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)

From a series of 712 patients with melanoma, 38 patients (5.3%) had more than one primary melanoma. Twenty-four patients had two primaries, 11 patients had three, 2 patients had four, and 1 patient had eight. Twelve patients (32%) had one or more synchronous primaries. Forty-five percent of all multiple primaries were diagnosed within the first year. Microstaging by level and depth was determined prior to treatment and in patients with nonsynchronous primaries, 83% had a subsequent melanoma equal or less advanced than the original. Twenty-six patients with Stage I primaries were skin-tested with DNCB prior to therapy. No significant differences in delayed cutaneous hypersensitivity reactions were found between multiple primary and matched controls with only a single melanoma. Four of 10 patients with multiple primaries treated with adjuvant BCG or BCG-tumor cell vaccine developed subsequent melanomas suggesting that immunotherapy with BCG will not prevent the development of a new primary melanoma. Survival in patients with Stage I and II multiple primary melanomas was improved compared to Stage I and Stage II patients with a single primary. This study suggests that prognosis in multiple primary melanomas is better reflected by the most advanced primary based on microstaging and the presence or absence of regional lymph node metastases than by multiplicity.
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PMID:Multiple primary melanoma. 42 33

35 patients with malignant melanomas in different stages were treated with dinitrochlorobenzene according to Malek-Mansour in the last three years. Nine typical cases are demonstrated. The treatment is more effective when the tumor lies close to skin surface and has not yet spread. Distant metastases may react--but normally these metastases cannot be removed. Regarding effects and side effects of DNCB, the methods of treatment and the range of indications are described.
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PMID:[Treatment of malignant melanoma with dinitrochlorobenzene ointment]. 64 Aug 34

Fifty six patients with metastatic cancer of the breast (stage IV) were treated with Cyclophosphamide, 5-Fluorouracil and Cyclophosphamide + 5-Fluorouracil. Tests for delayed hypersensitivity to homologous tumor antigen before treatment were positive in 83.9% and negative in 16.1%. Response to DNCB was positive before treatment in 51.8% and negative in 48.2%. Following chemotherapy the skin reaction, to homologous tumor antigen remained positive, only in 12.6% and negative in 87.4%. The reaction of DNCB remained positive after treatment only in 17.8%. In the remaining 82.2% suppression of the reaction occurred. These data show that chemotherapy may suppress, to a certain excent, immune responses. It is established that among patients who have shown a positive reaction to homologous tumor antigen 55.3% of all cases have displayed objective response to the treatment, and among these with negative skin reactions objective responses were observed in 22.22% of all cases. In patients with positive DNCB reactions objective responses were observed in 79.3% and among the negative ones--in 37.4%.
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PMID:Delayed hypersensitivity reactions in patients with breast cancer. 75 18

Fifty patients with testicular carcinoma, 45 with prostatic neoplasm, 84 with bladder carcinoma, and 13 with benign bladder papilloma were evaluated for skin reactivity to DNCB and other intradermal antigens. Correlation between pathologic staging and skin-test reactivity was sought. Reaction to DNCB among patients with testis tumors was more significantly depressed by chemotherapy than by the extent of retroperitoneal or distant metastatic disease indicating that skin testing as a means of following the course of disease or of predicting survival may be limited by alterations caused by chemotherapy. DNCB reactivity did not correlate with the prognosis for the different stages of disease, but follow-up studies of individual patient survival are needed for substantiation. Depression of DNCB reactivity exists among patients with prostatic carcinoma whether the disease is localized or widely metastatic. Only lengthy follow-up will determine if there is any correlation of reactivity with survival in individual patients. DNCB reactivity among patients with bladder tumors shows progressive reduction with increasing stage disease and lends support to the evidence suggesting immune deficiency in patients with bladder neoplasm.
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PMID:Immune evaluation with skin testing. A study of testicular, prostatic, and bladder neoplasms. 94 11

General immune competence was examined 255 breast cancer patients, including 104 operable, 44 locally advanced/inoperable, and 44 with demonstrable metastatic dissemination, all at the time of diagnosis, as well as 63 disease-free long survivors; this was compared with that of 100 normal controls. The parameters employed were PPD and DNCB skin testing, lymphocyte response to PHA mitogen, E-rosette formation, and lymphocyte number. Significant patients, with only 31% showing optimal and 25% showing minimal levels of immune function, as compared with 70% optimal and 2% minimal function in controls. Immune competence was not affected by metastatic involvement of regional lymph nodes. In patients with early, occult metastatic dissemination (as determined in retrospect), the degree of immune competence was found to be identical to that of patients who did not develop disease dissemination. Remarkably, this early phase of tumor spread is not accompanied by immune impairment, such as is evident in clinically demonstrable metastatic disease and, to a lesser degree, in advanced local and regional disease. Since tumor dissemination preceded impairment of general immunocompetence, it emerges as the cause rather than the result of immunosuppression. Long disease-free survivors, who had postoperative irradiation 5-12 years previously, were shown to have a notably low level of immune competence. Lymphocyte response to PHA stimulation was found to be impaired in the earlier stages of disease, while skin DHR was still well maintained; in advanced disease both parameters tend to correlate as total immunologic impairment ensues. The sequence of immunologic events leading up to immunosuppression with disease progress is discussed.
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PMID:Immunocompetence, immunosuppression, and human breast cancer. I. An analysis of their relationship by known parameters of cell-mediated immunity in well-defined clinical stages of disease. 95 63

The concept of whether immune function was related to risk of recurrence was examined in patients with operable breast cancer in whom careful clinical and pathologic staging had been performed. Patients were classified according to the risk of recurrence. The "low risk" group included patients with minimal breast cancer, noninfiltrating cancer, or infiltrating cancer less than 1 cm with negative nodes. The "high ridk" group included patients with lesions greater than 1 cm or who had greater than or equal to 4 nodal metastases or who had macrometastases at Level II or III (apex). In the "intermediate risk" group were patients with infiltrating cancer less than 1 cm or with less than 4 nodal metastases at I only. Immune reactivity was assessed by skin tests, by measurement of absolute lymphocyte count, T and B cells, lymphocyte stimulation by mitogens and a battery of common antigens, serum immunoglobulins and complement levels. There were 134 patients with operable breast cancer and 63 patients with benign breast lesions. The breast cancer patients showed minimal or no impairment of DNCB skin test. Only patients with nodal metastases showed a slight but not significant impairment of DNCB responses (80% were DNCB positive compared to 90% in the controls.) The lymphocyte responses to mitogens were normal in the breast cancer patients, but there was a significant depression of lymphocyte responses to certain recall antigens such as Candida albicans and E coli. The absolute lymphocyte count and the T cell counts were normal, but B cells bearing complement receptors were decreased and B cells bearing sufface immunoglobulins were increased in the breast cancer patients. Analysis of immune function according to the pathologic stage of disease "risk of recurrence" categories showed no correlation with skin tests or lymphocyte levels. A striking and paradoxical finding was the demonstration that patients with "low risk" cancer overall had markedly lower responses to the battery of stimulating mitogens and antigens than found in patients with "high risk" or "intermediate risk" disease. Only the lymphocyte responses to PHA showed a significant linear correlation with increasing pathologic stage or "risk of recurrence." Current evidence from this study suggests that PHA response is markedly influenced by the primary tumor burdenand thus indirectly reflects the risk of recurrence.
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PMID:Immunobiology of operable breast cancer: an assessment of biologic risk by immunoparameters. 96 94

This is a report on first experiences with epifocal DNCB therapy of Malek-Mansour in metastases and primary tumors of melanoma. Clinical, histological, and fluorescencemicroscopical documentation of six cases with melanoma metastases and twelve cases with primary melanomas, treated epifocally with DNCB (solution or ointment) are given. Metastases of melanoma react variably to DNCB, whereas primary tumors especially flat forms the SSM with or without invasion, usually disappeare totally after four to twelve DNCB applications. The results of Malek-Mansour et al. could be confirmed. During the DNCB treatment, which does not require a preceding sensibilization, initial caustic effects, chemosurgical effects, and a longterm "immuno-chirurgical" effect must be distinguished. An apparent immunological effect of treatment is shown by the therapeutical reaction of non-treated metastases. A sensitization to DNCB occurred also in all cases of older patients. Recurrences of melanoma, which could be due to the new method of therapie, did not occur within 18 months.
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PMID:[The nonspecific epifocal Malek-Mansour immunotherapy of malignant cutaneous melanoma using DNCB]. 101 Jul 45

Cellular immunity was assessed in patients with operable squamous cell cancer of the head and neck using in vivo skin tests and in vitro lymphocyte stimulation tests. An expansion of a previous study continued to show that 30 per cent of patients with T1N0M0 lesions were DNCB-negative and that with more advanced lesions there was further impairment. A similar finding was observed in the blastogenic response to phytohemagglutinin and concanavalin A but not pokeweed mitogen. Overall, 40 per cent of patients with resectable cancer had a significant depression of the blastogenic responses to conconavalin A and phytohemagglutinin. This depression ranged from 15 per cent in patients with T1N0M0 lesions to 71 per cent in those with T3N0M0 lesions. Although this depression was more severe in patients with palpable cervical node metastases, it was related more to the size of the primary tumor than to the nodes per se. An exception occurred in patients with large fixed nodes in whom the depression of lymphocyte stimulation was most severe. The absolute T-cell count was also depressed in patients with head and neck cancer. This depression parallelled the lymphocyte stimulation results with phytohemagglutinin and conconavalin A and was progressive with increasing stage of disease. A correlation exists between DNCB negativity and early recurrence and shortened survival. Clinical follow-up study is too short to assess the correlation of in vitro immune function with these clinical prognostic factors.
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PMID:T-cell deficiency in patients with squamous cell cancer of the head and neck. 110 24

2-4 Dinitrochlorobenzene (D.N.C.B.) is a synthetic primary allergenic molecule which has proved to have at least two useful clinical applications as regards neoplastic conditions. As a diagnostic measure, it serves in the detection of global alterations of cellular immunity. As a therapeutical measure, its epicutaneous use has proved to stimulate immune defence reactions loco-regionally if not systemically. This second property finds an important field of application in the treatment of malignant melanoma (M.M.), the reason for this being that natural immune defence reactions seem to play an important role in the natural history of this type of tumor. This review collects literature data on the therapeutical use of D.N.C.B: which, together with personal cases, show that this type of treatment may be proposed as a palliative measure for the treatment of skin metastases or as an adjuvant measure for surgery in the treatment of M.M. with surgically accessible metastases. D.N.C.B. appears to be part of a new therapeutical group, the Biological Response Modifiers (B.R.M.), and would seem to have a place in future treatment protocols associating B.R.M. with other treatment methods (e.g. chemotherapy).
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PMID:D.N.C.B. for malignant melanoma: significance in the treatment strategy. 269 80

At present the available treatment modalities are not therapeutic for disseminated stage III- and IV melanoma. The management of these patients therefore concentrates primarily on effective palliation taking care to improve the quality of life. As an exception from this rule, patients with regional or solitary metastases may be treated vigorously to improve survival: However, (a) regional tumor resection with or without radiotherapy; (b) regional perfusion of tumor-bearing extremities, and (c) indicator chemotherapy, followed by the resection of solitary metastases and sometimes secondary adjuvant treatment with the same cytostatic regimen, will cure only about 20% of these patients. Systemic treatment with cytostatic agents given alone or in combination fail to reproducibly reach an objective remission rate of more than 20% or a gain in median survival of more than 6 months. The addition of biomodulators may even worsen these results and endocrine treatments are rarely helpful. Current research therefore concentrates on defining a well selected patient population with skin-, soft tissues-, and lung-metastases, who will benefit from systemic treatment, as well as on the development of drug derivatives with fewer side effects. Another small step forward may be expected from sophisticated techniques such as linking cytotoxins to monoclonal antibodies for selective cell killing, or rendering tumor cell membranes vulnerable to endogenous and/or exogenous attacks by altering their structure with the help of biomodulators (Interferons, DNCB etc.), or priming lymphokine-activated killer cells for specific lysis of vital tumor-associated antigens. Melanoma remains the cornerstone for testing the efficiency of medical oncology in general.
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PMID:Clinical trials in disseminated malignant melanoma. 330


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