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A Zaniboni

Publications and source records attributed to A Zaniboni.

71 records · Page 4Linked to original sources

Estrogen and progesterone receptor guideline for tamoxifen therapy in chronic lymphocytic leukemia: a pilot study.

We studied estrogen and progesterone receptors (ER, PR) in 23 patients with chronic lymphocytic leukemia (CLL) and evaluated the results of this determination with other clinical and laboratory parameters. ER and PR activity was found respectively in 12 out of 23 (52%) and 6 out of 23 (26%) of the patients with a range between 2 and 23 fmol/mg protein (mean 10.3 fmol/mg) for ER and 18 and 92 fmol/mg (mean 41.8 fmol/mg) for PR. No correlations between ER/PR status and other parameters such as age, sex, stage, androgen and glucorticoid receptors (AR, GR), lymphocytic count or plasma estradiol and progesterone levels were noted. Seventeen consecutive patients out of 23 with a known receptor status and 1 with an unknown receptor status had been treated with tamoxifen 30 mg/day for 3 months. No objective response was achieved, despite some occasional reports of the literature.

Aged↗

Cytoxan, epirubicin, methotrexate and 5-fluorouracil with hormonal synchronization (tamoxifen/premarin) in advanced breast cancer. Preliminary results.

Thirty-three patients with advanced breast cancer were treated with combination chemotherapy and hormonal synchronization in an attempt to increase the overall response rate generally obtained with traditional modalities of treatment. Among the 31 evaluable patients 1 complete (3%), 7 partial (22%), 13 stable disease (42%) and 10 progression of disease (53%) were obtained. Side effects were quite manageable although there were two episodes of life-threatening hematological toxicity. Taking into account the poor prognostic characteristics of our patients (high percentage of dominant visceral disease, 21/31 previously treated patients), our preliminary results with this regimen are interesting and the treatment deserves further evaluation.

Adult↗

Estrogen and progesterone receptors in neoplastic cells of metastatic pleural effusion of breast carcinoma before and after tamoxifen therapy. Correlation with the clinical response.

We have investigated the activity of tamoxifen in 12 post-menopause patients affected by advanced breast carcinoma and, in this specific case, by metastatic pleural effusion. A receptor assay was carried out on all patients to assess the estrogen and progesterone receptor activity in pleural effusion tumor cells, cytologically confirmed. The assay was performed both at the moment of the diagnostic check and after a week of 30 mg/die of tamoxifen therapy. We obtained a temporary reduction of the pleural effusion in 5 patients out of 12 (42%). Four out of these 5 patients presented estrogen receptors (ER+) at the first assay. In the 4 patients with negative receptors (ER-) neither a decrease of the percentage of tumoral cells, nor a reduction of the effusion was ascertained. This study shows that also for pleural effusions tamoxifen's therapeutic benefit was obtainable only in those patients with estrogen receptors in the tumoral cells.

Adult↗

Treatment of advanced colorectal and gastric cancer with cisplatinum and 5-fluorouracil. A pilot study.

Eighteen patients with measurable advanced colorectal cancer and four with metastatic gastric cancer were treated with cisplatin 100 mg/m2 day 1 and 5-fluorouracil (5-FU) 1000 mg/m2 administered over 6 h i.v. infusion from days 2 to 5 every 21 to 28 days. Five out of 15 fully evaluable patients with colorectal cancer experienced a partial response (33%) while amongst the three evaluable patients with gastric cancer one complete and one partial remission were achieved. Both hematological and non-hematological side-effects were mild. Our preliminary results seem quite interesting and deserve further evaluation.

Adult↗

Decrease of granulocyte-macrophage colony-forming units during high dose medroxyprogesterone acetate treatment in advanced breast cancer.

We treated 18 post-menopausal women with advanced breast cancer with medroxyprogesterone-acetate 1000 mg p.o. daily. The study of granulocyte-macrophage colony forming units (GM-CFU) performed monthly, and peripheral white blood cell count showed an increase of granulocytes not statistically significant and a progressive decrease of GM-CFU that could protect marrow from chemotherapeutic agents or interfere with the myelosuppression of cytotoxic drugs.

Breast Neoplasms↗

Treatment of advanced breast cancer with 5-fluorouracil and high-dose folinic acid: preliminary results.

Twenty-eight patients with advanced breast cancer, all previously treated with hormonotherapy and/or chemotherapy, entered this study. Treatment was comprised of 5-day courses of folinic acid (200 mg/m2/day by i.v. bolus injection) and 5-fluorouracil, given immediately afterwards at a dose of 340-370-400 mg/m2/day according to toxicity. Cycles were repeated every 28 days. The remission rate was 60.7% (17/28): 10.7% CR (complete) (3/28), 50% PR (partial) (14/28), while 35% (1/28) had no change. Fourteen out of 23 patients previously treated with 5-FU also responded. The median duration of remission was about 6 months. Hematological toxicity was mild, while gastroenteric and ocular side-effects were important, even if not life-threatening. These data suggest that 5-FU combined with high-doses of folinic acid is effective in advanced breast cancer.

Adult↗

Remission continuation therapy for adult acute lymphoblastic leukemia. Preliminary results with a multidrug treatment protocol.

Twenty-four adolescent and adult patients with newly diagnosed acute lymphoblastic leukemia (ALL) were treated with the multidrug therapeutic program called IGG-74(9). Seventeen patients (71%) obtained a complete remission (CR) after induction therapy. They subsequently underwent a consolidation course with cytosine arabinoside and a seven drug maintenance regimen, lasting three years, with cyclophosphamide, 6 mercaptopurine, methotrexate, BCNU, adriamycin, vincristine and prednisone. The remission continuation treatment was well tolerated and produced an actuarial three-year disease-free survival rate of 57% and an overall median survival of 19 months. The efficacy of multidrug programs for the prevention of relapse in adults with ALL is discussed.

Adolescent↗

A phase II trial of ProMACE-CytaBOM in previously untreated non-Hodgkin's lymphoma of intermediate- or high-grade histology.

Between November 1985 and June 1989 the aggressive combination chemotherapy programme ProMACE-CytaBOM was used at a community-based hospital as primary treatment for non-Hodgkin's lymphoma (NHL) of intermediate or high-grade histology in Ann-Arbor stages IB-IV. The 53 patients entering the study represented 90 per cent of all consecutive eligible patients with NHL diagnosed during the time period considered. Their median age was 54 years and median observation time was 36 months. Of 50 patients evaluable for response, 35 (70 per cent) achieved complete remission (CR), seven (14 per cent) partial remission, and five (10 per cent) were refractory. Treatment was given on an outpatient basis. Actually delivered drug doses ranged from 88 per cent to 97 per cent of the theoretical doses. Life-threatening toxicity was experienced by four patients. Treatment was stopped in three cases (6 per cent) because of toxicity and there was one treatment-related death. Actuarial 2-year disease-free survival of patients in CR was 73 per cent. Overall actuarial 3-year survival and disease-free survival were 67 per cent and 51 per cent respectively. High LDH level was a significant adverse prognostic factor both for achievement of CR (P less than 0.005) and for survival (P less than 0.0002). Age was of no prognostic importance. We conclude that ProMACE-CytaBOM is an effective, easy to administer and well-tolerated regimen for patients with aggressive NHL.

Antineoplastic Combined Chemotherapy Protocols↗

The value of oxaliplatin in combination with continuous infusion +/- bolus 5-fluorouracil and levo-folinic acid in metastatic colorectal cancer progressing after 5FU-based chemotherapy: a GISCAD (Italian Group for the Study of Digestive Tract) cancer phase II trial.

AIMS AND BACKGROUND: The phase II trial was designed to evaluate the activity of combined oxaliplatin (L-OHP), continuous infusion (CI) +/- bolus 5-fluorouracil (5FU) and levo-folinic acid (I-FA) in patients with metastatic colorectal cancer progressing after one or more lines of 5FU-based chemotherapy. PATIENTS AND METHODS: We designed two contemporary studies: in the former we enrolled patients previously treated with 1 line of chemotherapy, and in the latter, patients previously treated with 2, 3 and 4 lines. Seventy-six consecutive patients were enrolled: 45 received L-OHP (85 mg/m2 i.v. 2 h on day 1) + I-FA (100 mg/m2 i.v. 2 h on days 1 and 2) + 5FU i.v. bolus (400 mg/m2 days 1 and 2) + 5FU (600 mg/m2 CI 22 h days 1 and 2 (FOLFOX 4); 31 received L-OHP (100 mg/m2 i.v. 2 h on day 1) + I-FA (250 mg/m2 i.v. 2 h on days 1 and 2), followed by 5FU (1500 mg/m2 Cl 24 h days 1 and 2 (FOLFOX 2). The treatment was recycled every 2 weeks and continued until progression and/or unacceptable toxicity or patient preference. The primary end point was activity (tumor growth control [TGC]: partial response [PR] + stable disease [SD]); the secondary end points were time to progression (TTP), overall survival (OS) and toxicity. RESULTS: Forty-five patients in 2nd line (22 FOLFOX 4, 23 FOLFOX 2), 23 (17 FOLFOX 4, 6 FOLFOX 2) in 3rd, 4 in 4th and 1 in 5th line were assessable; 3 were lost to follow-up. In 15 patients (11 FOLFOX 4, 4 FOLFOX 2), disease involved the liver only. A total of 533 courses were administered with a range of 1-14 in FOLFOX4 and 1-12 in FOLFOX2; dose intensity was 92.85%, and the total dose of the administered L-OHP was 98.29%. As a 2nd line treatment, FOLFOX 4 achieved TGC in 72.8% of the patients (PR, 18.2%; SD, 54.6%), with a median TTP of 6 months and a median OS of 7 months, whereas in the FOLFOX 2 group these figures were 78.3% (PR 21.8%, SD 56.5%), and 5 and 9 months. As a 3rd line treatment, FOLFOX 4 produced TGC in 41.1% of patients (PR 23.5%, SD 17.6%), with a median TTP of 5 months and median OS of 7+ months, whereas FOLFOX 2 obtained respective values of 50% (PR 16.7%, SD 33.3%), 7 and 9 months. As a 4th line of treatment, TGC was achieved in 2 patients (1 PR, 1 SD); the patient in 5th line therapy obtained a SD. With "de Gramont" as the first-line regimen, patients assessable were 24 in FOLFOX 4 and 18 in FOLFOX 2. In the former population, TGC was 70.8% (PR 37.5%, SD 33.3%), with a TTP of 6 months and OS of 10 months, whereas with FOLFOX2 these values were 61.1% (PR 5.6%, SD 55.5), 5 and 7 months. In patients with liver involvement only, FOLFOX 4 obtained TGC in 63.6% of cases (with a TTP of 7 months and OS of 6+ months), FOLFOX 2 in 100% (with a TTP of 9.5 months and OS of 13.5+ months). Both schedules exhibited an acceptable toxicity: neurologic, hematologic and hepatic grade 3 side effects occurred in a limited number of patients, with a higher frequency in the FOLFOX 2 group. CONCLUSIONS: Treatment with L-OHP, CI +/- bolus 5FU and I-FA was well tolerated. The activity in terms of TGC was interesting and comparable with results reported in the literature for the standard treatment for 2nd line, i.e. irinotecan alone. Treatment was effective in 2nd line and in patients previously treated with more than two chemotherapy lines; in particular, treatment was active in patients with hepatic disease only. Although the two schedules seemed to achieve the same benefit with the same tolerance, we could not define from the study the better regime.

Adult↗

Mitomycin-C and lonidamine as second-line therapy for colorectal cancer: a phase II study.

AIMS AND BACKGROUND: Recent preclinical data have suggested that lonidamine may potentiate the acitivity of mitomycin C in human colon cancer cell lines LoVo and HT29. STUDY DESIGN: A phase II study was carried out in 14 patients with advanced colorectal cancer pretreated with fluorouracil and folinic acid. Treatment consisted of lonidamine, 600 mg po, followed after 2 h by mitomycin, 20 mg/m2 by iv bolus, followed by lonidamine, 150 mg tio for 5 days; the cycle was repeated every 6 weeks. RESULTS: No objective response was seen. Three patients had stable disease; the median survival for the whole group was 4 months. Although hematologic toxicity was negligible, lonidamine-related side effects were moderate to severe in most patients and mainly represented by myalgia and gastric pain. DISCUSSION: Despite a sound preclinical rationale, this schedule of lonidamine and mitomycin C was ineffective and toxic in patients with advanced colorectal cancer. More experimental data about lonidamine are needed in order to design more effective regimens based on the combination of this interesting drug with other anticancer agents.

Adult↗

[Non-visual effects of light mediated via the optical route: review of the literature and implications for occupational medicine].

Artificial light which now plays an essential role in industrialized society differs from natural light both in intensity which is usually lower, and in spectrum, which is usually smaller. It is now a well-known fact that the human body is able to use luminous stimulation for aims other than sight; the pineal gland, though no longer directly sensitive to light as in lower animals, is nevertheless the fulcrum of a complex neuro-endocrine system which makes an interaction between light and the human body possible by means of the production of a number of substances of which melatonin is the most widely investigated. Melatonin is secreted at a circadian rhythm characterized by high nocturnal seric levels and low diurnal levels. This secretion appears to be correlated not only with the intensity of the light but also with its spectrum and time exposure. Even though the function of melatonin is still not fully understood, it seems possible to assign a mainly modulatory role to the pineal gland and melatonin. On the basis of studies performed on the pituitary-gonadal and/or hypothalamic axis and the reproductive system in animals, melatonin would appear to affect some endocrine functions (i.e., puberty) in man, too. Changes in melatonin secretion have been found in psychiatric illness, especially in cyclical affective disorders. Melatonin seems to be involved in stress-associated mechanisms, probably with an agonistic role, and also in carcinogenesis, where it seems to play a role in the growth of several tumors. Melatonin also affects both tumoral and cellular immune responses. Lastly, melatonin may be able to reduce the symptoms of the Jet Lag Syndrome. The consequences that prolonged and marked reduction in daylight exposure for occupational reasons could have on operators, especially young people, therefore constitute an interesting subject for occupational health; environmental photometry at the work-place, if adequately performed, could make a useful contribution to the development of this field of research.

Adolescent↗

Peptichemio, teniposide and high-dose dexamethasone: a new active combination for relapsing and refractory multiple myeloma. A pilot study.

Twelve patients with refractory (8 pts) and relapsing (4 pts) myeloma were treated with Peptichemio. Teniposide and high-dose dexamethasone. Eight patients experienced an objective response (5 out 8 with refractory and 3 out 4 with relapsing disease) with a median duration of 10+ months. Overall toxicity was mild to moderate and chiefly haematological. Our preliminary results seem very promising and justify a larger phase II study with this regimen.

Adult↗

Cyclophosphamide, epirubicin and cisplatin (CEP) in advanced breast cancer: preliminary results.

Twenty-five patients with advanced breast cancer were treated every 28 days with Cisplatin, 30 mg/m2 iv on days 1,3,5; Epirubicin, 40 mg/m2 iv on day 1; Cyclophosphamide, 200mg/m2 iv on days 1,3,5. Partial remission was achieved by 7 patients (33%), all of whom had been untreated with chemotherapy. Overall toxicity was moderate but manageable. Severe haematological toxicity was experienced by 5 patients (20%) with grade III anemia; 2 patients had grade II oral mucositis; 4 had grade II diarrhoea Moderate nausea and vomiting were seen in all patients. Although they are only preliminary, our results suggest that this treatment had considerable activity as first line chemotherapy in advanced breast cancer and deserves further evaluation.

Adult↗