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Biomedical subjects

H E Hynes

Publications and source records attributed to H E Hynes.

At least 37 records · Page 2Linked to original sources

A Southwest Oncology Group study on the use of a human tumor cloning assay for predicting response in patients with ovarian cancer.

A total of 211 patients with epithelial ovarian cancer (168 with tumors refractory to prior chemotherapy and 43 with no prior chemotherapy) from 33 different Southwest Oncology Group institutions had their tumors sampled and specimens shipped to two central laboratories for drug-sensitivity testing in a human tumor cloning assay. The 168 patients with a prior history of chemotherapy failure (median of four prior chemotherapeutic agents) were treated with the most effective agent(s) found in the cloning assay (23 patients), and those patients whose tumors did not form colonies in vitro or did not manifest any sensitivity to agent(s) were treated with a clinician's choice of agent(s) (101 patients). The remaining 44 of the 168 patients were not treated with chemotherapy because of deteriorating performance status or early death. The complete and partial response rate in patients treated according to assay results was 28% versus 11% for the patients treated according to clinician's choice (P = 0.03). There was no statistically significant difference in survival between the two options (6.25 versus 7 months, respectively). The 43 patients with no history of prior chemotherapy were all treated with standard combination chemotherapy, and their clinical response was compared with their in vitro sensitivity to the same agents. Overall there was a 100% true-positive rate and 100% true-negative rate for the seven evaluable patients. From these data the authors conclude that use of the human tumor cloning assay may increase the response rate but not the survival for selected patients with advanced chemotherapy-refractory ovarian cancer. The study is weakened, however, by the many steps of patient selection necessitated by inadequate tumor colony formation in vitro and the inability to treat all patients (because of early death or a rapid decline in performance status). The assay does appear to be worthy of additional study for predicting response to combination chemotherapy in patients without a prior history of chemotherapy. Finally the use of central chemosensitivity testing laboratories is feasible for testing in vitro predictive assays in a cooperative group setting.

Antineoplastic Combined Chemotherapy Protocols↗

Objective antitumor activity of acivicin in patients with recurrent CNS malignancies: a Southwest Oncology Group trial.

Acivicin (AT-125) is a glutamine antagonist with dose-limiting, schedule-dependent CNS toxicity and predictable CSF penetration after intravenous administration. Because of these properties, a trial in CNS malignancies was initiated. Thirty-two patients with recurrent or residual malignant astrocytomas were treated with AT-125. The majority of patients had glioblastoma multiforme (24) and had received prior nitrosoureas (21). The median age was 50 years, and Southwest Oncology Group (SWOG) performance status was 2. The major determinant of response was based upon radiologic criteria using computed tomographic (CT) scanning and/or magnetic resonance imaging (MRI) scans. The tumor mass was measured in two perpendicular planes, which yielded the largest cross-sectional area. Standard solid tumor criteria for response were used. All responding patients also had a stable or tapered dose of corticosteroids with stable or improved performance status and neurologic examination. There were four objective responses (12%): one complete remission (3 1/2+ years) and three partial remissions (57, 86, and 322 days). Two patients had improvement in disease that did not meet requirements for a partial remission. Toxicity was mild and primarily consisted of nausea, vomiting, and lethargy. Two patients were removed from study due to neurotoxicity (depression and hallucinations). The strict response criteria used in this trial were not those that have been used in testing other active agents such as carmustine (BCNU). We conclude that AT-125 has objective antitumor activity in malignant astrocytomas and warrants further study.

Adolescent↗

Phase II study of fludarabine phosphate in multiple myeloma. A Southwest Oncology Group study.

Thirty-one patients with multiple myeloma refractory to therapy or relapsing after response to initial therapy were treated with Fludarabine Phosphate utilizing a daily intravenous schedule for five consecutive days. There were no objective responses seen and only one patient showed clinical improvement. Myelosuppression manifest as leucopenia and granulocytopenia was the primary toxicity seen. Fludarabine Phosphate is inactive in previously treated myeloma patients when given by the daily intravenous route.

Adult↗

Phase II evaluation of aclacinomycin-A in advanced ovarian carcinoma.

Sixteen women with advanced epithelial ovarian carcinoma were treated with Aclacinomycin-A 40 mg/M2 given as a weekly infusion for four consecutive weeks followed by a two week rest period. All had failed prior chemotherapy. No responses were observed. Nausea and vomiting were the most frequent side effect. Myelosuppression was minimal. This dose and schedule of Aclacinomycin-A are not recommended for further trials in ovarian carcinoma.

Aclarubicin↗

A phase II trial of vinblastine in patients with advanced or recurrent endometrial carcinoma. A Southwest Oncology Group Study.

Forty-one patients with advanced or recurrent endometrial carcinoma no longer amenable to control with surgery and/or radiotherapy were entered into study. Five of these were ineligible for study. One eligible patient never received any treatment, another had no baseline information recorded; these were thus inevaluable. The remaining 34 patients received continuous infusion vinblastine (1.5 mg/m2) as a 24-h infusion daily for 5 days every 3 weeks. One complete and 3 partial responses were observed among these 34 patients, for an overall objective response rate of 12%. Two of these 4 responders are deceased, and 2 remain alive with disease at 18 and 22 months, respectively. The most common toxicity noted was leukopenia in 22 patients (65%); 12 (35%) of these had severe or life-threatening leukopenia (less than 2,000 WBC/microliter). Fourteen of the 34 (41%) experienced nausea and vomiting. Other adverse effects were less common. Overall, 15 of the 34 patients (44%) experienced severe or life-threatening toxicity. In this trial, continuous infusion vinblastine was toxic and had minimal to moderate efficacy at best. These facts suggest that the drug at the dose and schedule tested has no role in the management of advanced or recurrent endometrial carcinoma.

Adenocarcinoma↗

Hepatobiliary scintigraphy in patients receiving hepatic artery infusion chemotherapy.

Hepatic artery infusion chemotherapy is used in the treatment of certain selected hepatic tumors, especially metastatic adenocarcinoma of the colon. Chemical cholecystitis has been recognized recently as a complication of hepatic artery infusion chemotherapy. We performed hepatobiliary scans on ten patients receiving hepatic artery infusion chemotherapy. All ten patients had abnormal hepatobiliary scintigraphy. We present case reports of three patients with abnormal hepatobiliary scans who have required cholecystectomy for symptoms of chemical cholecystitis to illustrate the clinical, scintigraphic, and pathologic findings in these patients.

Adenocarcinoma↗

Ovarian carcinoma metastatic to breast.

We have described a case of ovarian carcinoma with bilateral breast involvement. In patients with a previous history of carcinoma who have a breast tumor, metastatic disease must be considered and the histologic features of the tumors compared. Therapy is focused on the primary site, though local treatment may be necessary. The presence of metastatic breast involvement generally indicates widespread metastases, and the prognosis is poor.

Antineoplastic Agents↗