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)

DNA ploidy and S-phase fraction were measured by flow cytometry in the tumour tissue of 87 patients with disseminated malignant melanoma, who had been classified either as responders or with progressive disease in a study of the effects of 2 chemotherapeutic regimens. The patients had been randomized to receive treatment with dacarbazine (DTIC) and vindesine (Eldesine) with or without addition of cisplatin (Platinol). Tumour tissue was obtained from both the primary tumours and the last histologically verified metastases, but in some cases only the primary tumours or the last metastases could be evaluated. There was a significantly higher mean S-phase value in melanoma metastases from patients with complete or partial responses compared with patients with progressive disease. Neither the S-phase fraction of the primary tumour, nor the DNA ploidy of the primary tumour or of the last histologically verified metastases taken before inclusion into the study were associated with therapeutic response. In the multivariate analysis, both the anatomical location of the metastases and the S-phase fraction measured on the last metastases remained significant prognostic factors of response. In the univariate survival analysis, there was an association between high S-phase fractions of the metastases and longer survival. In the multivariate survival analysis, the S-phase fraction, the number of involved metastatic sites and the treatment response were independent predictive factors. We conclude that, in disseminated melanoma treated with chemotherapy, a high S-phase fraction measured in the last histologically verified metastases is associated with a higher response rate and a longer survival. Our results clearly support the role of S-phase measurement as a potential tool for selecting patients for treatment.
 ...
PMID:Correlation of DNA ploidy and S-phase fraction with chemotherapeutic response and survival in a randomized study of disseminated malignant melanoma. 854 85

Infusional 5-fluorouracil (F) with cisplatin (C) and epirubicin (E), so-called infusional ECF, is a highly active new schedule against locally advanced or metastatic breast cancer. Cisplatin, however, is a major contributor to toxicity and usually requires inpatient treatment. In an attempt to overcome this, we have investigated the effect of substituting carboplatin for cisplatin in our original infusional ECF regimen. Fifty-two patients with metastatic (n = 36) or locally advanced/inflammatory (n = 16) breast cancer were treated with 5-fluorouracil 200 mg m-2 day-1 via a Hickman line using an ambulatory pump for for 6 months, with epirubicin 50 mg m-2 intravenously (i.v.) and carboplatin AUC5 i.v. every 4 weeks, for six courses (infusional ECarboF). The overall response rate (complete plus partial) was 81% (95% CI 67%-90%), with a complete response rate of 17% (95% CI 6-33%) in patients with metastatic disease and 56% (95% CI 30-80%) in patients with locally advanced disease. Median response duration and survival for metastatic disease was 8 and 14 months respectively, and two patients with locally advanced disease have relapsed. These results are very similar to those previously achieved with infusional ECF. Severe grade 3/4 toxicity was low. Infusional ECarboF is a highly active, well-tolerated, outpatient regimen effective against advanced/metastatic breast cancer and now warrants evaluation against conventional chemotherapy in high-risk early breast cancer.
 ...
PMID:Phase II study of continuous infusional 5-fluorouracil with epirubicin and carboplatin (instead of cisplatin) in patients with metastatic/locally advanced breast cancer (infusional ECarboF): a very active and well-tolerated outpatient regimen. 856 48

Between June 1987 and May 1991, 30 patients with Stage IIIB cervical cancers were treated using synchronous radiotherapy, 5-fluorouracil (5-FU), and daily low-dose cisplatin. External radiotherapy (3,600-3,960 cGy) was given to the whole pelvis in 4 weeks. Two courses of intracavitary brachytherapy were given 2 weeks later. Parametrial boost was then given. Continuous infusion of 5-FU 750 mg/m2 was given for 5 days during the first and third week of pelvic irradiation. Cisplatin (6 mg/m2) was given 30 min before every irradiation in the second and fourth week. The complete response rate was 87%. The 3-year local control rate was 77%. The 3-year overall and disease-free survival rate was 66% and 56%, respectively. Distant metastases were the major causes of treatment failure. Toxicities were acceptable. Our preliminary results indicate that this synchronous combination treatment is feasible. Further follow-up is required to determine whether this regimen has a genuine favorable impact on survival and chronic toxicity.
 ...
PMID:Concurrent 5-fluorouracil, daily low-dose cisplatin, and radiotherapy in stage IIIB cervical cancer. A phase II prospective study. 863 38

The aim of this study was to establish the feasibility, evaluate the response rate, and assess the impact on local control and survival in locally advanced (bulky nodal) squamous cell carcinoma of the head and neck (SCCHN) patients treated with neoadjuvant chemotherapy consisting of cisplatin followed by continuous infusion of vindesine and fluorouracil with intermittent i.v. folinic acid. Eligibility criteria included histologically proven SCCHN, previously untreated locally advanced stage III-IV with measurable or evaluable disease, no distant metastases, an Eastern Cooperative Oncology Group (ECOG) performance status of less than 2, patient age of at least 18 years, and adequate bone marrow, hepatic, and renal functions. The protocol consisted of three cycles (day 1, day 21, day 42) of Cisplatin (CDDP) 100 mg/m2/day i.v. on day 1 immediately followed by 4 days (96 h) of continuous infusion of vindesine 0.8 mg/m2/day and 5-fluorouracil (5-FU) 600-700 mg/m2/day with folinic acid 150 mg/m2 i.v. every 6 h x 16 doses before locoregional treatment with radiotherapy preceded by radical surgery when appropriate. Twenty-nine patients were enrolled in this study, and 28 were evaluable for activity; an objective response rate of 55% (four complete responses, 12 partial responses) was achieved. Leukopenia and mucositis were the most frequent and severe toxicities. The addition of vindesine did not improve the activity of the CDDP-FU-folinic acid combination, but this may be partly because of the particularly poor prognosis of the present patient population, with 75% of stage IV bulky nodal disease (N2c-N3).
 ...
PMID:Neoadjuvant chemotherapy with cisplatin-vindesine-5-fluorouracil and folinic acid for locally advanced head and neck carcinoma. 867 4

A prospective, single arm, phase-II trial was performed to assess the efficacy and local toxicity of the combination of low doses of platin and pelvic radiotherapy in patients with locally advanced carcinoma of the cervix. January, 1993, through August, 1994, twenty-three previously untreated patients with squamous carcinoma (stages IIB-IIIB UICC) entered the study. All patients were examined by a gynecologist and by a radiation oncologist and then submitted to conventional pretreatment staging procedures. Nine patients were classified as stage IIB and 14 patients as stage IIIB. Radiotherapy consisted of 60 Gy external beam irradiation (46 Gy to pelvis + 14 Gy boost to cervix uteri and parametria) plus one low dose rate intracavitary treatment to a dose of 8 Gy to point A. Cisplatin (3 mg/m2/day) or carboplatin (12 mg/m2/day) was also given for 6 weeks starting on radiotherapy day 1. The treatment was well tolerated and no patient required radiotherapy discontinuation. With a median follow-up time of 20 months, complete response was seen in 74% (17/23) of the patients. One of the 17 patients who achieved a complete remission, during follow-up, relapsed in the pelvis and one developed lung metastases. Total failure rate in the pelvis was 30.5% (7/23). Distant metastases were observed in 17.5% (4/23) of the patients. Actuarial overall and disease-free survival rates at 33 months were 69.1% and 65.2%, respectively. Late gastrointestinal toxicity (grade 3) occurred in 8.6% (2/23) of patients, with one patient developing a rectal ulcer-which was submitted to colostomy- and one patient a vaginal necrosis. The combination of platin and radiotherapy appears to be an effective regimen for the patients with locally advanced carcinoma of the cervix and caused a relatively low rate of late gastrointestinal complications.
 ...
PMID:[Locally advanced carcinoma of the cervix uteri (stage IIB-IIIB TNM-UICC): radiotherapy combined with simultaneous daily low-dose platinum. Phase II study]. 869 31

A phase I trial was performed to investigate the tolerability and efficacy of the novel nucleoside analogue gemcitabine in combination with cisplatin in the treatment of advanced non-small cell lung cancer. Both cisplatin and gemcitabine were administered as 30 min infusions weekly x 3 with a week of rest. There was one dose escalation of cisplatin from 25 mg/m2 (dose level 1) to 30 mg/m2 (in subsequent dose levels 2-5), such that the mean dose intensity for the weekly x 3 q 4 week cycle was 22.5 mg/m2/week which is close to that achieved with 100 mg/m2 bolus monthly. Gemcitabine was initiated at 1000 mg/m2 (dose levels 1 and 2) then escalated by 250 mg/m2/week to 1750 mg/m2 (dose level 5). Of 32 chemotherapy-naive patients entered (22 males, 10 females; median age 61 years, range 29-74 years), 11 had localized tumours (2 stage IIIa, 9 IIIb) and 21 had stage IV tumours with haematogenous metastases and a poor prognosis. Twenty-one patients had adenocarcinoma, 4 squamous cell carcinoma, 6 large cell undifferentiated tumors, and one had mixed squamous and adenocarcinoma. Dose-limiting toxicity was not seen in more than one patient in cycle 1 at any dose level. Grade 4 granulocytopenia and thrombocytopenia occurred more frequently with repeated dosing, necessitating dose reductions except at the lowest dose level (cisplatin 25 mg/m2, gemcitabine 1000 mg/m2). Non-haematological toxicity was mild and rapidly reversible. Cisplatin administration led to a higher frequency of nausea and vomiting than that seen with gemcitabine alone, but this was easily controlled with antiemetics. In the 28 patients evaluable, to date responses have been seen at most dose levels, with an overall response rate 35.7%. This phase I trial is ongoing and further dose escalation is intended to determine the MTD of gemcitabine.
 ...
PMID:Phase I trial of gemcitabine and cisplatin in advanced non-small cell lung cancer: a preliminary report. 869 17

Cisplatin-based conventional chemotherapy followed by surgery can cure 80-70% of disseminated testicular cancers. Effective salvage therapy is required for the remaining 20-30% of patients. High-dose chemotherapy (HDCT) combined with autologous stem-cell rescue for refractory testicular tumor results in about 10-20% durable complete responses. Hematologic toxicity is severe, and about 10% treatment-related deaths were reported in early investigations. Early salvage therapy or first-line therapy using HDCT is under investigation to improve treatment efficacy of the refractory or poor-risk testicular cancer. One of the important findings of these trials is that a platinum analogue may be critical to HDCT for cisplatin-refractory cases. Recent basic research has showed that platinum-containing anticancer drug provokes a complex response in the cancer cells. It is hoped that investigation of the mechanism of cisplatin-resistance or development of a new platinum complex will overcome the limitations of salvage chemotherapy for this disease. Finally, several investigators reported that highly selected chemorefractory patients, even with positive tumor markers, have definite potential for cure with surgical resection of localized metastatic disease. Thus, salvage surgery may be indicated for patients refractory to all potentially curative chemotherapeutic regimens.
 ...
PMID:[Salvage therapy for refractory testicular cancer]. 875 99

In order to improve the results obtained by cystectomy alone and to determine the possibilities of conservative treatment in invasive bladder cancer, we designed a prospective study using a combination of 5-FU--Cisplatin and concomitant radiation therapy, followed either by cystectomy or additional chemoradiotherapy. Sixty six patients (pts) with T2-T4 operable untreated invasive bladder cancer were entered into the study. Treatment was begun in all patients by trans-urethral resection (complete in 30 pts) and followed by 5-FU-Cisplatin combination with concomitant bifractionated split course radiation therapy. The neo-adjuvant irradiation dose was 24 Gy delivered in 8 fractions over 17 days, according to a modified bifractionated split course schedule. Each fraction delivered 3 Gy, twice on day (D1, D3, D15 and D17. The patients received concomitant Cisplatin (15mg/m2/d) and 5-FU (400mg/m2/d) on day D1, D2, D3 and D15, D16, D17. A control cystoscopy was performed six weeks after completion of the neoadjuvant program. Patients with persistent tumor underwent cystectomy. Complete responders were treated either by additional chemoradiotherapy (group A) or cystectomy (group B). At control cystoscopy, 51 of the 66 patients (77%) had histologically documented complete response. Among the 51 patients with complete tumor regression 31 were treated by conservative chemoradiotherapy and 20 underwent cystectomy. With a mean follow-up of 35 months, five responders developed recurrent pelvic disease (4/31 in group A and 1/20 in group B). Metastatic disease, which developed in 22 patients, occurred more frequently in the non responders (93%) than in responders (16%). Disease free survival at 5 years was 51%; it was significantly better in responders than in non responders. There was no difference in survival between groups A and B. This neoadjuvant chemoradiotherapy combination, easy to implement and well-tolerated even in elderly patients, provides a high CR rate. It may prove to be effective in inoperable patients and may be proposed as conservative treatment in patients with a complete response to the initial course of chemoradiation.
 ...
PMID:[Infiltrating cancer of the bladder: can radiochemotherapy be an alternative to cystectomy?]. 876 98

Combined radiation and chemotherapy is established as the preferred treatment for primary epidermoid cancer of the anal canal. This approach allows preservation of anorectal function without any apparent decrease in the survival rates obtained in the past with radical surgery. Most experience has been gained with radiation, 5-Fluorouracil (5-FU) and mitomycin C, but radiation, 5-FU and cisplatin are also effective. Regional lymph node metastases can be eradicated by radiation and chemotherapy, but cancers which have metastasized to regional nodes or to extrapelvic organs carry a poor prognosis. Extrapelvic metastases and recurrent pelvic cancer respond poorly to systemic chemotherapy, and to combinations of radiation and chemotherapy. Cisplatin combined with 5-FU is the most effective treatment presently available in such situations. No effective systemic adjuvant therapy has yet been devised.
 ...
PMID:Anal canal cancer: current treatment and results. 887 16

Hepatic arterial infusion chemotherapy (HAIC) using implantable reservoir was performed for liver metastases of gastric cancer and the therapeutic effects were evaluated. A catheter was placed in the hepatic artery via left subclavian artery or by direct insertion at laparotomy. Cisplatin, adriamycin and 5-FU were administered. The liver metastases of gastric cancer without unresectable primary tumors and hepatectomy were divided into two groups, 16 HAIC cases (11 synchronous, 5 metachronous metastases) and 23 systemic chemotherapeutic cases (10 synchronous, 13 metachronous metastases). As a result, HAIC revealed a 62.5% response rate. The 50% survival period was 395 days for HAIC, and it was significantly prolonged compared with 198 days for systemic chemotherapy (p < 0.01). But 4 among 10 cases responding to HAIC showed subsequent extrahepatic spread of the disease. Treatment of these extra-hepatic lesions is difficult.
 ...
PMID:[Evaluation of hepatic arterial infusion chemotherapy for gastric cancer]. 893 89


<< Previous 1 2 3 4 5 6 7 8 9 10