Encouraging news came from the land of the rising sun: Japanese scientists managed to make a breakthrough in the fight against cancer cells. Two years earlier, Dr. Signe Yamanaka, using laboratory methods, derived iPS - induced pluripotent stem cells, for which he was awarded the 2012 Nobel Prize in Medicine. But the victory was incomplete, because iPS is too unstable. They perish, not having time to destroy their goal - malignant cancer cells.
And the scientific portal techno.bigmir.net brought long-awaited good news about the fate of the Japanese discovery. A team of scientists was able to synthesize resistant T-lymphocytes on the basis of iPS that can attack cancer cells and fight the disease. Such natural killer cells are in the body of any person, but they are produced in quantities insufficient for a convincing victory over cancer.
The head of the research project, Dr. Kawamoto, spoke about the essence of the revolutionary development. Scientists had to do double work: first, to get iPS from human lymphocytes, and then to make resistant T-lymphocytes from stem cells. Now the team is coming large-scale studies - you need to empirically determine whether new artificial T-lymphocytes are active only against tumor cells, or they will begin to destroy also healthy cells of the body.
While there are no results of clinical studies, cancer patients have to rely on drugs that have been tested and proven effective, but which have a number of unpleasant side effects. One of these drugs is Temodal.
Temodal: instructions for use
The active component of the drug Temodal is temozolomide, an anticancer alkylating agent with an imidazotetrazine structure. Once in the bloodstream, it enters into a chemical reaction, the result of which is a special substance known by the abbreviation MTIK (monomethyltriazenoimidazolcarboxamide). It is the most powerful cytotoxin - killer of cancer cells. The bad news is that temozolomide has a detrimental effect on healthy tissue. Although it can be said about all modern chemotherapy drugs.
Temodal is manufactured by the German pharmaceutical giant Schering Plow and is considered the highest quality and most reliable drug based on temozolomide. There is the Indian counterpart of the same name, which is a bit cheaper.
Release form and chemical composition
Temodal is available in capsules with four dosage options: 5, 20, 100 or 250 mg of temozolomide in one capsule. In addition, the preparation contains a number of auxiliary components: starch, gelatin, sodium lauryl sulfate, stearic and tartaric acids, titanium dioxide, sodium carboxymethyl, silica and anhydrous milk sugar. In one pack of Temodal there are 5 or 20 capsules.
Indications for use Temodala
The drug is prescribed in three cases of cancer:
As a primary therapeutic agent in the treatment of malignant melanoma with numerous metastases,
As an adjunct to radiation therapy in the treatment of primary polymorphic glioblastoma, in this case, subsequent adjuvant therapy with Temodal is required,
As a remedy against the 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:
Congenital lactose intolerance or lack of lactase,
Pregnancy and lactation,
Children up to 3 years old and older than 70 years old,
Patients with primary malignant glioma under 18 years of age are usually not prescribed Temodal. 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.
Methods of treatment
Temodal take on an empty stomach, drinking a full glass of water, in any case, not chewing the capsule. The primary task of the treating oncologist is to correctly calculate the dosage and dispense with the minimum amount of the drug.
Consider first the primary therapy, which is always combined with radiation therapy. The course lasts forty-two days, but may be extended for a week if during this period it was necessary to suspend the medication due to strong side effects. Every day, the patient must take one capsule of Temodal with a dosage of 75 mg. During the entire course of primary therapy weekly monitoring of the most important indicators of the blood condition is carried out. This is what they should be like so that the drug is not interrupted:
Toxicity level - not more than 1 degree,
Neutrophils - not less than 1500 per 1 μl,
Platelets - not less than 100 thousand per 1 μl.
Now consider adjuvant monotherapy. It is started 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 each; during the first five days of the first cycle, the patient takes 150 mg temozolomide, and then, starting from the second cycle, 200 mg. After a five-day medication, a rest period follows - 23 days, then the cycle repeats. It is important to note that an increase in dosage from 150 to 200 mg of Temodal is possible only in the case of good tolerability, and if the indicators of the blood condition meet the above requirements.
Side effects Temodala
Unfortunately, almost no one can manage 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 the unpleasant effects most frequently occurring during Temodal's reception:
Nausea and vomiting, diarrhea and constipation, bowel incontinence and increased gas formation in the intestines, poor appetite, rapid weight loss, anorexia and hyperglycemia, pain in the liver and epigastria,
Anemia, leukopenia and neuropenia, small hemorrhages on mucous membranes and skin,
Decreased sexual desire, aggravation of genital herpes, candidiasis and vaginitis, urinary incontinence, erection problems and discomfort during ejaculation,
Pneumonia and bronchitis, shortness of breath, apnea and shortness of breath,
Convulsions and misoperation, dizziness and loss of consciousness, headaches and dizziness, sleep disturbances and memory loss, chronic fatigue syndrome and depression, epileptic seizures and mental disorders, unintelligible speech and hallucinations.
Interaction with other drugs Temodala
If this medicine is taken together with other drugs that have a negative effect on the bone marrow, this can significantly increase the risk of myelosuppression. It is also known that valproic acid somewhat reduces the rate and quality of Temodal's absorption, therefore their combined administration is undesirable.
In itself, the active substance temozolomide almost does not bind to blood proteins and is excreted mainly by the kidneys, and not by the liver. Therefore, Temodal has almost no effect on the clearance of other drugs, which makes it possible to combine it with many drugs without compromising the quality of the therapy being performed.
Important Information about Temodal
If the patient or patient is in childbearing age, for the duration of the therapy, as well as for at least six months after its termination, they must be carefully protected. It is practically impossible to conceive and carry out a healthy child against the background of such treatment, while the Temodal can cause disruptions in the ovaries and provoke additional untimely ovulation. It is recommended to use barrier methods of contraception even in those days when conception usually does not occur.
Prolonged treatment with Temodal, unfortunately, can cause infertility in patients of both sexes. Therefore, it is better to seriously think about cryopreservation of eggs and sperm, if there is a relapse of cancer, and a long struggle is ahead.
The capsules of the drug should 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 quickly as possible with plenty of cool running water.
People employed at work that require increased concentration of attention (drivers of vehicles, operators of complex production equipment) should take into account the destructive effect of Temodal on the nervous system. Drowsiness and impaired coordination of movement are possible, so for the duration of the therapy it is better to go to hospital or change the type of activity.
Education: He graduated from the residency in the "Russian Scientific Oncological Center named. N. N. Blokhin "and received a diploma in" Oncologist "