scholarly journals Targeted Nanomedicine to Treat Bone Metastasis

Pharmaceutics ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 205 ◽  
Author(s):  
Isaac Adjei ◽  
Madison Temples ◽  
Shannon Brown ◽  
Blanka Sharma
Keyword(s):  
Side Effects ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Drug Targeting ◽  
State Of The Art ◽  
Treatment Modalities ◽  
Pathological Fractures ◽  
Current State ◽  
Skeletal Related Events ◽  
New Treatment

Bone metastases are common complications of solid tumors, particularly those of the prostate, breast, and lungs. Bone metastases can lead to painful and devastating skeletal-related events (SREs), such as pathological fractures and nerve compressions. Despite advances in treatment for cancers in general, options for bone metastases remain inadequate and generally palliative. Anticancer drugs (chemotherapy and radiopharmaceuticals) do not achieve therapeutic concentrations in the bone and are associated with dose-limiting side effects to healthy tissues. Nanomedicines, with their tunable characteristics, have the potential to improve drug targeting to bone metastases while decreasing side effects for their effective treatment. In this review, we present the current state of the art for nanomedicines to treat bone metastases. We also discuss new treatment modalities enhanced by nanomedicine and their effects on SREs and disease progression.

Palliative treatment directives for bone metastases: A quality-directed approach to guiding institutional practice.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Lindsay Puckett ◽  
Lucille Lee ◽  
Petrina Zuvic ◽  
Isabella Bingchan Zhang ◽  
Louis Potters ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Bone Metastases ◽  
Radiation Treatment ◽  
Standard Of Care ◽  
Evidence Based ◽  
Chi Square ◽  
Evidence Based Treatment ◽  
Improve Compliance ◽  
Chi Square Test ◽  
New Treatment

188 Background: The efficacy of single fraction (fx) radiation treatment (RT) has proven to have equipoise for palliation of bone metastases when compared to courses of 10 fx or more. Despite these data, there has been a slow adoption of this practice in the US and worldwide. Examination of our multicenter practice from 2004 - 2016 showed that single fx RT utilization has remained at 17% and hypofractionationed (HFX) courses (1 or 5 fx) have remained at 71% since 2009. We hypothesized that evidence-based, treatment-guiding directives could improve HFX utilization in this population. Methods: Institutionally, palliative bone metastasis treatments are routinely tracked by a Quality Assurance committee. In 2/2016, two consensus-driven and evidence-based clinical directives were created within our electronic health system for use with either simple or complicated bone metastasis, irrespective of primary histology. The simple and complex directives had default prescriptions of 8 Gy/1fx or 20 Gy/5fx, respectively. The directives were reviewed with physician staff to improve compliance; directives were allowed to be edited at the physician’s discretion if an alternative fx was indicated. The chi-square test was used for analysis. Results: From 1/2009-5/2016, there were 1,781 treatment courses of palliative external beam RT. Following implementation in 2/2016, the new clinical directives were used for 96% of cases and were modified in 12 cases (n = 72). Single fx use increased from 17% to 36% among palliative bone metastasis treatments (p ≤ 0.001) and HFX (1 or 5 fx) utilization increased from 71% to 92% compared to other fractionation schemes (10 fx or other) (p = 0.001). Conclusions: The institution-wide adoption of evidence-based, treatment directives proved to be a straightforward and successful intervention which allowed for rapid adoption and increased utilization of the standard of care. Our early data suggests that this may be a useful approach in the setting of reticence to new treatment paradigms. Further examination of evidence based directives is warranted to address issues of overtreatment in palliation and in standardizing oncologic care.

scholarly journals Dealing with Bone Metastases from Breast Cancer - A Pathological and Clinical Overview

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 25
Author(s):  
O. Munteanu ◽  
A. Dumitru ◽  
O. Bodean ◽  
L. Arsene ◽  
D. Voicu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Malignant Tumors ◽  
Cord Compression ◽  
Pathological Fractures ◽  
Future Directions ◽  
Skeletal Related Events ◽  
Frequent Site ◽  
Clinical Overview

Abstract From breast malignant tumors, bone is the most frequent site of metastasis. Bone metastases from breast cancer are correlated with pathological fractures, spinal cord compression and other skeletal-related events as well as bone pain and hypercalcemia. These lead to impaired mobility, decreased quality of life, and overall decrease in survival. Clarification of mechanisms regulating bone metastasis has advanced greatly in the last years and this has translated into plentiful unused therapeutic options. Greater understanding of the pathophysiology of bone metastases has led to the detection and clinical efficiency of bone-targeted agents. This review summarizes the key evidence for current clinical practice and future directions.

scholarly journals The Therapeutic Landscape of Rheumatoid Arthritis: Current State and Future Directions

2021 ◽  
Vol 12 ◽  
Author(s):  
Shahin Shams ◽  
Joseph M. Martinez ◽  
John R. D. Dawson ◽  
Juan Flores ◽  
Marina Gabriel ◽  
...  
Keyword(s):  
Biological Sciences ◽  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Autoimmune Disease ◽  
Treatment Modalities ◽  
Systemic Autoimmune Disease ◽  
Inadequate Response ◽  
Current State ◽  
Therapeutic Landscape ◽  
Socioeconomic Consequences

Rheumatoid arthritis (RA) is a debilitating autoimmune disease with grave physical, emotional and socioeconomic consequences. Despite advances in targeted biologic and pharmacologic interventions that have recently come to market, many patients with RA continue to have inadequate response to therapies, or intolerable side effects, with resultant progression of their disease. In this review, we detail multiple biomolecular pathways involved in RA disease pathogenesis to elucidate and highlight pathways that have been therapeutic targets in managing this systemic autoimmune disease. Here we present an up-to-date accounting of both emerging and approved pharmacological treatments for RA, detailing their discovery, mechanisms of action, efficacy, and limitations. Finally, we turn to the emerging fields of bioengineering and cell therapy to illuminate possible future targeted therapeutic options that combine material and biological sciences for localized therapeutic action with the potential to greatly reduce side effects seen in systemically applied treatment modalities.

Clinical Usefulness of Bisphosphonates in Oncology: Treatment of Bone Metastases, antitumoral Activity and Effect on Bone Resorption Markers

2007 ◽  
Vol 22 (1) ◽  
pp. 24-33 ◽  
Author(s):  
A. Verì ◽  
M.R. D'Andrea ◽  
P. Bonginelli ◽  
G. Gasparini
Keyword(s):  
Bone Metastases ◽  
Advanced Disease ◽  
Cord Compression ◽  
Antitumoral Activity ◽  
Pathological Fractures ◽  
Antiangiogenic Activity ◽  
Treatment And Prevention ◽  
Oncology Treatment ◽  
Skeletal Related Events

The present article overviews the role of bisphosphonates for the treatment and prevention of bone metastases and their antiangiogenic effects and antitumoral activity. The skeleton is a frequent and clinically relevant site of metastasis in cancer patients. The major events related to bone metastases include bone pain, bone loss, hypercalcemia, spinal cord compression, and fractures. On the basis of their radiographic features, bone metastases are classified as osteoblastic, osteoclastic, or mixed. The primary goals of treatment of bone metastases are reduction of the risk of pathological fractures and other skeletal-related events, and pain control. Bisphosphonates are used to prevent pathological fractures by inhibition of osteoclasts. Recent studies suggest that bisphosphonates have some direct antitumoral activity, mainly mediated through the blockade of angiogenic pathways. Further clinical studies are needed to determine the optimal treatment duration, timing and schedule of bisphosphonates, assess their role as adjuvant therapy for the prevention of bone metastases, and establish their antiangiogenic activity in association with standard cytotoxic and hormonal drugs for treatment of patients with advanced disease.

Magnetic nanoparticles for magnetic drug targeting

2015 ◽  
Vol 60 (5) ◽  
Author(s):  
Stefan Lyer ◽  
Raminder Singh ◽  
Rainer Tietze ◽  
Christoph Alexiou
Keyword(s):  
Magnetic Nanoparticles ◽  
Side Effects ◽  
Drug Targeting ◽  
Superparamagnetic Iron Oxide ◽  
Magnetic Drug Targeting ◽  
Oxide Nanoparticles ◽  
Treatment Concept ◽  
Substantial Progress ◽  
New Treatment ◽  
Tumor Area

AbstractNanomedicine and superparamagnetic iron oxide nanoparticles (SPIONs) are thought to have an important impact on medicine in the future. Especially in cancer therapy, SPIONs offer the opportunity of improving the effectivity of the treatment and reduce side effects by magnetic accumulation of SPION-bound chemotherapeutics in the tumor area. Although still some challenges have to be overcome, before the new treatment concept of magnetic drug targeting will reach the patients, substantial progress has been made, and promising results were shown in the last years.

scholarly journals Efficacy of Skin Microneedling in Combination with Narrow Band - Ultraviolet B Phototherapy in Vitiligo

2021 ◽  
pp. 68-75
Author(s):  
Sarah Sanad Lotfy ◽  
Yomna Mazid El-Hamd Neinaa ◽  
Nahla El-Sayed Ramzy Ghaly ◽  
Noha Nabil Doghaim
Keyword(s):  
Side Effects ◽  
Narrow Band ◽  
Psychological Impact ◽  
Significant Degree ◽  
Ultraviolet B ◽  
Treatment Modalities ◽  
Duration Of Treatment ◽  
Mild Improvement ◽  
New Treatment

Background: Vitiligo is a chronic cutaneous disease characterized by milky white depigmented patches that leave psychological impact on the patient's quality of life. New treatment modalities have been developed to shorten the duration of treatment of vitiligo with the least side effects. Objective: To evaluate the safety & efficacy of microneedling in combination with narrow band-UVB in the treatment of vitiligo. Patients and Methods: This study included 20 patients with stable vitiligo. They were treated by microneedling (one session every 2 weeks) in combination with narrow band-UVB (3 sessions weekly) for 3 months. Results: The studied patients reported statistically significant degree of clinical improvements as follow;10%reportedgoodimprovement, 25% showe dmoderate improvement, 45% showed mild improvement and 20% showed noimprovement,after3months therapy. The reported side effects were minimal and transient in the form of minor pain, burning sensation and erythema at site of microneedling that disappeared spontaneously within few hours. Conclusion: Microneedling in combination with narrow band-UVB phototherapy could be considered as effective treatment of vitiligo. Microneedling is a tolerable technique, harmless with negligible side effects.

scholarly journals Advances in Wound Healing: A Review of Current Wound Healing Products

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Patrick S. Murphy ◽  
Gregory R. D. Evans
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Side Effects ◽  
Hyperbaric Oxygen ◽  
Negative Pressure ◽  
State Of The Art ◽  
Wound Care ◽  
Skin Substitutes ◽  
Healing Environment ◽  
Current State

Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing.

scholarly journals Hypoparathyroidism: State of the Art on Cell and Tissue Therapies

2021 ◽  
Vol 22 (19) ◽  
pp. 10272
Author(s):  
Francesca Miglietta ◽  
Gaia Palmini ◽  
Francesca Giusti ◽  
Simone Donati ◽  
Cinzia Aurilia ◽  
...  
Keyword(s):  
Side Effects ◽  
Replacement Therapy ◽  
Therapeutic Strategy ◽  
State Of The Art ◽  
Hormone Replacement ◽  
High Serum ◽  
Endocrine Function ◽  
Endocrine Disorders ◽  
Current State ◽  
Tissue Therapy

Hypoparathyroidism is an endocrine disorder characterized by low serum calcium levels, high serum phosphorus levels, and by inappropriate or absent secretion of the parathyroid hormone (PTH). The most common therapeutic strategy to treat this condition is hormone replacement therapy with calcium and vitamin D but, unfortunately, in the long term this treatment may not be sufficient to compensate for the loss of endocrine function. Glandular autotransplantation is considered the most effective technique in place of replacement therapy. Although it leads to excellent results in most cases, autotransplantation is not always possible. Allograft is a good way to treat patients who have not been able to undergo autograft, but this technique has limited success due to side effects related to tissue rejection. This therapy is supported by systemic immunosuppression, which leads to the onset of serious side effects in patients, with a risk of endocrine toxicity. Today, research on endocrine disorders is focused on discovering alternative graft therapies that can allow optimal results with the fewest possible side effects. In this review, we will make an update on the current state of the art about the cell and tissue therapy as treatment for hypoparathyroidism, to identify which type of therapeutic strategy could be valid for a future clinical use.

scholarly journals Evaluation of Intralesional Injection of 5-fluorouracil in Treatment of Vitiligo

2021 ◽  
pp. 11-16
Author(s):  
D. M. Abo Anber ◽  
D. A. Mohammed Ali ◽  
R. A. El-Tatawy ◽  
L. H. Elgarhy
Keyword(s):  
Side Effects ◽  
Narrow Band ◽  
Psychological Impact ◽  
Treatment Modalities ◽  
P Value ◽  
Intralesional Injection ◽  
Cutaneous Disease ◽  
Before And After ◽  
New Treatment

Background: Vitiligo is a chronic cutaneous disease characterized by depigmented patches that leave psychological impact on the patients. New treatment modalities have been developed to improve the results vitiligo with less side effects. Objective: To evaluate intralesional injection of 5-fluorouracil in treatment of vitiligo. Patients and Methods: The study included 20 localized stable vitiligo patients. Each patient was treated with intralesional injection of 5-fluorouracil every 2 weeks for 3 sessions followed by narrow band sessions twice weekly for 3 months. Results: There was statistically significant repigmentation after treatment with intralesional 5-FU (mean of 50.30 ± 34.60, P value =0.001 Wilcoxon signed ranks test between before and after). 55% of patients showed >50% repigmentation. after 3 months therapy. Side effects were minimal and transient. Conclusion: Intralesional injection of 5-FU is safe and effective in the treatment of vitiligo.

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