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Biomedical subjects

A S Coates

Publications and source records attributed to A S Coates.

At least 109 records · Page 6Linked to original sources
PubMed1982

Use of aminoglutethimide as second-line endocrine therapy in metastatic breast cancer.

Sixty-five patients with advanced breast cancer, progressive despite prior endocrine therapy in all cases and prior chemotherapy in most cases, were treated with aminoglutethimide, 250 mg four times a day. At present, 52 are evaluable for response assessment, and of these 10 (19%) showed an overall objective response, major sites of response being soft tissue and lung. A further 12 patients (23%) had stable disease during aminoglutethimide therapy, while a total of 9 patients with bone metastases reported marked relief of pain without objective evidence of response. Forty-nine patients had received prior treatment with tamoxifen, and of the 10 tamoxifen responders 4 (40%) responded to subsequent aminoglutethimide, while of the 20 tamoxifen failures only 2 (10%) responded to subsequent aminoglutethimide. Aminoglutethimide was reasonably well tolerated, although 6 patients (0%) discontinued treatment because of intolerable side effects. Six of the 10 responding patients have subsequently relapsed, with a mean duration of response of 17 weeks, but 4 continued to respond at 24, 32, 55, and 111 weeks, respectively. The median survival from the start of aminoglutethimide therapy is in excess of 41 weeks for responders and 11 weeks for nonresponders, while the median survival from first relapse is 48 months for aminoglutethimide responders and 28 months for aminoglutethimide nonresponders. These results confirm that aminoglutethimide can offer a useful alternative form of endocrine therapy for advanced breast cancer, but the response rates obtained in heavily pretreated patients are inferior to those obtained when aminoglutethimide is used earlier in sequential treatment. For optimal results, particularly in terms of quality of life, aminoglutethimide should generally be used prior to chemotherapy.

Adult↗
PubMed1982

Phase II study of doxorubicin and mitomycin in non-small cell bronchogenic carcinoma.

Thirty patients with advanced measurable non-small cell bronchogenic carcinoma were treated with a combination of doxorubicin (50 mg/m2 every 3 weeks) and mitomycin (20 mg/m2 every 6 weeks). One complete and three partial responses were observed. This response rate is similar to that reported for either drug used alone.

Carcinoma, Bronchogenic↗
PubMed1982

Ototoxicity in patients receiving cisplatin: importance of dose and method of drug administration.

A total of 146 serial audiograms that were performed for 32 patients who had received cisplatin treatment were analyzed. Fifteen patients developed significant audiometric abnormality after a mean cumulative dose of 203 mg/m2. Ototoxicity was more severe with higher cumulative doses and higher individual doses, and was most marked in those patients receiving bolus injections. Loss of perception of higher frequencies was most common. Symptoms of ototoxicity occurred in 23 patients and included deafness, tinnitus, otalgia, and recruitment. In some patients the symptoms were transient, and not all patients with symptoms developed audiometric abnormalities. Audiometric abnormalities were invariably preceded by one or more symptoms of ototoxicity. Ototoxicity resulted in dose modification or cessation of treatment in only three patients, and in each case the decision to modify the dose was made on the basis of symptoms of ototoxicity rather than on the audiometric findings. We conclude that audiometry has a limited role in the routine management of patients receiving cisplatin treatment.

Cisplatin↗
PubMed1981

Prolonged remission in recurrent bladder carcinoma after chemotherapy with cisplatin.

Two patients with who metastases from transitional cell carcinoma of the bladder have disappeared during chemotherapy which included cisplatin are described. Both patients have been free of tumour recurrence for over 12 months after chemotherapy was ceased. Side effects included peripheral neuropathy, but renal function was impaired. Cisplatin can produce clinically valuable remissions in recurrent and metastatic bladder carcinoma.

Carcinoma, Transitional Cell↗
PubMed1979

The survival of patients with malignant melanoma receiving BCG with or without chemotherapy.

The effects of treatment by immunotherapy and chemoimmunotherapy were assessed in 31 non-randomized patients with melanoma; 16 received only BCG and 15 BCG and chemotherapy. For advanced cases, the times of survival for the two treatment groups did not differ significantly, nor did there appear to be any improvement in survival over that recorded for the natural course of the disease. The pretreatment immune status as judged by hyporeactivity or normal reactivity to skin tests for delayed type hypersensitivity did not appear to influence survival. This study, together with other reports, does not support the use of immunotherapy in advanced melanoma. Immunotherapy for early melanoma is still to be assessed.

BCG Vaccine↗
PubMed1977

Growth of human melanoma in nude mice: suppression by T-lymphocytes from the tumor donor: brief communication.

Human malignant melanoma cell lines established in tissue culture were successfully transplanted sc into BALB/c nude mice. The growth rate of the resulting tumors was significantly suppressed when lymphocytes from the patient in whom the tumor arose were injected iv into BALB/c nude mice at the same time as sc tumor transplantation, but inoculation with lymphocytes from a person without a tumor was ineffective. Cell separation identified T-lymphocytes as the active subpopulation. Growth of the tumors was also significantly suppressed by reconstitution of the mice with normal BALB/c lymphocytes; lymphocytes from BALB/c mice previously immunized against the melanoma line were not more effective than nonimmune lymphocytes in preventing tumor growth. Sera from normal BALB/c mice or BALB/c mice immunized against a human melanoma cell line effectively suppressed growth of that cell line in BALB/c nude mice if given at the time of tumor transplant. The results suggested that, whereas murine lymphocytes reconstitute the ability of nude mice to react to xenogeneic antigens on the human tumor, human lymphocytes showed greater specificity to autologous human melanoma-associated antigens.

Animals↗
PubMed1977

Complete remission of metastatic malignant melanoma following immunotherapy with Bacillus Calmette-Guerin (BCG): report of a case.

A complete response to BCG is described in a case of recurrent melanoma. In a woman aged 38 years, intracutaneous metastatic deposits confined to the limb of origin had occurred after excision of a malignant melanoma from the ankle, and elective groin dissection had shown two lymph nodes infiltrated with melanoma. BCG vaccine was applied to the buttock, initially by scarification and later by a multiple puncture gun. All metastases slowly regressed, and biopsy of a metastatic site at six months showed no tumour cells. The patient remains free of detectable disease 36 months after the commencement of therapy. It is inferred that BCG may facilitate remission of melanoma, perhaps by reason of antigenic cross-reactivity between BCG and surface components of human melanoma cells.

Adult↗
PubMed1977

Carcinoembryonic antigen in renal allograft recipients and immunosuppressed renal patients.

Carcinoembryonic antigen (CEA) was estimated in plasma from 70 patients with a renal transplant, 105 patients with glomerulonephritis who had received immunosuppressive therapy, and 124 healthy controls. There were raised levels in 30% of those with a renal transplant, 10% of those with glomerulonephritis and 2% of controls, and levels were higher in current smokers. CEA levels did not correlate with pre-transplant dialysis time nor with serum creatinine levels, but tended to fall with increasing time after transplantation, especially in non-smokers. CEA levels did not correlate with prednisolone dosage nor with number of rejection episodes, after allowing for time after transplantation and smoking habit. Nine of 70 patients with a renal transplant and three of 105 with glomerulonephritis had cancer, of skin in seven, cervix uteri in four, and colon in one. CEA was raised in all four transplant recipients with a visceral cancer (cervix three and colon one), but in none of the five with cutaneous cancer. Raised CEA levels occurring late after a renal allograft should prompt a careful search for visceral cancer.

Adolescent↗
PubMed1976

Plasma carcinoembryonic antigen in an Australian hospital population.

Plasma carcinoembryonic antigen (CEA) levels have been determined by the zirconyl phosphate gel (Z-gel) method, using materials provided by Hoffman-LaRoche Inc., on 512 samples from 425 hospital patients, and on single samples from 124 normal controls (98 blood donors and 26 healthy staff members). Of the controls, 98% had CEA levels less than 5 ng/ml. Forty-six hospital patients had CEA levels above 20 ng/ml; 45 (98%) had known present or past cancer. Nineteen patients had levels between 10 and 20 ng/ml; 11 (58%) had present or past cancer. Sixty-seven patients had levels between 5 and 10 ng/ml, and most of these had non-malignant diseases; only 34% had present or past cancer. Cigarette smoking was associated with elevated CEA levels among patients with non-neoplastic diseases, notably those with cirrhosis of the liver and chronic renal disease. There was a gradation of increasing specificity for cancer with increasing levels of CEA from 5 to over 20 ng/ml; but, on the other hand, higher levels were associated with more disseminated cancer, which would be less amenable to cure.

Adolescent↗
PubMed1975

Immunological cross-reactivity between basic proteins of myelin and cancer. I. Lymphocyte transformation studies in immunized guinea-pigs.

The studies described were designed to examine the question of cross-reactivity between basic protein of myelin and a basic protein common to many human tumours. The lymphocytes from guinea-pigs injected with acid extracts of human cancer tissue showed significant (P less than 0-01) tranformation on exposure to basic protein of human myelin. Conversely lymphocytes from guinea-pigs injected with basic protein of human myelin showed significant (P less than 0-01) transformation on exposure to the acid extracts of human cancer tissue. Lymphocytes from control non-injected guinea-pigs did not transform on exposure to either antigen. These findings demonstrate immunological cross-reactivity in guinea-pigs between basic proteins of human myelin and of human cancer tissue using an assay system other than the macrophage electrophoretic migration hitherto used to show this effect in man.

Adenoma, Bile Duct↗
PubMedDate not supplied

Missing quality of life data in cancer clinical trials: serious problems and challenges.

Measurement of quality of life (QOL) in cancer clinical trials has increased in recent years as more groups realize the importance of such endpoints. A key problem has been missing data. Some QOL data may unavoidably be missing, as for example when patients are too ill to complete forms. Other important sources are potentially avoidable and can broadly be divided into three categories: (i) methodological factors; (ii) logistic and administrative factors; (iii) patient-related factors. Logistic and administrative factors, for example, staff oversights, have proven to be most important. Since most QOL measurements require patient self-report, it is usually not possible to rectify the failure to collect baseline data or any follow-up assessments. There is strong evidence that such data are not 'missing at random', and cannot be ignored without introducing bias. Although several approaches to the analysis of partly missing data have been described, none is entirely satisfactory. Prevention of avoidable missing data is better than attempted cure. In July 1996, an international conference on missing QOL data in cancer clinical trials reported the experience of most major groups involved. This paper will serve as an introduction to the problem and provide an estimation of its magnitude, and approaches to its prevention and solution.

Bias↗