The effect of structured exercise during chemotherapy on chemotherapy-induced peripheral neuropathy (CIPN): A role for interoceptive brain circuitry.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11590-11590
Author(s):  
Ian Kleckner ◽  
Jennifer S. Gewandter ◽  
Charles E. Heckler ◽  
Susan Staples ◽  
Ann Colasurdo ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Moderate Intensity ◽  
Home Based ◽  
Brain Circuitry ◽  
Approved Drugs ◽  
Future Work ◽  
To Receive ◽  
Fda Approved Drugs ◽  
Clinical Trial Information ◽  
Sensory Scale

11590 Background: Over half of patients receiving “neurotoxic” taxane, platinum, or bortezomib chemotherapy experience CIPN—a dose-limiting toxicity involving numbness and pain in the extremities. There are no FDA-approved drugs for CIPN, but exercise may help. This randomized pilot study explored whether structured exercise during chemotherapy ameliorates CIPN symptoms and whether improvements involve changes in the brain’s sensory processing (interoceptive) circuitry. Methods: Nineteen patients scheduled to receive taxane, platinum, or bortezomib were randomized to exercise (home-based, low-moderate intensity, walking and resistance training; EXCAP) or nutrition education (control) for 12 weeks starting at their first infusion. At 0, 6, and 12 weeks, we assessed CIPN symptoms using the CIPN-20 questionnaire (sensory scale, ranges 9-36, higher is worse) and a finger tactile sensitivity task. We assessed resting functional connectivity between the insula and thalamus via fMRI at 0 and 12 weeks. We used linear regression to model each outcome, tested for an effect of exercise, and controlled for baseline value and age because controls were older. Given the pilot nature of this study we present effect sizes, not p-values. Results: The 19 patients were 65±11 years old, 52% women, with cancer: 42% breast, 32% gastrointestinal, 16% myeloma, and 10% genitourinary. Exercise mitigated CIPN symptoms per the CIPN-20 sensory scale. At 6 weeks, exercisers increased from 11.0 to 12.5 whereas controls increased from 11.0 to 15.5 (+1.5 vs. +4.5; ES = 0.81). At 12 weeks, exercisers increased from 11.0 to 14.8 whereas controls increased from 11.0 to 16.2 (+3.8 vs. +5.2, ES = 0.46). The finger-touching test corroborated results at 6 and 12 weeks (ES = 1.03 and 0.07). Exercisers showed better (reduced) insula-thalamus connectivity vs. controls (ES = 0.41). Reductions in connectivity were correlated with smaller increases in CIPN symptoms (r = 0.74). Conclusions: Exercise during neurotoxic chemotherapy mitigated CIPN symptoms, perhaps via improvements in interoceptive brain circuitry. Future work should test for replication with a larger sample. Clinical trial information: NCT03021174.

Incidence, management, and resolution of stomatitis and noninfectious pneumonitis in BOLERO-2.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 159-159 ◽  
Author(s):  
Alejandra T. Perez
Keyword(s):  
Complete Resolution ◽  
Mtor Inhibitor ◽  
Treatment Initiation ◽  
Study Drug ◽  
Moderate Intensity ◽  
Grade 3 ◽  
Dose Modifications ◽  
To Receive ◽  
Clinical Trial Information

159 Background: Although the mTOR inhibitor everolimus (EVE) was generally well tolerated in combination with exemestane (EXE) in patients (pts) with HR+/HER2– advanced breast cancer, stomatitis and noninfectious pneumonitis (NIP) are the most clinically relevant and potentially dose-limiting toxicities. The incidence, grade, and clinical course of stomatitis and NIP among pts participating in the BOLERO-2 study are described. Methods: Pts were randomized 2:1 to receive EVE + EXE or placebo (PBO) + EXE. Incidence and severity of stomatitis and NIP, consequent dose interruptions/adjustments, study drug discontinuations, and time to resolution were recorded. Results: Stomatitis (any grade) occurred more frequently with EVE + EXE than with PBO + EXE (59% vs 12%, respectively). Grade 3 stomatitis occurred in 8% vs 1% of EVE + EXE vs PBO + EXE pts, respectively; no grade 4 events were reported. Onset of grade ≥ 2 stomatitis after treatment initiation was earlier for EVE + EXE arm vs PBO + EXE: median time was 15 d vs 24 d, respectively. For the EVE + EXE arm, 97% of pts with grade 3 stomatitis (n = 38) improved to ≤1 after a median of 13 d. Complete resolution was observed in 82% of pts after a median of 38 d. For the PBO + EXE arm, all pts with grade 3 stomatitis (n = 2) improved to ≤1 after a median of 18 d. Complete resolution was observed after a median of 29 d. 24% of pts on EVE + EXE required dose interruptions/adjustments vs 1% of pts on PBO + EXE, and 3% of pts (n = 13) discontinued EVE + EXE vs <1% of pts (n = 1) discontinuing PBO + EXE, all related to stomatitis. Overall, 16% in the EVE + EXE vs 0% in the PBO + EXE groups had a diagnosis consistent with NIP. For EVE + EXE, grade 1, 2, and 3 NIP occurred in 7%, 6%, and 3% of pts, respectively; no grade 4 events were reported. Complete resolution of NIP to grade ≤1 was recorded for all but 4 pts for whom NIP was still observed at last follow-up before study discontinuation. Overall, in the EVE + EXE arm, NIP was reason for dose interruption and treatment discontinuation in 7.5% and 5.6% of pts, respectively. Conclusions: In the BOLERO-2 study, stomatitis and NIP were of mild to moderate intensity and were generally reversible. Most incidents were successfully managed with palliative interventions and temporary dose modifications. Clinical trial information: NCT00863655.

Comparing the Metabolome of a Caribbean Sponge to 420 FDA Approved Drugs, a Molecular Networking Approach

Planta Medica ◽  
2013 ◽  
Vol 79 (10) ◽  
Author(s):  
H Houson ◽  
J Schlesser ◽  
J Beverage ◽  
V Macherla ◽  
E Esquenazi
Keyword(s):  
Molecular Networking ◽  
Approved Drugs ◽  
Fda Approved Drugs

Targeting COVID-19 in Parkinson’s patients: Drugs repurposed.

2020 ◽  
Vol 27 ◽  
Author(s):  
Firoz Anwar ◽  
Salma Naqvi ◽  
Fahad A. Al-Abbasi ◽  
Nauroz Neelofar ◽  
Vikas Kumar ◽  
...  
Keyword(s):  
Day Treatment ◽  
Treatment Options ◽  
Developed Countries ◽  
Methyl Transferase ◽  
Comt Inhibitors ◽  
Mao B ◽  
Pharmacokinetic Properties ◽  
Us Fda ◽  
Approved Drugs ◽  
Fda Approved Drugs

: The last couple of months have witnessed the world in a state of virtual standstill. The SARS-CoV-2 virus has overtaken globe to economic and social lockdown. Many patients with COVID-19 have compromised immunity, especially in an aged population suffering from Parkinson disease (PD). Alteration in dopaminergic neurons or deficiency of dopamine in PD patients is the most common symptoms affecting 1% population above the age of 60 years. The compromised immune system and inflammatory manifestation in PD patients make them an easy target. The most common under trial drugs for COVID-19 are Remdesivir, Favipiravir, Chloroquine and Hydroxychloroquine, Azithromycin along with adjunct drugs like Amantadine with some monoclonal antibodies. : Presently, clinically US FDA approved drugs in PD includes Levodopa, catechol-O-methyl transferase (COMT) inhibitors, (Entacapone and Tolcapone), Dopamine agonists (Bromocriptine, Ropinirole, Pramipexole, and Rotigotine), Monoamine oxidase B (MAO-B) inhibitors (Selegiline and Rasagiline), Amantadine and Antimuscarinic drugs. The drugs have established mechanism of action on PD patients with known pharmacodynamics and pharmacokinetic properties along with dose and adverse effects. : Conclusion and relevance of this review focus on the drugs that can be tried for the PD patients with SAR CoV-2 infection, in particular, Amantadine approved by all developed countries a common drug possessing both antiviral properties by downregulation of CTSL, lysosomal pathway disturbance and change in pH necessary to uncoat the viral proteins and antiParkinson properties. The significant prognostic adverse effect of SARS-CoV-2 on PD and the present-day treatment options, clinical presentation and various mechanism is warrant need of the hour.

Pd Catalyzed N1/N4 Arylation of Piperazine for Synthesis of Drugs, Biological and Pharmaceutical Targets: An Overview of Buchwald Hartwig Amination Reaction of Piperazine in Drug Synthesis

2018 ◽  
Vol 15 (2) ◽  
pp. 208-220 ◽  
Author(s):  
Vaibhav Mishra ◽  
Tejpal Singh Chundawat
Keyword(s):  
Bond Formation ◽  
Catalyst Design ◽  
Biologically Active ◽  
Reaction Conditions ◽  
Biological Targets ◽  
Amination Reaction ◽  
Drug Synthesis ◽  
Substituted Piperazine ◽  
Approved Drugs ◽  
Fda Approved Drugs

Background: Substituted piperazine heterocycles are among the most significant structural components of pharmaceuticals. N1/N4 substituted piperazine containing drugs and biological targets are ranked 3rd in the top most frequent nitrogen heterocycles in U.S. FDA approved drugs. The high demand of N1/N4 substituted piperazine containing biologically active compounds and U.S. FDA approved drugs, has prompted the development of Pd catalyzed C-N bond formation reactions for their synthesis. Buchwald-Hartwig reaction is the key tool for the synthesis of these compounds. Objective: This review provides strategies for Pd catalyzed C-N bond formation at N1/N4 of piperazine in the synthesis of drugs and biological targets with diverse use of catalyst-ligand system and reaction parameters. Conclusion: It is clear from the review that a vast amount of work has been done in the synthesis of N1/N4 substituted piperazine containing targets under the Pd catalyzed Buchwald-Hartwig amination of aryl halides by using different catalyst-ligand systems. These methods have become increasingly versatile as a result of innovation in catalyst design and improvements in reaction conditions. This review gives an overview of recent utilization of Buchwald-Hartwig amination reaction in drug/target synthesis.

Structural Basis of Antisickling Effects of Selected FDA Approved Drugs: A Drug Repurposing Study

2018 ◽  
Vol 14 (2) ◽  
pp. 106-116 ◽  
Author(s):  
Olujide O. Olubiyi ◽  
Maryam O. Olagunju ◽  
James O. Oni ◽  
Abidemi O. Olubiyi
Keyword(s):  
Drug Repurposing ◽  
Structural Basis ◽  
Approved Drugs ◽  
Fda Approved Drugs

scholarly journals Identification of 3-chymotrypsin like protease (3CLPro) inhibitors as potential anti-SARS-CoV-2 agents

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Vicky Mody ◽  
Joanna Ho ◽  
Savannah Wills ◽  
Ahmed Mawri ◽  
Latasha Lawson ◽  
...  
Keyword(s):  
Inhibitory Effect ◽  
Dynamics Simulation ◽  
Simulation Studies ◽  
Inhibitory Effects ◽  
Major Threat ◽  
Main Protease ◽  
Approved Drugs ◽  
Fda Approved Drugs ◽  
Computational Molecular Modeling

AbstractEmerging outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is a major threat to public health. The morbidity is increasing due to lack of SARS-CoV-2 specific drugs. Herein, we have identified potential drugs that target the 3-chymotrypsin like protease (3CLpro), the main protease that is pivotal for the replication of SARS-CoV-2. Computational molecular modeling was used to screen 3987 FDA approved drugs, and 47 drugs were selected to study their inhibitory effects on SARS-CoV-2 specific 3CLpro enzyme in vitro. Our results indicate that boceprevir, ombitasvir, paritaprevir, tipranavir, ivermectin, and micafungin exhibited inhibitory effect towards 3CLpro enzymatic activity. The 100 ns molecular dynamics simulation studies showed that ivermectin may require homodimeric form of 3CLpro enzyme for its inhibitory activity. In summary, these molecules could be useful to develop highly specific therapeutically viable drugs to inhibit the SARS-CoV-2 replication either alone or in combination with drugs specific for other SARS-CoV-2 viral targets.

U.S. FDA Approved Drugs from 2015–June 2020: A Perspective

2021 ◽  
Author(s):  
Priyadeep Bhutani ◽  
Gaurav Joshi ◽  
Nivethitha Raja ◽  
Namrata Bachhav ◽  
Prabhakar K. Rajanna ◽  
...  
Keyword(s):  
Approved Drugs ◽  
Fda Approved Drugs

scholarly journals A screen of FDA-approved drugs identifies inhibitors of protein tyrosine phosphatase 4A3 (PTP4A3 or PRL-3)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dylan R. Rivas ◽  
Mark Vincent C. Dela Cerna ◽  
Caroline N. Smith ◽  
Shilpa Sampathi ◽  
Blaine G. Patty ◽  
...  
Keyword(s):  
Protein Tyrosine Phosphatase ◽  
Tyrosine Phosphatase ◽  
Dependent Manner ◽  
Allosteric Site ◽  
Human Embryonic Kidney Cells ◽  
Protein Tyrosine ◽  
Tumor Cell Migration ◽  
Colorectal Cancer Cells ◽  
Approved Drugs ◽  
Fda Approved Drugs

AbstractProtein tyrosine phosphatase 4A3 (PTP4A3 or PRL-3) is highly expressed in a variety of cancers, where it promotes tumor cell migration and metastasis leading to poor prognosis. Despite its clinical significance, small molecule inhibitors of PRL-3 are lacking. Here, we screened 1443 FDA-approved drugs for their ability to inhibit the activity of the PRL phosphatase family. We identified five specific inhibitors for PRL-3 as well as one selective inhibitor of PRL-2. Additionally, we found nine drugs that broadly and significantly suppressed PRL activity. Two of these broad-spectrum PRL inhibitors, Salirasib and Candesartan, blocked PRL-3-induced migration in human embryonic kidney cells with no impact on cell viability. Both drugs prevented migration of human colorectal cancer cells in a PRL-3 dependent manner and were selective towards PRLs over other phosphatases. In silico modeling revealed that Salirasib binds a putative allosteric site near the WPD loop of PRL-3, while Candesartan binds a potentially novel targetable site adjacent to the CX5R motif. Inhibitor binding at either of these sites is predicted to trap PRL-3 in a closed conformation, preventing substrate binding and inhibiting function.

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