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)

A case of metachronous lung metastasis treated by the combination therapy of Etoposide, Epiadriamycin and CDDP (modified EAP) is reported. A 47-year-old female who had undergone standard radical mastectomy for left. breast cancer was shown to have multiple metastases to the right. lung two years and seven months after surgery. The metastatic lesions disappeared after six series of modified EAP (VP 16 450 mg + ADR 40 mg + CDDP 100 mg/body) x 6 in seven months. Major side effects such as leukopenia and thrombocytopenia were not observed during the course. No recurrence had been noted for 14 months since the disappearance of the metastatic lesions. It is thus emphasized that the effect of EAP may be expected for the treatment of breast cancer.
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PMID:[Remarkable effect of the combination therapy of etoposide, epiadriamycin, and CDDP (EAP) in the treatment of metachronous lung metastases of breast cancer--a case report]. 165 28

Surgery is the treatment of choice in early stages of gastric carcinoma. Systemic chemotherapy (CTx) is indicated in unresectable and metastatic disease. New studies have shown that CTx perioperatively improved median survival times compared with surgery alone in locally advanced, technically inoperable tumors. Moreover CTx induced resectability in 47-80% of the patients. Therefore, younger patients in these stages of disease should be treated with effective CTx, such as EAP, in order to induce objective remissions so that residual tumor masses can be surgically removed.
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PMID:[Perioperative chemotherapy of stomach cancer]. 172 92

In a multicenter trial, 49 patients with histologically proven advanced gastric cancer were treated with a combination chemotherapy consisting of etoposide 120 mg/m2 d 4, 5, 6 adriamycin 20 mg/m2 d 1, 7 and cisplatinum 40 mg/m2 d 2, 8. Therapy was repeated every 4 weeks, 45 patients were evaluable for response after 8 weeks of treatment. Eight patients achieved a partial remission (PR: 18%), 17 patients had no change (NC: 38%), and 20 patients showed tumor progression (P: 44%). Four patients with primarily inoperable tumor and without distant metastases who achieved a partial remission, underwent second look operation with curative intention. All 4 patients died within 12 months after second look operation due to tumor recurrence. Median survival time of all patients was 9 months. Toxicity was considerable. WHO grade 3/4 toxicity appeared in 20-30% of patients (nausea, vomiting, loss of appetite, leucopenia). After 3 cycles complete alopecia was present in 70% of patients. Severe infection, requiring treatment, occurred in 10 patients. Five patients discontinued therapy because of intolerable subjective toxicity. The observed response rate of 18% objective partial remissions is disappointing and does not give support to the communications reporting response rates over 50% with EAP and other regimens including cisplatinum. In conclusion, and considering the high subjective and objective toxicity of this regimen, it can not be recommended for standard use in patients with advanced gastric cancer.
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PMID:Etoposide, adriamycin, and cisplatinum (EAP) combination chemotherapy for advanced gastric cancer. A phase II trial by the "Chemotherapiegruppe Gastrointestinaler Tumoren (CGT)". 220 5

A 61-year-old male patient who developed brain metastasis 6 months after the lung resection for adenocarcinoma was treated with the 3 courses of EAP (Etoposide 150 mg/body/course, ADR 40 mg/body/course, CDDP 100 mg/body/course). Although our doses were lesser than Preusser's, symptoms soon subsided, and brain CT revealed a complete disappearance of metastases 16 days after the beginning of the first EAP course. During 5 months of CR, the patient had enjoyed his common daily life, the relapse, however, occurred. Since brain metastasis is life threatening, such an effective regimen like EAP should be made further studies to it.
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PMID:[A case of complete remission in brain metastasis from lung adenocarcinoma with EAP (etoposide, adriamycin, cisplatin)]. 239 12

In this phase II multicenter trial, 67 evaluable patients with advanced measurable gastric carcinoma were treated with a combination of etoposide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (EAP). The overall response rate was 64%, including 21% complete responses (CRs). In 55 patients with metastatic disease, 31 responses (51%) including eight CRs (15%) were achieved. Responses were seen in all metastatic sites, but the response rate was lower in patients with peritoneal carcinomatosis. In 12 patients with locoregional disease, six CRs and six partial responses (PRs) were observed. Eight CRs (three and five in patients with metastatic and locoregional disease, respectively) were pathologically confirmed. The overall median response duration was 7 months; it was 16 months for patients achieving CR (22 months for pathologically confirmed CR [pCR]), and 6 months for PR. The median survival time for all patients was 9 months, for the patients who achieved CR 17 months, for pCR 23 months, and for PR 9.5 months. Median survival time for all patients with metastatic disease was 8 months, and for locoregional disease 12.5 months. Six patients (9%) (four local, two metastatic disease) were alive at 2 years, and four patients are alive and disease free at 35+ to 56+ months. Main toxicities were leukopenia and thrombocytopenia, with 64% of patients developing grade 3 to 4 myelosuppression and 12% severe infections. Nonhematologic toxicities of World Health Organization (WHO) grade 4 were not observed.
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PMID:Phase II study with the combination etoposide, doxorubicin, and cisplatin in advanced measurable gastric cancer. 267 Dec 87

A 47-year-old male was diagnosed as having gastric cancer with metastases to liver, para-aorta node and Virchow node. He was treated with EAP (Etoposide, Adriamycin, Cisplatin) therapy, as a result of which a partial response was obtained according to the criteria of the Jpn. Soc. Cancer. Ther. The response was disappearance of subjective symptoms and Virchow's metastasis and reduction of chief tumor and liver metastases. However, this therapy was accompanied by severe side effects such as leucopenia and thrombocytopenia, but in this case, these side effects improved within 20 days.
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PMID:[A case of gastric carcinoma remarkably responding to etoposide, adriamycin and cisplatin (EAP) therapy]. 317 44

"Second generation" combination chemotherapy regimens were developed in the 1980s with high activity in locally advanced and metastatic disease. Among them were etoposide plus doxorubicin plus cisplatin (EAP), etoposide plus 5-fluorouracil plus leucovorin (ELF), continuous infusion of 5-fluorouracil plus cisplatin (FP) and high-dose methotrexate plus S-fluorouracil plus doxorubicin (FAMTX). In locally advanced disease a resectability rate of +/- 50% was reported with these protocols. FAMTX was felt to be superior to 5-fluorouracil, doxorubicin and mitomycin (FAM), which regimen had been considered "standard" treatment for many years. Randomized studies, however, did not reveal significant differences among various second generation regimens. Future studies should focus on innovative protocols in advanced disease, the role of neoadjuvant chemotherapy in clinically staged locally advanced disease, the role of local "consolidation treatment," ie, radiotherapy or intraperitoneal chemotherapy after primary chemotherapy plus resection, and preoperative and postoperative chemotherapy in operable disease.
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PMID:The treatment of advanced gastric cancer. 865 24

Patients with gastric adenocarcinomas have a poor prognosis. Because curative surgery is often impossible (metastatic disease) or extremely difficult (locally advanced tumors), and the majority of patients undergoing curative resection relapse, chemotherapy has been actively studied in gastric cancer. Many drugs have shown activity; however, single-agent chemotherapy failed to demonstrate increased survival benefit. Several combination regimens have been developed with high activity in locally advanced and metastatic disease. Among them are 5-fluorouracil (5-FU) plus high dose methotrexate plus doxorubicin (FAMTX), etoposide plus doxorubicin plus cisplatin (EAP), etoposide plus leucovorin plus 5-FU (ELF), and epirubicin plus cisplatin plus 5-FU (ECF). Although the response rates of these schedules are encouraging, the toxicity is considerable. Randomized trials comparing chemotherapy with best supportive care showed an increase in overall survival and in quality-of-life. Up to now adjuvant chemotherapy in curatively resected gastric cancer patients has failed to improve survival as compared with surgical controls. Phase II trials with preoperative chemotherapy have shown very promising results, but results of randomized trials should be awaited to judge the real value of this approach. At this moment it cannot yet be estimated whether preoperative chemotherapy does positively influence the resection rate and survival of patients with clinically resectable tumors.
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PMID:Chemotherapy of gastric cancer. 874 Jul 18

Patients with gastric cancer have a poor prognosis. Because curative surgery is often impossible (metastatic disease) or extremely difficult (locally advanced tumors), and the majority of patients undergoing curative resection relapse, chemotherapy has been actively studied in gastric cancer. Several combination chemotherapy regimens have been developed with high activity in locally advanced and metastatic disease. Among them are 5-fluorouracil (5-FU) plus high dose methotrexate plus doxorubicin (FAMTX). It represents the reference treatment in many clinical trials. Recent schedules like etoposid plus cisplatin (EAP); etoposid plus leucovorin plus 5-FU (ELF) and epirubicin plus cisplatin plus 5-FU (ECF) show encouraging response rates, their toxicity is considerable, however. Randomized trials comparing chemotherapy with best supportive care showed an increase in overall survival and in quality-of-life. Up to now adjuvant chemotherapy has failed to improve survival as compared with surgical controls. Only half of the patients with locally advanced gastric cancer (LAGC) undergo macroscopic and microscopic tumor-free resection. Preoperative chemotherapy has shown very promising results even in patients who had primarily unresectable tumors. Approximately half undergo R0 resection after downstaging induced by active chemotherapy and the long-term survival rises to about 20%. There are hopes that the newest regimes may do this: new cytostatic drugs and the immuno-chemical approach to combine cytostatic drugs with cytokines will be of great importance.
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PMID:[Neo-adjuvants, adjuvants and palliative therapy for gastric carcinoma]. 958 71

BACKGROUND: Despite recent developments in chemotherapeutic trials, the long-term results of chemotherapy remain to be clarified. We evaluated the impact of chemotherapy on long-term survival in patients with unresectable gastric cancer.METHODS: Between 1985 and 1991, a total of 363 patients with gastric cancer were enrolled into a single randomized phase II study and into three series of phase II studies of the Japan Clinical Oncology Group. The chemotherapy regimens consisted of tegafur + mitomycin C (FTM), uracil-tegafur + mitomycin C (UFTM), 5'deoxy-flurorouridine + cisplatin (5'P), etoposide + doxorubicin + cisplatin (EAP), and 5-fluorouracil + cisplatin (FP). After a review of the 363 patients' case records, 226 patients who fulfilled the criteria of having "unresectable" factors prior to chemotherapy became the subjects for this analysis. Of the 226 patients, 50 were in the FTM regimen group, 39, in the UFTM; 49, in the 5'P; 42, in the EAP; and 46, in the FP group. Survival was updated continually.RESULTS: Of the 226 patients, 22 (10%) survived longer than 2 years, and 8 (4%) have survived longer than 5 years. The 8 5-year survivors consisted of 6 patients who had para-aortic node metastases alone as an "unresectable factor", 1 who had para-aortic and cervical node metastases, and the remaining patient who had liver metastasis alone. Twenty-nine patients with para-aortic node metastasis alone had a significantly longer survival than the other 197 patients ( P < 0.001).CONCLUSION: Systemic chemotherapy may offer some hope of achieving long-term survival in patients with unresectable gastric cancer, particularly when the patient has metastasis only to para-aortic nodes.
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PMID:Long-term results for patients with unresectable gastric cancer who received chemotherapy in the Japan Clinical Oncology Group (JCOG) trials. 1198 28


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