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Biomedical subjects

H C Falkson

Publications and source records attributed to H C Falkson.

At least 55 records · Page 3Linked to original sources
PubMed1982

Carcinoembryonic antigen as a marker in patients with breast cancer receiving postsurgical adjuvant chemotherapy.

Serial plasma CEA levels were determined over a period of 1-3 years in 114 patients receiving adjuvant chemotherapy for T1, 2 or 3a N+ MO breast cancer. CEA values were correlated with clinical status, scintiscans, and other biochemical parameters. CEA values greater than 2.5 ng/ml were considered abnormal. Forty-one patients had normal values throughout the adjuvant period. In 73 patients where abnormal values occurred, four different patterns were seen: (1) a statistically significant number (30/73) had initial elevations with a decreasing titer; (2) rising titer (10/73); (3) fluctuating titer of transient elevation (25/73); and (4) persistent elevation (8/73). Seventeen patients developed overt metastases, this was associated with a rising CEA in nine patients (P less than 0.002). CEA was more sensitive for predicting relapse than alkaline phosphatase or LDH. The correlation between CEA determination and the eventual development of metastatic disease is striking, and has implications for the design of future clinical trials. Results indicate that CEA could be used to identify high risk patients, to estimate efficacy of chemotherapeutic regime, and to determine optimal duration of therapy.

Antineoplastic Agents↗
PubMed1982

Adjuvant chemotherapy for operable breast cancer in premenopausal women.

Surgery alone does not cure breast cancer, and adjuvant chemotherapy has changed the management of this disease. Data obtained in 81 premenopausal women with operable breast cancer, treated at our clinic, are presented. Patients with axillary node disease were treated on three different protocols: cyclophosphamide + methotrexate + fluoro-uracil + vincristine + prednisone (CMFVP), cyclophosphamide + methotrexate + fluoro-uracil (CMF), and CMF + immunotherapy with methanol extract residue of BCG (CMF + MER). Patient discriminants and treatment regimens are discussed. Analysis of the results obtained in 49 patients in one study showed an extension of disease-free survival to 4,25 years, that CMFVP was superior to CMF with or without MER, and that immunotherapy was not beneficial. The literature is briefly reviewed and the motivation for our newer studies stated.

Adult↗
PubMed1982

Mesnum as a protector against kidney and bladder toxicity with high-dose ifosfamide treatment.

Thirty-two patients with advanced cancer were treated in a phase I-II trial with ifosfamide plus mesnum. At doses up to 300 mg ifosfamide/kg the administration of mesnum prevented most of the expected kidney and bladder toxicity. With this high dose range hemopoietic dose-limiting. Only one of twelve evaluable patients with breast cancer showed definite therapeutic benefit. Complete remission or partial remission was seen in three patients with non-Hodgkin lymphoma and one patient with Hodgkin's disease.

Adult↗
PubMed1982

Dibromodulcitol and adriamycin +/- tamoxifen in advanced breast cancer.

The therapeutic effectiveness of combining tamoxifen with a combination chemotherapy regimen was tested in 135 patients with advanced breast cancer previously treated with chemotherapy. Patients were randomly allocated to received dibromodulcitol + Adriamycin (DA, 55 patients) or DA + tamoxifen (DAT, 67 patients). An additional 13 patients less than 50 years of age were assigned to DAT (DATN). Pretreatment characteristics were similar across both regimens. DAT and DATN yielded similar results in the less than 50-year-old cohort. DAT tended to be superior to DA with respect to response rate (55% versus 36%, p = 0.004), time to treatment failure (medians: 170 days versus 110 days, log rank p = 0.001), responders' time to treatment failure (360 days versus 220 days, p = 0.035), and survival (340 days versus 270 days, p = 0.18). Toxicity was similar in both regimens. Thus, addition of tamoxifen to a second-line DA regimen appears to increase the therapeutic effectiveness. It is suggested that the addition of this antiestrogen to other chemotherapy regimens would also be beneficial.

Adult↗
PubMed1981

Fluorouracil, imidazole carboxamide dimethyl triazeno, vincristine, and bis-chloroethyl nitrosourea (FIVB) in colon cancer.

One hundred and sixty patients with advanced metastatic colon cancer were treated with the drug combination of 5-fluorouracil (FU), imidazole carboxamide dimethyl triazeno (ICDT, DTIC), vincristine (VCR), and bis-chloroethyl nitrosourea (BCNU). All the agents were given in each cycle of treatment. The patients also received continuous ethylestranol. Special care was taken to ensure that the ICDT was not at any time exposed to light. Toxic effects included fall in hemoglobin, leukopenia, thrombocytopenia, alopecia, stomatitis, nausea and vomiting, and occasional diarrhea. Among 112 patients who had had no prior exposure to cytostatic agents, complete remission (CR) was recorded in 12, and partial remission (PR) in 31. The median duration of remission in these patients was 5.2 months. The median survival for the whole group was 8.4 months: for responders the median survival was 10 months, and for non-responders, 5.4 months. PR was also documented in 10 of 48 patients who had received prior treatment with FU or FU plus methyl-1,3-cis(2-chloroethyl-1-nitrosourea) (MeCCNU).

Antineoplastic Agents↗
PubMed1981

A five-drug combination in the treatment of metastatic breast cancer.

The five-drug combination of fluorouracil imidazole carboxamide dimethyl triazeno, vincristine, bis-chloroethyl nitrosourea, and prednisone (FIVB + P) was given to 120 women with metastatic breast cancer. Of 114 evaluable patients, complete response was seen in 12 and partial remission in 39. Complete or partial remission was documented a) in 21 of 59 patients who had had extensive prior chemotherapy and prednisone, b) in 15 of 33 patients who had had prior chemotherapy but no prior prednisone, and c) in 15 of 22 patients who had received no prior systemic treatment for breast cancer. The regimen was well tolerated, the main side effects being hemopoietic suppression, short duration nausea and vomiting, and alopecia. The FIVB + P regimen is a useful and acceptable second or third line treatment for patients with metastatic breast cancer. There is evidence that this treatment program provides a non-cross-resistant regimen to many chemotherapy combinations currently in use in breast cancer. The high activity in previously untreated patients offers a further option for cycling of multiple agents in order to gain better disease control in patients with advanced breast cancer.

Antineoplastic Agents↗
PubMed1980

Non-Hodgkin's lymphoma in pregnancy.

Non-Hodgkin's lymphoma associated with pregnancy is rare. To date, only 1 case in which lymphoma was diagnosed and treated during pregnancy, with normal pregnancy outcome, has been reported. We describe another case where life-threatening, diffuse, poorly differentiated lymphocytic lymphoma was diagnosed during the 13th week of pregnancy. Combination chemotherapy (cyclophosphamide, vincristine, bleomycin, and prednisone) resulted in remission and a health full-term infant was born.

Adult↗
PubMed1980

Anhydro-ara-5-fluorocytidine (AAFC) in gastrointestinal cancer. A phase II study.

Results of a phase II study of AAFC in 32 patients with advanced measurable gastrointestinal cancer are presented. Fourteen patients were treated with a weekly schedule, while 18 were treated with 5-day courses of the drug. There were 12 patients with pancreas cancer, eight with stomach cancer, seven with cancer of the esophagus, four with colorectal cancer, and one with cancer of the gallbladder. Response was observed in pancreas and stomach cancer. Two patients with pancreas cancer had partial remissions, three other patients (two pancreas and one stomach) had response of short duration, considered to be less than a partial remission. There appeared to be very little difference between the two different schedules of administration. AAFC shows limited activity in adenocarcinoma of pancreas and stomach; there does not appear to be a practical application for AAFC as a single agent.

Ancitabine↗
PubMed1979

Improved remission rates and remission duration in young women with metastatic breast cancer following combined oophorectomy and chemotherapy: a study of Cancer and Leukemia Groupe B.

One hundred fifty-seven premenopausal women with metastatic breast cancer were prospectively randomized to treatment consisting of oophorectomy + vincristine, prednisone, cyclophosphamide, methotrexate, 5-fluorouracil (VPCMF) (Reg. I) or oophorectomy + cyclophosphamide (Reg. II) or oophorectomy followed by an observation period (Phase 1), followed by VPCMF (Phase 2) (Reg. III). Complete plus partial response rates were 72% on Reg. I, 65% on Reg. II, 18% on Reg. III, Phase 1 and 50% on Reg. III, Phase 2. Median duration of response for Reg. I was 17 months, for Reg. II 16 months, and for Phase 1 and Phase 2 of Reg. III, respectively, 5 months and 8 months. The response rate for patients treated with oophorectomy plus chemotherapy is significantly higher than the response rate achieved with oophorectomy alone as first treatment following the appearance of metastases in premenopausal women.

Adult↗
PubMed1979

Acute leukemia as a complication of long-term treatment of advanced breast cancer.

Acute nonlymphocytic leukemia occurred in four women after long-term therapy for advanced breast cancer. The patients had inoperable/metastatic breast cancer that had been well-controlled with chemotherapy for many years (7 years and 4 months, 7 years and 1 month, 6 years and 3 months, and 4 years and 7 months, respectively). Two of the patients had also received extensive radiotherapy. The chemotherapeutic agent that all four patients had received in common was cyclophosphamide.

Adult↗
PubMed1979

Role of plasma carcinoembryonic antigen in evaluating patients with breast cancer treated with adjuvant chemotherapy.

Serial plasma carcinoembryonic antigen (CEA) levels were determined in 84 patients with breast cancer who were receiving postsurgical adjuvant chemoimmunotherapy or adjuvant chemotherapy. CEA values were correlated with clinical status, scintiscans, alkaline phosphatase, LDH, and SGOT. CEA values greater than 2.5 ng/ml were considered abnormal. Thirty patients had normal serial CEA values; all remain disease-free. In 54 patients one or more abnormal CEA values were recorded; nine of 54 developed overt metastatic disease. Relapses occurred in four of 38 patients in whom values up to 5 ng/ml were recorded, in three of 14 patients in whom values up to 10 ng/ml were recorded, and in two of two patients in whom values greater than 10 ng/ml were recorded.

Antineoplastic Agents↗
PubMed1978

Trofosfamide in the treatment of patients with cancer. A pilot trial.

The efficacy of trofosfamide (Ixoten; Noristan), a derivative of cyclophosphamide, was investigated in 76 patients. Those with solid tumours were given 50 mg/kg in 6 divided doses in 48 hours; those with chronic lymphatic leukaemia were treated with 100 mg orally 3 times a day for up to 10 weeks. Side-effects of treatment included leucopenia, thrombocytopenia, a fall in the haemoglobin level, haematuria and occasional alopecia. Nausea was never severe, and occurred in only half of the patients on a high dose and in none of the patients on a low dose. A therapeutic effect was observed in patients with breast cancer, cancer of unknown origin and pancreatic cancer. Twenty-one of 24 patients with chronic lymphatic leukaemia (all of whom had aggressive disease) responded to treatment, and complete remission (including normal bone marrow), was achieved in 5 of these patients.

Clinical Trials as Topic↗
PubMed1978

Carcinoembryonic antigen in patients with breast cancer: an adjunctive tool to monitor response and therapy.

Plasma carcinoembryonic antigen (CEA) levels were performed by radioimmunoassay in 234 patients with histologically proved breast cancer: 181 with advanced metastatic disease and 53 without distant metastases but nodal involvement at time of mastectomy. Four hundred and thirty-four assays were done and correlated with the clinical status of the patients. Values above 2.5 ng/ml were taken as abnormal. Active disease was associated with elevated plasma CEA levels. Very high values were not recorded in 109 patients when they were considered to be in complete remission, while only 22 patients out of 63 patients with progressive disease had normal values. In 16 of these values remained normal despite progression of disease. In 6 patients clinical relapse preceded CEA elevation by 2--5 months. Tumor burden and abnormal serial CEA values showed positive correlation in 38 patients. In 30 patients, change in clinical status and CEA values occurred simultaneously. In only 2 patients an increase in CEA value occurred 2--3 months before clinical documentation of relapse.

Antineoplastic Agents↗
PubMed1976

Leukaemia in Hodgkin's disease.

Three new cases of Hodgkin's disease terminating in leukaemia are described and the literature is briefly reviewed. The patients developed acute lymphocytic leukaemia, acute eosinophilic leukaemia and chronic myeloid leukaemia, 6 1/4 years, 6 years and 7 months respectively after the initial diagnosis of Hodgkin's disease. The 2 patients who developed acute leukaemia had been in complete remission from the Hodgkin's disease and had received no treatment for 5 3/4 and 2 1/2 years respectively. Possible causes for the occurrence of leukaemia in patients with Hodgkin's disease are discussed.

Adult↗
PubMed1976

Adriamycin in the treatment of cancer.

Adriamycin is a new anticancer antibiotic with a wide spectrum of activity against solid tumours. The results obtained with this agent in 159 patients with histologically confirmed advanced metastastic malignancies are reported. Encouraging results were obtained in patients with sarcomas of bone and soft tissue (12/22). Response was also seen in mesothelioma (3/9) and lung cancer (5/15). A variety of other neoplasms was also treated and results obtained in neuroblastoma, testicular tumours, stomach carcinoma, breast cancer and nephroblastoma are reported. Treatment is discussed, with reference to response rates and toxicity. Results in 72 patients with advanced breast cancer, who received adriamycin in combination with other chemotherapeutic agents, are presented. Seventeen patients with primary liver cancer were also treated with adriamycin. To date, this is the only chemotherapeutic agent that appears to significantly improve survival times in patients with this resistant form of cancer. The prophylactic use of adriamycin against osteogenic sarcoma is also discussed.

Adolescent↗