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Biomedical subjects

C G Moertel

Publications and source records attributed to C G Moertel.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

The presence of somatostatin receptors in malignant neuroendocrine tumor tissue predicts responsiveness to octreotide.

In 77 percent of patients suffering from a malignant carcinoid syndrome, administration of the somatostatin analog, octreotide (SMS 201-995, Sandostatin) induced clinical improvement coupled with a decrease in 24-hour urinary 5-hydroxyindole acetic acid (5-HIAA). This finding prompted an evaluation to determine the correlation between the presence of somatostatin receptors in tumor tissue and the response to octreotide in patients with advanced, metastatic, neuroendocrine tumors. In tissues of 31 tumors (20 carcinoid, eight islet-cell carcinoma, three medullary thyroid carcinomas), the presence of somatostatin receptors was analyzed by binding of the somatostatin analog 125I-Tyr3-SMS 201-995 and autoradiography. Receptors were detected in 16 of 20 samples of carcinoid tissues; all but one patient with receptor-positive tumors improved clinically after treatment with octreotide, and the urine 5-HIAA level was reduced a median of 63 percent (range, 39-94 percent) compared to values before treatment. Of the receptor-negative carcinoid patients, only one showed clinical improvement, which was minimal, and there was a negligible reduction in 5-HIAA after octreotide therapy. All eight patients with metastatic islet-cell carcinomas were positive for somatostatin receptors. Symptomatic improvement and a > 50 percent decrease in the level of at least one of the pathologically elevated marker hormones was seen in all eight. None of the three patients with medullary carcinoma of the thyroid had a decrease in calcitonin, and all three were initially somatostatin receptor-negative. We conclude that the presence of somatostatin receptors in malignant neuroendocrine tumor tissue appears to correlate with the response to octreotide therapy. Analysis of somatostatin receptors in malignant neuroendocrine carcinoma tissue should be included in future prospective clinical trials of this synthetic peptide.

Amino Acid Sequence↗
PubMedDate not supplied

Phase II-III chemotherapy studies in advanced gastric cancer. Eastern Cooperative Oncology Group.

In this study, 139 eligible and evaluable patients with advanced gastric cancer, measurable disease, and no prior chemotherapy were randomized between treatment with Adriamycin alone, 5-fluorouracil (5-FU) plus mitomycin C, and 5-FU plus methyl-CCNU. Objective responses were seen in eight of 37 patients (22%) receiving Adriamycin, in 17 of 53 (32%) receiving 5-FU plus mitomycin C, and in 12 of 49 (24%) receiving 5-FU plus methyl-CCNU. Median durations of response were 4, 3 1/2, and 8 1/2 months, respectively. Sixty-one patients were treated after previous failure to other chemotherapy regimens. Response rates were seen in seven of 47 patients (15%) receiving Adriamycin, in two of nine receiving 5-FU plus mitomycin C, and in one of five receiving 5-FU plus methyl-CCNU. Complete responses were observed more frequently with Adriamycin and with 5-FU plus methyl-CCNU than with 5-FU plus mitomycin C. Although 5-FU plus methyl-CCNU had a slight advantage in interval to disease progression, this was not statistically significant. Median survival for all previously untreated patients was slightly greater than 17 weeks, and there was no meaningful or significant survival difference between the three treatment groups.

Adenocarcinoma↗
PubMedDate not supplied

Phase I study of N-(phosphonacetyl)-L-aspartic acid (PALA).

N-(Phosphonacetyl)-L-aspartic acid, an inhibitor of aspartate transcarbamylase, was administered to 25 patients with advanced cancer by 10-minute infusion daily x 5 consecutive days to determine the toxicity and to look for evidence of therapeutic effect. Planned dose escalations ranged from 100 to 1250 mg/m2 (daily dose). Nausea, vomiting, and diarrhea were the most frequent toxic effects, with three of six patients treated at a daily dose of 1250 mg/m2 having severe diarrhea. Other toxic effects were encountered rarely and were not dose-limiting; these included mild leukopenia, thrombocytopenia, rash, stomatitis, and increases in SGOT. One patient with a widely metastatic carcinoid of unknown origin had an objective response lasting 6 weeks.

Adult↗
PubMedDate not supplied

Phase I study of hycanthone.

Hycanthone, an antischistosomal drug possessing activity against experimental murine tumors, was administered by 20-minute infusion daily x 5 days to 12 patients with advanced cancer to determine dose-limiting toxicity and to look for therapeutic effect. No objective responses were seen. The dose-limiting toxic effect was acute hepatitis occurring in two of four patients treated at 100 mg/m2/day x 5. Moderate nausea and vomiting occurring on treatment days was the only other toxic effect. Hycanthone was not myelosuppressive. Assay of plasma concentrations of hycanthone revealed a plasma half-life of 3-5 hours and no accumulation of drug over the 5 days of treatment.

Aged↗
PubMedDate not supplied

Lack of clinical therapeutic synergism between cyclophosphamide, adriamycin, and cis-dichlorodiammineplatinum(II) in metastatic human colorectal carcinoma.

Thirty patients with metastatic adenocarcinoma originating in the colon or rectum were treated with a combination of cyclophosphamide, Adriamycin, and cis-dichlorodiammineplatinum(II). Only one partial tumor regression of 12 weeks' duration was observed. Severe nausea and vomiting secondary to chemotherapy were frequently seen. This three-drug regimen, as employed in our study, was not associated with useful clinical activity against human metastatic colorectal cancer.

Adenocarcinoma↗
PubMedDate not supplied

Phase II trial of iv 6-thioguanine in advanced colorectal carcinoma.

Oral 6-thioguanine (6-TG) is an S-phase antimetabolite with significant activity against acute leukemia. Preliminary reports of activity of iv 6-TG indicated significant activity against advanced colorectal cancer. We conducted a phase II study of iv 6-TG in 29 patients with advanced measurable colorectal cancer. Only one transient partial response occurred. Toxic effects included mild myelosuppression, nausea, vomiting, and minor ECG changes. We discourage further use of iv 6-TG in the dose and schedule we used to treat advanced colorectal cancer.

Aged↗
PubMedDate not supplied

Phase I and pharmacokinetic studies of DON.

DON, a glutamine antagonist, was administered iv to 26 patients with advanced cancer either once every 3 wks or daily for 3 days every 3 wks to determine toxicity and to look for evidence of therapeutic effect. Total doses ranged from 150 to 600 mg/m2. The single-day schedule produced intolerable nausea and vomiting and no evidence of cytotoxicity at 450-550 mg/m2 given over 10 mins or over 4 hrs. On the 3-day schedule, patients had tolerable gastrointestinal toxic effects at total doses up to 480 mg/m2 given in three equally divided doses by 10-min infusion. This dose also produced cytotoxic activity manifested as transient mild leukopenia and, rarely, thrombocytopenia. No objective responses were seen. Analysis of the plasma elimination of DON demonstrated dose-dependent pharmacokinetic behavior. The parent compound was not detectable in the urine of any patient, indicating extensive metabolism of the drug.

Azo Compounds↗