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  • 1
    ISSN: 1569-8041
    Keywords: advanced breast cancer ; docetaxel ; epidoxorubicin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The combination of anthracyclines and taxanes iscurrently considered the first choice chemotherapy in advanced breast cancer(ABC) and considerable emphasis has been placed on programs exploring thesafest and most efficient way to integrate these classes of drugs in both themetastatic and, more recently, the adjuvant setting. We report here the overall results of the combination of epidoxorubicin (E)90 mg/m2 and docetaxel (D) 75 mg/m2 as first-linechemotherapy in ABC. Patients and methods:A total of 70 patients were entered in theinitial dose-finding study (20 patients) and in the subsequent extended phaseII trial (50 patients). Overall 54% of patients had dominant visceraldisease and 57% had at least two metastatic sites. Adjuvantanthracyclines were allowed in the phase II part of the study based on thelack of cardiac toxicity observed in the phase I study at a median cumulativeE dose of 480 mg/m2. A maximum of eight cycles of the combinationwas allowed, and cardiac function was monitored at baseline and after everysecond course by echocardiography. Results:Overall, the median number of cycles administered withthe combination was 4 (range 3–8). Neutropenia was confirmed to be themain haematological toxicity, with granulocyte colony-stimulating factor(G-CSF) support required in 44% of the cycles. Febrile neutropeniaoccurred in 12% of cycles of the combination but 52% of theepisodes could be managed on an outpatient basis with oral antibiotics.Overall, the median cumulative dose of E, including prior adjuvantanthracyclines, was 495 mg/m2 (range 270–1020mg/m2). One patient who received adjuvant E together withradiotherapy to the left chest wall developed fully reversible clinical signsof cardiotoxicity and a significant decrease of LVEF to 35% after acumulative E dose of 870 mg/m2, with four additional patients(6%) developing asymptomatic and transient decline of resting LVEF. Theoverall response rate (ORR) in 68 evaluable patients was 66%(95% confidence interval (95% CI): 54%–73%).A comparable antitumour activity of 71% was reported in the group ofpatients with a prior adjuvant chemotherapy with anthracyclines. After anoverall median follow-up time of 22 months (range 4–39+), the mediantime to progression (TTP) was 4.5 months and the median duration of responsewas 8 months (range 3–16). No pharmacokinetic (Pk) interaction could bedemonstrated between E and D when given simultaneously and sequentially witha one-hour interval. Conclusions:The combination of E and D in a multi-institutionalsetting is an active and safe regimen in poor- prognosis patients with ABC.New combinations and schedules are worth considering in an attempt to furtherimprove disease response and long-term control of the disease.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: docetaxel ; doxorubicin ; interaction ; mice ; paclitaxel ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The combination of doxorubicin (Dx) with paclitaxel or docetaxel is clinically effective but there are concerns regarding the higher incidence of cardiotoxicity of the combination compared with Dx alone. The mechanism of the increased toxicity is still unclear. Purpose: To assess whether there is a pharmacokinetic interaction between paclitaxel, docetaxel or their vehicles and Dx in mice. Materials and methods: CDF1 male mice were treated with Dx either alone (10 mg/kg i.v.) or in combination with paclitaxel (25 mg/kg) or docetaxel (25 mg/kg) or their vehicles, i.e., cremophor-ethanol-glucose (cremophor) or polysorbate80-ethanol-glucose (polysorbate). Four mice were killed 4, 8 or 24 hours after Dx in each experimental group and Dx was assayed in serum and in heart, liver, kidney and spleen by HPLC. Results: Four hours after treatment the concentrations of Dx in heart, liver and kidney were much higher in mice concomitantly treated with paclitaxel, docetaxel (dissolved in either cremophor or polysorbate) and cremophor. At subsequent times the differences were modest and only reached statistical significance in a few cases. Dx metabolites were modified by concomitant treatment with taxanes or their vehicles. In particular, the levels of Dx aglycone in liver and kidney were significantly lower in mice treated with the combination than in mice given Dx alone. Conclusions: paclitaxel, docetaxel and cremophor when given together with Dx modify its distribution and metabolism, increasing Dx levels in many tissues including the heart. This might have some bearing on the toxicity of regimens in which Dx is combined with taxanes.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Chichester : Wiley-Blackwell
    Biological Mass Spectrometry 22 (1993), S. 351-357 
    ISSN: 1052-9306
    Keywords: Chemistry ; Analytical Chemistry and Spectroscopy
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: We used gas chromatography/mass spectrometry to identify and quantitate some aphidicolin metabolites in plasma and urine of patients receiving aphidicolin-17-glycinate. The major metabolite found in plasma was 3-ketoaphidicolin, present at about one thent the concentrations of aphidicolin. 3-Ketoaphidicolin undergoes dehydroxymethylation to give 18-nor-3-ketoaphidicolin. This metabolite was also found in plasma and its concentration reached a maximum of 1% of aphidicolin.Small amounts of aphidicolin and 3-ketoaphidicolin were found free in urine but almost all of the drug was conjugated to glucuronic acid, as shown by mass spectrometric analysis of urine extracts and by enzymatic digestion with β-glucoronidase followed by gas chromatographic/mass spectrometric analysis.
    Additional Material: 8 Ill.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Chichester : Wiley-Blackwell
    Biological Mass Spectrometry 10 (1983), S. 485-488 
    ISSN: 0306-042X
    Keywords: Chemistry ; Analytical Chemistry and Spectroscopy
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Notes: High pressure liquid chromatography was used in combination with mass spectrometry to confirm that the main products of in vitro metabolism of 1-(4-acetylphenyl)-3,3-dimethyltriazene are 1-(4-acetylphenyl-3-methyltriazene and 4-aminoacetophenone. In addition a novel metabolite, 1-[4-(1-hydroxyethyl)-phenyl]-3,3-dimethyltriazene, possessing antitumour activity similar to the parent drug, was identified.
    Additional Material: 6 Ill.
    Type of Medium: Electronic Resource
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