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H Käpylä

Publications and source records attributed to H Käpylä.

4 recordsLinked to original sources

High-dose toremifene in advanced renal-cell carcinoma.

Toremifene (Fareston)-a novel antiestrogenic drug with a triphenylethylene structure-is effective in the treatment of postmenopausal breast cancer patients. It can be safely given even at high doses of up to 300 mg/day. The purpose of the present study was to investigate the effect and tolerability of high-dose toremifene in the treatment of patients with advanced renal-cell carcinoma (RCC). A total of 36 patients started treatment with toremifene at 300 mg/day, including 26 men and 10 women. Their mean age was 56 years (range 35-75 years). In all, 19 patients were nephrectomized. One patient was not evaluable for response because of insufficient treatment time. The response rate was 17%, including one complete response (CR, 3%) lasting for 121+ weeks and five partial responses (PRs, 14%) with a mean duration of 40+ weeks. Ten cases of no change (NC, 28%) had a mean duration of 24 weeks. There was no significant difference in the response rate when patients with lung metastases alone were compared with patients showing metastases of other sites with or without lung metastases. Total pain control was achieved in 45% of the patients who had pain at the beginning of the treatment, and partial control was attained in 20%. Ten patients (28%) developed adverse reactions, which led to discontinuation of the treatment in one case. Blood samples were taken from 16 patients on days 0, 1, 3, 7, 14, and 28 for drug analyses. The concentration of toremifene and its main metabolites measured in serum were about 1.5 times that detected after a conventional dose of 60 mg/day. It can be concluded that high-dose toremifene is an effective and safe palliative treatment in advanced RCC.

Adult↗

Intravesical cytostatics: pH-dependence of antitumour activity.

The effects of pH on the antitumour activity of six cytostatics--cisplatin, doxorubicin, ethoglucid, mitomycin C, thiotepa and VM-26--used in intravesical instillations were tested in vitro. The activity of cytostatics was determined on the Walker 256 carcinosarcoma cell line by using ATP-bioluminescence method. Cytostatics were incubated at different pH's (5.0-7.4) for 2 and 4 h. The activity of most of the cytostatics was not affected by pH, but mitomycin C had somewhat lower activity at pH 5.0 at 4 h and cisplatin at pH 6-7 at 2 and 4 h. Because the pH of normal urine is within the range used in this test, the use of a buffer solution during the intravesical instillation therapy is not necessary. However, according to our clinical experience, buffering is recommended to avoid chemical cystitis.

Adenosine Triphosphate↗

Optimising mitomycin C activity during intravesical instillation.

Walker 256 carcinosarcoma was shown to be sensitive to mitomycin C in vitro. In order to make practical recommendations for the clinical intravesical use of mitomycin C, this cell line was used to evaluate the activity of mitomycin C under different conditions. Mitomycin C loses its antitumour activity rapidly at pH's below 6. At higher pH's (up to 10) mitomycin C is stable and suitable for intravesical application. To secure a sufficiently high pH in the bladder during intravesical treatment, phosphate buffer 0.05 M with a pH of 7.4 is recommended. Constituents of urine very little decrease the activity of buffered mitomycin C during a 2 h application. Prednisolone, which has been suggested to prevent the harmful chemical cystitis, has no inhibitory effect on the activity of mitomycin C.

Animals↗