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  • 1
    Electronic Resource
    Electronic Resource
    A phase II study of weekly high-dose cisplatin combined with oral etoposide in advanced non-small-cell lung cancer (1997)
    Springer
    Cancer chemotherapy and pharmacology 40 (1997), S. 347-352 
    Details
    ISSN: 1432-0843
    Keywords: Key words: Non-small-cell lung cancer ; Cisplatin ; Oral etoposide ; Dose intensity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  As a dose-response relationship has been suggested for cisplatin, it appeared attractive to explore high-dose-intensity regimens in non-small-cell lung cancer. In a phase I study of weekly administration of cisplatin combined with oral etoposide we achieved a cisplatin dose intensity of 52.5 – 60 mg/m2 per week in most patients. We subsequently explored this regimen in advanced non-small-cell lung cancer. Patients were treated with cisplatin infused at 70 mg/m2 on days 1, 8, 15 and 29, 36, 43 in combination with oral etoposide given at 50 mg on days 1 – 15 and 29 – 43. Patients showing stable disease or a better response were continued on treatment with oral etoposide given at 50 mg/m2 per day on days 1 – 21 every 28 days for a maximum of four cycles. In all, 22 patients with stage III disease and 31 patients with stage IV disease entered the study. The median number of cisplatin administration was 6 per patient; 17 patients reached the planned cisplatin dose intensity of 60 mg/m2 per week, 11 patients achieved 52.5 mg/m2 per week, and 7 patients reached 47 mg/m2 per week. Overall, 11 of 21 stage III patients had a partial response [response rate 51%, 95% confidence interval (CI) 36 – 81%], as did 9 of 28 patients with stage IV disease (32%; 95% CI 15 – 49%). Toxicity was mainly hematologic, with leukocytopenia being the most frequent cause of treatment delay. Nephrotoxicity of grade 1 was observed in seven patients. Two patients developed clinical hearing loss. With this schedule a high median cisplatin dose intensity of 52.5 – 60 mg/m2 per week was reached. The 51% response rate achieved in stage III disease makes this schedule attractive for further exploration; however, it is not recommended for routine use in stage IV disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002800050668
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  • 2
    Electronic Resource
    Electronic Resource
    Ifosfamide given as a 24-h infusion with mesna in patients with recurrent ovarian cancer: preliminary results (1990)
    Springer
    Cancer chemotherapy and pharmacology 26 (1990), S. S51 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The continuous 24-h infusion of ifosfamide (IFX) with mesna was studied in 44 patients with therapyresistant or relapsing ovarian cancer. All patients had stage III disease and had been pretreated with at least one combination comprising an alkylating agent and a cisplatin analogue (22, with one combination; 16, with two; and 6, with three or more). The median number of IFX cycles received was two. Of 40 evaluable patients, 2 achieved a complete response, 5 showed a partial response and 6 had stable disease. A total of 27 patients had tumor progression after one or two treatment cycles. All seven responders had responded to previous treatment for a median duration of 5 months (range, 5–41 months). No patient who progressed during alkylating-agent treatment responded to IFX given subsequently. The median progression-free period was 6 months (range, 4–12 months), and the median overall survival was only 6 months, indicating the advanced stage of disease in these patients. The median overall survival in progressive patients was 5 months (range 2–13+months) and that in the remaining group was 13 months (ranges 3+-24 months) (P〈0.05). This treatment was moderately well tolerated. Grade 3 nausea and vomiting occurred in 27% of cycles and grade 3-4 leukopenia was observed in 47%, but thrombocytopenia was hardly ever found. In eight patients there was a deterioration of renal function. Among a total of 131 cycles, the dose was reduced for only 9 due to myelotoxicity and for 3 due to nephrotoxicity. IFX seems to be active only in patients who have relapsed after responding to previous cytotoxic treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00685420
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  • 3
    Electronic Resource
    Electronic Resource
    Evaluation of tissue polypeptide antigen serum levels for monitoring disease activity during chemotherapy in patients with transitional carcinoma of the urinary tract (1992)
    Springer
    Journal of cancer research and clinical oncology 118 (1992), S. 626-628 
    Details
    ISSN: 1432-1335
    Keywords: Tissue polypeptide antigen ; Chemotherapy ; Bladder cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 28 patients with transitional carcinoma of the urinary tract, all treated with chemotherapy, serial measurements of serum tissue polypeptide antigen (TPA) were performed and correlated to clinical evaluations of response. At the start of chemotherapy elevated levels of TPA were found in 4 out of 14 patients with T2-4NO-2MO tumours and in 7 out of 14 patients with distant metastases. In most patients with elevated TPA levels who responded to chemotherapy, TPA levels rapidly returned to normal. False positive elevations of TPA were observed in 2 patients. It is concluded that serial measurement of TPA for monitoring disease activity has limited value because of the low sensitivity of TPA, especially for patients with early-stage cancer, and because of the occurrence of false positive results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01211809
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  • 4
    Electronic Resource
    Electronic Resource
    Dexverapamil to modulate vinblastine resistance in metastatic renal cell carcinoma (1995)
    Springer
    Journal of cancer research and clinical oncology 121 (1995), S. R11 
    Details
    ISSN: 1432-1335
    Keywords: Dexverapamil ; Multidrug resistance ; Renal cell carcinoma ; Clinical study ; Chemosensitisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Multidrug resistance (MDR) in a variety of human tumours such as renal cell carcinoma (RCC) is thought to be caused by expression of theMDR1 gene and may be reversed by applying modern chemosensitisers such as dexverapamil, which inhibit theMDR1 gene product P-glycoprotein. This preliminary report gives information on a clinical study complying with good clinical practice regulations in patients with advanced RCC. The final evaluation is pending. Vinblastine, if anything the most effective chemotherapeutic agent (5-day continuous regimen), was combined with oral dexverapamil (6 times per day) as a chemosensitiser and dexamethasone to increase dexverapamil tolerance. All patients had histologically proven RCC, which was metastatic and progressive at study entry. The statistical design featured a pre-study regimen of two cycles of vinblastine alone followed by evaluation. If no response was documented, with all patients thus serving as their own control, dexverapamil and dexamethasone were added for three cycles of combination therapy. Having obtained institutional permission from the ethical review committee, we enrolled patients of whom 25 qualified for the combined-treatment arm; 13 patients finished the study, 5 patients failed to complete all treatment cycles (1 because of treatment-related toxicity, 3 for personal reasons, not related to treatment, 1 for tumour-related reasons) and 7 patients were at too early a stage for evaluation. Altogether, 61% of all patients tolerated a dose of dexverapamil of at least 2400 mg/day with peak serum levels reaching, in some cases, approximately 8 μM (the sum of dexverapamil plus nordexverapamil levels). WHO grade 3 and 4 toxicities were mainly myelosuppression (5/18). The combination of 1.4 mg m−2 day−1 vinblastine plus dexverapamil was generally felt to be safe and well tolerated. One partial response and 7 stable diseases were noted in this heavily pretreated study population. Four-hourly administration of dexverapamil in combination with dexamethasone plus escalation to the individually tolerated doses have permitted increases in serum levels of dexverapamil.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02351065
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  • 5
    Electronic Resource
    Electronic Resource
    The value of immunohistochemistry in patients with poorly differentiated adenocarcinomas and undifferentiated carcinomas of unknown primary (1996)
    Springer
    Journal of cancer research and clinical oncology 122 (1996), S. 181-185 
    Details
    ISSN: 1432-1335
    Keywords: Carcinoma of unknown origin ; Immunohistochemistry ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A subgroup of patients with metastatic carcinomas of unknown origin may benefit from combination chemotherapy. The relevance of immunohistochemistry in detecting such patients was investigated. Immunohistochemical studies with a panel of antibodies were performed on the tissue specimens of 41 patients having a light-microscopic diagnosis of poorly differentiated adenocarcinoma or undifferentiated carcinoma of unknown origin, who had been treated with cisplatin-containing chemotherapy. The study aimed to answer the following questions: (a) Can the tissue type of the tumor be verified? (b) Can a primary organ site be identified? (c) Can a prognostic immunohistochemical profile be recognized? The original diagnosis had to be changed in 2 of the 41 patients, who turned out to have a malignant lymphoma and neuroblastoma, respectively. The primary site was diagnosed in a patient with prostate cancer, whereas in one case the diagnosis could be narrowed down to a neuroendocrine tumor. No certain immunohistochemical profile with prognostic significance could be identified. It was concluded that immunohistochemistry should be routinely used in cases of undifferentiated carcinoma of unknown primary origin to verify the histological diagnosis and to select the appropriate therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01366960
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  • 6
    Electronic Resource
    Electronic Resource
    Evaluation of CA19-9 serum levels for monitoring disease activity during chemotherapy of pancreatic adenocarcinoma (1991)
    Springer
    Journal of cancer research and clinical oncology 117 (1991), S. 263-265 
    Details
    ISSN: 1432-1335
    Keywords: CA19-9 ; Pancreatic cancer ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between 1987 and 1990 21 patients with proven adenocarcinoma of the pancreas were treated with chemotherapy in four different phase II studies. For 14 patients, serial measurements of CA19-9 serum levels and clinical evaluations of response by computed tomography scan and/or ultrasound were available. Clinical stable disease and progressive disease were accompanied by stable or exponentially rising serum levels of CA19-9. One patient with clinical partial remission showed a 90% decline of CA19-9. However, a 75% decline of CA19-9 was also observed in a patient with rapidly progressive disease. These data seem to indicate that the CA19-9 serum level may be used as an easy and sensitive tool to evaluate progressive disease during chemotherapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01625436
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