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Biomedical subjects

G Cocconi

Publications and source records attributed to G Cocconi.

At least 73 records · Page 4Linked to original sources
PubMed1986

Randomized comparison of 5-FU alone or combined with carmustine, doxorubicin, and mitomycin (BAFMi) in the treatment of advanced gastric cancer: a phase III trial of the Italian Clinical Research Oncology Group (GOIRC).

Eighty-two evaluable patients with advanced gastric carcinoma were randomized to receive either 5-FU alone or the combination of carmustine, doxorubicin, 5-FU, and mitomycin (BAFMi). Objective remissions were seen in 15% of the patients who received 5-FU alone and in 22% of the patients on the BAFMi regimen. The difference was not statistically significant. The median duration of objective remission (31 vs 40 weeks) was longer using BAFMi combination, and the median duration of survival, calculated in the 85 randomized patients, was slightly longer using 5-FU (28 vs 24 weeks). The differences were not statistically significant. It is concluded that there is no therapeutic advantage in using the BAFMi combination over 5-FU alone.

Adult↗
PubMed1985

Successful treatment of subacute cerebellar degeneration in ovarian carcinoma with plasmapheresis. A case report.

Subacute cerebellar degeneration is a rare complication of some neoplasms, and is generally resistant to therapy. A case of subacute cerebellar degeneration in a 50-year-old woman with a Stage II grade 3 serous ovarian adenocarcinoma is reported. The onset of the neurologic symptoms preceded the diagnosis of cancer and progressively worsened during and after four cycles of chemotherapy. A quick, partial improvement of the neurologic syndrome was documented after three weekly treatments with plasmapheresis. The contribution of circulating factors in inducing subacute cerebellar degeneration can be postulated. A trial using this new type of treatment should be performed in patients who have this therapeutically refractory clinical condition.

Acute Disease↗
PubMed1985

Aminoglutethimide in advanced breast cancer.

From July 1980 to June 1983, 61 postmenopausal women with progressive metastatic breast cancer were treated with aminoglutethimide, 250 mg 4 times daily, plus cortisone acetate, 25 mg twice daily. Of 51 evaluable patients, an objective remission was observed in 22 (43%) (partial remission in 19, complete in 3), stable disease in 14 (27%), and progressive disease in 15 (30%). The median duration of response was 60 weeks (range 12+; 94+). The response rate was higher when the dominant disease site was soft tissue (50%) or bone (56%) rather than viscera (29%). Side effects were common but usually slight and transient. Somnolence (69%), dizziness (41%), nausea (35%) and skin rash (27%) were the most frequent. Serum levels of gamma-GT, alkaline phosphatase and total cholesterol rose during aminoglutethimide treatment, whereas levels of uric acid and indirect bilirubin decreased. Aminoglutethimide plus cortisone acetate appears to be an active and relatively safe treatment in advanced breast cancer and may be recommended as second-line endocrine treatment.

Adult↗
PubMed1985

Relationship between estrogen receptor concentration and cytomorphometry in breast cancer.

This study aimed to evaluate the relationship between estrogen receptor (ER) concentration and cytomorphometric parameters in breast carcinoma. Primary breast cancer specimens were both imprinted on cytologic slides and submitted to ER determination with a dextran-coated charcoal method. Patients were stratified by ER levels ranging from 0 to greater than or equal to 200 fmol/mg protein. Measurements were performed on cytologic imprint technique smears in five cases from each ER strata, using a computer-assisted tracing device. Nuclear, cytoplasmic, and cellular parameters were measured on 50 cells per case. The cytometric findings were correlated with ER concentrations. A statistically significant correlation between decreasing area (P = 0.011), perimeter (P = 0.015), maximum diameter (P = 0.034), minimum diameter (P = 0.008), and volume (P = 0.01) of nuclei and increasing ER levels was found. With regard to whole cells, the following parameters significantly decreased versus increasing ER levels: area (P = 0.038), perimeter (P = 0.046), minimum diameter (P = 0.011), and volume (P = 0.044). A statistically significant relationship between the decreasing cytoplasmic perimeter (P = 0.025), i.e., nuclear plus cellular perimeter, and increasing ER content was found. Cytoplasmic area and nuclear to cytoplasmic ratio (N/C) did not correlate with the amount of ER. In all classes of different ER concentration, cells and nuclei displayed a regular shape closer to a circle than to an ellipse. The results of the current investigation indicate that tumors with higher ER concentration are composed of smaller cells with smaller nuclei than are tumors with lower ER content.

Breast Neoplasms↗
PubMed1985

[Results and limits of endocrine therapy of carcinoma of the breast].

This review of endocrine therapy in breast carcinoma has been prepared principally with the aim of listing many persisting controversies in this area, even if significant advances have been made after the hormone receptor determination became available. Endocrine treatments include those indicated in an adjuvant setting and in metastatic disease. Indications for adjuvant endocrine therapy are still uncertain, even if a better selection of patients and the use of a non-toxic drug such as tamoxifen made more rationale and safer this type of treatment. Uncertainty is related to some doubts concerning consistency of survival advantages and to the relationship between advantages possibly obtainable by endocrine therapy or by adjuvant cytotoxic chemotherapy. Endocrine therapy can be cautiously combined with chemotherapy in amy adjuvant setting, as detrimental effects have been reported in some subsets of patients. Indications for endocrine treatment are mostly related to advanced disease, where more favourable results can presently be obtained through a better selection of patients and by less toxic hormone manipulations which are now available. In advanced disease, a sequential use of endocrine therapy and chemotherapy, or vice versa, is preferable to a concurrent administration of both types of treatment. Only some particular clinical situations suggest the latter type of approach. Some uncertainties are still present about the criteria by which, in the sequence, priority should be given to either therapeutic modality.

Biopsy↗
PubMed1984

Problems in evaluating response of primary breast cancer to systemic therapy.

The evaluation of the response of primary breast cancer to systemic therapy is difficult. Evaluable primary lesions may be assessed both by physical and by mammographic examination. In this study, response to therapy was evaluated after 4 cycles of CMF or CMF plus tamoxifen in 49 patients with locally advanced breast cancer entering a prospective randomized trial. In 35 patients response was evaluated by both physical examination and mammography. In some cases there was disagreement between physical examination and mammography in quantifying the magnitude of response. In 8 of 35 (22.9%), the overall response was overestimated by physical examination versus mammography, while in 3 of 35 (8.6%) the reverse was true. Taking into consideration different criteria in attributing the overall response, i.e. selecting physical examination only, mammography only, or the most favorable or the least favorable response between the two methods of assessment, the objective remission rates were 65.7%, 54.3%, 71.4% and 45.7%, respectively. The data suggest that both physical examination and mammography should be used in evaluating the response of primary breast cancer to a systemic treatment. Should these two methods yield contrasting results, the data obtained with each method should be reported. The best observed response may be employed in determining the overall response.

Adult↗
PubMed1983

Chemotherapy versus combination of chemotherapy and endocrine therapy in advanced breast cancer. A prospective randomized study.

One hundred-forty-five postmenopausal women with metastatic breast cancer entered a prospective randomized trial comparing treatment A (cyclophosphamide, methotrexate, and 5-fluorouracil; CMF) with treatment B (the same chemotherapy plus tamoxifen; CMF plus T). Patients on treatment A had T added to CMF at the time of progression or relapse (second-line CMF plus T). One hundred thirty-three cases were evaluable. Considering response rate to first-line treatment, CMF plus T appeared to be significantly superior to CMF alone (74 versus 51%, respectively; P less than 0.01). Median time to failure to first-line treatments, considering all patients, was longer in CMF plus T than in CMF arm (48 and 24 weeks, respectively; P = 0.06). Considering patients showing objective remission, median duration of response to CMF was similar to that of CMF plus T (47 and 51 weeks, respectively). Twelve of 39 evaluable women treated with second-line CMF plus T showed objective responses (31%). Median time to failure to treatment procedures scheduled in arm A (CMF leads to CMF + T) was longer than that to treatment in arm B (CMF plus T) (56 and 48 weeks, respectively; P = 0.08). Median survival was longer in patients randomized to treatment A (111 weeks) than in patients randomized to treatment B (78 weeks), but this difference was not statistically significant (P = 0.25). It can be concluded from this study that a combination of endocrine therapy and chemotherapy is significantly more active than chemotherapy alone in inducing an objective remission. This strategy of treatment is advisable in situations urgently requiring a clinical response. However, as a sequence of chemical and endocrine therapy induced a longer time to development of progressive disease and a better survival, sequential therapy is advisable for common clinical use.

Adult↗
PubMed1983

A phase II study of cisplatin in advanced gastric cancer.

Twenty patients with recurrent or metastatic gastric adenocarcinoma and prior chemotherapy were treated with cisplatin, 60-120 mg/m2 as a 6-hr infusion repeated every 3 weeks. There were 4 partial responses in 18 evaluable patients. Seven patients had stable disease. Time to progression ranged from 6 to 28 weeks. Median WBC nadir was 3.2 X 10(3)/mm3 (range, 1.5-7.1) and platelet nadir 120 X 10(3)/mm3 (range, 13-220). A transient increase in serum creatinine was observed in 6 cases, and nausea and vomiting in all. We conclude that this drug is active in stomach cancer and that it warrants further trials in combination chemotherapy.

Adult↗
PubMed1982

A randomized trial of adjuvant chemotherapy and immunotherapy in cutaneous melanoma.

In a randomized trial of adjuvant chemotherapy, immunotherapy, or immunochemotherapy, 761 evaluable patients with pathological Stage II cutaneous melanoma anywhere on the body or with pathological Stage I melanoma of the trunk (Clark's level 3 to 5) were studied by the World Health Organization International Melanoma Group. Wide local excision and excisional regional lymphadenectomy alone were performed in 185 patients and the results were compared with those of surgery plus chemotherapy with dacarbazine (in 192 patients), surgery plus immunotherapy with bacille Calmette-Guérin vaccine (in 203), and surgery plus chemotherapy combined with immunotherapy (in 181). The rates of disease-free survival and overall survival at 36 months were 30.4 +/- 8.3 per cent (mean +/- S.E.) and 41.6 +/- 10.0 per cent, respectively, after surgical treatment alone; 37.2 +/- 7.9 per cent and 46.5 +/- 8.3 per cent after surgery plus chemotherapy; 34.8 +/- 7.9 per cent and 48.7 +/- 8.7 per cent after surgery plus immunotherapy; and 33.6 +/- 7.9 per cent and 50.0 +/- 8.8 per cent after surgery plus a combination of chemotherapy and immunotherapy. None of the differences between groups was significant, and thus no effect of adjuvant therapy could be demonstrated in this study.

BCG Vaccine↗
PubMed1982

N-(phosphonacetyl)-L-aspartate (PALA) in advanced breast cancer: a phase II trial of the EORTC breast cancer cooperative group.

Twenty-nine evaluable patients with extensively pretreated breast cancer received PALA, a new pyrimidine antimetabolite. The drug was given by intravenous infusion over 60 min, at a daily dose of 2.5 g/m2 for 2 consecutive days. Courses were repeated at 2-week intervals and doses were escalated to toxicity. Two objective partial remissions were observed, lasting for 3 and 4.5 months respectively. Toxic effects were dose-related and consisted mainly of mucocutaneous manifestations, i.e., skin rashes, stomatitis, diarrhea, conjunctivitis and corneal ulcerations. Evidence of antitumor potential in far-advanced disease and lack of myelosuppression point to the need for additional trials of PALA in a more favorable selection of patients with breast cancer.

Adult↗
PubMed1982

Randomized comparison of 5-FU alone or combined with mitomycin and cytarabine (MFC) in the treatment of advanced gastric cancer.

In a prospective randomized study, 53 patients with advanced gastric cancer previously untreated by chemotherapy were randomly assigned to treatment with 5-FU alone or combined with mitomycin and cytarabine (MFC). The response rate with MFC was higher (28%) than with 5-FU alone (21%). The difference, however, was not statistically significant. Median response duration was practically identical with 5-FU (16 weeks) and MFC (17 weeks). There was no difference in median survival between the two groups (39 and 43 weeks, respectively).

Aged↗