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  • Induction therapy  (2)
  • paclitaxel  (2)
  • Aclacinomycin A  (1)
  • 1
    ISSN: 1569-8041
    Keywords: metastatic breast cancer ; paclitaxel ; weekly 24-hour 5-FU/leucovorin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0584
    Keywords: Key words Acute myeloid leukemia ; Cytosine arabinoside ; Idarubicin ; Induction therapy ; Karyotype
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We treated 153 patients with de novo acute myeloid leukemia (AML) with two induction courses of conventional-dose cytosine arabinoside (ara-C) and idarubicin (AIDA) followed by either a third course of AIDA, high-dose ara-C or bone-marrow transplantation. The complete remission (CR) rate for all patients was 63.4%, with a higher CR rate for patients with a normal (versus unfavorable) karyotype (73.2% vs 52.5%;P=0.038). The probability of overall survival (OS) was 30.7% after 5 years (26.3% after 7 years). Improved OS at 5 years could be observed for patients up to 50 years old versus patients older than 50 years of age (37.6% vs 19.9%;P=0.001) and patients with a normal (versus unfavorable) karyotype (42.9% vs 14.1%;P=0.0016). Disease-free survival (DFS) after 5 years was 33.2% for all 97 CR patients and was significantly better for patients with a normal (versus unfavorable) karyotype (44.3% vs 12.3%;P=0.003). Multivariate analysis revealed that the age for OS (P〈0.02) and the karyotype for both OS (P〈0.03) and DFS (P〈0.05) were independent prognostic factors. In conclusion, AIDA is an effective and well-tolerated induction regimen (even in elderly patients) with a 5-year survival of more than 30% when combined with ara-C-containing postremission therapy. The karyotype is the most powerful prognostic factor for predicting the outcome of patients treated with this protocol.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of cancer research and clinical oncology 105 (1983), S. 162-165 
    ISSN: 1432-1335
    Keywords: Aclacinomycin A ; Phase II study ; Refractory neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Aclacinomycin A (ACM) is a new anthracycline antibiotic with a reduced cardiac toxicity in animal models. A phase II study was performed in a total of 25 patients, 23 of whom are evaluable for response. All suffered from recurrent and advanced tumors. Pretreatment consisted of at least four different chemotherapeutic agents (range: 4–9). Lung cancer patients (3/9) were irradiated to the mediastinum. Eighteen patients were pretreated with doxo- or daunomycin. The dose for solid tumors was 2–3 mg/kg given on 3 consecutive days every 3 weeks. Leukemia patients received a daily dose of 20 mg/m2, and standard response criteria were used. Marked reductions of leukocyte counts were achieved in leukemia patients. The overall response rate was about 15% in solid tumors, but major objective responses (CR+PR) have not been observed. Myelosuppression was commonly moderate in solid tumor patients, nausea and vomiting were rare, and alopecia was not induced. Cumulative cardiotoxicity was not evaluated in this trial. Treatment with ACM requires further investigation in acute leukemias and solid tumors, not pretreated with anthracycline antibiotics.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1440
    Keywords: Small cell bronchogenic carcinoma ; Induction therapy ; Maintenance ; Remission rate ; Survival ; Kleinzelliges Bronchialkarzinom ; Induktionsbehandlung ; Erhaltungstherapie ; Remissionsraten ; Überlebenszeiten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Seit Juli 1978 wurden 103 Patienten mit inoperablem kleinzelligem Bronchialkarzinom mit der Zytostatikakombination Adriamycin, Cyclophosphamid und Vincristin (ACO) behandelt. Im Stadium „limited disease“ (n=64) erfolgte während des zweiten Chemotherapiekurses eine prophylaktische Schädelbestrahlung, nach dem vierten eine konsolidierende thorakale Bestrahlung. Nach Erreichen einer kompletten Remission erhielten die Patienten prospektiv randomisiert Etoposid oder keine weitere spezifische Therapie. Ein objektives Ansprechen konnte bei 88/100 auswertbaren Patienten erzielt werden. Im Stadium „limited disease“ fanden sich 72%, im Stadium „extensive disease“ nur 33% komplette Remissionen. Im Stadium „limited disease“ betrug die hochgerechnete mediane Überlebenszeit 15,8, im Stadium „extensive disease“ 9,3 Monate (p〈0.005). Es leben noch 29 Patienten, 4 rezidivfrei länger als 24 Monate. Patienten mit kompletter Remission hatten eine statistisch signifikant (p〈0.001) längere Überlebenszeit als Patienten mit geringerem Ansprechen. Regelmäßig traten gastrointestinale und hämatologische Nebenwirkungen auf, drei Patienten starben während der Induktionsphase an Infektionen. Die kurzzeitige Induktionsbehandlung verbesserte jedoch den Krankheitsverlauf subjektiv und objektiv. Bisher ist kein positiver Effekt der zyklischen Etoposid-Gabe nach ACO festzustellen.
    Notes: Summary Since July 1978 one hundred and three consecutive patients with unresectable small cell bronchogenic carcinoma were treated with a combination of doxorubicin, cyclophosphamide and vincristine (ACO). In limited disease patients (64) the second chemotherapy course was followed by prophylactic cranial irradiation, the fourth by irradiation towards primary disease sites. Complete responders were randomised to either receive etoposide or no further maintenance therapy. Objective responses were reached in 88/100 evaluable patients, with 72% of complete remissions in limited-stage disease and 33% in extensive disease, respectively. The actuarial median survival time for limited disease patients was 15.8 months compared to 9.3 months in extensive disease (p〈0.005). 29 of the 100 patients remain still alive, 4 for more than 24 months without disease recurrence. The survival advantage of patients reaching complete remissions relative to those who did not is highly significant (p〈0.001). Acute gastrointestinal and hematological side effects were common, with possibly three drug-related deaths from infections during transient granulocytopenia (mean nadir: 600–900 cells/mm3). The present induction regimen using only four courses of chemotherapy produces high complete remission rates on roentgenography and bronchoscopy and improved survival in the majority of patients. Thus far any effectiveness of etoposide-maintenance therapy following ACO could not be substantiated.
    Type of Medium: Electronic Resource
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  • 5
    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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