Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009402 (colorectal cancer)
 53,228 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acivicin, an amino acid antibiotic, was administered to 36 adult patients with previously treated metastatic colorectal cancer. The starting dose for good-risk patients was 15 mg/m2/day day given as a short intravenous infusion on 5 consecutive days every 3 weeks. Patients previously treated with radiation therapy, mitomycin, or nitrosoureas and those with inadequate bone marrow reserve received 12 mg/m2 on the same schedule. In 33 evaluable patients, one partial response occurred. Sixteen patients had stable disease with a median time to disease progression of 15 weeks (range 9-27) and a median survival of 8 months. The median survival of the whole group was, however, less than 6 months. Myelotoxicity was mild and resulted in no significant complications. Nonhematological toxicity primarily consisted of nausea, vomiting, drowsiness, depression, and altered mentation. Acivicin given by this schedule is inactive at these dose levels in previously treated patients with colorectal carcinoma.
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PMID:Phase II trial of acivicin in patients with advanced colorectal carcinoma. 372 71

After 1990's, the development of new generation anti-cancer agents produced encouraging improvement of prognosis in inoperable or relapsed stomach cancer and colorectal cancer. However, non-hematological toxicity, such as peripheral neuropathies, become a new dose-limiting toxicity. In several new generation drugs, measures for controlling peripheral neuropathy had not been established besides dose modification or schedule modification. We tried to control the peripheral neuropathy induced by anti-cancer agents with the assistance of an adjuvant analgesics ladder. A total of 18 digestive cancer patients who presented with peripheral neuropathy of grade 1 or more(NCI-CTCAE ver 3.0), in the chemotherapy including Taxol or Oxaliplatin, were enrolled. The first stage of the adjuvant analgesics ladder was set as the antidepressant(amoxapin), the second stage was anticonvulsive drugs(valproic acid or clonazepam) and the third stage was antiarrhythmic drug(mexiletine). In each stage, if the drug turned out to be ineffective after two / weeks follow-up, it shifted to the next stage. The response rate of each step was 61.1%(11/18)of the first stage, 50.0%(5/10)of the 2nd stage, 50.0%(2/4)of the 3rd stage, and the overall response rate was 77.8%. The discontinuance of cancer treatment by peripheral neuropathy was observed only in 1 patient 5.5%(1/18)in the Taxol administered group. The toxicity profile was skin eruption and drowsiness, but the skin eruption was observed only in 1 patient at the 3rd stage and the drowsiness in 2 patients at the 2nd stage. It appears that the method to control the peripheral neuropathy induced by anti-cancer agents with the assistance of adjuvant analgesics ladder was effective and safe, but a large-scale clinical trial was warranted.
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PMID:[Evaluation of efficacy and safety of adjuvant analgesics for peripheral neuropathy induced by cancer chemotherapy in digestive cancer patients-a pilot study]. 1915 68

Oxaliplatin (L-OHP) is a key drug in the treatment of colorectal cancer; however, L-OHP-induced peripheral neuropathy becomes a dose-limiting factor for which withdrawal is the only effective option. In the present study, we attempted to treat L-OHP-induced peripheral neuropathy using the algorithm consisting of pregabalin, duloxetine, and oxycodone at Iwate Medical University Hospital. The first, second, and third stages of the algorithm consist of pregabalin, duloxetine, and oxycodone, respectively. We examined the usefulness and safety of the treatment algorithm for 27 patients with colorectal cancer by evaluating the side effects and degree of improvement of subjective symptoms. When discontinuation was necessary due to adverse events or invalid treatment during the 4-week study period, the patient was transitioned to the next stage. The response rates of the first, second, and third stages of the algorithm were 33% (9/27), 33% (6/18), and 17% (1/6), respectively, whereas the overall response rate was 59% (16/27). The side effect rates of the first, second, and third stages were 37% (10/27), 33% (6/18), and 83% (5/6), respectively. Somnolence was the most common side effect of these drugs. Thus, our treatment algorithm appears to be useful for L-OHP-induced peripheral neuropathy. However, pregabalin, duloxetine, and oxycodone should be administered with specific attention on the potential side effects.
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PMID:[Treatment algorithm for oxaliplatin-induced peripheral neuropathy]. 2543 40

Oxaliplatin, a platinum-containing antineoplastic agent, is a key drug for the treatment of colorectal cancer and gastric cancer; however, some patients develop allergic reactions. Our hospital uses a regimen to control allergic reactions in patients with mild allergies(Grade 1 and 2). The aim of this study was to determine the effectiveness and safety of our allergy regimen. We retrospectively investigated 22 patients who initiated our allergy regimen between January 2017 and December 2017. The median number of administration cycles before allergy development was 8, and the median cumulative dose of oxaliplatin was 700mg/m2. Of the 22 patients, 18(82%)were able to continue oxaliplatin therapy. Drowsiness was the only adverse event that occurred in this cohort. Our allergy regimen may be effective for controlling allergic reactions to oxaliplatin in patients with mild allergies.
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PMID:[Effectiveness of Allergy Regimen for Allergic Reactions to Oxaliplatin]. 3163 Nov 36

We here report on a 74-year-old man diagnosed with a pT3cN0 BRAF-mutated and mismatch repair-deficient adenocarcinoma in the colon ascendens and 3 liver metastases. After hemicolectomy, the patient received treatment with the PD-1 inhibitor pembrolizumab. Three weeks later (on day 22), laboratory tests showed leukocytosis and an increase in transaminases; immune checkpoint inhibitor (ICI)-induced hepatitis was suspected and prednisolone therapy was initiated. On day 29, the patient was acutely hospitalized due to dyspnea, somnolence and walking difficulties. Dysarthria, hoarseness, muscle pain and weakness had developed and the dose of prednisolone was increased. Serum levels of lactate dehydrogenase, creatine kinase and myoglobin were increased and ICI-induced myositis was suspected. Antibodies against acetylcholine receptor and titin were present, indicating myasthenia gravis. Eventually, bulbar myopathy developed, including dysarthria and dysphagia, and the patient could no longer attain saturation without oxygen. The patient was transferred to the intensive care unit, intubated and given methylprednisolone, intravenous immunoglobulins and infliximab. The patient developed carbon dioxide retention and died on day 39. Microscopical examination of the intercostal musculature, diaphragm, cervical musculature and tongue showed inflammatory infiltration and fibrosis consistent with a pronounced myositis. In the liver, microscopical examination did not show metastases from colorectal cancer but instead a hepatocellular cancer. The cause of death was determined as respiratory insufficiency due to polymyositis. In conclusion, ICIs may induce myositis combined with neurological immune-related adverse events. In patients developing muscle weakness and pain under ICI therapy, myositis should be suspected.
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PMID:Immune Checkpoint Inhibitor-Induced Polymyositis and Myasthenia Gravis with Fatal Outcome. 3325 Jul 39