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  • 1
    ISSN: 1569-8041
    Keywords: biochemical modulation ; 5-fluorouracil ; methotrexate ; pancreatic cancer ; phosphonacetyl-L-aspartate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: docetaxel ; MRP ; multidrug resistance ; nude mice ; paclitaxel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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