Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A phase II evaluation of anguidine was carried out in 30 patients with advanced refractory breast cancer. A dose of 5.0 mg/m2 daily for 5 days was explored. The main toxic effects were nausea and vomiting, fever and chills, hypotension, skin erythema, somnolence, confusion, and lethargy. Myelosuppression was minimal. Among these extensively pretreated patients, there was one partial responder and one additional patient who showed improvement (less than a partial response); both responses occurred in soft tissue sites.
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PMID:Phase II study of anguidine in advanced breast cancer. 45 16

Patients with breast cancer were irradiated postoperatively to bilateral parasternal fields. The validity of the Cumulative Radiation Effect (CRE) formula for treatment once a week and three times a day was analyzed, and both schedules were compared with treatment once a day (five times a week). The biological radiation effect on normal tissue was studied by reflectance spectrophotometry of skin erythema and pigmentation. Early skin reactions were identical after irradiation daily and once a week, respectively, but were found to be significantly more pronounced after irradiation three times a day than after treatment once a day, corresponding to an overexposure of 7-10%.
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PMID:Control of dose administered once a week and three times a day according to schedules calculated by the CRE formula, using skin reaction as a biological parameter. 93 93

The validity of the CRE formula for prospective calculation of biologically equivalent radiation doses with different fractionation schedules has been investigated. Patients with breast cancer were irradiated postoperatively on bilateral parasternal fields. The biological radiation effect was studied by reflectance spectrophotometry of skin erythema and pigmentation. The results from daily irradiation in comparison with twice-a-week, once-a-week, 3-times-a-day and "split-course" irradiation indicate that the formula is a very good predictor of the acute skin erythema and pigmentation.
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PMID:Skin reaction as a biological parameter for prospective studies of different dose schedules with the CRE formula. 99 May 8

Previously published clinical data have been re-analysed to investigate individual differences in the radiosensitivity of human skin. In the clinical studies, acute and late skin reactions were recorded for 254 breast cancer patients receiving radiotherapy to the internal mammary nodes following simple or modified radical mastectomy. Each patient was treated bilaterally with different fractionation schedules to the right and left fields. Patients were assigned prospectively to 10 different treatment groups of 11-35 patients each, with all patients in a group receiving the same pair of fractionation schedules to the right and left fields. In the present study, correlations between the skin reactions in the two treatment fields per patient were investigated. For each of three different endpoints--peak reflectance measure of erythema, peak acute skin reaction score, and a ranking measure of the progression rate of telangiectasia--significant correlations were found between the levels of skin injury to the right and left treatment fields of the patients in most treatment groups. Although there were correlations between the absorbed doses in the right and left fields, statistical analyses indicated that dose effects were not sufficient to explain fully the patient-to-patient differences in skin response. Thus, these data provide evidence for the existence of individual differences in the radiation response of human skin, both for early and late effects. Whether these differences are dominated by heterogeneity in intrinsic cell radiosensitivity or by other factors has yet to be determined. However, there was no clear evidence of a correlation between the acute and late endpoints, suggesting that the individual differences in radiosensitivity are not dominated by a common genetic component expressed equally in all cells.
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PMID:Evidence for individual differences in the radiosensitivity of human skin. 138 11

It is apparent that a variety of vascular disorders have been reported after the administration of antineoplastic agents. However, it is not clear whether all of these entities are related to cytotoxic drugs, the malignancy itself, or some other unrelated factor. Nonetheless, there does appear to be a cause-effect relationship between cisplatin, bleomycin, velban chemotherapy, and Raynaud's phenomenon. In addition, painful acral erythema may occur in association with several drugs, especially protracted infusions of 5-fluorouracil and high-dose cytosine arabinoside. Mitomycin is the most common cause of the thrombotic microangiopathic syndrome, and in the majority of cases it is a lethal event. Unfortunately, HVOD is a major toxic effect of many preparatory bone marrow transplantation protocols and ways to prevent this potentially life-threatening complication should be avidly pursued. In this regard, pentoxifylline and low-dose heparin have recently been reported to be effective in preventing HVOD. Although recent reports have documented thromboses and thromboembolic events in patients with breast cancer treated with cytoxan, methotrexate, and 5-fluorouracil-based protocols, only one study had a no-treatment control arm. Future breast cancer studies should evaluate this problem prospectively. More studies are needed to help elucidate the pathogenesis of vascular toxicity associated with chemotherapy.
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PMID:Vascular toxicity associated with antineoplastic agents. 141 55

Seventy-five female patients suffering from advanced breast cancer were treated with toilet mastectomy, radiotherapy and oophorectomy (if premenopausal) or tamoxifen therapy (if postmenopausal) as well as chemotherapy with cyclophosphamide, methotrexate, 5-fluorouracil and prednisone. The most common side-effects of combined chemohormonal therapy were gastro-intestinal (nausea, vomiting, rarely diarrhoea) in 43 patients (57.3%), followed by alopecia in 23 patients (30.6%), myelosuppression in 12 patients (16%), extravasation and thrombophlebitis in 7 patients (9.3%), and mucositis and oral erythema in 3 patients (4%). Side-effects of tamoxifen therapy such as vaginal discharge, bleeding, hot flushes were encountered in 10 patients (13.3%). Hypercalcaemia, tumour flare and hepatic, renal, cardiac, pulmonary and neurological toxicities were not encountered. Improvement of 10-30% in Karnofsky performance status was noted in responders while 20-30% deterioration was observed in non-responders. Combination therapy was mostly well tolerated, side-effects were few and toxicities were temporary and reversible.
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PMID:Toxicity and side-effects of combination chemohormonal therapy of advanced breast cancer. 158 18

Twenty-eight patients with advanced breast cancer refractory to prior hormone and/or first-line chemotherapy (with or without anthracycline drugs) were treated with the investigational agent amonafide at a dose of 800 mg/m2 intravenously over 3 hours repeated every 4 weeks. Five objective tumour responses of 5.0 months' median duration were observed in the 20 patients without previous anthracycline exposure, including 1 CR. Leukopenia was the dose-limiting toxicity; though it was generally modest with the 800 mg/m2 amonafide starting dose, an initial dose reduction should be considered in patients with prior radiotherapy and/or bone marrow involvement. Other adverse reactions included nausea/vomiting (53%), phlebitis/erythema along the vein injected (7%), and mild neurotoxic symptoms during the drug administration such as headache, tinnitus, and diaphoresis (21%). Amonafide is an active compound for the treatment of patients with advanced breast cancer and should be considered for further evaluation and incorporation in combination chemotherapy.
Breast Cancer Res Treat 1991 Dec
PMID:Phase II study of amonafide in advanced breast cancer. 181 70

Trimetrexate (TMTX) is an analog of methotrexate and a potent inhibitor of the enzyme dihydrofolate reductase. In this phase I study, TMTX was given intravenously to 32 patients as a constant infusion over 24 hours every 28 days. The maximum-tolerated dose of TMTX was 200 mg/m2, with myelosuppression as the dose-limiting toxicity. Other toxicities included nausea and vomiting, stomatitis, erythema and phlebitis at the site of infusion, rash and skin hyperpigmentation, and elevated serum hepatic enzymes. Two drug-related deaths occurred secondary to leukopenia and sepsis. Twenty-six patients were evaluable for antitumor response. Twenty-one patients had progressive disease, while three patients had disease stabilization. There were two partial responses observed--one in a patient with breast cancer and a second in a patient with nasopharyngeal carcinoma. TMTX pharmacokinetics were studied in 15 patients. The drug had a mean terminal half-life of 13 hours. Steady-state was not achieved during the 24-hour infusions. Only 6% of the parent compound was excreted unchanged in the urine, and CSF levels averaged less than 2% of simultaneously measured plasma levels. A dose of 150 mg/m2 is recommended for phase II trials of TMTX using this 24-hour infusion schedule.
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PMID:A phase I and pharmacokinetic study of trimetrexate using a 24-hour continuous-injection schedule. 214

Four patients with inoperable, locally advanced breast cancer were treated i.a. with 25-35 mg/m2 doxorubicin given as a 6-h infusion on 2 successive days. In each patient, the catheter was introduced percutaneously via the femoral or brachial artery using local anaesthetic and positioned in the internal mammary artery without complications. However, within 48 h of starting treatment all four patients developed extensive erythema over the chest wall, which progressed to superficial ulceration in one case. Two patients also developed a raised hemidiaphragm and phrenic nerve paralysis that was associated with a pleural effusion in one case. This study closed prematurely because of unacceptable local toxicity; thus, we cannot assess the activity of doxorubicin given in this way. If this approach to local control is to be tested further in locally advanced breast cancer, lower doxorubicin doses should be used, or different drugs selected.
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PMID:Toxicity of intra-arterial doxorubicin in locally advanced breast cancer. 215 19

From tumor registry data of 7316 cancer patients, we found 367 cases (5.0%) with skin involvement. Skin involvement was present at the time of presentation in 92 patients (1.3%), only 26 of whom had remote metastases. Skin involvement was the first sign of cancer in 59 patients (0.8%); 22 had direct extension of their tumor into the skin, 20 had local metastases, and 17 had distal metastases. Direct invasion was most common with breast cancer and second most common with oral cavity cancer. Local metastases were also most frequently caused by breast cancer but occurred in surgical scars in three women with pelvic cancer and in perianal abscesses in one patient with rectal carcinoma as well. Except for metastases from unknown primary sites, distant metastases were rare as presenting signs, and their origins were widely distributed. Our data show that internal cancer uncommonly presents with skin involvement. Nevertheless, an index of suspicion should be maintained and biopsy performed, particularly for nonhealing ulcers, persistent indurated erythema, and unexplained skin nodules.
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PMID:Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. 229 62


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