Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:Q06643 (non-Hodgkin's lymphoma)
 11,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although many questions remain unanswered, recent clinical and pathologic studies have shed considerable light on the subject of carcinoma of unknown primary site. It is now clear that some patients in this group have extragonadal germ cell tumors. This is suggested by the superior treatment results in patients with clinical features of extragonadal germ cell tumor and is confirmed by the finding of the diagnostic chromosome abnormality in tumor cells of some patients. These patients have tumors that are unrecognizable using all available pathologic techniques other than molecular genetic analysis; most patients also do not have elevated serum tumor marker levels. Young men with poorly differentiated carcinoma located predominantly in the mediastinum or retroperitoneum should be strongly suspected of having germ cell tumors; chromosomal analysis should be obtained if possible, and these patients should be treated as for germ cell tumor. It is clear that some responsive patients with poorly differentiated carcinoma do not have extragonadal germ cell tumors. A few patients initially thought to have poorly differentiated carcinoma actually have non-Hodgkin's lymphoma. With the widespread availability of immunoperoxidase staining for LCA, this diagnostic error should be minimized. Other responsive patients have poorly differentiated neuroendocrine tumors. The nature and spectrum of neuroendocrine tumors is still being defined; however, our initial documentation of cisplatin responsiveness has been confirmed, even in poorly differentiated neuroendocrine tumors with a known primary site. It is likely that additional responsive subgroups also exist but have not yet been identified. With the availability of a diagnostic chromosomal marker, the answers to other questions regarding the relationship of poorly differentiated carcinoma and germ cell tumors will soon be forthcoming.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Poorly differentiated carcinoma and germ cell tumors. 166 41

Extended schedules of oral etoposide have been evaluated in many types of advanced cancer. In addition to their use in the common solid tumours, extended schedules have been employed in Kaposi's sarcoma (both AIDS-related and endemic types), medulloblastoma, glioma, and hepatocellular carcinoma. Single agent activity was demonstrated in all of these tumour subtypes. For patients with carcinoma of unknown primary site, we have recently incorporated a 10-day oral etoposide schedule into a combination regimen that also includes paclitaxel and carboplatin. With this regimen we achieved a 47% response rate in a group of 53 evaluable patients, with a median survival of 13.4 months. Patients with adenocarcinoma and poorly differentiated carcinoma of unknown primary site had comparable response rates and survival. According to a large number of clinical trials and pharmacokinetic data, a daily oral etoposide dose of 50 mg/m2 consistently produces serum concentrations >1 mg/L for several hours each day. Lower doses fail to consistently produce this serum concentration, which is considered necessary for optimum tumoricidal activity. Optimal dose duration is 10 to 14 days, particularly when combination regimens are being employed. Oral etoposide has an established role as a single agent in patients with low grade non-Hodgkin's lymphoma, Kaposi's sarcoma, and testicular cancer (if residual carcinoma is resected after first-line treatment). The optimal use of extended-schedule etoposide in combination regimens is not defined but is being evaluated in a number of etoposide-sensitive malignancies.
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PMID:Extended-schedule oral etoposide in selected neoplasms and overview of administration and scheduling issues. 1071 42