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Biomedical subjects

M Markman

Publications and source records attributed to M Markman.

At least 145 records · Page 8Linked to original sources
PubMed1996

Intraperitoneal chemotherapy in the treatment of ovarian cancer.

Over the past decade the intraperitoneal administration of chemotherapeutic agents has evolved from a pharmacokinetic concept into a rational treatment strategy for a selected group of women with advanced ovarian cancer. A recently reported large randomized controlled clinical trial has confirmed that the intraperitoneal administration of cisplatin is associated with superior efficacy and less toxicity than intravenous cisplatin in patients receiving initial chemotherapy for advanced small-volume residual ovarian cancer. Intraperitoneal chemotherapy is also a reasonable therapeutic option in women with very-small-volume residual disease following an initial response to a platinum-paclitaxel systemic chemotherapy programme. On the basis of the data available to date, further exploration of a role for intraperitoneal chemotherapy in the management of ovarian cancer is indicated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Intraperitoneal Therapy of Ovarian Cancer.

PURPOSE: This is a review of the rationale for the intraperitoneal administration of antineoplastic agents in the management of ovarian cancer. PATIENTS AND METHODS: Patients have been treated in a number of clinical trials to define the toxicity profile and efficacy of intraperitoneal therapy in this clinical setting. RESULTS: Phase I-II trials have confirmed that a number of cytotoxic and biological agents can be administered into the peritoneal cavity as treatment of ovarian cancer with an acceptable toxicity profile and with the attainment of surgically documented responses (including complete responses). In addition, a recently reported phase III trial comparing initial treatment of small-volume residual advanced ovarian cancer with either intravenous or intraperitoneal cisplatin concluded that the intraperitoneal route of drug administration was associated with a longer survival and less toxicity. DISCUSSION: In the salvage (second-line) setting, responses to intraperitoneally administered antineoplastic agents are seen principally in individuals with small-volume residual disease (largest tumor mass </= 0.5-1 cm in maximum diameter) who have previously responded to initial systemic treatment (i.e., documented chemosensitive cancers). Patients with cancers resistant to initial systemic chemotherapy or with larger tumor bulk should probably be treated by alternative strategies. Initial treatment of ovarian cancer with cisplatin delivered by the intraperitoneal route is a reasonable therapeutic option, based on currently available data. CONCLUSION: The intraperitoneal delivery of antineoplastic agents remains an interesting and potentially important management strategy for a select group of individuals (small-volume residual disease) with advanced ovarian cancer. Further exploration of a more defined role for this therapeutic approach in ovarian cancer is indicated

Journal Article↗
PubMed1996

Supportive care.

Explore the source record for details and available documents.

Antiemetics↗
PubMed1996

Ifosfamide in the treatment of ovarian cancer.

Ifosfamide has been assessed in the treatment of ovarian cancer for more than two decades. The drug possesses well-documented but modest activity (10% to 15% range) in women with platinum/alkylating agent-resistant ovarian cancer. A potentially important ongoing clinical trial is attempting to define the level of activity of ifosfamide administered in the salvage setting to patients with advanced ovarian cancer who have been previously treated with a platinum drug plus paclitaxel but not an alkylating agent.

Antineoplastic Agents↗
PubMed1996

Continuous subcutaneous administration of mesna to prevent ifosfamide-induced hemorrhagic cystitis.

Hemorrhagic cystitis is a major potential toxicity of ifosfamide that can be prevented by administering mesna along with the cytotoxic agent. Mesna is generally administered by the intravenous route, although experience with oral delivery of the drug has increased. The continuous subcutaneous administration of mesna has the advantage of not requiring intravenous access. In addition, subcutaneous delivery of the neutralizing agent will not be associated with the risk of inadequate urinary mesna concentrations, such as in a patient taking oral mesna who experiences severe ifosfamide-induced emesis and is unable to absorb the drug. Limited clinical experience with continuous subcutaneous mesna administration suggests it is a safe, practical, and economic method of drug delivery that permits ifosfamide to be administered successfully in the outpatient setting.

Administration, Oral↗
PubMed1996

Cancer chemotherapeutic agents.

Clinicians, in general, must understand the causes, methods of prevention, management principles, and complications of cancer therapy. They must recognize that patients with cancer require multidisciplinary treatment and coordination of care. The oncologist who manages the patient's care must involve the oral health care provider before the initiation of chemotherapy. The oral health care provider must recognize that cancer chemotherapeutic agents are not selectively tumoricidal and may produce adverse effects by direct toxicity at the cellular level or indirectly, characterized by myeloimmunosuppression, and has the obligation to deliver quality care, competently and timely before, during, and after cancer chemotherapy.

Antineoplastic Agents↗
PubMed1995

The immunohistochemical localization of the non-specific lipid transfer protein (sterol carrier protein-2) in rat small intestine enterocytes.

A 13 kDa protein was isolated from rabbit small intestine brush-border membrane vesicles that was postulated to be involved in intestinal phosphatidylcholine (PC) and cholesterol uptake. This protein has cholesterol and PC-transfer activity in vitro (Turnhofer, H. et al. (1991) Biochim. Biophys. Acta 1064, 275-286) and has a molecular mass and isoelectric point similar to that of the non-specific lipid transfer protein (nsL-TP, identical to sterol carrier protein-2). In addition, the first 28 N-terminal amino acid residues of the 13 kDa protein are nearly identical to nsL-TP from different species (Lipka, G. et al. (1995) J. Biol. Chem. 270, 5917-5925). In view of its possible role in intestinal lipid absorption, the localization of nsL-TP in rat small intestine was investigated using immunohistochemistry and immunoblotting. It is shown that nsLTP is predominantly localized in a subapical zone of the enterocyte but not in the brush-border membrane, thereby excluding a role in lipid uptake of this protein at the level of the plasma membrane. nsL-TP co-localized with the peroxisomal marker PMP70, underscoring earlier observations that nsL-TP is a peroxisomal protein. nsL-TP was found to be present along the entire length of the small intestine. The 58 kDa cross-reactive protein that was recently identified as a peroxisomal thiolase was shown to be present only in a small segment approximately halfway down the jejunum. The close apposition of the peroxisomes with the apical membrane and the discrete distribution of the 58 kDa protein may indicate that these organelles play a role in the intracellular processing of absorbed lipids.

Amino Acid Sequence↗
PubMed1995

Phase I feasibility and pharmacologic study of weekly intraperitoneal paclitaxel: a Gynecologic Oncology Group pilot Study.

PURPOSE: This study was designed to define the maximum-tolerated dose (MTD) and pharmacology of paclitaxel administered by the intraperitoneal (IP) route on a weekly schedule. PATIENTS AND METHODS: Thirty-three patients with residual ovarian cancer following standard chemotherapy were entered onto this phase I trial. Patients were treated weekly with IP paclitaxel administered in 2 L of normal saline following premedication. Patients with nonassessable disease received 16 weekly courses. The initial dose level was 20 mg/m2/wk. There was no intrapatient dose escalation. RESULTS: Multiple grade 2 toxicities were observed at the 75-mg/m2/wk dose level. These toxicities included abdominal pain, nausea, vomiting, leukopenia, and fatigue. One episode of grade 4 vomiting thought to be secondary to a transient partial small-bowel obstruction occurred at this dose level. At dose levels > or = 60 to 65 mg/m2, pharmacology studies documented the persistence of significant IP paclitaxel levels 1 week after drug administration, suggesting very slow peritoneal clearance and continuous exposure of the peritoneal cavity to active concentrations of paclitaxel. Low plasma paclitaxel concentrations were detected in the majority of patients treated at dose levels > or = 55 mg/m2. CONCLUSION: Paclitaxel can be delivered by the IP route on a weekly schedule with both an acceptable toxicity profile and a major pharmacokinetic advantage for cavity exposure. The recommended dose and schedule for phase II study of IP paclitaxel is 60 to 65 mg/m2 weekly.

Adult↗