Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with unresectable, previously untreated head and neck cancer were given cis-diamminedichloroplatinum (II) (DDP), 3 mg/kg, with mannitol diuresis (day 1), followed by a continuous infusion of bleomycin, 0.25 mg/kg/day, days 3 through 10, after an initial loading dose of 0.25 mg/kg by rapid IV injection on day 3. The DDP was repeated on day 22, following which radiotherapy was delivered using standard doses, fractionations and portals. Patients were evaluated for response on day 22 and again at the conclusion of radiotherapy. Of 21 patients evaluable at day 22, there were four CR and 11 PR (greater than 50% reduction of all measureable disease), for a major response rate of 71%. Of five MR, four showed 30-60% reduction at the primary site. Of 16 who have finished the radiation phase of treatment, there are six CR, five PR and one MR with durations four to eight months. Toxicity in 33 patients included vomiting (33), alopecia (33), WBC less than 3000 (five), platelets less than 100,000 (one), dose-limiting mucositis during bleomycin (six) and peak serum creatinine greater than 2 (five), with one fatality. The regimen thus appears promising as initial therapy for the previously untreated patient. The same chemotherapy has produced much less encouraging results in prviously treated patients.
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PMID:Combination therapy of advanced head and neck cancer: induction of remissions with diamminedichloroplatinum (II), bleomycin and radiation therapy. 7 60

Between June 1974 and January 1976, 50 patients with metastatic non-seminometous testicular carcinoma were treated with the VAB II protocol. The induction phase consisted of vinblastine (0.4 mg/kg) and actinomycin D (0.02 mg/kg) on day 1. Bleomycin (0.5 mg/kg) was given by continuous infusion for 7 days, and cis-diammine-dichloroplatinum (II) (DDP) (1 mg/kg) was given on day 8. A weekly maintenance of vinblastine and bleomycin, with actinomycin D and DDP on a rotating schedule was given followed by vinblastine, actinomycin D and chlorambucil every 3--4 weeks. Therapy was discontinued after 30--36 months of treatment in the face of continued remission. The response rate was 50% CR, 34% PR with 60% CR and 36% PR in previously untreated patients. Second-look surgery and excision of residual lesions was performed in selected cases. Alopecia, mucositis, nausea, and vomiting were universal. One patient died in the postsurgical period of toxicity from the combination of bleomycin and high concentrations of oxygen. There were seven instances of allergic reactions to DDP. Eleven of 25 complete responders and 4 partial or minor responders who underwent excision of stable disease remain alive from 19 to 35 months following start of therapy, 12 of them without evidence of disease.
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PMID:Germ cell tumors (II): VAB II in metastatic testicular cancer. 8 73

Eleven patients with measurable, previously treated oat-cell carcinoma of the lung received DDP 80 mg/m2 once every three weeks. The drug was given as a 6-hour infusion. In 4 patients a partial remission was achieved: 2 others showed a minor tumor regression. The main toxicity was vomiting, whereas generally myelosuppression and nephrotoxicity were manageable. Based on these preliminary data, a further investigation of DDP in the treatment of oat-cell carcinoma of the lung is definitely warranted.
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PMID:[Preliminary results of a phase-II study with DDP (cis-diaminedichloro-platinum) in the small cell bronchogenic carcinoma]. 22 37

Cisplatin (cis-diammine-dichloro-platinum) administered at a dose of 3 mg/kg iv induced a reproducible and characteristic emetic response in the dog. It was characterized by a latency period (90-120 min) and multiple emetic episodes occuring within 5 hours following drug administration with sporadic delayed emesis later within the first 24 hours. There was a qualitative similarity between the emetic response of Cisplatin seen in dogs and cancer patients. Metoclopramide (1, 3 mg/kg sc) was found to be the most effective antagonsit of Cisplatin emesis in the dog while haloperidol (1 mg/kg sc) and chlorpromazine (0.3, 1, 3 mg/kg sc) offered a less complete protection. Nabilone (0.1 mg/kg iv) and AL-1612 (1 mg/kg sc) failed to to demonstrate any significant activity. A relationship between antagonism patterns of emetic responses induced by Cisplatin and apomorphine was discussed.
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PMID:Antagonism of cisplatin induced emesis in the dog. 44 17

cis-Dichlorodiammineplatinum(II) (DDP), at a dose of 15 mg/m2/day x 5 consecutive days, was administered to 68 evaluable patients with metastatic soft tissue and bony sarcomas. All patients, except one, had received extensive prior chemotherapy and had had progressive disease at the start of the study. Responses observed included one complete response in a patient with mesothelioma and three partial responses in patients with soft tissue sarcomas (7%). No responses were seen in 18 patients with bony sarcomas. Significant leukopenia and thrombocytopenia were observed in less than 20% of evaluable courses, although two patients manifested life-threatening leukopenia (less than 1000 cells/microliter) and three had life-threatening thrombocytopenia (less than 24,000 cells/microliter). Nephrotoxicity was noted in less than 25% of evaluable courses. Nausea and/or vomiting was recorded in 55% of evaluable courses. DDP is considered to be marginally active in the secondary treatment of metastatic sarcomas at this dose and schedule. Further studies of DDP in mesothelioma are indicated.
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PMID:Cis-dichlorodiammineplatinum(II) in advanced soft tissue and bony sarcomas: a Southwest Oncology Group Study. 57 67

The preliminary results of Cycloplatin in non small cell lung cancer were presented. Cycloplatin is a new derivative of Cisplatin but less nephrotoxic. Its. referring preparation is Carboplatin 14% remissions were found in the cases of inoperable non small cell lung cancer and 12% remissions in advanced ovarian cancer. 84% of patients suffered from vomiting what was the most common reported side-effect.
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PMID:[Studies of the clinical use of cycloplatin--a new derivative of cisplatin]. 133 30

Cisplatin has many toxic effects; emesis, impairment of renal function, myelosuppression, peripheral neuropathy, ototoxicity and renal tubular wasting. We used MVP regimen (Mitomycin C, Vp-16, and Cisplatin) in advanced Non-Small Cell Lung Cancer (NSCLC). Using hydration and prophylactic supplementation of sodium and potassium before and during chemotherapy, we have observed the development of hyponatremia in 48 courses (43%), hypokalemia in 23 courses and hypomagnesemia in 11 courses. Some patients showed abnormalities of renal function in 16 courses. All the electrolyte depletion and renal problem was corrected before next courses by hydration and replacement of the wasting. Frequent measurement of serum cation and appropriate replacement are recommended when high dose Cisplatin containing regimen is used in chemotherapy of neoplasms.
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PMID:Renal salt wasting in patients treated with high-dose cisplatin, etoposide, and mitomycin in patients with advanced non-small cell lung cancer. 133 77

Cisplatin is generally accepted to be the most active cytotoxic agent for the treatment of ovarian cancer but the optimum dose remains unclear. We have performed a randomised trial to assess the importance of cisplatin dose in the treatment of advanced epithelial ovarian cancer. Patients were randomly assigned treatment with 50 mg/m2 (low dose) or 100 mg/m2 (high dose) cisplatin plus 750 mg/m2 cyclophosphamide, for a maximum of six cycles with intervals of 3 weeks. We planned to recruit 300 patients, but an interim analysis on the first 165 indicated a highly significant survival difference (p = 0.0008). Recruitment was therefore stopped and the trial patients were followed-up for 12 months longer. The relative progression rate (high-dose/low-dose) after 12 months' extra follow-up was 0.55 (95% confidence interval 0.37-0.81, p = 0.003) and the relative death rate 0.53 (0.34-0.81, p = 0.003). Overall median survival was 69 weeks in the low-dose group and 114 weeks in the high-dose group. Residual disease extent before chemotherapy had an important influence--patients with lesions of less than 2 cm did best; if given high-dose cisplatin their median survival was 3 years. 56 low-dose and 45 high-dose patients completed six cycles of chemotherapy; 15 and 9 patients, respectively, were withdrawn early because of progressive disease and treatment was stopped in 6 and 25, respectively, because of unacceptable side-effects or patient refusal. Toxic effects were significantly greater in the high-dose group, especially those on the nervous system and ears, alopecia, vomiting, and anaemia. Although the higher dose of cisplatin clearly leads to better results in terms of survival, its overall clinical benefit in the management of ovarian cancer will depend on further improvements in measures to alleviate toxic effects.
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PMID:Randomised study of two doses of cisplatin with cyclophosphamide in epithelial ovarian cancer. 135 47

Cisplatin may evoke both an acute emetic response during the first 24 hours following treatment and a less well-recognized syndrome of delayed emesis. While delayed emesis is usually less severe in terms of frequency of vomiting episodes, the problem continues to result in significant morbidity. In comparison with acute emesis, the exact pathogenesis of the delayed emesis syndrome remains unclear. Although a combination of oral metoclopramide and dexamethasone is effective in many patients in preventing delayed emesis, almost 50% continue to experience at least one emetic episode when treated with this regimen. A phase III multicenter study has evaluated oral ondansetron versus placebo in the prevention of the delayed-emesis syndrome in 50 patients during days 2 through 5 following high-dose cisplatin administration. Although the daily rates of complete emetic control, failure, and control of nausea favor ondansetron, this trial is statistically inconclusive in establishing efficacy of ondansetron as a single agent in the prevention of delayed emesis. Ondansetron was well tolerated in the dose and schedule used.
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PMID:The delayed-emesis syndrome from cisplatin: phase III evaluation of ondansetron versus placebo. 138 53

Cancer patients consistently rank nausea and vomiting as the most feared side effects of treatment. Cisplatin, one of the most active chemotherapeutic agents, causes acute emesis and a delayed emesis syndrome, which also results in considerable patient morbidity. Despite the use of metoclopramide-containing combination regimens, approximately one third of cisplatin-treated patients continue to experience emesis. In recent years, considerable progress has been made in managing chemotherapy-induced emesis. This review discusses several factors that have contributed to improved antiemetic control, including standardization of antiemetic trial methodology, insight into the pathogenesis of chemotherapy-induced emesis, and the development of a new class of antiemetic agents, the serotonin antagonists. In clinical studies performed to date, these agents have generally proven to be both effective and safe. Three multicenter trials of the selective serotonin antagonist ondansetron in the prevention of nausea and vomiting from cisplatin are reviewed.
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PMID:Advances in the control of chemotherapy-induced emesis. 139 Mar 17


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