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Fahmy S, Ramzy A, El Samaloty NM, Sedky NK, Azzazy HMES. PEGylated Chitosan Nanoparticles Loaded with Betaine and Nedaplatin Hamper Breast Cancer: In Vitro and In Vivo Studies. ACS OMEGA 2023; 8:41485-41494. [PMID: 37969975 PMCID: PMC10633871 DOI: 10.1021/acsomega.3c05359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/06/2023] [Indexed: 11/17/2023]
Abstract
The current study investigates the anticancer effects of PEGylated chitosan nanoparticles (CS NPs) coloaded with betaine (BT) and nedaplatin (ND) on breast adenocarcinoma (MCF-7) cells and breast cancer-bearing rats. Hereof, the ionotropic gelation approach was implemented for the synthesis of PEG-uncoated and PEG-coated CS NPs encompassing either BT, ND, or both (BT-ND). The sizes of the developed BT/CS NPs, ND/CS NPs, and BT-ND/CS NPs were 176.84 ± 7.45, 204.1 ± 13.6, and 201.1 ± 23.35 nm, respectively. Meanwhile, the sizes of the synthesized BT/PEG-CS NPs, ND/PEG-CS NPs, and BT-ND/PEG-CS NPs were 165.1 ± 32.40, 148.2 ± 20.98, and 143.7 ± 7.72 nm, respectively. The surface charges of the fabricated nanoparticles were considerably high. All of the synthesized nanoparticles displayed a spherical form and significant entrapment efficiency. Release experiments demonstrated that the PEGylated and non-PEGylated CS NPs could discharge their contents into the tumor cells' microenvironments (pH 5.5). In addition, the NPs demonstrated an outstanding ability to reduce the viability of the MCF-7 cell line. In addition, BT-ND/PEG-CS NPs were found to be the strongest among all NP preparations, where they caused around 90% decrease in the size of mammary gland tumors in rats compared to vehicle-treated animals.
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Affiliation(s)
- Sherif
Ashraf Fahmy
- Department
of Chemistry, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, R5 New Garden City, New Administrative
Capital, Cairo 11835, Egypt
| | - Asmaa Ramzy
- Department
of Chemistry, School of Sciences & Engineering, The American University in Cairo, AUC Avenue, P.O. Box 74, New Cairo 11835, Egypt
| | - Nourhan M. El Samaloty
- Biochemistry
Department, Faculty of Pharmacy and Drug Technology, Egyptian Chinese University, Cairo 11786, Egypt
- Pharmacology
and Biochemistry Department, Faculty of Pharmaceutical Sciences and
Pharmaceutical Industries, Future University
in Egypt, Cairo 12311, Egypt
| | - Nada K. Sedky
- Department
of Biochemistry, School of Life and Medical Sciences, University of Hertfordshire Hosted by Global Academic Foundation, R5 New Garden City, New Administrative
Capital, Cairo 11835, Egypt
| | - Hassan Mohamed El-Said Azzazy
- Department
of Chemistry, School of Sciences & Engineering, The American University in Cairo, AUC Avenue, P.O. Box 74, New Cairo 11835, Egypt
- Department
of Nanobiophotonics, Leibniz Institute of
Photonic Technology, Albert Einstein Str. 9, Jena 07745, Germany
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Nagasawa M, Kageyama S, Yoshida T, Okinaka Y, Kubota S, Wada A, Kobayashi K, Tomita K, Murai R, Tsuru T, Johnin K, Narita M, Kawauchi A. Changes in renal function following nedaplatin-containing chemotherapy in patients with urothelial carcinoma unfit for cisplatin. Oncol Lett 2019; 17:2551-2556. [PMID: 30675317 DOI: 10.3892/ol.2018.9859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 12/10/2018] [Indexed: 11/05/2022] Open
Abstract
The present study evaluated the impact of nedaplatin-containing chemotherapy on renal function in 35 patients with urothelial carcinoma (UC) between 2001 and 2014 who were unfit for cisplatin treatment. As comparative controls, the present study also examined 35 patients with the same disease who underwent cisplatin-containing chemotherapy during the same period. The changes in the estimated glomerular filtration rate (eGFR) prior to and following the administration of nedaplatin during each cycle of chemotherapy was investigated. The present study also reported the overall response rates and adverse events in each group. A total of 31 cycles of the gemcitabine/nedaplatin regimen and 66 cycles of the methotrexate/epirubicin/nedaplatin regimen were administered. In the nedaplatin group, the mean eGFRs prior to and following chemotherapy were 45.4 and 47.8 ml/min/1.73 m2, respectively. The eGFR of the post-chemotherapy group was significantly increased (P<0.001). On the other hand, in the cisplatin group, the eGFR following chemotherapy was significantly lower than the rate prior to chemotherapy (P<0.001). The overall response rates were 30.4 and 66.7% in the nedaplatin and cisplatin groups, respectively. In the two groups, myelosuppression was the most common side effect, but the occurrence rates in both groups were similar, and these adverse events were manageable. With regard to nephrotoxicity, nedaplatin-containing chemotherapy for cisplatin-unfit patients with UC is a safe treatment modality.
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Affiliation(s)
- Masayuki Nagasawa
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Susumu Kageyama
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tetsuya Yoshida
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Yuki Okinaka
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Shigehisa Kubota
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Akinori Wada
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Kenichi Kobayashi
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Keiji Tomita
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Ryosuke Murai
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Teruhiko Tsuru
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Kazuyoshi Johnin
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Mitsuhiro Narita
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Akihiro Kawauchi
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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A Low Psoas Muscle Index before Treatment Can Predict a Poorer Prognosis in Advanced Bladder Cancer Patients Who Receive Gemcitabine and Nedaplatin Therapy. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7981549. [PMID: 28497065 PMCID: PMC5406717 DOI: 10.1155/2017/7981549] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 04/03/2017] [Indexed: 01/05/2023]
Abstract
Introduction. Gemcitabine and cisplatin (GC) is a gold-standard first-line systemic chemotherapy for advanced urothelial carcinoma (UC). However, it may cause severe adverse effects such as renal toxicity, gastrointestinal toxicity, and neurotoxicity. Sarcopenia is the age-related loss of skeletal muscle mass. A correlation between sarcopenia and the oncological prognosis has been reported. In UC, several studies have noted that patients with sarcopenia had a greater incidence of complications and worse survival after radical cystectomy or chemotherapy. Our institute introduced gemcitabine and nedaplatin (GN) for UC patients with renal failure. We investigated whether the presence of sarcopenia predicted the prognosis of patients with advanced UC who were treated by GN chemotherapy. Methods. A total of 27 patients (male, n = 21; female, n = 6) received GN therapy for metastatic UC from 2005 to 2016. The institutional review board of Yokohama City University Hospital approved this study. The psoas muscle index (PMI, cm2/m2) was calculated using this formula: right psoas muscle area (cm2)/the square of the body height (m2). The overall survival (OS) of the high PMI group (male: ≥2.49, female: ≥2.07) and low PMI group (male: <2.49, female: <2.07) was compared. Results. Kaplan-Meier survival curves and a log-rank test revealed that the high PMI group had significantly better OS than the low PMI group (p = 0.015). The mean survival of the high and low PMI groups was 561 days and 223 days, respectively. Conclusions. In the present study, we revealed that sarcopenia (a low psoas muscle volume) might be a predictive factor for poorer overall survival in patients with advanced urothelial carcinoma who are undergoing GN chemotherapy.
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Pretreatment Neutrophil-to-Lymphocyte Ratio Can Predict the Prognosis in Bladder Cancer Patients Who Receive Gemcitabine and Nedaplatin Therapy. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9846823. [PMID: 27822480 PMCID: PMC5086366 DOI: 10.1155/2016/9846823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/18/2016] [Indexed: 01/04/2023]
Abstract
Introduction and Objectives. Neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a simple marker of the systemic inflammatory response in critical care patients. We previously assessed the utility of NLR as a biomarker to predict tumor recurrence and cancer death in bladder cancer patients who underwent radical cystectomy. In this study, we evaluated the prognostic impact of NLR in bladder cancer patients who received gemcitabine and nedaplatin (GN) chemotherapy. Methods. A total of 23 patients who received GN chemotherapy for advanced bladder cancer were enrolled in this study. The cut-off point of NLR according to the sensitivity and specificity levels was derived from the area under receiver operator characteristics (AUROC) curve plotted for disease progression or overall mortality. Results. The NLR cut-off point was determined as 4.14 for both tumor progression and overall mortality. Median progression-free survival (PFS)/overall survival (OS) in the higher NLR group (NLR ≥ 4.14) and lower NLR group (NLR < 4.14) were 194/468 days versus 73/237 days, respectively. Kaplan-Meier analysis showed that higher NLR significantly correlated with poorer PFS (p = 0.011) and OS (p = 0.045). Conclusions. NLR may serve as a new biomarker to predict responses to GN-based chemotherapy in advanced bladder cancer patients and/or their prognosis.
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Current and future potential of metallo drugs: Revisiting DNA-binding of metal containing molecules and their diverse mechanism of action. Inorganica Chim Acta 2016. [DOI: 10.1016/j.ica.2016.01.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Matsumoto K, Mochizuki K, Hirayama T, Ikeda M, Nishi M, Tabata KI, Okazaki M, Fujita T, Taoka Y, Iwamura M. Gemcitabine plus nedaplatin as salvage therapy is a favorable option for patients with progressive metastatic urothelial carcinoma after two lines of chemotherapy. Asian Pac J Cancer Prev 2016; 16:2483-7. [PMID: 25824784 DOI: 10.7314/apjcp.2015.16.6.2483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study was conducted to evaluate the effectiveness of a combination of gemcitabine and nedaplatin therapy among patients with metastatic urothelial carcinoma previously treated with two lines of chemotherapy. Between February 2009 and August 2013, 30 patients were treated with gemcitabine and paclitaxel as a second-line chemotherapy. All had received a first-line chemotherapy consisting of methotrexate, vinblastine, doxorubicin and cisplatin. Ten patients who had measurable histologically proven advanced or metastatic urothelial carcinoma of the urinary bladder and upper urinary tract received gemcitabine 1,000 mg/m2 on days 1, 8 and 15 and nedaplatin 70 mg/m2 on day 2 as a third-line chemotherapy. Tumors were assessed by imaging every two cycles. The median number of treatment cycles was 3.5. One patient had partial response and three had stable disease. The disease-control rate was 40%, the median overall survival was 8.8 months and the median progression-free survival was 5.0 months. The median overall survival times for the first-line and second-line therapies were 29.1 and 13.9 months, respectively. Among disease-controlled patients (n=4), median overall survival was 14.2 months. Myelosuppression was the most common toxicity. There were no therapy-related deaths. Gemcitabine and nedaplatin chemotherapy is a favorable third-line chemotherapeutic option for patients with metastatic urothelial carcinoma. Given the safety and benefit profile seen in this study, further prospective trials are warranted given the implications of our results with regard to strategic chemotherapy for patients with advanced or metastatic urothelial carcinoma.
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Affiliation(s)
- Kazumasa Matsumoto
- Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan E-mail :
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Jin T, Chen XZ, Liu JJ. Evaluation of the efficacy and safety of a neoadjuvant gemcitabine and nedaplatin regimen followed by radiotherapy or concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma. Oncol Lett 2015; 10:1123-1130. [PMID: 26622637 DOI: 10.3892/ol.2015.3349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 05/07/2015] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to evaluate the efficacy and safety of a neoadjuvant gemcitabine and nedaplatin chemotherapy regimen, followed by concurrent chemoradiotherapy or radiotherapy alone, in locoregionally advanced nasopharyngeal carcinoma (NPC). Eighty-six patients with stage III, IVA or IVB NPC, who received neoadjuvant chemotherapy [gemcitabine, 1,000 mg/m2 on day 1 (d1) and d5; nedaplatin, 25 mg/m2 on d 1-3] every 3 weeks for at least two cycles, followed by intensity-modulated radiotherapy every 3 weeks, with or without concurrent nedaplatin (25 mg/m2, d1-3) between September 2010 and December 2013, were retrospectively analyzed. By comparing pretreatment and post-treatment MRI images, it was shown that seven patients achieved a complete response (8.5%), while 66 achieved a partial response (80.5%), following completion of neoadjuvant chemotherapy (combined response rate, 89.0%). Grade 3-4 toxicities following neoadjuvant chemotherapy included neutropenia (29.1%), leukopenia (11.6%), liver dysfunction (9.3%), thrombocytopenia (9.3%) and nausea/vomiting (8.1%). The median follow-up was 18 months (range, 5-44 months). The 2-year relapse-free survival, distant metastasis-free survival, progression-free survival and overall survival rates were 96.6, 85.4, 83.3 and 96.1%, respectively. Compared with alternative neoadjuvant chemotherapy regimens in combination with radiotherapy or concurrent chemoradiotherapy, the present gemcitabine and nedaplatin did not provide additional survival benefit and led to a higher frequency of liver dysfunction. Therefore, neoadjuvant gemcitabine and nedaplatin should be used with caution in locoregionally advanced NPC.
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Affiliation(s)
- Ting Jin
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China ; Key Laboratory of Radiation Oncology in Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Xiao-Zhong Chen
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China ; Key Laboratory of Radiation Oncology in Zhejiang Province, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Jian-Jiang Liu
- Department of Radiation Oncology, Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, P.R. China
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Preclinical combination therapy of the investigational drug NAMI-A(+) with doxorubicin for mammary cancer. Invest New Drugs 2014; 33:53-63. [PMID: 25338748 DOI: 10.1007/s10637-014-0175-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 10/09/2014] [Indexed: 12/11/2022]
Abstract
AIM OF THE STUDY The tumor metastases targeting ruthenium complex NAMI-A synergistically improves the activity of gemcitabine in combination therapies. High-throughput screening was used to identify other potential drug combinations from a library of FDA approved drugs. Doxorubicin was identified as a hit compound and was therefore evaluated in combination with NAMI-A in vitro and in a preclinical in vivo model. RESULTS High-throughput screening identified eight structurally diverse compounds that synergize with NAMI-A including doxorubicin. The combination index on MCF-7 cells showed synergism as the concentration of NAMI-A increases independent of the doxorubicin concentration. In MCa mammary carcinoma of CBA mice, NAMI-A (35 mg/kg/day i.p. on days 7-12) followed by doxorubicin (10 mg/kg i.p. on day 16), significantly increased the effects of the individual drugs on metastases with 70 % animals resulting free of macroscopically detectable tumor nodules in the lungs at sacrifice. NAMI-A, unlike doxorubicin, cured 60 % of the treated mice but the combination therapy was toxic to the animals. CONCLUSIONS The combined therapy of NAMI-A with doxorubicin synergizes on lung metastasis in a preclinical mouse model. The combination therapy at the maximum tolerated doses of the two drugs is toxic. Hence, this combination is not suitable for clinical studies using maximum tolerated doses.
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ITOH YOSHIYUKI, IKEDA MITSURU, HIRASAWA NAOKI, ISHIHARA SHUNICHI, OKUDA TAKAHITO, MURAO TAKAYUKI, KUBOTA SEIJI, OKADA TOHRU, NAGANAWA SHINJI, ISHIGAKI TAKEO. Retrospective case series of 15 patients treated with chemoradiation using 5-FU and nedaplatin for gynecological malignancy: with regard to hemotoxicity. NAGOYA JOURNAL OF MEDICAL SCIENCE 2014; 76:11-6. [PMID: 25129987 PMCID: PMC4345731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We conducted a retrospective comparison of the hemotoxicity of the sequential administration of 5-Fluorouracil (5-FU) prior to Nedaplatin (NDP) (FN therapy) and that of its reverse sequence (NF therapy) for gynecological malignancy. From February 2002 to November 2004, a total of 15 gynecological malignancy patients were treated with radiation therapy combined with NDP and 5-FU. Of these 15 patients, 5 were treated with NF therapy, and 10 were treated with FN therapy. No significant differences were detected between the FN and NF groups with regard to white blood cell count (WBC), hemoglobin level (Hb), and platelet count. The results of this study do not show that the FN group has a lesser degree of hemotoxicity than the NF group.
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Affiliation(s)
- YOSHIYUKI ITOH
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - MITSURU IKEDA
- Departments of Radiological Technology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - NAOKI HIRASAWA
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - SHUNICHI ISHIHARA
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - TAKAHITO OKUDA
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - TAKAYUKI MURAO
- Department of Radiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - SEIJI KUBOTA
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - TOHRU OKADA
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - SHINJI NAGANAWA
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
| | - TAKEO ISHIGAKI
- Departments of Radiology, Nagoya University Graduate School of Medicine, Nagoya Japan
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Yang JJ, Zhou Q, Liao RQ, Huang YS, Xu CR, Wang Z, Wang BC, Chen HJ, Wu YL. Nedaplatin/Gemcitabine Versus Carboplatin/Gemcitabine in Treatment of Advanced Non-small Cell Lung Cancer: A Randomized Clinical Trial. Chin J Cancer Res 2012; 24:97-102. [PMID: 23359648 PMCID: PMC3555264 DOI: 10.1007/s11670-012-0097-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 12/22/2011] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of nedaplatin/gemcitabine (NG) and carboplatin/gemcitabine (CG) in the management of untreated advanced non-small cell lung cancer (NSCLC). METHODS Sixty-two patients with previously untreated advanced NSCLC were recruited between June 2006 and November 2007. Subjects were randomly assigned to the NG arm (n=30) and the CG arm (n=32). Only patients (24 and 25 in the NG and CG arms, respectively) who completed ≥2 chemotherapy cycles were included in the data analysis. The primary outcome measure was the objective response rate (ORR). The secondary outcome measures included progression-free survival (PFS), overall survival (OS) and adverse events. RESULTS There were no statistically significant differences in the efficacy measures (ORR, P=0.305; median PFS, P=0.198; median OS, P=0.961) or in the major adverse events (grade 3/4 neutropenia, P=0.666; grade 3/4 anemia, P=0.263; grade 3/4 thrombocytopenia, P=0.212) between the two treatment arms. However, there was a trend towards higher ORR (37.5% vs. 24.0%), longer PFS (6.0 vs. 5.0 months), and less adverse events in the NG arm. CONCLUSION NG regimen seems to be superior over CG regimen for advance NSCLS, but further investigation is needed to validate this superiority.
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Affiliation(s)
- Jin-Ji Yang
- Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Cancer Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Sugiyama T, Hirose T, Nakashima M, Ishida K, Oki Y, Murata Y, Kusumoto S, Shirai T, Yamaoka T, Okuda K, Ohnishi T, Ohmori T, Adachi M. Evaluation of the efficacy and safety of the combination of gemcitabine and nedaplatin for elderly patients with advanced non-small-cell lung cancer. Oncology 2011; 81:273-80. [PMID: 22122886 DOI: 10.1159/000334430] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the present study was to retrospectively assess the safety and efficacy of the combination of gemcitabine and nedaplatin in elderly patients with advanced non-small-cell lung cancer (NSCLC). METHODS Patients ≥75 years with previously untreated NSCLC who underwent chemotherapy consisting of gemcitabine (800 mg/m(2) on days 1 and 8) and nedaplatin (80 mg/m(2) on day 1) every 3 weeks were retrospectively analyzed. RESULTS Of the 35 patients, 28 were men and 7 were women, with a mean age of 78 years (range 75-87); 10 patients had stage IIIB disease and 25 patients had stage IV disease. The overall response rate was 45.7% (95% confidence interval 28.8-63.4). The median survival time was 14 months (range 3-44). Grade 3-4 toxicities included neutropenia in 74.3%, thrombocytopenia in 48.6%, anemia in 34.3%, hepatic dysfunction in 11.4%, and infection in 2.9%. There were no treatment-related deaths. There were no differences in response rate and survival between patients aged 75-79 years and patients ≥80 years, although grade 3-4 thrombocytopenia and anemia were significantly more frequent in patients ≥80 years. CONCLUSION Our results suggest that the combination of gemcitabine and nedaplatin is effective and well tolerated for selected elderly patients with advanced NSCLC.
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Affiliation(s)
- T Sugiyama
- Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
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Masago K, Fujita S, Kim YH, Hatachi Y, Fukuhara A, Irisa K, Nagai H, Sakamori Y, Togashi Y, Mio T, Mishima M. Phase I study of the combination of nedaplatin and gemcitabine in previously untreated advanced squamous cell lung cancer. Cancer Chemother Pharmacol 2010; 67:325-30. [PMID: 20401614 DOI: 10.1007/s00280-010-1321-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 04/01/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE The objectives of this phase I trial were to evaluate the toxicity of the nedaplatin/gemcitabine regimen, determine the maximum tolerated doses (MTDs) of these agents, and observe the anti-tumor effects of this regimen on advanced squamous cell lung cancer. METHODS Patients with previously untreated advanced squamous cell lung cancer were eligible if they had a performance status of 0 or 1 with adequate organ function. The doses of gemcitabine (days 1 and 8) and nedaplatin (day 8) studied were 800/70, 1,000/80, 1,000/90, and 1,000/100 (mg/m(2)), repeated every 3 weeks. RESULTS Toxicity and response could be assessed in all 13 patients enrolled. The patients included 12 men and one woman with a median age of 69 years (range 57-81 years). Three patients had stage IIIB disease and 10 patients had stage IV disease. The MTDs were reached at 1,000 mg/m(2) gemcitabine and 80 mg/m(2) nedaplatin. The most frequent toxic effects were thrombocytopenia and neutropenia; grade 3 or 4 thrombocytopenia was observed in 23% of patients, and grade 3 or 4 neutropenia was seen in 46% of patients. Non-hematologic toxicities were mild. Grade 3 fatigue, nausea/vomiting, and appetite loss occurred in two patients. The overall response rate was 62%. CONCLUSIONS We recommend doses of 800 mg/m(2) gemcitabine and 70 mg/m(2) nedaplatin for phase II study. This combination chemotherapeutic regimen is active and well tolerated.
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Affiliation(s)
- Katsuhiro Masago
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Syogoin-Kawaracho, Sakyo-ku, Kyoto 606-8507, Japan.
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To KKW, Ho YP, Au-Yeung SCF. Synergistic interaction between platinum-based antitumor agents and demethylcantharidin. Cancer Lett 2004; 223:227-37. [PMID: 15896457 DOI: 10.1016/j.canlet.2004.10.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2004] [Revised: 10/26/2004] [Accepted: 10/28/2004] [Indexed: 11/26/2022]
Abstract
A novel series of TCM-platinum complexes [Pt(C8H8O5)(NH2R)2] 1-5, designed from incorporating demethylcantharidin, a modified component from a traditional Chinese medicine (TCM) with a platinum moiety was found to circumvent cisplatin resistance in mouse leukemia and human hepatocellular carcinoma. These properties are most likely due to the inclusion of the protein phosphatase 2A (PP2A)-inhibiting demethylcantharidin in the novel compounds. We have investigated the potential synergistic effect of combining demethylcantharidin with a platinum-based antitumor agent, such as cisplatin, carboplatin, or oxaliplatin in vitro against L1210 mouse leukemia and SK-Hep-1 human hepatocellular carcinoma, and in vivo against a SK-Hep-1 subcutaneous-inoculated xenograft in nude mice, using median effect analysis. Demethylcantharidin and the platinum antitumor agents were synergistic in all cell lines tested in vitro, and the most effective antiproliferative regimen was when demethylcantharidin was added 24 h before cisplatin. Synergistic antitumor activity was also demonstrated in vivo without undue toxicity; no excessive loss in mouse body weight or overt pathology were observed at the effective doses. The results support a new approach for augmenting cytotoxic effect of established Pt-based drugs with demethylcantharidin in treating human hepatocellular carcinoma and other solid tumors.
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Affiliation(s)
- Kenneth K W To
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
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Kurata T, Tamura K, Yamamoto N, Nogami T, Satoh T, Kaneda H, Nakagawa K, Fukuoka M. Combination phase I study of nedaplatin and gemcitabine for advanced non-small-cell lung cancer. Br J Cancer 2004; 90:2092-6. [PMID: 15150564 PMCID: PMC2409510 DOI: 10.1038/sj.bjc.6601817] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To establish the toxicities and maximum tolerated dose (MTD) of nedaplatin with gemcitabine, and to observe their antitumour activity, we conducted a combination phase I study in advanced non-small-cell lung cancer (NSCLC). Patients received nedaplatin (60–100 mg m−2 given intravenously over 90 min) on day 1, and gemcitabine (800–1000 mg m−2 given intravenously over 30 min) on days 1, 8, every 3 weeks. In total, 20 patients with locally advanced or metastatic NSCLC who received no prior chemotherapy or one previous chemotherapy regimen were enrolled. The most frequent toxicities were neutropenia and thrombocytopenia; nonhaematological toxicities were generally mild. Three out of six patients experienced dose-limiting toxicities (neutropenia, thrombocytopenia and delayed anaemia) at dose level 4, 100 mg m−2 nedaplatin with 1000 mg m−2 gemcitabine, which was regarded as the MTD. There were three partial responses, for an overall response rate of 16.7%. The median survival time and 1-year survival rate were 9.1 months and 34.1%, respectively. This combination is well tolerated and active for advanced NSCLC. The recommended dose is 80 mg m−2 nedaplatin with 1000 mg m−2 gemcitabine. This combination chemotherapy warrants a phase II study and further evaluation in prospective randomised trials with cisplatin- or carboplatin-based combinations as first-line chemotherapy for advanced NSCLC.
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Affiliation(s)
- T Kurata
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - K Tamura
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - N Yamamoto
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - T Nogami
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - T Satoh
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - H Kaneda
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - K Nakagawa
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - M Fukuoka
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
- Department of Medical Oncology, Kinki University School of Medicine: 377-2, Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan. E-mail:
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Takeda Y, Wada T, Nishitani Y, Matsumoto M, Hojo K, Maekawa R, Yoshioka T. Preclinical combination chemotherapy of nedaplatin with gemcitabine against gemcitabine-refractory human lung cancer. Cancer Lett 2002; 182:61-8. [PMID: 12175524 DOI: 10.1016/s0304-3835(02)00066-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The antitumor efficacy of the combination of nedaplatin (NDP) with gemcitabine (GEM) was evaluated against Ma44/GEM, a GEM-refractory subline of Ma44 human lung cancer, which was established by serial in vitro passage of Ma44 cells in the presence of GEM.Ma44/GEM showed less sensitivity to GEM and cytosine arabinoside with resistance factors of 7.7 and 8.3, respectively, but not to Taxol, Irinotecan, Mitomycin C and NDP. Flow cytometry analysis demonstrated that membrane transporter molecules such as multidrug-resistant, multidrug-resistant related protein or lung resistant protein were not induced in Ma44/GEM cells. In vivo experiments confirmed the less sensitivity of Ma44/GEM to GEM. The resistant factor of Ma44/GEM to GEM in vivo was estimated to be 6.7 in terms of ED(50).MA44/GEM-implanted athymic mice were treated with GEM i.v. once followed by i.v. injection of NDP at an interval of approximately 30 min. The mice were treated again with GEM after 3 or 4 days. The combined dosing of NDP with GEM resulted in synergistically enhanced inhibition of tumor growth against Ma44/GEM. The antitumor efficacy of the combination of NDP and GEM was superior to the best effect of either monotherapy. These results demonstrate the effectiveness of the combination of NDP with GEM against the GEM-refractory human lung cancer model.
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Affiliation(s)
- Yukihiro Takeda
- Shionogi Research Laboratories, Shionogi & Co., Ltd, 12-4 Sagisu, 5-Chome, Fukushima-ku, Osaka 553-0002, Japan
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16
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Yamada H, Uchida N, Maekawa R, Yoshioka T. Sequence-dependent antitumor efficacy of combination chemotherapy with nedaplatin, a newly developed platinum, and paclitaxel. Cancer Lett 2001; 172:17-25. [PMID: 11595125 DOI: 10.1016/s0304-3835(01)00614-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We evaluated the sequence dependency of antitumor efficacy and toxicity in combination therapy of nedaplatin (NDP) with paclitaxel (TXL) against Lewis lung carcinoma. The sequential administration of NDP prior to TXL (NT therapy) resulted in severe body weight loss followed by frequent toxic death of mice. In contrast, the sequential dosing of TXL prior to NDP (TN therapy) resulted in synergistically enhanced inhibition of tumor growth with less toxicity compared with the NT therapy. Comparing the antitumor activity of NDP plus TXL with that of cisplatin (CDDP) plus TXL or carboplatin (CBDCA) plus TXL, the combination effect of NDP plus TXL was significantly higher than that of CDDP plus TXL or CBDCA plus TXL. These results indicate that the TN therapy may have significant potential in clinical use.
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Affiliation(s)
- H Yamada
- Discovery Research Labs, Shionogi Research Laboratories, Shionogi & Co., Ltd, 12-4 Sagisu, 5-chome, Fukusima-ku, Osaka 552-0002, Japan
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