The different percentages of acid hydrolases released by peritoneal macrophages obtained from C57B1/6 mice injected i.m. with talc, carrageenan or 3LL cells, and also the demonstration that hydrolase secretion from in vitro macrophage monolayers of tumor-bearing mice undergoes a further increase when zymosan is added to the culture, strongly suggest the possibility that more than one membrane surface receptor is involved in the triggering of lysosomal enzyme release. Furthermore, there is evidence from the reported results that, besides immune complexes, neoplastic cells or their metabolic product(s) could act as inducers of the lysosomal enzyme secretion by macrophages.

Acetylglucosaminidase↗

PubMedDate not supplied

Continuous infusion fluorouracil in the management of advanced breast cancer: a phase II study.

AIMS AND BACKGROUND: The evaluation of unconventional schedules of well-known drugs represents a promising avenue in the search for new regimens with a better therapeutic index in metastatic breast cancer. In particular, protracted continuous infusion (PCI) of 5-fluorouracil (5-FU) has yielded interesting results in gastrointestinal malignancies and in breast cancer. METHODS: From March 1996 30 consecutive patients with heavily pretreated breast cancer were treated with PCI 5-FU at a daily dose of 250 mg/m2 by means of disposable elastomeric pumps until progression or toxicity. The median age was 54 years (range, 28-71) and median performance status was 1 (range, 0-3). All patients but four were pretreated with anthracycline-containing regimens or taxanes; the median number of chemotherapy lines was 3 (range, 2-4). Metastatic sites were predominantly visceral in 60% of the patient population. RESULTS: All 30 patients were evaluable for response and toxicity. The median duration of PCI was 20 weeks (range, 2-36 weeks). Two complete responses (7%) and eight partial remissions (26%) were observed, giving an overall response rate of 33%. The median duration of response was six months (range, 4-9 months). Stabilization was observed in seven patients (23%) with a median duration of seven months (range, 3-9 months). The main toxic effects were grade I-II mucositis and hematologic toxicity, while grade 3 hand-foot syndrome was observed in eight patients (27%). CONCLUSIONS: This study confirms the efficacy and safety of 5-FU at this dosage and schedule in heavily pretreated women with advanced breast cancer. In order to improve on these results further studies are needed in a less advanced stage of the disease and together with other active drugs.

Adult↗

PubMedDate not supplied

Fourteen-day infusion of ifosfamide in the management of advanced breast cancer refractory to protracted continuous infusion of 5-fluorouracil.

AIMS AND BACKGROUND: Ifosfamide is an active drug in advanced breast cancer. Short-term continuous infusion schedules have been evaluated with encouraging results. The aim of the study was to evaluate in patients with advanced breast cancer a 14-day infusion schedule previously tested at our center in soft tissue sarcomas. METHODS: From July 1998 to February 2000, 26 consecutive patients with heavily pretreated breast cancer, progressing during protracted continuous infusion of fluorouracil, were treated with ifosfamide at the dose of 800 mg/m2/day for 14 consecutive days by means of an elastomeric pump via an in-dwelling Groshong catheter. The median age of the patients was 52 years (range, 32-67) and median PS was 1 (range, 1-3). All patients were pretreated with anthracyclines or taxanes; the median number of chemotherapy lines in the metastatic phase was 2 (range, 1-4). Predominant metastatic sites wen soft tissues in 5 patients, lung in 6, liver in 7 and serosal cavities in 3. RESULTS: Twenty-four patients were assessable for response Two complete responses and 2 partial remissions were noted for an overall 16.6% response rate. The duration of response was 3+, 5, 8 and 10 months, respectively. Stabilization or mi nor response was observed in 2 more patients. The main tox ic effect was myelosuppression (grade 1-2 in 15 patients grade 3-4 in 4). Other toxicities included nausea in 14 patients (grade 3 in 2) and grade 1-2 vomiting in 2 patients. Hair lost or alopecia was universal. CONCLUSIONS: The regimen yielded some clinically useful re sponses with acceptable toxicity. Its evaluation in less ad vanced cases appears to be warranted.

Adult↗

PubMedDate not supplied

[The use of prosthetic materials placed intraperitoneally in the repair of large defects of the abdominal wall, reflections on a limited case series].

To evaluate the best prosthetic material in direct contact with intestinal loops in the repair of large abdominal wall defects, four cases were reevaluated and an extensive review of the literature was undertake to point out the pathophysiology of prosthetic materials in abdominal wall surgery. For its intrinsic features, Gore-Tex represents the best prosthetic material to locate intraperitoneally, but the slow foreign body reaction is responsible for postoperative complications (e.g. hematoma, seroma, dehiscence). Marlex should not be used in direct contact with intestine because of the risk of multiple fistulas, very difficult to treat, while, the intense foreign body reaction rapidly integrate the mesh into the abdominal wall. To treat large abdominal wall defects are now been proposed mixed prostheses (Gore-Tex in intraperitoneal location, Marlex at the exterior) and dual mesh Gore-Tex (two textures at different microporosity on each side of the mesh). Preliminary studies have shown the safety and utility of these prostheses.

Abdominal Muscles↗