Japanese scientists create cancer-killing cells (Temodal)
Encouraging news came from the land of the rising sun: Japanese scientists have made a breakthrough in the fight against cancer cells. Two years earlier, Dr. Shinye Yamanaka laboratory-derived iPS - induced pluripotent stem cells, for which he was awarded the 2012 Nobel Prize in Medicine. But the victory was incomplete, because the iPS is too unstable. They die before they can destroy their target - malignant cancer cells.
And now the scientific portal techno.bigmir.net brought the long-awaited good news about the fate of the Japanese discovery. The team of scientists managed to synthesize resistant T-lymphocytes on the basis of iPS, capable of attacking cancer cells and fighting disease. There are such natural killer cells in the body of any person, but they are produced in an amount insufficient for a convincing victory over cancer.
The head of the scientific project, Dr. Kawamoto, spoke about the essence of the revolutionary development. Scientists had to do a double job: first, to obtain iPS from human lymphocytes, and then to make persistent T-lymphocytes from stem cells again. Now the team is facing large-scale research - it is necessary to experimentally establish whether the new artificial T-lymphocytes will be active only against tumor cells, or they will begin to destroy healthy cells of the body as well.
Until the results of clinical trials are available, cancer patients have to rely on drugs that have been tested and proven to be effective, but have a number of unpleasant side effects. One of these medicines is Temodal.
Temodal: instructions for use
The active component of Temodal is temozolomide, an antitumor alkylating agent with an imidazotetrazine structure. Once it enters the bloodstream, it undergoes a chemical reaction that results in a special substance known as MTIK (monomethyltriazenoimidazolecarboxamide). It is a powerful cytotoxin that can kill cancer cells. The bad news is that temozolomide has a detrimental effect on healthy tissues. Although this can be said about all modern chemotherapy drugs.
Temodal is produced by the German pharmaceutical giant Schering Plow and is considered the highest quality and most reliable drug based on temozolomide. There is an Indian analogue of the same name, which costs a little less.
Release form and chemical composition
Temodal is available in capsules with four dosage options: 5, 20, 100 or 250 mg temozolomide per capsule. In addition, the preparation contains a number of auxiliary components: starch, gelatin, sodium lauryl sulfate, stearic and tartaric acids, titanium dioxide, sodium carboxymethyl, silicon dioxide and anhydrous milk sugar. One package of Temodal contains 5 or 20 capsules.
Indications for Temodal's use
The medicine is prescribed in three cases of cancer:
- As a primary therapeutic agent in the treatment of malignant melanoma with multiple metastases;
- As an adjunct to radiation therapy in the treatment of primary polymorphic glioblastoma, and in this case, further adjuvant therapy with Temodal is required;
- As a remedy against recurrence of polymorphic glioblastoma and anaplastic astrocytoma (that is, both forms of malignant glioma).
Contraindications and special instructions
Temodal is contraindicated in the following cases:
- Glucose-galactose malabsorption;
- Congenital lactose intolerance or lactase deficiency;
- Severe myelosuppression;
- Pregnancy and lactation;
- Children up to age 3 and elderly over 70 years old;
- Acute hepatic and renal failure.
Temodal is usually not prescribed for patients with primary malignant glioma under 18 years of age. Moreover, it is sometimes advisable for elderly patients with weak kidneys and / or liver to prescribe this drug and carry out treatment under strict medical supervision and with a decrease in the usual dosage, if there is no worthy alternative.
Treatment methods
Temodal is taken on an empty stomach with a full glass of water, never chewing the capsule. The primary task of the attending oncologist is to correctly calculate the dosage and get by with the minimum amount of the drug.
Consider first the primary therapy, which is always combined with radiation. The course lasts forty-two days, but can be extended by a week if during this period it was necessary to stop taking the medication due to strong side effects. Every day the patient needs to take one Temodal capsule with a dosage of 75 mg. Throughout the entire course of primary therapy, weekly monitoring of the most important indicators of blood condition is carried out. Here's what they should be so that the drug intake is not interrupted:
- The toxicity level is not higher than 1 degree;
- Neutrophils - not less than 1500 per 1 μl;
- Platelets - at least 100 thousand per 1 μl.
Now let's look at adjuvant monotherapy. It begins no earlier than four weeks after the completion of primary therapy in combination with radiation. It is necessary to go through six cycles of 28 days, during the first five days of the first cycle, the patient takes 150 mg of temozolomide, and then, starting from the second cycle, 200 mg. After taking the medication for five days, a rest period of 23 days follows, then the cycle repeats. It is important to note that increasing the dosage from 150 to 200 mg of Temodal is possible only in case of good tolerance, and if the blood state indicators meet the above requirements.
Temodal side effects
Unfortunately, almost no one can do without side effects. The drug is cytotoxic, therefore, it will weaken the protective functions of the body, and cause serious disruptions in the work of all organs and systems.
Here is a list of unpleasant effects that most often occur while taking Temodal:
- Nausea and vomiting, diarrhea and constipation, stool incontinence and increased flatulence in the intestines, poor appetite, rapid weight loss, anorexia and hyperglycemia, pain in the liver and epigastrium;
- Anemia, leukopenia and neuropenia, small hemorrhages on the mucous membranes and skin;
- Decreased sex drive, exacerbation of genital herpes, candidiasis and vaginitis, urinary incontinence, problems with erection and discomfort with ejaculation;
- Hypertension, tachycardia and atrial fibrillation, edema of the lungs, face and legs;
- Pneumonia and bronchitis, shortness of breath, apnea and shortness of breath;
- Seizures and confusion, confusion and loss of consciousness, headaches and dizziness, sleep disturbances and memory loss, chronic fatigue syndrome and depression, epileptic seizures and mental disorders, slurred speech and hallucinations.
Interaction of Temodal with other drugs
If this drug is taken with other drugs that have a negative effect on the bone marrow, it can significantly increase the risk of myelosuppression. It is also known that valproic acid somewhat reduces the rate and quality of absorption of Temodal, therefore their combined intake is undesirable.
By itself, the active substance temozolomide almost does not bind to blood proteins and is excreted mainly by the kidneys, and not the liver. Therefore, Temodal practically does not affect the clearance of other drugs, which makes it possible to combine it with many drugs without compromising the quality of the therapy.
Important information about Temodal
If the patient or patient is of childbearing age, at the time of therapy, as well as for at least six months after its completion, they must be carefully protected. It is almost impossible to conceive and bear a healthy child against the background of such treatment, meanwhile Temodal is able to cause malfunctioning of the ovaries and provoke additional untimely ovulation. It is recommended to use barrier methods of contraception even on days when conception usually does not occur.
Long-term treatment with Temodal, unfortunately, can cause infertility in patients of both sexes. Therefore, it is better to seriously think about the cryopreservation of eggs and sperm, if there are relapses of cancer, and there is a long struggle.
The capsules of the drug must be handled very carefully, because their contents are toxic. If it accidentally gets on the skin, and even more so on the mucous membrane, it is necessary to rinse this place as soon as possible with plenty of running cool water.
People engaged in work requiring increased concentration of attention (drivers of vehicles, operators of complex production equipment) need to take into account the harmful effects of Temodal on the nervous system. Drowsiness and impaired coordination of movement are possible, therefore, during therapy, it is better to go on sick leave or change your occupation.
See also: Other cancer treatments
The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"
