PubMed · 2669919
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I R Judson. 1989. New endocrine agents, guidelines for future development.. https://doi.org/10.1038/bjc.1989.240
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Surgery is the only curative treatment of gastro-entero-pancreatic endocrine tumors. In inoperable or metastasized forms, therapeutic options are limited. The metabolic or systemic radiotherapy, using radiolabeled somatostatin analogs, constitutes a new therapeutic alternative, currently in development which requires the presence of high affinity somatostatin receptors on tumoral cells. Using (111)In-pentetreotide, the main result is a symptomatic effect. With new somatostatin analogs coupled to B- emitters, such as Octreother or (177)Lu-DOTA-Octreotate, 10 to 30% of objective tumoral responses are observed in progressive patients, unresponsive to conventional treatments. Such results are explained by the high affinity for somatostatin receptors and the large emission diameter of these radiolabeled compounds. Renal toxicity is limited by amino-acid infusion whereas changes in blood count are usually moderate and transient. Multicentric prospective studies are necessary to identify the predictive factors of tumoral response and toxicity. The prospects are related to the development of new radiopharmaceuticals, even more specific of somatostatin receptors sub-types and to the use of other peptide analogues whose applications will overflow the framework of endocrine tumours.
A structure-activity study on benzylpiperidine 1 was accomplished by utilizing high-throughput synthesis. Three focused libraries were designed and synthesized to quickly develop SAR. Further optimization led to the discovery of compound 2, an MCH receptor R1 antagonist with over 400-fold improvement in biological activity over the original lead.
Progesterone exhibits diverse biological activities, inducing proliferation of the mammary gland epithelium, but it opposes the mitogenic activity of estrogen in the uterus. These tissue-selective activities of progesterone are mediated by the progesterone receptor (PR), a member of the nuclear receptor superfamily of ligand-dependent transcription factors. Several clinically useful PR antagonists that block progesterone activity have been described, yet some of these compounds exhibit tissue-selective partial agonist activity, leading them to be termed selective progesterone receptor modulators (SPRMs). This partial agonist activity is mediated primarily through the N-domain of the B isoform of PR, although the mechanism has not yet been defined. In this review, we discuss mechanisms by which PR activates transcription and ways in which antagonists oppose progesterone activity. We discuss mechanisms by which the N-domain mediates tissue specific partial agonist activity of SPRMs, as well as receptor interacting coregulatory proteins that influence this activity of the N-domain. We also describe newly developed SPRMs that mediate subsets of agonist and/or antagonist activities, and discuss the clinical potential of these compounds.