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Biomedical subjects

F Cavalli

Publications and source records attributed to F Cavalli.

336 records · Page 19Linked to original sources

Phase II studies of 4'-iodo-4'-deoxydoxorubicin in advanced non-small cell lung, colon and breast cancers.

The new anthracycline analogue, 4'-iodo-4'-deoxydoxorubicin (I-DOX), was administered at 70 mg/m2 as first chemotherapy in 61 patients with advanced NSCL (19), colon (20) and breast cancers (22). Treatment was repeated every 3 weeks; the dose was decreased to 60 mg/m2 (19% of the cycles) or increased to 80 mg/m2 (17% of the cycles) according to the granulocyte count nadir. Partial responses were observed in 6% of the patients with NSCL, in 5.5% of those with colon and in 10% of those with breast cancers. The main toxicity was a selective granulocytopenia characterized by a duration of about 1 week, and a high inter-patient variability. Non-haematological toxicities were mild. The negative results obtained in breast cancer might be related to the dose administered. Further studies in this tumour type should be performed with a more aggressive schedule.

Adult↗

Pentostatin (2'-deoxycoformycin, dCF) in patients with low-grade (B-T-cell) and intermediate- and high-grade (T-cell) malignant lymphomas: phase II study of the EORTC Early Clinical Trials Group.

Thirty-seven eligible patients with advanced non-Hodgkin's lymphoma of low-grade, T-cell intermediate- and high-grade histology were treated with pentostatin (2'-deoxycoformycin, dCF) 4mg/m2 i.v. weekly for 3 weeks and then every 14 days to be followed after 3 doses by the same dosage every 4 weeks until maximum response or progression. Only patients with no more than two chemotherapy regimens were entered in this trial. All patients had measurable disease, performance status of 1,0 and 2 and adequate bone marrow, renal and liver function. Five of 37 eligible patients experienced a partial response of 8 months' median duration (range 7-12). The response rate was 17% in low-grade, 8% in T-cell intermediate- and high-grade and 14% in cutaneous T cell lymphoma. The only eligible patient with Hodgkin's disease underwent progression while on treatment. One case presented with grade 3 leukopenia and another one died of septicaemia, possibly treatment-related. Elevated but reversible creatinine levels were observed in 13% of patients and conjunctivitis in 7%. The toxicity of dCF at this low-dose schedule was acceptable, but the therapeutic activity in pretreated patients with low-grade, T-cell intermediate- and high-grade and cutaneous T-cell lymphomas was limited.

Adult↗

A combination of cyclophosphamide, methotrexate, vincristine and VP 16-213 (NSC 141 540) in the treatment of bronchogenic carcinoma.

Thirty patients with bronchogenic carcinoma were treated with an 8-week induction therapy consisting of cyclophosphamide, methotrexate, vincristine and VP 16-213 (NSC 141 540). Those who achieved objective remission of tumor stabilization were then placed on an intermittent treatment schedule with the same drugs. Of the 30 patients, 17 had an objective response, 5 remained without change, and 8 progressed. Responses were more frequent among anaplastic (13/19) than epidermoid or adenocarcinoma (4/11). The toxicity consisted mainly of leucopenia, thrombopenia, alopecia, nausea and vomiting. The implications of these findings in the planning of further chemotherapeutic programs are discussed.

Alopecia↗

Angiotropic (intravascular) large cell lymphoma: case report and short discussion of the literature.

We report a case of angiotropic (intravascular) large B-cell lymphoma in an 84-year-old woman who underwent diagnostic procedures for progressive, painful induration of the legs. Physical examination and imaging studies revealed only widespread telangiectasias and significant panniculities-like lymphedema of the legs, with no masses or lymphadenopathies. The patient achieved a complete clinical remission after the first three cycles of polychemotherapy. Although angiotropic lymphoma is a rare entity with polymorphic clinical presentations, its early diagnosis appears very important since it may be curable with appropriate chemotherapy regimens.

Aged↗

Primary extranodal lymphoma of skeletal muscles: a report of four cases.

Approximately one-fourth of non-Hodgkin's lymphomas originate in extranodal sites. True primary involvement of soft tissues is quite uncommon and only a few well-documented cases are reported in the literature. We report four cases of primary skeletal muscle lymphoma. Three of the four cases presented with a diffuse large B-cell lymphoma. The clinical history of two cases confirmed that soft tissue masses should be promptly biopsied, since the differential diagnosis comprises benign lesions, as well as sarcoma, primary or metastatic carcinoma, melanoma and lymphoma. As lymphomas have to be treated primarily according to the tumour histology and disease extent, treatment of primary skeletal muscle lymphomas must be planned with these factors in mind. For patients presenting with diffuse large cell histology, a CHOP-like regimen alone or a combined modality with radiotherapy seem to be proper approaches.

Aged↗

Role of angiogenesis inhibitors in acute myeloid leukemia.

Neovascularization is increasingly recognized as an important factor in the pathogenesis of hematologic malignancies as well as solid tumors. The complex interactions between several cell types and numerous cytokine mediators suggest the involvement of autocrine and paracrine signaling mechanisms. Vascular endothelial growth factor (VEGF) in particular is critical to both stimulation of leukemic growth and proliferation of endothelial cells. Tyrosine kinase receptors specific for certain growth factors represent attractive target molecules for anticancer therapy. SU5416 is a competitive inhibitor of VEGF receptor subtypes VEGFR-1 and VEGFR-2 and stem cell factor receptor c-kit. Preclinical evidence shows that SU5416 effectively inhibits VEGF-induced endothelial cell proliferation and slows growth of subcutaneous solid tumor xenografts. This agent is in late-stage clinical trials in patients with solid tumors, and a Phase 2 study was recently initiated to evaluate its utility in the treatment of acute myeloid leukemia. In this Phase 2 study, investigators are seeking to determine the response rate to the antiangiogenic agent SU5416. Translational research in this study is intended to aid our understanding of the precise mechanisms by which SU5416 affects acute myeloid leukemia cells and the bone marrow microenvironment.

Acute Disease↗

Phase II trial of cis-dichlorodiammineplatinum(II) in advanced malignant lymphoma and small cell lung cancer: preliminary results.

In an ongoing cooperative study of the Cancer and Acute Leukemia Group B, 21 evaluable patients with advanced malignant lymphomas were treated with 70 mg/m2 of cis-dichlorodiammineplatinum(II) (cis-platinum) once every 3 weeks. All patients had received extensive prior therapy. Partial remission was obtained in two of seven patients with Hodgkin's disease, for 1+ and 7 months, and in three of 14 patients with non-Hodgkin's lymphoma, for 2, 2+, and 2.5 months. In another ongoing trial, 11 patients with advanced, pretreated small cell cancer of the lung received 80 mg/m2 of cis-platinum once every 3 weeks. Four patients achieved partial remissions. These lasted 2+ and 2.5 months in the two patients evaluable for duration of response. Two further clear-cut tumor regressions were noted. The major toxic effects were myelosuppression and vomiting. In the second trial, one case of probable drug-related fatal nephrotoxicity was encountered despite optimal forced diuresis with mannitol and furosemide. cis-Platinum definitely warrants further evaluation in these diseases because of significant effectiveness even after extensive prior treatment.

Adult↗

[CT whole body scanning in pulmonary oat cell carcinoma (author's transl)].

By study about 18 patients suffering from oat cell carcinoma of the lung with systematic analysis with CT over target-organs, the authors have verified a more careful evaluation, regards traditional radiological methods of probable metastatic lesions. This advantage may influence accuracy of treatment plane, but not the fatal, brief-term evolution of this affection.

Carcinoma, Small Cell↗

The best available adjuvant treatments are within the framework of clinical trials. The International Breast Cancer Study Group.

The International Breast Cancer Study Group (IBCSG, formerly the Ludwig Group) is currently conducting several trials to improve available adjuvant therapies for operable breast cancer. Within the framework of clinical trials, treatment is available for several subpopulations of patients with operable disease. Two trials for patients with node-negative breast cancer question the efficacy of the combination of chemotherapy and endocrine manipulation. Four trials for patients with node-positive disease investigate questions of chemoendocrine therapy and of delayed reintroduction of chemotherapy after an initial cytotoxic treatment. One trial for elderly patients investigates the role of axillary lymph node dissection in terms of treatment outcome and quality of life. The ongoing trials are based on the results of past investigations by the Group: seven clinical trials, conducted since 1978, tested hypotheses of timing, duration, and the combined use of chemo- and endocrine therapies. Several ancillary studies were conducted using the database amassed from these trials, including pathological findings in node-negative disease, significance of micrometastases detected by serial sectioning of axillary nodes, importance of c-erbB-2 oncogene expression for prediction of treatment responsiveness, patterns of relapse, and assessing the impact of adjuvant treatment for breast cancer on the patients' quality of life. This report presents updated results of the seven IBCSG trials conducted from 1978 to 1993 and describes the trials currently open to patient accrual.

Aged↗

Treatment of metastatic nonseminomatous testicular cancer: a preliminary report of induction chemotherapy followed by maintenance chemotherapy or radiotherapy.

Patients with metastatic nonseminomatous testicular cancer received an induction regimen consisting of bleomycin in 24-hour infusions and bolus iv doses of vinblastine followed by an Adriamycin and cis-dichlorodiammineplatinum(II) combination. Patients achieving complete remission after one or two cycles of this induction chemotherapy were then randomized to receive either radiotherapy (RT) to the previously involved tumor areas or maintenance chemotherapy (MCT) with CCNU, methotrexate, and vinblastine for 2 years. Among 62 evaluable patients, induction chemotherapy achieved 15 (24%) partial remissions and 35 (56%) complete remissions. Two patients with partial remission and single pulmonary metastases were rendered disease-free by surgical resection of residual tumor. Twenty patients received MCT and 15 received RT. To date, median survival is 10,8+ months in the MCT group with five relapses and 12.5 months in the RT group with two relapses. Toxicity in the induction phase was moderately severe with two drug-related deaths.

Antineoplastic Agents↗