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Biomedical subjects

D Depisch

Publications and source records attributed to D Depisch.

At least 55 records · Page 3Linked to original sources
PubMed1993

Effective second line chemotherapy of advanced breast cancer with navelbine and mitomycin C.

The efficacy and toxicity of navelbine 30 mg/m2 administered intravenously (IV) over 30 minutes every 3 weeks, and mitomycin C 15 mg/m2 administered IV every 6 weeks was assessed in 34 patients with metastatic breast cancer refractory to first-line chemotherapy. An overall objective response rate of 35% was achieved (95% confidence interval, 20% to 53%), with an additional 47% of patients maintaining stable disease (SD). Four of 12 patients who responded had received previous anthracycline therapy. Median time to progression for responders and patients with SD was 6.3 months. The median survival of all patients was 8.8 months. Tolerance of this regimen was remarkable. WHO grade 3/4 side effects consisted of granulocytopenia in 12% and thrombocytopenia in 15%, and included only 1 patient each with grade 3 neurotoxicity and local toxicity due to extravasation. Delay of treatment was required for hematologic toxicity in 7 patients, and 5 required dose reductions. In conclusion, navelbine/mitomycin C is an active and well-tolerated regimen that may be considered for second-line treatment. If our results are confirmed by larger analyses of other patients studies, this combination might also warrant further exploration in combination with other active agents for front line chemotherapy of advanced breast cancer.

Adult↗
PubMed1993

MDR1 gene expression in primary colorectal carcinomas.

The expression of the MDR1 gene, a multidrug resistance gene, was prospectively determined in 113 primary colorectal carcinoma specimens and correlated with clinical data including survival durations of the patients. MDR1 RNA was detected in 65% of the carcinomas. No expression of the MDR2 gene was seen, MDR1 gene expression was independent of age and sex of the patients, size and histologic grading of the tumour, lymph node involvement and distant metastasis. Kaplan-Meier analysis revealed that the durations of both relapse-free survival and overall survival were not different between patients with MDR1 RNA positive tumours and those with MDR1 RNA negative tumours.

Adenocarcinoma↗
PubMed1992

Comparative analysis of CA72-4, CA195 and carcinoembryonic antigen in patients with gastrointestinal malignancies.

To establish further the clinical significance of the novel quantitative immunoradiometric assay system CA72-4 in patients with gastric and other digestive tract malignancies, the sera of a total of 208 subjects have been analysed and levels of carcinoembryonic antigen (CEA) and another promising new tumour marker, CA195, have been compared. Twenty patients had gastric (GC), 60 colorectal (CC), and 14 pancreatic carcinomas (CC); 94 patients had benign disorders, and 20 were healthy volunteers. CA72-4 elevations above normal (greater than 4 U/ml) were observed in 6 (30%) GC, 17 (28%) CC, and 8 (57%) PC patients. CA195 appeared more sensitive and was increased (greater than 10 U/ml) in 35% GC, 70% CC, and in 100% PC patients; CEA levels above normal (greater than 5 ng/ml) were noted in 35%, 45%, and 66% of patients respectively. CA72-4 had a rather high specificity and was increased in only 6/94 (6%) patients with benign diseases, whereas CA195 had a false positive rate of 23%, and CEA of 33%. Among 20 healthy donors, none had elevated levels of CA72-4 or CA195, but marginal elevations of CEA were noted in 3 smokers. Despite some advantage of the new tumour marker CA72-4 in terms of specificity, its value as a serodiagnostic test in gastrointestinal cancer patients seems inferior to that of CA195 and CEA.

Antibodies, Monoclonal↗
PubMed1991

Comparative analysis of cancer-associated antigen CA-195, CA 19-9 and carcinoembryonic antigen in diagnosis, follow-up and monitoring of response to chemotherapy in patients with gastrointestinal cancer.

To establish further the clinical significance of the CA-195 tandem immunoradiometric assay in gastro-intestinal malignancies, the sera of a total of 222 subjects have been analysed and compared with assays of the "classical gastrointestinal tumour markers", CA19-9 and carcinoembryonic antigen (CEA). CA-195 elevations above normal (greater than 10 U/ml) were noted in 51/72 (70.8%) colorectal, 15/15 (100%) pancreatic, and in 6/12 (50%) gastric cancer patients. Whereas CA19-9 was increased (greater than 37 U/ml) in 65%, 93%, and 42% of cases, only 54% colorectal, 45% pancreatic, and 42% gastric cancer patients had pathologically elevated serum CEA levels (greater than 5 ng/ml). No abnormal increase of both CA-195 and CA19-9 was found in healthy volunteers, whereas 3/20 (smoking) individuals had CEA levels slightly above normal. With a 29% false-positive rate noted among 103 patients with benign gastrointestinal disorders, the specificity of CA-195 was superior to that of CA19-9 (58%) and comparable with that of CEA (31%). A significant correlation between CA-195 levels and the clinical/pathological stage of disease was noted in colorectal (P less than 0.01) and pancreatic cancer patients (P less than 0.007). Preliminary results of serial measurements of CA-195 in colorectal cancer suggest that this new marker protein, which has no cross-reactivity with CEA, may be useful as a non-invasive test for postoperative surveillance of patients to detect disease recurrence, and serve to complement (though certainly not replace) standard clinical measurements of response to chemotherapy.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

Phase II study of amonafide in advanced breast cancer.

Twenty-eight patients with advanced breast cancer refractory to prior hormone and/or first-line chemotherapy (with or without anthracycline drugs) were treated with the investigational agent amonafide at a dose of 800 mg/m2 intravenously over 3 hours repeated every 4 weeks. Five objective tumour responses of 5.0 months' median duration were observed in the 20 patients without previous anthracycline exposure, including 1 CR. Leukopenia was the dose-limiting toxicity; though it was generally modest with the 800 mg/m2 amonafide starting dose, an initial dose reduction should be considered in patients with prior radiotherapy and/or bone marrow involvement. Other adverse reactions included nausea/vomiting (53%), phlebitis/erythema along the vein injected (7%), and mild neurotoxic symptoms during the drug administration such as headache, tinnitus, and diaphoresis (21%). Amonafide is an active compound for the treatment of patients with advanced breast cancer and should be considered for further evaluation and incorporation in combination chemotherapy.

Adenine↗
PubMed1991

MDR1 gene expression and prognostic factors in primary breast carcinomas.

To prospectively assess the role of the MDR1 gene in breast carcinomas, MDR1 RNA levels of breast carcinoma specimens were determined by slot blot analysis. In 59 evaluable patients with primary breast carcinomas, MDR1 RNA levels of the carcinomas were negative in 54%, low in 29% and high in 17% of the patients. No differences in age, menopause status, oestrogen and progesterone receptor levels, tumour size, lymph node involvement and c-erbB-2/neu gene expression were observed between MDR1 RNA negative patients and MDR1 RNA positive patients.

Adult↗
PubMed1990

[Chemotherapy of highly malignant thyroid tumors].

In a prospective phase II study 15 patients suffering from anaplastic thyroid carcinoma or thyroid sarcoma were treated by surgery and chemotherapy. Chemotherapy varied according to age of the patient and histological subtype of the tumour. The following regimen was used: 100 mg/m2 BSA CDDP, 20 mg/m2 mitoxantrone and 1.5 mg/m2 vincristine. 10 patients responded to chemotherapy, 4 of whom had a complete response. Responders showed a longer mean and median survival time (20.8 months versus 4.5 ms, 15.5 ms vs. 3.8 ms, respectively) than non-responders. In the group responding to chemotherapy no evidence of metachronous metastases was found. Local recurrence was absent only in the patients showing a complete response. Anaplastic carcinomas with areas of differentiated thyroid carcinoma and small cell carcinomas (after exclusion of malignant lymphoma of the thyroid) showed a higher response rate to chemotherapy than spindle or giant cell carcinoma or thyroid sarcoma.

Aged↗
PubMed1990

Pirarubicin (4'-o-tetrahydropyranil-adriamycin) for treatment of advanced breast cancer. A Clinical Phase II study.

In a phase II study, 77 patients with metastatic breast cancer were treated with pirarubicin, 70 mg/m2 iv every 3 weeks. Most of them had received prior hormonal (n = 39) and/or chemotherapeutic drug treatment for advanced disease, including anthracycline-containing regimens in 17. After a median of 5.5 treatment cycles (range 1-14), objective tumor response was seen in 22/71 (31%) evaluable patients (4CR, 18 PR). Stable disease occurred in 34 (48%) patients, whereas the tumor progressed in 15 (21%). Significant hematologic toxicity (WHO grade III-IV) requiring interval and/or dose adjustments was observed in 41 (58%) patients. Other treatment-related side effects were generally mild, and included alopecia in 52 (73%), nausea and/or emesis in 50 (70%), and stomatitis and diarrhea in 3 patients each. There was no treatment-related death, nor was there any evidence of cardiac toxicity thus far. In summary, the early results of this trial suggest that pirarubicin is an active and rather well tolerated drug in pretreated patients with advanced breast cancer.

Adult↗
PubMed1990

[Prevention of adhesions in abdominal surgery. A dose finding study with streptokinase/streptodornase].

UNLABELLED: Measurement of intraperitoneal fibrinolytic activity on 50 patients having undergone abdominal surgery (four of them controls). Instillation of streptokinase/streptodornase (Varidase) into the abdominal cavity. Determination of total protein, plasminogen, antiplasmin, alpha 2 Mx-plasmin-complex, spontaneous fibrinolysis and fibrinolysis + activator at different points in time p.op. RESULTS: Intraperitoneal fibrinolysis may be stimulated by local substitution of a plasminogen activator (Varidase). Systemic effects are confined to a high dose. No impaired wound healing nor increased propensity to hemorrhaging occurred.

Abdomen↗
PubMed1989

Phase II evaluation of 5-fluorouracil, folinic acid and cisplatin in advanced-stage colorectal adenocarcinoma.

Twenty-seven patients with advanced measurable colorectal carcinoma were treated with a combination protocol consisting of folinic acid (FA) 200 mg/m2 i.v. bolus followed by 5-fluorouracil (5-FU) 550 mg/m2, and cisplatin (CIS) 20 mg/m2 each administered as a 2-hour i.v. infusion. Treatment was given on 4 consecutive days at 3- to 4-weekly intervals. Of 25 evaluable patients, 1 achieved complete remission and 5 partial remission for an overall response rate of 24%, while 9 patients (36%) had stable disease. Two out of 6 responders had previously progressed on 5-FU-containing regimens. The 95% confidence interval for response is 7-41%. Median survival time for all 27 patients enrolled in the study is 27+ weeks. Tolerance was remarkable and consisted primarily of mild and reversible gastrointestinal symptoms and myelosuppression. This 3-drug-regimen had significant palliative activity in our patient population. Its definitive role in the treatment of metastatic colorectal cancer as well as the potential improvement of the therapeutic index of 5-FU/FA by addition of CIS, require further evaluation in a randomized phase III trial.

Adenocarcinoma↗
PubMed1987

[Toxicity results of an adjuvant study with intraperitoneal chemotherapy in patients with stomach cancer. Current status and future prospects of intraperitoneal therapy].

The peritoneum is a frequent location of recurrent disease after surgical treatment of carcinoma of the stomach, colon, rectum or ovary. Usually this type of recurrence does not respond very well to systemic chemotherapy. The rational of intraperitoneal (ip) perfusion with cytotoxic drugs is based on a 2- to 3-log-fold increase in ip level over plasma concentration for certain chemotherapeutic agents. Hence, malignant cells in the peritoneal cavity can be exposed to very high concentrations of cytotoxic agents without serious systemic side effects. Remission rates of peritoneal carcinoma after ip perfusion of a range of chemotherapeutic substances varied from between 15 to 50%. Minimal information is available about adjuvant ip perfusion after operation for cure. Toxicity data are presented from our adjuvant trial using ip perfusion after operation for gastric carcinoma for cure with cisplatin in a randomized fashion. Altogether 59 perfusions were performed, with minimal systemic toxicity, no occurrence of peritonitis and only 1 portal infection. Immunological data show that 1 day after ip perfusion the concentration of natural killer cells is increased in 60% of all perfusions, but decreased only in 28%. We conclude that ip perfusion with cisplatin is a safe procedure with limited toxicity. The efficacy of this technique in peritoneal carcinosis is not yet proven in randomized trials. The observation period of our trial in the adjuvant stage after operation for gastric carcinoma is too short as get to assess the usefulness of the procedure.

Antineoplastic Agents↗
PubMed1980

[Spontaneous mesenteric venous thrombosis, a rare complication of oral contraceptives (author's transl)].

Spontaneous mesenteric venous thrombosis without recognizable aetiology is a rare condition. Only 10 cases have been described in world literature as a complication of oral contraceptives. The case report is presented of a 51 year-old married woman who had been taking oral contraceptives for 7 years. After abdominal pain for weeks segmental mesenteric venous thrombosis with a gangrenous small bowel loop was diagnosed. The gangrenous small bowel loop was treated by resection. Subsequently after discontinuance of contraceptive medication she was symptom free. The problems of diagnosis are pointed out and it is suggested that immediate discontinuance of oral contraceptives in women with unexplained abdominal pain might prevent gangrene of small bowel.

Contraceptives, Oral↗
PubMed1980

[Papillary carcinoma of the thyroid gland (author's transl)].

Records were examined of 174 patients with papillary thyroid carcinoma operated on at the 1st Department of Surgery of the University Hospital in Vienna between 1948 and 1976. The overall mortality rates amount to 20 +/- 8% after 5 years, rising to 70 +/- 21% after 20 years. Clear relationships are demonstrated between lymph node metastases, distant metastases, extrathyroid tumours and higher mortality rates. An older age correlates in the extrathyroid tumour group only with a higher risk of death. In our material reclassified by the criteria of the WHO classification (1974) between 1965 and 1976 the incidence of papillary carcinoma is 25% of all thyroid carcinomas. The incidence of this tumour subgroup varies in the literature between 25 and 90% and is influenced by regional differences in the use of childhood radiation on the one hand and iodine uptake on the other hand, different methods of thyroid examination and the subjectivity of the pathologist.

Adult↗