Zucapsaicin

Endoplasmic reticulum (ER) stress underlies a variety of disorders involving inflammation, such as diabetes, neurodegenerative diseases. Guanabenz acetate (Wytensin®, GA), a clinically approved antihypertensive drug, efficiently counteracts ER stress. The entirety of clinically used GA is the E-isomer, while the Z-isomer is known to lack significant hypotensive properties. We recently discovered that the Z-isomer retains anti-ER stress activity. Coupled with its lack of sedative effects, (Z)-GA is well positioned as a potential therapeutic for a host of ER stress-related disorders. We set forth to characterize the metabolism and pharmacokinetics (DMPK) of (Z)-GA in vitro and in vivo. Toward this end, a reliable and sensitive LC-MS/MS method for simultaneous determination of the (E)- and (Z)-guanabenz was developed. Chromatographic separation of the isomers was achieved on a C18 reverse phase column with a gradient elution. Tandem mass spectrometric detection was conducted using an AB Sciex 5500 QTrap mass spectrometer with positive electrospray ionization. Full validation of the method was performed in mouse plasma with a simple and low plasma volume protein precipitation procedure. The method demonstrated good linearity, reproducibility, and accuracy over a range of 0.5-1000 nM with minimal matrix effect and excellent extraction efficiency. In addition, the developed method was successfully applied to DMPK studies of the GA isomers in vitro and in vivo. Results of these studies revealed for the first time that the DMPK profile of (Z)-guanabenz is distinct from that of (E)-guanabenz, with higher apparent volume of distribution (V_d) and clearance, presumably due to lower plasma protein binding.

Perioperative therapy is the standard‐of‐care for locally‐advanced gastric cancer but many patients do not respond. There are currently no known factors that predict response to therapy.

This was a retrospective study aimed to evaluate treatment effect grade (TEG) in patients with locally advanced gastric cancer treated with neoadjuvant therapy and surgery at a single center. Ordinal logistic regression was performed to identify predictors of TEG, scaled from 0 to 3.

Fifty patients were identified. The majority were male (n = 33) and 50% were Hispanic. The most common regimens given were: 5‐fluorouracil/leucovorin, oxaliplatin, and docetaxel (n = 23, 46%), epirubicin, cis‐ or oxaliplatin, and 5‐fluorouracil/leucovorin or Xeloda (n = 8, 16%), and 5‐fluorouracil/leucovorin and oxaliplatin (n = 9, 18%). Twenty‐seven patients (55%) had complete or partial response to therapy (TEG 0–2), and 23 patients (46%) had no response (TEG 3). Of numerous variables analyzed, only race and SRC histology were associated with TEG. TEG was associated with disease free, but not disease specific survival.

In this cohort, 46% of patients had no histologic response to therapy. SRC histology, and possibly race, should be considered in determination of optimal multidisciplinary regimens and in amount of therapy to be given upfront, as patients with SRC histology and those of non‐Asian race are less likely to respond to standard regimens.