Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A single centre phase II study was conducted to determine the toxicity and activity of Caelyx in hormone refractory metastatic prostate cancer. Doxorubicin is known to be active in this setting and liposomal encapsulation may enhance its therapeutic efficacy and also reduce toxicity. Fourteen patients with hormone refractory metastatic prostate cancer were treated with CaelyxTM 50 mg/m2 once every four weeks. All patients had radiologically proven bone metastases and three also had soft tissue metastatic disease. All patients were evaluable for toxicity and response was assessable in thirteen cases. Three PSA responses were documented in patients with non-measurable disease. No patient had an objective response in measurable disease. The commonest toxicity was cutaneous and this was dose limiting in two patients. Gastrointestinal upset was frequent but generally mild. One patient died shortly after an episode of neutropaenic sepsis with associated grade 3 mucositis following his third cycle of chemotherapy. We confirmed the toxicity profile of Caelyx but its modest antitumour efficacy in this group of patients suggests little promise for future study in metastatic prostate cancer.
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PMID:A phase II study of caelyx (liposomal doxorubicin) in metastatic carcinoma of the prostate: tolerability and efficacy modification by liposomal encapsulation. 1220 96

Doxorubicin is a commonly used and effective treatment for a variety of tumors in both people and cats. However, the use of this drug in cats has been associated with side effects such as renal injury, myelosuppression, anorexia, and weight loss. The goal of this study was to compare the toxicities associated with two dosing schemes for doxorubicin in tumor-bearing cats. Group A cats received 1mg/kg of doxorubicin, while group B cats received 25mg/m2 of doxorubicin plus 22ml lactated Ringer's solution per kilogram body weight subcutaneously. Toxicities were evaluated using laboratory data, physical examination, and history, and were graded using a standardized scale and compared between groups. Post-treatment neutrophil counts were significantly lower among cats in group B compared to cats in group A (P< or =0.001), although complete blood counts were not evaluated at identical intervals in all cases. No other significant differences in the type, frequency or severity of clinical or laboratory toxicities were noted between groups, and no episodes of sepsis were recognized in either group. The results of this study suggest that higher doses of doxorubicin may not be associated with an increased risk of toxicity in the cat. Additional studies are still indicated to determine optimal dosing for doxorubicin in this species.
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PMID:A comparison of toxicity of two dosing schemes for doxorubicin in the cat. 1843 24

Doxorubicin/vinblastine combined with the P-glycoprotein inhibitors trifluoperazine and verapamil was evaluated in the treatment of patients with metastatic renal carcinoma. Patients were treated with starting doses of doxorubicin/vinblastine of 30 mg/m(2) (doxorubicin) and 3 mg/m(2) (vinblastine) intravenously every 2 weeks, combined with 4 days of oral trifluoperazine/verapamil at 2 mg tid (trifluoperazine) and 160 mg tid (verapamil) administered I day before the chemotherapy was initiated. Response was assessed every three cycles of treatment. Of 26 evaluable patients, there were no responders. Six patients had stable disease for greater than 6 months on treatment. Therapy was generally well tolerated but 7 of 26 patients developed grade 4 granulocytopenia, including one patient who died due to sepsis. The possible reasons for the failure of P-glycoprotein inhibitors to enhance the effect of chemotherapy are discussed.
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PMID:Phase II evaluation of doxorubicin/vinblastine combined with inhibitors trifluoperazine/verapamil of P-glycoprotein in patients with advanced renal carcinoma. 2122 92

Due to a national shortage of daunorubicin we evaluated the effects of substituting doxorubicin 1:1 in the induction phase for adult patients with newly diagnosed acute lymphoblastic leukemia (ALL). We identified 10 patients receiving doxorubicin instead of daunorubicin as part of their induction on Cancer and Leukemia Group B (CALGB) 9511 or CALGB10403 and retrospectively compared them to 83 patients who received treatment on the same protocols with daunorubicin. Response rates were similar, independent of anthracycline received, with either CALGB9511 or CALGB10403. In either regimen, doxorubicin resulted in longer absolute neutrophil count (ANC) recovery time and hospitalization. Doxorubicin as part of CALGB9511 resulted in greater than three-fold higher mucositis. Sepsis and death during induction were significantly more frequent in patients who received doxorubicin on CALGB10403. While remission rates were similar, the use of doxorubicin was associated with prolonged neutropenia, higher risk of mucositis, infection and sepsis, and prolonged hospitalization. Higher induction mortality observed with doxorubicin substitution in this analysis needs further study.
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PMID:A single-center experience of the nationwide daunorubicin shortage: substitution with doxorubicin in adult acute lymphoblastic leukemia. 2338 99

Doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with or without radiation is standard therapy for limited-stage Hodgkin lymphoma (HL) but carries risks of bleomycin-induced lung injury and radiation toxicity. Brentuximab vedotin is highly active in relapsed HL and was recently approved with doxorubicin, vinblastine, and dacarbazine (AVD) for previously untreated stage III/IV HL. We evaluated brentuximab-AVD for nonbulky stage I/II HL in a multicenter phase 2 study. Patients received a lead-in cycle of brentuximab vedotin monotherapy on days 1 and 15, followed by an exploratory positron emission tomography/computed tomography scan. Patients then received brentuximab-AVD for 4 to 6 cycles based on interim positron emission tomography/computed tomography scanning after cycle 2. Thirty-four patients were enrolled with a median age of 36 years (range, 20-75 years). Risk was early favorable in 62% and unfavorable in 38%. The best complete response rate was 100%. At a median follow-up of 38 months, the progression-free survival and overall survival were 94% and 97%, respectively. The most common adverse events were peripheral sensory neuropathy (79%), neutropenia (76%), fatigue (74%), and nausea (71%). The most common grade 3/4 toxicities were neutropenia (62%), febrile neutropenia (35%), and peripheral sensory neuropathy (24%). One elderly patient died of neutropenic sepsis in the first brentuximab-AVD cycle. Brentuximab dose reductions were required in 38% of patients, most for peripheral neuropathy. In conclusion, brentuximab-AVD without bleomycin or radiation produced a high complete response rate, with most patients requiring only 4 total cycles of therapy. Because toxicity was higher than would be expected from AVD alone, this method may not be appropriate for early-stage patients with a highly favorable prognosis. This trial was registered at www.clinicaltrials.gov as #NCT01534078.
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PMID:Brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine for nonbulky limited-stage classical Hodgkin lymphoma. 3118 74


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