Management of infusion reactions in clinical trials and beyond: the US and EU perspectives

Monoclonal antibodies have expanded our cancer-fighting armamentarium in both the United States and Europe. While in general, monoclonal antibodies are well tolerated and do not have significant overlapping side effects with traditional cytotoxic agents, severe infusion reactions (IRs)--sometimes severe enough to be life threatening--have been reported. The pathophysiology of severe infusion reactions associated with monoclonal antibodies is poorly understood, but mechanisms are beginning to be elucidated. Geographic differences in the incidence of IRs have become apparent. Understanding the risk, recognizing the signs and symptoms, and being ready to promptly manage severe IRs are key for the clinician to avoid unnecessarily discontinuing these effective anticancer agents and prevent potentially tragic consequences for their patients. To date, clinical trials have incorporated monoclonal antibodies into combinations with standard cytotoxic regimens; it is expected that in time clinical trials will be testing promising new combinations utilizing multiple targeted agents, resulting in improved toxicity profiles and efficacy for cancer patients.

Studies on Electrophilic Substitution Reactions of 3-Phenyl-cycl[3.2.2]azine

Acetylation and formylation of 3-phenyl-cycl[3.2.2]azine derivatives, in the presence of Lewis acids, have been Investigated. It has been found that the orientation of substitution in 2-carbomethoxy- 3-phenyl-cycl[3.2.2]azine for these two reactions, under Identical conditions, is different.

Cycloaddition Reactions: Reaction of 3-Methyl-2-phenylpyrrocoline with Dimethyl Acteylenedicarboxylate

Reaction of 3-methyl-2-phenylpyrrocoline(I) and dimethyl acetylenedicarboxylate(II) in refluxing toluene furnishes cis-7',8-dihydro.4,5,8,9-tetramethoxycarbonyl-7'-phenyl-7' -methylazocino(2,1,8-cd]pyrrolizine (III) and trans-7',8-dihydro-4,5,8,9-tetramethoxycarbonyl-7-phenyl-7'-methylazocino[2,1,8-cd]pyrrolizine (IV), while the same reaction at ambient temperature yields 1-[(1,2-trans-dimethoxycarbonyl)vinyl]-3-methyl-2-phenylpyrrocoline (V) and 1-[(1,2-cis-di(methoxycarbonyl)vinyl)--methyl-2- phenylpyirocoUne (V) and 1-[(I,2-cis-di(methoxycarbonyl)Yinyl]-3-metbyl-2-phenylpyrrocoline(VI) as the major products. The structure of IV has been determined by X-ray crystallography.A possible mechanism of formation of these products is also discussed.

Modeling Calcium Concentration and Biochemical Reactions

Almost all regions of the brain receive one or more neuromodulatory inputs, and disrupting these inputs produces deficits in neuronal function. Neuromodulators act through intracellular second messenger pathways to influence the electrical properties of neurons, integration of synaptic inputs, spatio-temporal firing dynamics of neuronal networks, and, ultimately, systems behavior. Second messengers pathways consist of series of bimolecular reactions, enzymatic reactions, and diffusion. Calcium is the second messenger molecule with the most effectors, and thus is highly regulated by buffers, pumps and intracellular stores. Computational modeling provides an innovative, yet practical method to evaluate the spatial extent, time course and interaction among second messenger pathways, and the interaction of second messengers with neuron electrical properties. These processes occur both in compartments where the number of molecules are large enough to describe reactions deterministically (e.g. cell body), and in compartments where the number of molecules is small enough that reactions occur stochastically (e.g. spines). – In this tutorial, I explain how to develop models of second messenger pathways and calcium dynamics. The first part of the tutorial explains the equations used to model bimolecular reactions, enzyme reactions, calcium release channels, calcium pumps and diffusion. The second part explains some of the GENESIS, Kinetikit and Chemesis objects that implement the appropriate equations. In depth explanation of calcium and second messenger models is provided by reviewing code, both in XPP, Chemesis and Kinetikit, that implements simple models of calcium dynamics and second messenger cascades.