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Biomedical subjects

P Pronzato

Publications and source records attributed to P Pronzato.

At least 73 records · Page 4Linked to original sources

The role of surgery in the combined treatment of locally advanced breast cancer.

Sixty patients with stage IIIA and IIIB breast cancer have been treated with a combined modality approach including induction chemotherapy, surgery and adjuvant chemotherapy: 74.5% of patients achieved an objective response after 3 cycles of induction chemotherapy, and 98.3% of patients were rendered disease-free after induction chemotherapy and surgery or radiotherapy; at 4 years, actuarial survival and disease-free survival are 71.5% and 43%, respectively. These results are significantly better than our historical control, and locally advanced breast cancer must now be considered a curable disease when treated with an aggressive multimodal approach.

Adult↗

Cisplatin and 5-fluorouracil in refractory breast cancer patients: a phase II study.

24 patients with a median of 3 prior chemotherapy regimens were treated in our department with cisplatin 20 mg/m2 (with pre- and posthydration) and 5-fluorouracil 200 mg/m2 i.v. on day 1-5, every three weeks. 23 patients are evaluable; one had early death. 4 patients (17%) achieved a partial response, 8 had stable disease, and 11 progressed. Toxicity observed was moderate and no renal toxicity was noted. This study therefore shows tolerable toxicity but limited usefulness of adding cisplatin to 5-fluorouracil according to this schedule in these highly pretreated patients.

Adult↗

Adjuvant tamoxifen in primary breast cancer: influence on plasma lipids and antithrombin III levels.

The possible estrogenic effects of tamoxifen on plasma lipids and antithrombin III levels were investigated in 91 breast cancer patients. Mean values of total, HDL and LDL cholesterol, triglycerides, glucose, uric acid, and antithrombin III were evaluated in 55 patients on adjuvant tamoxifen for at least 3 months and compared with those found in 36 patients on no therapy. Total cholesterol, LDL cholesterol, and antithrombin III levels were significantly lower in treated patients (p less than 0.05). Our results support the hypothesis of a partial agonist action of this antiestrogen, although general clinical practice suggests that tamoxifen-related thrombotic events are rare.

Antithrombin III↗

Phase II trial of oral idarubicin in advanced non-small cell lung cancer (NSCLC).

The antitumoral activity and toxicity of a new daunorubicin analog (4-demethoxydaunorubicin, IMI 30, Idarubicin) was tested in 20 consecutive patients with non-small cell lung cancer mostly pretreated with chemotherapy. The drug was administered orally at a dose of 15 mg/m2 for three days every 3-4 weeks. There were no clinical responses. Hematological and nonhematological toxicities were mild.

Administration, Oral↗

Sequential administration of cyclophosphamide, methotrexate, 5-fluorouracil, and folinic acid as salvage treatment in metastatic breast cancer.

Experimental data show that sequencing methotrexate (MTX) and 5-fluorouracil (5-FU) may result in synergistic antitumor activity. Moreover, the effect of 5-FU is increased by folinic acid (FA), and finally, cyclophosphamide (CPA) produces an expansion of tumor growth fraction, suggesting an increased cytotoxic effect of cycle-specific drugs subsequently administered. Based on these premises, we have performed a Phase II study with CPA (600 mg/m2 i.v., day 1), MTX (200 mg/m2 1-h i.v. infusion, day 7), 5-FU (600 mg/m2 i.v., day 8), and FA (500 mg/m2 2-h i.v. infusion, day 8 plus 15 mg p.o. every 6 h on days 8 and 9) administered every 3 weeks. Thirty-six patients with metastatic breast cancer were admitted into the study. Median age was 52 years, and all but two patients were postmenopausal. Dominant sites of metastases were soft tissues in 10 patients, bones in 7 patients, and viscera in 19 patients. All patients were pretreated with chemo- and/or hormone therapy. Sixteen patients achieved an objective response (44.5%: 1 complete response and 15 partial responses), 8 had stable disease (SD) (22.2%), and 12 progressed (33.3%). Twenty-one patients had previously received conventional CMF in an adjuvant setting (15 patients) or for metastases (6 patients): 1 complete response (CR) and 7 partial responses (PR) were obtained in the first group and 1 in the second. Major toxic effects were hair loss (56.4%), nausea and vomiting (72%), mucositis (52.5%), and leukopenia (61%). A randomized study could be useful to assess the role of sequential CMF versus conventional CMF in metastatic breast cancer patients.

Adult↗

A phase II study with danazol in metastatic breast cancer.

Danazol is a synthetic steroid that inhibits the gonadotropin secretion. Its efficacy was tested in 27 patients with metastatic breast cancer at the dose of 200 mg three times daily. Characteristics of patients were as follows. The median age was 57 years (range, 44-85). All patients were postmenopausal, and all had previously received a median of two (range, 1-3) endocrine therapies. Estrogen receptor status was known in 12 (positive in five of 12; negative in seven of 12). Dominant sites of metastases were lung in seven, bone in ten, liver in three, and soft tissue in seven. Six of 27 patients were unevaluable for response (early death, four; lost to follow-up, two). Three of 21 patients showed an objective response, eight of 21 obtained stabilization of disease, and eight progressed. The therapy was well tolerated in the majority: gastric pain was observed in three and nausea in two. Danazol could have a role in the treatment of metastatic breast cancer as an alternative regimen when other treatment has failed.

Adult↗

Multimodality treatment of locally advanced breast cancer.

From 1976 to 1985, 61 consecutive patients with locally advanced breast cancer were treated with multimodality therapy. Overall 5-year survival was 30% with a median survival of 36 months. 50% of patients relapsed within 13 months. Other factors such as menopausal status, side of illness (right or left breast), responses to systemic or to local treatment, survival and progression-free survival in responders and non-responders have been analyzed.

Adult↗

Conventional versus cytokinetic polychemotherapy with estrogenic recruitment in metastatic breast cancer: results of a randomized cooperative trial.

Diethylstilbestrol (DES) can induce a recruitment into the proliferative pool of previously resting breast cancer cells in vivo. In order to verify if estrogenic recruitment could result in a larger tumor cell killing by chemotherapy, 117 patients with metastatic breast cancer were randomized to receive CEF (cyclophosphamide, 600 mg/m2; epidoxorubicin, 60 mg/m2; and 5-fluorouracil, 600 mg/m2 on day 1); DES-CEF (cyclophosphamide, 600 mg/m2 on day 1; DES, 1 mg orally on days 5, 6, and 7; and epidoxorubicin, 60 mg/m2, and 5-fluorouracil, 600 mg/m2, on day 8) every 21 days. No significant difference in objective response rates, survival, or progression-free survival was seen between the two regimens. Patients in the DES-CEF arm experienced a higher complete response (CR) rate (24.1% v 16.1%), which reached statistical significance in the case of soft-tissue metastasis (48% v 27.3%; P less than .05) and estrogen receptor-negative tumors (35.7% v 11.1%; P less than .025). Survival and progression-free survival of patients refractory to treatment were not worsened by estrogenic recruitment. In the subset of patients failing after adjuvant polychemotherapy, DES-CEF unexpectedly induced a significantly longer survival (greater than 802 days v 375 days; P = .029) and progression-free survival (239 days v 192 days; P = .041) than CEF. The DES-CEF regimen was more myelotoxic, and 43.3% of the DES-CEF cycles had to be delayed because of leukopenia in comparison with 11.8% of the CEF cycles (P less than .0001). In conclusion, chemotherapy with estrogenic recruitment was able to induce more CRs in certain subsets of patients and a significant prolongation in survival and progression-free survival of patients failing after adjuvant polychemotherapy. These results have been achieved despite a significantly lower dose intensity of chemotherapy.

Adult↗

Metastatic breast cancer: an analysis of prognostic factors in patients treated with aminoglutethimide.

An analysis of 127 women with metastatic breast cancer was carried out. All patients were treated with aminoglutethimide: of 117 evaluable patients, 29 responded, 46 remained stable and 42 progressed. A series of patients' characteristics were analyzed for their prognostic importance for response to this drug. The most important features able to predict response were found to be a previous response to tamoxifen and a long disease-free survival after mastectomy.

Adult↗

Survival of patients with relapsing breast cancer: analysis of 302 patients.

This retrospective study analyzes overall survival and relapse-free survival after mastectomy and survival after recurrence of 302 patients with metastatic breast cancer. In the whole group the median survival after mastectomy is 99 months: 5-year survival rate is 68.4% and 10-year survival rate is 38.5%. The median survival from relapse was 36 months: 5-year and 10-year survival rates were respectively 26.8 and 18.9%. Various subsets of patients divided according to several prognostic factors have been analyzed.

Adult↗

Adriamycin, cyclophosphamide and etoposide (ACE) in the treatment of small cell lung cancer.

Thirty-five small cell lung cancer (SCLC) patients were treated with combination chemotherapy including adriamycin, cyclophosphamide, etoposide (ACE). Out of 32 evaluable patients there were 21.9% complete responses and 53.1% partial responses with an overall median survival of 37 weeks (50 weeks for patients with limited disease and 34 weeks for patients with extended disease). Toxicity was generally well tolerated. In conclusion the ACE regimen results in being active and safe in the treatment of SCLC.

Adult↗

Idarubicin in advanced breast cancer: a phase II study.

Twenty-nine patients with metastatic breast cancer were treated orally with idarubicin (15 mg/m2 X 3 days every 3-4 weeks). Objective response was seen in 31% of all patients. Toxicity was acceptable. There should be further clinical trials of new anthracycline antibiotic.

Aged↗

Etoposide and high-dose cisplatin in good-risk patients with advanced squamous cell carcinoma and adenocarcinoma of the lung.

Fifty patients with advanced squamous cell carcinoma and adenocarcinoma of the lung having good prognostic features (performance status less than or equal to 2; weight loss less than or equal to 10%; age less than or equal to 70 years; absence of brain metastases; and no prior treatment) were treated on an outpatient basis with etoposide (120 mg/m2 on Days 1, 3, and 5) and cisplatin (60 mg/m2 on Days 1 and 2) every 21-28 days. One complete response and 14 partial responses were observed, with a median duration of response of 170 days and an overall median survival of 230 days. Toxicity was generally mild. Despite the high-dose cisplatin employed and the choice of patients with favorable prognostic factors in this study, results of this therapy remain disappointing.

Adenocarcinoma↗

A phase II study of mitoxantrone in advanced breast cancer.

A phase II study with mitoxantrone has been carried out in 30 metastatic breast cancer patients. Of 26 evaluable patients 7 (26.9%) experienced a partial response; 7 (26.9%) patients had stable disease and 12 (46.1%) had progression. Major toxicity observed was: nausea and vomiting in 52% of patients, moderate hair loss in 53% of patients and leukopenia in 53%.

Adult↗