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Synthesis of the antileukemic compound N,N(11)-[5-[bis(2-chloroethyl)amino]-1, 3-phenylene]bisurea.

Conversion of 5-nitro-1, 3-benzenedicarboxylic acid (1) to the diamide 2 followed by hypochlorite rearrangement to the idamine 3 and subsequent reaction with acetic anhydride gave the bisacetamide 4. Reduction to the amine 5 followed by treatment with ethylene oxide formed the diol 6. The latter was converted to the bistosylate 7, which undrewent facile displacement with lithium chloride in acetone to give the mustard 8. Removal of the acetyl groups with hydrochloric acid gave 9, which reacted with potassium cyanate to provide the bisurea 10. In an alternative, but less satisfactory synthesis of 10, the compound (5-nitro-1, 3-phenylene) biscarbamic acid diphenyl ester (11), or the corresponding diethyl ester 12, was converted by ammonolysis to 13. The nitrodiurea 13 was next reduced to the amine 14, the hydrochloride of which reacted with ethylene oxide to give the diol 15. Treatment of the latter in dimethylformamide with N-chlorosuccinimide in the presence of triphenylphosphine gave 10 in low yield. The nitrogen mustards 8, 9 and 10 showed significant antitumor activities against P388 lymphocytic leukemia in mice.

Animals

Malaria in studies in vitro. III: the protein synthesising activity of Plasmodium falciparum in vitro after drug treatment in vivo.

Aotus trivirgatus monkeys with established infections of Plasmodium falciparum were treated orally with either chloroquine or the novel compound 1-amidino-3-(3-chloro-4-cyanophenyl) urea. Blood samples were cultured in vitro, 18 hours after treatment, when no morphological abnormalities were apparent. The incorporation of radioactive leucine from the medium by the blood of treated monkeys was compared with that of the undosed control. Parasite maturation was also examined. Both chloroquine and the amidinourea were effective against the drug sensitive strain of P. falciparum. The combined use of an in vivo and in vitro test demonstrated that biochemical disturbance of the parasite may be demonstrable before morphological effects are seen. This system should prove useful in drug metabolism studies and in experiments using large or expensive animals.

Animals

Differential block of cardiac delayed rectifier current by class Ic antiarrhythmic drugs: evidence for open channel block and unblock.

OBJECTIVE: The aim was to compare the effects of the class Ic antiarrhythmic drugs flecainide, encainide, and recainam on the delayed rectifier current, IK. METHODS: Membrane currents were studied using the single suction pipette voltage clamp technique in freshly dissociated cat ventricular myocytes bathed in HEPES buffered physiological saline at 32 degrees C. RESULTS: Flecainide and encainide decreased IK with IC50 values of 2.1 microM and 6 microM, respectively. Recainam (100 microM) reduced IK by only 7 (SEM 3)% after 20-30 min exposure and by 19% after an 80 min exposure (IC50 > 400 microM). None of the compounds blocked the inward rectifier, IK1. Block of IK by flecainide and encainide increased with depolarisation following a voltage dependence similar to that describing channel activation. Flecainide and encainide also slowed the time course of the IK tail currents, consistent with drug dissociating from open channels. CONCLUSIONS: The observed voltage dependence for IK block by flecainide and encainide resembles the interaction reported between these agents and the excitatory sodium channel, ie, depolarisation enhances block while repolarisation leads to removal of block. The results further suggest that the electrophysiological profile of class Ic agents can have a markedly different ionic basis, ie, K+ channel block by flecainide and encainide is balanced by a potent block of sodium channels, while recainam appears to be a weak but relatively specific blocker of sodium channels only. These differences are not readily accommodated by the current Harrison-Vaughan-Williams classification scheme, and suggest the possibility that potentially important drug specific differences can exist within the same antiarrhythmic drug class.

Animals

Rat lymphocytic thyroiditis associated with ingestion of an immunosuppressive compound.

Lymphocytic thyroiditis was induced in young Wistar rats by feeding them the immunosuppressive compound frentizole [1-(6-methoxy-2-benzothiazolyl)-3-phenyl urea] for 1 year. About half of the rats given 0.060 and 0.150% frentizole in the diet had lymphocytic thyroiditis. The incidence of thyroiditis was low in the group given the high dose because of severe anemia and hepatic disease which resulted in increased mortality. Reversibility of the thyroid lesion was indicated by reduced incidence rates at 15 and 18 months after treatment was stopped at 1 year. The thyroiditis was characterized by interstitial infiltrates of many lymphocytes and plasma cells and fewer macrophages with mild degenerative changes in the follicular epithelium. This inflammatory cell infiltrate was generally diffuse but occasionally was multifocal, particularly in thyroid glands of rats late in the reversibility phase of the study. The inflammatory cell infiltrate caused the thyroid glands to be several times normal size. Sera from rats with lymphocytic thyroiditis contained hemagglutinating antibody against rat perfect correlation between the presence of anti-thyroglobulin antibody and enlarged thyroid glands. Fine granular deposits of IgG and complement were identified in some areas of the follicular basement membrane. We concluded that the lymphocytic thyroiditis was immunologically mediated, at least in part, by anti-thyroglobulin antibody.

Animals

A mode of selective action of thiadiazolyl urea herbicides.

1,1-Dimethyl-3-(5-tert-butyl-1,3,4-thiadiazol-2-yl)urea(I) was newly synthesized by the authors. (I) was found to have the strongest herbicidal activities among the thiadiazolylurea derivatives and selectivity of (I) was found between barley (tolerant)and wheat (susceptible) plants. Neither absorption by roots nor translocation from roots to shoots of 35S-labeled (I) in barley and wheat correlated with selectively between these species of plants. (I) was metabolized in both species of plants by N-demethylation to 1-methyl-3-(5-tert-butyl-1,3,4-thiadiazol-2-yl)urea(II), and further to non-phytotoxic 3-(5-tert-butyl-1,3,4-thiadiazol-2-yl)urea(III). The rates of the N-demethylating reactions from (I) to (II) and from (II) to (III) were much greater in barley shoots than in wheat shoots, especially in the second demethylation. It was concluded that the selective activity of (I) between barley and wheat plants was mainly due to the difference in rates of N-demethylation of (I). In addition, it was found that cotton plants, well known as tolerant to phenylurea herbicides, were remarkably susceptible to (I). It was indicated that different rates of the N-demethylating reaction between the phenyl and thiadiazolyl herbicides correlated with susceptibility to them.

Biotransformation

Anti-tumour effects of combined lenvatinib and EGFR Inhibition in advanced differentiated thyroid cancer cells.

PURPOSE: Differentiated thyroid cancer (DTC) typically has a favourable prognosis, while advanced forms of these tumours exhibit aggressive behaviour, leading to decreased survival. Lenvatinib has demonstrated effectiveness in managing advanced DTC. However, its long-term efficacy is compromised by resistance mechanisms, which remain unexplored, limiting its clinical utility. METHODS: In vitro studies were conducted using three advanced DTC cell lines of the papillary subtype: K1 (BRAF p.V600E), BCPAP (BRAF p.V600E) and TPC-1 (RET/PTC1). IC50 for Lenvatinib and Gefitinib were defined, and their effects on cell viability, colony formation, gene expression, and pathway activation were assessed individually and in combination. Comparative genomic hybridisation was performed to uncover intrinsic resistance mechanisms. RESULTS: Lenvatinib IC50 was higher in K1 and BCPAP than in TPC-1, indicating greater TPC-1 susceptibility, as confirmed by viability assays. Gefitinib showed similar IC50 values across all cell lines. The Lenvatinib plus Gefitinib combination (Combo) significantly reduced K1 and BCPAP viability when comparing with monotherapies, with no significant effects in TPC-1. Clonogenic assays mirrored these results and revealed higher recovery in K1 and BCPAP after Combo withdrawal. Combo treatment increased EGFR expression and induced ERK1/2 and AKT phosphorylation’s dysregulation in all cell lines. CONCLUSIONS: This study showed that RET/PTC1 cells are more responsive to Lenvatinib than BRAF-mutated cells, and that EGFR targeting with Gefitinib enhanced Lenvatinib’s inhibitory effect in BRAF-mutated cells. Dysregulation of EGFR and Lenvatinib target gene’s expression, as well as of MAPK and PI3K signalling may indicate short-term adaptive resistance. These findings provide insight into Lenvatinib resistance mechanisms in thyroid cancer and highlight the need for further research to overcome refractoriness.

Humans

Continuous administration of lenvatinib after first documented disease progression in patients with radioiodine-refractory thyroid cancer.

PURPOSE: To determine the efficacy and safety of lenvatinib beyond first documented disease progression (LBP) and prognostic factors after progression in patients with radioiodine-refractory thyroid cancer. METHODS: This retrospective study included adults with radioiodine-refractory thyroid cancer who received lenvatinib between January 2012 and November 2023 and continued treatment after initial RECIST 1.1 progression. Patients who subsequently received other multikinase inhibitors or selective targeted therapies were excluded. Time to second treatment failure (second TTF) was defined as time from initial progression to permanent lenvatinib discontinuation for any reason; second progression-free survival (second PFS) as time from initial progression to subsequent radiographic progression or death; and post-progression survival (PPS) as time from initial progression to death. Outcomes were estimated by Kaplan–Meier methods, and prognostic factors were explored by Cox regression. Safety was assessed. RESULTS: Twenty-four patients met the eligibility criteria for LBP. The objective response rate after progression was 0%, whereas the disease control rate was 50.0%. Median second PFS and second TTF were 6.0 months and 8.0 months, respectively. Median PPS was 14.8 months. At 12 months after initial progression, 37.5% of patients remained on lenvatinib and 56.5% were alive. Baseline progressive disease at initial progression (tumor burden returning to or exceeding the pretreatment baseline) was associated with shorter second TTF, with similar trends for second PFS and PPS. The most common adverse events were hypertension, proteinuria, peripheral edema, and renal dysfunction. CONCLUSION: Continuation of lenvatinib beyond disease progression achieved modest additional disease control with acceptable safety in selected patients. In settings where access to subsequent-line systemic therapies is limited or no actionable targets are identified, LBP may serve as a pragmatic bridging approach for carefully selected patients.

Humans

Metabolic and cardiovascular effects of carbuterol and metaproterenol.

Metabolic and cardiovascular responses to selective beta-adrenergic bronchodilators, carbuterol and metaproterenol, were studied during an asymptomatic period in 8 male subjects with bronchial asthma diagnosed as mile to moderate. On separate days each individual received either placebo, carbuterol 2 mg, carbuterol 4 mg, or metaproterenol 20 mg orally in a double-blind fashion. Subsequently, metabolic and cardiovascular responses were measured periodically for 5 hr. Carbuterol 2 mg was indistinguishable from placebo except for small elevations of glucose at 3 and 4 hr. Carbuterol 4 mg produced significant increases in glucose, insulin, lactate, and free fatty acids as well as in pulse rate and arterial pulse pressure. Metaproterenol produced increases only in plasma glucose and insulin. The majority of patients reported drug-related side effects which were all mild, after taking either carbuterol 4 mg or metaproterenol 20 mg. Fewer subjective side effects were noted with carbuterol 2 mg. These findings indicate that a 2-mg dose of carbuterol can be administered to typical asthmatic subjects without significant subjective or objective side effects. The larger dose (4 mg) may be accompanied by a greater frequency of side effects.

Adrenergic beta-Agonists

Genome-wide CRISPR Screening Identifies NFκB and c-MET as Druggable Targets to Sensitize Lenvatinib Treatment in Hepatocellular Carcinoma.

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC), the dominant form of liver cancer, is a leading cause of cancer death worldwide. Sorafenib and lenvatinib have long been the 2 limited options of first-line treatments for patients with unresectable advanced HCC. However, the single-drug treatment strategy only shows modest survival benefit, mostly because of the survival ability of cancer cells to activate alternative pathways for compensation. In this study, we aim to identify druggable targets contributing to lenvatinib resistance and evaluate the efficacy of combining respective inhibitors and lenvatinib on HCC. METHODS: Genome-scale clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 knockout library screening was applied on the vehicle group and lenvatinib treatment group. Identified druggable candidates were validated individually on HCC cell models. Therapeutic effects of the combined treatment of inhibitors of candidate genes and lenvatinib were evaluated in vitro and in vivo. RESULTS: We successfully identified NFKB1 and MET as critical drivers for the development of lenvatinib resistance in HCC cells. By perturbing the 2 genes with either CRISPR knockout or RNA interference approaches, lenvatinib treatments were significantly sensitized. Moreover, using small molecules QNZ and cabozantinib to target NFKB1 and MET, respectively, this together with lenvatinib could synergistically induce apoptosis and suppress HCC growth in vitro and in vivo. CONCLUSION: Our results demonstrated that genome-wide CRISPR/Cas9 screening is a powerful tool for the design of rational combinational cancer therapy and provided candidate genes possible for combined treatments with lenvatinib to improve therapy efficacy.

Carcinoma, Hepatocellular

Durvalumab and tremelimumab, with or without lenvatinib, combined with transarterial chemoembolisation in participants with embolisation-eligible hepatocellular carcinoma (EMERALD-3): a global, randomised, open-label, sponsor-blinded, phase 3 study.

BACKGROUND: Transarterial chemoembolisation (TACE), a standard treatment for embolisation-eligible hepatocellular carcinoma (HCC), induces tumour immune responses. Single tremelimumab regular interval durvalumab (STRIDE) is a standard treatment in advanced HCC. In this phase 3 trial, we assessed the efficacy and safety of STRIDE, with or without lenvatinib, plus TACE, in participants with embolisation-eligible HCC. METHODS: EMERALD-3 is a phase 3, randomised, open-label, sponsor-blinded study, conducted at 177 medical sites in 21 countries. Eligible participants were 18 years or older (aged &#x2265;21 years in Egypt or Singapore) at screening and had confirmed HCC (by imaging or histopathologically from biopsy specimen, surgery, or both) not amenable to curative surgery, curative ablation, or transplantation but amenable to TACE. Participants had Child-Pugh class A liver function, an Eastern Cooperative Oncology Group performance status of 0-1, and at least one measurable target intrahepatic lesion per modified Response Evaluation Criteria in Solid Tumours. Participants were randomly allocated in a 1:1:1 ratio to receive STRIDE plus lenvatinib plus TACE, STRIDE plus TACE, or TACE until each group reached its preplanned enrolment target of 175 participants. After the STRIDE plus TACE group reached its enrolment target, randomisation was adjusted to continue in a 1:1 ratio between the STRIDE plus lenvatinib plus TACE group and TACE group until approximately 275 participants were enrolled in each of these two groups. Randomisation used a centrally assigned interactive response technology system, stratified by region, baseline tumour burden, and previous palliative embolisation. In the STRIDE plus lenvatinib plus TACE group, on the first day, participants were given 300 mg tremelimumab intravenously, followed by 1500 mg durvalumab plus oral lenvatinib (8 mg for <60 kg bodyweight or 12 mg for &#x2265;60 kg bodyweight); participants then received 1500 mg durvalumab every 4 weeks plus once-daily lenvatinib for up to 36 cycles. In the STRIDE plus TACE group, participants were given 300 mg tremelimumab and 1500 mg durvalumab intravenously on the first day, followed by 1500 mg durvalumab every 4 weeks. The technique and number of TACE procedures were at the investigators' discretion, with the first procedure administered at least 7 days after the first dose of durvalumab in the two investigation treatment groups and within 7 days of random allocation in the TACE group. The primary endpoint was progression-free survival for STRIDE plus lenvatinib plus TACE versus TACE. Key secondary endpoints were overall survival for STRIDE plus lenvatinib plus TACE versus TACE and progression-free survival and overall survival for STRIDE plus TACE versus TACE. This study was registered with ClinicalTrials.gov (NCT05301842), with enrolment completed. FINDINGS: From March 28, 2022, to Nov 20, 2024, 1124 participants were screened. The full analysis set comprised 760 participants, who were randomly allocated to STRIDE plus lenvatinib plus TACE (n=293), STRIDE plus TACE (n=175), or TACE (n=292). 633 (83%) participants were male and 127 (17%) were female; 548 (72%) were Asian. At the first data cutoff (Sept 2, 2025); the overall median follow-up for progression-free survival was 10&#xb7;0 months (IQR 4&#xb7;6-17&#xb7;2); median follow-up for progression-free survival was 11&#xb7;0 months (IQR 4&#xb7;8-18&#xb7;4) for STRIDE plus lenvatinib plus TACE and 8&#xb7;3 months (4&#xb7;1-15&#xb7;5) for TACE. Median progression-free survival was 13&#xb7;0 months (95% CI 12&#xb7;2-16&#xb7;7) for STRIDE plus lenvatinib plus TACE versus 9&#xb7;8 months (8&#xb7;0-11&#xb7;4) for TACE (HR 0&#xb7;70 [95% CI 0&#xb7;57-0&#xb7;86]; p=0&#xb7;0007). At the second data cutoff (Feb 23, 2026) and a median follow-up for overall survival of 24&#xb7;6 months (IQR 16&#xb7;5-31&#xb7;5) for STRIDE plus lenvatinib plus TACE and 22&#xb7;9 months (14&#xb7;9-30&#xb7;2) for TACE, median overall survival was 39&#xb7;5 months (95% CI 34&#xb7;1-not reached) for STRIDE plus lenvatinib plus TACE and 34&#xb7;7 months (28&#xb7;8-not reached) for TACE (HR 0&#xb7;84 [95% CI 0&#xb7;65-1&#xb7;09]; p=0&#xb7;18). At this data cutoff, median progression-free survival was 12&#xb7;9 months (95% CI 10&#xb7;2-15&#xb7;9) for STRIDE plus TACE and 8&#xb7;1 months (6&#xb7;5-10&#xb7;2) for the first 175 participants randomised to TACE (HR 0&#xb7;71 [95% CI 0&#xb7;56-0&#xb7;91]), with median follow-up of 10&#xb7;3 months (IQR 4&#xb7;6-23&#xb7;7) for STRIDE plus TACE and 7&#xb7;7 months (3&#xb7;0-18&#xb7;5) for the first 175 participants randomly allocated to TACE. The most common adverse events of maximum grade 3 or 4 were hypertension (34 [12%] of 287) for STRIDE plus lenvatinib plus TACE, post-embolisation syndrome and anaemia (ten [6%] of 175 each) for STRIDE plus TACE, and post-embolisation (17 [6%] of 290) for TACE. 184 (64%) participants receiving STRIDE plus lenvatinib plus TACE, 89 (51%) receiving STRIDE plus TACE, and 68 (23%) receiving TACE had serious adverse events. Treatment-related adverse events with an outcome of death during the treatment-emergent period occurred in seven (2%) of 287 participants who received STRIDE plus lenvatinib plus TACE (two for myocarditis; and one each for hepatic failure, haemophagocytic lymphohistiocytosis, septic shock, cardiac failure, and unknown cause), none of 175 participants who received STRIDE plus TACE, and two (1%) of 290 participants who received TACE (one each for acute myocardial infarction and unknown cause). INTERPRETATION: STRIDE plus lenvatinib plus TACE showed a statistically significant progression-free survival improvement versus TACE. These findings support a STRIDE-based regimen as a potential new treatment option for people with embolisation-eligible HCC; additional follow-up is being conducted for final analysis of overall survival across treatment groups. FUNDING: AstraZeneca.

Adult

Laboratory evaluation of pyriminyl used as a rodenticide against the lesser bandicoot rat, Bandicota bengalensis.

The properties of pyriminyl (N-3-pyridylmethyl-N'-p-nitrophenyl urea) as a rodenticide against the lesser bandicoot rat (Bandicota bengalensis) in Rangoon, Burma, were investigated in the laboratory. The acute LD 50 and LD 95 dose of orally administered pyriminyl for B. bengalensis were found to be 6.7 mg/kg and 23.0 mg/kg of body weight respectively. When caged bandicoots were given a choice between plain and poisoned baits, the optimum rodenticidal concentration in the bait was found to be 0.25-0.5%. Symptoms of pyriminyl poisoning appear from 1 to 4 h after feeding starts, giving individual animals time to consume from 2 to over 30 LD 50 doses of 0.5% pyriminyl before feeding stops. Deaths occurred from 4 to 96 h after either oral dosing or free-choice feeding. There appeared to be no significant aversion to the poison at 0.25% or 0.5% concentration in foods. The potential hazards and use of pyriminyl as a field bait against populations of B. bengalensis are discussed.

Administration, Oral

Trials of the rodenticide pyriminil against wild house mice (Mus musculus L.).

Pen field trials were conducted to assess the performance of the acute rodenticide pyriminil against the house mouse (Mus musculus L.). Four types of poison treatment were carried out using penned family groups of warfarin-resistant mice supplied with alternative plain foods. In each treatment pyriminil was included at 2% in a wholemeal flour/pinhead oatmeal/corn oil bait. Mortality was highest (46/54; 85.2%) when poison bait was offered for 4 days following 3 days of pre-baiting. The same pre-baiting and poisoning technique was adopted in five field trials carried out against mice infesting farm buildings. The efficacy of each poison treatment was estimated from the results of pre- and post-treatment census baitings; treatment success ranged between 53.7% and 96.7%, mean 80.5%. It is concluded that pyriminil treatments are best carried out after a period of pre-baiting and that when pyriminil is used in this manner it is about as effective as zinc phosphide for the control of mice.

Animals