Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0345904 (liver cancer)
 15,188 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy of systemic chemotherapy in the treatment of primary and secondary liver cancer is poor. Intra-arterial delivery of fluoropyrimidines resulted in a significantly higher tumor response, but survival was prolonged by only a few months. Obviously, there is still a great need for improved therapeutic strategies. As the regional blood flow is of importance for the advantage of intra-arterial administration of cytotoxic drugs, degradable starch microspheres (DSMs) have been developed specifically to achieve temporary vascular occlusion during coadministration of cytotoxic drugs. Peak plasma concentrations, as well as the area under the concentration-time curve (AUC) of mitomycin C in plasma have been found to be significantly reduced following intra-arterial coadministration with DSMs. Similar results were also obtained with other drugs, such as nitrosoureas, doxorubicin, and 5-fluorouracil. The temporary vascular occlusion induced by DSMs enables a coadministered drug to be lodged in the target area for a prolonged period of time, resulting in a selectively increased uptake of labeled low molecular weight markers and several cytotoxic drugs into liver tumors compared with normal liver tissue. Vascular occlusion induced by DSMs has been demonstrated to redistribute the blood flow to hypovascular areas, which might be of particular importance for improving the efficacy of intra-arterial chemotherapy of hypovascular liver tumors. Passage through arteriovenous shunts was generally increased after DSM injection. However, this was without clinical significance as respiratory distress symptoms were found in only 1% of the sessions and were not considered to be serious in any of these patients. To take advantage of the pharmacokinetic modulation of coinjected drugs and, in addition, the redistribution of blood flow to hypovascular tumor areas, the goal is to achieve an almost complete vascular occlusion by injection of DSMs. Therefore, due to the wide variation between patients in the size and vascularity of liver tumors, the dose of DSMs has to be individualized. Degradable starch microspheres have been shown to enhance the antitumor efficacy of several cytotoxic drugs in animal experimental models and in noncomparative and randomized clinical studies.
 ...
PMID:Spherex (degradable starch microspheres) chemo-occlusion--enhancement of tumor drug concentration and therapeutic efficacy: an overview. 915 24

In the belief that the advantages stemming from a minimally invasive approach are significant, particularly in cirrhosis patients, we decided to apply this technique in the treatment of a group of patients suffering from HCC associated with cirrhosis. Sixteen patients (10 men, 6 women; mean age 60.1 years) underwent laparoscopic surgery for HCC associated with well compensated HCV-related liver cirrhosis (Child-Pugh class A; mean tumour size 2.9 cm). Seven of these lesions were located in the left liver and 9 in the right lobe. Laparoscopy was performed with a CO2 pneumoperitoneum (12-14 mmHg). The Pringle manoeuvre was not used. There was one conversion to laparotomy due to inadequate exposure. We performed 13 non-anatomical resections, 1 VI segmentectomy and 1 anatomical left lobectomy. None of the patients required blood transfusions. One patient died of severe respiratory distress syndrome on postoperative day 3. Major morbidity included 2 moderate postoperative ascites successfully resolved with conservative treatment. To date (mean follow-up: 18 months) no recurrences at the resection site or port-site metastases have been observed. Limited laparoscopic liver resections for HCC in cirrhotic patients are technically feasible and safe when careful selection criteria are adopted (hepatic involvement limited and located in the left or anterior right segments, tumour size smaller than 5 cm, Child-Pugh class A).
 ...
PMID:[Laparoscopic liver resection without a Pringle maneuver for HCC in cirrhotic patients]. 1583 34

Alcohol consumption alters factors that modify gene expression without changing the DNA code (i.e., epigenetic modulators) in many organ systems, including the immune system. Alcohol enhances the risk for developing several serious medical conditions related to immune system dysfunction, including acute respiratory distress syndrome (ARDS), liver cancer, and alcoholic liver disease (ALD). Binge and chronic drinking also render patients more susceptible to many infectious pathogens and advance the progression of HIV infection by weakening both innate and adaptive immunity. Epigenetic mechanisms play a pivotal role in these processes. For example, alcohol-induced epigenetic variations alter the developmental pathways of several types of immune cells (e.g., granulocytes, macrophages, and T-lymphocytes) and through these and other mechanisms promote exaggerated inflammatory responses. In addition, epigenetic mechanisms may underlie alcohol's ability to interfere with the barrier functions of the gut and respiratory systems, which also contribute to the heightened risk of infections. Better understanding of alcohol's effects on these epigenetic processes may help researchers identify new targets for the development of novel medications to prevent or ameliorate alcohol's detrimental effects on the immune system.
 ...
PMID:Epigenetic targets for reversing immune defects caused by alcohol exposure. 2431 69

Graft versus host disease (GVHD) is an uncommon complication following liver transplantation. In the present case report, a 53-year-old male hepatitis B virus carrier was diagnosed with primary liver cancer with post-hepatitis cirrhosis. Preoperative cytomegalovirus (CMV), Epstein-Barr virus, coxsackievirus, herpes simplex virus and autoimmune antibody series were negative. Preoperative human leukocyte antigen type was also negative. Following classic orthotropic liver transplantation, postoperative treatment included immunosuppression therapy, infection protection, anti-human immunodeficiency virus therapy and CMV infection protection therapy. Chemotherapy was initiated at day 16 following surgery. At day 26 following the transplantation, the patient developed a fever of unknown cause, and a scattered red rash was observed behind the left ear and on the neck. The patient presented with a fever of unknown cause, rash, symptoms of the digestive tract, leukocytopenia and pancytopenia. A diagnosis of GVHD was confirmed following a skin biopsy. Symptomatic therapies, including antivirals, anti-anaphylaxis drugs and steroids were administered. However, the patient succumbed to infection, acute respiratory distress syndrome and multiple organ failure at day 46 following surgery. Therefore, an effective therapeutic strategy for the treatment of GVHD following liver transplantation is yet to be established, and further research is required prior to such a regimen being developed.
 ...
PMID:Graft versus host disease following liver transplantation: A case report. 2518 16

At an intermediate or advanced stage, i.e. stage B or C, based on the Barcelona Clinic Liver Cancer classification of hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) may be offered as a treatment of palliative intent. We report the case of a patient suffering from acute respiratory distress syndrome after TACE with drug-eluting beads loaded with doxorubicin for HCC. To our knowledge, this is the first case described where a bronchoalveolar lavage was performed, and where significant levels of alveolar eosinophilia and neutrophilia were evident, attributed to a pulmonary toxicity of doxorubicin following liver chemoembolization.
 ...
PMID:Acute eosinophilic and neutrophilic pneumonia following transarterial chemoembolization with drug-eluting beads loaded with doxorubicin for hepatocellular carcinoma: a case report. 2534 33