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Biomedical subjects

M Marty

Publications and source records attributed to M Marty.

At least 91 records · Page 5Linked to original sources
PubMed1995

Phase II randomized study of paclitaxel versus mitomycin in advanced breast cancer.

Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has been shown to be an effective agent in the treatment of metastatic breast carcinoma. This multicenter randomized study compared paclitaxel 175 mg/m2 given as a 3-hour infusion every 3 weeks with mitomycin 12 mg/m2 given as an intravenous infusion every 6 weeks. Eighty-one patients have been randomized, and preliminary results of a planned analysis of the first 36 evaluable patients per arm are reported. Pretreatment characteristics were well balanced between the two groups. All patients previously have received chemotherapy for metastatic disease, and half had both adjuvant therapy and chemotherapy for metastatic disease. All but one patient previously had received anthracyclines. Of the first 81 randomized patients, 72 were evaluable for response and toxicity (four never treated, five concomitant hormonotherapy). Partial responses were seen in 17% of patients in the paclitaxel arm and 6% in the mitomycin arm (P = .14). Crossover to paclitaxel therapy following progression on mitomycin achieved an objective response rate of 24% (five of 21 patients). Responses to paclitaxel therapy lasted for a median duration of 9.1 months (range, 6.2 to 12+ months). Median time to progression was significantly longer in the paclitaxel arm (3.5 months v 1.6 months; P = .026). The quality-of-life-adjusted analysis confirmed the advantage of paclitaxel therapy, even when the delay of disease progression was adjusted for important adverse events. Adverse events, most importantly neutropenia and neuropathy, were more frequently observed in the paclitaxel arm. However, patients remained on paclitaxel therapy for many more courses than did those treated in the mitomycin arm. In conclusion, paclitaxel 175 mg/m2 given as a 3-hour intravenous infusion has been demonstrated to be an active agent in the treatment of chemotherapy-refractory advanced breast cancer, even after therapy with mitomycin has failed.

Adult↗
PubMed1995

Is Navoban (tropisetron) as effective as Zofran (ondansetron) in cisplatin-induced emesis? The French Navoban Study Group.

The purpose of this study was to evaluate and compare the antiemetic effectiveness and tolerability of Navoban (tropisetron) and Zofran (ondansetron) following high-dose (> or = 50 mg/m2) cisplatin chemotherapy. In a randomised, multi-centre, double-blind, double-dummy, parallel group study, 117 evaluable chemotherapy-naive patients who received Navoban were compared with 114 who received Zofran. Patient diary cards were used to assess both acute (Day 1) and delayed (Days 2-6) nausea and vomiting. Total control of acute vomiting was achieved in 54% of Navoban and 65% of Zofran patients (p = 0.052), and total control of acute nausea in 66% and 62% respectively (p = 0.655). Total control of delayed vomiting was achieved in 44% of Navoban patients and 46% of Zofran patients (p = 0.765), and of delayed nausea in 56% and 47% respectively (p = 0.207). Both reactions combined were totally prevented during the entire 6-day trial period in 22% of Navoban and 24% of Zofran patients (NS), while a further 42% of patients in both groups remained largely free from both nausea and emesis. The few adverse reactions (e.g. headache, constipation, diarrhoea) were mainly mild and typical of the 5-HT3-receptor antagonists. In conclusion, there were no significant differences in efficacy and tolerability between Navoban 5 mg once daily and the highest recommended dose of Zofran (32 mg on Day 1, followed by 8 mg three times a day).

Antiemetics↗
PubMed1995

[Amyloidosis of the gallbladder. An unusual localization].

We report a rare case of amyloidosis of the gallbladder in a 60-year-old man. This amyloidosis was associated with hepatic amyloidosis and pancreatic adenocarcinoma. To our knowledge, this is the second case reported in the literature and the first associated with neoplastic pathology.

Adenocarcinoma↗
PubMed1995

[Inflammatory cancer of the breast: review and experience at Saint-Louis hospital].

Inflammatory breast cancer represents about 1 to 6% of all breast cancers. It has a sudden onset and affects women of the same age as other breast cancers. Its particular feature is the almost constant development of metastases. The 5-year survival after surgery or surgery and radiotherapy varies between 0 and 28% with a median survival of 18 months. The use of anthracycline-based chemotherapy has doubled the median survival, but has not achieved cure. Clinical research is directed towards therapeutic intensification with or without autologous bone marrow transplantation. The authors report their experience at Hôpital Saint-Louis.

Adolescent↗
PubMed1994

[Adamantinoma of the proximal end of the tibia. A case].

Adamantinoma is a rare primary tumour of long bones containing mesenchymatous and epithelial cells. There has been some controversy over the pathogenesis. We observed a localization in the right tibia. A 22-year-old patient from Algeria was seen for spontaneous progressively increasing pain in the upper part of the right tibia. The patient's general health had deteriorated somewhat, with fever. On examination there was ulceration of the skin, costal and pelvic pain and inflammatory right inguinal lymph nodes. Radiography revealed lateral metaphyseal lytic image with interruption of the cortex also seen on magnetic resonance imaging which revealed invasion of the soft tissue and multiple bilateral pulmonary nodules. Bone scintigraphy showed several zones of hyperfixation. The diagnosis of adamantinoma was confirmed by pathology examination of the biopsy specimen. On surgical exeresis, the capsule of the knee joint was found to be involved without invasion of the knee joint. Node dissection showed inguinal and popliteal invasion. Macroscopically, the surgical specimen was a red-whitish osteolytic tumour. Microscopically, the tumour was composed of hyperchromatic epithelial cells in an abondant fibrous stroma. Immunohistochemical studies were negative for vimentine, cytokeratin and factor VIII. Adjuvant chemotherapy was based on a sarcoma protocol. Unfortunately, after two cycles, white cell counts fell sharply and multiple skin nodules appeared together with progression of the bone metastases. The chemotherapy was modified without any therapeutic effect and the patient died in February 1993. An epithelial origin would appear most probable, but at least two groups of adamantinoma can be described: one with typical epithelial differenciation and one overlapping to the differential diagnosis of osteofibrous dysplasia. Although considered as a low grade malignant tumour, we emphasize the aggressive forms with local relapse or metastatic resistance to chemotherapy. Treatment relies on wide surgery and prognosis is generally good. Neither chemotherapy nor radiotherapy has stood the test of time in cases with metastasis.

Adult↗
PubMed1994

Dysgerminoma in a pure 45,X Turner syndrome: report of a case and review of the literature.

There is a high risk of neoplasm in dysgenetic gonads. Classically, in Turner syndrome, only patients with 45, X/46, XY mosaicism karyotype or with a fragment of Y chromosome (45, X+mar) are at risk of developing gonadal tumor. A case of a dysgerminoma arisen on the dysgenetic gonad of a 45, X Turner patient in the absence of Y chromosome material at cytogenetic and molecular biology analysis is reported. Five cases of gonadal tumor with a pure 45, X chromosome constitution have been previously reported in the literature. In these cases only cytogenetic analysis was performed. This is the first case of an ovarian tumor in a 45, X Turner syndrome in which the presence of Y material can be ruled out by an extensive molecular analysis of the blood and the tumor.

Adult↗
PubMed1994

High dose chemotherapy with stem-cell transplantation in a metastatic medulloblastoma in an adult: a case report and review of the literature.

Medulloblastoma is a rare tumor in adult. High doses of megavoltage irradiation of the posterior fossa have been resulted in a better survival (48 to 78% at 5 years) of the patient. It is sensitive to a wide variety of chemotherapy drugs, but adjuvant chemotherapy has not been proved effective in adults although data are limited. We report the case of a cerebellar medulloblastoma with bony and medullar metastases. High-dose chemotherapy with peripheral stem-cell transplantation was performed while the patient was in remission following conventional chemotherapy. Complete remission lasted for 8 months. This therapeutic approach of metastatic medulloblastoma might be of value as this tumor is chemosensitive and not cured by conventional treatment. Internal radiotherapy by Samarium-153 was also carried out and proved to be an effective palliative treatment of pain.

Adolescent↗
PubMed1994

A small GTP-binding protein is frequently overexpressed in peripheral blood mononuclear cells from patients with solid tumours.

ras oncoproteins and ras-related proteins constitute a large family of the small GTP-binding protein family. The rab branch of the ras superfamily is involved in the intracellular transport along the secretory and endocytic pathway in eukaryotic cells. We here demonstrate that a member of the rab branch, the rab2 protein, is frequently overexpressed in peripheral blood mononuclear cells from patients with solid neoplasms. Moreover, this expression is shown to be greatly modified during the course of therapy. Our results provide strong evidence for the implication of a small GTP-binding protein in immunological events associated with neoplastic diseases. The precise cellular population involved as well as the potential prognostic value of this process remains to be determined.

Antineoplastic Agents↗
PubMed1994

[Metastatic eye neoplasms. Review of the literature apropos of 4 cases].

Malignant disease metastatic to the eye is a common entity afflicting hundred patients each year. Breast carcinoma is the most common carcinoma responsible for ocular metastases with an estimated range probably closer to 30% and prevalence of 11.000 women by year in United-States. Breast carcinoma is followed by lung cancer and adenocarcinoma of an unknown primary. The diagnosis should be suspected in patient with history of carcinoma and a decreased visual acuity or any other visual symptom. The most useful diagnostic techniques include direct ophthalmoscopy, ultrasonography, computed tomography and magnetic resonance imaging. The cornerstone of treatment of ocular metastases remains radiation therapy. The overall response rates of earlier diagnosis, according to measurement of visual acuity, may be ranged from 72 to 94%. Early diagnosis and treatment of those lesions are a primary concern to maximize the quality of life until death of patients with metastatic disease. We report four cases of women with breast cancer metastatic to the eye.

Breast Neoplasms↗
PubMed1994

p53 mutations and overexpression in locally advanced breast cancers.

Alterations in the p53 gene were analysed in 39 patients with locally advanced breast cancers (LABCs) (stage III-IV) with inflammatory signs in most cases (UICC stage T4d = 32 patients) by molecular and immunohistochemical (IHC) approaches. All patients were included in the same therapy protocol. Using polymerase chain reaction (PCR) and a single-strand conformational polymorphism migration technique (SSCP), the presence of mutations in exons 2-11, covering the entire coding sequence of the p53 gene, was evaluated. Using the mouse specific anti-human p53 monoclonal antibody (PAb 1801), we also looked for overexpression of the p53 protein in tissue sections. In 16 cases shifted bands were reproducibly identified by PCR-SSCP, and all but one (localised to exon 10) were in exons 5-8, the usual mutational hotspots. Fifteen of these 16 samples were sequenced and 14 of the suspected mutations (36%) were confirmed. Most of them (12) were single nucleotide substitutions, and transitions were more frequent (eight cases) than transversions (four cases). Fourteen of the tumour samples were positively stained with the monoclonal antibody PAb 1801, 11 with nuclear staining only, two with mixed cytoplasmic and nuclear staining and one with cytoplasmic staining only. Staining patterns were very heterogeneous in terms of the percentage of positive cells (10-75%) and their distribution in the tissue section (isolated foci or dispersed cells). In 11 of the 14 mutated cases a positive immunostaining was observed. The presence of a p53 mutation was significantly associated with larger tumour diameter (chi 2 = 7.490, P = 0.0062) and the presence of clinical metastases (stage IV) (chi 2 = 10.113, P = 0.0015). A non-statistically significant trend of association was observed between p53 mutation, negative oestrogen receptors and lower response rate to therapy. Our results in this group of patients and the heterogeneity of the staining of tumour cells in tissue sections suggest that p53 mutations could be a late event in this non-familial form of breast cancer.

Base Sequence↗
PubMed1994

Methylprednisolone enhances the efficacy of ondansetron in acute and delayed cisplatin-induced emesis over at least three cycles. Ondansetron Study Group.

This double-blind multicentre study has been carried out in order to confirm the improvement of ondansetron's antiemetic efficacy when combined with a corticosteroid and to determine whether this increased efficacy is maintained over three chemotherapy courses. One hundred and two patients receiving their first course of cisplatin (50-120 mg m-2)-containing chemotherapy were randomised to receive one of the two following treatments: 8 mg OND i.v. injection and 120 mg MPD i.v. injection before chemotherapy, followed 8-12 h later by an 8 mg OND tablet and a 16 mg MPD tablet (oral treatment administered twice daily for 3-5 days): or 8 mg OND plus placebo i.v. injection before chemotherapy, followed by 8-12 h later by an 8 mg OND tablet and placebo p.o. (oral treatment administered twice daily for 3-5 days). The number of emetic episodes (EEs = vomits + retches) and the grade of nausea were recorded. Of the 101 patients studied (efficacy analysis), complete or major control (0-2 EEs) was experienced in 90.4% of patients in the first 24 h in the OND/MPD group compared with 71.4% of patients in the OND group during the first course. This difference in favour of OND/MPD was noted over the three courses and is statistically significant. In the control of delayed emesis (worst day between days 2 and 6) there is a trend in favour of the OND/MDP group during the first course [56.2% vs 43.2% for complete response (no emetic episodes)] which was statistically significant on courses 2 and 3. The global antiemetic control over the course was always in favour of OND/MPD, which leads to a better efficacy maintained over the three courses. Both treatments were well tolerated. The results of this study confirm the increased antimetic efficacy of ondansetron and methylprednisolone in combination in cisplatin-induced acute and delayed emesis which led to a better maintained efficacy over three repeated chemotherapy courses.

Acute Disease↗
PubMed1994

The optimal dose of glycosylated recombinant human granulocyte colony stimulating factor for use in clinical practice: a review.

In pharmacokinetic studies, higher maximum plasma concentrations of granulocyte colony stimulating factor (G-CSF) were achieved after intravenous administration of lenograstim than after subcutaneous administration of the same dose. However, subcutaneous administration resulted in a longer elimination half life, and a greater and more sustained neutrophil response. The safety of lenograstim at doses up to 40 micrograms/kg/day has been demonstrated in Phase I studies involving 21 healthy volunteers and 37 cancer patients. In controlled Phase II dose-ranging studies which included 66 solid tumour and 121 bone marrow transplantation (BMT) patients, doses from 2 micrograms/kg/day were shown to effectively restore neutrophil counts. A dose of 5 micrograms/kg/day was chosen for further clinical trials. Phase III double-blind randomised studies in a further 439 patients with solid tumours or postBMT confirmed the clinical efficacy of the recommended therapeutic dose of lenograstim of 150 micrograms/m2/day which is equivalent in efficacy to 5 micrograms/kg/day. At this unique dose, one 263-microgram vial of lenograstim is sufficient to effectively treat the average adult patient in solid tumour or bone marrow transplantation settings.

Drug Administration Schedule↗
PubMed1994

[Radio-chemotherapy combinations: from biology to clinics].

Combination of radiotherapy and chemotherapy (CRC) is actually one important way of research in oncology. Theoretical advantages are: 1) Spatial cooperation; 2) Additivity, which is only obtained if the toxicity of each modality are different; 3) Supra-additivity, which needs a rigorous in vitro definition; the only way to prove it is to make an isobologram analysis. This model has however, some limitations: qualitative variable could not be used, results could be different, depending on the cell line and isoeffect chosen... In fact, a supra-additivity was only demonstrated for cisplatinum and etoposide. Interactions mechanisms were: 1) at the molecular level, creation of new lesions or inhibition of radiation lesions repair; 2) At the cellular level, either cytokinetic cooperation with S-phase dependent drugs, or synchronisation for the drugs which blocked the cells in M-phase; 3) At the tissular level, reoxygenation, cycle redistribution... In clinical practice, three mains schedules have been described: sequential, alternating and concomitant. Only the latter try to use the supra-additivity phenomena. Aims of CRC could be: improvement or in survival or in local control, preservation of an functional organ... Depending on the tumor site and aim of the CRC, some schedules had to be preferred. For head and neck cancers, alternating or concomitant schedules offer a better local control. In bronchial carcinomas, sequential administration of the two modalities reduce the metastatic rate, but not the local control. Concomitant schedule improve the local control rate only. In some conservative protocol of bladder cancers, sequential and concomitant administration were used. In conclusion, CRC begins to be the usual clinical practice. The present schedules could be improved with the help of laboratory findings, which are now more and more precise.

Antineoplastic Agents↗
PubMed1994

Taxoids: a new class of cytotoxic agents.

Taxoids (paclitaxel and docetaxel) are a new class of cytotoxic agents. Their mechanism of action (enhanced polymerization of tubulin and inhibition of its depolymerization) acts thereby as mitotic spindle inhibitors. Significant experimental antitumor activity, although more marked with docetaxel, has been observed with both agents. Their main side-effects are reversible non cumulative neutropenia and alopecia; significant hypersensitivity reactions using cortico-steroids antiHT1/2 premedication are seen in < 5% of patients receiving paclitaxel as a pulsed (3 h) infusion; neurotoxicity appears dose-related; docetaxel can induce a peculiar skin toxicity often associated with edema. Paclitaxel at the recommended dose of 175 mg/m2 achieves responses in 20-30% of patients with relapsed ovarian carcinoma; its activity in advanced breast cancer although significant is clearly dose-related with an optimal dose still debatable; responses are observed in approximately 30% of patients with non small cell lung cancer (NSCLC). Docetaxel (100 mg/2) is active in first line treatment of advanced breast cancer (50-72% RR) as well as 2nd line treatment (> 40% RR); an activity in the range of that observed with paclitaxel is reported in NSCLC.

Animals↗