EMEA Annual Report 2007 EMEA/MB/17464/2008 2.4, CURRENT Page 2/138 6

Total Page:16

File Type:pdf, Size:1020Kb

EMEA Annual Report 2007 EMEA/MB/17464/2008 2.4, CURRENT Page 2/138 6 European Medicines Agency London, 13 May 2008 Doc. ref.: EMEA/MB/17464/2008 Annual report of the European Medicines Agency 2007 Adopted by the Management Board on 6 March 2008 7 Westferry Circus, Canary Wharf, London, E14 4HB, UK Tel. (44-20) 74 18 84 00 Fax (44-20) 74 18 84 16 E-mail: [email protected] http://www.emea.europa.eu © European Medicines Agency, 2008. Reproduction is authorised provided the source is acknowledged. CONTENTS CONTENTS..................................................................................................................................................................2 MISSION STATEMENT.............................................................................................................................................4 FOREWORD BY THE CHAIR OF THE MANAGEMENT BOARD....................................................................5 INTRODUCTION BY THE EXECUTIVE DIRECTOR .........................................................................................6 1. EMEA IN THE EUROPEAN SYSTEM.................................................................................................................8 1.1 Management Board ______________________________________________________________ 8 1.2 European medicines network _______________________________________________________ 8 1.3 Transparency and communication ___________________________________________________ 9 1.4 Support for innovation and access to medicines ________________________________________ 9 1.5 European public-health activities ___________________________________________________ 10 1.6 Preparations for future enlargement _________________________________________________ 11 1.7 International cooperation _________________________________________________________ 12 1.8 Integrated management at the Agency _______________________________________________ 12 2. MEDICINES FOR HUMAN USE ........................................................................................................................13 2.1 Orphan medicinal products _______________________________________________________ 13 2.2 Scientific advice and protocol assistance _____________________________________________ 15 2.3 Initial evaluation________________________________________________________________ 18 2.4 Post-authorisation activities _______________________________________________________ 23 2.5 Parallel distribution _____________________________________________________________ 26 2.6 Pharmacovigilance and maintenance activities ________________________________________ 28 2.7 Arbitration and Community referrals ________________________________________________ 30 2.8 Medicines for children ___________________________________________________________ 34 2.9 Herbal medicinal products ________________________________________________________ 36 2.10 Emerging therapies and new technologies ____________________________________________ 37 2.11 Provision of information to patients and healthcare professionals__________________________ 38 2.12 Scientific committees, working parties and scientific advisory groups ______________________ 40 2.13 Coordination Group for Mutual-Recognition and Decentralised Procedures–Human___________ 42 2.14 Regulatory activities_____________________________________________________________ 44 3. MEDICINES FOR VETERINARY USE .............................................................................................................45 3.1 Scientific advice________________________________________________________________ 45 3.2 Initial evaluation________________________________________________________________ 46 3.3 Establishment of maximum residue limits ____________________________________________ 49 3.4 Post-authorisation activities _______________________________________________________ 51 3.5 Pharmacovigilance and maintenance activities ________________________________________ 53 3.6 Arbitration and Community referrals ________________________________________________ 55 3.7 Committee for Medicinal Products for Veterinary Use __________________________________ 56 3.8 Coordination group _____________________________________________________________ 58 4. INSPECTIONS.......................................................................................................................................................59 4.1 Inspections ____________________________________________________________________ 59 4.2 Mutual-recognition agreements ____________________________________________________ 61 4.3 Certificates of medicinal products __________________________________________________ 62 4.4 Sampling and testing ____________________________________________________________ 63 4.5 Implementation of the Clinical Trials Directives _______________________________________ 64 4.6 GMP harmonisation _____________________________________________________________ 64 5. EU TELEMATICS STRATEGY..........................................................................................................................65 EMEA annual report 2007 EMEA/MB/17464/2008 2.4, CURRENT Page 2/138 6. SUPPORT ACTIVITIES.......................................................................................................................................67 6.1 Administration _________________________________________________________________ 67 6.2 Information technology __________________________________________________________ 70 6.3 Meetings and conferences at the EMEA _____________________________________________ 72 6.4 EMEA document management and publishing ________________________________________ 73 ANNEXES...................................................................................................................................................................76 Annex 1 Members of the Management Board ________________________________________________ 77 Annex 2 Members of the Committee for Medicinal Products for Human Use________________________ 79 Annex 3 Members of the Committee for Medicinal Products for Veterinary Use _____________________ 83 Annex 4 Members of the Committee for Orphan Medicinal Products ______________________________ 86 Annex 5 Members of the Committee on Herbal Medicinal Products _______________________________ 88 Annex 6 Members of the Paediatric Committee_______________________________________________ 91 Annex 7 National competent authority partners _______________________________________________ 92 Annex 8 EMEA budget summaries 2006–2008 ______________________________________________ 101 Annex 9 EMEA establishment plan _______________________________________________________ 102 Annex 10 IT projects and operational activities _______________________________________________ 103 Annex 11 CHMP opinions in 2007 on medicinal products for human use___________________________ 104 Annex 12 CVMP Opinions in 2007 on Medicinal Products for Veterinary Use ______________________ 113 Annex 13 COMP opinions in 2007 on designation of orphan medicinal products_____________________ 115 Annex 14 HMPC Community herbal monographs_____________________________________________ 123 Annex 15 Entries to the ‘List of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products’_______________________________________________________ 125 Annex 16 PDCO opinions and EMEA decisions on paediatric investigation plans and waivers in 2007 ___ 126 Annex 17 Guidelines and working documents in 2007 _________________________________________ 127 Annex 18 Arbitration and Community referrals overview 2007 __________________________________ 134 Annex 19 EMEA contact points ___________________________________________________________ 137 EMEA annual report 2007 EMEA/MB/17464/2008 2.4, CURRENT Page 3/138 MISSION STATEMENT The mission of the European Medicines Agency is to foster scientific excellence in the evaluation and supervision of medicines, for the benefit of public and animal health. Legal role The European Medicines Agency is the European Union body responsible for coordinating the existing scientific resources put at its disposal by Member States for the evaluation, supervision and pharmacovigilance of medicinal products. The Agency provides the Member States and the institutions of the EU the best-possible scientific advice on any question relating to the evaluation of the quality, safety and efficacy of medicinal products for human or veterinary use referred to it in accordance with the provisions of EU legislation relating to medicinal products. Principal activities Working with the Member States and the European Commission as partners in a European medicines network, the European Medicines Agency: provides independent, science-based recommendations on the quality, safety and efficacy of medicines, and on more general issues relevant to public and animal health that involve medicines; applies efficient and transparent evaluation procedures to help bring new medicines to the market by means of a single, EU-wide marketing authorisation granted by the European Commission; implements measures for continuously supervising the quality, safety and efficacy of authorised medicines to ensure that their benefits outweigh their risks; provides scientific advice and incentives to stimulate the development and improve the availability of innovative new medicines; recommends safe limits for residues of veterinary medicines used in food-producing animals, for the establishment of maximum residue limits by the European Commission; involves
Recommended publications
  • Fig. L COMPOSITIONS and METHODS to INHIBIT STEM CELL and PROGENITOR CELL BINDING to LYMPHOID TISSUE and for REGENERATING GERMINAL CENTERS in LYMPHATIC TISSUES
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date Χ 23 February 2012 (23.02.2012) WO 2U12/U24519ft ft A2 (51) International Patent Classification: AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, A61K 31/00 (2006.01) CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (21) International Application Number: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, PCT/US201 1/048297 KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, (22) International Filing Date: ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, 18 August 201 1 (18.08.201 1) NO, NZ, OM, PE, PG, PH, PL, PT, QA, RO, RS, RU, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, (25) Filing Language: English TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (26) Publication Language: English ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 61/374,943 18 August 2010 (18.08.2010) US kind of regional protection available): ARIPO (BW, GH, 61/441,485 10 February 201 1 (10.02.201 1) US GM, KE, LR, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, 61/449,372 4 March 201 1 (04.03.201 1) US ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, (72) Inventor; and EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, ΓΓ, LT, LU, (71) Applicant : DEISHER, Theresa [US/US]; 1420 Fifth LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, Avenue, Seattle, WA 98101 (US).
    [Show full text]
  • Targeted Review List Kaiser HMO, Multi-Choice, PPO, Senior Advantage Effective 1/01/2020
    Kaiser Permanente Georgia Region Provider Targeted Review List Kaiser HMO, Multi-Choice, PPO, Senior Advantage Effective 1/01/2020 The Affiliated Community Physician is responsible for verification of member eligibility and benefit coverage by logging on to KP Online-Affiliate or calling Member Services at 404-261- 2590. Failure to obtain authorization prior to providing the services listed below will result in a denial of payment. A medical necessity review decision will be issued to your office and to the member upon completion of the review process. Receipt of complete clinical information with the initial request will expedite the process. Authorization for approval of services based on medical necessity is never a guarantee of payment which must also meet the criteria of member eligibility and benefit availability. The Kaiser Permanente Quality Resource Management Department requires authorization of all post stabilization care including observation and inpatient admissions. Please call our Emergency Care Management hub at 404-365-4254 for authorization. For emergency authorization of home health or durable medical services after regular business hours, contact 404-365-0966 or 800-611-1811 to speak with the QRM case manager on call. Hours of Operation: Quality Resource Management Department Monday through Friday 8:00 am – 5:00 pm 404-364-7320/800-221-2412 Member Services Department Monday through Friday 7:00 am – 7:00 pm 404-261-2590 Emergency Care Management Hub Available 24/7 404-365-4254 Medical necessity review is required for the following services/conditions: HMO members require QRM review and approval for reimbursement of any non- contracted, out of network (office based, outpatient, inpatient) services.
    [Show full text]
  • Challenges and Approaches for the Development of Safer Immunomodulatory Biologics
    REVIEWS Challenges and approaches for the development of safer immunomodulatory biologics Jean G. Sathish1*, Swaminathan Sethu1*, Marie-Christine Bielsky2, Lolke de Haan3, Neil S. French1, Karthik Govindappa1, James Green4, Christopher E. M. Griffiths5, Stephen Holgate6, David Jones2, Ian Kimber7, Jonathan Moggs8, Dean J. Naisbitt1, Munir Pirmohamed1, Gabriele Reichmann9, Jennifer Sims10, Meena Subramanyam11, Marque D. Todd12, Jan Willem Van Der Laan13, Richard J. Weaver14 and B. Kevin Park1 Abstract | Immunomodulatory biologics, which render their therapeutic effects by modulating or harnessing immune responses, have proven their therapeutic utility in several complex conditions including cancer and autoimmune diseases. However, unwanted adverse reactions — including serious infections, malignancy, cytokine release syndrome, anaphylaxis and hypersensitivity as well as immunogenicity — pose a challenge to the development of new (and safer) immunomodulatory biologics. In this article, we assess the safety issues associated with immunomodulatory biologics and discuss the current approaches for predicting and mitigating adverse reactions associated with their use. We also outline how these approaches can inform the development of safer immunomodulatory biologics. Immunomodulatory Biologics currently represent more than 30% of licensed The high specificity of the interactions of immu- biologics pharmaceutical products and have expanded the thera- nomodulatory biologics with their relevant immune Biotechnology-derived peutic options available
    [Show full text]
  • WHO EML Application Tocilizumab
    WHO EML Application Tocilizumab Condition Juvenile Idiopathic Arthritis 1 Summary statement of the proposal for inclusion. The application proposes the inclusion of Tocilizumab on the complementary list of the EML/EMLc/both for the treatment of Systemic Onset Juvenile Idiopathic Arthritis (SOJIA). The rationale for the complementary list is that the use of this drug requires specialised care. The proposed listing on both the EML and EMLc reflects the fact that JIA affects children through adolescence and into adulthood. This rationale is consistent with the listing for the anti-TNF biologics currently listed for JIA. Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease of childhood, affecting approximately one per 1000 children (1, 2). JIA is characterised by joint inflammation of more than 6 weeks’ duration, with onset before age sixteen years and where no other cause is found (2). JIA is an autoimmune, non-infective, inflammatory joint disease, the cause of which remains poorly understood with both genetic and environmental contributions (3). It is a distinct entity from rheumatoid arthritis, differing in clinical presentations, prognosis, disease outcomes and treatment approaches. The age of onset in JIA is typically young, with a peak incidence between 1-3 years of age, although the disease persists into adulthood in approximately 50% of cases (4). Even in patients in whom the inflammatory disease resolves, joint or extra-articular damage – with associated disability – are common and if not treated then can result in irreversible sequelae and impact on quality of life (5). Current treatment approaches for children with JIA aim for normal physical and psychosocial functioning, and with access to modern treatments, good outcomes are a realistic and achievable goal for many children with this condition (6) .
    [Show full text]
  • Specialty Guideline Management
    Reference number 1800-A SPECIALTY GUIDELINE MANAGEMENT ARCALYST (rilonacept) POLICY I. INDICATIONS The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy. FDA-Approved Indications Treatment of Cryopyrin Associated Periodic Syndromes (CAPS), including Familial Cold Auto-inflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS) in adults and children 12 years of age and older. All other indications are considered experimental/investigational and not medically necessary. II. CRITERIA FOR INITIAL APPROVAL Cryopyrin-associated periodic syndrome (CAPS) Authorization of 12 months may be granted for treatment of CAPS when all of the following criteria are met: A. Member has a diagnosis of familial cold auto-inflammatory syndrome (FCAS) with classic signs and symptoms (i.e., recurrent, intermittent fever and rash that were often exacerbated by exposure to generalized cool ambient temperature) or Muckle-Wells syndrome (MWS) with classic signs and symptoms (i.e., chronic fever and rash of waxing and waning intensity, sometimes exacerbated by exposure to generalized cool ambient temperature). B. Member has functional impairment limiting the activities of daily living. III. CONTINUATION OF THERAPY Authorization of 12 months may be granted for all members (including new members) who are using the requested medication for an indication outlined in Section II and who achieve or maintain positive
    [Show full text]
  • Preclinical Activity of the Liposomal Cisplatin Lipoplatin in Ovarian Cancer
    Author Manuscript Published OnlineFirst on September 17, 2014; DOI: 10.1158/1078-0432.CCR-14-0713 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Preclinical activity of the liposomal cisplatin Lipoplatin in ovarian cancer 1Naike Casagrande, 1Marta Celegato, 1Cinzia Borghese, 1Maurizio Mongiat, 1,2 Alfonso Colombatti, 1*Donatella Aldinucci 1Experimental Oncology 2, CRO Aviano National Cancer Institute, Aviano, PN, Italy; 2Department of Medical and Biological Science Technology and MATI (Microgravity Ageing Training Immobility) Excellence Center, University of Udine, Italy. *Corresponding Author: Donatella Aldinucci, Experimental Oncology 2, CRO Aviano National Cancer Institute, via F. Gallini 2, Aviano I-33081, Italy. Phone: Italy-0434- 659234; Fax: Italy-0434-659428; e-mail: [email protected] Running title: Preclinical activity of Lipoplatin in ovarian cancer Key words: ovarian cancer; liposomal Cisplatin; spheroids; migration; cancer stem cells. Acknowledgments: This research was supported by Ministero della Salute, Ricerca Finalizzata FSN, I.R.C.C.S., Rome, Italy The authors declare no potential conflicts of interest. Word count: 4703 Figures: 5 Table: 1 Statement of translational relevance At present, standard treatment for ovarian cancer involves tumor debulking with platinum- based chemotherapy. The response to this regimen is at least 70% of patients; however, 60- 80% of the first responders relapse within 18 months with a platinum-resistant disease. Lipoplatin is one of the most promising liposomal platinum drug formulations under clinical investigation. Our preclinical data demonstrated that Lipoplatin was active in a panel of ovarian cancer cell lines, including Cisplatin-resistant cells. We have shown that Lipoplatin induced apoptosis and ROS production, reduced spheroid growth and migration, reduced cancer stem cell number, and inhibited more than 90% tumor xenograft growth with low toxicity, while cisplatin resulted either un-effective or effective but too toxic.
    [Show full text]
  • Prior Authorization Policy
    PRIOR AUTHORIZATION POLICY POLICY: Inflammatory Conditions – Arcalyst® (rilonacept for subcutaneous injection Regeneron Pharmaceuticals) DATE REVIEWED: 11/06/2019; selected revision 04/01/2020 OVERVIEW Arcalyst is an interleukin-1 (IL-1) blocker indicated for the treatment of Cryopyrin-Associated Periodic Syndromes (CAPS), including Familial Cold Autoinflammatory Syndrome (FCAS) and Muckle-Wells Syndrome (MWS) in adults and children aged 12 years and older.1 Arcalyst, also known is a recombinant dimeric fusion protein that blocks IL-1β signaling and to a lesser extent also binds IL-1α and IL-1 receptor antagonist (IL-1ra). In adults ≥ 18 years of age, Arcalyst is initiated with a loading dose of 320 mg delivered as two subcutaneous (SC) injections of 160 mg on the same day at two separate sites. Dosing is continued with 160 mg once weekly as a single injection. In adolescents aged 12 to 17 years, therapy is initiated with a loading dose of 4.4 mg/kg, up to a maximum of 320 mg, delivered as one or two SC injections with a maximum single-injection volume of 2 mL. If the initial dose is two injections, then patients should be given Arcalyst on the same day at two separate sites. In adolescents, dosing is continued with 2.2 mg/kg, up to a maximum of 160 mg, once weekly as a single injection. Disease Overview CAPS is a rare inherited inflammatory disease associated with overproduction of IL-1. CAPS encompasses three rare genetic syndromes. FCAS, MWS, and neonatal onset multisystem inflammatory disorder (NOMID) or chronic infantile neurological cutaneous and articular syndrome (CINCA) are thought to be one condition along a spectrum of disease severity.2-3 FCAS is the mildest phenotype and NOMID is the most severe.
    [Show full text]
  • Systemic Lipoplatin Infusion Results in Preferential Tumor Uptake in Human Studies
    ANTICANCER RESEARCH 25: 3031-3040, (2005) _______________________________________________________________________________________________ Systemic Lipoplatin Infusion Results in Preferential Tumor Uptake in Human Studies T ENI BOULI K AS1, GEO RGE P. STAT HOPO U LOS 2, N IKOL A OS VO LAKA K IS1 and MARIA VOUG I OUKA 1 , 1Regulon, Inc. 715 Nor th Shoreline Blvd., Mountain View, C alifornia 94043, U.S.A. and Regulon AE, Grigoriou Afxentiou7, Athehs 174 55; 1Errik os Dunant Hos pital, Mes ogeion 107, Athens 15128, Gr eece ; Abstract. LipoplatinTM, a liposomal formulation of cisplatin, Key words: Lipoplatin, cisplatin, tumor targeting, gastric cancer, colon was developed with almost negligible nephrotoxicity, ototoxic ity , cancer, hepatocellular cancer. and ne urotoxicity as demonstrated in prec linical and Phase I human studies. A polyethy le ne-gly col c oating of the liposome w ith a m odel where Lipoplatin damage s more tumor c ompare d to nanoparticles is s upposed to r e sult in tumor accum ulation of the normal c ells. In c onclusion, Lipoplatin has the ability to drug by extravas ation through the altere d tumor vasculatur e. We prefe r entially conce ntr ate in malignant tis sue both of primar y and e xplored the hypothe s is that intrav e nous infusion of Lipoplatin m etastatic origin following intravenous infusion to patients. In r esults in tumor targeting in four independent patient c ases (one this respect, Lipoplatin emerges as a very promising drug in the w ith hepatocellular adenoc ar cinom a, two w ith gastr ic cancer, arsenal of chemotherapeutics. and one with colon c ancer ) w ho under went Lipoplatin infusion followed by a pr esche dule d s urger y ~ 20h later.
    [Show full text]
  • Arcalyst® (Rilonacept)
    Arcalyst® (rilonacept) (Subcutaneous) Document Number: IC-0182 Last Review Date: 01/05/2021 Date of Origin: 11/07/2013 Dates Reviewed: 11/2013, 08/2014, 07/2015, 04/2016, 04/2017, 04/2018, 08/2018, 08/2019, 08/2020, 01/2021 I. Length of Authorization Coverage will be provided for 6 months and may be renewed. II. Dosing Limits A. Quantity Limit (max daily dose) [NDC Unit]: Arcalyst 220 mg injection: 8 vials every 28 days B. Max Units (per dose and over time) [HCPCS Unit]: Cryopyrin-Associated Periodic Syndromes (CAPS) Loading Dose given on Day 1: 320 billable units Maintenance Dose: 160 billable units every 7 days Deficiency of Interleukin-1 Receptor Antagonist (DIRA) 320 billable units every 7 days III. Initial Approval Criteria 1 Coverage is provided in the following conditions: Patient is up to date with all vaccinations, in accordance with current vaccination guidelines, prior to initiating therapy; AND Universal Criteria 1 Patient has been evaluated and screened for the presence of latent tuberculosis (TB) infection prior to initiating treatment and will receive ongoing monitoring for the presence of TB during treatment; AND Patient does not have an active infection, including clinically important localized infections; AND Must not be administered concurrently with live vaccines; AND Proprietary & Confidential © 2021 Magellan Health, Inc. Patient is not on concurrent therapy with other IL-1 blocking agents (e.g., canakinumab, anakinra*, etc.) [*Note: For DIRA, anakinra must be discontinued 24 hours prior to starting Arcalyst];
    [Show full text]
  • Section B Changed Classes/Guidelines Final
    EPHMRA ANATOMICAL CLASSIFICATION GUIDELINES 2019 Section B Changed Classes/Guidelines Final Version Date of issue: 24th December 2018 1 A3 FUNCTIONAL GASTRO-INTESTINAL DISORDER DRUGS R2003 A3A PLAIN ANTISPASMODICS AND ANTICHOLINERGICS R1993 Includes all plain synthetic and natural antispasmodics and anticholinergics. A3B Out of use; can be reused. A3C ANTISPASMODIC/ATARACTIC COMBINATIONS This group includes combinations with tranquillisers, meprobamate and/or barbiturates except when they are indicated for disorders of the autonomic nervous system and neurasthenia, in which case they are classified in N5B4. A3D ANTISPASMODIC/ANALGESIC COMBINATIONS R1997 This group includes combinations with analgesics. Products also containing either tranquillisers or barbiturates and analgesics to be also classified in this group. Antispasmodics indicated exclusively for dysmenorrhoea are classified in G2X1. A3E ANTISPASMODICS COMBINED WITH OTHER PRODUCTS r2011 Includes all other combinations not specified in A3C, A3D and A3F. Combinations of antispasmodics and antacids are classified in A2A3; antispasmodics with antiulcerants are classified in A2B9. Combinations of antispasmodics with antiflatulents are classified here. A3F GASTROPROKINETICS r2013 This group includes products used for dyspepsia and gastro-oesophageal reflux. Compounds included are: alizapride, bromopride, cisapride, clebopride, cinitapride, domperidone, levosulpiride, metoclopramide, trimebutine. Prucalopride is classified in A6A9. Combinations of gastroprokinetics with other substances
    [Show full text]
  • New Insights Into Mechanisms of Cisplatin Resistance: from Tumor Cell to Microenvironment
    International Journal of Molecular Sciences Review New Insights into Mechanisms of Cisplatin Resistance: From Tumor Cell to Microenvironment Shang-Hung Chen 1,2 and Jang-Yang Chang 1,2,* 1 National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan 2 Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan * Correspondence: [email protected] or [email protected]; Tel.: +886-6-2757575 (ext. 50002) Received: 28 July 2019; Accepted: 21 August 2019; Published: 24 August 2019 Abstract: Although cisplatin has been a pivotal chemotherapy drug in treating patients with various types of cancer for decades, drug resistance has been a major clinical impediment. In general, cisplatin exerts cytotoxic effects in tumor cells mainly through the generation of DNA-platinum adducts and subsequent DNA damage response. Accordingly, considerable effort has been devoted to clarify the resistance mechanisms inside tumor cells, such as decreased drug accumulation, enhanced detoxification activity, promotion of DNA repair capacity, and inactivated cell death signaling. However, recent advances in high-throughput techniques, cell culture platforms, animal models, and analytic methods have also demonstrated that the tumor microenvironment plays a key role in the development of cisplatin resistance. Recent clinical successes in combination treatments with cisplatin and novel agents targeting components in the tumor microenvironment, such as angiogenesis and immune cells, have also supported the therapeutic value of these components in cisplatin resistance. In this review, we summarize resistance mechanisms with respect to a single tumor cell and crucial components in the tumor microenvironment, particularly focusing on favorable results from clinical studies.
    [Show full text]
  • Lipoplatin™ As a Chemotherapy and Antiangiogenesis Drug. Cancer
    Cancer Therapy Vol 5, page 351 Cancer Therapy Vol 5, 351-376, 2007 Molecular mechanisms of cisplatin and its liposomally encapsulated form, Lipoplatin™. Lipoplatin™ as a chemotherapy and antiangiogenesis drug Review Article Teni Boulikas1,2,* 1Regulon, Inc. 715 North Shoreline Blvd, Mountain View, California 94043, USA and 2Regulon AE, Afxentiou 7, Alimos, Athens 17455, Ellas (Greece) __________________________________________________________________________________ *Correspondence: Teni Boulikas, Ph.D., Regulon AE, Afxentiou 7, Alimos, Athens 17455, Greece; Tel: +30-210-9858454; Fax: +30- 210-9858453; E-mail: [email protected] Key words: Lipoplatin™, cisplatin, signaling, tumor targeting, angiogenesis, liposomes, nanoparticles, drug resistance, carboplatin, oxaliplatin, glutathione, caspase, apoptosis, ERK, stress signaling, FasL, DNA adducts, DNA repair, gene expression profiling, antiangiogenesis, HSP90 Abbreviations: 17-allylamino-17-demethoxygeldanamycin, (17-AAG); 7-ethyl-10-hydroxy-camptothecin, (SN-38); Brain-derived neurotrophic factor, (BDNF); chronic myelogenous leukemia, (CML); copper transporters, (CTRs); dipalmitoyl phosphatidyl glycerol, (DPPG); DNA-protein cross-links, (DPC); dose limiting toxicity, (DLT); epidermal growth factor receptor, (EGFR); epidermal growth factor, (EGF); extracellular signal-regulated kinase, (ERK); Focal adhesion kinase, (FAK); glutathione S-transferase P1, (GSTP1); Heat shock protein 90, (Hsp90); heparin-binding epidermal growth factor, (HB-EGF); high mobility group, (HMG); hypoxia-inducible factor-
    [Show full text]