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Biomedical subjects

F Boccardo

Publications and source records attributed to F Boccardo.

At least 109 records · Page 6Linked to original sources

Phase II study of tamoxifen and high-dose retinyl acetate in patients with advanced breast cancer.

Retinoids have shown a tumor growth inhibition and a synergistic activity with hormonal manipulations in human breast cancer cell lines and rat mammary carcinoma. To investigate the potential usefulness of this synergistic activity in human breast cancer, 33 postmenopausal patients with advanced disease were treated with the combination of tamoxifen (10 mg p.o. three times a day) and retinyl acetate (300,000 IU p.o. daily). Out of 31 evaluable patients, 3 achieved complete response, 9 partial response (overall response rate: 38.5%, 95% confidence interval = 21%-56%) and 16 (52%) showed no change. The median duration of response was 11.5 months (range: 3-19+ months), while the 2-year overall survival rate for the entire group of patients was 63%. Toxicity was generally mild, hot flushes, nausea (and/or vomiting), headache and cutaneous itching being the most frequent side-effects. Only 1 patient discontinued treatment for severe toxicity. These preliminary results suggest that the combination of tamoxifen and high-dose retinyl acetate is a safe and effective regimen for breast cancer patients. However, the study design does not allow us to establish whether the very low rate of early disease progression we observed might be related to a possible synergistic effect between retinoids and antiestrogens or rather to the quite indolent disease of the patients who have been selected for entry into this trial.

Aged↗

Role of blood groups as prognostic factors in primary breast cancer.

The role of blood groups as risk factors for breast cancer and their predictive value after radical surgery have been retrospectively evaluated in 315 breast cancer patients. The AB0 group distribution in these breast cancer patients was not significantly different from that of control women. Patients with blood group 0 showed a significantly lower risk of death than those with groups A, B and AB. Moreover, by using Cox's multivariate analysis, blood groups were shown to possess a predictive value independent of other known prognostic factors. These results suggest that also genetic factors could be involved in the pathophysiology of breast cancer growth and need to be further investigated.

Blood Group Antigens↗

Zoladex with or without flutamide in the treatment of locally advanced or metastatic prostate cancer: interim analysis of an ongoing PONCAP study. Italian Prostatic Cancer Project (PONCAP).

Since March 1987, 304 evaluable patients with stage C and D prostate cancer have been entered into a prospective trial comparing Zoladex and Zoladex plus flutamide. To date, there has been no significant difference in over-all and progression-free survival between the 2 treatment groups. However, combined treatment produced a higher response rate (particularly in stage D patients) and a more rapid normalization of abnormal prostatic acid phosphatase levels. In addition, more prompt relief of bone pain was evident in the Zoladex plus flutamide group. However, significantly more side-effects were associated with combined treatment. These findings should be considered with caution because they form an interim analysis, and follow-up time is short. The results do suggest, however, that there is no particular advantage in using a combination of Zoladex plus flutamide compared to adding flutamide on failure of treatment with Zoladex alone.

Aged↗

Chemotherapy versus tamoxifen versus chemotherapy plus tamoxifen in node-positive, estrogen receptor-positive breast cancer patients: results of a multicentric Italian study. Breast Cancer Adjuvant Chemo-Hormone Therapy Cooperative Group.

Between November 1, 1983 and June 30, 1987, 510 node-positive, estrogen receptor (ER)-positive breast cancer patients have been randomly allocated to receive either chemotherapy (six intravenous [IV] cyclophosphamide, methotrexate, and fluorouracil [CMF] courses followed by four IV epirubicin courses) or 5 years of tamoxifen treatment or a combination of both therapies. After a median follow-up of 40 months, patients receiving the combined treatment achieved the best results, and those treated with chemotherapy alone achieved the worst, the difference being particularly evident in postmenopausal women. However, while the concurrent use of chemotherapy and tamoxifen did improve the results achieved by chemotherapy alone, particularly in postmenopausal women and in those with four or more involved nodes, it did not significantly improve the results achieved by tamoxifen alone, particularly in patients with higher ER tumor concentrations. Side effects were more numerous and more severe in patients receiving chemotherapy (with or without tamoxifen). Our findings, although still preliminary, confirm that tamoxifen should be the treatment of choice for postmenopausal breast cancer patients with node-positive, ER-positive tumors. In addition, the findings suggest that tamoxifen may represent a safe alternative to chemotherapy (at least to the cytotoxic regimen we used) for younger women, provided they have ER-positive tumors. In patients with ER-positive tumors, the addition of chemotherapy to tamoxifen does not seem to improve significantly the effectiveness of tamoxifen alone.

Adult↗

Evidence for testicular impairment after long-term treatment with a luteinizing hormone-releasing hormone agonist in elderly men.

Testicular responsiveness to 5,000 IU of human chorionic gonadotropin was evaluated in 14 patients with prostate cancer who were being treated with a slow-release luteinizing hormone-releasing hormone agonist for a median of 21 months. Serum testosterone response to human chorionic gonadotropin was markedly reduced in most patients, with the median level increasing from 0.25 to 1.65 nmol. per l. A second human chorionic gonadotropin test was repeated later in 5 patients who had been off treatment for a median of 6 months. Median serum testosterone levels increased to a maximum of 2.6 nmol. per l. compared to 28.2 nmol. per l. in an age-matched control group (p equals 0.008). Therefore, we conclude that long-term treatment with luteinizing hormone-releasing hormone agonists in elderly men leads to gonadal impairment that may not be as reversible as generally suggested.

17-alpha-Hydroxyprogesterone↗

Recombinant alpha-2a interferon plus vinblastine in the treatment of metastatic renal cell carcinoma.

Twenty consecutive metastatic renal cell carcinoma patients were treated with a combination of recombinant alpha-2a interferon (18 X 10(6) U three times weekly) and vinblastine (0.1 mg/kg every 3 weeks). Two patients (10% response rate; 95% confidence limits 1.23-31.7%) achieved partial response and 11 (55%) stable disease. Toxicity was significant but always acceptable: most frequently, patients complained of fever and flu-like symptoms (18 of 19 patients), fatigue (18 of 19 patients), worsening in performance status (15 of 19 patients), and anorexia (15 of 19). The combination of recombinant alpha-2a interferon and vinblastine is active in renal cell carcinoma.

Adult↗

Epidermal growth factor in breast cyst fluid: relationship with intracystic cation and androgen conjugate content.

In recent years, several studies focused on the biochemical analysis of breast cyst fluid composition. It has been shown that breast cysts lined by apocrine epithelium contain higher levels of potassium and dehydroepiandrosterone-sulphate as compared to cysts lined by flattened cells, and that women with apocrine cysts are more likely to develop breast cancer. In the present study, we measured the intracystic levels of sodium (Na+), potassium (K+), dehydroepiandrosterone-sulphate (DHEA-S), and epidermal growth factor (EGF), a factor which could play a role in the autocrine or paracrine control of breast cancer cell growth as recently proposed by some investigators. Breast cyst fluids obtained by fine-needle aspiration from 86 women with gross cystic breast disease were assayed. On the basis of the relative intracystic concentrations of Na+ and K+ two main classes of cysts were defined. An arbitrary cut-off value of 3 for the Na+/K+ ratio seemed adequate to separate these two types of cysts. An inverse relationship was found between the Na+/K+ ratio and DHEA-S concentration, median levels of the androgen conjugate being 3615 micrograms/dl in Na+/K+ less than 3 cysts and 480 micrograms/dl in Na+/K+ greater than 3 cysts (P less than 0.001). EGF levels were found to be significantly higher in Na+/K+ less than 3 cysts as compared to Na+/K+ greater than 3 cysts: 103.26 ng/ml versus 57.22 ng/ml, respectively (P less than 0.001). EGF appeared inversely correlated with total protein concentration in the Na+/K+ greater than 3 cysts, while in the Na+/K+ less than 3 cysts high EGF levels were observed independently of total protein content. In addition, a direct correlation was found between EGF and DHEA-S concentrations. On the basis of these results, the hypothesis can be made that EGF, which is measurable in all breast fluids tested and is nearly undetectable in plasma, is actually produced by the epithelium lining the cyst wall, particularly as far as the Na+/K+ less than 3 cysts are concerned. In view of our results this type of cyst, which has been shown to be lined by apocrine epithelium, appears to be characterized by high DHEA-S and EGF levels. It is suggested that the latter finding could provide a clue for understanding the increased risk of subsequent breast cancer in women bearing apocrine cysts.

Adult↗

Hormone receptors in breast cancer: a conservative determination of receptors' presence in tumor tissue and ipsilateral normal mammary gland.

Estrogen (ER) and progesterone (PgR) receptors were evaluated in the tumor tissue (T) and in the mammary gland far from malignancy (D) in 36 breast cancers. Results were correlated with the pathological grading of the tumor and the axillary nodal status. It is suggested that a lower cancer malignancy with negative nodes and lower values of pathological grading (G1-G2) may be associated with a high level of ER in the mammary parenchyma far from the tumor (D).

Adult↗

Estramustine phosphate (estracyt) following androgens in men with refractory stage D2 prostate cancer.

Twenty-two orchiectomized men with progressive stage D2 prostate cancer were treated with a 3-week cycle of estramustine phosphate (EMP: from day 3 to day 21) and androgen priming (from day 1 to day 4). A partial response according to the NPCP-USA criteria was shown in 4 of 20 evaluable patients. Median progression-free survival of all patients was 24 weeks (range, 4-48) and median survival, 42 weeks (range, 4-112). Although in two cases treatment had to be stopped due to a marked increase in bone pain, no life-threatening side effects were observed. The androgen sensitivity of tumors was supported by the occurrence of increase in prostatic phosphatase and in bone pain in most patients. In this group of patients, androgen priming did not seem to potentiate the effectiveness of EMP, our results being comparable to those previously reported using EMP alone.

Aged↗

Long-acting (depot) D-TRP-6 LH-RH (Decapeptyl) in prostate cancer. An Italian multicentric trial.

Ninety-five patients with stage C (C1 + C2) or D (D1 + D2) prostatic carcinoma were treated with the long-acting formulation of D-TRP-6 LH-RH (Decapeptyl) for up to 39 months. Of 88 patients evaluable for response, about one-half showed an objective response. In most cases, subjective improvement with relief of bone pain and/or urinary symptoms was obtained. Five patients claimed a mild increase in bone pain and one patient a slight worsening of dysuria following the first injection. Median progression-free survival was 13.1 and 16.4 months in patients with stage D2 and D1, respectively. Median survival in stage D2 patients was 27.6 months. These results indicate that the depot formulation of D-TRP-6 LH-RH offers an effective therapeutic alternative for patients with advanced prostatic cancer.

Aged↗

Long-term results with a long-acting formulation of D-TRP-6 LH-RH in patients with prostate cancer: an Italian prostatic cancer project (P.O.N.CA.P.) study.

Ninety-five patients with stage C (C1 + C2) or D (D1 + D2) prostatic carcinoma were treated with the depot formulation of D-TRP-6 LH-RH ("Decapeptyl") for up to 33 months. Serum testosterone (T) levels were significantly reduced to castration levels within 4 weeks and maintained persistently low. Similarly, LH levels were decreased, although they remained in the normal range. Stimulation tests with either Gn-RH or HCG in course of treatment showed the achievement of a complete pituitary desensitization and almost a complete down-regulation of testicular LH receptors. Of 88 patients evaluable for response, about one-half showed an objective response. In most cases, subjective improvement with relief of bone pain and/or urinary symptoms was obtained without major side effects. These results indicate that the depot formulation of D-TRP-6 LH-RH offers an effective therapeutic alternative for patients with advanced prostatic cancer.

Acid Phosphatase↗

Alternating tamoxifen and medroxyprogesterone acetate in postmenopausal advanced breast cancer patients--short and long term endocrine effects.

The endocrine effects of alternating tamoxifen and medroxyprogesterone acetate have been evaluated in 26 post-menopausal patients with metastatic breast cancer. Endocrine evaluations included the RIA determination of plasma levels of sex-hormone binding globulin, follicle-stimulating hormone, luteinizing hormone, estradiol, prolactin, cortisol, and testosterone. The evaluation of the study parameters at different intervals during therapy indicates that with this schedule an alternate sequential effect on the endocrine system is achievable because each drug exerts its own endocrine activity that is completely reversed when the other drug is administered. We can hypothesize that the same alternate activity as seen on the endocrine system could be obtained also on other tissues and organs including tumors.

Breast Neoplasms↗

Priming action on progesterone receptor synthesis by estradiol and tamoxifen in the 7,12-dimethylbenz(a)anthracene-induced rat mammary carcinoma.

The priming action of estradiol and the antiestrogen tamoxifen (TMX) on progesterone receptor (PgR) synthesis has been investigated in the 7,12-dimethylbenz(a)anthracene-induced rat mammary tumor model testing different priming times. Rats received either TMX or estradiol benzoate (E2B) for 3 or 7 days. Tumors were assayed before and after treatment to investigate the changes produced by each treatment on estrogen receptor (ER) and PgR concentration. As expected, ER concentration decreased in each treatment group. PgR concentration increased after 3 days of either E2B or TMX administration, but decreased when treatment was prolonged to 7 days. These findings point out the time dependency of PgR induction in this tumor model, similarly to what was observed in other experimental and clinical conditions.

9,10-Dimethyl-1,2-benzanthracene↗