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)

The administration of two chemoimmunotherapy programs to 103 consecutive patients with metastatic colorectal cancer resulted in improved survival for patients who achieved either objective tumor regressions or disease stabilization for more than 8 weeks. Objective tumor regression was observed in 47% of patients treated with the Ftorafur-methyl-CCNU-methotrexate-Bacillus Calmette-Guerin (FTOR-MeM-BCG) program and in 34% of patients treated with the 5-fluorouracil-methotrexate-Baker's antifol (FU-M-BAF) +/- Levamisole program. The combinated median duration of survival for patients who achieved objective tumor regression and disease stabilization with FTOR-MeM-BCG was 13 months compared with 6 months for patients who had progression of disease (p = 0.001). The corresponding values for patients treated with FU-M-BAF +/- levamisole were 11 months and seven months, respectively (p = 0.001). While the role of BCG immunotherapy in these results remains speculative, the administration of levamisole immunotherapy did not appear to have influenced results significantly. Patients who presented at diagnosis with Dukes A, B and C lesions, and therefore had longer disease-free intervals, responded more frequently to chemoimmunotherapy and survived longer than patients who presented at diagnosis with Dukes D lesions. Similarly, greater antitumor effect was observed in patients with lower pretreatment plasma CEA levels evaluation of these pretreatment characteristics may have insignificant implications for the design of future clinical trials.
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PMID:Chemoimmunotherapy of metastatic large bowel cancer: nonspecific stimulation with BCG and levamisole. 33 90

Recently published results of large randomized trials have changed the recommendations for adjuvant treatment in patients with colorectal cancer. Patients with Dukes C cancer of the large bowel should be treated with a combination of Levamisole and 5-FU. For patients with rectal carcinoma Dukes B and C, a combined chemo-/radiotherapy is recommended.
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PMID:[Adjuvant therapeutic possibilities in carcinoma of colon and rectum]. 162 59

Levamisole (LMS) has been considered an immunorestorative agent capable of enhancing host's antitumor immune responses. Clinical studies showed that LMS plays a significant role in adjuvant chemotherapy of colorectal cancer. Therefore studies were performed to test whether LMS would be able to restore graft responsiveness in mice with drug-dependent, age-dependent or virus-dependent immunodeficiency. The results show that LMS has little or no influence on the limited antitumor effects of Dacarbazine or Ara-C in mice bearing allogeneic leukemias (i.e. in a host-tumor model in which immuno-chemotherapy synergism occurs with less immunodepressive anticancer drugs). Moreover LMS does not alleviate allograft response inhibition produced by high-dose Dacarbazine or by a mouse RNA virus. However the agent restored graft responsiveness in aged animals. The limited immunoenhancing effects of LMS, as detected in the present study, suggest that the clinical efficacy of the agent could be due to mechanisms not entirely related to its immunopharmacological properties.
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PMID:Role of levamisole as immunomodulant in mouse lymphoma model. 194 57

Levamisole has been used in a wide array of clinical research and treatment settings over the past two decades, ranging from such diseases as helminthic infestations to various autoimmune diseases. Numerous preclinical evaluations and clinical trials with levamisole in the cancer arena have been sponsored by the National Cancer Institute and other agencies worldwide with the hopes of demonstrating anticancer activity. Trials in advanced breast cancer, lung cancer, colorectal cancer, melanoma, and lymphoproliferative diseases have generally been negative or inconclusive. However, there is some indication that levamisole may be useful by itself as an adjuvant therapy for resected melanoma; recently it has been shown to be effective in combination with fluorouracil (5-FU) as adjuvant therapy for tumor-node-metastasis (TNM) stage III (Dukes' C) colon carcinoma. In the aggregate, the past 20 years of clinical experience with levamisole has resulted in as many questions as answers. However, further testing of the anticancer activity of levamisole can be expected in clinical research trials over the next few years. Hopefully, these future trials will include studies of the mechanisms of action of this agent.
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PMID:Levamisole: known effects on the immune system, clinical results, and future applications to the treatment of cancer. 194 Oct 64

The initial aim of the present study was to verify in a randomized trial whether the addition of Levamisole, an immunomodulator, could increase the effectiveness of postoperative chemotherapy (MeCCNU + 5-FU) in Dukes C colorectal cancer patients. After entering 29 consecutive patients, the poor results of most studies of adjuvant therapy in colorectal cancer prompted an early end to patient accrual. After 8 years, the lack of significance in survival (48.9 versus 37.3%) and disease-free survival (50 versus 38.8%) between the two treatment arms rules out any improvement associated with Levamisole administration.
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PMID:Adjuvant immunochemotherapy in colorectal cancer Dukes C. 355 85

After radical surgery for colo-rectal cancer, the prevention of local recurrence and/or distant metastasis, represents the key factor of the active measures adopted by surgeons and oncologists. Recent trends of the research in this field, show that an effective chemotherapy is the goal to achieve. Our review of the literature on this subject, is aimed to make some remarks about the results of the main randomized protocols of adjuvant chemotherapy conducted in recent years, comparing the efficacy of different treatments. We should consider two ways of administering the chemotherapy: the systemic route, the classic one, and the portal route, especially designed to prevent liver metastasis. At the end of our review, we can conclude the following: poly-chemotherapy (MF or MOF) did not show real advantages compared to 5-FU alone the combination of 5-FU + Levamisole, showed an undoubtable efficacy in Dukes' C colorectal cancer the efficacy of intra-portal vein chemotherapy for Dukes' B colorectal cancer, has been proved in one report only, therefore we are waiting for a confirmative answer from the several similar investigations prompted recently. The analysis of such investigations may contribute, in future, to establish new protocols combining chemotherapy with immunotherapy and particularly, systemic chemotherapy with loco-regional one.
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PMID:[The current state of adjuvant treatment in carcinoma of the resected colon]. 835 50

366 patients fully resected from a Dukes B2 or C colorectal cancer were randomised to receive 6 courses of systemic chemotherapy comprising either 5-fluorouracil (5 FU) alone (arm A: 450 mg/m2/day-5/21 days) or combined folinic acid (FOL) and 5 FU (arm B: respectively 200 mg/m2 racemic form or 100 mg/m2-l-form and 370 mg/m2/day-5/21 days). 173 patients had also been initially randomised to receive one course of intraportal chemotherapy just after surgery or no portal treatment. Oral levamisole (150 mg/day; 3 days every other week) was given to all patients for one year. A significantly higher incidence of leuco-granulocytopenia was observed in the arm A (5 FU alone) inducing more frequent dose delays and adaptations as well as levamisole's withdrawal. Then dose-intensities and dose-intensity products were lower in this arm but the dose intensity expressed in mg/m2/week remained higher (631 +/- 107 vs 557 +/- 99; p < 0.001). The median follow-up in the study was 4.5 years. Relapse free (RFS) and overall survivals (OAS) were prolonged in the 5 FU alone group peculiarly in those patients who had not been randomised for portal treatment. Curves diverged progressively with longer follows-up (at 8 years; RFS in arm A: 67-71% vs 59-53% in arm B; OAS in arm A: 72-74% vs 56-46% in arm B). Patients suffering from a colon or a Dukes C cancer benefited the most from the treatment with 5 FU alone. The results are discussed in the light of other recent adjuvant trials. Well dosed 5 FU over a short period of time without folinic acid may be a valuable and inexpensive adjuvant treatment for colorectal cancer. Levamisole may no longer be recommended in this setting.
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PMID:Importance of 5-fluorouracil dose-intensity in a double randomised trial on adjuvant portal and systemic chemotherapy for Dukes B2 and C colorectal cancer. 1120 98

Standard adjuvant chemotherapy for colorectal cancer consists of 5-fluorouracil with leucovorin or levamisole. The large, multicenter, randomized, double-blind QUASAR (Quick and Simple and Reliable) trial investigated whether treatment with a higher dose of leucovorin or the addition of levamisole to 5-fluorouracil and leucovorin improved survival. In the QUASAR study, 4,927 patients with colorectal cancer with no evidence of residual disease following resection, were randomized to receive fluorouracil (370 mg/m2) with high-dose (175 mg) or low-dose (25 mg) leucovorin and either levamisole (50 mg) or placebo. The fluorouracil and leucovorin regimen was given either monthly (as six 5-day courses with 4 weeks between the start of each course) or weekly (as 30 once-weekly doses). Levamisole or placebo was given three times daily for 3 days, repeated every 2 weeks for 12 courses. The primary endpoint was death from any cause. Survival was similar with both high- and low-dose leucovorin (70.1% v 71.0% at 3 years; P = .43) as well as recurrence rates (36.0% v 35.8%; P = .94), and with levamisole compared with placebo (69.4% v 71.5%; P = .06) as well as recurrence rates (37.0% v 34.9%; P = .16). Monthly and weekly treatments were equally effective (although this was a nonrandomized comparison), while weekly treatment was associated with significantly fewer toxic effects (neutropenia, mucositis, and diarrhea). High-dose leucovorin was not associated with a survival or recurrence benefit when compared with low-dose leucovorin. The ongoing QUASAR-1 trial aims to establish whether adjuvant chemotherapy has any worthwhile survival benefit in colorectal cancer patients with an uncertain indication following surgical resection.
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PMID:A United Kingdom coordinating committee on cancer research study of adjuvant chemotherapy for colorectal cancer: preliminary results. 1127 87

Adjuvant chemotherapy in colorectal cancer patients is aimed at decreasing the relapse rate of the disease and increasing the disease-free and the overall survival of the patients. In a prospective study we evaluated the efficacy of 5-FU plus levamisole as an aduvant therapy for 153 patients with Dukes' B-2 or C colon or rectal cancer following a curative-intended surgery. Adjuvant chemotherapy was started within 4 to 6 weeks following the operation. Combination of 5-FU 375 mg/m(2)/day was given intravenously over 15-20 min for 5 consecutive days, every month for 1 year. Levamisole 50 mg t.i.d. was administered orally during the first 3 days of each course of chemotherapy. Rectal cancer patients were also irradiated to the tumor bed and pelvic lymphatics. The dose intensities (DI) of 5-FU and levamisole in our study were 432.6 mg/m(2)/w and 103.8 mg/m(2)/w, respectively. Failure analysis in Dukes' B and C patients showed that the rectum accounted for 47.5% of the relapses, of which only 3 cases were in the vicinity of the resected area. Almost half of the failures were observed within the year of adjuvant treatment. The liver was the most common site for first relapse (50%). The 3-year disease-free survival of Dukes' B-2 patients group was 84%, compared with 64% in Dukes' C. The main toxic manifestations were diarrhea, nausea and vomiting, weakness and mucositis. No dose reduction was needed. Our protocol, using lower DI of levamisole yielded similar results with a lower rate of toxicity than other common protocols.
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PMID:Adjuvant levamisole and fluorouracil in high risk colorectal cancer patients. 2159 47

Levamisole is an anthelmintic agent and also immunostimulant drug which is used to treat colorectal cancer. The present study aimed to show accidental consumption of levamisole alone induced multifocal inflammatory leukoencephalopathy. A 53-year-old male was admitted to the Neurology Department of Farabi Hospital (Kermanshah, Iran) with walking inability and recognition disorder. Following clinical examinations, the patient diagnosed as multifocal inflammatory leukoencephalopathy following levamisole consumption.The patient was treated with intravenous methylprednisolone followed by prednisolone. The magnetic resonance imaging (MRI) was done 1 month later and did not show a reduction or remission in the lesions. History of the patient showed that he had accidentally consumed levamisole 8 months ago. It seems that the consumption of levamisole can induce multifocal inflammatory leukoencephalopathy and delayed treatment of the patient with corticosteroid cannot diminish the neurotoxicity of levamisole. In addition, the cytotoxic dose of levamisole induces irreversible multifocal inflammatory leukoencephalopathy.
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PMID:Multifocal inflammatory leukoencephalopathy induced by accidental consumption of levamisole: A case report. 2425 Aug 64


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