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Biomedical subjects

R Epelbaum

Publications and source records attributed to R Epelbaum.

60 records · Page 4Linked to original sources

Mitomycin, doxorubicin, and vinblastine as second-line chemotherapy in patients with advanced breast cancer.

Thirty-seven patients with disseminated breast cancer refractory to previous therapy were treated with a combination of mitomycin, doxorubicin, and vinblastine (MAV). One complete and eight partial responses were achieved, with an overall response rate of 24.3%. The median duration of response was 5+ months. The MAV regimen had generally moderate but acceptable toxicity. This study indicates that the MAV combination is no better than doxorubicin given as a single agent.

Adult↗

Further studies on the treatment of advanced gastric cancer by 5-fluorouracil, Adriamycin (doxorubicin), and mitomycin C (modified FAM).

Twenty-two previously untreated patients with advanced gastric adenocarcinoma were treated with a modification of the original 5-fluorouracil, Adriamycin (doxorubicin), and mitomycin C (FAM) combination chemotherapy. The cycles were repeated every 6 weeks. There were four partial remissions and no complete response (overall response rate of 18%, with confidence interval of 0.02-0.34 for a confidence level of 95%). Duration of response ranged between 2.5 and 12 months. The overall median survival was 6.8 months. The median survival of responding patients (13.6 months) and the nonresponders (5.8 months) did not significantly differ. Sex and initial performance status did not influence the response to FAM. Toxicity was mild to moderate, and in only a few patients was it necessary to significantly reduce the drug doses or to prolong the intervals between treatments. Combining the current results with those obtained in a study recently reported the authors in which the original FAM was given to 33 evaluable patients, 11 responders have been seen among 55 consecutive patients with evaluable disease. These results are obviously inferior to those reported by other groups of investigators and led the authors to try another combination chemotherapy.

Adenocarcinoma↗

The value of serum copper levels in non-Hodgkin's lymphoma.

A study of 306 serum copper levels (SCL) determinations in 115 patients with non-Hodgkin's lymphoma indicates a positive correlation between SCL and the state of disease. Patients with advanced disease (Stages II, III and IV) before treatment, those with active disease while under treatment, or in a relapse had a significantly higher SCL than patients in Stage I or those with no evidence of disease (NED). The mean SCL of patients with Stage I was similar to that of patients with NED. The mean values of these two groups did not differ significantly from that of healthy controls. Histological subtypes, according to the Rappaport classification, has no influence on SCL. Grouping into nodular versus diffuse lymphoma, histiocytic versus lymphocytic lymphoma and favorable versus unfavorable histology failed to demonstrate a difference between the groups. Within each subset a wide range of SCL was evident. However, good correlation was observed with the degree of disease activity. SCL may provide a useful parameter for patient monitoring. In this series, however, SCL was not useful for the prediction of an early relapse.

Adult↗

Efficacy of pentoxifylline as a modulator of alkylating agent activity in vitro and in vivo.

Pentoxifylline, a methylxanthine that is used to treat veno-occlusive disease, can increase perfusion in undervascularized tissues. Addition of high concentrations, like caffeine, causes progression through radiation or drug induced G2 phase blocks, thereby limiting time for repair of DNA breaks and crosslinks. We have examined the potential of pentoxifylline to augment the effects of antitumor alkylating agents in vitro and in vivo. In MCF-7 human breast cancer cells in vitro, pentoxifylline (2 mM) present for 24 h was only slightly cytotoxic (approximately 10% cell kill at 2 mM), but when present prior to and during AA it increased the cytotoxicity of CDDP by 2 logs at 250 microM. With L-PAM in vitro, pentoxifylline was much less effective and only at a concentration of 250 microM L-PAM did 2 mM pentoxifylline increase cytotoxicity (approximately 0.3 logs). In the FSaIIC murine fibrosarcoma system, 100 mg/kg of pentoxifylline i.p. immediately prior to the alkylating agent or 50 mg/kg x 5 of pentoxifylline over 24 h with the alkylating agent given immediately after the third dose increased the tumor cell kill achieved by CDDP, carboplatin, cyclophosphamide, and thiotepa. The increase in tumor cell killing was modest (2.9-fold). Pentoxifylline in the multiple dose regimen (50 mg/kg x 5 over 24 h) was more effective than in the single dose (100 mg/kg) protocol. In the EMT6 mouse mammary adenocarcinoma, pentoxifylline (100 mg/kg daily x 5) improved the tumor growth delay produced by CDDP (3.3 mg/kg alternate days x 3), carboplatin (25 mg/kg daily x 5), cyclophosphamide (100 mg/kg alternate days x 3) and thiotepa 5 mg/kg (daily x 5). Only with cyclophosphamide, however, did the interaction appear to be large, as a 2.4-fold increase was observed.

Alkylating Agents↗

Dose-intensity analysis for CHOP chemotherapy in diffuse aggressive large cell lymphoma.

Dose intensity may play an important role in the success of cancer chemotherapy. We have investigated the relationship between RDI of the combination of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) and the results of therapy in a group of 78 newly diagnosed patients with diffuse histiocytic and diffuse mixed non-Hodgkin's lymphoma. The achievement of CR was associated with high DI. In the initial cycles needed to achieve a maximal response, a significantly greater proportion of complete responders received average RDI, RDI of CTX and RDI of adriamycin greater than 0.8, as compared with noncomplete responders: 52 vs. 23%, 62 vs. 34% and 61 vs. 29%, respectively (P less than 0.05). Sixty-one patients achieved CR. Among these, RDI of CTX was best and significantly correlated with survival: 81 and 54% 5-year actuarial survival of patients receiving greater than 0.7 and less than 0.7 RDI, respectively (P less than 0.05). Our data indicate that there is a clear dose-rate effect of CHOP, particularly of CTX, on the therapeutic outcome. High DI may improve results of treatment in patients with diffuse, large cell lymphoma.

Adolescent↗