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  • 1
    ISSN: 1569-8041
    Schlagwort(e): metastatic breast cancer ; paclitaxel ; weekly 24-hour 5-FU/leucovorin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Purpose: To evaluate the antitumor activity in terms of response rate (RR), time to progression (TTP) and survival of paclitaxel in combination with weekly 24-hour infusional 5-fluorouracil (5-FU)/leucovorin in pretreated metastatic breast cancer (MBC). Patients and methods: Fifty-four patients with bidimensionally measureable disease were included during phase II. Thirty-two had anthracycline resistant disease. Treatment consisted of 5-FU (24-hour i.v. infusion) 2.0 g/m2, leucovorin (two-hour i.v. infusion prior to 5-FU) 500 mg/m2, weekly for six weeks (day 1, 8, 15, 22, 29, 36) and paclitaxel (three-hour i.v. infusion) 175 mg/m2 was administered additionally on days 1 and 22, q 50 days. Results: We observed complete remissions in 4% of patients (2 of 54), partial remissions in 55% (30 of 54), stable disease in 37% (20 of 54) and progressive disease in 4% (2 of 54). The overall RR was 59% (95% CI 48%–72%). The RR in 32 patients with anthracycline resistant disease was 59% (19 of 32). The median duration of response was 12 months (3–22), median TTP eight months (2–22) and median survival time 15 months (2–28). Neutropenia was common, but of CTC grade 2 or 3 in most patients. Nonhematologic toxicities mostly consisted of CTC grade 1 and 2 myalgia, diarrhea, mucosits, nausea and vomiting. Conclusions: Paclitaxel combined with weekly 24-hour infusional 5-FU/leucovorin is well tolerated in the second line treatment of MBC. High efficacy was documented even in the treatment of anthracycline resistant disease, which warrants further evaluation.
    Materialart: Digitale Medien
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  • 2
    ISSN: 1569-8041
    Schlagwort(e): biochemical modulation ; 5-fluorouracil ; methotrexate ; pancreatic cancer ; phosphonacetyl-L-aspartate
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Purpose: To evaluate the effect of biochemical modulation by PALA and methotrexate on the therapeutic activity of 5-fluorouracil (5-FU) in patients with advanced pancreatic adenocarcinoma. Patients and methods: The treatment protocol consisted of phosphonacetyl-L-aspartate (PALA) 250 mg/m2 i.v. 15-minute infusion followed by methotrexate 200 mg/m2 i.v. 30-minute infusion on day 1 and 5-FU 600 mg/m2 i.v. push on day 2. Folinic acid was given at 15 mg/m2 p.o. every six hours for eight doses, starting 24 hours after methotrexate infusion. Cycles were repeated every two weeks. Results: Thirty patients with advanced chemotherapy-naive pancreatic cancer were included; 26 had measurable disease. Median age 56 years (27–72); median PS 1 (0–2). One PR (3.9%) was achieved; nine patients had stable disease. Median time to progression was 91 days. Median survival was 177 days and one year survival was 13.3% (4 of 30 patients). Treatment was well tolerated; diarrhea WHO grade 2 or 3 occurred in six patients; stomatitis WHO grade 2 and 3 in nine patients. Conclusions: Modulation of 5-FU by PALA and MTX given in this dose and schedule appears to be ineffective in patients with advanced pancreatic adenocarcinoma.
    Materialart: Digitale Medien
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  • 3
    ISSN: 1432-1440
    Schlagwort(e): Small cell lung cancer ; Sequential chemotherapy ; Thoracic irradiation
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary To study the potential benefit of sequential chemotherapy in inoperable small cell lung cancer (SCLC), from 1982 to 1986 ninety-one patients with histologically proven and previously untreated SCLC (median age: 53 years; median Karnofsky status: 80%) were randomly assigned to an initial therapy with adriamycin (since 1984 epirubicin), cyclophosphamide, vincristine (ACO resp. EPICO) or etoposide/cisplatin (VP16/DDP). Treatment courses were repeated every 3 weeks for a total of ≤6 courses with a crossover after a maximum of 3 cycles of either regimen. Limited disease (LD) patients with bronchoscopical, computertomographical and (re-) mediastinoscopical complete remission (CR) randomly received either a thoracic irradiation with 40 Gy or observation only. Overall, 60 out of 85 evaluable patients achieved an objective remission. A CR was observed in 24/51 patients (47%) with limited disease, and in 8/34 patients (24%) with extensive disease. Both, ACO (EPICO) and VP16/DDP were equally effective as initial and second-line therapy. Moreover, after failure to the initial therapy an objective remission could be achieved in 13% of the patients following the alternative second line combination. In 28% of LD patients with an otherwise complete remission residual tumor was detected by (re-) mediastinoscopy. Median survival times were 14 (CR: 16) months in LD patients and 10 (CR: 15) months in ED patients. At present, median survival is significantly improved in irradiated versus non-irradiated LD patients (25 vs. 13 months, p〈0.04). The remission rates and median survival times observed in this study are comparable to those of a historical control group treated with ACO plus radiotherapy alone.
    Materialart: Digitale Medien
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    Journal of cancer research and clinical oncology 124 (1998), S. 627-632 
    ISSN: 1432-1335
    Schlagwort(e): Key words Bendamustine ; Breast cancer
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A phase II pilot study of bendamustine as salvage treatment in patients with advanced breast cancer was performed to determine the objective response rates and make further observations on the toxicity of this drug. A group of 37 patients, pretreated with chemotherapy for advanced disease, entered the trial. Treatment consisted of 150 mg/m2 bendamustine on days 1 and 2 of a 4-week treatment course. Patients continued to receive treatment until complete remission and then two further courses, until tumour progression or unacceptable toxicity ensued. A total of 36 patients received at least one treatment course and were assessable for toxicity; 33 patients were evaluable for treatment results. Dose-limiting grade 3 and 4 WHO toxicity occurred in 5 and 3 patients respectively; 27% of patients entered complete or partial tumour remission. The median time to tumour progression was 2 months with a range of 1–14 months. The efficacy of bendamustine was apparently independent of pretreatment with anthracyclines, suggesting a lack of cross-resistance between bendamustine and anthracyclines. It can be concluded that bendamustine in the dose and application schedule used here is active in the salvage therapy of women with advanced breast cancer. The toxicity was acceptable. Future studies have to confirm the data of this pilot trial and to define the role of bendamustine in the combination chemotherapy of metastatic breast cancer that has been suggested by previous trials.
    Materialart: Digitale Medien
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  • 5
    Digitale Medien
    Digitale Medien
    Springer
    Der Onkologe 5 (1999), S. 47-54 
    ISSN: 1433-0415
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Die zytostatische Chemotherapie ist etablierter Bestandteil im Behandlungskonzept des kolorektalen Karzinoms. Im metastasierten Stadium führt eine auf 5-Fluorouracil-basierende Chemotherapie zu einer signifikant längeren Überlebenszeit und zu einer deutlichen Reduktion tumorbedingter Symptome. In den letzten Jahren wurden zudem mehrere Substanzklassen, die eine relevante Aktivität beim kolorektalen Karzinom zu besitzen scheinen und damit potentiell das therapeutische Arsenal erheblich erweitern könnten, entwickelt und klinisch geprüft. Im folgenden Artikel wird ein Überblick über den derzeitgen Entwicklungsstand der wichtigsten neuen Substanzen für die Therapie des kolorektalen Karzinoms gegeben.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Cancer chemotherapy and pharmacology 18 (1986), S. S1 
    ISSN: 1432-0843
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Antitumor activity (increase in lifespan and cure) was greater for ifosfamide (IFO) in several experimental tumors, some of which were primarily resistant to cyclophosphamide (CYC). IFO has been shown to be active in anthracycline-resistant and in adriamycin/cisplatin-resistant sublines of an Ehrlich ascites tumor, as well as in tumor cells primarily resistant to CYC. The few comparative controlled clinical trials available suggest superior single-agent activity of IFO compared with CYC in soft tissue sarcoma and ovarian cancer. Combination chemotherapy with IFO has been effective in second-line treatment of sarcomas, malignant lymphomas, lung cancer, and testicular cancer, most of them pretreated with or refractory to CYC. Although it is difficult to obtain clinical proof that there is no cross-resistance between IFO and CYC, IFO has been shown to be active in multirefractory malignant lymphomas, in small cell lung cancer not responding to adriamycin, vincristine, and etoposide, and in soft tissue and bone sarcomas. Testicular cancer and pancreatic cancer are some of the tumors in which IFO activity is currently being evaluated and in which CYC has so far failed to show sufficient clinical activity. More comparative controlled clinical trials are needed in ovarian cancer, breast cancer, malignant lymphomas, sarcomas and cervical cancer, in which IFO has already shown sufficient single-agent activity. Due to its lower level of cross-resistance with a variety of heterocyclic products, but also with other alkylating agents, in addition to its use in induction chemotherapy, IFO is an important second-line agent in many clinical situations.
    Materialart: Digitale Medien
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  • 7
    Digitale Medien
    Digitale Medien
    Springer
    Journal of cancer research and clinical oncology 121 (1995), S. 51-56 
    ISSN: 1432-1335
    Schlagwort(e): Gastric lymphoma ; MALT lymphoma ; Non-Hodgkin's lymphoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Pathological findings in 41 patients (male/female ratio: 1.3/1) with primary localized gastric non-Hodgkin's lymphoma (NHL) were retrospectively studied and correlated with survival. The median observation period after diagnosis was 32 (0–189) months. Nineteen patients were low-grade NHL, all but one B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) type. Twenty-two patients had primary (n-7) or secondary (n=15) high-grade lymphomas; Musshoff stage IE was found in 29 and II E in 12 cases. The median age at diagnosis was 61 years (range, 26–88 years), and proliferation, measured by the number of mitosis and Ki-67 antigen positivity (MIB-1), was high or moderately high in 24 cases and low in 17 cases. Follicular lymphatic hyperplasia could be found in 25 of 34 evaluable cases, more often in low-grade than in high-grade NHL. Most of the patients were treated by resective surgery and additional ratio- or chemotherapy. Thirteen patients (31%) died (median survival: 10 months), 5 of them within 3 months after surgery owing to postoperative complications. Survival was superior, though not statistically significant, in low-grade lymphomas. Our retrospective anlysis of heterogeneously treated gastric lymphomas reveals that gastric lymphomas, especially of the low-grade MALT type, often remain a localized disease with a good long-term prognosis. Our study confirms previous reports indicating that lymphomas of the MALT type represent a specific clinicopathological entity.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1569-8041
    Schlagwort(e): docetaxel ; MRP ; multidrug resistance ; nude mice ; paclitaxel
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: Multidrug resistance has been associated with expression ofthe multidrug resistance protein (MRP). Recently, MRP-expression has beendetected in human tumor samples of patients with breast cancer andnon-small-cell lung cancer. Since taxoids are the most active drugs in thetreatment of both tumor entities, the antitumor efficacies of paclitaxel anddocetaxel were compared in nude mice bearing human tumor xenografts thatexpress MRP. Materials and methods: Athymic nude mice (nu/nu) bearing tumor xenograftsof parental human sarcoma HT1080 or MRP-expressing HT1080/DR4 cells (asconfirmed by Northern blot analysis) were treated with the maximum tolerateddoses (MTD) of doxorubicin ([Dx] 10 mg/kg i.v. push), paclitaxel ([PC] 50mg/kg three-hour i.v. infusion), or docetaxel ([DC] 40 mg/kg three-hour i.v.infusion). In vitro, the activity of doxorubicin, paclitaxel and docetaxelwas evaluated by the sulphorhodamine B (SRB) assay using the pyridineanalogue PAK-104P (5 µM), a potent inhibitor of MRP-function. Results: At their MTDs both taxoids showed significant activity againstMRP-negative HT1080 xenografts with response rates of 80% (40%CR) for PC and 100% (60% CR) for DC. In contrast, DC wassignificantly more active than PC in nude mice bearing doxorubicin resistantMRP-expressing HT1080/DR4 tumor xenografts (overall response rates:100% (60% CR) for DC; 10% (0% CR) for PC;0% for Dx). Since treatment of mice with the MTD of PC or DC yieldedsimilar overall toxicity (maximum weight loss for HT1080: PC 8.6 ±2.2%; DC 7.5 ± 2.2% and for HT1080/DR4: PC 11.6± 3.0%; DC 7.5 ± 1.8%, respectively), theseresults demonstrate the increase in the therapeutic index for docetaxelagainst MRP-expressing tumors. In vitro, HT1080/DR4 cells were 270-fold,6.4-fold and 2.8-fold more resistant than parental cells to doxorubicin, PCand DC, respectively. Pyridine analogue PAK-104P completely restored drugsensitivity to PC and DC, while no effect of PAK-104P on parental HT1080cells was observed. Conclusions: Both taxoids, when given at their MTDs, showed significantefficacy against parental HT1080 tumor xenografts. However, docetaxel at itsMTD was significantly more active against MRP-expressing tumor xenografts thanpaclitaxel. Furthermore, in vitro resistance of HT1080/DR4 cells was higherfor PC (6.4-fold) than for DC (2.8-fold). Since PAK-104P completely restoredsensitivity to both taxoids, the observed resistance appears to be related toMRP. These data suggest, that docetaxel is not as readily transported by MRPas paclitaxel leading to an increased therapeutic ratio in MRP-expressingtumors in vivo. Therefore, docetaxel may have therapeutic advantages in theclinical treatment of MRP-expressing tumors.
    Materialart: Digitale Medien
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  • 9
    ISSN: 1573-7217
    Schlagwort(e): chemotherapy ; endocrine maintenance therapy ; medroxyprogesterone acetate
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The purpose of this randomized phase III trial was to study whether medroxyprogesterone acetate (MPA) maintenance treatment prolongs the time to progression in advanced breast cancer patients responding to an induction chemotherapy. Patients with progressive advanced breast cancer previously untreated with anthracylines and progestins were given epirubicin (30 mg/m2) and ifosfamide (2 g/m2) on days 1 and 8 at 3‐weekly intervals. Patients without disease progression after 6 cycles of chemotherapy were randomly assigned to receive, until progression, either no treatment or MPA at a daily total dose of 500 mg. Ninety patients were randomized: 46 to the MPA arm and 44 to the observation arm. Median time to progression was longer in the MPA arm: 4.9 months versus 3.7 months in the intent‐to‐treat analysis (p=0.02), and 4.9 months versus 3.0 months in the secondary efficacy analysis (p=0.012). Seven patients were removed from MPA due to side effects. The changes in patient‐rated quality of life scores were similar in both groups. The median length of survival from randomization was 17.4 months for patients receiving MPA and 18.3 months for patients randomized to observation (p=0.39). In conclusion, in patients with advanced breast cancer achieving remission or non‐progression with 6 cycles of epirubicin and ifosfamide chemotherapy, MPA maintenance treatment led to a significant, though modest, prolongation of the time to progression without affecting overall survival of the study patients.
    Materialart: Digitale Medien
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