Biomedical subjects

M Bahlo

Publications and source records attributed to M Bahlo.

28 records · Page 2Linked to original sources

PubMed1986

Radioimmunotherapy of xenografts of human pancreatic carcinomas--intravenous and intratumoral application of 131I-labelled monoclonal antibodies.

The effects of radioimmunotherapy were tested in xenografts of 2 different human pancreatic carcinomas comparing the intravenous and intratumoral application. On principle, intravenous injections of high doses of 131I-anti-CA 19-9 or -BW 494/32 may inhibit tumor growth. In view of the low direct radiation dose (360-2100 rad), however, other factors than direct toxic effects have to be discussed, e.g. systemic effects due to the high whole-body irradiation. Intratumoral application, however, may induce tumor regression or growth inhibition due to the high local irradiation dose. Consequently, this treatment modality might be of clinical value at least in some patients.

Animals↗

PubMed1984

[CA 12-5 in cancer of the digestive tract. A comparison with CA 19-9 and CEA in cancer of the pancreas and colon].

In 42 control subjects and 134 patients with benign or malignant disease of the pancreas or large intestine, the recently produced tumour-associated antigen CA 12-5 was determined together with CEA and CA 19-9. Only 4% of controls and patients with benign disease (except those with acute pancreatitis) had CA 12-5 values above 35 U/ml, compared with 60% of patients with pancreas carcinoma and 21% with colon carcinoma. For the former (pancreas carcinoma) there was also a good correlation to stage of tumour (0 of 6 tumours stage TxN0M0, 7 of 11 TxN1M0, 16 of 20 TxN1M1 greater than 35 U/ml) and progression of the malignancy. Simultaneous determination of all three antigens increased the rate of tumour-marker positive patients from 87% (CA 19-9) to 92% for pancreas carcinoma and from 25% (CEA) to 51% for colon carcinoma.

Acute Disease↗

PubMedDate not supplied

TNM staging, histopathological grading, and tumor-associated antigens in patients with a history of mucoepidermoid carcinoma of the salivary glands.

BACKGROUND: The aim of this study was to evaluate the TNM categories and histopathological grading as prognostic factors in mucoepidermoid carcinoma (MEC). In addition, the study was designed to provide baseline data on levels of tumor-associated antigens (TAA) in sera of MEC patients. MATERIALS AND METHODS: Fifty-nine patients with MEC of the salivary glands were evaluated. RESULTS: Reclassified TNM stage, at the time of initial diagnosis, varied considerably. In disease-free patients, none of the tested sera were TAA elevated above the cut-off levels. Our patients who died of tumor metastasis had all been classified as stage III or IV at the time of initial diagnosis. Distant metastases are rarely found even decades after surgical therapy. CONCLUSIONS: Long-term follow-up is recommended for patients with MEC of the salivary glands. TAA are not elevated in disease-free patients. The value of TAA in the monitoring of MEC patients remains to be evaluated in further studies.

Adolescent↗

PubMedDate not supplied

CEA, TPS, CA 19-9 and CA 72-4 and the fecal occult blood test in the preoperative diagnosis and follow-up after resective surgery of colorectal cancer.

In a prospective clinical study we examined the diagnostic procedures used in the preoperative diagnosis of colorectal cancer patients (n = 176) and the value of supplementation of standard diagnostic methods (clinical investigation, colonoscopy, barium enema, ultrasound, computer tomography) with a test for occult fecal blood (FOBT) and an expanded tumor marker panel (CA 19-9, TPS and CA 72-4 in addition to CEA) in the postoperative follow-up (n = 116, mean follow-up 21 months). Preoperative diagnosis based on colonoscopy/barium enema, followed by histology and the imaging methods, in most cases US and/or CT. Patients with postoperative stage Dukes D and after palliative surgery were excluded from the follow-up study (n = 43). The patients were seen every three months (clinical investigation, US, CT, tumor markers, FOBT) within the first two postoperative years and every half a year thereafter. 83 of the 116 patients (16%) developed a recurrent disease and 5 of them could be reoperated with curative intention. In addition to the 19 patients 14 simultaneously admitted patients with recurrence of colorectal cancer (total n = 33) were studied. The results of our study analyzing the sensitivity and specificity of colonoscopy, tumor, markers and the FOBT in the preoperative and postoperative phases as well as in the diagnosis of recurrent disease of colorectal cancer confirms the view that FOBT and tumor markers cannot replace endoscopic and imaging methods. However they support the concept, that diagnosis and follow-up of colorectal cancer should be based on a combination of clinical investigation and imaging methods (US, CT etc. and endoscopic and/or x-ray examination) with supplementation by FOBT and determination of tumor markers, mainly CEA. In the case a patient is asking for prognostic and recurrence information as early and as valid as possible we currently recommend the following procedure for the first two years after surgery: every three months the determination of tumor markers, FOBT as well as ultrasound of the upper abdomen and CT of the lower abdomen and every half year a total colonoscopy. The question of whether this program will also have a therapeutical relevance depends on several factors like the personal experience and concepts of the consulting surgeons and oncologists and also on the tasks and duties which are considered worthy by the patient for his further life if confronted with the diagnosis of recurrent colorectal cancer.

Adolescent↗

PubMedDate not supplied

Fluctuations of tumor markers in heart failure patients pre and post heart transplantation.

BACKGROUND: Elevated plasma levels of tumor markers may be caused by diseases other than malignancy, i.e. kidney, liver or circulatory disturbances. These conditions are not well defined, especially since there are only sparse reports on fluctuations of tumor markers related to cardiac function. PATIENTS AND METHODS: During our routine pre- and postoperative follow-up tumor marker determinations in heart failure patients were made in order to screen for possible occult neoplasm's which may either be a contraindication or a sequela of heart transplantation. The markers CA 12-5, CEA, CA 19-9, CA 72-4, TPA, TPS and CYFRA 21-1 were determined at three month intervals, besides clinical examination and hemodynamic measurements in a total of n = 118 patients pre- and n = 74 patients post heart transplantation. RESULTS: The results were grouped according the clinical status (NYHA-stage 1-4): CA12-5 (29.4 +/- 40.63 omega 151, 174 +/- 345 and 491 +/- 633 U/ml, p < 0.001 between all groups) and TPS (64 +/- 32, 118 +/- 153, 163 +/- 311 and 181 +/- 232 U/ml, p = 0.06 between all groups) were increasingly elevated in NYHA stages 1, 2, 3 or 4 respectively. A direct correlation to right atrial pressure (r = 0.41, p < 0.0001) and pulmonary capillary wedge pressure (r = 0.27, p < 0.001) was only found for CA 12-5. After heart transplantation a normalization of elevated pre-OP levels could be found. Comparable to heart failure patients poor graft function was also associated with elevated levels of CA 12-5 (113 +/- 99 vs 21.6 +/- 31 U/ml, p < 0.0001), CA 72-4 (8.4 +/- 3 vs 3.6 +/- 4, U/ml p = 0.03) and TPS (154 +/- 133 vs 66 +/- 28 U/ml, p < 0.001). The individual time course of the markers, especially of CA 12-5, correlated nicely to clinical events and hemodynamic measurements in some patients. Another finding was that CYFRA 21-1 levels were correlated to renal function. CEA, CA 19-9 and CYFRA 21-1 serum levels were not influenced by circulatory disturbances. CONCLUSION: We concluded that the tumor markers CA 12-5 and TPS (but not CEA, CA 19-9 and CYFRA 21-1) are associated with congestion and the clinical course of heart failure and HTx patients. These "nonspecific" changes have to be considered when tumor markers are determined in cancer patients with heart failure. Whether CA 12-5 blood levels may yield additional prognostic information in the management of cardiovascular patients has to be determined in further studies.

Antigens, Neoplasm↗

PubMedDate not supplied

Improvement of survival by efficacy orientated sequential polychemotherapy of exocrine pancreatic cancer.

Results of palliative chemotherapy in 104 patients suffering from exocrine pancreatic carcinomas are presented. First-line therapy included intraarterial approaches with gemcitabine + mitomycin-C and intravenous systemic treatments with gemcitabine, gemcitabine + mitomycin-C and oxaliplatin, respectively. In addition, it was the aim to improve survival by adding second- and third-line chemotherapies, mainly including high dose 5-FU/FA and irinotecan resp. alone or in combinations. Follow-up included clinical investigations, imaging methods and determination of tumor markers. Evaluation of efficacy followed the WHO guidelines. The results indicated the intraarterial locoregional treatment of exocrine pancreatic cancer with a combination of mitomycin-C + gemcitabine as a highly effective treatment modality with PR + CR of 40% measured by imaging methods and 81% analysed by tumor marker determinations. The survival analyses suggested relevant prolongation of survival in relation to the number of effective second- and/or third-line therapies (0/1/> 1) with median survival--based on the imaging data--of 7, 11 and 20 months for Mo tumors and 3, 8 and 14 months for tumor diseases with liver metastases at time of admission, respectively. Relevant preconditions for second- and/or third-line therapies of pancreatic carcinomas are given by more or less effective first-line treatment modalities of this cancer disease on the one hand and by the actual diagnostic aids allowing the beginning of first-line therapy as well as the detection of recurrence early enough to try a second- or third-line therapy before clinical/ethical aspects prevent further antitumoral treatment trials in the individual patient.

Adult↗

PubMedDate not supplied

Sequential polychemotherapy in exocrine pancreatic cancer.

The results of palliative chemotherapy in 162 patients suffering from exocrine pancreatic cancer are presented. They are mainly discussed with respect to the possibility of improving survival of exocrine pancreatic cancer patients by an efficacy-orientated sequential polychemotherapy (EOSP). In about 40% of the patients treated between 1998 and 2001, sequential chemotherapy induced more than one effective treatment in the case that SD after a progressive prephase as well as MR, PR and CR are considered as antitumoral efficacy. Sequential polychemotherapy seems to be able to prolong the survival of these patients. The whole group of patients showed a 1-year survival of 56% and a 2-year survival of 16%. Especially in the case of metastasized tumor disease (M1), sequential polychemotherapy seems to be able to prolong survival: 45% of the metastasized tumor patients survived more than 1 year, 12% more than 2 years. The median survival for the whole group of locally advanced tumors was 15 months and the median survival for the whole group of metastasized tumors was 8 months. The results should stimulate clinicians to try palliative chemotherapy for pancreatic cancer more actively than before and to rediscuss the actual concepts of prospective therapeutical trials mainly based on analysing the effects of single agents or drug combinations on survival.

Adult↗

PubMedDate not supplied

Atypical courses of serum tumor markers--4 case reports.

We report on 4 cancer patients with transient unspecific elevations of the serum tumor markers CA 19-9, CEA, CA 125 and CA 72-4, respectively. In one patient cholangitis due to biliary obstruction induced a significant transient increase of CA 19-9, in another patient HUS, probably as a severe complication after Mitomycin-C + Gemcitabine therapy resulted in a significant increase of serum CA 125. One patient demonstrated an extensively elevated and inexplicable serum CA 19-9 concentration (9450 u/ml) during a period of abdominal pain with continuous decrease and finally normalization within the following 5 years. Also inexplicable is an unexpected remittent increase of serum CA 72-4 in the course of chemotherapy after gastrectomy for gastric carcinoma. The presented data underline the necessity of interpreting serum courses of tumor markers only in the light of all available clinical data, imaging data and other laboratory tests in order to avoid misinterpretations.

Adult↗

PubMedDate not supplied

Further evidence for prolongation of survival of pancreatic cancer patients by efficacy orientated sequential polychemotherapy (EOSPC) based on serial tumor marker determinations (CA 19-9/CEA).

The results of palliative chemotherapy in 55 patients suffering from exocrine pancreatic cancer are reported, following our concept of efficacy orientated sequential polychemotherapy (EOSPC). Tumor answer/regression was mainly analyzed on the basis of the serum courses of the tumor markers CA 19-9 and CEA. Up to four different treatment trials were tried in the individual patients. The results confirm previously published data: a prolongation of survival in relation to the number of effective treatments (CR/PR/MR/SD vs. PD). The median survival of the whole group of patients (n=55, including n=39 patients with distant metastasis) was 12 months. The results support our concept of EOSPC in pancreatic cancer patients in order to improve survival. Furthermore, the data should stimulate attention not only on new and potentially more effective 1st- line regimens, but also to effective 2nd- and/or 3rd-line treatments. Moreover, the results should encourage clinicians to rediscuss the actual concepts of prospective therapeutical trails mainly based on analyzing the effects of single agents or drug combinations on survival. Furthermore, a comparison of 1st-line treatments with gemcitabine as monotherapy, and in combination with mitomycin-C, confirms that the combination of gemcitabine + mitomycin-C seems to be more active than gemcitabine monotherapy and that this combination might also be of value as 2nd-line therapy after gemcitabine monotherapy.

Adult↗

PubMedDate not supplied

P53 auto-antibodies in the sera of patients with oral squamous cell carcinoma.

AIM: To investigate the sera of patients with oral squamous cell carcinoma (OSCC) for the existence of p53 auto-antibodies. MATERIAL AND METHODS: The sera of thirty-nine OSCC-patients were investigated. All samples were from untreated patients with no history of another neoplastic disease. The sera of nine healthy subjects served as controls. RESULTS: P53 auto-antibodies were not detected both in all healthy subjects and in 20.6% OSCC-patients with their disease at an advanced stage. We prove that the extinction rates for p53 auto-antibodies in OSCC are very weak in the majority of investigated sera (50%) and are not related to tumour stage. CONCLUSION: It is unlikely that p53 auto-antibodies can serve as a prognostic marker of OSCC.

Autoantibodies↗