Network-targeted combination therapy : a new concept in cancer treatment

Toxicity is a major concern for anti-neoplastic drugs, with much of the existing pharmacopoeia being characterized by a very narrow therapeutic index. 'Network-targeted' combination therapy is a promising new concept in cancer therapy, whereby therapeutic index might be improved by targeting multiple nodes in a cell's signaling network, rather than a single node. Here, we examine the potential of this novel approach, illustrating how therapeutic benefit could be achieved with smaller doses of the necessary agents.

BRAF inhibitor therapy for melanoma, thyroid and colorectal cancers : development of resistance and future prospects

BRAF is a major oncoprotein and oncogenic mutations in BRAF are found in a significant number of cancers, including melanoma, thyroid cancer, colorectal cancer and others. Consequently, BRAF inhibitors have been developed as treatment options for cancers with BRAF mutations which have shown some success in improving patient outcomes in clinical trials. Development of resistance to BRAF kinase inhibitors is common, however, and overcoming this resistance is an area of significant concern for clinicians, patients and researchers alike. In this review, we identify the mechanisms of BRAF kinase inhibitor resistance and discuss the implications for strategies to overcome this resistance in the context of new approaches such as multi-kinase targeted therapies and emerging RNA interference based technologies.

A review of the profile of endothelin axis in cancer and its management

The endothelins and their associated receptors are important controllers of vascular growth, inflammation and vascular tone. In cancer, they have roles in the control of numerous factors in cancer development and progression, including angiogenesis, stromal reaction, epithelial mesenchymal transitions, apoptosis, invasion, metastases and drug resistance. Also, we consider current information on the role of this signalling system in cancer and examine the state of the current cell, animal and clinical trials utilizing endothelin targeted drugs for cancer management. Although targeting the endothelin axis in cell lines and xenografts show some promise in retarding cellular growth, results from limited clinical trials in prostatic cancer are less encouraging and did not offer significant survival benefit. The ability to target both cancer cells and vasculature via endothelin is an important consideration that necessitates the further refining of therapeutic strategies as we continue to explore the possibilities of the endothelin axis in cancer treatment.

A comparative study of Sr-incorporated mesoporous bioactive glass scaffolds for regeneration of osteopenic bone defects

SUMMARY: Recently, the use of the pharmacological agent strontium ranelate has come to prominence for the treatment of osteoporosis. While much investigation is focused on preventing disease progression, here we fabricate strontium-containing scaffolds and show that they enhance bone defect healing in the femurs of rats induced by ovariectomy. INTRODUCTION: Recently, the use of the pharmacological agent strontium ranelate has come to prominence for the treatment of osteoporosis due to its ability to prevent bone loss in osteoporotic patients. Although much emphasis has been placed on using pharmacological agents for the prevention of disease, much less attention has been placed on the construction of biomaterials following osteoporotic-related fracture. The aim of the present study was to incorporate bioactive strontium (Sr) trace element into mesoporous bioactive glass (MBG) scaffolds and to investigate their in vivo efficacy for bone defect healing in the femurs of rats induced by ovariectomy. METHODS: In total, 30 animals were divided into five groups as follows: (1) empty defect (control), (2) empty defects with estrogen replacement therapy, (3) defects filled with MBG scaffolds alone, (4) defects filled with MBG + estrogen replacement therapy, and (5) defects filled with strontium-incorporated mesopore-bioglass (Sr-MBG) scaffolds. RESULTS: The two groups demonstrating the highest levels of new bone formation were the defects treated with MBG + estrogen replacement therapy and the defects receiving Sr-MBG scaffolds as assessed by μ-CT and histological analysis. Furthermore, Sr scaffolds had a reduced number of tartrate-resistant acid phosphatase-positive cells when compared to other modalities. CONCLUSION: The results from the present study demonstrate that the local release of Sr from bone scaffolds may improve fracture repair. Future large animal models are necessary to investigate the future relationship of Sr incorporation into biomaterials.

A review on solar assisted heat pump systems in Singapore

A solar assisted heat pump is used for different applications, such as, water heating, drying and air conditioning. The unglazed evaporator-collector enables to absorb both solar energy and ambient energy due to low operating temperature. Three different systems are described: solar assisted heat pump system for hot water using an unglazed evaporator collector; solar assisted heat pump for hot water and drying, where evaporator collector and air collector are used; an integrated solar heat pump system making use of solar and ambient energy, and air-con waste heat. Unlike conventional collector, evaporator collector was found to have higher efficiency, 80% to 90%, and the coefficient of performance attained a value as high as 8.0. The integrated system leads to a reduction of global warming, as it uses solar energy, ambient energy and air-con waste heat.

Desalination with a solar-assisted heat pump : an economic optimization

The solar-assisted heat pump (SAHP) desalination, based on the Rankin cycle, operates in low temperature and utilizes both solar and ambient energy. An experimental SAHP desalination system has been constructed at the National University of Singapore, Singapore. The system consisted of two main sections: an SAHP and a water distillation section. Experiments were carried out under the different meteorological condition of Singapore and results showed that the system had a performance ratio close to 1.3. The heat pump has a coefficient of performance of about 8, with solar collector efficiencies of 80% and 60% for evaporator and liquid collectors, respectively. Economic analysis showed that at a production rate of 900 L/day and an evaporator collector area of around 70m2 will have a payback period of about 3.5 years.

Mathematical modelling and experimental validation of solar assisted heat pump system

Singapore is located at the equator, with abundant supply of solar radiation, relatively high ambient temperature and relative humidity throughout the year. The meteorological conditions of Singapore are favourable for efficient operation of solar energy based systems. Solar assisted heat pump systems are built on the roof-top of National University of Singapore’s Faculty of Engineering. The objectives of this study include the design and performance evaluation of a solar assisted heat-pump system for water desalination, water heating and drying of clothes. Using MATLAB programming language, a 2-dimensional simulation model has been developed to conduct parametric studies on the system. The system shows good prospect to be implemented in both industrial and residential applications and would give new opportunities in replacing conventional energy sources with green renewable energy.

Assessment of cone beam CT registration for prostate radiation therapy : fiducial marker and soft tissue methods

Introduction This investigation aimed to assess the consistency and accuracy of radiation therapists (RTs) performing cone beam computed tomography (CBCT) alignment to fiducial markers (FMs) (CBCTFM) and the soft tissue prostate (CBCTST). Methods Six patients receiving prostate radiation therapy underwent daily CBCTs. Manual alignment of CBCTFM and CBCTST was performed by three RTs. Inter-observer agreement was assessed using a modified Bland–Altman analysis for each alignment method. Clinically acceptable 95% limits of agreement with the mean (LoAmean) were defined as ±2.0 mm for CBCTFM and ±3.0 mm for CBCTST. Differences between CBCTST alignment and the observer-averaged CBCTFM (AvCBCTFM) alignment were analysed. Clinically acceptable 95% LoA were defined as ±3.0 mm for the comparison of CBCTST and AvCBCTFM. Results CBCTFM and CBCTST alignments were performed for 185 images. The CBCTFM 95% LoAmean were within ±2.0 mm in all planes. CBCTST 95% LoAmean were within ±3.0 mm in all planes. Comparison of CBCTST with AvCBCTFM resulted in 95% LoA of −4.9 to 2.6, −1.6 to 2.5 and −4.7 to 1.9 mm in the superior–inferior, left–right and anterior–posterior planes, respectively. Conclusions Significant differences were found between soft tissue alignment and the predicted FM position. FMs are useful in reducing inter-observer variability compared with soft tissue alignment. Consideration needs to be given to margin design when using soft tissue matching due to increased inter-observer variability. This study highlights some of the complexities of soft tissue guidance for prostate radiation therapy.

Development of a Solar Assisted Heat Pump Desalination System

In view of the growing global demand for energy and concern expressed for environmental degradation, a clean and "free" energy source, such as solar energy, has been receiving greater attention in recent years for various applications using different techniques. The Direct Expansion Solar Assisted Heat Pump (DX-SAHP) principle is one of the most promising techniques as it makes use of both solar and ambient energy. As the system has capability to function at low temperatures, it has the potential to operate at night in the tropics. The system utilizes multi-effect distillation (MED) principle for the conversion of seawater to fresh water. An experimental setup of the DX-SAHP desalination system has been built at the Department of Mechanical Engineering, National University of Singapore (NUS). This system uses two types of flat-plate solar collectors. One is called evaporator-collector, where no glazing is used, and the efficiency varies between 80 and 90%. The other type of collector is single-glazed, where the maximum efficiency is about 60%, and it is used for feed water heating. For the heat pump cycle, refrigerant R134a is used. The present study provides a comprehensive analyses and performance evaluation of this system under different operating and meteorological conditions of Singapore. The Coefficient of Performance (COP) of the heat pump system reached a maximum value of 10. For a single effect of desalination, the system shows a Performance Ratio (PR) of around 1.3.

Can bone tissue engineering contribute to therapy concepts after resection of musculoskeletal sarcoma?

Resection of musculoskeletal sarcoma can result in large bone defects where regeneration is needed in a quantity far beyond the normal potential of self-healing. In many cases, these defects exhibit a limited intrinsic regenerative potential due to an adjuvant therapeutic regimen, seroma, or infection. Therefore, reconstruction of these defects is still one of the most demanding procedures in orthopaedic surgery. The constraints of common treatment strategies have triggered a need for new therapeutic concepts to design and engineer unparalleled structural and functioning bone grafts. To satisfy the need for long-term repair and good clinical outcome, a paradigm shift is needed from methods to replace tissues with inert medical devices to more biological approaches that focus on the repair and reconstruction of tissue structure and function. It is within this context that the field of bone tissue engineering can offer solutions to be implemented into surgical therapy concepts after resection of bone and soft tissue sarcoma. In this paper we will discuss the implementation of tissue engineering concepts into the clinical field of orthopaedic oncology.