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Biomedical subjects

M Lopez

Publications and source records attributed to M Lopez.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

[Renal carcinoma: effective modulation of low-dose interferon-alpha and interleukin-2 with medroxyprogesterone acetate and 13-cis retinoic acid].

We report a case history of a patient with clear renal carcinoma. After surgical treatment of primary tumor patient had been treated with medium-high doses IL-2 and alpha IFN for lung metastasis and paraaortic nodes, without significant response. Subsequently, low doses alpha IFN/IL-2 produced a response, and further response have been obtained by the combination of low-doses alpha IFN/IL-2 plus medroxyprogesterone acetate and cis-retinoic acid. We can therefore conclude that in immunogenic tumors, such as renal cancer, various immunologic strategies are justified, also employing in combination drugs not active as single agents, or modifying doses and schedules.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

Production of human macrophages with potent antitumor properties (MAK) by culture of monocytes in the presence of GM-CSF and 1,25-dihydroxy vitamin D3.

Antitumoral macrophages (MAK) were obtained by the culture of human mononuclear cells in hydrophobic bags. From one cytapheresis, up to 10(9) mature macrophages could be purified by elutriation after one week of culture in IMDM medium in the presence of 2% human AB serum. These MAK cells were used for adoptive treatment in metastatic cancer patient with no dose-limiting toxicity. The present study aimed to improve the average MAK yield by addition of GM-CSF and of dihydroxy-cholecalciferol. The differentiated macrophages obtained presented higher antitumoral functionality in response to rh-IFN gamma than in their absence. These MAK presented all the differentiation antigens of cytotoxic macrophages compared to MAK cells differentiated in standard medium. They killed human tumor targets effectively in vitro at a low (1/1) effector/tumor ratio; furthermore, the antitumoral activity reached by MAK cells after IFN gamma activation appeared to be stabilized for several days.

Antigens, CD↗
PubMedDate not supplied

[Breast cancer: HER2 changes one's cards on the table].

Recently, preliminary results of several randomized studies using trastuzumab in the adjuvant or neoadjuvant treatment of HER2-positive breast cancer have been reported. In the neoadjuvant setting, patients have been randomized to receive either chemotherapy alone (Group I), 4 cycles of paclitaxel followed by FEC (fluorouracil, epirubicin, cyclophosphamide) fo 4 cycles, or the same chemotherapy with concomitant weekly trastuzumab for 24 weeks (Group II). Pathologic complete responses were 25% in Group I and 66.7% in Group II, showing a significant superiority of treatment including trastuzumab. Among several ongoing studies of adjuvant therapy with trastuzumab, NSABP B-31 trial and NCCTG N9831 trial compared a standard treatment of sequential AC (doxorubicin, cyclophosphamide) followed by paclitaxel to the same chemotherapy regimen in combination with weekly trastuzumab for 1 year. In a third study (HERA trial), patients were randomized to 3 arms following adjuvant chemotherapy: observation, triweekly trastuzumab for 1 year or for 2 years. Joint analysis of B-31 and N9831 trials and interim analysis of patients randomized to receive 1 year trastuzumab in the HERA trial, show a significant improvement in disease-free survival with chemotherapy combined with trastuzumab. Treatment has been generally well tolerated with acceptable cardiotoxic effects (< 4%). However, the short follow-up precludes any information about long-term side-effects. Overall, although the risk/benefit ratio is in favor of trastuzumab including regimens, the use of this monoclonal antibody in the neoadjuvant or adjuvant treatment of HER2-positive breast cancer, should be carefully discussed with the patient.

Antibiotics, Antineoplastic↗
PubMedDate not supplied

[Metastatic breast cancer: new chemotherapy regimens with taxanes].

Patients with breast cancer are frequently treated with anthracyclines and/or taxanes, which are among the most useful agents in this disease. Therefore, it is increasingly difficult to find active regimens in heavily pretreated patients. Gemcitabine is a cytosine arabinoside prodrug analog which shows significant activity, as single agent, in metastatic breast cancer. The combination of gemcitabine and taxanes is particularly valuable because of the different mechanisms of action of each drug and their non-everlapping toxicities. During the last years, we have carried out several trials with gemcitabine in combination with either docetaxel or paclitaxel. The combination of gemcitabine and docetaxel in 53 previously treated patients resulted in 53% response rate (RR) with a median time to progression of 7.5 months, and an overall survival of 16.5 months. When gemcitabine was combined with paclitaxel in a biweekly schedule in 34 evaluable patients with prior exposure to several chemotherapy regimens, RR was 53%. It was 50% in patients previously treated with docetaxel. Toxicity was generally mild to moderate. Paclitaxel plus gemcitabine given as an every 2-weeks schedule is a practical, well tolerated and active regimen in advanced breast carcinoma, which deserves further evaluation in less heavily pretreated patients.

Adult↗