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Biomedical subjects

G Falkson

Publications and source records attributed to G Falkson.

285 records · Page 16Linked to original sources
PubMedDate not supplied

Antiemetic treatment with oral granisetron in patients receiving moderately emetogenic chemotherapy: a dose-ranging study.

The antiemetic efficacy and tolerability of four different oral doses of granisetron (0.25, 0.5, 1, and 2 mg twice daily [BID]) were compared in a randomized, double-blind, parallel-group, multicenter study involving 930 patients with malignant disease receiving moderately emetogenic chemotherapy over a 7- or 14-day period. On the first day of granisetron treatment, a statistically significant association between complete response and dose was seen (P = 0.001), with the maximum response (81.1%) achieved at a dose of 1 mg BID. The 24-hour complete response rate with granisetron 1 mg BID was significantly higher than with 0.25 mg BID (61.1%) or 0.5 mg BID (70.2%) (P < 0.009). The complete response rate for days 0 to 6 was significantly higher with granisetron at 1 mg BID (58.8%) than with 0.25 mg BID (43.7%) or 0.5 mg BID (53.6%) (P < 0.009). No advantage in terms of complete response rate was shown for 2 mg BID over 1 mg BID. Granisetron was well tolerated, and few patients required additional treatment with other antiemetics.

Administration, Oral↗
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Fadrozole versus megestrol acetate: a double-blind randomised trial in advanced breast cancer.

Ninety-six patients were entered into a randomised, double-blind, double-dummy, clinical trial to assess the efficacy and safety of fadrozole as compared to megestrol acetate as second-line hormonal treatment for patients with advanced breast cancer. Analysis of results was on an intention-to-treat basis and included response rate, time to progression (TTP), time to treatment failure (TTF) and survival. Forty-six patients received fadrozole and 50 were randomised to megestrol acetate. Patients and pretreatment prognostic variables were balanced in the two arms of the trial. The objective response rates [3/46 (7%) for fadrozole and 3/50 (6%) for megestrol acetate], TTP, TTF and survival were similar in the two arms of the trial. Toxicity was also similar in the two arms of the trial and consisted mainly of oedema, hypertension and minor gastrointestinal symptoms. Fadrozole appears to be as active as megestrol acetate in second-line hormonal treatment of advanced breast cancer.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

Recombinant human erythropoietin in the treatment of cancer-related anaemia.

The aim of this study was to investigate the effects of recombinant human erythropoietin (rh-EPO) in patients with cancer-related anaemia. Thirty-six ambulatory patients who had malignant neoplasms and haemoglobin (Hb) values of < 11 g/dl (Pretoria is 1,310 m above sea level) entered the study. Patients with renal insufficiency or anaemia caused by bleeding or haemolysis, and patients with iron deficiency or megaloblastic anaemia, were not entered in the study. 22 IU/kg rh-EPO was given subcutaneously 3 times/week. The dose was escalated if Hb values did not rise after 4 weeks. All 36 patients were evaluable for toxicity. Side effects ascribed to rh-EPO were pain or discomfort at the site of injection (12 patients), heart palpitations (3 patients), skin rash (2 patients) and hypertension, deep vein thrombosis, and myalgia in 1 patient each. Thirty of the 36 patients who entered the study were evaluable for response. There were 16 females and 14 males among the evaluable patients. Median age was 64.5 years. Response, defined as an increase of Hb of at least 2 g/dl or to 12.5 g/dl, for at least 1 month, was documented in 12 patients. This was accompanied by an improvement in performance status and occurred within 1 month in 5 of the 12 patients who responded. rh-EPO has a limited but measurable therapeutic value for patients with cancer-associated anaemia.

Adult↗
PubMedDate not supplied

Small cell lung cancer: analysis of factors influencing the response to treatment and survival.

The aims of this study were to identify prognostic factors in patients (pts) with small cell lung cancer and to identify dominant prognostic factors independent of disease stage, to define prognostic subsets through recursive partitioning and amalgamation (RPA) and to analyze the clinical characteristics of long-term survivors. The prognostic significance of 27 pre-treatment variables was evaluated in 144 pts seen at a single institution. The current study confirmed the superior outcome for pts with limited disease (LD) in terms of response, response duration, time to treatment failure and survival when compared to those with extensive disease (ED). None of the variables independently predicted for response in patients with LD. Response correlated significantly with a good performance status (PS) for pts with ED and for the whole group. A good PS was the most significant predictor for prolonged survival in pts with LD. In ED a longer survival was associated with a normal pre-treatment albumin value, absence of weight loss and female gender. When the whole group was considered, PS and number of metastatic sites were identified as the most influential factors for survival independent of disease stage. RPA analysis defined 3 prognostic subsets based on stage of disease, PS and number of metastatic sites. The best survival rates were seen in pts with LD with a good PS and pts with ED, only one metastatic site and a good PS. 11% of pts survived > 2 years (18% LD, 6% ED). A complete response to chemotherapy was the most important predictor for long-term survival. Comparison of the data from this study with published results of protocol studies showed similar outcomes.

Adult↗
PubMedDate not supplied

A phase II trial of vindesine in hepatocellular cancer.

Sixteen patients with histologically confirmed inoperable hepatocellular carcinoma were treated with vindesine 3 mg/m2 i.v. weekly. Anemia, leukopenia and neuritis were documented but no severe or life-threatening toxicity was seen. There were no objective responses among the 14 evaluable patients. Eight had a no change status (median duration of 16 weeks, range 6-33), while the remaining 6 had progressive disease as their best evaluation. The median survival time was 20 weeks. Vindesine does not have a therapeutic effect in patients with advanced hepatocellular carcinoma.

Adolescent↗
PubMedDate not supplied

Cisplatin versus cisplatin plus D-Trp-6-LHRH in the treatment of ovarian cancer: a pilot trial to investigate the effect of the addition of a GnRH analogue to cisplatin.

Thirty-four patients with histologically confirmed ovarian cancer were entered into a pilot study. Patients were randomized to receive cisplatin alone or cisplatin plus D-Trp-6-LHRH(decapeptyl). Objective response (complete and partial response) was documented in 9 of 14 patients on cisplatin and in 12 of 18 patients on cisplatin plus decapeptyl. Median time to treatment failure and median survival times were the same in the two treatment regimens. Toxicities were similar in the two treatment arms, except for hot flashes which only occurred in patients on cisplatin plus decapeptyl.

Antineoplastic Agents↗
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The low-grade lymphoproliferative disorders.

Rapid advances in our understanding of the biology and pathology of lymphoproliferative disorders, permitted mainly by new diagnostic tools, constantly change our approach to this heterogenous group of disorders. In this review of the more indolent subgroup of lymphoproliferative disorders, some of the recent advances are highlighted, and treatment options discussed.

Humans↗
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Postmenopausal breast cancer. Drug therapy in the 1990s.

In summarising current drug treatment strategies for postmenopausal women with breast cancer, it is essential to emphasise that we are dealing with a group of diseases that are treatable, and that appropriate treatment decisions will give longer disease-free intervals for patients with early breast cancer, and better control with better survival for patients with advanced (i.e. locally advanced and/or metastatic) disease. Women greater than 65 years of age have a predictably better response to hormone treatment versus women less than 65 years of age. Hormone treatment may, therefore, be considered as primary treatment or as adjuvant treatment after limited surgery. Hormone treatment is also the treatment of first choice for elderly patients with advanced disease. For middle-aged women (45 to 65 years of age), various patient factors are important in predicting the value of treatment. Estrogen receptor (ER) status is prognostic of survival irrespective of treatment. Patients with ER-positive disease have a better prognosis than those with ER-negative disease, both in the adjuvant setting and in the face of metastatic disease. This is because ER-positive tumours tend to grow slower. The availability of the serotonin type 3 (5-hydroxytryptamine;5-HT3) antagonists, which effectively control nausea and vomiting in most patients, make chemotherapy combinations more acceptable, and combination chemotherapy can more readily be considered as first treatment option both as adjuvant treatment and for treatment of advanced disease. For patients with organ metastases there is no doubt that combined chemotherapy treatment is indicated.

Aged↗
PubMedDate not supplied

Mitomycin and tamoxifen versus mitolactol, doxorubicin, and tamoxifen in patients with previously treated breast cancer.

One hundred thirty patients with previously treated advanced breast cancer were treated in a cooperative trial to investigate the effect of mitomycin plus tamoxifen (MT) and to compare its relative value to combination therapy with mitolactol, doxorubicin (ADM), and tamoxifen. An additional 76 patients who had had prior exposure to ADM were randomized to receive MT or MT plus fluoxymesterone. MT versus mitolactol, ADM, and tamoxifen was not significantly different in efficacy; however, there were significant differences in toxicity. This study showed that MT is an effective and acceptable second-line treatment for advanced breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Trials of single-agent and combination chemotherapy for advanced cancer of the pancreas.

In a study of 127 patients with advanced measurable pancreatic cancer, objective response rates of 2% (melphalan), 10% (5-FU and methyl-CCNU), and 7% (5-FU, methyl-CCNU, and streptozocin) were achieved. No responses occurred in the 28 patients treated with VP-16-213 who had already received prior chemotherapy. Toxicity was greater for the two- and three-drug combinations than for melphalan. There was no difference in survival following use of the three treatment regimens. Further studies are needed to develop effective chemotherapy for patients with cancer of the pancreas.

Antineoplastic Agents↗