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Biomedical subjects

A Pecking

Publications and source records attributed to A Pecking.

At least 19 recordsLinked to original sources
PubMed1998

Radioimmunoscintigraphy of recurrent, metastatic, or occult colorectal cancer with technetium Tc 99m 88BV59H21-2V67-66 (HumaSPECT-Tc), a totally human monoclonal antibody. Patient management benefit from a phase III multicenter study.

PURPOSE: The study contained herein was undertaken to evaluate the accuracy of radiolabeled human monoclonal antibody, 88BV59H21-2V67-66 (88BV59 or HumaSPECT-Tc), in predicting disease resectability in presurgical subjects with recurrent, metastatic, or occult colorectal carcinoma. METHODS: A total of 219 patients with disease visualized on computed tomographic scan (recurrent or metastatic disease) or with negative or equivocal computed tomographic scan and rising carcinoembryonic antigen serum levels (occult group) received technetium Tc99m-labeled 88BV59 intravenously. Planar and single photon emission computed tomograhic images were obtained 14 to 20 hours postinfusion, before surgery. The ability of computed tomographic and HumaSPECT-Tc imaging to define the extent of disease and to predict resectability was evaluated based on surgical and histopathologic results. RESULTS: In patients with recurrent or metastatic disease (170 evaluable patients), the accuracy of predicting nonresectability of disease was significantly greater (P < 0.001) for HumaSPECT-Tc than for computed tomography (60 vs 29 percent). Computed tomography understaged 41 percent of patients believed to have resectable disease compared with 27 percent for HumaSPECT-Tc (P < 0.001). In occult disease patients (29 computed tomographic and 28 HumaSPECT-Tc evaluable patients), the overall accuracy of predicting resectability/nonresectability was 6 percent for HumaSPECT-Tc compared with 24 percent from computed tomography. Administration of HumaSPECT-Tc had no effect on monoclonal antibody-based in vitro diagnostic assays. Only a single patient demonstrated an anti-antibody response (90 ng/ml) at nine weeks postinfusion. CONCLUSION: HumaSPECT-Tc was more accurate than computed tomography in determining disease resectability in patients with metastatic, recurrent, or occult cancer. The addition of HumaSPECT-Tc imaging can play a significant role in patient management decisions.

Adult↗
PubMed1998

Radioimmunoscintigraphy of recurrent, metastatic, or occult colorectal cancer with technetium 99m-labeled totally human monoclonal antibody 88BV59: results of pivotal, phase III multicenter studies.

PURPOSE: To assess the performance and potential clinical impact of a totally human monoclonal antibody, 88BV59 (HumaSPECT) (INTRACEL, Corp, Rockville, MD), in 202 assessable presurgical patients with recurrent, metastatic, or occult colorectal cancer. METHODS: 88BV59, labeled with technetium Tc 99m (99mTc) (HumaSPECT-Tc), was injected intravenously, and planar and single photon emission tomography (SPECT) images were obtained 14 to 20 hours postinjection. Surgical and pathologic verification of tumor were used as the standard against which the performance of HumaSPECT-Tc imaging and computed tomography (CT) analysis were evaluated. RESULTS: All patients entered onto the recurrent disease study had at least one tumor site defined on CT. The sensitivity of HumaSPECT-Tc in those CT-positive patients was 87%. The specificity of HumaSPECT-Tc was 57% compared with 17% for CT and the difference was statistically significant (P < .001). The diagnostic information provided by HumaSPECT-Tc significantly (P < .001) improved the accuracy of the identification of resectable and nonresectable disease over that of CT (80% v 62%). HumaSPECT-Tc scans resulted in a significant (P < .001) reduction versus CT in terms of the proportion of patients understaged (27% v 41%) and overstaged (4% v 26%). In patients with occult disease (increasing carcinoembryonic antigen [CEA] titer, negative diagnostic work-up, negative CT), HumaSPECT-Tc correctly identified disease in 15 of 22 (68%) patients. HumaSPECT-Tc images provided additional clinical data that would have affected patient management decisions in 40 of 202 (19.8%) patients. In 365 patients who received 88BV59, only a single detectable human anti-human antibody (HAHA) response (90 ng/mL) at 9 weeks postinfusion was observed. CONCLUSION: HumaSPECT-Tc can provide important and accurate information about the presence and location of disease in patients with a high clinical suspicion of metastatic or recurrent colorectal cancer and either positive (known disease) or negative (occult disease) CT scans.

Adult↗
PubMed1997

[Follow-up of treated cancers of the ovary].

The main goal of the follow up in ovarian cancer is to achieve an early detection of recurrence after a complete remission or to assess the antitumoral efficiency of the treatment used. When the tumoral antigen CA125 is expressed by the primary tumor, the most sensitive test is the sequentially evaluation of the CA125 in the blood. An increasing slope of the serous CA125 is related to disease progression which must be confirmed by imaging techniques including immunoscintigraphy.

CA-125 Antigen↗
PubMed1997

A dose-controlled study of 153Sm-ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastases.

One hundred and fourteen patients with painful bone metastases participated in this randomised, dose-controlled study of the efficacy and safety of 153Sm-ethylenediaminetetramethylenephosphonate (EDTMP), a systemically administered radiopharmaceutical. Fifty-five patients received single doses of 0.5 mCi/kg and 59 patients received single doses of 1.0 mCi/kg. Treatment with 153-Sm-EDTMP produced improvement from baseline in all patient-rated efficacy assessments, including degree of pain, level of daytime discomfort, quality of sleep and pain relief. During the first 4 weeks after dose administration, when the patients evaluated efficacy daily, there were statistically significant changes from baseline with the 1.0 mCi/kg dose but not with the 0.5 mCi/kg dose. The difference between doses in visual analogue pain scores was statistically significant at week 4 (P = 0.0476). Among subsets of patients examined, female patients with breast cancer receiving 1.0 mCi/kg had the most noticeable improvement. The physicians judged that approximately half of the patients in each dose group were experiencing some degree of pain relief by week 2. This value increased to 55% for the 0.5 mCi/kg group and 70% for the 1.0 mCi/kg group at week 4. More patients in the higher dose group (54%) than in the lower dose group (44%) completed the 16-week study. A predictable level of dose-related marrow suppression was the only toxicity associated with 153Sm-EDTMP treatment. Values for platelets and WBCs reached nadirs at 3 or 4 weeks with both doses and recovered by 8 weeks. Even at their lowest point, the values were generally higher than those associated with infectious or haemorrhagic complications. Myelotoxicity was no greater in female patients than in male patients. Long-term follow-up revealed longer survival among breast cancer patients who had received the higher dose than among those who had received the lower dose. The results suggest that the 1.0 mCi/kg dose of 153Sm-EDTMP is safe and effective for the treatment of painful bone metastases.

Adult↗
PubMed1993

Current status of cancer immunodetection with radiolabeled human monoclonal antibodies.

The use of radiolabeled murine monoclonal antibodies (MoAbs) for cancer immunodetection has been limited by the development of human antimouse antibodies (HAMA). Human monoclonal antibodies do not elicit a significant human antihuman (HAHA) response. The generation and production of human monoclonal antibodies met with technical difficulties that resulted in delaying their clinical testing. Human monoclonal antibodies of all isotypes have been obtained. Most were immunoglobulin (Ig) M directed against intracellular antigens. Two antibodies, 16.88 (IgM) and 88BV59 (IgG3k), recognize different epitopes on a tumor-associated antigen, CTA 16.88, homologous to cytokeratins 8, 18, and 19. CTA 16.88 is expressed by most epithelial-derived tumors including carcinomas of the colon, pancreas, breast, ovary, and lung. The in vivo targeting by these antibodies is related to their localization in nonnecrotic areas of tumors. Repeated administration of 16.88 over 5 weeks to a cumulative dose of 1,000 mg did not elicit a HAHA response. Two of 53 patients developed a low titer of HAHA 1 to 3 months after a single administration of 88BV59. Planar imaging of colorectal cancer with Iodine-131 (131I)-16.88 was positive in two studies in 9 of 12 and 16 of 20 patients preselected by immunohistochemistry. Tumors less than 2 cm in diameter are usually not detected. The lack of immunogenicity and long tumor residence time (average = 17 days) makes 16.88 a good candidate for therapy. Radioimmunlymphoscintigraphy with indium-111 (111In)-LiLo-16.88 administered by an intramammary route was used in the presurgical staging of primary breast cancer. The negative predictive value of lymph node metastases for tumors less than 3 cm was 90.5%. Planar and single photon emission computed tomography imaging of colorectal carcinoma with technetium-99m (99mTc) 88BV59 was compared with computed tomography (CT) scan in 36 surgical patients. The antibody scan was more sensitive than the CT scan in detecting abdominal and pelvic tumors: 68% versus 40% (P < .05). The combination of antibody scan and CT scan was superior to CT scan alone: 80% versus 40% (P < .01). Lesions as small as 0.5 cm in diameter were detected by antibody scan. The CT scan appears superior to the antibody scan for liver metastases. Patients with a high serum titer of HAMA from previous exposure to murine antibodies were successfully imaged. Antibody scans obtained with 99mTc-88BV59 have imaging characteristics similar to murine antibody scans obtained with radiolabeled IgGs. The absence or weak immunogenicity of the human monoclonal antibodies makes them good candidates for radioimmunodetection and radioimmunotherapy.

Breast Neoplasms↗
PubMed1992

Tumor fixation of bleomycin labeled with 57 cobalt before and after cryotherapy of bronchial carcinoma.

The combined effect of cryotherapy and chemotherapy was studied in 12 patients with bronchial carcinoma. Radiolabeled (57 Co) Bleomycin (BLM) was injected intravenously and initial detection was carried out with a gamma-camera. Plasma half-life and clearance of 57 Co-BLM, as well as tumor/normal tissues ratios were calculated. The same protocol was performed 15 days later immediately after cryotherapy. A mean increase of 30% of radiolabeled BLM was found in the tumor area after cryotherapy, and pharmacokinetic data were significantly different after cryotherapy. The vascular component of cryodestruction offers an explanation for these results, with trapping of the anticancer drug in the tumor and immediately surrounding area due to vascular stasis. It seems that chemotherapy may be more effective after cryotherapy, and a multicenter study is in progress to evaluate the association of cryo-chemotherapy in France.

Adenocarcinoma↗
PubMed1991

[Treatment of postoperative lymphedema of the upper limb].

In breast cancer the overall incidence of post-therapeutic lymphedemas of the arm remains at 20% despite the use of new conservative treatments. Patients suffering from pains and heaviness require additional treatment for their swollen arm. One hundred and seventy-nine women with a post therapeutic edema of the upper limb have been treated in a special medical unit where medical and physiotherapeutic care were given as an intensive treatment for 4 weeks. More than 80% of good results were obtained with a median decrease in volume of swelling of 45%. The duration of the clinical improvement during the 6 months following the intensive first treatment was excellent for 76% of all improved cases. Treatment failure occurred in 16.2% of upper limb swelling mostly in relation to a recurrence of the disease (81%). 84.3% of cases undergoing a second intensive treatment 6 months later displayed a new decrease in volume and a new real clinical improvement. Small post therapeutic lymphedemas must be treated as soon as possible to avoid more serious delayed disorders.

Arm↗
PubMed1990

[Medical treatment of lymphedema with benzopyrones. Experimental basis and applications].

The frequency of secondary lymphedema occurrence following breast cancer therapy has been decreasing since new conservative surgical treatment and radiotherapy are applied. However, about 20% of female patients treated for breast cancer will develop mild swelling of the arm or forearm and seek specific treatment. Decongestive physiotherapy remains the most effective treatment, although medical treatment is often necessary. Coumarin, tested both in vitro and in vivo, has yielded true stimulation of lymphatic function. Like other benzopyrone derivatives, coumarin acts through macrophage stimulation. A randomized double blind study versus placebo has confirmed the occurrence of significant improvement of these mild swelling cases, and recommend the use of coumarin as supplemental therapy in mild lymphedema.

Arm↗
PubMed1989

[Response of bone metastases to medical treatment: definition of evaluation criteria and classification trials].

Bone metastases are very frequent. Some are sensitive to the action of anticancer drugs. However, there is as yet an unsolved methodological problem in the evaluation of response to these drugs. The uniquely radiological UICC criteria are quite insufficient, in as much as they appear with a long delay and sometimes give erroneous results. In this work we give a brief review of biological and clinical knowledge about bone metastases, and we attempt to give an array of the possible evaluation criteria and their respective value. We propose as a working hypothesis a classification of responses taking into account the criteria: the urinary hydroxyproline to urinary creatinine ratio, the serum dosage of bone isoenzyme of alkaline phosphatase and propeptide of type III procollagen (P III NP), and as an essential element, an analysis of all available imaging techniques. A visual study of bone scintillation scans must precede that of radiographs and, when possible, it must be associated to computerized scintillation scanning. When metastasis are located to the pelvis, the vertebral column, or the sternum, a CT scan or better, a nuclear magnetic resonance study (IRM), is indispensable in order to have a direct measure of the tumor extension to soft tissues. Furthermore, in the case of isolated metastases, one of these imaging techniques allows a diagnostic biopsy. Finally an analysis of response at the bone level will always be associated with a measure of their duration and an evaluation of metastases to other sites.

Acid Phosphatase↗
PubMed1984

[Gougerot-Sjögren syndrome. Functional study of the salivary glands by scintigraphy].

One-hundred and twenty patients with sicca syndrome, connective tissue disease or chronic graft-versus-host disease were investigated in the Saint-Louis Hospital Department of Nuclear Medicine. Technetium scanning of the salivary glands was performed in all patients. The results of the scintigraphic study were closely correlated with clinical and histological data in patients with Sjögren's syndrome. This method, which accurately quantifies the salivary function without danger nor discomfort to the patients, has a number of advantages: (a) it is sensitive enough to detect minimal salivary gland dysfunction; (b) it differentiates between parotid gland and submandibular gland involvement and demonstrates asymmetry in pathological processes; (c) it helps in following up patients with Sjögren's disease and in assessing the results of immunosuppressive or anti-inflammatory treatment.

Adolescent↗
PubMed1983

[Cardiac risks of adriamycin. Early detection of high-risk patients by isotopic cardiac function study].

Adriamycin is known to be effective in the treatment of breast cancer. Serial radionuclide determinations of the left ejection fraction can provide advanced warning of adriamycin cardiotoxicity, prior to clinical signs of the left ventricular dysfunction. Patients at high risk of congestive heart failure can be detected. Depending on the results of the second course of chemotherapy, guidelines and criteria can be laid down to predict the appropriate time for drug discontinuation.

Adult↗
PubMed1983

[Bone metastases in cancer of the breast. Diagnostic and predictive value of quantified bone scintigraphy].

Distant metastases from carcinoma of the breast are most commonly located in the skeleton. Although it has been clearly shown that bone radionuclide scanning is more sensitive than X-rays in detecting such metastases, diverging opinions have recently been voiced concerning its sensitivity and specificity. The authors have quantitatively analyzed 1631 focal alterations, taking the uptake index value as yardstick. They found that quantitative scanning increases the sensitivity of the method and makes it possible to differentiate between malignant and benign bone lesions.

Adult↗
PubMed1981

[Detection of malignant melanoma metastases. Value of radioisotopic methods (author's transl)].

No single radioisotopic exploration is capable of detecting metastases of malignant melanomas, but the successive use of three different scintigraphic techniques (liver, bone and 67Ga citrate) has increased the detection rate from 55 to 68%. Since these metastases are small and may develop anywhere in the body, several methods must systematically be combined, particularly when one of them gives normal results. Experience has shown that 13% of metastases would have passed unnoticed if the three scintigraphic techniques had not been used.

Bone and Bones↗
PubMed1980

[Lymphoedema of the upper limb following surgery or radiotherapy. Investigation by indirect radioactive lymphography (author's transl)].

Indirect radioactive isotope lymphography using intravenous 99 m Tc-labelled colloidal antimony sulfide was performed on 76 patients with lymphoedema of the upper limb consecutive to surgery or radiotherapy. The time required to reach 50% of maximum radioactivity was taken as index of the lymphatic flow rate, and the patients were divided into 3 groups depending upon the index (< 20 min; 20-60 min; > 60 min). It appears that in huge lymphoedemas the lymphatic flow rate index may remain subnormal, owing to associated veno-occlusive oedema. This non-invasive method provides data on the site and, frequently, on the nature and importance of lymph blockade. It might also help to predict the efficacy of a new drug currently under study.

Arm↗