Introduction to Cancer, Conventional Therapies, and Bionano-Based Advanced Anticancer Strategies
D. Sakthi Kumar, Aswathy Ravindran Girija in Bionanotechnology in Cancer, 2023
Chemotherapy is the use of anticancer drugs to destroy cancer cells. The drugs work by killing cancer cells or interfering with tumor growth. Chemotherapy is usually considered one of the most effective cancer treatment methods; however, this type of therapy can induce severe side effects, as it can also destroy healthy cells. The adverse effects depend upon the type of cancer and the type of drugs used to treat it. Generally, the side effects are not associated with the treatment effectiveness, and once the treatment process is over, the side effects may stop. Normally, chemotherapy agents are prescribed to a patient in measured dosages and in specific intervals of time. Sometimes a combination chemotherapy is used, during which two or more drug agents are used at the same time [114].
Liposome-Based Nanocarrier System for Phytoconstituents
Madhu Gupta, Durgesh Nandini Chauhan, Vikas Sharma, Nagendra Singh Chauhan in Novel Drug Delivery Systems for Phytoconstituents, 2020
Upon the use of phytoconstituents in medicine, one important problem arising from prolonged drug use that receives continuous attention from researchers is drug resistance. In fact, drug resistance plays a key role in low anticancer activity of many drugs, leading to low therapeutic efficacy and high systemic toxicity due to the need for higher doses. The underlying mechanisms for such resistance are (1) the efflux of drugs out of tumor cells by the ATP-binding cassette (ABC), including P-glycoprotein, (2) high interstitial fluid pressure preventing drugs from internalizing, and (3) genetic mutations that affect the normal cell cycle, thus avoiding specific activity of several drugs. Combination chemotherapy is a relatively new approach in dealing with cancers and drug-resistant tumors (Dai Hai, 2017, Mengjie et al., 2016, Nguyen et al., 2015b). It is believed to improve therapeutic efficacy and reduce side effects in comparison to individual drugs. Moreover, combination therapy has been proven effective in even drug-resistant cancers, possibly thanks to the fact that targeting multiple pharmacological pathways could overcome the genetic barriers and suppress the efflux receptors involved in drug resistance (Nguyen et al., 2015a, 2015b, 2016b, Sepideh et al., 2017).
Mechanisms of Resistance to Antineoplastic Drugs
Robert I. Glazer in Developments in Cancer Chemotherapy, 2019
Chemotherapy with cytotoxic drugs remains the most effective method of treatment for a wide variety of disseminated cancers. Particular success has been achieved through the use of combination chemotherapy regimens in the treatment of Hodgkin’s disease, acute lymphocytic leukemia, diffuse lymphoma, and testicular cancer.1 In these diseases, chemotherapy regimens frequently produce complete clinical remissions. Combination chemotherapy regimens are also beneficial in patients with many other cancers, including ovarian cancer, breast cancer, and small-cell lung cancer. Although response rates to initial therapy are quite high in these diseases, many patients will eventually relapse. Whereas salvage chemotherapy may be successful in some of these patients, tumors in most patients who relapse are quite refractory to antineoplastic agents. A particularly vexing aspect of this phenomenon is that tumor cells in the setting of relapse are often cross-resistant to agents to which they have never been exposed.
Hypothesis of using albumin to improve drug efficacy in cancers accompanied by hypoalbuminemia
Published in Xenobiotica, 2021
Soghra Bagheri, Ali A. Saboury
Cancer cells may develop drug resistance during chemotherapy, in which case a higher dose of the drug is needed to produce the same antitumor effect, but higher doses often create more side effects (Zheng 2017). In this regard, combination chemotherapy is used in a wide range of cancers instead of traditional chemotherapy because of its benefits, which include increasing its effectiveness and reducing its side effects. In addition, finding natural compounds with less toxicity is of particular importance (Lin et al. 2020). An important advantage of combination chemotherapy is reducing the dose of drug, which can lead to less resistance (Lin et al. 2020). It seems that the use of albumin in patients with hypoalbuminemia can have the same effect. Because excess albumin entering the body can both increase the half-life of the circulating drug and increase the drug's entry into cancer cells, it can reduce the dose of the drug. In general, due to the penetration of albumin into cancer tissues, which is known as the EPR effect, there is hope for obtaining tumour-specific activity of drugs using albumin as carrier (Mayr et al. 2017). Similarly, the addition of albumin to the treatment regimen of cancer patients with hypoalbuminemia is expected to lead more specific drug delivery to cancer tissues (Figure 3).
Mixed micelles of TPGS and Soluplus® for co-delivery of paclitaxel and fenretinide: in vitro and in vivo anticancer study
Published in Pharmaceutical Development and Technology, 2020
Yutong Wang, Yanfang Ding, Youwei Xu, Changyuan Wang, Yingying Ding, Meng Gao, Chengge Ma, Xiaodong Ma, Lei Li
Paclitaxel (PTX) is widely used in a large variety of human cancers such as head and neck cancer, lung cancer, breast cancer, ovarian cancer and so on (Surapaneni et al. 2012; Sun et al. 2014). PTX exerts its antitumor activity through a unique mechanism by stoichiometrically binding to the microtubule and hyper stabilizing its structure. But the disadvantages such as severe toxicity, poor solubility and drug multidrug resistance made its clinical application limited (Varma and Panchagnula 2005; Sun et al. 2014). Drug combination chemotherapy would be a promising treatment means as an effective strategy to anticancer therapy. As the coadministration of two antitumor drugs at the same time, the synergistic effect of different chemotherapeutic drugs would contribute to improve the therapeutic effect, decrease the side effects and prevent multidrug resistance.
The effect of postoperative gemcitabine on overall survival in patients with resected pancreatic cancer: A nationwide population-based Danish register study
Published in Acta Oncologica, 2019
Louise Skau Rasmussen, Benny Vittrup, Morten Ladekarl, Per Pfeiffer, Mette Karen Yilmaz, Laurids Østergaard Poulsen, Kell Østerlind, Carsten Palnæs Hansen, Michael Bau Mortensen, Frank Viborg Mortensen, Mogens Sall, Sönke Detlefsen, Martin Bøgsted, Claus Wilki Fristrup
Improvements in the effects of adjuvant chemotherapy in PC have been reported recently. Significantly prolonged mOS was shown for combined treatment with gemcitabine and capecitabine compared to gemcitabine monotherapy (28 versus 25 months, respectively) [30]. An impressive treatment effect with modified FOLFIRINOX compared to gemcitabine showed an increased mOS of 54.4 versus 35 months, respectively [15]. Tegafur/gimeracil/oteracil (S-1) compared to gemcitabine has also shown an increased mOS of 45.5 versus 25.5 months, respectively, in Japanese patients [39]. Adjuvant therapy with the combination of gemcitabine and capecitabine was implemented in Denmark in autumn 2016 and then with modified FOLFIRINOX in autumn 2018. Combination chemotherapy improves clinical outcomes but worsens side effects, making the selection of patients with a good PS necessary [15]. Obviously, there will still be a subgroup of patients who can only be offered gemcitabine monotherapy. In light of the new standard therapies, the results of the present study will be useful as a clinical reference in the future for comparing the OS in unselected PC patients receiving new adjuvant combination chemotherapy regimens. Danish national real-time register data will be available in the DPCD during the next three years.
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