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Objective: Myrica esculenta (family Myricaceae), a valuable plant species in China and India, has been traditionally used by many tribes and local communities to manage gut disorders. Scientific validation of its anti-ulcerative colitis activity was aimed. Methods: The ethyl acetate fraction of Myrica esculenta (MeEa) was prepared and evaluated for its potency against DSS-induced ulcerative colitis (UC) in mice at 200 and 400 mg/kg BW oral dose. The effective dose of MeEa was determined through its effect on DSS-induced UC and was further analyzed through its effects on disease activity index (DAI), colon length, colon weight/length ratio, spleen weight, serum and colon tissue cytokine level, cell count and hemoglobin content. Further, the effect was determined through histopathology and FITC-dextran-induced membrane permeability assay. Results: Between the two doses, MeEa at 400 mg/kg BW was found to be the most effective dose in terms of reduced DAI scores, protected colon length from shortening, decreased colon weight/length ratio, reduced spleen weight, decreased pro-inflammatory cytokine level and stabilized the anti-inflammatory cytokine level in serum and colon tissue. MeEa 400 reduced cell counts and increased hemoglobin content and platelet count. MeEa 400 also prevented the colon by protecting epithelial cells and crypts. MeEa 400 provided significant protection from intestinal leakage and reduced FITC dextran level in serum. Discussion: MeEa 400 possesses significant anti-inflammatory potential and acts via attenuation of DSS-induced UC and inhibition of DAI scores. It reduces pro-inflammatory cytokines and stabilizes anti-inflammatory cytokine levels, reduces cell count, and protects epithelial tissue and crypts in the colon, as well as intestinal membrane leakage that occurred due to FITC-dextran administration in mice.

Abstract Epigenetic modulation is well established in hematologic malignancies but to a lesser degree in solid tumors. Here we report the results of a phase Ib/II study of guadecitabine and durvalumab in advanced clear cell renal cell carcinoma (ccRCC; NCT03308396). Patients received guadecitabine (starting at 60 mg/m2 subcutaneously on days 1-5 with de-escalation to 45 mg/m2 in case of dose limiting toxicity) with durvalumab (1500 mg intravenously on day 8). The study enrolled 57 patients, 6 in phase Ib with safety being the primary objective and 51in phase II, comprising 2 cohorts: 36 patients in Cohort 1 were treatment naive to checkpoint inhibitors (CPI) with 0-1 prior therapies and 15 patients in Cohort 2 were treated with up to two prior systemic therapies including one CPI. The combination of guadecitabine 45 mg/m2 with durvalumab 1500 mg was deemed safe. The primary objective of overall response rate (ORR) in cohort 1 was 22%. Sixteen patients (44%) experienced stable disease (SD). Secondary objectives included overall survival (OS), duration of response, progression-free survival (PFS), clinical benefit rate, and safety as well as ORR for Cohort 2. Median PFS for cohort 1 and cohort 2 were 14.26 and 3.91 months respectively. Median OS was not reached. In cohort 2, one patient achieved a partial response and 60% achieved SD. Asymptomatic neutropenia was the most common adverse event. Even though the trial did not meet the primary objective in cohort 1, the tolerability and PFS signal in CPI naive patients are worth further investigation.

Background. Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) delineated by inflammation or ulcers in the colon that may cause diarrhea, abdominal pain, blood in the stool, tenesmus, etc. Objective. To determine therapeutic effectiveness and explore the mechanism of MeEt extract against DSS (3%)-induced UC in Swiss albino mice. Methods. Six mice were allocated into five groups at random: group1: vehicle control; group 2: DSS control; group 3: DSS+mesalazine (MSZ, 100 mg/kg BW); group 4: DSS+MeEt (200 mg/kg BW); and group 5: DSS+MeEt (400 mg/kg BW). Except for group 1, DSS (3%) in drinking water was given to all other groups to induce UC. %BW, average food intake, and mean stool consistency were determined for obtaining DAI scores. Mice were euthanized on the 8th day, and colonic tissues were taken to measure the colon length. Serum and tissue levels of the cytokines were also determined using ELISA kits, followed by histopathological analysis of colon tissue. In addition, hematological and serum biochemical parameters were also determined to assess the treatment effectiveness. Result. During the induction, DAI scores, colon length, and cytokines levels were significantly increased. MSZ at 100 mg/kg BW and MeEt at 400 mg/kg BW doses via oral route significantly reversed the DAI scores and colon length. Further, MeEt 400 also downregulated the expression of IL-6, IL-8, TNF-α, IFN-γ, and IL-1 and upregulated the production of IL-1β and IL-10. Also, improvements in hematological and serum biochemical parameters were reported. Histopathological analysis revealed a decrease in inflammation and damage to colon tissue with the administration of MeEt extract. Conclusion. MeEt at a 400 mg/kg BW dose may be used as an alternate treatment for the management of UC, which is comparable with that of MSZ.

Background: Erdafitinib is indicated for the treatment of adults with locally advanced/metastatic urothelial carcinoma and susceptible FGFR3/2 alterations progressing on/after one or more lines of prior platinum-based chemotherapy. Objective: To better understand the frequency and management of select treatment-emergent adverse events (TEAEs) to enable optimal fibroblast growth factor receptor inhibitor (FGFRi) treatment. Design, setting, and participants: Longer-term efficacy and safety results of the BLC2001 (NCT02365597) trial in patients with locally advanced and unresectable or metastatic urothelial carcinoma were studied. Intervention: Erdafitinib schedule of 8 mg/d continuous in 28-d cycles, with uptitration to 9 mg/d if serum phosphate level was

Background: Limited information is available for patients with breast cancer (BC) and coronavirus disease 2019 (COVID-19), especially among underrepresented racial/ethnic populations. Methods: This is a COVID-19 and Cancer Consortium (CCC19) registry-based retrospective cohort study of females with active or history of BC and laboratory-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 2020 and June 2021 in the US. Primary outcome was COVID-19 severity measured on a five-level ordinal scale, including none of the following complications, hospitalization, intensive care unit admission, mechanical ventilation, and all-cause mortality. Multivariable ordinal logistic regression model identified characteristics associated with COVID-19 severity. Results: 1383 female patient records with BC and COVID-19 were included in the analysis, the median age was 61 years, and median follow-up was 90 days. Multivariable analysis revealed higher odds of COVID-19 severity for older age (aOR per decade, 1.48 [95% CI, 1.32–1.67]); Black patients (aOR 1.74; 95 CI 1.24–2.45), Asian Americans and Pacific Islander patients (aOR 3.40; 95 CI 1.70–6.79) and Other (aOR 2.97; 95 CI 1.71–5.17) racial/ethnic groups; worse ECOG performance status (ECOG PS ≥2: aOR, 7.78 [95% CI, 4.83–12.5]); pre-existing cardiovascular (aOR, 2.26 [95% CI, 1.63–3.15])/pulmonary comorbidities (aOR, 1.65 [95% CI, 1.20–2.29]); diabetes mellitus (aOR, 2.25 [95% CI, 1.66–3.04]); and active and progressing cancer (aOR, 12.5 [95% CI, 6.89–22.6]). Hispanic ethnicity, timing, and type of anti-cancer therapy modalities were not significantly associated with worse COVID-19 outcomes. The total all-cause mortality and hospitalization rate for the entire cohort was 9% and 37%, respectively however, it varied according to the BC disease status. Conclusions: Using one of the largest registries on cancer and COVID-19, we identified patient and BC-related factors associated with worse COVID-19 outcomes. After adjusting for baseline characteristics, underrepresented racial/ethnic patients experienced worse outcomes compared to non-Hispanic White patients. Funding: This study was partly supported by National Cancer Institute grant number P30 CA068485 to Tianyi Sun, Sanjay Mishra, Benjamin French, Jeremy L Warner; P30-CA046592 to Christopher R Friese; P30 CA023100 for Rana R McKay; P30-CA054174 for Pankil K Shah and Dimpy P Shah; KL2 TR002646 for Pankil Shah and the American Cancer Society and Hope Foundation for Cancer Research (MRSG-16-152-01-CCE) and P30-CA054174 for Dimpy P Shah. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH). The funding sources had no role in the writing of the manuscript or the decision to submit it for publication. Clinical trial number: CCC19 registry is registered on ClinicalTrials.gov, NCT04354701.

Bladder cancer can often exhibit genomic and morphological heterogeneity. Here, the authors use genomics analysis to show lineage plasticity of bladder cancers with squamous differentiation, and identify key transcription factors related to this morphological and immune heterogeneity.

The presence and persistence of hazardous contaminants including heavy metals and pharmaceutical compound in water have become a matter of great concern worldwide due to their negative impacts on the natural ecosystem and human health. Very few studies have been reported to check the efficiency of a nanosorbent for simultaneous removal of both the contaminants i.e., heavy metals and pharmaceutical compounds. Here, we have attempted to achieve removal of Cr(VI) and DFS by developing a suitable adsorbent. In this study, iron oxide/activated carbon (IAC) magnetic nanocomposite was used as a nanosorbent for decontamination of chromium (VI) and diclofenac sodium (DFS) from aqueous solution over a certain range of experimental parameters. Activated carbon was synthesized using green microalgae Chlamydomonas sp., while to make a sustainable novel nanosorbent, iron oxide nanorods were embedded in the matrix of activated carbon. The composition and structure of nanosorbents were characterized by scanning electron microscopy (SEM), energy dispersive X-ray (EXD) spectroscopy, Brunner-Emmett-Teller (BET), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). The batch adsorption studies were conducted from the removal of Cr(VI) and DFS from water by IAC sorbent. The maximum adsorption efficiency of 95.2 and 82.1% for Cr(VI) and DFS, respectively were achieved in less than 4 h for initial concentrations of 10 mgL−1. The adsorption of Cr(VI) and DFS was much higher at acidic pH than at alkaline range. The equilibrium data for Cr(VI) ions adsorption was fitted well with pseudo-second order kinetics, Langmuir isotherm model, Elovich and intraparticle diffusion model. 5 cycles of regeneration and reuse showed that sorption capacity individually decreased by 6.6 and 8.2% for Cr(VI) and DFS, respectively as compared to the original adsorption. Also, excellent magnetic properties enabled via application of iron oxide nanorods significantly ease the separation and regeneration of spent magnetic adsorbents.

This observer study investigates the effect of computerized artificial intelligence (AI)-based decision support system (CDSS-T) on physicians’ diagnostic accuracy in assessing bladder cancer treatment response. The performance of 17 observers was evaluated when assessing bladder cancer treatment response without and with CDSS-T using pre- and post-chemotherapy CTU scans in 123 patients having 157 pre- and post-treatment cancer pairs. The impact of cancer case difficulty, observers’ clinical experience, institution affiliation, specialty, and the assessment times on the observers’ diagnostic performance with and without using CDSS-T were analyzed. It was found that the average performance of the 17 observers was significantly improved (p = 0.002) when aided by the CDSS-T. The cancer case difficulty, institution affiliation, specialty, and the assessment times influenced the observers’ performance without CDSS-T. The AI-based decision support system has the potential to improve the diagnostic accuracy in assessing bladder cancer treatment response and result in more consistent performance among all physicians.

Summary: Background: Breakthrough SARS-CoV-2 infections following vaccination against COVID-19 are of international concern. Patients with cancer have been observed to have worse outcomes associated with COVID-19 during the pandemic. We sought to evaluate the clinical characteristics and outcomes of patients with cancer who developed breakthrough SARS-CoV-2 infections after 2 or 3 doses of mRNA vaccines. Methods: We evaluated the clinical characteristics of patients with cancer who developed breakthrough infections using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19; NCT04354701). Analysis was restricted to patients with laboratory-confirmed SARS-CoV-2 diagnosed in 2021 or 2022, to allow for a contemporary unvaccinated control population; potential differences were evaluated using a multivariable logistic regression model after inverse probability of treatment weighting to adjust for potential baseline confounding variables. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. The primary endpoint was 30-day mortality, with key secondary endpoints of hospitalization and ICU and/or mechanical ventilation (ICU/MV). Findings: The analysis included 2486 patients, of which 564 and 385 had received 2 or 3 doses of an mRNA vaccine prior to infection, respectively. Hematologic malignancies and recent receipt of systemic anti-neoplastic therapy were more frequent among vaccinated patients. Vaccination was associated with improved outcomes: in the primary analysis, 2 doses (aOR: 0.62, 95% CI: 0.44–0.88) and 3 doses (aOR: 0.20, 95% CI: 0.11–0.36) were associated with decreased 30-day mortality. There were similar findings for the key secondary endpoints of ICU/MV (aOR: 0.60, 95% CI: 0.45–0.82 and 0.37, 95% CI: 0.24–0.58) and hospitalization (aOR: 0.60, 95% CI: 0.48–0.75 and 0.35, 95% CI: 0.26–0.46) for 2 and 3 doses, respectively. Importantly, Black patients had higher rates of hospitalization (aOR: 1.47, 95% CI: 1.12–1.92), and Hispanic patients presented with higher rates of ICU/MV (aOR: 1.61, 95% CI: 1.06–2.44). Interpretation: Vaccination against COVID-19, especially with additional doses, is a fundamental strategy in the prevention of adverse outcomes including death, among patients with cancer. Funding: This study was partly supported by grants from the National Cancer Institute grant number P30 CA068485 to C-YH, YS, SM, JLW; T32-CA236621 and P30-CA046592 to C.R.F; CTSA 2UL1TR001425-05A1 to TMW-D; ACS/FHI Real-World Data Impact Award, P50 MD017341-01, R21 CA242044-01A1, Susan G. Komen Leadership Grant Hunt to MKA. REDCap is developed and supported by Vanderbilt Institute for Clinical and Translational Research grant support (UL1 TR000445 from NCATS/NIH).

Background Patients with bladder cancer (BC) who are cisplatin ineligible or have unresectable disease have limited treatment options. Previously, we showed targeting programmed death-ligand 1 (PD-L1) with durvalumab (durva) and radiation therapy (RT) combination was safe in BC. We now report results from a phase II study evaluating the toxicity and efficacy of durva and RT in localized BC.Methods This is a single-arm, multi-institutional phase II study; N=26. Enrolled patients had pure or mixed urothelial BC (T2-4 N0-2 M0) with unresectable tumors and were unfit for surgery or cisplatin ineligible. Patients received durva concurrently with RT ×7 weeks, followed by adjuvant durva × 1 year.Primary endpoints: (A) progression-free survival (PFS) at 1 year and (B) disease control rate (DCR) post adjuvant durva. Key secondary endpoints: (A) complete response (CR) post durvaRT (8 weeks), (B) overall survival (OS), (C) PFS and (D) toxicity. Correlative studies included evaluation of baseline tumor and blood (baseline, post durvaRT) for biomarkers.Results Median follow-up was 27 months. Evaluable patients: 24/26 post durvaRT, 22/26 for DCR post adjuvant durva, all patients for PFS and OS. Post adjuvant durva, DCR was seen in 72.7%, CR of 54.5%. 1-year PFS was 71.5%, median PFS was 21.8 months. 1-year OS was 83.8%, median OS was 30.8 months. CR at 8 weeks post durvaRT was 62.5%. Node positive (N+) patients had similar median PFS and OS. DurvaRT was well tolerated. Grade ≥3 treatment-related adverse events: anemia, high lipase/amylase, immune-nephritis, transaminitis, dyspnea (grade 4-COPD/immune), fatigue, rash, diarrhea and scleritis. No difference in outcome was observed with PD-L1 status of baseline tumor. Patients with CR/PR or SD had an increase in naïve CD4 T cells, a decrease in PD-1+CD4 T cells at baseline and an increase in cytokine-producing CD8 T cells, including interferon gamma (IFNγ) producing cells, in the peripheral blood.Conclusion Durva with RT followed by adjuvant durva was safe with promising efficacy in localized BC patients with comorbidities, including N+ patients. Larger randomized studies, like S1806 and EA8185, are needed to evaluate the efficacy of combining immunotherapy and RT in BC.Trial registration number NCT02891161.

Nanocomposite of ZnO-CdS having an equal molar ratio (1:1) of the two components has been synthesized using chemical co-precipitation method, with optimized parameters for efficient photocatalytic properties. A variety of suitable techniques including synchrotron based extended X-ray absorption fine structure (EXAFS) have been used to investigate structural, morphological and optical properties of the nanocomposite. The synthesized nanostructured ZnO-CdS nanocomposite is found to have homogenously distributed crystalline grains of both ZnO and CdS. The uniform distribution of grains and the equal molar ratio of the two components have resulted in excellent optical and photocatalytic performance. The UV-Vis absorption spectrum of nanocomposite shows absorption behavior, extended almost uniformly in the entire UV-visible region, with a red shift in the optical band gap of ZnO, suggestive of efficient photocatalytic ability. The photoluminescence spectrum shows the absorbance in both UV and visible regions, corresponding to the near-band-edge emissions of the ZnO and CdS, respectively. Finally, the photocatalytic performance has been studied in photodegradation of methylene blue dye, showing an enhanced efficiency of almost 99% in 110 min, much higher than that of pristine ZnO, as well as CdS and one of the best reported in the literature.

Rheumatoid arthritis [RA] is a painful disorder that causes inflammation in synovial membrane followed by damage to cartilage and bone. Several therapies are available for its management that include anti-inflammatory and disease- modifying antirheumatic drugs. Due to the severe side effects associated with them, phytotherapy may serve as a promising and beneficial approach for management of rheumatoid arthritis and the therapeutic potential can be attributed to their ability to target various inflammatory mediators including nitric oxide [NO], cytokines, chemokines, adhesion molecules, nuclear factor kappa-b [NF-kb], lipoxygenase [LOXs] and arachidonic acid [AA]. Further, nanomedicine could serve as a prominent formulation strategy to overcome the challenges associated with phytoconstituents like poor bioavailability, high first pass metabolism and lower stability. Present review focuses on providing an exhaustive account of various phytoconstituents that have significant potential in RA management, their drawbacks, reported novel drug formulations, regulatory aspects involved therein.

Polycystic ovarian syndrome (PCOS) is a multifactorial disease affecting women of all age groups in reproductive age and post-menopausal women. It is associated with a large range of clinical manifestations. Medical treatment depends on the symptoms observed, and the most common symptoms addressed in the case of PCOS are infertility, hirsutism, menstrual disorders, and obesity. There are significantly fewer therapies that can work on many symptoms, and the most difficult one is to treat infertility and hirsutism together, leading to a very hectic, tedious, and frustrating therapeutic period for patients. Current treatments are associated with severe side effects, including visual disturbance, hot flushes, abdominal distension, mood swings associated with clomiphene citrate, while polymenorrhagia with spironolactone. Thus, phytoconstituents and lifestyle modification can be considered as a safe and effective treatment approach for PCOS management as are free from serious adverse effects and can work out at multiple targets simultaneously. The research reports have demonstrated the fact that phytoconstituents like curcumin, resveratrol, and berberine have great potential in reducing insulin resistance, modulating L.H. to FSH ratio, and reducing metabolic syndromes associated with the disease. The results obtained revealed that these phytoconstituents have comparable results with first-line drugs such as clomiphene and metformin in improving fertility, reducing obesity, and regularizing the menstrual cycle. The present review covers the pathophysiology of PCOS, the current treatment approach and their drawbacks, detailed preclinical and clinical studies phytoconstituents that have proven potential in managing PCOS symptoms along with their regulatory aspects.

Abstract Background It remains controversial if radical prostatectomy or definitive radiation therapy produces equivalent outcomes in high‐risk localized prostate cancer. Methods We queried The Surveillance, Epidemiology, and End Results (SEER) database for those who received upfront surgery or who were recommended for surgery but instead received radiation. Inverse probability of treatment weighing was used to adjust for covariate imbalance and the weighted Cox proportional hazards model was used to estimate the effects of treatment groups on survival. A meta‐analysis was performed to pool estimates from published studies. Results Among eligible 62 533 patients, 59 540 had upfront surgery and 2993 patients had upfront radiotherapy. EBRT + BT was associated with a superior cancer‐specific survival (CSS) compared with surgery or EBRT alone (HR, 0.55, 95% CI, 0.3‐1.0; HR, 0.49, 95% CI, 0.24‐0.98, respectively), whereas EBRT was associated with an inferior overall survival (OS) compared with surgery (HR, 1.46, 95% CI, 1.16‐1.8). Radiotherapy (EBRT ± BT) was inferior to surgery by OS (HR, 1.63, 95% CI, 1.13‐2.34) in patients ≤ 65 years, and was superior to surgery by CSS in patients > 65 years (HR, 0.69, 95% CI, 0.49‐0.97). The meta‐analysis showed consistent results. Conclusion EBRT + BT was associated with a significantly better prostate CSS compared with surgery or EBRT. EBRT alone was inferior to surgery by OS.

Post-translational modifications (PTMs) of histone proteins play essential functions in shaping chromatin environment. Alone or in combination, these PTMs create templates recognized by dedicated proteins or change the chemistry of chromatin, enabling a myriad of nuclear processes to occur. Referred to as cross-talk, the positive or negative impact of a PTM on another PTM has rapidly emerged as a mechanism controlling nuclear transactions. One of those includes the stimulatory functions of histone H2B ubiquitylation on the methylation of histone H3 on K79 and K4 by Dot1L and COMPASS, respectively. While these findings were established early on, the structural determinants underlying the positive impact of H2B ubiquitylation on H3K79 and H3K4 methylation were resolved only recently. We will also review the molecular features controlling these cross-talks and the impact of H3K27 tri-methylation on EZH2 activity when embedded in the PRC2 complex.

A highly sensitive and selective NO2 gas sensor dependent on SnO2/ZnO heterostructures was fabricated using a sputtering process. The SnO2/ZnO heterostructure thin film samples were characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), Energy-dispersive X-ray spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS). Sensors fabricated with heterostructures attained higher gas response (S = 66.9) and quicker response-recovery (20 s, 45 s) characteristics at 100 °C operating temperature towards 100 ppm NO2 gas efficiently in comparison to sensors based on their mono-counterparts. The selectivity and stability of SnO2/ZnO heterostructures were studied. The more desirable sensing mechanism of SnO2/ZnO heterostructures towards NO2 was described in detail.

The phase 4 ABOUND.70+ trial assessed the safety and efficacy of nab-paclitaxel/carboplatin continuously or with a 1-week break between cycles in elderly patients with advanced non-small cell lung cancer (NSCLC). Patients ≥70 years with locally advanced/metastatic NSCLC were randomized 1:1 to first-line nab-paclitaxel days 1, 8, 15 plus carboplatin day 1 of a 21-day cycle (21d) or the same nab-paclitaxel/carboplatin regimen with a 1-week break between cycles (21d + break; 28d). The primary endpoint was the percentage of patients with grade ≥ 2 peripheral neuropathy (PN) or grade ≥ 3 myelosuppression. Other key endpoints included progression-free survival (PFS), overall survival (OS), and overall response rate (ORR). A total of 143 patients were randomized (71 to 21d, 72 to 21d + break). The percentage of patients with grade ≥ 2 PN or grade ≥ 3 myelosuppression was similar between the 21d and 21d + break arms (76.5 and 77.1%; P = 0.9258). Treatment exposure was lower in the 21d arm compared with the 21d + break arm. Median OS was 15.2 and 16.2 months [hazard ratio (HR) 0.72, 95% CI 0.44–1.19; P = 0.1966], median PFS was 3.6 and 7.0 months (HR 0.48, 95% CI 0.30–0.76; P

The present investigation was focused to formulate semi-solid capsules (SSCs) of hydrophobic drug telmisartan (TLMS) by encapsulating semi-solid matrix of its solid dispersion (SD) in HPMC capsules. The combinational approach was used to reduce the lag time in drug release and improvise its dissolution. SDs of TLMS was prepared using hot fusion method by varying the combinations of Pluronic-F68, Gelucire 50/13 and Plasdone S630. A total of nine batches (SD1-SD9) were characterized for micromeritic properties, in vitro dissolution behavior and surface characterization. SD4 with 52.43% cumulative drug release (CDR) in phosphate buffer, pH 7.4, in 120 min, t50% 44.2 min and DE30min 96.76% was selected for the development of semi-solid capsules. Differential scanning calorimetry of SD4 revealed molecular dispersion of TLMS in Pluronic-F68. SD4 was formulated into SSCs using Gelucire 44/14 and PEG 400 as semi-solid components and PEG 6000 as a suspending agent to achieve reduction in lag time for effective drug dissolution. SSC6 showed maximum in vitro drug dissolution 97.49 % in phosphate buffer, pH 7.4 with in 20 min that was almost a three folds reduction in the time required to achieve similar dissolution by SD. Thus, SSCs present an excellent approach to enhance in vitro dissolution as well as to reduce the lag time of dissolution for poorly water soluble drugs especially to those therapeutic classes that are intended for faster onset of action. Developed approach based on HPMC capsules provided a better alternative to target delivery of telmisartan to the vegetarian population.

V-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) mutated lung cancer is relatively aggressive and is resistant to currently available therapies. In a recent phase II study for patients with BRAF-V600E non-small cell lung cancer (NSCLC), BRAF V600E inhibitor demonstrated evidence of activity, but 30% of this selected group progressed while on treatment, suggesting a need for developing alternative strategies. We tested two different options to enhance the efficacy of vemurafenib (BRAF V600E inhibitor) in BRAF mutated NSCLC. The first option was the addition of erlotinib to vemurafenib to see whether the combination provided synergy. The second was to induce MEK inhibition (downstream of RAF) with trametinib (MEK inhibitor). We found that the combination of vemurafenib and erlotinib was not synergistic to the inhibition of p-ERK signaling in BRAF-V600E cells. Vemurafenib caused significant apoptosis, G1 arrest and upregulation of BIM in BRAF-V600 cells. Trametinib was effective as a single agent in BRAF mutated cells, either V600E or non-V600E. Finally, the combination of vemurafenib and trametinib caused a small but significant increase in apoptosis as well as a significant upregulation of BIM when compared to either single agent. Thus, hinting at the possibility of utilizing a combinational approach for the management of this group of patients. Importantly, trametinib alone caused upregulation of p-AKT in BRAF non-V600 mutated cells, while this effect was nullified with the combination. This finding suggests that, the combination of a MEK inhibitor with a BRAF inhibitor will be more efficacious in the clinical setting for patients with BRAF mutated NSCLC.