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E Kumpulainen

Publications and source records attributed to E Kumpulainen.

36 records · Page 2Linked to original sources
PubMed1995

Intermittent interferon and polychemotherapy in metastatic melanoma.

This study was conducted to evaluate the efficacy and the tolerability of a four-drug chemotherapy regimen combined with interferon alpha (IFN) in metastatic melanoma. Between March 1991 and August 1993, 55 patients with advanced melanoma were enrolled for the present multicentre phase II study. Forty-nine patients were eligible and evaluable for toxicity; 48 patients were evaluable for response. The treatment schedule consisted of a 5-day regimen of dacarbazine, vincristine, bleomycin and lomustine, plus 6 x 10(6) IU IFN alpha three times weekly subcutaneously for 2 weeks starting on day 8. The cycle was repeated on day 29. Among the 48 assessable patients, 16 objective responses were seen, yielding a response rate of 33% (95% confidence interval 20%-46%). Seven patients achieved a complete response (CR) of a median of 6+ months (range 1+ to 21+ months) and 9 patients achieved a partial response (PR) of a median of 9 months (range 4-13 months). The median overall survival was 12+ months (range 6+ to 23+ months) for the patients with CR and 15+ months (range 8-20 months) for the patients with PR. Even the survival of the 7 patients with stable disease was fairly long (median 12, range 7-17 months), appearing to be significantly longer than the survival of the 25 patients with progressive disease (median 5, range 1-24+ months). The treatment was moderately well tolerated, although all patients experienced some mild form of toxicity, mostly gastrointestinal symptoms, neurotoxicity and haematotoxicity. Grade 3-4 adverse effects were noted in 39% of the patients. No toxic deaths occurred. It can be concluded that the present regimen produces meaningful responses for patients with metastatic melanoma. A randomised study is needed to determine the effect on survival.

Adult↗
PubMed1994

Delayed diagnosis and large size of breast cancer after a false negative mammogram.

The aim of this prospective, multicentre study was to investigate the effects of a false negative mammogram on treatment delay and tumour size. Among 306 consecutive women with histologically diagnosed, invasive breast cancer, the frequency of a false negative mammogram was small (13%) among women aged over 50 years, but 35% among those aged 50 or younger (P < 0.0001). Forty-five per cent of the women with a false negative mammogram had a longer than 2-month and 29% a longer than 6-month interval from mammography to surgery as compared with only 2 and 0% of women, respectively, who had a true positive mammogram (P < 0.0001 for both). Women with a false negative mammogram and a longer than 2-month interval to surgery had larger primary tumour size (60 versus 26% pT2-4, P = 0.005) and more often positive axillary nodes (60% versus 32% pN+, P = 0.03) at the time of surgery than those with a shorter delay. We conclude that a false negative mammogram is common in women younger than 50, and may lead to treatment delay and advanced clinical stage.

Age Factors↗
PubMed1994

Samarium-153-EDTMP in bone metastases.

Thirty-five patients with painful bone metastases arising from a variety of tumor types underwent a clinical trial in which 153Sm-EDTMP was injected as a single intravenous dose. The injection ranged in amount from 330 MBq to 1110 MBq of 153Sm-EDTMP. Pain relief usually occurred within one week after administration. The duration of pain relief lasted from 2 to 17 weeks. A detectable degree of pain palliation was experienced by 80% of the treated patients; 54% reported substantial or complete pain relief. Due to the small number of patients, no clear-cut dose-related response was detectable. Moderate myelosuppression was observed in one patient (WHO grade III). The metastatic lesion-to-normal bone ratios remained constant (varying from 1.5 to 4.8) for at least 5 days post-injection. 153Sm cleared very rapidly from the blood. Less than 1% of the injected dose remained in circulation at 4 hours post-injection. No local accumulation of the tracer could be detected outside the skeleton. Urinary excretion was quite complete at 6 hours post-injection. The biodistributions of 153Sm-EDTMP and 99mTc-DPD are very similar in metastatic and normal bone; thus, bone scanning can be used for patient selection and followup. According to our results, it seems that higher doses of 153Sm-EDTMP can be given safely and without any irreversible myelosuppression.

Bone Neoplasms↗
PubMed1992

Treatment of metastatic carcinoid tumour with recombinant interferon alfa.

14 patients with metastatic carcinoid tumour were treated with recombinant interferon alfa 6-30 x 10(6) IU weekly for 3-25 (median 6.5) months. A decrease in the 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) level to less than 50% of the pretreatment value was observed in 5 of the 10 cases with an elevated urinary 5-HIAA level. In 4 of the 5 remaining patients, the 5-HIAA level decreased 30-50% from the pretreatment value. 5 of the 9 evaluable patients with carcinoid syndrome experienced symptomatic relief, but none became symptom-free. Severe toxicity was not observed. The median time to progression was 4.5 months, and, in patients with a greater than 50% decrease in 24-h urinary-5-HIAA, it was 17 months. Objective regression in tumour size could not be demonstrated in any of the patients.

Adult↗
PubMed1992

Natural interferon alfa as maintenance therapy for small cell lung cancer.

We performed a 3-armed phase III study between 1982 and 1990 to evaluate low dose natural interferon alfa (nIFN-alpha) as a maintenance therapy in small cell lung cancer (SCLC) following induction chemotherapy (CT) and consolidation radiotherapy (RT). All patients received four cycles of CT (cyclophosphamide, vincristine, etoposide), followed by split-course RT (55 Gy in 20 fractions over 7 weeks). 410 patients entered the study. 237 patients who completed induction CT + RT and were classified as responders (complete response + partial response) were randomly assigned to arm 1: low dose nIFN-alpha (91 patients); arm 2: maintenance CT, six cycles of CAP (cyclophosphamide, doxorubicin, cisplatin) (59 patients); or arm 3: control arm (no maintenance treatment) (87 patients). Halfway through the study the CAP arm was discontinued. There was no difference in median survival between the groups (IFN: 11 months, CAP: 11 months, control: 10 months), but a clear difference in long-term survival and in survival in the limited disease group, favouring nIFN-alpha maintenance therapy. Proportional hazards regression analysis also showed a significant effect of IFN treatment on survival. Our results suggest a role for nIFN-alpha in maintaining a clinically disease-free status achieved with other treatment modalities.

Aged↗
PubMed1992

A phase II study of metastatic melanoma treated with a combination of interferon alfa 2b, dacarbazine and nimustine.

52 patients with metastatic melanoma have been treated with a combination of recombinant interferon-alfa-2b, dacarbazine and nimustine. The objective response rate was 23% with 9 complete responses (CR) and 3 partial responses (PR). The mean duration of the response was 18+ months for CR (6-31+ months) and 7 months for PR patients (4-10 months). The mean survivals were 24+ months (8-38 months) and 7 months (4-12 months), respectively. The mean duration of the response for patients with stable disease was 10+ months (2-48+ months) and the mean survival 17+ months (3-48+ months), while the patients with progressive disease died within 12 months (mean 4 months). The best responding sites were the lymph node, the lung and the subcutaneous metastases. Myelosuppression was the main adverse effect of the therapy. WHO grade 3-4 toxicity was seen in 27 patients leading to delay and reduced dosage of therapy; in 4 patients treatment was discontinued, 8 patients had no side effects. Combination therapy with interferon and dacarbazine and nimustine for metastatic melanoma offers no advantage over interferon and dacarbazine.

Adult↗
PubMed1990

Oral carmofur in advanced gastrointestinal cancer.

One hundred and twenty-four patients with a diagnosis of metastatic gastrointestinal cancer and no prior therapy were included in this clinical study of carmofur monotherapy, 300-500 mg/m2 daily for 6 weeks. For the 115 evaluable patients, the response rates were 19.4% in gastric cancer, 27.2% in cancer of mobile colon, and 12.5% in rectal cancer. No objective responses were seen in 38 patients with pancreatic cancer, although the disease of 13 of these patients has remained stable over a considerably long period of follow-up. The toxicity profile was interesting; the main adverse effects were urinary bladder symptoms and flush. Hematologic toxicity was minimal. The treatment proved to be safe and could be used for outpatients.

Administration, Oral↗
PubMed1982

Exchange of isethionate between blood and tissues in adult and 7-day-old mice.

[14C] Isethionate was injected intramuscularly into adult and 7-day-old mice and the distribution of the label in the blood, brain, heart, liver and spleen was determined. Endogenous isethionate in these tissues was determined and approximate exchange rates calculated from the endogenous isethionate tissue levels and specific radioactivities after certain time intervals. The concentration of isethionate was higher and its exchange rates between plasma and tissues faster in the adult mice than in the 7-day-old mice. A close correlation between isethionate transport rates and tissue levels in vivo was obtained in both age groups. The tissues eliminated isethionate rapidly, even faster in the adult than in the 7-day-old mice. The elimination of isethionate showed three different components, fast, intermediate and slow, in the heart, liver and spleen of the adult mice, but only two components, fast and slow, in the other cases.

Alkanesulfonates↗
PubMed1979

Ability of calf brain synaptic membranes to bind [35S]taurine to their triton X-100 and chloroform extracts.

A protein fraction containing reducing sugars was prepared from calf brain synaptic membranes with 0.5% Triton X-100, and another fraction containing bound phosphorus with a 2 : 1 chloroform--methanol mixture. Both protein fractions bound small amounts of [35S]taurine, the first fraction about 25 pmol/g protein and the second about 220 pmol/g protein. The Triton X-100 extract represented 13.8% of the membrane proteins, but the chloroform--methanol extract only 0.9%. The binding of taurine to the Trition X-100 extract was temperature sensitive, but was only slightly inhibited by hypotaurine and beta-alanine.

Alanine↗
PubMed1979

Synaptosomal accumulation of intracerebrally injected amino acids.

The distribution of the labels of [35S]taurine, [3H]lysine, [14C]glutamate and [14C]norleucine in mouse brain subcellular fractions was followed after intracerebral injection in vivo. [35S]taurine, [3H]lysine and [14C]glutamate and its metabolites accumulated in the nerve terminals, lysine and glutamate also occurring in the synaptic vesicles, while remained mainly in soluble synaptoplasm [14C] nor leucine penetrated the brain cell membranes slowly, but was still bound to the synaptic vesicles to a greater extent than taurine.

Amino Acids↗