Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C1140680 (ovarian cancer)
 28,141 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because the initial evaluation of N,N',N''-triethylenethiophosphoramide (thioTEPA) preceded the standardized approach to the Phase I trials, uncertainty surrounds the recommended dose. Since it has recently been demonstrated that an almost 100-fold increase in dose can be administered in bone marrow transplant regimens, we conducted a Phase I reevaluation of thioTEPA. ThioTEPA was administered i.v. in 50 ml 5% dextrose in water over 10 min. Twenty-seven patients were entered at doses ranging from 30 to 75 mg/m2. The major toxic effect was myelosuppression; thrombocytopenia greater than or equal to grade 3 occurred in four of seven patients, and leukopenia greater than or equal to grade 3 in two of seven patients at 75 mg/m2. Among eight patients at 65 mg/m2 only two had greater than or equal to grade 3 myelosuppression making this the recommended new phase II dose for the majority of patients. Moderate (grade 2) easily controlled nausea and vomiting was the only other major side effect. There was no alopecia or mucosal or neurological toxicity. Three partial remissions were observed among nine previously treated ovarian cancer patients. Plasma concentrations of thioTEPA and its major active metabolite triethylenephosphoramide (TEPA) were measured by gas chromatography. The half-life of thioTEPA ranged from 51.6 to 211.8 min, and its pharmacokinetics was dose dependent; total body thioTEPA clearance decreased with increasing dose. The half-life of TEPA was considerably longer than that of the parent compound (3.0 to 21.1 h); as a result, the area under the plasma concentration-time curve (AUC) of TEPA was severalfold greater than that of the parent compound. The ratio of TEPA AUC to thioTEPA AUC decreased with increasing dose, suggesting that formation of TEPA is a saturable step in elimination. The AUC and total body clearance of thioTEPA, but not of TEPA, were closely correlated with neutrophil but not platelet toxicity.
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PMID:Phase I/pharmacokinetic reevaluation of thioTEPA. 171 Jan 67

In November 1985, the New York State Department of Health was altered to extraordinary concentrations of asbestos leachate in the drinking water in the Town of Woodstock. Concentrations of 3.2 million fibers per liter (MFL) to 304.5 MFL were found, depending on location. An investigation of cancer incidence in the area was conducted for the period 1973-83 using the State Cancer Registry to compute standardized incidence ratios. No evidence was found of elevated cancer incidence at sites associated with asbestos exposure. A statistically non-significant excess of kidney cancer was seen among men, but not women. Colon cancer among men was significantly low, but incidence among women was similar to that expected. Lung cancer incidence was lower than expected for both sexes. Ovarian cancer rates were not different from expected rates. At sites not previously related to asbestos exposure, cancer of the oral cavity was significantly high, with most affected persons having a history of cigarette smoking. Surveillance of the community is continuing because of an insufficient latent period for some exposed groups.
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PMID:Cancer incidence following exposure to drinking water with asbestos leachate. 249 74

The mechanisms responsible for the cross-resistance between radiation and certain antineoplastic agents have been examined in human ovarian cancer cell lines. Cell lines established from patients at a time when they were resistant to combination chemotherapy regimens, which included cisplatin and an alkylating agent as well as cell lines with resistance induced in vitro to melphalan and cisplatin, all have increased cellular levels of glutathione (GSH) compared with drug-sensitive cell lines from untreated patients. In addition, cell lines with acquired resistance to melphalan and cisplatin, but not to doxorubicin, were cross-resistant to radiation. L-Buthionine sulfoximine (BSO), an irreversible inhibitor of gamma-glutamylcysteine synthetase, lowered GSH levels in all the resistant cell lines studied. Lowering of GSH levels to less than 10% of control values potentiated the in vitro cytotoxicity of melphalan and cisplatin. Furthermore, BSO was also shown to potentiate the cytotoxicity of melphalan in a nude mouse model system of ovarian cancer in which mice die of disseminated intra-abdominal carcinomatosis. The BSO administered in the drinking water decreased GSH levels by 96%. A single melphalan treatment of 5 mg/kg following GSH depletion produced a 72% increase in median survival time compared with treatment with melphalan alone. In addition, depletion of GSH levels in cell lines with acquired resistance to melphalan led to a marked sensitization of these cells to irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Mechanisms of cross-resistance between radiation and antineoplastic drugs. 335 59

The thymidylate synthase (TS) inhibitor CB 3717 was administered intravenously to 24 adult patients as a single bolus repeated every 3-4 weeks. The doses were escalated from 50 to 400 mg/m2. At the highest level, hydration and urinary alkalinization were routinely performed. A greater than 20% decrease of the creatinine clearance value occurred in 35% of the cycles performed at 400 mg/m2, a dose which could be recommended for phase II studies. Hepatic toxicity, represented by an increase of the glutamic pyruvic transaminase (GPT) plasma levels, occurred in 70% of the patients after the first cycle. GPT peak levels were neither related to the dose nor to the peak drug plasma concentrations or AUC values in the dose range from 225 to 400 mg/m2. Malaise, reported after 46% of the cycles, was the most disturbing side-effect and its occurrence was statistically correlated with the degree of elevation of GPT. A suggestion of antitumor activity was reported for dosages of 300 and 400 mg/m2 in three patients with ovarian cancer refractory to cisplatin. Further clinical evaluations of TS inhibitors rely on the development of more water soluble and less hepato- and nephrotoxic agents.
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PMID:Phase I study of the antifolate N10-propargyl-5,8-dideazafolic acid, CB 3717. 338 77

The development of acquired resistance to alkylating agents frequently limits the effectiveness of chemotherapy in the treatment of ovarian cancer. While the resistance to alkylating agents is multifactorial, the association of drug resistance with elevations in glutathione (GSH) is of potential clinical relevance since there exist pharmacologic means to lower intracellular GSH levels. We have used in vitro and in vivo models of human ovarian cancer to demonstrate that selective inhibition of GSH synthesis with L-buthionine-S,R-sulfoximine (L-BSO) leads to a lowering of GSH levels and an increase in cytotoxicity of the alkylating agent melphalan. In the human ovarian cancer cell line NIH:OVCAR-3, derived from a patient clinically refractory to alkylating agents, L-BSO resulted in a 3.6-fold enhancement of melphalan cytotoxicity. This cell line was also adapted for intraperitoneal growth in athymic nude mice. In this in vivo model, in which the mice die of massive ascites and intraabdominal carcinomatosis, L-BSO given orally in drinking water for 5 days decreased GSH levels in the tumor cells by 96% compared to a 79 and 86% reduction in GSH levels in the bone marrow and gastrointestinal mucosa respectively. Lowering of GSH levels with BSO was not accompanied by an increase in lethality for melphalan in non-tumored nude mice. However, in tumor-bearing nude mice, a single melphalan (5 mg/kg) treatment following GSH depletion with L-BSO was markedly superior to treatment with melphalan alone, producing a 72% increase in median survival time. Furthermore, L-BSO treatment of human bone marrow cells prior to melphalan exposure had little effect on melphalan toxicity as assessed in a CFUc-GM assay. These results suggest that treatment with the GSH synthesis inhibitor BSO may preferentially enhance the cytotoxic effects of alkylating agents against human ovarian cancer and overcome acquired resistance.
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PMID:Enhanced melphalan cytotoxicity in human ovarian cancer in vitro and in tumor-bearing nude mice by buthionine sulfoximine depletion of glutathione. 380 Oct 51

The effects of cimetidine on the growth of a human ovarian cancer cell line inoculated into BALB/c nude mice were examined. The cell line, designated "KK," was derived from a cystadenocarcinoma of the ovary. The passage number was about 40, and its tumorigenicity in nude mice was 100% even when 10(5) cells were inoculated. About 2 weeks after inoculation, the KK cells formed palpable tumors, and the tumor volume reached 2.29 cm3 on day 36. Conversely, the nude mice given cimetidine (100 mg/kg/day) orally with drinking water had about one-third the tumor volume (0.81 cm3) of that in untreated nude mice on day 36. The natural killer activity against the YAC-1 (a T-cell lymphoma) cell line in spleen cells of the nude mice challenged with human xenogeneic tumor (KK cell line) was not affected by treatment with cimetidine while inhibiting the tumor growth. The capacity to lyse the KK cells did not exist in the spleen cells of nude mice challenged with the KK cell xenograft and not treated with cimetidine. The cimetidine-treated spleen cells acquired the capacity to lyse the KK cells on day 14. Thereafter, the capacity was maintained at the same level as long as cimetidine was administered, whereas that in untreated nude mice remained undetectable.
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PMID:Effects of cimetidine on tumor growth and immune function in nude mice bearing human ovarian carcinoma. 387 72

An updated review of the anticancer agents hexamethylmelamine (HMM) and its water-soluble analog pentamethylmelamine (PMM) is presented. Severe gastrointestinal and hematologic toxicity have limited the use of HMM drug combinations in ovarian cancer. Combinations involving HMM, cyclophosphamide, cisplatin, and doxorubicin in advanced ovarian cancer have resulted in only moderate response rates, with little to no change in median survival of previously treated patients. HMM now is being studied in previously untreated patients with advanced disease, in combination with these agents. In lung cancer, HMM continues to be a part of intensive and other regimens for the treatment of small-cell and non-small-cell carcinoma, although the value of the HMM is yet to be determined. Future trials have been recommended to determine whether HMM has a role in the treatment of endometrial and prostatic carcinomas. Five phase I studies of PMM have demonstrated severe, dose-limiting gastrointestinal and central nervous system toxicities. Thus, this agent may offer little advantage over HMM. Further phase I studies, with different PMM dosage schedules, are necessary before phase II studies can be recommended.
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PMID:Hexamethylmelamine and pentamethylmelamine: an update. 640 10

L-Phenylalanine mustard (L-PAM), a bis-choroethylamine, is an important drug in the treatment of multiple myeloma and ovarian cancer. It undergoes rapid hydrolysis in vitro and in vivo, forming the mono-and dihydroxy degradation products. L-PAM's first-order disappearance rate in a phosphate-buffered solution did not differ statistically according to the presence or absence of activated rat liver microsomal enzymes. Furthermore, L-PAM's disappearance rate in a rat whole liver perfusion system was not greater than its hydrolysis rate in water. In vitro plasma recovery studies showed that up to 85% of the 14C L-PAM drug equivalents could be recovered as the parent compound and the mono- and dihydroxy degradation products. Thus, L-PAM in in vitro degradation was similar qualitatively and quantitatively to its reported in vivo degradation in animals and man. It is concluded that L-PAM does not undergo important, active in vivo metabolism.
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PMID:In vitro degradation of L-phenylalanine mustard (L-PAM). 710 81

CPT-11, a semisynthetic derivative of camptothecin, exhibited strong antitumor activity against lymphoma, lung cancer, colorectal cancer, gastric cancer, ovarian cancer, and cervical cancer. CPT-11 is a pro-drug that is converted to an active metabolite, SN-38, in vivo by enzymes such as carboxylesterase. We synthesized a water-soluble and non-pro-drug analog of camptothecin, DX-8951f. It showed both high in vitro potency against a series of 32 malignant cell lines and significant topoisomerase I inhibition. The anti-proliferative activity of DX-8951f, as indicated by the mean GI50 value, was about 6 and 28 times greater than that of SN-38 or SK&F 10486-A (Topotecan), respectively. These three derivatives of camptothecin showed similar patterns of differential response among 32 cell lines, that is, their spectra of in vitro cytotoxicity were almost the same. The antitumor activity of three doses of DX-8951f administered i.v. at 4-day intervals against human gastric adenocarcinoma SC-6 xenografts was greater than that of CPT-11 or SK&F 10486-A. Moreover, it overcame P-glycoprotein-mediated multi-drug resistance. These data suggest that DX-8951f has a high antitumor activity and is a potential therapeutic agent.
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PMID:A new water-soluble camptothecin derivative, DX-8951f, exhibits potent antitumor activity against human tumors in vitro and in vivo. 755 2

Altretamine (hexamethylmelamine) is an antitumour drug with demonstrated antitumour activity in refractory ovarian cancer. Due to its poor water solubility, the drug has been given by the oral route. In all animal species, including humans, altretamine undergoes oxidative N-demethylation with the formation of hydroxymethyl derivatives as intermediates. Hydroxymethylmelamines are believed to be responsible for the cytotoxic and antitumour activity of the drug. The inter-hand intrapatient variability of the bioavailability of altretamine after oral administration represents an important drawback for effective clinical use of this drug. The variability appears to be mostly related to the first-pass effect and therefore may be overcome by intravenous administration of the drug. Although attempts to administer the drug intravenously have not been successful in the past, some investigations on the use of the new parental formulation of altretamine are in progress.
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PMID:Clinical pharmacokinetics of altretamine. 765 2


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