Pancreaticobiliary fistula and obstructive jaundice complicating 125I interstitial implants for pancreatic cancer: endoscopic diagnosis and management.
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Adenocarcinoma↗
Biomedical subjects
A Mittelman
Publications and source records attributed to A Mittelman.
Oral estramustine phosphate (NSC-89199) in the treatment of advanced (stage D) carcinoma of the prostate.
Thirty-two patients with stage D carcinoma of the prostate were treated with oral estramustine phosphate at a dose of 15 mg/kg/day from 3 to 15 months. Objective remissions, reduction of greater than 50 percent of measurable lesions such as soft tissue masses, lymph nodes, and prostatic masses, were seen in seven of 32 patients (22 percent response rate). Subjective response, ie, relief of pain, weight gain, sense of well being, snd improved performance status, occurred in all objective responders and in seven other patients with stable disease (15 of 32 patients = 47 percent). No hematologic, hepatic, or renal toxic effects were observed. Transient nausea occurred early in one half of the patients and nausea and vomiting was dose limiting in only two patients. Oral estramustine phosphate is well tolerated and worthy of further clinical use.
Acid Phosphatase↗
Phase I clinical trial of isophosphamide (NSC-109724).
An initial clinical phase I trial of isophosphamide has been carried out at dose levels of 200-10,000 mg/m2 of body surface area using a single-dose, every-3-week schedule. Significant toxicity was not seen at isophosphamide dose levels less than 2900 mg/m2. At higher doses, nausea and vomiting was nearly universal. Hematologic toxicity manifested by leukopenia occurred in 12 of 20 patients treated with doses of 3800-7000 mg/m2. Thrombocytopenia to 100,000 platelets/mm3 was not seen in any patient. Urinary bladder toxicity manifested by hemorrhagic cystitis was seen in 15 of 23 patients treated with doses of 3800-10,000 mg/m2. Hemorrhagic cystitis could be completely prevented by bladder irrigation with N-acetyl-L-cysteine (1% solution, 2000 ml/day). With careful attention to hydration, renal toxicity was largely prevented with blood urea nitrogen elevations to 30 mg/dl in only two of 14 patients receiving isophosphamide doses of 5000-7000 mg/m2. Another side effect was central nervous system toxicity in seven of 17 patients at doses of 5000-10,000 mg/m2. For phase II trials a dose of 5000 mg/m2 is recommended, with careful attention to the state of hydration in the patient and with the knowledge that bladder irrigation may be necessary for the prevention and/or amelioration of bladder toxicity.
Adenocarcinoma↗
Clinical phase I trial of inosine dialdehyde (NSC-118994).
An initial clinical phase I trial of inosine dialdehyde has been carried out in 40 patients at dose levels of 30-4000 mg/m2 for 5 days given intravenously (iv) monthly. At 1.5 g/m2, noncumulative dose-related toxicity occurred in all patients which consisted of nausea and vomiting, local pain, alterations in coagulation mechanism, elevated partial thromboplastin time, and positive Coombs' test. No dose-limiting leukopenia, thrombocytopenia, anemia, or bleeding occurred; however, depression of the leukocyte and platelet counts, and decreased hemoglobin value were observed. The dose-limiting toxic effect was renal tubular damage with reversible acute renal failure in one of four patients who received 3000 mg/m2 iv for 5 days. Refractory hypercalcemia was controlled in three of three patients without tumor effect. Responses occurred in patients with seminoma, oat cell carcinoma, and melanoma. A starting dose of 2 g/m2 for 3 days monthly is recommended for phase II trials and a trial in lung carcinoma is now being conducted.
Aldehydes↗
Phase II trials with procarbazine (NSC-77213), streptozotocin (NSC-85998), 6-THIOGUANINE (NSC-752), and CCNU (NSC-79037) in patients with metastatic cancer of the large bowel.
One hundred and ninety-seven patients with measurable metastatic cancer of the colon have been treated with one of four anticancer drugs which have had little prior trial in this disease. Objective tumor responses lasting a median of 9 weeks occurred with 0.5 g/m of streptozotocin given intravenously every week (10 percent), 130 mg/m of CCNU given orally every 6 weeks (10%), 1.0 mg/kg/day of 6-thioguanine given orally (8%), and 3 mg/kg/day of procarbazine given orally (3%). Performance status declined more rapidly with streptozotocin and 6-thioguanine and the median survival time was less (12 and 16 weeks respectively) than with procarbazine and CCNU (23 and 20 weeks respectively). This study suggests that procarbazine given in this way is ineffective but trials of streptozotocin or 6-thioguanine combined with other agents active against colon cancer should ensue as well as further exploration of the usefulness of other nitrosoureas.
Clinical Trials as Topic↗
Hypercalcemia associated with adenocarcinoma of the rectum. A case report and review of the literature.
Hypercalcemia is a well described complication of cancer both in solid tumor and hematologic malignancies. Metastatic adenocarcinoma of the rectum has not been reported to be associated with hypercalcemia. We report a case of a patient with metastatic adenocarcinoma of the rectum to the liver with hypercalcemia. Evaluation for other causes of hypercalcemia was negative. We suggest that adenocarcinoma of the rectum can lead to the development of hypercalcemia.
Adenocarcinoma↗
Circannual variation in human erythrocyte adenosine aminohydrolase.
In serially independent samples of blood from apparently healthy subjects controlled as to clock-hour of blood withdrawal but not as to any circannual changes in circadian state, human erythrocyte adenosine aminohydrolase undergoes a statistically significant circannual rhythm, which may or may not be aliased. This rhythm is also demonstrated in patients with a variety of neoplastic diseases and it occurs around a statistically significantly lower mesor in patients with a variety of malignant tumors investigated.
Adenosine Deaminase↗
A phase II study of fluorodopan in the treatment of advanced colorectal cancer.
In an early phase II study, fluorodopan (5-(2'-fluoroethyl-2'-chloroethyl)-amino-6-methyl uracil) was given to 17 patients with advanced colorectal cancer previously treated with multiple agents. Side effects included mild nausea and vomiting in 14 patients, platelet counts of less than 50,000/microliter in four patients, and wbc counts of less than 2000/microliter in two patients. Partial remission lasting 9 weeks was achieved in one patient, and stable disease with a mean duration of 7.1 weeks was achieved in ten patients. Given in this setting fluorodopan does not appear to have a significant effect in terms of regression of tumor or prolongation of survival.
Antineoplastic Agents↗
New steroidal alkylating agents in advanced stage D carcinoma of the prostate.
In a previous study, 50 patients with prostatic carcinoma were given continuous oral estramustine phosphate at a dose of 15 mg/kg/day. All patients had progressed on prior standard treatment. The objective and subjective response rates were 19% and 36% respectively. Seven of the 50 patients are still receiving treatment after 1-3 years. One patient who was given estramustine phosphate therapy for 1 year achieved a complete response, which included disappearance of osteoblastic metastasis. He still continues in unmaintained remission despite the fact that estramustine phosphate therapy was stopped because of gastrointestinal toxicity. No serious side effects related to the drug have been seen. Estramustine phosphate may be given safely for a prolonged period and has a place in the treatment of advanced prostatic cancer refractory to hormonal therapy. Twenty-one patients with stage D prostatic adenocarcinoma who failed hormonal therapy were treated with a combination of estramustine phosphate (600 mg/m2/day) plus prednimustine (Leo-1031) (15 mg/m2/day) in daily oral doses. Fifteen patients have been treated with prednimustine alone. The preliminary results of the combination therapy (after 2-9 months) are as follows: five patients (24%) had an objective response and nine patients (44%) had subjective improvement. Only five (24%) did not benefit from the drug and seven (33%) are stable. Of the 16 patients treated with prednimustine alone, one patient has had an unequivocal objective response and one experienced a considerable objective improvement. These preliminary results indicate the possible advantage of adding an alkylating agent (prednimustine) to estramustine phosphate in advanced prostatic carcinoma.
Aged↗