Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cognitive dysfunction has been reported in subsets of cancer patients and has been related to their underlying disease (small-cell lung cancer [SCLC]) or to a specific therapy (prophylactic cranial irradiation in SCLC, chemotherapy in breast cancer). Patients with uremic encephalopathy who have had their hemoglobin levels normalized by erythropoietic therapy have shown improved cognitive function in some studies. The mechanism responsible for the improvement is unknown and might reflect either a direct neuroprotective effect of erythropoietins on the central nervous system or the benefit of increased tissue oxygenation secondary to the correction of peripheral anemia. Whether erythropoietic agents can affect the cognitive dysfunction reported among some cancer patients is currently being investigated. The current state of knowledge about the use of erythropoietic agents for neuroprotection or the treatment of neurologic syndromes is described.
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PMID:Erythropoietic agents in the management of cancer patients. Part 2: studies on their role in neuroprotection and neurotherapy. 1533 Mar 71

Irinotecan is a topoisomerase I inhibitor that is highly active against small cell lung cancer (SCLC). Etoposide is another drug that is effective for SCLC. Since combination of these two topoisomerase inhibitors revealed a synergistic effect in vitro and showed a safety in phase I study, we conducted a phase II study in patients with previously un-treated extensive disease (ED) SCLC to evaluate the efficacy and toxicity of this combination. Fifty patients with previously untreated ED-SCLC were enrolled. Irinotecan was administered intravenously at 60mg/m(2) on days 1, 8, and 15, while etoposide was given at 80mg/m(2) on days 2-4. Treatment was repeated every 4 weeks for four cycles. The overall response rate was 66.0%, with a complete response rate of 10.0%. The median survival time was 11.5 months and the 1- and 2-year survival rates were 43.2 and 14.4%, respectively. The major toxicity of this regimen was myelosuppression, including grade 3 or 4 neutropenia (62.9%), leukopenia (28.0%), and anemia (14%). The other grade 3 toxicity was diarrhea (2%). This irinotecan and etoposide regimen is active against ED-SCLC with relatively mild toxicity.
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PMID:Irinotecan and etoposide for previously untreated extensive-disease small cell lung cancer: a phase II trial of West Japan Thoracic Oncology Group. 1602 21

To assess the efficacy of carboplatin when used as a single agent in patients with advanced non small cell lung cancer (NSCLC) and who are refractory to chemotherapy with a non-platinum combination, we recruited patients (n=40) NSCLC patients, 36 of whom were males, with an overall median age of 59 years (range 39-79) and Karnofsky Performance Status of 70% (range 60-90%). At baseline, the patients had a median of one disease site (range 1-3) and had received a median of one prior regimen (range 1-2). Carboplatin was administered (i.v.; AUC=6) every 3 weeks until disease progression or non-acceptable toxicity was reached. In total 169 cycles were administered (median 4 cycles/patient; range 1-8). Main toxicities were grade 2-3 anemia and grade 4 thrombocytopenia (22.5% of patients). Overall clinical response rate was 10% (4 partial responses); 26 patients (65%) had stable disease and 8 (20%) had disease progression. Median time to progression and median survival time were 90 and 187 days, respectively. One year survival rate was 13%. We conclude that carboplatin shows minimal toxicity with a discrete anti-tumor activity in patients with NSCLC and who are refractory to non-platinum combinations.
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PMID:Activity of carboplatin in patients with advanced non-small cell lung cancer pre-treated with a non-platinum combination. 1603 19

Irinotecan/cisplatin (IP) is an active regimen for extensive-disease small-cell lung cancer (ED-SCLC). However, the optimal dose/schedule is unsettled. To evaluate the efficacy and safety of a dose-intensified, weekly concomitant administration of IP, we conducted a phase II study in chemo-naive patients with ED-SCLC. Between October 2001 and February 2004, 37 patients were enrolled. Twenty-nine (78%) were male, 21 (57%) had ECOG PS 0 or 1, and the median age was 62 yr. The initial six patients received cisplatin 50 mg/m2 followed by irinotecan 90 mg/m2 iv on d 1 and 8 of a 21-d cycle (dose level I), with one treatment-related death, three febrile neutropenias. Thereafter, the doses of cisplatin and irinotecan were reduced to 40 mg/m2 and 80 mg/m2, respectively (dose level II). The treatment was continued for up to six cycles. The overall response rate was 97%, with a complete response (CR) rate of 26%. The median duration of response was 6.4 mo (range, 1.6-13.1 mo). At a median follow-up of 27.3 mo, the median survival time was 11.1 mo and 1- and 2-yr survival rates were 44.1% and 11.8%, respectively. The median progression-free survival (PFS) was 6.0 mo (range, 1.5-13.1 mo) and 1-year PFS rate was 7%. Major grade 3 or 4 toxicities included neutropenia (89%), anemia (59%), and diarrhea (27%). Despite of significant myelosuppresion, this dose-intensified weekly concomitant administration of cisplatin and irinotecan was feasible. This dose-schedule showed promising activity with high rate of complete remission in patients with ED-SCLC.
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PMID:A phase II study of dose-intensified weekly concomitant administration of cisplatin and irinotecan in chemonaive patients with extensive-disease small-cell lung cancer. 1611 Jan 39

The purpose was to conduct an integrated analysis of the cumulative hematologic toxicity of topotecan in patients with relapsed ovarian cancer and small cell lung cancer (SCLC). Data were pooled from eight phase II and phase III clinical studies performed in patients with relapsed stage III/IV ovarian cancer or extensive SCLC treated with topotecan at a dose of 1.5 mg/m(2) per day on days 1-5 of a 21-day course. Quantitative hematologic toxicities were assessed using the National Cancer Institute Common Toxicity Criteria. A total of 4,124 courses of therapy was administered to the 879 patients in the pooled population. Grade 4 neutropenia was experienced by 78% of patients. The lowest nadirs for neutrophils and platelets generally occurred after the first course of therapy, followed by improvement or stabilization in subsequent courses. Neutropenia was noncumulative. During the first course, significant risk factors were identified: renal impairment and advanced age (grade 3/4 thrombocytopenia and grade 4 neutropenia) and prior radiotherapy; performance status score > or =2; SCLC; and exposure to both cisplatin (Platinol; Bristol-Myers Squibb, Princeton, NJ, http://www.bms.com) and carboplatin (Paraplatin; Bristol-Myers Squibb) (grade 3/4 thrombocytopenia only). The most frequent interventions for hematologic toxicities were RBC transfusions, treatment delays, G-CSF support, and dose reductions. Analysis of neutrophil and platelet nadirs and dosing for each course of therapy showed no apparent evidence of cumulative neutropenia or thrombocytopenia. The risk of grade 3 or 4 anemia was higher during the first four courses of therapy and may need to be more aggressively managed with erythropoietin therapy.
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PMID:Hematologic safety and tolerability of topotecan in recurrent ovarian cancer and small cell lung cancer: an integrated analysis. 1672 Aug 54

BBR 3464 is a novel triplatinum compound that has exhibited anti-tumor activity in both cisplatin-sensitive and cisplatin-resistant, as well as in p53 mutant tumor models. In phase I testing, the dose-limiting toxicities have included myelosuppression and diarrhea. Both an intermittent (day 1 every 21-28 days) and a continuous (dailyx5 days) schedule have been studied, and the intermittent schedule has been chosen for further development. The primary objective of this study was to assess the efficacy of BBR 3464 administered at a dose of 0.9 mg/m i.v. over 1 h every 21 days in patients with small cell lung cancer who have progressed after first-line therapy. Pharmacokinetic analysis was also performed and will be reported. Patients were stratified based on prior response into resistant and sensitive (response duration 3 months or longer) subgroups. Thirty-seven patients were enrolled onto this multicenter study. The median number of cycles delivered was 2 in the resistant subgroup (range 1-12) and 3 in the sensitive subgroup (range 1-8). Most common grade 3/4 hematological toxicities included neutropenia (62%), febrile neutropenia (16%), anemia (10%), fatigue (5%) and hypokalemia (5%). Although no objective responses were seen in 34 evaluable patients, 11 patients (32%) had disease stabilization (four resistant/seven sensitive) with 23 patients (68%) experiencing continued disease progression (12 resistant/11 sensitive). Median time to progression was 53 days in the resistant subgroup [95% confidence interval (CI) 37-63] and 66 days in the sensitive subgroup (95% CI 51-136). The median and 1-year survival rate based on subgroup was 78 (resistant) (95% CI 56-165) versus 209 days (sensitive) (95% CI 83-296) and 6 (resistant) (95% CI 0-17) versus 20% (95% CI 2-38%), respectively. We conclude that the toxicity profile of BBR 3464 in this phase II trial is consistent with the phase I experience. The lack of activity in either patient subgroup, however, does not support further evaluation of this drug as a single agent in this disease.
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PMID:Phase II study of BBR 3464 as treatment in patients with sensitive or refractory small cell lung cancer. 1691 15

A 71-year-old man who had small cell lung cancer was referred to our institution. Before starting chemotherapy, anemia progressed and stool examination was positive for occult blood. An abdominal computed tomography scan with contrast medium enhancement of the gastrointestinal tract disclosed a small intestinal tumor. Histological examination after the surgery confirmed that the tumor was metastasis of lung cancer. The patient survived for 3 years after the resection. Although clinically apparent metastases of lung cancer to the small intestine are rare and are reported to have a poor prognosis, early detection and intervention might enhance the chance of survival.
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PMID:Small intestinal metastasis from small cell lung cancer. 1697 60

Anemia occurs frequently in patients with lung cancer receiving chemotherapy and has a negative impact on quality of life (QoL). Erythropoietic proteins effectively increase hemoglobin (Hb) levels, reduce transfusion requirements and improve QoL in anemic patients with a range of malignancies. This prospective, observational study evaluated epoetin beta 30,000 IU once weekly in patients with lung cancer in a real-life, clinical-practice setting. Forty patients (72.5% with NSCLC and 27.5% with SCLC) were treated with epoetin beta during any cycle of chemotherapy when Hb decreased to <12 g/dL. Hb levels were assessed at regular intervals and transfusion needs were monitored throughout the study. In total, 72.5% of patients required epoetin treatment by the second cycle of chemotherapy. Epoetin beta treatment duration ranged from 1 to >9 (median 4) weeks. Mean (+/-S.D.) baseline Hb was 10.4+/-1.2 g/dL. Epoetin beta was associated with a rapid increase in Hb levels, with a mean increase of 1.3 g/dL by week 4. Most patients (95%) remained transfusion-free throughout the study. Epoetin beta was well tolerated. This early intervention strategy with epoetin beta 30,000 IU once weekly is an effective and well-tolerated therapy for anemia in patients with lung cancer.
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PMID:Once-weekly epoetin beta (30,000 IU) in anemic patients with lung cancer receiving chemotherapy. 1708 84

Anemia is very common among patients with malignant tumors, due to the disease and chemotherapy. Anemia decreases the patient's quality of life. Erythropoietin therapy is accessible in Hungary for the treatment of chemotherapy-induced anemia in patients suffering from small cell lung cancer. In our case report we present the case of a 62-year-old female small cell lung cancer patient with severe anemia, treated by erythropoietin-beta. The erythropoietin treatment provided the possibility of effective chemo- and radiotherapy. The patient's quality of life greatly improved due to the lack of the symptoms of anemia. The adequate use of erythropoietin is of great help to the physician in the management of small cell lung cancer patients, by improving the quality of life.
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PMID:[Erythropoietin is a novel therapeutic option in the treatment of anemia caused by small cell lung cancer]. 1709 85

Anaemia seriously threatens the quality of life (QOL) in cancer patients receiving chemotherapy. In this article results are presented on the lung cancer population from a Dutch observational study. This study addressed the real-life situation of recombinant human erythropoietin (r-Hu-EPO or epoetin alfa) treatment in anaemic cancer patients receiving chemotherapy, with a focus on efficacy. In total 781 patients were enrolled in the observational study, including 382 patients with lung cancer. At enrolment patients were receiving epoetin alfa treatment and/or patients had a haemoglobin (Hb) level </=11.3g/dl. Analysis was focused on lung cancer patients who were treated with epoetin alfa (n=343). Type of cancer, chemotherapy agents, type of anaemia management and Hb levels were documented. Hb development was analysed and the effect of epoetin alfa treatment was investigated. In total 343 lung cancer patients were treated with epoetin alfa: 210 patients with non-small cell lung cancer (NSCLC) and 133 patients with small cell lung cancer (SCLC). The majority of patients (99.4%) received 40,000 IU epoetin alfa once weekly. Before epoetin alfa treatment was started during chemotherapy, Hb levels decreased with a rate of 1.3g/dl per 4 weeks, both for NSCLC as well as for SCLC. Epoetin alfa treatment was started on average at an Hb level of 10.6g/dl for NSCLC and 10.4g/dl for SCLC, respectively. Hb increases of 0.5-0.6g/dl per 4 weeks and 0.2g/dl per 4 weeks were reached for NSCLC and SCLC, respectively. Although significant increases of Hb levels were reached, the epoetin alfa treatment could not fully correct the Hb decrease which had taken place during chemotherapy before the start of epoetin alfa, resulting in suboptimal Hb levels. In contrast, early intervention with epoetin alfa (start in first week of chemotherapy at Hb>11.3g/dl) was especially effective for NSCLC patients where it resulted in a stabilization of Hb at baseline level. For SCLC patients this strategy was less effective. Furthermore, early intervention seemed to diminish the need for a blood transfusion, i.e., the higher the Hb at epoetin initiation the more patients did not receive any blood transfusion. Results from this observational study demonstrate that epoetin alfa treatment corrects chemotherapy-related anaemia in both NSCLC as well as SCLC patients. Early epoetin alfa intervention seems advantageous for lung cancer patients both in terms of maintaining adequate Hb levels during chemotherapy as well as reducing transfusions.
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PMID:Anaemia management with epoetin alfa in lung cancer patients in The Netherlands. 1760 32


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