scholarly journals Modulating Metabolism to Improve Cancer-Induced Muscle Wasting

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Fabio Penna ◽  
Riccardo Ballarò ◽  
Marc Beltrá ◽  
Serena De Lucia ◽  
Paola Costelli
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Clinical Studies ◽  
Cancer Cachexia ◽  
Muscle Wasting ◽  
Muscle Metabolism ◽  
Preclinical Models ◽  
Oncologic Patients ◽  
Clinical Conditions

Muscle wasting is one of the main features of cancer cachexia, a multifactorial syndrome frequently occurring in oncologic patients. The onset of cachexia is associated with reduced tolerance and response to antineoplastic treatments, eventually leading to clinical conditions that are not compatible with survival. Among the mechanisms underlying cachexia, protein and energy dysmetabolism play a major role. In this regard, several potential treatments have been proposed, mainly on the basis of promising results obtained in preclinical models. However, at present, no treatment yet reached validation to be used in the clinical practice, although several drugs are currently tested in clinical trials for their ability to improve muscle metabolism in cancer patients. Along this line, the results obtained in both experimental and clinical studies clearly show that cachexia can be effectively approached by a multidirectional strategy targeting nutrition, inflammation, catabolism, and inactivity at the same time. In the present study, approaches aimed to modulate muscle metabolism in cachexia will be reviewed.

scholarly journals Muscle alterations in the development and progression of cancer-induced muscle atrophy: a review

2020 ◽  
Vol 128 (1) ◽  
pp. 25-41 ◽  
Author(s):  
Megan E. Rosa-Caldwell ◽  
Dennis K. Fix ◽  
Tyrone A. Washington ◽  
Nicholas P. Greene
Keyword(s):  
Cancer Patients ◽  
Protein Turnover ◽  
Cancer Cachexia ◽  
Muscle Wasting ◽  
Cell Function ◽  
Developmental Stages ◽  
Muscle Loss ◽  
Inflammatory Signaling ◽  
Mortality And Morbidity ◽  
Cancer Types

Cancer cachexia—cancer-associated body weight and muscle loss—is a significant predictor of mortality and morbidity in cancer patients across a variety of cancer types. However, despite the negative prognosis associated with cachexia onset, there are no clinical therapies approved to treat or prevent cachexia. This lack of treatment may be partially due to the relative dearth of literature on mechanisms occurring within the muscle before the onset of muscle wasting. Therefore, the purpose of this review is to compile the current scientific literature on mechanisms contributing to the development and progression of cancer cachexia, including protein turnover, inflammatory signaling, and mitochondrial dysfunction. We define “development” as changes in cell function occurring before the onset of cachexia and “progression” as alterations to cell function that coincide with the exacerbation of muscle wasting. Overall, the current literature suggests that multiple aspects of cellular function, such as protein turnover, inflammatory signaling, and mitochondrial quality, are altered before the onset of muscle loss during cancer cachexia and clearly highlights the need to study more thoroughly the developmental stages of cachexia. The studying of these early aberrations will allow for the development of effective therapeutics to prevent the onset of cachexia and improve health outcomes in cancer patients.

Philosophical Perspectives on Medicine and Religion

2017 ◽  
Author(s):  
James A. Marcum
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Clinical Outcomes ◽  
Clinical Studies ◽  
Ethical Issues ◽  
Human Suffering ◽  
Philosophical Issue ◽  
Research And Practice ◽  
Spirituality And Religion

In this chapter, I survey the literature concerning selected metaphysical, epistemological, and ethical issues surrounding the intersection of spirituality and religion with medicine. The metaphysical issues concern what constitutes spirituality and its distinction from religion, especially with respect to medical research and practice; the nature of the causal relationship, particularly in mechanistic terms, between spirituality and clinical outcomes; and, the presuppositions animating clinical studies. The epistemological issues pertain to empirical evidence from clinical trials. The main issue is whether the evidence from these trials justifies an impact of spirituality and religion on health and clinical outcomes. The ethical issues involve how best to incorporate spirituality and religion into clinical practice, if they should be incorporated at all. Finally, the fundamental philosophical issue addressed in this chapter is whether the intersection of spirituality and religion with medicine has led to a humanized medicine that achieves medicine’s primary goal of relieving or reducing human suffering associated with illness.

Specific humoral response in cancer patients treated with a VEGF-specific active immunotherapy procedure within a compassionate use program. 

2020 ◽  
Author(s):  
Javier Sánchez Ramírez ◽  
Yanelys Morera Díaz ◽  
Mónica Bequet-Romero ◽  
Francisco Hernández-Bernal ◽  
Yenima Martín Bauta ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Recombinant Antibody ◽  
Therapeutic Vaccine ◽  
Humoral Response ◽  
Active Immunotherapy ◽  
Phase I Clinical Trials ◽  
Compassionate Use ◽  
Medical Institutions

Abstract Background: CIGB-247 is a cancer therapeutic vaccine that uses as antigen a variant of human vascular endothelial growth factor (VEGF) mixed with the bacterially-derived adjuvant VSSP. CIGB-247 has been already evaluated in two phase I clinical trials (CENTAURO and CENTAURO-2), showing to be safe and immunogenic in advanced cancer patients selected under well-defined and controlled clinical conditions. Surviving patients were submitted to monthly re-immunizations and some of them showed objective clinical benefits. Based on these results, a compassionate use program (CUP) with CIGB-247 was initiated for patients that did not meet the strict entry criteria applied for the CENTAURO and CENTAURO-2 clinical trials, but could potentially benefit from the application of this cancer therapeutic vaccine. Results: Polyclonal IgM, IgA and IgG antibodies specific for VEGF were detected by ELISA in serum samples from patients vaccinated with 400 µg of antigen combined with 200 µg of VSSP. Polyclonal antibody response showed no cross reactivity for other VEGF family member molecules like VEGF-C and VEGF-D. Serum from immunized individuals was able to block the binding of VEGF to its receptors VEGFR2 and VEGFR1. IgG fraction purified from immune sera shared the aforementioned characteristics and also inhibited the interaction between VEGF and the therapeutic recombinant antibody bevacizumab, an anti-angiogenic drug approved for the treatment of different tumors. No serious adverse events attributable to CIGB-247 have been documented yet in participants of the CIGB-247 CUP.The present paper is a first report of our findings concerning the humoral response and safety characteristics in treated CIGB-247 CUP cancer patients. The study has provided the unique opportunity of not only testing CIGB-247 in a broader clinical spectrum sample of Cuban cancer patients, but also within the context of the day-to-day clinical practice and treatment settings for these diseases in Cuban medical institutions. Conclusions: The CIGB-247 CUP has demonstrated that immunization and follow-up of a variety of cancer patients, under day-to-day clinical practice conditions in several Cuban medical institutions, replicate our previous findings in clinical trials: CIGB-247 is safe and immunogenic.

scholarly journals Multidisciplinary molecular tumour board: a tool to improve clinical practice and selection accrual for clinical trials in cancer patients

2016 ◽  
Vol 27 ◽  
pp. vi15 ◽  
Author(s):  
C.D. Rolfo ◽  
A. Machado Coelho ◽  
P. Van Dam ◽  
A. Dendooven ◽  
C. Weyn ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Tumour Board

scholarly journals Corticostriatal circuitry in regulating diseases characterized by intrusive thinking

2016 ◽  
Vol 18 (1) ◽  
pp. 65-76 ◽  
Keyword(s):  
Clinical Trials ◽  
Nucleus Accumbens ◽  
Drug Addiction ◽  
Clinical Studies ◽  
Clinical Symptoms ◽  
Neuropsychiatric Disorders ◽  
Preclinical Models ◽  
Drug Seeking ◽  
Positive Effects ◽  
Preclinical And Clinical Studies

Intrusive thinking triggers clinical symptoms in many neuropsychiatric disorders. Using drug addiction as an exemplar disorder sustained in part by intrusive thinking, we explore studies demonstrating that impairments in corticostriatal circuitry strongly contribute to intrusive thinking. Neuroimaging studies have long implicated this projection in cue-induced craving to use drugs, and preclinical models show that marked changes are produced at corticostriatal synapses in the nucleus accumbens during a relapse episode. We delineate an accumbens microcircuit that mediates cue-induced drug seeking becoming an intrusive event. This microcircuit harbors many potential therapeutic targets. We focus on preclinical and clinical studies, showing that administering N-acetylcysteine restores uptake of synaptic glutamate by astroglial glutamate transporters and thereby inhibits intrusive thinking. We posit that because intrusive thinking is a shared endophenotype in many disorders, N-acetylcysteine has positive effects in clinical trials for a variety of neuropsychiatric disorders, including drug addiction, gambling, trichotillomania, and depression.

scholarly journals Les limites de l’ « oncologie de précision »

2019 ◽  
Vol 35 (11) ◽  
pp. 905-907
Author(s):  
Bertrand Jordan
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Genomic Analysis ◽  
Routine Clinical Practice ◽  
Precision Oncology ◽  
Advanced Cancer Patients ◽  
Targeted Drug

The concept of precision oncology is straightforward, but the actual results of treating advanced cancer patients with the targeted drug suggested by genomic analysis have been generally disappointing, indicating that this approach is not yet ready for routine clinical practice. A number of possible improvements can and will be tested by additional clinical trials.

scholarly journals Clinical Pharmacology ofCitrus aurantiumandCitrus sinensisfor the Treatment of Anxiety

2018 ◽  
Vol 2018 ◽  
pp. 1-18 ◽  
Author(s):  
Carmen Mannucci ◽  
Fabrizio Calapai ◽  
Luigi Cardia ◽  
Giuseppina Inferrera ◽  
Giovanni D’Arena ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Studies ◽  
Citrus Sinensis ◽  
Dental Treatment ◽  
Great Part ◽  
Anxiety Level ◽  
Citrus Aurantium ◽  
Beneficial Effects ◽  
Preclinical And Clinical Studies ◽  
Clinical Conditions

Objective. The aim of this review is to analyze preclinical and clinical studies investigating the anxiety effects ofCitrus aurantiumorCitrus sinensisessential oils (EOs).Design. The bibliographic research was made on the major scientific databases. Analysis included only articles written in English and published on peer-reviewed scientific journals describing preclinical experiments and clinical trials carried out to investigate the antianxiety effects ofCitrus aurantium or Citrus sinensisEOs on anxiety disorders. Clinical studies reporting the antianxiety effects of products containingCitrus aurantiumorCitrus sinensisEOs in combination with other active substances, including medicinal plants, were excluded. Nine clinical studies fulfilled the criteria adopted for analysis.Results. Data show thatCitrus aurantiumorCitrus sinensisEOs produce anxiolytic effects both in preclinical experiments and in different clinical conditions.Citrus aurantiumEO aromatherapy reduced anxiety level in the great part of stress conditions studied (subjects affected by chronic myeloid leukemia and preoperative patients) except for a sample of patients subjected to colonoscopy. Exposition toCitrus sinensisEO in clinical studies shows to be positive in reducing anxiety level in patients waiting for dental treatment as well as in healthy volunteers submitted to an anxiogenic situation.Conclusions. Overview of clinical trials conducted withCitrus aurantiumorCitrus sinensison people with anxiety showed that inhalation or oral administration ofCitrus aurantiumand inhalation ofCitrus sinensiscan exert beneficial effects on anxiety; however, because of incomplete accuracy in the reporting of methodology, further more complete clinical studies are warranted.

A Study of Thyroid Function in Cancer Cachexia

1989 ◽  
Vol 75 (2) ◽  
pp. 185-188 ◽  
Author(s):  
Gabriele Tancini ◽  
Sandro Barni ◽  
Sergio Crispino ◽  
Franco Paolorossi ◽  
Paolo Lissoni
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Serum Levels ◽  
Biologically Active ◽  
Advanced Cancer Patients ◽  
Oncologic Patients ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Low Levels

The mechanisms responsible for cancer cachexia have not yet been clarified. To further investigate the role played by the hypothalamic-pituitary-thyroid axis in cancer cachexia, we evaluated serum levels of T3, FT3, T4, FT4, TSH and TBG in a group of 26 cancer patients, 14 of whom showed cachexia, whereas the other 12 had a body weight within the normal range despite their advanced diseases. As controls, 58 healthy subjects and 11 patients with benign weight loss were included in the study. Low levels of both T3 and FT3 were observed in all patients with benign weight loss and in 9/12 advanced cancer patients who had no cancer cachexia. On the contrary, only 4/14 cachectic cancer patients presented decreased values of T3 and FT3. Moreover, the mean serum levels of T3 and FT3 in cachectic oncologic patients were significantly higher than those seen both in non-cachectic cancer patients and in patients with benign weight loss. Since T3 is the biologically active thyroid hormone, the lack of a decrease in its production might play a role in the pathogenesis of cancer cachexia.

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