Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on favorable results we reported earlier with the CAP regimen in breast cancer (CAP vs CMFVP), the present study compared the CAP with the FAC regimen, which is so far one of the most active adriamycin containing chemotherapy regimens in breast cancer. The aim of the study was to find the optimal first line treatment and possibly evaluate the role of cis platinum in breast cancer chemotherapy. The CAP schedule consisted of cyclophosphamide 200 mg/m2 i.v. days 1, 3 and 5, adriamycin 40 mg/m2 i.v. day 1, and platinum 30 mg/m2 i.v. day 1, 3 and 5. The FAC schedule included 5-FU 500 mg/m2 days 1 and 8, adriamycin 50 mg/m2 day 1, and cyclophosphamide 500 mg/m2 day 1. One hundred and twenty-six previously untreated patients received greater than 2 cycles and were evaluated. In the CAP arm 15 complete (26%) and 24 partial remissions were observed, resulting in a 67% overall response rate (39/58). The response in soft tissue and visceral organs was notable (78% - 22/28, 71% - 15/21) with an important complete response rate (32%). In the FAC arm there was an overall response in 41% (28/68) of patients, with 8 complete (12%) and 20 partial responses. The difference in overall response, complete response, and response in soft tissue and visceral organs, was statistically significant in favor of the CAP arm (P less than 0.005). Concerning bone metastases there was no difference between the two schedules in response rate, nor in the median remission duration (CAP 11, FAC 10 months). In spite of a somewhat longer median survival in the CAP group, the difference (13 months vs 9 months) was not statistically significant (P = 0.10). Toxicity was moderate and tolerable in both regimens with more pronounced myelosuppression and vomiting in the CAP group. Compared with the FAC schedule the platinum containing combination chemotherapy (CAP) showed higher antitumor activity with no reflection on remission duration and survival.
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PMID:Combination of cyclophosphamide, adriamycin and platinum (CAP) versus 5-fluorouracil, adriamycin and cyclophosphamide (FAC) as primary treatment in metastatic breast cancer: results of a prospective randomized study. 274 Dec 18

The case of a 36 year old patient in whom breast cancer was diagnosed in February 1983 is reported. At the time of the diagnosis bone metastases, were already present. Therapy was started on the basis of a FAC-regimen (Ftorofur-, Adriamycin-Cyclophosphamide), where after the patient developed clinical and laboratory signs of hepatic lesion. At the time of the first FAC-course the suspicion of viral hepatitis of cholestatic type was raised; HBsAg was consistently negative. In the 3rd week after completion of the second FAC-course clinical signs of cholestatic hepatitis with high fever and leucopenia of increasing severity were suggestive of drug-induced hepatitis. Cyclophosphamide was incriminated, therefore, this component was omitted from the subsequent FAC-course. Nevertheless, the clinical manifestations reappeared in a more pronounced form. This time, too steroids were administered, with beneficial effect. In view of the complaints pointed to bone-metastases further cytostatic treatment, Vepesid monotherapy was started, but after the first course the patient developed hepatitis and died. Necropsy revealed, in addition to extensive bone-metastases, microscopic signs of drug-induced hepatitis. The types of liver damage caused by the cytostatic agents used in this study are reviewed. No hepatitis has been reported in connection with these drugs (Adriamycin + Ftorofur or Vepesid) thus far. The diagnostic criteria of drug-induced hepatitis are outlined. It is pointed out that with the eves more extensive use of cytostatic therapy a growing incidence of this complication should be taken into account.
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PMID:Drug hepatitis of cholestatic type in association with a FAC-regimen for breast cancer. 344 15

A clinical phase II study was performed to evaluate the therapeutic efficacy of simultaneously administered aminoglutethimide and polychemotherapy in 31 patients with predominant bone metastases of breast cancer. The majority of patients was postmenopausal and pretreated with hormones and (or) chemotherapy. In 28 evaluable patients an overall objective response rate of 61% was achieved. Patients who received aminoglutethimide and polychemotherapy containing anthracyclines as FAC- or AV-regimen showed the highest objective response rate (67%). Thus, simultaneous combination of aminoglutethimide and polychemotherapy containing anthracycline derivatives is the most effective therapeutic regimen for those patients who were either pretreated or have progressive bone metastases with confinement to bed or have concomitant visceral metastases.
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PMID:[Combination of aminoglutethimide and polychemotherapy for the treatment of predominant bone metastasis in breast cancer]. 378 Apr 35