Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment

Evaluation of a Nurse-Delivered Pre-Chemotherapy Educational Intervention to Increase Knowledge and Reduce Anxiety Among Ethnically Diverse Patients

Patients who are undergoing chemotherapy for cancer often have high-unmet information and psychological needs at the beginning of their treatment. Pre-chemotherapy education is an oncology nursing standard of care. However, few pre-chemotherapy education interventions have reported on their effectiveness among ethnically diverse samples. The aim of the study was to evaluate the implementation of an oncology nurse-led pre-chemotherapy intervention delivered to an ethnically diverse sample of patients treated at a comprehensive cancer center on day one of their first chemotherapy cycle. The aim of the intervention was to increase knowledge about treatment in order to improve patient self-management and to reduce treatment-related anxiety. We found that the intervention was effective in improving patient self-reported knowledge and decreasing treatment-related anxiety; however, differential effects were found for Hispanic/Latino patients, whose anxiety increased post-intervention, as well as for patients who reported poorer health status. These findings suggest that further research should investigate what factors trigger an increase in anxiety among diverse patient populations, and how these factors can be mitigated through development of tailored and culturally competent interventions.

Hierarchical bioresponsive nanocarriers for codelivery of curcumin and doxorubicin

Hierarchical responsive nanocarriers have received much attention for targeted delivery of chemotherapeutics. In this study, we designed pH and redox dual-stage responsive nanocarriers in the different delivery stages for co-delivery phosphorylated curcumin (p-Cur) with doxorubicin (Dox). The MSNs nanocarriers were functionalized via specific cleavable PEGylation and hydrogel coating crosslinked by disulfide bonds: MSNs as core load Dox; p-Cur encapsulated in hydrogel coating. In blood circulation, PEGylation endow the nanocarriers with long time during blood circulation; while in tumor tissue, PEG shells could be cleaved due to the pH-sensitive bond and expose the cationic hydrogel coating to improve cell uptake; while inside tumor cells, hydrogel coating could be cleaved due to the GSH and release the drugs. The results showed that the dual-responsive shells endowed the nanocarriers with tumor extracellular pH-triggered cell uptake and specific cancer cell target release. The synergistic effects of the p-Cur and Dox enhanced cellular apoptosis in Hela cells.

Multifunctional Peptide-Amphiphile End-Capped Mesoporous Silica Nanoparticles for Tumor Targeting Drug Delivery

A tumor targeting redox-responsive drug delivery system (DDS) with bioactive surface was constructed by immobilizing peptide-based amphiphile C12-CGRKKRRQRRRPPQRGDS (defined as ADDA-TCPP) onto the mesoporous silica nanoparticles (MSNs) as an end-capping nanovalve, which consists of two main segments: a hydrophobic alkyl chain ADDA and a hydrophilic amino acid sequence containing a Tat_48-60 peptide sequence with a thiol terminal group and an RGDS targeting ligand, via a disulfide linkage for redox-triggered intracellular drug delivery. A series of characterizations confirmed that the nanosystem had been successfully fabricated. The antitumor drug doxorubicin (DOX) was selected as a model drug and efficiently trapped in the pores of MSNs, and an in vitro release experiment demonstrated that the mesopores of the resulting DOX-loaded MSNs (DOX@MSN-ss-ADDA-TCPP) could be sealed tightly with ADDA-TCPP self-assemblies through hydrophobic interactions between the alkyl chains; the resulting DDS exhibited "zero premature release" of DOX in the physical environment. However, a burst drug release was triggered by a high concentration of glutathione (GSH) in simulated cellular cytosol. Moreover, detailed investigations confirmed that incorporation of RGDS peptide facilitated the active targeting delivery of DOX to α_vβ₃ integrin overexpressed tumor cells, and Tat_48-60 modification on MSNs could enhance intracellular drug delivery, exhibiting an obvious toxicity to tumor cells. The multifunctional nanosystem constructed here can realize the controlled drug release and serve as a platform for designing multifunctional nanocarriers using diversified bioactive peptide-based amphiphile.