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Biomedical subjects

F Cavalli

Publications and source records attributed to F Cavalli.

At least 253 records · Page 14Linked to original sources
PubMed1982

[Simultaneous or sequential hormono/chemotherapy and a comparison of various polychemotherapies in the treatment of metastatic breast cancer].

Since in the treatment of advanced breast cancer chemotherapy and the various hormonal manipulations seem recently to have reached a plateau of effectiveness when used alone, it is widely assumed that the combination of both treatment modalities could improve therapeutic results. The outcome is reported of a study encompassing 109 pre- and 297 postmenopausal evaluable cases with previously untreated metastatic breast cancer. The patients were randomized either to a concurrent chemo/hormonotherapy or to the hormonal treatment alone, chemotherapy being delayed until the occurrence of tumor progression. All patients were further randomized to 3 chemotherapy regimens (LMFP, LMP/FVP, LMFP/ADM) representing three different degrees of intensity. Pre-menopausal patients tend to live longer with the concurrent combination of both modalities, whereas postmenopausal patients fare better when chemotherapy is delayed until the occurrence of tumor progression with hormonotherapy alone. However, the differences in survival are statistically significant only in postmenopausal patients with a less aggressive tumor ("low-risk"). The more aggressive cytotoxic combinations elicit higher response rates than "minimal chemotherapy", but the differences translate only marginally into different survivals. These findings are discussed with regard in particular to their importance in establishing widely acceptable therapeutic rules for the treatment of advanced breast cancer.

Adult↗
PubMed1982

[Idiopathic splenomegaly: the preliminary stage of a malignant lymphoma? Report on 2 cases].

Two patients with splenomegaly and a mild degree of hypersplenism are presented. Both underwent diagnostic splenectomy and in both the histologic examination of the spleen disclosed follicular lymphoid hyperplasia. The clinical picture and histologic findings were compatible with the diagnosis of idiopathic splenomegaly. 33 months after splenectomy a non-Hodgkin lymphoma was diagnosed in one patient. The literature on idiopathic splenomegaly is reviewed and the high incidence of non-Hodgkin lymphoma in the follow-up of such patients is pointed out.

Adult↗
PubMed1982

Pharmacokinetics of VP16-213 given by different administration methods.

Plasma pharmacokinetics of VP16-213 were investigated after a 30-60 min infusion in 14 adult patients and six children. In adult the elimination half-life (T1/2 beta), plasma clearance (Clp) and volume of distribution (Vd) were respectively 7.05 +/- 0.67 h, 26.8 +1- 2.4 ml/min/m2, and 15.7 +1- 1.8 l/m2; in children 3.37 +/- 0.5 h, 39.34 +1- 6.6 ml/min m2, and 9.97 +/- 3.7 l/m2. After repeated daily doses no accumulation of VP16-213 was found in plasma. The unchanged drug found in the 24 h urine after administration amounted to 20-30% of the dose. In eight choriocarcinoma patients plasma levels of VP16-213 were measured after oral capsules and drinkable ampoules. The bioavailability compared to the i.v. route was variable, mean values being 57% for capsules and 91% for ampoules. In one further patient, with abnormal d-Xylose absorption results, VP16-213 was not detectable in plasma after the oral ampoule dose. Steady state levels investigated in three patients after 72 h continuous VP16-213 infusion (100 mg/m2/24h) were around 2-5 micrograms/ml. Levels of VP16-213 were undetectable in CSF after i.v. or oral administration.

Administration, Oral↗
PubMed1982

Pharmacokinetic approach to the selection of dose schedules for medroxyprogesterone acetate in clinical oncology.

The pharmacokinetic and bioavailability properties of medroxyprogesterone acetate (MPA) after single PO and IM doses in man were used as a basis to predict, on a theoretical pharmacokinetic basis, the blood level profile of the drug during repeated dose administration with various dosage schedules. Because of the unusually long-lasting depot effect of IM MPA, a different build-up process of blood levels is expected during repeated IM or PO administration, and this should be taken into account when dose schedules for use in clinical oncology are selected. As regards the IM route, dose schedules based on 4 weeks' treatment with daily injections of 500-1,000 mg followed by a maintenance therapy with 1,000 mg/week are suggested, since they permit rapid achievement and maintenance of relatively high plasma levels. A similar plasma level profile can be obtained with oral MPA provided that daily doses twice as large as the IM doses are given during the first month of treatment and continued during the maintenance period. The serum levels observed in 25 patients with advanced breast cancer treated with MPA given IM or PO according to various dose schedules and recent literature data are very close to the serum level profiles predicted on a theoretical pharmacokinetic basis.

Biological Availability↗
PubMed1982

Cisplatin and vindesine combination chemotherapy in advanced malignant melanoma: an EORTC phase II study.

Sixty-one evaluable patients with measurable advanced malignant melanoma received 4-week courses of a combination of cisplatin 100 mg/m2 as a 24-hr i.v. infusion on day 1 and vindesine 3 mg/m2 as an i.v. bolus on days 1, 8, 15 for two courses and every other week thereafter. Two patients achieved complete response for 46 and 81+ weeks respectively, eleven patients achieved partial response for a median of 17 weeks (range 8-26) and three patients had no change for 24 weeks or more. The overall response rate of 21% did not seem to be affected by prior chemotherapy or site of indicator lesions, soft tissue vs visceral. Myelosuppression, consisting essentially of leucopenia, required dose schedule modifications in 41% of the first two courses and 12% of the remaining courses, but never produced major complications. Non-hematologic toxic effects were prominent, especially nausea and vomiting, which were universal. Alopecia was seen in 71% of the patients, neuromuscular manifestations in 39%, diarrhea in 30%, renal impairment in 25%, mucositis in 12%, ototoxicity in 7% and phlebitis in 3%. These results do not suggest striking additive or synergistic antitumor activity of cisplatin and vindesine in advanced malignant melanoma, at least with the method of drug administration selected for this trial.

Adult↗
PubMed1982

Phase I trial of 4-demethoxydaunorubicin with single i.v. doses.

Sixteen adult patients with a variety of solid tumors entered a phase I trial with 4-demethoxydaunorubicin, a new analogue of daunorubicin. The drug was given as a single i.v. dose of 5-18 mg/m2 repeated every 3-4 weeks. Myelosuppression, especially leucopenia, was dose-limiting. Other toxic effects included mild to moderate nausea and vomiting. The maximum tolerated dose for ambulatory treatment was 18 mg/m2, and 15 mg/m2 every 3-4 weeks is proposed as a starting dose for phase II trials in solid tumors.

Adult↗
PubMed1982

Combination hormonotherapy with tamoxifen and fluoxymesterone in patients with advanced breast cancer relapsing on hormonotherapy.

33 patients were treated with a combination of tamoxifen and fluoxymesterone (10 mg t.i.d. each) after progression on prior hormonotherapy (HT). 6 of 22 patients (27%) exhibiting a partial response (PR) or stable disease (NC) on previous HT responded to the combination (median time to relapse 7 months, range 3.5 to 17+ months). 11 (50%) maintained NC (median duration 5 months, range 2% to 9.5 months). No response has been seen in 11 patients who experienced progressive disease during prior hormonal manipulation or who were not evaluable for response to prior HT. The overall response rate was 18% for the patient population as a whole (responders and nonresponders to previous HT), which most probably would be similar to the response rate if these patients received only fluoxymesterone.

Adult↗
PubMed1982

Which staging for malignant lymphomas?

The appropriate staging for malignant lymphomas continuous to be a matter of debate. In Hodgkin's disease the relative merits of different non-surgical procedures are becoming evident. Nevertheless some authors still advocate staging laparotomy with splenectomy in almost all patients up to stage III A disease. This procedure, however, seems already now questionable in many subsets of patients, which are in the process of being clearly defined. In spite of the complex nature of non-Hodgkin's lymphomas, our current knowledge permits adapting the staging to the characteristics of the individual patients and to the therapeutic plan.

Humans↗
PubMed1982

An evaluation of tamoxifen dose escalation in advanced breast cancer.

We escalated the dose of tamoxifen (TAM) to 30 or 40 mg daily in 23 patients who had experienced remission or stable disease (NC) under prior treatment with TAM 20 mg daily. One patient, whose bone and soft tissue disease had previously been stabilized under TAM 20 mg daily for 13 months, showed a partial remission (PR) lasting for 6 months. In 14 patients (64%) the disease remained stable for a median duration of 6 months (1.5-18+ mos.). Subjective improvement was noted in nine patients (39%), including the patient with PR and another one with progressive disease (PD). We conclude that dose escalation has no relevant activity in patients failing prior treatment with conventional doses of TAM.

Adult↗
PubMed1981

Phase II trial of cis-dichlorodiammineplatinum (II) in advanced malignant lymphoma: a study of the cancer and acute leukemia group B.

In a cooperative study of the Cancer and Acute Leukemia Group B, 27 evaluable patients with advanced malignant lymphomas were treated with 70 mg/m2 of cisdichlorodiammineplatinum(II) (cis-platinum) once every three weeks. All patients had received extensive prior therapy. Partial remission was obtained in two of eight patients (25%) with Hodgkin's disease, for six and 40 weeks, and in five of 19 (26%) patients with non-Hodgkin's lymphoma, for a median duration of six weeks. The major toxic effects were profuse vomiting and, to a lesser degree, myelosuppression. Nephrotoxicity was easily controlled. Cis-platinum is an active agent in lymphoma and should merit incorporation into combination therapy for recently diagnosed disease.

Adult↗
PubMed1981

[Chemotherapy of non-small-cell bronchial cancer with a combination of Cis-diamminedichloroplatinum (II) and VP 16-213].

In a phase II study 40 patients with non-small-cell lung cancer were treated with 100 mg/m2 cis-diamminedichloroplatinum (II) (DDP) i.v. on day 1, combined with VP 16-213 (VP) in a dose of either 80 mg/m2 daily i.v. on days 1, 2 and 3 or 120 mg/m2 daily by mouth on days 3, 4, 5 and 6. The course was repeated every 3 weeks. In 30 evaluable patients, 10 partial remissions were recorded with a median duration of 3 months. Eleven patients had stable disease and 9 showed progression under treatment. Leukopenia was more pronounced with intravenous administration of VP than with oral VP (median leukocyte nadir 2400/mm3 and 3700/mm3 respectively). Two patients had thrombocytopenia under 50,000/mm3. All patients suffered from moderate to marked nausea and vomiting. All patients had alopecia. Nine patients had serum creatinine elevations over 1.4 mg/dl. Six patients with renal toxicity were treated in one institution with incorrectly applied forced diuresis during DDP administration. DDP and VP are an active regimen for remission induction in non-small-cell lung cancer. Due to cumulative and marked gastrointestinal intolerance this regimen cannot be given over prolonged periods of time.

Adenocarcinoma↗