China
Africa
Explore chapters and articles related to this topic
Advances in the Treatment of Brain Metastases
Published in Kishan J. Pandya, Julie R. Brahmer, Manuel Hidalgo, Lung Cancer, 2016
Malika L. Siker, Minesh P. Mehta
Future directions in the medical management of brain metastases include the development of new agents with less toxicity than the standard approach of anticonvulsants and steroids. Long-term use of steroids is associated with myopathies, muscle wasting, weight gain, osteoporosis, and gastrointestinal bleeding. Furthermore, preclinical studies have suggested that dexamethasone may interfere with apoptotic death of glioma cells and induce resistance to chemotherapeutic agents and radiotherapy (24–26). One agent currently being evaluated in an ongoing study is corticorelin acetate, which is human corticotropin-releasing factor (hCRF). This agent functions like the naturally occurring neuropeptide that stimulates the hypothalamic–pituitary–adrenal axis. Administration of hCRF has been shown to reduce vasogenic peritumoral brain edema in animal models, independent of adrenal function with 100-fold greater potency and reduced weight gain (27). A prospective phase III trial is currently enrolling patients who are randomized to receive hCRF or placebo after a 50% reduction in baseline dexamethasone dose. Results from this trial are awaited.
Excipients in parenteral formulations: selection considerations and effective utilization with small molecules and biologics
Published in Drug Development and Industrial Pharmacy, 2018
Bindhu Madhavi Rayaprolu, Jonathan J. Strawser, Gopal Anyarambhatla
Collapse temperature modifiers are used in some lyophilized formulations which can modify the by increasing the collapse temperature. Examples include Ficoll, Gelatin, Human Serum Albumin, Hydroxyethyl Starch, Dextran which act as collapse temperature modifiers. Peptides and protein drugs containing Methionine residues are prone to oxidation. To prevent this, antioxidants are added to these biopharmaceuticals to prevent oxidation. Some of the marketed biopharmaceuticals that contain antioxidants include ascorbic acid in Vivotif Berna® (live typhoid vaccine), cysteine hydrochloride and ascorbic acid in ACHTHREL® (Corticorelin Ovine) [33,34].