Side Effects Of Cancer Treatment Research Articles

Royal jelly and its hormonal effects in breast cancer: a literature review.

Breast cancer is the most common cancer in women which can be cured in most individuals with early-stage non-metastatic disease. Imbalance in estrogen signaling pathways and propagating levels of estrogens has important roles in breast cancer development. Targeting the estrogen receptor signaling pathway is linked to breast cancer treatment. Royal jelly is one of the bee products containing 10-hydroxy-2-decenoic acid, a structure similar to mammalian estrogen, allowing it to attach to estrogen receptors. It is considered as a general tonic and immunomodulator which may be helpful in reducing the side effects of cancer treatments. Currently, there are controversial data regarding the pros and cons of royal jelly in cancer. Here we provide an overview of the effects of royal jelly on sex hormones and its possible role in breast cancer. Electronic databases including PubMed, Scopus, and Web of Science were searched with the search terms royal jelly, cancer, and sexual hormones. All preclinical and clinical studies regarding the hormonal effects of royal jelly were included. According to the collected preclinical data, consumption of royal jelly at daily doses below 200mg/kg can be useful to decrease the risk of breast cancer since it reduces the serum level of estrogen; whereas increases progesterone, which subsequently decreases the expression of ERs on the ER-positive cells. Future clinical studies are essential to confirm the safe dose of royal jelly as an adjuvant therapy in breast cancer.

Systemic Anti-Inflammatory Agents in the Prevention of Chemoradiation-Induced Mucositis: A Review of Randomised Controlled Trials.

Mucositis is a pathological condition characterised by inflammation and ulceration of the mucous membranes lining the alimentary canal, particularly in the mouth (oral mucositis) and the gastrointestinal tract. It is a common side effect of cancer treatments, including chemotherapy and radiotherapy, and it is sometimes responsible for treatment interruptions. Preventing mucositis throughout the alimentary tract is therefore crucial. However, current interventions mainly target either oral or gastrointestinal side effects. This review aimed to investigate the use of systemically administered anti-inflammatory agents to prevent mucositis in cancer patients undergoing cancer treatment. PubMed, Ovid, Scopus, Web of Science, WHO ICTRP and ClinicalTrials.gov were screened to identify eligible randomised controlled trials (RCTs). The published literature on anti-inflammatory agents provides mixed evidence regarding the degree of efficacy in preventing/reducing the severity of mucositis in most anticancer treatments; however, sample size continued to be a significant limitation, alongside others discussed. Our review yielded a list of several anti-inflammatory agents that exhibit potential mucositis-preventive effects in cancer patients undergoing cancer treatment, which can be used to inform clinical practice.

Abstract PO5-12-09: A Single-Arm Pilot Study of the Feasibility and Efficacy of Electro-Acupuncture in Subjects with Chemotherapy-Induced Peripheral Neuropathy

Abstract Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a very common dose-limiting side effect of many cancer treatments. However, the optimal treatment for CIPN remains unclear. Electroacupuncture (EA) is a non-pharmacologic treatment that combines traditional acupuncture with electrical stimulation. EA is being examined for CIPN and has shown modest benefits. Design: This is a pilot, single-center, prospective, single-arm, non-blinded study. All subjects had residual grade ≥2 CIPN after having received curative intent chemotherapy for stage I-III breast cancer, completed at least 3 months prior to study enrollment. Patients received 10 sessions of electro-acupuncture, administered by a licensed professional, over the course of 7 weeks. A sub-group of patients also had baseline and post-treatment skin punch biopsies to assess intra-epithelial nerve density (IEND). The primary objective was to determine the feasibility of completing a 10-treatment EA program in this patient population. Feasibility was defined as ≥15 subjects completing ≥8 EA treatments. Secondary endpoints included neuropathic pain, as assessed by the Brief Pain Inventory-Short Form (BPI-SF), and change in the quality of life, as assessed by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-NTX) subscale. Results: Twenty eligible female subjects were included in the study, with a median age of 66.5 years (range 45-81 years old). All patients received taxane chemotherapy, with 15 (75%) patients receiving weekly paclitaxel, 4 (8%) patients receiving Taxotere every 3 weeks, and 1 (2%) patient received weekly abraxane. The duration between chemotherapy completion and EA treatment initiation ranged between 4-92 months, with a median of 29 months. Eight (40%) patients were taking gabapentin, 2 (10%) on duloxetine, 1 (5%) pregabalin, and 3 (15%) on NSAIDS before and during the study. The study met its primary endpoint of feasibility, with 18 of 20 (90%) patients completing 8 or more EA sessions. Pain level, as assessed by the worst pain score on BPI-SF, improved significantly from a mean of 6.3 to 3.7, 2 weeks after completion of EA treatments (p = .0058). FACT/GOG-NTX quality of life measurement, “I am bothered by side effects of my treatment” also significantly improved from a mean score of 2.1 to 0.8 (p = .0177). There were no major adverse events (AEs) related to EA. Nine mild AEs were noted among 6 (30%) patients; localized skin biopsy site infections: G1=3, G2=3, nonlocalized cellulitis G3=1, Fatigue G1-2 =2. The localized skin biopsy site infections led to the discontinuation of further skin biopsy procedures. [We will also present data on the IEND for the nine patients who have paired before and after skin punch biopsies – this will be available at the time of the conference.] Conclusion: Electroacupuncture is a feasible treatment for CIPN. Furthermore, this pilot study did show a benefit for perceived pain and quality of life. Further studies will need to be conducted in regards to longevity of response. As larger studies in the future confirm the benefit of acupuncture, insurance payors are more likely to cover this important service. Citation Format: Nikitha Vobugari, John Paul Liang, Loni Savage, Dharamvir Jain, Kai Sun, Hanh Mai, Jenny Chang, Monica Desai, Tejal Patel, Polly Niravath. A Single-Arm Pilot Study of the Feasibility and Efficacy of Electro-Acupuncture in Subjects with Chemotherapy-Induced Peripheral Neuropathy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-09.

Abstract PO2-12-05: Scalp Cooling with the Capelli System to Reduce Doxorubicin-induced Alopecia in Patients with Localized Breast Cancer: A Phase 2 Randomized Controlled Trial

Abstract Introduction: Chemotherapy-induced alopecia (CIA) is a distressing side effect of breast cancer (BC) treatment. Scalp cooling (SC) devices have shown promise in reducing the severity of CIA. However, the impact of reducing alopecia occurrence on the quality of life of Brazilian patients remains unclear. Objectives: This study aimed to assess the effectiveness of the Capelli System, a new SC device, in reducing CIA. Methods: This was a single-center, controlled, randomized phase 2 clinical trial involving women with TNM stage I to III BC undergoing neoadjuvant or adjuvant doxorubicin-based chemotherapy (AC regimen: doxorubicin 60 mg/m² plus cyclophosphamide 600 mg/m², i.v., q21 days), with or without a taxane (paclitaxel or docetaxel). Participants were randomized in a 1:3 ratio into the scalp cooling (n = 33) or control (n = 12) groups. All participants were advised to cut their hair short and avoid heat-inducing tools or processes throughout chemotherapy, using cold or lukewarm water and wide-toothed combs for hair washing. The primary efficacy endpoint was grade 2 alopecia (>50% hair loss or hair shaving due to alopecia) after 4 cycles of AC. Secondary endpoints included measures of hair loss distress (BRHL) and body image (BRBI) from the EORTC Quality of Life Questionnaire - Breast Cancer Module (EORTC QLQ-BR23), as well as symptoms of anxiety and depression from the Hospital Anxiety and Depression Scale (HADS). Fitzpatrick phototype and hair type were assessed. Statistical analyses utilized generalized linear models and Fisher's Exact test (p-value < 0.05). Results: Patients were enrolled from October 11, 2019, to January 17, 2022. Out of the 45 patients included, 8 were excluded: 2 due to intolerance, 1 with alopecia associated with COVID-19, and 5 who withdrew consent (2 with grade 2 headache, 3 without justification). The median age was 44.6 (min-max: 23-63) years, with 18 (40%) and 27 (60%) receiving adjuvant and neoadjuvant chemotherapy, respectively. Grade 2 alopecia or hair shaving occurred in 52% of scalp cooling patients and 100% of controls (p = 0.003), demonstrating a significant 48% reduction in alopecia. There were no significant differences in HADS-A, HADS-D, BRHL, or BRBI scores between the two groups. Alopecia occurrence did not show significant associations with skin or hair types. No serious adverse events related to the scalp cooling device were reported. Conclusions: SC with the Capelli System significantly reduced CIA by half. Some patients experienced discomfort or headaches and discontinued device use. Further research is needed to understand why reduced alopecia rates do not correlate with improvements in body image or reduced hair loss distress. Citation Format: Carlos Paiva, Fabiola Dias, Angelo Matthes, Bianca Paiva, Cristiano Souza, Domício Lacerda, Augusto Antoniazzi, Maria Fernanda Machado, Matheus Godinho, Crislaine de Lima, Cristiane Cárcano, Marina Zorzetto. Scalp Cooling with the Capelli System to Reduce Doxorubicin-induced Alopecia in Patients with Localized Breast Cancer: A Phase 2 Randomized Controlled Trial [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-12-05.

Design of advanced buccal films with kiwiberry extract to prevent oral mucositis: From in vitro buccal models to ex vivo studies

Oral mucositis (OM) is a common side effect of cancer treatments characterized by disruption of the oral mucosa integrity, inflammation, and pain. The treatment strategies to prevent and treat OM are still unsatisfactory, leading to the search of new active compounds, particularly from natural sources, such as Actinidia arguta fruits. A. arguta is a perennial vine and its fruit, commonly known as kiwiberry, has been associated with different therapeutic properties and pro-healthy benefits, particularly antioxidant, anti-inflammatory and anticancer effects. These bioactive properties are due to the fruit outstanding content in phenolic compounds, vitamins, and organic acids, which attracted the researcher's attention for potential application in pharmaceutical industry. The aim of this study is to develop buccal films with A. arguta fruit extract as active ingredient to prevent OM symptoms. The films were prepared by solvent casting after placing 50 g of a buccal film mixture prepared with 1% of HPMC K100 LV EP, 2.5% glycerin, and 100 mL of A. arguta extract as solvent. Different films parameters were assessed, namely physical features (weight: 194.8 mg; thickness: 0.37 mm; disintegration time: 15.05 min; moisture content: 10.53%; swelling capacity: 55.95%), mechanical properties (resistance to extension: 10.11 N; percent of elongation: 36.10%; Young's modulus: 0.0034 MPa) and antioxidant/antiradical activities (TPC = 6.46 mg GAE/g film; FRAP = 49.45 μmol FSE/g film; ABTS = 3.74 mg AAE/g film; DPPH = 4.90 mg TE/g film). In vitro cell assays attested the absence of negative effects on HSC-3 and TR146 oral cell lines. Most important, the compounds release profile were assessed through in vitro and ex vivo models coupled to LC/DAD-ESI-MS quantification and the results revealed high permeation of rutin, quercetin-3-O-glucoside and catechin. Overall, these results highlight the significant potential of buccal films with A. arguta fruit extract to prevent OM condition.

Multidisciplinary analysis of cancer-related fatigue at the time of diagnosis: preliminary results of the BIOCARE FActory cohort.

Cancer-related fatigue (CRF) is a common side effect of cancer and cancer treatment that significantly impairs the quality of life and can persist for years after treatment completion. Although fatigue is often associated with cancer treatment, it is also a result of the disease itself, even before intervention. CRF at the time of diagnosis may affect treatment timing or completion and is a consistent predictor of post-treatment fatigue at any time. The mechanisms underlying CRF are multidimensional and not well understood, particularly at the time of diagnosis. Sixty-five breast cancer patients at the time of diagnosis were included. The participants completed self-assessment questionnaires about CRF, sleep disturbances, and emotional symptoms and wore an accelerometer to assess levels of spontaneous physical activity and sleep quality. During the experimental session, the participants underwent cognitive, neuromuscular, and exercise metabolism evaluations. Using augmented backward elimination regression, this study found that emotional symptoms and perceived sleep disturbances were the strongest predictors of CRF (adjusted r2 = 0.51). Neuromuscular fatigability and sleep disturbance were also associated with physical dimensions, whereas cognitive performance was associated with cognitive dimensions. At the time of diagnosis, emotional and cognitive dimensions are over-represented compared to the general population, and specific subdimensions have specific predictors that support the idea of distinct mechanisms. Evaluating CRF subdimensions and their potential mechanisms at the time of diagnosis would be particularly relevant for identifying high-risk patients and offering them appropriate interventions. This study was registered at ClinicalTrials.gov (NCT04391543) in May, 2020.

Atorvastatin attenuates intestinal mucositis induced by 5-fluorouracil in mice by modulating the epithelial barrier and inflammatory response

Chemotherapy-induced intestinal mucositis is a major side effect of cancer treatment. Statins are 3-hydroxy-3-methyl glutaryl coenzyme reductase inhibitors used to treat hypercholesterolemia and atherosclerotic diseases. Recent studies have demonstrated that atorvastatin (ATV) has antioxidant, anti-inflammatory, and resulting from the regulation of different molecular pathways. In the present study, we investigated the effects of ATV on intestinal homeostasis in 5-fluorouracil (5-FU)-induced mucositis. Our results showed that ATV protected the intestinal mucosa from epithelial damage caused by 5-FU mainly due to inflammatory infiltrate and intestinal permeability reduction, downregulation of inflammatory markers, such as Tlr4, MyD88, NF-κB, Tnf-a, Il1β, and Il6 dose-dependent. ATV also improved epithelial barrier function by upregulating the mRNA transcript levels of mucin 2 (MUC2), and ZO-1 and occludin tight junction proteins. The results suggest that the ATV anti-inflammatory and protective effects on 5-FU-induced mice mucositis involve the inhibition of the TLR4/MYD88/NPRL3/NF-κB, iNos, and caspase 3.

The role of food during oncology treatment: perspectives of cancer patients, caregivers and healthcare professionals

PurposeMany cancer patients have problems eating which are usually connected to taste and smell alterations due to side effects of cancer treatment. These problems have consequences both in terms of malnutrition and reduced quality of life. In order to explore social and psychological consequences of eating problems in cancer patients, qualitative interviews were conducted with cancer patients, their caregivers and healthcare professionals.MethodsThe study was conducted in three European countries (Poland, Spain and the UK) that differed in culture, oncology care approaches and availability of nutritional products targeted to cancer patients in the market.ResultsDifferences in the social role of eating between the three European countries were observed which subsequently influenced the impact of eating problems for cancer patients in these countries. Furthermore, the study found that problems with food affect not only the quality of life of cancer patients, but can also distress their caregivers, who are often unable to cope with such food-related problems. In addition, the study showed that commercially available nutritional products for cancer patients focus on nutritional value but tend to neglect an important aspect of eating, which is the enjoyment of food, both individually and socially.

Pegylated-liposomes increase the efficacy of Idelalisib in lymphoma B-cells

New drugs and technologies are continuously developed to improve the efficacy and minimize the critical side effects of cancer treatments. The present investigation focuses on the development of a liposomal formulation for Idelalisib, a small-molecule kinase inhibitor approved for the treatment of lymphoid malignancies. Idelalisib is a potent and selective antitumor agent, but it is not indicated nor recommended for first-line treatment due to fatal and serious toxicities. Herein, liposomes are proposed as a delivery tool to improve the therapeutic profile of Idelalisib. Specifically, PEGylated liposomes were prepared, and their physicochemical and technological features were investigated. Light-scattering spectroscopy and cryo-transmission electron microscopy revealed nanosized unilamellar vesicles, which were proved to be stable in storage and in simulated biological fluids.The cytotoxicity of the liposome formulation was investigated in a human non-Hodgkin's lymphoma B cell line. Idelalisib was able to induce death of tumor cells if delivered by the nanocarrier system at increased efficacy. These findings suggest that combining Idelalisib and nanotechnologies may be a powerful strategy to increase the antitumor efficacy of the drug.

Hormonal basis of brain fog in cancer treatment.

The cognitive side effects of cancer treatment are common, but no targeted therapy exists yet to treat or prevent such neurological sequelae. We explore the role of hormones as mediators between cancer therapy and cognitive impairment, discussing potential future directions.

Hyaluronic acid functionalized iron–platinum nanoparticles for photothermal therapy and photoacoustic imaging

This study represents an innovative approach to construct multi-functional nanoplatforms for cancer diagnosis and therapy by combining hyaluronic acid (HA) with iron-platinum nanoparticles (FePt NPs). These HA-coated FePt NPs, referred to as FePt@HA NPs, demonstrated remarkable biocompatibility, high absorption, and excellent light-to-heat conversion properties in the near-infrared (NIR) region, making them ideal candidates for photothermal therapy (PTT). In vitro studies revealed their effective cancer cell eradication under NIR laser irradiation, while in vivo experiments on mice showcased their superior heating capabilities. Moreover, FePt@HA NPs exhibited a distinct and strong photoacoustic (PA) signal, facilitating enhanced and precise intra-tumoral PA imaging. Our results highlight the potential of FePt@HA NPs as promising photothermal agents for future PTT applications. They offer high selectivity, precision, and minimal side effects in cancer treatment, along with their valuable PA imaging application for tumor localization and characterization.

Plasma Lipidomic Profiling Identifies Elevated Triglycerides as Potential Risk Factor in Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect of cytotoxic cancer treatment, often necessitating dose reduction (DR) or chemotherapy discontinuation (CD). Studies on peripheral neuropathy related to chemotherapy, obesity, and diabetes have implicated lipid metabolism. This study examined the association between circulating lipids and CIPN. Lipidomic analysis was performed on plasma samples from 137 patients receiving taxane-based treatment. CIPN was graded using Total Neuropathy Score-clinical version (TNSc) and patient-reported outcome measure European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN (EORTC-QLQ-CIPN20). A significant proportion of elevated baseline lipids were associated with high-grade CIPN defined by TNSc and EORTC-QLQ-CIPN20 including triacylglycerols (TGs). Multivariable Cox regression on lipid species, adjusting for BMI, age, and diabetes, showed several elevated baseline TG associated with shorter time to DR/CD. Latent class analysis identified two baseline lipid profiles with differences in risk of CIPN (hazard ratio, 2.80 [95% CI, 1.50 to 5.23]; P = .0013). The higher risk lipid profile had several elevated TG species and was independently associated with DR/CD when modeled with other clinical factors (diabetes, age, BMI, or prior numbness/tingling). Elevated baseline plasma TG is associated with an increased risk of CIPN development and warrants further validation in other cohorts. Ultimately, this may enable therapeutic intervention.

The N-LVA Study: effectiveness and cost-effectiveness of lymphaticovenous anastomosis (LVA) for patients with cancer who suffer from chronic peripheral lymphoedema – study protocol of a multicentre, randomised sham-controlled trial

IntroductionCancer-related lymphoedema is one of the most debilitating side-effects of cancer treatment with an overall incidence of 15.5%. Patients may suffer from a variety of symptoms, possibly resulting in a...

Making Sense of Gynecologic Cancer: A Relational Dialectics Approach

ABSTRACT This study used the relational dialectics theory (RDT) as a theoretical lens to examine how the interplay of competing discourses shaped meaning making about gynecologic cancer. A reflexive thematic analysis of the narratives of 12 survivors of cervical cancer, ovarian cancer, and uterine cancer in Arkansas showed two discursive struggles at play, including continuity of care versus change, and voicing versus repressing of feelings. The findings showed that long history of care with physicians contributed to how participants privileged the discourse of continuity of care when faced with a decision to travel for care or receive care locally. We also found that cultural discourses about concealing women’s cancer-afflicted bodies, lack of supportive spaces for women to discuss side effects of cancer treatments, and appropriate communication behavior between patients and physicians shaped the interplay of the discursive struggle of voicing versus repressing. The findings extend the RDT by showing that geographic location, disease characteristics, history of care between patients and physicians, and prevailing cultural discourses can contribute to the interplay of discursive struggles in the gynecologic cancer context. Further, the findings suggest to healthcare professionals to address harmful discourses about gynecologic cancer to help create support avenues for survivors.

Quality of Life and Associated Factors among Cancer Patients Receiving Chemotherapy during the COVID-19 Pandemic in Thailand.

The dynamics of the COVID-19 pandemic have significantly changed since its initial outbreak. This study aimed to investigate the quality of life (QoL) of patients with cancer receiving chemotherapy in the specific context of Thailand during the COVID-19 pandemic. A cross-sectional study was conducted with 415 patients with cancer. Instruments used were a demographic and clinical characteristics form, the Edmonton Symptom Assessment Scale (cancer symptom burden), Strategies Used by People to Promote Health (self-care self-efficacy), and a Thai version of the Brief Form of the WHO Quality of Life Assessment. Data were analyzed using descriptive and inferential statistics. The participants had an average age of 56 years. They reported a moderate level of QoL across all domains and for the overall QoL during the pandemic. The results of the multiple linear regression model indicated that positive self-care self-efficacy, being married, having health insurance, stage of chemotherapy, and reduced cancer symptom burden were significant predictors of overall QoL (adjusted R2 = 0.4940). Positive self-care self-efficacy also emerged as a primary predictor, positively influencing all QoL domains and overall QoL (p < 0.001). These findings emphasize the significance of self-care self-efficacy in enhancing the QoL of patients with cancer undergoing chemotherapy during the pandemic. Integrating interventions to bolster self-care self-efficacy into the care plans for these patients can help them manage their symptoms, cope with the side effects of cancer treatment, and enhance their overall well-being.

Evolution of Radiotherapy- A Brief Review

Beginning with the discovery of X-rays by Wilhelm Conrad Röntgen in 1895 and the subsequent application of X-rays for cancer treatment in 1896, the narrative unfolds through the advancements in radiation therapy modalities. The discussion covers External Beam Radiotherapy (EBRT), including various techniques like 3D-CRT, IMRT, IGRT, stereotactic radiotherapy, and proton therapy. Emerging technologies such as Tomotherapy, Stereotactic Radiosurgery (SRS), Boron Neutron Capture Therapy (BNCT), Carbon Ion Therapy, and Brachytherapy are explored, offering tailored approaches for different cancer types. The article delves into the history and advancements of brachytherapy, highlighting its techniques like intracavitary, interstitial, and HDR surface mould brachytherapy. The continuous pursuit of precision, efficacy, and reduced side effects in cancer treatment is evident throughout the narrative. The article emphasizes the crucial role of radiation therapy, employing various ionizing radiation types, in targeting and eradicating cancer cells while minimizing harm to normal cells. The ongoing quest for advancements in technology and techniques reflects the commitment to improving cancer treatment outcomes. This article provides a comprehensive overview of radiation therapy's historical evolution and current state in cancer treatment Keywords: Radiotherapy, EBRT, Brachytherapy, IMRT, SRS, IGRT, Proton therapy

Development and Validation of a Chromatographic Method for Ibrutinib Determination in Human and Porcine Skin

Ibrutinib (IBR) is a tyrosine kinase inhibitor investigated for treating solid and non-solid tumors. Considering the advantages that a topical application of IBR could generate in terms of dose reduction and side effects in skin cancer treatment, this paper presents a simple and selective HPLC method for determining IBR concentration in in vitro skin permeation studies to support the development of topical formulations. The method uses a reversed-phase C18 column and a mobile phase composed of acetonitrile and 0.01 mol/L phosphoric acid at pH 3.5 (35:65 v/v), flowing at 1.0 mL/min. The oven temperature was set at 35 °C, the injection volume was 20 μL, and UV drug detection was performed at 259 nm. The validation procedure certified that this method was selective for IBR determination even when extracted from human or porcine skin matrices. The method was linear over a range of 0.2 to 15.0 μg/mL, precise, robust, and accurate, with recovery rates from the skin layers higher than 89.5 ± 5.9% for the porcine skin and higher than 92.0 ± 0.2% for the human skin. The limits of detection and quantification were 0.01 and 0.02 μg/mL, respectively. The method showed, therefore, to be adequate for use in further skin permeation studies employing IBR topical formulations.

Exosomes: A Cutting-Edge Theranostics Tool for Oral Cancer.

Exosomes are a subpopulation of extracellular vesicles (EVs) secreted by cells. In cancer, they are key cellular messengers during cancer development and progression. Tumor-derived exosomes (TEXs) promote cancer progression. In oral cancer, the major complication is oral squamous cell carcinoma (OSCC). Exosomes show strong participation in several OSCC-related activities such as uncontrolled cell growth, immune suppression, angiogenesis, metastasis, and drug and therapeutic resistance. It is also a potential biomarker source for oral cancer. Some therapeutic exosome sources such as stem cells, plants (it is more effective compared to others), and engineered exosomes reduce oral cancer development. This therapeutic approach is effective because of its specificity, biocompatibility, and cell-free therapy (it reduced side effects in cancer treatment). This article highlights exosome-based theranostics signatures in oral cancer, clinical trials, challenges of exosome-based oral cancer research, and future improvements. In the future, exosomes may become an effective and affordable solution for oral cancer.

Aqueous Extract of Leaves and Flowers of Acmella caulirhiza Reduces the Proliferation of Cancer Cells by Underexpressing Some Genes and Activating Caspase-3.

The increasing prevalence of cancers and the multiple side effects of cancer treatments have led researchers to constantly search for plants containing bioactive compounds with cell death properties. This work aimed at evaluating the antiproliferative effect of an Acmella caulirhiza extract. After evaluation of the in vitro antioxidant potential of the three extracts of Acmella caulirhiza (aqueous (AE-Ac), hydroethanolic (HEE-Ac), and ethanolic (EE-Ac)) through the scavenging of DPPH● and NO● radicals, the extract with the best antioxidant activity was selected for bioactive compound assessment and antiproliferative tests. Subsequently, the cytotoxic activity was evaluated on the viability of breast (MCF-7), brain (CT2A, SB-28, and GL-261), colon (MC-38), and skin (YUMM 1.7 and B16-F1) cancer lines using the MTT method. Then, the line where the extract was the most active was selected to evaluate the expression of certain genes involved in cancerogenesis by RT-PCR and the expression of cleaved caspase-3 involved in cell death mechanism by western blot. The AE-Ac showed the best scavenging activity with IC50s of 0.52 and 0.02 for DPPH● and NO●, respectively. This AE-Ac was found to contain alkaloids, flavonoids, and tannins and was more active on YUMM 1.7 cells (IC50 = 149.42 and 31.99 μg/mL for 24 and 48 h, respectively). Results also showed that AE-Ac downregulated the expression of inflammation (IL-1b (p = 0.017) and IL-6 (p = 0.028)), growth factors (PDGF (p = 0.039), IGF (p = 0.034), E2F1(p = 0.038), and E2F2(p = 0.016)), and antiapoptotic protein genes (Bcl-2 (p = 0.028) and Bcl-6 (p = 0.039)). The cleaved caspase-3 was positively modulated by the AE-Ac inducing thus cell death by apoptosis. AE-Ac showed inhibitory effects on the expression of genes involved in cancer progression making it a potential health intervention agent that can be exploited in cancer therapy protocols.

Nanoliposome-loaded phenolics from Salvia leriifolia Benth and its anticancer effects against induced colorectal cancer in mice.

Colon cancer is one of the leading causes of death among various types of cancer. Despite the significant progress made in cancer treatment, chemotherapy resistance and various side effects are still prevalent. The objective of this study is to assess the therapeutic potential of phenolic-rich fraction encapsulated nanoliposome (PRF-NLs) of Salvia leriifolia Benth in the treatment of colon cancer in mice. Initially, the phenolic-rich fraction (PRF) was extracted and then encapsulated into nanoliposomes. The physicochemical properties of the nanoliposomes were evaluated using dynamic light scattering, zeta potential, and field emission scanning electron microscopy. Subsequently, 24 mice with HT-29 colon cancer cells were divided into three groups, and the anticancer effects of PRF-NLs were measured. The results showed that the ethyl acetate fraction of S. leriifolia was the highest PRF containing 14.27 ± 2.39mg (gallic acid) GA/g DW (dry weight), and the PRF successfully loaded into the nanoliposome structure resulted in the synthesis of nanoliposomes with a nanometer size and spherical shape and homogenous dispersion. Some of the abundant bioactive phenolic compounds in the nanoliposome-loaded PRF are salicylic acid and naringin. The average daily weight gain and food intake, and changes in the expression of caspase 3, Bax (Bcl-2 associated X-protein), and Bcl2 (B-cell lymphoma 2), inducible nitric oxide synthase genes, were observed in the mice group induced colorectal cancer cells. At a dose of 100mg TPC (total phenolic content)/kg BW/day, the nonencapsulated PRF dietary addition improved these parameters; however, the potential shown by nanoliposome-encapsulated PRF than the nonencapsulated PRF in enhancing health parameters in mice was higher. The developed intestinal absorption and bioavailability of nanoliposome-encapsulated PRF contribute to its increased health-promoting activity. Thereby, the synthesized nanoliposome may be a potential natural anticancer drug to prevent colorectal cancer.