scholarly journals ENDOCRINE SIDE-EFFECTS OF ANTI-CANCER DRUGS: mAbs and pituitary dysfunction: clinical evidence and pathogenic hypotheses

2013 ◽  
Vol 169 (6) ◽  
pp. R153-R164 ◽  
Author(s):  
Francesco Torino ◽  
Agnese Barnabei ◽  
Rosa Maria Paragliola ◽  
Paolo Marchetti ◽  
Roberto Salvatori ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Patients ◽  
Anticancer Agents ◽  
Cytotoxic T Lymphocyte ◽  
Hormonal Treatment ◽  
Primary Tumors ◽  
Pituitary Dysfunction ◽  
Solid Malignancies ◽  
Anti Cancer ◽  
Life Threatening

mAbs are established targeted therapies for several diseases, including hematological and solid malignancies. These agents have shown a favorable toxicity profile, but, despite their high selectivity, new typical side-effects have emerged. In cancer patients, pituitary dysfunction may be mainly due to brain metastases or primary tumors and to related surgery and radiotherapy. Anticancer agents may induce hypopituitarism in patients cured for childhood cancers. These agents infrequently affect pituitary function in adult cancer patients. Notably, hypophysitis, a previously very rare disease, has emerged as a distinctive side-effect of ipilimumab and tremelimumab, two mAbs inhibiting the cytotoxic T-lymphocyte antigen-4 receptor, being occasionally seen with nivolumab, another immune checkpoint inhibitor. Enhanced antitumor immunity is the suggested mechanism of action of these drugs and autoimmunity the presumptive mechanism of their toxicity. Recently, ipilimumab has been licensed for the treatment of patients affected by metastatic melanoma. With the expanding use of these drugs, hypophysitis will be progressively encountered by oncologists and endocrinologists in clinical practice. The optimal management of this potentially life-threatening adverse event needs a rapid and timely diagnostic and therapeutic intervention. Hypopituitarism caused by these agents is rarely reversible, requiring prolonged or lifelong substitutive hormonal treatment. Further studies are needed to clarify several clinical and pathogenic aspects of this new form of secondary pituitary dysfunction.

Nitrogen Mustards as Alkylating Agents: A Review on Chemistry, Mechanism of Action and Current USFDA Status of Drugs

2019 ◽  
Vol 19 (9) ◽  
pp. 1080-1102 ◽  
Author(s):  
Ghansham S. More ◽  
Asha B. Thomas ◽  
Sohan S. Chitlange ◽  
Rabindra K. Nanda ◽  
Rahul L. Gajbhiye
Keyword(s):  
Side Effects ◽  
Mechanism Of Action ◽  
Anticancer Agents ◽  
Nitrogen Mustard ◽  
Alkylating Agents ◽  
Cross Linking ◽  
Nitrogen Mustards ◽  
Information Leaflets ◽  
Anti Cancer ◽  
Approved Drugs

Background & Objective: :Nitrogen mustard derivatives form one of the major classes of anti-cancer agents in USFDA approved drugs list. These are polyfunctional alkylating agents which are distinguished by a unique mechanism of adduct formation with DNA involving cross-linking between guanine N-7 of one strand of DNA with the other. The generated cross-linking is irreversible and leads to cell apoptosis. Hence it is of great interest to explore this class of anticancer alkylating agents.Methods::An exhaustive list of reviews, research articles, patents, books, patient information leaflets, and orange book is presented and the contents related to nitrogen mustard anti-cancer agents have been reviewed. Attempts are made to present synthesis schemes in a simplified manner. The mechanism of action of the drugs and their side effects are also systematically elaborated.Results::This review provides a platform for understanding all aspects of such drugs right from synthesis to their mechanism of action and side effects, and lists USFDA approved ANDA players among alkylating anticancer agents in the current market.Conclusion: :Perusing this article, generic scientists will be able to access literature information in this domain easily to gain insight into the nitrogen mustard alkylating agents for further ANDA development. It will help the scientific and research community to continue their pursuit for the design of newer and novel heterocyclic alkylating agents of this class in the coming future.

Ursolic and Oleanolic Acids as Potential Anticancer Agents Acting in the Gastrointestinal Tract

2018 ◽  
Vol 16 (1) ◽  
pp. 78-91 ◽  
Author(s):  
Mateusz Pięt ◽  
Roman Paduch
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Anticancer Agents ◽  
In Vivo Studies ◽  
Pentacyclic Triterpenoids ◽  
Liver Cancers ◽  
Anti Cancer ◽  
Tumorigenic Activity

Background:Cancer is one of the main causes of death worldwide. Contemporary therapies, including chemo- and radiotherapy, are burdened with severe side effects. Thus, there exists an urgent need to develop therapies that would be less devastating to the patient’s body. Such novel approaches can be based on the anti-tumorigenic activity of particular compounds or may involve sensitizing cells to chemotherapy and radiotherapy or reducing the side-effects of regular treatment.Objective:Natural-derived compounds are becoming more and more popular in cancer research. Examples of such substances are Ursolic Acid (UA) and Oleanolic Acid (OA), plant-derived pentacyclic triterpenoids which possess numerous beneficial properties, including anti-tumorigenic activity.Results:In recent years, ursolic and oleanolic acids have been demonstrated to exert a range of anticancer effects on various types of tumors. These compounds inhibit the viability and proliferation of cancer cells, prevent their migration and metastasis and induce their apoptosis. Both in vitro and in vivo studies indicate that UA and OA are promising anti-cancer agents that can prevent carcinogenesis at each step. Furthermore, cancers at all stages are susceptible to the activity of these compounds. </P><P> Neoplasms that are formed in the gastrointestinal tract, i.e. gastric, colorectal, pancreatic, and liver cancers, are among the most common and most lethal malignancies. Their localization in the digestive system, however, facilitates the action of orally-administered (potential) anti-cancer agents, making chemopreventive drugs more accessible.In this paper, the anti-tumorigenic effect of ursolic and oleanolic acids on gastric, colon, pancreatic, and liver cancers, as well as the mechanisms underlying this process, are presented.

scholarly journals Study of Side Effects of Patients Receiving Cisplatin in the Treatment of Cervical Cancer by Age Group

2020 ◽  
Vol 43 (4) ◽  
pp. 28-38
Author(s):  
Rachadapan Chaitosa ◽  
Worathida Maskasame
Keyword(s):  
Cervical Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Older Patients ◽  
Concurrent Chemoradiotherapy ◽  
Combined Therapy ◽  
Age Groups ◽  
Cervical Cancer Patient ◽  
Younger Patients ◽  
Life Threatening

Background: Cisplatin is one of the options of chemotherapy used to treat cervical cancer. Patient can experience side effects from drugs frequently with many factors as a catalyst including the age of the patient. Objective: To compare the side effects of cervical cancer patients receiving concurrent chemoradiotherapy (Cisplatin) 2 rounds between patients ≤ 60 years and > 60 years. Methods: A retrospective study, 70 cervical cancer patients undergoing concurrent chemoradiotherapy at Ramathibodi Hospital were investigated. Questionnaires about adverse effects were completed by patients at home 7 days after 1st and 2nd courses of combined therapy. The side effects of cervical cancer patients between groups was analyzed. Results: Of 70 patients, there were 47 patients ≤ 60 years and 23 patients > 60 years. After the 1st course, life-threatening side effects occurred in 9 patient’s ≤ 60 years but none occurred in patients > 60 years. Younger patients also had significant more nausea than older patients (P < .05). After the 2nd course, younger patients also had significant more vomiting than older patients (P < .05). The most common side effects for both age groups were fatigue and anorexia respectively. Conclusions: Patients younger than 60 year would experience significantly more symptoms of nausea and vomiting after the 1st and 2nd courses of concurrent chemoradiotherapy.

scholarly journals Irinotecan—Still an Important Player in Cancer Chemotherapy: A Comprehensive Overview

2020 ◽  
Vol 21 (14) ◽  
pp. 4919 ◽  
Author(s):  
Mateusz Kciuk ◽  
Beata Marciniak ◽  
Renata Kontek
Keyword(s):  
Side Effects ◽  
Anticancer Agents ◽  
Active Metabolite ◽  
Comprehensive Overview ◽  
Liposomal Formulations ◽  
Crucial Component ◽  
Important Player ◽  
Life Threatening ◽  
Molecular Mode ◽  
Source Of Information

Irinotecan has been used in the treatment of various malignancies for many years. Still, the knowledge regarding this drug is expanding. The pharmacogenetics of the drug is the crucial component of response to irinotecan. Furthermore, new formulations of the drug are introduced in order to better deliver the drug and avoid potentially life-threatening side effects. Here, we give a comprehensive overview on irinotecan’s molecular mode of action, metabolism, pharmacogenetics, and toxicity. Moreover, this article features clinically used combinations of the drug with other anticancer agents and introduces novel formulations of drugs (e.g., liposomal formulations, dendrimers, and nanoparticles). It also outlines crucial mechanisms of tumor cells’ resistance to the active metabolite, ethyl-10-hydroxy-camptothecin (SN-38). We are sure that the article will constitute an important source of information for both new researchers in the field of irinotecan chemotherapy and professionals or clinicians who are interested in the topic.

scholarly journals Gastrointestinal disorders as immune-related adverse events

2021 ◽  
Author(s):  
Daniele Balducci ◽  
Claudia Quatraccioni ◽  
Antonio Benedetti ◽  
Marco Marzioni ◽  
Luca Maroni
Keyword(s):  
Cell Death ◽  
Cancer Therapy ◽  
Programmed Cell Death ◽  
Adverse Events ◽  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitors ◽  
Survival Rates ◽  
Programmed Cell Death 1 ◽  
Anti Cancer ◽  
Life Threatening

Immune checkpoint inhibitors, such as cytotoxic T-lymphocyte antigen 4 inhibitors, programmed cell death 1 inhibitors and programmed cell death-ligand 1 inhibitors, have recently emerged as novel drugs in the anti-cancer therapy. Their use in different types of advanced cancer has shown good results and an increase in survival rates. However, immune-related adverse events (irAEs) are frequent and often require special care. IrAEs may affect all the organs, but they are most commonly seen in skin, lungs, endocrine glands and in the gastrointestinal tract where small bowel, colon, the liver and/or the pancreas can be involved. Despite being usually mild and self-resolving, irAEs may present in severe and life-threatening forms, causing the withdrawal of anti-cancer therapy. IrAEs, therefore, represent a challenging condition to manage that often requires the cooperation between the oncologists and the gastroenterologists in order to identify and treat them adequately.

Drug interactions in ambulatory cancer patients receiving cancer-directed therapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6129-6129 ◽  
Author(s):  
R. P. Riechelmann ◽  
L. Wang ◽  
I. F. Tannock ◽  
M. K. Krzyzanowska
Keyword(s):  
Risk Factors ◽  
Drug Interactions ◽  
Cancer Patients ◽  
Scientific Evidence ◽  
Significant Risk ◽  
Median Number ◽  
Cancer Type ◽  
Solid Malignancies ◽  
Life Threatening ◽  
Treatment Intent

6129 Background: Cancer patients (pts) are susceptible to drug interactions (DI) because they receive multiple medications. Here we evaluate the epidemiology of potential DI in cancer patients. Methods: Ambulatory, adult pts with solid malignancies who were receiving antineoplastic treatment completed a questionnaire about drugs taken in the previous month. Drug Interactions Facts software was used to screen for potential DI and to classify them in terms of severity (major, moderate and minor, where major is a life-threatening interaction) and level of scientific evidence (1 to 5, with 1 being the highest level). Summary statistics and logistic regression were used to describe the results. Results: Between Sept -Dec 2005, 183 pts completed the questionnaire: median age was 61 (range 26–88), and 114 (62%) were women. Cancer sites included breast 63 (35%), gastrointestinal 45 (25%), and genitourinary 36 (20%). Treatment intent was palliative in 139 (60%). Most pts (76%) were receiving chemotherapy; 111 (66%) had at least one co-morbid condition, and 72 (47%) had abnormal liver and/or renal function. The median number of drugs per pt was 5 (range 0–16). Among the 183 pts, 131 potential DI were identified of which 65 (50%) were due to pharmacokinetic interactions. Sixteen (12%) of all potential DI were major, 94 (72%) were moderate, and 21 (16%) were minor. Fourteen (11%), 54 (41%), 5 (4%), 42 (32%), and 16 (12%) were supported by levels 1,2,3,4,5 of evidence respectively. Most potential DI involved non-chemotherapy agents such as warfarin, antihypertensives, and anti-inflammatory drugs. In multivariate analyses, number of comorbidities (p= .0001), number of drugs (p= .005), and cancer type (p= .03) were significant risk factors for DI. Conclusion: PotentialDI are common in oncology, and usually involve non-chemotherapeutic drugs. Risk factors for potential DI include comorbid illness, number of medications and type of cancer. Oncologists should be aware of such an important issue. No significant financial relationships to disclose.

Phytosynthesized Nanoparticles for Effective Cancer Treatment: A Review

2019 ◽  
Vol 9 (4) ◽  
pp. 437-443
Author(s):  
Anjana Goel ◽  
Ashok K. Bhatia
Keyword(s):  
Side Effects ◽  
Medicinal Plants ◽  
Metabolic Disorders ◽  
Bimetallic Nanoparticles ◽  
Reduction Rate ◽  
Cost Effective ◽  
Atomic Level ◽  
Anti Cancer ◽  
Life Threatening ◽  
The Stability

Introduction: Nanotechnology is a branch of nanosciences which includes the manipulation of particles at their atomic level in order to obtain certain desirable properties that enhance their use in the treatment of various metabolic disorders as well as other life-threatening diseases including cancer. Photosynthesized nanoparticles are eco-friendly, reliable and cost-effective. This biogenic route of nanoparticles synthesis is emerging as a beneficial method as plants contain diverse bioactive phytochemicals which act as reducing and capping agent thus, increase the stability and reduction rate of nanoparticles. The most commonly used nanoparticles are of silver, gold, iron oxides and copper. In few studies, bimetallic nanoparticles have been reported to have anti-cancer potential. The use of medicinal plants for the purpose of designing nanoparticles has paved a way for targeting a drug to the particular affected site of the tumor. Conclusion: This review focuses on the anti-cancerous potential of nanoparticles of different metals using a variety of medicinal plants. These biogenic nanoparticles could limit the use of chemotherapy and radiation therapy, as these therapies have huge side effects which cannot be tolerated by the cancer patients, and in many cases, the patients die because of these treatments. Hence nanoparticles mediated therapy is now gaining attention for the treatment of cancer as targeted drug therapy, without having undesirable side effects.

scholarly journals Novel selective anticancer agents based on Sn and Au complexes. Mini-review

2020 ◽  
Vol 92 (8) ◽  
pp. 1201-1216
Author(s):  
Elena R. Milaeva ◽  
Dmitry B. Shpakovsky ◽  
Yulia A. Gracheva ◽  
Taisiya A. Antonenko ◽  
Tatyana D. Ksenofontova ◽  
...  
Keyword(s):  
Side Effects ◽  
Anticancer Agents ◽  
Antitumor Agents ◽  
Inorganic Compounds ◽  
Acquired Resistance ◽  
Cytotoxic Action ◽  
Mitochondrial Potential ◽  
Anti Cancer ◽  
Gold Compounds

AbstractCancer is one of the most common causes of death in modern medicine. Molecular design of novel substances with pharmacological activity is one of the goals of medicinal inorganic chemistry. Platinum complexes are widely used in the treatment of cancer, despite high efficacy their use is limited by side effects, as well as primary or acquired resistance. In this regard, the search for novel metal-containing antitumor compounds is underway. Organotins and gold compounds are promising pharmacological agents with anti-cancer properties. The introduction of protective antioxidant fragments into inorganic compounds molecules is a way to reduce the side effects of anti-cancer drugs on healthy cells. 2,6-dialkylphenols belonging to vitamin E (α-tocopherol) mimetics are widely used as antioxidants and stabilizers. The properties of Ph3SnCl (Sn-I), Ph3PAuCl (Au-I) and complexes Ph3SnSR (Sn-II) and Ph3PAuSR (Au-II) based on 2,6-di-tert-butyl-4-mercaptophenol (RSH) as radical scavengers and reducing agents were studied in model reactions. For Sn-II and Au-II the comparative study of cytotoxic action was made and the IC50 values on different cancer cell lines were found to be depended on the nature of metal. In general, Sn(IV) complexes possessed higher cytotoxicity than Au(I) complexes. In order to clarify the mechanism of cytotoxic mode of action the effect of compounds on Fe3+-induced lipid peroxidation, mitochondrial potential and mitochondrial permeability, cell cycle and induction of apoptosis was studied. Organotin compounds can bind tubulin SH-groups and inhibit its polymerization by a dose-dependent mechanism, whereas gold compounds inhibit Thioredoxin reductase (TrxR). In vivo experiments on acute toxicity of Sn-II and Au-II proved their moderate toxic action that opens prospects for the further study as antitumor agents.

Liposomes: An emerging approach for treatment of cancer

2021 ◽  
Vol 27 ◽  
Author(s):  
Akhlesh K. Jain ◽  
Keerti Mishra
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Targeted Delivery ◽  
Cancer Drugs ◽  
Early Disease ◽  
Normal Cells ◽  
Drug Delivery Carrier ◽  
Conventional Drug ◽  
Anti Cancer ◽  
Life Threatening

Background: Conventional drug delivery agents for life-threatening disease cancer lacks specificity towards cancer cells, results in seriously toxicities to normal cells with a poor therapeutic indices. These toxic side effects often limit dose escalation of anticancer drugs, leading to incomplete tumor suppression/cancer eradication, early disease relapse, and ultimately, the development of drug resistance. Accordingly, targeting of the tumor vasculatures is essential for the treatment of cancer. Objective: To search and describe a safer drug delivery carrier for the treatment of cancer with reduced systemic toxicities. Methods: Data were collected from Medline, PubMed, Google Scholar, Science Direct through searching of keywords: ‘liposomes’, ‘nanocarriers’, ‘targeted drug delivery’, ‘ligands’, ‘liposome for anti-cancerous drugs’, ‘treatment for cancer’ and ‘receptor targeting’. Results: Liposomes have provided a safe platform for the targeted delivery of encapsulated anti-cancer drugs for the treatment of cancer which results in the reduction of the cytotoxic side effects of anti-cancer drugs on normal cells. Conclusion: Liposomal targeting is a better emerging approach as an advanced drug delivery carrier with targeting ligands for anti-cancer agents.

scholarly journals Potential of Tithonia diversifolia Hemsley A. Gray (Kembang Bulan) Leaf Extract as Anti-Cancer Agents

2021 ◽  
Vol 10 (2) ◽  
pp. 87-91
Author(s):  
Muflihah Rizkawati
Keyword(s):  
Side Effects ◽  
Anticancer Agents ◽  
Health Benefit ◽  
The Body ◽  
Tithonia Diversifolia ◽  
Lower Side ◽  
Anti Cancer ◽  
Herbal Plants ◽  
Global Concern ◽  
Positive Effect

The main objective of this review is to explain the great potential of herbal plants as anticancer agents. Cancer is a disease caused by abnormal cell growth in the body. The high number of cancer incidents still become a global concern because of the high mortality rate. The treatments of cancer such as chemotherapy can cause serious side effects by killing the normal cells. This is the reason why it is necessary to develop an alternative treatment of cancer. I discussed a plant that is believed to has health benefit. Many studies have showed the positive effect of Tithonia diversifolia plant for health. After 2000, the researchers discovered a new potential through its cytotoxicity to neoplastic cells. This plant needs to be developed sustainably. However, in the future this plant might become an effective alternative to treat cancer with lower side effects.

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