Growth of tumors is strongly dependent upon supply of nutrients and oxygen by de novo formed blood vessels. Inhibiting angiogenesis suppresses growth of primary tumors as well and affects development of metastases. We demonstrate that recombinant MBP/vasostatin fusion protein inhibits proliferation of endothelial cells in vitro. The therapeutic usefulness of such intratumorally delivered recombinant protein was then assessed by investigating its ability to inhibit growth of experimental murine melanomas. In the model of B16-F10 melanoma the MBP/vasostatin construct significantly delayed tumor growth and prolonged survival of treated mice. A combination therapy involving MBP/vasostatin construct and cyclophosphamide was even more effective and led to further inhibition of the tumor growth and extended survival. We show that such combination might be useful in the clinical setting, especially to treat tumors which have already formed microvessel networks.
Isothiocyanates (ITCs) are a group of compounds of natural origin which exhibit anticancer properties. In addition to the cytotoxic impact on cancer cells, confirmed in the multiple cell lines and the in vivo models, ITCs exhibit the cytoprotective effect in normal cells by regulating the activity of enzymes involved in xenobiotic metabolism. These properties of ITCs have led to a continuing increase in the number of studies which have shown that ITCs can sensitize cancer cells to cytostatic drugs used as standard in cancer therapies. On the other hand these compounds may decrease the effectiveness of drugs by deregulating the metabolising system of the cell. This paper discusses the results of preclinical study on ITCs applications in combination therapy as well as their role in drug metabolism.
Multiple myeloma is a neoplastic disease which is characterised by proliferation of monoclonal plasmocytes in the bone marrow. It is the second most common hematologic cancer and it represents 1% of all cancer deaths. Despite enormous development in multiple myeloma biology and treatment over the last 30 years - it is still incurable disease with a median survival of 50 – 55 months. Currently, one of the most important goals in the treatment of multiple myeloma is to achieve long-term control of the disease, without negative impact on the patient’s quality of life. Thanks to therapeutic regimens based on new immunomodulatory drugs, this aim seems to be achievable. In this paper we present the case of a female patient living with multiple myeloma for 14 years. Initially patient was treated with standard VAD (vincristine, doxorubicin, dexamethasone) chemotherapy regimen. After a nearly complete remission of the disease, autotransplantation of hematopoietic cells was performed. One year after transplantation there was a relapse of the disease. In the treatment of relapse it was decided to use scheme based on lenalidomide and dexamethasone. After 4th cycle of treatment, a complete remission was achieved. So far, the patient received 149 cycles. In the evaluation of minimal residual disease still maintains a state of complete remission maintains. During over 12 years of treatment no complications in grade 3 and 4 of the CTCAE v.4 was observed. Currently the patient is 58 years old, she still receives lenalidomide and leads moderately active life.
The first research on liposomes took place in the mid-19th century. It was then that lecithin was isolated from egg yolk for the first time. The phenomenon of swelling of lipids in aqueous solution was then observed. This was done by Maurice Gobley. In the early 1960s, English biophysicist Alec Bangham noticed that lipids had a natural tendency to spontaneously transform into a closed, double bilayer vesicle. Bangham called the discovered structures "spherulites". In subsequent years, this name evolved through the term "banghosomes", giving today's name - liposomes. Liposomes can be carriers of various drugs, including anticancer ones.
A good therapeutic option in hypercholesterolemia is the use of combination preparations containing an HMG-CoA reductase inhibitor, such as atorvastatin, and a drug that selectively inhibits the absorption of holesterol and plant sterol derivatives from the gut - ezetimibe - in a single tablet. Such treatment can be implemented in adults with primary hypercholesterolemia, familial hypercholesterolemia or mixed hyperlipidemia, which is already controlled with atorvastatin and ezetimibe as separate preparations, at the same doses as in the combination preparation. The preparation is administered 1x /day at any time, day. It is mostly a safe drug and well tolerated by patients. Possible side effects are mainly due to possible side effects of statins.
This review assesses the evidence regarding the use asthma-treatment with combination long-acting β2-agonist (LAβA) and inhaled corticosteroid (ICS). The first line-treatment in asthma is inhaled corticosteroid. The integral part of asthma management is β2-agonist, which present the strongest bronchodilators. Currently, two long-acting β2-agonist – salmeterol and formoterol are widely available. Recently several clinical studies have proved that LAβAs in combination with ICS are effective and safe option in asthma management. GINA guidelines recommend the addition of LAβAs to a low and medium dose ICS, when low doses of ICS do not allow to achieve control of asthma symptoms. From some clinical trials we have knowledge that LAβAs given in combination with ICS demonstrate that addition LAβAs is more beneficial in control asthma symptoms than doubling dose of ICS. Asthma is a chronic inflammatory disease of the airways with their hyperresponsiveness. The clinical course of asthma is usually different in different patients and even in the same subject. In normal clinical practice, a maintenance dose of ICS appropriate to the severity of the patient’s asthma of either combination of ICS and LAâA is administered twice daily, and a separate â2-agonist (SAâA – short acting â2-agonist) is used as needed to relieve asthma symptoms. Recently a new model of combination of ICS budesonide and LAâA (formoterol) in one inhaler has been proposed. This model is called SMART (Single Maintenance and Reliever Therapy). In this treatment concept combination budesonide/formoterol in one inhaler is used for both maintenance and as-needed therapy for symptoms relief, without a separate rescue medication. Several clinical trials have shown that SMART method reduced the risk of severe exacerbations and was well tolerated. This method has a beneficial role in patients who remain symptomatic despite treatment with combination maintenance therapy.
PL
Dokonany w tym artykule przegląd badań ocenia dowody dotyczące leczenia astmy kombinacją wziewnych glikokortykosteroidów (wGKS) i długo działających β2-agonistów (LAβA). Za leki pierwszego wyboru w astmie uznaje się wGKS. Integralną częścią leczenia astmy są β2-agoniści, najsilniejsze leki rozszerzające oskrzela. Obecnie dostępne są dwa leki z grupy długo działających β2-agonistów – formoterol i salmeterol. W kilku badaniach klinicznych udowodniono, że kombinacja wGKS i LAβA stanowi skuteczną i bezpieczną opcję w leczeniu astmy. Raporty GINA zalecają dodanie LAβA do małych i średnich dawek wGKS, co pozwala na uzyskanie kontroli astmy. Także z badań klinicznych uzyskaliśmy wiedzę, że kombinacja wGKS i LAβA daje większe korzyści w kontroli objawów astmy niż dwukrotnie większa dawka wGKS. Astma jest przewlekłą chorobą zapalną z rozwojem nadreaktywności oskrzeli. Przebieg kliniczny astmy jest zazwyczaj inny u różnych chorych, a nawet u tej samej osoby. W praktyce klinicznej choremu zaleca się podawanie stałych dawek wGKS, odpowiednich do stopnia ciężkości astmy, lub kombinacji wGKS i LAβA dwa razy dziennie i dodatkowo krótko działającego β2-agonisty „według potrzeby” (lub „na żądanie”) dla złagodzenia objawów astmy. Ostatnio wprowadzono nowy model stosowania kombinacji wGKS i LAβA (budezonid/formoterol) – tzw. SMART (Single Maintenance and Reliever Therapy). Jest to połączenie leków według koncepcji SMART stosowane zarówno w leczeniu przewlekłym dwa razy dziennie, jak i „według potrzeby” dla złagodzenia objawów bez dodatkowego stosowania leków tylko przynoszących ulgę. Badania kliniczne wykazały, że metoda SMART zmniejsza ryzyko ostrych zaostrzeń i jest dobrze tolerowana. Metoda ta ma korzystne działanie u pacjentów, u których utrzymują się objawy astmy pomimo leczenia kombinacją leków stosowanych tylko w leczeniu przewlekłym.
Growth of tumors is strongly dependent upon supply of nutrients and oxygen by de novo formed blood vessels. Inhibiting angiogenesis suppresses growth of primary tumors as well and affects development of metastases. We demonstrate that recombinant MBP/vasostatin fusion protein inhibits proliferation of endothelial cells in vitro. The therapeutic usefulness of such intratumorally delivered recombinant protein was then assessed by investigating its ability to inhibit growth of experimental murine melanomas. In the model of B16-F10 melanoma the MBP/vasostatin construct significantly delayed tumor growth and prolonged survival of treated mice. A combination therapy involving MBP/vasostatin construct and cyclophosphamide was even more effective and led to further inhibition of the tumor growth and extended survival. We show that such combination might be useful in the clinical setting, especially to treat tumors which have already formed microvessel networks.
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