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)

A multicenter phase II trial of carboplatin, a new platinum analog of cisplatin, was carried out in bronchogenic carcinoma at 17 institutions throughout Japan. Of 139 patients enrolled in this trial, 10 were excluded from analysis as inevaluable and the remaining 129 were judged to be evaluable for response and toxic effects by the Extramural Review Committee. Patients were treated i.v. with either 300 or 400 mg/m2 carboplatin every 4 weeks. Responses and toxic effects were assessed at both dose levels. The overall response rate was 17.8% (23/129), with response rates of 28.4% (19/67) for small-cell disease, 7.1% (2/28) for squamous-cell carcinoma, and 6.9% (2/29) for adenocarcinoma. The most frequent toxic effects were thrombocytopenia and leukopenia, with a platelet count of less than 7 x 10(4) microliters recorded in 60 patients (46.5%) and a WBC count of less than 3,000/microliters recorded in 60 cases (46.5%). Vomiting occurred in 28 patients (21.7%). Renal, aural, and neurotoxicities were not seen. Hydration was not required. Carboplatin was demonstrated to be active against lung cancer, especially against small-cell lung cancer.
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PMID:Phase II study of carboplatin in patients with nonresected lung cancer. Japan Cooperative Oncology Group on Lung Cancer. 216 Dec 95

A phase II study of the effectiveness and toxicity of carboplatin in the treatment of metastatic or locally advanced endometrial cancer was carried out by the Southwest Oncology Group. Thirty-two patients were registered in the study and 23 were fully evaluable for response and toxicity. Carboplatin was administered in a dose of 400 mg/m2 at 28-day intervals without concomitant hydration if blood counts had recovered sufficiently. There were seven responses (two complete and five partial responses) among the 23 evaluable patients, for an overall response rate of 30%. Four (two of two complete responders and two of five partial responders) of the seven responding patients remain alive at 839+ to 987+ days from the start of therapy. The two complete responders and one of the partial responders had small-volume disease, which may have contributed to their prolonged survival. Myelosuppression was the most prominent toxicity encountered. Seventeen of 27 patients evaluable for toxicity developed platelet counts of less than 75 X 10(3)/muL during therapy, but no hemorrhagic complications were encountered. Leukopenia was less prominent, with only nine of 27 patients developing white blood cell counts of less than 3.0 X 10(3)/microL. No important nephrotoxicity or neurotoxicity was observed. Emesis occurred in ten of 27 patients but was not dose-limiting. No unexpected toxicities were encountered. Carboplatin appears to be an active agent in the treatment of endometrial carcinoma.
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PMID:Carboplatin therapy in advanced endometrial cancer. 217 83

Thirty-one patients with advanced malignant mesothelioma, previously untreated or having received only one prior cytotoxic regimen, were treated in a prospective, single-arm phase II trial with carboplatin (NSC 241240) at a dose of 150 mg/m2 per day intravenously (IV) for 3 days (450 mg/m2/course). One complete remission and four partial remissions were achieved, yielding an overall objective response rate of 16% (95% confidence interval [CI], 5.4% to 34%). The median duration of remission was 8 months (range, 5 to 17). Nonhematological toxicity was mild (only 12% with World Health Organization [WHO] grade 3 vomiting); 16% suffered WHO grade 3 to 4 hematological toxicity, but there were no life-threatening episodes and no treatment-related deaths. Carboplatin has modest activity against malignant mesothelioma and, because of its low toxicity, has a role in the management of this disease.
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PMID:Phase II trial of carboplatin in the management of malignant mesothelioma. 240 86

Forty four patients with advanced non-small cell lung cancer (NSCLC) were treated with carboplatin (CBDCA; cis-diammine-1, 1-cyclobutane dicarboxylate platinum II) at a dose of 400-450 mg/m2 intravenously every four weeks in a phase II study. Forty three patients were evaluated for response and toxicity. Two patients achieved responses resulting in an overall response rate of 4.7% (95% confidence limits: 0.6-15.8%); one of these had not been treated previously and the other had been treated previously with vinblastine. The durations of their responses were 5 and 7 months, respectively. The response rate in 28 previously untreated patients was 3.6% (1/28; 95% confidence limits: 0.1-18.3%). Myelosuppression was the most commonly found toxicity, and thrombocytopenia especially was dose-limiting. Thrombocytopenia (less than 75,000/mm3) was observed in 12 patients (28%). Leukopenia (less than 3,000/mm3) was observed in 14 patients (33%). No serious infection or bleeding occurred, however. Treatment with 400-450 mg CBDCA/m2 was well tolerated in the good risk patients in this study. Mild to moderate emesis was observed in 28 patients (65%). No renal toxicity, neurotoxicity or ototoxicity was seen. It was demonstrated that CBDCA had little efficacy in NSCLC at the dose and schedule given in the present study.
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PMID:Phase II study of carboplatin in non-small cell lung cancer. 253 7

Eighty-eight patients with stage IIB-III epithelial ovarian cancer were randomised to receive first line single agent cisplatin (100 mg/m2) monthly or carboplatin (400 mg/m2) monthly for up to 5 cycles. Crossover to the opposite analogue occurred with progression or lack of response. All patients were premedicated with i.v. methylprednisolone (500 mg at 0 hours and 250 mg at 3 hours) and the first 20 patients in both groups received lorazepam and prochloperazine for nausea and vomiting. The median number of vomiting episodes per cycle with cisplatin was 16 and with carboplatin 2 (p less than 0.001). In the cisplatin arm 27/40 (67.5%) developed mild renal toxicity, 9/40 (22.5%) WHO grade I neurotoxicity and 18/40 (45%) evidence of ototoxicity at audiometry. To date we have seen no neuro- or ototoxicity with carboplatin and 1/40 (2.5%) have developed WHO grade I renal toxicity. Myelosuppression and anaemia was more common with carboplatin but only 1 episode of grade IV thrombocytopenia has been seen with first line carboplatin. The clinical response rate (CR+PR) for cisplatin was 19/40 and for carboplatin 27/40. Actuarial survival for cisplatin group at 24 months was 50% and for carboplatin group 58% with no significant difference. Carboplatin appears less toxic than cisplatin producing to date similar survival and response as a single agent.
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PMID:A comparison of the toxicity and efficacy of cisplatin and carboplatin in advanced ovarian cancer. The Swons Gynaecological Cancer Group. 265 Jul 22

Carboplatin, a new cisplatin analogue, appears as active as cisplatin in patients with advanced ovarian cancer, but in phase I and II trials has proven significantly less toxic. In single-agent phase II trials, carboplatin has been associated with clinical complete response (CR) rates of up to 13% and overall objective response rates of up to 32% in patients with prior cisplatin exposure. As first-line treatment in phase II trials, single-agent carboplatin has produced clinical CR rates ranging from 9% to 62% and overall objective response rates of 45% to 85%. In phase III trials in this patient population, single-agent carboplatin has been associated with clinical CR rates comparable with or exceeding those of single-agent cisplatin. Phase I/II trials of combination chemotherapy have yielded overall objective response rates of 44% to 75% when carboplatin was combined with either cyclophosphamide or chlorambucil. In randomized phase III trials of combination chemotherapy, response rates similar to those of cisplatin have been achieved. However, toxicities were greatly reduced in the carboplatin-treated patients. The data from these phase I, II, and III trials document that carboplatin is as active as cisplatin in patients with advanced ovarian cancer and is associated with a significantly lower incidence of emesis, ototoxicity, peripheral neuropathy, and renal dysfunction. Thus, carboplatin may become the platinum compound of choice in the first-line treatment of advanced ovarian cancer.
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PMID:Carboplatin in the treatment of ovarian cancer. 265 95

Cisplatin has modest activity in squamous cancer of the oesophagus but substantial toxicity limits its usefulness. Carboplatin (Paraplatin; BM Group), a second-generation platinum analogue, was developed to maintain the antitumour activity of cisplatin and reduce toxicity. Eleven patients with advanced oesophageal cancer were treated with carboplatin. A partial response was seen in 1 patient (9%) and minor responses in 2 cases. The median survival was 12 months in responding patients and 3 months in non-responders. One patient suffered reversible myelosuppression but nephrotoxicity and vomiting were not observed. Carboplatin is well tolerated and may have a role as a less toxic substitute for cisplatin in combination chemotherapy regimens for oesophageal cancer.
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PMID:Carboplatin in the treatment of oesophageal cancer. 267 77

Carboplatin, a cisplatin analog without significant clinical nephrotoxicity, has been evaluated in the treatment of 56 patients with small cell lung carcinoma at a dose of 300-400 mg/m2 iv monthly in a phase II study. Twenty-three patients (41%) achieved a response, including five (9%) complete remissions. Of 30 previously untreated patients, 18 (60%) achieved a response, including three (10%) complete remissions. Median response duration was 4.5 months (range, 2-9). No nephrotoxicity was seen and hydration was not required. Nausea or vomiting occurred in only 24 patients (43%) and was rarely severe. Myelosuppression was dose-limiting: 20 patients (36%) developed leukopenia and eight (14%) developed thrombocytopenia, but leukopenic infections occurred in only three patients. Carboplatin is a very active new agent in the treatment of small cell lung cancer, with less toxicity and better tolerance than cisplatin. It merits further investigation in combination chemotherapy and against non-small cell lung cancer.
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PMID:Carboplatin: a very active new cisplatin analog in the treatment of small cell lung cancer. 298 20

Carboplatin, a cisplatin analogue without significant nephrotoxicity, was used as a single agent in the treatment of 56 patients with small cell lung carcinoma at a dose of 300-400 mg/m2 i.v. monthly. Twenty-three patients (41%) achieved a response including 5 (9%) complete remissions. Eighteen (60%) of 30 previously untreated patients achieved a response. The drug was well tolerated with nausea or vomiting in only 43% of patients and no nephrotoxicity was seen. Myelosuppression was dose limiting and 39% of patients developed leukopenia. In a subsequent study carboplatin in a dose of 300 mg/m2 was used in combination with etoposide 100 mg/m2 i.v. days 1-3, repeating monthly for 4 courses. So far 32 (89%) of 36 evaluable patients have achieved a response. In patients with limited disease 20/23 patients (87%) have responded including 7 (30%) complete remissions. Leukopenia was dose limiting and occurred in 83% of patients. Carboplatin is a highly active new drug in the treatment of small cell lung cancer.
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PMID:Carboplatin (JM8) as a single agent and in combination in the treatment of small cell lung cancer. 300 24

Sixty patients with FIGO stage IIb, IIc, III and IV ovarian cancer were entered into a randomized Phase III study of cyclophosphamide 600 mg/m2 with cisplatin 100 mg/m2, iproplatin 240 mg/m2 or carboplatin 300 mg/m2. Dose modifications were made according to renal function and myelotoxicity. The arms containing carboplatin (CBDCA) and iproplatin (CHIP) were not shown to be significantly different from the cisplatin containing arm with regard to response rate, duration of response and survival. Subjective toxicity showed that cisplatin and cyclophosphamide therapy was associated with more nausea and vomiting (P = 0.0005). The duration of vomiting showed a significant increase with successive courses of chemotherapy for the cisplatin containing arm only (P less than 0.003). The cyclophosphamide/CHIP combination caused significantly more diarrhoea (P less than 0.0006). Alopecia was more severe (P less than 0.02), and neurotoxicity was more common, in patients who received cyclophosphamide and cisplatin (paraesthesiae P = 0.0007, tinnitus P less than 0.00005, deafness P = 0.0018). All three combinations caused cumulative toxicity on haemoglobin (Hb) (P less than 0.001 for each treatment), leukocyte count (WCC) (P less than 0.0005 for each treatment), and platelet count (P less than 0.0005 for each treatment). The degree of fall in Hb for each course of therapy was greater in the cisplatin containing arm compared with the CHIP and CBDCA arms which were not significantly different from each other (P = 0.0005). For WCC the cisplatin/cyclophosphamide regimen was significantly less toxic than CHIP/cyclophosphamide, with CBDCA/cyclophosphamide falling between the two and not being significantly different from either (P = 0.0005). The CHIP containing arm caused more thrombocytopenia than the other arms which were of equal toxicity (P less than 0.0005). Serum creatinine showed a gradual significant overall rise with each course of cisplatin/cyclophosphamide therapy (P less than 0.0005), whereas the CBDCA arm showed no change and the CHIP arm showed a small fall in serum creatinine after most courses of therapy. This study showed that CHIP or CBDCA in combination with cyclophosphamide was less toxic than cisplatin/cyclophosphamide therapy with regard to alopecia, degree and duration of nausea and vomiting, renal toxicity, neurotoxicity and anaemia. The CHIP/cyclophosphamide regimen caused more thrombocytopenia and diarrhoea. The CHIP and CBDCA containing arms caused more leukopenia than the cisplatin containing regimen. Either iproplatin or carboplatin would be an acceptable alternative to cisplatin in chemotherapy regimens, and would result in reduced toxicity.
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PMID:Comparative toxicity of cisplatin, carboplatin (CBDCA) and iproplatin (CHIP) in combination with cyclophosphamide in patients with advanced epithelial ovarian cancer. 305 7


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