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

A 53-year-old woman with recurrent ovarian cancer sustained an intracerebral hemorrhage after the 4th course of a chemotherapy regimen which included cis-platinum (DDP). She received high-dose methylprednisolone as an antiemetic along with the DDP. No metastases or abnormal vascularity were found on histological examination of the right frontal lobe which had been removed surgically. Causes of cerebrovascular accidents during and following chemotherapy are discussed.
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PMID:Acute cerebrovascular accident after treatment with cis-platinum and methylprednisolone. 668 45

A phase II clinical trial was set up in metastatic breast cancer patients who had not received previous cytotoxic drug therapy, involving the administration of cis-dichlorodiammine platinum (cis-DDP). Patients aged up to 75 years and with pathohistologically confirmed disease were entered on the trial. All patients had measurable disease, a performance status (Karnofsky) of greater than 40, and an expected survival of greater than 6 weeks. In all 38 patients entered the trial, and 35 have been evaluated. The predominating metastatic sites included soft tissues (19), visceral organs (12), and bones (7 patients). cis-DDP was administered in a daily dose of 30 mg/m2 IV by a 4-h drip for 4 days, with customary hyperhydration. The results indicate a pronounced antitumorigenic effect of cis-DDP and a response rate of 54% (19/35), with 13 complete remissions (37%) and six partial remissions (17%). In terms of site the best response was obtained in soft-tissue processes (13/19; 68%), followed by visceral organs (4/10; 40%); the response rate was lowest in bones (2/6; 33%). The menopausal status and prior hormone therapy did not essentially influence the results of treatment, unlike previous irradiation. Patients with a lower performance status (40-70) had a significantly lower response rate (36% vs 63%; P less than 0.05). Toxic side-effects were moderate and did not substantially affect the general condition of the patients. A transient increase of serum creatinine was observed in 4 patients, and neurotoxicity in 2 patients. The results of the trial warrant the conclusion that cis-DDP has a pronounced antitumorigenic effect in untreated metastatic breast cancer, particularly in soft-tissue metastases. These results call for additional clinical study of the cytotoxic effect of cis-DDP in untreated metastatic breast cancer.
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PMID:Phase II clinical trial of cis-dichlorodiammine platinum (cis-DDP) for antitumorigenic activity in previously untreated patients with metastatic breast cancer. 668 1

Cisplatin (DDP) is an active agent in the treatment of disseminated bladder cancer. In addition to its direct tumor cytotoxicity, recent animal and clinical data suggest synergism with radiation therapy (RT). Since improved survival with preoperative RT is largely restricted to bladder cancer patients in whom radiation-induced downstaging (P less than T) may be recognized, the authors administered DDP + RT preoperatively to patients with locally advanced (T3, T4) bladder tumors selected for cystectomy. The aim was to evaluate the feasibility of such a combination in relation to surgical and hematologic complications, the immediate effect on tumor downstaging, disease progression, and survival. Two thousand rad (400 rad X 5 days) was delivered to the whole pelvis, followed by cystectomy in 2 days. DDP (70 mg/m2) was given intravenously on day 2 of the RT. Twenty-four patients received preoperative DDP + RT and underwent attempted cystectomy; however, six patients were nonresectable owing to extensive pelvic disease, and an additional five patients had resectable pelvic lymph node metastases. Pelvic complications developed in 3 of 24 (12%) patients, but none required reoperation. No patient had a wound dehiscence. Transient myelosuppression was similar to that induced by 2000 rad preoperative RT alone. Tumor downstaging (P less than T) was seen in 9 of 24 (38%) patients, and in 5 (21%) patients, no tumor was found in the surgical specimen (P0). Distant metastases alone have been detected in 4 of 18 (22%) patients who had a cystectomy (all 4 had nodal metastases). Disease-free survival at a median follow-up of 22 months (range, 12-34 months) is 60% (14/24) for all patients (89% for P less than T and 40% for P greater than or equal to T patients) and 78% (14/18) for the resected patients. Combined preoperative DDP + RT proved to be a safe and feasible regimen which resulted in a possibly greater recognition of radioresponsive bladder tumors, and after cystectomy, an encouraging early survival rate in patients with locally advanced disease.
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PMID:Planned preoperative cisplatin and radiation therapy for locally advanced bladder cancer. 668 67

14 patients with advanced malignant melanoma were treated in 36 therapy cycles with cisplatin. 8 patients had been pretreated with dacarbazine and 6 had received additional BCG immunotherapy. 4 patients had been irradiated after surgical removal of lymph node metastases. All patients showed significant tumor progression. 4 patients were treated showing ultimately disseminated melanoma with widespread visceral involvement. 5 patients with lymph node metastases had been operated radically and were treated postoperatively. Cisplatin was administered as a 24-h high-dose therapy (200 mg or 120-200 mg/m2) under forced mannitol diuresis, treatment cycles were repeated monthly. Of all the patients, 1 showed complete remission of supraclavicular metastases lasting for 6 months until now. 1 patient showed an initial minor response with subsequent stabilization without appearance of additional metastases for 1 year. 2 patients who had received cisplatin postoperatively showed no reappearance of tumor growth for 8 months up until now. 11 patients showed no change or progression of disease, 6 of them had received only one therapy cycle. Under clinical conditions, side effects of cisplatin treatment can be managed satisfactorily, no irreversible kidney damage could be observed under forced diuresis. As far as the above-mentioned results are concerned, antineoplastic activity of cisplatin as to advanced malignant melanoma must be considered to be of limited benefit using cisplatin as a single-agent treatment. Improvement of results might be obtained using cisplatin in a combination therapy together with other antineoplastic agents, which at the present time are being investigated in several prospective trials.
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PMID:[Experiences with high-dose cisplatin therapy in metastasized malignant melanoma]. 675 Apr 82

Eighteen evaluable patients with squamous cancer of the uterine cervix recurrent after radiation therapy or with distant metastases were treated with dianhydrogalactitol (150 mg/m2) and cisplatin (DDP) (50 mg/m2), both given iv every 3 weeks. Only 39% of the patients responded, a result no better than that previously reported for DDP alone and only one-half as good as that previously reported by our group for a combination of this drug with mitomycin, vincristine, and bleomycin. Responses lasted a median of only 5 months. Hematologic toxicity was life-threatening in 22% of the patients and was severe in all but 11% of the remaining patients. We conclude that the addition of substantial and toxic doses of dianhydrogalactitol to DDP failed to substantially enhance the rate, quality, or duration of response compared to DDP alone.
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PMID:Dianhydrogalactitol and cisplatin in combination for advanced cancer of the uterine cervix. 688 13

The antimetastatic effects of two drugs, cis-diamminedichloroplatinum(II) (DDP) and hydrocortisone (liposome-incorporated or free), were studied. The experimental models were regional and distant metastases of hepatoma A and pulmonary adenocarcinoma, which were transplanted into the footpads of A/He mice. Liposomes were prepared from phosphatidylcholine by sonic dispersion. DDP and hydrocortisone were injected sc into the region of the plantar aponeurosis of the foot with the primary tumor. This administration route was considered to be equivalent to the intralymphatic route. Evidence indicated that only liposome-incorporated DDP and hydrocortisone decreased significantly the frequency and growth rate of tumor metastases in the regional lymph nodes. The effect observed was not due to the direct action of the drugs on the primary tumors. When nonencapsulated, these drugs were ineffective. Both liposome-encapsulated and free DDP did not affect distant metastases of pulmonary adenocarcinoma. The intralymphatic administration of liposome-encapsulated antitumor agents is suggested as a method for the prophylactic treatment of tumor metastases in the lymph nodes.
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PMID:Intralymphatic administration of liposome-encapsulated drugs to mice: possibility for suppression of the growth of tumor metastases in the lymph nodes. 693 32

From December 1973 to november 1978, 31 patients with osteosarcoma were treated with combination chemotherapy consisting of cyclophosphamide, vincristine, adriamycin and DTIC. 11 out of 19 patients with localized osteosarcoma are alive with no evidence of disease, 14+ to 40+ months after initiation of adjuvant postoperative chemotherapy. The probability of relapse-free survival for this group was calculated as 62% at 2 years and 48% at 3 years. Considering the 15 patients with osteosarcoma of the limbs relapse-free survival will be 79% at 2 years and 62% at 3 years. In 10 of 11 patients with no relapse the primary tumor has been located in the metaphysis of the proximal tibia or the distal femur. All patients with osteosarcoma of the trunk have died from metastases. Most of the 12 patients with metastasizing osteosarcoma died within one year after onset of chemotherapy. In none of these patients a complete remission could be achieved. For patients receiving adjuvant chemotherapy results are comparable with those reported by other investigators. In patients with disseminated osteosarcoma alternative chemotherapy regimens including adriamycin, cis-dichloro-diammine-platinum and ifosfamide may prove superior. In a pilot-study using vincristine-adriamycin-DDP or ifosfamide-DDP response to chemotherapy was noted in 4 out of 7 patients with two continuing complete remissions for 13+ and 5 1/2+ months, respectively.
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PMID:[Results of cytostatic therapy with cyclophosphamide, vincristine, adriamycin and DTIC (CYVADIC) in localized and metastasized osteosarcoma. A retrospective analysis]. 699 10

The authors report the results of a trial of the treatment of recurrences of advanced carcinomas of the bladder using Cis-Diamino-Dichloro-Platinum administered by continuous IV infusion over a period of 24 hours at a dose of 100 mg/m2, under cover of hyperhydration and anti-haematizing drugs. The trial involved 10 patients who has had the following initial treatment : - excision for 8 of them (2 total cystectomies for T4, one total cystectomy for T3B, 2 total cystectomies for T3A and 3 partial cystectomy for T1); - preoperative cobalt therapy for 7 of them (2 flashes of 7.5 gray) - postoperative chemotherapy (VM26 and 5FU) for 5 patients. The targets evaluated were : 7 remaining pelvic tumours or recurrences, 3 lung metastases, two cases of venous compression with oedema of the lower limbs, 3 node metastases, 3 bone and 1 sciatic metastases. Results : - 1 complete remission with disappearance for 10 months in the same patient of pulmonary metastases, venous compression and an inguinal node; - 3 partial remissions for 2 to 9 months; - 2 minor remissions of 3 to 5 months; - 3 stabilizations and 1 progression. It is interesting to note the greater efficacy on distant metastases (2/3 complete disappearances of lung metastases, 2/2 disappearances of oedema of the lower limbs) than on pelvic tumours (4/7 regressions). In total, 4 objective responses out of 10 occurring between the 2nd and 6th week after the first course. The authors announce a valuable synergism of DDP with cyclophosphamide and adriamycin.
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PMID:[Evaluation of the efficacy of cis-diamino-dichloro-platinum as monochemotherapy in the treatment of advanced malignant tumours of the bladder (author's transl)]. 719 29

Two patients with who metastases from transitional cell carcinoma of the bladder have disappeared during chemotherapy which included cisplatin are described. Both patients have been free of tumour recurrence for over 12 months after chemotherapy was ceased. Side effects included peripheral neuropathy, but renal function was impaired. Cisplatin can produce clinically valuable remissions in recurrent and metastatic bladder carcinoma.
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PMID:Prolonged remission in recurrent bladder carcinoma after chemotherapy with cisplatin. 719 73

Platinum-based chemotherapy has been used to treat head and neck cancer for approximately 15 years. For patients with recurrent disease, cisplatin/5-fluorouracil (5-FU) and carboplatin/5-FU combinations have proved superior to single agents in producing higher overall response rates. However, survival rates are not substantially affected, indicating a need to identify alternative new agents with activity. Newly diagnosed patients with advanced stages III and IV disease generally have a poor prognosis. The most common site of failure and cause of death is locoregional recurrence. To improve survival and alter patterns of failure in this population, platinum-based chemotherapy regimens have been combined with surgery or radiotherapy as initial curative treatment. Cisplatin/5-FU chemotherapy in this setting is effective in significantly reducing the incidence of distant metastases as shown in several randomized trials. The sole indication for induction chemotherapy in patients with advanced laryngeal cancer is as an alternative to laryngectomy. The Department of Veterans Affairs Laryngeal Cancer Study Group trial demonstrated no significant differences in survival in patients who received induction cisplatin/5-FU and radiotherapy or total laryngectomy and postoperative radiotherapy. An alternative approach utilizing cisplatin or carboplatin alone or combined with 5-FU, administered simultaneously with radiotherapy, is under investigation. Pilot data suggest that this approach may be more effective in improving locoregional control and hence survival. Three intergroup prospective, randomized trials currently are comparing sequential chemoradiotherapy, simultaneous chemoradiotherapy, and standard radiotherapy alone in advanced nasopharyngeal cancer, advanced resectable laryngeal cancer, and unresectable cancers from other sites in the head and neck. These trials are designed to definitively address questions of treatment modality sequence and its impact on pattern of failure and survival.
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PMID:Overview of platinum chemotherapy in head and neck cancer. 752 91


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