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Nucleic Acids as Therapeutic Targets and Agents
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Doxorubicin can also be administered by intravesical instillation into the bladder to treat papillary bladder tumors, recurrent superficial bladder tumors, transitional cell carcinoma, and carcinoma in situ. Liposomal formulations are also available and claimed to reduce the risk of cardiotoxicity and local tissue necrosis. However, infusion reaction can occur which may be severe. Hand-foot syndrome, painful reddening eruptions on the hands and feet, can also occur with liposomal doxorubicin, and this can be dose limiting. It may occur after two or three cycles, and can be prevented by cooling the patient’s hands and feet. CaelyxTM is approved in the UK for advanced acquired immunodeficiency syndrome (AIDS)–related Kaposi’s sarcoma in patients with low CD4 count and extensive mucocutaneous or visceral disease and for advanced ovarian cancer when platinum-based chemotherapy has failed. It is also approved for progressive multiple myeloma (in combination with bortezomib) in patients who have received at least one prior therapy and who have undergone or are unsuitable for bone marrow transplantation, and as monotherapy for metastatic breast cancer in patients with increased cardiac risk. A similar product, MyocetTM, is licensed for use with cyclophosphamide for metastatic breast cancer. Doxorubicin can also be given by bladder instillation for superficial bladder tumors. It is important to note that doxorubicin is photosensitive, and so original containers and subsequent IV bags need to be protected from light.
Cosmetic-Medical Treatments
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
M. Lourdes Mourelle, B. N. Díaz
Hand-foot syndrome: This is a specific clinical manifestation of cancer treatments and occurs both in chemotherapy treatments and in targeted therapies, although in the first case they are more diffuse, and with targeted therapies they appear earlier and are more localized [5]; it is also called acral erythema or Burgdorf syndrome. It presents as an extensive inflammatory erythema on the palms of the hands and soles of the feet (usually bilateral), sometimes with edema and varying degrees of desquamation, hyperkeratosis, or blisters. It has a great impact on the QoL of the patient, so it may be necessary to reduce the dose and even stop treatment [17].
Systemic therapy for appendiceal cancer
Published in Wim P. Ceelen, Edward A. Levine, Intraperitoneal Cancer Therapy, 2015
Farquharson et al. [12] were first to publish a study demonstrating a benefit of systemic chemotherapy in patients with advanced unresectable PMP. This phase II study evaluated tumor response, OS, toxicity, and quality of life (QOL) in patients receiving mitomycin-C 7 mg/m2 intravenously (IV) day 1 and capecitabine 1250 mg/m2 twice daily on days 1–14 of a 21-day cycle (cycle 1), alternating with capecitabine 1250 mg/m2 twice daily on days 1–14 of a 21-day cycle (cycle 2). These 3-week cycles 1 and 2 were alternated until a total of 8 cycles were completed (MCap). Forty patients were treated from April 2003 through December 2006. Thirty-nine patients were evaluable for response, of which 15 (38%) showed a benefit from chemotherapy by demonstrating reduction in mucinous ascites or displaying SD after progressing on prior treatments. Tumor-related survival rates were 84% and 61%, respectively, at 1 and 2 years. Of note, 2 patients who were deemed unresectable at study entry underwent potentially curative CS following MCap administration and subsequent restaging. The MCap regimen was considered to be well tolerated, with Grade 3/4 toxicity events occurring in only 6% of 277 total cycles of chemotherapy; all were hand–foot syndrome. This study is an important benchmark, as it was the first to demonstrate the benefit of systemic chemotherapy, with mitomycin-C and capecitabine, in patients with advanced unresectable PMP [12].
A Systematic Review of the Benefit of B-Vitamins as a Complementary Treatment in Cancer Patients
Published in Nutrition and Cancer, 2022
L. Heilfort, S. Kutschan, J. Dörfler, M. Freuding, J. Büntzel, K. Münstedt, J. Hübner
Nevertheless, there are several side effects of chemotherapeutic drugs for which B-vitamins are recommended as preventive or therapeutic agents, even in patients without a vitamin-deficiency. One of these side effects is the hand-foot syndrome (HFS), which can be triggered by various chemotherapeutic drugs like capecitabine, doxorubicin, cytarabine, docetaxel, and fluorouracil (13). Depending on the medication, this painful erythema occurs in up to 64% of the patients treated (13, 14). So far, there is still no valid standard therapy for this side effect. As a result, dose modifications of the chemotherapeutic drugs may be necessary. In some cases chemotherapy may have to be stopped completely (15). Besides other symptomatic and prophylactic methods, vitamin B6 is an agent that is used to treat this side-effect.
The role of Eph receptors in cancer and how to target them: novel approaches in cancer treatment
Published in Expert Opinion on Investigational Drugs, 2020
Oscar J Buckens, Btissame El Hassouni, Elisa Giovannetti, Godefridus J Peters
JI-101 is a multi-tyrosine kinase inhibitor with a high selectivity for EphB4, VEGFR2 and PDGFRβ [159]. In phase 1 and 2 clinical trials, the drug was well tolerated and led to stable disease in 25% of the patients. The tested doses, 100 mg or 200 mg daily, did not cause severe adverse effects. In some patients, side-effects such as hypertension and proteinuria were observed, but no diarrhea [160,161]. In some patients treated with a higher dose (400 mg), short-lasting hand-foot syndrome was also observed [161]. In a pharmacokinetics study, JL-101 showed median progression free survival of 5.6 months in ovarian cancer patients in which mostly gastrointestinal side-effects, such as nausea and abdominal pain were observed [18]. A study in rats showed a good oral availability (55%) and a rapid absorption in the body with an accumulation of the drug in the lungs, liver, kidney and small intestine [162].
Pegylated liposomal doxorubicin as neoadjuvant therapy for stage II–III locally advanced breast cancer
Published in Journal of Chemotherapy, 2020
Jia Yao, Shaobo Pan, Xiao Fan, Xue Jiang, Yuhong Yang, Jing Jin, Yu Liu
Hand-foot syndrome is a PLD-specific adverse event. Hand-foot syndrome occurred in 10 (37.0%) patients and only 2 (7.4%) patients reached grade 3 toxicity in our study. This side effect is not life threatening and is reversible and manageable with appropriate supportive care. To minimize the rate of hand-foot syndrome, we advise patients to wear loose-fitting clothing and to avoid exposure to heat and vigorous exercise; we also suggested oral vitamin B6. Published reports21 suggest that concomitant medication with vitamin B6 and/or dexamethasone may alleviate the symptoms of hand-foot syndrome, and thus if patients reach grade 2 toxicity, vitamin B6 and dexamethasone are given. Although this adverse effect is reversible and controllable, patients should be informed of this common drug-related effect before receiving PLD.