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Biomedical subjects

P Pronzato

Publications and source records attributed to P Pronzato.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Sequential high dose-density chemotherapy in advanced ovarian cancer.

Introduction of paclitaxel or anthracyclines can improve the results of chemotherapy in advanced ovarian cancer. Dose intensification (by shortening of intervals between cycles) and sequential administration of active regimens at least theoretically may improve chemotherapy effectiveness. 18 patients entered into a pilot trial of combination chemotherapy. Treatment consisted of cisplatin 50 mg/m2, epidoxorubicin 60 mg/m2 and cyclophosphamide 500 mg/m2 every 14 days for six cycles, followed by paclitaxel 175 mg/m2 (3-hour infusion) every 14 days for four cycles. Granulocyte colony stimulating factor at 300 mcg was employed between cycles on days 5-10. 16 out of 18 patients who entered the study received a full dose chemotherapy with a ratio between actually received and planned dose intensity of 0.8 or more. No life-threatening side effect was observed and toxicity was acceptable. This new approach based on sequential administration of active regimens at high dose intensity proved feasible, active and devoid of unacceptable toxicity. The administration the booth of paclitaxel and epidoxorubicin with cisplatin and cyclophopshamide has been rendered possible. Further studies are warranted.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Sequential high dose-density chemotherapy with two active regimens for advanced small cell lung cancer.

16 patients with advanced small cell lung cancer were treated with a combination of cyclophosphamide (1000 mg/m2 day 1), epidoxorubicin (60 mg/m2 day 1) and vincristine (1.4 mg/m2 day 1) every 14 days for six cycles followed by a combination of cisplatin (40 mg/m2 days 1 & 2) and etoposide (100 mg/m2 days 1-3) every 14 days for four cycles. Shortening of intervals was obtained with the prophylactic employment of granulocyte colony-stimulating factor (filgrastim, 300 mcg subcutaneously from day 5 to dsy 10). In 11 patients ratio between actually delivered dose intensity and planned dose intensity of > 80% was obtained. Toxicity was acceptable and no life-threatening toxicities were observed. An objective response (partial or complete) was observed in 11 patients. The new regimen, incorporating the concepts of dose-intensification and sequential administration of regimens, is feasible and may be considered for further studies.

Aged↗
PubMedDate not supplied

Prognostic factors in node positive primary breast cancer patients treated with adjuvant CMF.

The influence of various patient and disease-related parameters on survival (S) and disease-free survival (DFS) in 217 node positive primary breast cancer patients treated with surgery followed by adjuvant i.v. cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) was evaluated by univariate and multivariate analyses. Five year actuarial S and DFS were 73.3% and 54.8%, respectively. Univariate analysis revealed that patient age, number of involved axillary nodes and ER status had a significant impact on both S and DFS. PgR positive tumors had improved DFS but no S difference was observed. Menopausal status predicted S but not DFS. Primary tumor size and CMF-induced amenorrhea did not predict disease outcome. Multivariate analysis demonstrated that only degree of nodal involvement and PgR status had independent significant impact on prognosis. Both S and DFS are significantly influenced by the number of involved nodes, whereas improved DFS but not S was evident in patients with PgR positive tumors.

Adult↗
PubMedDate not supplied

Chemotherapy with mitomycin-C, epidoxorubicin and vinblastine in CMF failing breast cancer patients.

Since most patients with breast cancer are treated with CMF as first line chemotherapy (usually in the adjuvant setting), schedules with alternative drugs are needed for the metastatic disease. In this study a new combination of Mitomycin, Epidoxorubicin and Vinblastine was employed in a group of 24 patients with metastatic breast cancer. A response rate of 37.5% was observed with a mild to moderate toxicity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Neurovegetative regulation of gastrin secretion].

The literature is reviewed in an account of the part played by the adrenergic and cholinergic systems in the regulation of gastrin secretion. As matters now stand, it can be said that, whereas the adrenergic system is capable of activating such secretion, the cholinergic system appears to be capable of modulating it by inhibition rather than stimulation. While it can be agreed that mediation of the adrenergic function occurs via the beta receptors, the possibility that the alpha receptors may also be responsible under certain conditions cannot be ruled out.

Autonomic Nervous System↗
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Oral chemotherapy for poor risk small-cell lung cancer patients with combined idarubicin and etoposide.

Sixteen patients with previously untreated small-cell lung cancer, unsuitable for standard aggressive intravenous chemotherapy due to advanced age or poor performance status or very advanced disease including brain metastases or either extensive liver or marrow involvement with impaired organ function, were treated with combined oral chemotherapy including 4-demethoxydaunorubicin (IMI30, idarubicin) 30 mg/sm on day 1 and etoposide (VP16) 150 mg/sm on days 2,3,4 every 4 weeks. Out of 13 evaluable patients 1 had a complete response and 2 had a partial response with an overall objective response rate of 23% (95% confidence-limits 5-53.8%). Toxicity was generally very mild. Although the compliance of this regimen is excellent, its antitumor activity seems unsatisfactory even in this category of poor-risk small-cell lung cancer patients.

Administration, Oral↗
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Continuous venous infusion of vindesine in metastatic breast cancer: experience with a subcutaneously implanted system and portable pump.

Fourteen patients with advanced pretreated breast cancer were treated with vindesine in continuous venous infusion (1.5 mg/sm/24 hours for 72 hours every 3 weeks). A totally implanted venous access and a portable pump were used. A total of 33 courses was administered. No objective response was observed and treatment was stopped. Drug-related toxicity consisted mainly of alopecia (64% of patients), nausea and vomiting (29%) and mucositis (29%). Catheter - related toxicity was observed in 6 patients (43%) and consisted of infection of the skin pocket in 4 patients and dislodging of the needle and catheter break in one patient. The feasibility of continuous venous infusion of vesicant drugs in outpatients is discussed.

Adult↗
PubMedDate not supplied

Adjuvant systemic treatment of resectable breast cancer: eleven years results of a monoinstitutional chemo-hormone-immunotherapy trial.

131 patients with resectable, node-positive breast cancer were treated at the National Institute for Cancer Research of Genoa, Italy with a systemic adjuvant regimen based on 14 cycles of chemotherapy, immunostimulation with levamisole, and--for postmenopausal patients--hormone therapy with tamoxifen. The present evaluation is performed eleven years after the admission of the first patient: so far, 75 patients (57.3%) have relapsed and 52 (39.7%) have died. An analysis of prognostic factors for relapse and death shows that the number of positive axillary lymph nodes and the dimension of the primary tumor are significantly associated with survival and relapse-free survival, while age and menopausal status are not.

Age Factors↗
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Idarubicin: an evaluation of cardiac toxicity in 77 patients with solid tumors.

Idarubicin (4-demethoxydaunorubicin) is a daunorubicin analog that has shown comparable activity and less cardiotoxicity than daunorubicin and doxorubicin in preclinical studies. Phase I and II studies appear to confirm its safety but no definitive conclusion about cardiotoxicity was possible due to the small number of patients in each study. We evaluated 77 patients with advanced solid tumors treated with oral single agent (idarubicin 15 mg/m2 for three days every 4 weeks). Physical examinations and ECGs were performed before every course of treatment and at discontinuation. Eighteen patients also received sequential radionuclide angiocardiographies for evaluation of LVEF. After the administration of a median of 135 mg/m2 of idarubicin (range 45-540), no clinical sign of cardiotoxicity was observed: in three patients minor and transient ECG changes occurred. No significant reduction in mean LVEF values was observed during treatment.

Aged↗
PubMedDate not supplied

Radiotherapy plus carboplatin and teniposide in patients with brain metastases from non small cell lung cancer.

BACKGROUND: The role of chemotherapy alone or added to radiation treatment for the palliation of multiple, unresectable brain metastases from non small cell lung cancer (NSCLC), is not yet well defined. Carboplatin and teniposide, however, are an interesting combination in this setting since they are active in NSCLC and because of encouraging results against brain metastases in other tumor types. METHODS: Twenty patients with brain metastases from NSCLC were treated with whole brain irradiation (total dose of 45 Gy) and chemotherapy (carboplatin, 300 mg/sm on day 1 and teniposide, 60 mg/sm on days 1, 2 and 3). RESULTS: Nine patients (45%) showed a complete remission of neurologic symptoms, and 7 (35%) an improvement. Neurologic signs disappeared in 8 patients (40%) and improved in 7 (35%). Three patients (15%) had partial (50%) regression of brain metastases at CT scan, and also showed response in other tumor sites. One other patient had a response of chest and liver lesions, while the cerebral metastases remained stable. Median survival was 7 months with a range of 1-9 months. Toxicity was mild, with no toxic deaths. CONCLUSIONS: Aggressive treatment can be taken into consideration also in the case of NSCLC patients with brain metastases and negative prognostic features. Their participation in clinical trials should be encouraged, since this will allow definition of the contribution of combined radiotherapy, chemotherapy and supportive care to the quality and duration of the patient's life.

Aged↗
PubMedDate not supplied

Failure of vinorelbine to produce responses in pretreated non-small cell lung cancer patients.

Fifteen patients with advanced non-small cell lung cancer, already treated with first-line chemotherapy, entered a protocol of palliative second-line treatment with the hemysynthetic vinca alkaloid vinorelbine (25 mg/sm weekly for two months). No patient obtained an objective response and the trial was stopped. Toxicity was not as mild as expected, with one treatment-related death due to leukopenia. It is concluded that single-agent vinorelbine, although effective as front-line chemotherapy for non-small cell lung cancer patients, is probably not suitable for palliative treatment of pretreated patients.

Aged↗
PubMedDate not supplied

Granisetron-dexamethasone combination for multiple day cisplatin.

Thirty-four, patients being given polychemotherapy schedules including cisplatin at the dose of 20 mg/sm for 5 days entered an antiemetic protocol with granisetron and dexamethasone at the doses of 3 mg and 8 mg respectively, both administered i.v. before cisplatin. A complete response (no episodes of vomiting) and a major response (< or = 2 episodes of vomiting) were observed in 14 and 12 patients respectively; the toxicity of the antiemetics was mild. It is concluded that the granisetron dexamethasone combination is able to achieve a high rate of antiemetic control in the special set of multiple day cisplatin treated patients.

Adult↗
PubMedDate not supplied

Biochemical modulation of 5-fluorouracil with methotrexate in advanced colorectal cancer patients pretreated with adjuvant 5-fluorouracil and leucovorin.

PURPOSE: 5-fluoracil (5-FU) remains the standard treatment in advanced colorectal cancer patients. An increasing number of recurring patients, however, have already received this drug as adjuvant after surgery. An attempt to increase 5-FU cytotoxicity through biochemical modulation is justified in this setting. In our study, a combination regimen of methotrexate followed by 5-FU, with leucovorin rescue, was employed. METHODS: Patients were required to have symptomatic, measurable, inoperable lesions from colorectal cancer, recurring after adequate radical surgery of the primary tumor and adjuvant 5-FU + leucovorin concluded at least 3 months before recurrence. Patients received methotrexate. 250 mg/m2 as a 2-hour i.v. infusion, followed by two doses of 5-FU, 500 mg/m2 as i.v. bolus 1 hour and 21 hours after the end of methotrexate infusion. Leucovorin rescue, 15 mg orally every six hours for 7 times, was started 1 hour after the second 5-FU dose. The cycle was repeated every 2 weeks. RESULTS: Twenty-two patients entered the trial, and 21 were evaluable. An objective response was observed in one patient (4.8%), 7 patients (33.3%) obtained tumor regression < 50% or disease stabilization. Thirteen patients (61.9%) progressed. Median survival in the whole group was 11 months. Subjective responses were observed in 7 patients (33.3%). Toxicity was mild. CONCLUSIONS: Biochemical modulation with methotrexate does not seem a satisfactory means of increasing 5-FU activity, when the patient has been previously exposed to 5-FU plus leucovorin. On the other hand, any possible advantages in terms of quality and prolongation of life with this schedule were obtained at the cost of very acceptable toxicity.

Adult↗
PubMedDate not supplied

Intensified M-VEC chemotherapy with G-CSF support as outpatient treatment for advanced bladder cancer.

The M-VAC regimen (methotrexate, vinblastine, doxorubicin and cisplatin) is widely used in the treatment of advanced or metastatic bladder cancer. In the present trial, an alternate week regimen of M-VEC (with epidoxorubicin instead of doxorubicin) supported by G-CSF (filgrastim) was evaluated. Eligible patients had metastatic or surgically unresectable bladder cancer, not previously treated with systemic chemotherapy. Treatment consisted of methotrexate 30 mg/m2 day 1, vinblastine 3 mg/m2 day 2, epidoxorubicin 60 mg/m2 day 2 and cisplatin 35 mg/m2 days 2 and 3. G-CSF was administered s.c. at the dose of 300 mcg from day 4 to day 11: the treatment was repeated every 2 weeks for six cycles. Twenty-one patients entered the study, and 19 received more than 1 cycle: 78.9% were able to receive full doses of M-VEC as scheduled. The treatment resulted feasible on an outpatient basis, with mild toxicity. Three complete responses (15.8%) and 9 partial responses (47.4%), with an overall objective response rate of 63.2%, were observed.

Aged↗
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A new schedule for etoposide, epidoxorubicin and cisplatin with granulocyte colony stimulating factor for advanced gastric cancer: a feasibility study.

A new polychemotherapy regimen has been developed for gastric cancer. Etoposide at the dose of 120 mg/m2 for three days, Epidoxorubicin at the dose of 30 mg/m2 on day 1 and Cisplatin at the dose of 40 mg/m2 on day 2 were administered to 26 advanced gastric patients every two weeks with the support of Granulocyte Colony Stimulating Factor from day 8 to day 12 of each cycle. The treatment was feasible with most cases (21/25) having received at least four cycles with a dose intensity > 85%, without life-threatening side effects. Toxicity was lower than that observed in the classical combinations of Etoposide-Anthracycline-Cisplatin.

Adult↗