ISSN:0378-584X    

DOI:10.1159/000216749

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

ISSN:0378-584X    

DOI:10.1159/000216750

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Based on the hypothesis of Goldie and Coldman, rapid cyclic alternating chemotherapy has been supposed to be a favorable treatment modality in small cell lung cancer. This approach has been tested in a large series of trials since the late 70’s. A few trials performed randomization between alternating and continuous treatment after a period of initial common continuous therapy. The results of these studies are controversial and their interpretation is complicated by the effects of the continuous pretreatment. Recently, most trials were designed as 2-arm approaches with a comparison of continuous standard therapy based on the CAV- or CMC-protocol with an alternating schedule often consisting of the CAV- or CMC-derived combinations and a second regimen including cisplatinum and/or etoposide. In these trials the addition of the second regimen in the alternating treatment arms has improved the treatment results. However, these trials could not clarify whether this advantage was due to the concept of alternating treatment or to the high activity of new drugs given early in the course of therapy in the alternating treatment arms. To ameliorate this weakness, 3 studies were designed as 3-arms approaches using both alternating protocols as continuous control arms. Whereas one investigation noticed an advantage of the alternating schedule, the two others observed no difference. These studies did not report their criteria for shifting non-responding patients from continuous treatment to second line therapy. The longer these patients stayed on the continuous protocol the more the study design favoured the alternating therapy. We considered this point of criticism in a German multicenter study comparing a fixed cyclic alternating treatment with IE and CAV to a response orientated protocol with IE therapy up to the maximum response and subsequently a immediate switch to CAV. The study showed no advantage of the alternating treatment arm indicating that cyclic alternating therapy is not superior to an optimal performed continuous therapy in small cell lung cance

ISSN:0378-584X    

DOI:10.1159/000216751

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Specific application of immunological markers in acute lymphoblastic leukemia (ALL) for detection of inadequate blast cell reduction after induction therapy or early recognition of a. relapse requires a precise characterization of the immunophenotype at the time of diagnosis and an understanding of the biology of the disease. Therefore, the ALL-BFM 83 study is first used to demonstrate the incidence, antigen expression and dynamics of relapse occurrence of immunological subtypes in childhood ALL. This is then followed by a discussion of the different immunological features hitherto applied for identification of residual leukemia cells in ALL (terminal deoxynucleotidyl transferase – TdT; common acute lymphoblastic leukemia-associated antigen – CALLA, CD10; various T-cell differentiation antigens; kappa/lambda labelling); these are, however, not leukemia-specific and are expressed to varying degrees by normal lymphoid progenitor cells. The sensitivity of these analyses is therefore largely determined by the markers applied and the type of investigational material. Finally, suitable markers are presented for detecting residual leukemia cells in the different immunological subtypes of ALL. Their clinical relevance still remains to be evaluated in prospective therapy stud

ISSN:0378-584X    

DOI:10.1159/000216752

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Pirarubicin is a more lipophilic derivative of doxorubicin, with a higher uptake rate of cells, lower cardiotoxicity and better antitumor efficacy in preclinical models. Thirty-four patients with metastatic breast cancer were treated in a multicenter phase II study with pirarubicin (THP) using a dosage of 75 mg/m2/every 3 weeks. The patients had a median age of 56 years (range 41–73) and a performance status of WHO grade 0–2. Patients pretreated with anthracycli-nes, or who were older than 75 years and without sufficient bone marrow reserve were excluded. The 32 evaluable patients received a median number of 4 cycles (range 2–8). The myelosuppression was dose-limiting and led to infections (grades 1 and 2) in 5 patients. Twenty-eight patients developed leukocytopenia grade 3 and 4 toxicity and 7 patients experienced thrombocytopenia grade 1 and 2. The drug was subjectively well tolerated and nausea, vomiting and alopecia were mild. One complete remission with a duration of 15.4 months (67 weeks) and 7 partial remissions with a median duration of 9.3 months (40 weeks) were achieved, which resulted in an overall response rate of 25 %. Twenty-one patients were stable for 17 weeks (median) under the treatment with piraru

ISSN:0378-584X    

DOI:10.1159/000216753

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Forty-seven patients with advanced non-small cell lung cancer (NSCLC) were treated in a multicentre phase II study with pirarubicin (THP), 4’-O-tetrahydropyranyl-doxorubicin using a dosage of 70mg/ m2 every 3 weeks. The median age of the patients was 59 years (range 45–70) and the performance status grade 0–2 (WHO). Thirty-eight patients had stage IV and 9 stage III (UICC). Twenty-six patients had an adenocarcinoma, 19 a squamous cell carcinoma, and 2 a polymor-phocellular carcinoma. Six out of 45 evaluable patients achieved a partial remission leading to an overall response rate of 13 %. Eighteen patients showed no change (NC), 12 were progressive (PD), 2 patients had early progression (EP), and 7 patients died during the first course with clinical signs of tumor progression (early death). The median survival time was 4.6 months. Leukocytopenia and thrombocytopenia (WHO grade 4) was experienced in 8.5% and 2.1%, nausea and vomiting (grade 2 and 3) by 32% of the patients. There was no cardiotoxicity or other severe side effects. Pirarubicin has only a moderate antineoplastic activity in patients with advanced NSCLC. Observed response rates are similar to those reported for doxorubicin, but the toxic side effects are m

ISSN:0378-584X    

DOI:10.1159/000216754

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Tauromustine (TCNU) is a newly developed nitrosourea compound. As a result of molecular modification, TCNU is more hydrophilic than BCNU and CCNU. In experimental data there was a high therapeutic index, especially in Walker 256 carcinosarcoma in rats, and in phase I trials antitumor activity was observed in NSCLC (10/33 remissions). There was also activity in melanoma, breast cancer, pleurameso-theliomas and ovarian cancer. To determine the effectiveness, duration of response and toxicity of TCNU the following phase II trial was performed. Patients received 130 mg/m2 TCNU every 35 days orally. Twenty-five patients were treated; 22 were evaluable. The female/male ratio was 18/4, 1 patient was stage III, 21 patients stage IV, the mean age was 62.3 years (range 32–70). Between 1 and 4 courses (mean 1.9) were administered. Histology was as follows: 6 squamous cell, 11 adeno-carcinoma, 2 large cell and 3 polymorph cell carcinomas. No objective response (CR + PR) was observed; 6/18 patients had stable disease, 7/18 progression and 5/18 early progression. The median survival time is 4.9 months. The most severe side effect was thrombocytopenia (WHO grade 3 + 4, 4/22 patients). TCNU administered at this dose and schedule does not show substantial antitumor activity in patients with NSCLC. The fact that no objective tumor remission was observed suggests that the true response rate is < 20% (p < 0.05). It is improbable that TCNU has a relevant impact on the course of inoperable NSCL

ISSN:0378-584X    

DOI:10.1159/000216755

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Eighteen patients with advanced squamous cell carcinoma of the esophagus without prior chemotherapy were treated with carboplatin. Based on experimental data a split dose of carboplatin of 130 mg/m2 given on days 1, 3 and 5 was administered. In cases showing no WBC and platelet suppression, an escalated dose of 160 mg/m2 was proposed. Out of 18 evaluable patients no complete and partial responses were observed and there were only 5 patients with stable disease (27.8%) lasting 2–7 months. Therefore, carboplatin in the regimen used shows no meaningful antitumor activity in patients with advanced esophageal carcinoma. The escalated dose (mean 107–123% of the starting dose) was well tolerated and was followed by only minor gastrointestinal and hematological toxicity. Therefore, this regimen can be recommended for future tri

ISSN:0378-584X    

DOI:10.1159/000216756

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

In a multicenter trial, 49 patients with histologically proven advanced gastric cancer were treated with a combination chemotherapy consisting of etoposide 120 mg/m2 d 4, 5, 6 adriamycin 20 mg/m2 d 1, 7 and cisplatinum 40 mg/m2 d 2, 8. Therapy was repeated every 4 weeks. 45 patients were evaluable for response after 8 weeks of treatment. Eight patients achieved a partial remission (PR: 18%), 17 patients had no change (NC: 38%), and 20 patients showed tumor progression (P: 44%). Four patients with primarily inoperable tumor and without distant metastases who achieved a partial remission, underwent second look operation with curative intention. All 4 patients died within 12 months after second look operation due to tumor recurrence. Median survival time of all patients was 9 months. Toxicity was considerable. WHO grade 3/4 toxicity appeared in 20–30% of patients (nausea, vomiting, loss of appetite, leucopenia). After 3 cycles complete alopecia was present in 70% of patients. Severe infection, requiring treatment, occurred in 10 patients. Five patients discontinued therapy because of intolerable subjective toxicity. The observed response rate of 18% objective partial remissions is disappointing and does not give support to the communications reporting response rates over 50% with EAP and other regimens including cisplatinum. In conclusion, and considering the high subjective and objective toxicity of this regimen, it can not be recommended for standard use in patients with advanced gastric cance

ISSN:0378-584X    

DOI:10.1159/000216757

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger

摘要:

Zehn Patienten mit fortgeschrittenem C-Zell-Karzinom wurden alle 3 Wochen mit Adriamycin (50mg/m2), Cisplatin (60mg/m2) und Vindesin (3 mg/m2) behandelt. Nur bei einem Patienten kam es zu einer partiellen Remission (PR). Bei drei Patienten beobachteten wir eine weitere Tumorprogression und bei den anderen sechs einen unveränderten Befund (no change). Die Polychemotherapie aus Adriamycin, Cisplatin und Vindesin scheint somit im Vergleich zu Literaturdaten der meist angewandten Adriamycin-Monotherapie nicht überlegen zu sein. Die Tumormarker Calcitonin (CT) und karzinoembryonales Antigen (CEA) waren in alien Fallen pathologisch erhöht. Während der Chemotherapie erwiesen sich CT und CEA als wertvolle Verlaufsparameter. Bei dem Patienten mit PR spiegelten die CT- und CEA-Werte die klinische Remission wider. Dagegen stiegen sie bei den Patienten mit Tumorprogression kontinuierlich

ISSN:0378-584X    

DOI:10.1159/000216758

出版商:S. Karger GmbH    

年代:1990

数据来源: Karger