Podcasts about Fluorouracil

BUFFALO, NY - February 25, 2025 – A new #research paper was #published in Oncotarget, Volume 16, on February 18, 2025, titled “Leukopenia, weight loss and oral mucositis induced by 5-Fluorouracil in hamsters' model: A regenerative approach using electrospun poly(Lactic-co-Glycolic Acid) membrane." Researchers from the Federal University of Rio de Janeiro and Brazilian Center for Research in Physics have investigated a novel approach to treating oral mucositis, a painful and debilitating side effect of chemotherapy. Led by first author and corresponding author Ana Chor, the study examined the effectiveness of an electrospun poly (Lactic-co-Glycolic Acid) (PLGA) membrane in promoting tissue regeneration in an animal model of chemotherapy-induced oral mucositis. The findings suggest that PLGA membranes, particularly when combined with the body's own healing cells, significantly accelerate the recovery process and reduce inflammation. This promising discovery could lead the way for improved treatments for cancer patients experiencing severe mouth ulcers during chemotherapy. Oral mucositis affects many cancer patients undergoing 5-Fluorouracil (5-FU) chemotherapy, often leading to difficulty in eating, drinking, and speaking. Despite its prevalence, effective treatments remain limited. In this study, researchers applied electrospun PLGA membranes to 5-FU-induced ulcers in hamsters. Some of these membranes were infused with autologous mesenchymal cells—cells taken from the animal itself—to enhance the healing process. The study showed significant results, as ulcers treated with PLGA membranes containing autologous cells healed completely within six days, along with reduced inflammation and the formation of new blood vessels essential for tissue repair. While PLGA membranes without added cells also contributed to healing, the recovery process was slower. "This innovative approach holds significant therapeutic potential, as it utilizes the host's mesenchymal cells and nanotechnology tools to design a scaffold that mimics the organism's microenvironment." These findings highlight the potential of using bioengineered materials to treat chemotherapy-induced oral lesions. While further research is necessary before this approach can be tested in clinical settings, the study provides a strong foundation for future investigations. If successfully translated to human treatment, this technique could significantly improve the quality of life for cancer patients by offering a more effective solution for managing chemotherapy-related mouth ulcers. DOI - https://doi.org/10.18632/oncotarget.28685 Correspondence to - Ana Chor - anamedoral@gmail.com Video short - https://www.youtube.com/watch?v=0hGgRAlcBQA Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Dr. Reetesh Bose is a dermatologist at the Ottawa Hospital and lecturer on the faculty of the University of Ottawa. In 2021, he founded Canada's first skin of color dermatology clinic at the Ottawa Hospital.

Dr. Neeraj Agarwal and Dr. Jeanny Aragon-Ching discuss promising combination therapies and other compelling advances in genitourinary cancers in advance of the 2024 ASCO Annual Meeting. TRANSCRIPT Dr. Neeraj Agarwal: Hello and welcome to the ASCO Daily News Podcast. I'm Dr. Neeraj Agarwal, your guest host of the ASCO Daily News Podcast today. I'm the director of the Genitourinary Oncology Program and a professor of medicine at the University of Utah Huntsman Cancer Institute, and editor-in-chief of the ASCO Daily News. I'm delighted to be joined by Dr. Jeanny Aragon-Ching, a GU medical oncologist and the clinical program director of genitourinary cancers at the Inova Schar Cancer Institute in Virginia. Today, we will be discussing some key abstracts in GU oncology that will be featured at the 2024 ASCO Annual Meeting.  Our full disclosures are available in the transcript of this episode. Jeanny, it's great to have you on the podcast. Dr. Jeanny Aragon-Ching: Thank you so much, Dr. Agarwal. It's a pleasure to be here. Dr. Neeraj Agarwal: So, Jeanny, let's start with some bladder cancer abstracts. Could you tell us about the Abstract 4509 titled, “Characterization of Complete Responders to Nivolumab plus Gemcitabine Cisplatin versus Gemcitabine Cisplatin Alone in Patients with Lymph Node Only Metastatic Urothelial Carcinoma from the CheckMate 901 Trial.”  Dr. Jeanny Aragon-Ching: Of course, Neeraj, I would be delighted to. First, I would like to remind our listeners that the CheckMate 901 trial was a randomized, open-label, phase 3 study, in which this particular sub-study looked at cisplatin-eligible patients with previously untreated, unresectable, or metastatic urothelial carcinoma who were assigned to receive the combination of gemcitabine and cisplatin, followed by up to 2 years of nivolumab or placebo. Based on the data presented at ESMO 2023 and subsequently published in the New England Journal of Medicine, which shows significantly improved progression-free survival and overall survival in patients receiving the combination of gemcitabine, cisplatin, and nivolumab, this regimen was approved in March 2024 as a first-line therapy for patients with unresectable or metastatic urothelial carcinoma.  In the abstract that will be featured at ASCO this year, Dr. Matt Galsky and colleagues present a post-hoc analysis that aims to characterize a subset of patients with complete response as well as those with lymph node-only metastatic disease. In patients receiving the experimental treatment, 21.7% achieved a complete response, while 11.8% of the patients in the control arm achieved a complete response.  Among these complete responders, around 52% had lymph- node-only disease in both arms. Furthermore, when characterizing the subgroup of patients with lymph-node-only disease, those receiving the combination of gemcitabine-cisplatin plus nivolumab had a 62% reduction in the risk of progression or death and a 42% reduction in the risk of death compared to those treated with gemcitabine-cisplatin alone.  The median overall survival in the experimental arm in this subgroup was around 46.3 months, while it was only 24.9 months in the control arm. The ORR in patients with lymph-node-only disease receiving gem-cis plus nivo was about 81.5% compared to 64.3% in those treated with gem-cis alone. Dr. Neeraj Agarwal: Thank you, Jeanny, for the excellent summary of this abstract. We can say that nivolumab plus gemcitabine-cisplatin induced durable disease control and clinically meaningful improvements in OS and PFS compared to gem-cis alone in patients with lymph- node-only metastasis, and deserves to be considered as one of the options for these patients.  In a similar first-line metastatic urothelial carcinoma setting, Abstract 4502, also reported data on a recently approved combination of enfortumab vedotin and pembrolizumab. Can you tell us more about this abstract, Jeanny? Dr. Jeanny Aragon-Ching: Sure, Neeraj. So, as quick reminder to our audience, this regimen was tested in the EV-302 phase 3 trial, where patients with previously untreated, locally advanced or metastatic urothelial carcinoma were randomized to receive enfortumab vedotin, plus pembrolizumab or gemcitabine plus either cisplatin or carboplatin. These data were also first presented at ESMO 2023 and subsequently published in the New England Journal of Medicine. They showed that this immune based combination significantly improved both progression free survival and overall survival, which were the primary endpoints compared to chemotherapy. In this abstract, Dr. Shilpa Gupta from the Cleveland Clinic and colleagues present the results of patient reported outcomes based on quality-of-life questionnaires in this trial.  Time to pain progression and time to confirm deterioration were numerically longer in patients treated with EV plus pembro, and patients with moderate to severe pain at baseline receiving this combination had a meaningful improvement in the Brief Pain Inventory Short-Form worst pain from week 3 through 26. Dr. Neeraj Agarwal: Thank you, Jeanny. This means that patients treated with EV plus pembro did not only have improved survival compared with platinum-based chemotherapy, but also improvement in their quality-of-life and functioning, further supporting the value of this combination for patients with locally advanced or metastatic urothelial carcinoma. This is terrific news for all of our patients.   Before we wrap up the bladder cancer section, would you like to tell our listeners about Abstract 4565, which provides the data on the efficacy of trastuzumab deruxtecan in patients with bladder cancer? Dr. Jeanny Aragon-Ching: Yes, Neeraj; this is timely given the recent FDA approval, which we will talk about. The abstract is titled, “Efficacy and Safety of Trastuzumab Deruxtecan in Patients with HER2 Expressing Solid Tumors: Results from the Bladder Cohort of the DESTINY-PanTumor02 Study.” And as a quick reminder, the DESTINY-PanTumor02 was a phase 2 open-label study where trastuzumab deruxtecan, an antibody-drug conjugate targeting HER2 expression on cancer cells, was evaluated in patients with HER2-expressing locally advanced or metastatic disease who previously received systemic treatment or who had no other treatment options. The expression of HER2 was evaluated on immunohistochemistry by local or central testing.   The primary endpoint was confirmed objective response rate by investigator assessment. Secondary endpoints included duration of response, progression free survival, disease control rate, and safety. The primary analysis, which was published in the Journal of Clinical Oncology, showed an ORR of 37.1% and responses across all cohorts and the median duration of response was 11.3 months. Based on these results, fam-trastuzumab deruxtecan-nxki was just granted accelerated FDA approval for unresectable or metastatic HER2-positive solid tumors in April 2024.  So, back to this abstract; Dr. Wysocki and colleagues report the results of the bladder cancer cohort. This study included 41 patients with urothelial cancer and at a median follow up of around 12.6 months, the objective response rate among these patients was 39%, the median PFS was 7 months, and the duration of response median was 8.7 months. The disease control rate at 12 weeks was around 71%. Regarding the safety profile, 41.5% of patients experienced grade ≥3 drug related adverse events and interstitial lung disease or pneumonitis did occur in about 4 patients. Although there was no statistical comparison between different groups, the ORR was numerically highest among the HER2 3+ group with 56.3%.  Dr. Neeraj Agarwal: Thank you, Jeanny. So, these data support consideration of trastuzumab deruxtecan as a salvage therapy option for pre-treated patients with HER2 expressing urothelial cancers and show that we are extending our treatment options to include therapies with novel mechanisms of action. This is definitely exciting news for patients with bladder cancer. Dr. Jeanny Aragon-Ching: Yes, absolutely, Neeraj. Now, let's switch gears a bit to prostate cancer. Could you tell us about Abstract 5005 which is titled, “EMBARK Post Hoc Analysis of Impact of Treatment Suspension on Health Quality-of-Life?” Dr. Neeraj Agarwal: Of course, I'd be happy to. So, enzalutamide was recently granted FDA approval for the treatment of patients with non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high-risk of metastasis, based on the results of the EMBARK trial, which was a phase 3 study where patients with high-risk biochemical recurrence were randomized to receive either enzalutamide with leuprolide, enzalutamide monotherapy, or placebo plus leuprolide. The primary endpoint was metastasis-free survival with secondary endpoints including overall survival and safety.  Results showed that patients receiving enzalutamide alone or enzalutamide plus leuprolide had significantly improved metastasis-free survival compared to those treated with leuprolide alone while preserving health-related quality-of-life.   One important aspect in the design of the trial was that patients who achieved undetectable PSA at week 37 underwent treatment suspension. The treatment was resumed if PSA rose to more than 2 ng/ml for patients who underwent radical proctectomy or when PSA rose to more than 5 ng/ml for those who did not undergo surgery.  In this abstract, Dr. Stephen Freedland and colleagues present a post-hoc analysis of health-related quality-of-life outcomes after treatment suspension between weeks 37 and 205. They found that treatment was suspended in 90.9% of patients receiving enzalutamide plus leuprolide, 85.9% of those receiving enzalutamide monotherapy, and 67.8% of those receiving leuprolide monotherapy. Among those patients who stayed on treatment suspension, a trend toward numerical improvement in health-related quality-of-life after week 37 was seen in all 3 arms and this reached clinically meaningful threshold at week 205 in pain questionnaires, physical well-being, urinary and bowel symptoms. For hormonal treatment side effects, all arms reached clinically meaningful improvement at the subsequent assessments of week 49 to week 97. However, patients slowly deteriorated, with clinically meaningful deterioration at week 205 relative to week 37 in patients receiving the combination of enzalutamide and leuprolide and those treated with leuprolide.    Concerning sexual activity, a clinically meaningful improvement was reported only in patients receiving enzalutamide plus leuprolide, possibly because sexual function was better preserved prior to suspension in the enzalutamide monotherapy arm and thus there was less opportunity for “improvement” while on suspension.  Dr. Jeanny Aragon-Ching: Thank you, Neeraj, for this great summary. This analysis confirms that treatment suspension in good responders might lead to a clinically meaningful improvements in health-related quality-of-life.   Now, moving on to patients with metastatic castration-resistant prostate cancer, what can you tell us, about Abstract 5008 titled, “Baseline ctDNA analyses and associations with outcomes in taxane-naive patients with mCRPC treated with 177Lu-PSMA-617 versus change of ARPI in PSMAfore”?  Dr. Neeraj Agarwal: Sure, Jeanny. The PSMAfore trial was a phase 3 study that compared the efficacy of 177Lu-PSMA-617 versus an ARPI switch in patients with mCRPC and prior progression on a first ARPI, and not previously exposed to docetaxel chemotherapy. The primary endpoint was rPFS and OS was an important secondary endpoint. The primary analysis presented at ESMO 2023 showed a significantly prolonged rPFS in patients receiving lutetium. In the abstract that will be featured at the 2024 ASCO Annual Meeting, Dr. Johann De Bono and colleagues present an exploratory analysis regarding the associations between baseline circulating tumor DNA and outcomes.  ctDNA fraction was evaluated in all samples as well as alterations in key prostate cancer drivers prevalent in more than 10% of participants.  The investigators sought to interrogate the association of ctDNA fraction or alterations with rPFS, PSA response, and RECIST response at data cutoff. They showed that median rPFS was significantly shorter in patients with a ctDNA fraction >1% compared to those with a fraction < 1% regardless of the treatment arm. Furthermore, ctDNA fraction >1% was also associated with worst RECIST response and PSA50 response. Regarding prostate cancer drivers, median rPFS was significantly shorter in patients with alterations in the AR, TP53 or PTEN in both treatment arms. There was no significant association between ctDNA alterations and PSA or objective responses. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. So, these results show that the presence of a ctDNA fraction >1% or alterations in AR, P53 and PTEN were all associated with worse outcomes regardless of treatment with lutetium or change in the ARPI. These data are definitely important for counseling and prognostication of patients in the clinic and may guide the design of future clinical trials. Let's move on to kidney cancer. Neeraj, do you have any updates for us?  Dr. Neeraj Agarwal:  Sure. In Abstract 4512 titled, “A Multi-institution Analysis of Outcomes with First-Line Therapy for 99 Patients with Metastatic Chromophobe Renal Cell Carcinoma,” Dr. Sahil Doshi and colleagues present a retrospective, multi-institutional study comparing survival outcomes, including time-to-treatment failure and overall survival, between different first-line treatment options in patients with metastatic chromophobe renal cell carcinoma, where limited clinical trial data exists to guide systemic therapy. They categorized patients into 4 treatment groups: and immune checkpoint inhibitors + targeted therapy doublets (such as ICI VEGF TKI); pure immune checkpoint inhibitor monotherapy and doublets (such as ipilimumab plus nivolumab); targeted therapy doublets (such as lenvatinib plus everolimus), and targeted monotherapy (such as sunitinib).  They identified 99 patients, of whom 54 patients received targeted monotherapy, 17 received ICI VEGF-TKI, 14 received targeted doublet, and 14 patients received only ICI therapies. So the patients treated with any doublet containing a targeted agent had a 52% decrease in the risk of treatment failure and a 44% decrease in the risk of death compared to those treated with targeted monotherapy. The median time to treatment failure was 15 months with IO-targeted doublet, and the median overall survival was 56 months. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. So, these results show that targeted doublet regimens resulted in a longer time to treatment failure and overall survival compared to any monotherapy in patients with chromophobe metastatic RCC and definitely provides valuable insights on treatment selection, albeit I would say there's still a small number of patients that were included in this retrospective analysis. Dr. Neeraj Agarwal: I completely agree this is a relatively small number of patients, but I decided to highlight the abstract given how rare the cancer is, and it is highly unlikely that we'll see large randomized clinical trials in patients with metastatic chromophobe renal cell carcinoma.  So, before we wrap up the podcast, what would you like to tell us about Abstract 5009 which is titled, “A Phase II Trial of Pembrolizumab Platinum Based Chemotherapy as First Line Systemic Therapy in Advanced Penile Cancer: HERCULES (LACOG 0218) Trial.” Dr. Jeanny Aragon-Ching: I'm glad you brought this up, Neeraj. As our listeners may know, advanced penile squamous cell carcinoma has a poor prognosis with limited treatment options. From this perspective, the results of the LACOG 0218 trial are very important. As you mentioned, this was a phase 2 single-arm study evaluating the addition of pembrolizumab to platinum-based chemotherapy as first-line treatment in patients with metastatic or locally advanced penile squamous cell carcinoma not amenable to curative therapy. Patients enrolled received chemotherapy, namely 5-Fluorouracil with cisplatin or carboplatin and pembrolizumab 200 mg IV every 3 weeks for 6 cycles, followed by pembrolizumab 200 mg IV every 3 weeks up to 34 cycles. The primary endpoint was confirmed overall response rate by investigator assessment.  In the 33 patients eligible for the efficacy analysis, the confirmed ORR by investigator assessment was 39.4% and included one complete response and 12 partial responses. The confirmed ORR was 75% in patients with high TMB and 55.6% in patients positive for HPV16, making TMB and HPV16 potential predictive biomarkers for efficacy in this study. Concerning the toxicity profile, any grade treatment-related adverse events were reported in around 92% of patients, and grade 3 or more treatment-related adverse events occurred in 51% of patients. 10.8% of patients discontinued treatment due to adverse events.  Dr. Neeraj Agarwal: Thank you, Jeanny. I would like to add that HERCULES is the first trial to demonstrate the efficacy of an immune checkpoint inhibitor in advanced penile squamous cell carcinoma with a manageable safety profile. Thus, the combination of ICI with platinum-based chemotherapy is a promising treatment for advanced penile squamous cell carcinoma and warrants further investigation.  Dr. Jeanny Aragon-Ching: I agree, Neeraj. Any final remarks before we conclude today's podcast? Dr. Neeraj Agarwal: Jeanny, I really want to thank you for your participation and valuable insights. Your contributions are always appreciated, and I sincerely thank you for taking the time to join us today. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. It was a pleasure.  Dr. Neeraj Agarwal:  As we bring this podcast to an end, I would like to acknowledge the significant advances happening in the treatment of patients with genitourinary cancers. During our upcoming 2024 ASCO Annual Meeting, there will be an array of different studies featuring practice-changing data presented by researchers and physicians from around the globe. I urge our listeners to not only participate in this event to celebrate these achievements, but to also play a role in sharing these cutting-edge data with healthcare professionals worldwide. Through our collective efforts, we can surely optimize the benefits of patients on a global scale.   And thank you to our listeners for joining us today. You will find links to the abstracts discussed today on the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcast. Thank you very much.   Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Find out more about today's speakers:  Dr. Neeraj Agarwal  @neerajaiims  Dr. Jeanny Aragon-Ching    Follow ASCO on social media:   @ASCO on Twitter     ASCO on Facebook     ASCO on LinkedIn       Disclosures:    Dr. Neeraj Agarwal:     Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences    Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas     Dr. Jeanny Aragon-Ching:  Honoraria: Bristol-Myers Squibb, EMD Serono, Astellas Scientific and Medical Affairs Inc., Pfizer/EMD Serono  Consulting or Advisory Role: Algeta/Bayer, Dendreon, AstraZeneca, Janssen Biotech, Sanofi, EMD Serono, MedImmune, Bayer, Merck, Seattle Genetics, Pfizer, Immunomedics, Amgen, AVEO, Pfizer/Myovant, Exelixis,   Speakers' Bureau: Astellas Pharma, Janssen-Ortho, Bristol-Myers Squibb, Astellas/Seattle Genetics. 

In this explainer episode, we've asked Professor Matt Brown, Chief Scientific Officer at Genomics England, to explain what personalised medicine is and how it could change the way we treat genetic conditions and cancer. You can also find a series of short videos explaining some of the common terms you might encounter about genomics on our YouTube channel. If you've got any questions, or have any other topics you'd like us to explain, feel free to contact us on info@genomicsengland.co.uk. You can read the transcript below or download it here: https://files.genomicsengland.co.uk/documents/Podcast-transcripts/What-is-personalised-medicine.docx Naimah: What is personalised medicine? I'm joined by Matt Brown, chief scientific officer for Genomics England, to find out more. So, first of all, Matt, can you tell me, what is personalised medicine?   Matt: So, personalised medicine is about giving the right dose of a medicine and the right medicine to the right person. So, it's exactly the opposite of one size fits all. It's what doctors have been trying to do ever since we had effective medicines, that is generally looking at the patient, what disease have they got, what factors are there about the patient that can help judge what dose they should give and for how long, of which medicine.   Naimah: So, people often refer to this as precision medicine. Is this the same thing?   Matt: Generally, the two terms are used interchangeably. I think precision medicine is more specifically about the dose perhaps, but effectively they both mean the right medicine at the right dose for the right person.   Naimah: And how can we predict what treatment will suit each individual patient best?   Matt: Well, to some extent, of course, this depends on the disease the patient actually has. We also know from a patient's history how they've reacted to similar medications in the past. So for example, some patients have lots of problems with anti-inflammatories, other patients don't, so if you give an anti-inflammatory to somebody who's had problems with them before, you're likely to cause the same problems all over again. So nowadays, we have much, much better ways, other than trial and error, to predict what treatment will suit a patient best, and in particular, development of genetic markers to look at how their condition is going to respond best, and how the patient is going to tolerate the medicine you give them, and what dose you should be giving them.   Naimah: How could personalised medicine change the way we treat genetic conditions and cancer?   Matt: So, I'll talk about cancer first up. In the past, we used to treat cancers based on the organ from which the cancer actually arose, and the more we've learnt about what the genetic mutations are that cause cancers, the more cancer treatments are being decided based on the genetic mutation which is driving the cancer, and this has proven to be more effective than just looking at the organ from which the cancer arose. It turns out then that some medications which were only being used for specific cancers, are actually useful across multiple cancers that are driven by the same genetic mutations.   In lots of other common diseases though, we now know a lot about genetic variants which predispose people to adverse drug reactions, and so we can use genetic tests to predict who's going to get those adverse drug reactions and avoid them. And similarly, we also know about genetic determinants of how people metabolise and, in many cases, activate medications, and that helps us a lot learning about what dose to give people.   Naimah: And how far away are we from seeing this routinely in clinical care?   Matt: We are seeing it in routine clinical care in some pretty narrow settings. So, there are genetic tests available for enzymes which are involved in activation of particular chemotherapy 5 agents. So, DPYD testing, for example, is widely used to predict people's likely response to a class of chemotherapy agent called fluoropyrimidines, or 5-Fluorouracil is a common one, and the genetic test basically picks out a group of people, a small number of people who are likely to have severe adverse drug reactions to that class of medication, and that's been a really big success.   We also use it for picking some other severe adverse drug reactions to medications like gout medications, HIV medications and so on, but generally it's pretty narrow. What we want to get to the point is where we have people tested in advance of them needing medications, so that when they go to the doctor to be seen about a particular condition, the doctor already has the genetic test available to them, so the doctor can say if the medication is safe and what dose to use. This is what we call pre-emptive testing.   Naimah: That was Matt Brown explaining what is personalised medicine. If you'd like to hear more explainer episodes like this, you can find them on our website at www.genomicsengland.co.uk. Thank you for listening. 

Today's episode is a Drug Disposal Quiz in honor of the up-coming DEA National Prescription Drug Take Back Day (USA), which will be Saturday, October 28, 2023, from 10 AM - 2 PM.   Thank you for listening to episode 242 of The Pharmacist's Voice ® Podcast! To read the FULL show notes, visit https://www.thepharmacistsvoice.com/podcast.  Select episode 242. Subscribe to or follow The Pharmacist's Voice ® Podcast to get each new episode delivered to your podcast player and YouTube every time a new one comes out!   Apple Podcasts   https://apple.co/42yqXOG  Google Podcasts  https://bit.ly/3J19bws  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt During my 22 years as an Ohio-licensed pharmacist, I've taken an interest in Drug Disposal.  I believe that pharmacists can make a positive impact in their communities by knowing how to safely dispose of all types of drugs at various times of the year.   Ideally, there would be a magical box at every pharmacy, and everything could go in it:  solid tablets, liquid allergy medicine, ear drops, Epi-Pens, creams, nasal sprays, inhalers, and so on.  However, it just doesn't work that way.  As a result, we field questions about drug disposal all the time.  To prepare you for those inevitable questions you may field about drug disposal, I put together a Drug Disposal Quiz.   This is a crowd-sourcing episode.  Feel free to answer one or all of these questions.  If you submit a response, you may hear it on the podcast!  I'm accepting answers until Oct 20, 2023.   Step One: go to https://www.thepharmacistsvoice.com.   Step Two: Click the Contact tab.   Step Three: Click, “Start recording”  Step Four: Leave a voicemail message with the question and answer.   As an alternative, fill out the contact form. I may read your answer on the show.  If no one answers, you'll hear my responses on Saturday, October 28, 2023 (Drug Take-Back Day). Listen to the episode for the full questions.  Key words are below. Fluorouracil cream  Expired Epi-Pen Expired OTC's Discontinued lisinopril tablets Info table at the health fair Disposing of illicit substances Grocery sack full of unwanted meds from a patient. When is the last time you cleaned out your medicine cabinet?   Where is the closest drug disposal box to you? On drug take-back day, where can you get rid of odd dosage forms? Links from this episode DEA Take-Back Day https://www.dea.gov/takebackday  National Pharmaceutical Association (NPhA) Frank North, PharmD on LinkedIn will be my guest Sept 22, 2023. Kim's websites and social media links: ✅Business website https://www.thepharmacistsvoice.com ✅The Pharmacist's Voice ® Podcast https://www.thepharmacistsvoice.com/podcast ✅Pronounce Drug Names Like a Pro © Online Course https://www.kimnewlove.com  ✅A Behind-the-scenes look at The Pharmacist's Voice ® Podcast © Online Course https://www.kimnewlove.com  ✅LinkedIn https://www.linkedin.com/in/kimnewlove ✅Facebook https://www.facebook.com/kim.newlove.96 ✅Twitter https://twitter.com/KimNewloveVO ✅Instagram https://www.instagram.com/kimnewlovevo/ ✅YouTube https://www.youtube.com/channel/UCA3UyhNBi9CCqIMP8t1wRZQ ✅ACX (Audiobook Narrator Profile) https://www.acx.com/narrator?p=A10FSORRTANJ4Z ✅Start a podcast with the same coach who helped me get started (Dave Jackson from The School of Podcasting)! **Affiliate Link - NEW 9-8-23**    Thank you for listening to episode 242 of The Pharmacist's Voice ® Podcast!

A new research paper was published in Oncotarget's Volume 14 on January 12, 2023, entitled, “The chromatographic constitution of andiroba oil and its healing effects, compared to the LLLT outcomes, in oral mucositis induced in golden Syrian hamsters: a new treatment option.” The oral mucositis is a mucosal alteration that usually arises from oncological treatments, such as chemotherapy, and it is characterized as an inflammatory process. In this new study, researchers Jessica T. Gomes, Ana Márcia V. Wanzeler, Sergio M.A. Júnior, Rosa Helena F. Chaves Soares, Carolina P. de Oliveira, Emanuelle de M. Rodrigues, Bruno M. Soares, Diego D.F.A. Alcantara, Rommel M.R. Burbano, and Fabrício M. Tuji from Federal University of Pará and the University Center of Pará aimed to demonstrate the chromatographic constitution of Andiroba oil, while comparing and evaluating Andiroba oil and laser scarring efficiency in treatments of oral mucositis in hamsters. “The low-level laser therapy (LLLT) is the best standard treatment and the most efficient method in treating OM. Similarly, the andiroba oil presents great potential for the treatment of inflammatory diseases. Thus, this study aims to evaluate the healing and toxicological effects of andiroba oil, compared to the LLLT outcomes, observing if andiroba presents a similar/higher potential than the LLLT.” The animals were submitted to 5-Fluorouracil. Included in the study were total of 122 animals that were randomized and divided into the following groups: (a) positive control; (b) laser associated to andiroba oil; (c) laser; (d) andiroba oil; (e) negative control; (f) cyclophosphamide (genotoxicity control). The induction of oral mucositis occurred by the administration of intraperitoneal Fluorouracila (60 mg/kg) and trauma to the mucosa. The laser protocol was performed once a day and the andiroba oil applied 3 times a day (1,5 ml/day). The mucosae were photographed and removed for clinical and histopathological analysis on day 4, 8, 12, and 15. The analysis was based in OM severity, in specific scoring for the clinical and histopathological aspect. Toxicity was evaluated on day 15 using comet assay and it was performed by variant DNA damage parameters. The data were analyzed using analysis of variance (ANOVA) Tukey post-test and Kruskal–Wallis Dunn post-test. The “andiroba oil” and “laser” groups presented better results when compared to the control groups and the treatment associations. The andiroba oil presented the best scarring results, even considering its efficiency proximity to the laser treatment. “Andiroba and laser, separately, did not present genotoxicity, however their association evidences damage to DNA.” DOI: https://doi.org/10.18632/oncotarget.28338 Correspondence to: Diego D.F.A. Alcantara - diegoalcantara@globo.com Video: https://www.youtube.com/watch?v=wMwTGk7-VGU Keywords: phytotherapeutic drugs, medical oncology, stomatitis, wound healing, low-level light therapy About Oncotarget: Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, visit Oncotarget.com and connect with us on social media: Twitter – https://twitter.com/Oncotarget Facebook – https://www.facebook.com/Oncotarget YouTube – https://www.youtube.com/@OncotargetJournal Instagram – https://www.instagram.com/oncotargetjrnl/ LinkedIn – https://www.linkedin.com/company/oncotarget/ Pinterest – https://www.pinterest.com/oncotarget/ LabTube – https://www.labtube.tv/channel/MTY5OA SoundCloud – https://soundcloud.com/oncotarget For media inquiries, please contact: media@impactjournals.com.

Dr. Emrullah Yilmaz reviews the latest evidence and recommendations for health care providers on biomarker testing and immunotherapy for head and neck cancers. He discusses the ASCO Expert Panel's recommendations for biomarkers for the selection of patients with head and neck squamous cell carcinoma for anti-PD-1 immune checkpoint inhibitor therapy. Additionally, he reviews recommended treatment options, including first-line treatment based on PD-L1 status, therapies for platinum-refractory disease, options for patients with nasopharyngeal cancer, the role of radiation therapy for oligometastatic head and neck cancer, and immunotherapy for rare head and neck cancers. Dr. Yilmaz also explores future areas of research for therapeutic options for patients with head and neck squamous cell carcinoma. Read the full guideline, “Immunotherapy and Biomarker Testing in Recurrent and Metastatic Head and Neck Cancers: ASCO Guideline” at www.asco.org/head-neck-cancer-guidelines. TRANSCRIPT Brittany Harvey: Hello, and welcome to the ASCO Guidelines podcast series, brought to you by the ASCO Podcast Network; a collection of nine programs, covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at: asco.org/podcasts. My name is Brittany Harvey, and today I'm interviewing Dr. Emrullah Yilmaz, from Cleveland Clinic in Cleveland, Ohio, lead author on, 'Immunotherapy and Biomarker Testing in Recurrent and Metastatic Head and Neck Cancers: ASCO Guideline'. Thank you for being here today, Dr. Yilmaz. Dr. Emrullah Yilmaz: Thank you so much. Brittany Harvey: Then first, I'd like to note that ASCO takes great care in the development of its guidelines, and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The full conflict of interest information for this guideline panel is available online with the publication of the guideline in the Journal of Clinical Oncology. Dr. Yilmaz, do you have any relevant disclosures that are directed related to this guideline topic? Dr. Emrullah Yilmaz: No, I don't have a relevant disclosure. Brittany Harvey: Thank you. Then let's dive right into this guideline. So, generally, what is the purpose and the scope of this guideline? Dr. Emrullah Yilmaz: Immunotherapy with anti-PD-1 immune checkpoint inhibitors has become one of the most important treatment options for patients with recurrent metastatic head and neck cancers. And in the last few years, there has been new studies leading to new indications such as combinations with chemotherapy, or single-agent immunotherapy in the first-line treatment. And moreover, several studies also shown the effectiveness of immunotherapy for patients with nasopharyngeal carcinoma. All these advances in this complex disease group made it necessary to have an evidence-based guideline. So, that was the basis of building this guideline. Brittany Harvey: Understood. And then this evidence-based guideline addresses six clinical questions. So, I'd like to review the key recommendations for each of those questions for our listeners. So, let's start with the first question. What did the expert panel recommend regarding biomarkers for selecting patients with head and neck squamous cell carcinoma for anti-PD-1 immune checkpoint inhibitor therapy? Dr. Emrullah Yilmaz: Biomarkers are key for selection of treatment for immunotherapies, especially for the first-line treatment for head and neck cancer patients. PD-L1 is measured by immunohistochemistry and reported as Combined Positive Score, CPS, or Tumor Proportion Score, TPS. CPS is slightly different than TPS, and it includes lymphocyte and macrophage PD-L1 expression, in addition to tumor cells. Head and neck cancer studies have shown that CPS is a better marker for predicting response to immune checkpoint inhibitors, and key head and neck trials started to use CPS for reporting PD-L1 status. Therefore, we recommend CPS for recurrent metastatic head and neck cancers for PD-L1 reporting. This also makes it important for the oncologists to have a communication with the pathologists to make sure the right PD-L1 scoring is reported for head and neck cancer patients. Tissue tumor mutation burden is another emerging biomarker when CPS is not available, or for rare head and neck tumors, tumor mutation burden can be used as a biomarker as well. Brittany Harvey: Great. And then based on that PD-L1 status that you just mentioned, what is the optimal first-line treatment regimen for patients with recurrent or metastatic head and neck squamous cell carcinoma? Dr. Emrullah Yilmaz: If PD-L1 is positive, which is CPS more than one, there are two different options. Both pembrolizumab, single agent or pembrolizumab plus chemotherapy with platinum and 5-Fluorouracil can be offered. KEYNOTE-048 study showed an overall survival benefit with pembrolizumab alone for patients with CPS more than one, which was greater for the patients with CPS 20 or more. However, the pembrolizumab plus chemotherapy has showed benefit for the patients regardless of the PD-L1 status. So, if an early response is needed for a patient with high disease burden, pembrolizumab with chemotherapy could be an option, even if the PD-L1 is positive. For patients with negative PD-L1, which is CPS less than one, we recommend pembrolizumab and chemotherapy. There was a recent subgroup analysis of KEYNOTE-048 for CPS-low patients. Patients with CPS less than one subgroup did not have significant survival difference with pembrolizumab plus chemotherapy when compared to cetuximab plus chemotherapy. This included a small number of patients, and this study was not powered to look at this subgroup, but cetuximab and chemotherapy can also be considered in the PD-L1 negative patient. Brittany Harvey: Understood. It's important to recognize which patients benefit from these treatments more than others in different subgroups. So, following that, what is the effect of immunotherapy compared to other systemic treatments in platinum-refractory recurrent, or metastatic head and neck squamous cell carcinoma? Dr. Emrullah Yilmaz: Platinum-refractory disease is defined as recurrence within six months of platinum-based chemotherapy. And effectiveness of immunotherapy was actually proven in this disease group first, several years ago. The effectiveness of immunotherapy as a single agent was proven in two similarly designed phase III trials in this setting. CheckMate 141 trial compared nivolumab to standard-of-care methotrexate, cetuximab, or docetaxel, and KEYNOTE-040 trial compared pembrolizumab to similar standard-of-care agents. And both studies showed overall survival benefit when compared to standard-of-care systemic agents, and the responses were independent from the PD-L1 expressions. So, nivolumab or pembrolizumab, are options as single-agent immunotherapy treatments for the patients with platinum-refractory head and neck squamous cell carcinoma, regardless of their PD-L1 expression. Brittany Harvey: Understood, and thank you for getting into those options for those patients. Getting into the specifics for nasopharyngeal carcinoma, what did the panel recommend regarding the role of immunotherapy for patients with recurrent or metastatic nasopharyngeal carcinoma? Dr. Emrullah Yilmaz: So, the combination of immunotherapy with cisplatin and gemcitabine was shown to be effective in first-line treatment of recurrent metastatic nasopharyngeal carcinoma, in several phase III studies from Asia in the last few years. JUPITER-02 study used toripalimab, CAPTAIN-1 study used camrelizumab, and RATIONALE-309 study used tislelizumab in combination with cisplatin and gemcitabine in the first-line treatment, and all these studies showed progression-free survival benefit with addition of immunotherapy to chemotherapy. Since these agents are not available in the United States as of now, our panel members recommend that pembrolizumab or nivolumab may be offered in combination with chemotherapy for the first-line treatment of recurrent or metastatic nasopharyngeal carcinoma. But the role of immunotherapy in the platinum-refractory nasopharyngeal carcinoma without the prior immunotherapy use is not well established yet. There are phase II studies that have shown that responses to immunotherapy are comparable to chemotherapy with a better safety profile. So, single-agent immunotherapy could be considered in a platinum-refractory setting if a PD-1 inhibitor was not used before. Brittany Harvey: Those are excellent points that you just made. So, following that, the next question that the panel considered is, what is recommended regarding the use of radiation therapy in combination with immunotherapy versus immunotherapy alone, for the treatment of locoregionally recurrent or oligometastatic head and neck squamous cell carcinoma? Dr. Emrullah Yilmaz: This is a great question, and radiation therapy is used a lot in head and neck cancers for different purposes. And immunotherapy and SBRT combinations were not shown to increase efficacy for abscopal effect for the treatment of oligometastatic disease in head and neck cancers. So, radiation therapy should not be given to increase the effectiveness of immunotherapy in recurrent metastatic head and neck cancers. However, there are several ongoing studies to evaluate the efficacy of radiation such as SBRT with immunotherapy for locoregional recurrence. So, although radiation therapy is safe to give the patients with recurrent and metastatic cancers, with immunotherapy, it should be considered for palliation or local control until the results of these trials are available. Brittany Harvey: Great. And yes, we'll look forward to the results of those trials to find some more definitive results for these patients. So, then, the last clinical question that the panel addressed, what is recommended for the role of immunotherapy for rare head and neck cancers? Dr. Emrullah Yilmaz: The role of the immunotherapy for rare head and neck cancers depends on the biomarkers. KEYNOTE-158 study has shown the effectiveness of pembrolizumab in advanced cancer patients, which included different types of cancers with high tissue TMB defined as more than 10 mutations per megabase. And looking at the results from that study for the patients with advanced rare head and neck cancers with limited treatment options, such as, salivary gland cancers or sinonasal cancers, if high TMB, which is Tumor Mutational Burden, is identified, then pembrolizumab may be considered for those patients. And pembrolizumab was also shown to have activity in salivary gland cancer patients expressing more than 1% PD-L1. So, that makes it an option for these patients as well. Brittany Harvey: It sounds like understanding the biomarker status of these patients with rare head and neck cancers is essential for determining their therapy options. I want to thank you so much for reviewing all of those recommendations. So, in your view, Dr. Yilmaz, what is the importance of this guideline, and how will it impact clinicians and patients with head and neck squamous cell carcinoma? Dr. Emrullah Yilmaz: This guideline was written by panel members, experts in their field, including medical oncologists, radiation oncologists, head and neck surgeons, pathologists, and radiologists. It is really important for oncologists to communicate the treatment options to their patients clearly while planning treatment of head and neck cancers. So, this guideline can help the clinicians to provide evidence-based resource when to use the immunotherapy for their head and neck cancer patients. So, that can be really helpful to the clinicians. Brittany Harvey: Excellent. Yes, it's important to have a multidisciplinary group working on these guidelines to help clinicians in all capacities. Finally, what outstanding questions or ongoing research are you interested in for future therapeutic options in head and neck squamous cell carcinoma? Dr. Emrullah Yilmaz: Our guideline focuses on recurrent metastatic head and neck cancers since it is the only area where the immunotherapy is approved as of now. We've had a few studies in the curative intent setting, which has not shown the benefit of addition of immunotherapy to radiation therapy, or chemoradiation. There's still several studies ongoing to investigate the effectiveness of immunotherapy in the curative intent setting, and the neoadjuvant setting, or adjuvant setting, or different combinations with the radiation therapy, with the immunotherapy, with the different sequences. So, it will be interesting to see the results of those studies in the future. So, that might be another area that the field might be moving in the future. There are also studies ongoing to improve effectiveness of the immunotherapy in the recurrent and metastatic disease. Chemoimmunotherapy seems to be among the strongest systemic treatment options right now that we have, but there are several other combination strategies that are being developed combined with the PD-1 inhibitors, including combinations with EGFR inhibitors, angiogenesis inhibitors, intratumoral injections, vaccine developments, and there are a lot of different novel checkpoint inhibitors being developed. So, the field is advancing in that area as well. So, those are the areas that research are ongoing at this point. Brittany Harvey: Definitely. We'll look forward to the results of those ongoing trials to inform future updates and future guidelines in this area. So, I want to thank you so much for all of your work that you put into developing these evidence-based guidelines and thank you for your time today, Dr. Yilmaz. Dr. Emrullah Yilmaz: Thank you so much. Brittany Harvey: And thank you to all of our listeners for tuning to the ASCO Guidelines podcast series. To read the full guideline, go to: www.asco.org/head-neck-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, available in iTunes or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast, and be sure to subscribe, so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy, should not be construed as an ASCO endorsement.  

A infusão hepática de quimioterapia intra-arterial com fluorouracil infusional, leucovorin e oxaliplatina (HAIC-FO) vem demonstrando segurança e atividade antitumoral encorajadoras quando utilizados estudos prévio menores para pacientes com CHC localmente avançado.Neste episódio, Tiago Biachi e Allan Pereira discutem o estudo fase III, FOHAIC-1, que avaliou essa estratégia de infusão intra-arterial para pacientes com CHC avançado, previamente não tratados com terapia sistêmica vs. sorafenibe. Apesar de positivo, a principal crítica desse estudo é exatamente o braço controle com sorafenib, que não vem demonstrando ser o melhor tratamento para essa situação.Sejam bem vindos ao episódio 103 do Clinical Papers Podcast!Para saber mais sobre o paper, acesse:https://pubmed.ncbi.nlm.nih.gov/34905388/

In this latest podcast, Prof David Wilkinson (Chief Medical Officer of National Skin Cancer Centres) speaks with Dr Yevgeny (Gene) Filanovsky (a Family Physician with Cutaneous Surgery and Skin Cancer Focus at Skin Care West, Canada) about his extensive experience using topical 5 fluorouracil-calcipotriol compound to treat actinic keratosis. Dr Filanovsky describes how he got started in skin cancer medicine and came to work full-time in cutaneous surgery at Skin Care West, which utilises a team-based approach combining dermatologists and family physicians. It is quite unique in Canada and is one of the largest dermatology clinics in its province. Dr Filanovsky goes on to give a very detailed explanation of his experiences with topical 5 fluorouracil-calcipotriol compound use for actinic keratosis. He has treated over 1,000 patients with this treatment. Download his handout here and his slides here.

Commentary by Dr. Giorgio Minotti

Fluoropyrimidine Cardiotoxicity   |Not Medical Advice or Opinion|

Commentary by Dr. Bonnie Ky

Exploring How Animals Think, Talk, and Feel Nancy Castaldo authored a book with vivid photographs, first-person interviews and historical anecdotes exploring animals' ability to show empathy, communicate and develop complex social societies. Humans have changed their overall perception of animals. As little as 40 years ago, many considered animals to be "machine-like" creatures that feel no pain. Now, we know different. But how much do we really know? Nancy will share her research on the clever little rat and why cats don't rank. Listen Now Police Given Okay To Shoot Dogs In a shocking and controversial decision, a Michigan Federal Court granted police the right to shoot a dog that moves or barks at them when they are inside a home. The decision stems from an incident in Battle Creek, Michigan where police shot and killed two dogs while executing a search warrant looking for drugs inside a couple's house. While this doesn't give permission across the board, it will set a legal precedence in the justice system. One has to ask why such lethal force is necessary? Why won't a stun-gun or pepper spray suffice? Listen Now Kids Don't Need Siblings, Just a Pet! According to a new study from the University of Cambridge, children get more satisfaction from the relationships they have with their pets than with their brothers and sisters. The research also found that many children get along with their pets better than their siblings. While boys and girls were equally satisfied with their pets, girls reported more companionship and conflict with their pet than boys, and girls talks more to their pets. Listen Now Skin Cream Kills Dogs A skin cancer cream that is usually used to cure and prevent skin cancer has killed at least five dogs after they accidentally swallowed it. The FDA is warning pet owners to keep the prescription cream out of reach from pets. It is called Fluorouracil and is sold under the brand names Fluoroplex, Efudex and Carac. Listen Now Third Hand Smoke Harms Pets The FDA has a new warning for pet owners who smoke saying it's not just second-hand smoke that's harmful to pets.  Animals are also at risk for being exposed to third-hand smoke, which includes the residue that lingers on skin, clothes, carpets and other household items that ends up on their fur. Obviously most animals groom themselves, meaning that residue getting transferred from the floor, couch or your hand to their fur – is ingested. Listen Now Read more about this week's show.

This episode covers 5 fluorouracil!

The cover for issue 27 of Oncotarget features Figure 4, "(A) Bimodal imaging examples of control and treated tumors (red) before and after the treatment period," by Browning, et al. and reported that the authors developed a 3-dimensional bioprinted skin model of cutaneous squamous cell carcinoma (cSCC) tumors together with a microscopy assay to test chemotherapeutic effects in tissue. Fluorescence-derived imaging biomarkers indicated that 50% of cancer cells were killed in the tissue after 1μM 5-Fluorouracil 48-hour treatment, compared to a baseline of 12% for untreated controls. The imaging biomarkers also showed that normal keratinocytes were less affected by treatment than the untreated tissue, which had no significant killing effect. Data showed that 5-Fluorouracil selectively killed cSCC cells more than keratinocytes. The authors' 3DBPS assay platform provides the cellular-level measurement of cell viability and can be adapted to achieve non-destructive high-throughput screening in bio-fabricated tissues. Dr. Daniel S. Gareau from The Laboratory for Investigative Dermatology at The Rockefeller University, New York said, "Global incidence of cSCC is 2.2 million people and accounts for most of the ~10,000 annual non-melanoma skin cancer deaths in the United States." Drug discovery for small molecule therapies to treat locally advanced/inoperable or metastatic cSCC and other cancers can be accelerated using patient-specific, physiologically relevant models amenable to high-throughput screening. Models should mimic the tumor microenvironment, given its influence on tumor progression and metastasis, and should reproduce in vivo tumor cell physiochemical signaling and mechanical cues from the surrounding tissue extracellular matrix. Animal models may not be readily translatable to human cancer treatment, and three-dimensional tissue culture models offer a viable alternative for pre-clinical screening of small molecule therapeutics. 3D models using human-derived cell lines offer increased complexity and physiological fidelity compared with two-dimensional monocultures and have been developed for several cancer models, including melanoma, pancreatic cancer, and cervical cancer. In the disease model presented here, A431 cSCC spheroids were introduced into the tissue, and histopathology and cDNA microarray analysis was used to confirm the biological fidelity of the cancer model. The authors' objective was to quantify the therapeutic efficacy of a standard of care treatment for a cSCC skin tissue model that recapitulates the microenvironment in which this cancer grows. The Gareau Research Team concluded in their Oncotarget Research Paper that the model described provides a higher degree of clinical relevance because it enables the testing of chemotherapeutics against tumor cell growth in a tissue-specific context, thus capturing any potential interactions between the tumor and its microenvironment. They envision that this model could be adopted in a “bedside” manner and applied to cells from cSCC patient tumor biopsies. DOI - https://doi.org/10.18632/oncotarget.27570 Full text - https://www.oncotarget.com/article/27570/text/ Correspondence to - Daniel S. Gareau - dgareau@rockefeller.edu. Keywords - squamous cell carcinoma, screening, 3D printing, in vitro model, confocal microscopy About Oncotarget To learn more about Oncotarget, please visit https://www.oncotarget.com or connect with: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ Twitter - https://twitter.com/oncotarget LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Oncotarget is published by Impact Journals, LLC please visit http://www.ImpactJournals.com or connect with @ImpactJrnls Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957x105

In this first episode of the new Dermatology Weekly podcast, Dr. Vincent DeLeo talks with Dr. Daniel Siegel and Ramiz Hamid about indoor tanning behaviors among adolescents, and they outline tips for communicating with patients about the harmful effects of tanning. You can read their related article on MDedge Dermatology: https://bit.ly/2Jpetpf. We also bring you the latest in dermatology news and research: 1. Fluorouracil beats other actinic keratosis treatments in head-to-head trial. https://bit.ly/2SNmWC5 2. Match Day 2019: Dermatology steps up growth after slow 2018. https://bit.ly/2unA8Ud 3. Don't miss baby scabies. https://bit.ly/2Tkd0jF Contact us: podcasts@mdedge.com Twitter: @MDedgeDerm          

Pharming Your Career: #HowIRxoll Part 4: A Passion for Clinical Pharmacology - Dr. Grigor Abelien   Grigor Abelian's Bio: Dr. Abelian graduated as University Valedictorian from Philadelphia College of Pharmacy at University of the Sciences with Bachelor of Science in Pharmaceutical and Healthcare Studies and Doctor of Pharmacy degrees.   During pharmacy school, he augmented his didactic training through internships at multiple institutions including Johns Hopkins Hospital at Critical Care/Surgery Department of Pharmacy, Janssen Research & Development in Clinical Pharmacology and Global Trial Management, and United States Food and Drug Administration at Office of Health Informatics. He supported and led multiple research projects spanning from pharmaceutics development of Tegafur and its parent drug 5-Fluorouracil in the Colon Cancer setting at University of the Sciences, Alcohol Withdrawal Syndrome in the Surgical Intensive Care setting at Johns Hopkins Hospital, and Trauma Registry Validation in the Venous Thromboembolism Prevention setting at University of Pennsylvania Perelman School of Medicine Center for Clinical Epidemiology and Biostatistics. Upon graduation, he completed a joint Postdoctoral Fellowship in Clinical Pharmacology at University of Southern California and Allergan, plc where he supported and led clinical pharmacology drug development efforts in the CNS, GI, Ophthalmology, Immunology, and Dermatology therapeutic areas.   Currently, he serves as a Research Investigator in the Global Clinical Pharmacology and Pharmacometrics function at Bristol-Myers Squibb where he supports research and development in the Cardiovascular, Immunology, and Oncology therapeutic areas. His core discipline interests include translational and precision medicine, pharmacogenomics, and model-based drug development.   In his spare time, he enjoys several sports including weight training, snowboarding, professional and pick-up football, soccer, basketball, and tennis in addition to traveling, hiking, and stock market investing.   LinkedIn: https://www.linkedin.com/in/grigor-abelian-pharmd-938a39bb/  See omnystudio.com/listener for privacy information.

5-FU: both its mechanisms, all its toxicities, most of its uses, and some of its history are discussed.

Interview with Martin A. Weinstock, author of Chemoprevention of Basal and Squamous Cell Carcinoma With a Single Course of Fluorouracil, 5%, Cream: A Randomized Clinical Trial

In this episode, I continue with our book review of Wheelbarrow Profits and then move to a very interesting study that used 5% Fluorouracil instead Modified Carnoy’s solution to decrease the recurrence rate of keratocystic odontogenic tumors with a decrease in paresthesias.  If you treat these lesions you will not want to miss this discussion.  The Interesting Case shows the surgical approach to removal of a mandibular bicuspid that is an extra tooth.  The pictures are worth checking out!  Resources Mentioned: dentistbraincandy.com/dentistinventory/

Exploring How Animals Think, Talk, and Feel Nancy Castaldo authored a book with vivid photographs, first-person interviews and historical anecdotes exploring animals' ability to show empathy, communicate and develop complex social societies. Humans have changed their overall perception of animals. As little as 40 years ago, many considered animals to be "machine-like" creatures that feel no pain. Now, we know different. But how much do we really know? Nancy will share her research on the clever little rat and why cats don't rank. Police Given Okay To Shoot Dogs In a shocking and controversial decision, a Michigan Federal Court granted police the right to shoot a dog that moves or barks at them when they are inside a home. The decision stems from a 2013 incident in Battle Creek, Michigan where police shot and killed two dogs while executing a search warrant looking for drugs inside a couple's house. While this doesn't give permission across the board, it will set a legal precedence in the justice system. One has to ask why such lethal force is necessary? Why won't a stun-gun or pepper spray suffice? Kids Don't Need Siblings, Just a Pet! According to a new study from the University of Cambridge, children get more satisfaction from the relationships they have with their pets than with their brothers and sisters. The research also found that many children get along with their pets better than their siblings. While boys and girls were equally satisfied with their pets, girls reported more companionship and conflict with their pet than boys, and girls talks more to their pets. Skin Cream Kills Dogs A skin cancer cream that is usually used to cure and prevent skin cancer has killed at least five dogs after they accidentally swallowed it. The FDA is warning pet owners to keep the prescription cream out of reach from pets. It is called Fluorouracil and is sold under the brand names Fluoroplex, Efudex and Carac. Third Hand Smoke Harms Pets The FDA has a new warning for pet owners who smoke saying it's not just second-hand smoke that's harmful to pets.  Animals are also at risk for being exposed to third-hand smoke, which includes the residue that lingers on skin, clothes, carpets and other household items that ends up on their fur. Obviously most animals groom themselves, meaning that residue getting transferred from the floor, couch or your hand to their fur – is ingested. Read More about this week's show.

 A substitute for one of the bases in DNA that can cause the death of cancer cells

Background To overcome the limitations of animal-based experiments, 3D culture models mimicking the tumor microenvironment in vivo are gaining attention. Herein, we investigated an alginate-based 3D scaffold for screening of 5-fluorouracil (5-FU) or/and curcumin on malignancy of colorectal cancer cells (CRC). Methods The potentiation effects of curcumin on 5-FU against proliferation and metastasis of HCT116 cell and its corresponding isogenic 5-FU-chemoresistant cells (HCT116R) were examined in a 3D-alginate tumor model. Results CRC cells encapsulated in alginate were able to proliferate in 3D-colonospheres in a vivo-like phenotype and invaded from alginate. During cultivation of cells in alginate, we could isolate 3 stages of cells, (1) alginate proliferating (2) invasive and (3) adherent cells. Tumor-promoting factors (CXCR4, MMP-9, NF-κB) were significantly increased in the proliferating and invasive compared to the adherent cells, however HCT116R cells overexpressed factors in comparison to the parental HCT116, suggesting an increase in malignancy behavior. In alginate, curcumin potentiated 5-FU-induced decreased capacity for proliferation, invasion and increased more sensitivity to 5-FU of HCT116R compared to the HCT116 cells. IC50 for HCT116 to 5-FU was 8nM, but co-treatment with 5 μM curcumin significantly reduced 5-FU concentrations in HCT116 and HCT116R cells (0.8nM, 0.1nM, respectively) and these effects were accompanied by down-regulation of NF-κB activation and NF-κB-regulated gene products. Conclusions Our results demonstrate that the alginate provides an excellent tumor microenvironment and indicate that curcumin potentiates and chemosensitizes HCT116R cells to 5-FU-based chemotherapy that may be useful for the treatment of CRC and to overcome drug resistance.

This trial supports the use of neoadjuvant capecitabine monotherapy as a potentially more convenient radiosensitizer that does not sacrifice surgical and pathologic outcomes in rectal cancer. However, further study is needed.

Objective Treatment of colorectal cancer (CRC) remains a clinical challenge, as more than 15% of patients are resistant to 5-Fluorouracil (5-FU)-based chemotherapeutic regimens, and tumor recurrence rates can be as high as 50–60%. Cancer stem cells (CSC) are capable of surviving conventional chemotherapies that permits regeneration of original tumors. Therefore, we investigated the effectiveness of 5-FU and plant polyphenol (curcumin) in context of DNA mismatch repair (MMR) status and CSC activity in 3D cultures of CRC cells. Methods High density 3D cultures of CRC cell lines HCT116, HCT116+ch3 (complemented with chromosome 3) and their corresponding isogenic 5-FU-chemo-resistant derivative clones (HCT116R, HCT116+ch3R) were treated with 5-FU either without or with curcumin in time- and dose-dependent assays. Results Pre-treatment with curcumin significantly enhanced the effect of 5-FU on HCT116R and HCR116+ch3R cells, in contrast to 5-FU alone as evidenced by increased disintegration of colonospheres, enhanced apoptosis and by inhibiting their growth. Curcumin and/or 5-FU strongly affected MMR-deficient CRC cells in high density cultures, however MMR-proficient CRC cells were more sensitive. These effects of curcumin in enhancing chemosensitivity to 5-FU were further supported by its ability to effectively suppress CSC pools as evidenced by decreased number of CSC marker positive cells, highlighting the suitability of this 3D culture model for evaluating CSC marker expression in a close to vivo setting. Conclusion Our results illustrate novel and previously unrecognized effects of curcumin in enhancing chemosensitization to 5-FU-based chemotherapy on DNA MMR-deficient and their chemo-resistant counterparts by targeting the CSC sub-population.

This VETgirl podcast reviews the dangers of fluorouracil, also referred to as 5-FU. 5-FU is a topical chemotherapeutic agent commonly prescribed for human actinic keratosis and superficial basal cell carcinomas. When accidentally ingested by dogs and cats, this topical cream can be life-threatening as it has a very narrow margin of safety. In this VETgirl podcast, we discuss toxicosis concerns including decontamination, clinical signs, treatment options, and prognosis. When in doubt, contact the ASPCA Animal Poison Control Center (APCC) for life-saving advice 24/7 as needed!

This VETgirl podcast reviews the dangers of fluorouracil, also referred to as 5-FU. 5-FU is a topical chemotherapeutic agent commonly prescribed for human actinic keratosis and superficial basal cell carcinomas. When accidentally ingested by dogs and cats, this topical cream can be life-threatening as it has a very narrow margin of safety. In this VETgirl podcast, we discuss toxicosis concerns including decontamination, clinical signs, treatment options, and prognosis. When in doubt, contact the ASPCA Animal Poison Control Center (APCC) for life-saving advice 24/7 as needed!

Colorectal Cancer

The addition of oxaliplatin to fluorouracil-based neoadjvuant chemoradiation for locally advanced rectal cancer significantly increases toxicity but does not improve the pathologic complete response rate.

Einleitung und Ziel der Arbeit: Immunchemotherapie-Protokolle mit 5-Fluorouracil (5-FU) in Kombination mit Interleukin-2 (IL-2) und Interferon-alpha2a (IFN-alpha) zeigten eine verbesserte Ansprechrate bei Patienten mit metastasiertem Nierenzellkarzinom (NZK). Die Rolle des 5-FU im Rahmen eines synergistischen bzw. additiven Effektes ist bislang nicht geklärt. Die vorliegende Arbeit hinterfragt, ob die Gabe von 5-FU im Zusammenhang einer Immuntherapie aus immunologischer Sicht gerechtfertigt ist. Hierzu wurden die Effekte des 5-FU auf die Lymphozytenfunktion in vitro und ex vivo während der Immunchemotherapie analysiert. Methoden: Periphere Blutmononukleäre Zellen (PBMC) wurden aus dem Blut gesunder Spender isoliert und für 5 Tage mit verschiedenen NZK-Linien in Mixed lymphocyte tumor cell cultures (MLTC) koinkubiert. IL-2, IFN-alpha, 5-FU wurden allein oder in Kombination dazugegeben. Die Lymphozyten wurden im Hinblick auf Proliferation, Zytotoxizität mittels colorimetrischer Verfahren und bezüglich ihrer Aktivität in der Immunfluoreszenz analysiert. Zusätzlich entwickelten wir eine Langzeit-Kultur mit PBMC in Kokultur mit NZK-Linien und den Pharmaka nach dem Hannoveraner Protokoll (IL-2, IFN-alpha, 5-FU). Der Lymphozyten-Phänotyp und ihre Funktion wurden bei 5 Patienten mit metastasiertem NZK, die die Immunchemotherapie nach dem Hannoveraner Protokoll und bei 6 weiteren Patienten in modifizierter Form erhielten, analysiert. Ergebnisse: Die Lymphozyten-Proliferation in der MLTC war um mehr als das doppelte gesteigert nach der Gabe von IL-2 und/oder IFN-alpha. 5-FU inhibierte die Proliferation vollständig allein und in der Kombination mit IL-2 und/oder IFN-alpha. Die Zytotoxizität der aktivierten Lymphozyten war in ähnlicher Weise vermindert. Die Langzeitkultur (MLTC mit PBMC und NZK-Linien, IL-2, IFN-alpha und 5-FU) führte zu einer kontinuierlichen Lymphozyten-Proliferation und ergab einen deutlichen Anstieg der Zellzahl. Die Proliferation und die Vitalität waren nach Gabe von 5-FU vollständig aufgehoben. Nach 14-tägiger Kultur mit NZK-Linien IL-2 und IFN-alpha zeigten die aktivierten Lymphozyten eine allospezifische Zytotoxizität. Die Gabe von 5-FU führte zu einem starken Absinken der zytotoxischen Aktivität der stimulierten Zellen. Analog durchgeführte ex vivo – Analysen der Lymphozyten-Funktion aus dem Vollblut von 5 Patienten mit metastasiertem NZK, die die Immunchemotherapie erhielten, zeigten ähnliche Ergebnisse. Die Zytotoxische Aktivität der stimulierten Lymphozyten der behandelten Patienten gegen NZK-Linien stieg nach der Zytokinbehandlung erst an von 35.5% auf 62.2% allospezifische Lyse (E:T ratio 40:1)und fiel nach der Gabe von 5-FU auf weniger als 30% ab. Analog zeigten die Untersuchungen der 6 weiteren Patienten, die zuerst die Kombination aus 5-FU und IFN-alpha und anschließend IL-2 und IFN-alpha erhielten, zunächst einen Abfall der zytotoxischen Aktivität der NK-Zellen. Die Gabe von IL-2 und IFN-alpha wiederum führte zu einem Anstieg der aktivierten Lymphozyten sowie zu vermehrter zytotoxischer Aktivität der NK-Zellen. Schlussfolgerung: 5-FU führt inhibiert die Proliferation und die Zytotoxizität von aktivierten Lymphozyten auch in Kombination mit Zytokinen in vitro. Die ex vivo – Analysen der behandelten Patienten zeigen den gleichen Effekt. Ob eine Änderung der sequentiellen Applikation der einzelnen Pharmaka eine klinische Konsequenz hat, sollte in einer klinischen Studie überprüft werden.

After surgical intervention with curative intention in specialised centres the five-year survival of patients with carcinoma of the exocrine pancreas is only 15%. The ESPAC-1 trial showed an increased five-year survival of 21% achieved with adjuvant chemotherapy. Investigators from the Virginia Mason Clinic have reported a 5-year survival rate of 55% in a phase II trial evaluating adjuvant chemotherapy, immunotherapy and external-beam radiation. Design: The CapRI study is an open, controlled, prospective, randomised multi-centre phase III trial. Patients in study arm A will be treated as outpatients with 5-Fluorouracil; Cisplatin and 3 million units Interferon alpha-2b for 5 1/2 weeks combined with external beam radiation. After chemo-radiation the patients receive continuous 5-FU infusions for two more cycles. Patients in study arm B will be treated as outpatients with intravenous bolus injections of folinic acid, followed by intravenous bolus injections of 5-FU given on 5 consecutive days every 28 days for 6 cycles. A total of 110 patients with specimen-proven R0 or R1 resected pancreatic adenocarcinoma will be enrolled. An interim analysis for patient safety reasons will be done one year after start of recruitment. Evaluation of the primary endpoint will be performed two years after the last patients' enrolment. Discussion: The aim of this study is to evaluate the overall survival period attained by chemo-radiotherapy including interferon alpha 2b administration with adjuvant chemotherapy. The influence of interferon alpha on the effectiveness of the patients' chemoradiation regimen, the toxicity, the disease-free interval and the quality of life are analysed. Different factors are tested in terms of their potential role as predictive markers.

In der vorliegenden Arbeit wurden prospektiv 40 Augen von 34 Patienten operiert und untersucht, aufgeteilt in eine Gruppe von 20 Augen, die eine konventionelle Trabekulektomie erhalten hat und eine weitere Gruppe von 20 Augen, bei der intraoperativ 5 FU appliziert wurde. Es waren kambodschanische Patienten, die bisher keine antiglaukomatöse Lokaltherapie erhalten hatten und kein erhöhtes Vernarbungsrisiko aufwiesen. Die Mehrzahl der behandelten Augen (31) wies dabei ein chronisches Engwinkelglaukom auf, 5 Augen hatten ein chronisches Offenwinkelglaukom und 4 Augen ein Normaldruckglaukom. Es wurden verschiedene Gruppenmerkmale miteinander verglichen, wie z. B. Alter, Geschlecht, Sehschärfe und Augendruck jeweils vor und nach dem Eingriff, Gonioskopie, Anamnesedauer, Komplikationen, Papillenexcavation, Filterkissenaspekt und Aufenthaltsdauer. Die Nachkontrolle erstreckte sich über einen Zeitraum von bis zu einem Jahr, wobei die einzelnen Untersuchungen 1 Monat, 6 Monate und 12 Monate nach der Operation vorgenommen wurden. Nach Abschluß der Beobachtungen ergab die Analyse der Ergebnisse bei der Gruppe, die ohne 5 FU operiert wurde eine 88,23 % ige Erfolgsrate und bei der Vergleichsgruppe (Niederdruckglaukom ausgeschlossen) eine erfolgreiche Drucksenkung von 90,90 %. Die prozentuale Drucksenkung in der Gruppe ohne 5 FU betrug 56,94 % in der Vergleichsgruppe (Niederdruckglaukom ausgeschlossen) 57,23 %. Das postoperative Druckniveau bei der letzten Kontrolle betrug in der Gruppe ohne 5 FU 15,76 mmHg und in der Vergleichsgruppe (Niederdruckglaukom ausgeschlossen) 15,31 mmHg. Alle diese Ergebnisse weisen keine statistisch signifikanten Unterschiede auf, was mit dem Pearson Chi-Quadrat und dem T-Test nachgewiesen wurde. Zusammenfassend lässt sich sagen, dass die primäre Anwendung von intraoperativem 5 FU bei einer unkomplizierten Patientengruppe in Kambodscha nicht gerechtfertigt ist.

Mon, 23 Jun 2003 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/1108/ https://edoc.ub.uni-muenchen.de/1108/1/Funck_Sabine.pdf Funck, Sabine ddc:610, dd

Objective: Angina pectoris, arrhythmic sudden death and myocardial infarction, all these cardiac events have occasionally been reported during 5-fluorouracil (5-FU) chemotherapy. Underlying mechanisms leading to these events are unknown; damage to the myocytes or vasospasms have been discussed. Methods: 102 consecutive and unselected patients were monitored with 12-lead ECG, echocardiography and radionuclide ventriculography prior to the first cycle of 5-FU chemotherapy and 3 months from baseline. Results: 19% of the patients developed reversible symptoms of angina pectoris during treatment which lasted up to 12 h after cessation of the infusion. Most of the 19 patients showed corresponding ECG changes. 6 out of the 19 patients with severe angina pectoris had subsequent coronary angiography. In none of these patients the coronary angiography showed coronary artery disease, but it showed low ventricular function (ejection fraction

Sat, 1 Jan 1994 12:00:00 +0100 https://epub.ub.uni-muenchen.de/6885/1/Chronotherapy_with_5-Fluorouracil_6885.pdf Hallek, M.; Emmerich, B.; Rump, W.; Eibl-Eibesfeldt, B.; Langenmayer, Irmgard; Lang, S.; Adler, S. d

Fri, 1 Jan 1993 12:00:00 +0100 https://epub.ub.uni-muenchen.de/6906/1/Chronotherapy_with_5-Fluorouracil_and_folinic_acid_6906.pdf Hallek, M.; Emmerich, B.; Rump, W.; Eibl-Eibesfeldt, B.; Langenmayer, Irmgard; Lang, S.; Adler, S.