Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to select a suitable combination chemotherapy with BOF-A2 from the view of both anti-tumor effect (IR) and decrease of side effect, we studied a combination significance of BOF-A2 with CPT-11 that promised for a new anticancer drug, CDDP or mitomycin C (MMC) that used widely to many cancer patients and interferon-alpha (IFN-alpha) against colon, stomach and renal cancer, respectively, by using xenografted nude mice. The combination therapy of BOF-A2 with CDDP was effective against stomach cancer (H-111) from the cellular change and decreased side effect. The combination therapy of BOF-A2 with MMC showed additive effect against stomach cancer (H-111) from IR and cellular changes. The combination effect of BOF-A2 with IFN-alpha was additive and synergistic against renal cancer (H-12). The combination therapy with CPT-11 was effective (IR > or = to 58%) from antitumor effect, additive from IR and synergistic from cellular change against lung cancer (H-74) and colon cancer (H-110), to which conventional drugs were generally insensitive and spontaneously tolerant. BOF-A2 was expected to be a promising new anti-cancer agent in the future clinical trial.
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PMID:[Combination chemotherapy of BOF-A2, a new 5-FU derivative, with various anticancer agents against human cancer xenografts in nude mice]. 806 Jan 37

Irinotecan (CPT-11), a new derivative of camptothecin, showed schedule-dependent antitumor activity and toxicity in preclinical animal studies. We carried out a phase I study of weekly CPT-11 infusion, which indicated that the recommended dose for phase II studies was 100 mg/m2. In a phase II trial, CPT-11 achieved a response rate of 32% for non-small cell lung cancer (NSCLC). In two phase II trials, CPT-11 achieved objective response rates of 37% and 47% for small cell lung cancer (SCLC). The high activity of CPT-11 in these phase II studies suggested that the next rational step was to investigate combination chemotherapy. The first phase I trial of CPT-11 combined with cisplatin achieved an encouraging response rate of 54% in 27 patients with previously untreated NSCLC, and the recommended schedule for phase II studies was 60 mg/m2 of CPT-11 (days 1, 8, and 15) plus 80 mg/m2 of cisplatin (day 1) given at 4-week intervals. Given the high single-agent activity of CPT-11 against SCLC and NSCLC, a regimen with a higher dose of this agent and a lower dose of cisplatin seemed likely to be more effective. In the second trial, the cisplatin dose was accordingly reduced from 80 to 60 mg/m2, and the recommended dose of CPT-11 was concluded to be 80 mg/m2. Thus, reduction of the cisplatin dose to 60 mg/m2 allowed the safe administration of CPT-11 at 80 mg/m2 (33.3% dose intensification compared with the original regimen). The most recent trial of this combination with recombinant human granulocyte colony-stimulating factor (rhG-CSF) support demonstrated that the recommended dose is 80 mg/m2 of CPT-11 and 80 mg/m2 of cisplatin. Thus, we could raise the CPT-11 dose 33% above that given in the original regimen while maintaining the original cisplatin dose by the use of rhG-CSF support. Further trials are needed to evaluate the effect of CPT-11 given in combination with other active agents for the treatment of lung cancer.
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PMID:Clinical studies of irinotecan alone and in combination with cisplatin. 807 18

Irinotecan hydrochloride (CPT-11) is a water-soluble semisynthetic derivative of camptothecin. CPT-11 is a prodrug that undergoes deesterification in vivo to produce SN-38, a metabolite that is 1,000-fold more potent than the parent compound in vitro. CPT-11 is a potent topoisomerase I inhibitor with a broad spectrum of experimental antitumor activity. Recent clinical trials also reveal that CPT-11 is very effective in the treatment of cancers including lung cancer, cervix cancer, ovary cancer, etc. Now, comparative trials of combination chemotherapy in responsive tumors are indicated from these excellent clinical results.
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PMID:[Irinotecan hydrochloride (CPT-11)]. 815 99

We have conducted a Phase I trial to determine the maximum tolerated dose of CPT-11 together with a fixed dose of cisplatin in patients with advanced lung cancer, and the dose-limiting toxicities of this combination. Fourteen previously untreated patients with stage IIIB or IV disease were treated with CPT-11 (90-min intravenous infusion on days 1, 8, and 15) plus cisplatin (60 mg m-2, intravenously on day 1). The starting dose of CPT-11 was 60 mg m-2, and diarrhea was the dose-limiting toxicity at the 90 mg m-2 dose level. All three patients (all four cycles) given 90 mg m-2 of CPT-11 experienced grade 3 diarrhea. Hematologic toxicity was relatively mild. Elimination of CPT-11 was biphasic with a mean (+/- s.d.) beta half-life of 11.36 +/- 7.26 h. The mean terminal half-life of the major metabolite (7-ethyl-10-hydroxycamptothecin; SN-38) was 22.13 +/- 13.28 (s.d.) h, and modest escalation of the CPT-11 dose from 80 mg m-2 to 90 mg m-2 resulted in a statistically significant apparent increase in the plasma concentrations of SN-38. There were one complete response (7%) and five partial responses (36%) among the 14 patients for an overall response rate of 43%. The recommended dose for Phase II studies is 80 mg m-2 of CPT-11 and 60 mg m-2 of cisplatin.
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PMID:Phase I and pharmacologic study of irinotecan in combination with cisplatin for advanced lung cancer. 839 7

Irinotecan hydrochloride (CPT-11), topotecan, sobuzoxane, NC-190, and IST-622 are unique topoisomerase inhibitors and are investigational in Japan. CPT-11 is a water-soluble, semisynthetic derivative of camtothecin. CPT-11 shows its anticancer activity by inhibiting topoisomerase I activity, now a target of anticancer agents with major interest. Recent clinical trials reveal that CPT-11 is very effective in the treatment of cancer including lung cancer, cervical cancer, ovary cancer, stomach cancer, colon cancer, and non-Hodgkin's lymphoma. Major dose limiting toxicities are leukopenia and diarrhea, and are dose related. Topotecan is an another semisynthetic derivative of camtothecin and is also topoisomerase I inhibitor. Topotecan has undergone phase I clinical evaluations in USA, europe, and recently in Japan. DLF are leukopenia and neutropenia. Topotecan is more hydrophilic than its parent compound and shows lesser protein binding. Renal excretion appears to be the major route of elimination. Sobuzoxane (MST-16) is a unique derivative of dioxopiperazine, an inhibitor of topoisomerase II. In phase II studies, definite anticancer effects are observed in patients with non-Hodgkin's lymphoma and adult T-cell leukemia/lymphoma. Responses are seen even in pretreated cases. Leukopenia is also dose-limiting. Non-hematologic toxicities are mild and include alopecia and G.I. toxicities. NC-190 is a novel benzophenazine derivative with excellent antitumor activities against murine tumors. NC-190 also inhibits topoisomerase II. Now the drug is an early clinical phase II studies in Japan. Toxicities include bone marrow suppression, transient mild to moderate liver enzyme elevation, alopecia and mild G.I. toxicities. Tumor responses are occasionally encountered. IST-622 is a semisynthetic derivative of chartreusin. The drug is an inhibitor of topoisomerase II (and I in high concentration). IST-622 shows excellent, broad anticancer activity against murine tumors. The drug is well absorbed from small intestine. IST-622 is now in phase I clinical trial in Japan.
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PMID:[Topoisomerase inhibitors developing in Japan]. 842 86

Recent studies have suggested that glutathione S-transferase pi (GST-pi) may play a role in determining tumor sensitivities to cytotoxic drugs. In order to better understand the role of this enzyme in chemo- and/or radioresistance of lung cancer cells, we examined whether introduction of GST-pi cDNA into a chemo- and radiosensitive lung cancer cell line altered its sensitivities to various chemotherapeutic agents and/or ionizing radiation, which are often used in the management of lung cancers. Modestly increased resistance of the GST-pi transfectants preferentially to sublethal damage caused by ionizing radiation as well as to adriamycin (ADM) was observed. In contrast, resistances to cisplatin (CDDP), etoposide (VP-16), irinotecan hydrochloride (CPT-11) and paclitaxel were virtually unaltered. These results suggest that GST-pi may not play a major role in chemo- and radioresistance of lung cancers, although it could afford selective and limited protection against ADM- and ionizing radiation-induced damage.
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PMID:Modification of chemo-radiosensitivity of a human lung cancer cell line by introduction of the glutathione S-transferase pi gene. 855 60

The incidence of lung cancer is increasing, and therapy for patients with this disease is not satisfactory. Surgery is done for patients with clinical (c)-stage I, II, and resectable stage IIIA non-small cell lung cancer (NSCLC). Chemotherapy, alone or in combination with radiotherapy, is given to patients with unresectable stage IV and stage III NSCLC, respectively. Chemotherapy is an important therapeutic modality for patients with small cell lung cancer (SCLC). CDDP + VP-16 (PVP) and CPA + ADM + VCR (CAV) alternating PVP regimens are standard treatment for patients with SCLC. Chemotherapy and radiotherapy are given to patients with limited disease. To develop more effective treatments, we are investigating (1) the schedule and timing of radiotherapy, (2) combination chemotherapy including new drugs, (3) dose-intensive chemotherapy, and (4) new strategies such as gene therapy. Radiotherapy is commonly used sequentially and the standard fractionation is 2 Gy/fr/day. We are studying other timings, such as concurrent and alternating, and other schedules, such as hyperfractionation and accelerated hyperfractionation. Promising new drugs include paciltaxel, docetaxel, vinorelbine, and CPT-11. These are now used in combination with platinum. To evaluate dose-intensive chemotherapy for SCLC, we are conducting a phase III study comparing CODG + G-CSF with CAV/PVP.
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PMID:[Can improvement in therapy decrease the rate of death due to lung cancer?]. 875 77

We encountered a case of small-cell lung cancer in a patient with subacute sensory neuropathy that began 5 months before the cancer was diagnosed. A 60-year-old man complained of abnormalities in the functioning of his peripheral sensory systems (senses of pain, touch, position, and vibration). A chest X-ray film obtained on admission showed an anterior mediastinal tumor. The anti-Hu antibody was found in his serum. The diagnosis was small-cell lung cancer. Combination chemotherapy (cisplatin and irinotecan, CPT-11) was begun and the response was a complete remission. The symptoms of neuropathy continued. The anti-Hu antibody was useful in the diagnosis in the case of small-cell lung cancer combined with subacute sensory neuropathy.
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PMID:[Small-cell lung cancer and subacute sensory neuropathy in a patient positive for the anti-Hu antigen]. 881 Jul 65

CPT-11 is a derivative of camptothecin, which has a broad spectrum of antitumor activity, both in vitro and in vivo. Like camptothecin, CPT-11 is a selective inhibitor of the DNA enzyme topoisomerase I. Phase I trials were conducted in Europe with the aim of determining the recommended CPT-11 dose and schedule for evaluation in phase II trials. The phase I trials assessed the toxicity of CPT-11 in 235 patients and tested three different administration schedules. CPT-11 was administered as a single infusion once every three weeks, as a weekly infusion for three weeks out of every four, and as a daily infusion for three consecutive days every three weeks. The maximum tolerated dose (MTD) was 115 mg/m2 in the daily schedule and 145 mg/m2 in the weekly schedule. When the drug was administered once every three weeks, diarrhea became the dose-limiting toxicity at doses above 350 mg/m2. This schedule allowed the highest dose intensity to be obtained, was the best tolerated, and allowed ambulant treatment. Finally, using this schedule, a combination of CPT-11 with high doses of loperamide allowed the dose of CPT-11 to be increased to 750 mg/m2. An ongoing phase I trial is investigating the combination of CPT-11 and 5-fluorouracil (5-FU) in various solid tumors. Although the MTD has not yet been reached, preliminary results have not demonstrated any pharmacokinetic interaction between the two drugs, contrary to the findings of a previous Japanese study. Based on the results of the three phase I trials, CPT-11 administered at a dose of 350 mg/m2 as an intravenous infusion over 30 minutes once every three weeks has been recommended for assessment in phase II trials. The phase II trials started in Europe at the beginning of 1992. To date, CPT-11 has showed remarkable efficacy in colorectal cancer, even in patients resistant to 5-FU. Interesting results have also been obtained in pancreatic, cervical and lung cancer. Future trials will make it possible to assess whether there is a place for CPT-11 in combination with other cytotoxic agents or radiotherapy.
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PMID:CPT-11. The European experience. 899 22

A phase I study was performed to establish the optimum dose for combination therapy with infusional cisplatin and irinotecan (CPT-11) in non-small-cell lung cancer (NSCLC). The subjects were 20 patients with a performance score of 0-2 with untreated advanced NSCLC. Cisplatin was administered by 5-day continuous intravenous infusion at 20-25 mg/m2 per day. CPT-11 was administered by bolus infusion at a starting dose of 20 mg/m2 on days 1 and 8 or 60 mg/m2 per day on day 1 alone, followed by serial increments of 20 mg/m2. Since grade 4 granulocytopenia was observed in two of the five patients receiving 20 mg/m2 per day cisplatin (days 1-5) and 100 mg/m2 CPT-11 (day 1), and since one of them developed severe pneumonia and sepsis associated with the granulocytopenia, the regimen was considered to be intolerable. In the same patient, grade 4 thrombocytopenia and grade 3 diarrhea were observed. Therefore, the optimum dose appeared to be 20 mg/m2 per day (days 1-5) for cisplatin and 80 mg/m2 (day 1) for CPT-11. The side effects were grade 2 diarrhea in one of three patients, and grade 2 vomiting in three patients, but grade > or = 2 hemotoxicity was not observed. This combined regimen resulted in a partial response in 9 out of 19 assessable patients. The dose-limiting factor in this combination therapy was granulocytopenia, and a high efficacy rate was obtained.
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PMID:A phase I study of irinotecan and infusional cisplatin for advanced non-small-cell lung cancer. 902 73


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