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P Ruffie

Publications and source records attributed to P Ruffie.

At least 19 recordsLinked to original sources
PubMed2004

The doxorubicin-streptozotocin combination for the treatment of advanced well-differentiated pancreatic endocrine carcinoma; a judicious option?

Due to their rarity, only few trials have studied the role of the doxorubicin-streptozotocin (DS) combination in advanced well-differentiated pancreatic endocrine carcinomas (AWDPEC). However, the published results are inconsistent. We reviewed all AWDPEC (5-year period, 45 patients) treated in our institution with the DS combination for: objective response rate (ORR), progression-free survival, overall survival (OS) and toxicity. An ORR of 36% (95% Confidence Interval (CI) 22-49) was obtained, with 16 partial responses (PR). The mean duration of PR was of 19.7 months. Two and 3-year OS rates were 50.2 and 24.4%, respectively. Toxicities were mainly digestive (grade > or =3 vomiting, 13%) and haematological (grade > or =3 neutropenia, 24%). Previous systemic chemotherapy and malignant hepatomegaly were associated with a poorer ORR (P=0.033, P=0.016) and OS (P=0.008, P=0.045). Multivariate analysis demonstrated previous chemotherapy as the only independent predictive-factor for survival (P=0.013). In conclusion, our data confirm the sensitivity of AWDPEC to the DS combination, with an ORR of 36% and a remarkable median response duration of 19.7 months, and suggests that it could be considered as a valid option in first-line therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

[Pulmonary carcinosarcoma with jejunal metastasis: complete response to chemotherapy].

We report a case of pulmonary carcinosarcoma with jejunal metastasis. The lung is an exceptional localization for carcinosarcoma, a tumor with carcinomatous and sarcomatous components. These two components are closely related but well-defined morphologically and immunohistochemically. Risk of metastasis and local recurrence is high. Surgery is the treatment of choice for localized forms. Prognosis depends on the sarcomatous component which is usually sensitive to chemotherapy, with at least doxorubicin and ifosfamide. This rare case illustrates the potential for jejunal metastasis and complete response to chemotherapy, proven histologically at 33 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Long term analysis of survival in the European randomized trial comparing vinorelbine/cisplatin to vindesine/cisplatin and vinorelbine alone in advanced non-small cell lung cancer.

In the period 1989-1991, 612 patients with inoperable stage IIIA/B and IV non-small cell lung cancer (NSCLC) were randomized in a phase III trial comparing three chemotherapy regimens. Survival data at five and six years of follow-up confirm the overall benefit of treatment with a combination of vinorelbine and cisplatin compared to vindesine plus cisplatin or vinorelbine alone. Of the 612 patients randomized at the start of the study, 17 have survived beyond five years. Of these patients, eight had entered the trial with metastatic disease. Multivariate analysis to detect prognostic factors suggested a possible interaction between the effect of having cisplatin in the chemotherapy received and baseline performance status. Subgroup analysis subsequently confirmed that the survival benefit of the vinorelbine plus chemotherapy regimen is evident only in patients with initial World Health Organization performance status (PS) of 0-1. Among these patients, the one-year survival rate is 38% for the vinorelbine/cisplatin arm, 29% for vindesine/cisplatin and 34% for vinorelbine alone. The corresponding figures for median survival are 43, 33 and 36 weeks. Among inoperable NSCLC patients with a PS of 2, who appear from this trial not to have benefited from the presence of cisplatin in their chemotherapy, use of single agent vinorelbine is an appropriate treatment option.

Antineoplastic Agents, Phytogenic↗
PubMed2001

[Meningeal metastasis of pleural mesothelioma].

Meningeal metastases from malignant mesotheliomas are rarely observed. We report the case of a 54-year-old man with an asymptomatic pleural effusion and simultaneous sensitive and motor disorders of the right hemibody. A meningeal localization of a pleural malignant mesothelioma was discovered and confirmed by a comparative immuno-histological analysis. Here we present a differential diagnosis and a review of the literature to give prominence to diagnostic pitfalls in this rare disease.

Humans↗
PubMed2000

A dose-finding study of gemcitabine and vinorelbine in advanced previously treated malignancies.

PURPOSE: Gemcitabine and vinorelbine are active drugs with broad spectrum of activity and manageable toxicity in clinical trials. The aims of this study were to describe the toxicity, to determine the dose-limiting toxicity, and to define the doses of gemcitabine and vinorelbine to be recommended for phase II studies in patients with advanced cancers. PATIENTS AND METHODS: Drugs were given as 30-min infusions on day 1 and 8 (vinorelbine before gemcitabine) every 3 weeks. Thirty-six patients (male:female ratio 25:11; mean age 54, PS > 60) were treated including 1 retroperitoneal sarcoma, 7 head and neck, 10 lung, 4 thyroid, 6 pancreatic, 1 bladder, 2 ovary, 2 gastric, 1 rectum, 1 unknown primary, and 1 renal cell carcinoma. Doses of gemcitabine/vinorelbine ranged from 800/20 mg/m2 to 1500/30 mg/m2. RESULTS: The dose-limiting toxicity was neutropenia. A transient grade 2-3 elevation of transaminases was frequently observed at several dose-levels, although this toxicity did not appear to be dose dependant and was reversible at day 21 before the next cycle. Other toxicities were mild and easily manageable, consisting of fatigue and flu-like syndromes. Since the MTD was not reach at the higher dose-level, the recommended dose level of the gemcitabine-vinorelbine combination was 1500/30 mg/m2. One toxic death due to hematologic toxicity was reported in a heavily pretreated patient who underwent prior chemotherapy and pelvic radiotherapy. A total of 12 patients were treated at the recommended dose level which was associated with grade 3-4 neutropenia in 3 of 12 patients and in 22.9% of cycles. CONCLUSIONS: This study estimates that the recommended dose for phase II studies of gemcitabine-vinorelbine is 1500/30 mg/m2 at day 1 and 8 every three weeks. A careful monitoring of the hematologic toxicity is recommended in heavily pretreated patients and in patients who received pelvic radiotherapy. Partial responses observed in a patient with an advanced cisplatin-5-fluorouracil-resistant pancreatic adenocarcinoma and in a patient with mesothelioma support further evaluation of this combination in patients with tumors refractory to classical antitumor agents.

Adult↗
PubMed2000

[Neurotrichinosis: a case report with MRI evaluation].

Neurological complications are rare in trichinosis. A case of trichinosis involving the central nervous system documented by MRI is presented. To our knowledge, only three cases of neurotrichinosis with MRI abnormalities have been already reported. The physiopathological mechanism are discussed (transport of the parasite through the blood-stream, immuno-allergic reaction or eosinophilic neurotoxic effect).

Adult↗
PubMed1999

[Malignant mesothelioma: clinical and therapeutic study].

Like lung cancer, mesothelioma is difficult to diagnose early. Nevertheless disease stage is the determinant factor for outcome of treatment. Effective diagnostic examinations must be undertaken promptly. Thoracoscopy is one of the best diagnostic procedures provided that it is skillfully performed to prevent complications such as development of subcutaneous nodules along the pathway of the trocar. Several arguments have been proposed against routine screening including low incidence of the disease, poor sensitivity and specificity of screening techniques, and lack of effective therapy documented by phase III study. However there are a number of arguments in favor of screening. The high-risk population is well defined. Although no control study is currently available, promising new results have been observed in limited forms, i.e., 62% response rate at stage IA with 39% survival at 5 years in patients presenting epithelial forms without lymph node involvement treated by pleuro-pneumonectomy, chemotherapy, and radiotherapy. Screening is necessary to recruit more early-stage patients for further clinical trials to improve therapeutic techniques. Poor outcome of treatment could be due to delayed diagnosis. Early diagnosis is also needed to allow compensation of occupational disease to begin while the patient is still alive.

Adult↗
PubMed1998

Docetaxel (Taxotere) plus cisplatin: an active and well-tolerated combination in patients with advanced non-small cell lung cancer.

The activity of the combination of intravenous docetaxel 75 mg/m2 plus cisplatin 100 mg/m2 administered every 3 weeks for 3 cycles then every 6 weeks was investigated in 51 chemotherapy naive patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). The population was 92% male, with a median age of 54 years and median performance status of 1; 80% of patients had metastatic disease, including 37% with bone involvement. All patients received prophylactic premedication (ondansetron, dexamethasone plus cetirizine) and standard hyperhydration. With a median of 4 treatment cycles (range 1-9), 14 of 42 evaluable patients responded (overall response rate 33.3%, 95% CI 19.6-49.6%); the median response duration was 7.3 months, median survival 8.4 months, and 1-year survival rate 35%. The most common adverse event was neutropenia, occurring in two-thirds of patients. Neurosensory effects were cumulative but generally mild. No treatment-related deaths occurred. This combination of docetaxel/cisplatin showed activity in advanced NSCLC. While it was not clearly superior to single-agent docetaxel, due to differences in prognostic factors among the patients in open trials, a randomised study would be needed to demonstrate definitively whether cisplatin adds to the activity of docetaxel or not.

Adolescent↗
PubMed1996

[Results of a randomized study comparing combination of navelbine-cisplatin to combination of vindesine-cisplatin and to navelbine alone in 612 patients with inoperable non-small cell lung cancer].

The combination of vindesine and cisplatin is considered a reference regimen in advanced NSCLC which has yielded a significant improvement in the duration of survival. A phase II study of a new semi-synthetic vinca alkaloid, Navelbine, reported an unusually high 29% response rate in stage III-IV NSCLC and a phase I-II study established the feasibility of the combination of Navelbine and cisplatin. We, therefore, designed a prospective randomized trial to compare Navelbine and cisplatin (NVB-P) to vindesine and cisplatin (VDS-P) and to evaluate whether the best of these regimens affords a survival benefit compared to Navelbine alone (NVB), an outpatient regimen. Forty-five centers included 612 patients in this study: 206 in NVB-P, 200 in VDS-P and 206 in NVB. Navelbine was given at a dose of 30 mg/m2 weekly, cisplatin at 120 mg/m2 on day 1, day 29 and then every 6 weeks and vindesine at 3 mg/m2 weekly for 6 weeks and then every other week. Treatment was continued until progression or toxicity. Patients' characteristics were similar in the three groups with 59% of patients presenting with metastatic disease. An objective response rate was observed in 30% of patients in NVB-P versus 19% in VDS-P (P = .02) and 14% in NVB (P < .001). The median duration of survival was 40 weeks in NVB-P compared to 32 weeks in VDS-P and 31 weeks in NVB. The comparison of survival between the three groups demonstrated an advantage for NVB-P compared to VDS-P (P = .04) and NVB (P = .02). Neutropenia was significantly higher in the NVB-P group (P < .001) and neurotoxicity more frequent with VDS-P (P < .004). Since our results have demonstrated that NVB-P yields a longer survival duration and a higher response rate than VDS-P or NVB alone, with acceptable toxicity, this combination should be considered a reference regimen in advanced NSCLC.

Adult↗
PubMed1995

Phase I/II study of paclitaxel plus cisplatin as first-line chemotherapy for advanced non-small cell lung cancer: preliminary results.

From March 1993 to May 1994, 32 chemotherapy-naive patients with advanced non-small cell lung cancer entered a phase I/II study to determine the maximum tolerated dose and the activity of the paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ)/cisplatin combination. The 21 men and 11 women had a median age of 59 years (range, 25 to 72 years) and a median performance status of 1 (range, 0 to 2). Histologic types were adenocarcinoma (13 cases), squamous cell carcinoma (10), and large cell carcinoma (nine). Nine patients had stage IIIB disease and 23 had stage IV disease. The first four dose levels of paclitaxel were 135, 175, 200, and 225 mg/m2 given with a fixed cisplatin dose of 100 mg/m2; at level 5, paclitaxel 225 mg/m2 was again given, and the cisplatin dose was increased to 120 mg/m2. Cycles were given every 3 weeks. Paclitaxel was administered as a 3-hour infusion followed by cisplatin, with standard premedication and hyperhydration. The maximum tolerated dose for the first cycle was not reached. Grades 3 and 4 neutropenia occurred in 24% and 16% of cycles (two cases with fever), respectively. Grades 2 and 3 peripheral axonal neurotoxicity occurred in two and 16 patients, respectively; the neurotoxicity appeared to be dose dependent and cumulative after a median total paclitaxel dose of 1,300 mg/m2. Of the 29 patients evaluable for efficacy, 11 (38%) had a partial response; efficacy was superior at paclitaxel doses of at least 200 mg/m2, with eight (47%) of 17 evaluable patients responding at these levels. In conclusion, at these doses of paclitaxel and cisplatin, the dose-limiting neurologic toxicity is dose dependent and cumulative after a total paclitaxel dose of approximately 1,300 mg/m2. This combination is highly active, with a total objective response rate of 38% and an objective response rate of 47% at paclitaxel doses of 200 mg/m2 or higher. Further evaluation is warranted.

Adenocarcinoma↗
PubMed1995

Somatostatin receptor imaging: a preliminary experience in forty-nine patients.

We report our experience with the 111In-pentetreotide scanning of 47 adult patients presenting with neuroendocrine tumors (n = 38) or malignant pheochromocytomas or related tumors (n = 9), and 2 children with metastatic neuroblastomas. A dynamic study was performed after i.v. administration of 50-190 MBq of 111In-pentetreotide followed by a whole body scan at 1.5-4 hours and at 24 hours. Where indicated, tomoscintigraphy or a dual isotope bone, liver or kidney scan was performed in order to improve the anatomical definition. Lesions were visualized in the earliest phases of the examination but contrast was enhanced on delayed images due to an improved signal to background ratio. In 9/49 patients, octreotide scan (OS) detected unknown tumors sites. On the other hand, the lesion uptake of 111In-pentetreotide varied, and not all the sites shown by other imaging modalities were visualised, probably due to differences in membrane receptor expression. In conclusion, OS can be useful in the diagnosis, follow-up and therapeutic management of neuro-endocrine tumors. Further investigations are required to assess the role of OS in other pathologies. Short title: Somatostatin receptor imaging.

Adolescent↗
PubMed1994

Radiotherapy alone versus combined chemotherapy and radiotherapy in unresectable non-small cell lung carcinoma.

We report the results observed in a large randomized study comparing radiotherapy alone to combined radiotherapy and chemotherapy in unresectable squamous cell and large cell lung carcinoma. Radiation dose was 65 Gy in both groups and chemotherapy included vindesine, cyclophosphamide, cisplatin and lomustine. One hundred seventy-seven patients received radiotherapy alone, and 176 received the combined treatment. The 2-year survival rate was 14% for patients receiving radiotherapy vs. 21% for patients receiving the combined treatment (P = 0.02). The distant metastasis rate was significantly lower in the group receiving the combined treatment (P < 0.001). Local control at 1 year was poor in both groups (17% and 15%, respectively) and remains a major problem in locally advanced non-small cell lung cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Neuroendocrine tumor of the trachea of the intermediate type. Value of its individualization].

Tracheobronchial neuroendocrine tumours can be divided into 4 main groups: typical carcinoid; well-differentiated neuroendocrine carcinoma (atypical carcinoid); neuroendocrine carcinoma of the intermediate type, and small-cell carcinoma. Typical and atypical carcinoids are differentiated tumours, whereas intermediate neuroendocrine tumours and small cell carcinomas are little or not differentiated. Morphological or architectural criteria usually suffice to distinguish between carcinoid tumours and small cell carcinomas. In some cases, however, the neuroendocrine nature of poorly differentiated and non-small cell carcinomas is suggested by morphological criteria, but it can be confirmed only by immunohistochemistry and electron microscopy. Tracheobronchial neuroendocrine tumours of the intermediate type have been studied from a first, well-documented clinical case which demonstrated two important points: the prognosis of these tumours seems to be worse than that of carcinoid tumours, and they favourably respond to chemotherapy. In view of the therapeutic consequences, it is necessary to investigate, by the appropriate techniques, the neuroendocrine nature of these poorly differentiated carcinomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Phase I-II study of vinorelbine (Navelbine) plus cisplatin in advanced non-small cell lung cancer.

32 patients with advanced non-small cell lung cancer previously untreated by chemotherapy were included in a phase I-II study in order to determine the feasibility of the combination of vinorelbine and cisplatin, each administered at its optimal dose, i.e. 30 mg/m2 weekly and 120 mg/m2 every 4-6 weeks, respectively. There were 27 males and 5 females with a mean age of 55 years and a median performance status of 80%. 13 had locally advanced disease and 19 had distant metastases at the time of inclusion. Our study demonstrated the feasibility of this protocol. Dose intensities could be maximised by adapting vinorelbine doses rather than by postponing treatment in the event of neutropenia. Both response rate (33%) and overall survival of the population (median 11 months) justify further studies.

Adult↗