A quimioterapia metronômica é uma modalidade terapêutica onde o agente quimioterápico é administrado em baixas doses, em curtos intervalos e continuamente, diferente da quimioterapia em dose máxima tolerada. Dirigida contra células tumorais e outros tipos de células, como as endoteliais e do sistema imunológico, a metronômica altera o microambiente tumoral e suprime características inatas que apoiam o crescimento dos tumores. O objetivo deste trabalho foi analisar prospectivamente o uso da quimioterapia metronômica com lomustina em pacientes com mastocitoma cutâneo, seus efeitos adversos e comparar com o protocolo de vimblastina e prednisona. Para tanto foram incluídos neste estudo 40 neoplasias obtidas de 32 cães de ambos os sexos e idades variadas, com o diagnóstico citológico e histopatológico de mastocitoma cutâneo, os mesmos foram divididos em dois grupos de forma randomizada. O grupo VP foi tratado com vimblastina na dose de 2mg/m² e prednisona por 12 sessões e o grupo LP foi tratado a metronômica com lomustina na dose de 2,84mg/m²/VO por 4 meses. Quanto à classificação histopatológica dos tumores estudados 67,5% (27/40) das formações mostrou graduação intermediária, correspondendo a grau II/baixo grau. Os efeitos adversos foram avaliados de acordo com os critérios do VCOG. Dos pacientes pertencentes ao grupo VP 62,5% (5/16) apresentaram algum tipo de efeito adverso, sendo os mais frequente os efeitos sob o trato gastrointestinal como: disorexia, anorexia, êmese e diarreia ocorrendo em cinco pacientes (5/16), seguido de leucopenia em três animais (3/16). No grupo LP 50% (8/16) dos pacientes tiveram algum tipo de efeito adverso, o mais comum foi êmese, sendo que apenas um cão apresentou efeito adverso classificado em grau III. Os dois protocolos foram bem tolerados pelos pacientes e não houve significância estatística sobre os efeitos adversos de ambos os grupos (p=0,715). A trombocitose foi a síndrome paraneoplásica mais observada, acometendo 25% de todos os animais (8/32), apresentando significância estatística em relação ao temo de sobrevida global (p=0,000049). A média de sobrevida do grupo VP foi de 404,25 dias (104-815dias) enquanto que do grupo LP foi de 320,25 dias (83-669). Não houve diferença estatística entre os grupos de acordo com o tempo de sobrevida (p=0,662) e o tempo livre de recorrência (p=1). A quimioterapia metronômica com lomustina teve boa aceitação junto aos proprietários dos animais, já que é administrada por via oral e os efeitos adversos foram toleráveis e pouco frequentes. / Metronomic chemotherapy is a therapeutic modality where the chemotherapeutic agent is administered in low doses, continuously for short and regular periods, as opposed to the chemotherapy in maximum tolerated dose. Directed against tumor cells and other cell types, such as endothelial cells and immune system cells, the metronomic chemotherapy alters the tumor microenvironment and suppresses innate features that support the growth of tumors. The aim of this study is to prospectively analyze the use of metronomic chemotherapy with lomustine in patients with mast cell tumors, evaluate the therapeutic action and adverse effects and compare with the chemotherapy protocol with vinblastine and prednisone. For this, 40 neoplasms obtained from 32 dogs of both sexes and varied ages, with cytological and histopathological diagnosis of mast cell tumor, were divided into two groups in a randomized fashion. The VP group was treated with vinblastine at a dose of 2mg/m² and prednisone for 12 sessions and the LP group was treated with metronomic chemotherapy with lomustine at a dose of 2.84mg/m²/ VO for 4 months. Regarding the histopathological classification of the studied tumors, 67.5% (27/40) of the formations showed an intermediate degree, corresponding to grade II / low grade. Adverse effects were assessed according to the VCOG criteria. Of the patients belonging to the VP group 62.5% (5/16) presented some type of adverse effect, being the most frequent the effects under the gastrointestinal tract as: dysorexia, anorexia, emesis and diarrhea occurring in five patients (5/16), Followed by leukopenia in three animals (3/16). In the LP group 50% (8/16) of the patients had some type of adverse effect, the most common was emesis, and only one dog presented grade III adverse effect. The two chemotherapeutic protocols were well tolerated by the patients and there was no statistical significance regarding the adverse effects of both groups (p = 0.715). Thrombocytosis was the most observed paraneoplastic syndrome, affecting 25% of all animals (8/32), presenting statistical significance in relation to the overall survival rate (p = 0.000049). The mean survival time of the PV group was 404.25 days (104-815 days) while the LP group was 320.25 days (83-669). There was no statistical difference between the groups according to the survival time (p = 0.662) and the free time of recurrence (p = 1). Metronomic chemotherapy with lomustine was well accepted by animal owners, since it is administered orally and the adverse effects were tolerable and infrequent.

<p dir="ltr">The present work seeks to use High Throughput Experimentation (HTE) and continuous flow chemistry as tools to guide drug discovery and development. HTE allows for the grouping, miniaturization and automation of common operations so that hundreds of experiments can be done simultaneously employing less reagents and less time and promoting faster reaction optimization. Continuous flow chemistry provides a greater surface-area-to-volume ratio relative to batch synthesis, promoting greater mixing and heat transfer. Furthermore, it is a complete closed system protected from air exposure and light, ideal for the synthesis of light and oxygen sensitive, as well as toxic compounds. In this context, two themes on this work are Stargardt disease and the use of HTE and continuous flow for the green synthesis of small molecules. Chapter One introduces Stargardt disease and its key culprit, A2E. Through Chapter Two, we revisited the synthesis of A2E and utilized HTE and continuous flow to optimize the classical synthesis from 48 h to a residence time of 33 min, and yield from 49 to 78%. On Chapter Three, we studied the design and synthesis of IRE1 inhibitors for potential treatment of Stargardt disease. Our molecular docking approach afforded us the design of 66 compounds that were synthesized with the aid of HTE for reaction optimization and were evaluated by RT-qPCR and viability assays. Our studies indicated that three of our inhibitors have lower IC_50s than KIRA6 at inhibiting IRE1 activity in retinal cells. On Chapter Four we introduced the use continuous flow chemistry to make a process greener by revisiting the synthesis of Lomustine. Our method substituted DCM for a mixture of two green solvents, 2MeTHF and acetic acid as well as improved the yield and productivity of the reaction by increasing the solubility of the reaction intermediate produced. Finally, in Chapter Five, we studied the use of HTE to guide catalyst and solvent selection for development of a green synthesis of benzamides. Our method was further optimized by the use of microwave heating and was able to convert sterically hindered amines and carboxylic acids into the corresponding benzamides.</p>