scholarly journals New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 134
Author(s):  
Krzysztof Bilmin ◽  
Kamil J. Synoradzki ◽  
Anna M. Czarnecka ◽  
Mateusz J. Spałek ◽  
Tamara Kujawska ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Uveal Melanoma ◽  
Focused Ultrasound ◽  
Early Stage ◽  
Treatment Options ◽  
Treatment Strategies ◽  
High Intensity Focused Ultrasound ◽  
Local Concentration ◽  
Proton Beam Radiotherapy ◽  
Stage Of Development

Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the choroid, ciliary body, or iris. The current eye-sparing treatment options include surgical treatment, plaque brachytherapy, proton beam radiotherapy, stereotactic photon radiotherapy, or photodynamic therapy. However, the efficacy of these methods is still unsatisfactory. This article reviews several possible new treatment options and their potential advantages in treating localized uveal melanoma. These methods may be based on the physical destruction of the cancerous cells by applying ultrasounds. Two examples of such an approach are High-Intensity Focused Ultrasound (HIFU)—a promising technology of thermal destruction of solid tumors located deep under the skin and sonodynamic therapy (SDT) that induces reactive oxygen species. Another approach may be based on improving the penetration of anti-cancer agents into UM cells. The most promising technologies from this group are based on enhancing drug delivery by applying electric current. One such approach is called transcorneal iontophoresis and has already been shown to increase the local concentration of several different therapeutics. Another technique, electrically enhanced chemotherapy, may promote drug delivery from the intercellular space to cells. Finally, new advanced nanoparticles are developed to combine diagnostic imaging and therapy (i.e., theranostics). However, these methods are mostly at an early stage of development. More advanced and targeted preclinical studies and clinical trials would be needed to introduce some of these techniques to routine clinical practice.

scholarly journals New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

2021 ◽  
Author(s):  
Krzysztof Bilmin ◽  
Kamil J. Synoradzki ◽  
Anna M. Czarnecka ◽  
Mateusz J. Spałek ◽  
Tamara Kujawska ◽  
...  
Keyword(s):  
Cancer Cells ◽  
Uveal Melanoma ◽  
Focused Ultrasound ◽  
Genetic Material ◽  
Treatment Strategies ◽  
Antifungal Drugs ◽  
High Intensity Focused Ultrasound ◽  
Local Concentration ◽  
Particle Radiotherapy

Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the choroid, ciliary body, or iris. Radiotherapy is the mainstay of therapy for most patients with localized uveal melanoma. Another RT technique used in the treatment of uveal melanomas is charged-particle radiotherapy. Photodynamic therapy is based on the selective destruction of cancer cells or pathological vessels. High-Intensity Focused Ultrasound (HIFU) is a promising technology of thermal destruction of solid tumors located deep under the skin. The principle of operation is based on the heating of a tumor. Sonodynamic therapy (SDT) induces the reactive oxygen species and kills cancer cells. Electroporation applied in vivo delivers drugs or genetic material from the intercellular space to cells. Iontophoresis is a technique in which using electric current increases the biodistribution of drugs in the eyeball. Transcorneal iontophoresis has been shown to increase the local concentration of antibacterial and antifungal drugs, steroids, DNA, and RNA molecules. Theranosticsincorporates diagnostic imaging and therapy. Although no theranostic markers have been developed specifically for uveal melanoma, some NPs have already found use in ophthalmology. UM presents an unmet clinical need. Novel eye-preserving therapeutic approaches for the localized disease are needed.

scholarly journals Emerging Prevention and Treatment Strategies to Control COVID-19

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 501 ◽  
Author(s):  
Vipul K. Singh ◽  
Abhishek Mishra ◽  
Shubhra Singh ◽  
Premranjan Kumar ◽  
Manisha Singh ◽  
...  
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Clinical Development ◽  
Definitive Treatment ◽  
Prevention Therapy ◽  
Potential Alternative ◽  
Novel Coronavirus ◽  
Global Threat ◽  
New Vaccines

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has now become a serious global threat after inflicting more than 8 million infections and 425,000 deaths in less than 6 months. Currently, no definitive treatment or prevention therapy exists for COVID-19. The unprecedented rise of this pandemic has rapidly fueled research efforts to discover and develop new vaccines and treatment strategies against this novel coronavirus. While hundreds of vaccines/therapeutics are still in the preclinical or early stage of clinical development, a few of them have shown promising results in controlling the infection. Here, in this review, we discuss the promising vaccines and treatment options for COVID-19, their challenges, and potential alternative strategies.

scholarly journals Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Overview of Emerging Applications (Part 2)

2019 ◽  
Vol 191 (06) ◽  
pp. 531-539 ◽  
Author(s):  
Florian Siedek ◽  
Sin Yuin Yeo ◽  
Edwin Heijman ◽  
Olga Grinstein ◽  
Grischa Bratke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Local Treatment ◽  
Review Literature ◽  
High Intensity Focused Ultrasound ◽  
Malignant Tissue ◽  
Safe Alternative

Background High-intensity focused ultrasound (HIFU) allows noninvasive heating of deep-seated tissues. Guidance under magnetic resonance imaging (MR-HIFU) offers spatial targeting based on anatomical MR images as well as MR-based near-real-time temperature maps. Temperature feedback allows delivery of a well-defined thermal dose enabling new applications such as the ablation of malignant tissue. Methods Peer-reviewed publications on MR-HIFU were studied and are summarized in this review. Literature was restricted to applications in oncology. Results Several MR-HIFU-based applications for the treatment of malignant diseases are currently part of clinical trials or translational research. Recent trials regarding the treatment of prostate cancer with MR-HIFU have already shown this to be a safe and patient-friendly method. For the treatment of breast cancer and malignancies within abdominal organs, MR-HIFU has been applied so far only in proof of concept studies. Conclusion MR-HIFU is currently being investigated for the ablative treatment of malignant tissue in a variety of oncological applications. For example, the transrectal as well as transurethral ablation of prostate cancer using MR-HIFU was shown to be a patient-friendly, safe alternative to other local treatment options with low side effects. Key points:  Citation Format

scholarly journals Long-Term Visual Outcomes for Small Uveal Melanoma Staged T1 Treated by Proton Beam Radiotherapy

Cancers ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1047 ◽  
Author(s):  
Adélaïde Toutée ◽  
Martina Angi ◽  
Sylvain Dureau ◽  
Christine Lévy-Gabriel ◽  
Livia Lumbroso-Le Rouic ◽  
...  
Keyword(s):  
Proton Beam ◽  
Optic Disc ◽  
Uveal Melanoma ◽  
Early Stage ◽  
Tumor Control ◽  
Proton Beam Radiotherapy ◽  
Visual Outcomes ◽  
The Mean

There is increasing evidence of the survival benefit of treating uveal melanoma in an early stage, however it is important to discuss with the patient the associated risk of visual loss. We investigated visual outcomes for uveal melanomas staged T1 (T1UM) treated by proton beam radiotherapy (PBR) as a function of their distance to fovea-optic disc. This retrospective study included a cohort of 424 patients with T1UM treated with PBR between 1991 and 2010 with at least a 5-year follow-up. Visual acuity (VA) was analyzed for patients with posterior edge of tumor located at ≥3 mm (GSup3) or <3 mm (GInf3) from fovea-optic disc. The mean follow-up duration was 122 months, no tumor recurrence was observed. The mean baseline and final VA were 20/25 and 20/32 for GSup3 (n = 75), and 20/40 and 20/80 for GInf3 (n = 317) respectively. The frequency of a 20/200 or greater visual conservation was 93.2%(CI95%:87.7–99.1) and 60.1%(CI95%:54.9–65.9) for GSup3 and GInf3 respectively. This difference between groups was statistically significant (p < 0.001). The risk factors for significant VA loss (less than 20/200) were GInf3 location (p < 0.001), tumor touching optic disc (p = 0.04), initial VA inferior to 20/40 (p < 0.001), documented growth (p = 0.002), and age greater than 60 years (p < 0.001). In summary, PBR for T1UM yields excellent tumor control and good long-term visual outcomes for tumors located ≥3 mm from fovea-optic disc.

scholarly journals Mild hyperthermia with magnetic resonance-guided high-intensity focused ultrasound for applications in drug delivery

2012 ◽  
Vol 28 (4) ◽  
pp. 320-336 ◽  
Author(s):  
Ari Partanen ◽  
Pavel S. Yarmolenko ◽  
Antti Viitala ◽  
Sunil Appanaboyina ◽  
Dieter Haemmerich ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Magnetic Resonance ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Mild Hyperthermia

scholarly journals Current Overview of Treatment for Metastatic Bone Disease

2021 ◽  
Vol 28 (5) ◽  
pp. 3347-3372
Author(s):  
Shinji Tsukamoto ◽  
Akira Kido ◽  
Yasuhito Tanaka ◽  
Giancarlo Facchini ◽  
Giuliano Peta ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Pedicle Screws ◽  
High Intensity Focused Ultrasound ◽  
Team Approach ◽  
Postoperative Function ◽  
Spine Stabilization ◽  
Number Of Patients ◽  
Surgical Methods

The number of patients with bone metastasis increases as medical management and surgery improve the overall survival of patients with cancer. Bone metastasis can cause skeletal complications, including bone pain, pathological fractures, spinal cord or nerve root compression, and hypercalcemia. Before initiation of treatment for bone metastasis, it is important to exclude primary bone malignancy, which would require a completely different therapeutic approach. It is essential to select surgical methods considering the patient’s prognosis, quality of life, postoperative function, and risk of postoperative complications. Therefore, bone metastasis treatment requires a multidisciplinary team approach, including radiologists, oncologists, and orthopedic surgeons. Recently, many novel palliative treatment options have emerged for bone metastases, such as stereotactic body radiation therapy, radiopharmaceuticals, vertebroplasty, minimally invasive spine stabilization with percutaneous pedicle screws, acetabuloplasty, embolization, thermal ablation techniques, electrochemotherapy, and high-intensity focused ultrasound. These techniques are beneficial for patients who may not benefit from surgery or radiotherapy.

scholarly journals Recent Advances in Extracellular Vesicles as Drug Delivery Systems and Their Potential in Precision Medicine

Pharmaceutics ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 1006 ◽  
Author(s):  
Bart de Jong ◽  
Eric Raul Barros ◽  
Joost G. J. Hoenderop ◽  
Juan Pablo Rigalli
Keyword(s):  
Drug Delivery ◽  
Extracellular Vesicles ◽  
Current Knowledge ◽  
Early Stage ◽  
Treatment Options ◽  
Cell Types ◽  
Administration Routes ◽  
The Individual ◽  
Key Steps

Extracellular vesicles (EVs) are membrane-bilayered nanoparticles released by most cell types. Recently, an enormous number of studies have been published on the potential of EVs as carriers of therapeutic agents. In contrast to systems such as liposomes, EVs exhibit less immunogenicity and higher engineering potential. Here, we review the most relevant publications addressing the potential and use of EVs as a drug delivery system (DDS). The information is divided based on the key steps for designing an EV-mediated delivery strategy. We discuss possible sources and isolation methods of EVs. We address the administration routes that have been tested in vivo and the tissue distribution observed. We describe the current knowledge on EV clearance, a significant challenge towards enhancing bioavailability. Also, EV-engineering approaches are described as alternatives to improve tissue and cell-specificity. Finally, a summary of the ongoing clinical trials is performed. Although the application of EVs in the clinical practice is still at an early stage, a high number of studies in animals support their potential as DDS. Thus, better treatment options could be designed to precisely increase target specificity and therapeutic efficacy while reducing off-target effects and toxicity according to the individual requirements of each patient.

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