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Biomedical subjects

K W Brunner

Publications and source records attributed to K W Brunner.

At least 127 records · Page 7Linked to original sources
PubMed1977

[Therapeutic results using VP 16-213 alone or in combination with 5-fluorouracil in liver cancer (hepatoma)].

The podophyllotoxin derivative VP 16-213 was used as monotherapy in 6 patients and combined with 5-fluorouracil in another 6. Of the 12 patients treated, 11 had measurable tumor criteria and 5 of these responded to treatment. These responses were attributed mainly to the effects of VP 16-213. Patients responding to chemotherapy lived significantly longer than non-responders. Each case of objective tumor response was accompanied by subjective improvement. In view of these results, a more active approach to the treatment of hepatocellular carcinoma would seem to be justified.

Adult↗
PubMed1977

[The CEA test and other immunological tests as disease course controls in gastrointestinal adenocarcinoma].

161 patients with adenocarcinoma of the gastrointestinal tract were studied to determine the value of the CEA test and a battery of non-specific immunological tests during the course of the disease. The ability of these tests to detect a tumor recurrence in radically operated patients was evaluated. A false negative preoperative CEA value was found in 40% of the patients with gastric carcinoma and 32% with colorectal carcinoma. Patients with a negative preoperative CEA value, and those with only slightly elevated values, had a distinctly better prognosis regarding initial operability and tendency to postoperative recurrence than patients with primarily markedly elevated values. With few exceptions, the development of distant metastases was detected earlier and more easily with the CEA test than by the usual routine follow-up methods. However, in the event of isolated local recurrence the CEA test was positive in only 1 of 5 patients. This reflects the direct correlation between tumor size and CEA elevation. The CEA test is a valuable supplement in the follow-up of patients with gastrointestinal carcinoma.

Adenocarcinoma↗
PubMed1977

[VP 16-213 in combination with endoxan, methotrexate and oncovin as polychemotherapy for bronchogenic carcinoma].

Thirty patients with bronchogenic carcinoma underwent an 8 week course of induction therapy consisting of cyclophosphamide, methotrexate, vincristine, and VP 16-213 (NSC 141 540). Those who achieved objective remission or tumor stabilization were then placed on an intermittent treatment schedule with the same drugs. Of the 30 patients, 17 had an objective response, 5 were unchanged and 8 progressed. Responses were more frequent in anaplastic carcinoma (13/19) than epidermoid or adenocarcinoma (4/11). The toxicity mainly consisted of leukopenia, thrombopenia, alopecia, nausea and vomiting. The implications of these findings in the planning of further chemotherapeutic programs are discussed.

Adenocarcinoma↗
PubMed1976

[First therapeutic experience with cis-platinum(II)diamindichloride (NSC 119875) in metastasizing ovarian and testicular carcinoma].

Ten patients with metastatic testicular or ovarian carcinoma were treated with cis-platinum II diaminedichloride. All had received prior chemotherapy with other agents. A therapeutic effect was seen in 7 cases, though it was of short duration in all instances. The drug proved to be very nephrotoxic and caused marked bone marrow depression. The future of this highly effective cytostatic agent, either with different dosage schedules or in combination with other drugs, is discussed. The possibility of new platinum derivatives with a better therapeutic index is also mentioned.

Adult↗
PubMed1976

Treatment of bronchogenic carcinoma with simultaneous or sequential combination chemotherapy, including methotrexate, cyclophosphamide, procarbazine and vincristine.

One hundred and eighteen patients with inoperable carcinoma of the lung were randomly selected for treatment with methotrexate, cyclophosphamide, procarbazine, and vincristine. These drugs were adminsitered simultaneously to one group of patients and sequentially to the second group. As the statistically sicame evident (51% vs. 21%), an additional 85 cases were treated in this manner without randomization. The objective clinical responses were associated with prolonged survival. A higher response rate with the simultaneous treatment was also evident in patients with anaplastic small cell carcinoma (65% vs. 36%) as well as those with epidermoid carcinoma (33% vs. 13%). These differences were not statistically significant. Toxicity remained within acceptable limits, with a 2% drug related mortality, and was similar in both treatment regimens. Initial performance status was definitely related to survival, but not to tumor response. Patients with epidermoid carcinomas showing stabilization of tumor growth under treatment had the longest survival. Maintenance therapy with continued four-drug polychemotherapy was not superior to single agent maintenance with cyclophosphamide.

Adenocarcinoma↗
PubMed1975

Bleomycin in testicular teratomas.

Bleomycin and its combinations have a definite place in the treatment of metastatic testicular carcinomas other than seminomas and may also prove to be effective, when given as adjuvant postoperative therapy in state II disease. A study, using the combination of Bleomycin and CCNU in 17 patients with metastatic testicular teratoma, is reported. A remission rate of 59% has been observed. Only patients with a complete remission had a satisfactory remission duration. Sequential combinations, using all drugs effective in this disease, may be the most promising way to further improve therapeutic results in terms of remission rate and survival.

Adult↗
PubMed1975

[The value of cooperative studies for the evaluation of new forms of therapy].

The principles of clinical therapeutic research that have evolved over the last few years are presented and illustrated with examples. The basis remains prospectively planned, controlled studies using standardized criteria for evaluation and documentation. Such studies are usually carried out cooperatively by several hospitals using a standard protocol. The principles underlying such studies are presented in detail, taking malignant lymphoma and acute leukemia as concrete examples.

Clinical Trials as Topic↗
PubMed1975

[Initial results with a epipodophyllotoxin derivative VP 16-213 in the treatment of acute leukemia].

Ten acute leukemia patients were treated with the new cytostatic agent VP 16-213. Almost all these patients had received previous therapy. One complete and two partial remissions were achieved, while one patient showed brief clinical improvement. VP 16-213 appears to be effective not only in acute monocytic leukemia, as therapeutic effects could also be observed in other forms of acute leukemia. VP 16-213 should further be tested in therapy of refractory acute leukemia patients as a drug of second choice. The relatively mild toxic effect of this substance and its special mode of action would appear to make it highly suitable for incorporation into combination chemotherapy regimes and further clinical trials.

Acute Disease↗
PubMed1975

A controlled study in the use of combined drug therapy for metastatic breast cancer.

Three prospectivelyly planned and controlled cooperative clinical studies in the use of combination drug therapy for metastatic breast cancer are reported. Each study contained two drug regimen arms. A total of 326 evaluable patients were treated with one of the five various drug combinations employed. As the number of drugs used in each regimen was increased from two to five, a concommitant increase in remission rates from 50% to 75% was observed. Remission duration of approximately 8 months and survival from the onset of treatment, however, remained relatively constant at 13 to 16 months in all drug regimens. Patients achieving tumor remission survived an average of three times longer than those with progressive disease under therapy. The results are correlated to patient age and predominant metastatic type. Subjective improvement was definitely related to objective tumor regression or stabilization. Treatment was relatively well tolerated and well applicable to outpatient care. Dosage adjustments were often necessary during the initial phases of therapy. Combined cystostatic drug therapy is highly effective in the prognostically worst forms of metastatic breast cancer, and is the treatment of choice for younger patients with visceral type metastases.

Age Factors↗