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Exploring the Concept of Safety and Tolerability
SECOND ANNUAL WORKSHOP ON CLINICAL OUTCOME ASSESSMENTS IN CANCER CLINICAL TRIALS April 25, 2017 Bethesda, MD Co-sponsored by Session 1 Exploring the Concepts of Safety and Tolerability: Incorporating the Patient Voice SECOND ANNUAL WORKSHOP ON CLINICAL OUTCOME ASSESSMENTS IN CANCER CLINICAL TRIALS April 25, 2017 Bethesda, MD Co-sponsored by Disclaimer • The views and opinions expressed in the following slides are those of the individual presenters and should not be attributed to their respective organizations/companies, the U.S. Food and Drug Administration or the Critical Path Institute. • These slides are the intellectual property of the individual presenters and are protected under the copyright laws of the United States of America and other countries. Used by permission. All rights reserved. All trademarks are the property of their respective owners. 3 Session Participants Chair • Bindu Kanapuru, MD – Medical Officer, Division of Hematology Products, OHOP, FDA Presenters • James (Randy) Hillard, MD – Professor of Psychiatry, Michigan State University • Crystal Denlinger, MD, FACP – Associate Professor, Department of Hematology/Oncology; Chief, Gastrointestinal Medical Oncology; Director, Survivorship Program; Deputy Director, Phase 1 Program, Fox Chase Cancer Center • Katherine Soltys, MD – Acting Director, Bureau of Medical Sciences, Therapeutic Products Directorate, Health Products and Food Branch, Health Canada • Karen E. Arscott, DO, MSc – Associate Professor of Medicine-Patient Advocate and Survivor, Geisinger Commonwealth -
Bugs, Drugs, and Cancer: Can the Microbiome Be a Potential
REVIEWS Drug Discovery Today Volume 24, Number 4 April 2019 Reviews Bugs, drugs, and cancer: can the GENE TO SCREEN microbiome be a potential therapeutic target for cancer management? 1,z 2,z 1 1 Biying Chen , Guangye Du , Jiahui Guo and Yanjie Zhang 1 Department of Oncology, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, 280 Mohe Road, Shanghai, 201999, China 2 Department of Pathology, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, 280 Mohe Road, Shanghai, 201999, China Outnumbering our own cells over ten times, gut microbes can even be considered an additional organ. Several studies have explored the association between microbiomes and antitumor drug response. It has been reported that the presence of specific bacteria might modulate cancer progression and the efficacy of anticancer therapeutics. Bacteria-targeting intervention can provide crucial guidance for the design of next-generation antitumor drugs. Here, we review previous findings elucidating the impact of gut microbiomes on cancer treatment and the possible underlying mechanisms. In addition, we examine the role of microbiome manipulation in controlling tumor growth. Finally, we discuss concerns regarding the alteration of the microbiome composition, and the potential approaches to surpass existing limitations. Introduction cantly during life [5] (Fig. 1). Gut microbial density increases from The microbiota is defined as all microorganisms that are associated the proximal to the distal GI tract and along the tissue–lumen axis. with a specific host cellular environment [1]. These microorganisms Similarly, diversity further increases in the same pattern [6]. More- are identified using 16S ribosomal RNA (rRNA)sequencing. -
Live Biotherapeutic Products, a Road Map for Safety Assessment
Live Biotherapeutic Products, A Road Map for Safety Assessment Alice Rouanet, Selin Bolca, Audrey Bru, Ingmar Claes, Helene Cvejic, Haymen Girgis, Ashton Harper, Sidonie Lavergne, Sophie Mathys, Marco Pane, et al. To cite this version: Alice Rouanet, Selin Bolca, Audrey Bru, Ingmar Claes, Helene Cvejic, et al.. Live Biotherapeutic Products, A Road Map for Safety Assessment. Frontiers in Medicine, Frontiers media, 2020, 7, 10.3389/fmed.2020.00237. hal-02900344 HAL Id: hal-02900344 https://hal.inrae.fr/hal-02900344 Submitted on 8 Jun 2021 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Distributed under a Creative Commons Attribution| 4.0 International License POLICY AND PRACTICE REVIEWS published: 19 June 2020 doi: 10.3389/fmed.2020.00237 Live Biotherapeutic Products, A Road Map for Safety Assessment Alice Rouanet 1, Selin Bolca 2†, Audrey Bru 3†, Ingmar Claes 4†, Helene Cvejic 5,6†, Haymen Girgis 7†, Ashton Harper 8†, Sidonie N. Lavergne 9†, Sophie Mathys 10†, Marco Pane 11†, Bruno Pot 12,13†, Colette Shortt 14†, Wynand Alkema 15, Constance Bezulowsky 16, Stephanie Blanquet-Diot 17, Christophe Chassard 18, Sandrine P. Claus 19, Benjamin Hadida 20, Charlotte Hemmingsen 21, Cyrille Jeune 7, Björn Lindman 22, Garikai Midzi 8, Luca Mogna 11, Charlotta Movitz 22, Nail Nasir 23, 24 25 25 26 Edited by: Manfred Oberreither , Jos F. -
Pharmacology Part 2: Introduction to Pharmacokinetics
J of Nuclear Medicine Technology, first published online May 3, 2018 as doi:10.2967/jnmt.117.199638 PHARMACOLOGY PART 2: INTRODUCTION TO PHARMACOKINETICS. Geoffrey M Currie Faculty of Science, Charles Sturt University, Wagga Wagga, Australia. Regis University, Boston, USA. Correspondence: Geoff Currie Faculty of Science Locked Bag 588 Charles Sturt University Wagga Wagga 2678 Australia Telephone: 02 69332822 Facsimile: 02 69332588 Email: [email protected] Foot line: Introduction to Pharmacokinetics 1 Abstract Pharmacology principles provide key understanding that underpins the clinical and research roles of nuclear medicine practitioners. This article is the second in a series of articles that aims to enhance the understanding of pharmacological principles relevant to nuclear medicine. This article will build on the introductory concepts, terminology and principles of pharmacodynamics explored in the first article in the series. Specifically, this article will focus on the basic principles associated with pharmacokinetics. Article 3 will outline pharmacology relevant to pharmaceutical interventions and adjunctive medications employed in general nuclear medicine, the fourth pharmacology relevant to pharmaceutical interventions and adjunctive medications employed in nuclear cardiology, the fifth the pharmacology related to contrast media associated with computed tomography (CT) and magnetic resonance imaging (MRI), and the final article will address drugs in the emergency trolley. 2 Introduction As previously outlined (1), pharmacology is the scientific study of the action and effects of drugs on living systems and the interaction of drugs with living systems (1-7). For general purposes, pharmacology is divided into pharmacodynamics and pharmacokinetics (Figure 1). The principle of pharmacokinetics is captured by philosophy of Paracelsus (medieval alchemist); “only the dose makes a thing not a poison” (1,8,9). -
Pharmacokinetic Models to Characterize the Absorption Phase and the Influence of a Proton Pump Inhibitor on the Overall Exposure of Dacomitinib
pharmaceutics Article Pharmacokinetic Models to Characterize the Absorption Phase and the Influence of a Proton Pump Inhibitor on the Overall Exposure of Dacomitinib Ana Ruiz-Garcia 1, Weiwei Tan 2, Jerry Li 2, May Haughey 2, Joanna Masters 2, Jennifer Hibma 2 and Swan Lin 2,* 1 Metrum Research Group, San Diego, CA 92121, USA; [email protected] 2 Department of Pharmacometrics, Pfizer Inc, San Diego, CA 92121, USA; weiwei.tan@pfizer.com (W.T.); jerry.li@pfizer.com (J.L.); may.haughey@pfizer.com (M.H.); joanna.c.masters@pfizer.com (J.M.); jennifer.e.hibma@pfizer.com (J.H.) * Correspondence: swan.lin@pfizer.com; Tel.: +1-(858)-622-7377 Received: 17 March 2020; Accepted: 3 April 2020; Published: 7 April 2020 Abstract: Introduction: Dacomitinib is an epidermal growth factor receptor (EGFR) inhibitor approved for the treatment of metastatic non-small cell lung cancer (NSCLC) in the first line in patients with EGFR activating mutations. Dacomitinib is taken orally once daily at 45 mg with or without food, until disease progression or unacceptable toxicity occurs. Oncology patients often can develop gastroesophageal reflux disease (GERD), which may require management with an acid-reducing agent. Proton pump inhibitors (PPIs), such as rabeprazole, inhibit sodium-potassium adenosine triphosphatase (H+/K+-ATPase) pumps that stimulate acid secretion in the stomach and have a prolonged pharmacodynamic effect that extends beyond 24 h post-administration. The aim of this work was to characterize the absorption of dacomitinib via modeling with a particular interest in quantifying the impact of rabeprazole on the pharmacokinetics (PK) of dacomitinib. -
International Union of Pharmacology Committee on Receptor Nomenclature and Drug Classification
0031-6997/03/5504-597–606$7.00 PHARMACOLOGICAL REVIEWS Vol. 55, No. 4 Copyright © 2003 by The American Society for Pharmacology and Experimental Therapeutics 30404/1114803 Pharmacol Rev 55:597–606, 2003 Printed in U.S.A International Union of Pharmacology Committee on Receptor Nomenclature and Drug Classification. XXXVIII. Update on Terms and Symbols in Quantitative Pharmacology RICHARD R. NEUBIG, MICHAEL SPEDDING, TERRY KENAKIN, AND ARTHUR CHRISTOPOULOS Department of Pharmacology, University of Michigan, Ann Arbor, Michigan (R.R.N.); Institute de Recherches Internationales Servier, Neuilly sur Seine, France (M.S.); Systems Research, GlaxoSmithKline Research and Development, Research Triangle Park, North Carolina (T.K.); and Department of Pharmacology, University of Melbourne, Parkville, Australia (A.C.) Abstract ............................................................................... 597 I. Introduction............................................................................ 597 II. Working definition of a receptor .......................................................... 598 III. Use of drugs in definition of receptors or of signaling pathways ............................. 598 A. The expression of amount of drug: concentration and dose ............................... 598 1. Concentration..................................................................... 598 2. Dose. ............................................................................ 598 B. General terms used to describe drug action ........................................... -
Receptor Af®Nity and Potency of Non-Steroidal Antiandrogens: Translation of Preclinical ®Ndings Into Clinical Activity
Prostate Cancer and Prostatic Diseases (1998) 1, 307±314 ß 1998 Stockton Press All rights reserved 1365±7852/98 $12.00 http://www.stockton-press.co.uk/pcan Review Receptor af®nity and potency of non-steroidal antiandrogens: translation of preclinical ®ndings into clinical activity GJCM Kolvenbag1, BJA Furr2 & GRP Blackledge3 1Medical Affairs, Zeneca Pharmaceuticals, Wilmington, DE, USA; 2Therapeutic Research Department, and 3Medical Research Department, Zeneca Pharmaceuticals, Alderley Park, Maccles®eld, Cheshire, UK The non-steroidal antiandrogens ¯utamide (Eulexin1), nilutamide (Anandron1) and bicalutamide (Casodex1) are widely used in the treatment of advanced prostate cancer, particularly in combination with castration. The naturally occurring ligand 5a-DHT has higher binding af®nity at the androgen receptor than the non-steroidal antiandrogens. Bicalutamide has an af®nity two to four times higher than 2-hydroxy¯utamide, the active metabolite of ¯utamide, and around two times higher than nilutamide for wild-type rat and human prostate androgen receptors. Animal studies have indicated that bicalutamide also exhi- bits greater potency in reducing seminal vesicle and ventral prostate weights and inhibiting prostate tumour growth than ¯utamide. Although preclinical data can give an indication of the likely clinical activity, clinical studies are required to determine effective, well-tolerated dosing regimens. As components of combined androgen blockade (CAB), controlled studies have shown survival bene®ts of ¯utamide plus a luteinising hormone-releasing hormone analogue (LHRH-A) over LHRH-A alone, and for nilutamide plus orchiectomy over orchiectomy alone. Other studies have failed to show such survival bene®ts, including those comparing ¯utamide plus orchiectomy with orchiectomy alone, and nilutamide plus LHRH-A with LHRH-A alone. -
Today's Topic
January 30th, 2020 Vol. 6, No. 4 Palliative Care TODAY’S TOPIC: Pharmacy Team: What’s New in Palliative Care Medications Drug #4: Bremelanotide (Vylessi®) Clinical Pharmacy Specialist: Background: Jenn Pruskowski, Bremelanotide (Vylessi®) is a melanocortin receptor (MCR) agonist PharmD, BCPS, that nonselectively activates several receptor subtypes that BCGP, CPE improves hypoactive sexual desire disorder in women [email protected] - Initial US approval: 2019 - Available as: 1.74mg/0.3mL subcutaneous solution If you have a topic you would like the pharmacy Importance: team to answer, please In a US national household survey of adult sexual behavior send your suggestions conducted in 1992, the overall prevalence of sexual dysfunction to: [email protected] among women 18–59 years old was 43%. Palliative care providers should be aware of pharmacological options for hypoactive sexual desire disorder in premenopausal women. Pharmacology: Bremelantoide is a melanocortin receptor (MCR) agonist that nonselectively activates several receptor subtypes with the following order of potency: MC1R, MC4R, MC3R, MC5R, MC2R. At MoA: therapeutic dose levels, binding to MC1R and MC4R is most relevant. Neurons expressing MC4R are present in many areas of the central nervous system (CNS) - A: Tmax: 1 hour - M: Hydrolyses of the amide bond of the cyclic ADME: peptide - E: T ½: 2.7 hours Concomitant use naltrexone may result is DIs: naltrexone treatment failure Key: MoA: Mechanism of Action; ADME: Absorption, Distribution, Metabolism, and Excretion; DI: -
Multidrug-Resistant Gram-Negative Bacteria: How to Treat and for How Long Helen Giamarellou
Multidrug-resistant Gram-negative bacteria: How to treat and for how long Helen Giamarellou To cite this version: Helen Giamarellou. Multidrug-resistant Gram-negative bacteria: How to treat and for how long. International Journal of Antimicrobial Agents, Elsevier, 2010, 36, 10.1016/j.ijantimicag.2010.11.014. hal-00650375 HAL Id: hal-00650375 https://hal.archives-ouvertes.fr/hal-00650375 Submitted on 10 Dec 2011 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Accepted Manuscript Title: Multidrug-resistant Gram-negative bacteria: How to treat and for how long Author: Helen Giamarellou PII: S0924-8579(10)00475-9 DOI: doi:10.1016/j.ijantimicag.2010.11.014 Reference: ANTAGE 3468 To appear in: International Journal of Antimicrobial Agents Please cite this article as: Giamarellou H, Multidrug-resistant Gram-negative bacteria: How to treat and for how long, International Journal of Antimicrobial Agents (2010), doi:10.1016/j.ijantimicag.2010.11.014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. -
Challenges of Antibacterial Discovery Lynn L
CLINICAL MICROBIOLOGY REVIEWS, Jan. 2011, p. 71–109 Vol. 24, No. 1 0893-8512/11/$12.00 doi:10.1128/CMR.00030-10 Copyright © 2011, American Society for Microbiology. All Rights Reserved. Challenges of Antibacterial Discovery Lynn L. Silver* LL Silver Consulting, LLC, 955 S. Springfield Ave., Unit C403, Springfield, New Jersey 07081 INTRODUCTION .........................................................................................................................................................72 The Discovery Void...................................................................................................................................................72 Class Modifications versus Novel Classes.............................................................................................................72 BACKGROUND............................................................................................................................................................72 Early Screening—a Brief and Biased Philosophical History .............................................................................72 The Rate-Limiting Steps of Antibacterial Discovery ...........................................................................................74 The Multitarget Hypothesis ....................................................................................................................................74 ANTIBACTERIAL RESISTANCE ..............................................................................................................................75 -
DOSE-EFFECT RELATIONSHIP Drug Receptor K1 K2 Drug-Receptor
DOSE-EFFECT RELATIONSHIP A fundamental principle of pharmacology is that the intensity of effect produced by a drug is a function of the quantity of drug administered (or the concentration of the drug at the target site). The relationship between dose and drug effect can be expressed mathematically by two methods, which are called graded and quantal. • Graded - The graded dose-effect is measured in a single biologic unit (a cell, a tissue or organ, or an entire organism). The effect is measured on a continuous scale and the intensity of effect is proportional to the dose. • Quantal - A quantal effect is an all-or-none effect such as alive or dead, asleep or awake, pain-free or in pain. Quantal dose-effect studies are performed in populations of subjects and they relate dose to the frequency of the all-or-none effect, such as the % of animals that are killed. GRADED DOSE-EFFECT RELATIONSHIP The effects of most drugs result from their interaction with macromolecules, which are called receptors. A receptor can be any cellular macromolecule to which a drug binds to initiate its effect. Proteins form the most important class of drug receptors Drug Drug-Receptor Complex Receptor k1 k2 EFFECT Cellular proteins that are receptors for endogenous regulatory ligands (hormones, growth factors, neurotransmitters) are the most important drug receptors. These proteins have a ligand binding domain where the drug interacts and an effector domain that propagates the message, leading to an effect. Other receptors include enzymes (e.g., acetylcholinesterase), transport proteins (e.g., Na+,K+-ATPase), structural proteins (e.g., tubulin), and nucleic acids. -
The Role of Epigenomics in Personalized Medicine
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Expert Rev Manuscript Author Precis Med Drug Manuscript Author Dev. Author manuscript; available in PMC 2018 January 31. Published in final edited form as: Expert Rev Precis Med Drug Dev. 2017 ; 2(1): 33–45. doi:10.1080/23808993.2017.1284557. The role of epigenomics in personalized medicine Mohamad M. Kronfola, Mikhail G. Dozmorovb, Rong Huangc, Patricia W. Slattuma, and Joseph L. McClaya,* aDepartment of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA bDepartment of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA cDepartment of Medicinal Chemistry, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA Abstract Introduction—Epigenetics is the study of reversible modifications to chromatin and their extensive and profound effects on gene regulation. To date, the role of epigenetics in personalized medicine has been under-explored. Therefore, this review aims to highlight the vast potential that epigenetics holds. Areas covered—We first review the cell-specific nature of epigenetic states and how these can vary with developmental stage and in response to environmental factors. We then summarize epigenetic biomarkers of disease, with a focus on diagnostic tests, followed by a detailed description of current and pipeline drugs with epigenetic modes of action. Finally, we discuss epigenetic biomarkers of drug response. Expert commentary—Epigenetic variation can yield information on cellular states and developmental histories in ways that genotype information cannot. Furthermore, in contrast to fixed genome sequence, epigenetic patterns are plastic, so correcting aberrant, disease-causing epigenetic marks holds considerable therapeutic promise.