platinum drugs

铂金药物
  • 文章类型: Journal Article
    随着化疗药物的相继发展,在临床应用中取得了良好的效果。然而,心肌毒性是最大的挑战。蒽环类药物,免疫检查点抑制剂,和铂类药物被广泛使用。靶向给药,纳米材料和动态成像评价都是新兴的研究方向。本文回顾了最近关于使用靶向纳米药物递送和成像技术评估抗肿瘤药物的心肌毒性的文献,并讨论了潜在的机制。
    With the successive development of chemotherapy drugs, good results have been achieved in clinical application. However, myocardial toxicity is the biggest challenge. Anthracyclines, immune checkpoint inhibitors, and platinum drugs are widely used. Targeted drug delivery, nanomaterials and dynamic imaging evaluation are all emerging research directions. This article reviews the recent literature on the use of targeted nanodrug delivery and imaging techniques to evaluate the myocardial toxicity of antineoplastic drugs, and discusses the potential mechanisms.
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  • 文章类型: Journal Article
    临床前研究表明,PARP抑制剂(PARPi)和铂的抗肿瘤机制在DNA损伤修复途径中存在一些交叉和重叠,对铂类化疗有反应的患者也更可能对PARPi敏感.这项真实世界的研究主要旨在评估铂类化疗(PBC)和尼拉帕尼之间的TRAE(治疗相关不良事件)是否也相关。
    纳入2020年1月至2023年8月在赣南医科大学第一附属医院接受尼拉帕尼维持治疗或挽救治疗晚期卵巢癌的患者。记录了尼拉帕尼治疗的生存数据和在开始尼拉帕尼治疗之前的最后一个基于铂的化疗周期期间发生的不良事件。相关分析采用Fisher精确检验。
    1.40例接受尼拉帕尼治疗的患者被纳入分析,包括31例接受尼拉帕尼一线维持治疗的患者,6例PSR(铂敏感复发)维持治疗,和3名患者进行抢救治疗。中位随访时间为15.0个月(2.2个月至32.1个月)。2.总体等级≥3TRAE(40%vs70%,p=0.012),包括贫血(20%vs45%,p=0.041)和中性粒细胞计数减少(17.5%vs57.5%,与化疗期间相比,在尼拉帕尼治疗期间p<0.001)显着降低。3.任何等级的TRAE(75%对100%,p=0.002)包括白细胞计数下降(47.5%vs87.5%,p<0.001),红细胞计数下降(57.5%vs92.5%,p<0.001),贫血(55%vs87.5%,p<0.001)和中性粒细胞计数降低(35%对85%,与化疗组相比,尼拉帕尼治疗组的p<0.001)也显着降低。没有发现新的安全信号。
    1.在现实世界的实践中,我们观察到,在化疗期间出现任何级别和≥3级TRAE的晚期卵巢癌患者在接受尼拉帕尼治疗时耐受性良好,特别是任何等级和≥3级贫血的发生率,尼拉帕尼治疗期间中性粒细胞计数下降明显低于化疗期间。2.对于在铂类化疗期间出现≥3级血液学不良反应的卵巢癌患者,在随后使用尼拉帕尼治疗期间,应更加重视血液学不良反应的监测和管理。
    UNASSIGNED: Pre-clinical studies showed the anti-tumor mechanisms of PARP inhibitors (PARPi) and platinum have some crossover and overlap in the DNA damage repair pathway, patients who respond to platinum-based chemotherapy are also more likely to be sensitive to PARPi. This real-world study mainly aimed to evaluate whether TRAE (treatment-related adverse event) between platinum based chemotherapy (PBC) and niraparib are also associated.
    UNASSIGNED: Patients received niraparib as maintenance treatment or salvage therapy for advanced ovarian cancer at the First Affiliated Hospital of Gannan Medical University from January 2020 to August 2023 were included. Survival data of niraparib treatment and adverse events occurred during the last platinum-based chemotherapy cycle before starting niraparib treatment and during niraparib treatment are documented. Fisher\'s exact test were used for correlation analysis.
    UNASSIGNED: 1. 40 patients treated with niraparib were included in the analysis, including 31 patients treated with niraparib for 1st-line maintenance therapy, 6 patients for PSR (platinum-sensitive recurrence) maintenance therapy, and 3 patients for salvage therapy. The overall median follow-up time was 15.0 months (ranged from 2.2 months to 32.1 months). 2. Overall grade≥3 TRAE (40% vs 70%, p=0.012) including anemia (20% vs 45%, p=0.041) and neutrophil count decreased (17.5% vs 57.5%, p<0.001) was significantly lower during niraparib treatment compared to during chemotherapy. 3. Any grade TRAE (75% vs 100%, p=0.002) including white blood cell count decreased (47.5% vs 87.5%, p<0.001), red blood cell count decreased (57.5% vs 92.5%, p<0.001), anemia (55% vs 87.5%, p<0.001) and neutrophil count decreased (35% vs 85%, p<0.001) were also significantly lower in niraparib treatment group compared with chemotherapy group. No new safety signals were identified.
    UNASSIGNED: 1. In this real-world practice, we observed that patients with advanced ovarian cancer who experienced any grade and grade ≥3 TRAE during chemotherapy were well tolerated when treated with niraparib, particularly the incidence of any grade and grade ≥3 anemia, and neutrophil count decreased during niraparib treatment were significantly lower compared with that during chemotherapy. 2. For patients with ovarian cancer who have experienced grade ≥3 hematological adverse reactions during prior platinum-based chemotherapy, greater attention should be paid to the monitoring and management of hematological adverse reactions during subsequent treatment with niraparib.
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  • 文章类型: Journal Article
    乳腺癌易感基因(BRCA)是一种重要的抑癌基因,包括BRCA1和BRCA2,这是一种评估乳腺癌风险并影响患者个性化治疗方案的生物标志物。BRCA1/2突变(BRCAm)会增加患乳腺癌的风险。然而,保乳手术仍然是BRCAm的一种选择,预防性乳房切除术和保留乳头的乳房切除术也可以降低患乳腺癌的风险。由于特定类型的DNA修复缺陷,BRCAm对聚(ADP-核糖)聚合酶抑制剂(PARPi)治疗敏感,并与其他DNA损伤途径抑制剂及内分泌治疗和免疫治疗联合应用于BRCAm乳腺癌的治疗。本文就目前BRCA1/2突变型乳腺癌的治疗及研究进展作一综述,为该类乳腺癌患者的个体化治疗提供依据。
    The breast cancer susceptibility gene (BRCA) is an important tumor suppressor gene, including BRCA1 and BRCA2, a biomarker that assesses the risk of breast cancer and influences a patient\'s individualized treatment options. BRCA1/2 mutation (BRCAm) increases the risk of breast cancer. However, breast-conserving surgery is still an option for BRCAm, and prophylactic mastectomy and nipple-sparing mastectomy may also reduce the risk of breast cancer. BRCAm is sensitive to Poly (ADP-ribose) polymerase inhibitor (PARPi) therapy due to specific types of DNA repair defects, and its combination with other DNA damage pathway inhibitors and endocrine therapy and immunotherapy are also used for the treatment of BRCAm breast cancer. The current treatment and research progress of BRCA1/2 mutant breast cancer in this review provides a basis for the individualized treatment of patients with this type of breast cancer.
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  • 文章类型: Journal Article
    具有明显治疗效果的铂类药物被广泛使用,但是它们的全身毒性和癌细胞获得的耐药性限制了它们的临床应用。因此,探索适当的方法和策略来克服传统铂类药物的局限性变得非常必要。铂类药物的联合治疗可以以累加或协同的方式抑制肿瘤的生长和转移,并且可以潜在地降低铂类药物的全身毒性并克服铂耐药性。这篇综述总结了以铂类为基础的联合治疗的各种方式和当前进展。一些铂类抗癌复合物在铂类药物与基因编辑结合中的合成策略和治疗效果,基于ROS的治疗,热疗,免疫疗法,生物建模,光活化,简要描述了超分子自组装和成像模式。还讨论了他们的潜在挑战和前景。我们希望这篇综述能启发研究人员对未来开发高效铂基抗癌复合物有更多的想法。本文受版权保护。保留所有权利。
    Platinum drugs with manifest therapeutic effects are widely used, but their systemic toxicity and the drug resistance acquired by cancer cells limit their clinical applications. Thus, the exploration on appropriate methods and strategies to overcome the limitations of traditional platinum drugs becomes extremely necessary. Combination therapy of platinum drugs can inhibit tumor growth and metastasis in an additive or synergistic manner, and can potentially reduce the systemic toxicity of platinum drugs and overcome platinum-resistance. This review summarizes the various modalities and current progress in platinum-based combination therapy. The synthetic strategies and therapeutic effects of some platinum-based anticancer complexes in the combination of platinum drugs with gene editing, ROS-based therapy, thermal therapy, immunotherapy, biological modelling, photoactivation, supramolecular self-assembly and imaging modality are briefly described. Their potential challenges and prospects are also discussed. It is hoped that this review will inspire researchers to have more ideas for the future development of highly effective platinum-based anti-cancer complexes.
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  • 文章类型: Journal Article
    铂(Pt)药物在临床上广泛用于癌症治疗,但是严重的副作用和获得性耐药性严重损害了它们的治疗效果。随着新兴的免疫疗法和成像引导的癌症治疗,铂药物的精确递送和释放最近引起了极大的关注。铂药物的靶向递送可以大大增加在肿瘤部位的积累,最终增强抗肿瘤功效。Further,将铂药物和其他治疗诊断药物结合到一个纳米系统中,它不仅具有良好的协同作用,而且实现了实时监测。在这次审查中,介绍了铂类药物及其特性后,总结了用于有效递送Pt药物的聚合物纳米系统的最新进展,重点是多模式协同治疗和成像引导的基于Pt的癌症治疗。最后,给出了铂封装纳米系统的结论和未来展望。
    Platinum (Pt) drugs are widely used in clinic for cancer therapy, but their therapeutic outcomes are significantly compromised by severe side effects and acquired drug resistance. With the emerging immunotherapy and imaging-guided cancer therapy, precise delivery and release of Pt drugs have drawn great attention these days. The targeting delivery of Pt drugs can greatly increase the accumulation at tumor sites, which ultimately enhances antitumor efficacy. Further, with the combination of Pt drugs and other theranostic agents into one nanosystem, it not only possesses excellent synergistic efficacy but also achieves real-time monitoring. In this review, after the introduction of Pt drugs and their characteristics, the recent progress of polymeric nanosystems for efficient delivery of Pt drugs is summarized with an emphasis on multi-modal synergistic therapy and imaging-guided Pt-based cancer treatment. In the end, the conclusions and future perspectives of Pt-encapsulated nanosystems are given.
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  • 文章类型: Journal Article
    结直肠癌(CRC)可对铂类药物耐药,可能是通过铁沉积抑制,尽管需要进一步的工作来完全理解这种机制。这项工作旨在总结与奥沙利铂耐药性(OR)或耐药性有关的最新发现,以确定铁凋亡调节奥沙利铂作用的潜力。在这次审查中,与铁稳态有关的肿瘤发展,其中包括确定细胞对铁凋亡的敏感性的铁水平,氧化应激,或结直肠肿瘤细胞中的脂质过氧化与铁凋亡起始有关,特别是c-Myc/NRF2信号在调节铁稳态中的作用,结合NRF2/GPX4介导的铁凋亡进行了讨论。重要的是,铁凋亡在OR中起关键作用,铁凋亡诱导可能基本上逆转CRC细胞的OR,进而抑制奥沙利铂诱导的细胞内氧化还原失衡和铁凋亡,以及在CRC中引起化疗耐药。此外,小分子的基础研究,铁凋亡诱导剂,GPX4抑制剂,还总结了OR的天然产物及其在CRC中的临床应用。此外,还讨论了小分子或药物的潜在分子靶标和机制。建议,铁凋亡诱导可显著逆转CRC细胞的OR,其中该结果在当前综述中讨论。Prospective,本综述中讨论的现有文献将为科学家研究联合抗癌药物的潜在用途提供坚实的基础,这些药物可以通过靶向多种铁凋亡机制来克服OR。尤其是,有希望的治疗策略,挑战,将讨论CRC治疗的机会。
    Colorectal cancer (CRC) can be resistant to platinum drugs, possibly through ferroptosis suppression, albeit the need for further work to completely understand this mechanism. This work aimed to sum up current findings pertaining to oxaliplatin resistance (OR) or resistance to ascertain the potential of ferroptosis to regulate oxaliplatin effects. In this review, tumor development relating to iron homeostasis, which includes levels of iron that ascertain cells\' sensitivity to ferroptosis, oxidative stress, or lipid peroxidation in colorectal tumor cells that are connected with ferroptosis initiation, especially the role of c-Myc/NRF2 signaling in regulating iron homeostasis, coupled with NRF2/GPX4-mediated ferroptosis are discussed. Importantly, ferroptosis plays a key role in OR and ferroptotic induction may substantially reverse OR in CRC cells, which in turn could inhibit the imbalance of intracellular redox induced by oxaliplatin and ferroptosis, as well as cause chemotherapeutic resistance in CRC. Furthermore, fundamental research of small molecules, ferroptosis inducers, GPX4 inhibitors, or natural products for OR coupled with their clinical applications in CRC have also been summarized. Also, potential molecular targets and mechanisms of small molecules or drugs are discussed as well. Suggestively, OR of CRC cells could significantly be reversed by ferroptosis induction, wherein this result is discussed in the current review. Prospectively, the existing literature discussed in this review will provide a solid foundation for scientists to research the potential use of combined anticancer drugs which can overcome OR via targeting various mechanisms of ferroptosis. Especially, promising therapeutic strategies, challenges ,and opportunities for CRC therapy will be discussed.
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  • 文章类型: Journal Article
    未经批准:随着铂类药物在抗肿瘤治疗中的广泛应用,铂类药物不良事件(ADEs)的发生率始终很严重.本研究旨在探讨顺铂的不良事件信号,卡铂和奥沙利铂,三种广泛使用的含铂药物,为临床合理个体化用药提供参考。
    UNASSIGNED:从FAERS数据库中提取了2017年第一季度至2021年第四季度的三种铂类药物的不良事件报告数据,采用报告比值比(ROR)法、比例报告比(PRR)法和综合标准法(MHRA)对相关报告进行数据挖掘和危险因素分析。
    UNASSIGNED:三种铂类药物共获得1853个有效不良事件信号,包括558个有效的顺铂信号,卡铂的896个有效信号,和399个奥沙利铂的有效信号。信号涉及23个有效的不同系统器官(SOC)。顺铂的不良反应主要集中在血液和淋巴系统疾病,胃肠道疾病,全身性疾病和给药部位的各种反应。卡铂的不良事件主要集中在血液和淋巴系统疾病,呼吸系统,胸部和纵隔疾病,而奥沙利铂的不良事件主要集中在呼吸系统,胸部和纵隔疾病,各种神经系统疾病,和胃肠系统疾病。
    UNASSIGNED:发现铂类药物常见不良事件涉及的主要系统有所不同,铂类药物与各系统某些不良事件的相关强度不同。
    UNASSIGNED: With the widespread application of platinum drugs in antitumor therapy, the incidence of platinum drug adverse events (ADEs) is always severe. This study aimed to explore the adverse event signals of Cisplatin, Carboplatin and Oxaliplatin, three widely used platinum-containing drugs, and to provide a reference for rational individualized clinical drug use.
    UNASSIGNED: The adverse event report data of the three platinum drugs from the first quarter of 2017 to the fourth quarter of 2021 were extracted from the FAERS database, and the data mining and risk factors for the relevant reports were carried out using the reporting odds ratio (ROR) method the proportional reporting ratio (PRR)and the comprehensive criteria (MHRA) method.
    UNASSIGNED: A total of 1853 effective adverse event signals were obtained for the three platinum agents, including 558 effective signals for Cisplatin, 896 effective signals for Carboplatin, and 399 effective signals for Oxaliplatin. The signals involve 23 effective different system organs (SOCs). The adverse events of Cisplatin are mainly fixed on blood and lymphatic system diseases, gastrointestinal diseases, systemic diseases and various reactions at the administration site. The adverse events of Carboplatin are mainly focused on blood and lymphatic system diseases, respiratory system, thoracic and mediastinal diseases, while the adverse events of Oxaliplatin are mainly concentrated in respiratory system, thoracic and mediastinal diseases, various nervous system diseases, and gastrointestinal system diseases.
    UNASSIGNED: It was found that the main systems involved in common adverse events of platinum drugs are different, and the correlation strength of platinum drugs with the certain adverse events of each system is different.
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  • 文章类型: Journal Article
    锌稳态药物在癌症化学免疫疗法中具有巨大潜力,然而,关于能引发Zn2+介导的免疫反应的抗肿瘤化合物的报道很少。在这项工作中,我们开发了一种新型的环金属化Pt(IV)-叔噻吩复合物Pt3,不仅诱导DNA损伤和细胞代谢失调,但也破坏锌稳态,如锌调节蛋白的异常转录水平所表明,细胞质中Zn2+的过量积累,和金属硫蛋白(MTs)的下调,这进一步导致了氧化还原失衡。响应Pt3治疗的锌和氧化还原稳态的同时破坏激活gasdermin-D介导的焦亡伴随细胞骨架重塑,从而释放促炎细胞因子以促进树突状细胞(DC)成熟和T细胞肿瘤浸润,最终在体内消除原发性和远处肿瘤。据我们所知,这是第一个可以调节锌稳态以激活抗肿瘤免疫的金属络合物。
    Zinc homeostatic medicine is of great potential for cancer chemo-immunotherapy; however, there are few reports on antitumor compounds that can trigger Zn2+ -mediated immune responses. In this work, we developed a novel cyclometalated PtIV -terthiophene complex, Pt3, that not only induces DNA damage and cellular metabolism dysregulation, but also disrupts zinc homeostasis as indicated by the abnormal transcriptional level of zinc regulatory proteins, excess accumulation of Zn2+ in cytoplasm, and down-regulation of metallothioneins (MTs), which further caused redox imbalance. The simultaneous disruption of zinc and redox homeostasis in response to Pt3 treatment activated gasdermin-D mediated pyroptosis accompanied by cytoskeleton remodeling, thus releasing pro-inflammatory cytokines to promote dendritic cell (DC) maturation and T cell tumor-infiltration, eventually eliminating both primary and distant tumors in vivo. As far as we know, this is the first metal complex that can regulate zinc homeostasis to activate antitumor immunity.
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  • 文章类型: Journal Article
    胶质瘤是中枢神经系统(CNS)最常见和恶性的原发性肿瘤。胶质母细胞瘤是原发性脑肿瘤的最恶性和侵袭性形式,占脑肿瘤相关死亡的大多数。目前神经胶质瘤的标准治疗方法是手术切除辅以术后化疗。铂类药物是影响细胞周期的一类化疗药物,作用的主要部位是细胞的DNA,是临床上常见的化疗药物。化疗铂类药物如顺铂,卡铂,奥沙利铂,或其组合用于治疗多种肿瘤。然而,胶质瘤化疗的结果不能令人满意,而对铂类药物耐药是其重要原因之一。胶质瘤对铂类药物的耐药是多种影响因素综合作用的结果。细胞内药物浓度降低,增强细胞处理活性产物的功能,增强细胞DNA损伤的修复能力,相关凋亡通路的阻断在其中发挥了重要作用。众所周知,神经胶质瘤细胞的致病特性和神经胶质瘤对铂类药物的反应受到非编码RNA的强烈影响,特别是,由microRNAs(miRNAs)和长链非编码RNAs(lncRNAs)组成。miRNAs和lncRNAs控制药物敏感性和肿瘤对铂类药物耐药性的发展。这篇小型综述总结了胶质瘤对铂类药物的耐药机制,以及可以提高神经胶质瘤对铂类药物敏感性的分子和疗法。
    Gliomas are the most common and malignant primary tumors of the central nervous system (CNS). Glioblastomas are the most malignant and aggressive form of primary brain tumors and account for the majority of brain tumor-related deaths. The current standard treatment for gliomas is surgical resection supplemented by postoperative chemotherapy. Platinum drugs are a class of chemotherapeutic drugs that affect the cell cycle, and the main site of action is the DNA of cells, which are common chemotherapeutic drugs in clinical practice. Chemotherapy with platinum drugs such as cisplatin, carboplatin, oxaliplatin, or a combination thereof is used to treat a variety of tumors. However, the results of gliomas chemotherapy are unsatisfactory, and resistance to platinum drugs is one of the important reasons. The resistance of gliomas to platinum drugs is the result of a combination of influencing factors. Decreased intracellular drug concentration, enhanced function of cell processing active products, enhanced repair ability of cellular DNA damage, and blockage of related apoptosis pathways play an important role in it. It is known that the pathogenic properties of glioma cells and the response of glioma towards platinum-based drugs are strongly influenced by non-coding RNAs, particularly, by microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). miRNAs and lncRNAs control drug sensitivity and the development of tumor resistance towards platinum drugs. This mini-review summarizes the resistance mechanisms of gliomas to platinum drugs, as well as molecules and therapies that can improve the sensitivity of gliomas to platinum drugs.
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  • 文章类型: Journal Article
    奥沙利铂是一种铂类药物,用于临床癌症化疗。尽管取得了成功,对正常细胞的非选择性作用会导致严重的副作用并阻碍其应用。将奥沙利铂靶向递送至癌细胞是增强药物疗效和减少不良反应的有效方法。在这项工作中,已经将奥沙利铂的Pt(IV)前药缀合至聚(乙二醇)(PEG)修饰的纳米抗体,以实现肿瘤靶向以及改善体内循环。Pt(IV)前药与抗表皮生长因子受体(EGFR)纳米抗体位点特异性连接,因此,该药物在EGFR阳性肿瘤细胞中的积累比在正常细胞中更明显。研究了不同长度的PEG对药物循环的影响,而抗白蛋白纳米抗体的融合用于比较。结果表明,延长的药物循环显著增加奥沙利铂-纳米抗体缀合物的体内药物效率。
    Oxaliplatin is a platinum-based drug used in clinic for cancer chemotherapy. Despite of its success, the non-selective effect on normal cells causes severe side-effects and hampers its applications. Targeted delivery of oxaliplatin to cancer cells is an effective approach to enhance drug efficacy and reduce adverse effect. In this work, the Pt(IV) prodrug of oxaliplatin has been conjugated to poly(ethylene glycol) (PEG) modified nanobody in order to achieve tumor targeting as well as improved circulation in vivo. The Pt(IV) prodrug was site-specifically linked to an anti-epidermal growth factor receptor (EGFR) nanobody, so that the drug can be accumulated more pronounced in EGFR positive tumor cells than in normal cells. The effect of different length of PEG on the drug circulation has been investigated, while the fusion of anti-albumin nanobody was used for comparison. The result demonstrates that the prolonged drug circulation significantly increases the in vivo drug efficiency of the oxaliplatin-nanobody conjugate.
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