RESUMO
Colorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient's profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.
Assuntos
Inibidores da Angiogênese/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Substituição de Medicamentos , Receptores de Fatores de Crescimento do Endotélio Vascular/uso terapêutico , Proteínas Recombinantes de Fusão/uso terapêutico , Fatores Etários , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/uso terapêutico , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Ensaios Clínicos Fase III como Assunto , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Fluoruracila/uso terapêutico , Genes ras , Humanos , Leucovorina/uso terapêutico , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Mutação , Neovascularização Patológica/tratamento farmacológico , Compostos Organoplatínicos/uso terapêutico , Proteínas Proto-Oncogênicas B-raf/genética , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidoresRESUMO
Prevalence of metabolic syndrome and progression of nephropathy depend on sex. We examined a protective effect of estradiol against nephropathy in metabolic syndrome through the modulation of the arachidonic acid metabolism by activating the 5-lipoxygenase and cytochrome p450 4A pathways. 28 female Wistar rats were divided into four groups of seven animals each: control, intact metabolic syndrome, ovariectomized metabolic syndrome, and metabolic syndrome ovariectomized plus estradiol. Blood pressure, body weight, body fat, triglycerides, insulin, HOMA-index, albuminuria, and TNF-α were increased in ovariectomized metabolic syndrome rats (p < 0.001). The perfusion pressure in isolated kidneys of ovariectomized metabolic syndrome rats in presence of 4 µg of arachidonic acid was increased. The inhibitors of the arachidonic acid metabolism Baicalein, Miconazole, and Indomethacin in these rats decreased the perfusion pressure by 57.62%, 99.83%, and 108.5%, respectively and they decreased creatinine clearance and the arachidonic acid percentage. Phospholipase A2 expression in the kidney of ovariectomized metabolic syndrome rats was not modified. 5-lipoxygenase was increased in metabolic syndrome ovariectomized rats while cytochrome p450 4A was decreased. In conclusion, the loss of estradiol increases renal damage while the treatment with estradiol benefits renal function by modulating arachidonic acid metabolism through the 5-lipoxygenase and cytochrome p450 4A pathways.
RESUMO
A study was established to evaluate concentration temperatures (25, 30, 35, 40 and 45 degrees C) on kiwi fruit pulp concentrated to 32 degrees Brix, with vacuum regulation. Munsell and sensorial colour, ascorbic acid and chlorophyll amount remanent were analyzed. Both, 25 and 30 degrees C concentration temperatures treatments, in the most of variables, experimented low deteriorate and differ with the other treatments. Ascorbic acid measurements had not significative differences (P < 0.95). Chlorophyll assays showed a decreased (70%) in the amount remanent over 35 degrees C in comparison to 25 degrees C treatments. 40 and 45 degrees C treatments showed traces of chlorophyll. Sensorial colour did not showed variations on 25 and 30 degrees C treatments; they were classified as bright green. Other treatments present colour deteriorate: 35 degrees C treatment was green-yellowish classified, and 45 degrees C treatments brown-greenish categories. Munsell colour showed the same relations, were increasing the concentration temperatures, decrease the green colour and increase the yellow colour.
Assuntos
Ácido Ascórbico , Clorofila , Manipulação de Alimentos , Frutas/química , Temperatura Alta , PigmentaçãoRESUMO
The effect of three storage temperatures (0, -9 and -18 degrees C) of the kiwi-fruit pulp reduced pressure concentrate, by a period of 3 months, in the physical (soluble solids, water activity, consistency and color), chemistry (pH, acidity, ascorbic acid, chlorophyll and pheophytin) and sensorial (appearance, aroma, acidity, sweetness, color and flavor) characteristics were studied. The greater deterioration was produced in the stored pulp to 0 degree C, while to -9 degrees C there is no significative differences, on the other hand, the kiwi-fruit pulp stored to -18 degrees C maintained large part of the original characteristics. It was observed that while the temperature and storage time increased, vitamin C and chlorophyll contents decreased, varying significantly consistency, color and appearance of product. The rest of the analyzed variables did not present significative differences during storage.