Biomedical subjects

E Scardino

Publications and source records attributed to E Scardino.

24 records · Page 2Linked to original sources

PubMedDate not supplied

Prognostic factors of the clinical response to subcutaneous immunotherapy with interleukin-2 alone in patients with metastatic renal cell carcinoma.

The intravenous immunotherapy with interleukin 2 (IL-2) represents one of the most active therapies of metastatic renal cell carcinoma (RCC). Recently, it has been demonstrated that IL-2 given subcutaneously in association with interferon alpha (IFN) may determine a response rate in RCC comparable to that obtained with an intravenous route of administration, but with a lower toxicity. Moreover, our previous data have suggested that IFN is not essential for IL-2 efficacy. On the basis of these data, we have designed a protocol of immunotherapy with IL-2 alone given subcutaneously in the treatment of metastatic RCC. The study included 48 consecutive evaluable patients. IL-2 was given at a daily dose of 6 million IU for 5 days/week for 6 consecutive weeks, corresponding to one IL-2 cycle. The overall response rate was 14/48 (29%; CR:1; PR:13). Response rate was significantly higher in nephrectomized than in nonnephrectomized patients, and in patients with a good compared to those with a low performance status. Patients with an interval between the diagnosis of primary renal tumor and of its metastases longer than 1 year did better than those with a lower interval, as did patients with a single metastasis compared to those with multiple metastases, while no significant difference was seen in relation to sex, age and previous IFN therapy. As far as dominant metastasis sites are concerned, patients with liver metastases showed a response rate significantly lower than that seen in patients with metastases in sites other than liver. Toxicity was low in all patients. This study shows that the subcutaneous immunotherapy with IL-2 alone is a well tolerated and effective therapy of metastatic RCC. The evidence of a low PS, disseminated tumor and liver metastases represents the most important negative prognostic factor for the response to therapy.

Adult↗

PubMedDate not supplied

Late solitary thyroid carcinoma metastasis to the kidney: a case report.

Secondary tumour to the kidney is quite frequent. Even if, theoretically, all solid tumours may give rise to renal metastasis, secondary lesions to the kidney occur more commonly in patients with lung and breast cancer, melanoma and lymphoma. Only 15 cases of renal metastasis arising from a follicular thyroid carcinoma have been reported in the literature. Rarely, metastases to the kidney present as primary renal tumours and may be treated surgically for that mistaken diagnosis. Nevertheless, in patients with solitary late distant metastasis of thyroid cancer, complete surgical resection may be proposed, followed by 131I ablation in order to offer a better chance of prolonged survival. We describe a case of a renal mass undergoing radical surgery and revealing itself as a solitary metastasis from follicular carcinoma of the thyroid, appearing 10 years after total thyroidectomy and 131I ablation therapy.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Spermatic cord liposarcoma: a report of four cases.

Spermatic cord liposarcoma is a rare pathology (1-4); currently about one hundred cases are documented. The therapy of choice is surgery, followed sometimes by radiotherapy. We herein describe our experience of 4 cases between 1995 and 2000, with median follow-up of 34 months (mean 48 months, range 28-95 months), in order to stress the role of orchifuniculectomy, even when mass-ablation first procedure may seem radical.

Aged↗

PubMedDate not supplied

Gn-RH antagonist possible response, after Gn-RH agonist failure in a man with metastatic prostate cancer.

Gn-RH agonists or surgical castration are considered standard treatment for patients affected by metastatic prostate cancer. Despite greater cost, chemical castration is often considered the treatment of choice as it is psychologically better tolerated. We report our experience of one patient undergoing treatment with Gn-RH agonist who developed an early resistance to the administered drug, with serum testosterone levels within the range of normality.

Aged↗

PubMedDate not supplied

Vinorelbine-based chemotherapy in hormone-refractory prostate cancer.

BACKGROUND: No consensus exists regarding further therapy for the management of hormone-refractory prostate cancer. In this phase II study, the combination of Vinorelbine with 5-Fluorouracil and folinic acid (FLN regimen) was evaluated in patients with progressive or resistant disease after hormone therapy. PATIENTS AND METHODS: Thirty-four patients were treated with Vinorelbine at a dose of 20 mg/m2 intravenously (i.v.) on days 1 and 3, folinic acid (FA), 100 mg/m2 i.v. and 5-Fluorouracil (5-FU), 350 mg/m2 i.v. as a short infusion on days 1 to 3. The therapy was given in an out-patient setting, every 3 weeks. RESULTS: All of the 34 eligible patients were evaluable for toxicity and 30 for activity. A total of 127 cycles was administered (91% at full dose). Among thelS5 patients with measurable disease, four had a partial response (26.6%; C.I. 95%, 28.3% to 65.7%) and four achieved stable disease. In 14 patients (47%) a clinical benefit was documented. Six out of 15 patients with bone-only involvement had stable disease (40%). The median duration of stabilization and partial response was 16 weeks (range 4-24 weeks). The most common toxicity was hematological: Grade 4 (NCI-CTC scale) in five patients at re-cycle. Other toxicities were of low incidence and easy to manage. CONCLUSION: The encouraging results obtained with the FLN regimen in terms of clinical benefit and its predictable and manageable toxicity support the palliative role of this chemotherapeutic strategy in hormone-refractory prostate patients.

Adenocarcinoma↗

PubMedDate not supplied

Correlation between pretreatment serum levels of neopterin and response to interleukin-2 immunotherapy in cancer patients.

IL-6 levels have been proven to correlate with resistance to IL-2 immunotherapy. Since IL-6 may be produced by both macrophages and TH2 lymphocytes, it is not possible to establish whether the negative prognostic significance of IL-6 levels may primarily depend on an enhanced macrophage or TH2 activation. Macrophage activation may be documented by the increase in its specific marker neopterin. In an attempt to establish whether the negative significance of IL-6 high levels prior to IL-2 immunotherapy may reflect an enhanced macrophage activation, we have investigated the relation existing between pretreatment concentrations of neopterin and response to IL-2 immunotherapy in cancer patients. The study included 20 metastatic renal cell cancer patients, who were treated with IL-2 subcutaneously at 6 million IU/day for 5 days/week for 6 weeks. Before the onset of IL-2 therapy, abnormally high serum levels of neopterin were seen in 11/20 patients. Moreover, neopterin concentrations were significantly correlated with those of IL-6. Tumor regression rate was significantly higher in patients with normal than in those with elevated levels of neopterin prior to therapy (5/9 vs 1/11, P < 0.05), as well as the percent of the survival at 1 year (9/9 vs 4/11, P < 0.01). This preliminary study would suggest that pretreatment values of the macrophage marker neopterin correlate with resistance to IL-2 cancer immunotherapy.

Adult↗