Research in Your Backyard Developing Cures, Creating Jobs
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WO 2018/223101 Al 06 December 2018 (06.12.2018) W !P O PCT
(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 WO 2018/223101 Al 06 December 2018 (06.12.2018) W !P O PCT (51) International Patent Classification: (71) Applicant: JUNO THERAPEUTICS, INC. [US/US]; 400 A 61K 35/1 7 (20 15.0 1) A 61P 35/00 (2006 .0 1) Dexter Ave. N., Suite 1200, Seattle, WA 98109 (US). (21) International Application Number: (72) Inventor: ALBERTSON, Tina; 400 Dexter Ave. N., Suite PCT/US2018/035755 1200, Seattle, WA 98109 (US). (22) International Filing Date: (74) Agent: AHN, Sejin et al; Morrison & Foerster LLP, 1253 1 0 1 June 2018 (01 .06.2018) High Bluff Drive, Suite 100, San Diego, CA 92130-2040 (US). (25) Filing Language: English (81) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of national protection available): AE, AG, AL, AM, (30) Priority Data: AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, 62/5 14,774 02 June 2017 (02.06.2017) US CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, 62/5 15,530 05 June 2017 (05.06.2017) US DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, 62/521,366 16 June 2017 (16.06.2017) u s HR, HU, ID, IL, IN, IR, IS, JO, JP, KE, KG, KH, KN, KP, 62/527,000 29 June 2017 (29.06.2017) u s KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, 62/549,938 24 August 2017 (24.08.2017) u s MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, 62/580,425 0 1 November 2017 (01 .11.2017) u s OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, 62/593,871 0 1 December 2017 (01 .12.2017) u s SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, 62/596,764 08 December 2017 (08.12.2017) u s TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. -
Research in Your Backyard Developing Cures, Creating Jobs
Research in Your Backyard Developing Cures, Creating Jobs PHARMACEUTICAL CLINICAL TRIALS IN ILLINOIS Dots show locations of clinical trials in the state. Executive Summary This report shows that biopharmaceutical research com- Quite often, biopharmaceutical companies hire local panies continue to be vitally important to the economy research institutions to conduct the tests and in Illinois, and patient health in Illinois, despite the recession. they help to bolster local economies in communities all over the state, including Chicago, Decatur, Joliet, Peoria, At a time when the state still faces significant economic Quincy, Rock Island, Rockford and Springfield. challenges, biopharmaceutical research companies are conducting or have conducted more than 4,300 clinical For patients, the trials offer another potential therapeutic trials of new medicines in collaboration with the state’s option. Clinical tests may provide a new avenue of care for clinical research centers, university medical schools and some chronic disease sufferers who are still searching for hospitals. Of the more than 4,300 clinical trials, 2,334 the medicines that are best for them. More than 470 of the target or have targeted the nation’s six most debilitating trials underway in Illinois are still recruiting patients. chronic diseases—asthma, cancer, diabetes, heart dis- ease, mental illnesses and stroke. Participants in clinical trials can: What are Clinical Trials? • Play an active role in their health care. • Gain access to new research treatments before they In the development of new medicines, clinical trials are are widely available. conducted to prove therapeutic safety and effectiveness and compile the evidence needed for the Food and Drug • Obtain expert medical care at leading health care Administration to approve treatments. -
Physiologically Based Pharmacokinetic Modeling in Regulatory Decision‐Making at the European Medicines Agency
ARTICLES Physiologically Based Pharmacokinetic Modeling in Regulatory Decision-Making at the European Medicines Agency E Luzon1, K Blake1, S Cole2,3,4, A Nordmark4,5, C Versantvoort3,6 and E Gil Berglund3,5 Physiologically based pharmacokinetic (PBPK) modeling is a valuable tool in drug development and regulatory assessment, as it offers the opportunity to simulate the pharmacokinetics of a compound, with a mechanistic understanding, in a variety of populations and situations. This work reviews the use and impact of such modeling in selected regulatory procedures submitted to the European Medicines Agency (EMA) before the end of 2015, together with its subsequent reflection in public documents relating to the assessment of these procedures. It is apparent that the reference to PBPK modeling in regulatory public documents underrepresents its use. A positive trend over time of the number of PBPK models submitted is shown, and in a number of cases the results of these may impact the decision- making process or lead to recommendations in the product labeling. These results confirm the need for regulatory guidance in this field, which is currently under development by the EMA. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE WHAT THIS STUDY ADDS TO OUR KNOWLEDGE TOPIC? þ This is the first work presenting the situation in the Europe- þ PBPK is a cutting-edge technology that is increasingly being an Union and confirms what was detected by the FDA is a applied to drug development to address various aspects related global trend. to clinical pharmacology. Previous works by the FDA acknowl- HOW THIS MIGHT CHANGE CLINICAL PHARMA- edge its use in regulatory submissions in the US, but so far there COLOGY OR TRANSLATIONAL SCIENCE is no analysis of the European perspective. -
Drug Name Plate Number Well Location % Inhibition, Screen Axitinib 1 1 20 Gefitinib (ZD1839) 1 2 70 Sorafenib Tosylate 1 3 21 Cr
Drug Name Plate Number Well Location % Inhibition, Screen Axitinib 1 1 20 Gefitinib (ZD1839) 1 2 70 Sorafenib Tosylate 1 3 21 Crizotinib (PF-02341066) 1 4 55 Docetaxel 1 5 98 Anastrozole 1 6 25 Cladribine 1 7 23 Methotrexate 1 8 -187 Letrozole 1 9 65 Entecavir Hydrate 1 10 48 Roxadustat (FG-4592) 1 11 19 Imatinib Mesylate (STI571) 1 12 0 Sunitinib Malate 1 13 34 Vismodegib (GDC-0449) 1 14 64 Paclitaxel 1 15 89 Aprepitant 1 16 94 Decitabine 1 17 -79 Bendamustine HCl 1 18 19 Temozolomide 1 19 -111 Nepafenac 1 20 24 Nintedanib (BIBF 1120) 1 21 -43 Lapatinib (GW-572016) Ditosylate 1 22 88 Temsirolimus (CCI-779, NSC 683864) 1 23 96 Belinostat (PXD101) 1 24 46 Capecitabine 1 25 19 Bicalutamide 1 26 83 Dutasteride 1 27 68 Epirubicin HCl 1 28 -59 Tamoxifen 1 29 30 Rufinamide 1 30 96 Afatinib (BIBW2992) 1 31 -54 Lenalidomide (CC-5013) 1 32 19 Vorinostat (SAHA, MK0683) 1 33 38 Rucaparib (AG-014699,PF-01367338) phosphate1 34 14 Lenvatinib (E7080) 1 35 80 Fulvestrant 1 36 76 Melatonin 1 37 15 Etoposide 1 38 -69 Vincristine sulfate 1 39 61 Posaconazole 1 40 97 Bortezomib (PS-341) 1 41 71 Panobinostat (LBH589) 1 42 41 Entinostat (MS-275) 1 43 26 Cabozantinib (XL184, BMS-907351) 1 44 79 Valproic acid sodium salt (Sodium valproate) 1 45 7 Raltitrexed 1 46 39 Bisoprolol fumarate 1 47 -23 Raloxifene HCl 1 48 97 Agomelatine 1 49 35 Prasugrel 1 50 -24 Bosutinib (SKI-606) 1 51 85 Nilotinib (AMN-107) 1 52 99 Enzastaurin (LY317615) 1 53 -12 Everolimus (RAD001) 1 54 94 Regorafenib (BAY 73-4506) 1 55 24 Thalidomide 1 56 40 Tivozanib (AV-951) 1 57 86 Fludarabine -
Monotherapy with Pixantrone in Histologically Confirmed Relapsed Or
research paper Monotherapy with pixantrone in histologically confirmed relapsed or refractory aggressive B-cell non-Hodgkin lymphoma: post-hoc analyses from a phase III trial Ruth Pettengell,1 Catherine Sebban,2 This post hoc analysis of a phase 3 trial explored the effect of pixantrone in Pier Luigi Zinzani,3 Hans Gunter patients (50 pixantrone, 47 comparator) with relapsed or refractory aggres- 4 5 Derigs, Sergey Kravchenko, Jack W. sive B-cell non-Hodgkin lymphoma (NHL) confirmed by centralized histo- 6 7 Singer, Panteli Theocharous, Lixia logical review. Patients received 28-d cycles of 85 mg/m2 pixantrone 7 8 Wang, Mariya Pavlyuk, Kahina M. dimaleate (equivalent to 50 mg/m2 in the approved formulation) on days Makhloufi8 and Bertrand Coiffier9,10 1, 8 and 15, or comparator. The population was subdivided according to 1St George’s University of London, London, UK, 2 previous rituximab use and whether they received the study treatment as Leon Berard Cancer Centre, Lyon, France, – 3Institute of Haematology “Le A Seragnoli”, 3rd or 4th line. Median number of cycles was 4 (range, 2 6) with pix- – University of Bologna, Bologna, Italy, 4St€adt Kli- antrone and 3 (2 6) with comparator. In 3rd or 4th line, pixantrone was Á Á nikum, Frankfurt-Hoeschest, Klinik fur€ Innere associated with higher complete response (CR) (23 1% vs. 5 1% compara- Medizin III, Frankfurt am Main, Germany, tor, P = 0Á047) and overall response rate (ORR, 43Á6% vs. 12Á8%, 5Chemotherapy and Intensive Treatment of Hae- P = 0Á005). In 3rd or 4th line with previous rituximab (20 pixantrone, 18 matology Diseases, Haematology Scientific Centre comparator), pixantrone produced better ORR (45Á0% vs. -
Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy with Hospitalization for Upper Gastrointestinal Tract Bleeding
Supplementary Online Content Ray WA, Chung CP, Murray KT, et al. Association of oral anticoagulants and proton pump inhibitor cotherapy with hospitalization for upper gastrointestinal tract bleeding. JAMA. doi:10.1001/jama.2018.17242 eAppendix. PPI Co-therapy and Anticoagulant-Related UGI Bleeds This supplementary material has been provided by the authors to give readers additional information about their work. Downloaded From: https://jamanetwork.com/ on 10/02/2021 Appendix: PPI Co-therapy and Anticoagulant-Related UGI Bleeds Table 1A Exclusions: end-stage renal disease Diagnosis or procedure code for dialysis or end-stage renal disease outside of the hospital 28521 – anemia in ckd 5855 – Stage V , ckd 5856 – end stage renal disease V451 – Renal dialysis status V560 – Extracorporeal dialysis V561 – fitting & adjustment of extracorporeal dialysis catheter 99673 – complications due to renal dialysis CPT-4 Procedure Codes 36825 arteriovenous fistula autogenous gr 36830 creation of arteriovenous fistula; 36831 thrombectomy, arteriovenous fistula without revision, autogenous or 36832 revision of an arteriovenous fistula, with or without thrombectomy, 36833 revision, arteriovenous fistula; with thrombectomy, autogenous or nonaut 36834 plastic repair of arteriovenous aneurysm (separate procedure) 36835 insertion of thomas shunt 36838 distal revascularization & interval ligation, upper extremity 36840 insertion mandril 36845 anastomosis mandril 36860 cannula declotting; 36861 cannula declotting; 36870 thrombectomy, percutaneous, arteriovenous -
Related Kinases (VRK) Bound to Small-Molecule Inhibitors Identifies Different P-Loop Conformations
Structural characterization of human Vaccinia- Related Kinases (VRK) bound to small-molecule inhibitors identifies different P-loop conformations Rafael M. Couñago1,2*, Charles K. Allerston3, Pavel Savitsky3, Hatylas Azevedo4, Paulo H Godoi1,5, Carrow I. Wells6, Alessandra Mascarello4, Fernando H. de Souza Gama4, Katlin B. Massirer1,2, William J. Zuercher6, Cristiano R.W. Guimarães4 and Opher Gileadi1,3 1. Structural Genomics Consortium, Universidade Estadual de Campinas — UNICAMP, Campinas, SP, Brazil. 2. Centro de Biologia Molecular e Engenharia Genética, Universidade Estadual de Campinas, Campinas, SP, Brazil. 3. Structural Genomics Consortium and Target Discovery Institute, Nuffield Department of Clinical Medicine, University of Oxford, UK. 4. Aché Laboratórios Farmacêuticos SA, Guarulhos, SP, Brazil. 5. Department of Biochemistry and Tissue Biology, Institute of Biology, State University of Campinas, Campinas, Brazil. 6. Structural Genomics Consortium, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC, USA. *Correspondence to Rafael M. Couñago: [email protected] (RMC) Supplementary information 1 SUPPLEMENTARY METHODS PKIS results analyses - hierarchical cluster analysis (HCL) A hierarchical clustering (HCL) analysis was performed to group kinases based on their inhibition patterns across the compounds. The average distance clustering method was employed, using sample tree selection and sample leaf order optimization. The distance metric used was the Pearson correlation and the HCL analysis was performed in the TmeV software 1. SUPPLEMENTARY REFERENCES 1 Saeed, A. I. et al. TM4: a free, open-source system for microarray data management and analysis. BioTechniques 34, 374-378, (2003). SUPPLEMENTARY FIGURES LEGENDS Supplementary Figure S1: Hierarchical clustering analysis of PKIS data. Hierarchical clustering analysis of PKIS data. -
Sarcoma Metabolomics: Current Horizons and Future Perspectives
cells Review Sarcoma Metabolomics: Current Horizons and Future Perspectives Miguel Esperança-Martins 1,2,3,* , Isabel Fernandes 1,3,4 , Joaquim Soares do Brito 4,5, Daniela Macedo 6, Hugo Vasques 4,7, Teresa Serafim 2, Luís Costa 1,3,4 and Sérgio Dias 2,4 1 Centro Hospitalar Universitário Lisboa Norte, Medical Oncology Department, Hospital Santa Maria, 1649-028 Lisboa, Portugal; [email protected] (I.F.); [email protected] (L.C.) 2 Vascular Biology & Cancer Microenvironment Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; tserafi[email protected] (T.S.); [email protected] (S.D.) 3 Translational Oncobiology Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal 4 Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; [email protected] (J.S.d.B.); [email protected] (H.V.) 5 Centro Hospitalar Universitário Lisboa Norte, Orthopedics and Traumatology Department, Hospital Santa Maria, 1649-028 Lisboa, Portugal 6 Medical Oncology Department, Hospital Lusíadas Lisboa, 1500-458 Lisboa, Portugal; [email protected] 7 General Surgery Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal * Correspondence: [email protected] Abstract: The vast array of metabolic adaptations that cancer cells are capable of assuming, not Citation: Esperança-Martins, M.; only support their biosynthetic activity, but also fulfill their bioenergetic demands and keep their Fernandes, I.; Soares do Brito, J.; intracellular reduction–oxidation (redox) balance. Spotlight has recently been placed on the en- Macedo, D.; Vasques, H.; Serafim, T.; ergy metabolism reprogramming strategies employed by cancer cells to proliferate. -
Five Years of the Cipa Project (2013–2018) REVIEW - What Did We Learn? Dong-Seok Yim* Department of Clinical Pharmacology and Therapeutics, Seoul St
2018;26(4):145-149 TCP Transl Clin Pharmacol https://doi.org/10.12793/tcp.2018.26.4.145 Five years of the CiPA project (2013–2018) REVIEW - what did we learn? Dong-Seok Yim* Department of Clinical Pharmacology and Therapeutics, Seoul St. Mary’s Hospital, Seoul 06591, Korea, PIPET (Pharmacometrics Institute for Practical Education and Training), College of Medicine, The Catholic University of Korea, Seoul 06591, Korea *Correspondence: D. S. Yim; Tel: +82-2-2258-7327, E-mail: [email protected] Cases of drug-induced QT prolongation and sudden cardiac deaths resulted in market withdrawal Keywords of many drugs and world-wide regulatory changes through accepting the ICH guidelines E14 and Cardiomyocytes, S7B. However, because the guidelines were not comprehensive enough to cover the electrophysi- CiPA, hERG, ological changes by drug-induced cardiac ion channel blocking, CiPA was initiated by experts in In silico, governments and academia in the USA, Europe, and Japan in 2013. Five years have passed since the JT peak launch of the CiPA initiative that aimed to improve the current ICH guidelines. This report reviews pISSN: 2289-0882 the current achievements of the CiPA initiative and explores unresolved issues. eISSN: 2383-5427 tive include the regulators FDA, European Medicines Agency, Background Health Canada, Japan’s Pharmaceuticals and Medical Devices Cases of drug-induced torsade de Pointes (TdP) that were Agency, industry, and academia. The initiative also coordinates reported in the 1990s and 2000s resulted in the market with- with several organizations such as the Health and Environmen- drawal of many drugs.[1] Because QTc interval prolongation tal Science Institute, the Safety Pharmacology Society, and the by blocking the cardiac hERG channel was reported to provoke Cardiac Safety Research Consortium. -
Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01 -
Ventricular Tachycardia Drugs Versus Devices John Camm St
Cardiology Update 2015 Davos, Switzerland: 8-12th February 2015 Ventricular Arrhythmias Ventricular Tachycardia Drugs versus Devices John Camm St. George’s University of London, UK Imperial College, London, UK Declaration of Interests Chairman: NICE Guidelines on AF, 2006; ESC Guidelines on Atrial Fibrillation, 2010 and Update, 2012; ACC/AHA/ESC Guidelines on VAs and SCD; 2006; NICE Guidelines on ACS and NSTEMI, 2012; NICE Guidelines on heart failure, 2008; NICE Guidelines on Atrial Fibrillation, 2006; ESC VA and SCD Guidelines, 2015 Steering Committees: multiple trials including novel anticoagulants DSMBs: multiple trials including BEAUTIFUL, SHIFT, SIGNIFY, AVERROES, CASTLE- AF, STAR-AF II, INOVATE, and others Events Committees: one trial of novel oral anticoagulants and multiple trials of miscellaneous agents with CV adverse effects Editorial Role: Editor-in-Chief, EP-Europace and Clinical Cardiology; Editor, European Textbook of Cardiology, European Heart Journal, Electrophysiology of the Heart, and Evidence Based Cardiology Consultant/Advisor/Speaker: Astellas, Astra Zeneca, ChanRX, Gilead, Merck, Menarini, Otsuka, Sanofi, Servier, Xention, Bayer, Boehringer Ingelheim, Bristol- Myers Squibb, Daiichi Sankyo, Pfizer, Boston Scientific, Biotronik, Medtronic, St. Jude Medical, Actelion, GlaxoSmithKline, InfoBionic, Incarda, Johnson and Johnson, Mitsubishi, Novartis, Takeda Therapy for Ventricular Tachycardia Medical therapy Antiarrhythmic drugs Autonomic management Ventricular tachycardia Monomorphic Polymorphic Ventricular fibrillation Ventricular storms Ablation therapy Device therapy Surgical Defibrillation Catheter Antitachycardia pacing History of Antiarrhythmic Drugs 1914 - Quinidine 1950 - Lidocaine 1951 - Procainamide 1946 – Digitalis 1956 – Ajmaline 1962 - Verapamil 1962 – Disopyramide 1964 - Propranolol 1967 – Amiodarone 1965 – Bretylium 1972 – Mexiletine 1973 – Aprindine, Tocainide 1969 - Diltiazem 1975- Flecainide 1976 – Propafenone Encainide Ethmozine 2000 - Sotalol D-sotalol 1995 - Ibutilide (US) Recainam 2000 – Dofetilide US) IndecainideX Etc. -
Distinct Cargos of Small Extracellular Vesicles Derived from Hypoxic Cells and Their Effect on Cancer Cells
International Journal of Molecular Sciences Review Distinct Cargos of Small Extracellular Vesicles Derived from Hypoxic Cells and Their Effect on Cancer Cells Geoffroy Walbrecq, Christiane Margue, Iris Behrmann and Stephanie Kreis * Department of Life Sciences and Medicine (DLSM), University of Luxembourg, 6, avenue du Swing, L-4367 Belvaux, Luxembourg; Geoff[email protected] (G.W.); [email protected] (C.M.); [email protected] (I.B.) * Correspondence: [email protected] Received: 17 June 2020; Accepted: 17 July 2020; Published: 17 July 2020 Abstract: Hypoxia is a common hallmark of solid tumors and is associated with aggressiveness, metastasis and poor outcome. Cancer cells under hypoxia undergo changes in metabolism and there is an intense crosstalk between cancer cells and cells from the tumor microenvironment. This crosstalk is facilitated by small extracellular vesicles (sEVs; diameter between 30 and 200 nm), including exosomes and microvesicles, which carry a cargo of proteins, mRNA, ncRNA and other biological molecules. Hypoxia is known to increase secretion of sEVs and has an impact on the composition of the cargo. This sEV-mediated crosstalk ultimately leads to various biological effects in the proximal tumor microenvironment but also at distant, future metastatic sites. In this review, we discuss the changes induced by hypoxia on sEV secretion and their cargo as well as their effects on the behavior and metabolism of cancer cells, the tumor microenvironment and metastatic events. Keywords: exosomes; extracellular vesicles; cancer; hypoxia; TME; immunity; biomarker 1. Introduction Extracellular vesicles are defined as particles, which are delimited by a lipid bilayer and which cannot replicate [1].