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Biomedical subjects

A Adenis

Publications and source records attributed to A Adenis.

At least 55 records · Page 3Linked to original sources
PubMed1995

Randomized trial comparing conventional intravenous bolus FEC and FEC with high-dose infusional 5-fluorouracil as first-line treatment of advanced breast cancer.

FEC (5-FU 500 mg/m2, epirubicin 50 mg/m2, and cyclophosphamide 500 mg/m2) administered as a conventional bolus schedule is widely used in treatment of advanced breast cancer. 5-FU is thought to be more efficient when administered at high doses as a continuous infusion. The aim of this study was to compare the response rate, time to treatment failure, and overall survival obtained with standard FEC regimen (group A) and FEC with high-dose infusional 5-FU (750 mg/m2 per day/days 1 to 5) (group B). One hundred and seventy-eight patients entered this study, 89 in each arm; 10 were noneligible. Both groups were comparable for age, performance status, menopausal status, hormonal receptor status and prior treatment of the initial tumor, duration of relapse free interval, and type and number of disease sites. One hundred and forth patients were evaluable for efficacy. The response rate was 33.3% in group A (1.4% complete response-CR), and 39.4% in group B (9.8% CR) (ns). In an intent to treat basis (n = 168) the response rates were 26.8% and 34.1%, respectively, in groups A and B (ns). The response rate in liver metastasis was significantly higher in group B (57.1%) than in group A (20.0%) (P = 0.03). The time to treatment failure and overall survival were not different between the two groups. One hundred and fifty-three patients were evaluable for toxicity. 10.7% of the patients in group A and 16.0% in group B stopped treatment due to toxicity. Stomatitis was more frequently observed in group B than in group A (46.7% versus 2.6%, respectively, p < 10(-9)). The rates of other side effects were similar in the two groups. In conclusion, the two regimens gave similar overall response rates, time to treatment failure and survival, but infusional 5-FU yielded a better response rate in the liver metastasis.

Adult↗
PubMed1994

1,25-dihydroxyvitamin D3 receptors in normal and malignant human colorectal tissues.

1 alpha,25-Dihydroxyvitamin D3, (1,25(OH)2D3), the active metabolite of vitamin D3, has important physiological effects on growth and differentiation in a variety of malignant and non-malignant cell types. In order to better understand the significance of 1,25(OH)2D3 receptors (VDR) in human colorectal cancer, we determined the levels of VDR in paired samples (malignant and adjacent normal tissues) of 24 colorectal cancer bearing patients. Our results demonstrated differences in the relative abundance of VDR between normal and transformed tissues according to the localization of the tumor. While colonic tumors exhibited significantly higher VDR values than their normal counterparts, the contrary seemed to occur in the rectal tumors. In colonic tumors, we found significant correlations between VDR levels and the absence of node involvement or a low Astler-Coller stage. The increased VDR values in colonic tumors as compared with the normal adjacent tissues, may warrant, at least in this type of cancer, the action of 1,25(OH)2D3 or its non-calcemic analogs, to help induce cell differentiation and growth inhibition.

Adult↗
PubMed1994

[Antiemetic treatment and chemotherapy: general review].

Chemotherapy-induced nausea and emesis are frequent and patients fearful. Emesis caused by cytotoxic agents can be related to their effects on central chemoreceptor or on the gut chemoreceptor by serotonin. 5HT3 receptor antagonists produce a major improvement in the control of cisplatin induced-emesis (70 to 80% of patients). The 5HT3-antagonist efficacy is significantly better than metoclopramide alone, or antimemetic combinations in highly emetogenic chemotherapy regimens but less good in moderately emetogenic chemotherapy. Studies with 5HT3 receptor antagonist plus corticosteroids show advantage over 5HT3 antagonist alone. Comparison studies between the different setrons didn't show any significant difference. Anticipary emesis are treated with anxiolytic drugs. The prevention of delayed emesis, not yet well controlled by 5HT3 antagonist, is a great therapeutic deal. Finally, some therapeutic problems are not resolved: minimal dose, use of oral route, efficacy in fractionated chemotherapy, treatment after loss of efficacy of 5HT3 antagonist.

Antiemetics↗
PubMed1994

Vinorelbine (navelbine) as a salvage treatment for advanced breast cancer.

BACKGROUND: Vinorelbine (Navelbine), a new vinca alkaloid, is an effective drug in breast cancer. Our study was undertaken to assess the efficacy and tolerance of Navelbine in refractory advanced and/or metastatic breast cancer (AMBC). PATIENTS AND METHODS: One hundred heavily pretreated patients with AMBC entered the study and were scheduled to receive 30 mg/m2 of Navelbine weekly by a 20 min i.v. infusion with dose adjustments according to tolerance. All patients had previously received at least one chemotherapy regimen including an anthracycline for advanced disease. RESULTS: Sixteen of the 100 assessable patients responded (1 complete response and 15 partial responses), for an overall response rate of 16% (IC 95: 8%-23%). The median duration of response was 5 months (3-18). Responses were seen in lymph nodes (13/27), breast (11/34), soft tissue and skin (13/36), lung (3/14) and liver (2/25), but not in bone metastases. The main toxicities (WHO grade > or = 3) were granulocytopenia and anemia in, respectively, 51% and 9% of all 100 eligible patients. Thrombocytopenia and other non-haematological toxicities consisting of peripheral neuropathy, constipation, nausea/vomiting, alopecia and phlebitis were rare and mild. CONCLUSION: Vinorelbine is an active drug in AMBC, particularly in breast, lymph nodes and skin/soft tissue sites, with an excellent tolerance. Since the mean dose intensity was 19.7 mg/m2/week, a dose of 20 mg/m2/week is recommended for heavily pretreated patients (radiotherapy and chemotherapy).

Adult↗
PubMed1994

Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn's disease. A prospective multicentre study of 121 cases. The Groupe d'Etudes Thérapeutiques des Affections Inflammatoires Digestives.

The relationships between clinical activity, endoscopic severity, and biological parameters in Crohn's disease have not been thoroughly investigated and a link was therefore sought between these three elements. The following parameters were determined simultaneously in 121 consecutive patients with colonic or ileocolonic Crohn's disease: Crohn's disease activity index, Crohn's disease endoscopic index of severity, and serum albumin, alpha 2-globulin, alpha 1-antitrypsin, orosomucoid, C reactive protein, erythrocyte sedimentation rate, platelets, lymphocyte and polymorphonuclear cell counts, haematocrit, and faecal alpha 1-antitrypsin concentration. The distribution of these parameters was studied and transformation was used so that data matched the normal distribution closely. A weak but significant correlation (r = 0.32; p < 0.001) was found between clinical and endoscopic indices in the whole group of patients and this correlation seemed to be homogenous in various patient subgroups (clinically quiescent or active disease, pure colonic disease, untreated patients). Endoscopic or clinical indices were also found to be weakly linked with biological parameters (r < 0.50). Stepwise linear regression identified C reactive protein as predictive of the clinical index, and, successively, alpha 2-globulin, erythrocyte sedimentation rate, faecal alpha 1-antitrypsin, serum orosomucoid, and alpha 1-antitrypsin as predictive of the endoscopic index. Both predictions were poor--the biological variables accounting for only 22 and 44% respectively of the clinical and endoscopic index variations. In conclusion, Crohn's disease clinical activity seems to be virtually independent of the severity of the mucosal lesions and biological activity.

Adolescent↗
PubMed1994

[Etoposide, epirubicin and cisplatin (EEP) combination in metastatic cancers of the cardia and the stomach. Groupe de recherche en cancérologie du Nord (GRECNO)].

This study was aimed to confirm the therapeutic activity of the combination of etoposide, doxorubicin and cisplatin which has shown some clinical efficiency as first line therapy in advanced gastric cancer. Seventeen patients with metastatic gastric cancer were treated with etoposide (120 mg/m2, i.v., on day 5, 6 and 7), epirubicin (20 mg/m2, i.v., on day 1 and 7) and cisplatin (40 mg/m2, i.v., on day 2 and 8), q 4 weeks. In 16 patients evaluable for response, three (19%) obtained a partial response lasting from 93 to 360 days. Fifteen patients were evaluable for toxicity. Main toxicities > grade 2 included anemia (2/15), neutropenia (5/15), alopecia (8/15), fatigue (3/15), diarrhea (2/15), vomiting (2/15). Twenty nine per cent of severe toxic events were documented all along 52 cycles. Therefore we failed to confirm that this regimen could be of clinical efficiency in advanced gastric cancer as regards the benefits/toxicity ratio.

Adenocarcinoma↗
PubMed1994

Loss of efficacy of ondansetron-dexamethasone during successive courses in female patients receiving high-dose cisplatin.

This study was designed to evaluate the efficiency of the association ondansetron-dexamethasone during successive courses in 22 chemotherapy-naive female patients receiving a chemotherapy regimen including cisplatin at a dose of 100 mg/m2. The antiemetic treatment consisted of dexamethasone 20 mg i.v. and ondansetron 24 mg i.v. the day of chemotherapy, then ondansetron 8 mg per os every 8 hours for 5 days. A complete control of emesis with no or mild nausea was observed in 41% of cases on the first day of the first course, in 9.5% after the 3rd course. No patient experienced a complete response after the sixth. Similar results were obtained when nausea and vomiting were assessed on the worst day of D2 or D3. Our study shows that, as with other antiemetics, ondansetron-dexamethasone efficiency decreases with the number of courses.

Adult↗
PubMed1993

Phase II study of cystemustine in metastatic colorectal carcinoma. A trial of the EORTC Clinical Screening Group.

27 patients with metastatic colorectal carcinoma were treated, every 2 weeks, with 60 mg/m2 cystemustine, a new chloro-2-ethyl nitrosourea derivative. Haematological toxicity was the major side-effect including neutropenia and thrombocytopenia. We did not observe any complete or partial response. Cystemustine, with this dose and this schedule, has no activity in colorectal cancer.

Adolescent↗
PubMed1993

Aminoglutethimide (AG) and hydrocortisone (HC) in bone metastases: a retrospective study.

The response rate in bone metastases in 57 patients treated with aminoglutethimide and hydrocortisone was retrospectively assessed. All the X-rays were reviewed by two senior radiologists. A response was observed in 23% of the patients, a stabilization in 32%. The survival was not different whether a response or stabilization was observed. Conversely, survival was significantly worse in patients who experienced a progressive disease.

Adult↗
PubMed1992

Basic fibroblast growth factor (bFGF): mitogenic activity and binding sites in human breast cancer.

We investigated binding characteristics of basic fibroblast growth factor (bFGF) on membranes prepared from 4 human breast cancer cell lines and 38 primary BC biopsies. Competitive binding experiments were performed and analyzed using the "Ligand" program. Furthermore bFGF mitogenic activity was measured by [3H]thymidine incorporation into DNA from breast cancer cell lines. The presence of high-affinity binding sites was demonstrated in each cell type (MCF-7: Kd = 0.60 nM; T-47D: Kd = 0.55 nM; BT-20: Kd = 0.77 nM; MDA-MB-231: Kd = 0.34 nM). The presence of these high-affinity binding sites was confirmed with saturation experiments. A second class of low-affinity binding sites was detected in the 2 hormone-independent cells (BT-20: Kd = 2.9 nM; MDA-MB-231: Kd = 2.7 nM). bFGF stimulated the proliferation of MCF-7, T-47D, BT-20 but not MDA-MB-231 cell lines. With competition experiments, binding sites were detectable in 36/38 breast cancers; high-affinity binding sites (Kd less than 1 nM) were present in 19/36 cases and low-affinity binding sites (Kd greater than 2 nM) were present in 29/36 cases (the two classes of binding sites were present in 12 breast cancers). No relation between bFGF binding sites and node involvement, histologic type or grading of the tumor was evidenced. There were negative correlations (Spearman test) between total bFGF binding sites and estradiol receptor (P = 0.05) or progesterone receptor (P = 0.009). The demonstration of (1) bFGF specific binding sites in breast cancer membranes, and (2) bFGF growth stimulation of some breast cancer cell lines indicates that this factor may be involved directly in the growth of some breast cancers.

Adult↗
PubMed1992

Aminoglutethimide in malignant melanoma. A phase II study.

The role of steroid hormones has been suggested in the growth of malignant melanoma, and since aromatase activity has been found in melanoma tissue, we carried out a phase II study of aminoglutethimide, an aromatase inhibitor in malignant melanoma patients. Fifteen heavily pretreated patients entered the study. No response was observed--the treatment was well tolerated. We concluded that aminoglutethimide is very unlikely to be useful in melanoma patients.

Adult↗
PubMed1992

Increased pulmonary and intestinal permeability in Crohn's disease.

We tested the hypothesis that an increased epithelial permeability may affect sites other than the intestine in patients with Crohn's disease by simultaneously evaluating their pulmonary and intestinal permeability. Pulmonary and intestinal permeability were measured by clearance of inhaled technetium-99m diethylene triamine pentacetate (99mTc-DTPA) and by urinary recovery of chromium-51 ethylene diamine tetracetate respectively in 22 patients with Crohn's disease. The half time clearance of 99mTc-DTPA from lung to blood (t1/2LB) was decreased--that is pulmonary permeability increased--in the whole group of patients with Crohn's disease as compared with 13 controls (median 45.5 minutes (8-160) v 85 minutes (34-130) (p less than 0.003)). When analysed separately only patients with active Crohn's disease (n = 15) had a decreased t1/2 lung to blood v controls (42 minutes (8-160) v 85 minutes (34-130) (p less than 0.0025)). Among patients with active Crohn's disease, six were studied again when their disease was quiescent and their t1/2 lung to blood did not differ significantly. The intestinal permeability was increased in the whole group of Crohn's disease patients as compared with 15 controls (5.25% (1.2-24) v 1.7% (0.65-5.75) (p less than 0.0002)). When analysed separately both patients with active and inactive Crohn's disease had increased intestinal permeability v controls (8.1% (1.6-24) and 3.5% (1.2.9.2) v 1.7% (0.65-5.75)) (p less than 0.0001, p = 0.05 respectively). Six patients with active Crohn's disease were studied again when their disease was quiescent and their intestinal permeability decreased significantly p less than 0.04). Pulmonary permeability was increased in patients with Crohn's disease but was not greatly influenced by Crohn's disease activity as opposed to intestinal permeability. The mechanism of this increase is unknown, but may be related in some patients to the presence of an alveolitis.

Adolescent↗
PubMed1992

Increased intestinal permeability in active pulmonary sarcoidosis.

Altered permeability of the gut is a well-described feature in Crohn's disease. Because of pathologic similarities between Crohn's disease and sarcoidosis, we initiated this study to evaluate the permeability of the gut mucosal lining in patients with pulmonary sarcoidosis. A group of 18 patients with biopsy-proven pulmonary sarcoidosis (active n = 8, inactive n = 10) were included in the study. Control groups included 22 patients with Crohn's disease (active n = 12, inactive n = 10), nine untreated patients with recent pulmonary tuberculosis, six patients with coal worker's pneumoconiosis (CWP), eight patients with idiopathic pulmonary fibrosis (IPF), and 16 healthy subjects. All were nonsmokers. The 24-h urinary excretion of 100 microCi 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA) was used to test the intestinal permeability (IP). As previously demonstrated, patients with active Crohn's disease demonstrated a dramatic increase in IP (7.7 +/- 1.4%) that was clearly reduced in inactive CD (2.34 +/- 0.54%). Patients with active pulmonary sarcoidosis exhibited a marked increased IP to 51Cr-EDTA (4 +/- 0.54%), which was not found in patients with inactive sarcoidosis (1.6 +/- 0.17%). IP was normal in patients with pulmonary tuberculosis (1.03 +/- 0.25%), CWP (2.1 +/- 0.54%), and IPF (1.9 +/- 0.33%) and did not differ from the control group (1.76 +/- 0.23%). In addition, in 6 patients with active pulmonary sarcoidosis, the concentrations of albumin and hyaluronan were measured in jejunal perfusion fluid and compared with those obtained from 10 patients with active Crohn's disease and 16 control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Albumins↗
PubMed1992

[A study of VMMC protocol (vindesine, mitoxantrone, mitomycin C) as a salvage chemotherapy in advanced breast cancers].

One hundred and three patients previously treated with chemotherapy including an anthracycline were entered in a VMMC protocol study: vindesine (Eldisine), mitoxantrone (Novantrone) and mitomycin C (Ametycine). Group A consisted of 41 women who received the protocol published by Belpomme: vindesine (2.5 mg/m2 day 1 and 8) and mitoxantrone (12 mg/m2/day) every 4 weeks, and mitomycin C (8 mg/m2) every 8 weeks. Group B consisted of 62 patients who were treated with a modified protocol: vindesine (2.5 mg/m2) and mitoxantrone (12 mg/m2) every 3 weeks on day 1, and mitomycin C (8 mg/m2) every 6 weeks. Tolerance was acceptable with 79% of patients complaining of weakness. There was a 66% incidence of gastro-intestinal toxicity, a 10.7%-incidence of neurotoxicity (reversible dysethesias), and a 5.8% incidence of cardiotoxicity. There was considerable hematotoxicity of grade 2, 3 and 4: neutropenia 16.6%, thrombocytopenia 7.7%, anemia 21.4%. There was a 19.2% overall objective response rate (CR and PR) (95% confidence interval: 12-30) (CR: 3.2%). The median duration of the response was 39 weeks. There was no significant difference in response rates whether or not the patients (19 cases) were undergoing simultaneous hormonal therapy and no difference according to the protocol used. Similarly, neither menopause nor a previous response to anthracyclines had any effect on the response rate. The 19.2% response in this protocol is similar to other breast cancer salvage chemotherapy protocols for patients who have failed to respond to anthracyclines (< 20%).

Adult↗