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F Calabresi

Publications and source records attributed to F Calabresi.

52 records · Page 3Linked to original sources

Prognostic factors for chemotherapy response and survival using combination chemotherapy as initial treatment of advanced head and neck squamous cell cancer.

Between May 1981 and December 1987, 152 consecutive patients with locally advanced and previously untreated head and neck squamous cell cancer (HNSCC) received two or three courses of neoadjuvant chemotherapy (NAC) prior to surgery and/or radiotherapy. Eighteen percent of patients achieved a complete response and 45% a partial response (PR), for an overall response rate of 63%. A variety of pretreatment patient and tumor characteristics were analyzed for both the tumor response to NAC and survival rate. Significantly higher CR rates were found in patients with a World Health Organization (WHO) performance status (PS) of 0 to 1 than in those patients with a PS of 2 (P = .03). Patients with stage III disease were significantly more likely to respond than those with stage IV (P = .006). Evaluation of all parameters through multivariate analysis identifies the tumor classification (P = .001) and the primary site (P = .006) as the most significant in predicting CR. The overall 5-year survival rate of the entire group of patients was 18% (median survival, 14.3 months). Analysis by PS (P = .001), stage (P = .002), and tumor (P = .001), and node (P = .01) classes showed significant differences. Patients achieving a CR after NAC had a significantly improved survival rate as compared with those with residual disease at assessment (P = .0003). With the multistep regression analysis, the tumor (P = .005) and node (P = .007) classifications, and the sex (P = .03) were significant factors, but CR (P = .0004) remained the most important and independent predictive factor. Randomized prospective trials are requested to clearly establish the role of NAC on survival rates.

Adult↗

Phase III randomized study of fluorouracil, epirubicin, and cyclophosphamide v fluorouracil, doxorubicin, and cyclophosphamide in advanced breast cancer: an Italian multicentre trial.

From February 1983 to January 1985, 497 patients with advanced breast cancer were randomly allocated to receive either epirubicin or doxorubicin in the following combination chemotherapy regimen: fluorouracil (5-FU) 500 mg/m2 intravenous (IV) on days 1 and 8; epirubicin or doxorubicin 50 mg/m2 IV on day 1; cyclophosphamide 500 mg/m2 IV on day 1 (FEC or FAC). Cycles were repeated every 21 days until progression or to cumulative doses of 700 mg/m2 for epirubicin and 550 mg/m2 for doxorubicin. Dose reductions were applied according to the standard criteria. Activity was evaluated in 443 patients (222 in the FEC arm and 221 in the FAC arm). The two experimental groups were comparable in age, performance status, menopausal status, histology, previous treatments, and site of the disease. The overall response rate (complete response and partial response [CR + PR]) was not significantly different: 53.6% for FEC and 56.5% for FAC. The median time to progression was 273 days for FEC and 314 days for FAC; the median survival time was 591 and 613 days, respectively. Leukopenia, anemia, nausea, and vomiting were significantly lower in patients treated with FEC. As for cardiotoxicity, four cases of congestive heart failure (CHF) were recorded among patients treated with FAC while only one was observed in the FEC group. These results indicate that epirubicin in a combination chemotherapy regimen is as active as doxorubicin and is significantly less toxic.

Adult↗

Randomized trial comparing two short courses of moderate-dose metoclopramide for moderate-dose cisplatin-induced emesis.

To better define the dose-response relationship of moderate-dose (MD) metoclopramide (MCP), 42 patients receiving their first course of cisplatin (50 mg/m2) were randomly allocated to receive a short-course regimen of MCP, either at 1 mg/kg X 1 dose, 30 min before cisplatin (regimen A) or 1 mg/kg X 2 doses, 30 min before and 1 h after cisplatin (regimen B). The antiemetic response was assessed only by objective means (duration and volume of emesis over a 6-hour period). The results obtained in the two groups show a significantly better antiemetic effect (p = 0.03) employing the higher dose of this short-course regimen, with as much as 76% of the patients experiencing no vomiting or only a low degree of emesis. Furthermore, the lower-dose MCP regimen seems to be inadequate for preventing emesis, especially in the subgroups at higher emetic risk (patients with prior chemotherapy exposure and those concurrently receiving adriamycin. No significant side effects were present with either treatment. Further studies are required to define the best short-course regimen of MCP for patients receiving MD cisplatin.

Adult↗

Etoposide prior to cis-diamminedichloroplatinum in combination chemotherapy: in vitro and in vivo studies.

Antitumor effect and toxicity of etoposide (VP 16) in combination with cis-diamminedichloroplatinum (DDP) were studied on the in vitro C108 line and its in vivo counterpart, the M1087 line, both deriving from Lewis lung carcinoma. A colony-forming assay was used to assess the in vitro cytotoxicity of each drug and, on the basis of survival curve shape indications, different drug sequences were analyzed in order to find the optimal combination. Tumor growth inhibition, growth delay, metastasis reduction and percentage increase in lifespan were considered as parameters of therapeutic effect. From the present work it can be derived that the VP 16-DDP combination produces a poor antitumour effect against the Lewis lung carcinoma lines, otherwise associated with a highly acute toxicity. The sequence in which VP 16 is given before DDP induces a significant antimetastatic effect together with acceptable toxicity.

Animals↗

Different metastatic potential of in vitro and in vivo lines selected from Lewis lung carcinoma: correlation with response to different bleomycin schedulings.

In vitro and in vivo variant cell lines selected from Lewis lung carcinoma are described. In vitro tumor lines are shown to differ in their metastatic potential, evaluated as lung colony-forming ability. Moreover, corresponding in vivo sublines, derived from intramuscular implant of cultured tumor cells, exhibit the same behavior for metastases formation as their in vitro counterpart. The metastatic potential of the in vivo lines has been evaluated both as lung colony-forming ability and as spontaneous metastasis formation. Response to bleomycin (BLM) treatment has been studied on the in vitro and the in vivo lines. Results reported show that the most metastatic lines, in vitro and in vivo, appear to be more resistant to a BLM treatment and that appropriate fractionation regimens can improve both the percentage of cell kill and the percentage of metastases reduction.

Animals↗

Chemotherapeutic activity and histopathologic feature of BCNU + 5-FU effect on Lewis lung carcinoma.

In this study we investigated the effects of BCNU + 5-FU on the intramuscularly implanted Lewis lung carcinoma and on its spontaneous lung metastases. Chemotherapeutic agents were given i. v. either alone and in combination seven days after transplantation of 2.5 x 10(5) viable tumor cells, when the average weight of the primary tumor was 500 mg. The analysis of the following parameters: T/C, T--C, of %-metastases reduction, indicates that the simultaneous administration of BCNU + + 5-FU induces a more relevant response on the Lewis lung carcinoma than single drug therapy, especially evident at level of lung metastases.

Animals↗

Cyclophosphamide and iphosphamide against Lewis lung carcinoma: evaluation of toxic and therapeutic effects.

In the present report, investigations have been carried out to evaluate toxic and therapeutic effects of cyclophosphamide vs its isomer iphosphamide. Cytostatic action of the 2 drugs was assayed on the murine Lewis lung carcinoma (3LL). It has been observed that iphosphamide is less toxic as compared to cyclophosphamide (LD50 IP LD50 CP = 1.5); on the other hand, to reach the same therapeutic effectiveness on 3LL, an iphosphamide dose 1.6 - 2 times higher than that of its parent compound is necessary.

Animals↗

Phase II studies of 4'-iodo-4'-deoxydoxorubicin in advanced non-small cell lung, colon and breast cancers.

The new anthracycline analogue, 4'-iodo-4'-deoxydoxorubicin (I-DOX), was administered at 70 mg/m2 as first chemotherapy in 61 patients with advanced NSCL (19), colon (20) and breast cancers (22). Treatment was repeated every 3 weeks; the dose was decreased to 60 mg/m2 (19% of the cycles) or increased to 80 mg/m2 (17% of the cycles) according to the granulocyte count nadir. Partial responses were observed in 6% of the patients with NSCL, in 5.5% of those with colon and in 10% of those with breast cancers. The main toxicity was a selective granulocytopenia characterized by a duration of about 1 week, and a high inter-patient variability. Non-haematological toxicities were mild. The negative results obtained in breast cancer might be related to the dose administered. Further studies in this tumour type should be performed with a more aggressive schedule.

Adult↗

Interleukin-2, interferon-alpha and interleukin-2 plus interferon-alpha in renal cell carcinoma. A randomized phase II trial.

BACKGROUND: The purpose of the present study was to investigate the therapeutic effectiveness of interleukin-2 (IL-2) and interferon (IFN), either alone or in combination, in comparable groups of patients affected by advanced renal cell carcinoma (RCC). PATIENTS AND METHODS: In order to limit selection biases, treatment was allocated on a random basis. Patients randomized to IL-2 alone were scheduled to receive eight rlL-2 24-hour i.v. infusion cycles, days 1 to 4, at a daily dose of 18 x 10(6) lU/m2 for a total of 25 weeks. Patients randomized to IFN alone were scheduled to receive rIFN-alpha at a daily dose of 6 x 10(6) IU/m2, days 1, 3 and 5, every week for a total of 52 weeks. Patients randomized to the combination of IFN and IL-2 were given the same drugs at the same daily doses for a total of 24 weeks. Drug dose was modified according to toxicity. RESULTS: Twenty-three percent (95% CI:+/-17.5) of patients treated with IL-2 alone showed an objective response to treatment (9% CR). The corresponding figures in patients treated with IFN alone or IFN plus IL-2 were 9% (95% CI:+/-11.9) and 9% (95% CI:+/-11.9), respectively. Complete responses were observed only in patients treated with IL-2. The median duration of response in the IL-2 arm was 18 months (range, 9.5-24). The duration of the two responses achieved by IFN alone was seven and nine months, respectively. The corresponding figures in the two patients responding to the combination of IFN with IL-2 were 19 and 27 months, respectively. Total IL-2 dose appeared to be a major predictor of response. Only a minority of patients experienced grade 3-4 toxicity, the incidence being higher in those treated with IL-2 or IL-2 plus IFN. CONCLUSIONS: Neither IFN nor IL-2 or the combination of the two appear to be very active in patients with advanced RCC, even when trial entry was restricted to patients with relatively indolent disease. This stresses the need for the development of new approaches.

Adult↗

Schedule-dependent effectiveness of ADM and multiple cycles of DDP on a murine reticulum sarcoma.

The therapeutic index of adriamycin (ADM) and cisplatin (DDP) combination versus repeated sequences of the more active drug (DDP) was investigated on a murine reticulum cell sarcoma of ovarian origin (M5) implanted i.m. in C57BL/6 mice. The antitumor efficacy of multiple cycles of DDP according to different regimens at a prefixed time (every 7 days) or at tumor regrowth was also evaluated. Our data demonstrate that the ADM-DDP combination did not improve the antitumoral efficacy of DDP as single agent, while repeated cycles of DDP led to a significant increase in the host life span. Differences in therapeutic effect were elicited by the two schedules: the regimen at a prefixed time showed a major effect on local tumor control, although the regimen at tumor regrowth was better tolerated.

Animals↗

Surgical-adjuvant chemotherapy with AMSA in Lewis lung carcinoma bearing mice.

The effect of 4'-(9-Acridinylamino) methanesulfon-m-anisidide (AMSA) in combination with surgery was studied on Lewis lung carcinoma-bearing mice. The surgical removal of the primary tumor was performed at a late stage of growth and the drug was administered i.p. according to different schedules. Results of the present study indicate that the AMSA-surgery combination displays a modest effect against the Lewis lung carcinoma, slightly improved when chemotherapy is given before tumor removal, and that double courses of AMSA, given both before and after surgery, prove to be equally effective as a single preoperative chemotherapy.

Aminoacridines↗