1
|
McCray TN, Nguyen V, Heins JS, Nguyen E, Stewart K, Ford CT, Neace C, Gupta P, Ortiz DJ. Bronchioalveolar organoids: A preclinical tool to screen toxicity associated with antibody-drug conjugates. Toxicol Appl Pharmacol 2024; 485:116886. [PMID: 38452946 DOI: 10.1016/j.taap.2024.116886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/06/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
Despite extensive preclinical testing, cancer therapeutics can result in unanticipated toxicity to non-tumor tissue in patients. These toxicities may pass undetected in preclinical experiments due to modeling limitations involving poor biomimicry of 2-dimensional in vitro cell cultures and due to lack of interspecies translatability in in vivo studies. Instead, primary cells can be grown into miniature 3-dimensional structures that recapitulate morphological and functional aspects of native tissue, termed "organoids." Here, human bronchioalveolar organoids grown from primary alveolar epithelial cells were employed to model lung epithelium and investigate off-target toxicities associated with antibody-drug conjugates (ADCs). ADCs with three different linker-payload combinations (mafodotin, vedotin, and deruxtecan) were tested in bronchioalveolar organoids generated from human, rat, and nonhuman primate lung cells. Organoids demonstrated antibody uptake and changes in viability in response to ADC exposure that model in vivo drug sensitivity. RNA sequencing identified inflammatory activation in bronchioalveolar cells in response to deruxtecan. Future studies will explore specific cell populations involved in interstitial lung disease and incorporate immune cells to the culture.
Collapse
Affiliation(s)
| | - Vy Nguyen
- Seagen Inc., Bothell, Washington, USA
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Oura K, Tanaka M, Matsumoto K, Satake R, Inoue M, Yoshida Y, Wakabayashi W, Hasegawa S, Iwata M, Suzuki T, Maezawa M, Nakao S, Liao J, Iguchi K, Nakamura M. Analysis of drug-induced interstitial lung disease caused by herbal medicine using the Japanese Adverse Drug Event Report database. BMC Complement Med Ther 2024; 24:121. [PMID: 38486172 PMCID: PMC10938654 DOI: 10.1186/s12906-024-04428-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Drug-induced interstitial lung disease (DIILD) is a severe adverse event leading to morbidity and mortality. This study evaluated the adverse event indicators of DIILD and time-to-onset profiles following the daily intake of herbal drugs (Scutellariae radix ["ogon" in Japanese], Bupleuri radix ["saiko" in Japanese], and Pinelliae tuber ["hange" in Japanese]) using the Japanese Adverse Drug Event Report database. DIILD was defined in accordance with the Medical Dictionary for Regulatory Activities. METHODS The Japanese Adverse Drug Event Report database contained 830,079 reports published between April 2004 and April 2023. The association between herbal medicines and DILLD was evaluated using the pharmacovigilance index as the reporting odds ratio (ROR), logistic regression models, propensity score-matching techniques, and Weibull shape parameters. RESULTS The adjusted RORs using multivariate logistic regression models for Scutellariae radix (daily intake), Pinelliae tuber (daily intake), sex (male), age (≥ 60 years), Scutellariae radix (daily intake)*age (≥ 60 years), and Scutellariae radix (daily intake)* Pinelliae tuber (daily intake) were 1.47 (1.36 - 1.59), 1.05 (1.01 - 1.10), 1.45 (1.34 - 1.57), 1.92 (1.74 - 2.11), 3.35 (3.12 - 3.60), and 1.49 (1.46 - 1.53), respectively. DIILD onset profiles were evaluated using the Weibull shape parameter. A logistic plot of daily intake and onset of DIILD was drawn. ROR signals were detected in 32 of 54 herbal medicines, including Scutellariae radix, Bupleuri radix, and Pinelliae tuber. The median duration (days) (interquartile range) to DIILD onset was 36.0 (27.0-63.0) for Saikokaryukotsuboreito, 35.0 (21.0-55.0) for Saireito, and 31.0 (13.5-67.5) for Shosaikoto. The Weibull shape parameter beta (95% confidence interval) values for Saikokaryukotsuboreito, Saireito, and Shosaikoto were 1.36 (1.08-1.67), 1.36 (1.20-1.52), and 1.31 (0.98-1.68), respectively. CONCLUSIONS DIILD demonstrated a dose-dependent to crude drugs. Clinicians should strive for the early detection of DIILD and avoid the inadvertent administration of herbal medicines.
Collapse
Affiliation(s)
- Keita Oura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Mizuki Tanaka
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Kiyoka Matsumoto
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Riko Satake
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Misaki Inoue
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Yu Yoshida
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Wataru Wakabayashi
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Shiori Hasegawa
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Kaneichi Pharmaceutical, Company, Limited, Osaka, Japan
| | - Mari Iwata
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Kifune Pharmacy, Gifu, Japan
| | - Takaaki Suzuki
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Gifu Prefectural Government, Gifu, Japan
| | - Mika Maezawa
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Satoshi Nakao
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Liao
- Department of Information Science and Information System, China Pharmaceutical University, Nanjing, China
| | - Kazuhiro Iguchi
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Mitsuhiro Nakamura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan.
| |
Collapse
|
3
|
Mizusawa J, Sato H, Rubinstein LV, Fujiwara T, Yonemori K, Hirakawa A. Racial differences in longitudinal toxicities of anticancer agents in early phase cancer clinical trials. Cancer Med 2023; 12:18098-18109. [PMID: 37519123 PMCID: PMC10524029 DOI: 10.1002/cam4.6370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/25/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Racial differences have been reported in toxicity outcomes for anticancer drug treatments. However, these observations were often from studies with small sample sizes, and many only reported the maximum grade of toxicity and no longitudinal information. This current analysis aims to investigate racial differences in longitudinal toxicities using a large-scale clinical trials database. METHODS Early-phase clinical trials sponsored by the Cancer Therapy Evaluation Program at the National Cancer Institute, USA, that evaluated cytotoxic drugs and molecularly targeted agents between March 2000 and December 2012 were studied. Race was categorized as White, Black or African-American, and Asian. Each toxicity's grade prevalence, mean grade at each cycle, and time to develop grade 2 or higher toxicity was evaluated. RESULTS In total, 25,442 patients from 697 trials were included in this study. The number of patients categorized as White, Black, and Asian designations was 22,756 (89%), 1874 (7%), and 812 (3%), respectively. Notable findings include the rate of any grade of diarrhea in Black people was 26% and 21% lower than that of White and Asian people. The median time to the first grade 2 or higher event was 6 cycles in White people, 8 in Black people, and 6 in Asian people. The rate of any grade hyperglycemia was significantly higher in Asian people. CONCLUSIONS Although we identified several racial differences in longitudinal toxicities, most were of generally lower grade. Further study is needed to clarify the cause of racial differences in treatment-associated toxicities.
Collapse
Affiliation(s)
- Junki Mizusawa
- Biostatistics Section, Clinical Research Support Office, National Cancer Center Hospital/Biostatistics Division, Center for Research Administration & SupportNational Cancer CenterTokyoJapan
- Department of Global Health PromotionTokyo Medical and Dental UniversityTokyoJapan
| | - Hioryuki Sato
- Department of Clinical Biostatistics, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Larry V. Rubinstein
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer InstituteNational Institute of HealthRockvilleMarylandUSA
| | - Takeo Fujiwara
- Department of Global Health PromotionTokyo Medical and Dental UniversityTokyoJapan
| | - Kan Yonemori
- Department of Breast and Medical OncologyNational Cancer Center HospitalTokyoJapan
| | - Akihiro Hirakawa
- Department of Clinical Biostatistics, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| |
Collapse
|
4
|
Henning JW, Brezden-Masley C, Gelmon K, Chia S, Shapera S, McInnis M, Rayson D, Asselah J. Managing the Risk of Lung Toxicity with Trastuzumab Deruxtecan (T-DXd): A Canadian Perspective. Curr Oncol 2023; 30:8019-8038. [PMID: 37754497 PMCID: PMC10529919 DOI: 10.3390/curroncol30090582] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023] Open
Abstract
Ongoing advances in precision cancer therapy have increased the number of molecularly targeted and immuno-oncology agents for a variety of cancers, many of which have been associated with a risk of pulmonary complications, among the most concerning being drug-induced interstitial lung disease/pneumonitis (DI-ILD). As the number of patients undergoing treatment with novel anticancer agents continues to grow, DI-ILD is expected to become an increasingly significant clinical challenge. Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate targeting human epidermal growth factor receptor 2 that is gaining widespread use in the metastatic breast cancer setting and is undergoing exploration for other oncologic indications. ILD/pneumonitis is an adverse event of special interest associated with T-DXd, which has potentially fatal consequences if left untreated and allowed to progress. When identified in the asymptomatic stage (grade 1), T-DXd-related ILD can be monitored and treated effectively with the possibility of treatment continuation. Delayed diagnosis and/or treatment, however, results in progression to grade 2 or higher toxicity and necessitates immediate and permanent discontinuation of this active agent. Strategies are, therefore, needed to optimize careful monitoring during treatment to ensure patient safety and optimize outcomes. Several guidance documents have been developed regarding strategies for the early identification and management of T-DXd-related ILD, although none have been within the context of the Canadian health care environment. A Canadian multidisciplinary steering committee was, therefore, convened to evaluate existing recommendations and adapt them for application in Canada. A multidisciplinary approach involving collaboration among medical oncologists, radiologists, respirologists, and allied health care professionals is needed to ensure the proactive identification and management of T-DXd-related ILD and DI-ILD associated with other agents with a similar toxicity profile.
Collapse
Affiliation(s)
| | | | - Karen Gelmon
- BC Cancer Agency, 600 10th Avenue West, Vancouver, BC V5Z 4E6, Canada; (K.G.); (S.C.)
| | - Stephen Chia
- BC Cancer Agency, 600 10th Avenue West, Vancouver, BC V5Z 4E6, Canada; (K.G.); (S.C.)
| | - Shane Shapera
- University Health Network, University of Toronto, Toronto General Hospital, 9N-971, 585 University Avenue, Toronto, ON M5G 2N2, Canada;
| | - Micheal McInnis
- Department of Medical Imaging, University of Toronto, 585 University Ave, Toronto, ON M5G 2N2, Canada;
| | - Daniel Rayson
- Department of Medical Oncology, Dalhousie University, QEII-Bethune Building, 1276 South Park Street, Halifax, NS B3H 2Y9, Canada;
| | - Jamil Asselah
- Cedars Cancer Centre, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC H4A 3J1, Canada;
| |
Collapse
|
5
|
Rugo HS, Crossno CL, Gesthalter YB, Kelley K, Moore HB, Rimawi MF, Westbrook KE, Buys SS. Real-World Perspectives and Practices for Pneumonitis/Interstitial Lung Disease Associated With Trastuzumab Deruxtecan Use in Human Epidermal Growth Factor Receptor 2-Expressing Metastatic Breast Cancer. JCO Oncol Pract 2023; 19:539-546. [PMID: 37207306 PMCID: PMC10424906 DOI: 10.1200/op.22.00480] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/01/2023] [Accepted: 03/22/2023] [Indexed: 05/21/2023] Open
Abstract
Trastuzumab deruxtecan (T-DXd) is an antibody drug conjugate with a topoisomerase I payload that targets the human epidermal growth factor receptor 2 (HER2). T-DXd is approved for patients with previously treated HER2-positive or HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+/ISH-) metastatic/unresectable breast cancer (BC). In a second-line HER2-positive metastatic BC (mBC) population (DESTINY-Breast03 [ClinicalTrials.gov identifier: NCT03529110]), T-DXd demonstrated significantly improved progression-free survival (PFS) over ado-trastuzumab emtansine (12-month rate: 75.8% v 34.1%; hazard ratio, 0.28; P < .001), and in patients with HER2-low mBC treated with one prior line of chemotherapy (DESTINY-Breast04 [ClinicalTrials.gov identifier: NCT03734029]), T-DXd demonstrated significantly longer PFS and overall survival than physician's choice chemotherapy (10.1 v 5.4 months; hazard ratio, 0.51; P < .001, and 23.4 v 16.8 months; hazard ratio, 0.64; P < .001, respectively).Interstitial lung disease (ILD) is an umbrella term used for a group of diseases characterized by lung injury including pneumonitis, which can lead to irreversible lung fibrosis. ILD is a well-described adverse event associated with certain anticancer therapies, including T-DXd. An important part of T-DXd therapy for mBC consists of monitoring for and managing ILD. Although information on ILD management strategies is included in the prescribing information, additional information on patient selection, monitoring, and treatment can be beneficial in routine clinical practice. The objective of this review is to describe real-world, multidisciplinary clinical practices and institutional protocols used for patient selection/screening, monitoring, and management related to T-DXd-associated ILD.
Collapse
Affiliation(s)
- Hope S. Rugo
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | | | | | - Kristen Kelley
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | | | | | | | - Saundra S. Buys
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| |
Collapse
|
6
|
Felip E, Llobera L, Perez-Mañá C, Quintela D, Guasch I, Margelí M, Teruel I, Cirauqui B, Centeno C, Romeo M, Ballana E, Quiroga V. New Drugs, Old Toxicities: Pneumonitis Related to Palbociclib - A Case Report. Breast Care (Basel) 2020; 15:548-552. [PMID: 33224001 DOI: 10.1159/000504618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/06/2019] [Indexed: 02/05/2023] Open
Abstract
Background Palbociclib is a specific inhibitor of cyclin-dependent kinases 4 and 6 that is approved for the treatment of advanced or metastatic breast cancer patients. Despite a good toxicity profile in pivotal trials, where asymptomatic neutropenia was the main adverse effect, its wider use in clinical practice may show less prevalent but serious toxicities. Case Presentation Here, we describe a case of pneumonitis due to palbocicblib. A 57-year-old female with breast cancer with bone metastasis presented dyspnea at rest 3 months after beginning treatment with palbociclib and letrozole. Palbociclib-induced pneumonitis was considered the most probable cause after ruling out all alternatives, and the patient was successfully treated with steroids and showed complete remission. Conclusions In summary, we present a well-documented case report of pneumonitis related to palbociclib. However, the mechanism of toxicity is still unknown, and there are as yet no reliable biomarkers to predict toxicity with cyclin-dependent kinase 4/6 inhibitors. In this case report, we alert physicians about new drugs that can provoke old toxicities.
Collapse
Affiliation(s)
- Eudald Felip
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain.,Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain.,AIDS Research Institute-IrsiCaixa and Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - Laia Llobera
- Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Clara Perez-Mañá
- Clinical Pharmacology Unit, Hospital Germans Trias i Pujol, Badalona, Spain, Badalona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - David Quintela
- Department of Clinical Hematology, Catalan Intistute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ignacio Guasch
- Radiology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mireia Margelí
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain.,Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Iris Teruel
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain.,Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Beatriz Cirauqui
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain.,Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Carmen Centeno
- Pulmonology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Margarita Romeo
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain.,Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Ester Ballana
- AIDS Research Institute-IrsiCaixa and Health Research Institute Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Badalona, Spain
| | - Vanesa Quiroga
- Badalona Applied Research Group in Oncology (B-ARGO Group), Oncology Department, Catalan Institute of Oncology, Badalona, Spain
| |
Collapse
|
7
|
Terbuch A, Tiu C, Candilejo IM, Scaranti M, Curcean A, Bar D, Estevez Timon M, Ameratunga M, Ang JE, Ratoff J, Minchom AR, Banerji U, de Bono JS, Tunariu N, Lopez JS. Radiological Patterns of Drug-induced Interstitial Lung Disease (DILD) in Early-phase Oncology Clinical Trials. Clin Cancer Res 2020; 26:4805-4813. [PMID: 32332017 DOI: 10.1158/1078-0432.ccr-20-0454] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/08/2020] [Accepted: 04/21/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Drug-induced interstitial lung disease (DILD) is a rare, but potentially fatal toxicity. Clinical and radiological features of DILD in the early experimental setting are poorly described. PATIENTS AND METHODS A total of 2,499 consecutive patients with advanced cancer on phase I clinical trials were included. DILD was identified by a dedicated radiologist and investigators, categorized per internationally recognized radiological patterns, and graded per Common Terminology Criteria for Adverse Events (CTCAE) and the Royal Marsden Hospital (RMH) DILD score. Clinical and radiological features of DILD were analyzed. RESULTS Sixty patients overall (2.4%) developed DILD. Median time to onset of DILD was 63 days (range, 14-336 days). A total of 45% of patients who developed DILD were clinically asymptomatic. Incidence was highest in patients receiving drug conjugates (7.4%), followed by inhibitors of the PI3K/AKT/mTOR pathway (3.9%). The most common pattern seen was hypersensitivity pneumonitis (33.3%), followed by nonspecific interstitial pneumonia (30%), and cryptogenic organizing pneumonia (26.7%). A higher DILD score [OR, 1.47, 95% confidence interval (CI), 1.19-1.81; P < 0.001] and the pattern of DILD (OR, 5.83 for acute interstitial pneumonia; 95% CI, 0.38-90.26; P = 0.002) were significantly associated with a higher CTCAE grading. The only predictive factor for an improvement in DILD was an interruption of treatment (OR, 0.05; 95% CI, 0.01-0.35; P = 0.01). CONCLUSIONS DILD in early-phase clinical trials is a toxicity of variable onset, with diverse clinical and radiological findings. Radiological findings precede clinical symptoms. The extent of the affected lung parenchyma, scored by the RMH DILD score, correlates with clinical presentation. Most events are low grade, and improve with treatment interruption, which should be considered early.
Collapse
Affiliation(s)
- Angelika Terbuch
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Crescens Tiu
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Irene Moreno Candilejo
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
- Division of Medical Oncology, START Madrid-HM Sanchinarro CIOCC Early Phase Program, Medical University Hospital of Sanchinarro, Madrid, Spain
| | - Mariana Scaranti
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Andra Curcean
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Dan Bar
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Miriam Estevez Timon
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Malaka Ameratunga
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
- Monash University, Melbourne, Australia
| | - Joo Ern Ang
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
- Department of Oncology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jonathan Ratoff
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
- Epsom and St. Helier University Hospitals NHS Trust, Epsom, United Kingdom
| | - Anna R Minchom
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Udai Banerji
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Johann S de Bono
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Nina Tunariu
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom
| | - Juanita S Lopez
- Phase I Drug Development Unit, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, United Kingdom.
| |
Collapse
|
8
|
Incidence of interstitial pneumonitis in breast cancer patients treated with pegylated liposomal doxorubicin. Cancer Chemother Pharmacol 2019; 85:3-7. [DOI: 10.1007/s00280-019-03909-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/25/2019] [Indexed: 12/15/2022]
|
9
|
de Pablo E, Fernández-García R, Ballesteros MP, Torrado JJ, Serrano DR. Nebulised antibiotherapy: conventional versus nanotechnology-based approaches, is targeting at a nano scale a difficult subject? ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:448. [PMID: 29264365 DOI: 10.21037/atm.2017.09.17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Nebulised antibiotics offer great advantages over intravenously administered antibiotics and other conventional antibiotic formulations. However, their use is not widely standardized in the current clinical practice. This is the consequence of large variability in the performance of nebulisers, patient compliance and a deficiency of robust preclinical and clinical data. Nebulised antibiotherapy may play a significant role in future pulmonary drug delivery treatments as it offers the potential to achieve both a high local drug concentration and a lower systemic toxicity. In this review, the physicochemical parameters required for optimal deposition to the lung in addition to the main characteristics of currently available formulations and nebuliser types are discussed. Particular attention will be focused on emerging nanotechnology based approaches which are revolutionizing inhaled therapies used to treat both infections and lung cancer. Promising carriers such as Trojan-Horse microparticles, liposomes, polymeric and lipid nanoparticulate systems have been investigated and proposed as viable options. In order to achieve site-specific targeting and to optimize the PK/PD balance critical nanoscale design parameters such as particle size, morphology, composition, rigidity and surface chemistry architecture must be controlled. Development of novel excipients to manufacture these nanomedicines and assessment of their toxicity is also a keystone and will be discussed in this review.
Collapse
Affiliation(s)
- Esther de Pablo
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain
| | - Raquel Fernández-García
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain
| | - María Paloma Ballesteros
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
| | - Juan José Torrado
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
| | - Dolores R Serrano
- Departamento de Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Madrid, Spain.,Instituto Universitario de Farmacia Industrial (IUFI), Facultad de Farmacia, Universidad Complutense de Madrid, Avenida Complutense, Madrid, Spain
| |
Collapse
|
10
|
Yonemori K, Hirakawa A, Kawachi A, Kinoshita F, Okuma H, Nishikawa T, Tamura K, Fujiwara Y, Takebe N. Drug induced interstitial lung disease in oncology phase I trials. Cancer Sci 2016; 107:1830-1836. [PMID: 27685762 PMCID: PMC5198943 DOI: 10.1111/cas.13087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 11/26/2022] Open
Abstract
Interstitial lung disease is a serious drug‐related condition that can cause life threatening organ failure. The incidence and risk factors of drug‐induced interstitial lung disease (DILD) are unknown in oncology phase I trials. This study analyzed clinical information from 8906 patients with malignancies who were enrolled in 470 phase I trials sponsored by the Cancer Therapy Evaluation Program, National Cancer Institute, from 1988 to 2014. Logistic and Cox statistical analyses were utilized to determine clinical differences between patients who developed DILD and patients who did not. In this study, the overall incidence rate of patients with pulmonary toxicity was 2.7%. The overall incidence rate for DILD was 0.77%, whereas for grade 3 or 4 DILD it was 0.31%. Median time to occurrence of DILD was 1.4 months. The Cox hazard analysis indicated smaller body surface area and a combination of thoracic radiation with investigational drug regimens were significant risk factors for time to occurrence of interstitial lung disease. Investigators should carefully monitor for DILD in oncology patients enrolled in phase I trials with identified risk factors. A 6‐month observation period would be sufficient to detect the onset of most DILD in such patients.
Collapse
Affiliation(s)
- Kan Yonemori
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan.,Office for Advanced Medical Care Evaluation, National Cancer Center, Tokyo, Japan.,Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institute of Health, Rockville, Maryland, USA
| | - Akihiro Hirakawa
- Biostatistics and Bioinformatics Section, Center for Advanced Medicine and Clinical Research, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Asuka Kawachi
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan
| | - Fumie Kinoshita
- Biostatistics and Bioinformatics Section, Center for Advanced Medicine and Clinical Research, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hitomi Okuma
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan
| | - Tadaaki Nishikawa
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Breast and Medical Oncology, National Cancer Center Hospital, National Cancer Center, Tokyo, Japan.,Office for Advanced Medical Care Evaluation, National Cancer Center, Tokyo, Japan
| | - Naoko Takebe
- Investigational Drug Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institute of Health, Rockville, Maryland, USA
| |
Collapse
|