Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic cancers are associated with cellular oxidative stress, and during cancer chemotherapy excess drug-induced oxidative stress can limit therapeutic effectiveness and cause a number of side effects, including fatigue, nausea, vomiting, diarrhea and more serious adverse effects, such as cardiomyopathy, peripheral neuropathy, hepatotoxicity and pulmonary fibrosis. We review here the hypothesis that the acute and chronic adverse effects of cancer chemotherapy can be reduced by molecular replacement of membrane lipids and enzymatic cofactors, such as coenzyme Q(10). By administering nutritional supplements with replacement molecules and antioxidants, oxidative membrane damage and reductions of cofactors in normal tissues can be reversed, protecting and restoring mitochondrial and other cellular functions and reducing chemotherapy adverse effects. Recent clinical trials using cancer and non-cancer patients with chronic fatigue have shown the benefit of molecular replacement plus antioxidants in reducing the damage to mitochondrial membranes, restoring mitochondrial electron transport function, reducing fatigue and protecting cellular structures and enzymes from oxidative damage. Molecular replacement and antioxidant administration mitigates the damage to normal tissues, such as cardiac tissue, and reduces the adverse effects of cancer therapy without reduction in therapeutic results.
Clin Exp Metastasis 2008
PMID:Reversing mitochondrial dysfunction, fatigue and the adverse effects of chemotherapy of metastatic disease by molecular replacement therapy. 1805 28

Many patients with stage IV nonsmall cell lung cancer (NSCLC) are unfit for cisplatin-based chemotherapy because of poor performance status, impaired renal function or severe comorbidity. We documented the feasibility of a combination of weekly vinorelbine and biweekly oxaliplatin in a population of stage IV NSCLC patients unable to receive cisplatin. Fifty-five chemo-naive patients (40 males, median age 60 years, range 43-84) were treated on an outpatient basis, and received every 2 weeks: vinorelbine 25 mg/m intravenously on day 1 and 60 mg/m orally on day 8, and oxaliplatin 85 mg/m intravenously on day 1. Patients were considered unfit for cisplatin because of performance status > or =2 (30 patients), impaired renal function (17 patients) or severe comorbidities (eight patients). Twenty-two patients (40%) had two or more metastatic sites, and 14 (25%) had central nervous system metastases. A total of 288 cycles were given (median per patient: 4, range 1-11). The planned dose intensity of vinorelbine was administered in 65% of patients. One complete and 13 partial responses were observed, providing an objective response rate of 26% (95% confidence interval: 14.4-37.6). The median progression-free survival and overall survival were 3.5 months and 9.5 months, respectively. The 1-year survival rate was 24% (95% confidence interval: 12.7-35.3). The main grade 3/4 toxicities were: neutropenia (15 patients, 27%), anaemia (12 patients, 22%) and peripheral neuropathy (eight patients, 15%). Three patients (5.5%) experienced febrile neutropenia. In a nonselected NSCLC patient population, the vinorelbine-oxaliplatin doublet had clinical activity in the same range as cisplatin-based combinations. This doublet allows combining a platinum derivative with a sustained dose intensity of vinorelbine in unfit patients.
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PMID:Vinorelbine and oxaliplatin in stage IV nonsmall cell lung cancer patients unfit for cisplatin: a single-center experience. 1920 26

Adenocarcinomas and other various tumors are known to metastasize to various locations without any significant predilection and the metastasis could be the first presentation of the malignancy by the patient. Involvement of peripheral nerves without the central nervous system involvement has been rarely reported. Perineural tumor spread has been infrequently reported with soft tissue tumors without central nervous system involvement. Here we present an unusual case of an elderly gentleman presenting with symptoms consistent with peripheral neuropathy involving multiple nerves. After failure of symptomatic therapy, electromyogram, and nerve conduction study showed severe bilateral carpal tunnel syndrome. Interestingly, symptoms worsened in the left hand after bilateral release surgery. Due to persistence of significant lifestyle-limiting symptoms, biopsy of the sural nerve was done that showed metastatic poorly differentiated adenocarcinoma cells. A complete surveillance for the primary lesion has been negative so far. The peripheral neuropathy was considered to be arising from the involvement of the perineural sheaths by the metastatic tumor lesions. The patient was then started on gemcitabine therapy and after just 2 cycles of chemotherapy, the patient has shown notable improvement of his symptoms. After completion of the duration of chemotherapy, he has been symptom-free for more than 6 months. Metastatic lesions to the peripheral nervous system should be considered in patients who have persisting neuropathic symptoms because treatment of those lesions can results in improvement of symptoms.
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PMID:Reversible neuropathy after chemotherapy for metastatic adenocarcinoma from an unknown primary tumor to the sural nerve. 2053 15

While uncommon, isolated avulsion fractures of the lesser trochanter occur in children and adolescents prior to the fusion of this apophysis as a result of athletic activities. In the elderly, isolated fractures of the lesser trochanter are rare but can occur as a result of trauma. They have been identified in patients with primary or secondary bone malignancies, which were previously considered pathognomonic for metastatic disease. In the absence of trauma, weakening of the bone due to systemic disorders such as osteoporosis or osteomalacia chronica renal failure may also be responsible. Diagnosis may be difficult with physical examination and radiographs alone. This case report details this rare fracture in 2 patients suffering from debilitating chronic disease. Patient 1 was a 30-year-old woman with an 18-year history of type 1 diabetes mellitus, a 6-year history of end-stage renal disease, hypertension, hypothyroidism, peripheral vascular disease, and a 3-year history of systemic lupus erythematosus with antiphospholipid syndrome treated with warfarin. Patient 2 was a 66-year-old woman with a history of type 2 diabetes mellitus, peripheral neuropathy, obesity, chronic obstructive pulmonary disease, gout, hypertension, and chronic neck and low back pain. Both were assessed with magnetic resonance imaging following physical examination, which revealed atraumatic avulsion of the distal iliopsoas tendon from the lesser trochanter. Following retraction of the iliopsoas tendon, the patients were treated with conservative therapy and anti-inflammatory medication. These 2 cases broaden the range of patients for whom spontaneous avulsion of the distal iliopsoas tendon should be considered in the differential diagnosis.
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PMID:Atraumatic avulsion of the distal iliopsoas tendon: an unusual cause of hip pain. 2070

Reported is a case of advanced accessory breast cancer to which weekly injection of paclitaxel plus weekly oral administration of cyclophosphamide proved very effective. The patient was a 49-year-old woman who noticed a tumor in the right axilla around October 2007 but then left it alone. In October 2008, the patient visited a nearby physician who made a diagnosis of locally advanced accessory breast cancer. Because the tumor enlarged despite endocrinotherapy, the patient was referred to our hospital in July 2009. CT scan showed a tumor with a size of infant's head, multiple lymph node metastases and metastases to the skin, liver and bones. Following weekly injection of paclitaxel plus weekly oral administration of cyclophosphamide for 4 months, the tumor in the right axilla and metastases to the lymph nodes, skin and liver disappeared. Adverse events were alopecia and grade 1 peripheral neuropathy. The treatment continues at present. Weekly injection of paclitaxel plus weekly oral administration of cyclophosphamide has few adverse reactions and can be performed at an outpatient clinic, suggesting that it is a useful treatment.
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PMID:[Weekly injection of paclitaxel plus weekly oral administration of cyclophosphamide were very effective for a case of advanced accessory breast cancer]. 2071 87

Hodgkin's lymphoma is a hematolymphoid neoplasm, primarily of B cell lineage, that has unique histologic, immunophenotypic, and clinical features. Neurologic complications of Hodgkin's Lymphoma can be separated into those that result directly from the disease, indirectly from the disease, or from its treatment. Direct neurologic dysfunction from Hodgkin's Lymphoma results from metastatic intracranial spinal disease, epidural metastases causing spinal cord/cauda equina compression, leptomeningeal metastases, or intradural intramedullary spinal cord metastases. Indirect neurologic dysfunction may be caused by paraneoplastic disorders (such as paraneoplastic cerebellar degeneration or limbic encephalitis) and primary angiitis of the central nervous system. Hodgkin's lymphoma treatment typically includes chemotherapy or radiotherapy with potential treatment-related complications affecting the nervous system. Neurologic complications resulting from mantle-field radiotherapy include the "dropped head syndrome," acute brachial plexopathy, and transient ischemic attacks/cerebral infarcts. Chemotherapy for Hodgkin's lymphoma may cause cerebral infarction (due to emboli from anthracycline-induced cardiomyopathy) and peripheral neuropathy.
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PMID:Hodgkin's Lymphoma: A Review of Neurologic Complications. 2097 72

A 69-year-old female visited our department with a diagnosis of rectosigmoid cancer and multiple hepatic metastases (stage IV). Abdominal CT revealed multiple metastatic lesions in the bilateral lobes of the liver. The primary lesion was considered to be resectable, and high anterior resection of the rectum was performed. After the operation, 6 courses of therapy with bevacizumab (BV) and modified FOLFOX6 were performed. CT showed a partial response, and tumor marker levels became normal. After a total of 11 courses of this therapy, grade 3 peripheral neuropathy developed, and the therapy was changed to BV and capecitabine (Cape). After 6 courses of this therapy, CT showed the maintenance of partial response, and tumor marker levels were also within the normal range. BV and Cape therapy may be useful not only for reducing peripheral neuropathy, but also as a maintenance therapy in patients requiring the suspension of oxaliplatin administration due to peripheral neuropathy.
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PMID:A case of long partial response to combination therapy of bevacizumab and capecitabine for liver metastases of rectal cancer. 2132 55

After extensive literature review utilizing PubMed and Medline searches, we present a rare case of oxaliplatin-induced grade 3/4 hepatocellular injury and ototoxicity. The patient is a 46-year-old female diagnosed with stage IIIC (pT3N2bM0) adenocarcinoma of the sigmoid colon. PET/CT prior to surgery and chemotherapy was negative for distant metastatic disease and baseline liver-associated enzymes were within normal limits. Following sigmoidectomy, patient began adjuvant chemotherapy with 5-florouracil, leucovorin, and oxaliplatin (mFOLFOX-6). Cycle 1 was complicated only by refractory nausea. However, cycle 2 was complicated by vertigo with refractory nausea, tinnitus, and marked elevation in liver enzymes in a hepatocellular pattern. Extensive workup was negative and the etiology of her symptoms and grade 3/4 hepatocellular injury was hypothesized to be the result of oxaliplatin. Aspartate aminotransferase and alanine aminotransferase decreased after two additional weeks off therapy and during cycle 3 in which oxaliplatin was held. She had no evidence of 5-florouracil toxicity. On cycle 4, oxaliplatin was restarted at 50% dose; symptoms and liver-associated enzymes remained stable. However, oxaliplatin was increased up to 75% full dose for cycle 5 with reported vertigo, tinnitus, nausea, and return of elevation in liver-associated enzymes. Oxaliplatin is a chemotherapy agent widely used in the treatment of many malignancies including colon cancer. Side effects include peripheral neuropathy, gastrointestinal toxicity, neutropenia, grade 1/2 hepatocellular injury, and hepatic vascular lesions. However, grade 3/4 hepatocellular injury and ototoxicity are extremely rare with the administration of oxaliplatin. Therefore, we present the unusual chemotherapy side effects.
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PMID:Oxaliplatin-induced hepatocellular injury and ototoxicity: a review of the literature and report of unusual side effects of a commonly used chemotherapeutic agent. 2233 69

A 52-year-old man underwent ileocecal resection for cecal cancer, followed by left hepatectomy and S6 partial resection for liver metastasis. A month later, abdominal computed tomography revealed metastases in the mediastinal lymph nodes, para-aortic lymph nodes, and left adrenal gland. After 4 courses of the capecitabine plus oxaliplatin(CapeOX) regimen and 4 courses of CapeOX plus bevacizumab, a complete response was observed regarding the lymph nodes metastasis. Then, left adrenalectomy was performed for the residual left adrenal metastasis. CapeOX plus bevacizumab was administered as a postoperative chemotherapy for 8 courses, Capecitabine was started due to adverse reactions, such as peripheral neuropathy (grade 2) and a gastric ulcer. After the gastric ulcer healed, capecitabine plus bevacizumab was administered for 5 courses. The patient has had no recurrence for almost 2 years since the resection of the adrenal metastasis.
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PMID:[A case report of stage IV cecal cancer exhibiting a complete response to multidisciplinary therapy]. 2326 38

Combination therapy with docetaxel, cisplatin, and 5-FU has been shown to increase time to progression (TTP) and overall survival (OS) for patients with advanced gastric cancer; this regimen is limited by significant toxicity, including complicated neutropenia. This study was designed to incorporate docetaxel into a tolerable biweekly (once every 2 weeks) oxaliplatin-based chemotherapy regimen. Patients with measurable advanced and metastatic gastric or gastroesophageal cancer, aged >18 years, and with ECOG two or less, received oxaliplatin 85 mg/m(2), docetaxel 50 mg/m(2) on day 1, leucovorin 200 mg/m(2) on days 1 and 2, and 5-FU 1,200 mg/m(2) 24-h infusion on days 1 and 2 of every 2-week cycle. Toxic effects were graded according to NCI-CTC version 3. Responses were classified according to World Health Organization criteria. Fifty patients were included, 47 assessed for efficacy and toxicity. Median age was 55 years. The majority had metastatic disease (72 %). The over all response was observed in 55.3 % patients. Median TTP and OS were 6 and 10 months, respectively. Grade 3 or 4 hematological toxic effects were included neutropenia, leukopenia, and thrombocytopenia observed in 21 (44.7 %), 12 (25.5 %), and 1 (2.1 %) patients, respectively. Non-hematological were diarrhea (14.9 %), fatigue (12.7 %), and peripheral neuropathy (8.5 %). Complicated neutropenia (febrile neutropenia associated with infection) was observed in one (2.1 %) patient only. Biweekly FLOT regimen has tolerable toxicity, and efficacy in line with that of DCF protocol. The FLOT regimen needs more evaluation to be considered as alternative to DCF.
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PMID:The safety and efficacy of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) combination in the front-line treatment for patients with advanced gastric or gastroesophageal adenocarcinoma: phase II trial. 2330 58


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