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)

Nabilone, a synthetic cannabinoid, and Prochlorperazine were compared in a double-blind crossover study of 34 patients with lung cancer undergoing a 3-day schedule of chemotherapy with Cyclophosphamide, Adriamycin and Etoposide. Symptom scores were significantly better for patients on nabilone for nausea, retching and vomiting (P less than 0.05). Fewer subjects vomited with nabilone (P = 0.05) and the number of vomiting episodes was lower (P less than 0.05); no patients on nabilone required additional parenteral anti-emetic. More patients preferred nabilone for anti-emetic control (P less than 0.005). Adverse effects common with nabilone were drowsiness (57%), postural dizziness (35%) and lightheadedness (18%). Euphoria was seen in 14% and a "high" in 7%. Erect systolic blood pressure was lower in nabilone patients on Day 1 (P = 0.05) but postural hypotension was a major problem in only 7%. Nabilone is an effective oral anti-emetic drug for moderately toxic chemotherapy, but the range and unpredictability of its side-effects warrant caution in its use.
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PMID:Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy. 631 40

Eighteen patients with advanced germ-cell cancer (12 primary gonadal, six extragonadal) that was refractory to vinblastine (V), cisplatin (P), and bleomycin (B) were treated with Etoposide (VP-16-213) and cisplatin +/- bleomycin sulfate +/- doxorubicin hydrochloride. All patients experienced nausea, vomiting, alopecia, and myelosuppression. There were no treatment-related deaths. Five (42%) of 12 patients with primary gonadal germ-cell cancer achieved a complete remission and are presently alive with no evidence of disease. None of the six patients with extragonadal germ-cell cancer achieved a complete response. Thirteen patients died 6.2 months (median) after starting Etoposide treatment. Etoposide-containing chemotherapy is useful in patients with primary gonadal germ-cell cancer. Alternative therapies are needed for patients with extragonadal germ cell cancer.
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PMID:Chemotherapy of refractory germ cell cancer with Etoposide. 632 75

Etoposide (VP 16) is a semi-synthetic derivative of 4'- demethylepipodophyllotoxin , a naturally occurring compound synthesized by the North American May apple (Podophyllum peltatum ) and the Indian species Podophyllum emodi Wallich . Although podophyllotoxins are classical spindle poisons causing inhibition of mitosis by blocking mitrotubular assembly, etoposide inhibits cell cycle progression at a premitotic phase (late S and G2), probably via inhibition of DNA synthesis. There appears to be a selective antileukemic dose response relationship when compared to normal hematopoietic elements. Etoposide is effective when administered orally at about twice the recommended parenteral dosage. Schedule dependency in both animal models and clinical trials has been observed; multiple dosing over three to five consecutive days is superior to weekly single dose administration. Etoposide's dose-limiting toxicity is myelosuppression (leukopenia), which is quite predictable; alopecia and Gl toxicity (nausea, vomiting, stomatitis) occur in about 20-30% of patients given recommended dosages. Etoposide appears to be one of the most active drugs for small cell lung cancer, testicular carcinoma (the Food and Drug Administration approved indication), ANLL and malignant lymphoma. Etoposide also has demonstrated activity in refractory pediatric neoplasms, hepatocellular, esophageal, gastric and prostatic carcinoma, ovarian cancer, chronic and acute leukemias and non-small cell lung cancer, although additional single and combination drug studies are needed to substantiate these data. Its contribution in front-line combination chemotherapeutic regimens for these cancers will be better defined in the forthcoming years. Etoposide appears to have minimal activity in breast cancer and, based on current data, it is inactive against malignant melanoma, colorectal adenocarcinoma and cancer of the head and neck, although the dosage and schedules used in many of the Phase II studies may have been suboptimal.
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PMID:Etoposide: a semisynthetic epipodophyllotoxin. Chemistry, pharmacology, pharmacokinetics, adverse effects and use as an antineoplastic agent. 632 63

Forty-six patients with non-small cell lung cancer were treated with a combination of cis-platinum 90 mg/m2 i.v., day 1 and VP 16-213 100 mg/m2 i.v. on days 1, 3 and 5. The overall remission rate was 22% (10 out of 46 patients) with a median remission duration of 7 months. Squamous cell and large cell undifferentiated carcinomas responded to the chemotherapy with a remission rate of 27% (7 out of 26 patients) and 22% (3 out of 13 patients). Seven patients with adeno-carcinoma did not respond to chemotherapy. The overall survival was 7 months (1-27+). The survival time for patients entering remission was 11.5 months (7-27+), for those with stable disease 8.5 months (3-27+), and for patients with progressive disease 5 months (1-9). Performance status of less than 80%, a weight loss of more than 10.0 kg in the last three months before starting treatment and a "major" atelectasis (collapse of at least one superior or inferior lobe) adversely influenced prognosis. Only 1 out of 31 patients with one or more poor prognostic factors came into remission. In contrast, 9 out of 15 patients (60%) without poor prognostic factors had a remission. Stage, limited versus extensive disease, and age did not affect the results. Hematologic and renal toxicity of the combination were mild, but poor subjective tolerance (nausea, vomiting, loss of appetite) was prominent.
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PMID:[Results of drug therapy of inoperable non-small cell lung carcinoma with VP 16-213 (Etoposide) and cis-platin. A phase II study]. 636 76

VP-16-213 at standard dose is one of the more active agents for the treatment of germ cell tumors. In previous phase I studies, VP-16-213 has been investigated in suprastandard dose when hematopoietic reconstitution was assured by autologous bone marrow transplantation (ABMT). This phase II study was performed to explore the possibility that an augmented dose of VP-16-213 may be more active than standard dose against germ cell tumors. Eleven patients with progressive refractory germ cell tumors were treated with high-dose VP-16-213: 2,400 mg/m2 with ABMT every three to four weeks followed by 1,200 mg/m2 without ABMT. Seven patients had received VP-16-213 at standard dose prior to high-dose VP-16-213. Toxicity to high-dose VP-16-213 included severe myelosuppression, nausea, vomiting, alopecia, mucositis, and hepatitis. Of 10 evaluable patients, two complete responses and four partial responses, all of short duration, were obtained. However, some patients unresponsive to standard-dose VP-16-213 exhibited responses to the augmented-dose VP-16-213. Therefore, although more myelosuppressive, VP-16-213 may have increased activity against germ cell tumors when administered at augmented dose. High-dose VP-16-213 may be considered in designing new approaches for initial management of patients with germ cell tumors not expected to be cured with standard chemotherapy.
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PMID:High-dose VP-16-213 monotherapy for refractory germinal malignancies: a phase II study. 636 60

A phase II clinical trial of oral VP 16-213, a semisynthetic podophyllotoxin, was undertaken in twenty nine patients with advanced non-Hodgkin's lymphoma. All patients had received extensive prior chemotherapies including adriamycin, cyclophosphamide, vinka alkaloids and/or bleomycin and has become refractory to these drugs. The dosage of VP 16-213 was 200 mg/day p.o. bid for 5 days at 3 to 4-week intervals. There were 3 CRs (10.3%) and 6 PRs (20.7%) with a median duration of remission of 16 weeks ranging from 7 to 185+ weeks. Leukopenia less than 4 X 10(3)/cm3 and thrombocytopenia less than 100 X 10(3)/cm3 were seen in 80% and 26.7% of cases, respectively. Alopecia (100%), anorexia (44%) and nausea (26%) were observed but these were well tolerated. We conclude that the oral administration of VP 16-213 has considerable antitumor activity with no cross-resistance to vinka alkaloids, anthracyclines and alkylating agents.
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PMID:[A phase II clinical trial of oral VP 16-213 in advanced non-Hodgkin's lymphoma]. 647 37

Forty-six patients with non-small cell lung cancer were treated with a combination of cis-platinum, 90 mg/m2 i.v. on day 1 and VP 16-213, 100 mg/m2 i.v. on days 1, 3 and 5. The overall remission rate was 22%, with a median duration of 7 months. Squamous cell and large cell undifferentiated carcinomas responded in 27 and 22% of patients, and seven patients with adenocarcinoma did not respond to chemotherapy. Survival was 7 months for all patients, 11.5 months for responders (7-27+), 8.5 months for patients with stable disease (3-27+) and 5 months for progressive tumours (1-9). Prognosis was adversely influenced by a performance status of less than 80%, a weight loss of more than 10 kg during the last 3 months before start of treatment and a radiologically demonstrable 'major' atelectasis (collapse of at least one superior or inferior lobe of the lung). Only one out of 31 patients with one or more poor prognostic factors came into remission. In contrast, nine out of 15 patients without poor prognostic factors showed objective tumour regression (60% remission rate). Stage and age did not affect the results. Haemotologic and renal toxicity were mild, but poor subjective tolerance (nausea, vomiting, loss of appetite) was prominent.
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PMID:cis-Platinum (DDP) and VP 16-213 (etoposide) combination chemotherapy for advanced non-small cell lung cancer. A phase II clinical trial. 653 96

The treatment of refractory acute nonlymphocytic leukemia remains a major clinical problem in leukemia therapy. VP 16-213 is an investigational agent that may have specificity for monocytic blasts, and the combination of VP 16-213 and cyclophosphamide is synergistic in experimental leukemia. Seven patients with highly refractory acute nonlymphocytic leukemia, which demonstrated monocytic features, were treated with a combination of VP 16-213 and cyclophosphamide after they had failed to respond to multiple courses of intensive induction regimens. Three complete remissions and one partial remission were achieved. The times to complete remission were 21, 23, and 34 days. The durations of complete remission were 5, 9, and 12+ months. Myelosuppression was the most common side effect; one patient experienced nausea and stomatitis. There were no documented infections or hemorrhage, and no one died as a result of therapy. This combination is both well tolerated and effective in the treatment of refractory leukemia with monocytic features.
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PMID:VP 16-213 and cyclophosphamide in the treatment of refractory acute nonlymphocytic leukemia with monocytic features. 701 68

Etoposide is a semisynthetic podophyllotoxin derivative with a broad spectrum of antitumor activity and a relatively high therapeutic index. The synergism in animal with cis-platinum, cyclophosphamide, BCNU, and cytosinarabinoside is interesting for combination regimen. Mechanisms of action are inhibition of nucleoside transfer and of DNA and RNA synthesis, single stranded breaks, inhibition of protein synthesis and of microtubular assembly. While in lower concentrations etoposide is acting cell-cycle-dependent with accumulation of cells in the G2-phase it has, in high concentrations, also a cellcycle-phase-unspecific lethal effect. Most suitable is the oral and i.v. application of etoposide in fractionated doses of 80--120 mg/m2 on 3--5 consecutive days and repetition after 21 [14--28] days. Side effects are dose-limiting bone marrow toxicity, nausea, vomiting, fever, hypotension, phlebitis, mucositis, neuropathy, cardiotoxicity, alopecia. Etoposide is one of the most active single agents in small-cell bronchus carcinoma with a remission rate of 37% (10% CR), and is very active in NHL (36%), testicular carcinoma (37%), AMML (35%), choriocarcinoma (35%), and neuroblastoma (29%). The role of etoposide in combination with other active drugs in these tumors is currently investigated in bronchus and testicular carcinoma and NHL, where etoposide will belong to the drugs of the first choice in the future.
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PMID:[Etoposide VP 16--213)--a podophyllotoxinderivative with high antitumor activity (author's transl)]. 703 50

Fifty-one patients with metastatic non-small-cell lung cancer (NSCLC) were treated with VP-16-213 (4'-demethylepipodophyllotoxin) during a phase II trial. Of the 49 patients who had adequate trials, 2 patients achieved a partial response (PR), for an overall 4% major response rate. The median Karnofsky performance status (PS) was 80%; 85.7% of patients had adenocarcinoma and 14.2% had epidermoid carcinoma. Prior treatment with chemotherapy may have adversely affected response rate; the two responses occurred among the 25 previously untreated patients, while no responses were seen in patients who had previously received chemotherapy. Myelosuppression was the most frequent side effect and two drug-related deaths due to septicemia occurred. Other toxic effects noted included anorexia, nausea and hypotension during drug infusion. We conclude that VP-16-213 has minimal activity as a single agent in NSCLC.
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PMID:Phase II trial of VP-16-213 in non-small-cell lung cancer. 708 Nov 37


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