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)

The French Epirubicin Study Group carried out a randomized trial comparing epirubicin alone 75 mg/m2 with fluorouracil (5FU) 500 mg/m2, cyclophosphamide 500 mg/m2, and epirubicin 50 mg/m2 (FEC 50) and 5FU 500 mg/m2, cyclophosphamide 500 mg/m2, and epirubicin 75 mg/m2 (FEC 75) as first treatment for advanced breast cancer patients. Patients were stratified according to whether or not there were bone metastases only. Four hundred twelve patients entered this trial; 378 were assessable for tolerability and 365 for efficacy. The overall response rates were comparable between FEC 50 (44.6%) and FEC 75 (44.7%), but both were better than the epirubicin alone (30.6%) (P = .04 and P = .0006, respectively). The complete response rate was better in FEC 75 (15.5%) than in FEC 50 (7%) (P = .025) or epirubicin (4%) (P = .002). Similar results were obtained in the group of patients without bone-only metastases. No difference in the three treatments was observed in the patients with bone metastases only. Mean durations of response were similar in the three groups, being 412 days, 440 days, and 350 days for FEC 50, FEC 75, and epirubicin, respectively. Patients without previous adjuvant chemotherapy fared better than those with previous treatment (without anthracyclines). Tolerability was fair in the three groups. Overall, the epirubicin-alone group showed better tolerance than the two other groups, which did not differ significantly. Time to progression and survival were not different among the three groups, but more early relapses occurred in the epirubicin and FEC 50 groups; survival seemed to be better during the first 8 months in the FEC 75 group, and the survival difference between the epirubicin group and the FEC 75 group was of borderline significance. No difference in survival was observed between epirubicin- and FEC 50-group patients, even though the response rate was significantly worse in the monochemotherapy group.
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PMID:A prospective randomized trial comparing epirubicin monochemotherapy to two fluorouracil, cyclophosphamide, and epirubicin regimens differing in epirubicin dose in advanced breast cancer patients. The French Epirubicin Study Group. 204 73

An ongoing trial of combination chemotherapy using ifosfamide (Holoxan), epirubicin and 5-fluorouracil was started in 1987. A total of 30 patients with metastatic cancer of the breast received 1.5 g/m2 i.v. ifosfamide over 60 min on days 1-3, 50 mg/m2 i.v. epirubicin on day 1 and 500 mg/m2 i.v. 5-fluorouracil on day 1, followed by mesna (Uromitexan) given at 20% of the ifosfamide dose at 0, 4 and 8 h. The courses were repeated every 4 weeks. In all, 198 courses were given, ranging from 3 to 13 (median, 7) cycles/patient. The mean age of the 30 patients was 48 years (range, 35-66 years); 5 had not previously received chemotherapy and the others had failed prior cytotoxic and endocrine therapy. Overall, 28 patients were evaluable, 7 (25%) showed a complete response and 15 (54%) had a partial response, for an overall response rate of 22/28 (79%). Three patients showed stable disease with improved symptoms, and in three cases disease progression occurred. The median duration of response was 9 months (range, 3-20 months). Median survival was 11 months for all patients, 15 months for CRs, 10 months for PRs, 6 months for stable disease and 12 months for progressive disease (PD). Survival for the 22 responding patients was 12 months. Toxicity was acceptable and included alopecia, mucositis, nausea, vomiting, diarrhoea, mild cystitis and myelosuppression. Epirubicin did not appear to produce cardiac toxicity, and ifosfamide with mesna did not seem to result in severe urotoxicity. Chemotherapy with ifosfamide, epirubicin and 5-fluorouracil proved to be effective for treatment of advanced breast cancer and should be further studied in large, controlled trials.
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PMID:Treatment of metastatic breast cancer with the combination of ifosfamide, epirubicin and 5-fluorouracil. 234 52

Epirubicin (epiDX) pharmacokinetics was followed in 10 advanced cancer patients with hepatic metastases from colorectal carcinoma or primary liver tumor after single bolus administration (20-40 mg) in the hepatic artery, through a surgically implanted catheter and subcutaneous access port. EpiDX plasma and whole blood concentrations follow a triphasic decay qualitatively similar to that observed after IV administration. Blood levels are consistently higher than plasma levels. Plasma clearance (nine patients, mean: 93.4 l/hr; range: 69.3-129.5 l/hr) is higher than the corresponding parameter determined in patients with hepatic metastases after intravenous therapy. The remaining patient is characterised by an abnormally low plasma clearance (13.6 l/hr), due to a hepato-pulmonary shunt. The subjects in this study were exposed to very low drug concentrations, and therefore experienced no relevant adverse side-effects.
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PMID:Intrahepatic arterial administration of 4'epidoxorubicin (epirubicin) in advanced cancer patients. A pharmacokinetic study. 347 Jan 78

Epirubicin was applied in combination with vincristine and cyclophosphamide (VEC) against metastatic cancer of the breast in 14 patients, against advanced cancer of the ovaries. Epirubicin was applied in combination with cisplatin and cyclophosphamide (PEC) in 12 patients. Treatment of metastatic cancer of the breast achieved retrogression in 64%, the tumor was brought to a standstill in 12%. Treatment of cancer of the ovaries achieved complete retrogression in 75%, the tumor was brought to a standstill in 8.3%. There was no incidence of considerable myelo- or cardiotoxic side effects resulting in a necessary interruption of treatment. The achieved results of this treatment correspond to those with doxorubicin combinations, the toxicity, however, is less.
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PMID:[Epirubicin in combination chemotherapy of metastasized breast cancer (VEC) and advanced ovarian cancer (PEC)]. 352 66

We have studied the metabolism and pharmacokinetics of epirubicin (4'-epidoxorubicin), as compared to those of doxorubicin, in a total of 16 patients with metastatic breast cancer. Epirubicin metabolism markedly differs from that of doxorubicin, in that large amounts of glucuronides of epirubicinol and epirubicin were observed in plasma as well as in urine samples. The total plasma clearance of epirubicin was significantly higher than that of doxorubicin; this was interpreted as due to an increase of the distribution volume of epirubicin, since the terminal plasma half-lives of both drugs were similar. No significant modifications were observed in patients with hepatic metastases. The differences in the pharmacokinetic and metabolic properties of the two drugs may be responsible for the differences in toxicity that have been noticed between them in previous phase I and II studies.
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PMID:Comparative pharmacokinetics and metabolism of doxorubicin and epirubicin in patients with metastatic breast cancer. 389 93

A 49-year-old female presented with a low abdominal tumor. Before operation, she had neither evidence of androgen excess nor abnormal tumor marker values, but US, CT and MRI findings strongly suggested the possibility of a malignant ovarian tumor. Her operative findings were as follows: a goose egg-sized main tumor in the low abdomen, with a walnut-sized tumor in the right side, which grew around the right ureter, causing right non-functional kidney. Pathological examination revealed her tumor was a very rare type of malignant Sertoli-Leidig cell tumor with pelvic lymph nodes metastases. Most patients with this disease usually have good prognoses, but with metastasis or recurrence, no therapy is as effective as in epithelial ovarian cancer. In this case, we selected a new combination chemotherapy of CBDCA, Etoposide and Epirubicin, considering current changes in the chemotherapy for ovarian germ cell tumors and Sertoli-Leidig cell tumors of testis. Now, 1 year and 4 months after operation, she has no evidence of recurrence or metastasis. This study proposes a new, presumably more effective chemotherapy for an ovarian malignant Sertoli-Leidig cell tumor.
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PMID:[A case of ovarian malignant Sertoli-Leidig cell tumor treated with CBDCA, etoposide and epirubicin chemotherapy]. 757 20

A total of 46 consecutive patients were entered into this study to assess the efficacy and toxicity of an epirubicin/ifosfamide combination in treating locally advanced and/or metastatic adult sarcomas (38 soft-tissue sarcomas and 7 bone sarcomas in 45 evaluable patients). Epirubicin was given at escalating doses (from 50 to 100 mg/m2) as an intravenous (i.v.) bolus on day 1, and ifosfamide was given i.v. at 1.2 g/m2 daily on days 1-5. Cycles were repeated every 4 weeks. The overall response rate was 38% (17 of 45 patients), reaching 42% (16 of 38) in the soft-tissue sarcoma group and 44% (17 of 39) in patients who had not been treated previously. In all, 4 complete responses (CRs, 9%) and 13 partial responses (PRs, 29%) were obtained. Most responses (about 68%) were reached within the first 2 cycles. The high-dose intensity of epirubicin (P < 0.04), the histologic type (P < 0.03), the presence of metastatic lesions only (P < 0.01), and the lack of previous treatment (P < 0.04) were found to be positively correlated with the probability of response. The median duration of response was 8 months. The median survival period was 10 months for all evaluable patients and 21 months for those achieving CRs and PRs (P < 0.01). The tumor grade, performance status, and extent of disease at entry into the study correlated with survival. The treatment was well tolerated; no case of sepsis occurred, and neither acute nor cumulative cardiotoxicity was observed. Epirubicin in combination with ifosfamide is therefore effective in advanced and/or metastatic disease with acceptable toxicity. The activity of this combination as compared with that of either of the two drugs given alone at optimal doses needs to be evaluated in prospective randomized trials.
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PMID:Ifosfamide plus epirubicin at escalating doses in the treatment of locally advanced and/or metastatic sarcomas. 845 3

The French Epirubicin Study Group undertook a retrospective study to evaluate the response rate at relapse, time to treatment failure, and overall survival according to previous CMF-type adjuvant chemotherapy in patients who had taken part in two successive clinical trials. The statistical significance of the comparisons was tested after adjustment for the factors that differed most between the two groups. Patients who had received previous adjuvant chemotherapy had a lower response rate (p = 0.03), a shorter time to treatment failure (p = 0.007), and shorter overall survival after relapse (p = 0.008); overall survival after initial diagnosis was not significantly different. With respect to patients with axillary node metastases at the time of diagnosis (N+ patients), those with previous adjuvant chemotherapy had a lower response rate (p = 0.01) and shorter time to treatment failure (p = 0.02), but overall survival after relapse and after initial diagnosis were not significantly different. This retrospective and descriptive study suggests that chemotherapy is less effective after relapse, as measured by response rate and time to treatment failure, in patients with previous adjuvant chemotherapy.
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PMID:Response to chemotherapy after relapse in patients with or without previous adjuvant chemotherapy for breast cancer. The French Epirubicin Study Group. 848 30

Twelve patients with hormone-refractory prostate cancer were treated with combination chemotherapy of etoposide, epirubicin and carboplatin (EEC). At relapse, all patients had metastases to the bone and/or soft tissues. The median number of courses was 3 (range 1-10). Epirubicin was not administered in 6 patients because of heart disease. Three patients (25%) had a partial response and 8 (67%) showed no change. The overall response rate was 92%. Pain relief was observed in 4 patients (44%). Four patients were still alive after a mean observation period of 18 months (range 4-36 months), while 8 died with a mean survival period of 11 months (range 7-15 months). Nausea, appetite loss, and alopecia were observed in some patients. All except one patient experienced bone marrow suppression, 5 of whom were treated with granulocyte-colony stimulating factor. EEC chemotherapy in hormone-refractory prostate cancer is considered to be more effective than other kinds of chemotherapy, whereas it frequently induces bone marrow suppression.
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PMID:Etoposide, epirubicin and carboplatin in hormone-refractory prostate cancer. 873 24

Epirubicin, an anthracycline antitumour antibiotic which is structurally related to doxorubicin, is among the most active single agents used in the management of patients with breast cancer. The drug may be administered alone or in combination with other agents both to patients with early breast cancer and to those with metastatic disease. There is a clear relationship between epirubicin dose and tumour response. Dose intensified regimens have produced improved response rates in patients with advanced breast cancer compared with standard dose therapy; however, improved overall survival has not yet been demonstrated. The combination of epirubicin with newer agents such as vinorelbine or paclitaxel shows considerable promise, as does the use of epirubicin in high dose regimens with peripheral blood progenitor cell support. The major adverse effects of epirubicin are acute dose-limiting haematological toxicity and cumulative dose-related cardiac toxicity. These effects are less severe after epirubicin administration than after equimolar doses of doxorubicin. Other major adverse effects of epirubicin administration include mucositis, nausea and vomiting, reversible alopecia and local cutaneous and vesicant reactions. In summary, epirubicin has an established role in the treatment of both early and advanced breast cancer. Incombination with other highly active agents or in dose intensified regimens administered with haemopoietic growth factor and/or peripheral blood progenitor cell support, epirubicin may play a significant role in emerging breast cancer treatment strategies.
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PMID:Epirubicin. An updated review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of breast cancer. 907 45


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