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系统癌症时间疗法及其与家庭护理的整合

Toward Systems Cancer Chronotherapeutics and its integration into home care
课程网址: http://videolectures.net/mdo2014_levi_cancer_treatments/  
主讲教师: Francis Lévi
开课单位: 华威大学
开课时间: 2014-07-21
课程语种: 英语
中文简介:
时间疗法旨在通过根据生物钟计时系统(CTS)提供药物来改善治疗效果,CTS是一个复杂的层次结构和动态网络系统,涉及人体所有细胞。因此,在实验模型和癌症患者中,昼夜节律时间改变了抗癌药物耐受性的10倍。然而,在涉及大量转移性结直肠癌患者的国际研究中,性别、昼夜节律紊乱和肿瘤蛋白表达是最佳时间治疗方案的独立决定因素。这些临床数据推动了在小鼠身上的实验证实研究。此外,对癌症患者的临床疗效进行了随机对照分析,其中56例癌症患者的临床疗效较好。随机和确定性数学模型有助于分析生物钟、细胞周期和药物药效学之间从单个细胞到整个生物体的动态相互作用。生物模拟导致了基于模型的最佳时间疗法计划的设计,通过探索广泛的参数值,如伊立替康所示。时间咽动力学建模的系统方法进一步揭示了最佳的时间疗法要求昼夜夹带在健康细胞中是健壮的,在癌细胞中是被破坏的。此外,根据基因型和性别,小鼠的最佳化疗时间可长达8小时,这一发现与在癌症患者身上观察到的结果相似。将Rev-erba和Bmal1这两个相互调节的时钟基因的肝脏昼夜节律表达模式作为一个数学模型的输入,该模型设计并能够识别伊立替康的最佳昼夜节律,而不考虑基因型和性别。在实践中,无创可靠的昼夜节律生物标志物对于模拟CTS动力学以及通过干预措施提高CTS的稳健性以及有效地个性化昼夜节律给药时间表至关重要。
课程简介: Chronotherapeutics aim at improving treatment outcomes through the delivery of medicines according to the Circadian Timing System (CTS), a complex hierarchical and dynamic network system involving all cells in the body. As a result, circadian timing modifies up to 10-fold the tolerability of anticancer medications in experimental models and in cancer patients. However, sex, circadian disruption and tumor protein expressions are independent determinants of the optimal chronotherapeutic schedule, in international studies involving large number of patients with metastatic colorectal cancer. Such clinical data have driven experimental confirmation studies in mice. Moreover, human cancer chronotherapeutics constitute a unique paradigm for cancer therapy, where "the lesser the toxicity, the better the efficacy", based on several land mark analyses of a randomized clinical trial involving 564 patients. Stochastic and deterministic mathematical models help analyze the dynamic interactions between circadian clocks, cell cycle and drug pharmacodynamics from single cell to whole organism. Biosimulation leads to the design of model-based optimal chronotherapeutic schedules, through the exploration of a wide range of parameter values, as shown for irinotecan. The systems approach to chronopharmacokineticschronopharmacodynamics modeling further reveals that optimal chronotherapeutics require circadian entrainment to be robust in healthy cells and disrupted in cancer cells. Moreover, optimal chemotherapy timing can vary by up to 8 h according to genotype and sex in mice, a finding similar to that observed in cancer patients. The liver circadian expression patterns of Rev-erba and Bmal1, two clock genes that regulate each other, were used as inputs into a mathematical model that was designed and enabled the identification of optimal circadian timing of irinotecan irrespective of genotype and sex. In practice, non invasive reliable circadian biomarkers are critical for modeling CTS dynamics as well as for increasing CTS robustness through intervention measures, and effectively personalizing circadian drug delivery schedules.
关 键 词: 慢性疗法; 药物; 健康
课程来源: 视频讲座网
数据采集: 2020-12-14:yxd
最后编审: 2020-12-14:yxd
阅读次数: 62