Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From June 1988 to November 1990 the Southwest Oncology Group initiated nine protocols for the phase II evaluation of recombinant human tumor necrosis factor alpha (rhuTNF alpha) in cancer patients. Patients with diverse metastatic malignancies including breast, colon, gastric, pancreatic, endometrial, and bladder cancers, as well as multiple myeloma and various sarcomas received 150 micrograms/m2 of rhuTNF alpha daily for 5 days every other week. Of 147 patients entered in the study, 127 were eligible and were evaluated for toxicity and response. Of 124 patients known to have completed treatment, 92 (74%) went off study for progression, 21 (17%) for toxicity, and 12 (10%) for other causes, mainly that of worsening medical condition. Thirteen percent of patients experienced grade 4 or fatal toxicity. The most serious toxicities were pulmonary failure and coagulopathies. The predominant grade 3 toxicities were symptomatic (chills, fever, malaise, headache, myalgia, and nausea or vomiting). Only one partial remission was seen in a patient with metastatic bladder cancer lasting 4 months (rate 0.8%, exact 95% confidence interval 0-4%). At the study dose and schedule, rhuTNF alpha does not appear to have significant antitumor activity. The biological basis for this finding is discussed.
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PMID:Phase II studies of recombinant human tumor necrosis factor alpha in patients with malignant disease: a summary of the Southwest Oncology Group experience. 176 76

Combination three-drug chemotherapy with adriamycin (ADM), cyclophosphamide (CPM), and 5-fluorouracil (5-FU) was performed in 24 cases of advanced bladder cancer who underwent surgical treatment, and three cases with recurrent or metastatic bladder cancer. The average age (25 men and 2 women) was 53. Of the 24 cases, nine were in stage T2, 10 in T3, and five in T4. One course consisted of a combination of 30 mg/m2 of ADM, 300 mg/m2 of CPM, and, 250 mg of 5-FU, administered five times. The combination was administered to three groups: every day for 5 days consecutively in group A, twice a week for 21/2 weeks in group B, and once every 4 weeks for 16 weeks in group C. After injection of ADM, CPM, and 5-FU, 200 mg/day of 5-FU was administered PO daily in all three groups. The 5-year survival rate of the 24 cases (apart from 3 cases with measurable metastatic tumor) was 58%. The 5-year survival rate for stage T2 was 88%, and that for stage T3 was 62.5%; all patients with stage T4 disease died before 3 years and 6 months. Partial response was seen in two out of three patients with recurrent or metastatic disease. Alopecia was observed in all cases as a side-effect of the chemotherapy. Also anorexia, nausea, and myelosuppression were observed in many cases, though the degree was tolerable. However, there were no disorders of the cardiovascular system, except for one case with transient hypotension.
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PMID:Combination chemotherapy for advanced bladder cancer with adriamycin, cyclophosphamide, and 5-fluorouracil. 664 Aug 34

Since October 1978, 25 patients with metastatic carcinoma of the bladder have been treated with cis-platinum, doxorubicin hydrochloride and cyclophosphamide. Patient selection for this protocol was relatively strict and included only patients who had measurable parameters. All 3 drugs (60 mg./m.2 cis-platinum, 40 mg./m.2 doxorubicin hydrochloride and 400 mg./m.2 cyclophosphamide) were given as a single dose every 4 weeks. Over-all, 19 of the 23 evaluable patients (82 per cent) responded to therapy. There were 5 complete drug-induced remissions and 14 partial remissions. Generally, the treatment was tolerated well and common toxic effects were myelosuppression, nausea, vomiting and alopecia. One patient died of septicemia as a result of agranulocytosis. These promising results seem to indicate the high degree of effectiveness of this combination chemotherapy against transitional cell carcinoma of the bladder.
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PMID:The management of advanced bladder carcinoma. 719 23

Combination chemotherapy with newer, more active drugs in patients with advanced and/or metastatic bladder cancer might show improved response rate and survival. Gemcitabine (GEM) and Epidoxorubicin (EPI) have demonstrated activity in this disease. In addition, experimental studies in vitro have shown that the two agents have additive-synergistic effects when used in combination. Our prior phase I dose-finding study in previously untreated patients with advanced or metastatic bladder cancer defined recommended doses for further trials of GEM 1000 mg/m2 and EPI 25 mg/m2 on days 1, 8 and 15 every 28 days. A phase II trial at this dose level was initiated in previously untreated patients to assess efficacy and toxicity. Eligible patients had measurable disease; Karnofsky performance status (PS) of > 40; no prior chemotherapy; and adequate bone marrow reserve, cardiac, hepatic and renal function. Thirty- one patients (22 males, 9 females) with median age of 64 (range 44-75) and median PS of 80 were accrued, and all were eligible. Twelve patients had T4N1-2 M0, 8 had lymph node only metastases, while 11 had visceral metastases (liver, bone, lung). A total of 181 cycles was administered (range 3-7 per patient). Major toxicities (WHO grade > or = 3) were: neutropenia in 5 patients, thrombocytopenia in 2 patients, and anemia in 2 patients. Three patients had febrile neutropenic episodes and only 3 patients required dose reduction. Grade 1-2 non-hematological toxicities included nausea/vomiting, stomatitis and alopecia. No cardiac toxicity was observed. Of the 30 response evaluable patients, 17 (57%) demonstrated a major response (3 complete and 14 partial) (95% CI: 39%-75%), 7 had stable disease (23%) and 6 progressed (20%). These preliminary results confirm the phase I observation that the combination of GEM--EPI is highly active in the treatment of advanced and metastatic bladder cancer with a favourable toxicity profile.
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PMID:Gemcitabine plus Epi-doxorubicin as first-line chemotherapy for bladder cancer in advanced or metastatic stage: a phase II. 1253 29