Le cisplatine est l’un des trois agents anticancéreux les plus utilisés en chimiothérapie contre les tumeurs solides. Cependant, les doses utilisées sont limitées par des effets secondaires importants et l’existence des résistances innées ou acquises vis-à-vis de cette drogue. Ce travail vise à augmenter l’index thérapeutique du cisplatine (réduire ses effets secondaires et augmenter son activité anti-tumorale). Pour cela des nanoparticules hautement chargées en cisplatine en couche par couche à base de nucléolipides ont été préparées. Les études physico-chimiques (TEM, DLS, XPS, microscopie à fluorescence, ICP-optique) ont révélé que les nanoparticules à double couche étaient plus stables en milieu biologique par rapport aux formulations en mono-couche. Les études biologiques réalisées sur deux lignées tumorales ovariennes (IGROV1 et SKOV3) ont montré que cette formulation améliore l’activité cytotoxique du cisplatine et inhibe le développement des résistances. L’étude du mécanisme d’action (internalisation, apoptose, génotoxicité, réplication de l’ADN) a confirmé que les nanoparticules à double couche augmentent le taux de cisplatine internalisé qui, une fois libéré dans les cellules, arrête la réplication de l’ADN et induit la mort cellulaire par apoptose. Aucune toxicité intrinsèque aux nano-objets n’est observée. Les études in vivo de ces nanoparticules à double couche après injection en intraveineuse de 5, 7 et 9 mg/Kg ont révélé que cette formulation augmente la dose maximale tolérée et présente une activité anti-tumorale vis-à-vis des lignées cellulaires PROb et GV1A1. Cette stratégie d’élaboration des nanoparticules en couche par couche de nucléolipides nous a permis d’insérer des PEG avec ou sans acide folique pour le ciblage et d’introduire une deuxième drogue lipophile, le paclitaxel. Les tests in vitro (cytotoxicité, internalisation) ont montré l’intérêt de ces modifications. / Cisplatin is one of the three most commonly used anticancer drugs in chemotherapy against solid tumors. However, the doses used are limited by significant side effects and the existence of resistance. The aim of this work is to increase the therapeutic index of cisplatin. For this purpose, highly charged nucleolipids nanoparticles “layer-by-layer” of cisplatin were prepared. The physico-chemical studies (TEM, DLS, XPS, ICP, Fluorescence microscopy) revealed that the bilayer nanoparticles were more stable in biological environment compared with mono-layer formulations. Biological studies carried in two ovarian carcinoma cells lines (IGROV1 and SKOV3) showed that this formulation enhances the cytotoxic activity of cisplatin and inhibits the development of resistance. The study of the mechanism of action (internalization, apoptosis, genotoxicity, DNA replication) demonstrated the nanoparticles with double layer increases the rate of cisplatin internalized then released into the cells, stops the replication of DNA and induces cell death by apoptosis. No intrinsic toxicity of nano-objects is observed. In vivo studies of these nanoparticles double layer after intravenous injection of 5, 7 and 9 mg/Kg in the rats showed this formulation increases the maximum tolerated dose and has an antitumor activity against PROb en GV1A1 cells lines. This strategy of developing layer-by-layer nucleolipids nanoparticles allows to insert PEG with or without folic acid for targeting and introducing second drug, a lipophilic paclitaxel. In vitro study (cytotoxicity, internalization) have shown the benefits of both modification.

Testicular germinal tumors (TGCT) are relatively rare solid tumors in adults. Even so, they affect more than 700 men a year in the Czech Republic, mostly young patients aged 18- 45 years. A large number of patients are curable by a combination of surgery and chemotherapy, yet about 50 men a year in the Czech Republic succumb to this tumor, in the vast majority of cases due to the development of resistance to chemotherapy containing cisplatin. The rare occurrence and high curability are probably the cause of infrequent molecular and clinical studies carried out in these tumors, and our understanding of the biological processes leading to primary tumor development and the development of cisplatin resistance (CDDP) is still limited. At present, no specific molecular markers that could be used as prognostic or predictive factors and improve patient stratification or treatment tailoring are available in TGCT management. In this work, we studied the molecular-genetic background of TGCT development and CDDP resistance at several levels. To comprehensively study the development of cisplatin resistance, we prepared and analyzed CDDP-exposed TGCT cell lines. Long-term exposure to CDDP increased resistance 10-fold in the NCCIT cell line, while no significant resistance was achieved with Tera-2. The...

Les reins sont les organes cibles de nombreuses molécules toxiques. Les cellules épithéliales du tubule proximal rénal sont particulièrement vulnérables vis-à-vis de xénobiotiques utilisés comme médicaments ou non. Ces agressions peuvent être corrélées à une augmentation du stress oxydatif et induire la mort cellulaire. Elles peuvent également mener à la perte des caractéristiques phénotypiques des cellules épithéliales, initiant leur dédifférenciation en cellules mésenchymateuses et éventuellement en fibroblastes, principaux responsables de la fibrose rénale.<p>Les stratégies de protection – notamment implémentées en clinique lors de l'administration de médicaments néphrotoxiques – reposant sur une approche pharmacologique restent rares.<p>A partir de données de médecines traditionnelles, nous avons sélectionné une série de plantes considérées utiles pour le traitement ou la prévention de troubles associés aux maladies rénales :Angelicae sinensis radix, Eleutherococci radix, Ginseng radix, Schisandrae chinensis fructus et Silybi mariani fructus.<p>A l'aide d'un modèle in vitro reposant sur l'emploi de la lignée cellulaire HK-2, nous avons examiné si ces produits pouvaient apporter une protection efficace vis-à-vis de 3 xénobiotiques néphrotoxiques :les acides aristolochiques, le cisplatine et la ciclosporine. Cinq phénomènes impliqués dans la néphrotoxicité et couramment retrouvés lors du développement de la fibrose rénale ont été investigués :(i) la mortalité cellulaire et l'apoptose ;(ii) la génération de stress oxydatif ;(iii) la modulation des capacités de régénération ;(iv) la production de matrice extracellulaire ;et (v) l'activation de la voie de signalisation de la β-caténine. <p>Parmi les 5 plantes étudiées sur ce modèle, celle présentant l'activité la plus intéressante vis-à-vis de l'un des 3 toxiques a été investiguée plus en détails afin d'identifier le(s) composé(s) responsable(s) de sa bioactivité. Les résultats ont indiqué que l'extrait méthanolique d'Angelica sinensis était le plus efficace pour réduire la néphrotoxicité induite par le cisplatine. Ces principes actifs – l'acide férulique, le Z-ligustilide et le E-ligustilide – ont été testés selon la même méthodologie. <p>L'acide férulique a été le plus efficace pour améliorer la survie cellulaire et diminuer l'apoptose induite par le cisplatine. Il a également permis de réduire la production de matrice extracellulaire, de stimuler les capacités de régénération de cellules saines et d'inhiber partiellement la voie de signalisation de la β-caténine. Il n'a toutefois pas été capable de limiter la génération de stress oxydatif induite par le traitement au cisplatine. <p>L'acide férulique semble être un candidat prometteur pour protéger les tubules rénaux vis-à-vis du cisplatine et pourrait contribuer à limiter l'initiation et le développement de la fibrose rénale. <p>/<p>The kidneys are targets of numerous toxic compounds. Proximal tubular epithelia cells are particularly vulnerable to xenobiotics used as drugs or not. These injuries can be associated with an increased oxidative stress and can trigger cell death. They can also lead to the loss of phenotypic characteristics of epithelial cells and initiate their dedifferentiation in mesenchymal cells, eventually evolving in fibroblasts, major actors responsible for renal fibrosis. <p>Protective strategies – including those implemented in clinical practice during the administration of nephrotoxic drugs – relying on a pharmacological approach remain seldom.<p>By means of data issuing from traditional medicines, we selected a series of herbs potentially useful for the treatment or prevention of troubles associated with kidney diseases: Angelicae sinensis radix, Eleutherococci radix, Ginseng radix, Schisandrae chinensis fructus and Silybi mariani fructus.<p>Using an in vitro model based on HK-2 cell line, we examined if these herbal products could bring an effective protection towards 3 nephrotoxic drugs: aristolochic acids, cisplatin and ciclosporin. Five phenomena involved in nephrotoxicity and regularly occurring during the progression of renal fibrosis were investigated: (i) cell death and apoptosis; (ii) oxidative stress generation; (iii) modulation of regeneration capacities; (iv) extracellular matrix production; and (v) β-catenin pathway activation.<p>Among the 5 herbs that were studied, the one presenting the most interesting effects towards one of the 3 toxicants has been investigated in details in order to identify the compound(s) responsible for its bioactivity. Results indicated that the crude methanolic extract of Angelica sinensis was the most potent for reducing cisplatin-induced nephrotoxicity. Its active principles – ferulic acid, Z-ligustilide and E-ligustilide – were tested according to the same methods.<p>Ferulic acid was the most potent compound for improving cell survival and for alleviating cisplatine-induced apoptosis. It also allowed to restrain the extracellular matrix production, enhanced the regeneration capacities of healthy cells and partially inhibited the activation of the β-catenin pathway. It was however ineffective in preventing the generation of oxidative stress induced during cisplatin treatment. <p>Ferulic acid appears as a promising candidate for protecting renal tubules against cisplatin's nephrotoxicity and could contribute to limit the onset and progression of renal fibrosis. / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Проведено исследование цитотоксического действия синтезированных препаратов платины на нормальные клетки человека и различные линии опухолевых клеток. Выполнена оценка фрагментации ДНК методом электрофореза. Исследована целостность цитоплазматической мембраны клеток, подверженных действию препаратов платины. Выявлено наиболее перспективное соединение платины как возможный субстрат для разработки фармацевтических препаратов для лечения онкологических заболеваний. / Within the framework of this work, reviews of the literature on tumor cells and methods of combating malignant neoplasms, including those using platinum preparations, are collected. A study was made of the cytotoxic effect of the synthesized platinum preparations on normal human cells and various tumor cell lines. DNA fragmentation was studied by electrophoresis. A study was made of the integrity of the cytoplasmic membrane of cells exposed to platinum preparations. The most promising platinum compound has been identified as a possible substrate for the development of pharmaceutical preparations for the treatment of oncological diseases.

Background: About five to 10% of cancers in the head and neck region are neck squamous cell carcinoma of unknown primary (NSCCUP). Their diagnosis and treatment are challenging given the risk of missing occult tumors and potential relapse. Recently, we described human papillomavirus (HPV)-related NSCCUP-patients (NSCCUP-P) as a subgroup with superior survival. However, standardized diagnostic workup, novel diagnostic procedures, decision-making in the multidisciplinary tumor board (MDTB) and multimodal therapy including surgery and post-operative radio-chemotherapy (PORCT) may also improve survival. Methods: For assessing the impact of standardized diagnostic processes simultaneously established with the MDTB on outcome, we split our sample of 115 NSCCUP-P into two cohorts treated with curative intent from 1988 to 2006 (cohort 1; n = 53) and 2007 to 2018 (cohort 2; n = 62). We compared diagnostic processes and utilized treatment modalities applying Chi-square tests, and outcome by Kaplan–Meier plots and Cox regression. Results: In cohort 2, the standardized processes (regular use of [18F]-FDG-PET-CT imaging followed by examination under anesthesia, EUA, bilateral tonsillectomy and neck dissection, ND, at least of the affected site) improved detection of primaries (P = 0.026) mostly located in the oropharynx (P = 0.001). From 66.0 to 87.1% increased ND frequency (P = 0.007) increased the detection of extracapsular extension of neck nodes (ECE+) forcing risk factor-adapted treatment by increased utilization of cisplatin-based PORCT that improved 5-years progression-free and overall survival from 60.4 and 45.3 to 67.7% (P = 0.411) and 66.1% (P = 0.025). Conclusions: Standardized diagnostic workup followed by ND and risk-factor adapted therapy improves survival of NSCCUP-P.

No description available.

No / Novel 1- and 1,4-substituted chloroethylaminoanthraquinones with DNA binding and alkylating properties along with their respective hydroxyethylaminoanthraquinone intermediates were synthesized. Selected chloroethylaminoanthraquinones were shown to cross-link DNA and alkylate guanines (at low nM concentration) with a preference for reaction sites containing 5'-PyG. A compound (Alchemix) with the bis-chloroethyl functionality confined to one side chain alkylated but did not cross-link DNA. All the 1,4-disubstituted chloroethylaminoanthraquinones were potently cytotoxic (nM IC50s) against cisplatin-resistant ovarian cancer cell lines.

No description available.

AQ4N (banoxantrone) is a prodrug that, under hypoxic conditions, is enzymatically converted to a cytotoxic DNA-binding agent, AQ4. Incorporation of AQ4N into conventional chemoradiation protocols therefore targets both oxygenated and hypoxic regions of tumors, and potentially will increase the effectiveness of therapy. This current pharmacodynamic and efficacy study was designed to quantify tumor exposure to AQ4 following treatment with AQ4N, and to relate exposure to outcome of treatment. A single dose of 60 mg/kg AQ4N enhanced the response of RT112 (bladder) and Calu-6 (lung) xenografts to treatment with cisplatin and radiation therapy. AQ4N was also given to separate cohorts of tumor-bearing mice 24 hours before tumor excision for subsequent analysis of metabolite levels. AQ4 was detected by high performance liquid chromatography/mass spectrometry in all treated samples of RT112 and Calu-6 tumors at mean concentrations of 0.23 and 1.07 microg/g, respectively. These concentrations are comparable with those shown to be cytotoxic in vitro. AQ4-related nuclear fluorescence was observed in all treated tumors by confocal microscopy, which correlated with the high performance liquid chromatography/mass spectrometry data. The presence of the hypoxic marker Glut-1 was shown by immunohistochemistry in both Calu-6 tumors and RT112 tumors, and colocalization of AQ4 fluorescence and Glut-1 staining strongly suggested that AQ4N was activated in these putatively hypoxic areas. This is the first demonstration that AQ4N will increase the efficacy of chemoradiotherapy in preclinical models; the intratumoral levels of AQ4 found in this study are comparable with tumor AQ4 levels found in a recent phase I clinical study, which suggests that these levels could be potentially therapeutic.

INTRODUÇÃO: Quimiorradioterapia (QRT) concomitante adjuvante aumenta a sobrevida livre de doença (SLD) em pacientes portadores de carcinoma epidermóide de cabeça e pescoço (CECCP) de alto risco operados com intenção curativa, porém está associada a toxicidade não desprezível e seu impacto na sobrevida global (SG) é incerto. ERCC1 (Excision Repair Cross Complementing Group 1) é uma proteína com função crítica no reparo de DNA por excisão de nucleotídeos (NER) e está envolvido na resistência à quimio- e radioterapia. Neste trabalho tivemos como objetivos determinar a expressão da proteína ERCC1, a expressão do RNA mensageiro (mRNA) de ERCC1 e a ocorrência do polimorfismo de nucleotídeo único T19007C de ERCC1 em pacientes portadores de CECCP de alto risco, operados e tratados com QRT adjuvante, bem como o valor prognóstico destes marcadores. MÉTODOS: Trata-se de um estudo retrospectivo em pacientes portadores de CEC de cavidade oral, orofaringe, hipofaringe ou laringe, operados com intenção curativa e portadores de doença de risco alto ou intermediário. Pacientes elegíveis haviam sido tratados com QRT adjuvante: 60-70 Gy e cisplatina concomitante (100 mg/m2, dias 1, 22 e 43), não apresentavam metástases a distância e nem sinais de recidiva após cirurgia. A expressão da proteína ERCC1 foi avaliada por imunohistoquímica, através de um escore H semiquantitativo, obtido pelo produto da intensidade da coloração nuclear (0-3) pelo escore proporcional atribuído à porcentagem estimada de núcleos corados (0;0,1;0,5;1). O método da transcrição reversa e reação em cadeia da polimerase (PCR) em tempo real quantitativo foi utilizado para determinação da expressão do mRNA de ERCC1 em tecido de tumor primário, normalizada em relação à expressão da fração 18S do RNA ribossomal. Genotipagem de ERCC1 (códon 118) foi realizada por PCR - polimorfismo do tamanho do fragmento de restrição a partir de DNA genômico extraído de linfonodos normais destes pacientes, após digestão com BsrDI. RESULTADOS: 69 pacientes com idade mediana de 56a, sendo 81% homens, foram estudados. Em relação à neoplasia, os sítios primários observados foram: cavidade oral (41%), laringe (32%), hipofaringe (16%) e orofaringe (12%), com estadio III 14% e estadio IV 86%, sendo pT3-pT4 78% e pN2-pN3 58%. Quarenta e três pacientes apresentaram-se com pelo menos dois linfonodos positivos, 27 com extravazamento extracapsular da metástase linfonodal e 18 com margens positivas. Achados de alto risco foram detectados em 40 pacientes (58%). No seguimento mediano de 47 meses, observou-se 11 recidivas loco-regionais, sete recidivas a distância, 10 casos com segundo tumor primário (sendo quatro com primário em pulmão e quatro em esôfago) e 30 óbitos (22 pela doença). A taxa de SG em 5 anos foi 40% e a taxa de SLD em 5 anos foi 31%. Escore H superior a 1,5 foi encontrado em 32 pacientes (54%), os quais apresentaram melhor taxa de sobrevida global em 5 anos (50% versus 18%, HR 0,43, 95%CI 0,20-0,90, p=0,026). Quinze pacientes (33%), dos 45 analisados, apresentaram elevada expressão do mRNA de ERCC1 (> 3,1) e estes pacientes tiveram melhor taxa de sobrevida global em 5 anos em comparação com aqueles com baixa expressão (86% versus 31%, HR 0,26, 95%CI 0,14-1,01, p=0,052). A distribuição dos genótipos de ERCC1 no códon 118 em 49 pacientes foi 39% C/T, 37% C/C, e 24% T/T. Não foi encontrada associação significativa entre idade, sexo, estadiamento e achados anatomopatológicos de risco, e os polimorfismos genéticos no códon 118 de ERCC1 ou a expressão do mRNA de ERCC1. Não houve diferença entre os genótipos C/C, C/T e T/T seja em termos taxa de sobrevida global em 5 anos (45%, 46%, 46%; p=0,808), seja em termos de taxa de sobrevida livre de doença em 5 anos (31%, 34%, 20%, p=0,770, respectivamente). O escore H (> 1,5 versus 1,5; HR ajustado 0,20, 95%CI 0,07-0,57, p=0,003) e a expressão normalizada do mRNA de ERCC1 (> 3,1 versus 3,1; HR ajustado 0,12, 95%CI 0,03-0,59, p=0,009), permaneceram significantes do ponto de vista estatístico, como fatores prognósticos na análise multivariada. CONCLUSÕES: Alta expressão imunohistoquímica da proteína ERCC1 e alta expressão do mRNA de ERCC1 conferem melhor prognóstico em pacientes portadores de CECCP operados de alto risco tratados com QRT adjuvante baseada em cisplatina. O polimorfismo genético T19007C de ERCC1 não apresentou valor prognóstico nestes pacientes. / BACKGROUND: Adjuvant concurrent chemoradiation (CRT) improves diseasefree survival (DFS) in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) presenting with high-risk features treated with surgery with curative intent, but treatment-related toxicity is not negligible and its impact on overall survival (OS) is uncertain. ERCC1 (Excision Repair Cross Complementing Group 1) is a protein with a critical role in the nucleotide excision repair (NER) pathway, associated with resistance to chemo- and radiation therapy. We aimed here to study ERCC1 protein expression, ERCC1 messenger RNA (mRNA) expression and the single nucleotide polymorphism T19007C of ERCC1 as prognostic markers in HNSCC patients presenting with high-risk features treated with surgery and adjuvant CRT. METHODS: It is a retrospective study in patients with oral cavity, oropharynx, hypopharynx or larynx SCC submitted to radical surgery with curative intent and presenting with pathologic features of high- or intermediate-risk. Eligible patients were treated with adjuvant CRT: 60-70 Gy and concurrent cisplatin (100 mg/m2, days 1, 22 and 43), with no distant metastasis and no relapsed disease after surgery. ERCC1 protein expression was evaluated by immunohistochemistry, using a semi-quantitative H-score, calculated by multiplying the nuclear staining intensity (0-3) by the proportion score attributed to the percentage of positive tumor nuclei (0;0,1;0,5;1). Quantitative real-time reverse transcriptase polymerase chain reaction (PCR) assay was performed to determine ERCC1 mRNA expression in primary tumors tissue specimens. The ERCC1 mRNA expression was normalized using 18S fraction of ribosomal RNA expression as internal reference. ERCC1 (codon 118) genotypes were detected using PCR restriction fragment length polymorphism method carried out in genomic DNA extracted from normal lymph nodes. The PCR products were digested with BsrDI. RESULTS: 69 patients (median age 56 y, 81% male) were studied. Regarding tumor characteristics, primary sites were: oral cavity 41%, larynx 32%, hypopharynx 16%, oropharynx 12%, stage III 14%, stage IV 86%, pT3- pT4 78% and pN2-pN3 58%. Forty-three patients presented with two or more positive lymph nodes, 27 with extracapsular spread of nodal disease and 18 with positive margins. High-risk pathologic features were detected in 40 patients (58%). During the median follow-up of 47 months, we observed 11 locoregional relapses, seven distant relapses, 10 patients were diagnosed with secondary primary tumors (four in lungs and four in esophagus) and 30 deaths (22 disease-related). The 5-year overall survival rate was 40% and the 5-year disease-free survival rate was 31%. High H-score (> 1.5) was seen in 32 patients (54%), who presented better 5-year overall survival rate in comparison to those with lower H-scores (50% versus 18%, HR 0.43, 95%CI 0.20-0.90, p=0.026). Fifteen patients (out of 45, 33%) whose tumors presented normalized ERCC1 expression > 3.1 were classified as having high ERCC1 mRNA expression, and these patients presented better 5-year overall survival rate in comparison to those with lower ERCC1 mRNA expression (86% versus 30%, HR 0.26, 95%CI 0.14-1.01, p=0.052). Genotype distribution at ERCC1 codon 118 in 49 patients was 39% C/T, 37% C/C, and 24% T/T. No significant association was found between age, gender, stage, grading and pathological risk features and ERCC1 codon 118 genotypes or ERCC1 mRNA expression. No difference was detected among C/C, C/T and T/T genotypes, either in terms of 5-year overall survival rates (45%, 46%, 46%; p=0.808), or 5-year diseasefree survival rate (31%, 34%, 20%, p=0.770, respectively). H-score (> 1.5 versus 1.5; adjusted HR 0.20, 95%CI 0.07-0.57, p=0.003) and ERCC1 mRNA normalized expression (> 3.1 versus 3.1; adjusted HR 0.12, 95%CI 0.03-0.59, p=0.009), remained significant as favorable prognostic factors after adjusting for prognostic factors in a multivariate analysis. CONCLUSIONS: High immunohistochemical expression of ERCC1 protein and high ERCC1 mRNA expression, but not the T19007 single nucleotide polymorphism, were associated with better prognosis in HNSCC patients submitted to surgery and adjuvant cisplatin-based chemoradiation.