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Biomedical subjects

M J Peckham

Publications and source records attributed to M J Peckham.

At least 55 records · Page 3Linked to original sources
PubMed1986

Transient tumor marker elevation following chemotherapy for germ cell tumors of the testis.

A total of 22 adults with metastatic nonseminomatous germ cell tumor of the testis and raised pretreatment serum levels of the beta subunit of human chorionic gonadotropin (HCG) had serial monitoring of serum HCG by weekly assay following initiation of chemotherapy with bleomycin, etoposide, and cisplatin (BEP). A transient rise in HCG (the marker "surge") was detected in 9 patients (41%), of whom one relapsed. None of the other 13 patients have relapsed (follow-up, 24-60 months), and the BEP regimen overall leads to an 83.3% disease-free survival (Br J Cancer 47:613-619, 1983). The marker surge is not an adverse prognostic factor during initial chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Protection from procarbazine-induced damage of spermatogenesis in the rat by androgen.

Protection of spermatogenesis from cytotoxic drug-induced damage has been investigated in the rat. Complete germinal aplasia was observed at 8 and 11 weeks after four doses of procarbazine hydrochloride administered weekly (150 mg/kg, first dose; 100 mg/kg, 3 subsequent doses). Pretreatment of rats for 6 weeks plus continued treatment during procarbazine administration with testosterone enanthate, 240 micrograms/100 g body weight, resulted in a marked protection of spermatogenesis. A mean of 22% of seminiferous tubule cross-sections at both 8 and 11 weeks exhibited spermatogenesis, and developing spermatids were observed in 60% of these repopulating tubules at the later time. These results provide evidence that protection of spermatogenesis during chemotherapy may be achieved by androgen treatment.

Androgens↗
PubMed1985

Children fathered by men treated for testicular cancer.

Children fathered by 27 testicular cancer patients treated with radiotherapy, 25 treated with chemotherapy, and 57 control men (46 community controls and 11 Stage I testicular cancer patients) were examined for evidence of congenital malformations. The proportion of malformations in children in the treatment group did not differ from that in children in the control group or from incidence rates for malformations in the general population. Our results suggest that treatment for testicular cancer should not constitute a reason for advising termination of pregnancy, although numbers were too few to detect a relative risk smaller than 3 X 2. More observations are needed to provide a definite answer.

Abnormalities, Drug-Induced↗
PubMed1985

cis-Diammine-1, 1-cyclobutane dicarboxylate platinum II (carboplatin) in the treatment of testicular germ-cell tumours: a preliminary report.

Between 1982 and 1985 47 patients with metastatic testicular germ-cell tumours were treated with carboplatin alone or combined with bleomycin and etoposide and/or vinblastine. Of 14 untreated seminoma patients 13 (93%) are free from active disease at 7-38 months (median 12 months). Twenty patients with untreated advanced non-seminomatous testicular germ-cell tumours have been entered into a study of carboplatin, etoposide and bleomycin (CEB) as first-line treatment. Preliminary data show that of 15 men observed for 6-12 months (mean 7.5 months) 11 are disease-free. Toxicity with the single agent and combination has been mild. Of 12 patients receiving carboplatin alone or in combination for relapse after cisplatin chemotherapy 10 showed no response, one a transient complete response and one a partial response consolidated with radiotherapy. On the basis of these preliminary observations it is concluded that carboplatin is an active drug in testicular germ-cell tumours and that cross resistance with cisplatin may be a significant problem.

Antineoplastic Agents↗
PubMed1985

The radiobiology of human neuroblastoma.

The radiation response of a human neuroblastoma xenograft HX138 has been studied in vitro and in vivo using single cells in suspension, multicellular spheroids, and xenografts in immune-suppressed mice. End-points used were growth delay and clonogenic cell survival. Growth delay experiments with spheroids and xenografts showed a high degree of radioresponsiveness. Cell survival curves obtained from all systems were characterised by the lack of a shoulder. An increase in Do of the cell survival curve was seen after irradiation of intact spheroids and xenografts, perhaps due to the presence of a contact effect. Cellular capacity for split-dose recovery in vitro was modest. Delayed assay experiments using spheroids and xenografts showed some potentially lethal damage (PLD) repair in vitro but not in vivo. The results show this human tumour line to be intrinsically highly radiosensitive, with a limited repair capacity.

Animals↗
PubMed1985

Advanced seminoma: treatment with cis-platinum-based combination chemotherapy or carboplatin (JM8).

Between 1978 and 1983, 44 patients with advanced seminoma were treated with cis-platinum-based combination chemotherapy (39 patients) or with carboplatin (JM8), as a single agent (5 patients). Of the total group, 40 (90%) are alive and disease free. Two of the 4 patients who died relapsed as non-seminomatous germ-cell tumours. Results in previously untreated patients indicate that tumour volume is less important as a prognostic factor than in non-seminomas. Residual masses were present in almost 80% of patients 1 month after chemotherapy; such masses regress slowly and surgery is not indicated. Elective radiotherapy after chemotherapy appears to be inessential since relapse rates are comparable in irradiated (1/15) and unirradiated patients (1/16). Pretreatment serum HCG concentrations did not influence the outcome of chemotherapy. Preliminary results with JM8 suggest that it is an active single agent in the treatment of seminoma.

Adult↗
PubMed1985

Placental alkaline phosphatase as a tumour marker in seminoma using the H17 E2 monoclonal antibody assay.

Serum samples from 62 patients with seminoma were assayed for placental alkaline phosphatase-like activity using the monoclonal antibody H17 E2, in order to evaluate its utility as a serum tumour marker. Fifteen of 16 patients (94%) with active seminoma had elevated serum PLAP levels. Sixteen of 46 (35%) of patients considered to be in remission had elevated PLAP levels (false positive rate 35%). Fifteen false positive results were considered attributable to concomitant smoking, and if these patients are excluded, only one false positive case was detected. In 7 out of 7 patients sequential PLAP assays reflected clinical response to treatment.

Adult↗
PubMed1985

The accuracy of CT scanning prior to para-aortic lymphadenectomy in patients with bulky metastases from testicular teratoma.

The accuracy of CT scanning prior to para-aortic lymphadenectomy was assessed in 108 patients with metastatic testicular teratoma. In 106 its presence was confirmed by surgery. The site was accurately predicted in 95%. A good correlation (P less than 0.0025) was found between mean tumour cross-sectional area assessed by CT scanning and that measured in the excised pathological specimens.

Humans↗
PubMed1985

Clinical stage II non-seminomatous germ cell testicular tumours. Results of management by primary chemotherapy.

Between 1977 and 1984, 92 patients with clinical Stage II non-seminomatous germ-cell testicular tumours were treated by primary chemotherapy, with surgery reserved for the excision of persisting masses. Eighty patients (87%) are alive and disease-free: 96% for Stages IIA and IIB and 74% for Stage IIC. Of 43 Stage IIA, B and C patients treated with bleomycin, etoposide and cisplatin (BEP), 40 (93%) are disease-free. For the whole group there was a significant difference between the outcome of treatment in patients with retroperitoneal masses greater than 8 cm in transverse diameter compared with those in whom masses were less than 8 cm, the disease-free rates being 54 and 97% respectively. Primary histology did not influence the outcome of treatment. However, whereas 51% of patients with teratocarcinoma had masses resected after chemotherapy, only 26% of embryonal carcinoma patients came to surgery. The results obtained in this series are as good as those obtained when lymph node dissection is employed as the initial form of treatment. The avoidance of surgery with preservation of ejaculatory function in 78% of Stage IIA and IIB patients argues in favour, of an initially non-surgical approach to management.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Etoposide and cisplatin with or without bleomycin as first-line chemotherapy for patients with small-volume metastases of testicular nonseminoma.

Between December 1981 and September 1982, a phase II study of etoposide and cisplatin was carried out in 17 patients with small-volume metastases of testicular nonseminoma to see whether the toxicity associated with bleomycin could be avoided without loss of therapeutic effect. Of 16 evaluable patients followed for 13-23 months (median, 18.5), four failed to achieve complete remission and three had disease progression. Conversely, all 18 equivalent patients treated with bleomycin, etoposide, and cisplatin between January 1981 and November 1982 (observation time, 12-34 months; median, 25) achieved complete remission and have been continuously disease-free since treatment (P = 0.07). The results suggest that bleomycin contributes significantly to the combination chemotherapy for testicular nonseminoma, and although its omission led to a marked reduction in toxicity, loss of therapeutic activity was also apparent. Prolongation of the intervals between cycles of etoposide and cisplatin from 3 to 4 weeks may significantly reduce the effectiveness of the two-drug combination, whereas no evidence of this was seen in patients treated with bleomycin, etoposide, and cisplatin.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Serum tumour marker regression rate following chemotherapy for malignant teratoma.

The rate of fall of the serum tumour markers alphafetoprotein (AFP) and the beta sub-unit of human chorionic gonadotrophin (HCG) was analysed following platinum-based chemotherapy for metastatic non-seminomatous germ cell tumours. Of 90 evaluable patients 81% were alive and disease-free 1.5-4 yr (median 28 months) from the start of chemotherapy and 69 (77%) had remained continuously disease free. All three patients with an initial AFP half-life greater than 9 days relapsed; however, a further eight relapsing patients had an initial regression rate of serum AFP within the same range as patients remaining in remission (half-life 6-9 days). The HCG regression rate did not discriminate between patients remaining well or those who relapsed after chemotherapy. In 11 examples of a pattern of late slowing of the rate of marker fall (i.e. increasing half-life), five relapses were seen (45%), though this pattern was also observed in the context of large residual differentiated teratoma masses.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Chemotherapy and radiotherapy in advanced testicular non-seminoma. 2. Results of treatment.

Between 1976 and 1981, 63 patients with Stage II-IV testicular non-seminoma were treated by chemotherapy followed 4-6 weeks later by involved field radiotherapy. Of this group, 58 (92.1%) are alive and tumour-free, one patient died post-operatively and four of uncontrolled disease. There were no deaths from drug-induced neutropenic sepsis. During the same period a second group of 53 patients who had received radiotherapy were given chemotherapy for recurrent disease. Of this group, 38 (71.7%) are alive and tumour-free, eight died of uncontrolled malignancy, six from drug-related complications and one from a myocardial infarct. In patients receiving elective post-chemotherapy irradiation, tumour volume exerted little influence on treatment outcome, the disease-free survival rates for small volume and bulky disease being 100% and 87.2%, respectively. Conversely, in patients receiving chemotherapy after prior irradiation there was a significant difference; 96.7% and 43.4%, respectively (p less than 0.001). Of the 63 patients in the drug-irradiation protocol group 23 (36.5%) had residual masses excised. In 18 patients (78.2%) the excised tissue showed either fibrosis or mature teratoma. Despite the excellent survival figures for patients receiving post-chemotherapy irradiation the value of this approach cannot be assumed, although the slight difference between small and bulky presentations suggests that radiotherapy may have contributed to the therapeutic result.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

The radioresponsiveness of human tumours and the initial slope of the cell survival curve.

Published data on the inherent radiosensitivity of human tumour cells has been analysed in order to reexamine the relationship between the initial slope of the cell survival curve and clinical radioresponsiveness. A clear positive correlation between these parameters is demonstrated. The surviving fraction at 2 Gy is shown to give good discrimination between resistant and sensitive tumour types.

Cell Line↗
PubMed1984

Post-chemotherapy surgery in advanced non-seminomatous germ-cell testicular tumours: the significance of histology with particular reference to differentiated (mature) teratoma.

Of a total of 307 patients treated with chemotherapy for advanced non-seminomatous germ-cell testicular tumours between 1976 and 1983, 73 (23.8%) had masses excised after treatment. Resected tissue showed residual malignancy in 16 (22%), fibrosis and necrosis in 25 (34%) and differentiated (mature teratoma) in 32 (44%). Of the 16 patients with tumour only 7 (44%) are alive and disease-free compared with 21/25 (84%) and 27/32 (84%) for fibrosis/necrosis and differentiated teratoma respectively. In addition to histological evidence of residual tumour, elevated serum markers at the time of surgery and/or incomplete excision of residual masses were adverse prognostic features. Of 12 patients with differentiated teratoma or fibrosis who had incomplete resections or densely adherent masses excised with difficulty, 7 subsequently relapsed. The majority of differentiated teratoma patients (75%) had evidence of differentiation in their primary tumours; 88% showed cystic change in metastases and almost one-third showed an increase in the size of metastases during chemotherapy. The data suggest that post-chemotherapy surgery may have a therapeutic as well as a diagnostic role and that complete excision of residual disease should be attempted even if resection at one site has shown either fibrosis or differentiated teratoma. The significance of these findings in relation to treatment induced differentiation is discussed.

Combined Modality Therapy↗