Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0178874 (tumor progression)
 40,807 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of specific immunotherapy with allogeneic cells transformed by Schmidt-Ruppin Rous sarcoma virus (SR-RSV), of treatment with BCG, and of surgery on the growth of SR-RSV-induced sarcomas in white-lipped marmosets were studied. Tumor incidence, tumor progression, and survival did not differ between control and treated animals. Animals immunized with BCG developed lymphocyte reactivity to tuberculin, which remained until the animals died. BCG was isolated from the spleen of one tumor-bearing animal.
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PMID:Immunization of Rous sarcoma virus-inoculated marmosets with BCG and transformed allogeneic cells. 16 12

This study assess the effects of oral BCG, as a single agent, on tumor progression and on cell-mediated immune function in patients with metastatic malignant melanoma. Thirty patients were studied including 22 with measurable metastatic lesions and 8 with no detectable disease, following treatment of metastases by surgery, radiotherapy, or 5-(3, 3-dimethyl-1 -triazeno)-imidazole-4-carboxamide (DTIC; DIC). Oral BCG was given in doses of 120--240 mg, 1--3 times per week for periods ranging from 9 to 80 weeks and to total doses of from 1.2 to 20.1 gm. Patients were assessed by direct measurements of tumor mass, PPD skin test and in vitro blastogenic responses to PPD PHA. Of the 22 patient with measureable disease, 19 showed tumor progression and none showed regression of any lesion. Of the 8 without apparent disease, 5 remained stable and 3 had tumor recurrence. Of the total group of 30 patients, 8 showed some increased sensitivity to skin testing with PPD. Of 19 tested, 3 showed an increased PPD response in vitro, while 3 showed a decreased response. Six of 20 tested showed an increased PHA response in vitro. Oral BCG alone was not effective as an antitumor agent in patients with metastatic malignant melanoma.
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PMID:The use of oral BCG in the treatment or metastatic malignant melanoma. 78 99

Bacillus Calmette-Guerin (BCG) has been shown in randomized trials to be the most effective agent against superficial bladder tumors. BCG therapy prevents or reduces tumor recurrences, abrogates tumor progression and improves survival over surgery alone. The optimal BCG schedule varies among patients, reflecting a heterogeneous tumor population. Multifocality, high grade (G2,3) and T1 tumors are risk factors for tumor recurrence or invasion. Patients presenting with such features are most likely to benefit from BCG. An incomplete response to BCG portends a high risk of tumor progression. Non-responders have a 40-60% risk of developing muscle invasion or metastases within 10 years, compared with 10-15% for BCG responders. Further, 80% of non-responders progress in the bladder within 3-5 years. After 5 years, relapses are more common in the prostate (13-35%) and upper collecting system (15-33%); one-half of these are invasive tumors. This suggests that intense therapy directed at premalignant and early bladder lesions coupled with a chemoprevention strategy designed to protect the whole urothelium will be required to reverse a pan-urothelial tumor diathesis.
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PMID:Intravesical BCG: current results, natural history and implications for urothelial cancer prevention. 130 73

Approximately 70% of all bladder cancers are superficial at the time of presentation. Superficial bladder cancer includes tumors confined to the urothelium (clinical stage Ta) or lamina propria (stage T1) and flat carcinoma in situ (stage Tis). Because the biological behavior of bladder neoplasms is variable, several important prognostic factors must be addressed. Multivariate analyses have shown that factors predictive of tumor recurrence and tumor progression include multifocal tumors, high grade tumors, T1 tumors and positive urinary cytology after transurethral resection (TUR). The patient with superficial bladder cancer should be monitored via endoscopy supplemented by urinary cytology, using either voided or bladder irrigation specimens and urinalysis. Frequent intravenous urography is not required, even in high grade tumors, as long as the clinical and pathologic studies remain negative and the patient is asymptomatic. The "gold standard" of treatment for superficial bladder carcinoma is TUR of the entire tumor. Despite TUR, new tumors will occur in approximately 50% of all patients; those at highest risk for tumor recurrence and progression require adjuvant intravesical therapy after TUR. A variety of drugs are used as intravesical therapy, including thiotepa, mitomycin C, doxorubicin hydrochloride, Bacillus Calmette-Guerin (BCG), epirubicin, and interferon. Although associated with the most toxicity, BCG appears to be the most efficacious agent in increasing the time to recurrence and progression and in reducing the recurrence rate.
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PMID:Superficial bladder cancer: diagnosis, surveillance and treatment. 130 74

Intravesical chemotherapy will cause complete regression of existing papillary tumor in one third to one half of patients. Controlled clinical trials have demonstrated that chemotherapy reduces the short-term incidence of tumor recurrence by 15% to 18%, but by 5 years, the number of patients suffering tumor recurrence is equal to that in patients treated with surgery alone. Tumor progression cannot occur in the absence of tumor recurrence, but existing studies of intravesical chemotherapy have failed to demonstrate significant reduction in disease progression or mortality rate with treatment. Immunotherapy has the advantage of a mechanism of action different from that of cytotoxic chemotherapy. Immunotherapy with BCG has resulted in complete tumor regression in one half or more of treated patients with papillary tumors and in more than 70% of those with CIS. Controlled studies similarly demonstrate a significant reduction in tumor recurrence, and protection from tumor recurrence has been observed to persist for 5 years or more. At the present time, data remain limited, but three controlled studies have found statistically significant reductions in the rate of disease progression, and one has found a significant reduction in the mortality rate, with BCG immunotherapy. These observations provide convincing evidence that immunotherapy is the treatment of choice for patients with aggressive superficial tumors and suggest that the development of immunotherapeutic alternatives to BCG is likely to be rewarding.
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PMID:Long-term results of intravesical therapy for superficial bladder cancer. 163 41

Topical therapy is administered after transurethral resection (TUR) for superficial cancer to reduce the frequency of recurrence, to avoid local tumor progression and to increase the survival rate. However, the results of prospective randomized studies on topical chemotherapy show that successful reduction of tumor recurrence is limited to a small group of patients. Topical immunotherapy with BCG seems to be more efficient, but prospective multicenter studies have not confirmed the superiority of BCG treatment. At present neither chemotherapy nor immunotherapy can influence progression or survival rate. It therefore seems advisable to continue to enroll patients with superficial bladder tumors in prospective studies to obtain more information on treatment schedules and their side-effects and therapeutic activity. The following information may be helpful in deciding on individual treatment schedules for patients with superficial bladder cancer: (1) Carcinoma in situ is the only therapeutic indication for topical therapy, and BCG may be more potent than chemotherapy. (2) Patients with pTaG1 tumor should be excluded from topical therapy. (3) Topical therapy may not be indicated at all for pT1G3 tumors. The rate of local progression and distant metastasis is high and cannot be influenced by this form of adjuvant treatment. (4) At present no drug of first choice is known. (5) Early application of intravesical chemotherapy immediately after TUR has no advantage over delayed treatment. (6) Long-term chemoprophylaxis is equivalent to short-term prophylaxis (6-24 months) in effect. (7) Immunotherapy with BCG can be limited to a period of 6 months.
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PMID:[Therapy of superficial bladder carcinoma]. 201 83

Bacillus Calmette-Guerin (BCG) intravesical therapy represents a major advance in the treatment of superficial transitional cell carcinoma of the bladder. To date, however, the optimal treatment schedule must be defined and the toxicity related to the treatment is significant. The preliminary results of a randomized ongoing study performed to evaluate the effectiveness and relative toxicity of a low dose (75 mg.) BCG regimen in the treatment of superficial bladder cancer therapy are reported. A total of 126 patients (70 for prophylaxis of recurrent stages Ta and T1 papillary tumors and 56 for treatment of carcinoma in situ or with microinfiltration of the subepithelial connective tissue) underwent a 6-week course of 75 mg. BCG (Pasteur vaccine). An additional course was given in patients who failed to respond to the induction course. Maintenance therapy was administered in complete responders monthly for 1 year and then quarterly for 1 year. The prophylaxis group (transurethral resection plus BCG) was randomized versus transurethral resection alone (63 patients, control group). A complete response in the prophylaxis, control and therapy groups was observed in 74, 17 and 57% of the patients, respectively, while 4, 17 and 12.5%, respectively, experienced tumor progression. The additional course of therapy increased the response rate. On the contrary, previous unsuccessful intravesical chemotherapy did not affect the response rate. In regard to toxicity, irritative disturbances (27%) and fever (17%) appeared to be significantly decreased compared with the rates reported in the literature. No major complications were experienced. In conclusion, a low dose (75 mg.) Pasteur strain BCG regimen was effective as prophylaxis against recurrent superficial papillary tumors and as treatment of carcinoma in situ or with microinfiltration of the subepithelial connective tissue. Toxicity related to the treatment appeared to be low.
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PMID:A low dose bacillus Calmette-Guerin regimen in superficial bladder cancer therapy: is it effective? 205

The preliminary results of a randomized ongoing study performed in order to evaluate the efficacy and the relative toxicity of a low dose (75 mg). BCG regimen in the treatment of superficial bladder cancer were considered. Ninety-eight patients (58 patients for prophylaxis of the recurrences of Ta-T1 papillary tumors; 40 patients for therapy of carcinoma in situ) received a 6-weeks course of 75 mg. BCG Pasteur vaccine. An additional course was given to non-responders. A maintenance therapy was administered in complete responders monthly for the first year and quarterly for the second. The prophylaxis group (TUR + BCG) was randomized vs TUR alone (40 patients = control group). Complete response in evaluated patients of the prophylaxis, control and therapy groups achieved 86%, 17% and 78%, respectively, after 18 months; 5%, 20% and 9% of patients, respectively, experienced tumor progression. As regards the toxicity, irritative disturbances (27%) and fever (16%) appeared significantly decreased in comparison with those reported in the literature. No major complications were experienced. In conclusion, the low dose (75 mg.) Pasteur BCG regimen used in our trial was effective as a prophylaxis against recurrent superficial papillary tumors and as a treatment of carcinoma in situ, with a significant decrease in toxicity.
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PMID:[Low-dose BCG in the therapy of superficial neoplasms of the bladder]. 220 64

After reviewing the data on intravesical therapy for treatment or prophylaxis of urothelial tumors of the bladder, several statements seem appropriate. Bladder tumors confined to the mucosa and lamina propria represent a heterogeneous group. Papillary, grade I, noninvasive tumors (Ta) may recur frequently, subjecting the patient to numerous endoscopic procedures but these patients very infrequently have tumor progression. Treatment should not be overly aggressive and result in significant morbidity. These patients should be informed that they have a choice and may decide that they would rather take the risk of subsequent endoscopic procedures and avoid the regular visits to the office for intravesical drug instillation. High grade tumors, be they confined to the mucosa or invade the lamina propria, place the patient at significant risk of recurrence and local progression and thus require careful monitoring (Jordan et al, 1987; Torti et al, 1987). Intravesical therapy should be seriously considered, either to eradicate residual malignant cells or prevent a subsequent tumor. Thiotepa is moderately effective in delaying the development of subsequent low grade tumors when used for prophylaxis. Toxicity with Thiotepa is low and the drug is not expensive. Mitomycin C is effective for the treatment of residual tumor as well as when instilled regularly following complete transurethral resection. Side effects are primarily confined to chemical cystitis with an occasional patient having a rash. BCG may be the most effective intravesical agent in the treatment of carcinoma in situ. Randomized trials comparing BCG and chemotherapy are in progress and are eagerly awaited. The frequency and severity of local and systemic side effects are somewhat greater than with chemotherapeutic agents.
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PMID:Should all superficial bladder tumors be treated with intravesical therapy? 267 6

We report on our experience with 21 patients with superficial bladder cancer who were treated with intravesical BCG instillation. The BCG vaccine was effective in the treatment of carcinoma in situ. Tumor regression was achieved in 83.3% at 3 months, and 61.1% at 24 months. It is advisable to follow patients closely because of the possibility of tumor progression.
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PMID:[Our experience in the treatment of superficial cancer of the bladder with BCG]. 278 59


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