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J Bonneterre

Publications and source records attributed to J Bonneterre.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Topoisomerase I inhibitors. Review of phase II trials with irinotecan (CPT-11) and topotecan].

Topoisomerase I inhibitors are a new therapeutic class whose clinical evaluation began a few years ago; Irinotecan (CPT-11) gave interesting results in colon cancer; side effects were neutropenia, diarrhea, vomiting and a cholinergic syndrome. Topotecan was useful in lung and ovarian cancer; side effects were mostly hematologic. Undergoing studies concern dose optimization, mode of administration and therapeutic associations.

Antineoplastic Agents↗
PubMed1995

[Insufficient efficacy of the use of a single 8 mg tablet of ondansetron in the prevention of nausea and vomiting induced by FEC chemotherapy].

This study was performed in a group of 89 patients treated for breast carcinoma with a FEC regimen (5-fluorouracil, epirubicin, cyclophosphamide). The aim was to evaluate the antiemetic efficacy of one 8 mg tablet ondansetron (OND), and in case of failure, to measure the recovering level by the administration of 8 mg i.v. OND. One tablet of OND was given before the first course. A complete or major control of emetic episodes (EE) (0-2 EE) over the 24 first hours was obtained in 55 patients (62%). A complete or major control of nausea (absent or mild) was obtained in 46 patients (52%). A success, defined as a complete or major control for EE and nausea during the first 5 days, was obtained in 36 patients (40%). These 36 patients were treated again with 8 mg oral OND at the second course, with a success level of 61% (22/36). Among the 53 patients unresponsive to the oral OND, 38 were treated by 8 mg i.v. OND at the second course. A complete or major control for EE and for nausea over the first 24 hours was obtained respectively in 11 patients (29%), and 11 patients (29%). No success was obtained. The 15 remaining patients, who had a very bad tolerance at the first course were excluded from the study and treated by OND-methylprednisolon, with only one success obtained. This study shows that the exclusive use of one 8 tablet OND is not sufficient in prevention of emesis induced by a FEC regimen, and that failures are only partially recovered by the i.v. route.

Administration, Oral↗
PubMed1995

Presence of the two growth hormone receptor messenger RNA isoforms in human breast cancer.

In the present study, we have investigated specific growth hormone (GH) receptor gene expression in breast cancer cell lines and tissues. By Northern blot analysis, using a human GH receptor cDNA probe, the classically observed 4.7-kilobase GH receptor mRNA was evidenced in 2 of 29 cancer biopsies and in the MCF7 and T47-D cell lines. Reverse transcription coupled to PCR was used to amplify the GH receptor sequence encompassing a part of the extracellular domain as well as the transmembrane domain. An amplification product of the expected size (456 base pairs) was observed in 28 of 29 breast biopsies and in all the breast cancer cell lines studied (T47-D, MCF7, MDA-MB-231, and BT-20). The reverse transcription-PCR product was shown to be specific by Southern blot hybridization with the GH receptor cDNA probe and by specific cleavage of the amplified products with restriction enzymes. For the first time, the expression of GH receptor gene in breast cancer cell lines and biopsies is demonstrated in this study, suggesting a GH-specific action in tumor development. Additionally, the two isoforms of the human GH receptor (hGHR) mRNA, one containing exon 3 (hGHR-wt mRNA) and one excluding exon 3 (hGHR-d3 mRNA), were found to be expressed independently or simultaneously (29 tumors analyzed). The presence of hGHR-d3 mRNA appears to be patient specific, as demonstrated by comparing the expression pattern of both mRNAs between tumor biopsy and lymphocytes of the same patient.

Base Sequence↗
PubMed1995

Granisetron (IV) compared with ondansetron (IV plus oral) in the prevention of nausea and vomiting induced by moderately-emetogenic chemotherapy. A cross-over study.

The French Northern Oncology Group carried out a randomised, cross-over study comparing two anti-emetic treatment strategies in 150 chemotherapy-naive patients, receiving their first two courses of moderately-emetogenic drugs. Nausea and vomiting were assessed using a self-administered questionnaire for five days. Anti-emetic treatments consisted of granisetron (G) 3 mg intravenously (iv) before chemotherapy or ondansetron (O) 8 mg intravenously, followed by 8 mg orally every eight hours for the next three days (for a total of 9 tablets). No significant difference was detected between treatment regimens in terms of their ability to control either acute vomiting (no vomiting - G = 72%; O = 77%) or acute nausea (no nausea - G = 54%; O = 47%), nor in terms of the number of total responders, (no emesis and no nausea) on day 1 (G = 52%; O = 45%) or on days 1- 5 ( mean G - 37%; O = 32%). Furthermore, there was also no significant difference between patient preference for the two treatments, either with regard to efficacy (G = 39%; O = 34%) or tolerability (G = 29%; O = 27%). In conclusion, no difference was observed between the two treatments.

Administration, Oral↗
PubMed1995

Randomized trial comparing conventional intravenous bolus FEC and FEC with high-dose infusional 5-fluorouracil as first-line treatment of advanced breast cancer.

FEC (5-FU 500 mg/m2, epirubicin 50 mg/m2, and cyclophosphamide 500 mg/m2) administered as a conventional bolus schedule is widely used in treatment of advanced breast cancer. 5-FU is thought to be more efficient when administered at high doses as a continuous infusion. The aim of this study was to compare the response rate, time to treatment failure, and overall survival obtained with standard FEC regimen (group A) and FEC with high-dose infusional 5-FU (750 mg/m2 per day/days 1 to 5) (group B). One hundred and seventy-eight patients entered this study, 89 in each arm; 10 were noneligible. Both groups were comparable for age, performance status, menopausal status, hormonal receptor status and prior treatment of the initial tumor, duration of relapse free interval, and type and number of disease sites. One hundred and forth patients were evaluable for efficacy. The response rate was 33.3% in group A (1.4% complete response-CR), and 39.4% in group B (9.8% CR) (ns). In an intent to treat basis (n = 168) the response rates were 26.8% and 34.1%, respectively, in groups A and B (ns). The response rate in liver metastasis was significantly higher in group B (57.1%) than in group A (20.0%) (P = 0.03). The time to treatment failure and overall survival were not different between the two groups. One hundred and fifty-three patients were evaluable for toxicity. 10.7% of the patients in group A and 16.0% in group B stopped treatment due to toxicity. Stomatitis was more frequently observed in group B than in group A (46.7% versus 2.6%, respectively, p < 10(-9)). The rates of other side effects were similar in the two groups. In conclusion, the two regimens gave similar overall response rates, time to treatment failure and survival, but infusional 5-FU yielded a better response rate in the liver metastasis.

Adult↗
PubMed1994

[Antiemetic treatment and chemotherapy: general review].

Chemotherapy-induced nausea and emesis are frequent and patients fearful. Emesis caused by cytotoxic agents can be related to their effects on central chemoreceptor or on the gut chemoreceptor by serotonin. 5HT3 receptor antagonists produce a major improvement in the control of cisplatin induced-emesis (70 to 80% of patients). The 5HT3-antagonist efficacy is significantly better than metoclopramide alone, or antimemetic combinations in highly emetogenic chemotherapy regimens but less good in moderately emetogenic chemotherapy. Studies with 5HT3 receptor antagonist plus corticosteroids show advantage over 5HT3 antagonist alone. Comparison studies between the different setrons didn't show any significant difference. Anticipary emesis are treated with anxiolytic drugs. The prevention of delayed emesis, not yet well controlled by 5HT3 antagonist, is a great therapeutic deal. Finally, some therapeutic problems are not resolved: minimal dose, use of oral route, efficacy in fractionated chemotherapy, treatment after loss of efficacy of 5HT3 antagonist.

Antiemetics↗
PubMed1994

Vinorelbine (navelbine) as a salvage treatment for advanced breast cancer.

BACKGROUND: Vinorelbine (Navelbine), a new vinca alkaloid, is an effective drug in breast cancer. Our study was undertaken to assess the efficacy and tolerance of Navelbine in refractory advanced and/or metastatic breast cancer (AMBC). PATIENTS AND METHODS: One hundred heavily pretreated patients with AMBC entered the study and were scheduled to receive 30 mg/m2 of Navelbine weekly by a 20 min i.v. infusion with dose adjustments according to tolerance. All patients had previously received at least one chemotherapy regimen including an anthracycline for advanced disease. RESULTS: Sixteen of the 100 assessable patients responded (1 complete response and 15 partial responses), for an overall response rate of 16% (IC 95: 8%-23%). The median duration of response was 5 months (3-18). Responses were seen in lymph nodes (13/27), breast (11/34), soft tissue and skin (13/36), lung (3/14) and liver (2/25), but not in bone metastases. The main toxicities (WHO grade > or = 3) were granulocytopenia and anemia in, respectively, 51% and 9% of all 100 eligible patients. Thrombocytopenia and other non-haematological toxicities consisting of peripheral neuropathy, constipation, nausea/vomiting, alopecia and phlebitis were rare and mild. CONCLUSION: Vinorelbine is an active drug in AMBC, particularly in breast, lymph nodes and skin/soft tissue sites, with an excellent tolerance. Since the mean dose intensity was 19.7 mg/m2/week, a dose of 20 mg/m2/week is recommended for heavily pretreated patients (radiotherapy and chemotherapy).

Adult↗
PubMed1994

Is ondansetron cost effective?

5-Hydroxytryptamine3 (5-HT3) receptor antagonists are a major breakthrough in the prevention of nausea and vomiting induced by cancer chemotherapy. The acquisition cost of these drugs is considerably higher than for more conventional antiemetics. In this study, the authors reported on the economic consequences of giving ondansetron in Thomas Jefferson University Hospital, Philadelphia, USA. The study was divided into 3 parts. The first part was retrospective, and had the primary aim of comparing lengths of hospital stay and overall hospital costs for patients who had received intravenous ondansetron or standard antiemetic therapy. The purpose of the second part, which was prospective, was to determine the cost of emesis. In the third part, quality of life was studied; however, the results of this part were difficult to interpret because only 27 of the 52 selected patients completed the questionnaire, and only 4 of these patients received standard antiemetic therapy. In the retrospective study, costs were evaluated for patients who never received ondansetron, those who always received it, and those who received ondansetron during at least 1 hospital stay. In the prospective study, the costs associated with vomiting were nursing time, time required to obtain antiemetic therapy from the pharmacy, telephone calls to contact physicians, additional use of ancillary services, and laundry costs for soiled items. In the retrospective analysis, it was found that the average length of hospital stay for patients who were always given ondansetron was significantly shorter than for those who never received it.(ABSTRACT TRUNCATED AT 250 WORDS)

Antiemetics↗
PubMed1994

Taxol (paclitaxel) safety in patients with platinum pretreated ovarian carcinoma: an interim analysis of a phase II multicenter study.

The objective of this phase II, multicenter, prospective study was to evaluate the safety and the response rate of paclitaxel administered to patients with ovarian cancer. Eligible patients had histologically proven ovarian carcinoma and measurable or evaluable disease and had received at least one platinum-containing regimen and no more than three prior chemotherapy regimens. Paclitaxel was given as a continuous intravenous (i.v.) infusion over 3 hours every 3 weeks. Dose was determined by the number of prior chemotherapy regimens. Patients with one or two prior chemotherapy regimens received 175 mg/m2 (group A) and patients with three prior chemotherapy regimens 135 mg/m2 paclitaxel (group B) after premedication. Treatment was repeated every 3 weeks. An interim safety analysis for the first 99 evaluable patients, 72 treated with 175 mg/m2 and 27 treated with 135 mg/m2 paclitaxel, is reported here. Median number of courses analyzed per patient was four (range, 1 to 6) in the two groups, for a total of 393 courses evaluable for toxicity (286 in group A, 107 in group B). World Health Organization (WHO) grade 3-4 neutropenia was observed in 29.6% of courses in group A and in 23.3% in group B. Two group A patients, 1 at courses 3 and 4 and 1 at course 6, experienced WHO grade 2 fever or infection associated with a WHO grade 4 neutropenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Loss of efficacy of ondansetron-dexamethasone during successive courses in female patients receiving high-dose cisplatin.

This study was designed to evaluate the efficiency of the association ondansetron-dexamethasone during successive courses in 22 chemotherapy-naive female patients receiving a chemotherapy regimen including cisplatin at a dose of 100 mg/m2. The antiemetic treatment consisted of dexamethasone 20 mg i.v. and ondansetron 24 mg i.v. the day of chemotherapy, then ondansetron 8 mg per os every 8 hours for 5 days. A complete control of emesis with no or mild nausea was observed in 41% of cases on the first day of the first course, in 9.5% after the 3rd course. No patient experienced a complete response after the sixth. Similar results were obtained when nausea and vomiting were assessed on the worst day of D2 or D3. Our study shows that, as with other antiemetics, ondansetron-dexamethasone efficiency decreases with the number of courses.

Adult↗
PubMed1993

Response to chemotherapy after relapse in patients with or without previous adjuvant chemotherapy for breast cancer. The French Epirubicin Study Group.

The French Epirubicin Study Group undertook a retrospective study to evaluate the response rate at relapse, time to treatment failure, and overall survival according to previous CMF-type adjuvant chemotherapy in patients who had taken part in two successive clinical trials. The statistical significance of the comparisons was tested after adjustment for the factors that differed most between the two groups. Patients who had received previous adjuvant chemotherapy had a lower response rate (p = 0.03), a shorter time to treatment failure (p = 0.007), and shorter overall survival after relapse (p = 0.008); overall survival after initial diagnosis was not significantly different. With respect to patients with axillary node metastases at the time of diagnosis (N+ patients), those with previous adjuvant chemotherapy had a lower response rate (p = 0.01) and shorter time to treatment failure (p = 0.02), but overall survival after relapse and after initial diagnosis were not significantly different. This retrospective and descriptive study suggests that chemotherapy is less effective after relapse, as measured by response rate and time to treatment failure, in patients with previous adjuvant chemotherapy.

Adult↗
PubMed1993

Absence of germline mutations of exons 5 to 8 of the P53 gene in 26 breast cancer families from the north of France.

We looked for germline mutations of exons 5 to 8 of the P53 gene in 27 female patients from 26 families originating from the north of France who had breast cancer and at least one first degree relative also affected with breast cancer. Detection of the mutations was made by single strand conformation polymorphism analysis. No mutation was found in any patient, confirming that germline mutations of the P53 gene are very rare in familial breast cancer (apart from Li Fraumeni families).

Adult↗