Thermo-induced modifications and selective accumulation of glucose-conjugated magnetic nanoparticles in vivo in rats - increasing the effectiveness of magnetic-assisted therapy - pilot study.

Ferro-Magnetic nanoparticles (Fe-MNP) have gained a lot of attention in biomedical and industrial applications due to their biocompatibility, ease of surface modification and paramagnetic properties. The basic idea of our study is whether it is possible to use glucose-conjugate Fe-MNP (Glc-Fe-MNP) for targeting and more accurate focusing in order to increase the effect of high-frequency electromagnetic fields induced hyperthermia in solid tumors. Tumors demonstrate high metabolic activity for glucose in comparison with other somatic cells.Increasing of accumulation of glucose conjugated (Glc)-Fe-MNP on tumor site and precision of radio frequency electro-magnetic field (RF-EMF) energy absorption in solid tumors, precede RF-EMF induced hyperthermia. Rat model for monitoring the early development of breast cancer. Twenty female Wistar rats (MU-line-6171) were divided into two groups of 10 rats that were either treated with N-methyl-N-nitrosourea to induce breast cancer and 10 with carrageenan to induce inflammation (control). Glc-Fe-MNP can offer a solution to increase hyperthermia effect to the desired areas in the body by accumulation and increasing local concentration due to high tissue metabolic assimilation. In this condition, it is considered that the magnetization of the nanoparticles is a single-giant magnetic moment, the sum of all the individual magnetic moments and is proportional to the concentration of Glc-Fe-MNP.

Neoadjuvant chemotherapy and targeted therapy in patients with liver metastases from colorectal cancer; medical oncologist's point of view.

Colorectal cancer (CRC) is one of the most frequent malignancies, with more than 1,000,000 new cases annually worldwide and more than 4,000 new cases annually in Bulgaria. Liver metastases (LM) occur in more than 50% of CRC patients, but curative liver resection is possible only in 15% of them, resulting in 5-year survival rates of 30% on average. Improving resectability rates and hopefully patient's prognosis by adding up front active chemotherapy and biological agents in metastatic CRC is a challenging opportunity for both medical and surgical oncologists. This review encompasses clinical trials of modern chemotherapy combinations in metastatic CRC and their application as neoadjuvant therapy before liver surgery. The different surgical methods for improving resectability of LM in patients with CRC are also discussed. In the neoadjuvant setting an emerging concern about chemotherapy-induced liver toxicity gained further attention. The recent data of liver injury following up front systemic chemotherapy are revealed. The impact of anti-angiogenesis agents on liver regeneration and wound healing, which is not yet fully understood, is being discussed, focusing on patient-to-patient individualized decision by multidisciplinary team.

Serum level changes of matrix metalloproteinases 2 and 9, vascular endothelial growth factor and epidermal growth factor receptor during platinum-based chemotherapy in advanced non-small cell lung cancer patients.

PURPOSE: To evaluate serum changes of matrix metalloproteinases (MMPs) 2 and 9, vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) levels in patients with advanced non-small cell lung cancer (NSCLC) and their association with main clinicopathological parameters during chemotherapy with cisplatin and gemcitabine. PATIENTS AND METHODS: In this prospective study, consecutive patients with stage III and IV NSCLC were enrolled. Serum MMP2 and 9, VEGF and EGFR levels were monitored in blood samples taken on day 1 of starting chemotherapy (baseline 1st), and after 3 cycles of chemotherapy (2nd) using commercial sandwich ELISA method. RESULTS: 116 patients were evaluated. Males / females 100 / 6, ECOG performance status (PS) 0/1/2: 47/65/4, stage III / IV: 49/67, squamous /adeno/large cell carcinoma 41/31/19. Forty-two (36%) patients achieved partial response (PR), 32 (28%) stable disease (SD) and 42 (36%) showed progressive disease (PD). Mean serum values -/+ standard deviation (SD) of the analyzed markers at baseline/at response evaluation were: EGFR 86 -/+ 87/96 -/+ 47 fmol/ml; MMP9 236 -/+ 156/162 -/+ 133 ng/ml ; MMP2 525 -/+ 189/569 -/+ 201 ng/ml; VEGF 555 -/+ 476/599 -/+ 611 pg/ml; VEGF adjusted for platelets (PLT) 1.9 -/+ 1.45/2.4 -/+ 2.78 pg/10(6). In logistic regression model for response rate adjusted for stage, the increase in MMP9 levels during chemotherapy (mean = 74 ng/ml -/+ SD 140) was predictive for progression (p=0.041) with 5% increase in the odds of progression for an increase of 10 ng. CONCLUSION: MMP9 level increase was found to be predictive of disease progression. EGFR levels could refl ect extracellular domain (ECD) loss from resistant cells and its shedding into the circulation.

Control of acute emesis in repeated courses of moderately emetogenic chemotherapy.

PURPOSE: Cyclophosphamide (CY)-containing chemotherapy is usually characterized as moderately emetogenic. The aim of this study was to evaluate the efficacy of different antiemetics in the control of acute emesis in repeated cycles of moderately emetogenic chemotherapy. PATIENTS AND METHODS: A total of 101 patients with breast cancer (41, 40.6%), Hodgkin's disease (46, 45.5%) and non-Hodgkin's lymphoma (14, 13.9%) were studied. These patients received standard protocols of CY-based (>/=750 mg/m(2)) moderately emetogenic chemotherapy. Intravenous (i.v.) bolus metoclopramide (MCL), ondansetron (OND) and their combinations with corticosteroids (CS) were administered to the patients. The MCL-alone group of patients was used as control group. Emesis was evaluated during the first 3 courses of chemotherapy according to the internationally accepted criteria. All calculations were performed using the SPSS-5.0 statistical computing package. RESULTS: During the first course of chemotherapy no differences in the efficacy between the control group and the other groups were noted (p >0.05). On the contrary, during the next 2 courses the efficacy of MCL progressively decreased and OND, OND plus CS and MCL plus CS showed significantly higher efficacy compared with MCL alone (p <0.05). Excluding MCL alone, the other antiemetics showed similar efficacy in the 2nd and 3rd course of chemotherapy (p >0.05). Patients aged over 35 years had more severe emesis. CONCLUSION: The combination of MCL plus CS showed similar efficacy compared with OND and OND plus CS, and is cost-effective. The control of acute emesis in the first course and the patients' age are significant factors, influencing the efficacy of the antiemetic therapy in repeated courses of moderately emetogenic chemotherapy.