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

A total of 12 patients with advanced renal cell carcinoma received interferon alpha (3 million units intramuscularly 6 times weekly) and OK-432 (5 KE (Klinische Einheit) intramuscularly twice weekly). Metastatic lesions appeared before operation in six patients and after operation in six patients. Among them 5 patients had received interferon therapy and this combination therapy was started after the judgment of progressive disease for interferon therapy. Eleven pulmonary and 5 bone metastases were evaluable. The median duration of the combination therapy was 89.3 weeks. There were 4 partial responses and no complete responses among the 12 patients, giving a response rate of 33.3%. The median duration of response was 25 months, with a range of 6 to 54 months. Responses were seen predominantly in patients in whom metastases appeared after operation (3 of 4 responders). However, regarding the individual organs, two complete and 2 partial responses were observed among 11 pulmonary metastases and 2 partial responses among 5 bone metastases. The survival period after discovery of the metastasis was 10 to 67 months and the 5-year survival rate was 70.5%. Almost all patients had fever and induration at the injection site. Other side effects included leukopenia, anorexia, and depression. This combination therapy is thought to be effective against bone or other organs metastasis resistant to interferon alone.
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PMID:[Treatment of advanced renal cell carcinoma with interferon alpha and OK-432 (streptococcal preparation)]. 148 85

Continuous subcutaneous infusion of peplomycin was performed on 17 patients with metastatic prostate carcinoma, 9 of whom were refractory to conventional hormone therapy. Peplomycin was administered 5 mg daily through a newly-developed "microinfusion pump" for 14 consecutive days. This therapy was discontinued in 3 patients at the cumulative dose of 35, 35 and 55 mg. The mean cumulative dose was 84.7 mg. One patient who received 140 mg of peplomycin developed pulmonary fibrosis which was so mild that he recovered soon after the conservative therapy was instituted. There were no other episodes of pulmonary toxicities. Other major toxicities observed were anorexia (47%) and fever (41%). Of 15 patients who were evaluable with the response criteria of NPCP, 4 patients achieved objective partial regression (two for pulmonary metastases, one for bone metastases and the other for supraclavicular lymphnode metastases) and the other 11 patients remained stable. No progression of the disease was noted. Continuous subcutaneous infusion of peplomycin is advantageous over the bolus injection for increasing its anti-tumor activity as well as for decreasing its pneumotoxicity. It can also be performed for out-patients without difficulty. We believe this therapy should be incorporated in the multidisciplinary therapy of prostatic cancer.
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PMID:[Continuous subcutaneous infusion of peplomycin for advanced prostatic cancer patients]. 241 47

A 53-year-old man complained of anorexia and abdominal distention of one month's duration. The chest X-ray demonstrated a mass in the left lung with hilar and mediastinal adenopathy and a lytic lesion in the right fourth rib. A transbronchoscopic biopsy of the mass revealed oat cell carcinoma (WHO classification). The endoscopic evaluation also revealed a gastric lesion (IIc type). Biopsy of this lesion indicated signet ring cell gastric cancer. An abdominal CT scan demonstrated multiple liver metastases. Based on these findings, the patient was diagnosed as having synchronous lung and gastric primaries, with liver and bone metastasis from lung cancer. Carboplatin (CBDCA) was administered by intravenous drip infusion of 450 mg/m2. After a second treatment with CBDCA about 3 weeks later, the patient achieved a partial response at the primary site of lung cancer as well as at the liver and bone metastases. In addition, repeat endoscopy of the stomach demonstrated a complete regression. A biopsy specimen taken by gastroscopy was negative for cancer cells. Subsequent chemotherapy for small cell lung cancer was administered with cyclophosphamide, adriamycin, and vincristine, and to date there is no evidence of recurrence. Further studies on CBDCA treatment of small cell lung cancer and gastric cancer are needed to establish the efficacy of this drug against these two histologically different cancers.
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PMID:A case report of synchronous small cell lung cancer and gastric cancer successfully treated with carboplatin. 301 77

A phase II trial was conducted in 57 patients with advanced metastatic breast cancer given 2-N-methyl 9-hydroxy-ellipticine (NMHE) as 100 mg/m2 weekly. Evaluation of response, after at least 4 injections, was possible in 46 patients. Two complete regressions (of 3 and 12 months) and 7 regressions of over 50 p. cent were observed, a total regression rate of 19 p. cent. Regression was mainly observed in cutaneous or subcutaneous metastases. No objective regression was noted for pulmonary or hepatic metastases. Bone metastases were not taken in account when assessing response to treatment. Absence of haematological changes must be emphasized. The most frequent side effects were anorexia, nausea +/- vomiting and dryness of mouth. Major toxicity was intravascular haemolysis, observed in 6 of 175 patients receiving NMHE in the Institut Gustave-Roussy, always controlled by symptomatic treatment. This product, of acceptable efficacy in breast cancer treatment, will probably occupy an original place in anti-cancer chemotherapy because of its lack of myelotoxicity.
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PMID:[2 N methyl 9 hydroxy-ellipticine in treatment of metastatic breast cancers (author's transl)]. 703 78

A group of 135 patients with osseous metastases from breast cancer were treated with hydroxy-9-methyl-2-ellipticinium (100 mg/m2 weekly). Although it was impossible to grade the response precisely, because only indirect criteria are available for assessing the course of bone metastases (radiographs, quantified 99mTc pyrophosphate scintigrams, CEA), it was considered that an objective response was obtained in 44 cases. These responses lasted from 3 to 17 months. The main characteristic of the compound is its lack of marrow toxicity, a valuable property in osseous lesions, where frequent marrow involvement makes it difficult to use conventional drugs. The major and most unpleasant side effect was an inhibition of salivary secretion, which causes other complications such as tongue mycosis, anorexia, and asthenia. Immunologic disorders were less frequent, and four patients developed severe tubular renal insufficiency.
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PMID:Hydroxy-9-methyl-2-ellipticinium for osseous metastases from breast cancer: a 5-year experience. 713 36

Corticosteroids are extensively prescribed in advanced cancer for various specific indications (e.g. spinal cord compression), for pain relief, as hormone therapy and to stimulate appetite and wellbeing. Choice of corticosteroid is dictated largely by local fashion, and times of administration are more traditional than pharmacological. Corticosteroids have many potential disadvantages, some life-threatening (e.g. masked septicaemia). Others are seriously debilitating (e.g. myopathy, avascular bone necrosis). Oropharyngeal candidiasis is a common complication. Corticosteroids are withdrawn in about 5% of patients because of unacceptable adverse effects, including moon-face and diabetes mellitus. Corticosteroid hypersensitivity occurs, and the succinate salts have been associated with bronchospasm. Steroid pseudorheumatism may occur with high dose therapy or when tailing off after a prolonged course. Important drug interactions with corticosteroids relate to salt and water retention, and decreased glucose tolerance. Some anticonvulsants cause an increased clearance of corticosteroids and, with dexamethasone, up to a 50% reduction in the anticipated effect. The benefit of corticosteroids in terms of increased appetite, mood and activity has been demonstrated in several controlled trials. The effect may well be time-limited in most patients. In several studies, corticosteroids have resulted in an analgesic-sparing effect. Some centres use very high doses of dexamethasone in cases of spinal cord compression, although the justification for these is not obvious. Corticosteroids are used to help relieve nerve compression pain and in symptomatic raised intracranial pressure. Corticosteroids are also injected locally into or around bone metastases, particularly ribs and the sacro-iliac joints. Epidural injections are used for patients with troublesome intractable low back pain. Corticosteroids are now used less often in hypercalcaemia because of poor response rates. More benefit is obtained, however, if high dosages are used, e.g. prednisolone 60 to 80 mg/day. Dexamethasone is widely used as an antiemetic in association with chemotherapy. Some centres use dexamethasone by continuous subcutaneous infusion in selected patients when the oral route is not feasible. The choice of starting dose of a corticosteroid is largely arbitrary. It is important, however, not to miss a possible treatment benefit by prescribing too low a dose. For most patients, an initial dosage of prednisolone of 30 to 60 mg/day (dexamethasone 4 to 8 mg/day) is appropriate. In patients with anorexia, there are several alternative options that should be considered. There is evidence to suggest that patients with advanced cancer receiving a corticosteroid are not as closely monitored as other patients. There is a need to state clearly in writing the reason(s) for prescription and to review after 1 or 2 weeks.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The risks and benefits of corticosteroids in advanced cancer. 781 99

The clinical efficacy of "CMF" chemotherapy, (cyclophosphamide, methotrexate, 5-fluorouracil), was evaluated on advanced and recurrent breast cancer. The response rate was 36.1% in 61 evaluable cases, including four CR and eighteen PR. In terms of efficacy classified by metastatic lesion, the effective rates were 51.4% in soft tissue, 28.6% in viscera, and 20.0% in bone metastases. The main side effects were nausea/vomiting, anorexia, and leucopenia. In this study, CMF chemotherapy resulted in good clinical effects, and its response rate was almost the same as that to CMF chemotherapy in Europe and USA, but slightly lower than that to CAF chemotherapy. As to the side effects, the incidence of leucopenia, thrombocytopenia or alopecia was lower in CMF chemotherapy than in CAF chemotherapy. Also, unlike CAF chemotherapy, CMF chemotherapy had no cumulative dose-limitation and showed no cardiotoxicity. In conclusion, CMF chemotherapy is considered to be one of the most useful treatments for advanced and recurrent breast cancer.
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PMID:[Clinical evaluation of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) on advanced and recurrent breast cancer. Clinical study group of CMF for breast cancer in Japan]. 808 46

A 71-year-old man who had undergone a total cystectomy and a transureterocutaneostomy more than a year earlier was admitted to our hospital on February, 1992 because of the chief complaints of anorexia and systemic bone pain due to multiple bone metastases of bladder cancer. At two weeks after the admission, he had a sudden attack of dyspnea. His chest reontgenogram revealed no significant abnormalities. He had repeated attacks and died of respiratory failure two days after the first attack. An autopsy disclosed diffuse microscopic pulmonary tumor emboli in the pulmonary arteries and arterioles of bilateral lungs, but there was no parenchymal metastasis. The metastatic lesions in the sinusoids of the liver were also occupied by numerous tumor emboli, suggesting that the tumor emboli in the lungs had derived from those in the sinusoids. Microembolization of the whole lung area must be considered as a cause of clinically unexplained dyspnea.
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PMID:[Acute respiratory failure resulting from diffuse microscopic pulmonary tumor emboli by bladder cancer: a case diagnosed at autopsy]. 832 32

The scope of supportive care and cancer rehabilitation is very wide and heterogeneous. In this review we focus on nutritional aspects, sexual and gonadal function, psychological rehabilitation, treatment of cancer pain, and rehabilitation of patients with bone metastases. The anorexia-cachexia syndrome is a particularly frequent manifestation of cancer that profoundly affects body image and significantly impairs quality of life of cancer patients. However, enteral feeding through nasogastric tubes, gastrostomies, or jejunostomies is an efficient method for providing long-term enteral nutrition at home and for contributing to complete rehabilitation after cancer therapy. Recent effort has focused on nutritional pharmacology and on the optimalization of the use of appetite-stimulating drugs, such as progestational agents. The psychological components of cancer, anticancer therapy, and quality of life have now been widely recognized and studied. Effective pharmacological and psychotherapeutic interventions help patients and their family to better adjust to the chronic stress of cancer, but more specific determinants of psychological morbidity should be developed. In particular, the safe and efficient use of the most recent classes of antidepressants and anxiolytics should be urgently studied. More than 90% of cancer patients present one or more pain syndromes during their illness. The adequate use of drugs is the cornerstone of treatment. The development on new molecules and new routes of administration opens interesting perspectives for cancer pain control. Bone metastases are the source of considerable morbidity. Intravenous bisphosphonates have been successfully used for the treatment of the symptoms of metastatic bone disease, especially bone pain. Moreover, monthly pamidronate infusions in addition to chemotherapy reduce the mean skeletal morbidity rate by more than one third and contribute to the rehabilitation of cancer patients with bone metastases from breast cancer or with multiple myeloma.
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PMID:The concept of rehabilitation of cancer patients. 925 83

The purpose of this study was to evaluate the antitumor activity of vinorelbine and oral estramustine phosphate in patients with metastatic, hormone-refractory prostate cancer. We evaluated the activity of this association using the following schedule: estramustine phosphate 600 mg/m2/day orally days 1-42 and vinorelbine 25 mg/m1 days 1, 8, 22, 29 cycles repeated every 56 days. Twenty-five patients were included in the study, 24 being evaluable for response and 25 for toxicity. Out of 5 patients with measurable disease, none had an objective response. Of the 24 assessable patients with bone metastases, 9 patients had a > or = 65% decline in pretreatment prostate-specific antigen (PSA) level, stable disease was observed in 10 and 5 patients progressed. Toxicities were minimal. Anemia was observed in 5 patients, alopecia in 4 and nausea and vomiting was observed in 6 patients. Anorexia and weight loss of more than 10% were observed in 2 patients. This combination is active and well tolerated in hormone-resistant prostate cancer. These results support the therapeutic strategy of combining agents that impair microtubule function.
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PMID:Phase II study of estramustine and vinorelbine in hormone-refractory prostate carcinoma patients. 963 14


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