dasatinib

达沙替尼
  • 文章类型: Journal Article
    目的:达沙替尼是酪氨酸激酶抑制剂之一。这些试剂的主要用途是抑制癌细胞增殖。酪氨酸激酶抑制剂的治疗重要性提出了许多类型的研究的必要性,特别是这些药物在人体中的药代动力学分析。这个分析,以及其他调查和临床研究,将有助于药物的整体知识。本研究集中于达沙替尼的群体药代动力学。该研究的目的是调查健康参与者群体药代动力学研究中达沙替尼变异性的来源。
    方法:我们利用了110名受试者的4180个血浆观察结果,这些受试者在禁食条件下两次分别给予SPRYCEL®;提取了20%受试者(22名受试者)的数据用于内部模型评估,并将88名受试者的数据用于建模。通过对三个不同数据集的视觉预测检查来评估该模型。基于校正的贝叶斯信息准则评估,具有一阶吸收和运输隔室的两隔室模型被认为是描述数据的最简单的基础模型。在Monolix2020R1版本中,通过逐步方法筛选程序的条件采样测试了协变量。逐步方法的条件采样用于将相关协变量包含在前向包含步骤的基础模型中,然后向后消除它们,以确保关键协变量在最后阶段保留在模型中。
    结果:体重指数对吸收率常数的影响在最终建立的模型中被认为是显着的协变量。模拟的视觉预测检查,20%的原始数据集(内部数据集)和外部数据集证明了最终模型的适当性。
    结论:进行群体药代动力学建模以描述健康受试者中的达沙替尼药代动力学。体重指数被认为是未来可能使用的因素,以及对患者进行的研究以调整给药方案。
    结论:达沙替尼被归类为高度可变的药物;这种可变性在研究中通过体重指数对吸收率常数的影响得到了证明。
    OBJECTIVE: Dasatinib is one of the tyrosine kinase inhibitors. The main use of these agents is inhibition of cancerous cell proliferation. The therapeutic importance of tyrosine kinase inhibitors raises the necessity of many types of investigations, especially the pharmacokinetic analysis of these drugs in humans. This analysis, along with other investigations and clinical research, will contribute to the overall knowledge of the drug. This study focused on the population pharmacokinetics of dasatinib. The objective of the study was to investigate the sources of the variability of dasatinib in a population pharmacokinetics study in healthy participants.
    METHODS: We utilized 4180 plasma observations from 110 subjects who were administered SPRYCEL® on two separate occasions under fasting conditions; data from 20% of the subjects (22 subjects) were extracted for the purpose of internal model evaluation and data from 88 subjects were used in modeling. The model was evaluated by visual predictive check of three different datasets. A two-compartmental model with first order absorption and transit compartment was considered the simplest base model to describe the data based on the corrected Bayesian information criterion evaluation. Covariates were tested through conditional sampling for the stepwise approach-screening procedure in Monolix 2020R1 version. Conditional sampling for the stepwise approach was used to include the correlated covariates within the base model in the forward inclusion step and then to eliminate them backwardly to ensure that the key covariates were kept in the model at the final stage.
    RESULTS: The effect of body mass index on the absorption rate constant was considered as significant covariate in the final established model. Visual predictive check for simulations, 20% of the original dataset (internal dataset) and an external dataset demonstrated the appropriateness of the final model.
    CONCLUSIONS: Population pharmacokinetic modeling was performed to describe dasatinib pharmacokinetics in healthy subjects. Body mass index was considered as a factor that might be used in the future along with studies on patients to adjust the dosing regimens.
    CONCLUSIONS: Dasatinib is classified as a highly variable drug; this variability was demonstrated in the study by the effect of body mass index on the absorption rate constant.
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  • 文章类型: Journal Article
    达沙替尼是第二代酪氨酸激酶抑制剂之一,用于治疗慢性粒细胞白血病,包括KIT,PDGFR,和SRC家族激酶。由于其广泛的药物谱,据报道,达沙替尼在基础研究水平上可以通过消除衰老细胞去除来改善运动表现,并对Duchenne肌营养不良等肌肉疾病产生影响,但其对成肌细胞的影响尚未被研究。在这项研究中,我们评估了正常情况下和再生状态下达沙替尼对骨骼肌的影响.达沙替尼抑制C2C12成肌细胞的增殖并促进其融合。在肌肉再生过程中,达沙替尼增加了肌源性相关基因的基因表达(Myod,Myog,和Mymx),并在CTX诱导的肌肉损伤小鼠模型上引起异常细的肌纤维。从这些结果来看,达沙替尼改变肌肉分化过程中肌源性调节因子的基因表达模式,破坏正常肌肉再生。我们的数据表明,当使用达沙替尼时,应考虑其对骨骼肌的影响,特别是在再生阶段。
    Dasatinib is one of the second-generation tyrosine kinase inhibitors used to treat chronic myeloid leukemia and has a broad target spectrum, including KIT, PDGFR, and SRC family kinases. Due to its broad drug spectrum, dasatinib has been reported at the basic research level to improve athletic performance by eliminating senescent cell removal and to have an effect on muscle diseases such as Duchenne muscular dystrophy, but its effect on myoblasts has not been investigated. In this study, we evaluated the effects of dasatinib on skeletal muscle both under normal conditions and in the regenerating state. Dasatinib suppressed the proliferation and promoted the fusion of C2C12 myoblasts. During muscle regeneration, dasatinib increased the gene expressions of myogenic-related genes (Myod, Myog, and Mymx), and caused abnormally thin muscle fibers on the CTX-induced muscle injury mouse model. From these results, dasatinib changes the closely regulated gene expression pattern of myogenic regulatory factors during muscle differentiation and disrupts normal muscle regeneration. Our data suggest that when using dasatinib, its effects on skeletal muscle should be considered, particularly at regenerating stages.
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  • 文章类型: Journal Article
    细胞衰老,细胞经历停滞并可以呈现炎症表型的情况,在啮齿动物模型和人类中,与炎症驱动多种疾病过程的启动和延续有关。衰老细胞分泌炎性细胞因子,蛋白质,和基质金属蛋白酶,称为衰老相关分泌表型(SASP),加速老化过程。在临床前模型中,称为“senotherapeutics”的药物干预措施选择性清除衰老细胞,代表了一种有希望的策略,可以预防或治疗人类和兽医物种中多种与年龄相关的疾病。在这次审查中,我们总结了目前可用的文献,描述了在体外的证据,疾病的临床前模型,正在进行的人体临床试验,以及在兽医学中的潜在临床应用。迄今为止,这些有希望的数据为未来研究确定最活跃的药物治疗组合提供了进一步的理由。剂量,以及用于兽药的给药途径。
    Cellular senescence, a condition where cells undergo arrest and can assume an inflammatory phenotype, has been associated with initiation and perpetuation of inflammation driving multiple disease processes in rodent models and humans. Senescent cells secrete inflammatory cytokines, proteins, and matrix metalloproteinases, termed the senescence associated secretory phenotype (SASP), which accelerates the aging processes. In preclinical models, drug interventions termed \"senotherapeutics\" selectively clear senescent cells and represent a promising strategy to prevent or treat multiple age-related conditions in humans and veterinary species. In this review, we summarize the current available literature describing in vitro evidence for senotheraputic activity, preclinical models of disease, ongoing human clinical trials, and potential clinical applications in veterinary medicine. These promising data to date provide further justification for future studies identifying the most active senotherapeutic combinations, dosages, and routes of administration for use in veterinary medicine.
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  • 文章类型: Journal Article
    表皮生长因子受体(EGFR)的异常表达和激活导致批准了几种形式的EGFR抑制剂用于治疗患有多种上皮癌的患者。然而,尚未批准EGFR抑制剂用于治疗脑癌患者,这表明在某些患者中,仅靶向EGFR可能是不够的。
    在这项研究中,我们调查了EGFR家族所有成员的作用,其他生长因子受体,细胞周期蛋白,和下游细胞信号通路(例如,丝裂原活化蛋白激酶(MAPK),丝氨酸/苏氨酸蛋白激酶(AKT),信号转导和转录激活因子(STAT3),Src,Abelson鼠白血病病毒癌基因同源物(Abl))对一组人脑癌细胞系(HBCCL)的生长。与两种细胞毒性药物相比,我们检查了HBCCL对17种靶向药物治疗的生长反应。
    在目标特工中,不可逆的泛人表皮生长因子受体(HER)抑制剂neratinib和afatinib在抑制所有HBCCL的生长方面比厄洛替尼和拉帕替尼更有效,细胞周期蛋白依赖性激酶(CDK)1/2/5/9抑制剂dinaciclib是最有效的靶向药物。我们发现用Src/Abl/c-kit抑制剂达沙替尼治疗,信号转导和转录激活因子(STAT3)抑制剂stattic,Abl/血小板衍生生长因子受体(PDGFR)α/血管内皮生长因子(VEGFR)2/成纤维细胞生长因子受体(FGFR)1抑制剂普纳替尼,原肌球蛋白受体激酶(TRK)/ROS原癌基因1受体酪氨酸激酶(ROS)/间变性淋巴瘤激酶(ALK)抑制剂entrectinib,也抑制了所有HBCCL的生长。有趣的是,当以较慢的速率增殖时,这些药物对抑制HBCCL的生长更有效.除了抑制HBCCLs的增殖,用neratinib治疗,dinaciclib,达沙替尼,stattic和trametinib抑制脑肿瘤细胞系A172的迁移。
    值得注意的是,我们发现,奈拉替尼联合palbociclib(CDK4/6抑制剂)治疗,或miransertib(AKT1/2/3抑制剂)导致所有HBCCL的协同生长抑制。我们的结果支持,将neratinib等药物与palbociclib或miransertib联合使用可能具有治疗脑癌的潜力,值得进一步研究。
    UNASSIGNED: Aberrant expression and activation of epidermal growth factor receptor (EGFR) resulted in approval of several forms of EGFR inhibitors in the treatment of patients with a wide range of epithelial cancers. However, no EGFR inhibitor has yet been approved for the treatment of patients with brain cancer, indicating that targeting EGFR alone may not be sufficient in some patients.
    UNASSIGNED: In this study, we investigated the role of all members of the EGFR family, other growth factor receptors, cell-cycle proteins, and downstream cell signaling pathways (e.g., mitogen-activated protein kinase (MAPK), serine/threonine protein kinase (AKT), signal transducer and activator of transcription (STAT3), Src, Abelson murine leukemia viral oncogene homolog (Abl)) on the growth of a panel of human brain cancer cell lines (HBCCLs). We examined the growth response of HBCCLs to treatment with 17 targeted agents compared to two cytotoxic drugs.
    UNASSIGNED: Of the targeted agents, the irreversible pan-human epidermal growth factor receptor (HER) inhibitors neratinib and afatinib were more effective than erlotinib and lapatinib at inhibiting the growth of all HBCCLs, and the cyclin-dependent kinase (CDK)1/2/5/9 inhibitor dinaciclib was the most potent targeted agent. We found that treatment with Src/Abl/c-kit inhibitor dasatinib, signal transducer and activator of transcription (STAT3) inhibitor stattic, Abl/platelet-derived growth factor receptor (PDGFR)α/vascular endothelial growth factor (VEGFR)2/fibroblast growth factor receptor (FGFR)1 inhibitor ponatinib, and the tropomyosin receptor kinase (TRK)/ROS proto-oncogene 1 receptor tyrosine kinase (ROS)/anaplastic lymphoma kinase (ALK) inhibitor entrectinib, also inhibited the growth of all HBCCLs. Interestingly, these agents were more effective in inhibiting growth of HBCCLs when proliferating at a slower rate. In addition to inhibiting the proliferation of HBCCLs, treatment with neratinib, dinaciclib, dasatinib, stattic and trametinib inhibited the migration of brain tumor cell line A172.
    UNASSIGNED: Notably, we found that treatment with neratinib in combination with palbociclib (CDK4/6 inhibitor), or miransertib (AKT1/2/3 inhibitor) resulted in synergistic growth inhibition of all HBCCLs. Our results support that repurposing drugs like neratinib in combination with the palbociclib or miransertib may be of therapeutic potential in brain cancer and warrants further investigations.
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  • 文章类型: Journal Article
    肝内胆管癌(ICC)是一种侵袭性胆管恶性肿瘤,经常表现出异柠檬酸脱氢酶(IDH1/IDH2)突变。突变IDH(IDHm)ICC依赖于SRC激酶的生长和存活,并且对达沙替尼的抑制过敏,但这种敏感性的分子机制尚不清楚.我们发现达沙替尼降低p70S6激酶(S6K)和核糖体蛋白S6(S6),导致细胞大小和从头蛋白质合成的大幅减少。使用无偏的磷酸蛋白质组筛选,我们鉴定了膜相关的鸟苷酸激酶,WW,和含有1的PDZ结构域(MAGI1)作为IDHmICC中的SRC底物。生化和功能测定进一步表明,SRC抑制MAGI1-蛋白磷酸酶2A(PP2A)复合物的潜在肿瘤抑制功能,以激活IDHmICC中的S6K/S6信号传导。抑制SRC导致激活和增加PP2A去磷酸化S6K,导致细胞死亡。来自患者组织和细胞系模型的证据表明对达沙替尼的内在和外在抗性都是由于增加的磷酸-S6(pS6)。为了阻断pS6,我们将达沙替尼与S6K/AKT抑制剂M2698配对,这导致体外IDHmICC细胞系和患者来源的类器官中pS6的显着减少,并在体内ICC患者来源的异种移植物中大量生长抑制。一起,这些结果阐明了达沙替尼在IDHmICC中的作用机制,揭示了一个独立于mTOR调节S6K磷酸化的信号复合物,达沙替尼敏感性的建议标志物,并描述了一种可能在临床上可行的IDHmICC联合疗法。
    Intrahepatic cholangiocarcinoma (ICC) is an aggressive bile duct malignancy that frequently exhibits isocitrate dehydrogenase (IDH1/IDH2) mutations. Mutant IDH (IDHm) ICC is dependent on SRC kinase for growth and survival and is hypersensitive to inhibition by dasatinib, but the molecular mechanism underlying this sensitivity is unclear. We found that dasatinib reduced p70 S6 kinase (S6K) and ribosomal protein S6 (S6), leading to substantial reductions in cell size and de novo protein synthesis. Using an unbiased phosphoproteomic screen, we identified membrane-associated guanylate kinase, WW, and PDZ domain containing 1 (MAGI1) as an SRC substrate in IDHm ICC. Biochemical and functional assays further showed that SRC inhibits a latent tumor-suppressing function of the MAGI1-protein phosphatase 2A (PP2A) complex to activate S6K/S6 signaling in IDHm ICC. Inhibiting SRC led to activation and increased access of PP2A to dephosphorylate S6K, resulting in cell death. Evidence from patient tissue and cell line models revealed that both intrinsic and extrinsic resistance to dasatinib is due to increased phospho-S6 (pS6). To block pS6, we paired dasatinib with the S6K/AKT inhibitor M2698, which led to a marked reduction in pS6 in IDHm ICC cell lines and patient-derived organoids in vitro and substantial growth inhibition in ICC patient-derived xenografts in vivo. Together, these results elucidated the mechanism of action of dasatinib in IDHm ICC, revealed a signaling complex regulating S6K phosphorylation independent of mTOR, suggested markers for dasatinib sensitivity, and described a combination therapy for IDHm ICC that may be actionable in the clinic.
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  • 文章类型: Case Reports
    胸腔积液,心包积液,和肺动脉高压已被证明与成人使用达沙替尼存在潜在关联.然而,由于有关酪氨酸激酶抑制剂(TKIs)在儿科患者中的疗效和安全性的数据有限,因此必须依赖治疗成人的临床经验。
    我们介绍了一例12岁女性慢性粒细胞白血病(CML)患者的右侧胸腔积液,中度心包积液,达沙替尼治疗期间肺动脉高压。发现这些不良事件后,立即停用达沙替尼。随后使用波生坦治疗肺动脉高压,呋塞米和螺内酯利尿剂,泼尼松抗炎,尤其是通过乙酰半胱氨酸雾化来改善肺内皮通透性的大胆尝试。同时,根据美国食品和药物管理局(FDA)不良事件报告系统(FAERS)报告的患者数据并结合实际情况,为患者选择合适的TKI继续CML治疗.
    FAERS在OpenVigil上收集的数据表明,当使用伊马替尼而不是达沙替尼时,与心包积液相关的信号在18岁以下的个体中更强(与成人组的结果正好相反)。然而,这并不意味着达沙替尼对于较小的组更安全.在我们的情况下,达沙替尼引起的不良反应包括心包积液.因此,在给儿科患者服用TKIs时,我们仍需加强监测,尤其是对肺和心血管毒性的监测,并在发生重大不良反应时迅速采取行动.此外,为了给使用TKIs的儿科患者提供更多有用的信息,尽可能报告这些不良反应非常重要.
    UNASSIGNED: Pleural effusion, pericardial effusion, and pulmonary arterial hypertension have been shown to have potential associations with the use of dasatinib in adults. However, due to the limited data regarding the efficacy and safety of tyrosine kinase inhibitors (TKIs) in pediatric patients necessities reliance on clinical experience gained from treating adults.
    UNASSIGNED: We present a case of a 12-year-old female patient with chronic myelogenous leukemia (CML) who developed significant right-sided pleural effusion, moderate pericardial effusion, and pulmonary arterial hypertension during dasatinib therapy. Dasatinib was promptly discontinued upon identification of these adverse events. This was followed by the use of bosentan for pulmonary hypertension, furosemide and spironolactone diuretics, prednisone anti-inflammatory, and especially a bold attempt to improve pulmonary endothelial permeability with acetyl cysteine aerosolization. At the same time, according to the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) data reported by the patient and combined with the actual situation, the appropriate TKI was selected for the patient to continue the CML treatment.
    UNASSIGNED: FAERS data gathered on OpenVigil indicates that the signal associated with pericardial effusion is stronger among individuals under the age of 18 when imatinib is used instead of dasatinib (exactly the reverse of the results in the adult group). However, this does not imply that dasatinib is safer for the smaller group. In our situation, dasatinib-induced adverse effects include pericardial effusion. As a result, while administering TKIs to pediatric patients, we still need to increase monitoring-particularly for pulmonary and cardiovascular toxicity-and take swift action in the event that a major adverse reaction occurs. In addition, it is important to report these adverse effects as much as possible in order to give pediatric patients utilizing TKIs more helpful information.
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  • 文章类型: Journal Article
    皮质畸形,例如局灶性皮质发育不良II型(FCDII)与小儿耐药性癫痫有关,需要进行神经外科手术。FCDII是由PI3K-AKT-mTOR通路基因的合子后突变引起的体细胞镶嵌性结果,在健康的脑组织中产生一个亚组的畸形细胞。在这里,我们显示了从人类手术FCDII脑组织获得的急性皮质切片中的癫痫样活动与畸形神经元密度之间的相关性。我们发现了这些病理细胞中细胞衰老的多重特征,包括p53/p16表达,SASP表达和衰老相关β-半乳糖苷酶活性。我们还表明,在MtorS2215FFCDII临床前小鼠模型中,使用抗衰老药物(达沙替尼/槲皮素)可降低衰老细胞的负荷并降低癫痫发作频率,提供概念证明,感觉疗法可能是控制癫痫发作的有用方法。这些发现为选择性靶向FCDII脑组织中的突变衰老细胞的治疗策略铺平了道路。
    Cortical malformations such as focal cortical dysplasia type II (FCDII) are associated with pediatric drug-resistant epilepsy that necessitates neurosurgery. FCDII results from somatic mosaicism due to post-zygotic mutations in genes of the PI3K-AKT-mTOR pathway, which produce a subset of dysmorphic cells clustered within healthy brain tissue. Here we show a correlation between epileptiform activity in acute cortical slices obtained from human surgical FCDII brain tissues and the density of dysmorphic neurons. We uncovered multiple signatures of cellular senescence in these pathological cells, including p53/p16 expression, SASP expression and senescence-associated β-galactosidase activity. We also show that administration of senolytic drugs (dasatinib/quercetin) decreases the load of senescent cells and reduces seizure frequency in an MtorS2215F FCDII preclinical mouse model, providing proof of concept that senotherapy may be a useful approach to control seizures. These findings pave the way for therapeutic strategies selectively targeting mutated senescent cells in FCDII brain tissue.
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  • 文章类型: Journal Article
    达沙替尼(DAS),一种有效的抗癌药物,由于挑战,如显著的首过代谢,吸收差,和有限的口服生物利用度。为了改善其释放特性,将DAS嵌入亲水性聚合物聚乙烯吡咯烷酮(PVP)的基质中。在行星球磨机中通过无溶剂共研磨诱导药物无定形化,促进机械化学活化。该方法导致形成无定形固体分散体(ASD)。与含有初始药物的胶囊相比,ASD胶囊的DAS释放速率显着提高。鉴于抗癌药物通常在体内代谢有限,排泄不变,还研究了DAS天然形式的生态毒理学效应,考虑到它在环境中的潜在积累。对细菌费氏弧菌观察到最高的生态毒理学作用,而其他测试生物(细菌恶臭假单胞菌,微藻小球藻。,浮萍和浮萍小调)表现出微不足道的影响。增强的药物释放不仅有助于改善口服吸收,而且具有降低通过人类排泄进入环境的DAS比例的潜力。这种全面的方法突出了在考虑其对环境的影响的同时整合药物开发进展的重要性。
    Dasatinib (DAS), a potent anticancer drug, has been subjected to formulation enhancements due to challenges such as significant first-pass metabolism, poor absorption, and limited oral bioavailability. To improve its release profile, DAS was embedded in a matrix of the hydrophilic polymer polyvinylpyrrolidone (PVP). Drug amorphization was induced in a planetary ball mill by solvent-free co-grinding, facilitating mechanochemical activation. This process resulted in the formation of amorphous solid dispersions (ASDs). The ASD capsules exhibited a notable enhancement in the release rate of DAS compared to capsules containing the initial drug. Given that anticancer drugs often undergo limited metabolism in the body with unchanged excretion, the ecotoxicological effect of the native form of DAS was investigated as well, considering its potential accumulation in the environment. The highest ecotoxicological effect was observed on the bacteria Vibrio fischeri, while other test organisms (bacteria Pseudomonas putida, microalgae Chlorella sp., and duckweed Lemna minor) exhibited negligible effects. The enhanced drug release not only contributes to improved oral absorption but also has the potential to reduce the proportion of DAS that enters the environment through human excretion. This comprehensive approach highlights the significance of integrating advances in drug development while considering its environmental implications.
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  • 文章类型: Journal Article
    酪氨酸激酶抑制剂(TKIs)的使用已成为慢性粒细胞白血病(CML)患者的主要治疗方法,由9号染色体和22号染色体之间的相互易位引起的成人白血病,这种易位会产生癌基因,导致骨髓增生性肿瘤。这些药物通过抑制融合癌蛋白上的ATP结合位点并随后停止增殖活性而起作用。这项工作的目的是调查影响四种FDA批准的用于治疗CML的TKIs疗效的遗传因素的研究现状。本概述试图确定在选择一种药物而不是其他药物时可以考虑的遗传标准,并确定需要更多研究的地方。我们的结果表明,影响患者反应的常见肝酶可能不是影响伊马替尼疗效的主要因素。尼洛替尼,和博舒替尼,然而,这是过去大多数研究的重点。关于CYP酶的人类多态性对达沙替尼的影响,有更多的研究是必要的。UGT1A1多态性的影响应在其他TKIs中进行彻底调查,不仅仅是尼洛替尼。到目前为止,流入和流出转运蛋白的作用一直不一致,可能是由于未能解释可以转运TKIs的多种蛋白质以及肿瘤对转运蛋白表达的影响。因为医生目前无法使用患者的遗传特征来更好地针对TKIs进行治疗,至关重要的是,对辅助途径或脱靶结合效应进行更多研究,以产生新的线索进行进一步研究。希望,新的研究途径将有助于解释治疗失败和改善患者预后.
    The use of tyrosine kinase inhibitors (TKIs) has become the mainstay of treatment in patients suffering from chronic myeloid leukemia (CML), an adult leukemia caused by a reciprocal translocation between chromosomes 9 and 22, which creates an oncogene resulting in a myeloproliferative neoplasm. These drugs function by inhibiting the ATP-binding site on the fusion oncoprotein and subsequently halting proliferative activity. The goal of this work is to investigate the current state of research into genetic factors that influence the efficacy of four FDA-approved TKIs used to treat CML. This overview attempts to identify genetic criteria that could be considered when choosing one drug over the others and to identify where more research is needed. Our results suggest that the usual liver enzymes impacting patient response may not be a major factor affecting the efficacy of imatinib, nilotinib, and bosutinib, and yet, that is where most of the past research has focused. More research is warranted on the impact that human polymorphisms of the CYP enzymes have on dasatinib. The impact of polymorphisms in UGT1A1 should be investigated thoroughly in other TKIs, not only nilotinib. The role of influx and efflux transporters has been inconsistent thus far, possibly due to failures to account for the multiple proteins that can transport TKIs and the impact that tumors have on transporter expression. Because physicians cannot currently use a patient\'s genetic profile to better target their treatment with TKIs, it is critical that more research be conducted on auxiliary pathways or off-target binding effects to generate new leads for further study. Hopefully, new avenues of research will help explain treatment failures and improve patient outcomes.
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  • 文章类型: Case Reports
    患有系统性红斑狼疮(SLE)等长期自身免疫性疾病的患者患血液恶性肿瘤的风险更高。然而,慢性粒细胞白血病(CML)在SLE患者中的报道很少。医学诊断和治疗的进步导致SLE和CML患者的预期寿命接近普通人群,在癌症幸存者中遇到一个以上的恶性肿瘤并不少见。尽管已经报道了CML患者的皮肤鳞状细胞癌(SCC),很少仅在CML幸存者中报告头颈部粘膜SCC.本病例报告的目的是分享我们治疗患有双重异时性原发性恶性肿瘤的患者的经验。CML,和舌癌,以及长期存在的SLE,由一个多学科团队管理。
    Patients with long-standing autoimmune diseases like systemic lupus erythematosus (SLE) are at a higher risk of developing hematological malignancies. However, chronic myeloid leukemia (CML) has rarely been reported in patients with SLE. Advancements in medical diagnostics and treatment have led to the life expectancy of SLE and CML patients moving closer to that of the general population, and it is not uncommon to encounter more than one malignancy in a cancer survivor. Although squamous cell carcinoma (SCC) of the skin has been reported in CML patients, mucosal SCC of the head and neck has rarely only been reported in CML survivors. The objective of this case report is to share our experience in treating a patient with dual metachronous primary malignancies, CML, and tongue carcinoma, along with long-standing SLE, managed by a multidisciplinary team.
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