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Biomedical subjects

J Gyves

Publications and source records attributed to J Gyves.

13 recordsLinked to original sources
PubMed1993

Multicenter phase II study of brequinar sodium in patients with advanced lung cancer.

A total of 53 patients with advanced lung cancer [non-small-cell (NSC), 21; small-cell (SC), 32] were treated with brequinar sodium. All of the NSC patients were chemotherapy-naive, but 31/32 (97%) SC patients had failed a multiagent chemotherapy program prior to study entry. Brequinar was given intravenously at a median weekly dose of 1200 mg/m2. The toxicity was moderate, with 19 patients (36%) experiencing grade 3 or 4 toxicity. Objective responses were observed in one NSC and two SC patients. We conclude that at this dose and on this schedule, brequinar does not have sufficient activity in patients with NSC or in patients with previously treated SC to warrant further evaluation. However, since responses were observed in previously treated SC lung-cancer patients, further evaluation in chemotherapy-naive patients may be warranted.

Aged↗
PubMed1993

Multicenter phase II study of brequinar sodium in patients with advanced gastrointestinal cancer.

Eighty-six patients with advanced colorectal, gastric or pancreatic carcinoma and no prior exposure to chemotherapy were treated with brequinar sodium. Brequinar was administered at a median weekly dose of 1200 mg/m2 intravenously. The toxicity was moderate, with thirty patients (35%) experiencing grade 3 or 4 toxicity. Objective responses were observed in 1/32 evaluable colorectal and 2/29 evaluable gastric carcinoma patients. There were no objective responses in 17 evaluable pancreatic cancer patients. We conclude that, at this dose and schedule, brequinar does not have sufficient activity in these gastrointestinal malignancies to warrant further evaluation.

Adult↗
PubMed1993

Multicenter phase II study of brequinar sodium in patients with advanced breast cancer.

In this study, 34 patients with advanced breast cancer were treated with brequinar sodium: 75% of the patients were postmenopausal, and 94% had received chemotherapy previously; 50% had previously received an anthracycline-containing regimen. Brequinar was administered intravenously at a median weekly dose of 1,200 mg/m2. The toxicity was moderate, with 17 patients (50%) experiencing grade 3 or 4 toxicity. There were 33 patients evaluable for response: 4 patients (12%; 95% confidence interval, 3.4-28.2%) achieved partial responses, 10 patients (30%) were stable, and 19 patients (58%) had progressive disease. We conclude that, at this dose and schedule, brequinar has only modest activity in patients with advanced breast cancer.

Adult↗
PubMed1992

Multicenter phase II trial of brequinar sodium in patients with advanced squamous-cell carcinoma of the head and neck.

A total of 19 patients with advanced squamous-cell carcinoma of the head and neck who had not previously been exposed to chemotherapy were treated with brequinar sodium as first-line chemotherapy. Brequinar was given intravenously at a median weekly dose of 1,200 mg/m2. The toxicity was moderate, with 7 patients (37%) experiencing grade 3 or 4 toxicity. In all, 16 patients who were evaluable for efficacy showed no objective response. We conclude that brequinar given at this dose and on this schedule has no significant activity in advanced squamous-cell carcinoma of the head and neck.

Adult↗
PubMed1992

Multicenter phase II trial of brequinar sodium in patients with advanced melanoma.

Seventeen patients with advanced melanoma and no prior exposure to chemotherapy were treated with brequinar sodium as first-line chemotherapy. Brequinar was given at a median weekly dose of 1200 mg/m2 intravenously. In 14 patients evaluable for efficacy, there were no objective responses. The toxicity was moderate. We conclude that, at this dose and schedule, brequinar has no activity in advanced melanoma.

Adult↗
PubMed1989

Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer.

STUDY OBJECTIVE: To determine the utility of the serologic marker CA19-9 in the diagnosis of pancreatic cancer in patients suspected of having a pancreatic disorder. DESIGN: Blinded study of frozen pedigreed serum samples collected at time of diagnostic evaluation with follow-up review at a mean of 8 years. SETTING: A general university teaching hospital serving both primary and referral patient populations. MEASUREMENTS AND MAIN RESULTS: Sera collected prospectively from 1978 to 1980 from 261 patients undergoing imaging studies of the pancreas (ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography) for a variety of symptoms were assayed for CA19-9 levels, and the results were compared with earlier determinations of other potential markers for pancreatic cancer. In 54 patients ultimately shown to have pancreatic cancer, the CA19-9 assay showed a sensitivity of 70% with a median value of 349 u/mL (normal less than 70 u/mL) and range, 7.3 to 2,859,964 u/mL, whereas specificity of the marker in this population was 87%. The positive predictive value was 59%, and the negative predictive value was 92%. Results of CA19-9 testing in the small group of patients with definitive staging information showed no difference in sensitivity between patients with local/regional disease (n = 6) and those with distant metastases (n = 14), 50% compared with 71% (P = 0.613). CONCLUSION: CA19-9 was found to be a more sensitive and specific marker of pancreatic cancer than other serologic markers and should be a useful test in the patient with suspected pancreatic disease.

Adenocarcinoma↗
PubMed1989

SPECT of the peritoneal cavity: method for delineating intraperitoneal fluid distribution.

Seventeen single-photon emission CT (SPECT) studies were performed after intraperitoneal administration of 99mTc-sulfur colloid in patients with a history of colon cancer to assess the extent of intraperitoneal fluid distribution prior to intraperitoneal chemotherapy. Planar gamma images were also obtained in all patients for correlation with the SPECT findings. Four patients had transmission CT scans of the abdomen after intraperitoneal administration of iodinated contrast material. In seven patients, repeat planar and SPECT studies were performed with the original or a different infusion volume to determine if different volumes altered the fluid distribution qualitatively or quantitatively (using a linear profile method). We found that 360 degrees peritoneal SPECT is easily performed after intraperitoneal administration of 99mTc-sulfur colloid. SPECT provides more detailed anatomic information than planar scans do. Spaces of the upper abdomen, such as the lesser sac, were resolved better with SPECT than with planar imaging. SPECT assessment of intraperitoneal fluid distribution also correlated well with transmission CT scans. Quantitative linear-profile radionuclide plots were reproducible at the same volume and showed no major differences in relative intraperitoneal fluid distribution between the 1.5- and 3.0-l infusion volumes, suggesting that the two delivery volumes were equivalent in relative distribution. SPECT appears to be a useful procedure to define the extent and location of intraperitoneally administered fluids. Thus, it may be of value in determining the intraperitoneal distribution of drugs and radiopharmaceuticals used in the treatment of intraabdominal tumors.

Adult↗
PubMed1987

Adenocarcinoma of the alimentary tract: peritoneal distribution scintigraphy.

Effective intraperitoneal (IP) chemotherapy and colloidal radiation therapy depend on contact of the drugs with the entire peritoneal surface. Using technetium-99m sulfur colloid, one can evaluate the completeness of peritoneal fluid distribution. Forty-eight planar IP scans from 26 patients with gastrointestinal malignancies were reviewed and scan findings were correlated with the site of primary tumor, surgical findings, and the location of any residual disease. Of the 26 patients, 22 had undergone resection of the primary lesion prior to scanning. Scans typically demonstrated more activity in the upper and lower portions of the abdomen than in the midabdomen. Diminished uptake in the pelvis, right lower quadrant, and right upper quadrant was generally due to metastases. A tumor mass was identified as responsible in only one of eight patients with diminished or absent left upper quadrant activity. Knowledge of variability in patterns seen on IP scans is essential to rational guidance of IP chemotherapy and radiation therapy.

Adenocarcinoma↗
PubMed1986

A dog model using an implanted system for protracted hepatic arterial chemotherapy.

A model for hepatic arterial chemotherapy studies using large dogs and an implantable infusion pump has been developed. Using this technique near complete perfusion (greater than 90%) of the liver can be achieved in vivo as determined by hepatic arterial perfusion scintigraphy with technitium 99m macroaggregated albumin. The system is reliable and has been in use for a total of 1353 days (mean of 104 days, range 52-239) in 13 dogs. Pump implantation causes no apparent acute liver damage based on pre- and post-operative alkaline phosphatase and serum glutamic-pyruvic transaminase determinations and does not affect the general mobility or behavior of the animals. Careful placement of the catheter and attention to the physicochemical properties of the solutions loaded are factors contributing to the success of the model. The model permits comprehensive preclinical pharmacokinetic and toxicologic studies of new or preexistent chemotherapeutic agents in the same device that will be used for later administration in human subjects. By providing the means to examine and develop new treatment modalities, it enables the design of even more potent cytotoxic therapy directed into the tumor vascular bed.

Animals↗
PubMed1985

Pharmacology of intraperitoneal infusion 5-fluorouracil and mitomycin-C.

The pharmacokinetics of intraperitoneal infusion 5-fluorouracil and bolus administration mitomycin-C have been evaluated and permit one to determine the exposure advantage for this route of administration. as with other forms of regional chemotherapy, the limiting toxicity is locoregional. The therapeutic efficacy of this approach awaits the design and conduct of clinical trials.

Ascitic Fluid↗
PubMed1984

Regional chemotherapy of colorectal cancer metastatic to the liver.

Ninety-three patients with biopsy-proven colorectal cancer metastatic to the liver were treated with hepatic arterial infusion of 5-fluorodeoxyuridine (FUDR). There were 52 men and 41 women (median age, 60 years). Forty-two patients (45%) had failed prior systemic chemotherapy. Catheters were operatively placed and multiple catheters were used if dictated by hepatic arterial anatomy in order to obtain perfusion of the entire liver. The drug was delivered by a totally implanted INFUSAID model 400 pump and patients received cyclic therapy consisting of 2 weeks of 0.3 mg/kg/d FUDR alternating with 2 weeks of saline. Patients with extrahepatic tumor or patients whose hepatic tumor failed to respond to FUDR were given a 30 minute intraarterial infusion of mitomycin C, 15 mg/m2, every 6 to 8 weeks in addition to FUDR. Fifty of the 93 evaluable patients presented with metastatic tumor confined to the liver. Of these 50 patients, 83% demonstrated a significant reduction in tumor size with a median duration of response of 13 months and a median survival of 25 months from diagnosis of liver metastases. Twenty-four of these 50 patients remain alive. Forty-three patients presented with extrahepatic metastases in addition to their liver tumor, and 74% had a response with a median duration of 6 months and a median survival of 14 months. Only six patients of those presenting with extrahepatic tumor remain alive. None of the 93 patients died solely of uncontrolled liver tumor, and only 9 died as a result of uncontrolled liver metastases and disseminated extrahepatic tumor. The duration of survival for both groups was determined by the uncontrolled progression of extrahepatic tumor. In patients with metastatic colorectal cancer involving only the liver, hepatic arterial FUDR alone and with the addition of mitomycin C provided excellent control of hepatic tumor. Survival appeared to be prolonged in this uncontrolled study.

Antineoplastic Agents↗
PubMed1982

Totally implanted system for intravenous chemotherapy in patients with cancer.

A totally implanted system for improved central venous access has been investigated in 20 patients with cancer (six with solid tumors, four with leukemia, and 10 with lymphomas) who were treated with aggressive chemotherapy regimens and who lacked peripheral venous sites. The system is implanted using local anesthesia and consists of a subcutaneous injection port connected to a Silastic catheter threaded through the subclavian vein into the superior vena cava. Injections and continuous infusions (for up to three weeks) of virtually all classes of antineoplastic agents, antibiotics, blood components, and intravenous solutions were administered through the system. The system was filled with heparinized saline and not otherwise flushed between uses. The system has remained functional for periods exceeding 450 days (mean 235 days). There was no significant local irritation and no system became infected. None of 18 large-bore catheters (0.63 mm lumen) became occluded (seven to 300 days), whereas five of six small-bore catheters (0.38 mm lumen) became occluded (90 to 420 days). Three of the occluded systems were replaced. Acceptance has been excellent, and patients have had no impediment to normal activities. This system appears to be an alternate means of safe and reliable central venous access with improved convenience and cosmetic acceptability.

Antineoplastic Agents↗