IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
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IntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
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Designed to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
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After a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
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Our innovative Book Series format brings you:
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Topic Focused Publications - Each topic showcases high impact subject areas
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Renowned Editorial Expertise - Series Editors, Topic Editors, and a team of international Board Members that permanently support each Book Series
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Fast Publishing - quick turnaround which is unique for book publishing
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The benefit of ISSN and ISBN for increased citation and indexing possibilities
\n
\n\n\n\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\n
IntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
We invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
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Note: Edited in October 2021
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Solid bodies will deform when satisfying forces are applied to them. Elasticity solution of materials will be grouped in forms of linear and nonlinear elasticity formulations. The main subject of this book is engineering elasticity and consists of five chapters in two main sections. These two main sections are "General Theorems in Elasticity" and "Engineering Applications in Theory of Elasticity." The first chapter of the first section belongs to the editor and is entitled "Analytical and Numerical Approaches in Engineering Elasticity." The second chapter in the first section is entitled "A General Overview of Stress-Strain Analysis for the Elasticity Equations" by P. Kumar, M. Mahanty, and A. Chattopadhyay. The first chapter of the second section is entitled "FEA and Experimental Determination of Applied Elasticity Problems for Fabricating Aspheric Surfaces" by Dr. D.N. Nguyen. The second chapter is entitled "Concept of Phase Transition Based on Elastic Systematics" by Dr. P.S. Nnamchi and Dr. C.S. Obayi. The third chapter is entitled "Repair Inspection Technique Based on Elastic-Wave Tomography Applied for Deteriorated Concrete Structures" by Dr. K. Hashimoto, Dr. T. Shiotani, Dr. T. Nishida, and Dr. N. Okude. Finally, this book includes the basic principles of elasticity and related engineering applications about theory and design.',isbn:"978-1-78984-928-8",printIsbn:"978-1-78984-927-1",pdfIsbn:"978-1-83881-579-0",doi:"10.5772/intechopen.71471",price:119,priceEur:129,priceUsd:155,slug:"elasticity-of-materials-basic-principles-and-design-of-structures",numberOfPages:106,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"0fa760a58144d1a77a16afba49a3685d",bookSignature:"Ezgi Günay",publishedDate:"January 30th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/6597.jpg",numberOfDownloads:5915,numberOfWosCitations:2,numberOfCrossrefCitations:4,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:4,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:10,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 21st 2018",dateEndSecondStepPublish:"March 14th 2018",dateEndThirdStepPublish:"May 13th 2018",dateEndFourthStepPublish:"August 1st 2018",dateEndFifthStepPublish:"September 30th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"186402",title:"Associate Prof.",name:"Ezgi",middleName:null,surname:"Günay",slug:"ezgi-gunay",fullName:"Ezgi Günay",profilePictureURL:"https://mts.intechopen.com/storage/users/186402/images/system/186402.jpeg",biography:"Ezgi Günay graduated from the Engineering Sciences Department at the Middle East Technical University (METU, Ankara, Turkey) in 1985. She completed her Master of Science degree in 1989 at the same department. The title of her thesis was “Development of a Preprocessor and Modification of a Finite Element Procedure for the Analysis of Metal Forming Processes” (December 1989, METU). She received her PhD from the Mechanical Engineering Department at Gazi University in 1996. The title of the thesis was “A Nonlocking Finite Element Model for Nonlinear Analysis of Thin and Thick Composite Plates.” She worked as an assistant professor between 1999 and 2009 and studied academically by giving basic courses as an associate professor between 2010 and 2020 at the same department. During these years, she gave courses on the following subjects: technical drawing, FORTRAN-computer programming languages, applied mathematics for mechanical engineers, differential equations, statics, dynamics, strength of materials, introduction to numerical analysis, introduction to composite materials, introduction to finite element analysis, finite element method, plate and shell theories, and elasticity. She has authored about 40 papers published both in national and international proceedings and journals. 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The theory of elasticity contains equilibrium equations relating to stresses, kinematic equations relating to the strains and displacements and the constitutive equations relating to the stresses and strains. Concept of normal and shear stresses, principal stress, plane stress, Mohr’s circle, stress invariants and stress equilibrium relations are discussed in analysis of stress section while strain-displacement relationship for normal and shear strain, compatibility of strains are discussed in analysis of strain section through geometrical representations. Linear elasticity, generalized Hooke’s law and stress-strain relations for triclinic, monoclinic, orthotropic, transversely isotropic, fiber-reinforced and isotropic materials with some important relations for elasticity are discussed.",signatures:"Pulkit Kumar, Moumita Mahanty and Amares Chattopadhyay",downloadPdfUrl:"/chapter/pdf-download/64342",previewPdfUrl:"/chapter/pdf-preview/64342",authors:[null],corrections:null},{id:"64709",title:"FEA and Experimentally Determination of Applied Elasticity Problem for Fabricating Aspheric Surfaces",doi:"10.5772/intechopen.79402",slug:"fea-and-experimentally-determination-of-applied-elasticity-problem-for-fabricating-aspheric-surfaces",totalDownloads:1131,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The elastic deformation machining method is suitable for fabricating aspheric surfaces that have excellent physical properties of elastic materials. The machining process is carried out with the deformation model without mold. When vacuum pressure is supplied to the workpiece, the top surfaces of workpiece are deformed into aspheric shape. After machining process, the bottom surface will be formed into the aspheric shape and the top surface returns to its original flat surface form due to internal force and bending moments of the material. However, the accuracy will decrease due to the reduced thickness while the vacuum pressure keeps unchanged during machining process. Therefore, it is necessary to carry out the finite element analysis (FEA) to determine the vacuum pressure with corresponding to the reduced thickness. In addition, the mold with its surface approximates and the desired surface form of the lens is also presented. When uniform vacuum pressure is supplied to the workpiece through small holes of the mold, the workpiece will be deformed into aspheric profile as similar to the mold surfaces. In order to improving the form accuracy, the FEA and the experiment are studied for modifying the mold profile to correspond with bending strength of workpiece material.",signatures:"Duc-Nam Nguyen",downloadPdfUrl:"/chapter/pdf-download/64709",previewPdfUrl:"/chapter/pdf-preview/64709",authors:[null],corrections:null},{id:"63939",title:"Concept of Phase Transition Based on Elastic Systematics",doi:"10.5772/intechopen.81340",slug:"concept-of-phase-transition-based-on-elastic-systematics",totalDownloads:1009,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The use of elastic constants systematics to describe fundamental properties of engineering materials has made materials science education and its related subjects increasingly important not only for manufacturing engineers but also for mankind at large. In this chapter, we present actual scaling of phase transition-driven considerations, such as martensitic transformation and transformable shape memory formation via elastic constant systematics. The scaling in terms of the simple and polycrystals mechanical stability criteria based on the elastic moduli and an acoustic anisotropy is in good agreement with novel experimental data from the literatures, and further, a long-standing concern in predicting polycrystalline elastic constants was considered beyond the commonly encountered criteria.",signatures:"Paul S. Nnamchi and Camillus S. Obayi",downloadPdfUrl:"/chapter/pdf-download/63939",previewPdfUrl:"/chapter/pdf-preview/63939",authors:[{id:"248411",title:"Dr.",name:"Paul Sunday",surname:"Nnamchi",slug:"paul-sunday-nnamchi",fullName:"Paul Sunday Nnamchi"},{id:"271156",title:"Dr.",name:"Camillus",surname:"Obayi",slug:"camillus-obayi",fullName:"Camillus Obayi"}],corrections:null},{id:"63814",title:"Repair Inspection Technique Based on Elastic-Wave Tomography Applied for Deteriorated Concrete Structures",doi:"10.5772/intechopen.80649",slug:"repair-inspection-technique-based-on-elastic-wave-tomography-applied-for-deteriorated-concrete-struc",totalDownloads:959,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Applying elastic wave tomography as an innovative NDT method, the evaluation of velocity distribution in three-dimensional (3D) before and after the repair is introduced in this study. The increase in the velocity with penetration of the repair material according to the repair effect is identified visually and quantitatively. The 3D tomography technique is newly proposed for one-side access inspection, using drill hammering to generate an elastic wave. Accordingly, the elastic wave velocity distribution result enables to visualize the internal quality of concrete after patch repair is successfully done. In addition, an attempt for reinforced concrete (RC) slab panels is made to confirm the effectiveness of the repair by comparing the velocity distribution of elastic waves obtained from acoustic emission (AE) tomography analysis, before and after the repair. Thus, the velocity recoveries due to injection are found in all the slab panels, and it is confirmed that the elastic wave velocities obtained using this technique can serve as an indicator for examining the state of crack and void filling with injected material. Further, a good correlation is found between the low-velocity region before repair and the amount of injection. These results show the potential of the AE tomography technique to be used as a method for estimating the effect of injection repair.",signatures:"Katsufumi Hashimoto, Tomoki Shiotani, Takahiro Nishida and Nobuhiro Okude",downloadPdfUrl:"/chapter/pdf-download/63814",previewPdfUrl:"/chapter/pdf-preview/63814",authors:[null],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6233",title:"Natural and Artificial Fiber-Reinforced Composites as Renewable Sources",subtitle:null,isOpenForSubmission:!1,hash:"3bdc5c86f24513451093c4484320aa8a",slug:"natural-and-artificial-fiber-reinforced-composites-as-renewable-sources",bookSignature:"Ezgi Günay",coverURL:"https://cdn.intechopen.com/books/images_new/6233.jpg",editedByType:"Edited by",editors:[{id:"186402",title:"Associate Prof.",name:"Ezgi",surname:"Günay",slug:"ezgi-gunay",fullName:"Ezgi Günay"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5503",title:"Wood in Civil Engineering",subtitle:null,isOpenForSubmission:!1,hash:"fb659c92f0d45acc8f960d9a656b54e2",slug:"wood-in-civil-engineering",bookSignature:"Giovanna Concu",coverURL:"https://cdn.intechopen.com/books/images_new/5503.jpg",editedByType:"Edited by",editors:[{id:"108709",title:"Dr.",name:"Giovanna",surname:"Concu",slug:"giovanna-concu",fullName:"Giovanna Concu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2193",title:"Advances on Analysis and Control of Vibrations",subtitle:"Theory and Applications",isOpenForSubmission:!1,hash:"926bac5ebecf5b70140e42105b5e2527",slug:"advances-on-analysis-and-control-of-vibrations-theory-and-applications",bookSignature:"Mauricio Zapateiro de la Hoz and Francesc Pozo",coverURL:"https://cdn.intechopen.com/books/images_new/2193.jpg",editedByType:"Edited by",editors:[{id:"148213",title:"Dr.",name:"Mauricio",surname:"Zapateiro",slug:"mauricio-zapateiro",fullName:"Mauricio Zapateiro"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8822",title:"Advances in Structural Health Monitoring",subtitle:null,isOpenForSubmission:!1,hash:"429d24d493e64821ae08df0a71d33e37",slug:"advances-in-structural-health-monitoring",bookSignature:"Maguid H.M. 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The book presents state-of-the-art techniques for calculating ground motion amplification due to sediments above the engineering bedrock employing strong-motion recordings and microtremor data. It also explains liquefaction phenomena through interpretive structural modeling techniques. Finally, the book presents pile foundations’ seismic behavior on liquefiable soils and remedial countermeasures against earthquake attacks.",isbn:"978-1-83962-429-2",printIsbn:"978-1-83962-424-7",pdfIsbn:"978-1-83962-430-8",doi:"10.5772/intechopen.87816",price:119,priceEur:129,priceUsd:155,slug:"earthquakes-from-tectonics-to-buildings",numberOfPages:224,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"1f9859a0a16af53d80bf3952fba7a272",bookSignature:"Walter Salazar",publishedDate:"May 19th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/9993.jpg",keywords:null,numberOfDownloads:2979,numberOfWosCitations:1,numberOfCrossrefCitations:7,numberOfDimensionsCitations:9,numberOfTotalCitations:17,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 9th 2020",dateEndSecondStepPublish:"September 10th 2020",dateEndThirdStepPublish:"November 9th 2020",dateEndFourthStepPublish:"January 28th 2021",dateEndFifthStepPublish:"March 29th 2021",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:'Dr. Salazar has been recently presented with a Distinguished Salvadoran national Award on 2011 and led the Seismic Hazard/Risk Assessment projects at the University of the West Indies (UWI) – Seismic Research Centre, Trinidad and has been appointed to be a peer reviewer of several scientific journals including Natural Hazards, Journal of Seismology and International Journal of Disaster Risk Science (Springer). He is also a peer reviewer of "Soil Dynamics and Earthquake Engineering" (Elsevier).',coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"236461",title:"Dr.",name:"Walter",middleName:null,surname:"Salazar",slug:"walter-salazar",fullName:"Walter Salazar",profilePictureURL:"https://mts.intechopen.com/storage/users/236461/images/system/236461.jpg",biography:"Dr. Walter Salazar is a structural civil engineer who obtained a doctoral degree in Engineering Seismology from the Interdisciplinary Graduate School of Science and Engineering, Tokyo Institute of Technology, Japan, in 2004. Dr. Salazar has been active in site-effects and seismic hazard research, producing several peer-reviewed maps for El Salvador, Jamaica, and the Eastern Caribbean. He has published sixty articles in peer-reviewed journals, books, and international conferences. 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1. Introduction
\n
In food, pharmaceutical, and biotechnology industries, spray drying is the most used drying method. In this, a material in liquid state is fed by atomization in the form of fine droplets into a drying chamber, to obtain a solid product (powder). The outlet temperature of the dried product is between the wet bulb temperature and the outlet drying air temperature, remaining below 100°C [1]. Some factors that have shown effect on the final quality characteristics of food powders obtained by spray drying are the type of atomizer (two-fluid nozzle, sonic nozzle, spray nozzle, or rotatory disc), the physical properties of fed materials, heat and mass transfer phenomena, the average size of the atomized drops and their distribution, particle trajectory, size, and speed of particles [2, 3].
\n
The food powders with high sugar content can be classified into two groups: sticky and non-sticky. The non-sticky products such as milk products and egg powders are obtained by spray drying in simple operating conditions and are characterized by free-flowing powders [4]. The powders obtained from fruit juices, honey, and lactose are examples of sticky products. These products are difficult to dry in a spray dryer due to their high sugar content (sucrose, glucose, lactose, and fructose), organic acids (citric, malic, and tartaric acid) [5], and hygroscopic characteristics. To improve the efficiency of drying process of sticky materials, agents of high molecular weight such as maltodextrins are used because of their high solubility, low viscosity, and high glass transition temperature [4, 6].
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2. Drying
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Drying is defined as the elimination of water in relatively small quantities of certain materials, under controlled conditions. Drying or dehydration of biological materials, in particular food products, is used as a conservation method [7]. The microorganisms that cause food decomposition cannot grow and multiply in the absence of water, and many enzymes that cause biochemical changes in the food and other biological materials may be inactive [8]. Microorganisms are inactive when the moisture content is below 10%. However, it is usually necessary to reduce the moisture content below 5% of weight in food to preserve its flavor and nutritional value [9].
\n
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3. Spray drying
\n
Spray drying, as unitary operation, is used to transform liquid into solid particles (powder), eliminating moisture. In food industry, spray drying is widely used as an encapsulation method for food ingredients such as flavors, vitamins, minerals, dyes, waxes, and oils, in order to protect them from environmental stress and prolong the storage stability [10, 11]. Spray drying is commonly used in the food industry since, in comparison with other encapsulation techniques, its cost of production is low, has high availability of equipment, and also produces particles of good quality [12]. The fed materials (solution, emulsion, suspension) are atomized within the drying chamber in the form of very small drops (between 20 and 250 μm). This increases the total contact surface, improving the evaporation of the solvent (usually water).
\n
When the product is encapsulated by spray drying, the nucleus exists as microparticles or droplets distributed within the dry solid capsule. According to the size of the particle, the encapsulation is classified as macro (>5000 μm), micro (0.2–5000 μm), and nano (<0.2 μm). Some authors point out that spray drying can be considered a sustainable process for the consolidation of nanoparticles within a spherical particle of micron size, but with properties in nano scale [13, 14].
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Spray-drying equipment components are heating system and circulation of air, atomizer (nozzle or rotary disk), and powder recovery system. The most important stage of spray drying is atomization, because this affects the size, distribution of the droplets and, consequently, the final particle size. The most used atomizers are the rotary disc and pressure nozzle. Two-fluid pneumatic nozzles are used in special applications or in low-capacity dryers in pilot plants. Surface tension, viscosity, and density are the main characteristics of liquid that influence atomization [15]. Processing parameters such as configuration of dryer and operating conditions exert a significant influence on the properties of the final product [16, 17].
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3.1. Drying stages
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The main stages of a dryer spray are atomization of the fed product, contact air-drop, evaporation of moisture from the product, and recovery of the dry product [15].\n
Atomizing—this stage generates fine drops, increasing the relationship surface-mass, and it is the key parameter to determine the size of the particle. In all cases, the atomization occurs when the magnitude of the disruptive force exceeds the size of the surface tension [15].
Contact of drying air droplet—at this stage, the atomized droplets fall into a hot air flow inside the drying chamber. The contact can be on different arrays of liquid flow with the drying air flow (co-current, countercurrent, or mixed flow) [18].
Evaporation—the process of elimination of solvent contained in the droplet is divided into two phases. In the first stage, the droplet is heated when contacting with hot air, achieving a value closer to the wet bulb temperature, which corresponds to the drying air condition; in the second stage, a shell is formed, and diffusional process of water and soluble solids are detected [19].
Solids recovery—in the last stage, the powder is collected in a cyclone, which consists of a cylinder with a tangential opening through which the gas flows with particles generated in the dryer [20].
\n
During evaporation stage, in the first step, the drying rate is almost constant, at which the surface of the drop remains saturated by the migration of water from the inside to the outside of the particle, and at the same time the solutes are concentrated, and the droplet diameter can be reduced. On the contrary, the drying air temperature decreases, and the particle temperature is increased [21]. In the second step, two regions of the particle are distinguished: a dried shell and a wet core. Drying of the particle speed is controlled by the moisture diffusion from the center to the surface of the shell. As a result of drying, the thickness of the crust increases, and its temperature rises to the set by the end of the process. Once the moisture content drops to a minimum value, the product is considered as a dry particle [22, 23].
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3.2. Spray drying of high-sugar products
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Food products dried by this process can be classified into sticky and non-sticky products. This categorization is relative, since some non-sticky products behave in an opposite manner, depending on the process conditions and hygroscopicity [24].
\n
The non-sticky products can be treated through a simple dryer, and the powders obtained have a low hygroscopicity and can be classified as free-flow powders. The non-sticky products are dairy powders, micro-encapsulated powders, and powdered white egg. These powders can be dried in single operating conditions and are characterized by dust that flows free [5, 25].
\n
In sticky products such as juicy fruits and vegetables, the spray drying treatment is usually difficult [24]. Sticky products hinder spray drying in normal conditions, such as powders obtained from the juice of fruits and vegetables, honey powder, and lactose powder. This is mainly due to the high content of sugars (sucrose, glucose, lactose, and fructose) and organic acids (citric, malic, and tartaric acid). During drying a product with a high content of sugar, the viscosity of the drops increases until it reaches a critical value (107 Pa s), making it a rubbery product prior to obtaining an amorphous structure. This kind of gumminess is considered as a sticky structure that is linked to the water activity (Aw) and temperature, which is between the glass transition temperature and the temperature at which the product is sticky (10–30°C) [26]. When the surface of the droplet reaches a sticky state, it raises the coalition with any area of the surface of another particle. This accumulation or agglomeration depends on the speed, strength, angle, and contact time. The result is considered negative for the case in which the particles adhere to the internal walls of the dryer chamber, causing a loss of the product. However, there are positive benefits when the particles are linked among them, contributing to the drying and changing its structure, forming clumps [27]. The moisture content in sticky products such as juice powder fruit must be between 2 and 4% [25]. Controlling the moisture content is very important, since it has a direct effect on the powder quality.
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\n
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4. General characteristics of powders
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Spray drying of liquid foods or biological materials produces amorphous particles mainly due to the rapid evaporation and the short time for crystallization [28]. Since morphological features are created by the loss of moisture, the rigidity of the surface of amorphous particles depends on the temperature and moisture content [28, 29].
\n
The formation of microparticles takes place when the sprayed droplet enters in contact with the gas (hotter than 100°C). While the moisture is removed, the shell particle is formed, creating structures with different shapes. The vapor produced inside particles expands and collapses the particle structure; therefore, such vapor is primarily responsible for the powder development [30, 31].
\n
When the initial solution is a homogeneous product, it is transformed into two layers; one of them is dense, and the other reveals a porous surface. However, the development of particle microstructure is complex due to the interaction of drying operation conditions and physicochemical liquid-fed composition [31, 32]. When using maltodextrin, changes in the morphological structure of particles are related to the moisture content of material and drying air temperatures. At low temperatures, particles with rough surface were observed; at high temperatures, a smooth surface (but with a greater number of particles broken or fragmented) was developed [31].
\n
4.1. Morphology and microstructure
\n
The particle morphology is described in terms of particle size, shape, surface properties, and internal structure [33]. It is determined by the physical and chemical properties of the particle shell, which at the same time depend on the composition and concentration of power, viscosity, and drying air conditions [34].
\n
Optical microscopy, confocal laser scanning microscopy, and electron microscopy scanning are different techniques used to characterize powder (primary and secondary or agglomerates). Additionally, through digital image analysis, quantitative information is obtained [30, 35]. The scanning electron microscopy (SEM) is one of the most appropriate techniques for the characterization of the morphology and microstructure of food. It is based on the scanning of the sample surface, and it produces results in the form of digital images obtained directly from the microscope. The images can be translated into numeric data for subsequent statistical analysis, and its quantification at any resolution scale may indicate structural changes due to processing [36].
\n
In this sense, digital image analysis is a useful tool that allows using an image to quantitatively describe the different morphometric, colorimetric, and statistical characteristics. Quantification and classification of images via dimensional descriptors such as shape, texture, diameter, and area allow the identification of structural changes at any resolution level. Digital image analysis can be used to evaluate, compare, and characterize microencapsulation under different processing conditions [37, 38].
\n
\n
\n
5. Case study
\n
A fruit of special interest is the xoconostle (Opuntia matudae). It is an acid fruit containing a significant amount of polysaccharides, soluble fiber, simple phenols, betalains, and ascorbic acid (which confers antioxidant capacity) [39], among other compounds such as proteins and ashes. In order to improve the sustainable development in rural agricultural areas, the processing of xonocostle could be done by the spray drying of the juice, and the resulting product could be used as a food additive. However, due to its high sugar content, the juice has to be added with a drying adjuvant such as maltodextrin in order to improve the drying process.
\n
5.1. Opuntia xoconostle fruit
\n
The xoconostle fruit is a pyriform berry with an apical depression or receptacle. It is composed of the epicarp (skin or shell), mesocarp (pulp), and the endocarp where the seeds are tightly bound in a mucilaginous structure [40] (Figure 1). In the genus Opuntia, a wide variety of species that produce xoconostle fruit have been reported, including Opuntia joconostle and Opuntia matudae (Xoconostle cuaresmeño). Xoconostle is an acid fruit that has been underused and considered as an agricultural waste product, although it contains a significant amount of fiber, minerals, phenolic compounds, betalains, organic acids, and waxes [39] with an important nutritional contribution, which makes it an attractive product.
\n
Figure 1.
Image of whole and half of Xoconostle cuaresmeño fruit. The arrows show the epicarp, mesocarp, endocarp, and seeds.
\n
\n
5.2. Production of xoconostle juice and powder
\n
Xoconostle cuaresmeño (Opuntia matudae) of the municipality of San Martín de las Pirámides, Mexico State, Mexico, was collected. The xoconostle batch was put in wooden boxes with kraft paper covering the fruit. Then, it was stored under refrigeration conditions until processing.
\n
Juice extraction was performed by subjecting the fruit clean, after cut into slices, to water bath using the 2:1 ratio (fruit-water) at 70°C for 20 min. Then it was crushed in a pulper machine. The fruit juice was extracted including compounds of the mucilage and seed. Maltodextrin 20DE was added in the ratio 1:1 w/w (with respect to xoconostle total solids). Maltodextrin was used as adjuvant for spray drying juice. After obtaining the blend, an aliquot was separated for analysis, and the rest was spray dried.
\n
A two-fluid nozzle laboratory co-current spray dryer (Mobile Minor 2000, GEA Niro, Denmark) was used, equipped with a peristaltic pump (Model 520, Watson Marlow, USA) for liquid flow control. The spray drying was conducted under 110/60, 155/70, and 200°C/80°C, as inlet/outlet drying air temperature.
\n
\n
5.3. Characterization of xoconostle juice and powder
\n
5.3.1. Degrees Brix (°Bx)
\n
The degrees Brix refers to the amount of dissolved solids extracted from fruit or sugary liquids. The method is based on the change of direction of the light because of the separation of two media in which the velocity of propagation is different. Degrees Brix reading was carried out with a refractometer (Master T, Atago, Japan). Measurements were done in triplicate.
\n
\n
5.3.2. Powder moisture content (MC)
\n
One gram of powder sample was poured into an aluminum tray (constant weight) and was placed in a vacuum oven at 60°C for 24 h [41]. Measurements were done in triplicate.
\n
\n
5.3.3. Water activity (Aw)
\n
One gram of xoconostle powder sample was put in a cell and then subjected to scanner computer activity using a water activity analyzer (AquaLAB 4TE, Decagon Devices, USA), at a constant temperature of 24 ± 1°C. Measurements were done in triplicate.
\n
\n
5.3.4. Glass transition temperature (Tg)
\n
Fifteen milligrams of xoconostle juice powder were poured into an aluminum capsule to be analyzed using a calorimeter (DSC Diamond, Perkin Elmer, USA). The temperature interval of the analysis was from −40 to 120°C, at a heating speed of 5°C/min. The resulting thermograms were analyzed to determine the glass transition temperature (Tg) [42].
\n
\n
5.3.5. Scanning electron microscopy (SEM)
\n
To assess the morphology of microparticles, powders were fixed on carbon tape placed on a specimen slide, and the remainders were removed. Samples were observed by means of a double-beamed scanning electron microscope (Dual Beam Nova 200 Nanolab, FEI) operated at 1.00 kV (for sensible materials), a total amplification of 1000×, 3000×, and 5000× [30]. Measurements were done in triplicate.
\n
\n
5.3.6. Particle size and shape by digital image analysis
\n
To assess the distribution and particle size, powder samples obtained after spray drying were analyzed using software ExpertShape, where the acquisition of images was carried out manually using the light microscope (CILAS 1090-ExpertShape-NT 2107380, France), which has a video camera with a peak bandwidth of 23.2 MB/s. A microscope suited with a 10× objective lens was used. Illumination was provided by a light-field source. A total of 1300 particles were analyzed for each experiment.
\n
For particle measuring, software ExpertShape acquires the image of a particle defined as a group of contiguous nonzero pixels. Particles can be characterized by a relationship of measures depending on their attributes such as location of the particle, area, and form factor. The coordinates are expressed with reference to the origin (0, 0), located at the upper left corner of the image. When extracting a particle in the image, the outline is defined by the projection of the sensor cutting. Contour is defined by scanning the sequence of adjacent pixels for each particle. The outline is drawn using the chain of “Freeman” code (gray-level image, the thresholder image, the shape without holes and smooth contour, and extracted contour with Freeman chain-code algorithm). Some morphological parameters that could be evaluated are area (A); perimeter (P, as the length of the contour of the particle); mean Feret diameter (Calipter diameter) defined as the distance between two tangents on opposite sides of the particle, parallel to some fixed directions, touching opposite sides of particle; maximum Feret diameter, as the length of particle; minimum Feret diameter is the width of particle; equivalent circular diameter is calculated as the circumference with the same area as the projected particle; roundness is defined as the ratio of the area of a circle (the most compact shape) that has the same perimeter, and the closer the shape of the particle is to a disk, the closer the roundness is to 1; equivalent ellipse ratio, as the ratio of the major axis to its minor axis (elliptical shapes exhibit ratio >1) [43].
\n
\n
5.3.7. Total phenols by Folin-Ciocalteu method
\n
Total phenols of xoconostle juice and powder were obtained by the method of Folin-Ciocalteu to determine the thermal damage caused by drying air temperature as an operation condition of spray drying.
\n
For the extraction of total phenols, 1 g of powder was mixed with 5 mL of 80% methanol and shaken for 30 min at 200 rpm at room temperature. The sample was decanted using filter paper of 110 mm (qualitative circles Whatman 3). The supernatant was separated and placed into an amber glass bottle. The sediment was reconstituted, using 8 mL of 80% ethanol, and the procedure was repeated twice. Thereby, three extractions were joined to be analyzed. For the xoconostle juice, a sample of 4 mL was used, following the previous methodology. For the quantification stage, 0.75 μL of Folin-Ciocalteu reagent (1:10) was added to 100 μL of the extract, and the mixture was left to stand for 5 min in the dark. Subsequently, 0.75 mL of NaHCO3 60 g/L solution was added to neutralize the reaction. The solution was left to stand for 90 min, and the absorbance was determined at 725 nm. The results were reported as mg gallic acid equivalents/100 g (db) [44]. Measurements were done in triplicate.
\n
\n
5.3.8. Extraction and quantification of betalains
\n
One gram of powder sample was mixed with 5 mL of a solution: methanol ((80:20 v/v), stirring (at maximum speed) using a magnetic stirrer for 30 min and 5°C. The solution was filtered using a membrane pore with a size of 110 mm. The obtained extract was analyzed, expressing the result as mg of betacyanin/100 g of sample (db), since it has been reported that betacyanins are the main components of betalains [45, 46].
\n
\n
5.3.9. Antioxidant activity
\n
ABTS (7 mM) radical cation (ABTS•+) solution was prepared by reacting ABTS (2, 2\'‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulphonic acid)) with 2.45 mM potassium persulfate and allowing the mixture to stand in the dark at room temperature for 12–16 h. The ABTS•+ radical was diluted with ethanol to give an absorbance of about 0.700±0.02 at 734 nm. In order to measure the antioxidant capacity, 10 μL of the extract was mixed with 990 μL of radical solution. The absorbance was monitored at 734 nm for 7 m. All experiments were carried out in triplicate. The results were expressed in terms of mM Trolox equivalent/g sample (mM TE/g, db) [44, 47].
\n
\n
\n
5.4. Results and discussion
\n
Spray drying of xoconostle juice was conducted with low content of maltodextrin as carrier substances, improving the drying characteristics, avoiding technical problems such as the presence of sticky powder and the accumulation of wet material on the walls of the drying chamber and the mechanical cyclone. Although xoconostle juice contains a very low solid concentration (3°Brix), this value was the reference to choose the quantity of carrier agents to be mixed with the juice. The relation of juice solids-maltodextrin (1:1) was enough to reach yield levels from 42 to 79%, the best drying condition being at 110°C/60°C, to obtain the highest powder recuperation (Figure 2). This fact could be affected by the powder density and mean particle size, by keeping constant the concentration of the feed flow and atomizer pressure (0.6 Bars). Low drying air temperature produces compact and small particles, as reported by Alamilla-Beltrán et al. [31].
\n
Figure 2.
Images of the xoconostle juice and the xoconostle juice powder obtained by spray drying at 110°C/60°C as inlet/outlet drying air temperatures.
\n
Moisture content, water activity, and glass transition temperature (Tg) were evaluated for all conditions, obtaining values of 4–4.98% (db), 0.19–0.23, and 34.37–38°C, respectively (Table 1). The results showed that powdered xoconostle juice was highly stable due to reduced values of moisture and water activity, improving storage stability with the incorporation of a carrier of high molecular weight such as maltodextrin by increasing the glass transition temperature, and considering that fructose has lower values of Tg (16–17.6°C).
\n
\n
\n
\n
\n
\n\n
\n
Parameters
\n
Drying air temperature (inlet/outlet) (°C)
\n
\n
\n
110/60
\n
155/70
\n
200/80
\n
\n\n\n
\n
Moisture content (% db)
\n
4.99
\n
4.07
\n
4.88
\n
\n
\n
Water activity (Aw)
\n
0.19
\n
0.22
\n
0.23
\n
\n
\n
Glass transition temperature (°C)
\n
34.70
\n
34.75
\n
38.45
\n
\n
\n
Feret diameter mean (μm)
\n
14.76
\n
16.11
\n
16.12
\n
\n
\n
Feret diameter max (μm)
\n
12.12
\n
11.12
\n
13.27
\n
\n
\n
Feret diameter min (μm)
\n
16.87
\n
17.76
\n
18.40
\n
\n
\n
Equivalent elliptical ratio
\n
1.94
\n
1.80
\n
1.85
\n
\n
\n
Form factor (roundness)
\n
0.8055
\n
0.8571
\n
0.8453
\n
\n
\n
Phenolic content (mgGAE/100 g)
\n
1250.10
\n
1365.60
\n
1359.10
\n
\n
\n
Betalain content (mg/100 g)
\n
2.65
\n
2.14
\n
2.42
\n
\n
\n
Antioxidant capacity (mM TE/g)
\n
65.08
\n
64.39
\n
67.26
\n
\n\n
Table 1.
Mean values of different parameters evaluated for xoconostle juice powder obtained by spray drying process at three different inlet/outlet drying air temperatures.
\n
This variety of fruit contains compounds such as oxalates, organic acids, vitamins, and wax. In this study, the effect of these has not been analyzed; however, it could exist as an important interaction between wax and maltodextrin, which may improve the protective effect upon powdered xoconostle juice. Regarding the drying temperature, the highest condition improves the reduction on powder moisture content, although this difference is minimal. No evident difference was found in the water activity values, which means that drying temperatures do not affect this parameter, getting low values in all cases. At all combined values of water activity and moisture content obtained in this work, biochemical reaction and enzymatic activity were inhibited, and bacterial growth could be reduced.
\n
During spray drying, mass and heat transfer mechanisms act inducing the evaporation of water; meanwhile, solids and moisture content diffuse from the inside of droplets to the outside, developing solid particles. This migration of components was induced by the air-drying temperature and diffusion factors, to create powders with microstructures that influence the final quality of powders.
\n
Powder microstructure could be analyzed by using diverse methods. In this work, scanning electron microscopy (SEM), optical microscopy, and digital image analysis provided information about morphometric parameters such as size, perimeter, area, shape, and structure of microparticle (Table 1). Under all conditions, the powdered xoconostle juice (analyzed with SEM) revealed spherical individual particles (primary particles) forming weak agglomerates (secondary particles). The shape of primary particles tends to be spherical with slightly deep depressions of surface; meanwhile, agglomerates form an elliptical shape, without a structured order. Some particles exhibit an external surface with highly porous aspect. This fact could be caused by a selective migration of solutes dissolved in the xoconostle juice. Solutes with low molecular weight could diffuse quickly to the surface forming the porous shell, which means that sugars may be structured and form the external surface. These kinds of particles are not desirable due to the high hygroscopicity of sugars. For all drying temperatures, particle microstructure was similar, with differences assessed by morphometric parameters.
\n
Morphometric parameters evaluated by optical microscopy and digital image analysis described differences in particles for all experimental conditions. In this case, knowledge on morphometric parameters is useful to improve the particle description, so identifying any change induced by the processing conditions (drying air temperature, atomizing pressure, and concentration of feed flow) is useful to improve the spray drying process. This means that any change in the processing conditions will be translated into physicochemical properties of powders. In this work, the morphological parameters gave information about dimensions and particle shape.
\n
The highest particles measured by mean Feret diameter (16.12 μm), maximum Feret diameter (18.4 μm), minimum Feret diameter (13.3 μm), and area (209 μm2) were obtained at 200°C/80°C. These results could explain the lower moisture content and water activity values obtained at 200°C/80°C, and due to particle expansion, the moisture diffusion could be facilitated through thin wall particles. The opposite was observed in products obtained at reduced drying air temperatures.
\n
Although primary particles observed by SEM seem to be spherical and the agglomerates showed an elliptical form, form factor (or roundness) and equivalent ellipse ratio were calculated as a descriptor of bulk powder. Values of roundness were close to 0.85 for all conditions, being lightly higher for particles obtained at 200°C/80°C, so it could be related to particle expansion and less formed agglomerates (1.84 as equivalent elliptical ration). In the case of 110°C/60°C, this parameter was 1.94.
\n
For all drying air temperatures, total phenolics (1250–1366 mg GAE/100 g), betalain content (2.14–2.65 mg/100 g), and antioxidant activity (64–67 mM TE/g) did not exhibit significant differences. This means that any option could be applied to produce a powdered xoconostle juice containing phenolic compounds and betalains; however, microstructural, physicochemical, and flow properties have to be considered when a powder with functional properties is designed.
\n
\n
\n
6. Conclusions
\n
The spray drying process has been widely used as a useful tool to generate functional products in the form of powders. The processing of xoconostle juice by spray drying allows proposing an option to strengthen the sustainable use of this product as a natural additive in the food Industry, reinforcing the valorization and reutilization of valuable components found in the agro-industrial waste. By keeping constant the drying conditions (such as feed concentration, atomization pressure, flow arrangement, and type of atomizer) and changing the drying air temperature, the powdered xoconostle juice was obtained.
\n
For all cases, the drying air temperature had an evident positive effect upon physical stability given by the low values of water activity and moisture content, and the increase in Tg by the addition of maltodextrin. The biological functionality (evaluated by total phenolics, betalains, and antioxidant activity) was also kept in similar values for all drying conditions. The most evident changes were observed at microscopic scale. For designing similar products, it is necessary to consider the interactions between food properties (microstructural, functional, physicochemical, and flow) to take the best decision.
\n
\n
Acknowledgments
\n
The authors acknowledge SIP-IPN (Projects 20160284, 20161775, and 20161749); CONACyT-Mexico for financial support (Projects 216044 and 272150-MOR2015); and COFAA-IPN. Jaime Jiménez-Guzmán thanks CONACYT-Mexico and IPN for study grant.
\n
\n',keywords:"spray drying, food powders, xoconostle juice, microstructure, betalains, phenolics content, antioxidant activity",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/51104.pdf",chapterXML:"https://mts.intechopen.com/source/xml/51104.xml",downloadPdfUrl:"/chapter/pdf-download/51104",previewPdfUrl:"/chapter/pdf-preview/51104",totalDownloads:2098,totalViews:375,totalCrossrefCites:1,totalDimensionsCites:2,totalAltmetricsMentions:0,impactScore:1,impactScorePercentile:73,impactScoreQuartile:3,hasAltmetrics:0,dateSubmitted:"November 17th 2015",dateReviewed:"April 15th 2016",datePrePublished:null,datePublished:"August 31st 2016",dateFinished:"June 11th 2016",readingETA:"0",abstract:"The xoconostle fruit (Opuntia matudae) is rich in polysaccharides, soluble fiber, simple phenols, betalains, and ascorbic acid. However, its consumption is limited due to its high acidity. Spray drying could be a technological option to strengthen the sustainability of xoconostle giving a re-valorization as a possible natural additive for the food industry. The food powders have to be designed considering aspects related to the effect of processing conditions on final quality properties; in this case, the effect of different drying air temperatures was evaluated on moisture content, water activity (Aw), glass transition temperature, microstructure, antioxidant activity, phenolic, and betalain compounds. For all cases, the drying air temperature had a positive effect on physical stability, at low levels of water activity and moisture content, and glass transition temperature (Tg) was increased. The biological functionality (assessed through phenolics, betalain compounds, and antioxidant activity) was also kept constant for all processing conditions investigated. However, the most evident changes were observed at microscopic scale analyzed through morphometric parameters.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/51104",risUrl:"/chapter/ris/51104",book:{id:"5266",slug:"sustainable-drying-technologies"},signatures:"Jaime Jiménez-Guzmán, Diana E. Leyva-Daniel, Brenda H. Camacho-\nDíaz, Antonio R. Jimenéz-Aparicio and Liliana Alamilla-Beltrán",authors:[{id:"182399",title:"Dr.",name:"Liliana",middleName:null,surname:"Alamilla-Beltrán",fullName:"Liliana Alamilla-Beltrán",slug:"liliana-alamilla-beltran",email:"liliana.alamilla@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"186389",title:"MSc.",name:"Jaime",middleName:null,surname:"Jiménez-Guzmán",fullName:"Jaime Jiménez-Guzmán",slug:"jaime-jimenez-guzman",email:"jaimejimenezguzman@yahoo.com.mx",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"186390",title:"MSc.",name:"Diana E.",middleName:null,surname:"Leyva-Daniel",fullName:"Diana E. Leyva-Daniel",slug:"diana-e.-leyva-daniel",email:"diana.leyva@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"186391",title:"Dr.",name:"Brenda H.",middleName:null,surname:"Camacho-Díaz",fullName:"Brenda H. Camacho-Díaz",slug:"brenda-h.-camacho-diaz",email:"bcamacho@ipn.mx",position:"Researcher",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"186392",title:"Dr.",name:"Antonio R.",middleName:null,surname:"Jiménez-Aparicio",fullName:"Antonio R. Jiménez-Aparicio",slug:"antonio-r.-jimenez-aparicio",email:"aaparici@ipn.mx",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Drying",level:"1"},{id:"sec_3",title:"3. Spray drying",level:"1"},{id:"sec_3_2",title:"3.1. Drying stages",level:"2"},{id:"sec_4_2",title:"3.2. Spray drying of high-sugar products",level:"2"},{id:"sec_6",title:"4. General characteristics of powders",level:"1"},{id:"sec_6_2",title:"4.1. Morphology and microstructure",level:"2"},{id:"sec_8",title:"5. Case study",level:"1"},{id:"sec_8_2",title:"5.1. Opuntia xoconostle fruit",level:"2"},{id:"sec_9_2",title:"5.2. Production of xoconostle juice and powder",level:"2"},{id:"sec_10_2",title:"5.3. Characterization of xoconostle juice and powder",level:"2"},{id:"sec_10_3",title:"5.3.1. Degrees Brix (°Bx)",level:"3"},{id:"sec_11_3",title:"5.3.2. Powder moisture content (MC)",level:"3"},{id:"sec_12_3",title:"5.3.3. Water activity (Aw)",level:"3"},{id:"sec_13_3",title:"5.3.4. Glass transition temperature (Tg)",level:"3"},{id:"sec_14_3",title:"5.3.5. Scanning electron microscopy (SEM)",level:"3"},{id:"sec_15_3",title:"5.3.6. Particle size and shape by digital image analysis",level:"3"},{id:"sec_16_3",title:"5.3.7. Total phenols by Folin-Ciocalteu method",level:"3"},{id:"sec_17_3",title:"5.3.8. Extraction and quantification of betalains",level:"3"},{id:"sec_18_3",title:"5.3.9. Antioxidant activity",level:"3"},{id:"sec_20_2",title:"5.4. Results and discussion",level:"2"},{id:"sec_22",title:"6. Conclusions",level:"1"},{id:"sec_23",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'\nSougnez, M. The development of the spray drying (L’évolutione du séchage par atomisation). Chim. Mag. 1983, 1, 1–4.\n'},{id:"B2",body:'\nAllen, R, Bakker, H. Spray dryer control based on-line particle size analysis. Chem. Eng. Res. Des. 1994, 72: 251–254. DOI: 10.1017/CBO9781107415324.004.\n'},{id:"B3",body:'\nOakley, DE. Scale-up of spray dryers with the aid of computational fluid dynamics. Dry. Technol. 1994, 12: 217–233. DOI: 10.1080/07373939408959954.\n'},{id:"B4",body:'\nGoula, AM, Adamopoulos, KG. Effect of maltodextrin addition during spray drying of tomato pulp in dehumidified air: I. Drying kinetics and product recovery. Dry. Technol. 2008, 26: 714–725. DOI: 10.1080/07373930802046369.\n'},{id:"B5",body:'\nAdhikari, B, Howes, T, Bhandari, B, Troung, V. Effect of addition of maltodextrin on drying kinetics and stickiness of sugar and acid-rich foods during convective drying: experiments and modelling. J. Food Eng. 2004, 62: 53–68. DOI: 10.1016/S0260-8774(03)00171-7.\n'},{id:"B6",body:'\nLangrish, TAG, Kota, K. A comparison of collision kernels for sprays from one and two-nozzle atomisation systems. Chem. Eng. J. 2007, 126: 131–138. DOI: 10.1016/j.cej.2006.07.015.\n'},{id:"B7",body:'\nMuzaffar, K, Kumar, P. Moisture sorption isotherms and storage study of spray dried tamarind pulp powder. Powder Technol. 2016, 291: 322–327. DOI: 10.1016/j.powtec.2015.12.046.\n'},{id:"B8",body:'\nSamborska K, Witrowa-Rajchert, D, Goncalves, A. Spray‐drying of alpha-amylase – the effect of process variables on the enzyme inactivation. Dry. Technol. 2005, 23: 941–953. DOI: 10.1081/DRT-200054243\n'},{id:"B9",body:'\nTan, SP, Kha, TC, Parks, SE, Stathopoulos, CE, Roach, PD. Effects of the spray-drying temperatures on the physiochemical properties of an encapsulated bitter melon aqueous extract powder. Powder Technol. 2015, 281: 65–75. DOI: 10.1016/j.powtec.2015.04.074.\n'},{id:"B10",body:'\nEzhilarasi, PN, Indrani, D, Jena, BS, Anandharamakrishnan, C. Microencapsulation of Garcinia fruit extract by spray drying and its effect on bread quality. J. Sci. Food Agric. 2014, 94: 1116–1123. DOI: 10.1002/jsfa.6378.\n'},{id:"B11",body:'\nAdhikari, B, Howes, T, Bhandari, BR, Truong, V. Experimental studies and kinetics of single drop drying and their relevance in drying of sugar-rich foods: a review. Int. J. Food Prop. 2000, 3: 323–351. DOI: 10.1080/10942910009524639.\n'},{id:"B12",body:'\nRisch, S. Encapsulation: overview of uses and techniques. ACS Symp. Ser. 1995, 7: 2–7. DOI: doi:10.1021/bk-1995-0590.ch001.\n'},{id:"B13",body:'\nOkuyama, K, Wuled Lenggoro, I. Preparation of nanoparticles via spray route. Chem. Eng. Sci. 2003, 58: 537–547. DOI: 10.1016/S0009-2509(02)00578-X.\n'},{id:"B14",body:'\nJafari, SM, He, Y, Bhandari, B. Encapsulation of nanoparticles of d-limonene by spray drying: role of emulsifiers and emulsifying techniques. Dry. Technol. 2007, 25: 1069–1079. DOI: 10.1080/07373930701396758.\n'},{id:"B15",body:'\nLefebvre, AH. Atomization [Internet]. 2011. Available from: http://www.thermopedia.com/content/573/ [Accessed: 2016-01-15]\n'},{id:"B16",body:'\nSoottitantawat, A, Bigeard, F, Yoshii, H, Furuta, T, Ohkawara, M, Linko, P. Influence of emulsion and powder size on the stability of encapsulated d-limonene by spray drying. Innov. Food Sci. Emerg. Technol. 2005, 6: 107–114. DOI: 10.1016/j.ifset.2004.09.003.\n'},{id:"B17",body:'\nKim, EH-J, Chen, XD, Pearce, D. Surface composition of industrial spray-dried milk powders. 2. Effects of spray drying conditions on the surface composition. J. Food Eng. 2009, 94: 169–181. DOI: 10.1016/j.jfoodeng.2008.10.020.\n'},{id:"B18",body:'\nPeighambardoust, SH, Golshan Tafti, A, Hesari, J. Application of spray drying for preservation of lactic acid starter cultures: a review. Trends Food Sci. Technol. 2011, 22: 215–224. DOI: 10.1016/j.tifs.2011.01.009.\n'},{id:"B19",body:'\nMezhericher, M, Levy, A, Borde, I. Heat and mass transfer of single droplet/wet particle drying. Chem. Eng. Sci. 2008, 63: 12–23. DOI: 10.1016/j.ces.2007.08.052.\n'},{id:"B20",body:'\nBilancetti, L, Poncelet, D, Loisel, C, Mazzitelli, S, Nastruzzi, C. A statistical approach to optimize the spray drying of starch particles: application to dry powder coating. AAPS PharmSciTech. 2010, 11: 1257–1267. DOI: 10.1208/s12249-010-9492-y.\n'},{id:"B21",body:'\nMezhericher, M, Levy, A, Borde, I. Spray drying modelling based on advanced droplet drying kinetics. Chem. Eng. Process. Process Intensif. 2010, 49: 1205–1213. DOI: 10.1016/j.cep.2010.09.002.\n'},{id:"B22",body:'\nHandscomb, CS, Kraft, MÃ. Simulating the structural evolution of droplets following shell formation. Chem. Eng. Sci. 2010, 65: 713–725. DOI: 10.1016/j.ces.2009.09.025.\n'},{id:"B23",body:'\nBayu, A, Nandiyanto, D, Okuyama, K. Progress in developing spray‐drying methods for the production of controlled morphology particles: from the nanometer to submicrometer size ranges. Adv. Powder Technol. 2011, 22: 1–19. DOI: 10.1016/j.apt. 2010.09.011\n'},{id:"B24",body:'\nBoonyai, P, Bhandari, B, Howes, T. Stickiness measurement techniques for food powders: a review. Powder Technol. 2004, 145: 34–46. DOI: 10.1016/j.powtec.2004.04.039.\n'},{id:"B25",body:'\nMani, S, Jaya, S, Das, H. Sticky issues on spray drying of fruit juices. In:North‐Central International meeting sponsored by ASAE and CSAE (2002 ASAE/CSAE); 27–28 September 2002; Saskatoon, Saskatchewan, Canada. 2002. p. 1–18\n'},{id:"B26",body:'\nRoos, Y. Importance of glass transition and water activity to spray drying and stability of dairy powders. Lait 2002, 82: 475–484. DOI: 10.1051/lait:2002025.\n'},{id:"B27",body:'\nTurchiuli, C. Fluidization in food powder production. In: Bhandari, B., Bansal, N., Zhang, M., Schuck, P, editors, Handbook of Food Powders: Processes and Properties. 1st ed. Woodhead Publishing Limited, 2013. p. 178–199. DOI:10.1533/9780857098672.1.178\n'},{id:"B28",body:'\nWoo, MW, Daud, WRW, Tasirin, SM, Talib, MZM. Effect of wall surface properties at different drying kinetics on the deposition problem in spray drying. Dry. Technol. 2008, 26: 15–26. DOI: 10.1080/07373930701781033.\n'},{id:"B29",body:'\nAdhikari, B, Howes, T, Lecomte, D, Bhandari, BR. A glass transition temperature approach for the prediction of the surface stickiness of a drying droplet during spray drying. Powder Technol. 2005, 149: 168–179. DOI: 10.1016/j.powtec.2004.11.007.\n'},{id:"B30",body:'\nPorras-Saavedra, J, Palacios-Gonzalez, E, Lartundo-Rojas, L, Garibay-Febles, V, Yañez-Fernández, J, Hernández-Sánchez, H, Gutiérrez-López, G, Alamilla-Beltrán, L. Microstructural properties and distribution of components in microparticles obtained by spray-drying. J. Food Eng. 2015, 152: 105–112. DOI: 10.1016/j.jfoodeng.2014.11.014.\n'},{id:"B31",body:'\nAlamilla-Beltrán, L, Chanona-Pérez, JJ, Jiménez-Aparicio, AR, Gutiérrez-López, GF. Description of morphological changes of particles along spray drying. J. Food Eng. 2005, 67: 179–184. DOI: 10.1016/j.jfoodeng.2004.05.063.\n'},{id:"B32",body:'\nWalton, DE, Member, CJM. Spray dried products-characterization of particle morphology. Trans. IChemE 1999, 77: 21–38.\n'},{id:"B33",body:'\nVehring, R. Pharmaceutical particle engineering via spray drying. Pharm. Res. 2008, 25: 999–1022. DOI: 10.1007/s11095-007-9475-1.\n'},{id:"B34",body:'\nParamita, V, Futura, T, Yoshii, H. Microencapsulation efficacy of d-limonene by spray drying using various combinations of wall materials and emulsifiers. Food Sci. Technol. Int. Tokyo 2010, 16: 365–372. DOI: 10.3136/fstr.16.365.\n'},{id:"B35",body:'\nSchoonman, A, Mayor, G, Dillmann, ML, Bisperink, C, Ubbink, J. The microstructure of foamed maltodextrin/sodium caseinate powders: a comparative study by microscopy and physical techniques. Food Res. Int. 2001, 34: 913–929. DOI: 10.1016/S0963-9969(01)00116-8.\n'},{id:"B36",body:'\nGonzalez, AL, Noguez, C. Influence of morphology on the optical properties of metal nanoparticles. J. Comput. Theor. Nanosci. 2006, 4: 231–238.\n'},{id:"B37",body:'\nQuintanilla-Carvajal, MX, Meraz-Torres, LS, Alamilla-Beltrán, L, Chanona-Pérez, JJ, Terres-Rojas, E, Jiménez-Aparicio, AR. Morphometric characterization of spray-dried microcapsules before and after A-tocopherol extraction (Caracterizac on Morfo Etrica De Microcapsulas Secadas Por Aspers on Antes Y Desp Es De La Extracc on De A-Tocoferol). Rev. Mex. Ing. Química 2009, 8: 301–312.\n'},{id:"B38",body:'\nMeraz-Torres, LS, Quintanilla-Carvajal, MX, Hernández-Sánchez, H, Téllez-Medina, DI, Alamilla-Beltrán, L, Gutiérrez-López, GF. Assessment of the kinetics of contact angle during the wetting of maltodextrin agglomerates. Rev. Mex. Ing. Química 2011, 10: 273–279.\n'},{id:"B39",body:'\nMorales, P, Ramírez-Moreno, E, Sanchez-Mata, M de C, Carvalho, AM, Ferreira, ICFR. Nutritional and antioxidant properties of pulp and seeds of two xoconostle cultivars (Opuntia joconostle F.A.C. Weber ex Diguet and Opuntia matudae Scheinvar) of high consumption in Mexico. Food Res. Int. 2012, 46: 279–285. DOI: 10.1016/j.foodres.2011.12.031.\n'},{id:"B40",body:'\nOsorio-Esquivel, O, Alicia-Ortiz-Moreno, Álvarez, VB, Dorantes-Álvarez, L, Giusti, MM. Phenolics, betacyanins and antioxidant activity in Opuntia joconostle fruits. Food Res. Int. 2011, 44: 2160–2168. DOI: 10.1016/j.foodres.2011.02.011.\n'},{id:"B41",body:'\nAOAC. Official methods of analysis Method 930.15. 18th ed. Asociation of official analytical chemists; Arlington, VA, USA. 2005\n'},{id:"B42",body:'\nOzmen, L, Langrish, TAG. Comparison of glass transition temperature and sticky point temperature for skim milkpowder. Dry Technol. 2002, 20: 1177–1192. DOI: 10.1081/DRT-120004046.\n'},{id:"B43",body:'\nCILAS. Expertshape Software: Instruction Manual. Orleans Cedex, France. 2011\n'},{id:"B44",body:'\nJaramillo-Flores, ME, González-Cruz, L, Cornejo-Mazón, M, Dorantes-Alvarez, L, Gutiérrez-López, GF, Hernández-Sánchez, H. Effect of thermal treatment on the antioxidant activity and content of carotenoids and phenolic compounds of cactus pear cladodes (Opuntia ficus-indica). Food Sci. Technol. Int. 2003, 9: 271–278. DOI: 10.1177/108201303036093.\n'},{id:"B45",body:'\nStintzing, FC, Herbach, KM, Mosshammer, MR, Carle, R, Yi, W, Sellappan, S, Akoh, CC, Bunch, R, Felker, P. Color, betalain pattern, and antioxidant properties of cactus pear (Opuntia spp.) clones. J. Agric. Food Chem. 2005, 53: 442–451. DOI: 10.1021/jf048751y.\n'},{id:"B46",body:'\nSánchez-González, N. Extraction and characterization of major pigments Opuntia joconoste c.v. (Extracción y caracterización de los principales pigmentos del Opuntia joconoste c.v.) (xoconostle). Master thesis. 2006, 1–107.\n'},{id:"B47",body:'\nRe, R, Pellegrini, N, Proteggente, A, Pannala, A, Yang, M, Rice-Evans, C. Antioxidant activity applying an improved ABTS radical cation decolorization assay. Free Radic. Biol. Med. 1999, 26: 1231–1237. DOI: 10.1016/S0891-5849(98)00315-3.\n'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Jaime Jiménez-Guzmán",address:null,affiliation:'
National School of Biological Sciences-National Polytechnic Institute, Department of Biochemical Engineering, CP, México
'},{corresp:null,contributorFullName:"Diana E. Leyva-Daniel",address:null,affiliation:'
National School of Biological Sciences-National Polytechnic Institute, Department of Biochemical Engineering, CP, México
'},{corresp:null,contributorFullName:"Brenda H. Camacho-Díaz",address:null,affiliation:'
Biotic Products Development Center, National Polytechnic Institute, Yautepec, Morelos, México
'},{corresp:null,contributorFullName:"Antonio R. Jimenéz-Aparicio",address:null,affiliation:'
Biotic Products Development Center, National Polytechnic Institute, Yautepec, Morelos, México
National School of Biological Sciences-National Polytechnic Institute, Department of Biochemical Engineering, CP, México
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1. Introduction
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Multiple Myeloma is characterized by the upregulation and expansion of plasma cells malignant clones in the bone marrow [1]. The introduction of novel agents such as immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) has led to significant improvement of disease prognosis and survival. However, the disease remains incurable, and all patients will relapse. Patients who are refractory to both Imids and PIs have poor survival outcomes, with a median overall survival of 9–13 months [2, 3]. The identification of novel therapeutic approaches for this group of patients represents an unmet medical need. In addition to that, patients with advanced disease characteristics and high-risk cytogenetics have a poor prognosis [4, 5]. Immune dysregulation represents a hallmark of MM pathophysiology. A better understanding of mechanisms that govern immune impairment in MM, has led to the development of several immunotherapeutic agents such as monoclonal antibodies, bispecific antibodies (BiTEs), and chimeric antigen receptor (CAR) T-cells.
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2. Monoclonal antibodies
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2.1 Daratumumab
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2.1.1 Daratumumab mechanism of action
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Daratumumab (Dara) is the first in class humanized IgG1-κ monoclonal antibody targeting CD38 through binding to a unique epitope which includes amino acids 233–246 and 267–280 [6]. Following binding to CD38, Dara exerts its action through canonical (classical) and noncanonical mechanisms [7]. Canonical mechanisms are immune-mediated, dependent on Dara binding to CD38 on the tumor cell, and include complement-mediated cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC), antibody-dependent cell-mediated phagocytosis (ADCP), direct cytotoxicity upon secondary cross-linking, and inhibition of CD38 enzymatic activity. Canonical mechanisms could be either Fcgamma receptor (FcgR) dependent or independent [6, 8, 9]. Whilst the canonical mechanisms explain the activity of Dara against CD38+ cells, noncanonical mechanisms are independent of Dara binding to CD38 and based on modulation of immune cells [10]. Dara targets three main categories of immunosuppressor cells that express CD38. These categories are Regulatory B cells (Bregs), which promote tumor growth and immune escape, a subset of regulatory T cells (Tregs), and Myeloid-derived suppressor cells (MDSC). After Dara binding to the CD38 in the surface of the above-mentioned cells causes depletion of their population [11]. Following the depletion of regulatory cells, there is a significant increase in the populations of CD4+ and CD8+ effector T-cells [12, 13, 14, 15]. Effector T-cells have increased levels of granzyme-B, which results in enhanced killing capacity [12, 16].
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2.1.2 Daratumumab combinations in the newly diagnosed setting
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2.1.2.1 Transplant-ineligible patients
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The combination of bortezomib melphalan and prednisone (VMP) is considered a standard of care regimen for patients who are not candidates for transplant. ALCYONE (NCT02195479) is a phase 3 trial in which patients with NDMM were randomized to receive bortezomib melphalan and prednisone either alone or in combination with Dara. The primary endpoint was PFS. The comparison of PFS rates at 16.5 and 40.08 months showed a sustained superiority of Dara-VMP versus VMP groups. At 16.5 and 40.08 months, PFS rates for Dara VMP and VMP groups were 71.6% (95% [CI], 65.5 to 76.8) vs. 50.2% (95% CI, 43.2 to 56.7) and 36.4 vs. 19.3 months respectively [17, 18]. At the time point of 40.08 months, the median PFS2 was not reached versus 42.3 months for the Dara-VMP and the VMP arm, respectively 32376237. The combination of Dara-VMP also demonstrated a significant reduction in the risk of death by 40% in comparison with VMP (HR 0.60 95% CI 0.46–0.80; p = 0·0003) [19]. At the time point of 42 months, the estimated overall survival rate in Dara-VMP and VMP groups was 75% vs. 62% (median not reached in either group HR: 0.60; 95% CI: 0.46 to 0.80; P = 0.0003) respectively [17, 18, 20]. The proportion of patients achieving MRD negativity was better in the Dara-VMP group (28% versus 7%) 32376237 After a median follow-up of 40.1 months, Dara-VMP increased the ORR (90.9% vs. 73.9%) and the rates of ≥VGPR (73% vs. 50%), ≥CR (46% vs. 25%), MRD-negativity (28% vs. 7%; all P < 0.0001), and ≥ CR with MRD-negativity (27% vs. 7%) vs. VMP. Time to subsequent therapy, OS, and PFS was prolonged for patients with deeper responses in both groups Alcyone 2020.
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MAIA trial (NCT02252172) is a phase 3 trial in which the addition of Dara to Rd. was compared to Rd. alone. Seven hundred thirty-seven patients who were ineligible for transplant were recruited. Patients were randomly assigned to receive Rd. with or without Dara in 28-day cycles until disease progression or unacceptable toxicity. The primary end-point was progression-free survival [21]. Results from the primary analysis (median follow-up 28 months) showed that the addition of Dara to Rd. improved PFS and MRD-negativity rates. After a longer follow up period (36.4 months), patients in the DRd arm maintained deeper and durable response along with PFS benefit [22]. After a median follow-up of 47.9 months, patients in the DRd arm had better PFS in comparison with the control group (median, not reached [NR] vs. 34 mo; HR, 0.54; 95% CI, 0.43–0.67; P < 0.0001). Median PFS2 was not reached for DRd vs. 51 months in the Rd. arm. (HR, 0.65; 95% CI, 0.52–0.83; P = 0.0005). The addition of Dara to Rd. resulted in deeper responses with higher rates of CR or better and VGPR or better. The median duration of response was not reached for responders in the DRd arm vs. 44 months in the Rd. arm [23].
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2.1.2.2 Transplant-eligible patients
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The combination of Dara Bortezomib, cyclophosphamide, and dexamethasone (Dara-VCD) resulted in ORR and VGPR or better rates of 81% and 56%, respectively, in NDMM patients enrolled in the LYRA (NCT02951819) study 30828799. After 6–8 cycles of Dara-VCD induction, eligible patients underwent ASCT. All patients received Dara maintenance. The administration of Dara as maintenance therapy improved the depth of response and was associated with prolongation of both PFS and OS [24].
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GRIFFIN (NCT02874742) is a phase 2 trial evaluating the addition of Dara to the induction regimen Bortezomib Lenalidomide and Dexamethasone (VRD) in NDMM transplant eligible patients. Patients were randomized to receive Dara-VRD or VRD as induction regimen, ASCT, two cycles of Dara-VRD or VRD consolidation, and Revlimid alone or in combination with Dara as maintenance for 24 cycles. The primary endpoint was the rate of s CR post-consolidation. Regarding the randomized phase of the trial, results indicated that the combination of Dara-VRD was safe and potent. Regarding the primary endpoint results favored the quadruplet regimen (D-VRD)) 42 patients (42.4%) in the D-VRD and 31 patients (32.0%) in the VRD group achieved sCR by the end of consolidation (odds ratio, 1.57; 95% [CI], 0.87–2.82 1-sided P = .068) Response improved over time. After a median follow up of 22.1 months, the sCR (62.6% vs. 45.4%; P = .0177) and MRD negativity (51.0% vs. 20.4%; P < .0001, threshold 10−5) improved in the D-VRD arm in the intent to treat population [25]. In the final analysis of the safety run-in cohort, at the end of consolidation, 9 (56.3%) patients achieved sCR, and 8 (50.0%) were MRD negative (10–5 threshold). After maintenance, 15 (93.8%) patients achieved sCR, and 13 (81.3%) were MRD (10−5) negative. Estimated 36-month overall and progression-free survival rates were 93.8% and 78.1%, respectively. Results showed that the addition of Dara to R AND VRD resulted in durable responses and sustained MRD negativity. The depth of response improved over time [26].
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CASSIOPEIA (NCT02541383) is an ongoing phase III clinical trial in newly diagnosed transplant eligible MM patients divided into two parts. Patients were randomized to receive four pre-transplant induction and two post-transplant consolidation cycles of VTd with (VTd group) or without daratumumab (D-VTd group). The primary endpoint of part 1 was the Scr rate assessed 100 days after transplantation. Part 2 (maintenance) is ongoing. After completion of induction and consolidation, the sCR rate in the D-VTd group was 28.9% vs. 20.3% in the VTd group (odds ratio 1.60, 95%CI 1.21–2.12, p = 0.0010). Additionally, the D-VTd group had significantly prolonged PFS in comparison with VTd (HR: 0.47; 95%CI: 0.33–0.67, p < 0.0001) [27].
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MASTER (NCT03224507) is an ongoing phase II clinical trial. Newly diagnosed transplant eligible MM patients received four cycles of Dara-Carfilzomib Dexamethasone (Dara-KRD) induction, followed by autologous stem cell transplantation (ASCT) and consolidation with Dara-KRD based on the MRD status. The MRD assessment method was next-generation sequencing (NGS), and the threshold was 10−5. Evaluation of MRD status was performed at specific time points. At the end of the induction, post ASCT and post cycles 4 and 8 of consolidation. Patients with two consecutive negative MRD results stopped treatment. Patients who concluded treatment underwent imaging. The administration of Dara-KRD resulted in rapid and durable responses. More than 90% of patients achieved VGPR or better response by the end of induction. The MRD negative rates at the end of induction at ASCT and at best response were 34%, 70%, and 80% (threshold 10−5) and 28%, 45%, and 65% (threshold 10−6), respectively. Until today 11 patients have concluded treatment after achieving MRD negativity without evidence of relapse. The trial is ongoing, and long term follow up results are awaited [28].
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PERSEUS (NCT03710603) is a randomized, phase 3 study comparing DARA-VRd vs. VRd in transplant eligible NDMM patients, which has recently concluded its enrollment of patients. PFS is the primary endpoint, while key secondary endpoints include, ORR, MRD-negative rate and OS.
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2.1.3 Daratumumab combinations in the R/R setting
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POLLUX (NCT02076009) is a phase III clinical trial that compared the combination of Lenalidomide Dexamethasone with or without daratumumab in MM patients who had received at least one prior line of treatment and were not refractory to Lenalidomide [15]. The addition of Dara significantly improved PFS at 12 (83.2%, 95% CI, 78.3 to 87.2 vs. 60.1%, 95% CI, 54.0 to 65.7), 25,4 (median not reached vs. 17.5 months; HR 0.41; 95% CI,0.31–0.53; P < 0.0001) and 44,3 (median 44.5 vs. 17.5 months; HR, 0.44; 95% CI, 0.35–0.55; P < 0.0001) months follow up in comparison with the control group [15, 29, 30]. The overall response rate was significantly better in the DRd group (92.9% vs. 76.4%, P < 0.001) 30237262. Post hoc analyses revealed that Dara improved PFS independently of the prior lines of treatment and high-risk cytogenetics [29]. At 25.4 months, the assessment of MRD status (threshold 10−5) revealed deeper responses in the DRd arm (26.2% vs. 6.4% P < 0.0001) [29].
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CASTOR study (NCT02136134) compared the combination of Dara Vd (Dvd) versus Vd in 498 patients who had received at least one prior line of therapy (median of 2, range, 1–10; 10% three or more) and were not Bortezomib refractory. The study met its primary endpoint with a significant prolongation of PFS in the Dvd group after 7.4 months follow up (not reached in the Dvd versus 7.2 months in the Vd group), along with a significant reduction (61%) regarding the risk of disease progression or death (HR: 0.39; 95% CI, 0.28–0.53; p < 0.001). ORR was 82.9% in the Dvd vs. 63.2% in the Vd group, P < 0.001 [31]. Updated results of this trial after 40 months, reinforce the tolerability and effectiveness of Dvd. PFS was improved in all subgroups (16.7 vs. 7.1 months, [HR], 0.31; 95% [CI], 0.25–0.40; P < .0001). 32482541. The addition of Dara to Vd manage to overcome the impact of high-risk cytogenetic abnormalities (12.6 vs. 6.2 months; HR, 0.41; 95% CI, 0.21–0.83; P = 0.0106) 32819447 Patients in the Dvd group had 2.5 fold higher MRD negativity rate (10–5 threshold) [31]. Based on the results of CASTOR trial FDA and EMA approved in 2016 Dvd for RRMM patients who had received at least one prior line of treatment.
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In a phase 1b study (MMY1001), the addition of Dara to Pomalidomide and Dexamethasone was tested. The study included 103 patients with a median age of 64 years and a median of four prior lines of therapy. Notably, 89% were refractory to Lenalidomide, 71% to Bortezomib, and 30% to Carfilzomib. The median OS and PFS were 17,5 and 8,8 months, respectively. The ORR was 60%. The combination of Dara Pom Dex was clearly safe and effective in this group of heavily pretreated patients [32]. Based on these results, FDA approved this triple combination for patients who had received at least two prior lines, including both a PI and Lenalidomide [32].
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APOLLO trial (NCT03180736) explored the addition of Dara to Pomalidomide and dexamethasone (Pd) in 304 patients with RRMM who had received ≥one prior line of therapy, including a PI and Lenalidomide. PFS was the primary endpoint. Patients received Pomalidomide 4 mg d1–21, dexamethasone 40 mg (20 mg for patients ≥75 years of age) on 28 days cycles. Patients initially received Daratumumab iv 16 mg/kg. After protocol amendment, patients continued with Dara sc 1800 mg. Administration of Dara every week for cycles one and two, every two weeks for cycles 3–6, and every month thereafter. Prior Pomalidomide or anti-CD-38 administration was not permitted. The patient’s median age was 67 (35–90) years, 35% had high-risk cytogenetics, and 63% were refractory to both Len and PI. The study met its primary endpoint. The addition of Dara to Pd led to a significant prolongation of PFS (12.4 months) versus 6.9 months in the Pd arm (HR 0.63 (95% CI, 0.47–0.85; P = 0.0018), which represents a 37% reduction in the risk of death or progression. Data regarding OS are immature, and longer follow-up is warranted. No new safety signals have emerged. Additionally, the sc formulation of Dara shortens the duration of administration. These data suggest that the D-Pd combination is safe, effective, and convenient in the RR setting [33].
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CANDOR (NCT03158688) is another phase 3 trial exploring the addition of Dara to Carfilzomib and dexamethasone (Kd). Four hundred sixty-six patients were randomized to receive Dara Carfilzomib dexamethasone (DKd) vs. Kd. All patients received iv Dara at 16 mg/kg, every week for the first two cycles (the first dose was administered on days 1 and 2 of the first cycle), every two weeks for cycles 3–6, and every month thereafter, Carfilzomib, twice per week at 20 mg/m2 on days 1 and 2 of cycle 1 and at 56 mg/m2 thereafter and dexamethasone 40 mg every week (20 mg for patients 75 years or older). After an initial follow up of 17 months, median PFS was not reached in the DKd group versus 15.8 months in the Kd group (HR 0.63; 95% CI 0.46–0.85; two-sided p = 0.0027) [34]. Data presented in the last ASH meeting showed further improvement in PFS for patients in the KRd arm. After 28 months of follow-up, the median PFS for KRd and Kd group were 28.6 and 15.2 months, respectively (HR, 0.59, 95% CI, 0.45–0.78]. PFS benefit was consistent among subgroups, especially in Lenalidomide refractory patients. Additionally, the MRD negativity rate at 12 months was significantly better in the DKd arm at 12.5% vs. 1.3% P < 0.0001. No new safety alerts have emerged [35].
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2.2 Isatuximab
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2.2.1 Mechanism of action
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Isatuximab (SAR650984) is another chimeric IgG1κ monoclonal antibody, which binds on human CD38 by targeting a different epitope in comparison with Daratumumab [36]. Isatuximab and Daratumumab have several differences regarding the mechanism of action. 1/Isatuximab anti-tumor activity is mainly dependent on ADCC [37, 38] 2/Isatuximab induces direct apoptosis of CD-38 even in the absence of cross-linking agents [39] 3/Isatuximab inhibits CD-38 enzymatic activity in a dose-dependent manner [40].
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2.2.2 Isatuximab clinical trials
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In a phase I dose-escalation study, 84 patients with RRMM (median 5, range 1–13 prior lines of therapy) received Isatuximab monotherapy. Isatuximab administration showed clinical activity and a manageable safety profile. ORR was 24%, median PFS was 3.7 months. IRRs were mainly grade 1 or 2 that occurred during the first cycle [40]. These results were confirmed in a dose-finding phase II trial. Patients with RRMM who had received three or more prior lines of therapy were allocated to four different dosing schedules of isatuximab monotherapy: 3 mg/kg or 10 mg/kg every two weeks, 10 mg/kg every two weeks for one month and every month thereafter, and 20 mg/kg every week for one month and every two weeks thereafter. At doses ≥10 mg/kg 10 mg/kg OS and PFS were 18.7 and 4.6 months respectively, whereas ORR was 24.3% [41]. During the second part of the same study, patients with RRMM (median 4, range 2–10 prior lines of therapy) were randomized to receive isatuximab 20 mg/kg every week for one month, followed by 20 mg/kg every two weeks, with (n = 109) or without (n = 55) dexamethasone. Median PFS and OS were 4.9 and 18.9 and 10.2 for Isatuximab monotherapy and 10.2 and 17.3 for Isatuximab DEX group, respectively [42].
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Isatuximab has also shown a synergistic effect when combined with Lenalidomide and dexamethasone. Fifty-seven patients with RRMM (median 5, range 1–12 prior lines of therapy) with 83% refractory to Lenalidomide received Isatuximab in combination with Lenalidomide and dexamethasone in this phase Ib dose-escalation study. The primary objective of the study was the determination of maximum tolerated dose (MTD) of Isatuximabwithin the combination with Lenalidomide and dexamethasone. The ORR was similar in both cohorts, 56%. Only one dose-limiting toxicity was reported (pneumonia grade II at 20 mg/kg/QW/Q2W), which resolved after discontinuation of treatment. The MTD was not reached. IRRs occurred mostly during the first infusion and were mild (grade I or II) regarding severity. These results demonstrate that the combination of Isatuximab with standard doses of Lenalidomide and Dexamethasone was active and well-tolerated in patients with RRMM [43].
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Another phase Ib trial (NCT02283775) evaluated the tolerability and safety of Isatuximab in combination with Pomalidomide and low-dose dexamethasone in patients with RRMM, who had received prior treatment with a PI and Lenalidomide. Forty-five patients with a median of three (range 1–10) prior lines of therapy were recruited. 91% of patients were refractory to their last line of therapy, 84% were PI refractory, and 82% Lenalidomide refractory. Patients received Isatuximab at 5, 10, or 20 mg/kg (every week for four weeks and every two weeks thereafter), Pomalidomide 4 mg (days 1–21), and dexamethasone 40 mg weekly, in 28-days cycles until progressive disease or unacceptable toxicity. The primary objective was the determination of the recommended dose of Isatuximab within this combination, along with safety. Secondary objectives included evaluation of efficacy, pharmacokinetics, and immunogenicity. Among 45 enrolled patients, 8 received Isatuximab at 5 mg/kg, 31 at 10 mg/kg and 6 at 20 mg/kg for median duration of 9.6 months. The most common adverse events included fatigue (62%), infusion reactions (42%), and upper respiratory tract infections. Infusion-related reactions, which were mainly grade I or II, occurred mostly during the first administration of the drug and were manageable with corticosteroids and antihistamines. Median PFS and median duration of response were 17.6 and 18.7 months, respectively. ORR was 62%. These results demonstrated that the combination of Isatuximab with Pomalidomide and dexamethasone was safe and effective in heavily pretreated patients with MM [44].
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Based on these encouraging results, the phase III ICARIA trial (NCT02990338) compared the combination Of Isatuximab Pom Dex (IPd) versus Pom dex (Pd) in 307 patients with RRMM who had received at least two prior lines of treatment, including Lenalidomide and a proteasome inhibitor (median three range 2–4). Patients received Isatuximab 10 mg/kg every week for the first cycle and on days 1 and 15 in the subsequent cycles, plus pomalidomide 4 mg/day (day 1–21) and dexamethasone 40 mg (or 20 mg for patients >75 years) weekly on 28 days cycles. Progression-free survival was the primary endpoint. After a median follow-up of 11.6 months, median progression-free survival was 11.5 months (95% CI 8.9–13.9) in the IPd group versus 6.5 months (4.5–8.3) in the Pd group;(HR 0.596, 95% CI 0.44–0.81; p = 0·001). Responses in the IPd arm occurred faster with a significantly longer duration in comparison with the IPd arm. Additionally, patients in the IPd arm achieved a higher percentage of MRD negativity. The addition of Isatuximab to Pom dex, resulted in significant improvement of PFS [45]. The consistency of the results from the primary analysis was evaluated in patients with soft tissue plasmacytomas. Data presented at the last ASH meeting showed that PFS and ORR were improved from the addition of Isatuximab to Pd in the subgroup of patients with extramedullary disease. Median PFS was 4.57 (95% CI: 2.40, not calculable) vs. 1.56 (95% CI: 0.95, 4.47) months in the IPd and Pd arm, respectively, whereas ORR was 50% (7/14 responders) and 10% (1/10 responders) in the IPd and Pd group. ASH 2289 Based on the results of the ICARIA trial, FDA and EMA approved the combination of IPd, in patients with RRMM.
\n
The combination of Isatuximab with Carfilzomib has been evaluated in a phase Ib clinical trial (NCT02332850) [46]. In the dose-escalation part of the study, patients with RRMM who had received at least two prior (median three range 2–8) lines of treatment were randomized to receive Isatuximab in 3 different dose levels (DL) 10/kg every two weeks, 10 mg/kg every week for a month and every two weeks thereafter and 20 mg/kg every week for a month and every two weeks thereafter, in combination with K at dose 27 mg/m 2. Fifteen patients received treatment in the dose-escalation and 18 in the dose-expansion cohort at DL2. The primary objective was the determination of the maximum tolerated dose (MTD). Secondary objectives included the assessment of efficacy and safety. Preliminary results showed a 66% ORR in all dose levels. Median PFS was not reached. Based on these results, the phase III IKEMA study (NCT03275285) compared the combination of IKd vs. Kd in the RR setting. Three hundred two patients with RRMM were randomized to receive IKd (n = 179) or Kd (n = 123). The administration of Isatuximab was 10 mg/kg iv weekly during the first month and every two weeks thereafter, whereas administration of Carfilzomib was 20 mg/m2 and 56 mg/m2 thereafter. The primary endpoint was PFS, and the secondary endpoints were OS and ORR [47]. Preliminary data were presented in the last ASH meeting. After a median follow-up of 20.7 months there was a statistically significant improvement of PFS in the IKd group (median PFS was not reached for IKd vs. 19.15 months for Kd; HR 0.531 (99% CI 0.318–0.889), one-sided p = 0.0007, with consistency among subgroups. ORR was 86.6% IKd vs. 82.9% for Kd, one-sided p = 0.1930. MRD negativity (10–5) in the intent to treat population (ITT) was 29.6% (53/179) vs. 13.0% (16/123) in the IKd and Kd groups, respectively descriptive p = 0.0004. Data regarding OS were immature at the time of primary analysis. The percentages of AES and SAEs were similar between the two groups. To conclude, the addition of Isatuximab to Kd lead to a significant improvement in PFS and depth of response. IKD may represent a new standard of care regimen for patients with RRMM [48].
\n
Isatuximab is currently under investigation in the upfront setting. In transplant-ineligible patients, IMROZ trial (NCT03319667) is comparing the quadruplet combination Isatuximab-VRd with VRD, while another ongoing trial is comparing Isatuximab-VRd to Isatuximab VCD(NCT02513186). In transplant-eligible patients, ISKIA trial is currently investigating the combination of Isatuximab-KRd vs. KRd as part of induction and consolidation regimen (NCT04483739).
\n
\n
\n
\n
2.3 Elotuzumab
\n
\n
2.3.1 Elotuzumab mechanism of action
\n
SLAMF7 (signaling lymphocytic activation molecule family 7) or CD319 is a cell surface glycoprotein CD2/subset 1 (CS1). SLAMF7 expression is restricted to normal and abnormal plasma cells and NK lymphocytes [49]. Activation of SLAMf7 pathway promotes cell growth and survival. It also plays a critical role in the interaction with the bone marrow microenvironment [49, 50]. Elotuzumab is humanized, first in class IgG1 monoclonal antibody targeting SLAMF7. Elotuzumab primarily activates NK cells promoting antibody-dependent cellular cytotoxicity (ADCC). Elotuzumab has shown no activity when used as a single agent in MM patients.
\n
\n
\n
2.3.2 Elotuzumab clinical trials
\n
The large phase III ELOQUENT 2 trial (NCT01239797) evaluated the addition of Elotuzumab at the dose of 10 mg/kg to Lenalidomide and dexamethasone (Rd) in 646 patients with RRMM (94% lenalidomide naïve patients) who had received 1–3 prior lines of treatment. Patients received Lenalidomide 25 mg for days 1–21 and dexamethasone 40 mg on a weekly basis on 28-day cycles. Elotuzumab administration was 10 mg/kg weekly for the first two cycles, and 20 mg/kg on a monthly basis thereafter. Primary endpoints included PFS and ORR. OS was one of the key secondary endpoints. After an initial follow-up of 24.5 months, the rates of median PFS and ORR were 19.4 versus 14.9 months (HR for progression or death 0.70; 95% CI 0.57 to 0.85; P < 0.001) and 79%, versus 66% in the ELO Rd. and Rd. groups respectively. 26035255. PFS rates demonstrate sustained improvement after two (52%) and three (44%) years of follow-up (relative risk of disease progression or death by 30% and 27% respectively) 30204239. More recent data, after a 4-year follow-up, demonstrate sustained OS benefit (50 months for ELO Rd. versus 43 months for Rd. HR: 0.78; 95%CI: 0.63–0.96). 30719202 Administration of Elotuzumab was relatively safe. Most common grade 3 or 4 AEs in both arms included lymphopenia, neutropenia, pneumonia, and fatigue. Based on this trial Elotuzumab was granted approval by the FDA in December 2015 and EMA in 2016, in combination with Rd., for patients with RRMM, who had received at least one prior line of treatment [51].
\n
Elotuzumab has also been evaluated in combination with Pomalidomide and dexamethasone (Pd). Eloquent 3 (NCT02654132) is a randomized phase II trial, comparing the combination of ELO Pd versus Pd in 117 patients who were refractory or relapsed and refractory to Lenalidomide and a proteasome inhibitor. Patients received Pomalidomide 4 mg for day 1–21 and dexamethasone 40 mg on a weekly basis on 28-day cycles. Elotuzumab administration was 10 mg/kg weekly for the first two cycles and 20 mg/kg on a monthly basis thereafter. Sixty patients were assigned to the ELO Pd group and 57 patients to the Pd group. After a follow up of 9.1 months, patients in the ELO Pd group had significantly increased PFS (10.3 vs. 4.7 months HR 0.54 CI0.34 to 0.86; P = 0.008) and ORR (53% vs. 26% odds ratio, 3.25; 95% CI, 1.49 to 7.11) in comparison with the Pd group. No significant differences were reported in the safety profiles of the two arms. Based on the results of the ELOQUENT III trial, Elotuzumab granted approval by the FDA in 2018 for RR patients who had received at least two prior lines of treatment, including Lenalidomide and a PI [52].
\n
\n
\n
\n
2.4 Antibody drug conjugates (ADCs)
\n
BCMA, is a and member of the tumor necrosis factor receptors (TNFR) superfamily [53, 54]. BCMA is primarily expressed in late-stage B-lineage cells, normal and malignant plasma cells, and B-lymphocytes, with very low expression on non-hematologic cells [55]. BCMA has two main ligands: a proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) [56, 57, 58]. Following binding of APRIL and BAFF, BCMA expression is selectively upregulated during malignant transformation of plasma cells, playing a critical role in survival, drug resistance, and tumor cell growth through activation of intracellular signal transduction pathways such as STAT3, phosphoinositide 3-kinase (PI3K), AKT, NFB and MAPK [59, 60, 61, 62, 63]. As demonstrated in BCMA knock-down mouse models, BCMA is not required for normal B-cell differentiation and homeostasis [64]. The shedding of BCMA from the cell surface is mediated by γ-secretase and results in a soluble form (soluble BCMA, sBCMA). Higher sBCMA levels have been associated with inferior clinical outcomes. In preclinical models, inhibition of BCMA, with specific antibodies, showed significant anti-myeloma activity. The aforementioned facts make BCMA an ideal therapeutic target for the treatment of Multiple Myeloma and provide the rationale for the development of anti-BCMA monoclonal antibodies.
\n
GSK2857916 (Belantamab Mafodotin) is the first anti-BCMA ADC that has been investigated in clinical trials. This afucosylated, humanized, IgG1 monoclonal antibody is conjugated to monomethyl auristatin F (MMAF), an inhibitor of tubulin polymerization, through a protease-resistant maleimidocaproyl linker. Following binding to the plasma cell surface, GSK2857916 is internalized and the active cytotoxic drug (cys-mcMMAF) is released following enzymatic cleavage leading to cell death. Mechanisms of action include NK-cell mediated ADCC and ADCP [65].
\n
DREAMM 1 (NCT02064387) is a first in human phase I, open-label study, which evaluated the administration of GSK2857916 in patients with RRMM and other hematologic malignancies expressing BCMA in terms of efficacy and safety. Dose escalation cohort (part I) included solely patients with MM who have failed previous treatment regimens, including stem cell transplant (if eligible) IMiDs, PIs, and alkylators, while the dose-expansion cohort (part2) included both patients with MM and relapsed follicular lymphoma or diffuse large B-cell lymphoma. Regarding MM patients in the expansion cohort, 57% had five or more prior lines of therapy; 89% were double (PI and IMiD) and 34% triple (PI, IMiD, and daratumumab) refractory. GSK2857916 was administered intravenously every three weeks as a 1 hr. infusion in 38 patients at different dose levels (0.03–4.6 mg/kg). Primary endpoints were safety, determination of maximum tolerated dose (MTD), and recommended phase 2 dose. Secondary objectives were the determination of pharmacodynamics and pharmacokinetics parameters, anti-drug antibodies, and clinical activity. In dose-expansion, patients received the selected recommended phase 2 dose of 3.4 mg/kg. Overall, 73 patients were recruited, thirty-eight in dose escalation and thirty-five in the dose-expansion cohort. Notably, BCMA expression was not included in the eligibility criteria of study [66].
\n
Updated results of this study, after an extended median follow-up of 12.5 months, demonstrate that was effective in this heavily pretreated group of patients [67]. Achievement of response occurred early during the study after the first or second infusion. Interestingly, dose reduction did not affect the depth and duration of response. 21/65 patients in the dose-expansion part achieve partial or better response, including 2PRs, 14VGPRs, 3CRs, and two sCRs. 18/32 (56.3%) patients who were double refractory (IMiDs and PIs) achieved response to treatment. For double refractory patients (IMiDs and PIs), with prior Daratumumab exposure, OR was 38.5%. The median PFS and DOR were 12 and 14.3 months, respectively. Among double refractory patients, the median PFS was 7.9 months. For patients with and without prior Daratumumab exposure, median PFS was 6.8 and 15.7 months, respectively. For double refractory patients with prior Daratumumab exposure, median PFS was 6.2 months [67].
\n
The most frequent AEs were fatigue, nausea, chills, anemia, pyrexia, hypercalcemia, thrombocytopenia, and dry eye, while the most common grade 3 or 4 toxicities included neutropenia, anemia, and thrombocytopenia. Infusion-related reactions (IRRs) (Grade 1 or 2) were reported in 7 patients across all dose levels, and all of them occurred during the first dose. Of note, there were no dose-limiting toxicities (DLT) and no MTD identified in the dose-escalation phase. Ocular toxicity, including blurred vision, foreign body sensation, and photophobia, were common presented in 53% of patients in part 1 and in 63% in part 2. Most common findings during eye examination under a slim lamp included keratitis and corneal microcystic changes. All AEs were reversible. The median time to onset was 23 days (range 1–84). Management included dose reductions and/or delays, artificial tears, and steroid eye drops. The median time to resolution was 30 days (range 5–224). Even though the exact pathophysiologic mechanism of keratopathy is unknown, it may be attributed to the uptake of the payload (MMAF) in the basal epithelial layer of the cornea 2938270. Ocular toxicity resulted in two treatment discontinuations in part 1 and no discontinuations in part 2 of the study. The main reasons for treatment discontinuation were disease progression (n = 15) and AEs (n = 2). Based on these promising results, FDA granted GSK2857916 a breakthrough therapy designation for the treatment of RRMM patients who had receive three prior lines of treatment, including an anti-CD38 antibody, and were refractory to both an IMiD and a PI [68].
\n
Following the encouraging results of DREAMM-1 study, the subsequent DREAMM-2 trial (NCT03525678) further explored the safety and activity of Belantamab mafodotin (GSK2857916) in the RR setting. Patients were refractory to PI, IMiD and an anti-CD38 mAb alone or in combination and randomized 1:1 to receive 2.5 mg/kg (n = 97) or 3.4 mg/kg (n = 99) Belantamab Mafodotin iv, every three weeks until disease progression or unacceptable toxicity. Regarding refractoriness to previous lines of treatment, 76% and 75% were refractory to bortezomib, 65% and 58% to Carfilzomib, 90% and 89% to Lenalidomide, 87% and 78% to Pomalidomide and 100% and 92% to Daratumumab in the 2.5 and 3.4 mg/kg dose arms, respectively. Patients had receive a median of 6 (range 3–21) and 7(range 3–21) prior lines of treatment, respectively [69].
\n
Overall response rate (ORR) was the primary objective of the study. After a median follow up of 6.5 months (6.3 in the 2.5 mg cohort and 6.9 in the 3.4 mg cohort), median PFS was 2.9(95% CI: 2.1–3.7) and 4.9(95% CI: 2.3–6.2) months in the two groups while the ORR was 31% (30/97 97.5% CI 20.8–42.6) and 34% (34/99CI 23.9–46) respectively 31859245. At this time point, OS data were not mature. Updated analysis of this trial, with a median, follow up of 9 months, demonstrated a median PFS of 2.8 and 3.9 months in the two cohorts with one year OS probability of 53% 21/48 and similar ORR among the group of patients with 3–6 (34%) and seven or more (30%) prior lines of therapy [69]. Two post hoc analyses demonstrate the efficacy of Belantamab mafodotin in the subgroups of patients with high-risk cytogenetics and impaired renal function (EGFR 30 ml/min) [70, 71].
\n
Regarding AEs, this study confirmed the frequent occurrence of corneal events. 72% of patients developed keratopathy of any grade, while 31% developed keratopathy grade 3–4. Keratopathy was attributed to the MMAF payload and was reversible after temporary discontinuation of the drug. Other frequent adverse events grade 3–4 were anemia (21%) and thrombocytopenia (22%). Infusion-related reactions (IRRs) were reported in 21% and 16% in the two treatment arms and were mostly grade 1 or 2. Serious AEs occurred in 40% and 47% in the 2.5 mg/kg and 3.4 mg/kg cohorts respectively. Two reported cases lead to death, potentially connected to study drug. One case of sepsis in the 2.5 mg/kg and one of haemophagocytic lymphohistiocytosis in the 3.4 mg/kg cohort.
\n
Currently, the role of Belantamab Mafodotin (GSK2857916) is being evaluated in the RRMM setting.
\n
DREAMM-6 (NCT03544281) is an ongoing Phase I/II, a two-part study of GSK2857916 in combination with lenalidomide/dexamethasone (Arm A) or BorDex (Arm B) in patients with RRMM who had received ≥one prior therapy. Refractory to Bortezomib patients were not excluded. Preliminary results from Arm B, presented in the last ASH meeting, have shown a high ORR of 78% (95% CI 52.4–93.6). No new safety signals have emerged.
\n
Three-phase III studies are currently ongoing, evaluating the safety and efficacy of belantamab mafodotin in combination with Pomalidomide (NCT04162210; DREAMM-3) daratumumab plus bortezomib (NCT04246047; DREAMM-7) or Pomalidomide plus Bortezomib (NCT04484623: DREAMM-8). The results are eagerly awaited.
\n
MEDI2228 is another antibody-drug conjugate (ADC) composed of fully human monoclonal antibody, conjugated to a dimeric cross-linking pyrrolobenzodiazepine (PBD) dimer (tesirine) via a protease-cleavable dipeptide (valine-alanine) linker8/42 MEDI2228 has shown potent antitumor activity in preclinical models, including cell lines resistant to Lenalidomide. Based on these reports, a phase I open-label, dose-escalation, and expansion first in-human study (NCT03489525) evaluated safety, clinical activity, and pharmacokinetics of MEDI2228 in patients with RRMM. All patients had progressive disease after treatment with an IMiD, a PI, and a monoclonal antibody. In the dose-escalation part of the study, MEDI2228 was administered iv every three weeks in five sequentially ascending dose levels (0.0125, 0.025, 0.05, 0.1, and 0.2 mg/kg). DLTS lead to dose de-escalation from 0.2 mg/kg to 0.14 mg/kg. Primary endpoints included safety and tolerability. 0.14 mg/kg Q3W was determined as the maximum tolerated dose (MTD). In the 0.14 mg/kg cohort 53.7% experienced photophobia and 19.5% eye dryness. There were no incidents of visual acuity loss or keratopathy in the 0.14 mg/kg cohort. Other treatment-related AEs included thrombocytopenia (31.7%) rash (29.3%), increased gamma-glutamyltransferase (24.4%) and pleural effusion (19.5%). In the 0.14 mg/kg cohort, ORR was 61.0% (95% [CI]: 44.5%, 75.8%), including 10 (24.4%) VGPRs and 15 (36.6%) PR. These data suggest that MEDI2228 is clinically efficient in this heavily pretreated group of patients [72].
\n
\n
\n
2.5 Bispecific antibodies
\n
Bispecific T-cell engagers (BiTEs) are monoclonal antibodies with two separate antigen recognition domains. One with a high affinity to an antigen in the surface of tumor cell and another targeting CD-3 in the surface of T-cells. Binding to those two distinct epitopes leads to the formation of an immunologic synapse. Binding to the CD3e epitope augments the t-cell recruitment and activation, leading to cell death. In MM, the majority of BiTEs targeting BCMA in the surface of plasma cells.
\n
AMG-420, formerly known as BI 836909, is the first BiTE demonstrating clinical activity. It is comprised of two single-chain variable fragments (scFvs), one targeting BCMA and one targeting CD3. AMG-420 is the compound with the most available data to date. In a first in human dose-escalation study, AMG420 was administered in 42 patients with RRMM (NCT02514239). Eligible patients had progressed after a minimum of 2 prior lines of treatment, including a PI and an IMiD 31895611. The median number of prior lines of therapy was 4 (range 2–13). 31% of patients were double refractory to IMiDs and PIs, and 21% were daratumumab refractory. AMG420 was administered at different dose levels, 0.2-800 μg/d, through a continuous iv infusion for four weeks in 6-week cycles due to its low molecular weight and short half-life. Patients received treatment for up to 10 cycles Monitoring of toxicities required hospitalization at the beginning of cycles one (4 days) and two (1 day) [73].
\n
There were two deaths reported from adverse events: One patient in the 50 μg/d cohort died after the first cycle due to respiratory distress syndrome caused by concurrent influenza and aspergillosis, and one from hepatic failure from adenovirus. None of these incidents were considered related to treatment. There were no grade 3 or greater CNS toxicities reported. At the 800 μg/d dose level, two-thirds of the patients experienced DLTs. One patient had gr 3 CRS and one gr 3 peripheral polyneuropathy, which included progressive dysfunction of the peripheral motor and sensory nerves. Following the interruption of the study drug, both toxicities resolved. No DLTs were observed up to the level of 400 μg/d. In the most recent follow-up of the study, 40 patients discontinued treatment. Twenty-five due to disease progression, seven due to AEs, four died, three completed treatment (10 cycles), and 1 withdraw consent [73]. ORR was 31% (13/42patients). At the MTD of 400 μg/d, the response rate was 70% (7/10). In the 400 μg/d group, five patients achieved MRD negativity, one achieved PR, and one VGPR.
\n
As mentioned, because of its low molecular weight and short half-life, AMG420 was administered through a continuous iv infusion for four weeks in 6-week cycles due to its low molecular weight and short half-life. AMG 701, a BiTE with an extended half-life allowing once-weekly subcutaneous administration, was developed and is currently under investigation (NCT03287908).
\n
PF-06863135 (PF-3135) is a humanized Ig-like Bispecific antibody targeting both BCMA and CD3. PF-06863135 has been administered intravenously at 0.1–50 μg/kg weekly in patients with RRMM. Preliminary results demonstrate antimyeloma activity. The maximum tolerated dose was not reached [74]. In order to reduce the maximum concentration (Cmax) of the drug, which was possibly associated with inflammatory response and cytokine release syndrome (CRS), subcutaneous administration of the drug was tested. Preliminary results were reported in the last ASH meeting [75]. 2 6/8(75%) patients achieved a response at the two highest dose levels evaluated. The sc administration modulates Cmax. This could allow the administration of higher doses without increased incidence of CRS. The trial is ongoing.
\n
\n
\n
\n
3. Immune checkpoint inhibitors
\n
The programmed death-1 (PD-1) receptor is a type-1 transmembrane glycoprotein, expressed on antigen-activated B-cells, T-cells, and NK-cells. The binding of PD-1 ligands (PD-L1 and PD-L2) on PD-1 receptor results in downregulation of immune functions mediated by T-cells such as cytokine production, t-cell proliferation, and cytotoxicity [76]. The overexpression of PD-L1 and PD-L2 is a well recognizable mechanism of immune evasion. Preclinical data from MM patients have shown an increased expression of PD-L1 and PD-1 on malignant plasma cells and T and NK cells respectively [77, 78]. The deciphering of this particular mechanism of action has lead to the development of immune checkpoint inhibitors that block receptors (PD-1) and ligands (PD-L1 and PD-L2), resulting in the recovery of immune response.
\n
Pembrolizumab is a humanized IgG4 monoclonal antibody with high specificity against PD-1 receptors. Pembrolizumab was evaluated in combination with Lenalidomide and low dose dexamethasone in a phase I dose-escalation study (KEYNOTE-023 trial NCT02036502). Sixty-six patients with RRMM were recruited. Pembrolizumab was treatment-related AEs. Grade 3 AEs (mainly cytopenias fatigue and diarrhea) occurred in 37 (59,7%) patients. ORR OS and median PFS were 44%, not reached, and 7.2 months respectively [79, 80]. Pembrolizumab has also been evaluated in combination with Pomalidomide and dexamethasone in another phase II study (NCT02289222). Forty-eight patients with RRMM were recruited. Patients had received 2–5 (median 3) prior lines of treatment. 73% were refractory to both IMIDs and PIs. ORR was 60%. The percentage of SCR and CR, VGPR, and PR were 8%, 19%, and 33%, respectively. After a median follow-up of 15.6 months, OS and PFS were not reached and 17.4 months, respectively.(40%) [81].
\n
Based on these results, two-phase three trials were designed to evaluate the combination of Pembrolizumab dexamethasone with Lenalidomide (KEYNOTE-185 NCT02579863) or Pomalidomide (KEYNOTE-183 NCT02576977) in ND and RR setting respectively. Interim analysis of both studies showed excessive administered for a median of 7 cycles (range 1–67). Overall, 95% of patients experienced unanticipated deaths attributed to the combination of Pembrolizumab Dexamethasone with Lenalidomide or Pomalidomide. These results showed that the risk profile of these novel combinations was unfavorable, and both trials were terminated early [82, 83].
\n
Nivolumab is a fully human IgG4 Moab targeting PD-1 receptors. Investigation of Nivolumab with IMiDS has been placed on clinical hold after reviewing data regarding Pembrolizumab. Nivolumab is currently under investigation in combination with daratumumab (NCT03184194), Elotuzumab (NCT02612779), Pomalidomide (NCT02726581), and Carfilzomib (NCT03605719) in phase 2 trials.
\n
In \nTable 1\n, we present selected clinical trials conducted with monoclonal antibodies in the newly diagnosed and relapsed refractory setting.
\n
\n
\n
\n
\n
\n\n
\n
Description
\n
Phase
\n
NCT number
\n
Population
\n
\n\n\n
\n
DARATUMUMAB
\n
\n
\n
\n
\n
\n
A Study of Daratumumab Plus Lenalidomide Versus Lenalidomide Alone as Maintenance Treatment in Participants With Newly Diagnosed Multiple Myeloma Who Are Minimal Residual Disease Positive After Frontline Autologous Stem Cell Transplant (AURIGA)
\n
3
\n
NCT03901963
\n
NDMM
\n
\n
\n
Study of Melphalan Flufenamide (Melflufen) in Combination With Daratumumab in Relapsed Refractory Multiple Myeloma (LIGHTHOUSE)
\n
3
\n
NCT04649060
\n
RRMM
\n
\n
\n
Daratumumab, VELCADE (Bortezomib), Lenalidomide and Dexamethasone Compared to VELCADE, Lenalidomide and Dexamethasone in Subjects With Previously Untreated Multiple Myeloma (PERSEUS)
\n
3
\n
NCT03710603
\n
NDMM
\n
\n
\n
ISATUXIMAB
\n
\n
\n
\n
\n
\n
Isatuximab Bortezomib, Lenalidomide and Dexamethasone Combination in NDMM Patients Not Eligible for Transplant (IMROZ)
\n
3
\n
NCT03319667
\n
NDMM
\n
\n
\n
Isa-KRd vs. KRd in Newly Diagnosed Multiple Myeloma Patients Eligible for Autologous Stem Cell Transplantation (IsKia)
\n
3
\n
NCT04483739
\n
NDMM
\n
\n
\n
ANTIBODY-DRUG CONJUGATES
\n
\n
\n
\n
\n
\n
Study of Single Agent Belantamab Mafodotin Versus Pomalidomide Plus Low-dose Dexamethasone (Pom/Dex) in Participants With Relapsed/Refractory Multiple Myeloma (DREAMM-3)
\n
3
\n
NCT04162210
\n
RRMM
\n
\n
\n
Study Evaluating Safety, Tolerability and Clinical Activity of GSK2857916 in Combination With Pembrolizumab in Subjects With Relapsed/Refractory Multiple Myeloma (DREAMM-4)
\n
1/2
\n
NCT03848845
\n
RRMM
\n
\n
\n
Platform Study of Belantamab Mafodotin as Monotherapy and in Combination With Anti-cancer Treatments in Participants With Relapsed/Refractory Multiple Myeloma (RRMM) (DREAMM 5)
\n
1/2
\n
NCT04126200
\n
RRMM
\n
\n
\n
To Evaluate Safety, Tolerability, and Clinical Activity of the Antibody-drug Conjugate, GSK2857916 Administered in Combination With Lenalidomide Plus Dexamethasone (Arm A), or in Combination With Bortezomib Plus Dexamethasone (Arm B) in Participants With Relapsed/Refractory Multiple Myeloma (DREAMM-6)
\n
1/2
\n
NCT03544281
\n
RRMM
\n
\n
\n
Evaluation of Efficacy and Safety of Belantamab Mafodotin, Bortezomib and Dexamethasone Versus Daratumumab, Bortezomib and Dexamethasone in Participants With Relapsed/Refractory Multiple Myeloma (DREAMM-7)
\n
3
\n
NCT04246047
\n
RRMM
\n
\n
\n
Belantamab Mafodotin Plus Pomalidomide and Dexamethasone (Pd) Versus Bortezomib Plus Pd in Relapsed/Refractory Multiple Myeloma (DREAMM-8)
\n
3
\n
NCT04484623
\n
RRMM
\n
\n
\n
Study of Belantamab Mafodotin Plus Standard of Care (SoC) in Newly Diagnosed Multiple Myeloma (DREAMM-9)
\n
1
\n
NCT04091126
\n
NDMM
\n
\n
\n
A Study of Belantamab Mafodotin (GSK2857916) in Multiple Myeloma Participants With Normal and Varying Degree of Impaired Renal Function (DREAMM-12)
\n
1
\n
NCT04398745
\n
RRMM
\n
\n
\n
A Study of Belantamab Mafodotin (GSK2857916) in Multiple Myeloma Participants With Normal and Impaired Hepatic Function (DREAMM-13)
\n
1
\n
NCT04398680
\n
RRMM
\n
\n
\n
BISPECIFIC ANTIBODIES
\n
\n
\n
\n
\n
\n
PF-06863135 As Single Agent And In Combination With Immunomodulatory Agents In Relapse/Refractory Multiple Myeloma
\n
1
\n
NCT03269136
\n
RRMM
\n
\n
\n
MagnetisMM-3: Study Of Elranatamab (PF-06863135) Monotherapy in Participants With Multiple Myeloma Who Are Refractory to at Least One PI, One IMiD and One Anti-CD38 mAb
\n
2
\n
NCT04649359
\n
RRMM
\n
\n
\n
First in Human (FIH) Study of REGN5458 in Patients With Relapsed or Refractory Multiple Myeloma
\n
1/2
\n
NCT03761108
\n
RRMM
\n
\n
\n
A Study of Teclistamab, in Participants With Relapsed or Refractory Multiple Myeloma
\n
2
\n
NCT04557098
\n
RRMM
\n
\n
\n
A Study of Talquetamab in Participants With Relapsed or Refractory Multiple Myeloma
\n
2
\n
NCT04634552
\n
RRMM
\n
\n\n
Table 1.
Ongoing clinical trials.
\n
\n
\n
4. Conclusion
\n
Despite therapeutic improvements Multiple Myeloma remain an incurable disease. The treatment of patients with RR remains a challenging issue. Antibody therapy has significantly enhanced the armamentarium of therapeutic options. Further research should focus on tailoring the combination regimens based on disease and patient characteristics in order to optimize the efficacy and safety.
\n
\n\n',keywords:"Monoclonal Antibodies, Antibody Drug Conjugates, Daratumumab, Belantamab Mafodotin",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/77271.pdf",chapterXML:"https://mts.intechopen.com/source/xml/77271.xml",downloadPdfUrl:"/chapter/pdf-download/77271",previewPdfUrl:"/chapter/pdf-preview/77271",totalDownloads:165,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 25th 2020",dateReviewed:"May 31st 2021",datePrePublished:"July 7th 2021",datePublished:"July 28th 2021",dateFinished:"June 23rd 2021",readingETA:"0",abstract:"Multiple Myeloma (MM) is characterized by the abberant proliferation and expansion of plasma cells in the Bone marrow. Despite the broad use of proteasome inhibitors and IMiDs, Multiple Myeloma remains an incurable disease. The introduction of Monoclonal antibodies, along with bi-specific antibodies and check point inhibitors, has significantly enhanced the armamentarium of available therapeutic options in the relapsed setting. The incorporation of the above-mentioned novel agents in triplet or quadruplet therapeutic regimens has led to significant prolongation of overall survival (OS) and progression free survival (PFS), without adding significant toxicity. Anti-CD38 monoclonal antibodies has become the cornerstone of antimyeloma therapy in both the newly diagnosed and relapsed setting.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/77271",risUrl:"/chapter/ris/77271",signatures:"Nikolaos Kanellias, Maria Gavriatopoulou and Evangelos Terpos",book:{id:"9791",type:"book",title:"Multiple Myeloma",subtitle:null,fullTitle:"Multiple Myeloma",slug:"multiple-myeloma",publishedDate:"July 28th 2021",bookSignature:"Ota Fuchs",coverURL:"https://cdn.intechopen.com/books/images_new/9791.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83968-621-4",printIsbn:"978-1-83968-620-7",pdfIsbn:"978-1-83968-622-1",isAvailableForWebshopOrdering:!0,editors:[{id:"36468",title:"Dr.",name:"Ota",middleName:null,surname:"Fuchs",slug:"ota-fuchs",fullName:"Ota Fuchs"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"52484",title:"Prof.",name:"Evangelos",middleName:null,surname:"Terpos",fullName:"Evangelos Terpos",slug:"evangelos-terpos",email:"eterpos@hotmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"332827",title:"M.D.",name:"Nikolaos",middleName:null,surname:"Kanellias",fullName:"Nikolaos Kanellias",slug:"nikolaos-kanellias",email:"nick.kanellias@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"419708",title:"Prof.",name:"Maria",middleName:null,surname:"Gavriatopoulou",fullName:"Maria Gavriatopoulou",slug:"maria-gavriatopoulou",email:"mariagabria@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Monoclonal antibodies",level:"1"},{id:"sec_2_2",title:"2.1 Daratumumab",level:"2"},{id:"sec_2_3",title:"2.1.1 Daratumumab mechanism of action",level:"3"},{id:"sec_3_3",title:"2.1.2 Daratumumab combinations in the newly diagnosed setting",level:"3"},{id:"sec_3_4",title:"2.1.2.1 Transplant-ineligible patients",level:"4"},{id:"sec_4_4",title:"2.1.2.2 Transplant-eligible patients",level:"4"},{id:"sec_6_3",title:"2.1.3 Daratumumab combinations in the R/R setting",level:"3"},{id:"sec_8_2",title:"2.2 Isatuximab",level:"2"},{id:"sec_8_3",title:"2.2.1 Mechanism of action",level:"3"},{id:"sec_9_3",title:"2.2.2 Isatuximab clinical trials",level:"3"},{id:"sec_11_2",title:"2.3 Elotuzumab",level:"2"},{id:"sec_11_3",title:"2.3.1 Elotuzumab mechanism of action",level:"3"},{id:"sec_12_3",title:"2.3.2 Elotuzumab clinical trials",level:"3"},{id:"sec_14_2",title:"2.4 Antibody drug conjugates (ADCs)",level:"2"},{id:"sec_15_2",title:"2.5 Bispecific antibodies",level:"2"},{id:"sec_17",title:"3. Immune checkpoint inhibitors",level:"1"},{id:"sec_18",title:"4. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'\nPalumbo A, Anderson K. Multiple myeloma. N Engl J Med 2011; 364: 1046-1060\n'},{id:"B2",body:'\nKumar SK, Lee JH, Lahuerta JJ et al. Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia 2012; 26: 149-157\n'},{id:"B3",body:'\nKumar SK, Dimopoulos MA, Kastritis E et al. Natural history of relapsed myeloma, refractory to immunomodulatory drugs and proteasome inhibitors: a multicenter IMWG study. Leukemia 2017; 31: 2443-2448\n'},{id:"B4",body:'\nvan de Donk NW, Sonneveld P. Diagnosis and risk stratification in multiple myeloma. Hematol Oncol Clin North Am 2014; 28: 791-813\n'},{id:"B5",body:'\nSonneveld P, Avet-Loiseau H, Lonial S et al. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood 2016; 127: 2955-2962\n'},{id:"B6",body:'\nde Weers M, Tai YT, van der Veer MS et al. Daratumumab, a novel therapeutic human CD38 monoclonal antibody, induces killing of multiple myeloma and other hematological tumors. J Immunol 2011; 186: 1840-1848\n'},{id:"B7",body:'\nPelton JG, Wemmer DE. Structural modeling of the distamycin A-d(CGCGAATTCGCG)2 complex using 2D NMR and molecular mechanics. Biochemistry 1988; 27: 8088-8096\n'},{id:"B8",body:'\nOverdijk MB, Verploegen S, Bogels M et al. Antibody-mediated phagocytosis contributes to the anti-tumor activity of the therapeutic antibody daratumumab in lymphoma and multiple myeloma. MAbs 2015; 7: 311-321\n'},{id:"B9",body:'\nPhipps C, Chen Y, Gopalakrishnan S, Tan D. Daratumumab and its potential in the treatment of multiple myeloma: overview of the preclinical and clinical development. Ther Adv Hematol 2015; 6: 120-127\n'},{id:"B10",body:'\nJain A, Ramasamy K. Evolving Role of Daratumumab: From Backbencher to Frontline Agent. Clin Lymphoma Myeloma Leuk 2020; 20: 572-587\n'},{id:"B11",body:'\nBonello F, Mina R, Boccadoro M, Gay F. Therapeutic Monoclonal Antibodies and Antibody Products: Current Practices and Development in Multiple Myeloma. Cancers (Basel) 2019; 12\n'},{id:"B12",body:'\nKrejcik J, Casneuf T, Nijhof IS et al. Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma. Blood 2016; 128: 384-394\n'},{id:"B13",body:'\nvan der Veer MS, de Weers M, van Kessel B et al. The therapeutic human CD38 antibody daratumumab improves the anti-myeloma effect of newly emerging multi-drug therapies. Blood Cancer J 2011; 1: e41\n'},{id:"B14",body:'\nUsmani SZ, Weiss BM, Plesner T et al. Clinical efficacy of daratumumab monotherapy in patients with heavily pretreated relapsed or refractory multiple myeloma. Blood 2016; 128: 37-44\n'},{id:"B15",body:'\nDimopoulos MA, Oriol A, Nahi H et al. Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med 2016; 375: 1319-1331\n'},{id:"B16",body:'\nChatterjee S, Daenthanasanmak A, Chakraborty P et al. CD38-NAD(+)Axis Regulates Immunotherapeutic Anti-Tumor T Cell Response. Cell Metab 2018; 27: 85-100 e108\n'},{id:"B17",body:'\nMateos MV, Dimopoulos MA, Cavo M et al. Daratumumab plus Bortezomib, Melphalan, and Prednisone for Untreated Myeloma. N Engl J Med 2018; 378: 518-528\n'},{id:"B18",body:'\nTerpos E, Ntanasis-Stathopoulos I, International Myeloma S. Clinical Updates Regarding Multiple Myeloma From the 2019 American Society of Hematology Annual Meeting. Clin Lymphoma Myeloma Leuk 2020; 20: 499-508\n'},{id:"B19",body:'\nMateos MV, Cavo M, Blade J et al. Overall survival with daratumumab, bortezomib, melphalan, and prednisone in newly diagnosed multiple myeloma (ALCYONE): a randomised, open-label, phase 3 trial. Lancet 2020; 395: 132-141\n'},{id:"B20",body:'\nSan-Miguel JF, Avet-Loiseau H, Paiva B et al. Sustained Minimal Residual Disease (MRD) Negativity and Clinical Efficacy in Transplant-Ineligible (TIE) Newly Diagnosed Multiple Myeloma (NDMM) Patients (Pts) Treated with Daratumumab-Based Regimens: Analysis of Maia and Alcyone. Blood 2020; 136: 18-20\n'},{id:"B21",body:'\nFacon T, Kumar S, Plesner T et al. Daratumumab plus Lenalidomide and Dexamethasone for Untreated Myeloma. N Engl J Med 2019; 380: 2104-2115\n'},{id:"B22",body:'\nBahlis N, Facon T, Usmani SZ et al. Daratumumab Plus Lenalidomide and Dexamethasone (D-Rd) Versus Lenalidomide and Dexamethasone (Rd) in Patients with Newly Diagnosed Multiple Myeloma (NDMM) Ineligible for Transplant: Updated Analysis of Maia. Blood 2019; 134: 1875-1875\n'},{id:"B23",body:'\nKumar SK, Facon T, Usmani SZ et al. Updated Analysis of Daratumumab Plus Lenalidomide and Dexamethasone (D-Rd) Versus Lenalidomide and Dexamethasone (Rd) in Patients with Transplant-Ineligible Newly Diagnosed Multiple Myeloma (NDMM): The Phase 3 Maia Study. Blood 2020; 136: 24-26\n'},{id:"B24",body:'\nChari A, Martinez-Lopez J, Mateos M-V et al. Daratumumab plus carfilzomib and dexamethasone in patients with relapsed or refractory multiple myeloma. Blood 2019; 134: 421-431\n'},{id:"B25",body:'\nVoorhees PM, Kaufman JL, Laubach J et al. Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma: the GRIFFIN trial. Blood 2020; 136: 936-945\n'},{id:"B26",body:'\nVoorhees PM, Rodriguez C, Reeves B et al. Daratumumab plus RVd for newly diagnosed multiple myeloma: final analysis of the safety run-in cohort of GRIFFIN. Blood Advances 2021; 5: 1092-1096\n'},{id:"B27",body:'\nMoreau P, Attal M, Hulin C et al. Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet 2019; 394: 29-38\n'},{id:"B28",body:'\nCosta LJ, Chhabra S, Godby KN et al. Daratumumab, Carfilzomib, Lenalidomide and Dexamethasone (Dara-KRd) Induction, Autologous Transplantation and Post-Transplant, Response-Adapted, Measurable Residual Disease (MRD)-Based Dara-Krd Consolidation in Patients with Newly Diagnosed Multiple Myeloma (NDMM). Blood 2019; 134: 860-860\n'},{id:"B29",body:'\nDimopoulos MA, San-Miguel J, Belch A et al. Daratumumab plus lenalidomide and dexamethasone versus lenalidomide and dexamethasone in relapsed or refractory multiple myeloma: updated analysis of POLLUX. Haematologica 2018; 103: 2088-2096\n'},{id:"B30",body:'\nBahlis NJ, Dimopoulos MA, White DJ et al. Daratumumab plus lenalidomide and dexamethasone in relapsed/refractory multiple myeloma: extended follow-up of POLLUX, a randomized, open-label, phase 3 study. Leukemia 2020; 34: 1875-1884\n'},{id:"B31",body:'\nPalumbo A, Chanan-Khan A, Weisel K et al. Daratumumab, Bortezomib, and Dexamethasone for Multiple Myeloma. N Engl J Med 2016; 375: 754-766\n'},{id:"B32",body:'\nChari A, Suvannasankha A, Fay JW et al. Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma. Blood 2017; 130: 974-981\n'},{id:"B33",body:'\nDimopoulos MA, Terpos E, Boccadoro M et al. Apollo: Phase 3 Randomized Study of Subcutaneous Daratumumab Plus Pomalidomide and Dexamethasone (D-Pd) Versus Pomalidomide and Dexamethasone (Pd) Alone in Patients (Pts) with Relapsed/Refractory Multiple Myeloma (RRMM). Blood 2020; 136: 5-6\n'},{id:"B34",body:'\nUsmani SZ, Quach H, Mateos M-V et al. Carfilzomib, Dexamethasone, and Daratumumab Versus Carfilzomib and Dexamethasone for the Treatment of Patients with Relapsed or Refractory Multiple Myeloma (RRMM): Primary Analysis Results from the Randomized, Open-Label, Phase 3 Study Candor (NCT03158688). Blood 2019; 134: LBA-6-LBA-6\n'},{id:"B35",body:'\nDimopoulos MA, Quach H, Mateos M-V et al. Carfilzomib, Dexamethasone, and Daratumumab Versus Carfilzomib and Dexamethasone in Relapsed or Refractory Multiple Myeloma: Updated Efficacy and Safety Results of the Phase 3 Candor Study. Blood 2020; 136: 26-27\n'},{id:"B36",body:'\nDeckert J, Wetzel MC, Bartle LM et al. SAR650984, a novel humanized CD38-targeting antibody, demonstrates potent antitumor activity in models of multiple myeloma and other CD38+ hematologic malignancies. Clin Cancer Res 2014; 20: 4574-4583\n'},{id:"B37",body:'\nNijhof IS, Groen RW, Noort WA et al. Preclinical Evidence for the Therapeutic Potential of CD38-Targeted Immuno-Chemotherapy in Multiple Myeloma Patients Refractory to Lenalidomide and Bortezomib. Clin Cancer Res 2015; 21: 2802-2810\n'},{id:"B38",body:'\nvan der Veer MS, de Weers M, van Kessel B et al. Towards effective immunotherapy of myeloma: enhanced elimination of myeloma cells by combination of lenalidomide with the human CD38 monoclonal antibody daratumumab. Haematologica 2011; 96: 284-290\n'},{id:"B39",body:'\nOverdijk MB, Jansen JH, Nederend M et al. The Therapeutic CD38 Monoclonal Antibody Daratumumab Induces Programmed Cell Death via Fcgamma Receptor-Mediated Cross-Linking. J Immunol 2016; 197: 807-813\n'},{id:"B40",body:'\nMartin T, Strickland S, Glenn M et al. Phase I trial of isatuximab monotherapy in the treatment of refractory multiple myeloma. Blood Cancer J 2019; 9: 41\n'},{id:"B41",body:'\nMikhael J, Richter J, Vij R et al. A dose-finding Phase 2 study of single agent isatuximab (anti-CD38 mAb) in relapsed/refractory multiple myeloma. Leukemia 2020; 34: 3298-3309\n'},{id:"B42",body:'\nDimopoulos M, Bringhen S, Anttila P et al. Isatuximab as monotherapy and combined with dexamethasone in patients with relapsed/refractory multiple myeloma. Blood 2021; 137: 1154-1165\n'},{id:"B43",body:'\nMartin T, Baz R, Benson DM et al. A phase 1b study of isatuximab plus lenalidomide and dexamethasone for relapsed/refractory multiple myeloma. Blood 2017; 129: 3294-3303\n'},{id:"B44",body:'\nMikhael J, Richardson P, Usmani SZ et al. A phase 1b study of isatuximab plus pomalidomide/dexamethasone in relapsed/refractory multiple myeloma. Blood 2019; 134: 123-133\n'},{id:"B45",body:'\nAttal M, Richardson PG, Rajkumar SV et al. Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study. Lancet 2019; 394: 2096-2107\n'},{id:"B46",body:'\nChari A, Richter JR, Shah N et al. Phase I-b study of isatuximab + carfilzomib in relapsed and refractory multiple myeloma (RRMM). Journal of Clinical Oncology 2018; 36: 8014-8014\n'},{id:"B47",body:'\nMoreau P, Dimopoulos MA, Yong K et al. Isatuximab plus carfilzomib/dexamethasone versus carfilzomib/dexamethasone in patients with relapsed/refractory multiple myeloma: IKEMA Phase III study design. Future Oncol 2020; 16: 4347-4358\n'},{id:"B48",body:'\nMartin T, Mikhael J, Hajek R et al. Depth of Response and Response Kinetics of Isatuximab Plus Carfilzomib and Dexamethasone in Relapsed Multiple Myeloma: Ikema Interim Analysis. Blood 2020; 136: 7-8\n'},{id:"B49",body:'\nTai YT, Dillon M, Song W et al. Anti-CS1 humanized monoclonal antibody HuLuc63 inhibits myeloma cell adhesion and induces antibody-dependent cellular cytotoxicity in the bone marrow milieu. Blood 2008; 112: 1329-1337\n'},{id:"B50",body:'\nPazina T, James AM, MacFarlane AWt et al. The anti-SLAMF7 antibody elotuzumab mediates NK cell activation through both CD16-dependent and -independent mechanisms. Oncoimmunology 2017; 6: e1339853\n'},{id:"B51",body:'\nLonial S, Dimopoulos M, Palumbo A et al. Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma. N Engl J Med 2015; 373: 621-631\n'},{id:"B52",body:'\nDimopoulos MA, Dytfeld D, Grosicki S et al. Elotuzumab plus Pomalidomide and Dexamethasone for Multiple Myeloma. N Engl J Med 2018; 379: 1811-1822\n'},{id:"B53",body:'\nMadry C, Laabi Y, Callebaut I et al. The characterization of murine BCMA gene defines it as a new member of the tumor necrosis factor receptor superfamily. Int Immunol 1998; 10: 1693-1702\n'},{id:"B54",body:'\nSanchez E, Li M, Kitto A et al. Serum B-cell maturation antigen is elevated in multiple myeloma and correlates with disease status and survival. Br J Haematol 2012; 158: 727-738\n'},{id:"B55",body:'\nCarpenter RO, Evbuomwan MO, Pittaluga S et al. B-cell maturation antigen is a promising target for adoptive T-cell therapy of multiple myeloma. Clin Cancer Res 2013; 19: 2048-2060\n'},{id:"B56",body:'\nThompson JS, Schneider P, Kalled SL et al. BAFF binds to the tumor necrosis factor receptor-like molecule B cell maturation antigen and is important for maintaining the peripheral B cell population. J Exp Med 2000; 192: 129-135\n'},{id:"B57",body:'\nNovak AJ, Darce JR, Arendt BK et al. Expression of BCMA, TACI, and BAFF-R in multiple myeloma: a mechanism for growth and survival. Blood 2004; 103: 689-694\n'},{id:"B58",body:'\nGavriatopoulou M, Ntanasis-Stathopoulos I, Dimopoulos MA, Terpos E. Anti-BCMA antibodies in the future management of multiple myeloma. Expert Rev Anticancer Ther 2019; 19: 319-326\n'},{id:"B59",body:'\nShen X, Guo Y, Qi J et al. Binding of B-cell maturation antigen to B-cell activating factor induces survival of multiple myeloma cells by activating Akt and JNK signaling pathways. Cell Biochem Funct 2016; 34: 104-110\n'},{id:"B60",body:'\nDemchenko YN, Kuehl WM. A critical role for the NFkB pathway in multiple myeloma. Oncotarget 2010; 1: 59-68\n'},{id:"B61",body:'\nChatterjee M, Jain S, Stuhmer T et al. STAT3 and MAPK signaling maintain overexpression of heat shock proteins 90alpha and beta in multiple myeloma cells, which critically contribute to tumor-cell survival. Blood 2007; 109: 720-728\n'},{id:"B62",body:'\nLentzsch S, Chatterjee M, Gries M et al. PI3-K/AKT/FKHR and MAPK signaling cascades are redundantly stimulated by a variety of cytokines and contribute independently to proliferation and survival of multiple myeloma cells. Leukemia 2004; 18: 1883-1890\n'},{id:"B63",body:'\nChatterjee M, Stuhmer T, Herrmann P et al. Combined disruption of both the MEK/ERK and the IL-6R/STAT3 pathways is required to induce apoptosis of multiple myeloma cells in the presence of bone marrow stromal cells. Blood 2004; 104: 3712-3721\n'},{id:"B64",body:'\nO’Connor BP, Raman VS, Erickson LD et al. BCMA is essential for the survival of long-lived bone marrow plasma cells. J Exp Med 2004; 199: 91-98\n'},{id:"B65",body:'\nTai YT, Mayes PA, Acharya C et al. Novel anti-B-cell maturation antigen antibody-drug conjugate (GSK2857916) selectively induces killing of multiple myeloma. Blood 2014; 123: 3128-3138\n'},{id:"B66",body:'\nTrudel S, Lendvai N, Popat R et al. Targeting B-cell maturation antigen with GSK2857916 antibody-drug conjugate in relapsed or refractory multiple myeloma (BMA117159): a dose escalation and expansion phase 1 trial. Lancet Oncol 2018; 19: 1641-1653\n'},{id:"B67",body:'\nTrudel S, Lendvai N, Popat R et al. Antibody-drug conjugate, GSK2857916, in relapsed/refractory multiple myeloma: an update on safety and efficacy from dose expansion phase I study. Blood Cancer J 2019; 9: 37\n'},{id:"B68",body:'\nTzogani K, Penttila K, Lahteenvuo J et al. EMA Review of Belantamab Mafodotin (Blenrep) for the Treatment of Adult Patients with Relapsed/Refractory Multiple Myeloma. Oncologist 2021; 26: 70-76\n'},{id:"B69",body:'\nLonial S, Lee HC, Badros A et al. Belantamab mafodotin for relapsed or refractory multiple myeloma (DREAMM-2): a two-arm, randomised, open-label, phase 2 study. Lancet Oncol 2020; 21: 207-221\n'},{id:"B70",body:'\nCohen AD, Trudel S, Lonial S et al. DREAMM-2: Single-agent belantamab mafodotin (GSK2857916) in patients with relapsed/refractory multiple myeloma (RRMM) and high-risk (HR) cytogenetics. Journal of Clinical Oncology 2020; 38: 8541-8541\n'},{id:"B71",body:'\nLee HC, Cohen AD, Chari A et al. DREAMM-2: Single-agent belantamab mafodotin (GSK2857916) in patients with relapsed/refractory multiple myeloma (RRMM) and renal impairment. Journal of Clinical Oncology 2020; 38: 8519-8519\n'},{id:"B72",body:'\nKumar SK, Migkou M, Bhutani M et al. Phase 1, First-in-Human Study of MEDI2228, a BCMA-Targeted ADC in Patients with Relapsed/Refractory Multiple Myeloma. Blood 2020; 136: 26-27\n'},{id:"B73",body:'\nTopp MS, Duell J, Zugmaier G et al. Anti-B-Cell Maturation Antigen BiTE Molecule AMG 420 Induces Responses in Multiple Myeloma. J Clin Oncol 2020; 38: 775-783\n'},{id:"B74",body:'\nLesokhin AM, Raje N, Gasparetto CJ et al. A Phase I, Open-Label Study to Evaluate the Safety, Pharmacokinetic, Pharmacodynamic, and Clinical Activity of PF-06863135, a B-Cell Maturation Antigen/CD3 Bispecific Antibody, in Patients with Relapsed/Refractory Advanced Multiple Myeloma. Blood 2018; 132: 3229-3229\n'},{id:"B75",body:'\nLesokhin AM, Levy MY, Dalovisio AP et al. Preliminary Safety, Efficacy, Pharmacokinetics, and Pharmacodynamics of Subcutaneously (SC) Administered PF-06863135, a B-Cell Maturation Antigen (BCMA)-CD3 Bispecific Antibody, in Patients with Relapsed/Refractory Multiple Myeloma (RRMM). Blood 2020; 136: 8-9\n'},{id:"B76",body:'\nParry RV, Chemnitz JM, Frauwirth KA et al. CTLA-4 and PD-1 receptors inhibit T-cell activation by distinct mechanisms. Mol Cell Biol 2005; 25: 9543-9553\n'},{id:"B77",body:'\nPaiva B, Azpilikueta A, Puig N et al. PD-L1/PD-1 presence in the tumor microenvironment and activity of PD-1 blockade in multiple myeloma. Leukemia 2015; 29: 2110-2113\n'},{id:"B78",body:'\nChen D, Tang P, Liu L et al. Bone marrow-derived mesenchymal stem cells promote cell proliferation of multiple myeloma through inhibiting T cell immune responses via PD-1/PD-L1 pathway. Cell Cycle 2018; 17: 858-867\n'},{id:"B79",body:'\nMateos M-V, Orlowski RZ, Siegel DSD et al. Pembrolizumab in combination with lenalidomide and low-dose dexamethasone for relapsed/refractory multiple myeloma (RRMM): Final efficacy and safety analysis. Journal of Clinical Oncology 2016; 34: 8010-8010\n'},{id:"B80",body:'\nMateos MV, Orlowski RZ, Ocio EM et al. Pembrolizumab combined with lenalidomide and low-dose dexamethasone for relapsed or refractory multiple myeloma: phase I KEYNOTE-023 study. Br J Haematol 2019; 186: e117-e121\n'},{id:"B81",body:'\nBadros A, Hyjek E, Ma N et al. Pembrolizumab, pomalidomide, and low-dose dexamethasone for relapsed/refractory multiple myeloma. Blood 2017; 130: 1189-1197\n'},{id:"B82",body:'\nMateos MV, Blacklock H, Schjesvold F et al. Pembrolizumab plus pomalidomide and dexamethasone for patients with relapsed or refractory multiple myeloma (KEYNOTE-183): a randomised, open-label, phase 3 trial. Lancet Haematol 2019; 6: e459-e469\n'},{id:"B83",body:'\nUsmani SZ, Schjesvold F, Oriol A et al. Pembrolizumab plus lenalidomide and dexamethasone for patients with treatment-naive multiple myeloma (KEYNOTE-185): a randomised, open-label, phase 3 trial. Lancet Haematol 2019; 6: e448-e458\n'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Nikolaos Kanellias",address:"nick.kanellias@gmail.com",affiliation:'
Department of Clinical Therapeutics, Medical School, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
Department of Clinical Therapeutics, Medical School, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Those limitations can be characterized as “innovation ghettos.” In that logic, the researchers have also demonstrated the presence of “ghettos of sustainability, ghettos of innovation, and therefore, ghettos of sustainability and innovation” in the sectors of this Brazilian regional economy, but in differentiated and restricted perspectives",signatures:"Eric Charles Henri Dorion, Pelayo Munhoz Olea, François Coallier,\nCleber Cristiano Prodanov, Eliana Andrea Severo, Julio Cesar Ferro\nGuimarães, Cristine Hermann Nodari, Ana Cristina Fachinelli, Vânia\nBeatriz Merlotti Heredia, Fernando Fantoni Bencke, Nilson Varella\nRubenich, Paula Patricia Ganzer, Claudio Baltazar Corrêa De Mello,\nAdrieli Alves Pereira Radaelli, Cassiane Chais, Oberdan Teles Da\nSilva, Luana Folchini Da Costa, Vanessa Machado, Joel Tshibamba\nMukendi and Vandoir Welchen",authors:[{id:"22626",title:"Dr.",name:"Eric",surname:"Dorion",fullName:"Eric Dorion",slug:"eric-dorion",email:"echdorion@gmail.com"},{id:"114255",title:"Dr.",name:"Eliana Andrea",surname:"Severo",fullName:"Eliana Andrea Severo",slug:"eliana-andrea-severo",email:"elianasevero2@hotmail.com"},{id:"137241",title:"Dr.",name:"Pelayo Munhoz",surname:"Olea",fullName:"Pelayo Munhoz Olea",slug:"pelayo-munhoz-olea",email:"pelayo.olea@gmail.com"},{id:"137242",title:"Dr.",name:"Cristine Hermann",surname:"Nodari",fullName:"Cristine Hermann Nodari",slug:"cristine-hermann-nodari",email:"cristine.nodari@gmail.com"},{id:"204862",title:"Dr.",name:"Paula Patricia",surname:"Ganzer",fullName:"Paula Patricia Ganzer",slug:"paula-patricia-ganzer",email:"ganzer.paula@gmail.com"},{id:"204863",title:"Dr.",name:"Claudio Baltazar",surname:"Corrêa de Mello",fullName:"Claudio Baltazar Corrêa de Mello",slug:"claudio-baltazar-correa-de-mello",email:"cbcmello@gmail.com"},{id:"209651",title:"Dr.",name:"Vânia Beatriz Merlotti",surname:"Heredia",fullName:"Vânia Beatriz Merlotti Heredia",slug:"vania-beatriz-merlotti-heredia",email:"vbmhered@gmail.com"},{id:"209653",title:"Dr.",name:"François",surname:"Coallier",fullName:"François Coallier",slug:"francois-coallier",email:"francois.coallier@etsmtl.ca"},{id:"209654",title:"Dr.",name:"Cleber Cristiano",surname:"Prodanov",fullName:"Cleber Cristiano Prodanov",slug:"cleber-cristiano-prodanov",email:"prodanov@feevale.br"},{id:"209655",title:"MSc.",name:"Adrieli Alves",surname:"Pereira Radaelli",fullName:"Adrieli Alves Pereira Radaelli",slug:"adrieli-alves-pereira-radaelli",email:"adrieli.radaelli@gmail.com"},{id:"209656",title:"MSc.",name:"Oberdan",surname:"Teles Da Silva",fullName:"Oberdan Teles Da Silva",slug:"oberdan-teles-da-silva",email:"oberdanteles@hotmail.com"},{id:"209657",title:"BSc.",name:"Luana",surname:"Folchini Da Costa",fullName:"Luana Folchini Da Costa",slug:"luana-folchini-da-costa",email:"luana.folchini@gmail.com"},{id:"209658",title:"BSc.",name:"Vanessa",surname:"Machado",fullName:"Vanessa Machado",slug:"vanessa-machado",email:"machadv@miamioh.edu"},{id:"209659",title:"BSc.",name:"Joel",surname:"Tshibamba Mukendi",fullName:"Joel Tshibamba Mukendi",slug:"joel-tshibamba-mukendi",email:"tshibambajoel@yahoo.fr"},{id:"209660",title:"BSc.",name:"Vandoir",surname:"Welchen",fullName:"Vandoir Welchen",slug:"vandoir-welchen",email:"vwelchen@ucs.br"},{id:"209712",title:"M.Sc.",name:"Cassiane",surname:"Chais",fullName:"Cassiane Chais",slug:"cassiane-chais",email:"cassichais@gmail.com"},{id:"209728",title:"Dr.",name:"Julio Cesar Ferro",surname:"Guimarães",fullName:"Julio Cesar Ferro Guimarães",slug:"julio-cesar-ferro-guimaraes",email:"juliocfguimaraes@yahoo.com.br"},{id:"209844",title:"Dr.",name:"Fernando Fantoni",surname:"Bencke",fullName:"Fernando Fantoni Bencke",slug:"fernando-fantoni-bencke",email:"fernando.bencke@unoesc.edu.br"},{id:"209845",title:"Dr.",name:"Nilson Varella",surname:"Rubenich",fullName:"Nilson Varella Rubenich",slug:"nilson-varella-rubenich",email:"nilsonvr@gmail.com"},{id:"209852",title:"Dr.",name:"Ana Cristina",surname:"Fachinelli",fullName:"Ana Cristina Fachinelli",slug:"ana-cristina-fachinelli",email:"afachinelli@gmail.com"}],book:{id:"6165",title:"Entrepreneurship",slug:"entrepreneurship-development-tendencies-and-empirical-approach",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"22626",title:"Dr.",name:"Eric",surname:"Dorion",slug:"eric-dorion",fullName:"Eric Dorion",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"103802",title:"Ph.D.",name:"Ondrej",surname:"Zizlavsky",slug:"ondrej-zizlavsky",fullName:"Ondrej Zizlavsky",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQJQA0/Profile_Picture_1643100292225",biography:"Ondrej Zizlavsky is a Czech Expert specialized in corporate finance, management control and performance measurement systems with particular emphasis on the concept of innovation projects. He is well established in research which particularly aims to understand what drives the success of innovation and how to measure and develop an innovative performance in the company. He is co-author of a certified methodology of innovation success measurement in agile and other working environments called Innovation Scorecard. He has conducted research projects in the Czech Republic supported by the Czech Science Foundation, Technology Agency of the Czech Republic as well as many research short-term projects under the auspices of the Brno University of Technology. His work has been published in four books, in a number of scientific peer-reviewed journals indexed in Thomson Reuters and Scopus, and chapters within other research books.",institutionString:null,institution:{name:"Brno University of Technology",institutionURL:null,country:{name:"Czech Republic"}}},{id:"105314",title:"Prof.",name:"Heiko",surname:"Haase",slug:"heiko-haase",fullName:"Heiko Haase",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ernst Abbe University of Applied Sciences Jena",institutionURL:null,country:{name:"Germany"}}},{id:"105529",title:"Dr.",name:"Mário",surname:"Franco",slug:"mario-franco",fullName:"Mário Franco",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/105529/images/system/105529.jpg",biography:"Mário Franco is an Associate Professor of Entrepreneurship and SME Administration at the Department of Management and Economics, Beira Interior University, Portugal. He received his Ph.D. in Management from Beira Interior University in 2002. In 1997, he was a doctoral candidate and participated in the European Doctoral Programme in Entrepreneurship and Small Business Management in Spain and Sweden. He is the director of the 2nd Cycle (Master) of Management. His research focuses on strategic alliances, business networks, innovation, and business creation. He is a member of a research unit at the Center for Advanced Studies in Management and Economics of the University of Beira Interior (CEFAGE-UBI) and is currently involved in several research projects on SMEs. He has authored several articles published in journals such as Long Range Planning, R&D Management, International Entrepreneurship and Management Journal, and Management Decision, and some books and book chapters published by international publishers.",institutionString:"University of Beira Interior",institution:{name:"University of Beira Interior",institutionURL:null,country:{name:"Portugal"}}},{id:"109428",title:"Dr.",name:"António Carrizo",surname:"Moreira",slug:"antonio-carrizo-moreira",fullName:"António Carrizo Moreira",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS0gUQAS/Profile_Picture_1618818100011",biography:"António Carrizo Moreira obtained Bachelor’s degree in Electrical Engineering and Master’s degree in Management, both from the University of Porto, Portugal. He received his PhD in Management from the University of Manchester, England. He has a solid international background in industry leveraged working for a multinational company in Germany as well as in Portugal. He has also been involved in consultancy projects and in research activities. Dr. Carrizo Moreira is currently an Associate Professor at the Department of Economics, Management, Industrial Engineering, and Tourism, University of Aveiro, Portugal, where he headed the Bachelor and Master Degrees in Management for five years. He is a member of GOVCOPP research unit and the Director of the PhD program in Business and Economics Studies.",institutionString:"University of Aveiro",institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"112260",title:"Dr.",name:"Vesa",surname:"Puhakka",slug:"vesa-puhakka",fullName:"Vesa Puhakka",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/112260/images/2563_n.jpg",biography:"Dr. Vesa Puhakka is Professor of Management and Entrepreneurship and Vice Dean for Education at the Oulu Business School, University of Oulu. He is doing research especially on entrepreneurship and new venture creation trying to understand the emerging mechanisms of becoming an international entrepreneur, opportunity-creating processes and growth of new ventures and as well strategy practices of new ventures. The Academy of Management and the NFIB Education Foundation awarded his doctoral dissertation for outstanding research in the fields of entrepreneurship and independent business in 2003.",institutionString:null,institution:{name:"University of Oulu",institutionURL:null,country:{name:"Finland"}}},{id:"114073",title:"Prof.",name:"Jörg",surname:"Freiling",slug:"jorg-freiling",fullName:"Jörg Freiling",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS2UPQA0/Profile_Picture_1642580983875",biography:"Dr. Jörg Freiling is Full Professor and Head of the LEMEX Chair in Small Business and Entrepreneurship at University of Bremen, Faculty of Business Studies and Economics. His major research fields are transnational entrepreneurship, immigrant entrepreneurship, refugee entrepreneurship, entrepreneurial ecosystems, entrepreneurial support systems (incubators, accelerators, etc.), small business management, business succession, business model innovation and entrepreneurship theory. 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General requirements for Open Access to Horizon 2020 research project outputs are found within Guidelines on Open Access to Scientific Publication and Research Data in Horizon 2020. The guidelines, in their simplest form, state that if you are a Horizon 2020 recipient, you must ensure open access to your scientific publications by enabling them to be downloaded, printed and read online. Additionally, said publications must be peer reviewed.
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Publishing with IntechOpen means that your scientific publications already meet these basic requirements. It also means that through our utilization of open licensing, our publications are also able to be copied, shared, searched, linked, crawled, and mined for text and data, optimizing our authors' compliance as suggested by the European Commission.
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Publishing with IntechOpen means that your scientific publications already meet these basic requirements. It also means that through our utilization of open licensing, our publications are also able to be copied, shared, searched, linked, crawled, and mined for text and data, optimizing our authors' compliance as suggested by the European Commission.
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Metadata for all publications is also automatically deposited in IntechOpen's OAI repository, making them available through the Open Access Infrastructure for Research in Europe's (OpenAIRE) search interface further establishing our compliance.
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
\r\n
\r\n\t
\r\n
\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
\r\n
\r\n\t
\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
\r\n
\r\n\t
\r\n
\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
\r\n
\r\n\t
\r\n
\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
\r\n
\r\n\t
\r\n
\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
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Kasenga",hash:"91cde4582ead884cb0f355a19b67cd56",volumeInSeries:4,fullTitle:"Malaria",editors:[{id:"86725",title:"Dr.",name:"Fyson",middleName:"Hanania",surname:"Kasenga",slug:"fyson-kasenga",fullName:"Fyson Kasenga",profilePictureURL:"https://mts.intechopen.com/storage/users/86725/images/system/86725.jpg",institutionString:"Malawi Adventist University",institution:{name:"Malawi Adventist University",institutionURL:null,country:{name:"Malawi"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. 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Saxena",hash:"d92a4085627bab25ddc7942fbf44cf05",volumeInSeries:2,fullTitle:"Current Perspectives in Human Papillomavirus",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Bacterial Infectious Diseases",value:3,count:2},{group:"subseries",caption:"Parasitic Infectious Diseases",value:5,count:4},{group:"subseries",caption:"Viral Infectious Diseases",value:6,count:7}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:250,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:null},{id:"7227",title:"Dr.",name:"Hiroaki",middleName:null,surname:"Matsui",slug:"hiroaki-matsui",fullName:"Hiroaki Matsui",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Tokyo",country:{name:"Japan"}}},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"338222",title:"Mrs.",name:"María José",middleName:null,surname:"Lucía Mudas",slug:"maria-jose-lucia-mudas",fullName:"María José Lucía Mudas",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}}]}},subseries:{item:{id:"14",type:"subseries",title:"Cell and Molecular Biology",keywords:"Omics (Transcriptomics; Proteomics; Metabolomics), Molecular Biology, Cell Biology, Signal Transduction and Regulation, Cell Growth and Differentiation, Apoptosis, Necroptosis, Ferroptosis, Autophagy, Cell Cycle, Macromolecules and Complexes, Gene Expression",scope:"The Cell and Molecular Biology topic within the IntechOpen Biochemistry Series aims to rapidly publish contributions on all aspects of cell and molecular biology, including aspects related to biochemical and genetic research (not only in humans but all living beings). We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11410,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,series:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983"},editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",slug:"ana-isabel-flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",slug:"christian-palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},onlineFirstChapters:{paginationCount:14,paginationItems:[{id:"82103",title:"The Role of Endoplasmic Reticulum Stress and Its Regulation in the Progression of Neurological and Infectious Diseases",doi:"10.5772/intechopen.105543",signatures:"Mary Dover, Michael Kishek, Miranda Eddins, Naneeta Desar, Ketema Paul and Milan Fiala",slug:"the-role-of-endoplasmic-reticulum-stress-and-its-regulation-in-the-progression-of-neurological-and-i",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"80954",title:"Ion Channels and Neurodegenerative Disease Aging Related",doi:"10.5772/intechopen.103074",signatures:"Marika Cordaro, Salvatore Cuzzocrea and Rosanna Di Paola",slug:"ion-channels-and-neurodegenerative-disease-aging-related",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Ion Channels - From Basic Properties to Medical Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/10838.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"81647",title:"Diabetes and Epigenetics",doi:"10.5772/intechopen.104653",signatures:"Rasha A. 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Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",annualVolume:11410,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/51104",hash:"",query:{},params:{id:"51104"},fullPath:"/chapters/51104",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()