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13010-47-4

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13010-47-4 Usage

Chemical Properties

Lomustine is a pale yellow powder.

Uses

Different sources of media describe the Uses of 13010-47-4 differently. You can refer to the following data:
1. CCNU is an oral anticancer drug that was approved by the U.S. Food and Drug Administration in 1976 for marketing, as lomustine (FDA 2009a). CCNU is used alone or in combination with other antineoplastic agents, including procarbazine and vincristine, etoposide and prednimustine, and other combinations (IARC 1981, HSDB 2009). It is used primarily in the treatment of Hodgkin’s disease and brain tumors, but it has also been used to treat other cancer, includ-ing lung cancer, non-Hodgkin’s lymphoma, malignant melanoma, breast cancer, kidney cancer, and cancer of the gastrointestinal tract (MedlinePlus 2009). It has also been applied to the skin to treat mycosis fungoides and psoriasis.
2. Lomustine USP is used to treat Malignant brain tumors; Hodgkin’s disease.
3. Chloroethylnitrosourea derivative with antitumor activity. Similar to carmustine, chlorozotocin, nimustine, ranimustine. Antineoplastic.

Definition

ChEBI: An N-nitrosourea that is urea in which one of the nitrogens is substituted by a 2-chloroethyl group and by a nitroso group, while the other nitrogen is substituted by a cyclohexyl group. An alkylating antineoplastic agent, it is used in he treatment of brain tumours, lung cancer, malignant melanoma and other solid tumours.

Brand name

Ceenu (Bristol-Myers Squibb).

Synthesis Reference(s)

Journal of Medicinal Chemistry, 18, p. 104, 1975 DOI: 10.1021/jm00235a023Synthesis, p. 1027, 1987 DOI: 10.1055/s-1987-28160

General Description

Lomustine is available in 10-, 40-, and 100-mg capsules fororal administration in the treatment of primary and metastaticbrain cancers and Hodgkin’s lymphoma. This lipophilicagent is well absorbed, widely distributed, and crosses theblood-brain barrier. Lomustine undergoes extensive hepaticmetabolism, which is mediated by CYP3A4 to give severalhydroxylated metabolites, which arise as a result of oxidationof the cyclohexyl ring. Several of these are more activethan the parent compound. Denitrosation and dechlorinationhave also been demonstrated to occur for lomustine as well.The intact drug was not found in plasma when the agent wasadministered orally. Elimination occurs primarily in theurine with an elimination half-life of 16 to 72 hours.Myelosuppression is dose limiting and presents in a mannersimilar to that seen with carmustine. Other toxicities includenausea, vomiting, anorexia, impotence, sterility, amenorrhea,and infertility. Pulmonary and renal toxicity are rarelyseen during standard-dose therapy but increase during highdosetherapy.

Biological Activity

lomustine is an antineoplastic drug used in chemotherapy [1]lomustine has been revealed to inhibit the growth of tumour cell lines with ic50 values of 25μm, 8.8μm and 13μm for breast zr-75-1, astrocytoma u87mg and colorectal ls174t cell lines [2]. besides, lomustine has been found to be particularly effective in the treatment of certain neoplasms of the central nervous system, because of the high lipid solubility and permeability through the blood brain barrier. in addition, lomustine has shown the effect function in treatment of meningeal leukemia in the mouse and in children who have acute leukemia with central nervous system involvement [1].

Biochem/physiol Actions

Antineoplastic agent with cellular DNA effects. Lomustine induces p53 expression in A2870 cells.

Mechanism of action

Like other nitrosoureas, lomustine acts as a DNA-alkylating agent, and it also inhibits various key enzymatic reactions by carbamoylating proteins.

Clinical Use

#N/A

Safety Profile

Confirmed carcinogen with experimental carcinogenic and tumorigenic data. Poison by ingestion, intraperitoneal, subcutaneous, intravenous, and possibly other routes. Human systemic effects by ingestion: anorexia, nausea or vomiting, leukopenia (decrease in the white blood cell count), and thrombocytopenia (decrease in the number of blood platelets). Experimental teratogenic and reproductive effects. Human mutation data reported. When heated to decomposition it emits very toxic fumes of Cland NOx. See also NNITROSO COMPOUNDS.

Synthesis

Lomustine, 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (30.2.4.3), is made by reacting ethanolamine with cyclohexylisocyanate, which forms 1-(2-hydroxyethyl)-3- cyclohexylurea (30.2.4.1). Upon reaction with thionyl chloride, the hydroxyl group in it is replaced with a chlorine atom, giving 1-(2-chloroethyl)-3-cyclohexylurea (30.2.4.2). This is nitrated in non-aqueous conditions with formic acid and sodium nitrite to give lomustine (30.2.4.3).

Potential Exposure

A potential danger to those involved in the manufacture, administration or consumption of this antineoplastic (anti-cancer) agent

Veterinary Drugs and Treatments

Lomustine may be useful in the adjunctive treatment of CNS neoplasms, lymphomas, and mast cell tumors in dogs and cats.

Carcinogenicity

1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) is reasonably anticipated to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in experimental animals.

Metabolism

Molecular weight (daltons) 233.7 % Protein binding 60 % Excreted unchanged in urine 50 (as metabolites) Volume of distribution (L/kg) No data Half-life - normal/ESRF (hrs) 16-48 (metabolites)

Waste Disposal

It is inappropriate and possibly dangerous to the environment to dispose of expired or waste drugs and pharmaceuticals by flushing them down the toilet or discarding them to the trash. Household quantities of expired or waste pharmaceuticals may be mixed with wet cat litter or coffee grounds, double-bagged in plastic, discard in trash. Larger quantities shall carefully take into consideration applicable DEA, EPA, and FDA regulations. If possible return the pharmaceutical to the manufacturer for proper disposal being careful to properly label and securely package the material. Alternatively, the waste pharmaceutical shall be labeled, securely packaged and transported by a state licensed medical waste contractor to dispose by burial in a licensed hazardous or toxic waste landfill or incinerator.

references

[1] cheng cj, fujimura s, grunberger d, weinstein ib. nteraction of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (nsc 79037) with nucleic acids and proteins in vivo and in vitro. cancer res. 1972 jan;32(1):22-7.[2] baer jc1, freeman aa, newlands es, watson aj, rafferty ja, margison gp. depletion of o6-alkylguanine-dna alkyltransferase correlates with potentiation of temozolomide and ccnu toxicity in human tumour cells.br j cancer. 1993 jun; 67(6):1299-302.

Check Digit Verification of cas no

The CAS Registry Mumber 13010-47-4 includes 8 digits separated into 3 groups by hyphens. The first part of the number,starting from the left, has 5 digits, 1,3,0,1 and 0 respectively; the second part has 2 digits, 4 and 7 respectively.
Calculate Digit Verification of CAS Registry Number 13010-47:
(7*1)+(6*3)+(5*0)+(4*1)+(3*0)+(2*4)+(1*7)=44
44 % 10 = 4
So 13010-47-4 is a valid CAS Registry Number.
InChI:InChI=1/C9H16ClN3O2/c1-2-12(10)9(14)13(11-15)8-6-4-3-5-7-8/h8H,2-7H2,1H3

13010-47-4 Well-known Company Product Price

  • Brand
  • (Code)Product description
  • CAS number
  • Packaging
  • Price
  • Detail
  • TCI America

  • (L0251)  Lomustine  >98.0%(HPLC)

  • 13010-47-4

  • 200mg

  • 690.00CNY

  • Detail
  • TCI America

  • (L0251)  Lomustine  >98.0%(HPLC)

  • 13010-47-4

  • 1g

  • 2,450.00CNY

  • Detail
  • Sigma-Aldrich

  • (L0745000)  Lomustine  European Pharmacopoeia (EP) Reference Standard

  • 13010-47-4

  • L0745000

  • 1,880.19CNY

  • Detail
  • USP

  • (1369419)  Lomustine  United States Pharmacopeia (USP) Reference Standard

  • 13010-47-4

  • 1369419-200MG

  • 4,647.24CNY

  • Detail

13010-47-4SDS

SAFETY DATA SHEETS

According to Globally Harmonized System of Classification and Labelling of Chemicals (GHS) - Sixth revised edition

Version: 1.0

Creation Date: Aug 10, 2017

Revision Date: Aug 10, 2017

1.Identification

1.1 GHS Product identifier

Product name lomustine

1.2 Other means of identification

Product number -
Other names 1-chloroethyl-3-cyclohexyl-1-nitrosourea

1.3 Recommended use of the chemical and restrictions on use

Identified uses For industry use only.
Uses advised against no data available

1.4 Supplier's details

1.5 Emergency phone number

Emergency phone number -
Service hours Monday to Friday, 9am-5pm (Standard time zone: UTC/GMT +8 hours).

More Details:13010-47-4 SDS

13010-47-4Synthetic route

N-(2-chloroethyl)-N'-cyclohexylurea
13908-11-7

N-(2-chloroethyl)-N'-cyclohexylurea

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
With tin(IV) chloride; sodium nitrite In dichloromethane at 20℃; for 2h;100%
With tert.-butylnitrite In ethanol; acetonitrile at 25℃; for 0.133333h; Reagent/catalyst; Solvent; Temperature; Time; Flow reactor;91.2%
With tert.-butylnitrite In ethanol; acetonitrile at 25℃; for 0.133333h; Reagent/catalyst; Temperature; Solvent;91.2%
N-(2-chloroethyl)-N-nitrosocarbamic acid N-hydroxypyrrolidine-2,5-dione ester
80354-49-0

N-(2-chloroethyl)-N-nitrosocarbamic acid N-hydroxypyrrolidine-2,5-dione ester

cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Ambient temperature;81%
In N,N-dimethyl-formamide at 0℃; for 2h;80%
(2-chloroethyl)nitrosocarbamic acid 2,4,5-trichlorophenyl ester
80354-51-4

(2-chloroethyl)nitrosocarbamic acid 2,4,5-trichlorophenyl ester

cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
In N,N-dimethyl-formamide at 0℃; for 2h;80%
N-(2-chloroethyl)-N-nitrosocarbamic acid pentachlorophenyl ester
80354-53-6

N-(2-chloroethyl)-N-nitrosocarbamic acid pentachlorophenyl ester

cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
In N,N-dimethyl-formamide at 0℃; for 2h;80%
cyclohexylamine
108-91-8

cyclohexylamine

pentafluorophenyl N-(2-chloroethyl)-N-nitrosocarbamate
80354-55-8

pentafluorophenyl N-(2-chloroethyl)-N-nitrosocarbamate

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
In N,N-dimethyl-formamide at 0℃; for 2h;80%
p-nitrophenyl N-(2-chloroethyl)-N-nitroso-carbamate
55661-43-3

p-nitrophenyl N-(2-chloroethyl)-N-nitroso-carbamate

cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
With pyridine; benzotriazol-1-ol 1.) -10 deg C, 1 h; 2.) 0 deg C, 24 h;75%
2-chloroethyl isothiocyanate
1943-83-5

2-chloroethyl isothiocyanate

cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Stage #1: 2-chloroethyl isothiocyanate; cyclohexylamine With triethylamine In tetrahydrofuran; dichloromethane at 50℃; for 0.0166667h;
Stage #2: With tert.-butylnitrite In dichloromethane; acetonitrile at 25℃; for 0.133333h; Reagent/catalyst; Solvent; Temperature;
63.7%
2-(cyclohexylimino)-3-nitroso-2-oxazolidine
76310-06-0

2-(cyclohexylimino)-3-nitroso-2-oxazolidine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
With hydrogenchloride In diethyl ether at 0 - 4℃; for 0.5h;43%
cyclohexylamine
108-91-8

cyclohexylamine

1,2,2,2-Tetrachloroethyl N-(2-chloroethyl) N-nitroso-carbamate
113900-20-2

1,2,2,2-Tetrachloroethyl N-(2-chloroethyl) N-nitroso-carbamate

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
With potassium carbonate In tetrahydrofuran for 2h; Ambient temperature; Yield given;
cyclohexylamine
108-91-8

cyclohexylamine

N.N'-dicyclohexyl-hydrazine

N.N'-dicyclohexyl-hydrazine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Multi-step reaction with 2 steps
1: H2O / Heating
2: 85percent formic acid, sodium nitrate / 0 °C
View Scheme
cyclohexylamine
108-91-8

cyclohexylamine

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Multi-step reaction with 2 steps
1: diethyl ether / Ambient temperature
2: NaNO2, HCO2H / 0.5 h / 0 - 5 °C
View Scheme
Cyclohexyl isocyanate
3173-53-3

Cyclohexyl isocyanate

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Multi-step reaction with 2 steps
1: diethyl ether / Ambient temperature
2: NaNO2, HCO2H / 0.5 h / 0 - 5 °C
View Scheme
2-(cyclohexylamino)-2-oxazoline
10002-37-6

2-(cyclohexylamino)-2-oxazoline

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Multi-step reaction with 2 steps
1: 50 percent / n-butyl nitrite, sodium methoxide / diethyl ether / 12 h / Ambient temperature
2: 43 percent / HCl(g) / diethyl ether / 0.5 h / 0 - 4 °C
View Scheme
cyclohexylamine
108-91-8

cyclohexylamine

sodium chloro sulfate

sodium chloro sulfate

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Conditions
ConditionsYield
Multi-step reaction with 2 steps
1: H2O / Ambient temperature
2: NaNO2, HCO2H
View Scheme
Multi-step reaction with 2 steps
1: CHCl3
2: NaNO2, HCO2H
View Scheme
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

β‐cyclodextrin
7585-39-9

β‐cyclodextrin

3C42H70O35*C9H16ClN3O2

3C42H70O35*C9H16ClN3O2

Conditions
ConditionsYield
In ethanol; water at 60℃; for 48h; Temperature;80.03%
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

β‐cyclodextrin
7585-39-9

β‐cyclodextrin

2C42H70O35*C9H16ClN3O2

2C42H70O35*C9H16ClN3O2

Conditions
ConditionsYield
In ethanol; water at 40℃; for 72h; Temperature;74.67%
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

β‐cyclodextrin
7585-39-9

β‐cyclodextrin

C42H70O35*C9H16ClN3O2

C42H70O35*C9H16ClN3O2

Conditions
ConditionsYield
In ethanol; water at 60℃; for 72h; Temperature;50.44%
In acetonitrile
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

A

Diazoethan
1117-96-0

Diazoethan

B

N-(2-chloroethyl)-N'-cyclohexylurea
13908-11-7

N-(2-chloroethyl)-N'-cyclohexylurea

C

ethanol
64-17-5

ethanol

D

cyclohexylamine
108-91-8

cyclohexylamine

E

ethylamine
75-04-7

ethylamine

F

2-chlorodiazomethane

2-chlorodiazomethane

Conditions
ConditionsYield
With potassium hydroxide; aluminum nickel In methanol Product distribution; Mechanism; degradation under various conditions (HBr in glac. CH3CO2H) with preparation of nonmutagenic reaction mixtures of products;
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

A

ethylene glycol
107-21-1

ethylene glycol

B

acetaldehyde
75-07-0

acetaldehyde

C

2-chloro-ethanol
107-07-3

2-chloro-ethanol

Conditions
ConditionsYield
In water; acetonitrile at 36.9℃; for 23h; Mechanism; other N-(2-haloethyl)-N'-cyclohexyl-N-nitrosoureas; var. pH;
1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

trifluoroacetic anhydride
407-25-0

trifluoroacetic anhydride

1-(2-Chloro-ethyl)-3-cyclohexyl-1,3-bis-(2,2,2-trifluoro-acetyl)-urea

1-(2-Chloro-ethyl)-3-cyclohexyl-1,3-bis-(2,2,2-trifluoro-acetyl)-urea

Conditions
ConditionsYield
at 85℃; for 3h;
C128H148F18N4O70

C128H148F18N4O70

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea
13010-47-4

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

C9H16ClN3O2*C128H148F18N4O70

C9H16ClN3O2*C128H148F18N4O70

Conditions
ConditionsYield
In water; dimethyl sulfoxide at 20℃; for 1.16667h;

13010-47-4Related news

ArticlesSingle-agent bevacizumab or Lomustine (cas 13010-47-4) versus a combination of bevacizumab plus Lomustine (cas 13010-47-4) in patients with recurrent glioblastoma (BELOB trial): a randomised controlled phase 2 trial09/04/2019

SummaryBackgroundTreatment options for recurrent glioblastoma are scarce, with second-line chemotherapy showing only modest activity against the tumour. Despite the absence of well controlled trials, bevacizumab is widely used in the treatment of recurrent glioblastoma. Nonetheless, whether the ...detailed

Original ArticleCombination toceranib and Lomustine (cas 13010-47-4) shows frequent high grade toxicities when used for treatment of non-resectable or recurrent mast cell tumours in dogs: A European multicentre study09/01/2019

Mast cell tumours (MCTs) in dogs can present in a variety of forms. Non-resectable, recurrent or metastatic MCTs usually carry a poor prognosis and present a therapeutic challenge. Both toceranib and lomustine have shown single agent activity against MCTs in dogs. In this study, 10 dogs with adv...detailed

Spectroscopic analysis of the interaction of Lomustine (cas 13010-47-4) with calf thymus DNA08/31/2019

Investigation of drug–DNA interaction is important for understanding the drug action at molecular level and for designing specific DNA targeted drug. Lomustine (CCNU = 1-[2-chloroethyl]-3-cyclohexyl-1-nitroso-urea) is an alkylating antineoplastic nitrosourea derivative, used to treat different ...detailed

ArticlesRegorafenib compared with Lomustine (cas 13010-47-4) in patients with relapsed glioblastoma (REGOMA): a multicentre, open-label, randomised, controlled, phase 2 trial08/30/2019

SummaryBackgroundGlioblastoma is a highly vascularised tumour and there are few treatment options after disease recurrence. Regorafenib is an oral multikinase inhibitor of angiogenic, stromal, and oncogenic receptor tyrosine kinases. We aimed to assess the efficacy and safety of regorafenib in t...detailed

Electrochemical behaviour of anticancer drug Lomustine (cas 13010-47-4) and in situ evaluation of its interaction with DNA08/28/2019

Electrochemical techniques were used to investigate the behavior of lomustine (CCNU) and its degradation in aqueous solution at a glassy carbon electrode (GCE). The in situ interaction of CCNU and chemically degraded CCNU (cdCCNU) with dsDNA was then investigated in dsDNA incubated solutions, us...detailed

13010-47-4Relevant articles and documents

Tin(IV) chloride-sodium nitrite as a new nitrosating agent for N-nitrosation of amines, amides and ureas under mild and heterogeneous conditions

Celaries, Benoit,Parkanyi, Cyril

, p. 2371 - 2375 (2006)

We have developed a new method of N-nitrosation of various secondary and tertiary amines, amides and ureas using a mixture of tin(IV) chloride and sodium nitrate. This method leads to a selective, high-yielding and mild heterogeneous N-nitrosation by in situ generation of nitrosyl chloride (NOCl). The reaction can be carried out in several different solvents such as chloroform, dichloromethane, ethers, ethyl acetate and alcohols, at room temperature. Georg Thieme Verlag Stuttgart.

Johnston et al.

, p. 104,105 (1975)

Concatamers for Immunemodulation

-

, (2012/04/23)

The invention relates to a polymeric, non-coding nucleic acid molecule for modulation of the activity of the human and animal immune system as well as a method for the manufacture thereof and a vaccine, comprising the polymeric, non-coding nucleic acid molecule, wherein polymeric, non-coding nucleic acid molecules may be understood as non-coding nucleic acid molecules, comprising at least four covalently bound molecules (tetramer) or are assemblies of more non-coding nucleic acid molecules (high molecular polymers) which are covalently bound to each other.

Anti-Claudin 3 Monoclonal Antibody and Treatment and Diagnosis of Cancer Using the Same

-

, (2010/05/13)

Monoclonal antibodies that bind specifically to Claudin 3 expressed on cell surface are provided. The antibodies of the present invention are useful for diagnosis of cancers that have enhanced expression of Claudin 3, such as ovarian cancer, prostate cancer, breast cancer, uterine cancer, liver cancer, lung cancer, pancreatic cancer, stomach cancer, bladder cancer, and colon cancer. The present invention provides monoclonal antibodies showing cytotoxic effects against cells of these cancers. Methods for inducing cell injury in Claudin 3-expressing cells and methods for suppressing proliferation of Claudin 3-expressing cells by contacting Claudin 3-expressing cells with a Claudin 3-binding antibody are disclosed. The present application also discloses methods for diagnosis or treatment of cancers.

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