SOUTHERN JOURNAL OF SCIENCES

Background: Acute lymphoblastic leukemia (ALL) is a heterogeneous hematological malignancy predominantly affecting individuals under 20 years of age. Traditional chemotherapy, such as clofarabine, has shown efficacy; however, novel immunotherapeutic strategies like tisagenlecleucel (Kymriah®) have significantly altered the treatment paradigm. Aim: This study aimed to perform a comparative analysis of tisagenlecleucel, a CAR-T cell therapy, and clofarabine, a second-generation purine nucleoside analog, evaluating their mechanisms of action, therapeutic benefits, limitations, and clinical applicability across diverse patient populations. Methods: A systematic comparative evaluation was conducted, encompassing pharmacological characteristics, mechanisms of action, treatment protocols, efficacy, safety profiles, and clinical indications of both agents. The analysis considered pharmacokinetic and pharmacodynamic data and included patient demographic variables. Results: Tisagenlecleucel demonstrated high efficacy in refractory B-cell ALL, with durable responses and a blood half-life of 128 days, but with notable immune-related adverse effects such as cytokine release syndrome. Clofarabine, effective across a broader patient population, acts via multiple antitumor mechanisms but carries significant toxicity risks, including infection and sepsis. Discussion: The therapies present distinct clinical profiles: tisagenlecleucel offers targeted immunotherapy with high specificity but requires specialized infrastructure and management of immune toxicities. Clofarabine is more widely accessible and applicable, but is associated with conventional chemotherapy-related side effects. Treatment accessibility and cost differ markedly between the two. Conclusions: Therapy selection should be personalized based on patient-specific factors and institutional resources. Tisagenlecleucel is ideal for pediatric and young adult patients with relapsed/refractory B-cell ALL in CAR-T-capable centers, while clofarabine remains a viable option for broader ALL populations, particularly when genetic therapies are not feasible. Further research is needed to optimize therapeutic strategies and improve access to advanced treatments.

Background: Drug repurposing offers potential advantages for cancer therapy development, particularly when utilizing medications with established safety profiles and expired patents. While individual repurposed medications have been investigated for oncological applications, comprehensive comparative analyses of research distribution patterns across multiple therapeutic candidates appear limited in the literature. Understanding these patterns may provide insights into research priorities and potential knowledge gaps. Aim: This exploratory study was designed to quantify and compare the volume of scientific literature examining the anticancer potential of eleven selected off-patent medications across different pharmacological classes. Methods: Bibliometric searches were conducted across five databases (Google Scholar, BVS, PubMed, NIH, and Science.gov) using standardized search terms combining each medication name with "cancer" and "cancer treatment." The selected medications included ivermectin, fenbendazole, mebendazole, albendazole, metformin, propranolol, disulfiram, valproic acid, thalidomide, dexamethasone, and hydroxychloroquine. Basic statistical analyses were performed to examine the distribution patterns and correlations within the database. Results: The search yielded 3,226,066 total publications with considerable variation in distribution patterns. Dexamethasone accounted for the largest proportion (1,538,058 publications, 47.68%), followed by metformin (697,172 publications, 21.61%). Some medications with smaller overall publication volumes demonstrated higher proportions of treatment-specific research, such as fenbendazole (87.82%), disulfiram with copper (86.54%), and hydroxychloroquine with zinc (75.21%). The Herfindahl Index indicated a high concentration of research attention (0.2870). Discussion: The findings suggest substantial variation in research attention across the selected medications. While some medications dominate the literature, others with focused treatment-specific research may warrant further investigation. The inverse relationship observed between total publication volume and treatment specificity suggests that research patterns in this field may be more complex than absolute publication counts indicate. Conclusions: This preliminary bibliometric assessment reveals an uneven distribution of research attention among repurposed medications being investigated for cancer applications. These patterns may inform future research prioritization, though further qualitative analysis would be valuable to assess the clinical significance of these quantitative observations.

Introdução: A entrevista com Élcio Gerônimo de Oliveira, conduzida pelo repórter Luis, apresenta a trajetória profissional de um pesquisador brasileiro com experiência na Força Aérea Brasileira e no meio acadêmico, com foco em sistemas espaciais e veículos hipersônicos. Objetivos: Documentar a carreira e contribuições de Élcio para o desenvolvimento aeroespacial brasileiro, destacando sua transição da carreira militar para a acadêmica e sua participação em projetos estratégicos, especialmente o projeto 14X. Métodos: A entrevista foi estruturada em blocos temáticos, abordando a carreira militar, a experiência acadêmica e, com maior detalhamento, o envolvimento no projeto do veículo hipersônico 14X. Foram realizadas perguntas abertas, permitindo ao entrevistado compartilhar sua experiência e conhecimento técnico. Resultados: Élcio descreveu sua progressão na Força Aérea Brasileira, desde pesquisador até vice-chefe da Diretoria de Espaço, destacando o desenvolvimento de veículos lançadores, sistemas de navegação inercial e o projeto SARA. Relatou sua transição para a carreira acadêmica, incluindo sua experiência como professor na Universidade de Luleå, na Suécia. Élcio detalhou sua coordenação no projeto 14X, um veículo hipersônico que alcançou Mach 7, com perspectivas de atingir Mach 10. Discussão: A entrevista revela a importância da cooperação internacional e da transferência de tecnologia, exemplificada pela doação do primeiro laboratório de hipersônica do Brasil. Evidencia também os desafios técnicos na construção de veículos hipersônicos e o potencial dessas tecnologias para aplicações militares e civis. Conclusão: A carreira de Élcio Gerônimo de Oliveira exemplifica a contribuição brasileira para pesquisa aeroespacial avançada, demonstrando a capacidade nacional de desenvolver tecnologias estratégicas como veículos hipersônicos, apesar das limitações de recursos, e apontando possibilidades futuras para o transporte e exploração espacial.