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Biomedical subjects

J Verwey

Publications and source records attributed to J Verwey.

10 recordsLinked to original sources
PubMed1990

Chemotherapy as treatment of choice in extrapulmonary undifferentiated small cell carcinomas.

Extrapulmonary undifferentiated small cell carcinomas, especially those arising in the upper aerodigestive tract, form a group of neoplasms with a clinical behavior which resembles small cell carcinoma of the lung. In 11 patients treated by combination chemotherapy an objective response rate of 82% was achieved for a median duration of 8+ months. Median survival for all patients was 12 months. Long-term survival was observed in those patients with limited disease who achieved a complete response after chemotherapy followed by radiotherapy.

Adult↗
PubMed1988

Pharmacokinetics and toxicity of mitomycin C in rodents, given alone, in combination, or after induction of microsomal drug metabolism.

The pharmacokinetics of mitomycin (MMC) was studied in Wistar rats. Up to five half-lives, the plasma concentration-time curve was biphasic. The AUC changed linearly with increasing doses between 0.5 and 7.5 mg/kg, which corresponds to 0.2 and 3 times the LD50 value in rats. Most of the drug was metabolized, and only 1%-2% and 10%-15% of the dose was eliminated unchanged by biliary and urinary excretion, respectively. The AUC of MMC at the LD50 is slightly less than that reported for the human MTD. Inoculation of MMC together with 5-fluorouracil and doxorubicin did not change the terminal half-life of MMC but decreased the total body clearance and the volume of distribution. The lack of significant influence of phenobarbital and 3-methylcholanthrene pretreatment on the terminal elimination half-life suggests that microsomal drug-metabolizing enzymes inducible by these compounds do not play a decisive role in the in vivo biotransformation of MMC.

Animals↗
PubMed1987

Mitomycin C-induced renal toxicity, a dose-dependent side effect?

Mitomycin C (MMC) has been known to be nephrotoxic since 1971. Whether this side effect was dose-dependent is unknown, while data on incidence are scanty. The presently-reported prospective study was initiated with the objective to obtain more data on these subjects. Forty-four patients treated with MMC entered the study, 37 were evaluable. All patients were subjected to extensive serial laboratory tests to study renal function and to detect hemolysis or coagulation disorders. The results were evaluated per cumulative dose level. One patient developed a lethal hemolytic uremic syndrome after 40 mg/m2 MMC. None of the laboratory tests predicted this side effect. None of the other patients developed renal toxicity, while all laboratory tests remained within normal ranges. All available literature on this subject was also reviewed. Based on the results of the present study, as well as on the literature review, it is concluded that MMC-related renal toxicity is a dose-dependent side effect, occurring at cumulative dose levels of 30 mg/m2 or more. The incidence is likely to be less than 10%. Predictive laboratory test could not be indicated.

Adult↗
PubMed1987

Cyclophosphamide versus ifosfamide: final report of a randomized phase II trial in adult soft tissue sarcomas.

Ifosfamide (IFOS) 5 g/m2 and its parent analog Cyclophosphamide (CYCLO) 1.5 g/m2 were studied in a randomized phase II study, accruing 171 patients with advanced soft tissue sarcoma. Both drugs were administered as 24 hr infusions, every 3 weeks, with comcomitant Mesna 400 mg/m2 i.v. bolus 4 hourly X 9 doses. Twenty-four patients were ineligible and 12 were not evaluable. The groups were well matched for age, previous chemotherapy (42% of the total) or radiotherapy, the presence of distant metastases and performance status, but there were more females (59% vs. 45%) in the IFOS arm. Among the 68 evaluable patients receiving IFOS, there were 2 CR, 10 PR (overall response 18%), 27 SD and 29 PD. For CYCLO, the corresponding results in 67 patients were 1 CR, 4 PR (overall response 8%), 23 SD and 39 PD. Using the chi-square test the P values for response rate and linear trend were 0.13 and 0.04 respectively. Response rates were higher for females (20% vs. 5%, P = 0.01) and patients who had not received previous chemotherapy (19% vs. 4%, P = 0.01). Fourteen of the 17 responses came from a group of 43 females, who had not received previous chemotherapy, for whom the overall response rate was 37.5%. Remissions were noted in only 4 histological subtypes (centrally reviewed material), i.e., 5 of 17 synovial sarcomas, 7 of 13 mixed mesodermal sarcomas and 2 of 7 fibrosarcomas. One of the 31 leiomyosarcomas responded to Cyclophosphamide. Durations of response did not differ significantly between the 2 arms--median 26, range 10-81+ weeks. Leucopenia was significantly more severe on CYCLO, particularly in patients who had received previous chemotherapy (P = 0.007). Serious infections occurred in approx. 7% of patients with no difference between the two drugs, although there was one toxic death on CYCLO. Nausea and vomiting were significantly worse on IFOS and alopecia, related in extent to dose, was seen in both arms. Other side-effects, such as hematuria or rises in serum creatinine and encephalopathy, were infrequent and mild. A higher response rate with less myelosuppression suggests that IFOS may have advantages over CYCLO in combination therapy.

Adolescent↗
PubMed1986

The cold pressor test during radionuclide ventriculography: a feasibility study in cancer patients.

To monitor the use of cardiotoxic drugs, adequate assessment of myocardial function is required. Although serial radionuclide left ventricular ejection fraction (EF) studies allow a simple and rapid assessment of the myocardial function without risk or discomfort to the patient, they appear not to be sensitive enough. Determination of the EF during cold application may be more sensitive. In this study we tested the feasibility of the cold pressor test (CPT) in relation to EF determination in 23 cancer patients. Only minor side effects were recorded. The response of heart rate to cold was similar to the response reported in healthy volunteers and patients with coronary artery disease. In selected cases EF determination during CPT appeared to be more sensitive than EF at rest. EFCPT may be an attractive alternative for EFexercise in cancer patients who cannot perform enough exercise to stress cardiac function adequately, but for a more definite conclusion a prospective comparative study is required.

Adult↗
PubMed1985

Neuroepithelioma (neuroblastoma) arising in an adult. A case report.

Cytogenetic studies on neuroblastomas arising in children have revealed consistent abnormalities of the short arm of chromosome number 1. Partly because of the rare occurrence of neuroblastomas in adults, extensive cytogenetic studies in this group of patients have not been performed. We report a case of a neuroepithelioma (neuroblastoma) arising in a 50-year-old male patient. On chromosome analysis of a metastasis, a stemline with karyotype 47,XY, +der1 (1 qter---1 cen::1q21---1 qter) was identified. The possible consequences of this result and those of results previously reported in the literature are discussed.

Chromosome Aberrations↗
PubMed1984

Recovery from mitomycin C-induced hemolytic uremic syndrome. A case report.

Mitomycin C (MMC) is a cytotoxic agent that may induce a hemolytic uremic syndrome (HUS) with severe renal insufficiency. Of all reported patients with terminal renal failure only two survived with chronic hemodialysis. A patient with advanced gastric cancer in complete remission, who developed MMC-induced HUS, is reported; hemodialysis was necessary because of oliguria. Hemolysis subsided, and after addition of captopril renal function recovered partially. The patient is alive 6 months after discontinuation of hemodialysis. Recently she developed brain metastases. Symptoms of hemolysis did not recur. The pathogenesis and treatment of HUS are discussed.

Blood Transfusion↗