Ethanol sclerotherapy: Is it gold standard for venous malformation management as well?
Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic in Vascular Malformations, 2019
Bleomycin is a cytotoxic antibiotic isolated from the gram-positive bacteria Streptomyces verticillus. Bleomycin inhibits DNA synthesis and is used as a chemotherapy agent. When used as a sclerosing agent, it induces an inflammatory reaction that subsequently causes fibrosis. It is very well tolerated with minimal swelling and pain after sclerotherapy.4 In a systemic review and meta-analysis, the outcomes of intralesional bleomycin injection for VMs were studied in 12 articles including 690 patients. Good to excellent size reduction was reported in 87% of VMs without nerve injury.13 Pulmonary fibrosis was not reported. Nausea, vomiting, and chills may occur soon after sclerotherapy. Treatment with bleomycin alone usually requires more procedures than other sclerosing agents.4, 13 A combination of bleomycin and other sclerosing agents (ethanol or foam sclerosing agents) shows better results with less complication rates. Because of concern for pulmonary fibrosis, the bleomycin dose is limited to 0.5 units/kg or 15 units per procedure, with a lifetime limit of 400 units.
Combined radiotherapy and chemotherapy
Michael C. Joiner, Albert J. van der Kogel in Basic Clinical Radiobiology, 2018
Classically, cytotoxic anti-neoplastic drugs are divided into different classes based on their mechanisms of action, i.e. anti-metabolites, alkylating agents, topoisomerase inhibitors, anti-microtubule agents and antibiotics. Compared to radiotherapy or surgery, chemotherapy is a systemic treatment administered mainly intravenously or orally. Chemotherapy agents are used alone (monochemotherapy) or in combination (polychemotherapy). Typically, chemotherapeutic agents are biologically active by killing dividing cells, thus exerting both their efficacy and their toxicity (Table 19.2). The main side effects typically observed with chemotherapy, but with important variations in intensity from one drug to another, include nausea, vomiting, alopecia, mucositis, fatigue, anaemia, thrombopenia and neutropenia. In addition, some specific toxicities can be observed with specific agents (e.g. cardiac dysfunction with anthracyclines, bladder toxicity with ifosfamide). Table 19.2 describes the main cytotoxic agents with their biological activity and specific toxicities.
Molecular Imaging of Viable Cancer Cells
Shoogo Ueno in Bioimaging, 2020
Cancer is a global healthcare concern: its annual incidence worldwide in 2018 was estimated to be 18.1 million people, while mortality was 9.6 million people. It is said that one out of five to six people worldwide develop cancer during their lifetime, and one out of eight to ten people die from cancer. Since there is a better chance of recovery when cancer is found and treated at an early stage, as judged in terms of improved five-year survival rates, various types of cancer screening tests, such as blood tests, urine tests, cytology, endoscopic examination, and medical imaging, have been developed and are in routine clinical use. However, substantial numbers of cancer patients are still diagnosed late due to the lack of obvious cancer signs or symptoms, or for other reasons. Available types of cancer treatment include surgery, radiation therapy, chemotherapy, immunotherapy, hormone therapy, and so on. In the case of surgical treatment, accurate and complete resection of the tumor is critical to achieve a cure.
Monoclonal antibody as a targeting mediator for nanoparticle targeted delivery system for lung cancer
Published in Drug Delivery, 2022
Nasrul Wathoni, Lisa Efriani Puluhulawa, I Made Joni, Muchtaridi Muchtaridi, Ahmed Fouad Abdelwahab Mohammed, Khaled M. Elamin, Tiana Milanda, Dolih Gozali
The lungs are an important organ in the human body, particularly in the respiratory system. Damage to this organ can endanger lives and perhaps result in death. Lung cancer is a form of cancer that affects the human lungs (Bade & Dela Cruz, 2020). This malignancy is the second most common after breast cancer and has the greatest fatality rate of any type of cancer (International Agency for Research on Cancer (IARC), 2020). It is reported that this cancer has a mortality rate of 1,796,144 or 18% of the total number of cancer deaths and an incidence rate of 2,206,771 which is 11.4% of all cancer incidences worldwide both in women and men (Globocan, 2020). There are currently three options for cancer treatment: surgery, radiation therapy, and chemotherapy (Abbas & Rehman, 2018). Stage I or II Non-Small Cell Lung Cancer ‘NSCLC’ treatment is surgical resection of the tumor followed by adjuvant therapy. When the cancer progresses to stage III or IV, the treatments are chemotherapeutic and/or radiation therapy. Since the cancer invaded surrounding tissues, metastases can occur through the circulatory system or lymphatic system (Huang et al., 2015). Chemotherapy is a form of cancer treatment that employs medications. As a result of the drug’s inability to target specific cells, this therapy is often associated with severe adverse effects (Ohnoshi et al., 1992; Partridge et al., 2001; Sun et al., 2005; Aslam et al., 2014). It has inspired the development of cancer medicines, one of which is the use of nanoparticles.
An update on: molecular genetics of high-risk chronic lymphocytic leukemia
Published in Expert Review of Hematology, 2020
Riccardo Moia, Andrea Patriarca, Clara Deambrogi, Silvia Rasi, Chiara Favini, Ahad Ahmed Kodipad, Mattia Schipani, Gianluca Gaidano
Chemotherapy agents exert their antineoplastic activity by interfering with the normal structure of cellular genomic DNA. In normal cells, if the DNA damage induced by chemotherapy cannot be restored by the physiological DNA repairing enzymes, a cascade of intracellular signaling (namely, related to TP53 and ATM functions) causes the apoptosis of the cell. On these grounds, the correct function of the proteins involved in the DNA damage response machinery is essential for inducing cell death in cells treated with chemotherapy. Among these proteins, TP53 plays a pivotal role in the DNA repair pathway. Loss of TP53 function, by mutation and/or deletion, can prevent cell apoptosis, thus leading to the survival and subsequent proliferation of cells with an increased degree of complexity in the number and type of chromosomal and genetic abnormalities [14,15].
Safety evaluation of durvalumab for the treatment of non-small-cell lung cancer
Published in Expert Opinion on Drug Safety, 2020
Non-small-cell lung cancer (NSCLC) accounts for 85%–90% of all cases of lung cancer, and most NSCLC patients are diagnosed with locally advanced or metastatic disease [1]. Cytotoxic treatments with platinum-based chemotherapy for advanced NSCLC without driver mutations or platinum-based chemotherapy concurrent with radiotherapy (chemoradiotherapy) for locally advanced NSCLC have been the standards of care in patients with a good performance status. Most cytotoxic chemotherapy shows some efficacy against cancer cells by inhibiting essential processes, such as DNA replication and cell division. However, these anticancer drugs also directly affect normal cells, causing various side effects [2]. Because the therapeutic window for these cytotoxic chemotherapies is narrow, most patients treated with cytotoxic chemotherapy experience adverse events (AEs) such as hematological toxicity, gastrointestinal reactions, and organ damage. The discontinuation of treatments in response to severe AEs can affect the efficacy of treatment, so the management of AEs is important.
Related Knowledge Centers
- Alkylation
- Cancer Treatment
- DNA Damage
- DNA Repair
- Palliative Care
- Cancer
- Mitosis
- Chemotherapy Regimen
- Cure
- Pharmacotherapy