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Molecules (Basel, Switzerland) Nov 2021Ideally, antineoplastic treatment aims to selectively eradicate cancer cells without causing systemic toxicity. A great number of antineoplastic agents (AAs) are... (Review)
Review
Ideally, antineoplastic treatment aims to selectively eradicate cancer cells without causing systemic toxicity. A great number of antineoplastic agents (AAs) are available nowadays, with well-defined therapeutic protocols. The poor bioavailability, non-selective action, high systemic toxicity, and lack of effectiveness of most AAs have stimulated the search for novel chemotherapy protocols, including technological approaches that provide drug delivery systems (DDS) for gold standard medicines. Nanostructured lipid carriers (NLC) are DDS that contain a core of solid and lipid liquids stabilised by surfactants. NLC have high upload capacity for lipophilic drugs, such as the majority of AAs. These nanoparticles can be prepared with a diversity of biocompatible (synthetic or natural) lipid blends, administered by different routes and functionalised for targeting purposes. This review focused on the research carried out from 2000 to now, regarding NLC formulations for AAs (antimetabolites, antimitotics, alkylating agents, and antibiotics) encapsulation, with special emphasis on studies carried out in vivo. NLC systems for codelivery of AAs were also considered, as well as those for non-classical drugs and therapies (natural products and photosensitisers). NLC have emerged as powerful DDS to improve the bioavailability, targeting and efficacy of antineoplastics, while decreasing their toxic effect in the treatment of different types of cancer.
Topics: Animals; Antineoplastic Agents; Biological Availability; Drug Carriers; Drug Compounding; Humans; Lipids; Nanoparticles; Particle Size; Surface-Active Agents
PubMed: 34834022
DOI: 10.3390/molecules26226929 -
Natural Product Reports Apr 2012Phenazines are a large group of natural and synthesised nitrogen-containing heterocycles, including more than 100 different compounds of natural origin and over 6000... (Review)
Review
Phenazines are a large group of natural and synthesised nitrogen-containing heterocycles, including more than 100 different compounds of natural origin and over 6000 synthetic compounds. Many of these compounds have been investigated as potential anti-cancer agents. Despite a large number of research publications, no recent attempt to summarise and critically evaluate the experimental findings relating to the anti-cancer activity of this class of compounds has been made. The present review fills this gap in the literature and discusses both natural and synthetic phenazines with a critical focus on in vitro, in vivo and available clinical anti-cancer activities of these compounds.
Topics: Antineoplastic Agents; Humans; Molecular Structure; Phenazines
PubMed: 22337153
DOI: 10.1039/c2np00079b -
La Revue Du Praticien Jan 1980
Review
Topics: Animals; Antineoplastic Agents; Humans; Neoplasm Metastasis; Neoplasms
PubMed: 6990462
DOI: No ID Found -
JCO Oncology Practice Jul 2020Some elderly patients (≥ 65 years old) with small-cell lung cancer (SCLC) do not receive chemotherapy likely because of fear of toxicity and uncertainty regarding...
PURPOSE
Some elderly patients (≥ 65 years old) with small-cell lung cancer (SCLC) do not receive chemotherapy likely because of fear of toxicity and uncertainty regarding benefits. Thus, we aimed to study real-world trends in utilization of antineoplastics over the years and predictors of utilization, survival, and Medicare expenditure in elderly patients with extensive-stage (ES) SCLC.
PATIENTS AND METHODS
Using the linked SEER and Medicare database, we identified elderly patients with newly diagnosed ES-SCLC between 2001 and 2013. The Wald test was used to determine the significance of trends. Cox proportional hazards models were applied for survival analyses. We used SAS, version 9.4 (SAS Institute, Cary, NC).
RESULTS
We identified 15,763 patients with newly diagnosed ES-SCLC. Approximately 6,838 patients (43.38%) received antineoplastics, and 8,925 patients (56.61%) received supportive care only. Every year since 2001, the percentage of patients receiving antineoplastics has decreased (45.8% 36.6% in 2001 and 2013, respectively; < .0001). Patients with advanced age ( < .001), patients from high-poverty areas ( < .001) or rural areas ( = .005), patients with Charlson comorbidity index ≥ 3 ( < .001), and non-Hispanic blacks ( = .003) and Hispanics ( = .001) were less likely to receive antineoplastics. Mean Medicare spending per patient decreased over the study period for patients treated with antineoplastics ($45,998 in 2001 and $35,053 in 2013; < .001) and for those receiving supportive care only ($34,197 in 2001 and $25,265 in 2013; < .001).
CONCLUSION
Decreasing utilization of antineoplastics in elderly patients with ES-SCLC since 2001 could be partly secondary to higher comorbidities and physiologic age, leading to poor candidacy. Medicare expenditures decreased likely as a result of value-based treatment initiatives by the Centers for Medicaid and Medicare Services. However, expenditures are likely to increase with use of expensive novel agents.
Topics: Aged; Antineoplastic Agents; Humans; Lung Neoplasms; Medicare; Small Cell Lung Carcinoma; Survival Analysis; United States
PubMed: 32074011
DOI: 10.1200/JOP.19.00559 -
Postepy Higieny I Medycyny... 1981
Review
Topics: Animals; Antineoplastic Agents; Drug Interactions; Drug Therapy, Combination; Humans; In Vitro Techniques; Kinetics; Mice; Neoplasms; Rats
PubMed: 6752915
DOI: No ID Found -
La Revue Du Praticien Sep 1998
Comparative Study Review
Topics: Antineoplastic Agents; Antineoplastic Agents, Hormonal; DNA, Neoplasm; Drug Resistance, Multiple; Drug Resistance, Neoplasm; Female; Humans; Male; Neoplasm Metastasis
PubMed: 9814057
DOI: No ID Found -
Chemical Society Reviews Dec 2015
Topics: Antineoplastic Agents; Humans; Molecular Medicine; Neoplasms
PubMed: 26595319
DOI: 10.1039/c5cs90123e -
Anti-cancer Agents in Medicinal... 2015
Topics: Animals; Antineoplastic Agents; Humans; Neoplasms
PubMed: 25629101
DOI: 10.2174/187152061501141204095828 -
Giornale Italiano Di Medicina Del... Jun 2020Antineoplastic drugs are used to treat cancer, having their therapeutic effect by inhibiting the cell division process. Although cancer cells, due to their rapid growth,...
Antineoplastic drugs are used to treat cancer, having their therapeutic effect by inhibiting the cell division process. Although cancer cells, due to their rapid growth, are more sensitive to the toxic effects of chemotherapeutic agents, healthy cells and tissues may also be damaged. Many studies show acute and chronic toxicity both in patients treated with chemotherapy and in exposed workers. In fact, exposure to these substances can also be linked to the formation of different types of secondary tumors. The International Agency on Research on Cancer (IARC) included some antineplastic drugs in Group 1 (carcinogenic to humans), in Group 2A (probable carcinogens for In recent years, many studies have evidenced the presence of antineoplastic drug contamination on work surfaces, materials and floors and based on these observations, international and national guidelines have been published to limit occupational exposure, with particular attention to procedures post-preparation of chemotherapy to limit as much as possible the accumulation of contaminated residues. The aim of the following study is to determine the effectiveness of the degradation of four antineoplastic drugs: 5-fluorouracil, azacitidine, cytarabine and irinotecan using a low concentration of sodium hypochlorite solution (0.115%). The analytical platform used to monitor the degradation course of the substances under examination was hydrogen nuclear magnetic spectroscopy (1H NMR). In the same experimental conditions the effectiveness of the degradation of the same antineoplastic drugs with a 99.9% ethanol solution was also evaluated. The study showed that the best degradation efficiency (> 90% ) is obtained with the hypochlorite solution after 15 minutes.
Topics: Antineoplastic Agents; Azacitidine; Carcinogens; Cytarabine; Decontamination; Drug Interactions; Ethanol; Fluorouracil; Humans; Hypochlorous Acid; Irinotecan; Magnetic Resonance Spectroscopy; Occupational Exposure; Preliminary Data; Sodium Chloride; Sodium Hypochlorite; Time Factors
PubMed: 32614541
DOI: No ID Found -
Medical Care Apr 2013Oral antineoplastic drugs, not generally covered by Medicare Part B, have assumed an increasingly important role in cancer treatment. (Comparative Study)
Comparative Study
BACKGROUND
Oral antineoplastic drugs, not generally covered by Medicare Part B, have assumed an increasingly important role in cancer treatment.
OBJECTIVE
We examined use and spending on infused/injected (Part B covered) and non-Part B antineoplastic agents in a Medicare beneficiary population with cancer, and the effect of supplemental insurance.
RESEARCH DESIGN
This retrospective, observational study used pooled 1997-2007 data from the Medicare Current Beneficiary Survey, linked to Medicare claims. Logistic regression models identified factors associated with antineoplastic use. Generalized linear models were used to estimate spending among antineoplastic users.
POPULATION STUDIED
A total of 1836 Medicare beneficiaries with newly diagnosed cancer were selected based on the presence of claims-based diagnoses after a 12-month washout period.
RESULTS
Five hundred fifty-nine (31.0%) Medicare beneficiaries received antineoplastic therapy; 395 (21.3%) used Part B, 253 (14.6%) used non-Part B antineoplastics. Spending per user was $7841 (any), $10,364 (Part B), and $1535 for non-Part B antineoplastics. Supplemental insurance was associated with antineoplastic use. Primary cancer site and age were key predictors of spending among users. Spending on non-Part B antineoplastics increased during 2006-2007 relative to 2004-2005 but time trends were not significant in multivariate analysis.
CONCLUSIONS
Antineoplastic therapy use by Medicare beneficiaries is sensitive to the presence but not type of supplemental insurance. Non-Part B therapy was used by a relatively large proportion of beneficiaries with cancer receiving therapy, although spending was less than for Part B therapy. Monitoring the role of supplemental insurance, and particularly the role of Medicare Part D is a critical area for ongoing research.
Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Financing, Personal; Health Care Costs; Health Expenditures; Humans; Linear Models; Longitudinal Studies; Medicare; Medicare Part D; Middle Aged; Neoplasms; Retrospective Studies; United States
PubMed: 23222498
DOI: 10.1097/MLR.0b013e3182726ceb