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Biomedical subjects

J McClean

Publications and source records attributed to J McClean.

4 recordsLinked to original sources

A phase II study of weekly oral methotrexate and zidovudine (AZT) in advanced adenocarcinoma of the pancreas and hepatocellular carcinoma.

From January 1992 through May 1993, 31 patients with adenocarcinoma of the pancreas or hepatocellular carcinoma were treated with weekly oral methotrexate (7.5 mg/M2 every 6 hours for 6 doses) and continuous oral AZT (200 mg four times daily). Patients were treated for a total of 6 months or until disease progression. The median age was 66 (range 44-79) and the median KPS was 80. No patient had received prior chemotherapy. Hematologic toxicity was severe with 50% of patients developing hemoglobins less than 8 gm/dl and 70% with granulocyte counts less than 1000 per mm3. One patient achieved a radiographic complete remission and 2 had stable disease. Two-thirds of patients progressed within 2 months of beginning therapy. The combination of methotrexate and AZT is an inactive regimen in pancreatic and hepatocellular carcinoma and is associated with considerable toxicity.

Adenocarcinoma

Phase III trial of cyclophosphamide versus cyclophosphamide, doxorubicin, and methotrexate in hormone-refractory prostatic cancer. A Hoosier Oncology Group study.

BACKGROUND: Between August 1984 and November 1989, the Hoosier Oncology Group conducted a Phase III study comparing cyclophosphamide (CTX) with cyclophosphamide, doxorubicin, and methotrexate (CAM) in patients with hormone-refractory metastatic prostatic cancer to determine whether the addition of doxorubicin and methotrexate to the cyclophosphamide regimen conferred any survival advantage. METHODS: One hundred three patients were registered and randomized, 99 were evaluable for response, and all were evaluable for survival results. All had histologically confirmed metastatic prostatic cancer and had not responded to hormonal therapy. Fifty-three patients received CTX alone, and 50 received CAM. Seventy-one patients (69%) had evaluable disease, and 32 (31%) had measurable disease. RESULTS: There were no complete responses and only four (13%) partial responses in the patients with measurable disease. There was no difference in overall survival time between the two treatment arms in either patients with a Karnofsky performance status (KPS) of 80-100 (median survival, 9.0 versus 9.5 months; P = 0.93) or in those with a KPS of 50-70 (median survival, 5.0 versus 6.0 months; P = 0.51). There was no difference in overall time to progression between the two treatment arms (median time to progression; 4.4 versus 6.2 months; P = 0.07). Toxicity was tolerable in both regimens. CONCLUSIONS: It was concluded that there was no survival advantage to CAM over CTX alone. New chemotherapeutic agents with greater activity against prostatic cancer must be identified.

Aged

Phase II trial of daily oral VP-16 in refractory small cell lung cancer: a Hoosier Oncology Group study.

Twenty-six previously treated patients with refractory small cell lung cancer (SCLC) were entered into a Hoosier Oncology Group phase II trial of daily oral etoposide 50 mg/m2/d. Twenty-five patients had prior exposure to cisplatin plus etoposide, and 14 of the 26 patients (54%) had prior therapy with CAV (cyclophosphamide, doxorubicin, and vincristine). Nonhematologic toxicity was mild; the dose-limiting toxicity was granulocytopenia. One complete response and five partial responses were seen (duration, 6 to 20 weeks), for an overall response rate of 23%. We conclude that daily oral etoposide is a well-tolerated and easily administered drug in refractory SCLC and has definite therapeutic activity.

Administration, Oral

Unexplained second trimester oligohydramnios: a clinical-pathologic study.

The importance of oligohydramnios in the absence of fetal malformations has been recognized because of the associated high risk for adverse pregnancy outcome. Pathologic dissections were performed on four fresh fetuses whose mothers were identified by ultrasound as having oligohydramnios and had no clinical history or physical evidence of vaginal leakage of amniotic fluid. The fetuses were all normal except for hypoplasia of the lungs and varying degrees of Potter's facies. The kidneys were histologically normal but had increased weight. The more widespread use of ultrasound may have allowed us to detect an earlier stage of a previously present type of pregnancy failure.

Abortion, Induced