ObjectiveThe CYP2C19 loss-of-function (LoF) allele is present in half of the East Asian population and is associated with high on-treatment platelet reactivity (HTPR). This study aimed to investigate whether a rapid genotyping-guided approach is feasible and efficacious for selecting P2Y12 receptor blockers in Chinese patients suffering from acute coronary syndrome (ACS).MethodsThis was a single-centre, prospective, randomized, open-label study. A total of 132 patients with ACS were randomized to the rapid genotyping-guided treatment group (GG, N = 65) or the standard treatment group (SG, N = 67). Patients in the GG group were genotyped by the Verigene system. Patients with the CYP2C19 LoF allele were switched to ticagrelor and all remaining patients continued on clopidogrel. The endpoints were HTPR at 24 hours after the first loading dose of clopidogrel and 1 month afterwards.ResultsForty patients in the GG group switched to ticagrelor, while others continued on clopidogrel. The incidence of HTPR in the GG vs SG groups was 9.2% vs 40.3% at 24 hours and 6.5% vs 32.3% at 1 month, respectively. Rapid point-of-care genotyping showed 100% concordance with conventional genotyping by real-time polymerase chain reaction.ConclusionsIn Chinese patients suffering from ACS, the rapid genotyping-guided approach for selecting P2Y12 receptor blockers is feasible and reduces the incidence of HTPR.Clinical Trial RegistrationURL: http://clinicaltrials.gov. Unique identifier: NCT01994941.

This paper documented several natural products that have antineoplastic activities. Detailed descriptions of the mechanism of action of these products are given. Side effects of these natural products are also described. Based on these side effect profiles and their benefits, these natural products could be used as adjuvant cancer therapies. Traditional anticancer agents usually have debilitating side effects. These natural products would be of great benefit due to their anticancer activities. Additionally, some of these natural products can work proactively in preventing cancer formation with their chemopreventive properties. Incorporation into diet can be recommended after discussion with physician and other health care professionals.

Tumor-associated antigens recently have become very popular in cancer therapy. They can be targeted to reduce side effects of traditional cancer therapy. In this review, ten promising tumor-associated antigens are being discussed in detail. The characteristics of each one are being reviewed in detail. Monoclonal antibodies attached to traditional anticancer agents can target a specific type of cancer cells thereby reducing the amount of traditional anticancer agents reaching normal tissues. This sort of cancer targeting can be a very attractive anticancer therapy because it substantially reduces the amount of side effects normally caused by traditional anticancer agents.

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