Alterações de fluxos sanguíneos cerebrais regionais (FSCr) avaliados através de SPECT (Single Photon Emission Computed Tomography) em pacientes com câncer de mama submetidas à quimioterapia adjuvante

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Avaliação da resposta à quimiorradioterapia neoadjuvante em pacientes com adenocarcinomas retais

Pós-graduação em Bases Gerais da Cirurgia - FMB

Uso do LED vermelho em mucosite induzida por quimioterapia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Utilização do laser de baixa densidade (LILT) para tratamento da mucosite induzida em hamsters: comparação clínica e histopatológica entre parâmetros de irradiação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da presença da antineoplásico em água residuária de um hospital oncológico e do sistema de esgotamento sanitário municipal

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Efeito imunomodulador de baixas concentrações de antineoplásicos

Pós-graduação em Patologia - FMB

Efeito das baixas concentrações de agentes antineoplásicos sobre linfócitos humanos de sangue periférico

Our previous studies have shown that low concentrations (noncytotoxics) of antineoplastic agents modulate positively the dendritic cells, favoring their in vitro maturation and improving their antigen presenting function. The effects on colorectal cancer cells (HCT-116) were also investigated and we have observed an increased immunogenicity and susceptibility to cytotoxic T cells. Thereby, this study aimed to investigate the effect of 5-fluorouracil (5-FU) an azacitidine (AZA), in minimum effective and noncytotoxic concentrations on lymphocytes of healthy donors. In this study we have analyzed the cytotoxic effect of drugs at these concentrations as well as the proliferative ability of lymphocytes. In vitro production of IL-10 and IFN-γ has been also evaluated. We have observed that low concentrations of those chemotherapeutic agents are not cytotoxic for lymphocytes. However, the minimum effective concentrations (5-FU: 0,410±0,088 e AZA: 0,757±0,233; p<0, 05) have reduced the cell number. Proliferative activity of allogeneic lymphocytes in a mixed reaction (MLR) was not affected by the treatment. The cytokine production was not affected by the treatments, either. In conclusion, low concentrations of 5-FU and AZA has no deleterious effects on human peripheral blood lymphocytes and seems to be safe for combinatory administration with DC vaccines

Efeito protetor in vivo de vacinas de células dendríticas sensibilizadas com RNA de células MC-38 pré-tratadas com agentes antineoplásticos em concentrações efetivas minímas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação de diferentes protocolos de aplicação da terapia fotodinâmica antimicrobiana (aPDT) no tratamento da periodontite induzida em ratos imunossuprimidos com droga quimioterápica: estudo histomorfométrico, imunoistoquímico, imunológico e microbiológico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relationship between head and neck cancer therapy and some genetic endpoints

Head and neck cancer (HNC) is the sixth most common human malignancy worldwide. The main forms of treatment for HNC are surgery, radiotherapy (RT) and chemotherapy (CT). However, the choice of therapy depends on the tumor staging and approaches, which are aimed at organ preservation. Because of systemic RT and CT genotoxicity, one of the important side effects is a secondary cancer that can result from the activity of radiation and antineoplastic drugs on healthy cells. Ionizing radiation can affect the DNA, causing single and double-strand breaks, DNA-protein crosslinks and oxidative damage. The severity of radiotoxicity can be directly associated with the radiation dosimetry and the dose-volume differences. Regarding CT, cisplatin is still the standard protocol for the treatment of squamous cell carcinoma, the most common cancer located in the oral cavity. However, simultaneous treatment with cisplatin, bleomycin and 5-fluorouracil or treatment with paclitaxel and cisplatin are also used. These drugs can interact with the DNA, causing DNA crosslinks, double and single-strand breaks and changes in gene expression. Currently, the late effects of therapy have become a recurring problem, mainly due to the increased survival of HNC patients. Herein, we present an update of the systemic activity of RT and CT for HNC, with a focus on their toxicogenetic and toxicogenomic effects.

Metformin and soybean-derived bioactive molecules attenuate the expansion of stem cell-like epithelial subpopulation and confer apoptotic sensitivity in human colon cancer cells

Colorectal cancer (CRC) is a disease whose genesis may include metabolic dysregulation. Cancer stem cells are attractive targets for therapeutic interventions since their aberrant expansion may underlie tumor initiation, progression, and recurrence. To investigate the actions of metabolic regulators on cancer stem cell-like cells (CSC) in CRC, we determined the effects of soybean-derived bioactive molecules and the anti-diabetes drug metformin (MET), alone and together, on the growth, survival, and frequency of CSC in human HCT116 cells. Effects of MET (60 μM) and soybean components genistein (Gen, 2 μM), lunasin (Lun, 2 μM), β-conglycinin (β-con, 3 μM), and glycinin (Gly, 3 μM) on HCT116 cell proliferation, apoptosis, and mRNA/protein expression and on the frequency of the CSC CD133(+)CD44(+) subpopulation by colonosphere assay and fluorescence-activated cell sorting/flow cytometry were evaluated. MET, Gen, and Lun, individually and together, inhibited HCT116 viability and colonosphere formation and, conversely, enhanced HCT116 apoptosis. Reductions in frequency of the CSC CD133(+)CD44(+) subpopulation with MET, Gen, and Lun were found to be associated with increased PTEN and reduced FASN expression. In cells under a hyperinsulinemic state mimicking metabolic dysregulation and without and with added PTEN-specific inhibitor SF1670, colonosphere formation and frequency of the CD133(+)CD44(+) subpopulation were decreased by MET, Lun and Gen, alone and when combined. Moreover, MET + Lun + Gen co-treatment increased the pro-apoptotic and CD133(+)CD44(+)-inhibitory efficacy of 5-fluorouracil under hyperinsulinemic conditions. Results identify molecular networks shared by MET and bioavailable soy food components, which potentially may be harnessed to increase drug efficacy in diabetic and non-diabetic patients with CRC.

A multicenter, multinational analysis of mitomycin C in refractory metastatic colorectal cancer

Background: A considerable number of metastatic colorectal cancer (mCRC) patients who progress on standard treatment with 5-fluorouracil (5FU), oxaliplatin, irinotecan and monoclonal antibodies, still have adequate performance status and desire further treatment. Mitomycin C (MMC) has been widely used in this context, and despite good tolerability, there are doubts regarding its true benefit. Methods: In order to assess the activity of MMC in the refractory mCRC setting, we retrospectively evaluated 109 heavily pre-treated patients who received MMC as single agent or in combination for mCRC at three different institutions in two countries. Results: Median patient's age was 54 years old, 57% were male and 94% had performance status ECOG 0 or 1. MMC was used in second line in 11%, third line in 38% and fourth line or beyond in 51% of patients. 58% received MMC combinations, mainly with capecitabine. Grade 3 or 4 toxicity was observed in 5% of patients and 6% required dose reductions. Median time to treatment failure (TTF) was 1.7 months with MMC and 3.6 months on the regimen prior to MMC, with a ratio between these TTF below 1 in 82% of patients. Median survival was only 4.5 months (95% confidence interval (CI) of 3.48-5.56). Conclusions: This retrospective data represent the largest reported series of unselected refractory mCRC patients treated with MMC. The median survival of 4.5 months is similar to the survival expected for best supportive care. This lack of activity strongly suggests that MMC should not be routinely used in refractory mCRC. (C) 2012 Elsevier Ltd. All rights reserved.

Footprints of a trypanosomatid RNA world: pre-small subunit rRNA processing by spliced leader addition trans-splicing

The addition of a capped mini-exon [spliced leader (SL)] through trans-splicing is essential for the maturation of RNA polymerase (pol) II-transcribed polycistronic pre-mRNAs in all members of the Trypanosomatidae family. This process is an inter-molecular splicing reaction that follows the same basic rules of cis-splicing reactions. In this study, we demonstrated that mini-exons were added to precursor ribosomal RNA (pre-rRNA) are transcribed by RNA pol I, including the 5' external transcribed spacer (ETS) region. Additionally, we detected the SL-5' ETS molecule using three distinct methods and located the acceptor site between two known 5' ETS rRNA processing sites (A' and A1) in four different trypanosomatids. Moreover, we detected a polyadenylated 5' ETS upstream of the trans-splicing acceptor site, which also occurs in pre-mRNA trans-splicing. After treatment with an indirect trans-splicing inhibitor (sinefungin), we observed SL-5' ETS decay. However, treatment with 5-fluorouracil (a precursor of RNA synthesis that inhibits the degradation of pre-rRNA) led to the accumulation of SL-5' ETS, suggesting that the molecule may play a role in rRNA degradation. The detection of trans-splicing in these molecules may indicate broad RNA-joining properties, regardless of the polymerase used for transcription.

Accuracy of positron emission tomography/computed tomography and clinical assessment in the detection of complete rectal tumor regression after neoadjuvant chemoradiation Long-Term Results of a Prospective Trial (National Clinical Trial 00254683)

BACKGROUND: Neoadjuvant chemoradiation (CRT) therapy may result in significant tumor regression in patients with rectal cancer. Patients who develop complete tumor regression have been managed by treatment strategies that are alternatives to standard total mesorectal excision. Therefore, assessment of tumor response with positron emission tomography/computed tomography (PET/CT) after neoadjuvant treatment may offer relevant information for the selection of patients to receive alternative treatment strategies. METHODS: Patients with clinical T2 (cT2) through cT4NxM0 rectal adenocarcinoma were included prospectively. Neoadjuvant therapy consisted of 54 grays of radiation and 5-fluorouracil-based chemotherapy. Baseline PET/CT studies were obtained before CRT followed by PET/CT studies at 6 weeks and 12 weeks after the completion of CRT. Clinical assessment was performed at 12 weeks after CRT completion. PET/CT results were compared with clinical and pathologic data. RESULTS: In total, 99 patients were included in the study. Twenty-three patients were complete responders (16 had a complete clinical response, and 7 had a complete pathologic response). The PET/CT response evaluation at 12 weeks indicated that 18 patients had a complete response, and 81 patients had an incomplete response. There were 5 false-negative and 10 false-positive PET/CT results. PET/CT for the detection of residual cancer had 93% sensitivity, 53% specificity, a 73% negative predictive value, an 87% positive predictive value, and 85% accuracy. Clinical assessment alone resulted in an accuracy of 91%. PET/CT information may have detected misdiagnoses made by clinical assessment alone, improving overall accuracy to 96%. CONCLUSIONS: Assessment of tumor response at 12 weeks after CRT completion with PET/CT imaging may provide a useful additional tool with good overall accuracy for the selection of patients who may avoid unnecessary radical resection after achieving a complete clinical response. Cancer 2012;35013511. (C) 2011 American Cancer Society.

Untersuchungen zur Charakterisierung der Bystander-Effekte bei einer in vivo Therapie mit Suizidgenen

Untersuchungen zur Charakterisierung der Bystander-Effekte bei einer in vivo Therapie mit Suizidgenen Bei Tumoren eines syngenen Prostatakarzinoms der Ratte (Dunning R3327 AT-1), die zuvor ex vivo mit einem Fusionsgen aus Cytosin Deaminase und Tymidinkinase (AT-1/CDglyTK) transfiziert wurden, konnte durch Kombinationsbehandlung mit Ganciclovir (GCV) und 5-Fluorocytosin (5-FC) komplette Remission und Langzeitüberleben erzielt werden. Dagegen ergaben sich bei Applikation nur einer Pro-Drug lediglich lokale Tumorkontrollraten von 83% (GCV) und 57% (5-FC). Noch geringere therapeutische Effekte einer Kombinationstherapie mit GCV und 5-FC wurden beobachtet, wenn in Anlehnung an die klinische Situation der Anteil suizidgen-tragender Zellen in den Tumoren auf < 20% abgesenkt wurde. Molekularbiologische Analysen dieser Mischtumore zeigen eine Verminderung membranständiger Connexinproteine, welche für den interzellulären Transport phosphorylierter GCV-Metabolite über Gap-junctions erforderlich sind. Pharmakodynamische Untersuchungen mittels 19F-NMR belegen eine effiziente Metabolisierung von 5-FC zu 5-Fluorouracil (5-FU) und den anschließenden Einbau der F-Nukleotide in die DNA. Dennoch sind die intrazellulären und sezernierten 5-FU Konzentrationen für eine Inaktivierung benachbarter Zellen im Sinne eines „lokalen-Bystander-Effektes“ nicht ausreichend. Bei gleichzeitiger Therapie von AT-1 und AT-1/CDglyTK Tumoren, kommt es nicht zur Regression des AT-1 Tumors und damit nicht zu einem „Distalen-Bystander-Effekt“. Dagegen führt die Induktion eines immunologischen Gedächtnisses zu deutlich verminderten Angehraten bei später injizierten AT-1 Tumoren. Die Suizidgen-Therapie ist ein erfolgversprechender Ansatz zur Behandlung maligner Erkrankungen, bei dem die lokalen und distalen Bystander-Effekte individueller Tumoren den therapeutischen Erfolg maßgeblich mitbestimmen.