PubMed Health⌕ Search

Biomedical subjects

K Rieche

Publications and source records attributed to K Rieche.

At least 19 recordsLinked to original sources
PubMed1996

Epirubicin and ifosfamide in metastatic breast cancer.

In a randomized, phase II trial, we evaluated the effectiveness of continued chemotherapy with epirubicin/ ifosfamide versus unmaintained treatment interruption in advanced metastatic breast cancer. Three hundred fifty-seven patients were enrolled and 331 were evaluable for response. Complete response was achieved in 25 patients (8%) and partial response in 121 patients (37%). Pretreatment status correlated significantly with response (complete and partial response). While 54% of unpretreated patients responded, only 42% of the patients responded who had been pretreated with adjuvant chemotherapy and 33% who had been pretreated in the metastatic stage of disease; 69 patients (21%) had disease progression. Of 11 patients pretreated in both the adjuvant and metastatic setting, only two responded. Toxicity of treatment was mild, with leukopenia being the treatment-limiting factor. Thrombocyte levels were not altered significantly by treatment. Thus, there seems to be room for dose escalation using granulocyte colony-stimulating factor. There was no considerable cardiotoxicity, central nervous system toxicity, or cystitis observed. The low rate of cardiotoxicity appeared to be related to dose fractionation of epirubicin. After randomization of patients to treatment interruption versus continuation of chemotherapy, a longer relapse-free survival was observed for patients who continued chemotherapy (mean relapse-free survival, 2+ months); however, this did not translate into prolonged survival. The cumulative scores of toxicity and quality of life parameters showed increasing superiority for treatment interruption. Therefore, a strategy of treatment until maximum response and subsequent treatment interruption seems to be superior to treatment continuation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Oral administration of idarubicin as first line cytostatic therapy in patients with metastasized breast cancer and favourable prognosis. A trial of the phase II study group of the Association for Medical Oncology of the German Cancer Society.

Idarubicin is a new anthracycline derivative with therapeutic efficacy in metastatic breast cancer. In a phase II trial we treated 23 patients with advanced breast carcinoma and favourable prognostic factors. Oral dose of idarubicin was 15 mg/m2 day 1-3 repeated every 3 weeks. All patients were pretreated with hormones. Idarubicin was administered as first line chemotherapy. 20 patients were evaluable for response: 3 patients achieved partial remission, 12 patients stable disease; tumour progression occurred in 5 patients. 3 patients were not evaluable for response because only 1 treatment cycle was administered. Main toxicites were leukopenia (median WHO-grade: 2,r:0-4), nausea and vomiting (median: 1,r:0-4) and alopezia (median: 1,r:0-3). 1 patient died in septic shock: Immediately after the administration of one idarubicine cycle, she was extensively irradiated because of bone metastasis. The fatal course of the disease in this patient does not depend only on the idarubicin therapy, but also on the extensive bone infiltration and on intensive radiation therapy. Idarubicin proved to be an effective drug in metastatic breast cancer with low systemic toxicity and the advantage of oral administration. The drug is an enrichment of therapeutic armament, especially in patients with soft tissue and bone metastasis.

Administration, Oral↗
PubMed1991

Phase II study of vinorelbine by oral route (in a hard gelatine capsule) for metastatic breast cancer patients. A trial of the phase I/II study group of the Association for Medical Oncology of the German Cancer Society.

17 patients with advanced low-risk breast carcinoma not previously pretreated by cytostatic agents were treated by Vinorelbine (VIN), 5'-Nor-anhydro-vinblastine, a new semisynthetic compound of the vinca alkaloid series. A dose of 130 mg per week was administered in a hard gelatine formulation for at least eight weeks. Out of 15 evaluable patients, no complete or partial remission was observed. However, there were 9 patients (60%) achieving no change and tumor stabilization, respectively, lasting for a median of 3.0 months. Main toxicities were leukopenia (17.7%, WHO grade 3-4), nausea and vomiting (17.7%, WHO grade 3-4), and acute diarrhea (70.6%, WHO grade 1-4). Thus, further trials with the oral medication used for this study are not recommended.

Aged↗
PubMed1990

Chemotherapy with tauromustine in advanced non-small cell lung cancer. A trial of the Phase II Study Group of the Association for Medical Oncology of the German Cancer Society.

Tauromustine (TCNU) is a newly developed nitrosourea compound. As a result of molecular modification, TCNU is more hydrophilic than BCNU and CCNU. In experimental data there was a high therapeutic index, especially in Walker 256 carcinosarcoma in rats, and in phase I trials antitumor activity was observed in NSCLC (10/33 remissions). There was also activity in melanoma, breast cancer, pleuramesotheliomas and ovarian cancer. To determine the effectiveness, duration of response and toxicity of TCNU the following phase II trial was performed. Patients received 130 mg/m2 TCNU every 35 days orally. Twenty-five patients were treated; 22 were evaluable. The female/male ratio was 18/4, 1 patient was stage III, 21 patients stage IV, the mean age was 62.3 years (range 32-70). Between 1 and 4 courses (mean 1.9) were administered. Histology was as follows: 6 squamous cell, 11 adenocarcinoma, 2 large cell and 3 polymorph cell carcinomas. No objective response (CR + PR) was observed; 6/18 patients had stable disease, 7/18 progression and 5/18 early progression. The median survival time is 4.9 months. The most severe side effect was thrombocytopenia (WHO grade 3 + 4, 4/22 patients). TCNU administered at this dose and schedule does not show substantial antitumor activity in patients with NSCLC. The fact that no objective tumor remission was observed suggests that the true response rate is less than 20% (p less than 0.05). It is improbable that TCNU has a relevant impact on the course of inoperable NSCLC.

Antineoplastic Agents↗
PubMed1990

Phase II evaluation of carboplatin in advanced esophageal carcinoma. A trial of the Phase I/II Study Group of the Association for Medical Oncology of the German Cancer Society.

Eighteen patients with advanced squamous cell carcinoma of the esophagus without prior chemotherapy were treated with carboplatin. Based on experimental data a split dose of carboplatin of 130 mg/m2 given on days 1, 3 and 5 was administered. In cases showing no WBC and platelet suppression, an escalated dose of 160 mg/m2 was proposed. Out of 18 evaluable patients no complete and partial responses were observed and there were only 5 patients with stable disease (27.8%) lasting 2-7 months. Therefore, carboplatin in the regimen used shows no meaningful antitumor activity in patients with advanced esophageal carcinoma. The escalated dose (mean 107-123% of the starting dose) was well tolerated and was followed by only minor gastrointestinal and hematological toxicity. Therefore, this regimen can be recommended for future trials.

Adult↗
PubMed1990

Tumor necrosis factor in advanced colorectal cancer: a phase II study. A trial of the phase I/II study group of the Association for Medical Oncology of the German Cancer Society.

In a phase II study, the efficacy and toxicity of human recombinant tumor necrosis factor (rh TNF-alpha) were evaluated in patients with advanced colorectal carcinoma. Rh TNF-alpha was given as short term infusion at a dose of 3 x 10(5) U/m2 on three successive days. Treatment was repeated after a two week interval. The response was evaluated after four treatment cycles. In 15 patients entering the study, we found one partial response, one stable disease, 9 progressive diseases, and four patients who were not evaluable for tumor remission. There were numerous side effects of the treatment, mainly fever, chills, loss of appetite, leukopenia, and hepatotoxicity. In this regimen, rh TNF-alpha does not suggest a therapeutic advantage for treatment of advanced colorectal carcinoma.

Adenocarcinoma↗
PubMed1986

[Combination of aminoglutethimide and polychemotherapy for the treatment of predominant bone metastasis in breast cancer].

A clinical phase II study was performed to evaluate the therapeutic efficacy of simultaneously administered aminoglutethimide and polychemotherapy in 31 patients with predominant bone metastases of breast cancer. The majority of patients was postmenopausal and pretreated with hormones and (or) chemotherapy. In 28 evaluable patients an overall objective response rate of 61% was achieved. Patients who received aminoglutethimide and polychemotherapy containing anthracyclines as FAC- or AV-regimen showed the highest objective response rate (67%). Thus, simultaneous combination of aminoglutethimide and polychemotherapy containing anthracycline derivatives is the most effective therapeutic regimen for those patients who were either pretreated or have progressive bone metastases with confinement to bed or have concomitant visceral metastases.

Aminoglutethimide↗
PubMed1984

Carcinogenicity of antineoplastic agents in man.

Review of the literature shows that: Anticancer drugs are in all probability mostly also carcinogenic. Alkylating agents such as melphalan, chlorambucil and cyclophosphamide seem to lead to the highest rate of second malignancies. Second malignancies after antitumour drugs are mostly acute leukaemias. Conditions which could influence the carcinogenicity of an antitumour drug are (a) its carcinogenic potency; (b) long-term administration; (c) the total dose used and (d) long-term survival of the patient. Irradiation and chemotherapy seem to have the greatest carcinogenic potential, e.g. in malignant lymphomas. The role of immunosuppression as a co-carcinogenic factor is difficult to estimate. Although transplant patients on anticancer drugs for immunosuppression have a higher risk of reticulosarcomas, but not of solid tumours, there is no evidence to suppose that in general immunosuppression and carcinogenicity are directly related. There is no reason to abandon intensive chemotherapy regimes if they lead to significant therapeutic results on the grounds of possible carcinogenicity of these drugs.

Antineoplastic Agents↗
PubMed1981

[Aminoglutethimide in metastasizing carcinoma of the breast resistant to hormonal and cytostatic treatment (author's transl)].

Aminoglutethimide (Elipten), at a dosage between 250 and 1500 mg/d by mouth, was administered in a clinical phase II study to 17 patients with metastasizing carcinoma of the breast resistant to hormones and cytostatic drugs. Results of this treatment were available for 14 patients. Nine women were given the drug alone, eight in combination with cytostatic drugs. In 11 women the drug significantly decreased pain within 3-14 days. Used alone aminoglutethimide produced objective regression of the metastases in two women, two further instances of regression occurred when the drug was combined with cytostatic agents. Five women developed urticarial rash, while six had somnolence and nausea or lethargy. Aminoglutethimide is suitable for symptomatic treatment of metastasizing treatment-resistant carcinoma of the breast, either alone or in combination with cytostatic drugs.

Adult↗
PubMed1978

[Androgen therapy of incurable breast neoplasms. Controlled clinical study: nandrolone-testololactone-drostanolone].

In 91 patients with advanced breast cancer testololactone, drostanolone, and nandrolone were compared in a controlled clinical trial. Remissions were registered after 4 weeks and after another 12 week period; during this second interval the patients received an additional treatment with cyclophosphamide. There was no difference in the effectivity between the three drugs. Remission rate was in average after 4 weeks 24% and after 16 weeks 46%.

Androstanols↗
PubMed1976

[General aspects of cytostatic therapy of hemoblastoses].

In haemoblastoses the chemotherapy is able to achieve remissions and prolongations of the survival time. The combined or polychemotherapy, respectively, is here comparatively more effective than the monotherapy. In haemoblastoses the concept of the maximal destruction of tumours (induction therapy) could be realised by means of consolidation and maintenance therapy. The prediction of the therapy effects by inclusion of different host parameters (morphology, immune state, age, sensibility test) may only approximately be done. In the induction and maintenance of the remission the supportive therapeutic measures play an essential role. By the development of selective cytostatic drugs and further utilisation of the results of molecular-biological experiments further ameliorations of the therapeutic situation are to be awaited.

Alkylating Agents↗
PubMed1976

Cellular immunity in mammary cancer patients as measured by the leukocyte migration test (LMT). A follow-up study.

In 58 cases of mammary cancer treated by surgery the leukocyte migration test (LMT) has been applied to the study of cellular immunity using homogenate from autochthonous and homologous tumors as antigens. A positive test, i.e. inhibition of migration by antigen, was observed in 52 patients from 1 day up to 40 days after surgery. Six patients were negative. There was extensive immunological cross-reactivity among mammary cancer in that a positive test was also obtained with homogenate from homologous mammary tumors. Generally, antigens from other tumors did not react. The test was also negative when the leukocytes were derived from healthy persons. Sera from mammary cancer patients abrogated the inhibitory effect of tumor antigen. The disappearance of positivity about 40 days after surgery and its reappearance during the metastatic process indicates that the positive LMT is associated with progressive disease.

Adult↗
PubMed1976

[Foundations of modern chemotherapy of malignant tumors].

Position of tumour chemotherapy among tumour treatment. Cytostatics as a systemic active means of tumour management. Adjuvant application of chemotherapy in the postoperative period. Achievements of nowadays chemotherapy in some tumours. Rules of chemotherapy action on tumours, tumour biological considerations. Cytokinetic aspects of tumour chemotherapy. Critics on partial synchronization. Specialties of the chemotherapy in the field of head and neck tumours. Some dosage recommendations for a few drugs to be systematically or locally administered. Possibilities for potentiating of cytostatic action--by using the oncobiogram, anticoagulation or defibrination and immunostimulation, respectively. Clinical evaluation of cytostatic effectivity applying the method of randomized clinically controlled study.

Alkylating Agents↗
PubMed1976

[Thoughts about the present state of tumour chemotherapy (author's transl)].

There are some impacts in tumour chemotherapy being worth-while to be discussed. Considering the information received during the Ninth International Congress of Chemotherapy, held in 1975, the author tries to evaluate the present state of clinical tumour chemotherapy from clinical point of view. The modern oncological clinician (oncologist) has to be faced with a lot of new facts, e.g. use of quantitative differences between normal and tumour cells for individualization of therapy, timing of cancer drug administration, new drugs for cancer treatment, mutual inhibition or potentiation of drug's effects, immunotherapy and possible adverse effects of clinically available drugs.

Antineoplastic Agents↗
PubMed1976

[Cellelectrophoretic studies of the effect of methylglyoxal-bis-guanylhydrazone on blood cells of tumour patients (author's transl)].

The effect of methylglyoxal-bis-guanylhydrazone has been studied on the electrophoretic mobility of blood cells of 10 unselected and untreated patients with preferably solid malignant diseases. Prior to the incubation with CH3-G the electrophoretic mobility of lymphocytes and erythrocytes showed increased and of platelets showed decreased rates which extend over a larger range than usual and for which reasons cannot be given till now. The incubation with CH3-G caused a concentration-dependent reduction of the electrophoretic mobility of all three tested types of blood cells. This can be estimated as an impairment of a function of surface membrane and confirms recently obtained results of activity of CH3-G on platelets' surface membrane.

Blood Cells↗