes, necessitating azole-based therapy. This paper aims to illustrate the diagnostic challenges associated with Trichosporon infections, analyze the complexities of treatment, review and synthesize known risk f

Antibodies to watch in 2018.

The pace of antibody therapeutics development accelerated in 2017, and this faster pace is projected to continue through 2018. Notably, the annual number of antibody therapeutics granted a first approval in either the European Union (EU) or United States (US) reached double-digits (total of 10) for the first time in 2017. The 10 antibodies granted approvals are: brodalumab, dupilumab, sarilumab, guselkumab, benralizumab, ocrelizumab, inotuzumab ozogamicin, avelumab, duvalumab, and emicizumab. Brodalumab, however, had already been approved in Japan in 2016. As of December 1, 2017, nine antibody

Acupuncture for post-chemoradiotherapy complications in lung cancer with bone metastasis: a case report and literature review.

Despite significant advances in oncologic therapeutics, chemoradiotherapy-induced complications, including chemotherapy-induced peripheral neuropathy (CIPN) and hip dysfunction, remain clinically challenging to manage with pharmacological interventions alone. This report presents the case of a 52-year-old male with a history of right-sided lung cancer resection performed more than three years previously and confirmed bone metastasis for over two years. Following metastasis to the right ilium and acetabulum, the patient developed pain, numbness, gait disturbance, and impaired mobility in the ri

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… . | The breakthrough pain disappeared completely. ( 30 ) | 78/F | Breast Cancer with C4-TH1 Vertebral Metastases and Spinal Cord Compression | Neuropathic pain persists, with frequent episodes of breakthrough pain. | Based on the ganglionic segment principle (corresponding to the spinal cord segments … Acupuncture has been frequently reported to alleviate neuropathic pain, including breakthrough pain and CIPN. …

Tapentadol: A Review of Experimental Pharmacology Studies, Clinical Trials, and Recent Findings.

Tapentadol is an analgesic compound that acts centrally to attenuate pain. Previous studies have shown that tapentadol has dual mechanisms of action as a mu-opioid receptor agonist and noradrenaline re-uptake inhibition. Therefore, tapentadol provides a great advantage over classic opioids in pain management from nociceptive to neuropathic. Cumulative evidence from in vitro data suggests that tapentadol effect of norepinephrine re-uptake could be a new target that overcomes other classic opioids in chronic neuropathic pain. Compared to tramadol and other opioids, tapentadol is associated with

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… Breakthrough pain: definition and management . Oncology . 1989 ; 3 ( 8 Suppl ): 25 – 29 . 2484297 42. Portenoy RK , Hagen NA . Breakthrough pain: definition, prevalence and characteristics . Pain . 1990 ; 41 ( 3 ): 273 – 281 . doi: 10.1016/0304-3959(90)90004-W 1697056 43. Davies AN . … Cancer-related breakthrough pain . Br J Hosp Med . 2006 ; 67 ( 8 ): 414 – 416 . doi: 10.12968/hmed.2006.67.8.21960 16918095 44. Greco MT , Corli O , Montanari M , et al. …

2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting.

PURPOSE: This review is an update of the MASCC/ESMO 2015 recommendations for the prophylaxis of acute and delayed nausea and vomiting induced by multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting. METHODS: A systematic literature search was conducted using PubMed from June 1, 2015, through February 1, 2023. RESULTS: We identified 56 references (16 were duplications or invalid), leaving 40 manuscripts for this search. The panel classified level I evidence (three manuscripts) and level II evidence (14 manuscripts). High-dose chemotherapy and stem cell trans

Netupitant/palonosetron is effective for preventing chemotherapy-induced nausea and vomiting in high-dose melphalan conditioning before autologous stem cell transplantation: A real-world analysis.

High-dose melphalan (HDM) is the standard conditioning regimen before autologous stem cell transplantation (ASCT) in plasma cell malignancies. Despite prophylactic antiemetics, chemotherapy-induced nausea and vomiting (CINV) remains a prevalent challenge. We retrospectively compared the efficacy of netupitant and palonosetron (NEPA) plus dexamethasone with that of serotonin receptor antagonist (5-HT3RA)-based regimens (the control group) for patients receiving HDM. The primary endpoint was complete resolution (CR) of CINV in the acute (0-24 hours) and delayed (24-168 hours) phases. Secondary e

Efficacy and Safety of Tixagevimab/Cilgavimab to Prevent COVID-19 (Pre-Exposure Prophylaxis): A Systematic Review and Meta-Analysis.

Background: Tixagevimab/cilgavimab (TGM/CGM) are neutralizing monoclonal antibodies (mAbs) directed against different epitopes of the receptor-binding domain of the SARS-CoV-2 spike protein that have been considered as pre-exposure prophylaxis (PrEP). Objectives: This study seeks to assess the efficacy and safety of TGM/CGM to prevent COVID-19 in patients at high risk for breakthrough and severe SARS-CoV-2 infection who never benefited maximally from SARS-CoV-2 vaccination and for those who have a contraindication to SARS-CoV-2 vaccines. Design: This study is a systematic review and meta-analy

Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved drastically. Despite the varied treatment options, major challenges persist. HNSCC chemotherapeutic and immunotherapeutic drugs are usually administered systemically, which could affect the patient's quality of life due to the associated side effects. Moreover, the systemic administration of salivary stimulating agent

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… Pain Management Just like other cancers, HNSCC is often associated with severe breakthrough pain, experienced in up to 80% of patients [ 79 ]. … It is available in different formulations as well, each of which provides effects against cancer breakthrough pain. One of the premier clinical trials in 2008 tested the safety of a mucoadhesive form of Fentanyl [ 166 ]. …