Prognostic factors in 236 patients with metastatic malignant melanoma were analyzed. The patients were all entered on clinical research studies at a single institution. Univariate and multivariate analyses were performed on data which was prospectively collected. Seven independent variables were analyzed for effect on response, time to treatment failure (TTF) and survival. Univariate analysis identified four factors which significantly effected response, TTF and survival: PS, dominant site of disease, number of sites of disease and treatment. In multivariate analyses dominant site of disease and treatment remained significant factors influencing response rates, but performance status (PS) and number of sites of metastases lost statistical significance. Treatment and number of sites were significant for TTF and treatment, PS and disease-free interval were significant for survival. The identification of prognostic factors may lead to identification of subgroups of patients who may benefit from existing treatment programs, and may allow for new treatment programs to be designed with greater insight, logic and rationale.

Adult↗

PubMedDate not supplied

Antiemetic efficacy of tropisetron in patients failing previous antiemetic therapy.

Tropisetron was studied for efficacy and safety in 164 patients who were refractory to other antiemetic agents. 5 mg tropisetron was given intravenously, followed by 5 mg by mouth per day for 4 days. Complete prevention of nausea and vomiting was documented in 42% of patients on day 1 of cycle 1. Delayed nausea and vomiting were prevented in 41% in the first cycle. The antiemetic control did not decrease with subsequent cycles. Side effects ascribed to tropisetron were mild.

Antiemetics↗

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↗

PubMedDate not supplied

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↗