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Biomedical subjects

H Y Yap

Publications and source records attributed to H Y Yap.

At least 55 records · Page 3Linked to original sources
PubMed1982

Treatment for meningeal carcinomatosis in breast cancer.

Forty breast cancer patients with meningeal carcinomatosis were treated with a combined program of whole brain irradiation therapy with intrathecal and intraventricular methotrexate and citrovorum factor rescue. Responses were seen in 26 patients (65%); 13 patients (35%) failed to respond. The median survival time for the responding patients was six months, and for the nonresponders, one month. Factors affecting response and survival included pretreatment spinal fluid glucose, protein, and duration of CNS-related symptomatology prior to onset of therapy. In contrast, pretreatment CSF tumor cell count, CEA and initial CNS functional status did not appear to have prognostic significance. The authors conclude that following intensive therapy there can be much improvement in the quality of life and disease-free survival in breast cancer patients with meningeal carcinomatosis.

Brain↗
PubMed1982

Adriamycin therapy by continuous intravenous infusion in patients with metastatic breast cancer.

Patients with metastatic breast cancer previously treated with non-Adriamycin containing chemotherapy were treated with Adriamycin at a dose of 60 mg/m2 administered as a continuous infusion through a central venous catheter. The duration of Adriamycin infusion was escalated by 100% increments from 24-96 hours, but the majority of patients were maintained on 96-hour infusions. Thirteen of 27 patients achieved objective response (1 CR, 12 PR), six improved, and eight failed to respond to Adriamycin. Administration of Adriamycin by infusion led to a decrease in the severity of nausea and vomiting, but had no effect on myelosuppression and alopecia secondary to Adriamycin. The cardiac toxicity of Adriamycin was reduced in patients who received maintenance therapy with 96-hour infusions of Adriamycin.

Adult↗
PubMed1982

Peptichemio versus melphalan (L-PAM) in advanced breast cancer.

Peptichemio is a polypeptide complex of L-phenylalanine mustard. Because of structural similarities between melphalan (L-PAM) and Peptichemio a prospective randomized study was done to compare the therapeutic efficacy of these two agents. After failing various combinations of doxorubicin, cyclophosphamide, fluorouracil, methotrexate, and vincristine patients with advanced breast cancer were randomized to receive either Peptichemio or L-PAM. Peptichemio was administered at 75-100 mg/m2 and L-PAM at 30-40 mg/m2 IV q 3-4 week interval. Of 56 evaluable patients, 28 received peptichemio and 28 received L-PAM. There were no objective responses in the L-PAM group, and disease stabilized in four patients (14%). The median duration of stable disease was three months (range, 3-4 months). In the peptichemio group seven patients (25%) achieved a partial remission, one patient (3%) achieved less than partial remission and three patients (11%) had stable disease. The median duration of response was six months (range, 5-7+ months) for responding patients and three months (range, 2-5 months) for stable disease. The major toxicity of both drugs was myelosuppression which was cumulative. In conclusion, peptichemio is an active agent in advanced breast cancer, but L-PAM is ineffective in previously treated patients with metastatic breast cancer.

Adult↗
PubMed1982

Cranial computed tomography of breast carcinoma.

Cranial computed tomographic (CCT) manifestations of brain metastases were reviewed in 304 patients with carcinoma of the breast. Metastases were demonstrated in 103 patients; 13 had other significant abnormalities. Single lesions were found in 55 (54%) patients (cerebral hemisphere, 48; cerebellar hemisphere, 4; pineal, 1; pituitary and optic chiasm, 1; vermis, 1) and multiple metastases were found in 48 patients. Continuity with bony metastases was seen in 4 patients. Prior to contrast infusion, 13 (12.5%) patients with metastases had a normal CCT, and 13 (12.5%) showed lesions of increased attenuation. All metastases demonstrated enhancement following contrast infusion; 74 (72%) had a zone of surrounding "edema." Histopathologic-CCT correlation was available in 54 patients. Precontrast, increased attenuation of metastases was associated with hemorrhage or calcification, or both. Calcification accompanied by necrosis was the result of previous treatment. Following therapy, 3 patients demonstrated lesions that were impossible to differentiate from metastases by CCT, but proved histologically to have no viable tumor cells present.

Adult↗
PubMed1982

Phase II trail of PCNU in refractory advanced breast cancer.

An evaluation of PCNU was carried out in 28 patients with extensively treated refractory breast cancer. The starting dose was 60 mg/m2 in 13 patients and 90 mg/m2 in 15 patients given intravenously every 6 weeks. The major side effect was myelosuppression, manifested mainly as thrombocytopenia. Nonhematologic side effects were minimal, consisting mainly of transient nausea. One mixed response was seen. Four patients had stable disease. PCNU demonstrated limited activity in advanced breast cancer and was not effective in the treatment of central nervous system metastases.

Adenocarcinoma↗
PubMed1982

Phase II trial of bruceantin in metastatic breast carcinoma.

A phase II evaluation of bruceantin was carried out in 15 patients with refractory metastatic breast cancer. All patients had received extensive prior therapy including adriamycin, cytoxan, 5-FU, methotrexate, and a vinca alkaloid. Except for two patients with stable disease, no complete or partial response was observed. Drug toxicity, mainly nonhematologic, was severe, with nausea, vomiting, mild hypotension, and fever being the most frequently encountered.

Adult↗
PubMed1982

Phase I clinical evaluation of 9,10-anthracenedicarboxyaldehyde[bis(4,5-dihydro-1H-imidazol-2-yl)hydrazone]dihydrochloride (bisantrene).

9,10-Anthracenedicarboxyaldehyde[bis(4,5-dihydro-1H-imidazol-2-y1)-hydrazone ]dihydrochloride (bisantrene) is one of a series of anthracenedicarboxyaldehyde compounds that has significant antitumor activity similar to that of doxorubicin in experimental mouse tumor systems. A phase I clinical study was conducted using a weekly x 3 schedule. Twenty-six patients with a wide variety of advanced malignant solid tumors received a total of 39 courses of the drug at doses ranging from 40 to 180 mg/m2/week x 3. Leukopenia was the dose-limiting toxic effect. Other toxic effects included malaise, which was observed in 49% of the courses, nausea and vomiting in 36%, fever in 21%, and phlebitis in 21%. No responses were observed in this study. For phase II studies, using this schedule, a starting dose of 150 mg/m2/week x 3 repeated every 4-5 weeks is recommended. In patients who have received minimal or no therapy, the starting dose should be 180 mg/m2.

Adult↗
PubMed1982

Potential cardiotoxicity with mitoxantrone.

Mitoxantrone is a promising new agent developed in an attempt to find drugs with a broad spectrum of antitumor activity and devoid of cardiotoxicity. In a phase II clinical trial for refractory metastatic breast cancer, we observed congestive heart failure in four of 31 high-risk patients either during or after treatment with this drug. This report calls attention to that observation, and recommendation is made that further evaluation of this agent include careful cardiac monitoring.

Adult↗
PubMed1982

Combination chemotherapy with continuous infusion vinblastine and peptichemio for patients with advanced metastatic breast cancer.

Forty patients with metastatic breast cancer were treated with a combination of continuous 5-day infusion vinblastine and peptichemio. All patients had received prior therapy with 5-fluorouracil, adriamycin, cyclophosphamide and methotrexate. Vinblastine was given at a dose of 1.2 mg/m2/day for 5 days. Following completion of the 5-day infusion vinblastine, peptichemio was given as a rapid I.V. injection at a dose of 60 mg/m2. Ten partial responses (30%) were observed among the 33 evaluable patients with a median time to treatment failure of 6 months. Myelosuppression, predominantly granulocytopenia, was the major toxicity resulting from this combination. The response rate of this combination is not better than that observed with continuous 5-day infusion vinblastine alone.

Adult↗
PubMed1981

Management of breast cancer patients failing adjuvant chemotherapy with adriamycin-containing regimens.

Sixty-two patients with breast cancer treated with Adriamycin-containing adjuvant chemotherapy developed recurrent disease. Four patients refused to take any form of systemic therapy at the time of relapse. Fifty-eight patients were managed with various treatment modalities, and of these 33 (57%) achieved on objective remission, 11 (19%) had stable disease and 14 patients (24%) did not respond to any form of therapy. Twenty-four patients received more than one treatment modality. Thirty-eight patients were treated with chemotherapy and 35 received endocrine therapy. Eight of 20 patients (40%) achieved objective remission upon retreatment with higher dose of 5-fluorouracil, Adriamycin, and cyclophosphamide at time of relapse, and seven of 18 patients (38%) treated with other chemotherapeutic agents showed objective remission. Fourteen of 35 patients (40%) achieved objective remission with hormonal therapies. The median survival from first relapse was 15 months for all patients, and was 25.7 months for responding patients. Survival was significantly longer in asymptomatic patients compared with those who were symptomatic from recurrent disease.

Adult↗
PubMed1981

Chemotherapy for postmastectomy lymphangiosarcoma.

Twenty-two patients with postmastectomy lymphangiosarcoma have been seen at M. D. Anderson Hospital during the past 20 years. Of these, 13 received chemotherapy, either regionally, systemically, or both. Six patients were treated with regional chemotherapy using either methotrexate alone, a combination of melphalan, nitrogen mustard, and actinomycin D, or a combination of melphalan with nitrogen mustard or actinomycin D; 3 achieved a partial or complete response. Eleven patients received 19 trials of systemic chemotherapy; one complete and seven partial responses were observed, giving an overall response rate of 42% (8/19). Responses occurred with 5-fluorouracil, methotrexate, a combination of vincristine, actinomycin D, and cyclophosphamide, and a combination of Adriamycin and dacarbazine with or without vincristine. The median survival time of the six patients who responded to at least one chemotherapeutic trial was 26.5 months compared with four months for the five patients who failed to respond. These data indicate that chemotherapy may play a significant role in the treatment of patients with this rare but distinctive tumor.

Adult↗
PubMed1981

Combination chemoimmunotherapy with FAC-BCG for metastatic breast cancer: the impact of CMF maintenance chemotherapy.

In an attempt to prolong the durations of remission and survival of patients with advanced breast cancer treated with the FAC-BCG protocol, we modified the CMF maintenance combination by increasing the dose of all three drugs and administering them intravenously. Eighty-five evaluable patients treated with this new regimen were compared with a recent historical control group of 105 evaluable patients treated with FAC-BCG and a lower-dose, oral CMF maintenance program. The overall (70% and 76%) and complete (16% and 19%) response rates were identical in these two groups. The median times to progression for all patients entered were similar too (13 months for both groups.). The durations of response were 17 months (PO-CMF) and 14 months (IV-CMF), not significantly different (P = .16). The durations of survival of the two treated groups were also very similar. After the administration of intensive FAC induction therapy, a high-dose, intravenous CMF maintenance program appears no better than a low-dose oral regimen. Other drug combinations consisting entirely of drugs not used in the induction regimen might be better choices for maintenance treatment

Administration, Oral↗
PubMed1981

Hepatic artery infusion chemotherapy: gastroduodenal complications.

Hepatic artery infusion chemotherapy is a recognized treatment of unresectable hepatic neoplasms. Because the arterial supply to the stomach and duodenum originates from the celiac and hepatic arteries, unavoidable infusion of the gastroduodenal and right gastric arteries may result in gastrointestinal complications. Of 174 patients (266 infusions) treated with hepatic artery infusion chemotherapy during a 12 month period, 18 developed severe dyspepsia. Ten of these 18 patients had gastrointestinal pathology documented by either endoscopy or upper gastrointestinal series; six had gastric ulcer and gastritis, two had duodenal ulcer, one pyloroduodenitis, and one pancreatitis. Endoscopically, the hepatic artery infusion chemotherapy-induced ulceration and gastritis were located in the distribution of the infused arteries. Radiographically, the gastric abnormalities ranged from typical benign ulcers to a pattern of multiple ulcerations with nodular fold mimicking malignancy. Angiographic correlation could be made on eight of the 10 patients. Vascular trauma, observed in five of these eight patients, seemed to contribute to gastrointestinal complications in hepatic artery infusion chemotherapy.

Adult↗
PubMed1981

Dihydroxyanthracenedione: a promising new drug in the treatment of metastatic breast cancer.

Thirty-one patients who had metastatic breast cancer extensively pretreated with combination chemotherapy, including doxorubicin, were tested with dihydroxyanthracenedione, 3 to 4 mg/m2 body surface area daily for 5 consecutive days every 4 weeks. Of 27 evaluable patients, one achieved a complete response and five had partial responses. Furthermore, responses were seen in patients who were refractory to doxorubicin, indicating a lack of cross-resistance between doxorubicin and dihydroxyanthracenedione. Acute drug toxicity was insignificant except for severe granulocytopenia at the dose level of 4 mg/m2 . d. The median duration of remission had not been reached, but was more than 26 weeks, with four of the six responding patients still in remission at last follow-up. We believe that dihydroxyanthracenedione has significant activity against refractory metastatic breast cancer and further evaluation is warranted.

Adult↗
PubMed1980

CSF carcinoembryonic antigen in meningeal carcinomatosis from breast cancer.

Levels of CSF carcinoembryonic antigen (CEA) were determined in 23 patients with breast cancer and meningeal carcinomatosis. Levels greater than 1.5 ng/mL were observed in 16 patients; seven patients had undetectable levels. The meningeal disease of seven patients with elevated CSF CEA levels completely responded to treatment, and their CSF CEA levels concurrently decreased. Two patients whose meningeal disease responded poorly to treatment had persistently elevated levels of CSF CEA. In two other patients, a rising CSF CEA level was detected before there was any other evidence of meningeal relapse. Serial measurement of CSF CEA may play an important role in the clinical management of meningeal carcinomatosis in patients with breast cancer.

Breast Neoplasms↗
PubMed1980

Chemotherapy for advanced male breast cancer.

An analysis of 29 chemotherapeutic trials in 18 male patients with advanced breast cancer disclosed an overall response rate of 44%. Most of these chemotherapeutic trials consisted of single-agent regimens, namely, fluorouracil, methotrexate, thiotepa, cyclophosphamide, and melphalan. Our data suggest that responsiveness of advanced male breast cancer to systemic chemotherapeutic agents is the same as that reported for advanced female breast cancer.

Antineoplastic Agents↗