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Biomedical subjects

M Markman

Publications and source records attributed to M Markman.

At least 361 records · Page 20Linked to original sources
PubMed1981

Spontaneous pneumothorax during adjuvant chemotherapy for soft-tissue sarcoma.

A 21-year-old man with fibrosarcoma of the left thigh, treated with adjuvant chemotherapy following surgery and radiation, presented with bilateral spontaneous pneumothoraces as the initial manifestation of metastatic disease. While the pathogenesis of this condition is uncertain, it is possible that in this patient drug-induced necrosis of peripherally located subclinical metastatic pulmonary nodules led to spontaneous pneumothorax.

Adult↗
PubMed1980

Definitive mapping of the immune response gene(s) for (T,G)-A--L to the I-A subregion.

Mice of strains B10, B10.A, B10.A(4R), B10.A(5R), and the new recombinant inbred strain B10.MBR (H-2 genotype Kb, Ik, Sk. Dq) were immunized with (T,G)-A--L and the primary (total and IgM component), and secondary antibody responses were measured by using radioimmunoassays. B10 and B10.A(5R) were high responders, whereas B10.A, B10.A(4R), and B10.MBR were low responders to (T,G)-A--L. Based on the genotypes of the strains utilized, the immune response gene(s) for (T,G)-A--L is located in the I-A subregion of the H-2 complex. The data are consistent with the concept that Ia antigens are Ir gene products.

Animals↗
PubMedDate not supplied

Second-line chemotherapy for refractory cancer: intraperitoneal chemotherapy.

Over the past decade intraperitoneal therapy in the management of ovarian cancer has evolved from a pharmacokinetic concept into a rationale treatment strategy for a specific subset of patients with this disease. Patients with small-volume residual ovarian cancer (microscopic disease only or macroscopic tumor with largest tumor nodule < or = 0.5 cm in maximum diameter) when treatment is initiated are reasonable candidates to be considered for this therapeutic strategy. At least for salvage platinum-based intraperitoneal therapy, a documented prior response to systemic cisplatin or carboplatin helps to define a patient population who would be anticipated to have the greatest opportunity to respond to a regional treatment approach.

Antineoplastic Agents↗
PubMedDate not supplied

Mediastinal fibrosis simulating residual Hodgkin's disease.

A 28-year-old male with nodular sclerosing Hodgkin's disease and massive mediastinal adenopathy was treated with combination chemotherapy and radiotherapy. Following 1,300 rads and six cycles of chemotherapy the patient was felt, on the basis of chest x-ray and CT scan, to have extensive residual mediastinal and intrapericardial involvement with tumor. At thoracotomy he was found to have markedly enlarged mediastinal lymph nodes with the normal tissue being replaced by dense sclerotic material without tumor. In Hodgkin's disease, CT scanning has proved to be an extremely valuable tool in assisting in staging and treatment planning. This case emphasizes, however, that one must be cautious in the interpretation of persistent abnormalities following curative therapy. Carefully selected patient information obtained from exploratory thoracotomy continues to be helpful in defining disease status.

Adult↗
PubMedDate not supplied

Long-term follow-up of a phase II trial of oral altretamine for consolidation of clinical complete remission in women with stage III epithelial ovarian cancer in the Southwest Oncology Group.

OBJECTIVE: This report provides follow-up progression-free survival (PFS) and median survival data for women who achieved clinical complete remission (cCR) from stage III ovarian cancer after first-line therapy and were treated with altretamine consolidation therapy. METHODS: Patients who enrolled in the SWOG 9326 study from September 1993 to July 1997 were required to have documented cCR from stage III ovarian cancer following front-line platinum-based therapy. Treatment consisted of 6 months of oral altretamine at 260 mg/m(2)/day for 14 consecutive days of a 28-day cycle. RESULTS: Ninety-seven of 112 enrolled patients were evaluable for efficacy. This report presents median 6.2-year follow-up, dating from study registration. Median PFS was 28 (95% CI: 19-43) months. Median PFS for patients with optimal disease was 45 (95% CI: 27-48) months and for patients with suboptimal disease was 17 (95% CI: 12-26) months. Twenty-six of 61 (43%) patients with optimally debulked lesions and 5 of 36 (14%) patients with suboptimally debulked lesions remained disease free. Median survival of patients with optimally debulked disease has not been reached; median survival of patients with suboptimally debulked disease was 39 (95% CI: 19-51) months. No treatment-related adverse events were reported during the follow-up period. CONCLUSIONS: Consolidation therapy with oral altretamine was generally well tolerated and associated with prolonged progression-free and overall survival in the Phase II setting.

Administration, Oral↗
PubMedDate not supplied

Consolidation therapy revisited: intravenous chemotherapy.

The administration of 'consolidation' therapy is designed to maximize the benefits achieved from primary chemotherapy, to both improve progression-free and overall survival. Paclitaxel is an excellent agent to consider for a consolidation strategy in ovarian cancer, based on its activity in the disease, its cycle-specificity, and the lack of serious cumulative toxicity (except for neuropathy). A recently reported randomized trial conducted by the South-west Oncology Group and the Gynecologic Oncology Group revealed that 12-monthly cycles of single-agent paclitaxel (175 mg/m2 over 3 h) improves progression-free survival (PFS), compared to 3-monthly cycles of the agent (median PFS: 28 months versus 21 months, P = 0.0023, and hazard ratio 2.31). Further exploration of consolidation/maintenance therapy in the management of ovarian cancer is indicated, focusing on agents that are easy to administer (eg, oral) and that result in limited cumulative toxicity.

Clinical Trials, Phase III as Topic↗
PubMedDate not supplied

Tirapazamine plus cisplatin in advanced or recurrent carcinoma of the uterine cervix: a Southwest Oncology Group study.

The objective of this study was to determine objective response and overall survival (OS) and progression-free survival (PFS) following cisplatin plus tirapazamine treatment in eligible consenting patients with metastatic or recurrent squamous or adenosquamous carcinoma of the cervix. Treatment consisted of intravenous tirapazamine, 260 mg/m(2), followed by cisplatin, 75 mg/m(2), every 21 days for six cycles. Of 56 registered cases, 52 were evaluable for toxicity. There were six grade 4 toxicities (anemia [three], dyspnea [one], neutropenia/granulocytopenia [one], and dehydration [one]). Fifty-three patients were evaluable for response, OS, and PFS. The 6-month OS rate was 56.6% (95% CI 43.3-69.9%). The objective response rate was 32.1% (4 complete [2 confirmed and 2 unconfirmed] and 13 partial [8 confirmed and 5 unconfirmed]). Higher response rates (16/34 [47.1%] vs 1/19 [5.3%], P= 0.0018) were observed in patients who had not previously received radiation-sensitizing chemotherapy, as were OS and PFS (13.9 vs 4.0 months, P < 0.0001; 5.3 vs 1.8 months, P= 0.01). The OS was considered too low to warrant further testing in this disease setting. Despite this, tirapazamine plus cisplatin was active in patients who had not received cisplatin previously. Prior use of radiosensitizing chemotherapy impacted response and survival significantly and should be considered in future clinical trials.

Adult↗
PubMedDate not supplied

Surgery alone or surgery with a combination radiation or chemoradiation for management of patients with bulky-stage IB2 cervical carcinoma.

The management of stage IB2 cervical carcinoma remains controversial. This retrospective review evaluates 47 IB2 cervical carcinoma patients treated with surgery alone (S), surgery plus postoperative radiotherapy (SR), or surgery plus postoperative chemoradiation (SRC). Median progression-free interval (PFI) was 70.3 months for the SR group (n= 21), 73.3 months for the SRC group (n= 15), and 33.5 months for the S group (n= 11). The survival rate was 76% for the SR group, 87% for the SRC group, and 55% for the S group. Overall 5-year survival rate for the three groups was 75%. Median follow-up for the patient population was 61.3 months. The number of the patient and the nonrandomized nature of this study preclude any definitive conclusions, but interestingly, the SRC and SR groups exhibited a substantially better PFI and overall survival compared to the S group. Selection bias does not appear to be a factor since patients in SR or SRC group were at greater risk for recurrence (eg, higher incidence of deep stromal invasion, parametrial involvement) than patients in the S group; yet, they still experienced superior PFI and overall survival. Further studies comparing postoperative irradiation and chemoradiation with these patients in a randomized phase 3 trial may be warranted.

Adenocarcinoma↗
PubMedDate not supplied

Progress in ovarian cancer research: proceedings of the 5th Biennial Ovarian Cancer Research Symposium.

Ovarian cancer remains the most lethal gynecological malignancy. The 5th Biennial Symposium overviewed the progress of ovarian cancer research over the last few years. Molecularly based technologies have allowed the identification of multiple biomarkers to aid in ovarian cancer diagnosis and treatment. Furthermore, data analysis systems evaluating the behavior of these markers have been designed. Therapeutic use of ovarian cancer protein markers has been fueled by the development of animal models that more closely simulate the pathogenesis of ovarian cancer, and multiple new therapies are being developed that may have impact against the disease. Finally, the design of clinical trials both for ovarian cancer treatment and prevention are key in advancing the science of ovarian cancer into the clinic. The need for strategies that would optimize patient participation in clinical trials is paramount.

Biomarkers, Tumor↗
PubMedDate not supplied

Ovarian cancer update: management challenges and advances.

BACKGROUND: Although less common than cervical or uterine cancer, ovarian cancer accounts for more deaths than the other two gynecologic malignancies combined. SUMMARY: Ovarian cancer produces few symptoms while confined to the ovary. A palpable ovary in a postmenopausal woman should arouse the clinician's suspicion. Most tumors have already spread at the time of the initial laparotomy and require chemotherapy. The standard regimen contains cisplatin or carboplatin plus cyclophosphamide; paclitaxel (Taxol) shows promise and will probably be incorporated into the standard regimen, as well. Estrogen replacement therapy is not contraindicated. The rate of relapse is high, even in women who have achieved a complete clinical response. If persistent disease is found at a second laparotomy, intraperitoneal chemotherapy may be appropriate in some patients. CONCLUSIONS: Because the patient's chance of survival is much better if the disease is discovered when it is still confined to the ovary, physicians should be alert to the possibility of ovarian cancer, particularly in postmenopausal women with vague abdominal complaints or with a palpable ovary.

Female↗
PubMedDate not supplied

Common complications and emergencies associated with cancer and its therapy.

BACKGROUND: As the incidence of cancer rises and as physicians treat it more aggressively, more patients will experience complications of cancer or of its therapy. OBJECTIVE: To review the pathogenesis, diagnosis, and treatment of the superior vena cava syndrome, malignant pericardial effusions, the syndrome of inappropriate antidiuretic hormone secretion, hypercalcemia, the tumor lysis syndrome, seizures, spinal cord compression, obstructive uropathy, infections, febrile neutropenia, bleeding, thrombocytopenia, and coagulopathies in patients with cancer. SUMMARY: In general, the best treatment for most of the complications of cancer is to successfully treat the cancer itself; if this is not feasible, palliative measures should be taken. The complications of treatment are well known and should be treated promptly when they arise if they cannot be prevented. CONCLUSIONS: Although treating the complications associated with cancer cannot always prolong the patient's life, it frequently can improve the quality of life remaining. Therefore, physicians who care for patients with cancer should anticipate these complications and treat them promptly when they occur.

Amphotericin B↗
PubMedDate not supplied

Realistic goals of cancer therapy: effective and humane care.

BACKGROUND: Cure is the ultimate goal of antineoplastic therapy, but currently available treatment falls short of this goal in many situations. OBJECTIVE: To present the general aims of antineoplastic treatment and to discuss specific examples. SUMMARY: The choice of therapy is influenced by the type of cancer, the extent to which it has spread, the effectiveness and toxicity of available therapy, the patient's performance status, the presence of symptoms, and the patient's preference. Goals of therapy include cure, prolongation of survival, improvement in quality of life, palliation of symptoms, and prevention of complications. CONCLUSIONS: Establishing the goals of therapy for a patient with cancer is an individualized process. Stopping to consider what one is trying to accomplish can help the physician give effective and humane care.

Adult↗
PubMedDate not supplied

Early recognition of spinal cord compression in cancer patients.

Spinal cord compression is a relatively common complication of a number of malignant diseases. Back pain is the presenting symptom in more than 90% of cases. Early recognition and prompt treatment, while the patient can still walk, are the most important factors in preventing permanent and debilitating neurologic dysfunction.

Back Pain↗